180 Final Prep

A surgical procedure to remove the gallbladder

-Cholesterol imbalance
-Bile stasis
-Female sex
-Older age

-Sudden, sharp pain in the upper right abdomen, often radiating to the back or shoulder
-Pain that worsens after eating fatty foods
-Nausea and vomiting
-Jaundice
-Fever and chills
-Clay-colored stools

-Abdominal ultrasound
-Endoscopic ultrasound
-CT
-Blood tests

-Preoperative assessment and evaluation
-Patient education and informed consent
-Medication management and optimization
-Nutritional counseling and support
-Psychological preparation and anxiety management
-Surgical site preparation

Glaucoma refers to a group of diseases involving eye pressure increases that lead to permanent vision loss and blindness due to damage

-Eye pain or pressure
-Headaches
-Red or bloodshot eyes
-Double vision
-Blurred vision
-Gradually developing low vision
-Gradually developing blind spots or visual field defects like tunnel vision

Sudden severe symptoms such as bulging or enlarged eyeballs, nausea and vomiting, sudden appearance or increase in floaters, sudden vision loss of any kind, and suddenly seeing flashing lights.

A buildup of fluid in the inner ear that causes episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness or pressure in the ear

-Medications: diuretics, anti-vertigo medications, and antihistamines can help reduce fluid bluidup and control vertigo
-Reducing salt intake can help decrease fluid retention
-Hearing aids can help compensate for hearing loss
-Surgery may be needed in severe cases to drain excess fluid

-Stress
-Fatigue
-Emotional upset
-Illness
-Dietary factors such as high salt intake, caffeine, and alcohol

-Nausea and vomiting
-Light sensitivity
-Strange smells
-Feeling weak prior to a headache

-Flashes of light
-Blind spots
-Zigzag lines
-Numbness
-Speech problems
-Muscle weakness

-Abdominal pain
-Bloating and distension
-Nausea and vomiting
-Constipation or inability to pass gas
-Absense of bowel sounds
-Loss of appetite
-Possible fever
-Possible diarrhea

-Surgical procedures
-Infections
-Paralysis
-Medications
-Abdominal injuries and spinal cord injuries

-NPO
-NG tube placement for gastric decompression

-Also known as autonomic hyperreflexia
-People with spinal cord injuries (more common above T6) are at a higher risk of developing this condition
-It is a potentially life-threatening conditioni characterized by an overreaction of the autonomic nervous system, leading to a sudden and severe rise in blood pressure, often triggered by stimuli below the level of a spinal cord injury

-Sexual intercourse
-Surgery below level of injury
-Overfilled bladder
-UTI

-Thrombolytic therapy
-Mechanical thrombectomy
-Aspirin

-Anticoagulation therapy such as warfarin or heparin
-Statins to reduce risk of future strokes
-Physical and occupational therapy
-Speech therapy

Tissue plasminogen activator (tPA)

To detect early signs of complications like infection, poor circulation, or pressure injuries that can lead to delayed healing or further complications

-Early mobilization
-Anticoagulants
-Dangle legs

Severe nausea and vomiting in pregnancy

-First line: non-pharmacological interventions like motion sickness bracelets and ginger candy
-Second line: Vitamin B6 and doxylamine
-Third line: Dimenhydrinate (dramamine), metoclopramide(antiemetic), odansetron (Zofran)

-Hypertension
-High cholesterol
-Diabetes
-Obesity
-Physical inactivity
-Smoking

-Increases with age
-Sex: risk for stroke and heart disease increases after menopause
-Race and ethnicity: African or South Asian heritage clients have a higher risk of stroke and heart disease
-Family history: close relative that has had a stroke, heart disease, or TIA at an early age increases risk
-Oral contraceptive use

*Exact cause is unknown, but it is believed to be a combination of genetic and environmental factors
-Genetic factors: family history is a significant risk factor
-Environmental: Exposure to toxins, head trauma, air pollution, rural living
-Age: More common in older adults
-Sex: Men are at a higher risk

-Dietary modifications: eating plenty of fruits and vegetables, limiting saturated and trans fats, reducing sodium intake, choosing whole grains over refined carbohydrates
-Exercise regularly
-Smoking cessation
-Limit alcohol consumption
-Manage stress effectively
-Monitor and control blood pressure
-Effectively manage diabetes if applicable

-Presbycusis: gradual decline in hearing with age due to the deterioration of the inner ear structures
-Exposure to loud noises over time which damages the delicate hair cells in the inner ear
-Infections can damage hearing structures
-Trauma such as concussions or ruptured eardrums
-Genetics
-Medications
-Other factors including low birth weight, allergies, autoimmune disorders, vascular problems, and environmental toxins

-Confusion and disorientation
-Difficulty concentrating and paying attention
-Memory problems, expecially with recent events
-Altered sleep patterns
-Hallucinations or delusions
-Fluctuating level of consciousness
-Changes in speech
-In severe cases seizures

-Infections
-Substance abuse
-Older age
-Being in a new environment

A progressive, degenerative brain disorder that causes a decline in memory, thinking, and reasoning skills, ultimately leading to dementia

*Currently incurable, but there are treatments available to manage symptoms and slow the progression of the disease
-Cholinesterase inhibitors: (donepezil, rivastigmine, and galantamine) increase levels of acetylcholine, a neurotransmitter important for memory and learning
-Memantine: Modulates glutamate, a neurotransmitter involved in brain communication, and can help improve cognitive function
-Aducanumab and lecanemab: Target amyloid plaques which are believed to be a key factor in Alzheimer's disease

-Swelling, especially in one leg
-Pain or tenderness, often described as a cramping or throbbing sensation
-Redness or discoloration of the skin
-Visible enlarged veins
-Warmth in the affected leg

-Anticoagulants
-Compression stockings
-Leg elevation
-Procedures like a thrombectomy

*A mandatory pause that occurs before the start of any surgical procedure to ensure patient safety
-Verify the correct patient, procedure, and surgical site
-To review and confirm all relevant information
-To ensure that all necessary equipment and supplies are present
-To communicate any potential risks or complications

-Initial imaging typically involves a non-contrast CT scan to quickly identify bleeding
-MRI is more sensitive for detecting ischemic changes

A condition that damages the nerves outside the brain and spinal cord. It can affect the nerves in the feet, legs, hands, arms, or other parts of the body

-Diabetes (most common cause)
-Alcohol abuse
-Vitamin deficiency (B12, B6)
-Autoimmune disorders
-Infections

-Numbness or tingling in the feet, legs, hands, or arms
-Burning or prickling sensations
-Pain, especially at night or when walking
-Muscle weakness or cramping
-Difficulty with balance or coordination

-Alcohol (especially red wine and beet)
-Caffeine
-Nicotine
-Stress
-Lack of sleep or changes in sleep patterns
-Skipping meals
-Dehydration
-Bright lights or strong smells
-Hormonal fluctuations

-Alcohol
-Smoking
-Nitroglycerin
-Strong odors
-Napping
-Circadian rhythms (often occur at night)
-Family history
-Gender: men are more likely to experience cluster headaches
-Head injury

-Missed period
-Vaginal bleeding or spotting
-Abdominal or pelvic pain, often one-sided
-Breast tenderness
-Nausea or vomiting

-Severe abdominal or pelvic pain, which may radiate to the back or shoulder
-Vaginal bleeding that may be heavy or clotted
-Dizziness or lightheadedness
-Shoulder pain
-Rectal pressure or pain
-Fever

-Severe abdominal pain: typically sharp, sudden, and intense, often localized to one side
-Vaginal bleeding: may range from light spotting to heavy bleeding
-Shoulder pain: pain radiating to the tip of the shoulder, caused by blood irritating the diaphragm
-Dizziness or lightheadedness due to blood loss

-The most common drug used to treat ectopic pregnancy
-Stops cells from growing, which ends the pregnancy
-The pregnancy is then absorbed by the body over 4-6 weeks
*Does not require the removal of the fallopian tube

Diabetes that develops during pregnancy

-First line includes dietary changes and exercise and regular blood glucose monitoring
-If lifestyle modification is not effective, medication may be prescribed (metformin or glyburide and insulin)

-Type 2 diabetes for the mother
-Preeclampsia
-Gestational hypertension
-Preterm birth
-Large babies
-Newborn hypoglycemia
-Increased risk of obesity for the baby

An autoimmune disorder where the body's immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas.
*Insulin dependent

-High blood sugar
-Frequent urination
-Excessive thirst
-Excessive hunger
-Weight loss
-Fatigue
-Blurred vision
-Slow-healing wounds

Examples: Aspart, lispro, glulisine
-Onset: 5-15 minutes
-Peak: 30 minutes
-Duration: 3-5 hours

Aspart, lispro, and glulisine

Example: Regular (Humilin R, Novolin R)
-Onset: 30 minutes
-Peak: 2-3 hours
-Duration: 6-8

Humulin R, Novolin R

Examples: NPH
-Onset: 1-2 hours
-Peak: 4 hours
-Duration: 16-24 hours

NPH

Examples: Detemir, glargine
-Onset: 1-2 hours
-Peak: None
-Duration: Detemir - 20 hours, Glargine - 24 hours

Detemir, Glargine

-Urinary output
-Vital signs
-Renal function
-Check for signs of infection
-Assess hydration status

An infection of the urinary tract, which includes the bladder, urethra, and kidneys

-Sex: females are at a higher risk due to a shorter urethra
-Sexual activity
-Diabetes
-Weakened immune system
-Recent surgery or hospitalization
-Use of a urinary catheter

-Frequent urination
-Pain or burning during urination
-Cloudy or foul-smelling urine
-Blood in the urine
-Lower back pain
-Fever (in severe cases)

*Kidney stones
Hard deposits that form in the urinary tract, typically in the kidneys. They are composed of various minerrals and salts, such as calcium oxalate, uric acid, and struvite.

-High levels of calcium, oxalate, uric acid, or cystine in the urine
-Dehydration
-Obesity
-Certain medical conditions, such as kidney disease, gout, and hyperparathyroidism
-Family history

-Severe pain in the flank, lower back, or groin that may radiate to the front
-Nausea and vomiting
-Blood in the urine (hematuria)
-Frequent urination
-Cloudy or foul-smelling urine

-Physical exam
-Blood and urine tests
-Imaging tests such as x-rays, CT scans, or ultrasounds

-Small stones may pass spontaneously with increased fluid intake
-Larger stones may require medical intervention, such as extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy, or open surgery

-Drink plenty of fluids
-Reduce salt intake
-Limit oxalate-rich foods (e.g. spinach, rhubarb)
-Manage underlying medical conditions
-Take prescribed medications to prevent stone formation

A common heart rhythm disorder where the upper chamgers of the heart (atria) beat irregularly and rapidly

-Many people are asymptomatic
-Others may experience palpitations, tachycardia, shortness of breath, or light-headedness

-Antiarrhythmics: to control the heart rhythm and prevent irregular beats
-Beta-blockers or calcium channel blockers to slow the heart rate
-Anticoagulants to prevent blood clots
-Electrical cardioversion, ablation, or maze procedure

Chronic lung disease that causes inflammation and narrowing of the airways with mucus production

-Environmental: smoke, pollen, perfume, cool or dry air, allergens
-Stress: emotional and exercise
-Illness

-Chest tightness
-Dyspnea/SOB
-Wheezing
-Anxiety
-Mucus production
-Retractions
-Tachypnea
-Tachycardia
-Air trapping
-Cough

-Peak flow meter
-Bronchodilators: Rapid (albuterol), long-acting (salmeterol)
-Corticosteroids: long term management
-Anticholinergics: Ipratropium

-Life threatening asthma complication where airway obstruction is not responsive to traditional treatments
-Symptoms include labored breathing, inability to speak, decreased LOC, cyanosis
-Treatments include O2, IV fluids, bronchodilators, corticosteroids, epinephrine

Lower respiratory tract infection that causes inflammation of the alveoli/lung tissue leading to impaired gas exchange

-Abnormal breath sounds (crackles)
-Hypoxia
-Fever, chills, diaphoresis
-Neuro changes especially in elderly
-Increased heart rate, respiratory rate, CO2, WBC
-Productive cough
-Muscle aches

-Chest x-ray
-Labs
-Sputum culture

-Antipyretics, antivirals, antibiotics, bronchodilators, cough suppressants, mucolytic agents
-Increase fluids to thin mucus secretions
-Semi or high fowler's to increase lung expansion
-Incentive spirometer

-Emphysema and chronic bronchitis
-Progressive pulmonary disease causing chronic airflow obstruction

-Medications: bronchodilators (-terol), then corticosteroids (-sone)
-Oxygen therapy **USE CAUTION, Too much oxygen can make patient stop breathing
-Breathing techniques: pursed lips, diaphragmatic, huff coughing

-*"pink puffer"
-Alveoli are damaged and enlarged which causes loss of lung elasticity
-Results in loss of lung tissue recoil and air trapping
-Pink skin, barrel chest, weight loss, tachypnea, dyspnea, SOB
-Older in age w/thin body and pink skin
-Will tripod to get air exchange

-"blue bloater"
-Chronic productive cough and sputum production
-Younger, overweight w/cyanosis
-Peripheral edema, cough, crackles/wheezing, recurrent infection
-Leads to right-sided heart failure causing edema
-Airway obstruction, mucus secretion

A condition that affects the blood vessels in the extremities causing pooling of blood in extremities and edema

-Dull, constant, aching pain
-Pulse may not be palpable due to edema
-Warm temperature
-Stasis dermatitis (brown/yellow skin color)
-Venous stasis ulcers (usually around ankles)

-Elevation of legs
-Medications: aspirin or clopidogrel and statins

-Smoking
-Diabetes
-Hyperlipidemia
-Hypertension

A condition where the arteries that carry blood to the legs, arms, and other parts of the body become narrowed or blocked

-Possible ischemia, necrosis, gangrene
-Weak or almost absent pulse
-Cool temperature
-Pale, hairless, dry, shiny, thin skin from low oxygen
-Sharp pain
-Round would with "punched out" appearance and minimal drainage

-Dangle extremity
-Medications: Vasodilators, antiplatelets

A medication used to treat ischemic stroke
-Thrombolytic agent
-Symptoms that started within 4.5 hours
-For those who have a confirmed blood clot on brain imaging

-Protein: helps build muscle, skin, and other tissues
-Vitamin A: Helps repair tissue damage and keep skin healthy
-Vitamin C: Helps make collagen and supports tissue health and repair
-Zinc: Helps fight and prevent infection and make wound tissue stronger
-Iron: Helps fight and prevent infection and makes wound tissue stronger
-Carbohydrates: Provides energy for white blood cells

-Oxygen
-Proper care
-Smoking cessation if applicable
-Stay hydrated

1. Hemostasis: immediately after injury, blood vessels constrict to stop bleeding; platelets form a clot to protect the wound
2. Inflammation: white blood cells arrive to fight infection and remove debris; wound becomes red, swollen, and tender
3. Proliferation: new blood vessels and granulation tissue form; fibroblasts produce collagen which strengthens the wound; epithelialization
4. Remodeling: collagen is reorganized and strengthened; scar tissue matures and becomes less noticeable

-Echocardiograms
-Chest x-rays
-EKGs
-Blood tests
-Potentially cardiac catheterization or MRI to evaluate the heart's structure, function, and electrical activity

-Swelling (edema), especially in the legs, ankles, feet, and hands
-Weight gain
-Shortness of breath
-High blood pressure
-Rapid heartbeat
-Pulmonary edema
-Headache, confusion, and seizures (in severe cases)
-Electrolyte imbalances

-ACE inhibitor
-Blocks conversion of angiotensin I to the potent vasoconstrictor angiotension II resulting in vasodilation and a decrease in blood pressure

-Dry cough
-Proteinuria
-Renal insufficiency
-Neutropenia
-Angioedema
-Tachycardia, chest pain, and palpitations
-Hypotension
-Hyperkalemia

-Atrial fibrillation
-Symptomatic management of heart failure

Inhibits the sodium-potassium ATPase pump within the cardiac muscle cell which leads to an increase in intracellular calcium concentration resulting in a stronger force of cardiac contraction and increased cardiac output while also slowing the heart rate

-Allergic reactions
-Digoxin toxicity: confusion, loss of appetite, nausea, vomiting, diarrhea, change in vision such as blurry or yellow vision, fatigue, fast or irregular heartbeat
-Slow heartbeat: dizziness, confusion, trouble breathing, unusual weakness
-Stomach pain
-Unexpected breast tissue growth

A treatment strategy used in the management of acute ischemic stroke that aims to maintain a higher blood pressure than usual in the immediate hours after an ischemic stroke to improve blood flow to the affected area of the brain
*220/120

Inflammation of the pericardium, the membrane that surrounds and protects the heart

-Sharp, stabbing pain in the center or left side of the chest
-Pain may worsen with deep breathing, coughing, or lying down
-Pain may radiate to the neck, shoulder, or back
-Difficulty breathing, especially when lying down
-Fever
-Fatigue
-Nausea and vomiting

-Medications: NSAIDs, corticosteroids, antibiotics
-Rest
-Pericardiocentesis
-Pericardectomy

-Infections
-Autoimmune disorders
-Heart conditions

Alcohol, caffeine, spicy food

Acid can damage enamel

Barret's esophagus

Face patient and speak with a normal voice

BP is regulated by constriction/dilation of vessels in the brain which helps to maintain the BP that is safe for the patient

-Smoking
-Hypertension
-Hyperlipidemia
-Diabetes

Tingling of the face and blind spots in the eyes

-Descending tract carries motor information from CNS to neurons in muscles
-Ascending tract delivers info from sensory receptors to the CNS

-Notify provider
-Insert NG
-Place on NPO

Paralysis and loss of sensation below injury level, impacting motor/sensory function

-Warmth of extremity
-Inflammation
-Calf irritation
-Edema

-Neuro assessment
-CT scan
-BIIIIG DONUT

State of confusion and rapid changes in brain function, often characterized by reduced awareness of surroundings, difficulty focusing, altered perception

Slow down disease progression