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197 Cards in this Set
- Front
- Back
- 3rd side (hint)
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transition for childhood to adulthood, begins with appearance of secondary sex characteristics
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adolesence
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examples of secondary sex characteristics
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deep voice, developing facial hair, pubic hair, fat deposits. Horomonal changes that play no active role in reproduction
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what are the primary sex characteristics
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breast develop, ovaries, penis enlargement, uterus
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age group for early adolescence
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11-14
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stage of adolesence involving rapid growth, secondary sex characteristics, limited abstract thought, dependant to parents, daydreaming, mood swings
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early adolescence
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age group for middle adolescents
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15-17
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stage where stature reaches 95% of adult height
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middle adolescents
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stage where child becomes self centered, acceptance by peers is important , tendency to withdrawl when upset
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middle adolescents
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stage where abstract thought is established, emotional and physical seperation from parents, forms stable relationships
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late adolescents
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maturational hormonal and growth process that occurs when reproductive organs begin to function and secondary sex characteristics develop
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puberty
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what are the 3 stages of puberty?
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pre-pubescence, puberty, post pubescence
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primary physical changes occuring 2 years prior to transition
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pre-pubescence
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first menses in girls marks sign of...
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puberty
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1-2 years following puberty
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post pubescence
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usually begins in girls 2 years after first signs of puberty
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menstration
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What are the stages of sexual maturation called in girls?
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Tanner Stages
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how much sleep do teens need?
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9-11 hours- they have a different sleep cycle than adults
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stage where child starts to care about how they look
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middle adolescence
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stage where child is comfortable with how they look and are interested in developing relationships
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late adolescence
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what lifestyle risks are presented to mothers of who have children in early adolescence?
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it will increase the number of children you have over life, live in poverty, more lifely to have another child within two years of the 1st
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girls born to teenage moms are more likely to....
boys born to teenage moms are more likely to.... |
be teenage moms/
end up in jail |
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What nutrients are essential for growth spurts?
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need calcium for bone density
need iron for blood and muscle mass |
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stage where child starts to care about how they look
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middle adolescence
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stage where child is comfortable with how they look and are interested in developing relationships
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late adolescence
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what lifestyle risks are presented to mothers of who have children in early adolescence?
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it will increase the number of children you have over life, live in poverty, more lifely to have another child within two years of the 1st
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girls born to teenage moms are more likely to....
boys born to teenage moms are more likely to.... |
be teenage moms/
end up in jail |
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What nutrients are essential for growth spurts?
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need calcium for bone density
need iron for blood and muscle mass |
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how many kila calories are needed for girls 9-13 and 14-18?
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1600/1800
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how many kila calories are needed for boys 9-13 14-18?
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1800/2200
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acute, self-limiting infectious disease. Will go away whether treated or not. The kissing disease
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Mononucleosis (Epstein Barr virus)
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symptoms are extremely tired, enlarged spleen, headache, fever, sore throat (sometimes strep)
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Mononucleosis (Epstein Barr virus)
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How is mononucleosis diagnosed?
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with a blood test called a monospot
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How soon do acute symptoms dissapear with mononucleosis
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7-10 days (fatigue can last 4 weeks)
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puberty is delayed but still progresses normally. Catch up in late teens, can be a result of chronic diseases
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constitutional delay
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excessively tall peers - organic disorder that runs in families.
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tall stature
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How is tall stature treated?
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HRT- estrogen (more common in girls), but it can alter final height.
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Last of growth- usually caused by other diseases like asthma, GI disease, cardiac anomalies, chronic renal distrubances
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short stature
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Not all symptoms are visible in each child with Turner syndrome except for 1 which is in all
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Ovarian failure. Some are born w/o ovaries
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Girls with turner syndrome- maximum height that can be obtained with and without HRT
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Without 4'10".
With HRT 5'2" HRT also aids in the formation of 2nd sex characteristics |
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Girls with turner syndrome run the risk of getting this medical condition as an adult
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Coarctation of aorta (narrowing or aorta)
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presence of 1 or more X chromosome in males- this is the most common sex chromosome disorder
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Klinefelter syndrome
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is Klinefelters syndrome genetic?
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no but it is seen more often in moms over the age of 35
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What 3 areas of development are impacted by Klinefelter syndrome?
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physical (motor skills are off), language (they talk late and have trouble expressing themselves), and social (usually seen at puberty)
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What is universal with all men that have Klinefelter syndrome?
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they are infertile
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What is the treatment for Klinefelter syndrome?
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testosterone
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herion, morphine, demerol, dilaudid, percocet
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narcotics - physical dependence. Give adivan or methodone to easy symptoms
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marijuana, LSD
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mind alterind drugs- psychological dependence. Can be immediately stopped
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alcohol, barbiturates
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CNS depressants- physical dependence
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amphetamines, cocain, inhalants, meth
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CNS stimulants- psychological dependence
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preoccupation with the thought of suicide, may be a precusor to suicide and should be taken seriously
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suicidal ideation
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action intended to cause injury or death
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suicide attempt
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Most commonly used method for suicide, then 2nd and 3rd in males and females
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most common-firearms
males-hanging overdose females-overdose strangulation |
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stretched ligament that connects bone to bone is called
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a sprain
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contussions are...
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bruises
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tendon stretched that connects muscle to bone
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strain
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what does RICE stand for?
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Rest ice compression and elevation for 6-12 hours
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repititive motion that causes injury
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overuse syndrome
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Peak and prime physical years
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Young adult 20-40
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Erikson stage for you adult
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Intimacy vs isolation
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Inflammation of veins, usually in the legs and it's associated with a blood clot
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Thrombophlebitis
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Risk factors for getting a thrombophlebitis
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P/o bed bound , obese, smokers, ortho pt, cancer pt, implantable devices (Picc) diabetes
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Prominent abnormally dialated veins that develop most often in the lower extremities
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Varicosities
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Endothelial injury, hyper coagulability, venous stasis (slowing of blood flow) (2 of 3 symptoms must occur)
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Virchow's triad
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Half of all DVTs are asymptomatic until ..
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PE
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Test that is gold standard for testing DVTs, invasive and not often used
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Venogram
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DVT test that is a doplar and ultrasound combo- looks for vein compressibility and listens to blood flow
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Venous duplex
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Endothelial injury, hyper coagulability, venous stasis (slowing of blood flow) (2 of 3 symptoms must occur)
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Virchow's triad
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Blood test for DVTs that recognizes clots are present but not where. Not effective of fistula patients
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D-dimer
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Half of all DVTs are asymptomatic until ..
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PE
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Test that is gold standard for testing DVTs, invasive and not often used
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Venogram
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DVT test that is a doplar and ultrasound combo- looks for vein compressibility and listens to blood flow
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Venous duplex
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Blood test for DVTs that recognizes clots are present but not where. Not effective of fistula patients
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D-dimer
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What are preventative doses of lovenox? Heparin?
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30 40 and 60mg doses
Or 5000 u heparin |
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What is iv heparin infusing rate based on?
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Sliding scale of PTT and APTT
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What does PTT stand for?
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Partial thromboplastin time
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What does PT stand for?
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Prothrombin time
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What labs must be obtained before starting a iv heparin drip?
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PTT, PT, CBC and also need current weight
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What must be tested every time while on heparin iv
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Need to test hema in stools
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What time is PTT testing scheduled?
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6 hours from the last rate change And not from when the blood was drawn
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When is patient give SQ heparin to treat DVTs?
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Never- only treated via iv
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What are the 4 goals of heparin therapy ?
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1 prevent clot from getting bigger 2 prevent clot from breaking off to the lungs 3 decreases chance of having another clot 4 reduce risk of post thrombotic syndrome
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What is something that heparin will not do to a clot?
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Heparin will not dissolve a clot. The body will break down and destory The clot
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What must be tested every time while on heparin iv
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Need to test hema in stools
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What time is PTT testing scheduled?
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6 hours from the last rate change And not from when the blood was drawn
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When is patient give SQ heparin to treat DVTs?
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Never- only treated via iv
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What are the 4 goals of heparin therapy ?
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1 prevent clot from getting bigger 2 prevent clot from breaking off to the lungs 3 decreases chance of having another clot 4 reduce risk of post thrombotic syndrome
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What is something that heparin will not do to a clot?
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Heparin will not dissolve a clot. The body will break down and destory The clot
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DVT escalates and causes chronic pain and discolored area. Syndrome called
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Post thrombotic syndrome
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Decline in platelets from heparin iv . Usually takes about a week
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Heparin induced thrombocytopenia
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What is the anecdote for Heparin
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Protamine sulfate
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Med that has more predictable anti-coagulant response that heparin
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Lovenox
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How is dose amount of lovenox determined?
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Patients weight
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DVT escalates and causes chronic pain and discolored area. Syndrome called
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Post thrombotic syndrome
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Decline in platelets from heparin iv . Usually takes about a week
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Heparin induced thrombocytopenia
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What is the anecdote for Heparin
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Protamine sulfate
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Med that has more predictable anti-coagulant response that heparin
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Lovenox
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How is dose amount of lovenox determined?
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Patients weight
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What are the dose to weight parameters for lovenox?
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1 mg/ kg BID as a preventative or 1.5 mg/kg/day. Check for banding or bruising around abdomen and stop admin if present
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Do not give lovenox if platelet count is
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Less than 100
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How long is a patient treated on lovenox if patient has DVTs
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7-17 days
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What is the length of treatment for a patient on coumadin?
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3-6 months
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Why do you start a patient on coumadin while they are still on iv heparin?
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Coumadin is long acting and heparin is short acting so it takes a little time for the coumadin to set in
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How is it determined forthe dosage amount of coumadin?
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Monitor pt/inr levels. INR must be 2-3 to be therapeutic
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What is the anecdote for coumadin?
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Vitamin K either po or sq
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What is the length of treatment for a patient on coumadin?
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3-6 months
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What amount is coumadin started at?
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5 mg/day
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Why do you start a patient on coumadin while they are still on iv heparin?
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Coumadin is long acting and heparin is short acting so it takes a little time for the coumadin to set in
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How is it determined forthe dosage amount of coumadin?
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Monitor pt/inr levels. INR must be 2-3 to be therapeutic
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What is the anecdote for coumadin?
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Vitamin K either po or sq
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What amount is coumadin started at?
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5 mg/day
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Ways to prevent DVTs
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Teds scds ambulate graduated compression stockings
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Ways to assist patient with a DVT
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Ted hose, warm compress, do not pull scds on a leg with DVTs, limit activities, coumadin
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Another word for varocos veins
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Varocosities
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Prominent abnormally dilated veins in lower extremities. Vessels stretch and valves can no longer close properly so blood pools in veins
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Varocosities or varocos veins
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What are some of the treatments to varicose veins?
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Ted hose, compression stockings, stripping and vein excision, scienotherapy- kills vein with chemicals
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What is the most accurate way to determine if a patient has asthma?
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Pulmonary function test
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A test that measures the level of u2 and co2 in e blood stream. It's an acid based balance , put pressure dressing on the site of withdrawal
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ABG - arterial blood gases test
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What are the 4 stages of asthma
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Intermittent , mild persistent, moderate persistent, severe persistent
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Asthma stage- no daily med needed, use rescue inhaler
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Mild interMittent
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How long do you hold your breath after taking albuterol
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10 seconds after using inhaler
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What can happen if you don't rinse out your mouth after taking albuterol?
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Can develop thrush. Also wait 5 minutes between each use.
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Asthma where symptoms occur 2 times a week or less. Symptom free between episodes. Episodes short and night symptoms no more than 2x a month
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Intermittent
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Asthma symptoms occur more than twice a week but not daily. Symptoms present at night more than 2x per month
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Mild persistent
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Asthma treatment involves use of daily anti inflammatory, inhaled cortincosteriod, leukotriene antagonist and rescue inhaler
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Mild persistent
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Three types of corticosteriods
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Pulmicort flovent azmacort
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Two types of leukotriene antagonists
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Singular, accolate
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Asthma symptoms occur daily, more than twice a week, inhaler used daily, symptoms persist at night at least 2x per week
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Moderate persistent
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Asthma treatment includes daily use of inhaled corticosteroid, long scting bronchodialator (serevent) and recuse inhaler
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Moderate persistent
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Asthma symptoms present continuously, episodes/exacerbations frequent, physical activity limited, night symptoms frequently present
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Severe persistent
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Asthma treatment includes daily use of corticosteroids, and bronchodialators, systemic corticosteroids
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Severe asthma
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Stage of rapid growth, develop 2nd sex characteristics, limited abstract thought, wide mood swings, day dreaming, wants to remain dependent
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Early adolescence (11-14)
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Stage where 2nd sex char are well advanced, abstract thinking ability increases, self centered, peer acceptance is important, withdrawals when upset, stature is 95% adult height
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Middle adolescence (15-17)
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Stage of physical maturity, established abstract thought, stable self esteem, consistent emotions, stable relationships
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Late adolescence. (18-20)
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Chronic inflammatory disorder of the airways with exaggerated bronchoconstrictor response
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Asthma
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Bronchi restriction of smooth muscle, inflammation increases mucous production
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Med that reduces inflammation of ghhe bronchioles
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Corticosteroids
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Erikson stage of identity vs role confusion is broken down into two subcategories called
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Group identity vs alienation ( early adolescence)
Personal identity vs role diffusion (late adolescence) |
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When do adolescents start to develop sexual identity?
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The middle adolescent stage- hetero and homo relationships
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How are the larynx and vocal chords affected with each sex during puberty?
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Girls- fuller voice, voice drops a little
Boys- voice will shift and squeak then go low- this is from vocal chords stretching |
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20-25% height achieved at puberty. Occurs during 24-36month period.
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Growth spurt
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9 1/2- 14 1/2 for girls
10 1/2-16 for boys |
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WheN will growth stop with girls and boys
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Girls- 2 1/2 years after they get their first period
Boys- between ages of 18-20 |
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Where is the initial growth spirt first seen
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Te love handles
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Before growth spurt- non lean body mass (seen more on boys). After growth spurt changes to
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Growth of lean body mass
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How long does it take for full maturity of breast buds?
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1 1/2- 6 years
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Short acting bronchodialator inhaler
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Albuterol
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Long acting bronchodialator
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Serevent
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What is the most effective long term medication for asthma control?
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Inhaled corticosteroid
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What does advair contain? (used for moderate or severe asthma)
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Flovent 500 and serevent 50. LA bronchodialator and a corticosteroid
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Inflammation of the bronchi and usually the trachea. Extension of upper respiratory tract infection. Either from chronic condition or viral
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Bronchitis
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Illness that has signs of pain from coughing, sputum, heavy fever, and adventitious lung sounds. Lasts 1-2 wks or up to 4
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Bronchitis
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What are some ways to treat bronchitis?
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Fluids, rest, musonex, elevate chest, cough medication that does not dry secretions, and antibiotics if chronic illness involved and over 2 wks
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Inflammation of the mucous membranes in any area
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Sinusitis
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What are the 3 types of sinusitis?
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Allergic, viral, and bacterial is the most common
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Symptoms include fever,yellow mucous, pressure above bridge of nose, pain when touching pressure, headache, sore throat
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Sinusitis
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What Mede are givn for sinusitis?
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Amoxicillin or zpac (zithromax) which is taken for less days and stays in the system longer. Also possible to do sinus scraping
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Chronic neuromuscular disease characterized by inflammation of white matter in the CNS, causes scattered demyelination of white matter
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Multiple sclerosis
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What type of disease is MS?
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An auto immune disease
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What age group has the highest incidence of MS?
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Young adults (
Possibly viral or hereditary, farther from equator, and more in females) |
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Synthetic myelin protein
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Copaxone
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Symptoms that present include fatigue, pain, blurred vision, dysphagia, weakness, eye twitching
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MS
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How is MS diagnosed.
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By ruling out all other possible diagnosis. Difficult to diagnose and mainly affects the brain, spinal cord, and optic nerves
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What are the 3 MS disease courses
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Relapse/remitting,
Primary progressive Secondary proressive |
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80%of all cases. Female to male 2:1 will have exacerbations and go away and patient returns to baseline (MS)
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Relapse/remitting disease
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ms type 2:1 ratiO f/m exacerbations never go away and progressively get worse. Never return to baseline
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Primary progressive disease
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MS type where exacerbations start returning to baseline, but then they eventually Stop and instead proressively get worse
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Secondary progressive
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What tests are used to determine MS?
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No one test, but If symptoms are reaccuring, can do MRI to identify areas of demylenation. Nerve testing. Spinal tap would show increased protein and white count
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What drugs are used to treat Relapse/remitting or secondary MS? (only treat symptoms in primary)
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Corticosteroids and disease modifying drugs(used to reduce frequency of exacerbations)
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What types of disease modifying drugs are available for MS?
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Gilenya which is the 1 st oral drug on market, and interferon which includes avonex (IM 1/wk), betaseron (SQ QOD), and copaxone (SQ QD)
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What are the two importNt interferons to know?
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Avonex (SE suicidal ideations) and betaseron (both have SE of flu like symptoms)
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What are the types of peptic ulcer disease?
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Gatric and duodenal (more common due to cells being less dense inthe lining)
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90% of all peptic ulcers are caused by (the other 10 is caused by chronic NSAID use)
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H pylori bacteria which burrows into the mucosal layer after some stress causes the mucosal barrier to be compromised
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Is peptic ulcers more common in men or women
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Men. Duodenal ulcer is concentrated at the junction of the Antrum and duodenum
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Symptoms include pain and burning in eppigastrix area for 30m- 2h long and occurs 1-3 hours after meals and between 12-3 am
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Peptic ulcer disease
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What test is used to determine peptic ulcer disease where pt swallows chalky substance, and dray shows a break in digestion track.
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Upper GI series test. Barium swallow. E barium makes patient very constipated. Run IV, drink fluids, laxatives
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What ways aRe there to diagnose peptic ulcers aside from barium swallow?
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EGD (esophageal gastric duodenoscopy), endoscopy with biopsy (NPO to do, numb gag reflex, NPO until gag reflex reinstated)
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What tests can be done to determine h pylori ulcers?
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Gastric biopsy with culture, serology, stool antigen testing
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How is h pylori spread
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Oral fecal route, contaminated food, sometimes in saliva
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Symptoms where stomach becomes rigid and board like, starts in the mid abdomen and spreads over stomach, initially hypperBS then hypo as symptoms progress
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Perforation of the bowel
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What meds are used to treat H Pylori?
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Antacids- tums, histamine receptor agonists - Zantac, pepcid, PPIs - protonix, and mucosal protective agents - carafate, pepto
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What ways aRe there to diagnose peptic ulcers aside from barium swallow?
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EGD (esophageal gastric duodenoscopy), endoscopy with biopsy (NPO to do, numb gag reflex, NPO until gag reflex reinstated)
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What tests can be done to determine h pylori ulcers?
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Gastric biopsy with culture, serology, stool antigen testing
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How is h pylori spread
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Oral fecal route, contaminated food, sometimes in saliva
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Symptoms where stomach becomes rigid and board like, starts in the mid abdomen and spreads over stomach, initially hypperBS then hypo as symptoms progress
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Perforation of the bowel
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What meds are used to treat H Pylori?
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Antacids- tums, histamine receptor agonists - Zantac, pepcid, PPIs - protonix, and mucosal protective agents - carafate, pepto
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Weak bases that neutralize hydrochloric acids, relieves burning sensation, and promotes healing primarily used for symptomatic relief
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Antacids
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Give 2 hrs after each meal and at bedtime. Tablets have better effect than liquids do, don't give within an hour of giving h2 or PPIs
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Med treatment for ulcers that blocks histamine. Given at bedtime for 4-6 weeks
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Histamine receptor agonists like zantac and pepcid
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Med that decreases 24 hour gastric acid production taken either QD or BID
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PPIs
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What is triple threat therapy for h pylori?
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PPI, 2 antibiotics , May also add Zantac which helps promote healing of ulcer. Use meds for 2 weeks
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What is a common antibiotic used to treat ulcers?
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Flagyl
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What are the goals when treating ulcers?
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Pain relief, h pylori eradication, heal ulcerations, prevent reoccurrence
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Who is at risk for getting hemorrhoids?
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Obese, people who sit a lot, pregnant women, constipated people
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How are hemorrhoids diagnoses?
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Digital palpation, inspection, or if internal a sigmoidoscopy
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What are some ways to treat hemorrhoids?
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Sita bath/ gentle cleaning, increased fiber, cryotherapy, rubber band ligation, hemorrhoidectomy, sclerotherapy (chemical injection)
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What are 90% of all UTIs caused from?
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Gram negative rod e coli
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Pathogenic bacteria invading 1 or more urinary tract structures
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UTIs - women more at risk
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Symptoms present with pain, burning, urgency, frequency, pressure, hematuria, fever
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UTIs
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How is a.UTI diagnosed?
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Urinalysis, urine culture
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What mEdicatiins are given to treat a UTI?
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Antibiotics- bactrim, cipro (if taken orally do not give within 2 hours of taking dairy products)
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