Test 3 Adult Health Flashcards
Blood Drainage: Jackson Pratt bulb
Report to HCP with more than 100mL Bright red drainage
Normal signs with Mastectomy
Numbness
Lymph node swelling
Self-breast examination
Report to HCP when breast are red, warm, orange peel skin, hard painless swelling
Breast changes not related to menstrual cycle
Eye Cancer (Retinoblastoma)
Most common eye cancer in childhood <2
White pupil (Leukocoria)
Leukemia
Blood cells and bone marrow
Overproduction of WBCs
Low H/H, Low platelets
ALL, AML, CLL, CML
ALL: Pediatrics more common
Frequent infections, fatigue, bruising (petechiae), anorexia
Private room
Leukemia Diagnosis
Bone marrow biopsy
Non-H/Hodgkin’s lymphoma
Hodgkin’s: Reed-Sternberg cells
Cause: Epstein Barr virus
Night sweats, painless bumps under arm
Ovarian Cancer
Bloating and pelvic pressure
Urinary urgency, frequency
Cervical Cancer
Cause: skin-to-skin contact (even with condom use)
Vaccine before sexual activity
Screening: Pap test every 3 years >21 years
Benign vs Malignant
BENign: Be Nice
MALignant: MALicious
Skin Lesions Screening
A: Asymmetry-irregular is bad
B: Border- irregularity
C: Color variation- black or dark
D: Diameter- over 6mm, size of coin
E: Evolving- changes in size, shape, or color
Causes: Immunosuppressant medications
Neutropenic Precautions Priority
Fever over 100.3F
Kidney filter out HUC
H: Hydrogen- Renal failure= High H+
U: Urea- BUN 7-18, protein waste
C: Creatinine-
Calcium Ca+
“Cocky”
9.0-10.5
Inverse relationship with phosphate
Hypo: positive trousseau’s/chvostek sign
Magnesium Mg+
“Magnum”
1.3-2.1
Hyper: decreased DTR w/depressed respirations
Hypo: torsades de pointes
Causes: crohns disease, celiac disease
Phosphate
“Frat boy”
3.0-4.5
Inverse relationship with calcium
Chloride
“4 eyed”
95-108
SAME AS SODIUM
only difference: has a fever w/Hypo
Potassium Hyper:
Hyper: High pumps, increased DTR, v fib, cardiac arrest, hypotension and bradycardia, muscular weakness, hyperactive bowel sounds, diarrhea
Causes: renal failure, low ALdosterone: A-adds sodium, L-loses potassium
Potassium Hypo:
Hypo: Low and slow pumps, shallow respirations, decreased DTR, constipation, paralytic ileus
Causes: Diarrhea, DKA, ALdosterone: A-adds sodium, L-loses potassium
Sodium Hyper:
Hyper: increased muscle tone, swollen dry tongue
Causes: low ADH: DI (dry inside), rapid respirations
Sodium Hypo:
Hypo: headache-cerebral edema
Causes: sweating, SIADH, low aldosterone
oliguria
low urine output
Hypertensive crisis
Headache
Nausea/vomiting
Change in mental status
Stage 4 CKD
29-15 GFR
every stage above goes by 30’s
Urinary incontinence
stress: urine spills out
neurogenic bladder: sudden urge to pee
Overflow/ retention: prostate cancer
VOID REGULARLY, KEEGAL EXERCISES
Med to shrink prostate cancer
FINasteRIDE
“painful to ride”
“have fun” to be “able to ride”
Early signs of Increased ICP
Altered LOC: irritability, restless
Decreased Mental Status
sudden vomiting without nausea
Late signs of Increased ICP
Irregular respirations
Nuchal rigidity
pupils fixed and dilated
Babinski reflex
Decorticate: arms flex toward core
Decerebrate: arms flexed out (WORSE)
Cushing triad
GCS meaning
15: highest score
8: intubate
3: lowest score
REPORT DECREASING GCS
ICP treatment
Phenytoin: prevents seizures
Steroids: dexamethasone
PhenoBARBITAL: barbituate decrease brain activity
Mannitol: osmotic diuretic
Mannitol
Osmotic diuretic
side effects: edema and s/s of heart failure
Monitor urine output (hypernatremia)
Autonomic Dysreflexia
Spinal above T6 with high BP (assess bladder)
s/s-Headache, profuse sweating (diaphoresis) : check urinary catheter for kinks
Kernig sign
laying on back and straightening the leg, very painful in neck “kicks”
Brudzinski sign
When neck flexes, hip and knee also flex “beach chair”
Brain lobes
Frontal: FRONT OFFICE-speech, memory, movement
Occipital: sight
Temporal: TEMPO-hearing
Parietal: PURRietal cat- sensory touch
Cerebellum: cereBALANCE
Brain stem: controls HR and RR
Sudden vomiting “emesis” without nausea
Early sign of increased ICP
Ataxia
Difficulty walking
Cerebral Perfusion Pressure
(70-100)MAP-ICP(5-15)
Blood pressure on brain
<50: ischemia (no oxygen)
Spinal cord compression
Assess gait
Retrosternal pain relieved when leaning forward
Cardiac tamponade
Anaphylaxis what to assess?
MAP
Pin point pupils
Damage to Pons
Drugs
Homan’s sign
Used to determine DVT’s
Any patient becoming unconscious acutely
Increased ICP
Signs and symptoms of SIADH
Headache, vomiting, confusion
Carsinogens
Black on food
Proto-oncognes
Normal cell genes
oncogenes
Mutation, tumor induced genes
Nadir
Lowest blood cell count
When they start feeling better
Administer vaccine during nadir (7-10 days)
Neutropenic Fever
Take temperature 3 times a day
100.5 critical level
Need to get antibiotics w/in one hour
How many liters does it take for edema to be present?
3L
Plasma osmolarity
280-295
Isotonic IV fluid
250-375
Levophed
First drug of choice for septic shock
What electrolyte binds to citrate in blood transfusion?
Calcium
Stage 2 CKD
60-90 Mild kidney damage
kidneys still work well
Daily weights
Best indicator of fluid retention
What medication can cause hypothyroidism?
Amiodarone: contains iodine and lithium which blocks hormone production
Stages of AKI
Initiation:
Oliguric: Uremic symptoms appear, hyperkalemia may develop
Diuresis: Gradual increase in urine
Recovery: Improving renal function 3-12 months
Completed hemodialysis and complains of headache, nausea, and extremely restless
Notify Health Care Provider
-Disequilibrium syndrome (rapid removal of solutes from body)
Diagnostic test for Cancer
Tissue biopsy and bone marrow biobsy
Nadir visit vaccine Taxol and carboplatin
Administer Injection: this is a killed virus (inactivated)
DO NOT NASAL SPRAY
Vesicant
Causes blistering or tissue necrosis
Irritant
Local inflammatory reaction but does not cause tissue necrosis
Neutropenia treatment
Neulasta/Neupogen; prophylactic antibiotic
Thrombocytopenia treatment
Platelet transfusion, steroids