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Exam 3 Material Flashcards

1
Q

Chronic Fatigue Syndrome is aka:

A

Chronic Fatigue and Immune Dysfunction Syndrome

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2
Q

Chronic Fatigue Mainly Affects

A

Women

All ethnic and socioeconomic groups affected

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3
Q

Dx Criteria for CFS (Major)

A

Unexplained, persistent, or relapsing chronic fatigue of new and definite onset not d/t ongoing exertion

Not alleviated by rest*

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4
Q

S/S CFS (Chronic Fatigue Syndrome)

A

Incapacitating fatigue and exhaustion; may

wax and wane for mo to yrs or happen acutely leading to frustration

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5
Q

Lab Test for Chronic Fatigue Syndrome

A

No lab test can diagnosis–> used to exclude other diseases

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6
Q

Other (Minor) S/S of CFS (Chronic Fatigue Syndrome)

A

Impaired short term memory or concentration
Sore throat/Tender cervical/axillary lymph nodes
Muscle pain/Multi- joint pain
HA/ Unrefreshing sleep
Post-exertional malaise lasting over 24h

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7
Q

Role of WBC

A 
Protection from invading organisms
Recognition of self vs not-self
Destruction of foreign invaders, debris, abnormal cells
Production of antibodies
Production of cytokines
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8
Q

Increase in total number of WBC’s d/t acute infection, tissue damage/death, leukemias

Elevation of any element of WBC differential

A

Neutrophilia

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9
Q

S/S of Neutorphillia

A

Related to cause of elevation –> tx cause

Exudate in form of pus

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10
Q

Dx Neutorphilia

A

CBC

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11
Q

Decrease in total WBC count

A

Leukopenia

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12
Q

Neutropenia

A

Reduced neutrophil count

occurs w/ other conditions or diseases→ not a disease in its self i.e. chemotherapeutic and immunosuppressive meds

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13
Q

ANC less than 1000 →

A

→ positive pressure room

Neutropenia – very compromised

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14
Q

ANC =

A

Absolute Neutrophil Count

WBC x %neutrophils

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15
Q

Other conditions/ diseases that causes Neutropenia include:

A

Hematologic malignancies
Autoimmune disorders – lupus/ ra
Nutritional deficiencies→ b12 or folic acid
Infections and Severe sepsis

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16
Q

Patients with neutropenia are at high risk of

A

opportunistic infections
Low grade fever = significant
Minor infections can lead rapidly to sepsis

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17
Q

Total WBC: less than 4,000

A

Neutropenia

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18
Q

ANC greater than 1500→

A

No increased risk of infection

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19
Q

ANC 1000-1500–>

A

→Slight increase in risk of infection

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20
Q

ANC 500-1000 →

A

Moderate increase in risk of infection

Neutropenia

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21
Q

ANC 100-500→

A

High risk of infection

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22
Q

ANC less than 100 →

A

Extremely high risk of infection

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23
Q

In patients with Neutropenia any ℅ pain/ infection–>

A

Serious

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24
Q

Common entry points for infection

A

Mucous membranes
Skin, throat, mouth
GU system
Pulmonary system

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25
Neutropenia fever of 100.4
→Broad spectrum Antibiotic therapy for fever
26
Neutropenia Treatment
Tx Cause Assist hematopoiesis in bone marrow Isolation (Direct contact w/ hands=common source of transmission) Monitor for infection, cultures
27
Neutropenia Treatment Teach
no fresh flowers, no fresh fruits or veggies
28
Neupogen, Neulasta
Granulocyte transfusion or stimulating factor | Pt w/ Neutropenia
29
V/S for pt w/ Neutropenia should be taken q….
q4h, call for T over 100.4
30
Myelodysplastic Syndrome (MDS)
producing plenty of cells, but they are all dysfunctional d/t Stem cell injury
31
Group of hematologic disorders --> changes in quantity and quality of bone marrow elements; May progress to leukemia (30%)
Myelodysplastic Syndrome (MDS)
32
AKA: Preleukemia
Myelodysplastic Syndrome (MDS)
33
Clinical Manifestations (MDS):
Anemia and fatigue, Infection risk, Bleeding risk
34
Diagnosing MDS
Bone Marrow biopsy – Dx, Classify, & Stage Others CBC & H&P
35
Goal in MDS Tx
Improve hematopoiesis & Prevent leukemia | Nursing goal: Prevent infection, bleeding, & Treat symptoms of anemia
36
Tx Myelodysplastic Syndrome (MDS)
(aggressive); only 1/3 of pts are candidates --Chemo --Stem cell transplant (difficult for elderly) TX should match severity of disease
37
Supportive therapy for Myelodysplastic Syndrom include:
Transfuse blood products prn Monitor CBC & bone marrow Ensure quality of life
38
Most common leukemia of older adults
Chronic Lymphocytic Leukemia (CLL)
39
Chronic Lymphocytic Leukemia (CLL) most commonly affects
men 50-70y → MORRIS
40
over-production & accumulation of dysfunx lymphocyte d/t genetic mutation
Chronic Lymphocytic Leukemia (CLL)
41
Lymphocytes infiltrate bone marrow, spleen, liver →Lymph nodes enlarge t/o body; Lymphocytes crowd out growth of RBC/Platelets
Chronic Lymphocytic Leukemia (CLL)
42
Chronic Lymphocytic Leukemia (CLL) S/S
``` Many can be asymptomatic  Chronic fatigue  Anorexia  Splenomegaly/Hepatomegaly  Lymphadenopathy ```
43
CLL (Labs)
``` Increase lymphocytes (WBC> 100,000 →Lymphocytosis) Mild anemia& Thrombocytopenia ```
44
CLL Dx Studies
CBC Bone marrow exam CT scan → Identify site of cancer
45
Average Length of Survival for CLL
7 years →untreated
46
Function of the Spleen
Filters blood-->destroys fact., old/ damaged platelets & RBCs -->Production, storage, & release of blood cells
47
Splenomegaly with peripheral cytopenias
Hypersplenism
48
S/S Splenomegaly
Asymptomatic or abdominal fullness with early satiety
49
Dx Splenomegaly
Physical, CT, MRI, US | Occasionally-- laparoscopy to eval. spleen
50
Splenectomy
Enlarged /ruptured spleen Relieve pain To increase circulating RBC, WBC & platelets
51
Post-Op Considerations (Splenomegaly)
Risk for developing immunologic deficiencies (Life Long) | Monitor for Hemorrhage, shock, Abdominal distention, Infection
52
Vaccination Post Op for (Splenomegaly)
pneumococcal vaccine post-op
53
Tissue from lower abdomen remains attached to muscle, nerves, and blood supply tunneled through abdomen to reach breast
Tram Flap
54
Bonus of Tram Flap
abdominoplasty
55
Autologous Myocutaneous Flaps
Muscle, fat & skin from another part of body moved to chest & shaped into form of a breast
56
Donor for Autologous Myocutaneous Flaps sites include:
Latissimus dorci muscle | Transverse rectus abdominis muscle
57
Latissimus dorci muscle donor site disadvantages
May need additional implant | Scar on back
58
DIEP Flap Breast Reconstruction:
Deep Inferior Epigastric Perforator Breast Reconstruction
59
Advantages of DIEP Flap Breast Reconstruction:
``` No muscles taken – Less post op pain than with TRAM – Faster recovery time – Less risk of hernia – Abdominoplasty! ```
60
Post Op Drain Placement for Breast Flap Recovery duration:
Drains in place for 2-3 days →Monitor for color and odor & temp
61
Liposuction IS NOT
a substitute for weight loss nor a cure for obesity
62
Best candidates for Liposuction
< 40y --> elastic skin
63
Pressure dressing post op Liposuction
Pressure drsg for 2-4 weeks
64
Rearranging or reshaping an existing scar so original scar is not as noticeable; Z platy
Scar Revision
65
Inflammatory response of the epidermis d/t infections, allergies, or irritating substances
Dermatitis
66
Condition in which the skin becomes red, sore, or inflamed after direct contact with a substance
Contact Dermatitis:
67
Inflammation intensity of contact dermatitis is related to:
Concentration of irritant, time exposed, and repetition of exposure (repeated use)
68
Rhus
Contact w/ a poisonous plant -Ivy, Oak, Sumac Type of Allergic Contact Dermatitis Washing ASAP minimizes severity and spread
69
Onset of S/S for Rhus
24-48h after contact; • Disappear 10d
70
S/S of Rhus
Severe itching, Red inflammation, blistering, oozing
71
Atopic Dermatitis is aka
Eczema
72
Common sites of Eczema in Children
face of children
73
Common sites of atopic dermatitis (Eczema) in Adults
AC and popliteal spaces of adults
74
Tx Eczema
no cure, only control Topical steroids (Protopic, Elidel) Phototherapy
75
S/S of Acute Eczema (Atopic Dermatitis)
Bright red, oozing vesicles Extreme pruritis (Worst)
76
S/S Subacute Eczema
Scaly plaques
77
S/S Chronic Eczema
Thickened, Dry skin (Xerosis) | Hypo or hyperpigmentation (differ in color from skin)
78
Dx Eczema
Blood Test (IgE) Patch test Fam Hx
79
Toxic Epidermal Necrolysis Syndrome (TENS)
Rare, acute drug reaction of the skin Diffuse erythema Large blister formation
80
Highest at Risk for TENS
Elderly & Immunocompromised
81
Skin loss d/t TENS
30-100% skin loss
82
Skin loss d/t SJS
<10%
83
Stevens-Johnson Syndrome (SJS)
Rare, acute drug reaction of the skin; Another form of TENS
84
TENS & SJS s/s begin as….
flu-like symptoms: High fever, cough, sore throat, burning eyes
85
The flu-like s/s of TENS & SJS are followed by:
Diffuse erythema, painful & burning rash which spreads from trunk to face & extremities with Bulla (blisters) & Severe skin peeling; MM usually involved
86
Deaths asc with TENS & SJS are usually d/t
sepsis followed by pulmonary complications
87
Urticaria
aka hives (wheels)
88
Common Causes of Angioedema
ACE-I Strawberries Shellfish Peanuts
89
Primary Concerns for a pt with Angioedema
Airway and Anaphylactic Shock
90
Angioedema Tx
H2 antagonist | Antihistamines, Epi, steroids,
91
Seborrheic Dermatitis aka
dandruff
92
Comedo
Plug of keratin, sebum and bacteria --> white & blackheads

N102 (13 decks)

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