Gen Med Flashcards

Question

Cancer

Answer 1

* Yearly screening starting at 40 * Drugs * Chemotherapy s/e * Thrombocytopenia (platelets) * avoid ASA, hold IM injections * s/s - petechiae, epistaxis, ecchymosis * Leukopenia (WBC low) * ANC below 500 → reverse isolation * Anemia * Alopecia * can be prevented with scalp tourniquets and ice packs in some * N/V/D * Stomatitis * Give lidocaine before meals * Wash mouth with H2O2 after meals * KY jelly can be used on lips * Cesium implants * symptoms that should be reported to PCP (indicate infection and perforation) * Profuse vaginal discharge * Elevated temp * N/V * HOB elevated to 45 max * Bed rest required * Low residue diet * No more than 30 minutes of exposure for nurse per day

Answer 2

* Handle a cast with your palm * Support with pillows (no plastic) * 24 hours to dry * White/shiny when dried * Petal edges to prevent irritation * Report s/s to HCP * Numbness * Tingling * Burning * Pallor * Unequal or absent pulses * Unequal coolness * Cast syndrome * caused by body casts * S/s * N/V due to bowel obstruction * Treatment * NPO * NG decompression *

Answer 3

* Types of skin traction * Bucks * used for hip fractures in adults * can turn on unaffected side * Bryants * used for hip fractures in children * hip should be off the bed * Pelvic * pt. should be in semi-fowlers w/ knee gatched * Russell traction * prone to thrombophlebitis * Types of skeletal traction * Cranial tongs * Thomas splints w/ pearson attachment

Answer 4

* Causes * Injury, congenital, exposure to heat, heredity, age * Symptoms * cloudiness * Diplopia (double vision) * Photophobia * Treatment * Laser removal * Surgical removal * Give pre-op * Mydriatics * Dilators * Antibiotics * Post -op * shield on operative eye for 24 hours, then metal shield (at night only) for 3 weeks * Antiemetics, analgesics, stool softeners * if no lens implanted, they will be fit for contacts 3 months post-op * Do not lie face down or on operative side for 1 month * S/s of hemorrhage * Severe pain * restlessness * Avoid * coughing, sneezing, bending at the waist, straining at stool, touching eye, rapid head movements * Increased intraocular pressure * Pain * Restlessness * Increased pulse rate

Answer 5

* Intolerance of gluten (protein) * S/s * large, greasy, foul-smelling stools * Inability to observe fat-soluble (ADEK) vitamins * Malabsorption of vitamin K leads to bleeding disorders * Distended abdomen w/ flatus * Treatment * avoidance of grains besides rice and corn * Avoid ice cream, puddings, cream soups

Answer 6

* Indications * Cancer * usually permanent * Diverticulitis * Ulcerative colitis * Double barrel colostomy * colon cut and both ends are brought out into the abdomen * stool comes out of proximal end * New stoma should be red, large and noisy * noise will go away in a few days to a week * patient should take care of the stoma by 3rd or 4th day post-op * Colostomy irrigation * done QD with warm tap water while sitting

Answer 7

* Ileostomy * Liquid stool * mild odor * Stool damaging to the skin * Continuous drainage * High risk for fluid/electrolyte imbalances * Incontinent * Never irrigate * Transverse Colostomy * Stool is soft * Typical stool odor * Stool damages the skin * Empty several times per day * May or may not be at risk for fluid * May irrigate * Descending Colostomy * Stool is formed * Typical stool odor * Stool doesn't irritate unless diarrhea * Empty 2-3 times per day * Lowest risk for fluid/electrolyte imbalances * Continent * May irrigate

Answer 8

* Affects exocrine glands (increased viscosity leads to obstruction) * Risk Factors * hereditary * S/S * Fat, frothy, foul-smelling, floating (steatorrhea) stools * most problems with lungs and pancreas (observe for steatorrhea) * Meconium ileus probably recorded at birth * Interventions * Decreased airway clearance (postural drainage, HOB elevated * Alteration in nutrition or absorption * Diet * High calorie, high protein, modified fat * Replace fat soluble vitamins * Take NaCl tablets * Diagnosis * Sweat test (Iontophoresis)

Answer 9

* Causes * Trauma * Aging * Cataract surgery * S/S * Veil or curtain in the line of sight * flashes of light * floaters * Treatment * Tranquilizers * Surgery (scleral buckling) * Laser surgery * Cryosurgery * Both eyes bandaged before and after surgery * Interventions * Bedrest * return to work 3 weeks * active jobs 6-8 weeks after that * Dimmed lighting * Complications * hemorrhage

Answer 10

* Herpes simplex II * Incubation 3-7 days (same for gonorrhea) * Treatment * Acyclovir (any -cyclovir) * Keep lesions dry * C-section if vesicles are present * Heals in 2-4 weeks * Gonorrhea * most common STI next to chlamydia * Can infect the eyes * particularly in neonates (Ophthalmia Neonatorum) * discharge starts 2-3 after birth * Given erythromycin or tetracycline * can lead to blindness * Can lead to sterility in women * S/S * dysuria or purulent discharge * can be asymptomatic in women * Incubation - 2-3 weeks * Treatment * IM penicillin * Pelvic Inflammatory Disease * Treatment * IV penicillin * Positioned semi to high fowlers

Answer 11

* Increased intraocular pressure due to imbalance in drainage of aqueous humor * Affects both eyes * Tunnel vision * Types * Open-angle * most common * seen in later life * Painless * Closed angle * painful * Treatment * Miotics (pilocarpine, timoptic) * constricts the pupil * Diamox * decreases aqueous humor * Surgery * Post-op * severe ocular pain sign of hemorrhage

Answer 12

* GBS * Ascending paralysis due to demyelination of peripheral nerves * recover in 4-6 months * Clumsiness first symptom * Respiratory arrest biggest danger * In acute stage, assess motor function q2H * Treatment * Plasma phoresis most aggressive

Answer 13

* Bleeding disorder * Deficiency of factor 8 * Labs * PTT increased * Clotting time increased * Hemarthrosis * bleeding in the joints * Immobilize and elevate above the heart * Wait 48 hours before ROM, weight-bearing exercise * Treatment * Cryoprecipitate * epinephrine topically to stop bleeding

Answer 14

* Overview * Acute inflammatory disease of the liver * Viral * S/S * Early stages look like the flu * Later stages urine turns dark * Pre-icteric - stage before jaundice * Pruritus * Jaundice * Aversion to cigarettes * Light-colored stools * Hep A * anorexia * fatigue * Hep B * more severe symptoms

Answer 15

* Overview * Vesicular rash over sensory nerve * Heals in 30 days * Pain * Impaired skin integrity * related to chickenpox * Treatment * Acyclovir * Tegretol * Steroids