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Med surg 2 > Final Review > Flashcards

Final Review Flashcards

1
Q

Chain of Infection
( 6 things)

A
  1. Causative Organism
  2. Reservoir
  3. Portal of exit
  4. Route of transmission
  5. Susceptible Host
  6. Portal of Entry
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2
Q

4 types of Hypersensitivity

A

Type1: Anaphylactic
Type 2: Cytotoxic
Type 3: Immune Complex
Type 4: Delayed

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3
Q

Type 1 Anaphylactic Hypersensitivity

A

Most Severe. Rapid onset.

edema in many tissues, including the larynx, and is often accompanied by hypotension, bronchospasm, and cardiovascular collapse in severe cases.

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4
Q

Type 2 Cytotoxic Hypersensitivity

A

ex: wrong blood given during a transfusion

occurs when antibodies are directed against antigens on cells or basement membranes of tissues. This reaction can lead to cell lysis and tissue damage.

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5
Q

Type 3 Immune Complex Hypersensitivity

A

ex: Rheumatoid Arthritis

damaging inflammatory reaction caused by the insoluble immune complexes formed by antigens that bind to antibodies.

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6
Q

Type 4 Delayed Hypersensitivity

A

ex: TB infection

T cell–mediated immune reaction after exposure to an antigen. This immune reaction typically occurs 24 to 48 hours after exposure to an antigen.

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7
Q

Airborne Precautions

Live on air on MTV

A

Measules
TB
Varicella

Hospitalized patient should be
in a negative pressure room with
the door closed; health care
providers should wear an N-95
respirator (mask) at all times
when in the room

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8
Q

Droplet Precautions

Pimp my ride Drop cars

PIMP

A

Pertussis
Influenza
Meningitis
Pneumonia

Wear a face mask but door may
remain open; transmission is
limited to close contact

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9
Q

EPI PEN
Epinephrine

A

Used to prevent an anaphylactic reaction.
- inject in the middle of your outer thigh (upper leg)
-hold for 10 seconds
- through clothing, if necessary

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10
Q

Barrett Esophagus

A

liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage

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11
Q

Cirrhosis

A

Scarring of the liver

-Nutritional deficiency with reduced protein intake contributes to liver destruction in cirrhosis, but excessive alcohol intake is the major causative factor in fatty live

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12
Q

Common cause of * Osteomyelitis

A

Staphylococcus aureus

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13
Q

DIGOXIN (cardiac glyceride) digs for a deeper contraction

A

Deep contractions.
Decreases the HR
Digoxin is a TOXIN (over 2)

Monitor Kidney function. Creatine Labs
Monitor potassium if its getting too low. (MONITOR ELECTROLYTES)

  • digoxin is used in HF and to control ventricular response to afib. (antiarrhythmic)
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14
Q

Diuretics

A

Decrease BP
Draining fluid
Dehydrate

Potassium wasting: end in IDE. Furosemide

Potassium Sparing: spironolactone spares and blocks aldosterone.

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15
Q

Diagnostic Test: CARDIAC CATHETERIZATION
* Remember you give contrast (iodine)

A

two types: Left or Right.

Test is used to show blockages and heart function. It can also be used to place a cardiac stent in the heart valves IF there is a blockage or a MI.

Nursing CONCERNS:
-Circulation (check peripheral pulses)
- Hematoma/ Bleeding
- hypotension due to loss of blood
- Evaluate temperature, color, and capillary refill of affected extremity
- Screen for arrhythmias
- Maintain bed rest 2 to 6 hours

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16
Q

Heart Failure (HF)

A

a disorder that impairs the ability of the ventricle to fill or eject blood; thus, the heart is unable to pump enough blood to meet the body’s metabolic demands or needs.

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17
Q

Right Sided HF
Right side ROCKS the body with fluid

A

Right side is TOO WEAK TO PUMP USED BLOOD TO the LUNGS.

  • Peripheral Edema
  • Weight Gain= water gain
  • Hepatomegaly (big liver)
  • Splenomegaly (big spleen)
  • JVD (big neck veins)
  • Ascites
18
Q

Left-sided HF
Lung Fluid
Caused by damage to the myocardia heart muscle.

A

Left side of your heart pumps FRESH BLOOD to the rest of your body THROUGH YOUR CIRCULATORY SYSTEM. The left ventricle is larger and stronger than the right because it must pump blood through your whole body.

-Pulmonary Edema
- Crackles (rales) in the lungs
- Dyspnea and Orthopnea (SOB lying flat)
- S3 or ventricular gallop
- pink frothy sputum
- low O2
- oliguria
- non productive cough
- Cyanosis

19
Q

hydrochloroTHIAZIDE

A

IS A POTASSIUM SPARING DIURETIC. aids in reducing BP

20
Q

B-Type Natriuretic Peptides (BNP) Lab
Diagnosing HF

BNP BULGING VENTRICLES

A

100 & Less is Normal
300+ Mild
600+ Moderate
900+ Severe

21
Q

Digoxin Dose, Side effects and Toxicity

A

Dose: 0.5-2

Side effects: anxiety, hallucinations, unusual tiredness and fatigue
CV: : dysrhythmias, including bradycardia or tachycardia
CNS: headaches, fatigue, malaise, confusion, convulsions

Poisoning and toxicity:
- Visual Disturbances
- Nausea/vomiting
- Arrhythmias
- Electrolyte imbalances

Antidote: Digibind (digoxin immune fab). It binds to the digoxin molecules.

22
Q

HIV Human Immune Deficiency Virus

A

Immune deficiency is acquired:
-Due to medical treatment such as chemotherapy
-Infection from agents such as HIV

Despite advances in treating HIV, acquired immune deficiency syndrome (AIDS) remains a public health issue

Prevention, early detection, and ongoing treatment are important aspects for care

PLWHA—persons living with HIV/AIDS

Treatments/ Medications: Anti-Virals, Antiretroviral Drugs (used in combination).

23
Q

Modes of Transmission of HIV

A

HIV-1 transmitted in body fluids that contain infected cells:
Blood and blood products
Seminal fluid
Vaginal secretions
Mother-to-child: Amniotic fluid, breast milk
Not through casual contact

24
Q

Cancer that is opportunistic to HIV

A

Kaposi sarcoma in the mouth and back.

Appears first on the oral mucosa as red, purple or blue lesions

25
Q

Lipid Panel what to do

A

NPO the night before so cholesterol is not altered.

26
Q

Hepatic Encephalopathy

Ammonia (should be 15-45) building up, gets into the blood stream and can cause swelling of the brain.

A

Two major alterations underlie its development in acute and chronic liver disease

Hepatic insufficiency: the inability of the liver to detoxify toxic by-products of metabolism

Portosystemic shunting: collateral vessels develop allowing elements of the portal blood (laden with potentially toxic substances usually extracted by the liver) to enter the systemic circulation

Early signs: mental changes and motor disturbances

27
Q

Standard Precautions

used for all patients
* The primary strategy
for preventing health
care–associated
infection (HAI)

A
  • Hand hygiene
  • Use of gloves and other
    barriers
  • Proper handling of patient
    care equipment and linen
  • Environmental control
  • Prevention of injury from
    sharp devices and needles
  • Patient placement
28
Q

Contact Precautions

skin to skin

A
  • Clostridium difficile
  • Use of barriers and cautious techniques to prevent
    transmission
  • Masks not needed
  • COVID-19: combination of
    transmission-based
    precautions, increased use of
    PPE, enhanced cleaning, and
    adjusted visitor policies
29
Q

Gerontologic
Considerations

A

Important to distinguish normal aging
changes from abnormal changes
* Structural and physiologic changes
* Motor and sensory alterations
* Temperature regulation and pain
perception
* As the body gets older, it is hard
to regulate body temperature.
Mostly due to the decrease in the
amount of fat below the skin
makes it harder to stay warm.
* Determine previous mental status for
comparison. Assess mental status
carefully to distinguish delirium from
dementia

30
Q

Seizure Medication

A

Anticonvulsants are FIRST

31
Q

Meningitis
Inflammation of the meninges

A

Bacterial : strep (septic) or Viral (Aseptic)

32
Q

Bacterial Meningitis

A
  • mostly caused by strep
    Manifestations: Painful, stiff neck
    with limited range of motion,
    Headaches, High fever, Feeling
    confused or sleepy, Bruising easily
    all over the body, A rash on the
    skin, Sensitivity to light.
  • Tx :Antibiotics: Rifampin,
    Quinolones (eg, Ciprofloxacin),
    Ceftriaxone
33
Q

Viral Meningitis

A
  • Is the most common type of
    meningitis.
  • Caused by viral infections that may
    include: Viruses such as herpes
    simplex virus, HIV , mumps virus,
    West Nile virus, etc.
  • Treatments vary
  • Average recovery can be
    between 7-10 days w/o
    treatment
  • Can use antibiotics,
    coticosteriods, fluids, etc
34
Q

Management of Bell’s Palsy

A

Medical
* Corticosteroid therapy may be
used to reduce inflammation
and diminish severity of the
disorder
* Nursing
* Provide and reinforce
information and reassurance
that stroke has not occurred
* Protection of the eye from
injury; cover eye with shield
at night, instruct patient to
close eyelid, use of eye
ointment and sunglasses
* Facial exercises and
massage to maintain muscle
tone

35
Q

Bell’s Palsy

A

Facial paralysis caused by
unilateral inflammation of the
seventh cranial nerve (facial nerve)
* Manifestations: unilateral
facial muscle weakness or
paralysis with facial
distortion, increased
lacrimation, and painful
sensations in the face; may
have difficulty with speech
and eating
* Most patients recover
completely in 3 to 5 weeks,
and the disorder rarely recurs

36
Q

Gabapentin

A

Anticonvulsant and Nerve pain medication

37
Q

Rheumatoid Arthritis

A
38
Q

Paget’s Disease

A

Disorder of localized bone turnover. new bone that is abnormally shaped, weak, and brittle.

S/S skeletal deformities. mild to moderate aching pain

Pharm: antineoplastic therapy
-NSAIDS
- Calcitonin
- Biphosphates
- Plicamycin (antibiotic) for severe cases.

39
Q

Rheumatoid Arthritis
RA=Rude Pain

Mainly seen in Hands

A

autoimmune disorder. body attacks its joints (causing major inflammation and joint deformity)

S/S: morning joint stiffness fatigue, anorexia, weight loss,
Diags: xray, mri, arthroscopy, synovial fluid aspiration, blood test( Rheumatic factor, ESR, c-reactive protien)

40
Q

Rheumatoid Arthritis management

A

Pain control
low impact exercise (swimming or walking)
heat and cold to affected area/ joints

Pharm: NSAIDS or SEROIDS decrease swelling

METHOTREXATE: immunosuppressant

41
Q

Lupus

A

Autoimmunie disorder. causing inflammation in the connecting tissues. (skin, joints, kidneys, and heart)

AVOID THE FOUR S’s
Sun/UV, Smoking, Stress (physical and emotional), Sepsis

Pleuritis: inflammation of the pleura tissues around the lungs. SCRATCHING sound heard in the lungs

Med surg 2 (5 decks)

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