lOMoARcPSD|36158580

Notes bundle practice

Adult Health Nursing I (Delaware State University)

Scan to open on Studocu

Studocu is not sponsored or endorsed by any college or university

Downloaded by Arpan Mangrati (arpanspark@[Link])
 lOMoARcPSD|36158580

Disease
and
Disorders
NURSING NOTES NO. 6

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

DISEASE AND DISORDERS

NEUROLOGICAL DISORDERS
Neurological disorders are medically defined as disorders
that affect the brain as well as the nerves found
throughout the human body and the spinal cord.
Structural, biochemical or electrical abnormalities in the
brain, spinal cord or other nerves can result in a range of
symptoms.

ANATOMY OF BRAIN

STUCTURES OF NEURON

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

TRAUMATIC HEAD INJURY

• A trauma or blunt force hits the skull causing damage to the brain.
• Mild traumatic brain injury may affect patients brain cells.

NURSING
MANAGEMENT
COMPLICATIONS SIGNS & SYMPTOMS • Assess neurological
changes or
• Cerebral bleed • Confusion change in level of
• Hematoma • Agitation consciousness
• Increased intracranial • Visible head injury • Monitor vital signs
pressure • Sleepiness • Assess patient for
• Increased carbon • Brown pupils headache,
dioxide level nausea/vomiting
• Check for cerebrospinal
fluid drainage
• Assess pupil size

SEIZURES
• A burst of uncontrolled electrical activity between brain cells that
causes temporary abnormalities in muscle tone or movements,
behaviors, sensations or states of awareness
• Seizures are not all alike.

COMPLICATIONS
NURSING
• Status epilepticus MANAGEMENT
• Difficulty learning
• Breathing in food or saliva causingCOMPLICATIONS
pneumonia
• Injury from falls, bumps, self- inflicted bites, driving or • Assess seizure history
operating machinery during a seizure • Note time and
• Permanent brain damage (stroke or other damage) duration
• Prevent injury but don't
restrain
SIGNS & SYMPTOMS RISK FACTORS • Monitor behavior
before and after
• Uncontrollable episode
• Genetic inheritance
involuntary muscle • Turn patient on side at
• Brain trauma Tumors
movements end of seizure to drain
• Toxicity
(Convulsions) secretions
• Metabolic disorders
• Gaze of the distance
• Infections
• No response to stimuli
• Lose consciousness for
seconds or minutes
Downloaded by Arpan Mangrati (arpanspark@[Link])
 lOMoARcPSD|36158580

PARKINSON'S DISEASE
• A neurological movement disorder
• Most patients can maintain a good quality of life with medications
• Decreased dopamine levels in the brain cause neurological and
musculoskeletal symptoms

COMPLICATIONS SIGNS & NURSING

SYMPTOMS MANAGEMENT
• Falls Self-care deficits
• Depression • Tremor • Monitor swallowing
• Constipation • Slowed movement activity and
• Poor posture (bradykinesia) neuroactivity
• Rigid muscles • Assist with
• Impaired posture ambulation
and balance • Promote physical
RISK FACTORS • Loss of automatic therapy and
movements rehabilitative care to
• Age • Speech changes preserve function
• Heredity • Writing changes • Increase fluid intake
• Sex by 2L/day
• Exposure to toxins

MULTIPLE SCLEROSIS
• A central nervous system disease characterized by demyelination of axons
• A potentially disabling disease of the brain and spinal cord
• DIAGNOTICS: Requires extensive neurological testing over many years of a
slow onset of disease

SIGNS & SYMPTOMS

COMPLICATIONS
Babinski reflex • Fatigue
• Falls • Emotional changes • Weakness
• Psychological • Less sensation • Ataxia
problems • Blurred vision • Vertigo
• Less mobility • Bladder and bowel • Tremors
disturbance
RISK FACTORS
NURSING MANAGEMENT
• Epstein-Barr virus
• Smoking • Provide energy preservation measures
• Obesity • Encourage independence while providing safety
• Monitor for urinary and bowel dysfunction

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

MENINGITIS
• Inflammation of the arachnoid and pia mater of the CNS
• Usually caused by a bacteria or virus
• DIAGNOSTICS: Cerebrospinal fluid is tested for the pathogen and used
to determine the treatment

COMPLICATIONS
RISK FACTORS
• Falls • Skipping vaccinations
• Age
• Psychological problems • Compromised immune system
• Pregnancy
• Less mobility • Living in a community setting

SIGNS & SYMPTOMS NURSE MANAGEMENT

• Red muscular rush • Monitor for seizures

• Pain with neck flexion • Assess cranial nerves
• Low leucocyte
differential count

MENINGITIS

• Neurological deficit caused by a block of blood flow to the brain.

• There are 3 types of stroke: Ischemic, Hemorrhagic, and Transient Ischemic
Attack

SIGNS & SYMPTOMS RISK FACTORS NURSING

MANAGEMENT

• One sided weakness • Anticoagulation • Airway is priority

• Facial drooping therapy • Monitor vital signs,
• Confusion • Oral Contraceptives LOC, pupils and reflexes
• Slurred speech • Atherosclerosis • Position patient on the
• Aphasia • Hypertension side to prevent
• Diabetes aspiration
• Stress
• Obesity

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

CARDIAC DISORDERS
A type of disease that affects the heart or blood vessels. The risk of
certain cardiovascular diseases may be increased by smoking, high
blood pressure, high cholesterol, unhealthy diet, lack of exercise, and
obesity.

CARDIAC OUTPUT BP

LOW BLOOD VOLUME L O W BL O OD P R ES S U R E

BLOOD PRESSURE HI GH H EA R T RA TE

HIGH HEART RATE L O W C A R D IA C OU TP U T

HEART SOUNDS
S1 Atrioventricular valves close Heard at apex - Normal

S2 Semilunar valves close Heard at base - Normal

S3 Heard in heart failure or regurgitation - Abnormal for ages >30 years old

Hear in resistance wit ventricular filling - Always Abnormal

S4

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

CORONARY ARTERY DISEASE

• Narrowing or obstruction of a coronary artery due to plaque
buildup/atherosclerosis
• Atherosclerosis: Buildup causes the inside of the arteries to narrow over time
• Plaque: Made up of cholesterol deposits
• DIAGNOSTICS: ECG, Catheterization, Blood lipid

COMPLICATIONS

• Low perfusion NURSING

SIGNS & SYMPTOMS
• Hypertension MANAGEMENT
• Angina • Weakness
• Acute myocardial • Light-headedness • Educate about
infarction • Nausea lowering
• Cold sweat kilocalories/fat and
RISK FACTORS • Shortness of breath increasing fiber diet
• Chest pain or and exercise
• Overweight discomfort
• Physical inactivity • Pain or discomfort in
• Unhealthy eating the arms or shoulder
• Smoking tobacco
• Family history

AORTIC ANEUROSYM
• Stretching of the medial wall of an artery caused by vessel weakness.

RISK FACTORS
COMPLICATIONS SIGNS &
SYMPTOMS • High blood pressure
• High blood cholesterol
• Tears in the wall of • Thoracic: neck, • Atherosclerosis
the aorta and rupture shoulders, lower back (hardened arteries)
of the aorta are the pain, high heart rate
main complications of and dyspnea
NURSING
thoracic aortic • Abdominal: pulsating
MANAGEMENT
aneurysm. mass in abdomen, and
• A ruptured aortic abdomen or back pain • Monitor vitals
aneurysm can lead to • Ruptured: Severe • Check peripheral
life-threatening internal abdomen or back pain, pulses
bleeding shock and low blood • Assess for abdominal
pressure tenderness
• Ask patient if
abdominal or backpain
is present
Downloaded by Arpan Mangrati (arpanspark@[Link])
 lOMoARcPSD|36158580

HEART FAILURE

• The heart can no longer pump enough blood to perfuse the tissues adequately

SIGNS & SYMPTOMS NURSINGMANAGEMENT

Left Sided Right Sided • Educate about low sodium low

• Pulmonary • Peripheral edema fat diet
congestion • Jugular distention • Instruct the client to weigh
•Tachypnea • Splenomegaly themselves daily and report and
• High blood changes of more than 2 lbs.
pressure • Educate about fluid restrictions
and safe exercise

CARDIOGENIC SHOCK
• Reduced cardiac output and tissue perfusion.
• Usually caused by a coronary artery blockage.

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Hypotension • Cool and clammy skin • Administer oxygen and morphine

• Tachycardia • Disorientation sulfate as ordered
• Pallor • Chest Pain • Prepare for intubation
• Monitor blood gas levels

ACUTE MYOCARDIAL INFARCTION

AND DYSRHYTHMIAS

VENTRICULAR
FIBRILATION
• Ventricle depolarize in a completely
disorganized way.

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Cardiac out put ceases • Activate emergency response

• No pulse, blood pressure, • Administer CPR
respirations and patient is • Defibrillate oxygen as ordered
unconscious

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

MYOCARDIAL
INFACATION
• Cardiac tissue no longer has
oxygen supply
which can lead to necrosis

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Administer oxygen
• Chest pain • Low back pain
• Establish IV access
• Shortness of breath • Diaphoresis
• Obtain 12-lead EKG
• Fear and Anxiety • Pallor
• Thrombolytic therapy
• Nausea
• Assess pulses
• Monitor blood pressure

PREMATURE
VENTRICULAR
CONTRACTION
• Ventricles contract prematurely due
to impulse initiation by Purkinje fibers
instead of the SA mode.

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Pounding or jumping heart rate NURSING MANAGEMENT
• Skipped beats and palpitations • Assess oxygen saturation
• An increased awareness of your • Monitor anticoagulant and
heartbeat electrolytes as ordered
• Fluttering or flip-flop feeling in the
chest

ATRIAL
FIBRILATION
• Multiple depolarizations from the
atrium occur in a disorganized way
causing the atria to quiver.

SIGNS & SYMPTOMS NURSING MANAGEMENT

• General fatigue • Faintness or confusion • Administer oxygen and

• Rapid and irregular • Fatigue when anticoagulants as ordered
heartbeat exercising • Educate about physical
• Dizziness • Shortness of breath therapy
• Weakness and anxiety
Downloaded by Arpan Mangrati (arpanspark@[Link])
 lOMoARcPSD|36158580

HEMATOLOGY DISORDERS
Involve the blood and include problems with red blood cells,
white blood cells, platelets, bone marrow, lymph nodes, and
spleen. Children can experience a variety of disorders, some
are genetic while others are acquired.

IRON DEFICIENCY

• Inadequate diet • Hemolysis

• Malabsorption - Microcytic
• Blood loss - Hypochromic

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Replace iron
• Pallor
• Transfusion
• Glossitis
• Diet
• Chillitis
• Teaching
• Black stool
• Emphasize compliance

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

COBALAMIN B12 DEFICIENCY

(MEGALOBLASTIC)

• Impaired DNA synthesis • Pernicious anemia

• GI surgery • Gastric bypass
• Smoking

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Neurological
- Tingling
• B12 injection or intranasal
- Paresthesia
(1 per week)
- Beefy tongue
- Weakness

SICKLE CELL DISEASE

• Genetically - Autosomal

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Occlusions • Avoid high altitude and

• Necrosis temperature
• Low
• Impaired perfusions
DNA synthesis • Bone marrow transplant
• GI surgery
• Pain on exersion • Oxygen therapy
• Smoking
• Pernicious anemia
• Gastric bypass
FOLIC DEFICIENCY DISORDER
• Celiac • Hemodialysis
• Chron's • Mala absorption
• Alcoholism

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Weakness
• Replacement
• Fatigue
(green leafy vegetables)
• Bruising
1 mg/day tablet
• Weight loss
• No neuro symptoms

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

APLASTIC ANEMIA (PANCYTOPENIA)

• Celiac • Hemodialysis
• Chron's • Mala absorption
• Alcoholism

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Weakness
• Transfusion
• Fatigue
• Drugs for WBC increase
• Bruising
• Bone Marrow Transplant
• Weight loss
• No neuro symptoms

THROMBOCYTOPENIA

• Diminished production • Sequestration

- Viral infections - Enlarged spleen, neonatal,
- Vitamin deficiencies gestational, pregnancy
- Aplastic anemia, drug-induced
• Increased destruction
- Drugs Heparin [HIT], idiopathic,
pregnancy, immune system

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Petechiae
• Fatigue • Platelet transfusion
• Purpura • Bone marrow transplant
• Jaundice • Corticosteroid treatment
• Splenomegaly
• Deep vein thrombosis
• Prolonged bleeding time
• Spontaneous bleeding from the
gums or nose
• Heavy menstrual bleeding that's
unusual for the female
• Blood in the urine or stools

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

RESPIRATORY DISORDERS
A type of disease that affects the lungs and other parts of the
respiratory system. Respiratory diseases may be caused by
infection, by smoking tobacco, or by breathing in secondhand
tobacco smoke, radon, asbestos, or other forms of air
pollution.

RESPIRATORY SYSTEM

COPD
• Also known as Chronic Obstructive Pulmonary Disease
• Progressive disorder of the airway that restricts airflow
and alveolar expansion
• Exacerbated by infection
• Caused by emphysema or bronchitis

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Cough • Administer oxygen therapy as

• Excess mucus ordered
• Wheezes • Monitor pulse oximetry
• Crackles • Monitor sputum color and
• Barrel chest characteristics
• Prolonged expiration • Place Fowler's position to aid in
• Use of accessory muscles to breathing
breathe • Suction patients airway PN

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

ASTHMA
• Chronic inflammatory disease of the airway
• Smooth muscles constrict the bronchi

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Recurrent episodes of: • Monitor vital signs and pulse

- Wheezing oximetry frequently
- Breathlessness • Administer oxygen as prescribes
- Chest tightness • Stay with the patient to reduce
- Cough anxiety
• These scenarios are cause by • Administer bronchodilators and
exercise or certain triggers corticosteroids as ordered
(allergy, etc.)

PNEUMONIA
• Infects of pulmonary tissue
• Inflames patient lungs' air sacs (alveoli)
- The air sacs may fill up with fluid or pus

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Chills • Encourage coughing and

• Fever deep breathing
• Tachypnea • Provide oxygen or CPT
• Rhonchi
• Wheezes
• Labored breathing

PLEURAL EFFUSION
• Collection of fluid in pleural space

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Progressive dyspnea • Identify the underlying cause

• Dry cough • Prepare patient for possible
• Sharp pain on inspiration thoracentesis
• Decreased breath sounds • Encourage cough and deep breathing

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

ACUTE RESPIRATORY
DISTRESS SYNDROME
• Respiratory failure caused by an underlying cause like a
lung trauma or inflammation interstitial edema causes
airway compression

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Abnormal ABG values • Titrate oxygen as ordered by the

• Tachypnea provider prepare for intubation or
• Hypoxia mechanical ventilation
• Pulmonary infiltrates

ENDOCRINE DISORDERS
Diseases related to the endocrine glands of the body. The
endocrine system produces hormones, which are chemical
signals sent out or secreted, through the bloodstream.

ENDOCRINE SYSTEM

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

ADRENAL HORMONES THYROID HORMONES

ADDISON'S HYPERTHYROIDISM
(LOW ACH) (HIGH T3 AND T4)

SIGNS & SYMPTOMS SIGNS & SYMPTOMS

• Tremors
• Decreased vascular tone
• Nervousness
• Hypotension
• Tachycardia
• Bronze skin tone
• Weight loss
• Weight loss and weakness
• Cramps & diarrhea

TREATMENT TREATMENT

• Lifelong replacement of • Lifelong replacement of

glucocorticoids or glucocorticoids or
mineralcorticoids mineralcorticoids

CUSHING'S HIGH ACH HYPOTHYROIDISM

(CORTISOL) (LOW T3 AND T4)

SIGNS & SYMPTOMS SIGNS & SYMPTOMS

• Moon face • Drowsiness

• Hypertension • Fatigue
• Weight gain • Excessive hunger
• Fragile skin • Weight gain

TREATMENT TREATMENT

• Glucocorticoid treatment
(in some cases the medication • Thyroid hormone replacement
lasts for life) therapy based on T3 and T4 levels
• Adrenalectomy with synthetic

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

DIABETES MELLITUS

TYPE I TYPE II
(Inability to make insulin) (Inability to absorb insulin)

SIGNS & SYMPTOMS SIGNS & SYMPTOMS

• Polyuria • Weight loss • Polydipsia

• Polydipsia • Blurred vision • Polyphagia
• Polyphagia • Poor wound healing
• Weight gain

TREATMENT TREATMENT
• Consistency in food intake
• Close monitoring and • Exercise
correction of blood glucose • Diet changes and weight
levels loss are preferred treatments
• Take medications such as
• Blood sugar is low: - Metformin
- Encourage patient to eat carb - Insulin
heavy snack
• Blood sugar level is high
- Administrate insulin Promote
exercise

GROWTH HORMONES

ACROMEGALY PITUITARY DWARFISM

(HIGH GH) (LOW GH)

SIGNS & SYMPTOMS SIGNS & SYMPTOMS

• Giantism • Deep voice

• Short height
• Oily skin • Hyperglycemia
• Reduced cardiac output
• Long arms and
• Moderate obesity
extremities

TREATMENT TREATMENT

• Suppress GH with a GH inhibition • If caught early can be cured with

medication GH supplementation

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

DIABETES INSIPIDUS
(LOW ADH)

SIGNS & SYMPTOMS TREATMENT

• Excretion of large amounts of

dilute urine • Vasopressin therapy
• Polypsida • Avoiding foods and
• Headache beverages that are diuretics
• Low specific gravity
• Dehydration

GASTROINTESTINAL DISORDERS
A type of disease that affects the lungs and other parts of the
respiratory system. Respiratory diseases may be caused by
infection, by smoking tobacco, or by breathing in secondhand
tobacco smoke, radon, asbestos, or other forms of air
pollution.

GI TRACT STRUCTURES

M mouth L arge Intestine

E sophagus P ancreas Memory tip!

MESS!
S tomach G allbladder Leave Please!
Get L ost!
S mall Intestine L iver

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

GASTROESOPHAGEAL REFLUX DISEASE

• Backflow of gastric and duodenal contents up into the
esophagus caused by a dysfunctional lower sphincter

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Teach patient to avoid irritants

• Frequent heartburn
like peppermint, chocolate, coffee,
• Epigastric pain
fatty foods, alcohol & smoking
• Nausea
• Avoid eating 2 hours before
• Dyspepsia
bedtime
• Dysphagia
• Avoid anticholinergics and NSAID's
• Regurgitation
• Keep height of bed elevated after
eating

PEPTIC ULCER DISEASE

• An ulceration that erodes the lining of the stomach caused

by irritation and Helicobacter pylori

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Sharp pain in left or mid • Surgical • Prescription

epigastric area after meals - Resection - Proton pump
- Vagotomy inhibitors and H2
- Pyloroplasty blockers
- Total gastrectomy

APPENDICITIS

• Acute inflammation of the appendix

and surrounding tissue

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Sharp constant abdominal pain that • Administer pain meds

moves to the right lower quadrant • Prep for imaging and or surgery
APPENDICITIS APPENDICITIS
Downloaded by Arpan Mangrati (arpanspark@[Link])
 lOMoARcPSD|36158580

CHOLEYCYSTITIS

• Inflammation of the gallbladder can be caused by slow bile

emptying, contracted gallbladder or bacterial invasion

SIGNS & SYMPTOMS

NURSING MANAGEMENT
• Murphy's sign
- Can't take deep breaths
when fingers are placed on • Maintain NPO status during
hepatic margin due to pain exacerbations
• Belching • Educate patient to eat small low
• Flatulence fat meals
• Right Upper quadrant pain

PANCREATITIS
• Acute inflammation of the pancreas

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Nausea
• Vomiting • Pain control
• Diarrhea • Limit oral intake
• Cramping • Nausea medication administration
• Diffuse abdominal pain

INFLAMMATORY BOWEL DISEASE

• Inflammatory diseases of the bowel

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Educate about low FODMAP diet

• Diarrhea • Help decrease trigger and stress
• Abdominal Cramps for > 6weeks • Avoid usage of NSAID's that may
lead to lower gastrointestinal
bleeding

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

RENAL AND URINARY DISORDERS

Any disease of the kidneys. Urological disorders are diseases
of the kidneys and urinary tract.

MALE AND FEMALE URINARY SYSTEM

CHRONIC KIDNEY DISEASE

• Slow progressive loss of kidney function resulting in uremia and

hypervolemia into the inability to conserve sodium and water

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Polyuria • Low protein, potassium and

• Lower skin turgor phosphorus diet
• Edema • Educate about fluid restriction
• Diluted urine and possible dialysis treatment
• Proteinuria

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

PYELONEPHRITIS
• Inflammation of the renal pelvis caused by bacterial infection

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Monitor temperature
• Fever • Frequency
• Encourage increased fluid
• Chills • Flank pain
intake and decreased protein
• Tachypnea • Cloudy urine
• Administer analgesics
• Nausea • Hematuria
• Antipyretics
• Monitor 1/0 and weight

HYDRO NEPHROSIS
• Distention of the renal pelvis caused by the obstruction trapping
urine proximally

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Monitor vitals
• Colicky or dull flank pain that
• Electrolytes
radiates to the groin
• Specific gravity
• Headache and hypertension
• Defydration

BENIGN PROSTATICHYPERTROPHY

• Slow enlargement of prostrate gland that can compress the urethra

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Increase fluid intake

• Diminished • Retention
• Encourage patient to decrease
urinary stream • Disuria
caffeine and artificial sweetener
• Nocturia • Bladder pain
intake
• Urgency
• Educate about a timed voiding
• Hematuria
schedule

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

POLYCYSTIC KIDNEY DISEASE

• Cyst formation and hypertrophy of the kidneys causing scar

tissue, infection, scar tissue and nephron damage

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Hematuria • Monitor for hematuria which could

• Proteinuria indicate a rupture
• Recurrent UTI's • Increase sodium and water intake
• Flank or lumbar pain that • Educate about possible need for
worsens with activity and surgical interventions
improves upon lying down

INTEGUMENTARY DISORDERS
The integumentary system is susceptible to a variety of
diseases, disorders, and injuries. These range from annoying
but relatively benign bacterial or fungal infections that are
categorized as disorders, to skin cancer and severe burns,
which can be fatal.

PSORIASIS

• Chronic non contagious inflammation of the skin due to over keratinization

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Red patches of skin covered • Teach the patient to avoid

with thick, silvery scales scratching and rear non-irritating
• Small scaling spots (commonly clothing such as cotton
seen in children) • Ensure that patient doesn't use
• Dry, cracked skin that may any over the counter medicines
bleed or itch without approval
• Itching, burning or soreness
• Thickened, pitted or ridged nails
• Swollen and stiff joints

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

HERPES ZOSTER (SHINGLES)

• Reactivation of Varicella zoster virus from previous chickenpox infections

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Isolate patient in contact

• Red skin vesicles along areas precautions
of sensory nerves • Prevent scratching and irritation
of vesicles
• Administer antivirals as ordered

STEVEN'S JOHNSON SYNDROME

• A skin reaction caused by an immunological response to taking

certain medications

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Vesicles • Discontinue medication that

• Erosions is causing the reaction
• Flu-like symptoms • Administer antibiotics and
• Redness corticosteroids as ordered

FROSTBITE

• Damage to tissue/vessels as a result of prolonged exposure to cold

SIGNS & SYMPTOMS NURSING MANAGEMENT

• White plaque around redness • Rewarm slowly with moist heat

• Blisters and monitor CMS and for signs of
• Bluish skin compartment syndrome
• Numbness of extremities

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

MUSCULOSKELETAL DISORDERS
Injuries and disorders that affect the human body's
movement or musculoskeletal systems such as the muscles,
nerves, tendons, joints, cartilage, and spinal discs.

MUSCULOSKELETAL SYSTEM

OSTEOARTHRITIS
• An inflammatory degeneration gradual loss of articular cartilage
• Assymetrical

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Regular exercise can be used as

• Exacerbated by temperature
preventive measure
and climate change
• Avoid prolonged standing,
• Joint space narrowing
kneeling and squatting
• One leg is shorter
• When experiencing
• Pain is incrased after rest
- Heat for stiffness
- Apply cold for inflammation

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

OSTEOPOROSIS

• Bone demineralization cause by loss of calcium and phosphorus

• Bone resorption occurs faster than bone formation

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Loss of bone density and • Encourage a well-balanced diet

easily fractured bones high in protein, calcium, iron and
vitamins D & C

GOUT
• Uric acid crystals build up in joints and body tissues can result
from poor metabolism of purine

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Swelling and inflammation of • Introduce low purine diet

joints • Increase fluid intake
• Low grade fever • Instruct patient to avoid
• Malaise alcohol and excessive use of
• Itchiness the joint
• Pain at the joints

RHEUMATOIDARTHRITIS

• An autoimmune response that cause deformities

SIGNS & SYMPTOMS

NURSING MANAGEMENT
• Fatigue • May trigger:
• Anorexia - Childbirth
• Stiffness - Infection
• Surgery to restore function
• Weight loss - Stress
• Symmetrical
• Permanent deformity

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

FRACTURE COMPLICATIONS

FAT EMBOLISM

• A piece of intravascular fat that lodges within a blood vessel and causes
a blockage of blood flow
• Fat emboli commonly occur after fractures to the long bones of the lower
body, particularly the femur (thighbone), tibia (shinbone), and pelvis

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Provide supportive care

• Altered mental status
• Monitor oxygen levels and
• Impaired respiratory function
provide oxygen or mechanical
• Decreased perfusion distal to
ventilation as prescribed
embolus site
• Give intravenous fluids and
drugs as prescribed

COMPARTMENT SYNDROME

• A painful condition that occurs when pressure within the muscles

builds to dangerous levels
• This pressure can decrease blood flow, which prevents nourishment
and oxygen from reaching nerve and muscle cells
• Compartment syndrome can be either acute or chronic

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Numbness and tingling • Fasciotomy: An incision and cut

• Pallor open the skin and fascia covering
• Pain with movement the affected compartment
• Pain that increases with • The swelling can be severe
elevation enough that the skin incision
cannot be closed immediately

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

HERNIATED DISK
• A vertebral disk slips out o place which can cause pain due to
compression of spinal nerve

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Surgery to realign vertebra

• Numbness and tingling in
physical therapy and adjustments
back and extremities
by a chiropractor can alleviate
• Severe pain
pain but does not fix the
herniation

AMPUTATION FRACTURE CLASSES

• Ensure Residual limb sock is • Stable: The broken ends of the

worn at all times, make sure it bone line up and are barely out of
is positioned in a prone place
position as prescribed • Segmental: a fracture composed
• Educate patient about of at least two fracture lines that
cleaning prosthesis socket together isolate a segment of
daily bone.
• Special Considerations: • Spiral: a bone fracture that
Above Knee occurs when a long bone is broken
- Prevent internal and by a twisting force
external rotation of the hip • Transverse: A break that is
Below Knee perpendicular to the long axis
- Discourage long periods of • Comminuted: The bone
sitting to lower flexion fragments into pieces
- Don't allow limb to dangle • Open/Compound: Part of the
bone is through the skin
• Greenstick: The bone is
splintered on one side

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

CASTS
4 ELEMENTS OF SOFT
• Elevate for 24-48 hours to promote
venous drainage
TISSUE INJURY TREATMENT
• Allow the plaster casts to dry for 24-72
hours
R - Rest: Keep patient from weight-
• Nursing Action
bearing or using joint
- Instruct the patient to report skin
I - Immobilize: Splint and prevent
irritation and hot spots
movement
- For the traction
C - Cold: Apply cold compress
• Ensure weights are freely hanging off
E - Elevate: Elevate pillows to reduce
the floor
swelling
• Assess skin integrity frequently with
skin traction

JOINT INJURIES

• Strains
The muscle or tendon attached to
a bone becomes injured or
overstretched
• Sprains
The ligaments connecting 2
bones become torn or stretched

REPRODUCTIVE DISORDERS
Diseases involving the reproductive system, including
reproductive tract infections, congenital abnormalities,
cancers of the reproductive system and sexual dysfunction.

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

FEMALE REPRODUCTIVE DISORDERS

POLYCYSTIC OVARIAN SYNDROME

• Abnormalities with the metabolism of androgens and estrogen

SIGNS & SYMPTOMS TREATMENT

• Hirsutism • Diet
• Infertility • Exercise
• Diabetes • Weight loss
• Sleep apnea • Oral Contraceptives
• Obesity • Antiandrogens
• Menstrual dysfunction • Hypoglycemic agents

ENDOMETRIOSIS
• The endometrium lining the uterus grows in places it should not
which can cause cramping or infertility

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Monitor for symptoms of anemia
during menstruation
• Intense pelvic pain
• Educate about the importance of
• Painful intercourse
annual exams
• Diagnosis is confirmed by
• Help patient relieve painful
laproscopy
cramps with ordered meds and
heat compress

PELVIC INFLAMMATORY DISEASE

• Infection of the reproductive system usually caused by STI's

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Discharge • Pelvic Pain

• Fever • Antibiotics
• Cramping
• Education about using protection
• Painful
Menstruation

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

MALE REPRODUCTIVE DISORDERS

VARICOCELE

• Enlargement of the veins in the scrotum caused by blood pooling in veins

SIGNS & SYMPTOMS NURSING MANAGEMENT

• A dull, recurring pain in

• Encourage to wear supportive
scrotum
underwear or jock strap
• Visibly large and twisted veins
• A lump swelling

STERILITY
• Chromosomal abnormalities or inadequate hormones
• Inability to reproduce as a result of various causes including low sperm count

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Hormone replacement
• A dull, recurring pain in
• Fertility drugs
scrotum
• Surgery
• Visibly large and twisted veins
• Artificial semination
• A lump swelling
• Psychological counseling to help
patient develop coping methods

ERECTILE DYSFUNCTION
• Inability to keep an erection long enough for sexual intercourse

SIGNS & SYMPTOMS NURSING MANAGEMENT

• Trouble getting an erection

• Vasodilators or hormone therapy
• Trouble keeping an erection
• Smoking cessation
• Reduced sexual desire

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

CANCER
A term for diseases in which abnormal cells divide without
control and can invade nearby tissues. Cancer cells can also
spread to other parts of the body through the blood and
lymph systems.

CARCINOMA
• Any cancer originating in the epithelium

SIGNS & SYMPTOMS RISK FACTORS

• A growing lump with a crusty • Overexposure to sun

surface • Repetitive irritation
• Slow growing flat patch of • Genetic predisposition
redness • Lighter skin Older than 60 years

SARCOMA

• Cancer originating in the connective tissue

SIGNS & SYMPTOMS RISK FACTORS

• Lymphedema
• Visible lump or mass in the soft
• Von Willebrand disease
tissue
• Genetic Predisposition

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

MELANOMA
• A cancer originating in melanocytes which are located in the basal
layer epithelium

SIGNS & SYMPTOMS RISK FACTORS

• New marks on skin • Fair skin

• Mole that changes shape • A history of sunburn
or size new pigments of the • Excessive ultraviolet (UV) light
skin exposure
• A family history of melanoma
• Weakened immune system
• Living closer to the equator or at a
higher elevation
• Having many moles or unusual
moles

LEUKEMIA
• A cancer a blood-forming cells
• Either acute or chronic

SIGNS & SYMPTOMS RISK FACTORS

• Fatigue and weakness • Smoking

• Pale skin tone • Exposure to certain chemicals
• Fever • Chemotherapy
• Easy bruising and bleeding • Radiation exposure
• Bone or joint pain and/or • Rare congenital disease
tenderness • Certain blood disease
• Swollen lymph nodes • Family history
• Frequent infections • Age
• Unplanned weight loss • Gender

Downloaded by Arpan Mangrati (arpanspark@[Link])

 lOMoARcPSD|36158580

TREATMENT

• Surgery GENERAL NURSING

- Tumor is removed or destroyed INTERVENTIONS
• Radiation
- Localized destruction of cancer • Treat nausea and educate about
cells carbohydrate low for prevention
- Can cause local irritation and • Maintain meticulous infection
fatigue control for yourself the patient and
• Chemotherapy visitors
- Kills and stops the reproduction • Provide nonpharmacological and
of neoplastic cells: pharmacological pain control
(Skin, Hair, Nails, GI cells)

Change in bowel/bladder
C

A Any sore that doesn't heal

WARNING
U Unusual bleeding/discharge
SIGNS

T Thickening or lumps

I Indigestion

O Obvious skin changes

N Nagging cough/hoarseness

Downloaded by Arpan Mangrati (arpanspark@[Link])