FINAL Flashcards by Brandie Alnobani

Depression of bone marrow function

Myleosuppression

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If bone marrow producing sites are irradiated, what conditions can this cause?

Anemia (decreased RBCs, hemoglobin, or volume of packed RBCs)
Leukopenia (decreased WBCs)
Thrombocytopenia (decreased platelet count)

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Common adverse effects associated with chemotherapy

N/V common w in first 24 hrs
Stomatitis and mouth soreness
Myleosuppression
Fatigue

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Results from inhibition of the manufacture of RBCs, WBCs and platelets

Myleosuppression

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The immune system is a collection of specialized ___ and __ that maintain ___

WBC & lymphoid tissue
Immunocompetence

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The ability to cooperatively protect a person from external invaders and the body’s own altered cells.

Immunocompetence

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Immunosuppressive drugs for autoimmune disorders
(Cytotoxic drugs)

Mercaptopurine azathioprine (Imuran)
-inhibit inflammatory immune of T and B cells (lymphocytes)
*safety warning: increases susceptibility to infections

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Promotes release of vasoactive chemicals such as histamine and bardykinin in allergic, hypersensitivity and inflammatory reactions. * see this w a latex allergy

IgE

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Manifestations of an anaphylactic reaction

Shock
Laryngeal edema
Wheezing
Stridor
Tachycardia
Generalized itching
Hypotension
Bronchospasm
Angioneurotic edema

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Inhaled allergens often trigger

Asthma

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A complex of symptoms primarily characterized y profound fatigue with no identifiable cause. The fatigue worsens with physical activity and *does not improved with rest

CFS

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Staining the surface with fluorescein dye identified a minute foreign body or abrasions to the cornea

Eye trauma diagnostic

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Normal IOP

10-21

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Glaucoma =

Increased IOP with progressive loss of peripheral vision
No atropine, allergy, cold meds

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In cataracts, after surgery vision is restored with one of 3 methods

IOL implant (most common)
Corrective eyeglasses
Contact lens

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__ or __ lens is implanted and reduces the need for corrective glasses
In cataracts

Monofocal (single vision)
Multifocal

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Cochlear implant may be beneficial

Profoundly deaf
Severe hearing loss
Hearing aid ineffective

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Result of a bony overgrowth of the stapes and a common cause of hearing impairment among adults. Fixation of the stapes occurs gradually over many years

Otosclerosis

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OTC antihistamines for motion sickness symptoms (N/V)

Dimenhydrinate (Dramanine)
Meclizine hydrochloride (Antivert)

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A disorder characterized by fluctuations in the volume and pressure in the endolymphatic sac of the inner ear

Meniere disease

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Triad of symptoms in meniere

Hearing loss
Vertigo
Tinnitus

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Jaundice caused by excessive destruction of RBCs

Hemolytic jaundice

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Jaundice caused by liver disease (damaged liver cells cannot clear normal amounts of bilirubin from the body)

Heptatocellular

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Jaundice caused by a block in the passage of bile between the liver and intestinal tract

Obstructive

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Acute hemorrhage from esophageal varices resuscitative measure

IV fluids and blood products IV octreotide (Sandostatin) started asap

Action of octreotide

Reduces pressure in the portal venous system

For a colectomy, a prepo “stress dose” of IV steroid ___ is given to clients who have been on prednisone within the previous 6 months to prevent adrenal crisis

Hydrocortisone

S&S of a adrenal crisis

Weakness Lethargy Hypotension N/V

Ileoanal Reservoir post op risks

R/o fluid volume deficit R/o bowel incontinence R/o impaired perianal skin integrity

When to empty ostomy pouch

1/3 full

Colostomy irrigation begins on the __ or __ postop day

4th or 5th

Standard irrigation amount for a colostomy

500-1500mL tepid water

Irrigate colostomy same __, every__, after__

Time Day Meals

Diagnostic findings for acromegaly

Glucose tolerance test GH measurement (Bolus of glucose should lower GH, but remains elevated with acromegaly)

Treatment of choice for acromegaly

Hypophysectomy Surgical removal of pituitary gland, which lies within the sella turcica, a saddle shaped depression in the sphenoid bone.

A GH receptor antagonist, is the newest and most effective drug for treating acromegaly. Injected subcut once a day

Pegvisomant

Antithyroid drugs given to block the production of thyroid hormone preop or for long term treatment if not candidate for surgery or radiation

Propylthiouracil (PTU,PropylThyracil) Methaimazole (Tapazole)

Require daily corticosteroids replacement therapy for the rest of their lives w this condition

Adrenal inssufficiency (Addison Disease)

Diagnostic for Addison disease (adrenal insufficiency)

Synthetic ACTH cosyntropin (cortrosyn) Administered IM as a screening test for adrenal function

HbA1c for diabetic

Less than 7%

__ & ___ cannot be mixed with other types of insulin in the same syringe

Glargine (Lantus) Detemir (Levemir) They are peakless

Only biguanide approved for use together with TZDs, which include..

Biguanide: Metformin (Glucophage) TZDs: rosiglitazone (Avandia) pioglitazone (Actos)

“Insulin sensitizers” they help tissues use available insulin more efficiently

TZDs Rosiglitazone (Avandia) Pioglitazone (Actos)

Pathologic changes in the nerves

Neuropathy

Results from poor glucose control and decreased blood circulation to nerve tissues. Manifestations more common in clients w DM who smoke & who’s blood glucose level is poorly controlled

Peripheral neuropathy

Peripheral neuropathy =

Blood vessels compromised

HPV is the cause of 70% __ and 90% __

Cervical cancer Cervical warts

Consequence of breast cancer surgery

Lymphedema

Lymphedema, a consequence of removing the axillary lymph nodes is evidenced by temporary or permanent ___

Enlargement of the arm and hand of the side of the amputated breast

__ is the basis for various drugs & therapeutic cancer vaccines. Rather than prevent breast cancer, it __

Immunotherapy Stimulates the immune systems ability to attack and rid the body of cancer cells

A breast cancer preventative study determined that __ reduced the occurrence of estrogen receptive positive tumors, but did not affect the occurrence of estrogen receptor negative tumors

Tamoxifen

Orchitis = __ = __

Mumps Sterility

No infectious epididymitis may result from

Long term indwelling catheter use

Nursing management for BPH

Teach how to maintain optimal bladder emptying Explain they will have continuous irrigation for at least 24 hrs after surgery

STIs that require national reporting

Chlamydia Gonorrhea Hep B HIV Syphilis Chancroid Zika

STI not required for reporting but is the most common STI

HPV

Of the reportable STIs, these are easily cured with early and adequate treatment

Chlamydia Gonorrhea Syphilis

STI that can be transmitted from the blood of a person who is infected directly from the lesion, or across the placenta to an unborn infant

Syphilis

STI that can be transmitted from the blood of a person who is infected directly from the lesion, or across the placenta to an unborn infant

Syphilis

In the primary (early stage), a chancre (painless ulcer) appears in the genitals, anus, cervix or other parts of the body

Syphilis

Secondary stage of syphilis includes

Fever, malaise, lymph node enlargement, rash on trunk, back, arms, palms, or soles of feet that do not itch, patchy hair loss, headache, sore throat

Secondary stage of syphilis includes

Fever, malaise, lymph node enlargement, rash on trunk, back, arms, palms, or soles of feet that do not itch, patchy hair loss, headache, sore throat

Symptoms of the tertiary stage of syphilis

*noninfectious (microorganism invades CNS & other organs Tabes dorsalis (degenerative condition of CNS that results in stabbing back pain & leg pain) Unsteady gait, urinary incontinence, blindness & other neurologic symptoms like dementia Charcot (neuropathic joint disease) Heart involvement as well as

Transmission can occur from mother to infant during vaginal birth and carries a high rate of neonatal mortality

HSV

Why does HSV reoccur

Bc the virus remains dormant in the ganglia of the nerves that supply the area until reactivation

Antiviral drugs for HSV

Acyclovir (Zovirax) Valacyclovir (Valtrex) Famciclovir (Famvir)

A __ is indicated if a stone has permanently and severely damaged a kidney beyond adequate function. The other kidney must be fully functional

Nephrectomy

A catheter inserted through the skin into the renal pelvis to drain fluid from the affected kidney after procedure

Nephrostomy tube or pyelostomy tube

Used to manage any obstruction to urine flow above the bladder. Kept in place with a suture through the skin

Nephrostomy tube

If a blood clot or kinking or compression of the tubing impairs urinary drainage for even a short time ___ and damage to surgically repair tissue can result

Hydronephrosis

Hydronephrosis =

Monitor I&O

It may take __ to __ or longer for recovery of AKI

3 to 12 months

Erythropoietin production is inadequate, causing anemia. Susceptibility to infection increases as a result of a deficient immune system

Chronic kidney disease

After dialysis completed, no injections for

2-4 hrs Nothing in/on this arm

A client with acute urinary retention usually __

Cannot void at all

A client with CUR (complete urethral obstruction) may __

Be able to void but not completely empty bladder (retention with overflow) and has a large residual volume Residual amount may vary for 30mL to several 100 or more

__ is a noninvasive bladder scan used to measure post voiding volume of urine in the bladder

Bedside ultrasound bladder scanning

For urinary retention __ or __ can determine post op residual volume

Catheterization Ultrasound

Acute urinary retention requires __

Immediate catheterization

Applying general downward pressure to the bladder during voiding

Crede maneuver

Beating down with defecation, contraindicated in pt with cardiac problems or who may be adversely affected by a vagal response (HR slows down)

Valsalva maneuver

With acute urinary retention, measure volume in bladder with ___ to help determine if catheter is needed. Collaboration with provider if it is left in place or removed. Pt is cathed every ___ depending on the amount of fluid obtained and the fluid intake.

Bedside scanner 4-8 hrs

The bladder should not be allowed to get distended beyond __, because bladder over distention results in ___

350mL Loss of bladder tone Decreased blood flow to the bladder

CIC continues until the postop residual volume of urine is

Less than 30mL

Goals when caring for a client with urinary incontinence

Maintain continence as much as possible Preventing skin breakdown Reducing anxiety Initiating a bladder training program

Teaching to prevent cystitis

Increase fluid to 2-3L/day Avoid coffee, tea,cola, alcohol Shower rather than bathe

Interstitial cystitis/painful bladder syndrome biopsy findings that confirm diagnosis

Biopsy of bladder mucosa reveals an inflammatory process with scarring and hemorrhagic areas

Stones may form in the __ or originate in the __ and travel to and remain in the ___

Bladder Upper urinary tract Bladder

Large bladder stones develop in those with

Chronic urinary retention Urinary stasis

__ enlargement can lead to bladder stones because it can impede urine flow through the urethra, resulting in urinary stasis

Prostate gland

Clients who are __ also may have a tendency to form bladder stones

Immobile (unconscious, para or quadriplegic)

Stones =

Strain urine

Before scabies treatment begins the client needs to

Bathe thoroughly

Treatment of tinea pedis

Topical antifungal benzoic and salicylic acid ointment Oral griseofulvin (Grisactin)-systemic antifungal & may be required for several weeks

Most common form of cancer in the United States. __ ranks as the 6th cause of cancer in the US

Skin cancer Melanoma

Nits hatch in __ and have a life span of __ which one female can lay __ nits

7-10 days 30 days 100-400

Live are transmitted through __ and cannot survive longer than __ w out blood

Direct contact 24 hours