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N102 > Exam 3 Material > Flashcards

Exam 3 Material Flashcards

1
Q

Chronic Fatigue Syndrome is aka:

A

Chronic Fatigue and Immune Dysfunction Syndrome

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2
Q

Chronic Fatigue Mainly Affects

A

Women

All ethnic and socioeconomic groups affected

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3
Q

Dx Criteria for CFS (Major)

A

Unexplained, persistent, or relapsing chronic fatigue of new and definite onset not d/t ongoing exertion

Not alleviated by rest*

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4
Q

S/S CFS (Chronic Fatigue Syndrome)

A

Incapacitating fatigue and exhaustion; may

wax and wane for mo to yrs or happen acutely leading to frustration

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5
Q

Lab Test for Chronic Fatigue Syndrome

A

No lab test can diagnosis–> used to exclude other diseases

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6
Q

Other (Minor) S/S of CFS (Chronic Fatigue Syndrome)

A

Impaired short term memory or concentration
Sore throat/Tender cervical/axillary lymph nodes
Muscle pain/Multi- joint pain
HA/ Unrefreshing sleep
Post-exertional malaise lasting over 24h

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7
Q

Role of WBC

A 
Protection from invading organisms
Recognition of self vs not-self
Destruction of foreign invaders, debris, abnormal cells
Production of antibodies
Production of cytokines
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8
Q

Increase in total number of WBC’s d/t acute infection, tissue damage/death, leukemias

Elevation of any element of WBC differential

A

Neutrophilia

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9
Q

S/S of Neutorphillia

A

Related to cause of elevation –> tx cause

Exudate in form of pus

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10
Q

Dx Neutorphilia

A

CBC

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11
Q

Decrease in total WBC count

A

Leukopenia

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12
Q

Neutropenia

A

Reduced neutrophil count

occurs w/ other conditions or diseases→ not a disease in its self i.e. chemotherapeutic and immunosuppressive meds

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13
Q

ANC less than 1000 →

A

→ positive pressure room

Neutropenia – very compromised

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14
Q

ANC =

A

Absolute Neutrophil Count

WBC x %neutrophils

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15
Q

Other conditions/ diseases that causes Neutropenia include:

A

Hematologic malignancies
Autoimmune disorders – lupus/ ra
Nutritional deficiencies→ b12 or folic acid
Infections and Severe sepsis

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16
Q

Patients with neutropenia are at high risk of

A

opportunistic infections
Low grade fever = significant
Minor infections can lead rapidly to sepsis

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17
Q

Total WBC: less than 4,000

A

Neutropenia

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18
Q

ANC greater than 1500→

A

No increased risk of infection

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19
Q

ANC 1000-1500–>

A

→Slight increase in risk of infection

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20
Q

ANC 500-1000 →

A

Moderate increase in risk of infection

Neutropenia

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21
Q

ANC 100-500→

A

High risk of infection

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22
Q

ANC less than 100 →

A

Extremely high risk of infection

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23
Q

In patients with Neutropenia any ℅ pain/ infection–>

A

Serious

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24
Q

Common entry points for infection

A

Mucous membranes
Skin, throat, mouth
GU system
Pulmonary system

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25
Q

Neutropenia fever of 100.4

A

→Broad spectrum Antibiotic therapy for fever

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26
Q

Neutropenia Treatment

A

Tx Cause
Assist hematopoiesis in bone marrow
Isolation (Direct contact w/ hands=common source of transmission)
Monitor for infection, cultures

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27
Q

Neutropenia Treatment Teach

A

no fresh flowers, no fresh fruits or veggies

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28
Q

Neupogen, Neulasta

A

Granulocyte transfusion or stimulating factor

Pt w/ Neutropenia

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29
Q

V/S for pt w/ Neutropenia should be taken q….

A

q4h, call for T over 100.4

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30
Q

Myelodysplastic Syndrome (MDS)

A

producing plenty of cells, but they are all dysfunctional d/t Stem cell injury

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31
Q

Group of hematologic disorders –> changes in quantity and quality of bone marrow elements; May progress to leukemia (30%)

A

Myelodysplastic Syndrome (MDS)

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32
Q

AKA: Preleukemia

A

Myelodysplastic Syndrome (MDS)

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33
Q

Clinical Manifestations (MDS):

A

Anemia and fatigue, Infection risk, Bleeding risk

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34
Q

Diagnosing MDS

A

Bone Marrow biopsy – Dx, Classify, & Stage

Others CBC & H&P

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35
Q

Goal in MDS Tx

A

Improve hematopoiesis & Prevent leukemia

Nursing goal: Prevent infection, bleeding, & Treat symptoms of anemia

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36
Q

Tx Myelodysplastic Syndrome (MDS)

A

(aggressive); only 1/3 of pts are candidates
–Chemo
–Stem cell transplant (difficult for elderly)
TX should match severity of disease

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37
Q

Supportive therapy for Myelodysplastic Syndrom include:

A

Transfuse blood products prn
Monitor CBC & bone marrow
Ensure quality of life

38
Q

Most common leukemia of older adults

A

Chronic Lymphocytic Leukemia (CLL)

39
Q

Chronic Lymphocytic Leukemia (CLL) most commonly affects

A

men 50-70y → MORRIS

40
Q

over-production & accumulation of dysfunx lymphocyte d/t genetic mutation

A

Chronic Lymphocytic Leukemia (CLL)

41
Q

Lymphocytes infiltrate bone marrow, spleen, liver →Lymph nodes enlarge t/o body; Lymphocytes crowd out growth of RBC/Platelets

A

Chronic Lymphocytic Leukemia (CLL)

42
Q

Chronic Lymphocytic Leukemia (CLL) S/S

A 
Many can be asymptomatic 
	Chronic fatigue 
	Anorexia  	
	Splenomegaly/Hepatomegaly 	
	Lymphadenopathy
43
Q

CLL (Labs)

A 
Increase lymphocytes (WBC> 100,000 →Lymphocytosis)
Mild anemia& Thrombocytopenia
44
Q

CLL Dx Studies

A

CBC
Bone marrow exam
CT scan → Identify site of cancer

45
Q

Average Length of Survival for CLL

A

7 years →untreated

46
Q

Function of the Spleen

A

Filters blood–>destroys fact., old/ damaged platelets & RBCs
–>Production, storage, & release of blood cells

47
Q

Splenomegaly with peripheral cytopenias

A

Hypersplenism

48
Q

S/S Splenomegaly

A

Asymptomatic or abdominal fullness with early satiety

49
Q

Dx Splenomegaly

A

Physical, CT, MRI, US

Occasionally– laparoscopy to eval. spleen

50
Q

Splenectomy

A

Enlarged /ruptured spleen
Relieve pain
To increase circulating RBC, WBC & platelets

51
Q

Post-Op Considerations (Splenomegaly)

A

Risk for developing immunologic deficiencies (Life Long)

Monitor for Hemorrhage, shock, Abdominal distention, Infection

52
Q

Vaccination Post Op for (Splenomegaly)

A

pneumococcal vaccine post-op

53
Q

Tissue from lower abdomen remains attached to muscle, nerves, and blood supply
tunneled through abdomen to reach breast

A

Tram Flap

54
Q

Bonus of Tram Flap

A

abdominoplasty

55
Q

Autologous Myocutaneous Flaps

A

Muscle, fat & skin from another part of body moved to chest & shaped into form of a breast

56
Q

Donor for Autologous Myocutaneous Flaps sites include:

A

Latissimus dorci muscle

Transverse rectus abdominis muscle

57
Q

Latissimus dorci muscle donor site disadvantages

A

May need additional implant

Scar on back

58
Q

DIEP Flap Breast Reconstruction:

A

Deep Inferior Epigastric Perforator Breast Reconstruction

59
Q

Advantages of DIEP Flap Breast Reconstruction:

A 
No muscles taken
–	Less post op pain than with TRAM
–	Faster recovery time
–	Less risk of hernia
–	Abdominoplasty!
60
Q

Post Op Drain Placement for Breast Flap Recovery duration:

A

Drains in place for 2-3 days →Monitor for color and odor & temp

61
Q

Liposuction IS NOT

A

a substitute for weight loss nor a cure for obesity

62
Q

Best candidates for Liposuction

A

< 40y –> elastic skin

63
Q

Pressure dressing post op Liposuction

A

Pressure drsg for 2-4 weeks

64
Q

Rearranging or reshaping an existing scar so original scar is not as noticeable; Z platy

A

Scar Revision

65
Q

Inflammatory response of the epidermis d/t infections, allergies, or irritating substances

A

Dermatitis

66
Q

Condition in which the skin becomes red, sore, or inflamed after direct contact with a substance

A

Contact Dermatitis:

67
Q

Inflammation intensity of contact dermatitis is related to:

A

Concentration of irritant, time exposed, and repetition of exposure (repeated use)

68
Q

Rhus

A

Contact w/ a poisonous plant -Ivy, Oak, Sumac
Type of Allergic Contact Dermatitis
Washing ASAP minimizes severity and spread

69
Q

Onset of S/S for Rhus

A

24-48h after contact; • Disappear 10d

70
Q

S/S of Rhus

A

Severe itching, Red inflammation, blistering, oozing

71
Q

Atopic Dermatitis is aka

A

Eczema

72
Q

Common sites of Eczema in Children

A

face of children

73
Q

Common sites of atopic dermatitis (Eczema) in Adults

A

AC and popliteal spaces of adults

74
Q

Tx Eczema

A

no cure, only control
Topical steroids (Protopic, Elidel)
Phototherapy

75
Q

S/S of Acute Eczema (Atopic Dermatitis)

A

Bright red, oozing vesicles
Extreme pruritis
(Worst)

76
Q

S/S Subacute Eczema

A

Scaly plaques

77
Q

S/S Chronic Eczema

A

Thickened, Dry skin (Xerosis)

Hypo or hyperpigmentation (differ in color from skin)

78
Q

Dx Eczema

A

Blood Test (IgE)
Patch test
Fam Hx

79
Q

Toxic Epidermal Necrolysis Syndrome (TENS)

A

Rare, acute drug reaction of the skin
Diffuse erythema
Large blister formation

80
Q

Highest at Risk for TENS

A

Elderly & Immunocompromised

81
Q

Skin loss d/t TENS

A

30-100% skin loss

82
Q

Skin loss d/t SJS

A

<10%

83
Q

Stevens-Johnson Syndrome (SJS)

A

Rare, acute drug reaction of the skin; Another form of TENS

84
Q

TENS & SJS s/s begin as….

A

flu-like symptoms: High fever, cough, sore throat, burning eyes

85
Q

The flu-like s/s of TENS & SJS are followed by:

A

Diffuse erythema, painful & burning rash which spreads from trunk to face & extremities with Bulla (blisters) & Severe skin peeling; MM usually involved

86
Q

Deaths asc with TENS & SJS are usually d/t

A

sepsis followed by pulmonary complications

87
Q

Urticaria

A

aka hives (wheels)

88
Q

Common Causes of Angioedema

A

ACE-I
Strawberries
Shellfish
Peanuts

89
Q

Primary Concerns for a pt with Angioedema

A

Airway and Anaphylactic Shock

90
Q

Angioedema Tx

A

H2 antagonist

Antihistamines, Epi, steroids,

91
Q

Seborrheic Dermatitis aka

A

dandruff

92
Q

Comedo

A

Plug of keratin, sebum and bacteria –> white & blackheads

N102 (13 decks)

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