FINAL Flashcards
Depression of bone marrow function
Myleosuppression
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)
Common adverse effects associated with chemotherapy
N/V common w in first 24 hrs
Stomatitis and mouth soreness
Myleosuppression
Fatigue
Results from inhibition of the manufacture of RBCs, WBCs and platelets
Myleosuppression
The immune system is a collection of specialized ___ and __ that maintain ___
WBC & lymphoid tissue
Immunocompetence
The ability to cooperatively protect a person from external invaders and the body’s own altered cells.
Immunocompetence
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
Promotes release of vasoactive chemicals such as histamine and bardykinin in allergic, hypersensitivity and inflammatory reactions. * see this w a latex allergy
IgE
Manifestations of an anaphylactic reaction
Shock
Laryngeal edema
Wheezing
Stridor
Tachycardia
Generalized itching
Hypotension
Bronchospasm
Angioneurotic edema
Inhaled allergens often trigger
Asthma
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
Staining the surface with fluorescein dye identified a minute foreign body or abrasions to the cornea
Eye trauma diagnostic
Normal IOP
10-21
Glaucoma =
Increased IOP with progressive loss of peripheral vision
No atropine, allergy, cold meds
In cataracts, after surgery vision is restored with one of 3 methods
IOL implant (most common)
Corrective eyeglasses
Contact lens
__ or __ lens is implanted and reduces the need for corrective glasses
In cataracts
Monofocal (single vision)
Multifocal
Cochlear implant may be beneficial
Profoundly deaf
Severe hearing loss
Hearing aid ineffective
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
OTC antihistamines for motion sickness symptoms (N/V)
Dimenhydrinate (Dramanine)
Meclizine hydrochloride (Antivert)
A disorder characterized by fluctuations in the volume and pressure in the endolymphatic sac of the inner ear
Meniere disease
Triad of symptoms in meniere
Hearing loss
Vertigo
Tinnitus
Jaundice caused by excessive destruction of RBCs
Hemolytic jaundice
Jaundice caused by liver disease (damaged liver cells cannot clear normal amounts of bilirubin from the body)
Heptatocellular
Jaundice caused by a block in the passage of bile between the liver and intestinal tract
Obstructive
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