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Exam 2- Med Surg
Terms in this set (89)
Philosophy of care for individuals with life-threatening illness. Still trying to restore function and slow the progression of the disease.
-prognosis may be greater than 6 months (copd patient)
Interdisciplinary approach to facilitate quality of life and peaceful death. Maintain function as long as we can but do not restore function because we know they are going to die.
-neither hastens nor postpones death
-6 months or less to live-no curative treatment
What medication should you avoid for anxiety in End of Life patients?
What is a medication that would be a better choice for anxiety in these patients?
Surgical Care Improvement Project
What does SCIP stand for? If hospitals use the to prevent infection, DVT, BP issues and other preventions, the hospital will get paid for it.
Preoperative medications used to reduce anxiety
sedatives or hypnotics
Preoperative medications that promote relaxation
Preoperative medications to reduce nasal and oral secretions.
use of positive pressure
What is a way to fix laryngospasm?
H2 histamine blockers
Preoperative medications that inhibit gastric secretions
Preoperative medications that decrease the amount of anesthetic needed for induction and maintenance
Higher (about 10%)
Is blood pressure higher of lower in the legs?
A rare life-threatening complication in which the skeletal muscle is exposed to a specific agent and causes increased metabolism and calcium levels in muscle cells. Leads to acidosis, high temperatures, dysrhythmias.
Cluster of: elevated end-tidal carbon dioxide level, decreases oxygen saturation, and tachycardia (High CO2, low Sats)
Drug that is given to reverse malignant hyperthermia.
presents of myoglobin in the urine-calcium that is invading and killing the cells.
Ondansetron (Zofran)- most common
Meclizine (Antivert, Dramamine)
Drugs given for nausea and vomiting postoperative.
Is glucagon released by alpha or beta cells?
Is insulin released by alpha or beta cells?
A transporter to get glucose into the cells for energy and removes glucose from the blood. It also prevents fat breakdown and protein breakdown.
What returns glucose to the blood?
carbohydrate, protein, and fat metabolism
What does glucagon and insulin affect?
What is normal glucose levels?
Elevated blood glucose levels is called
Decreased blood glucose levels is called
Lock and Key
What kind of hormone receptor binding does hormones have in the endocrine system?
What are early signs of diabetes mellitus?
Type 1 Diabetes
An autoimmune disorder. The person's beta cells are completely destroyed and they are unable to produce insulin.
Typer 2 Diabetes
a milder form in which there is increased tissue resistance to insulin. May be controlled by diet, exercise, and or oral hypoglycemics.
A metabolic disease that is characterized by CHRONIC hyperglycemia (to much sugar in the blood)
Polydipsia (increased thirst)
Polyuria (increased urine output)
Polyphagia (increased appetite or hunger)
What are the 3 P's of hyperglycemia
What is characterized by dark, thick, velvety skin in body folds and creases? Commonly seen on the back of the neck, under the arms, and in the groin area.
Metabolic Syndrome (MET S)
Presence of simultaneous metabolic factors that increase risk for Type 2 Diabetes Mellitus and CVD.
Atleast 3 of the following features:
What is the normal A1C range for adults?
Every 3 months
How often should Type I DM have their HbA1c drawn?
Every 6 months
How often should Type II DM have their HbA1c drawn?
Normal range for fasting blood glucose test
Normal range for glucose tolerance test (2-hr post-load result)
How many units of fast acting insulin for every 15 carbs ingested?
Should you exercise if there is ketone bodies present in the urine?
Sulfonylurea agents (oral antidiabetic medications)
Meglitinide analogues (oral antidiabetic medications)
What drug should people with kidney disease avoid?
Biguanides (oral antidiabetic medication)
Pioglitazone (Actos)- contraindicated in symptomatic heart disease and CHF
Rosiglitazone (Avandia)-contraindicated in symptomatic heart disease and CHF
Sitagliptin (Juanuvia)-increased risk acute pancreatitis
Exenatide Extended (Bydureon)
Sub-Q Antidiabetic drugs (GLP-1 agonist)
Review types of insulin
How much urine output is normal to prevent dehydration?
0.5-1.1 mg/dL (female)
0.6-1.2 mg/dL (male_
Normal serum creatinine levels
Normal blood urea nirtogen (BUN) levels
Normal specific gravity
What doe nitrites in the urine suggest?
What doe leukoesterase in the urine suggest?
divide the BUN by the creatinine to determine whether non-kidney related factors may be the cause of elevated BUN.
produced when muscle and other proteins are broken down. Best indicator of kidney function.
BUN (blood urea nitrogen)
measure effectiveness of kidney excretion of urea nitrogen (liver metabolism of food sources of protein)
inflammation of the bladder
inflammation of the urethra
Inflammation of the prostate
Inflammation of the kidneys
Most common bacterial cause of UTI
Get a UTI, then it clears up with antibiotic or goes away, then come back
Get a UTI and it stays around for a while
term for stays in the bladder to long and causes bacteria to build up causing a UTI
Catheter associated UTI in the hospital
entire lower UTI with no known cause
entire lower UTI and know the cause
not from bacterial cause. Can be caused from medication, radiation or chemical exposure.
What is the most common cause of urethritis in men?
As women age they decrease the production of ______, which increases dryness, allows for more bacterial growth and irritation.
narrowed areas of the urethra and causes the obstruction of urine flow.
Excess Urine Output
Common causes of transient incontinence
presence of calculi (stones) in urinary tract
Formation involves: obstructed urine flow, damage to the urinary tract, decreased amounts of bodies natural ability to prevent crystal aggregation.
Hematuria- #1 sign of urolithiasis
(testicular cancer is the most common form of cancer in me between the ages of 15-35)
Which ethnic group has a higher frequency of developing testicular cancer?
Benign Prostatic Hyperplasia
hyperplasia of glandular units in the prostate
*increased number of prostatic cells
What is though to be the cause of benign prostatic hyperplasia?
5-alpha reductase inhibitor (5-ARI)
drug used to decrease the DHT levels in males with prostatic benign hyperplasia.
Always get liver labs because this medication is dangerous and can damage the liver
First line drug therapy for BPH
Saw palmetto (over the counter herb)
Complementary or alternative nonsurgical management for BPH.
Alpha 1 selective blocking agents for BPH. These drugs help with urinary flow, just like 5-ARI's, they can cause orthostatic hypertension and require liver labs.
Very effective with flow of urine
*Encourage the patient to drink plenty of fluids.
Transurethral resection of the prostate
TURP-enlarged portion of the prostate is cut into pieces and removed through the urethra by an endoscopic instrument.
*Blood, messy procedure that can cause a lot of problems.
*Requires a large indwelling catheter for a day or two and should be taut (tight)
*Lots of fluids to keep it irrigated (continuous)
Holmium Laser Enucleation of the Prostate
HOLEP- pushes tissue into the bladder through laser and it comes out in urine.
*Minimally invasive which results in less trauma and allows the patient to heal quicker.
High red meat, complex carbs, and low fiber diet
Risk factors for prostate cancer
What is the 5 year survival rate for prostate cancer?
45- if African American with family history
40- for multiple 1st degree relatives
At what age should a PSA be drawn for prostate screening?
Laboratory screenings for prostate cancers
Bone pain/unexpected weight loss
Red flags for prostate cancer
digital rectal exam
Phospodiesterace-5 inhibitors (PDE-5 inhibitors)-First line oral drugs to manage ED
*Do not mix alcohol
*Do not take nitrates due to profound hypotension and reduced blood flow to vital organs
Patients with these problems have higher risk for testicular cancer
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