17) Health Promotion And Vital Signs Flashcards

1
Q

Why is there an increased need for home vital sign monitoring?

A
  • Emphasis on health promotion and maintenance
  • Early hospital discharge
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2
Q

What does the CASN state about health teaching for nursing graduates?

A
  • Should have ability to counsel and educate patients
  • To promote health, symptom and disease management
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3
Q

What should be incorporated in the patient’s plan of care?

A
  • Teaching on all vital sign measurements
  • To promote and maintain health
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4
Q

What must caregivers be aware of when teaching vital signs?

A
  • Changes that are unique to older persons
  • Such as variations identified in Box 31.18
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5
Q

What should be identified and taught regarding temperature?

A
  • Patient’s ability to initiate preventive care
  • Recognize temperature alterations
  • Ways to prevent temperature alterations
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6
Q

What risk factors for hypothermia and frostbite should be taught?

A
  • Fatigue
  • Malnutrition
  • Hypoxemia
  • Cold, wet clothing
  • Alcohol intoxication
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7
Q

What risk factors for heat stroke should be taught?

A
  • Strenuous exercise in hot, humid weather
  • Sudden exposure to hot climates
  • Insufficient fluid intake before/during/after exercise
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8
Q

What should be taught about antibiotics?

A
  • Importance of taking as directed until completed
  • To decrease infection resurgence
  • To prevent antibiotic resistance
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9
Q

Why do patients on certain cardiac meds need to assess their own pulse?

A
  • To detect adverse effects of the medications
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10
Q

Why do cardiac rehab patients need to assess their own pulse?

A
  • To determine their response to exercise
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11
Q

What should be taught to patients with family history of hypertension?

A
  • Risk factors like obesity, smoking, heavy alcohol use
  • High cholesterol/triglyceride levels
  • Continued stress exposure
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12
Q

What do hypertensive patients need to learn?

A
  • Their BP values
  • Need for long-term follow-up and therapy
  • Lack of obvious hypertension symptoms
  • Therapy controls but doesn’t cure hypertension
  • Benefits of consistently following treatment plan
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13
Q

What should be taught about home BP monitoring?

A
  • Importance of appropriate cuff size
  • Recommend electronic measurement
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14
Q

How should home BP be measured?

A
  • At same time each day after brief rest
  • Sitting or lying, same position and arm each time
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15
Q

What instructions for auscultation if electronic not available?

A
  • If difficult to hear, cuff may be loose, too small, too narrow
  • Ensure stethoscope over arterial pulse
  • Don’t deflate cuff too quickly/slowly
  • Pump cuff high enough for systolic
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16
Q

What should patients with decreased ventilation learn?

A
  • Deep breathing exercises
  • Coughing exercises
17
Q

When should patient/caregiver contact nurse or provider?

A
  • If unusual fluctuations in respiratory rate occur
18
Q

What are signs/symptoms of hypoxemia to teach?

A
  • Headache, somnolence, confusion
  • Dusky skin/mucous membranes
  • Shortness of breath, dyspnea
19
Q

What high-risk behaviors affect respiratory function?

A
  • Cigarette smoking
  • Environmental pollutants
20
Q

What’s an important factor when teaching vital signs?

A
  • The patient’s age
  • See Box 31.18 for considerations in older adults
21
Q

What is the normal temperature range for older adults?

A
  • Oral: 36°C - 36.8°C
  • Rectal: 36.6°C - 37.2°C
  • Temperatures in normal range may reflect fever
22
Q

How do thermoregulation changes affect older adults?

A
  • Diminished awareness of temperature changes
  • Impaired responses to hot/cold environments
  • Increased risk of hyperthermia and hypothermia
23
Q

How do sweat gland changes impact older adults?

A
  • Decreased sweat gland reactivity
  • Sweating may not occur until very high temperatures
  • Leads to hyperthermia and heat stroke risk
24
Q

How does loss of subcutaneous fat affect older adults?

A
  • Reduces insulating capacity of skin
  • Older men especially high risk for hypothermia
25
Q

What should nurses monitor in older adults? (Temperature)

A
  • Be attentive to subtle temperature changes
  • Watch for fever signs like tachypnea, anorexia, falls, delirium, functional decline
26
Q

What can provide a more accurate pulse reading for older adults or obese patients?

A
  • A Doppler device if pulse is difficult to palpate
27
Q

How does pulse rate response differ in older adults?

A
  • Longer for pulse to rise to meet increased demands from stress/illness/excitement
  • Once elevated, takes longer to return to normal resting rate
28
Q

Why may heart sounds be difficult to hear in older adults?

A
  • Increase in air space in the lungs can muffle sounds
29
Q

Why is cuff size selection important for older adults?

A
  • Decreased upper arm mass requires careful cuff sizing
30
Q

What makes accurate BP assessment difficult in older adults?

A
  • More variable BP
  • Fluctuates more in response to postural changes
31
Q

What conditions often occur in older adults related to BP?

A
  • Orthostatic hypertension
  • Postprandial hypotension (20 mmHg systolic drop after eating)
  • Assessing these helps reduce syncope, falls, strokes
32
Q

What instruction should be given to older adults regarding position changes?

A
  • Change positions slowly
  • Wait after each change before activity
  • Prevents orthostatic hypotension and injuries
33
Q

How does aging affect the rib cage and chest wall?

A
  • Ossification of costal cartilage
  • Ribs slant downward, increasing rib cage rigidity
  • Reduces chest wall expansion
  • Kyphosis and scoliosis restrict expansion and decrease tidal volume
34
Q

Which muscles do older adults rely on more for respiration?

A
  • Depend more on accessory abdominal muscles
  • Than weaker thoracic muscles
35
Q

How does the respiratory system change with age?

A
  • Matures by age 20, then begins declining
  • Can still perform usual activities with little effort
  • Sudden increased oxygen demand (stress, exercise, illness) may cause deficits
36
Q

What makes pulse oximetry difficult in older adults?

A
  • Peripheral vascular disease
  • Decreased cardiac output
  • Cold-induced vasoconstriction
  • Anemia