Final Nursing 2

• Red butterfly rash across the cheeks and bridge of the nose.
• Malaise and weakness.
• Early morning joint stiffness.

Hyper Uricemia- High levels of uric crystals.

Microscopy of synovial fliud. (Joint fluid.)

A systemic inflammatory disease that affects the synovial linig of the joints.

• NSAIDS, ASA (can cause tinnitus).
• Glucocorticoids (Prednisone).
• Corticosteroids (injectible at joints).

• Uricosuic agent (Probencid).
• Antigout agents.
• Allopurinal (can cause low plts. and bone marrow suppression).

The connective tissue cells produce too much of the protein called Collagen.

• C- Calcium deposits.
• R- Raynauds phenomenon.
• E- Esophageal dysfunction (acid reflux).
• S- Sclerodactyly (thickening and tightening of skin and hands).
• T- Telangiectasias (dilation of capillaries causing red marks).

• Increased ESR (Erythrocyte Sedimentation Rate).
• Positive CRP.
• Decreased WBC's.
• Increased uric acid.

• NSAIDS.
• Cortico steroids.
• Non opioid medications.
• Low dose antidepressants.

• Muscle spasms.
• Edema.
• Hemorrage.
• Compressed nerves.
• Fat embolisim.

• Tachycardia.
• Tachypnea.
• Hypoxia.
• Fever.
• Pain with movement.
• Loss of function.
• Ecchymosis.

Importance of reporting any s/sx of impaired circulation.

• Think 5 "P"s
• Pain.
• Pallor.
• Paralysis.
• Parasthesia.
• Pulselessness.

• Affected leg should not cross the center of the body.
• Don't bend more than 90 degrees.
• Don't let affected leg turn inward.
• Maintain hips in abduction.

• Idiopathic secondary to trauma to a joint.
• Non-inflammatory joint disease.

• Enlarged edematous joints.
• Joint stiffness.
• Heberdan's nodes and Bouchard's nodes.
• *Pain and stiffness* most common.

• Joint deformaties.
• Bone spurs.
• Narrowing of joint spaces.

Infection of the bone d/t extension of soft tissue infection or direct bone contamination.

• Elderly.
• Poor nursed.
• Immunosupressive agents.
• Obese.
• Impaired immune system.
• Chronic illnesses.
• Long term corticosteroid use.

• Localized edema and redness.
• Disorder known as Sepsis could be a possible test finding.
• Bone pain.

• Estrogen ( not the first choice anymore) can cause spotting and weight gain.
• Increased risk for DVT's.
• Calcium and Vit. D supplement.
• SERMS (Selective Estrogen Receptor Modulatior).
• Evista (weight gain, vaginal spotting).

• NSAIDS.
• Cold and heat applicatons.

• Tahycardia.
• Tachypnea.
• Febrile.
• Hypoxic.
• Cough produces large amounts of thick white sputum.

A precancerous condition caused by untreated reflux.

Need to be screened (EGD) because it will roll into cancer.

• Psych evaluation.
• BMI>30.
• 100 lbs. greater than IBW.

• Complication from bowel surgery.
• Happens 15 min. after eating, can cause hypoglycemia. No fluids with meals.

Low fat, high fiber diet increases stool volume.

• Diet- low residue bland diet, high in protien.
• Medication.
• Stress reduction.
• Family and emotional support.

Bland, low residue, high protien, high vitamin.

Bile duct injury is most serious(jaundice).

• Monitor BS every 3-4 hours.
• Continue meds.
• Call Dr. if BS>300 or unable to retain fluids.

• In use vials may be left at room temp for up to 4 weeks.
• Lantus only 28 days.
• Avoid direct sunlight.

• Give promptly.
• Rotate sites.
• Don't aspirate.

Adhere to meal plan and schedule diet and excercise.

• Casual BS of 200 or greater.
• Glucose tolerance test of >200.

Scar tissue formation d/t injecting insulin at the same site.

• High fever.
• Tachycardia.
• Altered neurological and mental state.

Erosion of the lining of the stomach or intestine. Caused by stress, anxiety, H-pylori infection.

• Dull gnawing pain.
• Burning pain in midepigastrium or back.
• Pt. reports eating relieves pain.

• Keep upright fpr at least 2 hours.
• Elevate HOB.

because it is less invasive

iodized salt and shellfish

• -dysphagia
• diffuse spasms
• achalasia(absence of peristalis in esophagas)
• diverticulum

• thyroid storm-tx:131 I , destroys overreactive thyroid cells
• thyroidectomy-parathyroid can be damaged, watch for s/s of hypocalcemia

• special positioning may be used to help with the eye healing properly
• pt will be on bedrest

• it can be spread to both eyes
• it is very contagious
• WASH HANDS

wash it out

floaters, flashers; can mean retinal detachment

FALLS risk!!

approach and talk to pt on the unaffected side

• Severe headache d/t increased crainial pressure from blood in the subarachnoid space.
• decrease in LOC

Focus on cardiac and respiratory status

in a hemorrhagic stroke, and if pt is on anticoagulants

• maintain airway,
• take meds as directed

• intentions tremors
• urinary hesitancy
• difficulty in coordination
• blurred vision
• plaques on ct

• s/s of infection
• pt teaching
• coumadin teaching
• PT consult
• surgical site care
• s/s of DVT

Bronchiectasis- is not COPD but can be a secondary problem with COPD. is caused by an airway obstruction.

Occurs when the spft tissue in the back of your throat relaxes causing blockage of the airway

abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea.

chronic inflammatory disease of the airways

• Rapid Breathing
• Cyanosis
• Lethargy/Lassitude
• Executing Poor Judgment
• Dizziness
• Headache

• stroke pts,
• intubated pts
• infants

To measure and improve the volume of air inhaled by your lungs

use alteranative communication techniques such as writing, yes and no questions, etc

a body position that allows the pt to breathe easier. usuall sitting up leaning forward

increases mucous production and all around damages!!

• Antituberculosis agents
• Isoniazid (INH)
• Rifampin
• Ethambutol
• Pyrazinamide
• INH used as prophylaxis for those at risk

to obtain info about pressure readings within the heart. used to diagnose CAD, determine the extent of atherosclerosis, assess coronary artery patency, stent

too heavy of exercise causes angina. so use a mild to moderate exercise in pts with CAD

recurring pain/discomfort in the chest that happens when some or part of the heart doesn't recive enough blood

• identify and manage the cause
• improve cardiac output

HTN that occurs when the pt is at the drs office but is lower at home

• Daily weights
• diet
• control anxiety
• exercise

Protect from and wear well fitting shoes d/t parasthesia and ischemia. avoid tight fitting shoes, walking and exercise program

because moderate exercise is good for the heart.

increasing blood pressure

• Diabetes
• HTN
• Heart failure

• When GFR is <15.
• Renal Failure

• anesethesia
• DM
• pregnancy
• BPH
• pelvic injury
• medications
• neurological disorders

• PRN
• Sterile Technique

• keep site clean,
• flush?

Blood and semen

extensive xposure to the sun

• Creams, shampoos,
• KWELL
• Lindane

• N/V
• Diarrhea
• headache
• kidney failure
• ulcers
• prolonged bleeding

• take entire prescribed amount.
• watch for an alergic reaction if its pts first time taking it

• ventricular arrhythmias
• bradycardia
• digoxin toxicity

• avoid activities that could cause injury and bleeding
• soft toothbrush
• oral care
• correct labs to check for theraputic range

• bradycardia
• hypotension
• orthostatic hypotension

• Orthostatic hypotension, so get up slowly.
• headache, pounding heartbeat, nausea, weakness, weight gain and small decreases in low-density lipoprotein (LDL) cholesterol

if pt has a high potassium, kayexalate helps the body get rid of the excess K+

Potassium and BUN and Creatnine