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MedSurg > Exam 2 Review for Finals > Flashcards

Exam 2 Review for Finals Flashcards

1
Q

GERD risk factors

A
  • *Hiatal hernia
  • *Obesity
  • Lower esophageal sphincter hypotension
  • Loss of esophageal motility
  • Increased states of gastric secretion (Zollinger-Ellison Synd)
  • Delayed emptying of gastric contents (diabetes)
  • Pregnancy, eating large meals
  • Ascites
  • Tight belts or girdles
  • NG tube
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2
Q

GERD complication: Barrett’s esophagus

A
  • Squamous epithelium replaced w Barrett’s epithelium
  • More resistant to acid
  • High propensity for malignancy –> esophageal CA
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3
Q

GERD atypical chest pain management

A

Caused by esophageal spasm
*CARDIAC assessment

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4
Q

Peptic Ulcer Disease risk factors

A
  • H. Pylori
  • NSAIDS
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5
Q

PUD complications

A
  • *Gastric adenocarcinoma (H Pylori)
  • GI hemorrhage
  • Abd or intestinal infarction
  • Perforation & penetration into attached structures
  • Obstruction
  • Peritonitis
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6
Q

PUD medications

A
  • Antacids: neutralize acids
  • H2 receptor antags: decrease acid prod
  • PPI: block acid prod
  • Sucralfate: enhance mucosal defenses by binding to necrotic ulcer tiss & serving as barrier
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7
Q

Which Hep viruses have vaccines?

A

Hep A, Hep B

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8
Q

Hep A transmission

A
  • Fecal
  • Oral
  • Contaminated food/water
  • Close contact w infected persons
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9
Q

Hep B transmission

A
  • Blood
  • Bodily fluids
  • Vertical transmission
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10
Q

Hep C transmission

A
  • Blood
  • Bodily fluids
  • Vertical transmission
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11
Q

HD basic process

A
  • Blood pumped from body to dialyzer
  • Blood moves across semipermeable memb
  • Concentration gradient causes diffusion, excess fluid removed via hydrostatic press
  • “Clean” blood moved back to vascular access
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12
Q

PD basic process

A

At peritoneal cavity
- Dialysate instilled into peritoneal cavity, remains w waste & electrolytes diffusing into dialysate
- Gravity drains fluid out of peritoneal cavity into sterile bag

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13
Q

Urolithiasis

A

Microscopic crystals in urinary tract come together and create stone

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14
Q

Urolithiasis clinical manifestations

A
  • *Severe colicky pain when stone lodges in ureter d/t distension & obstruction of urine flow
  • N/V
  • Upper ureter: flank pain, lower ureter: genital and lower abd pain
  • Gross hematuria or microscopic hematuria
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15
Q

Spinal cord injuries

A

Direct injury to spinal cord or indirect injury to surrounding bones, tissues, vessels resulting in loss of function

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16
Q

Spinal cord injury clinical manifestations

A

Lvl of injury predicts what part of body is affected
Cervical injuries:
- Quadriplegia
- C4 and above –> inability to breathe, phrenic nerve innervates diaphragm at this level

Thoracic injuries:
- Paraplegia, poor trunk control

Lumbar & sacral:
- Leg control, bowel and bladder function, sexual function

Other effects:
- Hypotension
- Chronic pain
- Decreased temp control

17
Q

Cushing’s triad

A
  • High BP
  • Low HR
  • Irregular RR

*Indicates increased ICP

18
Q

Polycystic kidney dz

A
  • One of most common genetic disorders in world
  • Silent dz that presents later in life w HTN
  • Progresses to ESRD
  • Results in kidney transplant
19
Q

Polycystic kidney dz patho

A
  • Cysts grow and burst –> disrupt renal function
  • Cystic degeneration in other organs (liver, GI tract)
20
Q

Alzheimers nursing intervention

A
  • Encourage and assist w eating
  • Implement safety measures (bed in low position)
  • Implement toilet sched
  • Place clock & Calendar
  • Provide routine w daily exercise and ADLS
  • Speak calmly using positive statements
  • Diversional activities – no naps
  • Caregiver support
  • Schedule PT/OT
21
Q

Urolithiasis relationship to hyperparathyroidism

A

Calcium causes stones (parathyroid increases calcium levels)

22
Q

Urolithiasis relationship to gout

A

Uric acid can cause the formation of kidney stones

23
Q

Hemorrhoids risk factors

A
  • Straining during defecation
  • Prolonged constipation
  • Heavy lifting
  • Prolonged standing/sitting
  • Portal HTN
  • Increased intraabd pressure
  • Pregnancy, obesity
  • Heart failure
24
Q

Hemorrhoids conservative management

A

Goal: symptom management
- Sitz bath/ice packs every 4hrs for pain
- Adequate fluid/fiber to reduce constipation
- Stool softeners
- Topical 0.4% nitroglycerine for thrombosed hemorrhoids
- OTC meds

25
Q

Hemorrhoids surgical management

A
  • Rubber band ligation: rubber band at base constricting circulation and hemorrhoid death
  • Bipolar, infrared, laser coag: coagul of hemorrhoid
  • Sclerotherapy: inject hemorrhoid and dries up vessel
  • Cryosurgery: freezing hemorrhoid
  • Hemorrhoidectomy: excision of vein
26
Q

Hemorrhoid

A

swollen or dilated vein in anorectal area (varicose veins or rectum)

27
Q

Long-term sequelae of Hep virus

A
  • Pruritus (itching under skin)
  • Jaundice
  • Hepatic encephalopathy (nervous syst disorder by liver dz)
  • Thrombocytopenia: decreased clotting factors
28
Q

Which Hep virus are carcinogen?

A

carcinogen - B and C virus are cause of 80% hepatocellular carcinomas
primary: intrahepatic cholangiocarcinoma

29
Q

What is short bowel syndrome?

A

Short Bowel Syndrome: 50-70% missing, malabsorption; greater than 75%, patients are TPN
dependent.
can happen with surgery

30
Q

short bowel syndrome is common in?

A

Ulcerative colitis

31
Q

IBD complications

A
  • Perianal abscesses/fistulas
  • Anal fissure d/t diarrhea
  • Strictures/obstruction
  • Surgical complications
32
Q

Fistulas and Crohn’s dz

A

1/3rd of Crohn’s patients, types of fistulas:
Enterocutaneous (skin)
Enteroenteral (intestine)
Enterovescicular (bladder)
Enterovaginal (vagina)

MedSurg (15 decks)

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