Ankylosing spondylitis (AS)
is a type of inflammatory arthritis and an autoimmune disease. is a long-term disease that causes inflammation of the joints between the spinal bones, and the joints between the spine and pelvis. affects between 150,000 and 300,000 Canadians.
In advanced, there is:
• Fusion of joints in the spine.
• Flattening of the normal curve in the low back.
• Often a flattening of the normal curve of the neck, an increase in the forward curve of the upper back, and bent posture at the hips.
The disease most often begins between ages 20 and 40, but may begin before age 10. It affects more males than females. Risk factors include:
• Family history of AS
• Male gender
The disease starts with low back pain that comes and goes.
• Pain and stiffness are worse at night, in the morning, or when you are not active. It may wake you from your sleep.
• The pain typically gets better with activity or exercise.
• Back pain may begin in the sacroiliac joints (between the pelvis and the spine). Over time, it may involve all or part of the spine.
You may lose motion or mobility in the lower spine. You may not be able to fully expand your chest because the joints between the ribs are involved.
Fatigue is also a common symptom. Other, less common symptoms include:
• Eye inflammation
• Heel pain
• Hip pain and stiffness
• Joint pain and joint swelling in the shoulders, knees, and ankles
• Loss of appetite
• Slight fever
• Weight loss
Although it is unusual, AS can also cause changes such as thickening of the aorta and the valve in the heart called the aortic valve. Scarring of the lungs also happens in rare cases. The kidneys and the digestive tract can also be affected.
Signs and tests
There is no specific test to diagnose AS. In fact, some people live with mild AS for many years without ever knowing they have it.
Tests may include:
• Complete blood count (CBC)
o The number of RBCs, WBCs, hemoglobin, hematocrit, platelets, average RBC size
• Erythrocyte sedimentation rate (ESR)
o a test that indirectly measures how much inflammation is in the body
• X-rays of the spine and pelvis
• MRI of the spine
There is no cure for AS. The goal is to keep the spine flexible and the joints moving, with the hope of preventing or delaying permanent damage. Often nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to reduce inflammation and pain.
Corticosteroid therapy or medications to suppress the immune system may also be prescribed. Drugs called TNF-inhibitors, which block an inflammatory protein, have been shown to improve the symptoms of AS.
Some health care professionals use drugs that block cell growth (cytotoxic drugs) in people who do not respond well to corticosteroids or who are dependent on high doses of corticosteroids.
Surgery may be done if pain or joint damage is severe.
Exercises can help improve posture and breathing.
• Range of motion exercises reduce pain and stiffness
• Strengthening exercises maintain or increase muscle tone and protect joints
• Moderate stretching exercises help to relieve the pain and keep the muscles and tendons around an affected joint flexible
• Endurance exercises strengthen your heart, given you energy, control your weight and a better feeling overall.
• Lying flat on the back at night can help maintain normal posture
Common Types of Arthritis
Osteoarthritis, Rheumatoid Arthritis, Gout, Ankylosing Spondylitis, Juvenile Arthritis, Psoriatic Arthritis, Lupus, Can be caused from; Lyme disease, Scleroderma, Fibromyalgia syndrome
is soft-tissue rheumatism that doesn't lead to joint deformity, but affects an estimated 4 million Canadians, mostly women.
is a systemic disease that involves the skin, but may include problems with blood vessels, joints, and internal organs.
can cause arthritis. Infectious arthritis can cause serious damage, but usually clears up completely with antibiotics.
can develop as a result of an infection. For example, bacteria that cause gonorrhea or
Involves skin, joints, muscles, and sometimes internal organs. Symptoms usually appear in women of childbearing age but can occur in anyone at any age. Also called lupus or SLE, it can be mild or life threatening. Affects nearly 17,000 Canadians, nine to ten times as many women as men.
Bone and other joint tissues become inflamed, and, like rheumatoid arthritis, it can affect the whole body. Affects about 5 percent of people with psoriasis, a chronic skin disease. Likely to affect fingers or spine. Symptoms are mild in most people but can be quite severe.
The most common form is juvenile rheumatoid arthritis. Arthritis diagnosis, treatment, and disease characteristics are different in children and adults. Some children recover completely; others remain affected throughout their lives. JA affects about 10,000 (one in 1000) children and teenagers in Canada. Four times as many girls as boys get JA.
A chronic inflammatory disease of the spine that can result in fused vertebrae and rigid spine. Often milder and harder to diagnose in women. Most people with the disease also have a genetic marker known as HLA-B27. AS affects between 150,000 and 300,000 Canadians, more males than females.
CXauses sudden, severe attacks, usually in the big toe, but any joint can be affected. A metabolic disorder in which uric acid builds up in the blood and crystals form in joints and other places. Drugs and attention to diet can control gout. It occurs more often in men than women, and affects about 2% of both men over age 30 and women over age 50 in Canada
Immune system attacks the lining, or synovial membrane, of the joints. Joint damage can become severe and deforming. Involves the whole body, and may also cause fatigue, weight loss and anemia, and affect the lungs, heart and eyes. One out of every 100 Canadians has RA, three times more women than men.
The most prevalent kind of arthritis. Also called degenerative arthritis. Occurs when the cushioning cartilage in a joint breaks down. Commonly affects feet, knees, hips, and fingers. There is no cure. It affects one in 10 Canadian adults, women and men equally (past 60).
Inflammation of a joint; most prevalent types are osteoarthritis, rheumatoid arthritis, and gouT
-joint pain is the predominant symptom
-asymmetrical joint pain
-early morning stiffness that is usually relieved in 30 mins.
-pain worsens with use or drop in barometric pressure
-overuse of joints especially with sports where they start and stop quickly
-deformity to involved joint
-Hererden's nodes and Bouchard's nodes: red, swollen and tender
-usually does not get to deformity stage
-rest and joint protection
-heat and cold application
-weight reduction and exercise
-collaborative and alternative therapies: acupuncture, yoga, massage
-Nonsteroidal anti-inflammatory drug (NSAIDs): ibuprofen
-fatigue, anorexia, weight loss, and generalized stiffness may come before the onset of arthritic complaints
-joint pain occurs symmetrically
-morning stiffness may last up to several hours or more
-can affect nearly every symptoms
-Autoimmune disease most widely accepted
-joint destruction begins as early as first year
-flexion contractures and hand deformities
-Noduloar myositis and muscle-fibre degeneration
-Education and drug therapy
-Apheresis: blood filtration device
- (topical agent, interferes with substance P which is responsible for the transmission of pain impulses)
found in joint fluid and articular cartilage, contributes to both the viscosity and elasticity of synovial fluid
-administered in 3 injections, 1 week apart, directly into the knee
blocks immune cell overproduction
also used to treat inflammatory bowel disease
anti-inflammatory, necessitates frequent lab monitorin
disease-modifying antirheumatic drugs (DMARDs)
Modify the course of inflammatory conditions such as rheumatoid arthritis, slowing progression of the disease
may decrease the loss of cartilage
An abnormal condition with excessive levels of red blood cells
a myeloproliferative disorder arising from a chromosomal mutation in a single pluripotent stem cell.
-increase in production of RBCs, granulocytes and platelets
-client has enhanced blood viscosity and blood volume and congestion of organs and tissues with blood, hyper-coagulopathies, splenomegaly and hepatomegaly are common
can be hypoxia driven or hypoxia independent
o Hypoxia stimulates erythropoietin production in the kidney, which in turn stimulates erythrocyte production
Clinical manifestations of polychemia
Occur because of the hypertension
First symptoms: headache, vertigo, dizziness, tinnitus and visual disturbances.
o Generalized pruritis may be a striking indicator.
o Paresthesias and erythromelalgia (painful burning and redness of the hands and feet cause by paroxysmal peripheral dilation) may also be present
o May experience angina, HF, intermittent claudication, and thrombophlebitis, caused by blood vessel distention, impaired blood flow, circulatory stasis, thrombosis, and tissue hypoxia caused by hypervolemia and hyperviscosity
o Caused by either vessel rupture from overdistention or inadequate platelet function: petechiae, ecchymoses, epitaxes, or GI bleed
Diagnostics of polychemia
1. Elevated hemoglobin and RBC count
2. Low to normal EPO level (secondary polycethemia)
3. Elevated WBC count with basophilia
4. Elevated platelets (thrombocytosis) and platelet dysfunction
5. Elevated leukocyte alkaline phosphatase, uric acid, and cobalamin levels
6. Elevated histamine levels
Collaborative Care of polychemia
Phlebotomy: aim is to reduce the hematocrit and keep it less than 45% to 48%
o 300-500mL of blood may be removed every other day until the hematocrit is reduced to normal levels.
o Individual usually becomes iron deficient
Hydration therapy is used to reduce viscosity
Myelosuppressive agents such as busulfan, hydroxyurea, and radioactive phosphorus may be given to inhibit bone marrow activity
Antiplatelet agents may be used to ease symptoms of erythromelalgia
has three sections:
1 - duodenum,
2 - jejunum,
3 - ileum.
= 20 ft total
1 - the ascending colon,
2 - the transverse colon,
3 - t he descending colon,
4 - the sigmoid colon,
5 - the rectum,
6 - the anus.
Surgical Procedures That Result in an Ileostomy
Many bowel operations may result in an ileostomy. The most common are the Subtotal
colectomy where the entire large bowel (colon) is removed leaving the rectum in place
and the Proctocolectomy where the entire large bowel is removed and the rectum is
is an opening on the abdomen
created at the time of your surgery. The doctor
brings the end of your small bowel out through
the skin and cuffs it back on itself to form a
stoma. The location of the stoma will most likely
be on the right hand side of your abdomen.
Stool and gas from the stoma collect in an appliance secured to your abdomen. You will
not feel the urge to go to the bathroom and you will not control your bowel as before.
After your operation, your stool will be liquid in consistency and you will have a lot of
gas. Later your stool will become thicker to resemble oatmeal. As you begin to eat and
the swelling in your bowel decreases, you will produce less gas.
If you have a " loop ileostomy", this is a little
different. The doctor brings out a loop of small
bowel through a small incision on your abdomen.
He/she places a plastic bridge under the loop to
support the bowel. The doctor then makes a
small incision in the exposed bowel and cuffs it
back on itself. A loop ileostomy is larger and
actually has two openings. One opening expels stool and gas and the other produces a jelly-like substance called
The location of this type of ileostomy will be on the right hand side and it is usually a
temporary stoma. The doctor/ET Nurse will remove the bridge 7 to 14 days after your
Basic Care of illeostomy
Common sense is the rule of thumb in stoma care. It is helpful to think of the care given
to a baby's bottom. You would not leave a baby in a soiled diaper for very long. You also
would not change a diaper without washing the baby's bottom thoroughly. Well, the skin
on your abdomen deserves the same considerations.
There are many kinds of bags. Whatever appliance you use, certain principles will guide
Change your appliance at least once a week.
None of your skin should be in contact with the output from your ileostomy. This
drainage contains elements that could easily irritate your skin.
You must change your appliance as soon as you feel burning or itchiness beneath
it. If you notice some redness or breaking down of the skin around the stoma, act
- Expose the skin to air for 15 to 20 minutes when you change your appliance.
- Stop using soap.
- Recheck the size of your stoma and change the opening of your appliance as
- Sprinkle a small amount of stoma powder on the reddened area.
If the problem worsens or persists for more than a week, get help!
Your stoma will probably get into a routine and function at regular intervals. Do your
appliance change during these "quiet times".
You can choose to remove your appliance to bathe or shower, soap and water will not
harm the stoma.
chronic autoimmune disorder that can occur anywhere in the digestive tract. Chronic digestive inflammation causing fever, cramping, diarrhea, weight loss, and anorexia; -25-30% diagnosed before 20years
-4% by 4 years
-CD stunts growth, when on the drug growth is regained
Elderly: use only if clearly needed, at a higher risk for adverse effects
-Children: safety is not established, there appears to be an increased risk of lymphoma, leukemia and other malignancies
is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for weeks or longer.
• Agitation, restlessness, and irritability
• Dramatic change in appetite, often with weight gain or loss
• Very difficult to concentrate
• Fatigue and lack of energy
• Feelings of hopelessness and helplessness
• Feelings of worthlessness, self-hate, and guilt
• Becoming withdrawn or isolated
• Loss of interest or pleasure in activities that were once enjoyed
• Thoughts of death or suicide
• Trouble sleeping or excessive sleeping
• Selective serotonin re-uptake inhibitors (SSRIs), including fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).
• Serotonin norepinephrine reuptake inhibitors (SNRIs), including desvenlafaxine (Pristiq), venlafaxine (Effexor), and duloxetine (Cymbalta).
Other medicines used to treat depression include:
• Tricyclic antidepressants
• Bupropion (Wellbutrin)
• Monoamine oxidase inhibitors
• is an abnormal tract between the gastrointestinal system and the skin.
• Seventy-five to 85% of enterocutaneous fistulas appear during the postoperative period
• Radiotherapy, inflammatory bowel disease, diverticular disease and intraabdominal malignancies are the main causes of a spontaneous enterocutaneous fistula.
• Despite improved therapeutic interventions and nutritional support, this disease continues to have a high rate of morbidity and mortality.
- is an abnormal tunnel leading out from the anus to the rectum. It may extend to the outside of the skin, the vagina, or the buttocks.
• Is a complication of Crohn's which often precedes to an anorectal abscess.
• Feces enter the fistula and may cause a localized infection. There may be persistent, blood-stained, purulent discharge or stool leakage
• Dressing may be needed to contain the drainage and protect the perifistular skin
• Surgical therapy may involve a fistulotomy or a fistulectomy
• Fistulotomy - the fistula is opened and healthy tissue is allowed to granulate
• Fistulectomy - is an excision of the entire fistulous tract. Appropriate topical therapy is used, and the wound is allowed to heal by secondary intention
• In severe cases of perianal disease caused by Crohn's, a diverting loop ileostomy may be required to manage the fistulas
• Care is the same as that given after a hemorrhoidectomy
a Cox-2 inhibitor (trade name Celebrex) that relieves pain without harming the digestive tract
proton pump inhibitor (GERD& stomach ulcer), antiulcer angent
Acetaminophen & Oxycodone
• is used to treat iron-deficiency. It is an oral iron salt sometimes known as an iron supplement. It is used to increase levels of iron and red-blood cells in the body. In general this drug is used to treat or prevent iron-deficient anaemia (low levels of red blood calls due to lack of iron)
• side effects: gastro-intestinal irritation, nausea, vomiting, epigastric pain, diarrhoea, constipation, blackening of stool, rashes, anaphylaxis.
• - is a B vitamin. It helps the body make healthy new cells. Everyone needs folic acid. For women who may get pregnant, it is really important. When a woman has enough folic acid in her body before and during pregnancy, it can prevent major birth defects of her baby's brain or spine.
• Foods include leafy green vegetables, fruits, dried beans, peas and nuts. Enriched breads, cereals and other grain products also contain folic acid. If you don't get enough folic acid from the foods you eat, you can also take it as a dietary supplement.
• used if taking medicines used to treat: Epilepsy, Type 2 diabetes, Rheumatoid arthritis, lupus, psoriasis, asthma, and inflammatory bowel disease. Other reasons for taking - kidney disease and are on dialysis, liver disease, sickle cell disease, celiac disease, consume more than one alcoholic drink a day.
Didrocal - Bisphosphonates
• work by reducing the activity of the cells that cause bone reabsorption (bone loss), which results in an overall increase in the amount of bone in most people
• Side effects are rare. Call your doctor right away if you have: skin rash, hives or, swelling of the face, lips, tongue and/or throat, black and/or bloody stools (bowel movements), chest pain
• is needed for the growth and repair of tissues in all parts of your body. It is used to: Form an important protein used to make skin, tendons, ligaments, and blood vessels, Heal wounds and form scar tissue, Repair and maintain cartilage, bones, and teeth. Vitamin C is one of many antioxidants. Antioxidants are nutrients that block some of the damage caused by free radicals. Free radicals are made when your body breaks down food or when you are exposed to tobacco smoke or radiation.The buildup of free radicals over time is largely responsible for the aging process. Free radicals may play a role in cancer, heart disease, and conditions like arthritis
• Side effects - Serious side effects from too much vitamin C are very rare, because the body cannot store the vitamin. However, amounts greater than 2,000 mg/day are not recommended because such high doses can lead to stomach upset and diarrhea. Too little vitamin C can lead to signs and symptoms of deficiency, including: Anemia, Bleeding gums, Decreased ability to fight infection, Decreased wound-healing rate, Dry and splitting hair, Easy bruising, Gingivitis, Nosebleeds, Possible weight gain because of slowed metabolism, Rough, dry, scaly skin, Swollen and painful joints, Weakened tooth enamel
" A chronic, inflammatory bowel disorder of unknown origin that can affect any part of the gastrointestinal tract from the mouth to the anus"
Occurs most often between 15-30
Both sexes affected but slightly higher in femalesJewish and upper middle class urban populations
Canada may have highest numbers
Characterized by idiopathic inflammation and ulceration
Clinical manifestations are varied, with unpredictable periods of remission interspersed with episodes of acute inflammation
Inflammation of pieces of the GI tract-usually end of ileum and colon
Involves all layers of the bowel
Ulcers are deep, with edema
Abscesses or fistulas can happen
crohns clinical manifestations
Depend upon site affected
Usual complaints: diarrhea and abdominal pain
Diarrhea- usually has no blood
Pain may be severe and constant or intermittent
Abdominal cramping, tenderness, distended, tired and fever
As it progresses: weight loss, poor nutrition, electrolyte imbalance
IS CHRONIC: unpredictable recurrence
Scar tissue makes tube smaller- strictures and/or obstruction
Fistulas very common
crohns diagnostic studies
MR Enterography (MRE) - Canadian Magnetic Imaging: MR Enterography or MRE
is a protocol for imaging the small bowel or small intestine. It may be used for patients with Inflammatory Bowel disease, Crohn's disease or Colitis disease. For elective scans, it is as good as CT scans but without the radiation. Are you a younger patient, have abdominal pain, or carry a diagnosis of Colitis or Crohn's, but are not acutely unwell? An MRE may be a better option for you.
contrast medium is injected into the rectum and x-rays are taken to search for lesions
crohns collaborative care
Medications: to decrease inflammation, to decrease GI motility, suppress immune response, correct deficiencies
Nutrition: PN, diet low residue, roughage and fat but high in calories and protein, lactose may need to be removed from diet,
Surgical Therapy: if unresponsive to other care
"Inflammation of a joint; most prevalent types are osteoarthritis, rheumatoid arthritis and gout"
"A chronic inflammatory disease that primarily affects the axial skeleton, including the sacroiliac joints, intervertebral disk spaces, and costovertebral articulations"
"surgical procedure in which an opening is made to allow the passage of urine from the bladder, or intestinal contents from the bowel, to an incision or stoma surgically created in the wall of the abdomen"
is when the ileum is brought through the abdominal wall
Stool is frequent and irritating to the skin
Pouch must be warn at all times
Following surgery strict in and outs
Low residual diet
Stoma may bleed
Closed wound drainage system connected to a suction often used for mastectomy and total knee/hip replacement.
1st-generation cephalosporin (Beta-lactam). Blocks cell wall synthesis: (1) binds penicillin-binding proteint, (2) blocks transpeptidase cross-linking, (3) activates degradative enzymes. No CNS entry.
Spectrum: gram(+)cocci, Proteus, E coli, Klebsiella pneumoniae
Tox: allergy; partial cross-reactivity with penicillins
antiprotozoal medication (trade name Flagyl) used to treat trichomoniasis and giardiasis
(isotonic solution) Used for trauma, dehydration from severe diarrhea or vomiting
abnormal redness of the skin resulting from dilation of blood vessels (as in sunburn or inflammation)
mouthlike opening (created by surgery on the surface of the body to create an opening to an internal organ)
inflammation of the peritoneum, the membrane lining of the abdominal cavity
International Normalised Ratio. A comparative rating of a patient's pro-thrombin time, used as a standard for monitoring the effects of Warfarin, which commonly interacts with other medications and foods, 1.3 - 2.0 therapeutic level 2-3 can be up to 4.5
a test that is used to detect the level of coagulation of the blood and the primary means buy which the body conducts homeostasis
Lipid Lowering Agent, blocks vitamin K uptake
Management of adrenocortical insufficiency, Chronic use in other situations is limited because of mineralocorticoid activity
condition, the sinus rate exceeds the norm,usually ranging between 100 to 160 beats per minute
This B-lactam bactericidal antimicrobial is empiric coverage of virtually all bacteria except MRSA and VRE
a B vitamin that is essential for cell growth and reproduction
a natural or surgical joining of parts or branches of tubular structures so as to make or become continuous
A disease or condition affecting the blood's ability to clot.
difficult or labored respiration
(Cardiac biomarker) This enzyme is found in cardiac muscle and reflects tissue breakdown resulting from cell trauma. The CK stands for Creatine Kinase, the MB stands for Cardiac Muscle. Increase indicates heart damage & death of cardiac tissue.
type one diabetes
pancreas does not produce insulin
type two diabetes
caused by inablity to use insulin
coronary artery bypass graft
open-heart surgery in which the rib cage is opened and a section of a blood vessel is grafted from the aorta to the coronary artery to bypass the blocked section of the coronary artery and improve the blood supply to the heart
diarrhea = bloody or mucoid
abdominal pain below umbilicus
PAINFUL DEFECATION= tenesmus
diarrhea (non bloody), fatigue, abd pain; commonly young adolescents; seen 2x more frequently in smokers
valve between the right atrium and the right ventricle
fibers attatched to the tricuspid valve which pull it closed when papillary muscles contract, preventing backwash of blood
located between the left atrium and left ventricle
A valve located at the two exits of the heart, where the aorta leaves the left ventricle and the pulmonary artery leaves the right ventricle.
the two arteries that supply blood to the heart muscle
collapse of an expanded lung (especially in infants)
a spasm of the bronchi that makes exhalation difficult and noisy
surgical procedure that creates an artificial opening for the elimination of bodily wastes
surgical procedure that creates an opening from the ileum through the abdominal wall to function as an anus
thickening of the tunica intima of the arteries due to deposits of fatty substance in them suggests a disease called`
irritable bowel syndrome
a common condition of unknown cause with symptoms that can include intermittent cramping, abdominal pain, bloating, constipation, and/or diarrhea
inflammation of the peritoneum (membrane lining the abdominal cavity and surrounding the organs within it)
herniations or sac-like outpouchings of the mucosa through the muscle layers; located in sigmoid colon can become inflamed
high pitched loud rushing bowel sounds, prod by hyperactive bowels
mature bone cells
sites of new blood formation
chronic obstructive pulmonary disorder
eg chronic bronchitis, emphysema, characterizd by progressive limitation of the flow of air in and out the lungs, alveoli walls become thickened and the air passaway becomes plugged with mucous, air can get in aveoli but difficulty getting out, decreased gas exchange with increased C02 accumlation
INFLAMMATORY DISEASE - a chronic allergic disorder characterized by episodes of severe breathing difficulty, coughing, and wheezing
the maximum amount of air that can be exhaled after a maximum inhalation (usually tested with a spirometer)
Amount of air that moves in and out of the lungs during a normal breath
functional residual volume
volume of air remaining in lungs after normal expiration
in sup vena cava & out pulm artery
in pulm vein & out descending aorta
detect changes in blood pressure
stimulated by change in concentration of chemicals
conary art disease
- most common cardio prob
- high risk for hypertension
- blood vessel disorder
- reduces flow of O2 and nutrients to myocardium
- caused by atherosclerosis
2nd most common cardio prob
- major cause of CAD
- condition in which fatty deposits called plaque build
- takes many years to develop:
1. fatty streak
2. fibrous plaque
3. complicated lesion
up on the inner walls of the arteries
an abnormal backward curve to the vertebral column
form of dyspnea in which the person can breathe comfortably only when standing or sitting erect. ask how many pillows
a sudden drop in blood pressure when rising to sit or stand.
black & aboriginals
lifestyle modifications for hypertension
- nutritional therapy - sodium restriction, maintenance of K, Ca, Mg, cal restriction if overweight
- mod alcohol consumption
- physical activity - 30 m a day moderate
- no tobacco
- stress management
a heart condition marked by paroxysms of chest pain due to reduced oxygen to the heart
destruction of heart tissue resulting from obstruction of the blood supply to the heart muscle
decreased blood flow to tissue caused by constriction or occlusion of a blood vessel
Plaques in the vessel wall, sign of hyperlipidemia
tenecteplase - TNKase
this fibrinolytic is genetically engineered to be more fibrin specific, more resistant to plasminogen inhibition, and to have a longer half life
used in the treatment of angina, vasodilator
acute coronary syndrome
sudden symptoms of insufficient blood supply to the heart indicating unstable angina or acute myocardial infarction
normal rhythm of the heartbeat
Abnormal origin, rate or direction of conduction of electrical impulses in the heart's electrical conduction system
the pace-maker of the heart; where the impulse conduction of the heart usually starts; located in the top of the right atrium
picks up electrical impulse from the SA node and causes ventricles to contract, causing blood to move into arteries
this classification of drugs dissolve clots. A complication of it could be bleeding. Streptokinase, Eurokinase, Activase.
This classification of drugs prevents thrombus from forming prevent agglutination. They decrease platelets and keep them from sticking together. Ticlopidine (ticlid)
Drugs used in the treatment of angina. They dilate blood vessels, increasing blood flow and oxygen to myocardial tissue.
antihypertensive drug that blocks the formation of angiotensin in the kidney, leading to relaxation of the arteries; promotes the excretion of salt and water by inhibiting the activity of the angiotensin converting enzyme
Angiotensin Receptor Blocker
lowers blood pressure by preventing angiotensin from acting on receptors in blood vessels
used to prevent blood clot formation
a polysaccharide produced in basophils (especially in the lung and liver) and that inhibit the activity of thrombin in coagulation of the blood
a chronic autoimmune disease with inflammation of the joints and marked deformities
chronic breakdown of cartilage in the joints
a type of wrist fracture; the fracture is at the lower end of the radius, the distal fragment being displaced backward
Simple: Clean, no skin broken.
Compound: Broken bone thru skin.
Comminuted: Bone fragments.
Compressed: Crushed bone.
Depressed: Bone pushed inward.
Impacted: Two bones forced together.
Spiral: Twisting break.
Greenstick: Incomplete break (in children).
open surgery to set fractured bones
joint replacement surgery
Most COMMON ortho operation performed on older adults. Surgery is aimed at relieving pain, improving joint motion, correcting deformity and malalignment, and removing intraarticular causes of erosion.
hematoma forms; break is splinted by a fibrocartilage callus; bony callus forms; bone remodeling occurs
**Hematoma, Granulation Tissue, Callus Formation, Ossification, Consolidation, Remodelling
the collection of blood under the skin as the result of blood escaping into the tissue from damaged blood vessels. bruise
new connective tissue and tiny blood vessels that form on the surfaces of a wound during the healing process
by day 14; minerals and new bone matrix are depositied in the osteoid and an unorganized network of bone is formed that is woven about the fracture parts
process of bone formation, during which cartilage is replaced by bone
Pulls hip and leg into extention, counter traction is applied by childs body.No High Fowlers position. Reduses pain and muscle spasms. Imporatant that child does not slip down in bed, watch for skin irritation.
Decreased muscle strength
post op care
Comfort care..pain, nausea, constipation
Congestive heart failure
syndrome where the heart is unable to pump enough blood to meet the body's needs for oxygen and nutrients; as a result, fluid is retained and accumulates in the ankles and legs
right side heart failure
fatigue, JVD (jugular vein distention), hepatomegaly, splenomegaly (ascites), dependent peripheral edema
left side heart failure
decreased fnc of L ventricle, decreased cardiac output, fatigue, breathlessness, dizziness, confusion, crackles on auscultation, hypoxia, shortness of breath, paroxysmal nocturnal dyspnea
Relieve resp. distress, promote fluid removal, control infection, maintain fluid and nutritional intake, promote rest/comfort/activity, discard tissues/sputum.
Congestive heart failure symptoms
symptoms: fatigue, shortness of breath, peripheral edema, awakeing at night severly short of breath, shortness of breath from walking stairs or simple activities, needing more than two pillows to sleeep, fatigue/exercise intollerance.
hyperkalemia and hypokalemia
Leg cramps followed by weakness or paralysis or skeletal muscles and disturbances in cardiac conduction, abdominal cramps and diarrhea may occur from hyper activity of smooth muscle.
Apathy, lethargy, fatigue, weak, irritable, confused, anorexia, n/v, flatulence, constipation, decreased gi, leg cramps, parasthesia, polyuria, resp paralysis, weak p, bp, long st, PVC, resp arrest, alkaline, ^glucose, dig toxicity, hypotn
hypernatremia and hyponatremia
Apathy, confusion, apprehension, delirium, fatigue, vertigo, ha, seizures, coma, anorexia, nausea, abd cramps, muscle weakness, twitching, tremors, decreased urine output, decreased osmoality
Tachycardia, Hypotension, seizures, Headache, AMS (altered Mental Status),personality changes/irritability, muscular weaknes, abdominal cramping/hyperactive BS (bowel sounds), muscle cramps, specific gravity <1.010