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Med Surg 1 > Test 1 - study guide > Flashcards

Test 1 - study guide Flashcards

1
Q

Signs and symptoms for dehydration are…

A
  • Thirst
  • Rapid, Weak Pulse
  • Low Blood Pressure
  • Dry Skin and Mucous Membranes
  • Skin Tenting
  • Decreased Urine Output
  • Increased Temperature
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2
Q

Causes of dehydration are…

A
  • fluid loss from vomiting
  • diarrhea
  • GI suctioning
  • sweating
  • decreased intake
  • inability to gain access to fluid
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3
Q

Laboratory data for dehydration are…

A
  • elevated BUN in relation to serum creatinine
  • increased hematocrit
  • Hypokalemia occurs with GI & renal losses
  • Hyperkalemia occurs with adrenal insufficiency
  • Hyponatremia occurs with increased thirst & ADH release
  • Hypernatremia results from increased insensible losses and Diabetes Insipidus
  • tenting
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4
Q

What is dehydration?

A

loss of water with no loss of electrolytes

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5
Q

Interventions for deficient fluid volume are…

A
  • Identify those at risk
  • Monitor Weight & vital signs
  • Assess skin turgor
  • Monitor Intake and Output – all types of loss
  • Evaluate urine specific gravity >1.025
  • Monitor labs
  • Increase Fluid Intake
  • Treat Underlying Cause
  • Encourage PO intake
  • Teach about adequate fluid intake
  • Do Not Overhydrate Elderly Patients
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6
Q

Fluid volume overload signs and symptoms

A
  • increased BP (bounding, tachy, jugular distention)
  • abnormal lung sounds (crackles)
  • increased RR
  • edema
  • weight gain
  • increased urinary output
  • confusion, lethargy
  • hyponatremia and muscle cramping
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7
Q

Interventions for Excess fluid volume

A
  • Monitor for changes in LOC
  • Monitor weight and urine output
  • Elevate head of bed
  • administer oxygen
  • administer diuretics
  • restrict fluid and sodium
  • encourage mobility
  • monitor electrolytes
  • communicate proper fluid intake
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8
Q

Signs and symptoms for compartment syndrome

A
  • dusky, pale appearance of extremity
  • cool skin Temp
  • delayed capillary refill
  • paresthesia (tingling)
  • extreme pain
  • complaint of device tightness
  • intensifying pain w/ movement
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9
Q

Interventions for compartment syndrome

A
  • removal or loosening of restricting device (cast, splint)
  • fasciotomy
  • elevation of limb (no higher than heart)
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10
Q

signs and symptoms of osteoporosis

A
  • joint pain
    • intensifies w/ activity
  • Stiffness
  • Bony nodes on joints of fingers (heberden’s and Bouchard’s nodes)
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11
Q

lab diagnostics for osteoporosis

A
  • X-rays
  • CT (cat scan)
  • MRI
  • Analysis of Synovial Fluid
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12
Q

interventions for osteoporosis

A
  • no cure
  • activity
  • pain/inflammation control
  • rest and exercise
  • heat or cold
  • weight control
  • surgery (joint replacement)
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13
Q

signs and symptoms of osteomyelitis

A
  • localized pain
  • edema
  • erythema (reddening of skin)
  • fever
  • drainage
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14
Q

lab diagnostics for osteomyelitis

A
  • Elevated WBCs
  • elevated ESR
  • MRI and CT can visualize areas of infection
  • positive bone biopsy for infection
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15
Q

interventions for osteomyelitis

A
  • primarily prevention is the goal
  • hydration
  • diet high in vitamins and protein
  • also correction of anemia
  • surgical debridement
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16
Q

signs and symptoms for gout

A

Acute
-swollen, red, hot, painfully inflamed joints

Chronic

  • Urate deposits in skin
  • Renal stones
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17
Q

lab diagnostics for gout

A
  • Serum Uric Acid levels

- Microscopy of uric acid crystals in Joint Fluid

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18
Q

interventions for gout

A

Medications

  • NSAIDS, colchicine, allopurinol, probenecid
  • avoidance of foods high in purines
  • avoid aspirin, diuretics, alcohol
  • increase fluids
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19
Q

signs and symptoms pelvic fracture

A
  • pain
  • shock
  • shortening/rotation of the leg
  • genitourinary or intra-abdominal co-injury
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20
Q

lab diagnostics for pelvic fracture

A
  • X-ray
  • Angiography
  • CBC
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21
Q

interventions for pelvic fracture

A
  • apply antishock garment

- anticipate/assist with application of external fixator

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22
Q

signs and symptoms sprain

A
  • Pain
  • swelling
  • bruising
  • instability
  • loss of the ability to move/use joint
  • pop or tearing sensation when injury happens
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23
Q

lab diagnostics for sprain

A

x-ray to rule out fracture

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24
Q

interventions for sprain

A
  • RICE
  • rest
  • ice
  • compression
  • elevate
  • heat after inflammation is reduced
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25
Q

signs and symptoms shingles (herpes zoster)

A
  • Vesicles
  • Plaques
  • Irritation
  • Itching
  • Fever
  • Malaise
  • Pain
  • follows nerve distribution
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26
Q

lab diagnostics for shingles (herpes zoster)

A
  • History

- culture and sensitivity

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27
Q

interventions for shingles (herpes zoster)

A
  • vaccination
  • anti-viral medications
  • analgesics to relieve pain
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28
Q

signs and symptoms scabies infestations

A
  • itching
  • rash
  • burrows
  • localized in armpits, wrists, groin
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29
Q

lab diagnostics for scabies infestations

A

-microscopic examination of skin scraping of a lesion

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30
Q

interventions for scabies infestations

A

-scabicide applied to all areas of the body

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31
Q

signs and symptoms skin cancer

A 
ABCD's!
Asymmetry 
Border irregularity 
Color
Diameter – big is bad :( (>5mm may be of concern)
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32
Q

lab diagnostics for skin cancer

A
  • examination
  • biopsy (Bx)
  • also note changes in lesion
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33
Q

interventions for skin cancer

A
  • prevention
    • limit exposure to UV
    • use sunscreen
    • wear protective clothing
    • report changes in moles
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34
Q

What is gout?

A

a type of inflammatory arthritis caused by hyperuricemia (uric acid)

  • uric acid crystals form in joints
  • phagocytosis of crystals causes pain
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35
Q

signs and symptoms lice

A
  • intense itching (pruritus)
  • rash
  • red bumps on the skin.
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36
Q

lab diagnostics for lice

A
  • combing of hair

- nits at base of hair shaft

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37
Q

interventions for lice

A
  • permethrin topical ointment

- treat others in household

38
Q

types of skin cancers include

A
  • basal cell carcinoma
  • squamous cell carcinoma
  • malignant melanoma
39
Q

squamous cell carcinoma are

A
  • 2nd most common
  • grow rapidly
  • can metastasize
40
Q

basal cell carcinoma are

A
  • most common

- rarely metastasize

41
Q

melanomas are

A
  • least common
  • highly metastatic
  • genetic component
42
Q

signs and symptoms of skin ulcers

A
  • pain
  • open ulcerated area
  • color tip
    • black = necrosis
    • yellow = infection
    • red = healing
43
Q

diagnoses for skin ulcers

A
  • physical exam
  • culture and sensitivity
  • blood supply studies
  • wound biopsy
44
Q

A stage 1 ulcer is

A

nonblanchable erythema of intact skin

45
Q

A stage 2 ulcer is

A

partial-thickness skin loss

46
Q

A stage 3 ulcer is

A
  • full-thickness skin loss

- not involving underlying fascia

47
Q

A stage 4 ulcer is

A

-full-thickness skin loss with exposed bone, tendon or muscle

48
Q

An unstageable ulcer is

A

-full-thickness tissue loss in which the base of the ulcer is covered.

49
Q

A deep tissue injury is

A
  • purple or maroon

- localized in area

50
Q

pressure ulcers can occur due to ___ and _____

A

pressure and stasis (blood pools)

51
Q

interventions for ulcers

A
  • identify at risk pt
  • keep pt dry
  • use lube and skin barriers
  • turn q 2h
  • relieve pressure points
  • nutrition and hydration
  • use lift sheet to move
52
Q

signs and symptoms of psoriasis

A

Plaques of red, inflamed skin, often covered with loose, silver-colored scales

53
Q

Dx of psoriasis

A
  • physical assessment

- biopsy

54
Q

Interventions for psoriasis

A
  • baths to remove scales

- medications

55
Q

signs and symptoms of cellulitis

A
  • inflammation and edema
  • warmth
  • redness
  • pain and tenderness
  • fever
56
Q

Dx tests for cellulitis

A

-culture and sensitivity

57
Q

interventions for cellulitis

A
  • antibiotics
    • only if immune system working
  • debridement
58
Q

Signs and symptoms of eczema

A
  • vesicles
  • surrounding redness
  • rupture of vesicles, open areas
  • secondary infection
59
Q

Dx of eczema

A
  • clinical symptoms
  • culture and sensitivity
  • rule out allergies
  • biopsy if nonresponsive to Tx
60
Q

Interventions for eczema

A
  • 1:40 Burow solution
  • drain large vesicles
  • antibiotics
  • corticosteroids topical
  • botulinum toxin A injection
  • biofeedback
  • bedrest if on feet.
61
Q

S/s of dermatitis

A
  • redness
  • pruritis
  • skin lesions
62
Q

Dx tests for dermatitis

A

-culture and sensitivity

63
Q

interventions for dermatitis

A
  • antihistamines
  • analgesics
  • antibiotics
  • antipruritics
  • steroids
  • colloidal oatmeal baths
  • wet dressings
64
Q

A macule or patch is

A
  • freckles
  • moles
  • petechia
  • rubella rash
  • ecchymosis (bruising)
65
Q

A plaque is

A
  • dry buildup
  • may flake off
  • psoriasis
66
Q

A papule is

A
  • warts
  • tissue buildup (solid)
  • causes a bump on the skin
67
Q

A vesicle/bulla is

A
  • tissue buildup (fluid filled)
  • burns
  • dermatitis
  • poison ivy
  • acne
  • chicken pox
  • herpes
68
Q

A wheal is

A
  • a large raised area
  • uticaria (hives)
  • generalized edema/swelling
  • allergic responses
  • insect bites
69
Q

Aging causes what in the musculoskeletal system?

A
  • bone calcium loss
  • articular cartilage wears down
  • muscle strength declination
70
Q

What do you look for when assessing the neurovascular system?

A

5-p’s

  • pain
  • pulse
  • pallor
  • paresthesia
  • paralysis
71
Q

What are the diagnostic evaluations of the musculoskeletal system?

A
  • x-rays
  • CT
  • MRI
  • arthrography
  • bone densitometry
  • bone scan
  • arthroscopy
  • electromyography
  • biopsy
  • lab studies
72
Q

When assessing the musculoskeletal system you look at…

A
  • data related to ADLs
  • health hx of pt and family
  • assess pain and altered senses
  • physical - posture, gait, joint fx, muscle strength and size
  • spine abnormalities
  • ROM
  • use of mobility aids
  • symmetry
  • redness
  • edemma
  • tenderness
73
Q

ligaments attach ____ to ____

A

bone to bone

74
Q

tendons attach ____ to ____

A

muscle to bone

75
Q

Anaerobic pathways in muscle use ____ and result in a buildup of _____

A

glucose

lactic acid

76
Q

osteoblasts

A

function in bone formation

77
Q

osteocytes

A

are mature bone cells
function in maintenance
They are on site!

78
Q

osteoblasts

A 
function as destroyers, resorbing, and remodeling
located in Howship's lacunae
79
Q

A comminuted fracture is

A

splintered with fragments

80
Q

Stage 1 of fracture healing is

A

hematoma and inflammation

81
Q

Stage 2 of fracture healing is

A

angiogenesis and cartilage formation

82
Q

Stage 3 of fracture healing is

A
  • cartilage calcification
  • cartilage removal
  • bone formation
  • remodeling
83
Q

Nursing care for bone fracture is

A
  • splint and immobilize
  • remove jewelry
  • avoid movement
  • assess neurovascular
  • apply ice/cold pack
  • elevate
  • Anticipate analgesics, antibiotics, stabilization, OR
  • provide psychosocial support
84
Q

Interventions for joint injury

A
  • immobilize joint
  • Assess/reassess neurovascular fx
  • anticipate/assist w/reduction
85
Q

symptoms of joint injury

A
  • pain
  • deformity
  • edema
  • inability to move
  • abnormal ROM
  • neurovascular compromise
86
Q

symptoms of femur fracture

A
  • pain
  • can’t bear weight
  • shortening
  • rotation (in or ex)
  • edema
  • deformity
  • hypovolemic Shock (2-3 Units blood)
87
Q

Interventions for femur fracture

A
  • immobilize
  • anticipate traction pin/dressing
  • anticipate OR/admission
88
Q

Symptoms of Open fractures

A
  • skin disruption
  • pain
  • neurovascular compromise
  • bleeding
  • bone protrusion
89
Q

Interventions for open fractures

A
  • irrigate wound
  • wound culture
  • sterile dry dressing
  • continued bleeding assessment
  • anticipate/prepare for OR
90
Q

complications of fractures

A
  • nonunion of bone
  • neurovascular compromise
  • infection
  • hemorrhage
  • thromboemolitic comp.
  • acute compartment syn
  • fat embolism syn
91
Q

Types of closed reductions

A
  • manual realignment
  • bandages/splints
  • casts
  • traction
    • skin
    • skeletal

Med Surg 1 (8 decks)

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