Hondros College LPN Med Surge II full term
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| How often to check VS after surgery | Every 15 minutes
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| Signs of shock | Increased HR, thready pulse, BP decreased, cool/clammy skin, urine output decreased
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| signs/symptoms of pulmonary embolism | Sudden chest pain, dyspnea, tachycardia, cyanosis, diaphoresis, and hypotension
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| Interventions for pulmonary embolism | HOB at 45 degrees, administer oxygen, notify dr
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| How often to inspect surgical dressings? | every 2 to 4 hours for the first 24 hours
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| How much drainage in 24 hours? | More than 300 ml should be treated as abnormal
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| Define: diplopia, strasmus, nystagmus. | Diplopia: double vision. Strabismus: lazy eye. Nystagmus: jerky eyes.
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| What do the pons regulate? What does the cerebellum regulate? | Pons: Respirations
Cerebellum: Balance
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| What are the 3 meninges? | Dura, arachnid, and pia
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| What to remember about cerebral angiography | 1)Allery to iodine (shellfish) 2) NPO after midnight 3)bed rest for 12 to 24 hours 4)force fluids
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| What to remember about lumbar puncture | 1)Patient should be well hydrated 2) Inserted between l3/l4 or l4/l5 3)must lie flat for 6 to 12 hours afterwards.
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| Increased Intracranial Pressure causes changes in: | 1)LOC 2)Pupil response 3)Speech 4)Motor function 5)Vitals
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| Degenerative disorder with demyelination of brain stem and nerves (CNS) | Multiple sclerosis
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| Neuromuscular disorder - nerve impulses fail at the myoneural junction, causing weakness | Myasthenia gravis
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| motor neurons in the brain degenerate - messages do not reach the muscles | ALS/Lou Gehrigs - results in death 2 to 5 years after onset
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| Overactivity of dopamine; genetically transmitted | Huntingtons
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| Cardinal symptom is chorea | Huntingtons
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| Degeneration of the trigeminal nerve | Trigeminal neuralgia
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| Cardinal symptom of trigeminal neuralgia | excruciating, burning facial pain
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| Cranial nerves in Bells and Trigeminal neuralgia | VII and V.
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| Cardinal symptom of Bells Palsy | Unilateral facial paralysis
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| Upward progressing paralysis preceded by an infection | Guilllain Barre Syndrome
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| Cardinal sign of meningitis | Stiff neck and headache. (Kernigs and Brudzinksis signs for diagnosis).
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| Exaggerated sympathetic response at the T6 level - triggered by full bladder or impaction | Autonomic Dysreflexia
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| Labyrinthitis | Inflammation of the labryinthine canals in the inner ear - usually caused by a URI
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| Chronic, progressive deafness due to formation of spongy bone | Otosclerosis
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| Increase in the endolymph fluid - chronic disease of inner ear and 8th cranial nerve | Meniere's disease
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| Cardinal sign of Menieres | Recurrent attacks of vertigo accompanied by tinnitus or deafness. The vertigo is severe - rotational, may cause them to be unable to stand
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| Abnormally low blood volume due to blood loss | Hypovolemic anemia|
1000 ml loss can cause severe complications |
Manifested by hypotension, tachy, hemoglobin less than 10g, hematocrit less than 40%
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| Absence of intrinsic factor, loss of vitamin B12 | Pernicious anemia |
Deficiency of B12 affects growth of all cells and myelination of of nerves
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| Manifestations of pernicious anemia | Cardinal: Sore tongue, dysphagia, neurological issues
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| Decrease of bone marrow function | aplastic anemia |
Primary = congenital, Secondary = viral, medications, chemicals
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| Manifestations and interventions of aplastic anemia | pancytopenia, fatigue, palpitations | splenectomy, platelet transfusion, bone marrow transplant
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| WBC less than 200/mm3 & causes | Agranulocytosis | Caused by medications, chemo, neoplastic disease, viral/bacterial infections
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| Manifestations & interventions of agranulocytosis | ulcerations of mucous membranes, pneumonia, UTI. | Interventions - remove cause, prevent infections - strict asepsis.
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| Malignant neoplastic immunodeficiency of the bone marrow (+manifestations) | Myeloma. Bone pain, fractures, hypercalcemia (which causes renal failure)
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| Inflammation of lymphatic vessels - name of disease, alternate name, and cardinal sign. | Lymphangitis; blood poisoning; fine red streaks from affected area.
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| What do helper T's / CD4 cells do? | initiate immune response
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| Barrier between the body and outside world againt microorganisms | Innate immunity.
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| Composed of the thymus, spleen, bone marrow, blood, and lymph, provides a specific reaction to an antigen. | adaptive/acquired immunity.
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| This immunity is a result of the development and presence of circulating antibodies and is divided into active and passive. | Humoral immunity.
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| Types of hypersensitivity | Level I - pollens, insects, food allergies | Level II - Blood transfusions | III - Autoimmune | IV - delayed response to an exposure (transplants or TB test)
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| CD4 levels | 600 to 1200 = normal | 200-499 minor immune problems | below 200 severe problems
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| Pathophysiology of HIV | kills CD4 cells, then reproduces in the lymphatic system, eventually spilling over into the blood.
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| Early symptomatic HIV process | CD4 below 500. Night sweats, diarrhea, fatigue, lymphadenopathy
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| the end stage/terminal phase of HIV | AIDS. CD4 count below 200.
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| Fever; night sweats; productive cough; short of breath | PCP (pneumocystis carinii pneumonia)
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| Combination therapy, given around the clock, for HIV. | Antiretroviral. Cannot miss a dose. Usually initiated when CD4 drops below 350.
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| Major side effects of chemotherapy | leukopenia, anemia, thrombocytopneia, alopecia, stomatitis, n/v/d
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| Herpes Zoster | Aka Shingles. Unilateral inflammation of ganglia, painful rash on the nerve pathway.
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| Virus causes scaly lesions with pink center, widespread rash within 14 days. | Pityriasis Rosea - there is no treatment.
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| Lesions that start as macules, then develop and rupture a honey color exudate. | Impetigo - caused by staph viruses, highly contagious.
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| Dermatophytoses - 4 types | These are fungal infections. | Tinea capitis - ringworm on scalp | Tinea corporis - ringworm of body | Tinea cruris - jock itch | Tinea pedis - athletes foot
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| Dermatitis venenata | skin rash/allergic reaction to certain plants.
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| Hives of the subcutaneous tissue, causing a reaction similar to anaphylaxis. | Angioedema. Should be treated with epinephrine and corticosteroids.
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| Noninfectious raised, silvery plaques on the skin. | Psoriasis
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| Autoimmune disorder that causes inflammation of any body part. | Systemic Lupus Erythematosus.
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| Verruca | A benign wart
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| A burn involving the epidermis, dermis, and subcutaneous tissue. | Full thickness burn. Skin will not blanch, patient will not feel pain any longer in that area.
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| Treatment for burns | Respiratory, Fluids, THEN Pain. First 48 hours, fluids are crucial. 48-72 hours, high protein/calorie/viatamin diet, ROM.
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| What functions as both an endocrine and exocrine gland? | Panceas - it releases via a duct into the duodenum, and releases insulin directly in the bloodstream
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| Hormones secreted by the anterior pituitary gland | TSH, ACTH, FSH, LH, GH. All are indirect except GH.
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| Hormones secreted by posterior pituitary | ADH and Oxytocin.
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| What are the targets of TSH, ACTH, FSH, and LH? | TSH - thyroid | ACTH - adrenals | FSH - ovaries | LH - testes
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| Hormone necessary for reabsorption of water in kidneys | Antidiuretic hormone (ADH)
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| The gland that secretes melatonin, gonadotropin, and is a matrix for calcium | Pineal gland
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| The 3 hormones of the thyroid gland. | T3, T4, and calcitonin. | T3 and T4 regulate metabolism/growth | Calcitonin returns blood calcium to the bones.
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| PTH | Parathormone - maintains calcium and phosphate balance in the body
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| 2 hormones of the Thymus gland | Thymosin - causes T lymphocytes to mature | Thymin - blocks transmission of neuro impulses.
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| Causes hypoglycemic effects by interfering with GH and glucagons | Somatostatin
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| 3 corticosteroids released by the adrenal cortex. | glucocorticods - cortisol | Mineral corticoids - aldosterone | gonadocorticoids - sex hormones
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| Secretions of the adrenal medulla | Epinephrine and norepinephrine
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| Disorder of the anterior pituitary in which too much GH is secreted. | Hyperpituitarism. Causes gigantism if it occurs prior to the closing of the epiphysis. If in adults, its called acromegaly. The hands and feet and face enlarge, very painful skeletal growth.
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| Posterior pituitary secretes too much ADH | SIADH - Syndrome of Inappropriate Antidiuretic Hormone | too much water is reabsorbed, diluting the blood and decreasing osmolarity.
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| Manifestations and treatment of SIADH | Increased BP, muscle weakness, concentrated urine (Specific gravity > 1.030 | Treated by fluid restriction and diuretics
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| Not enough secretion of ADH | Diabetes Insipidus - kidneys do not reabsorb enough water, so urine is diluted. | can be caused by tumor, meds, alcohol, or head trauma
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| Manifestations and treatment of Diabetes Insipidus | Urinate 3 to 15 L every 24 hours, always thirsty, intense desire for ice water. Specific gravity of near 1.000. LEADS TO HYPOVOLEMIC SHOCK IF UNTREATED. | Treatment: sodium restrictions, electrolytes/fluids by IV
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| The main admissions information of a client with pituitary disorder? | Excessive weight gain/loss, intake vs output, and a child's height/weight vs growth charts
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| Hyperparathyroidism | aka Graves Disease | Oversecretion of T3 and T4, causing: tachy, hypertension, heat intolerance, weight loss, fatigue.
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| Lack of T4 & T3 | Myxedema (cretinism in infants). May be autoimmune, due to iodine deficiency, or because of a thyroidectomy. Manifested by goiter, weight gain, cold intolerance.
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| Differentiation of types of diabetes | DM1 - pancreas stops producing insulin | DM2 - pancreas produces some, but cells are resistant | Gestational - due to pregnancy | IGT - borderline diabetes | Secondary - due to pancreatic trauma or disease, birth control |
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| Addison's disease & crisis | Low in aldosterone. Causes the skin to be a bronze color. | Addisonian crisis is life threatening, manifesting through hypotension, weak pulse, FV deficit, and collapse.
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| Cushings disease | Overproduction of cortisol - manifested by buffalo hump, moon face, muscle wasting.
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| Benign tumor in adrenal medulla, causing excessive epinephrine and norepinephrine production. | Pheochromacytoma. Symptoms include very high hypertension, pounding headache, tachycardia, diaphoresis.
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