question

Myxedema coma

answer

From persistently low thyroid production - coma can be precipitated by acute illness, rapid withdrawal of thyroid meds, anesthesia and surgery, hypothermia, and use of sedatives and opioid analgesics

question

Sx of myxedema coma

answer

gen puffiness around eyes and face - alopecia - bradycardia - potential for respiratory difficulty - obesity, wt gain - dec perception stimuli

question

hydrochlorothiazide

answer

potassium-sparing diuretic - use with caution for pts with DM or taking lithium or taking ACE inhibitors - watch for hyperkalemia, n/v, diarrhea, abdominal cramps, tachycardia followed by bradycardia, tall peaked T waves, oliguria - avoid exposure direct sunlight - sulfa-based med

question

Promethazine

answer

antiemetic, causes constipation, urinary rtn, dry mouth

question

When is child ready for potty training?

answer

parents have time off, diapers dry when wake up from nap, child loves to dress and undress self - fine motor skills pull clothing up and down

question

olanzapine

answer

atypical antipsychotic

question

thoracentesis

answer

SE: pulmonary edema, hypoxia, hemothorax, pneumothorax, subcutaneous emphysema, spleen and liver puncture, blood sputum, SOB

question

intravenous pyelogram (IVP)

answer

x-ray visualization of kidneys, ureters, and bladder - during injection, may feel burning or salty taste - skin may become flushed - x-rays taken at interval after dye injection - check allergies to shellfish or iodine, chocolate, eggs, milk, eggs

question

early stage alzheimer's sx

answer

recent memory loss and changes in motor activity, such as pacing, wandering, and agitation

question

Prostate risk factors

answer

- age (found in men over 50) - race: African Ams more affected than any other group - employment: exposure to carcinogens

question

Ventricular tachycardia treated with what med

answer

Lidocaine - antiarrhythmic - indicates severe myocardial irritability and causes chest pain, dizziness, and fainting

question

how many mL in an ounce

answer

30ml/1 oz

question

how fast will labor progress for first time mother

answer

first time mom progress should be 1-1.2cm per hour

question

Friedman curve

answer

identify whether a woman's cervical dilation is progressing at the expected rate

question

How to determine HR from EKG?

answer

To determine the heart rate for a regular rhythm, count the number of small boxes between two R waves; 1,500 divided by the number of boxes between two R waves equals the heart rate.

question

phlebitis

answer

inflammation of vein - Sx: heat, redness, tenderness at site, not swollen or hard, IV infusion sluggish - can cause thrombophlebitis - apply moist, warm compresses

question

DKA sx

answer

- to compensate for acidosis, hyperpnea with kussmaul's respiration occurs as lungs attempt to exhale the excess CO2 - blood glucose greater than 300 - increasing lethargy, dec LOC - monitor potassium level closely when giving IV insulin --> may need potassium replacement

question

pneumothorax sx

answer

- absent breath sounds on affected side - cyanosis -decreased chest expansion unilaterally - dyspnea - hypotension - sharp chest pain - subcutaneous emphysema - crepitus on palpation - sucking sound with open chest wound - tachycrdia - tachypnea - tracheal deviation to unaffected side with tension pneumothorax

question

Risperdone

answer

antipsychotic - sleep disturbances, abnormal dreams, insomnia, oversedation, photosensitivity, impaired temp reg, high risk orthostatic hypotension

question

What to do when someone having PTSD flashback

answer

Make envir quiet and keep distance until the person is less upset

question

laminectomy

answer

excision part of vertebrae (lamina) to remove the disk

question

why is propanolol bad for COPDers

answer

Beta-blockers block beta adrenergic impulses to bronchial tree that cause bronchodilation resulting in inc bronchoconstriction

question

probably pregnancy signs

answer

pos preg test uterine enlargement, souffle and contractions,pos urine preg test, hegar's sign, chadwick's sign

question

positive sign preg

answer

palpation fetal movement, sonogram fetus

question

presumptive sign preg

answer

felt by woman, such as n/v, breast sensitivity, fatigue, quickening

question

variable decels indicates what?

answer

umbilical cord occlusion that needs to be resolved

question

Stridor

answer

harsh, high-pitched noises on inspiration - indicates upper airway obstruction

question

inspection of anterior chest includes

answer

shape and configuration of the chest, facial expression, level of consciousness, color and condition of skin, and quality of respirations

question

dumping syndrome sx

answer

- Rapid emptying of the gastric contents into the small intestine, which occurs following gastric resection. - sx occuring 30 mins after eating - n/v, feelings abdom fullness and cramping - palpitations and tachycardia, perspiration - weakness and dizziness - loud gurgles indicating hyperperistalsis (Barborygmi)

question

Diet to prevent dumping syndrome

answer

- avoid sugar, salt, milk - eat high protein, high-fat, low-carb diet - lie down after meals - take antispasmodic meds to delay gastric emptying

question

phantom limb pain

answer

occurs after amputation - tingling, itching, and painful sensation where limb used to be - need pain meds

question

Normal Pa02

answer

80-100

question

When does Doll's eye reflex disappear?

answer

2-3 months

question

When do infants begin to drool

answer

about 4 months

question

At what age do children start responding to name?

answer

6-8 months

question

At what age can children pick up bite size pieces of cereal?

answer

11 months

question

Normal digoxin levels in adults?

answer

0.5-2.0 ng/mL

question

Normal lithium levels

answer

1-1.5 mEq/L

question

Therapeutic range Theophylline

answer

10-20 mcg/mL

question

Meniere's syndrome

answer

endolymphatic hydrops - dilation of endolymphatic system by overproduction or decreased reabsorption of endolymphatic fluid - char by tinnitus, unilateral hearing loss, vertigo, n/v, nystagmus, severe headaches - become totally incapacitated after attacks

question

Causes of Meniere's syndrome

answer

- infections - allergic rxns - biochemical disturbances - Vascular disturbances prod changes in microcirc in labyrinth - LT stress

question

neuroleptic malignant syndrome

answer

severe rxn to antipsychotic meds resulting from dopamine blockade in hypothalamus - stop meds, transfer to medical unit, cool body, admin bromocriptine to tx muscle rigidity and dantrolene to reduce muscle spasms

question

Glipizide

answer

oral hypoglycemic that decreases blood sugar by stim insulin release from beta cells in pancreas

question

expected labs from person with adrenocortical insufficiency

answer

- hyponatremia, hypoglycemia, and hyperkalemia

question

SLE side effects

answer

- renal impairment, butterfly rash on face, dry scaly rash on upper part body, anorexia, wt loss, weakness, malaise, fatigue, photosensitivity, joint pain, anemia, positive anti-nuclear antibody test, elevated ESR and c-reactive protein

question

Average head circumference of neonate

answer

32-36cm - increase in size may indicate hydrocephaly or increased intracranial pressure

question

Bell palsy symptoms

answer

1. Flaccid facial muscles 2. Inability to raise the eyebrows, frown, smile, close the eyelids, or puff out the cheeks 3. Upward movement of the eye when attempting to close the eyelid 4. Loss of taste

question

Bell's palsy interventions

answer

1. Encourage facial exercises to prevent the loss of muscle tone (a face sling may be prescribed to prevent stretching of weak muscles). 2. Protect the eyes from dryness and prevent injury. 3. Promote frequent oral care. 4. Instruct the client to chew on the unaffected side. - Protect head from cold or drafts - admin analgesics - assist with electric stimulation - recovery 3-5 wks

question

Root of anxiety

answer

conflict between expressing unacceptable impulses and need to hold onto social approval

question

Colitis diet

answer

high calorie, high protein, low-residue diet

question

why is full bladder necessary for pelvic ultrasound?

answer

serves as window for ultrasound beam transmission and provides less obstructed view by pushing uterus away from pubic symphysis and pushing intestine out of pelvis

question

When person with emphysema becomes restless and confused, what do you do?

answer

encourage client to perform pursed lip breathing

question

Dupuytren contracture

answer

slow progressive contracture of the palmar fascia causing flexion of the fourth and fifth fingers; results from inherited autosomal dominant trait; occurs most often in men over 50 years of age, of Scandinavian or Celtic descent, and is associated with diabetes, gout, arthritis, and alcoholism; age and diagnosis are risk factors

question

Why use z track method?

answer

Z-track method is a variation of standard IM technique for administering medications that are highly irritating to subcutaneous and skin tissues

question

precaution for herpes zoster?

answer

airborne and contact precautions

question

precautions for croup

answer

contact precautions

question

Hantavirus pulmonary syndrome (HPS)

answer

- can get from rodents - early sx: - fever, headache, muscle ache, gi upset, chills, dizziness - late sx: lungs fill with fluid, SOB - look for hematuria, hematemesis, bleeding gums, and melena

question

amitriptyline hydrochloride

answer

antidepressant

question

bromocriptine

answer

antiparkinson's med should be taken with meals

question

detached retina sx

answer

- blurred or "sooty" vision, floaters - sensation particles moving in line of vision - delineated areas of vision blank - feeling of curtain coming up or down - loss of vision

question

detached retina nursing actions

answer

bedrest - don't move forward - affected eye is patched - area of detachment should be in dependent position - avoid jerking head - no hair washing for 1 week - admin sedatives and tranquilizers - avoid strenuous activity for 3 months

question

abnormal blood levels

answer

less than or equal to 9 micrograms/dL

question

sx of hypoglycemia

answer

cool, clammy skin, diaphoresis, nervousness, anxiety, hunger, confusion, headache, slurred speech, coma

question

normal digoxin levels

answer

0.8-2.0 ng/mL

question

Standard precautions

answer

MRS WEE MRSA RSV Skin (scabies, chicken pox, etc), wounds, enteric (C.diff, eyes)

question

Droplet precautions

answer

SPIDERMAN - Scarlet fever, Pertussis, Influenza, Diptheria, Epiglottitis, Rubella, Mumps, Adenovirus, Neisseria meningitis

question

Airborne precautions

answer

"My chicken has TB" - Measles, chicken pox, herpes zoster, TB

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