NUR 112 Spring '12 1st 8 weeks

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  1. What causes appendicitis?
    obstruction in the lumen
  2. Why is it important to not give pain medications to someone who c/o abd pain that may be r/t appendicitis?
    administering pain meds will mask sxms, increased abd pain is sxm of appendicitis
  3. Why should we treat appendicitis quickly?
    risk for peritonitis
  4. Who gives report to PACU nurse after surgery?
    circulating nurse
  5. Who suprvises, confirms, and records final sponge and instrument count after surgery?
    circulating nurse
  6. Why should pts ambulate post-op?
    prevent complications such as DVT
  7. Define paralytic ileus
    absence of bowel sounds
  8. How do you correctly use a spirometer?
    inhale slowly, deeply, and hold
  9. Describe a wound healing by primary intention.
    incision made by surgeon and it is well approximated
  10. Describe a wound healing by secondary intention.
    not well approximated; needs more tissue replacement, often contaminated, and takes longer time to heal
  11. Describe a wound healing by tertiary intention.
    intentionally left open to promote healing, prevent infection; a delayed primary intention
  12. Dry mucous membranes, increased RR, flattened neck veins, increased HR and decreased BP are signs that a pt has too much of which electrolyte?
    Na+; s/s of hypernatremia
  13. Peripheral edema and neck vein distention are signs that a patient is deficient in which electrolyte?
    Na+; s/s hyponatremia
  14. Normal sodium level is _____.
  15. Normal potassium level is _____.
  16. What sxms do you expect to see with hypokalemia?
    muscle wekness; weak/thready pulse, shallow respirations, leg cramps
  17. What sxms do you expect to see with hyperkalemia?
    irregular/slow HR; peaked T waves, muscle cramps
  18. Too much _____ will cause muscle cramps and irregular/slow HR.
  19. What can you give to lower potassium level in a pt with hyperkalemia?
    kayexalate; calcium gluconate; IV insulin
  20. Normal phosphate level is _____.
  21. Normal calcium level is _____.
  22. Normal magnesium level is _____.
  23. Which electrolyte excess manifest flabby muscles?
  24. Which electrolyte deficit manifests Chovstek's or Trousseau's?
  25. Normal PCO2 is ____.
  26. Normal PO2 is ____.
  27. Normal HCO3 is ____.
  28. If a pt has metabolic acidosis, how will his breathing pattern be to compensate for excess acids?
    Kussmaul (deep rapid breathing)
  29. CNS depression is a symptom exhibited in pts who have what kind of ABB imbalance?
    metabolic acidosis
  30. If a pt is vomiting, had gastric suction, has peptic ulcers, and blood pH >7.35, which ABB imbalance pt exhbiting?
    Metabloic Alkalosis; vomiting=losing H+ ions!
  31. Which oxygen delivery method deilvers 20-40% O2 concentration?
    Nasal Cannula
  32. Which O2 delivery method delivers 40-60% O2 concentration?
    Simple Face mask
  33. Which O2 delivery method delivers most precise O2 concentration?
    Venturi Mask
  34. Which O2 delivery method has a one way valve?
    Nonrebreather mask; prevents room air from entering mask
  35. Which O2 delivery method requires nurse to frequently empty condensation from tubing?
    Aerosal Mask/Face Tent/Tracheostomy
  36. Where is air warmed, filtered, and humidified?
  37. What are the functional units of the lung?
  38. Which bronichi is aspiration more likely to occur and why?
    Right d/t shorter, straighter, and wider structure.
  39. What is the name of a lung disease that involves damage to alveoli so that they can't completely deflate and fill with fresh air?
  40. What is a classic sxm of pt with emphysema?
    Pink puffer
  41. What is classic sxm of pt with chronic bronchitis?
    "blue bloater"; barrel chest
  42. How can you be sure that someone has pulmonary edema?
    pink, frothy sputum
  43. What is RSV?
    Respiratory syncytial virus; pt wheezes, has deeper cough, and labored breathing.
  44. What is a COPD pt's drive to breathe?
    increased CO2
  45. What can happen if we give too much oxygen given to a pt with COPD?
    compromise drive to breathe; COPD drive to breathe = increased CO2
  46. Coryza, Malaise, Fever, Cough characterizes (FLU/PNEUMONIA/COLD).
  47. Thyrotoxicosis is a sign of _____.
  48. Myxedema is a sign of _____.
  49. Grave's disease is associated with _____.
    hyperthyroidism; excessive output of thyroid hormones caused by abnormal stimulation of thyroid gland by circulating immunoglobulins
  50. Constantly flushed skin, cannot sit still, palpitations, rapid pulse at rst, prespire freely are signs of which thyroid condition?
  51. Brittle nails, extreme fatigue, hair loss, numbness/tingling of fingers are signs of which thyroid disorder?
  52. Fine tremor of hands, increased appetite, progressive weight loss are signs of what thyroid disorder?
  53. How do you restore consciousness if myxedema progresses to myxedema coma?
    synthroid IV
  54. What kind of diet is a pt with hyperthyroidism on?
    high calorie-high protein
  55. Chronic thyroiditis is also known as _____
    Hashimoto's disease
  56. After a thyroidectomy, what is always kept at the bedside?
    tracheostomy set; edema of glottis my occur leading to resp. difficulty
  57. What should pt with a thyroidectomy order avoid consuming?
    coffee; stimulants like caffeine
  58. Hypoparathyroidism exhibits what sxms?
    tetany, Trousseau's, Chvostek's; rationale: PTH controls release of Ca+, therefore a deficiency of PTH means also deficiency of Ca+
  59. What BMI range is considered overweight?
  60. Where is glucose stored in pts with TYpe 1 DM?
    stays in blood stream, cannot be stored in liver d/t lack of insulin
  61. Are ketones more prevelant in Type 1 DM or Type 2 DM?
    Type 1; rationale: no insulin to inhibit breakdown of fat. Ketones are byproducts of fat breakdown.
  62. Which pt are you more likely to see obesity/weight gain? Type 1 or Type 2 DM?
    Type 2 DM
  63. What 3 factors are dx DM?
    FPG >=126; casual plasma glucose >200; OGTT: >=200
  64. What percentage of carbs consumed are converted to glucose?
  65. A patient with DM should not exercise if what two factors are present?
    ketones in urine; BS >250
  66. pts with IDDM are advised to do what before exercising?
    Check BS, eat 15 g carb snack to prevent hypoglycemia
  67. Onset, Peak, Duration of Rapid Acting Insulin
    Onset = 5-15 minutes; Peak=30 min-1 hour; Duration=2-4 hours
  68. What is the onset of rapid acting insulin?
    5-15 minutes
  69. What action does sulfonylureas & meglitinides have on DM Type II pts?
    increases secretion of insulin by beta cells
  70. What action do biguanides have on DM pts?
    increases body tissues' sensitivity to insulin, inhibits glucose prod by liver
  71. Upon observation of an intermediate insulin vial, how do you know when it should not be used?
    if it has a frothy, white coating then it should not be used
  72. What drug is used to prevent DM or slow destruction of beta cells?
  73. How do you treat a pt experiencing Somogyi phenomenon?
    Decrease insulin level, give bedtime snack
  74. How do you treat dawn phenomenon?
    change evening dose of insulin; give it later so it will peak later
  75. What happens in the final stage of diabetic retinopathy?
    blood vessels velop on surface of eye in vitrious, retinal detachment may occur
  76. What is Cullen's sign?
    periumbilical bruising
  77. What is Grey Turner's sign?
    bruising of the flanks
  78. How is acute pancreatitis dx?
    serum amylase >500; elevated urinary amylase; elevated serum lipase level; WBC, serum glucose, BUN, and LDH elevated; bulky pale foul smelling stool
  79. Why are pts with acute pancreatitis at risk for skin breakdown?
    poor nutrition
  80. What do alpha cells secrete?
  81. What do beta cells secrete?
  82. What are the 4 stages of carcinogenesis?
    1. Initiation 2. Promotion 3. Progression 4. Metastasis
  83. What stage of CA do carcinogens damage the cell's DNA and genes?
  84. All CA cells are a threat. (True/False)
    False. Only CA cells that can divide are a threat.
  85. In what stage do carcinogenesis mutate a cell's genes?
  86. In what stage of oncogenesis is the growth of the CA cell enhanced?
  87. In what stage of carcinogenesis does a tumor produce TAF?
  88. What is TAF?
    tumor angiogenesis factor; blood vessels branch into tumor to give it nutrition
  89. In what stage of CA development does CA cells spread to other parts of body?
  90. What are secondary tumors?
    aka metastatic tumors; break off from primary cell and end up in another area of body (i.e. lung cell found in uterus)
  91. What is grading?
    compares CA cell with parent tissue; how close does it resemble the parent cell?
  92. What is staging?
    determines exact location of CA and its degree of metastasis at dx.
  93. What is carcinoma in situ?
    early stage CA cells that has not spread to neighboring tissues
  94. What does a TIS, N0, M0 staging of CA mean?
    TIS=carcinoma in situ (has not spread to neighboring tissue); N0=did not spread to lymph nodes; M0=no metastasis
  95. What does a T4, N3, M1 staging of CA mean?
    larger size, involes lymph nodes, has spread
  96. What is the exposure of radiation?
    amount of radiation delivered to a tissue
  97. What is the dose of radiation?
    amount of radiation absorbed by tissue
  98. What 3 factors determine absorbed dose of radiation?
    intensity, duration, and closeness of exposure
  99. What is xerostomia?
    dry mouth
  100. Which CA therapy is systemic?
  101. Which CA therapy is localized?
    radiation, surgery
  102. What is thrombocytopenia?
    low platelet count ----> @ risk for bleeding
  103. What is NPPV mask?
    noninvasive positive pressure ventilation
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NUR 112 Spring '12 1st 8 weeks
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