AH2 Final

AH2 FinalStudy GuideAsterixis

Asterixis (flapping tremor, liver flap) is a hand-flapping tremor that is often seen frequently in hepatic encephalopathy. The tremor is induced by extending the arm and dorsiflexing the wrist causing rapid, non-rhythmic extension and flexion of the wrist while attempting to hold positionS/S EndometriosisInability to get pregnantAbodminal pain before menstrual cyclePainful intercoursePainful defacationLab value changes in ElderyIncreased protein in the urineslightly increased serum glucose levels.S/S pheochromocytomaHeadacheDiaphoresisPalpitations

These are the typical triad of symptoms of tumors of the adrenal medulla (symptoms depend on the relative proportions of epinephrine and norepinephrine secretion)PEG TubeCheck placement Q4h

Tube placement and residual volume should be checked before each feeding . Tube placement is checked by aspiration of stomach contents and measurement of pH. It is important to check for residual volume because gastric emptying is often delayed during illness. There is an increased risk for aspiration of the feeding with increased residual volume.Draw Peaks & troughs..For gentamicin sulfate (Garamycin)5 minutes before and 30 minutes after the next dose.A client with diabetes mellitus is experiencing polyphagia.What nursing diagnosis is the priority for this client?Diabetes mellitus Type 1 is characterized by hyperglycemia that precipitates glucosuria and polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). Polyphagia is a consequence of cellular malnourishment when insulin deficiency prevents utilization of glucose for energy, so the outcome statement should include stabilization of adequate cellular nutritionLab value decrease with hyperaldosteronismPotassiumClients with primary aldosteronism exhibit a profound decline in the serum levels of potassium (C) (hypokalemia)--hypertension is the most prominent and universal sign.SIADH / DISIADH weight gain, tachycardia, bounding pulse, (retaining water so everything is diluted)DI weak pulses, hypertension, dry skinSymptoms with..Meneires DisesaseTinnitus, vertigo, and hearing difficulties.(CN VIII)Bells PalsyFacial weakness and paralysis (CN VII)Trigeminal Neuralgia (tic douloureux)Sudden, stabbing, severe pain over the lip and chin. (CN V)hypoglossal cranial nerve (CN XII)Difficulty in chewing, talking, and swallowing.

What class of meds causes Bradycardia?A) Beta blockers (-olol)B) Ace Inhibitors (-pril)C) Loop Diuretic

Inderal (A) is a beta adrenergic blocking agent, which causes decreased heart rate and decreased contractility.

S/S Digitalis ToxicityanorexiaNausea/vomitingDiarrhea headachefatigueDysrhythmias are a concern for any client. However, the presence of a dysrhythmia is more serious in an elderly person becauseCardiac output is decreased with aging (D). Because of loss of contractility and elasticity, blood flow is decreased and tachycardia is poorly tolerated. Therefore, if an elderly person experiences dysrhythmia (tachycardia or bradycardia), further compromising their cardiac output, they are more likely to experience syncope, falls, transient ischemic attacks, and possibly dementiaDuring lung assessment, the nurse places a stethoscope on a client's chest and instructs him/her to say "99" each time the chest is touched with the stethoscope. What should be the correct interpretation if the nurse hears the spoken words "99" very clearly through the stethoscope?May indicate pneumonia.This test (whispered pectoriloquy) demonstrates hyperresonance and helps determine the clarity with which spoken words are heard upon auscultation. Normally, the spoken word is not well transmitted through lung tissue, and is heard as a muffled or unclear transmission of the spoken word. Increased clarity of a spoken word is indicative of some sort of consolidation process (e.g., tumor, pneumonia)Vasopressin is used to promote vasoconstriction, thereby reducing bleeding. Vasoconstriction of the coronary arteries can lead to angina and myocardial infarction, and should be counteracted byIV nitroglycerin per prescribed protocol (its a vasodilator)decorticate posturing indicates..Severe dysfunction of the cerebral cortex has occurred.Decorticate posturing (adduction of arms at shoulders, flexion of arms on chest with wrists flexed and hands fisted and extension and adduction of extremities) is seen with severe dysfunction of the cerebral cortexdecerebrate posturing isrigid extension and pronation of arms and legsThere is a probable dysfunction of the midbrain.

What lab values indicate pt is tumor lysis syndromeHyperkalemiaHypocalcemia (mainly)Hyperuricemia HyperphosphatemiaWhat intervention is important for multiple myleoma?Multiple myeloma is a malignancy of plasma cells that infiltrate bone causing demineralization and hypercalcemia, so maintaining a urinary output of 1.5 to 2 L per day requires an intake of 3 to 4 L (C) to promote excretion of serum calcium.Thrombophlebitis pain is relieved BY..rest and elevation of the extremityMeds For hyperlipidemia should be evaluated for what vitamin deficiency?Clients should be monitored for an increased prothrombin time and prolonged bleeding times which would alert the nurse to a vitamin K deficiency (A). These drugs reduce absorption of the fat soluble (lipid) vitamins A, D, E, and K.GLasGow coma scale

Cushings triad

R. Vs L. Sided heart failure

S/s R. Heart failureDependent Pedal EdemaDistended Neck VeinsHepatomegaly (swelling of liver)PolycythemiaTOO many RBCs in the blood (hyperviscous)Blood is poorly oxygenatedPolycythemia Vera:Increased risk of DVTHeart has to work harder to pump blood b/c its thickVenous stasisTx: phlebotomyCheck Hematocrit levels

thrombocytopeniaLow plateletsCranial Nerves

Digoxin levels0.8 2.0 (confirm w/ book?)SIADHOften related to small cell lung cancerIncreases ADHautosomal recessive disordertwo copies of an abnormalgenemust be present in order for the disease or trait to develop.Digitalis toxicityFat vs. non-fat soluble vitaminsFat solubleVitamins A, D, E, and KNon-Fat solubleVitamins B, C ??Respiratory sounds

arterial insufficiencyReview SlidesVenous stasisReview SlidesSuper vena cava syndromeSuperior vena cava syndrome occurs when the superior vena cava (SVC) is compressed by outside structures, such as a growing tumor that impedes the return blood flow to the heart. Superior vena cava syndrome is likely to occur with metastatic cancerpleurodesisPrevent the formation of effusion fluidCompartment syndromeFat embolism syndromeBattles signcredeManual pressure over lower abdomen to promote bladder emptyingPSA ValuesBelow 4.0A deficiency of intrinsic factor should alert the nurse to assess a client's history for which condition?Pernicious anemia (A) is a type of anemia due to failure of absorption of cobalamin (Vit B12). The most common cause is lack of intrinsic factor, a glucoprotein produced by the parietal cells of the gastric lining.

Dumping syndromeoccurs when the undigested contents of your stomach move too rapidly into your small bowel. Common symptoms include abdominal cramps, nausea and diarrhea.