ah 3 Flashcards
What is the command center of the endocrine system?
Hypothalamus
Which hormones are produced by the anterior pituitary?
- TSH
- ACTH
- LH
- FSH
- GH
- Prolactin
Which hormones are produced by the posterior pituitary?
- Oxytocin
- Vasopressin
What is homeostasis in the context of hormones?
Balance of hormone production
What condition is characterized by too little vasopressin?
Diabetes Insipidus
What are the clinical manifestations of diabetes insipidus?
- Excessive thirst
- Large volume of dilute urine
- Low urine specific gravity
- Signs/symptoms of dehydration
What tests are used for diagnosing diabetes insipidus?
- Blood and urine sodium
- Blood and urine osmolality
- Fluid deprivation test
- Trial desmopressin
What is the treatment goal for diabetes insipidus?
- Replace ADH
- Replace fluid
- Identify cause
What is a common nursing care action for diabetes insipidus?
Monitor fluid status
What is the syndrome of inappropriate antidiuretic hormone (SIADH)?
Excessive ADH secretion from the pituitary gland
What are the clinical manifestations of SIADH?
- Cannot excrete dilute urine
- Fluid retention
- Dilutional hyponatremia
- Signs/symptoms of volume overload
What is the key diagnostic test for hypothyroidism?
- High TSH
- Low T4
- Low T3
What is myxedema coma?
Persistently low thyroid production
What are the signs and symptoms of myxedema coma?
- Hypotension
- Bradycardia
- Hypothermia
- Edema
- Respiratory depression
- Severely altered LOC
What is hyperthyroidism?
Excessive secretion of thyroid hormones
What are the clinical manifestations of hyperthyroidism?
- Everything is increased
- Goiter
What medications are used to treat hyperthyroidism?
- Antithyroid medication
- Iodine solutions
- Beta blockers
What is a thyroid storm?
Severe form of hyperthyroidism
What are the signs of hyperparathyroidism?
- Kidney stones
- Bone demineralization
What is the treatment for hyperparathyroidism?
- Surgical removal of abnormal parathyroid tissue
- Give fluids
What are the signs of hypoparathyroidism?
- Tetany
- Chvostek’s sign
- Trousseau’s sign
What is Addison’s disease?
Adrenal glands do not produce enough cortical hormones
What are the signs and symptoms of Addisonian crisis?
- Hypoglycemia
- Hyperkalemia
- Hypotension
- Severe abdominal pain
What is Cushing’s disease?
Excessive adrenocortical activity or corticosteroid medication
What are the clinical manifestations of cirrhosis?
- Hepatomegaly
- Jaundice
- Infection
- Edema
- Vitamin deficiency
- Portal hypertension
- Ascites
- Esophageal varices
What is the most definitive test for liver dysfunction?
Liver biopsy
What is the first-line therapy for ascites?
Spironolactone
What are the common types of hepatitis?
- HAV
- HBV
- HCV
- HDV
- HEV
What is cholecystitis?
Inflammation of the gallbladder
What are the signs of gallbladder attack?
- Pain
- Positive Murphy’s sign
- Jaundice
- Pruritus
What is the purpose of ERCP?
For blockage treatment
What is biliary colic?
Gallbladder or gallstone attack
Biliary colic is characterized by abdominal pain due to gallstones obstructing the bile duct.
What is a positive Murphy’s sign?
Indicates gallbladder inflammation
A positive Murphy’s sign occurs when a patient experiences pain upon palpation of the gallbladder area during inhalation.
What are common symptoms of gallbladder issues?
- Jaundice
- Pruritus
- Changes in urine or stool color
- Vitamin deficiency (fat-soluble)
These symptoms can indicate issues such as gallstones or cholecystitis.
What are the key components of assessment and diagnosis for gallbladder issues?
- Patient history
- Diet history
- Medication history
- Various radiological scans
These assessments help in diagnosing conditions related to the gallbladder.
What is the purpose of Endoscopic Retrograde Cholangiopancreatography (ERCP)?
To visualize and treat blockages in the bile ducts
ERCP is a diagnostic and therapeutic procedure that can help in the management of gallbladder conditions.
What are the main treatments for cholecystitis and cholelithiasis?
- Rest
- Pain control
- Infection control
- NPO (nothing by mouth)
- NGT (nasogastric tube)
- Nutrition support
- Surgical management (e.g., laparoscopic cholecystectomy)
These treatments aim to alleviate symptoms and address the underlying condition.
What is the role of cholestyramine (Questran)?
Relieves pruritus by binding bile salts in the intestine
This medication increases fecal excretion of bile salts, thus reducing itching.
What dietary recommendations are given post-cholecystectomy?
Soft, low-fat, high carbohydrate diet
This diet helps accommodate the digestive changes following gallbladder removal.
What is acute pancreatitis?
Autodigestion of the pancreas
This condition is a medical emergency often caused by gallstones or heavy alcohol intake.
What are the classifications of acute pancreatitis?
- Mild
- Severe
- Interstitial edematous
- Necrotizing
These classifications help to determine the severity and management of the condition.
What are the clinical manifestations of acute pancreatitis?
- Abdominal pain
- Rigid, board-like abdomen
- Bruising around umbilicus
- N/V
- Fever
- Jaundice
- Tachycardia
- Hypotension
- Respiratory distress
These symptoms indicate a severe inflammatory response in the pancreas.
What laboratory tests are used to assess chronic pancreatitis?
- Glucose tolerance test
- Fecal fat content
- Serum amylase
These tests help evaluate pancreatic function and diagnose chronic pancreatitis.
What is the primary treatment for chronic pancreatitis?
- Pain control
- PPIs (proton pump inhibitors)
- Management of diabetes
- Low fat diet
- Avoid heavy meals
These measures aim to manage symptoms and prevent further complications.
What is the purpose of gastrointestinal intubation?
Insertion of flexible tube into the GI tract for decompression or administration of feedings, fluids, and medications
This procedure is crucial for patients unable to take food orally.
What are the complications associated with gastrointestinal intubation?
- Tube clog or obstruction
- Inadvertent misconnections
- Fluid volume deficit
- Pulmonary complications
- Tube-related irritations
- Dislodgment
These complications can arise from improper placement or care of the tube.
What is GERD?
Backflow of gastric duodenal contents into the esophagus
This condition can lead to complications such as esophagitis if not managed properly.
What lifestyle modifications are recommended for managing GERD?
- Avoid eating/drinking 2 hours before bedtime
- Maintain normal body weight
- Elevate HOB at least 30 degrees
- Avoid caffeine, tobacco, and certain foods
These changes can help reduce symptoms and improve quality of life.
What is the main cause of peptic ulcer disease (PUD)?
Erosion of the mucosa in the stomach or duodenum
PUD can lead to serious complications such as bleeding and perforation.
What are the signs and symptoms of constipation?
- Fewer than 3 BMs per week
- Hard, dry, small stools
- Abdominal distention
- Pain
- Bloating
- Straining at stool
Constipation can be a symptom of underlying diseases or disorders.
What dietary recommendations are made for diarrhea management?
BRAT diet: Bananas, Rice, Applesauce, Toast
This diet is gentle on the stomach and helps firm up stools.
What are the indications for a colonoscopy?
Direct visualization of the large intestine
This procedure is used to diagnose conditions such as inflammatory bowel disease, polyps, and cancer.
What are the key nursing interventions for managing GI bleeding?
- Monitor vital signs
- Monitor labs
- Maintain IV access
- Medical management (IV fluids, blood products)
These interventions are critical to manage hemodynamic stability.
What is the significance of McBurney point?
Location for assessing appendicitis
Tenderness at McBurney point indicates possible appendicitis, often requiring surgical intervention.
What is the primary medication used for managing diarrhea in patients with Irritable Bowel Syndrome?
Loperamide (Imodium)
It is classified as an opioid.
What are the key characteristics of Irritable Bowel Syndrome?
Chronic functional disorder characterized by recurrent abdominal pain associated with disordered bowel movements, which may include constipation, diarrhea or both
Symptoms include abdominal pain, bloating, and distention.
How is Irritable Bowel Syndrome diagnosed?
Diagnosis of exclusion
What is the primary goal of management for Irritable Bowel Syndrome?
Pain management and symptom control
What are some management strategies for Irritable Bowel Syndrome?
- Lifestyle modification
- Food diary
- Cognitive behavioral therapy
What is appendicitis?
Inflammation of the appendix
What are the common signs and symptoms of appendicitis?
- Abdominal pain
- Nausea/Vomiting
- Fever
- Constipation
What is the McBurney point?
Point of maximum pain in appendicitis
What is Rovsing’s sign?
Press on the opposite side and have pain in the right quadrant
What is the medical management for appendicitis?
Surgery
What preoperative care is required for appendicitis?
- IV access
- Antibiotics
- Analgesics
What are the postoperative care requirements for appendicitis?
- Incentive spirometer
- Pain management
- I&Os
- Early ambulation
- Assess bowel sounds
What is intestinal obstruction?
Blockage that prevents the normal flow of intestinal contents through the intestinal tract
What are the two types of intestinal obstruction?
- Mechanical
- Functional or paralytic
What are the signs and symptoms of intestinal obstruction?
- High pitched or absent bowel sounds
- Distention
- Vomiting
- Constipation
What is the diagnosis for intestinal obstruction based on?
Symptoms, X-ray, CT
What is the management for intestinal obstruction?
- NG tube for decompression
- Rehydration
- NPO
- May require surgery
What complications can arise from intestinal obstruction?
Perforation
What is inflammatory bowel disease?
Group of chronic autoimmune disorders
What are the two main types of inflammatory bowel disease?
- Crohn’s disease
- Ulcerative colitis
What are common lab values affected by inflammatory bowel disease?
- Albumin
- C-reactive protein
- Erythrocyte sedimentation rate (ESR)
- Electrolyte disturbances
What is Crohn’s disease also known as?
Regional enteritis
What is a characteristic appearance of Crohn’s disease?
Cobblestone appearance
What are the common symptoms of Crohn’s disease?
- Right lower quadrant pain unrelieved by defecation
- Diarrhea and fever
- Cramping after meals
What diagnostic tests are used for Crohn’s disease?
- Endoscopy/colonoscopy
- CT
What are the complications of Crohn’s disease?
- Obstruction
- Fluid and electrolyte imbalances
- Malabsorption
- Malnutrition
What are the key characteristics of ulcerative colitis?
Chronic ulcerative and inflammatory disease of the colon and rectum
What are the common symptoms of ulcerative colitis?
- Left lower quadrant pain
- Fever
- Diarrhea with passage of blood, mucus or plug (bright red)
What is the diagnosis for ulcerative colitis?
Colonoscopy
What complications can arise from ulcerative colitis?
- Fluid and electrolyte imbalances
- Megacolon
- Bleeding
- Perforation
- Malnutrition
What is the focus of nursing management for inflammatory bowel disease?
- Maintain normal elimination patterns
- Relieving pain
- Maintaining fluid intake
- Optimal nutrition
- Promoting rest
- Reducing anxiety
- Enhancing coping measures
- Preventing skin breakdown
- Monitoring and managing potential complications
What is the aim of medical management for inflammatory bowel disease?
- Reducing inflammation
- Suppressing inappropriate immune responses
- Providing rest for a diseased bowel
- Improving quality of life
- Minimizing complications
What are common pharmacological therapies for inflammatory bowel disease?
- Corticosteroids (e.g., hydrocortisone, prednisone, methylprednisolone)
- Antibiotics
- Biologics (immunosuppressant drugs)
What distinguishes surgical management for Crohn’s disease from that for ulcerative colitis?
- Crohn’s is usually only r/t complications of disease process, not curative
- Ulcerative colitis is more common and curative because disease is limited to large intestine
What are the preoperative nursing management steps for ostomy care?
- Patient education
- Fluids and/or blood products
- Antibiotics
- Steroids
- NPO at midnight
- Informed consent
What are the postoperative nursing management steps for ostomy care?
- Ambulation
- Analgesics
- Assess stoma
- Assess for return of bowel function
- I&Os
- Nasogastric decompression
- Emotional support
What are the steps to change an ostomy pouch?
- Gather supplies
- Empty and gently remove old pouch
- Wash the skin around the stoma with warm water only
- Assess the peristomal skin
- Measure the stoma with measuring guide
- Cut out the pouch to fit the size of the stoma
- Center over the stoma and apply to the skin
- Rub firmly around the stoma to get a good seal
- Ensure the opening of the pouch is closed
What are common nursing diagnoses related to ostomy management?
- Risk for impaired skin integrity
- Disturbed body image
- Deficient fluid volume
- Risk for imbalanced nutrition; less than body requirements
- Deficient knowledge
What are common assessment components for the urinary system?
- Health history
- Risk factors
- Chief complaint
- Common symptoms
- Physical assessment
- Diagnostics
What is benign prostatic hyperplasia (BPH)?
Can reduce flow of urine from the bladder
What are the clinical manifestations of BPH?
- Frequent urination
- Weak urine stream
- Leaking urine
What is a significant risk associated with incomplete bladder emptying in BPH patients?
Fever, high BP, infection
What are some non-pharmacological management strategies for BPH?
- Decrease alcohol and caffeine
- Avoid bladder irritants
- Encourage timely voiding
- Eliminate large volumes of liquids
- Weight loss
What is Tamsulosin (Flomax) used for?
Alpha blocker that relaxes muscles in prostate and bladder
What is TURP?
Transurethral resection of the prostate
What are the postoperative management steps following TURP?
- 3-way bladder irrigation
- Monitor color of output
- Watch for clots
- Patient teaching regarding activity restrictions
What is the most common symptom of urinary tract infections in elderly patients?
Confusion
What are common risk factors for urinary tract infections?
- Sex
- Improper hygiene
- Caffeine
- Dehydration
- Diabetes
- Elderly patients
What are the types of urinary tract infections?
- Lower UTI: Urethritis, Cystitis
- Upper UTI: Pyelonephritis
What does the acronym U.R.I.N.E stand for in urinary assessment?
- U: Urine characteristics
- R: Report pain
- I: Increase in WBC/temp
- N: Nausea/Vomiting
- E: Evaluate mental status
What are non-pharmacological management strategies for UTIs?
- Increase fluid intake
- Cranberry juice
- Avoid sugary drinks and alcohol
What is urinary incontinence?
Loss of bladder control caused by various disorders
What are the types of urinary incontinence?
- Stress
- Urge
- Overflow
- Iatrogenic
- Reflex (neurogenic)
What is the management approach for urinary retention?
- Teach urinary elimination methods
- Routine schedule
- Encourage fluid intake
- Assess need for catheter
What are the causes of urinary retention?
- Diabetes
- Prostate enlargement
- Urethral pathology
- Trauma
- Neurologic disorders
- Medications
What are common complications of urinary retention?
- Infection
- Renal calculi
What is urolithiasis and nephrolithiasis?
Calculi (stones) in the urinary tract or kidney
What are common causes of urinary stones?
- Infection
- Urinary stasis
- Immobility
- Hypercalcemia
What are the clinical manifestations of urinary stones?
- Pain
- Hematuria
What is urinary diversion?
Performed to divert urine from the bladder to a new exit site usually a surgically created opening (stoma)
What are reasons for performing urinary diversion?
- Bladder cancer
- Birth defects
- Trauma
- Strictures
- Neurogenic bladder
- Chronic infection
What is a cutaneous urinary diversion?
Ileal conduit, ureterostomy, vesicostomy, nephrostomy
What is a continent urinary diversion?
Indiana pouch, Kock pouch
What are key assessment points for ostomy care?
- Empty bag when it is ⅓ to ½ full
- Wear time is usually 3-7 days
- Change at the first sign of leakage
