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Adult Health Final
| Question | Answer |
|---|---|
| What are the complications with gastric ulcers? | hemorrhages, perforation, pyloric obstruction, and intractable disease |
| What are stress ulcers? | acute gastric mucosal lesions occurring after an acute medical crisis or trauma (sepsis, head injury, critically ill, extensive burns, increased IOP) multiple shallow erosions appear and may cause bleeding |
| What are the risk factors for colon cancer? | >50 years old, colon polyps, family history, history of IBD, diets high in fat proteins and carbohydrates and low in fiber, genital or breast cancer |
| What is involved with colostomy care? | appearance of the stoma, s/s of complications, protection of the skin, nutrition changes to control gas and odor, normal stool constancy, application to cover the stoma, care of the stoma |
| What are the clinical manifestations of Crohn's disease? | RLQ pain unrelieved by voiding, diarrhea, cramping, weight loss, anemia, anorexia, may develop abscesses, fistulas, fissures, Sx outside GI tract: oral ulcers, ocular disorders, arthritis, skin lesions |
| What are the clinical manifestations of Ulcerative Colitis? | DIARRHEA! LLQ pain, rectal bleeding, fatigue, anemia, weight loss, and dehydration |
| What are the clinical manifestations of a small bowel obstruction? | cramping, pain, no passage of stool but passes blood/ mucus, abdominal destination, N/V |
| What are the clinical manifestations of a large bowel obstruction? | constipation, stool size altered, blood in stool, weakness, weight loss, anemia, cramping, lower abdominal pain, fecal vomiting |
| What are the clinical manifestation of appendicitis? | vague epigastric or peri-umbilical pain, RLQ pain, low grade fever, N/V, rebound tenderness, maybe constipated or have diarrhea, positive Rovsing's sign |
| What is the treatment for appendicitis? | appendectomy, antibiotics, drain if abscess present |
| What are nursing interventions for appendicitis? | pain relief, maintenance of fluid and electrolytes, pre/ post op car, monitor vitals, monitor for complications |
| What are the clinical manifestations of diverticulosis? | often a-symptometic, occult blood test positive, nausea, anorexia, bloating, cramping and narrow stool |
| What is the treatment for diverticulosis/ diverticulitis? | analgesics, NPO then clear liquids, high fiber low fat diet, antibiotics (quinolones, metronidazole, beta-lactam), surgery |
| What are nursing interventions for a patient with diverticulosis/ diverticulitis? | pain management, monitor for complications, diet education, lots of fluids, pre/ post op care |
| What are clinical manifestations of diverticulitis? | acute onset of moderate to severe pain in the LLQ, N/V, fever, chills, leukocytosis, septicemia |
| What are the diet changes for diverticulitis? | avoid alcohol, foods containing seeds or indigestible material needs to be eliminated, dairy and fat intake should not exceed 30% of total calorie intake, AVOID ALL FIBER when symptoms of diverticulitis are present |
| What is thrombocytopenia? | Decreased number of platelets which leads to impaired clotting and bleeding |
| What are the nursing interventions for a patient with thrombocytopenia? | handle patient gently, instruct not to blow nose or put anything up the nose, fall prevention strategies, observe IV sites q4hr, use the smallest needle possible, call provider if trauma occurs or if bleeding or bruising is observed |
| What are neutropenic precautions? | monitor for s/s of infection (fever), practice good hand hygiene and teach pt family, seek medical attention if s/s of fever, avoid crowds, avoid fresh fruits and veggies, |
| What is ANC? | absolute neutrophil count |
| What are the signs and symptoms of a blood transfusion rejection? | anxiety, headache, chest pain, lower back pain, tachycardia, hypotension, hemoglobinuria, sense of impending doom, chills, fever, anaphylaxis shock, confusion, dyspnea |
| What are the colon cancer screenings or tests? | colonoscopy, visual exam |
| What are the clinical manifestations of colon cancer? | change in bowel habits, bowel movement not relieved by voiding, rectal bleeding with bright red blood, blood in stool (may book dark) |
| What is Dukes A? | invasion into but not through the bowel wall (90% 5 year survival rate) |
| What is Dukes B? | invasion through the bowel wall but not involving lymph nodes (70% 5 year survival rate) |
| What is Dukes C? | involvement of lymph nodes (30% survival rate) |
| What is Dukes D? | widespread metastases |
| Where does breast cancer spread to? | bone, lung |
| What does lung cancer spread to? | brain |
| Where does colorectal cancer spread to? | liver |
| Where does prostate cancer spread to? | bone (especially spine and legs) |
| Where does melanoma spread? | GI tract, lymph nodes, lung, and brain |
| Where does primary brain cancer spread? | central nervis system |
| What viruses can cause cancer? | Epstein-Barr virus, hep B, HPV, and H. pylori |
| What are precautions of chemotherapy? | Pregnant women should not handle, those who handle chemo must wear appropriate PPE/ gloves and dispose in yellow chemo containers |
| What is the teaching needed for chemotherapy? | teach those who handle chemo to use PPE, avoid direct skin contact with chemo, chemo should not be taken with other drugs, report signs of infection, monitor WBC, how to dispose and where, |
| What is the difference between HIV and AIDS? | HIV is an infection where as AIDS is a condition. HIV is something people can live with correct medications, AIDS has a high mortality rate, HIV can cause immune system damage but AIDS has completely damaged the immune system (0 CD4) |
| What are the complications of AIDS? | opportunistic infections, malignancies, dry skin, poor wound healing, shortness of breath, dementia, and visual changes |
| What are the psychosocial needs of HIV/ AIDS patients? | social support system (family, significant other, friend), resources for therapy, resources to help disclose to a sexual partner, help with ADLs, employment status, immigration status, encourage social activities/ hobbies, assess anxiety level |
| Who is at high risk for developing AIDS? | African American males, unprotected sex (male to male most common), injection drug users |
| What is the viral load count in relation to CD4 count? | CD4 counts are used to determine the effectiveness of HIV therapy where as viral load is based on the immune system to tell if a person has HIV and is undetectable below 40-75 |
| Who is at risk for developing pressure ulcers? | prolonged bed rest, immobility, incontinence, diabetes, inadequate nutrition or hydration, decreased sensory perception, cognitive problems, PVD |
| What is the Braden scale? | acts to prevent pressure ulcers |
| What is a stage I pressure ulcer? | redness that does not blanch, skin is intact, warm or cool skin, pain, and itching |
| What is a stage II pressure ulcer? | superficial break in the skin, partial thickness, loss of epidermis and dermis |
| What is a stage III pressure ulcer? | extends to subQ tissue but not into muscle or fascia, full thickness skin loss |
| What is a stage IV pressure ulcer? | extends down into fascia and possibly bone, undermining and tunneling appear |
| What is an unstable pressure ulcer? | skin loss is full thickness and the depth is obscured |
| What are the complications of shingles? | vision loss, skin infections, neurological problems, postherpetic neuralgia (pain after shingles is gone) |
| What is xerosis? | dry skin, caused by lack of moisture in the skin, may be due to aging or underlying diseases |
| What is psoriasis? | autoimmune disorder where the rate of cell division is sped up and plaque formation occurs, presents as thickened red patches with silver/ white scales, usually found bilaterally in elbows, scalp, trunk, knees, and outside surfaces of limbs |
| What is urge incontinence? | urine loss associated with a strong urge that cannot be suppressed |
| What is stress incontinence? | urine loss associated with a bladder stressor like laughing, coughing, or sneezing |
| What is reflex incontinence? | urine loss due to hyper-reflexes usually because of a spinal injury |
| What is overflow incontinence? | urine loss due to an overfilled bladder |
| What is functional incontinence? | urine loss due to cognitive impairment |
| What is iatrogenic incontinence? | urine loss caused by extrinsic factors such as medications |
| What is bladder irrigation for TURP? | The patient may a catheter and CBI in place for several days. For the CBI, a three-way urinary catheter is used to allow drainage of urine and inflow of a bladder irrigating solution. Be sure to maintain the flow of the irrigant to keep the urine clear. |
| What is mixed incontinence? | more than one type of incontinence |
| What are good dietary choices with kidney stone? | moderate protein, lots of fluids, reduce sodium intake, avoid foods high in purine, avoid oxalate containing foods, moderate calcium intake, no energy drinks |
| What are the warning signs of bladder cancer? | blood or blood clots in the urine, pain or burning during urination, frequent urination, not being able to pass urine, and lower back pain on one side |
| Who is at risk for developing kidney stones? | family or personal history, dehydration, being obese, diet, gastric bypass surgery, IBD, chronic diarrhea, renal tubular acidosis, UTIs, certain medications |
| What is the second most leading cause of cancer in men? | prostate cancer |
| What are the clinical manifestations of prostate cancer? | symptoms of urinary obstruction, blood in urine or semen, painful ejaculation, symptoms of metastasis |
| What is the treatment for prostate cancer? | surgery is most common either radial prostatectomy (prostate removal), bilateral orchiectomy (removal of both testicles), radiation therapy both internal and external, hormone therapy, and chemotherapy |
| What are precautions for prostate cancer? | health diet, increase fruits and veggies, maintain healthy BMI, and exercise |
| What teaching is needed for prostate cancer? | how to preform testicular exams, importance of screenings especially at a high risk, if at a high risk start screening earlier |
| What are the clinical manifestations for an upper UTI? | acute pyelonephritis, chronic pyelonephritis, renal abscess |
| What are the clinical manifestations of a lower UTI? | cystitis, prostatitis, urethritis |
| What is an uncomplicated UTI? | community acquired and common in young men |
| What is a complicated UTI? | often nosocomial and related to catheters, occurs in those with urologic abnormalities, immunocompromised, pregnant, or have diabetes |
| What is pyelonephritis? | bacterial infection in the kidney and renal pelvis which interferes with urinary elimination |
| What are the clinical manifestations of acute pyelonephritis? | fever, chills, tachycardia, N/V, nocturia, burning, itching, urgency, and frequency of urination, lower back pain |
| What are the clinical manifestations of chronic pyelonephritis? | hypertension, inability to conserve sodium, decreased urine contracting ability resulting in nocturne, tendency to develop hyerkalemia and acidosis |
| What are the causes of a neurogenic bladder? | brain disorders: alzheimer disease, tumors of the brain/ spinal cord, MS, parkinson's disease, injury to the spinal cord, stroke, birth defects other conditions: diabetes, long term alcohol abuse, pelvic surgery, or spinal nerve damage |
| What are the clinical manifestations of BPH | urinary frequency, nocturia, hesitancy, decreased urine volume, dribbling, sensation of incomplete emptying, urinary retention, recurrent UTIs |
| What are the precautions with BPH medications? | may take as long as six months to show improvement, may cause decreased libido, erectile dysfunction, or dizziness, with alpha-blockers assess for orthostatic hypotension and syncope, be careful with position changes, weakness, light-headedness, |
| What are the treatments for BPH? | alpha adrenergic blockers (flomax) 5-alpha reductase inhibitors (proscar/ avodart) surgical resection of the prostate |
| What are the clinical manifestations of prostatitis? | perineal discomfort, during, urgency, frequency, pain with or after ejaculation, fever, chills |
| What is the treatment for prostatitis? | antibiotics, analgesics, sitz baths, stool softeners, and antispasmodics |
| What is the medication precaution with avodart? | do not handle while pregnantle or, should not donate blood, liver function may be impaired, orthostatic hypotension, only men should take |
Created by:
erica_mastny
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