UTA NURS 3561 Adults Exam 3
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| tumor angiogenesis | the process of the formation of blood vessels within the tumor itself
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| initiation stage of cancer | initiator causes a genetic mutation
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| promotion stage of cancer | a promoter causes rapid cell growth
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| progression stage of cancer | a progressor causes cancer to become aggressive and spread
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| Fine-needle aspiration (FNA) | small-gauge aspiration needle that provides cells from the mass for cytologic examination.
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| large-core biopsy | cutting needles will deliver an actual piece of tissue (core) that can be analyzed with the advantage of preserving the histologic architecture of the tissue specimen.
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| excisional biopsy | surgical removal of the entire lesion, lymph node, nodule, or mass; therefore it is therapeutic as well as diagnostic.
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| incisional biopsy | (partial excision) may be performed with a scalpel or dermal punch.
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| anatomic classification of tumors | tumor is identified by the tissue of origin, the anatomic site, and the behavior of the tumor (i.e., benign or malignant)
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| carcinoma tissue of origin | embryonal ectoderm (skin and glands) and endoderm (mucous membranes of the respiratory, GI and GU tract)
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| Sarcoma tissue of origin | embryonic mesoderm (connective tissue, muscle, bone and fat)
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| Lymphoma and leukemia tissue of origin | hepatopoietic system (bone marrow or lymph glands
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| histologic grading of tumors | the appearance of cells and the degree of differentiation are evaluated pathologically.
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| Grade I of histologic grading of tumors | Cells differ slightly from normal cells (mild dysplasia) and are well differentiated (low grade).
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| Grade II of histologic grading of tumors | Cells are more abnormal (moderate dysplasia) and moderately differentiated (intermediate grade).
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| Grade III of histologic grading of tumors | Cells are very abnormal (severe dysplasia) and poorly differentiated (high grade).
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| Grade IV of histologic grading of tumors | Cells are immature and primitive (anaplasia) and undifferentiated; cell of origin is difficult to determine (high grade).
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| Grade X of histologic grading of tumors | Grade cannot be assessed.
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| dysplasia | The enlargement of an organ or tissue by the proliferation of cells of an abnormal type, as a developmental disorder or an early stage in the development of cancer
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| TNM classification system | used to determine the anatomic extent of the disease involvement according to three parameters: tumor size and invasiveness (T), presence or absence of regional spread to the lymph nodes (N), and metastasis to distant organ sites (M).
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| T in TNM classification | tumor size and invasiveness
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| N in TNM classification | presence or absence of regional spread to the lymph nodes
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| M in TNM classification | metastasis to distant organ sites
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| T0 | No evidence of primary tumor
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| Tis | Carcinoma in situ
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| T1–4 | Ascending degrees of increase in tumor size and involvement
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| Tx | Tumor cannot be measured or found
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| N0 | No evidence of disease in lymph nodes
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| N1–4 | Ascending degrees of nodal involvement
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| Nx | Regional lymph nodes unable to be assessed clinically
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| M0 | No evidence of distant metastases
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| M1–4 | Ascending degrees of metastatic involvement of the host, including distant nodes
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| Mx | Cannot be determined
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| clinical stage 0 | cancer in situ (no invasion)
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| clinical stage I | tumor limited to tissue of origin
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| clinical stage II | limited local spread
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| clinical stage III | extensive local and regional spread
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| clinical stage IV | metastasis
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| goals of collaborative care of cancer | cure, control, palliation
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| testicular cancer “cure” timeframe | 2 years d/t higher mitotic rate making less likely to recur
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| postmenopausal breast cancer “cure” timeframe | 20 years d/t slower mitotic rate making more likely to recur
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| chemotherapy | the treatment of disease with chemical agents
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| radiation therapy | emission and distribution of energy through space or material medium
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| biologic therapy | treatment using biologic agents such as interferons, interleukins, monoclonal antibodies, and growth factors to modify the relationship between the host and the tumor
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| myelosuppression | bone marrow suppression; can cause life-threatening and distressing effects including infection, hemorrhage, and overwhelming fatigue.
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| leukopenia | an abnormal decrease in the number of total white blood cells to <4000/μL
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| neutropenia | an abnormal reduction of the neutrophil count to <1000/μL; serious risk for life-threatening infection and sepsis.
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| thrombocytopenia | a reduction of the platelet count to <150,000/μL; risk for serious bleeding if < 50,000/μL
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| thrombocytopenia s/s | Petechiae, Ecchymoses, Active bleeding, Spleen enlarged, Headaches, Melena, Hematuria, Hypotension, Tachycardia, Prolonged menstruation
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| Normal platelet count | 150,000-400,000
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| nadir | the lowest point, such as the blood count after it has been depressed by chemotherapy
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| pancytopenia | marked decrease in the number of red blood cells, white blood cells, and platelets
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| Anemia s/s | Fatigue, Dyspnea, Palpitations, Sweating, Tachycardia, Dizziness, Headaches, Angina, Difficulty sleeping, Poor concentration, Irritability, Cold intolerance, Anorexia, Pallor
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| 3 P’s for energy conservation | Plan, Prioritize (plan high-priority activities at time of increased energy), Pace (physical activity within limits)
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| Mucositis | inflammation and ulceration of the mucous membrane lining the digestive tract
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| Stomatitis | mucositis of the mouth
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| Periodontium | supporting structure around teeth and bone structure
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| Alopecia | partial or complete lack of hair resulting from normal aging, endocrine disorder, drug reaction, anticancer medication, or skin disease
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| Major difference between benign and malignant neoplasms | the ability of malignant tumor cells to invade and metastasize
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| Cancer with highest death rates | lung cancer
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| Stomatitis, Mucositis, Espophagitis management | assess daily; provide supplements, analgesics, topical anesthetics, and artificial saliva as needed; avoid spicy or acidic foods, tobacco, and alcohol; frequent oral rinses with saline or salt and soda
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| gastroesophageal reflux disease (GERD) | any clinically significant symptomatic condition or histopathologic alteration presumed to be secondary to reflux of gastric contents into the lower esophagus
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| GERD aggravating substances | Substances that decrease LES pressure: chocolate, coffee, fatty foods, and alcohol; anticholinergics.
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| GERD risk factors | obesity, pregnancy, cigarette/cigar smoking, hiatal hernias
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| GERD drug therapy | H2R blockers, PPIs, Antacids
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| peptic ulcer disease (PUD) | a condition characterized by erosion of the GI mucosa that results from the digestive action of HCl acid and pepsin
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| acute ulcer | superficial erosion and minimal inflammation that has short duration and resolves quickly when the cause is identified and removed.
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| chronic ulcer | long duration, eroding through the muscular wall with the formation of fibrous tissue that is present continuously for many months or intermittently throughout the person's lifetime.
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| Gastric ulcer pain | high in epigastrium, 1-2 hrs after meals, burning or gaseous
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| Duodenal ulcer pain | midepigastric region beneath xiphoid process, back pain, 2-4 hrs after meals
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| PUD complications | hemorrhage, perforation, gastric outlet obstruction
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| Ulcer perforation manifestations | sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the abdomen, which becomes rigid and board-like; n/v, tachycardia
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| PUD treatment | rest, diet modification, drug therapy, quit smoking and alcohol, long-term f/u care, stress management
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| PUD drug therapy | H2R blockers, PPIs, Antibiotics, Antacids, Anticholinergics, Cytoproctective therapy
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| only drug approved for prevention of gastric ulcers induced by NSAIDs and aspirin | Misoprostol
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| nursing management of PUD | compliance with regimen, reduce discomfort, no GI complications
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| Diarrhea | the passage of at least three loose or liquid stools per day
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| Chronic diarrhea | diarrhea lasting > 4 weeks
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| Diarrhea causes | infection, disease, laxatives, antibiotics
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| Diarrhea treatment | remove cause, fluid & electrolyte replacement, protection of skin, and medications
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| major concerns of diarrhea | preventing transmission, fluid and electrolyte replacement, and resolution of the diarrhea
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| action of antidiarrheals | coat and protect mucous membranes, absorb irritating substances, inhibit GI motility, decrease intestinal secretions, and decrease central nervous system stimulation of the GI tract
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| Fecal Incontinence | Involuntary passage of stool occurs when the normal structures maintaining continence are disrupted.
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| Fecal incontinence treatment | remove cause, bowel retraining, skin care
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| Constipation | a decrease in frequency of bowel movements from what is “normal” for the individual, difficult-to-pass stools, a decrease in stool volume, and/or retention of feces in the rectum.
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| Constipation causes | decreased mobility, decreased fluids, medications, decreased fiber, ignoring call to stool, disease.
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| Fecal impaction | complication of constipation; the accumulation of hardened feces in the rectum or sigmoid colon that cannot be expelled.
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| Intestinal rupture | complication of constipation
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| Valsalva maneuver | complication of constipation; a maneuver that involves contraction of the chest muscles on a closed glottis with simultaneous contraction of the abdominal muscles
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| Intestinal obstruction | complication of constipation; intestinal contents cannot pass through the GI tract.
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| Hemorrhoids | complication of constipation; varicosities in the lower rectum or anus caused by congestion in the veins of the hemorrhoidal plexus
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| Diverticulosis | complication of constipation; multiple noninflamed diverticula (outpouchings of the colon); can progress to diverticulitis
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| Constipation treatment | fluids, positioning, fiber, digital removal, exercise, time, heeding the urge, laxatives and enemas.
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| C. difficile causes | antibiotics that destroy normal intestinal flora, mainly clindamycin
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| Drug treatment for C. difficile | Metronidazole (Vancomycin if not effective)
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| inflammatory bowel disease (IBD) | chronic, recurrent inflammatory diseases of the intestinal tract that include ulcerative colitis and Crohn's disease
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| ulcerative colitis | chronic inflammatory bowel disease that causes ulceration of the colon and rectum
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| IBD clinical manifestations | diarrhea, bloody stools, weight loss, abdominal pain, fever, and fatigue
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| Crohn’s disease differentiating factors | can be anywhere (terminal ileum), skip lesions, only slight cancer risk, no cure, affects all mucosal layers, weight loss is common
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| Crohn’s disease manifestations | nonbloody diarrhea of usually not more than four to five stools daily
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| Ulcerative colitis differentiating factors | limited to the colon, continuous lesions, big cancer risk, can be cured with colectomy, affects top layer only, weight loss is rare
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| Chrohn’s disease complications | strictures, fistulas (b/t intestine, bladder, or vagina), abscesses
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| Ulcerative colitis complications | hemorrhage, cancer (especially colon), tenesmus
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| stricture | complication of Chrohn’s disease; an abnormal temporary or permanent narrowing of the lumen of a hollow organ
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| anal fistula | complication of Chrohn’s disease; an abnormal tunnel leading from the anus or rectum that may extend to the outside of the skin, vagina, or buttocks and often precedes an abscess.
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| Anorectal abscesses | complication of Chrohn’s disease; collections of perianal pus that are the result of obstruction of the anal glands.
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| tenesmus | complication of ulcerative colitis; spasmodic contraction of the anal sphincter with pain and persistent desire to empty the bowel
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| IBD therapy goals | induce & maintain remission; heal mucosa; restore and maintain nutrition; maintain quality of life
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| Acute abdominal pain | Symptom associated with tissue injury, including damage to abdominal or pelvic organs and blood vessels.
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| Life threatening causes of acute abdominal pain | hemorrhage, obstruction, perforation
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| Acute abdominal pain goal of management | to identify and treat the cause, and monitor and treat complications, especially shock
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| Acute abdominal pain assessment | take vitals immediately to assess for hypovolemia (increased pulse, decreased BP), monitor I&Os, inspect abdomen, auscultate bowel sounds, gently palpate abdomen, assess pain.
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| Acute abdominal pain diagnostic studies | CBC, urinalysis, abdominal x-ray, and electrocardiogram are done initially, along with an ultrasound or CT scan
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| Hypovolemic shock s/s | ↓ Blood pressure, ↓ Pulse pressure, Tachycardia, Cool/clammy skin, ↓ LOC, ↓ Urine output (<0.5 mL/kg/hr)
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| Appendicitis | an inflammation of the appendix
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| Appendicitis clinical manifestations | periumbilical pain; anorexia, nausea, and vomiting; localized and rebound tenderness, muscle guarding; distended/hard abdominal
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| Appendicitis complications | perforation (rupture) can cause to peritonitis/abscesses
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| Appendicitis treatment | localized: immediate surgical removal (appendectomy); Ruptured with peritonitis/abscess: antibiotic therapy and parenteral fluids 6 to 8 hours before appendectomy to prevent sepsis and dehydration
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| Appendicitis patho | Feces, foreign body, tumor, or intramural thickening obstruct lumen > distention, venous engorgement, and accumulation of mucus and bacteria > gangrene and perforation (if not treated quickly)
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| Appendicitis diagnostic studies | WBC (elevated in 90% of cases), urinalysis (to rule out genitourinary conditions), and CT scan/ultrasound.
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| Perforated ulcer manifestations | sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the abdomen, which becomes rigid and board-like. Possible nausea/vomiting and tachycardia (as shock develops).
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| Sepsis s/s | Ruptured appendix with peritonitis or abscess
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| Peritonitis | localized or generalized inflammatory process of the peritoneum caused by chemical irritants or bacteria.
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| Primary peritonitis | occurs when blood-borne organisms enter the peritoneal cavity (ascites with cirrhosis)
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| Secondary peritonitis | occurs when abdominal organs perforate or rupture and release their contents (bile, enzymes, and bacteria) into the peritoneal cavity
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| Peritonitis clinical manifestations | abdominal pain, ascites, rebound tenderness, boardlike abdomen, n/v, muscular rigidity, and spasm
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| Peritonitis complications | hypovolemic shock, sepsis, intraabdominal abscess formation, paralytic ileus, and acute respiratory distress syndrome
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| Peritonitis treatment | surgery to locate the cause of the inflammation, drain purulent fluid, and repair the damage; Non-Surgical (milder cases/poor surgical risks): antibiotics, NG suction, analgesics, and IV fluid
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| Peritonitis goals | (1) resolution of inflammation, (2) relief of abdominal pain, (3) freedom from complications (especially hypovolemic shock), and (4) normal nutritional status
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| Peritonitis diagnostic studies | CBC, WBC, serum electrolytes; Abdominal x-ray, Abdominal paracentesis and culture of fluid, CT scan or ultrasound, Peritoneoscopy
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| Peritonitis abdominal pain interventions | knee flexed position, quiet environment, NG tube, medication
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| Peritonitis risk for fluid volume deficit | I&Os, large bore IV, NPO, NG to decompress
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| Hypovolemic shock interventions | monitor VS and I&Os, large bore IV, monitor electrolytes
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| Gastroenteritis | Inflammation of mucosa of the stomach and small intestine.
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| Gastroenteritis Clinical Manifestations | N/V, Diarrhea, Abd. Cramping, distention.
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| Gastroenteritis Nursing Management | I/O, symptomatic management
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| Colorectal cancer risk factors | increasing age, family or personal hx, colorectal polyps, and IBD.
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| Colorectal cancer left-sided manifestations | bleeding, alternating constipation and diarrhea, ribbonlike stools
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| Colorectal cancer right-sided manifestations | asymptomatic
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| Tests to find both early colorectal cancer and polyps | Flexible sigmoidoscopy (done every 5 years), Colonoscopy (done every 10 years), Double-contrast barium enema (done every 5 years), CT colonography (virtual colonoscopy) (done every 5 years)
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| age screening for colorectal cancer should be initiated | 50 years-old
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| Colonic polyps | arise from the mucosal surface of the colon and project into the lumen; account for 85% of colorectal cancers
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| Most common causes of small bowel obstructions | Surgical adhesion, hernias, and tumors
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| Small bowel obstruction clinical manifestations | rapid onset; frequent & copious vomiting; colicky, cramplike, intermittent pain; feces for a short time; greatly increased abdominal distention
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| intestinal obstruction treatment | NPO status, NG tube, IV fluids with potassium, analgesics; surgery if not resolved in 24 hrs or deteriorates
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| intestinal obstruction goals | (1) relief of the obstruction and return to normal bowel function, (2) minimal to no discomfort, and (3) normal fluid and electrolyte and acid-base status
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| Small bowel obstruction diagnostic studies | CT scans, abdominal x-rays (show gas, fluids or perforation); Sigmoidoscopy or colonoscopy; CBC, Serum electrolyte, amylase, and BUN
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| Intestinal strangulation s/s | Severe, constant pain with rapid onset; abdominal tenderness and rigidity; guarding; elevated temperature (above 100 F); elevated WBC and Decreased Hgb/Hct
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| nonmechanical obstruction | result from a neuromuscular or vascular disorder (most common form is paralytic ileus)
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| Paralytic ileus | lack of intestinal peristalsis; most common form of nonmechanical obstruction
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| Mechanical obstruction | a detectable occlusion of the intestinal lumen
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| Most common cause of small bowel obstruction | surgical adhesion, followed-by hernias and tumors
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| Most common cause of large bowel obstruction | carcinoma, followed by volvulus and diverticular disease
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| Pseudo-obstruction | an apparent mechanical obstruction of the intestine without demonstration of obstruction by radiologic methods
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| End stoma | can be permanent or temporary; surgically constructed by dividing the bowel and bringing out the proximal end as a single stoma.
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| Hartmann’s pouch | procedure where distal segment of GI tract is oversewn and left in abdominal cavity intact; potential for the bowel to be reanastomosed and the stoma to be closed.
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| Loop stoma | usually temporary; constructed by bringing a loop of bowel to the abdominal surface and then opening the anterior wall of the bowel to provide fecal diversion (one stoma with a proximal and distal opening).
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| Double-barreled stoma | usually temporary; both the proximal and distal ends are brought through the abdominal wall as two separate stomas (functioning stoma & mucus fistula)
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| Indications for ileostomy | ulcerative colitis, Crohn’s disease, diseased/injured colon, birth defect, familial polyposis, trauma, cancer
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| Indications for colostomy | Perforating diverticulum; trauma; inoperable tumors of colon, rectum, or pelvis; rectovaginal fistula; Cancer of the rectum or rectosigmoidal area; trauma
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| mesalamine (Asacol, Pentasa) | 5-Aminosalicylates (5-ASA); decreases GI inflammation through direct contact with bowel mucosa
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| Infliximab (Remicade) | immunomodulator; inhibits the cytokine tumor necrosis factor (TNF)
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| diphenoxylate with atropine (Lomotil) | Opioid and anticholinergic; decreases peristalsis and intestinal motility may increase
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| loperamide (Imodium, Pepto Diarrhea Control) | Inhibits peristalsis, delays transit, increases absorption of fluid from stools
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| H2-receptor blockers action | antisecretory; reduces gastric acid secretion and promotes ulcer healing; onset 1hr (take longer than antacids)
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| Proton pump inhibitors action | antisecretory; reduces gastric acid secretion and promotes ulcer healing; more effective than H2-receptor blockers
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| Antacid action | increase gastric pH by neutralizing the HCl acid.
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| Cytoprotective therapy | Sucralfate (Carafate) accelerates ulcer healing by forming ulcer-adherent complex covering the ulcer; Misoprostol protective and antisecretory
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| hepatitis | inflammation of the liver
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| hepatitis causes | drugs (including alcohol), chemicals, autoimmune diseases, metabolic abnormalities and rarely bacteria.
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| Hepatitis diet | low-fat, small frequent meals, larger meals in AM, adequate fluid intake
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| HAV transmission | Fecal-oral (primarily fecal contamination and oral ingestion)
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| HAV manifestations | anorexia, nausea, RUQ discomfort, weight loss, fatigue, malaise, light- or clay-colored stools if conjugated bilirubin unable to flow out of liver
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| HBV transmission | Percutaneous (parenteral)/permucosal exposure to blood or blood products; sexual contact; preinatal transmission
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| HCV transmission | Percutaneous (parenteral)/mucosal exposure to blood or blood products; High-risk sexual contact; Perinatal contact
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| HDV transmission | same as HBV: Percutaneous (parenteral)/permucosal exposure to blood or blood products; sexual contact; preinatal transmission
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| HEV transmission | Fecal-oral
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| cirrhosis | chronic progressive disease of the liver characterized by extensive degeneration and destruction of the liver parenchymal cells
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| cirrhosis causes | chronic liver disease (excessive alcohol intake and nonalcoholic fatty liver disease NAFLD)
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| nonalcoholic fatty liver disease (NAFLD) | a group of disorders that are characterized by hepatic steatosis (accumulation of fat in the liver) that is not associated with other causes such as hepatitis, autoimmune disease, or alcohol
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| Primary sclerosing cholangitis | a chronic inflammatory condition affecting the liver and bile ducts
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| Cirrhosis manifestations | Early: abrupt onset of anorexia, dyspepsia, flatulence, n/v, and change in bowel habits (diarrhea or constipation); Later: Jaundice, skin lesions (spider angiomas), hematologic problems, endocrine problems, peripheral neuropathy
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| When paracentesis performed | when ascites is accompanied by severe respiratory distress or abdominal pain
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| acute pancreatitis | an acute inflammatory process of the pancreas caused by autodigestion and marked by symptoms of acute abdomen and escape of pancreatic enzymes into the pancreatic tissues
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| pancreatitis causes | Biliary tract disease, Alchoholism, Trauma (post surgical & abdominal), Viral infections (mumps & coxsackievirus B), Penetrating duodenal ulcer, Cysts, abscesses, Cystic fibrosis, Kaposi’s sarcoma, Certain drugs
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| pancreatitis clinical manifestations | Epigastric pain, N/V, Abdominal tenderness, Low-grade fever, Leukocytosis, Hypotension, Tachycardia, Jaundice, ↓ or absent BS, Hypovolemia, Grey Turner’s spots & Cullen's sign
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| Cullen’s sign | bluish periumbilical discoloration caused by seepage of blood-stained exudate from the pancreas
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| Grey Turner’s spots | bluish flank discoloration caused by seepage of blood-stained exudate from the pancreas
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| Pancreatitis complications | pseudocyst, abscess, pleural effusion, Atelectasis, pneumonia, hypotension, hypocalcemia
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| pancreatic pseudocyst | a cavity continuous with or surrounding the outside of the pancreas
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| pancreatic pseudocyst manifestations | abdominal pain, palpable epigastric mass, n/v, anorexia, elevated serum amylase
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| pancreatic pseudocyst treatment | Internal drainage procedure with an anastomosis between pancreatic duct and the jejunum
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| pancreatic abscess | a large fluid-containing cavity within the pancreas
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| pancreatic abscess manifestations | upper abdominal pain, abdominal mass, high fever, leukocytosis
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| pancreatic abscess treatment | Prompt surgical drainage to prevent sepsis
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| pancreatitis pain control | Demerol, morphine, antispasmodic, avoid atropine-like when paralytic ileus present
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| Most effective means of relieving pain associated with acute pancreatitis | NPO status
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| Chronic Pancreatitis | Progressive destruction of pancreas with fibrotic replacement of the tissue
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| Symptoms of pancreatic insufficiency | Weight loss, Mild jaundice/dark urine, steatorrhea
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| steatorrhea | greater than normal amounts of fat in the feces (foul-smelling, frothy stools)
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| Pancreatic enzyme products (PEPs) | Creon, Zenpep, and Pancrease; contain amylase, lipase, and trypsin and are used to replace the deficient pancreatic enzymes.
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| Cholelithiasis | stones in the gallbladder
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| Cholelithiasis treatment | Cholesterol solvents, Drugs to dissolve stones, Endoscopic sphincterotomy, Extracorporeal shock-wave lithotripsy, Surgery
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| choledocholithiasis | stones in the common bile duct
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| cholecystitis | inflammation of the gallbladder
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| Cholecystitis clinical manifestations | Indigestion, Pain – moderate to severe, Fever, Jaundice, RUQ tenderness, Restlessness, Diaphoresis, N/V
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| Cholangitis | inflammation of biliary ducts
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| cholecystectomy | removal of gallbladder
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| common cholecystectomy post-op problem | referred pain to shoulder d/t CO2; place in Sims’ position (left side with right knee flexed)
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| Expected drainage from T-Tube | 500-1000 mL/day of bright yellow to dark green bile which is thick and acidic
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| cause of steatorrhea | no bile salts in duodenum, preventing fat emulsion and digestion
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| Parkinson's disease (PD) | a disease of the basal ganglia characterized by a slowing down in the initiation and execution of movement (bradykinesia), increased muscle tone (rigidity) tremor at rest, and impaired postural reflexes
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| Parkinson’s disease symptoms (triad of PD) | tremor, rigidity, and bradykinesia
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| generalized seizures | seizures characterized by bilateral synchronous epileptic discharge in the brain with loss of consciousness for a few seconds to several minutes
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| tonic-clonic (grand mal) seizure | seizure characterized by loss of consciousness and falling to the ground, followed by stiffening of the body for 10 to 20 seconds and subsequent jerking of the extremities for another 30 to 40 seconds
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| absence (petit mal) seizure | seizure characterized by a brief staring spell and a very brief loss of consciousness that usually occurs only in children and rarely continues beyond adolescence
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| atypical absence seizure | seizure characterized by a staring spell accompanied by other signs and symptoms, including brief warnings, peculiar behavior during the seizure, or confusion after the seizure.
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| myoclonic seizure | seizure characterized by a sudden, excessive jerk of the body or extremities.
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| atonic (“drop attack”) seizure | involves either a tonic episode or a paroxysmal loss of muscle tone and begins suddenly with the person falling to the ground
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| tonic seizure | involves a sudden onset of maintained increased tone in the extensor muscles
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| Clonic seizures | begin with loss of consciousness and sudden loss of muscle tone, followed by limb jerking that may or may not be symmetric
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| partial seizures | seizures that begin in a specific region of the cortex and may be confined to one side of the brain and remain partial or focal in nature, or they may spread to involve the entire brain
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| Nursing actions during a seizure | providing for privacy, loosening restrictive clothing, removing the pillow and raising side rails in the bed, and placing the client on one side with the head flexed forward
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| Parkinson’s teaching | exercise in AM, avoid sitting in soft deep chairs, rock back and forth to initiate movement and buy clothes with Velcro fasteners and slide-locking buckles
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| abdominal pain associated with Hepatitis | RUQ (discomfort)
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| abdominal pain associated with Acute Pancreatitis | LUQ or epigastric area and radiating to the back (severe and unrelenting)
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| abdominal pain associated with Cholecystisis/Cholelithiasis | RUQ, radiating to right scapula and shoulder
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| abdominal pain associated with cirrhosis | RUQ or epigastrium (full, heavy feeling)
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| abdominal pain associated with liver cancer | RUQ or epigastrium
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| abdominal pain associated with cecum obstruction | RLQ
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|
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| abdominal pain associated with Crohn’s | RLQ
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|
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| abdominal pain associated with diverticulitis | LLQ
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|
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| abdominal pain associated with constipation | LLQ
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|
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| abdominal pain associated with ulcerative colitis | LLQ
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|
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| abdominal pain associated with small bowel obstruction | Periumbulical and LUQ
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|
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| abdominal pain associated with appendicitis | Periumbulical and LUQ (early) or RLQ
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| abdominal pain associated with gastroenteritis | Periumbulical and LUQ
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| Esophagitis | inflammation of the mucosal lining of the esophagus caused by infection, irritation from a nasogastric tube, or, most commonly, backflow of gastric juice from the stomach
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| Chemo/radiation stomatitis, mucositis, esophagitis management | assess oral mucosa daily, nutritional supplements, analgesics, diet modification, frequent oral rinses with saline or salt and soda, artificial saliva, no tobacco/alcohol, anesthetics
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| Chemo/radiation nausea/vomiting management | eat/drink when not nauseated, antiemetics (before and after), diversion
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| Chemo/radiation anorexia management | monitor weight; small, frequent, high-protein, high-calorie foods; encourage don’t nag; pleasant eating environment
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| Chemo/radiation diarrhea management | antidiarrheals; low-fiber, low residue diet; 3L fluid intake
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|
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| Chemo/radiation constipation management | stool softners; high-fiber foods; fluid intake
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|
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| Chemo/radiation hepatotoxicity management | monitor liver function tests (serum bilirubin, urinary bilirubin, urinary urobilinogen, serum protein, ammonia, PT, Vitamin K, ALP, AST, ALT, GGT, cholesterol)
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|
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| Chemo/radiation anemia management | monitor Hgb and Hct; iron supplements and erythropoietin; foods promote RBC production
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|
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| foods promote RBC production | red meat, liver, fish, eggs, enriched and whole grains, green leafy vegetables, legumes, dried fruits, potatoes, cornmeal, bananas, milk, citris fruit, strawberries, cantaloupe
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|
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| Chemo/radiation leukopenia management | monitor WBC (especially neutrophils); monitor for fever; avoid large crowds; WBC growth factors
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|
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| Chemo/radiation thrombocytopenia management | monitor for bleeding; monitor platelet counts
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|
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| Chemo/radiation alopecia management | coping skills; cut hair before; avoid excessive shampooing, brushing, combing, hair dryers, curlers; self-image support
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|
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| Radiation skin reaction management | mild soap, lotion, expose to air, no tight-fitting clothes, no harsh fabrics, gentle detergents, no direct sun exposure, no excessive heat or cold temperatures, no swimming
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|
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| Chemo/radiation hemorrhagic cystitis management | increased fluid intake; monitor urgency, frequency, and hematauria; cytoprotectant agent and hydration
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| Chemo/radiation reproductive dysfunction management | discuss before; offer banking before
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|
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| Chemo/radiation nephrotoxicity management | monitor BUN, Creatinine; potentiating drugs; sodium bicarbonate
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|
||||
| Chemo/radiation ICP management | monitor neurologic status; corticosteroids
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|
||||
| Chemo/radiation peripheral neuropathy management | monitor for parathesias, areflexia, weakness; temporary chemo dose interruption; antiseizure drugs
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|
||||
| Chemo/radiation cognitive changes management | daily planner, sleep/rest, exercise brain, no multitasking
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|
||||
| Chemo/radiation Pneumonitis management | monitor for dry, hacking cough, fever, and exertional dyspnea
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|
||||
| Chemo/radiation pericarditis and myocarditis management | monitor for clinical manifestations
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|
||||
| Chemo/radiation cardiotoxity management | monitor ECG, drug therapy modification
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|
||||
| Chemo/radiation hyperuricemia management | monitor uric acid levels, prophylactic Allopurinol, increased fluid intake
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|
||||
| Chemo/radiation fatigue management | encourage rest, maintain usual patterns, pace activities; moderate exercise
🗑
|
||||
| Breast cancer screening guidelines | yearly mammograms starting at 40 y/o
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|
||||
| Colon and rectum cancer screening guidelines | colonoscopy every 10 years starting at 50 y/o
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|
||||
| Cervix cancer screening guidelines | yearly pap test starting 3 yrs after first intercourse
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|
||||
| Endometrium cancer screening guidelines | high-risk pts biopsy annually starting at 35 y/o
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|
||||
| Prostate cancer screening guidelines | offer PSA and rectal exam yearly starting at 50 y/o
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|
||||
| ulcer perforation management | NG tube; fluids (LR and albumin); blood replacement; CVP; foley; heart monitor; OR for repair
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|
||||
| Ostomy complications | mechanical breakdown, chemical breakdown, rash, leaks, dehydration, infection
🗑
|
||||
| PUD post-op complications | dumping syndrome, post prandial hypoglycemia, bile reflux gastritis
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|
||||
| Dumping syndrome | PUD post-op complication; generalized weakness, sweating, palpitations, dizziness, abdominal cramps, borboygmi, and urge to defecate; begin 15-30 minutes after eating a meal with hyperosmolar composition and last no longer than 1hr.
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|
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| Postprandial hypoglycemia | PUD post-op complication; sweating, weakness, mental confusion, palpitations, tachycardia, and anxiety; begin 2hrs after eating a meal high in carbohydrates.
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|
||||
| Bile reflux gastritis | PUD post-op complication; continuous epigastric distress that increases after meals and is relieved temporarily with vomiting; surgery involving pylorus causes reflux into stomach.
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|
||||
| PUD post-op changes in gastric secretions | usually bright red at first, with a gradual darkening within the first 24 hours after surgery; changes to yellow-green within 36 to 48 hours.
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|
||||
| PUD Post-op care | NGT secretions; assess abdomen, I&O, pain, IVF, check electrolytes
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|
||||
| Acute hepatitis manifestation | may be asymptomatic; malaise, anorexia, fatigue, nausea, occasional vomiting, and abdominal (RUQ) discomfort
🗑
|
||||
| Chronic hepatitis manifestations | malaise, easy fatigability, hepatomegaly, myalgias/arthralgias, elevated liver enzymes (AST and ALT)
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|
||||
| Hepatitis management | well-balanced diet, vitamin supplements, rest, no alcohol, drug therapy (for HBV and HCV)
🗑
|
||||
| Jaundice | symptom of yellowish discoloration of body tissues that results from an increased concentration of bilirubin in the blood
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
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To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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