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HA Final > Beginning the PE, General Survey, VS, Pain; Nutrition; Communication > Flashcards

Beginning the PE, General Survey, VS, Pain; Nutrition; Communication Flashcards

1
Q

Systolic

A

max pressure on artery during L ventricular contraction (SQUEEZE)

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2
Q

Diastolic

A

resting pressure that blood exerts constantly between each contraction (RELAX)

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3
Q

False high bp (6 things)

A

● Cuff too small (narrow)
● Cuff too loose or uneven - not the same as too large
● Arm below heart level
● Inflating or deflating too slow= high diastolic
● Deflating cuff too quickly= low systolic, high diastolic
● crossed legs

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4
Q

False low bp (4 things)

A

● Cuff too large (wide)
● Repeating BP too quickly - give 1-2 min
● Inaccurate level of inflation (radial pulse - put enough air)
● Pressing stethoscope too tightly

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5
Q

What is normal difference of mmhg in orthostatic hypotension?

What is ABnormal?

A

normal is 10 mmHg drop in systolic value or pulse

abnormal is 20 mmHg or >20bmp → not circulating to brain properly

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6
Q

Method for measure postural hypotension?

A

■ lying - rest for 2-3 min and take bp
■ Sitting - take bp & hr
■ Standing - take bp & hr

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7
Q

Things that affect pulse rate

A

drugs, disease, exercise, age, gender, temp, BP, electrolytes, edema…etc

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8
Q

Things that affect RR

A

exercise, age, physical shape, sex, smoking

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9
Q

Normal Temp

Things that affect temp

A

37 C

■ DIURNAL CYCLE (patterns of activity/behavior that follow day/night cycles)
■ menstrual cycle (elevate)
■ exercise (elevate)
■ age (elderly have lower core body temp)
■ location of temperature taken - rectal is higher than oral, axillary is lower than oral
■ medicines: recent ingestion of aspirin, acetaminophen, corticosteroids,= and NSAIDs may mask fever and affect the temperature recorded at the time of the physical examination

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10
Q

Types of pain, not including parietal

A

○ nocioceptive: r/t tissue damage
- visceral: kidney pain, stomach pain
- deep somatic: broken bones
- cutaneous: paper cut, sunburn
○ neuropathic: r/t NS damage → burning, shock-like - shingles, diabetic neuropathy, paresthesias, carpel tunnel, MS
○ psychogenic: r/t depression, anxiety
○ idiopathic

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11
Q

Tolerance

A

adaptation, diminished drug fx

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12
Q

Physical Dependence

A

withdrawal

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13
Q

Addiction

A

characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving

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14
Q

LOC levels in order

A 
Alert
Lethargic
Obtunded
Stupor
Coma
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15
Q

What is the difference between:

Fatigue
Lethargy
Weakness

A

Fatigue (r/t not enough sleep - loss of energy, normal response to hard work)

Lethargy: too tired to do even basic functions in life

Weakness: demonstrable loss of msk power, possible neuropathy or myopathy

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16
Q

Clutching chest, pallor, diaphoresis, labored breathing, shortness of breath, tripod position are all symptoms of?

A

Cardiac or respiratory distress

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17
Q

What do both hypothyroidism & edema cause?

A

weight gain

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18
Q

Ptn reports lactose intolerance. What is the nurse’s initial dietary concern?

A

inadequate intake of Calc and vitamin D → potential rickets

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19
Q

Rapid changes in weight over a few days suggests…

A

increase/decrease in body fluid, not tissue weight gain/loss

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20
Q

Weight gain or swelling in lower legs

A

water retention due to peripheral vascular disease, NOT nutrition issue

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21
Q

Questions regarding nutrition:

What does weakness/fatigue indicate?

A

anemia, electrolyte imbalance

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22
Q

Questions regarding nutrition:

What does weight loss indicate?

A

decreased calorie intake, increased calorie use, inadequate nutrient intake / absorption

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23
Q

Questions regarding nutrition:

What does pale skin or pale MMs indicate?

A

dehydration, possible anemia

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24
Q

Questions regarding nutrition:

What does spoon-shaped, brittle, or ridged nails indicate?

A

protein / iron deficiency

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25
Q

Questions regarding nutrition:

What do bleeding/cracking gums indicate?

A

vitamin deficiencies

26
Q

Questions regarding nutrition:

What does dark circles around the eyes indicate?

A

possible allergies

27
Q

Questions regarding nutrition:

What do night blindness or general eye issues indicate?

A

vitamin A deficiency

28
Q

Questions regarding nutrition:
What do tachycardia/weak pulse indicate?

What about a bounding pulse?

A

dehydration.

bounding pulse –> overhydration

29
Q

Questions regarding nutrition:

What does petechiae, ecchymosis indicate?

A

vitamin A deficiency

clotting issues (low platelets)

30
Q

Questions regarding nutrition:

What does edema indicate?

A

protein deficiency (think: liver), or overhydration in ptns with weak hearts

31
Q

Questions regarding nutrition:

What does distension/ascites indicate?

A

protein deficiency r/t liver disease

32
Q

Questions regarding nutrition:

What does poor turgor indicate?

A

dehydration

33
Q

Questions regarding nutrition:

What does waist circumference (>40 in men and >35 in women) raise the risk for?

A

increased risk of cardiac diseases

34
Q

Questions regarding nutrition:

What does msk wasting or flaccidity indicate?

A

protein deficiency

35
Q

Questions regarding nutrition:

What does bowing/pain in legs indicate?

A

vit D deficiency

36
Q

Questions regarding nutrition:

What do changes in mental status, irritability, inability to concentrate, paresthesias indicate?

A

dehydration or lack in vitamins

37
Q

How do you calculate BMI for pounds/inches VS kg/cm?

A

(weight (lbs)/height (in)(squared)) X 703

kg/cm(squared)

38
Q

How do you calculate waist-to-hip ratio?

A

Waist circumference / hip circumference

39
Q

Underweight BMI

A

<18.5

40
Q

NORMAL BMI

A

18.5 - 24.9

41
Q

Overweight BMI

A

25-29.9

42
Q

Obese BMI

A

30-39.9

43
Q

Extremely obese BMI

A

> 40

44
Q

Safe weight loss goal

A

.5 - 2 lbs per week

45
Q

marasmus

What deficiency?
What do they look like?

A

(protein-calorie malnutrition)

○ looks really malnourished

46
Q

kwashiorkor

What deficiency?
What do they look like?

A

(protein malnutrition)

○ round bellies

47
Q

● Scorbutic gum

A

Vit C deficiency

48
Q

● Follicular hyperkeratosis & Bitot’s spots → what kind of deficiency?

A

Vit A deficiency

49
Q

What kinds of foods should you eat with a Vitamin A deficiency?

What color is dominant in vitamin A foods?

A

Foods: Yellow, Orange foods –> cantaloupe, pink grapefruit, apricots, carrots, pumpkins, sweet potatoes

Other: broccoli, leafy greens, spinach, dark green leafy veggies

50
Q

● Rickets → what should someone with rickets eat?

A

Vit D, calcium deficient

○ Vit D: drink fortified milk, eat eggs, butter, margarine, fortified cereals
○ Calc: eat dairy (yogurt, milk, natural cheese), breakfast cereals, fruit juice w/ calc supplement, dark green leafy veggies (collards, turnip greens)

51
Q

What should someone w/ an iron deficiency eat?

A

shellfish, lean meat (dark turkey meat ok), cereals w/ iron supps, spinach, peas, lentils, enriched & whole grain bread

52
Q

Interviewing traps: example of false reassurance

A

“everything will be ok”

53
Q

Interviewing traps: giving unwanted advice

A

“if I were you, I would…”

54
Q

Interviewing traps: using authority

A

“As the nurse, this is why you should do this”

55
Q

Interviewing traps: distancing

A

using impersonal speech, spacing between yourself & the ptn

56
Q

Interviewing traps: leading/biased questions

A

“You do do drugs, do you?”

this forces the individual to be less truthful to avoid guilt

57
Q

Interviewing traps: talking too much –> what should you do instead?

A

LISTEN more.

58
Q

Interviewing traps: interrupting –> indicates what?

A

indicates that you are impatient or bored

59
Q

Interviewing traps: using “why” –> imparts what?

A

imparts blame.

60
Q

Interviews for special ptns: silent ptn

A

give them time
may be culturally silent
look for nonverbal cues

61
Q

Interviews for special ptns: confusing ptn

A

suspect psychiatric or neuro disorder –> shift to mental status exam (calculations, vocab, memory, abstract thinking)

check LOC

see if this is new onset (from family member)

62
Q

Interviews for special ptns: language barrier

A

work w/ interpreter (NOT family)
speak to ptn, not interpreter
interpret everything, not just summarize

HA Final (11 decks)

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