Med-Surg 2 Part II

What are some complications seen in MI?

Rib and pelvic fractures can cause...

Which lead is placed near right mid-clavicular, directly below the clavicle?

What do you do before RRT/Code Team arrives?

What are nursing interventions for TB pt?

What is the normal PRI rate?

S/s pain, ↓ROM, change bone alignment, alt in length of extremity, swelling, discoloration, crepitation, subq emphysema

Wheeze, tachypnea, sob, cough unproductive, chest pain, HR↑, anxiety, intercostal retract, nasal flare, prolong expirat.

Q wave is 1/3 of QRS or 1 box wide, If wider it indicates Hx of MI.

Chronic inflammatory disorder of airways, wheezing, sob, chest tightness, coughing, restricted airflow, reversible, gene

Loud snoring, snorting, gasp during sleep, recurrent waking during sleep, choking, daytime sleepy, morning headache, HTN

What must a nurse determine before terminating airborne precautions for a pt with pulmonary TB?

What are possible complications of acute arterial occlusion?

Which diagnostic testing has a two dimensional, ultrasound, evaluates structures/function (pumping ability)?

What are signs of organ dysfunction?

What are the manifestations of angina?

Catecholamines, meds, elicit drugs, digitalis toxicity, acidosis/alkalosis, hypoxia, MI/Infarc, K↓↑, Ca↓, Mg↓, causes___

Which is the most accurate test for asthma?

What is known to prolong QT intervals?

Which musculoskeletal diagnostic evaluates bone mineral density and checks for osteoporosis?

What is the normal value range for QTI interval?

Pt not physical able to do stress test, contrast, arteries affected CAD no dilate, consent NPO, no coffee, review meds

Disorder of peripheral vascular system interferes w/ circulation caused by damage to valves in veins. Blood pools.

Muscle mass decreases 30-40% as we age reducing strength.

Faster the rate the shorter QT

Which pacemaker produces 40-60bpm?

Where are muscle spasms commonly located?

What are the different types of polycythemia?

ST elevation indicates myocardial ischemia, reciprocal changes, and or digoxin.

What are conservative treatment for carpal tunnel syndrome

Which musculoskeletal diagnostic test evaluates MS trauma and consent is needed if IV contrast is used?

Sudden pain/claudication, embolus/thrombus commonly found in LE interrupting blood supply

No excess RBC, fluid deficit, RBC count WNL, ↑hct, corrected by hydration

What are some precipitating factors for Angina?

O2,Epi,amiodarone,atropine,adenosine,diltiazem,digoxin,ca,lidocaine,Mg sulfate,dobutamine,dopamine,narcan,NaHCO3 in cart

What diag. evaluates avascular necrosis, osteomyelitis, tumors, disc abnorm, ligament tear, consent/questionnaire need.

What diagnostic has a catheter inserted into coronary artery, guide wire, ballon inflated, and stent placed?

Fever, dehydration, infection/sepsis, anxiety, adrenergic agonists, intense physical activity all cause sinus ____

Pt was diagnosed with COPD has pulse ox reading 82% on RA. A nurse should obtain an MD order to do which intervention?

When planning care for assigned clients, what care can RN on med-surg floor safely delegate to LVN?

Male, obesity, smoking, alcohol use, age 40-65, menopause, nocturnal dysrhythmias, DM2, HF, Pulmonary HTN, are risks for

chest pain=↓heart blood flow, cause CAD, atherosclerosis, constrict., exercise, coke/stress, HF,vent hypertrophy, ische.

What are some cardiac marks that need to be monitored for Angina?

Loss of alveoli elasticity, hyperinflation of lungs

Pt assessment, ECG strip, notification Dr/orders received, treatments initial-response, post, rhythm strip,

Stretch/tear of ligament surround joint ankle/knee most common s/s cannot move joint, discolored, pain, rapid swelling.

Multiple wave forms beginning of Q wave and end of S wave. Represents depolarization of ventricles

Serum erythropoietin ↑, bone marrow studies how only red stem cells hyperplasia for secondary polycythemia diagnositcs

50% of pt who code exhibit warning signs up to ___hrs prior to arrest.

Which pacemaker predominates?

What are the s/s of acute arterial occlusion?

Prevents clot formation inhibits plt aggregation

Tear medial/lateral meniscus from twisting leg when knee flex/foot on ground, s/s pain, swell, tender, click/snap knee

What are non modifiable risks for Acute coronary syndrome-

Myocardial cells necrosis, portion of muscle blocked-ischemic, irreversible cell damage, tissue around ischemia inflam.

Vitamin D normal serum levels are 9-11 mg/dl

RN gives report to receive RN, family care, summary printed, EKG strip chart, sheet complete, eval to RM, cart exch, doc

cigarette smoke, air pollution, occupational substances, alpha 1 antitrypsin deficiency, barrel chest, clubbed finger

What are some indication that a pt is in need of ECG monitoring?

On an ECG graph paper, vertical lines measure time.

What is the treatment of given for disseminated disease for Valley fever?

What are the treatments for polycythemia?

Repolarization is systole when the heart contracts

Treated like cancer, ↑RBC production, affects European Jewish men age 40-70, cause unknown

Which diagnostic test consists of ultrasound with probe in esophagus visualize back of heart. Need consent, vs, & premed

urgent intervention needed, aspiration, culture of fluid, abx therapy IV, repeated aspiration, surgical drainage/removal

A hemorrhagic stroke can occur if thrombolytics are given too late or beyond the 12-24hr window of inset chest pain.

Which lead is placed near left mid-clavicular, directly below the clavicle?

Each box on an ECG graph paper=0.04sec

Patho cilia damage, ↑airway resistance scar tissue, pulmonary infections, polycythemia develops response to hypoxemia

Latent TB a granuloma forms w/necrosis center= fibrosis/calci. & limit further proliferation & spread mycobacterium TB.

Morphine, O2, NTG, ASA, Stent, CABG, fibrolytics within 30min, antidysrhythmics, and beta blockers treat MI

What can be seen in a CXR of a COPD patient?

How is carpal tunnel syndrome diagnosed?

What are the medications for soft tissue trauma

What is the normal value range for QRS complex?

HTN, smoking, high LDL, DM, obesity, physical inactivity, stress, excess ETOH are all modifiable risks associated with..

coronary obstruct necrosis, abrupt/severe/unrelief pain, arm/neck/jaw, epig., n, sob, sweat, HR/BP↑↓, ST↑, Q wave, m: ↑

Deadly v-tach, polymorphic, tall and small waves, outline looks like a party streamer.

Calcium is bound to albumin. When one is low the other will be low as well.

Phosphorus levels 2.5-4.5 increase with bone tumors

What are the two surgical procedures used to treat carpal tunnel syndrome by decompressing the nerve?

Albuterol is an off label treatment for hyperkalemia

On an ECG graph paper, horizontal lines measures voltage.

ST elevation indicates myocardial injury/myocardial infraction

Contusion is caused by blunt force trauma that cause bleeding in soft tissue.

What do you do to call a code blue?

Diagnosis of asthma is determined by frequency and severity of attacks

Block rule is # of QRS complexes x10

Thrombolytics are T-PA dissolves clots quickly/completely and are initiated within 12-24 hr after onset of chest pain.

What are the joint classifications by structure?

What are some relieving factors for Angina?

15 or more obstructive sleep events per hours during a sleep study confirms Obstructive Sleep Apnea

What is the treatment for symptomatic bradycardia?

What is the care/treatment for chronic venous insufficiency?

90% of muscle spasms recover within 2 weeks.

Pt c/o calf/foot pain. Leg below knee is cool/pale, dorsalis/posterior tibial pulse absent. Priority intervention is...

Which lead is placed between the 6th and 7th intercostal space on right mid-clavicular line?

Inadequate o2 supply for metabolic,stable angina,coronary perfusion/myocardial workload,plaque,thomb,spasm,↓perfusion

What are some extrinsic factors that trigger an asthma attack?

Any 2 of these qualifies as SIR Temp >100.9/<96.9, HR>90, RR>20, WBC>12,000/<4000/10%bands, BG>140 non DM, AMS, BP norm

Long term 3mos +, PT/INR monitored, INR 2-3 venous/3-4.5 arterial, same time everyday, antidote Vit. K. no leafy greens

MI↑workload plaque narrow artery,predict.,pain neck/shoulder/arm 5-10min, relief rest,n/sob/anxiety twave inver mark:wnl

What is used to diagnose a torn meniscus?

Artifact in an ECG is when there is movement, muscle tremors/shivers/seizures, loose electrode & electrical interference

What are some dysrhythmias seen in MI?

Infection in fluid filled sac adjacent to tendon near large joints shoulder/elbow/hip/knees, glide surface ↓friction

Fever, aches, chills, sweats, fatigue, cough, headache, LE nodular erythema

Wide and bizarre beats with compensatory pause (two beats fit), wide QRS >0.10 sec

SOB,wheeze,↑nonproductive cough,pinkfrothy sputum,night sweat, anorexia,weight loss,nausea,fever,chills,fatigue,lethargy

What are the diagnostic tests used to detect valley fever?

Which lead is placed between 6th and 7th intercostal space on left mid-clavicular line?

RN must delegate care of an assign pt to a CNA for the shift. Which pt would be most appropriate to delegate

As soon as Code team/RRT arrives you can stop administering CPR.

Success of treatment of TB is dependent largely on compliance of the pt.

Sepsis is a potentially life threatening infection triggering inflammatory response throughout body.

For disseminated Valley Fever, pt is pre-medicated with which medications?

Partial dislocation is called subluxation

3 thousand TB droplet nuclei are expelled with 1 cough, 1 min singing, 5 min of talking

Thrombus are debris that move through the bloodstream until it lodges in a narrow vessel and blocks circulation.

How is MI diagnosed?

What musculoskeletal diagnostic testing evaluates bone density and structure with no special prep or consent needed?

Early beats by atrium, P waves, and PR may vary. Noncompensatory pause. P wave may be found in T wave/P wave absent.

If there is no documentation on record then pt is considered No Code

What are the three different muscle types?

Bone marrow studies show hyperplasia of all hematopoietic elements and serum erythropoietin WNL for Primary polycythemia

Which lead is placed right of the sternum at the 4th intercostal space?

What is the non life-threatening disease treatment for Valley fever?

When are thrombolytics contraindicated?

_interval is the beginning of Q wave and end of T wave.

What are diagnostic tests used for Acute Arterial Occlusions?

What is the treatment for a torn meniscus?

Manifestations chest pain, HR↑, anxiety, vasoconstriction, tachypnea, BP changes, women/elderly atypical chest pain

What are the intrinsic factors that trigger an asthma attack?

Surgical embolectomy an incision in the occluded artery, surgeon evacuate embolus using catheter and close w/patch graft

Uric acid (3.5-8M; 2.8-6.8F) > 12.0 mg/dl diagnose gout

Anticoagulant ↓thrombin, no periodic labs, dc 24-48hr before elective surgery, dc drug ↑thrombus formation.

What interventions are used for sinus tachycardia?

For a COPD patient, what type of medications should be used for treatment?

Which vasopressor is the first line treatment used for sepsis hypotension/unresponsiveness?

Primary goal and treatment for soft tissue trauma?

What are some medication treatment used to treat muscle spasms?

Which pacemaker produces 20-40bpm?

bronchial tubes lining inflame/scar,vasodilation,congestion,mucus edema, bronchi/bronchioles spasm, pollutant/cig smoke

This thrombolytic used for large clots/PE, does nothing to existing clot, PTT monitored, IVP/IV, antidote protamine sulf

What are the MI core measures?

Mycobacterium tuberculosis, acid fast bacillus, gram+ bacteria, droplets in air for hrs/airborne, found in lungs

Sepsis tx 1hr,retest lactate if >2,blood culture before abx,broad spec abx, 30ml/kg crystalloid↓BP/lactate 4 vasopressor

Common, erythocytosis, erythropoietin↑, affects people of any age/origin, develops in hypoxia, COPD, high altitudes

COPD ABG results will show PO2↑ and PCO2↓

What are the possible complications of valley fever?

What is the diagnostic test used to for obstructive sleep apnea?

What are the second line medications for TB

Heparin is used to treat existing blood clots.

What are some age related changes in the musculoskeletal system?

s/s polycythemia portal/HTN,headache,dizzy,vision,hear prob,weight loss, night sweats, plethora,GI bleed,claudication

Pelvic fractures can damage bladder and bowel causing infection.

Polycythemia reduction of red blood cells characterized by a hct < 55%

What is seen in an ECG for an MI stemi?

What are some conservative treatments for muscle spasms?

Impaired blood flow to myocardium, two main coronary arteries, atherosclerosis

What is the purpose of the skeleton?

What are causes of Acute Arterial Occlusion?

Early defibrillation and ACLS measures increase survival by 50-60%.

Diagnostic w/201 injected, stress test done, nuclear scan 2-3hr after to eval CAD. Need consent, vs, & assess med/coffee

What is the joint classification by function?

Ends of two connected bones separate from extreme force put on ligament/congenital common site shoulder.

Alpha 1-antitrypsin is produced by liver and present in the lungs to protect lung tissue.

Change in HR <40/>130, systolic BP <90/>200, RR <8/>28/no airway/O2 sat, AMS, UO <50ml/4h, sepsis, MI, CVA, concern

Fungal soil/spore infect lungs, can spread skin (common),internal organs, bones, meninges, severe depends on #spores/sus

Artery spasm partial occlu.unstable plaque,10min↑,epig pain,sob,hr↑,BP↓, cool/pale skin, ST dep, Twave inver, m: norm

brown discoloration, ankle edema/stasis, dermatitis/no itch/rash, red/cyanotic, no claudication, blister, skin ulcer

Rib fractures can damage lungs causing pneumothorax or kidneys causing blood supply loss.

What are some treatments used for obstructive sleep apnea?

Diagnostic ID CAD/valve disease, pressures in PA/heart chambers, angioplasty, consent NPO 6-8hr, leg immobile 6-8hr post

For emergent intervention of an acute arterial occlusion complication what should be done?

Rapid Response Team is composed of ICU nurse, RT, PT, MD, and bedside nurse.

What causes bursitis?

A pt blood O2 sat level is 99% on RA. The nurse realizes O2 blood is transported to heart through what structure?

Which diagnostic test checks for blood supply in the bone and requires consent?

What is the first line medication treatment for TB?

Gangrene and Necrosis used the same thing and can be used interchangeably.

If medications are not effective for emergent complications of acute arterial occlusion, what are other treatments used?

What are the most important diagnositc tools for COPD?

RN has just received report on the team. Which tasks can he/she delegate to an LVN?

Stretch injury muscle-tendon, mech overload extended past elasticity, s/s pain, limit ROM, muscle spasm, swelling, weak

Immune dys, DM, HIV, crowded areas, elderly, foreign people, homeless, drug/alcohol abuser, poor, HC worker are risk for

Muscle fatigue, heavy exercise, dehydration, low Ca/Mg, Kidney failure, hypothyroidism, ETOH abuse can cause...

Which diagnostic test has the highest sensitivity and is more accurate in identifying pt with TB?

For MI core measures, pt are discharged with ACE and ARB medications.

How is bursitis diagnosed?

CAD,Angi,& Mona go to CABO SAn lucas: Morph,O2,Nitrate,ASA,CA blocker, Anticoag.,beta blocker,other ↓lipid, Stat,ACE/ARB

Complications of acute arterial occlusion is seen in ICU when using vasopressors due to the constricting of vessels

ER symptoms extreme difficult breathing, bluish color lip/face, severe anxiety, chest pain, sweat, alert↓,drowsy/confuse

Sinus bradycardia is caused by...