Lecture: comp review
Gross Hematuria- PROBLEM!!! Bigger than normal kidney, cyst can rupture and start bleeding into
abdomen.....hemorrhage or death. Assess patient =in bed, contact pcp, vitals
Wedge pillow for GERD
Polycystic kidney disease leads to ESRD—> TRANSPLANT OR DIALYSIS
Implanted radiation therapy-> stay in bed, no visitors over 30 mins no pregnant woman or kids under
18, if fall out use tongs to pick up to put in lead box, blood pressure machine does not have to stay in
room, linen stay in room until patient is discharged. No pregnant nurses, stay 6 feet away if can, staff
rotate, no more than 30 minutes at a time for care, no room mate
A-fib = anticoagulation therapy, never regular rhythm, QRS never march/even, YOU WILL CARDIO
VERT/cardioversion, anti arrhythmic, anti dysrhythmic amiodarone- drug of chose
a-fib at risk for clotting = low extremity pain or redness or swelling (urgent not emergent), ultrasound
riperamide- Imodium don’t give for IBS-Constipation
Addison’s disease- low and slow, potassium is high, tele monitor, steroids, educate on addisonian crisis
(shock like), at home patient can monitor blood pressure
pacemakers- no MRI, don’t raise arms for 2 weeks, shower don’t submerge, cell phone in opposite
pocket, can use microwave and electronic devices, medical alert bracelet, card with pacemaker number,
check pulse daily, loose clothing, no contact sport, can go through security at airport, follow up with
provider
trachea suction- no longer than 10 seconds, on suction on way out, hyper oxygenate before suctioning,
1 finger fit, sterile dressing change and suctioning in hospital but not at home
sickle cell> hydrate > get plenty of fluid, oxygen, pain management, avoid extreme heat, avoid stress
and trauma, avoid changes in altitude, if get sick watch for sickle cell crisis (extreme pain)
localized shingles—> contact precautions
disseminated shingles > spread in multiple areas air borne precautions N95
stem cell transplant or neutropenic—> protected isolation (put mask on patient, protect the patient)
contrast media—> check kidney function first check BUN and creatinine if elevated that’s a problem,
heart cath uses dye, CT, MRI, nuclear scans, swallow studies.... Contact provider with high BUN and
creatinine, need consent
if you have a patient with pertussis = droplet precaution
flu = droplet precaution
Ml and troponin levels, will be high and draw the troponin onset of chest pain and every few hours
, TPA time frame is 4 hours from onset of symptoms
Therapeutic communication and nutrition for pediatric patients- know when foods can be introduced
juice after a year, milk after a year
Postmortem care- know if patient is an organ donor, need to keep them breathing
Metformin- hold it 24 hours before contrast media and 48 hours after or until kidney function return to
baseline, if patient in kidney failure they have 2 hours to get dialysis after receiving contrast dye
Peptic ulcer disease and intervention for bleeding- drop NG tube, check for active bleeding, bright red
blood, coffee ground means its further down, IV 18 or 20 gauge, get ready to give blood, give oxygen
If patient is in shock, big IV, oxygen, vaso pressors/ vaso constrictors medication
Know blood gases values 7.35-7.43 34
Desmopressin for DI (DIABETES INSIPIDUS)
Signs of transplant rejection = increased temp, pain at site, if kidneys patient will go back into renal
failure, if rejecting WBC will increase, fever 100 or up by 1 degree is rejection, 2-3 Ibs over night weight
gain (kidney)
PVCs- check pulses, electrolytes, check the patient, electrolyte imbalances, too much caffeine, correct
underlying cause...don’t need to call a code or rapid, definitely check electrolyte
NG TUBE-> flush with water before meds, turn it off when listening for bowel sounds, NG TUBE to
suction turn off for 30 minutes, head of bed up for feedings, usually immobile, SCDs, range of motions,
irrigate, don’t move the tube placement
vent alarms = bag patient if cant figure out where problem is, low alarm is leak, high alarm is blockage
LECTURE 2
Infants birthweight at 6 months doubles and at 1 year it triples
Incident report is for if someone falls, equipment not working, spilled milk on floor etc it goes to
manager of unit, dietary, equipment manager etc
Patient comes in to the ED for hypothermia what is priority, warm patient up start with chest area first
(trunk/core to extremities)
You have a patient that just came back from surgery 3 hours ago that got a new colostomy, what do you
expect colostomy to look like......beefy red, pink and moist, will not expect it gray, purple, dark or day,
what to encourage patient to eat to decrease fatuous (gas) 2yogurt
You go into a patient’s room and gave the wrong patient the wrong medication, the first thing you
should do is assess the patient and see if they are having side effects then you will call the doctor
Priorities for an infant car seat - rear facing up to 2 years old, car seat needs to be in the middle, needs
to be anchored into the seat, and belt at chest/arm pit level
Gross Hematuria- PROBLEM!!! Bigger than normal kidney, cyst can rupture and start bleeding into
abdomen.....hemorrhage or death. Assess patient =in bed, contact pcp, vitals
Wedge pillow for GERD
Polycystic kidney disease leads to ESRD—> TRANSPLANT OR DIALYSIS
Implanted radiation therapy-> stay in bed, no visitors over 30 mins no pregnant woman or kids under
18, if fall out use tongs to pick up to put in lead box, blood pressure machine does not have to stay in
room, linen stay in room until patient is discharged. No pregnant nurses, stay 6 feet away if can, staff
rotate, no more than 30 minutes at a time for care, no room mate
A-fib = anticoagulation therapy, never regular rhythm, QRS never march/even, YOU WILL CARDIO
VERT/cardioversion, anti arrhythmic, anti dysrhythmic amiodarone- drug of chose
a-fib at risk for clotting = low extremity pain or redness or swelling (urgent not emergent), ultrasound
riperamide- Imodium don’t give for IBS-Constipation
Addison’s disease- low and slow, potassium is high, tele monitor, steroids, educate on addisonian crisis
(shock like), at home patient can monitor blood pressure
pacemakers- no MRI, don’t raise arms for 2 weeks, shower don’t submerge, cell phone in opposite
pocket, can use microwave and electronic devices, medical alert bracelet, card with pacemaker number,
check pulse daily, loose clothing, no contact sport, can go through security at airport, follow up with
provider
trachea suction- no longer than 10 seconds, on suction on way out, hyper oxygenate before suctioning,
1 finger fit, sterile dressing change and suctioning in hospital but not at home
sickle cell> hydrate > get plenty of fluid, oxygen, pain management, avoid extreme heat, avoid stress
and trauma, avoid changes in altitude, if get sick watch for sickle cell crisis (extreme pain)
localized shingles—> contact precautions
disseminated shingles > spread in multiple areas air borne precautions N95
stem cell transplant or neutropenic—> protected isolation (put mask on patient, protect the patient)
contrast media—> check kidney function first check BUN and creatinine if elevated that’s a problem,
heart cath uses dye, CT, MRI, nuclear scans, swallow studies.... Contact provider with high BUN and
creatinine, need consent
if you have a patient with pertussis = droplet precaution
flu = droplet precaution
Ml and troponin levels, will be high and draw the troponin onset of chest pain and every few hours
, TPA time frame is 4 hours from onset of symptoms
Therapeutic communication and nutrition for pediatric patients- know when foods can be introduced
juice after a year, milk after a year
Postmortem care- know if patient is an organ donor, need to keep them breathing
Metformin- hold it 24 hours before contrast media and 48 hours after or until kidney function return to
baseline, if patient in kidney failure they have 2 hours to get dialysis after receiving contrast dye
Peptic ulcer disease and intervention for bleeding- drop NG tube, check for active bleeding, bright red
blood, coffee ground means its further down, IV 18 or 20 gauge, get ready to give blood, give oxygen
If patient is in shock, big IV, oxygen, vaso pressors/ vaso constrictors medication
Know blood gases values 7.35-7.43 34
Desmopressin for DI (DIABETES INSIPIDUS)
Signs of transplant rejection = increased temp, pain at site, if kidneys patient will go back into renal
failure, if rejecting WBC will increase, fever 100 or up by 1 degree is rejection, 2-3 Ibs over night weight
gain (kidney)
PVCs- check pulses, electrolytes, check the patient, electrolyte imbalances, too much caffeine, correct
underlying cause...don’t need to call a code or rapid, definitely check electrolyte
NG TUBE-> flush with water before meds, turn it off when listening for bowel sounds, NG TUBE to
suction turn off for 30 minutes, head of bed up for feedings, usually immobile, SCDs, range of motions,
irrigate, don’t move the tube placement
vent alarms = bag patient if cant figure out where problem is, low alarm is leak, high alarm is blockage
LECTURE 2
Infants birthweight at 6 months doubles and at 1 year it triples
Incident report is for if someone falls, equipment not working, spilled milk on floor etc it goes to
manager of unit, dietary, equipment manager etc
Patient comes in to the ED for hypothermia what is priority, warm patient up start with chest area first
(trunk/core to extremities)
You have a patient that just came back from surgery 3 hours ago that got a new colostomy, what do you
expect colostomy to look like......beefy red, pink and moist, will not expect it gray, purple, dark or day,
what to encourage patient to eat to decrease fatuous (gas) 2yogurt
You go into a patient’s room and gave the wrong patient the wrong medication, the first thing you
should do is assess the patient and see if they are having side effects then you will call the doctor
Priorities for an infant car seat - rear facing up to 2 years old, car seat needs to be in the middle, needs
to be anchored into the seat, and belt at chest/arm pit level
