Unit 2 Flash cards
What disease is caused by the obstruction in the common bile duct causing bile to back up or be inflammed?
Cholecystitis
What are some clinical manifestations for cholecystitis?
Pain with movement lasting 4-6 hrs
N/v
Fever
Heart burn/ indigestion/ flatulence
Jaundice
Elevated pulse and rr
What are some modifiable factors associated with cholecystitis?
Oral contraceptives (estrogen)
Obesity
Diabetes
Liquid protein diet
Rapid weight loss
What are some non modifiable factors associated with cholecystitis?
Female
Fertile
Fair
What are some diagnostic testing for cholecystitis?
WBC count
Bilirubin
Liver enzyme
Serum amylase
Lipase count
Ct, MRCP, HIDA scan, ULT
What are the nursing priorities for a patient with cholecystitis?
Acute pain
Ineffective breathing
Risk for impaired skin integrity
what are the therapeutic measures for cholecystitis?
Pain control
Laparoscopic or open cholecystectomy
LOW FAT DIET
Elevate hob
What are some low fat diets for cholecystitis ?
Veggies, fruits , lean meats and fish, low fat dairy products
How should a low fat diet patient cook their meats??
Grill, boil or steam without skin on poultry
Hardened deposits w/in the fluid in the gallbladder are associated with what disease?
Cholethiasis
What are some manifestations of Cholethiasis ?
RUQ pain radiating to shoulder
Pain beginning after a fatty meal lasting 1-3 hrs
Jaundice
Fever;N/v
What are some teaching to recommend after cholecystectomy?
Low fat diet; avoid gassing forming foods
Report pain, fever, foul odor or jaundice
Resume activity gradually; avoid lifting for 4-6 weeks after sx
The nurse recognizes which as factors for cholecystitis? SATA
A.Obesity
B.Male
C.Female
D.African American descent
E. European descent
A.Obesity
C.Female
E. European descent
The nurse correlated which clinical manifestation with Cholecystitis ?
A. Retroperitoneal pain
B. Absence of bowel sounds
C. Diarrhea
D. RUQ pain
D. RUQ pain
The inflammation of the glomeruli within the bowman’s capsule of the kidney triggered by an immunological mechanism is the sign of what disease?
Glomerulonephritis
What is the etiological process in Glomerulonephritis?
A. Tubular necrosis caused by bacteria and antibody reactions
B. Deposition of immunological completes and complement along the GBM
C. Deposition of bacteria and immunological components within the loop of Henle
D. Destruction of proteolytic enzymes contained in the GBM
B. Deposition of immunological completes and complement along the GBM
What are some clinical manifestation of Glomerulonephritis?
**Protein and blood in urine **
WBC ^
Edematous.
Decreased urine output
HTN
Elevated BUN/Creatinine
What is the treatment option for Post streptococcal Glomerulonephritis?
Antibiotics mainly penicillin
Other treatment options given for Glomerulonephritis other than antibiotics?
Diuretics/ other Hypertensives
Sodium/ fluid restriction- Edema
Plasmapheresis- to txt immune triggered inflammation
If Glomerulonephritis is not treated in acute it can lead to what ?
Renal failure in weeks - months
What are some nursing diagnosis for Glomerulonephritis?
Impaired urinary elimination
Ineffective therapeutic regimen management
What are some teachings for the patient and or family related to Glomerulonephritis?
Overview the disease process- S/s associated with disease
Medication adherence
Dietary restrictions
Avoid infections
Plaque within the lumen of the vessels causing obstruction to blood flow is known as what disease
Atherosclerosis
What are some risk factors for developing atherosclerosis?
Cigarette smoking
High LDL
HTN
Diabetes
Obesity
Excessive alcohol consumption
What is the primary treatment for atherosclerosis?
Lipid lowering medications
What are other treatments for atherosclerosis?
Dietary modifications
Smoking cessation
HTN management
Anticoagulant medication
Reduce stress
What is a another form to treat atherosclerosis once manifestations have become irreversible?
PTCA (percutaneous transluminal coronary angioplasty) - stent
CABG (coronary artery bypass graft)
What are some cues to recognize in atherosclerosis in the coronary arteries?
Chest pain
SHOB
Fatigue
What are some cues to recognize of atherosclerosis in the peripheral vascular system ?
Severe pain
Difficulty walking
What are some actions the nurse should take with a patient who is showing signs of atherosclerosis?
Assess BP in both arms
Palpate major pulse sites and note differences
Auscultate for bruits
Monitor labs
What is some teaching considerations for atherosclerosis?
Management of chronic disease
-diabetes, HTN
Adhere to medication regimen
Follow up with pcp
Lifestyle changes
- Low-fat, low-cholesterol diet
*B-complex vitamin supplements if no contraindication
*Smoking cessation
*Exercise plan
*Weight loss
*Reduce/Manage stress
A PATIENT WITH ATHEROSCLEROSIS ASKS WHY SMOKING CESSATION IS IMPORTANT. HOW SHOULD THE NURSE RESPOND TO THIS CLIENT?
1.Tobacco toxins increase your HDL-C.
2.Tobacco reduces the effects of cholesterol in the body.
3.Tobacco causes the BP to drop and changes the cells within the arteries.
4.Tobacco smoke speeds the growth of atherosclerosis in coronary arteries, the aorta, and the legs.
4
THE NURSE IS PREPARING TEACHING MATERIAL TO HELP A CLIENT WITH ATHEROSCLEROSIS MANAGE LIFESTYLE CHANGES. WHAT SHOULD THE NURSE EMPHASIZE IN THIS TEACHING?
1.You need to limit cigarette smoking.
2.You need to follow a low-fat, low-cholesterol diet.
3.You should consider adopting an active lifestyle.
4.You may have dizziness at times, which is expected
2
IN REVIEWING LAB DATA FOR A CLIENT, WHICH VALUES ARE CONSISTENT WITH A DIAGNOSIS OF ATHEROSCLEROSIS? SELECT ALL THAT APPLY
1.Decreased homocysteine levels.
2.HDL-C 30mg/dL
3.LDL-C 120 mg/dL
4.Triglycerides 175 mg/DL
5.HgbA1c 5%
2
3
4
Elevated lipid levels in the blood ?
hyperlipidemia
What are risk factors for hyperlipidemia?
Genetics
High fatty foods
Can start at an early age
What are some treatments for hyperlipidemia ?
Low fat , low cholesterol diet
Lipid lowering medications
Lifestyle changes
What are some cues to recognize with HTN ?
headache
Chest pain
Vision changes
SHOB
Renal dysfunction
Dizziness
Fatigue
Nosebleeds
How is HTN diagnosed ?
two or more elevated BP readings on more than two office visits
Renal test
Endocrine test
Metabolic test
What are some complications to HTN
systolic dysfunction
Dilated cardiomyopathy
Renal failure
Stroke
HTN crisis
What are some lifestyle changes for HTN
Dash diet
Moderate exercise
Stress reduction
Smoking cessation
Other teaching for htn
Adhere to medication
Monitor BP at home
S/s of target organ damage stroke
A PATIENT’S BLOOD PRESSURE IS 140/86 MM HG; HOWEVER, PREVIOUS MEASUREMENTS HAVE BEEN WITHIN NORMAL LIMITS. THE PATIENT DENIES ANY OTHER COMPLAINTS. WHICH INTERVENTION WOULD BE APPROPRIATE FOR THIS PATIENT?
*REFER CLIENT TO THE ED FOR TREATMENT.
*PREPARE TEACHING ON ANTIHYPERTENSIVE MEDICATIONS.
*SCHEDULE AN ADDITIONAL MEASUREMENT IN A FEW WEEKS.
*INSTRUCT ON THE EFFECTS OF HTN ON MAJOR BODY ORGANS.
SCHEDULE AN ADDITIONAL MEASUREMENT IN A FEW WEEKS.
THE NURSE PROVIDES EDUCATION TO A PATIENT WHO IS PRESCRIBED THE DASH DIET. WHICH PATIENT STATEMENT INDICATES A NEED FOR ADDITIONAL TEACHING?
*I WILL EAT FOUR SERVINGS OF FRUIT EACH DAY.
*I WILL EAT ONE SERVING OF NONFAT DAIRY EACH DAY.
*I WILL EAT FIVE SERVINGS OF VEGETABLES EACH DAY.
*I WILL EAT A T LEAST THREE WHOLE-GRAIN FOODS EACH DAY.
I WILL EAT A T LEAST THREE WHOLE-GRAIN FOODS EACH DAY.
IN PROVIDING CARE TO A PATIENT WHO IS DIAGNOSED WITH HYPERTENSION, WHICH ASSESSMENT DATA ARE RISK FACTORS FOR THIS DISEASE PROCESS? SELECT ALL THAT APPLY.
*CURRENT AGE 45 YEARS OLD.
*BODY MASS INDEX OF 28 KG/M2
*HISTORY OF CIGARETTE SMOKING
*GFR 58 ML/MIN
*CONCURRENT DIAGNOSIS OF DIABETES MELLITUS
CURRENT AGE 45 YEARS OLD.
*BODY MASS INDEX OF 28 KG/M2
*HISTORY OF CIGARETTE SMOKING
*CONCURRENT DIAGNOSIS OF DIABETES MELLITUS
What does right heart failure affect in the patient?
Right sided rocks the body
What does left sided heart failure affect in the patient?
Left sided affects lungs
What are the clinical manifestations of right sided heart failure?
** think swelling**
Swelling of hands and feet
Weight gain
Edema (pitting)
Large neck veins (JVD)
Lethargy/fatigue
Irregular heart rate
Nocturia
Girth (ascities)
Hepatomegaly
Splenomegaly
What are some clinical manifestation of Left sided heart failure ?
* Left hurt Lungs
** Think left drowning**
Dyspnea
Rales ( Crackles)
Orthopnea
Weakness/fatigue
Nocturnal proxsymal Dyspnea
Increased HR
Nagging cough ( pink, frothy sputum)
Gaining weight (2-3 lbs a day)
Pallor
Weak pulses
Delayed capillary refill
what should the nurse prioritize in a patient with heart failure?
Impaired oxygen
Decreased cardiac output
Excess fluid volume