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a. Pharm 2 > E3 Concepts > Flashcards

E3 Concepts Flashcards

1
Q

Psychosis

A

Losing contact with reality, happens in many different psychiatric disorders
More than one symptom: difficulty processing information and coming to a conclusion, delusions, hallucinations, incoherence, catatonia, aggressive or violent behavior

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2
Q

Schizophrenia

A

Chronic psychotic disorder, begins in adolescence or early adulthood contains cognitive, positive and negative symptoms

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3
Q

Cognitive symptoms of schizophrenia

A

Disorganized thinking, problems with memory, poor attention span

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4
Q

Positive symptoms of schuzophrenia

A

Exaggeration of normal function: Agitation, delusions, paranoia, hallucinations, incoherent speech

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5
Q

Negative symptoms of schizophrenia

A

Depression of normal function, more chronic/persistent: Poor self-care, poverty of speech, social/emotional withdrawal, flat affect

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6
Q

EPS - Extrapyramidal symptoms or Pseudoparkinsonism

A

Tremors, masklike face, rigidity, shuffling gait, bradykinesia

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7
Q

Antipsychotic agents

A

Blocks the action of dopamine (risk of EPS)
Two major categories: Typical/First Generation (FGA) or Atypical/Second Generation (SGA)

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8
Q

Atypical Second Generation Antipsychotics (SGA)

A

Treats both positive and negative symptoms of schizophrenia
EPS is not as likely, still has other side effects (weight gain, DM2, constipation, fatigue, insomnia, increased appetite, headache)

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9
Q

Typical side effects of SGA’s

A

Prolonged QT, weight gain, diabetes, and leukopenia/neutropenia (ANC <1000)

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10
Q

Z-Track Injection Method

A

Pulls skin to leave a (zig-zag) in the skin, reduces any ‘spillage’
Used for long acting antipsychotics, 21 G needle with no massage

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11
Q

Nursing interventions r/t antipsychotics

A

Monitor for EPS, NMS and WBCS, inform may take 3-6 weeks to achieve effectiveness, encourage smoking cessation, do not combine medications with alcohol, narcotics or other CNS depressants, do not discontinue abruptly

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12
Q

Anxiety

A

Signs: sense of dread, choking, rapid HR, shaky, feeling faint
Still functional until it is situationally inappropriate or disabling

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13
Q

Benzodiazepine withdrawal

A

Develops in 2-10 days
Symptoms: Tremor, agitation, nervousness, sweating, insomnia, anorexia, paranoia, seizures

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14
Q

Benzodiazepine Interventions

A

Monitor vital signs, labs for signs of leukopenia, encourage pt to rise slowly to avoid dizziness, do not use for more than 3-4 months, check for cheeking, no antacids or caffeine at the same time (delays absorption) pt should take with meals to decrease Gi discomfort

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15
Q

Serotonergic Reuptake Inhibitors

A

Long term treatment of anxiety takes 8-12 weeks for full effect
SE: nausea, headache, insomnia, weight gain, sexual dysfunction, increased anxiety (start low)

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16
Q

Examples of SSRIS

A

Escitalopram (lexapro) Fluoxetine (prozac) paraxetine (paxil) sertraline (zoloft) citalopram (celexa)

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17
Q

SNRIS examples

A

Venlafaxine (effexor XR) duloxetine (cymbalta)

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18
Q

Tuberculosis

A

Mycobacterium tuberculosis (acid fast bacillus) spreads person to person via droplets, contained until AIDS epidemic in 1980s
Disease of lungs, liver, kidneys and other organs
Issues with: susceptibility (AIDS) drug resistance, poor compliance, lack of medications world wide
High Risk: homeless shelters, prison/jails, some nursing homes

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19
Q

Diagnosing TB

A

Mantoux (tuberculin) skin test (positive does not confirm infection) indicates exposure, those with vaccine may also show positive
Other tests: TB blood, sputum sample
Skin Test: Read in 48-72 hours, measuring the raised, hardened or swelled area in millimeters)

20
Q

Latent TB

A

They are infected but do not have the disease, blood will be positive
They are not infectious and cannot spread TB since the bacteria is not multiplying, treatment is required (prophylaxis)

21
Q

Treatment of latent TB

A

Isoniazid 6-9 months OR
Isoniazid plus rifapentine 3 mo OR
Rifampin 4 mo (when pt cannot tolerate isoniazid)

22
Q

Herpes simplex virus type 1 (HSV-1)

A

Cold sores

23
Q

Herpes simplex virus type 2 (HSV-2)

A

Genital herpes

24
Q

Varicella-zoster viruses (HSV-3 or VZV),

A

Chickenpoz or shingles

25
Q

Epstein-Barr virus (HSV-4 or EBV)

A

Mononucleosis

26
Q

Cytomegalovirus (HSV-5 or CMV)

A

pneumonia or blindness in immunocompromised

27
Q

Hepatitis C (HCV)

A

Serious, chronic liver infection
Transmission: Blood contact, IV drug use (contaminated needles), sexual contact (less likely that HBV), birthing process
May be asymptomatic for years can result in liver failure over time

28
Q

Hepatitis B (HBV)

A

Serious chronic liver infection
HBV: Needlestick, intimate sexual contact, or childbirth, HBV is found in all body fluids, including blood, semen, and vaginal fluid
S/S: Anorexia, vomiting, diarrhea, jaundice, malaise, myalgia

29
Q

Influenza

A

Contagious viral infection with antigens A, B, C
Spanish flu 1918 - 50 million deaths, killed many young adults quickly, US troops took to Europe in WW1

30
Q

Influenza Vaccines

A

Change yearly based on prediction of prominent strains, contains egg protein (CDC no longer considers allergy a contraindication)
Nasal spray: not to be used in pregnant or immunocompromised

31
Q

Diagnostic tests for influenza

A

Nasal swabs - not all tests detect both A/B strains

32
Q

SARS - Severe acute respiratory syndrome

A

Spread via animals (civets from china) outbreak in 2002-2003

33
Q

Ebola virus disease (EVD)

A

Infection from bats/primates
Discovered in 1976 as a breakout of fatal hemorrhagic fever
Spread - direct contact + fluids
2014-2016 outbreak in Guinea became and epidemic with some spread to the US

34
Q

MERS - Middle East respiratory syndrome

A

2012 outbreak with respiratory and GI symptoms, high death rate
Treatment: hydrations, antipyretics, pain relievers, O2, respiratory support

35
Q

Corona Viruses

A

Some affect humans, spread from exchange with wild animals

36
Q

Fungal infections (mycosis)

A

Superficial infections: mucous membranes, hair, nails, and moist skin areas, mild
Ex: Oral candidiasis/thrush + vaginal candidiasis + athletes foot (tinea pedis)
Systemic Infections: lungs, CNS or abdomen - severe

37
Q

Opportunistic fungal infections

A

Occur in immunocompromised, those taking antibotics, corticosteroids, chemotherapy or other immunosupressants
Candidiasis, asperfillosis, cryptococcosis, mucormycosis

38
Q

Nonopportunistic fungal infections

A

Often caused by environmental factors, bird droppings or spores
Ex: sporotrichosis, blastomycosis, histoplasmosis and coccidioidomycosis

39
Q

Antifungals General Nursing Assessment + Intervention

A

Cultures - identify organism
Toxicity: Monitor UO, BUN, creatine and liver enzymes
Assess for side effects
Education: Nystatin - swish, gargle, swallow/spit + Ketoconazole (no ETOH)

40
Q

Malaria - Phases

A

Protozoa transmitted by mosquitos
Pre-erythrocytic stage: Invasion of liver cells, lasts 12-26 days, often asymptomatic
Erythrocytic phase: Infections of erythrocytes - SS fever, chills, sweating, flulike symptoms

41
Q

Species of Malaria

A

P. Vivax - most common, 26 day incubation, fever chills, sweating in 48 hr cycle, relapse can occur for up to 2 years if treatment is not provided
P. Falciparum - more deadly, drug resistant, chills, sweats, fever, anemia, weakness r/t RBC destruction, dark urine d/t hemoglobin excretion, pulmonary edema, encephalopathy. Treatment needed immediately death can occur in days, no relapse

42
Q

Malaria prophylaxis - non pharm

A

Cover skin with clothing, use of DEET, permethrin-infused clothing + mosquito nets

43
Q

Helminths + groups + sources

A

Nematodes (roundworms)
Cestodes (tapeworms)
Trematodes (flukes)
Contaminated raw food, insects or direct penetration of the skin

44
Q

Assessment of Helminths

A

History or food intake, travel, family member symptoms, bowel pattern history + changes, anal itching, affected pets, children (sandbox/handwashing)
Diagnostic: stool sample

45
Q

Lower UTI

A

Acute cystitis, urethritis
E.Coli (most common pathogen)
More common in females
Symptoms: pain/burning on urination, frequency, urgency, pyuria

46
Q

Upper UTI

A

Acute pyelonephritis
Symptoms: chills, fever, flank pain, painful urination, frequency, urgency, pyuria, CVA tenderness

47
Q

Diagnosis of UTI

A

Urinalysis with dipstick - if positive (abnormal level of nitrites, blood, WBC) then urine is sent for culture and sensitivity

a. Pharm 2 (13 decks)

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