1. CERVICAL CA
Risk Factors:
• African- American/ Native
women
• Behavior (Sexual promiscuity)
• Chronic instrumentation of cervix
• Disease –STD
• Early age of Sex
• High Parity
• Poor Hygiene
• Low economic status
• Multiple sexual partners
• Partner with Prostate CA
Sx:
• Post-coital bleeding
• Painful sex
• Menstrual irregularities
2. OVARIAN CA
Risk factors:
• Ovarian dysfunction
• Vaginal use of talcum powder
• Alcohol
• Race - White women & family
history
• Infertility
• Age - Peak=5th decade of life
• Nulliparity
• Genetic predisposition
3. DM FOOT CARE
• Meticulous care to feet
• Wash feet with warm water not hot &
dry
• Can use lotion but No lotion in
between toes
• Wear socks to keep feet warm
• Avoid thermal baths, heating pads
• Do not soak feet
• Inspect feet daily
• Do not treat corns, blisters
• Wear loose socks and no barefoot
• Change into clean cotton socks daily
• Break in new shoes gradually
• Use emery board
• Do not smoke
• Do not wear same pair of shoes 2
days in a row
• Check shoes for cracks before using
4. BLOOD TRANSFUSION
REACTION
• Transfusion Reactions
Hemolytic Reaction
Allergic Reaction
• Circulatory Overload
• Septicemia
• Iron Overload
• Hypocalcemia
• Disease Transmission
• Hyperkalemia
• Citrate Intoxication
• Low K, P
• Restrict Na
5. HYPERTHYROIDISM
• Soft smooth skin & hair
• Mood swings
• HPN
• Diaphoresis
• Intolerance to heat
• PTU drug to block thyroid synthesis
6. LUNG CA
• Bronchogenic Carcinoma
• 1st leading cause of death
• From asbestos, bacterial invasion,
cigarette
• Sx: Nagging cough, hoarseness of
voice, dyspnea, diminished breath
sounds
7. SX OF PARKINSONS
• Tremors, akinesia, rigidity
• Weakness, “motorized propulsive
gait
• Slurred speech, dysphagia, drooling
• Monotonous speech
• Mask like expression
• Teach ambulation modification:
goose stepping walk (marching),
ROM exercises
• Meds—Artane, Cogentin, L-Dopa,
Parlodel, Sinemet, Symmetrel
• Activities should be scheduled for
late morning when energy level is
highest
• Encourage finger exercises.
• Promote family understanding of
disease intellect/sight/ hearing not
impaired,
8. ACUTE PANCREATITIS
• Abdominal Pain severe –acute sx
• Complication : Shock,Hypovolemia
• Limited fat & protein intake
9. CAST CARE
Don’t rest on hard surface
Don’t cover until dry 48+ hours
Handle with palms of hands not with
fingers
Keep above level of heart
Check for CSM
10. HYDROCEPHALUS
• Anterior fontanel bulges & nonpulsating
• Bones of head separated (cracked
pot sound)
• Check for sun-setting eyes
• D’ Increase ICP
• Evidence of Frontal Bossing
• Failure to thrive
• Irritability
• High-pitched cry11. ESRD DIET
• Restricted protein intake
• Increase CHO
12. NORMAL IN 8 MONTH OLD
CHILD
- can sit with out support
- can roll from front to back
- can hold a bottle
- closure of ant. fontanel
- can say mama and dada
- 2 teeth present
13. SUPERIOR VENA CAVA OCCLUSION
• Sx occur in the morning
• Edema of face, eyes & tightness of
shirt/ (Stoke’s sign)
• Late sx: edema of arms, hands,
dyspnea, erythema, epistaxis
14. ULCERATIVE COLITIS
Sx:
• Severe diarrhea with blood & mucus
• Abdominal tenderness & cramping
• Anorexia
• Wt. Loss
• Vit. K deficiency
• Anemia
• Dehydration
• Electrolyte imbalance
• Low residue & high protein diet
15. DILANTIN
• do not floss throughout the day
• do not use hard bristled
toothbrush
• Gingivitis S/E
16. ANAPHYLACTIC REACTION
(steps)
• Stop medication
• Maintain airway
• Notify MD
• Maintain IV access of 0.9 NSS
• Place in supine position with legs
elevated
• Monitor VS
• Administer prescribed
emergency drugs
17. BLADDER CA
Risk Factors:
• Hx of smoking
• Exposure to radiation
• Working in industrial Factory
18. S/S OF DKA
• Fruity breath Odor
• Oliguria
• Kusmaull'’s (deep & nonlabored)
19. SITE FOR IM INJECTION ADULT
• Deltoid
• Ventrogluteal
• Vastus Lateralis
• Gluteus Maximus
20. S/S OF BACTERIAL MENINGITIS
• N & V
• Seizures
• Stiff Neck
• Photophobia
• Moon face
• Truncal obesity
• Decreased resistance to infection
• Low Carbohydrate, Low Calorie,
High Protein, High K, Low sodium
• Monitor glucose level
• Check for color of stool, cortisol
increase secretion of gastric acid
– Peptic ulcer & GI bleeding
• C/I to Aspirin, increased bleeding
21. TB
• Waking up sweating at night
• Low grade fever
• Dull aching chest pain
• Cough streaked with blood
• Weight loss
• Anorexia
• Fatigue
22. LIVER CIRRHOSIS
• N & V
• Edema
• Ascites
23. PULMONARY EMBOLISM
Sx:
• Blood-tinged sputum
• Distended neck vein
• Chest Pain / Hypotension /
Cyanosis
• Cough / Shallow respirations
• Rales on auscultation
• Tachypnea / Tachycardia
24. COLON CA
Risk Factors:
• Family HX
• Age above 50
• Jewish
• Male
25. DIGOXIN THERAPY
• Do not administer in infants if <
90 bpm
• Do not give to older children if
<70 bpm
• Sx of toxicity to a child – N &V
26. S/S OF CAD
• Chest Pain
• Palpitations
• Dyspnea / Syncope
• Hemoptysis
• Excessive Fatigue
27. COPD
• Rhythmic, diaphragmatic
breathing
• If restless, perform purse-lip
breathing not more than 1
minute
• Perform deep breathing with
mouth held together during
expiration
28. SEEN IN 15 MONTH OLD CHILD
• Speaks 6 words
• Sits w/o support
• Builds a tower of 5 blocks
• Strong palmar grasp
29. CUSHING’S SYNDROME
• Osteoporosis
• Muscle wasting
• Hypertension
• Purple skin striations
• Severe abdominal pain
• Maternal shock
• Fetal distress
30. ADDISONS DISEASE
Fatigue
Weakness
Dehydration
Eternal tan
Decreased resistance to stress
Low Sodium
Low Blood Sugar
High Potassium
High protein, carbohydrate, Sodium,
Low potassium diet
Teach life-long hormone replacement
• Glucocorticoids (sugar) - Solu-
Medrol (succinate) to prevent
addisonian crisis
• Mineralocorticoids (salt) –
Florinef
6 A's of Addison's disease
1.) Avoid Stress
2.) Avoid Strenuous
3.) Avoid Individuals with Infection
4.) Avoid OTC meds
5.) A lifelong Glucocorticoids Therapy
6.) Always wear medic alert bracelet
Addisonian Crisis
• Hypotension
• Extreme weakness
• Nausea vomiting
• Abdominal pain /
• Severe hypoglycemia
• Dehydration
• Administer NaCl IV, vasopressors,
hydrocortisone
• Monitor VS /Absolute bedrest
31. PLACENTA PREVIA
• Check Hematocrit level
• External fetal monitor not internal
• No vaginal examination
• Assess for bleeding
• Improperly implanted placenta at
lower uterine
• Painless bright red, vaginal
bleeding
• Soft, relaxed, nontender uterus
• Fundal height greater than
32. ABRUPTIO PLACENTA
• Premature separation of
placenta from uterine wall
• Painful dark red bleeding
• Uterine rigidity
• Perspiration
• Weakness / dizziness
• Borborygmi sound
33. HEMODIALYSIS
• Palpate for a bruit or thrill
• Weigh client daily, before, during
& after
• Hold antihypertensive drugs b4
dialysis
• Check for thrill and bruit q 8 hours
• Don’t use extremity for BP, finger
stick
• Monitor vital signs, weight, breath
sounds
• Monitor for hemorrhage
34. PERITONEAL DIALYSIS
• Weight before and after treatment
• Monitor BP
• Monitor breath sounds
• Use sterile technique
• If problem w/ outflow, reposition
client
• Side effects: constipation
35. TYPE 1 IDDM
• Test blood glucose every 4 hrs if
no feeling well
• Eat fruit or cheese sandwich
before exercise
• Do not exercise if blood glucose
is >250mg/dl & urinary ketones
present
• Administer regular insulin 30
minutes before meals
36. COMPARTMENT SYNDROME
• Increased pain & swelling
• Pain with passive motion
• Loss of sensation
• Inability to move joints
• Pulselessness
37. CARDIAC CATHETERIZATION
• NPO 6-8 hrs. & no liquid for 4
hrs. prior to prevent vomiting &
aspiration
• Feel a flush, warm, fluttery
feeling, desire to cough,
palpitations in introduction of dye
• Shave & Clean insertion site with
antiseptic solution
38. PERNICIOUS ANEMIA
• Severe pallor
• Smooth, beefy red tongue
• Slight jaundice
• Paresthisias of hands & feet
• Disturbances with gait & balance
39. DUMPING SYNDROME
• Occurs 30 minutes after eating
• Abdominal fullness & cramping
• Diarrhea
• Tachycardia
expected
• Family Hx
• Obesity
• Smoking
• Men
40. TPN COMPLICATIONS
• Air Embolism
• Fluid Overload
• Hyperglycemia
• Hypoglycemia
• Infection
• Pneumothorax
41. DIC
• Bruising, purpura
• Presence of occult blood
• Low fibrinogen level, hct, platelet
• Increased PT, PTT
• Complication: RENAL FAILURE
42. PERIPHERAL ARTERIAL DISEASE
• Dry scaly skin on lower
extremities
• Rest Pain, at night
• Intermittent claudication/
• Thickened toenails
• Cold & gray-blue color of skin
• Decreased or absent peripheral
pulses
• Instruct pt. to walk to point of
claudication, stop & rest & walk
a little farther
43. THROMBOPHLEBITIS
• Avoid pressure behind legs
• Avoid prolonged sitting
• Avoid constrictive clothing
• Avoid crossing the legs
• Avoid massaging the legs
44. SYPHILIS
Painless chancre
fades after 6 weeks
Low grade fever
Copper-colored rash on palms and
soles of feet
Spread by contact of mucous
membranes
Treat with Penicillin G IM
If patient has penicillin allergy, will
use erythromycin for 10-15 days.
After treatment, patient must be
retested to make sure disease is gone
45. POLYCYTHEMIA VERA
• Increased RBC
• Leukocytosis / Thrombocytosis
• Angina
• Intermittent claudication
• Dyspnea /HPN
• Lethargy / Syncope / Paresthesia
46. PRIMARY HPN
Risk Factors:
• Aging
• Black race
• Chronic stress
47. CHOLECYSTITIS
Sx:
• N & V
• Belching
• Indigestion
• Flatulence
• Epigastric pain that radiates to the
scapula 2 hrs. after eating fatty food
• Pain localized in RLQ
• Guarding, rigidity & rebound
tenderness
• Cannot take a deep breath when
fingers are pressed below hepatic
margin (Murphy’s Sign)
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