Medical Surgical Nursing Review

Flashcards about Medical Surgical information. Style: Vocabulary

Tracheostomy

An established, secure airway; to establish a patent airway, bypass an upper airway obstruction, removal of secretions, for long-term mechanical ventilation

Speaking

Cannot speak with inflated cuff

Fenestrated trach

Can eat, swallow, drink, but has a huge risk for aspiration

Tracheostomy Complications

Airway obstruction, air leak, bad body image, aspiration, bleeding, fistula, poor cough, infection, subcutaneous emphysema, trachea stenosis and necrosis, displacement

Decannulation

Adequate air exchange and able to expectorate secretions on their own

Pulmonary Embolism (PE)

Blockage of 1 or more pulmonary arteries; Sx: sudden, sharp chest pain, tachypnea, hypoxia, dyspnea, tachycardia, hemoptysis, impending doom

PE Drug Therapy

Low weight heparin, lovonox, heparin, warfarin, Eliquis, tpa, activase

Venous Thromboembolism (VTE)

Clot in leg arteries that can travel to the lungs, brain, or heart; Sx: unilateral leg edema, tenderness, dilated superficial veins, paresthesia, erythema

Post-thrombotic syndrome

Edema, spider veins, redness, cyanosis, increased pigmentation, pain during compression, venous ulcerations

Sudden Cardiac Death

Majority have no history of acute MI and no warning signs, some have a history of MI; Risk factors: EF less than 30%, ventricular dysrhythmias after MI, hypertrophic cardiomyopathy, structural heart disease, history of syncope, aortic stenosis, male, family history

Acute Coronary Syndrome (ACS)

Blocked blood vessel that supplies the heart muscle resulting in myocardial ischemia

ACS Symptoms

New onset, unstable angina, occurs at rest, pain lasting >10 minutes, unpredictable, needs immediate treatment, ECG shows ST changes

Angina

Chest pain resulting from myocardial ischemia usually from insufficient blood flow due to narrowing of coronary arteries or blockage from plaque

Chronic (stable) Angina

Comes and goes, predictable, NOT AT REST  emotional stress, exercise, heavy meals

Unstable Angina

Unpredictable, AT REST, may see EKG changes; Often precedes MI

Prinz metals Angina

Vasospasm  increased calcium, narrowed blood vessels, medications; Often seen in people with migraines, Reynaud’s, heavy smokers

Cardiac Catheterization

Cardiac catheter to bypass deposits in an artery; Diagnostic: to figure out what’s wrong; Interventional: put something in to fix the problem

HHNS: HHS or HHNK

Enough circulating insulin to prevent ketoacidosis, fewer symptoms lead to higher glucose levels

DKA

Not enough insulin, hyperglycemia, ketosis, acidosis, dehydration

Diabetes Insipidus

Caused by deficiency of ADH or a decreased renal response to the hormone; Symptoms: polydipsia, polyuria, fatigue, nocturia

Central DI (neurogenic)

Interference with ADH synthesis, transport, or release; Caused by brain tumor, head injury, brain surgery, or CNS infection

Nephrogenic DI

Inadequate renal response to ADH despite adequate presence of hormone; Lithium patients, renal damage, hereditary renal disease

Primary DI

Excess water intake; Caused by structural lesion in the thirst center, or psychological disorder

Thyroid storm

Occurs when excessive amounts of thyroid hormones are released into circulation, early treatment is necessary; Caused by infection, trauma, thyroidectomy surgery

Addisonian Crisis: Addison’s adrenal insufficiency

Life threatening emergency; Stress, sudden withdrawal of steroid therapy, adrenal surgery, pituitary gland destruction are all triggers; Symptoms: hypotension, tachycardia, dehydration, hyperkalemia, hypoglycemia, fever, weakness, confusion, shock

Type I: Anaphylaxis

Anaphylactic, pollen foods “IgE Ellergic”; Rapid initial phase 5-30 mins; Secondary phase hours to days after

Skin Tests - Scratch test

Systemic DT actually breaking the skin

Skin Tests - Patch test

Externally, not breaking the skin; Will welt up, become red and itchy if positive

Thrombocytopenia

Platelets <150k (normal 150-450k); Acute, severe, or prolonged time leads to spontaneous bleeding, or major bleeding from minor trauma

Immune thrombocytopenia purpura (ITP)

Decreased production of platelets, H pylori infection, viral infections, autoimmune disease, acute, chronic; Abnormal destruction of circulating platelets, platelets coated with antibody, once reaches spleen they are destroyed by macrophages

Thrombotic Thrombocytopenia Purpura (TTP)

Plasma enzyme deficiency (ADAMTS13) that breaks down the von Willebrand clotting factor; Hemolytic anemia, thrombocytopenia, neuro and renal abnormalities, fever, HUS (small clots in kidneys will put pt in kidney failure)

Heparin Induced Thrombocytopenia (HIT)

Platelets lower than 150k or drops by 50% 5-14 days post heparin therapy initiation; Immune-mediated response to heparin

Multiple Myeloma

Neoplastic cells proliferate in the bone marrow and destroy the bones, 10% cured with stem cell transplants

Gastritis

Inflammation of the gastric mucosa, most common stomach issue, breakdown of gastric mucosal barrier

Acute Gastritis

Abdominal discomfort, headache, fatigue, nausea, vomiting, hiccup

Chronic Gastritis

Epigastric discomfort, anorexia, heartburn, belching, sour taste in mouth, nausea and vomiting, intolerance to foods, vitamin deficiency of B12

Oral Cancer

Squamous cell carcinoma

Appendicitis

Inflammation of the appendix, ages 10-30, fills with food and empties into the cecum, prone to infection or obstruction DT small size

UTI

Bacterial most common cause (E. coli), fungal and parasitic not as common

Upper UTI

Renal parenchyma, pelvis, ureters  flank pain, chills, fever

Lower UTI

Bladder and urethra  pain, burning, frequency, nocturia, incontinence, hematuria, change in urine pattern

Pyelonephritis

Inflammation of the renal parenchyma and collecting system  bacterial, fungal, protozoa, viruses, vesicoureteral reflex, dysfunction, pregnancy

AKI - Prerenal

Poor perfusion

AKI - Intrarenal

Ischemia

AKI - Post renal

Obstruction