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PULSE DEFICIT
diff between apical & radial pulse
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ORTHOSTATIC BP
BP drops 10+ when you get up
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PETECHIAE
small purple, red spots
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BRONCIAL SOUNDS
high pitched
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BRONCHIAL VESICULAR SOUNDS
blowing
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PRECORDIUM
over heart and lower thorax
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BRUITS
abnormal sounds heard over a BV as blood passes an obstruction
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THORACENTESIS
puncturing of chest wall to aspirate pleural fluid
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CORTICOSTEROIDS
reduce inflammation
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BIOTERRORISM
intentional spread of infection
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SHOCK
body's reaction to decrease in Blood Volume
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NEGATIVE NITROGEN IMBALANCE
results in muscle wasting due to cancer, anorexia, etc.
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ISOTONIC
active movement, running
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ISOMETRIC
no change in muscle length
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ISOKINETIC
muscle contraction with active resistance
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ISCHEMIA
deficiency of blood to particular area
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BODY TEMP
controlled by hypothalamus, axillary- 96.7, rectal- 99.6, oral- 98.6
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ORTHOPNEA
dyspnea when laying down
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CHEYNE STOKES
gradual increase, followed by decrease followed by apnea.
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KUSSMAUL BREATHING
rapid deep breathing
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BIOT'S RESPIRATIONS
CNS disorder, respirations are faster and deeper than normal, interspread with abrupt pauses
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BORBORYGMI
normal hyperactive bowel sounds (stomach growling)
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PARALYTIC ILEUS
intestinal muscle paralysis, causing blockage
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ACETYLCYSTEINE
reduces thickness of mucus; 1. Mucomyst 2. Parvolex 3. acetadote- for Tylenol (acetaminophen) Over dose
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CARDIOVASCULAR MEDS (HEART FAILURE)
- 1. increase contractility (inotrophic agents; Digoxin, Dopamine)
- 2. Reduce preload- Diuretics, vasodilators (Nitrates)
- 3. Reduce Afterload- vasodilators; ACE inhibitors, Calcium Channel Blockers.
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DRY POWDER INHALANTS
activated by Pts inspiration
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METERED DOSE INHALERS
controlled dose of meds with each compression
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NEBULIZERS
disperse fine particles of meds deeper into passages of respiratory tract where absorption occurs
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SINGULAIR (Montelukast)
- anti-inflammatory
- -treats difficulty breathing, asthma
- -can cause h/a, dizziness, heartburn
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ACCOLATE (Zafirlukast)
- -bronchodilator
- -used to prevent asthma attacks
- -h/a, dizziness, n & v
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PROVENTIL (Albuteral)
- -bronchodilator
- - for wheezing, COPD
- -200-400 mcg q 4-6 hrs
- may cause tremors, anxiety, insomnia, tachycardia
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LONG-ACTING BETA 2 AGONISTS
- 1. salmenterol
- 2. formoterol
- for asthma, prevent bronchospasms
- dry powder inhaler, 1 inhalation BID
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ALPHA-ADRENERGIC INHIBITORS
anti-hypertensives
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ANGIOTENSIN-CONVERTING ENZYME INHIBITORS
- Vasodilation, anti-hypertensives
- 1. benazePHRIL
- 2. enanaPHRIL
- 3. captoPHRIL
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ANGIOTENSIN II RECEPTOR BLOCKERS (ARB's)
antihypertensives
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BETA-ADRENERGIC BLOCKER
- antihypertensive, also treats abnormal heart rhythms.
- atenoLOL
- timoLOL
- propramoLOL
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CALCIUM CHANNEL BLOCKERS
- antihypertensive
- verapamil
- diltiazem
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DIURETICS
- antihypertension
- rid body of salt and water
- bumetanide
- furosemide
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INOTROPIC AGENTS
- increase force of cardiac contractions
- Digoxin
- dopamine
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ALUPENT (Metaproterenol)
- Bronchodilator (treats asthma)
- .65 mg per inhaltion
- may cause tremors, dizziness, weakness
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SLO-BID (theophylline, theodur)
- bronchodilator
- may cause N&V, tachycardia, irritability
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CROMOLYN (Initial)
- anti-inflammatory, treats asthma, prevents bronchospasms.
- 5 y.o + 2 oral inhalations (1.6-2 mg) QID @ 4-6 hr intervals
- may cause cough, nausea, nasal stinging.
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RESTORIL (Temazepan)
- sedative-hypnotic
- treats insomnia
- 7.5-30 mg PO @ HS
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AMBIEN (Zolpidem)
- sedative-hypnotic
- treats insomnia
- 10 mg @ HS
- mas cause Ataxia (lack of coordination), depression, hypersenitivity
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ATIVAN (Lorazepam)
- sedative-hypnotic
- treats anxiety
- .5-2mg PO q 6-8 hrs. 1-4mg PO @ HS PRN
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DALMANE (Flurazepan)
- sedative-hypnotic
- treats insomnia
- 15-30mg PO @ HS
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HYPOXIA
- low oxygen in cells
- can cause confusion, anxiety
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HYPOXEMIA
low oxygen in the blood
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PARAPLEGIA
paralysis of legs
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QUADRIPLIGIA
paralysis of arms and legs
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HEMIPLEGIA
paralysis of one half of the body
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PURULENT DRAINAGE
foul smelling gray drainage is a sign of infection
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PENROSE DRAIN
open drainage system
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MACERATION
- wound overhydration, excessive moisture.
- when cleaning would avoid touching wound bed with forceps or gloves.
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PARASOMNIAS
- Waking behavior during sleep
- sleep walking (somnambulism)
- enuresis (urinating)
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DYSSOMNIAS
- insomnia
- sleep apnea
- RLS (restless leg syndrome)
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HOW MANY HOURS OF SLEEP DO INFANTS NEED?
14-20 hrs
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NREM
- 1. transition from wake to sleep
- 2. light sleep
- 3. deeper sleep
- 4. DELTA sleep (BP & pulse decrease)
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MEDS THAT MAY CAUSE INSOMNIA
Alcohol, anticonvulsants, bronchodilators, MAO inhibitors, caffiene, cocaine
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PRIMARY LESIONS
macule (freckle), patch (vitiligo), papule (mole), plaque, nodule (wart), tumor, wheal (hive)
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VARIOUS METHODS OF ADMINISTERING OXYGEN
- nasal cannula (1-6 L/min)
- mask (5-8 L/min)
- Venturi mask
- parial rebreathing mask
- nonrebreathing mask
- ventilator
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NURSING INTERVENTIONS FOR IMMOBILE Pts.
- re-position frequently
- SCD's
- ROM excercises
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CYANOSIS
blue appeance of skin
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FLUID FILLED LESIONS
bulla (2nd degree burn), vesicle (herpes simplex), postule (acne)
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SECONDARY LESIONS
- result from changes in primary lesions
- erosion- loss of superficial epi
- ulcer- loss of epi and dermis
- fissure- deep linear crack
- crust- dried residue from pus or blood
- scale- dandruff, dry skin
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TREATMENT FOR STAGE 1 & 2 ULCERS
- apply A & D w/transparent dressing (OP site, tagaderm)
- may use hydrocolloid dressing (duoderm)
- hydrogel dressing (if low to moderate exudate)
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TREATMENT FOR STAGE 3 & 4 ULCERS
- clean wound w/wound cleanser
- for wounds with moderate to heavy drainage apply Calcium Algenate (packed loosely)
- Debridement for necrosis- enzymatic, mechanical, autolytic
- cover w/island dressing
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TEN- TOXIC EPIDERMAL NECROSIS or STEVENS-JOHNSON SYNDROME
- reaction to meds (antibiotics, NSAIDs)
- conjunctival burning or itching, may shed much of the dermis.
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PRESSURE ULCER RISK FACTORS
age, mobility, nutrition, incontinence
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