Review

Overview of Cirrhosis

  • Importance of avoiding alcohol for liver health

  • Key concerns to remember:

    • Complications relating to cirrhosis

    • Medications used in treatment

    • Management of symptoms

Cancer Overview

  • Types of Tumors:

    • Malignant Tumors:

    • Defined by rapid growth and invasiveness

    • Capable of metastasis (spreading)

    • Often poorly differentiated

    • Risk of recurrence is high

    • Benign Tumors:

    • Usually slow-growing and encapsulated

    • Do not metastasize

    • Have low recurrence risk

  • Etiology of Cancer:

    • Genetic Mutations: Can be inherited or acquired

    • Infectious Agents: Certain viruses (e.g., Hepatitis B leading to cirrhosis) can increase cancer risk

    • Environmental Factors:

    • Smoking, diet (high-fat, low-fiber), and alcohol exposure

Levels of Cancer Prevention

  • Primary Prevention: Prevent occurrence of cancer

    • Actions include:

    • Avoiding tobacco use

    • Vaccinations (e.g., HPV vaccine)

    • Maintaining a healthy diet and engaging in regular exercise

  • Secondary Prevention: Focuses on early detection

    • Includes screening methods such as:

    • Colonoscopy

    • Mammograms

    • Pap smears

  • Tertiary Prevention: Aims to reduce complications and recurrence post-diagnosis

    • Managing side effects of treatment such as chemotherapy

Chemotherapy

  • Mechanism: Destroys rapidly dividing cancer cells (e.g., hair follicles, skin, oral mucosa)

  • Outcomes:

    • Can shrink tumors prior to surgical intervention

    • Can either cure cancer or prolong life

  • Common Side Effects:

    • Alopecia: Hair loss

    • Neutropenia: Increased risk for infections

    • Stomatitis: Mouth sores due to mucosal damage

    • Fatigue: Distinct from regular tiredness, often debilitating

    • Nausea: Can be severe, often needing medication

  • Management of Side Effects:

    • Oral care includes soft toothbrushes and saline rinses

    • Use of topical anesthetics and medications like Maalox

    • Nutritional support with high-calorie, high-protein diets for energy

Cancer Specifics

  • Colorectal Cancer Risk Factors:

    • Low fiber diet, family history

    • Recommended screening now starting at age 45

  • Symptoms:

    • Blood in stool

    • Changes in bowel habits

    • Unexplained weight loss and fatigue

  • Complications:

    • Bowel obstruction, perforation, liver metastases

  • Prevention and Management:

    • High fiber, low-fat diet, regular screenings, and closer attention to bowel changes

Autoimmune Rheumatic Diseases

  • Key Symptoms:

    • Fatigue, joint pain, swelling, morning stiffness, fever

  • Non-Pharmacological Therapies:

    • Warm/cold therapy, exercise, stress reduction strategies

Rheumatoid Arthritis (RA) Specifics

  • Symptoms:

    • Symmetrical joint pain, morning stiffness lasting longer than one hour

    • Joint swelling, fatigue, lung involvement, and vasculitis

  • Laboratory Tests:

    • Rheumatoid factor, anti-CCP, elevated ESR and CRP, X-rays showing joint damage

  • Management:

    • Medications (DMARDs, biologics), monitor for infections, medication adherence, and joint protection strategies

Systemic Lupus Erythematosus Specifics

  • Characteristic Symptoms:

    • Butterfly-shaped rash, photosensitivity, joint pain, systemic symptoms affecting multiple body systems (e.g., kidneys, heart)

  • Education:

    • Avoid sun exposure; use sunscreen regularly

HIV/AIDS Overview

  • Definition:

    • HIV is a retrovirus attacking CD4+ T-cells in the immune system

  • Pathophysiology:

    • Low CD4+ counts lead to increased risk of opportunistic infections

    • Symptoms include weight loss, fatigue, flu-like symptoms initially, and severe infections in advanced stages

  • CD4+ Count Ranges:

    • > 500: Normal

    • 200-500: Immunocompromised (HIV)

    • < 200: AIDS diagnosis

  • Antiretroviral Therapy (ART):

    • Combination therapy must be taken consistently to suppress HIV

    • Monitoring for infections is critical due to the weakened immune system

Mobility and Functional Assessment

  • Assessment Tools:

    • Mobility aids, pain assessments, fall risk evaluations

    • Difficulty walking or transferring, limited range of motion, muscle weakness

  • Nursing Interventions:

    • Early ambulation, range of motion activities, pain management before movement, and collaboration with physical therapy

Osteoarthritis Specifics

  • Pathophysiology:

    • Degeneration of articular cartilage and joint space narrowing, leading to pain and stiffness

  • Symptoms:

    • Morning stiffness lasting less than 30 minutes, joint pain that worsens with activity

  • Treatment Options:

    • Initial treatments include acetaminophen, NSAIDs; potential corticosteroid injections for inflammation

  • Lifestyle Modifications:

    • Weight loss for obese patients, exercise, physical therapy, joint protection techniques

Osteoporosis Overview

  • Definition: Decreased bone density increases fracture risk

  • Diagnosis: DEXA scan with a score of less than -2.5 indicating osteoporosis

  • Prevention Strategies:

    • Calcium and vitamin D supplementation, weight-bearing exercises, avoiding smoking and excessive alcohol

  • Medications:

    • Bisphosphonates (e.g., alendronate) are the first-line treatment; important to stay hydrated and upright after administration

Paget's Disease Overview

  • Characteristics:

    • Disorganized bone remodeling leading to enlarged and weakened bones

  • Symptoms: Bone pain, deformities, specific complications like hearing loss

  • Treatment: Bisphosphonates and other supportive measures to manage symptoms and improve function