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nursing 101 > exam 3 > Flashcards

exam 3 Flashcards

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1
Q

 Constipation: Small frequent meals, high fiber/low fat diet, adequate fluid intake, evaluate medications, physical activity
 Diarrhea: diet, consider medications, lower stress, malabsorption problems, encourage liquids, foods low in bulk-bland diet, restrict milk, fresh fruits, veggies, and caffeine, monitor electrolytes and replace
 Fecal Incontinence: easy access to bathroom, assistive devices (Raised toilet seat), bowel retraining programs

A

interventions to prevent constipation, diarrhea, fecal incontinence

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2
Q

Age, diet, fluid intake, physical activity, psychological factors, personal habits, position during defecation, pain, pregnancy, surgery/anesthesia, medications, diagnostic tests

A

factors affecting defecation

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3
Q

Promote peristalsis - Laxatives, antibiotics
Inhibit Peristalsis - opioids, antacids, iron, anticholinergics, anesthesia-ileus, anti-diarrheal medications
Iron - black
Antacids - white
Antibiotics - green or gray
Anticoagulants - `pink, red, black

A

meds and how they affect patient

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4
Q

Usual pattern of bowel elimination, aids to elimination, recent changes in bowel elimination, problems with bowel elimination, presence of artificial orifices
 Abdomen - Inspect, auscultation (RLQ – clockwise), percussion (tympany – air), palpate

A

assessment of bowel elimination

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5
Q

visualizes esophagus and upper duodenum

A

Esophagogastroduodenoscopy (EGD)

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6
Q

rectum, colon, distal small bowel – looks for inflammatory disease

A

colonoscopy

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7
Q

sigmoid colon, rectum

A

sigmoidoscopy

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8
Q

drink barium and can look at esophagus stomach and small intestine

A

upper gastrointestinal (UGI) and Small Bowel Series

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9
Q

to look at large intestine under radiography

A

barium enema

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10
Q

how to assess urine…

A

 Color – should be almost clear
 Odor
• Longer it stands/sits the more ammonia smelling it becomes
 Turbidity – clear/cloudy. Should be clear, cloudy is not normal
 pH
• 4.6-8 (high protein makes more acidic)
 specific gravity – measure of concentration of dissolved solids (normal is 1.015-1.025)
 patterns, changes, aids, problems

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11
Q

inflammation of bladder

A

cystitis lower UTI

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12
Q

inflammation of prostate

A

prostatitis lower UTI

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13
Q

inflammation of urethra

A

urethritis lower UTI

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14
Q

obstruction of free-flowing urine-reflux of urine from urethra to bladder

A

urethrovesical reflux

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15
Q

backward flow of urine from the bladder into ureters

 Bacteriuria-more than 100,000 colonies of bacteria/ml of urine; if less, may be contamination

A

ureterovesical reflux

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16
Q

 Dysuria, burning, frequency, urgency, nocturia, incontinence, hematuria, back pain
 Elderly: confusion, lethargy, anorexia, incontinence, low grade fever

A

signs and symptoms of UTI

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17
Q 
	Nocturia
	Increased frequency
	Urine retention
	UTIs
	Decreased control
A

older adult and urinary problems

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18
Q

ultrasound over bladder

tells you how much urine is sitting in the bladder – shows retention

A

bladder scan

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19
Q

how much urine left in bladder after voiding

A

post void residual

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20
Q

collect urine specimens by…

A

Clean catch – midstream – don’t catch first/last of urination
Sterile catheterizing
24 hour don’t discard
routine urinalysis – not sterile

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21
Q

inventions to promote healthy urinary elimination

A

Maintain normal habits, schedule, privacy, position, hygiene
Promote fluid intake
Strength muscle tone - kegels
Assist with toileting

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22
Q

no cure, leading cause of irreversible blindness.
• Risk factors: family history, over 40 years, history of diabetes, hypertension, more prevalent among men, African American, and Asian.
• Diagnosed with tonometry test (to measure IOP)*

A

glaucoma

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23
Q

aim to prevent optic nerve damage
life long therapy of management of IOP
no peripheral vision

A

treatment for glaucoma

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24
Q

history of eye problems, smoking, diabetes and aging

A

risk factors for cataracts

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25
Q

• Severe irreversible vision loss, loss of “central vision”, tiny yellow spots (drusen) beneath the retina, drusen occur within the macula, central vision is lost

A

macular degeneration

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26
Q

disorder of inner ear that causes vertigo, tinnitus, fluctuating healing loss and feeling of fullness or pressure in ear

A

Meniere’s disease

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27
Q

low sodium diet (2000mg or less), no caffeine, no alcohol, drink plenty of fluids, avoid monosodium glutamate (MSG) – may increase symptoms, avoid aspirin and aspirin – containing products

A

management of Meniere’s disease

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28
Q

meclizine (antivert) and diuretics

A

meds for Meniere’s disease

29
Q

optic nerve damage due to intraocular pressure (IOP), problem with drainage of the fluid and the fluid builds up and causes pressure on optic nerve, pressure builds due to inadequate flow of aqueous humor (fluid that nourishes the iris and lens)
• Two types: open – angle and angle closure
• Symptoms: blurred vision, “halos” around lights, difficulty focusing, loss of peripheral vision

A

patho of glaucoma

30
Q

symptoms: cloudy lens, opaque, painless, blurry vision, surrounds are dimmer, sensitive to glare, reduced visual acuity, diplopia (double vision)

A

patho of cataracts

31
Q

central vision is lost

dots in central field of vision

A

patho of macular degeneration

32
Q

Endolymph (Fluid in inner ear) does not drain well, resulting in increased pressure in ear, resulting in symptoms
• Symptoms: tinnitus or roaring sound in ear, incapacitating vertigo with nausea and vomiting, feeling of pressure or fullness in ear, feeling of imbalance or disequilibrium, fluctuating progressive hearing loss

A

patho of Meniere’s disease

33
Q

eye gtts, miotics and sympathomimetics decrease size of pupil to help outflow of aqueous humor and decrease IOP – adrenergic agonist? Surgical laser procedures

A

meds for glaucoma

34
Q

Surgical – different procedures – remove cataract or replace lens. After surgery avoid activities that increase IOP

A

meds for cataracts

35
Q

Separation of one of the retinal linings of the eye Symptoms: no pain, sensation or a shade or curtain coming across the eye vision.

A

retinal detachment

36
Q

surgery for retinal detachment…

A

scleral buckling

37
Q

Wear eye shield night after surgery
Bathe, shampoo hair cautiously
Avoid lying on affected side night after surgery
Avoid activities which increase IOP: bending, lifting , stooping
Contact Dr. if increased pain, redness, swelling
Keep follow-up eye appts.

A

post op care after cataract removal

38
Q

nearsightedness

A

myopia

39
Q

farsightedness

A

hyperopia

40
Q

procedure of eye care that is performed to determine IOP. Tests risk for glaucoma

A

tonometry

41
Q

eye chart to measure visual activity

A

Snellen chart

42
Q

Substance that causes constriction of the pupil of the eye

A

miotics

43
Q

double vsion

A

diplopia

44
Q

progressive, irreversible neurological disease – gradual loss of cognitive function

A

Alzheimer’s Disease

45
Q

Tangled masses of nonfunctioning neurons in the brain

• Deposits of amyloid protein in the brain

A

patho of alzheimer’s

46
Q

Physical Examination - Rule out other causes
• Depression may mimic early stages of Alzheimer’s
• Only brain biopsy gives true evidence but clinical signs and symptoms will support the diagnosis

A

diagnosis of alzheimer’s

47
Q
  • Manage the cognitive and behavioral symptoms
  • Medications: enhance acetylcholine uptake in the brain
  • donepezil (Aricept) rivastigmine (Excelon) galantamine (Reminyl)
A

meds for alzheimer’s

48
Q

promote safety in environment

A

NSG for alzheimer’s

49
Q

progressive demyelinating disease of CNS

A

MS

50
Q

Destruction of myelin (protective material that surrounds certain nerve fibers in brain and spinal cord)
• Results in impaired transmission of nerve impulses
• May occur at any age- typically between ages of 20 and 40 years
• Risk factors: may be environmental- which triggers an immune response in the bod

A

Patho of MS

51
Q

Vision problems- blurring of vision, double vision
• Fatigue, chronic pain
• Paresthesia-tingling in extremities
• Gait disturbances- spasticity and ataxia
• Urinary problems- UTI’s incontinence
• **MS has exacerbations and remissions- new symptoms appear in exacerbations and existing symptoms worsen

A

Symptoms of MS

52
Q

No cure currently exists
• Goals of treatment - treat exacerbations and delay progression
• Manage chronic symptoms
• Medications: immunosuppressive meds, baclofen (Lioresal) for treating spasticity, UTI meds
• Individualized program for Rebab: PT and OT,
• Speech for swallowing difficulties
• Home management and modifications for the home

A

nsg for MS

53
Q

autoimmune disorder affecting neuromuscular junctions

A

Myasthenia Gravis

54
Q

Acetylcholine attaches to receptor sites
• This is required for muscular/motor contraction
• In MG there is a reduction of acetylcholine receptors sites

A

Patho of Myasthenia

55
Q

patient is given a short acting acetylcholinesterase inhibitor (tensilon)
o short duration of immediate improvement in muscular strength

A

tensilon test for myasthenia gravis

56
Q

• pryidostigmine bromide (mestinon) – Anticholinesterase meds
o inhibits the breakdown of acetylcholine
o increases the concentration of acetylcholine in neuromuscular junction
• Surgery – remove thymus gland (plays a part in immunosuppression)
o Partial or complete remission from MG by removing thymus

A

medical management for MG

57
Q

** maintenance of stable blood levels of anticholinesterase meds is needed to stabilize muscle strength
• Meds must be administered on time
• Cholinergic Crisis- problem with overmedication
• Myasthenic crisis- due to an infection - or under medicated
• **Both crisis result in weak respiratory muscles and respiratory depression

A

Complications in MG

58
Q

slow, progressive neurodegenerative disorder

A

Parkinson’s Disease

59
Q

decrease levels of dopamine stores in the brain which affects voluntary movement

A

patho of Parkinson’s

60
Q

Gradual onset and symptoms progress slowly

• TRAP: Tremor, Rigidity, Akinesia/Bradykinesia, Postural disubrances

A

Symptoms of Parkinson’s

61
Q
  • Levodopa (larodopa) – med is converted to dopamine in brain, producing symptom relief
  • Carbidopa (sinemet) – helps to maximize the effects of levodopa
  • Deep brain stimulation – high frequency electrical stimulation, blocks nerve pathways in brain that causes tremors
A

Medical management for Parkinsons’

62
Q

Degenerative disease characterized by loss of both upper and lower motor neurons

A

ALS

63
Q

fatigue/limb weakness, progressive advance of syptoms (affecting speech, swallowing, limb weakness)
• Diagnosed on basis of signs and symptoms-no clinical or laboratory tests are specific for this disease
• An EMG will show muscle wasting and atrophy

A

Symptoms of ALS

64
Q

riluzole (Rilutek) glutamate antagonist only drug approved for ALS
o may protect the neurons in early stages
• no specific therapy exists for ALS
• FOCUS on maintaining current function, well-being and quality of life

A

Meds of ALS

65
Q

Abnormalities of CNS affecting normal blood supply to brain or spinal cord

A

CVA

66
Q

• Sudden numbness or weakness of face, arm, or leg 9especially on one side of body)
• Sudden confusion or change in mental status
• Sudden trouble speaking or understanding speech
• Sudden visual disturbances
• Difficulty walking, dizziness or loss of balance or coordination
• Sudden severe headache
 diagnosis and immediate treatment within 3 hrs that can be given.

A

Symptoms of Stroke

67
Q

 TIA is a brief episode of neurological deficit
 Symptoms are transient- no evidence of infarction
 Referred to as “mini -strokes” -
 Take as a warning sign

A

TIA

68
Q

What are antiplatelet meds for prevention of strokes….

A

Aspirin and Clopidogrel

nursing 101 (4 decks)

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