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Tuesday, August 14, 2007

Acyclovir (Zovirax): May cause adverse GI effects such as diarrhea for recurrent genital herpes

Addison's disease: the production of all adrenal hormones, compromising the body's natural stress

response & the risk of infection Cause retention of Potassiu , hich may result in cardiac dysr!yt! ias" !esults in hypo function of the adrenal glands, hich causes !y#onatre ia and

!y#ovole ia , and !y#er$ale ia" Hyponatremia, hypoglycemia , and hyperkalemia %lucocorticoids

Convert protein & fat into glucose"ssential to life, are & in #ddison$s disease%

t ill need e ogenous Glucocorticoids therapy for the rest o #t s li e" Addisonian crisis: acute adrenal insufficiency precipitated by physical & psychological

stressors% manifestations include ()*, e treme eakness, severe hypoglycemia, +)+ ofshock,

(ursing care includes administering !ydrocortisone t!era#y &vaso#ressors , rest, monitor *)++hould fluid & salt intake during hot eather-

Air luidi ed sur ace: protects the skin from moisture used for pt ith pressure ulcers stage *+

A ino#!ylline: bronchodilator, causes rapid pulse & dysrhythmias +)+ includes confusion, headache, flushing, tachycardia, & sei.ures Antispasmodic

A niocentesis:/ 0etermines chromosomal & neural tube defects1 fetal se2 3etal lung maturity during 2 rd trimester

Amphojel ( AL (OH) 3): Antacid administer after meal.

o max acid secretion occurs 1 to 3 hrs a meal

Anticonvulsants: Can cause folate and vitamin 0 deficiencies


2/27

o " 0ilantin

Antie etic rochlopera.ine 4 co #a ine): used to prevent n)v after surgery

o especially important hen activities such as gagging & coughing can put pressure

on the suture line

Antidiarr!eal o#era ide 4imodium ): used for 5 travelers diarr!ea 5

o report fever & blood in stool

Antili#e ic 6o vastatin 4Mevacor78 administer ith food

o Cholesterol restricted diet +im vastatin 4.ocor78 used hen diet and e ercise fails to normali.e cholesterol

o causes lens opacity and liver dysfunction

Anti#syc!otic eds: -lo a#ine: has potential to suppress bone marro and cause agranulocytosis

o !eport fever and sore throato 9se for +chi.ophreniao Monitor C:C, drugs ill d)c if ;:C falls belo 1


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A#gar score:

/ @eart rate1 !espirations2 !efle irritabilityA Muscle toneB +kin color

Atenolol (tenor in): :eta / blocker C>, +: )0:

Atrial se#tal de ect: @allmark a ixed 2 s#lit, hich is continuous, & results from prolonged emptying of the

right ventricle

Autono ic ysre lexia: .3 50 degrees lace e tremities in dependent position to venous return to heart & venous return to

brain #ssess for :o el & :ladder impaction 6oose constrictive clothing #dminister antihypertensive medications

#void use of fan because cold draft may trigger autonomic dysrefle ia

ell s #alsy: Che food on unaffected side of mouth 9se artificial tears

o Causes an inability to close the eyeo revents drying of the cornea

=ape eyes shut at nighto @elp retain moisture

#void sleeping ith indo s openo 0ue to trigeminal hyperesthesia, protect face from cold & draft

io#!ysical #ro ile 8/ (onstress test1 3etal tone2 3etal breathingA 3etal motionB uantity of amniotic fluid


4/27

"lood trans#usion + All e uipment should 'e ready 'efore is ordered from 'lood 'ank %ormal saline is isotonic $ can 'e used ith 'lood transfusion #top - Amphotericin (antifungal 'ecause can cause allergic reaction ith

'lood transfusion"reast sel#$examination:

/se pads (palmar surface of the middle three 0ngers of your 0rst three0ngers

"ress the %reast against the %reast &all in a circular motion "alpation 'egins in the upper lateral guardant it mo)es from periphery to

the areola $mo)es around the 'reast counterclock ise.

reast il$: roduce ith the delivery of the placenta, hich causes the secretion of prolactin, hich

in turn produces breast milk

reat!ing: 'ursed lip: 'reath should never %e held during pursed lip 'reathing

o Do not take deep 'reath.o 2reathe in (inhale through nose slo ly for t o counts (1, keeping

mouse close.o 2reath out (exhale slo ly through pursed lips hile counting to 4

(1, ,3,4 .o /sed for emphysema , O' .

ronc!odilators ingulair: used for longDterm control of asthma by decreasing freEuency of asthma

attacks%o (ot used for acute asthma attackso =akes several eeks to lessen effects of chronic asthma

us#irone ( us#ar): =ake /AD2< hours before therapeutic effect take place

apoten 5 Antihypertensi)e


5/27

/se 1 hr 'efore food or hrs after food /se salt su'stitute.

-ataracts: :lurred vision, annoying glare, pupils changing from black to gray to milky hite teach pt about post activities & restrictions Remo)al cataract ith a lens implant allo s correction of refraction of

distant vision o "t may not re uire glasses to see distances, 'ut may still need glasses

for reading or close ork.

6eliac disease 7luten intolerance 7luten free diet

o heat, rye, oats

entral line: -f disconnected , * st nursing inter)ention+

o place pt on the left side in +rendelen%urg position This position the likelihood that the air ill pass into the RA $

'e dispersed 'y ay of the pulmonary artery

o then O treatment $ notify physician entral venous catheter (6 6 insertion* use alsal)a maneu)er to

pre)ent air em'olism or Trendelen'urg positiono 't should not deep %reathe-

ervical cancer: 8oman ith $ radioactive cesium implant should a)oid sexual

intercourse $ tampons for 9 eeks (until next follo *up )isit A)oid acti)ities that cause a'dominal strain for 9*: eeks.

-!eyne sto$es res#irations: #F# periodic breathing, irregular pattern of rapid breathing hich builds from s!allo6


6/27

to very dee# res#irations & then back to shallo , follo ed by a #eriod o a#nea" >ften referred to as crescendo decrescendo #attern seen in severe -.8 , drug overdose , 9-P , and renal ailure

-!est tu es: =he 1st 24 !rs after chest surgery about ;00 1000 l of drainage occur

o ith /


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Result of )itamin 2 de0ciency alcoholism,


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igoxin: +timulates parasympathetic division of the #(+ vagal tone% *agal effect slo s heart

rate, refractory period, & slo s conduction through atrioventricular nodes & ?unctionaltissues thus the potential for ne arrhythmias$ to develop

" creted in the kidneys

iverticulitis diet: Lo fat $ high 0'er ex+ tuna sand ich ith hole* heat toast ith carrot

sticks ill 'ulk in stools. Do not use tomato and cucum'er 'ecause containseeds and may stock in intestine.

o uta ine: #cts directly on beta receptors% #ctivate dopaminergic sites at lo doses

ressing change +1. ash hand ith soap

. ear (don clean glo)es3. remo)e the soiled dressing4. ash hand ith soap>. don sterile glo)es9. perform sterile dressing change.

u #ing syndro e: (o fluids /h before or 1h after meals intake of C>@ since they are the first to be digested, rest ill dumped in ?e?unum

causing pain, diarrhea ithin 2< minutes 6ie do n after eating Increase fat and proteins

> #!yse a: lung sound !y#eresonance pursed lip breathing 6o o ygen

>ne a: Insert * 4 inches

.pidural: 2egins 1 hr after the ?uid 'olus administration

o !x+ ?uid 'olus at :+3@, epidural has to start at +3@.


9/27

.tham%utol (myam%utol): optic neuritis $ )isual acti)ity

>ye disorders: /etina: portion of the eye that perceives light & transmit impulses from nerve cells to the

optic nerveo +)+ of retinal detac! ent include

3lashes of light, lurred sooty visionsensation of particles moving in the line of vision sensation of veil li$e clot!ing in front of eyeareas of visual field being blank Painless because there are no pain fibers in the retina

tra is us: Involuntary drifting of one eye out of alignment ith the other eyeo 5la y eye?

>ye #atc!: ou ill have difficulty ?udging distance o o @ects

8etal Positions: 3cci#ut #osterior: causes intense back pain because of fetal compression of the sacral

nerves

8osa ax: Inhibits bone resorption Can be highly irritating to the GI tract especially the esophagus, causing irritation &

ulcerations)erosions 0ysphagia can also result t should sit for at least 2< minutes to facilitate delivery to the stomach & prevent acid

regurgitation & esophageal reflu

8re uency: :eginning of one contraction to the beginning of another contraction

8reud s stages: >go: =est reality & direct behavior by mediating bet een the pleasure seeking

instinctual drives of the id and the restrictiveness of the superego 9d: source of psychic energy u#erego: conscience

/arlic 6an potentiate action of dia'etic drugs (-nsulin $ ethers $ cause

hypoglycemic e=ectB


10/27

%enta icin: after instilling drop, put pressure on the lacrimal sac for / min to prevent systemic

absorption% never touch eye tissue ith eEuipment 4 ould contaminate bottle of medication7

%lauco a: @alos around the eye, C I> loss f peripheral vision late symptom Aceta;olamide (Diamox is used for glaucoma

o -f pt allergic to sulfa do not gi)e this drug ith sulfonamide anti'iotic Open angle glaucoma * C - "

o %eeds miotics (constrict pupils iamox $ 'ilocarpine + sEs+ 'lurry $ cloudy )ision rain'o s orhalos around light

O 0O+ administer 1ydriatics (causes dilation of the pupils thus C - "

o !F. Atropine $ .pinephrine

%lucose: -f ptGs 7lucose le)el 3 mg2dl most concern is pt safety

o sei;ure, altered mental status, at this critically lo le)el "ad the side rails of the stretcher.

Glucose tolerance test : normal =140

/ranular cast -n urine indicates renal disease

Halo Vest traction :

Do not raise the leg rests of the wheelchair because weight of the halo vest will cause wheelchair

to tip backward.

.anta virus #ul onary syndro e: causes +)+ of t!ro ocyto#enia

.ead in@uries:
http://www.univie.ac.at/cga/courses/be524/spinal/halo.gif


11/27

-losed: prone to IC % .3 *0 4; degrees to promote venous drainage

oncussion: mild 'rain inHury in hich trauma to thehead results in a temporary disruption of normal 'rain functiono !x I- fell do n $ donGt remem'erJo sEs+ KA, retrograde amnesia, transient L 6.

.earing test: /!ine B n ;eber$s test sound laterali.es to good ear o #ir conductionJbone conduction

" 8 #ging, drugs, tumors -onduction dea ness:

o ;eber laterali.es to diseased ear o :one conductionJair conduction

" 8 >titis media, otosclerosis

Heimlich maneuver is used to dislodge food or other foreign 'odies in the throat

Heparin:

A'++ normal @*3@ sec %urse needs permission to administer "rotamine #ulfate 5 antidote of

Keparin. Therapeutic le)el * 4 5 times

.ista ine loc$er: +mall freEuent meals are not necessary =agamet

.y#er aric oxygen t!era#y:

:enefits a compromised skin graft, because it o ygen at the ound site promotehealing
http://www.beliefnet.com/healthandhealing/images/exh36219_ma.jpg


12/27

!arly sign of hypoxia

9nderal (("ropranolol + :eta blocker, May mask symptoms of hypoglycemia 6ontraindicated in K and "ulmonary edema

6n#ant developmental stage + month old can lift the head 4> degree hen in prone position 4*9 month

rolls o)er, plays ith o n hands and grasps o'Hects ith 'oth hands.

9n luen a: Most common complication is #neu onia" +hould be given to adults D;0 years , pt ith chronic conditions & persons traveling to

foreign countries Contraindicated if allergic to eggs roplet precaution: /se a facemask, a go n $ glo)es.

9#ecac syru#: Cot vo iting is #riorityE if none occurred, you may repeat dose in 1< minutes t to remain CP3 until follo ing day

9ntracranial #ressure: !ead circu erence is the 1 st sign of IC in children -!anges in s#eec!, 3-, restlessness, B con usion amount of procedures sensitive to touching, ?arring, loud noise

o ;ill cause IC 0o not hyperventilate, it ill C>1 4patent vasodilator7 & cause IC

9sc!e ic yocardial tissue c!anges:1" Cause of the T seg ent 2" or inverted t 6ave *" & a #at!ological F 6ave

7aundice:


13/27

'hysiological jaundice * immature hepatic functiono ccurs after 4 hrs, peak M , and last >*M days

"athological Haundice+ occurs ithin 4hrs after 'irth 6n#ant %iliru%in 8 *4 phototherapy considered at M hrs age.

9actate ingers: is gi)en during la'or 'ecause replaces electrolyte loss.

actovegeterian: 0o no eat eggs

evado#a: 9rine may appear darker than usual 9sed in treatment of arkinson disease

9icorice: Ker' that can


14/27

o results in ater absorption and dilutional hyponatremiaiuretics used to promote fluid loss

u#us: teach pt to a)oid all direct exposure to the #un no ork in garden ( immunosuppresed)

o Lesions ill 'ecome orse. 0iagnostic test include

1" above normal antiD0(# test2" antinuclear antibody test*" 6upus erythematous cell test

u ar #uncture: lace in flat supine position, hich prevents headache & leaking of C+3 at the site

ung sounds: Cor al sounds

o Gesicular: soft & lo pitch bree.y sound heard over most of the peripheral lungfields, normal

o ronc!ovesicular: harsh sounds heard over the mainstem bronchi, normalo ronc!ial 8 loud, coarse, blo ing sound heard over the trachea, normal

A nor al soundso /!onc!i 8 musical sound or vibration commonly heard on inspiration

Hagnesiu sul ate: -C depressant that blocks neuromuscular transmissions rela es smooth muscles, : , #C=@ 9se as an ad?unct to treat acute ne#!ritis & severe to emia

Hedication ad inistration !ectal administration offers the patient the longest duration of pain relief HDK hrs After administering rong dose of the medication, the nurse should do the

follo ingo Record the dose of med administered $ dose of med orderedo assess $record ptGs actual responseo inform &Do

record any ad)erse response to medo su'mit report as soon as possi'le ( ithin 4 hr

Hitral stenosis: Causes diastolic, rumbling & lo pitch murmur

1ononucleosis 5 ;


15/27

sEs+ constant #atigue , fe)er, sore throat, s ollen lymph glands

Hor#!ine: #dult dosage 10 gI70$g of body eight hen giving parentally

H/ A: !eEuires contact precautions

Hulti#le clerosis: =each pt to sleep on stomach to minimi.e spasm of the fle or muscles of the hips &

knees 'rone position can minimi;e spasm of ?exor muscles of the hips $ knees

during exacer'ation. )erextension a)oided

Hyocardial in arction: #fter MI cardiac arr!yt! ias causes roughly A


16/27

3xytocin: Tetanic contractions are the most serious adverse effect associated ith > ytocin

administration rolonged > ytocin infusion may cause 6ater intoxi ication , leading to sei.ures, coma

& death !esponsible for milk, let do n refle #dverse effects .TC, luid overload, uterine tetany"

Paroxetine (Paxetil): 1nd generation antidepressant, may cause consti#ation

P>>P: 0elivers positive pressure during e piration to keep air ays constantly open

'eritoneal dialysis: -f =oung &oman 2loody out?o could 'e 'ecause of menstruating

2ecause of hypertonocity of dialysate, 'lood from uterus is pulledthrough the fallopian tu'es into the eOuent

no inter)ention re uired ontinuous Am%ulatory peritoneal dialysis ( A' + some maHor

complication include cloudy or opa ue dialysate hich is the earliest sign of peritonitis %ormal out?o is yello $ clear. Dialysate can cause o)er eight, talk ith dietitian.

P!: lood:

o 7"*; 7"4; Jrine

o Child : 4"; K"0o #dult8 4"L L"0

P!otot!era#y: Common adverse effect in children is atery stool, hich result from e cretion of

bilirubin

PMJ 8 normal =2 Inborn error of metabolism involving an inability to properly metaboli.e phenylalanine

an essential ##


17/27

Placenta #fter delivering the placenta, the fundus is usually firmly contracted & located belo the

umbilicuso 3undus at umbilicus KD/1 hours postpartumo moves / fingerbreadth)day

roduces estrogen B #rogesterone 0eto ifies some drugs & chemicals " change site for food, gas & aste lacental transport of substance to and from fetus begins in ;t! 6ee$ 9 unity:

o 3etal immunity is transferred through the placentao Maternal immune system is actually suppressed during pregnancy to prevent

maternal re?ection of the fetus, hich the mothers$ body considers a foreign protein

P!eno ar ital: +hould be in?ested into a large muscle mass 0o not be mi or give ith any other drugs since barbiturates are involved in many drug

interactions 9sed ithin 2< minutes after opening

P!ysical assess ent: Cor al:

1" Inspect2" alpate*" ercuss4" #uscultate

A do en:1" Inspect2" #uscultate*" ercuss4" alpate

Ce6 orn1" #uscultate heart and lungs2" !ecord heart and respiratory rate


18/27

*" alpate and ercuss the abdomen4" " amine eyes, ears, and mouth;" "licit the Moro refle

'ost$op pt:

%e)er put ith pt considered IdirtyJ (6 "D, any other infection in the sameroom &ore important 'o el sounds 5 do not o=er oral ?uid until 'o el sounds

returned.

Pregnancy: ;eight gain8 2; *;l s total

/ st trimester8 1DAlbs 1nd trimester8 /1D/Albs

1 #oundI6ee$ until delivery 2rd trimester8 KD/1 lbs

'rimigravida + normal progress of la'or at * 5 * cm dilation of the cer)ixper hour

9a%or: 2 impending la%or: contractions > min in 1 hr 2 active la%or + contraction > 3$? min, %loody sho&

+ransition phase: :*1@ cm dilated, complete e=acement "ressure in pel)is causes intense desire to urinate.

Preload: *olume in left ventricle at end of diastole by any condition that circulating volume such as hemorrhage, sepsis, & anaphyla is @emorrhage Dcirculating volume by loss of volume from intravascular space +epsis & anaphyla is circulating volume by capillary permeability

'ro!ac : 6 for epression %e)er take omitted dose. Return to regular dosing. 6ause dry mouth 6he gum $ good hygiene. rthostatic hypotension

FT interval corrected or !eart rate 8 0ivide = interval by sEuare root of !D! interval


19/27

/e lexes: 1oro re@ex 5 child a'ducts his extremities $ fans his 0ngers hen hears a

noise o disappears at $3 month

A%sence of red re@ex in ne 'orn is .mergency-o cause 'lindness optic ner)e

Hip spica cast 6an cause 6ast syndrome* superior mesenteric syndrome sEs+ %E , a'd. pain,

'loating. 6all &DB

/eglan: +timulates motility of upper GI tract, used to treat nausea of chemotherapy revents or side effects of latinol, a chemotherapy agent

/itodrine (Nuto#ar): @elp manage preterm labor 3reEuency & intensity of uterine contractions by stimulating :1 receptors in the uterine

smooth muscle 0rug of choice hen trying to 9C.9 9T la or

aline compress: arm saline good for phle'itis from an -

e>uential compression device ( ) +1. put the anti*em'olism stocking on 'efore rapping $ securing the slee)es

a. the stockings can the itching, s eating $ heat that can 'uild up underthe plastic slee)es $ there'y can cause discomfort $ skin irritation

. #tart 'y positioning slee)e under the leg so that the opening is at the knee(in front .

nellen c!art: (ormal is 20I20 :ack number indicates distance at hich a person ith normal vision can read the chart 20I200 considered legally lind

#eci ic %ravity: (ormal value is 1"010 1"0*0 Measures concentration of particles in urine /rea nitrogen *B$3B #erum creatinine B 4$ * 4


20/27

pinal injury: Transfer+ 0ever %end knee, s ing legs. keep straight alignment, logroll, "t. focuses on using arms.

tadol +hould give in active phase to prevent respiratory depression of ne born +hould not give hen birth is e pected to occur ithin 1 hours

ti ulants 8 roduces mood s ings, tachycardia, anore ia, eight loss

tra is us: Involuntary drifting of one eye out of alignment ith the other eye% 5 la y eye?

tro$es: !ightDsided stroke include leftDsided eakness, impulsiveness, and poor ?udgment

tu #: 0o not elevate after / st 1A hrs may result in fle ion contraction

yphilis: de)elops in *9 ks 2egins ith papule $ then 'ecomes ulcer

ync!roni ed inter ittent andatory ventilation ( 9HG): #llo s for spontaneous breath at his o n rate and tidal volume bet een ventilator

breaths

ynt!roid: metabolic process in the body, including glomerular filtration rate thereby urinary

output

Tegretol: Inhibits nerve impulses & reduces the pain of the condition 9se in treatment of tic douloureux

Tetracycline +hould be taken on an empty stomach

Tetralogy o allot 8/ ulmonic stenosis


21/27

1 Interventricular septal defect2 0e troposition of the aorta so that it overrides the interventricular septum & receives

venous as ell as arterial bloodA !ight *entricular @ypertrophy

T!eo#!ylline: ('ronchodilator normal le)el *B$ B

T!ro olytic agent: =o salvage myocardium it must be administer ithin 12 !ours Dangerous* contraindicated after 'rain inHury.

+issue necrosis: 2 of %eginning of T# include

o -rregular, mottled ring ith 'luish purple central area

+oddler: &alking &ithout help at 13 5 1> month %uilding a to&er of 3*4 'locks 1: month using $3 &ord phrases 4 month jumping &ith %oth #eet at 3@ month -f they ha)e diPculty 'reathing $ hee;ing on inspiration, may 'e aspirating

large pieces of food (hot dog, nuts

Tonsils: 1+ 8 barely visible outside the tonsillar pilar 2+ 8 bet een tonsillar pilar and uvula *+: touches uvula 4+ 8 touching each other

TPC: @yperglycemia may occur if it is administered too rapidly

+ransdermal patch + %e)er use alcohol, soap, oil, lotion for cleansing. /se arm ater

Transs#!enoidal !y#o#!ysecto y: +urgical removal of the #ituitary gland

o # small oval gland at the base of the brain in vertebrates, producing hormonesthat control other glands & influence gro th of the bone structure, se ualmaturing, & general metabolism

Instruct pt to avoid activities that increase intracranial pressure
http://en.wikipedia.org/wiki/Theophyllinehttp://en.wikipedia.org/wiki/Theophylline


22/27

t not allo ed to brush teeth for /D1 eeks

+ricuspid area 5 (LL#2 4 th 6 Q the lo er le#t of thesternal 'order

* 5 closure &itral ('icuspid $ tricuspid )al)es. * closure Aortic $ "ulmonic )al)es. .r%Cs point 5 at the 3 rd -6# and the left of the sternum 7ood to Auscultate Aortic $ "ulmonic murmurs

+rochanter roll: /sed to position unconscious pt 6urrent location for a trochanter rolls from lateral aspect o# hip to the

mid$thigh Kip Hoints lie 'et een these points.

+u%erculosis: 6lassic sign dry cough ith 'lood 5tinged sputum $ night s&eat . %urse should D6 + + put a mask on pt Treatment include

o Isoniazid (-%K hich can cause neuropathy 7i)e 29 )itamin.

alk &ith crutches:
http://www.medicinenet.com/isoniazid_inh/article.htmhttp://upload.wikimedia.org/wikipedia/commons/thumb/b/be/Gray1218.png/250px-Gray1218.pnghttp://sprojects.mmi.mcgill.ca/mvs/IMAGES/fields.JPGhttp://www.medicinenet.com/isoniazid_inh/article.htm


23/27

/sing 'oth crutches on stairs+o the good leg goes up, the 'ad leg comes do n

alk on sur#ace +o 2ad leg ith crutches goes 0rst follo ed 'y good leg.

ithdra&als: Alcohol &ithdra&al * hyper alert startles easily, anorexia, tremor, insomnia,

incr pulse

o Alcoholism causes infantGs mental retardation 0arcotic &ithdra&al: atery eyes, cramps, and tremor

Oanax: shouldn't be used if Co #regnant

Z trac$ et!od: *ariation of standard IM techniEues for administering meds that is highly irritating to

subcutaneous and skin tissues revents meds from leaking into subcutaneous & skin tissues

24 ont!s old c!ild: child kicks ball ithout falling child builds a block to er of H blocks child uses t oDthree ord phrases
http://connection.lww.com/Products/taylor5e/documents/Ch39/jpg/39_024.jpg


24/27

B east pleasant grove road ?ackson, ne ?ersey


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