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nursing 2900 > Patho > Flashcards

Patho Flashcards

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1
Q

Pain def

A

an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage per iasp

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2
Q

Acute pain lasts for up to

A

6 months

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3
Q

Can pain be emotional or phyical

A

Yes

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4
Q

What is gate control theory?

A
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5
Q

What does gate control mean?

A
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6
Q

Nociceptors are

A

Physiological pain refers to the normal Pain transmission. Usually external

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7
Q

What is the most acute pain related to?

A

Trauma surgery or illness

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8
Q

Categories of pain stimuli

A

BIological *** like 6 more

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9
Q

Pain etiology

A

Nociceptive, neuropathic, acute pain,

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10
Q

types of acute pain

A

somatic, visceral, and referred

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11
Q

somatic pain

A

located in skin andn musculoskeletal tissues

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12
Q

visceral

A

body organs and cavities in chest, abdomen and pelvic areas

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13
Q

referred pain

A

sensed in regions other than site of origin

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14
Q

3 types of breakthroughpain

A

incident pain, idiopathic pain, end of dose medication failure

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15
Q

what is end of dose medication failure

A

pain at thte end of tone medication dose before the next scheduled dose

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16
Q

how to fix end of dose medication pain?

A

increase medication dose or shorten time between doses

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17
Q

Incident pain examples:

A

predictable pain: chest pain upon coughing

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18
Q

Pain risk factors

A

Gender, age, obesity, sedentary lifestyle, level of stress/anxiety, high risk activities-smoking, sports, cultural beliefs of pain.

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19
Q

Barriers to pain management from a client perspective

A
  • Doesn’t report
  • cultural
  • fear of being addict
  • worries about side effects
  • financial barriers
  • belief that minority populations do not get treated for pain adequately even when pain is reported
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20
Q

Barriers from HCP perspective

A

Regulatory issues
delay in administration of pain meds until diagnosis
knowledge deficit
fear of tolerance adverse effects
poor assessment
prescribe only small amount to prevent misuse
infrastructure barrier so inadequate reimbursement for pain management

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21
Q

pain prevention

A

pain relief pharm and non pharm
- take them as prescribed
- take regularly
- take safety precautions -> dont mix and don’t be stupid
- change modifiable risk factors > dont go to wefest after having hip surgery

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22
Q

Somatic manifestations

A

sharp, swelling, cramping, aching, gnawing, bleeding, localized

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23
Q

Visceral manifestations

A

Dull deep, squeezing, pressure, aching, vague and difficult to localize

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24
Q

What will people in pain look like

A

Maybe increased BP, HR, and RR, diaphoresis, pallor, and dilated pupils (this one is flight or flight)

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25
Q

Uncontrolled pain can manifest into prolonged life circumstances

A

appetite, sleep, circulation and O2 levels, increased risk of thrombosis, decreased quality of life

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26
Q

3 step approach which is 90% effective is

A

assess pain severity
begin treatment at proper step of ladder
move up ladder until pain controlled

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27
Q

steps of the pain ladder

A
  1. non opioid
  2. weak opioid or adjuvant
  3. strong opioid
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28
Q

fracture def

A

break or crack in continuity of bone

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29
Q

Depo-Provera (birth control) can cause

A

osteoporosis

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30
Q

Fracture classifications

A

closed or open

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31
Q

types of fracture lines

A

can be oblique, spiral transverse, linear, nondisplaced, greenstick, comminuted

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32
Q

Fractures in children can occur due to

A

trauma, abuse, or medical condition

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33
Q

Fracture healing phases (3)

A
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34
Q

Risk factors for fractures

A

osteoporosis, bone cancer, lack of viamin D, Calcium, phosphorus

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35
Q

Prevention

A

protect the goddamn head - just use protective equipment
oh! also safe living environments and dont fall

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36
Q

Compartment syndrome “6 Ps”

A

Pain
Pallor
Paresthesia - pins and needles sensation
Paralysis
Pulselessness
Poikilothermia - inability to regulate core body temp

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37
Q

What is a Fasciotomy

A
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38
Q

What is an SCD

A

Sequential compression device - leg massager for DVTs

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39
Q

READ about FAT EMBOLISM SYNDROME

A
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40
Q

Complications of Open fractures

A

Infection, comnamination, clostridium leading to gangrene, cellulitis, osteomyelitis.

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41
Q

Papilledema

A

Pressure in or around the brain causes the part of the optic nerve inside the eye to swell.

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42
Q

Symptoms of papilledema

A

Visual symptoms may be fleeting disturbances in vision.

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43
Q

myasthenia gravis (muscle grave) symptoms

A

Ptosis (eyelid drooping) is the most common

Muscle weakness varies depending on the muscles affected.

Shortness of breath and respiratory distress occurs later as the disease progresses.

NOT:
Muscle spasms are more likely in multiple sclerosis. Photophobia is not significant in myasthenia gravis.

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44
Q

As ICP increases due to what?

A

hypotension and hypoxia lead to vasodilation, which contributes to increased ICP.

45
Q

TRACTION pneumonic

A

T: temp
R: Ropes hang freely
A: Alignment
C: circululation checks (6 Ps)
T: type and location of Fx
I: Increase fluid intake
O: overhead Trapeze
N: no weights on bed or floor

46
Q

How often should someone be repositioned with fx

A

1-2 hours

47
Q

Best way to prevent DVT

A

move

48
Q

Late signs and symptoms

A

Widening pulse pressure

49
Q

What is widening pulse pressure

A

systolic higher diastolic may be same or decreased lack of oxygen to brain tissue MAP obviously goes down

50
Q

def of stupor

A

Deep sleep, pt can be aroused by vigorous and repetitive stimulation. Returns to deep sleep when not continually stimulated.

51
Q

Environmental Risk factors for ICP

A

Tetracycline, poor eatting, putting yourself in shit positions where youre going to hit your head bad (no helmet, biking, contact sports)

52
Q

How long can a CVA be indicated after a TIA

A

90 days

53
Q

Ischemic strokes are divided into three types. WHat are they?

A

Thrombotic - clot that usually resolve on their own (TIA)
Embolic - clot from different part of the body (afib)
Lacunar - infarcts within deep arteries of the brain stem and basal ganglia. leave cavities. THink dementia

54
Q

Diagnostics for stroke

A

CT - gold standard
MRI - if they cant see anything
CBC - infection?
Echocardiogram - did the clot come from the heart
angiogram - define blockage or or obstruction in head
carotid ultrasound - arterial obstruction mapping in neck

55
Q

Complications of Stroke

A

decreased cerebral blood flow due to increased ICP

inadequate o2 to brain

pneumonia (aspiration)

Seizure

56
Q

Treatment of Stroke

A

Tissue plasminogen activator tPA is given 3-4.5 hours after ct scan is done to approve there is no bleeding

57
Q

left sided stroke

A

aware of deficits (sad and anxious), slow performance, impaired speech and language, visual field deficits.

58
Q

intracerebral hemorrhage defined as

A

Hematoma in brain tissue called the parenchyma.

59
Q

parietal lobe

A

processinformation when people speak to us and sensations

60
Q

cerebellum controls

A

controls balance, oisture and coordination

61
Q

Brain stem controls

A

breathing sneezing, coughing, swallowing and heart beat

62
Q

Modifiable risk factors for stroke

A

hypertension #1, heart diseaase, hyperlipidemia, diabetes, drug abuse (the cocaine)

63
Q

Non modifiable

A

ethnicity (African), gender (men),

64
Q

Complication of lumbar punctures

A
65
Q

Contraindications for tPA

A

BP above 185/110,
bleed/on blood thinner
Hx of GI bleed
previous stroke with tPA
Craniotomy within 3 months
major surgery within 14 weeks

66
Q

4.5 hours to 24 hours of stroke

A

mechanical thrombectomy done in IR

67
Q

drugs for after stroke

A

Eliquis and warfarin, aspirin

68
Q

Reverse warfarin

A

vitamin k protrombin FFP

69
Q

stroke on left side will exhibit

A

comprehension, language***, expression

70
Q

Brocas area is

A

speech production or verbal expression

71
Q

When someone hhas a stroke in Wernickes what will you see as a deficit

A
72
Q

What do you see with global aphasia

A
  • non fluent
  • damage to extensive portions of the language areas of brain
  • severe communication difficulties
  • extremely limited in inability to speak or comprehend language
73
Q

Impulsiveness in right sided stroke

A

They don’t have control of their impulses. If you say “we are getting up on 3” and they go when they hear 3. they don’t mean to

74
Q

Aproxia

A
75
Q

Agnosia

A

inability to recognize object

76
Q

What is a Pontine Stroke

A

Stroke at the Pons
- Locked - in syndrome. it’s fucking horrific catastrophic

Pons
- any lesion, mass, infection, trauma, of demyelinating disorders
- Communicate through eye movement

77
Q

Nihilistic delusion involves a belief of what in schizophrenia

A

the client’s organs aren’t functioning or some body part or feature is horribly disfigured.

78
Q

A grandiose delusion involves the belief of what

A

that one has exceptional powers, wealth, skill, influence, or destiny.

79
Q

A persecutory delusion involves the belief…?

A

one is being watched, ridiculed, harmed, or plotted against

80
Q

.A somatic delusion involves a belief about

A

abnormalities in bodily structure or functions

81
Q

Which is a nonneurologic side effect of antipsychotic medications?

A

Weight gain

82
Q

A verbigeration is

A

the stereotyped repetition of words or phrases that may or may not have meaning to the listener.

83
Q

Clang associations are

A

ideas that are related to one another based on sound or rhyming rather than meaning.

84
Q

Neologisms are

A

words invented by the client.

85
Q

salem sump tubes are how many lumens?

A

two

86
Q

Salem sump blue tube is used to

A

neutralize air so the Salem can be suctioned and not cause a contusion then ulcer

87
Q

What are signs and symptoms of Salem sump tube being occluded? How can it happen, and how do you fix it?

A

Continued nausea, distended stomach, abdominal pain.
It can coil or kink, or be plugged. to fix it fluid challenge to unclog, check the back of the throat (open their mouth) and make sure it isnt fucking coiled in the back of their throat

88
Q

Salem Sump Tube

A

Sump pump that is used to continuously suctioned.
Avoids forming against the lining of the stomach

Used for suction or gastric feedings

89
Q

Who determines the size of tubing in OG or NG

A

You bitch - the nurse

90
Q

Post pyloric feeding tube - Cortrak or DubHoff are for what?

A

Tubes meant to go past the post pyloric area for feedings only. Dont suction that persons duodenum.

91
Q

How to confirm the post pyloric feeding tube is in

A

Check xray for confirmation incase it gets tugged, check the numbers and the size

92
Q

How long can a patient have a post pyloric feeding tube be placed

A

there is technically no timeline just watch for pressure ulcers with this tube - need to rotate it
and it getting clogged - well youre fucked redo it

93
Q

What is PUSH DOG for liver

A
94
Q

Acute Liver failure:

A

Onset of encephalopathy less than 7 days after the development of jaundice

95
Q

Sub-acute liver failure

A

5 weeks but less than 12 weeks after the development of jaundice

96
Q

S/S of Liver failure

A

Jaundice, abd pain and swelling, AMS, easy bruising and bleeding, Fatigue/weakness, encephalopathy

97
Q

What is encephalopathy?

A

When ammonia travels to the brain and causes ams because it is not converting to urea

98
Q

Fibrin is like a net why

A

Because it catches the platelets to make a clot

99
Q

Indications of psychoses

A

restlessness, auditory hallucinations, and pressured speech require immediate follow up

100
Q

manifestations of bacterial meningitis

A

fever, photophobia, nuchal rigidity, petechial rash, and impaired consciousness.

101
Q

Manifestations of encephalitis

A

fever, nuchal rigidity, and altered mental status

102
Q

Manifestations of Reyes

A

primarily by altered mental status and impaired hepatic function.

103
Q

what is Lanugo

A

Latin in origin (wool, down). First hair on baby and in anorexic patients

104
Q

Steps to care for trach

A

When teaching the parent to provide tracheostomy care, the nurse should instruct the parent to first remove the inner cannula. Next, the nurse should instruct the parent to remove the soiled dressing and then clean the stoma with 0.9% sodium chloride irrigation. Finally, the nurse should instruct the parent to change the tracheostomy collar.

105
Q

When analyzing cues, the nurse should identify that thyroid storm can be caused by trauma to the thyroid gland, such as surgery, and excessive release of thyroid hormone greatly increases the metabolic rate. What signs should the nurse look for

A

Fever greater than 38.5° C (101.3° F), heart rate greater than 130/min, systolic hypertension, and mental status changes, such as confusion, restlessness, and sleepiness, are characteristic of thyroid storm.

106
Q

The nurse should analyze cues of pneumonia that include tobacco use, elevated WBC count, a productive cough with blood-tinged sputum, elevated temperature, a decreased oxygen saturation level, and an ABG level indicating respiratory acidosis.

The nurse should also analyze cues of COPD that include tobacco use and a decreased oxygen saturation.

The nurse should also analyze cues of heart failure that include tobacco use, BNP level, and a decreased oxygen saturation.

A
107
Q

Upon analyzing cues, the nurse should identify that the client is at risk for confusion due to a sodium level that is greater than the expected reference range. Hypernatremia places the client at risk for a decreased level of consciousness, falls, and seizure activity. Therefore, the nurse should monitor the client’s level of consciousness and place the client on fall and seizure precautions.

A
108
Q
A

nursing 2900 (3 decks)

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