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S/S: lethargy, fatigue, muscle weakness, salt craving, anorexia, nausea, vomiting, diarrhea, abd. Pain, menstrual changes, impotence. Dx: low serum cortisol, low glucose, increased BUN, increased ACTH TMT: Replacement therapy Nursing: Strict I&O, daily weights, frequent v/s, watch for dysrhythmias, patient teaching for life long therapy.
Hyperthyroidism
S/S: Body is in hyperstimulatory state: heat intolerance, palpitations, visual disturbances, fatigue, weakness, insomnia, amenorrhea, mood changes, tremors, enlarged thyroid. Many Causes: Most common cause is Graves Disease and exopthalmos Dx: Thyroid profile, elevated levels T3 and T4. TMT: Drug therapy, PTU, Iodine products, Tapazone, Propanolol. Radioactive Iodine Therapy to destroy cell. Surgery: thyroidectomy. THYROID STORM: THYROIDTOXICOSIS.
Hypothyroidism
S/S: Decreased metabolism, Increased sleep, generalized weakness, anorexia, muscle aches, constipation, cold intolerance, decreased libido, menstrual changes (heavier bleeding), periorbital edema, slow about everything, depression, bradycardia. Dx: Thyroid studies (TSH elevated: yes) TMT: Life long replacement therapy, levothyroxine, Synthroid. MYXEDEMA COMA: life threatening characterized of coma, hypotension, hypothermia,resp. failure, hyponatremia, hypoglycemia.
Autonomic DysreflexiaTreatment
Elevated HOB immediately Check the BP Check for sources of irritation: bladder distension, constipation.
BURNS
-Infection Prevention -Wound Care -Silvadene -Sulfamylon -Pain Management -Nutrition -High Calcium , High Protein -80-90% of Pre-burn Weight -Prevent and minimize Deformity
Hodkins Disease
Dx: Reed-Sternberg Cell Sx: Painless enlarged nodes Night sweats Puritis Anorexia, Weight Loss, Fever, Fatigue
S/S: Bleeding tendencies Anemia, Pale, Fatigue, Infections, Fever, Pain-Bones and Joints Nursing Care 1. Prevent Infection 2. Prevent Injury 3. Prevent Fatigue
Post-Mastectomy Care
1. Positioning: operative hand-above heart level. 2. Protect Arm: No IV venipunctures, B/P 3. Arm/Shoulder Exercises 4. Discharge Instructions
Prevent Injury to Affected Arm Gloves, Oven Mitts, Thimbles to sew Nail cuticles, no sunburn, no shaving (affected axillae), avoid carrying objects (affected), no constriction (Clothes, Jewelery)
Ovarian Cancer
Risk Factors Infertility Fertility Drugs Nulliparity Late Menopause Family History
Testicular Cancer
Age: 20-40 Sx: Painless lump, Swelling of the testes, Dragging Sensation No biopsy AFP, Ultrasound Orchiectomy, chemotherapy Decreased Fertility Good Prognosis
Prostate Cancer
Age: over 50 African American (Earlier) PSA (Prostate Specific Antigen) Rectal Exam Sx: Painless hematuria, s/s BPH Rx: Radiation (external, internal) Surgery, Anti-Testosterone drugs, Orchiectomy
TB Medications
Rifampin: Red-orange body secretions INH: B6 deficiency, peripheral neuropathy INH and Rifampin: Liver toxicity, AST, ALT, LDH Streptomycin: (aminoglycoside), Ototoxicity and Renal Toxicity
TB Teaching
Spread by DROPLET: cover mouth Use tissues and dispose of properly Separate eating and drinking utensils Continue meds Three Negative Acid-Fast Sputums PPD will remain Positive
Priority Setting
AIRWAY BREATHING CIRCULATION SAFETY Who is at most risk or danger? Who is most likely to have serious or lifethreatening consequences if you dont assess them first?