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Mark Klimek Q&A Flashcards

If you want to save study time and revisit the most-tested NCLEX topics with focus, Mark Klimek Q&A Flashcards are for you. These are authentic Mark Klimek Q&A flashcards that mirror the exam format—concise questions, memorable rationales, and high-yield cues that flag common pitfalls.

Built for active recall and spaced repetition, they make short daily sessions easy—whether it’s your first attempt or a retake. Answers and rationales are on the back: just flip or tap to reveal (click-to-learn) and check your reasoning instantly.

Management Of Care Flashcards

[{"q":"If the pH and the BiCarb are both in the same direction then it is?","a":"Metabolic"},{"q":"If the pH is up it is?","a":"Alkalosis"},{"q":"If the pH is down it is?","a":"Acidosis"},{"q":"If disconnected tube on floor?","a":"Bag patient → call for help → new tube → reconnect."},{"q":"If disconnected tube on chest?","a":"Reconnect (above waist is ok)."},{"q":"“Bizarre” means?","a":"Tachycardia."},{"q":"If kernicterus & opisthotonos → ?","a":"Call MD, draw bili, increase IV, start phototherapy."},{"q":"Thyroidectomy post-op 0–12h risks?","a":"Hemorrhage, airway."},{"q":"Post-op 12–48h Subtotal risk?","a":"Thyroid storm."},{"q":"Adolescents (12–18 yrs) \"play\" is?","a":"Peer association."},{"q":"How often monitor in labor?","a":"q15min until 2h PP, then q1h."},{"q":"1st stage of labor has how many phases?","a":"3."},{"q":"3 phases of labor?","a":"Latent \/ Active \/ Transition."},{"q":"Side effects of Terbutaline?","a":"Maternal tachycardia (not safe if cardiac disease is present)."},{"q":"Side effects of Nifedipine?","a":"Headache and hypotension."},{"q":"Prioritization questions give what 4 details?","a":"Age \/ Gender \/ Diagnosis \/ Modifying phrase."},{"q":"Most important info in prioritization?","a":"Modifying phrase."},{"q":"What 2 details do NOT matter in prioritization?","a":"Age and gender."},{"q":"Four rules of prioritization?","a":"Acute > Chronic \/ others \/ Unstable > Stable \/ More vital organ > less vital (tie-breaker)."},{"q":"Best prioritization rule?","a":"Rule #4 (organ vitality)."},{"q":"What makes a patient stable?","a":"Chronic illness \/ >12h postop \/ Local\/regional anesthesia \/ Unchanged assessment \/ \"To be discharged\" \/ Lab values A or B \/ Expected signs and symptoms."},{"q":"What makes a patient unstable?","a":"Acute illness \/ &lt;12h postop \/ General anesthesia \/ Changed assessment \/ &quot;Newly admitted\/diagnosed&quot; \/ Lab values C or D \/ Unexpected signs and symptoms."},{"q":"Main 6 organs in order?","a":"Brain > Lung > Heart > Liver > Kidney > Pancreas."},{"q":"What do you NOT delegate to family?","a":"Safety responsibilities."},{"q":"Family can only do what you ____ them?","a":"Teach."},{"q":"If staff does something illegal you?","a":"Report to supervisor."},{"q":"If staff behavior is legal, not harmful but inappropriate you?","a":"Counsel them later."}]

Safety And Infection Control Flashcards

[{"q":"High pressure alarms trigger when?","a":"Ventilator cannot push air in."},{"q":"High pressure alarms are caused by?","a":"Kinking \/ Water in dependent loops \/ Mucus in airway."},{"q":"If tube kinking present?","a":"Unkink."},{"q":"If water in dependent loops?","a":"Open system and empty."},{"q":"If mucus present?","a":"Turn, cough, deep breathe. If ineffective → suction."},{"q":"Low pressure alarms trigger when?","a":"Too easy to push air in."},{"q":"Low pressure alarms are caused by?","a":"Disconnection."},{"q":"If tubing disconnected?","a":"Reconnect."},{"q":"If O2 sensor line disconnected?","a":"Reconnect."},{"q":"Overdose of an upper?","a":"Everything ↑"},{"q":"Withdrawal of an upper?","a":"Everything ↓"},{"q":"Withdrawal of a downer?","a":"Everything ↑"},{"q":"Contact precautions for?","a":"RSV, herpes, staph, enteric infections."},{"q":"Contact precautions include?","a":"Private room, gloves, gown (direct care), handwashing, disposable supplies."},{"q":"Droplet precautions for?","a":"All meningitis, all influenza."},{"q":"Droplet precautions include?","a":"Private room, gloves, mask (#1), handwashing, patient mask when leaving, disposable supplies."},{"q":"Airborne precautions are for what 4 diseases?","a":"SARS, TB, measles, varicella."},{"q":"Airborne precautions have what 9 things?","a":"Private room (door closed), mask, gloves, gown, handwashing, special respirator mask, patient wears mask when leaving room, disposable-dedicated supplies, negative airflow room."},{"q":"PPE contains?","a":"Gloves, gown, goggles, mask (unless told otherwise)."},{"q":"Proper order for donning PPE?","a":"1. Gown, 2. Mask, 3. Goggles, 4. Gloves."},{"q":"Where do you remove PPE?","a":"Inside the room."},{"q":"Where do you put on PPE?","a":"Outside the room."},{"q":"In airborne precautions it is ok to remove what PPE outside the room?","a":"Mask."},{"q":"What position are your hands for handwashing?","a":"Hands below elbows."},{"q":"How long do you wash hands?","a":"15 seconds."},{"q":"Can the faucet have handles for handwashing?","a":"Yes."},{"q":"What do you use in handwashing?","a":"Soap and water."},{"q":"When do you wash your hands?","a":"Before\/after gloves, entering\/exiting room, after soiling hands."},{"q":"Hand position for scrubbing?","a":"Elbows below hands."},{"q":"Length of hand scrubbing?","a":"3–7 minutes."},{"q":"What agent is used for hand scrubbing?","a":"Cleaning agent with prefix \"chlor\"."},{"q":"Can the sink have handles for scrubbing?","a":"No."},{"q":"When do you use scrubbing?","a":"Immunosuppression, surgery, transplant, chemo, HIV."},{"q":"Dry your hands from...?","a":"Cleanest to least clean."},{"q":"When can you use alcohol-based solution?","a":"Before\/after gloves, entering\/leaving room."},{"q":"Allow adolescents in each other’s rooms unless?","a":"Contagious, immunosuppressed, or fresh post-op."},{"q":"If WBC low, precautions?","a":"Strict handwashing, BID antimicrobial showers, avoid crowds, private room, no fresh flowers\/plants, low-bacteria diet (no raw fruits\/veggies, no undercooked meat), no sitting water, vitals q4h, daily WBC, and no reusable utensils."},{"q":"What 4 conditions are always unstable?","a":"Hemorrhage \/ Hypoglycemia \/ Fever >104°F \/ Pulselessness & breathlessness."},{"q":"If staff endangers patient physically\/psychologically you?","a":"Intervene and take over."}]

[{"q":"Teach Antabuse patients to avoid?","a":"Alcohol."},{"q":"Other things to avoid with Antabuse?","a":"Elixirs \/ Vanilla extract \/ Aftershave & perfumes \/ Alcohol hand sanitizer \/ Insect repellent \/ Mouthwash \/ Vinaigrette"},{"q":"“Supra” means?","a":"Above."},{"q":"Sick diabetic teaching?","a":"Take insulin \/ Sip fluids \/ Stay active."},{"q":"Children under 4 should not have?","a":"Small toys."},{"q":"If a child has O2, what toys are contraindicated?","a":"Metal toys."},{"q":"Best toy for a 0–6 month old?","a":"Musical mobile (remove at 6 months or if the child can sit)."},{"q":"2nd best toy for a 0–6 month old?","a":"Anything soft and large."},{"q":"Best toy for a 6–9 month old?","a":"Cover\/uncover toys (peek-a-boo)."},{"q":"2nd best toy for a 6–9 month old?","a":"Anything large they can't swallow."},{"q":"Best toy for a 9–12 month old?","a":"Talking toys."},{"q":"2nd best toy for a 9–12 month old?","a":"Purposeful activities (rolling ball back and forth)."},{"q":"5 words to avoid in toy questions under 9 months?","a":"Build, make, construct, sort, stack."},{"q":"Best toy for a toddler (1–3 yrs)?","a":"Push\/pull toys."},{"q":"What should you work on with a toddler?","a":"Gross motor skills."},{"q":"Toddler play is characterized by?","a":"Parallel play."},{"q":"What 2 things to work on with preschooler (3–6 yrs)?","a":"Fine motor (fingers), balance (dance, gymnastics)."},{"q":"What sort of play do preschoolers prefer?","a":"Pretend play."},{"q":"Preschooler play is characterized by?","a":"Cooperative play."},{"q":"School age (7–11 yrs) play is characterized by 3 C's?","a":"Creative (blank paper, no coloring book), collecting, competitive."},{"q":"Naegele’s rule for due date?","a":"LMP + 7 days – 3 months."},{"q":"Normal pregnancy weight gain?","a":"28 ± 3 lb."},{"q":"1st trimester weight gain?","a":"1 lb\/month."},{"q":"2nd\/3rd trimester weight gain?","a":"1 lb\/week."},{"q":"Fundus palpable at week?","a":"12."},{"q":"Fundus at umbilicus at week?","a":"20–22."},{"q":"If fundus not above umbilicus, baby not?","a":"Viable."},{"q":"Positive signs of pregnancy?","a":"Fetal skeleton (X-ray) \/ Fetal presence (US) \/ FHR auscultation \/ Examiner palpates fetal movement."},{"q":"Probable\/presumptive pregnancy signs?","a":"Urine & blood tests."},{"q":"Chadwick’s sign?","a":"Cervical cyanosis."},{"q":"Goodell’s sign?","a":"Cervical softening."},{"q":"Hegar’s sign?","a":"Uterine softening."},{"q":"Prenatal visit frequency (monthly)?","a":"Until 28 weeks."},{"q":"Visit frequency every 2 weeks?","a":"28–36 weeks."},{"q":"Visit frequency weekly?","a":"36–42 weeks."},{"q":"Is mild anemia in pregnancy normal?","a":"Yes."},{"q":"Pregnant women should void how often (pregnancy–6 weeks PP)?","a":"q2h."},{"q":"Teaching for Baclofen\/Flexeril?","a":"No driving or operating machinery \/ No alcohol \/ Do not care for children under 12 years."},{"q":"Mnemonic for Baclofen?","a":"\"On Baclofen you're back loafin’.\""},{"q":"Nursing teaching in sensorimotor stage?","a":"Teach while doing it \/ What you are doing \/ Use verbal teaching."},{"q":"Nursing teaching in pre-operational stage?","a":"Teach day-of \/ What you will do \/ Use play."},{"q":"Nursing teaching in concrete operational stage?","a":"Teach ahead of time \/ What you will do \/ Use visuals, audio, age-appropriate reading."}]

[{"q":"Biggest problem in abuse?","a":"Denial (applies to all abuse)."},{"q":"Treat denial by?","a":"Confrontation."},{"q":"How to confront?","a":"Point out the difference between words and actions."},{"q":"Only time to support denial?","a":"Loss & Grief."},{"q":"Dependency is?","a":"Abuser gets significant other to make decisions\/do things."},{"q":"Codependency is?","a":"Significant other gains self-esteem from helping the abuser."},{"q":"Treat dependency\/codependency?","a":"Set limits, enforce, and build the significant other’s self-esteem."},{"q":"Manipulation is?","a":"Abuser gets significant other to do harmful things for them."},{"q":"Treat manipulation?","a":"Set limits, enforce."},{"q":"Why is manipulation easier to treat?","a":"People hate being manipulated."},{"q":"Are AWS patients dangerous?","a":"No."},{"q":"Are DT patients dangerous?","a":"Yes."},{"q":"Delusion is?","a":"False fixed belief (no sensory)."},{"q":"Types of delusions?","a":"Paranoid \/ Grandiose \/ Somatic."},{"q":"Paranoid delusion?","a":"Others are out to harm you."},{"q":"Grandiose delusion?","a":"Superior identity (God, Pope)."},{"q":"Somatic delusion?","a":"False belief about the body (e.g. X-ray vision)."},{"q":"Types of hallucinations?","a":"Auditory \/ Visual \/ Tactile \/ Olfactory \/ Gustatory."},{"q":"Illusion is?","a":"Misinterpretation of reality (sensory)."},{"q":"Difference hallucination vs illusion?","a":"Illusion has a referent from reality."},{"q":"Functional psychosis types?","a":"Schizophrenia \/ Schizoaffective \/ Major depression \/ Mania."},{"q":"Manage functional psychosis delusion\/illusion?","a":"Acknowledge feelings → Present reality → Set limits → Enforce."},{"q":"Psychosis of dementia examples?","a":"Alzheimer’s \/ Dementia \/ Organic brain syndrome \/ Wernicke’s \/ Senility."},{"q":"Manage dementia psychosis?","a":"Acknowledge & redirect."},{"q":"Flight of ideas?","a":"Rapid topic change (word association)."},{"q":"Word salad?","a":"Random unrelated words."},{"q":"Neologism?","a":"New made-up words."},{"q":"Narrowed self-concept?","a":"Refusal to leave\/dress (don’t force)."},{"q":"Ideas of reference?","a":"Think everything is about them."},{"q":"Nevus\/Nevi is?","a":"Birthmark."},{"q":"Piaget stage 0–2 years?","a":"Sensorimotor."},{"q":"Piaget stage 3–6 years?","a":"Pre-operational."},{"q":"Piaget stage 7–11 years?","a":"Concrete operational."},{"q":"Piaget stage 12–15 years?","a":"Formal operational."},{"q":"Sensorimotor stage is characterized by?","a":"Present-oriented, focused on what they sense\/do now."},{"q":"Pre-operational stage is characterized by?","a":"Fantasy-oriented, illogical, no rules."},{"q":"Concrete operational stage is characterized by?","a":"Rule-oriented, cannot abstract."},{"q":"At what Piaget stage can you teach skills (e.g., insulin draw-up)?","a":"Concrete operational."},{"q":"Formal operational stage can be taught like?","a":"An adult."},{"q":"For Peds, when in doubt call it?","a":"Normal."},{"q":"For Peds, when in doubt pick?","a":"The older child."},{"q":"For Peds, when in doubt pick the?","a":"Easier task."},{"q":"Empathy questions have what?","a":"Quote in question + quote in answer."},{"q":"In Psych empathy questions, choose what?","a":"Feelings (not words)."}]

Basic Care And Comfort Flashcards

[{"q":"N\/I for DT?","a":"Private room near nurses \/ NPO → clear liquids \/ Strict bed rest \/ Restraints \/ Tranquilizer \/ Multivitamin (B1) \/ Antihypertensive"},{"q":"N\/I for AWS?","a":"Semi-private \/ Regular diet \/ Ad-lib activity \/ No restraints \/ Tranquilizer \/ Multivitamin (B1) \/ Antihypertensive"},{"q":"2-point restraint is?","a":"One arm + opposite leg."},{"q":"N\/I for restraints?","a":"Check every 15 minutes, rotate every 2 hours."},{"q":"Apical chest tube placed?","a":"High (air)."},{"q":"Basilar chest tube placed?","a":"Low (blood)."},{"q":"Post-surgery chest tube assumption?","a":"Unilateral pneumohemothorax."},{"q":"Pneumonectomy chest tube?","a":"No."},{"q":"Water seal breaks steps?","a":"Clamp → Cut → Submerge in NS → Unclamp."},{"q":"Best thing (not first) if seal breaks?","a":"Submerge in NS."},{"q":"Chest tube comes out steps?","a":"Hand cover → Vaseline gauze → Sterile dressing → Tape 3 sides."},{"q":"Clamp chest tube max time?","a":"15 seconds (no order)."},{"q":"Use what to clamp chest tube?","a":"Rubber-tipped double clamps."},{"q":"1 fingerwidth = ?","a":"1 cm."},{"q":"Proper crutch elbow flexion?","a":"30°."},{"q":"Crutches below armpit?","a":"2–3 fingerwidths."},{"q":"2-point gait?","a":"One crutch + opposite foot → other crutch + other foot."},{"q":"3-point gait?","a":"Both crutches + bad leg → good leg."},{"q":"4-point gait?","a":"One crutch → opposite foot → other crutch → other foot."},{"q":"Swing-through gait?","a":"For 2 braced legs: move crutches, then hop."},{"q":"Even-numbered gaits used when?","a":"Bilateral weakness."},{"q":"2-pt gait is for?","a":"Mild bilateral problem."},{"q":"4-pt gait is for?","a":"Severe bilateral problem."},{"q":"Odd-numbered gait used when?","a":"Unilateral problem."},{"q":"Stairs with crutches rule?","a":"UP with GOOD, DOWN with BAD."},{"q":"Crutches move with?","a":"Bad leg."},{"q":"Cane held on?","a":"Strong side."},{"q":"Cane advances with?","a":"Weak side (for wide base)."},{"q":"Walker use?","a":"Pick up → set down → walk to it."},{"q":"Calories\/day Type II?","a":"1200–1800."},{"q":"Feedings\/day Type II?","a":"6."},{"q":"Tx hypoglycemia conscious?","a":"Rapid carb or carb + protein\/starch."},{"q":"Tx hypoglycemia unconscious?","a":"Glucagon IM or Dextrose IV."},{"q":"Rapid carb examples?","a":"Juice, candy, icing, honey, syrup."},{"q":"HHNK Tx?","a":"Rehydrate (no insulin)."},{"q":"Hiatal hernia Tx?","a":"High Fowler’s \/ increase fluids \/ increase carbs."},{"q":"Dumping syndrome Tx?","a":"Side-lying \/ decrease fluids with meals \/ decrease carbs (increase protein)."},{"q":"Pre-op thoracic laminectomy assessment?","a":"1. Cough \/ 2. Bowel sounds."},{"q":"Pre-op lumbar laminectomy assessment?","a":"1. Voiding \/ 2. Leg motor-sensory."},{"q":"#1 post-op answer on NCLEX?","a":"Log roll patient."},{"q":"Post-op laminectomy activity restrictions?","a":"No dangling \/ May stand, walk, lie \/ Don’t sit >30 min."},{"q":"Which laminectomy incision site is more painful?","a":"Hip site."},{"q":"Default restriction timeframe if not given?","a":"6 weeks."},{"q":"Laminectomy discharge teaching (temporary)?","a":"No sitting >30 min \/ Lie flat & log roll \/ No driving \/ No lifting >5 lb (for 6 weeks)."},{"q":"Permanent restrictions after laminectomy?","a":"No lifting by bending at the waist \/ No jerky activities (rides, horses) \/ Cervical: no lifting above head."},{"q":"Treat morning sickness (1st trimester)?","a":"Dry carbohydrates."},{"q":"Treat urinary incontinence (1st & 3rd)?","a":"Void q2h."},{"q":"Treat dyspnea (2nd & 3rd)?","a":"Tripod position."},{"q":"Treat back pain (2nd & 3rd)?","a":"Pelvic tilt exercises."},{"q":"Most valid sign of labor?","a":"Regular contractions."},{"q":"Dilation is?","a":"Cervical opening (0–10 cm)."},{"q":"Effacement is?","a":"Cervical thinning (0–100%)."},{"q":"Station is?","a":"Fetal part relation to ischial spines (+ = below, good; – = above, bad)."},{"q":"Engagement is?","a":"Station 0."},{"q":"Lie is?","a":"Relation of baby’s spine to mother’s spine (parallel = good, transverse = bad)."},{"q":"Presentation is?","a":"Part of fetus entering birth canal first."},{"q":"1st stage of labor is?","a":"Labor."},{"q":"2nd stage of labor is?","a":"Delivery of baby."},{"q":"3rd stage of labor is?","a":"Delivery of placenta."},{"q":"4th stage of labor is?","a":"Recovery (first 2 hours after placenta)."},{"q":"How do you treat painful back labor?","a":"Knee to chest position \/ Use your fist and press on the patient's sacrum."},{"q":"How do you treat prolapsed cord?","a":"Push head back in \/ Position in knee-chest position or Trendelenburg."},{"q":"The second stage of labor and delivery is all about?","a":"Order."},{"q":"What do you do in order for the second stage?","a":"Deliver the head \/ Suction mouth then nose \/ Check for nuchal cord \/ Deliver shoulders and body \/ Apply ID band."},{"q":"During the third stage of labor and delivery you do what two things?","a":"Ensure the placenta is intact (if not → hemorrhage first, infection second) \/ Check for three vessels (2 arteries, 1 vein = AVA)."},{"q":"What are the 4 things you do 4 times an hour during the 4th stage?","a":"VS – check for shock \/ Fundus – if boggy, massage; if displaced, void\/cath \/ Perineal pad – excessive lochia = saturated pad in 15 min (911) \/ Roll patient to check for bleeding."},{"q":"The uterus should be like what after delivery?","a":"Firm (not boggy) \/ Fundal height = days postpartum \/ Midline (if not, catheterize)."},{"q":"Lochia color rubra?","a":"Red (rub it red)."},{"q":"Lochia color serosa?","a":"Pink (rose pink)."},{"q":"Lochia color alba?","a":"White (albino white)."},{"q":"Moderate lochia is?","a":"4–6 inches on pad in 1 hour."},{"q":"Excessive lochia is?","a":"Saturated pad in 15 minutes."},{"q":"Extremity assessment postpartum should include?","a":"Pulses \/ Edema \/ Signs of thrombophlebitis (bilateral calf circumference – unequal calves suggest DVT)."},{"q":"Postpartum assessment should include what?","a":"Uterus \/ Lochia \/ Extremities."},{"q":"Milia is?","a":"Distended sebaceous glands appearing as tiny white spots on the baby's face."},{"q":"Epstein's pearls are?","a":"Small white epithelial cysts on the baby's gums."},{"q":"Mongolian spots are?","a":"Bluish-black macules on the buttocks\/thighs of darker-skinned neonates."},{"q":"Erythema toxicum neonatorum is?","a":"Benign red papular rash on the torso, disappears after a few days."},{"q":"Hemangioma is?","a":"Benign tumor of capillaries."},{"q":"Vernix caseosa is?","a":"Whitish, cheese-like substance covering the unborn baby's skin."},{"q":"Acrocyanosis is?","a":"Normal cyanosis of the baby's hands\/feet in the first 7–10 days."},{"q":"For IM injection, needle must be?","a":"Gauge 21 (ends with 1), length 1 inch."},{"q":"For SubQ injection, needle must be?","a":"Gauge 25 (ends with 5), length 5\/8 inch."},{"q":"ACE of spades answer for Nutrition?","a":"Choose chicken or fish."},{"q":"Never choose what for children’s food?","a":"Casserole."},{"q":"For a toddler, pick what kind of food?","a":"Finger food."},{"q":"For a preschooler, ____ meals\/day is OK?","a":"1 meal\/day."},{"q":"First thing you do in Med-Surg?","a":"Airway."},{"q":"In Peds always give?","a":"More time."}]

Pharmacological And Parenteral Therapies Flashcards

[{"q":"If my pH is up my potassium (K+) is?","a":"Down"},{"q":"If my pH is down my potassium (K+) is?","a":"Up"},{"q":"Vitamin B1 helps breakdown?","a":"Alcohol."},{"q":"Antabuse onset & duration?","a":"2 weeks."},{"q":"5 uppers?","a":"Caffeine \/ Cocaine \/ Methamphetamines \/ PCP-LSD \/ ADHD meds"},{"q":"Downers are?","a":"Everything else."},{"q":"Aminoglycosides end in?","a":"“-mycin” (e.g. vancomycin)."},{"q":"If it has \"thro\" in it?","a":"Throw it out (not aminoglycoside)."},{"q":"Toxic effects of aminoglycosides?","a":"Ototoxicity \/ Nephrotoxicity \/ CN VIII damage (hearing, balance)."},{"q":"Monitor with aminoglycosides?","a":"Hearing, balance, tinnitus, creatinine."},{"q":"Frequency aminoglycosides?","a":"every 8 hours."},{"q":"Route aminoglycosides?","a":"IM or IV."},{"q":"Aminoglycosides PO for?","a":"Hepatic encephalopathy \/ Pre-op bowel surgery."},{"q":"Who can sterilize bowel?","a":"“Neo”, “Kan”."},{"q":"Trough level drawn?","a":"30 minutes before the next dose."},{"q":"Peak SL?","a":"5–10 minutes after dissolved."},{"q":"Peak IV?","a":"15–30 minutes after infusion."},{"q":"Peak IM?","a":"30–60 minutes after injection."},{"q":"Peak\/trough depend on?","a":"Route (not drug)."},{"q":"CCBs are like?","a":"Valium for the heart."},{"q":"CCB treat (6 A’s)?","a":"Antihypertensive \/ Anti-anginal \/ Anti-atrial arrhythmia \/ SVT"},{"q":"CCB side effects (2 H’s)?","a":"Headache, hypotension."},{"q":"90% of CCB end in?","a":"“-dipine” or “-zem”."},{"q":"Hold CCB if?","a":"SBP ≤100."},{"q":"Treat PVC?","a":"Lidocaine \/ Amiodarone."},{"q":"Treat V-Tach?","a":"Lidocaine \/ Amiodarone."},{"q":"Treat SV arrhythmias?","a":"Adenosine \/ Beta-blockers \/ CCB \/ Digoxin."},{"q":"Treat V-Fib?","a":"Defibrillate."},{"q":"Treat Asystole?","a":"Epinephrine + Atropine (reverse order)."},{"q":"Treat A-Fib first?","a":"Heparin (then ABCD medications)."},{"q":"Type I diabetes?","a":"Insulin dependent \/ Juvenile \/ Ketosis prone."},{"q":"Type II diabetes?","a":"Non-insulin \/ Adult \/ Non-ketosis prone."},{"q":"Treat Type I (DIE)?","a":"Diet (3rd) \/ Insulin (1st) \/ Exercise (2nd)."},{"q":"Treat Type II (DOA)?","a":"Diet (1st) \/ Oral meds (3rd) \/ Activity (2nd)."},{"q":"2 drugs ↑ blood sugar?","a":"Glucagon, Epinephrine."},{"q":"More exercise → need?","a":"Less insulin."},{"q":"Less exercise → need?","a":"More insulin."},{"q":"4 insulin types?","a":"Regular \/ NPH \/ Humalog \/ Lantus."},{"q":"Regular insulin onset?","a":"1 hour."},{"q":"Regular insulin peak?","a":"2 hours."},{"q":"Regular insulin duration?","a":"4 hours."},{"q":"NPH insulin onset?","a":"6 hours."},{"q":"NPH insulin peak?","a":"8–10 hours."},{"q":"NPH insulin duration?","a":"12 hours."},{"q":"Humalog onset?","a":"15 minutes."},{"q":"Humalog peak?","a":"30 minutes."},{"q":"Humalog duration?","a":"3 hours."},{"q":"Only safe insulin at bedtime?","a":"Lantus (Glargine)."},{"q":"Fastest insulin?","a":"Humalog."},{"q":"DKA Tx?","a":"IV fluids (fast) + Regular insulin."},{"q":"Lithium therapeutic?","a":"0.6–1.2."},{"q":"Lithium toxic?","a":">2.0."},{"q":"Digoxin therapeutic?","a":"1–2."},{"q":"Digoxin toxic?","a":">2.0."},{"q":"Aminophylline therapeutic?","a":"10–20."},{"q":"Aminophylline toxic?","a":">20."},{"q":"Dilantin therapeutic?","a":"10–20."},{"q":"Dilantin toxic?","a":">20."},{"q":"Dilantin is?","a":"Anticonvulsant."},{"q":"Aminophylline is?","a":"Airway antispasmodic."},{"q":"Digoxin is?","a":"CHF, atrial arrhythmia."},{"q":"Lithium is?","a":"Anti-mania."},{"q":"Never push what electrolyte?","a":"K+."},{"q":"To decrease K+ quickly?","a":"D5W + R insulin (buys time)."},{"q":"To remove K+?","a":"Kayexalate (slow)."},{"q":"Max K+ per IV liter?","a":"40 mEq."},{"q":"Graves Tx options?","a":"Radioiodine \/ PTU \/ surgery."},{"q":"Thyroidectomy types?","a":"Total \/ subtotal."},{"q":"Total Thyroidectomy needs?","a":"Lifelong hormone replacement."},{"q":"Thyroid storm Tx?","a":"O2, cooling (ice packs)."},{"q":"Tx hypothyroidism?","a":"Hormone replacement."},{"q":"Hypothyroid NPO pre-op → still give?","a":"Thyroid meds."},{"q":"Addison’s Tx?","a":"Steroids (“-sone”)."},{"q":"Cushing’s Tx?","a":"Adrenalectomy."},{"q":"INR monitors what?","a":"Coumadin\/Warfarin therapy."},{"q":"INR therapeutic level?","a":"2–3."},{"q":"If INR >4 you?","a":"Hold Warfarin, assess for bleeding, prepare Vitamin K, and call the doctor."},{"q":"If potassium &lt;3.5 you?","a":"Assess heart, prepare potassium, and call the doctor."},{"q":"If potassium 5.4–5.9 you?","a":"Hold potassium (IV), assess heart, prepare D5W with insulin, and call the doctor."},{"q":"If potassium >6 you?","a":"Assess; if symptomatic, call Rapid Response; if not, follow the same protocol as for 5.4–5.9."},{"q":"If pH &lt;6 you?","a":"Assess vitals and call the doctor ASAP."},{"q":"If Hgb &lt;8 you?","a":"Assess bleeding, prepare blood, and call the doctor."},{"q":"If CO2 in 50’s?","a":"Assess respirations, encourage pursed-lip breathing, prolong exhalation; if not working, call the doctor."},{"q":"If CO2 in 60’s (respiratory failure)?","a":"Assess, encourage pursed-lip breathing, prepare for intubation, and call RT and the doctor."},{"q":"If PO2 70–77?","a":"Assess and give O2."},{"q":"If PO2 &lt;60?","a":"Assess, give O2, prepare for intubation, and call RT and the doctor."},{"q":"If O2 sat &lt;93?","a":"Assess and give O2."},{"q":"If platelets &lt;90,000?","a":"Check for bleeding and implement bleeding precautions."},{"q":"If platelets &lt;40,000?","a":"Prepare for transfusion and call the doctor."},{"q":"Do not give what type of pain medication to a woman in labor if the medication is likely to peak when the baby is born?","a":"Systemic medications (IM, IV, Oral)."},{"q":"Tocolytics do what to labor?","a":"Stop contractions."},{"q":"What are the two tocolytics?","a":"Terbutaline (Brethine) \/ Nifedipine (Procardia)."},{"q":"What are the two oxytocics?","a":"Pitocin (Oxytocin) \/ Cervidil (Prostaglandin)."},{"q":"Side effects of Pitocin?","a":"Hyperstimulation (>90s, &lt;2min apart). If FHR &lt;110, stop it. If FHR is normal, slow it. Also used for postpartum hemorrhage."},{"q":"Side effects of Cervidil?","a":"Effacement leading to contractions."},{"q":"What are the two neonatal lung medications?","a":"Betamethasone \/ Survanta."},{"q":"How do you give Betamethasone?","a":"To the mother \/ Before delivery \/ IM."},{"q":"Side effect of Betamethasone?","a":"Increases maternal glucose (monitor blood sugar)."},{"q":"How do you give Survanta?","a":"To the baby \/ After delivery \/ Inhalation."},{"q":"Humulin 70\/30 is what?","a":"70% N insulin + 30% R insulin."},{"q":"When drawing up insulins it's?","a":"RN → Regular first, then N."},{"q":"If pressurizing vials for insulin draw-up you?","a":"Insert air in NR order, but draw up in RN order."},{"q":"What routes can you give Heparin?","a":"IV or SubQ."},{"q":"How quickly does Heparin work?","a":"Immediately."},{"q":"What do you monitor with Heparin?","a":"PTT."},{"q":"Antidote for Heparin?","a":"Protamine sulfate."},{"q":"Heparin is what pregnancy class?","a":"Class C."},{"q":"How is Coumadin given?","a":"Oral only."},{"q":"How long for Coumadin to work?","a":"3–5 days."},{"q":"What do you monitor with Coumadin?","a":"PT-INR."},{"q":"Antidote for Coumadin?","a":"Vitamin K."},{"q":"Coumadin is what pregnancy class?","a":"Class X."},{"q":"All K+ wasting diuretics end in?","a":"\"-x\" (if it ends in X, it wastes K+; others are K+ sparing)."},{"q":"What is Baclofen (Lioresal, Flexeril)?","a":"Muscle relaxant."},{"q":"Side effects of Baclofen\/Flexeril?","a":"Drowsiness and muscle weakness."},{"q":"If you know what a drug does, choose side effect in the ____ system?","a":"Same body system."},{"q":"If you don’t know the drug, and it’s PO, choose what side effect?","a":"GI side effect."}]

Physiological Adaptation Flashcards

[{"q":"Why does the MI patient’s white count go up?","a":"Inflammatory response."},{"q":"Why does their temperature go up?","a":"Inflammatory response."},{"q":"If a MI patient performs the Valsalva, which nerve can be stimulated?","a":"Vagus"},{"q":"If you stimulate the vagus nerve long enough, what is going to happen to the heart rate?","a":"Decrease"},{"q":"What happens to the size of the complex when the vagus nerve is stimulated?","a":"Widens; could lead to asystole."},{"q":"What is your natural pacemaker?","a":"SA Node"},{"q":"Can the electrical part of your heart be working and the mechanical not?","a":"Yes, but not for long."},{"q":"What are the major symptoms of left-sided failure and explain why?","a":"Dyspnea, cough, pulmonary congestion, blood-tinged sputum; restlessness, tachycardia; blood backs up into the lungs."},{"q":"Why does a patient in left-sided failure have restlessness and tachycardia?","a":"Because they are hypoxic."},{"q":"Why does a patient with left-sided failure have nocturnal dyspnea?","a":"When they lie down, more blood can go back up to the heart and lungs."},{"q":"Why does the patient with left-sided failure basically have pulmonary symptoms?","a":"Blood is backing up in the lungs."},{"q":"What are the major symptoms of right-sided failure?","a":"Enlarged organs, edema, weight gain, distended neck veins, ascites; blood backs up into the venous system, engorging everything."},{"q":"When a patient is in right-sided failure, is the blood backing up into the arterial system or the venous system?","a":"Venous"},{"q":"What does a Swan Ganz catheter measure inside the heart?","a":"Pressures"},{"q":"If volume is building up in the right side of the heart, what measurements (in regard to the Swan Ganz catheter) are going to be affected and why?","a":"Any pressure reading on the right side of the heart. More volume = more pressure."},{"q":"What is the wedge pressure?","a":"Indirect reading of left side of heart (left-sided pressures)."},{"q":"Why does the patient in heart failure develop cardiomegaly?","a":"Because the heart muscle is pumping so hard, it hypertrophies."},{"q":"When you slow down someone’s heart rate, you give the ventricles more time to do what?","a":"Fill with blood."},{"q":"When your heart squeezes down with more force and strength and on more blood, what is going to happen to cardiac output? What is going to happen to kidney perfusion?","a":"Cardiac output increases. Kidney perfusion is going to also increase."},{"q":"Anytime you increase kidney perfusion, what is probably going to happen to urine output?","a":"Urine output will increase."},{"q":"When you increase a patient’s cardiac output, what is actually happening inside the heart?","a":"More blood is being ejected from the left ventricle to the systemic circulation."},{"q":"When you increase a patient’s cardiac output, should they appear better oxygenated or less oxygenated?","a":"Better oxygenated"},{"q":"When you start giving somebody Dig, we expect their cardiac output to increase; therefore, what should happen to their: a. level of consciousness? b. lung sounds? c. urine output? d. skin? e. peripheral pulses? f. blood pressure?","a":"A. increase B. lungs should be dry C. urine output will increase D. skin should feel warmer E. should improve F. should go up"},{"q":"What is pulmonary edema?","a":"The sudden onset of fluid accumulation in the lungs leading to severe hypoxia."},{"q":"How does a patient develop pulmonary edema?","a":"The left ventricle is failing, so the blood is not being pumped forward into the systemic circulation; therefore, the blood backs up into the lungs."},{"q":"What are the major S\/S of pulmonary edema?","a":"Sudden onset, breathlessness, hypoxia, pink frothy sputum, tachycardia."},{"q":"When does pulmonary edema usually occur and why?","a":"At night – because when lying down preload increases, so we are dumping more blood into the right side of the heart and into the lungs."},{"q":"What is intermittent claudication?","a":"The pain that develops as a result of inadequate oxygenation in an extremity associated with arterial problems."},{"q":"Explain how intermittent claudication develops.","a":"When oxygenated blood cannot get to an area, the patient is going to switch in that extremity from aerobic metabolism to anaerobic metabolism. The product of anaerobic metabolism is a buildup of lactic acid. The lactic acid is what promotes the pain."},{"q":"When a patient has an arterial problem, that means the oxygen\/blood are having a hard time getting to the tissue, so therefore different S\/S develop. Explain the S\/S.","a":"Coldness, numbness, decreased pulses, atrophy of the extremity occur because oxygenated blood is not getting to the extremity. You may even see ischemia and gangrene."},{"q":"Could a patient with an arterial problem develop ischemia and necrosis in the affected extremity? Explain.","a":"Yes - Because oxygenated blood is not getting there."},{"q":"Whether you are studying Buerger’s disease or Raynaud’s disease, what is the key word that I told you to remember?","a":"Vasoconstriction"},{"q":"In Buerger’s disease and Raynaud’s disease, there is significant vasoconstriction. What types of things bring on the vasoconstriction in Buerger’s and Raynaud’s disease?","a":"Emotional upset, smoking, coldness"},{"q":"When a patient has a venous disorder, are they having trouble with oxygenation of the affected extremity?","a":"No"},{"q":"Explain or list some different venous problems a patient can have.","a":"Phlebitis, thrombophlebitis, deep vein thrombosis"},{"q":"Explain the pathophysiology behind a venous disorder.","a":"The blood can get to the area. The problem is once it gets there, it cannot get away. So you get stagnation of blood flow in one area."},{"q":"What is the pleural space?","a":"It is the potential space between the visceral and parietal pleura."},{"q":"When the pleural space fills with fluid, what happens to the lung?","a":"Collapse."},{"q":"When a patient has a pulmonary embolus, why does their pulse go up?","a":"Hypoxia."},{"q":"When a patient has a pulmonary embolus, describe their chest pain.","a":"Sharp, stabbing."},{"q":"When a patient has a pulmonary embolus, the blood pressure is going to go up in their lungs. What effect will that have on the right side of the heart?","a":"It will increase the workload on the right side of the heart."},{"q":"With a pulmonary embolus, the patient will have fever and their WBC count will go up. Why?","a":"Inflammation."},{"q":"Why does the PO2 go down with a pulmonary embolus?","a":"Hypoxia."},{"q":"With a mediastinal shift, what will happen to the trachea?","a":"Tracheal deviation."},{"q":"Why does the patient with flail chest develop paradoxical chest wall movement?","a":"Because of the broken ribs."},{"q":"What is the definition of cardiac tamponade?","a":"When fluid is accumulating in the pericardial sac."},{"q":"With cardiac tamponade, the blood pressure goes down and the CVP goes up. Explain why.","a":"Blood pressure goes down because you are hemorrhaging. CVP goes up because as the sac fills around the heart, this puts pressure on the heart, squeezing the heart. Therefore, the pressure inside the heart goes up, making the CVP go up."},{"q":"Why do the heart sounds sound muffled with cardiac tamponade?","a":"Because of all the blood around the heart."},{"q":"With cardiac tamponade, why does a patient go into shock?","a":"Because they are hemorrhaging."},{"q":"What are the major side effects of Rifampin?","a":"Fever; body fluids turn red or orange."},{"q":"When a patient is on streptomycin, what are two possible side effects?","a":"Ototoxicity and nephrotoxicity."},{"q":"What is the major cause of glomerulonephritis?","a":"Streptococcus."},{"q":"When a patient has glomerulonephritis, why do they develop malaise and headache?","a":"Build-up of toxins."},{"q":"When a patient has glomerulonephritis, why does their urine output go down?","a":"Because the kidneys are failing."},{"q":"When a patient has glomerulonephritis, why does their BUN and creatinine go up?","a":"They are unable to excrete the urea and creatinine through the kidneys."},{"q":"When a patient has glomerulonephritis, why do they get protein in the urine?","a":"Because the glomerulus has holes in it, so protein can leak out."},{"q":"In glomerulonephritis, why does the blood pressure go up?","a":"Retaining fluid."},{"q":"And what will happen to the urine specific gravity?","a":"Increases."},{"q":"In glomerulonephritis, why are the patient’s red blood cells affected?","a":"Erythropoietin can be altered."},{"q":"With any type of kidney disease, it is not uncommon for the BUN to be elevated; therefore, why do we limit the protein in the diet?","a":"Because protein increases your urea level in your blood."},{"q":"If you gave a patient with any type of renal disease protein in their diet, what will happen to the BUN?","a":"Increase."},{"q":"When a patient is in the acute stages of glomerulonephritis, do you think their serum potassium level will be increased or decreased? What about the magnesium? What about the phosphorus level?","a":"Potassium and magnesium will be increased in the blood, as will the phosphorus because the patient is unable to excrete the electrolytes as they should."},{"q":"When a patient has nephrotic syndrome, what is the major element that is leaking out into their urine?","a":"Protein."},{"q":"If a patient does not have protein or albumin in their vascular space (blood), what is going to happen to all the fluid that is supposed to stay in their vascular system?","a":"It goes out into the interstitial space tissue."},{"q":"How does this affect the vascular space?","a":"Decreases the volume in the vascular space."},{"q":"When a patient has nephrotic syndrome, they develop total body edema. What is the proper term for total body edema?","a":"Anasarca."},{"q":"How can bradycardia cause renal failure?","a":"Decreased perfusion."},{"q":"How can hypovolemia cause renal failure?","a":"Decreased perfusion."},{"q":"How can shock cause renal failure?","a":"Decreased perfusion."},{"q":"How can decreased cardiac output cause renal failure?","a":"Decreased perfusion."},{"q":"How can glomerulonephritis, nephrotic syndrome, or diabetes cause renal failure?","a":"Vascular damage."},{"q":"How can a kidney stone cause renal failure?","a":"Urine can be trapped in the kidney."},{"q":"How can ureteral swelling cause renal failure?","a":"Urine can be trapped in the kidney."},{"q":"How can a tumor or an enlarged prostate cause renal failure?","a":"Urine can be trapped in the kidney."},{"q":"When a patient is in renal failure, why does their BUN and creatinine go up?","a":"Because the patient is unable to excrete urea and creatinine."},{"q":"What happens to the specific gravity in renal failure?","a":"It usually goes up, but it can also become fixed. When it becomes fixed, this means that the patient’s urine specific gravity does not respond to high volumes of fluids or restriction of fluids; it stays the same."},{"q":"Why can a renal failure patient become anemic?","a":"Because erythropoietin can be altered."},{"q":"Why does the renal failure patient’s blood pressure go up?","a":"Because they are retaining fluid."},{"q":"Why is the renal failure patient at risk for congestive heart failure?","a":"Because they are retaining fluid."},{"q":"Why does the renal failure patient develop anorexia, nausea, and vomiting?","a":"Because of the build-up of toxins."},{"q":"Why does the renal failure patient develop an itching frost?","a":"Urea builds up in the blood and eventually accumulates on the skin."},{"q":"Why does a renal failure patient have to worry about osteoporosis?","a":"Because the renal failure patient retains phosphorus; therefore, that makes them excrete their calcium, which lowers the serum calcium, and then the patient starts pulling calcium from the bone."},{"q":"There are two phases of renal failure. The first phase is an oliguric phase. If a patient is oliguric, what has happened to the urine output?","a":"Urine output has decreased."},{"q":"Why does the oliguric patient develop hyperkalemia?","a":"Unable to excrete potassium"},{"q":"The second phase of renal failure is called the diuretic phase. When a patient is diuresing, what has happened to their urine output?","a":"Increasing"},{"q":"If a patient goes into a fluid volume deficit, what will happen to their blood pressure?","a":"Decrease"},{"q":"What will happen to their heart rate? Explain why.","a":"Increase – trying to compensate for the decrease in volume."},{"q":"When a patient is diuresing, their serum potassium level goes down (hypokalemia). Explain why.","a":"Because potassium is being excreted through the kidneys."},{"q":"When a patient has CAPD, why do they have a constant sweet taste and why do they have anorexia?","a":"The dialysate that is used is of high glucose content."},{"q":"What are the major signs of kidney stones?","a":"Hematuria and pain"},{"q":"Why is the serum creatinine not affected by what we eat?","a":"Because creatinine is constantly produced in our bodies due to skeletal muscle breakdown."},{"q":"Is the BUN affected by what we eat?","a":"Yes"},{"q":"In sickle cell, what is happening to the red blood cells and why?","a":"The shape of the red blood cell is changing due to hypoxia."},{"q":"Are patients who have sickle cell hypoxic?","a":"Yes"},{"q":"Why do sickled cells become tangled so easily?","a":"Due to the shape, they start hanging together."},{"q":"Why is a sickle cell patient always anemic?","a":"Because their red blood cells sickle. So their red blood count decreases."},{"q":"Why does a sickle cell patient develop jaundice?","a":"Jaundice develops when the overabundance of sickle cells are fragile and rapidly destroyed in circulation, releasing the bilirubin."},{"q":"Why does a sickle cell patient develop heart problems?","a":"Since the patient is hypoxic, they stay tachycardic most of the time; therefore, this stresses the heart."},{"q":"Why does the sickle cell patient have to be on folic acid?","a":"To help them make red blood cells."},{"q":"What is anemia?","a":"A decrease in red blood cells."},{"q":"When you do not have enough red blood cells, the patient will be hypoxic. Why?","a":"There aren’t enough RBCs to carry the oxygen."},{"q":"How can hemorrhage cause anemia?","a":"Losing red blood cells."},{"q":"How can poor nutrition cause anemia?","a":"Not forming red blood cells."},{"q":"How can decreased erythropoietin cause anemia?","a":"Without erythropoietin, immature red blood cells cannot mature."},{"q":"When a patient is anemic, why does their heart beat fast (tachycardia)?","a":"Because they are hypoxic."},{"q":"When a patient has anemia, why do they have shortness of breath?","a":"Because they are hypoxic."},{"q":"When a patient is anemic, why do they have a pale conjunctiva?","a":"They do not have enough red blood cells."},{"q":"Why do anemic patients develop heart problems?","a":"The heart is always stressed due to chronic hypoxia."},{"q":"Why do anemic patients feel weak and tired?","a":"Hypoxia."},{"q":"Patients with iron-deficient anemia develop poor red blood cells (anemia) due to the fact that they do not have enough iron in their diet. What are some foods that are high in iron?","a":"Organ meat, egg yolk, seafood, enriched bread, whole wheat cereals, legumes, green leafy vegetables, dried fruit, sunflower seeds, molasses, almonds, pecans, cashews, apricots, broccoli, prunes, brussels sprouts, raisins, brewer’s yeast, wild rice, Swiss cheese, yogurt, wheat germ, and bananas."},{"q":"When a patient has had pernicious anemia, what vitamin are they deficit in?","a":"Vitamin B-12."},{"q":"After what surgery can a patient develop pernicious anemia? Explain why.","a":"Gastrectomy - Because they have lost their intrinsic factor. Without intrinsic factor, you cannot absorb oral B-12; therefore, you would not develop normal red blood cells."},{"q":"What are the two odd signs you get with pernicious anemia?","a":"Red swollen tongue and neurological changes."},{"q":"What is the major diagnostic test for pernicious anemia?","a":"Schilling's Test."},{"q":"Will the Schilling’s test tell you about any other type of anemia besides pernicious anemia?","a":"No."},{"q":"What is the first thing you need to think of when you think of leukemia?","a":"Large amounts of immature white blood cells."},{"q":"Why does the leukemic patient develop anemia?","a":"Because there are so many immature white cells, there’s no room for red blood cells."},{"q":"Why does the leukemic patient develop thrombocytopenia?","a":"There is no room for platelets."},{"q":"Why does the leukemia patient develop weakness and fatigue?","a":"Hypoxia."},{"q":"Why does the leukemia patient have S\/S such as bleeding, bruises, or petechiae?","a":"Decreased platelets."},{"q":"Hemophilia is an inherited disease. Does it affect males or females?","a":"Males."},{"q":"Hemophiliacs are sometimes called “free bleeders.” Explain the major symptoms a hemophiliac will have.","a":"Large spreading bruises. They may bleed into the joints or into the muscles of the GI tract."},{"q":"When a patient is having bleeding into the joints, what is the proper term for this?","a":"Hemarthrosis."},{"q":"What are some of the purposes of traction?","a":"To realign bones; to decrease muscle spasms and to immobilize."},{"q":"What is phantom pain?","a":"Pain that is experienced in the amputated extremity. The pain is real to the patient."},{"q":"Rheumatoid arthritis is an altered immune response. What are some S\/S of rheumatoid arthritis?","a":"Swollen joints, fatigued patients, increased white count, reddened fingers due to inflammation, morning stiffness (stiffness lasting longer than 30 minutes), and a low-grade temperature."},{"q":"With rheumatoid arthritis, what happens to the pain with stress?","a":"Increases"},{"q":"Is rheumatoid arthritis seen more in males or females?","a":"Females"},{"q":"List the S\/S separately and explain why the patient develops each symptom.","a":"All signs and symptoms are due to inflammation. Morning stiffness, motion pain, tenderness in at least one joint, swelling of at least one joint, symmetrical joint swelling"},{"q":"Why is it so important that the rheumatoid arthritis patient’s joints stay in proper position?","a":"Because the joints tend to contract with inflammation."},{"q":"What is the difference in rheumatoid arthritis and osteoarthritis?","a":"Rheumatoid arthritis is an immune response whereas osteoarthritis is a degenerative disorder."},{"q":"What is gout?","a":"When uric acid crystals accumulate in an area of little blood flow"},{"q":"What are the S\/S of gout?","a":"Pain, redness, inflammation"},{"q":"When a patient is having a cerebral angiography, it is not uncommon for them to complain of warmth in the face. Explain why.","a":"The dye causes a flushed feeling."},{"q":"What are some general symptoms of meningitis?","a":"Fever, chills, headache, vomiting, stiff neck (nuchal rigidity), photophobia, Kernig’s sign, Brudzinski’s sign because the meninges have been punctured into, so an infection could have been introduced."},{"q":"Explain S\/S of a basal skull fracture.","a":"Bleeding in the eyes, ears, nose, and throat."},{"q":"What is Battle’s sign?","a":"Bruising on the mastoid; indicates a basal skull fracture."},{"q":"What are raccoon eyes?","a":"Bruises around the eyes."},{"q":"Explain the S\/S of a concussion.","a":"May become unconscious for a couple of seconds or may just get dizzy for a couple of seconds or see spots."},{"q":"What happens to intracranial pressure (ICP) when the patient sits up and lies down?","a":"When the patient sits up, ICP goes down; when they lie down, ICP goes up."},{"q":"What is posturing?","a":"A sign of severe neurological damage. Be sure to look at a picture in your med-surg book."},{"q":"Explain the two different types of posturing.","a":"A. Decerebrate – when the spine is arched and you have plantar flexion (worst type). B. Decorticate – when arms are flexed inwardly to the core of the body. The legs are extended with plantar flexion."},{"q":"Why are osmotic diuretics used in the treatment of intracranial pressure? Explain exactly how they work.","a":"To pull fluid off the brain. Osmotic diuretics pull fluid off of the brain into the vascular system and the excess fluid is excreted through the kidneys."},{"q":"Why are patients with increased intracranial pressure given steroids?","a":"To decrease cerebral edema"},{"q":"How can hyperventilation decrease intracranial pressure?","a":"Hyperventilation causes cerebral vasoconstriction and decreases cerebral blood flow to decrease ICP."},{"q":"What would happen to the intracranial pressure if the temperature were to exceed?","a":"ICP would go up"},{"q":"What is the purpose of a barbiturate induced coma?","a":"To decrease cerebral metabolism, therefore decreasing ICP."},{"q":"Why is it so important to restrict the fluids in a head injured patient?","a":"Too many fluids will increase ICP."},{"q":"If a patient were to become bradycardic, what would happen to the cerebral perfusion? Explain why.","a":"Decrease because not as much blood would be pumped out by the left ventricle; therefore, not as much blood would make it to the brain."},{"q":"If a patient were to develop an increased blood pressure, what will happen to cardiac output? Explain how this would affect cerebral perfusion?","a":"The higher the blood pressure is, cardiac output goes down; therefore, cerebral perfusion would decrease."},{"q":"What is myasthenia gravis?","a":"Defect in impulse transmission."},{"q":"When a patient has impulse problems, what is going to happen to their muscle tone?","a":"Muscle tone decreases."},{"q":"Explain the S\/S of myasthenia and explain why the patient develops these symptoms.","a":"Extreme muscle weakness that increases with effort and eases with rest; there is symmetrical involvement, diplopia, ptosis, sleepy mask-like expression, dysphonia, chewing, and swallowing problems, and the diaphragm and respiratory muscles can be affected. All of these symptoms are due to a decrease in muscle tone."},{"q":"Why do we have to worry about the airway with myasthenia gravis?","a":"Because the respiratory muscles could become affected."},{"q":"Why do we have to worry about aspiration with the myasthenia gravis patient?","a":"Because the patient may not be able to swallow as well as they did before."},{"q":"If a patient with myasthenia gets too tired or takes an over-the-counter medicine, what could happen?","a":"These things could promote a crisis."},{"q":"What is the difference in the myasthenic crisis and a cholinergic crisis? How do you differentiate them?","a":"In the myasthenic crisis, the patient has not had enough medicine. In a cholinergic crisis, the patient has had too much medicine. To differentiate, you inject with Tensilon again. If the patient improves after the Tensilon injection, it is a myasthenic crisis. If the patient gets worse, it is a cholinergic crisis."},{"q":"When a patient is in a crisis with myasthenia, why would you prepare them for the ventilator?","a":"Because of the progressive decreased tone in the respiratory muscles."},{"q":"What would be a major sign of perforation post-gastroscopy?","a":"Pain"},{"q":"What are the two major functions of the pancreas?","a":"Endocrine - insulin; Exocrine – digestive enzymes"},{"q":"What is the major cause of pancreatitis?","a":"Gallbladder disease and alcoholism."},{"q":"How can gallbladder disease cause pancreatitis?","a":"A gallstone can block the pancreatic duct, trapping the enzymes inside the pancreas."},{"q":"List all of the symptoms of pancreatitis. (explain WHY these occur) a. Abdominal distention and ascites b. Abdominal mass c. Rigid board-like abdomen d. Bruising e. Fever f. Nausea\/vomiting g. Jaundice h. Hypotension i. Serum lipase and amylase (up or down?) j. WBC’s (up or down?) k. Blood sugar (up or down?) l. SGOT, SGPT (up or down?) m. PT, PTT (shorter or prolonged?) n. Serum bilirubin (up or down?) o. H\/H (up or down?)","a":"A. Losing fluid into the abdomen. B. A large pancreas. C. Possible hemorrhage D. Possible hemorrhage E. Inflammation F. Inflammation G. Liver involvement H. Bleeding or ascites I. Increases J. Increases K. Increases L. Increases M. Prolonged N. Increases O. Increases if dehydrated; decreases if bleeding"},{"q":"Is it possible that a pancreatitis patient might have to have insulin? Explain why.","a":"Yes – because the pancreas is altered."},{"q":"What is cirrhosis?","a":"Liver cells are destroyed and are replaced with connective and scar tissue; therefore the blood pressure in the liver goes up and the patient has portal hypertension."},{"q":"When a patient has cirrhosis, what happens to the blood pressure in their liver and what is the proper term for this?","a":"Increased – portal hypertension"},{"q":"Explain the S\/S of cirrhosis and also explain why the patient develops each symptom.","a":"Firm, nodular liver – due to connective and scar tissue. Abdominal pain – liver capsule has been stretched. Chronic dyspepsia – GI tract is altered. Change in bowel habits – GI tract is altered. Ascites – liver is not producing albumin as it should; therefore we lose fluid out of the vascular space into the abdomen. Increased SGOT & SGPT – liver enzymes are increased because the liver is altered."},{"q":"Why does the cirrhosis patient sometimes develop hepatic encephalopathy and coma?","a":"A build-up of ammonia"},{"q":"Where is the first place a cirrhosis patient might develop jaundice?","a":"Sclera"},{"q":"What chemical builds up in the blood that makes a patient go into a hepatic coma?","a":"Ammonia"},{"q":"How did that chemical develop?","a":"Because the liver is unable to convert ammonia to urea."},{"q":"What are symptoms of a hepatic coma? Explain why the patient develops these symptoms?","a":"Minor mental changes; decreasing LOC, asterixis, decreased reflexes; slowing EEG and fetor. All of these symptoms are due to a build-up of ammonia in the blood."},{"q":"If a patient is in hepatic failure and eats protein, what is going to happen to the ammonia level in their blood? Explain why.","a":"Increase because the liver cannot convert ammonia to urea."},{"q":"What are bleeding esophageal varices?","a":"Protruding vessels in the esophagus waiting to rupture."},{"q":"Why does a patient develop bleeding esophageal varices?","a":"The back pressure in the liver forces the vessels in the esophagus to protrude."},{"q":"What is the difference in ulcerative colitis and Crohn’s disease?","a":"Ulcerative colitis is a large intestine disease. Crohn’s disease is a small intestine disease."},{"q":"What are the symptoms of ulcerative colitis and Crohn’s disease?","a":"Diarrhea, rectal bleeding, weight loss, vomiting, cramping, dehydration, blood in stool, anemia, rebound tenderness, and fever."},{"q":"What is another name for Crohn’s disease?","a":"Regional Enteritis"},{"q":"What is the surgical treatment for ulcerative colitis?","a":"They may do a total colectomy or a Koch’s pouch, or they could just remove the part that is damaged and re-hookup everything normally."},{"q":"What is the surgical treatment for Crohn’s disease?","a":"May remove the entire small intestine or only the affected area."},{"q":"Why does a patient develop appendicitis?","a":"Because the appendix fills with bowel contents and becomes inflamed and can rupture."},{"q":"Explain symptoms of peptic ulcers.","a":"Burning pain in the mid-epigastric area. The pain may radiate to the back."},{"q":"What is the difference in a peptic ulcer and a duodenal ulcer?","a":"The location."},{"q":"What is dumping syndrome?","a":"When the stomach empties too rapidly after a gastrectomy or gastric bypass."}]

Reduction Of Risk Potential Flashcards

[{"q":"Why is it so important that the angina patient avoid isometric exercise, overeating, caffeine, or any drugs that increase the heart rate and avoid cold weather?","a":"Because these increase the workload of the heart."},{"q":"What is the major complication of a thrombolytic?","a":"Hemorrhage"},{"q":"Before you give a thrombolytic, you are supposed to get a good history. What did I tell you to focus on (what type of diseases or illnesses)?","a":"Any past bleeding problems, stroke, pregnancy, surgery, bleeding ulcer."},{"q":"After someone has received a thrombolytic, why is it so important that we decrease puncture sites?","a":"To prevent hemorrhage. They will bleed at any puncture site."},{"q":"Why is it so important that you ask the patient if they are allergic to iodine before they go for a heart catheterization?","a":"Because contrast dye is used and it contains iodine."},{"q":"If a CHF patient notices their weight increasing, what could that put them at risk for?","a":"Pulmonary edema"},{"q":"Why is it so important that we hurry up and decrease the circulating volume in the pulmonary edema patient?","a":"Because they cannot handle the volume of blood in their lungs."},{"q":"Why are the elderly, the very young, MI patients, or kidney patients at risk for going into fluid volume overload or pulmonary edema?","a":"Because these patients may not have the ability to pump extra fluid or to excrete extra fluid."},{"q":"Any time you are pulling fluid from a patient’s body (thoracentesis, paracentesis, Foley catheter), you are putting the patient at risk for going into a fluid volume deficit or fluid volume excess. Why?","a":"Fluid volume deficit anytime you pull fluid from the body, the vascular space could deplete."},{"q":"There is a possibility with a thoracentesis that a pneumothorax could occur. Why?","a":"Because the doctor could puncture all the way into the lung."},{"q":"If a break in the chest system occurs, air from the outside can rush into the pleural space and cause what life-threatening complication?","a":"Pneumothorax."},{"q":"How can dehydration promote an embolus?","a":"Blood becomes thick and could form a clot."},{"q":"How can venous stasis promote a pulmonary embolus?","a":"Because a thrombus can form, dislodge, and go to the lungs."},{"q":"How can birth control pills promote a pulmonary embolus?","a":"Birth control pills make your blood thick."},{"q":"What is the name of the bacteria that causes TB?","a":"Mycobacterium tuberculosis."},{"q":"What type of light will kill TB?","a":"Ultraviolet light."},{"q":"When a patient is on INH, what lab work has to be monitored?","a":"Liver enzymes"},{"q":"When a patient is on INH, what should be eliminated from their diet?","a":"Alcohol"},{"q":"What lab work should be monitored with Rifampin?","a":"Liver enzymes"},{"q":"How would you monitor for these side effects?","a":"Nephrotoxicity – BUN and creatinine; Ototoxicity – hearing (ringing and pain in the ears)."},{"q":"What would be S\/S of infection with peritoneal dialysis?","a":"Cloudy or dark fluid return."},{"q":"What types of things will bring on a crisis in a sickle cell patient? Explain why.","a":"Any type of stress which increases oxygen demand; decreased O2 concentration causes the sickling process."},{"q":"What is the common cause of death for the sickle cell patient?","a":"Infection"},{"q":"When a patient has leukemia, they are at high risk for infection. Why?","a":"Because you cannot fight infection with immature white cells."},{"q":"What type of emboli do you worry about with a fracture?","a":"Fat."},{"q":"Give S\/S of a fat embolus?","a":"Petechiae over the chest; conjunctival hemorrhages, patchy infiltrates on chest x-ray, usually occurs within the first 36 hours of an injury."},{"q":"What is compartment syndrome?","a":"When circulation is being cut off to an extremity"},{"q":"If you suspect a compartment syndrome, what should you do first?","a":"Loosen the cast"},{"q":"When a patient with an orthopedic injury complains of pain, what is the first thing you should do?","a":"Neurovascular check"},{"q":"Weight on traction should hang freely. Explain why.","a":"If the weights are not hanging freely, then the amount of traction being applied is not what the doctor has ordered."},{"q":"Why is it so important that the total hip replacement patient avoid flexion?","a":"The hip could be dislocated."},{"q":"Give examples of things a total hip replacement patient should avoid specifically related to flexion.","a":"Bending over, sitting in a low chair, climbing stairs."},{"q":"Why is it important that we keep a tourniquet at the bedside with amputation?","a":"In case of hemorrhage"},{"q":"What happens to the pulse pressure with increased intracranial pressure?","a":"It widens."},{"q":"If a neuro patient complains of a headache, what would this mean?","a":"Increased intracranial pressure"},{"q":"Explain the doll’s eye reflex.","a":"When the eyes move the opposite way that the head is turned. Assesses brain stem function"},{"q":"Explain the ice water calorics test.","a":"When ice water is instilled into the ear canal by the physician to assess brain stem function. Normal response would be to look towards the painful stimuli."},{"q":"Explain the Babinski and what is the difference for a child less than one year of age and anyone greater than one year of age.","a":"When the bottom of the foot is stroked, you watch to see what the toes are going to do. In a child less than 1 year, a positive Babinski is okay --- + Babinski means toes fan out. Anyone greater than 1 year of age, we want the toes to curl up. This would be a negative Babinski."},{"q":"Why is it so important that a patient who is about to have cerebral angiography be well hydrated?","a":"To help the patient excrete the dye through the kidneys."},{"q":"Why is it so important that we assess the peripheral pulses before cerebral angiography?","a":"Post-procedure, we will need to check the circulation in the extremity to make sure a clot did not form distal to the puncture site, so baseline data should be collected pre-procedure."},{"q":"Why is it important that we watch for an embolus after cerebral angiography? Explain what you would watch for specifically in your patient.","a":"Because a clot could form and go to the brain. We’re looking for a change in LOC or any motor or sensory deficits, and one-sided weakness or paralysis."},{"q":"Why is the patient who has had a myelogram or any procedure where you have gotten into cerebrospinal fluid at risk for meningitis?","a":"Because the meninges have been punctured, so an infection could have been introduced."},{"q":"What are some reasons for doing a lumbar puncture?","a":"To check for blood, to measure pressures, and to obtain a specimen."},{"q":"What is the most common complication of a lumbar puncture?","a":"Headache"},{"q":"What is a fatal complication of a lumbar puncture?","a":"Herniation."},{"q":"If a patient has an epidural hematoma, explain the sequence of events that will occur and why the patient has these changes.","a":"The patient loses consciousness, then wakes up after going through a recovery period; but then as the bleeding in the head increases, the patient starts having neuro changes and they possibly will pass out again."},{"q":"What is the treatment for an epidural hematoma?","a":"Stop the bleeding; control the ICP."},{"q":"When a patient has a subdural hematoma, explain the sequence of events that can occur (S\/S).","a":"With a subdural hematoma, it can be acute or chronic. If it is an acute bleed, the ICP is going to go up rapidly due to the rapid bleeding; therefore, we must control the bleeding and control the ICP. If it is a chronic bleed, this one can present itself as other things (stroke) as they are bleeding slowly."},{"q":"With which fracture is the patient most at risk for infection?","a":"Open"},{"q":"With a neuro patient, why do we want to avoid narcotics?","a":"Because we do not want to mask the neuro checks."},{"q":"What would be a potential nursing diagnosis for a patient receiving an osmotic diuretic?","a":"Potential for fluid volume deficit"},{"q":"Why do we avoid restraints, bowel and bladder distension, hip flexion, valsalva, isometrics, suctioning, and coughing in the head injured patient?","a":"All of these things increase ICP."},{"q":"Your patient is going to have a liver biopsy. What clotting studies should be checked? Please explain why.","a":"PT; PTT – One of the main functions of the liver is to help our blood to clot. After puncturing into the liver, there is a chance our blood may not clot as quickly as it should."},{"q":"Why is it so important to monitor the vital signs pre- and post-paracentesis?","a":"Because you are worried about throwing the patient into a fluid volume deficit."},{"q":"During a paracentesis, the patient could be thrown into a fluid volume deficit or fluid volume excess?","a":"Deficit"},{"q":"Why does the respiratory status have to be monitored specifically for the pancreatitis patient?","a":"Because the ascites could be pressing up on the diaphragm."},{"q":"What is the major electrolyte imbalance a pancreatitis patient can get into? Explain why.","a":"Hypocalcemia – The pancreas is filled with calcium, but when it starts digesting itself we lose our calcium; therefore the serum calcium goes down."},{"q":"Why are we worried about I & O and daily weights with the cirrhosis patient?","a":"Because we have a patient with a fluid volume problem due to the ascites"},{"q":"Why are we worried about prevention of bleeding in the cirrhosis patient?","a":"Because the liver is altered; therefore the patient is at high risk for hemorrhage."},{"q":"Why is the ileostomy patient at risk for kidney stones?","a":"Because they are always a little dehydrated."},{"q":"Why is it important that the peptic ulcer patient decrease stress?","a":"Because stress increases stomach acid."},{"q":"Why is it important that the peptic ulcer patient stop smoking?","a":"Smoking increases stomach acid."}]

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