med surg quickies

8/3/2019 Med Surg Quickies

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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


- detects bacteria- Collect midstream sample in sterile

container


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24-hour Urine Collection


- 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

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