Competency Appraisal 2 - Comprehensive Nursing Review

Vocabulary practice flashcards covering medical-surgical, psychiatric, and leadership nursing concepts from the Competency Appraisal 2 lecture notes.

Transient Ischemic Attack (TIA)

A mild form of ischemic stroke where neurologic symptoms resolve in $< 24\,\text{hours}$ without permanent tissue infarction.

BE FAST

An assessment acronym for recognizing a stroke: Balance problem, Eye problem (such as homonymous hemianopsia), Facial drooping, Arm weakness, Slurred speech, and Time to call 911.

Homonymous Hemianopsia

A visual deficit associated with stroke wherein half of the field of vision is lost in each eye.

Recombinant Tissue Plasminogen Activator (r-TPA)

A thrombolytic agent that helps activate plasminogen into plasmin, which directly breaks down and destroys fibrin clots in acute ischemic stroke.

Permissive Hypertension

An intentional clinical management approach in ischemic stroke maintaining a Mean Arterial Pressure (MAP) of $110\text{--}130\,\text{mmHg}$ to preserve cerebral perfusion.

Mean Arterial Pressure (MAP) Formula

The clinical calculation used to estimate tissue perfusion: $\text{MAP} = \frac{\text{SBP} + 2(\text{DBP})}{3}$.

Cushing's Triad

A late sign of increased intracranial pressure (ICP) characterized by hypertension (with widened pulse pressure), bradypnea, and bradycardia ('HyperBradyBrady').

Mannitol

An osmotic diuretic used to manage elevated ICP by drawing fluid from brain parenchyma into the intravascular space to be excreted by the kidneys.

Multiple Sclerosis (MS)

A chronic autoimmune condition leading to the demyelination of nerve fibers in the central nervous system (CNS).

Charcot's Triad (Multiple Sclerosis)

The clinical triad characteristic of multiple sclerosis comprising staccato speech/scanning speech, intentional tremors, and nystagmus.

Uhthoff Phenomenon

A reversible worsening of neurological symptoms seen in patients with multiple sclerosis triggered by heat exposure.

Guillain-Barre Syndrome (GBS)

An acute autoimmune peripheral nervous system (PNS) demyelinating disorder characterized by ascending symmetric muscle weakness and paralysis ('Galing Baba Syndrome').

Myasthenia Gravis (MG)

An autoimmune disorder caused by autoantibodies destroying acetylcholine receptors at the neuromuscular junction, resulting in descending muscle paralysis ('Mountain to ground') that worsens toward the late afternoon.

Tensilon Test

A rapid, brief diagnostic test that transiently elevates acetylcholine availability to evaluate muscle strength improvement in suspected myasthenia gravis.

Brudzinski's Sign

A physical finding of meningeal irritation where passive forward flexion of the patient's neck induces involuntary flexion of both hips and knees ('ALL FLEX').

Kernig's Sign

A clinical sign of meningeal irritation where resistance and severe hamstring pain occur upon extension of the patient's leg with the hip flexed.

Osteoarthritis

A degenerative joint disease caused by loss of articular cartilage in large weight-bearing joints (and fingers) leading to morning stiffness lasting $< 30\,\text{minutes}$ and pain that increases with activity.

Rheumatoid Arthritis

A systemic, bilateral autoimmune disorder targeting the synovial membranes of small joints, characterized by morning stiffness lasting $> 30\,\text{minutes}$ and pain that decreases with joint activity.

Podagra

Acute, painful monoarticular inflammation of the first metatarsophalangeal joint (the big toe), classically caused by hyperuricemia and gouty arthritis.

Canal of Schlemm

A circular lymphatic-like vessel located between the sclera and cornea that drains aqueous humor from the anterior chamber of the eye.

Glaucoma

An ocular condition caused by impaired outflow and accumulation of aqueous humor, resulting in elevated intraocular pressure ($> 20\,\text{mmHg}$), optic nerve compression, and peripheral vision loss (tunnel vision).

Cataract

A condition characterized by opacity or clouding of the normally clear crystalline lens of the eye, manifesting earliest as blurred vision.

Retinal Detachment

An ophthalmic emergency in which the retina tears and vitreous humor enters beneath it, manifesting as floaters and a curtain-like obstruction across the visual field.

Meniere's Disease

An inner ear condition caused by excessive accumulation of endolymphatic fluid in the semicircular canals, resulting in the triad of episodic vertigo, tinnitus, and sensorineural hearing loss.

Internal Anatomy of the Heart

The cardiac circulation containing four chambers (Right Atrium, Right Ventricle, Left Atrium, Left Ventricle), heart valves (Tricuspid, Pulmonary, Mitral, Aortic), and great vessels (Vena Cavae, Pulmonary Artery, Pulmonary Veins, Aorta).

Tetralogy of Fallot

A congenital cyanotic heart disease consisting of four structural defects: Pulmonary Stenosis, Right Ventricular Hypertrophy, Overriding of the Aorta, and Ventricular Septal Defect.

Prinzmetal Angina

A form of chest pain caused by temporary coronary vasospasms rather than mechanical atheroma blockage, commonly occurring during rest or cold mornings.

Electrocardiogram (ECG) Deflections

Waveforms representing cardiac electrical conduction: the P wave reflects atrial depolarization, the QRS complex represents ventricular depolarization, and the T wave corresponds to ventricular repolarization.

STEMI vs. NSTEMI

STEMI is characterized by complete coronary artery occlusion leading to ST-segment elevation and positive cardiac biomarkers; NSTEMI results from partial occlusion with ST-segment depression, T-wave inversion, and positive cardiac biomarkers.

Beck's Triad

The characteristic diagnostic triad of cardiac tamponade: Distant/muffled heart sounds, Decreased blood pressure (hypotension), and Distended jugular veins ('3D's').

Right-Sided Heart Failure

Failure of the right ventricle resulting in systemic venous congestion characterized by peripheral/facial edema, hepatomegaly, splenomegaly, ascites, and jugular vein distension.

Left-Sided Heart Failure

Failure of the left ventricle causing pulmonary congestion and edema, manifesting as dyspnea, orthopnea, paroxysmal nocturnal dyspnea, wheezing, and pulmonary crackles.

Inotropic vs. Chronotropic Effect

Inotropic refers to the force or contractility of the myocardium; chronotropic refers to the rate or speed of cardiac contractions (heart rate).

Digoxin

A cardiac glycoside exhibiting positive inotropic effects (increases contractility) and negative chronotropic effects (decreases heart rate), contraindicated in patients with bradycardia.

Emphysema

A chronic pulmonary disease marked by alveolar destruction and loss of elastic recoil, leading to impaired exhalation, air trapping, hyperinflated lungs, and a barrel chest.

Chronic Bronchitis

An obstructive pulmonary condition characterized by chronic inflammation and narrowing of the bronchi with excessive mucus secretion, chronic cough, crackles, and cyanosis.

Peak Flow Meter Zones

Measurement categories for asthma monitoring: Green Zone indicates good control ($80\text{--}100\%$ of personal best), Yellow Zone indicates caution ($50\text{--}79\%$), and Red Zone represents severe airway obstruction ($< 50\%$) requiring immediate rescue intervention.

Anorexia Nervosa vs. Bulimia Nervosa

Anorexia nervosa involves extreme food restriction and distorted body image resulting in a severely underweight BMI; bulimia nervosa is characterized by binge eating followed by compensatory purging while typically maintaining a near-normal BMI.

Monoamine Oxidase Inhibitors (MAOIs)

Antidepressant medications (e.g., Tranylcypromine, Isocarboxazid, Phenelzine, Selegiline) that block the monoamine oxidase enzyme, preventing the degradation of serotonin, norepinephrine, and dopamine.

Tyramine Crisis ('Cheese Effect')

A severe hypertensive crisis occurring when patients taking MAOIs ingest tyramine-rich foods (such as aged cheeses, red wine, and processed meats), treatable with phentolamine mesylate.

Serotonin Syndrome

A potentially fatal toxic state caused by excessive serotonin accumulation, typically presenting with fever, altered mental status, autonomic dysregulation, hyperreflexia, rigidity, and clonus ('FAAT CHD').

Cluster A Personality Disorders

A grouping of personality disorders characterized by odd, eccentric, or suspicious behavior, including Paranoid, Schizoid, and Schizotypal disorders.

Cluster B Personality Disorders

A grouping of personality disorders marked by dramatic, emotional, erratic, and impulsive behavior, consisting of Borderline, Antisocial, Histrionic, and Narcissistic disorders.

Cluster C Personality Disorders

A cluster of personality disorders marked by anxious, fearful, or submissive behavioral patterns, including Avoidant, Dependent, and Obsessive-Compulsive Personality Disorder (OCPD).

Battery

An intentional tort consisting of unlawful, unconsented physical contact or carrying out clinical interventions against the expressed will of a patient.

Assault

An intentional tort characterized by an overt, willful threat that places another person in imminent apprehension of offensive or harmful contact.

Slander vs. Libel

Two forms of defamation of character: slander is spoken or oral false statements communicated to a third party, whereas libel is defamation published in permanent written, photographic, or recorded forms.

Res Ipsa Loquitur

A legal doctrine meaning 'the thing speaks for itself,' applied when injury occurs under circumstances where negligence is obvious without requiring direct proof of the act.

Respondeat Superior

A legal doctrine stating 'let the master answer,' holding an employer or hospital legally liable for the negligent actions of their employees committed within their scope of employment.

Living Will vs. Durable Power of Attorney

A living will is an advance directive specifying end-of-life treatment preferences; a durable power of attorney designates a health care proxy to make medical decisions on behalf of an incapacitated patient when circumstances are unaddressed in the living will.