Term
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Definition
| damaged tissues release chemicals that unlock gates that block pain in order for a sensation to be sent to brain which is perceived as pain |
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Term
|
Definition
| NOW or recently occurring, less than 2 months |
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Term
|
Definition
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Term
|
Definition
| injected into spinal chord outside of dura mater |
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Term
|
Definition
| penetrates dura mater and is physically across blood brain barrier |
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Term
|
Definition
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|
Term
| How do narcotic analgesics work? |
|
Definition
| bind to opiate receptors in CNS and alter pain perception |
|
|
Term
| what are some side effects of narcotic analgesics? |
|
Definition
| decreased LOC and respiratory function, confusion, dizziness, N and V, and allergic reactions |
|
|
Term
| where do ALL narcotics come from? |
|
Definition
|
|
Term
| list the common narcotic analgesics |
|
Definition
Demerol (Merperidine)
Morphine Sulfate
Codeine Sulfate
Dilaudid (Hydromorphone)
Fentanyl (Onsolis, Sublimaze) |
|
|
Term
| which narcotic analgesic works to alter pain perception by relieving pain but also has antitussive effects as well? |
|
Definition
|
|
Term
| what are some indications for the use of narcotic/opioid analgesics? |
|
Definition
| moderate to severe pain, anesthesia, and pre-op sedation |
|
|
Term
| give some examples of NON-narcotic analgesics |
|
Definition
Tylenol (Acetaminophen)
Aspirin (Acetylsalicylic Acid) |
|
|
Term
| what are the NON-narcotic analgesics used for? |
|
Definition
|
|
Term
what are the mild side effects and adverse side effects of:
Tylenol (Acetaminophen)
Aspirin (Acetylsalicylic Acid) |
|
Definition
Tylenol-
Mild:None
Adverse: Hepatic (liver) failure
Aspirin
Mild: Nausea and heartburn
Adverse: GI bleeding |
|
|
Term
| what's the difference between a loading dose and a basal rate in regards to a PCA pump? |
|
Definition
loading dose: unspecified amount given when pump initially starts. Can be set to any amount as ordered.
basal rate: continuous flow of an ordered amount regardless of button pushing |
|
|
Term
what does this order for a PCA read out as:
1-6-30 |
|
Definition
| 1 mg/mL with a 6 minute lockout at 30 ml total |
|
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Term
| what are benzodiazepines classified as? |
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Definition
|
|
Term
| what is the common ending for a benzidiazepine? |
|
Definition
|
|
Term
| what benzodiazepine is often used for conscious sedation? |
|
Definition
|
|
Term
| why are Benzodiazepine often given |
|
Definition
| to help patient relax, hypnotic effect before procedure, and induces sleep |
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|
Term
| what are the mild side effects and adverse effects of benzodiazepines? |
|
Definition
Mild: drowsy (safe)
Adverse: hangover feeling, respiratory depression which can stop breathing |
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Term
| in a situation where a patient is a given a benzodiazepine and go under severe respiratory depression and stop breathing, what are your option? |
|
Definition
| bag valve mask, intubation, or Romazicon as an antagonist to reverse effects |
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Term
|
Definition
| 2 meds with the same classification (2 HTN drugs) and their effects add up |
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Term
|
Definition
| 2 meds with different classifications (1 is an diuretic and the other is a Beta Blocker) and they improve the effect |
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Term
|
Definition
|
|
Term
what are the antagonists for
Benzodiazepines
and
Opiates |
|
Definition
Romazicon for Benzodiazepines
AND
Narcan for Opiates |
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Term
|
Definition
| an unexpected and undesirable response |
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Term
|
Definition
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Term
|
Definition
| separately they work but together they produce unwanted effects |
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Term
|
Definition
| is a histamine response that is treated with an antihistamine usually Benadryl (diphenhydramine) and adrenalin (Epinephrine) which will treat the RESPONSE to the allergen until the body can be rid of allergen |
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Term
|
Definition
| causes structural defects in a fetus |
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Definition
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Definition
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Term
| Prevention and Control Act of 1970 |
|
Definition
CI: Heroin and marijuana- NO med value
CII: Demerol and codeine- MED value, HIGH dep.
CIII: Hydrocodone and rectal phenobarbital- MED value and MOD dep.
CIV: Diazepam and phenobarbitol LOW dep
CV: Cough and diarrhea; LOWER dep |
|
|
Term
| what are the 5 rights of medication? |
|
Definition
1. patient
2. drug
3. route
4. dose
5. time |
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Term
|
Definition
| strength of the binding site to the receptor site |
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Term
|
Definition
| study of drugs obtained from animal and plant sources |
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Term
|
Definition
| inactive and illegal substance |
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Term
| talking multiple drugs for treatment |
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Definition
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Term
|
Definition
| ratio of therapeutic effect vs toxic effect |
|
|
Term
| what's an example of a drug with a wide therapeutic index? with a small? |
|
Definition
marijuana- wide
dijoxin-small |
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Term
|
Definition
| what the BODY does to the DRUG |
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Term
|
Definition
| rate at which a drug leaves the administration site |
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Term
|
Definition
| extent of drug absorption; how much is available for use in the body? |
|
|
Term
| what are the possible routes for drug administration and the approximate time frames for onset? |
|
Definition
IV and topical (burn): Immediate
oral: 30-45 minutes
IM: 10-15
SubQ: 15-20
Transdermal (normal): 10-20 |
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Term
|
Definition
| drugs absorbed from GI go to liver to be metabolized before reaching systemic circulation |
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Term
|
Definition
| blood is transported by the bloodstream to the site of action |
|
|
Term
| In regards of biotransformation, what does the liver do? the kidneys? |
|
Definition
liver-metabolizes drug
kidneys-filters it and excretes it |
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Term
|
Definition
| how long it takes for half of ingested drug to leave the body |
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Term
|
Definition
| length of the therapeutic response |
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Term
|
Definition
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Term
|
Definition
| when the therapeutic response begins |
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Term
|
Definition
| what the drug does to the body |
|
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Term
|
Definition
what method does the drug use to achieve its goal:
1. receptor interaction-higher affinity the better; binding to receptor site
2. enzyme reaction- stimulates or blocks enzymatic reactions (ACE inhibitors)
3. nonspecific |
|
|
Term
| what is the difference b/t an agonist and an antagonist? |
|
Definition
agonist: stimulates the reaction
antagonist: blocks the reaction |
|
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Term
|
Definition
| what is the pharmacological reason we are giving this drug? |
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Term
|
Definition
A: No risk
B: Animal studies fail to show risk, but no human evidence
C: Animal studies DO show adverse effects; no human studies. Benefits may warrant use despite the risks
D: Positive risk to humans, may warrant use in life-threatening situations
X: Risk no matter how you put it! BAD BAD BAD BAD BAD BAD |
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Term
| dosages for Neonatal & Pediatric patients have different dosage considerations and their dosages are determined by |
|
Definition
|
|
Term
| In terms of dosage considerations, geriatric patients have a slower metabolism and excretion so med levels are adjusted and probably [increased OR decreased]? |
|
Definition
|
|
Term
Implementation Uses of Meds
-Acute
-Maintenance
-Supplemental
-Palliative
-Supportive
-Prophylactic |
|
Definition
○ Acute: needs now!
§ Vasopressors
○ Maintenance: Status quo
§ HTN meds
○ Supplemental: supplement a missing component
§ Insulin
○ Palliative: meds for terminally ill
○ Supportive: Supports body function
§ Food and water IV
○ Prophylactic: prevents negative outcomes
§ Presurgery antibiotics
§ Antiemetics- given before Chemo |
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Term
|
Definition
| right after you give medication |
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|
Term
|
Definition
| right before you give medication |
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|
Term
| Both the peak and the trough of a medication you administered MUST be in the |
|
Definition
| Both the peak and the trough MUST be in the therapeutic range |
|
|
Term
| what are the pain characteristics? |
|
Definition
onset
duration
location
intensity
quality (use pain scale) |
|
|
Term
| what are the 5 basic needs from basic to highest? |
|
Definition
| physiological, safety, love and belonging, self-esteem, self-actualization |
|
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Term
|
Definition
| gathering data that will be the baseline criteria for developing a nursing diagnosis |
|
|
Term
| what are the components of a physical examination? |
|
Definition
inspection
palpation
percussion
auscultation
olfaction |
|
|
Term
| what are the temperature's for specific places? |
|
Definition
Oral & tympanic-98.6
Rectal- 99.5
Axilla- 97.7 |
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Term
|
Definition
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Term
|
Definition
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Term
| If a TO is given by a physician, by when should the order be cosigned by the physician? |
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Definition
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Definition
| once if necessary, if there is a need |
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Term
|
Definition
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Term
|
Definition
|
|
Term
1 gr= _____ mg
1000 mg= ______ gram
1 tsp= ______ ml
1 tbsp= ________ ml
1 oz= _____ml |
|
Definition
1 gr= 60 mg
1000 mg= 1 gram
1tsp=5 mL
1tbs= 15 mL
1 oz= 30 mL |
|
|
Term
|
Definition
a- before
p- after
c-with
s-without |
|
|
Term
|
Definition
| discontinuous, is due to fluid in the lungs, coughing can't help |
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|
Term
|
Definition
| continuous, due to secretion in airway, coughing DOES help |
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|
Term
|
Definition
| continuous, high pitched musical sounds due to rapid vibrations of bronchial walls |
|
|
Term
| Is being SOB objective or subjective? Why? |
|
Definition
| Subjective because the patient is the one that tells you they are SOB; you cannot look at a patient and see this. |
|
|
Term
|
Definition
| shortness of breath related to position (water bottle) |
|
|
Term
| what is used often by physicians as a "rating scale" for orthopnea? |
|
Definition
|
|
Term
|
Definition
| Dyspnea on exertion: getting short of breath when you put out an effort |
|
|
Term
|
Definition
| insufficient energy to complete daily activities |
|
|
Term
| what are the 6 types of chronic respiratory disorders? |
|
Definition
| emphysema, bronchitis, asthma, occupational exposure to pollutants, chronic hoarseness, and allergies |
|
|
Term
|
Definition
| buildup of CO2 when patient is unable to exhale all of CO2 out, trapped air forms pustules of blebs in the lungs |
|
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Term
|
Definition
| inflammation of the bronchioles caused by an antigen or bacteria |
|
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Term
|
Definition
| smooth muscles of the airways get constricted |
|
|
Term
|
Definition
| when pt loses ability to push air out of longs and through vocal chords |
|
|
Term
| what are 5 things to know about pt's family history in regards to respiratory health? |
|
Definition
| CA, TB, COPD (bronchitis, asthma, and emphysema), smoker (how long, how much: pack years), and exacerbation. |
|
|
Term
| exacerbation and an example |
|
Definition
to make something worse.
ex: a pt has bronchitis and then they have a flair up, so their conditions were exacerbated. |
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Term
|
Definition
| consolidation of the alveoli that impairs gas exchange |
|
|
Term
|
Definition
| bacterial, fungal, or viral infection of the lungs |
|
|
Term
| what is the difference between asthma and bronchitis? |
|
Definition
| asthma is due to smooth muscle contractions that narrow the airway while bronchitis is due to the inflammation of the bronchioles that leads to narrowing of the airway |
|
|
Term
|
Definition
| air moving in and out of lungs |
|
|
Term
|
Definition
| gas exchange between RBC and alveoli |
|
|
Term
|
Definition
| RBC to and from pulmonary capillaries (little trucks) |
|
|
Term
| an example of having decreased O2 carrying capacity |
|
Definition
|
|
Term
| what would cause decreased O2 concentration upon inspiration? |
|
Definition
|
|
Term
|
Definition
| decreased blood volume; may due to bleeding out |
|
|
Term
| why would a person that is hypovolemic appear to have anemia in tests? |
|
Definition
| Because they have lost blood volume, or carriers of oxygen. |
|
|
Term
| why would a person that is hypovolemic appear to have anemia in tests? |
|
Definition
| Because they have lost blood volume, or carriers of oxygen. |
|
|
Term
| what would cause an increase in metabolic rate? |
|
Definition
| pregnancy, would healing, and exercising. |
|
|
Term
| what could cause a decrease in chest wall movement? |
|
Definition
| obesity, kyphosis & scoliosis, and CNA alterations like a spinal chord injury |
|
|
Term
| the heart and the lungs are important to each other. What happens when the R side of the heart is not working? the left? |
|
Definition
R: decreased oxygenation to the tissues of the body
L: increase in pressure build-up and lungs could fill with fluid instead of air. |
|
|
Term
| what are the developmental stressors for the different age groups? |
|
Definition
premature: undeveloped lungs
infants/toddlers: URI
children/adolescents: URI, asthma and smoking and drugs
young adult/middle aged: diet, exercise, stress, smoking
older adults: atherosclerosis, decreased CO, cough reflex, chest compliance, # of cilia and immune response. Respiratory muscles weaken. |
|
|
Term
| what does exercise do to your oxygen carrying capacity? |
|
Definition
|
|
Term
| why does smoking decrease your oxygen carrying capacity? |
|
Definition
| nicotine is a vasoconstrictor that makes it harder for blood to move through and increases blood pressure |
|
|
Term
| ETOH and its affects on respiratory health |
|
Definition
| alcoholism; poor RBC production |
|
|
Term
| cocaine and its effects on respiratory health |
|
Definition
| directly deteriorates lung tissue and is a vasoconstrictor |
|
|
Term
| what is a psychological stressors that affects respiratory health? |
|
Definition
| stress and anxiety; increases metabolic rate and O2 demand, can lead to hyperventilation |
|
|
Term
| ineffective airway clearance |
|
Definition
can't cough effectively to clear their airway
solution: suctioning, secretions can be watered down, show proper coughing techniques |
|
|
Term
|
Definition
| something is blocking gas exchange, could be a fluid, secretion, or tumor |
|
|
Term
| ineffective breathing patterns |
|
Definition
| a change in rate,depth, or pattern of breathing |
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|
Term
|
Definition
|
|
Term
|
Definition
| period of apnea followed by an ascending then descending crescendo of breathing |
|
|
Term
|
Definition
| risk that something can be breathed into or lodged in lungs like secretions, food, or fluids |
|
|
Term
|
Definition
| crunchy sounds when broken bones rub against each other |
|
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Term
|
Definition
| when air gets underneath the skin |
|
|
Term
|
Definition
| when lung tissue vibrates |
|
|
Term
| what could be the cause of an abnormal tactile fremitus? |
|
Definition
|
|
Term
| why is percussion of the lung difficult? what is recommended? |
|
Definition
| because the lungs are well protected and enclosed. imaging |
|
|
Term
what breath sounds are:
-away from the center?
-over the trachea?
-on 1st and 2nd intercostal space? |
|
Definition
-vesicular
-bronchial
-bronchovesicular |
|
|
Term
| what are normal long sounds? abnormal? |
|
Definition
normal:eupnea, vesicular;
abnormal:adventitious |
|
|
Term
| what are crackles, rhonchi, wheezing, and pleural friction rubs, according to the effects of coughing? |
|
Definition
-crackles-fluid in the lungs, not cleared with coughing
-rhonchi-mucus type fluid leads to rattling, can be cleared with coughing
-wheezes-whistling
-pleural friction rub- lack of surfactant on the surface of lungs, very painful |
|
|
Term
|
Definition
| measures % of RBC carrying oxygen |
|
|
Term
| what places can a pulse oximeter be placed? |
|
Definition
| bridge of nose, toe, earlobe, index...anywhere with a pulse |
|
|
Term
| why is a high saturation % not necessarily a good indicator? |
|
Definition
anemia-will probably say 100% because all the RBC are 100% saturated BUT there are not enough RBC, value to high
edema- value to low
CO- carbon monoxide has a higher affinity to hemoglobin than oxygen does, so if it is CO or O2 bounded to the Hgb, it will still read as saturated |
|
|
Term
| what measures the amount of O2 carried in the arteries? |
|
Definition
|
|
Term
| what is an example of a use of radiography in regards to the respiratory system? |
|
Definition
|
|
Term
| what is the difference between infiltrate and effusion? |
|
Definition
| infiltrate is fluid in the lung and effusion is fluid produced by the lung that remains inside the thoracic cavity |
|
|
Term
|
Definition
| shows the blood flow through lung tissue and uses radioactive isotopes in the pulmonary arteries |
|
|
Term
|
Definition
| inhale radioisotopes to check ventilation and perfusion |
|
|
Term
|
Definition
| visual exam of lungs used fiberoptic tube. pt is consciously sedated |
|
|
Term
| after a bronchoscopy what are the precautions that must be taken for the pt? |
|
Definition
| have breathing support and oxygen available and also NPO because the pt might not be able to breath or swallow due to sedation |
|
|
Term
|
Definition
| placing pt under conscience sedation |
|
|
Term
| what test is performed on sputum? how long does it take? in the meantime what are 2 interventions that physicians implement? |
|
Definition
| culture & sensitivity, 5 days, empirical treatment and use of broad-spectrum antibiotics |
|
|
Term
| what are pulmonary function tests and why are they important? |
|
Definition
| measure tidal volume (air breathed in), measures air breathed out, etc, important before surgery to ensure that the pt's lung can withstand surgery |
|
|
Term
| what are 3 things that can lead to inaccurate pulse oximetry readings? |
|
Definition
-anemia-too high
-edema- too low
-systolic BP <90 (not enough oxygen being pumped to body) |
|
|
Term
| what are two types of blood tests? |
|
Definition
| complete blood count and serum electrolytes |
|
|
Term
| what can serum electrolytes tell you about? |
|
Definition
|
|
Term
| arterial blood gas can measure |
|
Definition
|
|
Term
| why is hydration important to help maintain an airway? |
|
Definition
| helps thin out secretions and facilitate breathing |
|
|
Term
| why is it important to humidify oxygen being given to a patient? |
|
Definition
| may lead to dry and crack sinus and mucus membranes |
|
|
Term
|
Definition
|
|
Term
|
Definition
| helps maintain a patent airway |
|
|
Term
|
Definition
| intermittent positive pressure breathing and constant positive air pressure, forces air into lungs |
|
|
Term
|
Definition
| works on inspiration, helps breathing great for immobilized and post-op pts |
|
|
Term
|
Definition
|
|
Term
|
Definition
| works on inspiration, helps breathing great for immobilized and post-op pts |
|
|
Term
|
Definition
| breathing too fast, bad because you are blowing out too much CO2 and it is CO2 in the blood (carbonic acid) that stimulates breathing via the diaphragm |
|
|
Term
| what causes hyperventilation? |
|
Definition
| anxiety, infection, metabolic acidosis, head injury, and asthma |
|
|
Term
|
Definition
| insufficient rate or depth of breathing |
|
|
Term
|
Definition
| tissues are not receiving sufficient O2 |
|
|
Term
|
Definition
|
|
Term
| what classification are albuterol and alupent? |
|
Definition
|
|
Term
| what are the 3 other names for Albuterol? |
|
Definition
| Ventolin, Proventil, and Volmax |
|
|
Term
| what is another name for Alupent? |
|
Definition
|
|
Term
| how do albuterol and alupent manage reversible airway obstruction? |
|
Definition
|
|
Term
| what are the side-effects of albuterol and alupent? |
|
Definition
| nervousness, tachycardia, and tremors |
|
|
Term
| what are the nursing implications for albuterol and alupent? |
|
Definition
| assess lung sounds before and after and all VS and monitor for paradoxical bronchiospasm |
|
|
Term
| what is the MOA for albuterol? |
|
Definition
| beta agonist: speeds up heart rate and BP |
|
|
Term
|
Definition
|
|
Term
| what is the MOA of alupent? |
|
Definition
|
|
Term
| what is paradoxical bronchiospasm |
|
Definition
| after medication when the bronchials reclose |
|
|
Term
| what kind of effect would using Albuterol and Alupent together have? |
|
Definition
|
|
Term
|
Definition
| 2 of the same kind of drug given and the effects add up, like 2 HBP meds |
|
|
Term
|
Definition
| 2 different kinds of meds that work together and improve effects like a HBP med and beta blocker |
|
|
Term
where is the apical pulse located?
how long do you need to take pulse? |
|
Definition
| 4th and 5th ICS; 1 full minute |
|
|
Term
| what are jugular veins affected by? |
|
Definition
| R atrium & ventricles and blood volume |
|
|
Term
| patients with jugular vein distention show signs of |
|
Definition
|
|
Term
| clubbing of the nails indicates |
|
Definition
|
|
Term
| when assessing the neurological in the pt in regards to CV health you looking for signs of |
|
Definition
| decreased perfusion like confusion, lethargy, dizziness, restlessness |
|
|
Term
| decreased perfusion leading to confusion, lethargy, mood changes and syncope have the same S & S of hypoglycemia so it is important to |
|
Definition
|
|
Term
|
Definition
| fainting or loss of consciousness |
|
|
Term
| a decrease in bowel sounds may be due to |
|
Definition
|
|
Term
| nausea and vomiting from the GI in regards to the CV may be due to |
|
Definition
|
|
Term
| when kidneys are hypoperfused there will be |
|
Definition
|
|
Term
| alterations in systemic blood flow might have an |
|
Definition
| arterial occlusion; increase in pain, temperature, cool, skin is pallor |
|
|
Term
| venous insufficiency shows what sign? |
|
Definition
| swollen and hot extremity |
|
|
Term
| neuro challanges, confusion, lethargy, syncope, and dizziness indicate |
|
Definition
| decreased perfusion and hypoclycemia |
|
|
Term
| pale, cool and painful extremities indicate |
|
Definition
|
|
Term
| swollen and hot extremities indicate |
|
Definition
|
|
Term
| what are the 5 sites for auscultation of the heart |
|
Definition
| aortic, pulmonic, tricuspid, mitral, PMI |
|
|
Term
| when auscultating the heart what affects the sounds of the heart? |
|
Definition
1. position of the pt
2. position of stethoscope |
|
|
Term
| what is the diaphragm of the stethoscope used for? |
|
Definition
| high pitched sounds, S1 and S2, normal heart sounds |
|
|
Term
| what is the bell of the stethoscope used for? |
|
Definition
| low-pitched sounds, S3 and S4, assessing for abn sounds or murmurs |
|
|
Term
| what is LUB & DUB? Closure? Loudest at? |
|
Definition
S1 is LUB: Systole, closure of AV (mitral and tricuspid), loudest at 5th ICS
S2:Diastole, closing of SA valves (pulmonic, aortic), loudest at 2nd ICS, right sternal border |
|
|
Term
| what are the abnormal heart sounds? |
|
Definition
S3: heard after S1, a large volume of blood flowing directly into ventricle, sign of volume overload
S4: heard immediately before S1, non compliant ventricles, rigid and stiff |
|
|
Term
| when auscultating S3 and S4... |
|
Definition
| use the bell in the left lateral recumbent position |
|
|
Term
|
Definition
| swishing or blowing sound caused by an increased blood flow through a valve |
|
|
Term
|
Definition
| flow across a restricted structure |
|
|
Term
|
Definition
| blood passing through an incompetent valve |
|
|
Term
|
Definition
|
|
Term
|
Definition
| developing without any apparent cause |
|
|
Term
|
Definition
| continuous palpable sensation |
|
|
Term
| pulse deficit? when should you report to the physician? |
|
Definition
| measuring the apical and radial pulse at the same time. if the radial pulse is slower than the apical pulse |
|
|
Term
ace inhibitors
pupose
SE
Examples |
|
Definition
purpose: vasodilators, decreases BP
SE: hypotension, cough, high BUN and creatine, hyperkalemia, angioedema
Examples:
Altace-Ramipril
Capoten-Captopril
Vasotec-Enalapril
Zestril-Lisinopril |
|
|
Term
beta-blockers
purpose
SE
Indications
Examples |
|
Definition
purpose: increase diastolic filling time and coronary perfusion time and decreases HR and BP
SE: bradycardia, hypotension, bronchospasms, and fatigue
Indications: angina, heart disease, HTN, valve problems
Examples: Lopressor, Inderal, Coreg |
|
|
Term
calcium channel blockers
purpose
indications
side effects |
|
Definition
purpose: vasodilators, decrease HR and BP
Indications: angina and HTN
SE: hypotension, flushing, headache,ankle edema |
|
|
Term
|
Definition
|
|
Term
| peripheral dependent edema |
|
Definition
| swelling of the feet or ankle that could be a sign of venous insufficiency |
|
|
Term
|
Definition
| seen on lower extremities |
|
|
Term
|
Definition
| inflammation of a vein that promotes clot formation |
|
|
Term
|
Definition
|
|
Term
| an increase in age causes an a decrease in |
|
Definition
|
|
Term
| an increase in ICP leads to a... too much ICP leads to a |
|
Definition
| -decrease in brain function -herniated brain that will squirt out through the foramen magnum |
|
|
Term
|
Definition
-idiopathic-don't know why
-tumors
-brain chemistry
-genetics
-uncontrolled electrical activity in the brain |
|
|
Term
| two "classifications" of seizures |
|
Definition
| grande mal and petite mal |
|
|
Term
| how do you document a seizure? |
|
Definition
| describe it rather than naming it |
|
|
Term
| what are the 2 types of posturing in seizures? |
|
Definition
1. decorticate- moving towards the body
2. decerebrate- moving away from body |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| continued seizures, one after the other |
|
|
Term
| longer seizures may lead to |
|
Definition
|
|
Term
| what can lead to increased ICP? (6) |
|
Definition
1. head injuries
2. tumors
3. inflammatory brain conditions
4. encephalitis
5. stroke
6. cranial surgery |
|
|
Term
| when someone has a head injury always |
|
Definition
1. assess ICP
2. assess for altered mental status with Glasgow coma scale |
|
|
Term
| what is the difference between a primary and secondary tumor? |
|
Definition
| primary comes from brain tissue while seondary is the metastasis from another site |
|
|
Term
| before cranial surgery be SURE to |
|
Definition
| establish a neurological baseline |
|
|
Term
| what are some examples of an inflammatory brain condition? |
|
Definition
| bacterial, viral, and fungal meningitis; encephalitis; brain abscess; and stroke |
|
|
Term
bacterial meningitis:
-what is it?
-what is the fatality time frame?
-what can it be treated with?
-how is it diagnosed?
-what are the signs and symptoms? |
|
Definition
-bacterial infection inside of the meninges that surround the brain
- within 24 hours without treatment
- antiobiotics
- lumbar puncture
-very bad headache, photophobia, nausea, vomitting, cloudy or pussy CSF
NORMAL CSF SHOULD BE CLEAR, stiff neck |
|
|
Term
| which is more favorable, viral or bacterial meningitis? Why? |
|
Definition
| Viral because a full recovery is expected as you treat the signs and symptoms not the actual disease |
|
|
Term
| what is so significant about fungal meningitis? |
|
Definition
| you will be on treatments forever |
|
|
Term
|
Definition
| acute inflammation of the brain |
|
|
Term
|
Definition
|
|
Term
|
Definition
| CVA, cerebrovascular accident, brain attack |
|
|
Term
| what are the two types of strokes? |
|
Definition
1. embolic- plaque that clogs blood flow and causes the tissue to become hypoxic and die
2. hemorrhagic stroke: something in the brain pops or breaks and causes bleeding into brain tissue called an intercerebral hemorrhage |
|
|
Term
| what are the S&S of a stroke? |
|
Definition
| decreased muscle function, memory and swallowing, weakness and droop on opposite side |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what is a late sign of hypoxia? |
|
Definition
| blue-grey skin and mucous membranes |
|
|
Term
| fever increases the tissue's need for oxygen which causes in an increase in |
|
Definition
| carbon dioxide production |
|
|
Term
| increased breathlessness is a symptom of what blood disease? |
|
Definition
|
|
Term
| the most crucial nursing assessment the nurse performs when a patient is receiving oxygen via a non-rebreathing mask is to be sure that |
|
Definition
| the bag attached to the mask is inflated at all times |
|
|
Term
| a nurse observes a patient blowing forcefully into an incentive spirometer what is the best action by the nurse? |
|
Definition
| instruct the patient to inhale slowly into the mouthpiece |
|
|
Term
| 11. While assessing a patient with a history of asthma, the nurse finds that the patient has bilateral inspiratory and expiratory wheezing , a respiratory rate of 32 breaths per minute, and an oxygen saturation of 86%. What treatments should the nurse anticipate implementing for this patient? |
|
Definition
| Bronchodilators and IV steroids (anti-inflammatory) |
|
|
Term
|
Definition
| drugs that are similiar to or mimic the effects of sympathetic nervous system neurotransmitters: epinephrine, nor epinephrine, and dopamine. |
|
|
Term
| the autonomic nervous system consists of |
|
Definition
| parasympathetic and sympathetic nervous system |
|
|
Term
| adrenergic drugs stimulate the |
|
Definition
|
|
Term
| adrenergic agonists vs adrenergic antagonists |
|
Definition
agonists: stimulate the SNS
atagonists: sympatholytics that inhibit the stimulation of the SNS by binding to the adrenergic receptors to inhibit binding of agonists |
|
|
Term
|
Definition
| throughout the body are receptor sites for endogenous sympathetic neurotransmitters epinephrine and norepinephrine are of two types: alpha and beta |
|
|
Term
| alpha 1 adrenergic receptors |
|
Definition
| located on the muscle, tissue, or organ that the nerve is stimulating |
|
|
Term
| alpha 2 adrenergic receptors |
|
Definition
| located on the actual nerves that stimulate presynaptic effector cells and is inhibitory |
|
|
Term
| the stimulation or agonist activity of alpha 2 adrenergic receptors leads to |
|
Definition
| inhibition of the stimulation of the SNS |
|
|
Term
| beta 1 and 2 adrenergic receptors are located |
|
Definition
1- heart
2- smooth muscles of the bronchioles and blood vessels |
|
|
Term
| what are the effects of heart and BP by a beta agonist? beta blocker? |
|
Definition
agonist- increase HR and BP
blocker- decrease HR and BP |
|
|
Term
| what type of drug is albuterol? |
|
Definition
| beta adrenergic agonist which increases HR and BP |
|
|
Term
| what 4 components of lab data are important to assess in the cardiovascular assessment? |
|
Definition
1. Cardiac Markers: CK-MB, Troponins, and BNP
2. Lipids
3. CBC
4. Electrolytes |
|
|
Term
| what is CK-MB? What is the normal range? |
|
Definition
creatine-kinase-MB, used to support a diagnosis of a myocardial infarction, its degree and onset.
Females: 30-135 units/L
Males: 55-170 units/L |
|
|
Term
| What are troponins? What is the normal range? |
|
Definition
If a pt has chest pain, test is used to see if ischemia is the cause.
T: <0.2 ng/mL
I: <0.03 ng/L |
|
|
Term
|
Definition
| brain natriuretic peptide; used to identify and stratify patients with CHF |
|
|
Term
| What are the normal values for K, Mg, and Na? |
|
Definition
K: (3.5-5)
Mg: (1.3-2.1)
Na: (136-145)
(all mEg/L) |
|
|
Term
|
Definition
| rapid swelling of the dermis, subq, mucous, and submucosa. |
|
|
Term
|
Definition
| Angiotensin converting enzyme is responsible for converting angiotensin I into angiotensin II which is a potent vasoconstrictor. Also angiotensin II induces the secretion of aldosterone from the andrenal glands which causes the reabsorption of sodium and water, which further increase BP. But ACE inhibitors inhibit aldosterone, and therefore cause diuresis which decrease blood volume, decreasing BP. |
|
|
Term
|
Definition
| beta blockers reduce or inhibit SNS stimulation of the heart and its conduction cells. So this prevents catecholamine-mediating reactions, resulting is decreased HR, delayed AV node conduction, reduced myocardial contractility, and decreased myocardial automaticity. |
|
|
Term
| causes increased diastolic filling time and increased coronary perfusion |
|
Definition
|
|
Term
| explain calcium channel blockers |
|
Definition
| By removing calcium from the excitation-contraction coupling process of the muscle cells of the heart, this prevents muscle contraction and promotes muscle relaxation. This causes the coronary arteries around these muscles to dilate, increasing the O2 supply. This dilation also occurs systemically, reducing the force that must be exerted by the heart to push blood into the body. This also depresses automaticity. |
|
|
Term
| when assessing the peripheral veins ask the client to |
|
Definition
|
|
Term
| when assessing the peripheral, inspect and palpate for |
|
Definition
1. varicosities
2. edema
3. phlebitis |
|
|
Term
|
Definition
| superficial veins that become dilated especially in the dependent position, are common in people who stand alot and older adults. |
|
|
Term
| in what regions are varicosities abnormal? |
|
Definition
| medial part of the thigh and posterior lateral calf |
|
|
Term
| dependent edema is a sign of: (2) |
|
Definition
1. venous insufficiency
2. right sided heart failure |
|
|
Term
|
Definition
| inflammation of vein that occurs after trauma to vessel wall, infection, immobilization, and prolonged insertion of IV catheters |
|
|
Term
| what does phlebitis promote? |
|
Definition
| clot formation which can lead to a pulmonary embolism |
|
|
Term
| to assess for phlebitis (2) |
|
Definition
1. inspect calves for redness, tenderness and swelling
2. palpate muscles for warmth, tenderness, and firmness of muscle |
|
|
Term
| what is the most reliable finding for phlebitis? what finding maybe contralateral to DVT? |
|
Definition
1. unilateral edema
2. if dorsiflexion of the foot (Homan's sign) causes pain |
|
|
Term
| swelling in the legs is a __________ ___________ problem |
|
Definition
|
|
Term
| untreated ischemia leads to |
|
Definition
|
|
Term
| use of an incentive spirometer |
|
Definition
| increases lung volume to prevent pneumonia |
|
|
Term
| pneumonia (formal definition) |
|
Definition
| infection of the lungs; when the lungs become consolidated or filled with fluid. Can be due to bacteria, virus, fungus, or parasite. |
|
|
Term
| what are the symptoms of pneumonia? (6) |
|
Definition
| fever, cough, fatigue, chest pain, elevated WBC, and sputum |
|
|
Term
|
Definition
M-morphine: vasodilator, reduces pain, be concerned with respiratory status
O- oxygen, 92 or greater
N- Nitroglycerin: vasodilator, drops BP
A- aspirin- prevents platlet aggregation |
|
|
Term
| 5 areas to auscultate the heart at: |
|
Definition
| aortic, pulmonic, erb's point, tricuspid, and mitral |
|
|
Term
| S3 is heard...and is a sign of... |
|
Definition
| directly after S1, early diastole, sign of volume overload |
|
|
Term
| S4 is heard...and is a sign of... |
|
Definition
| right before S1, noncompliant or stiff ventricles |
|
|
Term
| symptoms of arterial occlusion (5) |
|
Definition
| Pain, pallor, parasthesia, paralysis, and pulselessness |
|
|
Term
| signs of venous insufficiency |
|
Definition
| hot and swollen extremeties |
|
|
Term
|
Definition
| neuropathy and vasculopathy |
|
|
Term
|
Definition
| Diuretics (Lasix is an example, first line of defense to treat HTN, CHECK electrolytes), Anti-HTN (ACE inhibitors, Beta-Blockers, Calcium Channel blockers), nitroglycerin, aspirin |
|
|
Term
| what drugs may causes bronchospasms? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what drug has the symptom of ankle edema, bradycardia, and hypotension? |
|
Definition
|
|
Term
| What drugs are Very Nice Drugs? What classfication? |
|
Definition
| Verapamil, Nifedipine, and Diltiazem; Ca Channel Blockers |
|
|
Term
| all of the anti-HTN drugs cause |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| not oriented or aware and judgement is impaired |
|
Definition
|
|
Term
| drowsy and they quickly return to sleep when you pause talking |
|
Definition
|
|
Term
| slow response and you cant maintain their attention |
|
Definition
|
|
Term
| minimal response, moan or cry |
|
Definition
|
|
Term
| no response at all, but breathing on their own |
|
Definition
|
|
Term
| unconcious state where they can open their eyes and sleep but no signs of higher brain function are present |
|
Definition
| peristent vegetative state |
|
|
Term
| motor pathways are destroyed despite having cognitive functioning and being alert and aware |
|
Definition
|
|
Term
| no response to external stimuli, absent brainstem reflexes and respiratory breathing |
|
Definition
|
|
Term
| should a nurse delegate a neurological assessment to unlicensed personnel? |
|
Definition
|
|
Term
| what are the 3 categories of the Glasgow Coma Scale? What is the max score? |
|
Definition
| Eye opening (1-4), verbal response (1-5), and motor skills (1-6); 15 |
|
|
Term
| 90% of patient with less than an 8 on the Glasgow Coma Scale are |
|
Definition
|
|
Term
| what are the 3 neuro meds? |
|
Definition
| mannitol, dexamethasone, and methylprednisolone |
|
|
Term
|
Definition
| osmotic diuretic that decreases ICP |
|
|
Term
| dexamethasone and methylprenisolone |
|
Definition
| corticosteroids that decrease inflammation and must be tapered off |
|
|
Term
| which is worse, decorticate or decerebrate? |
|
Definition
|
|
Term
| lethargic, obtunded, and stupurous are objective or subjective? |
|
Definition
|
|
Term
| what are the risk factors for CVA? |
|
Definition
|
|
Term
|
Definition
| transient ischemic attack, mini stroke |
|
|
Term
| what is the body's largest organ? |
|
Definition
|
|
Term
| what are the three things that the skin is sensory for? |
|
Definition
| pain, temperature, and touch |
|
|
Term
| injury to the skin triggers |
|
Definition
| complex healing processes |
|
|
Term
| when assessing the skin of an older patient what would you expect to have a decrease in the skin (7); an increase? |
|
Definition
Decrease: thickness, subQ fat, elasticity, vascularity, strength, moisture, functioning of sebaceous glands
Increase: hair density in nose and ears, lentigo, dryness, benign or malignant skin growth |
|
|
Term
|
Definition
| small patches of pigmented area |
|
|
Term
| what are the characteristics of nails of pts of older age? |
|
Definition
| thicker and slower growing |
|
|
Term
| what are infectious processes due to? |
|
Definition
|
|
Term
| infectious processes can be due bacterial, viral, and fungal pathogens. Give examples of bacterial pathogens. |
|
Definition
| staph aureus and streptococci |
|
|
Term
|
Definition
| a common skin infection that happens mostly in children. caused by staphylococci and streptococci and MRSA |
|
|
Term
| infectious processes can be due bacterial, viral, and fungal pathogens. Give examples of viral pathogens. |
|
Definition
|
|
Term
| herpes zoster can lead to |
|
Definition
|
|
Term
| infectious processes can be due bacterial, viral, and fungal pathogens. Give an example of a fungal pathogen. |
|
Definition
|
|
Term
|
Definition
| accumulation of lymphatic fluid causing swelling in the extremities |
|
|
Term
| what is the cause of lymphadema? |
|
Definition
| when the venous or lymphatic vessels are impaired leading to an abnormal accumulation of fluid that collects |
|
|
Term
| what are 2 results of lymphadema? |
|
Definition
| increase in protein fluid and decrease in oxygenation |
|
|
Term
| what is the primary nursing intervention in pts with lymphadema? |
|
Definition
|
|
Term
| when assessing redness in the skin what is the cause? |
|
Definition
| dilated blood vessels causing increased blood flow to an area |
|
|
Term
|
Definition
| localized injury to the skin or localized tissue |
|
|
Term
| where are pressure ulcers usually found? |
|
Definition
|
|
Term
| what do pressure ulcers result from? |
|
Definition
| pressure in combination with shearing and friction |
|
|
Term
| what is the major contributor to pressure ulcers? |
|
Definition
|
|
Term
| what is the cause of pressure ulcers in terms of capillary pressure? |
|
Definition
| when the pressure on the capillary is greater than the normal capillary pressure the vessels become occluded leading to ischemia which leads to necrosis |
|
|
Term
|
Definition
| skin is intact and redness is nonblancheable |
|
|
Term
|
Definition
| partial thickness of skin loss involving the epidermis and dermis or both |
|
|
Term
|
Definition
| full thickness tissue loss with visible fat being seen |
|
|
Term
|
Definition
| full thickness loss with exposed bone, muscle, or tendon |
|
|
Term
| factors that cause pressure ulcers can be |
|
Definition
|
|
Term
| what are 4 other stressors to the integumentary system? |
|
Definition
| nutrition, hydration, circulatory and oxygenation changes |
|
|
Term
| appropriate assessment of the skin requires |
|
Definition
| proper lighting and proper temperature |
|
|
Term
| what type of lighting is best for dark-skinned pts? |
|
Definition
|
|
Term
| when finding skin that is either cyanotic or flushed what changes are occuring? |
|
Definition
|
|
Term
| when finding blue or dusky nail beds OR erythema, what changes are occuring in what? |
|
Definition
|
|
Term
| when finding dull, stringy, thin hair; dry scaly skin with rashes; or dry and brittle nails what changes are occurring in what? |
|
Definition
|
|
Term
| local tissue damage results in the need for (2) |
|
Definition
| O2 and protein rich diet to promote healing |
|
|
Term
| what does edematous skin look like? |
|
Definition
| swollen, shiny, taut, and red |
|
|
Term
| If there is a decrease in skin turgor, then |
|
Definition
|
|
Term
| when assessing temperature be sure to assess |
|
Definition
|
|
Term
| when assessing the texture of the skin assess for any |
|
Definition
| draining lesions or wounds |
|
|
Term
|
Definition
| hygiene, illness, and drainage |
|
|
Term
| what is the characteristic of a normal nail angle? |
|
Definition
|
|
Term
| a sluggish cap refill response takes how long? what does it indicate? |
|
Definition
| more than 3 seconds; oxygenation issues |
|
|
Term
| clubbing shows presence of |
|
Definition
| chronic O2 deficiency usually in COPD pts |
|
|
Term
| used to predict or assess for pressure ulcers? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| when inspecting the contour and symmetry of the abdomen what are you looking for? |
|
Definition
| distention, enlarged organs or masses, movements or pulsations |
|
|
Term
| absent bowel sounds may indicate |
|
Definition
|
|
Term
| upon palpation of all 4 quads of the abdomen, pain may indicate |
|
Definition
| cholecystitis and pancreatitis |
|
|
Term
| what 3 foods can you encourage your patient to eat in order to obtain fiber in their diet? |
|
Definition
| fruits, green vegetables and garins |
|
|
Term
| what are 3 diagnostic tests that can be done for the GI system? |
|
Definition
| stool specimens, ova/parasits, and guaiac testing |
|
|
Term
| what are the radiographic tests that can be done for the GI? |
|
Definition
| X-rays, endoscopy, and imaging |
|
|
Term
| when is a barium enema performed? |
|
Definition
|
|
Term
| when is a contrast given to the patient? |
|
Definition
|
|
Term
| what can the contrast for a CT scan cause for the patient? |
|
Definition
|
|
Term
| what are the causes of constipation? |
|
Definition
| post op, DM, MS, Parkinsons, and narcotics |
|
|
Term
| what are the S and S for constipation? |
|
Definition
|
|
Term
| what are the S and S for constipation? |
|
Definition
|
|
Term
| what are complications that can arise from constipation? |
|
Definition
| fecal impaction, hemorrhoids, and megacolon |
|
|
Term
| what are the causes of diarrhea? |
|
Definition
| colitis, crohn's disease, and irritable bowel |
|
|
Term
| what are medications that can causes diarrhea? |
|
Definition
| stool softeners, laxatives, antiobiotics, chemo, and contrast from CT |
|
|
Term
| what are the S and S for diarrhea? |
|
Definition
| abdominal cramping, distension, and dehydration |
|
|
Term
| how do you manage diarrhea? |
|
Definition
| Lomotil, Immodium, IV fluids |
|
|
Term
| in severe cases of diarrhea what must occur? |
|
Definition
|
|
Term
| what is a complication of diarrhea? |
|
Definition
|
|
Term
| what can dehydration via diarrhea lead to? |
|
Definition
| cardiac dysrhythmias and decreased urine output |
|
|
Term
| what does skin turgor assess? |
|
Definition
|
|
Term
| what is a NANDA for constipation? |
|
Definition
|
|
Term
| what are 2 NANDA's for diarrhea? |
|
Definition
| bowel incontinence and pain |
|
|
Term
| what is the main source of energy in the diet? |
|
Definition
|
|
Term
| what is required as building blocks for growth, maintenance and repair? |
|
Definition
|
|
Term
| what are two essential amino acids in the body? |
|
Definition
|
|
Term
| what is the major form of stored energy? |
|
Definition
|
|
Term
| what is accountable for 35-45% of the American diet? |
|
Definition
|
|
Term
| what are the water soluble vitamins? |
|
Definition
|
|
Term
| what are the fat soluble vitamins |
|
Definition
|
|
Term
| what are the macrominerals and how much of them do you need a day? |
|
Definition
| Ca, Mg, and P; more than 100 mg/day |
|
|
Term
| what are the diagnostic tests for malnutrition? |
|
Definition
| total protein and albumin |
|
|
Term
|
Definition
| released when blood sugar is low, released by alpha cells of pancreas to increase blood glucose levels |
|
|
Term
|
Definition
| released when blood sugar level is high, released by beta cells of pancreas to decrease blood glucose levels |
|
|
Term
| what is the normal range for blood glucose levels? |
|
Definition
|
|
Term
| what is the cause of diabetes? |
|
Definition
|
|
Term
| in type 1 diabetes what does the individual's body "attack" in this autoimmune response? |
|
Definition
| beta cells of the pancreas |
|
|
Term
|
Definition
| insulin dependent, juvenile onset diabetes. body makes no insulin and attacks beta cells of pancreas |
|
|
Term
| which type of diabetics require insulin? what are the different ways in which insulin can be given? In which ways can insulin NOT be given and why? |
|
Definition
| type 1. Can be injected suQ and inhaled into bloodstream. Cannot be given orally because stomach would break down insulin into amino acids. |
|
|
Term
| insulin that is self-made is also called what? and what type of diabetics virtually have no self-made insulin? |
|
Definition
|
|
Term
|
Definition
| adult onset diabetes, non-insulin dependent. make little insulin or inadequate amounts of insulin. |
|
|
Term
| are type 2 diabetics dependent on insulin? Why? What medications can they receive? |
|
Definition
| no, they create insulin, just not enough. they can be given oral antiglycemics |
|
|
Term
|
Definition
| force insulin out of pancrea, makes tissues more susceptible to insulin, and block sugar absorption in small intestines |
|
|
Term
| what type of diabetics use antiglycemics? |
|
Definition
|
|
Term
| what are the critical values for glucose in the blood? |
|
Definition
| less than 50 OR more than 400 |
|
|
Term
| what could you do for a patient who is hypoglycemic? |
|
Definition
| 1. give IV blood sugar, if they are conscious you can give them something to eat, or give them an injection of glucagon |
|
|
Term
| how could an injection on glucagon help a hypoglycemic person? |
|
Definition
| stimulates the increase of glucose in bloodstream |
|
|
Term
| what are some environmental factors associated with DM? |
|
Definition
|
|
Term
| how could you help a hyperglycemic individual's bloos sugar return to normal or baseline? |
|
Definition
| insulin on a sliding scale |
|
|
Term
| what are the clinical manifestations of type 1 DM? |
|
Definition
| polyuria, polydipsia, polyphagia |
|
|
Term
| what does the "typical" type 1 diabetic look like? type 2? |
|
Definition
type 1: young (less than 30), more than likely 11-13 during puberty, skinny (because sugar is not being turned into fat) and Caucasian
Type 2: 40 or older, overweight at diagnosis and African American |
|
|
Term
| in comparison to type 1 DM, type 2's symptoms have a more FASTER or SLOWER onset? |
|
Definition
|
|
Term
| is is true that type 2 DM has a slower onset in teens and young adults? |
|
Definition
| false, not according to the growing trends |
|
|
Term
| what important factors should be assessed in your patient in regards to diabetes? |
|
Definition
| nutrition, exercise, medication, and balanced diet |
|
|
Term
| most likely to be type 1 or type 2 diabetes... patient under 30 years old |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient is African American |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient is overweight |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient is lean |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient is suffering from polydipsia, polyuria, ad polyphagia? |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient is feeling tired and irritable? |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient produces no insulin |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...80-90% of patient's beta cells are destroyed |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient has inherited insulin resistance |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient is susceptible to islet cell antibody development |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient has a decreased ability to secrete insulin |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient has possible chromosome 11 mutation |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient's liver has increased glucose production |
|
Definition
|
|
Term
| most likely to be type 1 or type 2 diabetes...patient may have chromosome 7,12, or 20 mutation |
|
Definition
|
|
Term
|
Definition
| by-product of fatty acid oxidation |
|
|
Term
|
Definition
| when glucose is unavailable or can't be used, the body begins to break down or oxidize fatty acids the by-product is ketones |
|
|
Term
| ketones affect __________ and cause __________ |
|
Definition
| LOC; dizziness and confusion |
|
|
Term
| why is a diabetic undergoing diabetic ketoacidosis often mistaken as being drunk? |
|
Definition
| ketoacidosis causes breath the smell fruity and like alcohol. the ketones affect LOC and cause dizziness and confusion |
|
|
Term
|
Definition
| diabetic ketaoacidosis; body metabolizes fats when sugar cannot be used or metabolized |
|
|
Term
| Microvasculture effects of diabetes on the vessels causes |
|
Definition
|
|
Term
| Microvasculture effects of diabetes on the vessels of the brain causes |
|
Definition
|
|
Term
| Microvasculture effects of diabetes on the vessels of the hands and feet causes |
|
Definition
| peripheral vascular disease |
|
|
Term
| Microvasculture effects of diabetes on the vessels of the eyes causes .....which leads to.... |
|
Definition
|
|
Term
| Microvasculture effects of diabetes on the vessels of the kidney causes |
|
Definition
| end stage renal disease (ESRD) and kidney failure |
|
|
Term
|
Definition
| lose feeling in extremities, burning and tingling |
|
|
Term
| patient's toes with diabetes can be subject to |
|
Definition
|
|
Term
| what factors can causes ulcers in the feet of diabetics? |
|
Definition
1. poor circulation
2. sugar in blood promotes bacteria growth |
|
|
Term
| what is a patient called that even with managing their diet, exercise, nutrition and medication that is STILL easy for their blood sugar to fluctuate? |
|
Definition
|
|
Term
| how does smoking exacerbate (make worse) the condition of diabetes? |
|
Definition
1. nicotine is a vasoconstrictor that can add on to the hypertension already caused my diabetes due to its microvasculture effects.
2. Nicotine decreases the ability to carry oxygen to tissues
3. causes insulin resistance, cholesterol, and risk for CV disease |
|
|
Term
| what are the 3 main lab tests used for the diagnosis of diabetes? |
|
Definition
1. fasting plasma glucose
2. random or casual plasma glucose
3. hemoglobin A1C |
|
|
Term
|
Definition
| have pt be NPO for 8 hours, give sugary solution, measure BS at different intervals. |
|
|
Term
| random or casual fasting plasma glucose |
|
Definition
| taken anytime of the day without regard to meals, must be over 200 twice |
|
|
Term
| hemoglobin A1C and the ideal value |
|
Definition
tells the amount of glucose attached to RBC over the past 120 days
ideal: Hgb A1C of less than 6% |
|
|
Term
| what is the goal of primary interventions in regards to diabetes? what can be done? |
|
Definition
| prevention! you can educate on weight control and stress education |
|
|
Term
| what the main goal of secondary interventions for diabetics? Type 1? Type 2? |
|
Definition
TREATMENT!
Type 1: insulin
Type 2: oral antiglycemics, diet, and exercise |
|
|
Term
| a person who is dizzy with an altered LOC, shaky and nauseous is in what glycemic state? |
|
Definition
|
|
Term
| a person who is experiencing polydipsia, polyphagia, and polyuria, has ketones in their urine from dipstick testing is in what glycemic state? |
|
Definition
|
|
Term
| at about what glucose level is critical where fat metabolism may begin taking place? what is the called? what is the treatment? |
|
Definition
| 400; diabetic ketoacidosis; insulin |
|
|
Term
| what are the rapid acting insulins? |
|
Definition
|
|
Term
| what are the short acting regular insulins? |
|
Definition
|
|
Term
| What are the intermediate-NPH insulins? |
|
Definition
| humulin N, novalin N, and lente |
|
|
Term
| what are the long acting insulins? |
|
Definition
|
|
Term
|
Definition
| how long after it was injected does it start to work |
|
|
Term
|
Definition
| how long after it was injected does it have its strongest affect |
|
|
Term
|
Definition
| how long does it keep working in the body |
|
|
Term
| How is insulin usually injected? On the body map out at what sites and regions you could give an insulin injection depending upon the type of insulin |
|
Definition
subQ injections are used for insulin
medium speed: arms
fast speed: abdomen and posterior flanks
slow speed:lower buttocks, anterior and posterior thigh |
|
|
Term
| what is the main goal of tertiary interventions? what can be done? |
|
Definition
REEDUCATION TO PREVENT FURTHER OCCURENCE
blood glucose monitoring, s/s of hyper/hypoglycemia, and medication administration |
|
|
Term
| what is often the problem with insulin in diabetes in general? |
|
Definition
| abnormal insulin production or impaired insulin utilization |
|
|
Term
| which type of diabetes is more prevalent? |
|
Definition
|
|
Term
| in which type of diabetes would there be antiobodies present at the Islets of langerhans? |
|
Definition
|
|
Term
| in which type of diabetes would there be possibly an excessive amount of insulin but a delayed secretion or reduced utilization? |
|
Definition
|
|
Term
| in which type of diabetes is the primary defect absent or minimal insulin production? |
|
Definition
|
|
Term
| in which type of diabetes is the primary defect insulin resistance and decreased insulin production overtime? |
|
Definition
|
|
Term
| what are the different types of diabetes? |
|
Definition
1. type 1
2. type 2
3. gestational
4. other specific types |
|
|
Term
| under normal conditions how is insulin released? when is there an increase? |
|
Definition
in small pulsatile increments (basal rate)
and increase occurs when food is ingested |
|
|
Term
| what counterregulatory hormones work to counter the effects of insulin? |
|
Definition
| glucagon, epinephrine, growth hormone, and cortisol |
|
|
Term
| how do counterregulatory hormones work? |
|
Definition
| increase blood glucose levels by stimulating glucose production and output from the liver and decreasing to movement of glucose into cells |
|
|
Term
| insulin is released from the _________ cells of the pancreas and then routed through the ________ where ________ is cleaved by enzymes to form insulin and _________. The insulin molecule is composed of two polypeptide chains, chain A and B which are linked by _______ ________. The presence of ________ ________ in serum and urine is a useful indicator of beta cell function. |
|
Definition
| insulin is released from the beta (β) cells of the pancreas and then routed through the liver where proinsulin is cleaved by enzymes to form insulin and C-peptide. The insulin molecule is composed of two polypeptide chains, chain A and B which are linked by disulfide bridges. The presence of C-peptide in serum and urine is a useful indicator of beta cell function. |
|
|
Term
| what is the precursor molecule of insulin? |
|
Definition
|
|
Term
| insulin promotes glucose transport from the _________ across the cell membrane into the ____________ of the cell. |
|
Definition
| insulin promotes glucose transport from the bloodstream across the cell membrane into the cytoplasm of the cell. |
|
|
Term
| is insulin a catabolic or anabolic steroid? |
|
Definition
| anabolic because it is a storage hormone because it causes glucose to enter cells, and promotes storage as glycogen in the liver and muscle |
|
|
Term
| what is a universal finding in patients with type 2 diabetes? |
|
Definition
| insulin resistance r/t inherited defect in insulin receptors |
|
|
Term
| what type of diabetes is immunemediated? |
|
Definition
|
|
Term
| in type 1 diabetes, what attacks the beta cells? |
|
Definition
|
|
Term
| in type 1 diabetes what causes a reduction of 80-90% of beta cell function before hyperglycemia and other manifestations occur? |
|
Definition
|
|
Term
| predisposition to type 1 diabetes is r/t |
|
Definition
| HLAs: human leukocyte antigens; HLA-DR 3 and 4. A viral infection will cause destruction of beta cells |
|
|
Term
| without insulin, a type 1 diabetic will develop |
|
Definition
|
|
Term
| condition where an individual is at risk for diabetes |
|
Definition
|
|
Term
| which type of diabetes has a tendency to run in families and probably has a genetic basis? |
|
Definition
|
|
Term
| what is the most powerful risk factor for the development of type 2 diabetes? |
|
Definition
|
|
Term
| what does metabolic syndrome do to your chances of developing type 2 diabetes? |
|
Definition
|
|
Term
|
Definition
| cluster of abnormalities that synergistically work to increase risk for CVD and DM |
|
|
Term
| what are the differences in the onset of symptoms in type 1 and 2 DM? |
|
Definition
| type 1 is abrupt while type 2 is gradual |
|
|
Term
| conditions that can lead to diabetes aften cause injury to the function or structure of |
|
Definition
|
|
Term
| what medications can induce diabetes in SOME people? |
|
Definition
| prednisone (a corticosteroid), phenytoin (Dilantin), thiazides (diuretic), and atypical antipsychotics |
|
|
Term
| fatigue, recurrent infections, recurrent yeast of candidal infections, prolonged wound healing and visual changes are S/S for what? |
|
Definition
|
|
Term
| the fasting plasma glucose BS level must be what in order to diagnose someone with DM? how long is the "fasting" |
|
Definition
| greater than or equal too 126 mg/dl; 8 hours |
|
|
Term
| what is the level of blood glucose that is an indication of DM in a 2 hour plasma glucose test? |
|
Definition
| greater than or equal too 200 mg/dl |
|
|
Term
| what are the two major glucose lowering agents? |
|
Definition
|
|
Term
| what are the classifications of insulin? |
|
Definition
1. rapid acting
2. short acting regular
3. intermediate NPH
4. long acting
5. combination |
|
|
Term
rapid acting insulin
Names:
O:
P:
D: |
|
Definition
humalog and novlog
O: 15 min
P: 60-90 min
D: 3-4 hours |
|
|
Term
short acting insulin
Names:
O:
P:
D: |
|
Definition
novolin R and humilin R, reliOn R
O: 30 min-1 hour
P: 2-3 hours
D: 3-6 hours |
|
|
Term
intermediate acting insulin
Names:
O:
P:
D: |
|
Definition
NPH (humalin N, novolin N, and reliOn N)
rapid acting insulin
O: 2-4 hrs
P: 4-10 hrs
D: 10-16 hrs |
|
|
Term
long acting insulin
Names:
O:
P:
D: |
|
Definition
lantus and levemir
O: 1-2 hours
P: no peak
D: 24+ hours |
|
|
Term
| of the 5 classifications of insulin, which ones are cloudy with the rest being clear? |
|
Definition
| cloudy: intermediate NPH (Humulin N, Novalin N, and ReliOn N) AND combinations |
|
|
Term
| the exogenous insulin regimen that most closely mimics endogenous insulin production is the |
|
Definition
|
|
Term
| intensive insulin therapy; the regimen? the goal? |
|
Definition
use of the basal-bolus insulin regimen. MDI: multiple daily insulin injections along with frequent self monitoring of glucose
Bolus: rapid and short acting before meals
Basal: intermediate and long acting once or twice a day
the goal is to achieve a near normal glucose level |
|
|
Term
| what are the mealtime insulins? when should they be given prior to the meal? |
|
Definition
rapid: 0-15 minutes before
short: 30-60 minutes before |
|
|
Term
| what are the background insulins used to maintain blood glucose in between meals and overnight? |
|
Definition
| intermediate and long acting |
|
|
Term
| what are glargine and detemir? Are they mealtime or background insulins? Can they be mixed? Can they be diluted? |
|
Definition
glargine:Lantus and detemir: Levemir
they are long acting insulins used for background (in between meals and overnight) NO they cannot be mixed or diluted. |
|
|
Term
1. list the peak times for the insulins
2. at peak time would you expect hyper or hypo glycemia? |
|
Definition
rapid: 60-90 min
short: 2-3 hours
inter: 4-10 hours
long: no peak!
can expect HYPOglycemia, its insulin!!!
risk for hypoglycemia with long acting insulins is greatly reduced because they have no peak |
|
|
Term
| what is the only basal insulin that can be mixed with short and rapid acting insulins and is cloudy? |
|
Definition
|
|
Term
| what are the basal insulins? can they be mixed? |
|
Definition
| long acting and intermediate, only intermediate can be mixed |
|
|
Term
| what are the bolus insulins? |
|
Definition
|
|
Term
| if an insulin is cloudy what must be done prior to drawing up the insulin but after injecting the appropriate amount of air into the vial? |
|
Definition
| gently agitate it but rolling it |
|
|
Term
|
Definition
| rapid-acting inhaled insulin |
|
|
Term
| what are the defects of type 2 diabetes? |
|
Definition
1. insulin resistance
2. decreased insulin production
3. increased hepatic glucose production |
|
|
Term
| DKA is most likely to occur in individuals with type ___ diabetes |
|
Definition
|
|
Term
| DKA leads to severe dehydration and depletion of electrolytes K, Cl, Mg, P, and Na. It also causes _______ which leads to more fluid and electrolyte losses. Eventually ________ and shock will ensue. The _________ will then cause __________, causing a retention of ketones and glucose and the acidosis continues. If untreated the patient becomes _________ from dehydration, electrolyte imbalance, and acidosis. If left untreated, _______ is inevitable. |
|
Definition
| DKA leads to severe dehydration and depletion of electrolytes K, Cl, Mg, P, and Na. It also causes vomiting which leads to more fluid and electrolyte losses. Eventually hypovolemia and shock will ensue. The hypovolemia will then cause renal failure, causing a retention of ketones and glucose and the acidosis continues. If untreated the patient becomes comatose from dehydration, electrolyte imbalance, and acidosis. If left untreated, death is inevitable. |
|
|
Term
|
Definition
| causes an alteration of the pH balance causing metabolic acidosis. |
|
|
Term
|
Definition
| when ketones are excreted in the urine which causes electrolyte depletion of cations as they are eliminated with the anionic ketones to maintain electrical neutrality. |
|
|
Term
| what are some clinical manifestations of DKA? |
|
Definition
| dehydration and loose skin turgor, nausea, dizziness, vomiting, Kussmaul respirations (rapid deep breathing, to reverse the acidosis by letting out more CO2), acetone on breath (sweet and fruity smell), ketones in urine, arterial pH less than 7.30 |
|
|
Term
| what is essential to obtain before giving insulin? and why? |
|
Definition
| serum potassium levels b/c if pt is hypokalemic, insulin would further decrease K levels |
|
|
Term
| rapid administration of IV fluids and rapid lowering of serum glucose can lead to |
|
Definition
|
|
Term
| hyperosmolic hyperglycemic syndrome (HHS) |
|
Definition
| occurs in pts with enough insulin production to prevent DKA but not enough to prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion |
|
|
Term
| most common intracellular electrolyte? extracellular? |
|
Definition
| K intracellular. Na extracellular |
|
|
Term
| insulin causes potassium to |
|
Definition
| go inside the cells; risk for hypokalemia |
|
|
Term
| occurs when there is too much insulin in proportion to available glucose in the blood |
|
Definition
|
|
Term
| once the plasma glucose level falls below 70 mg/dl, the neuroendocrine hormoes are released and the autonomic nervous system is activated. What two hormones are released? |
|
Definition
|
|
Term
| during hypoglycemia, epinephrine is released to combat the low blood sugar. what are its effects? |
|
Definition
| shakiness, palpitations, nervousness, diaphoresis, and pallor etc. |
|
|
Term
| true or false: hypoglycemia can affect mental functioning. why? |
|
Definition
| true! because the brain requires glucose |
|
|
Term
| true or false: hypoglycemia can mimic alchohol intoxication |
|
Definition
|
|
Term
Treatment for Hypoglycemia
CHECK
1.check pt blood glucose-
a. if more than 70, ______________
b. if less than 70, begin ______________
3. if no way to check blood glucose is around but patient presents symptoms-______________
TREAT
1. hypoglycemia is treated with ______________: 4-6 fruit juice, 8 oz soft drink, or low fat milk
2. avoid things with ______________ if you can like candy bars, cookies, and ice cream bc this slows sugar absorption
3. avoid overtreatment to prevent ______________
4.check blood gluose after 15 minutes
a. if still below 70, ______________ [15-20] g simple carb treatments] contact physician
I. if patient cannot swallow, give glucagon injection either IM or SubQ but ______________ injection is fastest. Because glucagon can cause nausea, ______________. Giving pt a ______________ after this can prevent ______________ that can be caused by glucagon.
II. if unable to respond to glucagon, give ______________
b. if above 70 allow pt to eat reguarly scheduled meals to prevent hypoglycemia. Give snacks like low-fat peanut butter, bread, or cheese and crackers
|
|
Definition
treatment for hypoglycemia:
CHECK
1.check pt blood glucose-
a. if more than 70, investigate other causes and S/S
b. if less than 70, begin hypoglycemic reatment
3. if no way to check blood glucose is around but patient presents symptoms-begin hypoglycemic treatment
TREAT
1. hypoglycemia is treated with 15-20 g of a simple fast acting carbohydrate: 4-6 fruit juice, 8 oz soft drink, or low fat milk
2. avoid things with fat if you can like candy bars, cookies, and ice cream bc this slows sugar absorption
3. avoid overtreatment to prevent hyperglycemia
4.check blood gluose after 15 minutes
a. if still below 70, after 2 or 3 [15-20 g simple carb treatments] contact physician
I. if patient cannot swallow, give glucagon injection either IM or SubQ but IM DELTOID injection is fastest. Because glucagon can cause nasea, turn pt on side until alertness is resumed.. Giving pt a complex carb after this can prevent hypoglycemic rebound that can be caused by glucagon.
II. if unable to respond to glucagon, give 20-50 mL 50% dextrose IV push
b. if above 70 allow pt to eat reguarly scheduled meals to prevent hypoglycemia. Give snacks like low-fat peanut butter, bread, or cheese and crackers |
|
|
Term
| chronic complications of diabetes are primarily those of end organ disease from ___________ that are secondary to |
|
Definition
| damage to blood vessels (angiopathy); secondary to chronic hyperglycemia |
|
|
Term
| chronic blood vessel dysfunctions secondary to diabetes are either |
|
Definition
|
|
Term
macrovascular complications
1. definition
2. diseases |
|
Definition
1. diseases of the large and medium sized blood vessels
2. cerebrovascular, cardiovascular, and PV disease |
|
|
Term
microvascular complications
definition and how it differs from macrovascular complications |
|
Definition
results from thinkening of the vessel membranes in the capillaries and arterioles in response to chronic hyperglycemia
specific to diabetes |
|
|
Term
| true or false: soaking a diabetic feet is a good thing |
|
Definition
| NO it increases chances of infection due to maceration (excessive softening of the skin) |
|
|
Term
|
Definition
| study of blood and blood forming tissue |
|
|
Term
| what organs are included in the study of hematology? |
|
Definition
| bone marrow, blood, lymph system, liver, and the spleen |
|
|
Term
| hematopoiesis and where does it take place? |
|
Definition
| blood cell production; bone marrow |
|
|
Term
| bone marrow and the two types; which one actively produces blood cells? |
|
Definition
| soft material that fills the central core of bones; yellow-adipose and red-hematopoetic; red marrow actively produces blood cells |
|
|
Term
| a nondifferentiated immature blood cell found in the bone marrow that responds to negative feedback and is stimulated various factors that causes diffrentiation of the stem cells into one of the committed hemopoietic cells |
|
Definition
|
|
Term
| a connective tissue that performs transportation, regulation and protection |
|
Definition
|
|
Term
|
Definition
| makes up 55% of the blood, composed primarily of water but also has proteins and gases, and nutrients. |
|
|
Term
|
Definition
| albumin, globulin and clotting factors, mostly fibrinogen |
|
|
Term
| a protein that helps maintain oncotic pressure in the blood |
|
Definition
|
|
Term
|
Definition
| compose 45% of the blood, RBC, WBC, and thrombocytes |
|
|
Term
what are the functions of:
1. RBC
2. WBC
3. Thrombocytes |
|
Definition
1. RBC: transportation/ acid-base balance
2. WBC: protection of the body from infection
3. Thrombocytes: promote blood coagulation |
|
|
Term
| stimulates the bone marrow to increase RBC cell production |
|
Definition
|
|
Term
|
Definition
| basophils, eosinophils, neutrophils, monocytes, and lymphocytes |
|
|
Term
| granulocytes and what they are also called |
|
Definition
| basophils, eosinophils, neutrophils; they are also called polymorphonuclear leukocytes |
|
|
Term
| agranulocytes and what they are called |
|
Definition
| monocytes and lymphocytes; mononuclear cells |
|
|
Term
| name the WBC in order of their prevalence |
|
Definition
N, L, M, E, B
Never Let Monkeys Eat Bananas
Neutrophil Lymphocyte Monocyte Eosinophil Basophil |
|
|
Term
| what is the primary function of granulocytes? |
|
Definition
|
|
Term
|
Definition
| inflammatory and allergic response; release heparin, histamine and serotonin |
|
|
Term
| what is the function (s) of the spleen? |
|
Definition
| stores RBC and platlets and removes old and defective RBCs from circulation, and filters out circulating bacteria, especially encapsulated organisms like gram-positive cocci |
|
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Term
|
Definition
| carries fluid from interstitial places to the blood which prevents edema and takes proteins and fats from the GI tract to the circulatory system |
|
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Term
|
Definition
| filter, produced procoagulants for hemostasis and coagulation, and stores excess iron |
|
|
Term
| what are the different types of blood? |
|
Definition
A, AB, B, and O
[all can be + or -] |
|
|
Term
| what types of blood can a person with type A blood receive? |
|
Definition
|
|
Term
| what types of blood can a person with type B blood receive? |
|
Definition
|
|
Term
| what types of blood can a person with type AB blood receive? |
|
Definition
|
|
Term
| what types of blood can a person with type O blood receive? |
|
Definition
|
|
Term
|
Definition
| loss of a large amount of blood in a short period |
|
|
Term
|
Definition
| decrease in concentration of blood elements |
|
|
Term
|
Definition
| destruction of RBC and removal or old and abnormal RBC from circulation |
|
|
Term
|
Definition
| decrease in RBC, WBC, and platelts |
|
|
Term
|
Definition
|
|
Term
| what are some causes of leukopenia? |
|
Definition
| medications, bleeding, cancer, and chemotherapy |
|
|
Term
|
Definition
|
|
Term
| what are the effects of aging in the levels of hemoglobin and nutritional intakes of Fe? |
|
Definition
|
|
Term
| decreased Hgb,RBC or hematocrit |
|
Definition
|
|
Term
what are the normal ranges of Hgb for a
male?
female? |
|
Definition
male: 13.5-18
female: 12-16 |
|
|
Term
| what are the different types of anemia? |
|
Definition
| aplastic anemia, thalassemia, iron deficiency, vitamin B12 deficiency, folic acid deficient, megaloblastic anemia, and hemolytic anemia |
|
|
Term
|
Definition
| peripheral blood pancytopenia |
|
|
Term
|
Definition
| may occur from inadequate dietary intake, malabsorption, blood loss, or hemolysis |
|
|
Term
| vitamin B12; what is relation to anemia? |
|
Definition
| cobalamin; a decrease can cause anemia |
|
|
Term
| what % of the WBCs are neutrophils? |
|
Definition
|
|
Term
| what % of the WBCs are lymphocytes |
|
Definition
|
|
Term
| what % of the WBCs are monocytes |
|
Definition
|
|
Term
| what % of the WBCs are eosinophils |
|
Definition
|
|
Term
| what % of the WBCs are basophils |
|
Definition
|
|
Term
| side effect of antihistamines |
|
Definition
|
|
Term
|
Definition
| reduce edema and pruitis (itching) |
|
|
Term
| what is the main problem in iron deficiency anemia? |
|
Definition
|
|
Term
| autosomal recessive disorder where there is an inadequate production of hemoglobin due to absent or deficient globulin protein that also involves decreased erythrocyte production |
|
Definition
|
|
Term
| what does vitamin C does the absorption of iron |
|
Definition
|
|
Term
|
Definition
| large RBC due to impaired DNA synthesis |
|
|
Term
|
Definition
| when intrinsic factor is not secreted by the gastric parietal cells so that cobalamin can not be absorbed. |
|
|
Term
| what is the most common cause of cobalamin deficiency? |
|
Definition
|
|
Term
| what could be a cause of megaloblastic anemia? |
|
Definition
| folic acid (folate) deficiency |
|
|
Term
| why is folic acid (folate) so important? |
|
Definition
| needed for DNA synthesis leading to RBC formation and maturation |
|
|
Term
| vitamin B12 and folic acid deficiency anemias are classifications of what type of anemia? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| sickle cell is an ______________ disease resulting in an abnormal form of ______________ . The resulting RBCs are stiffened, elongated, and cause low ______________ . |
|
Definition
| sickle cell is an inherited autosomal recessive disease resulting in an abnormal form of Hgb. The resulting RBCs are stiffened, elongated, and cause low O2 levels. |
|
|
Term
|
Definition
| vaso-occlusive conditions that lead to impaired blood flow, capillary hypoxia, tissue ischemia, and possible shock |
|
|
Term
| pain, swelling, headache, dizziness, SOB, and n/v are clinical manifestations of a hereditary disease of the blood cells that affects shape |
|
Definition
|
|
Term
| polycythemia; what does it lead to? |
|
Definition
| increased RBC which leads to impaired blood circulation; hypervolemia and hyperviscosity |
|
|
Term
|
Definition
| increased WBC, above 11,000 |
|
|
Term
| what is the normal range for WBC? |
|
Definition
|
|
Term
| prednisone and lithium can cause |
|
Definition
|
|
Term
| thrombocytopenia; some causes? |
|
Definition
| decreased platlets; alcohol, chemo, radiation,sepsis |
|
|
Term
|
Definition
| heparin induced thrombocytopenia: platlet destruction due to the use of heparin |
|
|
Term
|
Definition
| decreased coagulation factor |
|
|
Term
|
Definition
| disseminated intravascular coagulation: bleeding disorder from depletion of platelets and clotting factors |
|
|
Term
| what are 3 blood cancers? |
|
Definition
| leukemia,lymphoma, and mutiple myeloma |
|
|
Term
|
Definition
| red or purplish spots caused by minor hemorrhaging due to broken capillary vessels |
|
|
Term
|
Definition
|
|
Term
|
Definition
| localized collection of blood outside of the vessel |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| erythrocyte sedimentation rate: measures how much time RBC take to settle in a normal saline or plasma solution. Faster can mean an infectious process. In diabetics it will be increased. |
|
|
Term
| what are the diagnostic tests for hematology? |
|
Definition
| CBC, ESR, TIBC, Rh Factor, and Blood type |
|
|
Term
| what are the components of a CBC? |
|
Definition
RBC [4-6 x10^6]
Hgb: M [13.5-18] F [12-16]
Hct: M [42-52] F [37-47]
Platlets: [140,000-500,000]
WBC: [4,300-10,800]
Neutrophils [4,000-11,000]
N-60-70%, L-20-25%, M-3-8%, E-2-4%, B-.5%-.1% |
|
|
Term
|
Definition
partial thromboplastin time
for heparin therapy
60-70 seconds |
|
|
Term
|
Definition
prothrombin time: assess therapeutic levels of Coumadin
11-12.5 seconds |
|
|
Term
|
Definition
| international normalized ratio: standardized method of reporting results of blood coagulation results internationally; ideal is 2-3 |
|
|
Term
|
Definition
| present at birth, nonspecific, and involves neutrophils and monocytes |
|
|
Term
|
Definition
| development of immunity either actively or passively |
|
|
Term
|
Definition
| invasion of the body by foreign substances and a subsequent development of antibodies and sensitized lymphocytes |
|
|
Term
|
Definition
| recieving antibodies rather than making them |
|
|
Term
| being inoculated with a vaccine or being naturally affected by a disease is a form of what type of immunity? |
|
Definition
|
|
Term
| an injection of human gamma globulin |
|
Definition
|
|
Term
| transplacental and colustrum transfer from mother to child |
|
Definition
|
|
Term
|
Definition
| substance that elicits a response |
|
|
Term
| central & peripheral lymphoid organs |
|
Definition
central:thymus & bone marrow
peripheral:spleen, tonsils, and lymphoid tissues |
|
|
Term
| lymphocytes are created in the bone marrow and then migrate to the _________ where its main job is too _________ and ________ T lymphocytes. |
|
Definition
| thymus, differentiate and mature |
|
|
Term
|
Definition
| important in the differentiation of T lymphocytes and their maturation. Important in cell-mediated response |
|
|
Term
| what happens to the size of the thymus with age? |
|
Definition
| in a child it is large and it shrinks with size |
|
|
Term
| two important functions of lymph nodes |
|
Definition
| filtration of foreign material brought to the site and circulation of lymphocytes |
|
|
Term
|
Definition
| primary site for filtering out antigens in the blood. Has B and T lymphocytes, RBCs and macrophages |
|
|
Term
|
Definition
| lymphoid tissue that protects the body surface from microorganisms |
|
|
Term
| mononuclear phagocytes are responsible for capturing, processing, and presenting antigens to ______ and ____________ that then trigger an immune response |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what do B lymphocytes differentiate into when activated? In turn what do these produce? |
|
Definition
|
|
Term
| cells that migrate from the bone marrow to the thymus are |
|
Definition
|
|
Term
| what are the two types of T cells? |
|
Definition
Cytotoxic T cells (CD8)
Helper T Cells (CD4) |
|
|
Term
| natural killer cells are involved in which type of immunity? Are they T or B cell? What are they involved in? |
|
Definition
| cell-mediated; neither; killing of virus infected cells, tumor cells, and transplanted grafts |
|
|
Term
During the beginning (acute) phase of inflammation, particularly as a result of bacterial infection, environmental exposure,[4] and some cancer, are one of the first-responders of inflammatory cells to migrate towards the site of inflammation. They migrate through the blood vessels, then through interstitial tissue, following chemical signals such as Interleukin-8 (IL-8), C5a, and Leukotriene B4 in a process called chemotaxis. They are the predominant cells in pus, accounting for its whitish/yellowish appearance.
are recruited to the site of injury within minutes following trauma and are the hallmark of acute inflammation. |
|
Definition
|
|
Term
|
Definition
| soluble factors secreted by WBCs that act as messengers between the cell types for proliferation, diffrentiation, secretion, and activity |
|
|
Term
|
Definition
| antibody-mediated immunity |
|
|
Term
| cell mediated immunity vs humoral immunity |
|
Definition
| cell mediated initiated through specific antigen recognition by T cells and humoral is through B cells |
|
|
Term
| what are the effects of aging on the bone marrow? what however does decrease causing a suppressed humoral immunity response? |
|
Definition
| no changes to bone marrow, immunoglobin supression |
|
|
Term
| hypersensitivity reactions; what is an example? |
|
Definition
hypersensitivity reactions: overactive immune response against antigens that attacks own tissues causing damage
autoimmune disease is a hypersensitivity reaction, you react against your own antigens bc you failed to recognize your own proteins |
|
|
Term
| how many types of hypersensitivity reactions are they? Which are humoral, which are cell-mediated? |
|
Definition
| I-IV; I-III are humoral, IV is cell mediated |
|
|
Term
|
Definition
| type I hypersensivity reaction can be immediate and life-threatning, death will occur without treatment |
|
|
Term
|
Definition
| has been effectively used to treat autoimmune diseases; separates blood and removes on the components |
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