Med Surg

Question 1

complications post gastric bypass with nausea and vomiting especially if pt is obese

Answer 1

wound dehiscence and evisceration

Question 2

Multiple sclerosis

Answer 2

inflammation of myelin sheath causes nerve pulses to be blocked or slowed

autonomic dysreflexia can occur

cognitive deficits 
fatigue 
numbness 
tingiling 
weakness 
ataxia 
tremors 
difficulty swallowing

Question 3

Myasthenia Gravis

Answer 3

impulses blocked between nerve and muscles causing voluntary muscle weakness

face, throat, and facial weakness
NO cognitive impairment

not enough or too much meds causes RR failure

Question 4

GBS

Answer 4

decreased reflexes in lower extremities
paresthesia of hands and feet
disease starts from feet moving up

autonomic dysreflexia can occur

Question 5

Parkinsonism

Answer 5

loss of dopamine causes loss of voluntary movement

small handwriting 
shuffling gait 
pill rolling 
bradykinesia 
dysphonia 
dementia

Question 6

ALS

Answer 6

motor neurons die
can feel sensation just cannot move

decreased fine finger control
RR paralaysis- diaphragm affected

Question 7

autonomic dysreflexia

Answer 7

NEURO EMERGENCY
syndrome in which there is a sudden onset of excessively high blood pressure. It is more common in people with spinal cord injuries that involve the thoracic nerves of the spine or above (T6 or above)

causes: 
distended bladder 
fecal impaction 
low temperatures 
s/s 

high blood pressure
headache
sweating forehead
high pulse

Question 8

anticonvulsants

Answer 8

may become sleepy
avoid alcohol
give with food

Question 9

venous insufficiency

Answer 9

elevate legs above heart

Question 10

arterial insufficiency

Answer 10

lower legs

Question 11

pyelonephritis

Answer 11

bacterial infection of kidneys
begins lower urinary tract moves up
Ecoli most common way

s/s
n/v
fever
pain
leukocytosis- pyuria looks cloudy 

fluids and antibiotics

Question 12

bronchitis

Answer 12

airway constriction
build up of mucus

s/s 
cyanotic 
increased CO2 
acidosis 
edematous 
dyspnea 
right sided HF 
cardiac enragement 
accessory muscles

Question 13

Emphysema

Answer 13

breakdown of alveoli causing less surface area for gas exchange

s/s 
loss of lunch elasticity 
dyspnea 
increased CO2, RR 
pursed lip breathing 
barrel chest 
thin, right  sided heart failure

Question 14

fractures

Answer 14

above heart level

Question 15

ACS

Answer 15

keep at heart level

fasciotomy to release pressure

Question 16

Osteoporosis

Answer 16

porous bones

thin, asians, Caucasians

Question 17

dumping syndrome

Answer 17

s/s
dehydration 
tachycardia 
weakness
faint 
nausea 

tx: high protein high fat diet
avoid milk, sweets, sugar
drink 1hr before/after meals

Question 18

Paget disease - musculoskeletal

Answer 18

bowing of legs

the base of the skull is invaginated (soft)

Question 19

Adrenal cortical insufficiency (addison)

Answer 19

low cortisol and aldosterone
low BS,low BP, low Na,
high K, high Cl, high Ca

ACTH test to check for addisons 
muscle weakness 
dark pigmentation 
GI symptoms 
steroids cause this 

tx: orthostatic BP
give cortisol and aldosterone

Question 20

Cushing syndrome- adrenal cortical increase

Answer 20

increase cortisol and aldosterone or taking too much steroids 
high Na, high BS, low K
sodium fluid retention 
osteoporosis 
bruising 
thin skin
purple abdomen/ striae
thin legs 
moon face 
buffalo hump 
slow healing (high BS)

tx: low Na high K,
sliding scale
I/O daily weights

Question 21

Pheochromocytoma

Answer 21

medulla affected in kidneys 
high catecholamines (norepi and epi)

tachycardia 
extreme hypertension- RF stroke 
need to look at 24 hour plasma urine for catecholamines 
diaphoresis 
headache 
palpitations

Question 22

urine specific gravity

Answer 22

1.002- 1.030

concentrated 1.035