SI3 Flashcards
Anemia is
Not a disease, it’s a symptom
Decreased Hgb
Often r/t to iron def or chornic blood loss
C: Very young, very old, poor diet, women in repro years
SS: Pallor, glossitis, cheilitis
Tx Tx underlying cause, iron supplements, blood trsnfusion, nutriton
Glossitis
Swollen tonguw
Cheilitis
Swollen lips
Defective DNA synth of RBCs
Patho: Often r/t folic acid and Vit B12 Def
Tx Supplemental Vit
Dimished availability of erythrocyte precursors
Often lead to aplastic anemia
C: Renal dx, autimmune malignancy
SS: high ferritin and iron stores
Rarely w/ blood transfusion, often with EPO supplement
Acute blood loss causing anemia
May lead to hypobolemic shock, internal hemorrhage or tetroperitoneal bleed
C: Caused by trauma
SS: Pain that cant be explained otherwise
- Very bad back pain in LQ
Tx: Stop bleeding, tx pt, monitor lavs
Hemolytic anemia
Destruction of RBCs at a rate that exceeds production
Extrinisc (More common)
Damaged spleen
Intrisnic: SIckle cell
…
Sickle Cell Crisis SS
Pain+++, swelling, pallor of mucous membranes, fever, jaundice , vasooccluisve crisis - tachypnea, HTN, NV
Complications of sickle cell crisis
Gradual involvment of all body systems - spleen, lungs kidney and brain
Prone to infection, acute chest syndrome
Diagnostics of sickle cell anemia
Peripheral blood smear, sickl8ing test, electrophroesis of hgb, MRI
Genetic
Nursing mgmt of sikcle cell anemia
Aoid hifh altritiurdes, maintain fluid intake , tret infections, help with pain control, supplemental O2
Acute ches tsyndrome: Abx, O2, Fluid, transfusion
CURE: Stem cell transplant
Immune Thrombocytopenic purpura
Abn destruction of circulating platletsSS: Gums and nose bleed, purpura (Non blanching)
Tx: Corticosteriods splenectemy
HIT
Immune system cause splts to clot in presence of heparin
SS: Heparin causes pts plts count to fall 50% + From baseline
Tx: d/c heparin
Disseminatied intravascular coagulation
Abnormally initiated and accelerated clotting
SS: Bleeding out of everywhere
Tx: Underlying cause - must diagnose quickly, often too late
Leukemia BE ABLE TO INTERPRET what labs would look like for leukemia
Common in adults
Abrupt - dramatic onset, serious infection or abn bleeding
Sky high WBC - 80s to 100s (Blasts- immature)
Hyperplasia of bone marrow and spleen
Often responds well to chemo
Low RBC and Plt count bc there’s not room in the bone marrow for that
ALL Leukemia
Common in kids
SS: Fever, bleeding, fatigue, CNS manifsestations
More difficult to tx
CML Leukemia
Genetic marker - philadelphia chromosome
Can be well controlled w/ tx
Chronic onset - swelling of spleen, liver, lymph nodes - bleeding bruising
CLL
Lymphoma vs leukemia
Leukemia: Originates in bone marrow/blood
SS: Blood marrow crowed by increased WBC
DIfference in location causes difference in ss
Risk factors of sickling
Significant blood loss
Illness
Climbing/flying at high altitudes
Keeping continued stress (mental/physicaal)
Low fluid intake
Elevated temp (fever)
Manifestation of cirrhosis
Jaundice
Skine lesions - Spiders and red palms (low levels of estrogen)
Hematologoical problems
Periph neuropathy - vitamin def and malnoutrish
Esophaogeal varices causing anemia
Know the two types of encephalopathy
Portal vein hypertension
Increase in BP in protl venous sytem r’t liver blockage
SS May lead to large swollen veins that can rupture and bleed
Tx: Propranolol
Esophageal Varices
Collateral circulation in esophagus that is less strong
SS: Red blood in vomit black stool, high HR, low BP
Tx: Diagnosed with endoscopy, tx with vitamin K, pantoloc, octreotide, octaplex if acute leeting, ligation sx
Ascities
Accumulation of flood in peritoeal cavity
SS:Abd distention, wt gain, abd striae, ss of degydration hypoK
Tx : Na restriction, diurtetics, fluid removal, paracentesis, IV albumin
Edema is a hige risk for
Skin breakdown
Where can crohns be found?
Technically anywhere in GI, ususally lower SI
Which IBD results in non bloody stools
Crohns
Anemia caused by UC
Acute blood loss from ulcers (drop in Hgb) - low iron
Crohns caueses anemia
Reduced absorption (malabosorption)
Which IBD goes ALL the way through the tissue layers
Crohns
Which IBD has an increased risk to colorectal cancer
Colitis
Cobblestone appearance, inflamed, edematos mucosa with deep longitudinal lacerations is found in which IBD?
Crohns
Colitis colon tissue looks like
Hypermic + Edematous in affected area
Abscesses turning into ulceration that bleed
Tx for UC
Rest bowel
Control inflam
Mnaage fluids and nutrition
Manage pt stress
Provide education ab dx and tx
Provide SS relief
Why aren’t UC pts prescribed NSAIDS
bc they increase risk for GI Bleed
Drug therapy for UC
Sulphasalizine
Corticosteriods
Immunosuppressive drugs
Sx for UC
Removal of protions of the bowel
Crohn’s dx tx durg
Sulphasalazine
Corticosteriods
Flagyl (DIFFERENT FROM UC)
- Fistulas can cause secondary infections, so treated
Bio Drug
Which IBD spreads in continuous pattern and has presence of pseudopolyps
UC
Whic hematopoietic supp is used for anemia in Crohns
Cobalamin (B12) Supplements
With Crohn’s pts are on immunosuppressant therefore infections are often only shown by
Fever
MS manifestation
Weaknress or paralysis of body parts
Scanning speach
Sight and hearing loss
Bowel and bladder - Constipation, spastic bladder (Contracts)
Flaccid (No desire to void)
HD
Lots of abnormal movements and jerking
Self care deficit
Cognitive decline progresses, pt eventually becomes demented and incontinent
Severe mood swings
Sexual outbursts
Tx is palliative
Haloperidol is given to reduce ss of excessibe movment
PD
Tremor
Rigidy
Akinesia
Postural instability
SS worse with stress
Tx of PD
Dopaminergic
Loveodp-Cardipoa
To reduce fall risk in PD pts
Consciously lift feet while walking
PID SS
Resulting for untreated cervicitis often
Low abdom pain
Spotting after intercourse
Endometriosis
Secondary dysmenorrhea
Infertility
Pelic pain
Painful intercourse
Irreguar bleeding
Painful bm
Dysuria
Why is semi-fowlers used during PID
To drain out infection
Which action is taken if a pap test reveals minor cell changes
Schedule another pap test in 4 motnhs
