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Med Surg > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What are some contributing factors to developing diverticular bowel disease?

A
  • advanced age
  • constipation
  • diet: low in fiber, high fat, red meats
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2
Q

What protein should someone with a diverticular bowel disease eat instead of red meats?

A
  • lean protein
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3
Q

What are some interventions (diet) that a pt can use if they have a diverticular bowel disease?

A
  • meatless Monday
  • they shouldn’t have meat more than 7 times a week
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4
Q

What is diverticulosis?

A
  • pouch like herniation in the colon wall
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5
Q

What are the clinical manifestations of diverticulosis?

ES: CIBH, AB, B, F

A
  • usually asymptomatic
  • early signs are changes in bowel habits, abdominal bleeding, bloating, and flatulence
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6
Q

What are the clinical manifestations of diverticulitis?

LLQP, PAM, F

A
  • LLQ pain
  • palpable abdominal mass
  • N/V
  • fever
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7
Q

What are some treatment options for a pt w/ diverticulitis?

Initial + after

A
  • initial treatment: NPO, NG to low suction, IV fluids
  • post: clear liquids adv. to low fiber diet, pain meds and antibiotics
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8
Q

What are some complications to monitor for w/ diverticular diseases?

BIC

A
  • bleeding
  • infection
  • constipation
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9
Q

What are some examples of mechanical obstructions?

A, H, C, S , I

A
  • adhesion
  • hernia
  • Cancer
  • Stricture
  • intussusception
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10
Q

What are some examples of non mechanical obstructions?

disorders

A
  • neuromuscular disorders like paralytic ileum
  • vascular disorders like mesenteric artery occlusion
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11
Q

What are the CM of small intestine obstructions?

RO, SP, VVC, AB

onset? pain?

A
  • rapid onset,
  • sporadic pain
  • vomiting very common
  • acidic bile
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12
Q

What are some CM of large intestinal obstruction?

GO, PCP, IV, AD

A
  • gradual onset
  • persistent cramping pain
  • infrequent vomiting
  • abdominal distention
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13
Q

What are some nursing interventions for pt’s w/ an intestinal obstruction?

Diet, LS, IVF + ER, EA, PS

A
  • NPO
  • NG to low suction
  • IV fluids and electrolyte replacement
  • early ambulation
  • possible surgery
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14
Q

What are the risk factors for colorectal cancer?

A
  • first degree relative
  • personal/ family Hx of CRC, IBS, DM
  • obseity
  • smoking
  • alcohol
  • red meats
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15
Q

What are the early signs of colorectal cancer?

A
  • asymptomatic
  • nonspecific such as weight loss and fatigue
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16
Q

What are the late signs of colorectal cancer?

PAM, AT, A , HM

A
  • palpable abdominal mass
  • abdominal tenderness
  • hepatomegaly
  • ascites
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17
Q

What can polyps develop. Into after 5 yrs?

A

Cancer

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18
Q

How is colorectal cancer diagnosed?

A
  • double contrast barium enema
  • CEA level ( carcinoembryonic antigen)
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19
Q

What is cholelithiasis?

A

Stones in the gallbladder

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20
Q

What is Cholecystitis?

A

Inflammation of the gallbladder wall associated with/ cholelithiasis

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21
Q

What are the risk factors gallbladder disease?

W, OC, ET, O, SL, FHX

A
  • women
  • oral contraceptive
  • 40 yrs on estrogen therapy
  • obseity
  • sedentary lifestyle
  • fam hx
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22
Q

What are the clinical manifestations of cholelithiasis?

FP, RUQP, SP, J, CCS, I, BT, PWM

A

Asymptomatic
- late signs:
- flank pain
- RUQ pain
- shoulder pain
- jaundice
- clay colored stool
- itching
- bleeding tendency ( vitamin k)
- pain more intense w/ movement

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23
Q

What are some abnormal finding in draining tubes?

A
  • no drainage
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24
Q

What are the S+S of FVE?

A
  • bounding pulse
  • weight gain
  • edema
  • crackles in the lungs ( primary sign)
  • increased BP
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25
Q

What are the S+S of a FVD?

A
  • dry mucous membranes
  • poor skin turgor
  • increased HR + RR
  • decreased cap refill
  • orthostatic hypotension
  • hyperthermia
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26
Q

What are the severe clinical manifestations of Na+ imbalance?

A

Seizure, coma, and vomiting

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27
Q

What does potassium (K+) play a big role in?

A

Muscles including the heart

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28
Q

What are clinical manifestations for hypo and hyperkalemia?

A
  • muscle weakness
  • twitching
  • cardiac dysrhythmias
  • decreased LOC
  • decreased reflexes
  • parathesias
  • N/ V
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29
Q

How is hyperkalemia reversed?

A
  • kayexalate ( causes pt to excrete K+ in the form of stool)
  • loop thiazide ( diuretic)
  • dialysis
  • insulin
  • albuterol
  • calcium
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30
Q

What labs/ assessments need to monitored in pt’s with a potassium imbalance?

A

ECG
pulses
IV ( K+ is a vein irritant, check pts IV for redness, swelling, pain, etc.)
decreased UO

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31
Q

What is the primary level of prevention for cancer prevention?

A

smoking cessation
decreased or elimination of alcohol use
sunscreen 15- 30 SPF or higher
promote healthy behaviors

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32
Q

What are the warning signs of cancer?

CAUTION

A
  • Change in bladder and bowel habits
  • A sore that doesn’t heal
  • Unusual bleeding / discharge
  • Thickening or lump in the breast or elsewhere
  • Indigestion or difficulty swallowing
  • Obvious change in wart or mole
  • Nagging cough or hoarseness/ change in voice
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33
Q

How are cancers classified

TNM

A
  • Turmeric size and invasiveness
  • Node - prescience or absence spread to regional lymph node
  • Metastasis
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34
Q

What other rapid dividing cells does chemotherapy kill off?

A
  • GI
  • bone marrow
  • skin, hair, and nails
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35
Q

What are the main safety concerns with patients being treated by chemo?

A

infection and their bodily secretions are still toxic 48 hours after treatment

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36
Q

What should the nurse educate the chemo patient on 48 hours after treatment?

A
  • use separate toilets and double flush
  • replace toothbrush
  • abstain from sex
  • all body secretions are poisonous 48 hr after treatment
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37
Q

What is protocol for a central line extravasation?

A
  • stop the infusion
  • pull drug from the line
  • contact HCP
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38
Q

What are some safety concerns for pt’s receiving external radiation therapy?

A
  • gently clean with water and mild soap (no scents)
  • avoid powders, lotions, or creams unless Rx
  • avoid sun exposure
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39
Q

What is external radiation therapy?

A

Radiation to a specific body part marked by radiology

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40
Q

What are some safety concerns for pt’s receiving internal radiation?

A
  • they are radioactive after treatment
  • limited visitors
  • nurses wear lead aprons and cluster care
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41
Q

What is internal radiation therapy ?

A

Sealed radiative implants into the tumor or nearby the tumor

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42
Q

Which therapy doesnt leave the pt radioactive after treatment?

A

External radiation therapy

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43
Q

What are the adverse effects of chemo and radiation therapy?

A
  • bone marrow suppression
  • anorexia
  • N/V
  • alopecia
  • leukopenia
  • reproductive problems
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44
Q

What are some nursing interventions that can be put into place to prevent bone marrow suppression from effecting the WBCs?

EIS, AI, APT

A
  • enhance immune system through diet, rest, and handwashing
  • avoid infection by implementing neutropenic precautions
  • asses the pt’s temp daily
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45
Q

What should the patient report immediately to the HCP?

BTS, UexB, UB

A

black tarry stool
unexplained bruising
uncontrolled bleeding

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46
Q

What is the diagnostic criteria for DM?

A
  • Hgb A1C greater than 6.5%
  • fasting glucose greater than 126 mg/dL
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47
Q

What is the main goal of DM treatment?

A

maintain normal BG and prevent acute/ chronic complications

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48
Q

What are some interventions used to maintain normal BS?

A
  • monitor blood glucose levels
  • adequate Nutrtion
  • physical activity
  • recognize CM of hypo/hyperglycemia
  • correct use of medication
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49
Q

What are the CM of DKA?

A
  • fruit breath
  • kussmaul respirations
  • dehydration
  • serum glucose: >250mg/dL
  • ketones present
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50
Q

What is the CM is a priority in a hypoglycemic pt?

A
  • diaphoresis (sweating)
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51
Q

What are the CM of hypoglycemia?

S, D, P, CCS, A, P , N

A
  • shakiness
  • diaphoresis
  • palpitations
  • cold clammy skin
  • anxiety
  • pallor
  • nervousness
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52
Q

What is the rule of 15?

A

Hypoglycemic protocol
- 15g of fast acting carbs, recheck BS every 15 min

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53
Q

What are the CM of primary HTN?

A

fatigue
dizziness
palpitations
angina
dyspnea

54
Q

What is peripheral artery disease (PAD)?

A
  • thickening of arterial walls r/t atherosclerosis
  • reduces blood flow to lower extremities causing ischemia
55
Q

What are the CM of PAD?

IC, P, D/AP, EP/DR

A
  • intermittent claudication ( cramping, pain from lack of blood flow)
  • paresthesia
  • diminished or absent pulses
  • elevation pallor and dependent rubor
56
Q

What does the skin on the leg of PAD look like?

T, S, T, H

A
  • thin
  • shiny
  • taut
  • hairless
57
Q

How is PAD managed?

A
  • antihypertensive, anti diabetic
  • anti platelets
  • lifestyle mods
58
Q

What is an aortic aneurysm?

A

Out-pouching or dilation of arterial wall

59
Q

What is a true aortic aneurysm?

A

at least 1 layer intact due to congenital or acquired problems

60
Q

What is a false aneurysm?

A

involves all layers due to injury or trauma

61
Q

What should the nurse look for post aortic aneurysm repair?

A
  • circulation to the lower extremities and blood pressure
62
Q

what are the CM of chronic venous insufficiency (CVI)?

A
  • edema
  • leather skin
  • Brownish discoloration
  • Venous leg ulcer
63
Q

What are the diffrent managements used for CVI treatment?

A
  • compression therapy
  • frequently elevate legs
  • wet to dry dressings
64
Q

What are the risk factors for FVD?

A
  • hemorrhage
  • inadequate fluid intake
  • vomiting
  • abnormal loss of bodily fluids
65
Q

What the potential complications of FVD?

A
  • impaired cardiac output
  • hypovolemic shock
66
Q

What are the risk factors for FVE?

A
  • renal or cardiac disorders
  • fluid retention
  • too much sodium
67
Q

What are the potential complications of FVE?

A
  • pulmonary edema
68
Q

what should you teach a pt w/ FVE?

A
  • elevate legs
  • fluid restriction
  • diuretics and watch potassium levels
69
Q

What are the risk factors for developing pneumonia?

A
  • Age: 65 years and older
  • residents of long term facilities
  • abdominal/ chest surgery
  • alt level of consciousness
  • smokers
70
Q

what are the clinical manifestations of pneumonia?

C, F, CHI, H, PCP, F/CC

A
  • cough
  • fever
  • chills
  • headache
  • chest pain ( pleuritic)
  • fine or coarse crackles
71
Q

what are the clinical manifestations of pneumonia that are specific to older adults?

C, H

A
  • confusion
  • hypothermia
72
Q

what are normal readings on an ABG?

pH, PaO2, PaCO2, HCO3

A

pH ( 7.35- 7.45)
PaO2 ( 80- 100mmHg)
PaCO2 ( 35- 45mmHg)
HCO3- 22-26 mEq/L

73
Q

what can be done to prevent pnumonia?

F/PV, EA, IS, FP

A
  • flu and pnumococcal vaccines
  • early ambulation
  • Incentive spirometer
  • feed precautions
74
Q

What intervention is important in a pt w/ pneumonia?

nutrition

A
  • rest before meals
  • use bronchodilator before meals
  • avoid excuse 1 hour before and after meals
  • limit fluid w/ meals because they will get full before they eat
  • moderate carb, high caloric
  • eat 5 to 6 small meals a day
75
Q

What are the none obvious signs of lung cancer?

A
  • change in voice
  • hoarseness
76
Q

What are the clinical manifestations of lung cancer?

PC, D, BTS, PNR, A, F

A
  • persistent cough
  • dyspnea
  • blood tinge sputum
  • pneumonia that’s not responding to treatment
  • anorexia
  • fatigue
77
Q

what is COPD?

chronic obstructive pulmonary disease

A

when air can’t leave the lungs because it’s trapped in the lungs ( persistant expiratory airflow limitation causing an abnormal gas exchange)

78
Q

what are the CM of COPD?

cc, d, ef, uoam, bc, pet, dc, db, w

A
  • chronic cough
  • dyspnea
  • easily fatigued
  • use of accsessory muscles
  • barrel chest
  • prolonged expiratory time
  • digital clubbing
  • decreased breath sounds
  • wheezing
79
Q

what are the complications of late stages COPD?

PHTN, CP

A
  • pulmonary HTN
  • cor pulmonale
80
Q

what is respiratory acidosis?

pH down

A

low pH, increased CO2, normal HCO3

81
Q

what are the manifestations of respiratory acidosis?

H, L , W, C, HK, DBP, DR

A
  • headache
  • lethargy
  • weakness
  • confusion
  • hyperkalemia
  • hypotension
  • dysrthymia
82
Q

what is metabolic acidosis

breathing off sugar

A

low pH, CO2 N, HCO3 low

83
Q

what are the manifestations of metabolic acidosis?

H, L, W, C, HK, DBP, DMR

A

headache
lethargy
weakness
confusion
hyperkalemia
hypotension
decreased muscle reflexes

84
Q

what is respiratory alkalosis?

chicken little scene

A

high pH, CO2 low, HCO3 normal

85
Q

what causes respiratory alkalosis?

anxiety attack

A

when the pt is hyperventilation breathing off too much CO2

86
Q

what are the manifestations of respiratory alkalosis?

LH, HC, HK, HV, T, N/T

A
  • lightheadedness
  • hypocalcemia
  • hypokalemia
  • hyperventilation
  • tachycardia
  • numbness and tingling
87
Q

what is metabolic alkalosis

expolsive

A

high pH, CO2 normal, HCO3 high

88
Q

What interventions can be used for a pt experiencing metabolic alkalosis?

A

1 stop the loss

# 2 replace what has been lossed

89
Q

what are the signs of hypoxia?

A
  • restlessnes
  • frantic
  • cyanosis
90
Q

What interventions can be preformed for a pt exp. Hypoxia?

A

sit them up and check pulse aux

91
Q

What is the most important education for any pt w/ COPD?

A

avoid respiratory infection

92
Q

What is an intervention for a pt at risk for cholelithiasis?

A

loose weight and hydrate

93
Q

What is an intervention for a pt at risk for cholelithiasis?

A

loose weight and hydrate

94
Q

What is a nursing intervention for the side effect of chemotherapy ( tumor lysis syndrome)?

A

flushing w/ IV fluids
( buildup of chemo in the system)

95
Q

what are the CM of parkinson’s disease?

TRAP

A

T: tremors
R: ridgity
A: ankinesia and bradykinesia
P: postural instability

96
Q

what is parkinson’s disease?

A

chronic, progressive, uncurable neuro disorder that is caused by destruction of dopamine receptors

97
Q

what signs will be present physically in a pt with parkinson’s diease?

A
  • shuffling gait
  • difficulty walking
  • weakness
  • unstable posture
98
Q

what is Amyotrophic lateral sclerosis (ALS)?

A

progressive brain and spinal muscular atrophy from destruction of motor neurons

99
Q

what are the clinical manifestations of ALS?

A
  • muscle cramps
  • stiffness
  • pain
  • sleep disorder
  • GERD
  • slow dragging gait
  • drooling
  • difficulty chewing and speaking
  • tongue contractions
100
Q

what disability do you usually see stone face/ lack of emotion?

A

parkinson’s disease

101
Q

What is compartment syndrome?

A

Pressure build up and stops blood flow which causes pain

102
Q

What is acute pyelonephritis?

A

Inflammation of the renal parenchyma and collecting system

103
Q

What are the risk factors for developing acute pyelonephritis?

A
  • dysfunction of the lower UT
  • long term care residents
  • pregnancy induced changes
  • untreated UTI
104
Q

What are the clinical manifestations of acute pyelonephritis?

N/V, F/C, FP, D, U, F , LBT

A
  • N/V
  • fever
  • chills
  • flank pain/ lower back tenderness
  • dysuria
  • urgency/ frequency
105
Q

What clinical manifestation is more common in older adults w/ UTIs?

A

Cognitive effects like confusion (more common than burning)

106
Q

What are the symptoms of a UUTI?

Acute pyelonephritis

A
  • fever
  • malaise
  • N/V
  • flank tenderness
107
Q

What are the symptoms of a LUTI?

B, U, F, SSU, H, SPP

A
  • burning
  • urgency
  • frequency
  • strong smelling urine
  • hematuria
  • suprapubic pain
108
Q

What are the risk factors for developing UT calculi?

A
  • men
  • 50’s and up
  • genetics
  • summer heat
109
Q

What kind of education would you provide to a patient experiencing urinary tract calculi?

A
  • low Na diet
  • low calcium
  • increase hydration
  • decrease the use of tums, calcium vitamins + supplements
110
Q

What is osteoporosis?

A

chronic and progressive metabolic bone disease

111
Q

What are some preventative measures than can be used for osteoprosis?

A
  • regular weight bearing exercise
  • adequate intake of fluoride, calcium, vitamin D
112
Q

What should the nurses assessment focus on in a pt w/ osteoporosis?

A
  • proper nutrtion w/ calcium and vitamin d supplements
  • exercises
  • fall prevention
  • drug therapy
113
Q

What is rheumatoid arthritis?

A

a chronic systemic autoimmune disease, inflammation of the connective tissue

114
Q

What are some nursing considerations for pt’s w/ arthritis?

A

Non curative, focus on
- managing pain/ inflammation
- preventing disability
- maintaining and improving joint function
- drug therapy supplements no drug treatments

115
Q

What are some post op interventions for a total knee replacement?

A
  • no pillow under the knee
  • ROM: flexion and extension
  • weight bearing as tolerated
116
Q

What is osteoarthritis?

A

Slowly progressive non inflammatory disorder that cause the gradual loss of cartilage

117
Q

What are some goals for pts w/ amputations?

A
  • adequate relief from underlying health problem
  • pain management
  • max rehab
  • Cope w/ body image change
  • lifestyle adjustments
118
Q

What is gout?

A

Type of arthritis that is caused by hyperdrive is and deposition of urine acid crystals in r or more joints

119
Q

What are some foods high in purine that pt’s w/ gout should avoid?

OM, RM, S, SF/ D

A
  • organ meats ( liver, kidney)
  • red meats ( beef, lamb, pork)
  • seafood
  • sugary foods and drinks
120
Q

What does potassium not affect?

A

Blood volume (BP)

121
Q

What are some S+S of irritative bladder obstruction?

A
  • dysuria
  • nocturia
  • incontinence
  • bladder pain
122
Q

What are some S+S of bladder obstruction?

A
  • hesitancy
  • dribbling
  • intermittency
  • weal stream
123
Q

What are cute complications of an unmanaged blood sugar?

A
  • hypoglycemia
  • HHS
  • DKA
124
Q

What are the chronic complications of unmanaged Diabetes mellitus?

A
  • retinopathy
  • kidney issues
  • stroke
  • cardiac issues
125
Q

What is the priority assessment for a pt with PAD?

A
  • peripheral pulses
  • cap refill
  • temp
  • color
126
Q

What is the difference between PAD and CVI?

A

PAD: prolonged cap refill, decrease or absent pulses, loss of hair, resting pain , elevation pallor, cool to the touch

CVI: normal cap refill, pulses are hard to palpate, edema, painful ulcers, warm

127
Q

What are the S+S of hypoxia?

A
  • restlessness
  • frantic
  • cyanosis
128
Q

What does albuterol cause?

A
  • the pt to be hyped up ( increase in BP + HR)
129
Q

What are some interventions with MS?

A
  • teach them how to straight cath themselves
130
Q

What is the sign of a large bowel obstruction?

A

Abdominal distention

Med Surg (5 decks)

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