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special considerations > Patient Special Challenges > Flashcards

Patient Special Challenges Flashcards

1
Q

what is conductive deafness?

A

very common: Blockage of transmission of sound waves through external ear canal to the middle or inner ear (otitis media, cerumen (earwax), hair spray, bugs, etc.).

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2
Q

otitis media

A

inflammation of inner ear

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3
Q

cerumen

A

ear wax

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4
Q

can hair spray and bugs effect your hearing?

A

yes

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5
Q

Sensorineural deafness

A

Nerve Damage, Hair Cells in the Cochlea are damaged or destroyed (inner ear).

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6
Q

what is a big thing that can cause meningitis?

A

ear infections

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7
Q

Presbycusis

A

high pitched sounds first (age related hearing loss)

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8
Q

any acute onset of sensory loss what should we think?

A

Stroke

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9
Q

ski slope hearing test

A

start high and go to low hearing sounds

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10
Q

cookie bite

A

can hear high and low sounds but not sound in the middle.

A lot of hearing aids will be for this hearing loss

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11
Q

what meds can cause hearing loss?

A
  • lasex (pushed too fast)
  • ASA (asprin)
  • antibiotics
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12
Q

can medication change cause hearing loss?

A

yes

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13
Q

what is deafness?

A

Deafness is caused by the inability of nerve impulses to reach the auditory center of the brain because of nerve damage to either inner ear or to brain.

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14
Q

what are 3 causes that can cause deafness?

A
  • Brain injury (CVA) can cause the damage stopping the translation. Acute change on one side could be an indication.
  • Can be caused by meds.
  • Strokes
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15
Q

Cochlear implant

A

mounted on back of head behind ear. Goes into auditory nerve, picks up vibration from skull and it turns into sound.

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16
Q

What is normal vision?

A

normal vision depends on the uninterrupted passage of light from the front of the eye to the light-sensitive retina at the back

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17
Q

What can cause visual changes?

A 
- diseases 
(diabetes)
-congenital conditions
- infections
- degenerative disorders
- Enucleation
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18
Q

Macular Degeneration

A

causes loss in the center of the field of vision. Will see a dark spot in the middle of their vision. These pt will use their peripherals to see (so look off to the side)

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19
Q

Retinopathy

A

Disease of the Retina

causes can be from diabetes

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20
Q

what is vision loss?

A

Any condition that obstructs the passage of light from the retina can cause vision loss

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21
Q

Is acute eye loss an emergency?

A

YES

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22
Q

Diplopia

A

Double vision

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23
Q

Presbyopia

A

Age related Vision impairment.

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24
Q

Receptive aphasia (sensory)

A

process of losing the ability to understand the meaning of the spoken word, the ability to interpret objects, or understand the written word.

Stroke pt can have this

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25
Q

Expressive aphasia (motor)

A

Can’t figure out the right words. Might give you social security number instead of phone number you asked for- “word salad”

Stroke pt.
Drunk Pt. (sedated, signals not making connections)
Cancer pt.

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26
Q

Global aphasia

A

Both sensory and motor combined, cannot communicate at all

NOTHIN WORKS

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27
Q

phasia

A

s- for speech

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28
Q

plagia

A

g- gut (eat)

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29
Q

articulation dysarthria

A

Know want to say, but musculoskeletal system will not let mouth say it. Physically cannot make words (The loss of function of your tongue)

Word creation is from the mouth and tongue

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30
Q

fluency disorders

A

stuttering

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31
Q

dysarthria.

A

Loss of the ability to form words

“can’t treat an old dog new tricks”

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32
Q

Any acute change in speech is considered?

A

A medical emergency

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33
Q

accommodations with speech problems

A
  • Never assume the person lacks intelligence.
  • Form questions that require short, direct, answers.
  • Never pretend to understand when you don’t.
  • Let the patient write answers to questions.
  • Always rule out other medical conditions.
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34
Q

Obesity

A

40% of people in the US are obese

35
Q

why are people obese?

A
  • slow metabolism
  • excessive caloric intake
  • lack of exercise
  • metabolic disorder

the top two are excessive caloric intake and lack of exercise.

36
Q

What are some serious medical issue with obesity?

A
  • MI
  • Diabetes
  • Hypoxie
  • sleep apnea
37
Q

Paraplegia

A

full or partial paralysis of both legs and sometimes part of the trunk.

38
Q

Quadriplegia

A

full or partial weakness or paralysis of all four extremities and the trunk

39
Q

Tetraplegia

A

paralysis of the diaphragm with quadriplegia- must be on vent

40
Q

what causes paralysis?

A

Caused by nerve damage in the brain and spinal cord.

41
Q

when moving a tetraplegia pt what is something you should be careful about when moving them?

A

the vent cord

42
Q

what are the top two things that paralysis pt get medically?

A
  • UTI

- pnemonia

43
Q

halo traction

A

Halo-gravity traction is a method of gently stretching and straightening a severely compressed or curved spine.

seen a lot with cervical spine injury.

difficult to do CPR (can’t without removing the device) there is special way to remove it.

44
Q

What can traumatic brain injury cause?

A
  • cognitive injury
  • physical injury
  • psychological skills
45
Q

Down Syndrome

A

Trisomy 21 (there is an extra chromosome on #21)

  • abnormality and developmental delays, mild to severe mental retardation
  • large tongue
  • congenital heart disease (40-50%)
  • immunological deficiency (prone to infection)
  • epilepsy
  • 20% unstable atlantoaxial joint (complex joint between the atlas (C1) and the axis (C2).)

Treatment: get a good history and check the status of cognitive status.

46
Q

Patau Syndrom

A

Trisomy 13 (there is an extra chromosome on #13)
Multiple developmental abnormalities
1 in 6000 are born
Life longer than 1 year is rare
Most born stillborn, multiple developmental abnormalities

47
Q

Edwards Syndrom

A 
Trisomy 18 (there is an extra chromosome on #18)
- barley make it to age 2
- they have pointed ears
- hand and finger clamped down
Heart defects, 
95% die in 1st year, 
50% die in 1st 2 months
48
Q

Pierre Robin Syndrom

A
  • congenital
  • infant has a smaller than normal lower jaw
  • cleft palate
  • tongue falls back in the throat, choking is a big hazard
49
Q

what is the difference between congenital and genetic?

A

congenital- formed at birth

genetic- based down from genes

50
Q

what did down syndrome used to be called?

A

mongolianism

51
Q

What does mental illness cover

A

refers to any form of psychiatric disorder

52
Q

psychoses

A
  • looses contact with reality
  • biochemical disease that disorders brain function
  • Hallucinations, (auditory and visual)- any perception of a sensation that doesn’t exist-delusions are different-strong belief despite strong evidence to the contrary

Ex:

  • schizophrenia
  • bipolar disorder (manic- depressive illness)
  • organic brain disease
53
Q

What test are there for psychoses and neuroses?

A

There are ZERO test, x-ray, CT, etc… for these Pt’s. Diagnosis is strictly exclusion.

54
Q

what can result as mental illness that has to get ruled out first?

A

Hypothyroidism

55
Q

Hallucinations

A

any perception of a sensation that doesn’t exist-delusions are different-strong belief despite strong evidence to the contrary

56
Q

neuroses

A

person remains “in touch” with reality
Neurotic symptoms generally do not limit work or social activity and tend to fluctuate in intensity with stress.

Ex:

  • depression
  • phobias
  • obsessive compulsive behavior
57
Q

how early do we notice or diagnose Schizophrenia

A

Can present in adolescence stage of life

58
Q

developmentally disabled

A

impaired or insufficient development of the brain that causes an inability to learn at the usual rate.

59
Q

Neurasthenia

A

nervous exhaustion

60
Q

emotionally impaired

A

Persons with emotional impairments include

  • neurasthenia
  • anxiety neurosis
  • compulsion neurosis
  • hysteria
61
Q

what medication is the choice for neuroses?

A

SSRIs

62
Q

Mentally impaired

A

refers to persons who have impaired intellectual functioning (mental retardation) that results in an inability to cope with normal responsibilities of life.

63
Q

Cerebral Palsy (CP) is it a progressive disorder?

A

No, its a non-progressive (doesn’t get better or worse with time)

64
Q

what will cause Cerebral Palsy?

A

Results from damage to the fetal brain during later months of pregnancy, during birth, during the new born period, or in early childhood.

65
Q

What is Mucoviscidosis?

A

Cystic Fibrosis (CF)

66
Q

is cystic Fibrosis genetic or congenital?

A

Genetic (inherited metabolic disease of the lungs and digestive system that manifest itself in childhood)

67
Q

What is Cystic Fibrosis?

A 
increased mucous production 
inability to breakdown fats 
- pancreatic enzymes
failure to thrive
inability to regulate chloride
-causes mucous to become thick like glue like.
68
Q

What is Cystic Fibrosis?

A 
increased mucous production 
inability to breakdown fats 
- pancreatic enzymes
failure to thrive
inability to regulate chloride
-causes mucous to become thick like glue like.

Average life span is around 30.

69
Q

Multiple Sclerosis (MS)

A

a progressive and incurable autoimmune disease of the CNS, whereby scattered patches of myelin in the brain and spinal cord and destroyed

Like stripping a speaker wire, it will slowly make the speaker not work. This is happening with the nerves (the break down of it)

Cause is unknown

70
Q

When does MS begin?

A

usually begins early adult life.

71
Q

Muscular Dystrophy

A

An inherited muscle disorder that results in slow but progressive degeneration of muscle fibers.

72
Q

is Muscular Dystrophy curable?

A

no

73
Q

can you find muscular dystrophy in both male and female?

A

Found in males only

74
Q

What are signs and symptoms of Muscular Dystrophy?

A
  • Toe walking
  • Frequent falls
  • Difficulty rising from a lying or sitting position
75
Q

Poliomyelitis (Polio)

A

An infections disease caused by Poliovirus Hominis

76
Q

how is Poliomyelitis (Polio) virus spread?

A

the virus is spread through direct and indirect contact with infected feces

77
Q

Myasthenia Gravis

A

an autoimmune disorder in which muscles become weak and tire easily

78
Q

Is myasthenia more in woman or men?

A

woman (20-30 yo)

when in men usually 70-80 yo

79
Q

What is osteoarthritis?

A

common wear and tear on the joint.

- its the break down, and a calcification build up, and the joint stops working as well

80
Q

What age group “usually” get Osteoarthritis?

A

commonly in elderly pt

81
Q

Rheumatoid Arthritis?

A

RA is an autoimmune process

A chronic inflammatory disorder affecting many joints, including those in the hands and feet.

82
Q

what is a very lethal thing that can happen to someone with Rheumatoid Arthritis?

A

Silent Heart Attack

83
Q

What should you do if you have a pt that has cancer and you are going in the ambulance with them?

A

have them wear a mask and you wear a mask

special considerations (4 decks)

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