NUR 321 - exam 3 Flashcards
mammogram
- age 50-74
- age 40-49
50-74 grade b
40-49 grade c
colorectal cancer age 50-75
grade A
colorectal cancer age 45-49
grade b
colorectal cancer age 76-85
grade c
lung cancer age 55-80
grade b
prostate exam 55-69
grade c
prostate exam 70+
grade D
complementary therapy
o Therapies used together with conventional treatment recommended by person’s HCP
Integrative therapies
o Interventions provided by HCP
Alternative therapies
o When nonpharmacologic therapies are used in place of conventional pharmacologic or medical procedures
grade a
recommends
net benefit high
grade b
recommends services
net benefit moderate
grade c
net benefit small - depends on individual pt
grade d
recommends against
harm outweights benefits
grade i
insufficient data
–
live vaccine
weakened form of the whole germ that causes disease
long-lasting immune response
should not be given to immunocompromised or pregnant women
can cause mild symptoms
MMR
flu mist
rotavirus
varicella
inactivated vaccines
killed version of germ
immunity not as strong; need boosters/several doses
hep a
flu
polio
rabies
toxoid
use targeted toxin
boosters needed
can give to immunocomp. ppl
diphtheria
tetanus - need q10years
pneumoccocal vaccine
polysaccahride and conjugate
koplik spots
measles
thick gray membrane covering throat and tonsils
caused by diphtheria
hep b transmission, long term effects which organ?
contact; bodily fluidsliver - cirrhosis, liver cancer
HPV transmission, effects? vaccine recommendation
sexual contact
cancer of cervix***, vagina, vulva, anus, penis, back of throat
ages 11-12 – before sexual activity
influenza a and b
a - moderate to severe, all age groups
b - milder, mostly children
swollen parotid gland
mumps
meningitis as primary symptom
meningococcal disease
whopping cough
pertussis
polio
poliomyelitis
intussusception
rotavirus
one part of bowels slides into next - like closing of telescope
trismus
lockjaw
tetanus
herpes zoster - caused by? associated with? symptoms?
Shingles
Cause: Varicella zoster virus (VZV) - reactivation
Associated with • Aging • Immunosuppression • Intrauterine exposure • Varicella at younger than 18 months of age
Symptoms:
- Unilateral rash – can cover body on one site
- Manifestations: burning, tingling, itching of site, then rash appears
adults over 50
flu shot annually
o Tetanus vaccine every 10 years
o Zoster or variella vaccine age 50
o Pneumococcal polysacc, vaccine age 65
natural passive immunity
person given antibiotics through natural processes
ex: mother breastfeeding baby
artificial natural immunity
person given antibiotics through artificial means
ex: antibody injection
management of:
- local reaction
- systemic reaction
local: cold compress
systemic: acetaminophen (no aspirin bc associated with Reye’s syndrome for younger ppl)
treatment of anaphylaxis
- epipen
- oxygen
- antihistamines
- steroids
2 objectives of screening
1) Detection of a disease in its early stages to treat it and deter its progression.
2) Reduce cost of disease management by avoiding costly interventions required at later stages
College of Physicians recommend these therapies? why?
- Issued new clinical practice guidelines for the management of acute, subacute, and chronic low back pain
-Recommending use of
• Tai chi
• Yoga
• Other mind/body techniques
What is stress?
Stress is an actual or alleged hazard to the balance of homeostasis
-can lead to personal growth OR illness
What is a stressor?
Physical, psychological, or social stimuli that can produce stress and endanger homeostasis
What is appraisal?
How a person interprets the impact of stress
Primary and secondary apprasial
When a stressor occurs, a person’s two reactions to stress
Primary:
- is this stressor a threat?
- evaluation of event in terms of personal meaning
- stress occurs when person identifies event/circumstance as harm, threat or challenge
Secondary:
- how can I cope with this stressor?
- consideration of possible coping strategies
Problem-focused coping
takes action to change or address situation
ex: person feels stress from their drive to work so they commute earlier
Emotion-focused coping
- regulates emotions tied to the stress
ex: person feels anxious so they use breathing exercises to regulate emotions
Ego-defense coping
- help a person cope with stress indirectly and offer psychological protection from a stressful event
- unconscious
ex:
- compensation
- denial
- displacement
- regression
Inappropriate coping mechanisms
- increased sleeping
- increased fatigue
- loss of appetite
- laughing inappropriately
- disheveled appearance
General adaptation system (GAS)
- A three-stage set of physiological processes that prepare, or adapt, the body for danger so and individual is more likely to survive when faced with a threat
- Describes how the body responds physiologically to stress
- Triggered by either a physical event or psychological event
- Set off by PITUITARY GLAND
GAS: stage 1
Stage 1: Initial alarm
- Fight or flight response
- Central nervous system is aroused
- Body defenses immobilize
- Hormones levels rise resulting in increased blood volume, blood glucose, heart rate and mental alertness
GAS: stage 2
Stage 2: Resistance stage
- The body stabilizes and attempts compensate for the change
- Body tries to repair any damage that has occurred
- Compensation takes energy
GAS: stage 3
Stage 3: Exhaustion stage
- Continuous stress causes progressive breakdown of compensatory mechanisms
- The body no longer can resist effects of stressor.
- Energy is depleted
Chronic reactivation of GAS can cause ______________. What is the effect on the body?
Allostatic load
- Excessive wear on the bodily organs from chronic activation of GAS
- can lead to CHRONIC ILLNESS
PTSD
Post-traumatic stress disorder
- Begins when a person experiences or witnesses a traumatic event and responds with intense fear or helplessness
- Common among military, veterans, personal assault victims
- PTSD anxiety manifests in nightmares, emotional detachment, flashbacks
Crisis
Implies that a person is facing a turning point in life – their previous ways of coping are ineffective, and the person must change
- usually takes 6 weeks to resolve crisis
Maturational crisis
- also known as developmental crisis
- new developmental stage
ex: marriage, birth of a child, divorce
Situational crisis
external sources of stress
ex: job change, motor vehicle accident, or illness
Adventitious crisis
also known as disaster crisis
a major natural disaster, man-made disaster, or CRIME OF VIOLENCE
Situational stress
Short-term form of stress that occurs in certain temporary situations
Ex: situational stressors for nurses could be high-acuity patient load, intensity of care, conflicting priorities
Ex: adjusting to chronic illness
Maturational factors
- Stressors vary with life stage
- Each of Erikson’s developmental stages are experiencing a developmental stage stress
- Ex: middle adults stressors could include family, losing parents, children leave home, etc.-
Sociocultural factors
Environmental and social stressors often lead to developmental problems
ex: prolonged poverty, physical disability, living under conditions of continuing violence
Cultural variations produce stress
ex: religious beliefs, family relationships, language difference, disparities in health care
Compassion fatigue
Describe a state of burnout and secondary traumatic stress – physical and mental exhaustion
Ex: oncology nurse who cares for pt. undergoing chemotherapy, wife caring for spouse with Alzheimer’s
Common amongst healthcare workers
Stress/ coping assessment
- Identify actual or potential stressors – what do you believe is stressing you right now?
- Identify strategies to stress/ coping mechanisms
- ASK ABOUT SUICIDE – “Do you have plans to hurt yourself?” - BE DIRECT!
Stress /coping diagnosis
-Determine if patient has a potential or actual stressor – clustered clues
Ex: anxiety, despair, difficulty coping, risk for PTSD
Stress: planning /intervention
- help patient resume normal life
- increase resistance to stress
- decrease # situations that produce stress
- learn skills to reduce body’s response to stress
Coping: planning/intervention of healthy strategies
- Regular exercise and rest
- Support systems
- Guided imagery and visualization
- Progressive muscle relaxation techniques
- Journaling
- Mindlessness-cased stress reduction (MBSR)
What is SUD? Characteristics of SUD?
=Substance use disorder
- also known as drug use disorder
- medical condition in which the use of one or more substances leads to a clinically significant impairment or distress
- characterized by:
- An array of mental, physical, and behavioral symptoms that may cause problems related to loss of control
- Strain to one’s interpersonal life
- Hazardous use
- Tolerance
- Withdrawal
Tolerance
Using increasing amounts of a substance over time to achieve the same effect
Having diminished effect occurs with continued use
Addiction
- A chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.
- Considered a brain disorder – functionally changes brain
- Interferes with everyday life – can affect ANYONE
- Approach treatment like other diseases – addition is as much as a disease as heart disease
Withdraw and associated symptoms
-Symptoms develop when a substance is discontinued abruptly after frequent, heavy, and prolonged substance use
- Symptoms –specific to each substance Anxiety, irritability Restlessness Insomnia Fatigue
What is AUD?
Alcohol use disorder (AUD)
- A chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences
- Recovery is possible regardless of severity
alcohol abuse VS alcohol dependence
Alcohol abuse
•Too much, too often
Failure to fulfil roles or responsibilities
•Interpersonal problems
Alcohol dependence Inability to quit •Tolerance •Withdraw •Increased amt of time consuming and recovering
BAC KY law? 0.05 0.10 0.40 0.50
Blood alcohol concentration
KY 0.8% or higher = intoxication
- 05- sedation, slowed reaction time
- 10- slurred speech, poor coordination
- 40- coma, trouble breathing
- 050- death
What is binge drinking?
Binge drinking is a pattern of drinking that brings BAC levels to 0.08 g/dL
Occurs after 4 drinks for women and 5 drinks for men—in about 2 hours.
3 screenings for AUD
SBIRT
CAGE
Audit-C
Alcohol antidote?
Nope
Nursing care with alcohol intoxication/withdraw
- no antidote
- Supportive care- ABCs
- monitor vitals and LOC
alcohol withdraw DELIRUM
Serious complication
Onset 30 – 120 hours after last drink
Can be fatal
Can be prevented or controlled with benzodiazepine administration
Stimulants
and types
Stimulants make people more alert, increase attention, and raise blood pressure, heart rate, and breathing.
o amphetamines/ methamphetamines
o cocaine
o caffeine
o nicotine
Cocaine
- user experience
- post-use
- treatment
INCREASE BP- risk for stroke
Experience: euphoria, increased energy, confidence, mental alertness, and sexual arousal
Afterwards: restless, anxiety, agitation, irritability, and insomnia
o Treatment:
- Behavioral therapy
- No government-approved medications to treat addiction
Methamphetamine
- user experience
- post-use
Experience: increased sense of well-being or euphoria, increased alertness and energy, and decreased food intake and sleep
Afterwards: anxiety, confusion, insomnia, paranoia, aggression, visual & auditory hallucinations, mood disturbances & delusions
Teeth rot, skin rashs
Stimulant antidote
NONE BRUH
Stimulants: Nursing care withdraw
- Monitor vital signs
- Craving is intense
- Maintain a safe setting that limits potentially negative interactions with the outside environment.
- Prescribe medications to manage the acute withdrawal syndrome
Depressants
2 types and examples
Substances reduce arousal and stimulation – “downers”
Sedative-hypnotics
Opiods
Sedative-hypotics
psychoactive drugs that lower brainactivity used to treat anxiety, depression
o Barbiturates
o Benzodiazepines
o Barbiturate-like drugs
Opioids
Used to treat pain
Heroin
Prescription Opioids
Hydrocodone, Oxycodone, Morphine, Codeine
Overdose: barbiturates. antidote?
NO ANTIDOTE
-Dialysis may prevent irreversible CNS effects
Overdose: Benzodiazepines. ex? antidote?
- Xanax, Klonopin, Valium
- treated with the antagonist Romazicon (flumazenil) - can cause seizures
Opioid: overdose
-Due to their effect on the part of the brain that regulates breathing, opioids in high doses can cause respiratory depression and death
- NALOXONE
- opioid OD drug that binds to receptors to prevent overdose
- IV, IM, subcut, nasal
-decrease symptoms: methodone
Opioid overdose triad
and other symptoms
- Pinpoint pupils
- Unconsciousness
- Respiratory depression
other s/s
- face clammy, no color
- limp
- decreased heartrate
Heroin facts
type of opioid
- Major mental health issue is highly addictive
- Inexpensive, easily accessible
- Strength of product varies increasing risk of overdose
-addatives dont dissolve in blood- can clog BV
