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1

neutropenia

disease cause

bone marrow suppression, leukemia, aplastic anemia, blood sequestration, severe starvation

2

neutoprenia

drug causes

immunosuppressants, immunomodulators, antinoplastics, glucocorticoids, phenytoin

3

neutropenia

manifestations

inflammatory response is blunted, fever and chills, delirium, malaise

4

neutropenic management

antibiotics, avoid invasive line

5

neutropenic precautions

hand washing, gloves and mask, reassign if you dont feel well, no raw fruits and veggies, no fresh flowers, sterile water, positive air flow

6

neutropenic Granulocyte stimulating factor

fligastrim, stimulates moyelpcytes into granulocytes

7

filgrastrim side effects

bone pain, fever, IV sub q, CBC and temp, hold if ANC id over 10000, refrigerate

8

type 1

mast cells, allergies

9

type 1

local symptoms

runny nose, sneezing, watery eyes, rash, hives, wheezing, SOB, n/v, diarrhea

10

type 1

systemic symptoms

hives, wheezing, SOB, cyanosis, decrease BP increase HR< LOC, n/v, diarrhea, organ failure

11

type 1

local treatment

diphenhydramine, steroids

12

type 1

systemic management

epic pen, diphenhydramine, steroids, skin testing

13

type 2

plasma B cells, non self antigens

14

type 2

local symtoms

warmth, swelling, redness, tenderness, purulent drainage

15

type 2

systemic symtoms

fever/chills, malaise, headache, decreased breathing, chest pain

16

type 2

management

stop, diphenhydramine, acetaminophen, chase tubing, NS, notify provider, send blood and tubing back to bank

17

type 3

plasma B cells, non self antigens, ag ab complexes getting depositided

18

type 3 symptoms

depends on the tissue, swelling, pain, redness, warmth, decrease in suction, swelling obstructs blood Flow, tissue hypoxia and death

19

type 3 management

steroids, immunosuppressants, plasmapheresis, anticoagulants

20

type 4

T cells and macrophages, non self antigens, graft vs host

21

type 4 manifestaitons

depends on the tissue, low fever, dull redness, tenderness, loss of function

22

type 4 treatment

steroids, immunomodulators, immunosuppressants

23

lupus symptoms

fever/malise, decrease in wt, joint pain, butterfly ras, rash on arms, hair loss, mm ulcers, Raynouds phenomenon, frequent infections

24

lupus management

hydroxychloroquine, immunosuppressants, immunomodulators, steroids, NSAIDS, no opioids

25

lupus exacerbation

burst and taper, acetaminophen, hydration

26

thrombocytopenia

cause

bone marrow suppression, autoimmune destruction, platelet sequestration in liver or spleen, platelets are used up

27

immune thrombocytopenia purr

most common, syndrome of abnormal dystruction, of circulating platelets, autoimmune disease

28

heparin induced thrombocytopenia

increase use of heparin, life threatening

29

thrombocytopenia manifestations

mucosal or cutaneous bleeding, petechia, pupura, ecchymosis, prolonged bleeding, hemorrhage

30

thrombocytopenia callaborative care

removal or treatment of cause, avoid aspirin, steroids if unknown reason, transfusion if hemmorrhage

31

thrombocytopenia

nursing considerations

prevent bleeding, and bleeding needs to be evaluated, avoid IM, small needle if Sub Q, self care, platelet transfusion

32

disseminated intravascular coagulation

bleeding

petechiae, bruises, oozing, GI bleed, conjunctival bleeding, mucusal bleed, hemorrhagic stroke

33

disseminated intravscular coagulation

clotting

skin necrosis, organ failure, PE, stroke, MI

34

osteoarthritis

most common, localized, horns degeneration leads to deterioration of joint cartilage

35

osteoarthritis

manifestations

herberdens nodes, bouchards nodes, pain stiffness, edema, rest relieve symptoms, limited ROM, crepitus

36

osteoarthritis

treatment approach

reduce risk, NSAIDS, acetaminophen, PT, steroid injections, TJR

37

herberdens nodes

near tip of finger, boney growths

38

Bouchard nodes

middle of finger, boney enragements

39

rheumatoid arthitis

systemic autoimmune process of inflammation and joint destruction

40

rheumatoid arthritis

manifestations

symmetrical join inflammation, fingers, wrist, knees, spine, deformities, malaise, pain stiffness, swelling

41

pharm for osteo and RA

aspirin, NSAIDS, acetaminophen, corticosteriods, Cox 2 inhibitors

42

RA

hydroxychloroquine, immunosuppressants, Enbrel or humera

43

indications for TJR

uncontrolled pain, limited Rom

44

TJR contraindications

active of recent infection inability to follow post op treatment , comorbid condition

45

TJR pre op care

informed consent, diagnostics, chlornexide scrub, education

46

TJR post op

PT, home care, monitor site, monitor for DVT or PE

47

TJR post knee

continuous passive motion, no pillows, monitor neuro, refuse blood, disposition on common, 3 months, no kneeling or deep knee bends

48

TJR post hip

HbB and HcT, early ambulation, hip precautions

49

to avoid amputation

increase blood flow, maintain glucose, ensure blood flow with Pad, occupational safety, no smoking

50

residual limb pain

opioids, Ice

51

phantom limb pain

calcitonion, BB, anticonvulsants, antidepressants

52

amputation dressing

kerlix, ACE, compression

53

prevent contractures

ROM, avoid elevating after 48 hours, prone throughout the day, no prolonged sitting, stand with good posture

54

AKI

prerenal

decrease blood Flow

55

AKI

intra renal

ischemia, nephrotoxic agents

56

AKI

post renal

mechanical- clots, calculi, tumor, prostate

functional- neurpoathy, neuogenic badder

57

RIFLE

risk, injury, failure, loss, ESRD

58

AKI metabolic

n/v, increase in glucose and triglycerides

59

AKI electrolytes

increase in K and MA, Ca and phos and Na imbalanced

metabolic acidosis

60

AKI

hematologic

anemia, leukocytosis, impaired platelets

61

AKI

cardia

HTN is the leading cause of death in patients with AKI

62

AKI respiratory

kussmal, dyspnea, uremic pleuritis

63

AKI neuro

lethargic, headache, seizures, peripheral neuropathy, restless leg , no DTR, weakness/atrophy

64

AKI

Skin

pruitis, uremic frost

65

CKD nursing

preserve existing function, early recognition, identify and reverse cause

66

CKD hyperkalemia

IV insulin with glucose, kayexalate, dialysis

67

CKD HTN

AcE & ARB's monitor, after dialysis

68

CKD anemia

EPO injections

69

KD diet

low protein, fluid, N, K, phosphate

70

transplant contraindications

chronic malignancies, vascular disease, noncompliance

71

anti rejection

cyclosporine

nephrotoxic

72

anti rejection

corticosteroids

hyperglycemia, osteoporosis, infection

73

anti rejection

melcophenolate

n/v/d