Hemo-Immuno Showdown
Signs and symptoms of a TACO reaction and how to treat it
What is Rales, dyspnea, hypoxemia, pulmonary edema, circulatory overload, decreased EF, high BNP, hypertension, JVD, transudate edema fluid.
Tx: Diuretics
When can tPA be given? Type of stroke and amount of time
What is 3.5-4.5 hours for an ischemic stroke
What meds are aPTT, PTT, and INR associated with?
What is
aPTT- Heparin
PTT/INR- Warfarin
Where do people usually experience gout pain? What meds do you give?
What is the big toe
Meds: Cholchine and allopurinol
List A1C values of prediabetes and diabetes
What is
Prediabetes= 5.7-6.5%
Diabetes= >6.5%
Your patient is receiving a blood transfusion and begins to complain of SOB and chills within 10 mins of administration. QUICK!? What do you do?
what is
Stop the transfusion, call the provider, disconnect the blood from the patient, run normal saline through a new line, send the blood AND the tubing back to the blood bank, treat any s/s that arise
What is the pathophysiology of Parkinson's? What meds will you use to treat it?
What is Dopamine depletion from degeneration of basal ganglia, causes difficulty with movements.
Tx: Carbidopa/levadopa
What cardiac changes happen with hyper and hypokalemia?
Hyperkalemia= tall tented (peaked) T waves, wide QRS, flat P
Hypokalemia= ST depression, flat/inverted T waves, U wave
What are the precautions for patient post hip replacement
What is Crossing the legs, don't sit or stand for too long, orthostatic precautions, Use abduction pillow
Hallmark sign of Lyme disease and how to remove a tick
What is a Bullseye rash. Twist and pull up to ensure you get the head out
Name all the RANDI precautions and what kinds of patients you would use them for.
what is
R: electric razors
A: No Aspirin
N: Smaller gauge needles (means that they are bigger)
D: Decrease needle sticks
I: Prevent injury
Used for: patients with low platelet counts and other bleeding disorders
Name 6 seizure precautions
What is O2 and suction set up, padded side rails, good IV access, bed alarm on, no tongue blades, no restrictive clothing, no restraints, NPO till gag reflex is assessed
What ABG imbalance is this?
pH= 7.32 PaCO2= 51 HCO3= 22
What kind of patient would have this?
What is
Respiratory acidosis. Commonly seen in asthma and COPD
What are the signs of compartment syndrome and how to treat it
What is
Pain, paralysis, pulseless, pallor, paresthesia, poikilothermia.
Tx: Fasciotomy
Your patient requests to take their synthroid with their breakfast, and says they like to take their meds with milk. What do you educate them on?
You must take synthroid on an empty stomach at 6 am for the rest of your life. You can not take it with milk because it decreases the absorption of the medicine.
Which diet would be appropriate for a patient with leukemia?
Cereal with unpasteurized milk from the family's farm, pancakes, and bacon.
Mashed potatoes, steak, steamed peas, and cake.
Turkey sandwich with lettuce and tomato, and chips.
What is Mashed potatoes, steak, steamed peas, and cake.
They should not be eating or drinking anything raw! No raw fruits or veggies, or raw milk
What is status epilepticus and list some nursing interventions for it.
What is seizure that lasts longer than 5 minutes.
Tx: Establish airway, O2, EEG, IV push Valium/Ativan with a loading dose of IV phenytoin/keppra
Name the heart rhythm with unrecognizable P waves, and irregular QRS. How do you treat it?
What is A. fib
Tx: CCB, beta blockers, anticoags, amiodarone
What is this patient suffering from? Patient comes in with broken femur, 3 hours after admission patient spikes a fever, becomes tachypneic, and develops a petechial rash
What is a Fat Embolism
Your patient has returned from a thyroidectomy and you have assessed that their airway is not swollen, on the rest of your assessment you notice that the patient tingling in their hands and feet, and that their arm was twitching when you took their BP. What is their problem?
What is Hypocalcemia from accidental removal of the parathyroid glands.
What is a Sickle Cell Crisis and how do you treat it?
What is extreme pain caused by the obstructed flow of blood due to a sickled blood cell getting stuck in the vessel
Tx: Hydration, oxygen, pain management
What does BE FAST stand for
What is
B: balance
E: Eyes
F: Face
A: Arms
S: Speech
T: Time
Your patient in AKI is being put on a diuretic to treat their fluid overload. Which order would you question?
Hydrochlorothiazide, lasix, or spironolactone? And why...?
What is Spironolactone
Why: they are fluid volume overloaded, they are in the oliguric phase and will be hyperkalemic, we do not want them to hang onto even more potassium
List differences between rheumatoid and osteo arthritis
What is
Osteo: deterioration of joints. Pain after activity, decreases with rest. Unilateral. Tx: hip replacement
Rheumatoid: Autoimmune destruction of joints. Symmetrical. Pain after rest, decreases with movement. Bilateral. Tx: Paquenil and Prednisone
How does metformin work? What side effects do you have to look out for?
What is increases insulin sensitivity and decreases glucose production. Watch out for GI upset and renal damage