Adult Care 2 Flashcards
Iron Deficiency Anemia Causes
Acute blood, chronic blood loss, and inadequate nutrition
Routing Screening for Cancer
General Check-Up every 3 years age 20-39 and annually for age 40 and above
Mammogram (40 yrs/10qyrs)
GYN (21 yrs/qyr)
prostat (50 yr/qyr)
CAUTION
C - Change in bowel and bladder habits
A - Sore that does not heal
U - Unusual bleeding or discharge
T - Thickening or a lump in breast or elsewhere
I - Indigestion or difficulty swallowing
O - Obvious change in wart or mole
N - Nagging cough or hoarseness
GI Upset - N/V, stomatitis, anorexia, mucositis, diarrhea Care
Assess intake, might do TPN if they are not eating PO
Considered when they cannot tolerate eating due to stomatitis, N/V, etc
Use antiemetic prophylactically (decadron, benadryl, and ativan) prior to chemo
Anorexia: find food that they like
N/V: antiemetic, peppermint or ginger tea
Stomatitis or Oral mucositis: miracle mouthwash (contains lidocaine)
Diarrhea: Don’t give them anything red, if they vomit or diarrhea, you don’t know if it is blood.
Test for C. Diff
Electrolyte imbalance for Tumor Lysis
Hyperkalemia (dysrhythmias), hyperuricemia (bladder/renal issues) and hyperphosphatemia (renal damage, increased risk for MI) with secondary hypocalcemia (muscle cramps, bone/joint pain).
Check blood work every 3 hrs once chemo starts
Meds use for Tumor Lysis Syndrome
Preventative measure
Allopurinol
Urinary alkalinization
Prevents uric acid from crystallizing in the kidneys
Commonly given orally 2 to 4 days prior to chemotherapy
Hydration (forced diuresis with IV fluids if necessary)
Keep urine output at least 150 mL/hr.
Biphosphate Action
Slow Bone resorption
Bisphosphate Education
Sit up after taking for 30 min, take in empty stomach, and take with water
Do not take for long term; it can lead to osteonecrosis or long-bone fx
RA S/S
Early
Inflammation of the joint, fever, weakness fatigue, paresthesia
Late
Joint deformities, swan neck (severe deformity of hand)
anemia, subq nodules, peripheral neuropathy, etc
Sjogren’s syndrome (dry syndrome)
Felty’s syndrome (hepatosplenomegaly and leukopenia)
Chaplin’s syndrome (rheumatoid nodules in the lungs)
OA S/S
S/S: bone spur, crepitus, stiffness, fluid build-up, unilateral,
OA vs RA
RA is autoimmune and fast onset (weeks or months) and OA is wear and tear (years)
RA affect any age and OA affect ppl over 40
RA s/s is systematic and OA s/s is localized at the joint
RA affects joints throughout the body and OA affect the joints used in weight bearing
Lab for RA
ANA, rheumatoid factor, erythrocyte sedimentation rate (ESR), and C-reactive protein
NSAID S/E
SE: tinnitus, stomach irritation, heart problems, and liver and kidney damage
DMARDS S/E
SE: Liver damage, bone marrow suppression, and severe lung infections
Fish Oil and Plant Oil S/E
Fish Oil SE: nausea, belching, and fishy taste in the mouth
Plant Oil SE: Nausea, diarrhea, and gas
Steroids S/E and Action
Reduce inflammation, pain, and slow joint damage
Can only administer 4/yr
SE: thinning of bones, weight gain, and diabetes
Joint replacement Pre-Op
Assess for mobility issues (need for assistive/adaptive device)
Stop NSAIDS, Vit C/E, hormone replacement therapy or oral contraceptives one week before surgery.
Prevent DVT
Lovenox
LMWH
LMWH
Normal INR: 2-3
Normal PTT: 1.5-2
Monitor for bleeding
Iron Deficiency Cause
acute blood loss, chronic blood loss, inadequate nutrition
Consider GI bleed first `
Iron Deficiency Sx
weakness early on, brittle spooning fingernails, dry and cracked mucous membranes, soreness of tongue,
Hemolytic Anemia Causes
Hemolysis, premature destruction of RBC, autoimmune antibodies, burns, exposure to toxic chemicals, sickle cell
Anemia Chronic Disease Causes
Malnutrition: missing folic acid and vit C
Infection/inflammation: decreased EPO, impaired transport to bone marrow
Cancer: chemo side effects suppress bone marrow
Renal: decreased erythropoiesis and RBC survival
Liver: alcohol toxicity, decreased iron storage
Anemia Chronic Disease Mediation
Ferrous sulfate
Renal: erythropoietin supplements
Pernicious Anemia Cause
Gastrectomy, small bowel disease, h. pylori, prolonged antacids, vegetarian diet, heavy alcohol ingestion, cigarette smoking
Pernicious Anemia Sx
Infection, mood swings, general anemic sx, weight loss, sore mouth, beefy red tongue, abdominal pain, cardiac/gi/kidney issues
Pernicious anemia Medication
B-12 injection lifetime treatment (not tablets! They wont work)
Folic Acid Anemia Causes
Malabsorption syndromes, poor nutrition, alcoholism, malignancies
Malnourished from fat diets that limit vegetables (humans are totally dependent on nutritional intake of folic acid)
Folic Acid Anemia
Scales and fissures in mouth
Stomatitis
Painful ulceration of buccal mucosa and tongue
Dysphagia
Flatulence/watery diarrhea
B symptoms
Fevers, night sweats, unintentional weight loss, infection
CML and CLL treatment
Hydroxyurea in early stages
Bone marrow transplant
Multiple Myeloma SX
Most common presentation is bone pain
Pathological fractures
Multiple Myeloma Diagnosis
CRAB
Calcium elevated
Renal insufficiency
Anemia
Bone lesions
