NUR 171 block 2 test 4 study
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| show | Prescribed when the pancreas does not produce enough enzymes to break down food, common in cases of Pancreatic cancer. Also for management of cystic fibrosis to replace pancreatic insufficiency.
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| show | Organisms that cause disease and the resulting s/s that develop in response to the invasion.
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| show | Organisms such as bacteria, viruses or funguses that usually don’t cause problems until the host’s immune system is compromised.
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| RBC induces (Normal Values) | show 🗑
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| show | Low in fats, high in fiber, lots of whole grains, veggies, fruits, moderate to high protein.
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| How is HIV spread? | show 🗑
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| show | Neutrophils 50%-70% (0.50-0.70) Eosinophils 2%-4% (0.02-0.04) Basophils 0%-2% (0-0.02) Lymphocytes 20%-40% (0.20-0.40) Monocytes 4%-8% (0.04-0.08)
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| show | In early HIV infection the body is able to create more CD4+T cells for many years. Eventually, the ablility of HIV to destroy CD4+ T cells exceeds the body’s ability to replace them. (Higher viral load= more destruction of CD4+T cells
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| show | Immunoglobulins are antibodies with specific jobs
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| show | 76% located in plasma Only IG that crosses placenta. Responsible for secondary immune response
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| show | 15% body secretions, tears, saliva, breast milk. Lines the mucous membranes & protects body surfaces
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| show | 8% Plasma. Responsible for primary Immune response. Forms andtibodies to ABO blood antigens
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| show | 1% Plasma. Is present on lymphocyte surface. Assists in differentiation of B lymphocytes
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| IgE | show 🗑
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| Peritinitis | show 🗑
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| show | Peritinitis
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| show | Administration of nutrients via the blood stream. It’s a hypertonic solution of glucose, amino acids, fat emulsion, minerals, and vitamins in a central venous rout. Used when GI tract has issues with injestion, digestion and absorption.
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| Tube Feedings | show 🗑
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| show | excessive menstrual bleeding
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| show | History and physical focus on likely causes. Amt of bleeding, # of pads or tampons, degree of saturation. Fatigue level, BP, Pulse for anemia and hypovolemia.
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| show | Epoetin works by causing the bone marrow to make more red blood cells.
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| Normal CD4+ | show 🗑
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| CD4+ levels of concern | show 🗑
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| show | 1) Ineffective tissue perfusion, 2) disturbed sensory perception, 3) risk for injury
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| Stool characteristics for ascending, transverse, and desending colostomy | show 🗑
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| show | Tenderness over the involved area. Rebound tenderness, muscular rigidity, and spasm are major signs of irritation of the peritoneum.
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| Why is there bone pain with epoetin(Epogen) | show 🗑
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| show | These are S/S of obstruction of the bile ducts by stones. Also Jaundice, foamy urine, steatorrhea (excess fat in feces), fever and increased WBC count.
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| show | hypotension, abdominal pain due to tissue distension, weakness, fainting, dizziness, tachycardia, organ displacement, nerve compression. low H & H.
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| show | Liver function diseases
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| show | Lactulose is given to reduce ammonia. It traps the ammonia in the gut, and the laxative effect of the drug expels the ammonia from the colon.
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| In a “shift to the left” is there more segmented neutrophils or bands? | show 🗑
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| TSE (Testicular Self Exam) | show 🗑
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| Why is high ammonia level dangerous? | show 🗑
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| show | 1)imbalanced nutrition, less than body requirements. 2) Risk for imbalanced fluid volume. 3) impaired physical mobility R/T hospitalization.
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| “segmented neutrophils” | show 🗑
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| show | Band- are immature neutrophils released by bone marrow in response to infection. Their nucleus has the appearance of a band.
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| show | Immune response over reactive against foreign antigens or fails to maintain self tolerance, results in tissue damage. This is hypersensitivity reaction as happens when the body fails to recognize self proteins and reacts against them. Autoimmune disease.
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| show | Low molecular weight heparin has higher degree of bioavailability and longer elimination half life than reg heparin. Laboratory monitoring is not needed with Lovenox allowing pt discharge.
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| Chronic Renal Insufficiency (CRI) acidosis or alkalosis | show 🗑
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| S/S of Anemia | show 🗑
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| show | Small frequent meal (6 small per day), low in carbs, restrict refined sugar, moderate amounts of protein and fat (low-fat at first).Fluid in between meals, rest in recombent position 30 min after meals.
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| Irritable bowel syndrom (IBS) care. | show 🗑
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| Why is ELISA test viral load coded as “non-detected” instead of “negative”? | show 🗑
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| show | 135-145
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| show | 3.5-5.0
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| Cl | show 🗑
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| P | show 🗑
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| Mg | show 🗑
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| show | 35-45
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| show | 22-28
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| show | 7.35-7.45
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| BUN | show 🗑
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| show | 0.2-1.0
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| Albumin | show 🗑
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| show | 7-40 U/L (0.12-067ukat/L)
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| show | 5-36U/L (0.08-0.6 ukat/L)
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| show | Natural or native immunity consists of defenses in place before infection and exists without prior contact to antigen.
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| show | Passive acquired immunity implies that the host recieves antibodies to an antigen rather then making them.
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| show | Active acquired immunirty results from the invasion of the body by forgein substances such as microorganisms and subsequent development of antibodies and sensitized lympocytes.
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| Adaptive immunity | show 🗑
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| show | Inflammation involves all layers of the bowel wall and occurs anywhere in the GI tract from mouth to the anus but mostly in the terminal ileum to the anus. Ulcerations are deep and longitudinal and penetrate edematous mucosa make cobblestone appearance.
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| show | Usually starts in the rectum and moves in a continual fashion toward the cecum. This is a terminal disease of the colon and rectum.
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| show | S/S same- diarrhea, bloody stools, weight loss, ab pain, fever fatigue. Inflammation pattern is different between two.
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| show | Goal during acute episode of thrombocytopenia- prevent or control hemorrhage. No OTC drugs, especially ASA. If injection is unavoidable use a small needle, apply direct pressure 5-10 min. May administer the platelet transfusion.
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| Antigen | show 🗑
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| show | Immunoglobulin molecules that have antigen-specific amino acid sequences
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| B- cells | show 🗑
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| show | Responsible for immunity to intracellular viruses, tumor cells, and fungi. T cells live from a few months to the life span of an individual for long-term immunity. (2 types T Cytotoxic and T Helper Cells)
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| show | Involved in attacking antigens on the cell membrane of foreign pathogens and releasing cytolytic substances that destroy the pathogen. They have antigen specificity and and sensitized by exposure to the antigen.
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| T Helper Cells | show 🗑
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| show | Iron rich foods (liver, muscle meats, eggs, dried fruits, legumes, darkgreen leafy veggies, whole grain, potatoes) Orange juice helps absorption, 1 hour before meals, black stools possible, drink through straw to avoid staining teeth.
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| Vesicles and erosions appear with which STD? | show 🗑
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| Paralytic ileus | show 🗑
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| What causes Paralytic ileus | show 🗑
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| show | Assess= abdominal distention, presence of flatus or stool, bowel sounds, nausea and vomiting. • Maintain nothing-by-mouth (NPO) status until peristalsis returns and ensure patency of nasogastric tube to prevent vomiting and abdominal distention
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| show | Gonorrhea
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| Why are men on ED med cautioned about nitrate medications? | show 🗑
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| show | For Chronic Renal Failure. Given as part of conservative therapy for pts with chronic kidney disease, these pts haven’t yet begun maintenance dialysis. They are given with each meal, constipation is often a side effect of the binders.
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| Gammaglutamyltranspeptidase (GGTP) | show 🗑
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| H2 blockers | show 🗑
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| PPI (proton pump inhibitor) | show 🗑
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| show | ESR is the erythrocyte sedimentation rate which measures the settling of RBC’s used as a nonspecific measure for many diseases but more so indicates inflammatory conditions.
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| show | Common in inflammatory conditions both chronic and acute in which the destruction of the cells are increased. It may also indicate and MI, malignancy, or end-stage renal disease.
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| show | Surgery or trauma cause physiologic stress ulcers, they are highly prevalent and have a high morbidity rate-all pts are put on prophylaxis H2 blockers and PPI’s. H2 blockers and PPI reduce the amount of HCl secreted by the stomach.
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| show | Lab Value of low RBC count. Normal is 4.5 - 5.3. low WBC count and low platelet. Epoetin alfa is used to treat anemia that is associated w/end-stage renal diseae, HIV , & Cancer.
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| In what disease process is gamma glutamyl transferase (GGTP) most often elevated? | show 🗑
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| show | Serum Amylase, Serum Lipase and urinary Amylase. These are digestive enzymes that are released into systemic circulation.
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| Explain to your patient what a hiatal hernia is. | show 🗑
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| Why does liver disease affect clotting factors? | show 🗑
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| Urinary retention is a post surgical complication. What is it, what causes it and how can we prevent it? | show 🗑
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| show | Limit protein intake. No contrast dye. Good medication regimen. Ace-inhibitors (although contraindicated in end stage). No NSAIDS.
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| If milk makes an ulcer feel “better” why is it not a prescribed treatment? | show 🗑
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| Gastric ulcers | show 🗑
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| show | More in men ages 35-45, caused by high secretion of HCl acid. Risk for duodenal ulcer is increased in COPD, cirrhosis of the liver, chronic pancreatitis, hyperparathyroidism, chronic kidney disease, and the Zollinger-Ellison syndrome. H. pylori also.
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| show | Generally the same for both types. Rest, antacids, H2 blockers, and PPI’s are all given and an ABX may be given in pts with H. pylori infections.
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| Differentiate between gastric and duodenal ulcers | show 🗑
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| 27. Compare and contrast dietary needs of a person in acute diverticulitis and chronic diverticulitis. | show 🗑
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| show | Excess production, decreased hepatic uptake or impaired conjugation of bilirubin. When this occurs normal bilirubin metabolism or flow into the hepatic or biliary duct system altered. It causes +levels in the blood to become abnormally increased.
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| show | Aluminum: Constipation, phosphorus depletion with chronic use. Magnesium: diarrhea, hpermagnesemia.
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| show | Human papillomavirus (HPV). Genital warts are discrete single or multiple papillary growths that are white to gray and pink-flesh colored.
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| show | 30-45 degrees either sitting or lying down to prevent aspiration. It should remain elevated for 30-60 mins after the feeding.
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| Fistula | show 🗑
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| Graft | show 🗑
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| Name 3 functions of the immune response. | show 🗑
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| Why, in the prevention of allergies, does one wash their pillows in hot water often? The answer is NOT pollen. | show 🗑
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| What information is recorded on a medic bracelet? | show 🗑
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| What patient history would warrant the need for a medical alert bracelet? | show 🗑
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| show | Small frequent meals. Eliminate aggravating foods (client specific). Sit up while eating and remain in upright position for at least 1 hour after eating. Stop eating 3 hours before bed. Teach common meds (H2 blockers, antacids)
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| What cross sensitivities should be looked for w/ a person who has allergies to tape, bananas, avocados, tree nuts, or tomatoes? | show 🗑
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| Differentiate between benign and malignant cancers | show 🗑
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| Our #1 priority w/anaphylaxis is… | show 🗑
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| show | Signs can be as simple as redness, itching, and swelling and go all the way to anaphylactic reaction including closing of the airway.
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| show | Signs outside door, non latex gloves, bandages etc.
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| If a person is exposed to Hep B s/he receives gamma globulin instead of immunization, why? | show 🗑
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| show | The HIV/AIDS pt is highly immunocompromised therefore at risk of getting all bacteria and viruses around them. Any of these could kill the HIV/AIDS patient. There would need to be an exchange of bodily fluids in order to get HIV.
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| show | (radioallergosorbent test) is an invitro diagnostic test for IgG antibodies specific to antigens. Helpful in confirming reactivity to various foods or drugs in individuals w/ a history of severe anaphylactic reactions.
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| show | Autoimmunity is an immune response against self. In a sense your immune system sense that the body is the enemy and attacks it. The immune system develops auto antibodies and auto-sensitized T cells to causes pathophysiologic tissue damage
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| show | Stage one-Flu-like symptoms that last 3-12 weeks
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| 4th stage of HIV | show 🗑
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| 2nd stage of HIV | show 🗑
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| show | Stage three-Symptoms begin such as swollen glands, fever, weight loss, night sweats, n/v, CNS symptoms, diarrhea
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| show | Keep T cells up and viral load “undetectable” and stop HIV from replicating
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| What is HARRT therapy for HIV? | show 🗑
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| Rationalize health promotion with the HIV positive person. | show 🗑
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| show | Malignant is cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body. Benign is not cancerous. Benign tumors may grow larger but do not spread to other parts of the body.
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| show | NO a person does not have to disclose. State agencies will be notified however.
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| show | Allergic reactions cause vasodilation, which cause fluid to leak from vessels, which cause edema and swelling. This swelling closes airways and a person cannot breath - if the person's airways are not opened death will occur.
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| List 7 warning signs of cancer | show 🗑
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| show | Denial (this isn't happening to me!) Anger (why is this happening to me?) Bargaining (I promise I'll be a better person if...) Depression (I don't care anymore) Acceptance (I'm ready for whatever comes) Not all will hit all stages.
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| How do nursing interventions change if a person's goal of cancer treatment is cure? | show 🗑
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| How do nursing interventions change if a person’s goal of cancer treatment is Control? | show 🗑
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| show | Palliative= relief or control of symptoms and the maintainance of a satisfactory quality of life are primary goals rather than cure or control of disease process.
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| show | Smoking is a leading cause of cancer and death from cancer. It causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach, and cervix, as well as acute myeloid leukemia.
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| Goal of chemo: | show 🗑
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| How does chemo effect normal tissue? | show 🗑
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| What will you do to make your pt more comfortable? | show 🗑
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| show | To make sure that the pt and blood products are compatible.
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| Explain antigen-antibody response. | show 🗑
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| show | Exposure to known carcinogens tobacco & sun exposure, radiation, lack of exercise, poor diet, Lack of healthcare examinations, stress, lack of sleep, no self-examinations, Family Hx growing older. It’s also higher in African Americans and men.
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| show | The distinction between benign and malignant can be ambiguous. Some benign tumors can be as dangerous as malignant ones if in a dangerous or inaccessible location, such as the brain stem. Conversely, some malignant tumors can be successfully treated.
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| Explain the classifications of cancers; anatomic site | show 🗑
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| show | Histologic classification= appearance of cells and degree of differentiation. Four grades used to evaluate abnormal cells based on degree or resemblence to original tissue. Tumors poorly differentiated (undifferentiated) have a worse prognosis.
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| show | staging= based on descripton of extent of disease rather than cell appearance. Stage 0= cancer in situ Stage 1= tumor limited to tissue of origin, localized. Stage 2= limited local spread. Stage 3= extensive spread. Stage 4= metastasis.
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| Cancer Staging | show 🗑
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| show | biologic response modifier consists of agents that modify the relationship btwn the host and the tumor by altering the biologic response of the host to the tumor cells.
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| List 4 cancer treatments used today | show 🗑
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| Surgical Therapy | show 🗑
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| Chemotherapy | show 🗑
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| show | used to treat a carefully defined area of the body to achieve local control. Only has an affect on tissues wihtin the treatment field - it is not appropriate for patients with systemic disease.
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| Biologic and targeted therapy | show 🗑
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| show | Myelosuppression, fatigue, GI, n&v, diarrhea, mucositis (inflammation of the oral mucosa, anorexia. Skin reactions such as wet or dry desquamation, erythema, hyperpigmentation, PPE, and Alopecia. Pulmonary, cardiovascular and reproductive effects
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| show | Hospice is a type of care and a philosophy of care that focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. Both patient and family and surrounding people
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| show | pain management diary, nsaids, opiods,adjuvant pain medications. Analgesics on schedule with breakthrough coverage. Apropriate opiod dose is whatever necessary to control the pain using least to avoid SE. Nonpharmacologic interventions as well.
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| show | Cytology studies (study of cells), Pap test, bronchial washings, tissue biopsy, CXR, CBC/ Chem panel, Sigmoidoscopy/ colonoscopy, Radiologic, CT, PET, tumor markers, bone marrow.
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| What is the diagnostic considered “definitive” when making a cancer diagnosis? | show 🗑
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| Devise a teaching plan for a 17 year old in the prevention of pregnancy and STD | show 🗑
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| What is normal CD4+ cell count? | show 🗑
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| show | CD4+ levels drop below 500 at which time immune system problems start to occur. Severe problems develop below 200 CD4+ cells per microliter.
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| What CD4+ level depicts AIDS | show 🗑
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| show | Caregiver precautions include ALARA- as low as reasonably achievable, time, distance, and shielding. Limit the time in contact with patient while explaining reasons for precautions, other cautions relate to amount of dosage.
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| What assessment data suggests that the person who is HIV+ has converted to AIDS? | show 🗑
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| Bacterial STD’s | show 🗑
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| show | Can not be cured. Is usually treated with Antiviral agents which inhibit herpetic viral replication. Not a cure but shortens the duration of viral shedding and the healing time of genital lesions & reduce outbreaks.
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| Uterine prolapse | show 🗑
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| Cystocele | show 🗑
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| show | herniation or protrusion of the rectum through the wall of the vagina, resulting from weakened connective tissue support between the rectum and vagina.
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| Endometriosis | show 🗑
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| Uterine prolapse S/S | show 🗑
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| show | complete emptying of the bladder can be difficult and can predispose a woman to bladder infections.
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| Rectocele S/S | show 🗑
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| Endometriosis S/S | show 🗑
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| show | Elderly loose thirst response while ADH hormones remain same or become elevated. Nephrons become less able to conserve fluids. These issues are added to a decreasing tissue and skin area and a decline in lean tissue available for fluid storage.
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| Why are babies more prone to dehydration than adults? | show 🗑
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| How does one attempt to prevent uterine prolapse, Cystocele, and rectocele? | show 🗑
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| show | Normal range 1.003-1.030. Higher indicates Albuminuria, dehydration, glycosuria.
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| show | Abdominal pain, tenderness over involved area, rebound tenderness, muscular rigidity, and spasms, abdominal distention, ascites, fever, tachycardia, tachycardia, tachypnea, nausea, vomiting, and altered bowel habits.
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| What do cephalosporin’s and penicillin have in common? | show 🗑
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| From what “normal” organisms is the immune deficient person at risk against? | show 🗑
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| List the most common sites of metastasis with breast cancer. Why? | show 🗑
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| polycythemia | show 🗑
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| Primary polycythemia (polycythemia Vera) | show 🗑
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| show | hypoxia driven or hypoxia independent stimulation of the kidneys to stimulate erythropoietin production and therefore affects only RBC’s.
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| Differentiate between primary and secondary polycythemia Vera? | show 🗑
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| show | Iron binds to globule proteins “transferrins” to create a single hemoglobin molecule. “heme”= iron. Iron deficiency anemia can develop from inadequate dietary intake, blood loss, or hemolysis.
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| show | Red beefy appearance.
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| show | Factor VIII (made by the vascular endothelium) and vonWillebrand's factor which is also made in the endothelium and acts as a carrier for factor VIII.
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| Construct a diabetic diet meal plan? | show 🗑
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| diabetic diet meal plan? plate method | show 🗑
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| show | An abnormal reduction of the neutrophils count to <1000/. Normal levels are 4000-11000. Causes include drug induced (chemotherapy or immunosuppressant) hematological, autoimmune, infections.
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| diet guidelines for patient with dumping syndrome. | show 🗑
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| Dumping syndrome | show 🗑
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| show | Both are measures of solutes concentration in urine and are measures of fluid and electrolyte balance/ fluid balance. Osmolality is more exact measurement of concentration.
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| What is the function of albumin | show 🗑
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| show | Normal levels = 3.5-5.0 g/dl or 3.5-4.8
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| show | Normal Saline ONLY.
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| Pap (papanicolaou) test | show 🗑
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| show | Detects abnormal cells to screen for cancer.
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| show | Woman who are sexually active and who are over 18 should have test per American cancer guidelines. Once every 3 years beginning 3 years after first sexual intercourse but no later than age 21.
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| show | Therapeutic 46-70
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| show | Therapeutic = 2-3
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| show | Therapeutic = 12-15 seconds
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| Goal of radiation therapy? | show 🗑
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| show | Make the patient comfortable by helping them to deal with side effects and anxiety. Provide support, information, provide resources.
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| show | “there is no one single cause of GERD” “One of the primary factors in GERD is an incompetent LES (lower esophageal sphincter)”. Other factors, smoking, obesity, pregnancy, hiatal hernia.
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| Explain the importance of Na and K with the renal patient. | show 🗑
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| ED (erectile disfuntion) | show 🗑
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| show | Treatment is based on treating the cause. Also, Viagra, levitra, cialis, vacuum device, intraurethral medication, intracavernosal injections, penile implants, sexual counseling.
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| ED (erectile disfuntion) Risk factors | show 🗑
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| Impotence | show 🗑
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| show | Chlamydia Can also appear with non STD's -Viral – Candida albicans, candidiasis (yeast infection)
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| Sterility | show 🗑
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| show | Liver normally converts ammonia into urea. Impaired liver function can lead to elevated ammonia levels and hepatic encephalopathy as a result of liver cirrhosis.
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