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med surge exam 2
Terms in this set (96)
acute arterial occlusion
the sudden blockage of an artery, typically, in the lower extremity, in the pt. w/ chronic peripheral arterial disease.
ankle-brachial index (ABI)
a ratio derived by dividing the ankle blood pressure by the brachial bp; this calculation is used to asses the vascular status of the lower exremities. to obtain the ABI a bp cuff is applied to the lower extremities just above the malleoli. The systolic pressure is measured by doppler ultra sound at both the dorsalis pedis and posterior tibialis pulses. the higher of these 2 pressures is then divuded by the higher of the 2 brachial pulses.
a painful complication in the pt. w peripheral arterial disease. typically the ulcer is small and round, with a "punched out" appearance and well-defined borders. Ulcers develop on the toes(often the great toe), btwn the toes, or on the upper aspect of the foot. w/ prolonged occlusion, the toes can become gangrenous.
a char. leg peg experienced by pts. w/ chronic PAD. Typically pts. can walk only a certain distance before a cramping muscle pain forces them to stop. As the disease progresses, the pt. can walk only shorter and shorter distances before pain recurs. Ultimately pain may occur even at rest.
low molecular weight heparin (lmwh)
peripheral arterial disaease (PAD)
any disorder that alters the natural flow of blood through the arteries and veins of the peripheral circulation
thromboangitis obliterans or buergers disease
distended, protruding veins that appear darkened and tortous; common in pts. older than 30 whose occupation require prolonged standing. as the vein wall weakens and dilates, venous pressure increases and the valves become incompetent. The incompetent valves enhance the vessel dilation, and the veins become tortuous and distended.
alterations of venous efficiency by thrombosisor defective valves; caused by prolonged venous hypertension. which stretches the veins and damages the valves, resulting in further venous hypertansion, edema and evetually venous stasis ulcers, sweliing and cellulitis.
a term that refers to both deep vein thrombosis and pulmonary embolism; obstruction by a thrombus.
the occurrence of stasis of blood flow. endothelial injury, or hypercoaguability; often associated w/ thrombus formation.
blood glucose monitoring
in the pt. w/ diabetes, a condition of fasting hyperglycemia resulting from a nighttime release of growth hormone that causes blood glucose elevations at about 5am-6am. Providing more insulin for the overnight period helps avoid this condition.
abnormally high levels of blood glucose
abnormally low levels of blood glucose
a reduced ability of most cells to respond to insulin. It is associated w type 2 diabetes.
the loss or atrophy of subq fat; in pts. w/ diabetes, the loss of fat tissue in areas of repeated insulin injection.
referring to large blood vessels
a collection of related health problems w/ insulin resistance as a main feature. other features include obesity, low levels of phyical activity, hypertension, high blood levels of cholesterol, and elevated triglyceride levels. these increase the risk for coronary heart disease
referring to small blood vessels
pathologic change in the kidney that reduces kidney function and leads to renal failure
excessive intake of water
frequent and excessive urination
an impaired fasting glucose or impaired glucose tolerance
in the pt. w. diabetes, morning hyperglycemia from the effective counterregulatory response to night hypoglycemia. Treat by ensuring adequate dietary intake at bedtime and by evaluating the insulin dose and exercise program to prevent conditions that lead to hypoglycemia.
benign tumor cells
normal cells growing in the wrong place or at the wrong time.
the removal and examination of a sample of tissue from a living body for diagnostic purposes
"short" or "close" therapy. the radiation source comes into direct, continuous contact with the tumor tissues for a specific time period. W. this type of therapy the radiation source is w/ in the pt.. therefor the pt. emits radiation for a period of time and is a hazard to others.
extreme body wasting and malnutrition that develops from an imbalance btwn food intake and enrgy use.
the treatment of cancer with chemical agents that have systemic effects; used to cure and to increase survival time.
newer form of potential cancer prevention. This strategy uses drugs, chemicals, natural nutrients, or other substances to disrupt one or more steps important to cancer development.
escape of fluids or drugs into the sub q tissue; a complication of IV infusion
surgical removal of part or all of the larynx.
malignant tumor cells
the growth and spread of cancer
open sores on mucous membranes
in chemotherapy, the period of greatest bone marrow suppression, when the pt.s platelet count may be very low
decreased numbers of leukocytes, especially neutorphils, which causes immunosuppression
a deficiency of all three cell types (rbc, wbc, and platelets) of the blood.
the purpose of this therapy for cancer is to destroy cancer cells and have minimal damaging effects on the surrounding normal cells.
system of classifying clinical aspects of a cancer tumor
therapy used to disrupt the pathway and slow or stop cell division. The result of this cancer therapy is that the signal for turning on cell division genes (oncogenes) does not get through to the cells nucleus.
radiation delivered from a source outside of the pt. b/c the source is external, the patient is not radioactive and it not hazardous to others.
a reduction in the number of blood platelets below the level needed for normal coagulation, resulting in an increased tendency to bleed.
chemical that causes tissue damage on direct contact
abnormal dryness of the mouth caused by a severe reduction in the flow of saliva.
suppression of the bone marrow activity that causes decreased numbers of blood cells (pancytopenia).
the surgical removal of the sigmoid colon, rectum and anus through combined abdominal and perineal incisions. This resection is performed when rectal tumors are present.
axillary lymph node dissection
dissection usually done when there are palpable axillary lymph nodes or when cancer is suspected to be at a later stage.
surgery where the surgeon removes the tumor and a small amount of tissue rather than the entire breast. this procedure is used primarily for stage I and II breast cancer. ex.) lumpectomy
the surgical creation of an opening btwn the colon and the surface of the abdomen.
removing the right side of the colon and attaching the small intestine to the remaining portion of the colon.
the passage of red blood via the rectum
the surgical creation of an opening into the ileum, usually by bringing the end of the terminal ileum through the abdominal wall and forming a stoma, or ostomy.
loop electrosurgical excision procedure (LEEP)
diagnostic procedure/treatment in which a thin loop-wire electrode that transmits a a painless electrical current is used to cut away affected cervical cancer tissue
surgical removal of an entire lung lobe.
surgical removal of all or part of a breast
the number of packs of cigs per day multiplied by the number of yrs the pt. has smoked; used in recording the pts. smoking history.
an inflammation created by instilling a sclerosing agent through through a chest tube into the pleural space, which causes the pleura to stick to the chest wall and prevent formation of effusion fluid.
removal of an entire lung, including all blod vessels
the surgical creation of an opening; usually refers to an opening in the abdominal wall
the aspiration of pleural fluid or air from the pleural space
the (tracheal) stoma, or opening, that results from a tracheotomy (the surgical incision into the trachea for the purpose of establishing an airway)
continuous ambulatory peritoneal dialysis (CAPD)
type of dialysis performed by the pt. w/ the infusion of 4 2-L exchanges of dialysate into the peritoneal cavity. Each time, the dialysate remains for 4-8 hrs, and these exchanges occur 7 days/week.
the process, used in treating kidney disease, by which uric acid and urea are removed from circulating blood by means of a dialyzer
end-stage kidney stage (ESKD)
acute renal failure combined with chronic renal insufficiency, resulting in the inability of the kidney to excrete waste products normally. the pt. may need hemodialysis or a kidney transplant
acute inflammation of the visceral/parietal peritoneum and endothelial lining of the abdominal cavity, or peritoneum.
protein restriction, sodium restriction, potassium restriction, vitmain supplem, fluid restriction
the accumulation of nitrogenous wastes in the blood (azotemia); a result of renal failure; w/ clinical symptoms including n/v
benign prostatic hyperplasia (BPH)
age-associated enlargement of the prostate gland in men; which may cause bladder compression and can obstruct urinary flow
surgical removal of the bladder and surrounding tissue
digital rectal exam
an examination of the lower rectum. The doctor uses a gloved, lubricated finger to check for abnormalities.
the surgical anastomosis of the ureters to one end of a detached segment of ileum, the other end being used to form a stoma on the abdominal wall.
əl/, /ˈkiːɡəl/), consists of repeatedly contracting and relaxing the muscles that form part of the pelvic floor,
continent pouch formed by the terminal ileum after colectomy. The pouch has a volume of 500ml to 1000ml so that feces can be stored temporarily and the patient need not carry a stoma bag. This improves the patient's quality of life.
transurethral resection (TURP)
the traditional "closed" surgical procedure for removal of the prostate. In this procedure, the surgeon inserts a resectoscope (an instrument similar to a cytoscope, but w/ a cutting & cauterizing loop) through the urethra. The enlarged portion of the prostate gland is then resected in small pieces.
urothelial cancer "bladder cancer"
malignant tumors of the urothelium- the lining of transitional cells in the kidney, renal pelvis, ureters, urinary bladder, and urethra. most occur in the bladder.
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