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A comprehensive overview of various cardiac rhythms, including normal sinus rhythm, sinus bradycardia, sinus tachycardia, paroxysmal supraventricular tachycardia (svt), atrial flutter, atrial fibrillation, junctional rhythm, junctional tachycardia, idioventricular rhythm, premature ventricular contraction (pvc), ventricular tachycardia (vt), ventricular fibrillation (vf), and ventricular standstill (asystole). It also covers gastrointestinal disorders such as nausea, gerd, hiatal hernia, peptic ulcer disease (pud), gastritis, diarrhea, c.diff, fecal incontinence, and constipation. Detailed descriptions of each condition, their causes, symptoms, diagnostics, management, and nursing care considerations.
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Normal sinus rhythm (NSR)
rate: 61 - 100 idioventricular rhythm
TX: CPR, Defibrillation Ventricular Standstill (Asystole)
drug therapy for GERD
types of peptic ulcer disease acute, chronic, gastric, duodenal acute PUD Superficial erosion Minimal inflammation Short duration, resolves quickly once cause is identified and removed chronic PUD Long duration—present continually for many months or periodically More common than acute erosion gastric PUD location is in the stomach duodenal PUD location is in the duodenal causes of PUD H. pylori and NSAIDs, and smoking clinical manifestations of duodenal ulcers discomfort below diploid process, can cause back pain
antacids teaching for endoscopy NPO 8 hours before, signed consent is required light, not full sedation do not allow food until gag reflex has returned post-procedure complications with PUD GI bleeding, perforation, gastric outlet obstruction S/S of perforation side dramatic increased pain, no bowel sounds, tenderness in palpation of abdomen, N/V, weaker pulses goals of bowel perforation care stop spillage of Gi juices in abdomen, notify provider, place an NG tube to suction. S/S of GI bleeding bright red or coffee ground vomiting S/S of gastric outlet obstruction more pain at end of day, N/V, projectile vomiting, distended abdomen, electrolyte and fluid issues gastric surgery use tx for stomach, cancer, perforation, chronic gastritis, PUD complication fo gastric surgies
dumping syndrome, postprandial hypoglycemia, bile reflux gastritis dumping syndrome resection of portion of stomach with pyloric sphincter, wekened, palpitations, N/V, barter bowel sounds, loss of regulation of bowel content movement postprandial hypoglycemia card bolus stimulates insulin secretion bile reflux gastritis Surgery necessary to correct nursing care related to post-op gastric surgery fluid and electrolyte balance maintained NG tube monitored, IV fluids maintained, respiratory complications obviated, tx pain, infection prevented prevention of respiratory complications post-op incentive spirometer, assessments of respiratory status, splinting encouraged, early ambulation when to call doctor about blood in NG tube after surgery? when it is more than 75 ml/hour gastritis inflammation of the stomach S/S of gastritis
Tx for C.diff oral vancomycin fecal incontinence involuntary loss of stool interventions for fecal incontinence H&P, bowls management, high fiber diet, bulk forming laxatives, skin assessment, offer support what skin disorder is associated with fecal incontinence? incontinence associated dermatitis (IAD) biofeedback therapy for fecal incontinence electrical stimulation to promote continence constipation less than 3 stools a week T?F constipation is a disease False, it is a symptom. not a disease risk factors for constipation low fiber diet, decreased physical activity, ignore urge to poop, slowing of GU transit, medications clinical manifestations of constipation
clinical manifestation of peritonitis
hemorrhage, strictures, perforation, abscesses, fistulas, toxic megacolon, increased risk for colon cancer diagnostics for Crohn's disease and UC CBC, electrolyte, albumin, ESR and CRP, small bowel series, US/CT/MRI management of IBD bowel rest, control inflammation (steroids +food intake), manage nutrition, S/S relief, improved QOL Diverticula abnormal side pockets in the intestinal wall diverticulitis inflammation of the diverticula contributing factors of diverticulitis lack of fiber and constipation, lifestyle factors clinical manifestations of diverticulitis abdominal pain, bloating, farting, change in bowel habits, may have bleeding, acute pain, distention, N/V management of diverticulitis colon rest, clear liquids or NPO, fluids, antibiotics, tx systemic symptoms (fever), surgery if indicated hernias loop of bowel extended through abdominal muscle wall
types of stroke ischemic and hemorrhagic non modifiable risk factors for strokes age, gender, ethnicity, race (African American), family hx nested modified risk factors for strokes HTN, heart dz (a-fib), smoking, DM, sleep apnea, lack of exercise, poor diet, drug/alcohol use Transient Ischemic Attack (TIA) minit strokes, blood supply to part of the brain is blocked for a period and then a full recovery T/F TIAs don't increase risk for stokes false, they do increase the risk for stokes types of ischemic stroke thrombotic (clot formation) and embolic (clot that has traveled) clinical manifestations for strokes decreased motor function, communication, affect, intellectual function, spatial perceptual problems, elimination issues receptive aphasia cant understand what is being said expressive aphasia slurred speech or inability to speak global aphasia When both production and understanding of language is damaged
T/F stoke patient are emotional true elimination issues with a stroke constipation, and bladder control Diagnostic tests fro strokes non-contrast head CT or MRI CTA or MRA cardiac imaging what is the indication of CTA and MRA in stroke diagnostics? Looks at vessels and shows exactly where stroke is TX for ischemic stroke tPA (within 3 - 4.5 hours of onset of symptoms) endovascular therapy exclusions for tPA recent surgery, GI bleed, Hx of brain bleed, hemorrhagic stroke, hx of head injury assessment for strokes description of event, Hx of other events, current meds, presence of RFs, family Hx, complete neuro exam complications of stroke pneumonia, aspiration, venous thrombosis, contractures, muscle atrophy, foot drop, skin breakdown, constipation, UI, malnutrition/dehydration, communication barrier prevention of foot drop