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49 Cards in this Set
- Front
- Back
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What is LYMPHEDEMA?
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Impairment of the flow of lymph from an extremity.
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What are some S/SX of Lymphedema?
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painless
dull sensation normally a foot or extremity pitting edema woody texture mostly women |
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What is the treatment for LYMPHEDEMA?
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Intermittent elevation, especially with sleep
Meticulous care of feet to prevent recurrent lymphangitis due to decreased circulation Elastic stockings and bandages (TED hose) Massage towards trunk Broad spectrum antibiotics for infection (MTF will determine bactreria for accuracy of medication) (What’s in your AMAL) If due to trauma, surgery may be required |
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What are the complications of Lymphedema?
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cellulitis
lymphandentitis (nodes) lymphangitis (vessels) fibrosis |
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what is the disposition of lymphedema?
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handle onboard.
refer to UMO |
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What can cause lymphandenitis or lymphangitis?
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usually bacteria...
can be viral, fungal, protozoal, or rickettsial organisms (cat scratch fever) |
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what are the Signs and Symptoms of LYMPHADENITIS/ LYMPHANGITIS?
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Throbbing pain
Malaise Anorexia Lymph nodes enlargement Infection on skin of involved extremity Red streaking from infection to nodes Fever and chills |
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What is the treatment for lymphadenitis or lymphangitis?
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hot, most compresses
elevate analgesics antibiotics wound care |
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What is the dispostion for Lymphandeintis/lymphangitis?
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treat on board
refer to UMO MEDEVAC if signs of sepsis |
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What is hemolytic transfusion reaction?
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Transfusion of incompatible blood either due to ABO, Rh mismatches
ABO mismatch is the most severe reaction Severity of reaction is directly related to the amount given, cause of reaction, the rate at which the blood was administered and the integrity of the patients kidneys, heart, and liver |
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What are the signs/ symptons for hemolytic transfusion reaction?
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Fever & Chills
Severe backache & Headache Apprehension Hypotension Dyspnea Vascular collapse |
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what are the LABS for hemolytic transfusion reaction?
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HCT will decrease
Wine colored urine (hemoglobinuria) Elevated bilirubin (icteric plasma) |
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what is the treatment for hemolytic transfusion reaction?
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Stop transfusion at first sign of reaction
Substitute infusion w/ normal saline at 150-300ml/hr Monitor vital signs Maintain urine output at 100ml/hr for 6-8 hrs or until urine clear Maintain systolic b/p above 100mmhg Cath em….. |
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What is the dispostion for hemolytic transfusion reaction?
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MEDEVAC
refer to UMO |
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What is Von Williebrand's disease?
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Bleeding disorder characterized by prolonged bleeding times despite a normal platelet count
Possible family hx, or lifelong personal history. |
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What are the S/Sx of Von Willi'es?
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Mucosal Bleeding
- Epitaxis, gingival bleeding, menorrhagia (abnormally heavy menstrual period), gastrointestinal bleeding. Incisional bleeding after surgery or dental extractions Negative for Hemarthrosis (bleeding into joint spaces) as compared to hemophilia Bleeding tendency is prolonged by ASA Bleeding decreases during pregnancy or estrogen use. |
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What are the treatments for Von Willebrand's?
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avoid meds (NSAIDS, ASA)
avoid trauma Refer to UMO MEDEVAC |
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What is IDIOPATHIC THROMBOCYTOPENIC PURPURA?
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Autoimmune disorder resulting in the destruction of platelets in the spleen. NOT due to toxic exposure, or another disease.
Adult form is usually chronic Peak incidence between ages 20-50 years |
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What are the s/sx of IDIOPATHIC THROMBOCYTOPENIC PURPURA?
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Petechial hemorrhages
Purpura -------------------- Bruising Gingival bleeding GI bleeding NO SPLENOMEGALY |
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What is the treatment/dispo for idiopathic thrombocytopenic purpura?
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Avoidance of trauma
Avoid medications that decrease PLT function or clotting Prednisone 1-2 mg/kg/d PO MEDEVAC – if pt fails to respond to meds. Pt will require splenectomy |
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What are the s/sx of THROMBOCYTOPENIC PURPURA?
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flu
abd pain mental seizures PE: fever jaundice, purpura/petechia, splenomely |
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What is the treatment for THROMBOCYTOPENIC PURPURA?
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Plasma exchange
-W/O treatment 97% fatal -With early treatment 82% survivability MEDEVAC |
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What is DISSEMINATED INTRAVASCULAR COAGULATION(DIC)?
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Thrombohemorrhagic disorder resulting from depletion of circulating clotting factors by systemic microthrombi formation.
Can be a relatively mild subclinical disorder Severe cases are life threatening due to organ dysfunction/failure, severe hemorrhage/shock |
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what are some cause DISSEMINATED INTRAVASCULAR COAGULATION(DIC?
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Obstetric catastrophe
Metastatic malignancy (solid tumors and leukemia) Massive trauma, crush injury, burns Sepsis (Endotoxins from gram negative organisms) Hemolytic reactions |
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DISSEMINATED INTRAVASCULAR COAGULATION(DIC) s/Sx?
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Generalized bleeding from > 3 separate sites
Mucosa, IV sites, oozing from wounds, hematoma, internal, rectal bleeding. Thrombosis Depleted clotting factor Patient may go quickly into shock |
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Treatment for DIC?
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Treat underlying cause
Anticoagulate (ONLY under UMO Advisement) Lovenox, 1mg/kg Q 12hr Replace blood and clotting factors Request to be sent out on MEDEVAC. |
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What are some causes of Anemia?
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bloos loss
Iron deficiency V B12 foliate destruction of RBC intrinsic RBC chronic diseases |
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S/Sx of anemia?
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fatigue
tachy cardia palpitations tachypena on exertion headaches lightheadedness muscle weakness difficulty concentrating irritablity anxiety |
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What is the treatment fo anemia?
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diet
hydrate fix blood losses REFER to UMO |
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.What are some causes of B12 deficiiency
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fish tapeworm (rare)
ETOH (rare) pernicious anemia (cant make RBC) |
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What are the S/Sx of vit B12 deficiency?
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glossitis (beefy red sore tongue)
neurological syndrome |
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What are some causes of Iron Deficiency?
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hookworm
trauma pica gastric CA |
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What are the s/sx of iron deficiency anemia?
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Any of the symptoms of anemia
Asymptomatic Epithelial tissue abnormalities Koilonchia Glossitis Angular stomatitis Pica |
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Treatment for iron deficiency?
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Ferrous sulfate 325mg
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What is hemolytic anemia
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Premature destruction of RBCs leading to anemia
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What are some causes of Hemolytic anemia?
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Inherited genetic disorder
Deficiency of the RBC enzyme Glucose 6 - phosphate Dehydrogenase (G6PD) 10% African American males, some cases found in people of Mediterranean decent RBC’s especially susceptible to hemolysis when exposed to certain drugs: Antimalarial (AMAL) Aspirin Sulfonamides Nitrofuran Phenacetin |
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S/Sx hemolytic anemia?
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malaise
fever nausea abd pain jaundice tachycardia temperature red/dark urine splenomeglay hepatomegaly |
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What are the treatments for hemolytic anemia?
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stop transfusion
d/c drug treat cause |
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s/sx for sickle cell anemia?
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joint pain
fever back pain vomitting jaundice tender rigid abdomen paralysis cranial nerve palsies hematuria |
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What is the treatment for sickle cell anemia?
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treat pain
symptoms avoid ETOH antiboticts if needed clearn ulcers |
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What are some causes of leukemia?
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viruses
ionizing radiation chemicals antineoplastic drugs |
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what are some s/sx of leukemia?
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weakness, fatigue, dysnpnea on exertion
infections DIC, petechia |
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what is the treatment for AML?
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aggressive IV
Transfusions chemotherapy |
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What are some signs and symptoms associated with Chronic Myelogenous Leukemia (CML)?
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- Fatigue, weight loss, decrease exercise tolerance
- Enlarged spleen - Hyper metabolic rate |
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What are some common causes of CML?
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- Irradiation
- Benzene exposure |
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What is a malignant disease of lymphoid tissue?
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- Hodgkins disease
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What are some common signs and symptoms associated with hodgkins disease?
- “HARPS” |
- Hepatomegaly
- Asymptomatic Lymphadnopathy - Rubbery nodes on exam - Pel-Ebstein fever - Splenomegaly |
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What is a neoplastic proliferation of lymphoid cells?
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- Non hodgkins lymphoma
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What is the most common sign and symptom associated with non-hodgkins lymphoma?
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- Painless and slowly progressive peripheral adenopathy
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