Mid-term Adult Health
Things to know:
Systemic Lupus:
Butterfly rash, complaint of EXTREME FATIGUE
What it is
Affects KIDNEY
Gout:
Allopurinol drug of choice
Diet modification: low purine, organ beets, alcohol, adequate hydration, KIDNEY STONES
Big toes, joints pain
HIV vs. AIDS (2 questions)
Someone can have HIV and still have normal CD4, sometimes have opportunistic infection to get
full blown AIDS
Look at CD4 count, when that drops and get infection = AIDS
HAART Therapy take same time every day, where pts are noncompliance
When viral load changes, go from HIV to AIDS
Viral load must lower with AIDS
CD4 stay very low, CD4 drops
Opportunistic infection: candi
Must susceptible: Kaposi’s sarcoma, PCP (Pneumocystis pneumonia)
Hypersensitivity (Know 4 types, 5th type not on exam)
Type 1
Caused by inhalation or ingestion. Anaphylactic shock(pollen, animal dust)
Type 3
Autoimmune disorder (SLE, RA)
Type 2
Nothing on goodpasture’s
Infection (1-2 questions)
Understand drug resistance MDRO
Cancer Patients
Chemotherapy drugs delivered by IV (port)
Receiving via peripheral line. Assess phlebitis
Get combination of 2 drugs
Chemotherapy drugs affect all cells: systemic
Targeted PO meds
Assess TOXICITY
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Major side effects of chemo: nausea and vomiting. Assess for nausea. Don’t stop therapy b/c of
nausea. If they get too immunosuppressed, way too bad WBC counts then stop therapy. Do not
stop because of side effects. Alopecia= major side effects
Radiation
Radiation to the site where that tumor is
Damage to that skin
Assessment
No sun exposure
Watch skin area with soap and water
Side effects: GI(nausea and vomiting), if radiation in lower GI --> get diarrhea from that
radiation, if in esophagus --> swelling issue. Think where radiation is going. What problem they
can have. BIGGEST SIDE EFFECT: FATIGUE, extremely EXHAUSTED
Implantable cause more problems
Different ppl get diff doses of radiation
Fluid Electrolytes and Acid Base
In conjunction to heart failure pts
Hyperkalemic pts = cardiac dysrthymias
What do we have to do for these pts?
Do we report? Or what do we do early on?
LOW NA level = important and why? Seizures and confusion esp. In heart failure pts
Definitive test = BNP for cardiac
Identify respiratory acidosis, metabolic. Look at worksheet. Know if someone is hypoxic or not
from looking at those blood gases. Will have #s and figure out what they are.
2 Main: tumor lysis syndrome (ppl with chemotherapy—always hydrate them) and
hypercalcemia complications (bone fractures) specifically in cancer pts
Know acute vs. chronic leukemia (symptoms)
Nothing on lymphoma
Sickle Cell
PAIN management. Pain due to vasoocclusion. Hydrate them!
Tracheostomy
Important thing to assess: check airway (do they have humidified oxygen?)
If they have O2 going then having problem? Need suction, airway obstruction. Assess pts, watch
for saturation, always something that could affect airway
They could effective cough, if we don’t get anything, something is clogging
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When suctioning, have to HYPEROXYGENATE first before Suction.Catheter should be down 1015 seconds. When somebody comes back from surgery, if perfusely bleeding, get help! Don’t
want to see swollen especially 3-4 days out and still having problems. Assess pts!
Obstructive Sleep Apnea
How the pt is assessed. Give signs and symptoms. Go for testing. Assessing pt medication
Head & Neck Cancer
How to wash: soap and water
Regular gentle soap and water
Prophylactic. Pulmonary Emboli symptoms
TB (1 question)
Nothing about meds
Basic question
Pneumonia
How ppl contract pneumonia, why they get, how we vaccinatted them with flu vaccine and
pneumonia vaccine
Nothing on Pleural Effusion
Know Osteomalacia
VIT D deficiency
Paget’s Disease
Bones break and new bones from over it
Bone is damaged, then heal from the pathological
Osteomyelitis
Chronic or acute infection
Get MRSA due to to long term antibiotics
Develop VRE on top of it
Muscle Skeletal
Mostly assessment
Education
Treatment Modality
Does someone have a cast on, does it start to swell?
Nothing on specific fractures, mostly assessing pts
Anybody with an infection of any sort, always teach them about antibiotics and why they’re
getting and why they’re not. Viral can’t be treated with antibiotics
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Have to know DIFFERENCES between right and left side heart failure
Life Side Heart Failure: main s/s: congestion in lungs because fluid is backing up into lungs from
left side. If someone has pulmonary HTN, right side is affected first.
S3 gallop in mostly left side, sometimes S4
Crackles in the lungs
Pulmonary congestion and pulmonary edema with fluids in those spaces
Oliguria, they’re holding onto fluid and not peeing
Cant sleep well at night, cant breath well = Par
Apical pulse moved because all the fluids in the heart will move it down (should be between 3 rd
ad 4th intercostal space but moved to 5th)
Dyspnea
Right Side Heart Failure
JVD, fluid is on the other side
Edema
Pulmonary HTN
What thing could they say: Cant put shoes on, ring on, cant put belt on
Weight gain, 1L of liquid = 2 lbs. early sign. Weigh themselves same day same time everyday
Cardiomyopathy
Dilated one, just need to know this one
See in OB, more common in pregnancy
Infections: Pericarditis and Endocarditis
Know differences
HTN
Know nutrition and diet thing too
Sodium, sodium substitutes with potassium
Know arterial vs. venous
Know Raynaud’s vs. Buerger’s
Know the 5Ps
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