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NURSING PATHO > TEST #4 C. 37 > Flashcards

TEST #4 C. 37 Flashcards

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1
Q

rosing sign

A

palpate on the left side and makes right side hurt

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2
Q

mcburneys point

A

appendicitis starts periumbilical and goes down to RLQ

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3
Q

rebound tenderness

A

press down and let go hurts; appendicits

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4
Q

autonomic nervous system signs of g. barre

A

postural hypotension, arrhythmia, sweating, flushed face, urinary retention

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5
Q

damaged myelin causes scar tissue and the scar tissue is called

A

sclerosis; multiple sclerosis

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6
Q

wheres the phrenic nerve

A

c3-c5

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7
Q

No problem with blood getting there but blood isn’t oxygenated

A

hypoxia

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8
Q

A situation of greatly reduced or interrupted blood flow; Oxygen and glucose in that blood

A

ischemia

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9
Q

Glutamate, the brain’s most prevalent excitatory amino acid neurotransmitter, is released in excessive quantities when blood vessels are blocked.

A

Excitatory amino acid injury

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10
Q

Occurs with conditions that impair the function of the blood–brain barrier and allow transfer of water and proteins from the vascular into the interstitial space.

A

vasogenic edema

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11
Q

an increase in intracellular fluid.

A

cytotoxic edema

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12
Q

normal intracranial pressure

A

5-15 mm hg

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13
Q

signs of intracranial pressure ; LATE SYMPTOMS

A

cushings triad
widening pulse pressure/hypertension
bradycardia-heart rate less than 60
irregular breathing

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14
Q

Systolic going up and diastolic is going down

A

widening pulse pressure

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15
Q

differentiate between cushings and shock state

A

SHOCK
decrease bp
increase pulse
increase respirations

CUSHINGS
increase bp
decrease pulse
decrease respirations

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16
Q

cerebral perfusion pressure in the brain is normally

A

70-100

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17
Q

the most common herniation syndrome.

A

uncal syndrome / transtentorial

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18
Q

upward herniation; less frequent

A

infratentorial herination

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19
Q

downward herniation

A

posturing

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20
Q

bruising on the brain surface or a lacerations or tearing of brain tissue.

A

contusions

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21
Q

basilar skull fractures 2 signs

A

raccoons eyes-indicative of brain injury

battle sign-bruising behind ear

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22
Q

tear in the artery

A

epidural hematoma

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23
Q

develops between the inner side of the skull and the dura.

A

epidural hematoma

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24
Q

a history of head injury and a brief period of unconsciousness followed by a lucid period in which consciousness is regained.

A

epidural hematoma

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25
Q

whats worse epidural or subdural

A

epidural because its a tear in the artery and veins bleed slower so youd want that

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26
Q

develops in the area between the dura and the arachnoid (sub-dural space)

A

subdural hematoma

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27
Q

subdural they can stay away from the hospital. why

A

slower bleed because its a vein, and in elderly the brain shrinks so more room for blood

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28
Q

a&o x4

A

alert and oriented to person place time and date

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29
Q

level of consciousness LOOK UP

A

confusion
delirium-restlessness, illusions, and incoherence of thought and speech.
obtundation-the patient has a lessened interest in the environment, slowed responses to stimulation, and tends to sleep more than normal with drowsiness in between sleep states
stupor-only vigorous and repeated stimuli will arouse the individual, and when left undisturbed, the patient will immediately lapse back to the unresponsive state
coma-state of unarousable unresponsiveness.

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30
Q

measures of loss of consciousness

A

glasglow coma scale measures motor response, verbal response, and eyes (pupil)

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31
Q

total score of glasglow coma

A

15- best response
8 or less- comatose
3-dead

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32
Q

doll eyes

A

when you turn their head the eyes will stay midline -not good (comatose patient)

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33
Q

they will have period of aspirations

A

cheyne stokes breathing

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34
Q

respiratory response in brain injury early and late

A

yawning is early

cheynes stokes breathing is late

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35
Q

when somebody is having a stroke its usually

A

in circle of willis

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36
Q

syndrome of acute focal neurologic deficit resulting from a vascular induced disorder that injures brain tissue

A

stroke; cva; brain attack

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37
Q

most common

Interruption of blood flow; blockage; no bleeding

A

ischemic stroke

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38
Q

less common

More fatal ; have a bleed; must stop bleeding

A

hemorrhagic

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39
Q

2 types of ischemic strokes

A

embolic - clot that moves

thrombotic -clot that was formed there

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40
Q 
Hypertension
Smoking
Diabetes
Diet
Physical inactivity
Obesity
High blood cholesterol
Carotid Artery Disease
Peripheral Artery Disease
Atrial Fibrillation
Sickle cell disease
A

risk factors you can control

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41
Q 
Age
Family history
Race
Gender
Prior Stroke, TIA or Heart Attack
A

risk factors you cannot control

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42
Q

“ministroke” is equivalent to “brain angina” and reflects a temporary disturbance in cerebral blood flow, which reverses before infarction occurs, analogous to angina in relation to heart attack.

A

Transient ischemic attack-

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43
Q

common predisposition for a embolic stroke

A

deep vein thrombosis

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44
Q

common predisposition for a hemorrhagic stroke

A

advancing age and hypertension

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45
Q

Most frequently fatal stroke is caused by the spontaneous rupture of an intracerebral vessel

A

hem stroke

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46
Q

post stroke fast

A

facial drooping
arm drift
speech difficulties
time

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47
Q

headache, fever, and stiffness of the neck (nuchal rigidity).

A

bacterial meningitis

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48
Q

what causes bacterial meningitis

A

pneumococcal and meningococcal.

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49
Q

infection of the brain that looks the same as meningitis but they will get more neuro signs; confusion

A

encephalitis

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50
Q

stages of a seizure

A

aura- alterations in smell, taste, visual perception, hearing, and emotional state
ictus- actual seizure
postictal - alert but very sleepy because of the increased energy, oxygen, a seizure utilizes.

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51
Q

unconsciousness along with both tonic and clonic muscle contractions.

A

tonic clonic seizures

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52
Q

see Neurofibrillary tangles Neuritic plaques on the scans

A

alzheimers

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53
Q

previously called picks disease but there are changes in behavior and problem with language

A

Frontotemporal Dementia (FTD)

54
Q

Is an acute state of brain dysfunction.
Onset is usually abrupt.
Autonomic nervous system is overactive.
Is common in critical care units, postsurgically, or during withdrawal from CNS depressants (e.g., alcohol, narcotics).

A

delirium

55
Q

the progressive failure of many cerebral functions.
Onset is usually gradual.
Progressive dementias produce nerve cell degeneration and brain atrophy.
Age is the greatest risk factor.

A

dementia

56
Q

type of brain disorder caused by a lack of vitamin B-12, or thiamine.

A

Wernicke-Korsakoffsyndrome

57
Q

Rare, autosomal dominant hereditary-degenerative disorder; short arm on chromosome 4

A

hunington disease

58
Q

what is another name for huntingtons disease and where does it affect

A

chorea; basal ganglia

59
Q

originate in the target gland responsible for producing the hormone.

A

primary disorders of endocrine

60
Q

the target gland is essentially normal, but its function is altered by defective levels of stimulating hormones or releasing hormones from the pituitary gland.

A

secondary disorders of endocrine

61
Q

results from hypothalamic dysfunction… both the pituitary and target glands are under stimulated.

A

tertiary disorders of endocrine

62
Q

most common cause of hyperpituitarism

A

pituitary adenoma, or a benign tumor arising from the anterior pituitary*

63
Q

Exaggerated growth of the ends of extremities (fingers, hands, toes, and feet)

A

acromegaly

64
Q

most common cause of acromegaly

A

Growth hormone secreting adenomas

65
Q 
Exaggerated growth of the ends of the extremities (fingers, hands, and toes)
Broad and bulbous nose 
Protruding jaw
Slanting forehead
difficulty swallowing
Kyphosis (hunchback)
sleep apnea
A

acromegaly

66
Q

Acromegaly is commonly caused by: (select all that apply)

A

adenomas -tumor

excessive secretion of growth hormones

67
Q

A child’s body begins changing into that of an adult (puberty) too soon.
Early activation of hypothalamic-pituitary-gonadal gland

A

precocious puberty

68
Q

How do we diagnose precocious puberty?

A

Physical exam
Blood test
Ultrasound

69
Q

function of the thyroid gland

A

take in iodine and convert it into t3 and t4; Combine iodine and the amino acidtyrosineto make T3 and T4.

70
Q

when thyroid hormones t3 and t4 drop too low..

A

pituitary gland responds to make thyroid stimulating hormone - product the hormones

71
Q

p. 778

A

32.1

72
Q

two tests to do for meningitis

A

Kernig and Brudzinski

73
Q

abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest. herniation in brain

A

decorticate posture

74
Q

abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward.

A

decerebate posture

75
Q

inability to synthesize the thyroid hormone, or the deficiency of the thyroid stimulating hormone (TSH) secretion.

A

congenital hypothyroidism

76
Q

why does congenital hypothyroidism happen

A

defect in thyroid anatomy
iodine deficient-not permanent
error in mechanism

77
Q

manifestations of congenital hypothyroidism

A

prolonged jaundice
Respiratory and feeding difficulties
somonlence

78
Q

manifestations of congenital hypothyroidism if it is left untreated.

A

creatinism -teeth delayed, mental retardation, impaired physical growth

79
Q

regulates metabolism

A

t4

80
Q

Health condition where the thyroid is not producing enough hormones, resulting in a slowed metabolic rate

A

acquired hypothyroidism

81
Q

common cause of acquired hypothyroidism

A

Hashimoto thyroiditis: autoimmune disorder where the thyroid gland is destroyed by the immune system

82
Q

Onset of Hashimoto

A

will see goiter before hypothyroidism is evident

83
Q 
Extreme fatigue *
Cold intolerance*
Weight gain despite appetite loss*
Puffy face*
dry skin
constipation 
hoarse voice
A

acquired hypothyroidism

84
Q

Life-threatening condition caused by Hypothyroidism

A

Myxedematous Coma

85
Q

Myxedematous Coma triad

A

hypothermia
fluid and electrolyte imbalance
co2 retention and hypoxemia

86
Q 
A 20-year-old woman presents to the clinic with signs of peripheral edema, short stature, cold intolerance, weight gain, and her mother notices she is having trouble concentrating on her school work. She reports having heavier than normal menstrual cycles over the last few months. What diagnosis would the nurse suspect?  
A: Precocious Puberty 
B: Congenital Hypothyroidism 
C: Hyperthyroidism 
D: Acquired Hypothyroidism
A

acquired hypothyroidism

87
Q

most common cause of hyperthyroidism

A

graves disease and diffuse goiter

88
Q

normal sinus rhythm

A
  1. is it regular?
  2. identify the rate-count the r waves X by 10 to get the heart rate
  3. is there a p for every QRS
  4. QRS wide or narrow?
  5. PR interval is less than .20
89
Q

irregularly irregular

no P waves

A

atrial fib

90
Q

drug to put patient on in atrial fib

A

anticoagulant so that can’t form clots

91
Q

racing heart
shortness of breath
light headed

A

symptoms of atrial fib

92
Q

protruding eyes

A

Ophthalmopathy

93
Q

manifestations of graves disease

A

hyperthyroidism, ophthalmopathy, goiter

94
Q

most common type of hyperthyroidism

A

graves disease

95
Q

Extremely rare form of thyrotoxicosis (excess thyroid hormone in the body)

A

thyroid storm

96
Q 
Tachycardia
Fever (105-106 F)
Persistent sweating
Nausea & Vomiting
Confusion
Agitation
Restlessness
Diarrhea
Unconsciousness
A

thyroid storm- fever is #1

97
Q

PaCO2

A

35-45 respiratory

98
Q

HCO3

A

22-26 metabolic

99
Q

which one is flipped from the rest on ABGs

A

PaCO2 lower numbers are alk and higher are acid

100
Q

A disease characterized by an insufficiency of all hormones produced by the adrenal cortex

A

addison disease

101
Q 
Hyperpigmentation
Hypoglycemia
Weight loss
Hyponatremia
Hyperkalemia
Results in dehydration, weakness, and fatigue
A

addison disease

102
Q

Mrs. Jones presents to the ER with dehydration, weakness, and fatigue. She was diagnosed with Addson Disease. The nurse knows to watch for which lab values? (Select all that apply)

A

hyperkalemia

hyponatremia

103
Q

hypercortisolism from any cause

A

cushings syndrome

104
Q 
buffalo hump 
osteoporosis 
weight gain 
high blood pressure
pink and purple stretch marks 
round face 
copper tone
A

cushing syndrome

105
Q 
Mrs. Jones arrives at the clinic presenting with muscle weakness, thinning of the extremities, and purple striae over her abdomen. Based on these clinical manifestations, you suspect her body may be producing excess amounts of cortisol. As a good clinician, which test would you perform to support this diagnosis? Select all that apply.
A. Saliva test
B. Tensilon test
C. 24-hour urine test
D. BUN test
A

AC

106
Q

Addison’s disease, a condition where the adrenal glands aren’t able to produce even the minimum amount of corticosteroid that the body needs.

A

addisons

107
Q

A life-threatening condition that occurs when there is not enough cortisol being produced

A

acute adrenal crisis

108
Q

causes the adrenal gland to release cortisol

A

ACTH

109
Q

if the pituitary gland is injured then what could happen

A

the reduction of ACTH and therefore reduction of cortisol

110
Q

hypotension
shock
abnormal craving of salt
are the hallmark signs

A

acute adrenal crisis

111
Q 
A patient with known Addison disease presents to the ER after an MVA with nausea, vomiting, hypotension, abdominal pain, and shock. As a nurse, you suspect:
Cushing syndrome
Acute adrenal crisis
Thyroid storm
Myxedematous coma
A

acute adrenal crisis

112
Q

all shocks has signs of

A

hypoeperfusion on cellular level

113
Q

Used to diagnose hyperthyroidism or determine severity of hyperthyroidism

A

t3; elevated levels indicate hyperthyroidism

114
Q

determines how thyroid is functioning

A

thyroid stimulating hormone

115
Q

when TSH levels are elevated

A

t3 and t4 are decreased ; hypothyroidism. low levels of tsh and high levels of t3 t4 is hyperthyroidism

116
Q

thyroid absorbs iodine from the blood to product

A

t3 and t4

117
Q

radioactive iodine uptake test

A

measures how much iodine is in the thyroid

118
Q

Blood levels
24-Hour Urine Cortisol Test
ACTH Stimulation Test
Insulin-Induced Hypoglycemia Test

A

adrenal function tests

119
Q

An increase in ACTH from the pituitary will cause in increase in which hormone?

A

Cortisol

-example of a glucocorticoid released from the adrenal CORTEX

120
Q

people with metabolic syndrome are usually what shape

A

apple

121
Q

metabolic syndrome

A 
waist >35 in women >40 in men 
triglycerides >150
high density lipoproteins <50 women or <40 men 
bp >130/85
fasting plasma >100
122
Q

A state of continuous seizures lasting more than 5 minutes, or second seizure is experienced before the person has fully regained consciousness from the preceding seizure, or a single seizure lasts longer than 30 minutes.

A

status epileptics

123
Q

potential complication of status epileptics

A

respiratory status is compromised so they are concerned about air maintenance

124
Q

hallmark signs of intracranial pressure

A

headache and papillary edema

125
Q

Rare group involve neurons-control VOLUNTARY muscle movement

A

Amyotrophic Lateral Sclerosis

126
Q

who had als

A

lou gehrig and steven hawkings

127
Q

what signs can be elicited by bacterial meningitis

A

kernigs

brudzinski

128
Q

Normal activity of the spinal cord ceases at and below the level of injury; sites lack continuous nervous discharges from the brain

A

spinal shock

129
Q

5 a’s of alzheimers

A

amnesia- memory loss
aphasia- loss of speech
agnosia- can’t recognize things
apraxia- misuse of objects; using shoe for pen
anomia- inability to remember names of things

130
Q

whats the problem in myasthenic crisis

A

bulbar muscles -respiratory muscles -become weak which can lead to artifical airway

131
Q

cause of acromegaly

A

Growth hormone secreting adenomas

NURSING PATHO (16 decks)

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