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101 LEC > 101 FINAL > Flashcards

101 FINAL Flashcards

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1
Q

Different responsibilities of different members of the healthcare team?
Physical therapist?
Occupational Therapist?

A

Physical therapist - musculoskeletal strength and conditioning
Occupational therapist - ADL, how to use and adapt to limitations for daily life

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2
Q

How many years is the RN license in NV good for?
How many hours or credits need to renew license?

A

2 years
30 credits

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3
Q

Where can you find the laws and regulations for nurses in each state?

A

Nurse practice act - defined by state board of nursing

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4
Q

What is an incident report?
When do you fill one out?

A

Incident report is Agency record of unusual occurrence

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5
Q

What are ranges for
PULSE RATE
RESPIRATIONS
BLOOD PRESSURE

A

Pulse - 60-100
Respir - 12-20
Bp 120/80

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6
Q

What is the normal range for blood glucose level?

A

70-100

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7
Q

What are the 4 different ways in which you can normally lose heat?

A

Radiation- exposure to cold
Conduction - lose through contact
Convection - blowing air
Evaporation - sweat

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8
Q

What are the different sites for palpating pulses?

A

Temporal
Carotid -ER
Apical
Brachial - inside elbow
Radial
Femoral - inside thigh
Popliteal - behind knee / bp
Posterior tibial - behind medial maleoulous / ankle
Dorsalis pedis - top of foot between big toe and little toe

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9
Q

Where do you place cuff when taking bp?

A

around upper arm
1 in above antecubital space/elbow

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10
Q

When do you use a diaphragm?
When do you use a bell?

A

Diaphragm - high-frequency sounds
Bell - Low-frequency sounds / murmur

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11
Q

What are the 5 steps of nursing process?

A

Assess
Diagnosis
Plan
Implement
Evaluate

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12
Q

What is the clinical judgment model in relation to ADPIE?

A

ASSESS - Recognize clues
ANALYZE/DIAG - Analyze Clues, Prioritize hypothesis
PLAN - generate solutions
IMPLEMENT - Take action
EVALUATE - Eval outcomes

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13
Q

What is IPPA
What system does not follow this?

A

Inspection
Palpate
Percuss
Auscultate

*abdomen = IAPP

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14
Q

What is the difference between medical asepsis and surgical asepsis?

A

Medical asepsis -not wearing sterile gloves, starting an IV
Surgical asepsis - sterile technique, wearing sterile gloves, inserting a catheter

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15
Q

What is difference between acitve ROM and PASSVE ROM

A

active - ppt able to do it themselves
Passive - ppt being assisted through motions

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16
Q

What does patient autonomy mean?

A

ability to make own decisions

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17
Q

Difference between arterial and venous problems?

A

ARTERY - relief with rest, plae. cynaotic , shiny, pulseless, cool, ISCHEMIC ULCER

VEIN - Relief with walking, brown, red, warm, STATSIS ULCER

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18
Q

What is receptive aphasia?
What is expressive aphasia?

A

Receptive - cant understand what ppl are saying/writing
Expressive - cant talk at all or doesn’t make sense

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19
Q

What is range of glascow coma scale?
What score is coma?

A

1-15
7 or less is coma

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20
Q

What order do you put on PPE and take off?

A

ON: Gown, Mask, Goggles, gloves
OFF: Gloves, goggles, gown, mask

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21
Q

What are the standard precautions?
Airborne?
Droplet?
Contact?

A

Standard - everyone gets. Handwashing PPE
Airborne - TB N95
Droplet - mumps/pertussis. MASK
Contact - CDIFF, gloves

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22
Q

How does blood flow through the heart?

A

Deoxygenated > Veins > RIGHT Atrium> RIGHT ventricle>Pulmonary artery> LUNGS> Pulmonary veins> LEFT atrium> LEFT ventricle>AORTA>arteries>System

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23
Q

What is the natural pacemaker of the heart?

A

SA node

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24
Q

what is the electrical pathway in the heart?

A

SA NODE>AV NODE>BUNDLE of HIS» Purkinje Fibers

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25
Q

What causes the bruit sound in carotid artery?

A

buildup of plaque. Atherosclerosis

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26
Q

What is the z pattern of the heart?

A

apical, pulmonic, erbs point, tricuspid, mitral

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27
Q

Where is S 2 the loudest? and what valves are you hearing?

A

Closure of Semilunar valves loudest at base
end of systole

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28
Q

Where is S1 the loudest? and what valves are you hearing?

A

closure of AV valves loudest at apex - top
beginning of systole

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29
Q

What is the formula to measure cardiac output?

A

SvXHR= C/O

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30
Q

What are the signs of LEFT sided HEART failure?

A

Pulmonary congestion, Dyspnea, orthopnea

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31
Q

What are the signs of RIGHT sided heart failure?

A

extremities edema
Venous distention

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32
Q

what is atelectasis

A

collapse of aveloi

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33
Q

What is the correct technique for listening to lung sounds?

A

Side to side 18 on back, 10 on front
DEEP breathes in and out through the mouth
Use diaphragm - high frequency sound

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34
Q

What are CRACKLES lung sounds?

A

Non-musical, popping sound/bubbling
Fine: roll hair between fingers by ear
Coarse: opening Velcro
Due to fluid, mucus or pus

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35
Q

What are WHEEZING lung sounds?

A

High pitched - like whistling
Due to airway narrowing/constriction

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36
Q

What are STRIDOR sounds?

A

in trachea
High-pitched during inspiration/trachea
Due to obstruction of upper airway/narrowing

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37
Q

What are RONCHI lung sounds?

A

Low-pitched, snore-like
Due to airway narrowing and secretions

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38
Q

What are the 2 different types of advanced directives?

A

Living Will - a list of all the things you want or dont want done, YES or NO. does not kick in until person cannot tell what

Durable Power of Attorney for Health Care - name of person who will make health care decisions if patient cannot make own decisions

39
Q

What are the different ways to do nursing documentation?

A

ISBARR-
DAR

40
Q

What does ISBARR stand for

A

Identification or intro/
Situation (why calling or telling)- what is going on right now - breathing
Background- COPD & surgery
Assessment - vital signs
Recommendation - breathing treatments
repeat (verbal order)

41
Q

What are the risk factors for skin breakdown?

A

age
health
nutrition
hydration

42
Q

What are the stages of pressure ulcers?

A

Stage I: redness - skin intact
Stage II: skin is broken
Stage III: into subQ fat layer
Stage IV: damage to muscle - deep into muscle and possibly bone
Unstageable: base of ulcer covered by slough and/or eschar in wound bed

43
Q

What are the principles of pressure ulcer therapy?

A

Protect the wound
Provide a moist environment
Absorb excess exudate
Prevent maceration of wound edges
Remove necrotic tissue

44
Q

What are 4 ways we can remove necrotic tissue?

A

-Autolytic debridement - self/the body natural enzymes to eat away at any dead tissue/ slough
-Mechanical debridement - wet to dry dressing (wet gauze/wring out/pack) ./ maggot
-Enzymatic debridement - use ointments or creams that have chemical properties / takes days to weeks
-Sharp debridement -scalpel

45
Q

What are the 4 types of wound drainage?

A

Serous - clear
Sanguineous - bloody
Serosanguineous - watered-down blood
Purulent - thick yellow, green, tan, brown

46
Q

What is Dehiscence?
Evisceration?

A

-Dehiscence - when a surgical wound comes apart – could be from coughing, sneezing, pulling
-Evisceration - when contents spill out of a open wound

47
Q

What does the P, QRS, T Wave indicate?

A

P Wave - atrial depolarization

QRS Complex - ventricular depolarization

T Wave - ventricular repolarization

48
Q

What is the PR interval?

A

PR Interval
Amount of time for the impulse to travel through the AV node to the bundle of His

49
Q

In relation to oxygenation, what is diffusion? where does it occur?

A

Exchange of respiratory gases in the alveoli and capillaries (occurs at the alveolocapillary membrane)

Moving of molecules (CO₂ & O₂) from an area of higher concentration to an area of lower concentration

50
Q

why would a patient who is hyperventilation develop paresthesia

A

Hyperventilation causes increased blood pH which causes a decrease in free ionized calcium (Hypocalcaemia), which causes paresthesia

51
Q

What are early signs of hypoxia?

A

(Mental status ∆’s early sign)
Change in LOC
Restlessness
Apprehension
Inability to concentrate
Dizziness
Behavioral Changes
Cyanosis: Late sign of hypoxia

52
Q

What is the proper technique for an incentive spirometer? and whats purpose?

A

Lips should completely cover mouthpiece
Have patient inhale slowly, attempting to reach goal volume
Encourage 5-10 breaths per session every hour

-Helps prevent atelectasis

53
Q

Whats the different between low floe and high flow oxygen delivery systems?

A

Low-Flow Systems
amount of O2 delivered is variable and depends on the patient’s respiratory rate & breathing pattern

Nasal Cannula
Simple Mask
Nonrebreather

High-Flow Systems
patient’s entire inspired gas volume is consistently & predictably delivered by the system

Venturi Mask

54
Q

What are the normal levels for
SODIUM
POTASSIUM
CALCIUM
MAGNESIUM
CHLORIDE
PHOSPHATE

A

Sodium: 135-145 mEq/L
Potassium: 3.5-5.0 mEq/L
Calcium: 8.6-10.2 mg/dL
4.5-5.1 mg/dL (ionized)
Magnesium: 1.3-2.3 mEq/L
Chloride: 97-107 mEq/L
Phosphate: 2.5-4.5 mg/dL

55
Q

What are some signs of HYPO and HYPER volemia?

A

Hypovolemia
Tachycardia
Hypotension
-Thready Pulse
Decreased Skin Turgor
Orthostatic Hypotension
Dry Mucous membranes

Hypervolemia
Bounding Pulse
Crackles
Distended Neck Veins
Edema
Hypertension

56
Q

what is normal PH
PAcO2
HCO2

A

PH - 7.35-7.45
PAcO2 - 35-45
HCO3 - 22-26

57
Q

What are examples of complete and incomplete proteins?

A

Complete- meat, animal products, soy
Incomplete - beans, legumes

58
Q

What is difference between saturated and unsaturated fats?

A

Most animal fats are saturated (limit to <7-10% of total calories)
Most vegetable fats are unsaturated

59
Q

What is systole? what is Diastole?

A

Systole - a period of ventricular contraction
Diastole - a period of ventricular filling

60
Q

What happens during S1?

A

AV valves close - beginning of systole
blood flows from ventricles into pulmonary artery and aorta

61
Q

What happens during S2?

A

Close of Semilunar valves- end of systole
AV valves open and blood flows from atria into ventricles

62
Q

What is coronary circulation
What are the 2 main coronary arteries?

A

Coronary circulation - circulation into the myocardium
Right and left coronary arteries

63
Q

What is creatine phosphokinase (CPK) and troponin?

A

CPK (CK-MB)- enzyme will increase if MI
Troponin - protein gets released when damage to cardiac tissue
*Only elevated for a short time after MI

64
Q

How can we treat an arterial occlusion?

A

Thrombolytic drugs
Angioplasty- cardiac catheter/groin/inflate balloon
Stent placement

65
Q

How many BPM does SA node, AV node and bundle of his fire off?

A

SA - 60-100
AV - 40-60
Bundle - 20-40

66
Q

What happens during Polarization, Depolarization and repolarization?

A

Polarization - K+ leak out of cell/makes it -
Depolarization - Inflow of Na+ & Ca+/makes it +//TRIGGERS Contraction
Repolarization - Return to resting / makes it -

67
Q

What does the P, QRS, T wave mean?

A

P - Atrial depolarization
QRS - Ventricular depolarization
T - Ventricular repolarization

68
Q

What is definition of cardiac output?

A

Volume of blood pumped by heart each minute

69
Q

Contractility is affected by what 2 things?

A

-Venous return (starling law)- more volume = more stretch=greater contraction
-Inotropic effect - SNS - brain triggered to squeeze harder

70
Q

What is the ejection fraction?

A

How much blood is ejected out of the left ventricle with each beat

AVG for adults is 55-65%

71
Q

What are the 3 steps of respiratory physiology?

A

-Ventilation - moving gases in and out of lungs
-Diffusion - exchange of respiratory gases in alveoli and capillaries
-Perfusion- Pumping oxygenated blood into tissues and returning de-ox blood to lungs

72
Q

What is the goal of ventilation for Co2 and O2?

A

Co2 - 35-45 mmHg
O2 - 95-100 mmHg

*Brain is triggered by Co2 levels

73
Q

What are the 2 parts of the brain responsible for breathing?

A

Medulla - automatic/sensitive to narcotics
Cerebral cortex - voluntary

74
Q

What is hyperventilation?
Caused by…

A

Excess exhaling of Co2
causes - anxiety, infection, hypoxia, compensation for metabolic acidosis

75
Q

What is Hypoventilation?
Caused by..

A

Decrease in the amount of air entering alveoli
Inadequate amount of O2
Caused by an obstruction, atelectasis, too much o2 in COPD

76
Q

Holter monitor/event monitor

A

Holter - Records for 24 hours
Event monitor - 1 month

77
Q

Nasal Cannula
Delivers concentration of ?
Flow rates from ?

A

Concentrations 22-44%
Flow rate 1/2 to 6L/min
*usually admin humidified at 3L

78
Q

2L/MIN of oxygen is what FiO2?
*every 1/2 L is what FiO2?

A

28%
every 1/2 L is 2%

79
Q

A simple mask delivers what oxygen concentration? and flows between?

A

Delivers 40-60%
Flows between 5-8L/min

80
Q

Nonrebreather delievers oxygen concentrations of ? and flows from?

A

Oxygen concentration 80-95%
Flows from 10-15L/Min
*used for respiratory distress, severe asthma, trauma

81
Q

Venturi Mask
Delivers what specific oxygen concentration?

A

Specific - 24-40%

82
Q

When would you use oropharyngeal suctioning?

A

When able to cough but unable to clear secretions

83
Q

What is the autonomic bladder?

A

From injury or disease - just forms urine
no control - incontinent

84
Q

What is stress incontinence?

A

Increased abdominal pressure
*Wearing tight clothing
*If coughing, sneezing, laugh may cause them to dribble urine

85
Q

What is stress incontinence?

A

Increased abdominal pressure
*Wearing tight clothing
*If coughing, sneezing, laugh may cause them to dribble urine

86
Q

Alcohol inhibits the release of

A

ADH

87
Q

What is the primary organ of bowel elimination?

A

The large intestine

88
Q

The large intestine extends from

A

Ileocecal valve to anus

89
Q

What are the functions of the large intestine?

A

Absorption of water
Formation of feces
Expulsion of feces

90
Q

What is peristalsis?

A

Contractions under control of autonomic nervous system

*Parasympathetic stimulates movement
*Sympathetic inhibits movement

91
Q

How does hypertonic solution work?

A

Draws water into colon to extend it

92
Q

What kind of solution is saline?

A

Isotonic

93
Q

What is a colostomy?
Stoma?
Ostomy?

A

Colostomy - section of bowel surgically removed
Stoma - artificial opening
Ostomy - surgical procedure where artificial opening is created

101 LEC (15 decks)

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