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midterm med/surg2
nu140 midterm notes
| Question | Answer |
|---|---|
| C-reactive protein | indicates stroke |
| alcohol and immunity | chronic alcohol abuse decreases immune response |
| HIV protocol | notify infection control officer- 2 or 3 drug combo depending on exposure taken for 4 weeks |
| risk groups for immunosuppression | chronic diseases, alcohol, age, stress, surgical patients |
| S&S of scabies | curved or white lines or eryhtematosus ridges in skin |
| nodular malignant melanoma | may resemble blackberry,uniform grey or grey-black color-less favorable prognosis |
| Use of whirpools for healing pressure ulcers | whirlpool helps to debride and stimulated regranulation of cells |
| skin tear repairs and protocols | if flap dry remove, if viable put back on and secure,gently clean- do not disturb*5d steristrip or bandage |
| Rule of "9" for burns | arms&legs=9% each (front 4.54,back 4.5)chest 18, back (incl buttocks)18%,head front&back 4.5% each(total 9%) groin 1% |
| types of dermatitis | contact dermatitis,atopic dermatitis,stasis dermatitis,sebhorreic dermatitis |
| what defines an "open" dressing | ointment is placed on wound directly, wound may be covered but dressing is NOT secured |
| presbyopia | extension of the distance from the eye at which an item to be read is held |
| age related eye changes | lens harder, presbyopia, narrower field of vision, color discrimination loss, decreased moistuer secretions,ectopion, ptosis, subq fat and tissue elasticity decrease, arcus senilus, cornea flattens, sclera yellows, iris less able to dilate. |
| self assessment for sympathomimetics- patient teaching | BP, pulse, skin, orthostatic HTN- only what they can do on own- not what nurse can do for them |
| ataxia | inability to walk in an even steady gait as seen in neuro damage and parkinsonism |
| cataracts | opacity of lens causing blurry vision,smoking greatly increase developement risk. |
| how is accomodation of the pupil achieved? | ciliary muscles and ligaments change the shape of the LENS rounding or flattening it. |
| FOuR neuro checks | Full Outline of UnResponsiveness- measures eye motor brainstem and respiratory responses |
| series of responsive determination tests for determining LOC | 1st- shake, 2nd-eye press, 3rd-pich trapezius, last- sternal rub |
| subjective data pertinent to Dx of concussion | AMNESIA for event |
| Viruses associated with Guilliane Barre' | cytolomegalovirus and EBV |
| Parkinson' triad | bradykinesia, tremor, rigidity |
| difference between a partial and general siezure | partial siezures are localized, general siezures are bilaterally symetrical |
| what causes siezures ( basic etiology) | anoxia to brain tissue from either ischemia or infarct |
| Agnosia | condition in which there is a disconnect between what the object is and what you do with it. |
| Scotoma & migraines | "spots before the eyes" with or without an aura as a precursor to migraine onset |
| eye care in Bell's Palsy | patch if no blink, artificial ttears for corneal dryness, corticosteroids if <7d, acyclovir for underlying herpes infection |
| wax and waning of MS symptoms | evident in 80% of all MS cases. remission and exacerbation alternating |
| Underlying Cause of MS | AUTOIMMUNE, |
| MS is diagnosed by | S&S no definitive casue |
| main treatment for MS | methylprednisolone (Prednisone) |
| Guillain Barre precursors | viral infection. onset in typically 10-20 days |
| Early signs of MG | diploplia, dysphagia,, ptosis, hoarse /nasal voice, severe weakness that inproves with rest. |
| S&S of Subdural hematoma (esp. in elderly) | increase irritability, increased lethargy, dull headache, CONFUSION |
| side effect of parkinsons' | Insomnia R/T inability to decrease tremor |
| why immunoglobulin? | Immunoglobulins are delivered IV fro patients who may be immunocompromised or who already have a specific disease |
| why do the elderly have slow reflexes? | deterioration of myelin sheath and slowing of impulses with age |
| S&S of anaphalaxis | SOB,angioedema,wheals,drop in BP, Dyspnea, convulsions and RAPID INCREASE IN SEVERITY of symptoms |
| treatment for anaphalaxis | EPInephrine is initial intervention |
| AD (autonomic dysreflexia) | decrease Heart rate, increased BP and a small stimulus cause an exagerrated reaction to a stimulus |
| dysarthria | slurring or indistinct speech, difficulty speaking |
| lhermitties' sign | bending neck causes apainful electrical sensation to run down spine |
| menieres disease and patient precautions | no sudden movements (esp of head or neck) |
| stem cells | produce in Bone Marrow and fetal tissue. important becasue may be able to grow into any type of cells |
| acquired immunity | vaccination or have the disease |
| ELISA | enzyme linked immuno sorbant assay |
| sympathetic nervous system | fight or flight responses |
| parasympathetic | response to sympathetic |
| cranial nerves | 12pairs-OOOTTAFAGVSH- |
| Levels of consciousness | alert, confused answers with cues, lethargic (in/out) obtunded-unconscoius and unresponsive |
| Guillian Barre' syndrome | present 10-21 d post viral infection- manifests from TOES UP(this is why it is different) self limiting- nursing priority- PROTECT AIRWAY in acute phase |
| cornea | reflects light on lens |
| lens | lets light in out |
| retina | rods and cones for color and shape, FLASHES OF COLORED LIGHTS with detachment |
| glaucoma | loss of peripheral vision R/T increase in IOP of aqueaous humor |
| S&S of ICP increase | cushing's triad (widening oulse oressure with systolic rise), rapid and irregular respirations, bradycardia witha full bounding pulse) pupillary changes |
| S&S of EPIDURAL hematoma | peri-orbital fx, ecchymoses (racoon eyes), battles sign (bruising behind ear), rhinorrhea, otorrhea, tinnitus /hearing issues, facial paralysis, Conjugate deviation of eyes (eyes go opposite each other) |
| menieres disease | basically chronic severe vertigo with any movement of head |
| post surgical nursing care | most often POSITION ON UNAFFECTED SIDE |
| hyperopia | farsighted- light focuses after retina |
| myopia | nearsighted- light focuses before the retina |
| retinal detachment | demonstrated by flashing COLORED LIGHTs |
| menieres disease | basically chronic severe vertigo with any movement of head |
| post surgical nursing care | most often POSITION ON UNAFFECTED SIDE |
| hyperopia | farsighted- light focuses after retina |
| myopia | nearsighted- light focuses before the retina |
| retinal detachment | demonstrated by flashing COLORED LIGHTs |
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