Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NSG 322 Med Surge I > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

primary headaches

A

not caused by disease or another medical condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

secondary headaches

A

caused by another condition or disorder (sinus infection, neck injury, or stroke)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

primary classifications of headaches

A
  • tension-type
  • migraine
  • cluster
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

tension-type headaches

A
  • characterized by bilateral location and pressing/tightening quality
  • usually of mild or moderate intensity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

most common type of headache

A

tension-type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

migraine headache

A
  • recurring headaches
  • unilateral or bilateral throbbing pain
  • a triggering event or factor
  • manifestations associated with neurologic and ANS dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

categories of migraine headache

A
  • migraine without aura (most common)
  • migraine with aura
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cluster headache

A
  • rare form of headache
  • sharp, stabbing pain
  • can occur repeatedly for weeks to months at a time, followed by periods of remission
  • one of the most severe forms of head pain
  • all over the face
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what can occur with a pts. mood if they have a cluster headache?

A

they can become agitated and restless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

acute treatment for a cluster headache

A

inhalation of 100% oxygen at 6-8 L/min for 10-20 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PAD

A

involves progressive narrowing and degeneration of arteries of upper and lower extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

leading cause of PAD

A

atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

intermittent claudication

A
  • ischemic muscle pain that is caused by a constant level of exercise
  • caused by buildup of lactic acid resulting from anaerobic metabolism
  • resolves within 10 minutes
  • reproducible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what should you do if you have intermittent claudication?

A

sit down until it stops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

clinical manifestations of PAD

A
  • intermittent claudication
  • paresthesia
  • thin, shiny, taut skin
  • loss of hair on lower legs
  • diminished or absent pedal, popliteal, or femoral pulses
  • pallor of foot with leg elevation
  • reactive hyperemia of foot with dependent position
  • pain at rest (mostly at night)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

complications of PAD

A
  • atrophy of skin and underlying muscles
  • delayed healing
  • wound infection
  • tissue necrosis
  • arterial ulcers
  • nonhealing arterial ulcers and gangrene are most serious complications
  • may result in amputation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

risk factor modification for PAD

A
  • tobacco cessation
  • aggressive treatment of hyperlipidemia (dec. LDL and triglycerides, inc. HDL)
  • BP <140/90
  • A1C < 7.0% for diabetes`
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does exercise do in PAD?

A

improves oxygen extraction in the legs and skeletal metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ideal waist circumference

A

men: < 40 inches
women: < 35 inches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

percutaneous transluminal balloon angioplasty (PTA)

A
  • used for PAD
  • involves the insertion of a catheter through the femoral artery
  • balloon is inflated dilating the vessel by compressing atherosclerotic intimal lining
  • stent is places
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

atherectomy

A
  • removal of the obstructing plaque
  • can lead to clot floating around in circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

cryoplasty

A
  • combines percutaneous transluminal angioplasty and cold therapy
  • liquid nitrous oxide - the cold limits restenosis by reducing smooth muscle cell activity
  • freeze it
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what should we monitor for after a surgery with PAD?

A
  • skin color and temperature
  • capillary refill
  • presence of peripheral pulses distal to the operative site
  • sensation and movement of extremity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what position should be avoided after PAD surgery?

A

knee-flexed except for exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what do we want to tell someone for home care after surgery with PAD?

A
  • manage risk factors
  • long-term aspirin therapy
  • gradual physical activity
  • meticulous foot care
  • inspection of the feet
  • comfortable shoes with rounded toes and soft insoles
  • shoes lightly laced
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

acute arterial ischemic disorders

A
  • sudden interruption of arterial blood supply
  • if persists can cause tissue death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

clinical manifestations of acute arterial ischemic disorders

A

SIX Ps
- Pain
- Pallor
- Pulselessness
- Paresthesias
- Paralysis
- Poikilothermia (adaptation of the limp to environmental temperature)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how do we treat raynaud’s?

A
  • teach to avoid temperature extremes-wear gloves
  • immerse hands in warm water
  • stop all tobacco, caffeine, or any vasoconstricting drugs
  • debridement or sympathectomy (cut nerves)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how do we treat phlebitis?

A
  • remove IV
  • warm moist heat and elevation
  • NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

virchow’s triad

A
  • venous stasis
  • endothelial damage
  • hypercoagulability of blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

clinical manifestations of VTE

A
  • superficial: palpable cord, warm, tender, reddened area around the affected vein
  • deep: unilateral leg pain, tenderness, warm skin, erythema, leg edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

complications of VTE

A
  • PE
  • post thrombotic syndrome: persistent edema, pigmentations, varicosities, lipodermatosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

nursing care when giving anti-thrombolytics

A
  • monitor VS
  • examine for signs of bleeding
  • evaluate labs
  • avoid IM injections, use small calibers needles, hold pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

clinical manifestations of varicose veins

A
  • heavy achy feeling after prolonged standing
  • relieved by walking or elevation of limb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

treatment of chronic venous insufficiency and venous leg ulcers

A
  • compression
  • wound care
  • nutrition
  • position changes
  • walking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

modifiable risk factors for CVA

A
  • HTN
  • a fib
  • DM II
  • serum cholesterol
  • smoking
  • alcohol consumption
  • sedentary lifestyle
  • hypercoagulable state
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

non-modifiable risk factors for CVA

A
  • age >65
  • women increased risk due to increased estrogen
  • blacks
  • family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

normal LDL levels

A

< 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

normal triglyceride levels

A

< 150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

normal HDL levels

A

> 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

BEFAST of stroke

A

Balance off
Eyes - unclear vision
Face/facial droop
Arms/legs weak
Speech slurred, confused
Time lost is brain lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

ischemic stroke

A

lack of blood flow, lack of O2 to brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

hemorrhagic stroke

A

something bleeding into brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

prehospital principles to help with a stroke

A
  • keep airway safe
  • O2 if sat <90%
  • check BG, treat less than 60
  • avoid treating HTN: permissive HTN for 24 hours, post tPA >180/105, no tPA >220/120
  • report to ED
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

eligibility criteria for tPA

A
  • ischemic stroke causing measurable neurologic deficit
  • time from onset of stroke symptoms less than 4.5 hours before tPA administration
  • NIHSS >5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is the relationship between HTN and cardiovascular disease?

A

direct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

BP =

A

CO x SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

definition of HTN

A
  • sys. BP >=140 mm Hg
  • dia. BP >=90 mm Hg
  • current use of antihypertensive drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

definition of prehypertension

A
  • sys. BP 120-139 mm Hg
  • dia. BP 80-89 mm Hg
50
Q

primary HTN

A
  • elevated BP without an identified cause
  • 90-95% of all cases
51
Q

secondary HTN

A

elevated BP with a specific cause

52
Q

epilepsy

A
  • condition in which a person has spontaneously recurring seizures caused by underlying chronic condition
  • in US, 3 million people have epilepsy
53
Q

what is the main goal in a tonic-clonic seizure?

A

SAFETY

54
Q

how are focal seizures divided?

A
  • simple focal seizures
  • complex focal seizures
55
Q

simple focal seizures

A

person remains conscious

56
Q

complex focal seizures

A
  • person has change or loss of consciousness
  • produces a dreamlike experience
57
Q

complications of epilepsy

A
  • status epilepticus
  • tonic-clonic status epilepticus
  • severe injury and death from trauma during a seizure
  • effect on lifestyle
58
Q

status epilepticus

A
  • a state of constant seizure or condition when seizures recur in rapid succession with out return to consciousness between seizures
  • most serious complication
  • neurologic emergency
  • can involve any type of seizure
  • causes the brain to use more energy than is supplied
  • neurons become exhausted and cease to function
  • permanent brain damage can result
59
Q

tonic-clonic status epilepticus

A
  • most dangerous
  • can cause ventilatory insufficiency, hypoxemia, cardiac arrhythmias, hyperthermia, systemic acidosis
  • can be fatal
  • ask them if they breathe in post-ictal state!!!!
60
Q

mortality rate with epilepsy

A

2-3 times the rate of the general population

61
Q

when should we seek immediate medical care in a seizure?

A
  • status epilepticus occurs
  • significant bodily harm occurs
  • the event is a first- time seizure
62
Q

what do we give initially in status epilepticus?

A

rapid-acting IV lorazepam (Ativan) or diazepam (Valium) followed by long-acting drugs

63
Q

what do neurologic assessment test for in seizures?

A
  • testing for toxicity
  • nystagmus
  • hand and gait coordination
  • cognitive functioning
  • general alertness
64
Q

gerontologic considerations in seizures

A
  • consider liver function (can become toxic)
65
Q

health promotion for seizures

A
  • promote safety measures
  • wear helmet if risk for head injury
  • general health habit (diet, exercise)
  • assist to identify events or situations precipitating seizures and avoid if possible
  • instruct to avoid excessive alcohol, fatigue, and loss of sleep
66
Q

acute intervention for seizures

A
  • maintain patent airway, support head, turn to side, loosen constrictive clothing, ease to floor
  • do not restrain
67
Q

classic triad of PD

A
  • tremor
  • rigidity
  • bradykinesia
68
Q

tremor

A
  • so minimal initially that only the patient notices
  • more prominent at rest and is aggravated by emotional stress or increased concentration
  • describe as pill rolling
69
Q

rigidity

A
  • increased resistance to passive motion when limbs are moved through ROM
  • typified by a jerky quality when joint moved
  • similar to intermittent catches in the movement of a cogwheel
  • complaint of soreness, feeling tired and achy, pain in the head, upper body, spine or legs
70
Q

bradykinesia

A
  • slowing down in initiation and execution of movement
  • evident in loss of autonomic movements: blinking, swinging of arms while walking, swallowing, self-expression with facial movement
71
Q

what do we want to ensure with PD when they are eating?

A

can cause dysphagia, so food needs to be easily chewed and swallowed

72
Q

what can we do to help PD when they are discharged home?

A
  • remove rugs and excess furniture
  • simplify clothing from buttons and hooks
  • use elevated toilet seats
  • use ottoman to elevate legs
73
Q

myasthnia gravis

A

mouth to ground; muscles

74
Q

GB syndrome

A

ground to brain; worried about when it gets to diaphragm controlled by brain

75
Q

ALS (Lou Gehrig)

A

froze, loss of function in muscles everywhere except face; “frozen in own body”

76
Q

huntington’s

A

genetic, “sneaky movement”

77
Q

multiple sclerosis

A
  • chronic, progressive, degenerative disorder of the CNS
  • characterized by segmental demyelination of nerve fibers of the brain and spinal cord
78
Q

when is the onset of MS

A

20-50 years of age

79
Q

who is affected more with MS?

A
  • women are affected 2-3 times more than men
  • 5x more prevalent in temperate climates (don’t get a lot of vitamin D)
80
Q

how do researchers believe MS develops?

A

in genetically susceptible person as a result of environmental exposure, infection, smoking, physical injury, emotional stress, excessive fatigue, pregnancy, and a poorer state of health

81
Q

is MS autoimmune?

A

yes, it is orchestrated by activated T cells

82
Q

what happens with the T cells in MS?

A

they migrate to the CNS, cause blood-brain disruption. subsequent antigen-antibody reaction leads to demyelination of axons

83
Q

what does pregnancy do with autoimmune disease?

A

it makes them better

84
Q

most common classification of MS

A

relapsing-remitting: it is the most manageable too

85
Q

are there any diagnostic tests for MS?

A
  • no definitive
  • based on history, manifestations, diagnostic tests
  • MRI of brain and spinal cord may show the presence of plaques, inflammation, atrophy, and tissue breakdown and destruction
  • CSF increased in IgG and presence of oligoclonal banding
86
Q

for a diagnosis of MS, what must happen?

A
  • evidence of at least 2 inflammatory demyelinating lesions in at least 2 different locations within the CNS
  • damage or an attack occurring at different times (usually >= 1 month apart)
  • all other possible diagnoses must have been ruled out
87
Q

is there a cure for MS?

A
  • no cure; collaborative care is aimed at slowing disease process and symptomatic relief
  • risk of side effects and end organ damage versus rate of progression and severity of attacks
88
Q

planning for MS

A
  • maximise NM function
  • maintain independence
  • manage disabling fatigue
  • optimize psychosocial well-bring
  • adjust to illness
  • decrease factors that precipitate exacerbations
  • teah patient
89
Q

vascular dementia

A
  • loss of cognitive function due to brain lesions cause by CV disease
  • result of decreased blood supply from narrowing and blocking of arteries that supply brain
  • can be caused by a single stroke or multiple strokes
  • can be prevented through treatment of risk factors: HTN, diabetes, smoking, hypercholesterolemia, dysrhythmias
90
Q

what is the greatest risk factor for dementia?

A

aging; not a normal part of aging

91
Q

what does family history have to do with dementia?

A

those with a 1st degree relative at higher risk

92
Q

other predisposed risks of dementia

A
  • diabetes mellitus
  • head trauma
  • obesity
  • smoking
  • cardiac dysrhythmias
  • HTN
  • hypercholesterolemia
  • CAD
93
Q

acute or subacute pattern of change may be more indicative of what?

A

an infectious or metabolic change

94
Q

how is dementia diagnosed?

A
  • through determining the cause
  • ruling out other conditions
  • MRI and CT to identify cognitive loss and brain lesions
95
Q

alzheimer’s disease

A

chronic, progressive, degenerative disease of the brain; most common form of dementia

96
Q

cause of alzheimer’s

A

exact cause is unknown; likely a combination of genetic and environmental factors

97
Q

most important risk factor of alzheimer’s

A

age

98
Q

what is the main thing that happens in alzheimer’s?

A

brain atrophy

99
Q

in alzheimer’s, pathologic changes precede clinical manifestions…

A

by 5-20 years

100
Q

early signs of alzheimer’s

A
  1. memory loss that affects job skills
  2. difficulty performing familiar tasks
  3. problems with language
  4. disorientation to time and place
  5. poor or decreased judgement
  6. problems with abstract thinking
  7. misplacing things
  8. changes in mood or behavior
  9. changes in personality
  10. loss of initiative
101
Q

initial manifestations of AD

A
  • memory loss
  • mild disorientation
  • trouble with words and numbers
102
Q

what is the goal of AD?

A

early intervention

103
Q

MCI

A
  • does not yet meet criteria for dementia
  • is within 2nd stage in AD spectrum
  • is below defined norms
104
Q

causes of MCI

A

stress, anxiety, depression, physical illness

105
Q

primary treatment of MCI

A

based on careful monitoring - watch for 10 signs of AD

106
Q

how is AD diagnosed?

A

by exclusion

107
Q

what does a definitive diagnosis of AD require?

A

an autopsy

108
Q

collaborative management of AD

A
  • controlling undesirable behavior manifestations
  • providing support for the family caregiver
109
Q

what does drug therapy do for AD?

A
  • some modest decrease in rate of decline of cognitive function
  • treating associated depression
110
Q

overall goals of AD

A
  • maintain functional ability as long as possible
  • be maintained in a safe environment with a minimum of injuries
  • have person care needs met
  • have dignity maintained
  • reduce caregiver stress
  • maintain personal, emotional, and physical health
  • cope with long-term effects associated with caregiving
111
Q

what are some big problems for those with AD?

A
  • inability to communicate other healthcare problems
  • hospitalization can precipitate a worsening of disease or delirium
112
Q

what might family need when dealing with a family member with AD?

A

resources for respite

113
Q

what is sundowning and who experiences it?

A

AD patients can experience; patient becomes more confused and agitated late in afternoon or evening

114
Q

ultimate cause of death in many AD patients

A

pneumonia

115
Q

who might need to be consulted with help eating for AD patients?

A

OT

116
Q

delirium

A
  • state of temporary but acute mental confusion
  • common problem
  • life-threatening
  • possibly preventable syndrome
117
Q

main hypothesis of delirium

A

reversible impairment of cerebral oxidative metabolism and multiple neurotransmitter abnormalities

118
Q

precipitating factors for delirium

A
  • admission to ICU
  • use of physical restraints
  • pain (especially untreated)
  • emotional stress
  • prolonged sleep depreivations
  • dehydration
  • malnutrition
  • drugs
119
Q

acute delirium clinical manifestations

A
  • lasts from 1-7 days
  • may persists up to and after discharge
  • patient at increased risk for falls
  • manifestations are sometimes confused with dementia and dpression
120
Q

acute delirium clinical manifestations

A
  • lasts from 1-7 days
  • may persists up to and after discharge
  • patient at increased risk for falls
  • manifestations are sometimes confused with dementia and depression

NSG 322 Med Surge I (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions