. CERVICAL CARisk 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 CASx: Post-coital bleeding Painful sex Menstrual irregularities2. OVARIAN CARisk factors: Ovarian dysfunction Vaginal use of talcum powder Alcohol Race White women & family history Infertility Age Peak=5th decade of life Nulliparity Genetic predisposition3. 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 using4. BLOOD TRANSFUSION REACTION Transfusion ReactionsHemolytic ReactionAllergic Reaction Circulatory Overload Septicemia Iron Overload Hypocalcemia Disease Transmission Hyperkalemia Citrate Intoxication5. HYPERTHYROIDISM Soft smooth skin & hair Mood swings HPN Diaphoresis Intolerance to heat PTU drug to block thyroid synthesis6. LUNG CA Bronchogenic Carcinoma 1st leading cause of death From asbestos, bacterial invasion, cigarette Sx: Nagging cough, hoarseness of voice, dyspnea, diminished breath sounds7. 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 MedsArtane, 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 impaired8. ACUTE PANCREATITIS Abdominal Pain severe acute sx Complication : Shock,Hypovolemia Limited fat & protein intake9. CAST CARE Dont rest on hard surface Dont cover until dry 48+ hours Handle with palms of hands not with fingers Keep above level of heart Check for CSM10. 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 Low K, P Restrict Na12. 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 present13. SUPERIOR VENA CAVA OCCLUSION Sx occur in the morning Edema of face, eyes & tightness of shirt/ (Stokes sign)Late sx: edema of arms, hands, dyspnea, erythema, epistaxis14. ULCERATIVE COLITISSx: Severe diarrhea with blood & mucus Abdominal tenderness & cramping Anorexia Wt. Loss Vit. K deficiency Anemia Dehydration Electrolyte imbalance Low residue & high protein diet15. DILANTIN do not floss throughout the day do not use hard bristledtoothbrush Gingivitis S/E16. 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 drugs17. BLADDER CARisk Factors: Hx of smoking Exposure to radiation Working in industrial Factory18. S/S OF DKA Fruity breath Odor Oliguria Kusmaulls (deep & nonlabored)19. SITE FOR IM INJECTION ADULT Deltoid Ventrogluteal Vastus Lateralis Gluteus Maximus20. S/S OF BACTERIAL MENINGITIS N & V Seizures Stiff Neck Photophobia Positive Brudzinski sign21. TB Waking up sweating at night Low grade fever Dullaching chest pain Cough streaked with blood Weight loss Anorexia Fatigue22. LIVER CIRRHOSIS N & V Edema Ascites23. PULMONARY EMBOLISMSx: Blood-tinged sputum Distended neck vein Chest Pain / Hypotension / Cyanosis Cough / Shallow respirations Rales on auscultation Tachypnea / Tachycardia24. COLON CARisk Factors: Family HX Age above 50 Jewish Male25. DIGOXIN THERAPY Do not administer in infants if < 90 bpm Do not give to older children if 250mg/dl & urinary ketones present Administer regular insulin 30 minutes before meals36. COMPARTMENT SYNDROME Increased pain & swelling Pain with passive motion Loss of sensation Inability to move joints Pulselessness37. 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 solution38. PERNICIOUS ANEMIA Severe pallor Smooth, beefy red tongue Slight jaundice Paresthisias of hands & feet Disturbances with gait & balance39. DUMPING SYNDROME Occurs 30 minutes after eating Abdominal fullness & cramping Diarrhea Tachycardia Perspiration Weakness / dizziness Borborygmi sound40. TPN COMPLICATIONS Air Embolism Fluid Overload Hyperglycemia Hypoglycemia Infection Pneumothorax41. DIC Bruising, purpura Presence of occult blood Low fibrinogen level, hct, platelet Increased PT, PTT Complication: RENAL FAILURE42. 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 farther43. THROMBOPHLEBITIS Avoid pressure behind legs Avoid prolonged sitting Avoid constrictive clothing Avoid crossing the legs Avoid massaging the legs44. 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 gone45. POLYCYTHEMIA VERA Increased RBC Leukocytosis / Thrombocytosis Angina Intermittent claudication Dyspnea /HPN Lethargy / Syncope / Paresthesia46. PRIMARY HPNRisk Factors: Aging Black race Chronic stress Family Hx Obesity Smoking Men47. CHOLECYSTITISSx: 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 (Murphys Sign)