Ambulation and Upright Mobility

NM III Unit 3: Compensatory treatment strategies for upright and wheelchair mobility

Chapter 4 Skin and Body Membranes Body Membranes Functions of body membranes Cover body surfaces Line body cavities Form protective sheets around organs Classified according to tissue types Body Membranes Two major categories Epithelial membranes Cutaneous membranes Mucous membranes Serous membranes Connective tissue membranes Synovial membranes Epithelial Membranes Epithelial membranes are simple organs Also called covering and lining membranes These membranes contain both: Epithelial tissue layer Connective tissue layer Epithelial Membranes Cutaneous membrane = skin Dry membrane Outermost protective boundary Consists of two layers Epidermis is composed of keratinized stratified squamous epithelium Dermis is mostly dense (fibrous) connective tissue Epithelial Membranes • Mucous membranes (mucosae) • I Moist membranes Some mucosae secrete protective, lubricating mucus Line all body cavities that open to the exterior body surface • Adapted for absorption or secretion • ' Consists of two layers • Epithelium type depends on site • Loose connective tissue (lamina propria) Epithelial Membranes Serous membranes (serosae) Line compartments in the ventral body cavity that are ciosed to the exterior of the body Occur in pairs, separated by serous fluid, with a visceral and parietal layer Consists of two layers Simple squamous epithelium Areolar connective tissue Epithelial Membranes Specific serous membranes Peritoneum Cover organs in the abdominal cavity Pleurae Surround the lungs Pericardia Surround the heart Connective Tissue Membranes Synovial membranes Loose areolar connective tissue only (no epithelial tissue) Line fibrous capsules surrounding joints Line bursae Line tendon sheaths Secrete a lubricating fluid to cushion organs moving against each other during muscle activity Integumentary System Integumentary system consists of the: Skin (cutaneous membrane) Skin appendages Sweat glands Oil glands Hair Nails Functions of the Integumentary System Insulates and cushion deeper body organs Protects the entire body from: Mechanical damage (bumps and cuts) Chemical damage (acids and bases) Thermal damage (heat or cold) Ultraviolet (UV) radiation (sunlight) Microbes (bacteria) • Water loss Functions of the Integumentary System Regulates heat loss as controlled by the nervous system Acts as a mini-excretory system; sweat aids in the loss of Urea Salts Water Synthesizes vitamin D Secretions create a protective acid mantle Structure of the Skin Two kinds of tissue compose the skin Epidermis Dermis Subcutaneous tissue (hypodermis) Anchors the skin to underlying organs Not technically part of the integumentary system Composed mostly of adipose tissue Serves as a shock absorber and insulates deeper tissues Structure of the Skin Epidermisouter layer Composed of stratified squamous epithelium Most cells are keratinocytes which produce a fibrous protein called keratin Keratinization makes the epidermis tough Desmosomes connect keratinocytes together Avascular Composed of five layers (strata) Structure of the Skin Summary of strata (layers) of the epidermis from deepest to most superficial Stratum basale Stratum spinosum Stratum granulosum Stratum lucidum (thick, hairless skin only) Stratum corneum Structure of the Skin Stratum basale (stratum germinativum) Deepest layer of epidermis Lies next to dermis Wavy borderline with the dermis anchors the two together Cells undergoing mitosis Daughter cells are pushed upward to become the more superficial layers Stratum spinosum Cells become increasingly flatter and more keratinized Structure of the Skin Stratum granulosum Stratum lucidum Formed from dead cells of the deeper strata Occurs only in thick, hairless skin of the palms of hands and soles of feet Stratum corneum Outermost layer of epidermis Shingle-like dead cells are filled with keratin (protective protein prevents wat loss from skin Structure of the Skin Melanin Melanin is a pigment produced by melanocytes Melanocytes are mostly in the stratum basale of the epidermis Color is yellow to brown to black Structure of the Skin Epidermal dendritic cells Alert and activate immune cells to a threat (bacterial or viral invasion) Merkel cells Associated with sensory nerve endings Serve as touch receptors called Merkel discs Structure of the Skin Dermis Connective tissue Underlies the epidermis Two regions Papillary Reticular Structure of the Skin Two regions of the dermis Papillary layer (upper dermal region) contain projections called dermal papillae Areolar connective tissue Indent the epidermis above Many projections contain capillary loops, and others house pain and touch receptors On palm and sole surfaces, papillae increase friction and gripping ability Fingerprints are identifying films of sweat Structure of the Skin Two regions of the dermis Reticular layer (deepest skin layer) Dense irregular connective tissue Blood vessels Sweat and oil glands Deep pressure receptors (lamellar corpuscles) Structure of the Skin Other dermal features Cutaneous sensory receptors Phagocytes Collagen and elastic fibers Blood vessels I Nerve supply Skin Color • Three pigments contribute to skin color 1. Melanin • Yellow, reddish brown, or black pigments 2. Carotene • Orange-yellow pigment (also found in some vegetables) 3. Hemoglobin Red coloring from blood cells in dermal capillaries Oxygen content determines the extent of red coloring Skin Color Redness (erythema) due to embarrassment, inflammation, hypertension, fever, or allergy Pallor (blanching) due to emotional stress (such as fear), anemia, low blood pressure, impaired blood flow to an area Jaundice (yellow cast)-indicates a liver disorder • Bruises (black and blue marks)-hematomas Appendages of the Skin Cutaneous glands are all exocrine glands Sebaceous glands Sweat glands Hair and hair follicles Nails Appendages of the Skin Sebaceous (oil) glands Located all over the skin except for palms and soles Produce sebum (oil) Makes skin soft and moist Prevents hair from becoming brittle Kills bacteria Most have ducts that empty into hair follicles; others open directly onto skin surface Glands are activated at puberty with increased androgens Appendages of the Skin Sweat (sudoriferous) glands Produce sweat Widely distributed in skin Two types of sudoriferous glands Eccrine glands Apocrine glands Appendages of the Skin Eccrine glands More numerous, located all over the body Open via duct to sweat pores on the skin's surface Produce acidic sweat Water, salts, vitamin C, traces of metabolic waste Function in body temperature regulation Appendages of the Skin Apocrine glands Ducts empty into hair follicles in the armpit and genitals Begin to function at puberty Release sweat that also contains fatty acids and proteins (milky or yellowish color) • Play a minimal role in body temperature regulation Appendages of the Skin Hair Located body-wide except for palms, soles, nipples, lips Produced by hair follicle Root is enclosed in the follicle Shaft projects from the surface of the scalp or skin Consists of hard keratinized epithelial cells Melanocytes provide pigment for hair color Hair grows in the matrix of the hair bulb in stratum basale Appendages of the Skin Hair anatomy Central medulla Cortex surrounds medulla Cuticle on outside of cortex Most heavily keratinized region of the hair Melanin provides color Appendages of the Skin Associated hair structures Hair follicle Composed of an inner epithelial root sheath andan outer fibrous sheath Dermal region provides a blood supply to the hair bulb (deepest part of the follicle) Arrector pili muscle connects to the hair follicle to pull hairs upright when we are cold or frightened Appendages of the Skin Nails Heavily keratinized, scalelike modifications of the epidermis Stratum basale extends beneath the nail bed, which is responsible for growth Lack of pigment makes nails colorless Appendages of the Skin Parts of a nail Free edge Body is the visible attached portion Nail folds are skin folds that overlap the edges of the nail; the cuticle is the proximal edge Root of nail is embedded in skin Growth of the nail occurs from nail matrix of nail bed Homeostatic Imbalances of Skin Infections and allergies Athlete's foot Caused by fungal infection (Tinea pedis) Itchy, red peeling skin between the toes Boils (furuncles) and carbuncles Caused by inflammation of hair follicles Carbuncles are clusters of boils caused by bacteria Cold sores (fever blisters) Caused by human herpesvirus 1 Blisters itch and sting Homeostatic Imbalances of Skin Infections and allergies Contact dermatitis Caused by exposure to chemicals that provoke allergic responses Itching, redness, and swelling of the skin Impetigo Caused by bacterial infection Pink, fluid-filled raised lesions around mouth/nose Psoriasis Triggered by trauma, infection, hormonal changes, or stress Red, epidermal lesions covered with dry, silvery scales that itch, burn, Crack, or sometimes bleed Homeostatic Imbalances of Skin • Burns Tissue damage and cell death caused by heat, electricity, UV radiation, or chemicals Associated dangers Protein denaturation and cell death Dehydration and electrolyte imbalance Circulatory shock Result in loss of body fluids and infection from the invasion of bacteria Homeostatic Imbalances of Skin Extent of a burn is estimated using the rule of nines Body is divided into 11 areas for quick estimation Each area represents about 9 percent of total body surface area The area surrounding the genitals (the perineum) represents 1 percent of body surface area Homeostatic Imbalances of Skin . First-degree burn (superficial burn) Only epidermis is damaged Skin is red and swollen Second-degree burn (superficial partial-thickness burn) Epidermis and superficial part of dermis are damaged Skin is red, painful, and blistered Regrowth of the epithelium can occur Homeostatic Imbalances of Skin Third-degree burn (full-thickness burn) Destroys epidermis and dermis; burned area is painless Requires skin grafts, as regeneration is not possible Burned area is blanched (gray-white) or black Fourth-degree burn (full-thickness burn) Extends into deeper tissues (bone, muscle, tendons) Appears dry and leathery Requires surgery and grafting May require amputation Homeostatic Imbalances of Skin Criteria for deeming burns critical (if any one is met): Over 30 percent of body has second-degree burns Over 10 percent of the body has third-or fourth-degree burns Third-or fourth-degree burns of the face, hands, feet, or genitals Burns affect the airways Circumferential (around the body or limb) burns have occurred Homeostatic Imbalances of Skin Skin cancer Most common form of cancer in humans Most important risk factor is overexposure to ultraviolet (V) radiation in sunlight and tanning beds Cancer can be classified two ways Benign means the neoplasm (tumor) has not spread Malignant means the neoplasm has invaded other body areas Concept Link Recall that mitosis gone wild is the basis for cancer (Chapter 3, pp. 82-83). These cells lack normal control of cell division and divide quickly, resulting in errors during DNA replication, mitosis, or both. Cells experiencing rapid, uncontrolled growth become cancerous and can metastasize (spread) to other parts of the body. Homeostatic Imbalances of Skin . First-degree burn (superficial burn) Only epidermis is damaged Skin is red and swollen Second-degree burn (superficial partial-thickness burn) Epidermis and superficial part of dermis are damaged Skin is red, painful, and blistered Regrowth of the epithelium can occur Homeostatic Imbalances of Skin Third-degree burn (full-thickness burn) Destroys epidermis and dermis; burned area is painless Requires skin grafts, as regeneration is not possible Burned area is blanched (gray-white) or black Fourth-degree burn (full-thickness burn) Extends into deeper tissues (bone, muscle, tendons) Appears dry and leathery Requires surgery and grafting May require amputation Homeostatic Imbalances of Skin Criteria for deeming burns critical (if any one is met): Over 30 percent of body has second-degree burns Over 10 percent of the body has third-or fourth-degree burns Third-or fourth-degree burns of the face, hands, feet, or genitals Burns affect the airways Circumferential (around the body or limb) burns have occurred Homeostatic Imbalances of Skin Skin cancer Most common form of cancer in humans Most important risk factor is overexposure to ultraviolet (V) radiation in sunlight and tanning beds Cancer can be classified two ways Benign means the neoplasm (tumor) has not spread Malignant means the neoplasm has invaded other body areas Concept Link Recall that mitosis gone wild is the basis for cancer (Chapter 3, pp. 82-83). These cells lack normal control of cell division and divide quickly, resulting in errors during DNA • One or more of the ABCD characteristics is evolving Developmental Aspects of Skin and Body Membranes Lanugo, a downy hair, covers the body by the fifth or sixth month of fetal development but disappears by birth Vernix caseosa, an oily covering, is apparent at birth Milia, small white spots, are common at birth and disappear by the third week Acne may appear during adolescence Pimples, scales, and dermatitis are more common with aging skin Developmental Aspects of Skin and Body Membranes In youth, skin is thick, resilient, and well hydrated With aging, skin loses elasticity and thins Skin cancer is a major threat to skin exposed to excessive sunlight Balding (alopecia) and/or graying occurs with aging; both are genetically determined other factors that may contribute include drugs and emotional stress

Tarot (Upright)

Unit 1 Study Guide Review 1. Anatomy = study the structures (ex: names/locations of bones) Physiology = study the functions (ex: how bones heal) Both are needed to understand the body 2. Homeostasis = maintaining stable body  conditions; controlled using feedback systems 3. During exercise = heart rate increased After exercise = heart rate decreased Negative feedback was used to return the  heart back to its normal resting rate 4. Chemical = oxygen Cell = muscle cell Tissue = muscle tissue Organ = stomach Organ system = digestive system Organism = human 5. Frontal = divides body into front and back  Transverse = divides body into top and bottom  Midsagittal = divides body into left and right 6. Responsiveness = waking up to an alarm,  feeling hungry after smelling food Differentiation = cells are assigned a specific function Growth = children's bones increase in  length/size as they age Reproduction = having a bebé Movement = picking up a cup to take a drink Metabolism =digesting food to obtain  energy 7. The elbow is proximal to the wrist The toes are distal to the ankle The heart is medial to the lungs The ears are lateral to the nose The stomach is superior to the bladder The heart is inferior to the brain The muscle is superficial to the bones The muscle is deep to the skin The eyes are anterior to the brain The spine is posterior to the collarbone 8. Receptor =picks up info about the body  (ex: blood pressure) Control Center = decides if action is needed  (ex: lower blood pressure) Effector = takes action (ex: increases width of blood vessels to lessen  pressure) 9. Front = frontal,anterior, ventral Back = posterior, dorsal 10. Negative Feedback = reverses a change in the body; most commonly used; ex: lowering blood sugar back to normal after a meal Positive feedback = increases a change in the  body; used for emergency/special situations; ex: increasing the frequency and strength of contractions during childbirth 11.  Face upright, palms forward (supine), weight even on both feet, arms slightly away from body 12. Cephalic (head), Cervical (neck), upper limb (arm), trunk (torso), lower limb (leg) 13. Sweat (will cool the body) 14. Shiver (will warm the body) 15. More oxygen and nutrients need to be delivered to muscles quickly and carbon dioxide removed; increased heart rate allows for this 16. People with better cardiovascular health will return to resting heart rate after exercise more quickly due to conditioning and a stronger heart

📝 THEOC 1301 — QUIZ 1 COMPLETE STUDY GUIDE 🟣 SESSION 1: INTRODUCTION TO THEOLOGY slide 2 — overview: theology theology = a reasoning process about god and all he has made known to us through divine revelation. THEO2301 Session01 (1 per page)(1).pdf in simpler words: theology is using reason/thinking to understand what god has revealed. MEMORIZE: theology = reasoning about god + divine revelation ⸻ slide 3 — overview: oikonomia oikonomia = economy it means: * stewardship * administration it refers to: the works by which god reveals himself and communicates his life. THEO2301 Session01 (1 per page)(1).pdf MEMORIZE: oikonomia = stewardship/administration + god revealing himself and communicating his life ⸻ slide 4 — the bible the bible is: * the primary source for studying theology * the inspired and inerrant word of god * god’s self-communication to us * given for the sake of our salvation the slide also says: “the study of the sacred page should be the very soul of sacred theology” — dei verbum 24 THEO2301 Session01 (1 per page)(1).pdf what you need to understand: the bible is extremely important to theology because it is god communicating himself to us, and theology studies it to understand what god has revealed. MEMORIZE: bible = primary source + inspired/inerrant word of god + god’s self-communication + salvation ⸻ slide 5 — the church fathers the slide connects theology with: “faith seeking understanding” this is from st. anselm. THEO2301 Session01 (1 per page)(1).pdf fathers the fathers are: * orthodox * holy * pre-800 ad doctors doctors are people who made significant contributions through profound understanding of the faith. THEO2301 Session01 (1 per page)(1).pdf easiest way to remember: fathers → orthodox + holy + before 800 doctors → significant contributors + profound understanding ⸻ slide 6 — the magisterium what is the magisterium? the official teaching authority of the church. the pope’s primary duties regarding christ’s teaching: 1. protect 2. interpret 3. pass down THEO2301 Session01 (1 per page)(1).pdf MEMORIZE: magisterium = official teaching authority pope = protect, interpret, pass down ⸻ ⭐ slide 11 — the vocation of the theologian 🚨 ESSAY TOPIC this is one of the most important sections. the theologian’s vocation is: to pursue an ever-deeper understanding of the word found in scripture, handed on by tradition, in communion with the magisterium. THEO2301 Session01 (1 per page)(1).pdf the theologian also: * responds to the invitation of truth * seeks to understand faith * helps the people of god give an accounting for their hope * seeks truth so people can become disciples * communicates the faith * serves love by giving people better knowledge of god THEO2301 Session01 (1 per page)(1).pdf basically: the theologian is supposed to understand the faith more deeply and help other people understand it too. ⭐ essay formula: deeper understanding → scripture + tradition → communion with magisterium → help people understand faith → communicate faith → better knowledge of god ⸻ slide 12 — vocation of the theologian, continued the theologian should: 1. deepen their own faith they unite: research + prayer 2. use proper intellectual standards they should be attentive to: * epistemological requirements * critical standards * rational verification 3. grow spiritually they should make a spiritual effort to grow in: virtue + holiness THEO2301 Session01 (1 per page)(1).pdf remember: the theologian needs BOTH: intellectual growth → research + critical thinking + rational verification spiritual growth → prayer + virtue + holiness ⸻ slide 13 — vocation of the theologian, continued theologians understand revelation through: * philosophical concepts * historical disciplines * human sciences BUT: the ultimate normative principle is revealed doctrine. their teaching must in no way harm the doctrine of the faith. THEO2301 Session01 (1 per page)(1).pdf there is freedom within the church’s faith. the theologian should also be open to: * objective discussion * fraternal dialogue * modifying their own opinions THEO2301 Session01 (1 per page)(1).pdf ⭐ important idea: theologians can think, research, and discuss, but their work remains within the church’s faith and revealed doctrine. ⸻ ⭐ slide 17 — magisterium & theology (collaborative) 🚨 ESSAY TOPIC the magisterium and theology have the same goal: preserving the people in truth. but they have different roles: magisterium → authentically teaches doctrine theology → strives to clarify revelation with regard to reason the theologian must present doctrine with full accuracy and integrity. the magisterium’s infallible pronouncements call for assent of theological faith. THEO2301 Session01 (1 per page)(1).pdf memorize: same goal, different roles. ⸻ slide 18 — magisterium & theology (continued) definitive truths the magisterium’s definitive truths concerning: faith + morals must be: firmly accepted and held. non-definitive teaching teaching meant to: * aid understanding * guard against error calls for: religious submission of will and intellect. theologians theologians are expected to loyally submit to the teaching of the magisterium, including when it intervenes authoritatively. THEO2301 Session01 (1 per page)(1).pdf memorize this distinction: definitive → firmly accepted and held non-definitive → religious submission of will + intellect ⸻ slide 19 — magisterium & theology (continued) the relationship isn’t necessarily perfect agreement all the time. the slide says magisterial documents might not be free from all deficiencies. there can also be: non-hostile tensions between theologians and the magisterium. these tensions can become a dynamic factor stimulating both when they practice dialogue. THEO2301 Session01 (1 per page)(1).pdf basically: disagreement/tension isn’t automatically bad. non-hostile tension + dialogue → can stimulate both ⸻ slide 20 — magisterium & theology (continued) the theologian should not present personal opinions or divergences as if they were non-arguable conclusions. also: conscience is NOT an autonomous and exclusive authority for deciding doctrinal truth. obedience of faith leads to loyal acceptance of the magisterium’s teaching. if difficulties continue, the theologian should: make the problems known to the magisterium — NOT the mass media. they should also remain open to a deeper examination of the question. THEO2301 Session01 (1 per page)(1).pdf ⭐ remember: personal opinion ≠ unquestionable doctrine problem → magisterium, not mass media ⸻ slide 24 — dissent: following one’s conscience the slide says: “following one’s conscience” cannot legitimate dissent. a right conscience is: * illumined by faith * based on objective moral law * has an upright will * pursues the true good things that are NOT legitimate include: * polling public opinion * pressuring through public opinion * claiming there is a consensus among theologians * presenting theologians as a prophetic “base” THEO2301 Session01 (1 per page)(1).pdf important: the slide isn’t saying conscience doesn’t matter. it’s saying following your conscience cannot simply be used as a justification for dissent. ⸻ 🟢 slide 27 — why study theology? truth is food + truth is light revealed truth = food we need to be nourished by it. the eucharist ensures we aren’t entirely unnourished. doctrine = light much of reality can only be known if god tells us. the church helps communicate some truths even to people who aren’t very interested. living undernourished or half in the dark is a pity. THEO2301 Session01 (1 per page)(1).pdf MEMORIZE: truth = food doctrine = light ⸻ slide 28 — why study theology? ignorance is not a virtue ignorance is not a virtue. why? knowledge serves love. more knowledge of god: → helps us love him more → removes misunderstandings → gives us more reasons to love him. THEO2301 Session01 (1 per page)(1).pdf memorize: knowledge of god → greater love ⸻ slide 29 — ignorance is not a virtue continued the slide says millions are spiritually “starved” because they lack truth and don’t have the eucharist. the slide says spiritual starvation should largely be relieved by the laity, because they are in contact with those who need it. the laity need to understand the great dogmas: * for the sake of those who are hungry * and for their own sake. THEO2301 Session01 (1 per page)(1).pdf key idea: laity → understand the great dogmas → help relieve spiritual starvation ⸻ slide 30 — ignorance is not a virtue continued studying theology should be accompanied by: reading scripture because scripture has a wonderful power to make truths: come alive in the soul. THEO2301 Session01 (1 per page)(1).pdf ⸻ 🔵 SESSION 2 — FAITH & REASON slide 2 — faith & reason main idea: there can’t be a real discrepancy between faith and reason. why? because the light of both comes from god. THEO2301 Session02 (1 per page).pdf memorize: faith + reason don’t truly contradict because both come from god. ⸻ slide 3 — faith defined you have THREE definitions. biblical: “the assurance of things hoped for, the conviction of things not seen.” dogmatic: faith is: * a gift of god * a human act * complete submission of intellect + will to god common sense: faith = complete trust and confidence in someone. THEO2301 Session02 (1 per page).pdf MEMORIZE THIS: biblical → assurance of things hoped for dogmatic → gift of god + intellect/will submitted to god common sense → trust/confidence ⸻ slide 4 — knowledge revealed by god knowledge directly revealed by god is: more certain than knowledge gained through mere human experience. THEO2301 Session02 (1 per page).pdf that’s basically the entire slide. ⸻ slide 5 — faith is absolute trust faith = absolute trust in god. and this is: eminently reasonable. THEO2301 Session02 (1 per page).pdf again, this reinforces the idea that faith isn’t opposed to reason. ⸻ slide 9 — mysteries of christian faith the mysteries of christian faith: transcend human reason BUT never contradict reason. THEO2301 Session02 (1 per page).pdf THIS DISTINCTION IS IMPORTANT: transcend = go beyond contradict = go against so: faith can go beyond what human reason can fully understand without contradicting reason. ⸻ slide 10 — qualities of faith faith is: * personal + communal relationship * seeks understanding * friend of reason * necessary for salvation * gift of grace * free human act * believes with conviction in a message THEO2301 Session02 (1 per page).pdf memorize the list. ⸻ slide 11 — challenges to faith 1. “wall” of separation faith should have no impact on the state/society. 2. ideological secularism the idea that: we are self-sufficient + self-explanatory therefore: faith isn’t needed. THEO2301 Session02 (1 per page).pdf ⸻ slide 16 — complementary forms of wisdom there are two: philosophical wisdom the naturally limited capacity of the intellect to explore reality. theological wisdom explores the contents of faith based upon revelation. THEO2301 Session02 (1 per page).pdf memorize: philosophical → intellect → reality theological → revelation → faith they are complementary, meaning they’re meant to work together. ⸻ slide 17 — faith + reason this is another VERY important contrast: without faith: reason is in danger of losing sight of its final goal. without reason: faith has stressed feeling and experience. THEO2301 Session02 (1 per page).pdf easiest way: reason needs faith faith needs reason ⸻ slide 18 — st. bonaventure this is basically a warning about separating intellectual study from spiritual life. the slide says theologians should recognize the inadequacy of things like: * reading without repentance * knowledge without devotion * research without wonder * prudence without joy * action divorced from religion * learning separated from love * intelligence without humility * study without divine grace * thought without wisdom inspired by god THEO2301 Session02 (1 per page).pdf don’t worry about memorizing every word. remember the overall point: studying and intelligence aren’t enough by themselves; they need devotion, humility, love, religion, and divine grace. ⸻ slide 19 — final conclusion 1. god can be known with certitude by reason from created things. 2. revelation is necessary because we are ordained for a supernatural end that surpasses human understanding. THEO2301 Session02 (1 per page).pdf easiest way: reason → can know god revelation → necessary because supernatural end surpasses human understanding

Human Anatomy and Physiology Third Edition Chapter 1 Introduction to Anatomy and Physiology Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Characteristics of Living Organisms (1 of 2) Living Organisms share distinct properties •Cellular Composition—Cells are the smallest units that carry out the functions of life •Metabolism—Living organisms carry out chemical processes collectively called metabolism –“Building” processes are known as Anabolism –“Breaking down” processes are known as Catabolism •Growth—An increase in the size and/or number of cells Loading… Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Characteristics of Living Organisms (2 of 2) Living Organisms share distinct properties (continued) •Excretion—Elimination of potentially harmful waste products created by metabolic processes •Responsiveness or Irritability—Organisms sense and react to changes or stimuli in their environment •Movement—Organisms or individual cells of an organism move •Reproduction—Production of new cells during growth or repair or reproduction of new organisms Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Levels of Structural Organization and Body Systems (1 of 7) The body is constructed of a series of progressively larger “building blocks” known as the Structural Levels of Organization •Chemical Level—This is the smallest level; Chemicals range from tiny atoms to complex molecules •Cellular Level—Groups of many different types of molecules combine in specific ways to form cellular structures •Tissue Level—Two or more cell types and material outside them, called extracellular matrix, combine to perform a common function Loading… Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Levels of Structural Organization and Body Systems (2 of 7) Structural Levels of Organization (continued) •Organ Level—Two or more tissue types combine to form an organ with a recognizable shape that performs a specialized task •Organ System Level—Two or more organs that together carry out a broad function in the body –The human body has 11 organ systems •Organism Level—The organ systems function together to make up the working human body—an organism Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Levels of Structural Organization and Body Systems (3 of 7) Figure 1.5 Six structural levels of organization of the human body. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Levels of Structural Organization and Body Systems (4 of 7) Figure 1.6 The 11 organ systems of the human body Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Levels of Structural Organization and Body Systems (5 of 7) Figure 1.6 The 11 organ systems of the human body Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Levels of Structural Organization and Body Systems (6 of 7) Figure 1.6 The 11 organ systems of the human body Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Levels of Structural Organization and Body Systems (7 of 7) Figure 1.6 The 11 organ systems of the human body Loading… Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Types of Anatomy and Physiology (1 of 2) Study of Anatomy can be approached in several ways •Systemic Anatomy—Examines individual organ systems •Regional Anatomy—Examines the body in regions, such as the head and neck •Surface Anatomy—Examines surface markings •Gross Anatomy—Examines structures that can be seen with the unaided eye •Microscopic Anatomy—Examines cells (Cytology) and tissues (Histology) with the use of a microscope Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.2 Types of Anatomy and Physiology (2 of 2) Study of Physiology includes numerous subfields •Physiology subfields are classified by organ or organ systems, such as neurophysiology and cardiophysiology •Physiologists can also study other structural levels of organization of the body such as chemical, cellular, and tissue levels Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Word Parts •The language of science is built on Word Roots—core components of words with specific meanings •Word roots are combined with Prefixes and Suffixes to yield scientific terms •For example, combine the following: –Prefix an- (means without) –Word root encephala- (means brain) –Suffix -ic (means condition of) •“Anencephalic” is the condition of lacking a part of the brain Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 The Anatomical Position and Directional Terms (1 of 4) Anatomical Position—Common frame of reference from which all body parts and regions are described regardless of position –Body is standing upright –Feet are shoulder width apart –Upper limbs at the sides of trunk –Head and palms facing forward Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 The Anatomical Position and Directional Terms (2 of 4) Directional Terms—Describe the relative locations of body parts and markings to ensure accurate communication among scientists and healthcare professionals •Anterior/Posterior—Anterior refers to the front and posterior refers to the back; Can refer to body as a whole or to a body part •Superior/Inferior—Superior, or cranial, means towards the head and inferior, or caudal, means towards the tail; Used to refer to positions on head, neck, and trunk only Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 The Anatomical Position and Directional Terms (3 of 4) Directional Terms (continued) •Proximal/Distal—Proximal means closer to the point of origin and distal means further from the point of origin; Used to refer to positions on the limbs only •Medial/Lateral—Medial refers to a position closer to the middle line of the body, called the midline, and lateral refers to a position farther away from the midline •Superficial/Deep—Superficial refers to structures closer to the surface of the body and deep refers to structures farther below Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 The Anatomical Position and Directional Terms (4 of 4) Figure 1.7 Directional terms. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Medical Errors •Most medical errors occur when a patient is dispensed the wrong type or dose of medication •Occasionally, they involve surgery and are known as “wrong site” or “wrong body” procedures when the surgeon operates on the wrong part of the body or even the wrong patient •Precise communication with appropriate use of anatomical terminology is critical to prevent medical errors Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Regional Terms (1 of 7) Regional Terms—The body can be divided into two broad regions: Axial (head, neck, and trunk); and Appendicular (upper and lower limbs or appendages) •Each broad region can be divided into several smaller Regions •Regions may be named as nouns, such as the upper arm or brachium, or as adjective with the addition of a suffix such as -al, which is paired with the word “region” to give us the term brachial region Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Regional Terms (2 of 7) Figure 1.8 Regions of the body. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Regional Terms (3 of 7) Figure 1.8 Regions of the body. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Regional Terms (4 of 7) Table 1.1 Regional Terms Region of the Trunk Pertaining To: Abdominal The abdomen Cervical The neck Gluteal The buttocks Inguinal The groin Lumbar The lower back Pelvic The pelvis Pubic The pubis Sacral The sacrum Sternal The sternum Thoracic The chest Vertebral The spinal column Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Regional Terms (5 of 7) Table 1.1 Regional Terms Region of the Head and Face Pertaining To: Buccal The cheek Cranial The skull Cephalic The head Frontal The forehead Mental The chin Nasal The nose Occipital The back of the head Ocular The eye Oral The mouth Otic The ear Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Regional Terms (6 of 7) Table 1.1 Regional Terms Region of the Upper Limb Pertaining To: Acromial The point of the shoulder Antebrachial The forearm Antecubital The anterior surface of the elbow Axillary The armpit Brachial The arm Carpal The wrist Digital The fingers (or toes) Manual The hand Metacarpal The metacarpals (bones of the hand) Palmar The palm Pollex The thumb Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Regional Terms (7 of 7) Table 1.1 Regional Terms Region of the Lower Limb Pertaining To: Coxal The hip Crural The anterior surface of the leg Femoral The thigh Hallux The great toe Metatarsal The metatarsals (bones of the foot) Patellar The anterior surface of the knee Pedal The foot Plantar The sole of the foot Popliteal The posterior surface of the knee Sural The posterior surface of the leg Tarsal The ankle Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Concept Boost: Putting Anatomical Terms Together (1 of 2) 1.Name the Region—Cervical region 2.Add Descriptive Directional Terms— On anterior side, Lateral to midline; Begins inferior to mental region; Ends superior to thoracic region 3.Describe Depth of Incision—Deep to skin and muscle; Superficial to underlying larynx 4.Put It All Together—Incision on anterior cervical region lateral to midline; Extended vertically 1 centimeter inferior to mental region to 2 centimeters superior to thoracic region; Deep to skin and muscle, but superficial to larynx Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Concept Boost: Putting Anatomical Terms Together (2 of 2) 1.Name the Region—Left Crural 2.Add Descriptive Directional Terms— On anterior and medial side; Proximal to tarsal region and distal to patellar region 3.Describe Depth of Incision—Deep to skin and muscle but superficial to bone 4.Put It All Together—Wound on left anteromedial crural region, 10 centimeters proximal to tarsal region and 6 centimeters distal to patellar region; Pellet is lodged deep to skin and muscle but superficial to bone Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Concept Boost Mini Lecture: Putting Anatomical Terms Together Use the link below to view A D A compliant video: Concept Boost Mini Lecture: Putting Anatomical Terms Together https://mediaplayer.pearsoncmg.com/assets/_video.true/bc_amerman_hap_3_concept-boost_ch1 Loading… Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Planes of Section (1 of 4) Planes of Section—Divide a body or body part for examination •Sagittal Plane—Divides body into right and left sections –Midsagittal Plane: Also called a Median Plane; Sections are equal –Parasagittal Plane: Sections are unequal Figure 1.9a Sagittal plane. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Planes of Section (2 of 4) Planes of Section (continued) •Frontal Plane—Also called a Coronal Plane; Divides body into anterior and posterior sections Figure 1.9b Frontal plane. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Planes of Section (3 of 4) Planes of Section (continued) •Transverse Plane— Also called a Horizontal Plane or Cross Section; Divides body into superior and inferior sections or proximal and distal sections •Oblique Plane—Used less frequently; Taken at an angle Figure 1.9c Transverse planes. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.3 Planes of Section (4 of 4) Study Boost: How to Learn Anatomical Terms •Flashcards are popular because research shows that they work –Make customized flashcards with Practice Anatomy Lab™ Flashcards in the Study Area of Mastering® A&P –Make handwritten flashcards •Don’t forget to “Bring It Back” by quizzing yourself and “Mix It Up” by randomizing the order Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Posterior Body Cavity Cavity—Any space within the body; Protects internal organs and allows them to move Posterior Body Cavity— Located on posterior side of body •Cranial Cavity—Within the skull; Includes the brain •Spinal Cavity—Within the vertebral column; Includes the spinal cord •Both cavities are filled with Cerebrospinal Fluid, which bathes both organs Figure 1.10a Posterior body cavity, lateral view. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Anterior Body Cavity (1 of 8) Anterior Body Cavity—Has two main divisions separated by the muscular diaphragm •Thoracic Cavity is superior to the diaphragm •Abdominopelvic Cavity is inferior to the diaphragm •Smaller cavities exist within the thoracic and abdominopelvic cavities formed by sheets of tissue termed Serous Membranes Figure 1.10b Anterior body cavity, anterior view. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Anterior Body Cavity (2 of 8) Anterior Body Cavity (continued) •Thoracic Cavity –Pleural Cavities—Surround left and right lungs –Mediastinum—Between pleural cavities; Houses heart, great vessels, trachea (windpipe), and esophagus; Not within serous membrane –Pericardial Cavity—Within mediastinum; Within serous membrane that surrounds heart Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Anterior Body Cavity (3 of 8) Anterior Body Cavity (continued) •Abdominopelvic Cavity—Subdivided into superior Abdominal Cavity (diaphragm to bony pelvis) and inferior Pelvic Cavity (within bony pelvis) •Contains organs from digestive, lymphatic, urinary, and reproductive systems •Peritoneal Cavity—Abdominal subcavity found within serous membranes Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Anterior Body Cavity (4 of 8) Abdominopelvic Cavity can be divided into segments by drawing imaginary lines through its surface •One system divides the cavity into four Quadrants –Right and left upper quadrants (R U Q and L U Q); Right and left lower quadrants (R L Q and L L Q) •A second system divides the cavity into nine Regions –Right and left hypochondriac regions, Right and left lumbar regions; Right and left iliac regions; Epigastric region; Umbilical region; Hypogastric region Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Anterior Body Cavity (5 of 8) Figure 1.11 The four quadrants and nine regions of the abdominopelvic cavity. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 Abdominal Pain •Abdominal pain is a common reason for people to seek health care, but the number of structures in the abdominopelvic cavity make diagnoses difficult •The four-quadrant system helps to narrow down potential diagnoses •For example, R L Q pain may be from the appendix, ovaries in female, the first part of the large intestine, or the last portion of the small intestine Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Anterior Body Cavity (6 of 8) Serous Membranes—Thin sheets of tissue that fold over to form continuous double-layered structures filled with Serous Fluid to lubricate organs in the cavity –Visceral Layer—Contacts the organ –Parietal Layer—Attaches to surrounding structures Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Anterior Body Cavity (7 of 8) Serous Membranes (continued) •Pleural Membranes—Surround the lungs; Includes parietal and visceral pleura •Pericardial Membranes—Surround the heart; Includes parietal and visceral pericardium •Peritoneal Membranes—Surround some abdominal organs (Intraperitoneal); Includes parietal and visceral peritoneum •Organs behind the parietal peritoneum are Retroperitoneal Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 The Anterior Body Cavity (8 of 8) Figure 1.13 The serous membranes of the anterior body cavities. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 Medical Imaging (1 of 2) •Used to look inside patients without surgery; Different forms of radiation form images of internal structures often along specific planes •X-Ray uses ionizing radiation; Chest image is shown (top) •Computed Tomography Scan (C T) uses ionizing radiation; 3-D image is computer generated from data; Transverse section of abdominopelvic and peritoneal cavities is shown (bottom) Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.4 Medical Imaging (2 of 2) •Magnetic Resonance Imaging (M R I) involves the body being placed within a magnetic field; 3-D image is computer generated from data; Transverse section of the abdominopelvic cavity is shown Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Core Principles in Anatomy and Physiology Core Principles—Set of basic concepts of anatomy and physiology that are revisited repeatedly in the text; They are related to maintaining the body’s internal environment •Feedback Loops •Relationship of Structure and Function •Gradients •Cell-Cell Communication Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Overall Theme: Physiological Processes Operate to Maintain the Body’s Homeostasis •Homeostasis—The condition in which the body develops and maintains a relatively stable internal environment –Homeostatic Imbalances—Disturbances in homeostasis can lead to disease or death if uncorrected –Regulated Variables—Variables in the internal environment, such as temperature, blood sugar, and many others, are controlled to stay close to a particular normal value –Controlled Variables—Variables that are manipulated to maintain the regulated variables, such as the process that increases blood sugar from stored carbohydrates Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Feedback Loops Are a Key Mechanism Used to Maintain Homeostasis (1 of 8) Feedback Loops—A change in a regulated variable causes effects that feed back and in turn affect that same variable •Made up of a series of events that lead to an output •As the loops continue, this output then influences the events of the loops themselves •Negative Feedback Loops—Oppose the initial change and reduce the output •Positive Feedback Loops—Reinforce the initial change and increase the output Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Feedback Loops Are a Key Mechanism Used to Maintain Homeostasis (2 of 8) Negative Feedback Loops—Promote stability; Negating any stimulus that moves a variable away from homeostasis •Each variable has a Set Point that includes a Normal Range around that set point •The range differs for individual variables Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Feedback Loops Are a Key Mechanism Used to Maintain Homeostasis (3 of 8) Steps of a Negative Feedback Loop 1.Stimulus—Information that a regulated variable is outside the normal range 2.Receptor or Sensor—Cellular structure that registers the stimulus 3.Control Center—Stimulus is sent to the control center (brain or gland) by the nervous or endocrine systems 4.Effector—The cells or organ that will react 5.Responses—Effector causes the response that will return the variable to the normal range Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Feedback Loops Are a Key Mechanism Used to Maintain Homeostasis (4 of 8) Figure 1.14 Control of room temperature by a negative feedback loop. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Feedback Loops Are a Key Mechanism Used to Maintain Homeostasis (5 of 8) Figure 1.15 Control of body temperature by a negative feedback loop. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Feedback Loops Are a Key Mechanism Used to Maintain Homeostasis (6 of 8) Study Boost: Keeping Track of the Body’s Feedback Loops •Feedback loops occur in all body systems so there are many to remember •As you learn new feedback loops, add them to the Feedback Loops Master List page at the front of the Active-Learning Workbook •Use the list to quiz yourself “Bring It Back,” review feedback loops from other chapters “Space It Out,” and have a friend quiz you from the list in a random order “Mix It Up” Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Feedback Loops Are a Key Mechanism Used to Maintain Homeostasis (7 of 8) Positive Feedback Loops—Less common than negative feedback loops; Increases the response to a stimulus; Reinforces the initial stimulus •Will eventually shut off in response to an external stimulus or some outside event that is not part of the positive feedback loop •Positive feedback loops are often found within a negative feedback loop to produce a quicker response Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Feedback Loops Are a Key Mechanism Used to Maintain Homeostasis (8 of 8) Figure 1.16 Control of blood clotting by a positive feedback loop. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Common Misconceptions about Homeostasis (1 of 2) •Misconception 1: Negative feedback is bad for the body; Positive feedback is good –Under normal circumstances, both types of feedback loops promote homeostasis •Misconception 2: Maintaining homeostasis means the body’s internal environment is static or unchanging –Maintenance of normal ranges does not mean the internal environment is unchanging; Changes are normal and are occurring constantly Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Common Misconceptions about Homeostasis (2 of 2) •Misconception 3: Regulatory mechanisms and feedback loops are either “on” or “off,” like a switch –The internal environment is dynamic so feedback loops always exhibit some degree of activity •Misconception 4: Any physiological variable can be controlled –Variables can only be controlled through feedback loops if receptors exist to detect changes in the set point Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 BioFlix: Homeostasis Use the link below to view A D A compliant video: BioFlix: Homeostasis https://mediaplayer.pearsoncmg.com/assets/loMS4qosEmL53haP3z1Z_eWMupIkyIFv Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Childbirth, Pitocin, and Positive Feedback Loops •Childbirth begins when a woman goes into labor, which occurs by a positive feedback loop •Baby’s head stretches the cervix (stimulus); Data from nerves in the cervix (receptors) are sent to the brain (control center); Uterus (effector) produces hormone oxytocin which stimulates uterine contractions (response); This continues and is amplified until the baby is born, which stops the feedback loop •Pitocin is a synthetic version of oxytocin that is used when labor needs to be artificially started, or induced Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Structure and Function are Related at All Levels of Organization Principle of Complementarity of Structure and Function •The form of a structure is such that it best suits its function; Applies to all levels of organization Figure 1.17 The relationship between structure and function. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Gradients Drive Many Physiological Processes Gradients are present any time more of something exists in one area than another and the two areas are connected •Gradients drive many of our physiological processes Figure 1.18 Examples of gradients. Copyright © 2025, 2019, 2016 Pearson Education, Inc. All Rights Reserved 1.5 Cell-Cell Communication is Required to Coordinate Body Functions •Cells communicate with each other to maintain homeostasis •Electrical Signals are transmitted between neighboring cells •Chemical Messengers released from cells may work on neighboring cells or move to other cells through body fluids Figure 1.19 Communication between a nerve cell and a muscle cell.

Absolutely. Your list is very broad, so the best way to study it is not to memorize every disease. We can turn it into a high-yield nursing reviewer based on: What is it? → What will I see? → What should I assess? → What should I do? → What medications/treatments matter? → What is the priority/emergency? → What should I teach? Below is a condensed master reviewer. I’ll keep it nursing-focused and use simple language. ⸻ 🩺 MEDICAL-SURGICAL NURSING REVIEWER 1. ENDOCRINE SYSTEM Diabetes Mellitus Type 1 Type 2 Main problem Little/no insulin Insulin resistance + progressive insulin deficiency Usually Younger onset, but can occur any age More common in adults Treatment Insulin required Lifestyle + oral/injectable meds ± insulin Major acute problems DKA HHS Signs of hyperglycemia “3 Ps” * Polyuria – urinating frequently * Polydipsia – excessive thirst * Polyphagia – excessive hunger Other: * Fatigue * Blurred vision * Slow wound healing * Recurrent infections Hypoglycemia Think FAST: * F – Feeling shaky * A – Altered behaviour/confusion * S – Sweating * T – Tachycardia Treatment if conscious: 15 g fast carbohydrate → recheck glucose in 15 min → repeat if necessary. Examples: * Glucose tablets * Juice * Regular pop If unconscious/severe: * Glucagon if appropriate * IV dextrose in a healthcare setting DKA Usually associated with Type 1. Think: Hyperglycemia + ketones + metabolic acidosis Signs: * Dehydration * Abdominal pain * Nausea/vomiting * Fruity/acetone breath * Kussmaul respirations * Altered LOC Priority treatment: 1. IV fluids 2. Insulin 3. Monitor/correct electrolytes, especially potassium 4. Monitor glucose and acid-base status HHS Usually Type 2. * Extremely high glucose * Severe dehydration * Altered LOC * Little/no significant ketoacidosis Major nursing priority: fluid replacement and monitoring. Diabetes teaching Remember: * Foot care * Inspect feet daily * Proper footwear * Don’t walk barefoot * Don’t cut corns/calluses yourself * Monitor blood glucose * Know signs of hypo/hyperglycemia * Medication adherence * Sick-day management * Regular eye/kidney/foot assessments ⸻ ❤️ 2. CARDIOVASCULAR SYSTEM Stroke Two major types: * Ischemic → blocked blood vessel * Hemorrhagic → bleeding Recognize stroke: BE FAST B – Balance loss E – Eye/vision changes F – Face drooping A – Arm weakness S – Speech difficulty T – Time to call emergency services Nursing priorities * ABCs * Determine last known well * Neurological assessment * Blood glucose * Prepare for CT/imaging * Swallow assessment before oral food/fluids/medications * Prevent aspiration * Maintain safety Do not give food or water until swallowing is assessed. ⸻ Myocardial Infarction (MI) Think: “Time = muscle.” Common symptoms: * Chest pressure/pain * Radiation to arm/jaw/back * Dyspnea * Diaphoresis * Nausea * Anxiety Some patients, especially older adults and people with diabetes, may have atypical or minimal pain. Nursing priorities * ABCs * ECG * Vital signs * Cardiac monitoring * IV access * Blood work including cardiac biomarkers * Oxygen if hypoxemic/clinically indicated * Administer prescribed medications promptly Common medications: * Aspirin * Nitroglycerin * Antiplatelet drugs * Anticoagulants * Beta blockers * Statins Nitroglycerin Can cause: * Hypotension * Headache * Dizziness Never combine nitrates with PDE-5 inhibitors because of potentially severe hypotension. ⸻ Heart Failure Left-sided Think Lungs * Dyspnea * Crackles * Orthopnea * Pulmonary edema * Pink/frothy sputum in severe pulmonary edema Right-sided Think Body * Peripheral edema * Weight gain * JVD * Hepatomegaly * Ascites Nursing priorities * Daily weight * I&O * Respiratory assessment * Edema assessment * Fluid/sodium management as ordered * Medication adherence Sudden weight gain can indicate fluid retention. Common drugs: * Diuretics * ACE inhibitors/ARBs/ARNI * Beta blockers * Mineralocorticoid antagonists * SGLT2 inhibitors * Digoxin in selected patients Digoxin Watch for: * Bradycardia * Nausea/vomiting * Visual disturbances * Dysrhythmias Low potassium increases risk of digoxin toxicity. ⸻ Peripheral Vascular Disease Arterial Think: “Pain + Pale + Pulseless + Cold” * Cool extremity * Weak pulses * Pale colour * Pain with activity * Poor wound healing Venous Think: “Swollen + Warm + Edema” * Edema * Warm skin * Aching * Venous ulcers often near ankles ⸻ 🩸 3. HEMATOLOGY Anemia Reduced oxygen-carrying capacity. Signs: * Fatigue * Pallor * Weakness * Dyspnea * Tachycardia * Dizziness Iron-deficiency anemia May see: * Low hemoglobin * Low ferritin * Microcytic/hypochromic RBCs Iron teaching: * Take as directed * Vitamin C can improve absorption * Dark stools are common * Constipation can occur * Liquid iron may stain teeth ⸻ Leukemia Cancer of blood-forming tissues. Possible findings: * Infection → abnormal WBC function * Anemia → fatigue/pallor * Bleeding → low platelets * Bone/joint pain Think: Leukemia = infection + anemia + bleeding Nursing priorities: * Infection prevention * Bleeding precautions when indicated * Monitor CBC * Oral care * Avoid unnecessary invasive procedures * Monitor treatment adverse effects ⸻ 🍽️ 4. GASTROINTESTINAL SYSTEM Crohn’s vs Colitis Crohn’s Ulcerative Colitis Can affect anywhere mouth → anus Colon/rectum “Skip lesions” Continuous inflammation Transmural Mainly mucosal Fistulas common Bloody diarrhea common Strictures possible Toxic megacolon risk Crohn’s Watch for: * Diarrhea * Abdominal pain * Weight loss * Malnutrition * Fistulas Ulcerative colitis Watch for: * Bloody diarrhea * Abdominal cramps * Urgency * Risk of toxic megacolon ⸻ Diverticulitis Inflammation/infection of diverticula. Signs: * Usually LLQ abdominal pain * Fever * Change in bowel habits During acute inflammation: * Follow prescribed bowel-rest/diet plan * Monitor pain, fever and abdominal status * Watch for perforation/peritonitis ⸻ Colorectal Cancer Red flags: * Change in bowel habits * Blood in stool * Unexplained weight loss * Iron-deficiency anemia * Abdominal discomfort Important: Screening is important even before symptoms occur. ⸻ Constipation Risk factors: * Opioids * Immobility * Low fluid intake * Low fibre * Some medications Management: * Fluids if not contraindicated * Fibre * Activity * Bowel routine * Appropriate laxatives/stool softeners ⸻ Diarrhea Priority concerns: Fluid + electrolytes + cause Assess: * Frequency * Stool characteristics * Blood * Fever * Abdominal pain * Hydration * Recent antibiotics/travel/exposure ⸻ Peptic Ulcer Disease Major complications: * Bleeding * Perforation * Gastric outlet obstruction Warning signs: * Hematemesis * Melena * Sudden severe abdominal pain * Rigid abdomen Common causes: * H. pylori * NSAIDs ⸻ Appendicitis Classic: * Pain may begin around umbilicus and migrate to RLQ * Fever * Nausea/vomiting * Rebound/guarding may occur Priority Prevent rupture. Avoid: * Laxatives * Enemas * Applying heat to abdomen ⸻ 🚰 5. RENAL SYSTEM UTI Symptoms: * Dysuria * Frequency * Urgency * Suprapubic discomfort If infection reaches kidneys: * Fever * Flank pain * Chills * Nausea/vomiting Nursing * Obtain urine specimen correctly * Culture before antibiotics when ordered/appropriate * Encourage fluids if not contraindicated * Complete antibiotics ⸻ Renal Failure Major problems: Think: * Fluid overload * Electrolyte imbalance * Acid-base imbalance * Uremia * Anemia Possible findings: * Edema * Hypertension * Fatigue * Decreased urine output * Nausea * Confusion Particularly important: Hyperkalemia can cause life-threatening dysrhythmias. ⸻ Dialysis Hemodialysis Blood is filtered through a machine. Assess: * Weight * BP * Fluid status * Access site AV fistula Remember: “Feel + Hear” * Thrill → feel it * Bruit → hear it Protect the access: * No BP on that arm * No blood draws on that arm when avoidable * Don’t compress unnecessarily ⸻ Incontinence Types: Stress → coughing/sneezing Urge → sudden strong urge Overflow → bladder doesn’t empty Functional → can’t get to toilet Mixed → combination Management depends on cause. ⸻ 🫁 6. RESPIRATORY SYSTEM COPD Includes chronic bronchitis and emphysema. Common: * Dyspnea * Chronic cough * Sputum * Wheezing * Reduced exercise tolerance Nursing: * Position upright * Pursed-lip breathing * Energy conservation * Smoking cessation * Oxygen as prescribed * Inhaler technique Don’t automatically assume oxygen should be withheld from COPD patients. Oxygen is prescribed/titrated according to the patient’s clinical status and target saturation. ⸻ Asthma Usually reversible airway obstruction/inflammation. Symptoms: * Wheezing * Cough * Dyspnea * Chest tightness Rescue medication Short-acting bronchodilator, e.g. salbutamol. Controller Often: Inhaled corticosteroid Severe attack Red flags: * Difficulty speaking * Severe respiratory distress * Exhaustion * Altered LOC * Silent chest Silent chest = very serious. ⸻ Pneumonia Signs: * Fever * Cough * Sputum * Dyspnea * Crackles * Pleuritic chest pain Nursing: * Oxygen if needed * Antibiotics if bacterial/ordered * Hydration if appropriate * Mobilization * Cough/deep breathing * Monitor respiratory status ⸻ Lung Cancer Risk factors: * Smoking * Environmental/occupational exposures Symptoms: * Persistent cough * Hemoptysis * Weight loss * Dyspnea * Chest pain ⸻ Tuberculosis Classic: * Persistent cough * Fever * Night sweats * Weight loss * Possible hemoptysis Nursing priority Airborne precautions for suspected/confirmed infectious pulmonary TB according to institutional policy. ⸻ Atelectasis Collapsed alveoli, often after surgery. Prevention: * Deep breathing * Coughing * Incentive spirometry * Early mobilization * Adequate pain control ⸻ Pneumothorax Air in pleural space → lung collapse. Possible: * Sudden dyspnea * Chest pain * Decreased/absent breath sounds Tension pneumothorax Emergency. May cause: * Severe respiratory distress * Hypotension * Distended neck veins * Tracheal deviation * Cardiovascular collapse Requires immediate emergency treatment. ⸻ Hemothorax Blood in pleural space. Think: Respiratory compromise + blood loss. Chest tube may be required. ⸻ 🦴 7. MUSCULOSKELETAL Osteoporosis Loss of bone density. Risk: * Fractures * Vertebral compression * Hip fracture Prevention: * Weight-bearing activity * Calcium/vitamin D as appropriate * Fall prevention * Avoid smoking * Limit excessive alcohol ⸻ Fractures Priority: ABCs → bleeding → neurovascular status Assess the 6 Ps: * Pain * Pallor * Pulselessness * Paresthesia * Paralysis * Poikilothermia/coolness Neurovascular assessment is critical. ⸻ Arthritis Osteoarthritis Think: Wear and tear * Pain with activity * Stiffness * Often affects weight-bearing joints Rheumatoid arthritis Think: Autoimmune * Symmetrical joint involvement * Morning stiffness * Systemic effects ⸻ Scoliosis Abnormal lateral curvature of spine. Assess: * Posture * Shoulder/hip asymmetry * Spinal curvature * Respiratory effects if severe ⸻ Multiple Sclerosis Autoimmune demyelinating disease affecting CNS. Possible: * Weakness * Fatigue * Visual disturbances * Sensory changes * Balance problems * Bladder dysfunction Important nursing concept: Fatigue and heat can worsen symptoms. ⸻ 🦠 8. INFECTION/IMMUNE SYSTEM MRSA Methicillin-resistant Staphylococcus aureus. Key: * Resistant to several antibiotics * Contact precautions may be required * Strict hand hygiene ⸻ VRE Vancomycin-resistant enterococci. Key: * Resistant organism * Contact precautions according to facility policy * Hand hygiene * Environmental cleaning ⸻ C. difficile Often associated with antibiotic exposure. Symptoms: * Frequent watery diarrhea * Abdominal cramping * Fever VERY IMPORTANT Soap and water handwashing is preferred because alcohol-based hand sanitizer does not reliably kill C. difficile spores. Use appropriate contact/spore precautions according to facility policy. ⸻ Influenza * Fever * Cough * Myalgias * Fatigue * Headache Prevention: Annual vaccination + respiratory hygiene. ⸻ Sepsis Think: Infection + organ dysfunction Potential signs: * Fever or hypothermia * Tachycardia * Tachypnea * Altered mental status * Hypotension * Reduced urine output * Elevated lactate Nursing priority Recognize early and escalate rapidly. Expect: * Cultures * Lactate * IV fluids when indicated * Prompt antimicrobials when sepsis is suspected * Source control * Frequent reassessment ⸻ 🔬 9. DIAGNOSTIC TESTS Don’t memorize only the test. For every test ask: 1. Why is it being done? 2. What does it tell me? 3. What does the nurse do before? 4. What does the nurse do after? 5. What complications should I watch for? ⸻ CT Uses X-rays to create detailed cross-sectional images. Contrast may be used. Nursing: * Check allergies/previous contrast reactions * Assess kidney function when appropriate * Follow contrast-specific instructions ⸻ MRI Uses magnetic field. NO metal/unsafe metallic objects. Assess: * Implanted devices * Metal fragments * Claustrophobia ⸻ X-ray Useful for: * Fractures * Chest conditions * Some abdominal problems ⸻ Ultrasound Uses sound waves. Common: * Pregnancy * Abdomen * Pelvis * Blood vessels No ionizing radiation. ⸻ Mammogram Breast imaging for screening/assessment. ⸻ Endoscopy Allows direct visualization of GI tract. Nursing: * Usually NPO beforehand * Sedation may be used * Monitor airway and vital signs afterward * Ensure gag/swallow reflex has returned before oral intake when applicable ⸻ Bronchoscopy Visualizes airways. Post-procedure: * Monitor respiratory status * Watch for bleeding * Keep NPO until protective reflexes return if sedated/topical anesthetic used ⸻ Pulmonary Function Tests Measure lung function. Important for: * Asthma * COPD * Other pulmonary disorders ⸻ 🧪 10. LABORATORY VALUES For exams, know what the lab means, not just the number. CBC Hemoglobin/Hematocrit Think: oxygen-carrying capacity Low → anemia/bleeding/etc. WBC Think: infection/inflammation/immune response Platelets Think: clotting Low → bleeding risk. ⸻ INR Measures effect of warfarin therapy. Higher INR generally = increased anticoagulation and bleeding risk. Monitor for: * Bleeding * Bruising * Hematuria * Melena ⸻ Glucose Think: current blood glucose ⸻ HbA1c Think: “3-month-ish glucose picture.” Used for longer-term diabetes management. ⸻ BUN + Creatinine Think: Kidney function. Creatinine is particularly useful when evaluating renal function. ⸻ GFR Estimates kidney filtration. Lower GFR generally = worse kidney function. ⸻ Electrolytes Sodium Think: water balance + neurological function Potassium Think: heart rhythm Abnormal potassium can cause dangerous dysrhythmias. Calcium Think: bones + muscles + nerves ⸻ Cholesterol LDL “Lousy” cholesterol Higher LDL → increased cardiovascular risk. HDL “Healthy” cholesterol Generally protective. ⸻ Urinalysis Can help identify: * UTI * Protein * Blood * Glucose * Ketones * Kidney problems ⸻ Culture & Sensitivity Culture = What organism? Sensitivity = Which antibiotic is effective? ⸻ 💊 11. PHARMACOLOGY For every medication, memorize: Class → Why given → Major adverse effects → Contraindications/precautions → Nursing assessments → Patient teaching ⸻ Acetaminophen (Tylenol) Used for: * Pain * Fever Major concern: Liver toxicity with excessive dosing. ⸻ NSAIDs Examples: * Ibuprofen * Naproxen Watch for: * GI bleeding * Kidney injury * Fluid retention * Cardiovascular risks ⸻ Morphine Opioid. Watch: * Respiratory depression * Sedation * Hypotension * Constipation * Nausea Antidote for opioid-induced respiratory depression: Naloxone ⸻ Antibiotics Key nursing principle: Complete the prescribed course unless directed otherwise. Watch: * Allergic reactions * Diarrhea * Superinfection * C. difficile ⸻ Warfarin (Coumadin) Anticoagulant. Monitor: INR Major complication: Bleeding Teaching: * Consistent vitamin K intake rather than suddenly changing intake * Drug interactions matter * Report unusual bleeding ⸻ Heparin Anticoagulant. Monitor: * Bleeding * Platelets * aPTT for unfractionated heparin, depending on protocol Major complication: Bleeding Important adverse reaction: HIT – heparin-induced thrombocytopenia ⸻ Insulin Major adverse effect: HYPOGLYCEMIA Know: * Onset * Peak * Duration * Administration technique * Glucose monitoring ⸻ Nitroglycerin Used for angina. Can cause: * Headache * Hypotension * Dizziness Avoid with PDE-5 inhibitors. ⸻ Digoxin Remember: “Slow heart + low potassium = danger.” Monitor: * Apical pulse * Potassium * Signs of toxicity ⸻ Diuretics Example: Furosemide (Lasix) Causes: * Increased urine output * Decreased fluid volume Watch: * BP * Electrolytes * Dehydration * Potassium ⸻ Corticosteroids Example: Prednisone Long-term effects: * Infection risk * Hyperglycemia * Osteoporosis * Fluid retention * Skin changes * Adrenal suppression Do not abruptly stop long-term corticosteroids without medical direction. ⸻ Bronchodilators Example: Salbutamol Can cause: * Tremor * Tachycardia * Nervousness ⸻ Inhaled corticosteroids Important: Rinse mouth after use. Helps prevent oral candidiasis. ⸻ Statins Example: Atorvastatin Used to lower cholesterol. Watch: * Muscle pain/weakness * Liver-related adverse effects ⸻ Stool medications Psyllium Bulk-forming. Requires adequate fluid intake unless contraindicated. Docusate Stool softener. Stimulant laxatives Increase intestinal motility. ⸻ 🧠 12. NEUROLOGICAL Seizure During seizure: Protect, don’t restrain. * Protect from injury * Turn to side if possible * Protect airway * Remove nearby hazards * Don’t put anything in mouth * Time the seizure After: * Assess airway * Vital signs * Neurological status * Document characteristics Status epilepticus Emergency. ⸻ Increased Intracranial Pressure Think: Headache + vomiting + decreased LOC + pupil changes Late sign: Cushing’s triad * Increased BP/widened pulse pressure * Bradycardia * Irregular respirations Nursing: * Elevate head as ordered * Maintain neutral neck alignment * Avoid unnecessary stimulation * Monitor neurological status * Prevent hypoxia/hypercapnia ⸻ Parkinson’s Disease Classic: TRAP T – Tremor R – Rigidity A – Akinesia/bradykinesia P – Postural instability Nursing: * Fall prevention * Mobility support * Medication timing * Swallowing assessment * Nutrition ⸻ Spinal Cord Injury Priority: Airway + breathing + immobilization + neurological assessment Possible complications: * Neurogenic shock * Autonomic dysreflexia * Respiratory compromise * Loss of bowel/bladder control * Pressure injuries Autonomic dysreflexia Usually associated with injuries at/above T6. Signs: * Sudden severe hypertension * Headache * Flushing/sweating above injury * Bradycardia Priority: Sit patient upright and identify/remove the trigger. ⸻ 👁️ 13. SENSORY Cataracts Clouding of lens. Symptoms: * Blurred vision * Glare * Reduced visual acuity Treatment: Surgical removal when significantly affecting vision. ⸻ Glaucoma Optic nerve damage often associated with increased intraocular pressure. Key distinction: Glaucoma → pressure/optic nerve Cataract → cloudy lens Acute angle-closure glaucoma: * Severe eye pain * Headache * Halos * Nausea/vomiting * Red eye Emergency. ⸻ Hearing Loss Conductive Problem with sound transmission through outer/middle ear. Sensorineural Problem involving inner ear/auditory nerve. Communication: * Face patient * Speak clearly * Don’t shout * Reduce background noise * Verify understanding ⸻ 🔥 14. BURNS Think: Airway → Breathing → Circulation Inhalation injury Red flags: * Facial burns * Soot * Singed nasal hairs * Hoarseness * Stridor * Carbonaceous sputum Airway edema can worsen rapidly. ⸻ Burn priorities * Airway * Breathing * Circulation * Fluid resuscitation for significant burns * Pain management * Infection prevention * Temperature control * Nutrition * Wound care ⸻ 15. WOMEN’S & MEN’S HEALTH Menopause Decrease in estrogen. Common: * Hot flashes * Night sweats * Sleep problems * Vaginal dryness * Mood changes Long-term: * Bone loss * Cardiovascular considerations ⸻ Birth Control Know: * Effectiveness * How it is used * Contraindications * STI protection Most hormonal birth control does NOT protect against STIs. Condoms help reduce STI transmission. ⸻ STIs Examples: * Chlamydia * Gonorrhea * Syphilis * HPV * Herpes * HIV Nursing: * Testing * Treatment adherence * Partner notification/treatment when appropriate * Safer sex education * Prevention ⸻ Breast Cancer Warning signs: * New breast lump * Skin changes * Nipple changes/discharge * Axillary lymph node changes Know current screening recommendations and individual risk factors. ⸻ Prostate Cancer Possible: * Urinary hesitancy * Weak stream * Frequency * Hematuria Important: Early prostate cancer may have no symptoms. ⸻ 🚨 16. EMERGENCY NURSING Shock Basic concept: Tissues aren’t receiving enough oxygen/perfusion. Signs: * Tachycardia * Hypotension * Altered LOC * Cool/clammy skin in many shock states * Decreased urine output * Tachypnea Major types Hypovolemic → blood/fluid loss Cardiogenic → pump failure Distributive → vasodilation (e.g., septic/anaphylactic) Obstructive → obstruction to circulation Priority: ABCs + identify/treat cause + restore perfusion. ⸻ Hemorrhage Look for: * Tachycardia * Hypotension * Pallor * Weakness * Decreased LOC * Decreased urine output Priority: Control bleeding + support circulation + escalate. ⸻ Anaphylaxis Severe allergic reaction. Signs: * Airway swelling * Wheezing * Dyspnea * Hypotension * Hives * GI symptoms FIRST-LINE MEDICATION: IM epinephrine Do not delay epinephrine while waiting for other treatments. ⸻ 💧 17. FLUID & ELECTROLYTES Dehydration Signs: * Thirst * Dry mucous membranes * Tachycardia * Hypotension * Poor skin turgor * Decreased urine output * Weight loss ⸻ Fluid overload Signs: * Edema * Crackles * Dyspnea * Weight gain * JVD * Hypertension ⸻ Potassium Hypokalemia Think: Weak + irregular heart Causes: * Diuretics * GI losses Hyperkalemia Think: Dangerous heart rhythm Causes: * Renal failure * Tissue breakdown * Certain medications ⸻ Acid-Base Use: ROME Respiratory = Opposite Metabolic = Equal Examples: Respiratory acidosis CO₂ ↑ → pH ↓ Respiratory alkalosis CO₂ ↓ → pH ↑ Metabolic acidosis HCO₃ ↓ → pH ↓ Metabolic alkalosis HCO₃ ↑ → pH ↑ ⸻ 👶 MATERNAL-CHILD NURSING Prenatal Care Monitor: * Maternal vital signs * Weight * Blood pressure * Urine * Fetal growth * Fetal heart rate * Laboratory screening * Risk factors Important warning signs: * Vaginal bleeding * Severe headache * Visual changes * Severe abdominal pain * Fluid leakage * Decreased fetal movement * Sudden swelling/other signs of hypertensive disorders ⸻ Fetal Development High-yield concept: First trimester → organ formation Second trimester → growth and development Third trimester → maturation and preparation for birth ⸻ Labour Stage 1 Onset of true labour → complete cervical dilation. Stage 2 Complete dilation → birth of baby. Stage 3 Birth of baby → delivery of placenta. Stage 4 Immediate postpartum recovery. ⸻ Apgar At approximately 1 and 5 minutes. A P G A R A – Appearance P – Pulse G – Grimace A – Activity R – Respiration Each scored 0–2. Apgar helps assess newborn adaptation; it does not by itself diagnose asphyxia or determine long-term prognosis. ⸻ Newborn Assessment Assess: * Respiratory effort * Heart rate * Temperature * Colour * Tone * Feeding * Reflexes * Weight * Head circumference * Urine/stool ⸻ Breastfeeding Benefits: * Nutrition * Immune protection * Bonding Signs of effective feeding: * Good latch * Audible swallowing * Appropriate wet/dirty diapers * Expected weight pattern ⸻ 👶 PEDIATRIC NURSING Development General progression: Head → toe Simple → complex Large muscles → fine motor Always consider developmental stage when communicating with children. ⸻ Pediatric Safety Big priorities: * Falls * Choking * Burns * Poisoning * Drowning * Car-seat safety * Medication dosing * Safe sleep Medication principle Pediatric medications are often based on: weight (kg) Always verify calculations and concentrations. ⸻ Pediatric Asthma Same basic principles as adults: * Bronchodilator for acute symptoms * Controller medications for long-term control * Trigger avoidance * Asthma action plan ⸻ RSV Common in infants/young children. Signs: * Rhinorrhea * Cough * Wheezing * Increased work of breathing * Poor feeding Priority: Respiratory assessment and hydration. ⸻ Croup Classic: Barking cough + stridor Often worse at night. Severe respiratory distress requires urgent intervention. ⸻ Cystic Fibrosis Thick secretions affect lungs and GI system. Think: “Thick mucus + lung infections + malabsorption.” Nursing: * Airway clearance * Nutrition * Pancreatic enzymes when prescribed * High-calorie/high-protein nutrition * Infection prevention ⸻ Gastroenteritis Major concern: Dehydration. Assess: * Wet diapers/urine * Mucous membranes * Tears * Capillary refill * Weight * Activity/LOC ⸻ Pyloric Stenosis Classic: Projectile, non-bilious vomiting Often occurs in young infants. Possible: * Hunger after vomiting * Dehydration * Weight loss ⸻ ASD vs VSD ASD Hole between atria. VSD Hole between ventricles. VSD can produce: A significant murmur and increased pulmonary blood flow. ⸻ Sickle Cell Disease Problem: Abnormal hemoglobin → sickled RBCs → vaso-occlusion and hemolysis. Crisis triggers: * Dehydration * Infection * Hypoxia * Stress Management: * Hydration * Oxygen if hypoxemic * Pain management * Treat infection * Rest * Disease-specific therapies ⸻ Meningitis Think: Fever + headache + stiff neck + altered mental status May also have: * Photophobia * Vomiting * Seizures Emergency. Use appropriate isolation precautions according to suspected organism and institutional policy. ⸻ Hydrocephalus Excess CSF. Infants may have: * Increasing head circumference * Bulging fontanelle * Irritability * Poor feeding * “Sunsetting” eyes Older children: * Headache * Vomiting * Visual changes * Altered LOC ⸻ 🧠 MENTAL HEALTH NURSING Therapeutic Communication DO: * Use open-ended questions * Listen * Reflect * Clarify * Validate feelings * Maintain appropriate boundaries DON’T: * Give false reassurance * Judge * Argue * Give excessive advice * Say “everything will be fine” ⸻ Depression Symptoms: * Persistent sadness * Anhedonia * Sleep changes * Appetite changes * Fatigue * Poor concentration * Feelings of worthlessness * Suicidal thoughts Nursing priority: Assess suicide risk directly. ⸻ Bipolar Disorder Mania * Elevated/irritable mood * Increased energy * Decreased need for sleep * Rapid speech * Impulsivity * Grandiosity Nursing: * Reduce stimulation * Maintain safety * Set clear limits * Encourage nutrition/hydration * Administer medications as prescribed ⸻ Schizophrenia Positive symptoms: * Hallucinations * Delusions * Disorganized speech/behaviour Negative symptoms: * Flat affect * Social withdrawal * Reduced motivation Communication Don’t argue with delusions. Instead: Acknowledge the patient’s feelings while presenting reality. ⸻ OCD Obsessions: Intrusive thoughts Compulsions: Repetitive behaviours/mental acts ⸻ Eating Disorders Watch: * Electrolytes * Cardiac rhythm * Nutrition * Weight * Refeeding complications * Psychological safety ⸻ Substance Use Priorities: * Airway/breathing/circulation * Overdose recognition * Withdrawal * Safety * Nonjudgmental communication ⸻ 🧪 HIGH-YIELD DIAGNOSTIC TEST THINKING When you see a test question, ask: “Why are they ordering this?” Examples: CT head after sudden neurological deficit → looking for bleeding/structural abnormalities. MRI → detailed soft tissue/neurological/musculoskeletal imaging. ECG → electrical activity/ischemia/dysrhythmia. Troponin → myocardial injury. HbA1c → long-term glucose control. Creatinine/GFR → kidney function. INR → warfarin effect. Culture and sensitivity → organism + effective antimicrobial. Pulmonary function test → lung function/obstruction/restriction. ⸻ 💊 PHARMACOLOGY MASTER MEMORY MAP Instead of memorizing 100 medications individually, memorize the danger associated with each class: Drug/Class Think Insulin Hypoglycemia Opioids Respiratory depression Warfarin Bleeding + INR Heparin Bleeding + HIT Furosemide Fluid/electrolyte loss Digoxin Bradycardia/toxicity ACE inhibitors Hyperkalemia + cough/angioedema Beta blockers Bradycardia/hypotension Steroids Hyperglycemia + infection NSAIDs GI bleeding + kidney injury Statins Muscle/liver effects Bronchodilators Tachycardia/tremor Inhaled steroids Oral candidiasis Antibiotics Allergy + C. diff ⸻ 🚨 THE “PRIORITY QUESTION” METHOD When you’re stuck on an exam question, ask: 1. Is the airway threatened? If yes → AIRWAY 2. Is breathing compromised? If yes → BREATHING 3. Is circulation/perfusion compromised? If yes → CIRCULATION 4. Is there an acute neurological deterioration? Think neurological emergency. 5. Is there a safety risk? Falls, suicide, aspiration, seizures, etc. 6. Which patient is deteriorating? Unstable beats stable. ⸻ ⭐ TOP THINGS I WOULD MEMORIZE FIRST If you have limited study time, prioritize these: 🚨 Emergencies * Anaphylaxis → IM epinephrine * Stroke → BE FAST + last known well * MI → ECG + rapid intervention * Sepsis → early recognition + rapid treatment * Tension pneumothorax → emergency * Severe hypoglycemia → rapid glucose treatment * Status epilepticus → emergency * Increased ICP → neurological deterioration * Hemorrhage → control bleeding + perfusion * Severe burns → ABCs 💊 Medications * Insulin → hypoglycemia * Morphine → respiratory depression * Warfarin → INR/bleeding * Heparin → bleeding/HIT * Digoxin → pulse/potassium/toxicity * Furosemide → fluid/electrolytes * Nitroglycerin → hypotension + PDE-5 interaction * Steroids → infection/hyperglycemia * Antibiotics → allergy/C. diff * Inhaled steroids → rinse mouth 🧪 Labs * Hb → oxygen carrying * WBC → infection/immune response * Platelets → bleeding/clotting * INR → warfarin * Glucose → current sugar * HbA1c → long-term glucose * Creatinine/GFR → kidney * K⁺ → heart rhythm * Na⁺ → neurological/fluid balance * Culture → organism * Sensitivity → antibiotic choice 🩺 Nursing skills * Infection control * Medication administration * IVs * Oxygen * Suction * Tracheostomy * Chest tubes * Urinary catheter * Wound care * Ostomy care * Vital signs * Neurovascular assessment * Respiratory assessment ⸻ 📚 How I’d recommend studying this huge syllabus Don’t try to study all of these diseases in one sitting. Use system blocks: Day 1: Diabetes + cardiovascular Day 2: Respiratory + renal Day 3: GI + liver Day 4: Hematology + immune/infection Day 5: Neuro + musculoskeletal Day 6: Maternal/newborn Day 7: Pediatrics Day 8: Mental health Day 9: Pharmacology Day 10: Labs + diagnostics + clinical skills Day 11: Emergency/priority questions Day 12: Full mixed practice exam + review weak areas For each condition, make yourself answer only 5 questions: 1. What is happening? 2. What will I assess? 3. What is the biggest complication? 4. What will I do first? 5. What do I teach the patient? That approach will help you think like a nurse rather than memorize isolated facts, which matches the study framework you were given.

Tarot Card Meanings (Upright)

7. Swords - Upright

3. Cups - Upright

1. Major Arcana - Upright

5. Pentacles - Upright

9. Wands - Upright

NM III Unit 3: Compensatory treatment strategies for upright and wheelchair mobility

Vocabulary Notes wages Core Image: 働いて得るお金 Synonyms: salary, pay Antonyms: volunteer work Example 1: The company increased wages this year. Example 2: Many workers are asking for higher wages. throughout Core Image: 最初から最後まで全体に広がる Synonyms: all over, across Antonyms: partially Example 1: It rained throughout the day. Example 2: English is spoken throughout Canada. pair up Core Image: 2人・2つを組にする Synonyms: team up, match Antonyms: separate Example 1: We paired up for the project. Example 2: The teacher asked us to pair up. disabled Core Image: 機能・能力が使えない状態 Synonyms: impaired, handicapped Antonyms: able-bodied Example 1: The elevator is disabled right now. Example 2: The city improved access for disabled people. harness Core Image: 力やエネルギーを利用する Synonyms: use, utilize Antonyms: waste Example 1: We must harness solar energy. Example 2: She learned how to harness her emotions. gear Core Image: 目的に合わせた道具・装備 Synonyms: equipment, tools Antonyms: lack Example 1: I need new camping gear. Example 2: His camera gear is expensive. above Core Image: 基準より上 Synonyms: over, higher than Antonyms: below Example 1: The plane flew above the clouds. Example 2: Temperatures are above average today. below Core Image: 基準より下 Synonyms: under, beneath Antonyms: above Example 1: The village is below the mountain. Example 2: His score was below average. vertical Core Image: 縦方向 Synonyms: upright Antonyms: horizontal Example 1: The line is vertical. Example 2: Vertical videos are common now. horizontal Core Image: 横方向 Synonyms: flat Antonyms: vertical Example 1: Draw a horizontal line. Example 2: The building has horizontal windows. ingredient Core Image: 料理や物事を作る材料 Synonyms: component, element Antonyms: whole Example 1: Sugar is an important ingredient. Example 2: Trust is a key ingredient for success. take (someone) by surprise Core Image: 予想外で驚かせる Synonyms: shock, astonish Antonyms: expect Example 1: The news took me by surprise. Example 2: Her sudden visit took us by surprise. uneventful Core Image: 特に何も起こらない Synonyms: quiet, boring Antonyms: exciting Example 1: The flight was uneventful. Example 2: I had an uneventful weekend. viewer Core Image: 見る人 Synonyms: audience, watcher Antonyms: performer Example 1: The show attracted many viewers. Example 2: Viewers loved the final episode. anxious Core Image: 不安で落ち着かない Synonyms: worried, nervous Antonyms: calm Example 1: I feel anxious about the exam. Example 2: She was anxious to hear the results. journey Core Image: ある程度長い旅・過程 Synonyms: trip, voyage Antonyms: stay Example 1: Our journey to Banff was amazing. Example 2: Learning English is a long journey. murder Core Image: 意図的に人を殺すこと Synonyms: kill, homicide Antonyms: save Example 1: The police investigated the murder. Example 2: He was arrested for murder. scenery Core Image: 景色全体 Synonyms: landscape, view Antonyms: ugliness Example 1: The scenery in Vancouver is beautiful. Example 2: We enjoyed the mountain scenery. flirting Core Image: 好意をほのめかして距離を縮める Synonyms: teasing, chatting up Antonyms: ignoring Example 1: He was flirting with her at the party. Example 2: She enjoys flirting for fun. Lapland Core Image: 北欧の雪とオーロラで有名な地域 Synonyms: Arctic region Antonyms: tropics Example 1: Lapland is famous for Santa Claus. Example 2: Many tourists visit Lapland in winter. present Core Image: 目の前に存在する Synonyms: current, existing Antonyms: absent Example 1: All students were present today. Example 2: The present situation is difficult. literally Core Image: 文字通り・本当に Synonyms: actually, truly Antonyms: figuratively Example 1: I was literally shocked. Example 2: He literally ran five kilometers. argue Core Image: 意見をぶつけ合う Synonyms: debate, dispute Antonyms: agree Example 1: They argued about money. Example 2: I don't want to argue with you. register Core Image: 公式に記録・登録する Synonyms: sign up, record Antonyms: withdraw Example 1: I registered for the course. Example 2: Please register your account online. abduction Core Image: 連れ去ること Synonyms: kidnapping Antonyms: release Example 1: The movie was about an alien abduction. Example 2: Police are investigating the abduction. stubborn Core Image: 自分の考えを曲げない Synonyms: persistent, hard-headed Antonyms: flexible Example 1: He is too stubborn to apologize. Example 2: My dog is stubborn sometimes. associate Core Image: 結びつける・関連づける Synonyms: connect, link Antonyms: separate Example 1: People associate Canada with nature. Example 2: I associate this song with my childhood

Impactions, Ectopic Teeth, Molar Uprighting, & Extrusion

NURS 348 — EXAM 4 STUDY GUIDE Hypertension Definition & Overview • Persistent elevation of BP ≥130/80 mmHg (systolic at/greater than 130 OR diastolic at/greater than 80) on at least 2 separate visits, 2+ weeks apart. • Primary (Essential): No identifiable cause, most common (90–95% of cases). • Secondary: Caused by another condition or adverse effects of medications. Etiology/Pathophysiology • ↑ Peripheral resistance and/or ↑ cardiac output → ↑ blood pressure → When blood vessels get narrower (increased resistance) or the heart pumps more forcefully (increased output), pressure inside the vessels rises “like squeezing a hose while water is running” → Over time, this high pressure damages the vessel walls and heart muscle, increasing the risk for atherosclerosis, heart attack (myocardial infarction), and stroke. • ↑ Increased peripheral resistance (arteriolar constriction) → ↑ afterload → left ventricular hypertrophy → heart failure → The heart pushes against more resistance (afterload), making the heart muscle thicker (hypertrophy). Over time, it becomes weaker and can lead to heart failure. • Kidneys retain sodium and water → ↑ circulating volume → The kidneys hold onto extra salt and water, adding more fluid to the blood. More fluid means higher pressure—like overfilling a water balloon. • Activation of renin–angiotensin–aldosterone system (RAAS) = vasoconstriction + fluid retention. RAAS is like the “blood pressure booster” → When this system turns on, blood vessels tighten and the kidneys save even more salt and water, both of which raise blood pressure. Risk Factors: • Primary: family history, ↑ sodium intake, Obesity (BMI >25), African-American ethnicity, smoking, hyperlipidemia, diabetes mellitus, and stress. • Secondary: kidney disease, Cushing’s, pregnancy, pheochromocytoma, medic (steroids, OCPs). Clinical Manifestations (S/S) • Often asymptomatic (“silent killer”)!!! • Headache, dizziness, fainting, vision changes • Retinal damage on exam (cotton wool spots, papilledema). • Note: if blood pressure reading is elevated then take in both arms; pt legs uncrossed, and arms above heart; correct cuff Diagnostics (Dx)/Labs • Multiple BP readings (both arms, sitting and standing) • ECG → Left-Ventricular hypertrophy. evaluates cardiac function. • Labs → ↑ BUN/creatinine (kidney disease), lipids, glucose, cortisol (Cushing’s) Nursing Care / Nursing Interventions • Monitor pt BP regularly and accurately, check both arms/correct cuff • Put on DASH diet (Dietary Approach to Stop Hypertension) Medications • ⭐️Diuretics (first-line): excess fluids, they need to remove; increase urine • Thiazides (hydrochlorothiazide) inhibits water & sodium reabsorption and increases potassium excretion • Side effects/SE: hypokalemia; monitor potassium(K⁺) levels • Loop (furosemide) decreases sodium reabsorption & increase potassium excretion– SE: hypokalemia; monitor potassium(K⁺) levels • Potassium-sparing (spironolactone) – SE: hyperkalemia; monitor potassium levels. EKG: peaked T waves • Also watch out for muscle weakness, irregular, pulse, and dehydration. • ⭐️Calcium channel blockers (verapamil, amlodipine, and diltiazem) Calcium channel blockers relax and widen blood vessels by preventing calcium from entering muscle cells, leading to lower blood pressure (vasodilation) • SE: constipation; take fiber for verapamil, and all can ↓HR • Avoid grapefruit juice ➡️ toxicity, hypotensive effects Calcium= contract • ⭐️ACE inhibitors (lisinopril, enalapril): prevents angiotensin II → vasodilation • SE: - hypotension; monitor BP and pulse HR -hyperkalemia; monitor potassium levels -erectile dysfunction -⭐️cough linked to angioedema (swollen tissue under the skin around lips, tongue, and glottis); report swelling & discontinue med • ⭐️ARBs (valsartan, losartan): for ACE-intolerant pts from cough/hyperkalemia. ARBs lower blood pressure by blocking angiotensin II from binding to its receptors, preventing vasoconstriction, and reducing fluid retention. • SE: angioedema, heart failure, hyperkalemia • Change position, slowly, report, angioedema, edema, and avoid foods that are high in potassium (bananas, potatoes, apricots, spinach, beans); monitor potassium levels • Aldosterone-receptor antagonists (eplerenone, spironolactone): blocks aldosterone action. • SE: kidney damage, hypertriglyceridemia, hyponatremia, and hyperkalemia; monitor kidney function, triglycerides, sodium, and potassium levels • Avoid Grapefruit juice and St. John’s wort, salt substitutes, and potassium rich foods • ⭐️Beta blockers (metoprolol, atenolol): blocks beta receptors (adrenaline/epinephrine) ➡️reduces heart rate, cardiac output, and blood pressure ↓HR, ↓CO; use cautiously in diabetics • SE: -⭐️erectile dysfunction, -Fatigue, weakness, depression -hypoglycemia • Monitor heart rate (hold if HR is less than 60) and do not suddenly stop taking med (cause rebound hypertension); and don’t give to pts with asthma, airway disease (cause bronchospasms) • Central Alpha-2 agonists (clonidine): calm the nerves that raise blood pressure, letting blood vessels, relax, and BP go down, ↓SNS tone • SE: sedation, orthostatic, hypotension, and sexual dysfunction/impotence • Monitor BP and pulse • Alpha-adrenergic blockers (prazosin, doxazosin): vasodilator= relaxed BP; give at night to avoid first-dose hypotension. Start with low dose. • SE: postural hypotension; make sure patient rises slowly and caution. • Monitor BP 2 hrs after initiation Complications • Hypertensive Crisis: usually when patients do not follow the medication regimen • BP >180/120 → organ damage (encephalopathy, renal failure) • S/S: severe headache, dizziness, blurred vision, confusion, epistaxis • Treat: IV antihypertensives (nitroprusside, nicardipine, labetalol); the goal is to lower BP gradually by 20-25% in first hour. Not less than 140/90. Monitor BP every 5-15 mins Patient Education • Adhere to medication regimen, don’t abruptly stop even when you feel better • Change positions slowly • Encourage DASH diet (low sodium, high fruits/veggies, low-fat dairy) ex: grilled salmon, brown rice, steamed broccoli, and low-fat milk • Avoid high-sodium foods. Consume less than 2.3 g/day • Monitor BP at home • Report signs or symptoms of electrolyte imbalances • Encourage Weight loss, exercise 3x weekly • Encourage Smoking cessation • Encourage Limit alcohol (≤2/day men, ≤1/day women) • Manage stress • Report persistent cough or swelling (ACE inhibitor red flag) Peripheral Venous Disorders(PVD) Patho: problems with veins where Deoxygenated blood can't get back to the heart Oxygenated blood pools in the extremities. The valves are preventing backflow. • Venous Thromboembolism (VTE): blood clot that starts in a vein. -Two types: deep vein thrombosis (DVT) and pulmonary embolism (PE) • Venous insufficiency: Improper functioning of the veins. Veins aren’t able to push back blood to the heart which results in swelling, venous stasis ulcers, or cellulitis. Blood can go down into the veins just fine but cannot come back up. a. VTE ex: Deep Vein Thrombosis (DVT) Pathophysiology • Thrombus (Blood clot) forms in deep veins (usually in legs) → can embolize (travel and block vessel) its way to lungs (PE). • Caused by Virchow’s triad: venous/blood flow stasis, endothelial injury, hypercoagulability. Risk Factors • Surgery (hip, knee, prostate) • Immobility • Heart failure • Pregnancy • Family hx • Oral contraceptives or hormone therapy • Cancer • COVID-19 (elevated D-dimer) • Central venous catheters Clinical Manifestations • Note that clients can be asymptomatic • Calf/groin pain (dull/achy), tenderness, warmth, edema • Unilateral swelling • Shallow, irregular shaped wounds • Too much blood, brown/yellow discoloration • Sudden SOB and sharp chest pain → suspect PE • Positioning: “Elevate Veins”, position up in “V” shape, above heart. Worsens: if dangling, sitting/dangling for long periods of time. Diagnostics • ⭐️Venous duplex ultrasonography = gold standard; it’s an ultrasound of Leg to see blood clot/blood flow through the vessel. • ⭐️D-dimer ↑ = clot breakdown evidence • Venogram/MRI if ultrasound inconclusive Nursing Interventions • Bed rest until anticoagulation started • Elevate leg slightly above heart (no knee gatch). Positioning: “EleVate Veins”, think V as veins are up, to keep the veins open. • Warm compresses • DO NOT massage leg • Compression stockings (after swelling ↓) • Encourage early ambulation when safe • SCDS Medications/Procedures (Anticoagulants) stops blood from clotting, another nurse must be with you • Unfractionated heparin (given IV): prevents clots and growth of existing clot; monitor platelets, and aPTT (how long it takes blood to clot) (1.5–2× normal). Must be given in facility. MUST MONITOR CLOSELY • Antidote: protamine sulfate • Low-molecular-weight heparin (Lovenox/enoxaparin): given SubQ, weight-based, prevention and treatment of DVT, given twice daily, can be used in home setting. Don’t need labs. Monitor for bleeding, and take bleeding precautions (Electric razor, soft toothbrush, environment safety) • Warfarin (Coumadin): oral, inhibits vitamin K clotting factors overlaps; combined with heparin 3–4 days until INR 2–3 (takes awhile to kick in; therapeutic affect) • Antidote: vitamin K • Avoid high vitamin K foods (green leafy veggies) • Monitor PT (range: 11-13.5 secs), INR (must know range: 2–3) • Factor Xa inhibitors (fondaparinux; SubQ) (rivaroxaban, apixaban; oral): Prevents development of Thromboses; transitional medication; initial labs are PT and PTT; not routinely • Direct thrombin inhibitors (dabigatran): directly prevents growth of thrombus Formation, given sub Q ; initiate initial lab values only for PT and APTT. • Antidote: idarucizumab • Thrombolytics (tPA): for massive DVT/PE, directly infused into clot, start within 24hrs- 5 days of clot formation; monitor for bleeding, neuro status, dizziness, headache. Take bleeding precautions, pt must use electric razor and, brush teeth with a soft toothbrush. • Inferior vena cava filter: prevents embolus from reaching lungs (PE), inserted in femoral vein; catches blood clot. Used when pt is unresponsive to other treatments. Monitor: bleeding, hematoma, infection, PE (dyspnea, chest pain, tachycardia). Nursing actions: assess circulation and encourage leg exercises/ambulation early, have patient not sit for too long Anticoagulant Therapy Nurse’s Role • Verify labs,;Double-check with another RN for IV heparin, Assess for bleeding (bruises, gums, stools) and Monitor vitals, mental status (signs of intracranial bleed) Reversal Agents • Heparin → protamine sulfate • Warfarin → vitamin K • Dabigatran → idarucizumab Patient Education • Avoid contact sports • Soft toothbrush, electric razor • Avoid sudden diet changes (vitamin K) Complications (anticoagulants) • ⭐️Pulmonary embolism: sudden dyspnea, chest pain, SOB, anxiety, tachypnea → emergency; sit, patient in high Fowlers, and administer oxygen and anticoagulants • ⭐️Ulcer formation(venous): often formed over the medial malleolus, chronic, hard to heal, can reoccur. Can lead to amputation/death. Neuropathic patients might not feel this. Nursing care: Dressing is left 3–7 days; wound vacuums, diet: high in zinc, protein, iron, and vitamins A and C, debride necrotic tissue so wound can heel. Patient Education(Anticoagulants) • Bleeding precautions (soft toothbrush, electric razor) • Report bruising or black stools • Avoid prolonged sitting/crossing legs • Wear compression stockings b. Venous insufficiency Pathophysiology • Valves and legs are damaged due to prolong venous HTN Our previous blood clot Risk factors: • Sitting/standing in one position for a long period of time • Obesity • Pregnancy • Thrombophlebitis Clinical manifestations: • Status dermatitis(brown discoloration along ankles) • Edema • Stasis ulcers around ankles Labs/DX • D-dimer ↑ = clot breakdown evidence, detects clot Nursing interventions: Elevate legs to increase venous return (20 mins, 4-5/day), position: legs above heart, “Elevate Veins”, Apply stockings, and monitor for cellulitis Patient education: avoid sitting/standing still for too long, change positions often, avoid crossing legs, tight clothing. Apply stockings before getting out of bed in the morning Peripheral Arterial Disease (PAD) : affects blood vessels that carry blood away from the heart; artery carries blood away from heart but has difficulty going down to extremities. Pathophysiology • Atherosclerosis in lower extremities → decreased blood flow to tissues. Risk Factors • Smoking, DM, hypertension, hyperlipidemia, obesity, age, sedentary lifestyle. Clinical Manifestations • Intermittent claudication: leg pain with exercise, relieved by rest; not enough oxygen makes the tissue suffer = pain; ischemia • Pain(sharp) that is only relieved when resting in dependent position • Cool, pale, cyanotic skin • Loss of hair on legs, thick toenails • Weak/absent pedal pulses; dorsalis pedis; Doppler(verify), +1 • Numbness, burning at night • No blood and no edema due to an adequate blood flow • Note: think “A” in PAD as Antarctica, where it’s cold! For cold, pale skin! Diagnostics • ⭐️ABI < 0.9 = PAD; ankle pressure compared to break your pressure; expected finding is 0.9–1.3; less than is PAD • ⭐️Arteriography for visualization of occlusion/decreased arterial flow with contrast injection on a x-ray. Monitor for bleeding, hemorrhage, marked, pedal pulses • Doppler studies → decreased flow in DM patients • ⭐️Exercise tolerance testing → decreased pressure in lower limbs, read the workload of the heart/circulation, and clarification during exercise. May use treadmill or meds (dipyridamole, adenosine). Finding of a BP/pulse waveform = arterial disease. Monitor vitals before, during, and after. Stop test if chest pain or symptoms are severe. Nursing Interventions • Encourage graded exercise until pain, rest, repeat • Avoid elevating legs above heart (impairs flow) • Avoid cold, caffeine, nicotine, tight clothing • Keep extremities warm (no heating pad), they can’t feel • Foot care: inspect daily, no bare feet, toenails straight Medications • Antiplatelets: (aspirin, clopidogrel) reduces blood viscosity and increases blood flow and extremities. Monitor: bleeding, abdominal pain, black, tarry stools. • Statins: (atorvastatin, simvastatin). Relieved manifestations like intermittent claudication. • Pentoxifylline: improves RBC flexibility (claudication). Monitor for bleeding, abdominal pain, black tarry stools. Procedures • Angioplasty (balloon/stent). Opens and helps, maintain the patency of the vessel, however, laser vaporizes atherosclerosis plaque. Monitor for bleeding, vital signs, pulses, cap Refill. As patients rest limbs are straight for 2-6 hrs before ambulation. Anticoagulant/Antiplatelet therapy given 1-3 months after. • Atherectomy rotation, device removes, arterial plaque. Monitor for bleeding and distal pulses. rest limbs are straight for 2-6 hrs. Anticoagulant/Antiplatelet therapy given 1-3 months after. • Arterial revascularization bypass surgery • Used for clients at risk for losing a limb, severe claudication, or limb pain at rest. It reroutes the circulation around the arterial occlusion. • Post-op: ⭐️ maintain adequate circulation in repaired artery, mark pedal/dorsalis pulses(compare both), monitor color/temp, pain, cap refill, blood pressure (HTN= risk for bleeding; Hypotension=clot risk). • Complications: for these notify provider first -graft occlusion: acute blockage of bypass graft within 24 hr(absent pulse, cold foot, increased pain) -compartment syndrome: tissue pressure restricting blood flow; causing ischemia (numbness, tingling, edema, worsening/passive pain) -infection: infection of site (warm, tenderness, elevated, WBC, purulent drainage, use sterile technique) Patient Education • Walk until pain → rest → walk more • Stop smoking • Avoid crossing legs • Diet low in cholesterol and fat Postoperative Care – Peripheral Bypass/Revascularization Priorities • Assess extremity: color, temperature, cap refill, sensation, pulses q15min ×1hr • Mark pedal pulses before surgery • Maintain adequate BP (avoid hypo or hypertension) • Do not flex hip/knee excessively • Encourage ambulation when ordered • Report sudden pain, loss of pulse, pale/cool extremity = graft occlusion Complications • Graft occlusion, Compartment syndrome, Wound infection Arterial vs. Venous Ulcers Feature Arterial Ulcer Venous Ulcer Location Toes, feet, lateral ankle Medial ankle Appearance Pale, dry, round “punched out”, no drainage Irregular, leaky/moist, brown discoloration Pain Severe, worse with elevation Achy, relieved with elevation Skin Cool, shiny Warm, thickened Treatment Improve arterial flow Compression therapy, elevate legs Valvular Heart Disease OVERVIEW Overview • Stenosis = narrowed opening/thickening and hardening • Regurgitation = backflow of blood • Causes: rheumatic fever, degenerative calcification, endocarditis Diagnostics • Chest X-ray → chamber enlargement • ⭐️ECG → hypertrophy • Echo → valve dysfunction • TEE → direct view of valves ⭐️ Medications overview • Diuretics [furosemide, hydrochlorothiazide, spironolactone]: reduce pulmonary congestion, by removing excessive extracellular fluid. Monitor: hypokalemia, eats foods high in potassium, and administer furosemide IV slowly over 1 – 2 minutes. • Afterload–reducing agents [Beta-blockers (-lol); calcium channel blockers (-dipine); ACE inhibitors (-pril); angiotensin–receptor blockers (-artan); vasodilators (hydralazine]): control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Inotropic agents (digoxin): increases contractility, improves cardiac output. Hold medication if pulse rate (abnormal) is less than 60/min or greater than 100/min. Take medication same time every day, avoid combining with antacids (2hrs). Monitor: toxicity such as weakness, confusion, visual changes, low appetite. • Anticoagulants: reduces risk of thrombus. Monitor: stroke, PT, INR, bleeding/bruising. Procedures • Valvuloplasty (balloon dilation) • Valve replacement • Mechanical = lifelong anticoagulants • Tissue = replace every 7–10 years Patient Education • Prophylactic antibiotics before dental procedures • Good oral hygiene • Daily weights • Sodium restriction • Avoid caffeine/alcohol • Report HF signs (weight gain, edema, SOB) • Avoid alcohol, epinephrine, and ephedrine= can cause dysrhythmias THE 4 VALVULAR DISORDERS Mitral Stenosis Etiology/Pathophysiology: Narrowed mitral valve obstructs blood flow from left atrium (LA) → left ventricle (LV), increasing LA pressure and pulmonary congestion → right-sided heart failure. Often caused by rheumatic fever. Clinical Manifestations: Dyspnea on exertion, orthopnea, pitting edema, fatigue, palpitations, hemoptysis, apical diastolic murmur. Risk Factors: Rheumatic heart disease, aging, congenital malformations. Labs/Diagnostics: Echocardiogram (valve narrowing, pressure gradient), ECG (A-fib), chest X-ray (LA enlargement). Medications/Management: • Diuretics [furosemide, hydrochlorothiazide, spironolactone]: reduce pulmonary congestion, by removing excessive extracellular fluid. Monitor: hypokalemia, eats foods high in potassium, and administer furosemide IV slowly over 1 – 2 minutes. • Afterload–reducing agents [Beta-blockers (-lol); calcium channel blockers (-dipine): control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Anticoagulants: reduces risk of thrombus; prevent emboli from A-fib. Monitor: stroke, PT, INR, bleeding/bruising. • Surgical: Balloon valvuloplasty or valve replacement. NCLEX Tip: Rheumatic fever is the most common cause. Mitral Insufficiency Etiology/Pathophysiology: Incomplete closure of mitral valve causes blood to leak back into LA during systole → LV dilation and hypertrophy. Clinical Manifestations: Fatigue, dyspnea, orthopnea, palpitations, holosystolic murmur at apex, pitting edema, S3 sounds Risk Factors: Mitral valve prolapse, rheumatic disease, MI, endocarditis. Labs/Diagnostics: Echocardiogram (regurgitant volume), ECG (A-fib), BNP (HF indicator). Medications/Management: • Beta-blockers (-lol); ACE inhibitors (-pril); ARBS/angiotensin–receptor blockers (-artan): reduce afterload /control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Diuretics [furosemide, hydrochlorothiazide, spironolactone]: manage fluid overload. Monitor: hypokalemia, eats foods high in potassium, and administer furosemide IV slowly over 1 – 2 minutes. • Anticoagulants if A-fib present; reduces risk of thrombus; prevent emboli from A-fib. Monitor: stroke, PT, INR, bleeding/bruising. • Surgery for severe cases. NCLEX Tip: Afterload reduction decreases regurgitant flow. Aortic Stenosis Etiology/Pathophysiology: Narrowed aortic valve → obstructed LV outflow → ↑ LV pressure → hypertrophy → ↓ cardiac output. Clinical Manifestations: Triad: angina, syncope, dyspnea (heart failure); systolic murmur radiating to carotids. Risk Factors: Aging (calcification), congenital bicuspid valve, rheumatic fever. Labs/Diagnostics: Echocardiogram (valve area), ECG (LV hypertrophy), cardiac cath (pressure gradient). Medications/Management: • Avoid nitrates/vasodilators (can cause hypotension). • Use beta-blockers (-lol) cautiously. reduce afterload /control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Surgical aortic valve replacement (definitive). NCLEX Tip: Do not aggressively lower preload; maintain perfusion. Aortic Insufficiency Etiology/Pathophysiology: Incomplete closure of aortic valve → backflow of blood into LV → volume overload → dilation and LV hypertrophy. Clinical Manifestations: Dyspnea, palpitations, fatigue, bounding (“water hammer”) pulse, wide pulse pressure, diastolic murmur. Risk Factors: Rheumatic fever, endocarditis, Marfan syndrome, trauma. Labs/Diagnostics: Echocardiogram (backflow volume), ECG (LV enlargement), chest X-ray (cardiomegaly). Medications/Management: • Calcium channel blockers (-dipine); ACE inhibitors (-pril); vasodilators (hydralazine]): reduce afterload /control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Diuretics for volume management. • Surgical valve replacement when severe. NCLEX Tip: Bounding pulse and wide pulse pressure are hallmark findings. General Nursing & Exam Focus • Best diagnostic test: Echocardiogram (for all). • Monitor for A-fib in mitral disorders. • Valve replacement (mechanical): Lifelong anticoagulation. • Daily weights & fluid balance: Detect early HF. • Positioning: High-Fowler’s for dyspnea, low-sodium diet. Inflammatory Heart Disorders (Endocarditis, Pericarditis, Myocarditis, Rheumatic Carditis) Risk Factors • IV drug use, valve replacement, streptococcal infection, immunosuppression, lower socioeconomic status Pericarditis: inflammation of the pericardium (sac around heart) -RF: heart attack, lupus, rheumatoid arthriti -Clinical manifestations: Chest pain (relieved when leaning forward), coughing, Pericardial friction rub, fever, dysrhythmias, and SOB -Labs/DX: • High WBCs, EKG showing ST or T spiking, echocardiogram (inflamed heart) -Nursing care/Intervention: address pain/inflammation, and monitor for cardiac tamponade, position, patient upright, leaning forward, and monitor ECG - Medications: NSAIDs, corticosteroids, anti antibiotics for bacterial • Ibuprofen/NSAIDs for inflammation (pericarditis). Avoid if patient has peptic ulcer, monitor for G.I. bleeding, platelets, liver/kidney function. Must be taken with food, avoid alcohol. • Corticosteroids (prednisone) for autoimmune causes (pericarditis/myocarditis). Low-dose first, take with food, and patient must not stop abruptly. Monitor BP, glucose, electrolytes, wounds, infection, sudden weight gain. -Complication: cardiac tamponade → muffled heart sounds, paradoxical pulse, JVD, hypotension (Beck’s triad) Myocarditis: inflammation of the myocardium (heart muscle itself) -RF: viral (covid, Coxsackie), fungal, or bacterial infection; autoimmune disorder -Clinical Manifestations: Tachycardia, chest pain, murmur, friction rub, dysrhythmias, peripheral swelling, cardiomegaly. -Labs/Dx: ECG, echocardiogram, high troponin, CK – MB, ESR in CRP for inflammation/injury -Nursing Care/interventions: monitor for heart failure, and dysrhythmia’s, provide rest and activity restriction -Medication: • Amphotericin B for fungal infection (myocarditis/endocarditis). Monitor liver/kidney function for a G.I. upset. • Corticosteroids (prednisone) for autoimmune causes (pericarditis/myocarditis). Low-dose first, take with food, and patient must not stop abruptly. Monitor BP, glucose, electrolytes, wounds, infection, sudden weight gain. Endocarditis: bacterial infection that leaves inflammation of the endocardium (inner layer of the heart); bacterial or fungal Infection of endocardial tissues that leads to necrosis and embolization of growth -RF: congenital/valvular heart disease, prosthetic valve, IV drug use -Clinical Manifestations: janeway lesions, Fever, murmur, petechiae, splinter hemorrhages (red streaks under nail beds), Osler’s nodes -labs/dx: positive blood culture, echocardiogram -nursing interventions/care: administer IV antibiotics, antipyretics for fever, and anticoagulants, patient should use soft toothbrush, and prophylactic antibiotics before dental/invasive procedures -medication: • Penicillin for infection (rheumatic fever/endocarditis). Monitor for allergic reaction, kidney function/electrolytes. • Amphotericin B for fungal infection (myocarditis/endocarditis). Monitor liver/kidney function for a G.I. upset. Rheumatic Carditis/heart disease: infection of endocardium due to complication of rheumatic fever; GABHS triggers, rheumatic fever leading to inflammatory lesions in the heart -RF: children, Follows untreated strep infection -Clinical Manifestations: tachycardia, Fever, rash(trunk/extremities), joint pain, murmur, chest pain, muscle spasms, friction rub -Labs/Dx: throat culture (strep infection), positive ASO titer, echocardiogram -Nursing care/Interventions: administering antibiotics to stop strep infection, and promote rest, monitor for heart failure, and encourage life on prophylactic antibiotics. -Medications: antibiotics, valve replacement/repair • Penicillin for infection (rheumatic fever/endocarditis). Monitor for allergic reaction, kidney function/electrolytes. Nursing Interventions (Overview for Inflammatory disorders) • Monitor for tamponade & HF • Administer antibiotics (penicillin) • Pain relief (NSAIDs for pericarditis) • Bed rest • Emotional support • Auscultate heart sounds; murmur or friction rub • Collab with cardiologist and physical therapists Procedures (Overview for Inflammatory disorders) • Pericardiocentesis for fluid removal, then sent to laboratory; monitor for recurrence of cardiac tamponade. ( pericarditis.) • Valve surgery if damaged Complications (Overview for Inflammatory disorders) • Cardiac tamponade: medical emergency resulted from fluid accumulation in pericardial sac. S/S: dyspnea, dizziness, tightness in chest, restlessness. Administer IV fluids, notify the provider, obtain chest, x-ray or ECG Cardiac Diagnostics & Vascular Access (Ch. 28) Transesophageal Echocardiography (TEE) Provides clear heart images via probe in the esophagus to detect valve disease, thrombi, or heart failure. NPO 4–6 hr, monitor VS, ECG, and sedation; check gag reflex before eating post-procedure; keep HOB 45°. Stress Testing (Exercise or Pharmacologic) Assesses heart’s response to stress for angina, HF, MI, or dysrhythmia. NPO 2–4 hr, avoid caffeine/tobacco, wear comfortable clothes; stop test for chest pain, SOB, dizziness. Post: monitor ECG & BP until stable. Coronary Angiography (Cardiac Catheterization) Identifies coronary artery blockages using contrast dye via femoral, radial, or brachial artery. NPO 4–6 hr, assess renal function, allergies (iodine/shellfish), and hold metformin 48 hr before/after. Post: monitor VS and site for bleeding, hematoma, or thrombosis, keep limb straight, maintain bedrest. Complications: cardiac tamponade (↓BP, JVD, muffled heart sounds), embolism, hematoma, AKI—notify provider. Teach: report chest pain, bleeding, SOB, avoid lifting >10 lb, and take antiplatelets as prescribed if stent placed. Vascular Access Devices (VADs) Provide reliable central access for fluids, meds, TPN, or blood. Verify tip placement via x-ray before use. PICC: up to 12 mo use, insert in basilic/cephalic vein → SVC; no BP/venipuncture in that arm, keep dressing dry. Tunneled Catheter: long-term use, subcutaneous tunnel prevents infection; no dressing once healed. Implanted Port: long-term chemo access; access with Huber needle, flush with heparin after use. Complications: • Phlebitis: redness, pain, warmth—maintain sterile technique. • Occlusion: flush gently with 10 mL syringe; never force. • Mechanical issues: swelling or pain at port site = dislodgement → notify provider

ORTHO802: Impacted Canine and Molar Uprighting

Floral Tarot (Upright)