Diseases

Question 1

Myasthenia Gravis

Answer 1

Myasthenia Gravis

characterized by weakness and rapid fatigue of any of the muscles under your voluntary control
caused by a breakdown in the normal communication between nerves and muscles

Question 2

Myasthenia

Answer 2

Myasthenia Gravis Assessment

Muscular weakness produced by repeated movements soon disappears following rest
Diplopia, ptosis, impaired speech, dysphagia
Respiratory distress
Periods of remissions and exacerbations

Question 3

Myasthenia Gravis Nursing Diagnosis

Answer 3

Myasthenia Gravis Nursing Diagnosis

Self-care deficit
Airway clearance, ineffective
Physical mobility, impaired
Impaired swallowing
Anxiety/fear

Question 3

Myasthenia Gravis Diagnosis

Answer 3

Myasthenia Gravis Diagnosis

Based on administration of anticholinesterase (neostigmine) - positive result evidenced by striking increase in muscular strength 5-10 minutes after administration

Question 4

Systemic Lupus Erythematosus (SLE)

Answer 4

Systemic Lupus Erythematosus (SLE)

Chronic, systemic inflammatory disease of connective tissue that involves skin, joints, serous membranes, kidneys, hematologic system, CNS

Question 5

Systemic Lupus Erythematosus Assessment

Answer 5

Systemic Lupus Erythematosus Assessment

Musculoskeletal: polyarthralgia, polymyositis
Dermatological: butterfly rash on bridge of nose and cheeks, papular, erythematous, purpuric lesions, oral ulcers, alopecia
Cardio: pericarditis, pleural effusion
Renal: hematuria, proteinuria
Lymphandenopathy
Raynaud’s phenomenon

Question 6

Hyperthyroidism Assessment

Answer 6

Hyperthyroidism Assessment

Personality changes, such as irritability, agitation & mood swings
Nervousness & fine tremors
Heat intolerance
Weight loss
Smooth, soft skin and hair
palpitations, cardiac dysrhythmias
diarrhea
protruding eyeballs
diaphoresis
HTN
enlarged thyroid gland

Question 7

Hypothyroidism Assessment

Answer 7

Hypothyroidism Assessment

Lethargy and fatigue
Weakness, muscle aches, paresthesias
Intolerance to cold
Weight gain
Dry skin & hair, loss of body hair
bradycardia
constipation
generalized puffiness and edema around the eyes and face (myxedema)
forgetfulness and memory loss
menstrual disturbances
cardiac enlargement, tendency to develop HF, goiter may or may not be present

Question 8

Neuroleptic Malignant Syndrome

Answer 8

Potentially fatal syndrome that may occur at any time during therapy with antipsychotic medications

Question 9

Neuroleptic Malignant Syndrome Assessent

Answer 9

Neuroleptic Malignant Syndrome Assessent

Dyspnea
Tachycardia
Fever
High or low BP
Increased sweating
Loss of bladder control
Skeletal rigidity
Pale skin
Excessive weakness or fatigue
Altered LOC
Seizures
Severe EPS
Difficulty swallowing and excessive salvation
Oculogyric crisis
Dyskinesia
Elevated WBC, liver function results and creatine level

Question 10

Neuroleptic Malignant Syndrome Interventions

Answer 10

Neuroleptic Malignant Syndrome Interventions

Notify HCP
Monitor VS
Initiate safety & seizure precautions
Prepare to discontinue medication
Monitor LOC
Administer antipyretics as prescribed
Use a cooling blanket to lower body temp
Monitor electrolyte levels and administer fluid IV as prescribed

Question 11

Cushing’s Sydrome

Answer 11

Cushing’s Sydrome

A metabolic disorder resulting from the chronic and excessive production of cortisol by the adrenal cortex or by the administration of glucocorticoids in large doses

Question 12

Cushing’s Disease

Answer 12

Cushing’s Disease

A metabolic disorder characterized by abnormally increased secretion (endogenous) of cortisol, caused by increased amounts of adrenocorticotropic hormone (ACTH) secreted by the pituitary gland

Question 13

Cushing’s Disease Assessment

Answer 13

Cushing’s Disease Assessment

Generalized muscle wasting and weakness
Moon face, buffalo hump
Truncal obesity with thin extremities, supraclavicular fat pads, weight gai
Hirsutism (masculine characteristics in females)
Hyperglycemia, Hypernatremia
Hypokalemia, hypocalcemia
HTN
Fragile Skin that easily bruises
Reddish purple striae on the abdomen and upper thighs

Question 14

Addison’s Disease

Answer 14

Addison’s Disease

Hyposecretion of adrenal cortex hormones (glucocorticoids and mineralocorticoids) from the adrenal gland, resulting in deficiency of the corticosteroids hormones

Question 15

Addison’s Disease Assessment

Answer 15

Addison’s Disease Assessment

Lethargy, fatigue, muscle weakness
Gastrointestinal disturbances
Weight loss
Menstrual changes in women; impotence in men
Hypoglycemia, hyponatremia
Hyperkalemia, hypercalcemia
Hypotension
Hyperpigmentation of skin (bronzed) with primary disease

Question 16

Addison’s Crisis

Answer 16

Addison’s Crisis

A life-threatening disorder caused by adrenal hormone insufficiency. Crisis is precipitated by infection, trauma, stress, or surgery. Death can occur from shock, vascular collapse, or hyperkalemia

Question 17

Addison’s Crisis Assessment

Answer 17

Addison’s Crisis Assessment

Severe headache
Severe abdominal, leg, and lower back pain
Generalized weakness
Irritability and confusion
Severe hypotension
Shock

Question 18

Addison’s Crisis Interventions

Answer 18

Addison’s Crisis Interventions

Admin glucocorticoids as prescribed (usually IV hydrocortisone sodium)

Question 19

Wilm’s Tumor (Nephroblastoma)

Answer 19

Wilm’s Tumor (Nephroblastoma)

Most common intraabdominal and kidney tumor of childhood; it may manifest unilaterally and localized or bilaterally, sometimes w/ metastasis to other organs
Peak onset is age 3
Nurse - measure abdominal girth pre-op

Question 20

Atrial fibrillation (A Fib)

Answer 20

Atrial fibrillation (A Fib)

Irregular heartbeat (arrhythmia) often, but not always, resulting in a fast heart beat (greater than 100 bpm) at rest. Atrial fibrillation increases the risk of stroke so patients with this condition typically are placed on anticoagulants. Ex: Warfarin. Important things to monitor in these patients are INR levels, heart rate and changes in circulation.

Question 21

Diverticular disease

Answer 21

Diverticulosis is a chronic condition of multiple diverticula formation that develops most commonly in middle age. It is typically discovered during routine colonoscopy screening, is often asymptomatic, and does not usually require treatment. Diverticulitis is an inflammatory complication of diverticulosis. It causes signs and symptoms that can have serious consequences. Most uncomplicated diverticulitis patients with mild symptoms are treated with antibiotics and a clear liquid diet. Nursing interventions includes monitoring for strict intake and output and administering antibiotics.

Question 22

Crohn’s disease

Answer 22

Crohn’s disease

Crohn’s disease is an inflammatory disorder affecting mostly the distal ileum and colon. Crohn disease results in the malabsorption of water and nutrients, which may lead to fluid and electrolyte imbalances. Anemia often results, secondary to poor dietary intake and/or absorption of vitamins and nutrients.

Question 23

Irritable bowel syndrome

Answer 23

Irritable bowel syndrome

IBS is a disorder that produces chronic, uncontrolled inflammation of the intestinal mucosa, which can affect any part of the gastrointestinal (GI) tract, causing edema, ulceration, bleeding, and profound fluid and electrolyte losses. Patients experience abdominal cramping, pain with diarrhea, nausea, dehydration, weight loss, cachexia, and anemia. Patients may experience an average of 5 to 10 diarrhea stools each day that also contain mucus leading to anemia, hypovolemia, and malnutrition. Anemia is related to active bleeding and poor intake and/or absorption of nutrients. Nursing interventions includes monitoring hemoglobin levels and intake and output.

Question 24

COPD

Answer 24

COPD is a lung disease characterized by progressive airflow limitation resulting from small-airway disease and parenchymal destruction. Major risk factors include exposure to smoke (including tobacco, cooking fires, and fuel), occupational dust, or fumes. Oxygen should be titrated to improve hypoxemia, with an arterial oxygen saturation (SaO2) goal of 88% to 92% in patients without complications. The first intervention usually involves increasing the dose or frequency of a currently
prescribed, short-acting inhaled bronchodilator, such as the beta 2-agonist albuterol (Ventolin HFA). Nursing interventions include auscultating lung sounds and monitoring for shortness of breath.

Question 25

Acute pancreatitis

Answer 25

Acute pancreatitis is a sudden inflammation that lasts for a short time. It may range from mild discomfort to a severe, life-threatening illness. The most common symptom is abdominal pain. Nursing Interventions involve placing patient as NPO to inhibit pancreatic stimulation and secretion of pancreatic enzymes, administration of parenteral nutrition and insertion of nasogastric tube to suction and relieve nausea and vomiting, decrease painful abdominal distention and paralytic ileus and remove hydrochloric acid so that it does not stimulate the pancreas.

Question 26

Diabetes mellitus (DM)

Answer 26

Diabetes mellitus (DM) is a chronic disease characterized by insufficient production of insulin in the pancreas or when the body cannot effectively use the insulin it produces. Type 1 is a lack of insulin production. Type 2 is the body’s ineffective use of insulin. Nursing Interventions- Administer regular insulin by intermittent or by continuous IV method. Observe for signs of hypoglycemia: changes in LOC, cold and clammy skin, rapid pulse, hunger, irritability, anxiety, headache, lightheadedness, shakiness.

Question 27

Diabetes insipidus

Answer 27

Diabetes insipidus (DI) is a condition which causes frequent urination. The reduction in production or release of ADH results in a fluid and electrolyte imbalance caused by increased urinary output. Nursing Interventions- Monitor laboratory values and intake and output Dietary measures: limiting sodium intake to less than 3 g per day help to reduce urine output. · Fluid replacement: hypotonic saline is administered intravenously.

Question 28

Coronary artery disease

Answer 28

Coronary artery disease Characterized by the accumulation of plaque within coronary arteries, which progressively enlarge, thicken and calcify. Nursing Interventions- Monitor for signs of chest pain and administer antianginal medications. Monitor blood pressure, heart rate and prep patient for surgery.

Question 29

Cerebrovascular Accident (CVA)

Answer 29

Cerebrovascular Accident (CVA)

The sudden impairment of cerebral circulation in one or more of the blood vessels supplying the brain
which causes hemorrhage from a tear in the vessel wall or impairs the cerebral circulation by a partial or complete occlusion of the vessel lumen with transient or permanent effects. Nursing Interventions- Closely monitor patient’s neurological status and functional level in comparison to their baseline. Monitor vital signs and changes in blood pressure.

Question 30

Hepatic encephalopathy

Answer 30

Hepatic encephalopathy
A loss of brain function that occurs when the liver is unable to remove toxins from the blood. Nursing Interventions- Monitor ammonia levels and monitor level of consciousness.

Question 31

Hypertension

Answer 31

Hypertension
Characterized by abnormal blood pressure readings, and controlled with diet and medications. Nursing Interventions- Monitor blood pressure frequently. Many patients are typically asymptomatic. Administer blood pressure medications. Educate. Monitor for signs and symptoms of stroke.

Question 32

Hypothyroidism

Answer 32

Hypothyroidism
A condition where the thyroid gland does not produce enough thyroid hormone. Nursing Interventions- Monitor labs for FreeT3, T4 and TSH levels. Administer oral medication such as Synthroid. Everything slows down so you’ll see weight gain, fatigue, and constipation symptoms in the body.

Question 33

Hyperthyroidism

Answer 33

Hyperthyroidism
A condition caused by an overproduction of the thyroid hormone. Nursing Interventions- Monitor labs for FreeT3, T4 and TSH levels. Administer oral medication such as
Tapazole. Everything speeds up so monitor for tachycardia, diarrhea and complications of grave’s disease.

Question 34

Sickle cell anemia

Answer 34

Sickle cell anemia
A condition in which there are not enough healthy red blood cells to carry oxygen because the cells are “sickle” in shape. Nursing Interventions- Pain control management is very essential with these patients, as well as administering oxygen. Many of these patient’s require blood transfusions on a regular basis.

Question 35

Abdominal Aneurysm

Answer 35

Abdominal Aneurysm
An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. Nursing Interventions- Monitor for signs of rupture and notify MD immediately. Prep patient for surgery. NPO for at least 8 hours, obtain consent.

Question 36

Renal failure

Answer 36

Renal failure
A condition in which the kidneys fail to adequately filter waste toxins out of the body. Acute kidney failure is reversible and oftentimes occurs suddenly. Nursing Interventions- Monitor kidney function tests (BUN, Creatine) and monitor output.

Question 37

Pernicious Anemia

Answer 37

Pernicious Anemia
When the body does not produce enough intrinsic factor, and fails to absorb vitamin B12, it is known as pernicious anemia. Some stomach conditions, or procedures that are carried out on the stomach, can stop it absorbing enough vitamin B12. For example, a gastrectomy (the removal of part of the stomach) increases the risk of developing vitamin B12 deficiency anemia. Nursing Interventions- Monitoring blood count levels and administering B12 injections.

Question 38

Liver Cirrhosis

Answer 38

Liver Cirrhosis
Cirrhosis is a chronic disease characterized by replacement of normal liver tissue with diffuse fibrosis that disrupts the structure and function of the liver. The three classifications of Cirrhosis:
Alcoholic cirrhosis -scar tissue characteristically surrounds the portal areas. This is the most prevalent type that is caused by long history of chronic alcoholism Postnecrotic cirrhosis- consists of broad bands of scar tissue and results from previous acute viral hepatitis or drug-induced massive hepatic necrosis. Biliary cirrhosis- consists of scarring of the liver around the bile ducts. This type of cirrhosis usually results from chronic biliary obstruction and infection (cholangitis). It is much less common than the other two classifications of cirrhosis. Nursing Interventions- administer vitamins, fluid/electrolyte replacement and monitor for ascites.

Question 40

Vaso occulsive crisis