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NSG-430: Comprehensive Final Exam
Study & Review Pack.
HOW TO TREAT MODS - <<>>
-DECOMPENSATE QUICKLY, INTUBATE
-VASOPRESSORS
-MECHANICAL VENTILATION
-PRONE POSITIONING
S/S OF NEUROGENIC SHOCK - <<>>
-WARM PINK SKIN
-BRADYCARDIA
-HYPOTENSION
STAGES OF SHOCK - <<>>
-INITIAL
-COMPENSATORY
-PROGRESSIVE
-IRREVERSIBLE
TREATMENT FOR CELLULITIS - <<>>
-TOPICAL: MOIST HEAT, IMMOBILIZATION, ELEVATION
-SYSTEMIC: ANTIBX
TREATMENT FOR IMPETIGO - <<>>
-TOPICAL: WOUND CARE WITH WARM SALINE OR ALUMINUM ACETATE SOAKS
FOLLOWED BY SOAP-AND-WATER OF CRUSTS, ANTIBX CREAM (MUPIROCIN,
RETAPAMULIN)
-SYSTEMIC: CEPHALEXIN, DOXYCYLINE, DICLOXACILLIN, AND CLINDAMYCIN
TREATMENT FOR SJ SYNDROME - <<>>
-PHOTOTHERAPY
-TREAT LIKE THEY ARE A BURN PT.
-STAY WARM AND INFECTION FREE
-IMMUNE WILL GET MORE COMPROMISED W STEROIDS, MUST KEEP ANTISEPTIC
-STOP MEDS 3-4 WEEKS PRIOR, SILVER BASED BIOLOGICAL DRESSINGS, FLUID
RESUSCITATION, EN/PN NUTIRITON, OATMEAL TOPICAL PRODUCT, WET COMPRESS, BATH
SOAKS 15 MIN/DAY, CUT FINGEERNAILS, INJECTABLE CORTICOSTEROIDS, PREVENT
SECONDARY INFECTION (SCRATCHING IT)
PHASES OF BURNS - <<>>EMERGENT (RESUSCITATIVE), ACUTE
(WOUND HEALING), AND REHABILITATIVE (RESTORATIVE)
EMERGENT PHASE OF BURNS - <<>>
-HEALTH CARE TEAM PRIORITIZES LIFE-THREATENING PROBLEMS
- UP TO 72 HOURS
-PRIORITY NURSING CONCERNS: FLUID AND ELECTROLYTE SHIFTS; GAS EXCHANGE
ACUTE PHASE OF BURNS - <<>>
-BEGINS WITH MOBILIZATION OF INTERSTITIAL FLUID AND SUBSEQUENT DIURESIS
-CONTINUES UNTIL WOUNDS ARE NEARLY HEALED
-MAY TAKE WEEKS OR MONTHS
REHABILITATIVE PHASE OF BURNS - <<>>
-WOUNDS HAVE NEARLY HEALED
-PATIENT IS ENGAGING IN SOME LEVEL OF SELF-CARE
SEVERITY OF INJURY IS DETERMINED BY - <<>>DEPTH OF
BURN, EXTEND OF BURN IN & OF TBSA, LOCATION OF THE BURN, PRE-EXISTING HEALTH,
AND ASSOCIATED INJURIES
-POSSIBLE MUSCLE, TENDON, AND BONE INVOLVEMENT
WHAT CAUSES DYSRHYTHMIAS - <<>>LACK OF O
S/S OF MI - <<>>
-DISCOMFORT
-WEAKNESS
-NAUSEA
-INDIGESTION
-SOB
TREATMENT FOR MITRAL VALVES - <<>>BETA BLOCKERS AND
AVOID CAFFEINE
KNOW THE PRESSORS - <<>>ANTIHYPOTENSIVE AGENT,
VASOPRESSIN, PHENYLEPHRINE, EPINEPHRINE, NOREPIENPHRINE, DOPAMINE, AND
ANGIOTENSIN 2
S/S OF UTI - <<>>
-DYSURIA
-FREQUENCY
-BLOOD
-CLOUDY URINE
-FEVER
-CHILLS
-FLANK PAIN
-FATIGUE OR ANOREXIA
HOW TO TREAT RENAL CALCULI - <<>>LITHOTRIPSY
WHEN TO CALL A RAPID - <<>>DECOMPENSATING (DESATS),
PRESSORS AND FLUIDS BUT GOING DOWN, DONT CALL ICU
S/S OF CIRRHOSIS - <<>>
-JAUNDICE
-PORTAL HTN
-ASCITES
-ESOPHAGEAL VARICES
-HEPATIC ENCEPHALOPATHY
WHAT DO YOU MONITOR WHILE ON LOVENOX - <<>>INR,
APTT, AND THROMBOCYTES (150-450)
WHAT DO WE USE LOVENOX FOR - <<>>PROPHYLAXIS OF
ACUTE MI, THROMBOSIS, UA, PE, AND DVT
HOW TO ADMINISTER LOVENOX - <<>>SQ EVERY 12 HOURS
ANTIDOTE FOR LOVENOX - <<>>PROTAMINE SULFATE
SIDE EFFECT OF LOVENOX - <<>>ELEVATED LIVER ENZYMES
HOW TO TREAT SEPSIS - <<>>CULTURE FROM TWO SITES
PRIOR TO STARTING ANTIBIOTICS AND FLUIDS
NI FOR SEPSIS - <<>>-ANTIBIOTICS--> START BROAD SPECTRUM
AND THEN GET CULTURES FROM TWO SITES
-FILL TANK (FLUIDS); ISOTONIC, LR, NS
- IF STILL HYPOTENSIVE: NOREPINEPHRINE, VASOPRESSORS, PHENYLEPHRINE, AND BIG
DADDY EPI)
NI FOR SHOCK - <<>>-FLUIDS (0.9%NS AND 5% DEXTROSE/
D5W)
-HIGH DOSE HYDROCORTISONE REPLACEMENT
RESPIRATORY NURSING DIAGNOSIS - <<>>IMPAIRED GAS
EXCHANGE
LABS FOR SIADH - <<>>
-LOW UO AND INCREASED BODY WEIGHT (THEY ARE SOAKED INSIDE)
-AT FIRST, INCREASED THIRST, DYSPNEA, AND FATIGUE
-HYPONATREMIC (LESS THAN 135)
-LOW SERUM OSMOLALITY (LESS THAN 280)
- HIGH URINE SPECIFIC GRAVITY (MORE THAN 1.030) (LOW UO= MORE CONCENTRATED)
HGA1C IS IDEAL IF IT IS LESS THAN WHAT NUMBER - <<>>7,
WANT TO SEE AROUND 6 FOR DIABETIC
BALOON TAMPONADE CARE - <<>>
-DO NOT FULLY DEFLATE BALLOON ALL AT ONE
-CHECK O2 SATS
WHAT COULD HAPPEN IF WE DEFLATE THE BALOON TAMPONADE TOO FAST -
<<>>BALLOON CAN MIGRATE AND BE RIGHTS AT OPENING (O
WOULD DROP)
TIPS PROCEDURE - <<>>
-USED TO TREAT ASCITES THAT DOES NOT RESPOND TO DIURETICS
- SHUNTS BLOOD FROM PORTAL VEIN AND HEPATIC VEIN TO DECREASE PORTAL HTN
LABS FOR PANCREATITIS - <<>>
-HIGH GLUCOSE
-AMYLASE
-LIPASE
S/S OF PANCREATITIS - <<>>LOSS OF INFLAMMATION, LUQ
PAIN (EPIGASTRIC PAIN), FEVER
S/S OF LIVER CANCER - <<>>EARLY: HEPATOMEGALY,
SPLENOMEGALY, FATIGUE, PERIPHERAL EDEMA, ASITES, AND OTHER COMPLICATIONS
FROM PORTAL HTN)
LATE: FEVER/CHILLS, JAUNDICE, ANOREXIA, WL, PALPABLE MASS, AND RUQ PAIN
S/S OF PANCREATIC CANCER - <<>>DULL ACHING ABDOMINAL
PAIN, ANOREXIA, RAPID WL, NAUSEA, JAUNDICE, PAIN CAN RADIATE TO BACK
LABS FOR CIRRHOSIS - <<>>HIGH ALT, AST, APTT, BLIRUBIN,
LOW ALBUMIN
QUESTRAN IS USED FOR - <<>>LIVER
MOA OFR QUESTRAN - <<>>CONTROLD DIARRHEA FOR BILE
REFLEX GASTRITIS AFTER GASTRIC SURGERY. BINDS WITH THE BILE SALTS THAT ARE THE
SOURCE OF GASTRIC IRRITATION
WHEN TO TAKE QUESTRAN - <<>>BEFORE OR AFTER MEALS
NI FOR LIVER FAILURE - <<>>
-MONITOR FOR JAUNDICE
-MONITOR AMMONIA LEVELS (NORMAL: 10-80)
-THE BLEEDING TIME IS INCREASED SO MONITOR FOR INJURY
-SUPPORTIVE THERAPY
-EFFECTS KIDNEY
-FEVER
-WL
-JOINT PAIN
-RING-SHAPED LESIONS
-BUTTERFLY RASH
-ALOPECIA
-SWAN NECK DEFORMITY
-MILD PROTEINURIA D/T GLOMERULONEPHRITIS--> SCARRING LEADS TO ESRD
FRACTURE ASSESSMENTS - <<>>PAIN, PALLOR, PARESTHESIA,
PULSE, PRESSURE, PARALYSIS
PRIMARY SURVEY - <<>>
A- AIRWAY
B- BREATHING
C- CIRCULATION
D- DISABILITY (GCS: 15 NORMAL 8= INTUBATE)
SECONDARY SURVEY - <<>>HEAD TO TOE ASSESSMENT
SECONDARY SURVEY: MIST - <<>>
M- MECHANISM OF INJURY
I- INJURIES SUSTAINED
S- S/S BEFORE ARRIVAL
T- TREATMENT B/4 ARRIVAL
SECONDARY SURVEY: SAMPLE - <<>>
S- SYMPTOMS
A- ALLERGIES
M- MED HX
P- PMH
L- LAST MEAL INTAKE
E- EVENTS OR ENVIRONMENTAL FACTORS
HOW TO CARE FOR A DOG BITE - <<>>
-ASSESS WOUND
-CLEAN
-SERILE SALINE IRRIGATE
-CONSIDER RABIES, TETANUS, AND ANTIBX PROPHYLAXIS
-SPLINT WOUNDS OVER JOINT
ESI: EMERGENCY SEVERITY INDEX (LEVEL 1) - <<>>
-MI
-OVERDOSE WITH BRADYPNEA
-INTUBATED
-RESP. DISTRESS
-ANAPHYLACTIC SHOCK
-HYPOGLYCEMIA WITH NEURO CHANGE
ESI: EMERGENCY SEVERITY INDEX (LEVEL 2) - <<>>
-CHEST PAIN FROM ISCHEMIA
-MULTIPLE TRAUMA (UNLESS UNRESPONSIVE)
-SUICIDAL PT.
-ACUTE STROKE
-IMMUNOCOMPROMISED PT. WITH FEVER
ESI: EMERGENCY SEVERITY INDEX (LEVEL 3) - <<>>
NI FOR ANAPHYLACTIC REACTION - <<>>EPINEPHRINE
NI FOR CIRCULATORY OVERLOAD - <<>>
- SLOW INFUSION 4 HOURS MAX
-WAIT 2 HOURS BETWEEN INFUSIONS
- HOB ELEVATED
-OXYEGN
-PUSH DIURETICS (FUROSEMIDE)
-END ALL IV FLUIDS
TREATMENT FOR THROMBOCYTOPENIA - <<>>FFP
NEUTROPENIC DIET - <<>>-NO FRESH FRUIT OR VEGGIES
-COOKED OR PROCESSED ONLY
S/S OF ESOPHAGEAL CANCER - <<>>
-DYSPHAGIA
-COUGHING/ CHOKING
-HOARSE VOICE
-FEELING THAT FOOD IS NOT PASSING
-PAIN MAY RADIATE TO JAW OR NECK
S/S OF GASTRITIS - <<>>
-ANOREXIA
-N/V
-EPIGASTRIC TENDERNESS
-FEELING OF FULLNESS
WHAT CAUSES GASTRITIS - <<>>
-ASPIRIN
-BIPHOSPHONATES
-CORTICOSTEROIDS
-DIGOXIN
-IRON
-NSAIDS
-ALCOHOL
-SPICY FOODS
-H. PYLORI
WHEN TO GIVE PRESSORS - <<>>
-HYPOVOLEMIC SHOCK AFTER FLUIDS HAVE BEEN GIVEN
- HEART ATTACK
-HF
-BLOOD TRANSFUSIONS
-SEPSIS
-DRUG REACTION
-SNAKEBITE
