Cardiac, Respiratory, Cancer

Front 1

Depression of respiratory center caused by opiods

Back 1

Baseline vital signs should be taken before administration of medicine. Monitor for drop in vital signs. Narcan is the antidote for Opiods.

Front 2

Tumors of the bladder etiology

Back 2

The primary cause is exposure to aniline dyes used in the textile industry. cigarette smoking is associated with an increase in bladder tumors

Front 3

Tumors of the bladder pathophysiology

Back 3

Tumors range from small to benign papillomas to large invasive carcinomas. Most neoplasms are of the transitional cell type.

Front 4

Tumors of the bladder diagnostic tests

Back 4

Urinalysis that reveals blood in light of no other cause warrants further investigation via cystoscopy with cell analysis. IVP, CT scan, MRI, or ultrasound should also be done.

Front 5

Tumors of the bladder surgical treatment

Back 5

Endoscopic resection with transurethral fulguration or excision. Cystectomy is performed when the cancer appears curable.

Front 6

Ileal conduit, ileal loop or bricker procedure

Back 6

the ureters are excised from the bladder and transplanted into one end of a 15 to 20 cm segment of ileum that has been resected from the intestinal tract with its mesentery, which contains blood supply.

Front 7

Continent Urostomy (kock or indian pouch)

Back 7

Consists of loops of intestine anastomosed together and then connected to the abdomen via the stomal segment.

Front 8

Nursing management for preoperative urinary diversion surgery

Back 8

counseling and teaching; give time to grieve; time to prepare the person to the appearance of the stoma.

Front 9

Nursing Management for postoperative urinary diversion surgery

Back 9

Promote ventilation; monitor patentcy and output of urinary catheters; Prevent complications; administer meds for pain control.

Front 10

Percutaneous (closed) renal biopsy

Back 10

this is potentially the most accurate diagnostic tool for determining the type and stage of a pathological condition involving the kidneys.

Front 11

Percutaneous renal biopsy complications

Back 11

because the kidney is such a vascular organ, hemorrhage after biopsy is a potential threat. care is taken to detect and prevent early blood loss.

Front 12

Percutaneous renal biopsy postoperative care

Back 12

Bed rest in supine position and motionless for 4 hours after bio0psy. coughing is avoided for first 4 hours. Monitor vital signs on regular schedule. urine is observed. avoid heavy lifting for 10 days.

Front 13

Wilm's tumor

Back 13

This is a malignant renal tumor and is the most common renal neoplasm in children. Most common unilateral disease, but in 5% to 10% both kidneys are involved.

Front 14

Wilm's tumor complications

Back 14

Metastasis to the lungs, lymph nodes, liver, bone, and brain. Bowel obstruction. Hepatic damage, nephritits, sterility in girls, interstitial pneumonia, scoliosis. Approximately 15% who survive develop a soft tissue sarcoma, bone tumor, or leukemia in 5 to 25 years because of radiation.

Front 15

Wilm's tumor treatment

Back 15

Surgical removal; radiation or chemotherapy. avoid abdominal palpation pre and post operatively to decrease the danger of metastasis. excessive handling of the abdomen may cause seeding r/t the soft vascular nature of the tumor.

Front 16

Neuroblastoma

Back 16

Is a sarcoma of nervous system origin, composed chiefly of neuroblasts, affecting mostly infants and children up to 10 yrs of age, usually arising in the autonomic nervous system or in the adrenal medulla.

Front 17

Leukemia etiology

Back 17

This is the 5th leading cause of death in men and the 6th in womenl Cause is unknown, but some predisposing factors have been discovered such as persons with specific chromosomal aberrations, chronic exposure to chemicals, radiation exposure.

Front 18

Acute Leukemia

Back 18

Involves immature cells and are categorized according to predominant call in the bone marrow. Acute have a rapid onset and a short course ending in death if left untreated.

Front 19

Chronic Leukemia

Back 19

May be lymphocytic, or granulocytic. This has a more insidious onset. Median survival of patient with CML is 3 to 4 yrs and with CLL 2 to 10 yrs depending on stage of diagnosis.

Front 20

Chronic Myelogenous Leukemia Symptoms

Back 20

Weakness, fatigue, anorexia, weight loss, splenomegaly.

Front 21

Acute Myelogenous Leukemia Symptoms

Back 21

Fever, infections of respiratory tract, anemia, bleeding of mucous membranes.

Front 22

Acute lymphocytic leukemia symptoms

Back 22

Fever, infections of respiratory tract, anemiam, bleeding mucous membranes.

Front 23

Clinical manifestations for acute leukemia

Back 23

Common symptoms include pallor, fatigue, weakness, fever, weight loss, abnormal bleeding and bruising, bone and joint pain, HA, neurologic dysfunction.

Front 24

Management of acute leukemia

Back 24

Goal is to eradicate leukemic cells and slow restoration of normal hematoipoiesis. Supportive care and symptom management. high diose chemotherapy, radiation and leukapheresis might be given.

Front 25

Clinical manifestations for chronic leukemia

Back 25

Insidiou onset, fatigue, pallor, activity intolerance, fever, weight loss, night sweats abdominal fullness.

Front 26

Management of chronic leukemia

Back 26

Palliative treatment controlling symptoms includes chemotherapy.

Front 27

Sarcomas

Back 27

Sarcomas are highly malignant and composed of cells derived from connective tissue such as bone and cartilage, muscle, blood vessel, or lymphoid tissue. These tumors usually develop rapidly and metastasize through the lymph channels.

Front 28

Lymphomas

Back 28

These include any neoplastic disorders of the lymphoid tissue, including Hodgkin's disease.

Front 29

Hodgkin's disease etiology

Back 29

This is a malignant disorder of lymph nodes first described by Thomas Hodgkin in 1832. The etiology is unknown but there may be a genetic component to the disease. An infections etiology is under debate.

Front 30

Hodgkin's disease management

Back 30

Radiation therapy, chemotherapy or a combination of these are used to treat the disease.

Front 31

Carcinoma of the larynx

Back 31

Squamous cell carcinoma can arise from any part of the laryngeal mucous membrane. It is often preceded by leukoplakia. Grows slowly in the true voice box because of the limited lymphatic supply but spreads rapidly in the epiglottis, false vocal cords because of the abundant lymphatic supply.

Front 32

Patient with a total laryngectomy with ineffective airway clearance

Back 32

Interventions are to place patient in semi-fowlers position. Suction tube as often as needed. Provide tracheostomy care. Provide humidification. Encourage deep breathing and coughing. Evaluations would be respirations are effortless, quiet, and at baseline rate. Breath sounds clear at all lobes.

Front 33

Metastatic liver tumors

Back 33

Fatigue, anorexia, weakness, weight loss, hepatomegaly, hepatic bruits, jaundice, portal systemic encephalopathy.

Front 34

Surgical treatment for primary or metastatic liver tumors

Back 34

Surgery is an option after the extent of tumor and hepatic reserve have been considered. Surgical resection. Freezing hepatic tumors by cryosurgery. Liver transplantation.

Front 35

Cancer of the prostate

Back 35

This is the second leading cause of cancer death among American men and is the most common carcinoma in men over 65 years of age.

Front 36

Cancer of the prostate etiology

Back 36

The majority of prostate cancers arise from the peripheral zone of the gland; therefore, most prostatic cancers are palpable on rectal examination.

Front 37

Cancer of the prostate management

Back 37

Conserve measures, surgical interventions, radiation (curative), hormone manipulation (palliative).

Front 38

Perineal prostatectomy

Back 38

The perineal approach results in a draining incision in the perineal area. Often a penrose drain is placed to help direct the serous drainage from the surgery. Nerves may be damaged.

Front 39

Nursing interventions with perineal prostatectomy

Back 39

Teach high fiber diet, limit heavy lifting or straining, monitor for urine leaks, hemorrhage, and s/s of infection. Help restore urinary and bowel continence, promote sexual functioning, dealing with grief.

Front 40

Risk factors for breast cancer

Back 40

Female gender, hx of previous cancer, age 40, early menarche or late menopause, nulliparity or first child after 30, diet, alcohol, obesity, ionizing radiation, benign breast disease, oral contraceptives, exogenous hormones.

Front 41

Breast cancer clinical manifestations

Back 41

Lump that is irregular, star-shaped, firm to hard, fixed (not mobile), poorly defined or demarcated, single. Presence of skin or nipple retraction. Nipple discharge. Peau d'orange appearance (dimpling of the skin).

Front 42

Noninvasive tests for breast cancer

Back 42

Monthly BSE, mammography, digital mammography, and ultrasound.

Front 43

Invasive diagnostic tests for breast cancer

Back 43

Fine needle aspiration, tru-cut needle biopsy, excisional or incisional biopsies.

Front 44

Lumpectomy

Back 44

Removal of tumor and surrounding tissue.

Front 45

Quadectomy (partial mastectomy)

Back 45

Removal of breast quadrant that includes the tumor area and overlying skin.

Front 46

Axillary dissection

Back 46

Surgical removal of the axillary lymph nodes.

Front 47

Simple mastectomy

Back 47

Surgical removal of the breast and a few of the axillary lymph nodes close to the breast.

Front 48

Modified radical mastectomy

Back 48

Surgical removal of the entire breast and the axillary lymph nodes.

Front 49

Radical mastectomy

Back 49

Removal of the entire breast, pectoral muscles, axillary nodes.

Front 50

Hormonal therapy for breast cancer

Back 50

This targets cells that are dependent on estrogen for growth. Bioassay methods revealed the presence of estrogen receptors on the tumor cell surface.

Front 51

Chemotherapy for breast cancer

Back 51

Preoperative chemo can make larger inoperable tumors more amendable to surgical removal. Chemo works on rapidly dividing cells to achieve its effect. Some concerns with chemo is optimal drug combination optimal dosage, and length of treatment.

Front 52

Radiation therapy for breast cancer

Back 52

Radiation to the breast after preservation surgery is now considered to be standard therapy in the USA. Radiation to the breast eradicated tumor cells left behind after manipulation and handling of the tumor during surgery.

Front 53

Positve inotropic/cardiotonic, interventions

Back 53

For IV administration. Monitor apical pulse and BP. Monitor for hypersensitivity. Assess lungs for rales or wheezing. Monitor for edema.

Front 54

Cardiac glycosides actions

Back 54

Inhibit sodium-potassium pump, thus increasing ultracellular calcium, which causes the heart muscle fibers to contract more efficiently

Front 55

Cardiac glycosides side effects

Back 55

Anorexia, vomiting, nausea, HA, Visual disturbances, bradycardia

Front 56

Cardiac glycosides interventions

Back 56

Monitor for toxicity, serum digoxin levels, potassium levels, avoid over the counter medications.

Front 57

Antihypertensive, (Thiazide diuretics) actions

Back 57

Increase sodium and water excretion by inhibiting the sodium re-absorption in the distal tubule of the kidney.

Front 58

Antihypertensive, (Thiazide diuretics) side effects

Back 58

Hyper calcemia, hyperglycemia, hyperuricemia, hypokalemia, hypovolemia, hypotension, constipation, rashes.

Front 59

Antihypertensive, (Thiazide diuretics) interventions

Back 59

Monitor vital signs, weight, urine output, electrolytes, glucose, calcium, edema.

Front 60

Angiotensin-converting Enzyme (ACE) action

Back 60

Prevent peripheral vasoconstriction. Used to treat hypertension.

Front 61

Angiotensin-converting Enzyme (ACE), side effects

Back 61

Nausea, vomiting, diarrhea, persistent cough, hypotension, hypokalemia, tachycardia, fatigue, dizziness,

Front 62

Angiotensin-converting Enzyme (ACE) interventions

Back 62

Monitor vital signs, protein, albumin, BUN, white blood cells.

Front 63

Physiological indicators of stress

Back 63

S/S of stress result from the activation of the sympathetic and neuroendocrine systems of the body.

Front 64

Psychological indicators of stress

Back 64

Include anxiety, fear, anger and depression.

Front 65

Culture and family influences on health considerations

Back 65

Socioeconomic and cultural factors include dietary patterns, smoking, occupation, sedentary lifestyle, health practices.

Front 66

Pulmonary risk factors for occupational lung disease

Back 66

Usually occurs in textile workers. Chronic bronchitis and emphysema develop in time; constriction of bronchioles in response to something in crude cotton.

Front 67

Factors that influence chronic illness in minorities

Back 67

They don't go for preventative care. They can't afford follow up care to diagnosis.

Front 68

Nutritional status to cardiovascular/pulmonary problems

Back 68

Diet may be the single most important factor in determining a persons health and longevity. Vitamins, minerals, amino acids are vital in our diet.

Front 69

Signs of malnutrition

Back 69

Decreased reflexes, anorexia, enlarged liver, gums that bleed easily or are swollen, swollen tongue and lips, eyes that are pale or red conjunctiva, dry or dull hair, brittle and pale nails, dry flaky skin, general appearance is tired, apathetic.

Front 70

Effects of alcohol on cardio/pulmonary systems

Back 70

Depression, lessening of inhibitory functions, self-control and judgement lessened, increase pulse rate, vasomotor depression, hypertension, constipation or diarrhea, vomiting, liver enlargement.

Front 71

Clinical manifestations of amphetamines

Back 71

Restlessness, dizziness, insomnia, lack of appetite, diarrhea or constipation, agitation, paranoia, cerebral hemorrhage, MI, collapse from exhaustion.

Front 72

Clinical manifestations of cocaine use

Back 72

Stimulation of respiration and heart rate, rising of blood pressure and blood sugar levels, suppression of appetite, dilation of pupils, constriction of blood vessels, insomnia, trembling, extreme euphoria, feelings of energy, power, confidence, and talkativeness.

Front 73

Caring for a patient with a venous access device

Back 73

On insertion, document the date, site, brand, gauge, catheter length, location of catheter tip, length of the external segment and patient teaching.

Front 74

Teaching for a patient with a venous access device

Back 74

Do not allow anyone to take blood pressure on the arm in which the PICC line or PAS port is inserted. Wear a med-alert bracelet. You do not need to restrict activities, except do not immerse the arm in water.

Front 75

Caring for site of venous access device

Back 75

Use strict aseptic technique. The frequency of dressing changes may vary from every 3 to 7 days. Assess site for redness, swelling, tenderness, or drainage.

Front 76

Cardiac monitor

Back 76

There are various ways to monitor the cardiac system, and nursing assessment and management vary with the type of cardiac monitoring being done. This is a noninvasive procedure that poses minimal risk to the patient. It consists of placing conductive electrodes on the patient chest that recognize the electrical activity of the heart and relay it to a video display screen.

Front 77

Cardiac pacemakers

Back 77

Indications for a pacemaker include symptomatic chronic or recurrent dysrhythmias unresponsive to pharmacological therapy.

Front 78

Permanent pacemakers

Back 78

Use a pulse generator as the "control enter" for the pacemaker's functions. The generator attaches to one or two leads positioned in the right ventricle or right atrium. A surgically created subcutaneous pocket encloses the generator, most often supraclavicularly.

Front 79

Temporary pacemakers

Back 79

They are indicated for the short term management of dysrhythmias until the patient rhythm stabilizes or a permanent pacemaker can be inserted. The pacer wire usually is advanced transvenously to the right ventricle.

Front 80

Preoperative care for patient undergoing vascular bypass

Back 80

Focus on the physical, emotional, and psychological preparation of a severely stressed patient. Patient has extensive need for teaching and support.

Front 81

Postoperative care for patient undergoing vascular bypass

Back 81

Potential complications include bleeding, MI, cardiac failure, dysrhythmias, stroke, renal failure, and injury to organs.

Front 82

Risk factors for chronic arterial occulsive disease disorder

Back 82

Increasing age, smoking, hypertension, atherosclerosis, obesity, stress, family hx, sedentary lifestyle, hyperlipidemia.

Front 83

Pre-procedural care for angioplasty

Back 83

Tests performed before procedure: lab work. Anxiolytics for anxiety. IV access started to give medication and fluids. NPO after midnight. If groin access, groin will be shaved and scrubbed. Pedal pulse will be marked. Cardiac monitor placed.

Front 84

Post procedural care for angioplasty

Back 84

Clear dressing over entry site. Head of bed should be less than 30 degrees. May log roll with assistance. Vital signs and neurovascular assessments every 15 minutes. Fluids encouraged.

Front 85

Coronary artery bypass graft (CABG)

Back 85

The surgeon attaches an artery to vein graft to the coronary artery beyond the areas of blockage.

Front 86

Health instructions for COPD

Back 86

Breathing exercises, stress management, diagnostic and laboratory tests.

Front 87

Preventive measures for health maintenance with COPD

Back 87

Improve airway, improve nutrition, prevent fluid volume excess. Assist with breathing and rest, assist with control of environment, temperature and humidity, improve activity tolerance, assist with sleep, assist with fear reduction.

Front 88

Preoperative instruction for thoracic surgery

Back 88

Teaching needs to include: Patient knowledge of procedure, O2, blood administration and IV's, pain medication, including patient controlled analgesia (PCA) if used, where patient will be taken after surgery.

Front 89

Dietary modifications with sodium

Back 89

Advise patient to check over the counter drugs to ascertain sodium content (antacids, laxatives, cough remedies, AlkaSeltzer, pain relievers, estrogens, and other drugs.) Frozen dinners, canned soups, and canned vegetables should be avoided due to high sodium content.

Front 90

Problems resulting form benign abnormal cellular growth

Back 90

Fibroids, gestational trophoblastic disease (hydration mole), fibrocystic disease of the breast.

Front 91

Fibroid tumors (Uterine Leiomyomas)

Back 91

They are benign tumors of the utering myometrium (smooth muscle). Develop in women 25 to 50 years. May spontaneously regress after menopause. Unknown cause.

Front 92

Liver cancer clinical manifestations late s/s

Back 92

Fatigue, ascites, liver failure, fever, hepatic bruits, jaundice, variceal bleeding

Front 93

Beta-adrenergic blockers, action

Back 93

Inhibit response to beta-adrenergic stimulation, thus decreasing cardiac output.

Front 94

Beta-adrenergic blockers, side effect

Back 94

Bradycardia, bronchospasm, hypotension, weakness, fatigue, nightmares, depression.

Front 95

Beta-adrenergic blockers, interventions

Back 95

Monitor vital signs, hold medication if pulse and BP is not within prescribed parameters, assess for respiratory distress.

Front 96

Calcium channel blockers, action

Back 96

Cardiac contractility and the workload of the heart, thus decreasing the need for O2

Front 97

Calcium channel blockers, side effect

Back 97

Bradycardia, hypotension, HA, fatigue, lightheadedness, dizziness.

Front 98

Calcium channel blockers, interventions

Back 98

monitor vital signs, liver enzyme levels, kidney function, do not crush or chew sustained release tablets.

Front 99

Direct-acting artiolar vasodilators, action

Back 99

relax the smooth muscles of the blood vessels, mainly the arteries, causing vasodilation

Front 100

direct-acting artiolar vasodilators, side effects

Back 100

Hypotension, reflex tachycardia caused by vasodilation and and drop in BP, edema, dizziness, HA, GI bleeding, nasal congestion.

Front 101

Direct-acting artiolar vasodilators, interventions

Back 101

Monitor vital signs, sodium nitroprusside

Front 102

Nursing management for a person with angina pectoris

Back 102

Relieving pain, administer O2, place patient in comfortable position, determine pain intensity. Maintain cardiac output, monitor careful patient response to drug therapy. Decreasing anxiety, explain to patient reason for hospitalization, answer patient questions, explain the importance of reducing anxiety for the heart.

Front 103

Pt/Family teaching for a person with angina pectoris

Back 103

Review the chambers of the heart and coronary system. review risk factors, teach s/s that should be reported immediately.

Front 104

dysrhythmias

Back 104

Often occur secondary to the ischemic process of CAD. Direct damage to the myocardial cell creates electrolyte imbalances that alter the action potential.

Front 105

Cardiac dysrhythmias

Back 105

Is the result of alterations in impulse formation or propagation. Common etiologies include underlying cardiac disease, sympathetic stimulation, vagal stimulation, electrolyte imbalances, hypoxia.

Front 106

Dressler's syndrome

Back 106

Post-myocardial infarction syndrome, or Dressler's syndrome, is a late complication of AMI. Classic s/s include pericardial friction rub, and pericardial and pleural effusions. These s/s occur 2 to 10 weeks after the MI.

Front 107

Cardiogenic Shock

Back 107

Is caused by myocardial dysfunction that is sever enough to cause endrgan hypoperfusion. Cardiogenic shock is a medical emergency and early diagnosis is imperative.

Front 108

Explain the use of an electrocardiogram (ECG)

Back 108

Is a graphic representation of the electrical forces produces with in the heart. The ECG is an essential tool for cardiac evaluation, but it must be combined with other data sources for accurate diagnosis.

Front 109

Diagnosis's electrocardiogram (ECG) are used for

Back 109

May be used to diagnose the following tachycardia, bradycardia, sudden onset of dyspnea, pain in upper extremities, syncopal episodes, shock state or coma, preoperative hypotension, artificial pacemaker function.