States Exam Prep - Vocabulary Flashcards

Vocabulary flashcards covering ABG interpretation, acid-base disturbances, fluid therapy, electrolytes, cardiovascular, respiratory, renal, obstetric, pediatric, mental health, and emergency nursing concepts from the lecture notes.

PaO2

Partial pressure of oxygen in arterial blood; normal range 70-100 mmHg; <60 mmHg leads to tissue hypoxia.

PaCO2

Partial pressure of carbon dioxide in arterial blood; respiratory component; normal range 35-45 mmHg; CO2 is regulated by the lungs and acts as an acid (H2CO3/H+).

HCO3-

Bicarbonate; metabolic component of acid-base balance; regulated by kidneys; acts as a base (can accept H+).

pH normal range

7.35 to 7.45.

Acid-base disturbances

Four major disturbances: Respiratory acidosis, Respiratory alkalosis, Metabolic acidosis, Metabolic alkalosis.

Respiratory acidosis

CO2 retention leading to acidosis; caused by hypoventilation, COPD, acute respiratory failure, airway obstruction.

Respiratory alkalosis

CO2 loss due to hyperventilation; triggered by stress, pain, hypoxemia, CNS disorders, fever/sepsis.

Metabolic acidosis

Acid gain or bicarbonate loss (e.g., increased acid production, diarrhea, renal impairment).

Metabolic alkalosis

Loss of hydrogen ions or gain of bicarbonate (e.g., vomiting, diuretics, IV bicarbonate, Cushings, hypokalemia).

Renal compensation

Slow bicarbonate changes (up to ~1 day) to compensate metabolic disturbances.

Respiratory compensation

Rapid CO2 changes (minutes) to compensate metabolic disturbances.

ABG interpretation steps

1) Evaluate oxygenation 2) Evaluate pH 3) Evaluate PaCO2 4) Evaluate HCO3 5) Match PaCO2/HCO3 with pH 6) Assess compensation.

Assessing compensation

Check if the non-affected value has changed to match the primary disturbance (partial/complete/uncompensated).

Hypovolemia signs

Postural hypotension, tachycardia, absent JVP at 45°, dry mucosae, decreased skin turgor, supine hypotension, oliguria.

Hypervolemia signs

Hypertension, tachycardia, raised JVP, edema, pleural effusions, pulmonary edema, ascites.

Hyponatremia signs

Muscle twitching/weakness, edema/hypervolemia, hypotension, tachycardia, reduced urine output; CNS: lethargy, confusion, seizures.

Hypernatremia signs

Hypervolemia, hypertension, thirst, dry mucous membranes, weight gain, restlessness, CNS signs like tremor or seizures.

Hypokalemia signs

Muscle weakness, cramps, paralysis, arrhythmias, ECG changes, possible cardiac arrest, hypotension, respiratory depression, reduced GI motility.

Hyperkalemia signs

Muscle weakness, cramps, paralysis, fatigue, GI motility changes, arrhythmias, bradycardia, potential cardiac arrest.

Hypocalcemia signs

Muscle cramps, paresthesias, CNS changes (confusion, irritability), seizures, arrhythmias, possible heart failure.

Hypercalcemia signs

Nausea/vomiting, polyuria/polydipsia, weakness, fatigue, confusion, bone fragility.

Potassium effects on the heart

Fluctuations alter resting membrane potential, action potential duration, and conduction velocity, affecting arrhythmia risk.

Sodium effects on the heart

Fluctuations affect action potential initiation and conduction; osmotic balance influences perfusion.

Hypertonic solutions

Draw water from cells into extracellular space; reduce cellular edema; used in cerebral edema; examples include 3% NaCl, protein solutions.

Hypotonic solutions

Cause water to move into cells; rehydrate cells; used for intracellular dehydration; examples include 0.45% NaCl, 0.33% NaCl.

Isotonic solutions

Distribute evenly between intravascular and interstitial spaces; expand extracellular volume; examples include 0.9% NaCl, LR, D5W.

Colloids

Osmotic effect due to large molecules staying in vasculature; draw water into vascular space; used to maintain vascular volume (hypovolemia). Examples: Albumin, Dextran, Blood.

Crystalloids

Clear fluids with water and electrolytes; distribute quickly; provide rapid volume expansion.

Blood products

Replace specific blood components (RBCs, plasma proteins, platelets) to restore oxygen carrying capacity and coagulation.

Normal saline resuscitation

0.9% NaCl used for fluid replacement and resuscitation.

3% saline use

Hypertonic saline used for severe hyponatremia or ICP management; requires close monitoring.

Dextrose solutions (D5W)

Glucose-containing solution; used for hypernatremia, hypoglycemia, and maintaining water balance in NBM patients; limited in resuscitation.

Lactated Ringers (Hartmann's)

Balanced crystalloid used for resuscitation in dehydration, burns, trauma, metabolic acidosis, obstetric use.

Blood transfusion prerequisites

Group and screen, prescription, informed consent, patent vascular access, baseline obs, documentation, two certified staff.

Transfusion safety steps

Unit by unit transfusion; consent verified; no other meds in same line; saline bolus if needed; two nurses verify; monitor at bedside 15 min.

IV therapy complications

Infiltration (cannula in tissue) and phlebitis (vein inflammation).

VIP score

Visual Infusion Phlebitis score; graded from healthy IV site to signs of phlebitis (pain, erythema, induration, venous cord).

Asthma

Chronic inflammatory airway disease with reversible airflow obstruction; triggers include allergens, infections, exercise.

Asthma attack signs

Cough, wheeze, shortness of breath, chest tightness, cyanosis, tachypnea, tachycardia, anxiety.

Bronchodilator example

Ventolin (salbutamol) used to relieve bronchoconstriction.

Rheumatic fever

Post-streptococcal inflammatory disease that can lead to rheumatic heart disease; treated with antibiotics and anti-inflammatories.

Rheumatic heart disease (RHD)

Chronic valve damage from rheumatic fever; can cause stenosis or regurgitation and heart failure.

Carditis

Inflammation of the heart layers (endocardium, myocardium, pericardium) risk for murmurs and heart failure.

Sydenham's chorea

Involuntary rapid movements of face, hands, and feet associated with rheumatic fever.

Acute myocardial infarction (MI)

Heart attack – reduced blood flow causing myocardial ischemia and necrosis; risk factors include hypertension, hyperlipidemia, diabetes, smoking.

MONA therapy

Morphine, Oxygen, Nitro (nitroglycerin), Analgesics to manage acute MI.

CABG

Coronary artery bypass graft; reroutes blood around blocked arteries.

Angioplasty with stent

Catheter-based procedure to unblock arteries and place a stent to keep them open.

MI medications

Aspirin, thrombolytics, antiplatelets, nitro, beta-blockers, ACE inhibitors, analgesics.

MI complications

Angina, reinfarction, arrhythmias, valvular issues, cardiogenic shock, LV aneurysm, pericarditis, rupture, heart failure.

Stable vs unstable angina

Stable: predictable with rest or nitro; Unstable: unpredictable, may occur at rest, increasing severity.

ECG electrode placements

V1-V6 chest leads; RA, LA, RL, LL limb leads for rhythm assessment.

Normal sinus rhythm

Regular rhythm 60-100 bpm; originates at SA node with a P wave before each QRS.

Atrial fibrillation (AFib)

Irregularly irregular rhythm with no discernible P waves; variable ventricular rate.

Atrial flutter

Regular or irregular rhythm with sawtooth flutter waves; typical atrial rate 250-350 bpm; ventricular rate varies.

Ventricular tachycardia (VT)

Regular rhythm 100-250 bpm with wide QRS complexes.

IBD vs IBS

IBD: inflammatory bowel disease (ulcerative colitis, Crohn's); IBS: irritable bowel syndrome (functional).

AKI (acute kidney injury)

Sudden decline in renal function with reduced GFR, oliguria, azotemia, edema, metabolic acidosis.

Prerenal AKI causes

Low renal perfusion: hypovolemia, hemorrhage, hypotension, burns, septic shock, renal artery stenosis.

Intrarenal AKI causes

Intrinsic renal damage: ATN, glomerulonephritis, vasculitis, interstitial nephritis, nephrotoxins.

Postrenal AKI causes

Urinary tract obstruction leading to back pressure and reduced filtration.

AKI management signs

Azotemia, fluid overload, hyperkalemia, metabolic acidosis, hyponatremia, hypoalbuminemia, anemia; dialysis if needed.

Chronic kidney disease (CKD)

Progressive, irreversible nephron destruction leading to reduced function and potential dialysis.

CKD causes

Diabetes mellitus, hypertension, glomerulonephritis, polycystic kidney disease.

CKD symptoms

Azotemia/uremia, hypertension, anemia, bone disease due to vitamin D deficiency, edema.

CKD management

Dietary control, erythropoietin, ACE inhibitors, beta-blockers, glycemic control, analgesics as needed.

COPD

Chronic obstructive pulmonary disease; progressive airflow limitation due to airway remodeling and loss of elasticity.

Tension pneumothorax

Air trapped in pleural space causing lung collapse and mediastinal shift; life-threatening.

Pneumonia

Infection causing alveolar inflammation and fluid/pus; can be community or hospital acquired.

Tuberculosis (TB)

Infectious disease caused by Mycobacterium tuberculosis; diagnosed by imaging, sputum tests; treated with antibiotics.

Oxygen masks types

Nasal cannula, simple mask, nonrebreather, Venturi mask, high-flow nasal cannula, CPAP, transtracheal oxygen.

Nonrebreather mask

High-concentration oxygen mask delivering up to ~60-80% O2; used for short-term therapy; tight fit.

CPAP mask

Continuous positive airway pressure; supports spontaneous breathing with/without artificial airway.

Venturi mask

Deliver precise FiO2 by mixing air and oxygen; allows humidity or aerosol therapy.

Sepsis

Dysregulated host response to infection causing organ dysfunction; can progress to septic shock.

Sepsis stages

Stage 1 local infection; Stage 2 organ dysfunction; Stage 3 septic shock with cardiovascular collapse.

Sepis quick recognition (SISPIS)

S: Shivering/fever; E: Extreme pain; P: Pallor; S: Sleepiness; I: I feel like I might die; S: Shortness of breath.

ISBAR

Identification, Situation, Background, Assessment, Recommendation – a handoff communication framework.

Early Warning Score (EWS)

System to identify deteriorating patients; categories (Yellow/Orange/Red/Blue) with escalating actions.

HEADSSS

Comprehensive psychosocial assessment tool for youths: Home, Education, Activities, Drugs, Emotions, Sexuality, Suicide/Depression, Safety.

HEART assessment

Tool for pediatric mental health assessment focusing on Home, Education, Activity, Relationships, Temperament.

Gillick Competency

A child’s competence to consent to medical treatment if they understand purpose, benefits, risks; confidentiality may be protected.

Children's Act / Privacy Act / Health Act (NZ)

Legislation governing child welfare, privacy of health information, and health service delivery.

Postpartum hemorrhage (PPH)

Blood loss ≥ 500 mL after vaginal birth or ≥ 1000 mL after cesarean; major PPH requires prompt management.

Hyperemesis gravidarum

Excessive vomiting in pregnancy; risk of dehydration and electrolyte imbalance; treated with antiemetics and IV fluids.

Pre-eclampsia

Hypertension with organ involvement (e.g., proteinuria) after 20 weeks; risk to mother and fetus; managed with aspirin, MgSO4, delivery.

Dysregulated Deterioration signs (Deteriorating patient)

ABCDE approach to evaluate airway, breathing, circulation, disability, exposure; aggressive management for unstable patients.

Sepsis management sequence

Recognize sepsis early, obtain cultures, administer antibiotics, fluids, oxygen, monitor urine output.

Toxicity signs (Oxygen toxicity signs)

Monitor ABGs to ensure oxygen concentration is appropriate; avoid unnecessary high FiO2.

Rationale for vaccination/testing (NZ schedule)

Newborn screening, immunisations (Rotavirus, DTP, MMR, etc.) and routine pediatric preventive care.

Pediatric vital signs (Newborn)

HR 80-180 bpm; RR 30-80; BP 73/55; T 36.8°C (axillary).

Pediatric vital signs (Infant)

HR 80-140 bpm; RR 20-40; BP 90/55; T 36.5-37.5°C.

Pediatric vital signs (6-8 years)

HR 75-120 bpm; RR 15-25; BP 95-75; T ~37°C.

Diabetes Type 1 vs Type 2

Type 1: autoimmune destruction of beta cells; diagnosed in childhood; insulin deficiency. Type 2: insulin resistance with relative deficiency; usually adulthood but increasingly in youth.

Insulin regimens (basal/bolus)

Basal (long-acting) provides baseline insulin; bolus (rapid/short-acting) before meals to cover intake.

Insulin onset types (rapid/short/intermediate/long)

Rapid-acting: 15 min; 2-4 h; Short-acting: 30 min-6 h; Intermediate: ~8-12 h; Long-acting: up to 24 h.

Diabetes management goals

Maintain euglycemia; balance basal and bolus insulin; monitor HbA1c; prevent hypo/hyperglycemia.

Gillick competency vs consent

Young person may consent if competent; parents may be involved unless concerns for welfare.

Notifiable diseases (notifiable diseases)

Diseases requiring mandatory reporting to authorities to enable outbreak control and surveillance.

Five rights of medication administration

Right patient, right time, right dose, right route, right drug.