Glossary of last foundations test

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pain reception
body receives pain message
pain perception
body able to feel the pain, point when person aware of pain
pain reaction
phys and behav responses occuring after pain perceived
acute pain
usually has identifiable cause
which type of pain generally resolves itself?
which type of pain threatens recovery
chronic pain
prolonged, varies in intensity
intractable pain
lasts until death,
what is intractable pain also called
phantom pain
chronic non cancer pain
usually unidentifiable cause, ongoing, doesnt respond to tx
ABC's of pain: A
ask about pain regularily
ABC's of pain: B
believe pt and family about pain and tx and relief measures that work
ABC's of pain: C
choose pain control options appropriate for situation
ABC's of pain: D
deliver interventions in a timely, logical and coordinated fashion
ABC's of pain E
empower pt and family
4 classifications of pain by location
superficial or cutaneous, deep visceral, referred, radiating
superficial or cutaneous pain
pain resulting from stimulation of skin, short and localized
ex: of superficial pain
needle stick
deep visceral
pain resulting from stim. of internal organs
what type of pain radiates
deep visceral
ex of deep visceral pain
crushing and burning pain
referred pain
common in visceral pain, pain felt in part of body serperate from source of pain
ex of referred pain
radiating pain
sensation of pain extending from initial site of injury to another body part`
how does radiating pain feels
travels down and along body part
ex of radiating pain
low back pain
what do cts often fail to do when it comes to pain
report or discuss
who describes char of pain
how do you assess pain location
have ct point
what is the most subjective char of pain
severity or intensity
verbal descriptor scale
what is a VDS
line with 3 to 6 work descriptors equally spaced
numerical rating scale
what is a NRS
asks ct to rate pain on a scale of 0 to 10
visual analog scale
what is a VAS scale
straight line without labeled subdivisions
who developed the FACES sacle
wong and baker
FACES scale
6 faces to help children to describe pain
Oucher pain scale
two scales, 0-100 and faces
when asking about quality of pain, do you provide words to help the ct?
concomitant symptoms
symptoms that often occur with pain
ex of concomitant symptoms
N/V, H/A dizziness
should pain therapy be individualized
give an example of relaxation tech?
guided imagery
name some nonpharmacological pain relief measures
reduce pain recept and percept, anticipatory guidance, distraction, cutaneous stim, relax
should you know the ct's previous response to analgesics?
what do you do when more than one med is ordered
select the proper one
should you choose the right route for the med?
should you assess the right time and interval for administering meds
types of pharmacological pain therapy
analgesics, PCA, placebo effect, local anesthetics, epidural analgesia
patient controlled analgesia
should family and friends operate PCA
can a pt overdose on a PCA
not if it entered correctly
cutaneous stimulation ex
massage, warm bath, ice bag
most common method of pain relieft
what drug is effective in treating mild to moderate pain
what type of pain drugs are used for severe pain
examples of adjuvants
sedatives, anticonvulsants, steroids and antidepressants
meds that have no effect
local anesthesia
loss of sensation to a localized body part
how are local anesthetics usually administered
by injection
how are topical anesthetics obsorbed
through skin
epidural analgesia
form of local anesthesia
where is epidural analgesia administered
through spine
head lice
s/s of pediculosis
sever itching esp at night
tx of pediculosis
shampoo, pick/ cut hair, wash all cloths and bedding
tinea infection of scalp
tinea infection of groin
another name for cruris
jock itch
athletes foot
tinea infection of nails
tx for tinea
antifungals topical or systemic
what type of tinea can take a year or more to clean up
what is tinea
when is tinea common
cts with suppressed immune systems, diabetes
name a med used for tinea
what type of infection is herpes
two types of herpes
type one and two
where is type one herpes found
on face or mouth
where is type 2 herpes found
genital tract
what is the incubation period for type 2 herpes
2-20 days
tx of herpes
acyclovir cream or valtrex
is acyclovir cream systemic
how are herpes passed
is there a cure for herpes
do herpes always have symptoms
varicella zoster
chicken pox/shingles
is impetigo common
impetigo is not contagious
what causes impetigo?
staph or strep
what does impetigo look like?
honey colored lesions can be crusty
who is most often affected by impetigo?
how do you treat impetgo?
rigorous topical hygiene, topical antibiotics
localized cellulitis
what type of disease is psoriasis?
what is psoriasis?
overgrowth in epidermis
what is the key in psoriasis
immune system
what percentage of population is effected by psoriasis
what race is most affected by psoriasis
what does psoriasis look like?
silvery, whitish scaling
where is psoriasis common
scalp, elbows, knees, sacral-lumbar area
what is the cure for psoriasis?
ex of benign skin lesion
corn, callus, wart
3 types of malignant lesions
squamous cell carcinoma, basal cell carcinoma, malignant melanoma
what is the cause of squamous cell?
not known
tx for squamous cell
shave off
what does squamous cell carcinoma look like
indurated base with firm nodule
what is the cause of basal cell carcinoma
not known
what is the most common malignant tumor in people with light skin over 40
basal cell
does basal cell metastisize
what can happen if basal cell is untreated
deep skin injury
what type is traslucent and flat
basal cell
what is melanoma
tumor of melanocytes
where does melanoma occur
both sun exposed and non exposed areas
where does melanoma usually arise from
is there a genetic link to melanoma?
what is the most common form of cancer
where does melanoma usually go when it metastisizes
brain, colon, liver
what areas of the body is melanoma most common in
head, neck and lower extremities
how do you dx a melanoma
excisional bx
is melanoma staged
S/S melanoma A
asymmetry of borders
S/S melanoma: B
border irregularity
S/S melanoma: C
color, blue black or varigated
S/S melanoma: D
diameter 0.6 mm or larger
S/S melanoma : E
shave bx
scraping or scooping of lesion
punch bx
use tool to grab and remove
rapid freezing
electric current
name causes of melanoma
heredity, sun, tanning beds
what is an essential element of skin care
what may neutralize protection of skin
strong alkaline soaps
what hours should you avoid the sun
nutrition and manage. of melanoma
balanced, protein, vit. C iron zinc
increase in cell size
increase in number of cells
one adult cell type is substituted for another
cells vary from normal cells, or one mature type replaced by lessmature type
well differentiated
closely resembles normal cell but forms slow growing encapsulated tumor
which type of tumor is encapsulated
cells grow rapidly, the more undiff a cell the more cancerous
initiating agent
something that predisposes a cell to transformation
promoting agent
alters genetic information of cell
grade of cancer
classification of tumor cells
less differentiated
higher grade
staging of cancer
classification system based on the extent of the malignancy
size of tumor
whether lymph nodes are involved
absence or presenance of metastasis
complete eradication of disease
prolong survival and contain cancer growths
relief of symptoms, no cure
cancer in situ
stage 1 cancer
tumor limited to tissue of origin
stage 2 ca
limited local spread
stage 3 ca
extensive local and regional spread
stage 4 ca
widespread metastasis
what do you use to remember signs of CA
Signs of ca : C
changes in bowel or bladdar habits
signs of ca: A
a sore that does not heal
signs of ca: U
unusual bleeding or discharge
signs of ca: T
thickining or a lump in the breast or elsewhere
signs of ca: I
indigestion or difficulty in swallowing
signs of ca: O
obvious changes in a wart or a mole
signs of ca: N
nagging cough or hoarsness
primary function of stomach
3 parts of stomach
fundus, body, antrium
function of gallbladder
store and concentrate bile
what happens with gastric acid secretions in the elderly
it declines
what in regaurds to the gallbladder does aging do
increase risk of bile stones
what happens with absorption in the SI with aging
poor, esp with carbs and calcium
what is the cause of chronic gastritis in the elderly
H. Pylori
red blood in stools
lower GI bleeding
black blood in stools
upper GI blood
Upper GI
Upper Gastrointestinal series
what does the upper GI entail
bisualization of esophagus, stomach, duodenum jejunum
does an upper GI use contrast medium
what must the pt do with a upper GI
swallow barium
how long should a pt be NPO before an upper GI
6 hours
what is given after an upper GI
what can an upper GI detect
tumors, ulcers, inflammation, abnormal anatomy, malposition
What does a barium enema do?
outlines most of lower intestine
does a barium enema use contrast medium
what does a barium enema detect
polyps, tumors, IBS
what goes first if an upper GI and BE are needed
what is the prep for a BE
laxatives, enemas, clean bowel
how long must a pt be NPO before a BE
8 hours
what is given after a BE
Ultrasonography uses
high-frequency sound waves transmitted through abdomen
what is ultrasound used for
see organ size, shape, position and dx bysts tumors and stones
how long must a pt be NPO before a ultrasound
8-12 hours
what is done after ultrasound
diet as tolerated
what is a CT used for?
asses GB, biliary ducts and pancreatic probs
what are some downsides to a CT
high cost and moderate radiation exp
what test is useful with obese cts
how long must a pt be NPO before a CT
what is done after CT
diet as tolerated
is contrast medium used with a CT
yes or no
what is radionuclide imaging used for?
locate source of GI bleeding
what is the prep for radionuclide imaging
Schilling test evaluates?
B12 absorption
what develops with malabsorption of B12
pernicious anemia
how long must a pt be NPO before schilling test
what types of B12 do you give for a schilling test
radioactive and non-radioactive
how do you do a schilling test
collect urine for 24-48 hours ck output
what is in endoscopy
fiberoptic scope used to inspect, bx or remove polyps and stones
what test can be used to control BI bleeding
Upper GI endoscopy
what is an EGD used for
ID upper GI bleeding, ulcers, and gastric forms
how long must a pt be NPO for before an EGD
8 hours
what does an RN monitor for after an EGD
dyspnea, pain, bleeding, dysphasia
when do you give foods or liquids after an EGD
when gag reflex comes back
what does a colonoscopy examine
what is the worst part of a colonoscopy
how long must a pt be NPO before a cscope
8 hours
can a pt drive after a cscope
tests for GERD
24 hr ph and motility, esophageeal motility, barium swallow, endoscopy
two major types of hiatal hernia
sliding, paraesophageal
most common sx for hiatal hernia1
nissen fundoplication
aphthous stomatitis
canker sore
candidiiasis of mouth
causes of gastritis
damage to gastric muscosa
how many meals a day should a person with gastritis eat
what should you avoid with gastritis
alcohol, smoking, irritating foods
main thing to manage gastritic
remove causitive agent
type A gastritis
non erosive, decrease in gastiric secretions
Type B gastritis
most common, H[Pylori
tx of type A gastritis
manage symptoms, B12
tx of Type B gastritis
antibiotics, PPI , bismutsh
peptic ulcer disease
cause of PUD
NSAIDS and H pylori, smoking alcohol
S/S of PUD
vague burning usually 1-3 hours after meals,
pt has pain from 12-3 am relieved by food what do they have
most common PUD sx
anorexia and weight loss
what dx a PUD
upper GI, endos with bx, H pylori screensing
what heals a PU
meds in about 8 weeks, usually reoccurs
what do antacids do
neutralize HCl decrease irritation
Histamine receptor antagonists
block histamin and decrease HCL acid
ex of histamine receptor antagonists`
tagamet, zantac, pepsid, axid
Proton Pump Inhibitors
decreave HCL acid
ex of PPI
prilosec, prevacid, protonix, aciphex, nexium
main cause of ulcer relapse
H pylori

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