Med Surg LPN ATI
3 rs - ANS - - recognize manifestations
- respond
- relieve
\3 types of stroke - ANS - hemorrhagic, thrombotic, emolic
\4 meds for tb - ANS - isoniazid(nydrazid) rifampin ( rigadin) pyrazinamide and
ethambutol hydrochloride (myambutol)
\4 types of seizure - ANS - generalized
partial or focal/local
unclassified or idiopathic
\5 stages of parkinson disease - ANS - 1: unilateral shaking
2: bilateral shaking making walking difficult
3: physical movement slows
4: tremors decrease but rigidity sinks in
5: pt unable to walk or stand, may have dementia
\ABCDE- airway/cervical spine - ANS - most important step in primary survey
\ABG - ANS - reveals o2 status and acid base balance in the blood
ph- number of free hydrogen ions in the blood
pa02- partial pressure of o2
paco2- partial pressure of co2
HCO3- concentration of bicarb in the blood
Sao2- % of o2 bound to Hgb as compared with total amount that can possibly be
carried
obtain though arterial line
diagnoses: resp, renal, malnutrition, electrolyte imbalance, endocrine, neurologic
useful in treating acidosis interventions, guiding o2, data collection about pt
responses to weaning from mechanical vent
complications:
-hematoma, arterial occlusin
- observe for temp, swelling, color, loss of pulse or pain
- apply pressure
air emboli
- air during cath insertion
,- place pt on left side in trendelenburg
- monitor for sob, decrease sao2 levels, chest pain, anxiety, air hunger
-admin o2
\abgs - ANS - hypoxemia: decrease Pao2 less then 80 mm hg
hypocarbia: decrease Pa02 less then 35 early in attack
hypercarbia: increase Pao2 greater then 45 later in attack
\absence seizure - ANS - - common in children
- consist of: loss of consciousness for a few secs, blank staring, automatism(pts
unaware of a behavior like lip smacking)
- returns to normal activity
\ACLS- advanced cardiac life support - ANS - cardiac monitoring for special
resuscitation rhythms
invasive airway management
electrical therapies (defibrillation or cardioversion)
obtaining IV
admin of IV antidysrhythmic medications
management of pt post resuscitation
\acute pain - ANS - - physiologica response: sympathetic nervous system, are
fight or flight response(tachycardia, hypertension, anxiety, diaphoresis, muscle
tension
- responses are grimacing, moaning, flinching, guarding
\adjuvant analgesics - ANS - enhance nonopiod effects, help alleviate other
symptoms that accompany pain. (depression seizures and pain)
\AHA ACLS life threatening arrhythmias - ANS - v.fib, v tach
pulseless electrical activity
asystole
\alpha adrenergic blocking agents cab be used to treat(phentolamine) - ANS - epi
toxicity
\ALS - ANS - - disease of upper and lower motor neurons
- muscle weakness progrssing to muscle atrophy and eventualy paralysis and
death
- does not involve autonomic changes. sensory alteration and cog changes
- degeneratice neuro disorder
- AKA leu gehrigs sisease
- death by resp failure within 3-5 years of initial manifestations
risk factors:
-affects men more then women
- btwn ages 40-70
,subjective data:
- fatigue
- twitching and cramping muscles
objective data:
- muscle weakness
muscle atrophy
- dysphagia
-dysarthria
- hyperreflexia of deep tendon reflexes
lab test: increased creatine kinase level
diagnostic procedures:
- EMG= reduction in funciton motor units of peripheral nerves
- muscle biopsy: reduction of motor units of peripheral nerves an atrophic muscle
fibers
nursing care:
- monitor ABGs, oxygen admin, intermittent positive pressure ventilations, bilevel
positive airway pressure, mechanical venalatoin
- HOB 45 degrees
- dysarthrai= facilitate effective communication
meds:
- riluzole: slows deterioration of motor neurons by decreases glutamic acid. must
be taken early in the disease. adds 2-3 months to life. monitor liver and dizziness,
vertigo, and somnolence. avoid alcohol, take meds evenly spaced. store meds
away from light
- baclofen, dantrium, diazepam: antispasmodics
complications:
-pneumonia
- rest failure
\alternative therapy for AD - ANS - - estrogen therapy in women may help prevent
AD
- ginko biloba
\angle clousure glaucoma - ANS - IOP rises quickly
\antianxiet agent - ANS - diazepam (valium)
\anticonvulsant - ANS - carbamazepine(tegretol)
, \antiemetics - ANS - ondansetron (zofran)
\antiemietics - ANS - reglan to relieve nausea and vomiting
\antihistamine - ANS - hydroxyzine (vistaril)
\antivenin based on - ANS - type and severity of snake bite within 4-12 hrs
\asthma manifestations - ANS - mucosal edema
brochoconstrictin
excessive mucus production
\atypical - ANS - headache last 72 hours
- neur manifestations for 7 days
- ischemic infarct can be found on neuroimaging
\aura - ANS - alterations in vision, smell, emotions
\avoid activities to IOP - ANS - -head hyper flexion
- sexual intercourse
- tilting head backward
- cooking and house keeping
- avoid rapid jerky movements
- sports
\baccillus calmette-guerin - ANS - if vaccine has been received in last 10 years it
could have a false pos mantoux test
\bacterial or septic meningitis - ANS - it is fatal depending on how quickly care is
initiated. very contagious
\benign brain tumors - ANS - develop from meninges or cranial nerves and do not
metastasize.
clean boundaries
pressure on cranial cavity and imparting function of cranial nerve
\beta-adrenergic blocking agents (propranolol) - ANS - block beta receptors, treat
chest pain and dysrhythmias
\BLS - ANS - basic life support. restore breathing and airway circulation
\breathing - ANS - auscultate breath sounds
watch for chest expansion
note rate and depth
identify chest trauma
note position of trachea
observe jugular vein distention
\bronchoscopy - ANS - visualizes larynx, trachea, bronchi
- can be done while pt is on a vent through inserting the scope through the pt et
tube
indication:
abnormalities, biopsy, aspiration
3 rs - ANS - - recognize manifestations
- respond
- relieve
\3 types of stroke - ANS - hemorrhagic, thrombotic, emolic
\4 meds for tb - ANS - isoniazid(nydrazid) rifampin ( rigadin) pyrazinamide and
ethambutol hydrochloride (myambutol)
\4 types of seizure - ANS - generalized
partial or focal/local
unclassified or idiopathic
\5 stages of parkinson disease - ANS - 1: unilateral shaking
2: bilateral shaking making walking difficult
3: physical movement slows
4: tremors decrease but rigidity sinks in
5: pt unable to walk or stand, may have dementia
\ABCDE- airway/cervical spine - ANS - most important step in primary survey
\ABG - ANS - reveals o2 status and acid base balance in the blood
ph- number of free hydrogen ions in the blood
pa02- partial pressure of o2
paco2- partial pressure of co2
HCO3- concentration of bicarb in the blood
Sao2- % of o2 bound to Hgb as compared with total amount that can possibly be
carried
obtain though arterial line
diagnoses: resp, renal, malnutrition, electrolyte imbalance, endocrine, neurologic
useful in treating acidosis interventions, guiding o2, data collection about pt
responses to weaning from mechanical vent
complications:
-hematoma, arterial occlusin
- observe for temp, swelling, color, loss of pulse or pain
- apply pressure
air emboli
- air during cath insertion
,- place pt on left side in trendelenburg
- monitor for sob, decrease sao2 levels, chest pain, anxiety, air hunger
-admin o2
\abgs - ANS - hypoxemia: decrease Pao2 less then 80 mm hg
hypocarbia: decrease Pa02 less then 35 early in attack
hypercarbia: increase Pao2 greater then 45 later in attack
\absence seizure - ANS - - common in children
- consist of: loss of consciousness for a few secs, blank staring, automatism(pts
unaware of a behavior like lip smacking)
- returns to normal activity
\ACLS- advanced cardiac life support - ANS - cardiac monitoring for special
resuscitation rhythms
invasive airway management
electrical therapies (defibrillation or cardioversion)
obtaining IV
admin of IV antidysrhythmic medications
management of pt post resuscitation
\acute pain - ANS - - physiologica response: sympathetic nervous system, are
fight or flight response(tachycardia, hypertension, anxiety, diaphoresis, muscle
tension
- responses are grimacing, moaning, flinching, guarding
\adjuvant analgesics - ANS - enhance nonopiod effects, help alleviate other
symptoms that accompany pain. (depression seizures and pain)
\AHA ACLS life threatening arrhythmias - ANS - v.fib, v tach
pulseless electrical activity
asystole
\alpha adrenergic blocking agents cab be used to treat(phentolamine) - ANS - epi
toxicity
\ALS - ANS - - disease of upper and lower motor neurons
- muscle weakness progrssing to muscle atrophy and eventualy paralysis and
death
- does not involve autonomic changes. sensory alteration and cog changes
- degeneratice neuro disorder
- AKA leu gehrigs sisease
- death by resp failure within 3-5 years of initial manifestations
risk factors:
-affects men more then women
- btwn ages 40-70
,subjective data:
- fatigue
- twitching and cramping muscles
objective data:
- muscle weakness
muscle atrophy
- dysphagia
-dysarthria
- hyperreflexia of deep tendon reflexes
lab test: increased creatine kinase level
diagnostic procedures:
- EMG= reduction in funciton motor units of peripheral nerves
- muscle biopsy: reduction of motor units of peripheral nerves an atrophic muscle
fibers
nursing care:
- monitor ABGs, oxygen admin, intermittent positive pressure ventilations, bilevel
positive airway pressure, mechanical venalatoin
- HOB 45 degrees
- dysarthrai= facilitate effective communication
meds:
- riluzole: slows deterioration of motor neurons by decreases glutamic acid. must
be taken early in the disease. adds 2-3 months to life. monitor liver and dizziness,
vertigo, and somnolence. avoid alcohol, take meds evenly spaced. store meds
away from light
- baclofen, dantrium, diazepam: antispasmodics
complications:
-pneumonia
- rest failure
\alternative therapy for AD - ANS - - estrogen therapy in women may help prevent
AD
- ginko biloba
\angle clousure glaucoma - ANS - IOP rises quickly
\antianxiet agent - ANS - diazepam (valium)
\anticonvulsant - ANS - carbamazepine(tegretol)
, \antiemetics - ANS - ondansetron (zofran)
\antiemietics - ANS - reglan to relieve nausea and vomiting
\antihistamine - ANS - hydroxyzine (vistaril)
\antivenin based on - ANS - type and severity of snake bite within 4-12 hrs
\asthma manifestations - ANS - mucosal edema
brochoconstrictin
excessive mucus production
\atypical - ANS - headache last 72 hours
- neur manifestations for 7 days
- ischemic infarct can be found on neuroimaging
\aura - ANS - alterations in vision, smell, emotions
\avoid activities to IOP - ANS - -head hyper flexion
- sexual intercourse
- tilting head backward
- cooking and house keeping
- avoid rapid jerky movements
- sports
\baccillus calmette-guerin - ANS - if vaccine has been received in last 10 years it
could have a false pos mantoux test
\bacterial or septic meningitis - ANS - it is fatal depending on how quickly care is
initiated. very contagious
\benign brain tumors - ANS - develop from meninges or cranial nerves and do not
metastasize.
clean boundaries
pressure on cranial cavity and imparting function of cranial nerve
\beta-adrenergic blocking agents (propranolol) - ANS - block beta receptors, treat
chest pain and dysrhythmias
\BLS - ANS - basic life support. restore breathing and airway circulation
\breathing - ANS - auscultate breath sounds
watch for chest expansion
note rate and depth
identify chest trauma
note position of trachea
observe jugular vein distention
\bronchoscopy - ANS - visualizes larynx, trachea, bronchi
- can be done while pt is on a vent through inserting the scope through the pt et
tube
indication:
abnormalities, biopsy, aspiration
