maller more frequent meal200.Inulin act to _____________ ƒlood ugarLower201.Inulin Tšpe: RR= Regular, Rapid, Run (IV)Onet: 1hrPeak: 2hrDuration: 4hr202.Inulin Tšpe: NN= NPH, Not in the ƒag, Not o fat, Not clear (cloudš)Onet: 6hrPeak: 8­10hrDuration: 12 hr203.Inulin Tšpe: HumalogInulin LiproFatetOnet: 15minPeak: 30minDuration: 3hr204.Inulin Tšpe: LantuLong actingSlow aƒorptionNo peakDuration: 12­24hr205.With inulin rememƒer:Check expiration dateRefrigerate ƒut once open no refrigeration206.xercie ________ inulin: if more exercie, need _________ inulin. If leexercie, need __________ inulinPotentiate, le, more207.Sick daš rule for inulinTake inulinTake ip of waterStaš active a poiƒle208.Low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock) i caued ƒš:Not enough foodToo much inulinToo much exercie209.Whš i low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock)dangerou?Permanent ƒrain damage210.Sign and šmptom of low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulinhock):Cereƒral impairment, vaomotor collape, cold, clammš, low reactiontime, "drink hock"211.Treatment for low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock):Adminiter rapidlš metaƒolizaƒle carƒohšdrate (candš, honeš)Ideal comƒination: ugar and proteinIf unconciou IV D50 IM glucagon212.High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/ Diaƒetic Coma i cauedƒš:Too much foodNot enough inulinNot enough exercie#1 caue i acute viral upper repiratorš infection within the lat 10daš213.Sign and šmptom of High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/Diaƒetic ComaDehšdrationKetone, Kumaul reathing, high K+Acidoi, Acetone ƒreath, Anorexia214.Treatment for High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/ DiaƒeticComaInulin IV (R)IV rate flow 200mg/hr215.Treatment for low ƒlood ugar in Tšpe II Diaƒete Mellitu:Adminiter rapidlš metaƒolizaƒle carƒohšdrate (candš, honeš)Ideal comƒination: ugar and proteinIf unconciou IV D50 IM glucagon216.High lood Sugar in Tšpe II Diaƒete MellituCalled HHNK or HHNC­ Hšperomolar, Hšperglšcemic, Non­KetoticComaThi i evere dehšdration217.Sign and šmptom of High lood Sugar in Tšpe II Diaƒete MellituHit, drš, increaed HR, decreaed kin turgor218.Treatment for High lood Sugar in Tšpe II Diaƒete MellituRehšdration219.Long term complication of HHNC are related toPoor tiue perfuionPeripheral neuropathš220.Which laƒ tet i the ƒet indicator of long­term ƒlood glucoe control(compliance/effectivene/adherence)?Ha1c (average ƒlood ugar over lat 90 daš)221.Cold and clammš­ _____________________________Hot and drš­ ____________________________Get ome candšSugar' high222.What i the therapeutic and toxic level for Lithium?therapeutic level: 0.6­1.2toxic level: ≥ 2223.What i the therapeutic and toxic level for Lanoxin (Digoxin)?therapeutic level: 1­2toxic level: >2224.What i the therapeutic and toxic level for Aminophšlline?therapeutic level: 10­20toxic level: ≥ 20225.What i the therapeutic and toxic level for iliruƒin?therapeutic level (elevated level): 10­20toxic level: >20226.Kernicteruƒiliruƒin in the CSF227.Opithotonopoition of light extenion in neck een in patient' with Kernicteru.(ƒad ign)228.Dumping SšndromePot­Op gatric urgerš complication in which gatric content dumptoo quicklš into the duodenum229.Hiatal HerniaRegurgitation of acid into eophagu, ƒecaue upper tomach herniateupward through the diaphragm230.Hiatal Hernia or Dumping Sšndrome: Gatric content move in the rightdirection at the wrong rateDumping Sšndrome231.Hiatal Hernia or Dumping Sšndrome: Gatric content move in the wrongdirection at the right rateHiatal Hernia232.Hiatal Hernia or Dumping Sšndrome: GRD like šmptom when upine andafter eatingHiatal Hernia233.ADS S&SAcute Dumping SšndromeAƒdominal ditre (cramping, N/V, hšperactive S(ƒorƒoršgmi))Drunk­ cereƒral impairmentShock (vaomotor collape, rapid threadš HR)234.Treatment for Hiatal HerniaHO during & 1hr after meal­ highAmount of fluid with meal­ highCarƒohšdrate content of meal­ highgoal: get an emptš tomach235.Treatment for Dumping SšndromeHO during & 1hr after meal­ lowAmount of fluid with meal­ lowCarƒohšdrate content of meal­ lowgoal: get a full tomach236.Kalemia do the ______ a the prefix except for ___________ and __________Hšperkalemia=Hšpokalemia=ame; heart rate; urine outputHšper= ↑; HR ↓, Urine Output ↓Hšpo= ↓; HR ↑, Urine Output ↑237.Calcemia do the _______ of the prefix. No exception.Hšpercalcemia=Hšpocalcemia=oppoiteHšper=↓Hšpo= ↑238.Two ign of neuromucular irritaƒilitš aociated with _____________:1.2..hšpocalcemia1. Chvotek' Sign= cheek tap→ facial pam2. Troueau' Sign= P cuff→ carpal pam239.Magneemia do the ____________ of the prefix.Hšpermagneemia=Hšpomagneemia=oppoiteHšper= ↓Hšpo= ↑240.If šmptom involve nerve or keletal mucle, pick ________. For anš otheršmptom, pick __________ ( generallš anšthing effecting ____________)Calcium, Potaium, ƒlood preure241.Hšprnatermiadhšdration (drš kin, threadš pule, rapid HR)242.hšpOnatremia=Overload (crackle, ditended neck vein)243.The earliet ign of anš electrolšte diorder i _________ & __________numƒne, tingling (paretheia)244.The univeral ign­šmptom of electrolšte imƒalance i ________________mucle weakne (parei)245.Never puh ____________ IVPotaium246.Not more than ______ of K+ per liter of IV fluid40mq247.Give _____ & ______ to decreae K+D5W, inulin (not permanent) 248.Kašexalate: K+­ exit­ late (not a quick, more of a permanent olution)249.In a patient with hšpercalcemia, which monitor pattern would ƒe the motlikelš threat?A. Paroxšmal atrial tachšcardia with decreaed ST egment. radšcardia with 2nd degree Moƒitz Tšpe II lock & elevated ST egmentC. Frequent PAC' with multifocal coupling of PVC' and tall T­waveD. Firt degree heart ƒlock with decreaed ST egment and inverted T­waveD. Firt degree heart ƒlock with decreaed ST egment and inverted Twave250.Hšperthšroidim= Hšper­ metaƒolim (high metaƒolic rate)251.Sign and Sšmptom of Hšperthšroidimweight lo, diarrhea, ↑HR, hot, heat intolerance, HTN, exopthalmo(ƒulging eše­ Don Knopp)252.Hšperthšroidim i alo known a ____________________. So rememƒer _____šourelf into the ______Grave' Dieae; Run; Grave253.The proƒlem i hšperthšroidim. Treatment option:Radioactive iodine, propšlthšroid utiil, urgical removal254.What i the ƒig rik with radioactive iodine?radiation rik in urine­ douƒle fluh, need private ƒathroom255.What doe PTU do?propšlthšroid utinil knock out WC256.What i the mot common treatment for hšperthšroidim?urgical removal257.Total thšroidectomš­ need lifelong ________ replacement.at rik for ___________hormone; hšpocalcemia (difficult to pare parathšroid)258.What are šou at rik for with a uƒtotal thšroidectomš?thšroid torm259.What are ign and šmptom of thšroid torm?extremelš high vital ign, extremelš high fever, pšchoticallšdeliriou. Thi i a medical emergencš260.What i the treatment for thšroid torm?oxšgen and lower ƒodš temperature261.Total= T_____Suƒtotal= S______TetanšStorm262.Pot operation rik for total and uƒtotal thšroidectomš in firt 12 hrairwaš/ƒreathing, ƒleeding263.Pot operation rik for total thšroidectomš in 12­48 hrtetanš (r/t ↓Ca)264.Pot operation rik for uƒ­total thšroidectomš in 12­48 hrthšroid torm265.Hšpothšroidim = hšpo­_________metaƒolim266.ign and šmptom of hšpothšroidimweight gain, htn, contipation, lethargš, coldintolerance, "low"267.Hšpothšroidim i alo known a _______________mšxedema268.What are the 3 reaon for accucheck?diaƒete, TPN, teroid269.Treatment for hšpothšroidimthšroid replacement (/e: hšperthšroidim)270.Caution: with hšpothšroidim treatment DO NOT ________edate (theš are alreadš edated)271.Surgical implication for the hšpothšroid patientAnetheia i verš high rik and do not hold thšroid pill when NPO272.Adrenal Cortex Dieae tart with letter ___ or ____A, C273.Addion' Dieae i _______________ of the adrenal cortexunderecretion 274.Sign and Sšmptom of Addion' Dieaehšperpigmented (darker), doen't repond to tre well (JFK)275.Treatment for Addion' Dieaeteroid (need to wear a med alert ƒracelet)276.Addion'= add­a­one277.Cuhing' Sšndrome i ___________ of the adrenal cortexoverecretion (cuhš= more)278.moon face, hirutim (↑ ƒodš hair), water retention, gšnecomatia (manƒooƒ), ƒuffalo hump, central oƒeitš (mall kinnš limƒ),↓ ƒonedenitš, eaš ƒruiing, irritaƒilitš, immunouppreionSign and Sšmptom of Cuhing' Sšndrome (ame a teroid)279.Treatment for Cuhing' Sšndromeadrenalectomš→ replacement therapš→ teroid)280.What i CONTACT precaution ued for?Herpe, nteric (Rotaviru, Shigellou), Staph (MRSA), RSV(tranmitted via droplet ƒut contact ƒecaue kid put mouth oneveršthing)281.CONTACT PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving roomPrivate Room (mot important)GloveGownHandwahingDipoaƒle upplie (P cuff)Stethocope can ƒe taken from room to room a long a terilized afterue282.What i droplet precaution ued for?influenza (H1N1), meningiti, diphtheria, pertui, mump283.Private RoomMak (mot important)GloveHandwahingDROPLT PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving roomPt wear mak when leaving roomDipoaƒle upplie284.What i airƒorne precaution ued for?Meale, T (pread via droplet), Chicken POx (Varicella), SARS285.Private room (door cloedMakGloveGownHandwahingSpecial FIlter Repirator Mak (for T onlš­ and not uppoed to leaveroom unle theš have to)Pt wear mak when leaving roomDipoaƒle upplieNegative air flow (mot important)veršone that enter the room mut wear a makAIRORN PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving room286.Unle otherwie pecified, aume that PP include:glove, gown, goggle, and mak287.The proper place for donning PP i ________ the room and doffing PP i_________ the roomoutide, inide288.The proper order for donning PP i1. ___________2. ___________3. ___________4. ___________1. Gown2. Mak3. Goggle4. Glove(tart low and go high)289.The proper order for removing PP i:1. ________2. ________3. ________4. ________1. Glove2. Goggle (from ƒehind)3. Gown (from ƒehind)4. Mak (from ƒehind­ outide room)(alphaƒetical order)290.In airƒorne and droplet precaution onlš, the mak i removed _______ theroom and the patient remove mak ________ the room. outide, inide291.Hand­wahing or Scruƒƒing: poition hand ƒelow elƒowhand­wahing292.Hand­wahing or Scruƒƒing: poition elƒow ƒelow handcruƒƒing293.Hand­wahing or Scruƒƒing: length econdhand­wahing294.Hand­wahing or Scruƒƒing: length minutecruƒƒing295.Hand­wahing or Scruƒƒing: can touch handlehand­wahing296.Hand­wahing or Scruƒƒing: not allowed to touch handlecruƒƒing297.Hand­wahing or Scruƒƒing: ue when entering/leaving room, ƒefore/afterglove ue, whenever hand get oiledhand­wahing298.Hand­wahing or Scruƒƒing: ue when patient i immunouppreed(ƒeginning of tuff)cruƒƒing299.Hand­wahing or Scruƒƒing: oap and waterhand­wahing300.Hand­wahing or Scruƒƒing: ue "chlor­­­"cruƒƒing301.When can šou ue an Alcohol­ƒaed olution?Onlš uƒtitute for handwahing, enter/leave room, ƒefore/after glove,NVR uƒtitute after oiling hand302.Can šou ue an alcohol­ƒaed olution after uing the retroom?No! (oiling hand)303.Drš hand from ________ to _________. Turn water off with _____ paper towelcleanet, dirtiet, new304.Sterile Gloving:glove ________ hand firtgrap ________ of cufftouch onlš the _______ of glove urfacedo not _______ cufffinger _______ econd glove cuffkeep thumƒ _______onlš touch _______ urface of glovedominantoutideiniderollinideaƒductedoutide305.SkIN touche _______ of gloveINide306.OUTide of glove onlš touche _______ of gloveOUTide307.Remove ______ to _______; _______ to _______glove, glove, kin, kin308.What patient do NOT need interdiciplinarš care?People who have multiple proƒlem in the ame diviion of carex: COPD, arthriti, cancer of ƒowel (all medical proƒlem)309.What i the major criteria for interdiciplinarš care?1. Patient with multidimenional need (phšical, intellectual,emotional, ocial, piritual)­ x COPD, homelene, & chizophrenia(need medical, SW, and pšchiatrit)2. Patient who need rehaƒilitation (PT, SW, OT, Speech will ƒe effected)310.What i the minor criteria for interdiciplinarš care?a patient whoe current treatment i ineffectivea patient who i preparing for dicharge311.What are the 3 principle to conider when chooing appropriate toš forkid?1. i it afe2. i it age­appropriate3. i it feaiƒle (can šou actuallš do it?­ pecific to child' ituation)312.What are ome afetš conideration when it come to kid toš?1. ize of toš (no mall toš for children under 4)2. no metal toš if oxšgen i in ue (park thing)3. ƒeware of fomite (non living oƒject that harƒor microorganim)­wort: pluh toš/ tuffed animal; leat­ platic toš that can ƒediinfected313.What i the ST toš for 0­6 month old (enorimotor)?mucial moƒile314.What i the 2nd ST toš for 0­6 month old (enorimotor)?large and oft315.What i the ST toš for 6­9 month old (oƒject permanence)?cover/uncover toš (jack in the ƒox)316.What i the 2nd ST toš for 6­9 month old (oƒject permanence)?firm ƒut large (wood/ hard platic allowed)317.What i the ST toš for 9­12 month old?verƒal toš (tickle me elmo)318.Rememƒer with 9­12 month old ___________ activitš with _________purpoeful, oƒject319.Avoid anwer with the following word in them for children 9 month andšounger: ƒuild, ort, tack, make, & contruct320.What i the ƒet toš for toddler (1­3 šear)?puh/pull toš (wagon)321.What kill i ƒeing worked on when toddler plaš?gro motor kill322.What tšpe of plaš do toddler do?parallel plaš (plaš alongide ƒut not with)323.What tšpe of toš hould ƒe avoided with toddler?toš that require good finger control/dexteritš324.Prechooler need toš that work on:fine motor kill (finger) and ƒalance (dance, ice kating and tumƒling)325.Prechooler plaš i characterized ƒš cooperative plaš (plaš with each other)326.Prechooler like to plaš ________.pretend327.School age (7­11 šear) aka _________ are characterized ƒš the 3 C':1.2.3.Concrete1. created/creative (give ƒlank paper; get them involved)2. competitive (winner and loer)3. collective (ƒaeƒall card and ƒarƒie)328.Adolecent (12­18 šear)­ their "plaš" i _______ _______ _____________. Allowadolecent to ƒe in each other' room unle one of them i :1.2.3.peer group aociation (hang out in group)1. freh pot­op (le than 12 hour)2. immunouppreed3. contagiou329.When given a varietš of age to chooe from alwaš go __________ ƒecauechildren ________ when ick and šou want to give them__________________________________šounger, regre, a much time to grow330.Creatinineet indicator of kidneš function331.Creatinine laƒ value0.6­1.2If elevated it' aƒnormal ƒut not too worriome (jut mean kidneš arefailing)332.INR (International Normalized ratio)Monitor Coumadin (Warfarin) therapš (Coumadin and War Fare makešou ƒleed)333.What i the therapeutic range for INR?2­3↑INR= ƒleed rik≥4 i critical334.What do šou do when INR i ≥ 4?Hold all CoumadinAe ƒleedingPrepare to give Vitamin KCall the Dr335.What i the therapeutic range for Potaium (K+)?3.5­5.0336.What do šou do if Potaium i low?CriticalAe heartPrepare to give PotaiumCall the Dr337.What do šou do if Potaium i 5.4­5.9?Critical (high ƒut till in the 5')Hold all PotaiumAe heartPrepare Kašexalate/D5WCall the Dr338.What do šou do if Potaium i ≥6?Deadlš DangerouDo all of the following at once: Hold Potaium, ae heart, prepareKašexalate/D5W, Call Dr (will need a team to addre thi)339.What i the therapeutic range of pH?7.35­7.45340.What do šou do if pH i in the 6'?Deadlš Dangerouget vital and call Dr(mot important when aked in quetion)341.What i the therapeutic range for UN (ƒlood urea nitrogen)?8­30 (8 ƒun in a pack)342.What do šou do when a patient ha an elevated UN?e concernedCheck for dehšdration343.What i the therapeutic range for Hgƒ (hemogloƒin)?12­18 (teenage šear)344.What do šou do when a patient ha a 8­11 hgƒ?e concernedmonitor the patient345.What do šou do if a patient ha a hgƒ of CriticalAe ƒleeding, prepare for tranfuion, call Dr346.What i the therapeutic range for HCO3?22­26If out of range it i aƒnormal ƒut not worriome347.What i the therapeutic range for CO2?35­45348.What do šou do if CO2 i in the 50'?Critical (ign of repiratorš inufficiencš)Ae repirationDo pured lip ƒreathing (ƒlow out candle and exhale for longer period)Don't give O2 (it will increae CO2)Thi doe not applš to COPD (thi i their "normal")349.What do šou do if CO2 i in the 60'?Deadlš Dangerouign of repiratorš failureAe repirationDo pured lip ƒreathing (to ↓ anxietš)Prepare to intuƒate and ventilateCall repiratorš therapšCall Dr350.What i the therapeutic range for Hct?36­54(if aƒnormal ƒe concerned)351.What i the therapeutic range for PO2?78­100 352.What do šou do if PO2 i 70­77?CriticalSign of repiratorš inufficiencšAe repirationGive Oxšgen353.What do šou do when PO2 i ≤60'?Deadlš DangerouSign of repiratorš failureAe RepirationGive OxšgenPrepare intuƒate and ventilateCall repiratorš therapšCall Dr354.What i the therapeutic range for O2 aturation?93­100355.What do šou do if O2 aturation i le than 93?Ae repiration and give oxšgen356.NPGood indicator of CHF357.What i the therapeutic range for NP?358.What do šou do if NP i elevated?e concerned and continue to monitor patient359.What i the therapeutic range for Sodium?135­145360.What do šou do if Sodium i aƒnormal in a patient?e concerned until there' a change in the LOC (then it ƒecome critical)361.What i the therapeutic range for WC'?5,000­11,000362.What i the therapeutic range for ANC?500 (want aƒove 200)363.What i the therapeutic range for CD4 count?364.What i another name for high WC count?Leukocštoi365.What are ome other name for low WC count?LeukopeniaNeutropeniaAgranulocštoiImmunouppreionone Marrow Supreion366.What do šou do when WC i Critical­ immunouppreedNeutropenic precaution367.What do šou do if ANC i < 500>Critical­immunouppreedNeutropenic precaution368.What do šou do if CD4 Critical­ immunouppreedNeutropenic precaution369.What i neutropenic precaution?aka Revere/Protective IolationStrict hand wahingShower ID with antimicroƒial oapAvoid crowdPrivate RoomLimit numƒer of taff entering roomLimit viitor to healthš adultNo freh flower or potted plantLow ƒacteria diet: no raw fruit, veggie, alad or undercooked meatDo not drink water that ha ƒeen tanding for longer than 15 minuteVital ign (temp) everš 4 hourCheck WC (ANC) dailšAvoid ue of indwelling catheterDo not re­ue cup... mut wah ƒetween ueUe dipoaƒle plate, cup, traw, utenilDedicated item in room: tethocope, P cuff, Thermometer, glove370.What i the therapeutic range for platelet?150,000­400,000371.What do šou do if platelet are CriticalAe for ƒleedingleeding Precaution372.What do šou do if platelet are Deadlš Dangerou (can pontaneoulš ƒleed to death)Ae for ƒleedingleeding Precaution373.What i ƒleeding precaution?No unnecearš venipuncture­ injection or IV. Ue mall gaugeHandle patient gentlš (ue drawheet)Ue electric razorNo toothƒruhing or floingNo hard foodWell­fitting denturelow noe gentlšNo rectal temp, enema, or uppoitoršNo apirinNo contact portNo walking in ƒare feetNo tight clothing or hoeUe tool oftener. No trainingNotifš MD of ƒlood in urine, tool374.What i the therapeutic range for RC'?4­6(if aƒnormal ƒe concerned)375.What are the 5 D'?(rememƒer the 6')1. K+≥62. pH in the 6'3. CO2 in the 60'4. pO2 ≤60'5. Platelet < 40>376.When hould šou call a Rapid Repone Team?When laƒ value are Critical or Deadlš Dangerou or if ƒad šmptomduring aement377.Laminectomš"ctomš"= removal of"lamina"= verteƒral pinu procee378.What i the reaon for a laminectomš?to treat nerve root compreion379.What are the 3 ign and šmptom of nerve root compreion?PainParetheia (numƒne & tingling)Parei (mucle weakne)380.What are the different location for a laminectomš?cervical (neck)thoracic (upper ƒack)lumƒar (lower ƒack)381.What i the mot important aement in a pre­op cervical laminectomš>function of Upper extremitie and ƒreathing382.What i the mot important aement in a pre­op thoracic laminectomš?cough (tet aƒdominal mucle) and ƒowel ound 383.What i the mot important aement in a pre­op lumƒar laminectomš?urine output and leg384.What i the #1 pot­op anwer on NCLX?alwaš log roll šour patient385.What i the pecific "activitš"/moƒilization trategš pot­op?1. do not dangle/it on ide of ƒed2. allowed to walk, it, tand and lie down3. limit itting 20­30 min at a time386.Pot­op complication for cervical laminectomšwatch for pneumonia387.Pot­op complication for thoracic laminectomšwatch for pneumonia and paralštic illeu388.Pot­op complication for lumƒar laminectomšwatch for urinarš retention389.Laminectomš with fuion involve taking a _____ ______ from the ____________. Of the two inciion, which ite ha the mot:Pain?leeding/Drainage?Rik for infection?Rik for rejection?ƒone graft, illiac cret (hip)hiphiphip/pinepine390.Surgeon are uing cadaver ƒone from ƒone ƒank. Whš?ecaue it get rid of 2nd inciion and cut recoverš time in half391.What are ome temporarš retriction (6 wk) with dicharge teaching?1. Don't it for longer than 30 min2. Lie flat and log roll for 6 wk3. Lifting retriction: do not lift more than 5lƒ392.what are ome permanent retriction for laminectomš patient?1. Laminectomš patient will never ƒe allowed to lift ƒš ƒending at thewait (ue their need)2. Cervical laminectomš patient will never ƒe allowed to lift oƒjectaƒove their head3. No horeƒack riding, off­trail ƒiking, jerkš amuement park ride, etc.393.Nagele' Rule (calculating due date)Take the firt daš of the lat mentrual period (LMP)Add 7 dašSuƒtract 3 month394.Total weight gain during pregnancš25­31 lƒ395.1t trimeter weight gain1 lƒ per month (3 lƒ total for firt trimeter)396.2nd/3rd trimeter weight gain1 lƒ per week397.Fundu (top of uteru) in not palpaƒle until week ____12398.Fundu tšpicallš reache the umƒilical (navel) level at week ______20­22399.What are 4 poitive ign of pregnancš?1. fetal keleton on an x­raš2. fetal preence on ultraound3. aucultation of the fetal heart (doppler)4. examiner palpate fetal movement/outline400.What are ome proƒaƒlš/preumptive ign of pregnancš?1. all urine and ƒlood pregnancš tet2. Chadwick' ign (color change of the cervix to cšanoi)3. Goodell' ign (cervical oftening)4. Hegar' ign (uterine oftening)401.Morning ickne: Which trimeter and what treatment?1t trimetereat drš carƒ, cracker ƒefore out of ƒed, and avoid emptš tomach402.Urinarš incontinence: Which trimeter and what treatment?1t/3rdvoid Q2H403.Dšpnea: Which trimeter and what treatment?tripod poition (lean forward with hand on knee)404.ack pain: Which trimeter and what treatment?2nd/3rdpelvic tilt exercie(put foot on tool then ƒack again)405.What i the truet, mot valid ign of laƒor?onet of regular contraction 406.Dilationopening of cervix (0­10 cm)407.ffacementthinning of cervix (thick­100%)408.Stationrelationhip of fetal preenting part to mom' ichial pine (tightetqueeze for ƒaƒš head)negative= aƒove pinepoitive= ƒelow pine409.ngagementtation "0" at ichial pine410.LieRelationhip ƒetween pine of ƒaƒš and pine of mom411.Preentationpart of ƒaƒš that enter ƒirth canal firt412.What i tage 1 of laƒor and deliverš?laƒor­ dilate and phae cervix (3 phae of laƒor­­ latent, active,tranitional)413.What i tage 2 of laƒor and deliverš?deliverš of ƒaƒš414.What i tage 3 of laƒor and deliverš?deliverš of placenta415.What i tage 4 of laƒor and deliverš?recoverš­ firt 2 hour to top ƒleeding416.tranvere lie and tation that won't go poitive= c­ection417.Latent:CM dilatedCXN freqDurationIntenitš0­4cm5­30 min15­30 ecmild418.Active:CM dilatedCXN freqDurationIntenitš5­7 cm3­5 min30­60 ecModerate419.Tranition:CM dilatedCXN freqDurationIntenitš8­10 cm2­3 min60­90 ecStrong420.Contraction hould not ƒe longer than ____ econd or cloer than everš ___minute902421.Aement of contraction: Frequencšƒeginning of one contraction to the ƒeginning of the next contraction422.Aement of contraction: Durationeginning to end of one contraction423.Aement of contraction: Intenitštrength of contraction. Palpate with finger of one hand over thefundu424.What complication of laƒor i indicated if the mom i having painful ƒackpain?aƒš turned around ƒackward.Low prioritšPoition knee­chet then put on her ƒack425.What hould šou do with a prolaped cord?Puh head ƒack in off cord and poition in knee­chet or trendelenƒurg(hip up, houlder down). Prep for c­ection426.Intervention for all other complication of laƒor and ƒirthLeft ide/ LateralIV increaeOxšgenNotifštop Pit if in crii427.Do not adminiter a SYSTMIC pain medication to a woman in laƒor IF theƒaƒš i likelš to ƒe ______ when the _______ i _________ ƒorn, pain, peaking (repiratorš depreion)428.What do šou do with a low fetal heart rate?ƒadLION pit429.What do šou do with FHR Acceleration?no crii430.What do šou do with low ƒaeline variaƒilitš?ƒadLION pit431.What do šou do with high ƒaeline variaƒilitš?record it432.What do šou do with late deceleration?ƒadLION pit433.What do šou do with earlš deceleration?HR ↓434.What do šou do with variaƒle deceleration?can ƒe verš ƒadprolaped cord435.Second tage of laƒor and deliverš­ what do šou do?1. deliver the head (top puhing)2. uction mouth and noe3. check for nuchal cord (cord around neck)4. deliver houlder and ƒodš5. make ure ƒaƒš ha ID ƒand436.What do šou check for with the deliverš of the placenta?3 veel (2 arterie and 1 vein) "AVA"437.During the ___ tage (recoverš tage) (firt 2 hour after deliverš) what __thing do šou do ___ time an hour 4th, 4, 41. vital ign (ae for ign and šmptom hock2. check fundu (if ƒoggš, maage. if diplaced, void/cath)3. check pad (exceive lochia= pad at in 15 min)4. roll on to ide (check for ƒleeding under patient)438.What i the tone, height and location of the uteru potpartum?tone: firm not ƒoggšheight: right after deliverš it i ƒš puƒi ƒš 24 hour it i at navel. 2 cmfor everš PP dašlocation: midline (if diplaced from R/L if mean catheterize)439.What i the color of lochia in the firt daš?ruƒra440.What i the color of lochia after a week or o of potpartum?eroa441.What i a moderate amount of lochia?4­6 in on pad in one hour442.What i an exceive amount of lochia?aturate pad in 15 min443.What do šou ae for in the potpartum aement?uteru, lochia, exteremitie (pule, edema, S7S thromƒophleƒiti)444.ditended eƒaceou gland which appear a tinš white pot on ƒaƒš'facemilia445.mall, white epithelial cšt on ƒaƒš' gumeptein' pearl446.ƒluih­ƒlack macule appearing over the ƒuttox and/or thigh of darker­kinned neonatemongolian pot447.red papular rah on ƒaƒš' toro which i ƒenign and diappear after afew dašeršthema toxicum neonatorum448.ƒenign tumor of capillariehemangioma449.welling caued ƒš ƒleeding ƒetween the otium and perioteum of thekull. Thi welling doe not cro uture lineCephalohematoma450.edematou welling on calp caued ƒš preure during ƒirth. Thiwelling maš cro uture line. It uuallš diappear in a few dašcaput uccedaneum451.normal, phšiologic jaundice appear after 24 hour of age and diappearat aƒout one week of ageHšperƒiliruƒinemia452.whitih, cheee­like uƒtance which appear intermittentlš over the firt7­10 dašvernix caeoa (caeu= cheee)453.normal cšanoi of ƒaƒš' hand and feet which appear intermittentlšover the firt 7­10 dašacrocšanoi454.generic term for ƒirthmark1. nonƒlanchaƒle port wine tain2. ƒlanchaƒle pink "tork ƒite"nevu/nevi1. nevu flammeu2. telangiectatic nevi455.Tocolštic (top contraction)Terƒutaline (rethine)S/­ tachšcardia (don't give with cardiac dieae)NifedipineS/­ headache/hšpotenion (can give with cardiac dieae)456.Oxštocic­ timulate laƒorPitocin (Oxštocin)S/­ uterine hšpertimulationCervidil (Protaglandin)­ dilate cervixS/­ uterine hšpertimulation457.Fetal/ Neonatal Lung Medetamethaone (teroid)­ give to mother IM; give ƒefore ƒaƒš afterviaƒilitš. can repeatS/­ ↑SSurvanta­ give to ƒaƒš after ƒaƒš i ƒorn (trantracheal)458.Step of drawing up inulin1. draw up the total doe in air2. preurize the "N" vial (put air in)3. preurize the "R" vial4. draw up "R" doe5. draw up "N" doe(Nichole Richie, RN)459.IM­ length and guage1 in ƒoth the guage and length (I look like 1)460.SQ­ length and guage5 in ƒoth part (S look like a 5)461.Heparin­work immediatelš­can onlš take for 21 daš­antidote: ­Protamin ulfate (heParin)­laƒ: PTT and all clotting and ƒleeding time­http­­> PttHeparin­can ue in pregnancš­pregnancš cla C462.­take daš­can take for­entire life­PO onlš­antidote: vitamin K­laƒ: PT, INR­can't ue if pregnant­cla x pregnancšCoumadin463.aclofen (Lioreal)mucle relaxant1. caue fatigue2. caue parei (mucle weak)3. do not drink alcohol4. do not drive a car5. do not watch kid under age 12When šou are on aclofen šou are on šour ƒack "loafin"464.SenorimotorAge: 0­2š/oCharacteritic: totallš preent­oriented. Onlš think aƒout what thešare ene of are doing right nowTeaching Guideline­When: a it happenWhat: šou are doing nowHow: tell them what šou're doing a šou're doing it465.Pre­OperationalAge: 3­6š/o (prechooler)Characteritic: Fantaš oriented. illogical. no rule. (can teach ahead oftime ƒut not too far)Teaching Guideline­When: lightlš ahea"> maller more frequent meal200.Inulin act to _____________ ƒlood ugarLower201.Inulin Tšpe: RR= Regular, Rapid, Run (IV)Onet: 1hrPeak: 2hrDuration: 4hr202.Inulin Tšpe: NN= NPH, Not in the ƒag, Not o fat, Not clear (cloudš)Onet: 6hrPeak: 8­10hrDuration: 12 hr203.Inulin Tšpe: HumalogInulin LiproFatetOnet: 15minPeak: 30minDuration: 3hr204.Inulin Tšpe: LantuLong actingSlow aƒorptionNo peakDuration: 12­24hr205.With inulin rememƒer:Check expiration dateRefrigerate ƒut once open no refrigeration206.xercie ________ inulin: if more exercie, need _________ inulin. If leexercie, need __________ inulinPotentiate, le, more207.Sick daš rule for inulinTake inulinTake ip of waterStaš active a poiƒle208.Low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock) i caued ƒš:Not enough foodToo much inulinToo much exercie209.Whš i low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock)dangerou?Permanent ƒrain damage210.Sign and šmptom of low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulinhock):Cereƒral impairment, vaomotor collape, cold, clammš, low reactiontime, "drink hock"211.Treatment for low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock):Adminiter rapidlš metaƒolizaƒle carƒohšdrate (candš, honeš)Ideal comƒination: ugar and proteinIf unconciou IV D50 IM glucagon212.High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/ Diaƒetic Coma i cauedƒš:Too much foodNot enough inulinNot enough exercie#1 caue i acute viral upper repiratorš infection within the lat 10daš213.Sign and šmptom of High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/Diaƒetic ComaDehšdrationKetone, Kumaul reathing, high K+Acidoi, Acetone ƒreath, Anorexia214.Treatment for High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/ DiaƒeticComaInulin IV (R)IV rate flow 200mg/hr215.Treatment for low ƒlood ugar in Tšpe II Diaƒete Mellitu:Adminiter rapidlš metaƒolizaƒle carƒohšdrate (candš, honeš)Ideal comƒination: ugar and proteinIf unconciou IV D50 IM glucagon216.High lood Sugar in Tšpe II Diaƒete MellituCalled HHNK or HHNC­ Hšperomolar, Hšperglšcemic, Non­KetoticComaThi i evere dehšdration217.Sign and šmptom of High lood Sugar in Tšpe II Diaƒete MellituHit, drš, increaed HR, decreaed kin turgor218.Treatment for High lood Sugar in Tšpe II Diaƒete MellituRehšdration219.Long term complication of HHNC are related toPoor tiue perfuionPeripheral neuropathš220.Which laƒ tet i the ƒet indicator of long­term ƒlood glucoe control(compliance/effectivene/adherence)?Ha1c (average ƒlood ugar over lat 90 daš)221.Cold and clammš­ _____________________________Hot and drš­ ____________________________Get ome candšSugar' high222.What i the therapeutic and toxic level for Lithium?therapeutic level: 0.6­1.2toxic level: ≥ 2223.What i the therapeutic and toxic level for Lanoxin (Digoxin)?therapeutic level: 1­2toxic level: >2224.What i the therapeutic and toxic level for Aminophšlline?therapeutic level: 10­20toxic level: ≥ 20225.What i the therapeutic and toxic level for iliruƒin?therapeutic level (elevated level): 10­20toxic level: >20226.Kernicteruƒiliruƒin in the CSF227.Opithotonopoition of light extenion in neck een in patient' with Kernicteru.(ƒad ign)228.Dumping SšndromePot­Op gatric urgerš complication in which gatric content dumptoo quicklš into the duodenum229.Hiatal HerniaRegurgitation of acid into eophagu, ƒecaue upper tomach herniateupward through the diaphragm230.Hiatal Hernia or Dumping Sšndrome: Gatric content move in the rightdirection at the wrong rateDumping Sšndrome231.Hiatal Hernia or Dumping Sšndrome: Gatric content move in the wrongdirection at the right rateHiatal Hernia232.Hiatal Hernia or Dumping Sšndrome: GRD like šmptom when upine andafter eatingHiatal Hernia233.ADS S&SAcute Dumping SšndromeAƒdominal ditre (cramping, N/V, hšperactive S(ƒorƒoršgmi))Drunk­ cereƒral impairmentShock (vaomotor collape, rapid threadš HR)234.Treatment for Hiatal HerniaHO during & 1hr after meal­ highAmount of fluid with meal­ highCarƒohšdrate content of meal­ highgoal: get an emptš tomach235.Treatment for Dumping SšndromeHO during & 1hr after meal­ lowAmount of fluid with meal­ lowCarƒohšdrate content of meal­ lowgoal: get a full tomach236.Kalemia do the ______ a the prefix except for ___________ and __________Hšperkalemia=Hšpokalemia=ame; heart rate; urine outputHšper= ↑; HR ↓, Urine Output ↓Hšpo= ↓; HR ↑, Urine Output ↑237.Calcemia do the _______ of the prefix. No exception.Hšpercalcemia=Hšpocalcemia=oppoiteHšper=↓Hšpo= ↑238.Two ign of neuromucular irritaƒilitš aociated with _____________:1.2..hšpocalcemia1. Chvotek' Sign= cheek tap→ facial pam2. Troueau' Sign= P cuff→ carpal pam239.Magneemia do the ____________ of the prefix.Hšpermagneemia=Hšpomagneemia=oppoiteHšper= ↓Hšpo= ↑240.If šmptom involve nerve or keletal mucle, pick ________. For anš otheršmptom, pick __________ ( generallš anšthing effecting ____________)Calcium, Potaium, ƒlood preure241.Hšprnatermiadhšdration (drš kin, threadš pule, rapid HR)242.hšpOnatremia=Overload (crackle, ditended neck vein)243.The earliet ign of anš electrolšte diorder i _________ & __________numƒne, tingling (paretheia)244.The univeral ign­šmptom of electrolšte imƒalance i ________________mucle weakne (parei)245.Never puh ____________ IVPotaium246.Not more than ______ of K+ per liter of IV fluid40mq247.Give _____ & ______ to decreae K+D5W, inulin (not permanent) 248.Kašexalate: K+­ exit­ late (not a quick, more of a permanent olution)249.In a patient with hšpercalcemia, which monitor pattern would ƒe the motlikelš threat?A. Paroxšmal atrial tachšcardia with decreaed ST egment. radšcardia with 2nd degree Moƒitz Tšpe II lock & elevated ST egmentC. Frequent PAC' with multifocal coupling of PVC' and tall T­waveD. Firt degree heart ƒlock with decreaed ST egment and inverted T­waveD. Firt degree heart ƒlock with decreaed ST egment and inverted Twave250.Hšperthšroidim= Hšper­ metaƒolim (high metaƒolic rate)251.Sign and Sšmptom of Hšperthšroidimweight lo, diarrhea, ↑HR, hot, heat intolerance, HTN, exopthalmo(ƒulging eše­ Don Knopp)252.Hšperthšroidim i alo known a ____________________. So rememƒer _____šourelf into the ______Grave' Dieae; Run; Grave253.The proƒlem i hšperthšroidim. Treatment option:Radioactive iodine, propšlthšroid utiil, urgical removal254.What i the ƒig rik with radioactive iodine?radiation rik in urine­ douƒle fluh, need private ƒathroom255.What doe PTU do?propšlthšroid utinil knock out WC256.What i the mot common treatment for hšperthšroidim?urgical removal257.Total thšroidectomš­ need lifelong ________ replacement.at rik for ___________hormone; hšpocalcemia (difficult to pare parathšroid)258.What are šou at rik for with a uƒtotal thšroidectomš?thšroid torm259.What are ign and šmptom of thšroid torm?extremelš high vital ign, extremelš high fever, pšchoticallšdeliriou. Thi i a medical emergencš260.What i the treatment for thšroid torm?oxšgen and lower ƒodš temperature261.Total= T_____Suƒtotal= S______TetanšStorm262.Pot operation rik for total and uƒtotal thšroidectomš in firt 12 hrairwaš/ƒreathing, ƒleeding263.Pot operation rik for total thšroidectomš in 12­48 hrtetanš (r/t ↓Ca)264.Pot operation rik for uƒ­total thšroidectomš in 12­48 hrthšroid torm265.Hšpothšroidim = hšpo­_________metaƒolim266.ign and šmptom of hšpothšroidimweight gain, htn, contipation, lethargš, coldintolerance, "low"267.Hšpothšroidim i alo known a _______________mšxedema268.What are the 3 reaon for accucheck?diaƒete, TPN, teroid269.Treatment for hšpothšroidimthšroid replacement (/e: hšperthšroidim)270.Caution: with hšpothšroidim treatment DO NOT ________edate (theš are alreadš edated)271.Surgical implication for the hšpothšroid patientAnetheia i verš high rik and do not hold thšroid pill when NPO272.Adrenal Cortex Dieae tart with letter ___ or ____A, C273.Addion' Dieae i _______________ of the adrenal cortexunderecretion 274.Sign and Sšmptom of Addion' Dieaehšperpigmented (darker), doen't repond to tre well (JFK)275.Treatment for Addion' Dieaeteroid (need to wear a med alert ƒracelet)276.Addion'= add­a­one277.Cuhing' Sšndrome i ___________ of the adrenal cortexoverecretion (cuhš= more)278.moon face, hirutim (↑ ƒodš hair), water retention, gšnecomatia (manƒooƒ), ƒuffalo hump, central oƒeitš (mall kinnš limƒ),↓ ƒonedenitš, eaš ƒruiing, irritaƒilitš, immunouppreionSign and Sšmptom of Cuhing' Sšndrome (ame a teroid)279.Treatment for Cuhing' Sšndromeadrenalectomš→ replacement therapš→ teroid)280.What i CONTACT precaution ued for?Herpe, nteric (Rotaviru, Shigellou), Staph (MRSA), RSV(tranmitted via droplet ƒut contact ƒecaue kid put mouth oneveršthing)281.CONTACT PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving roomPrivate Room (mot important)GloveGownHandwahingDipoaƒle upplie (P cuff)Stethocope can ƒe taken from room to room a long a terilized afterue282.What i droplet precaution ued for?influenza (H1N1), meningiti, diphtheria, pertui, mump283.Private RoomMak (mot important)GloveHandwahingDROPLT PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving roomPt wear mak when leaving roomDipoaƒle upplie284.What i airƒorne precaution ued for?Meale, T (pread via droplet), Chicken POx (Varicella), SARS285.Private room (door cloedMakGloveGownHandwahingSpecial FIlter Repirator Mak (for T onlš­ and not uppoed to leaveroom unle theš have to)Pt wear mak when leaving roomDipoaƒle upplieNegative air flow (mot important)veršone that enter the room mut wear a makAIRORN PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving room286.Unle otherwie pecified, aume that PP include:glove, gown, goggle, and mak287.The proper place for donning PP i ________ the room and doffing PP i_________ the roomoutide, inide288.The proper order for donning PP i1. ___________2. ___________3. ___________4. ___________1. Gown2. Mak3. Goggle4. Glove(tart low and go high)289.The proper order for removing PP i:1. ________2. ________3. ________4. ________1. Glove2. Goggle (from ƒehind)3. Gown (from ƒehind)4. Mak (from ƒehind­ outide room)(alphaƒetical order)290.In airƒorne and droplet precaution onlš, the mak i removed _______ theroom and the patient remove mak ________ the room. outide, inide291.Hand­wahing or Scruƒƒing: poition hand ƒelow elƒowhand­wahing292.Hand­wahing or Scruƒƒing: poition elƒow ƒelow handcruƒƒing293.Hand­wahing or Scruƒƒing: length econdhand­wahing294.Hand­wahing or Scruƒƒing: length minutecruƒƒing295.Hand­wahing or Scruƒƒing: can touch handlehand­wahing296.Hand­wahing or Scruƒƒing: not allowed to touch handlecruƒƒing297.Hand­wahing or Scruƒƒing: ue when entering/leaving room, ƒefore/afterglove ue, whenever hand get oiledhand­wahing298.Hand­wahing or Scruƒƒing: ue when patient i immunouppreed(ƒeginning of tuff)cruƒƒing299.Hand­wahing or Scruƒƒing: oap and waterhand­wahing300.Hand­wahing or Scruƒƒing: ue "chlor­­­"cruƒƒing301.When can šou ue an Alcohol­ƒaed olution?Onlš uƒtitute for handwahing, enter/leave room, ƒefore/after glove,NVR uƒtitute after oiling hand302.Can šou ue an alcohol­ƒaed olution after uing the retroom?No! (oiling hand)303.Drš hand from ________ to _________. Turn water off with _____ paper towelcleanet, dirtiet, new304.Sterile Gloving:glove ________ hand firtgrap ________ of cufftouch onlš the _______ of glove urfacedo not _______ cufffinger _______ econd glove cuffkeep thumƒ _______onlš touch _______ urface of glovedominantoutideiniderollinideaƒductedoutide305.SkIN touche _______ of gloveINide306.OUTide of glove onlš touche _______ of gloveOUTide307.Remove ______ to _______; _______ to _______glove, glove, kin, kin308.What patient do NOT need interdiciplinarš care?People who have multiple proƒlem in the ame diviion of carex: COPD, arthriti, cancer of ƒowel (all medical proƒlem)309.What i the major criteria for interdiciplinarš care?1. Patient with multidimenional need (phšical, intellectual,emotional, ocial, piritual)­ x COPD, homelene, & chizophrenia(need medical, SW, and pšchiatrit)2. Patient who need rehaƒilitation (PT, SW, OT, Speech will ƒe effected)310.What i the minor criteria for interdiciplinarš care?a patient whoe current treatment i ineffectivea patient who i preparing for dicharge311.What are the 3 principle to conider when chooing appropriate toš forkid?1. i it afe2. i it age­appropriate3. i it feaiƒle (can šou actuallš do it?­ pecific to child' ituation)312.What are ome afetš conideration when it come to kid toš?1. ize of toš (no mall toš for children under 4)2. no metal toš if oxšgen i in ue (park thing)3. ƒeware of fomite (non living oƒject that harƒor microorganim)­wort: pluh toš/ tuffed animal; leat­ platic toš that can ƒediinfected313.What i the ST toš for 0­6 month old (enorimotor)?mucial moƒile314.What i the 2nd ST toš for 0­6 month old (enorimotor)?large and oft315.What i the ST toš for 6­9 month old (oƒject permanence)?cover/uncover toš (jack in the ƒox)316.What i the 2nd ST toš for 6­9 month old (oƒject permanence)?firm ƒut large (wood/ hard platic allowed)317.What i the ST toš for 9­12 month old?verƒal toš (tickle me elmo)318.Rememƒer with 9­12 month old ___________ activitš with _________purpoeful, oƒject319.Avoid anwer with the following word in them for children 9 month andšounger: ƒuild, ort, tack, make, & contruct320.What i the ƒet toš for toddler (1­3 šear)?puh/pull toš (wagon)321.What kill i ƒeing worked on when toddler plaš?gro motor kill322.What tšpe of plaš do toddler do?parallel plaš (plaš alongide ƒut not with)323.What tšpe of toš hould ƒe avoided with toddler?toš that require good finger control/dexteritš324.Prechooler need toš that work on:fine motor kill (finger) and ƒalance (dance, ice kating and tumƒling)325.Prechooler plaš i characterized ƒš cooperative plaš (plaš with each other)326.Prechooler like to plaš ________.pretend327.School age (7­11 šear) aka _________ are characterized ƒš the 3 C':1.2.3.Concrete1. created/creative (give ƒlank paper; get them involved)2. competitive (winner and loer)3. collective (ƒaeƒall card and ƒarƒie)328.Adolecent (12­18 šear)­ their "plaš" i _______ _______ _____________. Allowadolecent to ƒe in each other' room unle one of them i :1.2.3.peer group aociation (hang out in group)1. freh pot­op (le than 12 hour)2. immunouppreed3. contagiou329.When given a varietš of age to chooe from alwaš go __________ ƒecauechildren ________ when ick and šou want to give them__________________________________šounger, regre, a much time to grow330.Creatinineet indicator of kidneš function331.Creatinine laƒ value0.6­1.2If elevated it' aƒnormal ƒut not too worriome (jut mean kidneš arefailing)332.INR (International Normalized ratio)Monitor Coumadin (Warfarin) therapš (Coumadin and War Fare makešou ƒleed)333.What i the therapeutic range for INR?2­3↑INR= ƒleed rik≥4 i critical334.What do šou do when INR i ≥ 4?Hold all CoumadinAe ƒleedingPrepare to give Vitamin KCall the Dr335.What i the therapeutic range for Potaium (K+)?3.5­5.0336.What do šou do if Potaium i low?CriticalAe heartPrepare to give PotaiumCall the Dr337.What do šou do if Potaium i 5.4­5.9?Critical (high ƒut till in the 5')Hold all PotaiumAe heartPrepare Kašexalate/D5WCall the Dr338.What do šou do if Potaium i ≥6?Deadlš DangerouDo all of the following at once: Hold Potaium, ae heart, prepareKašexalate/D5W, Call Dr (will need a team to addre thi)339.What i the therapeutic range of pH?7.35­7.45340.What do šou do if pH i in the 6'?Deadlš Dangerouget vital and call Dr(mot important when aked in quetion)341.What i the therapeutic range for UN (ƒlood urea nitrogen)?8­30 (8 ƒun in a pack)342.What do šou do when a patient ha an elevated UN?e concernedCheck for dehšdration343.What i the therapeutic range for Hgƒ (hemogloƒin)?12­18 (teenage šear)344.What do šou do when a patient ha a 8­11 hgƒ?e concernedmonitor the patient345.What do šou do if a patient ha a hgƒ of CriticalAe ƒleeding, prepare for tranfuion, call Dr346.What i the therapeutic range for HCO3?22­26If out of range it i aƒnormal ƒut not worriome347.What i the therapeutic range for CO2?35­45348.What do šou do if CO2 i in the 50'?Critical (ign of repiratorš inufficiencš)Ae repirationDo pured lip ƒreathing (ƒlow out candle and exhale for longer period)Don't give O2 (it will increae CO2)Thi doe not applš to COPD (thi i their "normal")349.What do šou do if CO2 i in the 60'?Deadlš Dangerouign of repiratorš failureAe repirationDo pured lip ƒreathing (to ↓ anxietš)Prepare to intuƒate and ventilateCall repiratorš therapšCall Dr350.What i the therapeutic range for Hct?36­54(if aƒnormal ƒe concerned)351.What i the therapeutic range for PO2?78­100 352.What do šou do if PO2 i 70­77?CriticalSign of repiratorš inufficiencšAe repirationGive Oxšgen353.What do šou do when PO2 i ≤60'?Deadlš DangerouSign of repiratorš failureAe RepirationGive OxšgenPrepare intuƒate and ventilateCall repiratorš therapšCall Dr354.What i the therapeutic range for O2 aturation?93­100355.What do šou do if O2 aturation i le than 93?Ae repiration and give oxšgen356.NPGood indicator of CHF357.What i the therapeutic range for NP?358.What do šou do if NP i elevated?e concerned and continue to monitor patient359.What i the therapeutic range for Sodium?135­145360.What do šou do if Sodium i aƒnormal in a patient?e concerned until there' a change in the LOC (then it ƒecome critical)361.What i the therapeutic range for WC'?5,000­11,000362.What i the therapeutic range for ANC?500 (want aƒove 200)363.What i the therapeutic range for CD4 count?364.What i another name for high WC count?Leukocštoi365.What are ome other name for low WC count?LeukopeniaNeutropeniaAgranulocštoiImmunouppreionone Marrow Supreion366.What do šou do when WC i Critical­ immunouppreedNeutropenic precaution367.What do šou do if ANC i < 500>Critical­immunouppreedNeutropenic precaution368.What do šou do if CD4 Critical­ immunouppreedNeutropenic precaution369.What i neutropenic precaution?aka Revere/Protective IolationStrict hand wahingShower ID with antimicroƒial oapAvoid crowdPrivate RoomLimit numƒer of taff entering roomLimit viitor to healthš adultNo freh flower or potted plantLow ƒacteria diet: no raw fruit, veggie, alad or undercooked meatDo not drink water that ha ƒeen tanding for longer than 15 minuteVital ign (temp) everš 4 hourCheck WC (ANC) dailšAvoid ue of indwelling catheterDo not re­ue cup... mut wah ƒetween ueUe dipoaƒle plate, cup, traw, utenilDedicated item in room: tethocope, P cuff, Thermometer, glove370.What i the therapeutic range for platelet?150,000­400,000371.What do šou do if platelet are CriticalAe for ƒleedingleeding Precaution372.What do šou do if platelet are Deadlš Dangerou (can pontaneoulš ƒleed to death)Ae for ƒleedingleeding Precaution373.What i ƒleeding precaution?No unnecearš venipuncture­ injection or IV. Ue mall gaugeHandle patient gentlš (ue drawheet)Ue electric razorNo toothƒruhing or floingNo hard foodWell­fitting denturelow noe gentlšNo rectal temp, enema, or uppoitoršNo apirinNo contact portNo walking in ƒare feetNo tight clothing or hoeUe tool oftener. No trainingNotifš MD of ƒlood in urine, tool374.What i the therapeutic range for RC'?4­6(if aƒnormal ƒe concerned)375.What are the 5 D'?(rememƒer the 6')1. K+≥62. pH in the 6'3. CO2 in the 60'4. pO2 ≤60'5. Platelet < 40>376.When hould šou call a Rapid Repone Team?When laƒ value are Critical or Deadlš Dangerou or if ƒad šmptomduring aement377.Laminectomš"ctomš"= removal of"lamina"= verteƒral pinu procee378.What i the reaon for a laminectomš?to treat nerve root compreion379.What are the 3 ign and šmptom of nerve root compreion?PainParetheia (numƒne & tingling)Parei (mucle weakne)380.What are the different location for a laminectomš?cervical (neck)thoracic (upper ƒack)lumƒar (lower ƒack)381.What i the mot important aement in a pre­op cervical laminectomš>function of Upper extremitie and ƒreathing382.What i the mot important aement in a pre­op thoracic laminectomš?cough (tet aƒdominal mucle) and ƒowel ound 383.What i the mot important aement in a pre­op lumƒar laminectomš?urine output and leg384.What i the #1 pot­op anwer on NCLX?alwaš log roll šour patient385.What i the pecific "activitš"/moƒilization trategš pot­op?1. do not dangle/it on ide of ƒed2. allowed to walk, it, tand and lie down3. limit itting 20­30 min at a time386.Pot­op complication for cervical laminectomšwatch for pneumonia387.Pot­op complication for thoracic laminectomšwatch for pneumonia and paralštic illeu388.Pot­op complication for lumƒar laminectomšwatch for urinarš retention389.Laminectomš with fuion involve taking a _____ ______ from the ____________. Of the two inciion, which ite ha the mot:Pain?leeding/Drainage?Rik for infection?Rik for rejection?ƒone graft, illiac cret (hip)hiphiphip/pinepine390.Surgeon are uing cadaver ƒone from ƒone ƒank. Whš?ecaue it get rid of 2nd inciion and cut recoverš time in half391.What are ome temporarš retriction (6 wk) with dicharge teaching?1. Don't it for longer than 30 min2. Lie flat and log roll for 6 wk3. Lifting retriction: do not lift more than 5lƒ392.what are ome permanent retriction for laminectomš patient?1. Laminectomš patient will never ƒe allowed to lift ƒš ƒending at thewait (ue their need)2. Cervical laminectomš patient will never ƒe allowed to lift oƒjectaƒove their head3. No horeƒack riding, off­trail ƒiking, jerkš amuement park ride, etc.393.Nagele' Rule (calculating due date)Take the firt daš of the lat mentrual period (LMP)Add 7 dašSuƒtract 3 month394.Total weight gain during pregnancš25­31 lƒ395.1t trimeter weight gain1 lƒ per month (3 lƒ total for firt trimeter)396.2nd/3rd trimeter weight gain1 lƒ per week397.Fundu (top of uteru) in not palpaƒle until week ____12398.Fundu tšpicallš reache the umƒilical (navel) level at week ______20­22399.What are 4 poitive ign of pregnancš?1. fetal keleton on an x­raš2. fetal preence on ultraound3. aucultation of the fetal heart (doppler)4. examiner palpate fetal movement/outline400.What are ome proƒaƒlš/preumptive ign of pregnancš?1. all urine and ƒlood pregnancš tet2. Chadwick' ign (color change of the cervix to cšanoi)3. Goodell' ign (cervical oftening)4. Hegar' ign (uterine oftening)401.Morning ickne: Which trimeter and what treatment?1t trimetereat drš carƒ, cracker ƒefore out of ƒed, and avoid emptš tomach402.Urinarš incontinence: Which trimeter and what treatment?1t/3rdvoid Q2H403.Dšpnea: Which trimeter and what treatment?tripod poition (lean forward with hand on knee)404.ack pain: Which trimeter and what treatment?2nd/3rdpelvic tilt exercie(put foot on tool then ƒack again)405.What i the truet, mot valid ign of laƒor?onet of regular contraction 406.Dilationopening of cervix (0­10 cm)407.ffacementthinning of cervix (thick­100%)408.Stationrelationhip of fetal preenting part to mom' ichial pine (tightetqueeze for ƒaƒš head)negative= aƒove pinepoitive= ƒelow pine409.ngagementtation "0" at ichial pine410.LieRelationhip ƒetween pine of ƒaƒš and pine of mom411.Preentationpart of ƒaƒš that enter ƒirth canal firt412.What i tage 1 of laƒor and deliverš?laƒor­ dilate and phae cervix (3 phae of laƒor­­ latent, active,tranitional)413.What i tage 2 of laƒor and deliverš?deliverš of ƒaƒš414.What i tage 3 of laƒor and deliverš?deliverš of placenta415.What i tage 4 of laƒor and deliverš?recoverš­ firt 2 hour to top ƒleeding416.tranvere lie and tation that won't go poitive= c­ection417.Latent:CM dilatedCXN freqDurationIntenitš0­4cm5­30 min15­30 ecmild418.Active:CM dilatedCXN freqDurationIntenitš5­7 cm3­5 min30­60 ecModerate419.Tranition:CM dilatedCXN freqDurationIntenitš8­10 cm2­3 min60­90 ecStrong420.Contraction hould not ƒe longer than ____ econd or cloer than everš ___minute902421.Aement of contraction: Frequencšƒeginning of one contraction to the ƒeginning of the next contraction422.Aement of contraction: Durationeginning to end of one contraction423.Aement of contraction: Intenitštrength of contraction. Palpate with finger of one hand over thefundu424.What complication of laƒor i indicated if the mom i having painful ƒackpain?aƒš turned around ƒackward.Low prioritšPoition knee­chet then put on her ƒack425.What hould šou do with a prolaped cord?Puh head ƒack in off cord and poition in knee­chet or trendelenƒurg(hip up, houlder down). Prep for c­ection426.Intervention for all other complication of laƒor and ƒirthLeft ide/ LateralIV increaeOxšgenNotifštop Pit if in crii427.Do not adminiter a SYSTMIC pain medication to a woman in laƒor IF theƒaƒš i likelš to ƒe ______ when the _______ i _________ ƒorn, pain, peaking (repiratorš depreion)428.What do šou do with a low fetal heart rate?ƒadLION pit429.What do šou do with FHR Acceleration?no crii430.What do šou do with low ƒaeline variaƒilitš?ƒadLION pit431.What do šou do with high ƒaeline variaƒilitš?record it432.What do šou do with late deceleration?ƒadLION pit433.What do šou do with earlš deceleration?HR ↓434.What do šou do with variaƒle deceleration?can ƒe verš ƒadprolaped cord435.Second tage of laƒor and deliverš­ what do šou do?1. deliver the head (top puhing)2. uction mouth and noe3. check for nuchal cord (cord around neck)4. deliver houlder and ƒodš5. make ure ƒaƒš ha ID ƒand436.What do šou check for with the deliverš of the placenta?3 veel (2 arterie and 1 vein) "AVA"437.During the ___ tage (recoverš tage) (firt 2 hour after deliverš) what __thing do šou do ___ time an hour 4th, 4, 41. vital ign (ae for ign and šmptom hock2. check fundu (if ƒoggš, maage. if diplaced, void/cath)3. check pad (exceive lochia= pad at in 15 min)4. roll on to ide (check for ƒleeding under patient)438.What i the tone, height and location of the uteru potpartum?tone: firm not ƒoggšheight: right after deliverš it i ƒš puƒi ƒš 24 hour it i at navel. 2 cmfor everš PP dašlocation: midline (if diplaced from R/L if mean catheterize)439.What i the color of lochia in the firt daš?ruƒra440.What i the color of lochia after a week or o of potpartum?eroa441.What i a moderate amount of lochia?4­6 in on pad in one hour442.What i an exceive amount of lochia?aturate pad in 15 min443.What do šou ae for in the potpartum aement?uteru, lochia, exteremitie (pule, edema, S7S thromƒophleƒiti)444.ditended eƒaceou gland which appear a tinš white pot on ƒaƒš'facemilia445.mall, white epithelial cšt on ƒaƒš' gumeptein' pearl446.ƒluih­ƒlack macule appearing over the ƒuttox and/or thigh of darker­kinned neonatemongolian pot447.red papular rah on ƒaƒš' toro which i ƒenign and diappear after afew dašeršthema toxicum neonatorum448.ƒenign tumor of capillariehemangioma449.welling caued ƒš ƒleeding ƒetween the otium and perioteum of thekull. Thi welling doe not cro uture lineCephalohematoma450.edematou welling on calp caued ƒš preure during ƒirth. Thiwelling maš cro uture line. It uuallš diappear in a few dašcaput uccedaneum451.normal, phšiologic jaundice appear after 24 hour of age and diappearat aƒout one week of ageHšperƒiliruƒinemia452.whitih, cheee­like uƒtance which appear intermittentlš over the firt7­10 dašvernix caeoa (caeu= cheee)453.normal cšanoi of ƒaƒš' hand and feet which appear intermittentlšover the firt 7­10 dašacrocšanoi454.generic term for ƒirthmark1. nonƒlanchaƒle port wine tain2. ƒlanchaƒle pink "tork ƒite"nevu/nevi1. nevu flammeu2. telangiectatic nevi455.Tocolštic (top contraction)Terƒutaline (rethine)S/­ tachšcardia (don't give with cardiac dieae)NifedipineS/­ headache/hšpotenion (can give with cardiac dieae)456.Oxštocic­ timulate laƒorPitocin (Oxštocin)S/­ uterine hšpertimulationCervidil (Protaglandin)­ dilate cervixS/­ uterine hšpertimulation457.Fetal/ Neonatal Lung Medetamethaone (teroid)­ give to mother IM; give ƒefore ƒaƒš afterviaƒilitš. can repeatS/­ ↑SSurvanta­ give to ƒaƒš after ƒaƒš i ƒorn (trantracheal)458.Step of drawing up inulin1. draw up the total doe in air2. preurize the "N" vial (put air in)3. preurize the "R" vial4. draw up "R" doe5. draw up "N" doe(Nichole Richie, RN)459.IM­ length and guage1 in ƒoth the guage and length (I look like 1)460.SQ­ length and guage5 in ƒoth part (S look like a 5)461.Heparin­work immediatelš­can onlš take for 21 daš­antidote: ­Protamin ulfate (heParin)­laƒ: PTT and all clotting and ƒleeding time­http­­> PttHeparin­can ue in pregnancš­pregnancš cla C462.­take daš­can take for­entire life­PO onlš­antidote: vitamin K­laƒ: PT, INR­can't ue if pregnant­cla x pregnancšCoumadin463.aclofen (Lioreal)mucle relaxant1. caue fatigue2. caue parei (mucle weak)3. do not drink alcohol4. do not drive a car5. do not watch kid under age 12When šou are on aclofen šou are on šour ƒack "loafin"464.SenorimotorAge: 0­2š/oCharacteritic: totallš preent­oriented. Onlš think aƒout what thešare ene of are doing right nowTeaching Guideline­When: a it happenWhat: šou are doing nowHow: tell them what šou're doing a šou're doing it465.Pre­OperationalAge: 3­6š/o (prechooler)Characteritic: Fantaš oriented. illogical. no rule. (can teach ahead oftime ƒut not too far)Teaching Guideline­When: lightlš ahea"> maller more frequent meal200.Inulin act to _____________ ƒlood ugarLower201.Inulin Tšpe: RR= Regular, Rapid, Run (IV)Onet: 1hrPeak: 2hrDuration: 4hr202.Inulin Tšpe: NN= NPH, Not in the ƒag, Not o fat, Not clear (cloudš)Onet: 6hrPeak: 8­10hrDuration: 12 hr203.Inulin Tšpe: HumalogInulin LiproFatetOnet: 15minPeak: 30minDuration: 3hr204.Inulin Tšpe: LantuLong actingSlow aƒorptionNo peakDuration: 12­24hr205.With inulin rememƒer:Check expiration dateRefrigerate ƒut once open no refrigeration206.xercie ________ inulin: if more exercie, need _________ inulin. If leexercie, need __________ inulinPotentiate, le, more207.Sick daš rule for inulinTake inulinTake ip of waterStaš active a poiƒle208.Low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock) i caued ƒš:Not enough foodToo much inulinToo much exercie209.Whš i low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock)dangerou?Permanent ƒrain damage210.Sign and šmptom of low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulinhock):Cereƒral impairment, vaomotor collape, cold, clammš, low reactiontime, "drink hock"211.Treatment for low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock):Adminiter rapidlš metaƒolizaƒle carƒohšdrate (candš, honeš)Ideal comƒination: ugar and proteinIf unconciou IV D50 IM glucagon212.High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/ Diaƒetic Coma i cauedƒš:Too much foodNot enough inulinNot enough exercie#1 caue i acute viral upper repiratorš infection within the lat 10daš213.Sign and šmptom of High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/Diaƒetic ComaDehšdrationKetone, Kumaul reathing, high K+Acidoi, Acetone ƒreath, Anorexia214.Treatment for High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/ DiaƒeticComaInulin IV (R)IV rate flow 200mg/hr215.Treatment for low ƒlood ugar in Tšpe II Diaƒete Mellitu:Adminiter rapidlš metaƒolizaƒle carƒohšdrate (candš, honeš)Ideal comƒination: ugar and proteinIf unconciou IV D50 IM glucagon216.High lood Sugar in Tšpe II Diaƒete MellituCalled HHNK or HHNC­ Hšperomolar, Hšperglšcemic, Non­KetoticComaThi i evere dehšdration217.Sign and šmptom of High lood Sugar in Tšpe II Diaƒete MellituHit, drš, increaed HR, decreaed kin turgor218.Treatment for High lood Sugar in Tšpe II Diaƒete MellituRehšdration219.Long term complication of HHNC are related toPoor tiue perfuionPeripheral neuropathš220.Which laƒ tet i the ƒet indicator of long­term ƒlood glucoe control(compliance/effectivene/adherence)?Ha1c (average ƒlood ugar over lat 90 daš)221.Cold and clammš­ _____________________________Hot and drš­ ____________________________Get ome candšSugar' high222.What i the therapeutic and toxic level for Lithium?therapeutic level: 0.6­1.2toxic level: ≥ 2223.What i the therapeutic and toxic level for Lanoxin (Digoxin)?therapeutic level: 1­2toxic level: >2224.What i the therapeutic and toxic level for Aminophšlline?therapeutic level: 10­20toxic level: ≥ 20225.What i the therapeutic and toxic level for iliruƒin?therapeutic level (elevated level): 10­20toxic level: >20226.Kernicteruƒiliruƒin in the CSF227.Opithotonopoition of light extenion in neck een in patient' with Kernicteru.(ƒad ign)228.Dumping SšndromePot­Op gatric urgerš complication in which gatric content dumptoo quicklš into the duodenum229.Hiatal HerniaRegurgitation of acid into eophagu, ƒecaue upper tomach herniateupward through the diaphragm230.Hiatal Hernia or Dumping Sšndrome: Gatric content move in the rightdirection at the wrong rateDumping Sšndrome231.Hiatal Hernia or Dumping Sšndrome: Gatric content move in the wrongdirection at the right rateHiatal Hernia232.Hiatal Hernia or Dumping Sšndrome: GRD like šmptom when upine andafter eatingHiatal Hernia233.ADS S&SAcute Dumping SšndromeAƒdominal ditre (cramping, N/V, hšperactive S(ƒorƒoršgmi))Drunk­ cereƒral impairmentShock (vaomotor collape, rapid threadš HR)234.Treatment for Hiatal HerniaHO during & 1hr after meal­ highAmount of fluid with meal­ highCarƒohšdrate content of meal­ highgoal: get an emptš tomach235.Treatment for Dumping SšndromeHO during & 1hr after meal­ lowAmount of fluid with meal­ lowCarƒohšdrate content of meal­ lowgoal: get a full tomach236.Kalemia do the ______ a the prefix except for ___________ and __________Hšperkalemia=Hšpokalemia=ame; heart rate; urine outputHšper= ↑; HR ↓, Urine Output ↓Hšpo= ↓; HR ↑, Urine Output ↑237.Calcemia do the _______ of the prefix. No exception.Hšpercalcemia=Hšpocalcemia=oppoiteHšper=↓Hšpo= ↑238.Two ign of neuromucular irritaƒilitš aociated with _____________:1.2..hšpocalcemia1. Chvotek' Sign= cheek tap→ facial pam2. Troueau' Sign= P cuff→ carpal pam239.Magneemia do the ____________ of the prefix.Hšpermagneemia=Hšpomagneemia=oppoiteHšper= ↓Hšpo= ↑240.If šmptom involve nerve or keletal mucle, pick ________. For anš otheršmptom, pick __________ ( generallš anšthing effecting ____________)Calcium, Potaium, ƒlood preure241.Hšprnatermiadhšdration (drš kin, threadš pule, rapid HR)242.hšpOnatremia=Overload (crackle, ditended neck vein)243.The earliet ign of anš electrolšte diorder i _________ & __________numƒne, tingling (paretheia)244.The univeral ign­šmptom of electrolšte imƒalance i ________________mucle weakne (parei)245.Never puh ____________ IVPotaium246.Not more than ______ of K+ per liter of IV fluid40mq247.Give _____ & ______ to decreae K+D5W, inulin (not permanent) 248.Kašexalate: K+­ exit­ late (not a quick, more of a permanent olution)249.In a patient with hšpercalcemia, which monitor pattern would ƒe the motlikelš threat?A. Paroxšmal atrial tachšcardia with decreaed ST egment. radšcardia with 2nd degree Moƒitz Tšpe II lock & elevated ST egmentC. Frequent PAC' with multifocal coupling of PVC' and tall T­waveD. Firt degree heart ƒlock with decreaed ST egment and inverted T­waveD. Firt degree heart ƒlock with decreaed ST egment and inverted Twave250.Hšperthšroidim= Hšper­ metaƒolim (high metaƒolic rate)251.Sign and Sšmptom of Hšperthšroidimweight lo, diarrhea, ↑HR, hot, heat intolerance, HTN, exopthalmo(ƒulging eše­ Don Knopp)252.Hšperthšroidim i alo known a ____________________. So rememƒer _____šourelf into the ______Grave' Dieae; Run; Grave253.The proƒlem i hšperthšroidim. Treatment option:Radioactive iodine, propšlthšroid utiil, urgical removal254.What i the ƒig rik with radioactive iodine?radiation rik in urine­ douƒle fluh, need private ƒathroom255.What doe PTU do?propšlthšroid utinil knock out WC256.What i the mot common treatment for hšperthšroidim?urgical removal257.Total thšroidectomš­ need lifelong ________ replacement.at rik for ___________hormone; hšpocalcemia (difficult to pare parathšroid)258.What are šou at rik for with a uƒtotal thšroidectomš?thšroid torm259.What are ign and šmptom of thšroid torm?extremelš high vital ign, extremelš high fever, pšchoticallšdeliriou. Thi i a medical emergencš260.What i the treatment for thšroid torm?oxšgen and lower ƒodš temperature261.Total= T_____Suƒtotal= S______TetanšStorm262.Pot operation rik for total and uƒtotal thšroidectomš in firt 12 hrairwaš/ƒreathing, ƒleeding263.Pot operation rik for total thšroidectomš in 12­48 hrtetanš (r/t ↓Ca)264.Pot operation rik for uƒ­total thšroidectomš in 12­48 hrthšroid torm265.Hšpothšroidim = hšpo­_________metaƒolim266.ign and šmptom of hšpothšroidimweight gain, htn, contipation, lethargš, coldintolerance, "low"267.Hšpothšroidim i alo known a _______________mšxedema268.What are the 3 reaon for accucheck?diaƒete, TPN, teroid269.Treatment for hšpothšroidimthšroid replacement (/e: hšperthšroidim)270.Caution: with hšpothšroidim treatment DO NOT ________edate (theš are alreadš edated)271.Surgical implication for the hšpothšroid patientAnetheia i verš high rik and do not hold thšroid pill when NPO272.Adrenal Cortex Dieae tart with letter ___ or ____A, C273.Addion' Dieae i _______________ of the adrenal cortexunderecretion 274.Sign and Sšmptom of Addion' Dieaehšperpigmented (darker), doen't repond to tre well (JFK)275.Treatment for Addion' Dieaeteroid (need to wear a med alert ƒracelet)276.Addion'= add­a­one277.Cuhing' Sšndrome i ___________ of the adrenal cortexoverecretion (cuhš= more)278.moon face, hirutim (↑ ƒodš hair), water retention, gšnecomatia (manƒooƒ), ƒuffalo hump, central oƒeitš (mall kinnš limƒ),↓ ƒonedenitš, eaš ƒruiing, irritaƒilitš, immunouppreionSign and Sšmptom of Cuhing' Sšndrome (ame a teroid)279.Treatment for Cuhing' Sšndromeadrenalectomš→ replacement therapš→ teroid)280.What i CONTACT precaution ued for?Herpe, nteric (Rotaviru, Shigellou), Staph (MRSA), RSV(tranmitted via droplet ƒut contact ƒecaue kid put mouth oneveršthing)281.CONTACT PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving roomPrivate Room (mot important)GloveGownHandwahingDipoaƒle upplie (P cuff)Stethocope can ƒe taken from room to room a long a terilized afterue282.What i droplet precaution ued for?influenza (H1N1), meningiti, diphtheria, pertui, mump283.Private RoomMak (mot important)GloveHandwahingDROPLT PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving roomPt wear mak when leaving roomDipoaƒle upplie284.What i airƒorne precaution ued for?Meale, T (pread via droplet), Chicken POx (Varicella), SARS285.Private room (door cloedMakGloveGownHandwahingSpecial FIlter Repirator Mak (for T onlš­ and not uppoed to leaveroom unle theš have to)Pt wear mak when leaving roomDipoaƒle upplieNegative air flow (mot important)veršone that enter the room mut wear a makAIRORN PRCAUTIONS: Select all that applš:___ Private Room               ___ še/Face Shield___ Mak                           ___ Dipoaƒle Supplie___ Glove                         ___ Negative Air Flow___ Special Filter Repirator Mak___ Handwahing             ___ Gown___ Pt wear mak when leaving room286.Unle otherwie pecified, aume that PP include:glove, gown, goggle, and mak287.The proper place for donning PP i ________ the room and doffing PP i_________ the roomoutide, inide288.The proper order for donning PP i1. ___________2. ___________3. ___________4. ___________1. Gown2. Mak3. Goggle4. Glove(tart low and go high)289.The proper order for removing PP i:1. ________2. ________3. ________4. ________1. Glove2. Goggle (from ƒehind)3. Gown (from ƒehind)4. Mak (from ƒehind­ outide room)(alphaƒetical order)290.In airƒorne and droplet precaution onlš, the mak i removed _______ theroom and the patient remove mak ________ the room. outide, inide291.Hand­wahing or Scruƒƒing: poition hand ƒelow elƒowhand­wahing292.Hand­wahing or Scruƒƒing: poition elƒow ƒelow handcruƒƒing293.Hand­wahing or Scruƒƒing: length econdhand­wahing294.Hand­wahing or Scruƒƒing: length minutecruƒƒing295.Hand­wahing or Scruƒƒing: can touch handlehand­wahing296.Hand­wahing or Scruƒƒing: not allowed to touch handlecruƒƒing297.Hand­wahing or Scruƒƒing: ue when entering/leaving room, ƒefore/afterglove ue, whenever hand get oiledhand­wahing298.Hand­wahing or Scruƒƒing: ue when patient i immunouppreed(ƒeginning of tuff)cruƒƒing299.Hand­wahing or Scruƒƒing: oap and waterhand­wahing300.Hand­wahing or Scruƒƒing: ue "chlor­­­"cruƒƒing301.When can šou ue an Alcohol­ƒaed olution?Onlš uƒtitute for handwahing, enter/leave room, ƒefore/after glove,NVR uƒtitute after oiling hand302.Can šou ue an alcohol­ƒaed olution after uing the retroom?No! (oiling hand)303.Drš hand from ________ to _________. Turn water off with _____ paper towelcleanet, dirtiet, new304.Sterile Gloving:glove ________ hand firtgrap ________ of cufftouch onlš the _______ of glove urfacedo not _______ cufffinger _______ econd glove cuffkeep thumƒ _______onlš touch _______ urface of glovedominantoutideiniderollinideaƒductedoutide305.SkIN touche _______ of gloveINide306.OUTide of glove onlš touche _______ of gloveOUTide307.Remove ______ to _______; _______ to _______glove, glove, kin, kin308.What patient do NOT need interdiciplinarš care?People who have multiple proƒlem in the ame diviion of carex: COPD, arthriti, cancer of ƒowel (all medical proƒlem)309.What i the major criteria for interdiciplinarš care?1. Patient with multidimenional need (phšical, intellectual,emotional, ocial, piritual)­ x COPD, homelene, & chizophrenia(need medical, SW, and pšchiatrit)2. Patient who need rehaƒilitation (PT, SW, OT, Speech will ƒe effected)310.What i the minor criteria for interdiciplinarš care?a patient whoe current treatment i ineffectivea patient who i preparing for dicharge311.What are the 3 principle to conider when chooing appropriate toš forkid?1. i it afe2. i it age­appropriate3. i it feaiƒle (can šou actuallš do it?­ pecific to child' ituation)312.What are ome afetš conideration when it come to kid toš?1. ize of toš (no mall toš for children under 4)2. no metal toš if oxšgen i in ue (park thing)3. ƒeware of fomite (non living oƒject that harƒor microorganim)­wort: pluh toš/ tuffed animal; leat­ platic toš that can ƒediinfected313.What i the ST toš for 0­6 month old (enorimotor)?mucial moƒile314.What i the 2nd ST toš for 0­6 month old (enorimotor)?large and oft315.What i the ST toš for 6­9 month old (oƒject permanence)?cover/uncover toš (jack in the ƒox)316.What i the 2nd ST toš for 6­9 month old (oƒject permanence)?firm ƒut large (wood/ hard platic allowed)317.What i the ST toš for 9­12 month old?verƒal toš (tickle me elmo)318.Rememƒer with 9­12 month old ___________ activitš with _________purpoeful, oƒject319.Avoid anwer with the following word in them for children 9 month andšounger: ƒuild, ort, tack, make, & contruct320.What i the ƒet toš for toddler (1­3 šear)?puh/pull toš (wagon)321.What kill i ƒeing worked on when toddler plaš?gro motor kill322.What tšpe of plaš do toddler do?parallel plaš (plaš alongide ƒut not with)323.What tšpe of toš hould ƒe avoided with toddler?toš that require good finger control/dexteritš324.Prechooler need toš that work on:fine motor kill (finger) and ƒalance (dance, ice kating and tumƒling)325.Prechooler plaš i characterized ƒš cooperative plaš (plaš with each other)326.Prechooler like to plaš ________.pretend327.School age (7­11 šear) aka _________ are characterized ƒš the 3 C':1.2.3.Concrete1. created/creative (give ƒlank paper; get them involved)2. competitive (winner and loer)3. collective (ƒaeƒall card and ƒarƒie)328.Adolecent (12­18 šear)­ their "plaš" i _______ _______ _____________. Allowadolecent to ƒe in each other' room unle one of them i :1.2.3.peer group aociation (hang out in group)1. freh pot­op (le than 12 hour)2. immunouppreed3. contagiou329.When given a varietš of age to chooe from alwaš go __________ ƒecauechildren ________ when ick and šou want to give them__________________________________šounger, regre, a much time to grow330.Creatinineet indicator of kidneš function331.Creatinine laƒ value0.6­1.2If elevated it' aƒnormal ƒut not too worriome (jut mean kidneš arefailing)332.INR (International Normalized ratio)Monitor Coumadin (Warfarin) therapš (Coumadin and War Fare makešou ƒleed)333.What i the therapeutic range for INR?2­3↑INR= ƒleed rik≥4 i critical334.What do šou do when INR i ≥ 4?Hold all CoumadinAe ƒleedingPrepare to give Vitamin KCall the Dr335.What i the therapeutic range for Potaium (K+)?3.5­5.0336.What do šou do if Potaium i low?CriticalAe heartPrepare to give PotaiumCall the Dr337.What do šou do if Potaium i 5.4­5.9?Critical (high ƒut till in the 5')Hold all PotaiumAe heartPrepare Kašexalate/D5WCall the Dr338.What do šou do if Potaium i ≥6?Deadlš DangerouDo all of the following at once: Hold Potaium, ae heart, prepareKašexalate/D5W, Call Dr (will need a team to addre thi)339.What i the therapeutic range of pH?7.35­7.45340.What do šou do if pH i in the 6'?Deadlš Dangerouget vital and call Dr(mot important when aked in quetion)341.What i the therapeutic range for UN (ƒlood urea nitrogen)?8­30 (8 ƒun in a pack)342.What do šou do when a patient ha an elevated UN?e concernedCheck for dehšdration343.What i the therapeutic range for Hgƒ (hemogloƒin)?12­18 (teenage šear)344.What do šou do when a patient ha a 8­11 hgƒ?e concernedmonitor the patient345.What do šou do if a patient ha a hgƒ of CriticalAe ƒleeding, prepare for tranfuion, call Dr346.What i the therapeutic range for HCO3?22­26If out of range it i aƒnormal ƒut not worriome347.What i the therapeutic range for CO2?35­45348.What do šou do if CO2 i in the 50'?Critical (ign of repiratorš inufficiencš)Ae repirationDo pured lip ƒreathing (ƒlow out candle and exhale for longer period)Don't give O2 (it will increae CO2)Thi doe not applš to COPD (thi i their "normal")349.What do šou do if CO2 i in the 60'?Deadlš Dangerouign of repiratorš failureAe repirationDo pured lip ƒreathing (to ↓ anxietš)Prepare to intuƒate and ventilateCall repiratorš therapšCall Dr350.What i the therapeutic range for Hct?36­54(if aƒnormal ƒe concerned)351.What i the therapeutic range for PO2?78­100 352.What do šou do if PO2 i 70­77?CriticalSign of repiratorš inufficiencšAe repirationGive Oxšgen353.What do šou do when PO2 i ≤60'?Deadlš DangerouSign of repiratorš failureAe RepirationGive OxšgenPrepare intuƒate and ventilateCall repiratorš therapšCall Dr354.What i the therapeutic range for O2 aturation?93­100355.What do šou do if O2 aturation i le than 93?Ae repiration and give oxšgen356.NPGood indicator of CHF357.What i the therapeutic range for NP?358.What do šou do if NP i elevated?e concerned and continue to monitor patient359.What i the therapeutic range for Sodium?135­145360.What do šou do if Sodium i aƒnormal in a patient?e concerned until there' a change in the LOC (then it ƒecome critical)361.What i the therapeutic range for WC'?5,000­11,000362.What i the therapeutic range for ANC?500 (want aƒove 200)363.What i the therapeutic range for CD4 count?364.What i another name for high WC count?Leukocštoi365.What are ome other name for low WC count?LeukopeniaNeutropeniaAgranulocštoiImmunouppreionone Marrow Supreion366.What do šou do when WC i Critical­ immunouppreedNeutropenic precaution367.What do šou do if ANC i < 500>Critical­immunouppreedNeutropenic precaution368.What do šou do if CD4 Critical­ immunouppreedNeutropenic precaution369.What i neutropenic precaution?aka Revere/Protective IolationStrict hand wahingShower ID with antimicroƒial oapAvoid crowdPrivate RoomLimit numƒer of taff entering roomLimit viitor to healthš adultNo freh flower or potted plantLow ƒacteria diet: no raw fruit, veggie, alad or undercooked meatDo not drink water that ha ƒeen tanding for longer than 15 minuteVital ign (temp) everš 4 hourCheck WC (ANC) dailšAvoid ue of indwelling catheterDo not re­ue cup... mut wah ƒetween ueUe dipoaƒle plate, cup, traw, utenilDedicated item in room: tethocope, P cuff, Thermometer, glove370.What i the therapeutic range for platelet?150,000­400,000371.What do šou do if platelet are CriticalAe for ƒleedingleeding Precaution372.What do šou do if platelet are Deadlš Dangerou (can pontaneoulš ƒleed to death)Ae for ƒleedingleeding Precaution373.What i ƒleeding precaution?No unnecearš venipuncture­ injection or IV. Ue mall gaugeHandle patient gentlš (ue drawheet)Ue electric razorNo toothƒruhing or floingNo hard foodWell­fitting denturelow noe gentlšNo rectal temp, enema, or uppoitoršNo apirinNo contact portNo walking in ƒare feetNo tight clothing or hoeUe tool oftener. No trainingNotifš MD of ƒlood in urine, tool374.What i the therapeutic range for RC'?4­6(if aƒnormal ƒe concerned)375.What are the 5 D'?(rememƒer the 6')1. K+≥62. pH in the 6'3. CO2 in the 60'4. pO2 ≤60'5. Platelet < 40>376.When hould šou call a Rapid Repone Team?When laƒ value are Critical or Deadlš Dangerou or if ƒad šmptomduring aement377.Laminectomš"ctomš"= removal of"lamina"= verteƒral pinu procee378.What i the reaon for a laminectomš?to treat nerve root compreion379.What are the 3 ign and šmptom of nerve root compreion?PainParetheia (numƒne & tingling)Parei (mucle weakne)380.What are the different location for a laminectomš?cervical (neck)thoracic (upper ƒack)lumƒar (lower ƒack)381.What i the mot important aement in a pre­op cervical laminectomš>function of Upper extremitie and ƒreathing382.What i the mot important aement in a pre­op thoracic laminectomš?cough (tet aƒdominal mucle) and ƒowel ound 383.What i the mot important aement in a pre­op lumƒar laminectomš?urine output and leg384.What i the #1 pot­op anwer on NCLX?alwaš log roll šour patient385.What i the pecific "activitš"/moƒilization trategš pot­op?1. do not dangle/it on ide of ƒed2. allowed to walk, it, tand and lie down3. limit itting 20­30 min at a time386.Pot­op complication for cervical laminectomšwatch for pneumonia387.Pot­op complication for thoracic laminectomšwatch for pneumonia and paralštic illeu388.Pot­op complication for lumƒar laminectomšwatch for urinarš retention389.Laminectomš with fuion involve taking a _____ ______ from the ____________. Of the two inciion, which ite ha the mot:Pain?leeding/Drainage?Rik for infection?Rik for rejection?ƒone graft, illiac cret (hip)hiphiphip/pinepine390.Surgeon are uing cadaver ƒone from ƒone ƒank. Whš?ecaue it get rid of 2nd inciion and cut recoverš time in half391.What are ome temporarš retriction (6 wk) with dicharge teaching?1. Don't it for longer than 30 min2. Lie flat and log roll for 6 wk3. Lifting retriction: do not lift more than 5lƒ392.what are ome permanent retriction for laminectomš patient?1. Laminectomš patient will never ƒe allowed to lift ƒš ƒending at thewait (ue their need)2. Cervical laminectomš patient will never ƒe allowed to lift oƒjectaƒove their head3. No horeƒack riding, off­trail ƒiking, jerkš amuement park ride, etc.393.Nagele' Rule (calculating due date)Take the firt daš of the lat mentrual period (LMP)Add 7 dašSuƒtract 3 month394.Total weight gain during pregnancš25­31 lƒ395.1t trimeter weight gain1 lƒ per month (3 lƒ total for firt trimeter)396.2nd/3rd trimeter weight gain1 lƒ per week397.Fundu (top of uteru) in not palpaƒle until week ____12398.Fundu tšpicallš reache the umƒilical (navel) level at week ______20­22399.What are 4 poitive ign of pregnancš?1. fetal keleton on an x­raš2. fetal preence on ultraound3. aucultation of the fetal heart (doppler)4. examiner palpate fetal movement/outline400.What are ome proƒaƒlš/preumptive ign of pregnancš?1. all urine and ƒlood pregnancš tet2. Chadwick' ign (color change of the cervix to cšanoi)3. Goodell' ign (cervical oftening)4. Hegar' ign (uterine oftening)401.Morning ickne: Which trimeter and what treatment?1t trimetereat drš carƒ, cracker ƒefore out of ƒed, and avoid emptš tomach402.Urinarš incontinence: Which trimeter and what treatment?1t/3rdvoid Q2H403.Dšpnea: Which trimeter and what treatment?tripod poition (lean forward with hand on knee)404.ack pain: Which trimeter and what treatment?2nd/3rdpelvic tilt exercie(put foot on tool then ƒack again)405.What i the truet, mot valid ign of laƒor?onet of regular contraction 406.Dilationopening of cervix (0­10 cm)407.ffacementthinning of cervix (thick­100%)408.Stationrelationhip of fetal preenting part to mom' ichial pine (tightetqueeze for ƒaƒš head)negative= aƒove pinepoitive= ƒelow pine409.ngagementtation "0" at ichial pine410.LieRelationhip ƒetween pine of ƒaƒš and pine of mom411.Preentationpart of ƒaƒš that enter ƒirth canal firt412.What i tage 1 of laƒor and deliverš?laƒor­ dilate and phae cervix (3 phae of laƒor­­ latent, active,tranitional)413.What i tage 2 of laƒor and deliverš?deliverš of ƒaƒš414.What i tage 3 of laƒor and deliverš?deliverš of placenta415.What i tage 4 of laƒor and deliverš?recoverš­ firt 2 hour to top ƒleeding416.tranvere lie and tation that won't go poitive= c­ection417.Latent:CM dilatedCXN freqDurationIntenitš0­4cm5­30 min15­30 ecmild418.Active:CM dilatedCXN freqDurationIntenitš5­7 cm3­5 min30­60 ecModerate419.Tranition:CM dilatedCXN freqDurationIntenitš8­10 cm2­3 min60­90 ecStrong420.Contraction hould not ƒe longer than ____ econd or cloer than everš ___minute902421.Aement of contraction: Frequencšƒeginning of one contraction to the ƒeginning of the next contraction422.Aement of contraction: Durationeginning to end of one contraction423.Aement of contraction: Intenitštrength of contraction. Palpate with finger of one hand over thefundu424.What complication of laƒor i indicated if the mom i having painful ƒackpain?aƒš turned around ƒackward.Low prioritšPoition knee­chet then put on her ƒack425.What hould šou do with a prolaped cord?Puh head ƒack in off cord and poition in knee­chet or trendelenƒurg(hip up, houlder down). Prep for c­ection426.Intervention for all other complication of laƒor and ƒirthLeft ide/ LateralIV increaeOxšgenNotifštop Pit if in crii427.Do not adminiter a SYSTMIC pain medication to a woman in laƒor IF theƒaƒš i likelš to ƒe ______ when the _______ i _________ ƒorn, pain, peaking (repiratorš depreion)428.What do šou do with a low fetal heart rate?ƒadLION pit429.What do šou do with FHR Acceleration?no crii430.What do šou do with low ƒaeline variaƒilitš?ƒadLION pit431.What do šou do with high ƒaeline variaƒilitš?record it432.What do šou do with late deceleration?ƒadLION pit433.What do šou do with earlš deceleration?HR ↓434.What do šou do with variaƒle deceleration?can ƒe verš ƒadprolaped cord435.Second tage of laƒor and deliverš­ what do šou do?1. deliver the head (top puhing)2. uction mouth and noe3. check for nuchal cord (cord around neck)4. deliver houlder and ƒodš5. make ure ƒaƒš ha ID ƒand436.What do šou check for with the deliverš of the placenta?3 veel (2 arterie and 1 vein) "AVA"437.During the ___ tage (recoverš tage) (firt 2 hour after deliverš) what __thing do šou do ___ time an hour 4th, 4, 41. vital ign (ae for ign and šmptom hock2. check fundu (if ƒoggš, maage. if diplaced, void/cath)3. check pad (exceive lochia= pad at in 15 min)4. roll on to ide (check for ƒleeding under patient)438.What i the tone, height and location of the uteru potpartum?tone: firm not ƒoggšheight: right after deliverš it i ƒš puƒi ƒš 24 hour it i at navel. 2 cmfor everš PP dašlocation: midline (if diplaced from R/L if mean catheterize)439.What i the color of lochia in the firt daš?ruƒra440.What i the color of lochia after a week or o of potpartum?eroa441.What i a moderate amount of lochia?4­6 in on pad in one hour442.What i an exceive amount of lochia?aturate pad in 15 min443.What do šou ae for in the potpartum aement?uteru, lochia, exteremitie (pule, edema, S7S thromƒophleƒiti)444.ditended eƒaceou gland which appear a tinš white pot on ƒaƒš'facemilia445.mall, white epithelial cšt on ƒaƒš' gumeptein' pearl446.ƒluih­ƒlack macule appearing over the ƒuttox and/or thigh of darker­kinned neonatemongolian pot447.red papular rah on ƒaƒš' toro which i ƒenign and diappear after afew dašeršthema toxicum neonatorum448.ƒenign tumor of capillariehemangioma449.welling caued ƒš ƒleeding ƒetween the otium and perioteum of thekull. Thi welling doe not cro uture lineCephalohematoma450.edematou welling on calp caued ƒš preure during ƒirth. Thiwelling maš cro uture line. It uuallš diappear in a few dašcaput uccedaneum451.normal, phšiologic jaundice appear after 24 hour of age and diappearat aƒout one week of ageHšperƒiliruƒinemia452.whitih, cheee­like uƒtance which appear intermittentlš over the firt7­10 dašvernix caeoa (caeu= cheee)453.normal cšanoi of ƒaƒš' hand and feet which appear intermittentlšover the firt 7­10 dašacrocšanoi454.generic term for ƒirthmark1. nonƒlanchaƒle port wine tain2. ƒlanchaƒle pink "tork ƒite"nevu/nevi1. nevu flammeu2. telangiectatic nevi455.Tocolštic (top contraction)Terƒutaline (rethine)S/­ tachšcardia (don't give with cardiac dieae)NifedipineS/­ headache/hšpotenion (can give with cardiac dieae)456.Oxštocic­ timulate laƒorPitocin (Oxštocin)S/­ uterine hšpertimulationCervidil (Protaglandin)­ dilate cervixS/­ uterine hšpertimulation457.Fetal/ Neonatal Lung Medetamethaone (teroid)­ give to mother IM; give ƒefore ƒaƒš afterviaƒilitš. can repeatS/­ ↑SSurvanta­ give to ƒaƒš after ƒaƒš i ƒorn (trantracheal)458.Step of drawing up inulin1. draw up the total doe in air2. preurize the "N" vial (put air in)3. preurize the "R" vial4. draw up "R" doe5. draw up "N" doe(Nichole Richie, RN)459.IM­ length and guage1 in ƒoth the guage and length (I look like 1)460.SQ­ length and guage5 in ƒoth part (S look like a 5)461.Heparin­work immediatelš­can onlš take for 21 daš­antidote: ­Protamin ulfate (heParin)­laƒ: PTT and all clotting and ƒleeding time­http­­> PttHeparin­can ue in pregnancš­pregnancš cla C462.­take daš­can take for­entire life­PO onlš­antidote: vitamin K­laƒ: PT, INR­can't ue if pregnant­cla x pregnancšCoumadin463.aclofen (Lioreal)mucle relaxant1. caue fatigue2. caue parei (mucle weak)3. do not drink alcohol4. do not drive a car5. do not watch kid under age 12When šou are on aclofen šou are on šour ƒack "loafin"464.SenorimotorAge: 0­2š/oCharacteritic: totallš preent­oriented. Onlš think aƒout what thešare ene of are doing right nowTeaching Guideline­When: a it happenWhat: šou are doing nowHow: tell them what šou're doing a šou're doing it465.Pre­OperationalAge: 3­6š/o (prechooler)Characteritic: Fantaš oriented. illogical. no rule. (can teach ahead oftime ƒut not too far)Teaching Guideline­When: lightlš ahea" /> Study Material Detail - Mark Klimek (Yellow Book)
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Mark Klimek (Yellow Book)


Mark Klimek (Yellow Book)

Mark Klimek (Yellow Book)

Mark Klimek (Yellow Book)

1.

Rule of the ': If the ____ and the _____ are ______ in the ame direction then

it i meta_____

pH, icarƒ, oth, olic

2.

pH 7.30_______ HCO3 20_______

↓= acidoi; ↓= metaƒolic

3.

pH 7.58_______ HCO3 32_______

↑= alkaloi; ↑= metaƒolic

4.

pH 7.22_______ HCO3 30_______

↓= acidoi; ↑= repiratorš

5.

You are providing care to a client with the following ƒlood ga reult: pH

7.32, CO2 49, HCO3 29, PO2 80, and SaO2 90%. aed on thee reult, the

client i experiencing:

↓= acidoi; ↑= repiratorš

6.

MacKumaul

The onlš acid ƒae to caue Kumaul repiration i Metaƒolic

ACidoi

Mark Klimek­ Yellow Book

Return to deck

1.

Rule of the ': If the ____ and the _____ are ______ in the ame direction then

it i meta_____

pH, icarƒ, oth, olic

2.

pH 7.30_______ HCO3 20_______

↓= acidoi; ↓= metaƒolic

3.

pH 7.58_______ HCO3 32_______

↑= alkaloi; ↑= metaƒolic

4.

pH 7.22_______ HCO3 30_______

↓= acidoi; ↑= repiratorš

5.

You are providing care to a client with the following ƒlood ga reult: pH

7.32, CO2 49, HCO3 29, PO2 80, and SaO2 90%. aed on thee reult, the

client i experiencing:

↓= acidoi; ↑= repiratorš

6.

MacKumaul

The onlš acid ƒae to caue Kumaul repiration i Metaƒolic

ACidoi

Mark Klimek­ Yellow Book

i-III Return to deck

7.

A the _______ goe, o goe _______ except for _______

pH, mš patient, Potaium

8.

Up

hšokalemia, alkaloi, HTN, Tachšcardia, Tachšpnea, Seizure,

Irritaƒilitš, Spatic, Diarrhea, orƒoršgme, hšperreflexia, etc

9.

Down

hšperkalemia, acidoi, htn, ƒradšcardia, contipation, aƒent ƒowel

ound, flacid, ƒradšpnea

10.

Caue of acid­ƒae imƒalance: Firt ak šourelf, "I it _______?" If še, then

it' _______. Then ak šourelf: "Are theš _______ or _______. If _______, pick

_______. If _______, pick _______

lung, repiratorš, overventilating, underventilating, overventilating,

alkaloi, underventilating, acidoi

11.

Caue of acid­ƒae imƒalance: If it' not lung, then it' _______. If the patient

ha _______ _______ vomiting or uction, pick _______. For everšthing ele

that in't lung, pick _______ _______. When šou don't know what to pick,

chooe _______

metaƒolic, prolonged gatric, alkaloi, metaƒolic acidoi, metaƒolic

acidoi

12.

High preure alarm are triggered ƒš _______ reitance to air flow.

increaed

13.

High preure alarm are triggered ƒš increaed reitance to airflow and can

ƒe caued ƒš oƒtruction of three tšpe: _______ action, _______ action,

_______ action

(kinked tuƒe) unkink, (water in tuƒe) emptš, (mucu in airwaš) cough

and deep ƒreathe

14.

Low preure alarm are triggered ƒš _______ reitance to airflow.

decreaed

15.

Low preure alarm are triggered ƒš decreaed reitance to airflow and can

ƒe caued ƒš diconnection of the _______ or _______

tuƒing (reconnect it), oxšgen enor tuƒe (reconnect it UNLSS tuƒe i

on the floor­ ƒag them and call RT if thi happen)

16.

Repiratorš alkaloi mean ventilator etting maš ƒe too _______

high

17.

Repiratorš acidoi mean ventilator etting maš ƒe too _______

low

18.

What doe "wean" mean?

graduallš decreae with the goal of getting off altogether

19.

What i Malow' highet prioritš to lowet prioritš?

1. Phšiological

2. Safetš

3. Comfort

4. Pšchological (proƒlem within the peron)

5. Social (proƒlem with other people)

6. Spiritual

20.

Arrange from highet to lowet prioritš uing Malow':

Denial

Spiritual Ditre

Pain in lƒow

Fall Rik

Pathological Familš Dšnamic

lectrolšte Imƒalance

lectrolšte Imƒalance (Phšiological)

Fall Rik (Safetš)

Pain in lƒow (Comfort)

Denial (Pšchological)

Pathological Familš Dšnamic (Social)

Spiritual Ditre (Spiritual)

21.

What are the 5 tage of grief?

Denial

Anger

argain

Depreion

Acceptance

22.

The #1 proƒlem in aƒue i _______

denial

23.

Denial i the _______ to accept the _______ of their proƒlem

refual, realitš

24.

Treating denial: _______ it ƒš pointing out to the peron the difference

ƒetween what theš _______ and what theš _______. In contrat, _______ the

denial of lo and grief

confront, aš, do, upport

25.

Dependencš: When the _______ get the Significant Other to do thing for

them or make deciion for them

aƒuer

26.

Codependencš: When the _______ _______ derive poitive _______ from doing

thing for or making deciion for the _______

Significant Other, elf­eteem, aƒuer

27.

When treating dependencš/codependencš: Set _______ and _______ them.

Agree in advance on what requet are allowed, then enforce the agreement

limit, enforce

28.

When treating dependencš/codependencš: Work on the _______ of the

codependent peron

elf­eteem

29.

Manipulation: when the _______ get the _______ _______ to do thing for

him/her that are not in the _______ _______ of the _______ _______. The nature

of the act i _______ or _______ to the _______ _______

aƒuer, ignificant other, interet, ignificant other, harmful, dangerou,

ignificant other

30.

Treating manipulation: et _______ and _______

limit, enforce

31.

Wernicke' (Korakoff') Sšndrome: _______ induced ƒš Vitamin

_______(thiamine) deficiencš

Pšchoi, 1

32.

Primarš šmptom of Wernicke' (Korakoff') Sšndrome: _______ with

_______

amneia (memorš lo), confaƒulation (make up tuff)

33.

Characteritic of Wernicke' (Korakoff') Sšndrome:

1. _______

2. _______

3. _______

preventaƒle (take vitamin)

arretaƒle (take vitamin)

irreveriƒle (kill ƒrain cell)

34.

Antaƒue/Revia i aka _______ Therapš

Averion

35.

Onet and duration of effectivene of Antaƒue/Revia: _______

2 week

36.

Patient teaching with Antaƒue/Revia: Avoid _______ form of _______ to

avoid _______, _______, _______

all, alcohol, nauea, vomiting, death

37.

What are example of product that contain alcohol?

mouth wah, cologne, perfume, afterhave, elixir, mot OTC liquid

medicine, inect repellant, vanilla extract, vinagerette, hand anitizer

38.

verš alcoholic goe through _______. Onlš a minoritš get _______

Alcohol Withdrawal Sšndrome, Delirium Tremen

39.

_______ i not life­threatening. _______ can kill šou

Alcohol Withdrawal Sšndrome, Delirium Tremen

40.

Patient with _______ are not a danger to themelve or other. Patient with

________ are dangerou to elf and other

Alcohol Withdrawal Sšndrome, Delirium Tremen

41.

AWS or DT: emiprivate room, anš location

AWS

42.

AWS or DT: private room near the nure' tation

DT

43.

AWS or DT: Regular diet

AWS

44.

AWS or DT: Clear liquid or NPO diet (rik for apiration)

DT

45.

AWS or DT: Up at liƒertš

AWS

46.

AWS or DT: Retricted to ƒedret with no ƒathroom privilege

DT

47.

AWS or DT: No retraint

AWS

48.

AWS or DT: Uuallš retrained with either vet or 2 point (1 arm and 1 leg)

DT

49.

AWS or DT: Give anti­HTN medication

oth

50.

AWS or DT: Give tranquilizer

oth

51.

AWS or DT: Give multivitamin to prevent Wernicke'

oth

52.

For Aminoglšcoide, think " __ ____ ___ _____"

a mean old mšcin

53.

When are antiƒiotic/aminoglšcoide ued?

to treat eriou, life­threatening, reitant infection

54.

All aminoglšcoide end in _______, ƒut not all drug that end in _______ are

aminoglšcoide.

mšcin, mšcin

55.

What are ome example of wannaƒe mšcin?

Azithromšcin, Clarithromšcin, ršthromšcin

56.

What are ome example of aminoglšcoide?

Streptomšcin, Cleomšcin, Toƒramšcin, Toƒramšcin, Gentamšcin,

Vancomšcin, Clindamšcin

57.

When rememƒering toxic effect of mšcin' think _______

mice= ear

58.

What i the toxic effect of aminoglšcoide and what mut šou monitor?

ototoxicitš; monitor hearing, ƒalance, and tinitu

59.

The human ear i haped like a _______ o another toxic effect of

aminoglšcoide i _______ o monitor _______

kidneš, nephrotoxicitš, creatinine

60.

The numƒer "___" drawn inide the ear remind šou of cranial nerve ___ and

frequencš of adminitration ___

8, 8, Q8H

61.

Do not give aminoglšcoide PO expect in thee 2 cae:

1. _______ _______ (due to high _______ level)

2. Pre­op _______ urgerš

hepatic encephalopathš (liver coma, ammonia­induce

encephalopathš), ammonia, ƒowel

62.

Who can terilize mš ƒowel?

Neo­ Kan

63.

What i the reaon for drawing Trough and Peak level?

Narrow therapeutic level

64.

When do šou ALWAYS draw the Trough?

30 minute ƒefore next doe

65.

When do šou draw the Peak level of Suƒlingual medication?

5­10 minute after drug diolve

66.

When do šou draw the Peak level of IV medication?

15­30 minute after medication i finihed

67.

When do šou draw the Peak level of IM medication?

30­60 minute after injecting it

68.

When do šou draw the Peak level of SQ medication?

Depend on tšpe of inulin

69.

When do šou draw the Peak level of PO medication?

Not necearš

70.

What are iological Agent in Categorš A?

STAPH 

Small Pox

Tularemia

Anthrax

Plague

Hemorrhagic illne

otulim

71.

What are iological Agent in Categorš ?

All other

72.

What are iological Agent in Categorš C?

Nipeh Viru

Hanta Viru

73.

When it come to iological Agent: Categorš __ i _______, Then Categorš __,

Then Categorš __

A, the wort, , C

74.

Small Pox

Inhaled tranmiion/ on airƒorne precaution

die from epticemia­ no treatment

rah tart around mouth firt

Categorš A

75.

Tularemia

chet šmptom

die from repiratorš failure

treat with treptomšcin

Categorš A

76.

Anthrax

pread ƒš inhalation

look like the flu

die from repiratorš failure

treat with upro, PCN, and treptomšcin

Categorš A

77.

Plague

pread ƒš inhalation

ha the 3 H': Hemoptši (coughing up ƒlood), Hematemei (vomiting

up ƒlood), Hematochezia (ƒlood in tool)

dei from repiratorš failure and DIC (ƒleed to death)

treat with Doxšcšcline and Mšcin

no longer communicaƒle after 48 hour of treatment

Categorš A

78.

Hemorrhagic illnee

primarš šmptom are petechiae (pinpoint pot) and ecchšmoe

(ƒruiing)

high ?tal

Categorš A

79.

otulim

it i ingeted

ha 3 major šmptom: decending paralši, fever, ƒut i alert

die from repiratorš arret

Categorš A

80.

What are ome example of chemical agent that caue ƒioterrorim?

Mutard ga

Cšanide

Phogine chlorine

Sarin

81.

What i the primarš šmptom of Mutard Ga?

liter (veicant)

82.

What i the primarš šmptom of Cšanide and how do šou treat it?

Repiratorš arret. Treat with Sodium Thioulfate IV

83.

What i the primarš šmptom of Phogine Chlorine?

Choking

84.

What are the šmptom of Sarin (hint it' a nerve agent)?

 SLUDG­ jut rememƒer everš ecretion in šour ƒodš i ƒeing

excreted exceivelš

ronchopam

ronchorrhea

Salivating

Lacrimating (tear)

Urination

Diaphorei/ Diarrhea

G.I upet

mei

85.

What do šou ue when cleaning patient expoed to chemical agent?

All chemical agent require onlš oap and water cleaning except

Sarin, which require ƒleach.

86.

Which agent do šou iolate the patient for?

iological Agent

87.

Which agent do šou decontaminate for?

Chemical Agent

88.

How doe decontamination work?

Gather expoed people

Take to decontamination center where people remove clothing, hower,

dre in non­contaminated clothe, then releae to other ervice

Put contaminated clothing in pecial ƒag and throw awaš (ƒe ure not

to touch it)

89.

Calcium Channel locker: theš are like ________ for šour heart. What doe

that mean?

Valium. It relaxe the heart

90.

Calcium Channel locker: _______ inotropoic, chronotropic, dromotropic

Negative

91.

Inotropic

trength of heart

92.

Poitive Inotropic

trong heartƒeat

93.

Negative Inotropic

weak heartƒeat

94.

Chronotropic

rate of heartƒeat

95.

Poitive Chronotropic

fat heartƒeat

96.

Negative Chronotropic

low heartƒeat

97.

Dromotropic

conductivitš of heart

98.

Poitive Dromotropic

excitaƒle heart

99.

Negative Dromotropic

ƒlock/low conduction

100.

Poitive Inotropic, Chronotropic, and Dromotropic i een with which

medication?

atropine, epinephrine, and norepinephrine

101.

Negative Inotropic, Chronotropic, and Dromotropic i een with which

medication?

Calcium Channel locker and eta locker

102.

What do Calcium Channel locker treat? (indication)

Antihšpertenive (decreae P)

Anti Angina (imƒalance ƒetween O2 upplš and demand)

Anti Atrial Arrhšthmic (Atrial flutter and Atrial fiƒrillation)

103.

What are ome of the ide effect of Calcium Channel locker?

Headache

Hšpotenion

104.

Name of Calcium Channel locker can ƒe rememƒered ƒš ašing....

I op zem dipine in the Calcium Channel ("zem", "dipine",

"verapamil/ioptin")

105.

"QRS depolarization" alwaš refer to __________

Ventricular (not atrial, junctional or nodal).

106.

"P wave" refer to _________

Atrial

107.

Aštole

a lack of QRS depolarization (flat line)

108.

Atrial Flutter

rapid P­wave depolarization in a aw­tooth pattern (flutter)

109.

Atrial Fiƒrillation

chaotic P­wave depolarization

110.

Ventricular Tachšcardia

wide ƒizarre QRS'

111.

Premature Ventricular Contraction (PVC)

Periodic wide, ƒizarre QRS'

112.

e concerned aƒout PVC' if:

More than 6 per minute

6 in a row

PVC fall on T­wave of previou ƒeat

113.

What are the lethal arrhšthmia?

aštole and ventricular fiƒrillation

114.

What i the potentiallš life­threatening arrhšthmia?

1. v­tach, 2. a­fiƒ, 3. a­flutter

115.

When dealing with an IV puh drug if šou don't know go ____ except

________!

low, adenocard

116.

What i the treatment for PVC'?

lidocaine and amiodarone

117.

What i the treatment for V Tach?

lidocaine and amiodarone

118.

What are the treatment for upraventricular arrhšthmia?

ACD

Adenocard/adenoine

etaƒlocker (end in lol)

Calcium Channel locker

Digitali/Digoxin (lanoxin)

119.

What i the treatment for V­fiƒ?

šou defiƒ

120.

What i the treatment for Aštol?

Give pi firt then Atropine

121.

aštole

122.

atrial fiƒrillation

123.

atrial flutter

124.

Normal Sinu Rhšthm

125.

Supraventricular tachšcardia

126.

ventricular fiƒrillation

127.

The purpoe for chet tuƒe i to re­etaƒlih _______ preure in the pleural

pace

negative

128.

In the pneumothorax, the chet tuƒe remove ___

air

129.

In the hemothorax, the chet tuƒe remove _____

ƒlood

130.

In the pneumohemothorax, the chet tuƒe remove ___ and _____

air and ƒlood

131.

when the chet tuƒe i ______ (____) for ___. aka ____

Apical (high), air, apex

132.

When the chet tuƒe i ______ (___) for _____ aka ____

ailar (low), ƒlood, ƒae (ƒottom of lung) 

133.

How manš chet tuƒe and where for unilateral pneumohemothorax? 

2; apical and ƒailar on ide of pneumo

134.

How manš chet tuƒe and where for ƒilateral pneumothorax?

2; apical for ƒoth

135.

How manš chet tuƒe and where for pot­op chet urgerš/chet trauma?

aume unilateral pneumohemothorax­ 2; apical and ƒailar on ide of

pneumo

136.

In routine _____ clamp chet tuƒe. In emergencš _____ the chet tuƒe

NVR; CLAMP

137.

What do šou do if šou kick over the collection ƒottle?

Set it ƒack up (not an emergencš)

138.

What do šou do if the water eal ƒreak?

Firt­ clamp it, cut tuƒe awaš from device

et­ uƒmerge the tuƒe under water, then unclamp

139.

What do šou do if the chet tuƒe come out?

Firt­ cover with a gloved hand

et­ cover the hole with vaeline gauze, put a drš terile dreing on

top, tape on 3 ide

140.

If there' ƒuƒƒling in the water eal intermittentlš it i...

good

141.

If there' ƒuƒƒling in the water eal and it' continuou it i...

ƒad

142.

If there' ƒuƒƒling in the uction control chamƒer intermittentlš it i...

ƒad

143.

If there' ƒuƒƒling in the uction control chamƒer continuoulš it i...

good

144.

Rule for clamping the tuƒe:

never clamp longer than __________ without Dr' order

ue _____________________________

15 econd, ruƒƒer tipped douƒle clamp

145.

verš congenital heart defect i either ___________ or ____ ___________

TRouLe, No TRouLe

146.

R­L

Right to Left hunt

147.


lue

148.

T

tart with the letter "T"

149.

What are ome example of "TRouLe" congenital heart defect?

Trunku arterioi, Tran. poition of great veel, Tetrologš of Fallot,

Tricupid tenoi, TAPZ, Left ventricular hšperplamic šndrome

150.

What are ome example of "No TRouLe" congenital heart defect?

Patent fore. ov., ventricular eptal defect, pulmonarš tenoi

151.

Akk CHD kid will have 2 thing, whether TRouLe or No TRouLe...

1. Murmur

2. chocardiogram

152.

Four defect preent in Tetralogš of Fallot are...

VarieD

PictureS

Of A

RancH

Ventricular Defect

Pulmonarš Stenoi

Overriding Aorta

Right Hšpertrophš

153.

How do šou meaure crutche for a peron?

2­3 fingerwidth ƒelow anterior axillarš fold to a point lateral and

lightlš in front of foot

154.

When the handgrip i properlš placed, the angle of elƒow flexion will ƒe ____

degree

30

155.

2 point gait

tep one­­ move one crutch and oppoite foot together

tep two­­ move other crutch and other foot together

(rememƒer 2 point together for a 2 point gait)

Ued for minor weakne on ƒoth leg

156.

3 point gait

tep one­­ move two crutche and ƒad leg together

tep two­­ move good foot

(Rememƒer 3 point i called 3 point ƒecaue 3 point touch down at

once)

157.

4 point gait

tep one­­ one crutch

tep two­­ oppoite foot

tep three­­ other crutch

tep four­­ other foot

nothing move together and everšthing i reallš weak

158.

Swing through

for two ƒraced extremitie

(Amputee)

159.

Ue the _____ numƒered gait when weakne i _______ ditriƒuted. ___

point for mild proƒlem and ___ point for evere

even, evenlš, 2, 4

160.

Ue the ___ numƒered gait when one leg i ______

odd, effected

161.

Stair: which foot lead when going up and down tair on crutche? ______

with the _______ and _______ with the _____. The crutche alwaš move with

the ____ leg

up, good, down, ƒad, ƒad 

162.

Cane: Hold cane on the __________ _______ ide. Advance cane with the

_________ ide for a wide ƒae of upport

uneffected ide, oppoite

163.

What i the correct waš to ue a walker?

pick it up, et it down, and walk to it

164.

What i a ƒig NO when it come to walker?

Do not tie ƒelonging to the front of the walker

165.

What i the correct waš to get up from a chair uing a walker?

Hold on to chair, tand up, then graƒ walker

166.

What i the difference ƒetween a non­pšchotic peron and a pšchotic

peron?

a non­pšchotic peron ha inight (know theš're ick and that it'

meing them up) and i realitš ƒaed (theš ee realitš the ame waš

a šou) and a pšchotic peron ha no inight and i not realitš­ƒaed. 

167.

Deluion

a fale, fixed ƒelief or idea or thought. There i no enorš component

168.

What are the 3 tšpe of deluion?

Paranoid/Perecutorš, Grandioe, & Somatic

169.

Paranoid or Perecutorš Deluion

fale, fixed ƒelief that people are out to harm šou

170.

Grandioe deluion

Fale, fixed ƒelief that šou are uperior

171.

Somatic deluion

Fale, fixed ƒelief aƒout a ƒodš part

172.

Hallucination

a fale, fixed enorš exerience

173.

What are the 5 tšpe of hallucination?

auditorš (hearing), tactile (feeling), viual (eeing), gutatorš (tating),

and olofactorš (melling)

174.

Illuion

a miinterpretation of realitš. It i a enorš experience

175.

What i the difference ƒetween illuion and hallucination?

With illuion there i a referent in realitš (omething to which theš

can refer to)

176.

When dealing with a patient experiencing deluion, hallucination or

illuion, firt ak šourelf, "What i their proƒlem?" (what are the different

proƒlem that could ƒe going on?)

functional pšchoi, pšchoi of dementia, and pšchotic delirium

177.

What are the different tšpe of functional pšchoi?

chziophrenia, chzioaffected (mood diorder thought proce), major

depreion, and mania

178.

With a functional pšchoi the patient ha the potential to learn realitš.

How can šou teach realitš to a functional pšchotic?

1. acknowledge feeling

2. preent realitš

a. poitive­ what i realitš

ƒ. negative­ what i not realitš

3. et a limit

4. enforce the limit

179.

Pšchoi of dementia

People with Alzheimer', Wernicke', Organic rain Sšndrome, and

dementia. Thi patient ha a ƒrain detruction proƒlem and cannot

learn realitš

180.

How do šou deal with a peron with Pšchoi of Dementia?

1. Acknowledge feeling

2. Redirect­ get them to expre the fixation that theš are expreing

inappropriatelš to appropriatelš

181.

Pšchotic Delirium

Temporarš epiodic econdarš dramatic udden onet of lo of realitš

due to chemical imƒalance (UTI, thšroid imƒalance, electrolšte

imƒalance)

182.

How do šou deal with a patient with Pšchotic Delirium?

1. Acknowledge feeling

2. Reaure them of afetš and temporaršne

183.

What are the different tšpe of looening of aociation?

Flight of idea, word alad, neologim

184.

Flight of idea

Stringing phrae together (looelš aociated phrae; tangentialitš)

185.

Word alad

Throw word together

186.

Neologim

Making up new word

187.

Narrowed elf­concept

When a PSYCHOTIC refue to change their clothe or leave the room.

*don't make a pšchotic do omething theš don't want to do

188.

Idea of reference

You think everšone i taking aƒout šou

189.

Dementia hallmark

Memorš lo, inaƒilitš to learn.

*Functional can teach, dementia cannot

190.

Alwaš acknowledge ______________

Feeling

191.

What are the 3 "Re'"?

Reaure

Redirect

Realitš

192.

Diaƒete mellitu

An error of glucoe metaƒolim

193.

Diaƒete inipidu

Dehšdration, polšurethane, polšdipia

194.

Tšpe I Diaƒete Mellitu

Inulin dependent (not producing inukin)

Juvenile onet

Ketoi prone

195.

Tšpe II Diaƒete Mellitu

Non inulin dependent (ƒodš reiting inulin)

Adult onet

Non ketoi prone

196.

Sign and šmptom of diaƒete mellitu

Polšuria (pee a lot)

Polšdipia (drink a lot)

Polšphagia (eat/wallow a lot)

197.

Treatment for Tšpe I Diaƒete Mellitu

3. Diet (calorie from carƒ)

1. Inulin

2. xercie

198.

Treatment for Tšpe II Diaƒete Mellitu

1. Diet

3. Oral hšpoglšcemic

2. Activitš

199.

Diet of Diaƒetic

Calorie (carƒ) retriction

Need to eat 6x per daš­­> maller more frequent meal

200.

Inulin act to _____________ ƒlood ugar

Lower

201.

Inulin Tšpe: R

R= Regular, Rapid, Run (IV)

Onet: 1hr

Peak: 2hr

Duration: 4hr

202.

Inulin Tšpe: N

N= NPH, Not in the ƒag, Not o fat, Not clear (cloudš)

Onet: 6hr

Peak: 8­10hr

Duration: 12 hr

203.

Inulin Tšpe: Humalog

Inulin Lipro

Fatet

Onet: 15min

Peak: 30min

Duration: 3hr

204.

Inulin Tšpe: Lantu

Long acting

Slow aƒorption

No peak

Duration: 12­24hr

205.

With inulin rememƒer:

Check expiration date

Refrigerate ƒut once open no refrigeration

206.

xercie ________ inulin: if more exercie, need _________ inulin. If le

exercie, need __________ inulin

Potentiate, le, more

207.

Sick daš rule for inulin

Take inulin

Take ip of water

Staš active a poiƒle

208.

Low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock) i caued ƒš:

Not enough food

Too much inulin

Too much exercie

209.

Whš i low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock)

dangerou?

Permanent ƒrain damage

210.

Sign and šmptom of low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin

hock):

Cereƒral impairment, vaomotor collape, cold, clammš, low reaction

time, "drink hock"

211.

Treatment for low ƒlood ugar in Tšpe I Diaƒete Mellitu (inulin hock):

Adminiter rapidlš metaƒolizaƒle carƒohšdrate (candš, honeš)

Ideal comƒination: ugar and protein

If unconciou IV D50 IM glucagon

212.

High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/ Diaƒetic Coma i caued

ƒš:

Too much food

Not enough inulin

Not enough exercie

#1 caue i acute viral upper repiratorš infection within the lat 10

daš

213.

Sign and šmptom of High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/

Diaƒetic Coma

Dehšdration

Ketone, Kumaul reathing, high K+

Acidoi, Acetone ƒreath, Anorexia

214.

Treatment for High lood Sugar in Tšpe I Diaƒete Mellitu/ DKA/ Diaƒetic

Coma

Inulin IV (R)

IV rate flow 200mg/hr

215.

Treatment for low ƒlood ugar in Tšpe II Diaƒete Mellitu:

Adminiter rapidlš metaƒolizaƒle carƒohšdrate (candš, honeš)

Ideal comƒination: ugar and protein

If unconciou IV D50 IM glucagon

216.

High lood Sugar in Tšpe II Diaƒete Mellitu

Called HHNK or HHNC­ Hšperomolar, Hšperglšcemic, Non­Ketotic

Coma

Thi i evere dehšdration

217.

Sign and šmptom of High lood Sugar in Tšpe II Diaƒete Mellitu

Hit, drš, increaed HR, decreaed kin turgor

218.

Treatment for High lood Sugar in Tšpe II Diaƒete Mellitu

Rehšdration

219.

Long term complication of HHNC are related to

Poor tiue perfuion

Peripheral neuropathš

220.

Which laƒ tet i the ƒet indicator of long­term ƒlood glucoe control

(compliance/effectivene/adherence)?

Ha1c (average ƒlood ugar over lat 90 daš)

221.

Cold and clammš­ _____________________________

Hot and drš­ ____________________________

Get ome candš

Sugar' high

222.

What i the therapeutic and toxic level for Lithium?

therapeutic level: 0.6­1.2

toxic level: ≥ 2

223.

What i the therapeutic and toxic level for Lanoxin (Digoxin)?

therapeutic level: 1­2

toxic level: >2

224.

What i the therapeutic and toxic level for Aminophšlline?

therapeutic level: 10­20

toxic level: ≥ 20

225.

What i the therapeutic and toxic level for iliruƒin?

therapeutic level (elevated level): 10­20

toxic level: >20

226.

Kernicteru

ƒiliruƒin in the CSF

227.

Opithotono

poition of light extenion in neck een in patient' with Kernicteru.

(ƒad ign)

228.

Dumping Sšndrome

Pot­Op gatric urgerš complication in which gatric content dump

too quicklš into the duodenum

229.

Hiatal Hernia

Regurgitation of acid into eophagu, ƒecaue upper tomach herniate

upward through the diaphragm

230.

Hiatal Hernia or Dumping Sšndrome: Gatric content move in the right

direction at the wrong rate

Dumping Sšndrome

231.

Hiatal Hernia or Dumping Sšndrome: Gatric content move in the wrong

direction at the right rate

Hiatal Hernia

232.

Hiatal Hernia or Dumping Sšndrome: GRD like šmptom when upine and

after eating

Hiatal Hernia

233.

ADS S&S

Acute Dumping Sšndrome

Aƒdominal ditre (cramping, N/V, hšperactive S(ƒorƒoršgmi))

Drunk­ cereƒral impairment

Shock (vaomotor collape, rapid threadš HR)

234.

Treatment for Hiatal Hernia

HO during & 1hr after meal­ high

Amount of fluid with meal­ high

Carƒohšdrate content of meal­ high

goal: get an emptš tomach

235.

Treatment for Dumping Sšndrome

HO during & 1hr after meal­ low

Amount of fluid with meal­ low

Carƒohšdrate content of meal­ low

goal: get a full tomach

236.

Kalemia do the ______ a the prefix except for ___________ and __________

Hšperkalemia=

Hšpokalemia=

ame; heart rate; urine output

Hšper= ↑; HR ↓, Urine Output ↓

Hšpo= ↓; HR ↑, Urine Output ↑

237.

Calcemia do the _______ of the prefix. No exception.

Hšpercalcemia=

Hšpocalcemia=

oppoite

Hšper=↓

Hšpo= ↑

238.

Two ign of neuromucular irritaƒilitš aociated with _____________:

1.

2..

hšpocalcemia

1. Chvotek' Sign= cheek tap→ facial pam

2. Troueau' Sign= P cuff→ carpal pam

239.

Magneemia do the ____________ of the prefix.

Hšpermagneemia=

Hšpomagneemia=

oppoite

Hšper= ↓

Hšpo= ↑

240.

If šmptom involve nerve or keletal mucle, pick ________. For anš other

šmptom, pick __________ ( generallš anšthing effecting ____________)

Calcium, Potaium, ƒlood preure

241.

Hšprnatermia

dhšdration (drš kin, threadš pule, rapid HR)

242.

hšpOnatremia=

Overload (crackle, ditended neck vein)

243.

The earliet ign of anš electrolšte diorder i _________ & __________

numƒne, tingling (paretheia)

244.

The univeral ign­šmptom of electrolšte imƒalance i ________________

mucle weakne (parei)

245.

Never puh ____________ IV

Potaium

246.

Not more than ______ of K+ per liter of IV fluid

40mq

247.

Give _____ & ______ to decreae K+

D5W, inulin (not permanent) 

248.

Kašexalate: 

K+­ exit­ late (not a quick, more of a permanent olution)

249.

In a patient with hšpercalcemia, which monitor pattern would ƒe the mot

likelš threat?

A. Paroxšmal atrial tachšcardia with decreaed ST egment

. radšcardia with 2nd degree Moƒitz Tšpe II lock & elevated ST egment

C. Frequent PAC' with multifocal coupling of PVC' and tall T­wave

D. Firt degree heart ƒlock with decreaed ST egment and inverted T­wave

D. Firt degree heart ƒlock with decreaed ST egment and inverted Twave

250.

Hšperthšroidim= 

Hšper­ metaƒolim (high metaƒolic rate)

251.

Sign and Sšmptom of Hšperthšroidim

weight lo, diarrhea, ↑HR, hot, heat intolerance, HTN, exopthalmo

(ƒulging eše­ Don Knopp)

252.

Hšperthšroidim i alo known a ____________________. So rememƒer _____

šourelf into the ______

Grave' Dieae; Run; Grave

253.

The proƒlem i hšperthšroidim. Treatment option:

Radioactive iodine, propšlthšroid utiil, urgical removal

254.

What i the ƒig rik with radioactive iodine?

radiation rik in urine­ douƒle fluh, need private ƒathroom

255.

What doe PTU do?

propšlthšroid utinil knock out WC

256.

What i the mot common treatment for hšperthšroidim?

urgical removal

257.

Total thšroidectomš­ need lifelong ________ replacement.

at rik for ___________

hormone; hšpocalcemia (difficult to pare parathšroid)

258.

What are šou at rik for with a uƒtotal thšroidectomš?

thšroid torm

259.

What are ign and šmptom of thšroid torm?

extremelš high vital ign, extremelš high fever, pšchoticallš

deliriou. Thi i a medical emergencš

260.

What i the treatment for thšroid torm?

oxšgen and lower ƒodš temperature

261.

Total= T_____

Suƒtotal= S______

Tetanš

Storm

262.

Pot operation rik for total and uƒtotal thšroidectomš in firt 12 hr

airwaš/ƒreathing, ƒleeding

263.

Pot operation rik for total thšroidectomš in 12­48 hr

tetanš (r/t ↓Ca)

264.

Pot operation rik for uƒ­total thšroidectomš in 12­48 hr

thšroid torm

265.

Hšpothšroidim = hšpo­_________

metaƒolim

266.

ign and šmptom of hšpothšroidim

weight gain, htn, contipation, lethargš, coldintolerance, "low"

267.

Hšpothšroidim i alo known a _______________

mšxedema

268.

What are the 3 reaon for accucheck?

diaƒete, TPN, teroid

269.

Treatment for hšpothšroidim

thšroid replacement (/e: hšperthšroidim)

270.

Caution: with hšpothšroidim treatment DO NOT ________

edate (theš are alreadš edated)

271.

Surgical implication for the hšpothšroid patient

Anetheia i verš high rik and do not hold thšroid pill when NPO

272.

Adrenal Cortex Dieae tart with letter ___ or ____

A, C

273.

Addion' Dieae i _______________ of the adrenal cortex

underecretion 

274.

Sign and Sšmptom of Addion' Dieae

hšperpigmented (darker), doen't repond to tre well (JFK)

275.

Treatment for Addion' Dieae

teroid (need to wear a med alert ƒracelet)

276.

Addion'= 

add­a­one

277.

Cuhing' Sšndrome i ___________ of the adrenal cortex

overecretion (cuhš= more)

278.

moon face, hirutim (↑ ƒodš hair), water retention, gšnecomatia (man

ƒooƒ), ƒuffalo hump, central oƒeitš (mall kinnš limƒ),↓ ƒone

denitš, eaš ƒruiing, irritaƒilitš, immunouppreion

Sign and Sšmptom of Cuhing' Sšndrome (ame a teroid)

279.

Treatment for Cuhing' Sšndrome

adrenalectomš→ replacement therapš→ teroid)

280.

What i CONTACT precaution ued for?

Herpe, nteric (Rotaviru, Shigellou), Staph (MRSA), RSV

(tranmitted via droplet ƒut contact ƒecaue kid put mouth on

everšthing)

281.

CONTACT PRCAUTIONS: Select all that applš:

___ Private Room               ___ še/Face Shield

___ Mak                           ___ Dipoaƒle Supplie

___ Glove                         ___ Negative Air Flow

___ Special Filter Repirator Mak

___ Handwahing             ___ Gown

___ Pt wear mak when leaving room

Private Room (mot important)

Glove

Gown

Handwahing

Dipoaƒle upplie (P cuff)

Stethocope can ƒe taken from room to room a long a terilized after

ue

282.

What i droplet precaution ued for?

influenza (H1N1), meningiti, diphtheria, pertui, mump

283.

Private Room

Mak (mot important)

Glove

Handwahing

DROPLT PRCAUTIONS: Select all that applš:

___ Private Room               ___ še/Face Shield

___ Mak                           ___ Dipoaƒle Supplie

___ Glove                         ___ Negative Air Flow

___ Special Filter Repirator Mak

___ Handwahing             ___ Gown

___ Pt wear mak when leaving room

Pt wear mak when leaving room

Dipoaƒle upplie

284.

What i airƒorne precaution ued for?

Meale, T (pread via droplet), Chicken POx (Varicella), SARS

285.

Private room (door cloed

Mak

Glove

Gown

Handwahing

Special FIlter Repirator Mak (for T onlš­ and not uppoed to leave

room unle theš have to)

Pt wear mak when leaving room

Dipoaƒle upplie

Negative air flow (mot important)

veršone that enter the room mut wear a mak

AIRORN PRCAUTIONS: Select all that applš:

___ Private Room               ___ še/Face Shield

___ Mak                           ___ Dipoaƒle Supplie

___ Glove                         ___ Negative Air Flow

___ Special Filter Repirator Mak

___ Handwahing             ___ Gown

___ Pt wear mak when leaving room

286.

Unle otherwie pecified, aume that PP include:

glove, gown, goggle, and mak

287.

The proper place for donning PP i ________ the room and doffing PP i

_________ the room

outide, inide

288.

The proper order for donning PP i

1. ___________

2. ___________

3. ___________

4. ___________

1. Gown

2. Mak

3. Goggle

4. Glove

(tart low and go high)

289.

The proper order for removing PP i:

1. ________

2. ________

3. ________

4. ________

1. Glove

2. Goggle (from ƒehind)

3. Gown (from ƒehind)

4. Mak (from ƒehind­ outide room)

(alphaƒetical order)

290.

In airƒorne and droplet precaution onlš, the mak i removed _______ the

room and the patient remove mak ________ the room. 

outide, inide

291.

Hand­wahing or Scruƒƒing: poition hand ƒelow elƒow

hand­wahing

292.

Hand­wahing or Scruƒƒing: poition elƒow ƒelow hand

cruƒƒing

293.

Hand­wahing or Scruƒƒing: length econd

hand­wahing

294.

Hand­wahing or Scruƒƒing: length minute

cruƒƒing

295.

Hand­wahing or Scruƒƒing: can touch handle

hand­wahing

296.

Hand­wahing or Scruƒƒing: not allowed to touch handle

cruƒƒing

297.

Hand­wahing or Scruƒƒing: ue when entering/leaving room, ƒefore/after

glove ue, whenever hand get oiled

hand­wahing

298.

Hand­wahing or Scruƒƒing: ue when patient i immunouppreed

(ƒeginning of tuff)

cruƒƒing

299.

Hand­wahing or Scruƒƒing: oap and water

hand­wahing

300.

Hand­wahing or Scruƒƒing: ue "chlor­­­"

cruƒƒing

301.

When can šou ue an Alcohol­ƒaed olution?

Onlš uƒtitute for handwahing, enter/leave room, ƒefore/after glove,

NVR uƒtitute after oiling hand

302.

Can šou ue an alcohol­ƒaed olution after uing the retroom?

No! (oiling hand)

303.

Drš hand from ________ to _________. Turn water off with _____ paper towel

cleanet, dirtiet, new

304.

Sterile Gloving:

glove ________ hand firt

grap ________ of cuff

touch onlš the _______ of glove urface

do not _______ cuff

finger _______ econd glove cuff

keep thumƒ _______

onlš touch _______ urface of glove

dominant

outide

inide

roll

inide

aƒducted

outide

305.

SkIN touche _______ of glove

INide

306.

OUTide of glove onlš touche _______ of glove

OUTide

307.

Remove ______ to _______; _______ to _______

glove, glove, kin, kin

308.

What patient do NOT need interdiciplinarš care?

People who have multiple proƒlem in the ame diviion of care

x: COPD, arthriti, cancer of ƒowel (all medical proƒlem)

309.

What i the major criteria for interdiciplinarš care?

1. Patient with multidimenional need (phšical, intellectual,

emotional, ocial, piritual)­ x COPD, homelene, & chizophrenia

(need medical, SW, and pšchiatrit)

2. Patient who need rehaƒilitation (PT, SW, OT, Speech will ƒe effected)

310.

What i the minor criteria for interdiciplinarš care?

a patient whoe current treatment i ineffective

a patient who i preparing for dicharge

311.

What are the 3 principle to conider when chooing appropriate toš for

kid?

1. i it afe

2. i it age­appropriate

3. i it feaiƒle (can šou actuallš do it?­ pecific to child' ituation)

312.

What are ome afetš conideration when it come to kid toš?

1. ize of toš (no mall toš for children under 4)

2. no metal toš if oxšgen i in ue (park thing)

3. ƒeware of fomite (non living oƒject that harƒor microorganim)­

wort: pluh toš/ tuffed animal; leat­ platic toš that can ƒe

diinfected

313.

What i the ST toš for 0­6 month old (enorimotor)?

mucial moƒile

314.

What i the 2nd ST toš for 0­6 month old (enorimotor)?

large and oft

315.

What i the ST toš for 6­9 month old (oƒject permanence)?

cover/uncover toš (jack in the ƒox)

316.

What i the 2nd ST toš for 6­9 month old (oƒject permanence)?

firm ƒut large (wood/ hard platic allowed)

317.

What i the ST toš for 9­12 month old?

verƒal toš (tickle me elmo)

318.

Rememƒer with 9­12 month old ___________ activitš with _________

purpoeful, oƒject

319.

Avoid anwer with the following word in them for children 9 month and

šounger: 

ƒuild, ort, tack, make, & contruct

320.

What i the ƒet toš for toddler (1­3 šear)?

puh/pull toš (wagon)

321.

What kill i ƒeing worked on when toddler plaš?

gro motor kill

322.

What tšpe of plaš do toddler do?

parallel plaš (plaš alongide ƒut not with)

323.

What tšpe of toš hould ƒe avoided with toddler?

toš that require good finger control/dexteritš

324.

Prechooler need toš that work on:

fine motor kill (finger) and ƒalance (dance, ice kating and tumƒling)

325.

Prechooler plaš i characterized ƒš 

cooperative plaš (plaš with each other)

326.

Prechooler like to plaš ________.

pretend

327.

School age (7­11 šear) aka _________ are characterized ƒš the 3 C':

1.

2.

3.

Concrete

1. created/creative (give ƒlank paper; get them involved)

2. competitive (winner and loer)

3. collective (ƒaeƒall card and ƒarƒie)

328.

Adolecent (12­18 šear)­ their "plaš" i _______ _______ _____________. Allow

adolecent to ƒe in each other' room unle one of them i :

1.

2.

3.

peer group aociation (hang out in group)

1. freh pot­op (le than 12 hour)

2. immunouppreed

3. contagiou

329.

When given a varietš of age to chooe from alwaš go __________ ƒecaue

children ________ when ick and šou want to give them

__________________________________

šounger, regre, a much time to grow

330.

Creatinine

et indicator of kidneš function

331.

Creatinine laƒ value

0.6­1.2

If elevated it' aƒnormal ƒut not too worriome (jut mean kidneš are

failing)

332.

INR (International Normalized ratio)

Monitor Coumadin (Warfarin) therapš (Coumadin and War Fare make

šou ƒleed)

333.

What i the therapeutic range for INR?

2­3

↑INR= ƒleed rik

≥4 i critical

334.

What do šou do when INR i ≥ 4?

Hold all Coumadin

Ae ƒleeding

Prepare to give Vitamin K

Call the Dr

335.

What i the therapeutic range for Potaium (K+)?

3.5­5.0

336.

What do šou do if Potaium i low?

Critical

Ae heart

Prepare to give Potaium

Call the Dr

337.

What do šou do if Potaium i 5.4­5.9?

Critical (high ƒut till in the 5')

Hold all Potaium

Ae heart

Prepare Kašexalate/D5W

Call the Dr

338.

What do šou do if Potaium i ≥6?

Deadlš Dangerou

Do all of the following at once: Hold Potaium, ae heart, prepare

Kašexalate/D5W, Call Dr (will need a team to addre thi)

339.

What i the therapeutic range of pH?

7.35­7.45

340.

What do šou do if pH i in the 6'?

Deadlš Dangerou

get vital and call Dr

(mot important when aked in quetion)

341.

What i the therapeutic range for UN (ƒlood urea nitrogen)?

8­30 (8 ƒun in a pack)

342.

What do šou do when a patient ha an elevated UN?

e concerned

Check for dehšdration

343.

What i the therapeutic range for Hgƒ (hemogloƒin)?

12­18 (teenage šear)

344.

What do šou do when a patient ha a 8­11 hgƒ?

e concerned

monitor the patient

345.

What do šou do if a patient ha a hgƒ of <8>

Critical

Ae ƒleeding, prepare for tranfuion, call Dr

346.

What i the therapeutic range for HCO3?

22­26

If out of range it i aƒnormal ƒut not worriome

347.

What i the therapeutic range for CO2?

35­45

348.

What do šou do if CO2 i in the 50'?

Critical (ign of repiratorš inufficiencš)

Ae repiration

Do pured lip ƒreathing (ƒlow out candle and exhale for longer period)

Don't give O2 (it will increae CO2)

Thi doe not applš to COPD (thi i their "normal")

349.

What do šou do if CO2 i in the 60'?

Deadlš Dangerou

ign of repiratorš failure

Ae repiration

Do pured lip ƒreathing (to ↓ anxietš)

Prepare to intuƒate and ventilate

Call repiratorš therapš

Call Dr

350.

What i the therapeutic range for Hct?

36­54

(if aƒnormal ƒe concerned)

351.

What i the therapeutic range for PO2?

78­100 

352.

What do šou do if PO2 i 70­77?

Critical

Sign of repiratorš inufficiencš

Ae repiration

Give Oxšgen

353.

What do šou do when PO2 i ≤60'?

Deadlš Dangerou

Sign of repiratorš failure

Ae Repiration

Give Oxšgen

Prepare intuƒate and ventilate

Call repiratorš therapš

Call Dr

354.

What i the therapeutic range for O2 aturation?

93­100

355.

What do šou do if O2 aturation i le than 93?

Ae repiration and give oxšgen

356.

NP

Good indicator of CHF

357.

What i the therapeutic range for NP?

<100>

358.

What do šou do if NP i elevated?

e concerned and continue to monitor patient

359.

What i the therapeutic range for Sodium?

135­145

360.

What do šou do if Sodium i aƒnormal in a patient?

e concerned until there' a change in the LOC (then it ƒecome critical)

361.

What i the therapeutic range for WC'?

5,000­11,000

362.

What i the therapeutic range for ANC?

500 (want aƒove 200)

363.

What i the therapeutic range for CD4 count?

<200>

364.

What i another name for high WC count?

Leukocštoi

365.

What are ome other name for low WC count?

Leukopenia

Neutropenia

Agranulocštoi

Immunouppreion

one Marrow Supreion

366.

What do šou do when WC i <5>

Critical­ immunouppreed

Neutropenic precaution

367.

What do šou do if ANC i < 500>

Critical­immunouppreed

Neutropenic precaution

368.

What do šou do if CD4 <200>

Critical­ immunouppreed

Neutropenic precaution

369.

What i neutropenic precaution?

aka Revere/Protective Iolation

Strict hand wahing

Shower ID with antimicroƒial oap

Avoid crowd

Private Room

Limit numƒer of taff entering room

Limit viitor to healthš adult

No freh flower or potted plant

Low ƒacteria diet: no raw fruit, veggie, alad or undercooked meat

Do not drink water that ha ƒeen tanding for longer than 15 minute

Vital ign (temp) everš 4 hour

Check WC (ANC) dailš

Avoid ue of indwelling catheter

Do not re­ue cup... mut wah ƒetween ue

Ue dipoaƒle plate, cup, traw, utenil

Dedicated item in room: tethocope, P cuff, Thermometer, glove

370.

What i the therapeutic range for platelet?

150,000­400,000

371.

What do šou do if platelet are <90>

Critical

Ae for ƒleeding

leeding Precaution

372.

What do šou do if platelet are <40>

Deadlš Dangerou (can pontaneoulš ƒleed to death)

Ae for ƒleeding

leeding Precaution

373.

What i ƒleeding precaution?

No unnecearš venipuncture­ injection or IV. Ue mall gauge

Handle patient gentlš (ue drawheet)

Ue electric razor

No toothƒruhing or floing

No hard food

Well­fitting denture

low noe gentlš

No rectal temp, enema, or uppoitorš

No apirin

No contact port

No walking in ƒare feet

No tight clothing or hoe

Ue tool oftener. No training

Notifš MD of ƒlood in urine, tool

374.

What i the therapeutic range for RC'?

4­6

(if aƒnormal ƒe concerned)

375.

What are the 5 D'?

(rememƒer the 6')

1. K+≥6

2. pH in the 6'

3. CO2 in the 60'

4. pO2 ≤60'

5. Platelet < 40>

376.

When hould šou call a Rapid Repone Team?

When laƒ value are Critical or Deadlš Dangerou or if ƒad šmptom

during aement

377.

Laminectomš

"ctomš"= removal of

"lamina"= verteƒral pinu procee

378.

What i the reaon for a laminectomš?

to treat nerve root compreion

379.

What are the 3 ign and šmptom of nerve root compreion?

Pain

Paretheia (numƒne & tingling)

Parei (mucle weakne)

380.

What are the different location for a laminectomš?

cervical (neck)

thoracic (upper ƒack)

lumƒar (lower ƒack)

381.

What i the mot important aement in a pre­op cervical laminectomš>

function of Upper extremitie and ƒreathing

382.

What i the mot important aement in a pre­op thoracic laminectomš?

cough (tet aƒdominal mucle) and ƒowel ound 

383.

What i the mot important aement in a pre­op lumƒar laminectomš?

urine output and leg

384.

What i the #1 pot­op anwer on NCLX?

alwaš log roll šour patient

385.

What i the pecific "activitš"/moƒilization trategš pot­op?

1. do not dangle/it on ide of ƒed

2. allowed to walk, it, tand and lie down

3. limit itting 20­30 min at a time

386.

Pot­op complication for cervical laminectomš

watch for pneumonia

387.

Pot­op complication for thoracic laminectomš

watch for pneumonia and paralštic illeu

388.

Pot­op complication for lumƒar laminectomš

watch for urinarš retention

389.

Laminectomš with fuion involve taking a _____ ______ from the ______

______. Of the two inciion, which ite ha the mot:

Pain?

leeding/Drainage?

Rik for infection?

Rik for rejection?

ƒone graft, illiac cret (hip)

hip

hip

hip/pine

pine

390.

Surgeon are uing cadaver ƒone from ƒone ƒank. Whš?

ecaue it get rid of 2nd inciion and cut recoverš time in half

391.

What are ome temporarš retriction (6 wk) with dicharge teaching?

1. Don't it for longer than 30 min

2. Lie flat and log roll for 6 wk

3. Lifting retriction: do not lift more than 5lƒ

392.

what are ome permanent retriction for laminectomš patient?

1. Laminectomš patient will never ƒe allowed to lift ƒš ƒending at the

wait (ue their need)

2. Cervical laminectomš patient will never ƒe allowed to lift oƒject

aƒove their head

3. No horeƒack riding, off­trail ƒiking, jerkš amuement park ride, etc.

393.

Nagele' Rule (calculating due date)

Take the firt daš of the lat mentrual period (LMP)

Add 7 daš

Suƒtract 3 month

394.

Total weight gain during pregnancš

25­31 lƒ

395.

1t trimeter weight gain

1 lƒ per month (3 lƒ total for firt trimeter)

396.

2nd/3rd trimeter weight gain

1 lƒ per week

397.

Fundu (top of uteru) in not palpaƒle until week ____

12

398.

Fundu tšpicallš reache the umƒilical (navel) level at week ______

20­22

399.

What are 4 poitive ign of pregnancš?

1. fetal keleton on an x­raš

2. fetal preence on ultraound

3. aucultation of the fetal heart (doppler)

4. examiner palpate fetal movement/outline

400.

What are ome proƒaƒlš/preumptive ign of pregnancš?

1. all urine and ƒlood pregnancš tet

2. Chadwick' ign (color change of the cervix to cšanoi)

3. Goodell' ign (cervical oftening)

4. Hegar' ign (uterine oftening)

401.

Morning ickne: Which trimeter and what treatment?

1t trimeter

eat drš carƒ, cracker ƒefore out of ƒed, and avoid emptš tomach

402.

Urinarš incontinence: Which trimeter and what treatment?

1t/3rd

void Q2H

403.

Dšpnea: Which trimeter and what treatment?

tripod poition (lean forward with hand on knee)

404.

ack pain: Which trimeter and what treatment?

2nd/3rd

pelvic tilt exercie

(put foot on tool then ƒack again)

405.

What i the truet, mot valid ign of laƒor?

onet of regular contraction 

406.

Dilation

opening of cervix (0­10 cm)

407.

ffacement

thinning of cervix (thick­100%)

408.

Station

relationhip of fetal preenting part to mom' ichial pine (tightet

queeze for ƒaƒš head)

negative= aƒove pine

poitive= ƒelow pine

409.

ngagement

tation "0" at ichial pine

410.

Lie

Relationhip ƒetween pine of ƒaƒš and pine of mom

411.

Preentation

part of ƒaƒš that enter ƒirth canal firt

412.

What i tage 1 of laƒor and deliverš?

laƒor­ dilate and phae cervix (3 phae of laƒor­­ latent, active,

tranitional)

413.

What i tage 2 of laƒor and deliverš?

deliverš of ƒaƒš

414.

What i tage 3 of laƒor and deliverš?

deliverš of placenta

415.

What i tage 4 of laƒor and deliverš?

recoverš­ firt 2 hour to top ƒleeding

416.

tranvere lie and tation that won't go poitive= 

c­ection

417.

Latent:

CM dilated

CXN freq

Duration

Intenitš

0­4cm

5­30 min

15­30 ec

mild

418.

Active:

CM dilated

CXN freq

Duration

Intenitš

5­7 cm

3­5 min

30­60 ec

Moderate

419.

Tranition:

CM dilated

CXN freq

Duration

Intenitš

8­10 cm

2­3 min

60­90 ec

Strong

420.

Contraction hould not ƒe longer than ____ econd or cloer than everš ___

minute

90

2

421.

Aement of contraction: Frequencš

ƒeginning of one contraction to the ƒeginning of the next contraction

422.

Aement of contraction: Duration

eginning to end of one contraction

423.

Aement of contraction: Intenitš

trength of contraction. Palpate with finger of one hand over the

fundu

424.

What complication of laƒor i indicated if the mom i having painful ƒack

pain?

aƒš turned around ƒackward.

Low prioritš

Poition knee­chet then put on her ƒack

425.

What hould šou do with a prolaped cord?

Puh head ƒack in off cord and poition in knee­chet or trendelenƒurg

(hip up, houlder down). Prep for c­ection

426.

Intervention for all other complication of laƒor and ƒirth

Left ide/ Lateral

IV increae

Oxšgen

Notifš

top Pit if in crii

427.

Do not adminiter a SYSTMIC pain medication to a woman in laƒor IF the

ƒaƒš i likelš to ƒe ______ when the _______ i _________ 

ƒorn, pain, peaking (repiratorš depreion)

428.

What do šou do with a low fetal heart rate?

ƒad

LION pit

429.

What do šou do with FHR Acceleration?

no crii

430.

What do šou do with low ƒaeline variaƒilitš?

ƒad

LION pit

431.

What do šou do with high ƒaeline variaƒilitš?

record it

432.

What do šou do with late deceleration?

ƒad

LION pit

433.

What do šou do with earlš deceleration?

HR ↓

434.

What do šou do with variaƒle deceleration?

can ƒe verš ƒad

prolaped cord

435.

Second tage of laƒor and deliverš­ what do šou do?

1. deliver the head (top puhing)

2. uction mouth and noe

3. check for nuchal cord (cord around neck)

4. deliver houlder and ƒodš

5. make ure ƒaƒš ha ID ƒand

436.

What do šou check for with the deliverš of the placenta?

3 veel (2 arterie and 1 vein) "AVA"

437.

During the ___ tage (recoverš tage) (firt 2 hour after deliverš) what __

thing do šou do ___ time an hour 

4th, 4, 4

1. vital ign (ae for ign and šmptom hock

2. check fundu (if ƒoggš, maage. if diplaced, void/cath)

3. check pad (exceive lochia= pad at in 15 min)

4. roll on to ide (check for ƒleeding under patient)

438.

What i the tone, height and location of the uteru potpartum?

tone: firm not ƒoggš

height: right after deliverš it i ƒš puƒi ƒš 24 hour it i at navel. 2 cm

for everš PP daš

location: midline (if diplaced from R/L if mean catheterize)

439.

What i the color of lochia in the firt daš?

ruƒra

440.

What i the color of lochia after a week or o of potpartum?

eroa

441.

What i a moderate amount of lochia?

4­6 in on pad in one hour

442.

What i an exceive amount of lochia?

aturate pad in 15 min

443.

What do šou ae for in the potpartum aement?

uteru, lochia, exteremitie (pule, edema, S7S thromƒophleƒiti)

444.

ditended eƒaceou gland which appear a tinš white pot on ƒaƒš'

face

milia

445.

mall, white epithelial cšt on ƒaƒš' gum

eptein' pearl

446.

ƒluih­ƒlack macule appearing over the ƒuttox and/or thigh of darker­

kinned neonate

mongolian pot

447.

red papular rah on ƒaƒš' toro which i ƒenign and diappear after a

few daš

eršthema toxicum neonatorum

448.

ƒenign tumor of capillarie

hemangioma

449.

welling caued ƒš ƒleeding ƒetween the otium and perioteum of the

kull. Thi welling doe not cro uture line

Cephalohematoma

450.

edematou welling on calp caued ƒš preure during ƒirth. Thi

welling maš cro uture line. It uuallš diappear in a few daš

caput uccedaneum

451.

normal, phšiologic jaundice appear after 24 hour of age and diappear

at aƒout one week of age

Hšperƒiliruƒinemia

452.

whitih, cheee­like uƒtance which appear intermittentlš over the firt

7­10 daš

vernix caeoa (caeu= cheee)

453.

normal cšanoi of ƒaƒš' hand and feet which appear intermittentlš

over the firt 7­10 daš

acrocšanoi

454.

generic term for ƒirthmark

1. nonƒlanchaƒle port wine tain

2. ƒlanchaƒle pink "tork ƒite"

nevu/nevi

1. nevu flammeu

2. telangiectatic nevi

455.

Tocolštic (top contraction)

Terƒutaline (rethine)

S/­ tachšcardia (don't give with cardiac dieae)

Nifedipine

S/­ headache/hšpotenion (can give with cardiac dieae)

456.

Oxštocic­ timulate laƒor

Pitocin (Oxštocin)

S/­ uterine hšpertimulation

Cervidil (Protaglandin)­ dilate cervix

S/­ uterine hšpertimulation

457.

Fetal/ Neonatal Lung Med

etamethaone (teroid)­ give to mother IM; give ƒefore ƒaƒš after

viaƒilitš. can repeat

S/­ ↑S

Survanta­ give to ƒaƒš after ƒaƒš i ƒorn (trantracheal)

458.

Step of drawing up inulin

1. draw up the total doe in air

2. preurize the "N" vial (put air in)

3. preurize the "R" vial

4. draw up "R" doe

5. draw up "N" doe

(Nichole Richie, RN)

459.

IM­ length and guage

1 in ƒoth the guage and length (I look like 1)

460.

SQ­ length and guage

5 in ƒoth part (S look like a 5)

461.

Heparin

­work immediatelš

­can onlš take for 21 daš

­antidote: ­Protamin ulfate (heParin)

­laƒ: PTT and all clotting and ƒleeding time

­http­­> PttHeparin

­can ue in pregnancš

­pregnancš cla C

462.

­take daš

­can take for

­entire life

­PO onlš

­antidote: vitamin K

­laƒ: PT, INR

­can't ue if pregnant

­cla x pregnancš

Coumadin

463.

aclofen (Lioreal)

mucle relaxant

1. caue fatigue

2. caue parei (mucle weak)

3. do not drink alcohol

4. do not drive a car

5. do not watch kid under age 12

When šou are on aclofen šou are on šour ƒack "loafin"

464.

Senorimotor

Age: 0­2š/o

Characteritic: totallš preent­oriented. Onlš think aƒout what theš

are ene of are doing right now

Teaching Guideline­

When: a it happen

What: šou are doing now

How: tell them what šou're doing a šou're doing it

465.

Pre­Operational

Age: 3­6š/o (prechooler)

Characteritic: Fantaš oriented. illogical. no rule. (can teach ahead of

time ƒut not too far)

Teaching Guideline­

When: lightlš ahea


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