Medical-Surgical Review Flashcards

Flashcards covering key concepts for a medical-surgical nursing review.

What is COPD (Chronic Obstructive Pulmonary Disease)?

A chronic, progressive lung disease where airways become thick and inflamed, alveoli become damaged, and air gets trapped.

What are the risk factors for COPD?

Smoking, second-hand smoke, occupational chemicals, air pollution, genetic factors, recurring respiratory infections, and asthma.

What are the clinical manifestations of COPD?

Barrel chest, SOB, orthopnea, chronic cough/wheezing, weight loss, tripod position, chest tightness, pursed lip breathing, clubbing, hypercapnia, and low O2 sat.

What are the treatments for stable COPD?

Smoking cessation, bronchodilators, flu/pneumonia/COVID vaccines.

What are the potential complications of COPD?

Cor pulmonale (right-sided HF) and pulmonary hypertension.

What interventions are used during acute exacerbations of COPD?

Rescue inhalers, long-acting inhalers, corticosteroids, antibiotics, O2, and CPAP.

How can airway clearance be improved in COPD patients?

Good chest physical therapy, chest vibration, postural drainage, incentive spirometry, and encouraging coughing and deep breathing.

What are the nutritional considerations for COPD patients with weight loss?

Small frequent feedings, high protein, high carbohydrates, and high calories.

What is the purpose of a chest tube?

Reinflates the lung and drains fluid/air from the pleural space.

What can cause upper airway obstruction?

Tumor, abscess, or foreign object.

What is the pathology of asthma?

Bronchioles become constricted and inflamed causing wheezing and mucus production.

What are the common manifestations of asthma?

Wheezing on expiration, SOB, cough, and chest tightness.

What are common asthma triggers?

Exercise, genetics, allergens, pollutants, food/drug allergies, GERD, respiratory factors, emotions, occupational factors, and change of season.

What are the classifications of asthma?

Intermittent, moderate, and severe.

What medications are commonly prescribed for asthma?

Rescue inhaler (SABA) for intermittent asthma, LABA for persistent asthma, and inhaled corticosteroids to decrease inflammation.

What are the signs of an acute asthma exacerbation?

Expiratory wheeze, tachycardia, increased RR, low O2 sat, and cyanosis.

What are the key characteristics of ARDS (Acute Respiratory Distress Syndrome)?

Refractory hypoxemia, decreased lung compliance, and fluid-filled interstitial tissues and alveoli.

What are the risk factors for ARDS?

Shock, sepsis, multiple trauma, O2 toxicity, pancreatitis, pneumonia, and chest contusion.

What are the phases of ARDS?

Injury/exudative, proliferative, and fibrotic.

What are the key nursing interventions for ARDS?

Using PEEP, turning the patient to the prone position, delivering a good tidal volume, and providing nutritional therapy.

How is tuberculosis (TB) transmitted?

Airborne, via coughing, talking, or sneezing.

What are the primary tests for TB?

Skin test (48-72 hrs for results), Quantiferon (blood test).

What are the types of TB?

Active, primary, and latent.

What are the key manifestations of TB?

Cough (lasting more than 3 weeks), purulent/bloody sputum, lethargy, fatigue, anorexia/weight loss, flu-like symptoms, night sweats, and hemoptysis.

What is the typical treatment regimen for TB?

Initially INH, rifampin, pyrazinamide, and ethambutol every day for 2 months, followed by INH for 9 months for latent TB.

When are ventilators typically used?

Airway is compromised, at risk for losing airway patency, need to protect the airway, and need to deliver large amounts of oxygen.

What are the different modes of ventilation?

Assist control (CMV), synchronized intermittent mandatory ventilation (SIMV), and BiPAP.

What diseases commonly require ventilator support?

Pneumonia, closed chest trauma, asthma, COPD, and COVID.

What are the key ventilator controls and settings?

Breathe rate, tidal volume, FiO2, peak airway pressure, CPAP, and PEEP.

What are the essential nursing management considerations for patients on ventilators?

Frequent respiratory assessments, prevent infection, meet communication needs, and manage the ventilator safely.

What is Angina caused by?

Ischemic heart disease from lack of O2 or blocked arteries.

What are two types of angina?

Chronic stable angina, unstable angina .

What is unstable angina?

chest pain increases in frequency, duration, or severity even at rest

What is typically used to treat pain from Chronic Stable Angina?

SHORT ACTING NTG - Sublingual vasodilator

Through what route are blockages cleared during a cardiac catheterization?

Femoral or radial artery via cardiac catheterization.

What is Acute Coronary Syndrome (ACS)?

sudden decrease coronary blood flow (cardiac ischemia)

Wha are the three types of Acute Coronary Syndrome?

STEMI, NSTEMI, Unstable Angina

What a manifestation of Myocardial Infarction?

Persistent chest pain unrelieved by nitroglycerin.

What is a sign of renal system manifestation?

Decreased urinary output.

What Cardiac biomarker test is crucial to take and what are the parameters?

Troponin (drawn every 6 hours x3,) which is an normal would be between 0.00-0.40.

What Interprofessional Care should be taken?

Monitor 12 lead ECG, V/S, maintain upright position and O2 levels above 90%.

Who is most likely to get a Urinary Tract Infection?

Most common in women, females > males(10:1)

What are the most common cause of Urinary Tract Infections?

90% caused by E. coli, trauma + irritation, catheter

What are the Classification of a UTI?

Lower UTI(Cystitis) Upper UTI (Pyelonephritis)

What are the symptoms of Cystitis?

Dysuria, suprapubic discomfort, hematuria

Which are the most common causes of Lower UTIs

Health Care Associated Infections (HAIs)

What Diagnostic tools are used ?

History and physical Urine dipstick Urinalysis Urine C&S

Whats a the Primary Therapy/Treatment

Antibiotics

What is a cause of Pyelonephritis?

Begin with infection for lower UTI

What causes Chronic Pyelonephritis?

Recurring infections

What is health promotion for UTI's?

Aseptic technique must be followed during all procedures Hand Washing

What is Glomerulonephritis?

Inflammation of the glomeruli

What are the symptoms Glomerulonephritis?

Generalized Edema Decreased glomerular filtration rate (GFR)

What is Acute Kidney Injury?

Rapid loss of kidney function

What are the cause of Pre-Renal issue with kidney?

Dehydration, hemorrhage, burns, N/ V/D

What's Intra - Renal Injury

Damage to the kidney – glomerular, tubular damage

What cause Post-Renal issues?

Bladder CA, calculi, infection, stricture, spinal trauma

What are phases of of Acute Kidney Disease?

Oliguric Phase (1st Phase), Diuretic Phase, Recovery Phase

What Diagnostic tests can be ran?

History and physical CMP/ GFR Creatinine level/ BUN U/A

What is Chronic Kidney Disease ?

Progressive irreversible loss of kidney function GFR < 60ml/min X 3 months Presence of kidney damage ESKD – End Stage Kidney Disease GFR < 15ml/min

What is the term Uremia?

Urea in the blood

What some Manifestations?

GFR Low Serum creatinine and BUN increase BUN >

What causes CKD?

Diabetes Mellitus 50 % HTN 25%

What is the Pulse Pressure in regards to shock?

The difference between systolic and diastolic and should be around 40

Afterload in regards to shock?

the ventricles need for the blood to be forced out of the ventricle and into the systemic circulation

Scenarios of cardiogenic shick?

Blockage in the artery that can cause ischemia, MI, clot, atherosclerosis

What are the clinical manifestation of Hypovolemic Shock?

Altered Mental Status as it progresses Confused, agitated Low Blood Pressure Increased Heart Rate

How do you measure MAP?

(Systolic BP + x2 your diastolic BP / 3)

What pathology does Tuberculosis have?

Very contagious

Medication with Adverse affects?

Alot of these medications can cause diseases to the liver, toxicity

Ambulatory care for TB?

Cover mouth/nose Wear surgical mask if you’re out of the room

Positive-Pressure Ventilators What are the two?

Volume Ventilator Pressure Ventilator

Modes of Ventilation Assist Control or CMV

Allows the patient to rest

Shock Defintion?

Decreased in tissue perfusion, Decrease of oxygen, RBC Blood

Ischemic Stroke def?

Heart attack of the brain

Hemorrhagic Stroke cause?

Bleeding in the brain

Ischemic vs Hemhorragic stroke

Left = Language Right = Reckess

Seizure Definition?

Uncontrolled electrical discharge that interrupts normal brain function

Seizure Nursing Mngmnt?

Protect their head, turn on their side

Stoke Management

Rapid head CT Rule out bleeding or clot in the brain

TBI Management

Post-Concussive Syndrome: Lasts 2 weeks to 2 months.

Neurogenic shock cause

Hypothermia

Fractures- cause risk

High risk Open: skin isn’t teared Close: is teared skin

Hip Fracture teach pt

elevate hip less 90, no bend no cross

osteomyelitis cause?

swelling and redness warm skin or joint pain

What is C.S (49 yrs Male) cause?

GERD due to Heartburn, worsen at night, relief w/ antacids

Hepatitis types + route of cause

Hepatitis A: Fecal-oral route Hepatitis B: Bloodborne Hepatitis C: Bloodborne Hepatitis D: Requires Hep B to replicate Hepatitis E: Fecal-oral route