Med Surg Flashcards

Terms Definitions
scar tissue from inflammation
meds for oral cancer
Which med causes neutropenia?
meds for hiatal hernia
Also known as intravenous hyperailimentation
This is supplying nutrients via IV route
Used on pts. with burns, trauma, cancer, AIDS, malnutrition, anorexia nervosa
lab tests for hiatal hernia
Which med can cause bronchospasms?
The sensation pertaining to spatial-position & muscular-activity stimuli originating from within the body or to the sensory receptors that those stimuli activate?
What is PERRLA?
E- equal
R- reactive
L- to light
A- accommodation
The rate & size of constriction should be equal
About 10 inches long.
No digestion takes place here.
Peristalisis of the esophagus allows food to reach the stomach.
Therapeutic interventions for esophageal cancer
esophageal resection (Dacron)
esophageal dilation (to relieve dysphagia)
watch w/morphin
1. pain relief
2. s/s dehydration
3. lung sounds
4. TPN (may lead to tube feedings)
5. IV fluids
6. I/O
7. S/S hypovolemia shock
they need to be in semi fowlers to high fowlers position
meds/used for stomatitis
topical tetracycline, topical anesthetic
acyclovir ointment for pain
oral acyclovir for reoccurrences
What is the gastric pH range?
Bulimia Nervosa
compulsive eating with self-induced comiting, which is commonly known as binge-purge
 Provides visualization of the lining of the large intestine to identify abnormalities through a flexible endoscope inserted rectally.
complications of gastric surgeries
acute gastric distention
nutritional problems
pyloric obstruction
dumping syndrome
Which med can be sprinkled on applesauce?
Which med causes increase BUN and creatinine?
visualization of the lining of the large intestine to identify abnormalities through a flexible endoscope, which is inserted rectally
What does a serum bilirubin evaluate?
liver function
NSG interventions for anorexia
restoration of nutritional health
nutrition is supplied by IV infusions containing electrolytes
oral food supplements
GI assessment begins with the oral cavity.
The lips are examined for abnormalities.
Look inside the oral cavity for any ulcers, bleeding and discolorations.
Note the odor of the pts. breath
Certain infections carry certain odors
Look at dentures to make sure they properly fit
Look at the pts teeth to see if they may have trouble chewing
Assess their knowledge of dental care.
meds for GERD
1. antacids: mylanta, tums, gaviscon
2. H2 antagonist: (decrease acid) tagamet, zantac, axid
3. proton pump inhibitors (PPI) for severe symptoms and with barretis esophagus: nexium, prevacid, prilosec, aciphex, protonix
4. prokinetic agents (used last D/T side effects): reglan- increase gastric emptying
DG of gastric cancer
upper gastric x-ray examination
gastric fluid analysis
measurement of serum gastrin levels
Usually done by a physician or advanced nurse practitioner
Tympanic sounds indicate the location of air
Dull thuds indiciate fluid or solid organs
Endoscopic Ultrasonography
Performed through the endoscope using sound waves.
Used to detect tumors in various GI structures and organs.
Oral cavity and Pharynx
Teeth begin mechanical digestion.
The tongue is made of skeletal muscle innervated by the hypoglossal nerve which is the twelfth cranial nerve.
The tongues main function is chewing.
What is the degeneration of cartilage from wear and tear; bone spurs formation, often only  one side is effected with changes noted in hands, spine, knees and hips.
Which meds have rash as a side effect?
chronic gastritis (type b)
antrum and pylorus
h-pylori bacteria infection
s/s - poor appetite
sour taste
upper GI
gastric analysis
tx - antibiotitcs
Peptic ulcer disease
caused by gram negative bacteria helicobactor pylori. Lining of the stomach, pylors, duodenum, esophagus is eroded. May extend to the muscular layers of peritoneum D/T increase hydrochloric acid and pepsin. *Most common ulcers duodenum.
Which med should you monitor CBC and liver enzymes with?
surgery for hiatal hernia
funoplication- fundus is wrapped around the lower part of the esophagus
What type of medicines can cause bleeding to the GI tract?
Small intestine
About one inch in diameter and approximately 20 feet long.
Extends from the stomach to the cecum of the colon.
Digestion is complete in the small intestines.
Where does the absorption of most nutrients take place?
small intestines
Where is the majority of water absorbed?
large intestines
Bowel sounds are considered absent if none are heard within ...
5 minutes
What might causee a distention of the abdomen?
An increased in the curve at the lumbar region is?
What is a pathological condition the is caused by the progressive development of arterial vessel compression & reduced blood supply to an extremity?
Compartment Syndrome
What are some symptoms of cataracts?
blurred vision
photo sensitivity
abnormal color perception
difficulty in driving at night
What connect the midbrain to the medulla oblongata. Its the origin of cranial nerves V-VIII. Its composed of mylinated nerve fibers & is responsible for sending impulses to the structures that are inferior & superior to it?
Pons "bridge"
NSG interventions for oral cancer
radical neck dissection
-done when cancer has metasticized to the lymph nodes
Oral cancer
cancer found in the mouth or throat. Highest incidence throat (pharnyx)
Which med do you take on an empty stomach?
Reason for tube feedings
inability to swallow
severe burns or trauma to the face and the jaw
mental retardation
oropharyngeal or esophageal paralysis
comatose pts.
gastric surgeries
(Billroth I)
removes the distal portion (75%) of the stomach
Stool tests
Stool for ova (eggs) and parasites is collected to test for intestinal infections caused by parasites. These usually also require a series of three stool specimens. Stool must be examined within 30 mintues of obtaining the culture.
Interventions for Hiatal Hernia
1.assess for dysphagia after surgery (wrapped to tight)
 3.6 small meals - do not recline x 1hr. after meals
 4.elevate head 6-12ins. bedtime snacks
 6.avoid smoking, caffeine, spicy foods, and alcohol
 What are indicators that the feeding is to fast or too much?
N/V, stomach distention
gastric surgeries
a section of the vagus nerve is cut
What do elderly people use these meds for?
usually arthritis
When is a serum ammonia level elevated?
chronic liver failure, hepatitis
Large Intestines
Extends from the ileum of the small intestine to the anus.
It is about 5 feet long and 2.5 inches in diameter.
No digestion takes place here.
What is a proctosigmoidoscopy used for?
ulcerations, punctures, lacerations, tumors, hemorrihoids, polyps, fissures, fistulas, early malignancies and abscesses
Nausea & Vomiting
nausea is the subjective feeling of the urge to vomit
vomiting is the act of expelling stomach contents from the body through the esophagus and mouth
What is a temporary measure to provide support and comfort to a fractured extremity until a more difinite treatment is initiated called?
Bucks traction
It is applied directly to a bone. Wires and surgical pins are inserted through the bone distal to the fracture site while the pt is under local or general anesthesia. Weights are attached to a rope that is tied to a spreader bar for the purpose of tractio
Sketal traction
What is the most serious form of arthritis & leads to severe crippling. Its chronic, systemic disease?
Rheumatoid Arthritis
What occurs as a result of aabnormal cardiovascular response to stimulation of the  sympathetic division of the autonomic nervous system? 
Autonomic Dysreflexia
Upper GI series with Barium
invasive procedure
(mouth) x-ray of the esophagus, stomach, duodenum and jejunum using a radiopaque oral liquid contrast and fluroscopy to outline contours of these structures.
There are three pairs of salivary glands:
1. parotid
2. submandibular
3. sublingual
Functions of the Large Intestines
1. Stores and then eliminates undigestable material
2. Absorbs water, minerals, and vitamins
3. Elimination of feces
Nsg Interventions for GERD
1. increase HOB 4-6'' (home)
2. small meals
3. pain meds
4. breath sounds
5. semi fowlers
How are pts. positioned w/feeding tube feedings?
Sitting or High Fowlers
complications of anorexia
pulse & BP fall
heart & kidney failure at risk
osteoporosis & muscle loss occur
vitamin and electrolyte imbalances
diabetes may develop with a high morbidity
How do you give tagamet?
take with meals & at bedtime
How long do you give tagamet to ensure healing?
8 wks.
It is a wooden or steel attachment to the hospital bed and has adjustable pulleys & a trapeze bar attached to an overhead bar is what?
Balkin Frame
How often is residual checked?
Initially q hour the q4hours and always before giving meds or more feedings
What should you do if this occurs? – feeding too fast or too much
Stop the feeding
What is a pt. w/GERD at risk for?
aspiration or aspiration pneumonia
nursing management for ERCP?
NPO after 8pm the night before the exam. Check prothrombin time prior to procedure. Monitor for pain, fever, chills which could indicate infection. Monitor for onset of pancreatitis
Dg tests for Peptic Ulcer disease
IgG antibody
urea breath test
Upper GI
Nursing Interventions for a CT scan
Consent must be signed
NPO 2-4 hours prior to procedure
May have a clear liquid tray the morning of the test
nursing management of EGD
consent form is signed, NPO for 8-12 hrs. may need to premedicate to relax pt. Monitor v/s & prevent aspiration after the procedure. Monitor for pain, bleeding, fever & dysphagia after the procedure
What are the early signs of ICP?
headache, nausea, vomiting, ocular palsies, altered level of consciousness, back pain, papilledma
What are bony deposits that are formed between & around the broken ends of a fractured bone during healing called?
Callus formation of bone
What are some nursing interventions for hip fractures & post-arthroplasty?
Keep the pt abducted
Check VS
Check the suture line for skin edges & intact sutures Q8H
Check drainage tubes for amount, color, Q4H
Accurate I & O
Use incentive spirometer
Turning pt
Anticoagulation meds for clots
Nursing Interventions for a colonoscopy
Clear liquid diet 24 hours before the test
Go-lytely is given the night before the procedure
Conscious sedation is used
Positioned on the (L) side with knees bent
nursing management for a colonoscopy
clear liquid diet for 24 hours prior to exam
bowel preparation (Golytely) the night before exam
possibly enemas the evening prior to examination and the morning of the examination
pt will receive conscious sedation during examination
monitor for complications suh as hemorrhage and severe pain
instruct pt. that cramping will last for several hours after test, and blood may be present in stool if specimen was taken
Nursing Interventions for a proctosigmoidoscopy
Clear liquid diet 24 hours before the test.
The morning of the procedure give a warm tap water enema or a fleets.
Positioned in the (L) lateral knee position.
After procedure the pt. is placed in the supine position to avoid orthostatic hypotension
When should barium not be used?
If the pt. has active inflammatory disease or colon perforation
What is the difference in open-angle & closed-angle glaucoma?
the outflow of aqueous humor is decreased in the trabecular meshwork
abrupt angle change of the iris causing rapid vision loss & dramatic symptoms
Care of pt w/ a head injury?
Let it drain freely. Never pack anything in the nose or ears. maintain airway, and ensure adequate oxygen , check ABG frequently
What is a colonoscopy used for?
a biopsy specimen may be obtained or polyps be removed
inflammation, ulcers, polyps or cancer
Late s/s of fluid deficit for nausea and vomiting
confusion, oliguria, cold clammy skin, & chest or abdominal pain
How would you care for a blind pt?
Talk in a normal voice
Introduce yourself with each contact
Explain any activity occuring in the room
Announce when you are leaving the room so the blind person wont talk to someone not there 
Nursing Interventions for a Lower GI Series with Barium
Pt’s. are usually on a clear liquid or low residue diet 2 days before the procedure.
Laxatives, enemas or oral bowel evacuation meds such as Go-lytely will usually be given to the pt. to help completely clean the lower colon.
The pt. may have a clear liquid diet the morning of the test or might be NPO.
*Active GI bleeding may also prohibit the use of laxatives or enemas.
With a TPN feeding why should you always remember to start slowly?
To allow the pancreas time to adjust to increasing insulin production for high amounts of glucose in TPN
When a pt has postical signs, that would be what?
Pt will feel groggy & act disoriented after a seizure.
Pt will complain of headache & muscle aches
Will sleep after the seizure
May experience amnesia for the event
Lactic Dehydrogenase
(isoenzymes is a test to check how much LDH is in the blood)
diagnostic, ablative
Delirium Tremens
(alcohol withdrawal)
Complete Blood Count
CBC is used as a broad screening test to check for such disorders as anemia, infection, and many other diseases.
If patient is having symptoms such as fatigue or weakness or has an infection, inflammation, bruising, or bleeding, then the doctor may order a CBC to help diagnose the cause.
Premature Atrial Contraction
connective tissue (bone)
Kaposi's Sarcoma
Assoc. with AIDS
Kaposi's sarcoma is a cancer that causes patches of abnormal tissue to grow under the skin, in the lining of the mouth, nose, and throat or in other organs. The patches are usually red or purple and are made of cancer cells and blood cells. The red and purples patches often cause no symptoms, though they may be painful. If the cancer spreads to the digestive tract or lungs, bleeding can result. Lung tumors can make breathing hard.
Musculoskeletal:S&S ass/w.death
jaw/facial muscles relaxed
mouth breathing
toungue falls back causing death rattle
Infection into the bone
Ba Enema or B.E.
Barium Enema
procedure used to examine and diagnose problems with the human colon (large intestine). X-ray pictures are taken while barium sulfate fills the colon via the rectum
pneumonia, bacterial, fungal, viral, protozoa, ricketsiae, usually pneumococcus & influenza, also chemicals, dust, inactivity, aspiration
Syndrome of inappropriate anti diuretic hormone
Operative procedure designed to improve or restore hearing
 alterations of oral mucosa
Stomatitis-mouth sores
taste loss
Xerostomia-dry mouth
bone marrow transplant
replaces pre-procedural bone marrow

 high dose radiation & chemotherapy

leaves patient immunocompromised
@ risk for infection/bleeding
removal of an organ or gland
surgical Tx for cancer
curative, palliative, reconstructive
Hodgkin's disease
characterized by proliferation of abnormal giant, multinucleated cells called Reed-Sternberg cells which are located in lymph nodes
excessive bleeding longer than 7 days
Parents arguing about hospital bills, child begins to cry and complain of abdominal pain.
CT scan to diagnos cancer

To determine
density   >   of cancer

air in plural cavity, lung develops blebs or 2* to disease or trauma
Anatomic site
location of body parts or systems
the alpha cells in the pancreas secrete?
callus formation
stage three healing: minerals are deposited into osteiod, to make new boen, evidence of callus formation can be confirmed by an xray
presence of normal healthy tissue in sites outside the endometrial cavity. Not well understood patient may experience dysmenorrhea, infertility, pelvic pain, dyspareunia, painfull bowel movements and dysuria
patient has renal damage because of Diabetes, which puts the patient at risk for
Nursing Interventions for MS
-Bed rest during exacerbation
-Protect from injury-fall risk
-Monitor for potential complications
-Promote Independence
regular elimination by bladder and bowel training
establish a regualr exercise
moderate activity
provide assistive devices
-Avoid fatigue, stress, infection, overheating, and chilling
-Treat depression and anxiety
-Provide information about the National MS Society
the belief that one's own ways are superior to those of others from different cultural, ethnic, or racial backgrounds
other ways to diagnost cancer
lab tests
cytology studies>pap tests/bronchial cells/ascites fluid
Parathyroid glands
there are four parathyroid glands, two on the back of each lobe of the thyroid gland
parathyroid hormone (PTH)
What is necessary for the synthesis of thyroid hormone?
Grading of Tumors
process of differentiation. scale of 1-4
lymphogranuloma venereum
rare in the US, vibramycin, or erythromycin
topical corticosteriod ointments can cause this and must be assessed by the nurse on folow up visits
thinning of the skin
Management of transient ischemic attack
treat hypertension, diabetes
carotid endartectomy, stenting, and angioplasty
Senses:S&S of death
Impaired senses> hearing is last sense to go
What is pheochromocytoma
a tumor that results in hyper-activity of the adrenal medulla
dual energy x-ray
called DEXA, measures bone mass of spine, femur, forearm and total body. allows assessment of bone densitywith minimal radiation exposure
normal fluid loss in respiration is
300 to 400 mL/day
Side effects of chemotherapy
similar to radiation except for the burns
   What should the nurse do before infusing a brevity flow tube feeding using a large syringe you should?
Check for placement
what is morphne contradicted in
a patient with a tramatic injury
The nurse clarifies that the patients Bill of Rights ensures that the patient's will have
Provision of respectful care
Protetion of privacy
Access to medical records
Information about current condition
what can be used to detect ovarian masses
abdominal or vaginal ultrasound
left brain damage
right side of body and left side of face affected
-paralysis on the right side of the body
-speech/language problems
-slow, cautios behavioral style
-memory loss
what are the side effects with chemo and radiation therapy
anorexia, skin reactions, pulmonary effects, gastrointestion l effects, reprductive efects (potential for infertility).
     How would you assess the progress of ascites on a daily basis?
Asses respiratory status and Input and output ratio, check labs for electrolyte imbalances
pt is nervous about the procedure but that she knows it will help her physician to diagnose her problem. Coping strategy being used is
internal family coping by interpreting events in a positive manner
How can you intervene in a patient dealing with taste alteration rt cancer
teach the patient to experiment with spices and seasoning in atempt to mask alterations
Carcinoembryonic Antigen
serum from individuals with colorectal carcinoma,gastric carcinoma, pancreatic carcinoma, lung carcinoma and breast carcinoma, as well as individuals with medullary thyroid carcinoma, had higher levels of CEA than healthy individuals.
CEA measurement is mainly used as a tumor marker to identify recurrences after surgical resection. Elevated CEA levels should return to normal after surgical resection, as elevation of CEA during follow up is an indicator of recurrence of tumour.
CEA levels may also be raised in some non-neoplastic conditions like ulcerative colitis, pancreatitis and cirrhosis.
Cystoscopy is a procedure to see the inside of the bladder and urethra
Intravenous Pyelogram
(An intravenous pyelogram (IVP) is an x-ray examination of the kidneys, ureters and urinary bladder that uses iodinated contrast material injected into veins)
detects problems within the urinary tract resulting from:
kidney stones
enlarged prostate
tumors in the kidney, ureters or urinary bladder.
for breast tumors
Acid Fast Bacilli
Rod-shaped bacteria that can be seen and counted under the microscope on a specially stained sample on a glass slide, called an AFB smear. Most common acid-fast bacilli are members of the genus Mycobacterium.
Mycobacterium tuberculosis is the most prevalent species of mycobacteria and the most infectious. Most samples that are submitted for AFB smears and cultures are collected because the doctor suspects that the patient has TB.
Gonorrhea is a STD Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can also grow in the mouth, throat, eyes, and anus
providing an opening (stoma)
proven efficacy compared with ASA in patients with stroke, MI, or PAD
well tolerated

efficacy for TIA not proven
not more efficacious than ASA in the stroke and myocardial infarction subgroups
lowered resistence to infection because of lowered WBCs
What does ADH act on?
the most abundant intracellular positively charged electrolyte is
Kidneys:s&s ass. w/death
Dimineshed out put:< 20cc/hour.
Pituitary gland
also called Hypohysis
hangs from the hypothalamus
has two major parts:
1.  posterior pituitary-secretes 2 hormones
2.  anterior pituitary-secretes 6 hormones
What does TSH act on?
thyroid gland
removal of uterus, cervix, fallopian tubes and ovaries
Procedure that a “cleansing” agent is introduced into the vagina under low pressure, advise patients to ONLY do so if for a medical reason discussed with a health care provider
an act or manner of treating.
tumor that isnt cancerous and doesnt spread
parathyroid gland
an antagonist to calcitonin to maintain normal blood levels of calcium and phosphate.
Target areas: bones, small intestines, kidneys
Secretion of PTH is stimulated by hypocalcemia
Hard, swollen glands should NEVER be palpated because it may cause thyroid storming
pt presents with polydipsia, polyuria, and dehydration
diabetes insipidus
Formula used for fluid replacement in burn victims
The nurse congratulated the client for successfully coping with a family crisis. The state of having used coping strategies effectively is classified as
S/S of Stroke
-sudden weakness, numbness or paralysis of the face, arm, or leg (esp on one side of the body)
-loss of speech or trouble talking or understanding language
-sudden loss of vision, particularly in one eye
-sudden, severe headache with no apparent cause
-unexplained dizziness, loss of balance or coordination (esp if associated with any of the above symptoms)
GI function: S&S ass. w/death
Peristalsis slows
Little/no bowl movements
pulmonary edema
fluid in pulmonary spaces & air spaces
PT presents with puple stria, thin skin, moon face, and supraclavicular fat pads
Cushings syndrome
Myasthenia gravis
a disease that affects the nervous system and the musculoskeletal system. In the nervous system, the nerve endings fail to release acetylcholine, which leads to problems in movement of the muscles
each compartment of the body has a water-fluid distribution movement of its own. These fluids move distribute themselves between these compartments via a process known as
Type of treatment depends on
type of CA
extent of spread
reaction of tumor itself
Individual patient
   What could result for a client who has esophageal cancer tilts his head back while eating.

lyme disease
transmitted by a bit of an infected deer tick. Called the great imitator bc it can mimic other diseases such as MS, monoucleosis, and menigitis.
fracture hematoma
stage one healing: when the fracture occurs, a hematoma developes, that changes from aliquid to a semi-solid clot; happen 72 hours after injury
the patient's IV has been infusing at a very high rate and now the patient appears to be in fluid volume overload, as indicated by
pulmonary edema
marrow transplant comes from:
Crest of iliac>cleaned up> put into patient through IV
Hormone replacement therapy
HRT helps retard bone loss andmay help prevent osteoporosis, also helps to minimize changes in old age.
staging 1 of malignancies
in situ- cells confined at site w/o matastasising
what tests are use for HIV
elisa sensitivity test, and western blot confirmatory tes

 Why will a LeVeen peritoneal-venous shunt be done instead of a paracentesis for a client with ascites?


A protein rich serum is retained and returned to the vascular compartment and urine output will increase causes elimination of excess sodium and water
the nurse counsels a family that during the "families with adolescents stage" one of the developmental tasks is to
communicate openly between parent and children
When assessing the coping measures of famillies under stress, the first priority of the nurse should be
to determine what stressors the family is currently experiencing
What is the process when you collect several stool specimens that are to go to the laboratory?
Collect in a clean, dry container without any urine or toilet tissue in the container, deliver it to the laboratory immediately, instruct pt. not to eat red meat for 2-3 days before sample collection – if testing for occult blood, if visible blood or mucus is present in stool include it in specimen to be sent to the lab, have the container labeled with pt name and date.
 What would your plan be to prevent complications in a hepatitis patient on bed rest?
Teach the pt to cough and deep breathe q2h to reduce risk of pneumonia, gentle leg exercises to promote circulation and discourage thrombi, discourage crossing of legs, keep records of bowel movements and I&O’s, asses skin for signs of pressure sores
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