Patient Special Challenges Flashcards
(83 cards)
1
Q
what is conductive deafness?
A
very common: Blockage of transmission of sound waves through external ear canal to the middle or inner ear (otitis media, cerumen (earwax), hair spray, bugs, etc.).
2
Q
otitis media
A
inflammation of inner ear
3
Q
cerumen
A
ear wax
4
Q
can hair spray and bugs effect your hearing?
A
yes
5
Q
Sensorineural deafness
A
Nerve Damage, Hair Cells in the Cochlea are damaged or destroyed (inner ear).
6
Q
what is a big thing that can cause meningitis?
A
ear infections
7
Q
Presbycusis
A
high pitched sounds first (age related hearing loss)
8
Q
any acute onset of sensory loss what should we think?
A
Stroke
9
Q
ski slope hearing test
A
start high and go to low hearing sounds
10
Q
cookie bite
A
can hear high and low sounds but not sound in the middle.
A lot of hearing aids will be for this hearing loss
11
Q
what meds can cause hearing loss?
A
- lasex (pushed too fast)
- ASA (asprin)
- antibiotics
12
Q
can medication change cause hearing loss?
A
yes
13
Q
what is deafness?
A
Deafness is caused by the inability of nerve impulses to reach the auditory center of the brain because of nerve damage to either inner ear or to brain.
14
Q
what are 3 causes that can cause deafness?
A
- Brain injury (CVA) can cause the damage stopping the translation. Acute change on one side could be an indication.
- Can be caused by meds.
- Strokes
15
Q
Cochlear implant
A
mounted on back of head behind ear. Goes into auditory nerve, picks up vibration from skull and it turns into sound.
16
Q
What is normal vision?
A
normal vision depends on the uninterrupted passage of light from the front of the eye to the light-sensitive retina at the back
17
Q
What can cause visual changes?
A
- diseases (diabetes) -congenital conditions - infections - degenerative disorders - Enucleation
18
Q
Macular Degeneration
A
causes loss in the center of the field of vision. Will see a dark spot in the middle of their vision. These pt will use their peripherals to see (so look off to the side)
19
Q
Retinopathy
A
Disease of the Retina
causes can be from diabetes
20
Q
what is vision loss?
A
Any condition that obstructs the passage of light from the retina can cause vision loss
21
Q
Is acute eye loss an emergency?
A
YES
22
Q
Diplopia
A
Double vision
23
Q
Presbyopia
A
Age related Vision impairment.
24
Q
Receptive aphasia (sensory)
A
process of losing the ability to understand the meaning of the spoken word, the ability to interpret objects, or understand the written word.
Stroke pt can have this
25
Expressive aphasia (motor)
Can’t figure out the right words. Might give you social security number instead of phone number you asked for- “word salad”
Stroke pt.
Drunk Pt. (sedated, signals not making connections)
Cancer pt.
26
Global aphasia
Both sensory and motor combined, cannot communicate at all
NOTHIN WORKS
27
phasia
s- for speech
28
plagia
g- gut (eat)
29
articulation dysarthria
Know want to say, but musculoskeletal system will not let mouth say it. Physically cannot make words (The loss of function of your tongue)
Word creation is from the mouth and tongue
30
fluency disorders
stuttering
31
dysarthria.
Loss of the ability to form words
"can't treat an old dog new tricks"
32
Any acute change in speech is considered?
A medical emergency
33
accommodations with speech problems
- Never assume the person lacks intelligence.
- Form questions that require short, direct, answers.
- Never pretend to understand when you don’t.
- Let the patient write answers to questions.
- Always rule out other medical conditions.
34
Obesity
40% of people in the US are obese
35
why are people obese?
- slow metabolism
- excessive caloric intake
- lack of exercise
- metabolic disorder
the top two are excessive caloric intake and lack of exercise.
36
What are some serious medical issue with obesity?
- MI
- Diabetes
- Hypoxie
- sleep apnea
37
Paraplegia
full or partial paralysis of both legs and sometimes part of the trunk.
38
Quadriplegia
full or partial weakness or paralysis of all four extremities and the trunk
39
Tetraplegia
paralysis of the diaphragm with quadriplegia- must be on vent
40
what causes paralysis?
Caused by nerve damage in the brain and spinal cord.
41
when moving a tetraplegia pt what is something you should be careful about when moving them?
the vent cord
42
what are the top two things that paralysis pt get medically?
- UTI
| - pnemonia
43
halo traction
Halo-gravity traction is a method of gently stretching and straightening a severely compressed or curved spine.
seen a lot with cervical spine injury.
difficult to do CPR (can't without removing the device) there is special way to remove it.
44
What can traumatic brain injury cause?
- cognitive injury
- physical injury
- psychological skills
45
Down Syndrome
Trisomy 21 (there is an extra chromosome on #21)
- abnormality and developmental delays, mild to severe mental retardation
- large tongue
- congenital heart disease (40-50%)
- immunological deficiency (prone to infection)
- epilepsy
- 20% unstable atlantoaxial joint (complex joint between the atlas (C1) and the axis (C2).)
Treatment: get a good history and check the status of cognitive status.
46
Patau Syndrom
Trisomy 13 (there is an extra chromosome on #13)
Multiple developmental abnormalities
1 in 6000 are born
Life longer than 1 year is rare
Most born stillborn, multiple developmental abnormalities
47
Edwards Syndrom
```
Trisomy 18 (there is an extra chromosome on #18)
- barley make it to age 2
- they have pointed ears
- hand and finger clamped down
Heart defects,
95% die in 1st year,
50% die in 1st 2 months
```
48
Pierre Robin Syndrom
- congenital
- infant has a smaller than normal lower jaw
- cleft palate
- tongue falls back in the throat, choking is a big hazard
49
what is the difference between congenital and genetic?
congenital- formed at birth
| genetic- based down from genes
50
what did down syndrome used to be called?
mongolianism
51
What does mental illness cover
refers to any form of psychiatric disorder
52
psychoses
- looses contact with reality
- biochemical disease that disorders brain function
- Hallucinations, (auditory and visual)- any perception of a sensation that doesn’t exist-delusions are different-strong belief despite strong evidence to the contrary
Ex:
- schizophrenia
- bipolar disorder (manic- depressive illness)
- organic brain disease
53
What test are there for psychoses and neuroses?
There are ZERO test, x-ray, CT, etc… for these Pt’s. Diagnosis is strictly exclusion.
54
what can result as mental illness that has to get ruled out first?
Hypothyroidism
55
Hallucinations
any perception of a sensation that doesn’t exist-delusions are different-strong belief despite strong evidence to the contrary
56
neuroses
person remains "in touch" with reality
Neurotic symptoms generally do not limit work or social activity and tend to fluctuate in intensity with stress.
Ex:
- depression
- phobias
- obsessive compulsive behavior
57
how early do we notice or diagnose Schizophrenia
Can present in adolescence stage of life
58
developmentally disabled
impaired or insufficient development of the brain that causes an inability to learn at the usual rate.
59
Neurasthenia
nervous exhaustion
60
emotionally impaired
Persons with emotional impairments include
- neurasthenia
- anxiety neurosis
- compulsion neurosis
- hysteria
61
what medication is the choice for neuroses?
SSRIs
62
Mentally impaired
refers to persons who have impaired intellectual functioning (mental retardation) that results in an inability to cope with normal responsibilities of life.
63
Cerebral Palsy (CP) is it a progressive disorder?
No, its a non-progressive (doesn't get better or worse with time)
64
what will cause Cerebral Palsy?
Results from damage to the fetal brain during later months of pregnancy, during birth, during the new born period, or in early childhood.
65
What is Mucoviscidosis?
Cystic Fibrosis (CF)
66
is cystic Fibrosis genetic or congenital?
Genetic (inherited metabolic disease of the lungs and digestive system that manifest itself in childhood)
67
What is Cystic Fibrosis?
```
increased mucous production
inability to breakdown fats
- pancreatic enzymes
failure to thrive
inability to regulate chloride
-causes mucous to become thick like glue like.
```
68
What is Cystic Fibrosis?
```
increased mucous production
inability to breakdown fats
- pancreatic enzymes
failure to thrive
inability to regulate chloride
-causes mucous to become thick like glue like.
```
Average life span is around 30.
69
Multiple Sclerosis (MS)
a progressive and incurable autoimmune disease of the CNS, whereby scattered patches of myelin in the brain and spinal cord and destroyed
Like stripping a speaker wire, it will slowly make the speaker not work. This is happening with the nerves (the break down of it)
Cause is unknown
70
When does MS begin?
usually begins early adult life.
71
Muscular Dystrophy
An inherited muscle disorder that results in slow but progressive degeneration of muscle fibers.
72
is Muscular Dystrophy curable?
no
73
can you find muscular dystrophy in both male and female?
Found in males only
74
What are signs and symptoms of Muscular Dystrophy?
- Toe walking
- Frequent falls
- Difficulty rising from a lying or sitting position
75
Poliomyelitis (Polio)
An infections disease caused by Poliovirus Hominis
76
how is Poliomyelitis (Polio) virus spread?
the virus is spread through direct and indirect contact with infected feces
77
Myasthenia Gravis
an autoimmune disorder in which muscles become weak and tire easily
78
Is myasthenia more in woman or men?
woman (20-30 yo)
| when in men usually 70-80 yo
79
What is osteoarthritis?
common wear and tear on the joint.
| - its the break down, and a calcification build up, and the joint stops working as well
80
What age group "usually" get Osteoarthritis?
commonly in elderly pt
81
Rheumatoid Arthritis?
RA is an autoimmune process
| A chronic inflammatory disorder affecting many joints, including those in the hands and feet.
82
what is a very lethal thing that can happen to someone with Rheumatoid Arthritis?
Silent Heart Attack
83
What should you do if you have a pt that has cancer and you are going in the ambulance with them?
have them wear a mask and you wear a mask
