SI3

Question 1

Anemia is

Answer 1

Not a disease, it’s a symptom

Question 2

Decreased Hgb

Answer 2

Often r/t to iron def or chornic blood loss

C: Very young, very old, poor diet, women in repro years

SS: Pallor, glossitis, cheilitis

Tx Tx underlying cause, iron supplements, blood trsnfusion, nutriton

Question 3

Glossitis

Answer 3

Swollen tonguw

Question 4

Cheilitis

Answer 4

Swollen lips

Question 5

Defective DNA synth of RBCs

Answer 5

Patho: Often r/t folic acid and Vit B12 Def

Tx Supplemental Vit

Question 6

Dimished availability of erythrocyte precursors

Answer 6

Often lead to aplastic anemia

C: Renal dx, autimmune malignancy

SS: high ferritin and iron stores

Rarely w/ blood transfusion, often with EPO supplement

Question 7

Acute blood loss causing anemia

Answer 7

May lead to hypobolemic shock, internal hemorrhage or tetroperitoneal bleed

C: Caused by trauma

SS: Pain that cant be explained otherwise
- Very bad back pain in LQ

Tx: Stop bleeding, tx pt, monitor lavs

Question 8

Hemolytic anemia

Answer 8

Destruction of RBCs at a rate that exceeds production

Extrinisc (More common)
Damaged spleen
Intrisnic: SIckle cell

…

Question 9

Sickle Cell Crisis SS

Answer 9

Pain+++, swelling, pallor of mucous membranes, fever, jaundice , vasooccluisve crisis - tachypnea, HTN, NV

Question 10

Complications of sickle cell crisis

Answer 10

Gradual involvment of all body systems - spleen, lungs kidney and brain

Prone to infection, acute chest syndrome

Question 11

Diagnostics of sickle cell anemia

Answer 11

Peripheral blood smear, sickl8ing test, electrophroesis of hgb, MRI
Genetic

Question 12

Nursing mgmt of sikcle cell anemia

Answer 12

Aoid hifh altritiurdes, maintain fluid intake , tret infections, help with pain control, supplemental O2

Acute ches tsyndrome: Abx, O2, Fluid, transfusion

CURE: Stem cell transplant

Question 13

Immune Thrombocytopenic purpura

Answer 13

Abn destruction of circulating platletsSS: Gums and nose bleed, purpura (Non blanching)

Tx: Corticosteriods splenectemy

Question 14

HIT

Answer 14

Immune system cause splts to clot in presence of heparin

SS: Heparin causes pts plts count to fall 50% + From baseline

Tx: d/c heparin

Question 15

Disseminatied intravascular coagulation

Answer 15

Abnormally initiated and accelerated clotting

SS: Bleeding out of everywhere

Tx: Underlying cause - must diagnose quickly, often too late

Question 16

Leukemia BE ABLE TO INTERPRET what labs would look like for leukemia

Answer 16

Common in adults

Abrupt - dramatic onset, serious infection or abn bleeding

Sky high WBC - 80s to 100s (Blasts- immature)

Hyperplasia of bone marrow and spleen

Often responds well to chemo

Low RBC and Plt count bc there’s not room in the bone marrow for that

Question 17

ALL Leukemia

Answer 17

Common in kids

SS: Fever, bleeding, fatigue, CNS manifsestations

More difficult to tx

Question 18

CML Leukemia

Answer 18

Genetic marker - philadelphia chromosome

Can be well controlled w/ tx

Chronic onset - swelling of spleen, liver, lymph nodes - bleeding bruising

Question 19

CLL

Question 20

Lymphoma vs leukemia

Answer 20

Leukemia: Originates in bone marrow/blood

SS: Blood marrow crowed by increased WBC

DIfference in location causes difference in ss

Question 21

Risk factors of sickling

Answer 21

Significant blood loss
Illness
Climbing/flying at high altitudes
Keeping continued stress (mental/physicaal)
Low fluid intake
Elevated temp (fever)

Question 22

Manifestation of cirrhosis

Answer 22

Jaundice
Skine lesions - Spiders and red palms (low levels of estrogen)
Hematologoical problems
Periph neuropathy - vitamin def and malnoutrish
Esophaogeal varices causing anemia

Question 23

Know the two types of encephalopathy

Question 24

Portal vein hypertension

Answer 24

Increase in BP in protl venous sytem r’t liver blockage

SS May lead to large swollen veins that can rupture and bleed

Tx: Propranolol

Question 25

Esophageal Varices

Answer 25

Collateral circulation in esophagus that is less strong SS: Red blood in vomit black stool, high HR, low BP Tx: Diagnosed with endoscopy, tx with vitamin K, pantoloc, octreotide, octaplex if acute leeting, ligation sx

Question 26

Ascities

Answer 26

Accumulation of flood in peritoeal cavity SS:Abd distention, wt gain, abd striae, ss of degydration hypoK Tx : Na restriction, diurtetics, fluid removal, paracentesis, IV albumin

Question 27

Edema is a hige risk for

Answer 27

Skin breakdown

Question 28

Where can crohns be found?

Answer 28

Technically anywhere in GI, ususally lower SI

Question 29

Which IBD results in non bloody stools

Answer 29

Crohns

Question 30

Anemia caused by UC

Answer 30

Acute blood loss from ulcers (drop in Hgb) - low iron

Question 31

Crohns caueses anemia

Answer 31

Reduced absorption (malabosorption)

Question 32

Which IBD goes ALL the way through the tissue layers

Answer 32

Crohns

Question 33

Which IBD has an increased risk to colorectal cancer

Answer 33

Colitis

Question 34

Cobblestone appearance, inflamed, edematos mucosa with deep longitudinal lacerations is found in which IBD?

Answer 34

Crohns

Question 35

Colitis colon tissue looks like

Answer 35

Hypermic + Edematous in affected area Abscesses turning into ulceration that bleed

Question 36

Tx for UC

Answer 36

Rest bowel Control inflam Mnaage fluids and nutrition Manage pt stress Provide education ab dx and tx Provide SS relief

Question 37

Why aren't UC pts prescribed NSAIDS

Answer 37

bc they increase risk for GI Bleed

Question 38

Drug therapy for UC

Answer 38

Sulphasalizine Corticosteriods Immunosuppressive drugs

Question 39

Sx for UC

Answer 39

Removal of protions of the bowel

Question 40

Crohn's dx tx durg

Answer 40

Sulphasalazine Corticosteriods Flagyl (DIFFERENT FROM UC) - Fistulas can cause secondary infections, so treated Bio Drug

Question 41

Which IBD spreads in continuous pattern and has presence of pseudopolyps

Answer 41

UC

Question 42

Whic hematopoietic supp is used for anemia in Crohns

Answer 42

Cobalamin (B12) Supplements

Question 43

With Crohn's pts are on immunosuppressant therefore infections are often only shown by

Answer 43

Fever

Question 44

MS manifestation

Answer 44

Weaknress or paralysis of body parts Scanning speach Sight and hearing loss Bowel and bladder - Constipation, spastic bladder (Contracts) Flaccid (No desire to void)

Question 45

HD

Answer 45

Lots of abnormal movements and jerking Self care deficit Cognitive decline progresses, pt eventually becomes demented and incontinent Severe mood swings Sexual outbursts Tx is palliative Haloperidol is given to reduce ss of excessibe movment

Question 46

PD

Answer 46

Tremor Rigidy Akinesia Postural instability SS worse with stress

Question 47

Tx of PD

Answer 47

Dopaminergic Loveodp-Cardipoa

Question 48

To reduce fall risk in PD pts

Answer 48

Consciously lift feet while walking

Question 49

PID SS

Answer 49

Resulting for untreated cervicitis often Low abdom pain Spotting after intercourse

Question 50

Endometriosis

Answer 50

Secondary dysmenorrhea Infertility Pelic pain Painful intercourse Irreguar bleeding Painful bm Dysuria

Question 51

Why is semi-fowlers used during PID

Answer 51

To drain out infection

Question 52

Which action is taken if a pap test reveals minor cell changes

Answer 52

Schedule another pap test in 4 motnhs