U6 Cancer, HIV, Burns Flashcards Preview

Nursing > U6 Cancer, HIV, Burns > Flashcards

Flashcards in U6 Cancer, HIV, Burns Deck (64):
1

Sepsis S/S

Fever >101.3
HR 90 BPM
RR >20
Infection

2

Severe Sepsis S/S

Mottled skin
Decreased UO
Change in mental status
Decrease in platelets
Dyspnea

3

Septic shock criteria

S/S of severe sepsis
PLUS
Extremely low BP

4

DIC S/S

Pain
Stroke-like appearance
Dyspnea
Tachycardia
Reduced kidney function
Bowel necrosis

5

DIC tx

Anticoagulants (heparin)
Cryoprecipitated clotting factors
FFP

6

Hypercalcemia early S/S

Fatigue
Loss of appetite
NV
Constipation, polyuria

7

Hypercalcemia more serious S/S

Severe muscle weakness
Loss of DTR
Paralytic ileus
Dehydration
EKG changes

8

Superior Vena Cava Syndrome

SVC is compressed by tumor or clots
Occurs most often in pts with lymphoma, lung cancer, & breast cancer

9

SVCS early S/S

Facial edema esp around eyes
Tightness of shirt collar

10

SVCS S/S worsening compression

Distended blood vessels
Erythema of upper body
Edema in upper extremities
Dyspnea
Epistaxis

11

SVCS late S/S

Hemorrhage
Cyanosis
Change in LOC
Hypotension

12

Tumor lysis syndrome

Large number of cells are destroyed
Intracellular contents are released faster than body can eliminate them
Very high potassium levels
Large amounts of purines (crystals in kidneys)

13

Tumor lysis syndrome S/S

NVD
Elevated T wave, wide QRS
HTN
Decreased/absent UO
Flank pain
Hematuria
Seizures
Lethargy
Paresthesias

14

Tumor lysis syndrome lab results

Elevated uric acid
Elevated potassium
Elevated phosphate
Decreased calcium

15

Tumor lysis syndrome tx

Antiemetics
Diuretics (mannitol, allopurinol)
Kayexalate (pulls potassium out)
IV with glucose & insulin

16

HIV Clinical A

Flu-like symptoms
Lymphadenopathy
Sometimes no S/S

17

HIV Clinical B

HIV+ with 1 or more infections that are complicated by HIV

18

HIV Clinical C

HIV+ with accompanying AIDS conditions

19

HIV 1

CD4 at least 500

20

HIV 2

CD4 200-499

21

HIV 3

CD4 < 200

22

HIV tx HAART

Highly active antiretroviral therapy
3 or 4 HIV meds with other antiretrovirals

23

HIV complications

Opportunistic infections
Wasting syndrome
Fluid/electrolyte imbalance
Seizures

24

Pneumocystis carinii pneumonis (PCP)

Protozoan infection
Most common opportunistic infection
Dyspnea with exertion
Dry cough
Fever/fatigue
Crackles

25

Toxoplasmosis encephalitis

Protozoan infection
Contact with contaminated cat feces
Undercooked meat
Change in LOC
Headaches
Fever
Speech, gait, & vision problems

26

Cryptosporidiosis

Protozoan infection
Intestinal infection
Mild diarrhea to severe wasting
Electrolyte imbalance
Diarrhea may cause fluid loss of 15-20 L/day

27

Candida Albicans

Fungal infection
Normal flora of GI tract
Food tastes funny
Mouth pain
Difficulty swallowing

28

Tuberculosis

Bacterial infection
Cough
Dyspnea
Chest pain
Chest x-ray
Sputum culture

29

Kaposi's sarcoma

Most common malignancy
Small, purplish-brown, raised lesions
Occur anywhere on body
Not painful or pruritic

30

Pneumonia

Bacterial infection
HIV & 2+ episodes of pneumonia in 1 yr is AIDS
Chest pain
Productive cough
Fever

31

Herpes Simplex

Viral infection
Perirectal, oral, or genital
Numbness/tingling
Chronic lesions
Enlarged lymph nodes

32

Superficial thickness burns

Epidermis is injured
Epithelial cells & basement membranes still present
Heals 3-5 days

33

Superficial thickness burns S/S

Redness
Mild edema
Pain
Increased sensitivity to heat
Desquamation 2-3 days

34

Superficial partial-thickness burns

Involves entire epidermis
Small blood vessels injured--plasma leakage
Causes blister
Upper 1/3 dermis affected; skin has good blood supply
Heals 10-21 days

35

Superficial partial-thickness burns S/S

Redness
Moist
Blanchable
Increased pain (nerve endings exposed)
Blisters

36

Deep partial-thickness burns

Involves entire epidermis
Deeper into dermis
No blister
Heals 3-6 wks

37

Deep partial-thickness burns S/S

Red
Dry
White areas in deeper parts
May or may not blanch
Moderate edema
Decreased pain (nerve endings damaged)
May require skin grafts

38

Full-thickness burns

Destruction of epidermis & dermis
Grafting required
Healing time depends on blood supply (wks to mos)

39

Full thickness burns S/S

Hard, dry, leathery eschar
Severe edema
Waxy white, deep red, yellow, brown, or black
No blood supply (avascular)
Decreased sensation

40

Deep full-thickness burns

Extends beyond skin into underlying fascia & tissues
Damage & exposure of bones, muscles, tendons
Requires early excision & grafting
May have to amputate

41

Deep full-thickness burns S/S

Blackened
Depressed
Absence of sensation

42

Eschariotomy

Cut through eschar to relieve discomfort

43

Fasciotomy

Cut through eschar & fascia to increase blood flow & improve bleeding

44

Dry heat

Open flames
Clothing ignites

45

Moist heat

Scalding
Immersion injuries
More common in elderly

46

Contact burns

Contact with hot metal, tar, & grease
Deep injuries occur in seconds

47

Chemical burns

Dry chemicals should be brushed off skin & clothing
Remove wet clothing

48

Electrical injuries

Injuries look small on surface, but internal injuries can be huge

49

Radiation injuries

Exposure to large doses of radioactive material
Therapeutic radiation most common

50

Vascular changes

Fluid shift--capillary leak syndrome
1st 12 hrs
Hyperkalemia
Hyponatremia
Hemoconcentration

51

Cardiac changes

Initial--cardiac output decreases, HR increases
Later--cardiac output increases

52

Pulmonary changes

Direct airway injury
CO poisoning
Thermal injury
Pulmonary fluid overload

53

GI changes

Curling's ulcer--occurs from stress of severe injury due to decreased blood flow & mucosal damage

54

Metabolic changes

Hypermetabolism--increased need for 02 & calories
Core temp rises (low grade fever)

55

Resuscitation/Emergent Phase

First 24-48 hrs
Assessment (ABCs, head to toe)
Immediate measures to save life (cool, cover, carry)
Assess s/s inhalation injuries
Intubation
Fluid shift--fluid resuscitation for burns over 20%
Isotonic crystalloids (NS or LR)

56

Fluid replacement formulas

Calculated from time of INJURY
1st 1/2 given over 1st 8 hrs
2nd 1/2 given over next 16 hrs
4 mL/kg/% Total body surface area burn

57

Acute phase

36-48 hrs after burn
Assessment & maintenance of CV & resp systems
Prevent infection (tetanus shot, antibiotics)
Debridement
Antimicrobials (silvadene--may cause leukopenia)
Dressings
Grafting
Pressure garments

58

Open dressing

Open to air but covered with antimicrobial ointment

59

Closed dressing

Antimicrobial with gauze
May be kept wet or dry
Changed BID

60

Autograft

Permanent skin coverage
Healthy skin removed from victim & applied to burn

61

Homograft/allograft

Human skin harvested from cadaver
Usually rejected 2-3 wks
Temporary to allow site to heal

62

Heterograft/xenograft

Skin from another species, usually pig
High infection rate--silver nitrate

63

Support/pressure garments

Applied 5-7 days after graft
Wear 6mo-1yr

64

Rehabilitative phase

Begins when most of burn is healed
Ends when reconstructive & corrective procedures are complete
May last for years