Adult Health Final

Front 1

Cause of Parkinson's Dz

Back 1

Loss of dopamine, degenerative changes in substantia nigra (makes dop). Severe shortage of dop vs. Ach. Most common in white males

Front 2

Meds for Parkinson's dz

Back 2

L-dopa, Sinemet (levadopa and carbidopa), Dop-agonists, anticholinergics, COMT inhibitors

Front 3

Osteoarthritis (idiopathic and secondary)

Back 3

Idiopathic: women, 65+, genetic trait
Secondary: more prevalent in men, results from trauma, wear and tear.

Front 4

Characteristics of Osteoarthritis

Back 4

Chronic degenerative cond. in which cartilage degenerates and new bone forms. Becomes fibrotic w/ limited movt. Ls, CS, proximal, and distal jts. of hands. Pain and stiffness relieved by rest

Front 5

Mgt. of osteoarthritis

Back 5

Palliative. NSAIDs first line, then COX-2 inhibitors. Moderation is key. ROM, water aerobics, parafin dip, firm mattress.

Front 6

Nursing mgt. after THR

Back 6

*keep in place to prevent popping out.
drains (no more than 200 cc in 8 hr), HOB <70 degrees, don't cross legs, bend at waist, use high toilet seat for 6-8 wks.

Front 7

Rheumatoid arthritis char.

Back 7

Systemic,autoimmune, women more than men, exacerbations and remissions, WBCs move into synovium, causes thick secretion, both sides at same time.

Front 8

Medical mgt. of RA

Back 8

Pain and inflammation relief, maintain or restore jt. function, control systemic involvement.

Front 9

Fasting Blood Glucose levels

Back 9

>126 Diabetes
110-126 Pre-diabetes
<110 Normal

Front 10

Oral glucose tolerance test levels

Back 10

>200 Diabetes
140-200 Pre-diabetes
<140 Normal

Front 11

Steroids effects on [glu]

Back 11

Increases

Front 12

A1C levels

Back 12

Measures BG over last 3 mos. Normal <6, Goal <7 ([glu]<150)

Front 13

Insulin that is administered IV

Back 13

Regular (short acting)

Front 14

Somogyi Effect

Back 14

Hypoglycemia at night w/ rebound hyperglycemia in AM. Caused by excessive insulin at night. Monitor BG b/w 2-4 am and at 7 am

Front 15

Dawn Phenomenon

Back 15

Rise in early morning BS (b/w 4-8 AM), caused by nocturnal elevation of GH or incr. insulin clearance. Increase insulin dose

Front 16

Hyperglycemia symptoms

Back 16

Hot, dry, GI (thirst, polyurea, dry skin, flushed, hunger, blurred vision, drowsiness)

Front 17

Hypoglycemia symptoms

Back 17

Cold, wet, CNS

Front 18

Tx of DKA

Back 18

Rehydration, insulin, K replacement, monitor BS

Front 19

HHNKS S/S

Back 19

hyperosmolar hyperglycemia nonketotic syndrome. S/S: similar to DKA except BS >600, ketones absent, no Kussmaul

Front 20

Causes of goiter

Back 20

Lack of iodine, inflammation or tumor.

Front 21

Dx and Tx of goiter

Back 21

Dx: palpate, T3, T4, and TSH normal
Tx: iodine replacement, TH, surgery for dyspnea, resp. support

Front 22

Myxedema symptoms

Back 22

End stage of uncorrected hypothyroidism, life-threatening. Caused by stress. Char: dry, waxy swelling w/ abnormal deposits of mucin around eyes, women in 60s, Tx w/ TH

Front 23

Graves dz char. and clinical manifestations

Back 23

Char: hyperthyroidism, goiter, exopthalmos. Autoimmune.
Manifestations: incr. metabolism, incr. sensitivity to stimulation by SNS

Front 24

Thyroid storm char.

Back 24

thyrotoxicosis, caused by stress. Severe hyperthyroidism, severe tachycardia, heart failure, shock, hyperthermia, n/v, febrile

Front 25

Thyroid storm tx

Back 25

Fever reduction, fluid replacement, elemination or mgt. of stressor, reduce TH

Front 26

Thyroid ablation

Back 26

Renders thyroid useless, use radioactive iodine

Front 27

Post-op mgt. for thyroid surgery

Back 27

Ca gluconate at bedside to mamage tetany

Front 28

Tests for tetany

Back 28

Chvostek's sign-twitching of facial muscles after tapping nerve in front of ear
Trousseau's sign-carpal spasms when arm compressed

Front 29

Parathyroid function

Back 29

Manage Ca levels (8-11 mg/dL)

Front 30

Hyperparathyroidism manifestations

Back 30

Stones: r/t decreased volume
Bones: osteoporosis, joint and bone pain, fractures
Moans: fatigue, weakness, memory loss
Groans: constipation, n/v, indigestion

Plyuria leads to polydipsia
*Too much PTH

Front 31

Tx of hyperparathyroidism

Back 31

Hydration w/ NS, Lasix (Ca release in urine), glucocorticoids (prevent Ca absorption in GI), cranberry juice to prevent stones, 3L fluid qd,

Front 32

Hypoparathyroidism

Back 32

Abnormally low Ca, too little PTH, can be Iatrogenic (acute, caused by tx) or Idiopathic (chronic autoimmune disorder)

Front 33

Clinical manifestations of hypoparathyroidism

Back 33

Positive chosteks and trousseau's signs, hyperactive deep tendon reflexes, numbness and tingling of fingers, mouth, and eyes.

Front 34

Addison's dz

Back 34

Hypofuncion of adrenal gland caused by abnormal function of adrenal cortex or long-term use of glucocorticoids. Slow onset w/ mild symptoms of weakness, ortho. hypotn, weight loss, axillary and pubic hair loss

Front 35

Hallmarks of Addison's dz

Back 35

Hypoglycemia, hyponatremia, hypovolemia, hypotension, hyperkalemia, hyperpigmentation

Front 36

Tx of Addison's dz

Back 36

Replace steroids, f/e replacement, 5 S's (Salt, sugar, steroids, support, search for cause)

Front 37

Cushing's syndrome causes

Back 37

Too much cortisol: prolonged use of corticosteroids,ACTH secreting pituitary tumor, Cortisol secreting neoplasm in adrenal cotex

Front 38

Char. of Cushing's syndrome

Back 38

Abdominal obesity w/ very thin arms (wasting of extremeties), moon shaped face, fat pad on back (buffalo hump), excessive facial hair

Front 39

Tx of Cushing's

Back 39

Discontinuation of steroid admin., surgical removal of tumor, radiation on inoperable tumors

Front 40

SIADH clinical manif.

Back 40

Too much ADH->excess fluid volume, hyponatremia, anorexia, n/v, tachycardia,

Front 41

DI clinical manif. and tx

Back 41

Too little ADH, 5-20 L urine output qd
Tx: surgery for pituitary tumor, meds (ADH replacement), IV fluids

Front 42

Brain changes w/ Alzheimer's

Back 42

Senile plaques, nerofibrillary tangles, enlarged ventricles, generalized atrophy

Front 43

Stages of AD

Back 43

Stage 1: (1-3 yrs) memory disturbances
Stage 2: (2-10 yrs) Palilalia and echolalia, motor disturbances (apraxia, pacing, wandering)
Stage 3: (8-12 yrs) All mental and speech abilities lost

Front 44

Dementia vs. Delerium

Back 44

Dementia-irreversible, slow onset, MMSE <20
Delirium-reversible, rapid onset, medication related, infection

Front 45

Meds for AD

Back 45

AChE inhibitors: memory
Vit. E and Selegiline
Ginkgo biloba
Anxyiolytics
Haldol
Antidepressants
NO CURE, JUST DELAY PROGRESSION

Front 46

Hepatitis transmitted via fecal-oral route

Back 46

A,E, and F

Front 47

Hepatitis transmitted via blood

Back 47

B, C, D, G

Front 48

Prodromal stage of hepatitis virus

Back 48

Highly transmissible, 1-5 days before onset of clinical stage. lethargy, irritability, myaligia, arthralgia, anorexia, n/v, abd pain, diarrhea, fever

Front 49

Clinical stage of hepatitis

Back 49

1-2 wks after prodromal stage, phase of actual illness, aka icteric stage, itching, indigestion, jaundice (can last up to two weeks), abd. pain, anorexia,

Front 50

Recovery stage of hepatitis

Back 50

bigins w/ resolution of jaundice, contiued fatigue, flatulence, abd. pain

Front 51

Medical mgt. of hepatitis

Back 51

Rest, antihistamines to relieve itching, emooients and lipid creams, maintain nutrition and fluid balance, vit. K for elevated PT, avoid hepatotoxic drugs (tylenol), get most nutrients early in day

Front 52

These heps have a vaccine

Back 52

HAV and HBV

Front 53

Fulminant hepatitis

Back 53

Rare, B,D, and E, massive hpatic necrosis, jaundice, encephalopathy, and ascites, mortality rate reaches 90%

Front 54

Chronic hepatitis

Back 54

liver inflamed longer than 3-6 mos, three types (B, C, and autoimmune), mainly occurs in males

Front 55

Cirrhosis of the liver

Back 55

Chornic, progressive, fibrosis (scarring) and nodule formation. Collapse of reticulin network, distortion of vascular bed

Front 56

Risk factors for cirrhosis

Back 56

Excessive ETOH, viral hepatitis (postnecrotic cirrhosis), use of drugs, hepatic congestion, ingesting same toxin daily

Front 57

Causes of ascites

Back 57

Portal htn, lowered plasma osmotic pressure, Na retention, cor pulmonale, plasma leaks from congested protal capsule into abd.

Front 58

Mgt. of ascites

Back 58

Correct f/e imbalance, paracentesis, administer albumin and diuretics, diet modifications (low Na, fluid restrictions), effective breathing patterns, maintain skin integrity

Front 59

Hepatic encephalopathy

Back 59

Severe liver dz, liver's inability to metabolize ammonia to form urea, NH3 a CNS depressant (from GI and kidneys when decr. K)

Front 60

Manif. of hepatic encephalopathy and tx

Back 60

Neurologic (mild confusion to deep coma), liver flap (asterixis)
Tx: demodialysis, neomycin (dec. NH3), induce osmotic diarrhea, laxative, low protein diet

Front 61

Melena

Back 61

Black, tarry stool passed w/ GI bleed

Front 62

Manifestations of GI perforation

Back 62

Abd. hard and tender, diminished bowel sounds

Front 63

Ulcerative colitis s/s

Back 63

Inflammation, ulcers BLEED and produce pus, thickening of colon, congestion, edema, absesses->necrotic, bleed. Abd. pain, bloody diarrhea, weight loss, anorexia, becomes more severe as dz progresses,

Front 64

Crohn's dz manifestations

Back 64

Inflammation of segments of GI tract, no bleeding, cobblestone appearance, stricture development, blockage of intestine, steatorrhea (smelly b/c not reabsorbing fats and bile salts), incr. WBC