PUD
What are the types of PUD?
Acute
Maybe classified by locations gastric or duodenal
What is the most common and effective drug therapy?
Proton pump inhibitors
Histamine receptor blockers
antacids, cholonergic, cytoprotective, prokinetics
What are the types of surgeries?
Elective, urgent, required, emergent
What does OA mostly effect?
Weight-bearing joints and hands
What are the stages of bone healing?
Fracture hematoma granulation tissue callus formation ossification consolidation remodeling
What are the signs of gastric PUD?
Epigastric discomfort 1 to 2 hours after meal burning or gages pain food may worsen perforation is the first symptom in some patients
What is the primary factor?
Incompetent lower esophagus, sphincter
What are the nurse responsibilities for preoperative care?
Admission assessment, health and medication history, check all allergies, vital signs make sure consent is signed
What are the symptoms for OA?
Stiffness in the morning, less than 30 minutes
Joints, hard and bony no inflammation
Location, asymmetrical, and localized
Nodes deformities, Bouchard and heberden
What are the classification of fractures?
Pathologic Comminuted oblique transverse greenstick spiral
What are the manifestations of duodenal?
Burning or cramp light pain in mid epigastric or back 2 to 5 hours after. Other bloating, nausea, vomiting, maybe be silent and older adults and NSaids
What are the clinical manifestations?
Heartburn
Dyspepsia
Regurgitation
Respiratory, including wheezing, coughing, dyspnea, nighttime disturbances, hoarseness, sore throat, lump, and throat, choking increased saliva
What is the timeout?
With entire surgical team to clarify information to avoid harm to the patient.
Right patient
Right procedure
Right site
Right markings
What are the total joint replacement contraindictions?
Active infection anywhere in the body advanced, osteoporosis, rapidly, progressive inflammation
What is ORIF?
Surgical realignment of bone fragments using devices such as pin plates, intro, medullary, rods, and bio absorbable screws
What are the major PUD complications?
Hemorrhage perforation gastric outlet obstruction
What are the complications?
Esophagitis
Barretts esophagus
Aspiration
Dental erosion
What are the postoperative nursing responsibilities?
1 -15 minute assessments during initial phase
Vital signs and respiratory effort, level of consciousness, monitor airway, assess, and manage pain, educate patient
What are the diagnostic studies?
CT MRI x-rays synovial fluid analysis
What are the complication of hip fractures?
Circulatory compromise
imMobility complications
Delayed union – nonunion
Fat embolism
Nerve vascular injury
Infection
Emboli
What are the nursing implementation for acute care?
npo, ngt, IV fluids, vital signs, monitor for shock, gastric content, analysis; check, pH blood or bile
Monitor labs
Manage pain and anxiety, restful environment
What are the diagnostic studies?
Upper G.I. endoscopy with biopsy and cytologic analysis
Esophagram barium swallow
Motility studies
pH monitoring
Radionuclide studies
What are the nurses focus for the three phases?
Preop Support, teaching, procedure prep
Intra safety, infection prevention, physical, and emotional comfort
Post abcs, safety, pain management
What is the patient education?
Plan periods of rest with activity use of assistive devices, weight management, heat, and cold, range of motion exercises, PT and OT, low impact exercises, strength, training, rest, irritated joints
What are the six ps for compartment syndrome?
Pain pressure paresthesia pallor paralysis pulselessness