FINAL Flashcards

Question

Ostomy care and psychosocial concerns

Answer 1

1) Caring: look at stool in enteric coated pills, assess skin at each pouch change, tolerate foods, chew food more completely, high fiber, urolithiasis (dehydration from loss of fluid in GI tract) 2) Psychosocial: body image issues, activities interfere with pouch

Answer 2

a. Symptoms: hard to breath, chronic airflow limitation, bronchial edema, decrease elastic recoil, Sob, wheezing, barrel chest chronic cough b. Meds: bronchodilators, steroids, oxygen LOW DOSE

Answer 3

2) Asthma: impaired gas exchanges, chronic inflammatory disorder of airways, med b/f puberty, woman after, inherited, started by triggers, inflammation leads to bronchoconstriction and hyper-responsiveness of airways, allergen cross IgE receptors on mast cells, increase mucous production, rush of WBC, vascular congestion, bronchospasm, thickening of airway a. Symptoms: wheezing, cough, dyspnea, chest tightness, hypoxemia, thick sputum, difficult speaking, anxiety, restlessness, increase Co2 in body

Answer 4

Cancer: - dysplasia: altered size and shape - hyperplasia: increase number of normal cells - metastasis: spread of cancer cells from original cells to distant site - differentiation: cancer involved malfunction in genes that control differentiation and proliferation

Answer 5

-use when disease is widespread, risk of hidden disease is high -different drugs target different cell phases, cancer cell death multi exposure, combo drugs, nursing: specific training, side effects, route patient: watch vesicant extravasation SE: alopecia, GI effect, anorexia, stomatitis, pain, myelosuppression

Answer 6

-targets rapidly multiplying cells, kills other in its path -cell radiosensitivity: cell susceptibility -damages DNA, all cells, not dependent on cell cycle, oxygen free radicals are formed- interact with tissue causing tissue damage care: dry skin, warm/cool water, mild soap, ink marks, avoid powered, lotion, clothing friction, protect from sun, use electric razor SE: skin reaction, fatigue, stomatitis, esophagitis

Answer 7

Neutropenia, anemia, thrombocytopenia

Answer 8

Neutropenia: Less than 1000 Increase risk of infection, protective isolation, steroid use for treatment add to infection risk. Hand washing, oral care, do not share utensils, fever is emergency, avoid crowds, children, people with infection, avoid animal feces, vitals q4, avoid fresh flowers, change wound dressing, limit visitors Anemia: Fatigue, dizzy, dyspnea, tachycardia. Blood transfusion, IV drugs: epogen, procrit Increase iron Thrombocytopenia: Avoid injury, shave with electric razor, prevent dry cracked skin, good oral care, avoid constipation, enemas, rectal temp, avoid ASA, NSAIDs Pressure on bleeding 10in, avoid rectal temp, avoid injection, tarry stool, petechiae, watch change in LOC

Answer 9

From smoking and drinking, food causes pain, vomiting relieves pain Manage pain, rest and relaxation, teach causes and prevention, discuss stress reduction

Answer 10

pain on empty stomach, food eases pain Manage pain, rest and relaxation, teach causes and prevention, discuss stress reduction, Eat btw meals Take H2 antagonist or antacids

Answer 11

Biaxin, Flagyl (antibacterial), Prilosec (PPI) Hypo secretory agents -H2 receptor blockers: Zantac, Pepcid, etc.: Can take 24 hours -Prostaglandin analog: Cytotec : unusual drug, prostaglandin analog that increase mucous production ¯ acid, mucous -Proton Pump Inhibitor (PPI): Prilosec or omeprazole -Antacids (neutralize gastric acid): Mylanta (immediate effect) -Mucosal barrier fortifier: Carafate: increase healing

Answer 12

1) Hearing: speak slow, enunciate, lower pitch of voice, use non-verbal cues, face elder 2) Vision: large type, contrasting colors, avoid blues and greens, short paragraphs, non-glare paper 3) Safety concerns: delirium, dementia, depression, substance abuse, falling, pressure ulcers, stress fractures 4) Exercise needs: short sessions, work on balance, weight bearing exercise

Answer 13

Perform Glasgow coma scale, keep head of bed at 30degress, protect patient, fluid balance, mouth care very 2hrs, soft bristle toothbrush, rotate every 2hrs

Answer 14

Glasgow coma scale: eye opening, motor response, verbal response, higher the number the better

Answer 15

muscle relaxants, nerve block, a. CT scan, x-ray, MR b. Watch ICP, medication, dark room, decrease stimulants, sedation

Answer 16

Guillain-Barre syndrome: inflammatory unknown cause, degeneration of myelin on peripheral nerve, preceded by URI, or GI infection, Zika Virus, Cytomegalovirus, Epstein-barr, associated with HIV a. Phase: 1 weak, 2-weakness in resp 3-recover b. Manage: supportive care, ventilation assistance, ADLs, nutrition support, proper body alignment, aggressive rehab after recovery High risk: respiratory paralysis, can’t ventilate yourself, paralysis moves from feet to head

Answer 17

1) Heparin: (given first) inhibits thrombin: monitor APTT (20-36sec) reverse with protamine 2) Coumadin: (inhibits VitK): monitor with INR (2-3.5) takes 24-48hrs to start; antidote is vitamin K

Answer 18

Pre-op: RICE, move slowly, stabilize Post-op: bathe only accessible skin, apply lotion to exposed skin, avoid using powder in cast, inspect padding, hematoma form 24-72hrs, check for compartment syndrome, assess for infection Complication: Compartment syndrome: take cast off Fat embolism: can lead to pulm embolism, confusion, restlessness, elevated temp, anxiety Thromboembolism, neurovascular compromise, DVT, PE, necrosis, infection Osteomyelitis: infection directly in bone: antibiotic for 4-8 weeks, chronic, fever, pain, malaise, amputation

Answer 19

1) Assessment: give history, inspect skin, hair, JVD, cap refill, edema, ulcers, palpate temp and edema, auscultate a. Primary: no ID cause-genetic b. Secondary, resistant, isolated c. >140/>90 stage 1; >160/>100 stage 2 2) education/care: weight reduce, DASH diet, exercise, relaxation, decrease smoking, potassium supplementation, meds (ASA, antihypertensive, platelet inhibitor, OTC) a. meds: diuretics, beta blockers, Ca channel blockers, Arbs, ACE inhibitors,

Answer 20

Nitrates (during attack no more than 3, 5minuites in-between), ACE inhibitors/ARBs, Beta blockers, CCBs, Na current Inhibitors, diuretics

Answer 21

HTN diet: DASH (restrict sodium, fat, alcohol, caffeine), exercise, lose weight Cardiovascular disease: low salt, saturated fats, exercise, decrease weight Labs: a. HDL: want >40 >60 if CHD, good healthy cholesterol b. LDL: below 160 1 risk factor, below 130 two risk factors, below 100 if CHD c. Triglycerides less than 150 d. Total cholesterol >200 e. Troponin: heart disease indicator, indicate if heart attack occurred <0.01 f. CKMB: muscle damage and stress 3-5%

Answer 22

1) Angiogram: x-ray photo of blood or lymph vessels, use special dye watch asthma, allergy to meds, taking metformin, don’t drink for eat 4-8hrs before 2) Cardiac Catheterization: thin tube that goes into heart to check coronary arteries, inserted by groin, neck, and threaded to heart

Answer 23

1) SIADH: (FVE) a. Cause: CNS disorder, adrenal insufficiency, malignancy (small cell lung), pulm disease, meds (vasopressin, thiazide, SSRI) b. S/S: decrease urine output, low serum osmo <280, low Na, increase GFR, sudden weight gain, vomit, seizures, pain, muscle cramp, decrease LOC, fatigue, weakness c. Restrict fluids, measure urine and serum osmo, meds (Opioids, thiazide diuretics, SSRI)

Answer 24

Treatment for thyroid cancer. Attempt to save parathyroid gland to prevent hypocalcemia and tetany. Pre-op: deduce stress and anxiety to avoid precipitation of thyroid storm Teaching dietary guidance to meet patient metabolic needs and avoidance of test and procedures Monitor respirations, dressing for potential bleeding, ability to swallow, semi-fowlers, prepare for hypocalcemia

Answer 25

Perform for hyperparathyroidism Parathyroid adenoma Watch Ca levels

Answer 26

Excessive output of thyroid, toxic nodular goiter,excessive intake of thyroid hormones, pituitary tumor, infection, stress, cigarette smoking Hypertension, insomnia, hunger, weight loss, hyperthermia, goiter, diarrhea, dry skin, anxiety Expo thalamus Graves: watch temp, exopthalmus

Answer 27

Primary: Iodine deficiency, destruction of tissue, defective hormone synthesis, Secondary: pituitary disease in release of TRH, hashimoto’s thyroiditis, graves’ disease Hypotension, constipation, lethargy, hypothermia, weight gain, anorexia, slow speech, hair loss