Tuesday, August 14, 2007

Acyclovir (Zovirax):
May cause adverse GI effects such as diarrhea
for recurrent genital herpes
Addison's disease:
the production of all adrenal hormones, compromising the body's natural stress
response & the risk of infection
Cause retention of Potassium, which may result in cardiac dysrhythmias.
Results in hypo function of the adrenal glands, which causes hyponatremia and
hypovolemia, and hyperkalemia.
Hyponatremia, hypoglycemia, and hyperkalemia
Glucocorticoids
Convert protein & fat into glucose
Essential to life, are in Addisons disease;
Pt will need exogenous Glucocorticoids therapy for the rest of pts life.
Addisonian crisis: acute adrenal insufficiency precipitated by physical & psychological
stressors; manifestations include N/V, extreme weakness, severe hypoglycemia, S/S of
shock,
Nursing care includes administering hydrocortisone therapy &
vasopressors, rest, monitor V/S.
Should fluid & salt intake during hot weather?
Air fluidized surface:
protects the skin from moisture
used for pt with pressure ulcers stage 3+
Aminophylline:
bronchodilator, causes rapid pulse & dysrhythmias
S/S includes confusion, headache, flushing, tachycardia, & seizures.

Antispasmodic

Amniocentesis:
1. Determines chromosomal & neural tube defects
2. fetal sex
3. Fetal lung maturity during 3rd trimester
Amphojel (AL (OH) 3):
Antacid administer after meal.
o max acid secretion occurs 1 to 3 hrs a meal

Anticonvulsants:
Can cause folate and vitamin D deficiencies

o Ex. Dilantin
Antiemetic
Prochloperazine (compazine): used to prevent n/v after surgery
o especially important when activities such as gagging & coughing can put pressure
on the suture line
Antidiarrheal
Loperamide (imodium): used for "travelers diarrhea"
o report fever & blood in stool
Antilipemic
Lovastatin(Mevacor): administer with food
o Cholesterol restricted diet.
Simvastatin(zocor): used when diet and exercise fails to normalize cholesterol
o causes lens opacity and liver dysfunction
Antipsychotic meds:
Clozapine: has potential to suppress bone marrow and cause agranulocytosis
o Report fever and sore throat
o Use for Schizophrenia
o Monitor CBC, drugs will d/c if WBC falls below 2000
o Contraindicated in pregnancy; excreted in breast milk
Haldol: used in treatment of Tourette syndrome
Risperidone: s/s include extra pyramidal reactions, headache, insomnia
o

like all antipsychotics, Risperidone can potentially cause tardive

dyskinesia (TD), extrapyramidal symptoms (EPS), & neuroleptic
malignant syndrome (NMS), although the risk for trigger diabetes

Thorazine: used for treatment of schizophrenia.

Ultraviolet treatment contraindicated for pts who take antipsychotic drugs
(photosensitivity)
Stelazine: is an antipsychotic,
o breast- feeding is contraindicated

Antistreptolysin O :
Serum titer test indicates glomerulonephritis
Aortic area:
Located on second intercostals space, just to the right of the sternum
Auscultate for S2 caused by closure of semilunar valve.

Apgar score:
1. Heart rate
2. Respirations
3. Reflex irritability
4. Muscle tone
5. Skin color
Atenolol (tenormin):
Beta 1 blocker
CO, SBP/DBP
Atrial septal defect:
Hallmark a fixed S2 split, which is continuous, & results from prolonged emptying of the
right ventricle.
Autonomic Dysreflexia:
HOB 90 degrees
Place extremities in dependent position to venous return to heart & venous return to
brain.
Assess for Bowel & Bladder impaction
Loose constrictive clothing
Administer antihypertensive medications.
Avoid use of fan because cold draft may trigger autonomic dysreflexia.
Bells palsy:
Chew food on unaffected side of mouth
Use artificial tears
o Causes an inability to close the eye
o Prevents drying of the cornea
Tape eyes shut at night
o Help retain moisture
Avoid sleeping with windows open
o Due to trigeminal hyperesthesia, protect face from cold & draft
Biophysical profile:
1. Nonstress test
2. Fetal tone
3. Fetal breathing
4. Fetal motion
5. Quantity of amniotic fluid

Blood transfusion:
All equipment should be ready before is ordered from blood bank
Normal saline is isotonic & can be used with blood transfusion
Stop IV Amphotericin (antifungal) because can cause allergic reaction with
blood transfusion
Breast self-examination:
Use pads (palmar surface of the middle three fingers) of your first three
fingers
Press the breast against the breast wall in a circular motion
Palpation begins in the upper lateral guardant; it moves from periphery to

the areola &moves around the breast counterclockwise.

Breast milk:
Produce with the delivery of the placenta, which causes the secretion of prolactin, which
in turn produces breast milk.
Breathing:
Pursed lip: breath should never be held during pursed lip breathing
o
o
o
o

Do not take deep breath.

Breathe in (inhale) through nose slowly for two counts (1, 2) keeping
mouse close.
Breath out (exhale) slowly through pursed lips while counting to 4
(1,2 ,3,4).
Used for emphysema, COPD.

Bronchodilators
Singulair: used for long-term control of asthma by decreasing frequency of asthma
attacks;
o Not used for acute asthma attacks
o Takes several weeks to lessen effects of chronic asthma
Buspirone (Buspar):
Take 14-30 hours before therapeutic effect take place.
Capoten
Antihypertensive

Use 1 hr before food or 2 hrs after food

Use salt substitute.

Cataracts:
Blurred vision, annoying glare, pupils changing from black to gray to milky white
teach pt about post activities & restrictions
Removal cataract with a lens implant allows correction of refraction of
distant vision
o Pt may not require glasses to see distances, but may still need glasses
for reading or close work.

Celiac disease

Gluten intolerance
Gluten free diet
o wheat, rye, oats

Central line:
If disconnected, 1st
o

nursing intervention:
place pt on the left side in Trendelenburg position
This position the likelihood that the air will pass into the RA &

be dispersed by way of the pulmonary artery

o
then O2 treatment & notify physician
Central venous catheter (CVC) insertion- use Valsalva maneuver to
prevent air embolism or Trendelenburg position
o Pt should not deep breathe!

Cervical cancer:
Woman with CC & radioactive cesium implant should avoid sexual
intercourse & tampons for 6 weeks (until next follow-up visit)
Avoid activities that cause abdominal strain for 6-8 weeks.

Cheyne stokes respirations:

AKA periodic breathing, irregular pattern of rapid breathing which builds from shallow

to very deep respirations & then back to shallow, followed by a period of apnea.
Often referred to as crescendo-decrescendo pattern
seen in severe CHF, drug overdose, ICP, and renal failure

Chest tubes:
The 1st 24 hrs after chest surgery about 500-1000ml of drainage occur
o with 100-300 being in the first 2hrs & then a progressive decline in amount
Suction control chamber
o there should be continuous gentle, slow but steady bubbling
Water Seal chamber:
o There should be bubbles in water seal chamber when the pt exhale, cough, or
sneeze
These bubbles indicate that the system is removing air from the pleural
space
o Fluid in water seal chamber should fluctuate with respirations of the patient,
rising with inspiration, and falling with expiration
Absence of fluctuation indicates either that the lung has re-expanded
Or that there is an obstruction of the chest draining tube
Most common causes are pt lying on tube, kinking, dependent
loops, clots or fibrin
Chronic renal failure:
Dietary management: COH intake to help improve energy
o 1-2 liters of fluid
o No salt substitutes because many of them are in K+, which may not be
adequately excreted by the compromised kidneys
o Body unable to store excess protein, which breaks down into waste and cannot be
excreted by the compromised kidney
Cipro:
Must be given at equal intervals (12hrs) around the clock to maintain blood levels
take 1hr before or 2 hr after meals
encourage fluids
Circumcision:
Do not remove yellowish- white exudates during cleaning of the area.
Use Vaseline on gauze on circumcision before diapering
Dressing change after 3 days of procedure

Colchicine:
Used for acute Gout attack

Confabulation:

Lying to fill Memory gaps

Result of vitamin B deficiency

alcoholism, Korsakoff syndrome has confabulation

Corticosteroids:
Can take up to 3 weeks before therapeutic effect can be reached,
instruct pt to clear nasal passages before use
Oral corticosteroids: Cause gastric irritation & should be taken with meals
Coumadin
INR normal 2-3

CPR:
1.
2.
3.
4.
5.
6.

Assess responsiveness
activate emergency medical system
call for defibrillator
assess breathing
provide two slow breaths
assess pulse

Crede's maneuver:
Performed by applying manual pressure over lower abdomen; this procedure promotes
complete emptying of the bladder in pt with lower motor neuron damage that impairs the
voiding reflex.
Cushings disease:
Hypocortisolism, there is a in body fat, causing a buffalo hump, truncal obesity &
moon face.
Thin arms & legs due to muscle wasting
Edema, purple skin striations, & resistance to infection
Demerol:
Can cause respiratory depression in the neonate if given < 4 before birth
CNS depressant crosses placenta
Affects fetal HR variability
Dexamethasone:
Leukocyte infiltration at the site of ocular inflammation
o This the exudative reaction of diseased tissue, lessening edema, redness &
scarring
Prescribed to help edema caused by brain tumors
BG common adverse reaction to the drug

Digoxin:
Stimulates parasympathetic division of the ANS vagal tone; Vagal effect slows heart
rate, refractory period, & slows conduction through atrioventricular nodes & junctional
tissues thus the potential for new arrhythmias to develop.
Excreted in the kidneys
Diverticulitis diet:
Low fat & high fiber ex: tuna sandwich with whole-wheat toast with carrot
sticks will bulk in stools. Do not use tomato and cucumber because contain
seeds and may stock in intestine.

Dobutamine:
Acts directly on beta receptors;
Activate dopaminergic sites at low doses.

Dressing change:
1. wash hand with soap
2. wear (don) clean gloves
3. remove the soiled dressing
4. wash hand with soap
5. don sterile gloves
6. perform sterile dressing change.

Dumping syndrome:
No fluids 1h before or 2h after meals
intake of COH since they are the first to be digested, rest will dumped in jejunum
causing pain, diarrhea within 30 minutes.
Lie down after eating
Increase fat and proteins
Emphysema:
lung sound hyperesonance
pursed lip breathing
Low oxygen
Enema:
Insert 3-4 inches
Epidural:

Begins 1 hr after the fluid bolus administration

o Ex: fluid bolus at 8:30, epidural has to start at 9:30.

Ethambutol (myambutol):
optic neuritis & visual activity

Eye disorders:
Retina: portion of the eye that perceives light & transmit impulses from nerve cells to the
optic nerve
o S/S of retinal detachment include
Flashes of light, blurred sooty vision
sensation of particles moving in the line of vision
sensation of veil like clothing in front of eye
areas of visual field being blank
Painless because there are no pain fibers in the retina
Strabismus: Involuntary drifting of one eye out of alignment with the other eye
o "lazy eye"
Eye patch:
You will have difficulty judging distance of objects.
Fetal Positions:
Occiput posterior: causes intense back pain because of fetal compression of the sacral
nerves.
Fosamax:
Inhibits bone resorption
Can be highly irritating to the GI tract especially the esophagus, causing irritation &
ulcerations/erosions
Dysphagia can also result.
Pt should sit for at least 30 minutes to facilitate delivery to the stomach & prevent acid
regurgitation & esophageal reflux.
Frequency:
Beginning of one contraction to the beginning of another contraction
Freuds stages:
Ego: Test reality & direct behavior by mediating between the pleasure seeking
instinctual drives of the id and the restrictiveness of the superego.
Id: source of psychic energy
Superego: conscience
Garlic
Can potentiate action of diabetic drugs (Insulin & ethers) & cause
hypoglycemic effect!

Gentamicin:
after instilling drop, put pressure on the lacrimal sac for 1 min to prevent systemic
absorption;
never touch eye tissue with equipment (would contaminate bottle of medication)
Glaucoma:
Halos around the eye, IOP
loss f peripheral vision late symptom
Acetazolamide (Diamox) is used for glaucoma
o

If pt allergic to sulfa do not give this drug with sulfonamide antibiotic

Open angle glaucoma- IOP

o Needs miotics (constrict pupils)
Diamox & Pilocarpine: s/s: blurry & cloudy vision; rainbows or
halos around light;

DO NOT administer Mydriatics (causes dilation of the pupils) thus IOP

o

EX. Atropine & Epinephrine

Glucose:
If pts Glucose level 32 mg/dl most concern is pt safety
o

seizure, altered mental status, at this critically low level

Pad the side rails of the stretcher.

Glucose tolerance test: normal <140

Granular cast
In urine indicates renal disease
Halo Vest traction:

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

to tip backward.

Hanta virus pulmonary syndrome:

causes S/S of thrombocytopenia
Head injuries:

Closed: prone to ICP; HOB 30-45 degrees to promote venous drainage

Concussion:

mild brain injury in which trauma to the

head results in a temporary disruption of normal brain function
o Ex I fell down & dont remember
o s/s: HA, retrograde amnesia, transient LOC.

Hearing test:
Rhine & Weber help to distinguish between nerve deafness and conduction problems
due to middle ear disease.
Nerve deafness:
o On Webers test sound lateralizes to good ear
o Air conduction>bone conduction
Ex: Aging, drugs, tumors
Conduction deafness:
o Weber lateralizes to diseased ear
o Bone conduction>air conduction
Ex: Otitis media, otosclerosis
Heimlich maneuver
is used to dislodge food or other foreign bodies in the throat
Heparin:
APTT normal 20-30 sec
Nurse needs permission to administer Protamine Sulfate antidote of
Heparin.
Therapeutic level 1.5 2 times

Histamine blocker:
Small frequent meals are not necessary
Tagamet
Hyperbaric oxygen therapy:
Benefits a compromised skin graft, because it oxygen at the wound site promote
healing.

Early sign of hypoxia

Inderal ((Propranolol):
Beta blocker,
May mask symptoms of hypoglycemia

Contraindicated in HF and Pulmonary edema

Infant developmental stage:

2 month old can lift the head 45 degree when in prone position; 4-6 month
rolls over, plays with own hands and grasps objects with both hands.

Influenza:
Most common complication is pneumonia.
Should be given to adults >50 years, pt with chronic conditions & persons traveling to
foreign countries.
Contraindicated if allergic to eggs

Droplet precaution: Use a facemask, a gown & gloves.

Ipecac syrup:
Not vomiting is priority; if none occurred, you may repeat dose in 20 minutes.
Pt to remain NPO until following day
Intracranial pressure:
head circumference is the 1st sign of ICP in children
Changes in speech, LOC, restlessness, & confusion
amount of procedures
sensitive to touching, jarring, loud noise
o Will cause ICP
Do not hyperventilate, it will CO2 (patent vasodilator) & cause ICP
Ischemic myocardial tissue changes:
1. Cause of the ST segment
2. or inverted t-wave
3. & a pathological Q-wave

Jaundice:

Physiological jaundice- immature hepatic function

o Occurs after 24 hrs, peak 72, and last 5-7 days
Pathological jaundice: occurs within 24hrs after birth
Infant bilirubin > 15 phototherapy considered at 72 hrs age.

Lactate Ringers:

is given during labor because replaces electrolyte loss.

Lactovegeterian:
Do no eat eggs
Levadopa:
Urine may appear darker than usual

Used in treatment of Parkinson disease

Licorice:

Herb that can K+ loss!

Lidocaine:
Antiarrythmic drug
Sometimes used to treat V-tachycardia (mg & K+)
Signs of toxicity include confusion & restlessness.
Lithium:
Therapeutic level 1-1.5
Lithium replaces Sodium in the cells
o sodium diet will precipitate lithium toxicity
o

Pt has to have regular sodium diet & adequate fluid intake.

Lugols solution:
release of thyroid hormone
administered 10-14 days prior to surgery
Vascularity & size of the thyroid; will post-op hemorrhage.
Lupus:
Diagnostic test include
1. Lab test include an above normal anti-DNA test
2. + Antinuclear antibody test
3. + Lupus erythematous cell test
Proteinuria & hyperlipidemia are common
Lung Cancer:
Common cause of SIADH, which is abnormal secretion of ADH

o results in water absorption and dilutional hyponatremia

Diuretics used to promote fluid loss
Lupus:
teach pt to avoid all direct exposure to the Sun
no work in garden (immunosuppresed)
o Lesions will become worse.
Diagnostic test include
1. above normal anti-DNA test
2. + antinuclear antibody test
3. + Lupus erythematous cell test
Lumbar puncture:
Place in flat supine position, which prevents headache & leaking of CSF at the site.
Lung sounds:
Normal sounds
o Vesicular: soft & low pitch breezy sound heard over most of the peripheral lung
fields, normal.
o Bronchovesicular: harsh sounds heard over the mainstem bronchi, normal.
o Bronchial: loud, coarse, blowing sound heard over the trachea, normal.
Abnormal sounds
o Rhonchi: musical sound or vibration commonly heard on inspiration.
Magnesium sulfate:
CNS depressant that blocks neuromuscular transmissions
relaxes smooth muscles, BP, ACTH
Use as an adjunct to treat acute nephritis & severe toxemia.
Medication administration
Rectal administration offers the patient the longest duration of pain relief 6-8 hrs.

After administering wrong dose of the medication, the nurse should do the
following
o Record the dose of med administered & dose of med ordered
o assess &record pts actual response
o inform MD
o record any adverse response to med
o submit report as soon as possible (within 24 hr)

Mitral stenosis:
Causes diastolic, rumbling & low pitch murmur.
Mononucleosis
Kissing diseases caused by the Epstein Bar virus in children.

s/s: constant fatigue , fever, sore throat, swollen lymph glands

Morphine:
Adult dosage 10mg/70kg of body weight when giving parentally
MRSA:
Requires contact precautions
Multiple Sclerosis:
Teach pt to sleep on stomach to minimize spasm of the flexor muscles of the hips &
knees.

Prone position can minimize spasm of flexor muscles of the hips & knees
during exacerbation.
Overextension avoided

Myocardial infarction:
After MI cardiac arrhythmias causes roughly 40-50% of deaths.
Interior MI can cause heart failure.
Post MI sublingual nitro, tissue plasminogen activator, & telemetry
Necrotizing fasciitis:
Aka, flesh eating bacteria, is a rare infection of the deeper layer of the skin & the
connective tissue.
Causes severe pressure like pain out of proportion to visible signs
Nonrebreathing mask:
Provides the highest oxygen concentration
Nystagmus:
Abnormal, involuntary, rapid oscillating eye movement; may be horizontal, vertical,
rotary, or mixed in direction.
May reflex labyrinth, or vestibular dysfunction, neurologic disease, barbiturate
intoxication, congenital or occupational factors
Oral hypoglycemic:
Act by stimulating beta cells in the pancreas to release endogenous insulin
Some facilitate insulins action on peripheral receptor sites
Delay the absorption of glucose in the intestinal tract
Piggybacking oxytocin permits d/c of the drug if necessary while permitting the vein to
remain open via primary IV.
Otosclerosis:
Causes deafness; s/s include hearing loss & buzzing ear noise.

Oxytocin:
Tetanic contractions are the most serious adverse effect associated with Oxytocin
administration.
Prolonged Oxytocin infusion may cause water intoxification, leading to seizures, coma
& death.
Responsible for milk, let down reflex.
Adverse effects HTN, fluid overload, uterine tetany.
Paroxetine (Paxetil):
2nd generation antidepressant, may cause constipation
PEEP:
Delivers positive pressure during expiration to keep airways constantly open
Peritoneal dialysis:
If Young woman Bloody outflow could be because of menstruating
Because of hypertonocity of dialysate, blood from uterus is pulled
through the fallopian tubes into the effluent
no intervention required
Continuous Ambulatory peritoneal dialysis (CAPD): some major
complication include
cloudy or opaque dialysate which is the earliest sign of peritonitis
Normal outflow is yellow & clear.
Dialysate can cause over weight, talk with dietitian.

Ph:

Blood:
o 7.35-7.45
Urine
o Child: 4.5- 8.0
o Adult: 4.6- 6.0

Phototherapy:
Common adverse effect in children is watery stool, which result from excretion of
bilirubin.
PKU:
normal <2
Inborn error of metabolism involving an inability to properly metabolize phenylalanine
an essential AA

Placenta
After delivering the placenta, the fundus is usually firmly contracted & located below the
umbilicus
o Fundus at umbilicus 8-12 hours postpartum
o moves 1 fingerbreadth/day
Produces estrogen & progesterone
Detoxifies some drugs & chemicals
Exchange site for food, gas & waste.
Placental transport of substance to and from fetus begins in 5th week
Immunity:
o Fetal immunity is transferred through the placenta
o Maternal immune system is actually suppressed during pregnancy to prevent
maternal rejection of the fetus, which the mothers body considers a foreign
protein
Phenobarbital:
Should be injested into a large muscle mass
Do not be mix or give with any other drugs since barbiturates are involved in many drug
interactions.
Used within 30 minutes after opening.

Physical assessment:
Normal:
1. Inspect
2. Palpate
3. Percuss
4. Auscultate
Abdomen:
1. Inspect
2. Auscultate
3. Percuss
4. Palpate
Newborn
1. Auscultate heart and lungs
2. Record heart and respiratory rate

3. Palpate and Percuss the abdomen

4. Examine eyes, ears, and mouth
5. Elicit the Moro reflex
Post-op pt:
Never put with pt considered dirty (COPD, any other infection) in the same
room
More important bowel sounds do not offer oral fluid until bowel sounds
returned.

Pregnancy:
Weight gain: 25-35lbs total
1st trimester: 2-4lbs
2nd trimester: 12-14lbs
1 pound/week until delivery
rd
3 trimester: 8-12 lbs
Primigravida : normal progress of labor at 1 1.2 cm dilation of the cervix
per hour

Labor:

S/S impending labor: contractions q 5 min in 1 hr

S/S active labor: contraction q 3-4 min, bloody show

Transition phase: 8-10 cm dilated, complete effacement

Pressure in pelvis causes intense desire to urinate.

Preload:
Volume in left ventricle at end of diastole
by any condition that circulating volume such as hemorrhage, sepsis, & anaphylaxis.
Hemorrhage -circulating volume by loss of volume from intravascular space.
Sepsis & anaphylaxis circulating volume by capillary permeability

Prozac:

SSRI for Depression

Never take omitted dose.
Return to regular dosing.
Cause dry mouth
Chew gum & good hygiene.
Orthostatic hypotension

QT interval corrected for heart rate:

Divide QT interval by square root of R-R interval.

Reflexes:
Moro reflex child abducts his extremities & fans his fingers when hears a

noise
o disappears at 2-3 month
Absence of red reflex in newborn is Emergency!
o cause blindness optic nerve

Hip spica cast

Can cause Cast syndrome- superior mesenteric syndrome; s/s: N/V, abd. pain,
bloating. Call MD!

Reglan:
Stimulates motility of upper GI tract, used to treat nausea of chemotherapy
Prevents or side effects of Platinol, a chemotherapy agent.
Ritodrine (Yutopar):
Help manage preterm labor.
Frequency & intensity of uterine contractions by stimulating B2 receptors in the uterine
smooth muscle
Drug of choice when trying to INHIBIT labor
Saline compress:
Warm saline good for phlebitis from an IV
Sequential compression device (SCD):
1. put the anti-embolism stocking on before wrapping & securing the sleeves
a. the stockings can the itching, sweating & heat that can build up under
the plastic sleeves & thereby can cause discomfort & skin irritation
2. Start by positioning sleeve under the leg so that the opening is at the knee
(in front).

Snellen chart:
Normal is 20/20
Back number indicates distance at which a person with normal vision can read the chart.
20/200 considered legally blind
Specific Gravity:
Normal value is 1.010-1.030
Measures concentration of particles in urine
Urea nitrogen 10-30
Serum creatinine 0.5- 1.5

Spinal injury:
Transfer: Never bend knee, swing legs.
keep straight alignment, logroll,
Pt. focuses on using arms.

Stadol
Should give in active phase to prevent respiratory depression of newborn
Should not give when birth is expected to occur within 2 hours
Stimulants:
Produces mood swings, tachycardia, anorexia, weight loss
Strabismus:
Involuntary drifting of one eye out of alignment with the other eye; "lazy eye"
Strokes:
Right-sided stroke include left-sided weakness, impulsiveness, and poor judgment.
Stump:
Do not elevate after 1st 24 hrs may result in flexion contraction

Syphilis:

develops in 2-6 wks

Begins with papule & then becomes ulcer

Synchronized intermittent mandatory ventilation (SIMV):

Allows for spontaneous breath at his own rate and tidal volume between ventilator
breaths
Synthroid:
metabolic process in the body, including glomerular filtration rate thereby urinary
output
Tegretol:
Inhibits nerve impulses & reduces the pain of the condition.
Use in treatment of tic douloureux
Tetracycline
Should be taken on an empty stomach
Tetralogy of fallot:
1. Pulmonic stenosis

2. Interventricular septal defect

3. Dextroposition of the aorta so that it overrides the interventricular septum & receives
venous as well as arterial blood
4. Right Ventricular Hypertrophy.
Theophylline:

(bronchodilator) normal level 10-20

Thrombolytic agent:
To salvage myocardium it must be administer within 12 hours.
Dangerous- contraindicated after brain injury.
Tissue necrosis:
S/S of beginning of TS include
o Irregular, mottled ring with bluish purple central area
Toddler:
walking without help at 13 15 month
building a tower of 3-4 blocks 18 month
using 2-3 word phrases 24 month
jumping with both feet at 30 month
If they have difficulty breathing & wheezing on inspiration, may be aspirating
large pieces of food (hot dog, nuts)

Tonsils:
1+ : barely visible outside the tonsillar pilar
2+ : between tonsillar pilar and uvula
3+: touches uvula
4+ : touching each other
TPN:
Hyperglycemia may occur if it is administered too rapidly
Transdermal patch:
Never use alcohol, soap, oil, lotion for cleansing.
Use warm water

Transsphenoidal hypophysectomy:
Surgical removal of the pituitary gland
o A small oval gland at the base of the brain in vertebrates, producing hormones
that control other glands & influence growth of the bone structure, sexual
maturing, & general metabolism
Instruct pt to avoid activities that increase intracranial pressure

Pt not allowed to brush teeth for 1-2 weeks

Tricuspid area (LLSB) 5th ICS @ the lower left of the

sternal border
S1 closure Mitral (bicuspid) & tricuspid valves.
S2- closure Aortic & Pulmonic valves.
Erbs point at the 3rd ICS and the left of the sternum
Good to Auscultate Aortic & Pulmonic murmurs
Trochanter roll:
Used to position unconscious pt
Current location for a trochanter rolls from lateral aspect of hip to the
mid-thigh
Hip joints lie between these points.

Tuberculosis:

Classic sign dry cough with blood tinged sputum & night sweat.
Nurse should FIRST: put a mask on pt

Treatment include
o Isoniazid (INH) which can cause neuropathy
Give B6 vitamin.
Walk with crutches:

Using both crutches on stairs:

o the good leg goes up, the bad leg comes down
Walk on surface:
o Bad leg with crutches goes first followed by good leg.

Withdrawals:
Alcohol withdrawal- hyper alert startles easily, anorexia, tremor, insomnia,
incr pulse

o Alcoholism causes infants mental retardation.

Narcotic withdrawal: watery eyes, cramps, and tremor

Xanax:
shouldn't be used if No pregnant
Z-track method:
Variation of standard IM techniques for administering meds that is highly irritating to
subcutaneous and skin tissues.
Prevents meds from leaking into subcutaneous & skin tissues
24 months old child:
child kicks ball without falling
child builds a block tower of 6 blocks
child uses two-three word phrases

5 east pleasant grove road

jackson, new jersey 08527
Important information: http://www.hunter.cuny.edu/arts_sci/q_a_premed.shtml