Acid Base Imbalance
Expected acid base imbalance for a patient with NG tube to suction...
Metabolic alkalosis
Best nursing intervention for measuring effectiveness of diuretic therapy...
DAILY WEIGHT
Which term describes the occurrence where bone marrow activity and white blood cell counts are at their lowest levels after chemotherapy
Nadir
Normal colostomy stoma appearance
Beefy, pink-red
Lactulose...
Does what? How?
Decreases ammonia levels... by removing through stool
SIADH presents with what electrolyte imbalance?
Sick day teaching for diabetics includes educating on the need to....
TAKE INSULIN even with nausea/vomiting/anorexia
Significance of pre-op voiding
An empty bladder prevents involuntary elimination under anesthesia and reduces the risk for urinary retention during the early postoperative recovery.
Expected acid base imbalance for a patient with opioid overdose
Respiratory acidosis
Type of fluid used for fluid resuscitation
ISOTONIC -- Normal Saline
OR LR for burns, GI fluid loss, surgery
Most common manifestation associated with multiple myeloma
BONE PAIN
C-diff precautions
Contact precautions
-Private room
-Clean with bleach
-Soap and water, no alcohol based sanitizers
-May be hospital acquired
Drug anticipated for treatment of ascites... why...
Spironolactone -- patients at risk for hypokalemia due to fluid shifting from changes in osmotic pressure
Exopthalmos -- looks like what? exists with what disease process?
Bulging (dry) eyes -- Grave's disease
Used to manage severe hypoglycemia at home...
1 mg Glucagon IM
Age Related Changes of Immunity
•Decline in immune function
•Reduced number/function of neutrophils
•Delayed response of elevated WBC
•Later diagnosis of infection/sepsis
•Decreased cell-mediated immunity
•Decrease size of the thymus
•Decreased function of T and B cells
•Increased autoantibodies
Expected acid base imbalance for a patient with chronic diarrhea
Metabolic acidosis
Complication of administration of HYPERtonic fluids...
Fluid overload
Underlying problem that causes sick cell crisis...
Hypoxemia -- give oxygen FIRST!
Refeeding syndome
-Who is at risk?
-Clinical manifestations.... following what?
-Malnourished
-Presents as fluid overload following initiation of enteral feedings
Esophageal varicies priorities of care
AIRWAY, VOLUME
Pheochromocytoma -- presents how? avoid what?
With HTN, palpation of the abdomen
REGULAR INSULIN
RICE acronym for inflammation stands for...
Rest, ice, compression, elevation
Expected acid base imbalance for a patient with hyperventilation
Respiratory alkalosis
HYPERvolemia AKA ____________
Manifestations
Fluid volume OVERLOAD
Bounding pulse
Distended neck veins
Crackles in lungs
Hypertension
Tachycardia
Disorientation/confusion
Hodgkins lymphoma specific cells... & manifestations
Reed sternberg cells
PAINLESS inflamed lymph nodes with "B symptoms"
•Fever
•Night sweats
•Weight loss
•Pruritis
•Hepatosplenomegaly
Bowel perforation... clinical manifestation
At risk for...
-Rigid, board-like abdomen
-At risk for peritonitis
Symptomatic cholecystitis - location of pain, treatment, complication with management
RUQ, laparoscopic cholecystectomy, referred shoulder pain -- early ambulation
Myxedema coma is.... what? What is our expected ROUTE for medications? What medication?
Severe hypothyroidism. IV. Levothyroxine.
Lab value indicative of DM diagnosis
Hgb A1C >6.5
Post-mortem care includes:
Placing an absorbent pad under the patient.
Adjusting lighting to dim as appropriate.
Closing the patient's eyes and jaw.
HOB 30 or with pillow beneath head
Removing the patient's jewelry and eye glasses.
Interpret the following ABG:
pH 7.48 HCO3 22 PCO2 28
Respiratory alkalosis
Potassium
Normal range, ECG changes for too little/too much, drug to treat excess, drug to supplement & how to administer
3.5-5
HYPO - u waves, HYPER - peaked T waves
EXCESS - Kayexalate (Polystyrene sulfonate)
DEFICIENCY - IV NO BOLUS, NOT MORE THAN 10 mEq/hour, ORAL - do not crush or chew
FFP tranfusion.. for what abnormal labs? Infusion time?
INR, 30 minutes
This type of ulcer has pain 1-2 hours following meals and may be aggravated by food.
Avoid what types of drugs?
Gastric ulcer
Avoid NSAIDs/ASA
Cirrhosis manifestations
-Pruritis
-Ascites
-Portal hypertension
-Esophageal varices
-Jaundice
-Clay colored stool
-Dark colored urine
Manifestations of hyperthyroidism
Weight loss
Heat intolerance
Tachycardia/palpitations
Goal of diabetic medical management is ___________ to prevent chronic complications.
Tight glycemic control.
Surgical complication manifested by muscle rigidity and hyperthemia. Adverse effect of this drug.
Malignant hyperthermia.
Succinylcholine