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All topics Flashcards

1
Q

Influencers on growth and development?

A 
> genetics 
> nutrition
> health 
> family 
> environment 
> culture
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2
Q

Growth definition

A

Can be defined as the physical changes which occur and include; height, weight, bone size and dentition (the arrangement/condition of the teeth in a particular individual)

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3
Q

Development definition

A

A complex process which results in an individual developing

  • increasingly complex functionality and skill progression
  • the skills and capacity to adapt to the environment
  • behaviourally, including the ability to adapt to walk, talk and run
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4
Q

Erikson developmental stage

A

13-21 years - identity vs role confusion
21-39 years - intimacy vs isolation
40-65 years - generativity (is a concern for the future, a need to nurture and guide young people) vs stagnation (is a non acceptance of ageing)

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5
Q

Eriksons beliefs…

A
  • inner and outer conflict influences growth and development
  • life is a sequence of development stages
  • resolution of each stage can be complete, partial or unsuccessful
  • the degree of resolution of each stage influences the progression to the next level
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6
Q

Buhlers beliefs…

A

Buhler identified that for most people, self-actualisation and self-determination occurs through:

  • choosing life goals
  • working towards the goals
  • evaluating the achievement of the goals
  • redefining previously unachieved goals and developing new goals.
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7
Q

Buhlers developmental stages

A

Birth- 15 years - pre self-determination
15-25 years - tentative self-determination (uncertain/cautious)
25-50 years - definitive (reached) self-determination
50-65 years - assessment stage
65 - death - post self-determination

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8
Q

Levinsons beliefs…

A
  • Growth and development stop when we enter adulthood
  • stable periods vs development upheaval (violent or sudden change)
  • evaluation and change
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9
Q

Levinsons developmental stages

A
  1. Early Adult Transition (Age 17-22). a person leaves adolescence and begins to make choices about adult life.
  2. Entering the Adult World (Age 22-28). a person makes more concrete decisions regarding their occupation, friendships, values, and lifestyles.
  3. Age 30 Transitions (Age 28-33). Stage involves greater lifestyle changes i.e. marriage or children and these changes have differing consequences on how a person develops depending on how they embrace the event.
  4. Settling Down (Age 33-40). In this stage, one often begins to establish a routine, makes progress on goals for the future, and begins behaving like an adult.
  5. Mid-Life Transition (Age 40-45). person evaluates life, values may change. people begin to think of death and having a legacy
  6. Entering Middle Adulthood (Age 45-50). In this stage, choices must be made about the future and possibly retirement. People begin to commit to new tasks and continue to think about the legacy they are leaving.
  7. Late Adulthood (Age 60+). In this stage, one begins to reflect on life and the decisions they have made.
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10
Q

What is a tracheostomy

A

It is a surgical opening below a persons larynx into their trachea, usually into the 2nd or 3rd tracheal ring below the cricoid cartilage

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11
Q

Why is a tracheostomy placed

A
  • overcome an obstruction
  • facilitate mechanical ventilatory support
  • enable the removal of trachea-bronchial secretions
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12
Q

A tracheostomy can be required temporally or permanently … why?

A
  • head and neck surgery
  • maxillofacial trauma (face trauma)
  • congenital anomaly (medical condition occurring before/at birth)
  • supraglottic or glottis pathologic condition such as an infection or cancer
  • upper airway oedema from trauma, burns, infection or anaphylaxis
  • reduced respiratory resistance
  • improve ability to communicate
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13
Q

Humidification of a tracheostomy

A

Each patient with a tracheostomy should receive adequate humidification, checked and documented every 2 hours. Active temp = 37 degrees, H2O level = 1/3

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14
Q

The airways

A

Upper airway is above the larynx and the lower airway is below the larynx ( the larynx is the voice box at the top of the throat)

Conducting portion is from the nasal cavity to the terminal bronchioles
Respiratory portion is from the respiratory bronchioles and alveoli

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15
Q

The upper airways

A 
nostrils 
nasal cavity and sinus 
soft palate 
pharynx (the throat) 
vocal cords
cilia 
glotis 
trachea 
larynx 
cartilages 
epiglotis 
tonsils
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16
Q

The lower airways

A 
carina (found at the base of the trachea separating the lungs into right and left, most foreign objects likely to fall into the right lung because of how it splits) 
bronchioles 
pleura 
lungs 
bronchi 
alveoli 
diaphragm
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17
Q

Breathing terminology

Eupnea
Hyperpnea
Hyperventilation
Hypoventilation

A

Eupnea - normal/resting quiet breathing
Hyperpnea - increased respiratory rate and/or volume in response to increased metabolism (from exercise)
Hyperventilation - increased respiratory rate and/or volume without an increased metabolism
Hypoventilation - decreased alveolar ventilation (shallow breathing; asthma; restrictive lung disease)

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18
Q

Breathing terminology

Tachypnea
Dyspnea
Apnea

A

Tachypnea - rapid breathing, usually increased respiratory rate with a decreased depth (panting)
Dyspnea - difficulty breathing (hard exercise)
Apnea - cessation of breathing (voluntary breath-holding; depression of CNS control centres)

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19
Q

Respiratory volumes

Tidal Volume (TV)
Inspiratory reserve volume (IRV)
Expiratory reserve volume (ERV)
Residual volume (RV)

A

Tidal Volume (TV) - amount of air inhaled or exhaled with each breath under resting conditions (500 ml)
Inspiratory reserve volume (IRV) - amount of air that can be forcefully inhaled after a normal tidal volume inhalation (male 3100ml female 1900ml)
Expiratory reserve volume (ERV) - amount of air that can be forcefully exhaled after a normal tidal volume exhalation (m 1200ml f 700ml)
Residual volume (RV) - amount of air remaining in the lungs after a forced exhalation (m 1200ml f 1100ml)

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20
Q

Boyles law

A

Increased in the air pressure within the lungs = decreased the volume of the lungs or increased in the volume of the lungs = decreased pressure within the lungs

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21
Q

Pneumothorax

A

Is a collapsed lung. Air enters the potential space between the parietal and visceral pleura (lungs and chest wall)

  • Iatrongenic pneumothorax caused by medical procedure
  • primary spontaneous pneumothorax, patient without an underlying lung disease
  • secondary spontaneous pneumothorax occurs as a complication of underlying lung disease
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22
Q

Tension pneumothorax

A

Gradual build up of air in the pleural space.
1 air enters pleural space on inspiration
2 air cannot escape on expiration
3 intra-pleural pressure increased
4 lung collapse
5 mediastinal content shift
6 compression of heart, great vessels, trachea

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23
Q

Treatment for a pneumothorax

A
  • needle thoracotomy (surgical incision of the chest wall)
  • 2nd rib space mid-clavicular line
  • sometimes 5th ICS
  • chest tube insertion
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24
Q

Hypoxia
Hypoxaemia
Hypercapnia

A

Hypoxia - low oxygen at tissue level
Hypoxaemia - low oxygen in the blood
Hypercapnia - high level of CO2 in the blood

*Hypoxia RAT = signs of early BED = sings of late
Restlessness, Anxiety and Tachycardia (rapid heart rate) /tachypnea (rapid breathing)
Bradycardia (slow heart rate), Extreme restlessness and Dyspnea

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25
Q

Oxygen therapy

A

Low flow

  • nasal canula
  • simple mask
  • non-rebreather
  • partial non-rebreather

High flow

  • venture mask
  • CPAP (Continuous positive airway pressure)
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26
Q

10 main steps of failure to rescue

A

1 monitoring technology not present
2 ward monitoring is intermittent (vital signs)
3 intervals of vital signs is 8+ hours
4 rounds by RN vary in frequency and duration
5 DR’s visit daily
6 Vital signs measured by incomplete
7 no criteria for abnormal vital signs
8 individual judgement applied to a crucial decision
9 individual judgement varies in accuracy
10 if alert is activated, goes through a long chain of command

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27
Q 
The Nursing Process 
A
D
P
I
E
A

Assessment - evaluate the clients condition
Diagnosis - identify the client’s problems
Planning - set goals of care and desired outcomes and identify appropriate nursing actions
Implementation - perform the nursing actions identified in planning
Evaluation - determine if goals met and outcome achieved

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28
Q

Critical thinking

A

Skills include;

  • reflection
  • creativity
  • critical analysis
  • reasoning
  • divergent thinking and clarifying such as differentiating facts from opinion
  • evaluating credibility of sources
  • clarifying concepts and recognising assumptions
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29
Q

Clinical pathways

A

Standardised, evidence based multidisciplinary management plans, which identify an appropriate sequence of clinical interventions, timeframes, milestones and expected outcomes for a same patient group

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30
Q

Variance analysis

A

Quantitive investigation of difference between planned and actual behaviour

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31
Q

Hypertension risk factors…

A

Major risk factor in the development of stroke or chronic heart disease. Controllable contributing factors: obesity, smoking and stress

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32
Q

Blast injures

A

Caused by an explosion resulting in four categories.
1 primary 2 secondary 3 tertiary 4 miscellaneous
typically focusses on the lungs

33
Q

Under Water Seal Drain (UWSD)

A
  • any output of more than 70 ml/h needs to be reported
  • inserted through the chest wall between the ribs and into the plural space
  • 3 chambers.
    1st allows drained fluids from the chest to collect
    2nd is a water seal, acts as a one way valve allowing gas to escape but not to reenter the chest. Air will bubble when the patient coughs or exhales
    3rd is a suction control chamber. Height of water in this chamber regulates negative pressure applied to the system. Gentle bubbling indicates suction.
34
Q

Pleural effusion

A

Accumulation of fluid in the pleural space

35
Q

Chylothorax

A

Collection of lymphatic fluid in pleural space

36
Q

Empyema

A

Infection of the pleural space

37
Q

Hemothorax

A

Blood in the pleural space

38
Q

Hydrothorax

A

Serous fluid in pleural space

39
Q

Cardiovascular heart disease

A
  • damage or disease in hearts major BV

- usual cause is a build up of plaque causing coronary arteries to narrow, limiting blood flow to the heart

40
Q

Metabolic syndorme

A
  • collection of conditions that often occur together and increase your risk of diabetes, stroke and heart disease
  • main components include obesity, increased BP, increased blood triglycerides (type of fat found in your blood. Your body uses them for energy), low levels of HDL cholesterol and insulin resistance
  • also called syndrome x
41
Q

Hyperlipidemia

A

When the concentration of triglycerides or cholesterol in your blood is too high. Found when patient is overweight or has poor diet or too much alcohol. Rarely genetics
(triglycerides type of fat found in your blood. Your body uses them for energy. )

42
Q

Medication - Statins

A
  • lipid lowering medication
  • reduces cardiovascular disease and mortality in those who are at high risk
  • must be monitored for serum cholesterol and liver enzymes
43
Q

Blood test BUN

A
  • Blood Urea Nitrogen

- reveals how well your kidneys and liver are working

44
Q

Blood Test CK

A
  • Creatine Kinase
  • ordered when muscles damage is suspected
  • detects inflammation of muscles (mitosis) or muscle damage due to muscle disorders
45
Q

Troponin Blood Test

A
  • Measures the amount of troponin T or troponin 1 proteins in the blood
  • troponin is released when the heart muscle is damaged
  • the more damage the more troponin
46
Q

ECG: what do the waves mean?

A

In order:
P wave is the atrial contraction
QRS is the contraction of the ventricles
T is the relaxation of the ventricles

47
Q

What is Atherosclerosis

A

Atherosclerosis, the​ build-up of fatty plaque within the​ arteries, is the major contributor to cardiovascular disease and the leading cause of death in Australia.
* Elevated homocysteine levels are increased in many people with atherosclerosis.

48
Q

Heart sounds

A

The main normal heart sounds are the S1 and the S2 heart sound. The S3 can be normal, at times, but may be pathologic. A S4 heart sound is almost always pathologic or diseased

49
Q

Normal Electrolyte Values

A

The normal electrolyte values for adults are 135dash–145 ​mmo/L for​ sodium, 3.8dash–4.9 ​mmo/L for​ potassium, 95dash–110 ​mmo/L for chloride and 2.10dash–2.55 ​mmo/L for calcium.

50
Q

Cluster respirations

A

an abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea.

51
Q

Cheyne–Stokes respiration

A

is an abnormal pattern of breathing characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea.

52
Q

Apneustic respiration

A

is an abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release.

53
Q

Central neurogenic hyperventilation (CNH)

A

is an abnormal pattern of breathing characterized by deep and rapid breaths at a rate of at least 25 breaths per minute. Increasing irregularity of this respiratory rate generally is a sign that the patient will enter into coma.

54
Q

Decerebration

A

is the elimination of cerebral brain function in an animal by removing the cerebrum, cutting across the brain stem, or severing certain arteries in the brain stem.

55
Q

Decerebrate posture

A

is an abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward. The muscles are tightened and held rigidly.

56
Q

Migraine Headaches

A
  • type of headache has a strong familial​ connection, affects females​ three-to-one over​ males, and results in lost​ productivity
  • the main symptom is pain on both sides of the head that may be associated with muscle pain.
57
Q

Status epilepticus (SE)

A

is a single epileptic seizure lasting more than five minutes or two or more seizures within a five-minute period without the person returning to normal between them. Medication used to treat is Diazepam (valium IV)

58
Q

Focal onset seizure

A

Seizure activity starts in one (focal) area of the brain and may spread to other regions of the brain. These seizures can often be subtle or unusual and may go unnoticed or be mistaken for anything from intoxication to daydreaming.

Classified as:

Focal aware seizures – awareness is retained (formerly called simple partial seizures)
Focal impaired awareness seizures – awareness is altered during any part of the seizure (formerly called complex partial seizures)

59
Q

Generalised onset seizure

A

Generalised seizures are the result of abnormal activity in both hemispheres of the brain simultaneously. Because of this, consciousness is often lost at the onset of the seizure. Generalised seizures are divided into motor and non-motor (absence) seizures

There are many types of seizures classified as generalised, including:
Absence
Tonic-Clonic

60
Q

Deceleration injury

A

Deceleration injury is a traumatic injury to the brain, typically following an acceleration injury to the brain in a high-speed situation such as a motor vehicle accident or high-impact sports.

61
Q

Acceleration Injury

A

This injury is commonly referred to, or associated with whiplash. Whiplash involves the transfer of acceleration and deceleration forces; usually this is caused by car accidents which cause the body to be thrust forward and then backwards in quick succession.

62
Q

Vagus Nerve Stimulation (VNS)

A

Vagus nerve stimulation prevents seizures by sending regular, mild pulses of electrical energy to the brain via the vagus nerve.

63
Q

Eschar

A

Eschar is dried plasma proteins and dead cells. Occurs particularly after burns

64
Q

Shearing Forces

A

Shearing forces are friction and pressure applied to the interface of superficial and deep body tissues resulting in damage to blood vessels and tissues. This contributes to the development of pressure ulcers. Other factors that contribute to their development include altered​ nutrition, specifically a lack of adequate protein intake​; decreased oxygen supply to​ tissues; and excess body heat.  

65
Q

Terms to describe a wound

A

A contaminated wound is an open surgical incision where spillage from a body system tract​ (gastrointestinal, respiratory,​ urinary, genital) has​ occurred. Inflammation is present.
A​ clean-contaminated wound does not have an entry into the gastrointestinal​ tract, is closed with minimal inflammation.
A penetrating wound involves entry of a foreign object such as a bullet or metal fragment.
A contusion is a closed wound with bruising due to damaged blood vessels. 

66
Q

Wound Classification

A

Wounds are classified by how they are acquired​, which includes​: the layers of tissues​ involved; whether they were intentional or​ unintentional; and the likelihood and degree of wound contamination. The type of drainage is not used to classify a wound and has its own system of classification.

67
Q

Types of injury involving skin

A

Superficial or partial​-thickness wounds involve the dermis and epidermis​, which are the outer layers of the skin. Examples of this type of wound would be​ abrasions, blisters and sunburn. Wounds of the subcutaneous​ layer, adipose tissue and tendons are considered full​-thickness wounds and can extend into the bone below.      

68
Q

Pressure ulcers stage 1

A

skin temperature (warmth or coolness), tissue consistency (firm or boggy feel) and/or sensation (pain, itching). The ulcer appears as a defined area of persistent redness in lightly pigmented skin, whereas in darker skin tones, the ulcer may appear with persistent red, blue, or purple hues

69
Q

Pressure ulcers stage 2

A

Partial thickness skin loss involving epidermis, dermis, or both. The ulcer is superficial and presents clinically as an abrasion, blister or shallow crater.

70
Q

Pressure Ulcers stage 3

A

Full thickness skin loss involving damage to, or necrosis of, subcutaneous tissue that may extend down to, but not through, underlying fascia. The ulcer presents clinically as a deep crater with or without undermining of adjacent tissue.

71
Q

Pressure Ulcers stage 4

A

Full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures (e.g. tendon, joint capsule). Undermining and sinus tracts also may be associated with Stage IV pressure ulcers.

72
Q

Types of drainage from a wound

A

Purulent exudate is thick as it contains puslong dash—a collection of​ leukocytes, tissue​ debris, dead and living bacteria. It may vary in color from​ blue, green or yellow. Serous exudate is the clear serum portion of blood and appears watery.
Sanguineous exudate contains blood cells due to capillary damage.​
Sero-sanguineous is a mixed type of drainage consisting of clear fluid and bloody drainage.

73
Q

What is primary intention, secondary intention and tertiary intention healing?

A

Healing by first intention or Primary intention healing happens when the wound edges are approximated e.g. by sutures, staples or glue.

Healing by second intention or Secondary intention healing takes place when the wound edges cannot be approximated and the wound needs to heal from the bottom.

Tertiary intention healing is a combination of both of the above, i.e. the wound cannot be stitched up immediately but it can after a while.

74
Q

Minerals to promote wound healing

A

An increased intake of the minerals​ iron, zinc and copper is needed for wound healing. Foods rich in these minerals include red and organ​ meats, dried peas and​ beans, and nuts. Vitamins A and C are also needed for wound healing and they can be found in citrus fruits and​ juices, plant foods such as carrots and​ broccoli, egg​ yolks, milk, cheese and watermelon

75
Q

Pain in shoulder after eating?

A

Due to GERD or gastroesophageal reflux disease. Causes reoccurring hurt that causes radiating pain into your breast bone which can be felt in the shoulder or arm.

76
Q

Lithotripsy

A

Ultrasound shock waves cause calculus or stone to break down into smaller pieces so that the body can process it

77
Q

Hypovolemic shock, also known as hemorrhagic shock

A

is a life-threatening condition that results when you lose more than 20 percent (one-fifth) of your body’s blood or fluid supply. This severe fluid loss makes it impossible for the heart to pump a sufficient amount of blood to your body. Hypovolemic shock can lead to organ failure.

78
Q

Thrombophlebitis

A

A condition in which a blood clot in a vein causes inflammation and pain.

Health of Adults (1 decks)

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