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227 Cards in this Set
- Front
- Back
Endocrine System |
Secretes hormones into the blood stream |
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Oxytocin |
Milk production contraction causes labor used post delivery to help uterus contract and shrink back to size secreted from posterior pituitary |
|
Pituitary Gland |
containes Anterior lobe and posterior lobe and secretes hormones |
|
Vasopressin (ADH) |
causes a faster absorption of water from the kidney into the blood (don't pee hormone) Causes kidney tubules to save water potent vasoconstrictor |
|
Stimulus for ADH release |
plasma osmolality (solute concentration) decreased blood volume decreased BP pain, N/V, and certain meds results in concentrated urine |
|
Inhibition of ADH |
increased fluid volume Beta adrenergic agonist -epinephrine, dobutamine, dopamine alcohol results in dilute urine |
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Diabetes Insipidus |
disease caused by failure of the posterior lobe of the pituitary gland to secrete sufficient amounts of ADH ADH functions to increase the amount of water reabsorbed from the kidney tubules and in its absence large amounts of urine are excreted F&E losses - dehydration, insatiable, thirst, weakness, weight loss, anorexia |
|
Etiology of Diabetes Insipidus |
Tumor, Trauma to pituitary |
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Treatment of pituitary tumor |
transsphenoidal hypophysectomy |
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Medical Treatments for Diabetes Insipidus |
Parenteral Fluids ADH replacement therapy - parenterally or nasal spray Intake and Output Assist in daily care - weak |
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SIADH |
Syndrome of Inappropriate Antidiuretic Hormone Abnormal production or sustained secretion despite normal plasma osmolarity causes fluid retention and lower sodium levels Dilutional Hypernatremia because salt is diluted too much don't pee hormone ***opposite of Diabetes Insipidus*** |
|
Etiology of SIADH |
Head Trauma - Pituitary Tumor Lung CA Duodenal CA Pancreatic CA (Tumors that start producing ADH) Chronic in nature must treat underlying cause |
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SIADH diagnosis |
simultaneous urine and serum osmolality NA< 135 mEq/L plus Serum osmolality < 280 mOsm/kg and Urine sp gravity > 1.030 |
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Treatment for SIADH |
Fluid restriction (only if NA >125) ---800-1000 cc/day ----------------------------------------------------- Hypertonic Saline (if NA < 125) Lasix |
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Treatments for chronic SIADH |
Declomycin Lithium Block effect of ADH on renal tubules |
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pituitary anterior lobe secretes |
Growth Hormone Thhyrotopin Adrenocorticotropic Hormone (ACTH) Follicle Stimulating Hormone (FSH) Luteinizing Hormone (LH) Prolactine Melanocyte Stimulating hormone (MSH) |
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Dwarfism |
Congenital deficiency of GH |
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GIGANTISM |
tumor affecting the GH in childhood and adolescence causes the individual to grow extremely tall
|
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ACROMEGALY |
hyperescretion of growth hormone features become coarse, bones become large and heavy,hands and feet become broad and massive, chin protrudes tongue enlarges |
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Thyroid Gland |
regulate metabolism stores iodine to make thyroid hormone aka TH |
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hyperthhyroidism |
increase in all metabolic processes of the body overactive thyroid gland often follows infections or emotional stress other names : Graves disease, Toxic Goiter |
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S&S of hyperthyroidism |
increase apetite with weight loss increased BP and HR at REST Skin warm, perspires freely, sensitivity to hear fatigue, weakness, disturbanc of sleep, menstruation, increased bowel movements profound personality changes exopthalmos (bug eyed) mild tremors |
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Hyperthyroidism Interventions |
reduce the activity of the thyroid gland Antithyroid Drugs -iodine preparations: SSKI, PTU -liquids - diluted in fruit juice, administered through a straw, give with meals -Side Effects - metallic taste, GI discomfort most useful before surgery or in an emergency Propanolol for Cardiac Symptoms Radioactive Iodine - given po - enters into the bloodstream and becomes concentrated in the thyroid gland where it destroys the cells |
|
Radioactive Iodine |
after tracer dose is given to determine the correct dose I131 is given orally as single dose radioactive idone takes 2 weeks to 2 months to work patient is isolated for 3 days and should avoid close contact with others for 7 days esp pregnant women urine, saliva is slightly radioactive, vomitus is very radioactive |
|
thyroidectomy |
at risk for hemorrhage since the gland is vascular tetany since the parathyroid glands may be removed hyperthyroid crisis since the TH may be released during surgery |
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Hypothyroidism |
Under secretion of T4 or comlete lack of secretion |
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S&S of hypothyroidism |
Lack of energy, fatigue, depression, coma, bradycardia, weight gain, cold intolerance |
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the three conditions associated with hypothyroidism |
Goiter, Myxedema, Cretinism |
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simple goiter |
any enlargement of the thyroid gland results when dietary iodine is insufficient for synthesis pituitary secretes excessive amounts of TSH causing the gland to hypertrophy |
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treatment for goiter |
prevention - detary iodine and foods high in iodine reduce the size of the goiter by subtotal thyroidectomy |
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Myxedema S&S |
occurs gradually, sensitivty to cold, dryness of hair and skin, weight gain, loss of appetite, dull facial expression, thickening of lips and eyes, lethargic, responds slowly, decreases HT |
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Treatment of Myxedema |
replace the deficient hormone (T3 levothyroxine, or desicated thyroid) Replacement therapy done gradually slow process - monitor for CV status for bradycardia |
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Cretinism |
complete absence of thyroid secretion from birth gland may be absent or fail to secrete |
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S&S of Cretinism |
onset few weeks fter birth, difficulty in feeding, FTT, protrusion of tongue, dry skin, constipation, hoarse cry mandated testing at birth for T4 |
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hyperparathyroidism |
Too much parathyroid hormone excretion causes increased absorption of calcium from gut and cal in the bones is shifted into the bloodstream |
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causes of hyperparathyroidism |
primary - benign tumor of one of the glands secondary - caused by another disease |
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S&S of hyperparathyroidism |
increasedCa++levels, fatigue, depression, wgt loss, loss of muscle tone, renalcalculi, abdpain, constipation. Weak, tender, and painful bones. Bones dissolve and therewill be pathological fractures |
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hypoparathyroidism |
too little secretion of PTH Decreasein blood Ca++ and increase in phosphorus.Mostcommon cause - injury or the removal of parathyroid tissue during thyroid orparathyroid surgery.CongenitalabsenceAutoimmuneHypomagnesemia |
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S&S hypoparathyroidism |
Tetany-generalmuscle hypertoniaOverttetany- sudden dropLack of muscular coordination Tremor and spasm, cardiac dysrthymias, laryngeal spasm and generalized convulsions.Latenttetany- gradual drop numbness,tingling, cramps, stiffness in hands and feet |
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Treatment of hypoparathyroidism |
Goal:serum calcium level between 9-10mg/dlIncreaseCalcium levels Calcium gluconateVitaminD preparations ergocalciferol |
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Adrenal Medulla secretes |
Epinephrine - fight hormone Norepinephrine - Presor Hormone |
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PHEOCHROMOCYTOMA |
Catecholamine-producingtumor of the adrenal medulla. Usually small and benign. S& S - Hypertension - may be persistent, chronic, or intermittent. Often confused with essentialhypertension. Other symptoms -h/a, N/V,sweating, palpitations, acute anxiety. 24hour urine - elevated metanephrinelevel. Treatment- removal of the tumor.T.2 |
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Adrenal Cortex |
Secretes Glucocorticoids - regulate cell activity and maintain an optimum internal environment for the body cells . Also regulate the bodys ability to adapt to constant change - regulated by ACTH Hydrocortison (cortisol) Corticosterone |
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Cushings Disease |
hyperfunction of the adrenal cortex cause - usually a tumor in the anterior pituitary gland or adrenal cortex |
|
S&S of cushings |
uweaknessof muscle with muscle wasting, fat accumulation in the face, neck, and trunk,“humpback” appearance; Moon face, hemorrhagic tendencies, hirsutism,hypertension, obesity, menstrual irregularities, hyperglycemia, irritability,poor wound healing |
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Cushing's Treatment |
Treatment- Surgical removal of the tumor if possible. May require radiation. Conveyacceptance to the patient. Adrenal Steroids - administered in chronicdiseases can lead to Cushing’s syndrome (not disease). |
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Addisons's Disease |
Hypofunctionof the adrenal cortex with decrease in mineralocorticoids (aldosterone) and gluccocorticoids(cortisol). Aldosterone - most important mineralocorticoid - maintainhomeostasis of sodium concentration in the blood. may be autoimmune destruction of the gland after stressful situation |
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S&S of Addisons |
GIdisturbances, fatigues easily, show signs of hypoglycemia, hypotension,bronzeskin color from increased stimulation to melanocytes |
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Treatment of Addisons Disease |
normalhydration, replacing hydrocortisone and fludrocortisone. Both meds given after meals. |
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Addisonian Crisis |
serious exacerbation of the disease - oroduces a severe drop in B/P --- shock, coma, and death |
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Addisons Nursing interventions |
Fluids high in NA (broth, cola, tomato juice) monitor BP monitor weight monitor K levels |
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FSH |
development of the egg |
|
LH |
causes ovulation |
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Prolactin |
causes milk development |
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Gland that causes Graves Disease? |
Thyroid |
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Gland that causes Diabetes Insipidus |
Posterior Lobe of the Pituitary Gland |
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Gland That causes Cushings Disease? |
Adrenal Cortex |
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Gland that causes Addisons |
Adrenal Cortex |
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Gland that causes Pheocromocytoma? |
Adrenal Medulla |
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S&S of Diabetes Insipidus |
Increased Urination |
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S&S of Addison's Disease |
Hyperpigmentation, Hypotension, hypoglycemia |
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S&S of Cretinism |
Dwarfism, Retardism |
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S&S of Cushings Disease |
humpback, hirsutisms, hyperglycemia, trunkal obesity |
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S&S of hyperparathyroidism |
Stones, Bones, Abdominal Groans |
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Function of Aldosterone |
Causes Sodium and Water Reabsorption |
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Function of Calcitonin |
Decreases Serum Calcium |
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function of ADH |
Causes you to retain water |
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function of thyroid hormones |
Controls Metabolism |
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Function of Parathyroid Hormone |
increased serum calcium |
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Meds: dont stop taking this drug abruptly |
Steroids |
|
Report Nasal Congestion with this drug |
Vasopressin (ADH) |
|
Blocks synthesis of thyroid hormone |
PTU |
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Dilute in juice and give with a straw |
SSKI or Lugols |
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Start Low Go Slow (medicine) |
Synthroid |
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increased growth hormone in adults |
Acromegaly |
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increased glucocorticoids is what disorder |
cushings |
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decreased growth hormone as a child |
dwarfism |
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decreased ADH is what disorder |
Diabetes Insipidus |
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Increased catecholamines is what disorder |
pheocromocytoma |
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gland responsible for a goiter |
thyroid gland |
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Normal PaO2 |
80-100 mmHg |
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gentle bubbling is expected in this chamber of a chest tube? |
suction chamber |
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indicates an air leak in a chest tube? |
constant bubbling in the water seal |
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causes obstruction in the chest tube? |
Dependent Loop |
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reason tidaling may stop in water seal chamber? |
obstruction or lung reexpansion |
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why chest tubes are never left clamped |
causes mediastinal shift |
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presents with hoarseness, dysphagia, or a lump in the throat? |
cancer of larynx |
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may cause partial or total loss of voice |
laryngectomy |
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frequent swallowing with this indicates hemorrhage |
Tonsillectomy |
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used when there is anticipated prolonged intubation, head and neck surgery, trauma to facial features or airwat obstruction |
tracheostomy |
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pinch nose for 10 minutes no peaking |
epistaxis |
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DVT is most common cause |
pulmonary embolism |
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can be spontaneous, from trauma and invasive surgery |
pneumothorax |
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presenting symptoms include fever, chills, tachypnea, crackles, productive cough, retractions, grunting, nasal flaring |
Pneumonia |
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night sweats, weight loss, hemoptysis, fatigue, fever. chills |
TB |
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seen in immunicompromised host with non productive cough |
PJP PCP |
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Bronchodilator used as an emergency med |
albuterol |
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decrease sputum production by 1/3 if taken for a month |
anticholinergics (atrovent) |
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used to control disease and prevent exacerbations |
Inhaled Steroids |
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used to prophylactically prevent TB in an exposed person |
INH |
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Used to treat TB |
INH Rifampin Ethambutol PZA |
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Adventitious Breath Sounds |
Crackles Rhonchi Wheezes Pleural Friction Rubs Stridor |
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Pulmonary Function Test |
Evaluate Lung function Measures lung volume, ventilatory function, gas exchange, lung compliance, airway resistance |
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Thoracentesis |
Removes fluid from pleural cavity
aseptic technique local anesthetic |
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signs of obstruction |
gurgling, increased pulse and respirations, harsh respiratory sound, restlessness, anxiety, pallor with oral cyanosis |
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Percussion |
loosens mucus plugs and moves them into the bronchi rhythmically clapping and vibrating |
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antitussive |
cough medicine narcotic - codeine nonnarcotic - dextromethorphan |
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Demulcents |
relieve irritation, soothe, protects mucus membranes cough medicine |
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Expectorants |
thins secretions, to facilitate expectoration cough medicine |
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Sedatives |
depress cough reflex |
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Neosynephrine Ephedrine Sulfate |
Nose drops or sprays for nasal congestion and can cause rebound nasal congestion |
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low flow oxygen delivery devices |
Nasal cannula, face mask, non-rebreather |
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High flow oxygen delivery devices |
Venturi Mask, Trach Collar |
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precautions with oxygen |
No smoking sign outside door and in room do not use electrical appliances secure portable tanks don't place them near source of heat ** o2 can cause toxicity** |
|
signs of o2 deficiency |
restlessness, excitement, confusion, increased R and PR, headache, sighing and yawning, N&V, Anorexia |
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late signs of o2 deficiency |
Decreased BP, Cyanosis, twitching of muscles |
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Endotracheal Intubation |
Increases oxygenation allows for suctioning inserted through nose or mouth use in surgery but also in emergency situations to facilitate breathing ventilate by mechanical means |
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Thoracotomy |
Surgical opening into thoracic cavity to remove blood, pus, air, or to expedite the re-expansion of the lung to explore the thoracic cavity |
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lobectomy |
removal of an entire lobe |
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pneumonectomy |
removal of an entire lung |
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Chronic Bronchitis |
dx by symptoms: presence of cough for at least 3 months in each of two consecutive years, increase in mucous secreting cells bronchi become thickened and bronchioles become fibrosed normal function of cilia is impaired |
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Chronic Bronchitis S&S |
persistent cough with large amounts of thin sticky liquid mucous SOB Dyspnea Cyanosis Wheezing |
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Chronic Bronchitis Interventions |
healthy lifestyle Stop Smoking Avoid exposure to infections Antibiotic Therapy Medications have limited effects (except antibiotics) |
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Pulmonary Emphysema |
Alveolar walls and capillaries are destroyed which decreases the area available for exchange of gases between bloodstream and air cigarette smoking is the largest contributing factor |
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S&S of Pulmonary Emphysema |
Insidious Onset Dyspnea Hypoxia Coughing with copious amounts of mucopurulent sputum Barrel shaped chest use of accessory muscles wheezing pneumothorax |
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Pulmonary Emphysema interventions |
Prevention, Antibiotics, Cough and deep breathe, incentice spirometry, aerosilized bronchidilators, low levels of oxygen, nutrition |
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Coniditions associated with pulmonary emphysema |
Right sided HF Chronic Bronchitis peptic ulcer and GERD Exacerbations of COPD acute resp failure Depression/ Anxiety |
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Asthma |
Bronchi become narrow and edematous Spasms of bronchial muscles occur no cure |
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Asthma Triggers |
infection, allergies, exercise, irritants |
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S&S of Asthma |
SOB, Wheezing, Coughing |
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Anti inflammatory Drugs for Asthma |
corticosteroids mast cell stabilizers leukotriene modifiers monoclonal antibody to IgE |
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Bronchodilators for Asthma |
B2 adrenergic agonist drug methylxanthines anticholinergic drugs |
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Asthma Interventions |
Epinephrine, steroids and bronchodilators for relief of immediate attack control causative factors promotion of healthy lifestyle prevention of exacerbation's with inhaled corticosteroieds |
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S&S of cancer of the larynx |
Hoarseness Pain Burning throat with juices/ hot liquids lump in throat |
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Late S&S of cancer of the larynx |
dysphagia dyspnea continued hoarseness foul breath enlarged lymph nodes (metastasis) |
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Dc of cancer of the larynx |
Direct Visualization Biopsy CT scan |
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Treatment for cancer of the Larynx |
Laryngectomy Radiation |
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Care for Laryngectomy Tube |
Shorter and wider than a trach tube stoma heals in 3-6 weeks keep clean/ wash BID Avoid any water - shower with plastic bib No oil based ointments near stoma AC may be too cold and dry to tolerate |
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Pulmonary Embolism |
Occurs when a blood clot or other foreign matter becomes lodged in a branch of the pulmonary artery or arteriole |
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Pulmonary Infarction |
is the death of a portion of lung tissue resulting from an insufficient blood supply, often is a result of a pulmonary embolis |
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PE risk factors |
Immobility Surgery Cancer Pregnancy |
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Pneumonia |
Most common infectious cause of death in the US Lobar - substantial portion of one or more lobes Bronchopneumonia - patchy fashion bronchi > lungs |
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Causes of Pneumonia |
Opportunistic Bacterial Viral Fungal Parasitic Post radiation, post-chemical ingestion Aspiration |
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Risk factors for Pneumonia |
CA, COPD Smokers Immobility Decreased cough reflex Aspiration NPO |
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Bacterial Pneumonia S&S |
Sudden onset - affects one or more lobes Chest pain, myalgia, H/A increased T, P, R Severe Chills Cough - thick sputum Crackles ^ tactile fremitus WBC - 20k-30k |
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Viral Pneumonia S&S |
chills elevated temp - irregular profuse sweating body aches painful cough WBCs normal |
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PJP |
Fungus causing disease in immunocompromised host manifests with fever chills non productive cough SOB dyspnea Tachypnea tachycardia hypoxemia occasional chest pain treatment is Bactrim |
|
Pneumonia Interventions |
Avoid energy expenditure antibiotics analgesics cough analgesics increase humidity o2 increase fluids |
|
TB |
Airborne droplet Acid fast bacterium |
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TB S&S |
Cough -dry, productive, hemoptysis pleuritic chest pain systemic effects -weigh loss -night sweats -fever -malaise -anorexia -fatigue |
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Central Nervous System |
Brain, Spinal Cord |
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Peripheral Nervous system |
Cranial nerves, spinal nerves, and autonomic nervous system |
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GCS |
used for Level of Consciousness lowest score is a 3 - comatose client or completely unresponsive |
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Cranial nerve I |
Olfactory - smell |
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CN II |
Optic - visual fields and acuity |
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CN III |
Occulomotor |
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CN IV |
Trochlear |
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CN VI |
Adbucens |
|
CN 3,4,5 responsible for |
PERRLA - 6 cardinal positions of gaze - Eyes |
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CN V |
Trigeminal - light touch - chewing, jaw opening, clenching |
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CN VII |
Facial - Taste, Facial movements |
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CN VIII |
Auditory - Hearing and balance |
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CN IX |
Glossopharyngeal - Taste |
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CN X |
Vagus - swallowing, speech sounds, gag reflex
|
|
CN XI |
Spinal Accessory Nerve Turning head and shrugging shoulders |
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CN XII |
Hyopglossal - tongue movement |
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Musculoskeletal changes expected with aging? |
Reduced muscle mass Slower reaction time Decline in coordination Limited ROM |
|
Neurological changes expected in aging? |
Decreased in taste and smell Decrease in tactile sensation Decreased Temp regulation Visual Changes Loss of hearing Stage IV sleep is decreased Fewer brain cells, neurotransmitters, smaller brain volume Slowed Reflexes (DTR) Decline in short term memory. |
|
Findings that do NOT change in normal aging |
Touch, orientation, language, LOC, memory, judgement -- may take longer to process, but does not diminish-- |
|
CT scan |
provide cross sectional views of the brain showing differences in tissue density |
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Episodic Migraines |
fewer than 15 headache days a month - only some are migraines |
|
Chronic Migraines |
occur 15 or more days a month and headache lasts 4 hours or longer for at least 3 months |
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Migraine Risk factors |
family hx, increased body weight, HTN, hypercholesterolemia, impaired insulin sensitivity, stoke, CAD |
|
Triggers for migraines |
menstrual cycle, dietary habits, bright lights, stress, depression, lack of slep, meds, alchohol, foods (cheese, chocolate, milk products, coffee, tyramine, MSG) |
|
Phases of migrain |
Prodrome - 60% of patients Aura - minority of patients - last 1 hour visiaul disturbances are most common Headache Phase - 4-72 hours, unilateral throbbing pain with N/V Recovery - characterized by deep sleep - pain subsides |
|
Abortive Migraine meds |
--Triptans Imitrex (sumatriptan) Amerge Maxalt Zomig Axert Ergotamines Ergotamine tartate cafergot (caffeine) Antiemetics |
|
Preventative Migraine Meds |
Antiepileptic drugs (neurontin, topamax and depakote) Beta blockers (lopressor, inderal) Antidepressents (elavil) Calcium Channel Blockers (Verapamil) NSAIDS Botox |
|
Seizures |
Abrupt, abnormal, excessive, and uncontrolled electrical discharge of neurons in the brain that interrupts the normal function |
|
Epilepys |
A condition in which a person has spontaneously recurring seizures caused by a chronic underlying condition or unknown cause |
|
Status Epilepticus |
continuous seizure activity without full recovery of consciousness between seizures |
|
Intervention for Status Epilepticus |
Establish Airway and Oxygenation IV meds given to stop seizure - Valium, Ativan, or Cerebyx |
|
Causes of Seizures |
Fever Infection Head Trauam Alcohol, Drug Withdrawal Brain Tumor Cerebral Edema Metabolic Disorders Hypoxia CVA HTN Electrolytes Allergies Lead Poisoning Unknown |
|
Myoclonic Seizures |
*brief jerking or stiffening of extremities *symmetrical or asymmetrical |
|
Stages of Seizures |
Aura - alterations in smell, taste, visual perception, hearing, and emotional state Ictus - when seizure occurs Post Ictal - brain recovers, drowsiness and confusion are common |
|
Pharm for Seizures |
Tegretol Neurontin Lamictal Keppra Dilantin Topamax Depakote Klonopin |
|
Septic Meningitis |
Caused by bacteria (bacterial meningitis) HIGH MORTALITY RATE |
|
Aseptic Vital Meningits |
secondary to lymphoma, leukemia, or HIV, Chickn pox, herpre simplex (typically type 2) mumps, measles, west nile, rabies Fungal - common in clients with AIDS |
|
Kernigs and Brudzinski's |
Differentiates between meningitis and encephalitis
|
|
Encephalitis |
Acute inflammation of brain tissue |
|
causes of Encephalitis |
Virus - usually herpres simplex virus/ HSV is most common in the US presents with : fever, HA, N/V, could have seizures and altered LOC (Confusion, drowsiness) |
|
Treatment for Encephalitis |
Zovirax - antiviral given for up to 3 weeks Antiseizure meds if needed |
|
MS |
Chronic, progressive, degenerative disease with no cure destruction of the myelin sheath |
|
Dx of MS |
MRI - presence of multiple plaques in the CNS CSF Analysis/ LP - increased IgP ER - Evoked Potential - Measures time it takes for nerves to respond to stimulation |
|
Treatment for MS |
Goal - treat acute exacerbations, delay progression and manage chronic symptoms |
|
Pharm for MS |
Novantrone corticosteroids meds to treat specific symptoms |
|
Myasthenia Gravis/ MG |
Autoimmune disorder of neuromuscular junction -Antibodies attack acetylcholine receptor sites resulting in varying degrees of muscle weakness |
|
Myasthenia Crisis |
Acute exacerbation of muscle weakness can lead to resp failure |
|
Diagnostic |
Tensilon IV (acetylcholinesterase inhibitor) MRI - enlarged thymus Serum Analysis - increased acetylcholine antibodies EMG - Detects delay/ failure of neuromuscular transmission |
|
Medical Management of MG |
1st line - anticholinesterase medications - mestinon 2nd line - immunosuppressives - Corticosteroids Exacerbation - plasmapheresis and IVIG Surgical intervention - thymectomy |
|
Guillain - Barre Syndrome |
caused by autoimmune attack that results in the direct destruction of the myelin sheath surrounding the PNS or the axon of the nerve itself |
|
Diagnosis of Guillan-Barre |
Hx of terminal illness LP EP |
|
Trigeminal Neuralgia |
5th cranial nerve. unilateral shooting and stabbing pain due to blood vessel pressing on trigeminal nerve, injury to TN, or inflammation of TN |
|
Triggers of Trigeminal Neuralgia |
Chewing, brushing teeth Cold or hot air on the face Touching/ washing the face Talking, Yawning, Shaving |
|
DX of Trigeminal Neuralgia |
MRI and assessment to rule out other causes |
|
1st line drug for Trigeminal Neuralgia |
Tegretol |
|
Tensilon Test |
Used to diagnose MG |
|
Bell's Palsy |
a form of temporary facial paralysis resulting from damage or trauma to the facial nerve *Unilateral inflammation of the facial nerve which results in weakness or paralysis of the facial muscles on one side of the face |
|
Goal of Treatment for Bells Palsy |
Apply hear to promote comfort and blood flow electrical stimulation to prevent muscle atrophy Pharm - Corticosteroid therapy - to reduce inflammation analgesic for pain |
|
ALS |
Lou Gherigs Disease - type of motor neuron disease that causes nerve cells to gradually break down and die |
|
Dx of ALS |
based on signs and symptoms EMG and muscle biopsy will show a reduction in the number of functioning motor units |
|
Management of ALS |
Rilutek - reduces damage to motor neurons Baclofen and Valium - for spasticity |
|
Parkinsons Disease |
a progressive disorder of the nervous system that affects movement Decreased level of dopamine caused by destruction of nerve cells which causes an imbalance between dopamine and acetylcholine |
|
Cardinal signs of parkinsons |
TRAP Tremor Rigidity Akinesia Postural instability |
|
Thrombotic Stroke |
ischemic/blockage/area of plaque/stationary clot |
|
Embolic Stroke |
- ischemic/blockage/traveling clot |
|
Hemorrhagic Stroke |
brain bleed from ruptures BV/aneurysm |
|
TIA |
Temporary loss of neurologic function |
|
CVA classic deficits |
Hemiplegia hemiparesis unilateral neglect |
|
Stroke FAST |
Face - uneven look Arm - one arm hanging down Speech - slurred speech Time - call 911! |
|
Dx of a stroke |
CT scan is initial diagnostic test ECG Cerebral Angiography Carotid Ultrasound MRI/MRA LP - blood in CSF - hemorrhagic stroke |
|
normal PaCO2 |
35-45 mmHg |
|
normal pH |
7.35-7.45 |
|
normal HCO3 |
22-28 |
|
Respiratory Acidosis |
pH is acidic (less than 7.35) and CO2 is acidic (greater than 45) |
|
Respiratory Alkalosis |
pH is alkalotic (greater than 7.45) and CO2 is alkalotic (less than 35) |
|
Metabolic Alkalosis |
pH is alkalotic, greater than 7.45 and HCO3 is alkalotic or greater than 28 |
|
Metabolic Acidosis |
pH is less than 7.35 and HCO3 is less than 22 |