FlashCardExchange

I have many new flash cards at flashcardexchange.com you can select the link at the right. tag is studentnurselaura

Mental Case

I am inputting new flashcards for these modules we have studied in Chronic (Med Surg 2nd semester). I have not gone over spelling errors yet, but I will work on this

Now the cool thing is…. if you down load Mental Case from itunes, you can use your iphone/itouch to download questions from flashcard exchange. You can set up your own account and create your questions – just like 3×5 flash cards manually.

http://www.macflashcards.com/

Then on your itouch, under ‘exchange’ you can input your flashcardexchange username, select which flashcards you want on your Mental Case. It is awesome!

I promise to start this soon next semester!!!! 

Aortic Aneurysm

 

This amazing image is from: http://biomed.brown.edu/Courses/BI108/BI108_2007_Groups/group05/pages/guidant_stent.html

Hematology

A few disease processes are broken down on review sheets. This information is all derived from Brunner’s.

DIC

GVHD

Hemophilia

Hodgkin’s Disease

Leukemia

Multiple Myeloma

Sickle Cell Crisis

Thrombocytopenia

Hematology Cards

  4×6 Module 12 drug cards Updated 5/27/10

I’m still working these note cards of mine. If I repost – I’ll put the date up. Please note all drug cards are just my notes from Davis Drug Guide and Mosby’s Pharmacology.

Some images worth reviewing

Tulane University School of Medicine http://tulane.edu/som/index.cfm

Pericarditis – here you can see and imagine the pain a person would have. S/S of Pericarditis: pain, pericardial friction rub, pain aggravated by breathing, Dyspnea, Fever (it looks hot!), Decreased cardiac output (you wouldn’t want it to move!) Treatment: Antibiotics  Diagnosis: see below  Leads to:  See the pericardial effusion

Echocardiogram to confirm pericarditis or pericardial effusion

Myxoma  – what does “oma” mean?      not “coma” so …. ”oma” means it is benign, this is more a cancer item, but I had to throw it in. Luckily this can be removed. Benign.

Rheumatic Mitral Valve            - when you see the obstruction of the blood flow here due to the thickening or inflammation, you can see how rhematic endocarditis can cause Mitral Stenosis.                   

Ventricular Hypertrophy  – caused by increased work of the left ventricle – increased afterload (resistance) will make the heart over work.

Infective Endocarditis - s/s: malaise, wT loss, cough, back and joint pain w/fever. Leads to deformity of the leaflets. Treatment: Antibiotics – prophylaxis (esp before dental procedures). Leads to: CHF, CVA

Aortic Valve: destructive endocarditis caused by staph aureus, with abscess cavity under the pulmonary artery (aortic valve removed)
(RCA – right coronary artery, LCA – left coronary artery, MV – mitral valve) 

http://my.clevelandclinic.org/heart/disorders/valve/sbesurgerypics.aspx

Valve Disease Chart

Some Cardiac Visuals – click the ♥

Aortic Stenosis & Mitral Regurgitation   ♥

Mitral Valve Prolapse      ♥

Endocarditis   ♥

Cardiac catheterization ♥

Cholesterol    ♥

MI    ♥

Heart Sounds

 

Cancer Contemplations

Cancer Contemplations  When reviewing my oncology notes, there were a couple things I needed to clarify for myself. I decided to post them in case anyone else wanted another way to look at the same info.      Chemotherapy kills normal cells as well as neoplastic cells, whereas Radiation Therapy destroys cancer cells, but very minimal to normal cells.       Radiation       Radiation goes to the tumor. It damages the DNA. Tumor cells have a diminished ability to repair themselves, so radiation causes them to die or reproduce more slowly. Problem getting to some tumor cells is they may become hypoxic (in a low state of O2). This makes them 2-3 times more resistant to radiation as radiation uses O2 as a radio-sensitizer. External (teletherapy) does not emit radiation Internal (bradytherapy) does emit radiation (sealed or unsealed) most is out within 48 hrs.       What is Staging? Staging establishes the size of the tumor. Remember in situ?       What is Grading? Grading is classification of how closely they resemble the tissue of origin. “Differentiated”       What is Differentiated? Normal cells will differentiate to become specialized for their tissue. Differentiated is good. Like from elementary to HS, to college – we have differentiated. Cancer cells will not differentiate, because they want to become “cancer” cells not those special tissue cells you need. They are known as “undifferentiated.” You can think of “differentiated” as meaning “normal.”       Chemotherapy attacks rapidly growing and dividing cells. Doesn’t target normal body cells. It will destroy normal body cells that grow and divide fast such as ovarian tissue.       Interferons are biologic response modifiers with antiviral and antitumor properties. They stimulate immune response to eradicate malignant growths.

ECGs

I want to recommend a book on learning how to interpret EKGs. It is called Rapid Interpretation of EKG’s by Dr. Dale Dubin.

It is a bright orange book  – you can’t miss it!  This book is set up the same way our Fluids and Electrolytes book is. This format makes it easy to understand and you get to check your understanding along the way.

Click here for the ISBN #

After a busy day on the floor

Fluid & Electrolyte Notes on Heart Failure

Tropics ♥

 

Greek Meanings

•  Tropikos  – turning or influence

• Dromos – a course

• Inos – fiber

• Chronos – time

 cardiac drugs         4×6 cardiac drugs

Digoxin:

•   + Inotropic reaction
•    -  Chronotropic reaction 
•    -  Dromotropic reaction.

Oncology Drugs

mod 10 drugs sheet

4×6 cancer drugs

Week 6 & 7 Reading Cards

Week 6 Reading

Week 7 Reading

Pedal Pulses and Peripheral Vascular Diseases

From allnurses.com: According to Textbook of Physical Diagnosis: History and Examination, 3rd edition, by Mark H. Swartz, M.D., page 329 “The dorsalis pedis pulse is best felt by dorsiflexion of the foot. The dorsalis pedis artery passes along a line from the extensor retinaculum of the ankle to a point just lateral to the extensor tendon of the great toe.”

http://medicine.ucsd.edu/clinicalmed/extremities.htm – if you scroll down this page to the section near the end entitled The Distal Pulses you will find a discussion and photos (one anatomical from a cadaver) on how to locate and palpate the Dorsalis Pedis Pulse in the foot.

Some additional information for you, in the event that the subject of the “grading”, or amplitude, of pulses should come up. Here is the most popular grading scale that is used (page 330 of the Swartz textbook):

0 – absent
1 – diminished
2 – normal
3 – increased
4 – bounding

If your patient has Pain, Pallor, Pulselessness, Paresthesia, Paralysis (and you could go 6 with Poikilothermia  – coldness) – You have a good chance they have an Arterial Embolism.

Check their pedal pulses every 2 hrs after surgery to be sure there is no occlusion.

ABI  – ration systolic of ankle to arm.

Take systolic of each foot. Systolic of each arm(brachial). Divide each foot’s systolic with the highest arm’s systolic.

• Your ABI will be normal if  it = 1.0
• Claudication = 0.95 – 0.50
• Ischemic rest pain ABI = < 0.50
  • (ischemic – no blood flow to tissues)

Treatment of claudication: Trental pentoxifylline & clopidogrel Pletal. Trental to increase RBC flexibility and decrease fibrinogen concentrations. Pletal to inhibit phosphodiesterase III and vasodilate – not to treat the claudication.

Treatment for Arterial Embolism – Heparin  w/inital bolus of 5,000 to 10,000 units followed by continuous drip at 1000 units per hour to prevent further embolism. What treats Heparin? Protamine Sulfate!

Aspirin – prevents the formation of thromboemboli. Plavix for prevention of cardiovascular ischemic events w/PAD

Aneurism = Diastolic BP >100, Surgery > 2″ or 5.5cm.

Study Question on HTN

Question.

My son 21 was at the doctor. His BP was over 140 systolic, again! Can he be diagnosed as HTN? He is skinny, walks all over the UCLA campus, tells me he doesn’t smoke or drink too much. My dad has HTN. What type of HTN does he have?

What is the percent of the people diagnosed with HTN have this?

What would be his first action to lower his BP?

If this doesn’t work, what would be the 2^nd Step?

I don’t see any excess fluid on him. No way. His 24 urine last year showed elevations of epinephrine and norepinephrine. His ultrasound of his kidneys was WNL, no tumors. His ECG showed elevated T waves – so his K+ is high enough – therefore we know he doesn’t have a secondary cause such as  A______ or C______ disease.

What drug would block the adrenergic receptors stimulation from the epinephrine/norepinephrine?

 What drugs would decrease peripheral resistance? Which ones decrease contractility? Which work on blood volume?

The 1^st doctor said he will probably continue to have high BP and slowly continue to go higher…. what type of HTN is that?

The concern w/nursing managment of HTN is __________, based on statistics, he has a ___% chance of ____________ treatment in the   _____ year.

Have fun studying!!

Laura

Answers

Respiration Notes from McKenry

HTN Meds – Mod 7

These meds are not on cards. I am focusing on their classification and any special info.

Mod 7 drugs

Week 5 Reading

Week 5 Reading