This document provides information on various medical conditions organized by topic. It discusses stages of chronic renal failure, signs of acute renal failure and heart failure, treatments for conditions like unstable angina and shock. It also covers risks for GERD and sickle cell crisis, management of conditions like degenerative joint disease and pregnancy. Newborn respiration and the parasympathetic and sympathetic nervous systems are explained. Care for circumcision, signs of infection in COPD, and management of pulmonary embolism are outlined. The nurse-client relationship is summarized in four phases. Continuous passive movement devices and complications of jaundice are also mentioned.
This document provides information on various medical conditions organized by topic. It discusses stages of chronic renal failure, signs of acute renal failure and heart failure, treatments for conditions like unstable angina and shock. It also covers risks for GERD and sickle cell crisis, management of conditions like degenerative joint disease and pregnancy. Newborn respiration and the parasympathetic and sympathetic nervous systems are explained. Care for circumcision, signs of infection in COPD, and management of pulmonary embolism are outlined. The nurse-client relationship is summarized in four phases. Continuous passive movement devices and complications of jaundice are also mentioned.
This document provides information on various medical conditions organized by topic. It discusses stages of chronic renal failure, signs of acute renal failure and heart failure, treatments for conditions like unstable angina and shock. It also covers risks for GERD and sickle cell crisis, management of conditions like degenerative joint disease and pregnancy. Newborn respiration and the parasympathetic and sympathetic nervous systems are explained. Care for circumcision, signs of infection in COPD, and management of pulmonary embolism are outlined. The nurse-client relationship is summarized in four phases. Continuous passive movement devices and complications of jaundice are also mentioned.
CHRONIC RENAL FAILURE STAGE I: POLYURIA AND NOCTURIA
II- OLIGURIA AND SWELLING IN ANKLE AND LEGS
III DIALYSIS-END STAGE RENAL DISEASE
Acute renal failure
I- oliguria
Strep infection Not infectious after 24hrs of antibiotic therapy-
indicator to be able to care Heart failure- ventricular gallop -s3 sound is the Sodium 2g/day, fluid restriction, Lasix, O2,weigh first sign daily, i/o Best indicator of effective diuretic: WEIGHT 1pound lost = 500ml RHF LHF ACUTE CORONARY SYNDROME-Unstable angina, O2, iv access for nitro, morphine, hep, fibrinolytic myocardial infarction/ischemia Shock: increase pulse, light headedness, cold and Shock is priority than hypoglycemia, bleeding, early clammy, high resp labour fracture
GERD RISK Caucasian, female, age more than 45, obese,
smoking, NG tube Sickle cell crisis Hydration then oxygen Fluids 200cc/hr Prevent inf .. URI and blood borne pathogens Coumadin Carry cell phone, bandages, dressing Long term med, incorporate into lifestyle Degenerative joint disease- risk of contractures Keep in functional position For back pain elevate legs 8-10 inches Donot use big pillows Fundus level in pregnancy 10 to 12 weeks fundus slightly above symphysis pubis 2434 weeks, fundal height correlates well 16 weeks fundus halfway between symphysis with weeks of gestation pubis and umbilicus 20 to 22 weeks fundus at the level of the umbilicus 28 weeks fundus three fingerbreadths above the umbilicus 36 weeks fundus just below ensiform cartilage
TURP WITH CBI PAIN, leg with cath should be straight
Urinary retention Crede maneuver-cupped hand on bladder inward and downward pressure Urinary incontinence Toilet whn awaken and before and after meals Hemolytic reaction: n/v,back pain, high pulse, low Stop infusion, ns iv,o2, airway, Benadryl, draw bp, decrease urine output, hematuria blood, urine specimen, send blood bag to lab Body mechanics Determine if help required Then position close to the pt and use arms and legs and encourage pts to help Horners syndrome lung tumor that invades ribs Miosis, partial ptosis, anhidrosis of the affected and affects the sympathetic nerve ganglia side Pancoast tumor first thoracic and 8th cranial nerve Arm and shoulder pain and atrophy of arm and hand muscles on affected side Pleural tumor Chest pain, cough, dyspnea, fever,weight loss SLE-proteinuria, hyperlipidemia Dec s. complement, positive antinuclear test, increased anti DNA levels, positive lupus erth. Cell Pregnancy Primi: effaces then dilates Multi: both at same time Newborn respiration Calories, respiratory center, nerves in brain and chest, patent airway Parasympathetic nervous system Constricts pupil, increases heart rate,constricts Constricts and stimulates bronchi, increases GI motility and bile secretion, stimulates saliva, stimulates /contract urine/urine retention, relaxes rectum Sympathetic nervous system Dilates pupil, slows heart, decreases GI motility, Dilates and inhibits inhibit saliva, relaxes urinary muscles, contracts rectum, increases glucose by liver, epi and nor epi by kidney, dilates bronchi p. jairoveci pneumonia-opportunistic AIDS inf Can cause hypoxemia and cyanosis Crohns disease Corticosteroids, antidiarrheals Donot give protein, fibre and milk[causes diarhea] Circumcision care Should void before discharge Dont bathe, dont remove crust Small amount of bleeding expected Care for 2-4 days required for healing Lubricant/ Vaseline jelly over glans penis
Nurse client relationship Orientation phase:
Realistic limits, trust , rapport Prepare for termination Assess client, identify problems, discuss plan for visit Identification phase: Clarification and goal setting Working phase: Identify problems Ask questions Nurse was beneficial Termination phase Problem solved Reaches established goals, Relationship ended- sadness normal for nurse pt. Dependent personalities require help- reflect on positives and growth Fear of abandonment, Sign of prevention of infection in COPD Decrease in O2 requirements Sign of infection In COPD Increase in O2 req, fever, fatigue, sputum increase, shortness of breath Pulmonary embolism- serious emergency Petechia on chest, shortness of breath, chest pain,anxiety Give Oxygen first then notify doc. Wil prescribe hep and analgesics can be given. PNEUMONIA Crackles, pleuritic pain, fever t.b. Anorexia, fever, night sweats, weight loss Atrial fibrillation-emergency Can cause clots from atria and lead to stroke Sinus tachy and PVC are not emergency Hypokalemia Ventricular tachycardia Sprue [celiac disease] Diarrhea and constipation, bloating, flatulence, no imp vitamins minerals and nutrition absorbed, malnourished, less albumin and clotting factors, GLUTEN FREE DIET: WHEAT, OATS, RYE, BARLEY, BEER, COUSCOUS, GRAVY, BROTH, PROCESSED AND BATTERED FOOD, FLOUR, SPRUE FOUND MORE IN TROPICAL REGION
CONTINOUS PASSIVE MOVEMENT DEVICE Needed even if physical therapy is given
Prevents adhesions Bleeding is a complication Monitor skin intergrity Jaundice within 24 hrs- life threatening Can be hemolytic disease, rh /abo incompatability, sepsis Jaundice after 24-72 hrs Physiologic jaundice ACIDOSIS Hyperkalemia: during periods of hyperglycemia K leaves the cell along with glucose ALKALOSIS Hypokalemia: when the treatment is initiated and the glucose goes back to the cell K also goes back causing hypokalemia-watch out for arrhythmias- v.tach Nurse practice act Regulates the scope of nursing practice enacted and outlined by state legislature Involuntary admission Harm to self /others Should have a suicide plan Threatening to kill Schizos with hallu and delu are ok to live alone Advanced directive Includes living will Should be reviewed with doc at every admission Should be informed at admission and taken
Neck radiation Dysgeusia: absence of taste
Xerostomia: dry mouth and xerophthalmia Stomatitis: irritation of oral mucosa Internal pelvic radiation Cystitis Internal radiation Leukopenia, thrombocytopenia Head Cognitive decline Externalradiation Nausea, infertility, hair loss, dry skin, pink sore skin, lymphedema, gastric ulcers, Pyelonephritis: infection from blood, cath, Give more fluids procedures Acid ash diet-prune, cranberrry,tomato, buillon, no milkand citrus fruits-orange and lemon No sitz bath Myxedema coma [hypothyroidism] Resp depressed so patent airway imp-most critical Severe hypothermia: gradual heating or will cause vasodilation and shock Bradycardia- prolonged QT interval Thyroid replacement given IV Diabetes insipidus[pyelonephritis] Deficient volume related to inability to conserve water BIOPHYSICAL PROFILE[USG] Non stress test, fetal tone, fetal movement, amniotic fluid volume 1st trimester Crown rump length for gestational age 2nd n 3rd trimester Biparietal diameter, femur length for gestational age Rheumatic fever-non pruritic rash, fever, joint pain Ask previous sore throat with strep Not infectious Affects heart, joints and CNS HYPOGLYCEMIA If confused but conscious give orange juice If unconscious glucagon IM or dextrose 50% Epidural anesthesia RESPIRATORY DISTRESS-CNS DEPRESSION- decreased heart rate and blood pressure, Decreased sensation to the lower extremities Urine retention, hypotension, allergic reaction, Hypophsysectomy Head elevated, no coughing, sneezing, blowing nose for sutures, increase fluid because of diabetes insipidus and visual disturbances
Parkinsons crisis-confined to bed, risk for Ineffective airway clearance related to
pneumonia and aspiration drooling[airway obstruction] PARKINSONISM Shuffling gait, stooped posture, drooling, muscle rigidity, flat face, tremors Akasthisia Inability to stay still, pacing, restlessness BIB BABY SYNDROME Reason: insulin acts as a growth hormone for fetus Bone marrow Depression in 7-14 days noticed Recovery in 21-28days HCG Maintains pregnancy till placenta intact Monitored for knowing the status of pregnancy Relaxin Makes mommy tired to seek rest Progesterone Thickens the uterine lining before pregnancy and nurtures the fetus during pregnancy-supportive envt Estrogen For breast tissues and breast feeding and nurturing the fetus Stoma after surgery: danger signs Dusky stoma -Edema in 24hrs if ok Stomal protrusion out of the skin Abdominal rigidity and pain
Most common complication of influenza Pneumonia-bacterial /influenza
Others-exacerbation of COPD, reye syndrome, myositis Hypocalcemia Trousseau sign, cardiac arrhythmias, diarrhea, increased clotting time, irritation, anxiety, pathological fractures, Rombergs test Assess cerebellar function Rinne test Air and bone conduction Pulmonary emboli risk factors Immobility, pelvic fractures, obesity Mononucleosis- flu, sore throat, fever No contact for 3months, no need of isolation, no sharing of cups and glasses
Premature labour control Hydration
Sickle cell crisis Hydration, o2 Hyperglycemia Fluid volume deficit Burns Fluid volume deficit ECT Vitals for every 15mins for first 1hr, left side position for aspiration, orientation, no ambulation until oriented and awake Multiple myeloma Preventing bone injuries, hydration, pain control Chronic bronchitis Diaphragmatic pursed lip breathing-exhalation more than inhalation to prevent collapse of bronchioles Medication administration in infant[liquid] Verify order Right drug , dose, route, time Right pt. Position in the crook and raise 45 degree head Give through the corner of the mouth b/w gums and cheek Hemolytic reaction Stop transfusion, give NS, Notify doc, collect urine sample, send blood to lab Insulin administration air in syringe air in NPH air in regular withdraw regular then NPH Dont shake but rotate gently, not need to keep in fridge Herniated disc Comfortable position Give pain med Assess and teach non pharmacological measures Notify doc if pain unrelieved UPPER GI ENDOSCOPY Nbm for 6-12hrs Conscious sedative Gag and cough reflex gone for 2hrs Lower endoscopy GI cleansing with enema and golytely Clear liquid diet Mother negative baby positive Rh immunization at 28 weeks and after within 72 hrs-no antibodies will b formed if given Negative rubella antibodies during pregnancy Immediate rubella vaccine post delivery and counseling Hypoxia test ABG Cardiac tamponade Decrease in amplitude of QRS complex Insulin unit Its a measure of effect and not standard weight or quantity Apothecary system Grain and minim Avoirdupois system Ounce and pound Metric Liter, gram