Clinical 1 Flashcards
What is the Snellen test ? 3
1) test of visual acuity
2) pt stands 20 feet from chart of letters with one eye covered at a time
3) pt reads chart to smallest letter visible
What’s tonometry? 3
1) measures intra ocular pressure
2) when pressure is applied to the inner cornea if intra ocular pressure increases indicates glaucoma
3) advise not to squint,cough, or hold breath during procedure.
What is Myopia? 2
1) nearsightedness
2) light rays refract at a point in front of the retina
What’s hyperopia? 2
1) Farsightedness
2) the light rays refract behind the retina
What is presbyopia? 1
Impaired vision acuity caused by aging
What’s stigmatism? 1
1) uneven curvature of the cornea causing blurring
What’s conjunctivitis? 4
1) pinkeye
2) caused by virus, bacteria, allergies
3) apply warm moist compress
4) give topical antibiotics, hydrocortisone ophthalmic ointment
What’s a sty? 2
1) staphylococcal organisms
2) apply warm compresses, antibiotics, incision & drainage
What’s Retinopathy of prematurity (Rop)? 3
1) retina detachment
2) high concentrations of oxygen cause blindness
3) sometimes occurs when O2 concentration are greater than 40% for 48 to 72 hrs
What’s a detached retina? 3
1) flashes of light, floaters
2) a feeling of curtain coming up or down hallmark symptom
3) surgery to reattach retina choroid gas or air bubble to apply pressure to retina
What’s cataracts? 5
1) objects appear distorted or blurred
2) decreased color perception
3) intracapsular extraction- removal of entire lense & capsule; easier for Drs , but puts pt at risk for retina detachment
4) extra capsular extraction- cut anterior capsule to expose opaque lense material, most common procedure
5) hemorrhage indicated by sudden sharp pain
What’s Glaucoma? 5
1) artificial lights appear to have rainbows or halos around them,
2) decreased peripheral vision
3) close angle- sudden onset emergency
4) avoid mydriatics ( atropine)
5) open angle- (primary glaucoma) humor flow blockage
What’s otitis media? 5
1) ear tugging (child)
2) red bulging tympanic membrane
3) children more susceptible because short Eustachian tube
4) bx, antihistamine
5) myringotomy: tympanic membrane incision to relieve pressure & fluid
What’s Ménière’s disease? 5
1) vertigo
2) feeling of fullness in the ear
3) nystagmus (jerking ness of the eyes)
4) compazine, antivertigo meds ( antivertigo, Valium, raglan, Titan)
5) low sodium diet and diuretics
What’s trigeminal neuralgia (tic doulourex)? 4
1) V cranial nerve disorder
2) facial pain
3) alcohol injection to nerve ( destroy nerve)
4) avoid extreme temperatures
What’s Bell’s palsy? 4
1) VII cranial nerve
2) assist with electrical stimulation
3) teach exercises for facial muscles ( blow and suck from straw)
4) recover in 3-5 weeks
What’s acoustic neuroma? 3
1) deafness
2) grimacing of facial muscles
3) bening tumor of the eight cranial nerve
What’s Guillain-barre syndrom? 3
1) paresthesia motor looses usually beginning in lower extremities then extended up ward to trunk, upper extremities
2) demyelination occurs & alters nerve conduction
3) mech ventilation, elevate head of bed, suctioning
What’s Huntington’s disease? 3
1) depression, temper outbursts
2) person in constant motion by end of disease progression
3) Librium, haldol, Thorazine.
What’s hyperglycemia? 4
1) blood sugar 300-800mg/dl
2) hypotension, tachycardia,
3) skin warm & dry
4) fruity odor to breath
What’s hypoglycemia? 6
1) Bs <50-60
2) confusion, tremors, blurry vision, coma, seizures
3) hypotension, tachycardia
4) skin cool and diaphoretic
5) skim milk is ideal, dextrose 50% IV if unconscious, glucagon 1 mg IM,sq.
6) follow with carbohydrates
What’s phenylketonuria? 3
1) high blood phenylalanine that leads to retardation
2) lofenalac substitutes for infant milk
3) low protein diet for children ( no meat, dairy, eggs)
What’s Gout? 4
1) high Utica acid that lead to joint deterioration
2) low purine diet
3) kidney stones
4) inborn error of purine metabolism
What’s Celiac disease? 3
1) inborn error of wheat and rye metabolism
2) intestinal malabsorption that leads to malnutrition, diarrhea and failure to thrive
3) gluten free diet; no wheat, oats, rye, barely
What’s Renal failure and protein malabsorption? 2
1) increased protein & albumin losses in urine that leads to protein deficiency
2) high calorie, low protein as allowed by kidney function
What’s hepatobiliary disease? 2
1) decreased bile leads to fat malabsorption
2) low fat, high protein diet, vitamins
What’s Cystic fibrosis ? 2
1) absence of pancreatic enzymes leads to malabsorption of fat & fat soluble vit
2) weight loss, infection & lung disease lead to increase need for calories & protein
What’s Hiatal hernia? 2
1) Heart burn, regurgitation
2) the esophagus passes becomes enlarged part of the upper stomach comes up into the lower portion of the thorax
What’s Pyloric stenosis ? 5
1) projectile vomiting in infants
2) infant always hungry and irritable
3) palpable olive shape tumor in epigastrium
4) infants don’t show symptoms until the second to fourth week after birth
5) most seen in male white
What’s gastritis? 3
1) n&v and possible blood
2) Npo slowly progressing to bland diet
3) antacid to relieve pain
What’s Chronic duodenal ulcer? 2
1) pain 2-3 hrs PC; night often during sleep
2) foods relieve pain
What’s Chronic gastric ulcer? 3
1) 1/2 to 1 hr PC or when fasting
2) pain relieved by vomiting
3) foods don’t relief pain
What’s Chron’s disease ? 3
1) fatty stool with occasional rectal bleeding
2) R colon & Ileum
3) high protein, high calorie,low fat, & low fiber.
What’s Ulcerative colitis ? 4
1) absent fatty stools
2) common rectal bleeding, pus, mucus in stool
3) high protein & calories, low fat & fiber
4) increase fluids & electrolytes
What’s Appendicitis ? 4
1) peri umbilical pain shifts to right lower quadrant at McBurney’s point
2) low grade fever
3) ice bag to abd to alleviate pain; no heating pads, enemas, or laxatives
4) fowlers to alleviate abd pain
What’s peritonitis? 2
1) causes; ruptured appendix, ectopic pregnancies, perforated ulcer.
2) gastric decompression; ng tube
What’s Hirschsprung’s disease? 3
1) new born refusal to pass meconium
By congenital defect
2) refusal to suck, weight loss
3) abd distention, constipation & diarrhea
What’s intestinal obstruction? 3
1) high pitched bowel sounds above area of obstruction, decreased or absent bowel sounds below the area of obstruction
2) ng tube or mouth to DX
3) salem tube or levin tubes
What’s cirrhosis? 3
1) dark urine, clay color stool, esophageal varices, hemorrhage, purities, ascites, edema in extremities
2) portal hypertension with esophageal varices that may lead to hemorrhage
3) high amonia levels that lead to altered level of consciousness; reduced with lactulose
What’s Reye’s syndrome? 2
1) high fever and ICP, decreased LOC, decreased hepatic function, DX by liver biopsy
2) liked to aspirin & viral illness
What’s cholelithias ? 4
1) dark urine clay color stools
2) check for bleeding
3) T-tube to ensure drainage of bile until edema diminishes: keep T-tube bag below level of gallbladder
4) low fat, high calorie and protein
What’s pancreatitis? 4
1) abd pain after heavy meal or alcoholic beverage ingestion
2) pain relief by position changes
3) blue discoloration in flank and around umbilicus
4) autoimmunity by enzyme, principally by Trypsin
What’s systemic lupus erythematous?
3
1) arthritis joint swelling, oral ulcers, alopecia, muscle skeletal inflammation
2) raynaud’s syndrome: pain and color changes of extremities during cold exposure
3) antinuclear antibodies ANA
What’s Impetigo ? 3
1) reddish macular becomes honey colored crusted vesicles; than crusts
2) caused by staphylococcus streptococcus
3) monitor for acute glomeruli nephritis ( complications of untreated impetigo)
What’s psoriasis? 3
1) chronic recurrent thick itchy papules/plaques covered with silver white scales with symmetrical distribution
2) tar preps may stain skin
3) methotrexate
