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Nursing Semester 2 (Med surg & Peds) > Everything for TEST 1! > Flashcards

Everything for TEST 1! Flashcards

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1
Q

Similarities of Crohn’s and Ulcerative Colitis

A

Both a form of IBD (inflammatory bowel disease)

Both cause inflammation & ulcer formation

Cause is UNKNOWN- suggested due to a faulty immune system in overdrive…may be triggered by environment and genetics

Flare ups are common followed by remission

Increased risk of colon cancer

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2
Q

Cirrhosis complications

A

jaundice

ascites

portal hypertension

neurologic changes (buildup in ammonia that crosses blood brain barrier- delirium)

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3
Q

Medication used to decrease bilirubin levels

A

lactulose therapy

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4
Q

Leading cause of liver cancer:

A

cirrhosis

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5
Q

Major cause of cirrhosis

A

hepatitis c (major)

fatty liver can also induce cirrhosis

prolonged and excessive use of alcohol (alcohol subjects liver to stress)

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6
Q

clinical manifestations

A

Elevated liver enzymes (CBC, pro-thrombin)

distended abdomen

firm abdomen

weight loss, fatigue

dry skin, rashes, ecchymosis

vascular lesions with red center

tendency to bleed

spider angioma

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7
Q

clinical manifestations

A

Elevated liver enzymes (CBC, pro-thrombin)

distended abdomen

firm abdomen

weight loss, fatigue

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8
Q

diagnosis for liver cirrhosis

A

MRI

CT scan

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9
Q

Nonsurgical Interventions for cirrhosis

A

pain management

nutritional therapy

low sodium diet, fluid and electrolyte

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10
Q

Drugs to be given to cirrhosis patients

A

diuretics

antibiotics sometimes given

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11
Q

Hepatitis can occur during a

A

secondary infection

infection from another virus

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12
Q

Hepatitis can occur during a

A

secondary infection

infection from another virus

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13
Q

Hep A transmission

A

fecal-oral route

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14
Q

Hep B transmission

A

through sexual intercourse with affected parter

through contact with blood or other body fluids

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15
Q

symptoms of hep B

A

anorexia

nausea

fatigue

fever

right upper quadrant pain

joint pain

jaundice

light stool?

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16
Q

which hepatitis is waterborne

A

Hep E!

India, africa, Middle East, countries that don’t have source of clean water

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17
Q

which hepatitis is waterborne

A

Hep E!

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18
Q

major difference between chronic and acute hepatitis

A

chronic is reoccurring (chronic more specific to B and C)

acute: first attack, may progress to chronic

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19
Q

clinical manifestations of liver cancer

A

ascites

edema

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20
Q

Transplant complications

A

rejection!

infection

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21
Q

2 types of cholecystitis

A

acute

chronic

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22
Q

2 types of cholecystitis

A

acute

chronic

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23
Q

Goal of drug therapy for GI disorders is to treat:

A

peptic ulcers

nausea

constipation

diarrhea

IBS

IBD

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24
Q

Histamine2- Receptor Antagonists purpose:

A

Gastric and duodenal ulcers

heartburn, dyspepsia

Erosive esophagitis

Gastrointestinal reflux disease (GERD)

Aspiration pneumonitis

Hypersecretory disorders (Zollinger-Ellison syndrome [gastrin]), systemic mastocytosis [histamine])

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25
Q

Histamine2-Receptor Antagonist drugs:

A

Prototype drug: ranitidine hydrochloride (ZANTAC)

Cimetidine (TAGAMET)

Famotidine (PEPCID)

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26
Q

Physiologic change in compartment syndrome:

A

increased compartment pressure

increased capillary permeability

release of histamine

increased blood flow to area

pressure on nerve endings

increased tissue pressure

decreased oxygen to tissues

increased production of LACTIC ACID

muscle ischemia

tissue necrosis

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27
Q

Clinical findings of compartment syndrome:

A

edema

pulses present

pink tissue

pain

cyanosis

allow

unequal pulses

tense muscle swelling

tingling

numbness

severe pain unrelieved by drugs

paralysis

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28
Q

What is a fat embolism?

A

fat globules are released from the yellow bone marrow into the bloodstream within 12 - 48 hours after an injury or other illness

these globules clog small blood vessels that supply vital organs- most commonly the lungs, and impair organ perfusion

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29
Q

Fat embolism syndrome (FES) usually results from

A

fractures or fracture repair but occasionally is seen in patients who have total joint replacement

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30
Q

Early manifestations of FES:

A

hypoxemia

dyspnea

tachypnea

headache

lethargy

agitation

confusion

decreased level of consciousness

PETECHIA (a macular, measles-like rash may appear over the neck, upper arms and chest- NOT PRESENT IN DVT)

31
Q

Factors that make patients with fractures most likely to develop venous thromboembolism

A

cancer/ chemotherapy

surgical procedure lasting longer than 30 minutes

history of smoking

obesity

heart disease

prolonged immobility

oral contraceptives

older adults (especially with hip fractures)

32
Q

What is included in a neuromuscular assessment?

A

CSM!!

assess skin color

temperature

sensation

mobility

pain

pulses distal to fracture site

Can check capillary refill but not as reliable

33
Q

“6 P’s” for ACS (Acute compartment syndrome)

A

Pain

Pressure

Paralysis

Paresthesia

Pallor

Pulselessness (rare)

34
Q

Biggest risk factor for hip fractures:

A

osteoporosis

35
Q

Most common complications of amputations:

A

hemorrhage

infection

phantom limb pain

neuroma

flexion contractures

36
Q

Parietal cells secrete:

A

hydrochloric acid

intrinsic factor (substance that aids in absorption of vitamin b12)

37
Q

chief cells secrete:

A

pepsinogen (precursor to pepsin, a digestive enzyme)

38
Q

Liver stores:

A

many minerals and vitamins

iron

magnesium

fat soluble vitamins (ADEK)

39
Q

Sequence for abdomen assessment (IAPP)

A

inspect

auscultate

percuss

palpate

40
Q

Endoscopy is used to evaluate

A

bleeding

ulceration

inflammation

tumors

cancer of esophagus

stomach

biliary system or bowel

41
Q

EGD is used for

A

a visual examination of the esophagus, stomach, duodenum

42
Q

EGD preparation:

A

NPO 6-8 hours

Usual drug therapy for hypertension or other diseases may be taken morning of test (diabetics consult!)

avoid anticoagulants, aspirin, or other NSAIDS for several days before the test unless its absolutely necessary

43
Q

Normally used drugs for sedation:

A

Midazolam hydrochloride (versed)

fentanyl (fentanyl, sublimaze)

propofol (deprivan)

44
Q

ERCP is

A

visual and radiographic examination of the liver, gallbladder, bile ducts and pancreas to identify the cause and location of obstruction

45
Q

Stomatitis:

A

inflammation within the oral cavity that may present in many different ways

canker sores

46
Q

Primary stomatitis:

A

most common type

noninfectious stomatitis

herpes simplex stomatitis

traumatic ulcers

47
Q

Secondary stomatitis:

A

generally results from infection by opportunistic viruses, fungi or bacteria in patients who are immunocompromised

can result from chemotherapy drugs

48
Q

Drug therapy used for stomatitis:

A

antimicrobials

immune modulators

symptomatic topical agents

49
Q

Foods that can trigger aphthous (noninfectious) ulcers:

A

coffee

potatoes

cheese

nuts

citrus fruits

gluten

50
Q

Leukoplasia presents as

A

slowly developing changes in the oral mucous membranes causing

thickened, white, firmly attached patches that can’t be easily scanned off

slightly raised and sharply rounded

MOST COMMON LESION AMONG ADULT

51
Q

Oral hairy leukoplakia is associated with

A

Epstein-Barr virus (EBV) and can be an early manifestation of HIV infection.

52
Q

Erythroplakia appears as

A

red, velvety mucosal lesions on the surface and there are MORE malignant changes in this than in leukoplakia

often considered “precancerous”

53
Q

Possible preparation for patient undergoing are surgical resection

A

placement of temporary tracheostomy, oxygen therapy and suctioning

temporary loss of speech because of tracheostomy

frequent monitoring of post op vital signs

NPO stays until intraoral suture lines are healed

Need to have IV lines in place for drug therapy

54
Q

Most common upper GI disorder:

A

GERD!

55
Q

Most common cause of GERD is:

A

Excessive relaxation of the LES, which allows the reflux of gastric contents into the esophagus and exposure of the esophageal mucosa to acidic gastric contents

56
Q

Patients who are overweight or obese are at highest risk for development of GERD because

A

increased weight increases intra-abdominal pressure which contributes to reflux of stomach contents into the esophagus

57
Q

Factors contributing to decreased lower esophageal sphincter pressure:

A

caffeinated beverages, such as coffee, tea, and cola

chocolate

citrus fruits

tomatoes and tomato products

smoking and use of tobacco products

calcium channel blockers

nitrates

peppermint, spearmint

alcohol

anticholinergic drugs

high levels of estrogen and progesterone

NG tube

58
Q

Most accurate method of diagnosing GERD:

A

pH monitoring examination is most accurate

59
Q

Foods to avoid with GERD

A

peppermint

chocolate

alcohol

fatty foods (especially fried)

caffeine

carbonated beverages

spicy and acidic foods (OJ, tomatoes)

60
Q

Drugs that lower LES pressure and CAUSE reflex:

A

oral contraceptives

anticholinergic agents

sedatives

NAIDS (ibuprofen)

calcium channel blockers

61
Q

3 MAJOR Drug therapy groups to manage GERD:

A

antacids

histamine blockers

proton pump inhibitors

these drugs also used for peptic ulcer disease

functions:
- inhibit gastric acid secretion
- accelerate gastric emptying
- protect gastric mucosa

62
Q

Main drug therapy for GERD

A

Proton pump inhibitors (PPI’s) (given once a day)

omeprazole (prilosec)

rabeprazole (AcipHex)

pantoprazole (proton)

esomeprazole (nexium)

63
Q

standard surgical approach for treatment of severe GERD

A

Laparoscopic Nissen fundoplication

64
Q

2 major types of hiatal hernias

A

sliding hernia (most common)

paraesophageal (rolling) hernia

65
Q

Type A chronic gastritis

A

refers to an inflammation of the glands as well as the fungus and body of the stomach

66
Q

Type B chronic gastritis

A

usually affects the glands of the antrum but may involve the entire stomach

67
Q

Atrophic chronic gastritis:

A

diffuse inflammation and destruction of deeply located glands accompany the condition

affects all layers of stomach

muscle thickens and inflammation is present

total loss of fundal glands`

68
Q

Risks for gastritis

A

long term NSAID use

local irritation from radiation therapy

alcohol, coffee, caffeine, corticosteroids

accidental or intentional ingestion of corrosive substances

69
Q

Most common form of chronic gastritis

A

type B gastritis caused by H. Pylori infection

70
Q

Early pathologic manifestation of gastritis is

A

thickened, reddened mucous membrane with prominent rug (foldS)

71
Q

Acute gastritis features:

A

rapid onset of epigastric pain or discomfort

N/V

Hematemesis

gastric hemorrhage

dyspepsia (heartburn)

anorexia

72
Q

Chronic gastritis features:

A

vague report of epigastric pain relieved by food

anorexia

n/v

intolerance of fatty, spicy foods

73
Q

Standard for diagnosing gastritis

A

Esophagogastroduodenoscopy (EGD)

74
Q

Drugs to avoid with gastritis

A

corticosteroids

erythromycin

aspirin

saids

ibuprofen

Nursing Semester 2 (Med surg & Peds) (7 decks)

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