Metabolism
symptoms and treatment for hypoglycemia
symptoms: sweating, shaky, dizzy, tachycardia, blurred vision, weak/fatigued, HA, anxious, rapid/shallow breathing
treatments:
1st check blood glucose to confirm!
If alert and able to swallow give 15 grams of simple carb then recheck in 15 min (and repeat)
If unable to swallow give glucagon or D50W then recheck blood glucose in 15 min
risk factors for HTN
older age, Black/African Americans, excess alcohol, family history, assigned male at birth, high sodium diets, obesity, physical inactivity, dyslipidemia, DM, stress, smoking
types of goals for cancer care
cure: permanent removal of all cancer cells from the body
control: preventing the growth and spread
palliation: relieve symptoms to increase quality of life
Risk factors for chronic kidney disease and education to reduce them
risk factors: CV disease (diet/exercise, cholesterol levels WNL), diabetes (maintain stable glucose levels/diet/exercise), HTN(maintain BP within normal, BP meds, diet/exercise, stress reduction), obesity (diet/exercise)
teaching post thyroidectomy
monitor for bleeding
pain management
semi-fowlers with head on pillows, avoid turning head and talking as little as possible
educate on the need for life-long thyroid hormone replacement
treatment/care for peripheral venous disease (venous insufficiency)
compression
elevation
no prolonged sitting or standing
teaching for thrombocytopenia
bleeding precautions:
soft bristle tooth brush, electric razor, no contact sports, etc
treatment for hepatic encephalopathy
lactulose and antibiotics
chronic complications of diabetes and ways to reduce the risks
microvascular:
- retinopathy, nephropathy, neuropathy: for all of these maintain tight control of blood glucose. Vision checks for retinopathy. Daily foot checks and foot care for neuropathy. Maintain BP and low sodium diet to help with nephropathy
microvascular:
- CAD, PVD, and cerebrovascular disease: tight control of blood glucose, BP, and cholesterol
treatment/care for PAD
exercise program
cholesterol management, BP management, BG control, weight reduction and smoking cessation
drug therapy: statins, anti platelet drugs, and cilostazol
may have angioplasty or surgery
Nursing: foot care, avoid heating blankets, hot water (direct heat) but keep extremities warm, NO compression, keep extremities dependent (dangling down)
chemo precautions
to administer chemo you must be certified
need goggles, gown, mask, shoe covers, absorbent pads, and a chemo trash bucket
AV fistula nursing care
monitor for s/s infection, check bruit and thrill, NO blood draws of BP on that arm
what happens in DKA and what is the treatment
with DKA there is hyperglycemia (BG>250)- the kidneys cannot reabsorb that much glucose so it spills into the urine and with it goes a lot of fluids (osmotic diuresis), the body also goes through ketosis and metabolic acidosis. This can be life-threatening
treatment: fluid and electrolyte replacement, correct acidosis with sodium bicarb, treat hyperglycemia with insulin (regular insulin if IV), and educate on ways to prevent recurrence
stage 2 HTN (dx, treatment, and teaching)
stage 2 is SPB of 140+ and DBP 90+
to be diagnosed there needs to be 2 or more abnormal readings taken 1-4 weeks apart by a healthcare provider
treatment: thiazides, ACE inhibitors, ARBs or CCBs (CCBs or thiazides for Black patients)
teaching: therapeutic lifestyle changes, education on meds, low sodium diet (DASH)
types of radiation and nursing education/roles
external beam: people are not considered radioactive
internal beam (brachytherapy): radiation is implanted in the person so they can emit radiation to others (so they should be in a private room, etc)
nursing: manage symptoms, for external beam you need to assess skin (no lotions, deodorant, etc) and nutrition (from mucositis)
complications of hemodyalisis
anemia, hypotension, muscle cramps, sleep disturbances, PUD/metallic taste in mouth/N/V, SOB, dialysis disequilibrium, sepsis and access site
myxedema coma symptoms and treatment
symptoms:hypothermia, CV collapse, hypoventilation, hypoglycemia/hyponatremia/lactic acidosis
treatment: monitor O2 and give oxygen as needed, passive rewarming, correct sodium and glucose, IV thyroid replacement hormone
symptoms and dx for angina
*tip- also review cardiac rehabilitation :)
symptoms: agonizing chest pain that may radiate to neck/jaws/shoulder/left arm. May feel a choking/strangling sensation
diagnosis: ECG, CK-MB, and troponin to rule out MI
- NTG is given and if it helps it is angina, if it doesn't it is a sign it is an MI
stress test and cardiac Cath may also be done
cancer screening options for the colon and breasts
colon: a fecal occult blood test (gFOBT), sigmoidoscopy, or CT colonography every 5 years OR a colonoscopy every 10 years starting at age 45
breast: mammogram yearly starting at age 40
care for ascites
monitor weight and abdominal girth, I&O's, respiratory status and labs
low sodium diet
diuretics such as loops and spironolactone
IV albumin
bed rest in upright position
paracentesis