Exam 2 Review for Finals Flashcards
GERD risk factors
- *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
GERD complication: Barrett’s esophagus
- Squamous epithelium replaced w Barrett’s epithelium
- More resistant to acid
- High propensity for malignancy –> esophageal CA
GERD atypical chest pain management
Caused by esophageal spasm
*CARDIAC assessment
Peptic Ulcer Disease risk factors
- H. Pylori
- NSAIDS
PUD complications
- *Gastric adenocarcinoma (H Pylori)
- GI hemorrhage
- Abd or intestinal infarction
- Perforation & penetration into attached structures
- Obstruction
- Peritonitis
PUD medications
- 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
Which Hep viruses have vaccines?
Hep A, Hep B
Hep A transmission
- Fecal
- Oral
- Contaminated food/water
- Close contact w infected persons
Hep B transmission
- Blood
- Bodily fluids
- Vertical transmission
Hep C transmission
- Blood
- Bodily fluids
- Vertical transmission
HD basic process
- 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
PD basic process
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
Urolithiasis
Microscopic crystals in urinary tract come together and create stone
Urolithiasis clinical manifestations
- *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
Spinal cord injuries
Direct injury to spinal cord or indirect injury to surrounding bones, tissues, vessels resulting in loss of function
Spinal cord injury clinical manifestations
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
Cushing’s triad
- High BP
- Low HR
- Irregular RR
*Indicates increased ICP
Polycystic kidney dz
- One of most common genetic disorders in world
- Silent dz that presents later in life w HTN
- Progresses to ESRD
- Results in kidney transplant
Polycystic kidney dz patho
- Cysts grow and burst –> disrupt renal function
- Cystic degeneration in other organs (liver, GI tract)
Alzheimers nursing intervention
- 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
Urolithiasis relationship to hyperparathyroidism
Calcium causes stones (parathyroid increases calcium levels)
Urolithiasis relationship to gout
Uric acid can cause the formation of kidney stones
Hemorrhoids risk factors
- Straining during defecation
- Prolonged constipation
- Heavy lifting
- Prolonged standing/sitting
- Portal HTN
- Increased intraabd pressure
- Pregnancy, obesity
- Heart failure
Hemorrhoids conservative management
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
Hemorrhoids surgical management
- 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
Hemorrhoid
swollen or dilated vein in anorectal area (varicose veins or rectum)
Long-term sequelae of Hep virus
- Pruritus (itching under skin)
- Jaundice
- Hepatic encephalopathy (nervous syst disorder by liver dz)
- Thrombocytopenia: decreased clotting factors
Which Hep virus are carcinogen?
carcinogen - B and C virus are cause of 80% hepatocellular carcinomas
primary: intrahepatic cholangiocarcinoma
What is short bowel syndrome?
Short Bowel Syndrome: 50-70% missing, malabsorption; greater than 75%, patients are TPN
dependent.
can happen with surgery
short bowel syndrome is common in?
Ulcerative colitis
IBD complications
- Perianal abscesses/fistulas
- Anal fissure d/t diarrhea
- Strictures/obstruction
- Surgical complications
Fistulas and Crohn’s dz
1/3rd of Crohn’s patients, types of fistulas:
Enterocutaneous (skin)
Enteroenteral (intestine)
Enterovescicular (bladder)
Enterovaginal (vagina)
