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Med Surg 1 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Round or irregular macular lesion, larger than petechia, color varies and changes from black, yellow, and green hues, secondary to blood extravasation, associated with trauma, bleeding tendencies

A

Ecchymosis

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2
Q

Discoloration of the skin resulting from bleeding underneath, typically caused by bruising

A

Ecchymosis

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3
Q

Flat, nonpalpable skin color change (color may be brown, white, tan, purple, red)
Less than 1 cm in size with circumscribed regular borders

A

Macule

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4
Q

Freckles and moles are examples of..

A

Macules

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5
Q

Elevated mass with transient borders, often irregular, size and color vary
Caused by movement of serous fluid into the dermis and does not contain free fluid in a cavity like a vesicle does

A

Wheal

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6
Q

Hives (uticaria) and insect bites are examples of..

A

Wheals

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7
Q

Pus filled vesicle or bulla

A

Pustule

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8
Q

Acne, impetigo, furuncles, and carbuncles are examples of..

A

Pustules

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9
Q

Herpes simplex/zoster, varicella, poison ivy, and a 2nd degree burn blister are examples of..

A

Vesicles

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10
Q

Circumscribed, elevated, palpable mass containing serous fluid less than 0.5 cm

A

Vesicles

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11
Q

Herpes simplex/zoster, varicella, poison ivy, and a 2nd degree burn blister are examples of..

A

Vesicles

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12
Q

Loss of superficial epidermis that does not extend to dermis, depressed, moist area

A

Erosion

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13
Q

Ruptured vesicles and scratch marks are examples of..

A

Erosion

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14
Q

Skin loss extending past epidermis, necrotic tissue loss, bleeding and scarring possible

A

Ulcer

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15
Q

Circumscribed, elevated, palpable mass containing serous fluid greater than 0.5 cm

A

Bulla

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16
Q

Contact dermatitis, large burn blisters, poison ivy, and impetigo are examples of a…

A

Bulla

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17
Q

Shape varies, spiderlike or linear, color is bluish or red, does not blanch when pressure is applied, noted on legs and anterior chest, secondary to superficial dilation of venous vessels and capillaries, associated with increased venous pressure states (varicosities)

A

Telangiectasia

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18
Q

Shape varies, spiderlike or linear, color is bluish or red, does not blanch when pressure is applied, noted on legs and anterior chest, secondary to superficial dilation of venous vessels and capillaries, associated with increased venous pressure states (varicosities)

A

Telangiectasia

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19
Q

Hives are also called..

A

Urticaria

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20
Q

What are the functions of the skin

A

Protection
1st line of defense for immune system
Contains melanocytes which pigment the skin and tan the skin when it is exposed to sunlight
Thermoregulation (keep core body temperature at right levels)
Allows you to feel sensations
Excretes waste like sweat but also protects body from water loss
Helps make vitamin D

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21
Q

Honey colored drainage that is very contagious
Part of group A streptococcus
Should use soap and water several times a day
Do not reuse wash cloths because we dont want it to spread to other areas of skin
Use topical and oral antibiotics to help it

A

Impetigo

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22
Q

Acne, impetigo, furuncles (infection deep in the follicle), and carbuncles are examples of..

A

Pustules

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23
Q

Honey colored drainage that is very contagious
Part of group A streptococcus
Should use soap and water several times a day
Do not reuse wash cloths because we dont want it to spread to other areas of skin
Use topical and oral antibiotics to help it

A

Impetigo

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24
Q

MRSA (methicillin resistant staphylococcus aureus) is caused by..

A

People not taking all of their medications

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25
Q

The dormant chicken pox (varicella zoster) virus

Causes pain and vesicles along the dermatomes

A

Herpes Zoster (Shingles)

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26
Q

The dormant chicken pox (varicella zoster) virus
Causes pain and vesicles along the dermatomes
Appears in immunosuppressed patients and typically older patients

A

Herpes Zoster (Shingles)

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27
Q

This medication should be administered within 24 hours of the initial eruption of shingles

A 
Acyclovir (Zovirax)
or Valacyclovir (Valtrex) or Famciclovir (Famvir)
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28
Q

These help shingles to heal faster and many help reduce the incidence and duration of PHN (postherpetic neuralgia) which is the last and very painful phase of shingles

A

Systemic corticosteroids

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29
Q

Pediculosis is..

A

Lice

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30
Q

Pediculosis capitus is..

A

Head lice

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31
Q

Pediculosis corporus is..

A

Body lice

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32
Q

Phthirus pubis is..

A

Pubic lice

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33
Q

Sarcoptes scabei (mites) are..

A

Scabies

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34
Q

Sarcoptes scabei (mites) are..

A

Scabies

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35
Q

When should you treat scabies

A

When you live with someone who has it

Or when you have come in contact with someone who has it

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36
Q

Pediculosis capitus (head lice) is VERY

A

Contagious (but not a sign on uncleanliness)

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37
Q

How do you treat head lice

A

Insecticide or mayonnaise treatment

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38
Q

What should you do after you have used the treatment for head lice

A

Used a fine tooth comb to remove dead lice

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39
Q

What should you do with linens are furniture after someone with lice has come in contact with it

A

Bag anything that cant be washed for at least 2 weeks
Wash linens with very hot water and put them in a hot dryer for a long time
Vacuum floors and furniture

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40
Q

How should you treat pediculosis corporis (body lice)

A

Bathe in soap and water

Apply insecticide

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41
Q

How you remove nits/body lice from eye lashes

A

Apply vaseline and come off nits

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42
Q

Pediculosis pubis is also considered an..

A

STD

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43
Q

You should beware of seizures with insecticide because its..

A

Toxic to the CNS

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44
Q

What medications are used to treat scabies and how

A

Scabicide and it should be left on for 12-24 hours

45
Q

What medications are used to treat scabies and how

A

Scabicide and it should be left on for 12-24 hours

46
Q

This may occur even after the scabies are dead

A

Pruritis (itching) its normal, do not apply more treatment

47
Q

How you remove nits (baby lice) from eye lashes

A

Apply vaseline and come off nits

48
Q

What medications are used to treat scabies and how

A

Shower with warm soapy water

Scabicide and it should be left on for 12-24 hours

49
Q

This may occur even after the scabies are dead

A

Pruritis (itching) its normal, do not apply more treatment

Appears under the skin as an exclamation point

50
Q

In the folds of skin from unclean people

A

Scabies

51
Q

Silvery white scales or lesions in patches
Chronic non-infectious inflammatory disease
It is a life long disease that will get worse, then better, worse, then better and so on
When epidermal cells are turning over too fast
It is not painful and it is not contagious

A

Psoriasis

52
Q

Best way to treat psoriasis

A

Take baths to remove the scales, but don’t over wash
Creams can help
Prevent dryness and injury to the skin

53
Q

Might aggravate psoriasis

A

OTC drugs, heat, and stress

54
Q

Corticosteroids were a treatment for psoriasis but its very dangerous on the skin and especially around the eyes because..

A

It can cause cataracts

55
Q

Corticosteroids were a treatment for psoriasis but its very dangerous on the skin and especially around the eyes because..

A

It can cause cataracts

56
Q

The most common type of skin cancer but rarely fatal
Occurs in lighter skin people, older people, and can occur from sunburns as a child, those with an outdoor occupation are also at risk

A

Basal cell carcinoma

57
Q

What is the difference between basal and squamous cell carcinoma

A

Basal cell is localized

Squamous can metastasize and is much harder to treat

58
Q

What is the difference between basal and squamous cell carcinoma

A

Basal cell is localized

Squamous can metastasize and is much harder to treat

59
Q

The most lethal of all skin cancers
It can be superficial spreading or nodular
Risk factors include sun exposure, in the US its usually the left arm
Incidence and mortality rates are increasing
Peaks at 20-45 years old

A

Malignant melanoma

60
Q

What is the treatment for malignant melanoma

A

They can do a wide surgical incision

If it has metastasized then they can use chemo or radiation

61
Q

What is the ABCDE rule

A

Signs of melanoma

A: asymmetric
B: borders are irregular
C: color variations
D: diameter greater than 6 mm
E: elevated and evolving
62
Q

A rash of purple spots caused by internal bleeding

A

Purpura

63
Q

What does someone who is dehydrated look like

A

Their skin turgor will not snap back
Their mouth will feel dry and will be pulled back from their teeth
Their eyes will be sunken back into their head
Their cheeks will be hollowed out

64
Q

How can you help someone who is dehydrated

A

Give them fluids, either orally or IV

65
Q

How can you help someone who is dehydrated

A

Give them fluids, either orally or IV

66
Q

What is the normal range for sodium

A

135-145 mEq/L

67
Q

Signs of hyponatremia

A

Lethargic, headache, confused, tired

68
Q

Treatment for hyponatremia

A

They have too little salt because they have too much water so we want to restrict water intake or give them a diuretic such as lasix or furosemide, lower their saline if they are being given too much
Could also give a sodium replacement or extra salt, vegetables in the can, salty snacks, chips

69
Q

Signs of hypernatremia

A 
FRIED
F: fever
R: restless
I: increased B/P
E: edema/swelling
D: decreased output
70
Q

Treatment for hypernatremia

A

With hypernatremia they have too much salt so we want to try and dilute that salt down
Might increase their saline to dilute the salt, this time you want to add water to their diet rather than decrease it like in hyponatremic patients, and make sure their liquids are very low in sodium
Have them rinse off canned vegetables because that is a lot of salt

71
Q

What is the normal range for potassium

A

3.5-5 mEq/L

72
Q

Signs of hypokalemia

A

Generalized weakness
Cardiac dysrhythmias
EKG monitor might show changes in heart rhythm

73
Q

Treatment for hypokalemia

A

Add more potassium in diet either by supplement or IV (make sure its diluted, can never give potassium push)
Are they on lasix? We lose potassium with diuretics so make sure if they are on a diuretic that we are giving potassium as well
Broccoli, bananas, dark leafy greens, fortified cereals, orange juice, raisins are all high in potassium

74
Q

Signs of hyperkalemia

A

Irritable, anxious, abdominal cramping, diarrhea, weakness, an irregular pulse, and loose stools
Could have hyperkalemia with renal failure as well because kidneys get rid of potassium
Aladactone and spironolactone medications cause patients to hold on to potassium as well

75
Q

Treatment for hyperkalemia

A

Limit dietary potassium
Give a diuretic to flush some out
Kayexalate is a liquid that does not taste good and causes diarrhea so it will get rid of excess potassium
Dialysis (eliminates waste)
Monitor ECG because too much potassium can cause heart problems

76
Q

Treatment for hyperkalemia

A

Limit dietary potassium
Give a diuretic to flush some out
Kayexalate is a liquid that does not taste good and causes diarrhea so it will get rid of excess potassium
Dialysis (eliminates waste)
Monitor ECG because too much potassium can cause heart problems

77
Q

What are normal calcium ranges

A

8.5-10.5 mg/dL

78
Q

Signs of hypocalcemia

A 
(too much calcium in the bones and not enough in the blood/body)
Painful muscle spasms like a charlie horse
Tetany or lock jaw
Things get really right
Paresthesia
Muscle aches
Seizures
Achy bones
79
Q

Treatment of hypocalcemia

A 
Calcium gluconate
Calcium and vitamin D supplements
Broccoli, tofu, green leafy veggies, baked beans, salmon, and sardines
Weight bearing exercises will help
Can give calcium via IV
80
Q

Pumping a blood pressure cuff up, leave it on for a minute or so, their hand with rise and make a T if they have too little calcium

A

Trousseau’s sign

81
Q

If you tap their cheek they will do a half smile indicating too little calcium

A

Chvostek’s sign

82
Q

Signs of hypercalcemia

A 
Nausea and vomiting
Decreased appetite
Thirsty
Frequent urination
Constipated
Weak, lose muscles
Confusion
Lethargic and very tired (this is the opposite of hypocalcemia when they are really tense)
83
Q

Signs of hypercalcemia

A 
Nausea and vomiting (groans)
Decreased appetite
Thirsty
Frequent urination
-calcium makes kidney stones which can lead to renal fail
Constipated
Weak, lose muscles
Confusion (moans)
Lethargic and very tired (this is the opposite of hypocalcemia when they are really tense)
84
Q

Treatment for hypercalcemia

A

Dilute the calcium with fluids possible IV to try and push it out (furosemide works well)
3-4 liters/day of fluid
Calcetonin drags the calcium back into the bones (this works well for osteoporosis too)
Bisphosphonates put calcium back into the bones too

85
Q

Normal ranges for magnesium

A

1.5-2.5 mg/dL

86
Q

Signs of hypomagnesemia

A 
Vomiting
Looks similar tetany in hypocalcemic patients: confusion, tremors, seizures
Enteral or parenteral feedings might be too low in magnesium
Occurs from:
-Medications
-DKA
-Sepsis
-Burns
-Hypothermia
Often accompanied by hypocalcemia
Dysphagia is common
87
Q

Treatment for hypomagnesemia

A

Oral magnesium or magnesium sulfate IV

Beans, nuts, whole grains

88
Q

Treatment for hypomagnesemia

A

Oral magnesium or magnesium sulfate IV

Beans, nuts, whole grains

89
Q

Signs of hypermagnesemia

A

Muscle weakness, decreased reflexes, hypotension, drowsy, decreased RR
Renal failure can occur just like in hypercalcemia

90
Q

Treatment of hypermagnesemia

A

Diuretics
Hemodialysis
NS IV to try and dilute the magnesium in the blood
Do not administer meds containing magnesium

91
Q

What is a normal pH

A

7.35-7.45

92
Q

Metabolic always blaming it on the

A

Bicarb (HCO3)

93
Q

Respiratory always blaming it on the

A

CO2

94
Q

Metabolic acidosis is a ___ pH and a ___ bicarb

A

Low pH

Low bicarb

95
Q

Metabolic alkalosis is a ____ pH and a ____ bicarb

A

High pH

High bicarb

96
Q

Respiratory acidosis is a ____ pH and a ____ Co2

A

Low pH

High Co2

97
Q

Respiratory alkalosis is ___ pH and a ____ Co2

A

High pH

Low Co2

98
Q

Respiratory alkalosis is ___ pH and a ____ Co2

A

High pH

Low Co2

99
Q

Causes of metabolic acidosis

A

Renal failure
Sepsis
DKA (body is trying to blow Co2/acid out cuz it has too much)
Diarrhea (lose base out the butt)

100
Q

Causes of metabolic alkalosis

A

Vomiting or gastric secretion (getting rid of too much acid)

101
Q

Causes of respiratory acidosis

A

Holding your breath (holding on to too much Co2)

102
Q

Causes of respiratory alkalosis

A

Hyperventilating (breathing in too much O2)

103
Q

Co2 above 45 is..

A

Acidic

104
Q

Co2 below 35 is..

A

Basic

105
Q

HCo3 above 26 is..

A

Basic

106
Q

HCo3 below 22 is..

A

Acidic

107
Q

HCo3 below 22 is..

A

Acidic

108
Q

Fully compensated is when the pH is..

A

Normal

109
Q

To be partially compensated..

A

Something has to be the opposite of the pH

Med Surg 1 (4 decks)

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