MEDICAL SURGERY EXAM STUDY GUIDE

- The medication you would give for an uncontrolled flutter is adenosine, because it will bring the heart rate down. - Patient with dysrhythmias: - Maintain perfusion and cardiac output - Atrial fibrillation is the most common dysrhythmia and it produces clots, so patient is usually on coumadin and the nurse should monitor INR (it should be between 2-3) - The dysrhythmias you would use defibrillation for: - V. fibb and pulseless v. tach - A. fibb has a risk of blood clots because the blood is pooling into the chambers of the heart, the blood is not getting out - Medication for sinus bradycardia: atropine - EKG strips: - To calculate the heart rate: the 6 second strip is 30 boxes - To determine if a patient had a block: measure the PR interval - Normal PR interval is 0.12-0.2 - Treatment for 3rd degree block: pacemaker; probably external at first - Electrolyte most likely to be seen with dysrhythmias: potassium (usually hyperkalemia) - 6 symptoms for dig toxicity: - Visual disturbances, vomiting, nausea, bradycardia, anorexia, dysrhythmias - Hematology: - When administering blood transfusion: after the blood is picked up it has to be used within 30 minutes and the transfusion can not last longer than 4 hours - Patient with CHF: to get it over 4 hours, slow as possible, because of the risk for fluid overload (you could give them Lasix) - Platelets are good for 5 days before they have to be discarded - An autologous blood donation is when a patient donates blood for their own surgery - Leukemia: cancer of white blood cells, there are too many and their immature - A hemolytic reaction would occur within 15 minutes of the blood transfusion - V. tach is made up of a run of PVC’s - How to push adenosine: fast and flush after with 20 ml. of normal saline, put arm up - The 6 P’s: pain, pallor, paresthesia, paralysis, pulselessness, poikilothermia MEDICAL SURGERY EXAM STUDY GUIDE - Protein that adds volume: albumin - Antidote for coumadin: vitamin K - Antidote for heparin: sulfate - Vascular disease with intermittent claudication and rubor: arterial - Vascular disease with positive pulses: venous - Needed for absorption of B12: intrinsic factor, a deficiency is pernicious anemia - Amount of time to transfuse plasma: 30-60 minutes - If patient is having a reaction to transfusion, the meds to give: benadryl, epinephrine, steroids, prednisone - If patient needs spleen removed: make sure the patient has pneumonia vaccine - Aspirate bone marrow from iliac crest - Most common type of anemia in postmenopausal women: iron deficiency - Iron deficiency: craving of ice, called pagophagia - Protein that adds volume: albumin - End stage kidney disease: give patient erythropoietin, the synthetic form is Procrit - Low molecular weight heparin: Lovenox - Type of anemia with beefy red tongue: pernicious - Pt on neutropenic precautions: monitor ANC to see if they can be taken off - Patient on this precaution should be on low microbial diet (no raw fruits or veg.) - Regular heart sounds: S1 and S2 - Average stroke volume: 60-130 - Average cardiac output: 5 liters - With pulmonary edema, crackles would be auscultated - Diagnostic test for pulmonary embolism: D dimer and VQ scan - Blood clot in legs: use venous doppler - Pulse pressure: systolic minus diastolic - CAD diagnostic test: cardiac catheterization - CT with contrast: check for iodine allergy, shellfish allergy, and creatinine level - Lab value to look at for heart failure: BNP and they will do an EK