Mark Klimek­ Yellow Book Return to deck 1. Rule of the ': If the ____ and the _____ are ______ in the ame direction then it i meta_____ pH, icar, oth, olic 2. pH 7.30_______ HCO3 20_______ ↓= acidoi; ↓= metaolic 3. pH 7.58_______ HCO3 32_______ ↑= alkaloi; ↑= metaolic 4. pH 7.22_______ HCO3 30_______ ↓= acidoi; ↑= repirator 5. You are providing care to a client with the following lood ga reult: pH 7.32, CO2 49, HCO3 29, PO2 80, and SaO2 90%. aed on thee reult, the client i experiencing: ↓= acidoi; ↑= repirator 6. MacKumaul The onl acid ae to caue Kumaul repiration i Metaolic ACidoi 7. A the _______ goe, o goe _______ except for _______ pH, m patient, Potaium 8. Up hokalemia, alkaloi, HTN, Tachcardia, Tachpnea, Seizure, Irritailit, Spatic, Diarrhea, ororgme, hperreflexia, etc 9. Down hperkalemia, acidoi, htn, radcardia, contipation, aent owel ound, flacid, radpnea 10. Caue of acid­ae imalance: Firt ak ourelf, "I it _______?" If e, then it' _______. Then ak ourelf: "Are the _______ or _______. If _______, pick _______. If _______, pick _______ lung, repirator, overventilating, underventilating, overventilating, alkaloi, underventilating, acidoi 11. Caue of acid­ae imalance: If it' not lung, then it' _______. If the patient ha _______ _______ vomiting or uction, pick _______. For everthing ele that in't lung, pick _______ _______. When ou don't know what to pick, chooe _______ metaolic, prolonged gatric, alkaloi, metaolic acidoi, metaolic acidoi 12. High preure alarm are triggered _______ reitance to air flow. increaed 13. High preure alarm are triggered increaed reitance to airflow and can e caued otruction of three tpe: _______ action, _______ action, _______ action (kinked tue) unkink, (water in tue) empt, (mucu in airwa) cough and deep reathe 14. Low preure alarm are triggered _______ reitance to airflow. decreaed 15. Low preure alarm are triggered decreaed reitance to airflow and can e caued diconnection of the _______ or _______ tuing (reconnect it), oxgen enor tue (reconnect it UNLSS tue i on the floor­ ag them and call RT if thi happen) 16. Repirator alkaloi mean ventilator etting ma e too _______ high 17. Repirator acidoi mean ventilator etting ma e too _______ low 18. What doe "wean" mean? graduall decreae with the goal of getting off altogether 19. What i Malow' highet priorit to lowet priorit? 1. Phiological 2. Safet 3. Comfort 4. Pchological (prolem within the peron) 5. Social (prolem with other people) 6. Spiritual 20. Arrange from highet to lowet priorit uing Malow': Denial Spiritual Ditre Pain in low Fall Rik Pathological Famil Dnamic lectrolte Imalance lectrolte Imalance (Phiological) Fall Rik (Safet) Pain in low (Comfort) Denial (Pchological) Pathological Famil Dnamic (Social) Spiritual Ditre (Spiritual) 21. What are the 5 tage of grief? Denial Anger argain Depreion Acceptance 22. The #1 prolem in aue i _______ denial 23. Denial i the _______ to accept the _______ of their prolem refual, realit 24. Treating denial: _______ it pointing out to the peron the difference etween what the _______ and what the _______. In contrat, _______ the denial of lo and grief confront, a, do, upport 25. Dependenc: When the _______ get the Significant Other to do thing for them or make deciion for them auer 26. Codependenc: When the _______ _______ derive poitive _______ from doing thing for or making deciion for the _______ Significant Other, elf­eteem, auer 27. When treating dependenc/codependenc: Set _______ and _______ them. Agree in advance on what requet are allowed, then enforce the agreement limit, enforce 28. When treating dependenc/codependenc: Work on the _______ of the codependent peron elf­eteem 29. Manipulation: when the _______ get the _______ _______ to do thing for him/her that are not in the _______ _______ of the _______ _______. The nature of the act i _______ or _______ to the _______ _______ auer, ignificant other, interet, ignificant other, harmful, dangerou, ignificant other 30. Treating manipulation: et _______ and _______ limit, enforce 31. Wernicke' (Korakoff') Sndrome: _______ induced Vitamin _______(thiamine) deficienc Pchoi, 1 32. Primar mptom of Wernicke' (Korakoff') Sndrome: _______ with _______ amneia (memor lo), confaulation (make up tuff) 33. Characteritic of Wernicke' (Korakoff') Sndrome: 1. _______ 2. _______ 3. _______ preventale (take vitamin) arretale (take vitamin) irreverile (kill rain cell) 34. Antaue/Revia i aka _______ Therap Averion 35. Onet and duration of effectivene of Antaue/Revia: _______ 2 week 36. Patient teaching with Antaue/Revia: Avoid _______ form of _______ to avoid _______, _______, _______ all, alcohol, nauea, vomiting, death 37. What are example of product that contain alcohol? mouth wah, cologne, perfume, afterhave, elixir, mot OTC liquid medicine, inect repellant, vanilla extract, vinagerette, hand anitizer 38. ver alcoholic goe through _______. Onl a minorit get _______ Alcohol Withdrawal Sndrome, Delirium Tremen 39. _______ i not life­threatening. _______ can kill ou Alcohol Withdrawal Sndrome, Delirium Tremen 40. Patient with _______ are not a danger to themelve or other. Patient with ________ are dangerou to elf and other Alcohol Withdrawal Sndrome, Delirium Tremen 41. AWS or DT: emiprivate room, an location AWS 42. AWS or DT: private room near the nure' tation DT 43. AWS or DT: Regular diet AWS 44. AWS or DT: Clear liquid or NPO diet (rik for apiration) DT 45. AWS or DT: Up at liert AWS 46. AWS or DT: Retricted to edret with no athroom privilege DT 47. AWS or DT: No retraint AWS 48. AWS or DT: Uuall retrained with either vet or 2 point (1 arm and 1 leg) DT 49. AWS or DT: Give anti­HTN medication oth 50. AWS or DT: Give tranquilizer oth 51. AWS or DT: Give multivitamin to prevent Wernicke' oth 52. For Aminoglcoide, think " __ ____ ___ _____" a mean old mcin 53. When are antiiotic/aminoglcoide ued? to treat eriou, life­threatening, reitant infection 54. All aminoglcoide end in _______, ut not all drug that end in _______ are aminoglcoide. mcin, mcin 55. What are ome example of wannae mcin? Azithromcin, Clarithromcin, rthromcin 56. What are ome example of aminoglcoide? Streptomcin, Cleomcin, Toramcin, Toramcin, Gentamcin, Vancomcin, Clindamcin 57. When rememering toxic effect of mcin' think _______ mice= ear 58. What i the toxic effect of aminoglcoide and what mut ou monitor? ototoxicit; monitor hearing, alance, and tinitu 59. The human ear i haped like a _______ o another toxic effect of aminoglcoide i _______ o monitor _______ kidne, nephrotoxicit, creatinine 60. The numer "___" drawn inide the ear remind ou of cranial nerve ___ and frequenc of adminitration ___ 8, 8, Q8H 61. Do not give aminoglcoide PO expect in thee 2 cae: 1. _______ _______ (due to high _______ level) 2. Pre­op _______ urger hepatic encephalopath (liver coma, ammonia­induce encephalopath), ammonia, owel 62. Who can terilize m owel? Neo­ Kan 63. What i the reaon for drawing Trough and Peak level? Narrow therapeutic level 64. When do ou ALWAYS draw the Trough? 30 minute efore next doe 65. When do ou draw the Peak level of Sulingual medication? 5­10 minute after drug diolve 66. When do ou draw the Peak level of IV medication? 15­30 minute after medication i finihed 67. When do ou draw the Peak level of IM medication? 30­60 minute after injecting it 68. When do ou draw the Peak level of SQ medication? Depend on tpe of inulin 69. When do ou draw the Peak level of PO medication? Not necear 70. What are iological Agent in Categor A? STAPH Small Pox Tularemia Anthrax Plague Hemorrhagic illne otulim 71. What are iological Agent in Categor ? All other 72. What are iological Agent in Categor C? Nipeh Viru Hanta Viru 73. When it come to iological Agent: Categor __ i _______, Then Categor __, Then Categor __ A, the wort, , C 74. Small Pox Inhaled tranmiion/ on airorne precaution die from epticemia­ no treatment rah tart around mouth firt Categor A 75. Tularemia chet mptom die from repirator failure treat with treptomcin Categor A 76. Anthrax pread inhalation look like the flu die from repirator failure treat with upro, PCN, and treptomcin Categor A 77. Plague pread inhalation ha the 3 H': Hemopti (coughing up lood), Hematemei (vomiting up lood), Hematochezia (lood in tool) dei from repirator failure and DIC (leed to death) treat with Doxccline and Mcin no longer communicale after 48 hour of treatment Categor A 78. Hemorrhagic illnee primar mptom are petechiae (pinpoint pot) and ecchmoe (ruiing) high % fatal Categor A 79. otulim it i ingeted ha 3 major mptom: decending parali, fever, ut i alert die from repirator arret Categor A 80. What are ome example of chemical agent that caue ioterrorim? Mutard ga Canide Phogine chlorine Sarin 81. What i the primar mptom of Mutard Ga? liter (veicant) 82. What i the primar mptom of Canide and how do ou treat it? Repirator arret. Treat with Sodium Thioulfate IV 83. What i the primar mptom of Phogine Chlorine? Choking 84. What are the mptom of Sarin (hint it' a nerve agent)? SLUDG­ jut rememer ever ecretion in our od i eing excreted exceivel ronchopam ronchorrhea Salivating Lacrimating (tear) Urination Diaphorei/ Diarrhea G.I upet mei 85. What do ou ue when cleaning patient expoed to chemical agent? All chemical agent require onl oap and water cleaning except Sarin, which require leach. 86. Which agent do ou iolate the patient for? iological Agent 87. Which agent do ou decontaminate for? Chemical Agent 88. How doe decontamination work? Gather expoed people Take to decontamination center where people remove clothing, hower, dre in non­contaminated clothe, then releae to other ervice Put contaminated clothing in pecial ag and throw awa (e ure not to touch it) 89. Calcium Channel locker: the are like ________ for our heart. What doe that mean? Valium. It relaxe the heart 90. Calcium Channel locker: _______ inotropoic, chronotropic, dromotropic Negative 91. Inotropic trength of heart 92. Poitive Inotropic trong hearteat 93. Negative Inotropic weak hearteat 94. Chronotropic rate of hearteat 95. Poitive Chronotropic fat hearteat 96. Negative Chronotropic low hearteat 97. Dromotropic conductivit of heart 98. Poitive Dromotropic excitale heart 99. Negative Dromotropic lock/low conduction 100. Poitive Inotropic, Chronotropic, and Dromotropic i een with which medication? atropine, epinephrine, and norepinephrine 101. Negative Inotropic, Chronotropic, and Dromotropic i een with which medication? Calcium Channel locker and eta locker 102. What do Calcium Channel locker treat? (indication) Antihpertenive (decreae P) Anti Angina (imalance etween O2 uppl and demand) Anti Atrial Arrhthmic (Atrial flutter and Atrial firillation) 103. What are ome of the ide effect of Calcium Channel locker? Headache Hpotenion 104. Name of Calcium Channel locker can e rememered aing.... I op zem dipine in the Calcium Channel ("zem", "dipine", "verapamil/ioptin") 105. "QRS depolarization" alwa refer to __________ Ventricular (not atrial, junctional or nodal). 106. "P wave" refer to _________ Atrial 107. Atole a lack of QRS depolarization (flat line) 108. Atrial Flutter rapid P­wave depolarization in a aw­tooth pattern (flutter) 109. Atrial Firillation chaotic P­wave depolarization 110. Ventricular Tachcardia wide izarre QRS' 111. Premature Ventricular Contraction (PVC) Periodic wide, izarre QRS' 112. e concerned aout PVC' if: More than 6 per minute 6 in a row PVC fall on T­wave of previou eat 113. What are the lethal arrhthmia? atole and ventricular firillation 114. What i the potentiall life­threatening arrhthmia? 1. v­tach, 2. a­fi, 3. a­flutter 115. When dealing with an IV puh drug if ou don't know go ____ except ________! low, adenocard 116. What i the treatment for PVC'? lidocaine and amiodarone 117. What i the treatment for V Tach? lidocaine and amiodarone 118. What are the treatment for upraventricular arrhthmia? ACD Adenocard/adenoine etalocker (end in lol) Calcium Channel locker Digitali/Digoxin (lanoxin) 119. What i the treatment for V­fi? ou defi 120. What i the treatment for Atol? Give pi firt then Atropine 121. atole 122. atrial firillation 123. atrial flutter 124. Normal Sinu Rhthm 125. Supraventricular tachcardia 126. ventricular firillation 127. The purpoe for chet tue i to re­etalih _______ preure in the pleural pace negative 128. In the pneumothorax, the chet tue remove ___ air 129. In the hemothorax, the chet tue remove _____ lood 130. In the pneumohemothorax, the chet tue remove ___ and _____ air and lood 131. when the chet tue i ______ (____) for ___. aka ____ Apical (high), air, apex 132. When the chet tue i ______ (___) for _____ aka ____ ailar (low), lood, ae (ottom of lung) 133. How man chet tue and where for unilateral pneumohemothorax? 2; apical and ailar on ide of pneumo 134. How man chet tue and where for ilateral pneumothorax? 2; apical for oth 135. How man chet tue and where for pot­op chet urger/chet trauma? aume unilateral pneumohemothorax­ 2; apical and ailar on ide of pneumo 136. In routine _____ clamp chet tue. In emergenc _____ the chet tue NVR; CLAMP 137. What do ou do if ou kick over the collection ottle? Set it ack up (not an emergenc) 138. What do ou do if the water eal reak? Firt­ clamp it, cut tue awa from device et­ umerge the tue under water, then unclamp 139. What do ou do if the chet tue come out? Firt­ cover with a gloved hand et­ cover the hole with vaeline gauze, put a dr terile dreing on top, tape on 3 ide 140. If there' uling in the water eal intermittentl it i... good 141. If there' uling in the water eal and it' continuou it i... ad 142. If there' uling in the uction control chamer intermittentl it i... ad 143. If there' uling in the uction control chamer continuoul it i... good 144. Rule for clamping the tue: never clamp longer than __________ without Dr' order ue _____________________________ 15 econd, ruer tipped doule clamp 145. ver congenital heart defect i either ___________ or ____ ___________ TRouLe, No TRouLe 146. R­L Right to Left hunt 147. lue 148. T tart with the letter "T" 149. What are ome example of "TRouLe" congenital heart defect? Trunku arterioi, Tran. poition of great veel, Tetrolog of Fallot, Tricupid tenoi, TAPZ, Left ventricular hperplamic ndrome 150. What are ome example of "No TRouLe" congenital heart defect? Patent fore. ov., ventricular eptal defect, pulmonar tenoi 151. Akk CHD kid will have 2 thing, whether TRouLe or No TRouLe... 1. Murmur 2. chocardiogram 152. Four defect preent in Tetralog of Fallot are... VarieD PictureS Of A RancH Ventricular Defect Pulmonar Stenoi Overriding Aorta Right Hpertroph 153. How do ou meaure crutche for a peron? 2­3 fingerwidth elow anterior axillar fold to a point lateral and lightl in front of foot 154. When the handgrip i properl placed, the angle of elow flexion will e ____ degree 30 155. 2 point gait tep one­­ move one crutch and oppoite foot together tep two­­ move other crutch and other foot together (rememer 2 point together for a 2 point gait) Ued for minor weakne on oth leg 156. 3 point gait tep one­­ move two crutche and ad leg together tep two­­ move good foot (Rememer 3 point i called 3 point ecaue 3 point touch down at once) 157. 4 point gait tep one­­ one crutch tep two­­ oppoite foot tep three­­ other crutch tep four­­ other foot nothing move together and everthing i reall weak 158. Swing through for two raced extremitie (Amputee) 159. Ue the _____ numered gait when weakne i _______ ditriuted. ___ point for mild prolem and ___ point for evere even, evenl, 2, 4 160. Ue the ___ numered gait when one leg i ______ odd, effected 161. Stair: which foot lead when going up and down tair on crutche? ______ with the _______ and _______ with the _____. The crutche alwa move with the ____ leg up, good, down, ad, ad 162. Cane: Hold cane on the __________ _______ ide. Advance cane with the _________ ide for a wide ae of upport uneffected ide, oppoite 163. What i the correct wa to ue a walker? pick it up, et it down, and walk to it 164. What i a ig NO when it come to walker? Do not tie elonging to the front of the walker 165. What i the correct wa to get up from a chair uing a walker? Hold on to chair, tand up, then gra walker 166. What i the difference etween a non­pchotic peron and a pchotic peron? a non­pchotic peron ha inight (know the're ick and that it' meing them up) and i realit aed (the ee realit the ame wa a ou) and a pchotic peron ha no inight and i not realit­aed. 167. Deluion a fale, fixed elief or idea or thought. There i no enor component 168. What are the 3 tpe of deluion? Paranoid/Perecutor, Grandioe, & Somatic 169. Paranoid or Perecutor Deluion fale, fixed elief that people are out to harm ou 170. Grandioe deluion Fale, fixed elief that ou are uperior 171. Somatic deluion Fale, fixed elief aout a od part 172. Hallucination a fale, fixed enor exerience 173. What are the 5 tpe of hallucination? auditor (hearing), tactile (feeling), viual (eeing), gutator (tating), and olofactor (melling) 174. Illuion a miinterpretation of realit. It i a enor experience 175. What i the difference etween illuion and hallucination? With illuion there i a referent in realit (omething to which the can refer to) 176. When dealing with a patient experiencing deluion, hallucination or illuion, firt ak ourelf, "What i their prolem?" (what are the different prolem that could e going on?) functional pchoi, pchoi of dementia, and pchotic delirium 177. What are the different tpe of functional pchoi? chziophrenia, chzioaffected (mood diorder thought proce), major depreion, and mania 178. With a functional pchoi the patient ha the potential to learn realit. How can ou teach realit to a functional pchotic? 1. acknowledge feeling 2. preent realit a. poitive­ what i realit . negative­ what i not realit 3. et a limit 4. enforce the limit 179. Pchoi of dementia People with Alzheimer', Wernicke', Organic rain Sndrome, and dementia. Thi patient ha a rain detruction prolem and cannot learn realit 180. How do ou deal with a peron with Pchoi of Dementia? 1. Acknowledge feeling 2. Redirect­ get them to expre the fixation that the are expreing inappropriatel to appropriatel 181. Pchotic Delirium Temporar epiodic econdar dramatic udden onet of lo of realit due to chemical imalance (UTI, throid imalance, electrolte imalance) 182. How do ou deal with a patient with Pchotic Delirium? 1. Acknowledge feeling 2. Reaure them of afet and temporarne 183. What are the different tpe of looening of aociation? Flight of idea, word alad, neologim 184. Flight of idea Stringing phrae together (looel aociated phrae; tangentialit) 185. Word alad Throw word together 186. Neologim Making up new word 187. Narrowed elf­concept When a PSYCHOTIC refue to change their clothe or leave the room. *don't make a pchotic do omething the don't want to do 188. Idea of reference You think everone i taking aout ou 189. Dementia hallmark Memor lo, inailit to learn. *Functional can teach, dementia cannot 190. Alwa acknowledge ______________ Feeling 191. What are the 3 "Re'"? Reaure Redirect Realit 192. Diaete mellitu An error of glucoe metaolim 193. Diaete inipidu Dehdration, polurethane, poldipia 194. Tpe I Diaete Mellitu Inulin dependent (not producing inukin) Juvenile onet Ketoi prone 195. Tpe II Diaete Mellitu Non inulin dependent (od reiting inulin) Adult onet Non ketoi prone 196. Sign and mptom of diaete mellitu Poluria (pee a lot) Poldipia (drink a lot) Polphagia (eat/wallow a lot) 197. Treatment for Tpe I Diaete Mellitu 3. Diet (calorie from car) 1. Inulin 2. xercie 198. Treatment for Tpe II Diaete Mellitu 1. Diet 3. Oral hpoglcemic 2. Activit 199. Diet of Diaetic Calorie (car) retriction Need to eat 6x per da­­> maller more frequent meal 200. Inulin act to _____________ lood ugar Lower 201. Inulin Tpe: R R= Regular, Rapid, Run (IV) Onet: 1hr Peak: 2hr Duration: 4hr 202. Inulin Tpe: N N= NPH, Not in the ag, Not o fat, Not clear (cloud) Onet: 6hr Peak: 8­10hr Duration: 12 hr 203. Inulin Tpe: Humalog Inulin Lipro Fatet Onet: 15min Peak: 30min Duration: 3hr 204. Inulin Tpe: Lantu Long acting Slow aorption No peak Duration: 12­24hr 205. With inulin rememer: Check expiration date Refrigerate ut once open no refrigeration 206. xercie ________ inulin: if more exercie, need _________ inulin. If le exercie, need __________ inulin Potentiate, le, more 207. Sick da rule for inulin Take inulin Take ip of water Sta active a poile 208. Low lood ugar in Tpe I Diaete Mellitu (inulin hock) i caued : Not enough food Too much inulin Too much exercie 209. Wh i low lood ugar in Tpe I Diaete Mellitu (inulin hock) dangerou? Permanent rain damage 210. Sign and mptom of low lood ugar in Tpe I Diaete Mellitu (inulin hock): Cereral impairment, vaomotor collape, cold, clamm, low reaction time, "drink hock" 211. Treatment for low lood ugar in Tpe I Diaete Mellitu (inulin hock): Adminiter rapidl metaolizale carohdrate (cand, hone) Ideal comination: ugar and protein If unconciou IV D50 IM glucagon 212. High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic Coma i caued : Too much food Not enough inulin Not enough exercie #1 caue i acute viral upper repirator infection within the lat 10 da 213. Sign and mptom of High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic Coma Dehdration Ketone, Kumaul reathing, high K+ Acidoi, Acetone reath, Anorexia 214. Treatment for High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic Coma Inulin IV (R) IV rate flow 200mg/hr 215. Treatment for low lood ugar in Tpe II Diaete Mellitu: Adminiter rapidl metaolizale carohdrate (cand, hone) Ideal comination: ugar and protein If unconciou IV D50 IM glucagon 216. High lood Sugar in Tpe II Diaete Mellitu Called HHNK or HHNC­ Hperomolar, Hperglcemic, Non­Ketotic Coma Thi i evere dehdration 217. Sign and mptom of High lood Sugar in Tpe II Diaete Mellitu Hit, dr, increaed HR, decreaed kin turgor 218. Treatment for High lood Sugar in Tpe II Diaete Mellitu Rehdration 219. Long term complication of HHNC are related to Poor tiue perfuion Peripheral neuropath 220. Which la tet i the et indicator of long­term lood glucoe control (compliance/effectivene/adherence)? Ha1c (average lood ugar over lat 90 da) 221. Cold and clamm­ _____________________________ Hot and dr­ ____________________________ Get ome cand Sugar' high 222. What i the therapeutic and toxic level for Lithium? therapeutic level: 0.6­1.2 toxic level: ≥ 2 223. What i the therapeutic and toxic level for Lanoxin (Digoxin)? therapeutic level: 1­2 toxic level: >2 224. What i the therapeutic and toxic level for Aminophlline? therapeutic level: 10­20 toxic level: ≥ 20 225. What i the therapeutic and toxic level for iliruin? therapeutic level (elevated level): 10­20 toxic level: >20 226. Kernicteru iliruin in the CSF 227. Opithotono poition of light extenion in neck een in patient' with Kernicteru. (ad ign) 228. Dumping Sndrome Pot­Op gatric urger complication in which gatric content dump too quickl into the duodenum 229. Hiatal Hernia Regurgitation of acid into eophagu, ecaue upper tomach herniate upward through the diaphragm 230. Hiatal Hernia or Dumping Sndrome: Gatric content move in the right direction at the wrong rate Dumping Sndrome 231. Hiatal Hernia or Dumping Sndrome: Gatric content move in the wrong direction at the right rate Hiatal Hernia 232. Hiatal Hernia or Dumping Sndrome: GRD like mptom when upine and after eating Hiatal Hernia 233. ADS S&S Acute Dumping Sndrome Adominal ditre (cramping, N/V, hperactive S(ororgmi)) Drunk­ cereral impairment Shock (vaomotor collape, rapid thread HR) 234. Treatment for Hiatal Hernia HO during & 1hr after meal­ high Amount of fluid with meal­ high Carohdrate content of meal­ high goal: get an empt tomach 235. Treatment for Dumping Sndrome HO during & 1hr after meal­ low Amount of fluid with meal­ low Carohdrate content of meal­ low goal: get a full tomach 236. Kalemia do the ______ a the prefix except for ___________ and __________ Hperkalemia= Hpokalemia= ame; heart rate; urine output Hper= ↑; HR ↓, Urine Output ↓ Hpo= ↓; HR ↑, Urine Output ↑ 237. Calcemia do the _______ of the prefix. No exception. Hpercalcemia= Hpocalcemia= oppoite Hper=↓ Hpo= ↑ 238. Two ign of neuromucular irritailit aociated with _____________: 1. 2.. hpocalcemia 1. Chvotek' Sign= cheek tap→ facial pam 2. Troueau' Sign= P cuff→ carpal pam 239. Magneemia do the ____________ of the prefix. Hpermagneemia= Hpomagneemia= oppoite Hper= ↓ Hpo= ↑ 240. If mptom involve nerve or keletal mucle, pick ________. For an other mptom, pick __________ ( generall anthing effecting ____________) Calcium, Potaium, lood preure 241. Hprnatermia dhdration (dr kin, thread pule, rapid HR) 242. hpOnatremia= Overload (crackle, ditended neck vein) 243. The earliet ign of an electrolte diorder i _________ & __________ numne, tingling (paretheia) 244. The univeral ign­mptom of electrolte imalance i ________________ mucle weakne (parei) 245. Never puh ____________ IV Potaium 246. Not more than ______ of K+ per liter of IV fluid 40mq 247. Give _____ & ______ to decreae K+ D5W, inulin (not permanent) 248. Kaexalate: K+­ exit­ late (not a quick, more of a permanent olution) 249. In a patient with hpercalcemia, which monitor pattern would e the mot likel threat? A. Paroxmal atrial tachcardia with decreaed ST egment . radcardia with 2nd degree Moitz Tpe II lock & elevated ST egment C. Frequent PAC' with multifocal coupling of PVC' and tall T­wave D. Firt degree heart lock with decreaed ST egment and inverted T­wave D. Firt degree heart lock with decreaed ST egment and inverted T­ wave 250. Hperthroidim= Hper­ metaolim (high metaolic rate) 251. Sign and Smptom of Hperthroidim weight lo, diarrhea, ↑HR, hot, heat intolerance, HTN, exopthalmo (ulging ee­ Don Knopp) 252. Hperthroidim i alo known a ____________________. So rememer _____ ourelf into the ______ Grave' Dieae; Run; Grave 253. The prolem i hperthroidim. Treatment option: Radioactive iodine, proplthroid utiil, urgical removal 254. What i the ig rik with radioactive iodine? radiation rik in urine­ doule fluh, need private athroom 255. What doe PTU do? proplthroid utinil knock out WC 256. What i the mot common treatment for hperthroidim? urgical removal 257. Total throidectom­ need lifelong ________ replacement. at rik for ___________ hormone; hpocalcemia (difficult to pare parathroid) 258. What are ou at rik for with a utotal throidectom? throid torm 259. What are ign and mptom of throid torm? extremel high vital ign, extremel high fever, pchoticall deliriou. Thi i a medical emergenc 260. What i the treatment for throid torm? oxgen and lower od temperature 261. Total= T_____ Sutotal= S______ Tetan Storm 262. Pot operation rik for total and utotal throidectom in firt 12 hr airwa/reathing, leeding 263. Pot operation rik for total throidectom in 12­48 hr tetan (r/t ↓Ca) 264. Pot operation rik for u­total throidectom in 12­48 hr throid torm 265. Hpothroidim = hpo­_________ metaolim 266. ign and mptom of hpothroidim weight gain, htn, contipation, letharg, coldintolerance, "low" 267. Hpothroidim i alo known a _______________ mxedema 268. What are the 3 reaon for accucheck? diaete, TPN, teroid 269. Treatment for hpothroidim throid replacement (/e: hperthroidim) 270. Caution: with hpothroidim treatment DO NOT ________ edate (the are alread edated) 271. Surgical implication for the hpothroid patient Anetheia i ver high rik and do not hold throid pill when NPO 272. Adrenal Cortex Dieae tart with letter ___ or ____ A, C 273. Addion' Dieae i _______________ of the adrenal cortex underecretion 274. Sign and Smptom of Addion' Dieae hperpigmented (darker), doen't repond to tre well (JFK) 275. Treatment for Addion' Dieae teroid (need to wear a med alert racelet) 276. Addion'= add­a­one 277. Cuhing' Sndrome i ___________ of the adrenal cortex overecretion (cuh= more) 278. Sign and Smptom of Cuhing' Sndrome (ame a teroid) moon face, hirutim (↑ od hair), water retention, gnecomatia (man oo), uffalo hump, central oeit (mall kinn lim),↓ one denit, ea ruiing, irritailit, immunouppreion 279. Treatment for Cuhing' Sndrome adrenalectom→ replacement therap→ teroid) 280. What i CONTACT precaution ued for? Herpe, nteric (Rotaviru, Shigellou), Staph (MRSA), RSV (tranmitted via droplet ut contact ecaue kid put mouth on everthing) 281. CONTACT PRCAUTIONS: Select all that appl: ___ Private Room ___ e/Face Shield ___ Mak ___ Dipoale Supplie ___ Glove ___ Negative Air Flow ___ Special Filter Repirator Mak ___ Handwahing ___ Gown ___ Pt wear mak when leaving room Private Room (mot important) Glove Gown Handwahing Dipoale upplie (P cuff) Stethocope can e taken from room to room a long a terilized after ue 282. What i droplet precaution ued for? influenza (H1N1), meningiti, diphtheria, pertui, mump 283. DROPLT PRCAUTIONS: Select all that appl: ___ Private Room ___ e/Face Shield ___ Mak ___ Dipoale Supplie ___ Glove ___ Negative Air Flow ___ Special Filter Repirator Mak ___ Handwahing ___ Gown ___ Pt wear mak when leaving room Private Room Mak (mot important) Glove Handwahing Pt wear mak when leaving room Dipoale upplie 284. What i airorne precaution ued for? Meale, T (pread via droplet), Chicken POx (Varicella), SARS 285. AIRORN PRCAUTIONS: Select all that appl: ___ Private Room ___ e/Face Shield ___ Mak ___ Dipoale Supplie ___ Glove ___ Negative Air Flow ___ Special Filter Repirator Mak ___ Handwahing ___ Gown ___ Pt wear mak when leaving room Private room (door cloed Mak Glove Gown Handwahing Special FIlter Repirator Mak (for T onl­ and not uppoed to leave room unle the have to) Pt wear mak when leaving room Dipoale upplie Negative air flow (mot important) verone that enter the room mut wear a mak 286. Unle otherwie pecified, aume that PP include: glove, gown, goggle, and mak 287. The proper place for donning PP i ________ the room and doffing PP i _________ the room outide, inide 288. The proper order for donning PP i 1. ___________ 2. ___________ 3. ___________ 4. ___________ 1. Gown 2. Mak 3. Goggle 4. Glove (tart low and go high) 289. The proper order for removing PP i: 1. ________ 2. ________ 3. ________ 4. ________ 1. Glove 2. Goggle (from ehind) 3. Gown (from ehind) 4. Mak (from ehind­ outide room) (alphaetical order) 290. In airorne and droplet precaution onl, the mak i removed _______ the room and the patient remove mak ________ the room. outide, inide 291. Hand­wahing or Scruing: poition hand elow elow hand­wahing 292. Hand­wahing or Scruing: poition elow elow hand cruing 293. Hand­wahing or Scruing: length econd hand­wahing 294. Hand­wahing or Scruing: length minute cruing 295. Hand­wahing or Scruing: can touch handle hand­wahing 296. Hand­wahing or Scruing: not allowed to touch handle cruing 297. Hand­wahing or Scruing: ue when entering/leaving room, efore/after glove ue, whenever hand get oiled hand­wahing 298. Hand­wahing or Scruing: ue when patient i immunouppreed (eginning of tuff) cruing 299. Hand­wahing or Scruing: oap and water hand­wahing 300. Hand­wahing or Scruing: ue "chlor­­­" cruing 301. When can ou ue an Alcohol­aed olution? Onl utitute for handwahing, enter/leave room, efore/after glove, NVR utitute after oiling hand 302. Can ou ue an alcohol­aed olution after uing the retroom? No! (oiling hand) 303. Dr hand from ________ to _________. Turn water off with _____ paper towel cleanet, dirtiet, new 304. Sterile Gloving: glove ________ hand firt grap ________ of cuff touch onl the _______ of glove urface do not _______ cuff finger _______ econd glove cuff keep thum _______ onl touch _______ urface of glove dominant outide inide roll inide aducted outide 305. SkIN touche _______ of glove INide 306. OUTide of glove onl touche _______ of glove OUTide 307. Remove ______ to _______; _______ to _______ glove, glove, kin, kin 308. What patient do NOT need interdiciplinar care? People who have multiple prolem in the ame diviion of care x: COPD, arthriti, cancer of owel (all medical prolem) 309. What i the major criteria for interdiciplinar care? 1. Patient with multidimenional need (phical, intellectual, emotional, ocial, piritual)­ x COPD, homelene, & chizophrenia (need medical, SW, and pchiatrit) 2. Patient who need rehailitation (PT, SW, OT, Speech will e effected) 310. What i the minor criteria for interdiciplinar care? a patient whoe current treatment i ineffective a patient who i preparing for dicharge 311. What are the 3 principle to conider when chooing appropriate to for kid? 1. i it afe 2. i it age­appropriate 3. i it feaile (can ou actuall do it?­ pecific to child' ituation) 312. What are ome afet conideration when it come to kid to? 1. ize of to (no mall to for children under 4) 2. no metal to if oxgen i in ue (park thing) 3. eware of fomite (non living oject that haror microorganim)­ wort: pluh to/ tuffed animal; leat­ platic to that can e diinfected 313. What i the ST to for 0­6 month old (enorimotor)? mucial moile 314. What i the 2nd ST to for 0­6 month old (enorimotor)? large and oft 315. What i the ST to for 6­9 month old (oject permanence)? cover/uncover to (jack in the ox) 316. What i the 2nd ST to for 6­9 month old (oject permanence)? firm ut large (wood/ hard platic allowed) 317. What i the ST to for 9­12 month old? veral to (tickle me elmo) 318. Rememer with 9­12 month old ___________ activit with _________ purpoeful, oject 319. Avoid anwer with the following word in them for children 9 month and ounger: uild, ort, tack, make, & contruct 320. What i the et to for toddler (1­3 ear)? puh/pull to (wagon) 321. What kill i eing worked on when toddler pla? gro motor kill 322. What tpe of pla do toddler do? parallel pla (pla alongide ut not with) 323. What tpe of to hould e avoided with toddler? to that require good finger control/dexterit 324. Prechooler need to that work on: fine motor kill (finger) and alance (dance, ice kating and tumling) 325. Prechooler pla i characterized cooperative pla (pla with each other) 326. Prechooler like to pla ________. pretend 327. School age (7­11 ear) aka _________ are characterized the 3 C': 1. 2. 3. Concrete 1. created/creative (give lank paper; get them involved) 2. competitive (winner and loer) 3. collective (aeall card and arie) 328. Adolecent (12­18 ear)­ their "pla" i _______ _______ _____________. Allow adolecent to e in each other' room unle one of them i : 1. 2. 3. peer group aociation (hang out in group) 1. freh pot­op (le than 12 hour) 2. immunouppreed 3. contagiou 329. When given a variet of age to chooe from alwa go __________ ecaue children ________ when ick and ou want to give them __________________________________ ounger, regre, a much time to grow 330. Creatinine et indicator of kidne function 331. Creatinine la value 0.6­1.2 If elevated it' anormal ut not too worriome (jut mean kidne are failing) 332. INR (International Normalized ratio) Monitor Coumadin (Warfarin) therap (Coumadin and War Fare make ou leed) 333. What i the therapeutic range for INR? 2­3 ↑INR= leed rik ≥4 i critical 334. What do ou do when INR i ≥ 4? Hold all Coumadin Ae leeding Prepare to give Vitamin K Call the Dr 335. What i the therapeutic range for Potaium (K+)? 3.5­5.0 336. What do ou do if Potaium i low? Critical Ae heart Prepare to give Potaium Call the Dr 337. What do ou do if Potaium i 5.4­5.9? Critical (high ut till in the 5') Hold all Potaium Ae heart Prepare Kaexalate/D5W Call the Dr 338. What do ou do if Potaium i ≥6? Deadl Dangerou Do all of the following at once: Hold Potaium, ae heart, prepare Kaexalate/D5W, Call Dr (will need a team to addre thi) 339. What i the therapeutic range of pH? 7.35­7.45 340. What do ou do if pH i in the 6'? Deadl Dangerou get vital and call Dr (mot important when aked in quetion) 341. What i the therapeutic range for UN (lood urea nitrogen)? 8­30 (8 un in a pack) 342. What do ou do when a patient ha an elevated UN? e concerned Check for dehdration 343. What i the therapeutic range for Hg (hemogloin)? 12­18 (teenage ear) 344. What do ou do when a patient ha a 8­11 hg? e concerned monitor the patient 345. What do ou do if a patient ha a hg of <8? Critical Ae leeding, prepare for tranfuion, call Dr 346. What i the therapeutic range for HCO3? 22­26 If out of range it i anormal ut not worriome 347. What i the therapeutic range for CO2? 35­45 348. What do ou do if CO2 i in the 50'? Critical (ign of repirator inufficienc) Ae repiration Do pured lip reathing (low out candle and exhale for longer period) Don't give O2 (it will increae CO2) Thi doe not appl to COPD (thi i their "normal") 349. What do ou do if CO2 i in the 60'? Deadl Dangerou ign of repirator failure Ae repiration Do pured lip reathing (to ↓ anxiet) Prepare to intuate and ventilate Call repirator therap Call Dr 350. What i the therapeutic range for Hct? 36­54 (if anormal e concerned) 351. What i the therapeutic range for PO2? 78­100 352. What do ou do if PO2 i 70­77? Critical Sign of repirator inufficienc Ae repiration Give Oxgen 353. What do ou do when PO2 i ≤60'? Deadl Dangerou Sign of repirator failure Ae Repiration Give Oxgen Prepare intuate and ventilate Call repirator therap Call Dr 354. What i the therapeutic range for O2 aturation? 93­100 355. What do ou do if O2 aturation i le than 93? Ae repiration and give oxgen 356. NP Good indicator of CHF 357. What i the therapeutic range for NP? <100 358. What do ou do if NP i elevated? e concerned and continue to monitor patient 359. What i the therapeutic range for Sodium? 135­145 360. What do ou do if Sodium i anormal in a patient? e concerned until there' a change in the LOC (then it ecome critical) 361. What i the therapeutic range for WC'? 5,000­11,000 362. What i the therapeutic range for ANC? 500 (want aove 200) 363. What i the therapeutic range for CD4 count? <200= AIDS 364. What i another name for high WC count? Leukoctoi 365. What are ome other name for low WC count? Leukopenia Neutropenia Agranuloctoi Immunouppreion one Marrow Supreion 366. What do ou do when WC i <5,000 Critical­ immunouppreed Neutropenic precaution 367. What do ou do if ANC i < 500? Critical­immunouppreed Neutropenic precaution 368. What do ou do if CD4 <200? Critical­ immunouppreed Neutropenic precaution 369. What i neutropenic precaution? aka Revere/Protective Iolation Strict hand wahing Shower ID with antimicroial oap Avoid crowd Private Room Limit numer of taff entering room Limit viitor to health adult No freh flower or potted plant Low acteria diet: no raw fruit, veggie, alad or undercooked meat Do not drink water that ha een tanding for longer than 15 minute Vital ign (temp) ever 4 hour Check WC (ANC) dail Avoid ue of indwelling catheter Do not re­ue cup... mut wah etween ue Ue dipoale plate, cup, traw, utenil Dedicated item in room: tethocope, P cuff, Thermometer, glove 370. What i the therapeutic range for platelet? 150,000­400,000 371. What do ou do if platelet are <90,000? Critical Ae for leeding leeding Precaution 372. What do ou do if platelet are <40,000? Deadl Dangerou (can pontaneoul leed to death) Ae for leeding leeding Precaution 373. What i leeding precaution? No unnecear venipuncture­ injection or IV. Ue mall gauge Handle patient gentl (ue drawheet) Ue electric razor No toothruhing or floing No hard food Well­fitting denture low noe gentl No rectal temp, enema, or uppoitor No apirin No contact port No walking in are feet No tight clothing or hoe Ue tool oftener. No training Notif MD of lood in urine, tool 374. What i the therapeutic range for RC'? 4­6 (if anormal e concerned) 375. What are the 5 D'? (rememer the 6') 1. K+≥6 2. pH in the 6' 3. CO2 in the 60' 4. pO2 ≤60' 5. Platelet < 40,000 376. When hould ou call a Rapid Repone Team? When la value are Critical or Deadl Dangerou or if ad mptom during aement 377. Laminectom "ctom"= removal of "lamina"= verteral pinu procee 378. What i the reaon for a laminectom? to treat nerve root compreion 379. What are the 3 ign and mptom of nerve root compreion? Pain Paretheia (numne & tingling) Parei (mucle weakne) 380. What are the different location for a laminectom? cervical (neck) thoracic (upper ack) lumar (lower ack) 381. What i the mot important aement in a pre­op cervical laminectom> function of Upper extremitie and reathing 382. What i the mot important aement in a pre­op thoracic laminectom? cough (tet adominal mucle) and owel ound 383. What i the mot important aement in a pre­op lumar laminectom? urine output and leg 384. What i the #1 pot­op anwer on NCLX? alwa log roll our patient 385. What i the pecific "activit"/moilization trateg pot­op? 1. do not dangle/it on ide of ed 2. allowed to walk, it, tand and lie down 3. limit itting 20­30 min at a time 386. Pot­op complication for cervical laminectom watch for pneumonia 387. Pot­op complication for thoracic laminectom watch for pneumonia and paraltic illeu 388. Pot­op complication for lumar laminectom watch for urinar retention 389. Laminectom with fuion involve taking a _____ ______ from the ______ ______. Of the two inciion, which ite ha the mot: Pain? leeding/Drainage? Rik for infection? Rik for rejection? one graft, illiac cret (hip) hip hip hip/pine pine 390. Surgeon are uing cadaver one from one ank. Wh? ecaue it get rid of 2nd inciion and cut recover time in half 391. What are ome temporar retriction (6 wk) with dicharge teaching? 1. Don't it for longer than 30 min 2. Lie flat and log roll for 6 wk 3. Lifting retriction: do not lift more than 5l 392. what are ome permanent retriction for laminectom patient? 1. Laminectom patient will never e allowed to lift ending at the wait (ue their need) 2. Cervical laminectom patient will never e allowed to lift oject aove their head 3. No horeack riding, off­trail iking, jerk amuement park ride, etc. 393. Nagele' Rule (calculating due date) Take the firt da of the lat mentrual period (LMP) Add 7 da Sutract 3 month 394. Total weight gain during pregnanc 25­31 l 395. 1t trimeter weight gain 1 l per month (3 l total for firt trimeter) 396. 2nd/3rd trimeter weight gain 1 l per week 397. Fundu (top of uteru) in not palpale until week ____ 12 398. Fundu tpicall reache the umilical (navel) level at week ______ 20­22 399. What are 4 poitive ign of pregnanc? 1. fetal keleton on an x­ra 2. fetal preence on ultraound 3. aucultation of the fetal heart (doppler) 4. examiner palpate fetal movement/outline 400. What are ome proal/preumptive ign of pregnanc? 1. all urine and lood pregnanc tet 2. Chadwick' ign (color change of the cervix to canoi) 3. Goodell' ign (cervical oftening) 4. Hegar' ign (uterine oftening) 401. Morning ickne: Which trimeter and what treatment? 1t trimeter eat dr car, cracker efore out of ed, and avoid empt tomach 402. Urinar incontinence: Which trimeter and what treatment? 1t/3rd void Q2H 403. Dpnea: Which trimeter and what treatment? tripod poition (lean forward with hand on knee) 404. ack pain: Which trimeter and what treatment? 2nd/3rd pelvic tilt exercie (put foot on tool then ack again) 405. What i the truet, mot valid ign of laor? onet of regular contraction 406. Dilation opening of cervix (0­10 cm) 407. ffacement thinning of cervix (thick­100%) 408. Station relationhip of fetal preenting part to mom' ichial pine (tightet queeze for a head) negative= aove pine poitive= elow pine 409. ngagement tation "0" at ichial pine 410. Lie Relationhip etween pine of a and pine of mom 411. Preentation part of a that enter irth canal firt 412. What i tage 1 of laor and deliver? laor­ dilate and phae cervix (3 phae of laor­­ latent, active, tranitional) 413. What i tage 2 of laor and deliver? deliver of a 414. What i tage 3 of laor and deliver? deliver of placenta 415. What i tage 4 of laor and deliver? recover­ firt 2 hour to top leeding 416. tranvere lie and tation that won't go poitive= c­ection 417. Latent: CM dilated CXN freq Duration Intenit 0­4cm 5­30 min 15­30 ec mild 418. Active: CM dilated CXN freq Duration Intenit 5­7 cm 3­5 min 30­60 ec Moderate 419. Tranition: CM dilated CXN freq Duration Intenit 8­10 cm 2­3 min 60­90 ec Strong 420. Contraction hould not e longer than ____ econd or cloer than ever ___ minute 90 2 421. Aement of contraction: Frequenc eginning of one contraction to the eginning of the next contraction 422. Aement of contraction: Duration eginning to end of one contraction 423. Aement of contraction: Intenit trength of contraction. Palpate with finger of one hand over the fundu 424. What complication of laor i indicated if the mom i having painful ack pain? a turned around ackward. Low priorit Poition knee­chet then put on her ack 425. What hould ou do with a prolaped cord? Puh head ack in off cord and poition in knee­chet or trendelenurg (hip up, houlder down). Prep for c­ection 426. Intervention for all other complication of laor and irth Left ide/ Lateral IV increae Oxgen Notif top Pit if in crii 427. Do not adminiter a SYSTMIC pain medication to a woman in laor IF the a i likel to e ______ when the _______ i _________ orn, pain, peaking (repirator depreion) 428. What do ou do with a low fetal heart rate? ad LION pit 429. What do ou do with FHR Acceleration? no crii 430. What do ou do with low aeline variailit? ad LION pit 431. What do ou do with high aeline variailit? record it 432. What do ou do with late deceleration? ad LION pit 433. What do ou do with earl deceleration? HR ↓ 434. What do ou do with variale deceleration? can e ver ad prolaped cord 435. Second tage of laor and deliver­ what do ou do? 1. deliver the head (top puhing) 2. uction mouth and noe 3. check for nuchal cord (cord around neck) 4. deliver houlder and od 5. make ure a ha ID and 436. What do ou check for with the deliver of the placenta? 3 veel (2 arterie and 1 vein) "AVA" 437. During the ___ tage (recover tage) (firt 2 hour after deliver) what __ thing do ou do ___ time an hour 4th, 4, 4 1. vital ign (ae for ign and mptom hock 2. check fundu (if ogg, maage. if diplaced, void/cath) 3. check pad (exceive lochia= pad at in 15 min) 4. roll on to ide (check for leeding under patient) 438. What i the tone, height and location of the uteru potpartum? tone: firm not ogg height: right after deliver it i pui 24 hour it i at navel. 2 cm for ever PP da location: midline (if diplaced from R/L if mean catheterize) 439. What i the color of lochia in the firt da? rura 440. What i the color of lochia after a week or o of potpartum? eroa 441. What i a moderate amount of lochia? 4­6 in on pad in one hour 442. What i an exceive amount of lochia? aturate pad in 15 min 443. What do ou ae for in the potpartum aement? uteru, lochia, exteremitie (pule, edema, S7S thromophleiti) 444. ditended eaceou gland which appear a tin white pot on a' face milia 445. mall, white epithelial ct on a' gum eptein' pearl 446. luih­lack macule appearing over the uttox and/or thigh of darker­ kinned neonate mongolian pot 447. red papular rah on a' toro which i enign and diappear after a few da erthema toxicum neonatorum 448. enign tumor of capillarie hemangioma 449. welling caued leeding etween the otium and perioteum of the kull. Thi welling doe not cro uture line Cephalohematoma 450. edematou welling on calp caued preure during irth. Thi welling ma cro uture line. It uuall diappear in a few da caput uccedaneum 451. normal, phiologic jaundice appear after 24 hour of age and diappear at aout one week of age Hperiliruinemia 452. whitih, cheee­like utance which appear intermittentl over the firt 7­10 da vernix caeoa (caeu= cheee) 453. normal canoi of a' hand and feet which appear intermittentl over the firt 7­10 da acrocanoi 454. generic term for irthmark 1. nonlanchale port wine tain 2. lanchale pink "tork ite" nevu/nevi 1. nevu flammeu 2. telangiectatic nevi 455. Tocoltic (top contraction) Terutaline (rethine) S/­ tachcardia (don't give with cardiac dieae) Nifedipine S/­ headache/hpotenion (can give with cardiac dieae) 456. Oxtocic­ timulate laor Pitocin (Oxtocin) S/­ uterine hpertimulation Cervidil (Protaglandin)­ dilate cervix S/­ uterine hpertimulation 457. Fetal/ Neonatal Lung Med etamethaone (teroid)­ give to mother IM; give efore a after viailit. can repeat S/­ ↑S Survanta­ give to a after a i orn (trantracheal) 458. Step of drawing up inulin 1. draw up the total doe in air 2. preurize the "N" vial (put air in) 3. preurize the "R" vial 4. draw up "R" doe 5. draw up "N" doe (Nichole Richie, RN) 459. IM­ length and guage 1 in oth the guage and length (I look like 1) 460. SQ­ length and guage 5 in oth part (S look like a 5) 461. Heparin ­work immediatel ­can onl take for 21 da ­antidote: ­Protamin ulfate (heParin) ­la: PTT and all clotting and leeding time ­http­­> PttHeparin ­can ue in pregnanc ­pregnanc cla C 462. Coumadin ­take da ­can take for ­entire life ­PO onl ­antidote: vitamin K ­la: PT, INR ­can't ue if pregnant ­cla x pregnanc 463. aclofen (Lioreal) mucle relaxant 1. caue fatigue 2. caue parei (mucle weak) 3. do not drink alcohol 4. do not drive a car 5. do not watch kid under age 12 When ou are on aclofen ou are on our ack "loafin" 464. Senorimotor Age: 0­2/o Characteritic: totall preent­oriented. Onl think aout what the are ene of are doing right now Teaching Guideline­ When: a it happen What: ou are doing now How: tell them what ou're doing a ou're doing it 465. Pre­Operational Age: 3­6/o (prechooler) Characteritic: Fanta oriented. illogical. no rule. (can teach ahead of time ut not too far) Teaching Guideline­ When: lightl ahead of time (morning of...) What: ou will do How: pla, to, torie 466. Concrete Operation Age: 7­11/o Characteritic: Rule­oriented. Live and die the rule! Cannot atract Teaching Guideline­ When: da ahead of time What: ou're gonna do and kill How: age appropriate reading and A/V material, role pla i ok 467. Formal Operation Age: 12­14 /o Characteritic: ale to think atractl. Undertand caue­effect. Thinking like adult emotionall ut phicall not there ut the can think like one Teaching Guideline­ When: like an adult What: like an adult How: like an adult 468. kin till intact, non lanching, erthema (redne) tage 1 preure ore 469. ulcerated, uperficial,pink dermi tage 2 470. ellow ucutaneou (fat) Stage 3 471. red­white (mucle and one) tage 4 472. _______ eat _______ acute, chronic 473. _______ __________ eat _______ or _______ _________ freh pot op, medical, other urgical 474. ______ eat _______ tale, untale 475. What make a patient tale? 1. ue of the word tale 2. chronic illne 3. pot op> 12 hr 4. local or regional anetheia 5. unchanged aement 6. phrae: "To e dicharged" 7. la value A/ Stale patient are experiencing the expected tpical ign and mptom of the dieae with which the have een diagnoed and for which the are receiving treatment 476. What make a patient untale? 1. Ue of the word untale 2. acute illne 3. pot op <12 hour 4. general anetheia 5. changing aement 6. phrae: "newl admitted" or "newl diagnoed" 7. la value C/D Untale patient are experiencing unexpected atpical ign and mptom, complication 477. What 4 patient are alwa untale? 1. hemorrhage 2. hpoglcemia 3. fever ≥104 4. pulelene or reathlene 478. The more _____ the ______, the higher the priorit vital, organ Mot vital→ rain → lung → heart → liver → kidne → pancrea 479. What reponiilitie would ou not delegate to an LPN? ­Starting an IV ­Hanging or mixing IV med ­valuating an IV ite ­Giving an IV puh/P med ­Giving a lood tranfuion ­Performing aement that require inference/judgment (can gather data)­ can make oervation aout tale people ut cannot make aumption ­Plan of care ­Developing or performing teaching (can reinforce and review) ­Taking veral order from MD or trancriing order 480. What would ou not delegate to a UAP? ­cannot chart ut ma document what the did ­aement­ except for VS and accucheck ­med and IV­ ma appl otc topical lotion and cream ­treatment­ except for SS. Not fleet You ma delegate ath, ed, and ADL 481. Do not delegate to ___________: _______ reponiilitie. The can onl do what ou _______ them to do famil, afet, teach 482. how do ou intervene with inappropriate ehavior of taff? (4 option) 1. tell the upervior 2. intervene immediatel 3. counel them later on 4. ignore it. Jut let it go (never the right anwer) 483. What 4 quetion hould ou ak when dealing with inappropriate ehavior from taff? 1. i what the're doing illegal? (if e tell the upervior) 2. i the patient or taff memer in immediate danger of phical or pchological harm? (if e intervene immediatel) 3. i thi ehavior legal, not harmful, ut impl inappropriate? (if e counel them later on) 484. Pre­interaction phae purpoe: for the nure to explore hi/her feeling. to prevent judgmental, intolerant reaction length: egin when ou learn ou are going to e caring for omeone and end when ou meet them correct anwer: "the nure will explore hi/her feeling aout..." 485. Introductor phae (orientation phae) purpoe: to etalih and explore/ae length: egin when ou firt meet the patient and end when a mutuall agree­upon care plan i in place correct anwer: Should e ver tolerant, accepting, explorative, proing, "no". e warm and fuzz 486. Working phae (therapeutic phae) purpoe: to implement the plan of care length: from the finihed care plan until dicharge correct anwer: hould e focued, directive, "tough". in ome wa thee anwer will eem tern and lightl unfriendl. et limit. enforce proper communication 487. When doe the termination phae egin? on admiion 488. Pch Treatment Protocol for depreion Whenever a patient dipla an notion of uicide or harm ou MUST inquire aout it Mut get a afet contract *activitie with other people that doen't require interaction 489. Pch Treatment Protocol for chizophrenia If pacing Pch→ reduce timulation (clear the room), make oervation, offer preence *need realit aed activitie ut not competitive; hould e with other people 490. Pch Treatment Protocol for ipolar Mania' can't go to work or maintain famil order wherea a hpo manic can ­finger food are et; epeciall ↑ calorie ­8hr of leep. ncourage nap *exercie the gro motor that i non competitive 491. Pch Treatment Protocol for Anxiet Diorder Phoia­ irrational fear that limit dail life →tx: deenitization: graduall expoe 1. Talk aout it 2. Show pic 3. e around 4. Interact When ou move to next tep, make ure not anxiou 492. Retraint protocol In pch: need to e evaluated within 1 hr. Mut e contantl oerved Not pch: oerve ever 15 min. No evaluation. Need Dr order Q24h 493. Pch Treatment Protocol for Violent Client It take 5 people to control a violent client. One for each lim and head. Onl one peron talk. The peron i given a few econd to deecalate 494. All pch drug caue.... Hpotenion, weight change, and primar weight gain 495. Phenothiazine All end in "zine" x: Thorazine, compazine Action: large doe­ antipchotic, mall doe­ antiemetic, major­ tranquilizer 496. Side ffect of Phenothiazine Rememer ACDFG... A= anticholinergic (dr mouth) = lurred viion and ladder retention C= contipation D= drowine = PS (tremor, parkinonian) F= "f"otoenitivit (kin urn) G= aGranuloctoi (low WC count­ immunoupreed) Teach patient to report ore throat and ign and mptom of infection to doctor Never top the zine Never top the zine 497. Nuring care for Phenothiazine Treat ide effect. Numer one diagnoi i afet 498. Deconate or "D" Long acting IM form of Phenothiazine given to non compliant patient 499. Tricclic Antidepreant "Mood elevator" to treat depreion x­ lavil, Trofranil, Aventl, Derel 500. Side effect of Tricclic Antidepreant (lavil tart with "" o thi group goe to "") A= anticholinergic (dr mouth) = lurred viion C= contipation D= drowine = euphoria (happ) Mut take med for 2­4 week efore eneficial effect 501. enzodiazepine Antianxiet med (conidered minor tranquilizer) Alwa have "Pam"/"lam" in name Prototpe: Valium Indication: induction of anethetic, mucle relaxant, alcohol withdrawal, eizure (epeciall tatu epilepticu), facilitate mechanical ventilation Tranquilizer work quickl. MUST NOT take for more than 6 week­ 3 month. Keep on Valium until lavil kick in Numer one nuring diagnoi i afet 502. Side effect of enzoDiazepine A= anticholinergic = lurred viion C= contipation D= drowine 503. Monoamine Oxidae (MAO) Inhiitor Antidepreant Depreion i thought to e caued deficienc of norepinephrine, dopamine, and erotonin in the rain. Monoamine oxidae i the enzme reponile for reaking down norepinephrine, dopamine, and erotonin. MAO Inhiitor prevent the reakdown of thee neurotranmitter a and thu retore more normal level and decreae depreion Drug name: MARplan, NARdil, PARnate 504. Side effect of MAO inhiitor A= anticholinergic = lurred viion C= contipation D= drowine 505. Interaction/ patient teaching for MAO Inhiitor To prevent ever, acute, ometime fatal hpertenive crii, the patient MUST avoid all food containing tramine Food containing tramine: Fruit and veggie­ rememer alad "AR"→ avoid anana, Avacado, Raiin (an dried fruit); Grain: ll oka except thing made from active eat Meat: no organ meat­ liver, kidne, tripe, heart, etc. no preerved meat­ moked, dried, cured, pickled, hot dog Dair: no cheee except mozzarella and cottage cheee (no aged cheee) Other: no alcohol, elixir, tincture (iodine/etadine), caffeine, chocolate, licorice, o auce 506. Lithium An electrolte (notice "ium" ending a in potaium etc) Ued for treating ipolar diorder (manic­depreion)→ it decreae the mania 507. Side effect of Lithium The three "P'": Peeing (poluria) Pooping (diarrhea) Paretheia (tingling/numne) Medicall inducing a lithium/electrolte imalance Toxic: tremor, metallic tate, evere diarrhea, and an other neuro ign →numer one intervention: good fluid hdration. If weating give odium (or other electrolte) a well a fluid. Don't give water. Drink Gatorade or other electrolte olution. Monitor odium level 508. Prozac SSRI ( Selective Serotonin Reuptake Inhiitor) Similar to lavil Antidepreant­ mood elevator 509. Side effect of Prozac A= anticholinergic = lurred viion C= contipation D= drowine Caue inomnia, o give efore 12 noon. If ID, give at 6am and 12 noon When changing the doe of Prozac for an adolecent or oung adult, watch for uicide 510. Haldol (Haloperidol) Tranquilizer Alo ha a deconate form Long acting IM form given to non compliant patient 511. Side effect of Haldol A= anticholinergic = lurred viion C= contipation D= drowine = PS F= fotoenitvit G= aGranuloctoi lderl patient ma develop NMS from overdoe. NMS i Neuroleptic Malignant Sndrome­ a potentiall fatal hperplaia (fever) with temp of 104.0. Doe for elderl patient hould e half of uual adult doe. Safet concern r/t ide effect 512. Clozaril (clozapine) Atpical antipchotic Ued to treat evere chizophrenia Advantage: it doe not have ide effect A­F Do not confue with Klonopin (clonazepam) 513. Side effect of Clozaril Agranuloctoi (wore than cancer drug) Can ink precrie for 7 da then get WC drawn for 4 week, then once a month for 6 month then ever 6 month 514. Zoloft (Sertraline) Another SSRI like Prozac Antidepreant Alo caue inomnia ut can e given in evening Watch for interaction with St John' Wort (erotonin ndrome), and warfarin (watch for leeding) 515. Side effect of Zoloft SAD Head Sweating Apprehenive Dizz Headache
