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related to stomach surgery, food "dumps" into small intestine rapidly causing severe cramping and pain
Dumping Syndrome Nursing considerations
Small Frequent meals
High-fat, High-protein, low CHO diet
Avoid Liquids with meals
a serious chronic inflammatory disease of the large intestine and rectum characterized by recurrent episodes of abdominal pain and fever and chills and profuse diarrhea
Low-residue, low-fat, high-protein, high-calorie diet
No Dairy products
Bowel Obstruction Auscultation
-Early vs Late
High-pitched bowel sounds with early mechanical obstruction
Absent with Late
aka Liver Flap, a flapping tremor of the hands. When the client extends the arms & hands in front of the body, the hands rapidly flex & extend.
Acute Pancreatitis S/S
Severe pain LUQ
deep, piercing and continuous
Grey Turner spots
procedure for crushing a stone and eliminating its fragments either surgically or using ultrasonic shock waves, THEN STRAIN URINE
TURP post-op assessment
blood-tinged urine normal for first few days
irrigation adjusted to keep urine diluted toa reddish pink, clearing to a pink tinge within 48 hrs.
increased urine (water, not wastes). Kidney unable to conserve Na and H20. High BUN. Deficit of K, Na and H20. Azotemia
reduce glucose production by the liver and enhance insulin sensitivity
(metformin - Glucophage)
Rapid Acting Insulin
-Give 0-15 min before a meal
-Onset: 15 min
-Peak: 60-90 min
-Duration: 3-4 hrs
Regular Acting Insulin
-Peak: 2-4 hr
-Duration: 6-8 hrs
Long Acting Insulin Warning
Cannot be mixed with any other type of insulin.
Usually given in Morning
No not shake solution
Thyroidectomy and Calcium gluconate
Always have a bedisde for acute Hypocalcemia r/t parathyroid (watch for Trousseauand Chvostek)
advanced hypothyroidism in adults characterized by sluggishness, slow pulse, puffiness in the hands and face, and dry skin (myx = mucous)
extreme hypothyroidism(abrupt med cessation), rare with a high mortality rate = decreased cardiac output leads to decreased tissue perfusion which leads to brain and organ depletion leading to multi-organ failure
occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone
Addison Disease Causes
Sudden withdrawal from corticosteroids
Hypofxn of Adrenal cortex (infection, cancer, trauma)
Addison Disease S/S
Steroid Abuse/Chronic use
Loss of Body Hair
Excess adrenal corticoid activity caused by Adrenal, Pituitary or Hypothalamus Tumors
Cushing's Syndrome S/S
Thin skin easily bruised
Purple Strae abd. obesity
an abnormal condition in males in which the urethra opens on the under surface of the penis
a congenital abnormality in males in which the urethra is on the upper surface of the penis
Periods of difficult breathing (dyspnea) followed by periods of no respirations (apnea)
-"flexor posturing" or "mummy baby" (think Egyptian mummy preservation)
-adduction of arms (arms fold to chest); flexion of elbows and wrists
posturing in which the neck is extended with jaw clenched; arms are pronated, extended, and close to the sides; legs are extended straight out; more ominous sign of brain stem damage. MOST SEVERE!!!
a neurological disorder that seems to be caused by dopamine depletion, marked by muscular rigidity, tremors, and difficulty initiating voluntary action
Self-limiting polyneuropathy of peripheral motor, sensory & autonomic nerves (not CNS)
Distal to Proximal
Usually occurs after an upper respiratory infection
Intubation when paralysis ascends into thoracic space
Plasmapheresis over 10-15 days
May need TPN
Demyelination of the CNS myelin
Characterized by periods of remissions and exacerbations
Hypertensive crisis (elevated systolic pressures of 160-300mm Hg), bradycardia, severe headache, stroke or seizure activity
Autonomic Dysreflexia Causes
Noxious stimuli such as full bladder, fecal impaction, wrinkle in clothing, menstrual cramps, erection, ingrown toenail, bladder infection, sitting on catheter tubing.
Detached retina S/S
described as curtain falling over visual field
may have black spots of floaters (indicates bleeding has occurred with detatchment
Peak and Trough
used for drugs with narrow therapeutic index
trough-draw blood 30 min prior to next dose, peak is hour after admin
disseminated intravascular coagulation
-Abnormal Clotting then lack of clotting due to used up clotting factor.
A disorder of the lung tissue caused by infection, shock, burns, or other insults in which the capillaries became leaky and the air spaces fill with fluid.
Refactory hypoxemia, decrease pulmonary compliance (elasticity); dyspnea, noncardiac-associated bilateral pulmonary edema; dense pulmonary infiltrates on x-ray (ground-glass appearance
carpal spasm result when a blood pressure cuff is inflated above the client's systolic pressure, and left in place for three minutes.
HIV and Pregnancy
time of delivery
after birth through breast feeding
Surgical Wound, wound edges are brought together (well-repaired lacerations, well reduced bone fractures, healing after flap) surgery
Commonly used in the management of contaminated or infected wounds.
The wound is allowed to granulate
Surgeon may pack the wound with a gauze or use a drainage system
(Stage 3 Pressure Ulcer)
The wound is purposely left open due to heavy infection or contamination
initially cleaned, debrided and observed
(Tissue Graft, Stage 4 Pressure ulcer with necrotic tissue and infection)
A loop stoma can be made in the ileum ("loop ileostomy") or colon ("loop colostomy"). A loop stoma often is made when the stoma will be temporary. However, not all loop stomas are temporary
the surgeon divides the bowel completely. Each opening is brought to the surface as a separate stoma.
is formed when the proximal end of the bowel is brought to the outside abdominal wall.
Closed wound drainage system connected to a suction often used for mastectomy and total knee/hip replacement.
Closed wound suction drainage system often used for neurosurgery, neck surgery, abdominal surgery and urologic problems
Should be Pink
-Blue = compromised circulation(notify M.D.)
-Red = skin irritation (non stoma skin exposed to gastric contents, ensure tight fit of bag seal)
abnormal development (of organs or cells) or an abnormal structure resulting from such growth
Chronic sputum with cough production on a daily basis for a minimum of 3 months/year
Left-sided Heart Failure effects
Inspiratory rales beginining at lung bases
Expiratory Wheezes (mis-DX as Asthma)
Thrombolytic agent that is given in the event of a thrombosis or TIA. Increases chance of full recovery by 30%.
Fever, weigh loss, joint pain, changing heart murmur, splenomegaly, petechiae, clubbing, CHF signs
Bluish purple skin discoloration
Normal peripheral pulses
Warm to touch
Monitor for hx of DVT
Slightly painful ulcers /w marked edema
Pain in the calf when the foot is passively dorsiflexed, can indicate DVT
(not very reliable)
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