MS FALL FINAL 2

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matthewd
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MS FALL FINAL 2
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2011-12-08 09:53:11
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MS FALL FINAL 2
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  1. is based on degree of differentiation of malignant cells
    tumor grading
  2. tumor cells that retain many of the identifiable tissue characteristics of the original cell
    well differentiated
  3. tumor cells having little similarity to the tissue of origin
    undifferentiated
  4. Grades I – IV = the higher the grade the higher the number and the ____ the prognosis
    worse
  5. agent that destroys malignant cells by stimulating the bodys immune system
    biologic response modifiers
  6. antineoplastics
    caner meds
  7. meds for HIV/AIDs
    antiviral
  8. P wave on ECG; pace maker of heart
    SA Node
  9. located in lower right atrium
    AV node
  10. blood enters the heart; _____carry
    deoxygenated blood back into the heart
    veins
  11. blood leaves the heart; _____carry deoxygenated blood away from the heart
    arteries
  12. Left Sided HF is caused by:
    Ventricular MI

    Aortic valve stenosis

    Prolapsed valve complications

    HTN
  13. Dyspnea
    Cyanosis
    Restlessness
    Moist crackles
    Coughing blood tinged sputum
    Tachycardia
    Hypoxia
    Decreased urinary output

    are s/s of _________
    left sided heart failure
  14. right sided heart failure is caused by?
    • Untreated left ventricular failure
    • Right ventricle MI
    • Chronic obstructive coronary disease
    • Cor pulmonale
    • Pulmonic valve stenosis
  15. s/s of right sided HF
    • Distended jugular veins
    • Edema in the extremities and trunk
    • Hepatomegaly
    • Splenomegaly
    • Oliguria
    • Ascites
  16. Tx for HF
    Decrease workload of heart

    Digoxin

    Lasix

    Bedrest
  17. clot that forms in the deep veins of the arms, pelvic area,
    or legs.
    DVT
  18. Tx for DVT
    oral anticoagulants
  19. If there are obvious signs of thrombosis, _____ should not be assessed bc of possible dislodging of the clot which can lead to pulmonary embolism
    homans sign
  20. most common cause of V FIB
    CAD
  21. Characterized by chaotic quivering of ventricles &
    jagged unidentifiable waves on ECG

    S/S: no pulse/BP/respirations
    V-FIB
  22. what should be done if a client goes into VFIB
    ****Initiate CPR and defibrillate immediately *****
  23. Systematic inflammatory disease that occurs 2-3 weeks after untreated pharyngitis
    Rheumatic Fever
  24. a complication of group A strep
    Rheumatic Fever
  25. TX or Main Goal for Rheumatic Fever
    prevent cardiac complications and recurrence

    provide Broad Spectrum Antibiotics & Strict bedrest
  26. Treatment of myocarditis:
    digoxin
  27. Inflammation of the myocardium of the heart
    myocarditis
  28. temporary condition of chest pain. Give aspirin, Oxygen,
    nitro, morphine in order if pain does not resolve.
    angina pectoris
  29. collection of fluid in the pericardial sac hindering heart function
    cardiac tamponade
  30. oxygen deprivation to the heart
    myocardial ischemia
  31. most common cause of MI
    atherosclerosis
  32. Obstruction in coronary artery resulting in necrosis to
    tissues supplied by artery. Left ventricle most commonly affected.
    MI
  33. MI risk factors
    smoking, obesity, diet, HTN, high cholesterol, family HX
  34. Intermittent spasm of the digital arteries and arterioles
    resulting in decreased circulation to the fingers, toes, and sometimes ears and
    nose

    Fingers become pale and cyanotic when exposed to cold
    weather or emotional stress
    raynauds disease
  35. Fx of lymph system:
    assist in immunity, control edema, absorb digestive fats
  36. Fx of RBC:
    oxygenate blood and body tissues. Most numerous type of blood cells. (4.1-6.1 mill)
  37. Fx of WBC:
    fight infection. Assist with immunity. (4000 – 11000)
  38. Fx of platelets:
    active in clotting mechanism of body
  39. MOST COMMON TYPE OF ANEMIA
    iron deficiency anemia
  40. occurs when body does not have enough iron to synthesize functional Hgb. Most common cause is blood loss with menstrual periods, peptic ulcers, kidney bladder tumor, colorectal cancer.
    iron deficiency anemia
  41. Tx for iron deficiency anemia
    oral iron and rest periods
  42. type of anemia when bone marrow decreases or
    stops functioning. Cause is unknown.
    aplastic anemia
  43. Tx for aplastic anemia
    • immunosuppressant
    • bonemarrow transplant
    • antibiotics
  44. autoimmune disease in which the parietal cells are destroyedand the gastric mucosa atrophies. . Intrinsic factor absorbs Vitamin B12. Onset around age 60 and prevalent in northern European women.

    Tx: anesthetics, Vitamin B12, Folic Acid
    pernicious anemia
  45. destruction of RBC’s caused by autoimmune reaction, radiation, blood transfusion, arsenic, lead, and
    medication. s/s: jaundice, palpitation, hypotension, dyspnea, fatigue, pallor.

    Tx: remove cause; give blood transfusion, splenectomy, corticosteroids, and
    folic acid.
    acquired hemolytic anemia
  46. aka- inherited hemolytic anemia. GENETIC disorder with abnormal hemoglobin S rather than hemoglobin A.
    sickle cell anemia
  47. Nursing considerations for treating heart failure with Lasix
    caution bc lasix is a potassium wasting diuretic

    • monitor client’s loc, skin color and turgor and jugular
    • veins for distention

    assess breath, heart, and bowel sounds

    monitor electrolytes and vital signs

    keep bed in semi-fowlers
  48. “REST AND DIGEST.” conserves, restores,and maintains vital
    functions, slowing heart rate, increasing gastrointestinal activity, and
    activation bowel and bladder evacuation.
    parasympathetic nervous system
  49. activated by stress and prepares the body for “FIGHT or FLIGHT.”

    Causes:
    HR & BP increase, vasoconstriction, decrease peristalsis, dilated pupils,
    increased secretions of epinephrine and sweat, and decreased secretions of
    digestive juices and saliva.
    sympathetic nervous system
  50. hemorrhage of the nares or nostrils. Signs of airway obstruction or aspiration require immediate attention.
    Monitor vital signs. Monitor for nausea and vomiting caused by tipping head back or swallowing blood.
    epistaxis
  51. position clients with epistaxis should be in?
    • Client with episodes should sit up and have head bent
    • slightly forward, breathe through mouth, and allow blood to run freely.
  52. goal of Tx for epistaxis
    • maintain airway
    • stop bleeding
    • identify cause
    • prevent recurrence
  53. Primary Organs apart of the immune system
    bone marrow and thymus
  54. peripheral lymphoid organs apart of the immune system
    • lymph node
    • liver
    • spleen
    • peyer’s patches of small intestines
    • appendix
    • tonsils
  55. Rare lymphoma that arises in painless swelling in a lymph node and most commonly has painless enlarged lymph nodes in the neck, in the area above the clavicles and groin.
    hodgkins disease
  56. biopsied Reed-Sternberg cells from swollen lymph nodes diagnoses ________
    hodgkins disease
  57. hodgkins disease is treaed with ____ & _____
    radiation and rest
  58. Why do you need to assess cardiac system for clients with sickle cell anemia
    Anemia causes cardiac enlargement and arrhythmia.
  59. What involves assessing cerebral function
    • 1. level of consciousness
    • 2. mental status
    • 3. intellectual function
    • 4. emotional status
    • 5. pupil reaction
    • 6. communication
  60. most important indicator of change in neuro status
    LOC
  61. assesses consciousness with head injuries
    glasgow coma scale
  62. awareness of person, time, and place. Use open ended techniques such as “tell me what date and time
    it is”
    orientation
  63. glasgow scale of 15
    fully oriented person
  64. glasgow scale of 3
    lowest score, deep coma
  65. glasgow scale of 7
    state of coma
  66. what to do when glasgow score goes from 13 to 10?
    notify MD STAT
  67. Abnormal responses in neuro assessment
    abnormal reflex = fanning of the toes and dorsiflexion of the big toe in response to the assessment of the plantar reflex is called a positive babinski’s
  68. positive babinski is indicative of?
    corticospinal disease
  69. Interventions to decrease intracranial pressure
    -monitor with ICP device that has a small tube placed in brain ventricle to drain CSF

    -HOB semi fowlers

    -give oxygen check ABG’s

    -decompression

    • -corticosteroids, diuretics, antacids, antipyretics,
    • anticonvulsants
  70. Space-occupying intracranial lesions – either benign or
    malignant that originate in other body parts
    Metastatic brain tumors
  71. what is true about Metastatic brain tumors
    manifestations differ according to the area of the lesion and the rate of growth
  72. weakness in the wall of a blood vessel
    aneurysm
  73. inability to recognize either by sight or sound familiar objects such as a hairbrush
    agnosia
  74. temporary impairment of blood flow to the brain
    TIA
  75. major risk factor for stroke:
    HTN
  76. Guidelines for monitoring risk for stroke
    • monitor blood pressure
    • assess gag relex'
    • exercise
    • do not smoke
    • use alcohol in moderation
    • be aware of cholesterol
    • control DM
    • check circulation problems
  77. Method of controlling seizures
    maintain with minimal side effects
  78. primary method of controlling seizures
    pharmacological therapy
  79. Nursing implications for clients with spinal cord injury
    Assess BP immediately and monitor every few minutes until within normal limits
  80. nursing Tx for clients with spinal cord injury
    Surgical intervention for decompression, realignment and stabilizing vertebral column
  81. chronic, progressive, degenerative disease affecting area of the brain controlling movement
    parkinsons disease
  82. major cause of death for parkinsons is:
    injury or immobility
  83. s/s of parkinsons
    • Signs of PD muscular rigidity, muscular weakness, BRADYKINESIA
    • (slowness of voluntary movement and speech) impaired ADL’s. shuffling gait,
    • pill rolling movement, monotone, mask like face
  84. activity adn diet for parkinsons
    activity: encourage independence

    diet: is pureed food; monitor for choking bc of dysphagia
  85. Tx for tremors and ridgetity for parkinsons
    anticholinergecs
  86. disease of the CNS by loss of myelin in the brain, spinal cord, and sclerotic patches. the disease interferes w/ conduction of impulse.

    Dx between age 20-50, women are more affected
    multiple sclerosis
  87. multiple sclerosis is exacerbated by?
    periods of emotional and physical stress
  88. activity and diet for multiple sclerosis
    • activity: maintain highest possible function. Encourage
    • independence

    diet: high fiber to prevent constipation
  89. progressive fatal disease characterized by the degeneration of motor neurons in the cortex, medulla, and spinal cord

    upper and lower extremities deterioriate. Hands forearms and legs atrophy first

    s/s respiratory and communication affected. Drooling and impaired swallowing

    tube feeding with regular soft food

    activities and ambulation encouraged as long as possible
    amyotrophic lateral sclerosis (Lou Gherigs disease)
  90. Amyotrophic Lateral Sclerosis onset age 40 – 70 years = men affected more than women

    Average life from onset is ____ yrs
    3
  91. focus for ALS
    • treat symptoms and promote independence as long as
    • possible
  92. acute inflammation process involving the motor and sensory neurons of the peripheral nervous
    system

    cause us not known but preceded by infection

    Stages:
    acute onset = 1-3 wks
    plateau = days – 2 wks
    Recovery phase= remyelination, last to 2 yrs
    Guillain Barre Syndrome
  93. where does motor weakness with Guillain Barre syndrome begin
    legs and progresses up the body
  94. condition of pain in the head caused by stimulation of pain sensitive structures in the cranium, head, or neck
    HA
  95. HA’s are _______ not diseases
    symptom’s
  96. 2 types of HA
    • primary
    • secondary
  97. 3 types of primary HA
    • tension
    • migraine
    • cluster
  98. most common type of HA that affects both sides of the head
    tension
  99. HA that occurs behind the eye and is severe; occurs in men; alcohol can be a cause
    cluster HA
  100. HA that is vascular and recurrent = affects
    one side of head; occurs in women
    migraine
  101. pathological conditions such as aneurysm, brain
    tumor, inflamed cranial nerves.

    Caused by compression, inflammation, or hypoxia
    of pain sensitive structures
    secondary HA
  102. inflammation of the brain
    virus is a common cause
    highly contagious

    s/s fever, HA, nuchal rigidity, photophobia,
    irritability, vomiting

    lumbar puncture is performed to test CSF for
    causative agent
    encephalitis
  103. inflammation of the meninges
    virus is a common cause
    highly contagious
    prophylactic measurements for client contacts

    s/s fever, HA, nuchal rigidity, photphobia,
    irritability, vomiting

    lumbar puncture is performed to test CSF for
    causative agent
    meningitis
  104. chornic progressive hereditary disease of the nervous system

    characterized by progressive involuntary choreiform movement and progressive dementia

    ambulation is maintained as long as possible

    high calorie diet

    everyone who has the gene will develop the
    disease

    death results from HF, pneumonia, infection or
    choking
    huntingtons disease
  105. genetic counseling is suggested with ____?
    huntingtons disease
  106. inherited neurological movement disorder that
    also has a prominent behavioral manifestation including motor tics, involuntary repetitive movements, and copopraxia

    onset before 18 years old; affects males more

    psychotherapy and family counseling
    tourettes syndrome
  107. Triaging a client in the emergency department
    emergent = cardiac arrest multiple trauma, (sustain life or limb)

    urgent = compound fracture, persistent vomiting, diarrhea, (prevent worsening)

    Nonurgent = contusions, minor sprains, fractures (no riskfor permanent consquences)
  108. golden rules of emergency
    1. establish safety of the scene

    2. remove the client from danger

    • 3. manage ABCD’s (shock, bleeding, disability,
    • neuro status w/ Glasgow coma scale)

    4. attend to eye and skin injuries

    5. call for help
  109. Triaging a client in a disaster
    immediate (red) = head injuries, shock, risk for death

    delayed (yellow) = client can follow directions

    minor (green) = Tx is reassurance and transportation

    deceased = (black or navy)
  110. A situation or event of greater magnitude than an
    emergency that has unforeseen, serious, or immediate threats to public health
    disaster
  111. body’s inability to meet tissue demand for oxygen
    shock
  112. types of shock
    hypovolemic

    cardiogenic

    distributic (septic, anaphylactic, neurogenic)

    obstructive
  113. shock due to hemorrhage/ burns, diarrhea, vomiting, gastric ulcer
    hypovolemic shock
  114. Tx for hypovolemic shock
    fluid replacement
  115. shock caused by heart conditions. Most common cause is MI
    cardiogenic shock
  116. Tx for cardiogenic shock
    MAINTAIN ABC’S drug therapy for MI, replace fluid, emergency surgery
  117. shock that is caused by abnormal fluid distribution in circulatory system
    distributive shock
  118. Tx for distributive shock
    HTN meds and lasix
  119. shock caused by indirect pump failure such as arterial stenosis, pulmonary embolism, pulmonary htn,
    cardiac tamponade
    obstructive shock
  120. Tx for obstructive shock
    treat underlying cause, give fluids
  121. nurses focus on shock
    identify type of shock and intervene
  122. shock management is to ______
    maintain ABC’s
  123. when is CPR done?
    CPR is done when ABC’s are not functioning
  124. ____ is used for CPR in replacement of mouth to mouth
    bag valve mask
  125. all emergencies require?
    management of ABC's first
  126. what to do when a client with head trauma has hiccups
    inform MD immediately
  127. when a head trauma cleint has clear fluid leaking from ears and nose, what could be a possibility
    CSF leakage; test fluid for glucose level to determine
  128. Tx for rape victims
    accurate and methodical care must be given to the survivor of sexual assault
  129. To prevent atrophying of casted muscles teach client to?
    contract and release immobilized casted muscles
  130. RICE means
    REST, ICE, Compression, Elevation
  131. the client for transport to a burn unit usually
    involves insertion of at least two large-bore IV lines, insertion of a NG tube intubation. Foley catheterization, sterile wrapping, and temperature
    regulation/monitoring this is called
    packaging
  132. with burns pain meds are given before ______
    debriding
  133. what to do during a snake bite
    use rubber band above the site to prevent rapid spread of venom
  134. abrupt pain of facial and muscle contractions
    Trigeminal Neuralgia (TIC DOULOUREX):
  135. Inflammation of bronchioles and alveoli
    accompanied by solidification of exudate in lungs.

    Can result from bacteria, viruses, mycoplasms, fungi, chemicals, or parasite invasions.

    Also results from aspiration, oversedation, or inadequate ventilation.
    pneumonia
  136. Caused by inhalation of Mycobacterium tuberculosis

    Symptoms: Low-grade fever, persistent cough,
    hemoptysis, hoarseness, dyspnea, night sweats, fatigue, and weight loss
    TB
  137. Painful condition from inflammation of pleura

    Occurs with many conditions ie: viral infection, cancer of the lung, trauma, TB, CHF, and pulmonary embolism

    Symptoms: Pain on inspiration (pleura rubbing together)

    Described as “Sharp stabbing pain on inspiration”
    pluerisy
  138. Pleural fluid accumulation within
    pleural space

    Symptoms depend on amount of lung
    tissue compressed and source of effusion
    plueral effusion
  139. Viral illness with flu-like symptoms associated with coronovirus.

    Spread by close personal contact or contact with infectious material

    Treatment: Supportive care, follow standard
    and airborne precautions
    SARS
  140. most common cause of atelectasis
    obstruction
  141. Intermittent airway obstruction in response to variety of stimuli

    Symptoms: Sudden inspiratory and expiratory
    wheezing, increasing dyspnea, and chest tightness

    Treatment: Taking medications and avoiding
    known allergens
    asthma
  142. Inflammation of bronchial tree with hypersecretion of mucus

    Cause: environmental factors (cigarette smoke) plays an important factor!
    chronic bronchitis
  143. Complex and destructive lung disease where air accumulates in lungs

    Airflow impeded as it leaves lungs

    Results in alveoli distention, rupture of alveoli walls, loss of available areas for gas exchange

    First symptom: Daily morning cough with clear
    sputum
    emphysema
  144. Air in pleural space
    pneumothorax
  145. syndrome of alternating clotting and hemorrhging
    DIC
  146. inherited bleeding disorder with lack of clotting factor
    hemophilia
  147. 5th most common cancer in the US
    non hodgkins lymphoma

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