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Fall > Care Of Chronic Exam 1 > Flashcards

Care Of Chronic Exam 1 Flashcards

1
Q

Routine physical examinations should be done generally how often

A

1-3 yes females. 5 years males. More often after 40 yrs age

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2
Q

TB screening is done when

A

Every 2 years for skin test. Health care workers screened annually

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3
Q

Blood pressure testing should be done at least how often

A

Every 2 years Or annually if elevated

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4
Q

Blood cholesterol screening starts at what age

A
  1. Minimum every 5 years
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5
Q

Blood glucose screening starts at what age

A

45, minimum every 3 years

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6
Q

What domain of learning involves knowledge, comprehension, application, analysis, synthesis and evaluation. It required intellectual behaviors and focuses on thinking

A

Cognitive learning

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7
Q

What domain of learning involves feelings beliefs and values.

A

Affective learning

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8
Q

What domain of learning is gaining skills that require mental and physical activity?

A

Psychomotor learning

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9
Q

Teaching in small groups of 6 people or less often increases learning and learner satisfaction. T/f?

A

True

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10
Q

A nurse in a providers office is collecting data from the caregiver of a 12- mo old infant who asks if the child is old enough for toilet training. Following an educational session with the nurse, the client agrees to postpone toilet training until the child is older. Learning has occurred in which domain?

A

Affective. Because the clients ideas about toilet training changed.

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11
Q

Piaget’s developmental stage for the first two years old life and 3 essential component

A

Sensorimotor stage

Separation
Object permanence
Mental representation

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12
Q

Serving size for toddlers should be what for solid food?

A

1Tbsp solid food per year of age

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13
Q

Which theory of development includes assimilation, accommodation, and adaptation

A

The cognitive theory

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14
Q

What universal Princeton human growth and development is described as following a head to toe progression. Infants gain control over their neck and head before controlling extremities?

A

Cephalocaudal principle

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15
Q

What human development principle is based on the progression from center of the body in an outward direction? The spine first, extremities, then fingers and toes?

A

Proximodorsal principle

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16
Q

What human development principle is described as infants accomplishing head control before they are able to crawl?

A

Simple to complex

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17
Q

What human growth process is characterized by periods of growth spurts and periods of steady, slow growth?

A

Continuous process

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18
Q

“Human development occurs from large muscle movement to more refined muscle movement “ is a description of what universal principal?

A

General to specific

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19
Q

“Human development varies from individual to individual. Each person has their own growth timetable and rate of development “ is a description of what universal principal?

A

Individualized rates

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20
Q

What uses 5 indicators (appearance, pulse, grimace, activity, and respirations) to quickly asses whether a newborn requires immediate medical care at 1minute & 5 minutes post birth?

A

Apgar scoring

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21
Q

What is considered a normal apgar score?

A

7 or higher

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22
Q

A newborn with pink body & blue extremities; pulse over 100/min; minimal response to stimulation; active arms and legs, and a vigorous cry would score what on apgar ?

A

A= 1
P=2
G=1
A=2
R= 2
Total=8

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23
Q

At 6 months of age an infant has tripled his birth weight. Is this normal or concerning?

A

Concerning. An infants weight is not expected to triple until 12 months of age.

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24
Q

At 6 months of age the infant’s anterior fontanel (soft spot) is still present. Is this expected or concerning?

A

Expected. It will be present until after the first year of life due to the growth of brain

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25
Q

An infant should sit while unsupported at what age?

A

10 months

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26
Q

What is climacteric

A

Menopause in women
Decreased testosterone and sperm count in men
Happens during middle adulthood.

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27
Q

What is the Piaget stage of development where children use symbols to represent objects and learn to express themselves through language and symbolic gestures, but do not yet reason logically.

A

Preoperational stage at 2-6 years old

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28
Q

What is HCO3-

A

Concentration of bicarbonate in arterial blood

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29
Q

What is SaO2

A

Percentage of oxygen bound to hgb as compared with the total amount that can be possibly carried.

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30
Q

How do you obtain ABG

A

Arterial puncture or arterial line

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31
Q

Prior to arterial puncture what should be done to verify patency of radial and ulnar circulation?

A

Allen’s test

32
Q

Expected blood ph

A

7.35-7.45

33
Q

Expected PAO2 range

A

80-100 mmHg

34
Q

Expected PACO2 range

A

35-45 mmHg

35
Q

Expected HCO3- range

A

21-28 mEq/L

36
Q

Expected SAO2 measurement

A

95%-100%

37
Q

During a thoracentesis, client education would be what?

A

Remain absolutely still during the procedure. Do not cough or talk unless directed to by provider.

38
Q

During thorancentesis, what is the amount of fluid removed limited to at a time to prevent re-expansion pulmonary edema?

A

1 Liter

39
Q

Complications of thorancentesis

A

Mediastinal shift (shift of thoracic structures to one side of the body)
Pneumothorax (collapsed lung)
Bleeding.
Infection

40
Q

A nurse is caring for a client who is scheduled for a thorancentesis. Prior to the procedure, how is the client positioned?

A

Upright position, leaning over bedside table.

41
Q

In a 3- chamber chest tube system, what are the chambers for.

A

1st- drainage collection
2nd- water seal
3rd- suction control (wet or dry)

42
Q

To maintain the water seal with the chest tube system, what does the nurse need to do?

A

Keep chamber upright and below the chest tube insertion at all times
Monitor the water level due to possible evaporation
Add fluid if needed to maintain seal

43
Q

What is the typical suction pressure prescribed with chest tube systems?

A

-20cm H2O

44
Q

Indications for chest tube insertions

A

Pneumothorax
Hemothorax
Postoperative chest drainage
Pleural effusion
Pulmonary empyema (accumulation of pus in pleural space)

45
Q

When the chest tube is inserted to drain fluid from the lung, where is it inserted.

A

The tip of tube is inserted near the base of the lung on the side.

46
Q

When the chest tube is inserted to remove air from the pleural space, where is it inserted?

A

The tip of tube will be near the apex of the lung

47
Q

FiO2 rate of nasal cannula

A

24-44% at flow rates of 1-6 L/min

48
Q

FiO2 of simple face mask

A

40-60% at flow rates of 5-8 L/min.
Minimum flow rate is 5 L/min. To ensure flushing of CO2 from the mask

49
Q

FiO2 of partial rebreather mask

A

40-75% at flow rate of 6-11 L/min

50
Q

Non rebreather mask FiO2 rate?

A

80-90% at flow rates of 10-15 L/min
To keep reservoir bag 2/3rds full during inspiration and expiration

51
Q

High flow oxygen delivery systems.

A

Venturi mask.
Aerosol mask, face tent, and tracheostomy collar.
T-piece

52
Q

Examples of noninvasive positive pressure ventilation

A

Continuous positive airway pressure
Bi-level positive airway pressure
Transtracheal oxygen therapy

53
Q

Mechanical ventilation can be delivered via….

A

ET tube
Tracheostomy tube

54
Q

Pressure support ventilation (PSV) mode does what?

A

Allows preset pressure delivered during spontaneous ventilation to decrease the work of breathing

55
Q

How often should the nurse assess breath sounds for a patient receiving mechanical ventilation?

A

Every 4 hrs

56
Q

Nursing priority for clients who have a cute respiratory distress is what

A

Maintain a patent airway to promote oxygenation

57
Q

Mild intermittent asthma diagnosis means symptoms occur how often?

A

Less than twice a week

58
Q

Mild persistent asthma occurs how often?

A

More than twice a week but not daily

59
Q

Anticholinergic medications such as ipratropium, work how?

A

By blocking the parasympathetic nervous system to prevent bronchospasms.

60
Q

Methylxanthines, such as theophylline, is used only when other treatments are ineffective why?

A

They require close monitoring of blood medication level due to a narrow therapeutic range.

61
Q

For nasotracheal suctioning, how far do you advance the catheter for an adult

A

16-20 cm (6-8 in)

62
Q

For nasopharyngeal suctioning of an adult, how far do you advance the catheter

A

13-16 cm ( 5-6.5 in)

63
Q

How long is the recommended time you would suction nasotracheal or nasopharyngeal?

A

No more than
10-15 seconds at a time
Waiting at least 1 minute between passes. Some facilities limit to no more than 2-3 passes at a time.

64
Q

Hypocarbia (hypocapnia) co2 levels

A

Less than 35mmHg

65
Q

Hypercarbia(hypercapnea) CO2 levels

A

Greater than 45mmHg

66
Q

Laboratory test ordered for COPD

A

Hematocrit levels will be low.
Sputum cultures and WBC to test for infection
ABG- decreased PaO2 = hypoxemia
Increased PaO2 = hypercarbia.
Blood electrolytes

67
Q

In COPD patients, the the oxygen levels should be maintained at what percentage

A

88-92%

68
Q

What is the v/q ratio

A

V=ventilation
Q= perfusion
The amount of air that reaches the alveoli per minute/ the amount of blood that reaches the alveoli per minute.
Optimum would be v/q ration= 1.0
High ratio would mean more ventilation and less perfusion as seen in pulmonary embolism.
Low ratio means opposite as seen in atelectalis. Normal perfusion but decreased ventilation

69
Q

Pneumothorax

A

Air in the pleural space leading to a collapsed lung. Builds up of co2 due to decreased o2

70
Q

A patient is presenting with deep rapid exhalations. You know this is what kind of breathing and can mean what?

A

Kussmaul breathing can occur in metabolic acidosis

71
Q

A patient presents with deep rapid breathing and slow shallow breathing, with periods of apnea. You know this is what kind of breathing pattern and means what?

A

Cheyne-strokes breathing and can occur in congestive heart failure, increased intracranial pressure, and drug od

72
Q

Shallow breathing with periods of apnea is what

A

Boot breathing. Can occur in cns disorders

73
Q

A patient presents with increased restlessness, irritability, unexplained sudden confusion. Has a rapid heart rate and respiratory rate. What are these signs of?

A

Hypoxia

74
Q

examples of pulmonary function tests

A

Incentive spirometry
peak expiratory flow rate (PERF)

75
Q

Neonatal period is when

A

Birth to 28days

Fall (13 decks)

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