medsurg 1 Flashcards
what part of eye is responsible for blood supply and the optic nerve travels through
optic disc
what are the three layers to the orbit of the eye?
sclera; white part
choroid; blood distrubtede
retina; rods and cons
collection of blood in anterior chamber of eye
hyphema
collection of blood around eye … EMERGENCY
retrobulbar hematoma
cut or scratch on cornea
corneal abrasion
broken blood vessels in sclera
subconjunctival hemorrhage …no pain discharge or vision changes
serration of retina from the chorioid vitreous humor seeps behind the retina
retinal detachment
sudden onset of light flashes, floaters
retinal detachment
retinal degenerative process involving the macula .. two types dry and wet
age related macular degeneration
yellow exudate beneath retinal epithelium
AMD
abnormalities in retinal blood vessels secondary to diabetes mellitus
diabetic retinopathy
inflammation or infection of auricle and ear canal
external otitis.. swimmers ear
pain fecer malasie headache decreased hearing
acute otitis media
purulent drainage hearing loss nausea vertigo pain facial palsy
chronic otitits media and mastoididtis
sterile fluid effusion in middle ear behind ear drum… fullness in ear, pressure
serious otitis media
autosomal dominat gene disease in which footplate stapes is fixated to oval window by bony overgrowth
otosclerosis
a syndrome… vestibular auditory, tinnitus
menieres disease
normal white blood cell count
4,500 - 11,000
what does low WBC mean
neutropenia
what does high WBC mean
infection / inflammation
what is normal hematocrit
35-50%
low hematocrit means
cardiac failure
high hematocrit means
spontaneous blood clotting
what is a normal hemoglobin
12-16
low hemoglobin can cause
heart failure
a high hemoglobin can cause
clogging of capillaries due to hemoconcentration
what is a normal platelet count
150,000-400,000
low platelet count means
thrombocytopenia
with platelet count watch for
bleeding percautions
what is normal aPTT
20-36 seconds
should be how many times normal with heparin therapy
1.5-2.5 seconds
aPPT is used for ?
heparin
PT and INR is used for
warfarin (coumadin)
what is normal INR
2-3
what is normal sodium
135-145
low sodium means
hypnatremia
high sodium means
hypernatremia
what is normal potassium
3.5-5
what is low potassium
hypokalemia
high potassium
hyperkalemia
hyperkalemia means
renal problems … MURDER
what is the normal BUN
10-20
what is normal creatinine
1
what is normal glucose
70-110
normal hemoblogin A1c
less than 7 percent
7 percent or lower
good control
7-8 percent
fair
greater than 8
poor
what is internal radiation called
brachytherapy
how long does radiation treatment on average last
15-30 min
what is internal radiation used to treat
prostate and cervical cancer
the daily division of the total radiation dose is called
a fraction
pts should use skin care products but avoid how many hours before treatment?
2
WBC nadir at
1-2 weeks
platelet nadir at
2-3 weeks
RBC badir at
120 days
whats a medical emergency with neutropenia
FEVER
when do you give antimetic drugs
before treatment
how long withhold food before treatment
4-6 hours
how should they eat
small frequent meals high protein high calorie
stomatitis
painful mouth..
skin care
avoid soap plain water pat dry.
side effects of chemo
Bone marrow depression Alopecia Retching N&V Fear and anxiety Stomatitis(mouthpainful)
diagnosis classifcation
Tumor 1-4
N lymph node involment 1-4
M Metases 0 or 1
treatment options for cancer
chemo radation surgery
cancer treatment needs a what
multidisciplinary team
below what ANC count need protective isolation
1,000
Teach parents what for cancer
eating drinking non uncooked or spoiled, no salad veggies or fruit fresh water safe wash hands often house clean no crowds cat keep inside careful with pets stay away from young animals
fever in hospital do what
call provider
fever over what is bad
100.4 or 38
how many times fever
once over 38.5 of three over 38
what vaccines are contradicted
live ones !
what is deadly with cancer patients
chickenpox
make sure parents have what
good tire on immunizations… everyone around needs shots
check PICC or CCV or IVAD ports for what
signs of infection…red swelling warm
for protective isolation need what
private room
fown mask gloves
wash hands
no plants or flowers
bleeding precautions are..
shave with electric razor
no garlic or green leafy begs
brush soft toothbrush
hold pressure at least 5 minutes
cancer cells are highly
undiffrentiated
etiology of cancer
herdity immunity chemical physical viral bacterial lifestyle carcinogenesis
how many pairs of chromosomes
23
femal is
xx
male
xy
one of two or more alternative forms of gene that can occupy a particle chromosomal locus
allele
position of gene on chromsome
locus
condition present at birth
congential
transmission of a genetic disease or condition from parent to offspring
heredity
permanat chance in the sequence of dan
mutation
gene located on sex chromosome
x linked gene
clinically expressed gene… what you see
phenotype
the blueprint . internal code
geneotype
physical characteristic that one inherits
trait
having two different alleles for one given gene… one dominant one recessive
heterozygous
having two identical genes that allele from one given gene… two dominant or recessive
homozygous
gene that is expressed in phenotype
dominant allele
allele that has no noticeable effecy
recessive allele
genetics in future
own drug make up
teaching for genetics
watch over counter
support
backup plan
HIV is most transversable in
primary stage
before doing HIV test must have
INFORMED CONSENT
CD4 t cells less than what is aids
250
cd4 t cells less than what is infection
500
with HIV avoid…
cat liter
bad water
birds.chickens
no tattoos unless buy own ink and needles
ways to transmit
all fluids except sweat and tears
continuum of HIV
initial expisure primary asymptomatic early AIDs
what races are three times more likely to get SLE
african asian hispanic and native americans
SLE is a
multis stem disease
key signs of SLE
butterfly rash
vascular lesions
swan neck deformity
what do you teach with prednisone or any steroids
tapper off… hurts adrenal function
taking nsaids and steroid together what for
ulcers gi bleed
teaching with SLE
process names of drugs pain management conserve energy exercise heat stress avoidance avoid others with infection aroid dry soaps use sunscreen follow up prego counseling resources
what are the parts of the upper respiratory tract
nose mouth pharynx epiglottis larynx trachea .. crania
what are the three parts of the pharynx
naso oro laryngo
what are the parts of the lower respiratory tract
bronchi bronchioles alveolar ducts aveoli lung lobes
right lunch has how many lobes
3
left lung has how many lobes
2
which lung is wider shorter straigther
right.. more aspiration
how many alveoli in adult lung
300 million
what is the total lung volume
2,500 ml
what is the lipoprotein that decreases surface tension and keeps the alveoli from collapsing
surfactant
what coveres chest cavity
parietal pleura
what covers lung
viscreal pleura
how much fluid in intrapleural space
20-25
inspiration and expiration
ventilation
ease of lung expansion
compliance
02 and co2 moving back and forth across alveolar capillary membrane
diffusion
what is normal ph
7.35-7.45
what is normal PaO2
80-100
what is normal SaO2
less than 95 percent
what is normal PaCO2
35-45
what is normal HCO3-
22-26
what does H+ conc mean
acidosis.. increase respirations
what does decrease H+ mean
alkalosis
reflux that prevents you from over distending lungs
Hering-Breuer reflex
changes and effects on aging
structual changes. defense mechanisms respiratory control
what sound here when percuss over lung fields
reasonat
what does resonance sound like
low pitched sound
drum like sound loud empy
tympany
medium intensity pitch and duration
dull
soft high pitched short duration
flat
what sound over trachea
bronchial .. hollow tube sound
what sound over main bronchi
bronchovesicular… medium pitched
sound heard over less bronchi and bronchioles
soft low pitch rusting sound.. vesicular
whats a postive egophony
pt says e but you hear a
whats a postivie bronchophony
99 and hear it good
louder low pitch.. no cont brief
crackles
snoring sound
rhonci
high pitched musical cont
wheeze
squeeling
stridor
tb test less than 5mm duration
Hiv infected people.. recent contact
tb test less than 10mm
recent immigrants . drug users. high risk areas
less than 15mm
people who are at low risk
when suction if you touch what makes pt cough
carnia.. angle of louis
how do you measure airflow
spirometry
what are the defense mechanisms
cough, filter air,mucocillary , alveoli macrophages, reflex constriction
surgical reconstruction of the nose.. cosmetic or to improve breathing
rhinoplasty
after rhinoplasty when do you remove external splints
3-5 days
how do you calculate pack years
pack per day times years smoking
what does asbestos cause
mesothelomia
where does lung cancer go
segmented bronchi or prefer upper lobes
how does lung cancer begin
mutated epithelial cells
what are the two types of lung cancer
NSCLC and SCLC
where does lung cancer spread to
LBBLA .. liver brain bone lymph nodes and adrenal glands
which is deadly
SCLC
symptoms of lung cancer
cough, dyspnea, hemopytsis
how do you stage SCLC
limted or extensive
surgery with lung cancer works for
NSCLC stage one and two
surgical opening into thoracic cavity
thoracotomy .. PAINFUL .
chemo is primary treatment for
SCLC
what are the 5 A’s for individuals willing to quit
ask advise assess assist arrange
what are the 5 R for people unwilling to quit
relevance risks rewards roadblock repetition
pleural space usually contains how much fluid
20-25
lubricant between parietal pleura and visceral pleura .. abnormal fluid
pleural effusion
symptoms of pleural effusion
dyspnea
cough
decrease movement on affected side
sharp chest pain
aspiration of intrapleural fluid
thoracentesis
how much fluid can you take out with thoracentesis ..why?
1000-1200 max.. hypotension hypoxemia pulmonary edema
inflammation of the pleura .. pain is sharp with abrupt onset.. laying on effected side helps
pleurisy.. pleuritis
collapse of the alveoli
atelectasis
with atelectasis teach
cough and deep breath and inceptive spirometry
granuloma( defensse mechanism: walls off to prevent spread
gohn focus
bacteria widespread within body by bloodstream
military TB
symptoms of Tb
fatigue anorexis low grade fever night sweats dysnpea hemoptysis
TB drugs take for
9 months
Dot therapy needed
essential public heath measure
watch them swallow pills
non adherence
