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Advanced Med Surg > Adv MS Test #3 > Flashcards

Adv MS Test #3 Flashcards

1
Q

scarring of the liver due to necrosis or chronic inflammation over time; liver tissue replaced by non-functional fibrotic tissue

A

Cirrhosis

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1
Q

condition often associated with another syndrome (ex-Down’s) in which head circumference is smaller than normal and will fail to grow

A

Microcephaly

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1
Q

Nsg interventions for autonomic dysreflexia

A

Elevate HOB 45 degrees notify MD cath to empty bladder

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2
Q

best indicator of renal function

A

creatinine

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2
Q

Hydrocephalus etiology

A

Congenital: CNS malformation (genetic, spina bifida/NTDs, tumors, intrauterine infection) Acquired: meningitis, brain tumors, aneurysm, trauma

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2
Q

pts with meningitis are put in

A

respiratory isolation

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3
Q

hepatitis dx

A

ELISA test for antibodies to id strain

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3
Q

homonymous hemianopsia

A

loss of half the visual field in both eyes

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4
Q

azotemia

A

increased urea in blood

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4
Q

s/s of chronic pancreatitis

A

recurring attacks wt loss malabsrption-steatorrhea

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4
Q

Type of CP with poor coordination, wide gait, and difficulty with quick, precise movements

A

Ataxic

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5
Q

s/s cholecystitis

A

RUQ pain, full feeling, may radiate to back abd distention–these can worsen after fatty meal pruritis due to bile salts in skin n/v obstructive jaundice dark urine and clay-colored stool

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6
Q

sudden and reversible loss of kidney function

A

acute kidney failure/acute kidney injury

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6
Q

these two Hep viruses are fecal oral transmitted, acute onset and self-limiting, associated with poor sanitation

A

HepA and HepE

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6
Q

Chiari malformation

A

cerebellum protrudes into spinal canal

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6
Q

most common form of meningitis, self-limiting

A

Viral (aseptic) Mumps, measles, herpes

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6
Q

constant EKG monitoring with SCI because

A

SCI can cause bradycardia, asystole

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7
Q

IN a child with a Wilm’s tumor, DO NOT

A

palpate abdomen

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7
Q

cholecystitis patho

A

bile flow obstructed bile chemically irritates gb causing autolysis and edema cells die, destended gb presses on bvs and decreases blood flow can result in gangrene, infection, perforation

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7
Q

RFs for liver cancer

A

HepC cirrhosis toxin exposure smoking alcohol abuse

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8
Q

causes of nephrotic syndrome

A

Primary: Minimal Change (etiology unknown) or congenital Secondary: due to a systemic disease that damages glomeruli (drug toxicity, hypersensitivity rxn, infection…)

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8
Q

s/s Chiari malformation

A

occipital HA: worsened by coughing, straining vomiting difficulty swallowing

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9
Q

to dx enuresis, inappropriate urination must occur

A

at least 2x/week for at least 3 mos in a child 5 yrs or older

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9
Q

Hydrocephalus s/s in children

A

**Urinary incontinence **Change in personality, memory loss HA n/v sunsetting uncoordinated gait

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10
Q

consequence if VP/VA shunt placement decreases IICP too rapidly

A

subdural hematoma

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10
Q

seizure with a blank stare that ends suddenly, can have automatisms, hyperventilation or flushing; flashing lights can provoke

A

Absence seizure

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10
Q

chronic progressive degenerative autoimmune disease; antibodies attack myelin sheath in white matter (axons) of CNS, plaques form, slowing impulse transmission to muscles

A

Multiple Sclerosis

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10
Q

acute exacerbation of MG due to infection or medication underdose; emergency

A

Myasthenic crisis–improves with Tensilon

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10
Q

ALS Dx

A

Muscle biopsy for tissue changes and loss of muscle fibers

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12
Q

s/s of AGN

A

Brown, tea-colored urine (d/t rbc’s in urine) HTN Circulatory congestion/Edema-periorbital, JVD, crackles, SOB decreased UO fever

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12
Q

HOB post of VA/VP shunt placement

A

initially flat (too avoid subdural hematoma formation) then 30

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14
Q

two types of gallstones

A

pigment stones–from unconjugated pigments; must be surgically removed cholesterol stones–d/t decreased bile acid synthesis or increased chol synthesis

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15
Q

These two blood-borne hepatitis viruses occur together

A

Hep B and Hep D

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16
Q

can result in permenant renal failure; often due to eating food contaminated with Ecoli, Shigella, Salmonella

A

Hemolytic Uremic Syndrome (HUS)

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16
Q

meningitis with a chronically draining ear is associated with

A

Strep pneumoniae

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17
Q

mild concussion

A

unconscious 30 min or less

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18
Q

condition in which kidneys are unable to remove metabolites and wastes from blood, resulting in F&E and A/B imbalances

A

kidney failure

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19
Q

Spina bifida lesion at L2 or above

A

wheelchair bound L2-L5 chair or braces lower, may need braces

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19
Q

Epilepsy def

A

condition of 2 or more unprovoked seizures vs. acute seizures d/t acute issue

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20
Q

chronic hepatitis (B,C,D) increase r/f

A

liver cancer

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21
Q

s/s septic meningitis

A

high fever, chills severe HA, drowsiness Photophobia n/v red/ purple spotted rash late sign: nuchal rigidity….confusion, seizures +Brudzinski’s sign (flexion of knees and hips with neck flexion) +Kernig’s sign (resistance to leg extension from flexed position)

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22
Q

most common cause of ARF

A

Acute Tubular Necrosis due to decreased perfusion to tubular cells, necrosis and cell sloughing with obstruction of tubules results is reversible, cells can regenerate

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22
Q

Stage of CRF with normal BUN/Creat and no s/s

A

Reduced Renal Reserve lifestyle changes here can increase function

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22
Q

stroke secondary to ruptured artery or aneurysm

A

Hemorrhagic stroke

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23
Q

RFs for septic meningitis

A

bacterial URI immunosuppression penetrating injury to CSF Overcrowded living conditions

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23
Q

stroke caused by a blood clot that forms on an atherosclerotic plaque in a cerebral artery

A

Thrombotic stroke (Ischemic-type)

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24
Q

Meds that can cause drug-induced hepatitis

A

Tylenol some antidepressants anesthetics anticonvulsants

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26
Q

no loss of consciousness, pt knows what it happening and is responsive; motor (eyes turn away, facial tic, arrested speech) or sensory (tingling, change in vision or hearing), or psychic (Deja Vu, emotion) symptoms

A

Simple Partial Seizure

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27
Q

Ketogenic diet

A

seizure-suppressing Hi FAT, low PRO, low CHO

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27
Q

total loss of respiratory function in SCI above

A

C4

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28
Q

acute benign facial paralysis due to compression of facial (7th cranial) nerve; usually unilateral

A

Bell’s Palsy

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30
Q

cirrhosis s/s

A

Edema (decreased albumin production) muscle wasting spider angiomas fetor hepaticus confusion, personality changes, asterixis-hand flap bruising ascites

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30
Q

can develop after SCI d/t loss of autonomic NS function below level of injury

A

Neurogenic shock

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31
Q

Complications of spinia bifida repair

A

CSF leak infection IICP, hydrocephalus hypothermia/dehdration (loss thru sac) tethered cord

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32
Q

pancreatitis patho

A

autodigestion of the pancreas from premature activation of digestive enzymes; can cause inflammation, necrosis, and hemorrhage

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32
Q

sudden transient mechanical injury to head with disruption of neural activity

A

concussion

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32
Q

CMs of Parkinson’s besides primary 4

A

Autonomic: flushing, hHoTN, urinary retention, constipation Emotional lability, cognitive changes, eventually dementia Dysphagia

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33
Q

Contagious form of meningitis with high mortality rate

A

Bacterial (septic) N. mengitides (meningococcal) S. pneumoniae (pneumococcal) also Hib, Ecoli

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34
Q

autoimmune disorder in which antibodies cause demyelination of nerves in the peripheral NS, resulting in ascending paralysis, often associated with an acute infection 10-14 d prior

A

Guillain-Barre Syndrome

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35
Q

IICP Tx

A

Osmotic diuretics (Mannitol) to decrease cerebral edema Hi dose barbituates or paralyzers to decrease metabolic demands Fluid restriction decompressive craniectomy if needed

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36
Q

ARF due to obstruction of urinary outflow & Causes

A

Postrenal Causes: kidney stones, tumors, BPH

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37
Q

ARF diet

A

low Na/K/Phos/Protein, high cal

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38
Q

Ischemic stroke can be reversed by

A

tPA within 4-6 hours of event

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40
Q

hemorrhagic stroke Tx

A

stop bleed, Sx evacuation if needed monitor for IICP, herniation avoid anticoagulants

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40
Q

wait this long to tell the extent of a spinal injury

A

72 h

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41
Q

CP developmental warning signs

A

Poor head control, absence of smiling in 3 month old Persistent primitive reflexes (Moro, tonic neck) Inability to sit without support by 8 mos stiff extremities, arching back; or limp, floppy body feeding difficulties use of only one side of body

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42
Q

seizure assessment

A

what happens before, after, and during how long does it last Fam Hx Hx of head trauma, birth complications, febrile seizures

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43
Q

Phase of AKI: original insult until s/s become apparent

A

Initiation Phase

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44
Q

Diuretic phase of AKI

A

gradual increase to high UO, lab values stabilize, renal function is still impaired–watch closely for dehydration as they can excrete but cannot concentrate urine

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44
Q

Nephroblastoma; rapidly growing solid tumor of kidney

A

Wilm’s tumor

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45
Q

s/s septic meningitis in infants

A

bulging fontanels irritablity high-pitched cry high fever without URI or OM vomiting

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46
Q

edrophonium (Tensilon) action

A

cholinesterase inhibitor; inhibits breakdown of ACh

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47
Q

CMs of microcephaly

A

*Mental retardation *seizures dwarfism decreased coordination other…

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48
Q

seizure with impaired consciousness (confused or unresponsive), amnesia of event; may have automatic movements, aura (sensory hallucinations, strong emotions); usually weak and sleepy after

A

Complex Partial seizure

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49
Q

often first sign of MG

A

Ptosis (eyelid drooping), blurred vision

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50
Q

Recovery phase of AKI

A

may take 3-12 mos return to normal lab values with slight decrease from baseline GFR

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50
Q

muscle cramps can occur after HD due to

A

change in electrolyte levels.

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50
Q

s/s VP/VA shunt malfunction

A

signs of IICP: HA, blurred vision n/v irritability, sleepiness

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51
Q

s/s MG

A

Ptosis, blurred vision masklike expression dysphagia head bobbing decreased vital capacity stress incontinence

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52
Q

primary causes of ATN

A

ischemia and nephrotoxins

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53
Q

Major CMs of ARF (3)

A

FVE—SOB, crackles, pulmonary edema Anemia Hyperkalemia

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55
Q

APSGN usually presents

A

10-21 days after strep infection

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55
Q

complications of prolonged bile flow obstruction

A

fat soluble vitamin deficiency decreased Vitamin K—increased r/f bleeding

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56
Q

No LP if ICP is increased because

A

the sudden change in pressure can result in brain herniation

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58
Q

Dx of NTDs

A

AFP at 15-20 weeks sono/amnio

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59
Q

seizure manifestations depend on

A

area of brain involved

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60
Q

Monitor after Whipple or pancreatectomy

A

monitor for peritonitis ng drainage should be serosanguinous; bloody or bile-tinged could signal problem

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62
Q

food high in folic acid

A

leafy greens, nuts, beans, citrus, cereal

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64
Q

early detection of CP

A

accurate growth charts and developmental milestone checks

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64
Q

s/s ALS

A

Early: weakness of face/tongue, fatigue while talking, dysphagia, dysarthria, facial tics; hand/arm weakness Later: Muscle weakness and atrophy leading to flaccid quadriplegia respiratory compromise Pt remain alert, trapped in body

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66
Q

most common tx for hydrocephalus

A

Shunt placement (VP or VA) flexible tube under skin with a one-way valve that brings CSF to peritoneal cavity or atrium, where it can be reabsorbed

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68
Q

walled off fibrous tissue cysts resulting from necrosis during pancreatitis attack; can ber very large and contain caustic fluid

A

pancreatic pseudocyst

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69
Q

s/s viral hepatitis

A

fever fatigue a/n/v abd pain gray colored stool joint pain jaundice

70
Q

s/s of a concussion

A

HA n/v photophobia blurred vision

71
Q

this form of hepatitis causes 1/3 of liver cancers and is the most common cause of chronic liver disease/reason for liver transplant

A

HepC

71
Q

abnormal accumulation of CSF in the ventricles of the brain due to lack of reabsorption or increased production of CSF

A

Hydrocephalus

72
Q

subdural hematoma

A

venous bleeding into space between dura and brain slower bleed than epidural; can be chronic, subchronic, or acute

73
Q

Dx of cholecystitis

A

ERCP (r/f perforation, pancreatitis)

74
Q

disorder involving 5th cranial nerve causing paroxysmal unilateral stabbing pain in face

A

Trigeminal neuralgia

76
Q

Tubule changes due to ATN result in

A

a change in glomerular permeability causing abnormal reabsorption of filtrate

78
Q

Complication of HD in which fluid is moved too fast and the shift in fluid causes cerebral edema, nausea, HA

A

disequilibrium syndrome

79
Q

Type of CP with involuntary writhing movements, hyperactive facial muscles, drooling

A

Dyskinetic/atheoid

80
Q

Right CVA characterized by

A

overestimation of abilities, denial of stroke, one-sided neglect syndrome loss of depth perception, poor impulse control and judgement Left hemiparesis or hemiplegia hemianopsia

82
Q

classic concussion

A

unconscious less than 6h

83
Q

CP Patho

A

prenatal injury: anoxia, brain anomalies anoxia during birth postnatal injury: cerebral infection/meningitis, head trauma

85
Q

MS Dx

A

multiple MRIs to see progression

86
Q

primary causes of chronic pancreatitis

A

alcohol abuse, smoking and biliary tract disease (gallstones block CBD/pancreatic duct junction)

87
Q

all women of child-bearing age should get this much folic acid per day to avoid NTDs

A

0.4 mg/d especially 2 mos prior to conception and entire first trimester

88
Q

uremia

A

more serious azotemia, when increased nitrogenous wastes in blood cause toxic s/s

89
Q

4 stages of CRF

A
  1. Reduced renal reserve (GFR 60-90% of normal) 2. Renal Insufficiency (30-60%) 3. Renal Failure (15-30%) 4. End Stage Renal Disease (
91
Q

abnormal backflow of urine from bladder into the ureters and kidneys; bladder never fully drains, get urinary stasus

A

vesicoureteral reflux

92
Q

80% of MG is associated with tumor or hyperplasia of

A

thymus gland

94
Q

progressive irreversible deterioration in renal function, resulting in uremia

A

chronic renal failure

95
Q

Meningitis Dx

A

Lumbar Puncture (cloudy with bacterial; increased WBCs and PRO, decreased glucose, increased CSF pressure)

96
Q

Spina Bifida Cystica

A

Meningocele (fluid-filled sac outside body with no nerves) OR Myelomeningocele (fluid-filled sac outside body that contains nerves)

98
Q

seizures that involve both hemispheres; loss of consciousness, no memory of event

A

generalized seizure

99
Q

seizures that involve one location in brain

A

partial seizure

100
Q

melena, bruising, hematemesis, epistaxis can result from cirrhosis because

A

decreased production of clotting factors and prothrombin

101
Q

viruses associated with GBS

A

EBV, mono, HIV, Hepatits

102
Q

s/s MS

A

Early sign: weakness and fatigue in legs Flexor spasms at night intention tremor dysmetria blurred vision, nystagmus paresthesias, pain incontinence dysphagia, dysarthria cognitive changes progresses to quadriplegia

103
Q

main electrolytes altered in kidney failure

A

increased potassium and phosphorus decreased sodium and calcium

103
Q

Nsg considerations with IICP (4)

A

Airway: may hyperventilate or need suction, vent Temperature control Seizure precautions watch for urinary retention, promote bowel function

103
Q

stroke cause by an embolus traveling from aother pairt of the body into a cerebral artery; more instant onset of s/s than thrombotic

A

Embolic stroke (Ischemic-type)

105
Q

advantages of PD over HD

A

no vascular access needed freedom less diet and fluid restrictions bettwe BP control less CV problems

106
Q

Stage of CRF in which kidneys cannot regulate volume and solute concentrations, resulting in: overt uremia with s/s decreased UO metabolic acidosis Edema

A

Renal failure

108
Q

progressive autoimmune disease cause severe muscle weakness that improves with rest; antibodies destroy ACh receptors at NMJ; especially eye, facial, laryngeal, and respiratory muscles

A

Myasthenia Gravis

109
Q

pancreatitis attack can be triggered by

A

large intake of alcohol and/or fat

110
Q

sudden decrease in blood flow to a localized area of the brain; 3rd COD in US

A

Stroke

112
Q

progressive neurodegenerative disease due to the degeneration and demyelination of upper and lower motor neurons, resulting in weakness and muscle wasting without sensory or cognitive changes

A

Amyotrophic Lateral Sclerosis (ALS)

113
Q

Major CMs of CRF

A

Uremia Anemia FVE Hyperkalemia (and other electrolyte imbalances)

113
Q

generalized seizure with rhythmic and repetitive muscle contractions, quick return to baseline

A

Clonic seizure

114
Q

seizure first aid

A

lower to floor on side, align head with body remove harmful objects, loosen clothing stay with them, dont restrain don’t put anything in mouth ABCs

115
Q

normal GFR GFR indicative of kidney dysfunction

A

normal=85-105 mL/min

116
Q

new drug to slow degeneration of motor neurons in ALS

A

Riluzole

117
Q

Problems associated with myelomeningocele

A

Brainstem abnormalities (decreased RR, dysphagia, laryngeal spasm) Scoliosis and Kyphosis (impedes pulmonary function) Neurogenic bladder (r/t UTIs, straight cath or stoma, often prev abx)

117
Q

most common precipitating factors of autonomic dysreflexia

A

distended bladder or rectum

119
Q

if HCW exposed to hepatitis

A

give vaccine, IVIG

120
Q

pancreatitis management

A

pain relief rest pancrease–NPO, ng, TPN; bland diet when resume eating, no caffeine or EtoH BG control pancreatic enzymes

121
Q

potential sequelae of bacterial meningitis

A

brain damage hearing loss limb amputation learning disabilities

122
Q

manifestations of post-concussion syndrome (can last up to a year)

A

personality changes decreased attention span, concentration, and short term memory

124
Q

complications of AV fistula/graft

A

stenosis infection thrombosis

125
Q

s/s Myasthenic crisis

A

Increased HR, RR, and BP respiratory distress, oropharyngeal weakness incontinence

127
Q

Left CVA characterized by

A

aphasia agnosia (difficulty recognizing objects) alexia and agraphia Right extremity hemiparesis (weakness) or hemiplegia (paralysis) slow cautious behavior, anger and frustration, depression; decreased memory hemianopsia (loss of visual field)

129
Q

dangers if pancreatitis progresses (7)

A

Hemorrhage, shock Hypocalcemia-Tetany, spasms, paresthesias, cardiac dysrhythmias Paralytic ileus F&E imbalances/Hypovolemia due to ascites 3rd spacing (loss of protein rich fluid from autodigestion) Infection-pseudocyst of abcess due to fluid leakage Left lung effusion/atelectasis Coagulopathy/DIC

131
Q

generalized seizure; body stiffens with short cry, can be apnea, incontinence, eye deviation; followed by rhythmic jerking that slows to limpness; can be confused or unarousable after

A

Tonic Clonic seizure (Gran Mal)

132
Q

cirrhosis complications

A

Esophageal Varices (portal HTN increases pressure in veins, fragile collaterals develop; r/f hemorrhage) Hepatic Encephalopathy (asterixis, fetor hepaticus)

133
Q

s/s Skull Fx

A

periorbital edema and bruising rhinorrhea and/or otorrhea (check for glucose, CSF leak) post-auricular ecchymosis

134
Q

neuro checks in infants

A

behavior changes pupils reflexes

135
Q

RFs for cirrhosis

A

*alcohol abuse *chronic viral hepatitis chronic biliary obstruction

136
Q

post of VP/VA shunt placement, monitor

A

head circumference

138
Q

surgical correction of hypospadias usually done at this age

A

6-18 mos

139
Q

How to tell meningocele and myelomeningocele apart

A

Tranillumination (meningocele will tranilluminate, MMC won’t)

140
Q

sudden, time-limited events caused by excessive disorderly discharge of cortical neurons

A

seizures

142
Q

s/s HUS

A

*Bloody diarrhea gastroenteritis, n/v/d listless, pale, irritable bruising, anemia, TCP renal failure Triad: anemia + TCP + renal failure

143
Q

HoTN can occur after HD due to

A

excess fluid removal

144
Q

s/s epi/sub dural hematoma

A

restlessness, agitation then confusion and coma caused by brain compression due to bleed

146
Q

kidney dysfunction increases r/f anemia and bruising because

A

the production of EPO is decreased

147
Q

impaired blood flow leads to hypoperfusion of kidneys; restoring blood flow will stop damage

A

Pre-renal ARF

148
Q

bladder is adult sized by

A

1 year

149
Q

this condition occurs immediately after SCI causing flaccid paralysis and loss of reflexes below site of injury; can cause paralytic ileus

A

Spinal Shock

150
Q

Clonic or Tonic Clonic simple or complex seizure associated with acute illness and fever of >102.2

A

Febrile seizure

152
Q

when the flow of bile to the intestine is obstructed

A

increased bilirubin in blood dark urine stool changes

153
Q

most common cause of acute liver failure and s/s

A

drug-induced hepatitis fever and chills rash, pruritis arthralgia a/n/v later: jaundice, hepatomegaly, dark urine

154
Q

very brief generalized seizure of a shock-like jerk

A

Myoclonic seizure

156
Q

s/s of acute pancreatitis

A

acute onset of severe, constant knife-like pain in LUQ, mid epi or upper back, unrelieved by vomiting, worse when lying down or eating n/v abd distention, decreased peristalsis, guarding Turner’s sign: flank ecchymosis due to seepage of blood-tinged fluid into SubQ tissues Cullen’s sign: bluish periumbilical discoloration

157
Q

Stage of CRF in which s/s begin to appear: difficulty concentrating, azotemia, anemia, HTN

A

Renal insufficiency

158
Q

VUR can stop growth of the kidney if it causes

A

hydronephrosis

160
Q

HUS treatment

A

short-term dialysis, FFP, blood transfusions most kids recover without permanent damage

161
Q

CMs of Bell’s Palsy

A

flaccidity of affected side of face pain around ear fever tinnitus, hearing defecit excessive tearing, eye can’t close properly

163
Q

brief generalized seizure of extensor muscles, body stiffens and then returns to baseline

A

Tonic seizure

164
Q

nephrotic syndrome vs AGN

A

AGN has HTN, NS normal or low bp severe proteinuria in NS, mild in AGN

164
Q

may be first sign of DVT secondary to SCI

A

low grade fever

165
Q

Intrinsic ARF

A

caused by damage to kidney tissue

167
Q

Tensilon test used to Dx

A

MG Muscle tone improves within 1 minute of Tensilon–+ for MG

168
Q

amount of impairment in spina bifida depends on AND types of impairments

A

level of spinal injury decreased sensation, paralysis, incontinence, joint deformities, dev delays, hydrocephalus

170
Q

active inflammation in gomeruli, often following a streptococcal or pneumococcal infection; Immune complex hypersensitivity reaction in which antigen-antibody complexes become trapped in glomerular basement membrane causing swelling and occlusion

A

Acute Glomerulonephritis (AGN)

171
Q

most common permanent disability in children; nonprogressive impairment of muscle control and coordination

A

Cerebral Palsy

172
Q

these meds are used to treat trigeminal neuralgia

A

antiseizure meds (often used to treat neuropathic pain because they decrease transmission of nerve impulses)

173
Q

causes of epi/sub dural hematoma

A

trauma aneurysm rupture anticoagulants bleeding disorder

174
Q

4 types of jaundice

A

1) Hemolytic: destruction of RBCs increases bilirubin 2) Hepatocellular: liver can’t clear normal amounts of bilirubin 3) Obstructive: due to a stone 4) Hereditary hyperbilirubinemia

175
Q

RFs for pancreatic cancer

A

Smoking high fat/meat diet chronic pancreatitis DM Hep C

177
Q

acute gb inflammation that can occur without obstruction after surgery, trauma, other

A

acalculous cholecysitits

178
Q

Hydrocephalus s/s in infants

A

increased head circumference vomiting (d/t IICP) lethargy, irritability sunsetting (downward deviation of eyes) seizures

180
Q

treatment for patients too unstable for HD; does not produce rapid fluid shifts

A

CRRT-continuous renal replacement therapy

181
Q

inflammation of the kidney that can result in renal scarring and loss of glomeruli, and can progress into Gm- septic shock

A

Pyelonephritis

182
Q

advantages of HD over PD

A

rapid and better fluid removal less PRO loss q quick decrease in serum TGIs, urea and creatinine

183
Q

HUS Patho

A

bacterial toxins cause glomeruli to become swollen and occluded with platelets and fibrin (intravascular coagulation); RBCs are damaged as they move through glomeruli and are then removed by spleen; child becomes thrombocytopenic

185
Q

main assessment during PD dwell

A

respiratory status

186
Q

CMs of Neurogenic shock

A

decreased BP, HR, CO blood pools in extremities no sweating–watch for sudden onset of fever bc they are unable to regulate temperature.

187
Q

Crisis due to overmedication with cholinesterase inhibitors

A

Cholinergic crisis (too much ACh) improves with anticholinergic meds (atropine)

189
Q

two main causes of CRF

A

DM and HTN increase pressure on kidneys until they get exhausted

190
Q

Complications of AGN

A

reanl failure, sepsis *Hypertensive encephalopathy (HA, vision loss, photophobia, hemoparesis, disorientation, seizures) Pulmonary congestion

191
Q

s/s Cholinergic crisis

A

decreased HR and BP muscle twitching, hypersecretions n/v/d, hypermotility (abd cramps) respiratory distress

192
Q

post nephrectomy assess for

A

intestinal obstruction due to adynamic ileus: abd distention, decreased bowel sounds, vomiting

193
Q

distinguishing features of ALS

A

spasticity and paralysis

194
Q

causes of intrinsic ARF

A

most often ATN caused by ischemia (post-op, sepsis, burns, trauma) or nephrotoxins (poisons/OD, AG abx, NSAIDS, contrast media)

195
Q

earliest sign of neuro decline

A

change in level of consciousness

196
Q

Stage of CRF with atrophy and fibrosis in glomeruli, dialysis or transplant needed for survival

A

ESRD

197
Q

with meningitis patients, monitor for

A

IICP (decreased HR, increased BP/widening pulse pressure, change in RR) Shock

198
Q

Four primary s/s of Parkinson’s disease

A

Gradual insidious onset of: 1. Resting Tremor (“pill rolling”) 2. Muscle rigidity (jerky movement) 3. Bradykinesia (blank face, slurred slow speech, difficulty initiating movement, requires thought) 4. Postural instability (forward tilt; short shuffling gait)

199
Q

s/s renal failure

A

confusion, lethargy decreased UO Fluid Volume Overload: crackles, edema anemia, bruising metabolic acidosis bone demineralization, calcification of BVs (decreased Ca and increased Phos)

200
Q

s/s of Nephrotic syndrome

A

decreased UO; dark frothy urine high proteinurea hyperlipidemia hypoalbuminemia Edema-periorbital, facial, dependent) with a large weight gain Skin breakdown and Muerckhe bands

201
Q

predialysis assesments

A

neuro status VS condition of vascular access site (thrill, bruit) weight (before and after)

202
Q

Type of CP with hypertonicity and poor motor control and posture, impaired fine and gross motor skills

A

Spastic CP

204
Q

Pre op for repair of spina bifida (close lesion within 6-12 hours of birth)

A

sterile moist soaks to protect sac keep prone

205
Q

mild form of spina bifida in which the SC remains inside the body but the column is formed inccorectly; could have a hairy patch or dimple at base of spine

A

Spina Bifida Occulta

206
Q

brief episode of neuro defecits (

A

Transient Ischemic Attack (TIA)

207
Q

s/s pancreatic cancer

A

midabdominal pain unrelieved by position changes, more severe at night jaundice, hepatomegaly clay-colored stool dark urine ascites

208
Q

normal creatinine and increased BUN indicates

A

dehydration

209
Q

Parkinson’s Tx

A

correct NT imbalance with dopaminergics

210
Q

increased lab values in acute pancreatitis

A

serum amylase, lipase; wbcs bilirubin and LFTs if caused by liver dysfunction

211
Q

s/s of IICP

A

Early: decreased LOC, GCS; HA Cushing’s triad: widening pulse pressure, decreased HR, decreased RR altered resp pattern, increased effort pupil changes, slow reaction Late s/s: Posturing, rigidity; seizures Cheyne Stokes/Ataxic breathing projectile vomiting loss of brainstem reflexes

212
Q

stroke Dx

A

CT for size, location, ischemic vs hemorrhagic

213
Q

increased permeability of glomerular basement membrane allows protein to pass though into urine

A

Nephrotic Syndrome

214
Q

BP tends to be unstable (low side) in SCI injuries above

A

T7

216
Q

increased r/f this allergy with spina bifida

A

latex

217
Q

epidural hematoma

A

arterial bleeding into epidural space; faster bleed than subdural

218
Q

Treatment of nephrotic syndrome

A

Prednisone to stop protein leakage Diuretics Albumin

219
Q

often first sign of UTI in an infant

A

poor feeding, irritability +fever and no URI or OM, check for UTI

220
Q

ARF Nsg treatment : HDTV

A

Hyperkalemia: Kayexelate, monitor K Dilate renal arteries: dopamine Total Volume: cautious fluid admin to avoid dehydration (bolus NS) Volume control: Diuretics also: temporary dialysis may be needed

221
Q

Oliguric Phase of AKI

A

Increased serum concentrations of metabolites and wastes (increased BUN/creat, increased urine SG and K Decreased UO (

222
Q

Overactivity of autonomic NS that can occur after SCI above T5; causes acute uncontrolled HTN, bradycardia, HA

A

autonomic dysreflexia

223
Q

most definitive dx for pancreatic cancer

A

ERCP

224
Q

seizure with sudden and complete loss of muscle tone, momentary loss of consciousness; r/f injury

A

Atonic seizure

225
Q

causes of pre-renal ARF

A

HoTN, HoVol (shock, trauma, dehydration) decreased CO (HF, MI)

226
Q

progressive neurodegenerative disease involving degeneration of dopamine-producing neurons; balance between dopamine (inhibits muscles) and ACh (excites muscles) disrupted, ACh dominates making smooth, controlled movements difficult

A

Parkinson’s disease

227
Q

cholelithiasis RFs

A

female, BCPs, obesity, multiple births

228
Q

RFs for CP

A

*low birth weight premature/inadequate placenta/multiple birth RH or ABO incompatibility maternal infection

229
Q

fatal form of hepatitis that quickly leads to hepatic encephalopathy and death

A

fulminating hepatitis

230
Q

chronic pancreatitis patho

A

progressive and destructive, calcification and necrosis of pancrease, can lead to hemorrhage

231
Q

Causes of microcephaly

A

genetic abn that impedes cerebral growth in early fetal development maternal drug/alcohol abuse during pregnancy maternal infection (CMV, rubella, varicella) or toxin exposure

Advanced Med Surg (6 decks)

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