COA Exam 4

treatment for ganglions

-asymptomatic ganglions are monitored, since approximately 50% will resolve without treatment -other treatments may include aspiration, corticosteroid injection, surgical excision -after treatment, compression dressing and immobilization splint are used

nursing intervention after giving platelets

-check temperature -identify symptoms of rash, SOB, chills, fever, vomiting, headache

physical exam findings for IDA

-circumoral pallor -conjunctival pallor -brittle nails -angular cheilitis -tachycardia -hypotension -murmurs

which conditions should be considered if patient has hemoconcentration

-dehydration *BURNS -shock -hypothermia

what are the three primary cell types

-erythropcytes -leuokocytes -thrombocytes

cues for IDA

-fatigue -dizziness -pica -lightheadedness -palpitations

what are the symptoms of H&H

-fatigue -dyspnea -palpitations -poor activity tolerance -headaches -tinnitus -anorexia -indigestion -irritability -difficulty sleeping or concentration -abnormal menstruation -impotence -loss of libido -chest pain

signs and symptoms of Acute Myeloid Leukemia

-fever -infection -neutropenia -enlarged spleen -gum hyperplasia

complications of anemia

-heart failure -parasthesias -confusion

priority nursing interventions for AML

-infection prevention -bleeding prevention -promoting comfort -patient education

labs to look at for IDA

-iron -ferritin -iron saturation -increased TIBC (always opposite of iron)

what will assessment of a patient with osteomyelitis reveal?

-localized pain -edema -erythema -fever -guarding -purulent drainage

nursing management of anemia

-managing fatigue -promoting nutrition (iron, B12, folic acid, avoid alcohol) -educating patient on underlying cause of anemia -maintaining perfusion (transfusion of IV, supplemental O2, monitor vitals)

goals and interventions for osteomyelitis

-pain -improved physical ability and therapeutic limitations -control and eradication of infection -knowledge of the treatment regimen

who is at risk for developing carpal tunnel syndrome

-patients who have to perform repetitive movements or those whose hands are exposed repeatedly to cold temperature, vibrations, or extreme direct pressure

symptoms of bleeding

-petechiae -eccyhmosis -bleeding at puncture site -*hypotension -tachycardia -dizziness -nosebleed -*hemoptysis -*abdominal pain or back pain -*abdominal distention -rectal bleeding -vaginal bleeding -*headache -*mental status change -*blurred vision

nursing priorities for acute lymphoid luekemia

-prevention of infection and bleeding -management of symptoms such as nausea and pain

if patient is experiencing the following symptoms after getting a platelet infusion (rash, SOB, chills, fever, vomiting, headache) ...

1) stop infusion 2) lift head of bed

how much calcium do premenopausal women require daily

1,000 mg

recommended calcium intake age 19-50

1,000 mg

recommended daily calcium intake for people 9 to 19 years of age

1,300 mg/day

how much calcium do postmenopausal women require

1,500 mg

mild neutropenia

1,500 to 1,000/mm3

conservative treatment of bursitis and tendonitis

1. Rest of the extremity 2. Intermittent ice and heat to the joint 3. NSAIDS - to control the inflammation and pain] corticosteroid injections may be injected

normal hemoglobin FAB

12-16 g/dL

lifespan of RBC

120 days

normal hemoglobin MAB

14-18 g/dL

normal plaetelet count

150 - 400,000/mm3

normal platelet FAB

37%-47%

normal hematocrit MAB

40%-52%

lifespan of platetelet/thrombocyte

7-10 days

moderate neutropenia

999-500/mm3

at what platelet count would the patient be placed on bleeding precautions?

< 500,000/mm3

which disease renders the fingers more or less useless

Dupuytren

which medications would be given to someone with anemia of kidney disease?

ESA (erythropoietin stimulating agents) Epogen; Darbepoeitin

foods high in iron

Meats, eggs, legumes, whole grains, green leafy vegetables , and dried fruits

treatment for paget disease

NSAIDs, calcitonin, bisphosphonates

A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron? When they should take their iron?

Orange juice because vitamin C increased absorption of iron they should take their iron on an empty stomach in the morning

whats a weird symptom that can develop from iron deficiency anemia?

PICA

which tests might be used to identify carpal tunnel syndrome

Phalen test or Tinel sign

A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?

Take the supplement with meals or with orange juice.

osteomyelitis stage 1

acute fulminating: occurring during the first 3 months after orthopedic surgery; frequently associated with hematoma, drainage, or superficial infection

treatment of osteomyelitis

antibiotics, surgical debridement

complications of acute myeloid leukemia (AML)

bleeding and infection

therapeutic apheresis

blood is taken from the patient and passed through a centrifuge to remove a specific component

primary site of hemoatopoiesis

bone marrow

most common presenting symptom in multiple myeloma

bone pain

hallux vagus

bunion deformity in which the great toe deviates laterally

which nutrients are key for maintaining bone remodeling and body function

calcium and vitamin D

osteomyelitis stage 2

delayed onset: occurring between 4 and 24 months after surgery

pathophysiology of IDA

depletion of the body's iron stores

paget disease

disorder of localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae

action for IDA

education of food/dietary considerations, manage side effects of iron (constipation)

how often should PT and INR be checked if pt is on a heparin drip

every 6 hours

how often should type-and-draw occur after blood transfusion?

every 72 hours

what lab signs might you see for hemodilution

false low hematocrit (seen in CHF patients, symptoms would normalize with management of CHF)

what lab signs would you see for hemoconcentration

falsely elevated hematocrit

what is a good source of vitamin B12 for vegans?

fortified soy milk for vegans

primary component of RBCs

hemoglobin

nursing priorities for osteoporosis

improving bowel function, preventing injury, and managing fractures

where do bursitis and tendonitis most commonly occur?

in the shoulder

which therapy is indicated for acute lymphoid luekemia?

induction therapy

osteomyelitis

infection of the bone, usually staphylococcus aureus

solutions for iron deficiency anemia

iron PO prefered over IV

anemia of kidney disease presents very similarly to what other kind of anemia?

iron deficiency anemia

recommended daily calcium intake for people 51 years of age and older

is 1,200 mg/day

osteomyelitis stage 3

late onset: occurring 2 or more years after surgery, usually as a result of hematogenous spread

foods high in folic acid

leafy greens, dried peas, dried beans, seeds, orange juice

severe neutropenia

less than 500 mm3

an elderly patient whose chief complain is back pain and who has an elevated total protein level should be evaluated for which condition?

myeloma

treatment for multiple myeloma

no cure corticosteroids and chemotherapy

foods high in Vitamin B12

organ meats (liver) , clams, oysters, red snapper, muscle meats, fermented cheese, egg yolks, dairy

symptoms of carpal tunnel syndrome

pain, numbness, paresthesia, possibly weakness along median nerve

what is the treatment for metastatic bone cancer?

palliative

what is the most common sign of H&H?

pallor

who is likely to experience vitamin B12 deficiency?

patients who have gotten a partial or total gastrectomy

Hematocrit

percentage of blood volume consisting of erythrocytes

function of granulocytes

protect the body from invasion by bacteria or foreign body

therapeutic phlebotomy

removal of a certain amount of blood under controlled conditions

how does AML occur

results from a defect in the hematopoietic stem cell that differentiates into all myeloid cells

how does acute lymphoid leukemia occur?

results from an uncontrolled proliferation of immature cells (lymphoblasts) derived from the lymphoid stem cell

important nursing intervention for iron deficiency in older adults

should be investigated quickly for GI tract of colon CA

assesment of osteoporosis will reveal what

skeletal changes and bone density

osteomalacia

softening of the bone

hemoatopoiesis

the process of replenishing blood cells

special iron consideration for menstruating people

they need an additional 2 mg/day to replace iron lost by menstruation