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Med Surg > Med Surg Exam 4 Deck 2 > Flashcards

Med Surg Exam 4 Deck 2 Flashcards

1
Q

ESI

A

-emergency severity index

Level 1: highest priority or life-threatening
Level 4-5: frequently tx in fast track setting w/in emergency department

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2
Q

XABCDE (Primary Survey)

A

X: Apparent Life Threats (hemorrhage or if pt needs CPR)
A: Airway and AVPU (level of alertness) w/ c-spine precautions
B: Breathing
C: Circulation (tx pt not monitor, normal HR but pale, diaphoretic, tachy?)
D: Disability
E: Exposure

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3
Q

Secondary Survey

A
  • complete health history

- head to toe assessment

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4
Q

complete or partial airway obstruction

A
  • complete: death in under 5 minutes/can’t speak or breath or cough; NO MOVEMENT of air
  • partial: hear stridor (**most commonly from meat bolus)
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5
Q

RSI responsive pt meds

A

-sedative and paralytic (rocoronium)

**sedative first (etomidate)

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6
Q

s/s hemorrhage

A
  • decreasing pulse pressure
  • tachy
  • anxiety
  • hypotension
  • delayed cap refill
  • rapid respirations
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7
Q

when transfusing blood products…

A

-prevent hypocalcemia (blood products have citrate which eats up Ca which is needed for clotting cascade) and hypothermia (warm the blood product)

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8
Q

labs for hemorrhage

A
  • coag panel
  • type and screen
  • CBC
  • chem panel
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9
Q

tourniquet

A

leave on for up to hour

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10
Q

most common form of shock

A

-hypovolemic

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11
Q

trauma delineated as…

A

…penetrating or blunt trauma

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12
Q

injury from trauma predisposes pt to:

A
  • hypothermia (not warm enough? can’t clot.)
  • coagulopathy
  • hypocalcemia (even pts. who don’t get blood products)
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13
Q

trauma diamond of death

A

-add in acidosis which decreases ability to clot

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14
Q

irrigate wound

A

-if not bleeding too profusely

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15
Q

staples

A

-dont use for wounds that are visible

**use for head wounds

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16
Q

bitten

A

-increased risk for infection

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17
Q

solid organs

A
  • bleed more than hollow organs

ex. : liver and kidney

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18
Q

s/s intra-abdominal trauma

A
  • changes in bowel sounds
  • rigid
  • distended
  • tender
  • pain/guarding
  • Cullen sign/ Grey-Turner’s sign (kidney injury)
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19
Q

dx intra-abdominal injury

A
  • FAST
  • CT
  • CBC
  • coag labs (WBC always high as part of stress response but not all of them have infection)
  • chem panel
  • UA
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20
Q

FAST exam

A

-sonography for trauma

-) if no free-floating fluid or (+) if free floating fluid (typically internal bleeding

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21
Q

peritonitis/peritoneal inflammation

A

-cough pain also marker for peritoneal inflammation (if pain intensifies upon cough, positive for peritoneal involvement)

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22
Q

if abdominal viscera protruding

A

-moist sterile gauze applied and prep for surgery

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23
Q

s/s crush injury

A
  • hypovolemic shock
  • erythema and blistering of skin
  • rhabdomyolysis
  • AKI
  • hyperkalemia (K+ typically inside of cells)
  • swollen and hard extremity
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24
Q

management of crush injury

A
  • XABC’s
  • fluids
  • monitor for AKI
  • px management
  • splint fractures
  • fasciotomy if compartment syndrome
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25
Q

crush injury causes…

A

…muscle ischemia and necrosis from prolonged pressure

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26
Q

crush syndrome systemic effects

A
  • third spacing (fluid retention in extremities), causing hypotension
  • myoglobinuria, causing renal failure
  • metabolic/electrolyte abnormalities, causing cardiac arrhythmias
  • secondary complications, i.e. compartment syndrome
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27
Q

blood present at urinary meatus

A
  • do NOT place catheter

- consult urology

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28
Q

male and prostate

A

-high riding prostate during rectal exam can indicate urethral injury

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29
Q

anaphylaxis management

A
  • IM epi admin
  • airway
  • antihistamines
  • steroids
  • albuterol
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30
Q

if shock occurs in anaphylaxis…

A
  • IV fluids

- vasopressors

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31
Q

epi

A
  • alpha and beta adrenergic effects

* causes vasoconstriction and bronchial smooth-muscle relaxation

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32
Q

management of ingested poisons

A
  • induced vomiting
  • activated charcoal (corrosive agent)
  • gastric lavage (corrosive agent)
  • dialysis (can’t be absorbed thru kidneys
  • antidote admin
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33
Q

monitor w/ ingested poisons

A
  • hypotension
  • airway edema
  • electrolyte imbalances
  • seizures (alkolitic and acidic substance can affect nerves)
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34
Q

carbon monoxide poisoning s/s

A
  • dizzy
  • HA
  • confusion
  • coma
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35
Q

management carbon monoxide poisoning

A
  • remove pt from source
  • admin 100% O2
  • hyperbaric chamber may be utilized
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36
Q

labs for carbon monoxide

A

-carboxyhemoglobin

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37
Q

intermediate triage

A

**RED

-injuries life-threatening but survivable w/ minimal intervention (can progress rapidly to expectant category if tx is delayed)

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38
Q

Red examples

A
  • shock
  • hemothorax
  • airway obstruction secondary to mechanical obstruction
  • unstable chest/abd wounds
  • incomplete amputations
  • open fx long bones
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39
Q

delayed triage

A

**YELLOW

-injuries significant and require medical care but can wait hours w/out threat to life or limb (can’t delay tx and won’t die)

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40
Q

Yellow examples

A

-closed fx
-stable abd wounds w/out hemorrhage signs
-soft tissue injury
-maxofacial wounds w/out airway compromise
-vascular injuries w/ adequate circulation
most eye and CNS injuries

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41
Q

minimal triage

A

**GREEN (often walking)

-minor injuries and tx can be delayed hrs to days

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42
Q

Green examples

A
  • upper extremity fx
  • minor burns
  • sprains
  • behavioral dx/psych
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43
Q

expectant triage

A

**BLACK

  • injuries extensive, low survival chances even w/ care(do not abandon still)
  • comfort measures if possible
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44
Q

Black examples

A
  • unresponsive pts w/ penetrating head wounds
  • high spinal cord injuries
  • wounds involving multiple organs/anatomical sites
  • second/third degree burns in excess of 60% BSA
  • seizures/vomiting w/ in 24 hrs after radiation exposure
  • profound shock w/ mult injuries
  • agonal respirations
  • fixed and dilated pupils
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45
Q

Critical Incident Stress Management

A

-aims to assist health care providers w/ emotional trauma by defusing and debriefing after incident

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46
Q

report weapons of mass destruction

A
  • CDC
  • health department
  • infection control
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47
Q

PPE

A

-used to shield health care workers from chemical, physical, biologic, and radiologic hazards

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48
Q

2 steps of decontamination

A
  • remove all clothes and rinse with water

- soap and water rinse wash

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49
Q

bio agents

A
  • anthrax
  • smallpox
  • sever acute respiratory syndrome (SARS)
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50
Q

anthrax can be contracted thru

A

-exposure to infected, raw meat products

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51
Q

anthrax

A
  • resembles common cold
  • after several days, progresses to severe respiratory distress and shock

**frequently fatal even w/ aggressive ABx therapy and supportive tx

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52
Q

smallpox has…

A

…long incubation period and is highly contagious (no symptoms during incubation)

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53
Q

later symptoms of smallpox

A
  • fever
  • malaise
  • fatigue
  • flat lesioned rash
  • after several days, lesions fill with pus
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54
Q

management of smallpox

A

-no specific tx except supportive care, proper isolation, and vaccination

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55
Q

SARS

A
  • causes atypical pneumonia

- s/s: dry cough, SOB, progresses to ARDS

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56
Q

chemical agents

A
  • nerve agents

- blood agents

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57
Q

examples of chem agents

A
  • sarin (chemical warfare)
  • tabun
  • organophosphates

*inhaled or absorbed percutaneously

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58
Q

s/s nerve agents

A
  • cholinergic crisis
  • pupil constriction
  • vision disturbances
  • bradycardia
  • twitching
  • laryngeal spasm
  • increased GI motility
  • weakness
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59
Q

cholinergic crisis

A 
-SLUDGE 
S: salivation 
L: lacrimation 
U: urination 
D: defecation 
G: gi cramping 
E: emesis

*constricted pupils

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60
Q

lethal dose of nerve agents

A
  • LOC
  • seizures
  • increased secretions
  • apnea
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61
Q

management of nerve agent exposure

A
  • copious decontamination
  • airway maintenance
  • suctioning
  • atropine admin
  • benzodiazepines for seizures
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62
Q

blood agents examples

A
  • hydrogen cyanide (fires a lot)

- cyanogen chloride

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63
Q

blood agents act on…

A

….cellular metabolism resulting in asphyxiation thru alterations in hemoglobin

-inhibits aerobic metabolism

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64
Q

cyanide

A
  • released from burning of plastics and causes cyanide poisoning
  • can be ingested, inhaled, or absorbed thru skin
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65
Q

s/s blood agents/cyanide exposure

A
  • flushing
  • tachycardia
  • tachypnea
  • respiratory muscle failure
  • stupor/coma/seizures/respiratory arrest/death
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66
Q

management of blood agents exposure

A
  • intubation
  • admin of cyanide antidote
  • admin hydroxocobalamin (vitamin b12)
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67
Q

Trajectory Model

A

*phases of chronic illness

  • Pre-Trajectory (past life hx, genetics, lifestyle)
  • Trajectory Onset (onset of noticeable symptoms; announce dx)
  • Living w/ Progressive dz
  • Downward Phase
  • Dying Phase
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68
Q

critical times for terminally ill pts.

A
  • before death
  • death event
  • bereavement
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69
Q

anticholinergic

A

-atropine (for the death rattle from secretions)

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70
Q

cachexia

A

common phenomenon in elderly pts

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71
Q

dyspnea

A

-common and is often distressing for fam members (AIR HUNGER)

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72
Q

grief

A

personal feelings accompanying anticipated of actual loss

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73
Q

mourning

A

-individual, fam, group, and cultural expressions of grief and associated behaviors

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74
Q

bereavement

A

-period of time during which mourning takes place

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75
Q

stages of grief (Kubler-Ross)

A
  • shock/denial
  • anger
  • bargaining
  • depression
  • acceptance
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76
Q

neoplasm

A

can be benign or malignant

77
Q

second leading cause of death in US

A

cancer

78
Q

carcinogens may be:

A
  • chemical
  • radiation
  • viral
79
Q

EBV and cancer

A

Burkitt’s lymphoma

80
Q

HIV and cancer

A

Kaposi sarcoma

81
Q

Hep B virus and cancer

A

-hepatocellular carcinoma

82
Q

human papillomavirus

A

squamous cell carcinoma

83
Q

lymphomas

A

-cancers occurring in infection-fighting organs (ex lymphatic tissue)

84
Q

leukemias

A

-cancers occurring in blood-forming organ (ex spleen and in bone marrow)

85
Q

sarcomas

A

-cancers occurring in connective tissue (ex. bone)

86
Q

carcinomas

A

-cancers occurring in epithelial tissue (ex. skin)

87
Q

metastasis

A

rapid multiplication of malignant neoplasms which spread to distant body parts thru bloodstream or lymph system

88
Q

breast cancer health promotion

A

-women at age 40 should have a yearly mammogram and breast exam by health care provider

89
Q

detection of colon/rectal cancer health promotion

A
  • all aged 50 and up should have yearly fecal occult blood test
  • digital rectal exam and flexible sigmoidoscopy every 5 years
  • colonoscopy every 10 years
90
Q

for detection of uterine cancer health promotion

A
  • yearly pap for sexually active or over age of 18

- at menopause, high risk women should have endometrial tissue sample

91
Q

for detection of prostate cancer health promotion

A

-beginning age 50, yearly digital rectal exam and prostate-specific antigen (PSA) test

92
Q

staging and grading

A
  • staging: determines extent of spread of cancer

- grading: evaluates tumor cells in comparison to normal cells

93
Q

radiologic studies cancer dx

A
  • x-ray
  • CT scan
  • MRI
  • PET scan
94
Q

most accurate dx test for cancer

A

biopsy

95
Q

TNM staging

A

T– size and extent of main tumor (main tumor=primary tumor)

N–number of nearby lymph nodes that have cancer

M–whether cancer has metastasized (cancer spread from primary tumor to other parts of body)

96
Q

goals of cancer

A
  • cure
  • control
  • palliative
97
Q

chemotherapy

A

-systemic therapy for cancer for most solid organs and hematologic cancers

98
Q

technique for admin of chemo

A
  • PO
  • IM
  • IV
  • intracavitary
  • intrathecal (given into fluid around spinal cord)
  • intrarterial
99
Q

nursing care radiation tx

A
  • patient skin (burns their skin; no lotions or ointments; avoid direct exposure of skin to sun)
  • oral mucosa (xerostomia–dry mouth)
  • nutritional status
  • general feeling of well being
  • bone exposed to radiation more vulnerable to fracture
100
Q

skin rxns radiation

A
  • develops 1-24 hrs after tx

- progressive as tx dose accumulates

101
Q

HSCT

A

-hematopoietic stem cell transplantation

**healthy stem cells are transplanted into your bone marrow or your blood

102
Q

goal of HSCT

A

-restores body’s ability to create RBC, WBC, and platelets

103
Q

ADRs

A
  • infection
  • transplant rejection
  • infertility
  • N/V
104
Q

nursing management HSCT

A
  • vital signs

- monitor for ADR signs

105
Q

signs of ADR HSCT

A
  • fever
  • chills
  • SOB
  • CP
  • cutaneous rxns (hives)
  • n/v
  • hypo or hypertension
  • tachycardia
  • anxiety
  • taste changes
106
Q

nursing care cancer pts.

A
  • manage stomatitis
  • monitor bleeding/prevent bleeding
  • monitor infection/prevent (neutropenia)
  • manage fatigue
  • maintain skin integrity
107
Q

mod to severe px in cancer patients

A

-occurs in 50% of pts. who are receiving active tx and in 80-90% of pts w/ advanced cancer

108
Q

px in cancer

A

-sometimes does not occur until advanced stages of dz

109
Q

most common causes of pain in cancer

A
  • metastatic bone dz
  • venous or lymphatic obstruction
  • nerve compression
110
Q

common fears in cancer

A
  • disfigurement/emaciation
  • dependency
  • disruption of relationships
  • social displacement
  • px
  • financial depletion
  • abandonment
  • death

GOAL: quality of life not quantity of life

111
Q

hypersensitivity cells

A
  • B cells become hyperactive
  • IgE production increases

**this is an allergic response

112
Q

2 types of hypersensitivity

A
  • atopic: genetic and hereditary factors and produced IgE (ex. allergic rhinitis, asthma, atopic dermatitis/eczema)
  • nonatopic: lack genetic component and organ specificity (ex. tetanus, insect venom, airborne allergens) and low IgE
113
Q

anaphylaxis hypersensitivity type

A

Type I

  • clinical response to immunologic rxn
  • body’s immune system produces IgE antibodies toward a substance that is normally nontoxic
114
Q

reingestion of offending substance after IgE antibodies produced

A

results in excess amounts of histamine

115
Q

most common causes of anaphylaxis

A
  • foods
  • meds
  • insect stings
  • latex
116
Q

progressive development of symptoms in anaphylactic

A
  • bronchospasm
  • laryngeal edema
  • severe dyspnea
  • cyanosis
  • hypotension
117
Q

anaphylactic foods

A
  • milk
  • eggs
  • soy
  • wheat
  • nuts
118
Q

anaphylactic meds

A
  • ABX (penicillin and sulfa)
  • allopurinol
  • radiocontrast agents
  • anesthetics (lidocaine, procaine)
  • hormones (insulin, vasopressin, ACTH)
  • NSAIDs
  • aspirin
119
Q

anaphylactic bio agents

A
  • animal serums (tetanus, antitoxin, snake venom antitoxin, rabies antitoxin)
  • antigens used in skin testing
120
Q

mild symptoms anaphylaxis

A
  • peripheral tingling
  • sensation of warmth
  • sensation of fullness in mouth/throat
  • nasal congestion
  • periorbital swelling
  • pruritus
  • sneezing
  • tearing of eyes
121
Q

moderate symptoms anaphylaxis

A
  • flushing
  • warmth
  • anxiety
  • any of mild symptoms
122
Q

severe symptoms anaphylaxis

A
  • rapid, laryngeal edema
  • severe dyspnea
  • cyanosis
  • bronchospasm
  • hypotension
  • dysphagia (difficulty swallowing)
  • abs cramps/v/d
  • seizures
  • cardiac arrest and coma

***NEED SEVERAL doses of epi and corticosteroids

123
Q

activation of IgE and subsequent release of chemical mediators s/s

A

-feeling of impending doom/fright

124
Q

increased vascular permeability and subsequent decrease in peripheral resistance s/s

A
  • hypotension/shock

- possible cardiac arrhythmias

125
Q

increased capillary permeability and mast cell degranulation s/s

A
  • edema of upper resp tract

* *results in hypopharyngeal and laryngeal obstruction

126
Q

bronchiole smooth muscle contraction and increased mucus production s/s

A
  • hoarseness
  • wheezing
  • use of accessory muscles
127
Q

smooth muscle contraction of intestines/bladder s/s

A
  • cramps
  • n/d
  • urinary urgency and incontinence
128
Q

epi doses

A

0.3mg for adults and 0.15mg for peds

129
Q

if you have laryngeal edema…

A

…admin O2

130
Q

most common chronic respiratory allergic dz mediated by immediate rxn

A

-allergic rhinitis

131
Q

pharm tx for allergic rhinitis

A
  • antihistamines
  • adrenergic agents
  • mast cell stabilizers
  • corticosteroids
132
Q

success of immunotherapy

A

-successful in up to 90% of pts w/ seasonal allergic rhinitis and 70-80% with perennial allergic rhinitis

133
Q

indications for immunotherapy

A
  • allergic rhinitis, conjunctivitis, allergic asthma
  • hx rxn to hymenoptera (wasps/bees)
  • want to avoid long-term use or potential ADRs or cost
  • lack of control of symptoms by avoidance measures or med use
134
Q

contraindications for immunotherapy

A
  • beta blocker or angiotensin-converting inhibitor therapy can mask early signs of anaphylaxis
  • pulmonary or cardiac dz or organ failure
  • pt unable to report signs/s
  • nonadherence of pt to other med regiments and low probability of compliance
  • inability to monitor pt. for at least 30 minutes after
135
Q

contact dermatitis is a….

A

….delayed hypersensitivity rxn

136
Q

4 types of contact dermatitis

A

1-allergic
2-irritant
3-phototoxic
4-photoallergic

137
Q

s/s contact dermatitis

A
  • itch/burn/erythema
  • skin lesions (vesicles)
  • edema
  • weeping
  • crust/drying and peeling of skin
  • hemorrhagic bullae can occur
138
Q

allergic contact dermatitis

A
  • contact of skin and allergenic substance

- vasodilation and intracellular edema on dorsal aspects of hand

139
Q

irritant contact dermatitis

A
  • chemically or physically damages skin on nonimmunologic basis (occurs after first exposure to irritant)
  • dryness/fissures/cracks
140
Q

phototoxic contact dermatitis

A

-resembles irritant type but requires sun and chemical in combo to damage epidermis

(similar s/s to irritant dermatitis)

141
Q

photoallergic contact dermatitis

A

-resembles allergic dermatitis but requires light exposure in addition to allergen contact to produce immunologic activity

142
Q

atopic dermatitis =

A

eczema

143
Q

definition atopic dermatitis

A

-hypersensitivity dx causing inflammation and hyperreactivity of skin (often causes pruritus)

144
Q

most consistent features of atopic dermatitis

A

(1) pruritus

(2) hyperirritability

145
Q

tx of atopic dermatitis

A
  • avoidance therapy
  • corticosteroids
  • skin care
  • antihistamines
146
Q

contraindication to atopic dermatitis

A

-do not take long showers…rids our skin of oils

147
Q

dermatitis medicamentosa

A

***Drug Reactions

  • causes skin rashs associated w/ certain meds
  • avoidance and d/c of med
148
Q

urticaria

A
  • hypersensitive allergic rxn

* sudden appearance of pinkish, edematous elevations

149
Q

urticaria in adults vs children

A
  • adults: usually rxn to something

- kids: can be a virus/infection

150
Q

angioneurotic edema

A

-involves deeper layers of skin, resulting in more diffuse swelling

151
Q

food allergy tx

A
  • use of epi 1st
  • H1 blockers
  • antihistamines
  • adrenergic agents
  • corticosteroids
152
Q

ppl at risk for latex allergy

A
  • health care workers
  • pts w/ atopic allergies
  • multiple surgeries
  • people working in factories w/ latex products
  • females
  • pts. w/ spina bifida
153
Q

who is more likely to be affected by rheumatic dx

A

-women

154
Q

rheumatic disorders can include

A
  • autoimmune conditions
  • degenerative conditions
  • inflammatory conditions
  • systemic conditions

**affect joint, skeletal muscles, and soft tissues (connective tissues) of body

155
Q

s/s rheumatic dx

A
  • major one: pain
  • joint swelling
  • limited movement
  • stiff
  • weak
  • fatigue
156
Q

lab tests for rheumatic dx

A
  • ESR (erythrocyte sedimentation rate)
  • uric acid
  • antinuclear antibody (ANA)
  • anticentromere antibody test
  • anticyclic citrullinated peptide (Anti-CCP)
  • anti-double stranded DNA (Anti-dsDNA)
  • complement level–C3, C4
  • C-reactive protein test (CRP)
  • Rheumatoid factor (RF)
157
Q

NSAIDs

A

*salicylates, non-salicylates, second gen: COX-2 inhibitors

158
Q

disease-modifying antirheumatic drugs

A

**DMARDs

  • nonbiologic DMARDs (traditional)
  • nonbiologic DMARDs (minor)
  • biologic DMARDs (immunomodulators)
159
Q

3 med classes for tx

A
  • NSAIDs
  • DMARDs
  • glucocorticoids
160
Q

osteoarthritis definition

A

-chronic NONINFLAMMATORY progressive dx that causes cartilage deterioration in synovial joints and vertebrae

161
Q

risk factors OA

A
  • obesity
  • aging
  • trauma/malalignment of joints
  • women after menopause
162
Q

manifestations OA

A
  • px
  • stiff
  • loss of movement/fxn
163
Q

Heberden and Bouchard Nodes

A
  • Heberden: distal interphalangeal
  • Bouchard: proximal interphalangeal

**osteoarthritis

164
Q

gout definition

A

-deposition of monosodium urate crystals within joints and other tissues (defect in purine metabolism)

**METABOLIC dx

165
Q

gout results from..

A

….hyperuricemia

166
Q

primary concern in gout

A

px management

167
Q

nursing care gout

A
  • joint rested and elevated
  • ice for relief (NO HEAT)
  • low purine
  • avoid sugary drinks/food high in fructose (as fructose breaks down in the body, purines are released)
  • Vit C supplements may reduce risk of gout
168
Q

low-purine diet gout (eat less of this)

A
  • shellfish
  • organ meats (liver)
  • alcoholic beverages
  • soft drinks
169
Q

low-purine diet gout (eat more of this)

A
  • fruits/veggies
  • whole grains
  • low fat dairy
  • legumes/nuts
170
Q

meds for gout

A
  • colchicine
  • probenecid (Benemid), sulfinpyrazone (Anturane)
  • allopurinol (Zyloprim), febuxostat (Uloric)
  • pegloticase (Krystexxa)
171
Q

fibromyalgia

A

-chronic px syndrome characterized by diffuse musculoskeletal achiness, stiffness, fatigue, and exaggerated tenderness at 18 specific tender points (usually at least 11 tender spots or more)

172
Q

tx of fibromyalgia

A

-tramadol

173
Q

most common inflammatory arthritic disorder

A

-rheumatoid arthritis

174
Q

rheumatoid arthritis results from:

A

-autoimmune rxn involving macrophages, T cells, B cells, fibroblasts, chondrocytes, and dendritic cells

175
Q

s/s rheumatoid arthritis

A
  • joint px, swelling
  • warmth, erythema
  • lack of fxn
  • extra-articular symptoms
176
Q

tx of RA

A
  • NSAIDs

- DMARDs

177
Q

other issues in RA outside of joints

A
  • skin
  • eyes
  • lungs
  • heart
  • blood vessels

**unlike wear-and-tear damage of osteoarthritis, RA affects lining of joints, causing painful swelling that can eventually results in bone erosion and joint deformity

178
Q

lupus is

A

(SLE)

  • chronic inflammatory autoimmune dz
  • characterized by remissions and exacerbations
179
Q

SLE patho

A

-disturbed immune regulation that causes exaggerated production of autoantibodies and antigens

180
Q

COX-2

A

cardiovascular dz

181
Q

common manifestations of lupus

A
  • fatigue
  • myalgias (muscle px) and arthralgias (joint stiffness)
  • fever
  • weight loss
  • difficulty expressing thoughts (CNS)
  • can lead to anemia or pleursy (respiratory issues)
  • increase risk for heart dz
  • increase risk for miscarriage
182
Q

tx of SLE

A
  • DMARDs (includes antimalarials)
  • NSAIDs
  • glucocorticosteroids
  • immunosuppressive meds
183
Q

scleroderma

A

*begins w/ skin changes but pathogenesis integrates 3 cardinal features

1-vascular injury and damage
2- activation of innate and adaptive arms of immune system autoimmunity
3- generalized interstitial and vascular fibrosis

184
Q

cutaneous symptoms of scleroderma

A

CREST
C-calcinosis (calcium deposits in tissues)
R-raynaud phenomenon (spasm of BV in response to cold/stress)
E-esophageal dysfxn (acid reflux and decrease in mobility of esophagus)
S-sclerodactyly (thickening and tightening of skin on fingers and hands)
T-telangiecstasia (capillary dilation that forms vascular red marks on surface of skin)

185
Q

goals/interventions rheumatic dx

A
  • maintenance of self-care
  • adherence to therapeutic regimen
  • improved body image
  • effective coping
  • absence of complications
  • promotion of home care
186
Q

isometric exercise

A
  • improve muscle tone, endurance, and strength (weight-bearing exercises)
  • can increase BP and decrease blood flow to muscles
  • do not affect length of muscle
187
Q

dynamic exercise

A
  • increase dynamic strength/endurance

* lengthen muscles

188
Q

aerobic exercise

A

cardiovascular fitness

189
Q

aquatic exercise

A
  • supports or resists movement
  • warm water=muscle relaxation

**provides bouyant medium

Med Surg (4 decks)

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