MedSurg 1 Exam 2

Pulmonary

Right side of the heart pumps blood through the lungs to the ______________ circulation

Systemic

Left side of the heart pumps blood to all other body tissues through the ____________ circulation

Intermittent claudication

Pain in the leg muscles that occurs during exercise and is relieved by rest

Rest pain

Persistent pain in the foot or digits when the patient is resting

Lowered

When a patient has peripheral vascular problems their legs should be ____________ to allow gravity to move blood

Arteriosclerosis

Hardening of vessels

Atherosclerosis

Plaque build up in vessels

Statins

Cholesterol medications that help plaque not to form

Aneurysm

Localized sac or dilation formed at a weak point in the wall of the artery

Chronic venous insufficiency

Venous circulation is inadequate due to partial vein blockage or leakage of venous valves
*Causes brown skin due to dead RBCs

Venous thromboembolism

Blood clot that becomes dislodged and moves to another area of body
Risk factors: arteriosclerosis, pregnancy, sepsis

65

Ages _____ and older is considered a risk factor for venous thromboembolism

Gangrene

Death of tissue associated with loss of blood supply

*black on toes

Lymphangitis

Inflammation or infection of the lymphatic channels

Lymphadenitis

Inflammation or infection of the lymph nodes

Lymphedema

Tissue swelling related to obstruction of lymphatic flow

Cellulitis

Skin infection charectorized by hot and red skin
S&S: localized swelling, fever, chills, sweating

120-129/80

Elevated blood pressure

130-139/80-89

Stage 1 hypertension

>140/>90

Stage 2 hypertension

Secondary hypertension

Hypertension stemming from another disease such as renal disease, sleep apnea, or pregnancy

Masked hypertension

Normally high blood pressure but at doctor it's normal

White coat hypertension

Usually normal blood pressure but at the doctor its high

18.5-24.4

Normal BMI range for hypertension management

<100

Sodium range for hypertension management

Hypertensive emergency

Blood pressure >180/120 with evidence of organ damage

Hypertensive urgency

Blood pressure >180/120 with NO evidence of organ damage

25

With a hypertensive emergency you should decrease blood pressure by no more than ____% in the first hour

160/100

WIthin 2-6 hours after a hypertensive emergency you want to reduce BP to what

I&Os

Patients receiving intravenous vasodilators for hypertensive emergencies should be monitoring

Epinephrine

When there is decreased blood flow to the heart what is released to increase BP

Congestive

Failure of both sides of the heart

Left sided

Heart failure symptoms: crackles, ventricular gallop, dyspnea on exertion, low O2 sat, dry cough, oliguria, skinny & blue

Right sided

Heart failure symptoms: peripheral edema, jugular vein distention, hepatomegaly, ascities, weight gain, puffiness

ACE inhibitors

Drug that cause vasodilation which decreases afterload of the heart

Digitalis

Drug that improves contractility and strengthens heart beat

Renal

Decreased __________ function can make older patients resistant to diuretics and more sensitive to changes in volume

2 hours

How long should patients with HF wait after eating to exercise

<1000 ml (32 oz)

How much should a patient with heart failure be drinking per day

Frothy

In pulmonary edema sputum may be _________ and blood tinged

Thromboembolism

Blood clots common in patients with cardiovascular disorders

Pericardial effusion

accumulation of fluid in the pericardial cavity

Cardiac tamponade

Restriction of heart function because fluid around the heart is putting pressure on heart decreasing venous return and CO

Pericardiocentesis

Surgical puncture to aspirate fluid from the sac surrounding the heart

Pericardiotomy

Surgically created opening of the pericardium to allow fluid to flow into the rest of the body

Carotid

Which pulses are most important for assessing circulation during cardiac arrest

Type 1 diabetes

When the body can't make enough insulin

Type 2 diabetes

When the cells do not respond to insulin

Gestational diabetes

Diabetes in pregnant women

<99

Normal fasting blood sugar level

>126

Diabetic fasting blood sugar level

<140

Normal casual blood glucose level

>200

Diabetic casual blood glucose level

Insulin

Transports and metabolizes glucose for energy

Thin

People with Type 1 diabetes are typically young & ________

Obesity

Most common association of Type 2 diabetes

Polyuria, polydipsia, polyphagia

Three cardinal signs of diabetes mellitus

Polydipsia

Increased thirst

Polyphagia

Increased hunger

HA1C

Test to see how much glucose is attached to RBCs over the course of 3 months
Test range: 1-15

<6.5

What is the desire range for HA1C test

Glucose tolerance test

Sugar drink given to pregnant women and then casual blood glucose tested at 1 hour and 2 hours after drinking

15

1 unit of glucose equals _____ carbs

Glycemic

Combining starchy foods with protein and fat slows absorption and ___________ response

Deplete

Exercise can ___________ blood glucose

Hypoglycemia

People with exogenous insulin should eat a 15g carb snack before exercising to prevent _____________

Rapid acting

Insulins that take less than 15 minutes to produce an effect

*Aspart & lispril

Short acting

Insulins that take around 30 minutes to produce and effect

*Regular

Intermediate acting

Insulin that takes 2-4 hours to produce effect

*NPH

Long acting

Insulin where there is no peak throughout the entire durationg

*Glargine

Desensitization

Type 1 diabetics may need _____________ treatment to reduce systemic allergic reactions such as hives

Ketones

During DKA the body uses fat as energy and produces ________ as a biproduct

Glucagon

Is a patient is unconscious due to hypoglycemia they should be given __________ subQ

Potassium

Which electrolyte is most important in the management of DKA

Macrovascular

Long term complications of diabetes including heart attack, stroke, or vascular disease

Microvascular

Long term complications of diabetes including diabetic retinopathy and chronic kidney disease

Neuropathic

Long term complications of diabetes including tinging in fingers and no feeling in feet

Increase

Steroids can ___________ glucose requiring more insulin

30

The goal for production of urine is ___ mL/hr

720

The goal for production of urine is ______ mL/day

Oliguria

Less than 400mL of urine/day

Anuria

Less than 50mL of urine/day

Abdominal aorta

The blood comes off the ____________ ________ with high pressure, making the kidney very vascular

20

When ____% or lower of kidney function is remain --> Renal failure

BUN, creatinine, GFR

Which labs test the blood to determine the function of the kidneys

24 hour urine collection & creatine clearance

Which 2 labs test the urine to determine the function of the kidneys

Diabetes

Glucose in the blood can be a sign of

Glucose & protein

What does the glomerulus reuptake

Urea, creatinine, uric acid

What is filtered out of the body by the kidneys as metabolic wastes

Renin

What is secreted when there is low blood flow to the kidneys with the goal of increasing blood pressure

Sclerosis

Hardened renal artery

Full bladder

What is needed to perform a ultrasonography on the bladder

400-500

How many mL is a normal adult bladder capacity

24 hour urine collection

Primary test of renal function

Weight

Most accurate indicator of fluid loss or gain

5%

A gain of how much weight indicates fluid volume excess related to a kidney issue

Creatinine

Increased _____________ levels indicate an acute kidney injury

Blood flow

A prerenal acute kidney injury indicates a problem with

Nephron filtration

A intrarenal acute kidney injury indicates a problem with

Excretion

A postrenal acute kidney injury indicates a problem with``