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Med Surg 2 > Exam 2 > Flashcards

Exam 2 Flashcards

(108 cards)

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1
Q

What is prostate cancer?

A

Common cancer in the prostate gland, higher risk for men 50 or older

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2
Q

What is the cause of prostate cancer?

A

Unclear cause but can increase due to:
Age
Heavy Metal Exposure
Smoking
Hx of STDs/STIs

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3
Q

What are some assessment findings you might see of a patient who has prostate cancer?

A

Hard, Pea sized nodule
Painless hematuria
Weight Loss
Urinary obstruction
Bone pain

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4
Q

What are some nonsurgical interventions for prostate cancer?

A

Hormone Therapy
Luteinizing Hormone
Pain meds
Radiation and Chemotherapy
Corticosteroids
Bisphosphonates

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5
Q

What surgical interventions for prostate cancer?

A

Orchiectomy (Limits production of testosterone)
Prostatectomy
Cryosurgical Ablation

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6
Q

What is TURP?

A

Transurethral Resection of the prostate
The procedure involves insertion of a scope into the urethra to remove prostatic tissue

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7
Q

What is the most common post op complication of TURP?

A

Bleeding

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8
Q

What may be needed after a TURP procedure?

A

Continuous Bladder Irrigation (CBI)

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9
Q

What may be prescribed post TURP?

A

Antispasmodics for bladder spasms

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10
Q

What are the risk factors for bladder cancer?

A

smoking
exposure to chemical
exposure to radiation

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11
Q

What are some assessment findings you might see with bladder cancer?

A

Painless hematuria
Frequency or Dysuria
Clot induced obstruction

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12
Q

What are non surgical treatments for bladder cancer?

A

Radiation
Chemotherapy

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13
Q

What are surgical inventions for bladder cancer?

A

Removal of bladder tumor
Partial cystectomy
cystectomy/ Urinary diversion

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14
Q

When a urinary diversion is preformed what types of appliances will be implanted?

A

ileostomy (bag worn over stoma to collect urine)
Nephrostomy tubes

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15
Q

What is normal sinus rhythm?

A

A rhythm that originates from the SA node

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16
Q

What are the rates for normal sinus rhythm?

A

60-100 bpm

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17
Q

What are the rates for sinus bradycardia?

A

less than 60 bpm

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18
Q

When might treatment be necessary for a bradycardia patient?

A

If patient is symptomatic, showing signs of decreased cardiac output

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19
Q

Who may bradycardia?

A

Athletes and some healthy individuals

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20
Q

What medication is given to increase the heart rate?

A

Atropine Sulfate, do not give additional doses may induce tachycardia

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21
Q

What are other interventions for bradycardia?

A

Hold medications that may cause bradycardia
Give oxygen
Monitor for Hypotension (give fluid if indicated)

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22
Q

What may be necessary if bradycardia is not fixed with atropine?

A

Applying a Transcutaneous pacemaker or possibly a permanent pacer

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23
Q

What are the rates for tachycardia?

A

100-180 bpm

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24
Q

How do you treat sinus tachycardia?

A

Decrease the heart rate via:
medication (LOLs, CCB, Adenosine)
comfort measures (to relieve stress, anxiety, pain)
vagal manuever

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25
What are premature ventricular contractions?
Early contractions in the ventricles due to increased irritability of the ventricles
26
What causes PVCs?
Stimulants Electrolyte Imbalance (hyperkalemia/ hypo) Hypoxia Heart Disease
27
What is more than 3 PVCs in a row considered?
Run of V-Tach
28
How do you treat PVCs?
correct underlying cause (meds, electrolytes) Beta Blockers (Lols) Amiodarone Lidocaine Oxygen to fix hypoxia if necessary
29
What are other ways we can manage arrhythmia's if they are not responsive to other interventions?
Carotid Sinus Massage Cardioversion Defibrillate if pulseless VT or VF
30
What is a synchronous (demand) pacemaker do?
only paces if the clients rhythm falls below set rate, pacer will start stimulating depolarization
31
What is an asynchronous (Fixed rate) pacemaker do?
Paces at a preset rate regardless of clients normal rhythm, used most commonly when patient is asystolic or severely bradycardic
32
What is overdrive pacing?
suppresses the underlying rhythm so that SA node will regain control of the heart
33
What type of pacemaker would be given to a severely bradycardic patient or asystolic patient?
A temporary pacer, the transcutaneous pacing until invasive pacing can be initiated
34
What do you educate to a client with a pacemaker?
Keep pacemaker identification card Avoid contact sports How to take their own pulse
35
What is coronary artery disease?
narrowing of one or more arteries as a result of atherosclerosis
36
What does atheroscleosis cause?
decreased perfusion and inadequate o2 supply
37
What are complications of atherosclerosis?
HTN HF MI Dysrhythmias Angina
38
What is collateral circulation?
More than 1 artery supplying a muscle with blood, usually occurs in older people
39
What are some assessment findings of CAD?
Chest pain Syncope Palpitations Fatigue
40
How is CAD diagnosed?
ECG Cardiac Cath Blood Lipid levels elevated
41
What are some ways to manage or reduce risk of CAD?
Cholesterol lowering meds low calorie, fat, salt, cholesterol diet
42
What resources should be given to a patient with CAD?
community resources to exercise, smoking cessation, and stress reduction
43
What is important to stress to a client with CAD?
Dietary changes must be incorporated for the rest of their life
44
What medications treat CAD?
Nitrates Calcium Channel Blockers (PINE, MIL) Cholesterol Lowering meds (Statins) Beta Blockers to reduce BP
45
What is the drug alert for Nitrates?
Keep in the dark do not combine w/ erectile dysfunction meds Patient should have 10-14 hour free period of nitrates
46
What is angina?
Chest pain caused by imbalance between oxygen supply and demand
47
What is stable angina?
Occurs with activities that involve exertion, emotional stress
48
How is stable angina relieved?
rest or nitroglycerin
49
What is unstable angina?
Occurs with an unpredictable degree of exertion, or emotional stress
50
How long does unstable angina last?
15 minutes or longer
51
How is unstable angina treated?
MONA
52
How do you diagnose angina?
ECG Stress testing Troponin and cardiac enzymes will be normal Cardiac cath
53
What should the client do if nitro does not relieve pain?
Chew aspirin
54
How should the client be positioned during angina?
Bedrest in semi fowlers position, Stay with the client
55
What is a myocardial infarction?
Occurs when myocardial tissue is abruptly deprived of oxygen
56
What are symptoms of MI?
SOB Pulmonary Edema AMS Dizziness Pain radiate to the jaw, back, and left arm Unrelieved by nitro or rest Pain last 30 minutes or longer
57
What are risk factors for MI?
Atherosclerosis CAD Smoking HTN Obesity Stress Sedentary lifestyle
58
How is an MI diagnosed?
Troponin level Total CK level Myoglobin WBC ECG Cardiac Cath Thallium Scans Stress test
59
What is treatment for MI?
MONA Thrombolytic therapy Beta Blockers
60
What does cool diaphoretic skin and diminished or absent pulses indicate?
Poor cardiac output
61
What is recommended for a patient after an MI?
Cardiac Rehab
62
What is heart failure?
inability for heart to maintain cardiac output to meet bodies needs
63
What is left sided heart failure?
Fluid backs up to lungs can develop pulmonary edema
64
What is right sided heart failure?
Fluid trapped in other areas of the body usually lower than the heart
65
What are some characteristics of Left sided heart failure?
Dyspnea Tachypnea Crackles in lungs HTN or hypotension
66
What are some characteristics of right sided heart failure?
Edema in legs JVD Hepatomegaly Splenomegaly Weight gain HTN
67
What medications will the client take for HF?
Digoxin Diuretics Ace Inhibitors (Prils) Low dose beta blockers vasodilators (nitrates)
68
What should heart failure patient avoid?
Large amounts of caffeine, coffee, tea, cocoa, chocolate, acidic fruits and carbonated drinks
69
What type of diet should a patient with HF be on?
low sodium, low fat, low cholesterol diet Give a list of potassium rich foods Possible fluid restriction
70
What is important for a HF patient do daily?
Daily weight, must record and report to HCP if 3 pounds or more is gained
71
What are the signs and symptoms of pulmonary edema?
Severe dyspnea tachycardia Tachypnea Wheezing and crackles in lung Large amount thick frothy sputum cold and clammy
72
What nursing interventions should be done for pulmonary edema?
High Fowlers position Administer oxygen Auscultate lungs Give diuretics if ordered
73
What is pericarditis?
acute or chronic inflammation of the pericardium that results in loss of pericardial elasticity
74
What may pericarditis cause?
Heart failure cardiac tamponade
75
What are some assessment findings you might encounter with pericarditis?
Pain is aggravated by coughing, breathing, swallowing Pericardial friction rub (high pitched sound when auscultating heart
76
How might pain be relieved for pericarditis?
sitting edge of bed leaning forward or leaning forward in bed
77
What medications are given for pericarditis?
NSAIDs (aspirin, ibuprofen) Corticosteroids Antibiotics for bacterial infections Diuretics Digoxin
78
What is endocarditis?
Inflammation of the inner lining of the heart and valves
79
Who is at risk for endocarditis?
IV drug users Valve replacements/prosthetic materials structural cardiac defects
80
What are signs and symptoms of endocarditis?
weight loss murmurs petechiae splinter hemorrhages in nail beds Clubbing of fingers osler nodes (red lesions on pads of hands, fingers, and toes janeway lesions (nontender lesions on fingers, toes, nose, ears)
81
What is used to treat endocarditis?
Antibiotics
82
When you discharge a patient home who has endocarditis, what is important to educate?
Record daily temperatures Good oral hygiene, brushing twice a day avoid using floss or oral irrigation to avoid bactermia
83
What is cardiac tamponade?
Restricts ventricles from filling and cardiac output drops
84
What places a client at risk for cardiac tamponade?
Pericardial Effusion
85
What are signs and symptoms of cardiac tamponade?
Pulsus paradoxus (blood pressure drops when inhaling) Increased CVP JVD Muffled heart sounds
86
If a client continues to have reoccurring episodes what are the client's options?
a portion or all of the pericardium will be removed (pericardiectomy) May need a pericardiocentesis if pericardial effusion occurred (drain fluid off heart)
87
What are diagnostic test used to diagnose cardiac tamponade?
Chest xray Echocardiogram
88
What is valvular heart disease?
develops when the heart cannot fully open (stenosis) or close completely (regurgitation), does not provide efficient blood through the heart.
89
What is mitral valve stenosis?
Valvular tissue thickens and narrows valve opening, preventing blood from flowing from the left atrium to the left ventricle
90
What is mitral regurgitation?
Valve is incompetent, preventing complete valve closure during systole
91
What is mitral valve prolapse?
Valve leaflets protrude into the left atrium during systole
92
What are ways to fix these valve issues?
Valve replacement procedures (Mechanical or biologic valves) Open heart surgery
93
What is the difference between Mechanical Valve repairs and Biologic Valves?
Mechanical valves are more durable but clot formation is high Biologic valves are less durable but clot formation is small
94
The patient receives a mechanical valve, what is important to educate?
Anticoagulants must be taken lifelong
95
What is an Acute Kidney injury (AKI)?
Rapid loss of kidney function, can be reversible
96
What is prerenal caused by?
Volume depletion caused by blood loss, trauma, surgery, dehydration, decreased CO
97
What is intrarenal caused by?
Tubular necrosis, infection, obstruction, nephrotoxicity
98
What is postrenal caused by?
Bladder obstruction, bladder cancer, infection
99
What is Chronic Kidney Disease?
Irreversible loss of kidney function
100
What causes chronic kidney disease?
Diabetes HTN Chronic urinary obstruction Autoimmune disorders
101
What type of diet should a CKD patient be on?
Moderate protein, High carb, low potassium, low phosphorus
102
What it important to educate to CKD patients?
Keep up good oral care to prevent stomatis
103
What it important to educate to CKD patients?
Keep up good oral care to prevent stomatitis. Daily weight
104
What are the signs and symptoms of a UTI?
Frequency Urgency inability to void cloudy dark urine hematuria
105
What is BPH?
enlargement of the prostate gland that compresses the urethra resulting in partial or complete obstruction
106
What medications are used for BPH?
Alpha blockers (osin) 5a- alpha reductase inhibitors (asterides)
107
What is normal cardiac output?
4-6liters per minute
108
How is cardiac output calculated?
CO=SVxHR

Med Surg 2 (6 decks)

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