Term
| platelet count in the body |
|
Definition
|
|
Term
| erythrocyte count in the body |
|
Definition
|
|
Term
| lymphocyte count in the body |
|
Definition
|
|
Term
| esinophils are elevated when |
|
Definition
| there is AG/AB complexes to ingest, there is an allergic reaction, or parasitic infection |
|
|
Term
| basophils are apparent when |
|
Definition
| there is a immune response releases heparin, serotonin, histamine, and bradyakins |
|
|
Term
| what do the T and B cells do |
|
Definition
B cells release antibodies
T cells recognize |
|
|
Term
|
Definition
|
|
Term
|
Definition
120 days
10 days and 1/3 are in the liver |
|
|
Term
|
Definition
|
|
Term
| secondary lymphatic organs |
|
Definition
| spleen, peyers patch, tonsils, lymph nodes |
|
|
Term
|
Definition
| destroys old RBC, stores platelets, breaks down hemoglobin, filters antigens |
|
|
Term
| what are the three hemodynamic changes with aging |
|
Definition
| bone marrow produces fewer cells, RBC's and WBC's decrease, slower acid base response |
|
|
Term
| what signs, and assessment findings, would you see with hemodynamic changes with age? |
|
Definition
signs include: bleeding, infections, loss of mobility
assessment findings include: lack of WBC and RBC, cold, tired, pale, Shortness of breath, UTI, respiratory infections. |
|
|
Term
| what is included in a CBC |
|
Definition
hemoglobin
hematocrit
total RBC count
MCV, and MHV
NOT PLATELET COUNT!! |
|
|
Term
| blot test usually blood is blotted for intervals of 30 seconds and clots in between |
|
Definition
|
|
Term
|
Definition
|
|
Term
| normal INR is ? you take patients PT snd divide it by normal PT to get this. WHat is Coumadin goal for INR |
|
Definition
|
|
Term
| bone marrow biopsy taken from |
|
Definition
|
|
Term
| what should you tell the patient about how a bone marrow biopsy will feel |
|
Definition
| heavy pressure, and crunching sound, you need to watch for bleeding at the site and use ice for pain. |
|
|
Term
| what problems can create iron deficiency anemia? |
|
Definition
| chronic bleeding, menstrual blood loss, less than 1mg a day of iron,malabsorbtion or increase demand from lactation. |
|
|
Term
| what conditions make sickle cell disease worse |
|
Definition
| anything that decreases the bodys oxygenation: hypoxia, dehydration, infection, pregnancy, alcoholism, high altitiudes, cold, acidosis, exercise, anesthesia |
|
|
Term
| sickle cells only live for |
|
Definition
| 12-15 days and when the oxygen is restored the cells go back to normal they are just twisted from original shape. |
|
|
Term
| how can you get sickle cell disease |
|
Definition
| it is an autosomal recessive disease you inherit the gene from BOTH parents and 80-100% of all of your total Hb contains HbS. |
|
|
Term
| clinical signs of sickle cells crisis 16? |
|
Definition
pain
SOB
fatigue
heart failure, murmors S3
tachycardia
hypotension
priapism
cyanosis, pale palms and soles, nail beds, and bluish conjunctive
jaundice
open sores on extremedies
abdominal changes ( decreased blood supply)
MI, HF, PE
renal disease with elevated protein in the urine
muscoskeletal pain, swelling
strokes and seizures due to infarcts
depression, from passing to children
enlarged spleen and liver
headache |
|
|
Term
|
Definition
|
|
Term
with sickle cell crisis the
- hematocrit is ---
- bilirubin is ---
-WBC count is ---
reticulocyte counts is --- |
|
Definition
low
high
high due to chronic inflammation
high |
|
|
Term
| treatment for pain for sickle cell disease |
|
Definition
morphine
dilaudid
hydroxurea - decreases sickle cell episodes
NSAIDS
- warm compress
- hydration (IV, or PO). |
|
|
Term
| treatment for sickle cell patients |
|
Definition
PROTECT FROM INFECTION
aseptic technique
oxygen
fluids
avoid events where there is risk for infection |
|
|
Term
| education for sickle cell patients |
|
Definition
avoid large crowds and planes
no straneous exercise
3-4 L of fluid/ day
no alcohol or smoking= vasconstriction |
|
|
Term
| WBC disorder that results in uncontrolled growth of immature WBC in the bone marrow. The bone marrow becomes crowded with immature WBC and the normal cell production is decreased. This is seemed to be causes by a genetic defect ( downs syndrome, radiation, chemotherapy, bone marrow hypoplasia). |
|
Definition
leukemia
acute and chronic
lymphocytic or myelocytic |
|
|
Term
| the type of leukemia is mostly common type |
|
Definition
acute myelocytic leukemia
AML |
|
|
Term
| this type of leukemia has the philidelphia chromosome present and is most common in children |
|
Definition
| ALL acute lymphocytic leukemia |
|
|
Term
| this type of leukemia is the rarest and survivial rate is less than 19 months for advanced |
|
Definition
| CLL chronic lymphocytic leukemia |
|
|
Term
|
Definition
| chronic myelocytic leukemia it is most common in adults and has the philidelphia chromosome in it. ( slow progressing 10%, accelerated 10-30% fever wt loss spleen enlargment, blast 30%) |
|
|
Term
| cardiovascular signs of leukemia |
|
Definition
poor tissue perfusion
decrease capillary refill
increased heart rate
decreased blood pressure
murmors and bruits |
|
|
Term
| respiratory signs of leukemia |
|
Definition
shortness of breath
respirations increase
fatigue
weakness
hypoxia
risk for respiratory infection |
|
|
Term
| bleeding and tissue signs of leukemia |
|
Definition
ecchymosis, petechiae
cool to touch
pale, cyanosis
bleeding of gums, urine, rectum, nose bleed, menstrual
open sores that don't heal |
|
|
Term
|
Definition
wt loss
fever
nausea, anorexia
constipation and reduced bowel sounds
spleen and organ enlargement
joint pain and stiffness- from swelling in bone marrow. |
|
|
Term
| what are the two greatest risks for a leukemia patient |
|
Definition
risk for infection
risk for bleeding |
|
|
Term
| process of acute drug therapy for leukemia |
|
Definition
induction- aggressive chemo
consolidation- another course of the same drug or different drugs to put them into remission
maintaince- months to years, take medication to keep in remission |
|
|
Term
| what are the neutropenic precautions for a leukemia patient |
|
Definition
no flowers in the room
no fresh fruit or vegtables
HEPA room
handwashing before entering the room
patient will wear a mask out of the room or when cleaning is being done in the room
aseptic techniques
no ice from the machine either canned or frozen food.
THEY WANT ANC TO BE AT LEAST 500 before going home |
|
|
Term
| what are the 5 phases of a bone marrow transplant |
|
Definition
obtaining the cells ( from iliac crest 500-1000 aspirated or from PBSC taken 1-5 times to get enough stem cells).
conditioning- radiation BID for 3 days, and chemotherapy
transplantation- day zero frozen stem cells infused through central line
engraftment- take in new cells and rescue old 8-12 days for PBSC and 12-28 for bone transplant
recovery- |
|
|
Term
| what medications are given before transplantationand why |
|
Definition
| because of fever and hypertension Benadryl and Tylenol are given |
|
|
Term
| what are some common complications with stem cell transplants |
|
Definition
1. failure to engraft- two few cells or body rejects the new cells
2. VOD- veno occlusive disease. blockage of liver blood vessels by clotting and inflammation. signs of liver failure
3. GVHD: graft vs. host disease; skin starts to peel off, fever, diarrhea, enlargement of liver; allogenic transplant cells attack host cells, attack skin, GI, and live give immunosuppresents (Imuran, prograft, cellcept). |
|
|
Term
| type of cancer that occurs in lymph nodes and spleen |
|
Definition
|
|
Term
| what are the clinical signs of lymphomas? |
|
Definition
large painless lymph nodes, often in the neck
-fever
-night sweats
-wt loss |
|
|
Term
| what type of lymphoma progresses in a non-orderly fashion, common in transplant patients, HIV patients, and other cancer patients, and are classes as B or T cell lymphoma |
|
Definition
non-hodgkins lymphoma
they don't contain reed-Sternberg cell |
|
|
Term
| diet for leukemia patient |
|
Definition
| increase calories and protein diet. |
|
|
Term
| what cells grow fast in the body |
|
Definition
| skin, mucous membranes, hair, bone marrow, lining of organs, GI tract, Bladder |
|
|
Term
| do cancer or normal cells have a large cell to nucleus ratio |
|
Definition
|
|
Term
| the four steps of cancer development |
|
Definition
initiation- something enters the cells and turns off its genes. Carcingenes then enter the cells and turn them on but they have to under go promotion in order to divide
2. promotion- once initiated the cells go into a latency period for months or years until the cells grow. Promotors enhance cell growth
3. progression: grows the a detectable point 1 cm tumor has 1 billion cells, Tumor develops it own angiogenesis factor TAF, change to have fewer normal cells, Primary tumor identitified and pushes out the normal cells
4. metathesis: |
|
|
Term
| breast cancer cells migrate to the |
|
Definition
|
|
Term
| prostate cancer migrates to the |
|
Definition
|
|
Term
| where does colorectal cancer migrate to |
|
Definition
|
|
Term
|
Definition
|
|
Term
| secondary leading cause of cancer deaths in men and women |
|
Definition
|
|
Term
| third leadin cause of cancer deaths |
|
Definition
|
|
Term
| grading cancer cells means |
|
Definition
| looking at the cancer cells appearance compared to the normal cells |
|
|
Term
|
Definition
1. well differentiated slow growing
2. still resembles normal cell
3. not differentiated but can can tell where cell came from
4. no normal cell appreance |
|
|
Term
|
Definition
determines the location of the tumor and metathesis TNM
To= no tumor, Tis= tumor in situ, T1-4
No= no nodes, N1-4
Mo= no metatheisis M1=distant metathesis |
|
|
Term
| what is the single most important risk factor for cancer |
|
Definition
|
|
Term
|
Definition
stress
age
radiation
environmental factors
genetics
viruses (HIV, Epstein barr, HepB)
excess fatty food, red meats, alcohol, nitrates |
|
|
Term
| what food should you eat to avoid cancer |
|
Definition
| vitamin A and C, more bran and cruciferous vegtables |
|
|
Term
| 7 warning signs of cancer |
|
Definition
-Changes in urine or bowel habits
-A sore that doesn't heal
-Unusual bleeding or discharge
- Thickening or lump in the body
-I ndigestion or inability to swallow
- O- bvious change in wart or mole
- Nagging cough or horesness |
|
|
Term
| how does untreated cancer alter the GI tract |
|
Definition
impairs absorbtion
causes obstruction
increases metabolic rate and need for proteins and carbs
may spread to liver
malnutrition (anorexia, cachexia)
changes in taste
stomatitis ( mouth ulcer)
mucosititis (GI ulcer)
loss of teeth and dysphagia with radiation
enterititis and fistula formation with radiation therpay |
|
|
Term
| how does untreated cancer affect motor and sensory function |
|
Definition
invades the bones, brain, or compresses nerves
- causes fractures, spinal cord compressions, hypercalcemia
- cognitive function may be impaired by tumor or chemotherapy. |
|
|
Term
| what respiratory problems can arise from untreated cancer |
|
Definition
blockage/ obstruction in the lungs
- tumor presses on blood vessels and causes increased edema from blockages |
|
|
Term
| with what kind of therapy does the patient feel like they are heating from the inside out and you premedicate for nausea and give decadron |
|
Definition
|
|
Term
|
Definition
| type of radiation; it is a beam of radiation does not touch patient so they are not radioactive |
|
|
Term
|
Definition
| close or short dose of radiation in or touches the patient the patient is radioactive |
|
|
Term
|
Definition
patient is tattooed or marked for the site do not wash it off
never put lotion or oils o the site prior to radiation
wash site gently with soap and water
wear soft clothing and nothing with a tight belt or metal
do not go in the sun! |
|
|
Term
| side effects of radiation are |
|
Definition
| dry mouth, burns, fissures, teeth loss, fractures, enteritis, drop in RBC and WBC, difficulty swallowing, fatigue, altered taste and appetite |
|
|
Term
| rules with radioactive patient |
|
Definition
no pregnant women
visitors visit for only a few minutes
wear dosimeter
anything in the room does not leave
do not touch urine or blood products from patient |
|
|
Term
|
Definition
| IV by a chemo certified nurse , precautions with tubing and drug disposal |
|
|
Term
| if chemo drug leaks on hand what do you do |
|
Definition
| stop it apply cold compress, antidote |
|
|
Term
| what are the side effects of chemotherapy |
|
Definition
alopecia
nausea and vomiting
capillary leak syndrome
mucosititis ( use swish and spit and soft toothbrushes)
stomatitis
chemo induced peripheral neuropathy
changes in cognitive function (memory and concentrate) |
|
|
Term
| drugs to give chemo patients to prevent nausea and vomiting |
|
Definition
serotonin antagonists: Zofran, kytril, anzemet
neurokinin receptor antagonist- emend
corticosteroid- decadron
prokinetic- reglan
antihistmain- allegra
benzo- ativan |
|
|
Term
| chemotherapy results in mainly |
|
Definition
|
|
Term
| photosynamic therapy used on |
|
Definition
| lungs, eyes, and GI tract to treat cancer |
|
|
Term
| biological response modifiers |
|
Definition
interferons- slow tumor cell division and make you feel like you have the flu
interleukins- enhance NK cells and TIL |
|
|
Term
|
Definition
1. SIADH
2. hyerclacemia (bone metathesis, parathyroid hormone)
3. spinal cord compression
4. sepsis
5. DIC
6. superior vena cava syndrome
7. tumor lysis syndrome |
|
|
Term
| what is superior vena cava syndrome |
|
Definition
| when the superior vena cava in compressed by the tumor causes erythema in the upper body, edema in the head and neck, dyspnea, epistaxis, hemmorage, and death |
|
|
Term
| what is tumor lysis syndrome |
|
Definition
| the tumor is rapidly killed by treatment but the body can not respond fast enough. potassium rises and liver and kidneys can not adapt to the abundance of cells. YOU NEED dialysis and hydration. too many purines from DNA break down |
|
|
Term
| what medication can you give to help with tumor lysis syndrome |
|
Definition
| allopurinol to help the kidneys excrete purines from DNA breakdown. |
|
|
Term
|
Definition
| excites the nerves and muscles |
|
|
Term
|
Definition
| inhibits mood, sleep , and pain |
|
|
Term
|
Definition
| inhibits attention, emotion |
|
|
Term
|
Definition
| excites dream, arousal, mood |
|
|
Term
|
Definition
|
|
Term
|
Definition
| inhibits muscles and nerves |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| excites diolates blood vessels |
|
|
Term
|
Definition
| deals with personality, judgement, motor, memories, affect, reason |
|
|
Term
|
Definition
| sensation, taste, hand-eye coordination, texture |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| coordinated voluntary movements, balance, equilibrium |
|
|
Term
|
Definition
| controls respirations and cardiac slowing |
|
|
Term
|
Definition
|
|
Term
|
Definition
| sleep-wake cycle, emotions, survivial drive, pituitary hormones, appetite |
|
|
Term
| what is allow to cross ans not cross the blood brain barrier |
|
Definition
alcohol, anesthesia, oxygen, water, glucose, fat soluble, CO2
NO blood, antibiotics, albumin |
|
|
Term
| how much circulating CSF is there at all times |
|
Definition
| 125ml made in choroid plexus absorbed in the arachnoid villi |
|
|
Term
| what are the three ascendiong tracts |
|
Definition
| spinothalamic (pain, pressure, temperature). spinocerebellum ( proprioception). Fasiculus ( fine touch, two point descrimination, ans posterior tract). |
|
|
Term
| what are the descending tracts |
|
Definition
| extrapyramidial, pyramidial, lateral corticospinal |
|
|
Term
| Are afferent tracts posterior or anterior |
|
Definition
| posterior and efferent is anterior |
|
|
Term
| sympatheitc nervous system on what part of the spinal cord or parasympatheitc |
|
Definition
|
|
Term
| A patient has neck and shoulder muscle pain, pain at the base of the skull and forhead that can be caused by hunger, eye strain, sleep deprivation, caffeine deprived, stress |
|
Definition
|
|
Term
| what is a migraine headache |
|
Definition
| a headache vascular, genetic, chemical, blood vessels spasms, vasoconstriction and hypoxia triggers the release of seritonin. this creates a sensativity to pain and causes swelling. |
|
|
Term
| what are the signs and symptoms of migraine headaches |
|
Definition
| throbbing pain, anorexia, nausea, pain behind the eyes or ears, sensative scalp, photophobia |
|
|
Term
|
Definition
1. prodromal phase- you might get moody or crave a certain kind of food
2. aura- see flashing lights, dipolpia, blurred vision, rigging
3. headache pahse- lasts hours to days
4. termination phase
5. postprodomal- fatigue, muscle pain, irritable |
|
|
Term
| what foods may trigger migraines |
|
Definition
| chocolate, red wine, nuts, aged cheese, artificial sweetners, caffeine, |
|
|
Term
| what medications can trigger migraines |
|
Definition
nitrite
birth control
caffeine
decongestants
corticosteriods
hormone therapy
chemo therapy
blood thinners
radiation |
|
|
Term
| what other things can cause migraines |
|
Definition
fatigue
anger
stress
hunger
insomnia
hormones |
|
|
Term
| what drugs do you give for migraines? |
|
Definition
NSAIDS
beta blockers
opiods -demerol
calcium channel blockers
antidepressents
ergotamine prep
triptan preparations |
|
|
Term
| what drus are the abotive drugs for migraines? |
|
Definition
| tylenol and asprin give during aura to stop migraine |
|
|
Term
|
Definition
| inflammation of the protective membrane covering brain and spinal cord. "meningies" |
|
|
Term
| signs and symptoms of meningitis |
|
Definition
fever
chills
headache
nausea
vomiting
nuchal rigidity
photophobia
altered LOC
positive Kernigs sign
positive Brudzinski sign
tachycardia
seizures
red macular rash
nystagmus
abnormal eye movements
hemiparesis
hemiplagia
and decrease muscle tone
cranial nerve dysfunction
SEVERE HEADACHES
memory changes
gerenalized muscle aches and pains |
|
|
Term
|
Definition
| sever stiffness of the hamstring when hip is flexed at 90 degrees you cant put leg straight |
|
|
Term
|
Definition
| neck is so stiff that when neck is flexed hips and knees flex too |
|
|
Term
| what meningitis causes red macular rash |
|
Definition
|
|
Term
|
Definition
| organism enters CNS through blood brain barrier travels throughout the subarachnoid space --> inflammation--> more permeability causes the protective barrier of BBB to be destroyed |
|
|
Term
| what are the risk factors for meningitis |
|
Definition
upper respiratory infections, otitis media, pneumonia, sinusitis
- immunosuppression
- invasive procedures
- open skull fractures
- penetratinf head injuries
- overcrowded living conditions, army barracks, and college campus. |
|
|
Term
| what factors can cause a virus meningitis |
|
Definition
|
|
Term
| what type of meningitis does not cause exudate, frequently resolves without treatment, and is the most common type? |
|
Definition
|
|
Term
| diagnostic test for meningitis |
|
Definition
|
|
Term
| how do you provide care for a patient with meningitis |
|
Definition
watch input and output
monitor ICP
give mannitol and then steriods
check fluid and electrolytes
nuero checks and vital signs every 2-4 hours
watch for motor signs
assess CNS cranial nerves III,IV,VI, VIII
decrease enviromental stimuli
isolation precautions
monitor for shock and seizures
fever 101.5-105
monitor airway, breathing, circulation |
|
|
Term
| what is a neurodegenerative disease of the basal ganglia which results in decreased dopmain and increased Ach, and decreased norepinephrine |
|
Definition
|
|
Term
| when do parkinsons signs usually show up |
|
Definition
| when 80% of neurons are lost, usually after 60 years of age unless genetic |
|
|
Term
| what can cause parkinsons |
|
Definition
| any damage to the brian, hydrocephalus, hypoxia, infection, stroke, tumor, trauma, genetics |
|
|
Term
|
Definition
1. symptoms may involve one side of the body
2. symptoms affect both sides of the body, mask like face, slow gait
3. shuffling, propulsive gait with arms flexed, loss of postural reflexes
4. akinesia, rigidity
5. complete dependancy |
|
|
Term
| what are the signs of parkinsons disease |
|
Definition
AKINESIA
RIGIDITY
TREMORS
stooped posture
flexed trunk
fingers and wrist flexed
propulsive gait can not stop quickly
pill rolling
mask face
drooling
arm swing
soft , slow, low pitch voice
slurred speech (dysarthria)
echolia
phonation
oily skin, sweating, flushing, eye lid spasm
orthostatic hypotension
dementia
sleeping problems
paranoia mood swings
depression |
|
|
Term
|
Definition
when two of three are confirmed : rigidity, akinesia, tremors
or positive response to antiparkinsons meds. |
|
|
Term
| what is the first drug used for parkinsons patients |
|
Definition
levadopa - a precursor of dopamine that crosses the blood brain barrier
carvidopa- inhibits enzyme that breaks down levidopa
SINIMET |
|
|
Term
| parlodel, mirapex, requip |
|
Definition
| stimulates dopamine receptors used for parkinsons |
|
|
Term
|
Definition
| anticholinergics used for parkinsons |
|
|
Term
| COMT - catechol O methytransferase inhibitors |
|
Definition
| blocks enzymes that inactivates dopamine used for parkinsons |
|
|
Term
|
Definition
|
|
Term
| parkinson medications can cause |
|
Definition
| confusion, hallucination, cognitive impairment, may need to take qa drug holiday for 10 years or change the drug. |
|
|
Term
| what nutrition do you give parkinsons patients |
|
Definition
| speech therapy and thick and soft foods because of difficulty swallowing. |
|
|
Term
| surgical managment for parkinsons patients |
|
Definition
pallidotomy- electrodes inserted into thalmus, target areas, there is a electrical stimulation sent that decreases the tremors, by burning nerves
deep brain stimulator- electrodes in the thalamus controlled by the pacemakes in the heartyou can change the voltages by a magnet. This blocks cells that transmit tremors
- stem cell research: put in patient in hope of making more dopamine cells |
|
|
Term
| what disease has neurofibillary tangles and neuritic plaques with an increase in amyloud proteins results from a decrease in ACH. |
|
Definition
alzheimers
mental deterioration first then physical. |
|
|
Term
| early stages of alzheimers |
|
Definition
| forgets name, misplaces keys, change in personality, decrease performance when stressed, loss of judment, sundown confusion, wandering, decreased sense of smell |
|
|
Term
| middle and late stages of alzheimers |
|
Definition
intellectual and cognitive impairment
disoriented
agitated
loss of ability to care for oneself
speech defeceit
incontinient
totally dependant |
|
|
Term
| how do you talk to a alzheimers patient |
|
Definition
| slow, calm, yes no questions, unhurried |
|
|
Term
| aricept, reminyl, exelon, namenda, cholinesterase inhibitors |
|
Definition
| used for alzheimers patients to increase Ach |
|
|
Term
| a chronic, progressive, degenerative disease that results from progressive demylination of the white matter of the brain and spinal cord; gliosis hard yellow plaque forms, damage to axons irreversable. caused by autoimmune or infections, genetics |
|
Definition
|
|
Term
| what is the main thing to make sure you remember with MS patients |
|
Definition
|
|
Term
| with an alzheimers patient you want to make sure you keep them in the same enviroment, same nurse, and not to have lots of stimuli |
|
Definition
|
|
Term
| true or false MS patients have vague symptoms that occur over months and years they may come and go or never come back for a while |
|
Definition
|
|
Term
| what are the first symptoms of parkinsons |
|
Definition
| blurred vision, sensory issues with arms or legs, or other slow progressive motor disorders |
|
|
Term
| what are motor signs and symptoms of multiple sclerosis |
|
Definition
foot drop
weakness or paralysis of limbs, trunk,head
scanning speech (slurred, dysphagia, STRETCHES WORDS), dysarthria
spacity of muscles
intentional tremors
dysmetria ( inability to estimate distance in muscular actions)
dysdiadochokinesia ( inability to perform rapid altered movement)
poor coordination, loss of balance
blurred vision, nystagmus, dilopia, scotoma, |
|
|
Term
| what are the difference between parkinsons and MS tremors |
|
Definition
| parkinson tremors are at rest, and MS is wtih movement |
|
|
Term
| what are the sensory signs of MS? |
|
Definition
tingling and numbness
vertigo and tinnitus
decreased hearing
chronic neuropathic pain
decreased temperature perception
bowel and bladder dysfunction
sexual dysfunction
and mental status change in late stages |
|
|
Term
| what medications are given to a MS patient |
|
Definition
corticosteriods (solu-medrol)
biological response modifiers
immunosuppresents (can cause depression, suicidal thought) |
|
|
Term
| true or false MS patients have vague symptoms that occur over months and years they may come and go or never come back for a while |
|
Definition
|
|
Term
| what are the first symptoms of parkinsons |
|
Definition
| blurred vision, sensory issues with arms or legs, or other slow progressive motor disorders |
|
|
Term
| what are motor signs and symptoms of multiple sclerosis |
|
Definition
foot drop
weakness or paralysis of limbs, trunk,head
scanning speech (slurred, dysphagia, STRETCHES WORDS), dysarthria
spacity of muscles
intentional tremors
dysmetria ( inability to estimate distance in muscular actions)
dysdiadochokinesia ( inability to perform rapid altered movement)
poor coordination, loss of balance
blurred vision, nystagmus, dilopia, scotoma, |
|
|
Term
| what are the difference between parkinsons and MS tremors |
|
Definition
| parkinson tremors are at rest, and MS is wtih movement |
|
|
Term
| what are the sensory signs of MS? |
|
Definition
tingling and numbness
vertigo and tinnitus
decreased hearing
chronic neuropathic pain
decreased temperature perception
bowel and bladder dysfunction
sexual dysfunction
and mental status change in late stages |
|
|
Term
| what medications are given to a MS patient |
|
Definition
corticosteriods (solu-medrol)
biological response modifiers
immunosuppresents (can cause depression, suicidal thought) |
|
|
Term
| true or false MS patients have vague symptoms that occur over months and years they may come and go or never come back for a while |
|
Definition
|
|
Term
| what are the first symptoms of parkinsons |
|
Definition
| blurred vision, sensory issues with arms or legs, or other slow progressive motor disorders |
|
|
Term
| what are motor signs and symptoms of multiple sclerosis |
|
Definition
foot drop
weakness or paralysis of limbs, trunk,head
scanning speech (slurred, dysphagia, STRETCHES WORDS), dysarthria
spacity of muscles
intentional tremors
dysmetria ( inability to estimate distance in muscular actions)
dysdiadochokinesia ( inability to perform rapid altered movement)
poor coordination, loss of balance
blurred vision, nystagmus, dilopia, scotoma, |
|
|
Term
| what are the difference between parkinsons and MS tremors |
|
Definition
| parkinson tremors are at rest, and MS is wtih movement |
|
|
Term
| what are the sensory signs of MS? |
|
Definition
tingling and numbness
vertigo and tinnitus
decreased hearing
chronic neuropathic pain
decreased temperature perception
bowel and bladder dysfunction
sexual dysfunction
and mental status change in late stages |
|
|
Term
| what medications are given to a MS patient |
|
Definition
corticosteriods (solu-medrol)
biological response modifiers
immunosuppresents (can cause depression, suicidal thought) |
|
|
Term
| true or false MS patients have vague symptoms that occur over months and years they may come and go or never come back for a while |
|
Definition
|
|
Term
| what are the first symptoms of parkinsons |
|
Definition
| blurred vision, sensory issues with arms or legs, or other slow progressive motor disorders |
|
|
Term
| what are motor signs and symptoms of multiple sclerosis |
|
Definition
foot drop
weakness or paralysis of limbs, trunk,head
scanning speech (slurred, dysphagia, STRETCHES WORDS), dysarthria
spacity of muscles
intentional tremors
dysmetria ( inability to estimate distance in muscular actions)
dysdiadochokinesia ( inability to perform rapid altered movement)
poor coordination, loss of balance
blurred vision, nystagmus, dilopia, scotoma, |
|
|
Term
| what are the difference between parkinsons and MS tremors |
|
Definition
| parkinson tremors are at rest, and MS is wtih movement |
|
|
Term
| what are the sensory signs of MS? |
|
Definition
tingling and numbness
vertigo and tinnitus
decreased hearing
chronic neuropathic pain
decreased temperature perception
bowel and bladder dysfunction
sexual dysfunction
and mental status change in late stages |
|
|
Term
| what medications are given to a MS patient |
|
Definition
corticosteriods (solu-medrol)
biological response modifiers
immunosuppresents (can cause depression, suicidal thought) |
|
|
Term
| true or false MS patients have vague symptoms that occur over months and years they may come and go or never come back for a while |
|
Definition
|
|
Term
| what are the first symptoms of parkinsons |
|
Definition
| blurred vision, sensory issues with arms or legs, or other slow progressive motor disorders |
|
|
Term
| what are motor signs and symptoms of multiple sclerosis |
|
Definition
foot drop
weakness or paralysis of limbs, trunk,head
scanning speech (slurred, dysphagia, STRETCHES WORDS), dysarthria
spacity of muscles
intentional tremors
dysmetria ( inability to estimate distance in muscular actions)
dysdiadochokinesia ( inability to perform rapid altered movement)
poor coordination, loss of balance
blurred vision, nystagmus, dilopia, scotoma, |
|
|
Term
| what are the difference between parkinsons and MS tremors |
|
Definition
| parkinson tremors are at rest, and MS is wtih movement |
|
|
Term
| what are the sensory signs of MS? |
|
Definition
tingling and numbness
vertigo and tinnitus
decreased hearing
chronic neuropathic pain
decreased temperature perception
bowel and bladder dysfunction
sexual dysfunction
and mental status change in late stages |
|
|
Term
| what medications are given to a MS patient |
|
Definition
corticosteriods (solu-medrol)
biological response modifiers
immunosuppresents (can cause depression, suicidal thought) |
|
|
Term
| true or false MS patients have vague symptoms that occur over months and years they may come and go or never come back for a while |
|
Definition
|
|
Term
| what are the first symptoms of parkinsons |
|
Definition
| blurred vision, sensory issues with arms or legs, or other slow progressive motor disorders |
|
|
Term
| what are motor signs and symptoms of multiple sclerosis |
|
Definition
foot drop
weakness or paralysis of limbs, trunk,head
scanning speech (slurred, dysphagia, STRETCHES WORDS), dysarthria
spacity of muscles
intentional tremors
dysmetria ( inability to estimate distance in muscular actions)
dysdiadochokinesia ( inability to perform rapid altered movement)
poor coordination, loss of balance
blurred vision, nystagmus, dilopia, scotoma, |
|
|
Term
| what are the difference between parkinsons and MS tremors |
|
Definition
| parkinson tremors are at rest, and MS is wtih movement |
|
|
Term
| what are the sensory signs of MS? |
|
Definition
tingling and numbness
vertigo and tinnitus
decreased hearing
chronic neuropathic pain
decreased temperature perception
bowel and bladder dysfunction
sexual dysfunction
and mental status change in late stages |
|
|
Term
| what medications are given to a MS patient |
|
Definition
corticosteriods (solu-medrol)
biological response modifiers
immunosuppresents (can cause depression, suicidal thought) |
|
|
Term
| true or false MS patients have vague symptoms that occur over months and years they may come and go or never come back for a while |
|
Definition
|
|
Term
| what are the first symptoms of parkinsons |
|
Definition
| blurred vision, sensory issues with arms or legs, or other slow progressive motor disorders |
|
|
Term
| what are motor signs and symptoms of multiple sclerosis |
|
Definition
foot drop
weakness or paralysis of limbs, trunk,head
scanning speech (slurred, dysphagia, STRETCHES WORDS), dysarthria
spacity of muscles
intentional tremors
dysmetria ( inability to estimate distance in muscular actions)
dysdiadochokinesia ( inability to perform rapid altered movement)
poor coordination, loss of balance
blurred vision, nystagmus, dilopia, scotoma, |
|
|
Term
| what are the difference between parkinsons and MS tremors |
|
Definition
| parkinson tremors are at rest, and MS is wtih movement |
|
|
Term
| what are the sensory signs of MS? |
|
Definition
tingling and numbness
vertigo and tinnitus
decreased hearing
lack of coordination ataxia
chronic neuropathic pain
decreased temperature perception
bowel and bladder dysfunction
sexual dysfunction
and mental status change in late stages |
|
|
Term
| what medications are given to a MS patient |
|
Definition
corticosteriods (solu-medrol)
biological response modifiers
immunosuppresents (can cause depression, suicidal thought)immunomodulaters
antispasmatics - dantrium, baclophen
CNS stimulants- ritalin, symmetrel
anticholinergics- cogentin, ditropan
trycyclin antidepressents
anti-seizure meds (klonopin, tegretol)
baclophen pump |
|
|
Term
|
Definition
|
|
Term
| what disease is a destruction of motor cells in the anterior gray horns of the spinal cors, weakness, atrophy, fasiculation (twitiching) of the face and hands, converts to chronic paralysis of the limbs. SENESORY CHANGES ARE NOT PRESENT and patient remains alert and aware thoughout but is on a ventilator because they can not beath on their own |
|
Definition
| (AML)AMyotrophic Lateral Sclerosis Lou Gehrigs disease |
|
|
Term
| does the patient loose sensory function with AML ? |
|
Definition
| no, just motor they are alert and oriented throughout but they can not talk |
|
|
Term
| what tests do you run to test for AML |
|
Definition
neuro exam
electromyelogram
CPK elevated (from muscle and brain breakdown).
myelogram |
|
|
Term
|
Definition
fatigue
muscle atrophy
tongue atrophy
dysphagia
weakness of hands and arms
fasiculation of the face
dysarthria
respiratory muscles become weak |
|
|
Term
| is there any treatment for AML |
|
Definition
|
|
Term
| what is the treatment or palliative care of AML |
|
Definition
PT,ST, OT
ventilator , gastrostomy, teaching for family |
|
|
Term
| what medication can you give a AML patient |
|
Definition
| rilutek which is an antiglutamate |
|
|
Term
| how does a patient generally die from AML |
|
Definition
| pneumonia and pulmonary complications from the ventilator. |
|
|
Term
| this is an acute immunologic reaction , inflammatory polyneuropathy. It causes demyelination and affects the motor functions of the peripheral nerves. Usually the cranial and the motor because they are heavily myelinated. BUT most patients generally get better |
|
Definition
|
|
Term
| 3 stages of GUillian Barre syndrome |
|
Definition
1. inital- onset until no further deterioration 1-3 weeks
2. Plateau - little changes several days to two weeks
3. recovery- myelination and axonal regeneration may take months to years |
|
|
Term
| Ascending Guillian barre syndrome |
|
Definition
| weakness and numbness begins in the legs. Most common type. parethesia (numbness , tingling, hypotonia (decreased muscle mass), areflexia (absent reflexes)with decreased respiratory function |
|
|
Term
| what are the three main signs of any type of GBS |
|
Definition
| areflexia, paresethsia, hypotonia |
|
|
Term
| what are the 4 types of guillian barre syndrome |
|
Definition
ascending
descending
pure motor
miller-fisher variant |
|
|
Term
| what type of GBS is identical to ascending but has no sensory symptoms. No pain , but starts from feet and moves up. hypotonia, arefexia, parethesia |
|
Definition
|
|
Term
| areflexia, paresthesia, hypotonia |
|
Definition
|
|
Term
| patient comes in with decreased relfexes and numbess and tingling you assume they have |
|
Definition
|
|
Term
| progressive disorder that affects the motor components of the peripheral nervous system and demylination |
|
Definition
|
|
Term
| what is Miller-fisher variant guillian barre syndrome |
|
Definition
no motor or sensory loss
ataxia (impaired coordination)
areflexia
opthalmoplegia( paralysis or weakness of the muscles that control the eye) |
|
|
Term
| which disease is characterized by symmetrical muscle wekness amd areflexia |
|
Definition
|
|
Term
| what are the risk factors for GBS |
|
Definition
| viral infections, EBV,HIV,URI, swine flu, surgery, anythign that could lead to an infection which could lead to an autoimmune response. |
|
|
Term
| are GBS patients fully aware of what is going on?q |
|
Definition
| yes it does not affect LOC or cognitive function/ puppilary response |
|
|
Term
| does GBS affect puppillary respinse |
|
Definition
|
|
Term
| are drooping of the face and respiratory failure common in GBS ? |
|
Definition
|
|
Term
|
Definition
ventilator
immunotherapy- IV IG
plasmaphoresis
treat pain/ symptoms/
rehab for months to retrain ADL |
|
|
Term
| what is a chronic , progressive disease of muscular weakness caused by a defect at the myoneural junction (the synaptic connection of the axon of the motor neuron with a muscle fiber)and how does it happen? |
|
Definition
| myasthenia gravis which happens this hyperplasia of the thymus which releases antibi\odies that attack the Ach receptors --> causes decrease in Ach--> decrease in muscle contractions. |
|
|
Term
| what are the hallmarks of myasthemia gravis? |
|
Definition
-dramatic improvement in muscle strength with anticholinerase drugs
-improvement of muscle strength at rest
-weakness of certain voluntary muscles (ptosis, dilopia) |
|
|
Term
| what are the symptoms of myasthesia gravis |
|
Definition
muscles of the eye are affected first (ptosis, dilopia, eye closure)
then muscles of the face are affected, masticatory, speech and neck muscles next. The patient is unable to swallow or smile. and eventually the respiratory muscles become weak. |
|
|
Term
| myasthemia gravis symptoms can be relieved by |
|
Definition
|
|
Term
| a patient has muc\scle wekness with voluntary muscle groups that is relieved by rest what do they have |
|
Definition
|
|
Term
| how do you diagnose myasthemia gravis |
|
Definition
with a tensilon test which extends muscle stimulation and breifly improves strength. If muscle strength increases as a result of tensilon test then you have myasthemia gravis
serum antibodies to Ach are usually elevated. |
|
|
Term
| cholinergic crisis vs. myasthenic crisis |
|
Definition
cholinergic crisis- happens when there is too much Ach , you can get this from taking to many drugs to prevent myasthemia gravis. BP increases and you become shaky
myasthemia crisis- happens when there is not enough Achyou have difficult breathing and muscles weakness. |
|
|
Term
| what do anticholinerase drugs do ? |
|
Definition
| prevents breakdown of Ach |
|
|
Term
| medical managment of myasthemia gravis? |
|
Definition
anticholinergics
corticosteriods
plasmaphoresis |
|
|
Term
| what do you assess for in myasthemia gravis patients? |
|
Definition
respiratory function
and muscles strength of all muscles |
|
|
Term
| what do you observe for with myasthemia gravis |
|
Definition
signs ans symptoms of pneumothorax and pneumonia from ventilator
unpredictable responses to drugs |
|
|
Term
| what is trigeminal Neuralgia |
|
Definition
| aka tic douloreux which affects the 5th cranial nerve and it causes unilateral facial pain INTENSE. It is a result of minimal stimulation of a triggerzone like driving with the window down or heat to the face. |
|
|
Term
| pain for trigeminal Neuralgia is described as |
|
Definition
| shooting, burning, jabbing, piercing, no motor or sensory deficiets just PAIN, |
|
|
Term
| do symptoms get worse with trigeminal neuralgia |
|
Definition
| no they improve with age but usually life long |
|
|
Term
|
Definition
| face, jaw, forhead, around eyes |
|
|
Term
| what is the management of trigeminal neuralgia |
|
Definition
control pain
dilantin and tegretol
neuontin
local anesthesia
microcirculation decompression of the trigeminal nerve from the artery as it enters the pons. |
|
|
Term
| when you have a seizure patient what do you ? |
|
Definition
1. padd side rails
2. pulse ox
3. what time the seizure started how long
4. describe seizure activity
make sure nothing is in the patients mouth and no restraints |
|
|
Term
| what are the 4 types of generalized seizure |
|
Definition
1. tonic -clonic: 2-5 minutes
2. absence: children breif stare and loss of consciousness
3. myoclonic- break jerking lasts only for a few seconds
4. atonic- sudden loss of muscle tone fall and then have confusion |
|
|
Term
|
Definition
| local seizure from one part of the brain |
|
|
Term
|
Definition
| may loose consciousness for 1-3 minutes lip smacking automatisms |
|
|
Term
|
Definition
| remains conscious but has unusual sensations nausea, tachycardia, dejavu, flushing |
|
|
Term
|
Definition
metabolic disorders (diabetes, encephalitis)
alcohol withdraw
electrolyte embalance
heart disease (hypoxia) |
|
|
Term
|
Definition
prodromal- early warning of impeding attack
aura- visual or hearin disturbances
Ictus- tonic: contraction ; clonic: contraction and relaxation of muscles
postical: after seizure patient is exhausted |
|
|
Term
| tests to figure out seizure |
|
Definition
|
|
Term
|
Definition
| seizure episodes longer than 30 minutes or persistant seizure longer than 5 minutes call 911!. make sure they have oxygen and IV for ativan |
|
|
Term
| what is rescue drug for seizures |
|
Definition
|
|
Term
| patient on seizure precautions have a low O2 stat and irregular heartbeat what do you do |
|
Definition
|
|
Term
| what do you do for a patient after a seizure |
|
Definition
| lay on side check vitals, allow time to rest re-orient. |
|
|
Term
| you have to be one full year free of seiure in order to drive |
|
Definition
|
|
Term
|
Definition
|
|
Term
| most seizure meds work by |
|
Definition
| raising seizure threshold |
|
|
Term
|
Definition
dilantin
tegretol
luminal
depakote
neurontin
keppra
topamax
* they all cause sedation |
|
|
Term
| surgical interventions for epilepsy patient |
|
Definition
remove focus
remove lobe or cortex
corpuscalostomy -seperate lobes
vagal nerve stimulation- pacemaker in left chest electrodes to vagal nerve cause parasympathetic stimulation to slow activity
brain mapping- watch seizure burn arrea |
|
|
Term
|
Definition
take meds on time and check levels
dont drive or swim alone
dont go places alone
wear med braclet
avoid alcohol or other triggers
sedation from meds is commmon |
|
|
Term
| what are the affects of aging on the endocrine system? |
|
Definition
decreased ADH
decreased metabolism
decreased tolerance to glucose
decreased production of estrogen and ovulation |
|
|
Term
| what hormones are released from the anterior pituitary? |
|
Definition
|
|
Term
| what hormones are released from the posterior pituitary? |
|
Definition
|
|
Term
| what laboratory tests can you do for the endocrine system? |
|
Definition
stimulation/suppression test
assays- thyroid antibodies, radioactive iodine
urine test- 17 ketosteriods, 24 hour urine for cortisol
-test for glucose
-imaging assessment |
|
|
Term
| treatment for hypopituitary for males |
|
Definition
| LIFETIME therapy - IM or patch of androgen therapy watch for gynecomastia and virlization |
|
|
Term
| facial changes headache, and vision changes |
|
Definition
|
|
Term
| what suppression test do you perform for oversecretion of GH |
|
Definition
| high BS levels suppress or are supposed to suppress GH |
|
|
Term
| drug therapy for gigantism? |
|
Definition
dopamine agonists
parlodel
dostinex
permax
watch for cushings and monitor BS |
|
|
Term
| drug therapy for acromegaly |
|
Definition
sandostatin
somavert
bromocriptine |
|
|
Term
| postoperative care for hypophysectomy |
|
Definition
monitor neuro status
check for meningitis
elevate HOB
assess for post nasal drip
check for glucose in post nasal drip
avoid coughing
avoid bending
avoid straining at stool
life time hormone replacement
vasopressin
numbness of surgical site
decrease ability to smell
no brushing teeth at the site until healed |
|
|
Term
| what drugs can cause diabetes insipidus? this is a posterior pituitary disorder |
|
Definition
| lithium carbonate and demeclocycline |
|
|
Term
| signs and symptoms of diabetes insipidus? |
|
Definition
24 hour fluid intake and output >4L urine specific gravity less than 1.005 dehydrated makes them confused poor skin turgor dry mucous membranes
increased thirst and urination
increased hemo concentration
loss of K and NA |
|
|
Term
| what medications do you give diabetes insipidus patients |
|
Definition
oral chlorpropamide- for high BS levels
desmopressin DDVAP
vasopressin- life long
never deprive fluids more than 4 hours
make patient weigh themselves everyday |
|
|
Term
| interventions and drug therapy for a patient with SIADH |
|
Definition
fluid restriction
diuretics
hypertonic saline
demeclocycline
watch for seizures |
|
|
Term
| effects of adrenal glands insufficiency? |
|
Definition
loss of aldosterone and cortisol
loss supply of liver and muscle glycogen
GFR and gastric acid secretion |
|
|
Term
|
Definition
hyperpigmentation
vitiligo
tired
weak
muscle weakness
GI symptoms: abd pain, constipation, diarrhea, nausea, vomiting
thinning or auxillary hair
thin
anorexic
dizzy
syncope
hypotension |
|
|
Term
| if you take a long term dose of corticosteroids and then stop you could get |
|
Definition
|
|
Term
|
Definition
| K, NA, BUN, glucose, cortisol |
|
|
Term
| medication given for addisons |
|
Definition
cortisol hormone therapy
florinef
becareful with salt restrictions and diuretics |
|
|
Term
| what do you do for someone with adrenal crisis |
|
Definition
give NS or D5W IV
IV hydrocortisone
H2 IV for ulcer prevention
kayexlate
loop or thiazide diuretics |
|
|
Term
| signs and symptoms of cushings disease |
|
Definition
fat
osteoporosis
bruises
striae
emotional disturbances
thin, fragile skin
purpura
skin ulcers (poor wound healing)
buffalo hump
cardiac hypertrophy
moon face |
|
|
Term
| what tests do you do to determine if a patient has cushings? |
|
Definition
dexamethasone suppression test
24 hour urine test
blood cortisol levels
saliva cortisol test < 2.0ng.ml is normal |
|
|
Term
| what lab values for cushings |
|
Definition
hyperglycemia, hypernatremia
hypokalcemia, hypocalemia |
|
|
Term
|
Definition
hypoglycemia, hyponatremia
hyperkalemia, hypercalcemia |
|
|
Term
| hallmark of phenochromocytoma |
|
Definition
intermittent episodes of HTN
SO BEFORE AND AFTER SURGERY MAKE SURE YOU LOOK AT BLOOD PRESSURE |
|
|
Term
|
Definition
toxic multinodular goiter (neoplasm)
thyroiditis
thyroid storm
graves disease |
|
|
Term
|
Definition
myxedema coma
hashimotos thyroiditis
iodine deficiency |
|
|
Term
|
Definition
intolerance to heat
exophthalmos (globe lag, eye retraction)
tremors
muscle weakness
diarrhea
thin straight hair
enlarged thyroid
SOB
sweating
clubbing of fingers
edema of legs
wt loss
visual changes
plapitations/ chest pain
increase BP
increase HR
change in energy |
|
|
Term
| TSH elevated or lowered in primary hyperthyroidism |
|
Definition
| lowered ( like in graves) |
|
|
Term
| medications for hyperthyroidism |
|
Definition
potassium iodide
- tastes nasty take with OJ, don't take if allergic to shellfish and watch for bleeding
- tapazole, propylthiouracil (PTU)
monitor for hypothyroidism |
|
|
Term
| radioactive iodine therapy |
|
Definition
given orally 131 concentrates in thyroid cells and damages them so they produce less TH . taken at home no radiation precautions needed
DO not take if pregnant |
|
|
Term
| when do you do a subtotal thyroidectomy |
|
Definition
| when the thyroid is pressing on the trachea |
|
|
Term
|
Definition
iodided to reduce hemmorage risk
euthyroid preop
antithyroid meds |
|
|
Term
| post-op for thyroidectomy |
|
Definition
semifowlers position
check for bleeding on the back of head and neck
support head and neck to decrease stress on sutures
they are at risk for tetany if the parathyroid is harmed
keep emergency respiratory equip near by |
|
|
Term
|
Definition
results from infection or surgery of thyroid
high temp of 106, BP, HR, RR all increase patient becomes confused, had delirium
HIGH MORTALITY RATE |
|
|
Term
|
Definition
airway
antithyroid drugs
propranolol
glucocorticosteriod
sodium iodide
cooling blanket
Tylenol non-salicylate antipyretics
correct dehydration |
|
|
Term
| TSH levels are high or low in primary hypothyroidism |
|
Definition
|
|
Term
|
Definition
sleepiness
generalized weakness
constipation
cold intolerance
wt gain
anorexia
blank expression
slow movement
swollen tongue and slurred speech
receeding hairline
dry course skin
low BP
low HR
DEPRESSION |
|
|
Term
| treatment for hypothyroidism |
|
Definition
levothyroxine (synthroid)
liothyronine (cytomel)
levothroyrozine (levothroid)
liotrix |
|
|
Term
| what do you teach a patient about taking hypothyroidism medication |
|
Definition
take on empty stomach one hour before meal or two hours after
monitor for bruising, bleedin gums, and blood in the urine
monitor for chest pain, dyspnea, and tachycardia |
|
|
Term
|
Definition
a autoimmune disease triggered by bacterial or viral infection
which destroys thyroid tissue |
|
|
Term
| calcium and phosphorus have a |
|
Definition
|
|
Term
| S/S of hyperparathyroidism |
|
Definition
decrease bone density
increase renal calculi
hypophosphatemia
hypercalcemia
HTN
psychosis
muscle weakness |
|
|
Term
| TT of hyperparathyroidism |
|
Definition
fosfamax
zometa
drink fluids
remain active |
|
|
Term
| S/S of hypoparathyroidism |
|
Definition
tetany
muscle spasms
hyperreactive reflexes |
|
|
Term
| TT for hypoparathyroidism |
|
Definition
|
|
Term
|
Definition
falls
then MVT accidents
struck/by against
assault |
|
|
Term
|
Definition
males 3X
African americans
adults over 75 yrs
0-4 years
15-19 years |
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|
Term
| most severe type of brain injury |
|
Definition
closed head injury
skull remains intact
increase risk for spinal cord and intercranial pressure. |
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|
Term
| what are post concussion symptoms |
|
Definition
irritability
inability to sleep
depression
headache
memory loss |
|
|
Term
| severity of concussion is characterized by |
|
Definition
|
|
Term
| patient has a TBI and was bad off got better real quick are they okay to go? |
|
Definition
| no this is the lucid interval EMERGENCY |
|
|
Term
|
Definition
three components brain, blood, CSF
if one increased the others decrease |
|
|
Term
|
Definition
| cerebral perfusion pressure |
|
|
Term
|
Definition
head tilt
spinal cord soreness
loss of motor and sensory function |
|
|
Term
| individuals who had a TBI are first assessed for what before anything else |
|
Definition
|
|
Term
|
Definition
3-15
3-8 severe
9-12 moderate
13-15 mild |
|
|
Term
| when is the glascoma scale used |
|
Definition
|
|
Term
|
Definition
6 obeys commands to move body
5. withdraws from pain locally
4. withdraws from pain generally
3. flexes limb in response to pain
2. straightens limb in response to pain
1. no movement in response to pain |
|
|
Term
| glascoma scale eye movement |
|
Definition
opens eyes spontaneously
opens eyes to command
opens eyes to pain
doesn't open them |
|
|
Term
|
Definition
oriented speaks appropriate
confused speaks normally
inappropriate words
inappropriate sounds
no verbal responses |
|
|
Term
|
Definition
it is a late response
severe hypertension and temp increase
with decrease in HR and RR |
|
|
Term
| what are the signs of increased ICP |
|
Definition
severe headache
nausea
vomiting
seizures
papilledema |
|
|
Term
| the most important assessment when using the Glasgow coma scale is the |
|
Definition
|
|
Term
| first sign of worsening neurologic status? |
|
Definition
|
|
Term
| what frzcture is common for CSF leakage out the ears and nose |
|
Definition
|
|
Term
| is a lumbar puncture done and nuchal rigidity checked first with TBi |
|
Definition
| no not until spinal cord cleared |
|
|
Term
| motor signs of increased ICP |
|
Definition
| flaccidity, abnormal posturing, loss of motor function |
|
|
Term
| 4 nursing interventions to prevent increase in ICP |
|
Definition
assess for fever
monitor fluid and electrolyte
keep head in neutral position
head elevated 30 degrees
keep patient calm
calcium channel blockers to keep BP normal NOT LOW
no sneezing, coughing, suctioning
well oxygenated |
|
|
Term
|
Definition
headaches
nausea and vomiting
visual symptoms
seizures
changes in personaility
papilledema |
|
|
Term
|
Definition
Metabolic Coma: diffuse abnormal motorsigns, coma procedes motor abnormalties, pupils bilaterally reactive, partial dysfunction of many areas of CNS
CNS COma: focal abnormalties unilateral, coma follows motor abnormalties, pupils non-reactive, orderly progression of CNS dysfunction |
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|
Term
| this test is used to assess the level of recovery from brain injury in individuals recovering from coma |
|
Definition
rancho Los Amigos Scale
levels 1-8 |
|
|
Term
|
Definition
8 purposeful appropriate
7 automatic appropriate
6 confused appropriate
5. confused inappropriate
4. confused agitated
3. localized response
2. generalized response
1. no response |
|
|
Term
|
Definition
1. response to environment and self
2. responds to environment
3. localized response
2. generalized response
1. no response |
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|
Term
| most common cause of death from burn |
|
Definition
|
|
Term
| If you are working in the ER and a burn patient comes in what are the 6 interventions you will do |
|
Definition
ABCDE assessment
strict I and O
airway and fluid resuscitation
give tetanus
prophylactic antibiotic
sterile dressing for wound |
|
|
Term
| most accurate way to measure the size of burns ? |
|
Definition
|
|
Term
| the first vascular change for burns? and electrolyte status |
|
Definition
| hypovolemic stage :third spacing or capillary leak syndrome occurs from the first 48 hours. Metabolic acidosis, increased hemoconcentration, hyperkalemia, hyponatremia, low blood volume and olguria |
|
|
Term
| what happens with burn patients vascular change after 48 hours |
|
Definition
| diuretic stage begins you have hyponatrmia, and hypokalemia, metabolic acidosis, hemodilution |
|
|
Term
| what four burn injuries cause respiratory failure |
|
Definition
airway edema
carbon dioxide poisoning
chest burns
pulmonary capillary leak |
|
|
Term
| edema in the pulmonary system of a burn patient can occur as late as a |
|
Definition
|
|
Term
| what are the GI changes with a burn patient |
|
Definition
this occurs from decreased blood in the body its shunted to the heart, liver, brain so GI tract has decreased blood supply.
-paralytic ileus
-abdominal distention
-curling ulcer over 24 hours from stress or severe injury. |
|
|
Term
| metabolism changes with burn patients |
|
Definition
metabolism increases
produces:
-aldosterone
-cortisol
-ADH
-catecholamines
-loose water and heat (from increase metabolism rate)
-pt needs more calories and oxygen
-pt core is super hot |
|
|
Term
| immunologic changes with burn patients |
|
Definition
burns destroy the protective layer of skin
-activate inflammatory response
-suppress immune function |
|
|
Term
| cardiovascular changes with burn patients |
|
Definition
hypovolemic shock
monitor cardiac status with electrical burn injuries |
|
|
Term
| renal/urinary changes with burn patients |
|
Definition
changes are related to cellular debris and decreased renal blood flow
myoglobin is released from damaged muscles and circulates to the kidneys
check BUN, creatinine, NA levels, look at urine color, odor, and presence of particles/foam |
|
|
Term
possible lab results for burn patients
hemoglobin and hematocrit
BUN
glucose
sodium
chloride
total protein |
|
Definition
H & H elevated due to fluid loss
BUN elevated due to fluid loss
glucose elevated due to stress
sodium decreased
potassium increased
chloride elevated due to fluid volume loss
total protein low |
|
|
Term
| do you use IVS for fluid resuscultation with burn patients? |
|
Definition
| yes you use two large bore needles in the subclavian or jugular on unburned skin |
|
|
Term
| three types of fluid therapy for burn patients |
|
Definition
parkland (lactated ringer) crystalloid- 4ml/kg/%TBSA
- modified parkland
4ml/kg/% TBSA plus 2000 ml glucose water
-modified brooke
.05ml/kg/%TBSA plus 5% albumin plus 0.9 NS |
|
|
Term
| what fluid is most like extracellular fluid? |
|
Definition
|
|
Term
| how do you give lactated ringer to burn patients |
|
Definition
1/2 the first 8 hours
1/4 the second 8 hours
1/4 the third 8 hours |
|
|
Term
| what do you consider with extremity burn? |
|
Definition
remove jewelry
hold arm above heart
check peripheral pulses |
|
|
Term
| special considerations with facial burns |
|
Definition
| associated with airway compromise so elevate stretcher at least 30 degrees is no spinal trauma |
|
|
Term
| the emergent phase of burn injury is what? and what are the goals |
|
Definition
secure airway and maintain 100% FiO2 mask
fluid replacement
maintain temperature
prevent infection
provide emotional suporrt
this phase continues for about 48 hours |
|
|
Term
| upper airway edema becomes pronounced 8-12 hours after the beginning of fluid resuscitation and you may need intubation |
|
Definition
|
|
Term
| focus for acute period of a burn patient |
|
Definition
| focus shifts to care of wounds and prevention of complications |
|
|
Term
| what drugs do you give for pain control for burn patients |
|
Definition
5-10mg every 1-3 hours of morphine
valium
versed
diprivan
haldol |
|
|
Term
| what are the 6 signs of sepsis? |
|
Definition
fever
change in sensorium
paralytic ileus
olguria
abdominal distention |
|
|
Term
| nutrition for a burn patient |
|
Definition
|
|
Term
|
Definition
kelliods
contractures
it doesn't heal
scare |
|
|
Term
what dressing type speeds debridement and develops granulation tissue faster
makes skin grafting possible sooner? |
|
Definition
|
|
Term
| 4 indications for grafting |
|
Definition
<100,000 gram of tissue
wound pink and free of exudate
priority areas (face)
full thickness burns |
|
|
Term
| drug therapy for burn patients the main catagories |
|
Definition
antobiotics
silvadene
tetanus toxoid 0.5ml to prevent clostridium tenti
pain meds |
|
|
Term
| what do you do to protect burn patients from infections? |
|
Definition
isolation
aseptic techniques
no plants (risk of pseudomonas) |
|
|
Term
| 3 parts of rehabilitation with burn patients |
|
Definition
care of healing skin -wash daily and cover with cocoa butter
pressure garments, ace wraps- helps prevent contractures and scaring
promote mobility- position, exercises, splinting, ADL |
|
|
Term
|
Definition
stage I- viral syndrome- feels like you have the flu
stage II- asymptomatic can last up to 10 years
stage III- persistent generalized lymphadenopathy greater than 2 extra inguinal nodes more than 3 months
Stage IV- wasting fever > 1 month >10% TBW, diarrhea
opportunistic infections
kaposis sarcoma, cervical cancer
neurologic manifestations - AIDS, peripheral neuropathy |
|
|
Term
|
Definition
direct blood contact with blood products, or blood
prenatal transmission
sex |
|
|
Term
|
Definition
ELISA - can have false positives
western blot
OraQuick Rapid HIV
T-cells
viral load |
|
|
Term
|
Definition
reverse transcriptase inhibitors
non-nucleoside reverse transciptase inhibitors
protease inhibitors
fusion inhibitors
hydroxurea |
|
|
Term
genotype resistance
phenotype resistance
cross resistance
monotherapy
sub therapeutic levels |
|
Definition
mutation of virus
decreases sensitivity to drug
resistance to multiple drugs
resistance to one drug
not taking full dosage or not at prescribed levels |
|
|
Term
| adverse affects of Highly active antiretroviral therapy |
|
Definition
lactic acidosis
hepatic steatosis
hepatotoxicity
hyperglycemia
hyperlipidemia
fat misdistribution
osteoporosis |
|
|
Term
| fungal opportunistic infection of HIV patients |
|
Definition
candidiasis (thrush)-frequent first sign of diease
-esophagitis (dysphagia)
-thrush (oral lesion)
- intertrigo (cutaneous lesion)
-vaginitis (vulvovaginal lesion and discharge) |
|
|
Term
| protozoal opportunistic infections of HIV patients |
|
Definition
DOE, fever, non-productive cough
caused from pneumocystis Jiroveci
toxoplasmosis- CNS symptoms |
|
|
Term
| bacterial opportunistic infection with HIV patients |
|
Definition
fever, night sweats, diarrhea, abdominal pain, weight loss, anorexia
mycobacterium avium complex or TB (airborne) |
|
|
Term
| viral opportunistic infections with HIV patients |
|
Definition
cytomegalovirus (CMV)- almost everyone becomes infected with this
transmitted through direct contact with saliva, urine, semen, breast milk, feces, cervical fluid, blood.
LIFETIME THERAPY REQUIRED
* herpes simplex |
|
|
Term
| progressive multifocal leukocephalopathy (PML) |
|
Definition
caused by JC virus
results in limb weakness, vision loss, cognitive impairment, speech loss, ataxia, headache
in latter stages dementia, blind, death |
|
|
Term
|
Definition
fast growing, lees responsive to therapy, related to low CD4 count
- leg, pelvic, back pain
-edema, lymphadenopathy
-post-ictal bleeding, bleeding from vaginal discharge
- weight loss |
|
|
Term
|
Definition
| initial patch is flat and pink looks like a bruise, symmetrical on both sides of the body later it turns dark purple |
|
|
Term
| central nervous system results from HIV |
|
Definition
dementia, HIV encephalopathy
cognitive, behavioral, motor problems
peripheral neuropathy |
|
|
Term
|
Definition
| profound involuntary weight loss > 10 % TBW, diarrhea, weakness, fever from decreased food intake, malabsorbtion, altered metabolism |
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|
