Diseases-Exam 1

Cerebral Atrophy-patho

reduction in size of cells in the cerebellum; reduction of size of neurons

cerebral atrophy-risk factors

• reduced stimulation

• injury(mechanical)

• Traumatic brain injury

• Alzheimers

cerebral atrophy-S/S

Focal

• localized to particular region

Global

• affect entire brain

cerebral atrophy- diagnosis

• early identification of loss of fuction

• Health history

  • onset

  • duration

  • severity

• neurological exam

• imaging studies

cerebral atrophy- treatment

• prevention(intentional use of brain)

• interruption of injury process

• slowing course of disease

Cardiac hypertrophy-patho

• thickining of heath muscles

• can progress to heart failure

Primary

• inherited non-sex-linked genetic trait

Secondary

• underlying condition increased left ventricular workload

  • increase in L ventricle mass results from an increase in myocardial cell size

cardiac hypertrophy-etiology

• excessive cardiac workload

• increased functional demand

• inherited genetic trait

more workload = heart muscle increase in size

cardiac hypertrophy- S/S

• variable

  • mild to severe

• SOB

• chest pain

• syncope(fainting)

• impaired cardiac function

cardiac hypertrophy- diagnostic

• genetic testing

• hypertension

• reduced exercise tolerance

• ventricular arrhythmia

  • altered signals in the cells of the ventricle

• heart murmur

cardiac hypertrophy- treatment

• surgical

• pharm

  • drugs that relax the ventricles

  • drugs that reduce the workload(decrease pressure that heart pump against)

• activity restriction

Acromegaly- patho

• caused by excess growth hormone(due to pituitary adenoma)

• After puberty(epiphyseal plate closure)

• cellular hyperplasia

• excessive growth (bones, cartilage, soft tissue, organs)

acromegaly

Adults+ excess GH+ enlargement of feet& hands

acromegaly- S/S

• soft tissue swelling

• altered facial features

• pain and numbness in hands

• snoring

• altered reproductive function

acromegaly- diagnosis

• H&P

• Lab analysis

  • glucose tolerance test

  • growth hormone

  • IGF-1

acromegaly- treatment

• pharm:

  • drugs to reduce hormone secreation

• non-pharm

  • radiation therapy to promote death in growth hormone hypersecreting cells

• surgical

  • removal of tumor causing the hypersecreation

acromegaly- nursing considiration

• moniter BP, glucose, vision change, joint pain

Cervical metaplasia-patho

• protective change

• noncancerous by itself

• can be reversable

• changing of cell types as response to environmental stress & exposure to estrogen

cervical dysplasia-treatment

• ablation(removal of superficial cells)

  • cryosurgery

  • laser ablation

  • cold coagulation and electrocoagulation diathermy ablation

• surgical excision

cervical dysplasia and metaplasia- nursing consideration

regular screening and pap test

cervical dysplasia-patho

• abnormal & precancer risk

• abnormal growth and disordered differentiation in dividing cells

cervical dysplasia- S/S

No S/S

cervical dysplasia- risk factors

• early onset sexual activity

• multiple partners

• HPV exposure

• smoking

cervical dysplasia- diagnosis

• H&P exam

• screening test

  • Pap test

  • HPV screening

• diagnostic test

  • biopsy of cervical tissue

glaucoma-patho

damage to optic nerve(increased intraocular pressure) → blindness

Primary open-angle glaucoma(most common)

• incr. IOP due to incr. aqueous humor production and decreased outflow of aqueous humor

• likely hereditary

• IOP of 22 or more

Angle-closure glaucoma(acute glaucoma)

• inc. IOP due to narrowing or closure of anterior chamber angle

• complete closure is an acute crisis

glaucoma- risk factors

• age (over 60)

• family history

• diabetes, hypertension, sickle-cell anemia

• eye trauma

• long-term steroid use

glaucoma- clinical manifestations

• eye pain, headache, blurred vision, “rainbows” around lights at night

• scarring of trabecular network may result in chronic glaucoma

• permanent vision loss (when not treated)

glaucoma- diagnosis

• vision screening

• Snellen chart

• Jaeger eye chart

glaucoma- treatment

lower IOP by decreasing aqueous humor production and incr. aqueous humor outflow

• miotics: increase outflow of fluid

• epinephrine-based: incr. outflow of fluid

• beta blockers: decrease fluid levels

• trabeculoplasty: promote fluid outflow from the eye in open-angle glaucoma

• iridotomy: incision into iris to promote fluid outflow in angle-closure glaucoma

• cyclophotocoagulation: correction of ciliary tissue to decrease the production of fluid

• trabeculectomy: surgical removal of a small portion of the trabecular meshwork under the lid to create new drainage

macular degeneration-patho

• affects the macula, distortion or loss of central vision

• leading cause of blindness

• dry(atrophic) and wet (exudate) kinds

• deposition of drusen under the macula next to the basement membrane of retinal pigment epithelium

  • drusen thins and dries out macula

macular degeneration- risk factors

• age (older than 60y)

• smoking

• hypertension

• overweight or obese

• family history

macular degeneration- clinical manifestations

atrophic(dry)

• fluctuating vision difficulty reading, limited night vision

• s/s usually slow

exudate(wet)

• dark central spot

macular degeneration- diagnosis

• reg eye exams

• Amsler chart evaluation

• Fluorecein angiography

• optical coherence tomography

macular degeneration- treatment

• no treatment for dry

• Vascular endothelial growth factor

otitis media-patho

• most common infection of middle ear

• acute/recurrent

• fluid in middle ear

• profound hearing loss: 91dB or more

otitis media-risk factors

• infants and children

• immobility of the tympanic membrane, fluid accumulation of middle ear, scarring from rupture of the tympanic membrane

otitis media- clinical manifestations

• pain

• pressure

• tinnitus

• difficulty sleeping

• fever

• loss of balance

• hearing difficulties

otitis media-diagnosis

• hearing evaluation

• audiometric testing

• tympanometry

• bone conduction testing

otitis media-treatment

• antibiotic therapy for 2 weeks + pain meds

• cochlear implants

• electrical stimulation of nerve endings

• early screenings of hearing loss

Meniere disease-patho

• swelling of membranous labyrinth in cochlea and vestibular system of internal ear

• hearing loss is caused by progressive degeneration of vestibular and cochlear hair cells

meniere disease-clinical manifestations

• unilateral

• vertigo

• nystagmus(eye movement)

• tinnitus

• feeling of fullness and pain in ear

meniere disease- diagnosis

• auditory exam

• auditory brainstem

• electrocochleaography(ECOG)

• videonystagmography(VNG)

• electronystagmography(ENG)

• caloric test

meniere disease- treatment

• symptomatic

• reduce salt intake

• smoking cessation

• stress reduction

• antiemetics

• betahistine (histamine analog)

• vestibular neurectomy( reduce vertigo no effect on hearing)

• labyrinthectomy( reduce vertigo, loss of hearing may occur)

Fibromyalgia-patho

• chronic, more sensitivity to pain

• condition of soft tissue and muscles

• occurs in women 7 times more than men

• no known cause or cure

• there’s evidence of genetic predisposition

fribromyalgia- clinical manifestations

• heightened sensitivity to noxious stimuli

• sleep, tenderness, stiffness and pain in neck, shoulders, upper back, elbows, lower back, and hips

• nonrestorative sleep, along with fatigue

• decrease of serotonin levels with some individuals→ depression, sleep alteration, anxiety, and altered muscle function

fribromyalgia-diagnosis

• subjective findings→ fatigue and chronic musculoskeletal pain of at least 3 months

• pain must be present in 12/18 tender point sites for diagnosis

• no diagnostic test exist to confirm

fribromyalgia-treatment

• symptom management

• heat and cold