Term
|
Definition
Gallstones
Etiology: Abnormal bile composition, biliary stasis (not fully emptying of the gallbladder)
Cholecystitis
Pain: RUQ and R shoulder
Dx: Gallbladder scans, abdominal X-rays, ultrasound, serum amylase, serum lipase, serum bilirubin, CBC |
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Term
| Risk factors of cholelithiasis |
|
Definition
Age
Family history of gallstones
Race (Native American or Northern European heritage)
Obesity
High cholesterol
Rapid weight loss (bariatic surgery)
Female using oral contraceptives
Biliary stasis: pregnant, fasting, prolonged parenteral nutrition
Diabetes mellitus; cirrhosis; ileal disease or resection; sickle cell anemia |
|
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Term
| Treatment of cholelithiasis |
|
Definition
Ursodiol (Actigall)
Chenodiol (Chenix)
Antibiotics
Analgesics
Lithotripsy
Low cholesterol diet
Surgery |
|
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Term
|
Definition
Inflammation of the gallbladder
Etiology: Obstruction of cystic duct by stones |
|
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Term
| Nursing interventions for Cholecystitis |
|
Definition
Hold oral intake (don't want to add to the nausea and vomiting)
Insert NG tube (if ordered)
Administer analgesia-IV
Administer anti-infective
Place patient in Fowler's position
Assess for s/s of infection
nutrition consult (fat-soluble vitamins) |
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Term
|
Definition
It is rare
Etiology: multifactorial
Risks: women
S/S: Intense pain, palpable mass RUQ, jaundice, weight loss
Dx: Liver function tests, CT scan, MRI, ERCP, exploratory surgery |
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Term
| Nursing interventions for Gallbladder cancer |
|
Definition
Palliative care
Comfort maintenance (analgesia)
Sustenance of function level or independence |
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Term
|
Definition
Inflammation of the liver
Etiology: Virus (most common), Alcohol (barrier for transplant list), drugs (Tylenol: limit to 4mg/day), toxins
S/S: Jaundice, pruritis, clay colored stool, brown colored urine, malaise, fatigue, body aches, anorexia, NVD |
|
|
Term
| Dx and treatment of Hepatitis |
|
Definition
Dx: ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Treatment: Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered) |
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Term
|
Definition
Etiology: Fecal-oral contamination
Risks: international travel, close household contact, sexual contact
S/S: abrupt onset, jaundice, clay colored stool, brown colored urine, fatigue, malaise, body aches, anorexia, NVD, pruritis
Dx: ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Treatment: Self-limiting (2months),Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered) |
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Term
|
Definition
Etiology: infected blood/body fluid
Risks: injection drug users, multiple sex partners, male-male sex, hemodialysis, healthcare workers
S/S: Asymptomatic sometimes, slow onset, immune-mediated manifestations (urticaria,arthralgia, serum sickness, glomerulonephritis), jaundice, clay colored stool, brown colored urine, fatigue, malaise, body aches, anorexia, NVD, pruritis
Treatment:Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered) |
|
|
Term
| Diagnosis, complications, and treatment of Hepatitis B |
|
Definition
Dx:ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Complications: Chronic hepatitis, cirrhosis(failing liver, fluid, scarring), liver cancer
Treatment:Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered)
Liver failure: elevated bilirubin, jaundice, ammonia wouldn't be broken down to urea. Could administer lactulose! Need to titrate until patient has 3-5 bowel movements a day, but NO MORE THAN 5! |
|
|
Term
|
Definition
Etiology: infected blood/body fluid
Risk: injection drug users
S/S: Asymptomatic in acute phase, slow onset, no jaundice(often delayed diagnosis), more deadly than other hepatitis's
Dx:ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Complications: Chronic hepatitis, cirrhosis, liver cancer
Treatment: Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered),Often progresses to chronic active hepatitis |
|
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Term
|
Definition
Etiology: Infected blood/body fluid
Risks: only causes infection in presence of hepatitis B
S/S: Abrupt onset, abrupt onset, jaundice, clay colored stool, brown colored urine, fatigue, malaise, body aches, anorexia, NVD, pruritis
Dx:ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Complications: chronic hepatitis, cirrhosis, fulminant hepatitis (adding hep B,D,E)
Treatment:Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered) |
|
|
Term
|
Definition
Etiology: fecal water contaminiation
Risks: developing areas, young adults
S/S: abrupt onset, jaundice, clay colored stool, brown colored urine, fatigue, malaise, body aches, anorexia, NVD, pruritis
Dx: ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Treatment: Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered), severe/fatal in pregnant women |
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Term
|
Definition
Etiology: Hep C(most common),B,D
Risks: as related to specific etiologies (accidental needle sticks, we are worried about HIV and Hep C)
S/S: malaise, fatigue, hepatomegally, occasional jaundice
Dx: ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy, liver enzymes
Complications: cirrhosis, liver cancer, liver failure, liver transplant
Glucose is stored in liver, so if some of the liver was taken out, the way the liver stores glucose is different. Need to keep an eye on the blood glucose levels
Treatment: Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered) |
|
|
Term
|
Definition
Etiology: Hep B,E,D (concurrent)
Risks: as related to specific etiologies
S/S: Jaundice, pruritis, clay colored stool, brown colored urine, malaise, fatigue, body aches, anorexia, NVD
Dx: ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Treatment: Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered) |
|
|
Term
|
Definition
Etiology: alcohol, drugs(Tylenol), toxins(chemicals...safe doses of drugs, food, water, everything)
Risks: as related to specific etiologies
Complications: cirrhosis, liver failure
Dx: ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Treatment: Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered) |
|
|
Term
|
Definition
Etiology: Cell-mediated immune response
Risk: genetics
S/S: Jaundice, pruritis, clay colored stool, brown colored urine, malaise, fatigue, body aches, anorexia, NVD
Complications: cirrhosis, liver failure
Dx: ALT, AST, ALP (all increased), serum bilirubin (increased), viral antigen and/or antibody tests, liver biopsy
Treatment: Self-limiting, antiretroviral, antiviral, interferon, acetaminophen (carefully administered) |
|
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Term
| Nursing interventions for autoimmune hepatitis |
|
Definition
Use standard precautions
Bed rest
Nutrition consult (high calorie)/supplements
Small frequent meals-limit protein
Planned activity/avoidance if strenuous tasks-avoid constipation
Avoidance of alcohol(monitor for withdrawal 24-48hours after last drink)
Monitor potential toxic agents
Skin care (jaundice, pruritis)
Administer analgesia, anti-emetic, antihistamine, vitamin K
Provide education |
|
|
Term
|
Definition
Definition: liver fibrosis(alcoholic, post-hepatic, biliary)
Etiology: Alcohol(most common), chronic hep B or C(mainly C)
Risks: as related to specific etiology
S/S: Hepatomegally, RUQ pain, anorexia, weight loss, weakness, bleeding, ascites(form of 3rd spacing), peripheral edema, anemia, leukopenia, thrombocytopenia
The spleen works with the liver, when it gets enlarged, it does more work, it can start to affect healthy RBC's |
|
|
Term
| Dx, complications, and treatment for cirrhosis |
|
Definition
Dx: liver function tests, CBC, coagulation studies(Ptt, inr, pt), serum electrolytes, bilirubin levels, serum albumin, serum ammonia, serum glucose, serum cholesterol
Complications: Portal hypertension, splenomegaly, ascites, esophageal varices, portal systemic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis (sudden occurrence of an inflamed peritoneal)
Treatment: symptom management (diuretics, laxative/lactulose, anti-infective, blood pressure drugs, iron, vitamin K, anti-anxiety drug e.g. Oxazepam/Serax), avoidance of hepatotoxic agents, sodium restricted diet, vitamin supplements |
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Term
|
Definition
| The involuntary shaking of the hands when patient holds out their hand in a "stop in the name of love" position. |
|
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Term
|
Definition
Can put pressure and pain in the lower back and abdomen
If you have to lay the patient back, hyper-oxygenate them
Measure the ascites at the belly button |
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Term
| Cirrhosis nursing interventions |
|
Definition
Monitor vital signs (hypotension, tachycardia)
Perform neurological assessments
Monitor I&O
Daily weight (assess JVD, abdominal girth, peripheral edema)
Nutrition consult/low sodium, low protein diet
Small frequent meals
Monitor coagulation studies/bleeding risk
Avoid aspirin, NSAIDs, Tylenol
Skin care (pruritis)
Administer prescribed drugs to reduce nitrogenous products
Plan rest periods/activities |
|
|
Term
|
Definition
Etiology: chronic hep B or C, cirrhosis, Aflatoxin, chronic ethanol consumption, non-alcoholic fatty liver(steatohepatiti/NASH)
Risks: Hispanic, blacks(African), Asia
S/S: Weakness, anorexia, weight loss, fatigue, malaise, abdominal pain, palpable mass RUQ, ascites, jaundice, manifestation of liver failure
Dx: liver function tests, CT scan, MRI, biopsy (assess for bruising, hematomas)
Treatment: chemotherapy, radiation, surgery(tumor resection), liver transplant |
|
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Term
|
Definition
Inflammation of the pancreas
Etiology: Alcoholism, gallstones, idiopathic
Risks: blacks, as related to specific etiologies |
|
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Term
|
Definition
Inflammation of the pancreas
Etiology: gallstones(most common), alcohol
Risks: Men, middle-age adults
S/S: abrupt continuous severe epigastric and abdominal pain, radiation to back, positional relief sitting up-leaning forward, N/V, distention, hypo-active bowel sounds, tachycardia, hypotension, elevated temperature, cold clammy skin, possible jaundice, Turner's sign(bruising on the patients back side), and Cullen's sign(bruising around belly button)
Dx: Ultrasound, CT scan, MRI, MRCP
Complications: respiratory failure
Treatment: Self limiting(often), analgesia(need a lot, it is very painful), antibiotics(prophylactic) |
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Term
|
Definition
Chronic inflammation of the pancreas
Etiology: alcohol(most common)
Risks: Alcohol, malnutrition, cystic fibrosis
S/S: recurrent epigastric and abdominal pain, radiation to back, anorexia, N/V, weight loss, flatulence, constipation, steatorrhea(extra fat in feces)
Dx: ultrasound, CT scan, MRI, MRCP, ERCP, biopsy
Complication: malabsorption, malnutrition, peptic ulcer disease, diabetes mellitus
Treatment: analgesia, pancreatic enzyme supplements(given with meals), H-2 blockers, proton-pump inhibitors, surgery |
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Term
| Nursing interventions for chronic pancreatitis |
|
Definition
Monitor vital signs
Perform neurological assessments
Administer analgesic
Maintain NPO(allows time for pancreas to heal)
Monitor I&O
Insert NG tube (if ordered)
Place in fetal position or sitting up-leaning forward
Nutrition consult/low-fat diet
Small frequent meals
Provide cold foods
Administer pancreas enzyme supplements with meals
Monitor related lab values (amylyse, lypase)
Plan rest periods/activities
Encourage smoking cessation |
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|
Term
|
Definition
Etiology: multifactorial
Risks: chronic pancreatitis, cirrhosis, older age, genetics, smoking, DM, obesity
S/S(head of pancreas): epigastric pain, jaundice, clay-colored stool, dark urine, pruritis
S/S(body of pancreas): increased epigastric pain with supine position or meal consumption
S/S(tail of pancreas): Asymptomatic
Dx: ultrasound, CT scan, MRI, ERCP, biopsy
Treatment: chemotherapy, radiation, surgery(Whipple's procedure) |
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Term
|
Definition
| Whipple's procedure that is attached to duodenum |
|
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Term
|
Definition
| Whipple's procedure that is attached to jejunum |
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Term
|
Definition
Etiology: multifactorial
Risks: helicobacter pylori, genetics, chronic gastritis, pernicious anemia, gastric polyps, carcinogenic diet, achlorhydria(low or no production of stomach acid), partial gastric resection, older adults, low SES
S/S: Ulcer-like s/s unrelieved by antacids, weight loss, cachectic (wasting syndrome), palpable mass, occult blood
Dx: CBC(anemia), ultrasound, barium swallow, endoscopy, biopsy
Treatment: Chemotherapy, radiation, total or partial gastrectomy surgery(complication:dumping syndrome) |
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Term
| Nursing interventions for stomach cancer |
|
Definition
Administer analgesia
Small frequent meals(liquids and solids at separate times)
Increase protein and fats(exit stomach slowly)
Decreased simple sugar carbohydrates
Maintain gastrostomy tube
Place in recumbent or semi-recumbent position for 30-60 minutes post meals
Monitor anemia(pernicious/vitamin B12) |
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|
Term
|
Definition
Cancer of the colon or rectum
Etiology: idiopathic
Risks: Older adults, genetics, polyps, inflammatory bowel diseases, high animal fat diet, obesity, smoking, alcohol use
S/S: Asymptomatic(often till advanced), change in bowel habits, pain, anorexia, weight loss, palpable mass
Dx:sigmoidoscopy, colonoscopy, biopsy, CT scan, MRI, ultrasound, guaiac/hemoccult test, CBC, tumor markers
Complications: bowel obstruction, perforation, invasion of adjacent organs
Treatment: chemotherapy, radiation, surgery |
|
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Term
| Nursing interventions for colorectal cancer |
|
Definition
Administer analgesia
Provide support for altered body image
Encourage smoking cessation
Encourage regular exercise and weight control
Nutrition consult/high fruit, high vegetable, low saturated fat, low red meat, fiber supplements
Limit alcohol consumption |
|
|
Term
| Nursing interventions for colostomy |
|
Definition
Stool will be soft form and pasty
Avoid foods that cause excessive odor or gas
Provide education on foods that thicken or loosen stools(diet modification may not be required relative to pre-operative diet)
Monitor output |
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Term
| Nursing interventions (ileostomy) |
|
Definition
Stool will be watery
Avoid foods that cause excessive odor or gas
Avoid foods that may cause blockage(limit high fiber foods too)
Recommend low residue foods
Monitor output |
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|
Term
|
Definition
Definition: soft tissue bleeding related to blunt force
Etiology: blunt force trauma
Risks: as related to specific etiology
S/S: edema, purple-blue discoloration
Dx: H&P
Complications: Hematoma
Treatment: Rest, ice, compression, elevation |
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Term
|
Definition
Definition: stretching injury to muscle/tendon
Etiology: Mechanical overload
Risks: as related to specific etiologies
S/S: pain, limited ROM, muscle spasms, edema
Dx: H&P, X-ray, MRI
Treatment: immobilization, NSAIDs, surgery, rest, ice, compression, elevation |
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Term
|
Definition
Stretch or tear of joint ligaments
Etiology: opposite direction forces
Risks: as related to specific etiologies
S/S: loss of joint function, tear/pop sensation, discoloration, pain, rapid swelling
Dx: H&P, X-ray, MRI
Treatment: immobilization, NSAIDs, surgery, rest, ice, compression, elevation
Guarding behavior of the particular area |
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Term
|
Definition
Damage to shoulder rotator cuff
Etiology: Repetitive stress injury, degenerative injury
Risks: as related to specific etiologies
S/S: shoulder pain, limited ROM
Dx: H&P, X-ray, MRI
Treatment: joint rest, NSAIDs, moist heat, physical therapy, surgery |
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Term
|
Definition
Subluxation (partial dislocation, half in, half out)
Displacement of joint articulation
Etiology: trauma, infection, rheumatoid arthritis, paralysis, neuromuscular disease
Risks: as related to specific etiologies
S/S: Pain, deformity, limited ROM
Dx: H&P, X-ray, MRI
Treatment: Analgesia, manual traction realignment, immobilization, surgery |
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Term
|
Definition
Irritation of the median nerve
Etiology: repetitive use injury
Risks: as related to specific etiologies
S/S: Pain, numbness, tingling of thumb-index-middle fingers
Dx: H&P, Phalen's test, ultrasound, MRI, EMG |
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Term
|
Definition
Inflammation of the bursa
Etiology: repetitive use injury
Risks: as related to specific
S/S: Pain, edema, erythema, heat, guarding
Dx: H&P
Treatment: immobilization, joint rest, ice application, NSAIDs, surgery |
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Term
|
Definition
Disruption of bone continuity
Etiology: trauma
Risks: older age adults
S/S: deformity, edema, pain, numbness, guarding, crepitus, hypovolemic shock, muscle spasms, ecchymosis
Dx: H&P, X-ray, bone scan
Complications: compartment syndrome, fat embolism, DVT, infection, delayed union and nonunion, complex regional pain syndrome(nerve damage causing pain sensations)
Treatment: immobilization, analgesia, NSAIDs, antibiotic, anticoagulant, stool softener, traction, surgery, electrical bone stimulation
For pediatric patients you need to put a new cast on every 2 weeks to make sure there is enough room for growth, if not, one extremity will be shorter than the other. |
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Term
|
Definition
Cutting into the muscle of an arm or leg to relieve pressure caused by compartment syndrome.
Etiology: burn, shin spints, edema |
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Term
|
Definition
| When scar tissue heals wrong and it tightens the skin basically making it like a tourniquet. The surgeon would basically cut out the old scar and leave the wound to heal from the inside out, relieving pressure in the meantime. |
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Term
|
Definition
NEVER put the free weight on the floor
Weight is keeping the bone aligned |
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Term
|
Definition
Partial/total removal of extremity, severed limb
Etiology: trauma, chronic disorder (peripheral vascular disease, DM)
Risks: as related to specific etiologies
Dx(pre-op): Doppler flowmetry, segmental BP, trans-cutaneous partial pressure oxygen, angiography
Dx(post-op): CBC, BMP/CMP
Complications: infection, delayed healing, phantom pain(could last a year or more), contracture
Treatment: analgesia, anti-infective, steroid, histamine H2 antagonist, stool softener, prosthesis |
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|
Term
|
Definition
| It is okay to elevate extremity to limit edema |
|
|
Term
|
Definition
| Hip needs to be in alignment, lay flat on bed, don't elevate leg |
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|
Term
|
Definition
Metabolic disorder, acute inflammation arthritis
Etiology: Hyperuricemia
Risks: Males, age, diet high in meat and seafood, alcohol intake, consumption of sugar in soft drinks, obesity, medications, diuretics, aspirin
S/S: pain, erythema, edema, heat, elevated WBC/ESR, tophi(uric acid crystals that break through the skin around the joints of the fingers), joint stiffness, limited ROM, deformities
Dx: H&P, WBC, ESR, serum creatinine
Complications: kidney stones
Treatment: NSAIDs (Indomethacin), Colchicine, Allopurinol, Uricosuric drugs (Probenecid, Sulfinpyrazone), diet modification(low-purine/protein), adequate fluid intake, avoidance of alcohol, joint rest, joint elevation, ice application |
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Term
|
Definition
Metabolic bone disorder, loss of bone mass with increased risk of fractures
Etiology: Idiopathic, endocrine disorder, cancer
S/S: Loss of height, progressive spine curvature, fractures of forearm-spine-hip
Dx: bone mineral density(BMD), dual-energy X-ray absorptiometry (DXA), CT scan, ultrasound
Complications: fracture
Treatment: biophosphanates, calcium, vitamin D, estrogen replacement therapy (HRT) |
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|
Term
| Risks (modifiable and non-modifiable) for osteoporosis |
|
Definition
Non-modifiable: older age, family history of osteoporosis, history of fracture in a first-degree relative, being female, Caucasian or Asian, being thin and/or having a small frame
Modifiable: low estrogen levels in women(amenorrhea, menopause), low testosterone levels in men, dietary: low lifetime calcium intake, vitamin D deficiency, medication use: corticosteroids, some anti-convulsants, lifestyle: inactivity, smoking, excess alcohol use |
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|
Term
| Osteomalacia/"adult rickets" |
|
Definition
Metabolic bone disorder, inadequate/delayed mineralization of bone matrix causing softening of bones
Etiology: Vitamin D deficiency, phosphate depletion, systemic acidosis, bone mineralization inhibitors, chronic renal failure, calcium malabsorption
Risks: low vitamin D diet, inadequate sun exposure, impaired intestinal absorption, African American
S/S: bone pain, muscle weakness, difficulty making positional changes, waddling gait, dorsal kyphosis, pathological fractures
Dx: X-ray, serum calcium, parathyroid hormone, alkaline phosphatase
Treatment: Calcium, vitamin D, phosphate supplements |
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Term
|
Definition
Degenerative joint disease
Etiology: idiopathic, secondary to risk factors
Risks: older age adult, genetics, obesity, repetitive joint use, heavy lifting
S/S: pain, paresthesia(tingling), stiffness, limited ROM, crepitus
Dx: H&P, X-ray
Treatment: analgesia, NSAIDs, COX-2 inhibitors, ROM exercise, heat-ice application, weight loss, surgery |
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Term
|
Definition
Chronic systemic inflammation of joints
Etiology: autoimmune
Risks: genetics, environmental exposure to infectious agents, heavy smoking
S/S: Insidious(slow onset-it creeps up on people), pain, joint swelling, stiffness, heat
Dx: H&P, X-ray, C-reactive protein(released from liver during times of inflammation), ESR, anti-CCP test, rheumatoid factor
Treatment: NSAIDs, corticosteroid, DMARDs, immunosuppressive therapy, PT/OT, heat-ice application, assistive devices/splints, diet modification, surgery
Pregnant women could have a decrease in RA while pregnancy, but it could come back with a vengeance after giving birth
Worse in the morning and in cold weather |
|
|
Term
| Reactive arthritis/Reiter's syndrome |
|
Definition
Acute inflammatory arthritis(only get this in the presence of another disease)
Etiology: Bacteria
Risks: Genetics(HLA-B27 antigen), HIV
S/S: Asymmetric arthritis of weight-bearing joints
Dx: H&P
Treatment: Self-limiting, NSAIDs, DMARDs, immunosuppressant |
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|
Term
| Systemic Lupus Erythematosus(SLE) |
|
Definition
Chronic inflammation that affects all body systems
Etiology: idiopathic
Risks: Genetic, hormone, environmental factors
S/S: Painful joints, muscle pain, inexplicable fever, red facial rash, alopecia, cyanotic digits, photosensivity, leg edema, periorbital edema, enlarged glands, severe fatigue
Dx: ANA, anti-DNA, CBC, ESR, serum complement, urinalysis, kidney biopsy
Treatment: Avoidance of sunlight, sun screen(SPF 15 at least), topical corticosteroid, avoidance of oral contraceptives, dialysis, kidney transplant |
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Term
|
Definition
Inflammatory disorder
Etiology: Borrelia burgdorferi(tick-borne)
Risks: as related to specific etiology
S/S: Flu-like s/s, rash(bulls-eye shaped), arthalgia, myalgia(muscle pain), tendinitis
Dx: H&P, ELISA
Complications: chronic recurrent arthritis, meningitis, encephalitis, neuropathy, myocarditis, heart block
Treatment: Antibiotic, NSAIDs |
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Term
|
Definition
Bone infection
Etiology: bacteria, fungi, parasite, virus
Risks: older age adult
S/S(local): Drainage, ulceration, edema, erythema, heat, pain
S/S(systemic): Enlarged lymph nodes, fever, chills, malaise, tachycardia, N/V, anorexia
Dx: Bone scan, MRI, WBC, ESR, blood/tissue culture
Treatment: antibiotic, surgery |
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|
Term
| Systemic sclerosis/Scleroderma |
|
Definition
Chronic deposition of excess collagen tissue in skin and internal organs
Etiology: idiopathic
Risks: genetic, immune, environmental factors
S/S: hardening of skin, taut, shiny, hyper-pigmented skin, limited mobility(face, hands), dysphagia, respiratory effects, cardiovascular effects, GI effects, renal effects
Dx: ANA, CBC, ESR, skin biopsy
Treatment: Immunosuppressant, corticosteroid, calcium channel blocker, ACE inhibitor, H2-receptor blocker, antibiotic, physical therapy |
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Term
|
Definition
Chronic progressive dysfunction of exocrine glands
Etiology: Autoimmune
Risks: Older women
S/S: Xerophthalmia(dry eyes), xerostomia(dry mouth), arthritis, dysphagia, pancreatitis, pleuritis, migraine, vasculitis
Dx: H&P, Schirmer's test
Complications: Corneal ulcer, dental caries
Treatment: Artificial tears, saliva substitute/chewing gum, increased fluid intake |
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Term
|
Definition
Chronic musculoskeletal pain
Etiology: idiopathic
Risks: Older women
S/S: Widespread pain, fatigue, sleep disruption, thought/memory disturbance
Dx: H&P, no lab tests, depression, maybe insomnia, agitated, anxiety
Treatment: Aerobic exercise, stretching, antidepressant, analgesia/NSAIDs |
|
|
Term
| Acute/chronic low back pain |
|
Definition
Lumbar, lumbosacral, or sacroiliac back pain
Etiology: Stress, overuse
Risks: As related to specific etiologies, poor ergonomics, obesity, bending at the waist, nurses not raising the bed before moving patients
S/S: Pain, inability to bend, stiff flexed ambulation
Dx: H&P, CT scan, MRI
Treatment: NSAIDs, muscle relaxant, steroid, planned rest, heat-ice application, physical therapy, chiropractic therapy, acupuncture, massage |
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Term
|
Definition
Inflammation of conjunctiva(outer layer covering the eye)
Etiology: Bacterial, virus
Risks: Allergens, chemical irritants, radiation
S/S(acute conjunctivitis): Highly contagious, "pink eye", itching, photophobia, tearing
S/S of trachoma: chronic, redness, eyelid edema, photophobia, tearing, entropion (inversion of lower eyelid), ulceration, scarring
Dx: Culture and sensitivity, flourescein, conjunctival scrapings
Treatment: Antibiotic, antiviral, anti-inflammatory, antihistamine |
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|
Term
|
Definition
Etiology: foreign body, abrasion, laceration
Risks: as related to specific etiologies
Types: corneal abrasion, burns, penetrating trauma, blunt trauma
Dx: H&P, opthalmoscopic exam, facial x-ray, CT scan, ultrasonography
Treatment: Irrigation(from inner canthus to outer), antibiotic, analgesic |
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Term
|
Definition
Opacification/clouding of eye lens
Etiology: congenital, acquired
Risks: age, genetics, long-term sunlight exposure, smoking, alcohol, trauma, diabetes
S/S: Bilateral occurrence with different rates of progression, glare, impaired color discrimination(blue-purple), cloudy gray/white pupil(mature)
Dx:H&P
Treatment: Surgery |
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Term
|
Definition
Optic neuropathy with insidious loss of peripheral vision
Etiology of primary glaucoma: idiopathic, congenital
Etiology of secondary glaucoma: infection, cataract, tumor, hemorrhage, trauma
Risks: as related to specific etiologies
S/S of open-angle glaucoma: PAINLESS, gradual loss of visual fields, increased intra-ocular pressure
S/S of closed-angle glaucoma: SEVERE EYE-FACE PAIN, malaise, N/V, colored halos around lights, sudden decrease in visual acuity, reddened cloudy eye, fixed pupil
Dx: Tonometry, funduscopy, gonioscopy, visual field testing
Treatment of open-angle glaucoma: Beta-adrenergic blocker, adrenergic, prostaglandin analog, carbonic anhydrase, surgery
Treatment of closed-angle glaucoma: diuretic, fast-acting miotic, prostaglandin analog, beta-blocker, adrenergic |
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Term
| Age-related macular degeneration (AMD) |
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Definition
Degeneration of the macula
Etiology: idiopathic
Risks: Aging, female, smoking, genetics, Caucasian, Hispanic
S/S: Blur central vision, intact peripheral vision
Dx: H&P, vision/retinal exam
Treatment of dry AMD(without exudate such as bleeding and drainage): Antioxidant, zinc
Treatment of wet AMD: Laser surgery, photo-dynamic therapy |
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Term
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Definition
Retinal vascular disorder
Etiology: Diabetes disease
Risks: HTN
S/S: Retinal edema, hemorrhage, yellow exudate(opthalmoscope), light glare
Dx: H&P, retinal exam
Treatment: Diabetes management, laser photo-coagulation |
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Term
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Definition
Disruption of retina from choroid
Etiology: Trauma, diseases
Risks: Aging, myopia, aphakia(without a lens)
S/S: Floaters, light flashes, blurry vision
Dx: H&P, retinal exam
Treatment: Cryotherapy, laser photocoagulation, surgery (scleral buckling) |
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Term
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Definition
Surgical removal of an eye
Etiology: Trauma, infection, glaucoma, intractable pain, malignancy
Risks: as related to specific etiologies
Complications: Hemorrhage, infection
Treatment: Pressure dressing (24-46 hour post surgery), warm compresses, antibiotic, prosthesis |
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Term
| Impacted cerumen/foreign body |
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Definition
External auditory canal obstruction
Etiology: Cerumen, foreign body
Risks: Aging, Q-tips, hair pins
S/S: Ear fullness, tinnitus, coughing
Dx: H&P, otoscopy
Treatment: Irrigation, extraction by use of otoscope/ear speculum |
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Term
| Otitis externa/"swimmer's ear" |
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Definition
Inflammation of the ear canal
Etiology: Bacteria, fungus, trauma
Risks: Water sports, hearing aids, ear plugs
S/S: Ear fullness(pressure), pain(auricle manipulation), odorous drainage, edema
Dx:H&P
Treatment: Antibiotic, analgesic, anti-inflammatory |
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Term
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Definition
Inflammation of the middle ear
Etiology: Obstruction of Eustachian tube(equalizes pressure)
Risks: URI, allergies, narrow Eustachian tube
S/S: Decreased hearing, "popping", retraction or bulging of tympanic membrane, pain
Dx: H&P, typanometry, CBC
Complications: Tympanic membrane rupture, vertigo
Treatment: Anti-inflammatory, avoidance of air travel/underwater diving |
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Term
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Definition
Inflammation of the middle ear
Etiology: Bacteria
Risks: URI
S/S: Mild-severe pain, fever, diminished hearing, tinnitus, dizziness, vertigo, mastoid tenderness
Dx: H&P, CBC, otoscopic exam, tympanometry
Complication: tympanic membrane rupture, conductive hearing loss
Treatment: Self limiting, antibiotic, analgesic, antipyretic, antihistamine, heat application |
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Term
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Definition
Conducive hearing loss due to bone malformation in osseous labyrinth
Etiology: Heredity
Risks: Heredity, Caucasian, female
S/S: Asymmetric hearing loss, tinnitus
Dx: Otoscopic exam, Rinne test
Treatment: Hearing aid, sodium fluoride, surgery (stapedotomy) |
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Term
| Meniere's disease/endolymphatic hydrops |
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Definition
Chronic disorder of the inner ear
Etiology: Idiopathic, viral injury(suspected)
Risks: Age 35-60, trauma, bacterial infection, autoimmune processes, vascular disorder, genetic
S/S: Recurrent vertigo, gradual unilateral hearing loss, tinnitus
Dx: Caloric testing, Rinne test(tuning fork behind ear), Weber test(tuning fork on top of head), x-ray, CT scan, glycerol test
Treatment: Diuretic, CNS depressant, anti-vertigo/anti-emetic, antibiotic |
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Term
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Definition
Etiology: congenital, acquired
Risks: older adult
S/S: Increased voice projection, tuning better ear toward speaker, frequent requests for repetition of verbal statements, inappropriate responses to queries
Dx: Rinne test, Weber test, audiometry, speech audiometry, tympanometry, acoustic reflex
Treatment: Hearing aid, surgery |
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Term
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Definition
| Disruption of sound transmission from external auditory meatus to inner ear |
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Term
| Sensorineural hearing loss |
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Definition
| Disruption of inner ear, auditory nerve, or auditory pathways of the brain |
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Term
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Definition
| Conductive and sensorineural hearing loss combined |
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Term
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Definition
| Slow hearing loss associated with aging process |
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Term
Diabetes Mellitus (DM)
Type 1 |
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Definition
Hyperglycemia due to lack of endogenous insulin production
Used to be called Juvenile diabetes
No insulin produced
Tripled in the last 20 years
Without insulin, this person will die
Etiology: Destruction of beta cells in the pancreas(immune-mediated, idiopathic)
Risks: Genetics, viral infection(MMR, coxsackievirus B4), chemical toxin(smoked/cured meat), African American, Asian
S/S: Polyuria, glucosuria, polydipsia, polyphagia, weight loss, malaise, fatigue, blurry vision
Dx: H&P, casual plasma glucose(PG), fasting plasma glucose(FPG), oral glucose tolerance test(OGTT), hemoglobin A1c
Complications: Dawn phenomenon, Somogyi phenomenon, DKA, HHS, hypoglycemia, coronary artery disease(CAD), HTN, stroke, diabetic retinopathy, diabetic nephropathy, infection
Treatment: Insulin, anti-diabetic, diet modification, regular exercise, surgery(pancreas transplant) |
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