UTA NURS 3561 Nursing of Adults Exam 2
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| Acute bronchitis | an inflammation of the lower respiratory tract that is usually due to infection (Lewis 112010, p. G-2)
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| Acute Bronchitis s/s | persistent cough with cear mucoid sputum (sometimes purulent), fever, headache, malaise, normal chest x-ray, breath sounds: normal, rhonchi, or expiratory wheezing
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| Acute Bronchitis treatment | Supportive (fluids, rest, cough supressants), antibiotics (COPD)
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| Pneumonia | an acute inflammation of the lungs, often caused by inhaled pneumococci of the species Streptococcus pneumoniae (Lewis 112010, p. G-7)
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| Community-acquired pneumonia (CAP) | a lower respiratory tract infection of the lung parenchyma with onset in the community or during the first 2 days of hospitalization (Lewis 112010, p. G-2)
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| Hospital-acquired pneumonia (HAP) | pneumonia occurring 48 hours or longer after hospital admission and not incubating at the time of hospitalization (Lewis 112010, p. G-4)
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| Health care–associated pneumonia (HCAP) | new-onset pneumonia in pt who (1) was hospitalized >= 2 days within 90 days; (2) resided in a long-term care facility; (3) received IV antibiotics, chemotherapy, or wound care within past 30 days; or (4) attended hospital or hemodialysis clinic.
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| Ventilator-associated pneumonia (VAP) | pneumonia that occurs more than 48 hours after endotracheal intubation. (Lewis 112010, p. 548)
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| Aspiration pneumonia | the condition that occurs from abnormal entry of secretions or substances into the lower airway. (Lewis 112010, p. 548)
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| Opportunistic pneumonia | patients with altered immune systems are at high risk for this ( +HIV, dialysis pt., transplant pt., etc.)
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| Pneumonia s/s | fever, chills, productive cough, malaise, splinting of affected side, Tachypnea, crackles, friction rub dullness, increased femitus, Tachycardia, Maybe Decreased O2 saturation
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| Pneumonia treatment | antibiotics (if bacterial, fluids (3 L/day), nutritional support, rest, O2 (hospitalized), cough & deep breath, Change Positioning, bronchodilators
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| Ineffective airway clearance | Inability to clear secretions or obstructions from the respiratory tract to maintain a clear airway (Ackley 2011, p. 128)
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| Ineffective breathing pattern | Inspiration and/or expiration that does not provide adequate ventilation (Ackley 2011, pp. 192-193)
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| Impaired gas exchange | Excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane (Ackley 2011, p. 402)
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| tuberculosis (TB) | an infectious disease caused by Mycobacterium tuberculosis; usually involves the lungs, but also occurs in the larynx, kidneys, bones, adrenal glands, lymph nodes, and meninges and can be disseminated throughout the body (Lewis 112010, p. G-9)
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| TB s/s | malaise/fatigue, anorexia & wt. loss, night sweats, frequent cough, afternoon low grade fever, hemoptysis (not common/very advanced cases)
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| TB treatment | combination of medications (4) over at least 6 mo: isoniazid, rifampin, pyrazinamide, Streptomycin or ethambutol
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| Isoniazid Drug Alert | Alcohol may increase hepatotoxicity of drug. Instruct patient to avoid drinking alcohol during treatment; Monitor for signs of liver damage before and while taking drug. (Lewis 112010, p. 555)
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| β2-Adrenergic Agonists Drug Alert | May cause elevation in BP and heart rate, result in central nervous system stimulation/excitation, and increase risk of dysrhythmias (both short and long acting); Overuse may cause rebound bronchospasms (short acting).
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| Long-Acting β2-Adrenergic Agonists Drug Alert | Not firstline treatment of asthma; never use as only medication to treat asthma (added if other controller medicines work; Do not use to treat worsening wheezing; Always use a short-acting β2-agonist to treat sudden wheezing.
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| Theophylline Drug Alert | Instruct patient to report signs of toxicity: nausea, vomiting, seizures, insomnia; Avoid caffeine to prevent intensifying adverse effects. (Lewis 112010, p. 600)
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| Directly observed therapy (DOT) | providing the antituberculous drugs directly to patients and watching as they swallow the medications. (Lewis 112010, p. 556)
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| Requirements for discontinuation of TB isolation | The patient is on effective therapy, The patient is improving clinically, and Three consecutive sputum samples, obtained on different days, are smear-negative for AFB
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| Asthma | chronic inflammatory lung disease resulting in airflow obstruction; characterized by recurring episodes of paroxysmal dyspnea, wheezing caused by constriction of the bronchi, coughing, and viscous mucoid bronchial secretions
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| Asthma precipitating factors | Allergens, resp infect, nose & sinus, exercise, ASA & NSAIDs, gastroesophageal reflux, emotional stress
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| Dyspnea | shortness of breath; difficulty breathing that may be caused by certain heart or lung conditions, strenuous exercise, or anxiety (Lewis 112010, p. G-3)
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| Dyspnea early signs | Apprehension, resltessess, irritability, tachypnea, tachycardia, mild HTN
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| Asthma medications | Bronchodilators & Antiinflammatories
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| Bronchodilators | 1) β-adrenergic agonist (short term inhalent [Alupent, Albuterol], longer acting inhalent [Serevent]; 2) Theophylline
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| Antiinflammatories | 1) Corticosteroid MDI (Vanceril, Beclovent), Prednisone - short term; 2) Leukotriene inhibitor; 3) Nonsteroidal - Cromolyn
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| Asthma attack treatment | Assess lungs, Give oxygen prn, Measure peak flow & compare with normal, Ask about routine meds and OTC’s, Start IV, Meds as ordered (inhalers, Solu-medrol, etc)
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| Peak expiratory flow rate (PEFR) | Maximum airflow rate during forced expiration; aids in monitoring bronchoconstriction in asthma; Normal: Up to 600 L/min (< 300 may require hospitalization)
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| chronic bronchitis | obstructive pulmonary disease characterized by excessive production of mucus and chronic inflammatory changes in the bronchi (Lewis 112010, p. G-2)
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| Blue bloater | associated with chronic bronchitis; s/s: coughing, ventilation-perfusion deficit, hypoxemia and hypercapnia, polycythemia, cyanosis, cor pulmonale (RHF)
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| emphysema | an abnormal condition of the pulmonary system characterized by overinflation and destructive changes in alveolar walls (Lewis 112010, p. G-3)
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| Pink Puffer | associated with emphysema; s/s: earliest sign is dyspnea (no cough); ↑RR, accessory muscles, prolonged e, pursed lip; thin; flattened diaphragm & barrel chest; compensate for hypoxia by hyperventilation
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| Complications of COPD | Cor pulmonale; Acute respiratory failure from: infection (pneumonia), exacerbation of cor pulmonale, discontinuing bronchodilator or steroids, beta blockers, sedatives and narcotics; Peptic Ulcer and Reflux
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| COPD Diagnostic Tests | PFT’s, ABG’s
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| Purpose of pursed-lip breathing | Promote carbon dioxide elimination
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| COPD Medications | bronchodilators (Theophylline, Beta adrenergic agonist, anticholinergic agents); Corticosteroids for bronchitis (not emphysema); CNS depressant; expectorant (controversial); OXYGEN
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| Measures to improve ventilation | Pursed lip breathing, Diaphragmatic breathing, Effective coughing, Percussion, vibration, & postural drainage, Aerosol-Nebulization
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| O2 toxicity | a condition of oxygen overdosage caused by prolonged exposure to a high level of oxygen (Lewis 112010, p. G-6)
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| Bacteriologic testing for TB | Obtain consecutive sputum specimens from the patient for 3 days
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| Drugs that increase theophylline levels | Cimetidine, ciprofloxacin, erythromycin
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| Sprain | an injury to the ligamentous structures surrounding a joint, usually caused by a wrenching or twisting motion
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| first-degree (mild) sprain | tears in only a few fibers resulting in mild tenderness and minimal swelling.
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| second-degree (moderate) sprain | partial disruption of the involved tissue with more swelling and tenderness.
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| third-degree (severe) sprain | a complete tearing of the ligament in association with moderate to severe swelling.
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| strain | an excessive stretching of a muscle, its fascial sheath, or a tendon.
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| first degree strain | mild or slightly pulled muscle
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| second degree strain | moderate or moderately torn muscle
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| third degree strain | severely torn or ruptured or muscle
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| Sprain/Strain Acute Intervention | (1) stopping the activity and limiting movement, (2) applying ice compresses to the injured area, (3) compressing the involved extremity, (4) elevating the extremity, and (5) providing analgesia as necessary
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| RICE | rest, ice, compression, elevation
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| dislocation | a severe injury of the ligamentous structures that surround a joint resulting in the complete displacement or separation of the articular surfaces of the joint
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| dislocation major complications | open joint injuries, intraarticular fractures, avascular necrosis (bone cell death as a result of inadequate blood supply), and damage to adjacent neurovascular tissue.
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| first goal of dislocation management | realign the dislocated portion of the joint in its original anatomic position
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| dislocation nursing management | relief of pain and support and protection of the injured joint
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| avascular necrosis | complication of dislocation; bone cell death as a result of inadequate blood supply
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| subluxation | a partial or incomplete displacement of the joint surface
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| fracture | a disruption or break in the continuity of the structure of bone
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| Open fracture (aka compound) | the skin is broken, exposing the bone and causing soft tissue injury
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| Closed fracture (aka simple) | the skin has not been ruptured and remains intact
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| Transverse fracture | a fracture in which the line of the fracture extends across the bone shaft at a right angle to the longitudinal axis.
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| Spiral fracture | a fracture in which the line of the fracture extends in a spiral direction along the shaft of the bone.
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| Greenstick fracture | an incomplete fracture with one side splintered and the other side bent.
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| Comminuted fracture | a fracture with more than two fragments. The smaller fragments appear to be floating.
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| Oblique fracture | a fracture in which the line of the fracture extends in an oblique direction.
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| Pathologic fracture | a spontaneous fracture at the site of a bone disease.
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| Stress fracture | a fracture that occurs in normal or abnormal bone that is subject to repeated stress, such as from jogging or running.
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| Closed reduction | a nonsurgical, manual realignment of bone fragments to their previous anatomic position.
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| Open reduction | the correction of bone alignment through a surgical incision.
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| open reduction with internal fixation (ORIF) advantages | facilitates early ambulation, which decreases the risk of complications related to prolonged immobility, and promotes fracture healing with gradually increasing increments of stress placed on the affected joint and soft tissue structures.
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| fracture manifestations | edema, pain, muscle spasm, deformity, ecchymosis/contusion, loss of function
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| Fracture treatment | (1) anatomic realignment of bone fragments (reduction), (2) immobilization to maintain realignment, and (3) restoration of normal or near-normal function of the injured part.
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| traction | the application of a pulling force to an injured or diseased part of the body or an extremity while countertraction pulls in the opposite direction
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| traction purpose | (1) prevent/reduce pain & muscle spasm associated with low back pain or cervical sprain (e.g., whiplash), (2) immobilize a joint or part of the body, (3) reduce a fracture or dislocation, and (4) treat a pathologic joint condition (e.g., tumor, infection)
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| traction indications | (1) provide immobilization to prevent soft tissue damage, (2) promote active and passive exercise, (3) expand a joint space during arthroscopic procedures, and (4) expand a joint space before major joint reconstruction.
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| skin traction | used for short-term treatment (48 to 72 hours) until skeletal traction or surgery is possible; Tape, boots, or splints are applied directly to the skin
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| skeletal traction | used for long-term treatment; used to align injured bones and joints or to treat joint contractures and congenital hip dysplasia.
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| skeletal traction disadvantages | infection in the area of the bone where the skeletal pin is inserted and the consequences of prolonged immobility.
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| upper extremity immobilization | (1) the sugar-tong splint, (2) the posterior splint, (3) the short arm cast, and (4) the long arm cast
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| sugar-tong splint use | for acute wrist injuries or injuries that may result in significant swelling.
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| short arm cast use | treatment of stable wrist or metacarpal fractures.
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| long arm cast use | for stable forearm or elbow fractures and unstable wrist fractures
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| body jacket cast use | immobilization and support for stable spine injuries of the thoracic or lumbar spine
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| cast syndrome | condition that occurs if the body cast is applied too tightly and the cast compresses the superior mesenteric artery against the duodenum
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| hip spica cast use | treatment of femoral fractures
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| lower extremity immobilization | long leg cast, short leg cast, cylinder cast, a Jones dressing, or a prefabricated splint or immobilizer
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| long leg cast use | unstable ankle fracture, soft tissue injuries, a fractured tibia, and knee injuries
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| short leg cast use | stable ankle and foot injuries
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| cylinder cast use | knee injuries or fractures
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| external fixator | a metallic device composed of metal pins that are inserted into the bone and attached to external rods to stabilize the fracture while it heals.
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| Internal fixation devices | pins, plates, intramedullary rods, and metal and bioabsorbable screws that are surgically inserted at the time of realignment
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| Drug therapy for fractures | muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), or methocarbamol (Robaxin); tetanus immunization; prophylactic bone-penetrating antibiotics, such as a cephalosporin (e.g., cefazolin [Kefzol, Ancef])
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| Common side effects associated with muscle relaxants | drowsiness, headache, weakness, fatigue, blurred vision, ataxia, and gastrointestinal upset.
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| nutrition therapy for fractures | ample protein (e.g., 1 g/kg of body weight), vitamins (especially B, C, and D), and calcium, phosphorus, and magnesium to ensure optimal soft tissue and bone healing.
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| neurovascular assessment includes | peripheral vascular assessment (color, temperature, capillary refill, peripheral pulses, and edema) and a peripheral neurologic assessment (sensation, motor function, and pain)
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| nursing goals for fracture management | patient with a fracture will (1) have physiologic healing with no associated complications, (2) obtain satisfactory pain relief, and (3) achieve maximal rehabilitation potential.
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| Muscle atrophy | Decreased muscle mass normally occurs as a result of disuse following prolonged immobilization; Loss of nerve innervation can precipitate muscle atrophy.
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| Contracture | Abnormal condition of joint characterized by flexion and fixation; Caused by atrophy and shortening of muscle fibers or by loss of normal elasticity of skin over joint.
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| Footdrop | Plantar-flexed position of the foot (footdrop) occurs when Achilles tendon in ankle shortens because it has been allowed to assume an unsupported position.
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| Six Ps of Compartment syndrome | (1) paresthesia; (2) pain distal to injury not relieved by opioid analgesics and on passive stretch of muscle; (3) pressure; (4) pallor; (5) paralysis; (6) pulselessness
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| compartment syndrome | a condition in which elevated intracompartmental pressure within a confined myofascial compartment compromises the neurovascular function of tissues within that space
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| causes of compartment syndrome | (1) decreased compartment size resulting from restrictive dressings, splints, casts, excessive traction, or premature closure of fascia and (2) increased compartment contents related to bleeding, edema, chemical response to snakebite, or IV infiltration.
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| Most common fractures associated with compartment syndrome | Fractures of the distal humerus and proximal tibia
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| Volkmann's ischemic contracture | Compartment injury in upper extremity caused by prolonged pressure
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| anterior tibial compartment syndrome | Compartment injury in lower extremity caused by prolonged pressure
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| Prophylactic anticoagulant drugs | warfarin, low-molecular-weight heparin, or fondaparinux (Arixtra)
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| fat embolism syndrome (FES) | embolization of fat globules that occurs in a small percentage of patients with fractures
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| fat embolism manifestations | signs and symptoms of acute respiratory distress syndrome (ARDS), such as chest pain, tachypnea, cyanosis, dyspnea, apprehension, tachycardia, and decreased partial pressure of arterial oxygen (PaO2)
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| fat embolism treatment | fluid resuscitation to prevent hypovolemic shock, correction of acidosis, and replacement of blood loss
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| Hip fracture treatment | surgical repair (may immobilize by Buck's traction until stable for surgery)
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| femoral shaft fracture risk | Displacement of the fracture fragments often results in open fracture and increased soft tissue damage. This can lead to considerable blood loss (1 to 1.5 L).
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| Acute low back pain | lasts 4 weeks or less; usually associated with some type of activity that causes undue stress (often hyperflexion) on the tissues of the lower back
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| Acute low back pain treatment | (1) analgesics, such as NSAIDs; (2) muscle relaxants (e.g., cyclobenzaprine [Flexeril]); (3) massage and back manipulation; and (4) the alternating use of heat and cold compresses.15 Severe pain may require a brief course of opioid analgesics.
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| Chronic back pain | lasts more than 3 months or is a repeated incapacitating episode caused by degenerative disk disease, lack of physical exercise, prior injury, obesity, structural and postural abnormalities, and systemic disease.
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| Chronic back pain treatment | reduction in the pain associated with daily activities, a formal back pain program, and ongoing medical care
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| synovectomy | surgical removal of synovial membrane used as a prophylactic measure and as a palliative treatment of rheumatoid arthritis (RA)
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| osteotomy | removing or adding a wedge or slice of bone to change its alignment and shift weight bearing, thereby correcting deformity (such as ankylosing spondylitis) and relieving pain (osteoarthritis)
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| debridement | removal of dirt, foreign objects, damaged tissue, and cellular debris from a wound or a burn to prevent infection and promote healing
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| arthroplasty | surgical reconstruction or replacement of a joint
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| arthrodesis | the surgical fusion of a joint
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| osteomyelitis | a severe infection of the bone, bone marrow, and surrounding soft tissue
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| osteomyelitis clinical manifestations | fever, night sweats, chills, restlessness, nausea, malaise; bone pain unrelieved by rest and worsens with activity; swelling, tenderness, & warmth at site; restricted movement of affected part; Later, drainage from sinus tracts to skin/fracture site
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| Gentamicin Drug Alert | Instruct patient to notify health care provider if any visual, hearing, or urinary problems develop; Assess patient for dehydration before starting therapy.
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| osteomalacia | a rare condition of adult bone associated with vitamin D deficiency, resulting in decalcification and softening of bone
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| osteoporosis | a metabolic bone disease characterized by low bone mass and structural deterioration of bone tissue leading to increased bone fragility and pathologic fractures
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| Risk factors for osteoporosis | female gender, postmenopausal, advanced age, low calcium diet, excessive alcohol intake, being sedentary, and smoking cigarettes. Long term use of corticosteroids, anticonvulsants, and/or lasix also increase risk .
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| Bisphosphonates drug alert | nstruct patient to Take with full glass of water; Take 30 minutes before food or other medications; Remain upright for at least 30 minutes after taking.
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| Paget's disease of the bone | a skeletal bone disorder in which there is excessive bone resorption followed by replacement of normal marrow by vascular, fibrous connective tissue, and new bone that is larger, disorganized, and weaker
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| arthritis | inflammation of a joint; most prevalent types are osteoarthritis, rheumatoid arthritis, and gout
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| osteoarthritis | a slowly progressive noninflammatory disorder of the diarthrodial (synovial) joints
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| crepitation | crackling sound or grating sensation as a result of friction between bones
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| osteoarthritis deformities | Heberden's nodes, Bouchard's nodes
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| rheumatoid arthritis (RA) | a chronic, systemic autoimmune disease characterized by inflammation of connective tissue in the diarthrodial (synovial) joints, typically with periods of remission and exacerbation
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| rheumatoid arthritis deformities | Ulnar drift, Boutonnière deformity, Hallux valgus, Swan neck deformity.
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| gout | recurrent attacks of acute arthritis associated with increased levels of serum uric acid
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| gout manifestations | Affected joints may appear dusky or cyanotic and are extremely tender; precipitated by trigger events such as trauma, surgery, alcohol ingestion, or systemic infection; onset at night with sudden swelling and excruciating pain, low-grade fever
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| gout therapy | Joint immobilization; Local application of heat or cold; Joint aspiration and intraarticular corticosteroids; Dietary avoidance of food/fluids with high purine content (e.g., anchovies, liver, wine/beer); Drug therapy
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| gout drug therapy | colchicine, NSAIDs (e.g., naproxen [Naprosyn]), allopurinol (Zyloprim), probenecid (Benemid), febuxostat (Uloric), corticosteroids (prednisone), intraarticular corticosteroids (methylprednisolone acetate), adrenocorticotropic hormone (ACTH)
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| Importance of adequate urine volume with gout | Adequate urine volume with normal renal function (2 to 3 L/day) must be maintained to prevent precipitation of uric acid in the renal tubules
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| Sjögren's syndrome | an autoimmune disease that targets moisture-producing glands, leading to the common symptoms of xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes)
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| systemic lupus erythematosus (SLE) | a chronic multisystem inflammatory disease associated with abnormalities of the immune system
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| SLE diagnostic studies | Antibodies (e.g., anti-DNA, anti-Sm, ANA), Complete blood cell count, LE cell prep, Serum complement levels, Urinalysis, X-ray of affected joints, Chest x-ray, ECG to determine extraarticular involvement
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| SLE drug therapy | NSAIDs for mild disease, Steroid-sparing drugs, Antimalarials (e.g., hydroxychloroquine [Plaquenil]), Corticosteroids for exacerbations and severe disease, Immunosuppressive drugs (e.g., cyclophosphamide [Cytoxan], mycophenolate mofetil [CellCept])
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| SLE factors that may increase disease activity | fatigue, sun exposure, emotional stress, infection, drugs, and surgery
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| interventions that help reduce fatigue in the client with SLE | sit when ever possible, avoid hot bath (because they exacerbate fatigue), schedule moderate low impact exercise when not fatigued, maintain a balanced diet, and avoid long periods of rest because it promotes joint stiffness.
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| fractures that most often cause FES | those of the long bones, ribs,tibia and pelvis
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| Normal respiratory rate (Adult) | 10-20 breaths per minute
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| Prevention of Respiratory Diseases | Avoid cigarette smoking and exposure to environmental smoke; Avoid exposure to allergens, indoor pollutants, and ambient air pollutants; Wear proper protection when working in an occupation with prolonged exposure to dust, fumes, or gases.
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| acute bronchitis distinguishing manifestations | usually occurs with or after a viral (rhinovirus, influenza) upper respiratory tract infection; cough which lasts 10-20 days
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| pertussis | a highly contagious infection of the lower respiratory tract with a gram-negative bacillus, Bordetella pertussis
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| pertussis distinguishing manifestations | paroxysms of cough followed by inspiratory gasps, the “whooping” sound, or vomiting; lasts 6-10 weeks
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| pertussis treatment | antibiotics, usually macrolides (erythromycin, azithromycin [Zithromax])
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| pneumonia risk factors | Aging, air pollution, altered conciousness, altered flora, immobility, chronic/debilitating illness, Immunocompromised, inhalation/aspiration of noxious substance, tube feedings, malnutrition, smoking, intobation, upper resp tract infection
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| pneumonia severity index score requiring inpatient treatment | 91-130 points (moderate risk) >130 total points (high risk)
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| Pleurisy | complication of pneumonia; inflammation of pleura
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| Pleural effusion | complication of pneumonia; an abnormal accumulation of fluid in the intrapleural spaces of the lungs
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| Atelectasis | complication of pneumonia; an abnormal condition characterized by the collapse of alveoli, preventing the respiratory exchange of carbon dioxide and oxygen in a part of the lungs
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| Bacteremia | complication of pneumonia (usually pneumococcal); bacterial infection in the blood
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| Lung abscess | uncommon complication of pneumonia; a pus-containing lesion of the lung parenchyma that results in a cavity formed by necrosis of lung tissue
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| Empyema | complication of pneumonia; the accumulation of purulent exudate in the pleural cavity, occurs in less than 5% of cases and requires antibiotic therapy and drainage of the exudate by a chest tube or open surgical drainage.
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| pericarditis | complication of pneumonia; a condition caused by inflammation of the pericardial sac
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| Meningitis | complication of pneumonia; disoriented, confused, or drowsy may have a lumbar puncture to evaluate the possibility of meningitis
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| Endocarditis | complication of pneumonia; can develop when the organisms infect the endocardium and the valves of the heart
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| pneumonia diagnostic studies | chest x-ray, gram stain of sputum, sputum culture and sensitivity, pulse oximetry or ABGs, CBC, Blood cultures
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| pneumonia treatment | antibiotic, fluids (3L/day), limited activity and rest, antipyretics, analgesics, oxygen therapy
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| WBC Normal | 4.0-11.0 × 103/µL
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| Elevated WBC possible etiology | Inflammatory and infectious processes, leukemia
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| Low WBC possible etiology | Aplastic anemia, side effects of chemotherapy and irradiation
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| Groups for Which Pneumovax Vaccination is Recommended | =65 yrs, long-term health problem or diseases that lowers resistance to infection, smokers, asthmatics, and those living in speacial environments or social settings
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| TB diagnostic studies | tuberculin skin test (TST) using purified protein derivative (PPD); Chest x-ray; AFB test (microscopic examination of stained sputum smears for acid-fast bacilli); QuantiFERON-TB test (blood tested for interferon reaction to mycobacterial antigens)
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| Latent TB drug therapy | isoniazid (INH) daily for 6-9 months
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| TB acute intervention | (1) be placed on airborne isolation; (2) receive a medical workup, including chest x-ray, sputum smear, and culture; and (3) receive appropriate drug therapy.
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| thoracentesis | a surgical procedure done to remove fluid from the pleural space
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| interstitial lung disease (ILD) | acute and chronic lung disorders with variable degrees of pulmonary inflammation and fibrosis
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| Most common interstitial lung diseases | idiopathic pulmonary fibrosis and sarcoidosis
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| Most common vascular lung disorders | pulmonary edema and pulmonary embolism
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| pulmonary edema | an acute, life-threatening situation in which the lung alveoli become filled with serous or serosanguineous fluid caused most commonly by heart failure
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| Most common cause of pulmonary edema | left-sided HF
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| Pulmonary embolism (PE) | the blockage of pulmonary arteries by a thrombus, fat or air embolus, or tumor tissue.
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| PE collaborative therapy | oxygen, Fibrinolytic agent, Unfractionated heparin IV, Low-molecular-weight heparin (e.g., enoxaparin [Lovenox]), Warfarin (Coumadin) for long-term therapy, aPTT/INR, Limited activity, Opioids, Inferior vena cava filter, Pulmonary embolectomy
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| asthma | chronic inflammatory lung disease that results in airflow obstruction; with recurring episodes of paroxysmal dyspnea, wheezing on expiration, and/or inspiration caused by constriction of the bronchi, coughing, and viscous mucoid bronchial secretions
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| asthma manifestations | wheezing, cough, dyspnea, and chest tightness after exposure to a precipitating factor or trigger
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| Peak expiratory flow rate (PEFR) | Maximum airflow rate during forced expiration; aids in monitoring bronchoconstriction in asthma; can be measured with peak flow meter; Up to 600 L/min
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| cor pulmonale | hypertrophy of the right side of the heart, with or without heart failure, resulting from pulmonary hypertension
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| Reason COPD meds are given | to reduce or abolish symptoms, increase the capacity to exercise, improve overall health, and reduce the number and severity of exacerbations.
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| Meds used for mild or intermittent COPD | Short-acting bronchodilators (Albuterol or ipratropium [Atrovent])
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| Meds used for moderate COPD | long-acting bronchodilator (Salmeterol [Serevent] and formoterol [Foradil])in addition to a short-acting bronchodilator
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| Med used for dyspnea management in COPD | Tiotropium (Spiriva), a long-acting anticholinergic
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| Meds used for severe to very severe COPD | Inhaled corticosteroids (ICSs) combined with long-acting β2-adrenergic agonists (e.g., fluticasone/salmeterol [Advair])
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| pursed-lip breathing | a technique of exhaling against pursed lips to prolong exhalation, preventing bronchiolar collapse and air trapping
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| huff coughing | a forced expiratory technique; sitting, inhale slowly through mouth from diaphragm, hold breath 2-3 sec, forcefully exhale 2-3 times, cough when mucus felt, rest for 5-10 breaths and repeat
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| chest physiotherapy | a series of maneuvers including percussion, vibration, and postural drainage designed to promote clearance of excessive respiratory secretions
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| postural drainage | the use of various positions to promote gravity drainage of bronchial secretions
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