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Terms in this set (173)
females: 4.5-5.0 million
*High= renal failure
*will increase w/ hepatitis/jaundice
1.5-2.5 times the control value in patients receiving anticoagulant therapy
Urine Specific Gravity
Antidote: Vitamin K
Antidote: protamine sulfate
fetal heart rate
2—5 minutes apart with duration of < 90 seconds and intensity of <100 mmHg.
appearance, pulse, grimace, activity, respiration
Done at 1 and 5 minutes with a score of 0 for absent, 1 for decreased, 2 for strongly positive. Scores 7 and higher are generally normal, 4-6 fairly low, 3 and below critically low.
umbilical cord has two arteries and one vein (arteries carry deoxygenated blood and veins carry oxygenated blood)
STOP-Treatment for maternal hypotension after an epidural anesthesia:
-stop infusion of pitocin
-turn client on left side
-if hypovalemia present, push IV fluids
Assess pulses for a full minute, if less than 60 bpm hold dose. Check digitalis and potassium levels.
Treatment of GERD and kidney stones. WOF constipation.
Hydroxizine (Atarax®, Vistaril®)
treatment of anxiety/itching. WOF= dry mouth
given for conscious sedation. WOF respiratory
depression and hypotension.
WOF: diaphoresis, dyspnea, lethargy
Take missed dose, but never double dose
WOF for signs of bleeding, diarrhea, fever, or rash. Stress importance of complying with prescribed dosage and follow-up appointments.
Treatment of ADHD. Assess for heart related side-effects and reported immediately. Child may need a drug holiday because the drug stunts growth.
treatment of hypotension, shock, low cardiac output.
Monitor ECG for arrhythmias & bp
Causes red/orange tears & urine
-Obtain baseline visual acuity tests.
-Determine color discrimination ability.
-This medication should not be given to children younger than 13 years of age.
-Instruct the client to report changes in vision immediately. & liver
-Use: prevention and treatment of TB.
-Latent TB INH: 6-9 months.
-Active TB: multiple therapy up to 24 months.
-Precautions: risk of nephropathy and hepatotoxicity, consume foods high in vitamin B6, avoid foods with tyramine, increase risk of phenytoin (Dilantin) toxicity, avoid alcohol.
turn head up, & turn side to side. Cooing or gurgling noises, can turn head to sound
grasps, switch and roll over tummy to back. Can babble and can mimic sounds.
sits at 6 and waves bye-bye. Can recognize familiar faces and knows if someone is a stranger. Passes things back and forth between hands.
stands straight at eight, has favorite toy, plays peek-a-boo.
belly to butt (phrase has 10 letters)
twelve and up, drinks from a cup. Cries when parents leave, uses furniture to cruise.
18 % (9 each)
36% (18 each)
Acute Renal Disease
protein-restricted, high-calorie, fluid-controlled, sodium and potassium controlled.
Diet: Addison's Disease
increased sodium and low potassium
Diet: ADHD and bipolar
high calorie, provide finger foods
high protein, high caloric, increase in Vitamin C.
high calorie, high protein
Diet: Celiac Disease
gluten-free diet (no BROW: barley, rye, oat, and wheat).
Diet: chronic renal disease
protein-restricted, low sodium, fluid restricted, potassium restricted, phosphorus restricted
Diet: cirrhosis with hepatic insufficiency
restrict protein, fluids & sodium
high-fiber, increased fluids
Soft, high calorie, low- carb, high fat, small frequent feedings, with 30 min rest before meals
Diet: Cystic fibrosis
liquid, low fiber, regular, fluid, & electrolyte replacement
Diet: Gallbladder disease
low-fat, calorie-restricted, regular
low-fiber, bland diet
regular, high-calorie, high-protein
Diet: Hypertension, Heart Failure, CAD
low-sodium, calorie-restricted, fat-controlled
Diet: Kidney stones
Increase fluid intake, calcium controlled, low-oxalate
Diet: Nephrotic Syndrome
sodium-restricted, high-calorie, high-protein, potassium-restricted.
Diet: obesity, overweight
calorie restricted, high fiber
Low fat, regular, small freq feedings, tube feeding or TPN
Diet: Peptic Ulcer
Diet: pernicious anemia
increase vitamin B12 (Cobalamin), found in high amounts of shellfish, beef liver and fish
Diet: Sickle Cell Anemia
increase fluids to maintain hydration since sickling increases when patients become dehydrated.
mechanical soft, regular, or tube-feeding.
high calorie, high protein
fluid and electrolyte replacement
Orthopneic position where patient is sitting up and bent forward with arms supported on a table or chair
Positioning: Post bronchoscopy
Flat (supine) on bed with head hyperextended
HOB elevated 30 degrees to reduce ICP and facilitate venous drainage
HOB flat in midline, neutral position; to facilitate venous drainage and encourage arterial blood flow; avoid hip and neck flexion which inhibits drainage
Positioning: Cardiac Catherization
keep site extended
Positioning: Above Knee Amputation
elevate for first 24 hours on pillow, position prone daily to
provide for hip extension.
Positioning: Below Knee Amputation
foot of bed elevated for first 24 hours, position prone daily to
provide for hip extension.
Positioning: Tube Feeding w/ Decreased LOC
position pt on right side (promotes emptying of the
stomach) with the HOB elevated (to prevent aspiration)
Positioning: Air/Pulmonary Embolism
(S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic,
sense of impending doom) --> turn pt to left side and lower the head of the bed.
Lung segment to be drained should be in the uppermost position to allow gravity to work.
Positioning: post lumbar puncture
patient should lie flat in supine to prevent headache and leaking of CSF.
Positioning: continuous bladder irrigation (CBI)
catheter should be taped to thigh so legs should be kept straight
Positioning: after myringotomy
position on side of affected ear after surgery (allows drainage of secretions)
Positioning: post cataract surgery
pt will sleep on unaffected side w/ a night shield for 1-4 weeks
area of detachment should be in the dependent position
Positioning: Post thyroidectomy
low or semi-Fowler's, support head, neck and shoulders.
Sitting on the side of the bed and leaning over the table (during procedure); affected side up (after procedure)
Positioning: Spina bifida
position infant on prone so that sac does not rupture
Positioning: Buck's Traction
elevate foot of bed for counter traction
Positioning: Post total hip replacement
Don't sleep on operated side, don't flex hip more than 45-60 degrees, don't elevate HOB more than 45 degrees. Maintain hip abduction by separating thighs with pillow
Positioning: prolapsed cord
knee-chest position or Trendelenburg
Positioning: cleft lip
position on back or in infants seat to prevent trauma to suture line. While feeding, hold in upright positon
Positioning: Cleft palate
side lying, to prevent pain and bleeding
Positioning: Hiatal hernia
Positioning: Preventing dump syndrome
eat in reclining position, lie down after meals for 20-30 mins, also restrict fluids during meals, low fiber diet, small frequent meals
left side-lying (Sim's) with right knee flexed
Positioning: Post supratentorial surgery (incision behind hairline)
elevate HOB 30-45 degrees
Positioning: Post infratentorial (incision at nape of neck)
flat & lateral on either side
Positioning: Increased ICP
laminectomy (aka decompression surgery; surgical removal of the lamina [the back part of the vertebra that covers the spinal canal], which enlarges the spinal canal to relieve pressure on the spinal cord or nerves to alleviate pain)
back as straight as possible, log roll to move & sand bags on each side
Positioning: Spinal cord injury
immobilized on spinal back board, head in neutral position and immobilized to prevent any movement with a firm, padded cervical collar patient must be log-rolled without allowing any twisting or bending movement
Positioning: Liver Biopsy
Right side lying with pillow or small towel under puncture site for at least 3 hours
paracentesis (removal of fluid from peritoneal/abdominal cavity) post procedure
flat on bed or sitting
Positioning: Intestinal tubes
right side to facilitate passage into duodenum
Positioning: NG tubes
elevate HOB 30 degrees; maintain for continuous, or 1 hour after feeding for intermittent feedings.
Positioning: Pelvic exam
Positioning: rectal exam
knee-chest, sim's, dorsal recumbent
Positioning: During Internal Radiation
on bedrest while implant in place
Autonomic Dysreflexia/Hyperreflexia (S&S: pounding headache, profuse sweating, nasal
congestion, goose flesh, bradycardia, hypertension)
sitting, elevate HOB first before any other implementation
bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified Trendelenburg)
elevate HOB 30 degrees to decrease intracranial pressure
Positioning: peritoneal dialysis when output is inadequate
turn pt side to side before checking kinks in tubing
water-based dye: semi-fowler's for at least 8 hrs
oil-based dye: flat for at least 6-8 hrs to prevent leakage of CSF
air dye: Trendelenburg
Common S/S: Pulmonary Tuberculosis
low grade afternoon fever
Common S/S: Pneumonia
rust colored sputum
wheezing on expiration
S/S of emphysema
Pink puffers, barrel chest, pursed lip breathers, distant quiet breath sounds, wheezes, pulmonary blebs on radiograph
S/S: Kawasaki syndrome
S/S: Pernicious anemia
red tongue, ataxia, neurological changes, anorexia, n/v
S/S: Down syndrome
shorter 5th finger, single crease on palm of hand, slanted eyes, protruding tongue, short thick neck
rice-watery stool and washer woman's hands (wrinkled hands from dehydration).
stepladder like fever--with chills
S/S: Typhoid fever
rose spots on abdomen
fever, rash, and headache. Positive Herman's sign
(pseudo membrane) dirty looking gray-white membrane covering the pharynx and larynx along with swelling of the pharynx make swallowing and breathing difficult. removing the membrane leaves a bleeding surface.
* 3-5 days prior to rash; mild to moderate fever, cough, runny nose, red eyes and sore throat
* rash; Koplik's spots- tiny white spots in the mouth, red or brownish rash beginning on the face and spreading downward, spike in fever with rash
S/S of Systemic Lupus Erythematosus
Fatigue, malaise, anorexia, weight loss;
Polyarthralgia and myalgia;
Butterfly skin rash on face
S/S of Leprosy (*slowly progressing bacterial infection that affects the skin, peripheral nerves in the hands and feet, and mucous membranes of the nose, throat, and eyes. Destruction of the nerve endings)
leonine (thickened folded facial skin)
Chipmunk facies (parotid gland swelling)
rebound tenderness at McBurney's point. Rovsing's sign (palpation of LLQ elicits pain in RLQ). Psoas sign (pain from flexing the thigh to the hip).
S/S of meningitis
Kernig's sign (stiffness of hamstrings causing inability to straighten the leg when the hip is flexed to 90 degrees), Brudzinski's sign (forced flexion of the neck elicits a reflex flexion of the hips).
Hypocalcemia, positive Trousseau's sign, Chvostek sign
-Neck, back, abd. muscles become rigid->convulsions->laryngeal/resp spasms (apnea/anoxia)->overstimulation of SNS->seizures with slight stimulation->pain->death
S/S of pancreatitis
Cullen's sign (ecchymosis of the umbilicus), Grey Turner's sign (bruising of the flank).
S/S: Pyloric stenosis
olive shaped mass in epigastric region
peristalsis is obvious
s/s of patent ductus arteriosus
washing machine like murmur - loudest at the left upper chest
S/S: Addison's disease
Do not adapt to stress.
Also becomes dehydrated easily
S/S of Cushing's Syndrome
Think of the Cush Man... Moon face, buffalo hump, thin legs and bones, striae (stretch marks), male breasts, hirstusism etc
S/S: Grave's disease (hyperthyroidism)
accelerated physical and mental function. Sensitivity to heat. Fine/soft hair. exophthalmos
s/s of intussusception
- bilious vomiting (bile green/yellow)
- sausage shaped mass in RUQ
- progressive distension/tenderness/lethargy
- If not reduced, perforation/shock may occur. Signs of this would include "current jelly stool"
S/S: Multiple sclerosis
fatigue, weakness, numbness, difficulty in coordination, loss of balance, pain and visual disturbances. Spasticity and ataxia nystagmus
s/s of myasthenia gravis
-diplopia & ptosis (eyelid drooping)
-weakness of larynx & pharynx: dysphagia, choking, dysphasia
-M weakness improved by rest & worse by exercise
-bladder & bowel incontinence
S/S of Guillain-Barre Syndrome
-M weakness of legs progressing upwards (ascending)
-Paralysis of ocular, facial & oropharyngeal Ms
-increased pulse rate
-hypertension & orthostatic hypotension
-pain in back & calves
-weakness/paralysis of intercostal Ms & diaphragm
Unilateral leg swelling, pain or tenderness, skin discoloration (redness), Palpation of cord-like obstruction over vein
S&S of Myocardial Infarction
Crushing, stabbing pain radiating to LEFT shoulder, neck and arms.
S/S of Parkinson's disease
bradykinesia: slow movement
stooped posture, no arm swing when walking
slow, shuffling gait
pill rolling tremor
micrographia (small writing)
S/S Cytomegalovirus (CMV) infection
Owl's eye appearance of cells (huge nucleus in cells)
- appearance of halos around lights
- occasional and temporary blurred vision
- eye discomfort
- reduced peripheral vision
- may be asymptomatic
S/S of retinal detachment
- seeing floating specs in the eye, or cobwebs
- curtain vision - feeling as though someone put a sheet over their vision
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