NR 283 Final Exam Concept Review Pathophysiology
Gastrointestinal Chapter 17
Hiatal Hernia: causes, Signs and Symptoms
• Patho: protrusion or
... [Show More] herniation of the upper stomach through the diaphragm
• Causes: short esophagus, trauma, weak muscles, increased abdominal pressure
• Signs/symptoms: heartburn or pyrosis, frequent belching, increased discomfort when lying down, substernal pain that may radiate to shoulder and jaw
Gastritis: Acute vs. Chronic, Signs and Symptoms
• Acute: caused by injury to mucosal lining by microorganisms (e-coli), allergies, alcohol, aspirin, corrosive substances, radiation or chemo, increase risk of cancer
• Chronic: H-pylori, NSAIDS, alcohol, tobacco
• S/S: anorexia, nausea, vomiting, hematemesis (vomiting of blood), abdominal pain
Peptic Ulcer Disease: Cause, Signs and Symptoms, location
• Duodunal pectic ulcer is the most common due to high acid and inflammation from bacteria
• Gastric peptic ulcer
• Location: duodenum (#1 place), lower esophagus, stomach
• Causes: H.Pylori, NSAIDS, Zollinger Ellison Syndrome, stress, smoking
• S/S: pain (specific for each type of ulcer), nausea, vomiting, weight loss
Cholelithiasis: gallstone formation, which are masses of solid material or calculi that form in the bile.
• Causes: obstruction or inflammation, fat, fertile, forty, female, native American ancestry
• S/S: asymptomatic, idiopathic
• Types: cholesterol and pigmented
•
Cholecystitis – inflammation of the gallbladder
Hepatitis:
• Hepatitis A:
• found in feces and bile
• Hepatitis B:
• Transmitted through infected blood, bodily fluids
• Hepatitis C: (most deadly)
• Post transfusion, IV drug use (most common in hospital settings), liver cancer
• S/S: 3 stages: 1) preicteric or prodromal stage 2) icteric or jaundice stage 3) posticteric or recovery stage `
• Preicteric or prodromal stage: (2 weeks after exposure): may be idiopathic, fatigue, malaise, anorexia, nausea, general muscle aching, fever, headache, mild abdominal discomfort
• Icteric or jaundice stage: stool becomes light in color, urine becomes darker, skin becomes pruritic
• Posticteric or recovery stage: reduction of signs and symptoms
Hepatic Encephalopathy:
• Causes: loss of brain function when a damaged liver doesn’t remove toxins from the body
• S/S: forgetfulness, musty odor breath, shaking of the hands, slurred speech, round belly
• Diagnosis: blood test for abnormalities with liver and kidney functions, medication is given to remove the ammonia.
Cirrhosis:
• Irreversible, inflammatory liver disease. Decreased blood supply to liver leads to liver disease complications, atrophy, necrosis, and eventual failure
• Cause: alcohol and hepatitis
• S/S: inflammation, destruction, and scar tissue growth of liver, fatigue, anorexia, weight loss, anemia, diarrhea, ascites(fluid build-up in the peritoneal cavity), peripheral edema, jaundice
• Complications: frequent infections, respiratory or skin infections, death, esophageal varices
Esophageal varices:
• Abnormal veins in lower part of the tube running from the throat to the stomach (esophagus)
• Causes: Usually develops when blood flow to the liver is blocked, also occurs with advanced liver disease.
• S/S: Sometimes no symptoms, but vomiting blood, tar-like or bloody stool, and shock
• Complications: liver failure, bleeding, shock, death
Crohn’s disease:
• Unknown cause
• Recurrent inflammation of small and large intestine
• S/S: non-bloody diarrhea, abdominal pain, malabsorption, steatorrhea (fatty diarrhea), malnutrition, weight loss, pallor
• Ulcers are throughout the intestines
Ulcerative Colitis:
• S/S: abdominal pain, bloody diarrhea, tenesmus (spasm of rectum), fever, weight loss
• Starts at the rectum and goes up
• Small intestine is not involved unless it turns into Crohn’s
• Obstruction of rectum interferes with absorption and electrolytes
Appendicitis:
• Causes: inflammation of the appendix, obstruction, ischemia, increased intraluminal pressure, infection, ulceration
• S/S: Epigastric pain, RLQ pain, Rebound tenderness around belly button, fever
Intestinal Obstruction:
• S/S: Crampy pain followed by vomiting and distension, dehydration, hypovolemia, ischemia and necrosis
• Complications: Tissue death, infections
• Cause: constipation, surgery, stress, poor muscle movement
Gastric Cancer:
• Diet is a key factor, smoked foods, nitrites and nitrates, and genetic influence
• S/S: dark stool from blood, no appetite, vomiting, nausea, asymptomatic
Pancreatitis:
• Inflammation of the pancreas
• Causes: gallstone, large amount of alcohol
• Acute: bile tract disease and alcohol, usually mild and self-limiting. Obstruction of bile duct causes enzymes to collect in pancreas. Enzymes activated causes inflammation. Can get septic ischemia
Complication: adult respiratory distress syndrome and acute renal failure
• S/S: constant epigastric and abdominal pain, nausea, vomiting
• Chronic: Irreversible structural and function changes to pancreas.
• S/S: intermittent pain, weight loss, malabsorption
Gastroesophageal reflux (acid reflux) GERD:
• Patho: The regurgitation of reflux of chyme within 1-2 hours after eating
• Causes:
• Weakened LES, increased abdominal pressure, weak esophageal peristalsis, hernia or ulcer
• Treatment: avoid spicy foods, antacids, medication
• S/S: belching and heartburn
Renal
Functions of the Kidney
• A WET BED:
• Acid-base balance
• Water removal
• Erythropoiesis (production of RBC)
• Toxin removal
• Blood pressure control
• Electrolyte balance
• Vitamin D activation
Pyelonephritis: – infection of ureter, renal pelvis, medulla, and cortex
Causes, signs and symptoms
• Causes: One or both kidneys involved. From ureter to kidneys
• S/S: DUll, aching pain in lower back, high temperature, dysuria
• infection of ureter, renal pelvis, medulla, and cortex
o Causes:
Kidney stones, reflux, trauma
o Acute pyelonephritis
Associated with obstructions or reflux
Inflammation of structures
Kidneys become infiltrated with WBC’s
o Chronic pyelonephritis
Recurring episodes of acute pyelonephritis or chronic obstructions
Cause progressive inflammation, destruction, and scarring
Will eventually lead to kidney failure
o Clinical manifestations: dysuria, flank pain, urinary casts
•
Cystitis:
• Causes: bladder wall (cystitis) and urethra (urethritis) are inflamed
• Hyperactive bladder and reduced capacity
• Causative Organism: Escherichia Coli
• More common in women than men
• S/S: Dysuria, urgency, frequency, urine is cloudy and unusual odor, fever, malaise, nausea, nocturia
Renal Calculi:
• Causes: Kidney stones, urolithiasis (The process of forming stones in the kidney,); form from high levels of calcium in urine (hypercalcemia)
• S/S: back pain, cool moist skin, rapid pulse, frequently asymptomatic
• Complications: hydronephrosis (scar tissue untreated)
Glomerulonephritis
• Start as upper respiratory infection, middle ear and strep throat from streptococcus leading to kidneys
• s/s: dark, cloudy urine, facial edema, increased BP, back pain, nausea, anorexia, fatigue, headache
Kidney Disease: Causes, signs and symptoms
• Causes: kidney infections, glomerulonephritis, polycystic kidney disease, type 1 & 2 diabetes, kidney stones, HTN, enlarged prostate
• S/S: asymptomatic until severe (kidney failure), nausea, vomiting, loss of appetite, decreased mental sharpness, muscle twitches, edema, fatigue, shortness of breath, high BP, chest pain
• Chronic renal failure, select all that apply.
Bladder Cancer:
• Risk Factors: individuals working with chemicals in labs or industry, smoking, recurrent infection heavy intake of analgesics (ibuprofen)
• S/S: hematuria, dysuria, urinary frequency, infections
Polycystic Kidney Disease: fluid fill cyst that grows in the kidney
• Causes: autosomal dominant gene
• Mother passes it on to the son
• S/S: cyst in kidneys, liver, or cerebral aneurysm, back pain and side pain
Kidney Failure: Causes, Clinical manifestations, treatment
• Reduced blood flow into kidney, inflammation and necrosis
• Causes: disease, shock, burns, drugs, heart failure, DM (diabetes mellitus), most common cause is acute glomerulonephritis
• S/S: metabolic acidosis, hyperkalemia
• Treatment: Dialysis, transplant
Labs associated with kidney failure
• BUN, creatinine, electrolytes, ABG, anemia
***Be sure to cover pathophysiology, etiology, signs and symptoms, diagnostic tests for the following endocrine topics:
Endocrine Chapter 16
SIADH: Inappropriate Antidiuretic hormone syndrome
• Increased ADH- retaining fluid
• Causes: stress, hormone secreting tumor
• S/S: related to hyponatremia → mental confusion
• Treatment: diuretics, replace Na+
• Bun test, creatinine, plasma osmotic
DI :Diabetes Insipidus → diabetes = to run through
• Deficiency of ADH/vasopressin
• Causes: head injury, nephrogenic-tubules stop responding, drugs
• S/S: polyuria, thirst, leads to severe dehydration
• Treatment: Replacement therapy ADH
Hypo/hyperthyroidism:
• Hyperthyroidism (thyroid overworking):
• Graves disease is the most common
• Autoimmune disorder
• S/S: fever, sweating, hyperactivity, increased appetite, tachycardia, reduced BMI, goiter (enlarged thyroid gland), eat a lot, really skinny
• High T3 & T4 hormones
• Intolerant to heat
• Treatment: anti thyroid drug. Thyroid removal
• Hypothyroidism:
• Hashimoto's- destructive (fluctuates between hyper and hypo)
• Cretinism- congenital
• Myxedema- severe, untreated hypothyroidism
• Autoimmune disorder
• S/S: fatigue, weight gain, increased BMI, obese, intolerance to cold, decreased appetite, bradycardia, dry and flaky skin,
• Goiter
• Low T3 & T4
Hypo/hyperparathyroidism
• Hypoparathyroidism:
• Causes: congenital, surgical removal of thyroid , or autoimmune
• Leads to hypocalcemia and low serum (muscle weakness)
• S/S: lethargy, thin hair, muscle weakness, tetany, weak cardiac muscle, brittle bones
• Treatment: Calcium supplements
• Hyperparathyroidism:
• Leads to hypercalcemia
• Causes: tumor, renal failure, Paraneoplastic syndrome
Cushing’s Syndrome/Disease: way too much cortisol
• Disease is caused by adenoma, excessive levels of glucocorticoids,
• Syndrome is from too much steroid by mouth (prednisone)
• Can be fixed
• Pituitary adenoma
• Ectopic carcinoma
• Iatrogenic conditions
• Substance abuse
• Change in person’s appearance S/S:
• Round face, with ruddy color, truncal obesity, thin limbs, hypotension, hyperglycemia, mood swings, thin hair, fragile skin, stria/bruising, fatigue
• High risk for infection and depression
• Reduce steroid, surgery, radiation therapy
Addison’s Disease: Too little production of cortisol & aldosterone by the adrenal glands
• Autoimmune (triggered by cancer, trauma, tb)
• S/S: hyperpigmentation, Hypoglycemia, low sodium, hypotension, muscle weakness, fatigue weight loss, high potassium levels, low blood sugar
• High risk for infection and depression
• Treatment: steroids
Pheochromocytoma: Benign tumor of the adrenal medulla that secretes epinephrine, norepinephrine, and sometimes other substances
Signs and Symptoms: Fatigue, excessive sweating, headache, back pain, fever
Diabetes Mellitus, Type I, and II: Pathophysiology, causes, Signs and symptoms, diagnostic tests,
complications, nursing considerations, patient education
• Complications:
• Acute:
• Hyperglycemic Hyperosmolar nonketotic (HHNK) Syndrome
• Coma
• Occurs in Type 2 Only
• Insidious in onset and diagnosis may be missed
• Often occurs in older clients and assumed to be cognitive impairment
• S/S: severe dehydration, loss of turgor, muscle weakness, slurred speech, altered mental status, staggering gait/ lack of coordination, pale skin, tachycardia, increased respirations, anxiety, tremors
• Treatment: Concentrated carbs (orange juice, hard candy)
• Hypoglycemia (insulin shock/low sugar)
• increased insulin and decreased[a] glucose
• Type 1 ONLY
• Causes:excess oral hypoglycemic drugs, exercise, vomiting, skipping meals after taking insulin
• S/S: AMS, anxiety, low blood glucose, decreased BP, tachycardia, disorientation
• Treatment: administration of glucose immediately to prevent brain damage
• Diabetic Ketoacidosis (DKA)- type 1 (stress or severe ignored infection) MOST COMMON FOR TYPE 1
• Insufficient insulin, high glucose levels, mobilization of lipids, body begins to catabolize of fats and proteins
• Causes: error in dosage, infection, change in diet, alcohol intake, exercise
• S/S: dehydration, thirst, dry rough oral mucosa, low blood pressure, increase but weak pulse, Kussmaul respirations, lethargy, acetone breath
• Treatment: replace fluids, insulin drips, electrolytes
• Chronic: degenerative changes in the tissue. Stable glucose reduce the risk complications
• Vascular: increased incidence of atherosclerosis; changes may occur in small or large arteries
• Microangiopathy: changes in microcirculation
• Obstruction or rupture of small capillaries and arteries
• Tissue necrosis and loss of function
• Eyes- retinopathy→ leads to blindness
• Kidneys- chronic renal failure
• Neuropathy: impaired sensation
• Muscle weakness, tingling, muscle wasting
• Macroangiopathy: involves the large arteries
• MI, CVA, PVD → amputations
• Type 1: IDDM (Insulin Dependent Diabetes Mellitus)
• Pathophysiology/cause: autoimmune destruction of beta cells in pancreas, not linked to obesity, insulin replacement required
• S/S: polyphasia (increase appetite), polydipsia (increased thirst), polyuria (increased urine), pruritus (itchy skin), pallor (pale), weight loss, blurred vision
• Diagnostic Tests: fasting blood glucose level, glucose tolerance test, glycosylated hemoglobin test
• Nursing considerations: metabolic activity and dietary intake, glucose and BP levels
• Treatment: insulin (amount needed is dependent on metabolic activity & dietary intake)
• Type 2:
• Pathophysiology/cause: Obesity, insulin resistant, genetic, beta cells decrease production of insulin in pancreas, body cells become resistant to insulin, liver increases glucose production
• S/S: weight gain, 5 P’s
• Treatment: exercise, diet, oral meds
Musculoskeletal Chapter 9
Sprains/Strains
• Sprain: Tear or injury in a ligament
• Treatment: Rest, Ice, Compression, Elevation
• Strain: Tear in a tendon
• Grade 1: Stretching, minor tear
• Grade 2: Partial tear
• Grade 3: Ruptured
Fractures
• Complete Fractures: Bone is broken into 2 or more pieces
• Incomplete: Bone is only partially broken (ex. greenstick)
• Closed: S/S: swollen, bruised, abnormal position, cant see the bone
• Open: S/S: bone is visible, went through the skin
• Simple: Only one bone is broken
• Comminuted (crushed): bone is broken off into smaller pieces
• Compression Fracture: only happens in vertebrae; some people don’t know they have it; common in elderly (common with falls on the butt/back)
• Impacted: broken ends of the bone are jammed together due to the force of the injury
• Pathological: can tell something is wrong with the bone; some disease process going on in the bone
• Stress Fracture: caused by constantly putting stress on bone; common in runners (hairline fracture)
• Depressed: bone is sunken usually in the head (pushed) in
Dislocations
• Separation of two bones at a joint with loss of contact between articulating bone surfaces
• Soft tissue damage usually occurs
• Subluxation: Partially displaced bone
Compartment Syndrome: Causative factors, signs and symptoms
• Causes: muscles tissue starts swelling and push on nerves
• S/S: 5P’s Pain, pallor, paresthesia (tingling), paresis (can’t move it), pulselessness
Arthritis-Gout, RA, Osteoarthritis
• Osteoarthritis: Degenerative joint disease. Joints become worn, surface is rough. Osteophytes (bone spurs) are formed.
• These people wake up in no pain and pain worsens throughout the day
• RA: Autoimmune and systemic, large joints are affected
• Body attacks itself, these people wake up in horrible pain
• Gouty Arthritis: uric acid crystals build up. Tophi
• No alcohol, no red meats; men over 50, rare in women, starts at night
Osteomalacia/Rickets: Cause, signs and symptoms
• Cause: lack of vitamin D, soft bone
• Osteomalacia: in adults
• Rickets: in children
• S/S: cramping, muscle weakness, flaccid muscle, slow growth, bow leg
Osteoporosis: Causative factors, signs and symptoms, complications
• Causes: Bone resorption rate exceeds bone formation- most often affects vertebrae and femoral neck, decreased bone mass
• S/S: back pain, decrease in height over time, stooped posture, bone fracture, weak and brittle bones
• Risk Factors: age, sedentary lifestyle, hormones, Cushing’s or medication, deficits of Calcium or Vitamin D, smoking
• Complications: fractures
Disuse Atrophy: Causative factors, signs and symptoms
• Causes: Not using a muscle which refers to decrease in size of muscle, decrease of muscle activity
• S/S: skinny, pallor, sticky, darker hair, dry skin, weak, foul odor
Neurological
Levels of consciousness/arousal
• 8 or less we consider them in a coma
• Used to measure a person's responsiveness
• Confusion, disorientation, difficulty in arousal
• Test on a Glasgow Coma Scale
Cerebral vascular accident: Types, definition of deficits, signs and symptoms, prognosis
• Types:
• Hemorrhagic stroke (the worse type):
• Bleeding inside of the brain
• Mass of blood compresses and displaces tissue
• Causes: HTN, aneurysms, tumors, trauma
• s/s: Edema, ischemia, and IICP (increase intercranial pressure) can occur
• Ischemic stroke:
• Artery in the brain is occluded
• Causes: thrombus(inside brain) or embolus(clot detached, traveled upstream to the brain)
• Definition of deficits: loss of sensation and weakness
• S/S: facial droop, arm weakness, slurred speech
• Prognosis: depends on where the stroke occurs
• Risk factors: HTN, DM, smoking
Transient ischemic attack: Signs and symptoms
• Temporary reduction of blood flow to the brain; lasts less than 24 hours; occurs once or in a series
• S/S: similar to a stroke- facial droop, headache
• Warning sign that a stroke may occur
Traumatic Brain Injury (TBI): 2 different types
• Closed head injury: concussion/contusion
• Brain tissue injured
• Skull intact
• Contrecoup Injury: in some sort of crash where you sped up and slowed down so brain hit the front and back of head or side to side
• Ex: shaken baby syndrome
Hematomas(collection of blood outside of blood vessels)-epidural/subdural/subarachnoid
• Epidural: Results from an arterial bleed
• S/S: LOC (level of consciousness) for a period of time before regaining; as bleeding grows, get worse
• Medical emergency
• Subdural: Between the dura and arachnoid; venus bleed
• Acute: medical emergency- common cause of death for hematomas
• S/S: headache, LOC, pupillary changes, respiratory changes
• Subarachnoid: Arachnoid and pia mixes with CSF so it doesn't clot
• Between Pia mater and Arachnoid mater
Concussion: signs and symptoms
• Mild TBI: recovery with no permanent damage.
• S/S: headache, confusion, vomiting, nausea, LOC
• Never want the person to sleep for the first few hours
Skull Fractures: Types and locations
• Types: linear, compound, depressed, basilar
• Locations:
• Basilar: base of skull
• s/s: rhinorrhea, otorrhea, coon eyes
Increased Intracranial Pressure: Signs and symptoms, complications
• S/S: decrease level of consciousness, headache, vomiting, papilledema (swelling in optic nerve), vital signs, bradycardia, bradypnea, pupillary changes, high systolic, low diastolic
• Complications: Herniation → brain death
Parkinson’s Disease: progressive degenerative disorder affecting motor function through loss of extrapyramidal activity
• S/S: fatigue, muscle weakness, muscle aching, decreased flexibility, tremors in the hands at rest, repetitive “pill-rolling” motion of the hand, rigidity, bradykinesia (slow movement)
• Treatment: dopamine replacement therapy
Amyotrophic Lateral Sclerosis: nervous system disease that weakens muscles and impacts physical function.
• Also called Lou Gehrig’s Disease
• S/S: upper extremities, manifest weakness and muscle dystrophy, loss of motor coordination, paralysis throughout body, swallowing impaired, muscle twitches and spasms
• Etiology: cause is unknown; diffusely affects upper and lower motor neurons of the brain and spinal cord; disease leads to progressive weakness leading to respiratory failure and death
• Prognosis: 2-5 years due to respiratory failure
• Treatment: No available treatment
Multiple Sclerosis: Etiology, signs and symptoms, prognosis
• Involves a progressive demyelination of the neurons in the brain, spinal cord, and cranial nerves
• Etiology: onset of symptoms usually occurs between 20-40. More common in women. Occurs more frequently in people of european decent. More common in temperate zones. Usually develops after a viral infection
• S/S: vision and sensory impairment-initially, dysphagia (difficulty swallowing), muscle weakness, slurred speech, fatigue, depression
• Treatment: No treatment at this time
Huntington’s Disease: inherited disorder that doesn’t manifest until midlife. Mother passes it on to son.
• Autosomal dominant (50% chance of getting it)
• Also known as chorea
• S/S: mood swings, personality changes, restlessness, rapid movements in arms and face (athetosis), ballism, chorea, progresses slowly
• Treatment: No treatment available
Spinal Cord Injury:
• Most commonly occurs due to vertebral injuries, resulting from: hyperextension, dislocated vertebrae, compression (ex.diving), and penetrating injuries
• Most common locations: cervical (1,2, 4-7) and T1-L2 lumbar vertebrae
• Hemorrhage and edema form; Injured axons are removed
• Within 3-4 weeks, the injured area will be replaced by fibrous tissue
• Herniated Disc
• Usually caused by trauma or poor body mechanics (stress on the muscles)
• S/S: unilateral, muscle weakness, pressure on the lower back
• Treatment: bed rest, heat, ice, anti-inflammatory
Seizures: Types, signs and symptoms
• Sudden, transient alteration of brain function caused by an abrupt explosive, disorderly discharge of cerebral neurons
• Convulsion:
• Tonic-clonic movements associated with some seizures
• Causes:
• Cerebral lesions or trauma
• Biochemical disorders
• Types: Tonic-clonic (generalized), absence seizure (blanc spare) (petit mal), partial seizure, jacksonian seizure
• S/S:
• Aura: peculiar visual or auditory sensation before a seizure
• Prodromal: nausea, irritability, twitching before seizure
• Increase in oxygen consumption
• Prolonged seizure can cause damage
Meningitis: Causes and causative organisms, signs and symptoms, precautions
• Causes: Bacterial, viral, and fungal meningitis
• Causative organisms: meningococcus and pneumococcus
• S/S: Terrible headache, photophobia, positive kernig sign (stretching and bending leg causes back to hurt), positive brudzinski sign (neck down causes legs to involuntarily move), high fever, rose colored rash, petechiae
• Precautions: isolation and vaccine
Encephalitis:
• Causes/ causative organisms: viral; mosquitoes
• S/S: edema, hemorrhage, or necrosis of the brain
• Precautions: Good hygiene, wash hands frequently with soap and water
Environmental Factors
Results of Heavy Metal Damage:
• Lead and Mercury: can accumulate in tissues with long-term exposure
• Lead: can be ingested in food or water, inhaled, found in lead pipes and batteries, lead-based paint (toys or furniture), common childhood poison
• Toxic effects of lead:
• Hemolytic anemia
• Inflammation and ulceration of the digestive tract
• Inflammation of kidney tubules
• Damage to the nervous system:
• Neuritis, encephalopathy, seizures or convulsions, delayed development and intellectual impairment, irreversible brain damage
Chemical Types and damage: ingested in contaminated food, water, toys, household objects, inhaled, absorbed through the skin
• Damage: tissue damage can result from a large dose in a single incident or from repeated exposure to small amounts
• Inhalants: particles, pesticides, gases, solvents
• Toxic Inhalants: factories, laboratories, mines, aerosols, paints, floor coverings, heating systems, smog (hydrogen sulfide, dust and smoke, carbon monoxide)
• Asbestos, iron oxide, silica: lung damage in mine workers
• Cigarette smoking: lung disease, bladder cancer, cardiovascular disease
• Types:
• Hexachlorophene: was widely used in hospitals as an aseptic in soaps and powders
• Absorbed through the skin (eventually leads to brain damage)
• Use is now restricted
• Exposure to plastics: phthalates used to soften plastics and prevent shattering
• Toys, bottle nipples, and others-withdrawn from U.S. and Canadian markets
• Acids and Bases
• Base causes protein in body to denature
• Base is worse than acid
Biological Agents:
• Bites and Stings:
• Direct injection of animal toxin into body
• Neurotoxins by spiders or snakes
• Vascular agents in jellyfish
• Transmission of infectious agents through animal or insect vectors
• Rabies, malaria, lyme disease
• Allergic reaction to insect proteins
• Bee or wasp stings
Contaminated Food and Water:
• Staphylococcal contamination, escherichia coli, salmonella
• Food and water poisoning
• May be result in heat-labile toxins produced in contaminated food
• Botulism poisoning
• May result of heat-stable toxins produced in contaminated food
• Staphylococcal contamination
• May be the result of infection with microbe
• Most common outbreaks are caused by strains of Escherichia coli or Salmonella
Substance Abuse and Associated Problems
Physiological dependence:
• Refers to continuing desire to take the drug to be able to function
Predisposing factors:
• Psychological imbalances, dysfunctional interpersonal relationships
• Heredity and/or genetics
• Family systems and practices
• Disease
• The ready availability of drugs
• Increased acceptance of alcohol or marijuana as a recreational tool in all age groups
Potential Complications:
• Overdose, withdrawal
Immobility
Contracture: a condition of shortening and hardening of muscles, tendons, or other tissue; often leading to deformity and rigidity of joints.
Dermal Ulcers:
• Causes: Poor circulation, edema, elderly & thin, nutritional status, dehydrated, mechanical friction, friction sheer (rubbing across body)
• Pressure Injury: Red → breakdown (superficial skin breakdown) → ulceration (purplish/red indicator of deep tissue injury) → necrosis & large open area with “full thickness” down to the muscle infection
• Hard to heal TREAT THE UNDERLYING CAUSE
Paraplegia/Quadriplegia, Hemiplegia/Diplegia:
• Paraplegia: paralysis of the legs and lower body; caused by spinal cord injury
• Quadriplegia: paralysis of all four limbs
• Hemiplegia: paralysis of one side of the body (stroke patient)
• Diplegia: paralysis of corresponding parts on both sides of the body; legs more often than arms
Orthostatic Hypotension:
• Due to low blood pressure (hypotension); risk of falling when standing
Deep Vein Thrombosis:
• Blood clot in the legs that can detach and go to the heart or lungs; can lead to pulmonary embolism and death
• S/S: warmth in the leg(s), redness in leg(s), swelling of the leg(s)
Pneumonia:
• Caused by respiratory infection
Atelectasis:
• Nonaeration or collapse of a lung or part of a lung leading to decreased gas exchange and hypoxia
• S/S: dyspnea, increased heart and respiratory rates, chest pain, chest expansion
Constipation: The condition in which there are less frequent bowel movements than usual. Causes: Increased age, weakness of smooth muscle tissue.
• Inadequate dietary fiber, and fluid
• Neurologic disorders, drugs (opiates), antacids, iron medications, bowel obstruction caused by tumors
• Chronic constipation may lead to hemorrhoids or diverticulitis
Kidney Stones:
• Patho: calculi tend to form when there are excessive amounts of relatively insoluble salts in the filtrate, or when insufficient fluid intake creates a highly concentrated filtrate
• S/S: stones in kidney or bladder are frequently asymptomatic; obstruction of ureter causes intense spasms of pain in the flank area radiating to groin; nausea, vomiting, cool moist skin, rapid pulse, leg pain
Bladder Infection:
• UTI
• Causative agent: E. Coli
• More common in women than men due to women’s urethra being shorter
• May be caused by sexual activity, baths, and some feminine products
• S/S: dysuria, urinary frequency, lower pelvic pain [Show Less]