Perfusion

aneurysms and other blood vessel abnormalities.
Definition
X-Ray Xenon Computed Tomography:
Prep: -Evaluate blood flow to brain tissue
-Explain procedure to the patient -Patient breaths Xenon, a colorless, odorless gas, while
-Patient must remain still during procedure undergoing a standard CT scan.
-Assist with positioning Intrathecal Contrast-Enhanced CT Scan:
Purpose: -Diagnose disorders of the spine and spinal nerve roots;
determine bony fractures, curvatures, bone erosion, bone -Lumbar puncture to inject contrast dye
dislocation, and possible calcification of soft tissue, which -Patient may have a headache after procedure. Assist with
can damage the nervous system positioning.
Invasive or Non-Invasive
Head trauma and multiple injuries, one of the first priorities Term Definition
id to rule out cervical spine fractures. Precautions With Contrast
-Agency guidelines
Agents and informed concent
-Food or fluid restrictions
-Allergies to contrast agents, shellfish or iodine
Term Definition -Determining risk factors for contrast induced nephropathy
Cerebral Angiography (Arteriography) Prep: - pre-existing renaldisease
-Assess allergy to iodinated contrast -diabetic nephropathy
-NPO 4-6h. before the test -heart failure
-Dentures and hearing aids must be removed -dehydration
-Possible meds for relaxation -Drug Interference ( eg.metformin)
-Patient must remain still during the procedure
-Patient will feel warm/hot sensation when dye is injected
-Assess and document neuro signs, VS, and neurovascular Term Definition
checks Magnetic Resonance Imaging (MRI) Prep:
Purpose: -Magnetic Resonance Angiography
-Same as CT (MRA)
scan
Visualize cerebral circulation to detect blockages in the -Magnetic Resonance Spectroscopy
-Ask patient about
(MRS)any metal implants
arteries or veins in the brain, head, or neck. -Diffusion Imaging
-Remove
(DI)
all metal objects
Invasive or Non-Invasive -Check with radiologist about old tattoos (old ones contain
lead)
After the area has been numbed a catheter is inserted to the -No metal in MRI room!
femoral artery and a contrast medium is injected and images Purpose:
are recorded to identify aneurisms, traumatic injuries, Multiple sets of images are taken to determine normal and
strictures/occlusions, tumors, blood vessel displacement from abnormal anatomy.
edema, and arteriovenous (AV) malformations.
-Produces images better than the CT scan.
-Does not use ionizing radiation but, instead,
Term Definition relies on magnetic fields.
Computed Tomography Prep: -Images may be enhanced with the use of a non-iodine-based
-CT Angiography
-Guidelines for contrast contrast medium (gadolinium).
-Xenon Computed -Remain
Tomography
still Invasive or Non-Invasive
-Introthecal Contrast-Enhanced
-Determine if CTpatient is claustrophobic
necessary Magnetic Resonance Angiography (MRA):
-Remove all hair accessories -Evaluate blood flow and blood vessel abnormalities such as a
-Inform patient that scanner makes noise arterial blockage, intracranial aneurysms, and AV
-Warm/Cool sensation when dye is injected malformations.
-Metallic taste Magnetic Resonance Spectroscopy (MRS):
Purpose: -Detect abnormalities in the brains biochemical process, such
Accurate, quick, easy, noninvasive, painless, and least that which occurs in epilepsy, Alzheimer's disease, and stroke.
expensive method of diagnosis neuro problems. With the aid Diffusion Imaging (DI):
of a computer, pictures are taken at may horizontal levels, -Uses MRI technique to evaluate ischemia in the brain to
or slices, of the brain or spinal cord. determine the location and severity of a stroke.
Distinguish bone, soft tissue (brain, vascular system, and
ventricular system), and fluids (CSF or blood). Tumors,
infarctions, hemorrhage, hydrocephalus, and bone Term Definition
malformations can also be detected. Positron Emission Tomography (PET) Prep:
Invasive or Non-Invasive -Same as CT
-No caffeine, alcohol, or tobacco for 24h. before the test
CT Angiography: -NPO 4-12h. before test (if diabetic, no insulin)
-Contrast IV dye before the scan. -No drugs that alter glucose metabolism (glucose solution)
-Identifies blockages or narrowing of blood vessels, -Insert 2 IV lines
Purpose:
Provides information about the -Electrical test that assess the amplitude of the muscle's
specifically glucose and oxygen metabolism and cerebral response and how much it diminishes with progressive
blood flow. It evaluates drug metabolism and detect areas of stimulation.
metabolic alteration that occur in dementia, epilepsy, -A decrease in amplitude of more than 10% between the 1st
psychiatric and degenerative disorders, neoplasm's and and 5th responses generally indicates the defective
Alzheimer's disease. neuromuscular transmission characteristic of, but not unique
Invasive or Non-Invasive to, MG.
-2-3 hour procedure, patient will be blindfolded and have

earplugs. Term Definition
-Patient will be asked to perform certain mental functions to Electroencephalography (EEG) Prep:
activate different areas of the brain, -Patient on reclining chair or bed
-16-24 electrodes are placed on their head
-Lie still with eyes closed
Term Definition Purpose:
Single-Photon Emission Computed Tomography (SPECT)Prep: Records the electrical activity of the cerebral hemispheres
-Similar to PET/CT and each recording represents the voltage changes in
-Assess if patient has had recent other nuclear medicine various areas of the brain (determined by recording the
screenings (may leave traces of radiopharmaceutical agent). difference between two electrodes).
-Guidelines for contrast use It is performed to...
-Inject agent (gamma-emitting radionuclides) 1 hr. before -Determine general activities of cerebral hemispheres
scan -Determine origin of seizure activity
Purpose: -Determine cerebral functioning in pathologic conditions
This test uses a radieopharmeceutical agent that enables other than epilepsy
radioisotopes to cross the blood-brain barrier. The scan is -Differentiate between organic and hysterical or feigned
particularly useful in studying cerebral blood flow, blindness or deafness
amnesia, neoplasm's, head trauma, persistent vegetative -Monitor cerebral activity during surgical anesthesia
state, or brain death. -Diagnose sleep disorders
Invasive or Non-Invasive -Determine brain death
-Resolution of images are limited
-Injected with the material 1 hr before the scan. -Initial recording is while patient is still. The rest of the test
-Patient is positioned on a x-ray table in a quiet dark room. engages the patient in activities (hyperventilation (seizure
- Gamma cameras scan patients head and then images are inducing), photic stimulation (seizure inducing), sleep (tests
downloaded to a computer. temporal lobe epilepsy)).
Term Definition Term Definition

Magnetoencephalography (MEG) Prep: Evoked Potentials (Evoked Response) Prep:
-Auditory EP electrodes
-Attach
Purpose: -Visual EP Purpose:
Brain observed "in action" by measuring the magnetic -Somatosensory Measure
EPthe electrical signals to the brain generated by
fields produced by electrical activity in the brain via hearing, touch, or sight. Used to assess sensory nerve
extremely sensitive devices such as super-conducting problems and confirm neurologic conditions including MS,
quantum interference devices (SQUIDs). brain tumor, acoustic neuroma (small tumors of the inner
Invasive or Non-Invasive ear), and spinal cord injury. Also used to test sight and
hearing (usually in infants and young children), monitor
- Greater accuracy than EEG because of the minimal brain activity among coma patients, and confirm brain
distortion of the signal. death.
Invasive or Non-invasive
Term Definition -One set of electrodes are attached to the patients scalp, and
Electromyography Prep: the other to the body being tested.
-Testing is usually performed after exercise or exposure of -A stimulus is applied and the amount of time it takes to reach
the muscle to curare or to ischema the other electrode is recorded (a normal transmission time is
Purpose: instantaneous).
Identify nerve and muscle disorders as well as spinal cord
disease. It is considered a nerve conduction velocity study Auditory EP:
(NCVSs) -Assess high-frequency hearing loss, diagnose any damage to
Invasive or Non-Invasive acoustic nerve and auditory pathways in the brainstem, and
detect acoustic neuromas. evaluation cerebral vasospasm or narrowing or arteries
-Patient sits in soundproof room with headphones. Invasive or Non-Invasive
-Clicking sounds are delivered to one ear while a masking
sound is sent to the other.
Visual EP: Term Definition
-Detect loss of vision form optic nerve damage Muscle & Nerve Biopsies Prep:
-Patient sits close to a screen and focuses on the center of a Purpose:
checkerboard pattern Used to diagnose neuromuscular disorders. They may also
-One eye is tested at a time reveal if a patient is a carrier of a defective gene that could
Somatosensory EP: be passed onto children.
-Detect nerve or spinal cord damage or nerve degeneration Invasive or Non-Invasive
from MS and other degenerating diseases.
-Tiny electrical shocks are delivered by an electrode to a -Under local anesthesia, an incision is made and needle is
nerve in a leg/arm. inserted to remove a small sample.
-CT or MRI is performed before a brain biopsy which
involves injection of local anesthetic into the scalp, drilling a
Term Definition small hole through the scull, and inserting a hollow needle to
Cerebral Blood Flow Evaluation Prep: obtain the small sample.
-Explain Test -All samples are observed under a microscope to identify
-Ask physician in CNS depressants should be withheld 24h abnormalities
before the test
Purpose:
Measures CBF in many areas of the brain with the use of
radioactive substances and is useful in evaluating cerebral
vasospasm. Cards
Increased local blood flow can be seen with any neuronal Term Definition
activity, such as reading, hand movement, seizures, and Pleuirsy Thin membrane covering lungs surface (pleura) is irritated
temp elevation. Local blood flow decreases with or inflamed.
neurodegenerative disease, comas of metabolic origin,
increased intracrainial pressure (ICP), or subarachnoid
hemorrhage. Term Definition
Invasive of Non-Invasive Pericarditis Inflammation of the sac surrounding the heart. Worse when
breathing deeply or lying down (better when sitting up or
-Inhaled or injected xenon defuses into the brain tissue. leaning forward). Chest pain may radiate to shoulders.
-Patient receives various stimuli during the test Prescribed NSAIDs with possible steroids if pain is not
relieved within 48-96 hrs. Use of antibiotics are necessary if
infection is present.
Term Definition
Lumbar Puncture (Spinal Tap) Prep:
-Explain procedure, noting discomfort with local anesthetic Term Definition
and pain in leg(s) when needle is inserted. Pericardital Effusion complication of pericarditis when the space between the
-Place patient in fetal position remaining still parietal and visceral layers fills with fluid.
-Cleans sight thoroughly Diagnosed by X-ray, echo
-Injection site determained
Purpose:
-Obtain CSF pressure readings with manometer Term Definition
-Obtain CSF for analysis Cardiac Tamponade Excessive fluid in the pericardial cavity. It restricts diastolic
-Check for spinal blockage caused by a spinal cord lesion ventricular filling because the heart cannot expand, as a
-Inject contrast medium or air for diagnostic study result, cardiac output drops.
-Inject spinal anesthetics Diagnosed by ECG or X-ray. If not detected and it is a
-Inject certain drugs emergency, patient goes to cath. lab and the fluid needs to
-Reduce mild to moderate increased ICP in certain be removed (pericardiocentesis).
conditions
Term Definition
Pulmonary Embolus blockage of an artery in the lungs by fat,
Term Definition
air, a blood clot, or tumor cells.
Transcranial Doppler Ultrasonography Prep: Activity: bed rest, O2, modify living arrangements and
- ADL's
Purpose: Medication: Anticoagulant therapy (heparin, warfarin),
Evaluates intracranial hemodynamics. Uses sound waves to some fibrinolytic drugs (breaks down a fibrin clot- protein
measure the blood flow through the arteries. Valuable is that is involved in the clotting of the blood).
what do you do? 1. A (Airway)
Term Definition 2. B (Breathing- administer mouth-to-mouth)
Pneumothorax A collapsed lung is the collection of air in the 3. C (Circulation- CPR if needed)
space around the lungs. This buildup of air puts pressure on 4. D (Defibrillation- with AED or trained personnel)
the lung, so it cannot expand as much as it normally.
S/S: sudden, sharp pain on affected side (worse with
Term Definition
breathing/coughing), dyspnea (shortness of breath),
asymmetric chest wall movement. Expected medical orders for angina/MI -Frequent Vitals
-ECG monotoring
-IV NS
Term Definition -Obtain Labs (troponin, CK-MB, electrolytes)
Dyspnea (Nursing Considerations) Chest pain. -Possible Anti-coagulator Med
Nursing Considerations: Stay with patient and assess while -Chest X-ray
questioning. Assess pain (gradual/sudden, local/radiate, -Assessment/History
sharp/dull).

Angina Chest pain or discomfort due to ischemia (lack of O2 in the Nitro Prevention and treatment of MI and angina
tissues). SE: decreased BP, dizziness, anxiety, headache, tachycardia,
CHF, chest pain, cyanide toxicity
Term Definition
Term Definition
Severe Angina Chest pain or discomfort that occurs at rest or with exertion
and causes severe activity limitation. A increase in the Morphine Pain management for those with MI.
number of attacks and intensity of the pain is what SE: Respiratory depression
determines it unstable.
3 kinds: new-onset, varient (coronary artery spasm is a
Term Definition
temporary, sudden narrowing of one of the coronary
arteries), and pre-infarction. Platelet Inhibitor IV (Integrilin) Treats acute coronary syndrome and to prevent ischemic
episodes in patients undergoing coronary interventions.
SE: bleeding, headache, dizziness, and weakness
Term Definition
Term Definition
MI (myocardial infarction) Coronary artery occlusion with death of the tissue. Occurs
when the tissue is abruptly and severely deprived of O2. Fibrinolytic IV (t-pa) Therapy for acute MI (dissolves thrombi in the coronary
When blood flow decreases 80-90%, ischemia develops arteries).
(lack of blood supply). Necrosis (tissue death) of myocardial SE: Chest pain for greater than 30min., ECG will show
tissue can occur if blood flow is not restored. transmural ischema and injury, bleeding
Causes: -Atherosclerosis (plaque build up) Contraindications: recent abd surg or stroke, prior
-Rupture of plaque intracranial hemorrhage
-Subsequent thrombosis (blood clot)
-Occlusion of blood flow
Term Definition
Who "greets" MI patients? MONA
Term Definition M: Morphine
Silent Ischemia Lack of O2 without obvious pain but possible signs of O:Oxygen
decreased O2 sat, diaphoresis (excessive sweating), fatigue. N: Nitroprusside (vasodilator)
Seen more in women, those with diabetes and those who A: Aspirin
cannot speak.
Term Definition
Term Definition Coronary Reperfusion -restoration of blood flow to the heart
If you see someone lying on the floor that does not appear to 1. Assess (ABC's) 2 options
be breathing, what are the steps that need to be taken? 2. Reposition (Clear airway- tongue) 1. Fibrinolytics
3. Administer (mouth-to-mouth) 2. Percutaneous Coronary Intervention (PCI)
*No pulse? CPR (30 compressions, 2 vents)
*No Response? AED (Automated external defibrillator)
Term Definition
Percutaneous Coronary Intervention (PCI) e.g. -Angioplasty (widening a narrow/obstructed blood
Term Definition vessel)
If you find someone in a hospital room without a heartbeat ABC's (+D) -Angioplasty w/stent
-Atherectomy (procedure for opening a coronary artery hypotension if dehydrated
blocked by plaque, the buildup of cholesterol and other -hold for low BP
fatty substances in the inner lining of the artery.) -Hyperkalemia? Pregnant? dont give!
-Monitor electrolytes and I/O (contraindicated in renal
failure)
Term Definition
ST depression on a cardiac waveform lack of O2, but no cell death
Term Definition
Term Definition Angiotensin II receptor blockers (ARB) After MI: prevent ventricular remodeling and the
ST elevation -indicates a injury (reversible if dealt with quickly), can (Effect after MI and SE) development of heart failure (same as ACE-inhibitors)
progress to cell death SE: decrease BP, headache, dizziness, N/V, diarrhea, abd
- possible beginning signs of MI. pain, cough, rash, dry skin, cancer development
-Reperfusion: damage to tissue when blood returns after a
time if ischemia.
Interventions: Nitro (cath. lab), heparin, platelet inhibitor, Term Definition
treat unstable rhythms or BP's Lipid-lowering drugs After MI: reduces the incidence of CAD and MI due to
(Effect after MI and SE) reduction of cholesterol in serum
SE: none noted
Term Definition
How can you tell someone has had a MI? -ST elevation
(check 3x a few hrs apart to look for a trend. We want to see -T-wave inversion (reversed position) Term Definition
markers go DOWN not up.) -Possible new Q-wave Platelet Inhibitor (Plavix- if client received stent) After MI: prevent re-infarction after MI
Cardiac Markers: elevated troponin levels, positive CK-MB (Effect after MI and SE) SE: bleeding, increased bruising, headache, dizziness,
(creatine kinase- muscle and brain)= heart muscle damage weakness
has occurred. -Stopped 7 days before any procedures

A cardiac patient is walking the hospital halls. What -decreased systolic BP>20mm/hg Coronary Artery Bypass -internal mammary (IMA)
changes would you see that indicate the person needs to sit -HR changes 20bpm (vessels used) -saphenous vein
down? -chest pain/dyspnea -radial

What discharge teaching is important to a client after a MI? -Cardiac rehab Cardiopulmonary Bypass technique that temporarily takes over the function of
-1 Nitro for pain (if not relieved call 911) the heart and lungs during surgery, maintaining the
-wt. gain of >2lbs/day (call MD) circulation of blood and the oxygen content of the body.
-Low Na+ and cholesterol diet
-exercise gradually
Term Definition
Protamine Heparin antagonist. Used after cardiopulmonary bypass to
"thicken" the blood so the patient does not bleed out as
easy. Reduces post-op bleeding
Term Definition
Aspirin After MI: antiplatelet that prevents clots
(Effect after MI and SE) SE: GI upset if not taken with food, tinnitus (ringing in Term Definition
ears) Cardiopulmonary bypass complications Hypothermia, hypertension, "3rd spacing" (blood leaks out
of the vascular space), dysrhythmias, MI, renal
insufficiency from them not being perfused, microemboli
Term Definition
SNS blockers: beta-blocker After MI: reduce HR, decrease force of cardiac contraction,
(Effect after MI and SE) decrease cardiac workload and the demand for O2 Term Definition
SE: Increases exercise tolerance, hold if low "Off-Pump" bypass heart is still beating and is less traumatic to the body. Only
BP(systolic<60)/HR(<60), heart failure, CHF, arrhythmias, disadvantage is that the surgeon has to be very talented to
reduces CO work on a beating heart.

ACE-inhibitors After MI: prevent ventricular remodeling, and the Intra-aortic balloon pump Used to decrease myocardial oxygen demand while
(Effect after MI and SE) development of heart failure. at the same time increasing cardiac output. By
SE: rash, tachycardia, cough that may go away in 2 weeks, increasing cardiac output it also increases coronary
blood flow and therefore myocardial oxygen delivery.
It consists of a cylindrical balloon that sits in Term Definition
the aorta and counterpulsates. That is, it actively Non-surgical treatment for aneurysm monitor growth, maintain normal BP, yearly ultrasounds or
deflates in systole increasing forward blood flow by CT scans
reducing afterload thus, and actively inflates
in diastole increasing blood flow to the coronary antihypertensive medication
arteries.
Term Definition
Term Definition
Surgical management of a aneurysm resection/repair, stents
Immediate admission priorities for a patient that has just Vitals, monitors, IV fluids, tubes, ventilator
had CABG
Term Definition
Marfan's Syndrom A disorder of connective tissue, the tissue that strengthens
Term Definition
the body's structures. Disorders of connective tissue affect
Purpose of chest tubes for a patient that has CABG prevent excessive blood from accumulating in the the skeletal system, cardiovascular system, eyes, and skin.
pericardial sac or pleural cavity
-If drainage >200cc/hr in the first 4-6hrs, report. Term Definition

PVD (peripheral vascular disease) diseases of blood vessels outside the heart and brain. It's
often a narrowing of vesselsthat carry blood to the legs,
Term Definition
arms, stomach or kidneys.
Cardiac Tamponade Symptoms Changes in LOC, sensation of drainage, jugular venous
distention
Term Definition
Arterial Disease life-threatening, sudden onset (pale, cool, pain in extremity)
Term Definition
Products for excessive post-op bleeding -Protamine Term Definition
-Vit K Venous Disease defective valves- venous insufficiency and varicose veins,
-fresh frozen plasma phlebitis, thrombus
-PRBC's (packed RBC's)
Term Definition
Term Definition
Teaching for patients with chronic PVD manage hypertension and diabetes
Physiological consequences of pain vasoconstriction, increased HR, hypoventilation, collapsed
lung, hyperglycemia, water and Na+ retention
Term Definition
Term Definition Claudication Leg pain
Non-pharmacological interventions for pain hot/cold, TENS (transcutaneous electrical nerve -relieved by resting and lowering the effected leg
stimulation), massage, acupuncture, relaxation, distraction,
music
Term Definition
Tests to diagnose PAD ultrasound, angiography, exercise tolerance, BP in arm vs
Term Definition
foot
Expectations for recovery after CABG In-patient for 4-5 days, sternal precautions, appetite,
incision care, cardiac rehab
Term Definition
Term Definition Patients with PVD at risk for... heart disease, chronic angina, MI, CAD, stroke
Aneurysm abnormal widening or ballooning of a portion of an
artery due to weakness in the wall of the blood vessel Term Definition
Acute Arterial Occlusion Causes ischemia= pain, pallor, pulselessness, paresthesia,
cold
Term Definition
Atherosclerosis plaque within the arterial wall
(leading risk factor of CVD and PVD) Term Definition
Peripheral arterial revascularization check extremity every 15min for first hour, than every hour
Term Definition (Nursing priorities for the patient) after. Changes in color, temp, pulses, and BP.
How is a aortic aneurysm diagnosed? CT, X-ray, ultrasound
How is DVT diagnosed? physical examination Lymphedema inadequate drainage of plasma from interstitial space.
(Deep Vein Thrombosis) Treatment is massaging and compression stockings.

Activity guidelines for patient with DVT compression stockings, leg exercises, bed rest Causes of valve disease Infective pericarditis (inflammation of the pericardial sac),
HTN, genetic, connective tissue disease
-No massaging!
Term Definition
Term Definition Orthopnea Difficulty breathing while laying down
Unfractionated IV heparin given IV in hospital
Term Definition
Term Definition Petechiae pinpoint red spots that occur in patients with endocarditis
Low-molecular weight SQ heparin given after and major surgery to prevent DVT (inflammation of the inside lining of the heart)
can be given at home

Term Definition
Systolic Heart Failure Left ventricle does not pump effectively
Term Definition
When checking lab values to see if heparin levels in the INR (international normalized ratio), HBG, and platelets
patient are stable, what do you look at? Term Definition
Diastolic Heart Failure a filling problem- occurs more in women
Term Definition
Lab test measured to monitor someone on warfarin for a INR: 1.5-2.0 Term Definition
DVT or PE... Splinter hemorrhages little red dots in the eyes (occurs with endocarditis)
(normal range?)
Term Definition
Term Definition Ventricular remodeling Occurs after a MI. Part of the muscle dies and the ventricle
Teaching points for patient on anticoagulants -Avoid injury changes shape to compensate.
-Discontinue before dental visits and surgeries
-Bruising may occure
-monitor intake of vit K Term Definition
Ventricular Septal Defect "hole in the heart", hole is the septum wall.
Term Definition
"HIT" Heparin that causes a sudden drop in platelets Term Definition
(and its treatment) Treatment: Stop all heparin infusions and administer a S/S of digitalis toxicity low HR, visual disturbances (halos around lights)
thrombin inhibitor (argatroban or lepirudin)
Term Definition
Term Definition Causes of Rheumatic Fever Untreated strep with inflammatory involvement in the
Venous stasis ulcers stasis ulcer is an ulcer (a crater) that develops in an heart and joints
area in which the circulation is sluggish and the
venous return (the return of venous blood toward the
heart) is poor. A common location for stasis ulcers is Term Definition
on the ankle. How is rheumatic fever diagnosed and treated? Diagnosed: echocardiogram, throat culture
Stasis refers to a stoppage or slowdown in the flow of Treatment: bed rest, anti-inflammatories
blood (or other body fluid such as lymph).
Treatment: Viscopaste dressings, hydrocolloid
dressing, unna boot, and avoid tight pants and Term Definition
narrow banded knee socks Risk factors of infective endocarditis prosthetic valves, IV drug users

Raynaud's Arterial vasospasms treated with vasodialators S/S of infective endocarditis new murmur, fevers, wt. loss, heart failure, petechiae,
systemic embolization
Treatment of infective endocarditis antibiotics, rest, surgical removal of valve L vs R sided heart failure L side HF occurs first, then R
Left sided: blood backs up into pulmonary
Right sided: blood backs up into the periphery
Term Definition
Surgeries for valve disease -Balloon valvuloplasty (open a narrow heart valve)
-direct/open commissurotomy (surgical incision of Term Definition
a commissure in the body, as one made in the heart Heart Failure Causes: HTN, LV damage, aortic or mitral valve stinosis
to relieve constriction of the mitral valve) (Causes and diagnostic tests) Tests: X-ray, Echo, check liver enzymes (abnormal in RHF),
-Mitral valve reconstruction elevated BUN/creatinine
-prosthetic/biologic valves
Term Definition
Term Definition Teaching points for patients with HF daily weight (>2lbs/day or 5lbs/week, call), SOB or chest
What do you expect after a valve replacement surgery? HTN, hemorrhage, decrease in CO, lifelong anticoagulant pain (call), Na+ and possible fluid restriction, avoid
therapy, digotxin for 3-6 months to maintain CO and NSAID's (cause fluid and Na+ retention), separate meds
prevent A-fib that have the same effect of lowering BP.

S/S of valve disease fatigue, dyspnea, murmur, heart-failure Immediate care for acute exacerbation of HF O2 if sats are low, sitting position for easy breathing,
diuretics, nitrates/morphine for angina/dyspnea
Term Definition
Mitral Regurgitation between L atrium and L ventricle, backflow of blood into L Term Definition
atrium when ventricle contracts Surgeries for HF ICD (implanted cardioverter defibrillator), angioplasty,
transplant, LVAD (left ventricular assist devices)
Term Definition
Mitral Prolapse valvular leaflets enlarge and prolapse into the L atrium Term Definition
during systole Classes of Heart Disease Class I: no limitations
Class II: slight limitation but comfortable, physical activity
results in fatigue
Term Definition Class III: Limitation on activity, sm physical activity causes
Mitrial Stenosis Leaflets fuse and become stiff and cordae tendineae fatigue
contract and shorten Class IV: All physical activity is with discomfort. symptoms
may be present at rest
Term Definition
Aortic Regurgitation from L ventricle to aorta. Leaflets do not close properly Term Definition
during diastole. Regurgitation of blood from aorta back Cardiac resynchronization therapy defibrillator that shocks the ventricles at the same time so
into L ventricle during diastole. Ventricle dilates to they synchronize
accommodate the greater volume and eventually Used for patients in Class II and have a wide QRS (meaning
hypertrophies the ventricles do not contract at the same time)

Aortic Stinosis Stiffening aorta that causes increased after-load. Aortic Pacemaker speeds/slows the heart, helps ventricles beat "in sync"
orifice narrows and obstructs outflow
Term Definition
Term Definition ICD (implantable cardioverter defibrillator) Ventricular pacing and shocking
Dilated cardiomyopathy Heart becomes weakened, enlarged, and cannot pump
(risk factors) blood efficiently.
Risk factors: Cardiac patients undergoing chemo, viral Term Definition
infections, abuse of alcohol What should the patient avoid if they have a ICD Jackhammers, electrolysis, strong magnets (MRI), working
over a running engine, stun guns, airport security, TENS
units (transcutaneous electrical nerve stimulation), chain
Term Definition saws, cautery
Heart Failure ineffective pumping of the heart
Term Definition
Inotropes (digoxin) Increases strength of heart contraction, HR control Term Definition
SE: Bradycardia, AV block, toxicity Pneumothorax A collapsed lung is the collection of air in the
space around the lungs. This buildup of air puts pressure on
the lung, so it cannot expand as much as it normally.
Term Definition
S/S: sudden, sharp pain on affected side (worse with
Who is at risk for DKA? Anyone with DT1 breathing/coughing), dyspnea (shortness of breath),
asymmetric chest wall movement.
Usually triggered by...
1. A illness
2. problem w/insulin therapy Term Definition
Dyspnea (Nursing Considerations) Chest pain.
Nursing Considerations: Stay with patient and assess while
Term Definition
questioning. Assess pain (gradual/sudden, local/radiate,
Who is at risk for HHS? Patients with DT2 sharp/dull).
Possible onset causes...

1. illness (that produces dehydration) Term Definition
2. infection Angina Chest pain or discomfort due to ischemia (lack of O2 in the
3. Stress Responcec to a illness tissues).
Term Definition
Cards Severe Angina Chest pain or discomfort that occurs at rest or with exertion
and causes severe activity limitation. A increase in the
Term Definition
number of attacks and intensity of the pain is what
Pleuirsy Thin membrane covering lungs surface (pleura) is irritated determines it unstable.
or inflamed. 3 kinds: new-onset, varient (coronary artery spasm is a
temporary, sudden narrowing of one of the coronary
arteries), and pre-infarction.
Term Definition
Pericarditis Inflammation of the sac surrounding the heart. Worse when
breathing deeply or lying down (better when sitting up or
leaning forward). Chest pain may radiate to shoulders. Term Definition
Prescribed NSAIDs with possible steroids if pain is not MI (myocardial infarction) Coronary artery occlusion with death of the tissue. Occurs
relieved within 48-96 hrs. Use of antibiotics are necessary if when the tissue is abruptly and severely deprived of O2.
infection is present. When blood flow decreases 80-90%, ischemia develops
(lack of blood supply). Necrosis (tissue death) of myocardial
tissue can occur if blood flow is not restored.
Term Definition
Causes: -Atherosclerosis (plaque build up)
Pericardital Effusion complication of pericarditis when the space between the -Rupture of plaque
parietal and visceral layers fills with fluid. -Subsequent thrombosis (blood clot)
Diagnosed by X-ray, echo -Occlusion of blood flow

Cardiac Tamponade Excessive fluid in the pericardial cavity. It restricts diastolic Silent Ischemia Lack of O2 without obvious pain but possible signs of
ventricular filling because the heart cannot expand, as a decreased O2 sat, diaphoresis (excessive sweating), fatigue.
result, cardiac output drops. Seen more in women, those with diabetes and those who
Diagnosed by ECG or X-ray. If not detected and it is a cannot speak.
emergency, patient goes to cath. lab and the fluid needs to
be removed (pericardiocentesis).
Term Definition
If you see someone lying on the floor that does not appear to 1. Assess (ABC's)
Term Definition
be breathing, what are the steps that need to be taken? 2. Reposition (Clear airway- tongue)
Pulmonary Embolus blockage of an artery in the lungs by fat, 3. Administer (mouth-to-mouth)
air, a blood clot, or tumor cells. *No pulse? CPR (30 compressions, 2 vents)
Activity: bed rest, O2, modify living arrangements and *No Response? AED (Automated external defibrillator)
ADL's
Medication: Anticoagulant therapy (heparin, warfarin),
some fibrinolytic drugs (breaks down a fibrin clot- protein Term Definition
that is involved in the clotting of the blood). If you find someone in a hospital room without a heartbeat ABC's (+D)
what do you do? 1. A (Airway) -Atherectomy (procedure for opening a coronary artery
2. B (Breathing- administer mouth-to-mouth) blocked by plaque, the buildup of cholesterol and other
3. C (Circulation- CPR if needed) fatty substances in the inner lining of the artery.)
4. D (Defibrillation- with AED or trained personnel)
Term Definition
Term Definition ST depression on a cardiac waveform lack of O2, but no cell death
Expected medical orders for angina/MI -Frequent Vitals
-ECG monotoring
-IV NS Term Definition
-Obtain Labs (troponin, CK-MB, electrolytes) ST elevation -indicates a injury (reversible if dealt with quickly), can
-Possible Anti-coagulator Med progress to cell death
-Chest X-ray - possible beginning signs of MI.
-Assessment/History -Reperfusion: damage to tissue when blood returns after a
time if ischemia.
Interventions: Nitro (cath. lab), heparin, platelet inhibitor,
treat unstable rhythms or BP's
Term Definition
Nitro Prevention and treatment of MI and angina
SE: decreased BP, dizziness, anxiety, headache, tachycardia, Term Definition
CHF, chest pain, cyanide toxicity How can you tell someone has had a MI? -ST elevation
(check 3x a few hrs apart to look for a trend. We want to see -T-wave inversion (reversed position)
markers go DOWN not up.) -Possible new Q-wave
Term Definition Cardiac Markers: elevated troponin levels, positive CK-MB
Morphine Pain management for those with MI. (creatine kinase- muscle and brain)= heart muscle damage
SE: Respiratory depression has occurred.

Platelet Inhibitor IV (Integrilin) Treats acute coronary syndrome and to prevent ischemic A cardiac patient is walking the hospital halls. What -decreased systolic BP>20mm/hg
episodes in patients undergoing coronary interventions. changes would you see that indicate the person needs to sit -HR changes 20bpm
SE: bleeding, headache, dizziness, and weakness down? -chest pain/dyspnea

Fibrinolytic IV (t-pa) Therapy for acute MI (dissolves thrombi in the coronary What discharge teaching is important to a client after a MI? -Cardiac rehab
arteries). -1 Nitro for pain (if not relieved call 911)
SE: Chest pain for greater than 30min., ECG will show -wt. gain of >2lbs/day (call MD)
transmural ischema and injury, bleeding -Low Na+ and cholesterol diet
Contraindications: recent abd surg or stroke, prior -exercise gradually
intracranial hemorrhage
Term Definition
Who "greets" MI patients? MONA Term Definition
M: Morphine Aspirin After MI: antiplatelet that prevents clots
O:Oxygen (Effect after MI and SE) SE: GI upset if not taken with food, tinnitus (ringing in
N: Nitroprusside (vasodilator) ears)
A: Aspirin
Term Definition
Term Definition SNS blockers: beta-blocker After MI: reduce HR, decrease force of cardiac contraction,
Coronary Reperfusion -restoration of blood flow to the heart (Effect after MI and SE) decrease cardiac workload and the demand for O2
2 options SE: Increases exercise tolerance, hold if low
1. Fibrinolytics BP(systolic<60)/HR(<60), heart failure, CHF, arrhythmias,
2. Percutaneous Coronary Intervention (PCI) reduces CO

Percutaneous Coronary Intervention (PCI) e.g. -Angioplasty (widening a narrow/obstructed blood ACE-inhibitors After MI: prevent ventricular remodeling, and the
vessel) (Effect after MI and SE) development of heart failure.
-Angioplasty w/stent SE: rash, tachycardia, cough that may go away in 2 weeks,
hypotension if dehydrated blood flow and therefore myocardial oxygen delivery.
-hold for low BP It consists of a cylindrical balloon that sits in
-Hyperkalemia? Pregnant? dont give! the aorta and counterpulsates. That is, it actively
-Monitor electrolytes and I/O (contraindicated in renal deflates in systole increasing forward blood flow by
failure) reducing afterload thus, and actively inflates
in diastole increasing blood flow to the coronary
arteries.
Term Definition
Angiotensin II receptor blockers (ARB) After MI: prevent ventricular remodeling and the Term Definition
(Effect after MI and SE) development of heart failure (same as ACE-inhibitors) Immediate admission priorities for a patient that has just Vitals, monitors, IV fluids, tubes, ventilator
SE: decrease BP, headache, dizziness, N/V, diarrhea, abd had CABG
pain, cough, rash, dry skin, cancer development
Term Definition
Term Definition Purpose of chest tubes for a patient that has CABG prevent excessive blood from accumulating in the
Lipid-lowering drugs After MI: reduces the incidence of CAD and MI due to pericardial sac or pleural cavity
(Effect after MI and SE) reduction of cholesterol in serum
SE: none noted -If drainage >200cc/hr in the first 4-6hrs, report.

Platelet Inhibitor (Plavix- if client received stent) After MI: prevent re-infarction after MI Cardiac Tamponade Symptoms Changes in LOC, sensation of drainage, jugular venous
(Effect after MI and SE) SE: bleeding, increased bruising, headache, dizziness, distention
weakness
-Stopped 7 days before any procedures
Term Definition
Term Definition Products for excessive post-op bleeding -Protamine
Coronary Artery Bypass -internal mammary (IMA) -Vit K
(vessels used) -saphenous vein -fresh frozen plasma
-radial -PRBC's (packed RBC's)

Cardiopulmonary Bypass technique that temporarily takes over the function of Physiological consequences of pain vasoconstriction, increased HR, hypoventilation, collapsed
the heart and lungs during surgery, maintaining the lung, hyperglycemia, water and Na+ retention
circulation of blood and the oxygen content of the body.
Term Definition
Term Definition Non-pharmacological interventions for pain hot/cold, TENS (transcutaneous electrical nerve
Protamine Heparin antagonist. Used after cardiopulmonary bypass to stimulation), massage, acupuncture, relaxation, distraction,
"thicken" the blood so the patient does not bleed out as music
easy. Reduces post-op bleeding
Term Definition
Term Definition Expectations for recovery after CABG In-patient for 4-5 days, sternal precautions, appetite,
Cardiopulmonary bypass complications Hypothermia, hypertension, "3rd spacing" (blood leaks out incision care, cardiac rehab
of the vascular space), dysrhythmias, MI, renal
insufficiency from them not being perfused, microemboli
Term Definition
Aneurysm abnormal widening or ballooning of a portion of an
Term Definition artery due to weakness in the wall of the blood vessel
"Off-Pump" bypass heart is still beating and is less traumatic to the body. Only
disadvantage is that the surgeon has to be very talented to
work on a beating heart. Term Definition
Atherosclerosis plaque within the arterial wall
(leading risk factor of CVD and PVD)
Term Definition
Intra-aortic balloon pump Used to decrease myocardial oxygen demand while
at the same time increasing cardiac output. By Term Definition
increasing cardiac output it also increases coronary How is a aortic aneurysm diagnosed? CT, X-ray, ultrasound
Term Definition
Term Definition How is DVT diagnosed? physical examination
Non-surgical treatment for aneurysm monitor growth, maintain normal BP, yearly ultrasounds or (Deep Vein Thrombosis)
CT scans
Term Definition
antihypertensive medication
Activity guidelines for patient with DVT compression stockings, leg exercises, bed rest
Term Definition -No massaging!

Surgical management of a aneurysm resection/repair, stents
Term Definition
Term Definition Unfractionated IV heparin given IV in hospital
Marfan's Syndrom A disorder of connective tissue, the tissue that strengthens
the body's structures. Disorders of connective tissue affect
Term Definition
the skeletal system, cardiovascular system, eyes, and skin.
Low-molecular weight SQ heparin given after and major surgery to prevent DVT
Term Definition can be given at home

PVD (peripheral vascular disease) diseases of blood vessels outside the heart and brain. It's
often a narrowing of vesselsthat carry blood to the legs,
Term Definition
arms, stomach or kidneys.
When checking lab values to see if heparin levels in the INR (international normalized ratio), HBG, and platelets
patient are stable, what do you look at?
Term Definition
Arterial Disease life-threatening, sudden onset (pale, cool, pain in extremity)
Term Definition
Lab test measured to monitor someone on warfarin for a INR: 1.5-2.0
Term Definition DVT or PE...
Venous Disease defective valves- venous insufficiency and varicose veins, (normal range?)
phlebitis, thrombus
Term Definition
Term Definition Teaching points for patient on anticoagulants -Avoid injury
Teaching for patients with chronic PVD manage hypertension and diabetes -Discontinue before dental visits and surgeries
-Bruising may occure
-monitor intake of vit K
Term Definition
Claudication Leg pain
Term Definition
-relieved by resting and lowering the effected leg "HIT" Heparin that causes a sudden drop in platelets
(and its treatment) Treatment: Stop all heparin infusions and administer a
thrombin inhibitor (argatroban or lepirudin)
Term Definition
Tests to diagnose PAD ultrasound, angiography, exercise tolerance, BP in arm vs
Term Definition
foot
Venous stasis ulcers stasis ulcer is an ulcer (a crater) that develops in an
area in which the circulation is sluggish and the
Term Definition venous return (the return of venous blood toward the
Patients with PVD at risk for... heart disease, chronic angina, MI, CAD, stroke heart) is poor. A common location for stasis ulcers is
on the ankle.
Stasis refers to a stoppage or slowdown in the flow of
Term Definition blood (or other body fluid such as lymph).
Acute Arterial Occlusion Causes ischemia= pain, pallor, pulselessness, paresthesia, Treatment: Viscopaste dressings, hydrocolloid
cold dressing, unna boot, and avoid tight pants and
narrow banded knee socks
Term Definition
Term Definition
Peripheral arterial revascularization check extremity every 15min for first hour, than every hour
(Nursing priorities for the patient) after. Changes in color, temp, pulses, and BP. Raynaud's Arterial vasospasms treated with vasodialators
Term Definition
Lymphedema inadequate drainage of plasma from interstitial space. Term Definition
Treatment is massaging and compression stockings. Treatment of infective endocarditis antibiotics, rest, surgical removal of valve

Causes of valve disease Infective pericarditis (inflammation of the pericardial sac), Surgeries for valve disease -Balloon valvuloplasty (open a narrow heart valve)
HTN, genetic, connective tissue disease -direct/open commissurotomy (surgical incision of
a commissure in the body, as one made in the heart
to relieve constriction of the mitral valve)
Term Definition
-Mitral valve reconstruction
Orthopnea Difficulty breathing while laying down -prosthetic/biologic valves

Petechiae pinpoint red spots that occur in patients with endocarditis What do you expect after a valve replacement surgery? HTN, hemorrhage, decrease in CO, lifelong anticoagulant
(inflammation of the inside lining of the heart) therapy, digotxin for 3-6 months to maintain CO and
prevent A-fib
Term Definition
Systolic Heart Failure Left ventricle does not pump effectively Term Definition
S/S of valve disease fatigue, dyspnea, murmur, heart-failure
Term Definition
Diastolic Heart Failure a filling problem- occurs more in women Term Definition
Mitral Regurgitation between L atrium and L ventricle, backflow of blood into L
atrium when ventricle contracts
Term Definition
Splinter hemorrhages little red dots in the eyes (occurs with endocarditis)
Term Definition
Mitral Prolapse valvular leaflets enlarge and prolapse into the L atrium
Term Definition during systole
Ventricular remodeling Occurs after a MI. Part of the muscle dies and the ventricle
changes shape to compensate.
Term Definition
Mitrial Stenosis Leaflets fuse and become stiff and cordae tendineae
Term Definition contract and shorten
Ventricular Septal Defect "hole in the heart", hole is the septum wall.
Term Definition
Term Definition Aortic Regurgitation from L ventricle to aorta. Leaflets do not close properly
S/S of digitalis toxicity low HR, visual disturbances (halos around lights) during diastole. Regurgitation of blood from aorta back
into L ventricle during diastole. Ventricle dilates to
accommodate the greater volume and eventually
Term Definition hypertrophies
Causes of Rheumatic Fever Untreated strep with inflammatory involvement in the
heart and joints
Term Definition
Aortic Stinosis Stiffening aorta that causes increased after-load. Aortic
Term Definition orifice narrows and obstructs outflow
How is rheumatic fever diagnosed and treated? Diagnosed: echocardiogram, throat culture
Treatment: bed rest, anti-inflammatories
Term Definition
Dilated cardiomyopathy Heart becomes weakened, enlarged, and cannot pump
Term Definition (risk factors) blood efficiently.
Risk factors of infective endocarditis prosthetic valves, IV drug users Risk factors: Cardiac patients undergoing chemo, viral
infections, abuse of alcohol
Term Definition
S/S of infective endocarditis new murmur, fevers, wt. loss, heart failure, petechiae, Term Definition
systemic embolization Heart Failure ineffective pumping of the heart
Term Definition
Term Definition Inotropes (digoxin) Increases strength of heart contraction, HR control
L vs R sided heart failure L side HF occurs first, then R SE: Bradycardia, AV block, toxicity
Left sided: blood backs up into pulmonary
Right sided: blood backs up into the periphery
Term Definition
Who is at risk for DKA? Anyone with DT1
Term Definition
Heart Failure Causes: HTN, LV damage, aortic or mitral valve stinosis Usually triggered by...
(Causes and diagnostic tests) Tests: X-ray, Echo, check liver enzymes (abnormal in RHF), 1. A illness
elevated BUN/creatinine 2. problem w/insulin therapy

Teaching points for patients with HF daily weight (>2lbs/day or 5lbs/week, call), SOB or chest Who is at risk for HHS? Patients with DT2
pain (call), Na+ and possible fluid restriction, avoid
NSAID's (cause fluid and Na+ retention), separate meds Possible onset causes...
that have the same effect of lowering BP. 1. illness (that produces dehydration)
2. infection
3. Stress Responcec to a illness
Term Definition
Immediate care for acute exacerbation of HF O2 if sats are low, sitting position for easy breathing, Cards
diuretics, nitrates/morphine for angina/dyspnea
Term Definition
What are the eight rights of med admin? drug
Term Definition dose
Surgeries for HF ICD (implanted cardioverter defibrillator), angioplasty, patient
transplant, LVAD (left ventricular assist devices) route
right
education
Term Definition documentation
Classes of Heart Disease Class I: no limitations
Class II: slight limitation but comfortable, physical activity Term Definition
results in fatigue
Class III: Limitation on activity, sm physical activity causes what is standard in a syringe? barrel, plunger, syring tip
fatigue
Class IV: All physical activity is with discomfort. symptoms
may be present at rest
Term Definition
what is the size of a needle? 14-29
Term Definition the smaller the number the bigger the needle
Cardiac resynchronization therapy defibrillator that shocks the ventricles at the same time so
they synchronize
Term Definition
Used for patients in Class II and have a wide QRS (meaning
the ventricles do not contract at the same time) what is the length range of needles? 0.4-3 inches

Pacemaker speeds/slows the heart, helps ventricles beat "in sync" how do you choose a needle? body mass
intended angle
site and depth needed
Term Definition
ICD (implantable cardioverter defibrillator) Ventricular pacing and shocking
Term Definition
drawing up medications open up
Term Definition put equal amount of air in
What should the patient avoid if they have a ICD Jackhammers, electrolysis, strong magnets (MRI), working draw out medication
over a running engine, stun guns, airport security, TENS rid any air bubbles
units (transcutaneous electrical nerve stimulation), chain
saws, cautery
Term Definition
mixing medications CLEAR before cloudy
you cannot get the cloudy medication into the clear bottle, it Term Definition
will contaminate it and it will not work effectively Z-track method used to prevent skin staining and seal fluid in tissue
pull the skin 1-1.5 inches to side
keep needle in place for 10 sec
Term Definition withdraww and allow skin to go back
Intradermal technique cleanse with alcohol swab gentle pressure
bevel up, low angle
1/3-1/2 into skin
should make bleb Amniocentesis Definition
do not rub A diagnostic test involving the removal of a small amount of
amniotic fluid and some sloughed fetal cells
Term Definition Chorionic villus sampling Definition

ID needle size and amount 1cc syringe A diagnostic test that can be performed early in the
1/4-5/8 in needle pregnancy and is often used in cases of high-risk clients
25-27 gauge Definition
Edema
give small amounts 0.1 cc
Swelling caused by movement of protein and fluid into the
interstitial space
Term Definition Definition
Endogenous
subcutaneous administration dart, do not dawdle Refers to a condition arising from within the organism
rotate site every 6 weeks
check for alterations in skin
ask patient where they normally inject needle Term Definition
hold skin as syringe pulled out Endometritis Presence of endometrial tissue outside of the uterus on
do not aspirate structures such as the ovaries, ligaments, or colon
generally do not rub
Term Definition
Term Definition
Episiotomy A surgical incision made into the peritoneum to prevent
size of SC needle 1-3 cc tearing during childbirth
3/5-5/8 in needle
25 gauge
amounts less than 1 cc Term Definition
Erythroblastosis fetalis A potentially fatal disorder when blood incompatibility
Term Definition between the mother and fetus results in severe fetal anemia
Intramuscular Injection quick darting motion
can be painful Term Definition
quick absorption Estrogen A female sex hormone responsible for the development of
amount of fluid that can be given is dependent on the site female secondary sex characteristics
used and the size of the patient
relaxation of target muscle
must aspirate Term Definition
Exogenous Refers to a condition with external causes
Term Definition Hyperplasia Definition
size of needle used in IM 1-6 cc syringe A condition in which there is an abnormal multiplication or
up to 1- 1.5 in needle increase in the number of healthy cells
21-22 gauge
amount 1-4 cc
Term Definition
children less than 1 cc Lordosis An exaggerated concave lumbar curvature; also called
infants .5 cc "swayback"
Organogenesis Definition
Term Definition The formation of basic functional elements of the organ
sites for IM injection deltoid systems
vastus lateralis
dorsogluteal
ventralgluteal Term Definition
Parity The number of pregnancies in which the fetus has reached
viability
Term Definition
Peritonitis An inflammation of the peritoneum (membrane lining the
peritoneal cavity)
Term Definition
Placenta Previa A condition that occurs when the placenta is implanted int
he lower uterus or over the cervical os
Progesterone Definition
A female sex hormone that is primarily responsible for
preparing parts of the female body for and maintaining
them through pregnancy
Term Definition
Puerperal infection (childbirth fever) A potentially deadly infection that a mother may contract
after childbirth
Term Definition
Teratogen Any substance or situation that causes a developmental
abnormality
Thyroxin Definition
A hormone produced int he thyroid gland and responsible
for increasing the rate of cellular metabolism
Term Definition
Varicose veins Pronounced or permanently distended veins, usually in the
lower extremities
Term Definition
Ectopic pregnancy (tubal pregnancy) A pregnancy in which the zygote is implanted outside of the
uterus
Cards
Term Definition
Glascow Coma Scale
GCS based on 3 criteria of eye opening,
verbal responses and motor response to
verbal command or painful stimuli
Monitor very frequently during acute phase
It does not take the place of in-

depth neuroassessment
Term Definition
Trousseau's Sign seen in hypocalcemia, a carpal spasm of the hand when a
blood pressure cuff is inflated about the systolic pressure
for several minutes
Term Definition
Diabetes Insipidus excessive urination caused by deficiency of ADH, large
amounts of diluted urine which causes dehydration and
inreases of serum sodium
Term Definition
syndrome of inappropriate antidiuretic hormone (SIADH) increased ADH, causes decreased sodium level, decreased
urine output, lithium may block renal responses to ADH
Term Definition
osmotic diuresis increase in urine output caused by excretion of substances
like glucose, contrast dyes
Term Definition
atrial natriuretic peptide released from cells in the atria of the heart in response to
excess blood volume, decreases BP and blood volume,
promotes sodium wasting and acts as a potent diuretic.
inhibits thirst, reducing fluid intake
Term Definition
calcium gluconate used for dangerously high potassium levels, helps control
adverse cardiac rhythms, but does not reduce potassium
levels
Term Definition
kayexalate used to treat hyperkalemia, may be given Po or PR, moves
K+ from the blood to intestine to be excreted
Term Definition
lithium if hyponatremia occurs, pts taking lithium are at risk for
lithium toxicity
Term Definition
ADH regulates water excretion from the body, if serum osmolality
goes up, then urine output falls, and vice versa
Term Definition
osmolality concentration of solutes in body fluid
Term Definition
hypertonic IV fluid pulls fluid out of RBC's causing them to shrink
Term Definition
Cards hypotonic IV fluid pulls fluid into cells causing them to swell
ACTH hormone produced by the anterior lobe of the pituitary dementia characterized by a general decline in higher brain
gland that stimulates the secretion of cortisol functioning such as reasoning, with a pattern of eventual
decline in ability to perform ADLs
Term Definition
Selye's theory of adaptation syndrome consisting of enlargement of the adrenal cortex, Term Definition
shrinkage of thymus spleen and lymph nodes, and alzheimers disease progressive, irreversible, degenerative disease;
appearance of deep bleeding ulcers. **nonspecific response characterized by gradual loss of cognitive function and
to diverse, noxious stimuli disturbances in brain behavior and affect;
neurofibrillary tangles or plaques in brain
Term Definition
General adaptation syndrome Alarm: flight or fight response activated w/ release of Term Definition
catecholamines, response is defensive balanced analgesia using more than one form of pain management
Resistance: adaptation to the stressor occurs and cortisol concurrently to obtain more pain relief with fewer side
activity is increased effects
Exhaustion: endocrine activity increases, negative effects on
body systems that can lead to death
Term Definition
pain unpleasant sensory and emotional experience associated
Term Definition with actual or potential tissue damage
hypothalamus mediates the neuronal and hormonal actions that maintian
homeostasis
Term Definition
Term Definition pain threshold the point at which a stimulus is perceived as painful
hypothalamus and limbic system together regulates emotions and visceral behaviors necessary for
survival
Term Definition
pain tolerance the maximum intensity or duration of pain that a person is
Term Definition able to endure
cerebral hemispheres concerned with cognitive functions
Term Definition
Term Definition endorphins and enkephalins morphine like substances produced by the body that have to
hypothalamic-pituitary response longest acting, occurs in persistant stress, hypothalamus potential to reduce pain
secretes corticotropin-releasing factor that stimulates
anterior pituitary to produce ACTH which produces
cortisol-->stimulates protein synthesis-->liver converts Term Definition
amino acids to glucose and body has store of energy prostaglandins increase the sensitivity of pain receptors by enhancing the
pain-provoking effect of bradykinin
Term Definition
negative feedback monitor the internal environment and restore homeostasis Term Definition
when it shifts out of normal range (blood glucose, acid-base nociception activation of sensory transduction in nerves by thermal,
balance, temp, fluid/electrolyte imbalances); organs most mechanical or chemical energy on special nerve ending
affected are the heart, kidneys, liver, lungs, GI tract and (nerves convey info about tissue damage to the CNS);
skin includes tranduction, transmission, modulation, and
perception
Term Definition
positive feedback perptuates the chain of events set in motion by the original Term Definition
disturbance instead of compensating for it transduction noxious stimuli trigger the release of biochemical mediators
that sensitize nociceptors; also causes movement of ions
across cell membranes which excites nociceptors; pain meds
Term Definition work in this phase by blocking the production of
rehabilitation act of 1973 law that protects people from discrimination based on their prostaglandin
disabilities; applies to any business person receiving
financial support from federal gov't
Term Definition
transmission 1: pain impulse travels from peripheral nerves to spinal -spinal-extensive, produces anesthesia of lower half, n/v and
cord with the aide of substance P pain may occur during, headache after
2: transmission from the spinal cord to the brain stem and
thalamus
3. transmission of signals between the thalamus to the Term Definition
somatic sensory cortex where pain perception occurs (pain moderate sedation conscious sedation; reduce anxiety and contol pain during
control can occur by blocking the release of substance P) procedures, depress LOC to a mod level,

modulation "descending system"; neurons in the thalamus and brain monitored anesthesia moderate sedation that requires monitoring from
stem send signals down to the dorsal horn of the spinal cord anesthetist in case rapid general anesthesia is needed
and release susbsances such as endogenous opioids,
serotonin and norepinephrine which can inhibit the
ascending painful impulses in the dorsal horn Term Definition
potential intraop problems n/v, anaphylaxis, hypoxia and other respiratory problems,
hypothermia and malignant hypothermia
Term Definition
perception the client becomes conscious of the pain
Term Definition
hyponatremia sodium <135
Term Definition occurs d/t imbalance of water
algogenic pain causing substances released into the EC tissue as a S&S: poor skin turgor, dry mucosa, headache, orthostatic
result of damage BP, N/V ab cramps, altered mental status

opioid analgesics causes respiratory depression and sedation, n/v, hypernatremia sodium>145
constipation, tolerance and addiction is very possible; S&S: restlessness, weakness, disorientation, delusions,
inhibit acitivty of ascending nociceptive pathways hallucinations, thirst, dry swollen tongue, sticky mucosa

NSAIDs decrease pain by inhibiting cyclooxygenase (enzyme hyperkalemia potassium >5
involved in production of prostaglandin) S&S:ab pain, tingling fingers, skeletal muscle weakness and
even paralysis, paralysis of resp and speech muscles
tx: kayexalate PO
Term Definition
local anesthetics block nerve conduction, applied to nerve fibers
Term Definition
hypokalemia potassium <3.5
Term Definition S&S: fatigue, anorexia, n/vm muslce weakness, leg cramps,
adverse efects of analgesics respiratory depression, sedation, pruritus, N/V, constipation decreased bowel motility, numbness, tingling, dysrhythmias,
glucose intolerance, thirst
**potassium should only be administered through an
Term Definition infusion pump!
general anesthesia pts are not arousable, cannot feel pain
stage 1: warmth dizziness, feeling of detachment, ringing in
ears, still conscious Term Definition
stage 2: excitment, shouting, crying laughing etc, pupils assessment by pacu nurse airway
dilate but contract o2 sat
stage 3: surgical anesthesia, unconscious and quiet, RR are cardio
regular, skin is flushed LOC
stage 4: medullary depression, cyanosis, rapid HR, return of gag refulx
irregular RR, death can occur activity(can pt move all extremities)
fluid status
op site/tubes/drains
Term Definition pain level
regional anesthesia injected around nerves, pt is awake aware of suroundings check for n/v
-epidural-diffuses accross spinal cord to provide anesthesia side rails up/call light in reach
and pain relief, blocks sensory, motor, autonomic funcitons,
doses are higher no headache
Term Definition
Term Definition NKA No Known Allergies
1st intention wound healing incision wound with wound edges approximated
Term Definition
PO 1. Per Os > latin
Term Definition 1) Stands for? 2. Mouth
2nd intention wound healing edges not approximated 2) Route?
wound is left open to drain
left to heal by granulation
Term Definition
ID 1. Intradermal
Term Definition 1) Meaning? 2. Into dermis; under the epidermis
third intention wound healing deep wounds that are not sutured, will be at a later time 2) Route?
deeper wider scarring
Term Definition
Term Definition IM 1. Intramuscular
post op nursing care plan ABC 1) Meaning? 2. Directly into a muscle --> injections
pain 2) Route?
n/v
fluids
Term Definition
make sure pt t/db/c q2h
PR 1. Per Rectum
1) Meaning 2. Rectally (ya think?)
Term Definition 2) Route
reason for deep breathing postop reduce pneumonia
opens alveoli to increase O2
Term Definition
rid anesthesia
increase lung expansion PR 1. Per Rectum
decrease lung secretions 1) Meaning 2. Rectally (ya think?)
2) Route
Cards
6 steps in the PROCESS of ADMINISTERING 1. I.D. the patient using 2 qualifiers A "TRANSDERMAL" medication is administered how? A patch or gel on skin (i.e. nicotine/birth control patches)
MEDICATIONS 2. Inform the patient
3. Administer the medications using the first 5 rights (right
patient, drug, dose, route, time) Term Definition
4. Provide adjunct interventions as needed (proper Medical Term for Medications taken in the EYE Ophthalmic
positioning for injection)
5. Record medication administered
6. Evaluate patient response to medication Term Definition
NGT Nasogastric Tube
Term Definition
7 Assessments to make PRIOR to MEDICATION 1. Allergies Term Definition
ADMINISTRATION (Shortened version) 2. Ability to swallow PEG Percutaneous Endoscopic Gastrostomy
3. Presence of nausea, vomiting, diarrhea
4. Drug actions, side/adverse effects, interaction with other
drugs Term Definition
5. Patient knowledge SC 1. Subcutaneous
6. Perform approp. assess's (labs, VS, etc) 1) Stands for? 2. Just below skin in the subcutaneous tissue
7. Determine if it should be given or held 2) Route?

What are the 3 types of medications that HAVE TO BE 1. Anticoagulants SC 1. Subcutaneous
DOUBLE CHECKED by another licensed person BEFORE 2. Insulins 1) Stands for? 2. Just below skin in the subcutaneous tissue
administering? 3. Digoxin 2) Route?
Term Definition
IV 1) Intravenous Term Definition
1) Stands for? 2) Directly into a vein 4 Factors that can influence the STRENGTH/ACTIVITY of 1. AGE of the plant
2) Route? PLANT derived medications? 2. VARIETY of the plant
3. PLACE in which it was bred
4. The METHOD by which it is preserved
Term Definition
SL 1. Sublingual
1) Stands for? 2. Under the tongue Term Definition
2) Route? GENERIC 1. GENERIC NAME - given before a drug becomes
v. officially an approved medication; generally used
OFFICIAL throughout the drug's use. Example: AMOXICILLIN
Term Definition
v. 2. OFFICIAL NAME - name under which it is listed in an
Medical term for Medications taken in the EAR? Otic CHEMICAL official publication. Ex: Amoxil
v. 3. CHEMICAL NAME: name by which a chemist knows it;
TRADE describes the constituents of the drug precisely. Ex:
Term Definition NAMES for Medications? (2S,5R,6R)- 6-{[(2R)-2-amino- 2-(4-hydroxyphenyl)-
Nares In the Nares or I could just say up the nose with a rubber acetyl]amino}- 3,3-dimethyl- 7-oxo- 4-thia- 1-
1) Route? hose...ok now I'm just getting tired... azabicyclo[3.2.0]heptane- 2-carboxylic acid
4. TRADE NAME - name given by the drug
manufacturer(s). Ex: Amoxil, Dispermox, Trimox = all
Term Definition amoxicillin)
TOP 1) Topical
1) Stands for? 2) SURFACE area of the skin, wound, etc.
2) Route? Term Definition
If a nurse administers a dosage/medication that the YES
physician wrote incorrectly, is he/she also legally
Term Definition responsible for the error?
INH 1) Inhalation
1) Stands for? 2) Respiratory tract (nebulizers, asthma inhalers, etc)
2) Route? Term Definition
2 Examples of SULFONAMIDES (Antimicrobial drugs)
LABORATORY SYNTHESIZED &
Term Definition medications? PROPOXYPHENE HYDROCHLORIDE (Narcotic
What are a PATIENT's 2 RIGHTS in regards to Medication 1) Right to be educated about all medications being taken analgesic - pain killer)
Administration (As per Prof. DiP's packet, not book) 2) Right to refuse
Term Definition
Term Definition 2 Examples of ANIMAL/HUMAN derived medications? INSULIN (Diabetes control)
7 RIGHTS of Medication Administration? (As per Prof. 1. Right Patient &
DiP's packet, not book) 2. Right Drug VACCINES
3. Right Dose
4. Right Route
5. Right Time Term Definition
6. Right Reason 2 Examples of PLANT derived medications? DIGITALIS (treats heart diseases)
7. Right Documentation &
OPIUM (Morphine, Codeine; pain killers)
Term Definition
Most BIOTRANSFORMATION/Detoxication/Metabolism Biotransformation - LIVER Term Definition
takes place where in the body? Excretion - KIDNEYS 2 Examples of MINERAL medications? IRON (anemia, pregnancy)
&
Whereas EXCRETION occurs mainly through what part of SODIUM CHLORIDE (in IV's to replenish water &
the body? electrolytes)

Pharmacology Pharmacology - the study of the effect of drugs on living ANAPHYLACTIC A severe allergic reaction which usually occurs immediately
v. organisms REACTION after the administration of the drug. **CAN BE FATAL if
Pharmacy not spotted and/or treated promptly**
Pharmacy - the art of preparing, compounding and
dispensing drugs
Term Definition PEAK PLASMA LEVEL elimination rate of a drug equals the absorption rate
"HALF-LIFE" of a drug? The time interval required for the body's elimination as related to Drug Actions
processes to reduce the concentration of the drug in the
body by one-half
Term Definition
Define The time after administration when the body intially
Term Definition ONSET OF ACTION responds to the drug
4 Early Signs/Symptoms of an 1) Patient feels swelling in mouth & tongue as related to Drug Actions
ANAPHYLACTIC REACTION? 2) Acute Shortness of Breath
3) Acute Hypotension
4) Tachycardia Term Definition
IDIOSYNCRACTIC Unpredictable, unexplainable and unexpected effect of a
EFFECT drug on a particular client. May be individual to that client
Term Definition (i.e. no one else reacts that way to the drug)
IATROGENIC Disease caused unintentionally by medical/drug therapy
DISEASE
Term Definition
SYNERGISTIC When two different drugs increase the action of one or
Term Definition another drug.
Narcotics depress the __________ Center Respiratory
Term Definition
Term Definition DRUG INTERACTION Occurs when the administration of one drug (before, after
10 Factors other than the drug itself that can affect it's 1) Pregnancy (1st trimester highest risk for fetus) or with) another drug alters the effect of one or both drugs.
action: 2) Age (Infants & Elders especially) Increased effect of one or both = POTENTIATING
3) Gender EFFECT
4) Culture, ethnicity Decreased effect of one or both = INHIBITING EFFECT
5) Genetics
6) Diet
7) Environment (negative, also hot or cold) Term Definition
8) Psychologic Factors (what client thinks the meds will CUMULATIVE The increasing response to repeated doses of a drug that
do/won't do) EFFECT occurs when the rate of administration EXCEEDS the rate
9) Existing Illness & Disease of metabolism or excretion
10) Timing of Administration (on empty stomach, after (Drug Build Up in the body)
eating, etc)
Term Definition
Term Definition DRUG Exists in a person who has unusually low physiologic
ANY decrease in the ability of the LIVER to Accumulation of drug in blood stream; puts client at risk TOLERANCE response to a drug & who requires increases in the dosage
METABOLIZE medication can lead to? for toxic effects and adverse reactions to maintain therapeutic effect

When a drug enters the bloodstream where is it carried to The most vascular organs - LIVER, KIDNEYS & BRAIN DRUG -An immunologic reaction to a drug; body reacts to drug as
first? ALLERGY an antigen and thus develops symptoms of an allergic
reaction
- Can be MILD (Rash, diarrhea) or
Term Definition SEVERE (Anaphylactic --> Fatal)
4 Steps of a Drug's Movement through the Body 1) Absorption
2) Distribution
3) Biotransformation Term Definition
4) Excretion DRUG Deleterious effect of a drug on an organism or tissue
TOXICITY -Results from OVERDOSAGE, INGESTION OF A DRUG
MEANT FOR EXTERNAL USE, and BUILD UP of the
Term Definition drug in body
Define A maintained concentration of a drug in the plasma during
PLATEAU a series of scheduled doses.
as related to Drug Actions Term Definition
SUBLINGUAL SWALLOWED
MEDICATIONS SHOULD NOT BE?
Term Definition
Define The highest plasma level achieved by a single dose when the
Term Definition 4) Sublingual
4 Types of Medication Orders 1) STAT order - given immediately & only once
(in regards to timing/when they can be given) 2) SINGLE order - one-time order for medication to be
given once at a specified time Term Definition
3) STANDING order - may or may not have termination 5 scenarios in which an 1) Client has nausea or vomiting
date; may be carried out indefinitely until an order is ORAL medication should 2) Client has diminished or reduced bowel sounds (i.e. GI
written to cancel it. Also may be carried out for a specified NOT BE ADMINISTERED? tract motility is reduced/absent)
number of days. 3) Client cannot swallow or is unconscious
4) PRN order - as needed; permits nurse to give medications 4) Client is deemed NPO for any reason
when, in the nurse's judgment, the client requires it 5) Client has gastric/intestinal suction

The INTRAVENOUS method of administering medications Highly 2 Main Physiologic Responses to a Inflammatory Response
is limited to what types of drugs? Soluble VIRAL INFECTION and
are: Immune Reaction
Term Definition
Medications must be given within _______ minutes of their 30 Term Definition
scheduled time HYPOACTIVE IMMUNODEFICIENCY
IMMUNE DISEASES
RESPONSES
Term Definition RESULT IN:
Do not use liquid medications that appear ________ or have Cloudy or changed Color
changed ______
Term Definition
Hyperactive Hypersensitivity
Term Definition Immune Responses Disorders
3 most common 1) Hypodermic Result in:
TYPES of SYRINGES 2) Insulin
3) Tuberculin
Term Definition
Term Definition Define A non-specific cellular response to injury meant to serve as
A nurse should ALWAYS assess a client's _______ ________ Health Status & a protective function.
and obtain a __________ __________ PRIOR to giving any Medications History INFLAMMATION
medication or
A defensive reaction intended to neutralize , control or

Term Definition eliminate the offending agent and to prepare the site.
The 3 METRIC Units of gram (g)
WEIGHT
used for milligram (mg) Term Definition
DRUG DOSAGES 5 Systemic Effects 1) FEVER --> Most common one
microgram (mcg) of 2) Leukocytosis
INFLAMMATION 3) Malaise
4) Anorexia
Term Definition 5) Sepsis
An UNSIGNED drug order has NO ____________ & the VALIDITY
Doctor/Nurse Practioner NEEDS to be ___________
NOTIFIED Term Definition
Benson's Repeating a word that reflects your basic belief system
RELAXATION while in a comfortable position with eyes closed & muscles
Term Definition RESPONSE relaxed.
"PARENTERAL ROUTE" means Medications are given NEEDLE
by? (Briefly Describe) *Do twice daily; best on empty stomach

4 types of TABLETS that 1) Sustained Action PROGRESSIVE -Tensing and releasing muscles in sequence and sensing the
SHOULD NOT BE CRUSHED? 2) Enteric-coated MUSCLE difference in feeling (1st whole body then specific muscle
3) Buccal RELAXATION groups)
(Briefly Describe) -Works best lying down in a quiet room breathing easily 3) Lithium
4) Adrenal Insufficiency
Term Definition
Hypothalamus Homeostasis 5) Radiation
maintains
______________ by controlling Chemical Consistency
the ________ ___________ of the internal body Term Definition
1) What/When does 1) A carpal spasm of the hand when a Blood Pressure Cuff
TROUSSEAU'S SIGN is inflated above the systolic pressure for several minutes
Term Definition occur? (usually 3 minutes).
The Hypothalamus Emotions
regulates ____________ 2) What is it indicative of? 2) Sign of HYPOCALCEMIA
& many _______________ Visceral Behaviors (eating, temperature control, defense)
necessary for survival
Term Definition
4 Common side effects to 1) Respiratory Depression and Sedation
Term Definition OPIOID ANALGESICS 2) Nausea & Vomiting
The purpose/content of the Differentiates which drugs can be sold ONLY WITH A 3) Constipation
DURKHAM-HUMPHREY AMENDMENT? PRESCRIPTION, those that can be sold WITHOUT & 4) Pruritus
those that need a NEW PRESCRIPTION EVERY TIME
THEY ARE REFILLED.
Term Definition
What are the 3 general categories of 1) OPIOIDS
Term Definition 2) NSAIDS
The effect of the Sympathetic-Adrenal-Medullary Response Fight or Flight ANALGESIC AGENTS?
is also called? 3) Local Anesthetics
Term Definition
7 Things that happen in the FIGHT OR FLIGHT 1) Increased heart rate & B/P
(Sympathetic-adrenal-medullary) response to stress: 2) Increased Blood Glucose level Term Definition
3) Mental Acuity Define: Using more than 1 form of analgesia concurrently to obtain
4) Dilated Pupils more pain relief with fewer side effects.
5) Increased tension of skeletal muscles BALANCED
6) Increased ventilation (may be rapid & shallow)
7) Increased coagulability of blood ANALGESIA

Diabetes 1) Excess urination (specifically large amounts of diluted What happens during the 1) Endocrine activity increases (negative effects on body
Inspidus urine - 5-10 L/day) caused by a deficiency of ADH EXHAUSTION systems)
stage of G.A.S.
1) What is it? 2) Dehydration & increases of Serum NA+ 2) CIRCULATORY, DIGESTIVE & IMMUNE systems
2) What does it cause? especially affected!

SIADH 1) Syndrome of Inappropriate Antidiuretic Hormone 4 things that can cause CHEMICAL injuries to a cell? 1) Poisons
1) Stands for? 2) Increased ADH levels which causes decreased NA+ levels 2) Heavy Metals
2) What is it/causes? and urinary output
3) Why does it occur? 3) Drugs
3) Lithium may block renal responses to ADH
4) Alcohol

5 possible causes of 1) Brain Trauma What happens during the RESISTANCE stage of G.A.S. 1) Adaptation to the noxious stressor occurs
DIABETES INSIPIDUS 2) Neurosurgery 2) CORTISOL Activity increased

The Maintenance Function of a cell MAINTENANCE FUNCTION - refers to the activities that
Term Definition vs. the cell must perform with respect to itself.
COMPREHENSIVE DRUG ABUSE PREVENTION & Categorizes CONTROLLED SUBSTANCES & limits how The Specialized Function of a cell
CONTROL ACT (Controlled Substances Act) often a prescription can be filled; established government SPECIALIZED FUNCTIONS are those the cell performs in
funded programs to prevent and treat drug abuse. relation to the tissues/organs for which it is a part.

KEFAUVER-HARRIS AMENDMENT Requires PROOF of SAFETY & EFFICACY of a drug for 5 CELLULAR ADAPTATIONS to STRESS? (What 1) HYPERTROPHY-increase in cell size -> increased organ
approval happens to cells?) size
2) ATROPHY - shrinkage of cell size -> Decreased organ
size
Term Definition 3) HYPERPLASIA - increase in # of new cells; stops when
3 things CORTISOL does to the body during stress 1. Stimulates protein catabolism, releasing amino acids stimulus is removed
response 2. Stimulates liver uptake of amino's an their conversion to
glucose. 4) DYSPLASIA - bizarre changes in the appearance of cells
3. Inhibits glucose uptake by many body cells except those 5) METAPLASIA - transformation of 1 cell type to another.
of heart & brain.
Term Definition
Term Definition 3 most common causes of CELL INJURY? HYPOXIA
ADH stands for? Antidiuretic Hormone CHEMICAL INJURY
INFECTIOUS AGENT
Term Definition
Term Definition
What are the roles of ADH & ALDOSTERONE during a They promote sodium and water retention in the event of a
stress response? possible hemorrhage or loss of fluids caused by excessive 5 cardinal signs of 1)Redness
perspiration. INFLAMMATION 2) Heat
3) Swelling
4) Pain
Term Definition 5) Loss of Function
Why are endorphins increased during stress? They enhance the threshold for tolerance of painful stimuli
Term Definition
Term Definition RADIATION decreases the protective INFLAMMATORY
Major Cation (Electrolyte) in the Extracellular Fluid? Sodium ___________________ response of cells

Major cation (Electrolyte) in Intracellular Fluid Potassium PHYSIO STEPS Of STRESS? (What gets activated when?) 1. Sympathetic Nervous System discharge:
NOREPINEPHRINE RELEASED --->
2) Sympathetic-adrenal-medullary discharge:
Term Definition NOREPHINEPHRINE & EPINEPHRINE RELEASED
What do NEGATIVE FEEDBACK mechanisms do? Monitor the internal environment & RESTORE ---->
HOMEOSTASIS when conditions shift out of the normal 3) Hypothalamic-pituitary-system discharge: ACTH
range. production increases & this in turn increases production of
Glucocoticoids (specifically CORTISOL)
Term Definition
Term Definition
5 EXAMPLES of NEGATIVE FEEDBACK Mechanisms in 1) Blood Pressure
the body? 2) Acid-Base Balance ACTH stands for? ADRENOCORTICOTROPIC
3) Blood Glucose Level HORMONE
4) Body Temperature
5) Fluid & Electrolyte Balance Term Definition
3 phases of G.A.S. 1) ALARM
Term Definition 2) RESISTANCE
Give an example of a POSITIVE FEEDBACK mechanism BLOOD CLOTTING 3) EXHAUSTION
within the body?
Term Definition
Term Definition If stress becomes cyclic, this can created? Hypertension and hyperthermia (among others, but she
stressed these) Term Definition
In Post-op What must you report IMMEDIATELY? A systolic B/P of less than 90mm/Hg
Term Definition
Bladder distension caused by Stress can can itself cause? INCREASED PAIN & STRESS Term Definition
Patients with this disease are more at risk for infection post- DIABETES
op...
Term Definition
Normally, (without Alzheimer's/Dementia) people only lose SHORT TERM Memory loss
what type of memory loss with age? Term Definition
The nursing dx of spiritual distress is applicable to people Have a disturbance in their belief or value system that
who... provides strength, hope, and meaning of life
Term Definition
Normal urine output per hour is: 30 mL
Term Definition
ANXIETY A vague, uneasy feeling; cause may be unknown.
Term Definition
What are the 1) Denial
KUBLER-ROSS 5 stages of grief? 2) Anger Term Definition
3) Bargaining Morbidity v. Mortality MORBIDITY - 1) the state of being diseased; the number of
4) Depression sick persons or cases of disease in a specific population.
5) Acceptance
MORTALITY- The condition of being mortal; the number
of deaths in a population
Term Definition
The D, H, & V of a dosage calculation stand for? How is the D-Desired Dose
calculation (problem) set up? H-Amount on Hand Term Definition
V-Volume or Amount to be given 8 Pain Syndromes/Unusual Severe Pain Problems 1) COMPLEX REGIONAL PAIN SYNDROME
Set up: D/H X V = X (Type 1 - most common & Type II)
2) POSTMASTECTOMY PAIN SYNDROME
3) FIBROMYALGIA
Term Definition 4) HEMIPLEGIA-ASSOCIATED SHOULDER PAIN
Selye's definition of STRESS? A NON-SPECIFIC response to DIVERSE, NOXIOUS 5) SICKLE CELL DISEASE AND PAIN
STIMULI 6) ACQUIRED IMMUNODEFICIENCY SYNDROME-
RELATED PAIN
7) BURN PAIN
Term Definition 8) GUILLAIN-BARRE SYNDROME AND PAIN
One of the biggest differences between Grief & Depression? Grief is TEMPORARY; and the person can
verbalize/express to you why they are sad.
Depression can be temporary or LONG STANDING & the Term Definition
person usually cannot specify why they are sad. GUILLAIN-BARRE SYNDROME & PAIN A progressive, inflammatory disorder of the peripheral
What is this? nervous system.
Characterized by?
Term Definition Characterized by flaccid paralysis accompanied by muscle
T.C.D.B. means? When is it used? This is an acronym for POST-OP EXERCISES: pain and severe, unrelenting, burning pain
T-Turn (Nurse to be aware that syndrome also makes facial muscles
C-Cough flaccid so needs to disregard non-verbal cues that
D-Deep contradict report of pain)
B-Breath
Term Definition
Term Definition What is possibly the BURN PAIN
To know if a physician/surgeon has ordered adequete fluid The patient's EBL MOST SEVERE PAIN?
replacement IV therapy for your patient (you are the post- ESTIMATED BLOOD LOSS
op nurse); what do you need to know from the attending
RN/attending Surgeon (those that were in the surgery?) Term Definition
With this disease, additional problems including: AIDS
neuropathy, esophagitis, headaches, postherpetic,
Term Definition abdominal, back, bone and joint PAIN can occur..what is it?
What is a common early sign of HYPOXIA? RESTLESSNESS
Term Definition
Why do patients with SICKLE CELL DISEASE experience Results from venous occlusion caused by the sickle shape of maintain same level of pain relief.
pain? What is going on in their body / pain results from? RBC, this impairs circulation to muscles/organs, ischemia
and infarction
Term Definition
Name a few herbs/foods that will adversely react with pain Ginkgo
Term Definition meds? Garlic
What pain syndrome affects as many as 80% of STROKE HEMIPLEGIA-ASSOCIATED SHOULDER PAIN Ginger
Patients? Possibly created by gravity's pull on the impaired arm. Ginseng
Grapefruit juice
Chamomile
Term Definition Valerian
FIBROMYALGIA A chronic pain syndrome characterized by generalized Echinacea
musculoskeletal pain, trigger points, stiffness, fatigability Willow
Define and sleep disturbances Meadowsweet
*just tell them to avoid anything starting with the letter

Term Definition G* :)
COMPLEX REGIONAL PAIN SYNDROME Type 1 - the most common; unexplained diffuse burning
TYPE I pain, usu. in periphery of extremity; occurs after minor
v. trauma; often occurs after surgery/trauma to the extremity Term Definition
TYPE II but not limited to that area. With _______ administration, medication infuses INTRATHECAL - Direct
DIRECTLY into the subarachnoid space and cerebrospinal
TYPE II - Refers to causalgia; More likely to develop after fluid & with ________ administration, medication is EPIDURAL - diffuses
trauma with detectable peripheral nerve lesions; burning deposited in the DURA of the Spinal Canal and DIFFUSES
pain into the subarachnoid space
**Both types describe a variety of painful conditions that

often follow an injury; the magnitude and duration of pain Term Definition
often exceed what is expected for the specific type of injury What are the 3 stages of 1) Preadmission Testing (PAT)
the person may have and often results in significant PREOPERATIVE Nursing? (Teaching, Interview, verifies understanding of preoperative
impairment of motor function orders, Advanced Directive covered, Discharge planning
begins)
Term Definition 2) Admission to Surgical Center (complete preop

Paula's quickie definition of the Trying to block the perception of pain either before it gets assessment, assess for RISKS for post-op complications,
GATE CONTROL SYSTEM THEORY to the brain or before the message is sent out from the report any unexpected findings, verifies INFORMED
brain. CONSENT has been signed, Pt. teaching & Plan of care
coordinated, reinforcement of pt. teaching, explains phases
of op, answer ?'s)
Term Definition
3 Levels of PAIN according to the WORLD HEALTH 1) MILD PAIN (1 to 3)
ORGANIZATION? 3) In the Holding Area (Assess pt. status, baseline PAIN,
2) MODERATE PAIN (4 to 7) nutritional status, Review chart, ID pt., verify/mark
surgical site, put IV in, Administer meds, ensure pt.
3) SEVERE PAIN (8 to 10) comfort, provide psychological support, communicate pt.
status with other healthcare workers)
Term Definition
What are the main neuronal receptors of pain called? NOCICEPTORS Term Definition
MALIGNANT HYPERTHERMIA A rare inherited muscle disorder that is chemically induced
by ANESTHETIC agents. Calcium function is altered in
Term Definition skeletal muscle, which causes symptoms of
ADDICTION Addiction - behavioral pattern; COMPULSION to take hypermetablolism, in turn this causes muscle contraction
V. substance to experience its PSYCHIC effects (rigidity) and causes hyperthermia and damage to central
DEPENDENCE nervous system
V. Dependence - occurs when a pt. who has been taking **One of the most important things to watch for while a
TOLERANCE OPIOIDS experiences WITHDRAWAL once drugs are patient is having surgery***
discontinued; often occurs with opioid tolerance and is not
indicative of addiction
Term Definition
Tolerance - a person becomes LESS SENSITIVE to the What are some of the S&S of TACHYCARDIA - Earliest sign then
effects of opioids; they need INCREASING doses to MALIGNANT HYPERTHERMIA? Generalized MUSCLE RIGIDITY,
Which is the EARLIEST SIGN? Tetanuslike Movements, often in Jaw, Term Definition
Ventricular dysrhythmia, HYPOKALEMIA -Serum K under 3.5 mEq/L
Hypotension, characteristics -DECREASED B/P
Decreased cardiac output, -Fatigue
oliguria, -Anorexia
cardiac arrest -Nausea, vomiting
-Dysrhythmias
The rise in body temp is actually a LATE sign that develops -Muscle weakness/cramps
rapidly. -Glucose intolerance
-Decreased Deep Tendon Reflexes
Term Definition
HYPONATREMIA -Serum NA less than 135 mEq/L Term Definition
characteristics -Dry mucosa HYPERKALEMIA Serum K greater than 5.0 mEq/L
-Headache characteristics -Cardiac changes (Tachycardia -> Bradycardia)
-Cerebral Swelling -Flaccid paralysis
-INCREASED PULSE, DECREASED B/P -Dysrhythmias
-Edema -Muscle weakness
-Muscle Cramps/Weakness
-Anorexia
-Nausea & Vomiting Term Definition
-Dizziness, Confusion Common causes of -GI losses
HYPOKALEMIA -Medications
-Alterations in Ph Balance
Term Definition -Hyperaldosteronism
Normal levels of 135 - 145 mEq/L -Poor dietary intake
SODIUM in the
ECF
Term Definition
Common causes of -Usually treatment related
Term Definition HYPERKALEMIA -Impaired Renal Function
Common causes of Vomiting -Hypoaldosteronism
HYPONATREMIA Diarrhea -Tissue Trauma
Sweating -Acidosis
Overuse of diuretics
Adrenal insufficiency
Water Intoxification Term Definition
SIADH What is meant by The brain is "used to" having 2 arms, 2 legs, torso, etc.
NEUROSIGNATURE INTACT & when there is a significant change in
composition (i.e. leg amputation), the brain does not
Term Definition recognize that the leg is gone.
HYPERNATREMIA -Serum Sodium greater than 145 mEq/L
characteristics -INCREASED PULSE & INCREASED B/P
-Thirst Term Definition
-Elevated Temp DYSPNEA management at end of life? -BRONCHODILATORS & CORTICOSTEROIDS used to
-Dry, swollen tongue treat obstructive pathology, improving lung function
-Sticky mucosa -Low does of OPIOIDS
-Restlessness & weakness -Low flow OXYGEN
-Pt. and family should be educated about Anxiety (as relates
to bouts of dyspnea) and how to handle crisis situations --->
Term Definition i.e. emergency plans and strategies for coping
Common causes of -Excess water loss
HYPERNATREMIA -Excess NA administration
-Diabetes Insipidus Term Definition
-Heat Stroke 11 signs of -Loss of interest in eating and drinking
-Hypertonic IV solutions IMMINENT DEATH -Urine output decreases
-Sleeps more frequently & has less interest in surrounding
environment
Term Definition -Mental confusion
What is the normal serum POTASSIUM concentration? 3.5 to 5.0 mEq/L -Vision/hearing becomes impaired; Speech may become
difficult to understand
-Secretions collect in back of throat, Pt. rattles/gurgles as
they breath through mouth
-Apnea occurs (Irregular breathing with periods of no Term Definition
breathing) Autografts Tissues transplanted from one site of an individual to
-Oxygen supply to brain decreases, pt. becomes restless another site in the same individual
-Pt. may feel hot one moment and then cold the next
-Loss of bladder/bowel control
-Many pt's report seeing gardens, libraries or family/friends Term Definition
who have died Autoimmune disorders Disorder that occurs when the immune system does not
distinguish between self-antigens and non-self-antigens
Term Definition
What is a life & death crisis scenario in which the patient If ANYTHING gets into the PERITENEAL AREA Term Definition
MUST go into IMMEDIATE SURGERY? B Lymphocytes Cell type that produces specific antibodies, regulates the
antibody-mediated immune response, and develops into
plasma cells and/or memory cells
Term Definition
Signs and symptoms of Dry, unproductive cough
STATIC SECRETIONS? & Term Definition
Nursing Interventions for this? Crackles Basophils White blood cells involved in the inflammatory response,
usually associated with an allergic reaction
-Turn patient every 2 hours
-Deep Breathing/Coughing
Term Definition
Chronic/late rejection Tissue rejection that occurs after months or years, involving
Term Definition
gradual degeneration of the blood vessels
If a patient is having CATARACT surgery, they must not? Vomit, cough, sneeze during procedure or this may cause
BLINDNESS
Term Definition
Term Definition Complement system Cascade of protein reactions activated by the immune
response to destroy the antigen
What Herb will interact adversely with anesthetics? St. John's Wart
Term Definition
ELISA Enzyme-linked immunosorbent assay; a diagnostic test
Term Definition
Eosinophils A white blood cell usually associated with an allergic
Cards reaction or parasitic infection
Term Definition
Acute rejection Tissue rejection that develops several weeks after Term Definition
transplantation
Gamma globulins Serum protein antibodies produced by B lymphocytes
Term Definition
Term Definition
Allografts Transplants between genetically different individuals but
from the same species Hyperacute rejection Tissue rejection that occurs immediately after
transplantation
Term Definition
Term Definition
Antibodies (immunoglobulins - Ig) Produced by B lymphocytes in response to a specific antigen
challenge Immunity The body's ability to respond and defend against foreign
substances
Term Definition
Term Definition
Antibody titer Quantity of serum antibody required to react with a specific
antigen Immunosuppression Techniques applied to reduce the host's immune response
and prevent rejection
Term Definition
Antigen Agents that cause activation of the immune system
Term Definition Serum sickness A systemic reaction that occurs when immune complexes
Isografts Transplants between identical genetic entities such as are present in many tissues
identical twins
Term Definition
Term Definition T lymphocytes A specialized lymphocyte that is responsible for cellular
Leukocytes White blood cells immunity

Lymphocytes Mononuclear, nonphagocytic leukocytes found in the blood, Type I allergic reactions Reactions caused by an allergen that is an antigen that
lymph, and lymphoid tissue. Lymphocytes are stimultes the production of IgE's
immunologically competent
Term Definition
Term Definition Type II allergic reactions Reactions in which the antigen (either a normal body
Macrophages A differentiated phagocytic monocyte that has migrated antigen or a foreign antigen) is present on the cell
into the tissue membrane

Major histocompatibility complex Group of genes coded for production of self antigens Type III allergic reactions Reactions in which an antigen binds with an antibody and
forms a complex, which results in the activation of a
complement system
Term Definition
Memory cells Specialized lymphocytes that "remember" an antigen after
first exposure Term Definition
Type IV allergic reactions Delayed responses caused by sensitized T lymphocytes to a
specific antigen
Term Definition
Monocytes Agranulocytes and large circulating phagocytotic cells that
develop into macrophages when leaving the blood vessels Term Definition
Xenografts Transplants between different species such as pigs and
humans
Term Definition
Neutrophils Leukocytes that are the most abundant actively motile
phagocyte
Term Definition Cards

Opportunistic microorganisms Normally harmless organisms that can become pathogenic Term Definition
under the right conditions, such as lack of microbial homeostasis dynamic process through which the body maintains balance
competition by adjusting internal and external stimuli

Primary deficiency Type of immunodeficiency that occurs when there is an function of water transport of nutrients, electrolytes, and oxygen to
abnormality of the immune system caused by a genetic
cells
defect
acid base balance
Term Definition
Term Definition
Prophylactic Preventive; used as a protective measure
Interstitial fluid is found between cells
Term Definition
Term Definition
Secondary deficiencies Immunodeficiencies that arise when damage is caused by an
environmental factor such as infection, radiation, watery fluid in blood known as plasma is what kind of fluid Intravascular
chemotherapy, or burns
Term Definition
Term Definition fluid found in the epithelial spaces transcellular fluids
Term Definition
water loss you can not count insensible water loss
ex: perspiration
Term Definition
which element/electrolyte promotes water retention sodium
Term Definition
how does Protein and albumin promote body fluid retention Increases the oncotic pressure
oncotic pressure keeps fluid intravascular
albumin (a protein) pulls fluid into the veins
Term Definition
what is an example insensible water loss water excreted from the skin through perspiration
Term Definition
normal urine output 30 ml/day
Term Definition
assessment of body fluids: Skin appearance and turgor
(elasticity or tonus)
Term Definition
assessing body fluid: Urine Specific gravity and Urine volume
what do we test (concentration of urine)
Term Definition
fluid balance the difference between intake and output
Term Definition
what is the best indicator of fluid status DAILY WEIGHTS
Term Definition
ways to assess body fluids 1. Skin - apperance and turgor
name 4 2. Urine volume and specific gravity (urine
concentration)
3. Fluid balance - difference of intake and output
4. Daily weights - best indicator of fluid status
Term Definition
What is a common assessment for hydration or fluid loss skin turgor
status?
Term Definition
Diagnostics for fluid status: 1. BUN 6-20
name 5 2. Crt 0.5-1.2
3. CBC
4. UA 1.005-1.030
5. Total protein
Term Definition
BUN BUN 6-20
(blood urea nitrogen)
elevated BUN generally reflects intravascular depletion
the following treatments are for what condition hypervolemia
Term Definition identify cause
Crt Crt 0.5 - 1.2 fluid and sodium restriction
(Creatinine) provides an indication of renal perfusion that is TED hose to mobilize fluids
not affected by hydration status assess amount of edema
kidney function administer plasma proteins and albumin if
ordered
monitor VS and daily weight
Term Definition
CBC May provide some indication of dehydratioin
(complete blood count) Hematocrit and hemoglobin will be elevated in
dehyration and hypovolemia Term Definition
body's output of water is greater than its intake hypovolemia
Term Definition
Urinalysis 1.005 1.030 Term Definition
the specific gravity of the urine is related to the client's numbers go up in dehydration how does the body compensate if fluid intake can not keep the body compensates by decreasing urine output
hydration state - what are normal values? urine ions can be specifically requested and are helpful in up with fluid loss?
determining whether sodium is being retained or not
Term Definition
Term Definition these symptoms are signs of what condition hypovolemia
total protein 3 - 5 g/dL orthostatic hypotension
tachycardia
thirst
Term Definition flattened jugular veins
what happens if serum protein levels drop? the oncotic pressure goes down and fluid migrates to "third sunken eyeballs
spacing" dry mucous membranes
rapid weight loss
decreased urine output
Term Definition prolonged capillary refill
excess of water in the body hypervolemia
Term Definition
Term Definition the following treatment is appropriate for what condition: hypovolemia
excess of accumulation of fluid in the edema
interstitial (tissue)spaces administration of IV fluids
monitor for fluid overload

Term Definition
assessing edema 1 , 2mm, immediate rebound
2 , 4mm, a few seconds to rebound Term Definition
3 , 6mm, 10-12 seconds to rebound what are s/s of fluid overload SOB
4 , 8mm, >20 seconds to rebound JVD
CRACKLES
Term Definition B/P
these symptoms are a sign of what condition hypervolemia
rapid breathing Term Definition
dyspnea
passive transport 1. diffusion
crackles in lungs name 3 processes 2. osmosis
hypertension b/p 3. filtration
JVD
moist skin
acute weight gain Term Definition
edema movement of particles diffusion
solutes move from area of higher concentration
to lower concentration resulting in equal
Term Definition distribution
Term Definition
what is the most abundant electrolyte in the body? Na - Sodium
Term Definition
135-145 mEq/dL
movement of water from an area of lower solute osmosis
concentration to higher solute concentration
(higher water concentration to lower water concentration) Term Definition
through a semipermeable membrane to equalize the (Na) Sodium 135-145 mEq
concentration of ions or molecules normal values
Term Definition
in what process can water move in and out of cells to osmosis Term Definition
correct imbalances in water concentration influences distribution of water sodium - Na
maintains nerve function
acid - base balance normal values 135-145 mEq
Term Definition
are functions of what electrolyte?
same electrolyte concentration and same osmotic isotonic
pressure as extracellular fluid
risk of fluid overload Term Definition
Lactated Ringers is an example of what type of solution what is the greatest influence of water movement in the Na
(LR), NS (normal saline, or 0.9% saline in water) body Soduim
135-145 mEq
Term Definition
water is pulled from vasucular compartment in hypotonic Term Definition
the the interstitial fluid compartment hyponatremia Low Sodium (Na)
D5NS .45 (5% dextros in 1/2 normal saline) is an example of
what type of solution
Term Definition
confusion is a sign of what electrolyte deficiency sodium (Na)
Term Definition
why sodium maintains nerve function
pulls fluids and electrolytes from the intracellular hypertonic name hyponatremia
and interstitial compartments into the
intravascular compartment
2.0% NS, blood products and albumin are examples of what Term Definition
type of solution hypernatremia High Sodium (Na)
Term Definition
restlessness and irritablility are sympoms of what electrolyte high Sodium levels
Term Definition imbalance hypernatremia
what is the substance that is sometimes called minerals, Electrolytes
salts, or ions that develop electrical charges
Term Definition
potassium (k) 3.5 -5 mEq/L
Term Definition
sodium (Na) extracellular normal values
chloride (cl)
calcium (Ca)
Term Definition
Bicarbonate (HCO3)
are found where? (cellular) what electrolyte is the dominate intracellular cation ( ) potassium (k)

Potassium (K ) intracellular which electrolyte is found primarily in the muscle tissue potassium (K)
3.5 -5 mEq/L
Phoshorus
Magnesium (Mg )
Proteins Term Definition
are found where? (cellular) potassium (k) 3.5 -5 is important for which muscle the heart muscle
Term Definition
too much or to little of potassium (k) can lead to what? increase cardiac muscle excitability leading to
arrhythmias
hypokalemia Low Potassium (k) risk factors for hypochloremia prolonged vomiting
below 3.5 diarrhea

risk factors for hypokalemia older age due to diuretic and laxative use Calcium (Ca) 9.0 - 10.5 mg/dL
normal values
Term Definition
treatment for hypokalemia encourage foods high in potassium (k) Term Definition
oral potassium chloride liquid supplement (kcl) - where is calcuim found in the body bone, cartilage and teeth
mix with water or juice
NEVER GIVE IV PUSH - cardiac arrest
Term Definition
calcium has an inverse relationship with..... phosphorus
Term Definition
foods high in potassium avocados
Term Definition
broccoli
dairy hypocalemia Low calcium (Ca)
dried fruit
cantaloupe Term Definition
bananas s/s of hypocalcemia 1. Facial twitching (Chvostek's Sign)
name 2 2. Carpopedial spasms (Trousseau's Sign)
Term Definition
hyperkalemia high potassium Term Definition
above 5 mEq/L treatment of hypocalcemia oral or IV calcium
vitamin D to increase absorption
Term Definition seizure precautions
s/s of hyperkalemia 1. nausea encourage foods high in calcium - dairy, dark
name 5 2. vomiting green vegetables
3. increase motility
4. diarrhea Term Definition
5. hyperactive bowel sounds
s/s of hypercalcemia 1. lethargy
name 4 2. irritability
Term Definition 3. loss of energy
what procedure may be needed if there is inadequate renal dialysis 4. confusion
excretion in hyperkalemia
Term Definition
Term Definition treatment for hypercalcemia calcitonin
meds for hyperkalemia 1. Lasix - urine (decreases serum calcium by putting it into the bones)
name and type 2. Kayexalate - stool
name 2 Term Definition
what is the function of phosphorus combines with calcium ions in the bone providing hardness,
Term Definition strength and durability
Chloride maintains acid base balance
Term Definition
hypomagnesemia s/s 1. diminished reflexes
Term Definition name 2 2. muscle weakness
what element/electrolyte is a major component of Chloride
gastric secretion: combines hydrogen in stomach to Term Definition
form hydrochloric acid
Bicarbonate HC03 22 - 26 mEq/L
normal values 5. hepatic failure (increased ammonia(renal and
kidney) acidosis)

bicarbonate HC03 is regulated by: the kidneys having a patient breath into a paper bag is treatment for... respiratory alkalosis

function of HC03 maintains the normal levels of acidity (pH) in metabolic (kidney) acidosis kidney not producing bicarb
blood and other body fluids - neutralizes acids in
the body
one of the 4 major buffers or buffer systems in Term Definition
the body risk factors for metabolic acidosis 1. diarrhea
name 4 2. intestinal malabsorption
3. loss of HC03 (bicarb) by the intestine
Term Definition 4. salicylate intoxication, excess acids
acid base balance measured clinically by pH
Term Definition
Term Definition treatment of metabolic acidosis IV sodium bicarbonate
normal pH levels 7.35 - 7.45
Term Definition
Term Definition risk factors for metabolic alkalosis 1. chronic vomiting
renal mechanisms - urinary = HCO3 name 5 2. nasogastic drainage or lavage without electrolyte
22-26 mEq/L replacement
3. alkaline antacids
4. low serum chloride
Term Definition 5. low serum potassium
pulmonary mechanisms of pH - Lungs PaC02
35-45 mm Hg
Term Definition
Term Definition cardiovascular abnormalties due to decrease in potassium metabolic alkalosis
what happens with a systemic increase in hydrogen ion acidosis (K ) can be a sign of.....
concentration - lungs fail to eliminate C02
Term Definition
Term Definition Lab finding with metabolic alkalosis 1. decrease chloride
what is the result of excessive loss of C02 during alkalosis name 4 2. increase pH
hyperventilation, loss of acids during vomiting 3. increase Hct
4. decrease K (potassium)
Term Definition
Term Definition
compensation is happening if pH is in ______ limits normal
when is Allen's Test performed prior to puncture of an artery
Term Definition
Term Definition
decrease in pulmonary ventilation (not breathing) leads to respiratory acidosis
how do you know there sufficient collateral circutation no change in color
through the Ulnar artery (Allen's Test )
Term Definition
increase in pulmonary ventilation can lead to .... respiratory alkalosis Term Definition
what do you assess after the Alen's Test CMST
Term Definition
risk factors for respiratory alkalosis 1. hypermetabolic states Term Definition
name 5 2. fever
3. sepsis what test is the Allen's Test performed prior to ABG
4. anxiety (arterial blood gas)
Term Definition
what are the ABG normal values pH 7.35 -7.45
PaCO2 35 - 45
HCO3 22 - 26
Term Definition
renal failure metabolic acidosis
diabetic ketoacidosis
diarrhea
are possible causes of what
Term Definition
vomiting or metabolic alkalosis
GI suctioning
are possible causes for what....
Term Definition
hyperventilatin is a possible cause for respiratiory alkalosis
Term Definition
hypoventilation is a possible cause for what resperiatory acidosis
Term Definition
4 questions to ask in interpreting ABG's 1. what is the pH
2. what is the C02 - does it match the pH
3. what is the HC03
4. is pH normal
if CO2 does not match the pH it is metabloic
Term Definition
math formula amount to be infused
gtt/min
Term Definition
math formula volume
mL/hr
Cards
Term Definition
Assessment of the Fetus 1. Kick count: Assessment by mother, <3/hr requires further
testing
2. Ultrasonography
3. Nonstress Test (NST) via EFM for reactivity
4. Contraction test: fetal monitoring during contractions,
nipple stim, or pitocin
5. Biophysical profile (BPP)
Term Definition
Ultrasonography Fetal HR activity, gestational age, fetal growth, anatomy,
genetic disorders, Amniotic Fluid volume, placental
function and position
Term Definition
BPP fetal well being by point system
-reactivity of fetal HR: reactive=2
-Fetal breathing movements: at least 1 episode of 30 sec. in
30 min.
-Gross body movement: at least 3 body or limb extensions
with return to flexion
-Fetal Tone: extension to flexion
Amniotic fluid volume: at least 1 pocket of fluid cm in 2
planes
Term Definition
Amniotic Fluid Volume Normal AFI is 10-25 cm
-Oligohydraminos
-Polyhyamions
abnormalities in AFV are frequently associated with fetal
disorders
Term Definition
Indications for use of BPP Nonreactive stress test, suspected oligohydraminos or
polyhydramion, suspected fetal hypoxemia/hypoxia,
premature rupture of membranes, maternal infections
Term Definition
Amniocentesis HIGH RISK: can cause hemorrhage, infection, preterm
labor
aspiration of fluid for analysis
Term Definition
Indications for use of Amnio genetic disorders, fetal lung maturity, fetal hemolytic
disease
Term Definition
Chorionic Villus Sampling (CVS) 1rst trimester alternative to amnio
-early diagnosis and rapid results (performed at 10-12
weeks)
-Tissue specime from fetal portion of placenta

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aneurysms and other blood vessel abnormalities.

-2-3 hour procedure, patient will be blindfolded and have

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can be given at home

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Possible onset causes...

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Monitor very frequently during acute phase

It does not take the place of in-

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A defensive reaction intended to neutralize , control or

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DIABETES INSIPIDUS 2) Neurosurgery 2) CORTISOL Activity increased

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*just tell them to avoid anything starting with the letter

**Both types describe a variety of painful conditions that

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monitor for fluid overload

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