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MedSurg1 Final Exam > From Notes > Flashcards

From Notes Flashcards

1
Q

Number 1 symptoms for Crohn’s Disease?

What else will accompany?

A

Diarrhea and Abdominal Pain.

Also:

  • cramping, distention, tenderness
  • fever, fatigue

Can see fistulas, dehydration, malnutrition
(NO blood in stool).

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2
Q

How to encourage bowel movement in a patient after a partial gastrectomy?

A

Get them up and moving. “When do you want to walk?”

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3
Q

Why would cholecystitis lead to insulin problems?

A

The gallbladder is really close to the pancreas. The inflammation can progress to the pancreas and affect insulin production.

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4
Q

Peptic Ulcers can be located…

A

Either in the stomach (gastric) or the duodenum.

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5
Q

A patient wants to know how to decrease their risk factors for Peripheral Artery Disease progression. What can you tell them?

A

Quit smoking (#1)
Keep HbA1c close to 6.
Use statins and nutritional changes to keep lipid levels low.
Keep BP low (140/90 or 130/80 if diabetic and kidney complications)
(Take thiazides and ACE inhibitors, and DASH diet).
Exercise: walking, especially.

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6
Q

Nursing care for dementia should include

A

Familiar surroundings and routines.
Keep patients in home as long as possible.
Maintain independence as long as possible.
Maintain same caregivers.
Decrease stimuli.
Support family.

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7
Q

What diseases does Irritable Bowel Disease include?

A

Crohn’s and Ulcerative Colitis

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8
Q

What does the nurse need to remember for a stroke patient with expressive aphasia who is speaking slowly?

A

Don’t fill in the words for them. They need the practice.

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9
Q

Nursing management after Femoral Popliteal bypass surgery?

A

Monitor Q15m then Q1h for CMS + pulses.
(Be worried about loss of previously palpable pulses, pallor/cyanosis, numbness/tingling, cold extremities).
Pain management
Ambulating
Monitor for complications (Bleeding, bruising, compartment syndrome).

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10
Q

The nurse caring for a R-sided stroke victim should remember (2 things)

A

To give directions

To be aware of risk for falls (bed alarm)

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11
Q

What are some complications of PAD?

A

Muscle atrophy
Skin atrophy and delayed healing
Arterial ulcers
Gangrene/amputation

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12
Q

What’s the worry with aplastic anemia? Why?

A

Infection risk. A low grade fever can be an emergency.

Because all cell types have been decreased.

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13
Q

What factors make MS worse?

A 
Stress, Injury or trauma
Excessive fatigue (GET 8+hrs of sleep)
Pregnancy
Temperature extremes (hot, cold... no ice packs or hot baths)
Any pt-specific triggers.
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14
Q

How long do stroke symptoms last with a TIA?

A

30m.

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15
Q

What is global aphasia?

A

Both receptive and expressive aphasia.

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16
Q

What symptoms occur with severe anemia? What level is considered severe?

A

Less than 6.
Fast HR and RR (tachycardia, tachypnea)
Pallor (late)
Cyanosis (very late)

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17
Q

Pt has muscle aches, tingling and shooting pains with exercise. You notice that his legs are shiny and dusky-red while seated. What is likely to be his condition?

A

Peripheral Artery disease.

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18
Q

What can/can’t you eat with cholecystitis?

A

You can eat whatever you want as long as it doesnt’ make you hurt.

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19
Q

What is a gastrojejunostomy and why would you have one?

A

Take out the duodenum and attach it to the jejunum.

Treatment for duodenal ulcers if more conservative treatments don’t work.

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20
Q

What is chelitis and when would you see it?

A

Inflammation of the lips (they appear red and sore)

See this with anemia (and in kids with protein deficiency).

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21
Q

What is the most common symptom in chronic iron-deficiency anemia?

A

Pallor.

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22
Q

Where are you likely to see bleeding with thrombocytopenia?

A

Nosebleeds, gingival bleeding.

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23
Q

Dementia is characterized by

A

Slow onset, progressive, irreversible decline in cognitive function.
Loss of S/T memory at first, eventually L/T memory, too.
Deterioration in ability to do ADLs.
Agitation, anger d/t fear.
NORMAL EEG.
“Sun-downing”: gets worse at night.
Depression and alcoholism will make it worse.

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24
Q

GERD can be caused by

A 
Decreased LES tone
Hiatal hernia
Poor esophageal motility
Decreased gastric emptying
Pregnancy/obesity
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25
Q

How often to ambulate to prevent DVT?

A

4-6x/day.

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26
Q

When would you want to use an NG tube or intestinal tube for abdominal decompression?

A

When there’s a bowel obstruction.

Know that there will be lots of vomit. You’ll need extra suction.

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27
Q

Is Gout fast-onset or slow-onset? What are the s/s?

A

Rapid-onset
Swelling and pain in 1-4 joints within hours
low grade fever.

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28
Q

What sorts of surgeries are being used for Parkinson’s patients (3)

A

Ablation surgery (remove part of brain)
Deep brain stimulation
Fetal neural tissue transplants

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29
Q

What’s the key indicator for acquired hemolytic anemia?

What should you watch out for, too?

A

Jaundice

Watch for rhabdomyolysis, too

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30
Q

What is bile-reflux gastritis and when does it occur?

How do you treat it?

A

Abdominal pain/epigastric distress increases after meals.
Occurs after partial gastrectomies.

Bile acid Sequestrants and antacids.

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31
Q

Irritable Bowel Disease - how do food recommendations for this differ from IBS?

A

LOW fiber, low fat.

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32
Q

Why wouldn’t you give platelet transfusions to someone with HIT?

A

Because it can create more clots.

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33
Q

Rheumatoid arthritis is characterized by

A

Joint pain with stiffness, redness and inflammation.
Am stiffness that can last 60m or more.
Rheumatoid nodules

Systemic issues can occur:

  • Sjogren’s syndrome (fluids dry up)
  • Felty syndrome (inflammation in other places - like spleen: anemias)
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34
Q

What can you eat with IBS?

A

High Fiber (20-35g/day), Low Fat

Avoid anything that produces gas
Add yogurt to diet.

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35
Q

What labs should you watch if a patient is on anti-epileptic medications?

A

LFTs and serum levels of medications.

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36
Q

How can liver problems lead to anemia?

A

Decreased iron release

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37
Q

What would an intrathecal Baclofen pump be indicated for?

A

Spastic muscles and tremors associated with MS.

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38
Q

Fibromyalgia is characterized by

A

Widespread, fluctuating burning musculoskeletal pain (more than 3mos)
-not located in joints.

Can have cognitive problems, too (migraines, memory lapses, depression)
11/18 point tenderness
Restless leg syndrome, IBS, dysphagia
Increased urinary frequency/urgency

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39
Q

What can be used for pain in fibromyalgia patients?

A

TCAs

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40
Q

What is melena?

A

Dark, tarry stools that occur with lower GI bleeds.

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41
Q

What are the signs/symptoms of gallstones or cholecystitis?

A

RUQ tenderness
Referred pain to Right shoulder and Scapula (mod-severe)
Nausea, vomiting, sweating, fever, restlessness
Indigestion
Clay-colored stools, Jaundice (sclera of eye)
Tea-colored urine.

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42
Q

How is ITP treated? When is it likely to be treated?

A 
Treated when platelets are under 30k. 
Corticosteroids
IV immunoglobulin
Splenectomy
Platelet transfusion (if platelets are at 10k).
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43
Q

What is Thrombotic Thrombocytopenia Purpura?

A

Platelets will clump together in tiny clots.
Platelets not available = bleeding risk. Clots = stroke risk.
This is a medical emergency.

(can be caused by DDIs, lupus or sclerodoma: autoimmune)

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44
Q

S/s of Appendicitis?

A 
Fever
Tachycardia
Low BP
RLQ pain
Nausea, Vomiting
Knees pulled to chest.
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45
Q

What is glossitis and when would you see it?

A

Infection of the tongue. 2nd most common symptom with chronic iron deficiency anemia.

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46
Q

Crohn’s is likely to lead to poor absorption of _____?

A

Fat. This creates a DEAK deficiency.

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47
Q

Which hemorrhagic strokes are most likely to result in surgery?

A

Subarachnoid and intracerebral hemorrhage.

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48
Q

Can you do an endoscopy after a barium swallow? Would you do it before?

A

Can’t do it after, but it’s pretty expensive to do before for something like GERD.
(More likely for Crohn’s)

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49
Q

What are Purpura? What do they indicate?

A

Reddish bruise resulting from many petechiae.

Thrombocytopenia.

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50
Q

Atonic seizures are characterized by

A

Loss of consciousness and falling.

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51
Q

What does Bradykinesia look like in Parkinson’s?

A

Speech impediments
Loss of blinking
Slowed initiation and execution of movement.

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52
Q

What would you think if you see pink-tinged mucus?

A

Upper GI bleeds, maybe from GERD or esophagitis.

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53
Q

You see a low grade fever after gastroduodenostomy. What do you want to do for the patient?

A

Teach splinting
Pain control
So that patient can TCDB
(Atelectasis)

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54
Q

What are the characteristics of ulcerative colitis?

A

Continuous pattern in the colon and rectum.
Bloody diarrhea.
Involves both the mucosa and the su mucosa.
Abdominal pain.
Up to 20 stools a day if severe.

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55
Q

What is Heparin Induced Thrombocytopenia?

When is it likely to occur?

A

Some people make anti-heparin antibodies that create a pro-coagulation state.

Watch for it 5-10 days after heparin administration.

DVT and PE are most likely complications (not bleeding).

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56
Q

Partial seizures are characterized by

A

No loss of consciousness
Possible slowing of time
Possible jerking of arm/extremity (like myoclonic)

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57
Q

What is an endoscopic retrograde cholangiopancreatography and what should we know about it?

A

Invasive test for gallstones (cholelithiasis)

-needs consent, must be written out fully.

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58
Q

What is Apheresis and when would you use it?

A

Blood filtration to remove inflammatory pieces in bloodsteam.
Used in RA.

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59
Q

What is the problem with Gastric Ulcers?

A

Normal to Low gastric secretions (NOT high acidity)
Increased back diffusion
Causes: H. Pylori, NSAIDS, Corticosteroids.
Smoking makes it worse.

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60
Q

Agnosia means

A

The pt can’t recognize objects at all - by sight or by touch.

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61
Q

What do parasthesias and a burning sensation of the tongue have in common?

A

They both occur with iron-deficiency anemia.

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62
Q

What nutrients are nutrient-deficient anemia missing?

A

Iron, Cobalamin (B12) and Folic Acid

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63
Q

The family is wondering when their loved one’s acute delirium will go away. What do you tell them?

A

It usually goes away in 2-3 days after anaesthesia. Stay with them and it will help orient them.

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64
Q

What sort of diet do you want to recommend to someone with BPH? What else should they avoid?

A

Low acidity.
Avoid decongestants and anticholinergics
Avoid fluids at night.

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65
Q

Recommendations to avoid DVT?

A 
Bed rest
Elevate extremity
Reposition Q2h
Flex/extend feet, knees, hips every 2-4h while awake. 
Lovenox, warfarin, heparin
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66
Q

What are common post-stroke drug treatments for patients?

A 
Antiplatelet agents (ASA, clopidogrel)
Anticoagulants long-term (warfarin), especially if patients have Afib.
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67
Q

Hemiamnopsia means

A

The patient can only see half of the visual field

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68
Q

How often to monitor vitals with TPN?

How fast to administer?

A

Monitor VS and glucose Q4h.

Ramp up slowly - 25cc/hr to 125cc/hr, then ramp back down when done.

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69
Q

What is hematemesis?

A

Bloody vomit: coffee grounds if old, bright red if new.

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70
Q

What are the two biggest risk factors for stroke?

A

Diabetes and HTN

71
Q

Lavage of NG tube - what are the guidelines?

A

Tap water at room temperature.

(The only time you’d do an ice water lavage is with activated charcoal).

72
Q

Dysphasia means

A

Difficulty speaking: umbrella term that’s used before we know the specific problem.

73
Q

What is postprandial hypoglycemia and why/when does it occur?
How to prevent it?

A

Complication of partial gastrectomies.
2 hrs after a meal (when blood sugar is usually highest).

Body senses too many carbs in meal and overestimates insulin needed.
Prevent by eating less carbs.

74
Q

Why would you give CNS stimulants to someone with MS?

A

To help with fatigue, maybe attn/processing problems.

75
Q

What is a gastroduodenostomy and when would you get one?

A

Takes out part of the stomach and connects it to the duodenum.
Treatment for gastric ulcers (if PPIs/antacids don’t work)

76
Q

If your patient has a subphrenic abscess, where is it and what is it most likely from?

A

Under the liver

Most likely from cholecystitis and/or cholelithiasis.

77
Q

What are two autoimmune problems that are related to anemia?

A

Lupus (SLE)

Rheumatoid Arthritis

78
Q

How to ensure good nutrition with Parkinson’s?

A

Make sure food is easy to chew and swallow
Lots of small meals and snacks

(Note, don’t feed them unless you absolutely have to).

79
Q

What key symptoms to look for with pernicious anemia/megaloblastic anemia? What’s the missing component here?

A

Red, sore, beefy tongue
N/V/abd pain

Missing B12 (d/t missing intrinsic factor)

80
Q

Does biofeedback work in OA or RA?

A

RA

81
Q

What are the s/s of gastric ulcers?

A

Burning or gaseous pain 1-2 hours after eating high in the epigastrium. Aggravated by food.

82
Q

Education on stroke prevention should include

A
  • Healthy diet
  • Exercise
  • Stress reduction
  • cholesterol monitoring
  • managing BP and glucose levels
83
Q 
Why does intermittent claudication occur in PAD?
What will (temporarily) treat it?
A

Lactic acid buildup (secondary to hypoxia).

Rest and elevate your legs.

84
Q

Which lab tests will be abnormal in RA but not OA?

A

RF (+)
ESR and CRP increased (d/t inflammatory process)
Antinuclear Antibody (ANA)

85
Q

What are the characteristics of a Parkinsonian tremor?

A

More prominent at rest
Aggravated by stress
Aggravated by increased concentration.

Improved by purposeful movement (unaffiliated tasks).

86
Q

What is Immune Thrombocytopenic Purpura?

What sign would you see?

A 
Autoimmune disorder (often in women, childbearing years)
Body attacks platelets. Decreased lifespan (less than 8 days).

Slightly raised purple/red spots on face/neck.

87
Q

What is protamine sulfate and when would you see it used?

A

It reverses the effects of heparin - you’d use it in HIT.

88
Q

When would you do a lumbar puncture on a stroke victim?

A

To r/o infection
Or…
if a hematoma is suspected

89
Q

Absence seizures are characterized by

A

Spacing out for a few seconds. Maybe eyes rolling up into head.

90
Q

What causes cholecystitis?

A

Usually it’s from gallstones or biliary sludge - bile isn’t moving well. Can be Acalculus (without stones) or can occur with Cholelithiasis.

91
Q

What kinds of foods for ulcerative colitis?

A 
High calorie, high protein
Low residue (no fatty foods, whole grains, fried foods, some cheeses, raw veggies, fruits/nuts/raisins)

Iron, Folic Acid, Potassium, Zinc supplementation.

92
Q

What is somatostatin for when pt has a GI bleed?

A

Decreases acid secretions and decreases ulcer irritation.

93
Q

How does rigidity manifest in Parkinson’s?

A

It will look like jerky movements… cog-wheeling.

Soreness in head, upper body, spine, legs.

94
Q

Classic triad of symptoms for Parkinson’s?

A

Tremor, Rigidity, Bradykinesia

95
Q

What’s the biggest concern after a colectomy/ileostomy?

A

Dehydration. BMs will be 1500-2000 mls each. Drink as much as you put in.

96
Q

What foods/drugs to avoid with GERD?

A

Caffeine
chocolate
smoking
anticholinergics

97
Q

What sorts of foods are high in iron?

A

Liver, muscle meats, eggs
Potatoes, legumes, leafy greens
Dried fruits
Enriched grains

98
Q

Pernicious anemia is likely to occur after what surgery?

A

Partial gastrectomies (gastroduodenostomy).

99
Q

Do people with peptic ulcers have food restrictions?

A

No, just smoking and drinking restrictions.

They can eat what they want unless it worsens the pain.

100
Q

What differentiates the symptoms of moderate anemia from mild anemia? What level is considered “moderate”

A

Between 6-10
The symptoms of moderate anemia are the same (SOB, fatigue, palpitations), but are intensified: they occur while resting.

101
Q

What drug therapies do people with hemorrhagic strokes end up on? What are the parameters?

A

Anti-HTN medications, but SBP maintenance needs to be high - like 160 rather than 120.

Anti-seizure medications are important to prevent bleed/disruption in the brain.

102
Q

What are the components that make up gallstones (cholelithiasis)?

A

Bile salts, calcium, cholesterol.

103
Q

What is Dumping Syndrome and when is it likely to happen? How do you prevent it?

A

Happens after partial gastrectomies - up to 1 year after surgery.

Sudden onset (15-30m after meal) weakness, sweating, palpitations, dizziness, urge to defecate.

Has to do with the hypertonicity of the bolus and the movement of fluids into the intestines.

Prevent by not drinking while eating.

104
Q

When are SCDs contraindicated?

A

When a pt has an active VTE.

105
Q

Left-sided stroke damage often results in…

A
  • Right-sided neglect
  • Inability to distinguish between Right and Left
  • Mood disturbances: depression, anxiety
  • Learning and math problems
  • Cautiousness, slowness
106
Q

What can you take to increase iron absorption?

A

Vitamin C.

107
Q

What are key indicators of DVT?

A 
Unilateral leg edema
Extremity pain
Warm skin
Redness
Low grade fever
108
Q

What is McBurney’s point?

A

Appendicitis: halfway between xyphoid process and iliac crest. Press on it and get rebound tenderness. (RLQ).

109
Q

What are three things that block the absorption of iron?

A

Tea (and coffee)
Wine
Calcium

110
Q

What is a Vagotomy and Pyloroplasty and what does it prevent?

A

Severs the vagal nerve and enlarges the pyloric sphincter.

Done after partial gastrectomies (gastroduodenostomy, gastrojejunostomy) to prevent Gastric Outlet Syndrome

111
Q

What nursing care might help prevent delirium?

A 
Keep hydrated (to reduce UTI risk)
if opioids are indicated, keep doses low
Encourage good nutrition
112
Q

What does the CAM consist of? What’s a positive reading?

A
  1. Acute onset and fluctuation throughout day
  2. Inattention or Distraction
  3. Disorganized thinking
  4. Altered LOC

(Must have 1, 2 and 3 or 4 for it to be positive for Delirium)

113
Q

What should you watch for if the pt’s bleed is from drinking?

A

Watch for DTs (seizures, neuro deficits).

114
Q

Why would edema result from Ulcerative Colitis?

A

Body can’t break down proteins b/c food is passing through too quickly. Leads to low serum albumin and edema.

115
Q

Does acupuncture work in OA or RA?

A

OA

116
Q

What medication can lead to anemia? By what mechanism?

A

Methyldopa, because it promotes RBC destruction (hemolysis)

117
Q

How soon can you feed someone who has an active GI bleed? What do you give them?

A

You can’t feed them - must be NPO until the bleed is done.

Must give them clear liquids with no red when ready.

118
Q

What condition would belladonna and opium be for?

A

Bladder spasms associated with BPH (and BPH surgery).

119
Q

What is a Mallory-Weiss tear?

A

Happens after vomiting that becomes dry-heaving - turns into bloody vomit.

120
Q

What is a Nissen Fundoplication for?

A

Hiatal hernia: pulls it back down and wraps it around the top of the stomach to prevent it from going back up.

121
Q

Myoclonic seizures are characterized by

A

Sudden excessive jerk of an extremity (usually arm/neck).

122
Q

What are purine-rich foods?

A 
Dried beans/peas
Game meats and liver
chicken/beef/pork
Herring, anchovies, shrimp
Spinach, Asparagus, Leafy greens.
123
Q

What are two medical procedures (aside from surgery) that can lead to anemia?

A

Dialysis

Incompatible blood transfusions

124
Q

A stroke patient is having respiratory issues. The stroke was most likely located…

A

…close to the brainstem.

125
Q

What’s the difference in ASA dosage for symptomatic vs asymptomatic PAD? What if they can’t take ASA?

A

75-100mg/day if asymptomatic
325mg/day if symptomatic.

Can take Clopidogrel if symptomatic.

126
Q

S/s with duodenal peptic ulcers?

A

Sometimes no sx at all.

If pain is present, “Cramping” or “Burning” under the xyphoid process… can radiate to back.

127
Q

How often to take vitals when someone has a GI bleed?

A

Q15m.

128
Q

Advice for people with GERD?

A

Low fat, Low acid diet (avoid citrus fruits, tomatoes)
Elevate HOB for 30m after eating.
Don’t eat before bed.
Eat small meals.
Avoid peppermint, caffeine, chocolate.
Don’t drink milk (fat will cause body in increase bile)

129
Q

When would you have a barium swallow?

A

To diagnose GERD or rule out tumor/other GI probs

To confirm healing with Peptic Ulcer disease

130
Q

Right-sided stroke damage is likely to result in…

A
  • Left sided neglect
  • Impulse control problems, short attn span, forgetfulness
  • spatial/depth perception
  • difficulty with time
  • minimizing problems
131
Q

What is Lupus (SLE) characterized by?

A

-Inflammation of multiple systems (skin, joints, serous membranes, kidneys, blood, neuro).

-Initial symptoms are flu-like.
-Butterfly rash
-Morning stiffness, muscle/joint pain
…then…
-Cough, tachypnea, arrythmias
-Seizures can occur
-Peripheral neuropathy can occur
-Anemia
-Infections are a major cause of death because of inflammation all around the body.
-Lupus nephritis (kidney inflammation)

132
Q

Why wouldn’t you want to give prophylactic platelet transfusion to someone with ITP?

A

Because the body is likely to form antibodies and worsen the problem.

133
Q

What will happen first if someone goes to the ED complaining of chest pain?

A

GI cocktail to rule out hiatal hernia

then, an EKG.

134
Q

What do you need to tell a patient about their diet if they’re on levodopa?

A

Don’t eat too much protein - it will keep it from functioning well.

135
Q

What is a gastrographin swallow?

A

Similar to a barium swallow, but less opaque and less constipating.

136
Q

Delirium is characterized by

A 
Abnormally slow EEG. 
Waxing/waning severity. 
Acute onset loss of s/t and l/t memory. 
Mental status is altered from pt’s baseline. 
Inattention/distractibility.
137
Q

Why would you give anticholinergics to someone with MS?

A

If they had bladder spasticity problems.

138
Q

What is the treatment for ulcerative colitis?

A

REST the bowel.
Sulfasalazine to help remission.
Surgery: colectomies and ileostomies to cut out of the affected portion of bowel.

139
Q

How long before a patient can eat soft foods after a Nissen Fundoplication?

A

Could take months. Might even go home while still on clear liquids. Swelling must go down first.

140
Q

Dysarthria means

A

Difficulty moving the tongue, which makes the mechanics of speech difficult.

141
Q

A patient has an NG tube that is giving output. What fluids will you be hanging for the pt?

A

NS with potassium.

142
Q

Apraxia means

A

Can’t perform sequential procedures

143
Q

Signs/Symptoms of GERD?

A

1: heartburn.

Can be respiratory d/t esophageal probs (SOB/cough/etc)
Hoarseness, lump in throat, soreness
Tooth enamel erosion d/t regurgitation

144
Q

What is toxic megacolon related to? What is it?

A

It’s a complication with Ulcerative Colitis: large areas of inflammation prevent the bowel from working - need to cut out the area that’s not functional.

145
Q

Nursing care for Osteoarthritis?

A

Braces
Rest
Heat/cold for pain
Exercise to maintain ROM

146
Q

Why would someone with anemia get a headache?

A

Hypoxia and chronic O2 deficiency.

147
Q

Osteoarthritis is characterized by

A

Joint pain without inflammation (no redness). Just swelling/tenderness.
In weight-bearing joints.
Stiffness in the morning that resolves after 30m.
Crepitation and effusion in joints.
Joints subluxated/deformed but NOT symmetrically affected.
Heberden’s (distal) and Bouchard’s (proximal) nodes.

148
Q

What is thrombocytopenia?

A

Platelet deficiency. Less than 150k.

149
Q

Gout: what will affected toes look like?

A

Dusky, cyanotic. They’ll also be tender.

150
Q

Treatment for ischemic stroke: acute

A

tPA thrombolytics w/in 3-4.5 hours.
CT/MRI to diagnose
Angiography to see where the blockage is

151
Q

What are the s/s of anemia in older patients?

A

1 is likely confusion

Pallor happens sooner
Balance problems (gait, coordination)
Heart issues like angina can worsen

152
Q

How can kidney problems lead to anemia?

A

Decreased erythropoietin production

GFR drop

153
Q

What is panocytopenia?

A

Unexplained decrease in all blood cells

154
Q

What’s the problem (source) with Duodenal ulcers?

A

High HCL acid secretion
(Most peptic ulcers are duodenal)
Smoking/drinking makes it worse.

Risk increases with: 
COPD
Cirrhosis
Pancreatitis
Hyperparathyroidism
Renal failure
155
Q

Which veins are most likely to have a DVT?

A

Femoral and iliac.

156
Q

Which disease is characterized by disseminated demyelination and gliosis of the nerve fibers in the CNS?

A

Multiple sclerosis

157
Q

What is Virchow’s triad?

A
  • Venous stasis
  • Endothelial Damage
  • Hypercoagulability of blood

Can form a “perfect storm” for DVT formation.

158
Q

What drug therapy would you use for GERD? What role does it play in diagnosis?

A

Empirical PPI therapy for 2 weeks is a good way to treat mild GERD symptoms. If it goes away, it’s a good bet.

Generally, treatment will start with Antacids, progress to H2 blockers, then PPS, then back to H2 blockers, then back to Antacids.

159
Q

What are the signs/symptoms of multiple sclerosis?

A

Motor weakness (might start small)
Paralysis or spasticity (or both)
Problems with sensory stuff (tinnitus, blurred vision)
Nystagmus, joint pain, difficulty swallowing
Coordination problems.
Bowel/Bladder problems (incontinence or retention,spastic or flaccid)
Depression, executive fn problems.

160
Q

What are petechiae? What do they indicate?

A

Small, flat, reddish/brown pinpoint spots.

Indicate Thrombocytopenia.

161
Q

What are symptoms of mild anemia? What levels would this be?

A

Between 10-12.

  • shortness of breath
  • Fatigue
  • Palpitations
162
Q

What is Buck’s traction for and how long can it be used?

A

Applied after hip fracture.

Can only be be used for 24-48h.

163
Q

You have to give IV fluids to someone with a massive GI bleed. What kind of fluids will you give?

A

Normal saline

(If you were to give D5W, it would cause clots).

164
Q

What is plasmapheresis and when would you see it done?

A

Separation of blood

Done in TTP (thrombotic Thrombocytopenia Purpura) and HIT (heparin-induced thrombocytopenia) to filter out microclots.

165
Q

What are DMARDS? When would you use them?

A

Disease-modifying anti-rheumatic drugs.
-example: methotrexate.

Used for RA and SLE

166
Q

How to stop vasospasm with Raynaud’s?

A

Immerse hands in warm water.

167
Q

What tests are used when assessing Delirium?

A

MMSE

CAM (confusion assessment method).

168
Q

What are the SEs of levodopa?

A 
Dyskinesias
Hallucinations
OH
Weakness
Akinesia (loss of voluntary movement)
169
Q

What’s the best treatment option for someone with MS?

A

Physical therapy, especially water therapy.

Goal is for the unaffected muscles to support the affected muscles.

170
Q

What tests would tell you if you were dealing with an autoimmune disorder?

A

ANA (antinuclear antibody) and DNA antibody

171
Q

Some lesser-known complications of Parkinsons’

A 
Malnutrition
Aspiration
Pneumonia
UTIs
Skin breakdown
Constipation
Edema in ankles
Excessive sweating, seborrhea or dandruff
172
Q

Food requirements for Crohn’s?

A 
High calorie
High vitamin
High protein
Low residue
Milk-free.
173
Q

What is Gastric Outlet Syndrome? What is it associated with?

A

Body keeps putting fluid into the stomach, attempting to push fluid through the intestines.
Will lead to projectile vomiting.

Associated with Peptic Ulcers.

MedSurg1 Final Exam (2 decks)

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