Exam 4 Flashcards

1
Q

Blepharitis is
Characterized by
Management

A

Inflammation of eyelid edges
- Itchy, red, burning eyes & seborrhea of eyelids with greasy scales
- warm & moist compresses, avoid rubbing eyes

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2
Q

Hordeolum is
Management

A

A stye
- warm compresses 4x a day & antibacterial ointment (can blur vision)

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3
Q

Chalazion is
Characterized by
Treatment

A

Inflammation of sebaceous gland in eyelid (protrudes inside eyelid)
- eye fatigue, light sensitivity, excessive tears
- warm compresses 15min 4x a day, followed by ophthalmic ointment

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4
Q

Conjunctivitis is
Presentation
Parent teaching

A

Infection or inflammation caused by bacteria, viruses or trauma
- hyperemia, burning, mucropurulent discharge
- prevent cross contamination, warm compresses, ophthalmic ointment & antibiotic eye drops

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5
Q

Glaucoma
Open angle
Closed angle
Patient education

A
  • asymptomatic, increased IOP, loss of peripheral vision, tunnel vision, difficult adapting to dark, halo vision, mild headaches
  • severe acute ocular pain, sudden decrease in vision, pupils dilated, nausea/vomiting, significant increased IOP, halo vision, red conjunctiva
  • elevate HOB, protect eye with patch, administer eye meds
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6
Q

Cataract is
Manifestations
Classifications
Post-op care

A

Clouding or opacity of lens leading to loss of vision
- gradual painless blurring, decreased vision, night glare, cloudy white opacity
- congenital, senile, traumatic, secondary
- antibiotics, discharge within 1 hour, mild itching normal pain indicates complication, assess for bleeding

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7
Q

Management of ear wax impaction

A

irrigate canal with mixture of water & hydrogen peroxide

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8
Q

External otitis is
Treatment

Otitis media
Non-surgical management
Post-op surgical care

A

Irritating or infective agents come into contact with external ear causing pain
- reduce inflammation, edema & pain with heat, bedrest, analgesics, antibio

Throbbing pain in affected ear, fever, drainage, bulging eardrum
- quiet env, bedrest w limited head movement, heat & cold, systemic antibiotics, analgesics, antihistamines
- keep external ear canal free of substances, keep head dry for days

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9
Q

Ménière’s disease due to
Disease process
Management
Education

A

Overproduction & poor absorption of endolymph
- tinnitus, one-sided sensorineural hearing loss, vertigo
- slow head movement, salt & fluid restriction, smoking cessation, mild diuretics, nicotinic acid, antihistamines, gentamicin & steroids
- hearing in affected ear is sacrificed

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10
Q

Conductive hearing loss
Sensorineural hearing loss
Non-surgical treatment
Surgical

A

Results from any physical obstruction of sound wave transmission
- results from a defect in cochlea, 8th cranial nerve or the brain
- stand in front of patient, reduce background noise, speak slow & clear, use body language, assistive devices
- tympanoplasty, stapedectomy (hearing doesn’t improve till 6 weeks)

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11
Q

Common complications of fractures
Management

A

Compartment syndrome, crush syndrome, hemorrhage, fat embolism, venous thromboembolism, infection, malunion, avascular necrosis
- manage acute pain, increasing mobility, preventing & monitoring neurovascular compromise, prevent infection
6 P’s

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12
Q

Management of skeletal traction

A

Assist with application
maintain traction,
maintain positioning/mobility hazards
prevent skin breakdown
assess supportive devices
pin care
monitor neurovascular status

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13
Q

Post spinal surgery
Traction weight

A

Traction to cervical spine through crutch field tongs into skull
Possible rotorest bed or halo brace
Prevent complications of immobility
Skeletal traction 15-30 lbs (pins
Buck traction 5-10lbs (no pins)

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14
Q

Sprain
Strain
Manifestations
RICE

A

injury to ligaments
Injury to muscle tendon
Pain, edema, loss of fxn
Rest, Ice, compress, elevate

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15
Q

Colles vs smith fracture
Due to
Interventions for distal radial fracture

A
  • a common distal radius fracture
  • colles (outward) smith (inward)
  • due to a fall with hand outstretched landing on heel of hand
  • removing jewelry
    Preforming neurovascular assess
    Immobilizing wrist
    Elevating extremity
    Applying ice
    Managing pain
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16
Q

ACL drawer test
ACL Lachman test
Rotator cuff apley scratch test
Drop arm test
Empty can test

A
  • 90 degrees pull tibia forward from knee
  • 30 degrees pull tibia upward while holding femur
  • reach behind back
  • patient Lowers arm, if it immediately drops & lower than 90
  • raise arms & turn thumbs down, downward force is applied
17
Q

Carpal tunnel syndrome is due to
Tinel’s sign
Phalens test
Treatments

A

Pressure on the median nerve causing numbness, pressure & pain
- tapping in wrist causing outward tingling radiation
- back of hands together causing radiation of pain down fingers
- steroids, splinting, NSAIDs, surgical decompression

18
Q

Rheumatoid arthritis is
Risk factors
Signs
Lab diagnostics
Medications

A

Systemic Inflammatory autoimmune disease degeneration of joint
- more frequent in women
- morning joint stiffness, fatigue, erythema & warmth to affected joint
- RA factor, osteopenia on X-ray
- DMARDs, corticosteroids, enbrel, remicade, celecoxib

19
Q

Osteoarthritis is
Signs
Treatment

A

Loss of joint space typically affecting weight bearing joints
- pain worsens with movement, joint swelling, limited ROM, heberdens nodes, bouchards nodes
- heat & cold application, exercise (bike, water based), PT (assistive devices)

20
Q

Patient education after hip replacement

A

Abduction splint
Do not cross legs across midline
Do not sit in low chairs or cross legs
Avoid flexing hips past 90, use grippers to reach
Use elevated toilet
Sleep with pillow between legs

21
Q

Swan-neck
Heberdens nodes
Boutonnière
Ulnar deviation

A

Distal interphalangeal dip
Swelling of distal interphalangeal
Proximal interphalangeal
Metacarpophlangeal joint deviates finger to slant position

22
Q

HIV disease process
Diagnosis of AIDS CD4

A

HIV virus attacks & enters T cells to make copies
T cells burst spreading HIV to other cells
CD4+ T cell count begins to fall & viral load rises
Immune system weakens
Everyone with AIDS has HIV, Not everyone with HIV has AIDS
- CD4 count less than 200

23
Q

HIV disease prevention
Post exposure prophylaxis

A

Avoid sharing needles & practice safe sex
Antiretroviral therapy should be initiated in anyone living with HIV
Use of daily PrEP
- anyone who may have been exposed, must begin within 72hrs, consists of 2-3 ART meds,
Side effects include nausea

24
Q

PrEP is
Criteria
Patient education

A

Pre exposure prophylaxis
- used for high risk populations, homosexual men, heterosexually active men & women, injecting drug users
- PrEP is covered by insurance

25
Q

Adverse effects of HIV drugs
NRTIs
NNRTIs
PIs

A
  • pancreatitis w fatty foods, peripheral neuropathy, flu symptoms, hepatotoxicity
  • hepatotoxic (monitor LFTs), anemia, birth defects
  • hepatotoxicity, pancreatitis & atherosclerosis, heart blocks
26
Q

Opportunistic infections

A

Pneumocystis jiroveci (fungal; lungs)
Toxoplasmosis (protozoal; cat feces)
Cryptosporidium (protozoal; GI)
Candidiasis (fungal; mouth)
Cryptococcosis (fungal inhaled; CNS)
Histoplasmosis ( fungal; pulmonary)
Mycobacterium tuberculosis
HSV
Kaposis sarcoma

27
Q

Gout diagnosis
Manifestations
Management
Diet considerations

A

ID of MSU crystals on polarizing microscopy & serum uric acid > 6.8mg
- flares of inflammatory arthritis, chronic arthropathy, accumulation of urate crystals, uric acid nephrolithiasis
- NSAIDs, colchicine, steroids, allopurinol
- limit ETOH, avoid oats, soft drinks, sardines, red meat, Turkey

28
Q

Lyme disease transmission
Manifestations
Management

A

Through tick borrelia
- stage 1: erythema, migraines, fatigue, bulls eye
Stage 2: cardiac, neurological
Stage 3: arthritis, neuro impairment
- antibiotics, cardiac & neuro assessment

29
Q

Systemic lupus is
S/S
Leading cause of mortality
Management

A

Chronic inflammatory disease affecting skin, joints & kidneys
- pleural effusion, pneumonia, fever, fatigue, anorexia, erythema (butterfly shaped), ^ liver enzymes, cognitive dysfunction
- nephritis & infection
- Renal (cytoxan), arthritis (NSAIDs, methotrexate), skin care, avoid sun

30
Q

Osteoporosis risk factors
Manifestations
Diagnostic test
Management

A

Aging, female, nulliparity, family Hx, diet, smoking, sedentary lifestyle, Caucasian & Asian
- loss of height, back pain, fractures
- Bone mineral density studies (BMD)
- calcium, calcitriol, evista, miacalcin

31
Q

Spine management
Surgical complications

A

Heat/cold, NSAIDs or muscle relaxants, back exercises, PT, massages, proper body mechanics
- infection, CSF leak, Atelectasis, neuro impairment, bleeding

32
Q

Malignant melanoma ABCDE assessment

A

Asymmetry
Borders uneven
Color (dark black)
Diameter (>6 mm)
Evolving (changes in size, shape, color)

33
Q

Skin cancer prevention

A

Wear sunscreen
Avoid tanning
Skin self exams
Skin exposure
Sun protection

34
Q

Pruritis is
Management
Xerosis is
Prevention

A

Itchy skin condition
- trim finger nails, antihistamines, topical steroids
Dryness common in elderly (can lead to lichenification)
- humidifier, hydration, avoid ETOH & caffeine

35
Q

Insect infections include
Patient education
Pharm management

A

Pediculosis (lice) & scabies (mites)
- clean clothes & bed linens, don’t share items
- NIX, malathion, lindane, permethrin, lindane

36
Q

Fungal infections
Management

A

Candidiasis, Tinea
- nystatin, lotrimin, diflucan, nizoral, sporanox

37
Q

Bacterial infections
Management
Patient teaching

A

Folliculitis, furuncle, carbuncle, cellulitis, MRSA
- antibiotics: vancomycin, cindamycin
- don’t squeeze or pop, compress, avoid excess moisture

38
Q

Viral infections
Management

A

Herpes simplex virus, herpes zoster/shingles, dermatitis, acne
- acyclovir, analgesics, skin care, salicylic acid, avoid trigger, topical steroids, compresses, antihistamines

39
Q

Psoriasis is
Manifestations
Treatment

A

Lifelong scaling disorder with underlying dermal inflammation, autoimmune reaction
- scaling, erythema, pruritis, flare up (lesions thicken)
- topical steroids (triamicnolone), coal tar preparations, Phototherapy/ UV, vitamin D/ sunlight