Gallbladder/ Liver/ Pancreas
Name postoperative instructions following a cholecystectomy
Call the surgeon if signs of infection
Avoid dietary fats
Shoulder pain in right shoulder can be normal
Walking and repositioning can help release operative gases
Why is a client with leukemia at risk for a GI bleed?
Leukemia disrupts normal blood cell component production including RBCs, platelets, and WBCs. Reduced platelet production creates a bleeding risk. Bleeding may be seen from multiple areas. Signs of GI bleed may include melena (dark, tarry stools or blood stained) or coffee ground emesis.
The priority medication for anaphylactic shock is:
Epinephrine
Atrial fibrillation
What tool helps to communicate with a client with expressive aphasia?
Picture board
ipad using type feature
client using pen and paper
What is appropriate dietary teaching for a client experiencing cholelithiasis?
Avoiding fat in the diet
What is a hallmark diagnostic marker for chronic myelogenous leukemia (CML)?
Bone marrow aspirate reveals Philadelphia chromosome
The priority intervention for anaphylaxis is:
Anaphylaxis is often hallmarked by difficulty breathing, swelling of the airway (laryngospasms or bronchospams), wheezing, chest pain, etc.Therefore, the priority is to maintain and open airway and monitor the airway
Call 911
How would you evaluate BE FAST?
B: Balance- check for swaying or ask to close eyes
E: Eyes- look for vision changes or one eye drooping
F: FAce- look for one sign of face to show assymetry with smiling
A: Arms- look to see if can hold up both arms evenly
S: speech- is speech slurred?
T: Time- get help immediately needs TPA For ischemic stroke within 3-4 hours
A liver injury may result in which serum bloodwork results?
elevated ammonia
elevated bilirubin
elevated liver function tests (ALT/AST)
decreased albumin
increased clotting time
What medical treatment can result in neutropenia?
Chemotherapy and radiation of the bones
How long can the kidneys tolerate reduced blood flow before injury?
1 hour
During shock when the blood pressure is low, there is not enough blood pressure to push the oxygenated blood to the kidneys. After an hour the kidney cells of the nephron will begin to die causing an acute kidney injury
A client with no standing orders develops chest pain. Name the response.
Call rapid response or Call HCP
What is a normal Glasgow Coma Scale?
Less than 8 is severe head injury
Less than 3 is likely fatal
which over the counter medication is known to be caustic (injurious) to the liver if used with alcohol or in high amounts?
Acetaminophen
No more than 4,000mg (4g) per day- new recommendations no more than 3,000 in some places
Name components of neutropenic precautions
Limit visitors that may be sick, young, or had live vaccines
Bottled water rather than tap water
No fresh fruits or flowers
Wear a mask when in public areas
Avoid crowded areas
Blood pressure finding expected in shock
hypotension
When fluids are given in specific types of shock, blood pressure should always be reevaluated to see if the blood pressure is increasing in response to fluids given
Asystole, or flat line, requires what interventions?
1. CPR
2. Epinephrine
3. Assess for a pulse
Common manifestation of a mild concussion
Acute headache
Signs of acute severe pancreatitis
Cullen's Sign (periumbilical bruising)
Gray's sign (flank bruising)
nausea/ vomiting
Mid epigastric or Left upper quadrant pain that may radiate to the back
Hemophiliac bleeding precautions would include?
Avoiding IM injections - if need PAIN MEDICINE try at all costs to look at oral, IV through port, topical, etc
Avoiding contact sports, avoiding activities on heights, etc
Head protection for bikes
Use soft toothbrushess
Avoid aspirin
Monitor for unusual bruising, melena
Extreme dehydration (extreme exercise, vomiting illness, diarrheal illness)
Extreme blood loss (Trauma, GI bleed, etc)- In the case of blood loss this may warrant fluid replacement by blood INSTEAD of crystalloid fluids
Common symptoms with MI
Diaphoresis
Shortness of breath
Feeling of impending doom
Crushing pressure in chest
Left sided arm pain
Neck pain
Abdominal pain (Women especially)
Signs of severe concussion/ traumatic brain injury
seizures
Slow to react, uneven, or dilated pupils
loss of coordination
loss of bladder/ bowel control
Change in level of consciousness
Vomiting