319 Final Flashcards
WBC too high (7)
Infection, bacterial Inflammation Tissue death Allergies Asthma Intense exercise Leukemia
WBC too low (4)
Severe infection
Sepsis
Bone marrow issues
Autoimmune diseases
Nutophils too high/low
Same indications as general WBC count
Bands, aka…
Immature neutrophils
Are low bands/immature neutrophils a problem?
No
High Bands (3)
Acute infection
“a shift to the left “
Acute inflammation
Low Lymphocytes (4)
Autoimmune disease
Immunosuppression
Bone marrow damage
Corticosteroids
High lymphocytes (5)
Viral infection
Sometimes bacterial infection
Toxoplasmosis
Chronic inflammation
Some leukemias
Low monocytes (2)
Immunosuppression
Bone marrow failure
High monocytes (3)
Chronic infection
Autoimmune
Some leukemias
Eosinophils are only a concern when levels are
High
High Eosinophils (4)
Parasitic infections
Allergies
Asthma
Inflammatory disorders
Basophils matter when they are high because (1)
Acute allergic reaction
If RBC, hmc, hemoglobin are too high (1)
Polycythemia
If RBC, hmc, hemoglobin are too low (4)
Blood loss
Underproduction from bone marrow
Early elimination of RBCs
Destruction of RBCs
What is the MCV test for?
Size of RBC
Low MCV and MCH indicates (1)
Microcytic RBC
Microcytic RBCs indicate (2)
Iron deficiency
Lead poisoning
High MCV and MCH is called
Macrocytic RBC
Macrocytic RBC indicates
Vitamin B12 deficiency
Aplastic anemia
MCH test measures
Weight of RBC
Normal serum osmolarity
275-295 mOsm/kg
Three tests that help determine osmolarity
Sodium
BUN
Glucose
Low specific gravity means the urine is
Dilute
Normal sodium range
135-145 mEq/L
Normal potassium range
3.5-5 mEq/L
Normal magnesium range
1.8-2.5 mEq/L
Normal calcium range
8.5-10.5 mg/dl
Normal phosphorus range
2.5-4.5 mg/dl
With the elderly, infection typically shows less
Fever
What indicates infection in the elderly? (3)
Confusion
Falls
Incontinence
The elderly have decreased pain and temperature sensation, but their actual body is more sensitive to
Heat and cold
Signs of breathing problems (4)
Restlessness
Altered Mental Status
Increased respiratory rate
Increased work of breathing
For reflux or hiatal hernia,
Elevate the head of the bed
The Join Commission (TJC) has policies about documenting
Violence
It is mandatory to report abuse of (2)
Elders
Children
Violence Documentation must have (5)
Date and time
Patient narrative including name of abuser
History of previous abuse
Description of physical injuries
Providers assessment/recommendations/referrals
Nursing assessment for violence (5)
Any “yes” answers
How recent?
How serious?
Injuries sustained
Denial or minimization
Physical Exam (3)
Head to toe INSPECTION
Identify injuries
Genital exam for report of sexual abuse
Photographing injuries complements documentation but requires
Verbal and written consent
For photography…(6)
Photo that identifies pt
Medium range photo that gives location
Close up for detail
Ruler
Date time initial
Chain of custody
Tear-like wound
Laceration
Small red or purple dots caused by minor hemorrhage
Petechiae
Deeper than it is wide
Stab wound
Normally, breast development begins between
10-11 years old
What 2 groups begin breast development earlier?
African American
Obese
Range of time for woman to reach full sexual development
1.5-6 years
After menopause ovarian secretion of estrogen and progesterone decreases causing
Breast glandular tissue to atrophy
When the breast glandular tissue atrophies it is replaced by
Fibrous connective tissue
The breast also lose adipose tissue beginning in
Middle years
The atrophy of the breast make the inner structures more
Palpable
Breasts during pregnancy (3)
Enlargement
Darker nipple and areola
Colostrum
During pregnancy, when does colostrum form?
After 12 weeks
When does lactation begin?
3 days postpartum
Breast engorgement occurs during
Lactation
Breast inspection (6)
Lump
Skin changes
Pulled in nipple
Redness/rash
Dimpling
Dripping
BSE should be done…
4-10 days after the start of menses
How often should BSE be performed by postmenopausal women?
Monthly
Infant males may produce
Witch’s milk
Gynecomastia is normal in male
Adolescents
Lymphatics of the breasts (8)
Supraclavicular Infraclavicular Interpectoral Parasternal Lateral Central Subscapular Pectoral
Testes descend during
3rd trimester or early postnatal
Testes enlarge between ages
9.5-13.5
Male sexual maturity by age
17.5
Although erectile function declines with age,
Desire is usually still present
Male inspection (4)
Hair distribution
Penis
Scrotum
Inguinal hernia
Male palpation (4)
Penile shaft
Herniation
teste tenderness, nodules, and texture of skin
Palpate anal sphincter for tone
Warning signs of testicular cancer (5)
Lump
Feeling of heaviness
Enlargement
Change in testical feel to touch
Sudden fluid/blood accumulation in scrotum
Testicular lumps are (3)
Small, pea sized
Hard
Painless
