midterm Flashcards
(120 cards)
1
Q
characteristics of acute illness
A
- curable
- short disease course
ex. pneumonia, MI, trauma
2
Q
characteristics of chronic illness
A
- prolonged/long term
- generally uncurable
3
Q
what are chronic conditions
A
health problems with associated symptoms or disabilities that require long term management over 3 months
4
Q
what is a secondary condition/disorder
A
any physical/mental/social disorder resulting from an initial disabling condition
5
Q
4 main chronic conditions responsible for death/hospitalization
A
- cardiovascular disease
- cancers
- COPD
- diabetes
6
Q
reasons chronic conditions are becoming more prevalent
A
- lower infant mortality and increases in life expectancy
- improved screening and diagnostics
- tendency for developing diseases with advancing age
- lifestyle, and consumption factors
7
Q
non modifiable risk factors
A
- genetics
- age
- gender
- race
8
Q
diagnostics for inflammation
A
- WBC count
- differential
- CRP
- rheumatoid factor
9
Q
diagnostics for infection
A
- WBC count
- differential
- CRP
- procalcitonin
- gram stain
- C&S
10
Q
what does procalcitonin indicate
A
bacterial infection
11
Q
lifespan of a WBC
A
13-20 days
12
Q
increased WBCs indicate
A
activation of the inflammatory response system & possible infection
13
Q
neutrophils indicate
A
bacterial or pyogenic infection (pus producing)
14
Q
eosinophils indicate
A
allergic disorders & parasitic infections
15
Q
basophils indicate
A
parasitic infection & some allergic disorders
16
Q
lymphocytes indicate
A
viral infection
17
Q
monocytes indicate
A
chronic infection
18
Q
rheumatoid factor indicates
A
rheumatoid arthritis
negative: < 60
19
Q
CRP indicates
A
inflammation (non-specific)
20
Q
procalcitonin indicates
A
sepsis
low: low risk of sepsis
high: high probability of bacterial sepsis
21
Q
normal WBC range
A
4 - 10.5 x 10 9/L
22
Q
normal RBC range
A
3.8 - 5.2 x 10 12/L
23
Q
normal Hgb range
A
120 - 150 g/L
24
Q
normal HCT range
A
0.35 - 0.48 L/L
25
normal platelet range
150 - 400 x 10 9/L
26
normal neutrophil range
2 - 6 x 10 9/L
27
normal Na range
135 - 145 mmol/L
28
normal K range
3.5 - 5 mmol/L
29
normal glucose range
3.9 - 11 mmol/L
30
normal creatinine range
50 - 90 umol/L
31
normal GFR
> 60 mL/min
32
normal PTT range
23 - 32 seconds
33
normal PT-INR
0.9 - 1.1 seconds
34
hyponatremia
low sodium
35
hypernatremia
high sodium
36
causes of hyponatremia
vomiting, diarrhea, NG tube, diuretics, CRI
37
symptoms of hyponatremia
weakness, confusion, ataxia, stupor, coma
38
symptoms of hypernatremia
thirst, agitation, mania, convulsions, dry mucous membranes
39
causes of hypernatremia
increase Na (IV/PO), excessive free body water loss, cushing syndrome
40
hypokalemia
low potassium
41
hyperkalemia
high potassium
42
symptoms of hypokalemia
decreased contractility of smooth muscle, skeletal, cardiac muscle
weakness, paralysis, hyporeflexia, dysrhythmias, thirst
43
causes of hypokalemia
GI losses/disorders, diarrhea, vomiting, diuretics, burns
44
symptoms of hyperkalemia
irritability, n+v, diarrhea, intestinal colic
45
causes of hyperkalemia
dietary intake, renal failure, infection
46
symptoms of systemic infection
- increased temperature
- low BP
- high HR
47
what antibiotic is given for c diff
PO vancomycin
48
common side effects of antibiotics
n+v, diarrhea, nephrotoxicity, hepatic toxicity
49
antibiotic dosing considerations for pediatrics
based on weight
50
antibiotic dosing considerations for older adults
lower doses
51
ibuprofen class
anti-inflammatory, antipyretic
52
ibuprofen indication
mild fever
53
action of ibuprofen
inhibits prostaglandin synthesis
54
onset of ibuprofen
30 minutes
55
contraindications of ibuprofen
GI bleed, ulcers, liver/renal insufficiency
56
SE of ibuprofen
GI bleed, renal insufficiency
57
ASA should not be given to who?
infants - risk for Reye's syndrome (fatty liver, and encephalopathy)
58
ASA is not a good medication to treat what
a fever - inhibits platelet aggregation (blood thinner)
59
diagnostic tests for inflammation
WBC count, CRP
60
what diagnostic will indicate bacterial infection
neutrophils
61
what is colonization
a constant level of some bacteria
62
types of infection
- acute
- chronic
- colonization
63
symptoms of infection
fever, elevated WBC, inflammation (CRP), neutrophils
fatigue, malaise
decreased BP, increased HR
64
define pneumonia
inflammation of the lung parenchyma
65
risk factors for pneumonia
- conditions that increased mucus production or obstruct with drainage
- smoking
- prolonged immobility
- depressed cough reflex
- old age
66
nursing care for pneumonia
- improved airway patency (remove secretions)
- rest
- deep breathing/coughing
- fluid intake + nutrition
67
define UTI
pathogenic microorganisms in the urinary tract cause infection
68
UTI risk factors
- diabetes
- inability to empty bladder
- obstructed urinary flow
- catheter
- enlarged prostate
- decreased immune system
69
nursing care for UTI
- manage pain
- fluid intake
- avoid irritants (coffee, alcohol etc)
- hygiene
70
define c diff
acquired pore-forming bacterium - usually HAI
71
diagnostics for c diff
- C&S stool
- electrolytes
- WBC
- neutrophils
72
c diff risk factors
- antibiotics
- surgery of the GI
- colon disease
- weak immune system
- chemo drugs
73
c diff will result in diarrhea for up to
15 times a day
74
nursing care for c diff
- antibiotics (vancomycin)
- probiotics, antimedics
- fluid intake (PO/IV)
- isolation
- nutrition
- fecal transplant
- possible complications = skin breakdown etc.
75
define arthritis
inflammation response of the joint
76
risk factors for arthritis
- sex
- age
- family history
- smoking
- obesity
- environmental exposure (asbestos)
77
nursing care for arthritis
- suppress inflammation & autoimmune response
- manage pain
- joint mobility and function
- promote self management
- sleep & exercise
78
diagnostics for pneumonia
- chest xray
- physical exam
- sputum C&S
- blood C&S
- WBC & differential
- procalcitonin
- CRP
79
diagnostics for UTI
- urine analysis
- urine C&S
- blood C&S
- WBC and differential
- procalcitonin
- CRP
- GFR
- creatinine
80
NSAIDS with infants/children
ibuprofen & acetaminophen ok
| aspirin contraindicated d/t risk of Reye's syndrome
81
NSAIDS with pregnancy
contraindicated = may result in premature closure of the ductus arteriosus
82
cephalosporins use
antibiotic to treat bacterial infections
83
what is an AST test
Aspartate Aminotransferase (AST)
tests for liver damage
should be low
84
what is an ALT test
Alanine Aminotransferase (ALT)
tests for liver damage
should be low
85
procalcitonin
indicates systemic infection (sepsis)
86
tests for kidney function
- BUN
- GFR
- creatinine
87
tests for liver function
- ALT
- AST
- albumin
88
what type of antibiotic would be ok for those allergic to penicillin
vancomycin
89
if someone is allergic to penicillin, what else might they be allergic to?
cephalosporins
90
cystitis
inflammation of the urinary bladder
91
prostatitis
inflammation of the prostate gland
92
urethritis
inflammation of the urethra
93
pyelonephritis
inflammation of the renal pelvis
94
interstitial nephritis
inflammation of the kidney
95
adjuvant analgesics are especially useful for what
neuropathic pain
96
what is a primary intention wound
closed via stitches etc
97
what is a secondary intention wound
left to close with scar tissue
| ex. burns
98
what is a tertiary intention wound
left open for an extended period of time
| ex. infected surgical site left open
99
stages of wound healing
- hemostasis
- inflammation
- proliferation
- remodelling
100
the inflammation stage of wound healing:
how long is it?
what is happening?
problems?
up to 4 days
ridding the wound of bacteria
problem: immunodeficiency, continued irritation, infection
101
how long is the proliferation stage of wound healing:
4-21 days
102
how long does the remodelling stage of wound healing take
up to 2 years
103
describe stage 1 pressure ulcer
- skin intact
- redness, temperature, swollen, discomfort
- doesn't blanch
104
describe a stage 2 pressure ulcer
- skin breaks
- abrasion, blister or shallow crater
- edema, ulcer drainage
105
describe a stage 3 pressure ulcer
- through dermis, into subcutaneous/fat
| - necrosis and drainage
106
describe a stage 4 pressure ulcer
- through to muscle/bone/tendon
- deep pockets of infection develop
- necrosis and drainage
107
unstageable pressure ulcer
- ulcer is covered by slough or eschar
| - unable to determine depth
108
venous ulcer characteristics
- irregular border
- pulses present
- edema
- highly exudative
- bleeds easily
109
arterial ulcer characteristics
- forefoot pain at rest
- regular shaped border
- deeper
- no bleeding, minimal drainage
- weak or no pulse
- pale or black
110
interventions for ulcers
- elevation
- protection
- ambulation
- repositioning
- pain relief
- nutrition
- hygiene
111
types of pain
- acute
- procedural
- chronic
- cancer
112
define acute pain
pain up to 6 months
113
define procedural pain
brief, intense pain from a diagnostic/therapeutic procedure.
| lasts seconds to hours
114
define chronic pain
constant or intermittent pain that extends beyond the expected healing time
3 categories: nociceptive, neuropathic, mixed
115
what is nociceptive pain
aching/throbbing pain due to a constant stimulation of pain receptors
signals damage in skin/joint/bones/viscera (organs)
ex. arthritis, fibromyalgia
116
what is neuropathic pain
burning/tingling/piercing pain due to nerve damage or malfunction of peripheral or CNS resulting in abnormal signalling
117
what is allodynia
a type of neuropathic pain arising from a nonpainful stimulus (a light breeze or touch)
118
what is mixed chronic pain
a mix of nociceptive and neuropathic pain
| ex. migraine pain
119
explain cancer related pain
can be directly associated with cancer (tumor growth), result of treatment or not associated
120
non pharmacological pain interventions
- heat/cold
- deep breathing
- fresh linens
- personal care/hygiene
- acupuncture, massage
- meditation, art, music
- interprofessional team
