Term
| what are the 4 portions of the stomach? |
|
Definition
|
|
Term
| what do mucous cells in the stomach do? |
|
Definition
| secrete alkaline mucous to protect the stomach lining |
|
|
Term
| what do parietal cells in the fundus do? |
|
Definition
| secrete HCl acid and intrinsic factor |
|
|
Term
| HCl acid has what 2 properties? |
|
Definition
acidic so it is bacteriocidal
and it aids in the digestion of proteins |
|
|
Term
| intrinsic factor is essential for |
|
Definition
| vitamin B12 absorption in the intestines |
|
|
Term
| a deficiency in intrinsic factor can lead to |
|
Definition
|
|
Term
| what are some causes of deficient intrinsic factor? |
|
Definition
gastrectomy
severe hypothyroidism
atrophy of gastric mucosa as in the elderly |
|
|
Term
| the LES (lower esophageal spinchter) prevents... |
|
Definition
|
|
Term
| when does the stomach normally completely empty after a normal meal? |
|
Definition
|
|
Term
what do these enzymes digest?
amylase
trypsin
lipases
bile salts |
|
Definition
amylase- starches
trypsin- protein
lipases- lipids
bile salts- triglycerides |
|
|
Term
| how much cardiac output does the GI system receive? |
|
Definition
|
|
Term
| 1st part of the large intestine? |
|
Definition
|
|
Term
| parts of the large intestine? |
|
Definition
cecum
appendix
asc. colon
trans colon
desc colon
rectum
anus |
|
|
Term
| where does the cecum join the small intestine? |
|
Definition
|
|
Term
| significance of the ileocecal valve? |
|
Definition
| usually the first section to resume audible peristalsis after abd surgery |
|
|
Term
| where is the ileocecal valve located? |
|
Definition
|
|
Term
| what do microorganisms in the colon do? |
|
Definition
| break down protein that was not digested in the small intestine, synthesize Vit K and some vit V and produce flatus |
|
|
Term
| after breaking protein in the colon what happens? |
|
Definition
| ammonia is carried to the liver and is converted to urea |
|
|
Term
| bowel elimination pattern |
|
Definition
| varies from 2-3 a day to 2-3 a week |
|
|
Term
| in what fashion should you auscultate bowel sounds? |
|
Definition
|
|
Term
|
Definition
-shape and contour of abdomen
-bowel sounds
-palpate |
|
|
Term
| lack of peristalsis is determined how? |
|
Definition
| a lack of sounds for 5 min over each quadrant |
|
|
Term
|
Definition
| protrusion of the intestines through a tear in the muscles of the abdominal wall |
|
|
Term
| how is a hernia repaired? |
|
Definition
|
|
Term
| strangulation of the intestines is considered as what type of a priority? |
|
Definition
| a medical and surgical emergency |
|
|
Term
|
Definition
| accumulation of fluid in the abdominal cavity |
|
|
Term
| ascites usually accompanies: |
|
Definition
-peritoneal inflammation
-heart failure
-metastatic carcinoma
-hepatic cirrhosis |
|
|
Term
| lower abdominal distention can signal |
|
Definition
-ovarian mass
-distended bladder
-pregnancy |
|
|
Term
| a sunken abdomen is usually associated with |
|
Definition
|
|
Term
|
Definition
|
|
Term
| striae are associated with |
|
Definition
| conditions with rapid rapid gain |
|
|
Term
| spider angiomas and dilated veins as well will usually indicate |
|
Definition
|
|
Term
| increased pulsation along the abdomen could signal an |
|
Definition
|
|
Term
| upon auscultation of the GI, no sounds can indicate |
|
Definition
-surgery
-late bowel obstruction
-peritonitis |
|
|
Term
| upon auscultation of the GI, hyperactive sounds can indicate |
|
Definition
-diarrhea
-early bowel obstruction |
|
|
Term
| upon auscultation of the GI, a bruit can indicate |
|
Definition
|
|
Term
| upon auscultation of the GI, a venous hum over the liver can indicate |
|
Definition
|
|
Term
| upon auscultation of the GI, a friction rub can indicate |
|
Definition
| inflammation of the spleen or liver |
|
|
Term
| rebound tenderness of the abdomen could indicate |
|
Definition
|
|
Term
|
Definition
|
|
Term
| upper middle pain can indicate |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| an enlarged and or tender liver upon palpation may indicate |
|
Definition
hepatitis
or venous congestion |
|
|
Term
| an enlarged and NON tender liver may indicate |
|
Definition
|
|
Term
|
Definition
| sharp pain felt upon inspiration; indicates inflammation of the gallbladder if it occurs while palpating the liver |
|
|
Term
|
Definition
-remove stomach contents
-decompress bowel when peristalsis or malfunctioning
-introduce fluids or nutrition |
|
|
Term
| why would you need a NG tube for decompression of the bowel? |
|
Definition
-GI bleeding
-after lower GI tract surgery: peristalsis is absent
-evacuation of poison |
|
|
Term
| using an NG tube for nutrition |
|
Definition
it is short term
is if pt cannot swallow but lower GI tract is functional |
|
|
Term
| what pH will ensure proper placement of an NG tube? |
|
Definition
|
|
Term
|
Definition
| chyme backflow into esophagus |
|
|
Term
| what happens to the LES that causes GERD? |
|
Definition
|
|
Term
|
Definition
-heartburn
-regurgitation
-dysfunctional swallowing
-chest pain
-esophageal erosion |
|
|
Term
| nitrates and calcium channel blockers are both |
|
Definition
|
|
Term
| factors that contribute to GERD |
|
Definition
| preg,smoking, caffeine, ETOH, mints, muscle relaxants, and scleroderma and myopathy which are CT disorders |
|
|
Term
|
Definition
-erosive esophagitis
-strictures or narrowing
-Mallory-Weiss tear
-Barret's esophagus |
|
|
Term
|
Definition
increase in difficulty swallowing
ulcerations in esophagus |
|
|
Term
| strictures or narrowing of the esophagus can cause |
|
Definition
| delay in the passage of food |
|
|
Term
|
Definition
| occurs in esophageal lining, after prolonged vomiting, from introthoracic pressure |
|
|
Term
|
Definition
| pre-cancerous condition that must be closely monitored and may develop into an esophageal adenocarcinoma |
|
|
Term
| s/s of esophageal adenocarcinoma |
|
Definition
|
|
Term
| development of esophageal adenocarcinoma are r/t |
|
Definition
GERD
Barret's esophagus
obesity |
|
|
Term
| GERD lifestyle modifications |
|
Definition
| -STOP:smoking, eating fatty foods with ETOH, chocolate, mint, citrus juices, do NOT lay down after eating, lose weight, eat smaller portions |
|
|
Term
| categories of drugs used in the treatment of GERD |
|
Definition
-antacids
-histamine-2 antagonists
-PPI therapy
-prokinetics |
|
|
Term
|
Definition
|
|
Term
|
Definition
decrease acid
zantac
tagment
pepcid |
|
|
Term
|
Definition
| use CAUTIOUSLY in older adults; causes CNS effects of lethargy, depression,and confusion |
|
|
Term
|
Definition
prevacid
prilosec
nexium
aciphex
protonix |
|
|
Term
|
Definition
|
|
Term
|
Definition
-antireflux surgery (Nissen Fundoplication)
-endoscopic valvuloplasty/polymers |
|
|
Term
|
Definition
surgery to repair GERD
involves restructuring the stomach by wrapping the fundus around the base of the esophagus to protect what is left of it |
|
|
Term
| endoscopic valvuloplasty/polymers |
|
Definition
|
|
Term
| a hiatal hernia is most commonly found in an x-ray of where? |
|
Definition
|
|
Term
| hiatal hernias occur most often in what types of patients? |
|
Definition
|
|
Term
|
Definition
-sliding
-rolling or paraesophageal |
|
|
Term
|
Definition
-most common
-stomach slides through hiatal opening into thoracic cavity when they are supine and returns to abdomen when the sit or stand up |
|
|
Term
| rolling or paraesophageal hiatal hernia |
|
Definition
| when the fundus and portion of stomach roll up through the diaphragm and form a pocket through the esophagus |
|
|
Term
| clinical manifestations of hiatal hernia |
|
Definition
-none
-heartburn
-pain triggered by large meals, ETOH, and smoking |
|
|
Term
| patients with a Hx of hiatal hernia are more at risk for |
|
Definition
resp problems:
dyspnea
acute bronchial constriction |
|
|
Term
| Tx of a hiatal hernia is similiar to |
|
Definition
| GERD in terms of lifestyle changes and medicine |
|
|
Term
| surgical treatment of a hiatal hernia |
|
Definition
|
|
Term
|
Definition
| surgical repair of a hiatal hernia |
|
|
Term
| surgical goals in the Nissen/Toupet antireflux procedure |
|
Definition
-reduce the hernia
-acceptable LES pressure
-prevent movement of the gastroesophageal junction |
|
|
Term
|
Definition
-hematemesis: vomiting blood that looks like coffee grounds
-melena- black, tarry stools, sticky, foul smelling
-hematochezia- stools have bright red blood and unstable VS
-increase BUN from digestion of blood |
|
|
Term
| are the H and H best indicators for GI bleeds? |
|
Definition
|
|
Term
|
Definition
-peptic ulcer disease
-esophageal varicies
-mallory weiss tear
-arteriovenous malformations
-adenocarcinoma |
|
|
Term
| peptic ulcer disease (PUD) |
|
Definition
| erosion of the mucosal surface |
|
|
Term
|
Definition
H.pylori
NSAIDs induced injury
may be due to smoking, stress, and diet as well |
|
|
Term
| is gastric acid the primary cause of PUD? |
|
Definition
|
|
Term
| what are the Tx for all types of ulcers |
|
Definition
|
|
Term
| classes of drug therapy for PUD |
|
Definition
-H2 receptor antagonist
-antibiotics
-acid PPI
-cytoprotective agents |
|
|
Term
| H2 receptor antagonist uses and examples |
|
Definition
used to decrease gastric acid and acid secretion
tagament (cimetidine)
pepcid (famotidine)
axid (nizatidine)
zantac (rantidine) |
|
|
Term
| antibiotics used to treat PUD uses and examples |
|
Definition
used to supress H.pylori
metronidazole
tetracycline/amoxicillin
clarithromycin |
|
|
Term
| acid PPI used to treat PUD uses and examples |
|
Definition
decrease gastric acid secretion
prilosec (omeprazole)
prevacid (lansoprazole) |
|
|
Term
| cytoprotective agents used to treat PUD uses and examples |
|
Definition
protect the stomach lining from acid
carafate (sulcrafate) |
|
|
Term
| during an exacerbation of complication due to PUD what does the treatment include? |
|
Definition
-IV fluid replacement with lactated Ringer's
-blood transfusions
-monitor in ICU
-if pt vomits blood, obtain 2 IV sites with large bore 20 or 18 gauge and may insert NG tube PRN |
|
|
Term
| what should a nurse do if a patient with PUD vomits blood? |
|
Definition
| obtain 2 IV sites with large bore 20 or 18 gauge to administer blood or blood products and may insert NG tube PRN |
|
|
Term
| when on PPI therapy the patient should NOT be taking |
|
Definition
NSAIDs
anticoagulants: like coumadin or plavix
ASA
because the reduced pH inhibits clots from forming |
|
|
Term
|
Definition
|
|
Term
|
Definition
| acute or chronic inflammation of the gallbladder caused by an unpassed stone |
|
|
Term
| when cholecystitis is left untreated it can progress to |
|
Definition
|
|
Term
| increase incidence of cholelithiasis |
|
Definition
sedentary lifestyle
familial tendency
obesity |
|
|
Term
| clinical manifestations of cholelithiasis |
|
Definition
biliary colic pain
RUQ pain
F/V/N
increase liver function tests
intolerance to foods
pain is worse at night following a fatty meal |
|
|
Term
|
Definition
-ultrasound that shows pericholecystic fluid, GB wall thickening, stones
HIDA scan that may show cystic duct obstruction |
|
|
Term
|
Definition
pain meds
IV abx
surgical eval or cholecystectomy |
|
|
Term
|
Definition
endoscopic retrograde choleangiopancreatography
used to view the pancreatic and common bile ducts through the mouth and duodenum
contrast may or may not be injected
stones may be removed |
|
|
Term
|
Definition
| administering nutrition by a route other than the GI tract |
|
|
Term
| indications of the use of parenteral nutrition |
|
Definition
-chronic severe D/V
-bowel rest from surgery or trauma
-GI obstruction/anomalies/fistulas
-intractable diarrhea
-severe malnutrition/malabsorption
-short bowel syndrome |
|
|
Term
| typical composition of prepared bases for parenteral nutrition |
|
Definition
|
|
Term
| what is the conc of PN solutions in relation to the blood? |
|
Definition
|
|
Term
|
Definition
good for 24 hours
refrigerate until 1/2 before use
NOTHING should be added |
|
|
Term
|
Definition
| calories come from carbs (dextrose) and fat emulsion |
|
|
Term
| rate of CPN nutrition for a non obese patient |
|
Definition
|
|
Term
| a higher conc of fat emulsion will provide more |
|
Definition
|
|
Term
| 10% fat emulsion will provide how many cal/ml? what about 20%? |
|
Definition
|
|
Term
| normal adults need how much protein a day? |
|
Definition
|
|
Term
| how are proteins supplied in PN? |
|
Definition
|
|
Term
| for moderate-severe stress or illness what should the protein intake be? |
|
Definition
|
|
Term
| CPN involves a surgically inserted catheter that originates where? the tip lies where? |
|
Definition
| originates from the subclavian and its tip is at the superior vena cava |
|
|
Term
|
Definition
long term use
high protein/caloric needs |
|
|
Term
|
Definition
| collapsed lung when air builds up aroung the lung and the lung can no longer properly expand |
|
|
Term
|
Definition
| is a collection of blood in the space between the chest wall and the lung |
|
|
Term
|
Definition
| is a blood clot (thrombus) that forms within a vein. |
|
|
Term
|
Definition
| blood clot occurring inside a blood vessel. |
|
|
Term
|
Definition
| inserted via the basilica or cephalic veins and then advanced into central circulation by a PICC certified nurse |
|
|
Term
|
Definition
| catheter is in a peripheral large vein |
|
|
Term
|
Definition
short term
not high protein/caloric requirements
supplement to intake |
|
|
Term
| both CPN and PPN patients are NOT candidates for what type of nutrition? |
|
Definition
|
|
Term
| how often are the filters and IV tubing to be changed? |
|
Definition
|
|
Term
| if the PN solution runs out before another one is available then what should be done? |
|
Definition
| use a 10-20% dextrose solution to prevent hypogylcemia |
|
|
Term
| 3 types of PN complications |
|
Definition
infection
metabolic
mechanical |
|
|
Term
| metabolic complications from PN |
|
Definition
hyperglycemia
pre-renal azotemia
-vit/elec imbalances
-hyperlipidemia |
|
|
Term
| how often should BS be monitored with PN? |
|
Definition
|
|
Term
| with PN what should the BS be kept under? |
|
Definition
|
|
Term
| the use of fat emulsion is contraindicated with patients with |
|
Definition
impaired fat metabolism
risk for fat emboli: long bone fractures
egg allergy |
|
|
Term
| azotemia is characteristic of |
|
Definition
|
|
Term
| what to monitor and how often for PN |
|
Definition
-VS q4-6h
-BS q4-6h
-Weight/edema qDay
-elec/BUN/CBC/liver enz 3xqw |
|
|
Term
| hypophosphatemia results due to refeeding syndrome |
|
Definition
cardiac dysrhythmias
respiratory arrest
neurological disturbances |
|
|
Term
| post PN therapy treatment |
|
Definition
change dressing daily and observe daily
gradually encourage oral intake beginning with clear liquids
record intake |
|
|
Term
| is penile discharge normal? what should be done if it is found? |
|
Definition
| no it is abnormal and a culture should be obtained |
|
|
Term
| if there is penile discharge, genital warts, chancre, or lesions what should be done? |
|
Definition
| obtain a culture to rule out STDs |
|
|
Term
|
Definition
| left is often lower than the right due to a longer spermatic cord |
|
|
Term
|
Definition
|
|
Term
| a major risk factor for testicular cancer and potential cause of male infertility |
|
Definition
|
|
Term
| upon palpation of the testes how should they feel? |
|
Definition
|
|
Term
| where can the epididymis be palpated? how should it feel? |
|
Definition
| posterior lateral surface; smooth and nontender |
|
|
Term
| how should the spermatic cord feel? |
|
Definition
|
|
Term
| some causes of erectile dysfunction |
|
Definition
stress
depression
low self esteem
difficulty in relationships |
|
|
Term
|
Definition
| inability to perform sexually |
|
|
Term
| when should a scrotal exam be done? under what circumstances? |
|
Definition
| once a month when scrotum is relaxed such as after a warm bath and palpate scrotum |
|
|
Term
| benign prostatic hypertrophy (BPH) |
|
Definition
| enlargement of the prostate from an increase in epithelial cells and stromal tissue which produce nodular regions that change the consistency and size of prostate |
|
|
Term
| is erectile dysfunction a normal part of aging? |
|
Definition
|
|
Term
| common complaints from BPH |
|
Definition
| changes in flow of urination, initiation of flow, and reduction in urine stream |
|
|
Term
|
Definition
patient history
physical exam |
|
|
Term
|
Definition
| gloved lubricated finger is inserted into rectum and the prostate is palpated to check for smoothness, firmness and symmetry |
|
|
Term
|
Definition
| prostate specific antigen is a lab value that is used to detect prostate cancer and evaluate effectiveness of treatment of cancer and evaluate effectiveness of treatment |
|
|
Term
| BPH can cause what to happen to the PSA? |
|
Definition
|
|
Term
|
Definition
| visualize prostate size and evaluate extent of obstruction present |
|
|
Term
| combination drug therapy in treatment of BPH |
|
Definition
-5-alpha reductase inhibitors: proscar
-alpha adrenergic receptor blockers: cardura, flomax which are effective in the reduction of prostate size but effects can take months
-saw palmetto is an herb that improves urinary flow |
|
|
Term
| necessary for recurrent obstructive hypertrophy |
|
Definition
|
|
Term
| surgical management of BPH |
|
Definition
| TURP which a resectioning of the prostate |
|
|
Term
| both physiological and psychological factors that can lead to ED |
|
Definition
physiological:
DM, vascular disease, side effects from medications,chronic illness, trauma, age related changes, decreased hormone secretion |
|
|
Term
| when s/s of ED occur occasionally or has a gradual onset it is usually associated with |
|
Definition
|
|
Term
| when s/s of ED occur suddenly or has a rapid onset it is usually associated with |
|
Definition
|
|
Term
|
Definition
modification of reversible causes
erectogenic drugs: phosphodiesterase inhibitors such as viagra, cialis, and levitra
topical agents that enhance venous congestion
hormonal therapy if testosterone is low
more agressive:
intra-urethral insertion of vaso-active medication
intra-cavernosal self injection
penile implants |
|
|
Term
| phosphodiesterase inhibitors |
|
Definition
such as viagra, cialis, and levitra
help to promote blood flow and promotes erection |
|
|
Term
| why are phosphodiesterase inhibitors such as viagra, cialis, and levitra contraindicated for patients on nitrates or nitroglycerin? |
|
Definition
| because these drugs cause hypotension and so do nitrates and nitroglycerin |
|
|
Term
|
Definition
| painful, prolonged erection that lasts longer than 4-6 hours and is a medical emergency |
|
|
Term
|
Definition
use of vasodilators
thrombosis
leukemia
DM
lesions of the spine
neoplasms
cocaine use |
|
|
Term
|
Definition
must be treated because it can lead to penile necrosis and decreased circulation
sedatives
muscle relaxants
aspiration and irrigation of the corpus cavernosum
creation of a surgical shunt |
|
|
Term
|
Definition
| broad term for several inflammatory and noninflammatory process of the prostate gland. can be acute or chronic, and bacterial or nonbacterial |
|
|
Term
|
Definition
| identified by UA and CS. commonly from untreated UTI |
|
|
Term
|
Definition
| related to allergic or antibody antigen reactions |
|
|
Term
|
Definition
30 days of abx
forced fluids
stool softeners
physical rest
local application of heat
sitz bath is soothing |
|
|
Term
|
Definition
| fluid that fills or partially fills scrotal sac. it usually resolves spontaneously so treatment is needed. if very large and uncomfortable aspiration or surgical drainage may be performed |
|
|
Term
|
Definition
| inflammation of the epididymis usually due to an ascending infection from the ejaculatory duct |
|
|
Term
|
Definition
surgical intervention
diagnostic procedure or instrumentation that has introduced bacteria such as E coli
urine reflux where urine causes irritation and infection |
|
|
Term
| in the 19-35 age group the most common cause of epididymitis |
|
Definition
|
|
Term
| disease management of epididymitis |
|
Definition
treat the cause
adminster right abx
change behavior
remain in bed
elevate testicles with scrotal support
use ice packs
analgesics for pain relief
scrotal support may be needed for up to 6 weeks after tolerance of movement |
|
|
Term
|
Definition
| painless cyst in or near the head of the epididymis and can be palpated on the testicle or visible with translumination. if there are any lumps felt a HCP should be alerted |
|
|
Term
| why is important to alert a HCP immediately if you feel a lump on your testicles even though it could just be a spermatocele? |
|
Definition
| because you cannot distinguish a cyst from cancer with just a self examination |
|
|
Term
|
Definition
| dilation of blood vessels in testicles. causing increased temp to scrotum which can reduce or eliminate sperm production |
|
|
Term
|
Definition
injection of a sclerosing agent
surgical ligation of spermatic vein goal is to return normal sperm production |
|
|
Term
|
Definition
| twisting of the spermatic cord that reduces blood supply to that area which can lead to celluar death and necrosis if not treated RAPIDLY |
|
|
Term
| s/s of testicular torsion |
|
Definition
-sudden onset of severe testicular/scrotal pain
-change in lie of testicles
-no fever
-reduced or absent blood flow through a doppler ultrasound confirms diagnose |
|
|
Term
| difference between testicular torsion and epididymitis |
|
Definition
| in epididymitis there is a fever in testicular torsion there is not |
|
|
Term
| repair of testicular torsion |
|
Definition
manual rotation
surgical intervention |
|
|
Term
|
Definition
| inflammation of the testicle |
|
|
Term
|
Definition
secondary to trauma or surgery
untreated epididymitis
systemic infection: mumps, pneumonoa, TB, syphilis |
|
|
Term
| with orchitis what also develops? |
|
Definition
|
|
Term
|
Definition
fever
localized pain
elevated WBC |
|
|
Term
|
Definition
-gamma globulin for post-pubertal men that have been exposed to mumps or had mumps, nor have not been immunized
-for bacterial: broad spectrum abx and anti-inflammatory
-pain meds
-elevated scrotum
-ice packs |
|
|
Term
| testicular cancer predisposing factors |
|
Definition
cyptochidism
family history of it
in a contra-lateral testis: more common in the R
history of orchitis
infection with HIV
sons of women who took diethylstilbestrol (DES) during pregnancy |
|
|
Term
|
Definition
serum a-fetoprotein (AFP)
lactate dehydrogenase (LDH)
human chorionic gonadotropin (hCG) |
|
|
Term
| treatment of testicular cancer |
|
Definition
orchiectomy- removal of the testes amd regional lymph nodes
chemotherapy protocols use combination drugs |
|
|
Term
|
Definition
| malignant tumor of the prostate gland |
|
|
Term
| how does prostate cancer begin |
|
Definition
| localized hard nodule with 75% occurring in the peripheral zone |
|
|
Term
| prostate cancer characteristics |
|
Definition
| slow growing that can spread thorough the lymph or bloodstream |
|
|
Term
| prostate cancer is highest in |
|
Definition
|
|
Term
| the 3 nonmodifiable risk factors for protate cancer |
|
Definition
age
ethnicity: aa males are highest
family history |
|
|
Term
| primary screening tools for prostate cancer |
|
Definition
|
|
Term
| what should a normal prostate feel like? |
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Definition
|
|
Term
| mild elevations of PSA can be caused by |
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Definition
|
|
Term
| drug therapy for prostate cancer |
|
Definition
| hormonal and chemotherapy or both |
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|
Term
| PSA is alaso used to monitor |
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Definition
|
|
Term
| primary prevention of prostate cancer |
|
Definition
| men over 40 should have PSA levels checked and DREs |
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Term
|
Definition
| transurethral resection of the prostate uses a rectoscope inserted through the urethra to remove prostate tissue. pt is hospitalized and given a spinal or general anesthesia |
|
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Term
|
Definition
identify medications
anticoagulants and ASA should be stopped before surgery
bowel and urinations patterns should be the baseline
stool softeners to reduce hard stools |
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|
Term
|
Definition
patient will have a 3 way catheter in place to allow for continuous irrigation of bladder and tissues, irrigation makes catheter stay patient and that urinary drainage occurs.
nurse must monitor color and volume, at first it will be bright red with small clots
the nurse controls the flow rate
total output should not be less than volume instilled |
|
|
Term
| what should you do if output decreases from a 3 way catheter on your post op TURP patient? |
|
Definition
| increase the irrigation flow rate to flush the catheter to loosen any clots and tissue |
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|
Term
| length of bladder irrigation post TURP |
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Definition
| minimum of first 24 hours after surgery |
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Term
|
Definition
| most effective procedure if cancer is contained in prostate gland: removes entire prostate gland, seminal vesicles, and part of the bladder neck |
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|
Term
| pre op management for a prostatectomy |
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Definition
| similar to TURP but if they are doing a perineal approach, careful bowel prep must be done to prevent contamination |
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|
Term
| major post op complications from a prostatectomy |
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Definition
ED and urinary incontinence
may temporarily or permanently loss genital sensation unless it was nerve sparing, after months may gain control over urination. ejaculation may be impaired, but may be able to have sex and orgasm |
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Term
| complete physical exam for a female reproductive system |
|
Definition
patient history
physical evaluation
of both breasts and the pelvic exam |
|
|
Term
| is a pelvic exam usually done by nurses? |
|
Definition
| no unless you work in that specialty area or are a APN |
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Term
|
Definition
| inner and outer upper and lower quadrants |
|
|
Term
| majority of breast cancers occur in what breast quadrants and region? |
|
Definition
| in the upper outer quadrant or tail of spence |
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|
Term
| how often should woman do a breast self examination? |
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Definition
|
|
Term
| best time for a breast self exam |
|
Definition
| one week post menstrual period |
|
|
Term
| how often should a clinician exam a woman's breasts? |
|
Definition
| every 3 years until she is 40 and then every year after that |
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|
Term
| can detect 90% of breast malignancies |
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Definition
|
|
Term
|
Definition
| soft tissue x-ray of the breasts |
|
|
Term
| how often should a mammogram be done? |
|
Definition
| every 1-2 years 40-49 and then every year for 50 and over |
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|
Term
| criteria for a proper breast self examination |
|
Definition
lying flat: one arm raised about head, pressing lightly moving hand in a circular motion, always follow same pattern
standing position: look in mirror and observe color and contour of nipples and squeeze areola to check for drainage |
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|
Term
| changes in the areola or nipples such as introversion, puckering, or drainage should be followed up with what actions? |
|
Definition
| physical exam and screening for breast cancer immediately because these are serious signs and very significant for breast cancer |
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|
Term
| best way to ensure that the patient can properly self evaluate their breasts? |
|
Definition
|
|
Term
| risk factors for breast cancer |
|
Definition
-older than 50
-family history of breast cancer
-early menarche less than 12 years old
-late menopause after 60 years old
-nulliparity (female sterility)
-first child after 30
-obesity/high fat diet
-smoking
-repeated exposure to radiation
-HRT
-estrogen in form of birth control
-fibrocystic disease of breast |
|
|
Term
|
Definition
-lump or mass
-asymmetry in breast: small amount is normal, but changes such as thickening, edema, dimpling, or ulceration around areola
-discharge or drainage from areola
-pain or tenderness in breast or adjacent arm
-if the arm has edema than this may indicate that cancer may already be present |
|
|
Term
| how is breast cancer classified in? |
|
Definition
|
|
Term
|
Definition
| tumor is smaller than 2 cm with 0 lymph nodes positive for cancer and no metastasis is present |
|
|
Term
|
Definition
| tumor is 2-5 cm with 0-1 lymph nodes positive for cancer and no metastasis evident |
|
|
Term
| stage 3 breast cancer possibilities |
|
Definition
1: tumor is larger than 5 cm with 0 lymph nodes positive for cancer and no metastasis evident
2: tumor is smaller than 2 cm with axillary lymph nodes positive for cancer and no metastasis evident
3: tumor 25 cm with axillary lymph nodes positive for cancer cells and no metastasis evident |
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|
Term
|
Definition
| tumor of any size with or without lymph nodes positive for cancer cells and distant metastasis present |
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Term
|
Definition
lumpectomy
modified radical mastectomy
radical mastectomy |
|
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Term
|
Definition
| simple removal or a particular area |
|
|
Term
| modified radical mastectomy |
|
Definition
| removal or breast and ancillary lymph nodes, try to preserve pectoralis major muscle and breast reconstruction is usually a very good possibility |
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|
Term
|
Definition
| removal or the pectoralis major muscle |
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|
Term
| post op nursing care for breast surgery |
|
Definition
dressing and drains monitored
look for signs of bleeding and infection
jackson pratts drain is usually used to provide gentle suction and drainage.
drainage should be serosanguineous and is measured every 8-12 hours
drainage is considered output
pain
lymphedema |
|
|
Term
|
Definition
| caused by damage to intercostal brachial nerves, can cause numbness, prickly pain, and unbearable itching for several months |
|
|
Term
|
Definition
lymphedema is the accumulation of lymph fluids in the soft tissues from removal, incision, or radiation of lymph tissues, will collect in arm and puts pressure on veins and affect venous return
complaints:
heaviness in arm
pain
impaired motor function
numbness and paresthesia of fingers
cellulitis and progressive fibrosis which is not always preventable but early intervention is crucial |
|
|
Term
| post breast surgery follow up |
|
Definition
| every 6 months for two years and yearly for at least 5 years after that |
|
|
Term
| radiation therapy in breast cancer |
|
Definition
primary treatment
following mastectomy
palliative treatment for pain or metastasis
high dose brachytherapy |
|
|
Term
|
Definition
| is internal radiation is used to treat early stage breast cancer. while traditional radiation can take 5-6 weeks in contrast uses a balloon catheter to deliver the radioactive seed may need only 5 days of treatment |
|
|
Term
|
Definition
breast cancer responds favorably
combination drug therapy is also effective |
|
|
Term
| side effects of chemotherapy |
|
Definition
nausea
anorexia
weight loss
alopecia
bone marrow suppression
fatigue |
|
|
Term
|
Definition
estrogen can produce breast cancer cell growth if cancer cells are estrogen receptor positive.
hormonal therapy removes or blocks the source of estrogen and promotes tumor regression |
|
|
Term
| post menopausal women are more likely to have |
|
Definition
|
|
Term
| hormonal therapy can be used as a |
|
Definition
| primary treatment in those with recurrent or metastatic cancer |
|
|
Term
| the hormonal agent of choice in estrogen receptor positive women in all stages of breast cancer |
|
Definition
|
|
Term
| in order to properly ambulate post surgery what should be done to the operative side's arm? |
|
Definition
|
|
Term
| post surgery patient education |
|
Definition
support arm of operative side
decreased intake of caffeine
avoid constrictive clothing
follow program of prescribed exercise
avoid
injections
taking BP reading from arm of affected side due to impaired venous return and prevent lymphadema |
|
|
Term
| three reasons for a pelvic exam |
|
Definition
obtain a pap smear
obtain a culture
perform a transvaginal ultrasound |
|
|
Term
|
Definition
| microscopic study of exfoliated cells of endocervix and ectocervix,looking for changes that signify cancer or abnormalities in the cells |
|
|
Term
|
Definition
| ultrasound performed from inside of vaginal canal to detect abnormalities such as an ovarian cyst |
|
|
Term
|
Definition
| q1-2y after sexual activity |
|
|
Term
|
Definition
| no douche or intavaginal cleansing should be done 24 hours prior to exam |
|
|
Term
|
Definition
first episode of menstrual bleeding
occurs between 9-16 years old
important to history data because if it begins to early or late it may signify an abnormality |
|
|
Term
|
Definition
s/s:
breast changes
water retention
appetite changes and cravings
cramps
mood swings
based on hormone levels |
|
|
Term
| to prevent and relieve PMS |
|
Definition
stress management and relaxation
limit caffeine, salt, sugar, and chocolate
vitamin B6 and Mg supplements
OTC meds: motrin |
|
|
Term
|
Definition
absence of menses that is a sign of stress. is common in athletes
associated with hormone imbalance |
|
|
Term
|
Definition
| excessive bleeding that can drop Hgb to low, causing fatigue and feeling tired, syncopal episodes require more aggressive treatment such as blood transfusion |
|
|
Term
|
Definition
bleeding between menses
from minimal to significant |
|
|
Term
|
Definition
| painful menses linked to a high level of prostaglandins which begins with menarche and can be treated with hormones |
|
|
Term
|
Definition
onset of 30-40 years old
linked to chronic PID, fibroids, an intrauterine device, endometriosis, and infections |
|
|
Term
|
Definition
| endometrial cells have left the uterine lining and have displaced themselves in the pelvis, more than likely in the ovaries. these cells will bleed and are cyclical with menses |
|
|
Term
|
Definition
| pain and is associated with infertility |
|
|
Term
| inability to achieve pregnancy after at least one year of regular intercourse without contraception |
|
Definition
|
|
Term
| common causes of infertility |
|
Definition
anovulation
inadequate corpus luteum
tubal obstruction/dysfunction
uterine or cervical factors |
|
|
Term
|
Definition
| benign tumors that can cause bleeding between periods or with intercourse and is uncomfortable but life threatening and can be treated with a polypectomy |
|
|
Term
|
Definition
| herniation of the bladder into the vagina |
|
|
Term
|
Definition
| herniation of the rectum into the vagina |
|
|
Term
| both cystocele and rectocele are both |
|
Definition
|
|
Term
|
Definition
| benign tumor in ovary, often occur in reproductive years and asymptomatic and resolve themselves |
|
|
Term
| pelvic inflammatory disease |
|
Definition
| chronic condition from untreated infections, causes severe pain, especially with exercise or sexual activity. |
|
|
Term
|
Definition
vaginal and cervical discharge and tenderness
spotting after intercourse
fever
chills
positive cervical motion tenderness on bimanual exam |
|
|
Term
|
Definition
| can lead to life threatning sepsis, ruptured or draining abscess, generalized peritonitis, ectopic pregnancy, infertility, and chronic pelvic pain |
|
|
Term
STD: gonorrhea
nickname:
caused by:
s/s:
treatment: |
|
Definition
STD: gonorrhea
nickname: the clap
caused by: Neisseria gonorrhea
s/s:
purulent discharge
painful urination
treatment: 2 antibiotics |
|
|
Term
| why are gonorrhea and clymadia often treated concurrently even if the other one is not diagnostically proven? |
|
Definition
| they are so similar and hard to differentiate |
|
|
Term
|
Definition
1: sores called cankers are present
2: body rash
3: tumors, nervous and cardiac system damage: can be irreversible and may lead to death |
|
|
Term
|
Definition
| one time dose of penicillin G, 2.4 million units deep IM using z-track method |
|
|
Term
|
Definition
| very thick and oily form of penicillin |
|
|
Term
| most prevalent bacterial STD |
|
Definition
|
|
Term
|
Definition
purulent drainage
fever
chills
pain
vomiting |
|
|
Term
|
Definition
2 abx
sexual abstinence for 7 days with treatment of both partners |
|
|
Term
|
Definition
|
|
Term
| lesions from viral infections |
|
Definition
|
|
Term
| systemic manifestations of viral STD infections |
|
Definition
fever
HA
myalgia
regional lymphadenopathy |
|
|
Term
| when lesions are present the patient should avoid |
|
Definition
| sexual activity completely |
|
|
Term
|
Definition
causes genital warts
over 100 types of the virus
HPV 16 and 18 have been associated with cervical cancer |
|
|
Term
| have been associated with cervical cancer |
|
Definition
|
|
Term
|
Definition
gardisil
requires a series of IM injections for females 9-26 years old, $300 |
|
|
Term
| protozoan infections s/s and treatment |
|
Definition
sever vaginal itching
green discharge
treatment with vinegar douche |
|
|
Term
| yeast infections s/s and treatment |
|
Definition
severe vaginal itching
white cheesy discharge
occurs most often in summer
treat with otc nystatin and micomzole |
|
|
Term
|
Definition
| malignant tumor of the ovary |
|
|
Term
| why are survival rates so low for ovarian cancer? |
|
Definition
| because early diagnosis is hard since it is asymptomatic until late stages |
|
|
Term
|
Definition
lower abdominal pain
ascites
urinary frequency and urgency
urinary and bowel obstruction
pelvic masses
pleural effusion |
|
|
Term
| ovarian cancer risk factors |
|
Definition
>50
nulliparity
family history of cancer |
|
|
Term
| diagnosis of ovarian cancer |
|
Definition
bi-manual pelvic exam
cancer antigen test |
|
|
Term
|
Definition
| part of cancer antigen test |
|
|
Term
| primary interventions in treatment of ovarian cancer |
|
Definition
oophorectomy with or without hysterectomy
chemotherapy
pelvic and abdominal iiradiation |
|
|
Term
|
Definition
|
|
Term
| ways of performing a hysterectomy |
|
Definition
| through abdomen or vagina |
|
|
Term
| althought HRT used to be the standard therapy to prevent the onset of menopausal symptoms, studies have shown that it increases the risk for |
|
Definition
breast cancer
stroke
heart disease
blood clots |
|
|
Term
| the shortest and lowest doses of HRT creams can be used to |
|
Definition
| relieve hot flashes and vaginal atrophic changes |
|
|
Term
|
Definition
gradual decline in the ovarian production of estrogen, 45-55
may develop from a cyclic or noncyclic hormonal pattern
ovulation has stopped |
|
|
Term
| most s/s of menopause are |
|
Definition
| vasomotor: causing hot flashes and night sweats |
|
|
Term
|
Definition
|
|
Term
| frequently accompany life after menopause |
|
Definition
stress incontinence
increased incidence of osteoporosis |
|
|
Term
|
Definition
| downward displacement of the uterus that can cause dymenorrhea, back ache, pain, and stress incontinence |
|
|
Term
|
Definition
| device to support uterus to prevent uterine prolapse |
|
|
Term
| how many stages of prolapse (uterine) are there? |
|
Definition
|
|
Term
| 3rd stage of uterine prolapse |
|
Definition
| uterus is protruding from vagina |
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|
