Patho Flashcards
(108 cards)
1
Q
Pain def
A
an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage per iasp
2
Q
Acute pain lasts for up to
A
6 months
3
Q
Can pain be emotional or phyical
A
Yes
4
Q
What is gate control theory?
A
5
Q
What does gate control mean?
A
6
Q
Nociceptors are
A
Physiological pain refers to the normal Pain transmission. Usually external
7
Q
What is the most acute pain related to?
A
Trauma surgery or illness
8
Q
Categories of pain stimuli
A
BIological *** like 6 more
9
Q
Pain etiology
A
Nociceptive, neuropathic, acute pain,
10
Q
types of acute pain
A
somatic, visceral, and referred
11
Q
somatic pain
A
located in skin andn musculoskeletal tissues
12
Q
visceral
A
body organs and cavities in chest, abdomen and pelvic areas
13
Q
referred pain
A
sensed in regions other than site of origin
14
Q
3 types of breakthroughpain
A
incident pain, idiopathic pain, end of dose medication failure
15
Q
what is end of dose medication failure
A
pain at thte end of tone medication dose before the next scheduled dose
16
Q
how to fix end of dose medication pain?
A
increase medication dose or shorten time between doses
17
Q
Incident pain examples:
A
predictable pain: chest pain upon coughing
18
Q
Pain risk factors
A
Gender, age, obesity, sedentary lifestyle, level of stress/anxiety, high risk activities-smoking, sports, cultural beliefs of pain.
19
Q
Barriers to pain management from a client perspective
A
- Doesn’t report
- cultural
- fear of being addict
- worries about side effects
- financial barriers
- belief that minority populations do not get treated for pain adequately even when pain is reported
20
Q
Barriers from HCP perspective
A
Regulatory issues
delay in administration of pain meds until diagnosis
knowledge deficit
fear of tolerance adverse effects
poor assessment
prescribe only small amount to prevent misuse
infrastructure barrier so inadequate reimbursement for pain management
21
Q
pain prevention
A
pain relief pharm and non pharm
- take them as prescribed
- take regularly
- take safety precautions -> dont mix and don’t be stupid
- change modifiable risk factors > dont go to wefest after having hip surgery
22
Q
Somatic manifestations
A
sharp, swelling, cramping, aching, gnawing, bleeding, localized
23
Q
Visceral manifestations
A
Dull deep, squeezing, pressure, aching, vague and difficult to localize
24
Q
What will people in pain look like
A
Maybe increased BP, HR, and RR, diaphoresis, pallor, and dilated pupils (this one is flight or flight)
25
Uncontrolled pain can manifest into prolonged life circumstances
appetite, sleep, circulation and O2 levels, increased risk of thrombosis, decreased quality of life
26
3 step approach which is 90% effective is
assess pain severity
begin treatment at proper step of ladder
move up ladder until pain controlled
27
steps of the pain ladder
1. non opioid
2. weak opioid or adjuvant
3. strong opioid
28
fracture def
break or crack in continuity of bone
29
Depo-Provera (birth control) can cause
osteoporosis
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Fracture classifications
closed or open
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types of fracture lines
can be oblique, spiral transverse, linear, nondisplaced, greenstick, comminuted
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Fractures in children can occur due to
trauma, abuse, or medical condition
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Fracture healing phases (3)
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Risk factors for fractures
osteoporosis, bone cancer, lack of viamin D, Calcium, phosphorus
35
Prevention
protect the goddamn head - just use protective equipment
oh! also safe living environments and dont fall
36
Compartment syndrome "6 Ps"
Pain
Pallor
Paresthesia - pins and needles sensation
Paralysis
Pulselessness
Poikilothermia - inability to regulate core body temp
37
What is a Fasciotomy
38
What is an SCD
Sequential compression device - leg massager for DVTs
39
READ about FAT EMBOLISM SYNDROME
40
Complications of Open fractures
Infection, comnamination, clostridium leading to gangrene, cellulitis, osteomyelitis.
41
Papilledema
Pressure in or around the brain causes the part of the optic nerve inside the eye to swell.
42
Symptoms of papilledema
Visual symptoms may be fleeting disturbances in vision.
43
myasthenia gravis (muscle grave) symptoms
Ptosis (eyelid drooping) is the most common
Muscle weakness varies depending on the muscles affected.
Shortness of breath and respiratory distress occurs later as the disease progresses.
NOT:
Muscle spasms are more likely in multiple sclerosis. Photophobia is not significant in myasthenia gravis.
44
As ICP increases due to what?
hypotension and hypoxia lead to vasodilation, which contributes to increased ICP.
45
TRACTION pneumonic
T: temp
R: Ropes hang freely
A: Alignment
C: circululation checks (6 Ps)
T: type and location of Fx
I: Increase fluid intake
O: overhead Trapeze
N: no weights on bed or floor
46
How often should someone be repositioned with fx
1-2 hours
47
Best way to prevent DVT
move
48
Late signs and symptoms
Widening pulse pressure
49
What is widening pulse pressure
systolic higher diastolic may be same or decreased lack of oxygen to brain tissue MAP obviously goes down
50
def of stupor
Deep sleep, pt can be aroused by vigorous and repetitive stimulation. Returns to deep sleep when not continually stimulated.
51
Environmental Risk factors for ICP
Tetracycline, poor eatting, putting yourself in shit positions where youre going to hit your head bad (no helmet, biking, contact sports)
52
How long can a CVA be indicated after a TIA
90 days
53
Ischemic strokes are divided into three types. WHat are they?
Thrombotic - clot that usually resolve on their own (TIA)
Embolic - clot from different part of the body (afib)
Lacunar - infarcts within deep arteries of the brain stem and basal ganglia. leave cavities. THink dementia
54
Diagnostics for stroke
CT - gold standard
MRI - if they cant see anything
CBC - infection?
Echocardiogram - did the clot come from the heart
angiogram - define blockage or or obstruction in head
carotid ultrasound - arterial obstruction mapping in neck
55
Complications of Stroke
decreased cerebral blood flow due to increased ICP
inadequate o2 to brain
pneumonia (aspiration)
Seizure
56
Treatment of Stroke
Tissue plasminogen activator tPA is given 3-4.5 hours after ct scan is done to approve there is no bleeding
57
left sided stroke
aware of deficits (sad and anxious), slow performance, impaired speech and language, visual field deficits.
58
intracerebral hemorrhage defined as
Hematoma in brain tissue called the parenchyma.
59
parietal lobe
processinformation when people speak to us and sensations
60
cerebellum controls
controls balance, oisture and coordination
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Brain stem controls
breathing sneezing, coughing, swallowing and heart beat
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Modifiable risk factors for stroke
hypertension #1, heart diseaase, hyperlipidemia, diabetes, drug abuse (the cocaine)
63
Non modifiable
ethnicity (African), gender (men),
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Complication of lumbar punctures
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Contraindications for tPA
BP above 185/110,
bleed/on blood thinner
Hx of GI bleed
previous stroke with tPA
Craniotomy within 3 months
major surgery within 14 weeks
66
4.5 hours to 24 hours of stroke
mechanical thrombectomy done in IR
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drugs for after stroke
Eliquis and warfarin, aspirin
68
Reverse warfarin
vitamin k protrombin FFP
69
stroke on left side will exhibit
comprehension, language***, expression
70
Brocas area is
speech production or verbal expression
71
When someone hhas a stroke in Wernickes what will you see as a deficit
72
What do you see with global aphasia
* non fluent
* damage to extensive portions of the language areas of brain
* severe communication difficulties
* extremely limited in inability to speak or comprehend language
73
Impulsiveness in right sided stroke
They don't have control of their impulses. If you say "we are getting up on 3" and they go when they hear 3. they don't mean to
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Aproxia
75
Agnosia
inability to recognize object
76
What is a Pontine Stroke
Stroke at the Pons
- Locked - in syndrome. it's fucking horrific catastrophic
Pons
- any lesion, mass, infection, trauma, of demyelinating disorders
- Communicate through eye movement
77
Nihilistic delusion involves a belief of what in schizophrenia
the client's organs aren't functioning or some body part or feature is horribly disfigured.
78
A grandiose delusion involves the belief of what
that one has exceptional powers, wealth, skill, influence, or destiny.
79
A persecutory delusion involves the belief...?
one is being watched, ridiculed, harmed, or plotted against
80
.A somatic delusion involves a belief about
abnormalities in bodily structure or functions
81
Which is a nonneurologic side effect of antipsychotic medications?
Weight gain
82
A verbigeration is
the stereotyped repetition of words or phrases that may or may not have meaning to the listener.
83
Clang associations are
ideas that are related to one another based on sound or rhyming rather than meaning.
84
Neologisms are
words invented by the client.
85
salem sump tubes are how many lumens?
two
86
Salem sump blue tube is used to
neutralize air so the Salem can be suctioned and not cause a contusion then ulcer
87
What are signs and symptoms of Salem sump tube being occluded? How can it happen, and how do you fix it?
Continued nausea, distended stomach, abdominal pain.
It can coil or kink, or be plugged. to fix it fluid challenge to unclog, check the back of the throat (open their mouth) and make sure it isnt fucking coiled in the back of their throat
88
Salem Sump Tube
Sump pump that is used to continuously suctioned.
Avoids forming against the lining of the stomach
Used for suction or gastric feedings
89
Who determines the size of tubing in OG or NG
You bitch - the nurse
90
Post pyloric feeding tube - Cortrak or DubHoff are for what?
Tubes meant to go past the post pyloric area for feedings only. Dont suction that persons duodenum.
91
How to confirm the post pyloric feeding tube is in
Check xray for confirmation incase it gets tugged, check the numbers and the size
92
How long can a patient have a post pyloric feeding tube be placed
there is technically no timeline just watch for pressure ulcers with this tube - need to rotate it
and it getting clogged - well youre fucked redo it
93
What is PUSH DOG for liver
94
Acute Liver failure:
Onset of encephalopathy less than 7 days after the development of jaundice
95
Sub-acute liver failure
5 weeks but less than 12 weeks after the development of jaundice
96
S/S of Liver failure
Jaundice, abd pain and swelling, AMS, easy bruising and bleeding, Fatigue/weakness, encephalopathy
97
What is encephalopathy?
When ammonia travels to the brain and causes ams because it is not converting to urea
98
Fibrin is like a net why
Because it catches the platelets to make a clot
99
Indications of psychoses
restlessness, auditory hallucinations, and pressured speech require immediate follow up
100
manifestations of bacterial meningitis
fever, photophobia, nuchal rigidity, petechial rash, and impaired consciousness.
101
Manifestations of encephalitis
fever, nuchal rigidity, and altered mental status
102
Manifestations of Reyes
primarily by altered mental status and impaired hepatic function.
103
what is Lanugo
Latin in origin (wool, down). First hair on baby and in anorexic patients
104
Steps to care for trach
When teaching the parent to provide tracheostomy care, the nurse should instruct the parent to first remove the inner cannula. Next, the nurse should instruct the parent to remove the soiled dressing and then clean the stoma with 0.9% sodium chloride irrigation. Finally, the nurse should instruct the parent to change the tracheostomy collar.
105
When analyzing cues, the nurse should identify that thyroid storm can be caused by trauma to the thyroid gland, such as surgery, and excessive release of thyroid hormone greatly increases the metabolic rate. What signs should the nurse look for
Fever greater than 38.5° C (101.3° F), heart rate greater than 130/min, systolic hypertension, and mental status changes, such as confusion, restlessness, and sleepiness, are characteristic of thyroid storm.
106
The nurse should analyze cues of pneumonia that include tobacco use, elevated WBC count, a productive cough with blood-tinged sputum, elevated temperature, a decreased oxygen saturation level, and an ABG level indicating respiratory acidosis.
The nurse should also analyze cues of COPD that include tobacco use and a decreased oxygen saturation.
The nurse should also analyze cues of heart failure that include tobacco use, BNP level, and a decreased oxygen saturation.
107
Upon analyzing cues, the nurse should identify that the client is at risk for confusion due to a sodium level that is greater than the expected reference range. Hypernatremia places the client at risk for a decreased level of consciousness, falls, and seizure activity. Therefore, the nurse should monitor the client's level of consciousness and place the client on fall and seizure precautions.
108
