Term
|
Definition
Diagnostic/Exploratory
Curative
Palliative
Cosmetic Improvement
Preventative |
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Term
| When does preoperative care begin? |
|
Definition
| When patient realizes the need for surgery and determines they will indeed have the surgery |
|
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Term
| Details of the Informed Consent |
|
Definition
Can only reiterate what the surgeon says.
Pt. should be alert and aware of what is being signed. |
|
|
Term
| Who makes up the surgical team? |
|
Definition
| Anesthesiologist, surgeon, circulating nurse, scrub nurse |
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Term
|
Definition
| lack or normal pain sensation |
|
|
Term
|
Definition
| the absences of awareness of stimuli and events |
|
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Term
|
Definition
| partial or complete loss of sensation with or with out loss of consciousness |
|
|
Term
|
Definition
Balanced Technique
-begin with IVP of barbituates-pleasant sleep
-inhalation of gas
-continue with adjuncts
(opiods narcotics, benzodiazapines, neuromuscular blocking agents) |
|
|
Term
|
Definition
Used in OR
-combination of medications to achieve depressed LOC
-patient retains airway reflex and responds to verbal or physical stimulation |
|
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Term
|
Definition
Block's patient's sensory and motor function by interrupting nerve impulses
-pt. remains fully conscious |
|
|
Term
| Methods of Local Anesthesia |
|
Definition
Topical
Regional
Spinal & Epidural |
|
|
Term
| Side Effects of Spinal and Epidural |
|
Definition
| hypotension, bradycardia, nausea, vomiting, tingling in hands, numbness above site, respiratory depression |
|
|
Term
|
Definition
| increased CO2, muscle contractions, hyperthermia, hypoxia, arrhythmias, cardiovascular changes |
|
|
Term
| Immediate Assessments Post-Op |
|
Definition
| Airway, breathing, circulation, neurologic, LOC, ability to follow commands, Urine output, Surgical Site, BG of diabetic patients |
|
|
Term
|
Definition
lack of blood flow to the vital organs r/t low fluid volume
s/s: pallor, low BP, High HR |
|
|
Term
| Nursing Interventions for Hemorrhaging |
|
Definition
Apply pressure to area with gloved hand
Reinforce surgical dressing
-DO NOT remove the first surgical dressing |
|
|
Term
|
Definition
| DVT that traveled to the lungs |
|
|
Term
|
Definition
| Surgery, immobility, fracture, heart failure, chronic AFib, obesity, advanced age, oral contraceptive use, estrogen therapy. |
|
|
Term
| Clinical Manifestations of PE |
|
Definition
Subjective: anxiety, feeling of impending doom, pressure in chest, pain on inspiration, dyspnea, air hunger
Objective: pleurisy, tachycardia, hypotension, tachypnea, crackles and cough, diaphoresis, decreased O2 Sat. Petechiae, pleural effusion. |
|
|
Term
|
Definition
| Pulmonary Hypertension, pulmonary infarction (tissue death), Cor Pulmonary (hypertrophty of right ventricle) |
|
|
Term
|
Definition
Ventilation Perfusion Scan-checks circulation and gas distribution
D-dimer blood test
Coagulation and ABG's
Angiography
CXR, EKG |
|
|
Term
|
Definition
Morphine Sulfate-pain and anxiety
Vasopressors-shock (dopamine)
Digitalis & Diuretics - heart failure
Heparin/Coumadin
Fibrinolytic Therapy like tPA |
|
|
Term
| Surgical Treatment for PE |
|
Definition
Pulmonary Emboletomy- for large clots
Insertion of Filter -for prevention of further PE, CVA, etc. |
|
|
Term
|
Definition
Small cell carcinoma (25%, fast growth and spread)
Non-small cell carcinoma:
- Adenocarcinoma
- Squamous cell carcinoma
- Large Cell carcinoma |
|
|
Term
|
Definition
| Chronic Cough, hemoptysis, wheezing, SOB, dull chest pain, weight loss, anorexia, fatigue, weakness, paraneoplastic syndrome (hormones released the affect endocrine and autoimmune systems) |
|
|
Term
|
Definition
| CXR, sputum analysis, bronchoscopy with biopsy, CT, CBC, LFTs, electrolytes, PPD, PFTs, ABGs |
|
|
Term
|
Definition
Combo: particularly effective of small-cell
Surgery: non-small cell, 30% chance of cure
Radiation: may be used to treat vena cava syndrome
Bronchodilators
Analgesia and pain meds
CAM |
|
|
Term
| Primary Risk Factors R/t Breast Cancer |
|
Definition
Female, >50
prior breast cancer, atypical hyperplasia, carcinoma
1rst degree relatives with breast cancer
BRCA1 and BRCA2 mutation |
|
|
Term
| Secondary Risk Factors R/t Breast Cnacer |
|
Definition
Post menopausal obesity
early menarche or late menopause
1rst full term pregnancy >30 y.o.
Chest radiation <35 y.o.
Benign breast disease
hormone replacement
more than 2+ alcoholic beverages/day |
|
|
Term
| Noninvasive Breast Cancer |
|
Definition
Cancer in Situ= localized cancer
Ductal carcinoma= tends to be unilateral, may progress if untreated, most commmon
Lobular carcinoma in situ (LCIS)= premalignant lesion, often do not require treatment |
|
|
Term
|
Definition
Persistent lesion of nipple and areola with or without palpable mass.
s/s: itching, burning, nipple discharge with superficial erosion, ulceration
TX: simple or modified mastectomy |
|
|
Term
| Inflammatory Breast Cancer |
|
Definition
Most malignant, most rare
Aggressive and fast growing
Skin is rippled, warm and has thickened appearance
-inflammatory changes caused by cancer cells blocking lymph channels
-metastasis occur early and widely
-radiation, chemo, hormone therapy |
|
|
Term
| Diagnosis of Breast Cancer |
|
Definition
| Biopsy, Sentinel lymph node dissection (where it is likely to go next), axillary lymph node status, estrogen and progesterone receptor status, DNA content analysis, Her2 status, cell proliferation indices, CXR, CT of abd., Liver US, Bone scan |
|
|
Term
| Breast Conservation Therapy |
|
Definition
Lumpectomy
Partial Mastectomy |
|
|
Term
|
Definition
Total (simple) mastectomy
Modified radical mastectomy
Radical mastectomy |
|
|
Term
|
Definition
results from excision or radiation of lymph nodes, fluid causes obstructive pressure
S/S: swelling, heaviness, pain, impaired motor function, numbness/paresthesia of fingers |
|
|
Term
|
Definition
Frequent and sustained elevation of arms
Performing arm exercises
Avoid constricting clothes
Custom fitted pressure sleeve |
|
|
Term
| Breast Conservation Surgery |
|
Definition
Removal or entire tumor along with margin of normal tissue
-radiation delivered to entire breast following surgery
-Preserves breast including nipple
-considered standard treatment for early stages |
|
|
Term
| Modified Radical Mastectomy |
|
Definition
Removal of breast and most axillary lymph nodes
-preserves pectoralis major
-selected in tumor is too large to excise with good margins
-patient has option for reconstruction |
|
|
Term
| Postmastectomy pain syndrome |
|
Definition
chest and upper arm pain, phantom breast pain, tingling down the arm, numbness, shooting or pricking pain, unbearable itch.
TX: NSAIDS, antidepressants, topical lidocaine patches, EMLA, antiseizure meds. |
|
|
Term
|
Definition
Primary treatment to destroy or as companion to surgery
-shrink tumor
-palliative treatment to pain from local metastases recurrence. |
|
|
Term
|
Definition
-can decrease the size of the primary tumor
Suppresses tumor growth and prolongs survival
-often a combination of medications
-often for premenopausal women |
|
|
Term
|
Definition
Often for postmenopausalwomen
-blocks or destroys estrogen receptors
-EX: tamoxifen: reduces recurrence by 50% but carries the risk of uterine cancer
-Femara: reduces recurrence after surgery |
|
|
Term
|
Definition
for Her2+ tumors with mets
-attempts to stimulate the body's natural defenses and attack cancer cells
-trastuzmab :monoclonal antibody MAb to Her-2 antigen
-maybe given in combination to increase survival time
Side effects: cardiomyopathy, anaphylaxis, dyspnea, neutropenia exacerbation |
|
|
Term
|
Definition
3rd most common cancer diagnosed.
-most often from adenocarcinoma
tumors spread through the walls of the intestines or through the lymphatic or circulatory systems.
metastasis to lymph nodes is common. |
|
|
Term
| Clinical Manifestations of Colorectal cancer |
|
Definition
not specific and may not be noticeable until cancer has advanced. (5-15 years)
-early: change in bowel habits, rectal bleeding that leads to anemia.
-advanced: pain, anorexia, weight loss, palpable abdominal or rectal mass. |
|
|
Term
|
Definition
Diet: high it fruits and veggies, low in saturated fats, avoid red meats.
Exercise
Healthy Weight
Limit Alcohol
No smoking |
|
|
Term
| Diagnoses of Colorectal cancer |
|
Definition
| Family Hx., physical, sigmoidoscopy, colonoscopy, digital rectal exam, CXR, CT, MRI,US, CBC, CEA |
|
|
Term
| Stage 1 Colorectal Cancer |
|
Definition
tumor invaded submucosa or muscle
no metastasis |
|
|
Term
| Stage 2 Colorectal Cancer |
|
Definition
| Tumor through mucosa, perforates, not metastasis |
|
|
Term
| Stage 3 Colorectal Cancer |
|
Definition
| Any tumor invasion, 1-3 regional metastasis |
|
|
Term
| Stage 4 Colorectal Cancer |
|
Definition
| any tumor invasion, regional metastasis, distant metastasis |
|
|
Term
| Treatment of Colorectal Cancer |
|
Definition
Endoscopic polpectomy
Laser photocoagulation
Surgical therapy: hemicolectomy, resection, colostomy
Radiation, chemotherapy (5FU, Leucovorin, Camptosar) |
|
|
Term
|
Definition
| Permanent loss of blood flow to the myocardium resulting in cell death (irreversible damage) |
|
|
Term
|
Definition
| secondary channels used after a portion of the vessels are occluded |
|
|
Term
|
Definition
labeling is based on location
Location corresponds with the coronary artery.
-anterior wall MI= Left anterior descending coronary artery (LAD)
-Inferior wall MI: right coronary artery |
|
|
Term
|
Definition
| decrease in myocardial oxygen supply or increased oxygen demand, reversible, no permanent damage |
|
|
Term
| Clinical manifestations of MI |
|
Definition
angina: immobolizing, more intense, continuous, long lasting.
No change related to rest, nitrate or position change
heaviness, pressure, tightness, burning
Levine's sign: fist to chest
fatigue, SOB, indigestion, weakness, drenching perspiration, back pain |
|
|
Term
|
Definition
P= What precipates the pain? exertion? resting?
Q= quality of the discomfort, sharp, tightness, etc.
R= does pain radiate to te jaw, arm, back, etc.
S= severity (pain scale)
T= timing of onset of the current episodes and previous episodes |
|
|
Term
| Physical Assessment with MI |
|
Definition
Vitals: initially rapid HR and high BP but decreases causing hypotension and bradycardia, tachypnea, SOB, fever
BG: elevated
Skin:cool, pallor, clammy
Resp: crackles
Heart: distant hear sounds, develop. S3 or S4
GI: nausea, vomiting
Neuro: fatigue, dizziness, light-headed |
|
|
Term
|
Definition
Clinical hx of ischemia, ECG, Serum Cardiac Markers
(must have 2/3 for World health organization)
elevated cardiac enzymes |
|
|
Term
| Serum Cardiac Markers: Troponin T and I |
|
Definition
Troponin T (<.2 normal) and Troponin I (<3.1 normal)
-proteins released from the cardiac muscles due to necrosis , elevated 2-4 hrs. after MI, peak at 24 to 36 hrs.
-measured at time of admission and for 3 days following |
|
|
Term
| Serum Cardiac Markers: Ck and Ck-MB |
|
Definition
CK: Creatine Kinase-found in cardiac and skeletal muscles, elevated after MI for 4-6 hrs. peak 12-24, duratioin 48-72
CK-MB myocardial bands
-most sensative test for MI, present at 4-8 hrs, peak 18-24 hrs, duration 72 hrs. |
|
|
Term
| Serum Cardiac Markers: Myoglobin |
|
Definition
first to be elevated, non-specific tissue (found in cardiac and skeletal muscle)
elevated within 1-3 hrs, peaks at 12hrs, duration 24 hrs. |
|
|
Term
|
Definition
| nitroglycerin, beta-adrenergic blockers, anti-coagulant, antiplatelet, morphine, ACE inhibitor, Antidysrhthmia |
|
|
Term
|
Definition
| Arrythmia, CHF, Cardiogenic shock, papillary muscle disfunction, pericarditis, dressler syndrome |
|
|
Term
|
Definition
| Cardiac Catheterization, balloon angioplasty, stent implantation, atherctomy |
|
|
Term
|
Definition
focal deposits of cholesterol and lipids within the intimal wall of the artery
-lipids are entrapped in the endothelium and then calcify, platelets and adhere and clots form
-slow, progressive disease |
|
|
Term
|
Definition
coronary arteries are unable to dilate to meet increaed metabolic needs because they are already dilated beyond the obstructed area.
-ischemia occurs at >70-75%
reversible if <30 minutes |
|
|
Term
| Risk factors associated with CAD |
|
Definition
nonmodifiable: age, gender, genetics, race (more common in AA)
Modifiable: hypertension, DM, central obesity, smoking/second hand smoke, physical inactivity, elevated homocysteine levels, premature menopause, diet high in trans, saturated fat and triglycerides. |
|
|
Term
|
Definition
| CAD may lead to decreased O2 supply which leads to ischemia, which leads to anaerobic metabolism that produces lactic acid and causes chest pain. |
|
|
Term
|
Definition
pressure, pain, heavy sensation, suffocating, choking, does not change with position, or deep breath.
-also: indigestion, burning sensation, SOB, anxiety, cold sweat, weakness, paresthesis |
|
|
Term
|
Definition
| indigestion, nausea, vomiting, upper back pain, dyspnea, pallor, tachycardia, anxiety, fear |
|
|
Term
|
Definition
| does not occur with regular activity |
|
|
Term
|
Definition
| may occur with rapid or prolonged walking or stair climbing |
|
|
Term
|
Definition
| Significantly limits ordinary physical activity |
|
|
Term
|
Definition
| may have pain at rest along with during any physical activity |
|
|
Term
| Treatment of Stable Angina |
|
Definition
Nitrates, Calcium Channel Blockers, Beta Adrenergic Blockers
-goal is to decrease o2 demand and increase o2 supply |
|
|
Term
|
Definition
decrease heart work and O2 demand
-dilation
-decreased blood return to the heart
-decreases cardiac output
-decreases work load of the heart
-decreases o2 demand |
|
|
Term
|
Definition
blocks beta receptors on heart cells
-decreases HR and contractility
-decreased oxygen demand and blood pressure
*not for Asthma or COPD |
|
|
Term
|
Definition
block calcium ions to the heart
-decrease O2 consumption by relaxing arterial smooth muscle
-decreases BP and HR
-provides more O2 by dilating coronary arteries |
|
|
Term
|
Definition
may be a new onset or progression from stable to unstable.--EMERGENCY!
progressive and preinfarction in nature**
unpredictable, change in pattern of angina, increased frequency, easily provoked, lasts >10 minutes |
|
|
Term
|
Definition
| STAT ASA (chewable), Nitroglycerin (IV), beta blockers (IV) Heparin (IV), morphine (IVP) |
|
|
Term
|
Definition
occurs at rest, in response to spasm
-rare, not precipated by physical exertion
-triggered by smoking, demand for histamine, epinephrine, norepiniphrine, prostaglandins. |
|
|
Term
|
Definition
| Occurs while lying down, relieved by sitting up. |
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