Med Surg-office hours 7-16 Exam 3.docx - The most common symptom of rheumatic disease that causes a patient to seek medical attention is PAIN GOUT What

Med Surg-office hours 7-16 Exam 3.docx - The most common...

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Unformatted text preview: The most common symptom of rheumatic disease that causes a patient to seek medical attention is PAIN GOUT What are the clinical manifestations of gout? ­Tophi­­­­Great toe of crystallization ­Severe joint pain in the middle of the night or early morning ­Tenderness in the joint, Warm with red or purple coloring ­Stiffness in the joint !!Avoid foods high in purines KNOW labs RA ­symmetrical joint pain, Swelling, warmth, erythema (reddening of the skin), lack of function Methotrexate­Standard of treatment Relief of symptoms starts 2­6 weeks after treatment starts Raynoud’s Phenomenon­ belching of fingers when exposed to cold NSAID’s take with food to help avoid stomach irritation LUPUS­ Autoimmune Watch for infection Symptom management What symptoms they have and their triggers ­Butterfly rash Sun exposure encourages flare­ups­ Photo sensitivty Peroneal nerve injury­­­­Specific for nerve injury Assess: ­1. Burning ­2. numbness ­3. Tingling Unrelieved pain in a cast must be reported to avoid: 1. necrosis 2. Pressure ulcer formation 3. paralysis 4. impaired tissue profusion Assess fingers for color and temperature, assess for a pressure sore, determine exact site of the pain COMPARTMENT SYNDROME Symptoms: 1. decreased sensory function 2. excruciating pain 3. loss of motion Signs of possible circulatory constriction in a casted extremity: ­­Pain, swelling, discoloration, tingling, numbness, or inability to move fingers or toes, any temperature changes 5P’s for a neurovascular check—MUST KNOW 1. pain 2. pallor 3. pulse 4. parethesia 5. paralysis . Methods for preventing prothesis dislocation: 1. Keep knees apart at al times. 2. Put a pillow between legs when seated 3. Avoid bending forward to pick up object, or when seated in a chair. 4. Use a higher chair for sitting. 5. Use a raised toilet seat 6. Do not flex hip when putting on shoes External Fixator: (used for an open fracture) Monitor every 2­4 hours Pin site Monitor every 8­12 hours Redness, swelling, and pain around site, Check for warmth, and purulent drainage OSTERPOROSIS­ NSAIDS What are the clinical manifestations of osteoarthritis? Pain, Stiffness, functional impairment. Modification of lifestyle Weight bearing exercises Prevention of falls @ risk (41­47 chart in text book ) small boned female HIP FRACTURES Pre­op vs. post op Teaching for patients ­clot prevention ­Injury ­falls Traction vs. buck’s extension Coughing and deep breathing How to reposition them­ using a pillow Foot pumps, or SCD’s for blood clot preventing Neurovascular assessment Intervention to prevent pneumonia SKELETAL Traction Involves pins and limb in traction Weights are free flowing Maintain patient body alignment BUCK TRACTION Muscle spasms Heparin and Lovenox on the exam FRACTURES Assess for circulatory impairments Cast care Plaster cast vs fiberglass Elevate cast to reduce swelling Handle plaster cast with the palms of hands to avoid reshaping the cast. !!Neurovascular assessments OR for open reduction breaks­assess incision post op Chapter 42 checklist PARKINSONS DISEASE Decrease in dopamine neurotransmitter Safety#1 Goals: 1. 2. 3. 4. Improves functional mobility Maintain independence Adequate bowel elimination nutritional status Pyelonnephritis­ Upper urinary tact infection Symptoms: Chills, lower back pain (Flank pain), (costoveterbral angle area) pain with urination, nausea, and vomiting. **Performa a urine culture and sensitivity. STOP SMOKING 4­8 weeks prior to surgery SEIZURES 1.safety 2. education HIV KNOW LABS Relevant Fatigue Fever, diarrhea, (fluid balance problems) Ways to increase adherence to medication T­cell counts from HIV to Aids Pneumocystis pneumonia UTI Cyctitis (bladder infection) Pyelonephritis (kidney/ upper UTI infection) Related to an instruction Kidney stone Renal calculi­ Kidney stones Once stone passes send it to the lab for analysis Might need diet alterations CANCER Nursing management of cancer patient Low platelet count Low WBC count LAB—WBC, RBC, Hgb, Hct, platelet RADIATION THERAPY Complications Skin integrity problems GENDER SPECIFIC Male prostate, BHP symptoms, flomax medication, care of a patient for prostate removal, discharge teaching Women ...
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  • Fall '16
  • Denise Cauble
  • Nursing

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