Term
| Rheumatic disorders are thought to be? |
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Definition
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Term
| Rheumatic conditions usually affect the _______, but also have _________ complications as well |
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Definition
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Term
| Rheumatic disorders are usually detected when? |
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Definition
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Term
| Rheumatic conditions usually start with pain in the...? |
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Definition
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Term
| Erythrocyte sedimentation rate (ESR) is a broad measurement of what? |
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Definition
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Term
| ANA/ANA-8 are broad measures of what? |
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Definition
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Term
| Which is more specific an ANA or an ANA-8? |
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Definition
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Term
| What else is used to diagnose rheumatic conditions aside from blood work? |
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Definition
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Term
| What controls joint pain? |
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Definition
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Term
| Rheumatoid arthritis is the destruction of what type of tissue? |
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Definition
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Term
| Rheumatoid arthritis primarily affects who? |
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Definition
| young women, women of childbearing age |
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Term
| Etiology of rheumatoid arthritis |
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Definition
| autoimmune, genetics, can be triggered by infection or trauma |
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Term
| RA has a symmetric presentation. What does this mean? |
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Definition
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Term
| What are some signs/symptoms of RA? |
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Definition
| morning stiffness that lasts longer than 1 hour, 3 or more joints are involved, rheumatic nodules, elevated ESR/CRP/rheumatoid factor, fatigue, anorexia, weight loss, fever |
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Term
| How many signs/symptoms must be present to diagnose RA? |
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Definition
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Term
| What are some radiologic changes that occur with RA? |
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Definition
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Term
| What happens after the erosion of the joint? |
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Definition
| The body ossifies the joint, and the bones fuse= NO MORE JOINT |
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Term
| What should pt's with rheumatic conditions monitor daily? |
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Definition
| Temperature, to catch inflammatory process early |
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Term
| When does the greatest damage occur in RA pt's? |
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Definition
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Term
| True of false: RA is chronic condition |
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Definition
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Term
| What are the treatment goals for a pt. with RA? |
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Definition
| maintain function, prevent deformity, decrease pain/swelling |
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Term
| After the inflammatory process ends, is it better to use heat or cold? |
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Definition
| Alternate heat/cold to increase blood flow to the area |
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Term
| What is the drug of choice for pt's with RA? |
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Definition
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Term
| What other drugs are used to treat RA? (not long term) |
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Definition
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Term
| Long term RA drugs are known as |
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Definition
| Disease Modifying Anti-Rheumatic Drugs |
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Term
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Definition
| slow the disease process by modifying the immune system |
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Term
| What is the standard DMARD used to treat RA? |
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Definition
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Term
| When is methotrexate used in treatment? |
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Definition
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Term
| Is methotrexate slow acting or fast acting? |
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Definition
| Slow acting, takes about 8 weeks to start working |
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Term
| How should RA pt's modify their diet? |
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Definition
| Increase protein, vitamins and iron. small frequent meals |
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Term
| Lupus occurs most often in what populations? |
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Definition
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Term
| New research suggests what hormone is related to lupus? |
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Definition
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Term
|
Definition
| Environment- sunburn, medications |
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Term
| True or False: smoking is linked to lupus |
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Definition
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Term
| Lupus presents with what type of rash? |
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Definition
| A butterfly rash (usually across the nose) |
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Term
| One of the first signs of renal involvement in lupus is? |
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Definition
| elevated serum creatinine |
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Term
| Since lupus has systemic effects, the blood work will show? |
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Definition
| thrombocytopenia, anemia, leukocytosis |
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Term
| Why would a pt with lupus be on a low sodium diet? |
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Definition
| to prevent htn and renal damage |
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Term
| What types of medications are used to treat lupus? |
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Definition
| anti-inflammatories, chemo, Benelysta (monoclonal antibody- new drug) |
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Term
| Polymyalgia rheumatica usually affects which populations? |
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Definition
| those over 50, northern regions |
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Term
| A symptom specific to polymyalgia rheumatica is? |
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Definition
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Term
| What population is mostly affected by fibromyalgia? |
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Definition
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Term
| How does fibromyalgia present? |
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Definition
| pain, fatigue, muscle stiffness |
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Term
| What types of medications are used to treat fibromyalgia? |
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Definition
| NSAIDS, tricyclic antidepressants, regular exercise |
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Term
| How do we measure the spread of cancer/extent of the disease? |
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Definition
| Stages 0-IV (local, regional, extensive, widely spread) |
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Term
| How do we describe what cancer cells look like? |
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Definition
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Term
| In TNM classification, T describes what? |
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Definition
| The size of the tumor (1-4) |
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Term
| In TNM classfication, N describes what? |
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Definition
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Term
| In TNM classification, M describes what? |
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Definition
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Term
| How is the ANC calculated? |
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Definition
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Term
| For a patient to recieve chemo, the ANC must be? |
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Definition
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Term
| A patient is placed on neutropenic precautions when? |
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Definition
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Term
| Neutropenic pt's: skin must be monitored every ___ hours. |
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Definition
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Term
| Breast lumps are most often found where? |
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Definition
| The left breast, upper outer quadrant |
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Term
| At what age do women need to begin recieving annual mammograms? |
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Definition
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Term
| What are some early symptoms of breast cancer? |
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Definition
| nipple retraction, skin dimpling, nipple discharge |
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Term
| What are some late symptoms of breast cancer? |
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Definition
| peau d orange, edema, large fixed lymph nodes |
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Term
| What diagnostic tests are used to diagnose breast cancer? |
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Definition
| ultrasonography, galactography (dye), MRI, biopsy |
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Term
| What is the difference between a sentinal node biopsy and an axillary node biopsy? |
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Definition
| A sentinal node biopsy is the removal of one node: the sentinal node. An axillary node biopsy is the removal of several nodes. |
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Term
| In addition to TNM classification, breast cancers are also classified as? |
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Definition
| A,B, or C (higher the letter= worse) |
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Term
| What is the standard treatment for stage I/II breast cancer? |
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Definition
| lumpectomy (w/axillary node dissection or sentinel node), radiation, chemo |
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Term
| What is the standard treatment of stage III or breast cancer? |
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Definition
| modified radical (breast tissue + lymph nodes), radiation, chemo, hormonal treatment |
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Term
| What is the standard stage IV treatment? |
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Definition
| modified radical, chemo, hormonal manipulation |
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Term
| Systemic chemo is used for? |
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Definition
| All premenopausal women with breast cancer |
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Term
| What type of chemo is used to treat breast cancer? |
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Definition
| adriamycin (alopecia, cardiac- MUGA scan), taxanes |
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Term
| If the cancer is hormonally fed, the pt will be treated with? |
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Definition
| Anti-estrogen medications |
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Term
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Definition
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Term
| After surgery, breast cancer pt will have two JP drains where? |
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Definition
| one in the breast, one in axilla |
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Term
| Lymphadema usually occurs with what type of procedure? |
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Definition
|
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Term
| what are some risk factors for developing breast cancer? |
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Definition
| over age 50, menarche before 12, menopause after 54, nulliparity, first child after 30, |
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Term
| What are some signs/symptoms of leukemia/lymphoma? |
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Definition
| anemia, thrombocytopenia, CBC-large number of immature of WBC's, leukopenia |
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Term
| How is leukemia/lymphoma diagnosed? |
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Definition
| lumbar puncture, bone marrow aspiration, lymph node biopsy, CBC shows blast cells |
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Term
| The goal of chemotherapy in pt's with leukemia/lymphoma is to? |
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Definition
| Reduce blast cells in the bone marrow to less than 5% |
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Term
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Definition
| platelets less than 30,000, leads to spontaneous bleed |
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Term
| what should the nurse do if the pt has platelets less than 30,000? |
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Definition
| administer PRBC's or platelets |
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Term
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Definition
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Term
| How should leukemia/lymphoma pt's alter their diet? |
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Definition
| increase calories, increase vitamins, increase protein |
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Term
| Tumor lysis syndrome is... |
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Definition
| destruction of a large number of WBC's |
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Term
| Tumor lysis syndrome increases ____ and decreases ____ |
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Definition
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Term
| What is graft vs. host disease? |
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Definition
| it when the immune system sees the pt's tissues as abnormal |
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Term
| True or false: a little GVHD shows that the stem cells took |
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Definition
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Term
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Definition
| rash, diarrhea, elevated bilirubin, liver/gut involvement |
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Term
| True or false: Rash is the most mild effect of GVHD |
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Definition
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Term
|
Definition
| It is when the cancer arises from lymphatic structures |
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Term
| What is differentiates non-Hodgkin's lymphoma from Hodgkin's lymphoma? |
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Definition
| non=Hodgkins lymphoma lacks the prescence of Reed-Sternberg cells |
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Term
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Definition
| night sweats, fever, weight loss |
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Term
| What are signs and symptoms of lymphoma? |
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Definition
| enlarged lymph node, pruritis, fatigue, ttachycardia, b symptoms, abdominal pain, ESR elevated |
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Term
| True or false: B symptoms indicate poorer prognosis |
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Definition
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Term
| What is the treatment for lymphoma? |
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Definition
|
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Term
| What does CHOP stand for? |
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Definition
| cytoxan, hydrourea, oncovin, prednisone |
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Term
| Survival rate is best in what type of lymphoma? |
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Definition
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Term
| Which chromosome increases the risk for skin cancer? |
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Definition
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Term
| What things may decrease the risk of developing skin cancer? |
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Definition
| vit e, fish oil, green tea, soy, NSAIDS |
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Term
| True or false: basal cell carcinoma does not metastasize |
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Definition
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Term
| Where is basal cell carcinoma most common? |
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Definition
|
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Term
| True or false: basal cell carcinoma recurs frequently |
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Definition
|
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Term
| How does basal cell carcinoma appear? |
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Definition
| small, fleshy bump or nodule |
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Term
| How is basal cell carcinoma most commonly treated? |
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Definition
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Term
| How does squamous cell carcinoma appear? |
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Definition
| a bump or a red, scaly, itchy patch |
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Term
| Where does squamous cell carcinoma appear? |
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Definition
| rim of ear, face, lips, mouth |
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Term
| Can squamous cell carcinoma metastasize? |
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Definition
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Term
| Melanoma is usually treatable when? |
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Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
| color, pigment not uniform |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
| surgically (cryo, or cut out), phototherapy, chemo (if metastasis) |
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Term
| True or false: Melanoma is the most deadly skin cancer. |
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Definition
|
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Term
| what is considered upper gi? |
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Definition
| mouth to duodenum/jejunum |
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Term
| What is considered lower gi? |
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Definition
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Term
| What does green vomit indicate? |
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Definition
| bile reflux (pyloric sphincter opened) |
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Term
| What does bright red vomit indicate? |
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Definition
| An active bleed above stomach |
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Term
| What does vomit that looks like "coffee grounds" indicate? |
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Definition
| old blood, in the stomach, predigestion |
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Term
| What does black tarry stool indicate? |
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Definition
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Term
| What happens to Hgb and Hct lab values during dehydration? |
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Definition
|
|
Term
| What happens to electrolytes during N/V? |
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Definition
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Term
| What do we usually culture stool for? |
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Definition
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Term
| Pt should be NPO for how many hours prior to endoscopy? |
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Definition
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Term
| How long is pt NPO after endoscopy? |
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Definition
| Until gag reflex reappears, do not want pt. to aspirate |
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Term
| Seafood allergy also indicates what other type of allergy? |
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Definition
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Term
| For pH monitoring, pt should be NPO how many hours before? |
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Definition
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Term
| What are some feeding instructions for pt's with hiatal hernia? |
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Definition
| small frequent feedings, increased HOB, no eating 1 hour before bed |
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Term
| How is hiatal hernia treated? |
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Definition
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Term
| Hiatal hernia can lead to |
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Definition
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Term
| How should pt's with GERD change their diet? |
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Definition
| low fat, no acid producing food, no eating 2 hrs hs |
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Term
|
Definition
|
|
Term
| What is Barrett's esophagus? |
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Definition
|
|
Term
| What symptoms indicate esophageal cancer? |
|
Definition
| dysphasia, foul breath, difficulty breathing, indigestion, difficulty swallowing |
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Term
| How is esophageal cancer primarily treated? |
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Definition
|
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Term
| Put these in order of esophageal cancer treatment: surgery, chemo, radiation |
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Definition
| Radiation to shrink the tumor, Surgery, chemo |
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|
Term
| Should the NG tube be touched after pt has surgery to remove esophageal cancer? |
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Definition
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|
Term
| Postop pt. with esophageal cancer removed should be positioned |
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Definition
| low fowlers, then high fowlers |
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|
Term
| What needs to be placed in pt's mouth post op (esophageal cancer)? |
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Definition
|
|
Term
| After NG is removed pt should eat what? |
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Definition
| Clear liquids, then move on to solids (diet staging) |
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|
Term
| Peptic ulcers primarily affect what populations? |
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Definition
| Men and post-menopausal women |
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Term
| Peptic ulcers present with what type of pain? |
|
Definition
| epigastric gnawing/burning sensation |
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|
Term
| What are some other signs & symptoms of peptic ulcers? |
|
Definition
| black tarry stools, relief with food |
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|
Term
| Peptic ulcers are usually treated with? |
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Definition
| PPI's, H2 blockers, carafate, anatacids |
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|
Term
| Active GI bleed can cause |
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Definition
|
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Term
|
Definition
|
|
Term
| What types of surgery can be used to treat peptic ulcers? |
|
Definition
| vagotomy, billroth I, billroth II |
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|
Term
|
Definition
| Cut vagal nerve in stomach, which decreases acid production |
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Term
|
Definition
| removal of the bottom 1/3rd of the stomach, stomach joined to duodenum |
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Term
|
Definition
| removal of bottom of the stomach and part of the duodenum, stomach joined to jejunum |
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Term
|
Definition
| stomach removed, esophagus joined to jejunum, tx for cancer |
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|
Term
| What is the prep for a colonoscopy? |
|
Definition
| clear liquids, laxatives, enema |
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|
Term
| IBS is most often caused by |
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Definition
|
|
Term
| IBS is most often caused by |
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Definition
|
|
Term
| Who does IBS usually affect? |
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Definition
|
|
Term
| How can lifestyle be changed to help with IBS? |
|
Definition
| increase fiber, decrease stress, avoid foods that exacerbate |
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|
Term
| Gastroenteritis is usually caused by |
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Definition
|
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Term
|
Definition
| twisting of large intestine on itself |
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Term
|
Definition
| large intestine drops in scrotal sac and becomes gangrenous |
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Term
| What happens in the appendix ruptures? |
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Definition
| pain subsides, positive rebound tenderness, and SHOCK |
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|
Term
| appendicitis is associated with |
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Definition
|
|
Term
| diverticulosis usually occurs in |
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Definition
|
|
Term
| Diverticulosis is caused by |
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Definition
|
|
Term
| Diverticulitis is caused by |
|
Definition
| fecal matter in the outer pouches of the colon |
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|
Term
| How is diverticulitis treated? |
|
Definition
| antibiotics, low residue diet |
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