Adult Health Exam 1

inflammation

The body's general response to tissue injury, intended to neutralize harmful agents, clear damaged tissue, and prepare for healing

acute inflammation

Inflammation with a rapid onset that typically lasts 8 to 10 days from injury to healing

chronic inflammation

Inflammation that persists for weeks to years and involves different cells like macrophages and lymphocytes , often leading to tissue damage and fibrosis. It can result from a failure to eliminate the cause of acute inflammation or autoimmune responses.

vascular phase

The initial stage of inflammation involving brief vasoconstriction followed by vasodilation and increased capillary permeability, leading to plasma flow into tissues

cellular phase

The stage where neutrophils infiltrate the injured area to attack organisms through phagocytosis

histamine

A chemical mediator that increases capillary permeability, allowing fluid and immune cells to move into tissues

prostaglandins

Chemical mediators that cause vasodilation and contribute to the sensation of pain

cytokines

regulate immune and inflammatory responses by facilitating communication between cells.

complement system

A group of proteins that promote phagocytosis and cell lysis

ambulatory surical center

An outpatient setting where surgeries are performed that do not require an overnight hospital stay; often used for less complex procedures

minimally invasive surgery

Surgical techniques using smaller incisions and advanced technology (like endoscopes and robots) to reduce blood loss, tissue trauma, and recovery time; an example is a "Lap Colie"

lap cholie

A minimally invasive procedure to remove the gallbladder using small incisions and a laparoscope (thin tube with a camera

osteroporosis

A condition characterized by weak and brittle bones, increasing the risk of fractures and breaks. It commonly occurs due to hormonal changes, lack of calcium or vitamin D, and aging. be careful with surgical positioning to prevent long term injury or disability

osteoarthritis

A degenerative joint disease characterized by the breakdown of cartilage, leading to pain, stiffness, and reduced mobility, commonly associated with aging or joint injury. be careful with surgical positioning to prevent long term injury or disability

48

patients should avoid shaving for ____ hours before surgery

antidepressents

can increase the effect of opioids used for pain/anesthesia

antihypertensives

may predispose patient to hypotension from combined affect of drug and vasodilating anesthesias

insulin

may need to be adjusted when taking opioids because opioids can alter blood sugar levels.

antiplatelets

medications like aspirin and NSAIDs may contribute to post op bleeding, ask about herbal supplements

Chlorhexidine Gluconate

Patients shower with _______ (CHG/Hibiclens) from the neck down (avoiding face/hair/genitals) the night before and morning of surgery to reduce microorganisms

48

Patients should not shave for at least __hours before surgery to prevent micro-cuts that increase infection risk; if hair removal is needed, it is done at the facility immediately before surgery

positive air pressure system

Specialized ventilation in the OR that prevents air from the corridors from entering the sterile room

time out

A required safety pause immediately before surgery where the entire team verifies the patient ID, procedure, surgical site (marked by the surgeon), and allergies

sentinel event

A serious, preventable error in the OR, such as surgery on the wrong body part, wrong procedure, or wrong patient

circulating nurse

registered nurse who works outside the sterile field, managing documentation, patient positioning, and acting as the patient's advocate

scrub nurse

A member of the team who performs a surgical hand scrub, dons sterile attire, and handles only sterile items within the sterile field

general anesthesia

Causes complete loss of consciousness, memory, and sensation; requires an artificial airway (intubation) and carries risks of hypotension and nausea

regional anesthesia

Numbing a large region (like an arm or the lower half of the body) while the patient remains awake and can breathe on their own; examples include epidurals or spinal blocks

moderate sedation

A combination of sedation and pain control where the patient is relaxed and drowsy but can maintain their own airway; often used for colonoscopies

local anesthesia

Numbing a small, specific area (e.g., for a skin biopsy or dental work) while the patient remains fully awake

malignant hyperthermia

A rare, life-threatening hypermetabolic crisis triggered by general anesthesia agents; characterized by muscle rigidity (especially the jaw), tachycardia, and extreme fever (up to 110°F)
immediately discontinue of triggering anesthetic agents and administer dantrolene, along with aggressive body cooling and supportive care

dantrolene

the definitive antidote medication for Malignant Hyperthermia

spinal headache

A severe headache caused by the leakage of cerebrospinal fluid after a spinal or epidural procedure

lateral recovery position

Placing a patient on their side until they are conscious to keep the airway open and reduce the risk of aspiration

atelectasis

The collapse of alveoli due to shallow breathing or mucus plugs; it is the most common cause of hypoxemia in the post-op period

pulmonary edema

Fluid accumulation in the alveoli, often caused by fluid overload or aspiration; characterized by shortness of breath and crackles

pulmonary embolism

A blockage in a pulmonary artery, often by a blood clot from the leg (DVT); symptoms include sudden chest pain, shortness of breath, and tachycardia.

brochospasm

Closure of small airways due to increased smooth muscle tone; characterized by wheezing and use of accessory muscles

splinting

Using a pillow or folded blanket to support an abdominal or chest incision while coughing or taking deep breaths

DVT

A blood clot in a leg vein due to inactivity; prevented by early ambulation, SCDs, and anticoagulants

emergence delirium

A temporary state of confusion or agitation as the patient wakes up; "awake but not clear," often caused by hypoxemia

delayed emergence

When a patient remains unusually drowsy or sedated and does not wake up as expected after anesthesia

postoperative ileus

A decrease in gastric peristalsis; characterized by absent or decreased bowel sounds and abdominal distension

30

A patient should output at least ____mL per hour; lower output (oliguria) may indicate renal failure or poor perfusion

dehiscence

The partial or complete separation of closed wound edges (the incision "opens up")

evisceration

A surgical emergency where the wound opens wide enough for internal organs (like intestines) to protrude.

Stay with the patient, place them in low Fowler's, cover the wound with a sterile, moist saline dressing, and notify the surgeon immediatel

hyperemia

Increased blood flow to an area caused by arterials dilating; it is responsible for the redness and heat seen in inflammation

acute inflammation

Inflammation characterized by the predominance of neutrophils

chronic inflammation

inflammation characterized by the presence of macrophages and lymphocytes

histamine

A chemical mediator that increases capillary permeability, allowing fluid and immune cells to move into tissues

prostaglandins

Chemical mediators that cause vasodilation and sensitize nerve cells to create the sensation of pain

complement system

A group of proteins that promote phagocytosis and cell lysis to destroy pathogens

shift to the left

An increase in the production of immature white blood cells (called bands), indicating an acute bacterial infection or inflammation

malaise

A systemic manifestation of inflammation described as a general feeling of fatigue or being unwell

innate immunity

Protection present at birth that responds immediately to threats using physical barriers (skin/mucous membranes) and phagocytes; no prior exposure is needed

acquired/adaptive immunity

Immunity that develops after exposure to an antigen, providing long-lasting protection and immunological memory through B and T cells

natural active immunity

Immunity developed through natural contact with an antigen via an actual infection (e.g., chickenpox)

natural passive immunity

Immediate but short-lived immunity transferred from mother to child via the placenta or breast milk

artificial active immunity

Long-lasting immunity developed through immunization with vaccines

artificial passive immunity

Immediate but short-lived immunity provided by an injection of serum containing antibodies (e.g., Hepatitis B immune globulin

humoral immunity

Antibody-mediated immunity involving B cells that fight extracellular threats (bacteria/toxins) in body fluids

cell mediated immunity

Immunity involving T cells that act directly against intracellular threats like viruses and cancer cells

spleen

The primary organ site for filtering foreign antigens from the blood

thymus

The site for differentiation and maturation of T lymphocytes; it is located in the chest and shrinks with age

nociceptive pain

Pain resulting from actual tissue injury or inflammation

neuropathic

Pain resulting from nerve injury or dysfunction, often described as a "tingling" sensation

mcburneys point

The classic location for appendicitis pain, located between the anterior iliac crest and the umbilicus (Right Lower Quadrant)

10,000-18,000

A WBC count between _____ indicates infection of appendix

20,000

A WBC count above _____ indicates preforation of appendix

osteoarthritis

A progressive, degenerative joint disease involving the breakdown of articular cartilage, leading to bone rubbing on bone

Typically an asymmetrical joint pattern; pain worsens with activity and improves with rest

herberden nodes

bony growths on the joint tips of fingers associated with osteoarthritis.

bouchard nodes

bony growths on the middle joints of fingers associated with osteoarthritis.

osteophytes

bone spurs often seen in osteoarthritis

gout

A disorder of uric acid metabolism leading to hyperuricemia (excess uric acid in the blood) and crystal formation in joints

HIV

A retrovirus that targets CD4+ T-helper cells, replicating backward from RNA to DNA using reverse transcriptase

800-1200

Normal CD4 Count

AIDS

A CD4 T-cell count of less than 200 cells/mm³ or the presence of an opportunistic infection

ventilation

The movement of air into and out of the lungs

perfusion

The movement of blood through the capillary beds of the lungs to the body's organs and tissues

diffusion

The movement of gases (oxygen and carbon dioxide) down their concentration gradients across the alveolar-capillary membrane

alveoli

The tiny air sacs in the lungs where gas exchange occurs; they must be thin, pliant, and clear of mucus to function properly

atelectasis

The collapse of alveoli, which prevents normal gas exchange; often caused by shallow breathing or mucus plugs after surgery

sinusitis

Inflammation of the sinuses, usually following a viral infection, where trapped mucus causes facial pressure and pain

rheumatic fever

A serious complication of untreated strep throat that can damage heart valves; prevented by a full 10-day course of penicillin

community acquired pneumonia

An infection contracted in daily life by a patient who has not been hospitalized within 14 days of getting sick

hospital acquired pneumonia

An infection that starts 48 hours or longer after hospital admission

aspiration pneumonia

Caused by inhaling food, saliva, or gastric contents; prevented by turning unconscious patients on their side and monitoring those with swallowing problems

latent tb

The bacteria are "walled off" in a jail cell (Ghon focus); the patient has a positive skin test but no symptoms and is not contagious

active tb

The bacteria are in "attack mode"; the patient is symptomatic and infectious, often presenting with a dry/productive cough and night sweats

asthma

A reversible obstructive disease characterized by bronchial hyper-reactivity (twitchy lungs) and bronchoconstriction

inhaled corticosteroid

Long-term "controller" meds used daily to reduce inflammation; patients must rinse their mouth after use to prevent thrush

pulmonary function tests

Measures lung volumes; patients should hold bronchodilators for 6–12 hours and not smoke for 6–8 hours prior to the test

HIV

complex bloodborne retrovirus that causes significant immunosuppression by targeting and destroying CD4+ T-helper cells. These cells are essential regulators of the immune system, and their destruction leaves the body vulnerable to opportunistic infections and certain cancers

cd4 T cells

HIV is a complex bloodborne retrovirus that causes significant immunosuppression by targeting and destroying _______

200

Acquired Immunodeficiency Syndrome is defined by a CD4 T-cell count of less than _____ cells/mm³ or the presence of opportunistic infections, such as Pneumocystis pneumonia (PJP), oral thrush, or pulmonary tuberculosis

800-1200

normal CD4 cell count is

Antiretroviral Therapy

A treatment for HIV that uses a combination of medications to manage the virus, reduce viral load, and maintain immune function.

green zone

PEFR of 80-100%, indicates patient's asthma is under good control

yellow zone

PEFR of 50-80%, It serves as a warning shot that the asthma is worsening and a flare-up is starting.

The patient must follow their pre-written Asthma Action Plan to ramp up their rescue medication