Study Quiz 2 Flash Cards

 
Pile Management Card
Quiz 2

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Salpingectomy
removal of fallopian tube
Photophobia
light sensitivity
Diplopia
double vision
Pleuritic chest pain
inflammation of the membrane that surrounds and protects the lungs (the pleura).
Who can read a CT scan?
NOT a regular MD
HCG
Human chorionic gonadotropin; preggers test
Troponin
most preferred test used to diagnose cardiac injury. Troponin is an enzyme release into the blood stream by the heart when under stress; if critical, TELL MD!!
hematochezia
bright red, bloody stools; indicates lower gastrointestinal bleeding
melena
black, bloody BMs; A black stool usually means that the blood is coming from the upper part of the gastrointestinal (GI) tract. This includes the esophagus, stomach, and the first part of the small intestine; blood becomes blacks after exposure to digestive juices
Peritoneal signs
rebound tenderness, guarding; inflammation of the peritoneal (abdominal) cavity; if +, possible need for abdominal surgery
Positive GI exam example
MD will indicate which area of the abd demonstrates tenderness (RLQ, etc.) followed by +/- guarding or rebound.
Positive peritoneal signs may be an indication for a surgical abdomen
Negative GI exam example
abdomen is non-tender, normal bowel sounds, no organomegaly
Epigastric pain
Possible reflux-GERD, or worse yet cardiac in origin
gastroenteritis
inflammation of the gastrointestinal tract, involving both the stomach and the small intestine
gastritis
inflammation of the lining of the stomach
Periumbilical pain
Possible gastritis or gastroenteritis- usually viral and resolves on its own. Possible food poisoning
PID
Pelvic inflammatory disease; inflammation of the uterus, fallopian tubes, and/or ovaries
Suprapubic pain
Possible UTI, ovarian cyst, STD’s including PID, urinary retention
paresis
partial paralysis
Gastroparesis
paresis (partial paralysis) of the stomach, resulting in food remaining in the stomach for a longer period of time than normal. The vagus nerve controls stomach contractions. If vagus nerve is damaged, Food then moves slowly through the digestive tract.
NG tube
Nasogastric intubation; plastic tube through the nose, past the throat, and down into the stomach
Colitis
welling (inflammation) of the large intestine (colon)
SBO
Small Bowel Obstruction
diverticultitis vs. diverticulosis
inflammation vs. presence
diverticulosis
presence of the pouches themselves
diverticultitis
Diverticulitis is inflammation of an abnormal pouch (diverticulum) in the intestinal wall. The presence of the pouches themselves is called diverticulosis.
How is appendicitis diagnosed?
US or CT Abd depending on age/fertility of the patient
Signs of appendicitis (a point and 2 signs)
McBurny’s point tenderness/Rovsing’s signs/Psoas sign
Psoas sign
PE maneuver where patient feels abd pain when externally rotating the hip; indicates appendicitis
Rovsing's sign
PE maneuver where pain is elicited in the RLQ when palpating the LLQ
McBurney's point
1/3 of way from right hip bone to belly button
RLQ pain: What does it mean? What test?
Possible Appendicitis --> McBurny’s point tenderness/Rovsing’s signs/Psoas sign. Diagnosed with US or CT Abd depending on age/fertility of the patient
lipase/amylase
diagnoses pancreatitis
LUQ pain: What does it mean? What test?
Possible pancreatitis; diagnosed by lipase/amylase.
Murphy's test
diagnoses possible cholecystitis
RUQ pain: What does it mean? What test?
Possible cholecystitis --> Murphy’s test and diagnosed by US
suprapubic
above the pubis
Epigastric
area above the stomach
Periumbilical
round the umbilicus
Why is coumadin used? What is the risk?
used as prophylactic treatment for clots or ischemia (to help prevent possible CVA) but also increases the patient’s risk of a “bleed” especially in the older population
TPA candidacy is only for people having ______ stroke.
non-hemorrhagic
TPA
Tissue Plasminogen Activator; "coumadin x 10"; clot-busting drug; dissolve blood clots for patients having stroke
Non-hemorrhagic stroke
caused by thrombus or embolus blocking blood supply to a portion of the brain. Patients with non-hemorrhagic stroke are evaluated for potential TPA candidacy. Important to note if “This patient is not a candidate for thrombolytics/TPA
Hemorrhagic stroke
induced by spontaneous eruption of aneurysm, or trauma. Patient’s susceptible to traumatic bleed are elderly patients on blood thinners
2 types of stroke
Hemorrhagic, non-hemorrhagic
paresthesias
A skin sensation, such as burning, prickling, itching, or tingling, with no apparent physical cause
CVA signs
paresthesias, change in speech, vision, mentation, changes in motor function ( facial droop, weakness, paralysis), etc.
CVA
Cerebrovascular accident; abnormal neurological manifestations due to vascular malfunction in the brain
Multiple TIAs are a risk for a...
CVA
Carotid Bruit
abnormal whoosing sound when auscultating the carotid artery; indicates a fatty buildup; sign of higher stroke risk
Endarterectomy
removal of material on the inside of an artery
Carotid endarterectomy
surgical procedure used to prevent stroke, by scraping out plaque in the carotid artery
How is carotid artery disease diagnosed?
carotid duplex
carotid duplex
procedure that uses ultrasound to look for blood clots, plaque buildup, and other blood flow problems in the carotid arteries
Carotid artery
artery that supplies the head and neck with oxygenated blood
TIAs usually caused by...
carotid artery disease
TIA symptoms
difficulty in speaking, dizziness, confusion, or changes in sensation
TIA
Transient Ischemic Attack; momentary/relatively prolonged difficulty in speaking, dizziness, confusion, or changes in sensation that resolves with no medical intervention
Seizure alerts
aura: any missed doses of anti-sz meds?, recent illness, sleep deprivation
febrile sz: rapid increase in body temperature that initiates the sz, not the fever itself
WD sz: induced by recent alcohol cessation
After syncope, what has to be rechecked?
orthostats
ictal
headaches associated with seizure activity
febrile
w/ fever
Seizure types
epileptic, febrile, withdrawal, and pseudo
Seizures
Electrical malfunction in the brain typically causing convulsions. Types include epileptic, febrile, withdrawal, and pseudo
Syncope HPI (3 things)
1. What was happening before?
2. What happened during?
3. How feeling now?
During syncope LOC...
...possible resulting injuries (headache/confusion/memory loss, etc.)
2 types of syncope
witnessed/unwitnessed
near syncope
felt light headed and almost went unconscious
etiology
causes or origin of disease
Prodromal
early symptom indicating the onset of an attack or a disease
Syncope
momentary loss of consciousness due to transient lack of blood supply to the brain
CTA Chest
-diagnose a PE
-injection of contrast tracked at the pulmonary artery to highlight a PE
D-dimer
diagnoses thrombosis
If patient has SOB, what is the concern? What do you do?
PE! r/o w/ D-dimer --> if +, CTA Chest
3 types of blood thinners
1. aspirin
2. coumadin/warfarin
3. lovenox
How is DVT treated?
blood thinners!
thrombophlebitis
blood clot in superficial vein
venous doppler
diagnoses DVT
What are risk factors for DVT?
-long periods of immobilization
-recent prolonged travel
-recent surgeries
-history of blood clots
-pregnancy
-birth control
-smoking
thoracentesis
drains fluid in pleural cavity if pleural effusion occurs
Pleural Effusion
accumulation of fluid between the layers of tissue that line the lungs and chest cavity
Nebulizer
device used to administer medication in the form of a mist inhaled into the lungs
COPD
Chronic obstructive pulmonary disease; emphysema
Chest Wall Pain
muscular pain; result of recent trauma
Pleurisy
Inflammation of the pleura (thin layers of tissue covering the lungs) usually as a result of lower respiratory infection
What is presentation of Costrochondritis/Pleurisy?
Pain with inspiration, coughing or pain reproduced with movement. Breathing limited by pain
Costrochondritis
Inflammation of the cartilage around the ribs; pleuritic pain
Orthopnea
dyspnea when lying flat; has to sleep propped up in a chair
PND
paroxysmal nocturnal dyspnea; sudden, severe shortness of breath at night that awakens a person from sleep; closely associated with CHF
How is CHF treated?
Commonly treated w/ diuretics
CHF
-Congestive heart failure
Pulmonary edema/congestion, low EF (ejection fraction), and increased peripheral vascular resistance combine to cause notably decreased efficiency of the body’s circulatory system
-the heart can't pump enough blood to the body's other organs.
-can result from: narrowed arteries (CAD), past heart attack (scar tissue that interferes with the heart muscles), high blood pressure, cardiomyopathy
EF
ejection fraction
types of stress tests
Stress tests: Treadmill or Nuclear
Adenosine
Vasodilator for stress test
Thallium
radioactive tracer used in stress tests before treadmill
Chest pain may be diagnosed as... (2 things)
ACS or stable/unstable angina
Angina
heart pain; symptom of CAD
ACS
Acute Coronary Syndrome
STEMI
ST Elevation Myocardial Infarction: Active MI. Shown in morphological changes of EKG
Upon MI, what is always given (unless allergy)?
ASA (Aspirin)
SL
sublingual
What can NTG cause?
-vasodilator & decreases pain (drops BP and can cause light-headedness and headache)
-administered by SL spray or 1” patch (paste)
MI
-Myocardial Infarction
-
hypercholesterolemia
high cholesterol
hyperlipidemia
high cholesterol
CAD
Coronary Artery Disease; compromised coronary artery function causing an increased risk of MI. Risk factors include: age, hypertension, hyperlipidemia, history of smoking, obesity, diabetes, ethnicity, family history of cardiac disease
AICD
Implantable Cardioverter Defibrillator/ pacemaker; sense an abnormally slow heartbeat (bradycardia) and send small electrical signals to pace the heart
Stents
wire metal mesh tube used to prop open an artery during angioplasty
Angiogram
visualizes heart lumen; injects a contrast agent into the blood vessel and images using X-ray
CABG
coronary artery bypass graft; Arteries from elsewhere in the body are grafted to the coronary arteries to bypass atherosclerotic narrowings
Hypocapnia
lower-than-normal concentration of carbon dioxide in the blood
Hyponatremia
lower-than-normal concentration of sodium in the blood
Hypokalemia
lower-than-normal amount of potassium in the blood
GERD
Gastroesophageal reflux disease; heart burn
Cholecystolithiasis
stone formation within the gall bladder
nephrolithiasis
condition of having kidney stones
splenectomy
removal of spleen
nephrectomy
removal of kidney
kidney prefixes
renal, nephro
Bowel Resection
art of the large or small intestine is removed; "had 8 feet of bowel removed"
Partial Hysterectomy
the uterus is surgically removed but the cervix is left in place
TAH
total abdominal hysterectomy;
Hysterectomy
surgical removal of the and cervix
Tonsillectomy
surgical removal of the tonsils and adenoids
Mastectomy
surigcal removal of breast(s)
Colectomy
surgical resection of any extent of the large intestine (colon)
D&C
dilation of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage).
Tubal ligation
"tubes tied"
Salpingo-oophorectomy
removal of an ovary together with the fallopian tube
Oophorectomy
surgical removal of an ovary or ovaries
Cholecystectomy
urgical removal of the gallbladder
Appendectomy
surgical removal of the appendix
Differentials
MD's mental "list" of possible diagnoses; MD rules out differentials based on PE
MDM
Medical Decision Making
What is subjective? Objective?
Sub: HPI, ROS, PMH
Ob: PE
What 5 thing do MD/scribe do?
HPI: history of present illness (what brought patient in today)
ROS: review of systems (other symptoms, not related)
PMH: past medical history
FSHx: family/social history (smoke, drink, etc.)
PE: physical exam (full body)
(MDM)
(Differential Diagnosis)
Possible dispositions
discharge, admit, transfer, expired, AMA (against medical advice)
What are the vitals?
1. blood pressure
2. O2 saturation
3. body temp
4. heart rate
5. resp rate
What does triage nurse do?
vitals, CC, short hx, level of acuity assigned
Door to Dispo stops
1. Triage (RN): vitals, CC, short hx, level of acuity assigned
2. Bed assignment
3. Primary nurse assessment
4. MD/Scribe
5. Waiting for labs and test results
6. Determine the disposition: discharge, admit, transfer, expired, AMA
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