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Nursing > U6 Cancer, HIV, Burns > Flashcards

U6 Cancer, HIV, Burns Flashcards

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
Toxoplasmosis encephalitis
``` Protozoan infection Contact with contaminated cat feces Undercooked meat Change in LOC Headaches Fever Speech, gait, & vision problems ```
26
Cryptosporidiosis
``` Protozoan infection Intestinal infection Mild diarrhea to severe wasting Electrolyte imbalance Diarrhea may cause fluid loss of 15-20 L/day ```
27
Candida Albicans
``` Fungal infection Normal flora of GI tract Food tastes funny Mouth pain Difficulty swallowing ```
28
Tuberculosis
``` Bacterial infection Cough Dyspnea Chest pain Chest x-ray Sputum culture ```
29
Kaposi's sarcoma
Most common malignancy Small, purplish-brown, raised lesions Occur anywhere on body Not painful or pruritic
30
Pneumonia
``` Bacterial infection HIV & 2+ episodes of pneumonia in 1 yr is AIDS Chest pain Productive cough Fever ```
31
Herpes Simplex
``` Viral infection Perirectal, oral, or genital Numbness/tingling Chronic lesions Enlarged lymph nodes ```
32
Superficial thickness burns
Epidermis is injured Epithelial cells & basement membranes still present Heals 3-5 days
33
Superficial thickness burns S/S
``` Redness Mild edema Pain Increased sensitivity to heat Desquamation 2-3 days ```
34
Superficial partial-thickness burns
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
Superficial partial-thickness burns S/S
``` Redness Moist Blanchable Increased pain (nerve endings exposed) Blisters ```
36
Deep partial-thickness burns
Involves entire epidermis Deeper into dermis No blister Heals 3-6 wks
37
Deep partial-thickness burns S/S
``` Red Dry White areas in deeper parts May or may not blanch Moderate edema Decreased pain (nerve endings damaged) May require skin grafts ```
38
Full-thickness burns
Destruction of epidermis & dermis Grafting required Healing time depends on blood supply (wks to mos)
39
Full thickness burns S/S
``` Hard, dry, leathery eschar Severe edema Waxy white, deep red, yellow, brown, or black No blood supply (avascular) Decreased sensation ```
40
Deep full-thickness burns
Extends beyond skin into underlying fascia & tissues Damage & exposure of bones, muscles, tendons Requires early excision & grafting May have to amputate
41
Deep full-thickness burns S/S
Blackened Depressed Absence of sensation
42
Eschariotomy
Cut through eschar to relieve discomfort
43
Fasciotomy
Cut through eschar & fascia to increase blood flow & improve bleeding
44
Dry heat
Open flames | Clothing ignites
45
Moist heat
Scalding Immersion injuries More common in elderly
46
Contact burns
Contact with hot metal, tar, & grease | Deep injuries occur in seconds
47
Chemical burns
Dry chemicals should be brushed off skin & clothing | Remove wet clothing
48
Electrical injuries
Injuries look small on surface, but internal injuries can be huge
49
Radiation injuries
Exposure to large doses of radioactive material | Therapeutic radiation most common
50
Vascular changes
``` Fluid shift--capillary leak syndrome 1st 12 hrs Hyperkalemia Hyponatremia Hemoconcentration ```
51
Cardiac changes
Initial--cardiac output decreases, HR increases | Later--cardiac output increases
52
Pulmonary changes
Direct airway injury CO poisoning Thermal injury Pulmonary fluid overload
53
GI changes
Curling's ulcer--occurs from stress of severe injury due to decreased blood flow & mucosal damage
54
Metabolic changes
Hypermetabolism--increased need for 02 & calories | Core temp rises (low grade fever)
55
Resuscitation/Emergent Phase
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
Fluid replacement formulas
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
Acute phase
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
Open dressing
Open to air but covered with antimicrobial ointment
59
Closed dressing
Antimicrobial with gauze May be kept wet or dry Changed BID
60
Autograft
Permanent skin coverage | Healthy skin removed from victim & applied to burn
61
Homograft/allograft
Human skin harvested from cadaver Usually rejected 2-3 wks Temporary to allow site to heal
62
Heterograft/xenograft
Skin from another species, usually pig | High infection rate--silver nitrate
63
Support/pressure garments
Applied 5-7 days after graft | Wear 6mo-1yr
64
Rehabilitative phase
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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