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163 Cards in this Set
- Front
- Back
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What is the most common infectious reason for missing school or work, what is
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URI, Upper Respiratory Infection
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90% of URI’s are caused by Bacteria or Virus
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Virus
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List Upper Airway Disorders
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Rhinitis, Viral Rhinitis, Phayngitis, Tonsillitis, Adenoiditis, Peritonsillar Abscess, Laryngitis
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What is inflammation and irritation of the mucous membranes of the nose
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Rhinitis
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Edema of the glottis is common with which of the following Laryngitis, Urticaria or Scarlet Fever
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Scarlet Fever & Urticaria
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Another name for a nosebleed is
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Epistaxi
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True or False a laryngeal obstruction with edema can be life threatening
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True
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What this the age range and the gender most likely to get CA of Larynx
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Men 60-70
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Most Larynx CA arise from surface epithelium so ________ cell
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Squamous
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What are the risk factors that cause Larynx CA
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Smoking, or Smokeless Tobacco, Alcohol, Asbestos, Chemicals, Dust from Iron, Steel, Coal
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The following are signs and symptoms for what type of cancer, Hoarseness >2 weeks, harsh raspy voice, persistent cough, lump in the neck, dyspnea, dysphagia
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Cancer of the Larynx
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How is Larynx CA Dx
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CT, MRI, Laryngoscopy, HX, Tissue Sample
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Tx for Larynx Ca is Radiation or Chemotherapy
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Both
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List 5 types of Larynx CA Surgical Options
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Vocal Cord Stripping, Cordectomy, Laser Surgery, Partial Laryngectomy, Total Laryngectomy
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This TX for Larynx Ca is used w dysplagia, hyperdetratosis & leukoplakia, it removes the mucosa edge from the vocal cords
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Vocal Cord Stripping
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Tx that involves an Excision of the vocal cords usually by a transoral LASER
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Cordectomy
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This TX for Larynx Ca involves micro surgery considered to be TX of choice as improved outcomes and with fewer side effects
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Laser Sugery used for early tumors w/o lg vascular involvement
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This type of Tx is recommended when only one vocal cord is involved, what is
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Partial Laryngectomy
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With a Total Laryngectomy the PT will have a permanent tracheostomy True or False
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True
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With a Total Laryngectomy the PT will have a permanent loss of voice True or False
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True
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There are two methods for speech one the voice is lost after a total Laryngectomy, Esophageal speech and Electric Larynx, True or False
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False there are 3 Also Tracheoesphageal puncture which is the easiest
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List Nursing Management and Care for Larynx CA
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Airway management, Post Op Care, Education, Emotional Support
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Collapse or airless condition of the alveoli caused by hypoventilation, obstruction to the airways or compression..what is
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Atelectasis
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How to Prevent Atelectasis
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Freq Positioning, Early Mobilization, Deep Breathing IS, Secretion Mngt
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List the Hallmark signs of Atelectasis
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Tachypnea, Dyspnea, MILD/MOD Hypoxia
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What is the most common sign of neutropenia
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Fever
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What is the name given to the condition when Neutrophil counts are less than 2000mm3
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Neutropenia
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Chronic Leukemia has a majority of Blast or Mature RBC
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Mature
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What is the most common non-lymphocytic leukemia, What is
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Acute Myeloid Leukemia
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Describe the onset of Acute Leukemia
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Abrupt onset development cell is halted at blast phase
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Describe the onset of Chronic Leukemia
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Symptoms evolve over months/yrs majority of the Leukocytes are Mature
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List possible Nasal Obstructions
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Nasal Septum, Hypertrophy of Turbinate bone or nasal polyps
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Epistaxis originates were
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Anterior portion of the nose
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If a PT has a Epistaxis what is NSG intervention applied
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Apply Direct Pressure, Situ Up right tilt head forward to avoid, swallowing or aspiration
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CPAP
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Continuous Positive Airway Pressure
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True or False OSA (obstructive sleep apnea) are at a higher risk for HTN & MI
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True
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Lisa OSA Risk Factors
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Obesity, Male Gender, Post Menopausal
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Vanceril is a topical corticosteroid for what
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Laryngitis
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S/S of Laryngitis
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Hoarseness, Aphonia ( complete loss of voice) Sever Cough
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Laryngitis is Bacterial or Viral Infection
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Viral
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Inflammation of the Larynx is
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Laryngitis
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Quinsy or Sore Throat is also known as
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Peritonsillar Absecss
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Tonsillectomy Post Op Care & PT Positioning
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#1 Risk Factor is Hemorrhage, Prone Position head turned to side for drainage, Ice Collar, basin, kleenex
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Strep Throat is also known as
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Acute Pharyngitis
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Another name for Rhinosinusitis is
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Sinusitis
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True or False Antimicrobial should be used to treat the common cold
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False, it’s a virus
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Viral Rhinitis Medication Mngt
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Warm Salt Water Gargles, Nonsteriod Anti-Inflam, NSAIDS, Antihistamines, Mucinex
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S/S of Viral Rhinitis
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low grade fever, nasal congestion, nasal discharge, sneezing, tearing watery eyes, scratchy sore throat, malaise, chills, HA, muscle ache, *** Herpes Simplex - Cold Sore
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What is the most common cause of the non-allergic Rhinitis is
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The Common Cold
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The common cold is most common when
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Late Fall & Winter or Sept, Jan & April
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90% of URI disorders are viral or bacterial
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Viral
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URI’s are the most common reason individuals give for missing
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Work & School
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List Common URI’s
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COLD
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True or False a consent for BLOOD & PLTS is necessary
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True
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True or False both blood and plasma must be started with in 30min of arrival of product
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True
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True or False Both Blood and Plasma require the double check by a licensed individual
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True
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Irradiated Blood take out what
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The low dose Radiation removes the leukocytes
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What is the antidotes for Warfin
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Vitamin K
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What is the Antidote for Heprin
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Protamin Sulfate, usually if you stop infusion heprin has such a short half life problem will resolve. What 30 min.
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Multiple Myeloma is a malignancy of B or T Mature Lymphocytes
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B
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The RN is getting ready to administer Blood what things should she do
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Type & Cross Match, Confirm Physician Order, Written Consent, Explain Procedure, IV Access Lg Bore >20 g , Base Line VS BP,P,T,R. Double verify.
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When a blood screen is done it is looking for what
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HIV, Hep B & C, Human T Cell, Syphill, CMV, Genomi Nucleic Acids of viruses
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Name types of Blood Donation
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Directed (family or Friend), Standard Donate, Autologus (Me), Intraoperative (I am given back my own blood during operation)
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What is FFP
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Frozen Plasma, it good for 1yr, Immediately frozen to preserve clotting factor.
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This blood is 40% HCT, more volume it is
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Whole Blood only keeps 42 days
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This blood is 70% HCT w/o volume it is
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Packed Red Blood Cells only keeps 42 days
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Platelets are keep for 5 days True or False
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True
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What is DIC
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bleeding and clotting at the same time
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What is the TX action for DIC
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to stop the cause of the DIC trauma, sepsis, CA, Shock, Toxins
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True or False there is a cure for Multiple Myeloma
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False NO CURE, Supportive Care with Chemo
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Who is most likely to acquire Multiple Myeloma
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Males with bone pain
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The type of leukemia attacks when the individual is 20 year of age or late 50’s. It impacts a single node, what is
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Hodgkins
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List S/S of Hodgkin’s
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Night Sweats, Fever, Unprompted Wt Loss
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This Leukemia is wide spread to multi sites in lymph tissue and non-lymph tissue, usually in adults >67
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Non-Hodgkin’s Lymphoma
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List B Symptoms
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Fever, Night Sweats, Wt Loss
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A positive Biopsy with Reed –Sternberg cells indicate what type of leukemia
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Hodgkin’s
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True or False Hodgkin’s is highly curable
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True
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ABVD
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Adriamycin, Blenoxane, Velban, DTIC
TX for Hodgkin Lymphoma |
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True or False AML is generally related to previous cancer tx (secondary) with a poorer prognosis
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True
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Gleevec is a: Drug Used for Choric Myeloid Leukemia
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Tyrosine Kinase Inhibitor
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When taking Gleevec what RN education needs to be provided regarding diet & medications
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No antacids or grapefruit juice it limits drug absorption.
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Name the locations of lymph tissue in the human body
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spleen, liver, Bone Marrow, GI tract, Lymph Tissue
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True or False Acute Lymphocytic Leukemia is uncommon after age 15
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True
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Chronic Myeloid Leukemia involves the Philadelphia Chrom 22 mutation on the Chrom 9 with changes the protein production True or False
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True
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Tumor Lysis Syndrome is a complication of what type of leukemia
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Acute Myeloid / Induction Chemo Therapy
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Explain Consolidation Therapy related to Chemo
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2 Wks Appts or Monthly Appts , Leukemia is in remission lose dose.
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True or False all candidates over 65> are considered for Bone Marrow Transplants
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False
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If a pt is > or equal to 72, has node enlargement, and hepatosplenomegally this patient might have what type of leukemia
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Chronic Lymphocytic
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List two types of Lymphoma
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Hodgkin’s & Non-Hodgkin’s
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What does the D-Dimer test for
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DIC
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Increased D-Dimer indicates what regarding PTT & PT Thromine Time
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The are longer or extended
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Clinical Manifestations with Coag Disorders
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Petechia, Spontaneous bleeding gums or nose, Thrombocytopenia, Prolonged bleeding time, Hemorrhage sub q tissue, Ecchymosis
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Cryoprecipitate
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replaces fibrinogen Factor V & VII
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FFP =
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Fresh Frozen Plasma
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True or False Platelets are stored at room temperature while gently agitated
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True
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Most transfusion reactions are due to donor
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Leukocytes
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What three things can be done to reduce leukocyte exposure
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Filtering at collection, Filtering when infusing, Irradiating (low dose radiation)
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When starting a PRBC Transfusion what key things should the RN look for R/T blood
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Discoloration, Gas bubbles, Cloudiness
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TRALI =
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Transfusion-Related Acute Lung Injury
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TRALI occurs bilateral infiltrates with edema when no cardiac function issues , it’s a reaction to donor plasma what is the plan of care
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Supportive Care
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List how to prevent Atelectasis
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Frequent Repositioning, Early Mobilization, Deep Breathing or IS, Secretion Management
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True or False Atelectasis can be Acute or Chronic
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True
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Total Laryngectomy consist of removing
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Hyoidbone, Epiglottis cricoids cart, 2-3 rings of trachea, tounge pharyngeal wall.
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With a Total Laryngectomy what is the most favored voice solution
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Tracheaphageal Puncture & Device
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What is the #1 Surgery for Larynx CA
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Laser (fewer S/E)
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Cordectomy is
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excision of vocal cords usual transoral laser
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Removal of mucosa edge of the vocal cord is known as
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Vocal Cord Stripping
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Manifestation of Larynx CA
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Hoarness >2 wks , Harsh Raspy Lower Pitch Voice, Cough, Sore Throat, Lump in Neck
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Who is more likely to contract Cancer of the Larynx Men or Women
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Men 4-5x more likely
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Treatment for OSA
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Wt Loss, CPAP, BIPAP, No Alcohol
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TX for Pulmonary Edema
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Diuretics, Support Heart, Medications, Fluid Resources, Oxygen, Respiratory Support, Mech Ventilation.
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S/S of Pulmonary Edema
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Air Hunger, Pink Secretions, Central Cyanosis, Crackles in Base, Hemorrhage
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PE prevention
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Heprin, Warfin or Coumadin
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Is Pneumoconioses treatable
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NO
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Describe Staging of a Tumor
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Size of Tumor, Location, Lymph involvement, Any Metastasis
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NCLC Staging Scale I to IV
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I is Curable, IV Metastasis
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Most common sites for Lung CA Metastasis
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# 1 Lymph nodes, #2 Bone, # 3 Lung, #4 Adrenal Gland/Liver
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Give Example of A Low Velocity Penetrating Chest Trauma
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Stabbing
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Give Example of High velocity penetrating chest trauma
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GSW
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Impaired gas exchange from destruction of walls of over distended alveoli is
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Emphysema
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Dose Emphysema result in Acidosis or Alkalosis
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Acidosis
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Does Pulmonary VSR increase or Decrease with Emphysema
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Increases and results in CHF.
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Panlobualr Emphysema is
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panacinar across all areas
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COPD risk factors
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#1 Smoking Pipe /Cigar, #2 Second Hand Smoke
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Goal Management of COPD
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Assess & Monitor, Reduce Risk, Manage Stable COPFD, Manage Exacerbation
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List the 5 A’s related to a PT that smokes
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Ask, Advice, Assess, Assist, Arrange
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What does acronym NAVEL stand for
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Narcan, Atropin, Vasopressin, Epi, Lidocain
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ABG PH 7.37, PaCO2 38, Hco3 24
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Normal
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ABG PH 7.28, PACO2 51, HCO3 25
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Respiratory Acidosis
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ABG PH 7.23 PACO2 35, HCO3 14
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Metabolic Acidosis
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ABG PH 7.49 PACO2, HCO3 37
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Metabolic Alkalosis
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ABG PH 7.35, PACO2 59, HCO3 33
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Respiratory Acidosis
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ABG PH 7.52 PACO2 31, HCO3 24
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Respiratory Alkalosis
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ABG PH 7.30 PACO2 7.30, HCO3 16
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Metabolic Acidosis
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Give 1st Step in Adult Cardiac Arrest
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START CPR, Give O2, Attach Monitor/Defibrillatory
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What percent of burns are preventable
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75% to 90%
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Burns can come from the following sources
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Flame, Heat, Sun, Chemical, Electricity
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What do Children and Older Adults have in common related to burns
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Thinner Skin, Deeper Burn at shorter duration
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What is key about the Zone of Coagulation related to Burns
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Vessel constricted no blood flow
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When a PT suffer’s Burn decreased urine output can occur, is renal damage perminate?
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No
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Describe a 1st Degree Burn - Superficial
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Epidermis Only, Pink to Red, Painful, No bilsters, Healing 3-5 days no scaring
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Tx of a 1st Degree Burn – Superficial
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Fluids, NSAIDS, Mnt Fever, Cool Shower or Bath, Moisturization Aloe, Avoid re-exposure
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Decribe 2nd Degree burns –Partial Thickness
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Epidermis and part of dermis, Heal w/o surgical intervention, Blisters, Wet & Weepy, Very Painful, Blanches (Prolonged Cap Refill)
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Tx of 2nd Degree Burns Partial thickness
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Topicals, Vaseline, Antibiotic Ointement, SSD, Soaks, Dressing Sustained Silver
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Describe 3rd Degree Burn –Full Thickness
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Epidermis, Dermis, SubQ, Surgical Intervention, Insensate, No blanching, capillary refill, Charred, bright red, marbles, leathery tan, waxy or pearly white, Tight No elastic
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List 5 P’s for burn
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Pallor, Pain, Pulselessness, Progressive, Parathesia, Paralysis
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Management of Circumferential Burn
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Remove constrictive garments jewelry, Elevate burned extremities, Escharotomy
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What is key to know when performing Escharotomy
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Cut on both sides for equal expansion
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Name three types of Inhalation Injury
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Carbon Monoxide, Upper Airway (thermal), Lower Airway (Smoke or Chemical)
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S/S of Inhalation Injury
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Burns on Face & Neck, Singed Nasal or Facial Hair, Hoarseness, Sore throat, SOA, Hypoxia
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What factor is key with a patient burned by Tar
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Cool it down 1st.
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To stop the burning do what
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take off clothes, diapers, jewelry, metal, brush off chemicals,
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What does AMPLET stand for related to burn assessment
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Allergies, Medications, Past Med HX, Last Meal & Drink, Events & Environment, Tetanus
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True or False a Pt that was burn by a high voltage electrical injury will require more fluids
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True
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List Important Lab Values when working with a Burn Patient
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ABG’s, CBC, Electrolytes, Glucose, Cre, Bun
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Comfortable bath water temp for infant
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96-100
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A Thermal Burn is
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Flame, Contact, Scald or Steam or Tar
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A Chemical Burn is
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Acid, Alkali, Organic Compound
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A Electrical Burn is
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High Voltage, Low Voltage, Lighting
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This type of burn is Pain FREE is it a 2nd Degree Partial Thickness or 3rd Degree Full-Thickness
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No Pain associated with this burn 3rd Degree Full-Thickness
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True or False a PT with a sever burn is given nothing to drink or eat by mouth to prevent aspiration of vomitus. Generally N/V will occur due to paralytic ileus R/T to stress of injury
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True
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List three burn phases
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Emergent (resuscitative), Acute (intermediate), Rehabilitation
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The Expect Outcome for ALL is
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Complete Remission
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