Adults Health 🍎💚 Flashcards
Peptic ulcer disease
Lifestyle mods/Complications
Avoid spicy foods, acidic foods, and black pepper.
Avoid stimulants that stimulate acid secretion & delay healing (eg, NSAIDS (aspirin, ibuprofen/Motrin) 💊inhibits prostaglandin synthesis, gastric secretions, and reduce mucosal barrier.
Reduce stress and obtain rest. 💤
Complications ‼️
Call HCP if bleeding: Orthostatic hypotension (lightheaded/dizzy), tachycardia, & melena. ☕️
Perforation: increased epigastric pain, N/V, & fever (>99).
TRIPLE DRUG THERAPY: 💚💚💚
OMEPRAZOLE
AMOXICILLIN
CLARITHROMYCIN
Melanoma classification
Asymmetry: When bisected
Border irregularities: Uneven edges, pigment fading off
Color variation: Brown, tan, black, & red.
Diameter: >6mm
Evolving: Lesions changing in size, shape, or color; new lesion.
Melanoma originated from pigment producing cells (melanocytes) growing rapidly that are highly metastatic (deadliest) 🪦💀
Rule of Nines
Anterior
Head: 4.5
Torso: 18
Arm: 4.5
Leg: 9
Perineal: 1
Posterior ^^^
Minus perineal 🙅🏻♀️
Heart Attacks (Female)
Atypical symptoms: N/V, belching, indigestion, diaphoresis, dizziness, and fatigue.
GI distress as main symptom; evaluate with protocol for ACS.
Deep Vein Thrombosis
Do’s and Don’ts
Do: Ambulate, warm compress, bed rest with elevated limb for severe pain/edema.
Don’t: Massage or SCD’s may dislodge clot and become PE.
TX: 💚 Anticoagulant for VTE May become DVT when dislodged in vein of LE.
Acute Pancreatitis
Findings & Priorities
Elevated BG level is expected, severe burning mid epigastric abdominal pain that radiates to back (knee to chest), steatorrhea (decreased lipase production). 💩
Risk for PANCREATIC ABSCESS: High fever, leukocytes is, and increasing abdominal pains may equal sepsis!
Laparoscopic Cholecystectomy
CO2 inflate and expands abdominal cavity for better visualization of organs. May irritate oh remix nerve and diaphragm = shallow breaths and referred pain to shoulder.
Encourage EARLY AMBULATION to dissipate CO2 and facilitate breathing.
Client will be clear liquid diet until nausea and pain subside, typically after DC. Low fat diet for few weeks. Clients usually DC next day.
Osteoarthritis
No inflammatory degration of cartilage in synovial joints (eg, knee, hip, fingers). Pain worse as day progresses, deformity, and instability.
Weight loss can reduce pain by decreasing strain on joints.
Risk: Increased age, overuse of joints, excess weight bearing on joints, or trauma.
Osteoporosis 🦴🧀
Musculoskeletal DO rate or bone resorption exceeds formation equaling porous and fragile bone. Pain is not typical unless fracture.
Spine, hip, and wrist most affected.
Risk: Compression fractures, kyphosis, loss of height.
💊💚: VIT D, Bisphosphonates (alendronate, risedronate) inhibit osteoclast, and Calcium carbonate.
Laryngectomy
Cranial nerve XI (glossopharyngeal) involves gag reflex and ability to swallow.
Client will be taught supraglottic swallow to allow for voluntary control over closing vocal cords to prevent aspiration.
1. Inhale deeply
2. Hold breath tightly to close vocal cords
3. Place food, swallow, continue to hold
4. Cough to dispel remaining food
5. Swallow again before breathing
Tuberculosis (Airborne)
Latent: Noninfectious, positive TST or IGRA, normal CXY.
Hand hygiene recommended, mask not needed.
Active: Cough 😷, fever, chills, night sweats, anorexia, weight loss, fatigue, malaise, abnormal CXY, positive sputum AFB.
Rifampin daily (4 m)
Rifampin + Isoniazid daily (3m)
Rifapentine + Isoniazid weekly (3m)
Isoniazid mono (6-9m)
Diabetic Ketoacidosis
DKA is an acute, serious complication due to lack of insulin in type 1 patients. Hyperglycemia, ketosis, and acidosis. Osmotic diuretics = profound dehydration. May develop hyperkalemia as a compensatory response to acidosis despite having total body potassium deficit from urinary loss.
Typical patient is Type 1, young, and presents with S&S: polyuria, polydipsia, weight loss, fruity breath, dehydrated, kussmaul, AMS, and BG (250-800 mg/dL).
Ketones in urine or blood, metabolic acidosis.
TX: 💚 IV FLUIDS (0.9%), IV REGULAR INSULIN, MONITOR POTASSIUM (CONT. 🫀 MONITOR) and pH.
Cushings Disease 🦬💜
A condition associated with excess corticosteroid production.
S&S: Purple striae, hirsutism, and supraclavicar fat pad.
Addisons Disease 🧂
Adrenocortical insufficiency- hypo function of the adrenal cortex.
S&S: Bronze hyperpigmentation (ACTH increase in respond to low cortisol), vitiligo (blotchy/patchy skin), slow onset of weakness or fatigue, weight loss, orthostatic hypotension, salt craving, N/V, depression, irritability, and hyponatremia/hyperkalemia, tachycardia, and confusion.
TX 💚: IV push hydrocortisone (AMS/N/V/Abdominal pain), 💧 0.9% NS & 5% Dextrose.
Hypoglycemia
Blood glucose 🩸: <70 mg/dL (3.9 monk/L)
Neurological S&S: Alert 🚨 & Oriented give 15 g of simple carbohydrate (regular soda or fruit juice).
If no improvement within 15 minutes, additional simple carbohydrate given followed by protein & carb snack (cheese/crackers).
Adrenal Cortex 🧂 🍆
GFR: Glomerular, Fascicular, Reticular (ZONA).
Salt, sugar, & sex (the deeper you go, the sweeter it gets).
Stress hormones (epinephrine/norepinephrine), aldosterone, glucocorticoids.
Syndrome of Inappropriate Antidiuretic Hormone
Endocrine condition overproduction leads to water retention, increased total body water, and dilutional hyponatremia.
Risk for: Seizures, confusion, and other neurological complications.
- Fluid restriction <1,000 mL/day
- Oral salt tablets (increase serum sodium)
- Hypertonic saline (3%) first few hours for markedly decreased serum sodium and severe neuro manifestations.
- Vasopressin receptor antagonist (conviaptan).
Strict fluids I&O & carefully monitor neurological status.
SIADH S&S ❌🧂
Potential complication of a head injury - extra ADH leads to water reabsorption by the kidneys.
As ADH secretes & water retained, urine output is decreased and concentrated.
DECREASED SERUM OSMOLALITY
HIGH URINE SG
LOW SERUM SODIUM
Chronic Obstructive Pulmonary Disease 🫁
Generally refers to two conditions: emphysema & chronic bronchitis. Combination is common, slowly progressive, persistent airflow obstruction, and etiology is associated with chronic airway inflammation.
Risk: Former tobacco smoker, prolonged exposure to irritants, and genetic (alpha-anti trypsin deficiency).
