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Cystoscopy (4)
1.used to remove bladdler tumors or enlarged prostate
2.general or local anesthesia
3.PT NPO after midnight preop
4.bowel prep evening preop
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Acute pyelonephritis location
upper UTI
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Expected urine characteristics of urine from Cystitis
1.cloudy
2.foul smelling
3.blood tinged
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Catheter care (2)
1.unless told so, it is OK to shower with your catheter and urine collection bag
2.clean area around catheter twice daily using soap and water
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Drug treatment used for BPH (2)
- 1.finasteride
- 2.dutasteride
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Transurethral needle ablation (TUNA)
low radiofrequency energy shrinks the prostate
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Transurethral microwave therapy (TRUMPT)
high temp heat destroys excess tissue
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Interstitial laser coagulation (ILC)
laser energy coagulates excess tissue
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Electrovaporization
high frequency electrical current cuts and vaporizes excess tissue
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Normal blood level of PSA in men
less than 4ng/ml
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Total vaginal hysterectomy
removal of the uterus, cervix, and sometimes in pieces, the vagina
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Assessment postop for TAH
should be less than one saturated perineal pad in 4 hours
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PT teaching for Vaginal Hysterectomy (4)
1.avoid strenuous activity for 6 weeks
2.do not drive for 4 weeks
3.no sex for 4-6 weeks
4.record temp twice daily for 2 weeks
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Dysfunctional uterine bleeding caterogized by:
more than 80ml per cycle
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drug therapy management for DUB
estrogen 25mg q4-6 hrs IV until bleeding stops or 24hrs
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protrusion of the bladder through the vaginal wall
cystocele
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feeling as if something is "falling out"
retrocele
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lab studies elevated during liver failure
ALT
AST
LDH
Alkaline phosphatase
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four complications of hepatic dysfunction
hypertension, esophageal varices, ascites, hepatic encephalopathy
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describe bilirubin levels of a client with jaundice
decreased ability to conjugate and excrete bilirubin.
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describe patho of portal hypertension
compression and destruction of the portal and hepatic veins and sinusoids causing obstruction of normal blood flow through the portal system resulting in portal hypertension
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list teaching measures for home care of PT with ascites
proper diet, rest and avoidance of hepatotoxic OTC drugs such as acetaminophen, and abstinence of alcohol.
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type of diet for a PT with hepatic failure flow
- high in calories and protein
- low in fat and sodium
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symptoms and determining factors of encephalopathy
neurologic and mental responsiveness lacking
motor function involving tremors called Asterixis
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meds regarding encephalopathy
Lactulose, FLagyl, Vanc, and rifaximin
cathartics and enemas for constipation
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interventions for a PT who is bleeding or has a tendency to bleed easily
avoid aspirin, alcohol, irritating foods.
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functional clinical manifestations of a compensated liver
abdominal pain, ankle edema, continuous mild fever, spiders & palmar erythema
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functional clinical manifestations of a decompensated liver
splenomegaly, jaundice, clubbing of fingers, firm, enlarged abdomen, prpura, spontaneous bleeding, gonadal atrophy
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two main drugs used for liver transplant
cyclosporine
interleukin
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mode of transmission for HAV
fecal oral
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mode of transmission for HBV
parenteral, sexual and prenatal
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mode of transmission for HCV
Parenteral, sexual and prenatal
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mode of transmission for HEV
fecal oral
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mode of transmission for HDV
parenteral, sexual contact
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these hepatitis are acute only
A,E
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these hepatits are both acute and chronic
B,C,D
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hepatits viruses with immunizations available
A,B
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main cause of pancreatits 1 male, 1 female
- M alcoholism
- F biliary tract disease
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how do amylase and lipase react to acute pancreatitis
serum amylase and serum lipase elevate
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mineral lost with acute pancreatitis
calcium is lost
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nutritional teaching strategies for PT with pancreatitis
- small frequent meals
- high carbs
- low fat
- avoid alcohol, caffeine, smoking
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Platelets
150,000-400,000
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When is Leukorrhea considered normal
during pregnancy
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most frequent cause of anemia
GI bleeding
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PT teaching for Upper GI radiographic series preop (3)
NPO 8 h before surgery
drink 16 oz barium
stools may be chalky white 24-72 hrs afterwards
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PT teaching pre Esophagogastroduodenoscopy regarding diet
NPO 6-8 hrs
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PT teaching pre colonoscopy regarding diet
clear liquid 12-24 hr, NPO 6-8 hrs pre op
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common PPI's
prilosec, prevacid, aciphex, protonix, nexium
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common H2
zantac, pepcid, axid
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common prostaglandin analogue
cytotec
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how does metabolic alkalosis occur
an obstruction high in the small intestine, loss of gastric hydrochloride
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postop diet teaching for a PT treated for esophageal diverticulitis
NPO for several days, NGT
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What is done with a PT with esophageal bleeding?
emergency!
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Preop care and teaching of a PT with Hernia
overweight=lose weight
quit smoking
teach about NGT (several days postop)
Incentive spirometer
pain post op
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diet in post op laproscopic nissen fundoplication
near normal diet 4-6 weeks
no caffeine, carbonation, or alcohol
smaller portion sizes
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what foods are prohibited with an stomy
generally no foods
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voids to be expected with chronic cholecystitis
clay colored stool
dark urine
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post op teaching for a PT with cholecystectomy
PT discharged in a day
normal activities in a week
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lab expectations in a PT with pancreatitis
increased: amylase, lipase, glucose
decreased: calcium
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pre op care for a PT going through whipple surgery
catheter into jejunum
TPN
NPO 6-8 hrs pre procedure
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post op care for PT through whipple surgery
NPO
NGT with serosanguineous bile tinged drainage
PT in Semi fowlers
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excess of endolympphatic fluid
meniere's disease
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Use, given with, teaching:
Septra, Bactrum
decreases inflammation, improves tissue perfusion, reduce bacteria
full glass of water
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Use, given with, teaching:
antacids
increases pH of gastric contents
full glass of water
2 hrs after meal and bedtime
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Use, given with, teaching:
Ibuprophen
decrease pain, inflammation, fever
take with food or milk
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Use, given with, teaching:
Zantac
decrease gastric acid secretions
single dose at bedtime
dose doubled if missing one
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Use, given with, teaching:
carafate
heals ulcer
1 hr before 2 hrs after meals and bedtime
on empty stomach
no longer than 8 weeks
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Use, given with, teaching:
opthalic ointment
after eye surgery
two eyes, two bottles
keep eye closed one minute after admin
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Use, given with, teaching:
Nicotinic acid
treats menier's disease
give with meals or milk
side effects should discontinue after two weeks
REPORT clay stools, jaundiced skin, dark urine
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Use, given with, teaching:
tylenol
no more than 4000 mg daily
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Use, given with, teaching:
estrogen
give in morning with food or milk
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