Tuesday, September 17, 2019
Nursing Final
Its a beta blocker. ââ¬â Chapter 18- Peripheral Vascular Disorders -Hypertension- BP 140/90. -Hypertensive Crisis- 180/120 -DASH diet- 2,000 calories. 7-8 grains, fewer than 2 servings of protein Review pages 430- 438 Chapter 29- Urinary System ââ¬â Urinary Tract Infection- #1 Nonsocial infection Most common location is the bladder (cystitis) Most common upper OUT is kidney and renal pelvis (polytheists) Most common bacteria to cause OUT is e-coli Difference between Cystitis and PolytheistsCystitis- Disarray, urgency, nocturne, Papyri, Hematite Polytheists- Same as above plus flank pain, N-V-D, fever, malaise- Urinary Calculi. Stones made from Ca. Dull, aching to severe flank pain. Nausea, vomiting. Gross hematite. ââ¬â Lithography- crushing stones through sound waves ââ¬â Acute Renal Failure. -Rapid onset. Reversible.Most common cause is sashimi (poor perfusion to the kidney) Most common symptom is Algeria (urine output less than 400 muddy) High BUN and creating leve ls Page 2 Occurs in 3 stages: initiation (up to days), maintenance phase (up to 2 weeks) and this is here all the problems occur, and the recovery phase (up to 1 ââ¬â Globetrotting's Leading cause of kidney disease and failure Caused by strep (a beta-hemolytic strep) Surrounded by bowman's capsule Sex: hematite, proteins, hypoglycemia, azotes (increase Nitrogen) Lasts 10-14 days Nephritis- nephritis is any degenerative disease of the renal tubules.Nephritis can be caused by kidney disease, or it may be secondary to another disorder. It should not be confused with nephritis, where inflammation is implied. ââ¬â Nephritic Syndrome Same as above but there is a significant loss of protein lost in urine Found in lupus ND those with kidney disorders Sex: proteins, low albumin, high lipids, and severe edema in face and periodontal area. Blood clots are common. ââ¬â Urine Dipstick PH 6-6. 5 specific gravity 1. 010-1. 025 Everything else is negative in a healthy patient Potassium Normal 3. -5. 2 ââ¬â Sodium Normal 135-145 Drugs that lower sodium levels are diuretics, (pep-/ Noreen), decongestants and antithetic medications IV solutions that increase sodium are Nasal Chapter 31- Male Reproductive ââ¬â Tetrahedral resection of the prostate (TURN) ââ¬â is a surgical procedure that removes portions of the prostate gland through the TURN requires no external incision. Pen's. A Inserted through the penis and the wire loop is guided by the surgeon so it can remove carried by fluid the obstructing tissue one piece at a time.The pieces of tissue are into the bladder and flushed out at the end of the procedure. TURN is generally done to relieve symptoms due to prostate enlargement, often due to quite enlarged Problems with dribbling. BP. BP is a condition in which the prostate gland may become and cause problems with urination. Symptoms may include getting a urine stream started . Nocturne, urgency, Monitor tort hemorrhage tort the TLS 2 Chapter 32- Female Reproductive Meteorological Bleeding between periods Sign of cervical or uterine cancer Dilation and Curettage (D ;C) Page 3 ââ¬â Cervical canal is scraped 48 hours.Monitor for circulation. Avoid pillow under legs. Avoid tampons for 2 weeks. ââ¬â Vaginas Fungal (candidates) Protozoan (trice. ) bacteria (grandparent) Chapter 34/35- Endocrine System Biofeedback Mechanisms (3 below) 1) glucose maintenance- interplay between insulin and clangor, pancreatic hormones that release glucose and store glucose, respectively 2) body temperature maintenance -hypothalamus, nerves, skin, sweat glands, earth(beats faster if warm), kidneys -if your temp. Increases due to exercise/warm weather/illness: sweating occurs to produce evaporation which leads to cooling -if your temp. Decreases due to cold weather/being scared/illness: ââ¬Å"goose bumpsâ⬠(obliteration) occurs, which are thought to be derived from a response that enable the hair to stand on end causing more insulation and hea t 3) fluid maintenance- -kidneys regulate how much fluid is excreted. If you are dehydrated they will produce less urine. If you drink a lot of fluid quickly, then more urine will be excreted ââ¬â Thyroid sits on either side of tracheaIsthmus connects two lobes Needs iodine to secrete to (thyroxin) and to (trinitrotoluene) that increases metabolism Also secretes calculation that decreases excess calcium levels in the blood ââ¬â Hyperthyroidism Too much thyroid hormone AS: Increased appetite, yet loses weight. If left untreated, will cause cardiac dysphasia and heart failure Develops into 2 disorders: Graves disease and thyroid crisis Graves disease (goiters ; expostulates- protruding eyes) Expostulates- protruding eyes Thyroid storm- High fever (;102), tachycardia, hypertension, restlessness, seizures, delirium- Tracheotomy-Will be on lifelong replacement hormones Thyroid state (balanced hormonal state before surgery) Nursing precautions: hemorrhage, respiratory distress, la ryngeal nerve damage, tenant, thyroid storm Maxed- form of hypothyroidism Brought on by exposure to cold, infix, temp, trauma, narcotics ; tranquilizer More frequent in women AS: seizures, lethargy to coma, hypothermia. Respiratory and cardiovascular systems shut down. TX: airway, Cardiac function, increasing Temperature and HTH levels by getting labyrinthine by IV. Page 4 ââ¬â Cushing Syndrome Adrenal cortex produces too much cortical (hormone) or ACTAAS: fat deposits in abdomen, clavicle, buffalo hump, round moon face, hirsute (excessive facial hair) DXL: Increase cortical level and elevate 24 hour urine test with 17- sisterhoods and 17- horticulturalists. Low potassium, Sodium and glucose levels are also higher. Meds: lessoned and acetated are commonly used. Addison Disease Adrenal insufficiency AS: decrease glorifications, mineralogist's, and androgen's TX: IV fluids, glucose, An, sociolinguistics, warm and quiet environment DXL: Decreased levels of cortical, decreased 24 ho ur urine test with 17- sisterhoods, Potassium is increased, glucose and sodium are decreased.Phosphorescently benign tumor of adrenal medulla Produces excessive amounts of epinephrine and morphogenesis Stimulates the sympathetic nervous system AS: BP 200-300/150 +, pounding HA, profuse sweating, tachycardia, flushing, DXL: increased catecholamine levels in the blood or urine, CT scan. Tracheotomy Nursing care: stabilize BP ââ¬â Tracheotomy Removal of adrenal gland High risk of Addison crisis or adrenal crisis. ââ¬â Addison Crisis hypertension, rapid weak pulse, extreme weakness, confusion, circulating collapse and shock.Dangerously low K+ levels. ââ¬â Diabetes Insipid Results from lack of DAD hormone Two types: energetic (damage to pituitary) and nephritic (Kidneys) Risk for hyperthermia Sex: Polynesia, popularly (5-15 ml. ââ¬Ëday) urine specific gravity of less than 1. 005, mucous pale urine, weakens, dehydration, tachycardia, poor skin author, dry membranes Nursing Care: managing fluid and electrolytes, replacing DAD. Monitor daily weight. Meds: Visionaries (monitor for h/a and abdominal cramps).Ethicize diuretics sodium Chapter 36- Diabetes ââ¬â Normal blood glucose is 70-100. Diagnosing Diabetes plasma glucose level (>200) oral glucose tolerance test (2 hour test, >200) sting blood glucose (8 hour test, > 126) Peripheral Vascular Disease Greater in Type 2 Atherosclerosis of lower legs Page 5 Leads to gangrene. (Most common cause of amputations) AS: hair loss, atrophic skin, cool feet, red- white legs, thick toenails, pain with walking a pulses. ND at rest (usually at night), diminished or absent peripheral ââ¬â Type 1 Diabetes Destruction of beta cells leads to state of absolute insulin deficiency Usually occurs in childhood Prone to developing acidosis's Insulin dependent Sex: Popularly, Polynesia, polyphonic, weight loss, fatigue, malaise, blurred vision ââ¬â Type 2 Diabetes Sufficient insulin to prevent acidosis's, but to lowe r blood glucose Usually occurs after 30 Most clients are obese Insulin requiring but not dependent Sex: Popularly, Polynesia, obesity, recurrent infix, fatigue, blurred vision, parenthesis (numbness and tingling around mouth and hands and feet. ââ¬â DAD 1800 clone Diet Diabetic Acidosis Occurs in Type 1 diabetes Sex: hyperglycemia, dehydration, coma, BBS > 250, stentorian. Metabolic Acidosis's= fruity, alcohol breath Common in those who are undiagnosed. TX: fluids, insulin, correction of electrolytes. Unconsciousness patients need 0. 9% normal saline to replace sodium. Start with 0. 9, then 0. 45%. Dextrose is added to prevent hypoglycemia. Exercise Reduces blood glucose by increase glucose use by the muscles. Eat snack before exercising. Avoid exercising if fasting is ; 250. -Only regular insulin may be given b y the IV route.HAS (Hyperbolas Hyperglycemia State) Occurs in Type 2 Characterized by severely high glucose ( or ;), extreme dehydration, and alter LOC, grand mall seizu res. -Differences between DAKAR and HAS Type 1 Lethargy H HAS Type 2 Coma Samuels breaths Rapid, shallow breathing Glucose ;250 Glucose ; 600 *Samuels breathing ââ¬â rapid, deep respiration to prevent decrease in PH. Smoggy Effect Morning rise in glucose after a nighttime hypoglycemia. Sex: tenors, night sweats, and restlessness. TX: Eat bedtime snack Dawn phenomenon Rise in glucose between 4 am and 8 am.TX: increase insulin dose or changing injection time from dinnertime to bedtime Page Hyperglycemia Sex: Increased thirst and frequency Diet: low carbohydrates and sugar, sufficient hydration, and frequent small meals. ââ¬â Hypoglycemia Sex: carry an emergency snack high in carbohydrates to help raise low blood sugar. People who have experienced hypoglycemia in the past should eat meals at regular intervals, avoid excessive alcohol and never drink alcohol on an empty stomach. Chapter 37- Nervous system ââ¬â Cardiovascular Accident- Brain attack or stroke Thrombosis C.V.- Caused by atherosclerosis of arteries.Happens during or after sleep. Embolism C.V.- caused by problems with the heart Hemorrhagic C.V.- caused by hypertension Right Side vs. Left side Effects left side Effects right side Visual Unaware Impulsive Heat stroke Speech (Left-Language) Away re Slow, cautious heat cramps, heat syncope (fainting), and heat exhaustion . Nausea, seizures, confusion, disorientation, and sometimes loss of consciousness. Remove any extra clothes. ââ¬â Frost bite Don't put direct heat on it. Wrap in blankets or move to a warmer environment.Chapter 38- Interracial Disorders ââ¬â Closed head injuries Coup-contractor- Jerking forward-jerking back ââ¬â Concussion brain injury resulting trot violent snaking or impact ââ¬â Contusion bleeding into soft tissue resulting from blunt force Epidural Hematite severe blow to brain causing arterial bleeding between skull and durra mater. ââ¬â Suburbia Hematite injury between durra mater and subtractions laye r ââ¬â Antibacterial Hematite Bleeding into brain caused by gunshot wound or depressed skull fracture- Simple arterial seizure- Jerking of finger, hand, foot, leg and face.Called Jackson March. ââ¬â Sex: flashing lights, tingling sensations, or hallucinations. ââ¬â Complex Partial Seizures Sex: lip smacking, aimless walking, picking up clothing ââ¬â Absence seizures- In children. Blank stare. Lasts 5-10 seconds. May be unaware. ââ¬â Tonic-clinic seizures- Adults and children. From trauma. Stages: aura, tonic phase, clinic phase, postnatal phase Up to 30 miss Page 7 Chapter 39- Neurological and Spinal Multiple Sclerosis degenerative disease that damages myelin sheath surrounding axons. Marked by periods of exacerbation and remissionEffects Women between 20-50 Myelin sheath is the white matter in the CONS Put is prone to IT'S, pressure ulcers, Joint conjunctures, pneumonia, depression DXL: SF (cerebration's fluid analysis). Look for Gig. , MR. and CT scan. ââ¬â Parkinson Disease Results from a lack of dopamine 3 cardiac signs: tremor, rigidity, braininess. Pill-rolling. Leopard- Used to treat shaking, stiffness, and slow movement Interscholastic- Med for Parkinson Sex: dry mouth, orthodontic hypertension, constipation, urinary hesitation, pupil dilation, blurred vision, dry eyes, photosensitive, increased heart rate.Anesthesia Gravies Marked by periods of exacerbation and remission Sex: eyelid photos (drooping eye), diploma (double vision), slurred speech, nasal voice, difficulty chewing or swallowing Face appears to have a snarl or grimace Risk for aspiration and respiratory insufficiency ââ¬â Choleric Crisis caused by taking meds too early. Sex: Severe muscle weakness, NV, increased salivation, sweating, brickyard. ââ¬â Anesthetic crisis Caused by taking meds late Sex: muscle weakness, inability to speak/swallow, respiratory distress, anxiety ââ¬â Terminal Neuralgia Causes pain along both sides of face.Sex: periodic, severe pain in cheeks, forehead, lips. Triggered by wind, chewing, shaving. Rhizome- surgical severing of a nerve root to control pain. ââ¬â Autonomic Dyslexia Effects TO and above. Stimulated by full bladder or fecal impaction. TX: Elevate HOB 45 degrees. Check for kinks in catheter. ââ¬â CLC-CA injury puts a person on a ventilator. MONOCOTYLEDON a protrusion of impinges and spinal cord through a defect in the spinal column Chapter 40- Eye Disorders ââ¬â Cataracts Red-reflex (reddish-orange glow in pupil when light hits it) disappears. Intraocular lens is implanted to focus light and restore vision.Snell Chart Eye chart. Madrigals- med that causes dilation of pupil Page 8 Chapter 43- Musculoskeletal Trauma Mast Suit Used for carcinogenic & hypoglycemic shock in abdominal, pelvic and lower extremity Internal (Proportional) trauma ââ¬â Know: Diabetes, insulin ââ¬â peak time & preparing, when to administer, Insulin Comparison Chart: Insulin Type Onset Peaks at Ends Workin g in Low Occurs at Humanly- (Rapid) 15-20 miss 30-90 miss 3-4 hours 2-4 her Novel- (Rapid) 15-20 miss 40-50 miss 3-4 hours 2-4 her Regular (short)30-60 miss 80-120 miss 4-6 hours 3-7 her NAP (intermediate 2-4 hours 6-10 hours 14-16 hours 6-12 herLandaus (Long) 2-3 hours almost no peak 18-26 hours 4-24 her Oxalate: This medication is used to treat a high level of potassium in your blood. Too much potassium in your blood can sometimes cause heart rhythm problems. Sodium polystyrene sultanate works by helping your body get rid of extra potassium. Corticosteroids- from the adrenal cortex . Used to treat purists (itching) and psoriasis, bone cancer, chronic interpolator diseases such as Arthur s Sociolinguistics (creditors) raises blood glucose levels. Mineralogical (lodestone) maintains normal salt and water balance through kidneys.
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