Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MedSurg > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Palliative care

A

Care for seriously ill; includes psychosocial care, spiritual support, pain control, interdisciplinary collaboration
- “Anyone” can be on palliative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hospice care

A

Care for seriously ill; must accept death; illness not responding to curative care; strict reimbursement policies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Advanced directive

A

Oral and written instructions about end of life care, should the Pt become unable to
make decisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Durable power of attorney

A

A legal doc that authorizes an individual to make medical decisions on behalf of the
patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Living Will

A

Type of advanced directive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Physician Orders for Life-Sustaining Treatment

A

Translates the advanced directives into medical orders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Kubler-Ross Model

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cachexia

A

“Wasting syndrome”
A general state of ill health involving marked weight loss and muscle loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cheyne-Stokes breathing

A

An atypical pattern of breathing involving deep breathing followed by shallow breathing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Partial pressure

A

The pressure of a gas in a mixture
The exertion of the gas particles against the arteries in the alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Atelectasis

A

Collapsed alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tidal Volume

A

Normal volume of air that flows in and out in one breath
Includes dead space, or the air that sits in the bronchial tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Oxygenation

A

Obtaining oxygen from the air for gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ventilation

A

The movement of the walls of the thoracic cage
- Diaphragm moving up and down
- Ribs widening and relaxing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Elastic recoil

A

Lungs ability to return to it original size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Things that effect ventilation

A

Gravity: Pt sitting upright can breathe better
Airway blockage
Pt effort and strength
Compliance: Lungs ability to expand and contract
- Fibrosis, obesity, pneumothorax,
Resistance: Relationship between airflow and pleural pressure (determined by bronchi condition)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ventilation perfusion ratio

A

Amount of air getting to alveoli : amount of blood being sent to lungs
- AKA VQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What controls respirations

A

Chemoreceptors: Located in medulla, respond to hydrogen changes
- Chemoreceptors in carotid arteries respond to low oxygen
Mechanical receptors: Located in smooth muscle of lungs, upper airway, chest, and diaphragm; controls stretch and respiration or inhibits lung expansion
- Stimulated by irritants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Age related changes : defense system

A

Decreased cilia, decreased mucus, decreased cough and gag
Decreased protection against foreign invaders, increased risk of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Age related changes : Lungs

A

Narrowing airway, increased thickness of alveoli, decreased elasticity
- Increased airway resistance
- Decreased O2 levels, increased CO2 levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Age related changes : Chest

A

Decreased continuity of diaphragm, increased stiffness of thoracic cage
- Increased use of accessory muscles, harder to breath
- Barrel chest, kyphosis, SOB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tactile fremitus exam

A

Pt says “99” as you move palm of hand around pt’s back
Vibration increases over areas of congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Chest expansion exam

A

Chest should expand symmetrically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Normal breath sounds

A

Bronchial: Heard over the sternum, larynx and trachea
Bronchovescicular: Heard in center of chest
Vesicular: Heard over periphery of lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Crackles

A

Popping; usually first heard in base of lungs
- Ex. CHF, infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Wheezes

A

Whistling; usually heard in upper airway
- Ex. asthma - narrowing airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Stridor

A

Course/snoring;
- Ex. Obstruction, airway blockage, snoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Hyper-resonance

A

Increased loudness over areas of increased air
- Hyper-resonance bilaterally can indicate emphysema (air trapping)
- Hyper-resonance on one side may indicate pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Tympany

A

Loud, hollow, drum-like sounds
- May indicate pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What lab represents respiratory health?

A

CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What lab represents metabolic health?

A

Bicarbonate (HCO3)
- More = basic
- Less = acidic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Bronchoscopy

A

Lighted camera used to visualize the larynx, trachea, and bronchi
- Can get tissue sample or remove tumor/foreign body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Bronchoscopy nursing considerations

A
  • Pt NPO 48 hrs prior
  • Aspiration risk
  • Be sure gag reflex returns post-op before offering ice chips
  • Monitor pulse ox - high risk for perforation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Thoracoscopy

A

Light scope used to visualize pleural cavity
Enters between intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Thoracoscopy nursing considerations

A

Pt NPO at midnight
Look for signs of bleeding and infection
Monitor respiratory status (lung perforation risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Thoracentesis

A

Removing fluid from pleural space
Diagnostic or therapeutic (pleural effusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Nursing considerations post thoracentesis

A

Airway (!), SOB, pain, infection, drainage, redness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Tidal volume (TV)

A

Volume of air in each breath
- Spirometry can be used to measure this
- Measure several to get a range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Forced vital capacity (FVC)

A

Amount of air forced out with exhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How does asthma effect FVC?

A

They show a decrease of 15-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Nursing considerations before FVC test

A

NPO
Hold sedatives
Give any medications prior to testing
Light meal after
Avoid smoking for 3 days
Nose will be clipped during test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Forced expiratory volume in first second (FEV1)

A

Amount of air forced out of lungs in 1 second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Peak expiratory flow rate (PEFR)

A

Volume of air forcefully expelled from the lungs in one quick exhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Peak flow meter

A

Used by asthmatics to measure FVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Sputum culture nursing consideration

A

Best obtained in the morning before meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What does a chest xray (CXR) look for?

A

Foreign bodies, tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Fluoroscopy

A

Live xray view with camera; may use a dye
Views movement of the chest wall, diaphragm, or heart to locate masses
May be used during needle biopsy or bronchoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

CT

A

Cross section to see tissue density, tumors, abnormalities on bone that isn’t easily seen with chest xray
May be used with contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

MRI

A

Better for distinguishing normal/abnormal tissue (nodules, cancer, inflammation, or embolism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Angiography

A

Looks at the vasculature of the vessels with a radio-opaque dye
Looking at pulmonary embolism or thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Angiography nursing consideration

A

Check for allergy to shellfish or iodine
Check kidney function
Explain that a warm feeling or chest pain is normal when the dye is injected
Encourage fluids to excrete dye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

VQ Scan

A

Uses injected radio isotope to view blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Gallium scan

A

Uses an isotope to look for inflammation
Tumors, abscesses, adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

PET Scan

A

Uses an isotope to look at metabolic changes from malignancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Pneumoconiosis types

A

Silicosis
Asbestosis
Coal Miners Pneumoconiosis (CWP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Pneumoconiosis pathophysiology

A

Changing of lung tissue that occurs from inhaled particles
Lungs become fibrotic
- Symptoms may not show for 10-15 years after exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Silicosis

A

Inhaled silica - the primary ingredient in glass production
Nodules and fibrotic changes lead to lung disease and emphysema/pulmonary hypertension
Body tries to encapsulate the foreign particle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Silicosis s/sx

A

Does not present for about 5 years
SOB, fever, cough, weight loss
Can lead to heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Asbestosis pathology

A

Asbestos enters alveoli and becomes encased in fibrotic tissue which may lead to plaques
Gas exchange is impaired
Can lead to mesothelioma and other lung cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Asbestosis s/sx

A

SOB, dry cough, chest pain, weight loss, clubbed fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Coal Miners Pneumoconiosis (CWP) pathology

A

Macrophages encase the coal and become fibrotic, alveoli are filled with dust
Can lead to lesions, emphysema, respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Coal Miners Pneumoconiosis (CWP) s/sx

A

SOB, chronic cough, black or grey expectorant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Obstructive sleep apnea

A

Recurrent and repetitive upper airway obstruction
10 seconds or longer, at least 5 episodes per hour
Reduced ventilation or apnea during sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Obstructive sleep apnea risk factors

A

Male gender
Obesity
Post menopausal female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Obstructive sleep apnea pathology

A

Larynx is collapsible and can be compressed by surrounding soft tissue
Reduced upper airway during sleep
- Leads to hypoxia and hypercapnea, which causes hypertension and increased risk for MI or stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

3 S’s of obstructive sleep apnea characteristics

A

Snoring
Sleepiness
Significant other report of apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Obstructive sleep apnea s/sx

A

Daytime sleepiness, headache, irritability, weight gain, dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

How to dx obstructive sleep apnea

A

Sleep study with EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Deviated septum

A

Shift from midline
Usually from fracture from assault

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Deviated septum s/sx

A

Pain, bleeding, swelling, deformity, obstruction, crepitus
(AIRWAY)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Deviated septum and fracture tx

A

Avoid NSAIDs (risk for bleeding)
Pack nose and cold compress
Closed reduction (best done within 3 hours)
Rhinoplasty - reshaping exterior
Septorhioplasty - repairing deviated septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Epistaxis risk factors

A

Dry mucous membranes, hypertension, trauma, aspirin use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Epistaxis treatment

A

Anterior nose bleed: Pressure for 10 minutes, ice, tilt head forward, nasal decongestant spray (vasoconstrictor), silver nitrate cauterization, do not blow nose for 24 hours, avoid exercise
Posterior nose bleed:Emergent: packing placed for days, packing balloon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Packing balloon (epistaxis) nursing considerations

A

Assess respiratory status for distress
Give humidifier air/oxygen
Bed rest
Antibiotic (risk for toxic shock syndrome)
Pain medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Obstructive sleep apnea tx

A

Tonsillectomy, uvulopalatopharyngoplasty, nasal septoplasty
May need tracheostomy if not relieved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Deviated septum and fracture nursing considerations

A

Avoid NSAIDs (risk for bleeding)
Pack nose and cold compress
Clear liquid from nose could be cerebral spinal fluid
Monitor airway
Monitor for swallowing
Semi-fowlers to help with breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Allergic rhinitis

A

Can be seasonal (intermittent) or persistent (pet dander)
Caused by allergens, defects, or virus
May be associated with changes in temperature, humidity, or age
Allergens can be foods, medications, environmental particles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Acute viral rhinitis

A

Common cold; upper respiratory infection (URI)
Often occurs in fall, winter, and spring
Most common cold caused by “rhinovirus organism and influenza virus”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Allergic rhinitis tx

A

Remove allergen
Steroid, antihistamines, decongestants, pseudoephedrine, nasal spray (Flonase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Rhinitis from deformity tx

A

Remove nasal polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Viral rhinitis tx

A

Treat symptoms
Expectorant (Mucinex), steam, other meds similar to allergic rhinitis tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Influenza

A

Highly contagious respiratory illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Influenza patho

A

Virus that mutates, difficult to build immunity
Spread through infected droplets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

How to dx influenza

A

Cultures, nasal swab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Influenza s/sx

A

Abrupt onset, fever, chills, H/A, cough, sore throat, fatigue, SOB, crackles, weakness, lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Influenza tx

A

Prevent with vaccine (takes 2 weeks to work)
Tamiflu, antivirals, treat symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Rhinosinusitis and sinusitis patho

A

Inflammation of paranasal sinus and nasal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Rhinosinusitis/sinusitis causes

A

Mechanical obstruction (polyp or tumor)
Hormonal
Infectious
Chronic inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Rhinosinusitis/sinusitis classifications

A

Acute: acute bacterial or acute viral (edema, strep., influenza, or staph. grow easily)
Chronic: 8 weeks or longer of two or more symptoms
Recurrent: 4 or more episodes of acute bacterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Rhinosinusitis/sinusitis s/sx

A

Nasal congestion (due to inflammation or obstruction)
Drainage
Sinus pain
Pressure in periorbital area
Teeth/ear/nose pain
Transillumination shows blockage
Redness in nasal airway
Droopy eyelids from edema
Hoarseness
Headache around eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Difference between acute bacterial and acute viral rhinosinusitis

A

Acute bacterial: Lasts more than 10 days, accompanied by fever
Acute viral: Less than 10 days, no fever, lesser symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Rhinosinusitis dx

A

Xray or CT of sinuses
Culture and sensitivity of mucous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Rhinosinusitis tx

A

Viral: Treat symptoms
Bacterial: Antibiotic
Chronic: Treated for 2wks-12months; may have sinus surgery - functional endoscopic sinus surgery (FESS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What can untreated chronic rhinosinusitis lead to

A

Osteomyelitis, meningitis, or brain abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Pt education for rhinosinusitis

A

Recurrent - begin decongestants
When to see provider:
Periorbital edema or pain
Nuchal rigidity or high fever - immediate treatment, may be meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Nasal obstruction causes

A

Deviated septum
Bone
Polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Nasal obstruction s/sx

A

Mouth breathing, dry mouth, cracked lips, sleep deprivation, voice quality changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Nasal obstruction tx

A

Depends on cause:
Deviated septum - surgery
Polyps - corticosteroids for small ones, polypectomy for larger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Education for nasal obstruction post op

A

Avoid blowing nose
Watch for s/sx of bleeding and infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Pharyngitis

A

Sudden, painful inflammation of back of throat, back of tongue, tonsils, soft palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Causes of acute pharyngitis

A

Viral: Influenza, Epstein Barr virus, herpes
Bacterial: Strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Causes of chronic pharyngitis and types

A

Smoking, alcohol, dust, allergens
Hypertropic: generalized thickness of pharyngeal mucus membrane
Atrophic: late stage of first
Chronic granular: numerous swollen lymph follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Pharyngitis dx

A

Rapid antigen detection test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Pharyngitis s/sx

A

Inflammation, redness, bad breath, white exudate, enlarged lymph nodes
Bacterial: Temp over 101
Chronic: Complaints of fullness in throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Pharyngitis tx

A

Viral: Self limiting, 3-10 days (throat drops, gargling)
Bacterial: Antibiotic
Chronic: Tonsillectomy or remove irritant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What can untreated bacterial pharyngitis lead to

A

Meningitis and rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What patients are more at risk for strep throat

A

Those with a history of scarlet fever, rheumatic fever, or signs of an abscess
- Call doctor at first sign of pharyngitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Tonsillitis and Adenoiditis patho/cause

A

Acute:
Viral: Epstein Barr
Bacterial: Strep
Chronic: Can be mistaken for allergies, asthma, rhinosinusitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Tonsillitis and Adenoiditis s/sx

A

Sore throat, fever, snoring, enlarged adenoids, difficulty swallowing, ear infections, draining ears, bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Tonsillitis treatment

A

Viral: Supportive measures (throat drops, gargling, analgesics)
Bacterial: Antibiotics (PCN, cephalosporin)
Surgical removal: After repeated episodes despite ABX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What can bacterial tonsillitis/adenoiditis lead to if untreated

A

Otitis media, abscess, meningitis, rheumatic fever, nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Nursing considerations for tonsillitis/adenoiditis post op

A

Monitor for hemorrhage
Turn pt to side and elevate HOB to facilitate drainage
Provide ice chips and ice packs
No dairy, heat, or scratchy foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Peritonsillar abscess patho

A

“The Quincy”
Bacterial: staph
Suppurative (pus forming) complication of tonsillitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Peritonsillar abscess s/sx

A

Fullness in voice, displaced uvula, severe sore throat, fever, difficulty swallowing, ear pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Peritonsillar abscess tx

A

Needle aspiration
Antibiotics
Corticosteroids
Tonsillectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What can peritonsillar abscess lead to if left untreated

A

Intracranial abscess, empyema (infection of pleural space)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Laryngitis patho

A

Due to snoring, exposure to irritants (dust, chemicals, smoke), allergens, GERD, or infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Laryngitis classifications

A

Acute:
Viral: often same virus that causes common cold
Bacterial: may be secondary to other bacterial infection
Chronic: Can be mistaken for allergies, asthma, rhinosinusitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Laryngitis s/sx

A

Hoarseness, aphonia (complete loss of voice)
Sometimes worse in am, improves over day, and may worsen in evening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Laryngitis tx

A

Acute viral: Rest voice, avoid irritants, avoid smoking
Acute bacterial: Antibiotics
Chronic: Corticosteroids, GERD - PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Obstructive pulmonary disease patho

A

Preventable and slowly progressive
Changes in pulmonary vessels and narrowing in airway
Airway limitations due to chronic inflammation caused by thickening from fibrosis or scar tissue
Alveoli may have lost elasticity and recoil
Pulmonary veins and arteries can thicken and cause smooth muscle of the lung tissue to hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

What diseases are included in obstructive pulmonary disease

A

Bronchiectasis
Cystic fibrosis
Asthma
Chronic bronchitis
Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Bronchiectasis

A

Chronic irreversible dilation of bronchi and bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Bronchiectasis patho

A

Inflammation damages bronchiol wall, resulting in sputum
Sputum drains through the bronchi, then into lower lobes and alveoli
Causes reduced vital capacity and decreased ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Bronchiectasis causes

A

Airway obstruction
Congenital disorders - cystic fibrosis, childhood recurrent respiratory problems, measles, flu, immune deficiencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Bronchiectasis dx

A

CT scan: dilation of bronchioles
- Often misdiagnosed for chronic bronchitis
Sputum cultures - looking for Pseudomonas aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Bronchiectasis s/sx

A

Chronic productive cough with sputum
Possible hemoptysis
Clubbed fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Cystic fibrosis patho

A

Lethal genetic disease
Error of chloride transport, producing thick mucus with low water content
Mucus plugs up glands in lungs, pancreas, liver, salivary glands, and testes, causing atrophy and organ dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Cystic fibrosis dx

A

Sweat chloride analysis - increased sodium and chloride
GI enzyme evaluation - pancreatic enzyme deficiency
CXR - will show hyperinflation of lungs

130
Q

Cystic fibrosis s/sx

A

Chest congestion
Limited exercise tolerance
Sputum production
Use of accessory muscles
Decreased pulmonary function
Increased A:P diameter
Abdominal distention
Rectal prolapse/steatorrhea

131
Q

Nursing considerations for cystic fibrosis

A

Administer pancreatic enzymes with meals
Diabetic diet
Assess for s/sx of infection
Encourage fluids
Chest physiotherapy

132
Q

Comorbidities of cystic fibrosis

A

Vitamin deficiencies
DM: due to pancreatic enzyme deficiency
Osteoporosis
GERD

133
Q

Cystic fibrosis medication management

A

Mucolytics
Nebulized antibiotic
Inhaled hypertonic saline - hydration
Pancreatic enzyme therapy
Heliox therapy - helium + oxygen

134
Q

Cystic fibrosis surgical management

A

Lung or pancreas transplant

135
Q

What diseases fall under the COPD umbrella?

A

Chronic bronchitis
Emphysema
Irreversible or Refractory asthma

136
Q

Asthma

A

Chronic inflammatory disease of the airway that causes intermittent hyper responsiveness, mucosal edema and mucus
AKA Reactive Airway Disease

137
Q

Asthma exacerbation complications

A

Can be severe and life threatening
Acute episode of airway obstruction that intensifies
Complications: Pneumothorax, cardiac/respiratory arrest

138
Q

Asthma risk factors

A

Intrinsic: Sensitivity to NSAID’s or Aspirin, prone to respiratory infections, GERD, eczema

Extrinsic: Exposure to dust, pollen, and cigarette smoke

139
Q

Asthma patho

A

Allergen activates mast cell to release histamine, creating inflammation, increased blood flow, vasoconstriction, and bronchoconstriction
Also attracts WBC’s and mucus to the area

140
Q

Ways an airway obstruction occur in asthma

A

Reversible inflammation of pulmonary airway: Response to cold air, allergen, irritant
Airway hyper-responsiveness: Bronchoconstriction during exercise, GERD, or respiratory illness

141
Q

Asthma s/sx

A

Chest tightness, wheeze with inspiration, increased RR, SOB, cough, use of accessory muscles, “barrel chest” from air trapping, long breathing cycle, cyanosis, hypoxemia, tachycardia, changes in LOC

142
Q

Asthma dx

A

CXR
Pulmonary function tests
ABGs

143
Q

Asthma nursing considerations

A

Asthma action plan - diff medication plan for “green”, “yellow”, and “red” days
Educate:
Avoid triggers
Raise HOB - GERD
CPAP - sleep study if pt is snoring

144
Q

Bronchodilators used for asthma

A

Short and long-acting beta2 agonists (Ventolin/Serevent)
Cholinergic antagonists (Spiriva)
Methylxanthines

145
Q

Anti-inflammatory drugs used for asthma

A

Corticosteroids (Flovent, Pulmacort)
Leukotriene antagonists (Singular)
Cromones
Immunomodulators (Xolair)

146
Q

Combination drugs used for asthma

A

Long acting beta 2 and corticosteroid (Advair Diskus)

147
Q

Other drugs used for asthma

A

Mucolytics, antibiotics, vasodilators, A1A treatment, vaccines

148
Q

**Meter Dose Inhaler considerations

A

Timing has to be accurate - spacer
Rinse mouth after use

149
Q

**Dry Powder Inhaler considerations

A

Rapid inhaled delivery - must take deep breath

150
Q

Status asthmaticus

A

Complication of asthma
Rapid and persistent asthma exacerbation
EMERGENT

151
Q

Status asthmaticus s/sx

A

Labored breathing, wheezing, unable to speak, drowsy/coma, poor respiratory effort, bradycardia, paradoxical thoraco-abdominal breathing, silent chest, cyanosis, oxygen sat under 92%

152
Q

Status asthmaticus dx

A

ABGs
Pulmonary function tests (PFTs)

153
Q

Status asthmaticus tx

A

Short acting beta-adrenergic agonist nebulizer, steroid

154
Q

Chronic bronchitis and emphysema risk factors

A

Smoking, second-hand smoke, dust, chemicals, pollution, history of respiratory illness, allergies, asthma, polyps
A1A deficiency: genetic condition associated with emphysema

155
Q

Chronic bronchitis and emphysema assessment findings

A

SOB, barrel chest, clubbing, accessory muscle use, coughing, peripheral edema, anxiety

156
Q

Chronic bronchitis and emphysema dx

A

ABGs
Spirometry
Pulmonary function tests (PFTs)
CXR

157
Q

Chronic bronchitis and emphysema complications

A

Respiratory failure, hypoxemia, acidosis, respiratory infections (pneumonia), cardiac failure, dysrhythmias

158
Q

Chronic bronchitis s/sx

A

Chronic cough with sputum, dusky/cyanotic color, hypercapnia, increased RR, exertional dyspnea, clubbing

159
Q

Chronic bronchitis patho

A

Chronic irritants that produce mucous, which interferes with the cilia
Bronchioles and alveoli may become irreversibly damaged and fibrotic
Pt is susceptible to infections from increased macrophages

160
Q

Chronic bronchitis nursing considerations

A

O2 therapy
Conserving energy
Long term steroids and mucolytics
Assess for infections
Educate pt to get pneumonia vaccine
Stop smoking

161
Q

Emphysema

A

Chronic progressive lung disease
Impaired gas exchange that results in over distention and destruction of alveoli
Pulmonary veins resist blood flow causing pulmonary artery hypertension (Cor pulmonale-right sided HF)

162
Q

Panlobular vs Centrilobular emphysema

A

Panlobular: Bronchioles, alveolar ducts, and alveoli and enlarged
Centrilobular: Enlarged alveoli lobes

163
Q

Emphysema s/sx

A

Hypercapnia, purse lip breathing, hyperresonance on chest percussion, thin appearance, barrel chest, increased RR

164
Q

Emphysema tx

A

Bronchodilators: Short acting (albuterol) and Long acting (bromides)
Corticosteroids
Lung reduction surgery: removes hyper-inflated lung tissue

165
Q

COPD exacerbation

A

Acute change or worsening of symptoms
Cor pulmonale, worsening cyanosis, peripheral edema, SOB, confusion, lethargy

166
Q

COPD exacerbation causes

A

Need for new medication management
New allergen or season

167
Q

**COPD exacerbation tx

A

Oxygen - for severe only, watch for toxicity (O2 sat 90-95%)
Surgery - Bullectomy: removes enlarged airspaces, Lung Volume Reduction: removed damaged lung tissue, Lung transplant

168
Q

Types of chest physiotherapy

A

Postural drainage: Changing positions to loosen secretions
Chest percussion/vibration: Cupping hands, lightly strike chest wall
Breathing retraining: Pursed lip and diaphragmatic breathing
Incentive spirometry

169
Q

Oxygen delivery methods

A

Low Flow
Nasal cannula: 1-6L
Face mask: 6-12 L
Partial/Non Rebreather: 10-15L
Non-Invasive Positive Pressure Ventilation:
CPAP/BiPAP
High Flow
Venturi mask: measured in oxygen %
Trach collar/T tube
High flow nasal cannula: Max 60L, 100%

170
Q

Trach cuff pressure

A

Check Q8h
Should be 15-22 mmHg or 20-25 cmH2O

171
Q

During what part of the cardiac cycle does the heart receive oxygenation

A

Diastole

172
Q

Layers of the heart

A

Outer - pericardium
Middle - myocardium
Inner - endocardium

173
Q

Layers of pericardium

A

Visceral layer - epicardium
- Fluid between these layers
Parietal layer - outer layer

174
Q

Cardiac conduction pathway

A

Sinoatrial node (SA node) - 60-80 bpm
Atrioventricular node (AV node) - 40-60 bpm
Bundle of HIS
Purkinje fibers - stimulates ventricular contraction - 30-40 bpm

175
Q

P wave represents

A

SA node

176
Q

Depolarization =

A

Discharged energy

177
Q

Repolarization =

A

Rest

178
Q

Cardiac cycle

A

of cardiac cycles = HR

All events that occur from one beat to the next
Number of cardiac cycles = HR

179
Q

Atrial kick

A

Atria push 15-20% more blood just before the ventricles contract

180
Q

Cardiac output

A

Stroke volume x heart rate
Total amount of blood pumped by the left ventricle in liters per minute
4-6L per minute is normal

181
Q

Stroke volume

A

Amount of blood ejected by the left ventricle during one contraction

182
Q

What affects stroke volume

A
  1. Baroreceptors: In aortic arch and carotid arteries, affect vasoconstriction and dilation
  2. Preload and afterload
183
Q

What affects heart rate

A

SA node gets info from the parasympathetic and sympathetic NS to adjust HR

184
Q

Preload

A

How much cardiac muscle fibers can stretch during diastole

185
Q

Afterload

A

Resistance the ventricles must overcome to eject blood out of the heart

186
Q

Contractility

A

The strength of myocardium contraction
Reduced by hypoxemia, acidosis, and medications such as beta blockers

187
Q

Ejection fraction

A

% of blood ejected from the heart at the end of each beat
LV ejects 55-65% (40% = HF)

188
Q

S3 might mean

A

Ventricular gallop

189
Q

S4 might mean

A

Atrial gallop

190
Q

CK

A

Creatine kinase
Cardiac enzyme
Found in brain, heart, and skeletal muscle

191
Q

CK-MB

A

Creatine kinase-myocardial band
Cardiac enzyme
Heart specific
After MI shows rise and fall over 3 day period, peaks at 24 hours

192
Q

Troponin

A

Protein that represents cardiac necrosis

193
Q

Myoglobin

A

In cardiac and bone
Rises 30-60 minutes after MI, declines after 7 hours

194
Q

BNP

A

B-type natriuretic peptide
Neurohormone that regulates BP and fluid volume
>100 = HF

195
Q

C-reactive protein

A

Produced in liver
Shows inflammation
3 or > = CVD

196
Q

Homocysteine

A

Amino acid linked to atherosclerosis
>15 = CAD risk, stroke, PVD

197
Q

PT/INR

A

Prothrombin Time
For pt taking Coumadin (warfarin)

198
Q

PTT

A

Partial prothromin time
For pt on heparin

199
Q

Erythrocyte sedimentation rate

A

Indicates inflammation

200
Q

AP and lateral CXR

A

Shows size and position of heart
Calcifications
Can show HF

201
Q

Fluoroscopy

A

Dye used with xray to show heart as it is moving

202
Q

Myocardial perfusion testing

A

Isotope via IV to look at blood flow perfusion

203
Q

Multiple-Gated Acquisition (MUGA) scan

A

Radio isotope is used to take pictures
Measures ejection fraction

204
Q

CT scan for cardiac dx

A

Evaluates ventricle wall for thickness, lesions, tumors, masses, calcium deposits
May or may not use dye (kidney function and allergies)

205
Q

Calcium score

A

Determines risk for future cardiac event

206
Q

Positron Emission Tomography (PET) scan nursing consideration

A

No tobacco or caffeine for 4 hours before
Diet before depends on facility
Glucose need to be WNL

207
Q

Magnetic Resonance Angiography (MRA) what is it and nursing considerations

A

Magnet to look at heart, pericardium, great vessels, and lesions
Can’t be done on pts with pacer or metal

208
Q

Cardiac catheterization and angiography

A

Radiopaque iodine dye used to visualize arteries
Looks for CAD, atherosclerosis, valve disease

209
Q

Cardiac catheterization and angiography nursing considerations

A

Monitor ECG and BP during procedure
Check for allergies and kidney function (use of dye)
NPO 8-12 hours before
Pt may feel palpitations as catheter is inserted
Radial artery - pressure for 2 hours, Femoral artery - manual pressure for 30 minutes

210
Q

Electrophysiologic testing

A

Evaluation of AV node and dysrhythmias if ECG isn’t enough

211
Q

Electrophysiologic testing nursing considerations

A

NPO for 6-8 hours
Explain procedure
Lasts 1-4 hours
Pressure on puncture site

212
Q

Cardiac mapping

A

Shows electrical cells firing in addition to SA and AV nodes
Mapping will locate the origin of arrhythmias

213
Q

Radiofrequency ablation for arrhythmias

A

Uses radiofrequency energy to destroy the heart tissue that is causing rapid and irregular heartbeats
Helps restore your heart’s regular rhythm
Catheter through femoral artery into heart

214
Q

Radiofrequency ablation nursing considerations

A

Leg straight for 6-8 hours
Monitor pulse and BP
Teach to report pain or bleeding at puncture site and chest pain

215
Q

Central Venous Pressure Monitoring (CVP)

A

Used to monitor right ventricular functioning
2-6 mmHg, 6+ = elevated LV preload
*don’t need to know details

216
Q

Pulmonary Artery Pressure Monitoring (PAPM)

A

Monitor and assesses LV function - measures cardiac output
Used to assess the patients response to IV fluids, medications, and interventions
*don’t need to know details

217
Q

Systemic or Intra-arterial Blood Pressure Monitoring (SAPM)

A

For continuous BP monitoring for patients with high or low BP and when frequent ABG’s are needed

218
Q

Hypertension dx

A

Urinalysis
Labs (sodium, potassium, BUN, creatinine, lipids)
Renin levels
24 hours urine
EKG

219
Q

HTN s/sx

A

“silent killer” - sometimes no symptoms
Retinal damage
Nocturia
H/A, flushing, dizziness
TIAs (transient ischemic attacks)
Chest pain
Intermittent claudication (muscle pain with activity)

220
Q

HTN complications

A

CAD, left ventricular hypertrophy, HF, resistant HTN, orthostatic hypertension, hypertensive crisis (180+/120+)

221
Q

Coronary artery disease

A

Blockages of one or more of the arteries that supply the heart
- Usually due to arteriosclerosis and atherosclerosis

222
Q

Arteriosclerosis

A

Thickening or hardening of arterial wall
- often associated with aging

223
Q

Atherosclerosis

A

Intima accumulates with lipids, calcium, and carbs to make plaque

224
Q

Two types of lesions (CAD)

A
  1. Fatty streaks: Yellow and smooth, protrude slightly into the lumen
  2. Fibrous plaques: Whiteish, sometimes completely protrude into the lumen; often in abdominal aorta
    - Plaques form over fatty streak
    - Plaques are either stable or unstable
225
Q

Collateral circulation

A

Capillaries form around a clot to provide circulation

226
Q

Peripheral arterial disease (PAD)

A

Thickening of arterial wall due to atherosclerosis

227
Q

Peripheral arterial disease risk factors

A

Hypertension, hyperlipidemia, DM, smoking, obesity, family hx

228
Q

Lower extremity occlusion s/sx

A

Pain, intermittent claudication (calf pain with activity, worse at night, better with dangling legs)

229
Q

Peripheral arterial disease dx

A

Doppler
Angiography

230
Q

Aortoiliac occlusive disease

A

Form of PAD
Blockage of abdominal aorta as it transitions into the common iliac arteries

231
Q

Aortoiliac occlusive disease s/sx

A

Butt or low back pain associated with walking
Men - impotence

232
Q

Aortoiliac occlusive disease dx

A

Doppler
Angiography

233
Q

Aortoiliac occlusive disease tx

A

Aortoiliac and Aortofemoral bypass

234
Q

Aortoiliac occlusive disease nursing consideration

A

Surgery interventions
Abdominal assessment - returned bowel sounds in 3 days, NGT secretions, post op care, advance diet slowly

235
Q

Doppler ultrasound flow study

A

Transducer probe detects blood flow and measures pressure in lower extremities at different intervals to determine inflow vs outflow disease
- Use Doppler if having trouble obtaining pulse
- More useful when combined with ankle blood pressure to determine ABI

236
Q

Ankle-brachial index (ABI)

A

The ratio of systolic BP in the ankle compared to both arms

237
Q

Duplex ultrasonography

A

Doppler showing color flow
Non invasive
NPO for 6 hours - for decreased abdominal gas which can interfere with test

238
Q

Arteriogram

A

Radiopaque dye injected into arterial system to watch blood flow
Used to visualize aneurysms and collateral circulation

239
Q

Venogram

A

Radiopaque dye injected into venous system to watch blood flow

240
Q

Lymphoscintigraphy

A

Radioactive colloid to study lymphatic system

241
Q

C reactive protein

A

A protein produced in the liver
Nonspecific marker of inflammation
Increase is associated with vascular damage

242
Q

Arterial disease s/sx

A

Decreased/absent peripheral pulse
NO LE edema
Loss of hair, shiny, cool skin
Dependent rubor
Extremity is cool/blue
Pallor with elevation
Bruit

243
Q

Venous disease s/sx

A

LE edema
Peripheral pulses present but different due to edema
Skin is thick and warm, thick toenails

244
Q

What patients should not take statins/niacin

A

Patients with liver disease - can cause muscle pain and elevated liver enzymes

245
Q

Peripheral vascular/arterial disease nursing considerations

A

Antiplatelet medications
Exercise and positioning - exercise to point of pain then rest
**Vasodilation - socks, but NOT heating pad (numbness) **
Percutaneous transluminal angioplasty (PTA)
Foot care

246
Q

Percutaneous transluminal angioplasty (PTA)

A

Balloon catheter through groin towards occlusion and scrapes the plaque

247
Q

Surgical management techniques for PAD

A

Inflow procedures: Improves blood flow from aorta into femoral artery
Outflow procedures: Provides blood supply to vessels below femoral artery
Endarterectomy: Removal of plaque from internal layer of artery
Femoral popliteal bypass: Reroute blood flow around stenosis
Axillofemoral bypass: Reroute blood flow around stenosis

248
Q

Radiological intervention for an isolated lesion

A

Percutaneous transluminal angioplasty (PTA) and stent graft

249
Q

6 P’s for PAD

A

Pain
Pallor
Pulselessness
Paresthesia (numb skin)
Paralysis
Poikilothermia (inability to maintain temperature)

250
Q

Nursing consideration for PAD post op

A

Ankle-brachial pulse (ABI) Q8H for first 24 hours then QDay
Compartment syndrome - swelling that reduces circulation

251
Q

Thromboembolism

A

Can be arterial or venous

252
Q

Thromboembolism causes

A

Afib
MI
HF
Endocarditis
Less common: Crush injury, fracture, or penetrating wound

253
Q

Thromboembolism patho

A

Lack of blood flow doesn’t allow for clearing of vessels

254
Q

Thromboembolism complications

A

Breaks off and becomes embolism (blood or fat)
Travels to brain, heart, lungs, extremities
Gets caught in biforcation of arteries or spots of atherosclerosis

255
Q

Thromboembolism s/sx

A

Depends on size/location
Change in the 6 P’s

256
Q

Thromboembolism dx

A

CXR
TEE (transesophageal echo)
ECG
Doppler ultrasound

257
Q

Thromboembolism tx

A

Depends on cause
Heparin
Fibrinolytics/Thrombolytics (TPA)
Embolectomy/thrombectomy: for more emergent, if pt cannot tolerate slow therapy

258
Q

Pulmonary embolism patho

A

Ischemic disorder of the veins of the lungs
Can be life threatening

259
Q

Pulmonary embolism s/sx

A

SOB, chest pain, tachypnea, tachycardia

260
Q

Pulmonary embolism dx

A

CXR, Vqscan, angiogram, D-dimer

261
Q

Pulmonary embolism nursing consideration

A

Raise HOB, apply O2, call rapid response team

262
Q

Pulmonary embolism tx

A

Heparin, clot busters
Coumadin for 6 months
Prevent with compression hose, anticoagulants

263
Q

Buerger’s disease patho

A

Occlusive arterial disease resulting in fribosis and scarring of vessels and nerves

264
Q

Buerger’s disease cause

A

Unknown, but associated with smoking

265
Q

Buerger’s disease s/sx

A

Pain due to inadequate blood supply
Discolored finger tips

266
Q

Buerger’s disease tx and nursing considerations

A

Smoking cessation halts progression
Promote vasodilation
Pain control
Manage ulcerations or gangrene

267
Q

Raynaud’s phenomenon patho

A

Intermittent arterial vasoconstriction in fingers/toes
Defect in basal heat production that decreases ability of vessels to dilate

268
Q

Raynaud’s phenomenon forms

A

Primary/idiopathic: Independent of comorbidities
Secondary: Occurs in association with underlying disease, such as lupus, rheumatoid arthritis, trauma

269
Q

Raynaud’s phenomenon triggers

A

Emotional, stress, cold temperatures

270
Q

Raynaud’s phenomenon s/sx

A

Coldness, pain, numbness, pallor, cyanosis

271
Q

Raynaud’s phenomenon tx

A

Calcium channel blocker - if severe

272
Q

Raynaud’s phenomenon nursing considerations

A

Keep core warm
Avoid triggers
Use gloves
No heating pads if pt is in vasoconstriction

273
Q

Aortic aneurysm patho

A

Dilation or sac at a weak point in artery

274
Q

Aortic aneurysm forms

A

Fusiform: entire portion of vessel out pouches
Saccular: protrusion on one side of vessel
Mycotic: small, localized aneurysm

275
Q

Aortic aneurysm causes

A

Atherosclerosis in aorta

276
Q

Aortic aneurysm risk factors

A

HTN, hyperlipidemia, smoking
Age, gender, family hx, Marfan’s syndrome

277
Q

Aortic aneurysm common locations

A

Thoracic aortic
Abdominal aortic

278
Q

Aortic aneurysm s/sx

A

Some are asymptomatic
Abdominal, flank, back pain - gnawing quality

279
Q

Aortic aneurysm dx

A

CT scan, xray, duplex ultrasound

280
Q

Aortic aneurysm tx

A

Modifiable life changes
Anti hypertensives
Surgery: Thoracic endograft

281
Q

Aortic aneurysm nursing consideration

A

Observe for sign of rupture in peritoneal cavity - sudden, severe back pain; most common complication; life threatening
Watch kidney function post op
Monitor cardiac status, BP, hemorrhage, s/sx infection

282
Q

Aortic dissection patho/causes

A

Caused by poorly controlled HTN, blunt chest trauma, cocaine use, atherosclerosis, CT disorders - Marfan’s, aortic aneurysms - weaken aortic wall

283
Q

Aortic dissection s/sx

A

Tearing chest pain, sweating, N/V, fainting, tachycardia, apprehension/feeling of impending doom, rapid hypotension, decreased/absent pulses in LE, unequal BP

284
Q

Aortic dissection dx

A

CT, MRA, duplex ultrasonography

285
Q

Aortic dissection tx

A

Modifiable life changes
Anti hypertensives
Surgery: Thoracic endograft, stent
*same as aneurysm

286
Q

Thoracic endograft nursing considerations

A

Observe for sign of rupture in peritoneal cavity - sudden, severe back pain; most common complication; life threatening
Watch kidney function post op
Monitor cardiac status, BP, hemorrhage, s/sx infection
*same as aneurysm

287
Q

Venous thromboembolism (VTE) or deep vein thrombosis (DVT) causes/risk factors

A

Virchow’s triad: Venous stasis, vascular/endothelium damage, hypercoagulation

288
Q

Venous thromboembolism (VTE) or deep vein thrombosis (DVT) s/sx

A

Calf pain, groin tenderness, swelling in one leg, warmth, bluish color

289
Q

Venous thromboembolism (VTE) or deep vein thrombosis (DVT) dx

A

Venous flow studies, VQ scan, D-dimer

290
Q

Venous thromboembolism (VTE) or deep vein thrombosis (DVT) tx

A

Anticoagulants, thrombolytics, heparin, Coumadin
Vena Cava filter: Greenfield filter, placed as the clot is removed

291
Q

Venous thromboembolism (VTE) or deep vein thrombosis (DVT) nursing considerations

A

Evaluate anticoagulation therapy - monitor PT/INR PTT, platelets, signs of bleeding
Elevate LE
Pain meds
Compression stockings, SCD’s
Early ambulation
Cough, deep breathing
Educate pt to monitor for signs of PE

292
Q

Varicose veins patho

A

Abnormally dilated veins

293
Q

Varicose veins s/sx

A

Cramps, edema, protrusion of vein

294
Q

Varicose veins dx

A

Duplex ultrasound

295
Q

Varicose veins tx

A

Ligation, stripping: Cut or remove vein
Ablation: Electrical heat to decompress vein
Sclerotherapy: Chemically shrinking

296
Q

Chronic venous insufficiency patho

A

Valves in veins get damaged by obstruction or reflux
Veins have thin walls so venous pressure causes veins to distend
Valves in distended veins don’t meet each other to close, so blood backflows and pools

297
Q

Chronic venous insufficiency s/sx

A

Pain, swelling, change in color, less symptoms in morning worse in daytime

298
Q

Chronic venous insufficiency complications

A

Cellulitis
Leg ulcers

299
Q

Chronic venous insufficiency nursing consideration/tx

A

Compression stocking, avoid extreme temperature, warm packs to promote circulation

300
Q

Leg ulcer patho

A

Poor oxygenation leads to cell death

301
Q

Leg ulcer s/sx

A

Arterial ulcer: Intermittent claudication - pain with activity, continuous pain, smaller ulcer, deep, tips or webs of toes
Venous ulcer: Achy pain, foot/ankle edema, larger wounds, extravasation, fluid, exudate, sides of feet/ankles

302
Q

Leg ulcer tx

A

Compression stocking
Debridement with dressing changes
- Surgical
- Enzymes on dressing
- Wound vac

303
Q

Lymphangitis

A

Acute lymph channel inflammation

304
Q

Lymphadenitis

A

Large, red, tender lymph node

305
Q

Lymphangitis and Lymphadenitis cause

A

Infection from strep

306
Q

Lymphangitis and Lymphadenitis s/sx

A

Red streak up arm/leg from infected lymph system

307
Q

Lymphangitis and Lymphadenitis tx

A

Antibiotic

308
Q

Lymphedema patho

A

Tissue swelling due to increased lymph fluid
Due to blockage in drainage fluid (congenital or trauma - breast CA)
Chronic swelling leads to elephantiasis

309
Q

Lymphedema tx/nursing considerations

A

Compression socks
Diuretics (Lasix)
Elevation
Surgery to remove tissue, followed by skin graft - infection, rejection

310
Q

Cellulitis patho

A

Bacterial infection in subcutaneous tissue

311
Q

Cellulitis s/sx

A

Localized swelling, redness, pain, fever, chills, sweating
Regional lymph nodes may be tender and enlarged

312
Q

Cellulitis tx

A

Antibiotic
Severe: inpatient treatment

313
Q

Stroke types/patho

A

Change in normal blood supply to brain - brain tissue dies (infarction)

314
Q

Stroke causes

A

HTN
Arteriovenous malformation (AVM)

315
Q

Stroke types/classifications

A

Ischemic: Blockage of cerebral artery from thrombus (gradual) or embolus (abrupt)
Hemorrhagic: Vessel integrity is interrupted, leaks into brain space

316
Q

Ischemic stroke causes

A

HTN, afib, dysrhythmias, murmurs

317
Q

Hemorrhagic stroke causes

A

Aneurysm, vasospasm, AVM

318
Q

Stroke s/sx

A

Motor changes: Hemiplegia, hypotonia/hyporeflexia, hypertonia/hyperflexia, dysphagia, akinesia
Communication changes: Aphasia, dysphasia, agraphia, dysarthria
Cognitive changes: L damage = ride side impairment, R damage = left side impairment
Sensory changes: Agnosia, apraxia

319
Q

Stroke dx

A

CT scan - better for hemorrhagic stroke
MRI - better for ischemic stroke, after 24 hours ischemia and edema will start to show

320
Q

Stroke tx

A

Endartectomy: Remove thrombus
Embolectomy: Remove embolus
Fibrinolytics

MedSurg (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions