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ATI Funds Review
Delayed Wound Healing Stages: -Inflammatory -3-6 days -controlling bleeds with vasoconstriction, fibrin accumulation, and lot formation -delivering oxygen, WBC. -macrophages engulf phagocytosis -Proliferative -3-24 days -replacing lost tissue with connective tissue, granulated tissue, and collagen -contracting wounds edges to reduce area of healing -resurfacing of new epithelial cells -maturation or remodeling stage -21 days -strengthening pf collagen scar and restore to normal look Healing Process
- primary intention -little to no tissue loss -edges approximated -heals rapidly -low risk to infection -no or minimal scarring
- secondary intention -loss of tissue -wound edges separated -longer healing time -increase risk for infection -scarring -heals by granulation
- tertiary intention -widely separated -deep -spontaneous opening of previously closed wound -closure of wounds -risk of infection -extensive drainage and debris -closed later -longer healing time
Factors to decrease healing -older age -smoking -over all wellness -wound stress -low leukocyte count -infection -DM -medications -malnourishment -tissue perfusion is low
Hypokalemia -K+ <3. RF -hyperaldosteronism -prolonged administration of 5% dextrose -TPN -Metabolic Alkalosis -excessive GI loss -renal loss -skin loss S/S -weak, irregular pulse -hypotension -respiratory distress -muscle cramping -decreased muscle tone -hypoactive reflexes -paresthesia -mental confusion -bradycardia -inverted T waves -GI / decreased motility, hypoactive bowels, ileus, N/V, anorexia Tx -never IV bolus, can cause cardiac arrest (push)
Hyperkalemia -K+ >5. RF -salt substitutes, blood transfusion -insufficient insulin -acidosis / DKA -sepsis, burns, trauma, surgery, MI -kidney failure -dehydration -ACE inhibitors -adrenal insufficiency S/S -slow, irregular pulse, hypotension -confusion -flaccid paralysis -increased GI -peeked T-waves Oxygen Toxicity S/S -nonproductive cough -substernal pain -N/V -fatigue -dyspnea -restlessness -paresthesia
Hypocalcemia
- <9mg/dL RF -chronic diarrhea -laxative misuse -steatorrhea / pancreatitis -crohn’s -CKD -hypoparathyroidism -low albumin -alkalosis S/S NI -muscle twitches -seizure precautions -numbness and tingling -hyperactive DTR’s -positive Chvostek’s and Trousseau’s -laryngospasms -weak, thready. Pulse -prolonged QT interval and ST segments -hyperactive GI
Hypercalcemia
10.5mg/dL S/S -decreased DTR’s -bone pain -short QT and ST -increased risk for blood clot -anorexia, N/V, constipation -weakness -hypercalciuria
- Clonus = hyperactive DTR’s 4+
- Allergy to bananas and kiwi can indicate latex allergy Spinal Shock S/S: flaccid paralysis, loss of reflex, paralytic ileus Keep the mean art pressure > Neurogenic Shock S/S: bradycardia, hypotension, edema, loss of temp regulation Tx: vasopressors or atropine Autonomic Dysreflexia Lesions below T -distended bladder is the most common cause -have patient sit up to decrease hypertension / do first? less invasive over checking bladder Compartment Syndrome Causes: tight dressing, skin traction, trauma, burns, hemorrhage, severe IV infiltration or casting
- Effexor (venlafaxine) is in the same class as an SSRI
- Echolia is a fundamental sign of autism and is manifested in repeated speech sounds
-“Pines” are TCAs for depression / side effect can be sedation, dry mouth, constipation,
extrapyramidal side effects, pseudo parkinsonian symptoms
- Munchausen by proxy / a form of medical child abuse that ranges in severity from
frequent medical exams during which the caregiver demands tests or treatments to
faking or causing disease in the child.
Risk Factors:
-female caregiver
-substance abuse
-criminal activity
-self harm
-childhood deprivation or abuse
Weel 3 ATI Study questions
-Beers criteria
-a list of potentially harmful medications in elderly patients
-Pam’s and Pine’s = confusion, sedation, and loss of balance
-Benadryl = dizzy and sedation
-TCA = blurred vision, dry mouth…
-Zole = increased bone loss and C-diff
- isotretinoin / Accutane
-prescribed for severe cystic acne
Side effects:
-dry skin and eyes -arthralgia
-photosensitivity -myalgia
-thrombocytopenia -allergy
-anemia
Education
-take with meals
-no contact lenses
-avoid vit. A
-avoid driving at night due to
worse night vision
-take pregnancy test before use
-report rashes
-monitor HDL / can get low
Contraindication
-pregnancy
Complications
-Steven Johnson Syndrome
-Toxic Epidermolysis
-hyperuricemia
-hyperglycemia
- Mixing regular and NPH insulin
-draw regular before NPH
- Achalasia / a condition that affects the lower 2/3 of the esophagus resulting in a loss of
peristalsis of smooth muscle.
Tx: Myotomy
- Feverfew helps with migraines
ATI Ranges Children
-Iron children 50-120mcg/dL
-WBC Children 5,000 - 10,000/mm
-Lead <10mcg/dL
-HCT 30-40%
ICP S/S
-photophobia
PPN (peripheral parenteral nutrition)
-for patients where enteral nutrition is not possible
-infuse over 24hr OR a cyclic pattern over 8-16 hrs during the night
Skin macule / freckle
- trichomoniasis / icthy, burning, redness, sorness around the genitals, urination pain,
fishy odor, vagnial discharge
Fire rescue steps:
-move patient to safety
-pull alarm
-close doors and windows
-use fire extinguisher
-assist people to leave the larger area of the building
Abdominal pain with bright red blood
stool is described as
-hematochezia
-bleed from lower GI
After an IV push of frusemide , how ling until increased urine output
-5-10 minutes
Resuscitation phase of a deep partial burn over 40%. What is expected?
-dyspnea
-hyperkalemia
-hyponatremia
Normal ICP range : 5-15 mmHg
Grades for Phlebitis:
Grade 1: erythema at access site with or without pain
Grade 2: pain at site with erythema and/or edema cord
Grade 3: pain, erythema, edema, palpable venous cord
Grade 4: all of grade 3 plus purulent drainage
Muffled breath sounds can indicate a pneumothorax
Signs of CSF leak:
-positive for glucose
-Halo sign
-fluid forms ring / blood in center
Silver Nitrate / causses cellular toxicity and interacts with chloride ions
Cane use :
use weaker leg first
Change hearing aid batteries once per week
-mild soap and water
Lithium
-monitor a daily weight
DKA
-IV bolus 0.9% NS
FeverFew affects blood / thinner
Insulin Draw Order:
- Inspect vials for contaminants.
- Roll NPH vial between palms of hands.
- Inject air into NPH insulin vial.
- Inject air into regular insulin vial.
- Withdraw short-acting insulin into syringe.
- Add intermediate insulin to syringe.
Rotate insulin injections sites to prevent lipodystrophy. Keep 2.5cm (1”) apart within the same area
PPI’s (zole’s) -increased risk of pneumonia Walking upstairs with crutches 1-Stand, bearing weight on unaffected leg 2-Transfer body weight to the crutches 3-Advance the unaffected leg between the crutches
Vanc / administer over 1 hour, dilute with at least 100mL 0.9 NS Can cause “red man syndrome” / rash, redness, hypotension, itching
VT / defib if unresponsive, cardio vert if awake
Pacemaker education / check pulse 1 min every morning, no tight clothing over area
Why Vecuronium Is Used in ARDS:
- Facilitates Mechanical Ventilation: o In severe ARDS, patients may "fight the ventilator" (ventilator asynchrony), which can worsen lung injury. o Vecuronium induces full muscle relaxation, allowing the ventilator to fully control breathing and deliver lung-protective ventilation.
Pruritus is the medical term for itching , a common symptom that can range from mild to severe and is often associated with various underlying causes. If TPN runs out ….run 10% Dextrose DW10 in water You can palpate the spleen with Hemolytic Anemia
✅ Clear Liquids Safe for a 6-Month-Old:
- Breast milk (technically not a clear liquid, but often still allowed if tolerated — check with provider)
- Pediatric electrolyte solutions (e.g., Pedialyte – unflavored or clear)
- Oral rehydration solutions (ORS) – WHO formula or pharmacy-prepared
- Clear broths (vegetable or chicken, sodium content monitored)
- Plain water (in small amounts only, and usually not until after 6 months — monitor electrolytes)
- Diluted apple juice (50/50 with water, only if approved by provider and no vomiting)
- Ice chips or popsicles made from Pedialyte or clear juice (if the child can safely suck/swallow)
⚠️ Avoid: Sugary drinks (soda, undiluted juice) Caffeinated drinks Gelatin or sports drinks (inappropriate electrolyte balance) Cow’s milk or formula unless specifically advised
🕒 Important Notes: Clear liquid diets for infants are short-term only (24–48 hours max). Reintroduce breast milk or formula as soon as tolerated. Watch for signs of dehydration : dry mouth, few wet diapers, lethargy.
Myasthenia Gravis / ineffective coughing Hypovolemic Shock / elevate patients’ legs Genital Warts / referred to as Condyloma acuminata and projector warts Flush an implanted port with a 10mL syringe of NS
Ankylosing spondylitis (AS) is a chronic inflammatory arthritis that primarily affects the spine and sacroiliac joints , leading to pain, stiffness , and, over time, possible fusion of the spine ("ankylosis"). Symptoms: Chronic low back pain and morning stiffness (lasting >30 minutes, improves with activity) Reduced spinal flexibility (especially in lumbar spine)
Pt in ED for hematemesis, establish IV access with a large-bore IV Hearing Aid / keep out of extreme temps Gravity Drip / elevate the solution at least 18” above the infusion site After a any laparoscopic procedure , lay sim’s on left side with right knee flexed to help move the pocket of CO2 away from the diaphragm Common skin lesions in older adults / lentigines Only charting abnormal or significant findings is called charting by exception
- Fetal heart tones are best auscultated directly over the fetal bac which should be in the right upper quadrant
-Kaposi’s Sarcoma / associated with AIDs, hyperpigmented multicentric lesions that are firm, flat, raised, or nodular. *Reddish-purple skin lesions
Read up on CF Read up on cranial nerves p. 148 in new book Cranial nerve II is an optic nerve / provide a safe walking path -isotonic dehydration / increased hematocrit due to hemoconcentration caused by reduced plasma fluid volume
Retinopathy in newborns / caused by oxygen therapy
Renew restraint order Q24hrs
Increase Vit C during lactation to 115-120mg / day
Agoraphobia is the fear and avoidance of places or situations from which escape might be difficult.
Ciprofloxacin is used to treat anthrax
You can use lite suction after a cleft lip and palate repair
Signs of Pregnancy Presumptive: -amenorrhea -fatique -urinary frequency -breast changes -quickening -uterine enlargement Probable Signs: -abdominal enlargement -Hegar’s sign -Chadwick’s sign -Goodell’s sign -Ballottemement -Braxton Hicks -positive test Positive signs: -FHR -ultrasound -fetal movement Terbutaline / tocolytic relaxes contractions, tachycardia, palpitations, tremors, hyperglycemia, hypotension
