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med sure 2 > exam 1 med surg > Flashcards

exam 1 med surg Flashcards

1
Q

Physiologically, what should you avoid to not get a respiratory infection?

A

avoid trappage in mucocilliary and phagocytosis by alveolar macrophages

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2
Q

What is the only mode of transmission for a respiratory infection?

A

airborne transmission

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3
Q

What population is most likely to contract tuberculosis?

A

Homeless/incarcerated populations and people with HIV/AIDS

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4
Q

What is the mode of transmission for TB?

A

droplet

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5
Q

What are normally the clinical manifestations for someone with TB?

A

asymptomatic and noninfectious

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6
Q

What are clinical manifestations for someone who has symptomatic TB?

A

fatigue, weight loss, sweats, cough, bloody sputum

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7
Q

What are complications of TB?

A

bronchopleural fistula, meningitis, pleural effusions, bone disease, liver/kidney failure

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8
Q

What is the mode of transmission for influenza?

A

droplet transmission

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9
Q

What are the clinical manifestations of influenza?

A

fever, headache, sore throat, cough

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10
Q

What are the risk factors of pneumonia?

A

recent antibiotic therapy, immunosupression, chronic disease

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11
Q

What is pneumonia?

A

inflammation of the lung parenchyma from bacterial, viral, or fungal infection

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12
Q

What are the clinical manifestations of pneumonia?

A

altered mental status, >30 Resp, hypotension, >125 bpm, low/high temps, low pH, decreased Na

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13
Q

What are the complications of pneumonia?

A

empyema, sepsis, pneumothorax, respiratory failure

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14
Q

What are the diseases of the upper airway?

A

Rhinitis, obstructive sleep apnea, laryngeal trauma, rhinosinitis, laryngeal cancer

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15
Q

What is rhinitis?

A

inflammation of mucous membrane of nose in response to irritant

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16
Q

What are the clinical manifestations of Rhinitis?

A

itching, sneezing, congestion

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17
Q

What happens during obstructive sleep apnea?

A

upper airway narrows/collapses; increased resistance to airflow; hypoxemia, hypercapnia

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18
Q

What are risk factors for sleep apnea?

A

A-fib, type 2 diabetes, HF, men, obesity, smoking, alcohol, 40-65 y/o

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19
Q

What are the clinical manifestations of obstructive sleep apnea?

A

loud snoring, gasping during sleep, waking up a lot

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20
Q

Who is laryngeal trauma more common in?

A

men

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21
Q

How does laryngeal trauma occur?

A

Through injuries; ingestion/inhalation of causative agent; pressure from prolonged intubation

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22
Q

What is rhinosinitis?

A

Symptomatic inflammation of nasal/paranasal cavity; infection/inflammation of paranasal sinuses; nasal congestion, obstruction of airflow

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23
Q

What are the clinical manifestations of rhinosinitis?

A

purulent nasal drainage, facial pain, nasal obstruction

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24
Q

who is laryngeal cancer more common in?

A

men

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25
Q

What happens with your epithelial cells during laryngeal cancer?

A

Squamous cells line larynx, hypopharynx, and entrance to esophagus

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26
Q

What can cause cells to become more precancerous in laryngeal cancer?

A

irritants like alcohol and smoking

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27
Q

What are the clinical manifesations of laryngeal cancer?

A

hoarseness, change in voice, cough, sore throat, pain w/ swallowing, lump/mass in neck

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28
Q

What are the diseases of the lower respiratory airway?

A

asthma, cystic fibrosis, COPD, lung cancer

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29
Q

What do lower airway disease do?

A

negatively impact oxygenation, ventilation, and gas exchange

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30
Q

What is asthma?

A

reversible airway obstruction from inflammation

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31
Q

What happens to the muscles surrounding airways during asthma attacks?

A

they tighten

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32
Q

When the muscles tighten during an asthma attack what happens to those airways?

A

airway obstruction and hyper-responsiveness

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33
Q

What are the clinical manifestations of asthma?

A

Wheezing, dyspnea, coughing, increase in sputum, increase in respiratory rate

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34
Q

What is cystic fibrosis caused by?

A

Caused by defective gene carried by both parents

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35
Q

Cystic Fibrosis is a genetic disease of what glands?

A

exocrine glands

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36
Q

What is there a deficiency of with cystic fibrosis?

A

Protein

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37
Q

Because there is a deficiency in protein with cystic fibrosis, what occurs?

A

mucus build-up which blocks airways and GI as well as blocks pancreatic enzymes

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38
Q

What are the clinical manifestations of cystic fibrosis?

A

Cough, mucus, wheezing, lung infections, poor weight gain, blockage, constipation

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39
Q

What is the main issue with COPD?

A

airflow limitation that is progressive and not fully reversible

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40
Q

What is a disease that occurs in COPD?

A

emphysema (destruction of alveoli)

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41
Q

What are clinical manifestations of COPD?

A

increase work of breath, accessory muscle use, tripoding, skin change, cough, crackles, wheezing

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42
Q

What are risk factors for COPD?

A

smoking, occupational hazards, pollution

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43
Q

What is lung cancer?

A

Uncontrolled cell growth of abnormal cells

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44
Q

What are clinical manifestations of lung cancer?

A

cough, hemoptysis, SOB, Wheezing, hoarsness, chest pain

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45
Q

What is a pulmonary embolism?

A

blood clot in pulmonary artery

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46
Q

What happens with pulmonary embolisms?

A

high ventilation, low perfusion

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47
Q

What are risk factors for pulmonary embolisms?

A

obesity, smoking, fracture, trauma, heart disease, spinal cord injury

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48
Q

What are the clinical manifestations with pulmonary embolisms?

A

dyspnea, pleuritic chest pain, tachypnea

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49
Q

What are the 3 phases of acute respiratory distress syndrome?

A
  1. Exudate phase (24-48hours) inflammation of alveolar membrane
  2. proliferative phase
  3. fibrotic phase
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50
Q

What are the risk factors for ARDS?

A

sepsis, severe trauma, aspiration, smoking, bypass, overdose, PE

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51
Q

What are clinical manifestations of ARDS?

A

tachypnea, tachycardia

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52
Q

What are the two types of acute respiratory failure?

A

hypoxemic respiratory failure
hypercapnic respiratory failure

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53
Q

What are risk factors for ARF?

A

pulmonary edema, pneumonia, PE, Asthma, narcotics

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54
Q

What are clinical manifestations of hypoxemic respiratory failure?

A

Changes in respirations, change in HR, Change in BP

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55
Q

What are clinical manifestations of hypercapnic respiratory failure?

A

Headache, confusion, decrease in consciousness

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56
Q

What are the two types of chest trauma?

A

blunt force trauma, penetrating trauma

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57
Q

What are clinical manifestations of chest trauma?

A

decrease in oxygen and ventilation, impaired gas exchange

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58
Q

What are complications with chest trauma?

A

Pneumothorax, cardiac tamponade

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59
Q

location of AV valves

A

between atria and ventricles

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60
Q

location of semilunar valve

A

between ventricle and pulmonary/body

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61
Q

PR interval

A

depolarize atria

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62
Q

QRS interval

A

depolarize ventricles

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63
Q

QT interval

A

ventricles depolarizing and repolarizing

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64
Q

What is the order of the conduction system?

A

SA node
AV Node
Bundle of HIS
R and L bundle branches
Purkinje fibers

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65
Q

Depolarization

A

opening of Na channels

66
Q

Repolarization

A

closed Na channels and K out

67
Q

What are cardiac lab values that are vital in knowing?

A

lipid pannel (cholesterol, lipid density, trigycerides), creatinine, troponin, myoglobin, natriuretic peptide

68
Q

What is cardiac output?

A

HR x Stroke volume

69
Q

preload

A

blood in ventricle at the end of diastole

70
Q

afterload

A

resistance ventricle must overcome

71
Q

diastole

A

ventricles relaxed

72
Q

systole

A

ventricles contract

73
Q

Highest risk factor of cardiac dysrhythmias?

A

age

74
Q

Manifestations of cardiac dysrhythmias?

A

hypotension, sweating, shortness of breath, syncope

75
Q

sinus bradycardia

A

<60 bpm

76
Q

causes of sinus bradycardia

A

hypoxia, hypothermia

77
Q

Treatment for sinus bradycardia

A

beta blockers, Ca channel blockers

78
Q

Causes of arterial fibrillation

A

age, cardiomypathy, HTN, Pericarditis, obesity, diabetes

79
Q

treatment for Afib

A

control HR, cardiac abrasion, cardioversion

80
Q

atrial flutter

A

the heart’s upper chambers (atria) beat too quickly

81
Q

Causes of atrial flutter

A

acute MI, mitral valve disease, thyrotoxicosis, COPD

82
Q

treatment for atrial flutter

A

beta blockers, Ca channel blockers, digoxin, cardioversion

83
Q

ventricular tachycardia

A

the lower chamber of the heart beats too fast to pump well and the body doesn’t receive enough oxygenated blood

84
Q

What are the causes of ventricular tachycardia?

A

hypovolemia, hypoxia, acidosis, hyper/hypokalemia, hypoglycemia

85
Q

treatments for ventricular tachycardia

A

antiarrythmatic meds, electrolytes, cardioversion, resuscitation

86
Q

atrial fibrillation

A

an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart

87
Q

ventricular fibrillation

A

disorganized heart signals cause the lower heart chambers (ventricles) to twitch (quiver) uselessly

88
Q

causes of ventricular fibrillation

A

hypovolemia, hypoxia, acidosis, hyper/hypokalemia, hypoglycemia, MI, PE

89
Q

treatment for ventricular fibrillation

A

chest compressions, defibrillation

90
Q

idioventricular rhythm

A

SA and AV nodes fail

91
Q

causes of idioventricular rhythms

A

MI, post cardiac arrest, drug toxicity, electrolyte imbalance, myocarditis, cardiomyopathy

92
Q

What would you do during asystole

A

start CPR

93
Q

asystole

A

heart stops beating

94
Q

heart block

A

delay or block in conduction

95
Q

causes of heart block

A

acute coronary syndrome, electrolyte imbalance, med toxicities

96
Q

heart block can cause what

A

ischemia/death

97
Q

treatment for heart block

A

monitor, pacing, treat cause

98
Q

Risk factors for atherosclerosis

A

vessel damage, infammatory response, hard thickened vessels, plaque formation

99
Q

What causes atherosclerosis?

A

high cholesterol, high triglycerides (LDL)

100
Q

clinical manifestations of atherosclerosis

A

Mi, stroke, gangrene, cardiac death

101
Q

Peripheral artery disease risk factors

A

atherosclerosis

102
Q

What is peripheral artery disease?

A

obstruction of blood flow through large peripheral arteries, partial or total occlusion

103
Q

clinical manifestations of peripheral artery disease

A

diminished lower extremity pulses

104
Q

treatment for peripheral artery disease

A

anti-platelets, statins, angioplasty, atherectomy

105
Q

risk factors for aortic artery disease

A

men, family history

106
Q

What occurs with aortic artery disease

A

middle layer artery is weakened, stretching of inner layer, artery widens, tension increases

107
Q

clinical manifestations of aortic artery disease

A

asymptomatic till burst, thoracic or abdominal

108
Q

treatment for aortic artery disease

A

by controlling hypertension and repair or graft

109
Q

risk factors for hypertension

A

race, gender, socioeconomic status

110
Q

What does Na do with hypertension?

A

increases

111
Q

What happens to veins during hypertension?

A

vasoconstriction

112
Q

What does aldosterone do to cause hypertension?

A

increase stroke volume and blood pressure

113
Q

What does the SNS do during Hypertension?

A

promotes vasoconstriction

114
Q

what are the clinical manifestations of hypertension?

A

headache, chest pain, vision changes

115
Q

treatment for hypertension

A

lifestyle changes, diuretics, antihypertensives

116
Q

risk factors for carotid artery disease

A

smoking, hypertension, obesity

117
Q

What happens with carotid artery disease?

A

vessel wall thickening, plaque formation occluding coronary artery

118
Q

clinical manifestations of carotid artery disease

A

impaired profusion, stroke or TIA

119
Q

carotid artery disease usually does not present symptoms which means the patient is…

A

asymptomatic

120
Q

treatment for carotid artery disease

A

carotid endocardectomy, stenting

121
Q

risk factors for deep vein thrombosis

A

old age, cancer, varicose veins, pregnancy

122
Q

what happens to the rate of bloodflow with DVT

A

decreases

123
Q

deep vein thrombosis causes damage to what?

A

the vessel walls

124
Q

DVT increases the chances of a…

A

blood clot

125
Q

clinical manifestations of DVT

A

pain, swelling, redness, warmth

126
Q

what kind of monitoring can a nurse perform for cardiovascular dysfunctions?

A

hemodynamic monitoring

127
Q

what are ways to perform hemodynamic moniotring?

A

arterial catheter (BP), central venous catheter (R arterial pressure), pulmonary artery catheter (R heart function)

128
Q

What is cardiogenic shock

A

heart cannot contract, decrease in cardiac output

129
Q

what are the clinical manifestations of cardiogenic shock

A

chest pain, diaphoresis, nausea, vomiting

130
Q

treatment for cardiogenic shock

A

increase BP and CO, intra-aortic balloon, heart transplant mechanical support

131
Q

What is a myocardial infraction

A

destruction of heart muscle from lack of oxygenated blood supply

132
Q

what are clinical manifestations of MI

A

chest, shoulder, and arm pain

133
Q

what is a cardiomypathy?

A

structural changes to heart (weak, enlarged, thick or rigid), decrease in heart muscle function

134
Q

clinical manifestations fo MI

A

chest pain, dizziness, indigestion, nausea

135
Q

treatment for MI

A

Ace inhibitors, beta blockers, diuretics, pacemaker intervention (surgery)

136
Q

modifiable risk factors of coronary artery disease

A

high cholesterol, HTN, diabetes, obesity, smoking, activity

137
Q

non-modifiable risk factors of coronary artery disease

A

gender, race, heredity, age

138
Q

What process occurs during CAD that forms and occludes the coronary arteries?

A

atherosclerosis

139
Q

With CAD, what can occur if left untreated?

A

unstable angina, MI, sudden cardiac death

140
Q

What happens to blood flow as a result of CAD?

A

reduced blood flow and ischemic problems

141
Q

What are risk factors for myocarditis?

A

being a young men

142
Q

What happens during myocarditis?

A

damage to myocardium, virus is causative agent

143
Q

What are clinical manifestations of myocarditis?

A

heart failure, shock, angina, dyspnea, syncope

144
Q

Treatments for myocarditis

A

manage HF, dysrhythmias, immunsupressants

145
Q

What occurs with heart failure?

A

myocardial cell dysfunction, heart cannot meet bodys needs

146
Q

What are clinical manifestations of HF?

A

fatigue, weight gain, tachycardia, HTN/hypotension, murmur

147
Q

Complications with HF?

A

pulmonary edema (pink frothy sputum), renal failure

148
Q

Treatment for HF

A

beta blockers, diuretics, ace inhibitors, Ca channel blockers, digoxin, defibrillator

149
Q

What are risk factors for infective endocarditis?

A

age, immunodeficiency, drug use, diabetes, heart defect

150
Q

What happens with infective endocarditis?

A

infection of endocardium affecting heart valve (usually bacterial)

151
Q

Clinical manifestations of infective endocarditis

A

oslers nodes, janeway lesions, splinter hemorrhage, murmur, fever

152
Q

treatment for infective endocarditis

A

IV therapy, valve replacement/repair

153
Q

risk factors of pericarditis

A

non-ischemic chest pain, post MI

154
Q

what is pericarditis

A

inflammation of the pericardium

155
Q

clinical manifestations fo pericarditis

A

pleural chest pain, pericardial effusion, EKG changes, fever

156
Q

treatment for pericarditis

A

aspirin, NSAIDs, antiinflammatories

157
Q

What happens with valvular disease?

A

regurgitation, left or right sided heart failure

158
Q

clinical manifestations of valvular disease

A

murmur, SOB, crackles, angina, syncope, fatigue, edema

159
Q

treatment for valvular disease

A

ace inhibitors, diuretics, valve repair/replacement

160
Q

sinus tachycardia rate

A

> 100 bpm

161
Q

causes of sinus tachycardia

A

fever, anemia, hypovolemia, hypotension, PE, MI

162
Q

treatment for sinus tachycardia

A

beta blockers, Ca channel blockers

med sure 2 (5 decks)

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