Eye/Ear/Integument
What is the difference between Myopia and Hyperopia
Myopia: nearsighted. Ray focuses in front of the retina
Hyperopia: Farsighted. Ray focuses behind the retina
What are the symptoms of Parkinson's?
Tremor
Rigidity
Akinesia
Postural instability
What is the presentation of someone with DKA
dehydration
N/V
fruity breathkussmaul breathing
renal failure
electrolyte imbalance
comatose
What is the difference between a sprain and a strain
Sprain: injury to ligament
Strain: stretching of a muscle
How is Sarin treated
atropine and 2 Pam Chloride
What is the difference between bacterial and viral conjunctivitis?
Bacteria: contagious and has purulent drainage
- use abx drops to treat
Viral: more just itching. feels like a foreign body
- normally self limiting, use steroid drops
Normal ICP
Normal CCP
5-15
60-100
Nursing Care for Cushings
VS q 4: especially BP, worried about HTN
daily weights
monitor for sx of infection
assess mental status changes
check glucs
monitor for signs of abdominal pain or bone pain
What are the 5 P's of the neurovascular assessment
pain, pulses, pallor, paresthesia, paralysis
What is the Parkland (Baxter) Formula? What is it used for? Explain it
A formula for fluid therapy after burns
4 mL LR per kg body weight per percent TBSA
1/2 in the first 8 hour
1/4 in the second 8 hr
1/4 in the last 8 hr
What are the 3 things you need to consider before your patient gets hearing aids?
- Their motivation
- how much their hearing loss affects their life
- ability to manipulate small objects
What are the manifestations of Meningitis
- fever
- severe headache
- nuchal rigidity
- photophobia
What is the difference between Somogyi effect and Dawn phenomenon
Somogyi is too much insulin causes hypoglycemia overnight and then a rebound hyperglycemia
- tx with less insulin at night
Dawn: release of growth hormone and cortisol causing hyperglycemia and ketonuria on awakening
- tx with increase insulin or alter timing of insulin
Stages of Bone Healing
1. Fracture Hematoma
2. Granulation Tissue
3. Callus Formation
4. Ossification
5. Consolidation
6. Remodeling
What are sx of ductal ectasia
multicolor sticky nipple discharge
burning, itching and pain around nipple
swelling in areola area
What are the manifestations of Malignant Melanoma
Asymmetry
Border is irregular
Color is irregular
Diameter is greater than 5 mm
Evolving appearance
Often brown or black
What is the nursing care for status epilepticus?
- maintain patent airway
- protect the patient's head, turn the patient to the side
- loosen constrictive clothing
- do not restrain
- do not place anything in their mouth
- Obtain IV access/administer IV meds
- time seizure and note what it looks like
-Ensure bed is locked
- Suction as needed
- Monitor VS
- give dextrose if low gluc
- neuro checks
- Help reorient
How would you treat a patient with a positive Chvosteks sign and disorientation
Chvostek=Hypocalcemia/ could be decreased PTH
Tx with IV calcium gluconate diluted over 30 min
What is the nursing care for stable vertebral fractures
maintain good alignment
Use halo vest and/or body jacket cast
Use log rollin
Pain management
Explain the primary and secondary survey
Primary: ABCDEFG
Secondary: HI
What does cellulitis look like and how do you treat it?
hot, tender, erythematous, and edematous area with diffuse borders
Treat with broad spectrum abx and warm moist compresses to increase perfusion to the are
What is the difference between ischemic and hemorrhagic stroke treatment
Ischemic: aspirin, TPA, cerebral angiography, merci retriever
Hemorrhagic: Evacuate bleed, clip or coil aneurysm, ligate bleed, permissive HTN
Pre- and Post-op care for trans-sphenoidal approach removing a pituitary adenoma
Pre:
bacitracin nose drops
educate about mouth breathing
educate about avoiding vigorous coughing sneezing, valsalva
Post:
elevate HOB 30 degrees
mouth care q 4
avoid brushing teeth for 10 days
monitor for clear drainage
monitor for HA
What are the hallmark symptoms of Osteomyelitis
Fever, chills,night sweats
Nursing care for Pelvic Inflammatory Disease
VS
document color, amount, odor of vaginal discharge
Increase fluids
semi-fowlers
assess abdomen