EXAM 3 Weeks 6-8: Elimination&Perfusion

WEEK 6 - ELIMINATION

1. Malabsorption, Diarrhea, Constipation

  • Causes: Enzyme deficiencies, infections, IBS, low fiber intake.
  • Nursing care:
    • Monitor I&O (Intake & Output).
    • Encourage fluids.
    • Administer medications.

2. Appendicitis

  • Inflammation of the appendix; poses a risk of rupture.
  • Symptoms:
    • RLQ (Right Lower Quadrant) pain.
    • Rebound tenderness.
    • Fever.
    • Nausea.
  • Treatment:
    • Surgery.
    • Antibiotics.

3. Peritonitis

  • Infection of the peritoneum.
  • Signs:
    • Abdominal rigidity.
    • Pain.
    • Fever.
    • Tachycardia.
  • Emergency requiring antibiotics, possibly surgery.

4. Celiac Disease

  • Autoimmune reaction to gluten.
  • Symptoms:
    • Diarrhea.
    • Weight loss.
    • Bloating.
  • Treatment: Gluten-free diet.

5. Crohn's Disease

  • Chronic inflammation affecting any part of the GI (Gastrointestinal) tract.
  • Symptoms:
    • Diarrhea.
    • Weight loss.
    • Abdominal pain.
  • Treatment:
    • Anti-inflammatory medications.
    • Surgery.
    • Diet changes.

6. Ulcerative Colitis

  • Inflammation of the colon and rectum.
  • Symptoms:
    • Bloody diarrhea.
    • Abdominal pain.
  • Treatment:
    • Anti-inflammatory medications.
    • Surgery if severe.

Medications for Elimination Disorders

  • Polyethylene glycol: Osmotic laxative for constipation.
  • Senna: Stimulant laxative.
  • Docusate sodium: Stool softener.
  • Infliximab: Monoclonal antibody for Crohn's Disease/Ulcerative Colitis.
  • Metronidazole: Antibiotic used for peritonitis or abscess.

WEEKS 7-8 - PERFUSION

1. Basic Cardiac Arrhythmias

  • Include bradycardia, tachycardia, Atrial Fibrillation (AFib).
  • Use EKG (Electrocardiogram) for diagnosis; treat with medications or a pacemaker.

2. Pacemaker

  • Device to control heart rhythm.
  • Nursing Considerations:
    • Monitor insertion site.
    • Assess for infection or malfunction.

3. Heart Failure

  • Left-sided Heart Failure: Pulmonary symptoms
    • Dyspnea (shortness of breath).
    • Crackles (rales) in lungs.
  • Right-sided Heart Failure: Systemic symptoms
    • Edema (swelling).
    • JVD (Jugular Vein Distention).
  • Management:
    • Diuretics.
    • ACE inhibitors.
    • Lifestyle modifications.

4. Hypertension (HTN)

  • Often asymptomatic.
  • Risks:
    • Stroke.
    • Myocardial Infarction (MI).
    • Chronic Kidney Disease (CKD).
  • Treatment:
    • Lifestyle changes.
    • Antihypertensive medications.

5. Coronary Artery Disease (CAD)

  • Caused by atherosclerosis; leads to angina, Myocardial Infarction.
  • Treatment:
    • Statins.
    • Nitrates.
    • Lifestyle changes.

6. Myocardial Infarction (MI)

  • Symptoms:
    • Chest pain.
    • Shortness of breath (SOB).
    • Diaphoresis (sweating).
  • Treatment:
    • MONA: Morphine, Oxygen, Nitroglycerin, Aspirin
    • Cath Lab (Cardiac Catheterization Laboratory).

7. Anemia

  • Refer to previous anemia guide for details.

8. Deep Vein Thrombosis (DVT)

  • Clot in a deep vein, often in the leg.
  • Prevention:
    • Mobility.
    • Compression stockings.
    • Anticoagulants.

9. Pulmonary Embolus (PE)

  • Blockage in the pulmonary artery from a clot.
  • Signs:
    • Sudden dyspnea.
    • Chest pain.
    • Hemoptysis (coughing up blood).

10. Hemophilia

  • Genetic disorder; lack of clotting factors.
  • Treatment: Factor replacement therapy.

11. Disseminated Intravascular Coagulation (DIC)

  • Clotting and bleeding disorder; often triggered by sepsis.
  • Treatment:
    • Manage the underlying cause.
    • Blood products.

12. Venous Insufficiency

  • Impaired venous return; causes edema and ulcers.
  • Management:
    • Compression stockings.
    • Leg elevation.

13. Peripheral Artery Disease (PAD)

  • Narrowing of arteries in the limbs.
  • Symptoms:
    • Claudication (leg pain with exercise).
    • Cool skin.
    • Poor pulses.

Medications for Perfusion Disorders

  • Furosemide: Loop diuretic for fluid overload.
  • Spironolactone: Potassium-sparing diuretic.
  • Hydrochlorothiazide: Thiazide diuretic for hypertension.
  • Digoxin: Increases cardiac contractility; check apical pulse.
  • Nitroglycerin: Vasodilator for angina.
  • Metoprolol: Beta-blocker; reduces heart rate and blood pressure.
  • Diltiazem: Calcium channel blocker for hypertension and arrhythmias.
  • Lisinopril: ACE inhibitor for hypertension and heart failure.
  • Atorvastatin: Statin to lower cholesterol.
  • Enoxaparin: Low molecular weight heparin for DVT prevention.
  • Aspirin: Antiplatelet for CAD/MI prevention.
  • Clopidogrel: Antiplatelet for stroke and MI prevention.
  • Apixaban: Anticoagulant used to prevent and treat blood clots (DVT, PE) and reduce stroke risk in atrial fibrillation. Monitor for bleeding.
  • Cyanocobalamin: Vitamin B12 used to treat and prevent vitamin B12 deficiency, including pernicious anemia. Given IM or PO depending on severity.
  • Hydroxyurea: Used in sickle cell anemia to reduce frequency of painful crises by increasing fetal hemoglobin production. Monitor CBC regularly.
  • Hydromorphone: Opioid analgesic for moderate to severe pain. Monitor for respiratory depression, constipation, and sedation.