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Med Surg 1 > Ch 32 > Flashcards

Ch 32 Flashcards

1
Q

A network of vessels, known as lymphatics

A

Lymphatic system

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2
Q

Transport lymph

A

Lymphatics

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3
Q

Watery fluid derived from plasma that exits the walls of capillaries and enters interstitial spaces

A

Lymph

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4
Q

The lymphatic vessels carry lymph to and through the ___

A

Lymph nodes

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5
Q

Where are lymph nodes primarily located (6)

A

Neck
Axilla
Chest
Abdomen
Pelvis
Groin

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6
Q

Accumulation of lymphatic fluid that results from impaired lymph circulation

A

Lymphedema

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7
Q

Secondary lymphedema develops (2)

A

Complication of other disorders (repeated phlebitis & strep, burns, insect bites, and parasitic infections
Consequence of treatment (mastectomy, radiation)

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8
Q

Wordwide the most common cause of lymphedema is a

A

Parasitic work, mosquitos transmit parasite resulting in ephantiasis

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9
Q

S&S ion lymphedema

A

Skin swells & becomes firm, tight & shiny

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10
Q

A special exam in which an IV dye and radiography are used to detect lymph node involvement, reveals the degree & extent of blockages in the lymph system

A

Lymphangiography

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11
Q

Treatment of lymphedema

A

Treatment usually symptomatic
Compression garment with PROXIMAL TO DISTAL compression gradation

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12
Q

Complex decongestive physiotherapy includes (4)

A

1.distal to proximal massage of Demario’s areas to facilitate lymphatic drainage into collateral vessels
2. Application of compression dressing to relieve edema by reducing excess volume of fluid in interstitial space
3.active exercise to promote lymphatic circulation and maintain functional use of limb
4. Care & maintenance of skin & makes that are vulnerable to secondary complications

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13
Q

A ____ is applies to the arm & trunk. The alternating filling & emptying “milks” the lymph toward the duct, leading to venous drainage

A

Mechanical pulsating compression device or pneumatic device

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14
Q

Grade 1 of lymphedema

A

2cm but not more than 4cm

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15
Q

Grade 2 (moderate) of lymphedema

A

4cm but not more than 8cm

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16
Q

Grade 3 (severe) of lymphedema

A

8cm greater than unaffected limb. Involved the entire limb or is accompanied by infection or cellulitis

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17
Q

Client family teaching, use of a compression garment
SATA (5)

A

1.purchase 2 compression garments so that one can be worn while the other is washed & dried
2.change garment in morning & evening bc it becomes stretched after 12 hrs
3.limit time NOT worn to NO MORE than 30 to 60 minutes, to prevent recuperation of tissue & stretched skin
4.wash removed garment in soap & water each day to prolong elasticity & remove perspiration, bacteria & dead skin cells
5. Air dry out of direct sun to preserve longevity of garment (don’t put in dryer)

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18
Q

Inflammation of lymphatic vessels

A

Lymphangitis

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19
Q

When inflammation of lymphatic vessels affects the lymph nodes near the lymphatics

A

Lymphadenitis

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20
Q

What commonly causes lymphangitis & lymphandentitis

A

Strep virus

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21
Q

S&S of lymphangitis & lymphadentitis

A

Red streaks follow the course of the lymph channels & extend up arm or leg.
Fever

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22
Q

S&S when lymphandentis is present

A

Lymph nodes along the lymphatic channels are enlarged & tender in palpation

23
Q

Treatment for lymphangitis & lymphadenitis

A

Broad spectrum antibiotic

24
Q

Nursing management for lymphangitis & lymphandenitis
SATA (5)

A

1.inspect area & note response to ABT
2. Assistance for discomfort w ADLs
3.elevation to reduce swelling
4.warmth to promote comfort & enhance circulation
5.notify if area becomes enlarged, more lymph nodes become involved, temp stays elevated

25
Q

In severe cases with persistent swelling, the nurse teaches the client how to

A

Apply an elastic sleeve or stocking

26
Q

A viral disease that’s affects the lymphoid tissues such as tonsils and spleen

A

Mono

27
Q

What other organs can mono also involve

A

Brain, meninges & liver

28
Q

What virus causes mono

A

Epstein Barr virus

29
Q

Incubation period for mono

A

30-50 days

30
Q

Epstein Barr virus is believed to trigger ___ in approximately ___ of people with disease

A

Hodgkin lymphoma
40%

31
Q

S&S of mono (8)

A

Fatigue
Fever
Sore throat
Headache
Cervical lymph node enlargement
Tonsils ooze white or greenish gray
Faint red rash on hands ir abdomen
Liver & spleen may be enlarged

32
Q

Test to diagnose mono

A

Positive slide agglutination
Monospot
Monotest
Monosticon

33
Q

Withhold donating blood for how long after recovering from mono

A

At least 6 months

34
Q

A group of cancers that affect the lymphatic system

A

Lymphomas

35
Q

A malignancy that produces enlargement of lymphoid tissue, the spleen & the liver with invasion of other tissues such as bone marrow & lungs

A

Hodgkin disease

36
Q

What condition is purexia(elevated temp) & splenomegaly(enlarged spleen) found in?

A

Hodgkin disease

37
Q

Causes mutations in some lymphocytes, creating malignant cells

A

Reed sternberg cells

38
Q

Which lymphoma has reed sternberg cells

A

Hodgkin

39
Q

Early symptoms of hodgkins include

A

Painless enlargement of one or more lymph nodes

40
Q

Which lymph nodes are first to be infected in Hodgkin disease

A

Cervical lymph nodes

41
Q

As nodes enlarge they press on adjacent structures such as

A

Esophagus or bronchi

42
Q

As retroperitoneal nodes enlarge there is a sense of

A

Fullness in stomach & epigastric pain

43
Q

Stage 1 of Hodgkin

A

Single lymph node region

44
Q

Stage 2 of Hodgkin

A

Two or more lymph node regions on one side of diaphragm

45
Q

Stage 3 of Hodgkin

A

Lymph node regions on both sides of the diaphragm but extensions is limited to the spleen

46
Q

Stage 4 of Hodgkin

A

Bilateral lymph nodes affected and extensions include spleen plus one or more of the following: bones,bone marrow, lungs, liver, skin, GI structures, or other sites

47
Q

The b designation is given to clients with any of the following symptoms (3)

A

1.Unexplained loss of more than 10% if body weight in the 6 months before diagnosis
2.unexplained fever w temp above 100.4
3.drenching night sweats

48
Q

Treatment of hodgkins

A

Transfusions prescribed to control anemia. If resistance develops, autologous bone marrow or peripheral stem cells are harvested, followed by HIGH DOSES of chemo that destroy the bone marrow

49
Q

Drug combinations of Hodgkin

A

ABVD
Doxorubicin (Adriamycin)
Bleomycin
Vinblastine
Dacarbazine

50
Q

A group of 30 sub classifications of malignant disease that originate in the lymph glands & other lymphoid tissue

A

Non hodgkins

51
Q

Causes of NHL

A

Environmental triggers (viral agents, chemical herbicides, pesticides, hair dye)
Administration of immunosuppressive drugs to prevent transplant rejection

52
Q

NHL is classified as (2)

A

1.indolent (relatively asymptomatic at diagnosis & disorder relatively responsive to radiation & chemo
2. Aggressive (condition has a shorter onset with acute symptoms)

53
Q

Nursing management for NHL

A

Encourage >2500 ml of fluids a day to facilitate excretion of cells destroyed by therapy & compensate for fluids that are lost due to vomiting

54
Q

Nutrition of Hodgkin & NHL

A

N/V may accompany radiation & chemo
Must maintain food & fluid intake
Offer clear liquids (carbonated beverages,water,ice pops, flavored gelatin) until nausea subsides
Thereafter, small, frequent low fat meals to prevent nausea, improve nutritional intake & reduce weight loss

Med Surg 1 (19 decks)

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