Musculoskeletal Conditions
Peripheral Vascular Disease
Asthma
Heart Failure
Urinary/Renal Disorders
100
dxa scan
bone density test:
-a t score of +1 to -1 indicates normal bone density
-a t score of -1 to -2.5 indicates low bone mass or osteoporosis
-more than -2.5 indicates the presence of osteoporosis
100
3 e's
conservative varicose veins management:
-elastic stockings
-elevation of extremities
-exercise
100
asthma components
two main pathological processes cause bronchoconstriction:
-inflammation: occurs in response to specific allergens, general irritants(cold air), microorganisms, and aspirin/nsaid's
-hyperresponsiveness: occurs with exercise, uri, or unknown reasons
100
ef (ejection fraction)
-percentage of blood ejected from left ventricle during systole
-normal ef is 50-70%
-can be assessed with echo
100
-"overactive bladder"
-loss of urine after feeling an urgent need to urinate as a result of bladder contractions regardless of how full bladder is
What is urge incontinence?
200
heberdens nodes
-bony nodules at the distal interphalangeal joints
-top by nailbed
-manifestation of osteoarthritis
200
six p's
manifestations of arterial insufficiency:
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermia (coolness)
200
pulmonary function tests
most accurate measures for asthma are pulmonary function tests using spirometry including:
-forced vital capacity (fvc)
-forced expiratory volume in the first second (fev1)
-peak expiratory flow rate (pefr)
200
true or false: weight gain is a manifestation of both right and left sided hf, so these pts should get daily weights
What is true?
200
steven johnson syndrome
-skin gets rash from the inside out
-common reaction to antibiotic allergies
-monitor skin for rash after dose
-sulfa allergies common!!! bactrim is a sulfa based drug
300
osteomyelitis
-infection in bony tissue
-caused by bacteria (staph), virus, fungi (either exogenous or endogenous)
-exogenous: organisms enter body from outside
-endogenous: organisms come from within the body
-s/s: bone pain and fever
-severe and difficult to treat
300
arterial vs venous insufficiency
-arterial: necrosis of foot/toe, cold, punched out, dependent positioning to treat
-venous: ulcerations in lower leg (none on feet), warm, swollen, elevate to treat
300
step system
asthma drug therapy based on 5 steps starting with step 1 and progressing up to step 5 as needed for progression of symptoms:
1. least severe, saba prn
2. addition of low dose inhaled corticosteroid (ics) on daily basis
3. addition of laba
4. doses are increased
5. most severe, addition of oral dose corticosteroids
300
-lv fails to eject blood adequately
-increased pressure in lungs
-fluid leaks from capillaries into airways/tissues
-life-threatening event (acute!)
What is pulmonary edema?
300
pyelonephritis
-uti complication: bacterial infection in the kidney and renal pelvis (upper tract)
-bacterial infection that starts in the bladder and moves upward to infect the kidneys
-acute or chronic
-abscesses can develop on kidneys
400
crest syndrome
syndrome associated with scleroderma:
Calcinosis: painful ca deposits in skin
Raynaud's phenomenon
Esophageal dysmotility (gerd-like)
Sclerodactyly: hardening of skin and hands
Telangiectasia: spider veins due to dilation of capillaries
400
thoracic aorta is _____ the heart, while abdominal aorta is _____ the heart
What is above, below? 
400
bronchodilators
-short-acting beta2 agonists (saba): albuterol
-long-acting beta2 agonists (laba): salmeterol
-cholinergic antagonists: short acting (Ipratropium), long acting (tiotropium bromide)
-methylxanthines: aminophylline
400
cardiomems
-implantable monitoring system
-same day admission, catheter inserted into femoral vein
-device implanted into pa, gives constant reading of pressure in pa
-as pressure increases that means pt is entering fvo
400
if there are two saline bags that are 3000mL each, and you urinate 7500mL, what is your urine output?
- 3000(2) = 6000mL
- 7500-6000 = 1500mL
-total uo: 1500mL
500
-immunosuppressive medication
-used once a week, takes 4-6wks to see effects
-decreases wbc, putting us at higher risk for infection
-lowers platelet count
-needs pregnancy test prior to starting! on bc if sexually active while on med
What is methotrexate?
500
anticoagulants
-used for prophylaxis and treatment of thromboembolitic disorders like dvt, pe
-two main types: heparin, warfarin
500
-a severe, life-threatening, acute episode of airway obstruction that intensifies once it begins and often doesn't respond to common therapy
-if condition isn't reversed, the pt may develop pneumothorax and cardiac/respiratory arrest
What is status asthmaticus?
treatment:
-iv fluids
-potent systemic bronchodilator
-steroids
-epinephrine
-o2
500
Right & left-sided hf manifestations
(5 from each to get the point)
Left:
-weakness
-fatigue
-dizziness
-acute confusion r/t decreased perfusion (low flow)
-pulmonary congestion: crackles
-breathlessness
-oliguria
-arrhythmias
-orthopnea: have to sit up to breathe effectively (may sleep in recliner)
Right:
-distended neck veins (jvd), increased abdominal girth
-hepatomegaly (liver engorgement)
-hepatojugular reflux
-ascites
-dependent edema (feet and legs)
-weight: most reliable indicator of fluid gain or loss
500
hydro assessment
-obtain a history: any childhood urinary tract problems or structural defects.
-urine patterns, frequency, color, odor, clarity
-any recent flank or abdominal pain, chills, fever, malaise→infection.
-physical exam: inspect flanks/belly/bladder, gently palpate, percuss looking for lumps (cysts, tumors), tenderness, gentle pressure on belly can cause urine leakage indicating obstruction