1	Medical Signs How do I Sign THAT?!? Suzanne Hansen MSN Ed, RN April 12, 2008 Hansen.suz@gmail.com
2	Suzanne Crook Hansen Registered Nurse - Traveler/Float Interpreter CI/CT Hard of Hearing Red Cross Instructor - Emergency Response, First Aid, Disaster Services Teacher of Health Careers/Nursing Services - Fremont School for the Deaf Clinical Instructor - Ohlone College
3	Doctor’s Office Visit “The tests we have run on your son conclude that he has Kanner Syndrome. The nurse will give you a list of resources for follow up.” “What is Kanner Syndrome? How did he get it? Are there medications to cure it?”
4	Kanner Syndrome A spectrum of neuropsychiatric disorders characterized by deficits in social interaction and communication, and unusual and repetitive behavior. Some, but not all, people with autism are non-verbal. Autism is normally diagnosed before age six and may be diagnosed in infancy in some cases. The degree of autism varies from mild to severe in different children. Severely afflicted patients can appear profoundly retarded. The cause (or causes) of autism are not yet fully understood. However, it is believed that at least some cases involve an inherited or acquired genetic defect. Researchers have proposed that the immune-system, metabolic, and environmental factors may play an important part as well. It is not caused by emotional trauma, as was once theorized. Autism or autistic-like behavior may co-occur with many other neurological conditions. The optimal treatment of autism involves an educational program that is suited to the child's developmental level. Kanner syndrome (i.e., autism) is also called infantile autism. Also, Asperger syndrome, elective mutism, Pervasive Developmental Disorder, Rett syndrome.
5	How do I prepare?? You can’t feed a baby steak!! Do a little every day Utilize hospital libraries and free classes Utilize free resources Utilize the internet
6	Internet Resources Websites RSS/HTML Readers EMAIL Webcam/Video Phone
7	Websites www.webmd.com/a-to-z-guides/common- topics/default.htm http://science.nationalgeographic.com/science/health- and-human-body.html www.mayoclinic.com www.medicinenet.com www.nlm.nih.gov/medlineplus/druginformation.html www.webmd.com www.visiblebody.com www.radiologyinfo.org www.aslpro.com www.drugs.com www.health.yahoo.com www.kidshealth.org
8	RSS READER??? You don’t have to go find the news!!! When there is something new IT COMES TO YOU!!! Google Reader FeedDemon Shrook Feedster Pluck Yahoo Reader RSS Reader live.com You can even link to other people’s feeds!!
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21	Let’s PRACTICE!!
22	Professionals Doctor Nurse CNA/Tech Phlebotomist OT PT SP RT
23	Vitals Blood Pressure Respirations Pulse Temperature Height Weight Breath sounds Listening to my STOMACH?!? Bowel Sounds
24	Treatments/Procedures IV/PICC/Central Line Foley Catheter NG/NJ/Peg tube Nasal Cannula/Face Mask X-ray MRI/CT Scan EKG/ECG/Telemetry EEG/EMG ECHO Angiography Endoscopy/Colonoscopy
25	Common Diseases/Conditions Diabetes Stroke Seizure Allergies Diarrhea Congestion Constipation Contagious Headache Nausea
26	MEDS!?! Generic vs Trade Tylenol, Ibuprofen, Aspirin, Aleve Pill (PO, sublingual) Elixir Shot (IM, IV, Subcutaneous/SubQ) Suppository (PR, Vaginal) Epidermal Patch Nasal Spray
27	Analgesic A drug or medicine given to reduce pain without resulting in loss of consciousness. May be narcotic or non-narcotic Antipyretic - decreases fever Anaesthetic/Anesthetic - blocks sensation
28	Asthma Exacerbation A worsening of asthma. Asthma is a chronic inflammation of the bronchial tubes (airways) that causes swelling and narrowing (constriction) of the airways. The result is difficulty breathing. The bronchial narrowing is usually either totally or at least partially reversible with treatments. Inhalers are usually used first, followed by nebulizer treatments.
29	Bronchodilators Short-acting bronchodilators are used only as needed as asthma “rescue” medications. Long-acting bronchodilators are used every day to control asthma. Bronchodilators open up the bronchial tubes so that more air can move through. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can be coughed out (expelled) more easily. Examples: * Albuterol (Proventil HFA, Ventolin HFA, AccuNeb, also available as a generic solution for nebulizers) * Alupent (Metaproterenol, available as a generic solution for nebulizers, see below) * Combivent (combines a beta-agonist and an anticholinergic, see below) * DuoNeb (combines a beta-agonist and an anticholinergic, see below) * Maxair * Xopenex Long acting - Advair, Symbicort, Serevent, and Foradil inhalers
30	Dilantin (PHENYTOIN) Prevent and control seizures Irregular heartbeats (rare but more frequently used) Trigeminal neuralgia (facial nerve pain) Migraines (thought to be caused by nerve pain) Diabetic neuropathies not relieved by other medications
31	ARF vs CRF ARF - a sudden decrease or stopping in kidney function Most common causes - Sudden decrease in blood flow to kidneys usually from blood loss, infection, or dehydration Damage from medicines, poisons, or infections Blockage that prevents urine from leaving the kidneys CRF - Long term decrease in kidney function Common causes - High Blood Pressure High Blood Sugar/Diabetes Long term use of antibiotics or NSAIDs (Non-Steroidal Anti- Inflammatory Drugs ie. Tylenol and Ibuprofen) OFTEN RESULTS IN DIALYSIS TREATMENT
32	CHF Congestive heart failure (CHF), or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. This can result from * narrowed arteries that supply blood to the heart muscle — coronary artery disease * past heart attack, or myocardial infarction, with scar tissue that interferes with the heart muscle's normal work * high blood pressure * heart valve disease due to past rheumatic fever or other causes * primary disease of the heart muscle itself, called cardiomyopathy. * heart defects present at birth — congenital heart defects. * infection of the heart valves and/or heart muscle itself — endocarditis and/or myocarditis The "failing" heart keeps working but not as efficiently as it should. People with heart failure can't exert themselves because they become short of breath and tired. As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. Often swelling (edema) results. Most often there's swelling in the legs and ankles, but it can happen in other parts of the body, too. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down. Heart failure also affects the kidneys' ability to dispose of sodium and water. The retained water increases the edema.
33	ACE Inhibitor Used to treat Hypertension and Congestive Heart Failure. Often combined with diuretics (water pills) Examples: HCTZ - hydrochlorothiazide Lasix/furosemide - water pill * Enalapril (Vasotec/Renitec) * Ramipril (Altace/Tritace/Ramace/Ramiwin) * Quinapril (Accupril) * Perindopril (Coversyl/Aceon) * Lisinopril (Lisodur/Lopril/Novatec/Prinivil/Zestril) * Benazepril (Lotensin)
34	Plantar Faciitis * Sharp pain in the inside part of the bottom of your heel, which may feel like a knife sticking in the bottom of your foot * Heel pain that tends to be worse with the first few steps after awakening, when climbing stairs or when standing on tiptoe * Heel pain after long periods of standing or after getting up from a seated position * Heel pain after, but not usually during, exercise * Mild swelling in your heel The plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. But, if tension on that bowstring becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed. Common Causes : Physical Activity overload, Arthritis, Diabetes, Flat feet, high arches, long strenuous hours on your feet, improper shoes for activity (high heels while on feet for long hours), Pregnancy, obesity, walking on hard surfaces for long periods of time, being athletic with improperly supported arches
35	Antitussives Antitussive - used to treat a dry cough often a type of anaesthetic to numb the irritated throat Expectorant - promotes drainage of mucus from the lungs by thinning the mucus and also lubricates the irritated respiratory tract. Usually used in wet productive coughs. Mucolytics - thin mucus to make it less sticky and easier to cough up from the lungs and airways leading to the lungs (bronchial tubes). They are not commonly used. May be used in COPD, Chronic Bronchitis, and Cystic Fibrosis.
36	COPD Caused by damage to the lungs over many years, usually from smoking. COPD is often a mix of two diseases: * Chronic bronchitis (say “bron-KY-tus”). In chronic bronchitis, the airways that carry air to the lungs (bronchial tubes) get inflamed and make a lot of mucus. This can narrow or block the airways, making it hard to breathe. * Emphysema (say “em-fuh-ZEE-muh”). In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath. COPD cannot be cured. Many COPD patients eventually use oxygen at home to decrease the work of breathing.
37	Anemia Iron deficiency anemia. This most common form of anemia affects about one in five women, half of pregnant women and 3 percent of men in the United States. The cause is a shortage of the element iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells. The result is iron deficiency anemia. One way your body gets needed iron is when blood cells die — the iron in them is recycled and used to produce new blood cells. So, if you lose blood, you lose iron. Women with heavy periods who lose a lot of blood each month during menstruation are at risk of iron deficiency anemia. Slow, chronic blood loss from a source within the body — such as an ulcer, a colon polyp or even colon cancer — also can lead to iron loss and iron deficiency anemia. Your body also gets iron from the foods you eat. An iron-poor diet can lead to this anemia. In pregnant women, a growing fetus can deplete the mother's store of iron, leading to iron deficiency anemia.
38	Anemia Vitamin deficiency anemias. In addition to iron, your body needs folate and vitamin B-12 to produce sufficient numbers of healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. People who have an intestinal disorder that affects the absorption of nutrients are prone to this type of anemia. Some people are unable to absorb vitamin B-12 for a variety of reasons and develop vitamin B-12 deficiency anemia, which is sometimes called pernicious anemia. Vitamin deficiency anemias fall into a group of anemias called megaloblastic anemias, in which the bone marrow produces large, abnormal red blood cells. Anemia of chronic disease. Certain chronic diseases — such as cancer, rheumatoid arthritis, Crohn's disease and other chronic inflammatory diseases — can interfere with the production of red blood cells, resulting in chronic anemia. Kidney failure also can be a cause of anemia. The kidneys produce a hormone called erythropoietin, which stimulates your bone marrow to produce red blood cells. A shortage of erythropoietin, which can result from kidney failure or be a side effect of chemotherapy, can result in a shortage of red blood cells. Aplastic anemia. This is a life-threatening anemia caused by a decrease in the bone marrow's ability to produce all three types of blood cells — red blood cells, white blood cells and platelets. Many times, the cause of aplastic anemia is unknown, but it's believed to often be an autoimmune disease. Some factors that can be responsible for this type of anemia include chemotherapy, radiation therapy, environmental toxins, pregnancy and lupus. Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelodysplasia, a pre-leukemic condition, can cause anemia by affecting blood production in the bone marrow. The effects of these types of cancer and cancer-like disorders vary from a mild alteration in blood production to a complete, life-threatening shutdown of the blood- making process. Additionally, other cancers of the blood or bone marrow, such as multiple myeloma, myeloproliferative disorders and lymphoma, can cause anemia.
39	Anemia Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases can cause increased red blood cell destruction. Autoimmune disorders can cause your body to produce antibodies to red blood cells, destroying them prematurely. Certain medications, such as some antibiotics used to treat infections, also can break down red blood cells. Hemolytic anemias may cause yellowing of the skin (jaundice) and an enlarged spleen. Sickle cell anemia. This inherited and sometimes serious anemia, which affects mainly people of African and Arabic descent, is caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular-shaped red blood cells die prematurely, resulting in a chronic shortage of red blood cells. Sickle-shaped red blood cells can also block blood flow through small blood vessels in the body, producing other, often painful, symptoms. Other anemias. There are several other, rarer forms of anemia, such as thalassemia and anemias caused by defective hemoglobin.
40	HYDROCODONE with ACETAMINOPHEN USES: This medication is a combination of a narcotic (hydrocodone) and a non-narcotic (acetaminophen) used to relieve moderate to severe pain. Hydrocodone works by binding to opioid receptors in the brain and spinal cord, and acetaminophen decreases the formation of prostaglandins, therefore relieving pain. OTHER USES: This medication may also be used to suppress a cough. HOW TO USE: Take this medication by mouth, as directed by your doctor. You may take this drug with or without food. If you have nausea, you may take this drug with food, although doing so may decrease its effectiveness. Consult your doctor or pharmacist about alternatives for decreasing nausea (e.g., antihistamines, lying down for 1-2 hours with minimal head movement). The dosage is based on your medical condition and response to therapy. Pain medications work best in relieving pain before it becomes severe. Once the pain becomes intense, the medication is not as effective in relieving it. Use this medication exactly as prescribed. Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming. Also, if used for an extended period of time, do not suddenly stop using this drug without your doctor's approval. When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well. This medication contains acetaminophen. Do not take more acetaminophen than recommended (see Side Effects section). SIDE EFFECTS: Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, flushing, vision changes, or mental/mood changes may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Tell your doctor immediately if any of these unlikely but serious side effects occur: slow/irregular breathing, slow/irregular heartbeat, change in the amount of urine. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: impairment or loss of hearing (especially with high doses for long periods). If you do not have liver problems, the adult maximum dose of acetaminophen is 4 grams per day (4000 milligrams). If you take more than the maximum daily amount, it may cause serious (possibly fatal) liver disease. Tell your doctor immediately if you have any of the following symptoms of liver damage: severe nausea, yellowing eyes or skin, dark urine, stomach pain, extreme fatigue. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.
41	Cerumen Impaction Buildup of earwax that has hardened
42	ED Emergency Department Education ED (computer language) Ed (the talking horse) ED (alternative/indie/rock group) Erectile Dysfunction
43	Münchhausen syndrome A recurrent feigning of catastrophic illnesses, a psychological disorder that is characterized by the recurrent presentation of the patient for treatment of an acute and often dire illness that is, in reality, not present. The person with Münchhausen syndrome usually gives a plausible and dramatic history. All of it is entirely false. The patient tends to go from hospital to hospital feigning medical or surgical diseases and giving false and fanciful information about their medical and social background. They may even have unnecessary surgery repeatedly, resulting for example in a "mass of scars" on the abdomen, what has been called a "gridiron abdomen." Some patients with Münchhausen syndrome cause their own illness, as by secretly ingesting or injecting substances.
44	Hansen’s Disease Leprosy Not very contagious; approximately 95% of people have natural immunity to the disease. People with leprosy who are treated with medication do not need to be isolated from society. (Historically, people with leprosy were sent to "lepers' colonies" on remote islands or in special hospitals.) The earliest sign of leprosy is commonly a spot on the skin that may be slightly redder, darker, or lighter than the person's normal skin. The spot may lose feeling and hair. In some people the only sign is numbness in a finger or toe. If left untreated, leprosy has serious effects on the body, including: Hands and feet - Leprosy bacteria attack the nerves in the hands and feet and cause them to become numb. A person may get cuts or burns on the numb parts and not know it, leading to infections which cause permanent damage. Fingers and toes may be lost to infection. Serious infections in the feet may require amputation. Paralysis may cause the fingers and toes to curl up permanently. Eyes - Leprosy bacteria attack the nerves around the eyes causing the loss of blinking reflex (which protects the eye from injury and moistens the surface). The eyes become dry and infected, and blindness may result. Because of numbness of the eye, the person cannot feel dirt or scratches in the eye. Face - Damage to the internal lining of the nose causes scarring and eventual collapse of the nose.
45	More Practice Thank you for you time, attention, and effort to make my job easier. The more of you there are who are prepared the less I am expected to do!!! ☺