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Nurs104 Exam 4
Skin disorders, Hematology, Oncology
| Question | Answer |
|---|---|
| Macule | flat, non-palpable ex. freckle |
| Papule | elevated, palpable <5 cm ex. wart |
| Nodule | Solid, hard, into dermis. 0.5-2 cm ex. squamous cell carcinoma |
| Cyst | Like nodule but filled with fluid. 1cm+ |
| Pustule | Pus filled vesicle ex. acne |
| Vesicle | Elevated fluid filled , 0.5 cm ex. chicken pox |
| Crusts | blood, serum, pus that is dried onto skin |
| Foods that promote wound healing | Protein- cheese, eggs, meat, legumes Vit. C- strawberries, citrus, tomatoes, dk. green veggies Iron-liver, eggs, dried fruit, whole grains |
| Psoriasis | over production of cells (scalp, elbow, knees) s/s reddened raised round plaques with silvery scales tx steroids, tar prep, UV light |
| Cellulitis | Localized staph/strep infection derm & sq. Common in lower legs. s/s warm to touch, erythema, swollen, painful, chills, fever tx broad spectrum antibiotics, BR as indicated |
| Impetigo | *CONTAGIOUS* staph/strep infection of skin (usually face) s/s honey colored crut on red base, honey drainage, pruritis tx oral antibiotics, GHWT |
| Tinea | nammed according to body part involved (ex. tinea pedis-athletes foot). Fungal. s/s scaliness, itching, burning, pain (feet, scalp, chest, body, or groin) tx anti fungal med (Burrows solution potassium, Clotrimazole, Gold Bond Powder) |
| Candidiasis | yeast like infection (vaginitis, oral thrus, abd fold) s/s itching, erythema, drainage? tx teaching, meds (Nystatin, Diflucan) |
| Lice | *CONTAGIOUS* parasitic (scalp, neck, pubic area "crabs") s/s extreme itching, erythema, nits tx topical meds & shampoos |
| Scabies | *CONTAGIOUS* parasitic (between fingers and toes. "scab dashes") s/s intense itching esp @ night tx Lindane lotion or Kwell shampoo |
| Herpes Simplex I | viral-lies dormant in body aka fever blister (lips, face, mouth) s/s burning, tingling, pain & eruption of vesicle tx Zovriaz (Acyclovir), OTC Abreva |
| Herpes Simplex II | similar to herpes I, but below waste s/s burning, tingling, paint, & vesicle eruption tx Valtrex tell pt to avoid sexual contact during flare up (which can be caused by stress & ^ temps) |
| Herpes Zoster (shingles) | same virus as chicken pox (Varicella) follows linear dermatone of skin s/s severe pain 48h before rash vesicles appear on reddened base tx antiviral med (Acyclovir) topically, orally, or parentally. Contact isolation. |
| Dermatitis | inflammation of skin caused by chem, dyes, plants, etc. s/s erythema, pruritis, pain tx meds: antipuritics, antihistamines, corticosteroids |
| Acne Vulgaris | s/s painful, pruritis, some cysts, sometimes scarring tx Accutain, Retin-A: not given to pregant women (high risk of fetal abnormalities) |
| Actinic Keratosis | aka senile or solar keratosis premalignant lesion (could progress to squamous cell carcinoma-usually face, hands, & forearms) s/s rough erythema, macules (shiny or scaley) tx cryotherapy (freezing) outpatient |
| Risk factors for skin cancer | skin/hair color (light) family hx sun exposure other types of exposures repeated injury to skin |
| Basal cell carcinoma | reoccurance common caused by sun exposure s/s sm waxy nodule with pearly border tx cryosurgery, radiation, surgical excision, Moh's surgery |
| Squamous cell carcinoma | more aggressive than basal caused by sun exposure s/s sm. firm red nodule progresses to dermal tissue tx same as basal (cryosurgery, radiation, surgical excision, Moh's surgery) |
| Malignant melanoma | most dangerous s/s usually circular in shape with irregular border ABCD for assessment 80% of skin cancer deaths |
| ABCD rule of melanoma assessment | A ssymetry B order C olor D iameter |
| White blood cells | fight infection/inflammation norm: 5,000-10,000 neutrophyls most abundant segs: old neutrophyls bans: baby neutrophyls ("left shift" if high) |
| WBC Lab Terms | Leukocytosis >10,000 (infection) Leukopenia < 5,000 (immuno suppressed) Neutropenia < 1,500 (neutropenic isolation) Agranulocytosis <200 (caused: drug toxicity, chemo, radiation, increased incidence with age) |
| Severe Neutropenia | s/s infectious process: fever, chills, fatigue, oral ulcerations dx assessment, WBC counts, cultures and/or bone marrow aspiration tx remove causative agent, antibiotics, antipyretics *Prevent Infection!!* |
| Leukemia | WBC 20,000-100,000 immature WBCs crowd out RBC (=anemia) and Platelets (=hemmorage) s/s anemia, recurrent infections, bone pain, abnormal bleeding/bruising, spleenomegaly, hepatomegaly, lymph node enlargement, hepatomegaly, fever, wt loss, night sweat |
| Leukemia Types | ALL (Acute Lympocytic Leukemia): children and young adults. Tx marrow transplant. 90% remission. AML (Acute myelocytic leukemia): Adults. Poor prognosis CLL (chronic lympocytic leukemia): 60 yrs+. No tx CML (chronic myelocytic leukemia): adult ma |
| Lymphatic Cancer (Hodgkin's & Non-Hodgkin's Lymphoma) | males 15-35. 50+ s/s painless enlarged node, fever, night sweats, fatigue, wt loss Stage I: single node. II: 2 nodes. Same side of diaphragm. III: nodes on both sides of dia. IV: both sides plus liver, or lungs |
| Infectious Labs | WBC counts Erythrocyte Sedimentation Rate (Specific for Inflammatory Process) Hemoglobin/Hematocrit levels low |
| Cancer Screening | breast exam q mo. mammogram @40 q yr. fecal occult @50 q yr. colonoscopy @50 q 10yr. rectal prostate @50 q yr. routine pelvic and pap |
| 7 Warning Signs of Cancer | C hange in bowel/bladder habits A sore that doesn't heal U nusual bleeding or discharge T hickening/lump in breat or other I ndigestion/difficulty swallowing O bvious change in wart/mole (ABCD) N agging cough/hoarseness |
| Side Effects of Chemotherapy | fatigue, N/V, anorexia, diarrhea, stomatitis, alopecia, bone marrow suppression |
| Side Effects internal/external radiation | internal: burning sensations, excessive perspiration, n/v, diarrhea external: skin changes, diarrhea, n/v, GI bleeding |
| Stages of coping with loss (Kubler Ross) | Denial Anger Bargaining Depression Acceptance |
| Hemoglobin (Hgb) | O2 carrying capactiy Men: 14-16.5 Women: 12-15 |
| Hematocrit (Hct) | solid particle % Men: 40%-50% Women: 37%-47% |
| Red Blood Cells (RBC) | Men: 4.2-5.4 million Women: 3.6-5 million |
| s/s anemia (r/t hypoxia) | pallor, fatigue/weakness, parasthesia, tachypnea, tachycardia, palpitations, cheilosis (cracked lip edges), smooth sore red tongue. |
| s/s anemia (chronic) | spoon shaped nails, cheilosis, smooth red tongue, pica |
| diet for clients with anemia | protein, meats, eggs (yolk), green leafy vegs, whole grains, Vit C (citrus, strawberries, etc.) |
| supplemental iron | PO: ferrous sulfate IM: Dextran (z tracked) IV has high incidence of allergic reaction Side effects: constipation, gi irritation, skin staining, dk stools |
| aplastic anemia | arrested development of blood cells in bone marrow labs: |
| pernicious anemia | malabsorption (B12) s/s pallor to jaundice, smooth sore red tongue, CSN involvement, parasthesia tx: IM B12 wkly (initially), then monthly |
| folic acid deficiency anemia | malnourishment s/s similar to pernicious without parasthesia tx po folic acid (turns uring dk yellow) green leafy vegs, organ meats, milk |
| hemolytic anemia | RBC destruction (ex. sickle cell) RBC deficits, Hgb defects, drugs, chemicals, infections can all cause this |
| Iron deficiency anemia | most common type dietary deficiency decreased absorption increased requirement (ex. pregnancy) blood loss |
| Hemoglobin (Hgb) | O2 carrying capactiy Men: 14-16.5 Women: 12-15 |
| Hematocrit (Hct) | solid particle % Men: 40%-50% Women: 37%-47% |
| Red Blood Cells (RBC) | Men: 4.2-5.4 million Women: 3.6-5 million |
| s/s anemia (r/t hypoxia) | pallor, fatigue/weakness, parasthesia, tachypnea, tachycardia, palpitations, cheilosis (cracked lip edges), smooth sore red tongue. |
| s/s anemia (chronic) | spoon shaped nails, cheilosis, smooth red tongue, pica |
| diet for clients with anemia | protein, meats, eggs (yolk), green leafy vegs, whole grains, Vit C (citrus, strawberries, etc.) |
| supplemental iron | PO: ferrous sulfate IM: Dextran (z tracked) IV has high incidence of allergic reaction Side effects: constipation, gi irritation, skin staining, dk stools |
| aplastic anemia | arrested development of blood cells in bone marrow labs: |
| pernicious anemia | malabsorption (B12) s/s pallor to jaundice, smooth sore red tongue, CSN involvement, parasthesia tx: IM B12 wkly (initially), then monthly |
| folic acid deficiency anemia | malnourishment s/s similar to pernicious without parasthesia tx po folic acid (turns uring dk yellow) green leafy vegs, organ meats, milk |
| hemolytic anemia | RBC destruction (ex. sickle cell) RBC deficits, Hgb defects, drugs, chemicals, infections can all cause this |
| Iron deficiency anemia | most common type dietary deficiency decreased absorption increased requirement (ex. pregnancy) blood loss |
| Hemoglobin (Hgb) | O2 carrying capactiy Men: 14-16.5 Women: 12-15 |
| Hematocrit (Hct) | solid particle % Men: 40%-50% Women: 37%-47% |
| Red Blood Cells (RBC) | Men: 4.2-5.4 million Women: 3.6-5 million |
| s/s anemia (r/t hypoxia) | pallor, fatigue/weakness, parasthesia, tachypnea, tachycardia, palpitations, cheilosis (cracked lip edges), smooth sore red tongue. |
| s/s anemia (chronic) | spoon shaped nails, cheilosis, smooth red tongue, pica |
| diet for clients with anemia | protein, meats, eggs (yolk), green leafy vegs, whole grains, Vit C (citrus, strawberries, etc.) |
| supplemental iron | PO: ferrous sulfate IM: Dextran (z tracked) IV has high incidence of allergic reaction Side effects: constipation, gi irritation, skin staining, dk stools |
| aplastic anemia | arrested development of blood cells in bone marrow labs: |
| pernicious anemia | malabsorption (B12) s/s pallor to jaundice, smooth sore red tongue, CSN involvement, parasthesia tx: IM B12 wkly (initially), then monthly |
| folic acid deficiency anemia | malnourishment s/s similar to pernicious without parasthesia tx po folic acid (turns uring dk yellow) green leafy vegs, organ meats, milk |
| hemolytic anemia | RBC destruction (ex. sickle cell) RBC deficits, Hgb defects, drugs, chemicals, infections can all cause this |
| Iron deficiency anemia | most common type dietary deficiency decreased absorption increased requirement (ex. pregnancy) blood loss |
| polycythemia vera | excess RBC s/s hypertension, ruddy red face, severe puritis, spleeneomegaly, hepatomegaly tx: O2, low Na diet, fluid restriction, chemo, phlebotomy |
| platelets | 150,000-400,000 form in marrow, living in circulation for about 10 days, clotting |
| thrombocytopenia | <100,000 platelets high rish for bleeding s/s lg. purple lesions, petechia, epitasis, hemorrhage tx: platelet transfusion, corticosteriods, spleenectomy |
| hemophilia | most common type A (80% cases) < factor VIII males most common, however it is x-linked s/s excessive bruising, hemarthrosis, internal bleeding, prolonged bleeding tx: cryoprecipitate, fresh frozen plasma *no ASA, contact sports, use soft toot |
| Bone marrow aspiration | to obtain sm. sample of blood cells from bone marrow -leukemia -metastatic cancers -aplastic anemia -Hodgkins disease from: iliac crest, sternum, tibia high risk of bleeding&infection, post op VS, pressure dressing, no ASA, NSAIDS |
| sickle cell anemia | gene from 1 parent=sickle cell trait gene from both=sickle cell disease 40% Hgb S (or more) s/s pallor, fatigue, jaundice, irritability |
| sickle cell crisis | pain* cyanosis low grade fever leg & back pain seizures priapism stroke like symptoms tx: narcotic analgesic, hydration, O2 as indicated |
Created by:
THerald
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