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Pharmacology > Activity and Fatigue Review > Flashcards

Activity and Fatigue Review Flashcards

1
Q

Define Activity.

A

Exercise capability is dependent on VO2 max.

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2
Q

What is VO2 max?

A

-Circulation capacity
-The lung capacity
-The amount of oxygen delivered to working muscles
It examines the circulation and lung capacity required to match the demands of the working muscles
represented as (L/min)

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3
Q

Neurological Sequelae during Activity

A
  1. CNS command centers are stimulated during activity
  2. The hypothalamus is stimulated and signals the brainstem
  3. The brainstem stimulates the SNS
  4. The adrenal gland will be stimulated and secrete catecholamines
  5. Epinephrine causes vasoconstriction of arterioles and vasodilation of the bronchioles
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4
Q

Cardiovascular changes during activity.

A
  • Increased O2 consumption

- Increased perfusion demand to meet metabolic needs

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5
Q

How does the body meet cardiovascular demands during activity?

A
  • Increased CO
  • Increased HR
  • Increased SV
  • Increased BP
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6
Q

What causes muscular fatigue?

A

Energy is created from stored ATP sources. During glycolysis, glucose is converted to ATP as well as pyruvate. Excess pyruvate is converted to lactic acid which causes muscle fatigue.
-With pyruvate accumulation, the amount of lactic acid produced is also increased. This lactic acid accumulation in the muscle tissue reduces the pH, making it more acidic and producing the stinging feeling in muscles when exercising.

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7
Q

Define fatigue.

A

Activity intolerance due to exhaustion.

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8
Q

3 causes of Fatigue

A
  1. Physiological: inadequate ATP to generate muscle activity
  2. Psychological: inadequate CNS ability to generate activity
  3. Pathological: Alterations to normal function
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9
Q

Types of Fatigue.

A
  • Acute: sudden onset, clear cause, rest leads to recovery
  • Chronic: unclear onset, unclear cause, rest does not lead to recovery, when resting the lethargy feeling accumulates and interferes with ADLs
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10
Q

Chronic Fatigue Syndrome

A

Myalgic Encephalomyelitis or Systemic Exertion Intolerance Disease
- Defined as severe fatigue that lasts more than 6 months and effect ADLs

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11
Q

Signs and Symptoms of Chronic Fatigue Syndrome

A
  • Chronic Fatigue for more than 6 months with effect on ADLs
  • Post-exercise malaise
  • Unrefreshing sleep
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12
Q

Treatment for CFS

A

Cognitive behavioural therapy (CBT)

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13
Q

How much of the body is made up of the MSK system?

A

The musculoskeletal system is made up 70% of body mass.

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14
Q

What is included in the MSK?

A 
Bones 
Cartilage 
Articulation
Ligaments 
Tendons 
Muscles
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15
Q

Define Fracture.

A

A fracture is a broken bone. They occur when the physical force exerted on the bone is stronger than the bone itself. They commonly happen because of car accidents, falls, or sports injuries.

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16
Q

Acute VS Chronic Fractures.

A

Acute: Occurs with the sudden impact causing breakage of the bone. The impact can also cause bruising (contusions) and dislocations
Chronic: Result from overusing one body area over a long period of time. They can also arise when an acute fracture does not have enough time to heal properly.

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17
Q

Fracture Signs and Symptoms.

A
  • Severe pain (initial numbness due to shock)
  • Inflammation
  • Hematoma
  • Deformity
  • Loss of Function
  • Injury to Surrounding Tissues
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18
Q

Nursing Interventions for Fractures.

A
  • Conduct an Xray to identify the type of fracture

- Mobilize the area

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19
Q

Types of Fracture.

A
  • Open/Compound: skin is broke
  • Compression: 2 bones crushed together
  • Impacted: Fracture fragments crushes together
  • Unstable Fractures: spiral, comminuted (fragmented)
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20
Q

How to Treat a Fracture.

A
  • Pain management (Analgesics)
  • Inflammation Management (Anti-inflammatories)
  • mobilization
  • Manage complications
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21
Q

Local Anesthesia.

A

the temporary suppression of sensation at a specific region of the body by pharmacological intervention. This type of anesthesia does not induce unconsciousness in the patient.

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22
Q

Nerve Block.

A

An injection decreases inflammation and acts as a neuronal blockade to inhibit pain signals. Does not induce unconsciousness

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23
Q

Spinal Block.

A

Epidural and spinal blocks are types of anesthesia in which a local anesthetic is injected near the spinal cord and nerve roots. It blocks pain from an entire region of the body, such as the belly, the hips, the legs, or the pelvis. Does not induce unconscious.

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24
Q

General Anesthesia.

A

A combination of medications (via Iv or inhalation) to put the patient in an unconscious state before surgery or other medical procedure.

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25
Q

Define Reduction.

A

Reduction means restoration of alignment

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26
Q

Closed Reduction.

A

is a procedure to set (reduce) a broken bone without cutting the skin open. The broken bone is put back in place, which allows it to grow back together.

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27
Q

Open Reduction.

A

An open fracture reduction puts pieces of a broken bone into place using surgery. Screws and a plate or external support frame may be needed to hold the pieces in place.

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28
Q

Nursing Interventions for Fractures.

A

!Immobilize the area! It is essential to maintain alignment.
(Use a splint, cast, brace)

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29
Q

What is the average healing time for fractures?

A

Up to 6 months for long bones with small adhesions

Up to 4 weeks for stress fractures

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30
Q

What are the 6 major complications involved with fractures?

A
  1. Hypovolemic shock
  2. Fat embolisme Syndrome
  3. Compartment Syndrome
  4. Thromboembolism
  5. Complex Regional Pain Syndrome
  6. Fracture Blisters
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31
Q

Hypovolemic Shock.

A

Blood loss due to hemorrhage. Hypovolemic shock resulting from hemorrhage is more frequently noted in trauma patients with pelvic fractures and in patients with displaced or open femoral fractures.

32
Q

Treatment for Hypovolemic Shock.

A

IV resuscitation: isotonic crystalloid fluids (water-based IV solutions)

33
Q

Fat Embolism Syndrome

A

adipose tissue or bone marrow tissue migrate into circulation and create fat emboli.

34
Q

Signs and Symptoms of Fat Embolism Syndrome.

A

Chest pain, SOB, Decreased O2 stats, Cyanosis, Pallor, Changes in LOC and rash through the body and oral cavity

35
Q

Treatment for Fat embolism syndrome.

A
  • Prevention is best
  • Early stabilization
  • O2 administration
  • Glucocorticoids
36
Q

Compartment Syndrome.

A

Compartment syndrome develops when excessive swelling or bleeding increases the muscle volume beyond the ability of the fascia to stretch. As a result, pressure within the closed compartment rises, impairing blood flow. Without oxygen and nutrients from the blood, muscle and nerve cells cannot function properly and eventually die.

37
Q

Compartment Syndrome Etiology.

A

post-injury, common with immobilization devices. Takes hours to days to develop

38
Q

Signs and Symptoms of Compartment Syndrome.

A
  • Worsening Paim
  • Loss of sensation
  • Loss of motor function
  • Loss of reflexes
  • Risk of total tissue loss if not treated
39
Q

Compartment Syndrome Treatment.

A

Relive pressure immediately!

40
Q

Thromboembolism.

A

DVT’s or Pulmonary embolisms

Caused by decreased mobility due to injury. Causing blood stasis and weakened vessel tone.

41
Q

Thromboembolism Treatment.

A
  • Anticoagulants: Heparin and Enoxaparin
  • Compression stocking and pneumatic compression devices
  • Early ambulation
42
Q

Complex Regional Pain Syndrome

A

Increased level of pain that doesn’t suit the type of injury.

43
Q

Signs and Symptoms of Pain Syndrome.

A

Extreme pain; severe, burning, aching, pain elicit with low stimulus, changes to skin and tissue

44
Q

Complex Regional Pain Treatment

A
  • Physiotherapy for mobilization

- Chronic pain treatment (non-opioid)

45
Q

Fracture Blisters.

A

They are areas of skin bullae (bubbles) that arise where there is markedly swollen skin over a fracture or severe sprain. The skin adheres tightly to the bone with little subcutaneous fat cushioning. The blister that results resembles that of a second-degree burn.

46
Q

Traumatic Tension Pneumothorax.

A

Traumatic pneumothorax is air in the pleural space resulting from trauma and causing partial or complete lung collapse.
Injury to the chest wall causes air to enter the pleural space but no exit.
The increased pressure within the pleural space compresses the lungs, causing lung collapse.

47
Q

Pneumothorax

A

Air in the pleural space caused my trauma or injury

48
Q

Hemothorax.

A

blood in the pleural space, caused by hemorrhage.

  • Risk of hypovoemia and hypovolemic shock
  • Risk of low CO and cardiogenic shock
49
Q

Risks of Traumatic Tension Pneumothorax.

A
  1. Hypoxemia (inadequate oxygenation)
  2. Cyanosis (inadequate oxygenation)
  3. Compresses the myocardium, therefore creating an effect on CO
    - Risk of cardiogenic shock due to inadequate cardiac output
50
Q

Signs and Symptoms of Pneumothorax.

A 
SOB 
Declining O2 stats 
Tracheal Shift 
Signs of Cardiogenic shock 
-Tachycardia 
-Low BP
-Altered LOC
51
Q

Treatment for Pneumothorax.

A
  1. Administer Oxygen
  2. One-way valve seal
  3. Chest Tube
52
Q

One-way valve seal.

A

prevents fluid and air from going back into your chest. The chest tube drains air and fluid from around the lung. The valve allows the fluid and air to come out of the body into a drainage bag.

53
Q

Chest Tube.

A

A small chest tube is inserted near the second intercostal space to drain the fluid and air. The priority is to maintain the airway, breathing, and circulation. The most important interventions focus on reinflating the lung by evacuating the pleural air.

54
Q

Laceration.

A

Tearing of the skin results in an irregular wound. Lacerations may be caused by injury with a sharp object or by impact injury from a blunt object or force.

55
Q

Nursing considerations for Lacerations.

A
  • Infection
  • Soft Tissue Trauma
  • Nerve Trauma
  • Bleeding

Assess: Size, depth, deformity and contusions

56
Q

Treatment for Lacerations.

A
  1. Asepsis
  2. Decontamination if necessary
  3. Prevention
  4. Closure
  5. Pharmaceutical Intervention
57
Q

Asepsis.

A

Cleansing wound with NS irrigation

58
Q

Decontamination.

A
  • Debridement: The removal of foreign material or contaminated tissue from traumatic or infected lesions until surrounding healthy tissue is exposed
  • Antimicrobials: an agent that kills microorganisms or stops their growth
59
Q

Pharmaceutical Intervention for Lacerations

A

A. Local anesthesia (for pain)
B. Epinephrine
C. Analgesia Post Intenvetion (suture and staples)

60
Q

Contusion.

A

Bruising. Forceful impact causes local hemorrhage which results in bruising (ecchymosis)

61
Q

Signs and Symtpoms of Contusion.

A

Discoloration of the skin
Pain in a localized area
Inflammation

62
Q

Treatment for Contusion.

A
  1. Control Inflammation
    a. Immediate cold compress (to decrease bleeding and inflammation)
    b. After 24 hours alternate between warm and cold compressions (10-20 mins each)
  2. Pharmaceutical Intervention: NSAIDs
  3. Aspiration with a needle: if there is an excessive accumulation of fluids they can be aspirated with a thin needle
63
Q

Strain.

A

Mechanical overload of the muscles or muscle tendon. Caused by excessive stretching or contraction. This excessive extension causes tearing to the fascia, muscle and joint structures

64
Q

Signs and Symptoms of Strain.

A

Inflammation
Pain
Increased pain with aggravating activity

65
Q

Common Strains.

A

Muscles in the lower back, c-spine, joints, elbows, shoulders and feet. Individuals who play high-risk sports are more susceptible to strain

66
Q

Strain Assessment.

A

Assess pain
Check for signs of edema
Check for ecchymosis
Asses for decreased joint motion and function
Feeling of joint looseness with a severe sprain

67
Q

Nursing Intervention For Strains.

A 
Remember RICE
R: rest
I: ice
C: compression
E: elevation
68
Q

Sprain.

A

Mechanical overload of a joint. The ligaments that surround a joint are injured by a wrenching or twisting motion.

69
Q

Signs and Symptoms for Sprain.

A

Pain
Inflammation
Contusion
Decreased Function

70
Q

Common Sprains.

A

Ankle (inversion), knee (ACL), elbow and wrist

71
Q

Dislocation.

A

Complete displacement of the joint

72
Q

Subluxation.

A

A subluxation is an incomplete dislocation

73
Q

Etiology of Dislocation.

A

A dislocation is an injury in which the ends of your bones are forced from their normal positions. The cause is usually trauma resulting from a fall, an auto accident, or a collision during contact or high-speed sports.

74
Q

Common Dislocations.

A

Ball and socket joints

75
Q

Manual Closed Reduction.

A

a procedure to set (reduce) a broken bone without cutting the skin open. The broken bone is put back in place, which allows it to grow back together.

Pharmacology (27 decks)

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