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143 Cards in this Set
- Front
- Back
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the result of decrese iron supply due to excess bls loss and poor diet and malabsorption is called
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fe deficiency
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what is the average aduls has
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about 4 g (3 g HGB and 500-1 store in the liver
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how much does the body loss ecah day
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1.5 mg/ fe daily
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whwho is most at risk
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pregnant, hemodialysis, infants
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who is this comonly seen with
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poor nut
older adults lower SES phsiologic-mens patho- GI bleeding |
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What is the clinical manifestation seen with this pt (mild and severe?
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fatigue and exertional dyspnea(mild)
severe: cheilosis concave nails smooth red shiny tounghe |
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what type of DT test is done with this pt
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RBC= hypochromic and microcytic
peripheral bld smear -check anemia |
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diagnostic test to confirm if pt has anemia includes
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low serum fe
low ferritin elevate TIBC |
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What type of meds or tx how
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Ferous sulfate on empty stomach with Vit C avoit grapefruit juice
Stool softer |
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what are some teaching regarding meds SE
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stain teeth so take it with straw
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teach pt to report for sign of systemic rx such as
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flusing N/V and myalgia
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other managment includes
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teach to conserve energy
constipation(laxative, stool softner) quiet envt monitor dizziness check and determine stool color consistency, freq and amnt of black tarry stool |
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what vit def is absorb in the stomach that is carried in the ileum where absorb and transported to body?
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Vitamin B12
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who's pt is at more risk
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pt who had total gastrectomy and ileal resection= need parental v12 lifetime
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what cause b12 def
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poor diet
malabsorption pernicous anemia surgery vegetarian- lack B12 alter periperal nerves, spine and brain |
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what type of DT is done with this pt
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Serum=low
RBC- macrocytic and megaloblastic |
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what test is done to confirm pernicous anemia
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24 schilling test
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what type of sx are seen with this pt
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neuro ab
peripheral neuropathy loss proprioception deception loss balance diminish vibrating sence impaired memory and loss mental status |
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what type of treatment is done with this pt
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parenteral administration of Vit B12
for nut def- oral vegetarian- increase fortified soy Malabsorption pt0 lifetime meds |
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what type of teaching is done with this pt about the meds
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burn sensation may be felt
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diet should includ
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dairy, animal products, egg and clients w pernicous need to take their meds regularly
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what is ____ essential for DNA synthesis
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folic acid
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what are the cause
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poor diet, OH, HCG, anorexia
overcook food meds (contraceptive, antiepileptic) |
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who are more at risk
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TPN,
HCG teenager hemodialysis |
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what type of DT test are seen and done
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macrocytic anemia
meglaoblastic in BM (fragile state) Low serum folate |
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what type of sx seen with folic acid def
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NO NEURO SX
gi sx cardiac palpitation pallor, fatigue |
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what are some tx for this pt
pt with diet def? |
PO folic acid daily 100-200 mg well balance diet
diet def: 1 mg day for 3 mos |
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what type of diet may be given with this pt
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meet, egg
cabbage, brocolli, brussel green leafy veg cirtus fruits |
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nursing intervention
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energy saving tech
monitor lab encourage and assist with good oral hygience |
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What is the most common variation that occur in about 20 % of women
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uterine displacement
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what represent a severe uterine problem in which uterus is displaced downward into the vaginal canal to a point of cervix and uterus pass outside the body
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prolapse
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what is UP usually associated with
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cystocele and rectocele
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UP occur to whom
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multiparous white-injury to faschia
Obesity COPD ascites uterine tumor |
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UP may also be congenital or acquired how
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childbirth, close HCG
sugery obesity and aging |
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the severity is base on degree ist degrees pt are seen with
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within vagina
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second degree
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cervic protrudes fr vaginal orifice
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third degree
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entire uterus
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what happen premenopause
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uterus hypertrophy
engorge and flabby vaginal mucosa thickens stasis ulcer may develop |
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If patient complain ofprotrude of rectum in
vagina wall its called |
rectocele
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herniate into the bladder is called
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cystocele
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what is common in female and may remain asymptomatic
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cystocele
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what hormone help tone and with its lost result in atropic changes?
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estrogen
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a pt with 1st degree may experience what sx? and with severe?
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sense heaviness
falling out of vagina fell like sit in ball |
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as a result of uterine engorgement, premenoupause pt may develop
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leukorrhea
menometrorrhagia |
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postmenopause pt due to bleeding and discharde result fr
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ifection and ulceration
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pt with cystocele may complain of
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stress UI
(cough,lift, laugh) increase UTI |
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pt with rectocele complain of
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hemorrhoids and constipation
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what type of DT
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pelvic exam
Fistulogram- inj dye locate and severity small fistula-surgery |
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cystocele result with
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vaginal outlet relaxe and thin with smooth bulging mass, b/w th cervix
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rectocele patient have
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thin wall rectovaginal septum that project into the vagina
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with postmenopausal pt what type og tx are done
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estrogen therapy to maintain tone and integrity
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what is the biggest nursing intervention for all women
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exercise
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if pt have pain or bleeding other method inlcudes
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pesary ( rubber thatn maintain uterus in forward position)
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when is surgery done and what type
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A&P colporrhy (tighten the vagina wall)
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pt with mild sx rectocel and cystocele may have
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estrogen exercise and pesary
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what other method is done with pt with cystocele
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urothrovesical suspension
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what are some teaching needs to be considered with this pt
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kegel exercise 10-12 x daily
obeset pt- lose wt insertion of presary cleaning and removing 1 wk or mos if not tx right cause infection and fistula |
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what are some surgery guidelines with perineal care
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perinneal care after vid or BM
Normal saline, sterile cotton ball to clean |
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for discomfort may do
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sitz bath
douch daily |
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what should be avoided post op for A&P colporrhapy?
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Avoi straining-stool softner
avoid lifting for 6 wks avoid jarring/sex |
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leg exercise may be done for
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6 wks
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diet
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high fiber and increase fl intake
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Abnormal tunneling like opening
develop -vagina rectum bladder(vesico) urethro called |
Fistula;
rectovaginal vesico(urethra) |
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what cause fistula to form and result with
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surgery
childbirth, trauma, radiotherapu |
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patho includes
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compromise bld supply/tissue damage
constant leak of UA, flatus, fecal drain excoriate, irritate vaginal |
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dx how
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genitouirinary fistula leak of UA into vagina
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what type of test is done with this pt
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fistulogram
pelvic knee chest |
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small fistula may be treated with rest but with opening more than 6 mos treated with
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surgery A&P
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make sure what needs to be treated ist prior to surgery
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tissue inflammation and edema
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what is used temp to divert UA and fecal stream?
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foley, ureteral or nephrostomy catheter
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post op care is expected with what type of drainage
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seransangineous
monitor for fecal and ua drainage |
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what other nursing responsibility
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douche and bed rest
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what NI for pt with no surgery done?
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focus on comfort, infection
prevention sitz bath and careful cleasing with mild soap and water protective pads |
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____spermatic cord twist and testicle create loss f bld flow
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Testicular torsion
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decrease in bld flow in the testicle can cuase
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ischemia and pain
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pain maybe associated with
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trauma and physical exertion
most case no precipitating event pain may awaken pt at night |
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what is a congenital risk factor for TT
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bell clapper deformity
inappropriate attache of testicla and spermatic cord cord wist cause longer spermatic cord and L test |
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TT occur with whom?
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neonate and adolescent incidence peak in pt age 14 with 60% b/w 12 and 18
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sx of TT inlcudes
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iscemia
unrelieve pain scrotum isscrotum=swollen, tender and red affected side-eleveated due to twist and shrotening cord =pull up testicle absent cremasteric reflex no fever |
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during physical assestment testis is
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scrotum=swollen, tender and red
affected side-eleveated due to twist and shrotening cord =pull up testicle absent cremasteric reflex no fever UA normal testis elevated w/ abnormal lie testis swollen and tender epidi may also be tender |
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when pt no longer have pain maybe due to
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infarction and necrosis
severe=gangrene |
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what type of tx and when should it be treated
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surgery- tx within 6 hrs
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what type of DT are used
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doppler ultrasound
identify a decrease in bld flow check structure of bellclapper;trauma |
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what can be attempted mannually
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detorsion to untwist spermatic cord
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what if detorsion is unsuccessful what othe tx
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testis is fixed with scrotal wall-orchipexy
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when should it be excised
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if gangrenous/ orchioctetomy
inserted testicular prosthesis |
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nursing care includes
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ice bag (scrotal elevation and dec swelling
monitor sign of testicular necrosis and fever small penrose drain and maybe place dressing change |
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nurse continue to monitor pt for
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testicular necrosis and fever
penrose drain plaice in scrotum |
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educate pt about
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info on physiologic change result fr atrophy or
surgical removal Fertility may/may not be affected counseling |
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postoperatively pateint may
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take sitz bath as neede
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scrotal support should be worn for how long to control edema?
what are some limitation and what should be avoided? |
wear scrotal support for 3 wks to control edema
limit stair climbing to two flights for 4 wks to prevent strain on scrotal tissues Avoid lifing/carrying wt >5 lbs for four wks refrain sex activity for 6 wks to prevent starin for scrotal tissue |
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What is BPH
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enlargement of prostate gland tissue
part is atrophy large and nodular |
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what can interfere with pt
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urination and kidney function
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when is this commonly seen at what age
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S&S seen >50 yo
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who does not develop BPH
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male who is castrated before puberty
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BPH occur with what age group
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60 yo and 70 year old or older
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most often BPH develop where
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inner portion of the gland
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how does BPH bldder obstruction enlarges
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nodular tissue imrpinges the urethra- elongate, and compress obstruct urinary
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man strain to empty bladder due to
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urine stream is weak cause man to strain= hypertrophy
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trabeculation of bladder wall increses
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provide pockets of urinary retention and shows up on ultrasound
Due to muscular thickening bladder has less capacity and is less compliant Increase pressure in the bladder |
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what effects is seen with prolonged bladder exposure to high pressure
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hydronephrosis and kidney atrophy
bladder muscle tone diminish overtime blader have residual UA- alkaline |
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During acute U retention sx include for pt with BPH
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urinary hesitancy, freq, urgency, dribbling
nocturia, hematuria, urinary retention senstaion of incomplete emptying of the bladder strain to pie decreased fprce p irome strea, postvoid dribbling (UTI sx) |
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how is bPH diagnose
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Renal fx( BUN & creatinine)
UA (culture and sensitvity) prostate specific antigen bld test >50yo cystourethroscopy(outflow obstructio, lenth of urethra, bladder invol) uroflometry( nonivasive procedure-blader emptuing) urodynamics-computerized test0 bladder pressure dx obstruction IVP-outline urinary tract cystoscopy and bladder scan urinalyss with Culture and sensitivity |
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what are some complications that may be seen with this pt
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kidney do, backflow of UA
Urinary retention---UTI phylonephritis and sepsis |
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What is the meds to tx BPH
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Finasteride- decrease prostate size take few mos
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SE includes
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SE( dec libido, impotence, enjaculation d/o
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what other meds, se and when it should be given
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Alpha adrenerfic blocker- flomax , minipress (se orthos. Hypotension)
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diet
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lycopene
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what should be avoided
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anticholinergic, decongestant, tranquilizer, antidepressant
OTC cold meds, antihistamine, coffee, OH, |
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pt with mild bPH are tx wtih
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reg check up watchful waiting
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pt whose drug tx are not effective can do
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laser microwave tech
destroy tissue using A microwave thermotherapy outpt for pt with anticoag meds not 4 pt with hip rep, pacemaker and defib |
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for Pt with recurrent and obstrucive problem what is the tx of choice
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surgery base on severity, I sx and persistent UTi
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major glandular procedure is called
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TURP
general spiral anesthesia resectoscope pass throug urethra During proceurel=; irrigate continous |
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what are the pre op procedure
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baseline
doc use of OTC, acetulsaliculic acid coumadin NDAID anticougulant check BM inform 3 way foley cath bladder irrigation UA red or pink few days post op |
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during procedure pt may develop water intoxication or known as
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tur sundrome- excess irrigation
SE cerebral edema- confuse and agitation post resectoscope---large forley traction may be apply |
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spasm usually appear when
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24-48 hrs
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what is constant irrigation for
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dc 24- 2 days with no sx
preven clot, done via Foley use Genitourinary irrigating sol |
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the UA post op
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red pink- amber
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after removal of cath if pt unable to void due to edema
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reinsest cath
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What is the meds to tx BPH
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Finasteride- decrease prostate size take few mos
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SE includes
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SE( dec libido, impotence, enjaculation d/o
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what other meds, se and when it should be given
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Alpha adrenerfic blocker- flomax , minipress (se orthos. Hypotension)
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diet
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lycopene
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what should be avoided
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anticholinergic, decongestant, tranquilizer, antidepressant
OTC cold meds, antihistamine, coffee, OH, |
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pt with mild bPH are tx wtih
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reg check up watchful waiting
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pt whose drug tx are not effective can do
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laser microwave tech
destroy tissue using A microwave thermotherapy outpt for pt with anticoag meds not 4 pt with hip rep, pacemaker and defib |
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for Pt with recurrent and obstrucive problem what is the tx of choice
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surgery base on severity, I sx and persistent UTi
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major glandular procedure is called
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TURP
general spiral anesthesia resectoscope pass throug urethra During proceurel=; irrigate continous |
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what are the pre op procedure
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baseline
doc use of OTC, acetulsaliculic acid coumadin NDAID anticougulant check BM inform 3 way foley cath bladder irrigation UA red or pink few days post op |
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during procedure pt may develop water intoxication or known as
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tur sundrome- excess irrigation
SE cerebral edema- confuse and agitation post resectoscope---large forley traction may be apply |
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spasm usually appear when
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24-48 hrs
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what is constant irrigation for
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dc 24- 2 days with no sx
preven clot, done via Foley use Genitourinary irrigating sol |
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the UA post op
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red pink- amber
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after removal of cath if pt unable to void due to edema
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reinsest cath
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what need to be assessed for
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CONTINENCE
2 wks after turp tissue slough off MD if bleeding |
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persist bladder discofor spasm or failure of cath to drain is complication of
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hemoorrhage caths displace
perforation |
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other complication
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urethral stricture
retrograde ejaculation and urination |
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postoperatively
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Adeq UA elimination
bladder irrigation output >50 ml/ risk water intoxication nurse assess for hyponatremia elevated BP, dec pulse, Nausea and confuse tx with hypertonic salie & diuretic, MD |
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pt may control discomfort with what type of meds
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narcotic
beladomma and opium suppo 8-10 fluids/day freq voiding after remove cath use stool softener/laxative well hydrate |
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what type of nursing intervention to prevent infection
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IV antibiotics
increase fl nurse: check UTI sx fever, chills, dysuria, flank pain, malaise -=md relive anxiety perineal exercise-kegel freq voiding reassure infertility |
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prevent abd perineal pressure
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prevent abd/perineal pressure
avoid sitti long period/lifting wt >5lbs strenous activity for 6 wks don't climb>2 flight of stair no sex for 3 wks no drive for 2 wks avoid constipaition and strainig fresh veg, fruits, whole grain and brain |
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what should be reported
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constipation
no enema and suppository |
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teach pt to monitor
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sign of infection
bld clot in ua |
