17) Health Promotion And Vital Signs Flashcards

(36 cards)

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
What should nurses monitor in older adults? (Temperature)
- Be attentive to subtle temperature changes - Watch for fever signs like tachypnea, anorexia, falls, delirium, functional decline
26
What can provide a more accurate pulse reading for older adults or obese patients?
- A Doppler device if pulse is difficult to palpate
27
How does pulse rate response differ in older adults?
- Longer for pulse to rise to meet increased demands from stress/illness/excitement - Once elevated, takes longer to return to normal resting rate
28
Why may heart sounds be difficult to hear in older adults?
- Increase in air space in the lungs can muffle sounds
29
Why is cuff size selection important for older adults?
- Decreased upper arm mass requires careful cuff sizing
30
What makes accurate BP assessment difficult in older adults?
- More variable BP - Fluctuates more in response to postural changes
31
What conditions often occur in older adults related to BP?
- Orthostatic hypertension - Postprandial hypotension (20 mmHg systolic drop after eating) - Assessing these helps reduce syncope, falls, strokes
32
What instruction should be given to older adults regarding position changes?
- Change positions slowly - Wait after each change before activity - Prevents orthostatic hypotension and injuries
33
How does aging affect the rib cage and chest wall?
- 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
Which muscles do older adults rely on more for respiration?
- Depend more on accessory abdominal muscles - Than weaker thoracic muscles
35
How does the respiratory system change with age?
- 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
What makes pulse oximetry difficult in older adults?
- Peripheral vascular disease - Decreased cardiac output - Cold-induced vasoconstriction - Anemia