Mark Klimek- Yellow Book PDF

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University of Florida

Mark Klimek

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medical notes acid-base imbalances blood gases medical education

Summary

These notes provide a practice examination on medical topics such as acid-base balances and blood gases. The material includes questions to test understanding of the concepts.

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Mark Klimek­ Yellow Book Return to deck 1. Rule of the ': If the ____ and the _____ are ______ in the ame direction then it i meta_____ pH, icar, oth, olic 2. pH 7.30_______ HCO3 20_______ ↓= acidoi; ↓= meta...

Mark Klimek­ Yellow Book Return to deck 1. Rule of the ': If the ____ and the _____ are ______ in the ame direction then it i meta_____ pH, icar, oth, olic 2. pH 7.30_______ HCO3 20_______ ↓= acidoi; ↓= metaolic 3. pH 7.58_______ HCO3 32_______ ↑= alkaloi; ↑= metaolic 4. pH 7.22_______ HCO3 30_______ ↓= acidoi; ↑= repirator 5. You are providing care to a client with the following lood ga reult: pH 7.32, CO2 49, HCO3 29, PO2 80, and SaO2 90%. aed on thee reult, the client i experiencing: ↓= acidoi; ↑= repirator 6. MacKumaul The onl acid ae to caue Kumaul repiration i Metaolic ACidoi 7. A the _______ goe, o goe _______ except for _______ pH, m patient, Potaium 8. Up hokalemia, alkaloi, HTN, Tachcardia, Tachpnea, Seizure, Irritailit, Spatic, Diarrhea, ororgme, hperreflexia, etc 9. Down hperkalemia, acidoi, htn, radcardia, contipation, aent owel ound, flacid, radpnea 10. Caue of acid­ae imalance: Firt ak ourelf, "I it _______?" If e, then it' _______. Then ak ourelf: "Are the _______ or _______. If _______, pick _______. If _______, pick _______ lung, repirator, overventilating, underventilating, overventilating, alkaloi, underventilating, acidoi 11. Caue of acid­ae imalance: If it' not lung, then it' _______. If the patient ha _______ _______ vomiting or uction, pick _______. For everthing ele that in't lung, pick _______ _______. When ou don't know what to pick, chooe _______ metaolic, prolonged gatric, alkaloi, metaolic acidoi, metaolic acidoi 12. High preure alarm are triggered  _______ reitance to air flow. increaed 13. High preure alarm are triggered  increaed reitance to airflow and can e caued  otruction of three tpe: _______ action, _______ action, _______ action (kinked tue) unkink, (water in tue) empt, (mucu in airwa) cough and deep reathe 14. Low preure alarm are triggered  _______ reitance to airflow. decreaed 15. Low preure alarm are triggered  decreaed reitance to airflow and can e caued  diconnection of the _______ or _______ tuing (reconnect it), oxgen enor tue (reconnect it UNLSS tue i on the floor­ ag them and call RT if thi happen) 16. Repirator alkaloi mean ventilator etting ma e too _______ high 17. Repirator acidoi mean ventilator etting ma e too _______ low 18. What doe "wean" mean? graduall decreae with the goal of getting off altogether 19. What i Malow' highet priorit to lowet priorit? 1. Phiological 2. Safet 3. Comfort 4. Pchological (prolem within the peron) 5. Social (prolem with other people) 6. Spiritual 20. Arrange from highet to lowet priorit uing Malow': Denial Spiritual Ditre Pain in low Fall Rik Pathological Famil Dnamic lectrolte Imalance lectrolte Imalance (Phiological) Fall Rik (Safet) Pain in low (Comfort) Denial (Pchological) Pathological Famil Dnamic (Social) Spiritual Ditre (Spiritual) 21. What are the 5 tage of grief? Denial Anger argain Depreion Acceptance 22. The #1 prolem in aue i _______ denial 23. Denial i the _______ to accept the _______ of their prolem refual, realit 24. Treating denial: _______ it  pointing out to the peron the difference etween what the _______ and what the _______. In contrat, _______ the denial of lo and grief confront, a, do, upport 25. Dependenc: When the _______ get the Significant Other to do thing for them or make deciion for them auer 26. Codependenc: When the _______ _______ derive poitive _______ from doing thing for or making deciion for the _______ Significant Other, elf­eteem, auer 27. When treating dependenc/codependenc: Set _______ and _______ them. Agree in advance on what requet are allowed, then enforce the agreement limit, enforce 28. When treating dependenc/codependenc: Work on the _______ of the codependent peron elf­eteem 29. Manipulation: when the _______ get the _______ _______ to do thing for him/her that are not in the _______ _______ of the _______ _______. The nature of the act i _______ or _______ to the _______ _______ auer, ignificant other, interet, ignificant other, harmful, dangerou, ignificant other 30. Treating manipulation: et _______ and _______ limit, enforce 31. Wernicke' (Korakoff') Sndrome: _______ induced  Vitamin _______(thiamine) deficienc Pchoi, 1 32. Primar mptom of Wernicke' (Korakoff') Sndrome: _______ with _______ amneia (memor lo), confaulation (make up tuff) 33. Characteritic of Wernicke' (Korakoff') Sndrome: 1. _______ 2. _______ 3. _______ preventale (take vitamin) arretale (take vitamin) irreverile (kill rain cell) 34. Antaue/Revia i aka _______ Therap Averion 35. Onet and duration of effectivene of Antaue/Revia: _______ 2 week 36. Patient teaching with Antaue/Revia: Avoid _______ form of _______ to avoid _______, _______, _______ all, alcohol, nauea, vomiting, death 37. What are example of product that contain alcohol? mouth wah, cologne, perfume, afterhave, elixir, mot OTC liquid medicine, inect repellant, vanilla extract, vinagerette, hand anitizer 38. ver alcoholic goe through _______. Onl a minorit get _______ Alcohol Withdrawal Sndrome, Delirium Tremen 39. _______ i not life­threatening. _______ can kill ou Alcohol Withdrawal Sndrome, Delirium Tremen 40. Patient with _______ are not a danger to themelve or other. Patient with ________ are dangerou to elf and other Alcohol Withdrawal Sndrome, Delirium Tremen 41. AWS or DT: emiprivate room, an location AWS 42. AWS or DT: private room near the nure' tation DT 43. AWS or DT: Regular diet AWS 44. AWS or DT: Clear liquid or NPO diet (rik for apiration) DT 45. AWS or DT: Up at liert AWS 46. AWS or DT: Retricted to edret with no athroom privilege DT 47. AWS or DT: No retraint AWS 48. AWS or DT: Uuall retrained with either vet or 2 point (1 arm and 1 leg) DT 49. AWS or DT: Give anti­HTN medication oth 50. AWS or DT: Give tranquilizer oth 51. AWS or DT: Give multivitamin to prevent Wernicke' oth 52. For Aminoglcoide, think " __ ____ ___ _____" a mean old mcin 53. When are antiiotic/aminoglcoide ued? to treat eriou, life­threatening, reitant infection 54. All aminoglcoide end in _______, ut not all drug that end in _______ are aminoglcoide. mcin, mcin 55. What are ome example of wannae mcin? Azithromcin, Clarithromcin, rthromcin 56. What are ome example of aminoglcoide? Streptomcin, Cleomcin, Toramcin, Toramcin, Gentamcin, Vancomcin, Clindamcin 57. When rememering toxic effect of mcin' think _______ mice= ear 58. What i the toxic effect of aminoglcoide and what mut ou monitor? ototoxicit; monitor hearing, alance, and tinitu 59. The human ear i haped like a _______ o another toxic effect of aminoglcoide i _______ o monitor _______ kidne, nephrotoxicit, creatinine 60. The numer "___" drawn inide the ear remind ou of cranial nerve ___ and frequenc of adminitration ___ 8, 8, Q8H 61. Do not give aminoglcoide PO expect in thee 2 cae: 1. _______ _______ (due to high _______ level) 2. Pre­op _______ urger hepatic encephalopath (liver coma, ammonia­induce encephalopath), ammonia, owel 62. Who can terilize m owel? Neo­ Kan 63. What i the reaon for drawing Trough and Peak level? Narrow therapeutic level 64. When do ou ALWAYS draw the Trough? 30 minute efore next doe 65. When do ou draw the Peak level of Sulingual medication? 5­10 minute after drug diolve 66. When do ou draw the Peak level of IV medication? 15­30 minute after medication i finihed 67. When do ou draw the Peak level of IM medication? 30­60 minute after injecting it 68. When do ou draw the Peak level of SQ medication? Depend on tpe of inulin 69. When do ou draw the Peak level of PO medication? Not necear 70. What are iological Agent in Categor A? STAPH  Small Pox Tularemia Anthrax Plague Hemorrhagic illne otulim 71. What are iological Agent in Categor ? All other 72. What are iological Agent in Categor C? Nipeh Viru Hanta Viru 73. When it come to iological Agent: Categor __ i _______, Then Categor __, Then Categor __ A, the wort, , C 74. Small Pox Inhaled tranmiion/ on airorne precaution die from epticemia­ no treatment rah tart around mouth firt Categor A 75. Tularemia chet mptom die from repirator failure treat with treptomcin Categor A 76. Anthrax pread  inhalation look like the flu die from repirator failure treat with upro, PCN, and treptomcin Categor A 77. Plague pread  inhalation ha the 3 H': Hemopti (coughing up lood), Hematemei (vomiting up lood), Hematochezia (lood in tool) dei from repirator failure and DIC (leed to death) treat with Doxccline and Mcin no longer communicale after 48 hour of treatment Categor A 78. Hemorrhagic illnee primar mptom are petechiae (pinpoint pot) and ecchmoe (ruiing) high % fatal Categor A 79. otulim it i ingeted ha 3 major mptom: decending parali, fever, ut i alert die from repirator arret Categor A 80. What are ome example of chemical agent that caue ioterrorim? Mutard ga Canide Phogine chlorine Sarin 81. What i the primar mptom of Mutard Ga? liter (veicant) 82. What i the primar mptom of Canide and how do ou treat it? Repirator arret. Treat with Sodium Thioulfate IV 83. What i the primar mptom of Phogine Chlorine? Choking 84. What are the mptom of Sarin (hint it' a nerve agent)?  SLUDG­ jut rememer ever ecretion in our od i eing excreted exceivel ronchopam ronchorrhea Salivating Lacrimating (tear) Urination Diaphorei/ Diarrhea G.I upet mei 85. What do ou ue when cleaning patient expoed to chemical agent? All chemical agent require onl oap and water cleaning except Sarin, which require leach. 86. Which agent do ou iolate the patient for? iological Agent 87. Which agent do ou decontaminate for? Chemical Agent 88. How doe decontamination work? Gather expoed people Take to decontamination center where people remove clothing, hower, dre in non­contaminated clothe, then releae to other ervice Put contaminated clothing in pecial ag and throw awa (e ure not to touch it) 89. Calcium Channel locker: the are like ________ for our heart. What doe that mean? Valium. It relaxe the heart 90. Calcium Channel locker: _______ inotropoic, chronotropic, dromotropic Negative 91. Inotropic trength of heart 92. Poitive Inotropic trong hearteat 93. Negative Inotropic weak hearteat 94. Chronotropic rate of hearteat 95. Poitive Chronotropic fat hearteat 96. Negative Chronotropic low hearteat 97. Dromotropic conductivit of heart 98. Poitive Dromotropic excitale heart 99. Negative Dromotropic lock/low conduction 100. Poitive Inotropic, Chronotropic, and Dromotropic i een with which medication? atropine, epinephrine, and norepinephrine 101. Negative Inotropic, Chronotropic, and Dromotropic i een with which medication? Calcium Channel locker and eta locker 102. What do Calcium Channel locker treat? (indication) Antihpertenive (decreae P) Anti Angina (imalance etween O2 uppl and demand) Anti Atrial Arrhthmic (Atrial flutter and Atrial firillation) 103. What are ome of the ide effect of Calcium Channel locker? Headache Hpotenion 104. Name of Calcium Channel locker can e rememered  aing.... I op zem dipine in the Calcium Channel ("zem", "dipine", "verapamil/ioptin") 105. "QRS depolarization" alwa refer to __________ Ventricular (not atrial, junctional or nodal). 106. "P wave" refer to _________ Atrial 107. Atole a lack of QRS depolarization (flat line) 108. Atrial Flutter rapid P­wave depolarization in a aw­tooth pattern (flutter) 109. Atrial Firillation chaotic P­wave depolarization 110. Ventricular Tachcardia wide izarre QRS' 111. Premature Ventricular Contraction (PVC) Periodic wide, izarre QRS' 112. e concerned aout PVC' if: More than 6 per minute 6 in a row PVC fall on T­wave of previou eat 113. What are the lethal arrhthmia? atole and ventricular firillation 114. What i the potentiall life­threatening arrhthmia? 1. v­tach, 2. a­fi, 3. a­flutter 115. When dealing with an IV puh drug if ou don't know go ____ except ________! low, adenocard 116. What i the treatment for PVC'? lidocaine and amiodarone 117. What i the treatment for V Tach? lidocaine and amiodarone 118. What are the treatment for upraventricular arrhthmia? ACD Adenocard/adenoine etalocker (end in lol) Calcium Channel locker Digitali/Digoxin (lanoxin) 119. What i the treatment for V­fi? ou defi 120. What i the treatment for Atol? Give pi firt then Atropine 121. atole 122. atrial firillation 123. atrial flutter 124. Normal Sinu Rhthm 125. Supraventricular tachcardia 126. ventricular firillation 127. The purpoe for chet tue i to re­etalih _______ preure in the pleural pace negative 128. In the pneumothorax, the chet tue remove ___ air 129. In the hemothorax, the chet tue remove _____ lood 130. In the pneumohemothorax, the chet tue remove ___ and _____ air and lood 131. when the chet tue i ______ (____) for ___. aka ____ Apical (high), air, apex 132. When the chet tue i ______ (___) for _____ aka ____ ailar (low), lood, ae (ottom of lung) 133. How man chet tue and where for unilateral pneumohemothorax? 2; apical and ailar on ide of pneumo 134. How man chet tue and where for ilateral pneumothorax? 2; apical for oth 135. How man chet tue and where for pot­op chet urger/chet trauma? aume unilateral pneumohemothorax­ 2; apical and ailar on ide of pneumo 136. In routine _____ clamp chet tue. In emergenc _____ the chet tue NVR; CLAMP 137. What do ou do if ou kick over the collection ottle? Set it ack up (not an emergenc) 138. What do ou do if the water eal reak? Firt­ clamp it, cut tue awa from device et­ umerge the tue under water, then unclamp 139. What do ou do if the chet tue come out? Firt­ cover with a gloved hand et­ cover the hole with vaeline gauze, put a dr terile dreing on top, tape on 3 ide 140. If there' uling in the water eal intermittentl it i... good 141. If there' uling in the water eal and it' continuou it i... ad 142. If there' uling in the uction control chamer intermittentl it i... ad 143. If there' uling in the uction control chamer continuoul it i... good 144. Rule for clamping the tue: never clamp longer than __________ without Dr' order ue _____________________________ 15 econd, ruer tipped doule clamp 145. ver congenital heart defect i either ___________ or ____ ___________ TRouLe, No TRouLe 146. R­L Right to Left hunt 147.  lue 148. T tart with the letter "T" 149. What are ome example of "TRouLe" congenital heart defect? Trunku arterioi, Tran. poition of great veel, Tetrolog of Fallot, Tricupid tenoi, TAPZ, Left ventricular hperplamic ndrome 150. What are ome example of "No TRouLe" congenital heart defect? Patent fore. ov., ventricular eptal defect, pulmonar tenoi 151. Akk CHD kid will have 2 thing, whether TRouLe or No TRouLe... 1. Murmur 2. chocardiogram 152. Four defect preent in Tetralog of Fallot are... VarieD PictureS Of A RancH Ventricular Defect Pulmonar Stenoi Overriding Aorta Right Hpertroph 153. How do ou meaure crutche for a peron? 2­3 fingerwidth elow anterior axillar fold to a point lateral and lightl in front of foot 154. When the handgrip i properl placed, the angle of elow flexion will e ____ degree 30 155. 2 point gait tep one­­ move one crutch and oppoite foot together tep two­­ move other crutch and other foot together (rememer 2 point together for a 2 point gait) Ued for minor weakne on oth leg 156. 3 point gait tep one­­ move two crutche and ad leg together tep two­­ move good foot (Rememer 3 point i called 3 point ecaue 3 point touch down at once) 157. 4 point gait tep one­­ one crutch tep two­­ oppoite foot tep three­­ other crutch tep four­­ other foot nothing move together and everthing i reall weak 158. Swing through for two raced extremitie (Amputee) 159. Ue the _____ numered gait when weakne i _______ ditriuted. ___ point for mild prolem and ___ point for evere even, evenl, 2, 4 160. Ue the ___ numered gait when one leg i ______ odd, effected 161. Stair: which foot lead when going up and down tair on crutche? ______ with the _______ and _______ with the _____. The crutche alwa move with the ____ leg up, good, down, ad, ad 162. Cane: Hold cane on the __________ _______ ide. Advance cane with the _________ ide for a wide ae of upport uneffected ide, oppoite 163. What i the correct wa to ue a walker? pick it up, et it down, and walk to it 164. What i a ig NO when it come to walker? Do not tie elonging to the front of the walker 165. What i the correct wa to get up from a chair uing a walker? Hold on to chair, tand up, then gra walker 166. What i the difference etween a non­pchotic peron and a pchotic peron? a non­pchotic peron ha inight (know the're ick and that it' meing them up) and i realit aed (the ee realit the ame wa a ou) and a pchotic peron ha no inight and i not realit­aed. 167. Deluion a fale, fixed elief or idea or thought. There i no enor component 168. What are the 3 tpe of deluion? Paranoid/Perecutor, Grandioe, & Somatic 169. Paranoid or Perecutor Deluion fale, fixed elief that people are out to harm ou 170. Grandioe deluion Fale, fixed elief that ou are uperior 171. Somatic deluion Fale, fixed elief aout a od part 172. Hallucination a fale, fixed enor exerience 173. What are the 5 tpe of hallucination? auditor (hearing), tactile (feeling), viual (eeing), gutator (tating), and olofactor (melling) 174. Illuion a miinterpretation of realit. It i a enor experience 175. What i the difference etween illuion and hallucination? With illuion there i a referent in realit (omething to which the can refer to) 176. When dealing with a patient experiencing deluion, hallucination or illuion, firt ak ourelf, "What i their prolem?" (what are the different prolem that could e going on?) functional pchoi, pchoi of dementia, and pchotic delirium 177. What are the different tpe of functional pchoi? chziophrenia, chzioaffected (mood diorder thought proce), major depreion, and mania 178. With a functional pchoi the patient ha the potential to learn realit. How can ou teach realit to a functional pchotic? 1. acknowledge feeling 2. preent realit a. poitive­ what i realit . negative­ what i not realit 3. et a limit 4. enforce the limit 179. Pchoi of dementia People with Alzheimer', Wernicke', Organic rain Sndrome, and dementia. Thi patient ha a rain detruction prolem and cannot learn realit 180. How do ou deal with a peron with Pchoi of Dementia? 1. Acknowledge feeling 2. Redirect­ get them to expre the fixation that the are expreing inappropriatel to appropriatel 181. Pchotic Delirium Temporar epiodic econdar dramatic udden onet of lo of realit due to chemical imalance (UTI, throid imalance, electrolte imalance) 182. How do ou deal with a patient with Pchotic Delirium? 1. Acknowledge feeling 2. Reaure them of afet and temporarne 183. What are the different tpe of looening of aociation? Flight of idea, word alad, neologim 184. Flight of idea Stringing phrae together (looel aociated phrae; tangentialit) 185. Word alad Throw word together 186. Neologim Making up new word 187. Narrowed elf­concept When a PSYCHOTIC refue to change their clothe or leave the room. *don't make a pchotic do omething the don't want to do 188. Idea of reference You think everone i taking aout ou 189. Dementia hallmark Memor lo, inailit to learn. *Functional can teach, dementia cannot 190. Alwa acknowledge ______________ Feeling 191. What are the 3 "Re'"? Reaure Redirect Realit 192. Diaete mellitu An error of glucoe metaolim 193. Diaete inipidu Dehdration, polurethane, poldipia 194. Tpe I Diaete Mellitu Inulin dependent (not producing inukin) Juvenile onet Ketoi prone 195. Tpe II Diaete Mellitu Non inulin dependent (od reiting inulin) Adult onet Non ketoi prone 196. Sign and mptom of diaete mellitu Poluria (pee a lot) Poldipia (drink a lot) Polphagia (eat/wallow a lot) 197. Treatment for Tpe I Diaete Mellitu 3. Diet (calorie from car) 1. Inulin 2. xercie 198. Treatment for Tpe II Diaete Mellitu 1. Diet 3. Oral hpoglcemic 2. Activit 199. Diet of Diaetic Calorie (car) retriction Need to eat 6x per da­­> maller more frequent meal 200. Inulin act to _____________ lood ugar Lower 201. Inulin Tpe: R R= Regular, Rapid, Run (IV) Onet: 1hr Peak: 2hr Duration: 4hr 202. Inulin Tpe: N N= NPH, Not in the ag, Not o fat, Not clear (cloud) Onet: 6hr Peak: 8­10hr Duration: 12 hr 203. Inulin Tpe: Humalog Inulin Lipro Fatet Onet: 15min Peak: 30min Duration: 3hr 204. Inulin Tpe: Lantu Long acting Slow aorption No peak Duration: 12­24hr 205. With inulin rememer: Check expiration date Refrigerate ut once open no refrigeration 206. xercie ________ inulin: if more exercie, need _________ inulin. If le exercie, need __________ inulin Potentiate, le, more 207. Sick da rule for inulin Take inulin Take ip of water Sta active a poile 208. Low lood ugar in Tpe I Diaete Mellitu (inulin hock) i caued : Not enough food Too much inulin Too much exercie 209. Wh i low lood ugar in Tpe I Diaete Mellitu (inulin hock) dangerou? Permanent rain damage 210. Sign and mptom of low lood ugar in Tpe I Diaete Mellitu (inulin hock): Cereral impairment, vaomotor collape, cold, clamm, low reaction time, "drink hock" 211. Treatment for low lood ugar in Tpe I Diaete Mellitu (inulin hock): Adminiter rapidl metaolizale carohdrate (cand, hone) Ideal comination: ugar and protein If unconciou IV D50 IM glucagon 212. High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic Coma i caued : Too much food Not enough inulin Not enough exercie #1 caue i acute viral upper repirator infection within the lat 10 da 213. Sign and mptom of High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic Coma Dehdration Ketone, Kumaul reathing, high K+ Acidoi, Acetone reath, Anorexia 214. Treatment for High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic Coma Inulin IV (R) IV rate flow 200mg/hr 215. Treatment for low lood ugar in Tpe II Diaete Mellitu: Adminiter rapidl metaolizale carohdrate (cand, hone) Ideal comination: ugar and protein If unconciou IV D50 IM glucagon 216. High lood Sugar in Tpe II Diaete Mellitu Called HHNK or HHNC­ Hperomolar, Hperglcemic, Non­Ketotic Coma Thi i evere dehdration 217. Sign and mptom of High lood Sugar in Tpe II Diaete Mellitu Hit, dr, increaed HR, decreaed kin turgor 218. Treatment for High lood Sugar in Tpe II Diaete Mellitu Rehdration 219. Long term complication of HHNC are related to Poor tiue perfuion Peripheral neuropath 220. Which la tet i the et indicator of long­term lood glucoe control (compliance/effectivene/adherence)? Ha1c (average lood ugar over lat 90 da) 221. Cold and clamm­ _____________________________ Hot and dr­ ____________________________ Get ome cand Sugar' high 222. What i the therapeutic and toxic level for Lithium? therapeutic level: 0.6­1.2 toxic level: ≥ 2 223. What i the therapeutic and toxic level for Lanoxin (Digoxin)? therapeutic level: 1­2 toxic level: >2 224. What i the therapeutic and toxic level for Aminophlline? therapeutic level: 10­20 toxic level: ≥ 20 225. What i the therapeutic and toxic level for iliruin? therapeutic level (elevated level): 10­20 toxic level: >20 226. Kernicteru iliruin in the CSF 227. Opithotono poition of light extenion in neck een in patient' with Kernicteru. (ad ign) 228. Dumping Sndrome Pot­Op gatric urger complication in which gatric content dump too quickl into the duodenum 229. Hiatal Hernia Regurgitation of acid into eophagu, ecaue upper tomach herniate upward through the diaphragm 230. Hiatal Hernia or Dumping Sndrome: Gatric content move in the right direction at the wrong rate Dumping Sndrome 231. Hiatal Hernia or Dumping Sndrome: Gatric content move in the wrong direction at the right rate Hiatal Hernia 232. Hiatal Hernia or Dumping Sndrome: GRD like mptom when upine and after eating Hiatal Hernia 233. ADS S&S Acute Dumping Sndrome Adominal ditre (cramping, N/V, hperactive S(ororgmi)) Drunk­ cereral impairment Shock (vaomotor collape, rapid thread HR) 234. Treatment for Hiatal Hernia HO during & 1hr after meal­ high Amount of fluid with meal­ high Carohdrate content of meal­ high goal: get an empt tomach 235. Treatment for Dumping Sndrome HO during & 1hr after meal­ low Amount of fluid with meal­ low Carohdrate content of meal­ low goal: get a full tomach 236. Kalemia do the ______ a the prefix except for ___________ and __________ Hperkalemia= Hpokalemia= ame; heart rate; urine output Hper= ↑; HR ↓, Urine Output ↓ Hpo= ↓; HR ↑, Urine Output ↑ 237. Calcemia do the _______ of the prefix. No exception. Hpercalcemia= Hpocalcemia= oppoite Hper=↓ Hpo= ↑ 238. Two ign of neuromucular irritailit aociated with _____________: 1. 2.. hpocalcemia 1. Chvotek' Sign= cheek tap→ facial pam 2. Troueau' Sign= P cuff→ carpal pam 239. Magneemia do the ____________ of the prefix. Hpermagneemia= Hpomagneemia= oppoite Hper= ↓ Hpo= ↑ 240. If mptom involve nerve or keletal mucle, pick ________. For an other mptom, pick __________ ( generall anthing effecting ____________) Calcium, Potaium, lood preure 241. Hprnatermia dhdration (dr kin, thread pule, rapid HR) 242. hpOnatremia= Overload (crackle, ditended neck vein) 243. The earliet ign of an electrolte diorder i _________ & __________ numne, tingling (paretheia) 244. The univeral ign­mptom of electrolte imalance i ________________ mucle weakne (parei) 245. Never puh ____________ IV Potaium 246. Not more than ______ of K+ per liter of IV fluid 40mq 247. Give _____ & ______ to decreae K+ D5W, inulin (not permanent) 248. Kaexalate: K+­ exit­ late (not a quick, more of a permanent olution) 249. In a patient with hpercalcemia, which monitor pattern would e the mot likel threat? A. Paroxmal atrial tachcardia with decreaed ST egment . radcardia with 2nd degree Moitz Tpe II lock & elevated ST egment C. Frequent PAC' with multifocal coupling of PVC' and tall T­wave D. Firt degree heart lock with decreaed ST egment and inverted T­wave D. Firt degree heart lock with decreaed ST egment and inverted T­ wave 250. Hperthroidim= Hper­ metaolim (high metaolic rate) 251. Sign and Smptom of Hperthroidim weight lo, diarrhea, ↑HR, hot, heat intolerance, HTN, exopthalmo (ulging ee­ Don Knopp) 252. Hperthroidim i alo known a ____________________. So rememer _____ ourelf into the ______ Grave' Dieae; Run; Grave 253. The prolem i hperthroidim. Treatment option: Radioactive iodine, proplthroid utiil, urgical removal 254. What i the ig rik with radioactive iodine? radiation rik in urine­ doule fluh, need private athroom 255. What doe PTU do? proplthroid utinil knock out WC 256. What i the mot common treatment for hperthroidim? urgical removal 257. Total throidectom­ need lifelong ________ replacement. at rik for ___________ hormone; hpocalcemia (difficult to pare parathroid) 258. What are ou at rik for with a utotal throidectom? throid torm 259. What are ign and mptom of throid torm? extremel high vital ign, extremel high fever, pchoticall deliriou. Thi i a medical emergenc 260. What i the treatment for throid torm? oxgen and lower od temperature 261. Total= T_____ Sutotal= S______ Tetan Storm 262. Pot operation rik for total and utotal throidectom in firt 12 hr airwa/reathing, leeding 263. Pot operation rik for total throidectom in 12­48 hr tetan (r/t ↓Ca) 264. Pot operation rik for u­total throidectom in 12­48 hr throid torm 265. Hpothroidim = hpo­_________ metaolim 266. ign and mptom of hpothroidim weight gain, htn, contipation, letharg, coldintolerance, "low" 267. Hpothroidim i alo known a _______________ mxedema 268. What are the 3 reaon for accucheck? diaete, TPN, teroid 269. Treatment for hpothroidim throid replacement (/e: hperthroidim) 270. Caution: with hpothroidim treatment DO NOT ________ edate (the are alread edated) 271. Surgical implication for the hpothroid patient Anetheia i ver high rik and do not hold throid pill when NPO 272. Adrenal Cortex Dieae tart with letter ___ or ____ A, C 273. Addion' Dieae i _______________ of the adrenal cortex underecretion 274. Sign and Smptom of Addion' Dieae hperpigmented (darker), doen't repond to tre well (JFK) 275. Treatment for Addion' Dieae teroid (need to wear a med alert racelet) 276. Addion'= add­a­one 277. Cuhing' Sndrome i ___________ of the adrenal cortex overecretion (cuh= more) 278. Sign and Smptom of Cuhing' Sndrome (ame a teroid) moon face, hirutim (↑ od hair), water retention, gnecomatia (man oo), uffalo hump, central oeit (mall kinn lim),↓ one denit, ea ruiing, irritailit, immunouppreion 279. Treatment for Cuhing' Sndrome adrenalectom→ replacement therap→ teroid) 280. What i CONTACT precaution ued for? Herpe, nteric (Rotaviru, Shigellou), Staph (MRSA), RSV (tranmitted via droplet ut contact ecaue kid put mouth on everthing) 281. CONTACT PRCAUTIONS: Select all that appl: ___ Private Room ___ e/Face Shield ___ Mak ___ Dipoale Supplie ___ Glove ___ Negative Air Flow ___ Special Filter Repirator Mak ___ Handwahing ___ Gown ___ Pt wear mak when leaving room Private Room (mot important) Glove Gown Handwahing Dipoale upplie (P cuff) Stethocope can e taken from room to room a long a terilized after ue 282. What i droplet precaution ued for? influenza (H1N1), meningiti, diphtheria, pertui, mump 283. DROPLT PRCAUTIONS: Select all that appl: ___ Private Room ___ e/Face Shield ___ Mak ___ Dipoale Supplie ___ Glove ___ Negative Air Flow ___ Special Filter Repirator Mak ___ Handwahing ___ Gown ___ Pt wear mak when leaving room Private Room Mak (mot important) Glove Handwahing Pt wear mak when leaving room Dipoale upplie 284. What i airorne precaution ued for? Meale, T (pread via droplet), Chicken POx (Varicella), SARS 285. AIRORN PRCAUTIONS: Select all that appl: ___ Private Room ___ e/Face Shield ___ Mak ___ Dipoale Supplie ___ Glove ___ Negative Air Flow ___ Special Filter Repirator Mak ___ Handwahing ___ Gown ___ Pt wear mak when leaving room Private room (door cloed Mak Glove Gown Handwahing Special FIlter Repirator Mak (for T onl­ and not uppoed to leave room unle the have to) Pt wear mak when leaving room Dipoale upplie Negative air flow (mot important) verone that enter the room mut wear a mak 286. Unle otherwie pecified, aume that PP include: glove, gown, goggle, and mak 287. The proper place for donning PP i ________ the room and doffing PP i _________ the room outide, inide 288. The proper order for donning PP i 1. ___________ 2. ___________ 3. ___________ 4. ___________ 1. Gown 2. Mak 3. Goggle 4. Glove (tart low and go high) 289. The proper order for removing PP i: 1. ________ 2. ________ 3. ________ 4. ________ 1. Glove 2. Goggle (from ehind) 3. Gown (from ehind) 4. Mak (from ehind­ outide room) (alphaetical order) 290. In airorne and droplet precaution onl, the mak i removed _______ the room and the patient remove mak ________ the room. outide, inide 291. Hand­wahing or Scruing: poition hand elow elow hand­wahing 292. Hand­wahing or Scruing: poition elow elow hand cruing 293. Hand­wahing or Scruing: length econd hand­wahing 294. Hand­wahing or Scruing: length minute cruing 295. Hand­wahing or Scruing: can touch handle hand­wahing 296. Hand­wahing or Scruing: not allowed to touch handle cruing 297. Hand­wahing or Scruing: ue when entering/leaving room, efore/after glove ue, whenever hand get oiled hand­wahing 298. Hand­wahing or Scruing: ue when patient i immunouppreed (eginning of tuff) cruing 299. Hand­wahing or Scruing: oap and water hand­wahing 300. Hand­wahing or Scruing: ue "chlor­­­" cruing 301. When can ou ue an Alcohol­aed olution? Onl utitute for handwahing, enter/leave room, efore/after glove, NVR utitute after oiling hand 302. Can ou ue an alcohol­aed olution after uing the retroom? No! (oiling hand) 303. Dr hand from ________ to _________. Turn water off with _____ paper towel cleanet, dirtiet, new 304. Sterile Gloving: glove ________ hand firt grap ________ of cuff touch onl the _______ of glove urface do not _______ cuff finger _______ econd glove cuff keep thum _______ onl touch _______ urface of glove dominant outide inide roll inide aducted outide 305. SkIN touche _______ of glove INide 306. OUTide of glove onl touche _______ of glove OUTide 307. Remove ______ to _______; _______ to _______ glove, glove, kin, kin 308. What patient do NOT need interdiciplinar care? People who have multiple prolem in the ame diviion of care x: COPD, arthriti, cancer of owel (all medical prolem) 309. What i the major criteria for interdiciplinar care? 1. Patient with multidimenional need (phical, intellectual, emotional, ocial, piritual)­ x COPD, homelene, & chizophrenia (need medical, SW, and pchiatrit) 2. Patient who need rehailitation (PT, SW, OT, Speech will e effected) 310. What i the minor criteria for interdiciplinar care? a patient whoe current treatment i ineffective a patient who i preparing for dicharge 311. What are the 3 principle to conider when chooing appropriate to for kid? 1. i it afe 2. i it age­appropriate 3. i it feaile (can ou actuall do it?­ pecific to child' ituation) 312. What are ome afet conideration when it come to kid to? 1. ize of to (no mall to for children under 4) 2. no metal to if oxgen i in ue (park thing) 3. eware of fomite (non living oject that haror microorganim)­ wort: pluh to/ tuffed animal; leat­ platic to that can e diinfected 313. What i the ST to for 0­6 month old (enorimotor)? mucial moile 314. What i the 2nd ST to for 0­6 month old (enorimotor)? large and oft 315. What i the ST to for 6­9 month old (oject permanence)? cover/uncover to (jack in the ox) 316. What i the 2nd ST to for 6­9 month old (oject permanence)? firm ut large (wood/ hard platic allowed) 317. What i the ST to for 9­12 month old? veral to (tickle me elmo) 318. Rememer with 9­12 month old ___________ activit with _________ purpoeful, oject 319. Avoid anwer with the following word in them for children 9 month and ounger: uild, ort, tack, make, & contruct 320. What i the et to for toddler (1­3 ear)? puh/pull to (wagon) 321. What kill i eing worked on when toddler pla? gro motor kill 322. What tpe of pla do toddler do? parallel pla (pla alongide ut not with) 323. What tpe of to hould e avoided with toddler? to that require good finger control/dexterit 324. Prechooler need to that work on: fine motor kill (finger) and alance (dance, ice kating and tumling) 325. Prechooler pla i characterized  cooperative pla (pla with each other) 326. Prechooler like to pla ________. pretend 327. School age (7­11 ear) aka _________ are characterized  the 3 C': 1. 2. 3. Concrete 1. created/creative (give lank paper; get them involved) 2. competitive (winner and loer) 3. collective (aeall card and arie) 328. Adolecent (12­18 ear)­ their "pla" i _______ _______ _____________. Allow adolecent to e in each other' room unle one of them i : 1. 2. 3. peer group aociation (hang out in group) 1. freh pot­op (le than 12 hour) 2. immunouppreed 3. contagiou 329. When given a variet of age to chooe from alwa go __________ ecaue children ________ when ick and ou want to give them __________________________________ ounger, regre, a much time to grow 330. Creatinine et indicator of kidne function 331. Creatinine la value 0.6­1.2 If elevated it' anormal ut not too worriome (jut mean kidne are failing) 332. INR (International Normalized ratio) Monitor Coumadin (Warfarin) therap (Coumadin and War Fare make ou leed) 333. What i the therapeutic range for INR? 2­3 ↑INR= leed rik ≥4 i critical 334. What do ou do when INR i ≥ 4? Hold all Coumadin Ae leeding Prepare to give Vitamin K Call the Dr 335. What i the therapeutic range for Potaium (K+)? 3.5­5.0 336. What do ou do if Potaium i low? Critical Ae heart Prepare to give Potaium Call the Dr 337. What do ou do if Potaium i 5.4­5.9? Critical (high ut till in the 5') Hold all Potaium Ae heart Prepare Kaexalate/D5W Call the Dr 338. What do ou do if Potaium i ≥6? Deadl Dangerou Do all of the following at once: Hold Potaium, ae heart, prepare Kaexalate/D5W, Call Dr (will need a team to addre thi) 339. What i the therapeutic range of pH? 7.35­7.45 340. What do ou do if pH i in the 6'? Deadl Dangerou get vital and call Dr (mot important when aked in quetion) 341. What i the therapeutic range for UN (lood urea nitrogen)? 8­30 (8 un in a pack) 342. What do ou do when a patient ha an elevated UN? e concerned Check for dehdration 343. What i the therapeutic range for Hg (hemogloin)? 12­18 (teenage ear) 344. What do ou do when a patient ha a 8­11 hg? e concerned monitor the patient 345. What do ou do if a patient ha a hg of

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