Medical-surgical Nursing Demystified ( PDFDrive )

Answers to Quiz and Exam Questions 579

Chapter 10 2. a 3. b 4. b 5. b
7. d 8. d 9. a 10. c
1. d
6. c

Chapter 11 2. a 3. c 4. b 5. c
7. d 8. b 9. d 10. c
1. b
6. a

Chapter 12 2. d 3. b 4. d 5. c
7. b 8. b 9. b 10. d
1. a
6. c

Chapter 13 2. a 3. c 4. d 5. d
7. b 8. b 9. b 10. c
1. b
6. a

Chapter 14 2. d 3. a 4. c 5. b
7. a 8. a 9. a 10. c
1. d
6. b

Chapter 15 2. d 3. c 4. a 5. a
7. b 8. a 9. c 10. d
1. a
6. c

580 Medical-Surgical Nursing Demystified

Final Exam 2. d 3. a 4. c 5. b
7. a 8. d 9. a 10. a
1. d 12. b 13. c 14. b 15. d
6. b 17. c 18. b 19. c 20. a
11. d 22. a 23. d 24. d 25. b
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21. d 32. d 33. c 34. c 35. c
26. a 37. d 38. d 39. b 40. b
31. b 42. a 43. a 44. c 45. c
36. a 47. d 48. b 49. d 50. c
41. c 52. c 53. a 54. c 55. b
46. d 57. b 58. c 59. d 60. a
51. c 62. d 63. a 64. c 65. b
56. c 67. c 68. b 69. a 70. c
61. c 72. a 73. c 74. b 75. c
66. c 77. c 78. d 79. b 80. b
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76. b 87. d 88. b 89. d 90. d
81. a 92. b 93. c 94. b 95. b
86. d 97. b 98. a 99. a 100. b
91. b
96. b

Glossary

CHAPTER 1

ABG: A test that measures the arterial blood gas.
ANA complement: Antinuclear antibody test that measures the amount of auto-

immune antibodies.
antecubital fossa: Triangular cavity of the elbow joint.
AST/ALT: Enzymes released by liver tissue when the liver is damaged. Their levels

are used as a measure of liver function.
BNP: A test that measures the presence and severity of heart failure.
Bradycardia: A heart rate lower than 60 beats per minute.
cardiac troponin levels: A troponin test checks for elevated levels of these proteins

which are released when there is damage to the heart or skeletal muscle.
Cardiomyopathy: A disease of the heart muscle.
Complete Blood Count (CBC): A test used to determine the general health of the

patient.
CK isoenzymes: Enzymes released if there is damage to the heart muscle.
CK-MB: An enzyme released by damaged cardiac tissue 2 to 6 hours following an

infarction.
Creatine Kinase (CK): Enzyme released if there is damage to the heart muscle.

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582 Medical-Surgical Nursing Demystified

Creatinine: A waste product from protein metabolism and muscle that is removed by
the kidneys in urine. Creatinine is tested to determine kidney function.

CXR: Chest x-ray.
DVT: Deep vein thrombosis.
endocarditis antibiotic prophylaxis: Antibiotic given to prevent a bacterial infection.
Erythrocyte Sedimentation Rate (ESR): See sed rate.
Fowler’s position: A position where the client is semi-sitting with knees flexed.
Guaiac: A test to locate hidden (occult) blood in stool.
HTN: Hypertension.
Hypoxia: Decreased oxygen to tissues.
IM: Intramuscular.
Internationalized Normalized Ratio (INR): A medical blood test used to determine

the coagulation capability of a patient’s blood.
Ischemia: Reduced blood flow due to an obstructed vessel.
Lactate Dehydrogenase (LDH): Enzymes released when there is tissue damage in the

heart, liver, kidney, skeletal muscle, or lungs.
LDH isoenzymes: A test to check the level of lactate dehydrogenase in the blood.
Myoglobin: A protein in the heart and skeletal muscles. A rising level of myoglobin

is an early indication of a myocardial infarction.
NPO: Nothing by mouth.
Partial Throboplastin Time (PTT): A medical blood test used to measure the coagula-

tion capability of a patient’s blood.
Percutaneous Coronary Intervention (PCI): Commonly referred to as angioplasty

where the diameter of a narrow blood vessel is increased.
Prothrombin Time (PT): A medical blood test used to determine the coagulant capa-

bility of the patient’s blood.
PT/PTT/INR: Tests that help detect and diagnose bleeding disorders. Also used to

determine the effectiveness of anticoagulants.
RA: Rheumatoid arthritis.
radiopaque dye: Makes structures visible on x-rays.
sed rate: The rate at which red blood cells settle in a test tube. A high rate indicates

inflammation.
Troponins: Proteins in cardiac and skeletal muscles.

CHAPTER 2

Alpha 1-antitrypsin deficiency: A lack of a liver protein that leads to emphysema
and liver disease.

Glossary 583

Beta 2-agonist: A bronchodilator that relaxes muscles around the airway thereby
opening the airway during an asthma attack or in COPD.

Cardiac glycoside: Medication that improves cardiac output and reduces distention
of the heart.

Caseous granulomas: Destructive tissue that enters the bronchus causing tuberculous
bronchopneumonia.

Chronic Obstructive Pulmonary Disease (COPD): A lung disease where excess mucus
in the airways interferes with gas exchange in the lungs resulting in frequent coughing.

Computerized Tomography (CT) scan: A three-dimensional image of the body
structure created from a series of cross sectional images of the patient.

D-dimer: A blood test to diagnose conditions that cause hypercoagulability, a tendency
to produce inappropriate blood clots.

Eosinophils: White blood cells that respond to allergic diseases, parasitic infections,
and other disorders.

Exudate: Fluid from the circulatory system that enters into areas of inflammation.

FEV1: A measurement of the volume of air exhaled in the first second.
Ghon’s complex: Infection caused by Mycobacterium tuberculosis that usually

results in primary tuberculosis.

Granulomaous: Inflamed granulation tissue associated with ulcerated infections.

Helical CT scan: Computerized tomography scan produced by a scanner with a con-
tinuously rotating gantry. This innovation enabled a very quick scan time.

Histamine: A substance that is released from mast cells that causes itching, sneezing,
and nasal congestion related to an allergic reaction.

Incentive spirometer: A device that improves the functioning of lungs by exercising
breathing muscles. It is used to prevent development of pneumonia following surgery.

Indurated area: A raised thick or hardening area.

Induration: The process of becoming extremely firm or hard.

Leukotrienes: A substance, released by mast cells during an allergic reaction, which
constricts the bronchial passages in an asthma attack.

Mast cells: These are cells that make and release histamine during an allergic reaction.

Mediastinum: The middle section of the chest cavity.

Pulmonary Function Test (PFT): A test that measures how well the lungs take in
and exhale air and how efficiently they transfer oxygen into the blood.

Postural drainage: The patient is positioned with the head lower than the chest
allowing gravity to clear secretions from the lungs.

Prostaglandins: A hormone-like substance that dilates and constricts blood vessels as
well as contracts and relaxes smooth muscles during an immune response.

Serous fluid: Pale yellow and transparent body fluid.

584 Medical-Surgical Nursing Demystified

CHAPTER 3

Bamboo spine: Spinal fusion gives a bamboo-like appearance on an x-ray.
Buccal mucosa: Inner lining of the cheeks and lips.
CMV: Herpes virus found in healthy individuals without causing symptoms.
Coagulopathies: A defect in the body’s blood-clotting mechanism.
IgM antibody: The first immunoglobulin antibody made in response to an infection.
Lymphadenopathy: Disease of the lymph nodes.
NSAID: A medication that is an anti-inflammatory and pain-killer such as ibuprofen.
ROM: Range of motion.
Sicca complex: Dryness of mucous membranes in the absence of connective tissue

disease.
Synovial: A cavity filled with synovial fluid.

CHAPTER 4

Ataxia: Loss of muscle coordination.
Bilirubin: A substance, part of bile, that is formed when red blood cells are broken

down.
DDAVP: Medication that mimics the action of an antidiuretic hormone.
Demyelination: The loss or breakdown of myelin, which is the protective coating on

nerve cells.
Erythropoiesis: Formation of red blood cells.
Mean Corpuscular Hemoglobin (MCH): The amount of oxygen-carrying hemoglobin

inside red blood cells.
Mean Corpuscular Volume (MCV): The average size of red blood cells.
Myeloid: Relating to bone marrow.
Parenteral: Any type of injectable medication.
Parietal cells: Stomach cells that produce hydrochloric acid.
Petechiae: Small red, purple, or brown spots on the skin or mucosa.
Proprioception: Subconscious awareness of position, posture, movement, and changes

in equilibrium.
Red Cell Distribution Width (RDW): A calculation of various sizes of red blood cells.
Reagent: Substance used to produce a chemical reaction.
Reticulocytes: Immature red blood cells without a nucleus that are normally found in

the circulation.
Romberg test: A neurological test to detect poor balance.
Shilling test: Determines vitamin B12 deficiency.

Glossary 585

CHAPTER 5

ADL: Activities of daily living.
Afferent: Nerve signals which travel from the peripheral nervous system to the cen-

tral nervous system.
Aphasia: Unable to speak, write and/or understand due to brain damage.
Arachnoid mater: The middle portion of the meninges that encloses the brain and

spinal cord.
Bi-Level Positive Airway Pressure (BiPAP): Device used to provide oxygen to a

person who has sleep apnea.
Coninuous Positive Airway Pressure (CPAP): Device used to provide oxygen to a

person who has sleep apnea.
Diabetes insipidus: A condition characterized by excessive thirst and increased urina-

tion.
Efferent: Nerve signals which travel from the central nervous system to the peripheral

nervous system.
Lumen: The hollow area of a tube.
NG: Nasal gastric.
Nystagmus: Rapid involuntary eye movement.
Petechial: Small purple spot caused by a hemorrhage.
Pia mater: The inner portion of the meninges that encloses the brain and spinal cord.
Postcal stage: The final stage of an epileptic seizure in which the patient gradually

recovers. Also known as ictal.
Stenosis: Abnormal narrowing of a passage.
Vagal: Related to the vagus nerve.

CHAPTER 6

C-Reactive Protein (CRP): Increases during the inflammatory process and is part of
an early defense system against infections.

Haversian canals: Tubes around the channels in the region of a bone called compact
bone.

Uricosuric agent: Medication that increases the excretion of uric acid.

CHAPTER 7

A & D Ointment: All purpose skin protection ointment.
ALT: Serum glutamic-pyruvic transaminase is an enzyme that is elevated in liver

disease.

586 Medical-Surgical Nursing Demystified

AST: Serum glutamic-oxaloacetic transaminase is an enzyme that is elevated in liver
disease.

Cast: A cylindrically-shaped aggregation of some particulate in the urine. There are
several different types, such as hyaline casts, red blood casts, etc.

Colostomy: An opening into the colon usually from outside the body.
Encephalopathy: A degenerative brain disease.
Fecalith: Hard mass of fecal matter.
Fistulas: Abnormal connection between vessels or organs that normally do not connect.
Glomerulonephritis: Inflammation of the kidney.
HAV: Hepatitis A.
HBeAg: A test that measures hepatitis B antigen.
HBsAg: A test that measures hepatitis B surface antigen.
HBV: Hepatitis B.
HCV: Hepatitis C.
HDV: Hepatitis D.
hepatocellular: Liver cells.
IgM: A class of immunoglobulin involved in fighting blood infections.
IgG: A class of immunoglobulin that is the most common serum antibody. It is passed

from mother to fetus.
Manometry: Measures pressure of the rectum and anus muscles.
polyarteritis nodosa: Inflammation of the arteries caused by an autoimmune disease.
Polycast: Presence of many casts in the urine.
RIBA-2: Recombinant immunoblot assay.
septicemia: Blood poisoning.

CHAPTER 8

Dysmetabolic syndrome: Abnormalities in serum insulin/glucose levels.
Ectopic: Tissue growing in an unusual location.

CHAPTER 9

Cryptorchism: Absence of one or both testes from the scrotum.
Hematuria: Blood in urine.
Hydronephrosis: Enlarged kidney resulting from urine accumulation in the upper urinary

tract caused by a blockage of the urinary tract.
Median sulcus: Shallow midline groove.
Stoma: A surgical opening in the abdominal wall.

Glossary 587

CHAPTER 10

Atopic: Predisposition to allergies.
Radioallergosobent test (RAST): A test used to measure allergic reactions in the blood.

CHAPTER 11

Ketones: By-product of fat metabolism.
mEq/L: Milliequivalents per liter.
mOsm/L: Osmolarity per liter.
paresthesia: Numbness, prickly sensation or tingling of the skin.
Rhabdomyolysis: Degeneration of skeletal muscle.
SLE: Systemic lupus erythematosus.

CHAPTER 12

Caries: Tooth decay.
Echhymosis: Bruise.
Hypoxia: Oxygen reduction.
NMDA: Receptors in the brain.

CHAPTER 13

Asepsis: Without infection.
Atelectasis: Collapse of part or all of the lung.
Chemo receptors Trigger zone: This is the part of the brain responsible for nausea.
Cholecystectomy: Surgical removal of the gallbladder.
Laparoscopic: A surgical procedure performed through small incisions in the abdominal

wall using a camera transmitting images to a video monitor.
Paralytic ileus: Movement loss in the small intestine.
Stridor: High-pitched respiratory sound usually occurring in inspiration.

CHAPTER 14

Adnexal: An appendage of an organ.
Beta HCG: A fragment of the human chorionic gonadotropin (hCG) complex used to

determine pregnancy.
Brain hormone (BH): Hormone that causes stimulation of growth.

588 Medical-Surgical Nursing Demystified

CA 125: A cancer marker for ovarian cancer.
Dyspareunia: Painful intercourse.
Dysplasia: Noncancerous abnormal cells.
I&O: Intake and output of fluids.
Laparoscopically: A surgical procedure, using a camera transmitting images to a

video monitor, performed through small incisions in the abdominal wall.
Myomectomy: A surgical procedure to remove fibroids from the uterus.
MMR: Measles, mumps, and rubella vaccine.
Nulliparity: Never pregnant.
Peritonitis: Inflammation of the peritoneum.
RhoGAM: Rh immunoglobulin prevents an Rh-negative mother’s antibodies from

attacking the fetus’s Rh-positive cells.
Rapid Plasma Reagin Test (RPR): A new test to diagnose Syphillis.
Salpingitis: Inflammation of the fallopian tubes.
Venereal Disease Reference Laboratory (VDRL): Older test to diagnose Syphillis.

CHAPTER 15

Adjutant modalities: Additional methods of treatments given in addition to the primary
treatment

Epistaxis: Nosebleed.

INDEX

A adrenal cortex, 333
aldosterone secretion, 351–353, 421
“a fib”. See atrial fibrillation corticosteroid underproduction, 348–349
abdominal ultrasound, 325 glucocorticoid overproduction, 349–351
abdominal x-rays, 325
ABG (arterial blood gas), 79–80, 136–137 adrenal glands, 333
absence seizures, 253 adrenal medulla, 333
abused substances, 545–550
ACE inhibitors, 28–37 tumor on (pheochromocytoma), 353–354
acid-base balance, 422 AF (atrial fibrillation), 53–56
afferent neurons, 211
metabolic acidosis, 438–440 AI (aortic insufficiency), 62–63
metabolic alkalosis, 440–441 AIDS (acquired immunodeficiency syndrome),
acquired immunodeficiency syndrome (AIDS),
145–147
145–147 Kaposi’s sarcoma (KS) and, 151
Kaposi’s sarcoma (KS) and, 151 alanine transaminase (ALT) test, 327
acromegaly, 341–343 albumin and total protein test, 327
ACTH overproduction (Conn’s syndrome), aldosterone, 333, 421
measurement test, 365
351–353 overproduction (Conn’s syndrome), 351–353
ACTH stimulation test, 365 alimentary canal, 284
actual dehydration, 444–445 alkaline phosphatase (ALP) test, 327
acute bronchitis, 101 allergens
acute glomerulonephritis, 379–381 anaphylaxis, 145
acute leukemia, 189–191 asthma from, 93–95
acute nephritic syndrome, 379–381 allergy skin testing, 413–414
acute pain, 537–540 ALP (alkaline phosphatase) test, 327
acute renal failure, 388–390 ALS (amyotrophic lateral sclerosis), 216–218
acute respiratory distress syndrome (ARDS), 87–91 ALT (alanine transaminase) test, 327
acute respiratory failure, 124–127 alveoli, 87. See also respiratory system
addiction, drug, 550–553 amenorrhea, 497
Addison’s disease, 348–349 amputated extremities, pain from, 544–545
ADH (antidiuretic hormone), 421 amyotrophic lateral sclerosis (ALS), 216–218
ANA test, 167
diabetes insipidus, 345–346 anaphylaxis, 147–149
syndrome of inappropriate antidiuretic hormone anatomical location of surgery, 477

secretion (SIADH), 346–348

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590 Index

androgens, 333 atherectomy, 20
anemia, 177–179 atherosclerosis and arteriosclerosis, 4, 7, 11, 18
atonic seizures, 253
aplastic anemia (pancytopenia), 179–181 atopic asthma, 93
iron deficiency anemia, 181–183 atria, 1, 3
pernicious anemia, 183–185 atrial fibrillation (AF), 53–56
anesthesia, 482 atrial natriuretic peptide (ANP), 421
nausea from, 490 atrioventricular (AV) node, 3
postanesthesia care, 483–484 atrioventricular (AV) valves, 1, 3
anesthesiologists, 481 axial skeleton, 262
angina, 7–11
angiography, cardiac, 72–73 B
angiography, cerebral, 256
angiotensin-converting enzyme, 421 B-cells, 144–145
inhibitors, 28, 37 β-hCG test, 529
angiotensinogen, 421 bacterial infection. See infection
ankylosing spondylitis (AS), 149–151 bacterial meningitis, 234–236
anorexia nervosa, 465–467 basal cell carcinomas, 405, 406
ANP (atrial natriuretic peptide), 421 basal ganglia, 211
anterior pituitary glands, 333 basilar skull fractures, 213
antidiuretic hormone (ADH), 421 Bell’s palsy, 218–219
diabetes insipidus, 345–346 benign prostatic hypertrophy (BPH), 375–377
syndrome of inappropriate antidiuretic hormone beta cells (pancreatic), insulin from, 358, 363
beta subunit of human chorionic gonadotropin test,
secretion (SIADH), 346–348
antinuclear antibodies (ANA) test, 167 529
anxiety, 453–456 bile, 285
bilirubin test, 328
panic disorder, 456–458 biopsy, 128, 278
aortic aneurysm, 4–6
aortic insufficiency (AI), 62–63 bone marrow, 203–204
aortic valve, 1, 3 liver, 325–326
aplastic anemia (pancytopenia), 179–181 lung, 139–140
appendicitis, 286–287 musculoskeletal, 278
appendicular skeleton, 262 skin, 414
appendix, 285 women’s health, 529
ARDS (acute respiratory distress syndrome), bipolar disorder, 461–463
bladder, 375
87–91 cancer of, 377–379
arterial blood gas (ABG), 79–80, 136–137 testing for tumors (cystoscopy), 394
arterial stents, 301–304 x-ray of (KUB study), 394
arteriosclerosis and atherosclerosis, 4, 7, 11, 18 x-ray of (voiding cystogram), 396–398
arthritis bleeding from gastrointestinal tract, 304–306
bleeding time, 205
ankylosing spondylitis (AS), 149–151 blood, oxygenation of, 3
osteoarthritis, 271–273 blood acid-base balance, 422
rheumatoid arthritis, 155–157 metabolic acidosis, 438–440
arthrogram, 278 metabolic alkalosis, 440–441
arthroscopy, 278 blood calcium level test, 365
AS (ankylosing spondylitis), 149–151 blood chemistry, 77–78
asbestosis, 91–93 blood clots. See also coagulation
assessing pain, 537 myocardial infarction (MI) from, 11
AST (aspartate transaminase) test, 327 peripheral arterial disease (PAD) from, 18
asthma, 93–96 pulmonary embolism from, 127
astrocytoma, 222
asystole, 56–58
atelectasis, 96–98, 128

Index 591

removal of (embolectomy), 20 hyperparathyroidism and, 356–358
stroke from, 225, 249–252 hypoparathyroidism and, 354–356
in vein (thrombophlebitis), 51, 199 calcium deposits in blood vessels.
blood pressure, high. See hypertension (HTN)
blood production. See hematologic system See arteriosclerosis and atherosclerosis
blood urea nitrogen (BUN) test, 447 cancer. See also tumors
BNP (brain natriuretic peptide), 421
body fluids. See fluids and electrolytes bladder cancer, 377–379
body temperature during surgery, 481–482 brain tumor, 222–224
body weight/type issues, 465–469 breast cancer, 497–499
bone marrow, 176, 263 cervical cancer, 500–501
biopsy, 203–204 endometrial cancer, 505–506
bone scan, 278–279 kidney cancer, 381–382
bones, 262–263. See also musculoskeletal system leukemia, 189–192
Borrelia burgdorferi, 162 lung cancer, 110–112
bowel preparation, preoperative, 479 of lymphatic tissue and skin, 151
Bowman’s capsule, 374 lymphoma, 153–155
BPH (benign prostatic hypertrophy), 375–377 ovarian cancer, 512–514
Braden scale, 409 prostate cancer, 375, 384–386
brain, 211 testicular cancer, 390–392
brain abscess, 218–221 cancer antigen (CA) 125 test, 530
brain attacks. See stroke carbon dioxide in blood, 87, 120
brain natriuretic peptide (BNP), 421 cardiac catheterization (angiography), 72–73
brain tumor, 222–224 cardiac sphincter, 285
brainstem, 211 cardiac tamponade, 21–23
breast cancer, 497–499 cardiogenic shock, 23–26
Broca’s area, 211 cardiomyopathy, 26–29
bronchi, 87 cardiovascular system, 1–82
bronchiectasis, 99–101 how it works, 3
bronchitis, 101–104 map of, 1
bronchoscopy, 132 angina, 7–11
bronchospasm, 93 aortic aneurysm, 4–6
bulimia nervosa, 467–469 aortic insufficiency (AI), 62–63
bullae, 400 asystole, 56–58
BUN (blood urea nitrogen) test, 447 atrial fibrillation, 53–56
Bundle of His, 3 cardiac tamponade, 21–23
burns, 401–403 cardiogenic shock, 23–26
bursa, 263 cardiomyopathy, 26–29
coronary artery disease (CAD), 15–18
C diagnostic tests, 71–82

Ca. See calcium arterial blood gas (ABG), 79–80, 136–137
CA 125 (cancer antigen 125) test, 530 blood chemistry, 77–78
CABG (coronary artery bypass graph), 9–10 cardiac catheterization (angiography), 72–73
CAD (coronary artery disease), 15–18 chest x-rays, 76–77, 133
calcitonin, 333 digital subtraction angiography, 75
calcium (Ca), 276, 333 echocardiographs, 73–74
electrocardiogram (EKG, ECG), 71–72
abnormally high amount (hypercalcemia), 356, hematologic studies, 78–79
428–430 hemodynamic monitoring, 75–76
nuclear cardiology, 74
abnormally low amount (hypocalcemia), 354, pulse oximetry, 81–82
426–428 venograms, 80–81
endocarditis, 29–31
blood test for, 365, 447 heart failure, 31–35, 104–106

592 Index

cardiovascular system (continued) cilia (respiratory system), 87
hypertension (HTN), 35–38 CIN (cervical intraepithelial neoplasia), 500
hypovolemic shock, 38–40 circulating nurses, 481
mitral insufficiency, 63–65 cirrhosis, 290–294
mitral stenosis, 65–67 CK (creatine kinase), 77
mitral valve prolapse (MVP), 67–69 Cl (chloride) test, 447
myocardial infarction (MI), 11–15 classification of surgical procedures, 476–477
myocarditis, 41–42 clearance for surgery, 478
pericarditis, 42–44 clonic seizures, 253
peripheral arterial disease (PAD), 18–21 closed head injuries, 212
postoperative complications, 484–486 closed pneumothorax, 118
pulmonary edema, 45–47 closure, wound, 482
Raynaud’s disease, 47–49 clotting. See blood clots; coagulation; coagulation
rheumatic heart disease, 49–51
thrombophlebitis, 51–53, 199 studies
tricuspid insufficiency, 69–71 coagulation. See also blood clots
ventricular fibrillation, 58–59
ventricular tachycardia, 59–61 disseminated intravascular coagulation (DIC),
185–187
carpal tunnel syndrome, 263–265
cartilage, 263 hemophilia, 187–189
catecholamines, 333 coagulation studies, 79, 204–205
CBC (complete blood count), 78, 79, 145, 205 cognitive function. See mental health
CD4 and CD8 cells, 145 colonoscopy, 325
cell walls, 420 complete blood count (CBC), 78, 79, 145, 205
cellulitis, 407–409 complete bone fractures, 266
central nervous system, 210 complete mole (trophoblastic disease), 517–519
cerebral aneurysm, 225–227 complex partial seizures, 253
cerebral angiography, 256 complications, postoperative, 484–492
cerebral cortex, 211
cerebrovascular accident (CVA). See stroke cardiovascular, 484–486
certified registered nurse anesthetists (CRNAs), 481 gastrointestinal, 490–492
cervical cancer, 500–501 infection, 488–490
cervical intraepithelial neoplasia (CIN), 500 respiratory, 486–488
CFS (chronic fatigue syndrome), 160–162 compound bone fractures, 266
chambers of heart, 1, 3 computed tomography. See CT
chandelier sign, 517 concussion, 212
chest x-rays, 76–77, 133 congestive heart failure (CHF), 31–35
CHF (congestive heart failure), 31–35 Cor Pulmonale and, 104–106
connective tissues, 263
Cor Pulmonale and, 104–106 Conn’s syndrome, 351–353
chloride (Cl) test, 447 contractions (labor and delivery), 522
cholecystitis, 288–290 Cor Pulmonale, 104–106
cholesterol deposits in blood vessels. core biopsy, 529
coronary artery bypass graph (CABG), 9–10
See arteriosclerosis and atherosclerosis coronary artery disease (CAD), 15–18
cholesterol levels, 78 coronary artery stents, 301–304
chorea, 232–234 corpus luteum, 497
choriocarcinomas, 518 cortex (adrenal glands), 333
chronic bronchitis, 101 aldosterone secretion, 351–353, 421
chronic fatigue syndrome (CFS), 160–162 corticosteroid underproduction, 348–349
chronic leukemia, 189–191 glucocorticoid overproduction, 349–351
chronic pain, 540–542 cortex (bone), 263
chronic renal failure, 388–390 cortex (cerebral), 211
Chvostek’s sign, 338 corticosteroid underproduction (Addison’s disease),

348–349

Index 593

corticosteroids, inadequate secretion of, 348–349 diencephalon, 211
cortisol, 333 dietary intake and fluid balance. See fluids and
cortisol test, 366
cosmetic surgical procedures, 477 electrolytes
creatine kinase (CK), 77 digestion of food, 285
CRNAs (certified registered nurse anesthetists), 481 digital subtraction angiography (DSA), 75
Crohn’s disease, 294–297 dilated cardiomyopathy, 26
CT angiography, 256 direct feedback (hormone production), 333
CT scans, 256, 278–279, 325–326 disseminated intravascular coagulation (DIC), 185–187
culture and sensitivity tests diverticulitis disease, 297–299
dopamine, 463
sputum, 134–135, 169–170 drains, surgical, 482, 483
urine, 394 drug addiction, 550–553
curative surgical procedures, 477 drug testing, 553
Cushing’s syndrome, 349–351 DSA (digital subtraction angiography), 75
CVA (cerebrovascular accident). See stroke duodenal ulcers, 319, 324
cystoscopy, 394 duodenum, 285
cysts, ovarian, 514–515 DVT (deep vein thrombosis), 199–201
dysmenorrhea, 502–503
D dysmetabolic syndrome, 363–365

deep vein thrombosis (DVT), 199–201 E
dehydration, 444–446
delayed union (bone fractures), 267 eating disorders
delirium, 469–471 anorexia nervosa, 465–467
delivery (baby). See labor and delivery bulimia nervosa, 467–469
demyelination. See multiple sclerosis (MS)
depressed skull fractures, 213 ECG (electrocardiogram), 71–72
depression, 458–460 echocardiograph, 73–74
dermatitis, 403–405 eclampsia, 527–529
dexamethasone suppression test, 350 ectopic pregnancy, 503–505
diabetes insipidus, 345–346 edema, 420
diabetes mellitus, 358–363 EEG (electroencephalogram), 256
diagnostic studies, 478 EKG (electrocardiogram), 71–72
elective surgical procedures, 477
after surgery, 483 electrical conduction system of heart, 3
cardiovascular system, 71–82
endocrine system, 365–369 asystole, 56–58
fluids and electrolytes, 446–447 atrial fibrillation (AF), 53–56
gastrointestinal system, 324–329 graphic representation. See electrocardiogram
genitourinary system, 396–398
hematologic system, 175–205 (EKG, ECG)
immune system, 167–171 ventricular fibrillation, 58–59
integumentary system, 413–415 ventricular tachycardia, 59–61
musculoskeletal system, 277–280 electrocardiogram (EKG, ECG), 71–72
nervous system, 255–257 electroencephalogram (EEG), 256
pain management, 553 electrolytes. See fluids and electrolytes
respiratory system, 132–140 electromyography (EMG), 279
women’s health, 529–531 ELISA (enzyme-linked immunosorbent assay),
diagnostic surgical procedures, 477
diaphragmatic hernia, 311–313 168–169
diary, pain, 537 embolectomy, 20
DIC (disseminated intravascular coagulation), embolus, 127–128. See also blood clots

185–187 from bone fractures, 267
EMG (electromyography), 279
emotional pain, 537
emphysema, 107–110

594 Index

encephalitis, 227–229 excisional biopsy (skin), 414
endocarditis, 29–31 exocrine functions, pancreas, 285
endocrine functions of pancreas, 285 expiration (breathing), 86
endocrine system, 331–369 extent of surgery, 477
extracellular fluids, 420
how it works, 332–333 extrinsic asthma, 93
map of, 331
Addison’s disease, 348–349 F
Cushing’s syndrome, 349–351
diabetes insipidus, 345–346 fatty deposits in blood vessels. See arteriosclerosis
diabetes mellitus, 358–363 and atherosclerosis
diagnostic tests, 365–369
goiter, 338–340 fecal occult blood test, 204
Graves’ disease, 335–338 female body, about, 496–497. See also women’s health
hyperparathyroidism, 356–358 femoropopliteal bypass grafts, 19
hyperpituitarism (acromegaly and gigantism), fertilization, 497

341–343 ectopic pregnancy, 503–505
hyperprolactinemia, 343–344 infertility, 508–510
hyperthyroidism, 335–338 fibrin deposits in blood vessels. See arteriosclerosis
hypoparathyroidism, 354–356
hypopituitarism, 340–341 and atherosclerosis
hypothyroidism (myxedema), 333–335 fibroids (leiomyomas), 507–508
metabolic syndrome (Syndrome X), 363–365 fine needle biopsy/aspiration, 366
pheochromocytoma, 353–354 first-degree burns, 401–402
primary aldosteronism (Conn’s syndrome), flu (influenza), 130–132
fluids and electrolytes, 419–447
351–353
simple goiter, 338–340 how they work, 420–422
syndrome of inappropriate antidiuretic hormone dehydration, 444–446
diagnostic tests, 446–447
secretion (SIADH), 346–348 hypercalcemia, 356, 428–430
endometrial cancer, 505–506 hyperkalemia, 432–434
endoscopic retrograde cholangiopancreatiography hypermagnesemia, 436–438
hypernatremia, 424–426
(ERCP), 326–327 hyperphosphatemia, 443–444
endotracheal intubation, 59 hypocalcemia, 354, 426–428
enzyme-linked immunosorbent assay (ELISA), hypokalemia, 430–432
hypomagnesemia, 434–436
168–169 hyponatremia, 422–424
epidural anesthesia, 482 hypophosphatemia, 356, 441–443
epidural hematoma, 212–213 metabolic acidosis, 438–440
epinephrine, 333 metabolic alkalosis, 440–441
preoperative preparation, 479
overproduction (pheochromocytoma), 353–354 follicle stimulating hormone (FSH), 497
epiphyseal closure, 341–342 testing for, 366
Epstein-Barr virus, 160–162 follicular phase, menstrual cycle, 497
ERCP (endoscopic retrograde cholangio- food, digestion of, 285
food intake
pancreatiography), 326–327 anorexia nervosa, 465–467
ERT (estrogen replacement therapy), 511 bulimia nervosa, 467–469
erythocyte sedimentation rate (ESR), 78, 79, 167, preoperative, 479
fractures (skeletal), 266–268
447 frontal lobe (brain), 211
erythopoetin, 375 tumor in, 222
esophagus, 285

reflux of stomach acid into (GERD), 301–304
ESR (erythocyte sedimentation rate), 78, 79, 167, 447
estrogen, 497
estrogen replacement therapy (ERT), 511

Index 595

FSH (follicle stimulating hormone), 497 kidney cancer, 381–382
testing for, 366 kidney stones, 382–384
prostate cancer, 384–386
fungal meningitis, 234–236 pyelonephritis, 386–388
renal failure, 388–390
G testicular cancer, 390–392
urinary tract infection (UTI), 392–393
gallbladder, 285 GERD (gastroesophageal reflux disease), 301–304
inflammation of (cholecystitis), 288–290 gestational age, 519
gestational diabetes mellitus, 358–359, 362
gamma-glutamyl transferase (GGT) test, 328 GGT (gamma-glutamyl transferase) test, 328
gastric ulcers, 319, 324 GH (growth hormone)
gastrin, 285 measurement test, 367
gastritis, 306–308 overproduction (hyperpituitarism), 341–343
gastroenteritis, 299–301 Ghon’s complex, 122
gastroesophageal reflux disease (GERD), 301–304 gigantism, 341–343
gastrointestinal bleed, 304–306 glands, 332. See also endocrine system
gastrointestinal system, 283–329 Glasgow Coma Scale, 215
glioblastoma, 222
how it works, 284–285 gliomas, 222
map of, 283 glomerulonephritis, 379–381
appendicitis, 286–287 glucagon, 285
assessment after surgery, 483 glucocorticoid overproduction (Cushing’s syndrome),
cholecystitis, 288–290
cirrhosis, 290–294 349–351
Crohn’s disease, 294–297 glucose levels, 358
diagnostic tests, 324–329 glucose tolerance test, 367
diverticulitis disease, 297–299 glycosylated hemoglobin (Hgb A1C) test, 367
gastritis, 306–308 goiter, 338–340
gastroenteritis, 299–301 gout, 268–270
gastroesophageal reflux disease (GERD), Gram stain (Gram’s method), 414
Graves’ disease, 335–338
301–304 grief vs. depression, 458
gastrointestinal bleed, 304–306 growth hormone (GH)
hepatitis, 308–311
hiatal hernia, 311–313 measurement test, 367
intestinal obstruction and paralytic ileus, overproduction (hyperpituitarism), 341–343
Guillain-Barré syndrome, 230–232
313–314
pancreatitis, 315–317 H
peptic ulcer disease (PUD), 319–321
peritonitis, 317–319 H. pylori test, 329
postoperative complications, 490–492 Hct (hematocrit) test, 447
ulcerative colitis, 322–324 head injury, 212–216
gastrointestinal tract, 284 heart, map of, 1
gastroscopy, 324 heart failure, 31–35
gate control theory, 537
general anesthesia, 482 Cor Pulmonale and, 104–106
generalized seizures, 253 heartbeat, 3
genitourinary system, 373–396 heat loss during surgery, 481–482
how it works, 374–375 helicobacter pylori test, 329
map of, 373 helper T-cells, 145
acute glomerulonephritis, 379–381 hematocrit (Hct) test, 447
benign prostatic hypertrophy (BPH), 375–377 hematologic studies, 78–79
bladder cancer, 377–379
diagnostic tests, 396–398

596 Index

hematologic system, 175–205 human immunodeficiency virus (HIV), 145
how it works, 176–177 enzyme-linked immunosorbent assay (ELISA),
map of, 176–177 168
anemia, 177–179 Western Blot test, 169
aplastic anemia (pancytopenia), 179–181
deep vein thrombosis (DVT), 199–201 human papillomavirus (HPV), 500
diagnostic tests, 203–205 Huntington’s disease (chorea), 232–234
bone marrow biopsy, 203–204 hydatidiform mole, 517–519
coagulation studies, 204–205 hypercalcemia, 356, 428–430
complete blood count (CBC), 78, 79, 145, 205 hypercapnia, 120
fecal occult blood test, 204 hyperglycemia, 358. See also diabetes mellitus
disseminated intravascular coagulation (DIC), hyperkalemia, 432–434
185–187 hypermagnesemia, 436–438
hemophilia, 187–189 hypernatremia, 424–426
idiopathic thrombocytopenic purpura (ITP), hyperparathyroidism, 356–358
201–203 hyperphosphatemia, 443–444
iron deficiency anemia, 181–183 hyperpituitarism, 341–343
leukemia, 189–192 hyperprolactinemia, 343–344
multiple myeloma, 192–194 hypertension (HTN), 35–38
pernicious anemia, 183–185 hyperthyroidism, 335–338
polycythemia vera, 194–196 hypertonic solutions, 420
sickle cell anemia, 187–189 hypertrophic cardiomyopathy, 26
hypocalcemia, 354, 426–428
hemodynamic monitoring, 75–76 hypoglycemic agents, 361
hemoglobin, low. See anemia hypokalemia, 430–432
hemoglobin (Hgb) test, 447 hypomagnesemia, 434–436
hemophilia, 187–189 hypomania, 461
hemorrhage, from head injury, 212 hyponatremia, 422–424
hemorrhagic stroke, 225, 249–251 hypoparathyroidism, 354–356
hepatitis, 308–311, 328 hypophosphatemia, 356, 441–443
hepatitis panel, 328 hypopituitarism, 340–341
herpes simplex virus (HSV) test, 414–415 hypothalamus, 211
Hgb A1C (glycosylated hemoglobin) test, 367 hypothyroidism, 333–335
Hgb (hemoglobin) test, 447 hypotonic solutions, 420–421
hiatal hernia, 311–313 hypovolemic shock, 6, 38–40
high blood pressure. See hypertension (HTN) hypoxemia, 88
HIV (human immunodeficiency virus), 145 hysterosalpingogram (HSG), 530
hysteroscopy, 530
enzyme-linked immunosorbent assay (ELISA), 168
Western Blot test, 169 I
Hodgkin’s disease, 153
holding area nurses, 481 IDDM (insulin-dependent diabetes mellitus),
homeostasis, 333 358–363
hormones, 332. See also endocrine system
menstrual cycle, 497 idiopathic thrombocytopenic purpura (ITP),
regulation of fluids and electrolytes, 421 201–203
replacement therapy (HRT), 511
hospitalization for mental health issues, 453 ileocecal valve, 285
HPV (human papillomavirus), 500 ileum, 285
HRT (hormone replacement therapy), 511 ileus, paralytic, 313–314
HSG (hysterosalpingogram), 530 immovable joints, 263
HSV (herpes simplex virus) test, 414–415 immune system, 143–171
HTN (hypertension), 35–38
how it works, 144–145
map of, 143

Index 597

acquired immunodeficiency syndrome (AIDS), skin (cellulitis), 407–409
145–147, 151 sputum culture and sensitivity, 134–135, 169–170
tuberculosis (TB), 122–124, 128
anaphylaxis, 147–149 urinary tract (UTI), 392–394
ankylosing spondylitis (AS), 149–151 inferior vena cava, 1, 3
diagnostic tests, 167–171 infertility, 508–510
influenza, 130–132
enzyme-linked immunosorbent assay (ELISA), informed consent, 478–479
168–169 injury, intraoperative, 481–482
INR (Internationalized Normalized Ratio), 79, 205,
immunologic blood studies, 167–168
lymphangiography, 170–171 446
sputum culture and sensitivity, 169–170 inspiration (breathing), 86
Western Blot test, 169 insulin, 285
Epstein-Barr virus (chronic fatigue syndrome),
diabetes mellitus, 358–363
160–162 metabolic syndrome (Syndrome X), 363–365
Kaposi’s sarcoma (KS), 151–152 integumentary system, 399–415
lyme disease, 152–153 how it works, 400
lymphoma, 153–155 map of, 399
mononucleosis, 159–160 burns, 401–403
rheumatoid arthritis, 155–157 cellulitis, 407–409
scleroderma, 157–159 dermatitis, 403–405
septic shock, 163–165 diagnostic tests, 413–415
systemic lupus erythematosis (SLE), 165–167 preoperative skin preparation, 479
incisional biopsy, 529 pressure ulcers, 409–411
incomplete bone fractures, 266 skin cancers, 400, 405–407
infection, 168 wounds and healing, 411–413
of bone (osteomyelitis), 273–275 Internationalized Normalized Ratio (INR), 79, 205,
brain abscess, 218–221
bronchi and bronchioles, 99, 101 446
duodenal ulcers from, 319, 321 interstitial space (fluids), 420
encephalitis from, 227 intestinal obstruction, 313–314
of endocardium, 29–31 intestine. See large intestine; small intestine
of gastric and intestinal mucosa, 299–301 intracellular fluids, 420
of heart muscle, 41–42 intracerebral bleed, 213
hepatitis, 308–311, 328 intraoperative period, 480–482
herpes simplex virus (HSV) test, 414–415 intravenous access site, 479
human immunodeficiency virus (HIV), 145, intrinsic asthma, 93
invasive mole (trophoblastic disease), 517–518
168–169 iodine insufficiency (simple goiter), 338–341
human papillomavirus (HPV), 500 iron deficiency anemia, 181–183
influenza, 130–132 iron replacement therapy, 182–183
of intestinal diverticula, 297–299 iron studies, 205
kidney (acute glomerulonephritis), 379–381 ischemic stroke, 249–251
kidney (pyelonephritis), 386–388 isotonic fluids, 420
lyme disease, 152–153 ITP (idiopathic thrombocytopenic purpura),
meningitis, 234–237
mononucleosis, 159–160 201–203
pelvic inflammatory disease (PID),
J
515–517
of pericardium, 42–44 jejunum, 285
perioperative, 488–490 joints, 263
of peritoneum, 317–319
pneumonia, 115–117 arthritis in. See arthritis
septic shock, 163–165

598 Index

joints (continued) lungs, 87. See also respiratory system
visual examination of (arthroscopy), 278 acid-base balance, 422
x-ray of (arthrogram), 279 assessment of (PFT), 136
biopsy, 139–140
K cancer of, 110–112

K. See potassium lupus, 165–167
Kaposi’s sarcoma (KS), 151–152 luteinizing hormone (LH), 497
kidney stones, 382–384
kidneys, 374 testing for, 367–368
lyme disease, 152–153
acid-base balance, 422 lymphangiography, 170–171
acute nephritic syndrome, 379–381 lymphocytes, 144–145
cancer of, 381–382 lymphocytic leukemia, 189–191
infection (pyelonephritis), 386–388 lymphoma, 153–155
renal failure, 388–390
renin secretion, 421 M
x-ray of (KUB study), 394
KOH (potassium hydroxide preparation) test, macrophages, 145
macules, 400
415 magnesium
KS (Kaposi’s sarcoma), 151–152
KUB x-ray study, 394 abnormally high amount (hypermagnesemia),
436–438
L
blood test for, 447
labor and delivery, 521–523 magnetic resonance angiography (MRA), 257
lactate dehydrogenase (LDH) test, 77, 328 magnetic resonance imaging (MRI), 257, 279–280,
large intestine, 285
325–326
Crohn’s disease, 294–297 mammograms, 530–531
diverticulitis disease, 297–299 mania, 461
ulcerative colitis, 322–324 Mantoux intradermal skin test (PPD), 138–139
laser angioplasty, 20 melanoma, 405, 406
LDH (lactate dehydrogenase) test, 77, 328 menarche, 496–497
leiomyomas (fibroids), 507–508 meningiomas, 222
LES (lower esophageal sphincter), 285 meningitis, 234–237
leukemia, 189–192 menopause, 496–497, 510–512
LH (luteinizing hormone), 497 menstrual cycle, 496–497
testing for, 367–368
ligaments, 263 pain after ovulation (dysmenorrhea), 502–503
Likert pain scale, 537 mental health, 451–471
limb pain, phantom, 544–545
liver, 177, 285, 374 anorexia nervosa, 465–467
biopsy, 325–326 anxiety, 453–456
cirrhosis, 290–294 bipolar disorder, 461–463
function tests, 327–328 bulimia nervosa, 467–469
inflation of liver cells. See hepatitis delirium, 469–471
location (anatomical) of surgery, 477 depression, 458–460
loop of Henle, 374 panic disorder, 456–458
Lou Gehrig’s disease, 216–218 schizophrenia, 463–464
lower gastrointestinal bleeds, 304–306 metabolic acidosis, 438–440
lower upper esophageal sphincter (LES), 285 metabolic alkalosis, 440–441
lumbar puncture, 256–257 metabolic syndrome, 363–365
MI (myocardial infarction), 11–15
mineral (dietary) sufficiency. See calcium;

magnesium; phosphorus; potassium;
sodium

Index 599

misalignment (bone fractures), 267 myoglobin, 77
mitral insufficiency, 63–65 myxedema, 333–335
mitral stenosis, 65–67
mitral valve, 1, 3 N
mitral valve prolapse (MVP), 67–69
mole (trophoblastic disease), 517–518 Na. See sodium
monitoring patients after surgery, 483–484 natriuretic peptides, 421
mononucleosis, 159–160 nausea, caused by anesthetic, 490
motor neurons, 211 needle aspiration biopsy, 529
MRA (magnetic resonance angiography), 257 nephrolithiasis (kidney stones), 382–384
MRI (magnetic resonance imaging), 257, 279–280, nephron, 374
nerve blocks, 482
325–326 nervous system, 209–257
MS (multiple sclerosis), 237–240
multiple myeloma, 192–194 how it works, 210–211
multiple sclerosis (MS), 237–240 map of, 209
muscles, 263 amyotrophic lateral sclerosis (ALS), 216–218
Bell’s palsy, 218–219
fibroids (leiomyomas), 507–508 brain abscess, 218–221
testing potential (electromyography), 279 brain tumor, 222–224
musculoskeletal system, 261–280 cerebral aneurysm, 225–227
how it works, 262–263 diagnostic tests, 255–257
map of, 261 encephalitis, 227–229
carpal tunnel syndrome, 263–265 Guillain-Barré syndrome, 230–232
diagnostic tests, 277–280 head injury, 212–216
Huntington’s disease (chorea), 232–234
arthrograph, 278 meningitis, 234–237
arthroscopy, 278 multiple sclerosis (MS), 237–240
biopsy, 278 myasthenia gravis, 240–243
bone scan, 278–279 Parkinson’s disease, 243–246
CT scans, 279 seizure disorder, 252–255
electromyography (EMG), 279 spinal cord injury, 246–249
magnetic resonance imaging (MRI), stroke, 249–252
neurologic assessment after surgery, 483
279–280 neurons, 211
myelography, 280 neuropathies, 542–544
ultrasound, 280 neurotransmitters, 211, 453, 458
x-rays, 277 dopamine, 463
fractures (skeletal), 266–268 NHL (non-Hodgkin’s lymphoma), 153
gout, 268–270 NIDDM (non-insulin-dependent diabetes mellitus),
osteoarthritis, 271–273
osteomyelitis, 273–275 358–363
osteoporosis, 275–277 NMDA receptors, 463
MVP (mitral valve prolapse), 67–69 non-Hodgkin’s lymphoma (NHL), 153
myasthenia gravis, 240–243 non-insulin-dependent diabetes mellitus (NIDDM),
myectomy, 28
myelin coating on nerve cells, 211, 237 358–363
myelogenous (myelocytic) leukemia, non-small cell lung cancer, 110
nonatopic asthma, 93
189–191 nonunion (bone fractures), 267
myelography, 280 norepinephrine, 333
myeloma, multiple, 192–194
myocardial infarction (MI), 11–15 overproduction (pheochromocytoma), 353–354
myocarditis, 41–42 normotonic fluids, 420
myocardium, 26 nuclear cardiology, 74
myoclonic seizures, 253

600 Index

O parathyroid hormone (PTH), 333, 368
hypophosphatemia and, 441
obstruction, intestinal, 313–314 measurement test, 368
occipital lobe (brain), 211 overproduction of (hyperparathyroidism),
356–358
tumor in, 223 underproduction of (hypoparathyroidism),
oligodendroglioma, 222 354–356
open bone fractures, 266
open head injuries, 212 parietal lobe (brain), 211
open pneumothorax, 118 tumor in, 223
open receptor sites, 453
oral hypoglycemic agents, 361 parietal pleura, 87
osmolarity, 420–421. See also fluids and Parkinson’s disease, 243–246
partial mole (trophoblastic disease), 517–519
electrolytes partial seizures, 253
osteoarthritis, 271–273 partial thromboplastin time (PTT), 79, 205, 446
osteoblasts, 263 partially movable joints, 263
osteoclasts, 263 patient
osteomyelitis, 273–275
osteoporosis, 275–277 positioning, anesthesia and, 482
ovarian cancer, 512–514 preoperative teaching of, 479–480
ovarian masses, benign, 514–515 transfer of, 480, 484
ovulation, 497 pelvic joints, 263
oxygen, 87 peptic ulcer disease (PUD), 319–321
oxygenation of blood, 3 percutaneous transluminal angioplasty, 9, 19
pericardial biopsy, 44
P pericardiocentesis, 23, 44
pericarditis, 42–44
PACU (postanesthesia care unit), 483 pericardium, 21
PAD (peripheral arterial disease), 18–21 perioperative care, 475–492
pain management, 535–553 peripheral arterial disease (PAD), 18–21
peripheral edema, 420
acute pain, 537–540 peripheral nervous systems, 210
chronic pain, 540–542 peripheral neuropathy, 542–544
drug addiction, 550–553 peritoneovenous shunt, 293
peripheral neuropathy, 542–544 peritonitis, 317–319
phantom limb pain, 544–545 pernicious anemia, 183–185
substance use disorders, 545–550 PET (positron emission tomography), 257
urine toxicology screening, 553 petechiae, 400
pain medication, postoperative, 480 PFT (pulmonary function test), 136
palliative surgical procedures, 477 pH level, body, 422
pancreas, 285 phantom limb pain, 544–545
beta cells, insulin from, 358, 363 pheochromocytoma, 353–354
pancreatitis, 315–317 phosphorus
pancytopenia (aplastic anemia), 179–181 abnormally high amount (hyperphosphatemia),
panic disorder, 456–458
Pap (Papanicolaou) smear, 531 443–444
papules, 400 abnormally low amount (hypophosphatemia),
paralytic ileus, 313–314
parathyroid glands, 333 441–443
PTH overproduction (hyperparathyroidism), blood test for, 447
PID (pelvic inflammatory disease), 515–517
356–358 pituitary glands, 333
PTH underproduction (hypoparathyroidism), ACTH overproduction, 349–351
growth hormone overproduction, 341–343
354–356 pituitary hormone underproduction, 340–342

Index 601

placental site trophoblastic tumors, 518 prothrombin time (PT) test, 79, 205, 328, 446
plaque, in blood vessels. See arteriosclerosis and PSA (prostate specific antigen) test, 395
psychosocial stressors, 458
atherosclerosis PT (prothrombin time) test, 79, 205, 328, 446
plaque, skin, 400 PTH (parathyroid hormone, parathormone), 333
platelet count, 446
platelets, 176. See also hematologic system hypophosphatemia and, 441
measurement test, 368
idiopathic thrombocytopenic purpura (ITP), overproduction of (hyperparathyroidism),
201–203
356–358
overproduction of (polycythemia vera), 194–196 underproduction of (hypoparathyroidism), 354–356
pleural effusion, 113–115 PTT (partial thromboplastin time), 79, 205, 446
pleural sac, 87, 118 PUD (peptic ulcer disease), 319–321
pulmonary angiography, 133–134
draining fluid from (thoracentesis), 125 pulmonary edema, 45–47, 88
pneumonia, 115–117 pulmonary embolism, 127–130
pneumothorax, 118–120 pulmonary function test (PFT), 136
polycythemia vera, 194–196 pulmonic valve, 1, 3
portocaval shunt, 293 pulse oximetry, 81–82, 402
positron emission tomography (PET), 257 punch biopsy (skin), 414
postanesthesia care, 483–484 purpuras, 400
postoperative period, 482–484 pustules, 400
pyelonephritis, 386–388
pain medication, 480
postpartum health, 525–526 R
potassium hydroxide preparation (KOH) test, 415
potassium (K) radioallergosorbent (RAST) test, 415
RAST (radioallergosorbent) test, 415
abnormally high amount (hyperkalemia), Raynaud’s disease, 47–49
432–434 RBC. See red blood cells
reason for surgery, 477
abnormally low amount (hypokalemia), receptor sites, 453, 458
430–432 red blood cells (RBCs), 176. See also anemia

blood test for, 447 cell overproduction (polycythemia vera),
PPD (Mantoux intradermal skin test), 138–139 194–196
prednisone, 202
preeclampsia and eclampsia, 527–529 RBC count (test), 78, 79, 446
pregnancy, 519–522 Rh incompatibility, 526–527
Reed-Sternberg cells, 153
ectopic, 503–505 referred pain, 536
labor and delivery, 522–524 reflux of stomach acid (GERD), 301–304
postpartum health, 524–525 regional anesthesia, 482
preeclampsia and eclampsia, 527–529 relative rehydration, 444–445
Rh incompatibility, 526–527 renal artery, 374
testing for, 529 renal calculi (kidney stones), 382–384
preoperative period, 478–480 renal cancer, 381–382
preoperative teaching, 479–480 renal failure, 388–390
pressure ulcers, 409–411 renin, 421
primary aldosteronism, 351–353 renin substrate (angiotensinogen), 421
Prinzmetal’s angina, 7 respiratory acidosis, 120–122
progesterone, 497 respiratory system, 85–140
prolactin hormone overproduction, 343–345 how it works, 86–87
prolactin test, 368 map of, 85
prostate gland, 375
benign prostatic hypertrophy (BPH), 375–377
cancer of, 375, 384–386
prostate specific antigen (PSA) test, 395
prostatic fluid, 375

602 Index

respiratory system (continued) scleroderma, 157–159
acute respiratory distress syndrome (ARDS), 87–91 scleroderma autoantibodies, 167
acute respiratory failure, 124–127 scrub nurses, 481
asbestosis, 91–93 second-degree burns, 401–402
asthma, 93–96 seizure disorder, 252–255
atelectasis, 96–98 semen analysis, 531
bronchiectasis, 99–101 sensitivity and culture tests
bronchitis, 101–104
Cor Pulmonale, 104–106 sputum, 134–135, 169–170
diagnostic tests, 132–140 urine, 394
arterial blood gas (ABG), 136–137 septic shock, 163–165
bronchoscopy, 132 septum, 1, 3
chest x-rays, 133 shave biopsy (skin), 414
lung biopsy, 139–140 shunt, liver, 293
Mantoux intradermal skin test (PPD), 138–139 SIADH (syndrome of inappropriate antidiuretic
pulmonary angiography, 133–134
pulmonary function test (PFT), 136 hormone secretion), 346–348
sputum culture and sensitivity, 134–135, sickle cell anemia, 187–189
169–170 sigmoid colon, 285
thoracentesis, 135 simple goiter, 338–340
ventilation-perfusion (V/Q) scan, 137–138 simple partial seizures, 253
emphysema, 107–110 single photon emission computed tomography
influenza, 130–132
lung cancer, 110–112 (SPECT), 257
pleural effusion, 113–115 sino-atrial (SA) node, 3
pneumonia, 115–117 skeletal system. See musculoskeletal system
pneumothorax, 118–120 skin. See integumentary system
postoperative complications, 486–488 skin biopsy, 414
pulmonary embolism, 127–130 skin cancers, 400, 405–407
respiratory acidosis, 120–122 skin preparation, preoperative, 479
tuberculosis (TB), 122–124, 128 skull fractures, 213
SLE (systemic lupus erythematosis), 165–167
restorative surgical procedures, 477 small cell lung cancer, 110
restrictive cardiomyopathy, 26 small intestine, 285
Rh incompatibility, 526–527
Rh (Rhesus) factor test, 531 Crohn’s disease, 294–297
RHD (rheumatic heart disease), 49–51 diverticulitis disease, 297–299
rheumatic heart disease (RHD), 49–51 sodium (Na)
rheumatoid arthritis, 155–157 abnormally high amount (hypernatremia),
rheumatoid factor, 167
rhonchi, 88 424–426
risks of surgery, 477 abnormally low amount (hyponatremia), 422–424
blood test for, 447
intraoperative injury, 481–482 solar exposure, 405
rolling hernia, 311–312 somatotropin test, 367
rule of nines, 402 SPECT (single photon emission computed

S tomography), 257
spinal anesthesia, 482
SA (ino-atrial) node, 3 spinal column, 211
saliva, 285
schizophrenia, 463–464 myelography, 280
SCI (spinal cord injury), 246–249 spinal cord injury, 246–249
spinal tap. See lumbar puncture
spleen, 176
sputum culture and sensitivity, 134–135, 169–170
squamous cell carcinomas, 405, 406
SS-A and SS-B tests, 167

Index 603

stable angina, 7 third-degree burns, 401–402
statins (HMG CoA reductase inhibitors), 153 third space (fluids), 420
stem cells, 176 thoracentesis, 135
stomach acid reflux (GERD), 301–304 thromboendarterectomy, 20
stomach lining inflammation (gastritis), 306–308 thrombolytic therapy, 13
stomach ulcers, 319, 324 thrombophlebitis, 51–53, 199
stool testing, 204 thrombus. See also coagulation
stress ulcers, 319
stroke, 225, 249–252 myocardial infarction (MI) from, 11
subarachnoid hemorrhage, 212–213 peripheral arterial disease (PAD) from, 18
subdural hematoma, 212–213 pulmonary embolism from, 127
substance use disorders, 545–550 removal of (embolectomy), 20
substantia nigra, degeneration of. See Parkinson’s stroke from, 225, 249–252
in vein (thrombophlebitis), 51, 199
disease thyroid gland, 333. See also endocrine system
sucking chest wounds, 118 enlargement from iodine insufficiency (simple
superior vena cava, 1, 3
surfactant, alveoli, 87 gout), 338–341
surgeons, 480 hormone overproduction, 335–338
surgery. See perioperative care hormone underproduction, 333–335
surgical assistants, 480–481 thyroid scintiscan (thyroid scan), 369
surgical classifications, 476–477 thyroid stimulating hormone (TSH), 334, 335, 339
surgical scrub, 481 measurement test, 369
surgical team, 480–481 thyroxine (T4), 333
sympathectomy, 48 measurement test, 368
synchronized cardioversion, 54, 61 overproduction of (hyperthroidism), 335–338
syndrome of inappropriate antidiuretic hormone underproduction of (hypothroidism), 333–335
TIA (transient ischemic attack), 249
secretion (SIADH), 346–348 tonic and tonic clonic seizures, 253
Syndrome X, 363–365 total protein test, 327
synovial joints, 263 toxicology screening, urine, 553
systemic lupus erythematosis (SLE), 165–167 transcutaneous pacing, 57
transfer of patient, 480, 484
T transjugular intrahepatic portal systemic shunt, 293
tricuspid insufficiency, 69–71
T-cells, 144–145 tricuspid valve, 1, 3
T3 (triiodothyronine), 333 triiodothyronine (T3), 333
measurement test, 368
measurement test, 368 overproduction of (hyperthroidism), 335–338
overproduction of (hyperthroidism), 335–338 underproduction of (hypothroidism), 333–335
underproduction of (hypothroidism), 333–335 trimesters, pregnancy, 519–520
T4 (thyroxine), 333 trophoblastic disease, 517–519
measurement test, 368 troponin, 77
overproduction of (hyperthroidism), 335–338 Trousseau’s sign, 338
underproduction of (hypothroidism), 333–335 TSH (thyroid stimulating hormone), 334, 335, 339
tamponade, cardiac, 21–23 measurement test, 369
TB (tuberculosis), 122–124, 128 tuberculosis (TB), 122–124, 128
teaching, preoperative, 479–480 tumors. See also cancer
temporal lobe (brain), 211 on adrenal medulla, 353–354
tumor in, 223 bladder, testing for (cystoscopy), 394
tendons, 263 brain tumor, 222–224
tension pneumothorax, 118 Cushing’s syndrome, 349–351
testicular cancer, 390–392 ovarian masses, benign, 514–515
thalamus, 211

604 Index

tumors (continued) viral meningitis, 234–236
skin, 400, 405–407 visceral pain, 536
trophoblastic disease, 517–519 visceral pleura, 87
vitamin B12, 183
24-hour urine collection, 369, 395 vitamin D, 441
vitamin K, 177
U voiding cystogram, 396–398

UES (upper esophageal sphincter), 285 W
ulcerative colitis, 322–324
ulcers WBC. See white blood cells
Western Blot test, 169
gastric, 319, 324 wheals, 400
pressure (skin), 409–411 wheezing (rhonchi), 88
ultrasound white blood cells (WBCs), 176
abdominal, 325
of heart (echocardiograph), 73–74 cell overproduction (polycythemia vera), 194–196
of musculoskeletal system, 280 WBC count (test), 78, 79, 446
unstable angina, 7 women’s health, 495–531
upper esophageal sphincter (UES), 285 breast cancer, 497–499
upper gastrointestinal bleeds, 304–306 cervical cancer, 500–501
ureter, x-ray of (KUB study), 394 diagnostic tests, 529–531
urethra, 375 dysmenorrhea, 502–503
x-ray of (voiding cystogram), 396 ectopic pregnancy, 503–505
urgency of surgical procedure, 477 endometrial cancer, 505–506
uric acid, 268 fibroids (leiomyomas), 507–508
urinalysis, 395–396 infertility, 508–510
urinary catecholamines test, 369 labor and delivery, 521–523
urinary tract infection (UTI), 392–394 menopause, 510–512
urine, 375 ovarian cancer, 512–514
24-hour collection, 369, 395 ovarian masses, benign, 514–515
culture, 394 PID (pelvic inflammatory disease), 515–517
flow studies, 396 postpartum health, 525–526
toxicology screening, 553 preeclampsia and eclampsia, 527–529
uroflowmetry (urine flow studies), 396 pregnancy, 519–522
uterus, 497 Rh incompatibility, 526–527
UTI (urinary tract infection), 392–394 trophoblastic disease, 517–519
Wong pain scale, 537
V wound closure, 482
wounds and healing, 411–413
V/Q (ventilation-perfusion) scan, 137–138
“V tach”. See ventricular fibrillation X
valves, heart, 1, 3
x-rays
leakage, 62–65, 69–71 abdominal, 325
vasopressin challenge test, 369 of bladder and urethra, 396
vasospastic angina, 7 of blood flow (venograms), 80–81
venograms, 80–81 of bones and foreign bodies, 277
ventilation, 86–87. See also respiratory system of chest, 76–77, 133
ventilation-perfusion (V/Q) scan, 137–138 of joints (arthrograms), 279
ventricles, 1, 3 KUB (kidney, ureter, bladder) study, 394
ventricular fibrillation, 58–59 skin’s exposure to, 406
ventricular tachycardia, 59–61 of skull or spine, 255
vesicles, 400
viral infection. See infection