1-16 Flashcards
1
Q
Describe Celiac Disease
A
- Lining of the small intestine, intolerant of gluten.
- (avoid BROW) Barley, Rye, Oat, Wheat
2
Q
Where is celiac disease more pronounced
A
- duodenum
- jejunum
3
Q
S/S celiac
A
- abd pain
- distention
- diarrhea (pale, greasy, bulky, foul)
4
Q
Malnutrition complications of celiac
A
- rickets
- occult blood
- anemia (early bleeds and/or bruises)
5
Q
Imbalances that can be caused by celiac include hypo_____ and hypo_____
A
- hypomagnesemia
- hypocalcemia
6
Q
s/s of hypomagnesemia and hypocalcemia
A
- irritability
- tremors
- convulsions
- tetany (muscle spasms)
- bone pain
- osteomalacia (softening of bones)
7
Q
_____ lab is associated with celiac disease
A
IgA
8
Q
how to dx celiac
A
small intestine biopsy via endoscopy
9
Q
**normal lab value of IgA-tTg
A
0 - 3 U/mL, or 0.00 - 100.00 ug/g
10
Q
**normal lab value of total IgA
A
80 – 350 mg/dL
11
Q
**What is Sjogren’s syndrome
A
disorder of your immune system identified by its two most common symptoms: dry eyes and mouth
12
Q
Sjogren’s syndrome is mostly in _____ _____
A
older women and primary those with Rheumatoid arthritis or SLE (Systemic lupus erythematosus)
13
Q
How to test for Sjogren’s syndrome
A
SSA+ and SSB+ antibody test
14
Q
What affect does cinnamon have on these:
- _____ BG
- _____ cholesterol
- _____ HTN
- _____ risk for bleeding
A
↓ blood glucose
↓ cholesterol
↓ hypertension
↓ risk for bleeding
15
Q
Nursing considerations for cinnamon
A
- no breastfeeding
- no DM drugs/anticoagulants/heart meds
16
Q
Bodily affects from Gingko Biloba
A
↓ dementia
↓ erectile dysfunction
↑ bleeding
↓ seizure threshold
17
Q
What is glucosamine used for
A
osteoarthritis
18
Q
Perks of green tea
A
- lose weight
- mental clarity
19
Q
Green tea can cause _____ and _____ effects of warfarin
A
hepatotoxicity
decrease
20
Q
what meds to avoid when taking green tea
A
- vasodilators
- stimulants
- psychoactive meds
21
Q
Perks of lavender
A
↑ relaxation
↓ anxiety, stress, and insomnia
22
Q
Adverse affects of lavender
A
- constipation
- HA
- ↑ appetite
- may ↓ BP
23
Q
what meds to avoid when taking lavender
A
- BP meds
- depressents
24
Q
What is Saw Palmetto used for
A
BPH
25
What is Kava used for
anxiety
| *can be hepatotoxic*
26
Is comfrey PO okay
NO!! can cause sever liver poisoning
It's a topical cream
27
What is Ma Huang/Ephedra/Ephedrine
stimulant, helps with asthma and bronchitis
28
**What is Hypoplastic Left Heart Syndrome (HLHS)
birth defect where you're born with an open foramen ovale and ducturs arteriosus
↓ developed L ventricle & ↓ developed valves (mitral, aortic) (hole between L&R atria)
- ASD
- PFO
29
Survival rates of HLHS
3-5y is 70% with Stage 1 repair, 90% survival once they hit 12 months
30
Tx of HLHS
- surgery
| - fetal shunts
31
testing of HLHS
- prenatal ultrasound and echo
| - after birth s/s (after ductus arteriosus & foramen ovale close)
32
Tx for HLHS. Describe patent ductus arteriosus
- Stage 1 at <2 weeks (Norwood): shunt to pulm artery created (from aorta to R ventricle)
- Stage 2: shunt removed at 4-6 months
33
Tx for HLHS. Describe patent foramen ovale (PFO)
hole connecting R atrium to L atrium closed
34
Tx for HLHS. Describe Stage 3 (Fontan) at 18-36 months
IVC connected to Pulm artery, hole made from the IVC conduit attached to the right atrium
35
s/s of HLHS
- tachypnea
- SOB
- ↑HR (or pounding heart)
- poor sucking/feedings
- poor extremity blood flow (cold and cyanotic, clammy)
- weakness
36
Medications for HLHS
- tube feedings
- meds to strengthen heart muscles
- ↓ BP
- diuretics
37
**What does parathyroid secrete
regulates serum Ca+
38
↑ PTH hormone released = ↑ _____ released from the bones into the bloodstream, _____ density/hardness.
Ca+
| ↓
39
Hyperparathyroidism s/s
- low PTH (because excess was released into the blood)
- osteoporosis
- kidney stones
- ↑ urination
- abd pain
- fatigue
- fortgetfullness
- bone/joint pain
40
What are calicimimetics used for
to help bones retain calcium
41
What are calicimimetics used for
slow/prevent bone loss
42
Hypoparathyroidism s/s
- high PTH (because not released into bloodstream)
- low T3/T4
- parasthesia
- muscle cramps
- mood changes
- dry/rough skin
- twitching facial muscles
43
Tests for hypo/hyperparathyroid
- ultrasound
- bone densitometry
- body CT/MRI
44
normal Ca+ lab levels
8.6-10.3
45
normal PTH lab levels
11-51
46
what is Hutchinson-Gilford Progena Sx
genetic, rapid aging (10x faster)
- no cure
- appears by age 2 (live to 13 avg, up to 20 years)
47
Hutchinson-Gliford Progeria Sx:
| - _____ gene protein mutation (protein-______): causing...
- LMNA
- progerin
- causing cells to die prematurely
48
s/s Hutchinson-Gliford Progeria
- slow growth (height, hair)
- alopecia
- joint abnormalities
- wrinkles
- dry skin
- FTT
- delayed tooth development
49
**Treatment of Hutchinson-Gliford Progeria
- NSAIDS
- Statins
- Bone health meds
- OT/PT
50
Treatment of Diabetic Neuropathy
- gabapentin/neurontin
- duloxetine/cymbalta
- pregabalin/lyrica
51
What is hydrotherapy used for
MS and MG
52
**Pneumothorax vs hemothorax
- both decrease lung sounds
- pneumothorax: air between lungs and chest cavity = ↑ percussion
- hemothorax: blood between lungs and chest cavity = ↓ percussion
53
Describe tension pneumothorax
- mediastinal shift
- ↓ CO
- ↑ HR
54
Tx of Pneumothorax or hemothorax
chest tube thoracostomy
55
**_____ PPD induration = positive
- >5mm immunocompromised
- >10mm for high risk/from countries with TB, prisons, nursing homes, etc.
>15mm everyone
56
Other than PPD, test for TB
- chest xray
- CT scan
- looking for white spots in lungs or immune system walls of TB
57
**Meds for TB
- isoniazid
* *- Rifampin (avoid oral contraceptives)
- Ethambutol
- Pyrazinamide
58
If BCG vax gi en for TB, PPD is expected to be _____ but not positive
>10mm
59
normal TSH labs
- 0.5-5
| - With treatment: 0.5-4
60
normal T3 labs
80-220
61
normal T4 labs
5-12
62
**What 2 autoimmune diseases cause thyroid peroxidase antibodies (TPO)
- hashimotos (hypothyroidism)
| - graves disease (hyperthyroidism
63
Describe Hashimotos
- ↑ TSH
- high thyroglobulin (Tg)/TPO
- initial high T3 then low T3
64
hyperthyroidism causes _____ TSH and high _____
- low TSH
| - high T4/T3
65
s/s hyperthyroidism
- thyrotoxicosis
- ↑ HR/dysrhythmia/angina
- weakness/atrophy
- ↑ metabolic rate/appetite
- warm/moist skin
- ↑ body temp = heat intolerance
- stimulatied CNS = nervousness, insomnia, rapid though flow, rapid speech
66
**hypothyroidism causes _____ TSH and low _____
- high
| - low T3/T4
67
s/s hypothyroidism
- pale/puffy/expressionless face
- cold/dry skin
- brittle hair loss
- ↓ HR/temp = cold intolerance
- lethargy
- fatigue
68
Tx of hyperthyroid
- propylthouracil (PTU)
- Methimazole (Papazole)
- iodine
- BB's
69
Explain thyroid storm
- death 48 hrs from internal stress
- post-thyroid surgery
- High T4 T3 levels from stress s/s
- atrial tachy dysrhythmias
70
Chrohn's vs Ulcerative Colitis
- Chrohn's: inflammation/scarring of all digestive tract (generally just small intestines)
- Ulcerative Colities: chronic inflammation of large intestine and rectum
71
patients wil atopic dermatitis/eczema are at _____ risk of IBD
increased
72
s/s chrohn's
- skip lesions (cobblestones)
- intestinal bleeding/diarrhea/crampin
- fistula
- fissure
- ileus
- mouth ulcers
- pain worse after eating
- naval pain or ↓ abdomen
- malabsorption = anemia
73
Tests for Chrohn's
- ASCA protein
- CBC
- H/H
- occult bleeding test
- CRP
- ESR inflammation
- electrolytes for constant diarrhea
- iron &/or B12 absorption
74
Meds for chrohn's disease
- aminosalicylate
- sulfasalazine
- mesalamine
- IV corticosteroids for 3-10 days/oral steroids for exacerbation
- abx to manage intestinal bacterial overgrowth
- Immunosuppressive therapy: methotrexate
75
Diet for chrohn's disease
- low residue/fiber
- low fact
- probiotics
- avoid caffeine/alcohol (dehydration), sharp edges/large grains
76
s/s ulcerative colities
- diarrhea (blood/pus)
- cramping
- rectal pain/bleedings
- urgency plus inability to defecate
- wt loss
- fatigue
- fever
- FTT
77
tests for ulcerative colities
- pANCA
| - WBC in stool
78
diet for ulcerative colitis
- avoid dairy, big meals, alcohol, caffeine
79
meds for ulcerative colitis
- anti-inflammatories
- corticosteroids
- immune system suppressors
- anti-diarrheals
- antispasmodics
- iron supplements
80
Newborn sickle cell:
- _____ risk for pneumonia d/t non-functional _____ and _____ immune response
- infants are _____
- _____/_____ damage
- cries from pain
- ↑ risk
- non-functional spleens
- ↓ immune response
- infants = anemic
- speel/liver damage
81
Sickle cell crisis:
1.
2.
3.
1. vaso occlusive dactylitis
2. splenic sequestration
3. aplastic crisis
82
s/s vaso occlusive dactylitis
- severe pain/swelling in hands/feet
- back/chest pain
- fever
83
how to treat vaso occlusive dactylitis
- IV fluids
- pain meds
- transfusion high glow O2
84
what is splenic sequestration
- _____ in hemoglobin
- _____ shock
- seen in _____
- acute painful enlargement of spleen
- drop in hemoglobin
- hypovolemic shock
- seen in CT
85
s/s aplastic crisis:
- sudden _____
- _____ hemoglobin levels
- reticulocytopenia (_____)
- sudden pallor & weakness
- dropping hemoglobin levels
- reticulocytopenia (low immature RBCs)
86
Prevention of sick cell
- hydrate
- avoid being too hot or cold
- avoid high altitudes with low O2
87
**Tx sickle cell
- pain meds
- hydration
- O2
- hydroxyurea (prevents abn RBCs)
- avoid iron meds
- PCN prophylaxis for newborns
* *- don't give diuretics
88
sick cell prevention in infants
- vaccines
- abx
- folic acid
- regular eye exams
89
**UTI meds: pregnancy & pediatrics safe
Pregnancy:
- fosfomycin (Monurol)(one-time dose)
- Floxin
- PCN
- Nitrofurantoin
Pediatrics Safe:
* *- Bactrim (Trimethoprim-Sulfa)
- Augmentin
- Cephalosporins
- Suprax
- Cefzil
- Keflex
- if vomiting = IV dose cephalosporins
90
Negative s/s schizophrenia:
- anhedonia (inability to feel pleasure)
- alogia (no speech)
- avolition (no motivation)
91
first generation meds for schizophrenia
- for positive s/s
- -dazine
- chlorpromazine
- haldol
- modecate
92
side effects of 1st gen schizophrenia meds
extrapyramidal symptoms:
- dystonia (spasms/muscle contractions)
- akathisia (restlessness)
- parkinsonism (rigidity)
- bradykinesia (slow movement)
- tardive dyskinesia (jerky movement)
- antimuscarinic effects (dry mouth, constipation, blurred vision, urinary retention)
- alpha-1 receptor antagonism (orthostatic hypotension)
- histamine antagonist (wt gain, sedation)
93
2nd generation meds for schizophrenia
- for pos & neg symtpoms
- risperdal
- abilify
- zyprexa
- seroquel
- ziprasidon (geodon)
94
side effects of 1st gen schizophrenia meds
- dry
| - metabolic side effects (↑ gain, Dyslipidemia, Hyperglycemia)
95
vitamins that may help schizophrenia
- folic acid
| - thiamine (B vitamine)
96
**What is tamsulosin (fosamax) used for
BPH
- relaxas muscles
- alpha-1 antagonist (hypotension education!!!!!)
