MSN > 1-16 > Flashcards

1-16 Flashcards

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1
Q

Describe Celiac Disease

A
  • Lining of the small intestine, intolerant of gluten.

- (avoid BROW) Barley, Rye, Oat, Wheat

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2
Q

Where is celiac disease more pronounced

A
  • duodenum

- jejunum

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3
Q

S/S celiac

A
  • abd pain
  • distention
  • diarrhea (pale, greasy, bulky, foul)
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4
Q

Malnutrition complications of celiac

A
  • rickets
  • occult blood
  • anemia (early bleeds and/or bruises)
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5
Q

Imbalances that can be caused by celiac include hypo_____ and hypo_____

A
  • hypomagnesemia

- hypocalcemia

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6
Q

s/s of hypomagnesemia and hypocalcemia

A
  • irritability
  • tremors
  • convulsions
  • tetany (muscle spasms)
  • bone pain
  • osteomalacia (softening of bones)
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7
Q

_____ lab is associated with celiac disease

A

IgA

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8
Q

how to dx celiac

A

small intestine biopsy via endoscopy

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9
Q

**normal lab value of IgA-tTg

A

0 - 3 U/mL, or 0.00 - 100.00 ug/g

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10
Q

**normal lab value of total IgA

A

80 – 350 mg/dL

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11
Q

**What is Sjogren’s syndrome

A

disorder of your immune system identified by its two most common symptoms: dry eyes and mouth

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12
Q

Sjogren’s syndrome is mostly in _____ _____

A

older women and primary those with Rheumatoid arthritis or SLE (Systemic lupus erythematosus)

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13
Q

How to test for Sjogren’s syndrome

A

SSA+ and SSB+ antibody test

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14
Q

What affect does cinnamon have on these:

  1. _____ BG
  2. _____ cholesterol
  3. _____ HTN
  4. _____ risk for bleeding
A

↓ blood glucose
↓ cholesterol
↓ hypertension
↓ risk for bleeding

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15
Q

Nursing considerations for cinnamon

A
  • no breastfeeding

- no DM drugs/anticoagulants/heart meds

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16
Q

Bodily affects from Gingko Biloba

A

↓ dementia
↓ erectile dysfunction
↑ bleeding
↓ seizure threshold

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17
Q

What is glucosamine used for

A

osteoarthritis

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18
Q

Perks of green tea

A
  • lose weight

- mental clarity

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19
Q

Green tea can cause _____ and _____ effects of warfarin

A

hepatotoxicity

decrease

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20
Q

what meds to avoid when taking green tea

A
  • vasodilators
  • stimulants
  • psychoactive meds
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21
Q

Perks of lavender

A

↑ relaxation

↓ anxiety, stress, and insomnia

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22
Q

Adverse affects of lavender

A
  • constipation
  • HA
  • ↑ appetite
  • may ↓ BP
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23
Q

what meds to avoid when taking lavender

A
  • BP meds

- depressents

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24
Q

What is Saw Palmetto used for

A

BPH

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25
What is Kava used for
anxiety | *can be hepatotoxic*
26
Is comfrey PO okay
NO!! can cause sever liver poisoning It's a topical cream
27
What is Ma Huang/Ephedra/Ephedrine
stimulant, helps with asthma and bronchitis
28
**What is Hypoplastic Left Heart Syndrome (HLHS)
birth defect where you're born with an open foramen ovale and ducturs arteriosus ↓ developed L ventricle & ↓ developed valves (mitral, aortic) (hole between L&R atria) - ASD - PFO
29
Survival rates of HLHS
3-5y is 70% with Stage 1 repair, 90% survival once they hit 12 months
30
Tx of HLHS
- surgery | - fetal shunts
31
testing of HLHS
- prenatal ultrasound and echo | - after birth s/s (after ductus arteriosus & foramen ovale close)
32
Tx for HLHS. Describe patent ductus arteriosus
- Stage 1 at <2 weeks (Norwood): shunt to pulm artery created (from aorta to R ventricle) - Stage 2: shunt removed at 4-6 months
33
Tx for HLHS. Describe patent foramen ovale (PFO)
hole connecting R atrium to L atrium closed
34
Tx for HLHS. Describe Stage 3 (Fontan) at 18-36 months
IVC connected to Pulm artery, hole made from the IVC conduit attached to the right atrium
35
s/s of HLHS
- tachypnea - SOB - ↑HR (or pounding heart) - poor sucking/feedings - poor extremity blood flow (cold and cyanotic, clammy) - weakness
36
Medications for HLHS
- tube feedings - meds to strengthen heart muscles - ↓ BP - diuretics
37
**What does parathyroid secrete
regulates serum Ca+
38
↑ PTH hormone released = ↑ _____ released from the bones into the bloodstream, _____ density/hardness.
Ca+ | ↓
39
Hyperparathyroidism s/s
- low PTH (because excess was released into the blood) - osteoporosis - kidney stones - ↑ urination - abd pain - fatigue - fortgetfullness - bone/joint pain
40
What are calicimimetics used for
to help bones retain calcium
41
What are calicimimetics used for
slow/prevent bone loss
42
Hypoparathyroidism s/s
- high PTH (because not released into bloodstream) - low T3/T4 - parasthesia - muscle cramps - mood changes - dry/rough skin - twitching facial muscles
43
Tests for hypo/hyperparathyroid
- ultrasound - bone densitometry - body CT/MRI
44
normal Ca+ lab levels
8.6-10.3
45
normal PTH lab levels
11-51
46
what is Hutchinson-Gilford Progena Sx
genetic, rapid aging (10x faster) - no cure - appears by age 2 (live to 13 avg, up to 20 years)
47
Hutchinson-Gliford Progeria Sx: | - _____ gene protein mutation (protein-______): causing...
- LMNA - progerin - causing cells to die prematurely
48
s/s Hutchinson-Gliford Progeria
- slow growth (height, hair) - alopecia - joint abnormalities - wrinkles - dry skin - FTT - delayed tooth development
49
**Treatment of Hutchinson-Gliford Progeria
- NSAIDS - Statins - Bone health meds - OT/PT
50
Treatment of Diabetic Neuropathy
- gabapentin/neurontin - duloxetine/cymbalta - pregabalin/lyrica
51
What is hydrotherapy used for
MS and MG
52
**Pneumothorax vs hemothorax
- both decrease lung sounds - pneumothorax: air between lungs and chest cavity = ↑ percussion - hemothorax: blood between lungs and chest cavity = ↓ percussion
53
Describe tension pneumothorax
- mediastinal shift - ↓ CO - ↑ HR
54
Tx of Pneumothorax or hemothorax
chest tube thoracostomy
55
**_____ PPD induration = positive
- >5mm immunocompromised - >10mm for high risk/from countries with TB, prisons, nursing homes, etc. >15mm everyone
56
Other than PPD, test for TB
- chest xray - CT scan - looking for white spots in lungs or immune system walls of TB
57
**Meds for TB
- isoniazid * *- Rifampin (avoid oral contraceptives) - Ethambutol - Pyrazinamide
58
If BCG vax gi en for TB, PPD is expected to be _____ but not positive
>10mm
59
normal TSH labs
- 0.5-5 | - With treatment: 0.5-4
60
normal T3 labs
80-220
61
normal T4 labs
5-12
62
**What 2 autoimmune diseases cause thyroid peroxidase antibodies (TPO)
- hashimotos (hypothyroidism) | - graves disease (hyperthyroidism
63
Describe Hashimotos
- ↑ TSH - high thyroglobulin (Tg)/TPO - initial high T3 then low T3
64
hyperthyroidism causes _____ TSH and high _____
- low TSH | - high T4/T3
65
s/s hyperthyroidism
- thyrotoxicosis - ↑ HR/dysrhythmia/angina - weakness/atrophy - ↑ metabolic rate/appetite - warm/moist skin - ↑ body temp = heat intolerance - stimulatied CNS = nervousness, insomnia, rapid though flow, rapid speech
66
**hypothyroidism causes _____ TSH and low _____
- high | - low T3/T4
67
s/s hypothyroidism
- pale/puffy/expressionless face - cold/dry skin - brittle hair loss - ↓ HR/temp = cold intolerance - lethargy - fatigue
68
Tx of hyperthyroid
- propylthouracil (PTU) - Methimazole (Papazole) - iodine - BB's
69
Explain thyroid storm
- death 48 hrs from internal stress - post-thyroid surgery - High T4 T3 levels from stress s/s - atrial tachy dysrhythmias
70
Chrohn's vs Ulcerative Colitis
- Chrohn's: inflammation/scarring of all digestive tract (generally just small intestines) - Ulcerative Colities: chronic inflammation of large intestine and rectum
71
patients wil atopic dermatitis/eczema are at _____ risk of IBD
increased
72
s/s chrohn's
- skip lesions (cobblestones) - intestinal bleeding/diarrhea/crampin - fistula - fissure - ileus - mouth ulcers - pain worse after eating - naval pain or ↓ abdomen - malabsorption = anemia
73
Tests for Chrohn's
- ASCA protein - CBC - H/H - occult bleeding test - CRP - ESR inflammation - electrolytes for constant diarrhea - iron &/or B12 absorption
74
Meds for chrohn's disease
- aminosalicylate - sulfasalazine - mesalamine - IV corticosteroids for 3-10 days/oral steroids for exacerbation - abx to manage intestinal bacterial overgrowth - Immunosuppressive therapy: methotrexate
75
Diet for chrohn's disease
- low residue/fiber - low fact - probiotics - avoid caffeine/alcohol (dehydration), sharp edges/large grains
76
s/s ulcerative colities
- diarrhea (blood/pus) - cramping - rectal pain/bleedings - urgency plus inability to defecate - wt loss - fatigue - fever - FTT
77
tests for ulcerative colities
- pANCA | - WBC in stool
78
diet for ulcerative colitis
- avoid dairy, big meals, alcohol, caffeine
79
meds for ulcerative colitis
- anti-inflammatories - corticosteroids - immune system suppressors - anti-diarrheals - antispasmodics - iron supplements
80
Newborn sickle cell: - _____ risk for pneumonia d/t non-functional _____ and _____ immune response - infants are _____ - _____/_____ damage - cries from pain
- ↑ risk - non-functional spleens - ↓ immune response - infants = anemic - speel/liver damage
81
Sickle cell crisis: 1. 2. 3.
1. vaso occlusive dactylitis 2. splenic sequestration 3. aplastic crisis
82
s/s vaso occlusive dactylitis
- severe pain/swelling in hands/feet - back/chest pain - fever
83
how to treat vaso occlusive dactylitis
- IV fluids - pain meds - transfusion high glow O2
84
what is splenic sequestration - _____ in hemoglobin - _____ shock - seen in _____
- acute painful enlargement of spleen - drop in hemoglobin - hypovolemic shock - seen in CT
85
s/s aplastic crisis: - sudden _____ - _____ hemoglobin levels - reticulocytopenia (_____)
- sudden pallor & weakness - dropping hemoglobin levels - reticulocytopenia (low immature RBCs)
86
Prevention of sick cell
- hydrate - avoid being too hot or cold - avoid high altitudes with low O2
87
**Tx sickle cell
- pain meds - hydration - O2 - hydroxyurea (prevents abn RBCs) - avoid iron meds - PCN prophylaxis for newborns * *- don't give diuretics
88
sick cell prevention in infants
- vaccines - abx - folic acid - regular eye exams
89
**UTI meds: pregnancy & pediatrics safe
Pregnancy: - fosfomycin (Monurol)(one-time dose) - Floxin - PCN - Nitrofurantoin Pediatrics Safe: * *- Bactrim (Trimethoprim-Sulfa) - Augmentin - Cephalosporins - Suprax - Cefzil - Keflex - if vomiting = IV dose cephalosporins
90
Negative s/s schizophrenia:
- anhedonia (inability to feel pleasure) - alogia (no speech) - avolition (no motivation)
91
first generation meds for schizophrenia
- for positive s/s - -dazine - chlorpromazine - haldol - modecate
92
side effects of 1st gen schizophrenia meds
extrapyramidal symptoms: - dystonia (spasms/muscle contractions) - akathisia (restlessness) - parkinsonism (rigidity) - bradykinesia (slow movement) - tardive dyskinesia (jerky movement) - antimuscarinic effects (dry mouth, constipation, blurred vision, urinary retention) - alpha-1 receptor antagonism (orthostatic hypotension) - histamine antagonist (wt gain, sedation)
93
2nd generation meds for schizophrenia
- for pos & neg symtpoms - risperdal - abilify - zyprexa - seroquel - ziprasidon (geodon)
94
side effects of 1st gen schizophrenia meds
- dry | - metabolic side effects (↑ gain, Dyslipidemia, Hyperglycemia)
95
vitamins that may help schizophrenia
- folic acid | - thiamine (B vitamine)
96
**What is tamsulosin (fosamax) used for
BPH - relaxas muscles - alpha-1 antagonist (hypotension education!!!!!)
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