Inflammatory Bowel Disease and Ostomies
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Questions and Answers

What are the key nursing priorities when managing a patient with Inflammatory Bowel Disease?

  • Analgesic administration only
  • Frequent blood transfusions
  • Strict bed rest and isolation
  • Management of diarrhea and fluid balance (correct)

Which of the following symptoms is specifically indicative of Crohn’s disease in a patient with abdominal pain and rectal bleeding?

  • Inflammation in the mouth (correct)
  • Ulceration starting from the rectum
  • Absence of symptoms
  • Ulceration in the colon lining

What is a common characteristic of a new ostomy?

  • Light yellow irrespective of health
  • Gray and hardened appearance
  • Dark brown in color immediately
  • Bright red if healthy (correct)

What nursing priority is critical post-operatively for a patient with cholecystitis?

<p>Assessing and managing skin integrity (C)</p> Signup and view all the answers

Why would a physician recommend both NPO and TPN for a patient with pancreatitis?

<p>To avoid further inflammation of the pancreas (B)</p> Signup and view all the answers

What capability does an ERCP provide in assessing pancreatitis compared to other biliary disorders?

<p>It shows signs of elevated serum lipase levels (A)</p> Signup and view all the answers

What main dietary consideration should a nurse have for a patient with pancreatitis who is on NPO status?

<p>Consider nutritional support through TPN (A)</p> Signup and view all the answers

Which of these is NOT a typical nursing consideration for a patient with a colostomy?

<p>Promoting a vegetarian diet exclusively (C)</p> Signup and view all the answers

What is a positive Brudzinski's sign indicative of?

<p>Meningeal irritation (B)</p> Signup and view all the answers

Which of the following describes a generalized tonic-clonic seizure?

<p>Stiffening of muscles followed by jerking movements (D)</p> Signup and view all the answers

What is the primary goal of treatment for status epilepticus?

<p>To stop seizures quickly and ensure cerebral oxygenation (D)</p> Signup and view all the answers

Which of the following is NOT a common cause of seizures?

<p>High blood sugar (C)</p> Signup and view all the answers

How should a nurse respond during a seizure to ensure patient safety?

<p>Protect the patient from injury and time the seizure (A)</p> Signup and view all the answers

What type of seizure involves an impairment of consciousness?

<p>Complex partial seizure (A)</p> Signup and view all the answers

Which statement accurately describes the infection strategies to prevent HIV transmission?

<p>Medical male circumcision can reduce the risk of infection (C)</p> Signup and view all the answers

HIV primarily targets which type of cells in the human body?

<p>Cells with CD4+ receptors (C)</p> Signup and view all the answers

Which of the following is a characteristic of generalized absence seizures?

<p>They present as brief staring spells (A)</p> Signup and view all the answers

What is the main focus of post-exposure prophylaxis for healthcare providers after potential HIV exposure?

<p>Immediate initiation of antiretroviral therapy (B)</p> Signup and view all the answers

What could be a significant factor contributing to hyperglycemia in a post-operative diabetic patient?

<p>Decreased physical activity (B)</p> Signup and view all the answers

Which of the following is a common symptom associated with advanced hypoglycemia?

<p>Perpetual confusion (A)</p> Signup and view all the answers

What is the primary reason for weight loss in a patient with type 1 diabetes?

<p>Utilization of protein and fat for energy (A)</p> Signup and view all the answers

What nursing priority is essential for a patient diagnosed with tuberculosis (TB)?

<p>Medication adherence (D)</p> Signup and view all the answers

Which neurotransmitter is significantly decreased in patients with Parkinson’s disease?

<p>Dopamine (B)</p> Signup and view all the answers

In managing a patient with heart failure, which of the following interventions is NOT a typical nursing priority?

<p>Increase physical activity (B)</p> Signup and view all the answers

What is a common cause of death in patients with Amyotrophic Lateral Sclerosis (ALS)?

<p>Pneumonia (D)</p> Signup and view all the answers

Which of the following nursing priorities is important for a patient undergoing treatment for HIV/AIDS?

<p>Pain management (A)</p> Signup and view all the answers

Which indication suggests a patient may be undergoing neurogenic shock?

<p>Tachycardia and hypotension (A)</p> Signup and view all the answers

What type of insulin replacement method is being utilized by a patient who spreads their daily insulin dosage throughout the day?

<p>Insulin pump (A)</p> Signup and view all the answers

What is a primary risk factor for the development of urinary calculi?

<p>Inadequate hydration (D)</p> Signup and view all the answers

What complication is associated with hyperthyroidism?

<p>Osteoporosis (A)</p> Signup and view all the answers

What is typically NOT a symptom of hypothyroidism?

<p>Hypersensitivity to heat (B)</p> Signup and view all the answers

Which condition is defined by weakness that starts in the lower extremities and progresses upwards?

<p>Guillian-Barre syndrome (B)</p> Signup and view all the answers

What type of brain injury occurs due to acceleration and deceleration forces, potentially leading to widespread damage?

<p>Diffuse axonal injury (C)</p> Signup and view all the answers

Which of the following is not a common cause of brain injury?

<p>Sports injuries (D)</p> Signup and view all the answers

What is the primary risk associated with repeated concussions?

<p>Chronic traumatic encephalopathy (B)</p> Signup and view all the answers

Which statement regarding intracranial pressure is true after brain injury?

<p>It may lead to herniation if it continues to rise. (D)</p> Signup and view all the answers

What is a characteristic sign of a skull fracture?

<p>Halo sign (B)</p> Signup and view all the answers

What can lead to secondary brain injury?

<p>Cerebral edema and ischemia (A)</p> Signup and view all the answers

Which type of spinal cord injury results in paralysis of all four limbs?

<p>Quadriplegia (C)</p> Signup and view all the answers

What is a common consequence of neurogenic shock following a spinal cord injury?

<p>Decreased cardiac output (B)</p> Signup and view all the answers

What is the primary management goal in a patient with a head injury?

<p>Prevent secondary brain injury (C)</p> Signup and view all the answers

Which of the following signs indicates a possible cerebral hemorrhage?

<p>Battle's sign (A)</p> Signup and view all the answers

What is the immediate nursing action for a patient with a suspected spinal cord injury?

<p>Assume cervical spine injury (A)</p> Signup and view all the answers

Which of the following describes a contusion?

<p>Severe injury with potential hemorrhage (A)</p> Signup and view all the answers

How does spinal shock manifest after injury?

<p>Flaccidity and loss of reflexes (B)</p> Signup and view all the answers

In the case of intracerebral hemorrhage, what does the extent of injury depend on?

<p>Amount of force applied to a small area (D)</p> Signup and view all the answers

Which of the following reflects a sudden depression of reflex activity in the spinal cord below the level of spinal cord injury?

<p>Spinal shock (D)</p> Signup and view all the answers

What is a common trigger for autonomic dysreflexia?

<p>Distended bladder (B)</p> Signup and view all the answers

Which assessment sign indicates meningeal irritation?

<p>Kernig's sign (B)</p> Signup and view all the answers

What is the earliest sign of increasing intracranial pressure (ICP)?

<p>Change in the level of consciousness (D)</p> Signup and view all the answers

Which of the following is a characteristic symptom of bacterial meningitis?

<p>Stiff neck (A)</p> Signup and view all the answers

Which condition is NOT a potential complication of spinal cord injury?

<p>Cerebral edema (A)</p> Signup and view all the answers

What intervention is appropriate immediately for a patient experiencing symptoms of autonomic dysreflexia?

<p>Rapidly assess and relieve the triggering cause (A)</p> Signup and view all the answers

What is the recommended frequency for passive range-of-motion exercises for a patient to improve mobility after spinal injury?

<p>At least four times a day (D)</p> Signup and view all the answers

Which age group is at the highest risk for meningococcal disease?

<p>Individuals aged 11 to 26 years (C)</p> Signup and view all the answers

What is a common cause of bacterial meningitis?

<p>Streptococcus pneumoniae (D)</p> Signup and view all the answers

Which of the following is a non modifiable risk factor for cardiovascular disorders?

<p>Age (D)</p> Signup and view all the answers

What characterizes a myocardial infarction?

<p>Severe and abrupt deprivation of oxygen to tissue (A)</p> Signup and view all the answers

What is the major type of stroke accounting for 80% of cases?

<p>Ischemic stroke (B)</p> Signup and view all the answers

During a myocardial infarction, which vital sign typically increases initially?

<p>Heart rate (D)</p> Signup and view all the answers

Which symptom is NOT associated with ischemic stroke?

<p>Cool, clammy skin (D)</p> Signup and view all the answers

What is the primary treatment method for specific ischemic strokes within the initial window?

<p>Thrombolytic therapy (A)</p> Signup and view all the answers

Which of the following conditions is associated with a loss of half of the visual field?

<p>Hemianopia (A)</p> Signup and view all the answers

What is the purpose of percutaneous coronary intervention?

<p>To relieve ischemia by restoring blood flow (B)</p> Signup and view all the answers

Which factor increases oxygen requirements during a myocardial infarction?

<p>Increased pain and hypoxia (C)</p> Signup and view all the answers

What is a common manifestation of a transient ischemic attack (TIA)?

<p>Temporary neurological deficits (B)</p> Signup and view all the answers

What is the CD4+ T-lymphocyte count that defines Stage 3 HIV infection?

<p>Below 200 cells/mm3 (A)</p> Signup and view all the answers

Which symptom is commonly associated with the first stage of HIV infection?

<p>Rash (B)</p> Signup and view all the answers

What is the primary goal of antiretroviral therapy (ART) in HIV treatment?

<p>Suppress HIV replication (D)</p> Signup and view all the answers

Which type of angina is characterized by pain that occurs at rest and is not relieved by nitroglycerin?

<p>Unstable angina (A)</p> Signup and view all the answers

Which manifestation is NOT typically associated with HIV/AIDS?

<p>Angina pectoris (B)</p> Signup and view all the answers

How is Stage 1 HIV infection primarily defined?

<p>Development of HIV-specific antibodies (B)</p> Signup and view all the answers

Which of the following is a potential complication of HIV/AIDS?

<p>Wasting syndrome (B)</p> Signup and view all the answers

What is the normal range for CD4+ T-cell counts in healthy individuals?

<p>500-1,500 cells/mm3 (D)</p> Signup and view all the answers

Which form of angina is characterized by episodes of chest pain that may be relieved by rest?

<p>Stable angina (D)</p> Signup and view all the answers

What ethical dilemma surrounds HIV-positive individuals in Canada?

<p>Disclosure of HIV status before sexual activity (B)</p> Signup and view all the answers

Which medication is NOT typically used to treat anginal pain?

<p>Ibuprofen (D)</p> Signup and view all the answers

Which of the following describes silent ischemia?

<p>No reports of pain but evident on ECG changes (D)</p> Signup and view all the answers

What is the main characteristic of intractable or refractory angina?

<p>Severe incapacitating chest pain (B)</p> Signup and view all the answers

What distinguishes acute coronary syndrome from stable angina?

<p>Symptoms occurring at rest (A)</p> Signup and view all the answers

Which statement is true regarding thrombolytic therapy?

<p>It is indicated for patients who cannot speak. (B)</p> Signup and view all the answers

What characteristic is associated with right hemisphere communication impairments?

<p>Difficulty understanding non-verbal cues. (C)</p> Signup and view all the answers

In the context of muscular dystrophy, which type is known for early onset and rapid progression?

<p>Duchenne muscular dystrophy. (A)</p> Signup and view all the answers

Which of the following treatments is essential for managing Parkinson's disease symptoms effectively?

<p>Antiparkinsonian agents taken consistently. (B)</p> Signup and view all the answers

What is a primary risk factor for hemorrhagic strokes?

<p>Uncontrolled hypertension. (A)</p> Signup and view all the answers

Which symptoms are typically seen in Guillain-Barré syndrome?

<p>Weakness starting from lower extremities and moving upward. (D)</p> Signup and view all the answers

What defines status epilepticus in seizure management?

<p>Multiple seizures without recovery of consciousness lasting 30 minutes. (A)</p> Signup and view all the answers

What is an early symptom of Huntington's disease?

<p>Severe mood swings and emotional disturbances. (B)</p> Signup and view all the answers

Which condition is characterized by flaccidity?

<p>Lack of muscle tone. (A)</p> Signup and view all the answers

What is the primary intervention in managing muscle weakness in amyotrophic lateral sclerosis (ALS)?

<p>Physical therapy to maintain function. (C)</p> Signup and view all the answers

What adverse reaction is associated with long-term use of Sinemet in Parkinson's disease?

<p>Dyskinesia. (D)</p> Signup and view all the answers

Which of the following is a characteristic feature of apraxia?

<p>Impairment of purposeful movements. (D)</p> Signup and view all the answers

What dietary modification is recommended for individuals with Huntington's disease?

<p>Soft or pureed diets to prevent aspiration. (C)</p> Signup and view all the answers

Which medication is commonly used for seizure management?

<p>Valproic acid. (C)</p> Signup and view all the answers

Flashcards

Inflammatory Bowel Disease (IBD)

Inflammation and ulceration of the intestinal lining, including Crohn's disease and ulcerative colitis.

Crohn's Disease Symptoms

Symptoms like abdominal pain, rectal bleeding, and fistula formation, along with inflammation in areas beyond typical ulcerative colitis locations (mouth, etc.).

Ostomies

Temporary or permanent surgical procedures that create an opening in the abdominal wall to bypass a section of the intestine.

Cholecystitis

Inflammation of the gallbladder, often caused by gallstones.

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Pancreatitis

Autodigestion of the pancreas.

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Pancreatitis Treatment (NPO and TPN)

NPO and TPN (total parenteral nutrition) are used to rest the pancreas and provide nutrition without stimulating digestion, a common treatment for pancreatitis.

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ERCP and Pancreatitis Diagnosis

Endoscopic Retrograde Cholangiopancreatography (ERCP) examines the biliary system to distinguish pancreatitis from other biliary disorders by looking at the pancreas and ducts.

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Nursing Priorities for IBD, Ostomy, Cholecystitis, and Pancreatitis (General)

These conditions often involve managing pain, fluid/electrolyte balance, nutrition (including parenteral nutrition), skin care, and patient education for coping/anxiety/body image.

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What does a pancreatic duct obstruction indicate?

It suggests a blockage in the tube that carries pancreatic juice from the pancreas to the small intestine, potentially impacting digestion.

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What is Diabetes Mellitus?

A chronic condition where the body either doesn't produce enough insulin or can't use it properly, leading to high blood sugar levels.

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Insulin Resistance vs Deficiency

Insulin resistance (type 2) occurs when the body doesn't respond to insulin effectively, while insulin deficiency (type 1) is the inability to produce enough insulin.

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What are potential symptoms of advanced hypoglycemia?

Loss of concentration, nausea, abdominal pain, perpetual confusion, and seizures are all potential symptoms.

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What's the best response to Sarah, a type 1 diabetic patient with low body weight?

Explain that her body utilizes protein and fat for energy instead of glucose, leading to weight loss.

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What's Ben's insulin replacement method?

He practices basal-bolus insulin therapy, delivering a steady background insulin dose (basal) and additional boluses before meals (bolus).

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What are potential factors contributing to hyperglycemia in hospitalized diabetics?

Stress, intravenous dextrose, total parenteral nutrition (TPN), steroids, infection, decreased activity level, and insulin timing can all contribute to high blood sugar.

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What is Goitre?

It's an enlargement of the thyroid gland, often a sign of thyroid dysfunction.

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What are nursing priorities for clients with TB?

Transmission prevention, medication adherence, nutrition management, and oxygenation support are crucial.

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What are the key nursing priorities for pneumonia?

Focusing on maintaining a clear airway, ensuring adequate oxygenation, managing pain, addressing nutritional needs, dealing with fatigue, and providing patient education.

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What are the types of urinary incontinence?

Stress incontinence (leakage with activities like coughing), urge incontinence (sudden urge), functional incontinence (difficulty reaching the toilet), overflow incontinence (incomplete bladder emptying), and neurogenic incontinence (nerve damage).

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What is Heart Failure?

The heart is unable to pump blood effectively, leading to inadequate blood flow to meet the body's needs.

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What are common symptoms of Parkinson's Disease?

Tremors, bradykinesia (slow movements), micrographia (small handwriting), and shuffling gait are all hallmarks of Parkinson's.

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What neurotransmitter is decreased in Parkinson's?

Dopamine, a neurotransmitter involved in movement control, is significantly reduced in the brains of individuals with Parkinson's.

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What is the most common drug used to treat Parkinson's?

Levodopa, often combined with carbidopa, is a common medication used to treat Parkinson's symptoms.

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What's the concern with long-term Levodopa use?

Dyskinesia, involuntary or uncontrolled movements, can develop with prolonged Levodopa use.

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What is Guillian-Barre syndrome?

It's an autoimmune disorder that causes nerve damage, often triggered by an infection. It usually starts in the lower extremities and progresses upwards.

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Primary Brain Injury

The initial damage caused by the direct impact of the head injury. Examples include contusions, lacerations, and blood vessel damage.

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Secondary Brain Injury

Damage that occurs after the initial injury due to complications like swelling, lack of oxygen, or chemical changes in the brain.

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Intracranial Pressure (ICP)

The pressure inside the skull. It can increase when the brain swells, leading to reduced blood flow and potential brain damage.

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What is Battle's Sign?

A bruise behind the ear, often a sign of a skull fracture.

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Closed Brain Injury

Injury where the skull remains intact, but brain tissue is damaged due to the head's sudden movement.

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Open Brain Injury

Injury where the skull is fractured and something penetrates the scalp and skull, exposing the brain.

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Concussion

A mild brain injury characterized by temporary loss of consciousness but no visible brain damage.

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Diffuse Axonal Injury

A severe brain injury where nerve fibers (axons) are widespread throughout the brain, usually leading to coma.

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Epidural Hematoma

A collection of blood that forms between the skull and the dura mater (protective layer covering the brain), often causing rapid loss of consciousness followed by a period of lucidity.

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Subdural Hematoma

A blood collection that builds up between the dura mater and the brain, commonly caused by venous bleeding

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Spinal Cord Injury (SCI)

Damage to the spinal cord, resulting in potential paralysis and loss of sensation below the level of the injury.

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Incomplete Spinal Cord Injury

Some function remains below the level of injury, meaning some sensation or movement may be preserved.

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Complete Spinal Cord Injury

All function below the level of injury is lost, resulting in complete paralysis and loss of sensation.

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Spinal Shock

A temporary loss of reflexes and sensation below the level of a spinal cord injury.

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Neurogenic Shock

Shock caused by damage to the autonomic nervous system, affecting heart rate, blood pressure, and body temperature.

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Venous Thromboembolism (VTE)

A blood clot that forms in a vein, often in the legs, and can travel to the lungs, causing a pulmonary embolism.

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Orthostatic Hypotension

A sudden drop in blood pressure when standing up, leading to dizziness and lightheadedness.

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Autonomic Dysreflexia

An acute, potentially life-threatening condition that occurs in individuals with spinal cord injuries above T6. It involves exaggerated autonomic nervous system responses, causing a dangerous spike in blood pressure.

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Pressure Injury

A breakdown of skin and underlying tissue caused by prolonged pressure on the same area of the body. It can occur in individuals with reduced mobility and can be a serious complication.

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Meningitis

Inflammation of the membranes and the fluid space surrounding the brain and spinal cord. It can be caused by bacteria (septic) or viruses (aseptic).

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Nuchal Rigidity

Stiff neck, a common symptom of meningitis, caused by inflammation and irritation of the meninges.

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Kernig's Sign

A sign of meningitis where pain and resistance occur when trying to extend the knee with the hip flexed.

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Brudzinski's Sign

A sign of meningitis where flexing the head and neck into the chest causes pain in the neck and involuntary flexing of the knees.

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Increased Intracranial Pressure (ICP)

The pressure inside the skull increases, potentially caused by swelling, bleeding, or other factors, leading to reduced blood flow and brain damage.

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What are seizures?

Seizures are abnormal episodes of involuntary muscle activity, sensory changes, altered behavior, or a combination of these, caused by uncontrolled electrical discharges in the brain.

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Types of seizures: Partial

Partial seizures begin in one area of the brain. Simple partial seizures don't affect consciousness, while complex partial seizures impair consciousness.

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Types of seizures: Generalized

Generalized seizures involve the whole brain. They can include tonic-clonic seizures with stiffening and jerking, tonic seizures with stiffening, clonic seizures with jerking, absence seizures with staring, and myoclonic seizures with brief muscle jerks.

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What is status epilepticus?

Status epilepticus is a medical emergency where a person experiences continuous seizures without regaining consciousness between them, lasting at least 30 minutes.

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What are the main goals of treating a seizure?

The main goals are to stop the seizures as quickly as possible, ensure adequate oxygen supply to the brain, and prevent future seizures.

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What are some common anticonvulsant medications?

Common anticonvulsant medications include valproic acid, phenobarbital, carbamazepine, phenytoin, and benzodiazepines like clonazepam (Rivotril), diazepam (Valium), and lorazepam (Ativan).

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How is HIV transmitted?

HIV is transmitted through bodily fluids containing infected cells, like blood, semen, vaginal secretions, and breast milk. It can also be transmitted from mother to child during pregnancy, childbirth, or breastfeeding.

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How does HIV affect the body?

HIV targets cells with CD4+ receptors, found on certain immune cells. These cells are crucial for fighting infections, and their destruction by HIV leads to a weakened immune system.

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What are examples of HIV prevention strategies?

Prevention strategies include safer sexual practices, needle exchange programs, medical male circumcision, HIV testing and counseling, and antiretroviral pre-exposure prophylaxis (PrEP).

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What are standard precautions for healthcare workers?

Standard precautions include hand hygiene, wearing gloves, using masks and gowns when appropriate, and disposing of sharps properly. These help to reduce the risk of transmission of infectious agents, including HIV.

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Myocardial Infarction (MI)

Occurs when heart muscle tissue is severely deprived of oxygen due to a blocked artery, leading to cell death.

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Ischemia

Reduced blood flow to a tissue, causing oxygen deprivation.

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What are modifiable risk factors for MI?

Factors that can be changed to reduce the risk of MI, including high cholesterol, smoking, hypertension, diabetes, obesity, and lack of exercise.

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What are non-modifiable risk factors for MI?

Factors that cannot be changed, such as age, gender, family history, and ethnicity.

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What cardiovascular assessment findings are common in MI?

Increased blood pressure (initially), rapid and irregular heart rate, weak pulses, cool and clammy skin, abnormal heart sounds, shortness of breath, and crackles in the lungs.

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Percutaneous Coronary Intervention (PCI)

A minimally invasive procedure to open blocked coronary arteries using a balloon catheter to inflate and deploy a stent.

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What is an Aneurysm?

A permanent localized dilation or bulge in an artery, often caused by weakness in the vessel wall.

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What are the types of strokes?

Strokes are classified as ischemic (blockage) or hemorrhagic (bleeding). Ischemic strokes account for 80% and are caused by a blocked artery, while hemorrhagic strokes account for 20% and are caused by bleeding in the brain.

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What are the manifestations of an ischemic stroke?

Symptoms depend on the area of the brain affected and can include weakness, numbness, facial drooping, confusion, speech problems, and sudden headache.

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What is a Transient Ischemic Attack (TIA)?

A temporary interruption of blood flow to the brain, causing stroke-like symptoms that usually resolve within an hour.

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T lymphocytes

A type of white blood cell (WBC) crucial for the immune system's ability to fight infections, particularly viruses. They recognize and destroy infected cells.

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HIV Infection Stages

HIV infection is classified into five stages: 0, 1, 2, 3, and unknown. Stages 1, 2, and 3 are based on the CD4+ T-lymphocyte count, which measures the strength of the immune system.

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Stage 0 HIV Infection

Early HIV infection diagnosed through laboratory testing, even without symptoms. It's a crucial stage for early intervention.

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Stage 1 HIV Infection

Primary or acute HIV infection, characterized by a dramatic decrease in CD4+ T-cell count. It can be accompanied by flu-like symptoms.

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Stage 2 HIV Infection

Occurs when the CD4+ T-lymphocyte count falls between 200 and 499 cells/mm3 of blood.

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Stage 3 HIV Infection

CD4+ count falls below 200 cells/mm3 of blood, considered AIDS for surveillance purposes. This stage marks a severely weakened immune system.

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What are the effects of HIV on the brain?

HIV can affect cognition, motor function, attention, visual memory, and visuospatial abilities. It can also cause peripheral neuropathy and HIV encephalopathy.

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What is Antiretroviral Therapy (ART)?

ART is the main treatment for HIV, aiming to suppress HIV replication, reduce HIV-related morbidity and mortality, and improve quality of life.

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What is the main goal of ART?

The main objective of ART is to suppress HIV replication, preventing further damage to the immune system and allowing for a longer and healthier life.

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What are some potential complications of HIV?

Opportunistic infections, impaired breathing, wasting syndrome, fluid and electrolyte imbalance, and adverse effects from medications are common complications.

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What are the ethical considerations surrounding HIV?

In Canada, individuals need to disclose their HIV-positive status before engaging in sexual activity where there's a realistic possibility of transmission. However, with undetectable viral load and condom use, the risk is minimal.

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What is angina pectoris?

Angina pectoris is chest pain caused by insufficient blood flow to the heart muscle, often triggered by exertion or stress.

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What is stable angina?

Chest discomfort that occurs with exertion, is limited in duration, and is relieved by rest and nitroglycerin.

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What is unstable angina?

Angina that occurs at rest or with minimal exertion, is more frequent, severe, and lasts longer than stable angina, and is poorly relieved by nitroglycerin.

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What is acute coronary syndrome (ACS)?

ACS encompasses a spectrum of conditions including unstable angina and acute myocardial infarction.

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Carotid Endarterectomy

A surgical procedure to remove plaque buildup from the carotid artery, which helps prevent stroke by improving blood flow to the brain.

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Anticoagulant Therapy

Medication used to prevent blood clots from forming by thinning the blood, like heparin.

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Antiplatelet Therapy

Medication like aspirin that prevents platelets from sticking together and forming clots.

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Thrombolytic Therapy

Medication like tPA used to break up existing blood clots, often used in stroke emergencies.

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What is Expressive Aphasia?

A communication disorder where a person understands language but has difficulty speaking or writing due to damage to Broca's area in the brain.

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What is Receptive Aphasia?

A communication disorder where a person has difficulty understanding spoken or written language due to damage to Wernicke's area in the brain.

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What is Flaccidity?

A state of complete lack of muscle tone, resulting in limpness.

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What is Spasticity?

A state of increased muscle tone with exaggerated reflexes, causing stiffness and difficulty moving.

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What is Apraxia?

A neurological disorder that affects the ability to perform purposeful movements despite having the physical ability to do so.

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What is Dysphagia?

Difficulty swallowing, making it challenging to consume food and fluids, potentially requiring special feeding methods.

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What is Deconditioning?

A decline in physical and mental abilities that occurs due to inactivity or illness, leading to muscle weakness, cognitive impairment, and decreased endurance.

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What is Hemorrhagic Stroke?

A type of stroke caused by bleeding into the brain tissue, ventricles, or subarachnoid space, often due to uncontrolled hypertension.

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What is Parkinson's Disease?

A progressive neurological disorder characterized by slow, involuntary movements, tremors, and rigidity, due to loss of dopamine in the brain.

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What is Sinemet 25/100?

A medication commonly used to treat Parkinson's disease, containing levodopa and carbidopa to increase dopamine levels.

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What is Huntington Disease?

A chronic inherited neurological disorder leading to progressive involuntary movements (chorea), dementia, and emotional disturbances.

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What is Amyotrophic Lateral Sclerosis (ALS)?

A progressive neurodegenerative disease leading to muscle weakness and atrophy, eventually affecting breathing and swallowing.

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Study Notes

Inflammatory Bowel Disease (IBD)

  • IBD involves inflammation and ulceration of the intestinal lining, encompassing Crohn's disease and ulcerative colitis.

  • Nursing priorities for IBD include managing diarrhea, pain, fluid and electrolyte balance, nutrition (potentially parenteral nutrition), activity tolerance, anxiety, and coping mechanisms. Skin integrity is also crucial.

  • Crohn's disease symptoms that may confirm the presence of the disease include ulceration in areas besides the rectum, such as the colon, inflammation affecting various tissues, and inflammation in the mouth.

Ostomies

  • Ileostomy/colostomy procedures can be temporary or permanent to reroute the intestine.
  • Nurses specializing in wound ostomy and continence (NSWOC) provide crucial support.
  • Pre-operative support is important.
  • Stool characteristics vary depending on the ostomy location. New ostomy color is typically bright red; if damaged, it might become dusty and then black.
  • Post-operative nursing care focuses on stoma blood supply, skin integrity, body image, patient education and fluid balance.

Gallbladder

  • Cholecystitis is gallbladder inflammation often caused by gallstones.
  • Post-operative nursing priorities include pain management, maintaining adequate gas exchange, skin care, and nutritional support, along with patient education.

Pancreatitis

  • Pancreatitis is autodigestion of the pancreas.
  • Nursing priorities for pancreatitis include pain management, managing nasogastric (NG) tubes, ensuring adequate oxygenation, and managing fluid and electrolyte balance, and providing nutritional support.
  • An x-ray may be used to determine the placement of a feeding tube (G-tube).
  • A physician may recommend NPO (nothing by mouth) and TPN (total parenteral nutrition) to prevent complications.

Diabetes Mellitus (DM)

  • DM is categorized by insulin resistance (Type 2) or insulin deficiency (Type 1).

  • Priorities for newly diagnosed patients include nutrition, preventing fluid volume deficit, education regarding self-management, managing anxiety, monitoring for complications like hyperglycemia and hypoglycemia, and recognizing symptoms like those associated with diabetic ketoacidosis (DKA).

  • Advanced hypoglycemia symptoms can include loss of concentration, confusion, seizures, and abdominal pain. Nausea might also occur.

  • For a 16-year-old with Type 1 DM experiencing low body weight despite regular eating, emphasizing the body's use of protein and fat for energy instead of glucose would be the best nursing response.

  • Ben's insulin replacement method, using rapid-onset insulin in an insulin pump with half the daily dose for basal needs and the remaining used for meal coverage, signifies adjusting for daily insulin needs.

  • Stress, intravenous (IV) dextrose, total parenteral nutrition (TPN), steroids, infection, decreased activity, and the timing of insulin administration can contribute to hyperglycemia in a hospitalized patient with diabetes undergoing surgery.

Thyroid

  • Goiter is an enlarged thyroid gland.
  • Symptoms of hypothyroidism include fatigue and slowed function; hyperthyroidism symptoms require further specification.
  • Post-thyroidectomy care focuses on maintaining airway, breathing, and circulation and placing the patient in a semi-Fowler's position.

Pneumonia/Tuberculosis (TB)

  • TB typically affects the lungs but can spread to other organs.
  • TB nursing priorities include preventing transmission through education, medication, nutrition, and oxygenation support.
  • Pneumonia nursing priorities are airway management, improving oxygenation, pain management, nutrition support, fatigue management, and patient education.
  • TB medication can lead to resistance if not taken correctly and consistently.

Urinary Issues

  • Urinary incontinence types include stress, urge, functional, overflow, and neurogenic incontinence.
  • Strategies to address these issues include behavioral modifications.
  • Urinary tract infections (UTIs) risk factors and management also require further specification.
  • Regarding calculus or urinary stones, pain management and improving elimination are crucial components of care.

Heart Failure

  • Heart failure means the heart cannot meet the body's metabolic demands.
  • Left-sided failure leads to pulmonary edema.
  • Treatments involve medications and fluid/sodium restrictions.
  • Nursing care prioritizes oxygenation, activities, fluid balance, patient education, and medication management.

Parkinson's Disease

  • Parkinson's disease symptoms include tremors, slow movement (bradykinesia), small handwriting (micrographia), shuffling gait, and postural instability.
  • Dopamine is the significantly decreased neurotransmitter in Parkinson's disease.
  • Levodopa/carbidopa (Sinemet) is a commonly used treatment, but long-term use can cause dyskinesia (involuntary movements.)
  • Nursing care for individuals with Parkinson's disease prioritizes mobility, self-care, constipation management, nutritional support, communication, and coping mechanisms.

Amyotrophic Lateral Sclerosis (ALS)

  • ALS affects speech, but not cognition or dementia.
  • Average survival is 3-5 years.
  • The primary cause of death is respiratory insufficiency.

Guillain-Barré Syndrome

  • Guillain-Barré is an autoimmune response to a viral infection, commonly starting in the lower extremities and progressing upward.
  • Full recovery is typical for most patients.
  • Nursing priorities include oxygenation, preventing aspiration, mobility, nutrition, communication support, and addressing potential fear and anxiety.

HIV/AIDS

  • HIV transmission occurs through body fluids: blood, semen, vaginal fluids, amniotic fluid, and breast milk.
  • Needle sharing, unprotected sex, and blood transfusions (now rare) are major transmission routes.
  • Early HIV symptoms may include fever, fatigue, and rash.
  • Prolonged infection stages often have few symptoms; CD4+ T-cell counts diminish over time.
  • AIDS is diagnosed when CD4+ counts drop below 200 cells/mm³.
  • Nursing priorities for HIV/AIDS patients include managing complications, preventing infection, supporting nutrition and airway management, and addressing psychosocial needs like social isolation or bereavement.

Spinal Cord Injury

  • A completely severed spinal cord at T4 requires mechanical ventilation.
  • Spinal shock occurs immediately after spinal cord injury.
  • Autonomic dysreflexia signs include tachycardia, hypotension, and altered sweating.

Brain Injury - General

  • Brain injury encompasses damage to the scalp, skull, or brain, often a result of falls, accidents, or violence.
  • Primary brain injury is the initial damage, while secondary injury results afterwards from complications like edema or ischemia.
  • Intracranial pressure increases due to swelling; this leads to oxygen and blood flow issues.

Brain Injury - Types

  • Closed injuries (e.g., concussion, contusions) : Acceleration/deceleration injuries are common;
  • Open injuries penetrate the skull;
  • Concussion is a temporary loss of consciousness without structural damage. Symptoms include headaches, dizziness, fatigue, and emotional changes; repeated concussions may lead to chronic traumatic encephalopathy (CTE).
  • Contusion: Bruising, hemorrhage, or edema. Recovery depends on the amount of damage.
  • Diffuse axonal injury: widespread axon damage causing immediate coma.
  • Intracranial hemorrhage: Types include epidural, subdural, and intracerebral, which requires emergent treatment and monitoring of intracranial pressure.

Brain Injury Management

  • Assume cervical spine injury until ruled out.
  • Treat cerebral edema and maintain cerebral perfusion.
  • Support respiration.
  • Prevent and manage seizures.

Spinal Cord Injuries — Management

  • Assess for spinal shock and autonomic dysreflexia.
  • Manage potential complications like venous thromboembolism, orthostatic hypotension, and pressure injuries.
  • Implement strategies to enhance mobility gradually and safely.
  • Note risk of autonomic dysreflexia.

Meningitis

  • Meningitis is inflammation of the brain and spinal cord membranes.
  • Types include bacterial (septic, transmission via secretions/aerosol) and aseptic (viral). Septic meningitis is typically caused by Streptococcus pneumoniae, Neisseria meningitides, or Haemophilus influenzae.
  • Key symptoms include headache, fever, altered mental status, stiff neck (nuchal rigidity), and sensitivity to light (photophobia). Positive Kernig and Brudzinski signs indicate meningeal irritation. Increased intracranial pressure (ICP) is a possible complication.

Seizures

  • Seizures are abnormal electrical discharges from cerebral neurons.
  • Partial seizures affect one brain region (simple = conscious, complex = impaired).
  • Generalized seizures affect the whole brain (tonic-clonic, absence, myoclonic).
  • Assessment during a seizure includes duration, symptoms, and level of awareness before, during, and after.
  • Treatment primarily relies on anticonvulsants, including medications like valproic acid, phenobarbital, carbamazepine, and phenytoin.

Status Epilepticus

  • Status epilepticus is a prolonged seizure state lasting at least 30 minutes.
  • It's a medical emergency needing immediate intervention to stop seizures, maintain oxygenation, and prevent further complications.

Other

  • Other conditions explored include cardiovascular issues (angina, MI, aneurysms), cerebrovascular disorders (strokes), various neurological conditions (Huntington's disease, muscular dystrophy), and more. Each condition and its associated care focuses on symptoms assessment, management and potential complications.

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This quiz explores the nursing priorities related to Inflammatory Bowel Disease (IBD), including symptoms and care management. It also covers the essential knowledge needed for ostomy procedures and post-operative nursing considerations. Test your understanding of these crucial nursing topics!

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