rex-P1 Flashcards

Question

what is heparin measured with, what is its therapeutic range and what is the antidote?

Answer 1

aPTT 1.5-2.0x normal control value protamine sulfate

Answer 2

PT/INR 1.5-2.0 x normal control range vitamin K

Answer 3

70-100mmHg -anything below 60 organs are becoming ischemic

Answer 4

Acute kidney injury -sudden renal damage-causes a build up of waste, fluid, electrolyte imbalance. Can be reversed. -prerenal, post renal, intrarenal -onset: the cause -oliguric: urine output <400ml/24hrs, glomerulus decreases its ability to filter blood --low protein diet, limit fluids, strict I&O and daily weights, monitor EKG, watch for hyperkalemia, increased BUN and creatinine -diuretic: cause of AKI is corrected gradual increase in urinary output -large amounts of dilute and electrolytes, watch pt, for hypokalemia and dehydration. -recovery: increase in kidney function (can take 6-12 months)

Answer 5

-damage before the kidneys -decreased perfusion to the kidneys -causes: cardiac damage, MI, decreased cardiac output, vasodilation, hemorrhage (hypovolemia), burns, GI losses

Answer 6

-damage after the kidneys -blockage or obstruction in the urinary tract -causes: renal calculi (stones), blood clots, BPH, tumours, neurological damage (stroke)

Answer 7

-damage in the kidneys -prolonged ischemia -myoglobinuria, hemoglobinuria, rhabdomyolysis, nephrotic drugs (NSAIDS, antibiotics, chemo, contrast dyes) -infections (glomerularnephritis)

Answer 8

-inflammatory response in the glomerulus, damage to the membrane and loss of protein (albumin) -hypoalbuminemia causes: synthesis of cholesterol and triglycerides (hyperlipidemia), fluid shift (generalized edema), possible blood clots (thrombosis) and risk of infection *albumin naturally prevents clot formation and fights infection* -causes: bacterial or viral infection, cancer, genetic predisposition, systemic disease, NSAIDs -symptoms: hypoalbumenia, hperlipidemia, proteinuria >3 g/day

Answer 9

-monitor fluid, weight, abdominal circumference -decrease cholesterol, and saturated fats, sodium -moderate protein intake -monitor for infection and blood clots

Answer 10

-progressive and irreversible loss of kidney function-occurs over time -causes: untreated AKI, diabetes, hypertension, family history, recurrent infections, autoimmune disorders -5 stages -stage 1 >90 GFR -stage 5 <15 GFR s&s (everything is affected at some point) -decreased urine output -altered LOC -hypertension, hypervolemia -anorexia -impaired immune -anemia (decreased erythropoietin) -uremic frost treatment: dialysis and kidney transplant

Answer 11

lower -urethritis (infection urethra) -cystitis (infection in bladder) upper -ureteritis (infection ureter) -pyelonephritis (infection in kidney)

Answer 12

-stones in the kidneys -stones in the ureter types: calcium (oxalate and calcium), uric acid (acidic urine), struvite (bacteria), cystine (genetic) s&s -pain -hematuria -pyuria -vomitting diagnose -x-ray -ultrasound -intravenous pyelogram treatment -shock wave (non invasive) -percutaneous nephrolithotomy (invasive-incision made through the back)

Answer 13

-decreased LOC -lungs sounds wet (due to back flow) -shortness of breath -skin cold and clammy -decreased urine output -weak peripheral pulses

Answer 14

preload: amount of blood returned to the right side of the heart at the end of diastole afterload: pressure that the left ventricle has to pump against (systolic blood pressure)

Answer 15

S1 tricuspid and mitral valves closing S2 aortic and pulmonic valve closing systole: ventricle ejection S1 (heart contracting) diastole: ventricle filling S2 (heart resting/filling)

Answer 16

S3 early diastole in rapid ventricle filling S4 late diastole and high atrial pressure (forcing blood into a stiff ventricle)

Answer 17

-fluid is backing up into the lungs (pulmonary symptoms) -dyspnea -crackles -orthopnea -weakness -increased HR -cough with frothy blood tinged sputum -gaining weight (2-3lbs daily) -hypotension -s3

Answer 18

-fluid is backing up into the venous system -weight gain -edema (pitting) -large neck veins (JVD) -lethargy -irregular heart beat -nocturia -ascites (abdominal girth increased) -enlarged spleen and liver

Answer 19

weakened heart muscle -the ventricle does not eject properly

Answer 20

stiff and non compliant heart muscle -the ventricle does not fill properly

Answer 21

-BNP: b-type natriuretic peptide -secreted when there is increased pressure in the ventricle -Chest X-ray -enlarged heart/pulmonary infiltrates -Echocardiogram -looks at ejection fraction, back flow, and valve problems (decreased EF in HF usually)

Answer 22

-Monitor strict I&O, daily weights and oedema -Reduce sodium, restrict fluid, reduce fat and cholesterol -Elevate HOB -Report weight gain over 2-3lbs, and edema (signs of fluid retention)

Answer 23

-fatty plaques develop (atherosclerosis) and restrict blood flow to the heart -s&s: ischemia, angina pectoris, chest pain with activity, shortness of breath, fatigue -diagnose: blood test for lipoprotein profile -ECG treatment: physical activity, lipid lowering medication, coronary stent, CABG

Answer 24

LDL: BAD-want low levels HDL: GOOD-want high levels

Answer 25

-deoxygenated blood can't get back to the heart -oxygenated blood pools in the extremities -dull, achy pain -non palpable (edema) -edema -warm skin -brown/yellow skin -irregular shaped wounds Dx. with doppler ultrasound and ankle brachial index -elevate veins -aspirin -statins -angioplasty, CABG, endarterectomy

Answer 26

-narrow artery (atherosclerosis) where oxygenated blood can't get to the extremities -causes schema and necrosis -sharp pain-worst at night -absent pulse -cool extremities -pale, hairless, dry, scaly skin -gangrene -dangle arteries -no tight clothes -no heating pads -medications: vasodilators and antiplatelets

Answer 27

stable -predictable, occurs with exertion -increases heart demand for oxygen unstable -preinfarction -occurs at rest and more frequently prinzmetals/variant -cornorary artery vasospasm -pain at rest with reversible ST-elevation

Answer 28

-chest pain (radiating) -unusual fatigue -weakness -shortness of breath -pallor -diaphoresis goal: decrease oxygen demand -PCI -CABG -drug therapy

Answer 29

-complete blockage in one or more arteries of the heart -cornorary arteries become narrowed due to plaque (atherosclerosis)-----angina (due to ischemia)-----myocardial infarction (plaque rupture becomes a blood clot that blocks arteries to the heart) s&s -sudden, crushing, radiating chest pain -shortness of breath -nausea -sweating -pain felt in left arm and mid back diagnoses ECG -ST-elevation (no 02) -ST depression (low 02) -troponin -stress test

Answer 30

immediate -morphine (decrease workload of the heart and pain -oxygen -nitroglycerin (open blood vessels) -aspirin (prevent platelets from sticking together) Cath lab or clot buster -medications (clot buster) strepokinase -PCI or CABG or endarterectomy prevention and rest -prevent further clots and stabilize the clot (heparin IV) -rest the heart: nitro, beta-blockers, CCB

Answer 31

protein released in the blood stream when the heart muscle is damaged -best indicator of an acute MI -can remain elevated for 3 weeks -range: 0-0.4 (>0.4+ MI)

Answer 32

creatine kinase-MB an enzyme that released in the bloodstream when the heart, muscles or brains are damaged -cardiac specific isoenzyme -range 0-5 (peak 24 hrs)

Answer 33

found in cardiac and skeletal muscles -not a specific indicator of an acute MI, and a (-) sign is good to rule out an MI -range: 5-70 (peak 12 hrs)

Answer 34

brain natriuretic peptide -a peptide released when the ventricle is filled with too much fluid and stretches -indicated heart failure -range:<100 -severe HF: >700

Answer 35

-cell metabolism -transition of nerve cells, cardiac, lung and muscle cells -acid-base balance

Answer 36

Potassium can cause cardiac dysrythmias-life threatening!!! NEVER push potassium (always dilute) tight and contracted -muscle cramps, weakness -urine abnormalities -respiratory distree -decreased cardiac contractility (low HR, BP) -ECG changes (Tall T wave, widened QRS, prolonged PR intervals) -increased reflexes

Answer 37

Potassium can cause cardiac dysrythmias-life threatening!!! NEVER push potassium (always dilute) -thready, weak, irregular pulse -orthostatic hypotension -shallow rest -anxiety -constipation -ECG changes (ST depression, shallow T wave, prominent U wave)

Answer 38

-in cells, bones and teeth -needed for cardiovascular, neuromuscular and endocrine systems -blood clotting

Answer 39

-bone pain -arrhythmias -cardiac arrest -kidney stone -muscle weakness (decreased reflex) -excessive urination

Answer 40

-convulsions -arrhythmias -tetany -spasm and stridor -numbess -positive trousseaus -chvosteks signs

Answer 41

sodium K+ + NA=opposite

Answer 42

phosphate CA + PO=inverse

Answer 43

-found in bones -regulates BP, blood sugar and muscle/nerve contraction

Answer 44

sedated -low energy -low HR -low BP -decreased bowel sounds -decreased reflexes

Answer 45

not sedated -high HR -High BP -increased reflexes -shallow resp -twitches -tetany and seizures -irritability and confusion -positive trousseaus -chvosteks signs

Answer 46

calcium CA+ Mg=the same

Answer 47

-major electrolyte -essential for acid-base, fluid balance, irritability and conduction of nerve-muscle tissues.

Answer 48

-flushed skin -restless, anxious, confused -increased BP and fluid retention -edema -decreased urine output -low grade fever -thrist

Answer 49

hypovolemic hyponatremia (decreased fluid and sodium) -stupor -anorexia -lethargy -tachycardia hypervolemic hyponatremia (increased body water that is greater than Na+) -limp muscle -orthostatic hypotension -seizure -stomach cramping

Answer 50

ABC Airway Breathing Circulation (all priority questions should be answered that way) -then fluid -then nutrition -then shelter

Answer 51

Doning -hand hygiene -gown -mask -goggles -gloves Doffing -gloves -goggles -gown -mask -hand hygiene

Answer 52

-no insulin production -caused by an autoimmune response -cells are starved of glucose (since there's no insulin to bring it into the cell) -cells break down protein and fat into energy causing ketones to build up=acidosis -very abrupt onset treatment -insulin only -dependant for life

Answer 53

-not enough insulin production, or "bad" quality insulin that doesn't work -caused by insulin resistance, obesity, poor diet, adult onset -onset is gradual treatment -diet and exercise -oral hypoglycaemic agents (metformin) -possibly insulin

Answer 54

glucose >115 & HbA1C 6.5 + -polyuria (+urine) -polydipsia (+increased thirst) -polyphagia (+increased hunger)

Answer 55

-complication of type 1 diabetes -not enough insulin-blood sugar becomes very high, cells break down protein/fats for energy, ketones build up, ACIDOSIS s&s -ketosis and acidosis -hypergylcemia -dehydration -kussmaul respirations (blow off CO2) -acid breath treatment -IV insulin

Answer 56

-complication from type 2 diabetes -no acidosis present, simply high amounts of glucose in the blood s&s -hyperglycemia >600+ treatment -fluid replacement -correction of electrolyte imbalance -possible insulin

Answer 57

>200 mg/dL s&s -three ps -hot and dry skin -dry mouth -fruity breath -numbness and tingling -slow wound healing -vision changes causes -sepsis -stress -steroids -skipping meals treatment -insulin -test urine for ketones

Answer 58

<70mg/dL -happens suddenly s&s -cool and clammy skin -sweating -palpitations -fatigue -confusion -headache -shakiness -extreme tiredness causes -exercise -alcohol -peak times of insulin treatment 15x15x15 method -15grams of carbohydrate -recheck in 15 minutes -give another 15 grams of carbohydrates if needed UNCONSIOUS -IV dextrose 50% (D50)

Answer 59

-highest risk for hypoglycemia -lispro (Humalog) -aspart -glulisine -timed with meals onset: 5-30 min peak: 30-90 min

Answer 60

regular insulin -humulin R -Novolin R -timed with meals -onset: 30-60 min -peak: 2-4 hrs only insulin given IV!!!

Answer 61

NPH -Humulin N -Novolin N -not timed with meals -onset: 1-2hrs -peak: 4-12hrs NEVER give IV!!!!!

Answer 62

glargine detemir -lantus -levemir onset: 1-2hrs peak: none lowest risk for hypoglycaemia

Answer 63

mannitol osmitrol -increase the thickness of the filtrate so water can't be reabsorbed -excreation of Na+ and Cl- -to treat cerebral edema -decrease intraocular pressure s&s -edema -blurred vision -nausea, vomiting, diarrhea -urinary retention only administer by IV preform neuro assessments before/after

Answer 64

-spironolactone -aldactone -blocks aldosterone (salt water hormone) -increases urine output -excretion of Na and H2O -for hypertension -edema -hypokalemia -hyperaldosteronism s&s -hyperkalemia -diarrhea -gastritis -ED -gynecomastia don't eat foods high in potassium (risk for hyperkalemia)

Answer 65

furosemide bumetanide toresmide -inhibit reabsorption of Na and Cl- -for hypertension -heart failure -renal disease -edema -pulmonary edema s&s -hypokalemia -hypotension -hyperglycemia -decreased photosensitivity -hyponatremia -dehydration obtain baseline vitals administer furosemide slowly bc it can cause ototoxicity!!!!!

Answer 66

*for the peeps with gout -inhibits reabsorbtion of Na and Cl -excretion of Na, Cl and H2O -increases urine output---decreases blood volume -for hypertension -heart failure -renal disease -cirrohis -edema -corticosteroids -estrogen therapy s&s -hypokalemia -hypotension -hyponatremia -decreased libido -hyperglycemia -dehydration -azotemia avoid giving to pt.s without gout!! -don't use if patient has sulfa allergy!!

Answer 67

excessive production of thyroid hormone causes: -graves disease -too much iodine -toxic nodular goiter -thyroid replacement medication -elevated T3 and T4 -low TSH s&s -hyper-excitable -nervous -irritable -increased appetite -weight loss -hair loss -goiter -hot -increased GI function, pulse, BP -life threatening complication: thyroid storm treatment -anti thyroid medication (methimazole) -beta blockers (decrease HR and BP) -Radioactive thyroid therapy -Thyroidectomy

Answer 68

low production of thyroid hormone -not enough energy causes: -hashimotos disease -not enough iodine -thyroidectomy -anti thyroid medications -pituitary hormone -low T3 and T4 -high TSH s&s -no energy -fatigue -no exppressions -weight gain -cold -ammenorrhea -slurred speech -dry skin -coarse hair -decreased GI function -hypoglycemia -life threatening complication: myxedema coma treatment -hormone replacement (levothyroxine)

Answer 69

high PTH high calcium low phosphorus causes -tumor or hyperplasia of the parathyroid -chronic kidney failure s&s -stones -skeletal pain -abdominal pain/nausea/vomitting -mental irritability and confusion treatment -parathyroidectomy -removal of more than one gland -administer phosphate, calcitonin -increase fibre and calcium

Answer 70

low PTH low calcium high phosphorus causes: -accidental removal of parathyroid (thyroidectomy) -genetic p. -radiation exposure -magnesium depletion s&s -numbness/tingling -muscle cramps -tetany -hypotension -anxiety -positive trousseaus -postive chovsteks treatment -IV calcium -phosphorus binding drugs -diet

Answer 71

disorder of the adrenal cortex -too many steroids causes: -female -overuse of cortisol medication -tumor in the adrenal gland s&s -muscle wasting -moon face -buffalo hip -fat pads -weight gain -hirsutism -increased glucose and sodium -decreased potassium and calcium -hypertension treatment -adrenalectomy -avoid infection -chemo

Answer 72

not enough steroids causes: -surgical removal of adrenal glands -infection to adrenal glands -TB, bacterial infections s&s -fatigue -anorexia -hypotension/hyovolemia -confusion -decreased blood sugar -low sodium and water and high potassium -hyperpigmentation -vitiligo RISK: Addisons crisis: -profiund fatigue -dehydration -renal failure -vascular collapse -hyponatremia -hyperkalemia treatment -adm. glucocorticoid and mineralocorticoid -high protein and high carb diet

Answer 73

Antidiuretic hormone -regulates the amount of water in your blood -pituitary gland (brain)

Answer 74

-hypersecretion of ADH (water retention) often bc of non-endocrine origin -too much ADH--water retention causes: -pulmonary disease -disorders of CNS (tumor, head injury, brain surgery) -HIV -medications: antidepressants, thiazide diuretics, anticonvulsants, antidiabetic drugs, nicotine s&s -LUO -fluid volume overload -weight gain without edema -hypertension -tachycardia -nausea/vomitting -hyponatremia treatment -seizure precaution -elevate HOB -restrict fluid -adm. loop diuretic -adm. vasopressin antagonist

Answer 75

-not enough ADH -loses water causes -head trauma -pituitary manipulation -CNS infections-meningitis -failure of renal tubules to respond to ADH s&s -excretes large amounts of diluted urine -polydipsia -polyuria -dehydration -decreased skin tugor -dry mucous membranes -muscle pain/weakness -headache -tachycardia -low urinary specific gravity treatment -adequate fluids -IV hypotonic saline -ADH replacement (vasopressin or desmopressin) -monitor intake/output -monitor weight

Answer 76

epinephrine norepinephrine

Answer 77

rare tumour on the adrenal gland that secretes excessive amounts of epinephrine and norepinephrine causes: -family history s&s -hypertension -headache -heat -hypermetabolism -hyperglycaemia treatment -adrenalectomy -no smoking, drinking caffeine, changing positions suddenly -adm. anti-hypertensives -diet: high calories, vitamins and minerals

Answer 78

high pitched, crackling sounds -previously deflated airways popping back open -pulmonary edema, asthma, obstructive disease

Answer 79

low pitched, wet bubbling sound -from inhaled air collides with secretion in the trachea or large bronchi -pulmonary edema, penumonia, depressed cough reflex

Answer 80

low pitched, harsh, grating sounds -pleura is inflamed and losing its lubricant -pleuritis

Answer 81

high pitched continuous sounds (more than one sound to be heard) -from air moving through a narrow airway -asthma, bronchitis, chronic emphysema

Answer 82

high pitched whistling or gasping with harsh sounds -disturbed airflow in larynx or trachea -croup, epiglottis, airway obstruction EMERGENCY

Answer 83

hypErtonic=Enter the vessel from the cell -more concentrated and increased osmoladity uses: -cerebral edema -low sodium (hyponatremia) -metabolic alkalosis -maintenance fluid -hypovolemia 1. 5% dextrose in 0.9% saline (D5NS) 2. 5% dextrose in 0.45% saline 3. 5% dextrose in LR

Answer 84

Isotonic= stays where I put it same osmolality as body fluids (ISO means equal-equal water and particle ratio) uses: -expands intravascular fluids volume and replaces the fluid loss associated with -burns -hemorrhage -surgery -dehydration (vomiting and diarrhea) -also used for fluid maintenance 1. 0.9% saline (NS) 2. Lactated Ringers 3. Ringers lactate (LR) 4. 5% dextrose (D5W)

Answer 85

hypOtonic=Go Out of the vessel and into the cell -fluid that goes out of the vessel and into the cell making it swell! (OOO) -more diluted and decreased osmolality (less salt, more water) uses: -intracellular dehydration such as DKA -never give to clients with burns or liver disease -helps kidneys excrete excess fluids 1. 0.45% NS 2. 2.5% Dextrose 3. 0.33% NS

Answer 86

-fast HR -itching/urticaria/skin rash -wheezing/dyspnea/tachypnea -anxiety -flushing/fever -back pain STOP transfusion start saline running, notify HCP

Answer 87

uses -TB testing -Allergy sensitivity needle size -25-27 guage needle length -3/8-5/8in usual site -inner forearm

Answer 88

uses -non irritating, water soluble medications (insulin and heparin) needle size -25-27 gauge needle length -3/8-5/8 in usual site -abdomen, posterior upper arm, thigh

Answer 89

uses -irritating, solutions in oils, and aqueous suspensions needle size -18-25 gauge usual site: -deltoid (max 1-2ml), vastus lateralis (2ml), ventogluteal (3ml) -use the z track method -do not inject more than 3 ml

Answer 90

uses: -administering medications, fluids and blood product needle size: -16 gauge: clients who have trauma -18 gauge: surgery and blood administration -22-24 gauge: children, older adults, and clients with medical issues/stable post op usual site: -hand, wrist, foot, cubital fossa, foot, scalp

Answer 91

-pulmonary disease that causes chronic airflow obstruction -umbrella term for emphysema and bronchitis diagnostics: -ABGs -Chest x-ray -PFT: spirometry causes: -smoking -occupation exposure -infection -air pollution -genetic abnormalities -asthma -severe respiratory infection from childhood monitoring/interventions -oxygen status (88%-92%): COPD pt. are stimulated to breathe due to decreased O2 (too much O2 loses their drive to breathe) (healthy clients are stimulated to breathe due to increased CO2) -give O2 in the case of exacerbations or respiratory distress -only 1-2L in someone with elevated PaCO2 -small, frequent, high calorie meals (especially for clients with emphysema) -pursed lip breathing to promote CO2 elimination -diaphragmatic breathing medications: 1st. bronchodialator---open airway 2nd. corticosteroids---let the steroids do their thang

Answer 92

emphysema -hyperventilation (trying to blow off CO2) s&s -barrel chest (hyperinflation of the lungs) -thin-weight loss form breathing so much -shortness of breath -severe dyspnea chronic bronchitis -chronic productive cough and sputum production for >3 months s&s -overweight -cyanotic (blue)-low o2 and high CO2 -peripheral edema -rhonchi and wheezing -chronic cough

Answer 93

lower respiratory tract infection that causes inflammation of the alveoli sacks -impaired gas exchange -alveoli becomes full of fluid s&s -fever -increased HR -increased RR -decreased O2 -chills -chest pain -difficulty breathing -productive cough -unusual breathing sounds: coarse crackles and wheezes -respiratory alkalosis -increased CO2 and decreased O2 interventions -monitor vitals, sputum -high fluid and protein -semi fowlers diagnose -chest x-ray -increased WBC -sputum culture

Answer 94

chronic lung disease that causes an inflamed, narrow and swollen airway causes: allergy, cold air, smoke, dust air, genetics, GERD, exercise induced, NSAIDS s&s -dyspnea -tachypnea -chest tightness -anxiety -wheezing -coughing mucous production -use of accessory muscles -air trapping (retaining CO2=respiratory acidosis) treatment -staying calm -oxygen access peak flow monitor -high fowlers -assess for cyanosis and retractions emergency -status asthmaticus -oxygen, hydration, nebulization, systemic corticosteroids

Answer 95

type of anemia caused by low iron levels -iron is essential to hemoglobin in red blood cells -body uses iron to make hemoglobin (hemo. carries oxygen to cells) causes: -blood loss/hemorrhage -malabsorbtion -inadequate intake symptoms: -pallor -weakness/fatigue -small red blood cells -low hemoglobin and hematocrit interventions -diet changes -increased iron, protein and vitamins -take iron (causes constipation and black stool)

Answer 96

decreased platelets (<150,000) -platelets help clot blood (p.aggrevation is when they clump together to form a plug at the site of the injury) causes: -disorders -leukemia -anemiaa -trauma -enlarged spleen -liver disease -ethanol -toxins -sepsis s&s -weakness, dizziness -prolonged bleeding -pinpoint bleeding -bruising -bleeding from gums/nose -heavy menstrual cycle -blood in stool or urine -increased INR/PTT management: -platelet transfusion -bone marrow transplant -splenectomy

Answer 97

autoimmune disease where the body produces antibodies against it's own thrombocytes (<20,000) easy bruising and petechiae--hense the name purpura) causes: -children after viral illness -females (age 20-40) -pregnancy

Answer 98

secreting insulin and glucagon into the blood stream

Answer 99

-pancreatic tissue secretes digestive enzymes that break down carbs, proteins and fats pancreatitis is an auto-digestion of the pancreas by it's own digestive enzymes released too early into the pancreas. -increased amylase -increased lipase -increased WBC -increased bilirubin -increased glucose -decreased platelets -decreased Ca and Mg

Answer 100

breaks down carbs to glucose

Answer 101

breaks down protein

Answer 102

breaks down fats

Answer 103

sudden inflammation that is reversible if prompt recognition and treatment is done causes: -gallstones (blocks bile duct) -alcohol -infection -tumor -trauma in acute there will still be working functions of the pancreas s&s -sudden severe LUQ pain -nausea -fever -increased HR and low BP -increased glucose -mental confusion and agitation -abdominal guarding -rigid abdomen -grey turner sign (bluish discolouration of the flanks) -cullens sign (bluish discolouration of the umbilicus)

Answer 104

-NPO---rest the pancreas -IV fluids -Pain managment -Side lying (NOT supine) -Insert NG tube (remove stomach contents)

Answer 105

chronic inflammation that is irreversible causes: -repeated episodes of acute pancreatitis -excessive and prolonged alcohol use -cystic fibrosis s&s -chronic epigastric pain -pain after drinking ETOH or fatty meals -Fatty stools -Weight loss -Jaundice -Diabetes mellitus (damage to islets of langerhans) -Dark urine (excess bile)

Answer 106

inflammation that occurs anywhere in the GI tract s&s -cobble stone appearance -fever -cramping after meals -mucus diarhea -abdominal distension -nausea and vomitting no cure

Answer 107

inflammation and ulceration of only the large intestine and rectum s&s -ulcers cause rectal bleeding bloody diarhea abdominal cramping -increased HR and low BP hypovolemic shock -malnutrition -malaise -dehydration -vitamin k deficiency can be cured with colectomy with ileostomy

Answer 108

-viral (A, B, C, D, E) -excessive use of alcohol -hepatotoxic medications s&s -GI symptoms -Jaundice -Dark-coloured urine -Clay stool -Vomiting -Flu like symptoms labs: ELEVATED -high liver enzymes (ALT/AST) -high bilirubin -high ammonia

Answer 109

hAv acute transmissiom: fecal/oral hBv acute and chronic t: body fluids hCv acute and chronic t: body fluid hDv acute and chronic t: occurs with hep. B hEv acute t: fecal and oral

Answer 110

1. detox the body 2. helps to clot the blood 3. helps to metabolize (breakdown) drugs 4. synthesis (makes) albumin

Answer 111

liver cells are destroyed and replaced with fibrotic (scar) tissue -loss of normal function of the liver causes: -ETOH consumption -NAFLD: viral hep (B&C), autoimmune, hepatotoxic drugs, toxins & parasites, fat collection in the liver (obesity, diabetes, high cholesterol) s&s -asterixis (liver flap) -jaundice -ascites -edema -abdominal pain -chronic dyspepsia (GI upset) -itchy skin -high bilirubin and ammonia -low platelets -low WBCs treatment: -no more alcohol -prevent bleeding -measure abdominal girth -daily weights (I&O's) -paracentesis (removal of fluid from the peritoneal cavity (ascites)) -liver transplant

Answer 112

-portal HTN (narrowed portal veins from scar tissue) -GI bleeding (esophageal varices) -Splenomegaly -Anemia -Hepatic encepalopathy/coma (do to increased ammonia--which is sedative) -Gynnecomastia (breast development in men) -Hepatorenal syndrome (AKI) medications NO tylenol -antacids -vitamins -diuretics -lactulose (decreases serum ammonia through stool) -avoid narcotics ***Keep in mind the liver is not metabolizing drugs well it's sick***

Answer 113

abnormal and sudden electrical activity of the brain -high fever (febrile seizures in child) -CNS infection -Drug or alcohol withdrawl -ABG imbalances -Hypoxia -Brain tumor -Hypoglycemia -Head injury -Hypertension

Answer 114

generalized seizure (whole brain is affected) used to be grand mal -stiffening (tonic) of the muscles -rigidity (clonic) of the muscles

Answer 115

generalized seizure (whole brain is affected) sudden jerking or stiffening of the extremities (arms and legs)

Answer 116

generalized seizure (whole brain is affected) usually looks like a blank stare that lasts seconds, often goes un-noticed

Answer 117

generalized seizure (whole brain is affected) sudden loss of muscle tone -may lead to sudden falls or dropping things

Answer 118

partial (focal) seizure: only one area of the brain is affected sensory symptoms with motor symptoms and stays aware.

Answer 119

altered behavior/awareness and loss consciousness for a few seconds

Answer 120

a seizure that lasts longer than 5 minutes without any consciousness during the seizure -needs immediate attention

Answer 121

blockage (thrombotic or embolic) blood flow is cut off which leads to ischemia -thrombosis: blood clot that formed on the artery wall -embolism: a clot has left part of the body s&s F: face drooping (uneven smile) A: arm weakness (can't life, numbness) S: speech difficulty (slurred speech) T: time to call 911 APHASIA Receptive aphasia: unable to comprehend speech (wernicke area) Expressive aphasia: can comprehend speech, but cannot respond back (brocas area) treatment: 1. TPA: dissolves down blood clot

Answer 122

bleeding: from a ruptured artery -aneurysm (weakening of the vessel) -uncontrolled hypertension -the collection of blood in the brain leads to ischemia and increased ICP treatment: -stop the bleeding and prevent increased ICP -poor prognosis -remove blood to decrease pressure risk factors: -hypertension -atherosclerosis -anticoagulation therapy -diabetes melitus -obseity -stress -oral contraceptives -family history -older age -male/black/hispanic

Answer 123

olfactory -sense of smell

Answer 124

optic -vision

Answer 125

oculomotor -pupil constriction and upper eye movement

Answer 126

trochlear -downward and inward eye movement

Answer 127

trigeminal -motor: mastication -sensory: facial sensation

Answer 128

abducens -controls parallel eye movements

Answer 129

facial motor: facial expressions sensory: taste

Answer 130

vestibulocochlear -balance and hearing

Answer 131

glossopharnyngeal -motor: tongue and movement and swallowing -sensory: taste (sour/bitter)

Answer 132

vagus -motor: swallowing, speaking, cough -sensory: facial sensation

Answer 133

spinal accessory -strength of neck and shoulders

Answer 134

hypoglossal -tongue movement/swallowing/speech

Answer 135

air embolism -turn onto left side -call HCP infiltration (fluid leaks into surrounding tissue) -remove IV -elevate -cool compress -don't rub infection -remove IV -obtain cultures circulatory overload (rapid fluid administration) -lower flow rate -elevate HOB -keep warm -notify HCP phlebitis (inflammation of the vein) -remove IV -notify HCP -restart IV on other side hematoma (collection of blood) -elevate the extremity -apply pressure and ice

Answer 136

positive: -delusions -anxiety -hallucinations -auditory -jumbled speech -disorganized behaviour negative: -flattened -lack of energy -reduced speech -avolition (lack of motivation) -anhedonia (can't feel joy) -lack of social interaction

Answer 137

a type of dementia a continuous decline of function causes: -genetics -TBI -advanced age -cardiovascular disease, diabetes, lifestyle, obesity drugs -cholinesterase

Answer 138

gestational (40 weeks) -the number of completed weeks counting from the 1st day of the last normal menstrual cycle fetal age (38 weeks) -baby's age from estimated conception date (usually two weeks less than the gestational age)

Answer 139

first trimester 0-13 weeks second trimester 14-26 weeks third trimester 27-40 weeks

Answer 140

a pregnancy that made it to 20 weeks but before 37 weeks

Answer 141

1. Nurses respect clients’ dignity. 2. Nurses provide inclusive and culturally safe care by practicing cultural humility. 3. Nurses provide safe and competent care. 4. Nurses work respectfully with the health care team. 5. Nurses act with integrity in clients’ best interest. 6. Nurses maintain public confidence in the nursing profession.

Answer 142

Consent is considered informed when the patient receives enough information to make a decision. -The nature of the treatment -Benefits expected -Risks and side effects -Alternative treatments -What might happen if the treatment is not done -The patient must also have the opportunity to ask questions and receive answers. Consent can be given verbally, written or implied (pt. holds out their arm)

Answer 143

The patient must be capable of making the decision. Capacity means they can: -Understand the information about the treatment -Appreciate the consequences of their decision -If the client is not capable, consent must come from a substitute decision-maker (SDM) according to Ontario law. Ex. 1. Guardian of the person 2. Power of Attorney for Personal Care 3. Representative appointed by the 4. Consent and Capacity Board 5. Spouse/partner 6. Parent or custodial parent 7. Child or sibling 8. Other relative 9. Public Guardian and Trustee

Answer 144

there is no age -Ontario looks at capacity, not age

Answer 145

In an emergency, treatment can proceed without consent if: The patient is incapable, AND There is no SDM immediately available, AND The delay would cause serious harm or death. ✔ Treatment may proceed to preserve life or prevent serious suffering. Once the situation stabilizes, consent must be obtained as soon as possible.

Answer 146

RPN Focus on clients with predictable outcomes and stable conditions. Typical responsibilities: Basic assessments Medication administration Chronic disease management Stable patients in hospitals, LTC, community The 5 Controlled Acts (same for RPN and RN) 1. Performing a prescribed procedure below the dermis or mucous membrane Example: wound care, sutures removal 2. Administering a substance by injection or inhalation Example: IV meds, IM injections, nebulizers 3. Putting an instrument, hand or finger beyond certain anatomical points External ear canal Nasal passages beyond normal narrowing Larynx Opening of urethra Labia majora Anal verge Artificial body opening (stoma) 4. Dispensing a drug 5. Treating a serious mental disorder using psychotherapy (when it significantly impairs functioning).

Answer 147

Care for more complex, unstable, or unpredictable patients. Typical responsibilities: Advanced clinical judgment Complex care planning Leadership and coordination Critical care, emergency, complex assessments The 5 Controlled Acts (same for RPN and RN) 1. Performing a prescribed procedure below the dermis or mucous membrane Example: wound care, sutures removal 2. Administering a substance by injection or inhalation Example: IV meds, IM injections, nebulizers 3. Putting an instrument, hand or finger beyond certain anatomical points External ear canal Nasal passages beyond normal narrowing Larynx Opening of urethra Labia majora Anal verge Artificial body opening (stoma) 4. Dispensing a drug 5. Treating a serious mental disorder using psychotherapy (when it significantly impairs functioning).

Answer 148

NP Controlled Acts In addition to the 5 nursing acts, NPs can: 1. Communicate a diagnosis Identify a disease or disorder as the cause of symptoms 2.Prescribe, dispense, sell, or compound drugs Order and apply prescribed forms of energy Example: defibrillation, ultrasound 4. Set or cast fractures or dislocations 5. Perform procedures below the dermis or mucous membrane 6. Insert instruments beyond anatomical openings (same as RN/RPN) 7. Administer substances by injection or inhalation 8.Provide psychotherapy for serious mental disorders

Answer 149

CANNOT BE DELEGATED!! 1. prescribe a medication, or a drug from within a category of medications, set out in the regulation 2. communicate to a client or a client’s representative a diagnosis made by the RN where the purpose of that communication is for prescribing the medication

Answer 150

1. Direct Orders A direct order is an instruction from an authorized prescriber for one specific client. Examples: Medication orders Lab orders Treatment orders Example: “Administer 2 mg morphine IV to Jane Smith now.” The nurse must verify: Correct patient Correct order Their competence to perform it. 2. Directives A directive is a written medical order that authorizes nurses to perform treatments or controlled acts for a group of clients when specific conditions are met. Directives allow nurses to act without contacting the prescriber each time. Example situations: Emergency departments Vaccination clinics Public health programs Hospital protocols Example directive: “RNs/RPNs may initiate oxygen therapy for patients with oxygen saturation <92%.”

Answer 151

Delegation = giving someone permission to perform a controlled act they normally cannot do. It is transferring authority. 1. The nurse must already be allowed to do the act You cannot delegate something you cannot do yourself. Example RPN can give injections → so they can delegate injections. -RPNs and RNs can technically delegate all 5 of their acts to competent individuals. 2. The person receiving delegation must be trained The PSW or caregiver must: Know how to do it Be competent Understand when to get help Before delegating, ask: Is it a controlled act I am authorized to do? Is the client stable and appropriate? Am I competent to perform this act? Is the delegate trained and competent? Are instructions clear, and will I supervise appropriately? If all five = yes → safe to delegate. If any = no → do not delegate.

Answer 152

1. Authority 2. Competence 3. Context

Answer 153

1. nurses cannot delegate a controlled act that has been delegated to them. This is referred to as sub-delegation12 2. nurses in the Temporary Class13and the Emergency Class14are not permitted to delegate or accept delegation 3. nurses in the Special Assignment Class15are not permitted to delegate to other health care professionals

Answer 154

1. treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception, or memory that may seriously impair the individual’s judgement, insight, behaviour, communication or social functioning 2. dispensing a drug. -DISPENSING and ADMINISTERING are different. A nurse can delegate a UCP to administer an insulin injection, but they cannot delegate a UCP to dispense, or give a supply of insulin to the pt.

Answer 155

1. prescribing, dispensing, selling or compounding medication 2. ordering the application of a form of energy 3. setting a fracture or joint dislocation 4. treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behaviour, communication or social functioning

Answer 156

1. temporary class: finished nursing school, haven't work your exam/gained license 2. general class: have your license 3. extended class: nurse practitioners 5. non practicing class: nurses who have their license but are not working (mat leave) 6. emergency class (allows qualified nurses to practice quickly) Ex. Pandemic

Answer 157

-This form allows a physician to hold a patient in hospital for assessment. Purpose To determine if the person meets criteria for involuntary admission. How long it lasts Up to 72 hours During this time the patient: Cannot leave the hospital Is being assessed by a physician Important points for nurses -The patient is not yet involuntarily admitted. -They are detained only for assessment. A doctor must reassess the patient before the 72 hours ends. Possible outcomes after 72 hours The physician may: Discharge the patient Change them to voluntary admission Issue Form 3 (involuntary admission)

Answer 158

What happens after Form 2 is issued? Police can then: 1️⃣ Locate the person 2️⃣ Take them to a hospital 3️⃣ The person must be examined by a physician At the hospital, the physician may then: Discharge the patient Admit voluntarily Issue a Form 1 (psychiatric assessment)

Answer 159

If the physician determines the patient meets the criteria under the Mental Health Act, they may issue Form 3. Purpose This means the patient is officially involuntarily admitted to hospital. How long it lasts Up to 2 weeks (14 days) What this means The patient: Cannot leave the hospital Must remain for treatment and stabilization Patient rights Patients must be: Informed of their rights Given access to a Rights Adviser Allowed to appeal to the Consent and Capacity Board Nursing responsibilities Ensure patient understands their rights Provide safe care and monitoring Document the patient’s legal status

Answer 160

If the patient still meets involuntary criteria, the physician can renew the involuntary admission using Form 4. Purpose To extend the involuntary hospitalization. Renewal timeline The length increases with each renewal: 1️⃣ First renewal: 1 month 2️⃣ Second renewal: 2 months 3️⃣ Third renewal and after: 3 months each Key point Each renewal requires: Reassessment by a physician The patient must still meet involuntary criteria Patient rights continue Right to appeal the decision Right to legal advice Right to a rights adviser

Answer 161

allows for breast milk production

Answer 162

growth of fetal organs and maternal tissues

Answer 163

relaxes smooth muscles

Answer 164

produced by the placenta, prevents menstruation -indicator of pregnancy

Answer 165

stimulates contractions at the start of labor

Answer 166

-increased BMR -increased cardiac output -increased GFR (edema) -decreased FSH/LH due to increased progesterone -increased thyroxine -increased fibrinogen ---HYPERCOAGULABLE -plasma volume is greater than the amount of RBC=hemodilution=physiological anemia

Answer 167

for estimating the delivery date -date of last period-3 calendar months + 7 days and 1 year

Answer 168

1. latent phase -cervix dilates 1-3cm -mild intensity -contractions 15-30 minutes apart 2. active phase -cervix dilates 4-7cm -moderate intensity -contractions 3-5 minutes apart (30-60sec durations) 3. transition phase -cervix dilates 8-10cm -strong intensity -contractions every 2-3 min (60-90 secs)

Answer 169

-starts when cervix is fully dilated and effaced -ends after baby is delivered -pushing!! -baby delivered

Answer 170

the placenta is expelled 5-30 min after birth -placenta should have two arteries and one vein

Answer 171

recovery -assessing fundus -administer IV -monitor lochia (hemorrhage)

Answer 172

contractions -irregular -stops with walking/position change -felt in back or abdomen or above the umbilicus -stops with comfort measures cervix -may be soft -no significant changes in effacement or dilation -no bloody show -in posterior position fetus -presenting part is usually not engaged in the pelvis

Answer 173

contractions -occur regularly, stronger, longer, closer together -more intense when walking -felt in lower back-radiating to lower abdomen -continue despite comfort measures cervix -progressive change -softening -effacement -dilation signalled by the appearance of bloody show -moves to anterior position fetus -increased ease of breathing -presenting part compresses bladder (urinary frequency) -presenting parts become engaged in the pelvis

Answer 174

-hydration (IV) -elevate legs to correct hypotension

Answer 175

-amnioinfusion -side lying or knee chest will relieve pressure on cord -oxygen and breathing techniques

Answer 176

Nurse Role in MAID RPN Support care RN Coordinate + assist NP Assess + prescribe + administer determining eligibility for MAID requires two people: NP (both) or Doctor (both)

Answer 177

HTN after 20 weeks gestation with systemic features. patho: placenta is the root cause of -systemic vasoconstriction and endothelial dysfunction -defective spiral artery remodelling s&s -proteinuria -rising BP (systolic >140 or diastolic >90) -edema -severe headache -RUQ pain or epigastric pain -visual disturbances -decreased urine output -rapid weight gain -hyperflexia risk factors: -HX preeclampsia -very young or old -family history -obesity -medical conditions -chronic HTN, renal disease, diabetes, autoimmune disease

Answer 178

variant of preeclampsia life threatening complication H-hemolysis EL-elevated liver enzymes LP-low platelet count

Answer 179

seizures activity or a coma immediate care: -side lying -padded side rails -O2 -suction -do not restrain or leave magnesium sulfate (this is a depressant) -given to prevent seizures during and before labor -theraputic range: 4-7mg/dL -antidote: calcium gluconate

Answer 180

-space between the bones of the skull allows for molding anterior: -diamond shaped -ossifies in 12-18 months -larger posterior: -triangle shaped -closes 8-12 weeks

Answer 181

-gynecoid (circular) -android (heart shaped-resembles the male pelvis) -anthropoid (oval shaped-wider anteroposterior diameter) -platypelloid (flat pelvis, least common)

Answer 182

-shortening and thinning of the cervix during the first stage of labor -cervix normally (2-3 cm long, 1cm thick) -the cervix is pulled back/thinned out by a shortening of the uterine muscles -expressed in percent

Answer 183

primary -dilation -cervix closed-full dilation (10cm) -effacement -expressed in % (0-100%) Ferguson -when the stretch receptors release oxytocin, it triggers the maternal urge to bear down secondary -does not affect cervical dilation but helps with expulsion of the infant once the cervix is fully dilated -involuntary urge to push *the lithotomy position is the most common one*

Answer 184

APGAR (rated between 0-2 points, <4=aggressive resuscitation) -Activity -Pulse (110-160) -Grimace -Appearance -Respiration (30-60) Normal for a newborn -blueness of hands and feet (first 24hr) -transient murmurs -abnormal head shape -bulging fontanelles while crying

Answer 185

BUBBLES Breast Uterus Bowels Bladder Lochia (usually last 14 days, can last up to 6 weeks) Emotional status Section (C-section incision)

Answer 186

vaginal birth: loss of >500ml of blood cesarean birth: loss of >1000ml blood Or a change in hematocrit by 10% patio: -the uterus crimps off vessels protecting mom from hemorrhage, sometimes this doesn't work. s&s -hypotonia of the uterus -atony/boggy uterus -deviated to the right -uncontrolled bleeding risk: -multiple gestations -polyhydramnios -macrosomic fetus (>8lbs) -multi gestation drugs 1. oxytocin -stimulates contractions of the uterine smooth muscle 2. methergine -vasoconstriction *contradicted in ppl with hypertension 3. hemabate -uterine contractions -don't give to people with asthma 4. misprostol -given rectally -stimulates uterine smooth muscle contractions

Answer 187

1: fist clench 2: raises head, coos 4: lifts head and looks around, rolls from back to tummy 5: grasp things 6: tripod sitting, babbling 8: sit unsupported 9: crawls 10: pull to stand, able to cruise on objects (furniture) 11 12: walk independently

Answer 188

15 -walk independently -feeds self finger foods 18 -climb stairs -understands no 24 -kicks a ball -able to stand on tip toes -climbs ontop of furniture -builds block towers 30 -follows a series of two independent commands -150-300 word vocab 3 years -climbs and runs -pedals a tricycle -walks up and down stairs with alternating feet -undress themselves -holds pencil-draws circles 4 years -throws ball -hop on one foot -alternating feet up and down the stairs -use scissors -draw shapes and people -speaks in complete sentences 5 years -skip, swim, skate -can use utensils -cares for toileting -can be understood 100% -can count to 10

Answer 189

cardiac arrest in infants=usually from respiratory etiology 1. pulse -check the pulse no longer than 10 sec. -infant: check brachial pulse -child: check carotid pulse 2. call for help -call 911, get AED 3. chest compressions -2 minutes of CPR before retrieving the AED (100-120 compressions/minute_ -infant: equal to one third of the chest -child: 2 inches -single rescuer: 30:2 compressions to breath ratio -two rescuers: 15:2 compressions to breath ratio

Answer 190

nephrotic: s&s -generalized edema -proteinuria >3.5 g daily -hypoalbuminemia -hyperlipidemia nephritic: causes: gomerularnephritis -edema -high blood pressure -hematuria -oliguria -azotemia

Answer 191

0-2 years -development through the five senses -development through motor response -object permanence is developed -egocentric: only see the world from their own point of view

Answer 192

2-7 years -always asking why -symbolic thinking -imagination: animism: think objects are alive -abstract thinking is difficult -magical thinking, plays pretend -ask lots of questions (intuition)

Answer 193

7-11 years -develops concrete cognitive operations (sorting blocks inn order) -conservation is developed -conductive reasoning (math)

Answer 194

>11 -more logical, rationl, organized, moral and consistent thinking -hypothetical thinking -abstract concepts: love, hate, failure, successes -deductive reasoning

Answer 195

1. narrow airways, nose breathers, increased 02 requirements, increased risk of resp. failure 2. Eustachian tubes are wide, short and flat: increased risk for ear infection 3. Infant hearts are less compliant, thinner 4. Thin skin, blood vessels are close the skin: lose heat very easily 5. Kidneys are large in relation to the abdomen, GFR is slow, decreased ability to concentrate urine and reabsorb 6. Cranial bones are not completely fused -brain is highly vascular-increased hemorrhage risk -spine is very mobile--increased risk for cervical spine injury 7. increased infection risk--immature immune system and decreased inflammatory response 8.Myelination is incomplete at birth

Answer 196

sudden infant death syndrome -sudden death of a previously healthy infant younger than 1 years old risk -age 1-6 months -preterm -sleep position -sibling death -nicotine exposure -bedding, room temperature prevention -sleep SUPINE -firm mattress, nothing in the crib -do not over bundle the infant -avoid smoking -no co-bedding -normal room temp -use pacifier

Answer 197

rare disease affecting young children recovering from a viral illness (chicken pox, flu) -caused by salicylates containing products such as ASPIRIN, PEPTO, ALKA-SELTZER s&s -MAJOR: neuro symptoms (swelling of the brain and liver) -confusion -hyperflexia -irritabilty -lethargy -diarhea -seizures -increased AST, ALT -sometimes red spots treatment -prevention -monitor fluid -monitor ICP and seizure precautions

Answer 198

Bronchiolitis (RSV) -viral illness usually caused by respiratory syncytial virus (RSV) -very contagious -starts at upper resp. moves to the chest s&s -upper resp symptoms: nasal congestion, runny nose, cough, sneezing -fever -lower resp symptoms: tachypnea, cough, wheezing emergent symptoms: -grunting -nasal flare -cyanosis -hypoxia -resp, failure -apneic episodes treatment: -oxygen, suctioning, position at 30-40 degree angle -hydration -hospital: for severe symptoms

Answer 199

Laryngotracheobronchitis (Croup) -VIRAL: usually causes by parainfluenza virus -sudden: at night -fluctuating fever -stridor, hoarse voice, seal bark cough Epiglottitis -BACTERIAL: caused by haemophilus influenza type B or streptococcus pneumonia -rapid: within hours -no cough -dysphagia -emergency: inflammation leads to upper airway obstruction

Answer 200

complication of group A streptococcal infection (strep throat) -not all children with strep will get scarlet fever s&s -ABRUPT -red rash all over body -pharyngitis -fever, body aches, chills -strawberry tongue -tender cervical nodes -tonsils are red complications -rheumatic fever -glomerulonnephritis -abscesses of the throat -pneumonia

Answer 201

-Both mom and dad must be a carrier (autosomal recessive) -Cystic fibrosis (CF) is a genetic disorder caused by mutations in the CFTR gene, resulting in thick, sticky mucus that clogs lungs, damages the digestive system, and causes infections. Symptoms include -persistent coughing, lung infections, wheezing, delayed puberty, poor growth, insulin deficiency, and gallstones.

Answer 202

pH: 7.35-7.45 CO2: 35-45 HCO3: 22-26 acidosis: if any of these values are LOWER alkalosis: if any of these values are HIGHER normal pH: 7.40

Answer 203

uncompensated: if the pH is out of range, and CO2 and HCO3 are in range partially: if CO2 and HCO3 are both out of range and the pH is out of range fully: if the pH is in range Kidneys: SLOW -excrete excess acid and HCO3 or -retain hydrogen and HCO3 Bicarb=base Lungs: FAST -hyperventilating: low CO2= alkalosis -hypoventilating: high CO2=acidosis CO2=acid

Answer 204

Hypoglycemia = “TIRED”: Tremors Irritability/confusion Diaphoresis ↓ glucose Sometimes tachycardic

Answer 205

-in normal assignment no -if it requires nursing judgement, or care for an unstable patient the answer is no -delegation can happen if the UCP has specific training for these acts (insulin) but not for normal assignment

Answer 206

Classic infection signs: Fever Redness Swelling ↑ WBC

Answer 207

Early shock = body compensating: ↑ HR Vasoconstriction (cool, clammy) ↓ urine output hypotension (late sign)

Answer 208

Hyperkalemia affects the heart: Dysrhythmias Bradycardia Muscle weakness

rex-P1 Flashcards

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