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317 test 2 Flashcards

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1
Q

Risks factors that can lead to hypertension include

A 
Modifiable:
Alcohol, tobacco use. 
Diabetes mellitus 
Elevated serum lipids, excess dietary sodium 
Obesity, sedentary lifestyle 
Stress, sedentary lifestyle 
Socioeconomic status 
Non-modifiable: 
Age, family history, gender 
Genetics can be due do altered RAAS, stress and increased SNS, Insulin resistance, endothelial dysfunction, water and sodium retention
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2
Q

Risk to patients who have hypertension

A

Cardiac: CAD, LV hypertrophy, HF, MI
Cerebrovascular disease: cerebral atherosclerosis, stroke
Peripheral vascular disease
Nephrosclerosis: kidney damage and diseases.
Retinal damage

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3
Q

Compare and contrast the values associated with blood pressures

A

Normal SBP <120 and DBP <80
Prehypertension 120-139 or 80-89
Hypertension, stage 1: 140-159 or 90-99
Hypertension, stage 2: ≥160 or ≥100

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4
Q

relationship of blood pressure and the concept of perfusion

A

Blood pressure must be adequate to maintain tissue perfusion at rest and during activity. If someone is in a hypotensive state for a long time, this would mean that there is a decrease in perfusion to tissues.

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5
Q

primary hypertension

A

elevated BP without an identifying cause 90-95% of HTN cases. may have headache, fatigue, dizziness, dyspnea, and will eventually lead to organ damage

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6
Q

secondary hypertension

A

elevated BP resulting from a cause 5-10% of HTN.

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7
Q

secondary HTN causes include

A

kidney disease or disruption of BP that stimulates RAAS such as endocrine disorders, hyperthyroidism, high spinal cord injury, stimulants, pregnancy

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8
Q

non pharmacological treatment of hypertension

A

weight loss, health diets, sodium restriction, potassium supplements, increase physical activity, limit drinking

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9
Q

first line therapy for stage 1 hypertension includes

A

thiazide diuretics, calcium channel blockers, ace inhibitors, and ARBs

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10
Q

DASH diet

A

consists of lowering salt intake, increasing potassium, calcium, magnesium, and fiber. The diet should have low concentrated carbohydrates and be low calorie.

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11
Q

orthostatic hypertension

A

pt is normotensive and their BP decreased when rising to an upright position causing symptoms of lightheadedness or dizziness

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12
Q

what is going on with a patient who has orthostatic hypertension

A

may represent when a pt has a decreased blood volume or overmedicating a patient.

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13
Q

MAP (mean arterial pressure)

A

MAP is the average pressure within the arterial system that is felt by organs in the body. MAP of 60 is needed for proper organ perfusion. lower MAP can lead to ischemia and cellular death

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14
Q

how to figure out the MAP

A

((systolic) + (diastolic x2))/3

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15
Q

treatment of a hypertensive crisis.

A

treatment needs to occur within an hour. BP should be lowered gradually. Cardiac and renal function needs to monitored.

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16
Q

peripheral vascular disease

A

PVD is the thickening of the arterial walls which narrows and stiffens the arteries in the UE and the LE or an obstruction of the vein by a thrombus.

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17
Q

risks for peripheral vascular disease.

A

high BP, high cholesterol, old age, male, smoking, diabetes

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18
Q

relationship of peripheral vascular disease with the concept of perfusion.

A

Peripheral vascular disease makes it harder for blood to travel to these areas. decreases perfusion means decreased O2 to these tissues and muscles.

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19
Q

Compare and contrast the peripheral venous disease and peripheral arterial disease

A

PAD: narrowing of the arteries, shows as cramping, pain, tired legs that worsens during walking and subsides with rest
PVD: inadequate return of venous blood from the legs to the heart shows as achy cramping in legs worsens with standing and improves with elevation

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20
Q

6 Ps with peripheral arterial disease

A

pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia

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21
Q

poikilothermia

A

loss of temperature regulation

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22
Q

treatment of a patient with peripheral venous disease

A

exercise, elevating the affected area, bandaging or special compression stockings can help, but in more severe cases blood thinning medication may be prescribed like heparin

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23
Q

prophylaxis treatment for PVD

A

early mobilization after surgery, elastic stockings, anticoagulation

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24
Q

treatment of a patient with peripheral arterial disease

A

lifestyle modifications: smoking cessation, physical exercise, DASH diet, glucose control, BP control, control hyperlipidemia, antiplatelet agents

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25
Q

Bp highest at what part of the day

A

10 am - 6 pm

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26
Q

BP lowest at what part of the day

A

between midnight and 3 am

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27
Q

Nursing Dx with hypertension

A 
o	Ineffective health management 
o	Anxiety
o	Sexual dysfunction
o	Risk for decreased cardiac perfusion
o	Risk for ineffective cerebral and renal perfusion
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28
Q

LDL

A

bad cholesterol - promote formation of atherosclerosis. want it less than 100

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29
Q

HDL

A

good cholesterol - associated with coronary artery disease want it higher than 35

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30
Q

total cholesterol

A

want less than 200

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31
Q

triglycerides

A

fat storage - associated with coronary artery disease what less than 150

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32
Q

BMI that is categorized at obesity

A

BMI greater than 30

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33
Q

Two risk factors for coronary artery disease that increase the workload of the heart and increase myocardial oxygen demand are

A

hypertension and smoking

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34
Q

Microvascular angina

A

pain with coronary spasm of major coronary artery

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35
Q

Care for angina

A

o Decrease O2 demand and or increase O2 supply
o Short acting nitrates
o Long acting nitrates
o If they feel dizzy or lightheaded they should not take any more or BP will drop too low
o Patient will most likely get a headache

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36
Q

If they do not get tingling under tongue then

A

med most likely outdated

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37
Q

cardiac output is determined by

A

HR, stroke volume, BP

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38
Q

perfusion

A

force of blood movement generated by cardiac output

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39
Q

relationship of heart failure with the concept of perfusion.

A

During heart failure we have a decrease in cardiac output which decreases blood pressure which therefore is an impairment of perfusion. Having a perfusion impairment means we have less blood flow to our brain and tissues which can lead to systemic effects

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40
Q

population at risk for heart failure

A

You are at more risk for developing heart failure if you are of African American descent, are obese, a smoker, have high cholesterol, CAD, HTN, DM, or pulmonary hypertension.

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41
Q

Differentiate between clinical signs of right sided and left sided heart failure

A

left: dyspnea, cough, crackles, wheezes, blood tinged sputum, tachypnea, restlessness, cyanosis, fatigue
right: ascites, enlarged liver or spleen, distended jugular veins, weight gain, edema

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42
Q

Differentiate between right sided and left sided heart failure

A

right occurs when the right ventricle fails to contract effectively and causes back up into systemic
left sided HF results from left ventricular dysfunction and causes back up into the lungs

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43
Q

HFrEF

A

systolic heart failure

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44
Q

ejection fraction of systolic heart failure

A

is lower because the ventricle loses the ability to generate enough pressure to eject blood forward. EF usually less than 45% and can go as low at 10%

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45
Q

HFpEF

A

diastolic heart failure

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46
Q

diastolic heart failure

A

inability of the ventricle to relax and fill during diastole.Is often referred to as heart failure with a normal EF. decrease stroke volume and cardiac output

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47
Q

systolic heart failure

A

inability for the heart to pump blood effectively

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48
Q

Ejection Fraction

A

he amount of blood ejected from the ventricle with each contraction.The normal EF is 55-60%

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49
Q

FACES

A

fatigue, limitation in activity, chest congestion, chest congestion, cough, edema, SOB

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50
Q

stages of HF diagnosis

A

stages A: high risk for developing CHF
stages B: structural disorder of heart
stage C: past or current symptoms of CHF
Stage D is end-stage disease

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51
Q

core measure of heart failure

A

education and documentation on: medications, symptoms worsening, follow up with physician, daily weight, activity, dietary restrictions, smoking cessation

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52
Q

Explain the relationship of coronary artery disease and the concept of perfusion

A

If the lipid deposits in the intima develop to become complicated lesions, blood flow is severely decreased

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53
Q

coronary artery disease

A

type of blood vessel disorder that is included in the general category of atherosclerosis. is characterized by lipid deposits within the intima of the artery

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54
Q

population at risk for coronary arterial disease (CAD)

A

older populations, the ethnicities of Caucasians, African Americans, and Native American, smokers, obese, stress out people, diabetes, and people who do not move that much.

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55
Q

diagnostic procedures associated with CAD

A

chest x-ray, ECG, stress testing, electron beam computed tomography (EBCT), Coronary Computed Tomography Angiography (CCTA)

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56
Q

electron beam computed tomography (EBCT

A

locates and measures coronary calcification

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57
Q

Coronary Computed Tomography Angiography (CCTA)

A

using IV contrast and radiation, CCTA can detect calcified and noncalcified plaques in the artery

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58
Q

diagnosis of acute myocardial infarction

A

12-lead ECG, Serum Cardiac Biomarkers, Coronary Angiography

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59
Q

STEMI

A

usually have a complete coronary occlusion and will have an inverted T wave and pathologic Q waves

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60
Q

non-stemi

A

pt’s usually have transient thrombosis or incomplete coronary occlusion and will have ST depression or an inverted T wave

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61
Q

Serum Cardiac Biomarkers

A

Cardiac specific troponin, creatine kinase MB, and myoglobin are released into blood from necrotic heart muscle after an MI and can be tested fo

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62
Q

Coronary Angiography

A

Opens totally occluded artery

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63
Q

treatment associated with acute chest pain

A

Acute intensive drug therapy: nitroglycerin, antiplatelet therapy (aspirin, glycoprotein IIb/IIIa inhibitors), anticoagulation therapy (heparin, direct thrombin inhibitors)
Coronary angiography: PCI
CABG (coronary artery bypass graft) surgery

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64
Q

treatment associated with chronic stable angina

A

A: antiplatelet/anticoagulant therapy, antianginal therapy, ACE inhibitor, ARB
B: beta blocker, BP control
C: Cigarette smoking cessation, cholesterol management, CCB, cardiac rehabilitation
D: Diet (weight loss), diabetes management, depression screening
E: education
F: flu vaccine

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65
Q

treatment associated with Acute coronary syndrome

A

IV access
O2 therapy
Drug therapy: nitroglycerin, morphine sulfate, aspirin, beta blocker, ACE inhibitor, ARB, high dose statin

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66
Q

Nitroglycerine meds

A

“nitrates” dilate peripheral and coronary blood vessels

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67
Q

nitroglycerine administration

A

take a nitro tablet sublingually If no relief, repeat every 5 minutes for a max of three doses. Tell them of potential symptoms they will fell: headache, dizziness, flushing. you can also take it by ointment and transdermal patches

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68
Q

percutaneous coronary intervention

A

a method of increasing blood flow to the heart when it is at least 70% occluded with plaque. The tip of a catheter with a deflated balloon is inserted to the appropriate coronary artery and then the balloon is inflated and compresses the plaque

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69
Q

when is Percutaneous coronary intervention used

A

used if a coronary block is amenable to treatment. have this procedure done: within 90 minutes of MI symptoms or STEMI

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70
Q

thrombolytics

A

medications to dissolve dangerous clots in blood vessels and improve blood flow and prevent damage to tissues and organs during heart attacks

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71
Q

4 modifiable factors that are major contributing factors to CAD

A

Elevated serum levels
HTN
Tobacco use
Physical inactivity

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72
Q

Interpersonal communication

A

exchange of information between two or more people. uses verbal and nonverbal cues to accomplish personal and relational goals.

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73
Q

Transpersonal communication

A

specific responses that encourage the expression of feelings and ideas and convey acceptance and respect. When you confront someone in a therapeutic way you help them become more aware of inconsistencies in his or her feeling, attitudes, beliefs, and behaviors.

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74
Q

role of the message

A

The message is what is actually said plus nonverbal communication. The role of the message is to clearly communicate some kind of information to the receiver.

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75
Q

channels in communication

A

means of sending and receiving messages through visual, auditory, and tactile senses. Facial expressions send visual messages; spoken words travel through auditory channels. Touch uses tactile channels

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76
Q

feedback in communication

A

Feedback is a response to the message. Feedback can be positive, negative,verbal, or nonverbal.

77
Q

factors that influence communication

A

psychophysiological context, relational context, situational context, environmental context, and cultural context

78
Q

Psychophysiological Context

A

physiological status, emotional status, attitudes, values, beliefs

79
Q

relational context

A

nature of relationship - level of trust, caring, self disclosure, shared history, power and control

80
Q

situational context

A

reason for communication

81
Q

role of the environment in communication

A

environment is the setting for sender-receiver interaction. effective communication setting provides participants with physical and emotional comfort and safety

82
Q

zones space and touch

A

intimate zone, personal zone, socio-consultative zone, public zone

83
Q

intimate zone

A

(0- 18 inches): holding a crying infant, performing physical assessment, bathing, grooming, dressing, feeding, and toileting a patient

84
Q

personal zone

A

(18 inches to 4 ft): sitting at a pt’s bedside, taking a pt’s nursing history, teaching an individual pt

85
Q

socio-consultative zone

A

(4-12ft): giving directions to visitors in the hallway, asking if families need assistance from the pt doorway, giving verbal report to a group of nurses.

86
Q

public zone

A

(12ft. and more): speaking at a community forum, lecturing to a class of students, testifying at a legislative hearing

87
Q

zones of touch

A

social zone, consent, vulnerable zone, intimate zone

88
Q

social zone

A

(permission not needed): hands, arms, shoulders, back

89
Q

consent zone

A

(permission needed): mouth, wrists, feet

90
Q

vulnerable zone

A

(special care needed): face,neck, front of body

91
Q

intimate zone

A

(permission and great sensitivity needed): genitalia, rectum

92
Q

Therapeutic communication techniques

A

sharing empathy, humor, feelings, using touch, silence, clarifying, focusing, validating

93
Q

non-therapeutic technique

A

asking personal questions, giving opinions, changing the subject, false reassurance, sympathy, defensive response

94
Q

SOLER

A 
s- sitting posture
o- observe an open posture 
l- lean toward the patient 
e- establish and maintain eye contact
r- relax
95
Q

IPASS

A

I- illness severity
P- patient summary
A- action list
S- situation awareness and contingency planning
S- synthesis by receiver - receiver summarizes what was heard

96
Q

when calling a physician in addition to an SBAR, you need to

A

Make sure you have assessed the pt yourself
Read the most recent notes
Discussed the pt with the charge
Looked to make sure there is not a protocol in place for the issue
Have the most recent labs, vitals, and meds
Ask others if they need to talk to the doctor

97
Q

high priorities

A

life-threatening or that could result in harm to the client if they are left untreated are high priorities.

98
Q

intermediate priorities

A

Non-emergency and non-life-threatening client needs

99
Q

low priorities

A

needs that are not related directly to the client’s illness or prognosis

100
Q

ABCs

A

airway, breathing, circulation

101
Q

optimal goals of nursing

A

Ensuring optimal care through objectives, systematic monitoring, criteria based evaluations, goals,needs,values for the patient.

102
Q

patient acuity scale

A

stable pt, moderate risk pt, complex pt, high risk pt

103
Q

stable pt

A

A/O x4, room air, normal labs, IVPB/PO meds, etc.

104
Q

moderate risk pt

A

patient may be less oriented, on NC for O2, receiving TPN or heparin, low grade fever, etc.

105
Q

complex pt

A

delirious, tracheostomy, blood transfusion, moderate or changing fever, etc.

106
Q

high risk pt

A

unstable, afib, chemotherapy, serious air therapy, etc.

107
Q

patient acuity tool

A

RNs can use to assess patients risk level to help create equitable, quantifiable assignments

108
Q

what can be done to minimize risks associated with floating.

A

Inform your supervisor of any lack of experience
Receive an orientation of the unit
Before accepting a job, ask about floating and have an understanding of what it is - this ensures that you’re protecting yourself and the pt

109
Q

Hospital acquired pneumonia

A

occurs 48 hours or longer after admission to the hospital, highest mortality rate of nosocomial infections

110
Q

Aspiration pneumonia

A

abnormal entry of secretions into airway, usually history of a loss of consciousness, gag and cough reflexes suppressed, tube feedings are a risk factor, ventilator support is a risk factor

111
Q

etiology of asthma

A

asthma is caused by triggers such as allergens, food allergies, obesity, pollutants, occupants, beta blockers, NSAIDS

112
Q

extrinsic

A

outside the body like pollen and pollutants

113
Q

intrinsic

A

stress, anxiety, other internal factors

114
Q

clinical manifestations of asthma

A

accessory muscle use, anxiety, chest pain, costal and sternal retractions, dyspnea, nasal flaring, nonproductive cough, rhonchi, wheezing, and tachypnea.

115
Q

indications of O2 therapy

A

Oxygen therapy is needed in cases of hypoxemia when the SPO2 of a patient is less than or equal to 88% (w/o comorbidities) and 89%( w/ comorbidiites)

116
Q

methods of delivery of O2

A

Nasal cannula (1-6L/min), Simple mask (5-10 L/min), Partial rebreather (8-12 L/min), Non-rebreather (10-15 L/min), and the Venturi mask (4-12 L/min).

117
Q

chronic obstructive pulmonary disease (COPD)

A

COPD is essentially chronic airflow limitation. It encompasses both the diseases of emphysema and chronic bronchitis

118
Q

causes of COPD

A

inflammation and structural changes of the airway bronchioles with increased mucus blocking airflow, and also the destruction and enlargement of air spaces such as alveoli also limit air movement resulting in COPD.

119
Q

clinical manifestations associated with COPD

A

Easily fatigued, frequent respiratory infections (pneumonia), use of accessory muscle use, orthopneic, Wheezing, chronic cough, dyspnea, prolonged expiratory time, thin in appearance but can be heavy. Digital clubbing.

120
Q

emphysema

A 
pink puffer - Enlargement of the air space distal to the terminal bronchioles. 
Increased CO2 retention
No cyanosis
Dyspnea
Ineffective cough
Hyperresonance on percussion
Barrel chest
Usually a smoker
Prolonged respiratory time with accessory muscle usage
Leads to right sided heart failure
121
Q

chronic bronchitis

A 
blue bloater - 
Chronic inflammation further narrowing the small airways. Tendency to hyperventilate and retain co2
Usually dusky to cyanotic
Sputum production
Hypoxia and hypercapnia
Acidosis
Edematous
Increased resp rate
Exertional dyspnea
Digital clubbing
Usually a smoker
Cor pulmonale, cardiac enlargement
122
Q

huff coughing

A

in comfortable sitting position, slightly inhale deeper than usually, activate stomach to blow out air in 3 even breaths while making the sounds huff huff huff. Less tiring than a traditional cough.

123
Q

mild anxiety

A

shows with slight tension, effective problem solving, and increased alertness, energy, and concentration. Example: a person might show mild anxiety before a test

124
Q

moderate anxiety

A

may heighten productivity and abilities but also may cause selective inattention. Functional but uncomfortable for short periods of time, as well as short periods of effective problem solving. The person will be tense and alert but have a narrowed perceptual field. Example: giving a presentation in front of the class.

125
Q

severe anxiety

A

Uncomfortable and not useful. Requires intervention. Consumes energy. The person has a very narrow perceptual field and focuses on details. They do not necessarily see the “big picture”. They will be unaware of behaviors and effect on others. Helpful interventions include decreasing stimuli, giving simple commands or directions, and attending to the person’s physical needs. Interventions that are not helpful include increasing the unknowns and stimuli, letting the person take charge, and substance abuse

126
Q

strategies to decrease stress in patients

A

time management, meditation, journal writing, yoga, diet, open communication, positive self talk, problem solving

127
Q

Betty Neuman’s Systems Theory

A

used to describe the concepts of stress and reaction to stress. views a patient, family, or community as constantly changing in response to the environment and stressors.

128
Q

actions that are successful in a crisis

A

maintain a safe, calm, quiet atmosphere, make slow and deliberate movements, and to ensure the safety of everyone around. Additionally, the nurse can ask the pt to describe the problem and ask about past situations and learn about how the pt coped.

129
Q

responsibilities of a nurse when a legal 2000 is in place

A

keeping the patient’s safe and should identify when the patient is putting themselves or others at risk

130
Q

indicators of stress

A

sociocultural indicator, spiritual indicator, emotional indicator, and intellectual indicator

131
Q

Sociocultural indicator

A

a person avoiding meeting with people, family, friends

132
Q

Spiritual indicator

A

a person verbalising discontent with a higher being

133
Q

Emotional indicator

A

anger and crying

134
Q

Intellectual indicator

A

someone setting unreasonable standards for perfection

135
Q

maturational crisis

A

Varies with life stages
In preadolescents: puberty, school, and sex
In adults: major life changes including starting a family, losing their parents, and accepting physical changes

136
Q

situational crisis

A

external sources such as job changes, car crash, illness, caregiver stress

137
Q

General Adaptation System and the responses within the body

A

alarm stage, resistance stage, exhaustion stage

138
Q

alarm stage

A

flight-or-fight reaction, Rising hormone levels result in increased blood volume, blood glucose levels, epi and NE amounts, HR, blood flow to muscles, oxygen intake

139
Q

resistance stage

A

body stabilizes by normalizing and repairing damage, Hormone levels, HR, BP, and cardiac output should return to normal

140
Q

exhaustion stage

A

body is no longer able to resist effects of stressor and has depleted the energy to maintain adaptation

141
Q

what happens if stressor continues into exhaustion stage

A

continuous stress causes progressive breakdown of compensatory mechanisms. Chronic demands leads to chronic activation which can lead to excessive wear and tear on bodily organs called allostatic load.

142
Q

diseases that are related to stress responses

A

Depression, Hypertension, Insomnia, Fibromyalgia, Eating disorder, Low back pain Menstrual irregularities, Infertility

143
Q

type 1 diabetes

A

disorder of glucose metabolism that is related to absent or insufficient insulin supply and/or poor utilization.

144
Q

type 2 diabetes

A

the pancreas produces insulin, but the body doesn’t use it efficiently. Thus there is insulin resistance and then there is hyperinsulinemia (or a lot of insulin).

145
Q

symptoms of hyperglycemia

A

dry mouth, extreme thirst, frequent urge to urinate, drowsiness, frequent bed wetting, abdominal pain

146
Q

symptoms of hypoglycemia

A

“Cold and clammy, patient needs some candy.”

sweating, trembling, dizziness, mood changes, hunger, headaches, blurred vision, extreme tiredness and paleness

147
Q

actions for a patient who has hypoglycemia

A

Consume 15 grams of glucose, in the form of simple carbs for conscious patients. Check after 15 minutes, then repeat 15 grams of glucose if necessary. For unconscious patients: give glucagon D50

148
Q

somogyi effect

A

High blood sugar in early morning- low blood sugar at night causes rebound high blood sugar in the morning

149
Q

Dawn phenomenon

A

High blood sugar early in morning. A decrease in insulin with an increase in glucagon and cortisol cause hyperglycemia in morning

150
Q

type of insulin

A

rapid acting, short acting, intermediate, and long acting

151
Q

rapid acting

A

15 minute onset, peaks in 1 hour and works 2-4 hours

152
Q

short acting

A

‘regular’ - w/in 30 min, peaks 2-3 hrs, works 3-6 hours- Humulin R and Novolin R

153
Q

intermediate acting

A

2-4 hours, peaks 4-12 hrs, works 12-18 hrs - humulin N

154
Q

long acting

A

several hrs after, lowers B glucose over course of 24 hrs- Glargine

155
Q

Basal

A

mimics what pancreas does to keep blood sugar in normal range when a person’s not eating - Lantus/Levemir

156
Q

Bolus

A

mimics the increase of insulin the pancreases sends out in response to food - Humalog/Novolog

157
Q

Metformin

A

Oral (used as first line treatment for type II, Type I canNOT take this)

158
Q

what class is metformin

A

Biguanide

159
Q

normal Hbg A1C

A

6.5%

160
Q

amount glycosylated hgb depends on

A

B-glucose level

161
Q

DKA

A

Increase in ketones (can’t metabolize glucose - using fat, ketones are acidic) causes metabolic acidosis, osmotic diuresis causes hypovolemia and electrolyte depletion. Renal failure is possible. High respiratory rate and fruity breath.

162
Q

HHNKS

A

hyperosmolar hyperglycemic nonketotic syndrome - there is enough insulin to prevent DKA, but not enough to prevent severe hyperglycemia, osmotic diuresis, fluid depletion/hypovolemia, electrolyte depletion. Older adults with impaired renal function usually, so be mindful of renal function when treating.

163
Q

DKA treatment

A

fluid and electrolyte replacement - especially K+, insulin to correct hyperglycemia after fluid balance is improved, insulin allows water to enter the cells

164
Q

HHNKS treatment

A

fluid replacement is key! - then, insulin treatment - then, management of electrolyte levels. Give IV insulin until glucose levels are between 250 and 300 until pt is alert

165
Q

macrovascular effects of Diabetes.

A 
Large-medium sized blood vessels
Ischemic heart disease
Cerebrovascular disease
Peripheral vascular disease- atherosclerotic and blood clots
HTN
166
Q

microvascular effects of Diabetes

A

Eyes (retina) -> retinopathy which can lead to glaucoma
Nerve cells -> neuropathy which can lead to injury
Kidney -> nephropathy which leads to renal failure
Skin -> Dermopathy which leads to potential skin impairment

167
Q

Sliding scale

A

Dosage for the patients glucose levels. It does have have conflicts because it can lead to inconsistent glucose readings

168
Q

Basal bolus insulin

A

Pt will receive a basal insulin that mimics what the pancreas does to keep the blood sugar within normal range. This is long-lasting insulin injection.
The bosul insulin mimics the increase in insulin that the pancreas will send in response to food. Short lasting.
Correctional insulin is given for high blood sugars in addition to the bolus.

169
Q

educational priorities for patients with Diabetes

A 
Take blood glucose 3-4 xday
Know cost of strips (approx. $1 per strip)
Keep strict regime
Maintain med regim
Take fluids and limit simple carbs
Check ketones
170
Q

treatment plan for a patient with Diabetes type 1

A

Insulin regimen developed to coordinate w/ pt’s eating pattern-needs to be stable
Limit alcohol intake
Education!

171
Q

treatment plan for a patient with Diabetes type 2

A 
Calorie reduction
Limit alcohol intake
Reduction of total fat, unsaturated fat, and simple carbs
Regular exercise
Monitoring of glucose, A1C, lipds
Education
172
Q

HAIs

A

hospital acquired infection. primary cause of preventable death and disability among hospitalized patients.

173
Q

CLABSI

A

central line associated bloodstream infection. Microorganisms can enter the bloodstream and contaminate CVCs through 2 mechanisms: extraluminally or intraluminally.

174
Q

extraluminally

A

most common - patient’s skin organisms at the insertion site migrate into the area surrounding the catheter tip

175
Q

intraluminal

A

Intraluminal contamination occurs from direct contamination of the catheter through the intravenous (IV) system (needleless systems, hubs, connections).

176
Q

actions to prevent CLABSI

A

optimal site selection, maximal barrier precautions, hand hygiene, sterile prep of the insertion site, observer monitoring procedure

177
Q

CAUTI

A

catheter associated urinary tract infection. occurs in a patient who had an indwelling catheter in place 48 hours prior to the UTI diagnosis and up to 30 days post removal or discharge

178
Q

actions to prevent CAUTI

A

hand hygiene, use smallest bore catheter as possible, indwelling urinary catheter must be secured, date the fully collection bag, check skin condition around the device, remove catheter as soon as possible.

179
Q

signs of UTI

A

fever, suprapubic tenderness, acute hematuria, alter mental status, dysuria, urgency

180
Q

CAUTION

A

C- Close system catheter selection consider alternatives
A- Aseptic management
U- Universal standard precautions
T- Tie secure catheter to patient tubing to bed
I- Indication for use and to discontinue
O- Obstruction free specimen from sampling port
N- No dependent loops

181
Q

SSI

A

surgical site infection. as infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure

182
Q

actions to prevent SSI

A

Before surgery, patient should shower or bathe, skin preparation, antimicrobial prophylaxis should be administered only when indicated, glycemic control should be implemented, Normothermia should be maintained in all patients, oxygen should be administered during surgery

183
Q

Cognitive teaching method

A

Discussion- one-on-one. Lecture. Question and Answer

184
Q

affective teaching method

A

Role Play. Group Discussion. Discussion (one-on-one)

185
Q

psychomotor teaching method

A

Demonstration.Practice( perform skills in a controlled setting) Independent project and games(requires teaching method)

186
Q

teach back

A

explain, assess for clarity, clarify, reassess: confirms that your patient clearly understood what you taught. The nurse should ask the patient to demonstrate what they just learned or repeat it in his or her own words

187
Q

3 main purposes of pt education

A

health promotion and illness prevention, health respiration, and coping

188
Q

FEV1

A

FEV1 is the maximal amount of air you can forcefully exhale in one second. low in COPD patients

NURSING School (17 decks)

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