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Med Surg Exam 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Arthritis

A

Inflammation of one or more joints

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2
Q

Non-inflammatory arthritis (osteoarthritis)

A

Not systemic or an autoimmune disease that develops from overuse of the joint, most common type

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3
Q

Osteophytes

A

Bone spurs that form as cartilage and the bone beneath it begins to erode

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4
Q

Synovitis

A

Inflammation of the synovial tissue

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5
Q

Subluxation

A

Partial joint dislocation

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6
Q

Herberdens nodes

A

Swelling at the distal fingers

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7
Q

Bouchards nodes

A

Swelling of the proximal fingers

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8
Q

Joint effusions

A

Excessive joint fluid, ballottement

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9
Q

Joint involvement

A

Joint tenderness upon palpation or range of motion

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10
Q

Total joint arthroplasty or total joint replacement

A

Surgical creation of a joint or total knee replacement

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11
Q

Arthroscopy

A

Procedure to remove damaged cartilage

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12
Q

Osteotomy

A

Bone resection to correct a joint deformity

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13
Q

Rheumatoid arthritis

A

Chronic, progressive, systemic inflammatory Auto immune disease of musculoskeletal system involving many joints and connective tissue, characterized by remissions and exacerbations

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14
Q

Stages of rheumatoid arthritis

A

Body’s immune system begins to attack cells at synovial joints.
Causes inflammation in the synovial membrane,
synovial thickening,
cartilage and bone damage (calcification, bony ankylosis)

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15
Q

Systemic disease

A

Affects other organs in the body including many joints and other tissues

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16
Q

Vasculitis

A

Inflammation of the blood vessels

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17
Q

Subcutaneous nodules

A

On the on their surface of the arm, fingers, along the Achilles tendon

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18
Q

Pulmonary complications

A

Inflammation of lung lining, interstitial fibrosis

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19
Q

Periungal lesions

A

Brown spots around the nailbed, ischemic lesions

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20
Q

Paresthesias

A

Burning and tingling sensation in the extremities

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21
Q

Rheumatic disease

A

Any disease or condition involving the musculoskeletal system

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22
Q

Sjögren’s syndrome

A

Dry eyes, mouth and vagina

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23
Q

Feltys syndrome

A

Hepatospleenomegaly

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24
Q

Caplan’s syndrome

A

RA nodules in the lungs and pneumonia coniosis

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25
Q

Rheumatoid factor

A

Measures the presence of unusual antibodies of IGM

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26
Q

Anti-nuclear antibody titer

A

Measures the titer of unusual antibodies that destroys cells and cause tissue death not always accurate

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27
Q

Erythro site sedimentation rate

A

Measures inflammation

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28
Q

Serum complement

A

Measures the serum proteins C3 and C4 which are usually low in patients with autoimmune disease

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29
Q

C reactive serum protein

A

Also used to measure inflammation

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30
Q

NSAIDs

A

Usually the initial drug of choice to relieve pain and inflammation

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31
Q

Disease modifying antirheumatic drugs (DMARDS)

A

Slows the progression before it worsens

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32
Q

Methotrexate

A

Slow acting immunosuppressive medications

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33
Q

Leflunomide

A

Help diminish information such as joint swelling, stiffness, and improve mobility

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34
Q

Biological response modifiers (BRM)

A

Newest drug neutralize the biological activity of tumor in a crisis factor by binding with the TNF receptors

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35
Q

Glucocorticosteroids

A

Fast acting, anti-inflammatory and immunosuppressive effects can be given in high dose for short duration or as low chronic dose

Lots of complications

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36
Q

Plasmapheresis

A

Process which of the fluid part of the blood plasma is removed from blood cells by a cell separator. The blood plasma, which contains the antibodies, is discarded and replaced with other fluids

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37
Q

Autoimmune process

A

Where antinuclear antibodies affect the DNA of the cell nucleus, resulting in inflammation and damage to organs directly or cause vasculitis, compromising blood flow and oxygenation

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38
Q

Discoid lupus erythematosus

A

Chronic skin condition of sores with inflammation and scarring favoring the face ears and scalp and at times on other body areas only affects the skin

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39
Q

Systemic lupus erythematosus

A

Chronic progressive inflammatory connective tissue disorder that causes major body organs and systems to fail (kidneys and lungs)

–dry scaly butterfly rash on face, skin lesions, alopecia, mouth ulcers

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40
Q

Osteonecrosis

A

Bone necrosis due to prolonged steroid use causing constriction of blood vessels, hip commonly affected

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41
Q

Muscle atrophy

A

From disuse, steroid use, or immune complex invasion

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42
Q

Fever and fatigue

A

Very common finding with lupus erythematosus

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43
Q

Renal involvement

A

Common with lupus nephritis has the most common cause of death

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44
Q

Pleural effusions/pneumonia

A

Found in almost half of all cases of SLE

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45
Q

Drug therapy for a systemic lupus

A

Topical drugs like Cortizone cream, anti-malaria medication, Tylenol or NSAIDs, chronic steroid therapy, immunosuppressive agents like methotrexate

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46
Q

scleroderma (systemic sclerosis)

A

Chronic inflammatory autoimmune connective tissue disease that is not always progressive, hardening of the skin, has a higher mortality rate than SLE

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47
Q

Filtration

A

The movement of fluid through a cell or blood vessel because of hydrostatic pressure differences

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48
Q

Diffusion

A

Solutes move from higher concentration to lower concentration with no energy; important in transfer of most electrolytes and particles through cell membranes

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49
Q

Osmosis

A

Movement of water only through a selectively permeable membrane; thirst mechanism

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50
Q

Aldosterone

A

Secreted by the adrenal cortex when the ECF sodium level is decreased

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51
Q

Antidiuretic hormone

A

Vasopressin produced in the brain and stored in the pituitary. released by control of the hypothalamus in response to changes in blood osmolarity

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52
Q

Natriuretic peptide

A

Hormones secreted by cells in the atria and ventricles of the heart causing affects opposite of aldosterone

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53
Q

Fluid loss

A

Minimum amount of urine needed to excrete toxic waste products is 400 to 600 mL

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54
Q

1+ pitting edema

A

Slight indentation of 2 mm, normal contours, associated with interstitial fluid volume 30% above normal

55
Q

2+ pitting edema

A

Deeper pit after pressing 4 mm, last longer then one plus, fairly normal Contor

56
Q

3+ pitting edema

A

Deep pit 6 mm, remains several seconds after pressing, skin swelling obvious by General inspection

57
Q

4+ pitting edema

A

Deep pit 8 mm, remains for a prolonged time after pressing possibly minutes, Frank swelling

58
Q

Brawny edema

A

Fluid can no longer be displaced. No pitting,
tissue palpates as firm
Or hard, skin surface shiny warm moist

59
Q

Sodium

A

135 to 145; vital for skeletal muscle & cardiac contraction, nerve impulse transmission and normal osmolarity and volume of the ECF; positive and hangs with CL and opposes K

60
Q

Potassium

A

3.5-5; most dominant cation in ICF; regulates cellular excitability, assist skeletal and cardiac muscle contraction, neuromuscular transmission

61
Q

SUCTION

A

Occurs with hypokalemia; skeletal muscle changes, U wave, flattened T, depressed (ECG changes),
Constipation, toxicity of digoxin, irregular or weak pulses , orthostatic hypotension, numbness or Paresthesias

62
Q

3 P danger signs

A

For hypokalemia; paralytic ileus, paralysis of muscles including respiratory, pulse craziness including cardiac arrest

63
Q

Calcium

A

9.0-10.5; major cation in teeth and bones; Affects cell membrane permeability, acts as an enzyme activator within cells, aids coagulation

64
Q

Phosphorus

A

3.0-4.5; needed for activating vitamins and enzymes, forming ATP, assisting in cell growth and metabolism.

65
Q

Magnesium

A

1.3-2.1; critical for skeletal muscle contraction, carbohydrate metabolism, ATP formation, vitamin activation, cell growth

66
Q

STARVED

A

For hypomagnesium; seizures, tetany, anorexia, rapid heart rate, vomiting, emotional lability, deep tendon reflex is increased

67
Q

Chloride

A

98-106

68
Q

pH

A

Balance of hydrogen atoms (H+) to bicarbonate (HCO3)atoms in the blood

69
Q

Normal pH for arterial blood

A

7.35 to 7.45, arterial blood is alkaline

70
Q

Normal pH for venous blood

A

7.31 to 7.41

71
Q

Destruction of cells

A

Acids are released into the ECF

72
Q

Incomplete breakdown of glucose

A

When cells metabolize under anaerobic conditions; forming lactic acid or incomplete breakdown of fatty acid forming ketoacids

73
Q

Hyperventilation

A

When CO2 rises the respiration rate increases

74
Q

Hypo ventilation

A

When the H+ in the ECF is low CO2 level is low causing a decrease in respiration rate

75
Q

Kidney movement of bicarbonate

A

Renal mechanism where kidneys create bicarbonate as well as reabsorbed bicarbonate

76
Q

Formation of acid

A

Renal mechanism where excretion of hydrogen ions occur and increases the reabsorption of bicarbonate back in the blood

77
Q

Formation of ammonium

A

Renal mechanism which binds to the hydrogen ions for excretion in the urine

78
Q

PaCO2

A

35-45 mmHg

79
Q

PaO2

A

Greater than 70 mmHg

80
Q

HCO3

A

22-26 mmHg

81
Q

Base excess

A

Amount of H plus ions that would be required to return the pH of the blood to a normal limit if the PCO2 were adjusted to normal; +2 to -2

82
Q

Kussmaul respiration

A

Deep rapid involuntary breathing

83
Q

Normal serum osmolarity

A

270 to 300

Hypertonic: fluids greater than 300

Hypotonic: fluids less than 270

84
Q

Iso tonic infusate

A

Water does not move into or out of the body cells with no net transfer of fluid.

Pts receiving this are at risk for fluid overload
240-340 concentration

85
Q

Hypotonic infusate

A

Moves water into the cells and expands them which can cause swelling of the Venus pathway and inflammation

86
Q

Hypertonic infusate

A

Moves water out of the body’s cells and into the bloodstream

87
Q

Vascular access device (VAD)

A

Short peripheral catheters: superficial veins of the hand and forearm.

72-96 hours and then require removal and insertion into another site

Complains of tingling pins and needles and extremities or numbness can indicate nerve puncture

88
Q

Midline catheter

A

6 to 8 inches long, inserted through veins of the antecubital fossa.

Used for therapies lasting 1 to 4 weeks

Should not be used for infusion of vesicant or blistering medications

89
Q

Peripherally inserted central catheter (PICC)

A

40 to 65 cm, chest x-ray to determine placement the tip rest in the SVC

90
Q

Nontunneled percutaneous central catheter

A

15 to 20 cm long, inserted through subclavian vein in the upper chest or jugular veins in the neck, tip resides in SVC, placement confirmed by chest x-ray

91
Q

Tunneled.Central catheter

A

Used for infusion therapy that is frequent and long-term

92
Q

Implanted port

A

Consists of portal body, then septum, catheter.

Subcutaneous pocket is surgically created and the poor is placed in the upper chest or upper extremity

Port needs to be flushed after every use and at least once a month between courses of therapy

93
Q

Dialysis catheter

A

Used to accommodate the hemodialysis procedure or a pheresis procedure that harvest specific blood cells

Should not be used for administration of other fluids and medications

94
Q

Phlebitis and post infusion phlebitis

A

Inflammation of the vein after devices removed like a cord

95
Q

Thrombosis

A

Blood clot inside the vein

96
Q

Thrombophlebitis

A

Clot with the vein information

97
Q

Nerve damage

A

Transection of nerve

98
Q

Communicable pathogen

A

Ability to transfer disease to someone else can be infectious or contagious

99
Q

Pathogenicity

A

Ability to cause disease in someone

100
Q

Virulence

A

Degree in severity of the disease

101
Q

Colonization

A

Micro organism is present in the tissue but not yet causing symptomatic disease

102
Q

Gram-positive cocci

A

Staphylococcus aureus, skin infections, food poisoning, pharyngitis

103
Q

Gram-positive bacilli

A

Clostridium tetani (tetanus), clostridium botulism

104
Q

Gram-negative bacilli

A

Salmonella urinary tract infections, burn infections

105
Q

Spirilla

A

Acute enterititis, diarrhea, gastritis, peptic ulcer

106
Q

Contact transmission

A

Direct or indirect contact with items in the environment

c diff, mrsa, lice, scabies, VRE

107
Q

Droplet transmission

A

Organisms that can be in air and may travel up to 3 feet but is not suspended;

influenza, mumps, meningitis, h1n1

108
Q

Airborne transmission

A

Organisms that can be suspended in the air for prolonged periods of time;

Use negative airflow room and hepafilters

TB, varicella, measles

109
Q

Vector borne transmission

A

Involves insect or animal carrier; lyme disease, West Nile

110
Q

Inflammation

A

She’s become damaged, releasing neutrophils that are attracted to the affected side from the bloodstream

111
Q

Antibody mediated immune system (humoral immunity)

A

involves antigen to antibody interactions that neutralize, eliminate, or destroy foreign bodies

Produced by sensitized b-lymphocytes or B cells

Fluid immunity
Circulating antibody

112
Q

Cell mediated immunity (cellular immunity)

A

Involves many white blood cell actions and interactions, which are supplied by lymphocytes themselves that mature in the thymus and lymphoid tissues

Helps protect the body through the ability to differentiate self from nonself

Important in preventing the development of cancer and Mehta stasis after exposure to carcinogens

113
Q

Nosocomial or healthcare infection

A

Associated infections are infections acquired in the inpatient healthcare setting which were not present at admission

114
Q

Endogenous infection

A

Infection from clients Flora

115
Q

Exogenous infection

A

Infection is from outside the client, often from the hands of healthcare workers

116
Q

Sterilization

A

Kills all organisms

117
Q

Disinfection

A

Reduces the numbers of disease causing bacteria but does not kill spores

118
Q

Multi-drug-resistant organisms

A

Process where some infectious microorganisms have become resistant to previously effective antibiotics, becoming more difficult to treat

119
Q

MRSA

A

Multi-drug-resistant organisms that is commonly found on skin, perineum, nose;

Susceptible to vancomycin and linezolid

Community associate MRSA (prison, schools, dorms)

120
Q

Inflammation and immunity

A

To meet human needs protection by the neutralizing, eliminating, destroying organisms that invade the internal environment

121
Q

Human leukocyte antigen

A

Unique universal product code for each person, it is key for recognition and self tolerance

122
Q

Infection

A

Occurs in response to tissue injury and to the invasion of organisms;

Usually accompanied by inflammation

123
Q

Sequence of inflammatory responses

A

Warmth, redness, swelling, pain, decreased function

124
Q

Sequence of inflammatory responses (stages)

A 
Stage one (vascular): change in blood vessels 
Phase 1: constriction 
Phase 2: hyperemia and edema

Stage 2 (cellular exudate): neutrophilia, pus

Stage 3: tissue repair and replacement

125
Q

Innate native immunity

A

Natural immunity

126
Q

Adaptive active immunity

A

Natural active immunity (chicken pox)

Artificial active immunity (immunization)

127
Q

Passive immunity

A

Natural passive immunity (breast milk)

Artificial passive immunity (antibody injections)

128
Q

Hyper acute transplant rejection

A

Immediate response

129
Q

ACute transplant rejection

A

1 to 3 months after

130
Q

Chronic transplant rejection

A

When you get a chance plants, it’s reduced and function because of scar tissue, won’t work at 100%

131
Q

Treatment of transplant rejection

A

Maintenance is used after organ transplant, rescue therapy is used to treat acute rejection

132
Q

Polyarthritis

A

Early join changes similar to rheumatoid arthritis, small joints and knees are commonly involved

133
Q

CREST

A

Symptoms of scleroderma

Calcinosis (calcium deposits in the skin)

Raynaud’s phenomenon: spasm of blood vessels in response to cold or stress

Esophageal dysfunction: acid reflex and decrease in motility of esophagus

Sclerodactyly: thickening and tightening of the skin on the fingers and hands

Telangiectasias: dilation of capillaries causing red marks on surface of skin

134
Q

Arthralgia

A

Scleroderma manifestation: joint pain without inflammation or deformities

Med Surg Exam 1 (1 decks)

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