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NUR 141 EXAM 2
| Question | Answer |
|---|---|
| LPNs care for persons who are... | well, ill but stable, injured, convalescent, handicapped |
| LPNs work under... | own license and supervision, can not delegate tasks to unlicensed personnel |
| most facilities LPN does not... | start IVs, give IVP or IBPB meds, work with central lines, take verbal orders |
| LPN duties | caths, dressings, tube feedings, wound irrigation, med adm (not IV), pre-post mortom care |
| LPNs can direct, assign and supervise aides in extended care facilities | |
| PT does | motor |
| OT does | upper extremities and ADLs |
| ST does | swallowing, speaking |
| "study learning principles" | |
| domains of learning | cognitive, affective, psychomotor |
| cognitive | intellectual-understanding of risks and s/s of low blood sugar |
| affective | emotions, attitudes, values= values blood sugar control and health promotion |
| psychomotor | acquiring skills-can use glucometer to check blood sugar level |
| pain is the physical sensation, suffering is the emotional response to pain | |
| pain lasting > 3 months | chronic, vs can b normal |
| sudden pain | acute, inc in BP and vs |
| nocioceptive pain | caused by damage to tissue, heals quicker |
| nocioceptive somatic pain | superficial (sharp, burning, prickly), deep (aching, throbbing) |
| nocioceptive visceral | internal organs (referred pain) cramping, pressure |
| nocioceptive pain responds to | opioid and non opioid meds |
| neuropathic pain | caused by damage to nerves or CNS (numbing, burning, stabbing) |
| causes for neuropathic pain | trauma, inflam, metabolic disease, ETOH, inf. Not well controlled by opioids alone. |
| incident pain | is ambulation, change in posiiton |
| pattern of pain | onset, duration, breakthrough pain |
| non opioids | for mild/mod pain, nonsalicylate, salicylate, NSAIDS |
| nonsalicylate | acetminophen-analgesic, antipyretic, hepatic toxicity |
| salicylate | ASA-analgesic, antipyretic, antiplatelet, antinflamm |
| NSAIDS | losts of side effects |
| characteristics of nonopioids | analgesic ceiling, no tolerance/dependence to, OTC, opioid sparing |
| opioids | bind to CNS receptors for mod/severe pain, no ceiling |
| opioids to avoid | propoxyphene (seizures), meperedine (neurotoxicity) |
| side effects of opioids | contstipation, N/V, sedation, resp depression, itching, urinary retention, confusion |
| adjuvants for opioids | corticosteroids, antidepressants, antizeizure, GABA receptor agonists, alpha adrnergic agonists, local anesthetics, cannabinoids |
| corticosteroids | dec edema/inflam. SE=dose/duration dependent |
| antidepressants | inhibit reuptake of serotonin &/or norepinepherine higher levels in synapse. inhibits pain impulses. good for neuropathic pain |
| antiseizure | affect peripheral nerves &CNS, good for neuropathic pain, gabapentin (neurotin), pregabalin (Lyrica) |
| GABA receptor agonists | muscle spasms |
| marrinol | pot in pill form |
| a chart of conversion for other meds that do same thing | equianalgesic dosing |
| PCA pumps are a high risk for resp depression | |
| Tolerance | chronic exposure dec effect of drug. rotate |
| physical dependence | expected, experience withdrawl s/s when blood level drops. Taper off. |
| addiction | powerful drive to take substance for reasons other than the therapeutic purpose. Seeking SE instead of therapeutic effects |
| cancer pain | acute/chronic, r/t desease/tx, |
| palliative care | focus on pain control in incurable conditions |
| hospice | end of life care, focus on comfort/quality of life vs quantity |
| ethical concern with hospice | hasten death |
| nutrition in >50 yo | women=1920, men=2300, need more vit D, B12, protien, fat, CHO, fluids |
| dehydration in tne elderly | purposely avoid fluids, loose sense of thirst, forget to drink, can get fluids on their own |
| lack of nutrition in elderly | poor fitting teeth, taste/swallowing impaired, vision, constipation |
| white patches in mouth | leukoplakia |
| red velvety patches | erythroplackia |
| precursor to esphageal cancer | pharynxesphogitis from reflux |
| cancer that is mastatic at time of dx | esophageal cancer, to brain, lungs; removal of esophagus, stints, survial<20%, |
| after removal of esophagus | NG tube (do not touch), I/O, VS, pain, mobility, DB, cough |
| sign of fever, severe pain and NG contents change after esophagus removal | a leak |
| pts with inc temp after surgery | ateloactisis=DB and cough |
| gall stone blocking duct can cause | pancreantitis |
| lab the is relased with injury | LDL |
| lab the inc w other organ dmage | AST |
| lab that is liver specific | ALT |
| all fluids of body have billirubin except | CSF |
| hep A & E | trans w fecal oral |
| hep B | trans w body fluid, blood |
| hep C | trans blood |
| hep D | only have w B |
| drug of choice for liver disease | aldactone |
| what are some contributing causes for cirrhosis of liver | ETOH, hep C 7 B, chronic inflam, billary cirosis, obstructions |
| what labs are for cirrhosis of liver | ALT, LDH, bilirubin, albumin, amonia, PT |
| assessment data for cirrhosis liver | pain, fatique, brusing, acetises, LOC, what have been exposed to |
| what orders with sirrhosisi of liver | daily st, liver biopsy, parancitisis,, vit K, folic acid, thymiane, DTs, diuretics |
| wat liver does | stores carbs, protein, 1st pass, responsible for clotting factors, detoxes at 1st pass |
| must have PT prior to liver biopsy | want good clotting: after biopsy ly on R side |
| break down of protein | = amonia |
| jaundice | bilirubin is x3, clay stools, tea urine, skin itches, anorexic, fatique |
| ETOH need | thyamine and folic acid |
| common hepatotoxins | isoniazid, acetaminophen, thiazides, tetracycline, methotrexate, ETOH, poisons, heavy metals |
| pt adm w RUQ pain N/V, sudden onset, ate shell fis. wat tests dr order | hepatits profile (hep A) |
| how is HBV trans | blood, body fluid |
| how is HCV trans | blood (transfission, neeedles)_ |
| how protect yourself from transmission | hep B vac |
| hep B more than C can cause | liver cancer |
| causes of pancreatitis | obstruction, EToh, gall stones, billiary tract disease |
| assessment data for pancreatitis | pain, N/V, fever, HTN, vs, left upper gastric pain |
| lab teszts for pancreatitis | amalyse, lipase, BG |
| gall stone blocking duct can cause | pancreantitis |
| lab the is relased with injury | LDL |
| lab the inc w other organ dmage | AST |
| lab that is liver specific | ALT |
| all fluids of body have billirubin except | CSF |
| hep A & E | trans w fecal oral |
| hep B | trans w body fluid, blood |
| hep C | trans blood |
| hep D | only have w B |
| drug of choice for liver disease | aldactone |
| what are some contributing causes for cirrhosis of liver | ETOH, hep C 7 B, chronic inflam, billary cirosis, obstructions |
| what labs are for cirrhosis of liver | ALT, LDH, bilirubin, albumin, amonia, PT |
| assessment data for cirrhosis liver | pain, fatique, brusing, acetises, LOC, what have been exposed to |
| what orders with sirrhosisi of liver | daily st, liver biopsy, parancitisis,, vit K, folic acid, thymiane, DTs, diuretics |
| wat liver does | stores carbs, protein, 1st pass, responsible for clotting factors, detoxes at 1st pass |
| must have PT prior to liver biopsy | want good clotting: after biopsy ly on R side |
| break down of protein | = amonia |
| jaundice | bilirubin is x3, clay stools, tea urine, skin itches, anorexic, fatique |
| ETOH need | thyamine and folic acid |
| common hepatotoxins | isoniazid, acetaminophen, thiazides, tetracycline, methotrexate, ETOH, poisons, heavy metals |
| pt adm w RUQ pain N/V, sudden onset, ate shell fis. wat tests dr order | hepatits profile (hep A) |
| how is HBV trans | blood, body fluid |
| how is HCV trans | blood (transfission, neeedles)_ |
| how protect yourself from transmission | hep B vac |
| hep B more than C can cause | liver cancer |
| causes of pancreatitis | obstruction, EToh, gall stones, billiary tract disease |
| assessment data for pancreatitis | pain, N/V, fever, HTN, vs, left upper gastric pain |
| lab teszts for pancreatitis | amalyse, lipase, BG |
| what DO for pancreatitis | morphine, dilaudid, NPO, NG tube, previcid, Zofran |
| pancreas | endo/exocrine secretes insulin, glucagon, digestive enzymes |
| pancreatitis tx | NPO (cant excrete lipase,amalace until gone), NGT, morphine, fluid, low fat, bland, pancreatic enzymes, cant drink again or will b back in hosp |
| tests for a DM pt | DM diet, insulin, fluids, A1c |
| pts on beta blockers are tachy | |
| repeated hypoglycemia causes memory loss | |
| diabetic ketoacidosis only occurs in | type 1 |
| somogyi effect | caused by too much insulin, tto much insulin at night |
| dawn phenomenon | hypergycemia d/t coungterregulatory hormones, hormone imbalance |
| DM and renal failure go together | |
| DM causes dec in motility | give Regalan 1/2 hr before meals to inc motility |
| A1C | 4-6 non diabetic |
| if hypoglycemic give.. | no candy bars (too much fat, delays absorption) |
| if hypoglycemic give... | 15-20gm x15min, 6 oj, 4 cola, 8 milk, 3 glucose pills, 5 lifesavers, 1 dry toast, 1/2 c ice cream |
| what drug you cant give with a dye study | metforman |
| medulla adrenal gland (sympathetic NS) | epinephrine, norepinephrine |
| Cortex adrenal gland | mineralcorticoids, glucocorticoids, androgens, |
| too many mineralcorticoids, glucocorticoids, androgens = | cushings-pituitary (inc cortisol) |
| too little mineralcorticoids, glucocorticoids, androgens = | addisons-adrenal (dec cortisol) |
| cushings syndrome is caused from | too much steroids (prenidone) brusing, muscle waste, fatty, poor wound healing, moon face, moods up/down, anmenorea, impotent, gynomastia |
| side effects of steroid therapy | osteoparosis, fat to belly, cataracts, moon face, muscle atrophy, DM. diet dec Na, inc Ca |
| goup of disorders caused by impared DNA synthesis | Megaloblastic Anemia |
| Megaloblastic anemia causes | defective RBC maturation, large RBCs, the RBC have fragile cell membranes which are easily destroyed |
| Instrinsic factor is secreated by | gastric mucosa |
| Need IF to absorb | cobalamin (B12) |
| Absence of intrinsic factor | pernicious anemia-onset after 40yo, large RBCs, dec B12 levels, SERUM FOLATE IS NORMAL, |
| parietal cell function test with radioactive cobalamin adm | shillings test |
| Upper GI and biopsy of gastric mucosa test for pernicious anemia can cause | inc risk of gastric cancer |
| assessment finding for pernicious anemia | sore tongue (red, beefy/shiny), N/V, abd pain, weakness, |
| drug therapy for pernicious anemia | dietary B12 doesnt work...use parenteral, intranasal, sublingual. |
| increased production of RBCs and impaired circulation dt inc blood viscosity | Polycythemia |
| chronic chromosomal mutation with inc RBCs, WBCs and platelets | Polycythemia Vera |
| Hoypozia driven, inc O2 demand | secondary polycythemia |
| ns assessment for polycythemia | Plethora (ruddy complexion), intermittent claudication (pain in butt, back of legs at rest) |
| managemnt of primary polycythemia vera | phlebotomy, monitor i/o, RBC, WBC, platelets, active/passive leg exercises, amb when ordered. |
| amb would not be ordered due to | clots |
| managment of secondary polycythemia | control chronic pulmonary disease, no smoking, high altitudes |
| prehypertension | SBP 120-139, DBP 80-89 |
| HTN inc risks for | MI, hear failure, stroke, renal disease, silent killer, unknown cause |
| target organ diseases for HTN | heart, brain, pere\ipheral vascular disease, kidney, eyes |
| HTN heart disease | CAD, L ventricular hypertrophy, heart failure |
| HTN cerebrovascular disease | stroke, 4 times more likely to have one |
| HTN peripheral vascular disease | speeds up atherosclerosis in peripheral blood vessels |
| atherosclerosis can lead to | PVD, aortic aneurysm, aortic dissection intermittent claudication |
| death of nephrons from narrowing of the arteries and arterioles | nephrosclerosis, leading cause of ESRD |
| labs for nephrosclerosis | albumin, proteinuria, hematuria, elevated BUN and creatinine |
| s/s HTN | fatigue, reduced activity tolerance, dizziness, palpitations, angina dyspnea |
| ns mangement of HTN | inc fiber, dec fat, inc water, dec salt, dec wt |
| fall in bp when a person stands | orthostatic hypotension |
| 3 factors of orthostatic hypotension | cardiac func, vascular status, intravascular blood and fluid volumes |
| orthostatic vs | bp from lying to sitting to standing q 2 min. SBP inc by 20, DBP inc by 10 and HR inc by 20 |
| 2 main actions of antihypertensives | dec CO or reduce systemic vascular resistance (the squeeze of vessels |
| pts on thiazide should eat foods rch in | potassium |
| pt taking thiazides should avoid what OTC | NSAIDs-dec diuretic effects |
| monitor what for loop and K+ sparing diuretics | orthostatic hpyotension, hypokalemia, i/o, wt |
| pt taking aldoctone (aldosterone receptor blockers) should not eat | fruit w potassium |
| avoid what with catapres (adrenergic inhibitors) | any sedative |
| pt on lopressor (beta blocker) requires monitoring of | BP and P |
| pt on Apresoline (direct vasodilators)and urine is brown and 1+ edema on ankle what going on | rapidly progressing glomerilonephritis |
| side effect of Vasotec (ACE inhibitor) | dry hacking cough, in the lungs causes cough. angioedema |
| swelling of face and tongue | angioedema, allergic reaction from ACE-inhibitors |
| pt on Cozzar (angiotension II receptor blocker) still has high BP | med takes days to weeks to work |
| elevated BP w a specific cause that can b identifies and corrected | secondary HTN |
| causes of secondary HTN | MAO inhibitors w tyramine foods (wine, cheese, cured meats), estrogen replacement therapy, the pill, NSAIDS |
| clinical finding of secondary HTN | hypokalemia, abd buit, variable BPs w tacy, sweating, tremors, fam hx of renal disease |
| CAD | fatty deposits on aterial wall that cause inflam "hrdening of the arteries" |
| dec risk for CAD | diet, lifestyle, exercise, no smoking, no ETOH |
| causes of CAD | cholesterol>240, SBP>160, >1 pack a day smoker |
| CAD med that causes Rhabdomyolosis | statins |
| rhabdomyolosis | breakdown of skeletal muscle, products get caught in kidneys and cause renal failure |
| common side effects of niacin | itching, hot flashes |
| fibric acid derivative increase the effects of | coumadin |
| bile acid sequestrants interfere with absorption of | digozin, thiazide diuretics, warfarin, penicillins |
| cholesterol absorption inhibitors should not be use with what condition | liver impairment |
| natural lipid lowering agents | niacin, garlic, omega-3 fatty, psyllium, soy, phytosterols (nuts, seeds), red yeast rice |
| leading cause of death | CAD |
| chest pain | angina pectoris-caused by dec supply of oxygen to heart muscle |
| noncardiac factors that dec O2 to myocardial cells | anemia, asthma, COPD |
| noncardiac factors that inc O2 demand of myocardial cells | anxiety |
| cardiac factos that dec O2 to myocardial cells | coronary attery spasm, thrombosis, dysrhymias, heart failure |
| cardiac factors that inc O2 demand of myocardial cells | aortic stenosis, cardiomyopathy, tachy |
| type of Angina | Chronic Stable Angina-secondary to CAD, tx w rest and nitrate |
| type of angina | Prinzmetals angina-occurs at rest due to coronary artery spasm. tx w Ca Channel blockers |
| Chronic stable angina | pain at rest in neck, jaw, shoulders, arms, between shoulders lasts 5-15min. |
| manifestations of CAD tend to occur during | early morning after wakening |
| questions for chest pain | Precipitating evens, Quality of pain, Radiation of pain, Severity of pain, Timing |
| tx for chronic stable angina | Antiplatelet/anticoagulant, ACE, antiotension receptor blocker; B-adreergic blocker (BP); Cigarette smoling, calcium channel blockers, cholesterol; Diet, DM; Exercise, education; Flu vacc |
| unstable angina | at rest, worsening pattern, |
| nitro | pain should be relieved in 3 min and last for 30-60min. can give another 5 mins apart x3. |
| nitro can cause | dec BP and HA due to vasodilation |
| teaching of nitro | accessible at all times, keep in dark bottle, replace q 6 mths, under tongue, feel tingle, no ED drugs, change positions slowly, HA |
| sustained ischemia causing myocardial death | Myocardial infarction (MI) by thrombus, pain not relieved |
| cardiac disorder that impairs the ability of the ventricle to fill with or eject blood | Heart failure |
| why HF instead of CHF | not all pts have volume overload at the time of intial or subsequent evaluations |
| s/s HF | ventricular dysfunction, reduced exercise tolerance, diminished quality of life, shortened life expectancy |
| most common reason for hospitalization adm in adults >65yo | HF |
| two most common causes of L sided failure | systolic failure, distolic failure |
| systolic failure | most common, L ventricle fails to contract/pump dec ejection fraction ends up w pulmonary congestion. listen to lungs |
| diastolic failure | ventricls stiffen, dec filling, selling feet, some lung congestion |
| sign of L sided heart failure | no urinary output |
| right sided failure | R ventricle fails pump enough blood to meet body needs, ventricle cant accept all the blood returning to the heart. |
| s/s of R sided failure | backs up into veins/capillaries, edema, dry lungs, generalized edema |
| Heart failure assessment | Fatigue, Activities limited, Chest congestion/cough, Edema, SOB |
| Heart failure assessment | dec blood flow to extremities less hair, chest pain, dusky cool skin, edema, tachycardia, SOB |
| s/s R sided HF | Jugular vien distention, pedal edema, wt gain, fatigue, dependent bilat edema, URQ pain |
| s/s L sided HF | crackles, changes in mental status, confusion, restlessness, weak, dyspnea, shallow resp, SOB in recumbant, cry hacking cough, nocturia |
| 1+ edema | mild pitting, slight indentation, no perceptible swelling of the leg |
| 2+ edema | moderate pitting, indentation subsides rapidly |
| 3+ edema | deep pitting, indentation remains for a short time, leg looks swollen |
| 4+ edema | very deep pitting, indentation last a long time, leg is very swollen |
| digoxin (Lanoxin) | dec and strengthens heart beat, check apical HR (>60) prior to adm |
| digoxin toxicity | yellow vision, halos. anecdote=digibindIV |
| tx for heart failure | diuretics (K+ waisting loops) watch electorlytes (K+, Na), morphine for pain causes vasodilation of lungs to inc capacity |
| major cause of PAD | athrerosclerosis |
| drug for intermittent claudication | trental, pletal |
| tx for PAD | Trental, Pletal, walking, inspect feet, exercise till discomfort than rest start again |
| surg tx for PAD | percutaneous transluminal ballon angioplasty, atherectomy (remove plaque), peripheral artery bypass w graft, endarterectomy (remove plaqe from artery), amputation |
| thrombosis and fibrosis occur inside the vessel causing exchemia | Buerger's Disease |
| Buerger's Disease | obstruction of small arteries, loss of phlanges, stop smoking |
| episodic vasospastic disorder fo small cutaneous arteries of fingers and toes | Raynaud's phenomenon, 15-20 yo women. |
| second leading cause of cancer in women | breast cancer, 1st is lung |
| increased exposure to estrogen causes | breast cancer |
| breast cancer tumors are | hard, circular, dimpling, immovable, non tender, large |
| risk for endometrial cancer | having 1 or more 1st relative w oravrian cancer, too much extrogen |
| beta blockers cause | ED |
| S/S prostate cancer | painless enlargement, heaviness, dragging sensatoin |
| most dangerous rooms for elderly | kitchen, bathroom, bedroom |
| medication risks | absorption, distribution, biotransformation, excretion |
| medication errors | polyphrmacy, living alone, inadequate education, inadequate finances, medication regime understanding. 60% take meds wrong |
| drug toxicity | earliest sign.. mental confusion |
| 4 types of extrapyramidal reactions. Early onset.... | acute dystonia (severe spasm), Parkinsonism (mask face, drooling, tremors, shuffling, stoop, pill rolling), Akethisia (pacing, squirming) |
| late onset | tardive dyskinesia (tongue, face, swallowing dec) not reversiable |
| insulin reaction | speech disorder, slurring, confusion, disorientation. elderly w beta blockers have hpyoglycemic unawareness |
| fluid filled sac that cushions a jt. can become inflamed | bursa-bursitis |
| attaches muscle to bone | tendon-tendonitis is from overuse |
| inflammation of muscle | myositis |
| RICE | rest, ice, compression, elevation. Ice no more than 20min |
| tx for swelling and effusion | aspiration and rice |
| infection in bone | osteomyelitis by staff aureus |
| most common osteomyelitis | indirect via blood stream from elsewhere in body |
| direct osteomyelitis | contamination from surgical site, fx, DM foot ucler |
| bone deterioration | osteoporosis-deficit in bone replacement |
| ostoporosis | bone density test, post menopausal, kyphosis, fx, pain, Ca+vitD, no salt, caffeine, WB exercise, fosomax, evista |
| rehabilitation begins | the first day |
| loss of motor function | paralysis |
| lesser degree of paralysis | paresis |
| paralysis-legs lower body | paraplegic |
| paralysis all 4 limbs | tetraplegic |
| brain thru spinal cord | upper motor neuron |
| spinal cord to muscle | lower motor neuron |
| sensory impulse to corn, motor neuron, muscle or gland | motor reflex arc |
| sacral reflex arcs intact | sacral sparing |
| proprioception | ur understanding where ur limbs are |
| cervical injury | C1-2=freq fatal (vent dependant; C3-4 vent dependent, diaphragm weak; C5: if can shrug shoulders, no vent, only diaphragm to breath, no intercostals, has shoulder/elbow func, most common cervical injury |
| thoracic/lumbar:paraplegic | T1-6 confined to WC; T6down=parapareiss, WK, braces, they shake; above S2=reflex present for bowel/bladder emptying, S2-4, reflex arc destroyed |
| impaired resp-vent C1-4 | frequent pulmonary inf, assisted cough, breathing exercises, possible phrenic nerve stim |
| impaired O2 transport:immobility | TEDS to prevent pooling, no IMs below injury, ROM q 8* |
| Bladder problems above S2 (UMN)Reflexic | bladder Hypertonic, <150CC capacity, reflex voiding, urgency, frequency, stroke trigger areas |
| Badder problems S2-4 Areflexic | reflex destroyed, hypotonic,>500cc residual(cant empty), overflow voiding, crede or St cath |
| Bowel problems above S2 (UMN) Reflexic | spastic bowel, dulcolax suppos, digital stim |
| Bowel problems S2-4 (LMN) Areflexic | Atonic bowel, enemas, digital removal, |
| sexuality | above C5 and up, women use birth control (not pill) |
| exaggerated ANS response to stimuli | Autonomic dysreflexia |
| autonomic dysreflexia | pt w lesion above T6 (often due to full bladder or bowel)can last 6yrs after injury. |
| s/s autonomic dysreflexia | generalized vasoconstriction first then sudden severe HTN. HA, brady, inc BP, dec P |
| autonomic dysreflexia can result in | CVA, SAH, seizure and death |
| Ns intervention for autonomic dysreflexia | fast action..raise HOB (90*), BP,check for full bladder, bowel, UTI, kinked cath, use anesthetic lubricant for digital stim and cath, |
| device that prevents neck flexion | halo traction |
| musculo-skeletal changes in the elderly primary | dec muscle mas/strength, jt mobility, shoulder width, disc space mineral loss in bones, fat to belly |
| musculo-skeletal changes in the elderly secondary | unsteady gait, osteoporosis, fax, curvature of spine, osteo arthritis |
| inflammation of freely moveable jts, bilateral, symmetric, poy-arthritis in all extremities | Rheumatoid arthritis-autoimmune disease, genetic, rheumatoid factor present |
| systemic symptoms of RA | fever, wt loss, fatiue, feneralized aching, early morning stiffness, tachy, weakness, anemia |
| local s/s of RA | jts stiff, pain, edema, prosimal finger jts enlarged, swan neck deformity, nodules on extensor surfaces |
| who are more susceptible for getting RA | Pima and Chipawa tribe women |
| meds for RA | DMARDS (Methotrexate #1), NSAIDS, asprin (enteric coated 4-6gm), Anit inflams (Prednisone), |
| Ns interventions for RA | pain, inflam, ROM warm H2O therapy, own ADLs, assistive devices, splints for extension not flexion |
| removal of synovia, reduces inflam and helps maintain jt func | synovectomy |
| jt replace ment | arthroplasty |
| cut bone to change alignment or correct deformity | osteotomy |
| fusion of jt | arthrodesis |
| chronic inflam autoimmune disease (vascular and connective tissue) | systemic lupus erythematosus-multi system disease, reversible form, poly arthritis, red butterfly rash |
| what caused lupus | procame |
| dx of lupus | +LE cell prep and ANA, Anti-DNA, Anti-Smith (most dx) |
| inflam disease of voluntary muscle | polymyositis-degeneration of muscle fibers. tx high dose steroids |
| s/s of polymyositis | muscle weakness, difficulty moving/swallowing, symmetrical, includes polyarthritis, arthralgias and Raynauds |
| polymyositis with rash, | dermatomyositis-more prone to malignancy with in 5 yrs. tx high dose steroids |
| disease that affects jts and surrounding tissue, loss of srticular cartilage in WB jts | osteoarthritis (DJD) from over use |
| s/s of DJD | pain, stiffness in jts after rest, crepitation, Bouchard(PIP) and Heberden(DIP)nodes |
| tx for DJD | tylenol (4gm), |
| metabolic disorder, too much uric acid | gout-no meat, alcohol |
| 3 causes of gout | poor renal excretion of uric acid, metabolism of purine, inc in uric acid production, |
| s/s of gout | crystals in tissues cause pain (jts/kidneys), red swollen jts, |
| swollen red great toe | podagra |
| meds for gout | culchasine, fluids, uloric, cozar and zyloprim together |
| tx for gout | meds, ice, elevate, uric acid levels, foot craddle |
| benign bone tumor | osteoma |
| malignant bone tumor | osteosarcoma-young males 10-25yo and fatle, pain swelling in knee |
| dx of bone tumors | ALK phos and Ca will be inc, CAT scan, PET, MRI, biopsy |
| complications of amputations | hemorrhage, edema, contractures, inf |
| care for amputations | no elevations, chair rest x1hr, prone 3-4xdaily, monitor stump for bleeding, body image |
Created by:
vstein
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