GI
Contraindications for NGT placement
¡Midface trauma, recent nasal surgery, esophageal perforation or varices, Deviated septum, coagulation abnormalities
explain the BEFAST pneumonic
Balance, Eyes, Face, Arms, Speech, Time
Gold standard diagnostic for Pneumonia
Chest X-Ray
Name the main differences between NSTEMI and STEMI diagnostics
STEMI - EKG you will see ST elevations
NSTEMI - no ST elevations, troponins will elevate over 3-12hrs
low T3 and T4 = ?
Hypothyroidism
A client has an ileostomy and is complaining of loose stool what is the nurses priority intervention?
educating patient that it is an expected finding to have loose stool with an ileostomy.
Differentiate between thrombotic vs embolic stroke
Thrombotic stroke primarily caused by atherosclerosis while Embolic strokes are caused by a clot that moves from another location
•Increased respiratory rate
•Dyspnea
•Hypoxemia
•Cough
•Purulent sputum
•Fever
•Pleuritic chest pain
Name two main complications of MI
Dysrhythmias and heart failure
A client whom is being treated with synthroid for hypothyroidism is exhibiting diarrhea and insomnia, what is the nurses action?
Notify provider that dose may be too high
EGD vs ERCP
ERCP –image of liver, gallbladder, pancreas, and bile ducts, light sedation, Check for gag reflex when they wake up (aspiration precautions), check for contrast dye allergies, NPO
EGD - Check for gag reflex, NPO, Views esophagus, duodenum, stomach, GERD, gastritis
Differentiate between a stroke in Broca's area and Wernicke's area
Broca = expressive aphasia
Wernicke's = Receptive aphasia
Differentiate between Ventilation vs. Diffusion vs. Perfusion
Ventilation= the physical act of breathing (chest rising and falling)
Diffusion = oxygen diffusing into blood
perfusion= oxygen delivery to tissues
name Medications used in ACS and why a patient would be prescribed them
•Aspirin
•Clopidogrel (Plavix) – if ACS or stent placement
•Beta-Blockers
•Long-acting Nitrates – Isosorbide
•ACE/ARBs
•Statins/lipid-lowering medications
Identify primary complications of hyperthyroid and hypothyroid including key symptoms/manifestations of those complications
Hyperthyroid - thyroid storm (Fever, tachycardia, and systolic hypertension)
hypothyroid - myexedema coma (decreased cardiac output and decreased gas exchange)
Contraindications to laxatives
Do not give to patient with SBO or someone with flair up of UC or Crohns or diverticulitis
Name several post-tPA administration nursing priorities
•Frequent neurological assessments
•Vital signs
•Assess for bleeding
•Serial labs – CBC, PT/INR, PTT
•Occult Blood
•Hold antiplatelet medications for 24 hours!
•Follow-up CT scan
Identify the flow rate for each oxygen delivery system
Nasal Cannula
1-6 L/min
Simple Face Mask
5-8 L/min
Partial Rebreather
6-11 L/min
Non-Rebreather
10-15 L/min
Venturi Mask
4-10 L/min
Post- cardiac cath what are our nursing assessments/interventions?
ØActivity restrictions
ØFrequent vital sign assessment
ØAssess insertion site
ØPulse/circulation assessment
ØHydration
ØEducation
Walk through the pathophysology of the release of the hormones related to thyroid disorders including organs/glands/hormones (the flowchart)
hypothalamus-->TRH-->anterior pituitary-->TSH-->thyroid-->t3 + t4
Differentiate between the patho of Ulcerative Colitis and Crohns
UC - continuous ulceration in the lower colon, 15-20 bloody stools/day,
crohns - skip lesions, chronic, 5-6 loose stools a day,
Both inflammatory!
Identify the tPA exclusion criteria within a 3 hour window
Current hemorrhagic stroke
Previous stroke (within last 3 months)
Active internal bleeding
Recent trauma or surgery (within 3 months)
Severe uncontrolled hypertension
Brain neoplasms, AVMs, or aneurysms
Recent MI
Known bleeding disorders
Pregnancy
Differentiate between S/S of different signs of hypoxia (acute, late, chronic)
Early
ØRestlessness
ØConfusion
ØAnxiety
ØIncreased BP, HR, RR
ØDyspnea
Late
ØDecreased LOC, activity level
ØDecreased BP, HR
ØMetabolic acidosis
ØCyanosis
Chronic
ØClubbing of fingers/toes
ØPeripheral edema
ØRight-sided HF
ØRespiratory acidosis
ØSpO2 < 87%
Stable vs unstable angina
Stable: predictable, happens most with exertion, resolves when activity stops or nitroglycerin
unstable: occurs at rest, may take more time to resolve and several nitroglycerin, unpredictable
Name key S/S of hyperthyroidism
diarrhea, insomnia, hair loss, rapid respirations, tachycardia, weight loss, increased appetite, exopthalamos