M2 recap Flashcards

Question

peritonitis | what? Manifestations? managment

Answer 1

Localized/generalized inflammation of peritoneum Can be acute or chronic Ruptured organs can lead to organs into the peritoneal cavity Clinical manifestations Pain, rebound tenderness (gently palpate hold it for 10-15 seconds secer paiun upon release), distension, fever Nursing Management: Fluid replacement (I/0) Antibiotics narcotics NPO

Answer 2

Inflammation of mucosa of the stomach and small intestine Often misdiagnosed with appendicitis Signs and symptoms Nausea vomiting dirahhrea, fever, ncreased WBC, blood in mucosa Nursing management NPO IV fluids (glucose + electrolytes)

Answer 3

Inflammation and ulceration of rectum and colon → bleeding, decreased muscosal area → protein loss Starts in rectum and spread proximally along colon clinical manifestations - Bloody diarrhea and abdominal pain with/without systemic response drug therapy Antimicrobial 5-ASA Corticosteroids Antidiarrheals Immunosuppressant surgical therapy

Answer 4

- A chronic IBD of unknown origin that can affect any part of the GI tract from the mouth to anus - Elevated TNF-alpha levels, low RBC (ESR) - Skip lesions, abscesses or fistulas - Thick walls with narrowing of lumen clinical manifestations - Non-bloody diarrhea - stiaterria (fat in stool) complications - Scar tissue from inflammation narrows lumen Strictures and obstructions - Fistulas between segments of bowel, urinary tract, perianal areas - Intra-abdominal abscesses and peritonitis drug therapy - Antimicrobials - Corticosteroids - Immunosuppressants - Immunodilators - TPN

Answer 5

Immune mediated response - Chronic inflammation from the ingestion of gluten because it contains prolamins - This causes the partial digestion of gluten releasing prolamins which are releases the prolamin peptides into the intestinal mucosa Clinical manifestations - Foul smelling diahreea - Stinerrhea (fat in stool) - Abdominal distention after gluten consumption - Malnutrition (may look overweight but will be malnourished)

Answer 6

Types of intestinal obstruction Mechanical - Occlusion of lumen of intestinal tract - Small intestine: Adhesions, hernias, neoplasms - Large intestine: cancer, diverticular disease Nonmechanical - Neuromuscular or vascular disorder - Paralytic ileus Collaborative care NG tube – decompress bowel IV fluids TPN Surgery – partial or total colectomy, colostomy, ileostomy

Answer 7

- Due to fibre deficiency - Slows passage of stool with narrowed lumen of sigmoid colon causes high intraluminal pressure - due to retention of stool and bacteria in diverticulum - Increased risk for complete perforation with peritonitis Clinical manifestations - Cramping in left lower quadrant relieve with flatus or BM - Alternating constipation and diarrhea - Fever, n & v, anorexia, elevate therapy - High-fibre diet (during non-symptomatic periods) - Bulk laxatives - Stool softeners - Clear liquid diet - Oral antibiotics

Answer 8

care and drug therapy Medications: Trimethoprim–sulfamethoxazole (TMP–SMX) or nitrofurantoin (older adults); Cipro or levaquin Urinary analgesic

Answer 9

Inflammation of renal prigma and colecting system common cause is bacterial infection, but fungi, protozoa, or viruses can also cause Acute starts in the renal medulla and spreads to the adjacent cortex Recurring episodes (esp in the presence of abnormalities) scarring of kidneys → chronic pyeloneprhitis care and drug therapy Medications: ampicillin, vancomycin, cipro, septra, NSAIDS, antipyretic Nursing implementation Push fluids, Follow up urine culture

Answer 10

Initiation Phase - decrease in UO Maintenance Phase - Presence of kidney failure = low serum calcium results → decreased release of phosphate by kidneys oliguria → 10-14 days, toxins not removed by kidneys - Urinary output is less than 400 mL in less than 24 hrs Recovery Phase - GFR becomes normal, kidneys secrete waste but do not concentrate urine - Diuretic phase begins w gradual increase of UO 1-3L per day or more - High urine volume is by osmosis not nephrons as they are still recovering

Answer 11

Chronic irreversible loss of kidney function, a GFR of less than 60/min for 3 months or longer interventions - monitor I/o - retrict fluid, sodium, potassium - monitor protein if on dyalisis - monitor complications Drug therapy to treat - Hyperkalemia - Hypertension - Anemia - Dyslipidemia

Answer 12

Peritoneal dialysis is a treatment for kidney failure that uses the peritoneum to filter your blood complications of P dialysis - hernia - exit site infection - peritonitis hemodyalisis uses machine to clean blood along with: - Vascular access site - Arteriovenous fistulas and grafts - Central venous catheters - Temporary vascular access complications - hypotension - hepatitis - disequilibrium syndrome

Answer 13

- Ensure ABCs - Check for impaired circulation (colour movement sensation) - Control external bleeding with direct pressure or sterile pressure dressings and elevation of extremity. - Check neurovascular status distal to injury before and after splinting. - Obtain X-rays of the affected area. - Administer tetanus and diphtheria prophylaxis. - Mark location of pulses to facilitate repeat assessment. - CSM!!!!!

Answer 14

- Characterized by excessive 6 P’s - pain, pallor, paresthesia, paralysis, and pulselessness (emergency) - Pain unrelieved by medications and out of proportion to the level of injury - Ischemia can occur within 4–8 hours after onset.

Answer 15

Slowly progressive noninflammatory disorder Osteopenia is a decrease in bone density → osteoarthritis is severe - localized pain and stiffness, crepitation signs - Herberden’s nodes - crepitation tx: - hot and cold compress - pharm is an adjuvant

Answer 16

Chronic, systemic autoimmune disease menifestations - Sjögren syndrome --> Decreased fluid like tears/saliva - Felty syndrome (splenomegaly) - swan hands and bouteneir hands - Those affected usually have high levels of biomarkers such as rheumatoid factor (RF). - muscle fibre degeneration - Cataracts and loss of vision interventions - monitor for sjorgen syndrome - monitor for splenomegaly - pharm

Answer 17

- Methotrexate - Hydroxychloroquine (Plaquenil) - Immunosuppressants - Gold preparations - Corticosteroid therapy - NSAIDs and salicylates – high doses

Answer 18

Chronic, multisystem inflammatory, autoimmune disease Results from interactions among genetic, hormonal, environmental, and immunological factors manifestations: - rash on the nose - pericarditis - joint pain - nephritis - fever teaching - Medications --> Pain management - Conservation of energy - Avoid exposure to ultraviolet rays. - Use steroids for joint inflammation. - Therapeutic exercise and heat therapy

Answer 19

signs: - Dowager’s hump (outward curvature of the upper spine) - Kyphosis of the dorsal spine - Loss of height - Pathological fractures Pharm tx: Bisphosphonates (---inate) interventions: - Encourage diet high in vitamin D, protein, and calcium. - Encourage 20 minutes of UV exposure a day. - Routine DEXA screening begins at 60.