Med Surg

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  1. Alopecia
    localized or general loss of hair
  2. Carotenemia
    Discoloration (yellow) of skin, most noticeable on palms & soles. From veggies (carrots & squash) & hypothyroidism
  3. Cyanosis
    Bluish-gray or purple discoloration caused by presence of excessive amts of reduced hemoglobin in capillaries
  4. Hematoma
    Extravasation of blood of sufficient size to cause visible swelling from trauma or bleeding disorders. (Bruise)
  5. Hypopigmentation
    Loss of pigmentation resulting in lighter patches than a normal skin color. Caused by chemical agents, nutritional factors, burns, inflammation, & infection
  6. Jaundice
    yellow or yellowish-brown discoloration of the skin, best observed in sclera, secondary to increased bilirubin in the blood. Caused by liver disease, RBC hemolysis, pancreatic cancer, common bile duct obstruction.
  7. Tenting
    Failure of skin returning to normal position immediately after gently pinching. From aging, dehydration, or cachexia
  8. ABCDE rule for Melanoma
    Examine skin lesions for Asymmetry, Border irregularity, Color change/ variation, Diameter of 6 mm or more, and Evolving in appearance
  9. Wood's Lamp
    Exam of skin w/ long-wave UV light causes specific substances to fluorescence.
  10. Patch test
    Used to determine whether pt is allergic to specific testing material. Small amt of potentially allergenic material applied, usually to skin on back
  11. Impetigo
    Hemolytic strept or staph associated with poor hygiene. CONTAGIOUS. Thick, honey-colored crust most common on face. TREAT WITH ABX
  12. Furuncle
    Deep infection around hair follicle associated w/ severe acne. Tender, pus-filled areas on face, back of neck, axillae, breasts, butt, thighs, & perineum. Extremely painful. TREAT W/ ABX
  13. Carbuncle
    Multiple interconnecting furuncles. Most common on nape of neck. Pustules
  14. Cellulitis
    inflammation of SQ tissues following break in skin. Can progress to gangrene. TREAT W/ ABX, pt on contact precautions
  15. Herpes Simplex type 1 & 2
    Oral and genital. Life-long viral infection that effects skin and mucus membranes when exacerbated by sunlight, trauma, menses, stress, & systemic infection. TRANSMITTED BY RESP DROPLETS.
  16. Herpes Zoster (Shingles)
    Increased with age. Potentially contagious. Resembles chickenpox. Activated from varicella-zoster virus.
  17. Plantar Warts
    Caused by HPV. Wart on bottom surface of foot, growing inward. Painful when pressure applied
  18. Candidiasis
    Caused by candida albicans. Presents in warm, moist areas causing yeast to become pathogenic.
  19. Tinea Corporis
    Ringworm. Ringlike, scaly appearance w/ well-defined margins
  20. Tinea Cruris
    Jock itch. Well-defined scaly plaque in groin area. Does not effect mucus membranes.
  21. Tinea Pedis
    Athlete's foot. Interdigit scaling & maceration
  22. Tinea Unguirum (Onychomycosis)
    Increased w/ age. Effects finger & toe nails creating scaly, brittle, thickened, broken/ crumbling nails w/ yellow discoloration
  23. Bedbugs
    Feeding, usually at night. Wheal transforming into persistent lesion. Severe itching. Teach about hygiene. Fumigate home.
  24. Pediculosis (Lice)
    Parasites that suck blood & leave eggs and waste on skin & hair. Leaves small red points & severe itching. Occurs around back to school time
  25. Scabies
    Mites that penetrate stratum corneum, deposits eggs. Transmission by direct physical contact, presence of burrows.
  26. Ticks
    Causes Lyme disease. Spreads ringlike rask 3-4 wks after bite. Looks like a bulls-eye causes flu-like symptoms
  27. Drug Allergy
    Any rash w/ abrupt onset. Treat w/ antihistamines & corticosteroids (Benadryl is most common)
  28. Acne Vulgaris
    Inflammatory disorder of sebaceous glands. More common in teens. Corticosteroids can cause flair
  29. Nevi (moles)
    Grouping of norm cells derived from melanocyte-like precursor cells. Hyperpigmented areas (flat, raised, or hair)
  30. Psoriasis
    Autoimmune chronic dermatitis causing silvery scaling plaques
  31. Acrochordons (skin tags)
    common after midlife. Small, skin-colored, soft papules. Caused by high cholesterol
  32. Antibiotics
    Used both topically & systemically. Common OTC= Neosporin, bacitracin, & polymyxin. Prescription= mupirocin, gentamicin, & erythromycin
  33. Corticosteroids
    Topical=inflammation & itching. Corticosteroids can alter manifestations so dx before admin.
  34. Antihistamines
    Treats uticaria, angioedema, & pruritis. Warn about sedative effects. Claritin, Zyrtec
  35. Skin scraping
    Done with scalpel blade for microscopic inspection and dx
  36. Curettage
    scooping and removal of tissue w/ instrument w/ a circular cutting edge. Tissue sent for biopsy
  37. Punch biopsy
    Obtains tissue sample for study or removal of small lesion. Punches deep into flesh & tissue and placed in preservation solution
  38. CD4+
    • Main receptor HIV binds to. Pt can be asymptomatic for 10-12 years while HIV levels remain low in blood.
    • Norm values: 800-1200
  39. Systole
    Contraction of myocardium, resulting in ejection of blood from ventricles
  40. Diastole
    relaxation of myocardium, resulting in filling of ventricles
  41. Cardiac Output (CO)
    amt of blood pumped by each ventricle in 1 min
  42. Preload
    vol of blood in ventricles at end of diastole, before next contraction
  43. Afterload
    Peripheral resistance against which the left ventricle must pump.
  44. Contractility
    Can be increased by epi and norepi released by SNS. Increasing contractility raises the SV by increasing ventricular emptying
  45. Baroreceptors
    Located in aortic arch & carotid sinus. Sensitive to stretch or pressure in arteries. Stimulation inhibits SNS & influences PNS. Decreasing arterial pressure causes opposite
  46. Chemoreceptors
    located in aortic & carotid bodies. Capable o initiating change in HR & arterial pressure in response to increased arterial CO2 pressure (hypercapnia) & decreased arterial O2 pressure (hypoxia) & decreased plasma pH (acidosis)
  47. Pulse Pressure
    Difference between SBP & DBP. Normally about 1/3nof SBP. Increased= exercise or atherosclerosis. Decreased= HF or hypovolemia
  48. Mean Arterial Pressure (MAP)
    Avg pressure in arterial system that is felt by organs of body. Map>60. MAP=(SBP+2DBP)/3
  49. Normal VS. BP, HR, RR, Temp
    BP: 120/80, HR: 60-80, RR: 12-20, Temp: 97-99
  50. JVD
    jugular vein distention. Can be caused by R sided HF
  51. Pulse grades
    0=absent, 1+=weak, 2+=normal, 3+=bounding
  52. Bruit
    Turbulent flow sound in artery caused by obstruction or aneursym
  53. Murmur
    Turbulent sounds occurring between normal heart sounds caused by valve disorder or abn blood flow patterns.
  54. Valve replacement
    Mechanical clicking noise caused by a mechanical valve
  55. Pericardial friction rub
    High-pitched, scratchy sound heard during S1 &/or S2 at the apex. Heard best w/ pt sitting & leaning forward & at end of expiration. Caused by pericarditis
  56. Angle of Louis
    Raised notch where 2nd rib meets sternum
  57. Central cyanosis
    Bluish/ purplish tinge along center such as tongue, conjunctiva, inner mucosa of lips. Caused by inadequate O2 sat of arterial blood from pul or cardiac disorders
  58. Peripheral Cyanosis
    Bluish/ purplish tinge in extremities or nose & ears. Caused by decrease in blood flow due to HF, vasoconstriction, cold environment
  59. Cardiac Markers
    released into circulation as byproduct of myocardial cell injury or death
  60. Troponin
    myocardial muscle protein released into circulation after injury. Any rise is dx of myocardial injury. Troponin I=<0.5. Troponin T=<0.1
  61. CKMB
    enzymes released by heart. 6 hrs after onset of symptoms, peak in 18 hrs, & return to norm 24-36 hrs after MI
  62. ECG/ EKG
    records electrical cardiac activity from different views. Can detect: rhythm, abn condition, size of atria & ventricles, PM activity, heart position, Hx of MI, presence of injury
  63. Stress Test
    uses 3 min stages at set speeds & elevation of treadmill to get pt to target HR
  64. Systolic Failure
    Results from inability of heart to pump blood effectively. Caused by impaired contractile function, increased afterload, cardiomyopathy, & mechanical abnormalities. Decrease in EF
  65. Diastolic Failure
    Inability of ventricles to relax & fill during diastole. Decrease filling of ventricles results in decreased SV & CO. Characterized by high filling pressures & engorged veins in pulm & systemic vascular systems
  66. Dilation
    enlargement of heart chambers due to long term elevated pressure in heart chambers. Decreased CO
  67. Hypertrophy
    Increase in muscle mass & cardiac wall thickness in response to overwork & strain. Occurs slowly b/c it takes time for increased muscle tissue to develop.
  68. Left-sided HF
    Results from L ventricular dysfunction causing blood to back up into pulm veins manifesting into pulm congestion & edema
  69. Signs and symptoms of Left-sided HF
    Increased HR, Decreased PaO2, slight increase in PaCO2, crackles, pleural effusion, change in mental status, confusion, restlessness, dyspnea
  70. Right-sided HF
    causes back up of blood into venous circulation. Venous congestion results in JVD, hepatomegaly, splenomegaly, vascular congestion of GI & peripheral edema. Primary causes is L sided HF
  71. Signs and symptoms of R-sided HF
    Murmurs, JVD, Edema, weight gain, Increased HR, ascites, fatigue, anxiety, anorexia, N/V, RUQ pain
  72. Drug therapy for HF
    Diuretics to decrease venous return & amt of blood returned to LV during diastole. Vasodilators to decrease circulating vol by decreasing preload & increasing coronary artery circulation by vasodilation
  73. Morphine
    decrease preload & afterload & frequently used to treat ADHF & pulm edema. Dilates both pulm & systemic blood vessels to decrease pulm pressure & improve gas exchange
  74. Inotropes
    Increased myocardial contractility. Digitalis improves LV dysfunction & increased contractility & myocardial O2 consumption
  75. Normal BP
    SBP <120 & DBP<80
  76. Pre-HTN
    SBP 120-139 or DBP 80-89
  77. HTN stage 1
    SBP 140-159 or DBP 90-99
  78. HTN stage 2
    SBP (> or = to) 160 or DBP (> or = to) 100
  79. Modifiable risk factors of HTN
    Alcohol, cigarette smoking, DM, elevated lipids, excess dietary sodium, obesity, sedentary lifestyle, stress
  80. Non-modifiable risk factors of HTN
    Age, gender, FmHx, ethnicity, socioeconomic status
  81. CAD
    HTN effects endothelium resulting in stiffened arterial wall & a narrowed internal lumen
  82. L ventricular hypertrophy
    Sustained high BP increases cardiac workload & produces LV hypertrophy. It is initially an adaptive or compensatory mechanism but over a long period of time, the heart can no longer meet the demand & HF develops
  83. HF
    occurs when hearts compensatory adaptations are overwhelmed & the heart can no longer pump enough blood to meet body's needs
  84. CV disease
    Atherosclerosis is most common cause of cerebrovascular disease. Risk of stroke 4x higher
  85. Peripheral vascular disease
    Atherosclerosis in peripheral blood vessels caused by HTN that leads to PVD, aortic aneurysm, & aortic dissection
  86. Nephrosclerosis
    HTN causes end-stage renal disease, especially in African Americans. Narrowed lumen cuses ischemia. Intrarenal
  87. Retinal damage
    Indication of concurrent vessel damage in the heart, brain, & kidneys
  88. DASH diet
    diet that emphasizes fruits, veggies, fat-free or low-fat milk & milk products, whole grains, fish, poultry, beans, seeds, & nuts. Significantly lowers BP (AKA cardiac diet)
  89. HTN meds 2 main actions
    1. decrease vol of circulating blood. 2. decrease SVR (systemic vascular resistence)
  90. Diuretic physiology
    promote Na+, H2O excretion, decrease plasma vol, & vascular response to catecholamines
  91. Adrenergic Inhibitors physiology
    Diminishes SNS effects that increases BP
  92. Direct Vasodilators physiology
    Decreased BP by relaxing vascular smooth muscle & decreased SVR
  93. Calcium Channel Blockers (CCB) physiology
    Increased Na+ excretion & causes vasodilation by preventing the movement of extracellular Ca+ into cell. Causes decreased HR, contractility, & stroke volume
  94. Angiotensin Inhibitors physiology
    Reduce A-II mediated vasoconstriction & Na &H2o retention
  95. CAD
    soft deposits of fat that harden with age
  96. Collateral Circulation
    Arterial anastomoses that exist w/in the coronary circulation
  97. CAD developmental stages
    A. Damaged endothelium. B. Diagram of fatty streak & lipid core formation. C. Diagram of fibrous plaque. Raised plaque visible (yellow or white). D. Complicated lesion: thrombus is red, collagen is blue
  98. Chronic Stable Angina
    CP when demand for myocardial O2 exceeds the ability of the coronary arteries to supply the heart w/ O2, causing myocardial ischemia
  99. Prinzmetal's Angina (unstable angina)
    CP that occurs at rest, usually in response to spasm of a major coronary artery
  100. Major treatment of angina
    • A. antiplate (ASA)/ Anticoag, Antianginal (Nitro), ACE inhibitor/ ARB
    • B. Beta-blocker
    • C. Cigarette smoking, CCB
    • D. Diet, DM
    • E. Education, Exercise
    • F. Flu shot
  101. Rheumatic Heart Disease
    Chronic condition resulting from rheumatic fever that is characterized by scarring & deformity of the heart valves
  102. Stenosis
    Constriction or narrowing of valve
  103. Regurgitation
    incomplete closure of valve leaflets resulting in backward flow of blood
  104. Mitral Valve Prolapse
    Abnormality of mitral valve leaflets & the papillary muscles or chordae that allows leaflets to prolapse or buckle, back into the L atrium during systole
  105. Aortic regurgitation
    constituted as life-threatening emergency
  106. Asthma
    Persistent but variable inflammation of the airways. Caused by exposure to allergens or irritants initiates the inflammatory cascade
  107. COPD
    not fully reversible airflow limitation during forced exhalation caused by loss of elastic recoil & airflow obstruction
  108. Various disease processes that occur during COPD
    • 1. airway limitation
    • 2. gas exchange abnormalities
    • 3. Air trapping
    • 4. Mucus hypersecretion
    • 5. Severe disease pulm HTN
    • 6. Systemic features
  109. Asthma manifestations
    onset <40, presence of allergies, intermittent symptoms, dyspnea absent except in exacerbations, stable disease coarse.
  110. COPD manifestations
    onset 40-50, long history of smoking, infrequent allergies, symptoms are slowly progressive or persistent, dyspnea during exercise, disease coarse gets progressively worse.
  111. Normal ABGs for COPD
    Often normal-low pH & PaO2; normal-high PaCO2 w/ high HCO3 (comp resp acid)
  112. Total lung capacity
    Max vol of air lungs can contain. norm=6.0L
  113. Tidal volume
    vol of air inhaled & exhaled w/ each breath. Only a small portion of TLC. Norm=0.5L
  114. Residual Volume
    Amt of air remaining in lungs after forced expiration. Norm=1.5L
  115. Well controlled asthma
    • Symptoms </= 2 days a week
    • Nighttime awakenings </= twice a month
    • No interference/ norm activity
    • SABA use </= 2 days a week
    • FEV, or peak flow >80%
  116. Not well controlled asthma
    • Symptoms >2 days a week
    • Nighttime awakenings 1-3/ wk
    • Some limitations during norm activity
    • SABA use > 2days/wk
    • FEV, or peak flow 60-80%
  117. Very poorly controlled asthma
    • Symptoms throughout day
    • Nighttime awakenings>/= 4/wk
    • Extremely limited normal activity
    • SABA use several times per day
    • FEV, or peak flow <60%
  118. Flutter valve
    Airway clearance device that causes airway fluttering which loosens mucus
  119. Vest
    connected to pulse-generator thru hoses. Generator delivers air which vibrates the chest, dislodging mucus from airways
  120. Manual percussion
    vibrate hand on chest wall during slow expiration which facilitates movement of secretions to larger airways
  121. SABA
    short acting beta2 adrenergics. Inhaled is most effective for relieving acute bronchospasm
  122. MDI
    Metered dose inhaler. Small hand-held, pressurized device that delivers a metered dose of drug w/ each activation
Card Set
Med Surg
Medical Surgical Nursing 243
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