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58 Cards in this Set
- Front
- Back
S&S of Pneumothorax
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-Ipsilateral (same side) chest pain
-Increased respiratory rate -Dyspnea -Increased heart rate -Asymmetrical heart movement -Hyperresonant upon percussion -Decreased breath sounds |
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Immediate treatment of Pneumothorax
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Chest Tube
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S&S of Acute Onset Asthma
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-Wheezing
-SOB -Dyspnea -Chest tightness -Mucus production -Coughing -Use of accessory muscles |
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Immediate treatment of Asthma (quick relief)
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<b>Emergency Treatment: EPInephrine</b> causes: bronchodilation, increased RR, increased HR, increased BP
<b>Bronchodilators</b> -short-acting beta-adrenergic agonists -Anticholinergics -Corticosteroids |
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Ipratropium (Atrovent)
<b>Class, Uses, Actions, Contraindications</b> |
<b>Ipratropium (Atrovent)</b>
<b>Class:</b> inhaled anticholinergic <b>Action:</b> block muscarinic receptors on bronchi resulting in bronchodilation <b>Uses:</b> to relieve bronchospasm associated with COPD & allergen-induced & exercise-induced asthma <b>Contraindications:</b> -peanut allergy -narrow-angle glaucoma -benign prostatic hypertrophy (due to anticholinergic effects) |
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Albuterol (Proventil)
<b>Class, Uses, Actions, Contraindications</b> |
<b>Albuterol (Ipratropium)</b>
<b>Class:</b> Beta-2 Adrenergic Agonist <b>Action:</b> selectively activate the beta-2 receptors in the bronchial smooth muscle resulting in bronchodilation ~Bronchospasm is relieved ~Histamine release is inhibited ~Ciliary motility is increased <b>Uses:</b> to prevent asthma attack, tx for ongoing asthma attacks, long-term control of asthma <b>Contraindications:</b> -Tachydysrhythmias -Caution in clients with diabetes, hyperthyroidism, heart disease, hypertension, & angina |
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Theophylline (Theolair)
<b>Class, Uses, Actions, Contraindications</b> |
<b>Theophylline (Theolair)</b>
<b>Class:</b> methylxanthines <b>Action:</b> relaxes bronchial smooth muscle resulting in bronchodilation <b>Uses:</b> long-term control of chronic asthma <b>Contraindications:</b> -Caution in clients with heart disease, hypertension, liver & renal dysfunction, & diabetes -Caution in children & older adults <b>Do not stop or start smoking while taking theophylline. Decreases clearance</b> |
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Acetylcysteine (Mucomyst)
<b>Class, Uses, Actions, Contraindications</b> |
<b>Acetylcysteine (Mucomyst)</b>
<b>Class:</b> Mucolytic <b>Action:</b> enhance the flow of secretion in the respiratory passages <b>Uses:</b> acute & chronic COPD, cystic fibrosis, antidote for acetaminophen poisoning <b>Contraindications:</b> -Not to be used in clients at risk for GI hemorrhage -Caution in clients with PUD, esophageal varicies, & severe liver disease |
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Phenylephrine
<b>Class, Uses, Actions, Contraindications</b> |
<b>Phenylephrine</b>
<b>Class:</b> Decongestant <b>Action:</b> stimulate alpha-1 adrenergic receptors causing reduction in the inflammation of the nasal membranes <b>Uses:</b> allergic rhinitis by relieving nasal stuffiness, decongestant for clients with sinusitis & the common cold <b>Contraindications:</b> -clients with chronic rhinitis -Caution in clients with coronary artery disease & HTN |
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Reactive Airway Disease
<b>Patho, S&S, Tx</b> |
<b>Reactive Airway Disease (RAD)</b>
-an asthma-like syndrome that developed after a single exposure to high levels of an irritating vapor, fume, or smoke. <b>S&S:</b> -SOB -Chest tightness -Wheezing <b>Tx:</b> Bronchodilators |
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Chronic Obstructive Pulmonary Disease (COPD)
<b>Patho, & Tx</b> |
<b>COPD</b>
-a group of respiratory disorders including: <b>Chronic Bronchitis & Emphysema</b> characterized by chronic and recurrent obstruction of airflow in pulmonary airways -Bronchial-wall hypersecretion of mucus causes obstruction of airflow and mismatch of ventilation & perfusion <b>Tx:</b> Albuterol (Proventil) |
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Bodies response to Respiratory Hypoxemia
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-Hypoxemia
-Hypercapnea <b>(increased PaCO2)</b> -Cyanosis -Tachypnea (fast breathing) ...causes reflex vasoconstriction of the pulmonary vessels which further impairs gas exchange. <b>If left untreated, Hypoxemia can cause HTN & right-sided heart failure</b> |
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A patient born with Alpha1 Antitrypsin Deficiency is likely to develop....
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<b>Emphysema & COPD</b>
Alpha1 antitrypsin deficiency (AATD) can cause lung disease in adults and liver disease in adults & children. -Alpha1 antitrypsin: an enzyme that protects the lungs from injury <b>Clients with AATD increase their risk of developing Emphysema & COPD if they are smokers!</b> |
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Consistent use of nasal decongestant sprays can cause...
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<b>Rebound Congestion</b>
Often confused with "nasal spray addiction". Persistent use of nasal decongestants cause the nasal membranes to become "tolerant"--or less responsive to the effects of the medication. As a result, you must use more of the medication to have an effect or your congestion may worsen if you stop the medication (rebound congestion). <b>Reversible</b> -Stop using for several weeks to reduce tolerance. |
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Treatment for non-productive cough include:
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Expectorants: <b>Guaifenesin</b>
-Action: <b>Liquify & loosen secretions</b> Antitussives: <b>Dextromethorphan</b> -Action: <b>Control non-productive cough</b> |
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What medication class should not be used in an Asthmatic Patient?
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<b>Beta Blockers</b>
They cause bronchoconstriction! |
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What is the role of Nitric Oxide in the vascular endothelium?
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Nitric oxide is important to the regulation of blood flow.
Effects of NO: -Direct vasodilation -Indirect vasodilation by inhibiting Angiotensin II -Anti-thrombotic -Anti-inflammatory -Antiproliferative |
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If production of Nitric Oxide is impaired or its bioavailablity is reduced, what can result?
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-Vasoconstriction <b>(coronary vasospasm, elevated systemic vascular resistance, HTN)</b>
-Thrombosis due to platelet aggregation & adhesion to vascular endothelium -Inflammation due to upregulation of leukocyte & endothelial adhesion molecules -Vascular hypertrophy & stenosis |
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Disease conditions associated with abnormal Nitric Oxide production and availability:
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-<b>HTN</b>
-Obestiy -Dyslipidemias (hypercholesterolemia & hypertriglyceridemia) -Diabetes (type I & II) -<b>Heart Failure</b> -<b>Atherosclerosis</b> -Cigarette smoking |
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Which side of the heart if failing with (JVD) jugular venous distention?
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<b>JVD = Right-Sided Heart Failure</b>
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ACE inhibitors act on which body system?
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ACE inhibitors act on the renin-angiotensin-aldosterone system
eg. Captopril |
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S&S of Pulmonary Edema
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-Peripheral edema
-Sacral edema -Pink-frothy sputum |
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What is the leading cause of death in young athletes?
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Hypertrophic Cardiomyopathy
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<b>Inotropic</b> medications effect the hearts...
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Contraction
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<b>Chronotropic</b> medications effects the hearts...
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Heart Rate
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<b>Dromotropic</b> medications effects the hearts...
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Conduction velocity--impulse to contract
(dromo- "speed") |
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Preload of the Right Ventricle is measured by...
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Central Venous Pressure (CVP)
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Adverse effects of Phosphodiesterase Inhibitors...
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-Hypotension
-Hyperthermia |
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What class of medications should NOT be used in clients with Left-Heart Failure?
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<b>Beta-Blockers</b>
-Can causes further respiratory depression & exacerbate breathing difficulties |
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Dysrhythmia associated with sudden cardiac death...
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<b>Ventricular Fibrillation</b>
Ineffective contraction of the ventricles (fibrillation) occurs when blood flow to the heart muscle is decreased by partial or complete blockage of the coronary artery. A sudden, severe blockage may lead to MI |
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S&S of Cardiac Ischemia
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-Angina pectoris
-Neck or jaw pain -Arm pain -Clammy skin -SOB -Nausea & vomiting |
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S&S of Angina
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-Chest pain
-GERD -No belly pain! |
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A common symptom of Cardiomyopathy...
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Difficulty breathing
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Beta-Adrenergic Agonists
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<b>DoBUTamine</b>
-Increase HR <b>(+ chronotrope)</b> -Increase contractility <b>(+ inotrope)</b> -Increase rate of conduction through the AV node <b>(+ dromotrope)</b> <b>Tx of Acute CHF</b> |
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Beta-Adrenergic Blockers
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<b>Metoprolol (Lopressor)</b>
-Decrease HR <b>(- chronotrope)</b> -Decrease contractility <b>(-inotrope)</b> -Decrease rate of conduction though the AV node <b>(- dromotrope)</b> <b>Tx of Chronic CHF</b> |
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Cardiac Glycosides
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<b>Digoxin</b>
- Increase contractility <b>(+ inotrope)</b> -Decrease HR <b>(- chronotrope)</b> <b>Tx of HF & A-Fib</b> |
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Medications used for CHF & their effects...
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<b>Vasodilators: ACE inhibitors & nitrates</b>
-Decrease workload of overworked cardiac muscle by <b>reducing afterload</b> <b>Diuretics</b> -Decrease blood volume, which decreases venous return & BP <b>reducing preload</b> <b>Beta-Adrenergic Agonists</b> -Stimulate the beta-receptors in the sympathetic nervous system, increasing calcium flow into the myocardial cells and causing <b>increased contraction</b> <b>Beta-Adrenergic Blockers</b> -Reduces myocardial stress of <b>prolonged SNS activation</b> |
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Phosphodiesterase Inhibitors
<b>Class, Action, Uses, Contraindications</b> |
<b>Phosphodiesterase inhibitors</b>
-Class: <b>Cardiotonic (inotropic) agent</b> <b>Milrinone (Primacor):</b> short-term management of CHF in patients who are receiving digoxin & diuretics. -Action: <b>blocks the enzyme phosphodiesterase</b>, leading to an increase in myocardial cell adenosine monophosphate (cAMP), which <b>increases calcium levels in the cell</b>, causing stronger contraction & prolonged response to sympathetic stimulation -Uses: <b>short-term Tx of CHF in patients unresponsive to digitalis, diuretics, & vasodilators</b> |
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S&S of Kawasaki Disease
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-Fever
-Viral rash on stomach, chest, & genitals -Severely red eyes -Dry, cracked lips -Swollen tongue -White coating on tongue -Swollen palms of hands and soles of feet <b>Most often effects children <5yrs</b> |
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Pericarditis
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Inflammation of pericardium that can result from cardiomyopathy
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Angiotensin II Receptor Blockers (ARBs)
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<b>ARBs</b> (-sartan)
<b>Action:</b> selectively bind with angiotensin II receptor sites in vascular smooth muscle & the adrenal gland to <b>block vasoconstriction & the release of aldosterone</b> <b>Uses:</b> HTN, CHF, slows progression of renal disease in pts with HTN & type 2 diabetes <b>Contraindications:</b> -renal artery stenosis/dysfunction -pregnancy 2nd & 3rd trimester fetal injury |
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Angiotensin-Converting Enzyme (ACE) Inhibitors
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<b>ACE (-pril)</b>
<b>Action:</b> block the production of angiotensin II to cause: <b>vasodilation and excretion of sodium & water</b> <b>Uses:</b> Heart failure, HTN, MI, diabetic & nondiabetic nephropathy |
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What is the correlation between COX-2 enzyme & asthma?
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Some people suffer from asthma & rhinitis attacks in response to <b>aspirin & NSAIDs</b>
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NSAIDs effect on COX-2 Enzymes
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NSAIDs inhibit prostaglandin synthesis of COX-1 & COX-2.
-COX2 is active at sites of trauma or injury -NSAIDs block inflammation before all of the S&S can develop -NSAIDs is a COX-2 inhibitor -<b>COX-2 inhibitors block the inflammatory action</b> |
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What conditions cause Disseminated Intravascular Coagulation (DIC)?
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<b>Widespread coagulation and bleeding in the vascular compartment</b>
Clinical conditions that may cause DIC include: -<b>Obstetric disorders</b> (account for 50% of cases) -Massive trauma -<b>Shock</b> -Infections -Malignant disease (including Leukemia) |
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What conditions cause Idiopathic Thrombocytopenic Prupura (ITP)?
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<b>Widespread platelet thrombi in arterioles & capillaries of the heart, brain, & kidneys; thrombocytopenia; erythrocyte fragmentation causing hemolytic anemia and jaundice</b>
ITP syndrome is occasionally precipitated by: -<b>Estrogen use</b> -Pregnancy -Drugs -Infections associated with HIV |
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What organ clears old RBCs in the body?
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Spleen
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Dark, cola-colored urine is due in part by what part of RBCs?
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Iron
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Tx of Pernicious Anemia
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Pernicious anemia is a form of megaloblastic anemia due to vitamin B-12 deficiency due to impaired absorption.
<b>Tx: life-long parenteral administration of Vit. B-12</b> B-12 cannot be absorbed orally |
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Ferrous Sulfate (Feosol)
<b>Class, Action, Uses, Side Effects/Adverse Effects</b> |
<b>Ferrous Sulfate (Feosol)</b>
<b>Class:</b> Iron Preparation <b>Action:</b> provide the iron needed for RBC production <b>Uses:</b> Tx & prevention of Iron deficiency anemia <b>Side Effects/Adverse Effects:</b> -GI distress: nausea, constipation, heartburn -Teeth staining -Anaphylaxis risk with parenteral administration |
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What puts you at risk for Anemia?
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-Women in their childbearing years
-Pregnancy -Heavy menstrual periods -Low-iron diet -Chronic blood loss |
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WBCs that are mobilized for allergic response....
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<b>Lymphocytes:</b> 20-30% of WBCs.
-Move from blood to tissue -Function in lymph nodes or spleen to defend against foreign microbes <b>Monocytes:</b> 3-8% of WBCs. -Last for months of years -Engulf foreign material -Activate lymphocytes by presenting antigen to T-cells (immune response) |
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What are the types of WBC disorders & what precautions should be in place for these patients?
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<b>WBC Disorders:</b>
-Chronic lymphocytic leukemia (CLL) -Chronic myelogenous leukemia (CML) -Acute lymphocytic leukemia (ALL) -Acute myelogenous leukemia (AML) <b>Precautions:</b> -Infection protection -Bleeding precautions -Energy management |
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What is Agranulocytosis?
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Inadequate amounts of white blood cells called <b>neutrophils or granulocytes</b>.
<b>Causes:</b> -Bone marrow producing insufficient amounts of neutrophils -When WBCs are destroyed faster than produced <b>Patients with Agranulocytosis are more prone to infection</b> |
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Epoetin alfa (Epogen)
<b>Class, Action, Uses, Contraindications</b> |
<b>Epoetin alfa (Epogen)</b>
<b>Class:</b> Hematopoietic Growth Factor <b>Action:</b> act on the bone marrow to increase production of RBCs <b>Uses:</b> -Anemia in chronic renal failure -Chemotherapy-induced anemia <b>Contraindications:</b> -Clients with uncontrolled HTN -Caution in clients with cancers of the bone marrow |
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Dextromethorphan
<b>Class, Action, Uses, Contraindications</b> |
<b>Dextromethorphan</b>
<b>Class:</b> Antitussive <b>Action:</b> acts directly on medullary cough center of the brain to depress the cough reflex <b/>Uses: control of non-productive cough</b> <b>Contraindications:</b> -<b>Do NOT use on post-op patients or those with head injury</b> |
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What are the risk factors related to lab work with lipids?
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Lipid transport in the body:
-dietary lipids absorbed by chylomicrons -adipose & muscle cells take up lipids from chylomicrons -chylomicrons remnants are intermediate density lipoproteins -IDLs become LDL's (bad cholesterol) -LDL's deliver fat to liver -Some LDL's are taken by scavenger cells, macrophages |
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S&S of Venous Insufficiency
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<b>Venous Insufficiency</b>
-Stasis dermatitis (brown discoloration of ankles & calfs) -Edema -Ulcers -Shiny skin -No hair |