Vocabulary
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Tardative dyskinsia | Involuntary movement of jaw - call doctor immediately or could become permanent
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| CTZ | Chemoreceptor trigger zone
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| Serotonin Agents | Ondanestron (Zofran)
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| Serotonin Action | Blocks the serotonin receptor in our brain that makes us feel nauseous when it's stimulated
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| Metoclopramide (Reglan) | Dopamine & Prokinetic
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| Dopamine Antagonists | Prochlorperazine (Compazine)
Promethazine (Phenergan)
Metoclopramide (Reglan)
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| Dopamine Action | Blocks the dopamin receptor in our brain that makes us feel nauseous when it's stimulated
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| Ondanestron | Zofran
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| Metoclopramide | Reglan
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| Promethazine | Phenergan
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| Prochlorperazine | Compazine
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| Prokinetic | Metoclopramide (Reglan)
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| Prokinetic Action | Dopamine blocker
Increase tone of lower esophageal sphincter
Increase peristalsis
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| Serotonin Admin | PO 30 - 40 mins. before Surgery or expected nausea
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| Serotonin Indications | Nausea r/t pregnancy, chemo, cancer
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| Serotonin Side Effects | Headache, Dizziness, Diarrhea
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| Serotonin Teaching | No driving bc sedation
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| Dopamine Indications | Prevents Nausea
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| Dopamine Admin | PO, IV (slow-over 15 mins.), Rectal, No IV Push
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| Dopamine Side Effects | Muscle spasms, tremors, rigidity
Hypotension
Sedation
Dry mouth, urinary retention, constipation
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| Dopamine Teaching | Encourage fluids
Make Pt. aware of side effects
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| Prokinetic Indications | Nausea, Vomitting, Pt's w/reflux (moves things through quickly)
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| Prokinetic Admin | IV or PO, usually 30 mins before meals
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| Prokinetic Side Effects | Sedation, diarrhea, dry mouth, Tardative dyskinesia
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| Prokinetic Teaching | No alcohol or driving bc of sedation
Monitor BP & hypotension
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| Antihistamines | Dimenhydrinate (Dramamine)
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| Dimenhydrinate | Dramamine
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| Antihistamine Action | Blocks histamine receptors in the inner ear and CTZ - Prevents Motion Sickness
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| Antihistamine Indications | Motion sickness
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| Antihistamine Admin | PO, IV, IM, Rectal
Give 30 mins prior to activity that causes sickness
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| Antihistamine Side Effects | Sedation, Drowsiness, Dizziness, Dry mouth, constipation, Urinary retention
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| Antihistamine Teaching | Teach about side effects
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| Antiemetics | Seotonin Antagonists
Dopamine Antagonists
Prokinetic
Antihistamines
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| Seotonin Antagonists Dopamine Antagonists Prokinetic Antihistamines | Antiemetics
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| Histamine2 Receptor Agents | Cimetidine (Tagamet)
Famotidine (Pepcid)
Ranitidine (Zantac)
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| Histamine2 Receptor Agents Action | Block histamine receptors in stomach to decrease acid in stomach
(doesn't prevent reflux but increases pH)
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| Histamine2 Receptor Agents Indications | Reflux, Gastic & duodenum ulcers
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| Histamine2 Receptor Agents Admin | Admin w/or w/o food, don't admin antacids w/in 1 hr. of giving antagonist (effects absorption rate)
IV must be given slowly or can cause bradycardia
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| Histamine2 Receptor Agents Side Effects | Nausea, vomiting, diarrhea, constipation
Decreased WBC's (long term use)
Tagamet: Seizures, Lower labido, Lethargy
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| Histamine2 Receptor Agents Teaching | Antacids affect absorption rate of Antagonist, Smoking also interferes with absorption
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| Cimetidine | Tagamet
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| Ranitidine | Zantac
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| Famotidine | Pepcid
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| Proton Pump Inhibitors (PPIs) | Omeprazole (Prilosec)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
Esomeprazole (Nexium)
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| PPI Action | Decreases the acids in the stomach
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| PPI Indications | Reflux, duodenum & gastic ulcers
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| PPI Admin | Empty stomach, usually 1x daily before breakfast
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| PPI Side Effects | Nausea, vomiting, diarrhea
Long term use = bone loss
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| PPI Teaching | Antacids do not affect absorption
^ Vit D
^ Ca+
^ Exercise
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| Omeprazole | Prilosec
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| Lansoprazole | Prevacid
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| Pantoprazole | Protonix
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| Esomeprazole | Nexium
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| Mucosal Protectants | Sucralfate (Carafate)
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| Sucralfate | Carafate
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| Mucosal Protectants Action | Creates gel to coat stomach (good w/pt's already have ulcer)
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| Mucosal Protectants Indications | Pt.'s w/ Ulcers
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| Mucosal Protectants Admin | Empty stomach - wait 2hrs before/after meals or other meds - affects absorption
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| Mucosal Protectants Side Effects | Constipation, nausea, diarrhea, dyspepsia
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| Mucosal Protectants Teaching | Teach pt how to take
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| Antacids | Aluminum hydroxide (Amphojel)
Calcium carbonate (Tums)
Magnesium hydroxide (Milk of Magnesia)
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| Aluminum hydroxide | Amphojel
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| Calcium carbonate | Tums
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| Magnesium hydroxide | Milk of Magnesia
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| Aluminum hydroxide Action | Neutralize gastric acid
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| Aluminum hydroxide Indications | Ulcers and reflux
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| Aluminum hydroxide Admin | PO
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| Aluminum hydroxide Side Effects | Amphojel & Tums: Constipation
Milk of Magnesia: Diarrhea
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| Aluminum hydroxide Teaching | Know what other medications are being taken
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| Decreased Blood flow + Increased stomach acid = | Perfect environment for an ulcer
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| Prostaglandin E Analogs | Misoprostol (Cytotec)
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| Misoprostol | Cytotec
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| Prostaglandin E Analogs Action | Works to increase pH, protect against ulcer, allow adequate blood flow to the gastric wall
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| Prostaglandin E Analogs Indications | Prevents gastric ulcers from long-term NSAID use
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| Prostaglandin E Analogs Admin | Take w/meals while taking NSAID
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| Prostaglandin E Analogs Side Effects | Diarrhea, Ab pain, nausea
Women: uterine cramps, spotting
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| Prostaglandin E Analogs Teaching | Do not take if pregnant - spontaneous abortion
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| What drug can cause a spontaneous abortion in women if taken during pregnancy? | Misoprostol
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| Cancer of Oral Cavity Risk Factors | Alcohol/smoking
Greater in Males >50yrs
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| Cancer of Oral Cavity Pathophysiology | Lips, Tongue, Floor of mouth
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| Cancer of Oral Cavity Clin. Manifestations | Painless lesion that doesn't heal
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| Cancer of Oral Cavity Diagnostic Tests | Biopsy to confirm
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| Cancer of Oral Cavity Treatment | Depends on type/extent
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| Cancer of Oral Cavity #1 concern | Airway
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| A stroke is the | 3rd leading cause of death in USA
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| Up to 80% of strokes are | preventable
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| Strokes are the leading cause of | long-term disability
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| _______ are more likely to have a stroke. | Men
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| _______ are more likely to die from a stroke. | Women
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| Cerebrovascular Disorder | Any interruption of blood supply to brain causing CNS Functional abnormality
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| Stroke | O2 supply to the brain is disrupted
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| Stroke has 4x higher incidence in | left hemi-sphere
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| "STR" | Can a person... Speak simple sentence?
Talk?
Raise both arms?
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| "F A S T" | Facial
Arms
Speech
Time
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| Neuroplasticity | Neuron's ability to rearrange connections
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| Brain adaption | brain saturated w/blood or deprived of O2 = find alt. pathways
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| Transient Ishemic Attack (TIA's) | Cerebral ischemic event lasting < 24 hrs
May even last just a few minutes
No permanent neurological chgs.
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| Evolving Stroke | Worsening of deficits over minutes
Suggests widening area of ischemia
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| Completed Stroke | Acute cerebral ischemic event w/deficits
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| #1 risk factor for stroke | Hypertension
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| TIA aka | "warning strokes"
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| Blood clot temporarily clogs artery so part of brain doesn't get blood it needs | TIA
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| S/S of TIA | Similar to stroke, usually last 1 or 2 mins.
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| Ischemic Stroke | Obstruction of cerebral blood flow
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| 88% of all strokes are | Ischemic Stroke
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| "Worst headache of my life" | Subarachnoid hemorrhage
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| Receptive Aphasia | Person doesn't know what's going on
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| Expressive Aphasia | Person knows what's going on, but can't express
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| Broca's Area located in | Left hemisphere
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| Controls tongue, lips, vocal cords & ability to phonate (form words) | Broca's Area
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| Global Aphasia | Expressive & receptive aphasia
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| Dysphagia | Difficulty swallowing
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| Dysarthia | Impaired speech
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| Ataxia | Gait disturbance
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| Nystagmus | Rapid Eye Movements
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| Hemianesthesia | Pain on one half of body that doesn't completely register
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| Wernicke's Area | Can be in whichever hemisphere is dominant for pt.
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| Recalls, recognizes & interprets words & other sounds in the process of "phonating" | Wernicke's Area
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| Dmg. to Wernicke's Area (Temporal lobe of dominant hemisphere) | Inability to comprehend spoken or written words
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| If a Pt. is newly diagnosed with Afib, do TEE test to see if | There are clots behind the heart
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| Trans-esophageal echocardiogram | TEE test
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| Tissue Plasminogen Activator (tPA) | Time of onset is known and < 3 hrs
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| Pt not a candidate for tPA if | Pt is rcvg IV Heparin
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| Angioplasty | Any endovascular procedure to reopen narrowed blood vessels & restore forward blood flow
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| Atherectomy | Opens occluded, scarred or calcified vessels by removing atherosclerotic plaques with rapidly rotating drills
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| Balloon angioplasty | Relies on the inflation of high-pressure balloons within blocked arteries to force open
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| Laser & radiofrequency waves | Vaporize or ablate atheroscleroptic plaques
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| Endovascular stents | Hold vessels open with expandable lattices inserted across narrowed section of the artery
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| Cerebral Angioplasty | Coils surgically placed in cerebral vascular malformations to assure patency and prevent rupture (Aneurysm)
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| Hemorrhagic Strokes | Vessel ruptures & bleeds into brain or spaces around brain
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| Intracerebral Hemorrhage | Always hypertension related
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| Craniectomy | Removal of part of the brain
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| Craniotomy | Redirection - keep from getting to brain stem
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| Subarachnoid Hemorrhage | Bleeding into subarachnoid space
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| Arteriovenous Malformation | A tangle of blood vessels in the brain or on the surface of brain that bypasses norm brain tissue and diverts blood from arteries to the veins
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| Mandibular Fractures Clin. Manifestations | Dull ache -> throbbing pain
Restricted jaw movement
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| Mandibular Fractures Diagnostic | X-ray or MRI
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| Mandibular Fractures Treatment | Rigid plate fixation
Bone grafting
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| Mandibular Fractures Nurse Mngmnt. | #1 Airway
#2 Nutrition
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| Absent/ineffective peristalsis of distal esophagus Failure of esophageal sphincter to relax in response to swallowing | Achalasia
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| Achalasia | Food cannot get into the stomach
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| Achalasia Diet | Small frequent meals/soft/encourage fluids
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| Achalasia Meds | Ca+ channel blockers relax sphincters
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| Achalasia Pneumatic dilation | Balloon to try and open sphincter up
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| Achalasia Esophagomyotomy | Enter esophagus & cut muscle fibers
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| 90% of Hiatal Hernias are | Sliding esophageal hernias
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| sliding Hernia Manifestations | Heartburn
Regurgitation
Dysphasia
Belching
Reflux*
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| Reflux Occurs w/sliding hernia because | Sphincter is NOT intact - food easily regurgitates into esophagus.
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| Paraesophageal manifestations | Sense of fullness after eating
Indigestion
May be a symptomatic
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| The sphincter in a paraesophageal hernia | Is still intact.
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| Hiatal hernia complications | Strangulation
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| Gastroesophageal Reflux Disease (GERD) | Backflow of gastric contents into esophagus
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| Avoid these if you have GERD | High-fat diet
Caffeine, tobacco, alcohol, spearmint, peppermint, carbonated bevs
Eating 2 hrs before bed
Tight clothing
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| Meds for GERD | Antacids
Histamine Receptor Blockers
PPIs
Prokinetic Agents
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| Treatment of GERD | Nissen fundoplication
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| Nissen fundoplication | Surgery to wrap stomach around esophagus = No reflux
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| Barrett's Esophagus | Chgs cells in esophagus bc constant burning of lining from reflux -> pre-cancerous condition
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| S/S Barrett's Esophagus | Same as GERD -> ppl usually don't know it's happening
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| Barrett's Esophagus Diagnosis | Endoscopy
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| Barrett's Esophagus Treatment | Minor cell chgs
Photodynamic therapy (PDT)
Prohylactic esophagectomy
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| Photodynamic therapy (PDT) | Take out piece of esophagus & replace w/jejunum or part of stomach
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| Risk factors for Cancer of Esophagus | Barrett's
Alcohol
Tobacco
3x more common in men
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| Cancer of Esophagus Mgmnt | Radiation
Chemotherapy
Surgery (Esophagectomy)
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| Gastritis | Inflamation of the stomach
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| Gastritis Patho | Lining can become swollen & ulcerate
Can cause perferation of lining = hemorrhage
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| Acute Gastritis Clin. Manifest | Abdominal discomfort
Nausea
Vomiting
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| Chronic Gastritis Clin. Manifest | Abdominal discomfort
Nausea
Vomiting
Heart burn
Pain
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| Chronic Gastritis | Find the trigger
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| The most common location for ulcers is | the duodenum.
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| Peptic Ulcer Disease | Increased acid & decreased mucus allow acid to erode mucosal wall
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| Peptic Ulcer Disease occurs in the | Stomach
Pylorus
Duodenum
Esophagus
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| Increase gastric acid production | Caffeine
Smoking
Alcohol
Stress
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| H. pylori | Bact will burrow into the lining allowing acid in to create an ulcer
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| H. pylori requires | 2 different Ab's to cure
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| Intractable Ulcers | Incurable Ulcers - (perform Vagotomy)
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| Vagotomy | Cut Vagus nerve to decrease production of stomach acid - (incurable ulcers)
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| Antrectomy - Billroth I | Take out lower portion of stomach to decrease stomach acid
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| "Coffee Grounds" in stomach/vomit | Hemorrhage
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| Peritinitis | Stomach leak out causing bacterial infection - sepsis
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| Perforation complications can lead to | Peritinitis
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| Any leakage into the abdominal cavity... | Requires Ab's
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| Weight indications for surgery | BMI >40 or over 100 lbs overweight
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| 3 Categories of Bariatric Procedures | Malabsorptive
Restrictive
Combined Malabsorptive & Restrictive
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| Rstrictive Surgery: | Reduces food intake
Decrease in appetite
Early satiety
Control of stoma
Craving control (Ghrelin)
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| Laparoscopic Gastric Banding | Inflatable silicone band completely around upper portion of stomach
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| Vertical Sleeve Gastrectomy (VSG) | 85% of stomach removed - shaped like small banana
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| Gastric Bypass | Limits size of stomach and bypasses some of the small intestine
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| Secretory Diarrhea | Bowel doesn't reabsorb water - it excretes water
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| Osmotic Diarrhea | Pulling of water into the bowel
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| Infectious Diarrhea | C-diff
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| Antidiarrheals | Loperamide (Imodium)
Diphenoxylate (Lomotil)
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| Loperamide | Imodium
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| Diphenoxylate | Lomotil
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| Constipation | Abnormal infrequency or irregularity of defications
Abnormal hardening of stools
Retention of stool in rectum
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| Chronic Constipation | <3 bowel movements/week for 12 weeks in a 12 month period
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| Bulk forming Laxatives | Psyllium (Metamucil)
Methylcellulose (Citrucel)
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| Psyllium | Metamucil
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| Methylcellulose | Citrucel
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| Bulk forming Laxative Action | Promotes large soft stools by absorbing water into the intestines
Stimulates peristalsis
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| Lubricant Laxatives | Mineral oil
Glycerin suppository
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| Lubricant Laxative Action | Softens fecal matter and lubricates intestinal tract
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| Stimulant Laxatives | Bisacodyl (Dulcolax)
Senna (Senokot)
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| Bisacodyl | Dulcolax
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| Senna | Senokot
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| Stimulant Laxative Action | Irritates colonic epithelium by stimulating sensory nerve ending and increasing peristalsis
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| Fecal softener Laxatives | Docusate (Colace)
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| Docusate | Colace
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| Fecal softener Laxative Action | Promotes incorporation of water into the stool resulting in softer fecal mass
More of daily treatment
1-5 days to take effect
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| Osmotic Agent Laxatives | Polyethylene glycol and electrolytes
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| Osmotic Agent Laxative Action | Rapidly pulls H2O into colon -> diarrhea out
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| Common Hernia Locations | Inguinal
Femoral
Incisional
Umbilical
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| Volvulus - Mech. Obstruction | Twisting of the bowel - caused by congenital abnormality
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| Intussusception - Mech. Obstruction | Tunneling of bowel (folds in on itself)
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| Paralytic illeus - Functional obstruction | No blockage, lack of movement (caused by surgery)
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| Diverticulum | Sac like pouches -> sigmoid colon, usually
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| Diverticulosis | Multiple Diverticulum
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| Diverticulitis | Food or infection stuck in diverticula & cause inflammation
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| Diverticular Disease | Submucosal layers of the colon herniate through the muscular wall
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| Diverticular Disease Complications | Peritonitis
Abscess formation
Fistulas
Bleeding
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| End-to-end anastomosis | Cut out bad bowel & reconnect
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| Appendicitis | Food or infection gets lodged in the appendix
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| Diarrhea is common in | Chrohn's Disease
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| In Chrohn's Disease, constipation is | Occasional
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| Blood in stool in Chrohn's Disease is | Occult Common
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| Abdominal pain in Chrohn's Disease is | Typically mid-abdomen and right lower quadrant pain
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| Fever in Chrohn's Disease is | Common
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| Weight loss/growth failure in Chrohn's Disease is | Common
May occur for many months to years before diagnosis
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| Perianal disease in Chrohn's Disease is | Common for:
Fistula/fissures
Abscesses/skin tags
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| Diarrhea in Ulcerative Colitis is | Common, often with urgency
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| Constipation in Ulcerative Colitis is | Rare without obstruction
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| Blood in stool in Ulcerative Colitis is | Very common
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| Abdominal pain in Ulcerative Colitis is | Cramping pain, often with stools
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| Fever in Ulcerative Colitis is | Rare
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| Weight loss/growth failure in Ulcerative Colitis is | Rare
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| It is rare to have Perianal disease with | Ulcerative Colitis
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| Chrohn's disease... | often recurs after surgery
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| Ulcerative colitis... | is curable with a colectomy
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| Right hemisphere | right now, present
pictures, sound, sight, smell
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| Left hemisphere | past, future
associate present with past to prepare future
Broca's area - speech center
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| Broca's area | Speech center, left hemisphere
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| Magnetic Resonance Imaging | MRI
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| Second largest part of brain Balance and coordination, assists in controlling body movements | Cerebellum
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| Largest most advanced part of brain higher intellect, speech, movement, emotion, and integration or sensory stimuli | Cerbrum
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| Handles automatic functions Respiration, heart rate, BP, arousal, wakefulness & attention | Brain Stem
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| Artistic, creative, intuitive | Right hemisphere
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| Logic, reasoning, linear | Left hemisphere
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| Cerebral edema | any swelling of the brain
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| Frontal lobes | Voluntary muscle movements
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| Parietal lobes | regulate taste and touch
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| Temporal lobes | regulate hearing & smell
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| Occipital lobes | regulate vision
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| 3 ways Neurological Changes may affect the body | Structural
Metabolic
Drug Related
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| Cardiovascular Respiratory Infection | 3 ways Neurological Changes may affect the body
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| AEIOU Tips = A | acidosis, alcohol
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| AEIOU Tips = E | epilepsy
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| AEIOU Tips = I | infection
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| AEIOU Tips = O | overdose
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| AEIOU Tips = U | uremia
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| AEIOU Tips = T | trauma
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| AEIOU Tips = i | insulin
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| AEIOU Tips = p | psychogenic
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| AEIOU Tips = s | stroke
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| Often, the first sign that a neurological event is already in progress | Restlessness
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| Progressive dilation of pupils | increasing ICP
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| Fixed pupils | very serious injury at midbrain or lower
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| Corneal reflex is | unilateral or absent in coma
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| Cheyne-stokes respirations mean that | lesion or injury is deep within cerebral hemispheres (death is usually imminent)
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| CT Scan, MRI | Show displacement of brain structures
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| EEG | studies brain's electrical activity
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| Cerebral angiography | detects aneurysms, occluded vessels & tumors w/in cerebral arts/veins
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| Transcranial Doppler | assesses cerebral blood flow
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| Lumbar puncture | CSF detects blood, WBCs, meningitis
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| The 2 essential things the brain needs to survive are | O2 & glucose
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| Brain | 80% of skull's contents
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| CSF | 10% of skull's contents
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| Blood | 10% of skull's contents
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| Hypercapnia | Increased cerebral vasodilation then increased blood flow then increased ICP
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| Hypoxemia | Cerebral vasodilation, which raises ICP
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| Vasodilator drugs | increase cerebral blood flow -> temp increased ICP (Nitroglycerin)
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| Cerebral Perfusion Pressure | Pressure needed to perfuse brain cells
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| Normal CPP | 70-100 mm Hg
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|
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| CPP < 50 | irreversible brain dmg
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|
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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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.
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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