integumentary Flashcards

Question

what is patient teaching regarding decreasing the risk for antibiotic resistant infections?

Answer 1

1. Do not take antibiotics to prevent illness a. Prophylactic antibiotics are given for surgery 2. Wash your hands frequently 3. Follow directions when taking antibiotics 4. Do not request an antibiotic for flu or colds 5. Finish your antibiotic 6. Do not take leftover antibiotics

Answer 2

Infection acquired in health care setting - Surgical and immunocompromised patients at highest risk - Multiple organisms are responsible

Answer 3

Handwashing!!!

Answer 4

HAIs in elderly 2-3X higher At risk: - LTC (long term care) patients - due to impaired immune function, co-morbidities such as UTIs, pneumonia, skin infections, TB How does infection manifest in the elderly adult? ***decline in cognitive function and ability to perform ADLs…don’t rely on temperature!!! ***

Answer 5

standard precautions and transmission based precautions

Answer 6

Onset abrupt, highly contagious Cough, fever, chills, myalgia (muscle pain), HA, exhaustion Dyspnea and crackles signs of pulmonary complications Usually symptoms subside within 7 days Most common complications: 1. Pneumonia – can cause DEATH! 2. ear or sinus infection 3. High risk: elderly and chronic disease a. also prone to dehydration

Answer 7

inactivated vaccine

Answer 8

Incubation period of 1-4 days, with the peak transmission risk starting at 1 day BEFORE symptoms appear i.e. Transmissible 24 hrs before symptoms present

Answer 9

1. Symptomatic therapy 2. Antiviral drugs – within 2 days of symptoms for max benefit 3. Rest (older adult possible hospitalization) Prevention: vaccine

Answer 10

Contact with infected body fluids (blood, semen, vaginal secretions, breast milk) 1. Sexual intercourse with infected partner* - *most common mode of transmission 2. Perinatal (most common route of transmission for children) 3. During pregnancy, during delivery, breastfeeding 4. Exposure to HIV infected blood or blood products Can be transmitted within a few days after becoming infected, and continues for life NOT SPREAD BY: - HIV is not spread casually (hugging, shaking hands, sharing eating utensils, etc.) - HIV is not spread by tears, saliva, urine, emesis, sputum, feces, sweat, or respiratory droplet

Answer 11

flu-like syndrome, occurs 2-4 weeks after initial infection, lasts for 1-3 weeks - Viral load is high during the Acute Phase so measure for it if HIV is a possibility - MOST infectious during this stage S/S: i. Fever ii. Swollen lymph glands iii. Sore throat iv. Headache v. Malaise vi. Nausea vii. Muscle and joint pain viii. Diarrhea ix. Diffuse rash x. Some develop neurologic complications: facial palsy, Guillain-Barre, peripheral neuropathy, aseptic meningitis

Answer 12

time between infection and development of antibodies; can be several weeks before detection is possible after infected

Answer 13

1. CD4 T cell count - detects immune function 2. Viral load - detects amount of virus in body; “undetectable” doesn’t mean that virus has been eliminated also the CBC can be looked at for pancytopenia

Answer 14

prevent spread - via intercourse, drug use, perinatal, or work related incidents delay disease progression - 1. Getting nutritional support to maintain lean body mass 2. Moderating or eliminating alcohol, tobacco, and drug use 3. Keeping up to date with vaccines 4. Adequate rest and exercise 5. Reducing stress 6. Avoiding exposure to new infectious agents 7. Counseling 8. Support groups 9. Relationship with HCP’s/attend regular appointments

Answer 15

inflammation of the connective tissue in the synovial joints. many joints are involved and the lining of the joints (the synovium) is inflamed, damaging all tissues in the joint The joints are painful and stiff and appear warm, tender, and swollen with fluid Blood tests confirming RA show widespread inflammation that affects the body in general, often causing anemia, weight loss, and fatigue. X-ray images in rheumatoid arthritis show bones that are thin and eroded.

Answer 16

1. at onset -fatigue, anorexia, weight loss, generalized stiffness - systemic manifestations at onset 2. then stiffness becomes more localized in the following weeks and months 3. Joint symptoms: pain, stiffness, limitation of motion, warm to the touch, swelling, and tenderness 4. Joint symptoms occur symmetrically - May begin in a couple of joints only - Most frequently attacks the wrists, hands, elbows, shoulders, knees, and ankles a. Cervical spine may be affected, but not C1 & C2 5 may lead to permanent deformity and disability

Answer 17

1. deformity and disability 2. rheumatoid nodules 3. Sjögren's syndrome 4. Felty syndrome

Answer 18

``` Ulnar drift Boutonniere deformity Hallux valgus (bunion) Swan neck deformity ```

Answer 19

nodules that develop in about half of all pts with RA Appear subcutaneously as firm, non-tender, granuloma-type masses Base of spine, back of neck, and even scleral nodules

Answer 20

a syndrome that develops on its own or as part of RA or SLE (lupus) Autoimmune disease that targets the moisture-producing exocrine glands leading to dry mouth and dry eyes - Nose, throat, airways, and skin can also become dry - Other glands can be involved (glands in stomach, pancreas, small intestines) - Diminished lacrimal and salivary gland secretion

Answer 21

burning, gritty, itchy eyes, ↓ tearing, photosensitivity

Answer 22

Treat symptoms!! 1. artificial tears 2. surgical punctal occlusion 3. increase fluids with meals 4. Good dental hygiene important d/t dry mouth

Answer 23

a rare autoimmune disease characterized by triad of rheumatoid arthritis, enlargement of the spleen, and too few neutrophils in the blood

Answer 24

``` SANTA splenomegaly anemia neutropenia thrombocytopenia arthritis ```

Answer 25

ESR and C-reactive protein

Answer 26

Education on disease process and home management Drug therapy: anti-inflammatory medications and others Nutritional therapy: balanced nutrition Acute Intervention: primary goals are to have a reduction in inflammation, satisfactory pain management, have minimal loss of functional ability, prevent/minimize joint deformity Goals met through a comprehensive program of drug therapy, rest (pacing activities), joint protection, heat (chronic stiffness) and cold (acute exacerbation/inflammation) application, exercise, pt and family education

Answer 27

1. maintain joint in neutral position to minimize deformity. (press water from a sponge instead of wringing) 2. Use strongest joint available for any task. (when rising from a chair, push with arms rather than fingers; carry laundry in both arms rather than fingers) 3. Distribute weight over many joints instead of stressing a few (slide objects rather than lifting, hold packages close to body for support) 4. Change positions frequently (do not hold a book or grip a steering wheel for long periods, avoid grasping a pencil or cutting veggies for long periods) 5. Avoid repetitious movements (knitting, rest between rooms when vacuuming, faucets and doorknobs that are pushed not turned) 6. Modify chores to avoid stress on joints (avoid heavy lifting, sit on stool when meal prepping)

Answer 28

Type of acute arthritis caused by the elevation of uric acid and the deposit of uric acid in one or more joints painful flares with long periods without symptoms Caused by increase in uric acid production, reduced excretion by kidneys, or increase intake of foods containing purine (not usually a problem), can be related to alcohol intake

Answer 29

gouty arthritis may occur in one or more joints (usually less than 4) 1. Triggered by trauma, surgery, ETOH ingestion, systemic infection 2. Inflammation of great toe-podagra is the most common initial problem 3. Dusky, cyanotic joints 4. Other affected joints: mid-tarsal area of foot, ankle, knee, wrist 5. Onset-occurs at night with sudden swelling and excruciating pain 6. Often a low grade fever

Answer 30

multiple joints, visible deposit of Na urate crystals called tophi 1. Chronic inflammation may lead to joint deformity, cartilage destruction which may predispose to OA 2. Excessive uric acid may lead to kidney and urinary tract stone formation 3. Pyelonephritis

Answer 31

Synovial fluid aspiration - Fluid contains urate crystals - Pt may benefit with decompression - Usually not necessary as it can be diagnosed from clinical symptoms

Answer 32

joint immobilization local application of heat or cold joint aspiration and intraarticular corticosteroids dietary avoidance of food/fluids with high purine content (ie anchovies, liver, wine/beer) drug therapy

Answer 33

high purine: sardines, herring, mussels, liver, kidney, goose, venison, meat soups, sweetbreads moderate purine: chicken, salmon, crab, veal, mutton, bacon, pork, beef, ham

Answer 34

a COMPLEX AND MULTIFACTORIAL multi system inflammatory autoimmune disease in which connective tissue and fibrin deposits collect in blood vessels, on collagen fibers, and on organs. The deposits lead to necrosis and inflammation in blood vessels, lymph nodes, gastrointestinal tract, and pleura There is no known cure for the disease - Most cases in women of childbearing years - Women 10 times more likely to develop SLE than men

Answer 35

extremely variable no characteristic pattern

Answer 36

**#1 - Classic Butterfly Rash** Also: - Cutaneous vascular lesions in sun-exposed areas, - ulcers of the oral and pharyngeal membranes common, - patchy hair loss (alopecia) dry, scaly scalp Can also affect almost every other body system

Answer 37

FEVER SHOULD BE CONSIDERED SERIOUS AND INVESTIGATED also avoid live vaccines if patient is taking steroids or cytotoxic agents

Answer 38

Documentation of patient symptoms and response to therapy Assess fever pattern, joint inflammation, limitation of movement, location and degree of discomfort and fatigue Monitor weight and I&O 24-hour urine studies may be ordered Observe for signs of bleeding Treatment during pregnancy - should be considered (spontaneous abortion, stillbirth, and intrauterine growth retardation are common problems with pregnancy) - Exacerbation is common in the postpartum period

Answer 39

1. the disease process 2. names of drugs, actions, side effects, dosage, and admin 3. pain management strategies 4. energy conservation and pacing techniques 5. therapeutic exercise, use of heat therapy (for arthralgia) 6. avoidance of physical and emotional stress 7. avoidance of exposure to individuals with infection 8. avoidance of drying soaps, powders, household chemicals 9. use of sunscreen protection and protective clothing, with minimal sun exposure from 11am-3pm 10. regular medical and lab follow-up 11. marital and pregnancy counseling as needed 12. community resources and health care agencies Also: frequent oral care monitor skin integrity id contributors to fatigue

integumentary Flashcards

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