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MED-SURGE > EXAM 6 MEDSURGE > Flashcards

EXAM 6 MEDSURGE Flashcards

1
Q

develop from a mutation in a single cell and grows without the control of a normal cell. (they do not listen) They divide rapidly and are extremely aggressive.

A

Cancer cells

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2
Q

well-differentiated,

resembling normal cells from which they originated;

expands at a slow rate;

does not invade or infiltrate surrounding tissues;

usually does not cause tissue damage or death.

A

benign cells

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3
Q

undifferentiated,

look nothing like the cells from which they originated;

grow on the periphery of the tumor;

the less they resemble cells of origin,

the quicker they grow and replicate;

gain access to other areas of the body;

results in death if not detected and controlled.

A

malignant cells

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4
Q

Process by which malignant cells obtain nutrients and oxygen

A

angiogenesis

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5
Q

host tissue produces its own?

A

growth hormone (VEGF)

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6
Q

What causes cancer?

A

Viruses

Overexposed cells

Environment
(physical and chemical agents)

Diet

Genetics

Hormones

Immune system
(surveillance)

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7
Q

ALL cancers involve the malfunction of genes that control…..

A

cell growth and division.

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8
Q

The cells transformation from normal to cancerous is called

A

carcinogenesis!

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9
Q

American Cancer Society
Guidelines

A

Achieve and maintain a healthy weight

Adopt a Physically Active
Lifestyle

Consume a Healthy plant-based diet

Limit alcohol consumption

Involvement of Community

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10
Q

75% of cancers in the US are related to

A

environmental and lifestyle factors.

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11
Q

primary prevention

A

Avoid carcinogens

Dietary changes

Weight management

Reduction in alcohol consumption

Smoking cessation

Preventive medications

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12
Q

secondary prevention of CA

A

screening & early detection

PSA screening

Breast self-examination

mammography

colonoscopy

pap test

cancer-related check-ups

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13
Q

Tertiary Prevention

A

Monitoring for and prevention of recurrence

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14
Q

7 signs of CA acronym

A

CAUTION

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15
Q

C

A

change in bowel or bladder habits

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16
Q

A

A

a sore throat that does not heal

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17
Q

U

A

unusual bleeding or discharge from any body orifice

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18
Q

T

A

thickening or lump in the breast or elsewhere

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19
Q

O

A

obvious change in wart or mole

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20
Q

N

A

nagging cough or hoarseness

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21
Q

Epithelial tissues lining

A

(carcinomas)

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22
Q

Glandular tissues

A

(adenocarcinomas)

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23
Q

Connective, muscle, and bone tissues

A

sarcomas

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24
Q

Tissue of the brain and spinal cord

A

gliomas

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25
Q

Pigment cells

A

(melanomas)

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26
Q

Plasma cells

A

(myelomas)

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27
Q

Lymphatic tissue

A

(lymphomas)

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28
Q

Leukocytes

A

(leukemia)

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29
Q

Erythrocytes

A

(erythroleukemia)

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30
Q

The tumor is classified by

A

the appearance of the cells and the degree of differentiation

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31
Q

Grade 1:

A

mild dysplasia

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32
Q

Grade 2:

A

moderate dysplasia

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33
Q

Grade 3:

A

severe dysplasia

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34
Q

Grade 4:

A

anaplasia

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35
Q

Determines the extent of the disease process:

A

clinical staging

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36
Q

Stage 0:

A

cancer in situ

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37
Q

Stage 1:

A

tumor limited to tissue of origin

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38
Q

Stage 2:

A

limited local spread

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39
Q

Stage 3:

A

extensive local/regional spread

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40
Q

Stage 4:

A

metastasis

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41
Q

TNM Classification System

A

tumor size
lymph nodes
metastasis

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42
Q

how to measure tumor size

A

0=no tumor

4= large tumor and other tissue involvement

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43
Q

how to measure degree of lymph node involvement

A

0= no lymph node involvement

3= regional lymph nodes involved-metastasis expected

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44
Q

how to measure metastasis

A 
0= none
3= significant metastasis
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45
Q

Diagnostic studies are done to determine the extent of the disease:

A

bone and liver scans,

ultrasonography,

computed tomography,

MRI,

PET imaging, and

tumor markers

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46
Q

Interventions to manage cancer

A

surgery
chemo
radiation

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47
Q

complementary therapies

A

naturopathic medicine

nutritional therapy

physical rehabilitation

mind-body medicine

spiritual support

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48
Q

conventional therapies

A

surgery

chemo

immunotherapy

radiation

stem cell transplant

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49
Q

ND for patients with cancer

A

impaired oral MM

impaired tissue integrity: alopecia

imbalanced nutrition

fatigue

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50
Q

is a model of care that improves the quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and treatment of pain and other distressing symptoms (physical, psychosocial, and spiritual).

A

palliative care

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51
Q

Factors Affecting Responses to Loss

A

Age

Social Support

Families

Culture and Spiritual

Practices

Spiritual Beliefs

Rituals of Mourning

Nurses Response to Loss of
Patient

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52
Q

states that “each person has the right to be cared for by caring, sensitive, knowledgeable people who will attempt to understand my needs and be able to gain some satisfaction in helping me fact my death.”

A

the dying person’s bill of rights

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53
Q

the process of dying

A

preparation for death

death

after death

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54
Q

phase 1: preparation for death

A 
Coolness
Lethargy
Decrease in intake
Incontinence
Congestion
Breathing pattern change
Disorientation
Restlessness
Withdrawal
Visual hallucinations
Letting go, saying goodbye
Generalized edema
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55
Q

phase 2: death

A 
Asystole
Release of bowel and bladder
No response
Eyelids slightly open
Pupils enlarged
Fixed eyes, no blinking
Jaw relaxed
Mouth slightly open
Mottled extremities
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56
Q

phase 3: after death

A

Family decisions (organ donation, cremation, burial)

Post death rituals (funerals)

Postmortem care

Organ harvesting

Healthcare workers attend funeral?

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57
Q

the study of blood and blood forming tissues.

A

hematology

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58
Q

blood consists of?

A

55% plasma

45% formed elements

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59
Q

Formed elements include

A

erythrocytes, leukocytes, and thrombocytes.

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60
Q

bone marrow produces how many RBCs per day

A

175 billion

61
Q

hemoglobin level

A

13.5-17.5

62
Q

hematocrit levels

A

41-53

63
Q

what to RBCs look like

A

non-nucleated

biconcave

disk-shape cell

64
Q

Mature erythrocytes consist primarily of ?

A

hemoglobin.

65
Q

Principle function of RBCs is to

A

transport oxygen between the lungs and the tissue

66
Q

life span of RBCs

A

120 days

67
Q

leukocytes

A

WBCs

68
Q

WBC count

A

4,000-11,000

69
Q

granulocytes

A

eosinophils
basophils
neutrophils

70
Q

hypersensitivity reactions

A

eosinophils

71
Q

produce and store histamine

A

basophils

72
Q

ingestion and digestion of bacteria

A

neutrophils

73
Q

agranulocytes

A

monocytes

lymphocytes

74
Q

phagocytize bacteria within the tissues

A

monocytes

75
Q

principle cells of the immune system; produce antibodies

A

lymphocytes

76
Q

Involved in fighting infection, combatting allergic reactions, and immune responses.

A

leukocytes

77
Q

Not technically cells. Granular fragments from giant cells in the bone marrow.

A

thrombocytes

78
Q

normal range for thrombocytes

A

130,000-400,000

79
Q

normal life span of thrombocytes

A

7-10 days

80
Q

Active role in coagulation and maintaining hemostasis.

A

thrombocytes

81
Q

A complex process the body uses to stop bleeding.

A

Blood Clotting

82
Q

CBC

A

Erythrocytes

Leukocytes

Platelets

Hemoglobin

Hematocrit

RBC

MCV (Ch. 33)

MCHC (Ch. 33)

83
Q

(percentage of total blood volume consisting of RBCs)

A

hematocrit

84
Q

(iron-containing protein of the RBC)

A

hemoglobin

85
Q

The number, appearance and development of the various blood cell types are analyzed to diagnose hemolytic blood disorders.

A

Bone Marrow Aspiration 
and Biopsy

86
Q

Aspirate is typically obtained from the ?

A

posterior superior iliac crest (Biopsy), anterior iliac crest, or sternum.

87
Q

The Nurse’s Role in Bone Marrow Aspirate and Biopsy

A

Honest explanation of the procedure by physician and nurse

Signed Informed Consents

Positioning is based on the site where aspirate/biopsy will be obtained from

Aseptic cleansing, anesthetizing of the site, aspiration (generally 5 mLs), pressure applied to the site, covered with sterile dressing

88
Q

part of the lymphatic system

Role is to filter the blood, produce lymphocytes and store blood and platelets

A

spleen

89
Q

Hemoglobin concentration is lower than normal or the number of circulating RBCs is decreased

A

anemia

90
Q

anemia is caused by?

A

impaired RBC formation

excessive loss or destruction of RBCs

hemorrhage

chronic bleeding

Nutritional problems that interfere with the body’s ability to form RBCs

91
Q

3 classifications of anemia

A

defect in their production

by their destruction

by their loss

92
Q

bya defect in their production

A

hypoproliferative anemia

93
Q

by their destruction

A

hemolytic anemia

94
Q

by their loss

A

bleeding

95
Q

Catagorizes the RBCs by size (Normocytic, Microcytic, Macrocytic)

A

MCV (Mean corpuscular volume)

96
Q

Average concentration of Hemoglobin which is reflective in its color (Normochromic, Hypochromic)

A

MCHC (mean corpuscular hemoglobin concentration)

97
Q

hypoproliferative anemia have def. in ?

A

iron
B12
folate

98
Q

An inadequate supply of iron for RBC formation

Most common type of anemia

Body can not make hemoglobin without iron

Deficiency leads to fewer RBCs, smaller RBCs (microcytic) and pale RBCs (hypochromic)

A

iron deficiency anemia

99
Q

the usual cause of iron def. anemia

A

iron loss due to bleeding

100
Q

What are typical sources of bleeding in Adults?

A

Menstrual cycle in females

Chronic blood loss from ulcers

Hemorrhoids

Cancer

101
Q

Required for RBC formation and maturation

A

Vitamin B12 Deficiency (Pernicious) Anemia

102
Q

usual cause of Vitamin B12 Deficiency (Pernicious) Anemia is?

A

impaired absorption from the GI tract

103
Q

secreted by the gastric mucosa, binds with dietary B12 so it can be absorbed in the body

A

intrinsic factor

104
Q

Lack of B12 results in release of

A

immature, megaloblastic RBCs that are fragile and incapable of carrying oxygen in adequate amounts

105
Q

Required for normal production and maturation of RBCs

Absorbed from the intestines

Found in green leafy vegetables, fruits, fortified cereals and meats

A

folic acid

106
Q

Folic Acid Deficiency Anemia is characterized by what type of RBCs

A

fragile
immature
megaoloblastic

107
Q

Folic Acid Deficiency Anemia is more common among people who are?

A

chronically malnourished

on TPN

PG

108
Q

Characterized by the premature destruction of RBCs. May be destroyed due to improperly formed cells (intrinsic) or damage by an outside source (acquired)

A

hemolytic anemia

109
Q

ex of hemolytic anemia

A

altered erythropoiesis

hypersplenism

drug-induced anemia

autoimmune anemia

mechanical heart valve-related anemia

110
Q

Genetically transmitted, autosomal recessive trait (both parents)

Usually affects those of African American descent

A

sickle cell anemia

111
Q

sickle cell anemia is characterized by abnormal ___ in the RBCs

A

hemoglobin S

112
Q

when do cells sickle?

A

when blood O2 falls

113
Q

what do cells do when they sickle?

A

clump together and obstruct small blood vessels

114
Q

when does shape return to normal for sickle cells?

A

when O2 levels are restored

115
Q

what can damage overtime in sickle cell anemia?

A

membranes

116
Q

____ occurs in sickle cell which leads to anemia

A

hemolysis

117
Q

Sx of sickle cell anemia

A

abrupt onset of INTENSE PAIN in abd, chest, back, and/or joints

118
Q

the obstruction of BVs in sickle cell anemia can cause?

A

tissue ischemia

119
Q

in sickle cell anemia you may see ____ due to release of bilirubin

A

jaundice

120
Q

when will sickle cell anemia occur?

A

chronic

unpredictable

recurrent

121
Q

Entrapment of erythrocytes and leukocytes in the microcirculation causing hypoxia, inflammation, and necrosis

seen in sickle cell pts.

A

acute-vaso-occlusive crisis

122
Q

what to educate pts on with acute-vaso-occlusive crisis

A

Educate on ways to minimize precipitating events; alert the patient to signs and symptoms of tissue hypoxia, infection, neurological deficits, respiratory and cardiovascular dysfunction.

123
Q

what do you treat with acute-vaso-occlusive crisis

A

TX THE PAIN

124
Q

EVENTS Leading to CRISIS

A

Fever

Emotional or physical stress or events

Fatigue

Low oxygen- high altitude settings

Poorly pressurized planes

Hypoventilation

Vasoconstriction when cold

Dehydration

Vomiting

Acidosis

Alcohol consumption

Pregnancy

125
Q

Sickled cells can resume a normal shape when

A

rehydrated and reoxygenated.

126
Q

what to focus on in pts with sickle cell?

A

PAIN CONTROL
rehydrate
oxygenate

127
Q

Also referred to as Erythrocytosis (abnormally high red blood cell count with high hematocrit)

A

polycythemia

128
Q

Hematocrit of greater than ___% in females and ___% in males-blood becomes more viscous (sticky)

A

50; 55

129
Q

is most common form-result of chronic hypoxia/excess production of erythropoietin

A

Secondary Polycythemia

130
Q

what can cause polycythemia

A

high altitudes

smoking

chronic lung dx

131
Q

how to tx polycythemia

A

tx of the contributing factor

132
Q

A decrease in the number of circulating neutrophils either my decreased production or increased destruction

A

neutropenia

133
Q

Decreased neutrophil count greatly increases the risk of ?

A

infection

134
Q

First indication of deficiency of neutrophils is usually an ?

A

infection

135
Q

Platelet count of less than 100,000 /mL of blood

A

thrombocytopenia

136
Q

thrombocytopenia is the most common cause of?

A

abnormal bleeding

137
Q

if the platelet number falls below 20,000 what is likely?

A

spontaneous bleeding (internal & external)

petechiae

138
Q

thrombocytopenia can result from?

A

decreased platelet production

increase destruction of platelets

increased consumption of platelets (clotting process)

139
Q

sx of thrombocytopenia

A

Ecchymosis

Petichiae

Epistaxis

Menorrhagia

Hematuria

Gastrointestinal bleeding

Gingival bleeding

140
Q

Simultaneous blood clotting and hemorrhage

Tissue damage activates an abnormal activation of the body’s clotting mechanisms.

Widespread, continuous clot formation which consumes all of the clotting factors, resulting in generalized bleeding.

A

Disseminated Intravascular Coagulation (DIC)

141
Q

DIC is due to an underlying condition such as?

A

sepsis

shock

trauma

CA

abruptio placenta

toxins

allergic rxns

142
Q

what kind of temp in DIC

A

decreased

143
Q

increased ___ in extremities in DIC

A

cyanosis

144
Q

what kind of pain in DIC

A

increased

145
Q

what kind of bleeding in DIC

A

internally or from all orifices

146
Q

what kind of pulses in DIC

A

decreased

147
Q

what kind of cap refill in DIC

A

increased time

148
Q

where is the pain in DIC

A

gastric & chest

MED-SURGE (5 decks)

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