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Stack #199790
Test 1- med surg
| Question | Answer |
|---|---|
| Breast Cancer Screen | BSE monthly, and mammogram yearly over age 40 |
| Colorectal Cancer Screen | remove polyps, sigmoid & occult blood q 5 yrs over age 50, Rectal Exam after age 40, Colonocopy q 10 yrs |
| Cervical Screen | PAP yearly after age 18 or when become sexually active |
| Endometrial Screen | report bleeding, hormone replacement therapy after menopause |
| Ovarian cancer screen | report bleeding and generalized pain |
| Skin | examine skin over age 20 q 3 yrs, and yearly after age 40 |
| Prostate | PSA, and rectal exam yearly after age 50 |
| C | change in bowel or bladder habbit |
| A | a sore that does not heal |
| U | unsual bleeding or discharge |
| T | thickening or lump in breast or elsewhere |
| I | indigestion or difficulty in swallowing |
| O | obvious change in warts or moles |
| N | nagging cough or hoarseness |
| Internal Radiation | brachytherapy, sealed radioactive materials into hollow cavity within body tissues or body surface; limit visit to 10 min. can be needless, wires, seeds, beads, or catheters inserted into tumor tissue |
| External Radiation | body is marked, no sunlight to the area, diet increase protein, 2-3 quarts fluid q day, 60% of pt w cancer r treated with radiation therapy, it destroys all cancer |
| Biopsy | incision of tumor-excision-aspiration needle |
| Endoscopy | sidmoidoscopy |
| bonescan | detects cancer before x-ray |
| Tomography | x-ray at diff angles |
| CT | scanning at diff angles |
| Radiocope | increase concentrations |
| Ultrasound | sound wave for size |
| MRI | no metallic materials present |
| Complication of Treatment, Chemo | bladder, bowel, infection, anemia, thrombocytopenia, neutropenia (avoid fresh flowers and raw fruit), Stomatitis (soft toothbrush, nystatin) Septicemia, monitor lung sounds, alopecia, emesis, diarrhea, anorexia, pain, tumor lysis syndrome |
| Herpes Zoster (shingles) | immune difficiency, varicella lies dormant |
| Signs of Shingles | rash, then vesicles, unilateral and bandlike , rarely crossing midline, pain is burning, knifelike |
| Dx of shingles | culture and history |
| Tx of Shingles | analgesics, lotions, acyclovir (zorivax), tranquilizers, medicated baths |
| Impetigo | staph or strep |
| Signs of impetigo | lesions small to large over body, macule-pustulant vesicle, honey colored |
| Tx of impetigo | antibiotics topical and systemic |
| Nursing intervention for impetigo | gloves, antiseptics, hygeine, pennicilin (Rocephin), topical antibiotics applied several times a day, sterile technique |
| Eczema | antigen-antibody reaction |
| signs of eczema | vesicular lesions, rupture and crust (scalp, forehead, cheek, neck) |
| Dx of Eczema | family hx, diet and skin testing: IgE, asthma |
| Tx of Eczema | reduce allergin-hydration-soaks and ointments, and baths |
| Nursing intervention for eczema | apply dressing and med ointment, soaks |
| Melanoma | superficial spreading-malignant letigo, nodular, acral, lentiginous, prognosis depends on thickness |
| A | asymmetry |
| B | border irregularly scalloped |
| C | color variated from one area to another |
| D | diameter lager than 6mm (pencil eraser) |
| Contact Dermatitis | chemicals, plants, metals, food, poison ivy |
| Signs of Contact Dermatitis | vesicles, burning, pain, pruritis |
| Dx of contact dermatitis | intradermal testing, serum IgE, eosinophils |
| Tx of of contact dermatitis | corticosteroids, antihistamines, dressings, aseptic technique, b-cells and anaphalactic shock |
| Assessment of Skin Disorders | history, rhinitis, pressure points?, inspect for color, rashes, scars, hair distribution-palpation- temp,texure w/ palms. Dark skin-assess lips, mucous membranes bc all skin has redtones, feel rashes, nail beds |
| Chief Complaint | 1.Provacative & Palliative factors(cause) 2. QUALITY or QUANTITY(size and charcteristics)3. specific REGION of the body. 4. SEVERITY of S/S. 5. Length of TIME pt has had disorder |
| macule | freckle |
| papule | wart(round, slightly elevated) |
| patch | mongolian spots(birth marks) |
| plaque | psoriasis-dermatitis |
| wheal | insect bite, urticaria, allergic reaction |
| nodule | lipomas, fat tumor, deep in dermis |
| Tumor | neoplasms |
| vesicle | chx pox, blisters, herpes zoster, cluster |
| bulla | bilster, burn |
| pustule | acne |
| cyst | cystic acne, incapsulated w liquid |
| telangectasia | liver disease, face and nose |
| excoriation | abrasion, scabies |
| fissure | athletes foot, cracking |
| erosion | varicella rupture |
| crust | scab, eczema, intego |
| atrophy | striae, aged skin |
| Tinea Capitis | ring work of scalp |
| Tinea Corpius | ring worm of body |
| Tinea cruris | jock itch |
| tinea pedis | athlete foot |
| Tx of fungal infections | oral or topical antifungal, shampoos |
| Nursing for fungal infections | compresses, soaks, hygeine, decrease moisture |
| Natural immunity or innate | first line of defense, physical/chemical barriers, skin, mucous membranes, cilia ,tears, saliva, nat.flora, nonspecfic memory. |
| Aquired/adaptive immunity | vaccine, second line defense, has ability to Remeber antigen, highly specialized cells and tissues, specific and memory, Lymphocytes are T & B cells and NK. B cells produce antibodies(humoral), T-cells release lymphokine to attract phagocyes(cellmediated |
| Cell-mediated immunity | T-cells(attack and protect) aquired immunity by t-cell, mediated by sensitized t-cell lymphocytes not antibodies, attach to antigen and destroy, immunity against viruses and mycobacterium, fungal, rejection of tissue, malig.cells, foreign protein or tiss |
| Humoral Immunity | B-cells on 1st exp.to antigen,primary hum.reac.is initiated, and slow.2nd exposure, memory B cells cause a quick response.T suppresor cells maintain correct level.Helper to Supp.T cell is 2:1 |
| Hypersenstivity Disorders | host becomes sensitive after 1st exposure, genetic defect of inc. IgE. Signs: uticaria, angioedema, rhinitis, otitis media.Dx: H & P;CBC;skin testing;IgE- Medical-benadryl, hismanual, claritin, allegra, nasalide, adrenalin, control environment |
| Anaphylaxis | IgE mediated-system reaction;drugs, venom, IVP dye, penicillinS/S: hypotension, laryngeal edema, bronchospasm, CV collaps & Resp failure;Tx:epi,ET, o2 |
| Immunodeficiency Disease | cellular or humoral, severe infections or incomplete clearing, defects in Genes;heredity, primary-if immune cells not developed;Secondary-drug induced, stress, age, nutrition, radiation, surgery, diseases. |
| Autoimmune Disorders | against one's own tissue/body;immune cells are activated;alterations w/ t-cells & b-cells;may have more than 1 disorder; family related, increases as person ages, ex: RA, DM type 1; SLE |
| Vaccines | Influenza, pneumococcal, tetanus, skin tests(tb)(ppd-mantoux)2step |
| Erythrocyte(RBC) | lives 120 days, produced in red bone marrow, transports nutrients, renal stimulates rbc production, 4.5-5mm3; Hgb-12-18g/dl |
| Leukocyte(WBC) | function:defense;lives 12 hrs, 5000-10,000 |
| GRANULOCYTES category | (nuclei),neutrophils 60-70%(infection)phagocytosis kills and removes debris-shift to the left,Easoinophils 1-4%)allergic reac.,Basophils-0.5-1.0%(immune response)(WBC) |
| NONGRANULOCYTES(WBC)category | lymphocytes 20-40%(antibody production t and b cells), monocytes-2-6% (phagocytes) |
| Thrombocytes(platelets) | 150-400,000 mm3, function-clotting; Hemeostasis-vessel spasm, platelet plug, clot formation; thromboplastin released, reacts with Ca, converts prothrombin to thrombin, froms fibrin, traps rbcs and froms clot |
| coagulatoin disorder | cause, vascular, platelet or clotting dysfunction;signs-petechiae, bruising, cns change,PT-prolonged, PTT TNR-elevated;dx:low RBC, platelet, coagulation time; medical:blood transfusion, stop heparin,cumidon;nursing: VS, treat shock, monitor IV |
| Hemophilia | mostly males, Hemophilia A most common factor 8 is absent,B-Christmas disease low in factor 9. |
| Signs of hemophilia | bleeding, pain, joint bleeding, small cuts bleed bad |
| Dx of Hemophilia | factors, blood 8 & 9. |
| Nursing of Hemophilia | control bleeding, pain management, education, monitor factor and blood administration. |
| Hypovolemic Anemia | hemorrhage, Signs: weakness, pale, cool, moist skin, low BP, weak pulse, Medical: control bleeding, treat shock, plasma expander, blood transfusion, iron |
| Pernicious Anemia | absence of intrinsic factor needed for b12 aborption,degeneration of nerves; Signs:weakness,dyspnea,hypoxia,jaundice,weightloss,diarrhea/constipation,Smooth tongue/tingling of extremities; Medical: B12, folic acid, iron PRC: Nursing: up protein,vit & min, |
| Aplastic Anemia | bone marrow not working, failure of cell development: Signs: infection, bleeding, dyspnea |
| Medical of Aplastic Anemia | avoid blood transfusions, may give platelets if bleeding, splenectomy;marrow transplants;steroids and androgens to stimulate marrow;biological modifiers |
| Nursing of Aplastic Anemia | asepsis, skin protection, reverse isolation, protect from bleeding, rest, temp, turn,cough,deep breathe, no cumidon or Aspirin, dont strain |
| Iron Deficiency Anemia | iron loss due to chronic bleeding from GU and GI, great demand of iron;malapsorption disease |
| Signs of Iron Defic. anemia | pallor, dyspnea, glossitis, fatigue, crave ice or clay, spoon shape nails, stomatitis |
| Medical for Iron Defic. Anemia | ferrous, sulfate orally, ascortic acid, ztrack iron dextran IM, can give iron IV |
| Nursing for Iron Defic. Anemia | educate on meds such as take on empty stomach, diet high in iron, report diarrhea and nausea but not tarry stools |
| Sickle Cell Anemia | genetic,african americans, hgb S and rbc's are crescent shaped and occludes vessels, trait has hgb A and S. |
| Signs of Sickle Cell Anemia | anemia, painful joints, edema, jaundice.Stress/dehydration/smoking/illness are preicitating factors of a crisis, organ failure/infarction s are complications |
| Medical for sickle cell anemia | vaccines, o2, MS, blood, folic acid, hydroxyrea, marrow transplant |
| Nursing for sickle cell anemia | supportive, hydration, treat infection, genetic counseling |
| Polycythemia (Erythrocytosis) | primary-malignancy of the blood cell-idiopathic. Secondary-caused by hypoxia |
| Signs of Polycythemia | engorgement of organs, gi bleeding, petechiae, epistaxis, varices, skin changes, blurriness |
| Medical for polycythemia | phlebotomy, meds to inhibit marrow |
| Nursing for polycythemia | hydration, i and o, o2, ROM |
| Leukemia | excess leukocytes in marrow and nodes that infiltrate organs-immature wbc-risk for infection-overload of wbc and less rbc |
| signs of leukemia | anemia, thrombocytopenia, leukopenia, enlarged nodes and spleen. |
| Medical for leukemia | chemo/radiation/marrow transplant |
| Nursing for leukemia | asepsis, avoid trauma, pain contorl, treatment of chemo s/e, goal is remission |
| Plasma Cell Disorde(Multople Myeloma) | malignant neoplastic disease of bone marrow;specific immunoglobin |
| signs of Plasma cell disorder(mult.myeloma) | bone destruction, pain, pathological fx, infection, anemia, bleeding, hypercalcemia, hyperuricemia, high protein--effects mostly middle aged men |
| Medical for Plasms Cell Disorder | radiation/chemo to reduce tumor |
| Nursing for Plasma cell disorder | support/chemo/radiation;pain control, hydration-(3-4 L per day) dilute out Calcium and protein to prevent renal damage |
Created by:
allicat21
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