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?: acute
which type of pain threatens recovery: acute
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: MI
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: ct
how do you assess pain location: have ct point
what is the most subjective char of pain: severity or intensity
VDS: verbal descriptor scale
what is a VDS: line with 3 to 6 work descriptors equally spaced
NRS: numerical rating scale
what is a NRS: asks ct to rate pain on a scale of 0 to 10
VAS: 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?: no
concomitant symptoms: symptoms that often occur with pain
ex of concomitant symptoms: N/V, H/A dizziness
should pain therapy be individualized: yes
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?: Yes
what do you do when more than one med is ordered: select the proper one
should you choose the right route for the med?: yes
should you assess the right time and interval for administering meds: yes
types of pharmacological pain therapy: analgesics, PCA, placebo effect, local anesthetics, epidural analgesia
PCA: patient controlled analgesia
should family and friends operate PCA: no
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: analgesics
what drug is effective in treating mild to moderate pain: NSAIDS
what type of pain drugs are used for severe pain: opioid
examples of adjuvants: sedatives, anticonvulsants, steroids and antidepressants
placebos: 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
pediculosis: head lice
s/s of pediculosis: sever itching esp at night
tx of pediculosis: shampoo, pick/ cut hair, wash all cloths and bedding
erythema: redness
pallor: whiteness
cyanosis: bluish
tinea infection of scalp: capitus
ringworm: corporis
tinea infection of groin: cruris
another name for cruris: jock itch
athletes foot: pedi
tinea infection of nails: unguim
tx for tinea: antifungals topical or systemic
what type of tinea can take a year or more to clean up: toenail
what is tinea: fungus
when is tinea common: cts with suppressed immune systems, diabetes
name a med used for tinea: sporanox
boil: carbuncle
what type of infection is herpes: viral
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: yes
how are herpes passed: STD
is there a cure for herpes: no
do herpes always have symptoms: no
varicella zoster: chicken pox/shingles
is impetigo common: yes
impetigo is not contagious: no
what causes impetigo?: staph or strep
what does impetigo look like?: honey colored lesions can be crusty
who is most often affected by impetigo?: children
how do you treat impetgo?: rigorous topical hygiene, topical antibiotics
erysipela: localized cellulitis
what type of disease is psoriasis?: chronic
what is psoriasis?: overgrowth in epidermis
what is the key in psoriasis: immune system
what percentage of population is effected by psoriasis: 20%
what race is most affected by psoriasis: caucasians
what does psoriasis look like?: silvery, whitish scaling
where is psoriasis common: scalp, elbows, knees, sacral-lumbar area
what is the cure for psoriasis?: none
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: rarely
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: moles
is there a genetic link to melanoma?: yes
what is the most common form of cancer: melanoma
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: yes
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: elevation
shave bx: excision
curettage: scraping or scooping of lesion
punch bx: use tool to grab and remove
crysurgery: rapid freezing
electrosurgery: electric current
name causes of melanoma: heredity, sun, tanning beds
what is an essential element of skin care: bathing
what may neutralize protection of skin: strong alkaline soaps
what hours should you avoid the sun: 10-3
nutrition and manage. of melanoma: balanced, protein, vit. C iron zinc
hypertrophy: increase in cell size
hyperplasia: increase in number of cells
metaplasia: one adult cell type is substituted for another
dysplagis: 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: well-differentiated
undifferentiated: 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
T: size of tumor
N: whether lymph nodes are involved
M: absence or presenance of metastasis
cure: complete eradication of disease
control: prolong survival and contain cancer growths
palliation: relief of symptoms, no cure
cancer in situ: precancerous
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: CAUTIONS
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: reservoir
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: yes
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: laxative
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: yes
what does a barium enema detect: polyps, tumors, IBS
what goes first if an upper GI and BE are needed: barium
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: laxatives
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: CT
how long must a pt be NPO before a CT: 8-12
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: none
Schilling test evaluates?: B12 absorption
what develops with malabsorption of B12: pernicious anemia
how long must a pt be NPO before schilling test: 8-12
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: endoscopy
Esophagogastroduodenoscopy: 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: colon
what is the worst part of a colonoscopy: prep
how long must a pt be NPO before a cscope: 8 hours
can a pt drive after a cscope: NO
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: thrush
causes of gastritis: damage to gastric muscosa
how many meals a day should a person with gastritis eat: 4-6
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
PUD: 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: PUD
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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