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NUR 360 Flashcards

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1
Q

Cholecystitis

A

Inflammation of the gallbladder

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2
Q

Cholelithiasis

A

calculi in the gallbladder

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3
Q

Cholangitis

A

Cholangitis is an infection of the common bile duct, the tube that carries bile from the liver to the gallbladder and intestines. Cholecystectomy- removal of the gallbladder

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4
Q

Cholecystectomy

A

Removal of the gallbladder

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5
Q

Cholangiogram

A

imaging of bile ducts by x-ray

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6
Q

Icterus

A

Jaundice

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7
Q

ERCP

A

an endoscopic procedure using fiberoptic technology to visualize the biliary system.

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8
Q

Bile

A

A liquid made by the liver that helps digest food.

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9
Q

Common Causes of Constipation

A

diet, fluid, activity, medications (pain meds, anti-depressants, vitamins, BP meds, antihistamines)

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10
Q

Common causes of constipation, conditions

A

hypothyroidism, IBS, depression, pregnancy & childbirth, weakness, fatigue

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11
Q

Fecal impaction

A

Complication of constipation, A fecal impaction is a large lump of dry, hard stool that remains stuck in the rectum.

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12
Q

Fissures

A

Complication of constipation, An anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum

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13
Q

Megacolon

A

complication of constipation, Megacolon is an abnormal dilation of the colon (a part of the large intestine).[1] The dilation is often accompanied by a paralysis of the peristaltic movements of the bowel

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14
Q

Bulk Forming

A

work by increasing the amount of water in the stool, making it softer and easier to pass. These are generally the preferred laxatives for most ages.

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15
Q

Lubricant

A

Mineral oil (liquid petrolatum) coats and softens stool. Like stool softeners, mineral oil is used by patients who need to avoid straining

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16
Q

Stimulant

A

Stimulant laxatives induce bowel movements by increasing the contraction of muscles in the intestines, and are effective when used on a short-term basis.

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17
Q

Fecal Softener

A

prevent hardening of the feces by adding moisture to the stool. Used more to prevent constipation, not treat it.

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18
Q

Common causes of diarrhea

A

Viral infections, bacterial infections, parasitic infections, functional bowel disorders, intestinal diseases, food intolerances and sensitivities, medications

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19
Q

Diarrhea complications

A

Fluid & electrolyte, dehydration, cardiac dysrhythmias, skin breakdown

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20
Q

Diverticulosis

A

Multiple diverticula without inflammation

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21
Q

Diverticulitis

A

Infection and inflammation of diverticula

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22
Q

Obstruction within the lumen of the bowel or, pressure from outside the lumen

A

Mechanical obstruction

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23
Q

Intussusception

A

Part of the intestine slides into an adjacent part of the intestine. This “telescoping” often blocks food or fluid from passing through. Intussusception also cuts off the blood supply to the part of the intestine that’s affected. Intussusception can lead to a tear in the bowel (perforation), infection and death of bowel tissue.

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24
Q

Volvulus

A

A volvulus is a subtype of malrotation in which a loop of bowel is twisted about a focal point along the mesentery, which may result in a bowel obstruction.[

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25
Q

Strangulated hernia

A

Can be any place where gap in musculature; bowel sort of just slides through there. Problem begins when it gets out there then gets stuck and can’t slide back; problem with circulation/necrosis/gangrene

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26
Q

90% of acute cholecystitis is caused by….

A

Gallstones

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27
Q

Follows surgery, trauma, burns, torsion, cystic duct obstruction, multiple transfusions, alterations in fluid and e-lytes, visceral blood flow

A

Acalculous cholecystitis

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28
Q

ERCP

A

Endoscopic retrograde cholangiopancreatography- an endoscopic procedure using fiberoptic technology to visualize the biliary system.

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29
Q

Lipolysis

A

breakdown of fat

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30
Q

Proteolysis

A

breakdown of protein

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31
Q

Anemia

A

Decreased RBCs or decreased hemoglobin

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32
Q

Anemia causes (3)

A

Loss of RBCs, decreased production of RBCs, Increased destruction of RBCs

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33
Q

Epoietin

A

Antianemic, stimulates erythropoiesis, may decrease bleeding times and require additional heparin

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34
Q

Whole blood

A

human blood from a standard blood donation

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35
Q

packed red blood cells

A

have been collected, processed, and stored in bags as blood product units available for blood transfusion purposes.

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36
Q

Leukocyte-reduced RBCs

A

packed red blood cells that have been passed through filter to get all of WBC out of it as possible to decrease reaction

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37
Q

Washed RBCs

A

wash to get coating off, get immune causing factors out of blood

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38
Q

FFP (Fresh frozen plasma)

A

refers to the liquid portion of human blood that has been frozen and preserved after a blood donation[1] and will be used for blood transfusion.

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39
Q

Cryoprecipitate

A

Cryoprecipitate is prepared from plasma and contains fibrinogen, von Willebrand factor, factor VIII, factor XIII and fibronectin. (For bleeding)

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40
Q

Administration of incompatible blood
Preexisting antibodies against transfused RBCs
Improper administration (dextrose-containing fluids)

A

Acute hemolytic reactions

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41
Q

Fever, chills, nausea, dyspnea, low back pain, hemoglobinuria, tachycardia, hypotension, cardiovascular collapse, renal failure, DIC, pain at infusion site

A

Acute hemolytic reaction

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42
Q

Mild to severe response to foreign substance

A

Allergic reaction

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43
Q

Flushing, hives, itching, dyspnea, hypotension, chest pain,

A

Allergic reaction

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44
Q

Recipient antibodies to donor leukocytes
Bacterial contamination
Inflammatory cytokine release

A

Febrile reaction

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45
Q

Rise in temp 1.8 degree F. or greater within two hours after transfusion
chills

A

Febrile reaction

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46
Q

Contamination of blood product during procurement, storage, preparation, or administration of product.

A

Bacterial contamination

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47
Q

Fever, chills, sepsis

A

bacterial contamination

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48
Q

Too rapid infusion of too much volume

A

circulatory overload

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49
Q

Cough, dyspnea, pulmonary congestion, HTN, tachycardia, distended neck veins

A

Circulatory overload

50
Q

Allogenic lymphocytes in transfused blood engraft in profoundly immunocompromised patient

A

Transfusion associated graft versus host disease

51
Q

Fever, rash, hepatitis, diarrhea, bone marrow suppression, infection

A

Transfusion associated graft versus host disease

52
Q

Neutropenia

A

Absolute neutrophil less than 1,500

53
Q

Agranulocytosis

A

ANC < 200

54
Q

Filgrastim- Neupogen

A

been out for 10-15 yrs

Helps your body make white blood cells. This will help prevent infections during cancer treatments

55
Q

Pegfilgrastim- Neulasta

A

newer form of filgrastim; longer acting form

Helps your body make white blood cells. This will help prevent infections during cancer treatments

56
Q

large amount of chemo, patients will typically have low WBC, ANC, platelets (at high risk for bleeding and infection)

A

Chemo induction

57
Q

Type of ongoing treatment that is provided to cancer patients who appear to be in remission. The goal of this type of cancer therapy is to kill off any residual cancer cells that may be present, effectively increasing the potential of a complete recovery. The dosage of the chemotherapy is usually somewhat high, allowing the treatments to be highly effective.

A

Chemo consolidation

58
Q

The ongoing use of chemotherapy (the use of drugs to destroy cancer cells) or another treatment to help lower the risk of recurrence (return of cancer) after it has disappeared following initial therapy. Maintenance therapy also may be used for patients with advanced cancer (cancer that cannot be cured) to help keep it from growing and spreading farther. Lower doses for 2-3 years.

A

Chemo maintenance

59
Q

“B” symptoms

A

Fever, night sweats, unintentional weight loss > 10%

For Hodgkins lymphoma, requires more aggressive treatment.

60
Q

Urine for Bence-Jones protein and protein electrophoresis is a diagnosis for….

A

Multiple myeloma

61
Q

Serum electrophoresis is a diagnosis for….

A

Multiple myeloma

62
Q

bisphosphonates

A

Bisphosphonates are a class of drugs that prevent the loss of bone mass, used to treat osteoporosis and similar diseases.

63
Q

Plasmapheresis

A

used to remove from the blood the large chain immune complexes that are frequently produced by these tumor cells.

64
Q

Thalidomide

A

Thalidomide blocks the flow of blood to tumor cells.
Thalidomide interferes with the growth of tumor cells in the bone marrow.
Thalidomide stimulates the immune system to attack tumor cells.

65
Q

SERMS-tamoxifen

A

5 years after dx, estrogen and fits into estrogen and progesterone on the cells so that persons intrinsic hormones cannot bind to the cells.
Tamoxifen has many of the same side effects and OCP, increased risk for DVT, hot flashes, menopause, decreased bone density.

66
Q

Aromatase inhibitors

A

block the hormonal precursor of estrogen from turning into estrogen, use for 5 years is the standard after dx. Cut down the rate of recurrence of women who are candidates of BC.

67
Q

Antacids

A

These increase the pH of the stomach, and they coat the stomach

68
Q

Histamine receptor antagonists

A

Huge breakthrough drugs

Lower gastric acid secretion

69
Q

Proton pump inhibitors

A

Reduce gastric acid production for up to 24 hours

Binds to enzyme & prevents final transport of H ions to gastric lumen

70
Q

Gastric emptying agents

A

Blocks dopamine receptors in chemoreceptor zone of CNS; stimulates motility of UGI, accelerates gastric emptying

71
Q

Two causes of actue pancreatitis…..

A

Alcholol abuse & Gall stones lodged at the ampulla of vater (obstruct flow of pancreatic juice)

72
Q

symptoms of acute cholecystitis

A

pain, tenderness, rigidity of URQ, may radiate to mid-sternum, right shoulder
Nausea, vomiting
Fever, chills, elevated WBCs

73
Q

diagnostics of acute cholecystitis

A

ultrasound (identifies stones)
HIDA scan (tracks flow of bile from liver to sm. intestine
ERCP

74
Q

Medical interventions of acute cholecystitis

A

Decrease inflammation (IV antibiotics, Rest)
NPO-low fat diet
Pain management (opoid)
Dissolution therapy

75
Q

Signs of peritonitis

A 
Fever
Abdominal pain
Paralytic ileus
Increased or absent bowel sounds
Abdominal distention
76
Q

Signs of perforation & penetration

A 
Sudden, severe upper abdominal pain
May be referred to right shoulder or back
Vomiting and collapse
Tender, boardlike abdomen
Hypotension, tachycardia
Shock
77
Q 
Painless enlargement of one or more lymph nodes on one side of neck
Cervical, supraclav, mediastinal
Mediastinal mass
Pruritis (HL)
Pain after drinking alcohol
A

Hodgkins’ Lymphoma S/Sx

78
Q

Hepatocellular Jaundice

A

Damaged liver cells unable to clear normal amounts of bilirubin from the system

79
Q

Obstructive Jaundice

A

Bile can’t flow normally into intestine. Becomes backed up in the liver, is reabsorbed into the blood, & carried throughout the body.

80
Q

Hemolytic

A

Caused by increased destruction of RBCs rather than liver dysfunction

81
Q

WBC range

A

4.5-10.5

82
Q

RBC range

A

3.8-5.1

83
Q

Platelet range

A

150,000-400,000

84
Q

Hematocrit range

A

36-46%

85
Q

Hemoglobin range

A

12-15.5

86
Q

Shrinking

A

Unintentional weight loss of 10 or more pound in last year

87
Q

S.P.I.C.E.S

A 
Sleep disorders
Problems with eating or feeing
Incontinence 
confusion
Evidence of falls
skin breakdown
88
Q

MiniCOG

A

First the ‘patient’ is asked to repeat three unrelated words, the patient is then asked to draw a clock, The ‘patient’ is then asked to recall the three words.
If the ‘patient’ is unable to recall any of the three words then they are categorized as ‘probably demented.’
Results of The Clock Drawing Test: If the ‘patient draws a clock that is in any way abnormal they are considered as ‘probably demented’. If the clock is normally constructed then they are considered ‘probably not demented’.

89
Q

Vague presentation

A

Non-specific sx that may signify impending acute illness in an older adult (confusion, self-neglect, falling, incontinence.)

90
Q

Altered presentation

A

Patient presents with symptoms not usually associated with specific acute illness
ex. MI, infection

91
Q

Non-presentation

A

many illnesses may go unrecognized and untreated for many years in older adults, significantly impact QOL. (depression, incontinence, falling, dementia, hearing loss) Insidious onset, vague symptoms, reluctance of older adults to complain, difficulties communicating s/sx, tendency to regard as “normal” part of aging

92
Q

Institute of healthcare improvement

A

This non profit organization leads the improvement of health care worldwide by: inspiring change, cultivating innovative concepts for improving patient care, and implementing program to put ideas into action. (100,000 and 5 million lives campaign)

93
Q

100,000 lives campaign interventions

A

Deploy rapid response teams, prevent VAP, prevent adverse drug events, prevent central line infections, prevent surgical site infections, deliver evidence-based care to treat MI.

94
Q

5 million lives campaign interventions

A

Reduce surgical complications, prevent harm from high-alert meds, prevent pressure ulcers, MRSA, deliver reliable EBC for HF.

95
Q

Reservoirs for MRSS

A

anterior nares, skin of the axillae, perineum, hand, arms, GI tract, ostomy sites, pressure ulcers, sputum.

96
Q

Six medications types stood out as significantly risky:

A

insulin, heparin, opiods, injectable potassium chloride, neuromuscular blocking agents, chemotherapy.

97
Q

Roots of all cardiac evil

A

Smoking, diabetes, obesity, dyslipidemia, and hypertension.

98
Q

Total cholesterol range

A

<200

comes from animal fats

99
Q

HDL cholesterol

A

Men >45, women >55

100
Q

Triglycerides

A

150 or less

Diabetics will have high levels due to not breaking things down properly.

101
Q

LDL cholesterol

A

130 or less, must be <70

Bad cholesterol

102
Q

Metabolic syndrome

A

insulin resistance, High triglycerides, low HDL, possibly high LDL, Central obesity, hypertension
BMI > 24.9
Waist >35” women, >40” men *12 x greater risk for diabetes
Triglyceride level > 150 mg/dl
HDL < 40 mg/dl
B/P > 140/90
2 elevated FBG levels > 126 mg/dl or a random BG >200 mg/dl

103
Q

Treatment for metabolic syndrome

A

Lifestyle modifications-weight loss, diet
Lipid Management: diet, medications
B/P Management
Medications:
1) ACEIs and ARBs preserve renal function
2) Beta-blockers prevent endothelial damage (but increase lipid levels and insulin resistance)
3)Thiazides are particularly effective in African Americans and elderly; prevent osteoporosis, but they increase LDL and triglycerides and increase uric acid;
4) Calcium Channel blockers appropriate if patients don’t tolerate beta blockers
5) Oral hypoglycemics (metformin most commonly used)

104
Q

Statin side effect

A

Muscle pain. When muscles break down they release creatinine. Check to see if muscle has been damaged, and if they have, take them off the statin.
Whenever giving a patient their first dose of statin, always warn patient of muscle pain.

105
Q

Cardiogenic Shock

A

Failure of the heart to pump adequately to meet perfusion needs of the body *ineffective pumping
>40% damage to myocardium to cause cardiogenic shock
85% mortality
Tachycardia, hypotension, decreased urine output, cold, clammy skin, mental changes, HF, CP, tachypnea

106
Q

Cardiac Tamponade

A

Fluid accumulates rapidly in the pericardium
Can be caused by myocardial rupture following an MI or during cardiac surgery
Symptoms (Beck’s Triad):
1. JVD
2. Muffled heart sounds
3. Hypotension (Decreased CO)
**Pulsus Paradoxus

107
Q

Pulsus Paradoxus

A

Drop in systolic B/P of 10 mmHg or more on inspiration (r/t decreased CO)
Caused by decrease LV stroke volume

108
Q

Papillary Muscle Dysfunction

A

Causes mitral valve regurgitation

Systolic murmur at apex

Dyspnea, pulmonary edema, decreased CO

109
Q

Causes: AKI

A 
Severe Hypotension
Sustained hypotension decreases perfusion
Shock
Dehydration
Cardiac Disease
Low cardiac outputDecreased perfusion
Nephrotoxic Agents
Obstruction
Acute Glomerulonephritis
Vasculitis
Hepatorenal Syndrome of Cirrhosis
110
Q

Pre-renal

A

physiologic state of diminished perfusion

111
Q

Intra-renal

A

Renal cortical involvement of toxic, vascular, infectious or immunologic processes

112
Q

Post –renal

A

Associated with obstruction of the urinary collecting system

113
Q

Pre-renal ARF causes

A 
Severe dehydration
Excessive volume losses (GI, Renal, Cutaneous, or Hemorrhage) 
Hypotension
Cardiac failure
Embolism
Thrombosis
Sepsis
Vascular obstruction
114
Q

Intra-renal ARF causes

A 
Acute tubular necrosis
Diabetes
Glomerulonephritis (autoimmune process)
Pyelonephritis (infectious process)
Severe hypertension
Transfusion reaction
Toxins
Ibuprofen
ACE inhibitors
115
Q

Post-renal ARF causes

A

Urethral obstruction
Bladder obstruction
Neurogenic problem
Renal calculi

116
Q

Common Nephrotoxins

A

Aminoglycosides* -Gentamycin, neomycin, tobramycin, etc.
Angiotensin-converting enzyme inhibitors* (ACE-inhibitors)
Nonsteroidal anti-inflammatory drugs*
Radiocontrast media*

117
Q

Oliguria

A

low output of urine

Does not respond to fluid challenge or diuresis

118
Q

A rise in Cr could occur from…?

A

medications

119
Q

A rise in BUN can occur without…?

A

renal injury such as in GI bleeding, steroid use, and protein loading.

120
Q

Electrolytes in AKI

A

Hyperkalemia, hyperphosphatemia, hypocalcemia

Nursing (22 decks)

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