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.