med surg quickies
TRANSCRIPT
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QUICKIESPrepared By:
John Gil B. Ricafort, BSN, RN
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Diseases and Pathognomonic SignsA
Abdominal Aortic Aneurism
- pulsating abdominal mass
Abruptio Placenta
- painful bleeding, board-like abdomen
Acute Renal Failure
- azotemia, uremic frost on skin
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Addisons Disease
-b
ronze pigmentation of skinAngina Pectoris
- pain upon exertion
Appendicitis
- Mc Burneys sign
Atrial Septal Defect
- murmur heard high on chest
Autism- rocking, spinning, routines
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B
Bacterial Vaginosis- grayish white discharges
Basilar Fracture
- raccoons eyeBreech Birth
- meconium staining
Bulimia Nervosa- Binge eating
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C
Carb
on Monoxide Poisoning- cherry pink flushed face, carbon in thesecretions, non-productive cough
Carpal Tunnel Syndrome
- Jack Hammer Syndrome (TINELs sign)
Cataract
- cloudy vision
Celiac Disease- gluten sensitivity, foul smelling stool
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Chicken Pox
- maculopopular rashCholera
- rice water stools
Colic- pulling up of arms and legs, red-faced
crying
COPD
- barrel chest, clubbing of fingers
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Cushings Syndrome
- moon face, buffalo humpCVA
- homonymous hemianopsia
Cystocele & Rectocele- feeling of fullness at vagina
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D
Delirium- recent and past memory defect
Dementia
- recall or learning memory impairment
Detached Retina
- flashes of light, shadow/ curtain acrossthe vision
DM- polydipsia, polyuria, polyphagia
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Diptheria
- pseudomembraneDiverticular Disease
- cramping, colicky pain in left lower
ab
dominal quadrantDown Syndrome (Trisomy 21)
- saddle nose, brushfields spots
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E
Ectopic pregnancy- Cullen sign
Endometriosis
- premenstrual pain decreasing asmenstrual flow decreases
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F
Failure to Thrive (FTT)- Radar gaze
GGERD
- Barret esophagus
Glaucoma- halos around the light, tunnel vision
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Graves Disease
- exopthalmia
H
Hemophilia- hemarthoses
Hepatic Disease
- asterixis, jaundice
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Hirschprungs Disease
- ribbon-like, foul smelling stoolH-mole
- grapelike growth, large abdomen
Hydrocephalus- Setting sun eyes
Hypocalcemia
- Trousseau sign, Chvostek Sign,Hyperreflexia
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I
Increased ICP- high pitch cry
Increased IOP
- Dolls eyeIntestinal Obstruction
- no passage of meconium
IDA- activity intolerance
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K
Kawasaki- strawberry tongue
Kleibsiella Pneumonia
- red gelatinous sputum
L
Left-sided Heart Failure- pulmonary manifestations
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Low birth weight
- less than 2.5kg or 5 1/2lbsLyme Disease
- red-tinged circular rash (erythema
chronicum migrans)
M
Malaria- blackwater fever
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Menieres Disease
- whirling vertigo, tinnitusMeningitis
- Kernigs sign, Brudzinskis sign
Moniliasis- white cheesy discharge
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Multiple Sclerosis
- descending weakness, Charcots Sign(intention tremor, nystagmus, scanning
speech)
Myasthenia Gravis
- nasal smile
Mycoplasmal Pneumonia
- nonproductive that progresses to
mucoid sputum
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Myocardial Infarction
- Levine sign, viselike or crushing painradiating to shoulder, arms, jaw orback
O
Opthalmia Neonatorum
- purulent conjunctivitis
Oral Thrush- white patches on tongue
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Osteoporosis
- kyphosisOtosclerosis
- ringing orbuzzing, longerbone
conduction than air conduction
P
Pancreatitis- steatorrhea
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PDA
- machinery-type murmur throughoutthe heartbeat in the left 2nd or 3rd
interspace
Parkinsons Disease
- pill rolling, bradykinesia, rigidityPeritonitis
- board-like abdomen
PerniciousA
nemia- Beefy red tongue
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Pertusis
- paroxysmal cough ending with awhoop
PID
- fever, vaginal discharges, lowerabdominal cramping
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Placenta Previa
- painless bright red bleedingPneumococcal Pneumonia
- purulent rusty sputum
Pneumothorax (Flail Chest)- paradoxical respiration loose chest
segment moves inward during
respiration and outward during
expiration
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PIH
- edema, proteinuria, hypertensionPreterm infant
- 36 weeks or less
Prolapse Uterus- pelvic heaviness
Pulmonary Embolism
- sudden dyspnea, sharp pleuritic pain
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Pyloric Stenosis
- projectile vomiting, nonb
ile stainedvomitus,
R
Rab
ies- hydrophobia
Retinoblastoma
- diminished vision, strab
ismus, retinaldetachment, abnormal pupilary reflex
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Right Ventricular Failure
- Systemic manifestationRocky-Mountain Spotted Fever
- rose colored macules
Rubella (German Measles)- Foreschimers Spot (small red macules
on soft palate)
Rub
eola (Measles)- Koplik spots
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S
Schizophrenia- Association, affect, ambivalence,
autistic thinking
Sickle Cell Anemia
- painful episodes or vaso-occlusive
crisis
Staphyloccocal Pneumonia
- yellow-blood streaked sputum
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SIDS
- frothy,b
lood-tinged fluid fills mouthand nose
Syphilis
- chancre on genitalia, mouth, anus
SLE
- butterfly rash on face
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T
Tetanus (lockjaw)
- spasms
TOF
- Pulmonary valve stenosis, RVH,
Overriding of the Aorta, VSDThrombophlebitis
- Homans sign
Tracheoesophageal Fistula- coughing, choking, cyanosis
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Trichomoniasis
- malodorous thin yellow dischargesTyphoid fever
- rose-colored papules on the abdomen
Tuberculosis- low grade fever, night sweats,
hemoptysis
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U
UlcerativeC
olitis- bloody, watery, purulent, mucoid
stools
V
Varicosities
- tortous veins
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VSD
- low, harsh murmur heard throughoutsystole
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Common Laboratory ValuesAlbumin
3.5-5.0 g/100 ml
Ammonia
12-55 umol/L
Amylase
4-25 units/ml
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AST, SGOT
Male: 8-46U/LFemale: 7-34U/L
Bilirubin
Total: up to 1.0mg/100mlBleeding Time
3-7 min
BUN8-25mg/ml
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Calcium
8.5-10.5mg/100mlCarbon Dioxide
24-30mEq/L
Chloride
100-106mEq/L
Cholesterol
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Creatinine Kinase (CK)
Male: 17-148U/LFemale: 10-79U/L
CPK
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ESR
Male: 1-13mm/HrFemale: 1-20mm/Hr
Fibrinogen
160-450mg/dlGlucose
70-110mg/100ml
HCO322-26mmol/L
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HDL
30-75mg/dlHemoglobin
Male: 13-18g/ 100ml
Female: 12-16g/ 100mlHematocrit
Male: 45-52%
Female: 37-48%
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Iron
50-150u/100 mlWBC
-10,000-15,000/mm3
LDH70-180
Lipase
2 units/ml or less
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Magnesium
1.5-2 mEq/lpH
7.35-7.45
PO
275-100mmHg
PCO2
35-45mmHg
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Phosphorus
3.0-4.5mg/ 100mlPlatelets
150,000-400,000/mm3
Potassium3.5-5mEq/l
Protein
6.0-8.4g/ 100ml
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PT
10-12 secPTT
30-45 sec
RBC
Male: 4.6-6.2 million/ mm3
Female: 4.2-5.9 million/mm3
Sodium135-145mEg/L
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T3
75-195 ng/ 100mlT4, total
4-12 u/ml
Thromb
in Time11-15 sec
Triglycerides
40-150mg/ 100ml
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TSH
0.5-5U/ml
Urea Nitrogen
8-25mg/ 100ml
Uric Acid
Male: 4-9 mg/dl
Female: 3-6.6 mg/dl
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DIAGNOSTICTESTS &
PROCEDURES
Wag kalimutan
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Cardiovascular System Electrocardiography
- noninvasive test
- graphical representation of the heartselectrical activity
- interpret EKG for changes
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Holter Test Monitoring(Ambulatory EKG)
- noninvasive test
- records the hearts electrical activityand cardiac events for 24 hours
- advise the patient on activity limitations
while wearing monitor
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Cardiac Catheterization
- invasive, fluoroscopic procedure
- examines intracardiac structure,pressure, oxygenation and cardiacoutput.
- Note the patients allergies before
testing- Report immediately if with chest pain
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Echocardiography
- noninvasive test
- uses echoes from sound waves tovisualize intracardiac structures and
blood flow
- Determine the patients ability to liestill.
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Stress Testing
- noninvasive test
- study of the hearts electrical activityand ischemic events during levels ofexercise.
- Light breakfast before the test
- STOP the test if patient developscardiopulmonary symptoms
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Respiratory System
Bronchoscopy
- invasive test
- allows for visualization of the tracheaand bronchial tree
- Check cough and gag reflex AFTER
procedure
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Pulmonary Angiography
- invasive test involving injection of
radiopaque dye- allows for radiographic examination of
pulmonary circulation
-NOTE allergies to iodine, seafoods, andradiopaque dyes BEFORE test
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Thoracentesis
- invasive procedure using needle
aspiration- allows removal of pleural fluid and
specimen examination
- PLACE the patient in proper position
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Pulmonary Function Tests (PFTs)
- noninvasive test
- measures lung capacity
- Document bronchodilators or
narcotics used before testing
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Arterial Blood Gas analysis (ABG)
- blood test
- arterial blood measurements of tissueoxygenation, ventilation and acid-base
balance.
- APPLY pressure to the site 5 minutesafter procedure
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Lung Biopsy
- invasive test
- removal of a small amount of lungtissue for histologic evaluation
- OBSERVE for signs of pneumothorax
and air embolism after procedure
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Nervous System
Electroencephalography (EEG)
- noninvasive test
- graphic representation of the brainselectrical activity
- WITHHOLD medications and caffeine 8
hours before the procedure
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Cerebral Angiogram
- invasive procedure using a radiopaque
dye- allows examination for the cerebral
arteries
- NOTE patients allergies before theprocedure
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Lumbar Puncture
- invasive test
- collection ofCSF for analysis- CONTRAINDICATED in the presence of
increased ICP
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Gastrointestinal
System
Upper GI Series (Barium Swallow)
- allows for examination of the
esophagus, stomach, duodenum andother portions of the small bowel after
swallowing
- BEFORE procedure, administer fluids,
cathartics, and enema, as prescribed
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Lower GI Series (Barium Enema)
- Allows for examination of the large
intestine after administration of abarium enema
- BEFORE procedure, withhold food
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Endoscopy
- procedure using an endoscope for
visualization- WITHHOLD food and fluids 6 to 12
hours before the test
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Fecal Occult Blood Test
- laboratory test using a reagent
- analysis of stool forblood- ADVISE the patient to AVOID red meat,
iron and high fiber for 1 to 3 days prior
to the procedure
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Fecal Fat Test
- laboratory test using a stain
- analysis of stool for fat- ADVISE the patient to restrict alcohol
intake and maintain a high-fat diet for 72
hours before examination
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Cholangiography
- invasive procedure using an injection
of a radiopaque dye through a catheter- allows for examination of the biliary
duct system
- BEFORE the procedure, note thepatients allergies
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Liver Scan
- invasive procedure using an IV
injection of a radioisotope- provides an image ofblood flow in the
liver
-A
ssess the patient for allergic reactionafter the procedure
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Gastric Analysis
- aspiration of the contents of the
stomach through an NG tube- measures the acidity of gastric
secretions
- Instruct NO
T TO
SMOK
E for 8 to 12hours before the test
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Ultrasonography
- noninvasive procedure that uses
echoes from sound waves- provides visualization ofbody organs
- WITHHOLD food and fluids for 8 to 12
hoursb
efore the procedure
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Liver Biopsy
- invasive procedure using needle for
the percutaneous removal of a smallamount of liver tissue
- Before the test, assess clotting studies
- During the test, hold theb
reath- After the test, Right lateral position
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Urinary
System Urinalysis
- laboratory test for urine
- examines the color, appearance, pH,specific gravity, protein, glucose,
ketones, RBCs, WBCs and casts
-O
BTA
IN first morning urine specimen
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Urine Culture and Sensitivity
- laboratory test for urine
- detects bacteria- Collect midstream sample in sterile
container
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24-hour Urine Collection
- laboratory test for urine
- samples collected over 24 hours todetermine kidney function
- instruct the patient to void and note
time- discard the first urine collected
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Blood Chemistry
- laboratory test ofblood sample
- analysis for potassium, sodium,calcium, phosphorus, glucose,
bicarbonate, BUN, creatinine, protein,
albumin, and osmolality
- check the site forbleeding
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Cystoscopy
- procedure using cystoscope to
visualize the bladder- Check the patients urine forblood
clots after the procedure
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Renal Angiography
- procedure using injection of
radiopaque dye through a catheter- examination of the renal arterial supply
- NOTE the patients allergies before the
procedure
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Hematopoietic System
Bone Marrow Examination
- percutaneous removal ofbone marrow
- examines erythrocytes, leukocytes,thrombocytes, and precursor cells
- GIVE analgesics or anxiolytics, as
ordered.
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Schilling Test
- administration of oral radioactive
cyanocobalamin and I.M.cyanocobalamin
-microscopic examination of 24-hour
urine sample of cyanocobalamin
- WITHHOLD food and fluids post HS