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Nursing > U6 Cancer, HIV, Burns > Flashcards

U6 Cancer, HIV, Burns Flashcards

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1
Q

Sepsis S/S

A

Fever >101.3
HR 90 BPM
RR >20
Infection

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2
Q

Severe Sepsis S/S

A 
Mottled skin
Decreased UO
Change in mental status
Decrease in platelets
Dyspnea
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3
Q

Septic shock criteria

A

S/S of severe sepsis
PLUS
Extremely low BP

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4
Q

DIC S/S

A 
Pain
Stroke-like appearance
Dyspnea
Tachycardia
Reduced kidney function
Bowel necrosis
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5
Q

DIC tx

A

Anticoagulants (heparin)
Cryoprecipitated clotting factors
FFP

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6
Q

Hypercalcemia early S/S

A

Fatigue
Loss of appetite
NV
Constipation, polyuria

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7
Q

Hypercalcemia more serious S/S

A 
Severe muscle weakness
Loss of DTR
Paralytic ileus
Dehydration
EKG changes
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8
Q

Superior Vena Cava Syndrome

A

SVC is compressed by tumor or clots

Occurs most often in pts with lymphoma, lung cancer, & breast cancer

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9
Q

SVCS early S/S

A

Facial edema esp around eyes

Tightness of shirt collar

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10
Q

SVCS S/S worsening compression

A 
Distended blood vessels
Erythema of upper body
Edema in upper extremities
Dyspnea
Epistaxis
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11
Q

SVCS late S/S

A

Hemorrhage
Cyanosis
Change in LOC
Hypotension

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12
Q

Tumor lysis syndrome

A

Large number of cells are destroyed
Intracellular contents are released faster than body can eliminate them
Very high potassium levels
Large amounts of purines (crystals in kidneys)

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13
Q

Tumor lysis syndrome S/S

A 
NVD
Elevated T wave, wide QRS
HTN
Decreased/absent UO
Flank pain
Hematuria
Seizures
Lethargy
Paresthesias
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14
Q

Tumor lysis syndrome lab results

A

Elevated uric acid
Elevated potassium
Elevated phosphate
Decreased calcium

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15
Q

Tumor lysis syndrome tx

A

Antiemetics
Diuretics (mannitol, allopurinol)
Kayexalate (pulls potassium out)
IV with glucose & insulin

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16
Q

HIV Clinical A

A

Flu-like symptoms
Lymphadenopathy
Sometimes no S/S

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17
Q

HIV Clinical B

A

HIV+ with 1 or more infections that are complicated by HIV

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18
Q

HIV Clinical C

A

HIV+ with accompanying AIDS conditions

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19
Q

HIV 1

A

CD4 at least 500

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20
Q

HIV 2

A

CD4 200-499

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21
Q

HIV 3

A

CD4 < 200

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22
Q

HIV tx HAART

A

Highly active antiretroviral therapy

3 or 4 HIV meds with other antiretrovirals

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23
Q

HIV complications

A

Opportunistic infections
Wasting syndrome
Fluid/electrolyte imbalance
Seizures

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24
Q

Pneumocystis carinii pneumonis (PCP)

A 
Protozoan infection
Most common opportunistic infection
Dyspnea with exertion
Dry cough
Fever/fatigue
Crackles
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25
Q

Toxoplasmosis encephalitis

A 
Protozoan infection
Contact with contaminated cat feces
Undercooked meat
Change in LOC
Headaches 
Fever
Speech, gait, & vision problems
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26
Q

Cryptosporidiosis

A 
Protozoan infection
Intestinal infection
Mild diarrhea to severe wasting
Electrolyte imbalance
Diarrhea may cause fluid loss of 15-20 L/day
27
Q

Candida Albicans

A 
Fungal infection
Normal flora of GI tract
Food tastes funny
Mouth pain
Difficulty swallowing
28
Q

Tuberculosis

A 
Bacterial infection
Cough
Dyspnea
Chest pain
Chest x-ray
Sputum culture
29
Q

Kaposi’s sarcoma

A

Most common malignancy
Small, purplish-brown, raised lesions
Occur anywhere on body
Not painful or pruritic

30
Q

Pneumonia

A 
Bacterial infection
HIV & 2+ episodes of pneumonia in 1 yr is AIDS
Chest pain
Productive cough 
Fever
31
Q

Herpes Simplex

A 
Viral infection
Perirectal, oral, or genital
Numbness/tingling
Chronic lesions
Enlarged lymph nodes
32
Q

Superficial thickness burns

A

Epidermis is injured
Epithelial cells & basement membranes still present
Heals 3-5 days

33
Q

Superficial thickness burns S/S

A 
Redness
Mild edema
Pain
Increased sensitivity to heat
Desquamation 2-3 days
34
Q

Superficial partial-thickness burns

A

Involves entire epidermis
Small blood vessels injured–plasma leakage
Causes blister
Upper 1/3 dermis affected; skin has good blood supply
Heals 10-21 days

35
Q

Superficial partial-thickness burns S/S

A 
Redness
Moist
Blanchable
Increased pain (nerve endings exposed)
Blisters
36
Q

Deep partial-thickness burns

A

Involves entire epidermis
Deeper into dermis
No blister
Heals 3-6 wks

37
Q

Deep partial-thickness burns S/S

A 
Red
Dry
White areas in deeper parts
May or may not blanch
Moderate edema
Decreased pain (nerve endings damaged)
May require skin grafts
38
Q

Full-thickness burns

A

Destruction of epidermis & dermis
Grafting required
Healing time depends on blood supply (wks to mos)

39
Q

Full thickness burns S/S

A 
Hard, dry, leathery eschar
Severe edema
Waxy white, deep red, yellow, brown, or black
No blood supply (avascular)
Decreased sensation
40
Q

Deep full-thickness burns

A

Extends beyond skin into underlying fascia & tissues
Damage & exposure of bones, muscles, tendons
Requires early excision & grafting
May have to amputate

41
Q

Deep full-thickness burns S/S

A

Blackened
Depressed
Absence of sensation

42
Q

Eschariotomy

A

Cut through eschar to relieve discomfort

43
Q

Fasciotomy

A

Cut through eschar & fascia to increase blood flow & improve bleeding

44
Q

Dry heat

A

Open flames

Clothing ignites

45
Q

Moist heat

A

Scalding
Immersion injuries
More common in elderly

46
Q

Contact burns

A

Contact with hot metal, tar, & grease

Deep injuries occur in seconds

47
Q

Chemical burns

A

Dry chemicals should be brushed off skin & clothing

Remove wet clothing

48
Q

Electrical injuries

A

Injuries look small on surface, but internal injuries can be huge

49
Q

Radiation injuries

A

Exposure to large doses of radioactive material

Therapeutic radiation most common

50
Q

Vascular changes

A 
Fluid shift--capillary leak syndrome
1st 12 hrs
Hyperkalemia
Hyponatremia
Hemoconcentration
51
Q

Cardiac changes

A

Initial–cardiac output decreases, HR increases

Later–cardiac output increases

52
Q

Pulmonary changes

A

Direct airway injury
CO poisoning
Thermal injury
Pulmonary fluid overload

53
Q

GI changes

A

Curling’s ulcer–occurs from stress of severe injury due to decreased blood flow & mucosal damage

54
Q

Metabolic changes

A

Hypermetabolism–increased need for 02 & calories

Core temp rises (low grade fever)

55
Q

Resuscitation/Emergent Phase

A

First 24-48 hrs
Assessment (ABCs, head to toe)
Immediate measures to save life (cool, cover, carry)
Assess s/s inhalation injuries
Intubation
Fluid shift–fluid resuscitation for burns over 20%
Isotonic crystalloids (NS or LR)

56
Q

Fluid replacement formulas

A

Calculated from time of INJURY
1st 1/2 given over 1st 8 hrs
2nd 1/2 given over next 16 hrs
4 mL/kg/% Total body surface area burn

57
Q

Acute phase

A

36-48 hrs after burn
Assessment & maintenance of CV & resp systems
Prevent infection (tetanus shot, antibiotics)
Debridement
Antimicrobials (silvadene–may cause leukopenia)
Dressings
Grafting
Pressure garments

58
Q

Open dressing

A

Open to air but covered with antimicrobial ointment

59
Q

Closed dressing

A

Antimicrobial with gauze
May be kept wet or dry
Changed BID

60
Q

Autograft

A

Permanent skin coverage

Healthy skin removed from victim & applied to burn

61
Q

Homograft/allograft

A

Human skin harvested from cadaver
Usually rejected 2-3 wks
Temporary to allow site to heal

62
Q

Heterograft/xenograft

A

Skin from another species, usually pig

High infection rate–silver nitrate

63
Q

Support/pressure garments

A

Applied 5-7 days after graft

Wear 6mo-1yr

64
Q

Rehabilitative phase

A

Begins when most of burn is healed
Ends when reconstructive & corrective procedures are complete
May last for years

Nursing (9 decks)

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