Final Exam Patho Tutoring Flashcards
Patho of Pneumothorax:
Air accumulates in the pleural cavity and the lungs start to collapse
Collapsed lung causing the air to leak into the chest cavity
{E2} medical emergency that is treated with a needle decompression
Clinical manifestations {S/S} of tension pneumothorax:
- Mediastinal shift to the RIGHT
-
Tracheal shift
{E2} Diminished breath sounds
{E2} Tachypnea - Chest pain (angina)
- SOB
- Labored breathing
- Depressed hemidiaphragm
Priority nursing intervention for a pt who is status epilepticus:
Protect the airway
S/S of meningitis:
- Neucorigidity
- Photophobia
- Sudden severe H/ A
- Fever
- Changes in LOC
{E2} Changes in LOC is the priority nursing Dx
{E2} POS Brudzinski’s sign (hip flexion from lying position when neck is flexed)
{E2} Droplet precautions
{E2} Would NOT see increased apitite
Typical gate of a pt with Parkinson’s Disease:
- Unsteady
- Shuffling
- Narrow steps
Progression of ALS:
- Muscle loss
- Loss of the ability to:
- swallow
- sit up unassisted
- control bowel or bladder
- to breathe
Pt teaching for client with systemic lupus erythema (SLE):
- Avoid crowds
- Encourage rest periods
- Have the monitor S/S for infection
- Protect the skin (sunscreen and protective clothing)
Patho of Grave’s Disease:
- Overstimulation of thyroid follicle
- Extra TSH due to thyroid-stimulating immunoglobins
- Antibodies start to stimulate the production of thyroxine
S/S of BPH:
- Weak stream (dribbling)
- Frequent urination {polyuria}
- Urgency
- Nocturia {peeing at night}
+ When you find an enlarged prostate there will be profound effects on the urinary system
+ There is urgency because the pt is unable to empty their bladder
PT teaching for prostate cancer:
- Frequent screening for prostate cancer
- DRE (digital rectal exam)
- PSA (these levels will be elevated)
What would you instruct the pt to call the Dr. for / what would be an indication that prostate cancer might be metastisizing?
*notify the Dr. if the pt is having bone pain (metastisizes in the bone)
+ Hematuria
Risk factor for prostate cancer:
- Age
- Family Hx
- Obestity
- Sedentary lifestyle
Is it necessary to remove the entire prostate if the pt has cancer?
NO. depending on the stage and how involved the tumor is, they may be able to retain part of the prostate instead of removing all of it
Define: Auria
No urine produced in over a day
Causes of pre-renal acute kidney injury:
- Heart failure
- Shock (circulation and low blood volume)
- because the cardiovascular system is not functioning properly
S/S of Anterior cord syndrome:
- Motoparalysis {loss of motor function}
- Loss of pain and sensation
- Pain receptors are compromised; so they won’t feel pain
- Temperature discrimination is compromised
- their ability to feel touch / pressure is compromised
- They cant walk
{E2} S/S of autonomic dysreflexia:
Sudden increase in BP with a slow HR
(HTN and bradycardia)
{E2} Causes: noxious stimuli
Caused by spinal cord injury // also called Guillain Barre syndrome
Priority nursing Dx of cholyCYSTITIS:
Circulation
S/S of cholecystitis:
- Stomach pain
- N/ V
- If the pt is vomiting, we are concerned with hypovolemia
Nursing Dx for hypovolemia:
Fluid loss or volume loss
What is the dietary management for a client with cirrhosis and an elevated ammonia level?
- Decreased protein but give lactulose and neomycin
- you don’t want the pt to have too much protein because they won’t be able to metabolize it well
- lactulose helps bring down ammonia levels - Decrease fat intake
- More fiber (leafy green vegetables)
What are the common meds that cause toxic epidermal necrosis?
- Anticovulsants
2. Antibiotics
{E1} Parkland formula: [for burns]
4 mL x 40% burned x 88 kg PT
in the first 8 hours - the answer from above is divided by 2
Pt teaching for chronic kidney disease:
- Diet
- Limit fluid intake
- Modifiable risk factors
- Limit salt substitutes
* tell the pt that if they don’t follow orders that this could escalate to end-stage renal failure {dialysis and losing kidney function}
What are pts with CKD at risk for?
- Edema
- High BP
- If they are losing the ability to make vitamin D, theyre at risk for BONE FRACTURES
- HTN
What is the relationship between serum calcium levels and parathyroid hormone release?
A drop in calcium stimulates parathyroid hormone to release
Dietary management for kidney stones:
- More fluids
- Avoid:
- dairy (because of the calcium)
- chocolate
- foods high in purine and oxalate
Causes of renal struvite kidney stones:
Urine has become more alkaline (bacteria from a UTI)
Symptoms in lung disease requiring intervention:
- Low O2 sat
- If the pt is not ventilating well, they are hypoxic - Heard with a stethoscope: strider {loud pitched breathing / their airway is blocked}
- this requires an immediate response - Dypsnea
Proper technique for pursed lip breathing:
Inhale through the nose and EXHALE through pursed lips; slowly
Expected assessment findings for osteoarthritis:
- Pain
- Stiffness
- Swollen joints
PT teaching for Osteoarthritis:
Increased physical activity (?)
S/S of intussuseption:
Jelly-like stools
Clinical manifestaionsof bowel obstruction:
- N/ V
- Pain
- Inability to pass gas
- Abdominal distension
- Constipation
- Hyperactive sounds before the blockage and absent after
Patho of Type 1 Diabetes:
Inability to make insulin
Secondary result of gestational diabetes:
Previous birth of a large baby (low BG)
Define Hyperplasia:
Increase in the number of cells
Patho of Pathologic calcification:
Injury to the cell or cell death // collection of calcium deposits
{E1} WHO definition of health:
Absence of disease Well being - mental - physical - emotional
Define pathogenisis:
How disease develops
Causes of hypermagnesium:
Alcoholism
Clinical manifestations of diabetes insipidus:
- Polyuria
- Polydypsnea
- Low urine osmolaity
- High sodium
Phase of the cell cycle where DNA is sythesized:
S-phase
Types of cells targeted by chemo and radiation therapy:
Target is malignant cells/ cancer cells without harming or targeting healthy cells
Characteristics of Type 2 Respiratory failure:
- Low O2 {hypoximic}
2. High Co2 {hyperkapnic}
{E1} ABG findings you would see in Type 2 Respiratory failure:
Hyooxic respiratory acidocis
{E1} Management of ARDS:
Treating the underlying cause of the disease
- if severe, intubate or put pt on vent
Possible complication of PEEP:
Barotrauma {injury caused by change in air pressure [in ear or lung]}
Define Neuropathic pain:
Chronic pain caused by some type of trauma or disease
What is the role of nocioceptors?
To alert for potential damage
Genetics of hemophilia:
Hereditory bleeding d/o where both parents are carriers of the gene
S/S of tissue ischemia in sickle cell disease:
- Chest pain
2. SOB
Purpose of (?) exchange transfusion // Coombs test injection/administration:
Given to Rh NEG mothers with Rh POS babies to prevent miscarriage due to the mother creating antibodies that will attack the fetus {seen on e1}
Most common cause of hemolysis of erythrocytes during pregnancy:
Mother is Rh NEG and fetus is Rh POS {seen on e1}
Risk factors for Rheumatoid Arthritis:
Age
Gender
Clinical manifestations of psoratic arthritis:
- Skin will look red and scaly
- Dactylitis {answer on e1}
- Nail lesions
- Joint pain
- Joint inflammation
PT teaching for a pt who is experiencing a TIA:
Get to the emergency room immediately
Non-modifiable risk factors for stroke:
[ you cant change]
- Gender
- Age
- Family Hx
- Ethnicity
- Age
TBI - Define otorrhea:
Bleeding from the ears
Patho of disfusaxonal (?) injury:
Wont see this on imaging
PT teaching for client who has TB:
- Medication compliance
- Avoid crowds
- 3 sputum test that are consecutively NEG
- Isolate until pt gets NEG sputum results
{E2} airborne precautions
Risk factors for pneumonia:
- Age
- Co-morbidity that would cause the immune system to be compromised
{E2} walking pneumonia is caused by mycoplasma pneumoniae
S/S of pyelonephritis:
Abdominal flank or groin pain
High fever
Chills
N/ V
{E2} UA for a UTI:
Cloudy with POS nitrites
Pt teaching for AIDs:
Med compliance
No sharing toothbrush or razors
Use condoms and practice safe sex
Don’t donate blood
Lab findings in AID pts:
Low CD4/ T - cell count
Increased viral load
BG level in PT with Cushing Syndrome:
Hyperglycemic (elevated BG)
Clinical manifestations of pheochromal cytoma:
Rare large adrenal neoplasm (benign tumor over adrenal gland)
S/S of neochromalcytoma:
Tachycardic
Dysrhythmia
HTN
Consequences of andropause:
Decline in testosterone
Low sex drive (libido)
Decreased muscle mass
Hormonal change in menopause for women:
Loss of estrogen
What is the primary concern in managing a hypoxic episode of a child with TOF (tetralogy of Fallot)
Knee to chest (squatting position)
Supply oxygen
Pulse ox
What are some assessment findings in Coarctation of the aorta?
Difference in BP from the lower and upper extremities
Difficulty breathing (dyspnea)
Hypotensive
Cyanotic (in lower part of the body because that is where the BP will be lower)
Risk factors for breast cancer:
Family Hx Age Obesitiy Post menopausal HRT Late menses
Breast cancer screening considerations: When should women start mammograms?
Annually at 40 y/o
Risk factors for colon cancer:
Age Family Hx Chrons Disease / Ulcerative Colitis Diet high in: - alcohol - high fat - red meat
S/S of Pancreatic disease:
Jaundice
Dark urine
Clay stools - if severe, acities of the abdomen
S/S of euwing sarcoma:
Pain around the tumor
Swelling and tenderness on the affected side
Fever
redness
bone pain
swelling
What age does benign bone tumor occur?
Ages 10 - 30 mostly occurs more on the lower range
Risk factors for bladder cancer:
Cigarette smoking
elderly men over 40
Risk factors of testicular cancer:
Ages 20 - 35
Family Hx
Cryptorchidism (testicle doesn’t fall)
Modifiable risk factor for lung cancer:
Smoking
Risk factors for lung cancer:
Cigarette smok e
Significance of elevated troponin levels:
They are indicative of tissue death or damage
The first thing you do when a PT is having an MI is to apply O2
Pt teaching for a pt receiving biologic valve replacement:
It won’t last and will need to be replaced
Better for hemacodynamics
Best for pts over 70 y/o
Patient teaching on Heart Failure, this is what they need to know about the prognosis:
They will have to learn to live with this, it’s manageable but there is no cure. They need to follow Dr. recommendations and have little to no exacerbations
Monitor sodium and weight
Fluid restriction
S/S of left-sided heart failure:
The pts main complaint about sleeping will be PND (proximal nocturnal dismea)
Patho of variant angina:
Coronary vassal / artery spasm
Stages of HTN:
- Normal 120/ 80
- Pre mature (120 - 139 // 80 - 81)
- Stage 1 (140 - 159 // 90 - 99)
- Stage 2 (160/100)
* * Dx of essential HTN is manifested by consistent readings (3 or more) of 120/ 80 at separate occasions**
What is the priority care in a pt suspected of acute aortic dissection:
Get the BP under control
Define Intermittent claudication:
Pain in the extremity that occurs with activity
Pt undergoing cataract surgery, what do you tell them about the surgical outcome?
Avoid anything that increased IOP:
- coughing
- sneezing
- bending at the waist
- straining
- when the cataract is removed, you can expect improved vision**
Dietary management of Meniere’s disease:
- Low sodium (because too much will cause fluid retention - and will put the pt at risk for an increase of their symptoms) - will reduce their chanced of fluid volume overload
- no smoking, alcohol, caffeine
Pulmonary embolism: possible complication
Increased RR
right ventricular failure
Nursing assesment for pt who is post insertion for vena cava filter, what do we monitor the surgical site for?
Infeciton (fever and increased WBC)
Bleeding
Causes of hypovolvemic shock:
Hemmorhage
Severe burns
Blood loss
Type of med that can cause hypovolemia:
Diuretics
S/S of anaphylactic shock
Altered LOC Warmer flushed skin Angio edema **Tachycardia** **Strider**
S/S in chronic lung disease that requires nursing interventions:
Expiratory breathing
Strider
Decreased peak flow*
