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Nursing Semester 2 (Med surg & Peds) > Everything for TEST 1! > Flashcards

Everything for TEST 1! Flashcards

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1
Q

Similarities of Crohn’s and Ulcerative Colitis

A

Both a form of IBD (inflammatory bowel disease)

Both cause inflammation & ulcer formation

Cause is UNKNOWN- suggested due to a faulty immune system in overdrive…may be triggered by environment and genetics

Flare ups are common followed by remission

Increased risk of colon cancer

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2
Q

Cirrhosis complications

A

jaundice

ascites

portal hypertension

neurologic changes (buildup in ammonia that crosses blood brain barrier- delirium)

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3
Q

Medication used to decrease bilirubin levels

A

lactulose therapy

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4
Q

Leading cause of liver cancer:

A

cirrhosis

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5
Q

Major cause of cirrhosis

A

hepatitis c (major)

fatty liver can also induce cirrhosis

prolonged and excessive use of alcohol (alcohol subjects liver to stress)

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6
Q

clinical manifestations

A

Elevated liver enzymes (CBC, pro-thrombin)

distended abdomen

firm abdomen

weight loss, fatigue

dry skin, rashes, ecchymosis

vascular lesions with red center

tendency to bleed

spider angioma

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7
Q

clinical manifestations

A

Elevated liver enzymes (CBC, pro-thrombin)

distended abdomen

firm abdomen

weight loss, fatigue

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8
Q

diagnosis for liver cirrhosis

A

MRI

CT scan

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9
Q

Nonsurgical Interventions for cirrhosis

A

pain management

nutritional therapy

low sodium diet, fluid and electrolyte

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10
Q

Drugs to be given to cirrhosis patients

A

diuretics

antibiotics sometimes given

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11
Q

Hepatitis can occur during a

A

secondary infection

infection from another virus

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12
Q

Hepatitis can occur during a

A

secondary infection

infection from another virus

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13
Q

Hep A transmission

A

fecal-oral route

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14
Q

Hep B transmission

A

through sexual intercourse with affected parter

through contact with blood or other body fluids

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15
Q

symptoms of hep B

A

anorexia

nausea

fatigue

fever

right upper quadrant pain

joint pain

jaundice

light stool?

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16
Q

which hepatitis is waterborne

A

Hep E!

India, africa, Middle East, countries that don’t have source of clean water

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17
Q

which hepatitis is waterborne

A

Hep E!

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18
Q

major difference between chronic and acute hepatitis

A

chronic is reoccurring (chronic more specific to B and C)

acute: first attack, may progress to chronic

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19
Q

clinical manifestations of liver cancer

A

ascites

edema

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20
Q

Transplant complications

A

rejection!

infection

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21
Q

2 types of cholecystitis

A

acute

chronic

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22
Q

2 types of cholecystitis

A

acute

chronic

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23
Q

Goal of drug therapy for GI disorders is to treat:

A

peptic ulcers

nausea

constipation

diarrhea

IBS

IBD

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24
Q

Histamine2- Receptor Antagonists purpose:

A

Gastric and duodenal ulcers

heartburn, dyspepsia

Erosive esophagitis

Gastrointestinal reflux disease (GERD)

Aspiration pneumonitis

Hypersecretory disorders (Zollinger-Ellison syndrome [gastrin]), systemic mastocytosis [histamine])

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25
Histamine2-Receptor Antagonist drugs:
Prototype drug: ranitidine hydrochloride (ZANTAC) Cimetidine (TAGAMET) Famotidine (PEPCID)
26
Physiologic change in compartment syndrome:
increased compartment pressure increased capillary permeability release of histamine increased blood flow to area pressure on nerve endings increased tissue pressure decreased oxygen to tissues increased production of LACTIC ACID muscle ischemia tissue necrosis
27
Clinical findings of compartment syndrome:
edema pulses present pink tissue pain cyanosis allow unequal pulses tense muscle swelling tingling numbness severe pain unrelieved by drugs paralysis
28
What is a fat embolism?
fat globules are released from the yellow bone marrow into the bloodstream within 12 - 48 hours after an injury or other illness these globules clog small blood vessels that supply vital organs- most commonly the lungs, and impair organ perfusion
29
Fat embolism syndrome (FES) usually results from
fractures or fracture repair but occasionally is seen in patients who have total joint replacement
30
Early manifestations of FES:
hypoxemia dyspnea tachypnea headache lethargy agitation confusion decreased level of consciousness PETECHIA (a macular, measles-like rash may appear over the neck, upper arms and chest- NOT PRESENT IN DVT)
31
Factors that make patients with fractures most likely to develop venous thromboembolism
cancer/ chemotherapy surgical procedure lasting longer than 30 minutes history of smoking obesity heart disease prolonged immobility oral contraceptives older adults (especially with hip fractures)
32
What is included in a neuromuscular assessment?
CSM!! assess skin color temperature sensation mobility pain pulses distal to fracture site Can check capillary refill but not as reliable
33
"6 P's" for ACS (Acute compartment syndrome)
Pain Pressure Paralysis Paresthesia Pallor Pulselessness (rare)
34
Biggest risk factor for hip fractures:
osteoporosis
35
Most common complications of amputations:
hemorrhage infection phantom limb pain neuroma flexion contractures
36
Parietal cells secrete:
hydrochloric acid intrinsic factor (substance that aids in absorption of vitamin b12)
37
chief cells secrete:
pepsinogen (precursor to pepsin, a digestive enzyme)
38
Liver stores:
many minerals and vitamins iron magnesium fat soluble vitamins (ADEK)
39
Sequence for abdomen assessment (IAPP)
inspect auscultate percuss palpate
40
Endoscopy is used to evaluate
bleeding ulceration inflammation tumors cancer of esophagus stomach biliary system or bowel
41
EGD is used for
a visual examination of the esophagus, stomach, duodenum
42
EGD preparation:
NPO 6-8 hours Usual drug therapy for hypertension or other diseases may be taken morning of test (diabetics consult!) avoid anticoagulants, aspirin, or other NSAIDS for several days before the test unless its absolutely necessary
43
Normally used drugs for sedation:
Midazolam hydrochloride (versed) fentanyl (fentanyl, sublimaze) propofol (deprivan)
44
ERCP is
visual and radiographic examination of the liver, gallbladder, bile ducts and pancreas to identify the cause and location of obstruction
45
Stomatitis:
inflammation within the oral cavity that may present in many different ways canker sores
46
Primary stomatitis:
most common type noninfectious stomatitis herpes simplex stomatitis traumatic ulcers
47
Secondary stomatitis:
generally results from infection by opportunistic viruses, fungi or bacteria in patients who are immunocompromised can result from chemotherapy drugs
48
Drug therapy used for stomatitis:
antimicrobials immune modulators symptomatic topical agents
49
Foods that can trigger aphthous (noninfectious) ulcers:
coffee potatoes cheese nuts citrus fruits gluten
50
Leukoplasia presents as
slowly developing changes in the oral mucous membranes causing thickened, white, firmly attached patches that can't be easily scanned off slightly raised and sharply rounded MOST COMMON LESION AMONG ADULT
51
Oral hairy leukoplakia is associated with
Epstein-Barr virus (EBV) and can be an early manifestation of HIV infection.
52
Erythroplakia appears as
red, velvety mucosal lesions on the surface and there are MORE malignant changes in this than in leukoplakia often considered "precancerous"
53
Possible preparation for patient undergoing are surgical resection
placement of temporary tracheostomy, oxygen therapy and suctioning temporary loss of speech because of tracheostomy frequent monitoring of post op vital signs NPO stays until intraoral suture lines are healed Need to have IV lines in place for drug therapy
54
Most common upper GI disorder:
GERD!
55
Most common cause of GERD is:
Excessive relaxation of the LES, which allows the reflux of gastric contents into the esophagus and exposure of the esophageal mucosa to acidic gastric contents
56
Patients who are overweight or obese are at highest risk for development of GERD because
increased weight increases intra-abdominal pressure which contributes to reflux of stomach contents into the esophagus
57
Factors contributing to decreased lower esophageal sphincter pressure:
caffeinated beverages, such as coffee, tea, and cola chocolate citrus fruits tomatoes and tomato products smoking and use of tobacco products calcium channel blockers nitrates peppermint, spearmint alcohol anticholinergic drugs high levels of estrogen and progesterone NG tube
58
Most accurate method of diagnosing GERD:
pH monitoring examination is most accurate
59
Foods to avoid with GERD
peppermint chocolate alcohol fatty foods (especially fried) caffeine carbonated beverages spicy and acidic foods (OJ, tomatoes)
60
Drugs that lower LES pressure and CAUSE reflex:
oral contraceptives anticholinergic agents sedatives NAIDS (ibuprofen) calcium channel blockers
61
3 MAJOR Drug therapy groups to manage GERD:
antacids histamine blockers proton pump inhibitors these drugs also used for peptic ulcer disease functions: - inhibit gastric acid secretion - accelerate gastric emptying - protect gastric mucosa
62
Main drug therapy for GERD
Proton pump inhibitors (PPI's) (given once a day) omeprazole (prilosec) rabeprazole (AcipHex) pantoprazole (proton) esomeprazole (nexium)
63
standard surgical approach for treatment of severe GERD
Laparoscopic Nissen fundoplication
64
2 major types of hiatal hernias
sliding hernia (most common) paraesophageal (rolling) hernia
65
Type A chronic gastritis
refers to an inflammation of the glands as well as the fungus and body of the stomach
66
Type B chronic gastritis
usually affects the glands of the antrum but may involve the entire stomach
67
Atrophic chronic gastritis:
diffuse inflammation and destruction of deeply located glands accompany the condition affects all layers of stomach muscle thickens and inflammation is present total loss of fundal glands`
68
Risks for gastritis
long term NSAID use local irritation from radiation therapy alcohol, coffee, caffeine, corticosteroids accidental or intentional ingestion of corrosive substances
69
Most common form of chronic gastritis
type B gastritis caused by H. Pylori infection
70
Early pathologic manifestation of gastritis is
thickened, reddened mucous membrane with prominent rug (foldS)
71
Acute gastritis features:
rapid onset of epigastric pain or discomfort N/V Hematemesis gastric hemorrhage dyspepsia (heartburn) anorexia
72
Chronic gastritis features:
vague report of epigastric pain relieved by food anorexia n/v intolerance of fatty, spicy foods
73
Standard for diagnosing gastritis
Esophagogastroduodenoscopy (EGD)
74
Drugs to avoid with gastritis
corticosteroids erythromycin aspirin saids ibuprofen

Nursing Semester 2 (Med surg & Peds) (7 decks)

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