Chapter 22 - Assessing Patients and Managing Acute Situations Flashcards
incontinence
loss of bladder control
cyanotic
The term cyanotic denotes a bluish coloration in the skin and indicates a lack of sufficient oxygen (O2) in the tissues. This is most easily seen on the mucous membranes, such as the lips or the lining of the mouth. Nail beds may also show a bluish tinge.
diaphoretic
(perspiring) in what is frequently called a cold sweat
Normal oral temperatures
vary from 96.8°F to 99.6°F (36°C to 37.6°C)
dyspnea
difficulty in breathing
tachypnea
extremely rapid breathing
systolic
a measure of the pumping action of the heart muscle itself
diastolic
indicates the ability of the arterial system to accept the pulse of blood forced into the system when the left ventricle contracts
hypertension
abnormally high BP
hypotension
abnormally low BP
sphygmomanometer, often called a blood pressure cuff
Sphygmomanometers once measured pressure by using a mercury column that rose or fell according to the pressure. For this reason, BP is measured in units of millimeters of mercury (mm Hg). Equipment containing mercury is no longer used. Digital electronic models and aneroid manometers using air pressure have now replaced mercury units to meet OSHA requirements for eliminating mercury from the workplace.
When nasal prongs are used,
the O2 flow rate should be adjusted to 4L/min or less, because higher rates are drying to the nasal mucosa.
Oxygen Administration
Attach the mask to the O2 supply and adjust the flow meter to deliver 3 to 5L/min.
Asthma
Asthma is difficulty in breathing caused by bronchospasm, which restricts the patient’s ability to take in a sufficient volume of air.
Angina pectoris, often simply called angina,
is the term for chest pain that occurs when the coronary arteries are unable to supply the heart with sufficient O2 to meet current needs.
erythema
redness of the skin
urticaria
hives
anaphylaxis or anaphylactic shock
A severe allergic reaction
The earliest symptoms of anaphylaxis include
a sense of warmth, tingling, and itching of palms and soles. Within seconds or minutes, the patient experiences difficulty swallowing, constriction in the throat, a feeling of doom, an expiratory wheeze, and then progression into laryngeal and bronchial edema (swelling) that can block the airway completely.
hyperventilation
air hunger with rapid respirations
the term for excessive breathing
These patients have breathed in too much O2 and have exhaled too much carbon dioxide, which disturbs the chemical balance of the blood.
hyperglycemia
an elevated blood glucose level; it is characterized by a relatively slow onset.
diabetic coma
The individual who is terribly thirsty, urinates copious amounts frequently, and has fruity-smelling breath (because of ketones excreted via the respiratory tract)
hypoglycemia
a low blood glucose level
cerebrovascular accident (CVA), also called a stroke
is caused by lack of adequate blood circulation to the brain.
acronym FAST be used to help remember and identify the warning signs of a stroke:
*F—Face drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the smile uneven?
*A—Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
*S—Speech difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
*T—Time to call 9-1-1: If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to a hospital immediately. Check the time so you will know when symptoms first appeared.
Seizures may be a response to
drug sensitivity, infection, epilepsy, tumor, or fever. No direct, consistent correlation exists between seizures and mental acuity, emotional instability, or heredity.
anoxia
a lack of O2 to the brain
postural hypotension or orthostatic hypotension
A lightheaded or dizzy sensation is not unusual when patients sit up suddenly from a recumbent position. This is especially common after prolonged periods of bed rest.
syncope
fainting
is a very mild form of shock that sometimes occurs when fright, pain, or unpleasant events are beyond the coping ability of the patient’s nervous system.
Vertigo
a sensation of dizziness. The patient does not feel lightheaded but feels as if the room is moving or whirling.
This sensation is usually attributed either to a middle ear disturbance or to a lesion in the brain or spinal cord.
epistaxis
nosebleed
A nosebleed, or epistaxis
Instruct the patient to breathe through the mouth and to squeeze firmly against the nasal septum for 10minutes. The patient should not lie down, blow the nose, or talk. Provide an emesis basin or disposable emesis bag, instructing the patient to spit out blood that runs down the nasopharynx rather than swallow it.
Shock
general term used to describe a failure of circulation in which BP is inadequate to support O2 perfusion of vital tissues and to remove the byproducts of metabolism.
It may be caused by blood loss, severe infection, head trauma, heart failure, or a severe allergic response. Early signs of shock are pallor, increased heart rate and respiration rate, and restlessness or confusion.
The following symptoms, in any or all combinations, indicate some degree of shock:
*Restlessness and a sense of apprehension
*Increased pulse rate
*Pallor accompanied by weakness or a change in thinking ability
*Cool, clammy skin
*A fall in BP of 30mm Hg below the baseline systolic pressure or a drop in diastolic pressure below 50mm Hg
