Upgrade to remove ads
NURS 402 final
Terms in this set (23)
Abd/pelvis CT Scan
-evaluates structures and problems w/ solid organs
-evals abscesses, fluids, vascular disorders, obstructions, trauma
-w/ or w/o contrast: IV, rectal, or oral contrast to enhanced images
-NPO so food doesn't interfere
HIDA (hepatobiliary scan)
evals the cystic duct (which goes out of the GB), the ejection fraction of GB, and patency of cystic and common bile ducts
-nuclear IV med dye
-Increase fluid intake after scan
-more expensive and extensive than CT
-examines biliary system when persistent jaundice, vessels
-watch the bile go through the common bile duct
-iodine dye in common bile duct to visualize blockages
-commonly done in post op or intra op
-client assessment: iodine allergy, freq VS
atherosclerosis can cause (s/s)
triggers for angina
-paroxysmal pain (sudden)/discomfort
-quality: tight rubberband, elephant on chest, burning, pressure
-can radiate down left arm
-requires rapid assessment of pain
-seen more in women.
-unusual fatigue, dyspnea
-pain in shoulder blades, upper back
-jaw pain, neck pain, indigestion
-lasts 1-5 min if precipitating factor is relieved
-relieved by NTG or rest
- occurs with moderate to prolonged exertion
-slight activity limitations
-no permanent damage
-individual pattern-reproducible (same s/s each time)
-they dont go to the ER bc s/s go away
goals: decrease mo2 demands & increase mo2 supply; INCREASE O2 TO TISSUE/REPERFUSION TO FIX ISCHEMIA.
control risk factors
pharm tx (vasodilators (nitrates), CCB, ACE/ARBS, statins, BB, antiplatelets, o2)
Guidelines to manage angina RF
HTN goal under 140/90
DM glycemic control
sublingual: peak 3-5 min
-check BP before given another one
-one at a time
ointment: works over the course of 6hr
-wear even when s/s aren't present
*nitroprusside: for more HTN crisis; given IV
2. CCB: 'pines', amlodipine & diltiazem
3. ACE/ARB: 'prils'
6. antiplatelets- ASA, clopidogrel
3 types of acute coronary syndrome
(acute onset of myocardial ischemia resulting in myocardial death [MI] if interventions don't occur promptly)
NSTEMI, STEMI, unstable angina (UA)
-chest pain that occurs with rest
-onset with minimal exertion
-lasts longer than 20 min
-no muscle damage
NI: assess for MI
-stay with the patient!!
-IV, 02, monitor: all together
-educate ED nurse and paramedic
what CM would cause the pt in the ER to be taken immediately to cath lab for immediate PCI?
STEMI; to reperfuse location of decreased O2
pre-op teaching for cardiac cath
NPO 6 hrs; bedrest for 2 hrs to decrease stimulation
Check for iodine/shellfish allergy
teach: pt will be awake. Palpitations and flushing is normal.
Post-op cardiac cath
NI: assess for hematoma and bleeding
-MONITOR FOR V DYSRHYTHMIAS
-BR for 2-6hrs with legs straight
-HOB up to 20 degrees
-hold site with pressure
-assess site for s&s of infection
-hydrate to flush contrast
-assess coagulation studies
Teach: no coughing, sneezing or bladder distention (could dislodge clot that is starting to form)
Adequate cardiac output as evidenced by:
• Stable/improving electrocardiogram (ECG)
• Heart rate and rhythm
• Blood pressure
• Urine output
• Serum blood urea nitrogen (BUN) and creatinine
• Skin color and temperature
6) What is the primary reason for administering morphine to a client with an MI?
To sedate the client
To decrease the client's pain
To decrease the client's anxiety
To decrease oxygen demand on the client's heart
To decrease oxygen demand on the client's heart
WAYS TO IMPROVE COMMUNICATION WITH TEENS
Set aside appropriate amount of time to discuss subject matter without interruptions.
Talk face to face. Be aware of body language.
Ask questions to see why he or she feels that way.
Ask him or her to be patient as you tell your thoughts.
Choose words carefully so he or she understands you.
Tell him or her exactly what you mean.
Give praise and approval to your teenager often.
Speak to your teenage as an equal—don't talk down to him or her.
Be aware of your tone of voice and body language.
Don't pretend you know all the answers.
Admit that you do make mistakes.
Set rules and limits fairly.
FACTORS INFLUENCING THE ADOLESCENT'S DIET
Concern about weight control
Convenience of fast food
what is alteplase and what is it used for?
It's a thrombolytic used when a PCI is C.I. or there's not enough time.
-get within 30 min of initial medical evaluation!
-Get within 90min of initial medical evaluation.
indications: STEMI and possibly NSTEMI (ongoing chest pain, hempdynamically unstable, or increased risk of worsening condition)
YOU MIGHT ALSO LIKE...
Ch 27 Hinckle MOFOS
Exam 4 -Chapter 27: Management of Patients With Co…
Chapter 27: Management of Patients With Coronary V…
OTHER SETS BY THIS CREATOR
304 exam 3
308 test 3
OTHER QUIZLET SETS
Accounting T/F Chap. 4
Individualized Instruction Chapters 5, 6, and 7
Interest Groups/Media/Campaigns and financing them