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Med Surg > Med surg exam > Flashcards

Med surg exam Flashcards

0
Q

Doctyl sodium sulfosuccinate ( colace)

A

Is a fecal softner

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1
Q

Polyethylene glycol and electrolytes

A

Is an osmotic agent.

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2
Q

Bisacodyl sodium (dulcolax)

A

Is a stimulant relaxant

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3
Q

Magnesium hydroxide ( milk of magnesia)

A

Is a Saline agent

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4
Q

What is MS, amyotrophic sclerosis ( ALS) and myasthenia gravis (MG)

A

They are neurological diseases that typically result in impaired and worsening function of voluntary muscles.
MS & ALS affect nerve cells in the brain and spinal cord.
MG affects the neuromuscular junction.

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5
Q

What is MS

A

It is an autoimmune disorder characterized by development of plague in the white matter of the CNS. This plague damages the myelin sheath and interferes with impulse transmission between the CNS and the body.

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6
Q

ALS

A

Is a disease of the upper and lower motor neurons characterized by muscle weakness progressing to muscle atrophy and eventually paralysis and death.
ALS does not Involve autonomic changes, sensory alterations, or cognitive changes.

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7
Q

What is MG

A

It is an autoimmune disorder characterized by antibody- mediated loss of acetylcholine receptors at the neuromuscular junction, interfering with communication between motor neurons and innervated muscles.

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8
Q

Crede manuever

A

Placing manual pressure on abdomen over the bladder to expel urine

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9
Q

What are medications used to treat MS

A

Azathioprine ( Imuran) and cyclosporine ( sandimmune)
Immunosuppressive agents are used to reduce the frequency of relapses.
Prednisone- corticosteroids are used to reduce inflammation in acute exacerbations.
Dantrolene ( Dantrium), tizanidine ( zanaflex) baclofen ( lioresal) and diazepam ( Valium)- antispasmodics are used to treat muscle spasticity

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10
Q

What med can be used in severe cases of MS

A

INTRATHECAL baclofen

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11
Q

Interferon beta ( Betaseron)

A

Immunomodulators are used to prevent or treat relapses

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12
Q

Carbamazepine ( tegretol)

A

Anticonvulsants are used for paresthesia

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13
Q

Docusate sodium ( colace)

A

Stool softener used for constipation

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14
Q

Propantheline

A

Anticholinergics used for bladder dysfunction

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15
Q

What exactly is ALS

A

It is a degenerative neurological disorder of the upper and lower motor neurons that results in deterioration and death of the motor neurons.this results in progressive paralysis and muscle wasting that eventually causes respiratory paralysis and death. Cognitive function is usually not affected.

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16
Q

What is the other name for ALS

A

Lou Gehrig’s disease… After the baseball player who died of this in 1941.
Death usually occurs due to respiratory failure within 3-5 yrs of the initial manifestations.
There is no cure

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17
Q

Risk factors for MS

A

20-40 years of age
Woman
Genetic
Environmental factors include smoking, lack of vitamin D exposure, and exposure to Epstein Barr virus.

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18
Q

Because MS, is an autoimmune disease, what factors triggers relapse

A 
Viruses and infectious agents
Cold climates
Physical injury
Emotional stress
Pregnancy
Fatigue
Extreme temps
Hot shower or bath
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19
Q

What are the risk factors for developing ALS

A

Men

40-70 years of age

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20
Q

What are objective findings of a person with ALS

A 
Muscle weakness, usually begins in one part of the body
Muscle atrophy 
Dysphagia 
Dysarthria 
Hyperreflexia of deep tendon reflexes
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21
Q

What are lab test to diagnose ALS

A

Increased creatine kinase ( CK-BB) level

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22
Q

What are diagnostic procedures to diagnosis ALS

A

Electromyogram ( EMG)- reduction in number of functioning motor units of peripheral nerves.

Muscle biopsy- reduction in number of motor units of peripheral nerves and atrophic muscle fibers.

23
Q

What are medications used to treat ALS

A

Rilozole ( Rilutek) is a glutamate antagonist that can slow the deterioration of motor neurons by decreasing the release of glutamic acid. It must be taken early in the disease process and will add approx. 2-3 months of life to the clients lifespan.

Baclofen ( Lioresal), dantrolene sodium ( Dantrium), diazepam ( Valium)
Are antispasmodics used to decrease muscle spasticity

24
Q

What are complications of ALS

A

Pneumonia can be caused by respiratory muscle weakness and paralysis ncontributing to ineffective airway exchange

Respiratory failure may necessitate mechanical ventilation.

25
Q

What is MG

A

Myasthenia gravis is a Progressive autoimmune disease that produces severe muscular weakness.
It is characterized by periods of exacerbations and remission.
Muscle weakness improves with rest and worsens with increased activity

26
Q

What are risk factors of MG

A

Coexisting autoimmune disorder

Frequently assoc with hyperplasia of the thymus gland

27
Q

What are subjective symptoms of MG

A 
Progressive muscle weakness 
Diplopia
Difficulty chewing and swallowing 
Respiratory dysfunction  
Bowel and bladder dysfunction
Poor posture
Fatigue after exertion
28
Q

What are objective physical findings of a person with MG

A 
Impaired respiratory status
Decreased swallowing ability
Decreased muscle strength 
Incontinence
Droopy eyelids
29
Q

What are diagnostic tests performed to diagnose MG

A

Tensilon testing- baseline assessment of cranial muscle strength is done
Electromyography- shows the neuromuscular transmission characteristics of MG.

30
Q

What is atropine the antidote for

A

Atropine is the antidote for edrophonium ( bradycardia, sweating, and abdominal cramps.)

31
Q

What are medications used to treat MG

A

Anticholinesterase is the 1st line in therapy.
Pyridostigmine ( Mestinon) and neostigmine ( Prostigmin) are used to increase muscle strength. It inhibits the breakdown of acetylcholine and prolongs its effects.
Immunosuppressants- because MG is an autoimmune disease, immunosuppressants decrease the production of antibodies.

32
Q

What is bile

A

Bile is used for the digestion of fats

It is produced in the liver and stored in the gallbladder

33
Q

What are risk factors of SLE

A

Nephritis
Oral ulcers
Very fragile skin
Ulcers on skin

34
Q

What are tests to determine SLE

A

Blood tests

35
Q

S&s of cholecystitis

A 
Feeling of fullness
Cholesterol
Pigment stones
Dark urine
Pale stool
Jaundice
Itchiness, warmth on skin
RUQ PAIN    RUQ PAIN.    RUQ PAIN
36
Q

What are risk factors of cholecystitis

A 
Woman
Oral contraceptives 
Estrogens or clofibrate
Meds known to ^ biliary levels
Cholesterol saturation
Increased age
GI DISEASE
Diabetes
Obesity/rapid wt. loss
37
Q

What is treatment of cholecystitis

A

Decrease intake of fatty foods

38
Q

What are diagnostics to diagnose cholecystitis

A 
ERCP
ABDOMINAL X RAY
CHOLECYSTOGRAPHY
BILIRUBIN LEVELS
ULTRA SOUND
^ WBC
^ CHOLESTEROL LEVELS
39
Q

What are s&s of crohns

A 
Diarrhea
Abdominal pain
Anorexia
Wt.loss
Nutritional deficiencies
40
Q

What is treatment for crohns

A 
Sedatives
Anti diarrheal
Anti peristaltic meds
Amino salicylates ( sulfalazine)
Corticosteroids 
Immunosuppressants
41
Q

What tests determines whether a person has crohns

A 
Proctosigmoidoscopy
Stool examination
Barium study
^ WBC ^ ESR ^ CRP
⬇️ HCT ⬇️ HGB ⬇️ albumin
42
Q

What are s&s of ulcerative colitis

A 
10-20 stools
LLQ PAIN      LLQ PAIN        LLQ PAIN
Fever
Vomiting 
Abdominal distention
Hyperactive bowel sounds
Hypocalcemia
Rectal bleeding
43
Q

What is treatment of ulcerative colitis

A 
Steroids
Immunosuppressants
Anti inflammatory 
Surgical interventions
Colon resection
Colostomy/ illeostomy
44
Q

What tests determine ulcerative colitis

A

Endoscopy
Colonoscopy
Barium enema

⬆️ WBC ⬆️ ESR ⬆️ CRP
⬇️ albumin ⬇️ HCT ⬇️ HGB

45
Q

Where does the genetic predisposition of MS come from

A

It is indicated by the presence of a specific cluster ( halo type) of human leukocyte antigens on the cell wall.mits presence may increase susceptibility to factors such as viruses,mthat teigger that autoimmune response activated in MS.

46
Q

What does the RR course of MS involve

A

Relapsing remitting…with each relapse recovery is usually complete; however, residual deficits may occur and accumulate mover time.

47
Q

What does the primary progressive course of MS involve

A

Disabling symptoms steadily increase, with rare plateaus and temporary minor improvement.

48
Q

What are signs and symptoms of MS

A

PAIN, most ppl with MS also take opioids.
Paresthesia, dysesthesias, and proprioception loss.
Muscle Spasticity- usually occurs in in the lower extremities and can include loss of abdominal reflexes.
Ataxia ( impaired coordination of movements) and tremor
Bladder, bowel and sexual dysfunction

49
Q

What do secondary complications of MS include

A 
Urinary tract infections
Constipation
Pressure ulcers
Contracture deformities
Dependent pedal edema
Pneumonia
Reactive depression
And osteoporosis.
50
Q

What is treatment for MS

A

Analgesics
Antiimmune therapy
Interferon beta 1a ( rebif) and interferon 1b ( Betaseron) are administered SC every other day.
Another preparation of interferon : avonex, is administered IM once a week

51
Q

What are side effects of all interferon beta meds

A

Flulike symptoms that can be managed with acetaminophen and ibuprofen and resolve after a few months

Additional side effects include; potential liver damage
Fetal abnormalities and depression

52
Q

What med is the key agent in treating acute relapse in the RR course of MS

A

IV methylprednisolone, they key agent in treating acute relapse in the RR course shortens the duration of relapse.it eceprts anti inflammatory effects by acting on T cells and cytokines, it is administered 1g IV daily for 3-5 days followed by an oral taper of prednisone. Side effects include mood swings, wt. gain, and electrolyte imbalances.

53
Q

Mitoxantrone ( Novantrone)

A

Is used for MS.
It is administered by IV infusion every 3 months.
It can reduce the frequency of clinical relapses in patients with secondary progressive or worsening RR MS.
patients must be very closely monitored for side effects and there is a maximum life time dosage that can be used.

54
Q

What are medications used for the specific symptoms of MS

A

Baclofen ( lioresal) {GABA agonist}- is used to treat muscle spasticity
Benzodiazepines- diazepam, tizanidine ( Zanaflex), and dantrolene ( Dantrium) may also be used to treat muscle spasticity

Meds used to treat ataxia include; beta blockers ( propranolol)
The anti seizure gabapentin ( Neurontin) and benzodiazepines ( clonazepam)

55
Q

What may be used to acidify the urine making bacterial growth less likely

A

Vitamin C ( ascorbic acid)

Med Surg (19 decks)

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