Flashcards in NURS 302 EXAM 1 Deck (285):
a change in skin color, less than 1 cm- freckles, flat moles (nevi)
a solid raised lesion, less than 1cm - wart, elevated mole
elevated, irregular-shaped area of edema - insect bites, urticaria, allergic reaction
raised solid lesion, 1 to 2 cm, - lipoma
raised lesions filled with clear fluid, less than 1 cm - varicella (chickenpox), herpes zoster (shingles)
fluid-flled lesion, greater than 1 cm- blister
elevated lesion that contain pus - pus - acne, impetigo
enlarged scar, caused by excessive collagen formation during healing
linear, hollowed out - abrasion or scratch
linear crack or break which extends into dermis- athletes foot
loss of epidermis, concave, decubitus ulcer- pressure sore
abnormal growth in basal layer, most common, least aggressive, pearl colored, depressed center, rolled border
basal cell carcinoma
atypical squamous cells, more aggressive, slow growing, firm.
squamous cell carcinoma
form melanocytes (cells that produce pigment)
can metastasize to any organ, common in young people, may arise from moles
what does ABCDE stand for?
inflammatory disorder of sebaceous glands
liver spots- "age spots" (senile lentigo & lentigo maligna)
chronic, genetis, redness, dry patches, & heavy silver surface. lifelong with remissions and exacerbations
benign plaques 3-20 mm with variety of surfaces
arrhythmic vesicles, honey colored, highly contagious, face, arms, legs & butt
diffuse inflammation with various lesions, preceding wounds, common in adults.
inflammed hair follicle, red lesion or pustules, in eye it is called a stye
absess or boil, deep folliculitis, pus filled, painful, firm
furuncles (abscess or boil)
herpes simplex type I is?
herpes simplex type II is ?
herpes zoster is ?
type of macrole that is a yeast-like fungus?
ringworm of scalp, patchy hairloss
ringworm of the body, red circles
athletes foot, itchy
moist, dark areas, treated with powders or creams
candidiasis (oral thrush)
pediculosis capitis is?
reaction with something you've touched
itchy rash with raised areas, check airway
what is a burn?
injury to tissues caused by:
first degree burns affect what layers of skin?
outer layers of epidermis
red, pink, painful, usually no blisters
second degree affects what layers of skin?
entire epidermis and dermis
paintful, moist, red, blistered, and edema
third degree affects what layers?
extend into subcutaneous tissue & may involve muscle and bone
waxy white or yellow to tan, brown, deep red, or black
hard, dry, leathery
what is used to estimate percentage of total body surface area of burn (TBSA)
rule of nines
skeleton is made of
bones and joints
what are the two systems in musculoskeletal?
skeletal muscles and skeleton
2 types of connective tissue
cartilage and bone
rigid tissue, contains crystals and blood vessels, calcium and salts
gel-like and made of water
two types of bone
cancellous(spongy) and compact
outer shell of bone, more rigid
inferior bone, lattice-like pattern
end of bone
shaft of bone
what part contains bone marrow?
makes blood cells
widening before end of bone
growth plate is called?
when does the growth plate (epiphyseal cartilage) calcify?
to keep bones healthy they need _____ ____.
bone chewing cells--function in bone resorption
parathyroid hormone (PTH) is released when blood calcium levels ____
what are the 2 stages of osteoblasts....(bone building)
ossification and calcification
how does PTH increase blood calcium?
forms bones, kidneys, and intestines
released by thyroid gland when blood calcium is too highinhibits calcium release and reduce osteoclasts
calcitonin reduces the _____
osteoclasts--which break up bones to release calcium
fractures can be classified as:
complete or incomplete(green stick or partial)
open or closed
or direction of fracture line
pathologic, stress, or transchondral
parallel to axis
sloping angle to shaft
what type of break happens in osteoporosis patients?
what type of break happens in athletes?
what type of break happens in adolescence?
signs in symptoms of fractures?
loss of function
how can you diagnose fractures?
3 ways to treat fractures
preservation and restoration of function
how do you reduce a fracture?
closed manipulation (manual pressure)
or surigical reduction (hardware by surgery)
how do you immobolize a fracture?
splints or external devices
how do you preserve and restore function of a fracture?
exercise to maintain strength and reduce joint stiffness
common way to pull bones back to correct spot. used to control spasms, & immobilize area before surgery
what does ORIF stand for?
open reduction internal fixation
what are there 4 phases of fracture healing?
HEMATOMA- week 1
SOFT CALLUS- week 2-3
HARD CALLUS- week 4-16
REMODELING- week 17 and beyond
bone marrow or adipose tissue at fracture site releases fat droplets into circulation.
frequently occurs after fracture of long (femur) and pelvic bones
fat embolism syndrome
result of increased pressure within a limited space
causes decreased blood flow, tissue hypoxia, and necrosis
fascia unable to accommodate excessive edema
compartment syndrome is caused by:
bleeding and edema, related to fractures and bone surgery
or application of tight fitting dressing, splint, or cast
what are the 5 P's of compartment syndrome:
pail or cool
hallmark symptom of compartment syndrome?
severe pain out of proportion to initial injury
what are the 2 ways to reduce compartment pressures
fasciotomy and cast splitting or remove constrive dressings
tear or injury to a tendon(muscle to bone)
tear or injury to ligament (bone to bone)
complete seperation of a tendon or ligament from bony attachment site
loss of articulate of bone ends in joint- most common site: shoulder
inflammation of a tendon
inflammation of a bursa, caused by repeated trauma
type of bursitis caused by wound infection
what is the acronym for strains & sprains
rest ice compression elevation
causes of osteomyelitis
open wound or from blood borne infection
bacteria, fungi, parasites, & viruses
open wound with direct contamination.
ex: open fractures, surgery, penetrating wounds
what happens in children with hematogenous osteomyelitis:
purulent exudate inside bone. affects long bones, damages arteries to bone. may penetrate skin or involve joints
what happens in adults with hematogenous osteomyelitis:
spine, pelvis, and small bones (affects joint space)
treatment for hematogenous osteomyelitis:
antibiotics, debrievement, surgery, hyperbaric
decreased bone mineral density.
caused by osteoporosis
porous bone, poorly mineralized bone, decreased bone density and strength.
reduced bone mass/density and an imbalance of bone resorption and formation
1st line of defense to the body
normal bacterial flora
is inflammation good or bad? why or why not?
good because it's a protective response
caused by activation of chemicals and cellular components found in blood and tissues
loss of function
inflammation is the moves ___ & ____
fluid & leukocytes
itis follows what?
the name of the infected organ
long period of time
what type of cell "get to work" during acute inflammation?
chronic inflammation is what?
proliferation of blood vessels
endothelial cells are where?
lining of blood vessels
endothelial cells contain what>
antiplatelet and antithrobotic agents
vasodilators & vasoconstricters
contain histamines which cause leakiness
potent effect on cells.
increase blood flow
increase vascular permability
circulate in the blood stream until vascular injury occurs.
work to stop bleeding
what are the 3 types of leukocytes
1st one on the scene.
removes debris, dead cells, and bacteria
works then dies
cell ingests and gets rid of foreign matter
neutrophils and macrophages
leave blood stream and go to site of inflammation
2 jobs: defend against parasites & help limit inflammation by degrading histamine
important in allergic reactions
basophils and mast cells
basophils are a precursor for _____ cells.
monocytes become _____. which kill and eat debris
these replace the neutrophils and are important in chronic inflammation
immune system is challenged by foreign substances which causes the body to create antigens. these two things are the immune systems response
lymphocytes and plasma
produced by bone marrow and injure antigens
made by thymus and attack antigen directly
both B & T cells reside in peripheral ____ ____ once mature
recognize and eliminate cells infected with viruses and abnormal cells (Cancerous)
bind to infected or tumor cells & kill them
natural killer cells (NKs)
type of exudate that is clear liquid and makes blisters
like pneumonia, blood clot-more serious.
"whited out" in chest xray
found on mucous membranes.
necrotic cells in fiber & pus
purulent (discharging pus)
pocket of pus
epithelial surface eroded, necrotic
what are some symptoms of inflammation?
WBC count increase
"shift to the left"
lymph node changes
what does "shift to the left mean"?
immature leukocytes can't keep up with infections
what are way to tell if a lymph node is cancerous?
not painful, not tender
normal core temperature must be?
fever is higher when?
in the evening/night
fever is lower in the?
What controls core temp?
difference between heat production and heat loss
what is the body main heat source?
released when you need an increase in temp?
epinephrine and non epinephrine
what is shifted to produce heat, not energy?
what is a result of body metabolism being shifted?
weakness and fatigue
doing this 3-5 times increase in body temp?
shivering and chattering of teeth
what causes an increased body temp?
what is produced by muscle and viscera?
heat is transferred in the blood to what?
what is an example of heat loss?
when do you have more blood volume?
when do you have less blood volume?
when is heat lost?
what is the scientific name for fever?
what is caused by pyrogens?
causes of fever?
-increase in intracranial pressure
purposes of fever?
-cook the poison
-immune function enhanced with small temp increases
fever is considered harmful when it reaches?
what are the patterns of fever?
-recurrent or relapsing
sepsis, abscesses, bacterial endocarditis
viral upper respiratory infections
recurrent or relapsing
Your heart rate normally increases how many bpm with an increase of 1 degree fahrenheit?
when you have fever what also increases?
when you have fever you are also seen to have?
-chills (draw blood cultures)
4 stages of fever?
what are some signs that you may have fever?
if a patient has chills you should do what?
draw blood cultures
there are changes in fever because of?
increased oxygen need and metabolic rate
use of protein instead of glucose
what are some changes in the elderly and children?
elderly see confusion and agitation
fever unknown origin
treatment for fever
spongebaths, or alcohol solutions
have a high risk for bacterial infections
limited signs of infection
lethargy, poor feeding, cyanosis
neonates, young infants
the elderly's lower basal temp is?
in the elderly... fever is how many degrees above the baseline?
if the elderly don't show signs of fever, we should check for
change in mental status
in elderly use what kind of thermometers?
rectal or tympanic
tissue repair for same type cells. sometimes there is no trace of injury
repairs connective tissues which are scars or fibrosis
if regression is impossible-----
replacement with connective tissue and scar forms
growth of new blood vessels
when is granulation good?
when its red and moist
3 ways to repair connective tissue
scar forming by replacing CT
primary healing will.....
heal fine cause the cut was intended
secondary healing will heal....
from bottom up and will have trouble
"collagen on overdrive"
what affects wound healing?
blood flow & oxygen delivery
(Diagnosis of Diabetes mellitus, corticosteroids, infections, and foreign bodies in wound)
in the elderly does their skin change?
elderly are in increased risk of.....
do elderly have problem healing?
normal ranges for pH?
normal range for PaCO2?
(partial pressure of carbon dioxide)
normal range for HCO3?
who is most sensitive to fluid deficits?
happens to cell in isotonic?
what happens to cell in hypertonic?
what happens to cell in hypotonic?
normal levels of salt?
decreased salt; under 135
do hyponatremia patients have floppy of twitchy symptoms?
increased salt; over 145
do hypernatriema patients have floppy or twitchy?
normal potassium levels?
decrease in potassium; less than 3.5
hypokalemia; floppy or twitchy?
increase in potassium; over 5.0
hyperkalemia; floppy or twitchy?
floppy THAN twitchy
normal calcium levels
decrease in calcium; less than 8.5
hypocalcemia; floppy or twitchy?
increase in calcium; over 10.5
hypercalcemia; floppy or twitchy?
sperm and egg
somatic cells are..
in somatic cells how many chromosomes are there?
23/23 pairs identical are called
everyone inherits one copy of each ____ from each parent
presence of only one copy of a chromosome....LETHAL
presence of 3 copies of chromosome...may survive
birth defects are called..
congenital defects are caused by:
Disorders are almost always associated with what chromosome?
Risk factors for genetic problems:
type 2 DM
chromosome disorder on the 21st chromosome
down syndrome--- trisomy 21
down syndrome is a predisposition for:
Congenital heart disease
S&S of down syndrome?
intellectual---moderate to severe
sensory---eyes are different
one crease across palm(simian crease)
Downs syndrome problems?
-respiratory infections (since tongue protrudes)
-vital signs, congestion, can't feed
-monitor---urine, edema, feeding, skin color
deletion or abnormal x on chromosome 45
what does turners affect?
women; they will only have 1 X chromosome
turner's is a predisposition for:
aortic coarctication (aorta narrows)
behavioral and learning disturbances
what do the females look like with turners?
must give estrogen prior to 12 to develop normally
watch for cardiac, renal, thyroid dysfunction
how many turner's babies are spontaneously aborted?
syndrome in which you have X-linked one or more extra x chromsome
how many male births are affected by this?
how to klinfelter's look?
tall lean body
testicular dyngenesis (testes don't develop)
voice doesn't change after puberty
sparse facial hair
abnormalities in klinfelter's?
metabolic disorder --- lack enzyme which converts phyenylalanine to tyrosine
if untreated PKU can cause
how many are affected by PKU?
when are people screened for PKU?
S&S of PKU
musky odor to urine
failure to thrive
seizures, vomiting, rashes
special dairy products
avoid high protein foods
Problems with PKU
if phenylalanine is not converted it can increase to toxic levels
irreversable CNS probs. and mental retardation
degeneration of cerebral cortex.
25-55 yrs of age
connective tissue disorder
marfan's often causes what?
aortic aneurysm--common cause of early death
in marfan's syndrome you should monitor what?
growth, development, vision
give beta blockers for heart probs.
absence of tyrosinase---needed for melanin production
there are two types (I & II).
which is worse?
type I is worse
it is worse because they have NO melanin in their eyes. type II has some pigment
S&S of albinsim
lung and bowel disease
low vision or legally blind
interventions for albinism
check for melanomas
-interruption of development in utero
-risk for aspiration, malnutrition
interventions for cleft palate
monitor for ear infections/hearing loss
autosomal recessive chromosome disorder
cystic fibrosis involves blockages where?
cystic fibrosis also affects the respiratory system how?
thickened secretions decrease ciliary function
cystic fibrosis affects mostly
CF patients ____ is not transported. so people perform the ____ test to see if it is secreted through the sweat
NaCl & Kiss test
CF leads to ___ side heart failure (for pulmonale)
Treatment for CF
administer oxygen, but not too much cause it could kill
S&S of CF
large protruding abdomen
failure to thrive
steatorrhea ( foul smelling stool)
skull, brain malformation
small eye opening, thin upper lip, flat midface
fetal alcohol syndrome (FAS)
all women of child bearing age should take this
all enriched grain cereals in US have this
folic acid deficiency