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Stages of grief
- Denial
- Anger
- Barganing
- Depression
- Acceptance
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Calcium normal range
- 8.5-10.5
- < 8.5 = Trousseau's sign (BP cuff, arm spasm)
- < 8.5 = Chvostek's sign (facial tap -> twitch)
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indicates kidney function
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indicates kidney function
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ABGs
- pH - 7.35 to 7.45
- PCO2 - 35 to 45
- HCO3 - 22-26
- (release excess CO2 by hyperventilating, retain CO2 by hypoventilating)
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PT, PTT, INR
- PT and INR are for coumadin
- PTT is for heparin
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calcium and phosphate relationship
calcium and phosphate have an inverse relationship
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Foods high in potassium
- green leafy veggies
- OJ
- bananas
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How to administer insulin?
- Insulin - 90 degrees
- (other SQ at 45 degrees)
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Mandatory reporting for:
- Child abuse
- Elder abuse
- Disabled abuse
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Cannot delegate to UAs:
- Assessment/evaluation
- Teaching
- Invasive/sterile procedure
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Cannot delegate to LPNs:
- Assessment
- Planning
- Teaching
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Antidote for narcotic-induced respiratory suppression:
- Narcan
- 0.1mg-0.4mg over 2-3 minutes
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cytomegalovirus (CMV)
- a tretrogenic infection that HIV patients are prone to
- pregnant nurses may choose not to care for those patients
- (also prone to pneumonia, TB, meningitis, Karposki's sarcomas)
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Antivirals to treat HIV
- AZT
- Epivir
- Viramune
- Viracept
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Flow rate of an IV
- (Volume to be infused) x (drop factor)
- (time in minutes)
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ROME
respiratory opposite, metabolic equal
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Respiratory acid/alka
- respiratory acidosis - COPD, resp depression
- respiratory alkalosis - caused by hyperventilation
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Metabolic acid/alka
- metabolic acidosis - Ketoacidosis
- metabolic alkalosis - vomiting, burns
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Stages of shock
- Initial - agitation, hypoxemia
- Compensatory - decreased cardiac output -> decreased urinary output
- Progressive - low BP, weak pulse
- Irreversible - lower BP, organ failure
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Positions for shock
- High Fowlers: cardiogenic and pulmonary edema
- modified Trendelenburg: hypovolemic, vasogenic, septic
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Vasopressors and vasodilators
Vasopressors and vasodilators require weaning
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DIC
- shock -> widespread clotting -> widespread hemorrhage
- D-Dimer test
- treat with Heparin infusion
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Acute respiratory distress syndrome (ARDS)
- alveoli filled with fluid; lungs have O2, but can't use it d/t no gas exchange
- treat with PEEP
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Normal ECG
- QRS complex <0.11 seconds (ventricular depolarization)
- ST segment (ventricular repolarization)
- PR interval 0.12-0.2 seconds (impulse travels through SA node)
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Lung sounds
- crackles = rice crispies
- rhonchi = course
- wheezing
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COPD
- chronic bronchitis: cyanosis, low CO2, crackles/rhonchi/exp wheezes
- emphysema: barrel chest; pursed-lip breather; can get air in, can't get it out; quiet breath sounds or wheezes
- compensatory polycythemia
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Crepidus aka subcutaneous emphysema
- crackling sensation around chest tube insertaion site
- small amount is normal, mark with sharpie
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Dysphagia
difficulty swallowing
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TB drugs
- Isoniazid (INH therapy)
- Rifampin
- (liver toxicity)
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Lung lobes
- 2 left lobes
- 3 right lobes ~ right side of heart has the tricuspid valve
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Acute renal failure
- oliguric phase
- diruetic phase
- monitor K, Na, BUN, creatinine and weight
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Digoxin toxicity
- visual disturbances, N/V, arrhythmias, HR <60bpm
- esp. in kidney pts
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Stages of chronic kidney disease
- early - polyuria
- late - oliguria, hematuria, proneinuria
- end - anuria
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Treatment for chest pain
- M.O.N.A.
- morphine
- oxygen
- nitrates (HA, HOTN)
- aspirin
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