1-16 Flashcards
Describe Celiac Disease
- Lining of the small intestine, intolerant of gluten.
- (avoid BROW) Barley, Rye, Oat, Wheat
Where is celiac disease more pronounced
- duodenum
- jejunum
S/S celiac
- abd pain
- distention
- diarrhea (pale, greasy, bulky, foul)
Malnutrition complications of celiac
- rickets
- occult blood
- anemia (early bleeds and/or bruises)
Imbalances that can be caused by celiac include hypo_____ and hypo_____
- hypomagnesemia
- hypocalcemia
s/s of hypomagnesemia and hypocalcemia
- irritability
- tremors
- convulsions
- tetany (muscle spasms)
- bone pain
- osteomalacia (softening of bones)
_____ lab is associated with celiac disease
IgA
how to dx celiac
small intestine biopsy via endoscopy
**normal lab value of IgA-tTg
0 - 3 U/mL, or 0.00 - 100.00 ug/g
**normal lab value of total IgA
80 – 350 mg/dL
**What is Sjogren’s syndrome
disorder of your immune system identified by its two most common symptoms: dry eyes and mouth
Sjogren’s syndrome is mostly in _____ _____
older women and primary those with Rheumatoid arthritis or SLE (Systemic lupus erythematosus)
How to test for Sjogren’s syndrome
SSA+ and SSB+ antibody test
What affect does cinnamon have on these:
- _____ BG
- _____ cholesterol
- _____ HTN
- _____ risk for bleeding
↓ blood glucose
↓ cholesterol
↓ hypertension
↓ risk for bleeding
Nursing considerations for cinnamon
- no breastfeeding
- no DM drugs/anticoagulants/heart meds
Bodily affects from Gingko Biloba
↓ dementia
↓ erectile dysfunction
↑ bleeding
↓ seizure threshold
What is glucosamine used for
osteoarthritis
Perks of green tea
- lose weight
- mental clarity
Green tea can cause _____ and _____ effects of warfarin
hepatotoxicity
decrease
what meds to avoid when taking green tea
- vasodilators
- stimulants
- psychoactive meds
Perks of lavender
↑ relaxation
↓ anxiety, stress, and insomnia
Adverse affects of lavender
- constipation
- HA
- ↑ appetite
- may ↓ BP
what meds to avoid when taking lavender
- BP meds
- depressents
What is Saw Palmetto used for
BPH
What is Kava used for
anxiety
can be hepatotoxic
Is comfrey PO okay
NO!! can cause sever liver poisoning
It’s a topical cream
What is Ma Huang/Ephedra/Ephedrine
stimulant, helps with asthma and bronchitis
**What is Hypoplastic Left Heart Syndrome (HLHS)
birth defect where you’re born with an open foramen ovale and ducturs arteriosus
↓ developed L ventricle & ↓ developed valves (mitral, aortic) (hole between L&R atria)
- ASD
- PFO
Survival rates of HLHS
3-5y is 70% with Stage 1 repair, 90% survival once they hit 12 months
Tx of HLHS
- surgery
- fetal shunts
testing of HLHS
- prenatal ultrasound and echo
- after birth s/s (after ductus arteriosus & foramen ovale close)
Tx for HLHS. Describe patent ductus arteriosus
- Stage 1 at <2 weeks (Norwood): shunt to pulm artery created (from aorta to R ventricle)
- Stage 2: shunt removed at 4-6 months
Tx for HLHS. Describe patent foramen ovale (PFO)
hole connecting R atrium to L atrium closed
Tx for HLHS. Describe Stage 3 (Fontan) at 18-36 months
IVC connected to Pulm artery, hole made from the IVC conduit attached to the right atrium
s/s of HLHS
- tachypnea
- SOB
- ↑HR (or pounding heart)
- poor sucking/feedings
- poor extremity blood flow (cold and cyanotic, clammy)
- weakness
Medications for HLHS
- tube feedings
- meds to strengthen heart muscles
- ↓ BP
- diuretics
**What does parathyroid secrete
regulates serum Ca+
↑ PTH hormone released = ↑ _____ released from the bones into the bloodstream, _____ density/hardness.
Ca+
↓
Hyperparathyroidism s/s
- low PTH (because excess was released into the blood)
- osteoporosis
- kidney stones
- ↑ urination
- abd pain
- fatigue
- fortgetfullness
- bone/joint pain
What are calicimimetics used for
to help bones retain calcium
What are calicimimetics used for
slow/prevent bone loss
Hypoparathyroidism s/s
- high PTH (because not released into bloodstream)
- low T3/T4
- parasthesia
- muscle cramps
- mood changes
- dry/rough skin
- twitching facial muscles
Tests for hypo/hyperparathyroid
- ultrasound
- bone densitometry
- body CT/MRI
normal Ca+ lab levels
8.6-10.3
normal PTH lab levels
11-51
what is Hutchinson-Gilford Progena Sx
genetic, rapid aging (10x faster)
- no cure
- appears by age 2 (live to 13 avg, up to 20 years)
Hutchinson-Gliford Progeria Sx:
- _____ gene protein mutation (protein-______): causing…
- LMNA
- progerin
- causing cells to die prematurely
s/s Hutchinson-Gliford Progeria
- slow growth (height, hair)
- alopecia
- joint abnormalities
- wrinkles
- dry skin
- FTT
- delayed tooth development
**Treatment of Hutchinson-Gliford Progeria
- NSAIDS
- Statins
- Bone health meds
- OT/PT
Treatment of Diabetic Neuropathy
- gabapentin/neurontin
- duloxetine/cymbalta
- pregabalin/lyrica
What is hydrotherapy used for
MS and MG
**Pneumothorax vs hemothorax
- both decrease lung sounds
- pneumothorax: air between lungs and chest cavity = ↑ percussion
- hemothorax: blood between lungs and chest cavity = ↓ percussion
Describe tension pneumothorax
- mediastinal shift
- ↓ CO
- ↑ HR
Tx of Pneumothorax or hemothorax
chest tube thoracostomy
**_____ PPD induration = positive
- > 5mm immunocompromised
- > 10mm for high risk/from countries with TB, prisons, nursing homes, etc.
15mm everyone
Other than PPD, test for TB
- chest xray
- CT scan
- looking for white spots in lungs or immune system walls of TB
**Meds for TB
- isoniazid
- *- Rifampin (avoid oral contraceptives)
- Ethambutol
- Pyrazinamide
If BCG vax gi en for TB, PPD is expected to be _____ but not positive
> 10mm
normal TSH labs
- 0.5-5
- With treatment: 0.5-4
normal T3 labs
80-220
normal T4 labs
5-12
**What 2 autoimmune diseases cause thyroid peroxidase antibodies (TPO)
- hashimotos (hypothyroidism)
- graves disease (hyperthyroidism
Describe Hashimotos
- ↑ TSH
- high thyroglobulin (Tg)/TPO
- initial high T3 then low T3
hyperthyroidism causes _____ TSH and high _____
- low TSH
- high T4/T3
s/s hyperthyroidism
- thyrotoxicosis
- ↑ HR/dysrhythmia/angina
- weakness/atrophy
- ↑ metabolic rate/appetite
- warm/moist skin
- ↑ body temp = heat intolerance
- stimulatied CNS = nervousness, insomnia, rapid though flow, rapid speech
**hypothyroidism causes _____ TSH and low _____
- high
- low T3/T4
s/s hypothyroidism
- pale/puffy/expressionless face
- cold/dry skin
- brittle hair loss
- ↓ HR/temp = cold intolerance
- lethargy
- fatigue
Tx of hyperthyroid
- propylthouracil (PTU)
- Methimazole (Papazole)
- iodine
- BB’s
Explain thyroid storm
- death 48 hrs from internal stress
- post-thyroid surgery
- High T4 T3 levels from stress s/s
- atrial tachy dysrhythmias
Chrohn’s vs Ulcerative Colitis
- Chrohn’s: inflammation/scarring of all digestive tract (generally just small intestines)
- Ulcerative Colities: chronic inflammation of large intestine and rectum
patients wil atopic dermatitis/eczema are at _____ risk of IBD
increased
s/s chrohn’s
- skip lesions (cobblestones)
- intestinal bleeding/diarrhea/crampin
- fistula
- fissure
- ileus
- mouth ulcers
- pain worse after eating
- naval pain or ↓ abdomen
- malabsorption = anemia
Tests for Chrohn’s
- ASCA protein
- CBC
- H/H
- occult bleeding test
- CRP
- ESR inflammation
- electrolytes for constant diarrhea
- iron &/or B12 absorption
Meds for chrohn’s disease
- aminosalicylate
- sulfasalazine
- mesalamine
- IV corticosteroids for 3-10 days/oral steroids for exacerbation
- abx to manage intestinal bacterial overgrowth
- Immunosuppressive therapy: methotrexate
Diet for chrohn’s disease
- low residue/fiber
- low fact
- probiotics
- avoid caffeine/alcohol (dehydration), sharp edges/large grains
s/s ulcerative colities
- diarrhea (blood/pus)
- cramping
- rectal pain/bleedings
- urgency plus inability to defecate
- wt loss
- fatigue
- fever
- FTT
tests for ulcerative colities
- pANCA
- WBC in stool
diet for ulcerative colitis
- avoid dairy, big meals, alcohol, caffeine
meds for ulcerative colitis
- anti-inflammatories
- corticosteroids
- immune system suppressors
- anti-diarrheals
- antispasmodics
- iron supplements
Newborn sickle cell:
- _____ risk for pneumonia d/t non-functional _____ and _____ immune response
- infants are _____
- _____/_____ damage
- cries from pain
- ↑ risk
- non-functional spleens
- ↓ immune response
- infants = anemic
- speel/liver damage
Sickle cell crisis:
1.
2.
3.
- vaso occlusive dactylitis
- splenic sequestration
- aplastic crisis
s/s vaso occlusive dactylitis
- severe pain/swelling in hands/feet
- back/chest pain
- fever
how to treat vaso occlusive dactylitis
- IV fluids
- pain meds
- transfusion high glow O2
what is splenic sequestration
- _____ in hemoglobin
- _____ shock
- seen in _____
- acute painful enlargement of spleen
- drop in hemoglobin
- hypovolemic shock
- seen in CT
s/s aplastic crisis:
- sudden _____
- _____ hemoglobin levels
- reticulocytopenia (_____)
- sudden pallor & weakness
- dropping hemoglobin levels
- reticulocytopenia (low immature RBCs)
Prevention of sick cell
- hydrate
- avoid being too hot or cold
- avoid high altitudes with low O2
**Tx sickle cell
- pain meds
- hydration
- O2
- hydroxyurea (prevents abn RBCs)
- avoid iron meds
- PCN prophylaxis for newborns
- *- don’t give diuretics
sick cell prevention in infants
- vaccines
- abx
- folic acid
- regular eye exams
**UTI meds: pregnancy & pediatrics safe
Pregnancy:
- fosfomycin (Monurol)(one-time dose)
- Floxin
- PCN
- Nitrofurantoin
Pediatrics Safe:
- *- Bactrim (Trimethoprim-Sulfa)
- Augmentin
- Cephalosporins
- Suprax
- Cefzil
- Keflex
- if vomiting = IV dose cephalosporins
Negative s/s schizophrenia:
- anhedonia (inability to feel pleasure)
- alogia (no speech)
- avolition (no motivation)
first generation meds for schizophrenia
- for positive s/s
- -dazine
- chlorpromazine
- haldol
- modecate
side effects of 1st gen schizophrenia meds
extrapyramidal symptoms:
- dystonia (spasms/muscle contractions)
- akathisia (restlessness)
- parkinsonism (rigidity)
- bradykinesia (slow movement)
- tardive dyskinesia (jerky movement)
- antimuscarinic effects (dry mouth, constipation, blurred vision, urinary retention)
- alpha-1 receptor antagonism (orthostatic hypotension)
- histamine antagonist (wt gain, sedation)
2nd generation meds for schizophrenia
- for pos & neg symtpoms
- risperdal
- abilify
- zyprexa
- seroquel
- ziprasidon (geodon)
side effects of 1st gen schizophrenia meds
- dry
- metabolic side effects (↑ gain, Dyslipidemia, Hyperglycemia)
vitamins that may help schizophrenia
- folic acid
- thiamine (B vitamine)
**What is tamsulosin (fosamax) used for
BPH
- relaxas muscles
- alpha-1 antagonist (hypotension education!!!!!)
