Med Surg 1 Final Review Handicap: societal participation is used in WHO classification system, instead of handicap, to acknowledge that the environment is always interacting with people to either a... ssist or hinder participation in life activities Neutropenic precautions: Blood Transfusions: Acute hemolytic reaction o S/S of transfusion reactions: fever, chills, respiratory o Risks: arm stiffness and ringing in ears are complications of blood transfusions Anemia: o Patho: condition in which the hemoglobin concentration is lower than normal Iron Deficiency Anemia: o Patho: anemia caused by dietary problems (low iron), chronic blood loss, or malabsorption Vitamin B12 Deficiency: Pernicious anemia o Patho: anemia from impaired DNA synthesis b/c of lack of Vitamin B12; also r/t faulty absorption in Folate Deficiency: o Patho: anemia caused by a deficiency of folic acid Sickle Cell Anemia: o Patho: severe hemolytic anemia; results from inheritance of the HbS gene Aplastic Anemia: o Patho: deficiency of all types of blood cells caused by failure of bone marrow development (pancytopenia) Bleeding Disorders: o Patho: failure of normal hemostatic mechanisms (trauma, platelet factor abnormality, coagulation factor abnormality) Immune Thrombocytopenic Purpura: Radiation Therapy: o Used to treat localized lesions, kill tumor, reduce tumor size Chemotherapy: o Treats systemic disease Multiple Myeloma: o Patho: cancer of the bone marrow; myeloma cells replace bone marrow o Patho: uncontrolled proliferation of immature cells (lymphoblasts) derived from the lymphoid stem cell CLL: o Patho: Common in older adults Leukemia: o Patho: Hematopoietic malignancy characterized by unregulated proliferation of leukocytes Lymphoma: o Patho: neoplasms of cells of lymphoid origin; start in lymph nodes but can spread to spleen, GI tract, liver, or bone marrow Hodgkin’s Lymphoma: FEVER & WEAKNESS W/OUT CHILLS Non-Hodgkin’s Lymphoma: Polycythemia Vera: o Patho: Increased volume of RBC’s due to dehydration o Interventions: PHLEBOTOMY- 500 mL of blood o Educate on risk factors HIV: Priority AIDS patient- one with warm flushed skin & tented skin turgor o Interventions: Antiretrovirals o Promote skin integrity (avoid scratching, nondrying soap) Type 1 Hypersensitivity Reaction (IgE): o Patho: Anaphylactic reaction characterized by vasodilation, increased capillary permeability, smooth muscle contraction, laryngeal stridor, angioedema, hypotension, and bronchial, GI, or uterine spasm. Type 2 Hypersensitivity Reaction (IgG or IgM): Type 3 Hypersensitivity Reaction: Type 4 Hypersensitivity Reaction GERD: • Patho: Gastric content leakage into esophagus irritating tissue due to weakness in lower esophageal sphincter Gastritis: • Patho: inflammation of stomach related to alcohol, bile reflux, radiation, autoimmune, ulcers, H. pylori Gastroenteritis: o Patho: inflammation of the GI tract, involves stomach and small intestine Peptic Ulcer Disease: • Patho: erosion of mucosal lining of stomach or duodenum causing dull gnawing epigastric pain Appendicitis: • Patho: inflammation of appendix secondary to kink, occlusion (fecal related) or tumor Diverticular Disease: • Patho: Diverticulum (small pouch-like herniations on lining of bowel most commonly in sigmoid) without inflammation or symptoms: Diverticulosis. Inflammatory Bowel Disease (IBD): • Crohns Patho: transmural thickening granulomas anywhere in GI tract [mouth to anus] (common in ileum and ascending colon) resulting in diarrhea unrelieved by defecation Bowel Obstruction: • Patho: blockage (mechanical/functional) that prevents normal flow of intestinal contents through intestinal tract GI Bleeding: • Patho: bleeding due to gastritis, perforation, hemorrhage from PUD Colon Cancer: • Patho: may start as benign polyp, adenocarcinoma, change in bowel pattern. (pain is a late sign) o History in incidence in family, IBD, high calorie, low fiber diet, high protein diet contributes (red meat) Peritonitis: • Patho: inflammation of peritoneum secondary to infection Acute/Chronic Liver Disease: o Patho: Caused by cirrhosis, which develops from alcoholism or infection (hepatitis) o Results in anorexia, metabolic disorders, nutritional deficiencies Hepatitis A: o Patho: a systemic viral infection that causes necrosis & inflammation of liver cells Hepatitis B: o Patho: Transmitted through blood, saliva, semen/vaginal secretions, & mother to infant o Major cause of cirrhosis and liver cancer Hepatitis C: o Patho: Transmitted through blood (most common), sexual contact, needle sticks, sharing of needles Hepatitis D: o Patho: transmitted through blood and sexual contact Hepatitis E: o Patho: transmitted through fecal-oral route o Patho: necrosis of liver cells, replacement by scar tissue, scar tissue exceeds normal tissue, hobnail appearance Liver Cancer: o Patho: caused by primary liver tumors (HCC), Hepatitis B & C, history of alcoholism, and metastatic cancer Cholelithiasis: o Patho: gallstones (pigment stones or cholesterol stones) Acute Pancreatitis: Serum amylase/lipase (increased serum amylase & urine amylase) o Patho: self-digestion of pancreas by it’s own enzymes (trypsin); caused by Chronic Pancreatitis: Elevated serum amylase/lipase & abnormal glucose tolerance test (not releasing insulin) o Patho: inflammatory disorder characterized by destruction of the pancreas Pancreatic Cancer: o Patho: cancer caused by tobacco use, diabetes, alcohol, chronic pancreatitis, hereditary Teaching for someone going to have fecal occult blood testing (FOBT): Hyperpituitary- Acromegaly: o Patho: increase in serum somatotropin (growth hormone) Diabetes Insipidus: [Dehydrated] fluid volume deficit o Patho: deficiency of ADH so not retaining water o Caused by head injury, infections, or lithium use SIADH: [Intoxication] fluid volume excess o Patho: excessive release of ADH so retain a lot of water o Caused by hypothalamus stimulation (malignancies, head injury/infections, CVA, meds, trauma, pain and stress) Addison’s Disease: o Patho: adrenocortical insufficiency which may be the result of adrenal suppression by exogenous steroid use Cushing’s Disease: o Patho: over secretion of the adrenal cortex o Excess of glucocorticoids- increase in cortisol, aldosterone, & androgens o Interventions: PRIORITY NURSING DIAGNOSIS- RISK FOR INJURY Pheochromocytoma: o Patho: Benign tumor of the adrenal glands Hypothyroidism: o Patho: too little T3 and T4 being released from the thyroid gland Hyperthyroidism: o Patho: excessive output of thyroid hormone (thyrotoxicosis); ELEVATED T3, NORMAL T4, LOW TSH Hyperparathyroidism: o Patho: excessive output of parathyroid hormone Hypoparathyroidism: o Patho: deficiency of parathormone usually due to surgery- thyroidectomy, parathyroidectomy, or radical neck dissection Type 2 Diabetes: o Patho: decreased sensitivity to insulin (insulin resistance) and impaired beta cell function Gestational diabetes: o Patho: pregnancy-induced diabetes Urinary Tract Infection: o Patho: presence of microorganisms in the urinary tract leading to inflammation Urolithiasis & Nephrolithiasis: o Patho: calculi (stones) in the urinary tract or kidney Benign Prostatic Hyperplasia: o Patho: age-associated prostate gland enlargement that can cause urination difficulty o **Difficult urination but voids several times throughout the night** Prostate cancer: o Patho: caused by BPH or Prostatitis- inflammation caused by an infectious agent Bladder Cancer: o Patho: cancer of the bladder Chronic Glomerulonephritis: o Patho: antigen-antibody complex in glomeruli causing inflammation (decreased GFR) Acute Nephritic Syndrome: o Patho: renal disease characterized by massive edema and albuminuria (Postinfectious glomerulonephritis) Nephrotic Syndrome: o Patho: so much inflammation that it seriously damages the glomerular membrane Acute Renal Failure: o Patho: kidneys cannot remove wastes or perform regulatory functions Chronic Renal Failure (ESRD): o Patho: loss of renal function characterized by a GFR less than 20% of normal Renal Cancer: o Patho: tobacco use is a significant risk factor** Dialysis: hemodialysis & peritoneal dialysis o The artificial process of eliminating waste and unwanted water from the blood. Given to patients with Metabolic Acidosis: o Patho: occurs when the body produces too much acid, or when the kidneys are not removing enough acid from the body and they are producing too many hydrogen ions. Caused by- [Show More]
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