Module 6 Flashcards
Cellular regulation
any process that controls the series of events by which a cell goes through a cell cycle
Cellular growth
increase in the total mass of a cell, cytoplasmic, nuclear, and organelle volume
Cellular reproduction
cells duplicate their contents and divide to yield multiple cells within a similar if not duplicate content
Types of cancer
benign- noncancerous, grow slowly and doesn’t spread
malignant- cancerous, grow rapidly, it invades and destroys nearby normal tissue, spreads throughout the body
Solid tumors
an abnormal mass of tissue does not usually contain liquid or cysts and could be benign or malignant.
results from an error in DNA replication over time or exposure to carcinogens
Some risk factors- are exposure to viruses, exposure to the sun, poor diet choices, immunocompromise
Palliative surgery
it does not cure only relieves the symptoms
Surgeries (solid tumor)
Diagnostic: sample to confirm the diagnosis (ex. Biopsy) or CT scans
Primary treatment: remove the entire or as much of the tumor as possible (and any involved surrounding tissue)
Palliative: when cure isn’t possible; improves comfort
Ionizing radiation is used to interrupt cellular growth
Chemotherapy
antineoplastic agents are used to destroy tumor cells by interfering with cellular functions (especially replication).
nurse intervention- monitor for hypersensitivity, watch for toxicity (cells with rapid growth rates are most susceptible), and the side effects of the treatment/medication
Benign prostate hypertrophy/hyperplasia
an abnormal mass of tissue that does not contain cysts or liquid areas. Hypertrophied lobes of the prostate may obstruct the urethra, causing incomplete emptying of the bladder and urinary retention.
risk factors: african american race, smoking, alcohol consumption, HTN, diabetes, and dietary factors.
Assessment for BPH
get a urinalysis, and renal function test (ex. Cr and BUN> CMP and BMP is the labs for those), urinary retention (bladder scan) treatment is based on severity, urinary catheterization if retention is emergent such as coude catheter
Meds for BPH
alpha-adrenergic blocker: relaxes the smooth muscle of the bladder» improves urine flow (ex. doxazosin, and flomax)
5 alpha-reductase inhibitor: interferes with the conversion of testosterone to dihydrotestosterone (ex. finasteride)
saw palmetto: herbal product better and tolerable but lots of side effects
Gastroesophageal reflux disease (GERD)
backflow of gastric or duodenal contents into the esophagus. Excessive reflux due to an incompetent lower esophageal sphincter, pyloric stenosis, or a motility disorder.
risk factors: overweight, pregnancy, excess alcohol consumption, smoking
manifestations: pyrosis, dyspepsia, regurgitation, and complication is barrets esophagus
Medications for GERD
histamine 2 antagonists: reduces the amount of stomach acid secreted by glands in the lining of the stomach
Ex: Famotidine (Pepcid), Cimetidine (Tagamet)
Proton-pump inhibitors: irreversibly inhibit proton pumps in the stomach; most potent acid inhibitors available
Ex: Pantoprazole (Protonix), Omeprazole (Prilosec)
Antacids: neutralize the acid in the stomach
Ex: Calcium carbonate (Tums), Sodium bicarbonate (Alka-Seltzer Heartburn)
Endoscopy
Scope of GI tract to assess for motility, abnormalities, inflammation, neoplasm, or infection
ERCP
uses endoscopy with X-ray to view ductal structures of the biliary tract and detect/treat bile duct stones, strictures, pancreatic duct disruption
Nutrition
provides energy for cellular metabolism, tissue maintenance, and repair, organ function, growth, development, and physical activity
Absorption
a process by which a substance incorporated in one state is transferred into another substance of a different state
Elimination
Expulsion of waste matter from the body
Digestion
Mechanically and enzymatically breaking down food in
Enteral nutrition
Providing nutrients to the body by delivery to the stomach and small intestines via a feeding tube
Parenteral nutrition
Providing nutrients to the body by peripheral or central IV route
Macronutrients
Carbohydrates, fats, and proteins
Micronutrients
Vitamins and minerals
Types of diets
NPO- No food or fluid by mouth at all
clear liquid- Liquids that leave little residue
full liquid- Clears + liquid dairy products, all juices
mechanical- Clears + fulls + diced/ground food
soft- Low in fiber, easy to digest
regular- no restrictions
only the MD can change and decide on the diet.
cachexia
muscle wasting
IBW
100 pounds for the first 5 feet of height if males 6 pounds every inch over 5 feet and for females 5 pounds every inch over 5 feet
5’2- 110
5’8- 140
Enteral nutrition
nasogastric, gastrostomy, jejunostomy tubes
Achalasia- a food disorder that makes it difficult for food to pass into the stomach common side effect is difficulty swallowing
Nasogastric tube
placed in the nose, the tip goes into the stomach
Measure from the tip of the nose to the earlobe, to the xiphoid process; mark with tape.
used to decompress the stomach, liquid meds, crush pills, and flush well
nursing interventions: unclogging tubes with coke or cranberry juice, skin integrity, oral hygiene, listening to lung sounds
Gastronomy/jejunostomy
surgical opening in the stomach or jejunum to administer food, fluids, and medications via feeding tubes. preferred for long-term use or pt in comatose. regurgitation and aspiration are less likely than with NG tubes.
cleanse with water and soap daily, sit pt upright during and after feeding for 1 hour
Parenteral nutrition
-peripheral and central iv nutrition
-Used for patients who have minimal intake, inability to ingest food orally or by tube, unwillingness to ingest adequate nutrients
-2-3L of solution over 24 hours; has fat emulsions, electrolytes, vitamins, and minerals
-Have much higher glucose concentration than regular IV fluids, Initiate slowly, advance gradually; discontinue slowly to ensure stable glucose levels
-Always use the asepsis technique to access the central line
Dysphagia
risk factors- smoking, obesity, pregnancy, certain medications
pain or inability to swallow, hoarseness, regurgitation
sit the patient upright before and 1 hour after meals
Obesity
Body weight greater than ideal body weight (IBW); “morbid obesity” = body weight 2x their IBW or BMI >30kg/m2
Iron deficiency anemia
risk factors: Diet inadequate in iron, intestinal disorders, menstruation, pregnancy, chronic conditions, family history, age
manifestations: Lack of energy, shortness of breath, dizziness, lightheadedness, chest pain, swollen sore tongue, brittle nails, pica, pallor
assessment: check ferritin levels, take vitamin c
Diagnostic tools
malnutrition- albumin and pre-albumin levels (Normal pre-albumin- 16-30mg/dsL
Normal albumin 3.5-5.4 g/dsL)
iron deficiency anemia- transferrin/ferritin levels (Transferrin is a protein produced by the liver to regulate the absorption of iron in the blood 215-380, the higher the number of iron deficiency anemia, the lower-level hemolytic anemia or liver disease
Ferritin measures the amount of
- Normal for men is 24-336mcg/L
- Normal for women is 11-307mcg/L)
Iron supplementation
is better absorbed in the presence of vitamin c, and can cause gi upset if taken on an empty stomach, (ex. ferrous sulfate, or ferrous gluconate) Do not inject air into the vial before drawing out IV iron, the most common side effect is gi upset and darkened stools. Look up orange juice!
Interdisciplinary collaboration
- registered dietician: Certified to treat clinical conditions with nutrition
- nutritionist: Advises/educates on general nutrition, food, and wellness
- speech/language pathologist: Assess/treat patients with speech, language, swallowing, and voice disorders
- diabetes educator: Educate, empower, and coach those with DM to manage the disease
