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NURS 2003 > Week 7 > Flashcards

Week 7 Flashcards

1
Q

CM of Ulcerative Colitis

A 
Bleeding
Diarrhea
Loss of fluid and electrolytes
Abdominal pain
Fever
Weight loss
Anemia
Tachycardia
Dehydration
Protein loss
Malnutrition.
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2
Q

Diagnostic Tests for Ulcerative Colitis

A

CBC, serum electrolytes, serum protein, double-contrast barium enema, small bowel series, transabdominal ultrasound, CT, MRI, colonoscopy, sigmoidoscopy, patient history.

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3
Q

Interintestinal Complications of Ulcerative Colitis

A 
Hemorrhage (result of inflammation)
Perforation
Toxic Megacolon
Colonic Dilation
Increased risk for GI cancers
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4
Q

Extraintestinal complications of Ulcerative colitis

A

Joint, skin, mouth, eye disturbances, anemia, leukocytosis, thrombocytosis, skin lesions, uveitis.

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5
Q

What is ulcerative colitis?

A

Inflammatory condition of the bowel. Begins at the rectum and works its way up GI system.

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6
Q

What layers of the intestine does ulcerative colitis involve?

A

Mucosa and submucosa.

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7
Q

Where do abscesses develop in ulcerative colitis?

A

Can develop in the intestinal glands. Abscesses can break and leave ulcerations.

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8
Q

What can inflamed mucosa form as a result of ulcerative colitis?

A

Psuedopolyps in bowel hymen.

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9
Q

What are treatment options for Ulcerative colitis?

A 
Nutritional support
Antimicrobial therapy
Corticosteroids
Antidiarrheal agents
Sulphasazaline
Total proctocolectomy with a permanent ileostomy.
Total proctocolectomy with ileoanal reservoir.
Low residue diet
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10
Q

What ages are people most at risk for ulcerative colitis?

A

15-25 yrs and then again from 50-70 years.

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11
Q

What is Crohn’s disease?

A

Caused by inflammation in GI system. Happens all over. Systematic autoimmune disorder.

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12
Q

What parts of the GI system are most affected by Crohn’s disease?

A

Terminal ileum and colon.

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13
Q

What organs are uncommon to be affected by Crohn’s disease?

A

Esophagus, stomach, and duodenum.

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14
Q

What are skip lesions in Crohn’s disease?

A

Parts of the bowel are infected, with healthy parts in between.

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15
Q

What layers of the bowel does Crohn’s disease affect?

A

All layers.

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16
Q

What percent of patients are granulonmas present in patients with Crohn’s disease?

A

50%

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17
Q

What are the clinical manifestations of Crohn’s disease?

A 
Diarrhea
Fatigue
Weight loss
Abdominal Pain
Abdominal Distention
Finger clubbing and arthritis.
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18
Q

What are some diagnostic tests for Crohn’s disease?

A

History, CBC, ESR, serum chemistries, stool occult, radiological studies, sigmoidoscopy, colonoscopy.

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19
Q

What are some treatments for Crohn’s disease?

A

High calorie, high vitamin, high protein, low residue, dairy-free diet.
Antimicrobial agents, corticosteroid drugs, Immuno-suppressants, element diet, rest, surgery.

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20
Q

What are some risk factors of Celiac disease?

A

Genetic predisposition, gluten ingestion, immune-mediated response.

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21
Q

What is Celiac disease?

A

An autoimmune disease characterized by damage to the small intestinal mucosa. Tissue damage is a result of chronic inflammation.

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22
Q

What is the gene associated with Crohn’s disease?

A

NOD2.

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23
Q

What are some complications of Crohn’s disease?

A 
Narrowing of lumen may cause strictures and obstruction. 
Fistulas
Perforation
Arthritis
Liver disease
Ankylosing spondylitis
Pyoderma gangrenosum
Erythema
Nodosum
Uveitis
Renal disorders
Nutritional abnormalities
Deficiency in fat-soluble vitamins.
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24
Q

What peptide is found in gluten that causes problems in celiac patients?

A

Prolamins. They bind to human leukocyte antigens and activate an inflammatory response.

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25
Q

Where is the damage most severe in celiac patients?

A

Duodenum decreases distally.

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26
Q

What are the clinical manifestations of celiac disease?

A 
Smelly diarrhea
Flatulence
Abdo distention
Malnutrition
Rash may be present. 
Anemia
Calcium and Vit D deficiencies may cause osteoporosis and weak bones.
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27
Q

What are some atypical symptoms of Celiac disease?

A

Decreased bone density, osteoporosis, dental enamel hypoplasia, iron and folate deficiencies, peripheral neuropathy, reproductive problems.

28
Q

How is Celiac diagnosed?

A

Biopsy of small intestine, patient history and symptoms. Histological evidence disappears when gluten-free diet is followed. IGA and tTG lab testing also used.

29
Q

Which diseases are associated with Celiac?

A

Other autoimmune diseases: thyroid disease, T1D, RA.

30
Q

What are potential complications of Celiac?

A

Risk for non-hodgkins lymphoma, chronic inflammation, hyperplasia, GI cancers.

31
Q

What is the treatment for Celiac Disease?

A

Gluten free diet, corticosteroids.

32
Q

What is asthma?

A

Chronic inflammatory disorder of airways.

33
Q

What does asthma cause?

A

Causes airway hyper-responsiveness, leading to wheezing, breathlessness, cough and chest tightness.

34
Q

What are environmental triggers of asthma?

A

Cold air, exercise, air pollutants, emotional stress.

35
Q

What are some allergy triggers of asthma?

A

Dust mites, cockroaches, animals, mold, pollen.

36
Q

What are some respiratory triggers of asthma?

A

Increased inflammation due to hyperresponsiveness of tracheobronchial system.

37
Q

What are some drug/food additives that trigger asthma?

A

Beta-adrenergic blockers, NSAIDS, ASA, sensitivity to salicylates.

38
Q

What is the patho for the early phase of asthma?

A

Characterized by bronchospasm. Peaks 30-60 min after trigger exposure, subsides between 30-90 min after exposure.

39
Q

What are the CM in the early phase of asthma?

A

Increased mucous secretions, edema, increased amount of tenacious sputum.

40
Q

What is the patho for the late phase of asthma?

A

Primarily inflammation, can be more severe. Peaks 5-12 hrs after trigger. May last several hours to days. Can lead to irreversible lung damage if not treated.

41
Q

What is an effective treatment of late-stage asthma?

A

Corticosteroids.

42
Q

What are the clinical manifestations of asthma?

A

Recurrent episodes of wheezing, breathlessness, cough and tight chest.

43
Q

What time is the most common time for an asthma attack to occur?

A

0200 to 0500 hrs in the morning.

44
Q

What are the inspiration to expiration ratios?

A

1:2, 1:3, 1:4.

45
Q

What are some signs that the client is having difficulty with air movement during an asthma attack?

A

Client may be anxious, restless, sitting upright and slightlightly forward.

46
Q

What are the symptoms of cough variant asthma?

A

cought is the only symptom, bronchospams not severe enough to cause obstruction.

47
Q

What hormones are the mast cells releasing when aggravated by allergins?

A

Bradykinin, prostaglandins, luekotrinins,

48
Q

What do goblet cells do?

A

Responsible for mucus production.

49
Q

What are the signs of hypoxemia?

A

Increased anxiety and restlessness, increased pulse and BP, pulsus paradoxus, increased respiratory rate, use of accessory muscles, O2 stat less than 95%, cyanosis, poor tissue perfusion, difficulty speaking.

50
Q

What are the diagnostic tests for Asthma?

A

Detailed history and physical exam, pulmonary function test, peak flow monitoring, chest x-ray (not diagnostic), ABGs, oximetry, allergy testing, blood levels of eosinophils, sputum culture and sensitivity.

51
Q

What is the overall goal of asthma care?

A

Achieve asthma control with minimal pharmocotherapy.

52
Q

What is the green zone?

A

Peak flow results, 80%-100%. Medications continued.

53
Q

What is the yellow zone?

A

50%-79%. Indicates caution, something is triggering asthma.

54
Q

What is the red zone?

A

Less than 60% of personal best. Indicates a serious problem. Action needed.

55
Q

What is COPD?

A

Chronic Obstructive Pulmonary Disorder, a progressive respiratory disorder characterized by airflow obstruction, systematic manifestations, exacerbations of increasing frequency.

56
Q

What is emphysema?

A

enlargement of the airspaces distal to terminal bronchioles. Radiologically defined.

57
Q

What is chronic bronchitis?

A

Mucus gland hyperplasia and airway structure design, clinically defined.

58
Q

What are the major symptoms of COPD?

A

Dyspnea with activity limitation. Mucus production and cough.

59
Q

What are the risk factors for COPD?

A

Smoking, Pollution, Asbestos, alpha-1-antitrypsin deficiency (AAT) (autosomal recessive disorder causing destruction of lung tissue), aging.

60
Q

What is the defining characteristic of COPD?

A

Chronic inflammation.

61
Q

What happens to the body as a result of chronic inflammation in COPD?

A

Inflammation of the brionchioles and alveoli and pulmonary blood vessels cause a) airflow obstruction due to mucus, edema and bronchospasm.
b) airflow limitation due to loss of elastic recoil.

62
Q

What does oxidative stress inactivate and stimulate?

A

Inactivates anti-proteases

Stimulates mucus secretion

63
Q

What type of tissue does protease break down?

A

Connective tissue.

64
Q

Where is protease found?

A

Neutrophils and macrophages.

65
Q

What inhibits proteases?

A

Anti-proteases like AAT.

66
Q

What factor increases proteases and decreases anti-proteases?

A

Smoking.

67
Q

What happens when their is an imbalance of proteases and anti-proteases?

A

Alveolar walls are destroyed.

NURS 2003 (12 decks)

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