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Health Assessment, Jensen 2nd ed. > Chapter 28, 29,30 > Flashcards

Chapter 28, 29,30 Flashcards

1
Q

The older adult epidermis thins and renews itself every __ days compared to every __ days in children and adults.

A

30, 20

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2
Q

What change due to aging leads to a 50% reduction in rate of wound healing?

A

Decreased mitotic activity of cells

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3
Q

Describe how nail beds are affected by aging.

A

more rigid, thicker, and more brittle, with slowed growth

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4
Q

_____ wrinkles are caused by aging, ______ wrinkles are due to sun exposure.

A

Fine, coarse

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5
Q

With aging, increased lipid deposits may occur in what 2 places above the neck?

A

Increase lipid deposits may be found at the periphery of the cornea around the iris

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6
Q

What size change can occur to the lens of the eye with age?

A

Larger and denser

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7
Q

True of false: ears get bigger as we age

A

true- auricle gets bigger but auditory canal gets narrower

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8
Q

Olfactory dysfunction can reduce ______ _______

A

food intake

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9
Q

How does the tongue change with aging?

A

becomes smoother

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10
Q

At what age does the sense of taste often change?

A

Around age 60

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11
Q

What are the alveoli changes in older adult smokers?

A

thicker and fewer

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12
Q

Decreased compliance from arterial wall stiffening affects B/P by ________________________.

A

increasing the afterload of the left ventricle

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13
Q

Which increases with age, systolic or diastolic B/P?

A

systolic

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14
Q

Which ventricle usually hypertrophies with age?

A

left

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15
Q

How much does coronary artery blood flow decrease with age?

A

about 1/3

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16
Q

What causes the decrease of heart rate in aging?

A

Loss of pacemaker cells and bundle of His fibers

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17
Q

What are circulating catecholamines?

A

blood-borne amines derived from the amino acid tyrosine – examples include epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine – that act as hormones or neurotransmitters.

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18
Q

What happens to circulating catecholamines in aging?

A

they increase

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19
Q

What happens to jugular venous pulsations in aging?

A

increase with fluid volume excess and decrease with fluid volume deficit

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20
Q

Name 5 parts of the screening tool, DETERMINE.

A

D- Disease, E- Eating poorly, T- Tooth loss/mouth pain, E- Economic hardship, R- Reduced social contact, M- Multiple medications, I- Involuntary weight loss/gain, N- Needs assistance in health care, E- Elder above age 80

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21
Q

What happens to peristalsis with aging?

A

slows

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22
Q

What are important parts of the shift change assesment?

A

abdomen, auscultation of lungs, circulation and level of consciousness

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23
Q

Focused assessment: concentrates on assessing for _______________________

A

anticipated problems

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24
Q

The 4 main issues in quality hospital care include:

A

evidence-based medicine, quality assurance, medical ethics, and the reduction of medical error.

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25
Q

What are the 5 rights of delegation?

A

the right task, under the right circumstances, to the right person, with the right directions and communication, under the right supervision and evaluation

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26
Q

What are the 8 National Safety goals set by Joint Commission?

A

Adverse drug reactions
Catheter-associated UTI
Central line associated bloodstream infections
Injuries from falls and immobility (including delirium)
Pressure ulcers
Surgical site infections
Venous thromboembolism, if no palpable pulses notify physician if you are worried
Ventilator associated pneumonia

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27
Q

What is SBAR?

A

Situation, Background, Assessment, Recommendation

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28
Q

What are the 4 National Safety Interventions?

A

two patient identifiers, SBAR with staff communication, alarm safety, prevent infections

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29
Q

What is a surgical time out?

A

the final recapitulation and reassurance of accurate patient identity, surgical site, and planned procedure.

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30
Q

List 5 patient satisfaction factors.

A 
Bedside handoff reports
Purposeful hourly rounding
Show respect, protect confidentiality and privacy, always introduce yourself
Ask permission
Use best communication practices
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31
Q

Upon entering a patient room, what observation should you make of tubes?

A

Trace tubes to insertion site and check solutions and rate

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32
Q

It is urgent if respiratory rate is less than __ or greater than ___.

A

8, 28

33
Q

It is urgent if O2 sat goes below ___% despite oxygen administration.

A

90

34
Q

Urgent: Acute change in HR of less than ___or greater than ___

A

50, 120

35
Q

Urgent: Temperature greater than ______

A

39.0 C (102.0 F)

36
Q

This type of pain represents an urgent situation.

A

uncontrolled

37
Q

Urgent: Acute change in urine output less than __ ml over 4 hours

A

50

38
Q

What does Hgb A1c test for?

A

blood glucose, used in diabetics or to screen for diabetes

39
Q

What do hematocrit and hemoglobin test for?

A

bleeding and anemia

40
Q

What are the 4 main labs for clotting factors?

A

platelets, prothrombin time (PT), partial thromboplastin time (PTT), international normalized ration (INR)

41
Q

What are the 2 labs for renal function?

A

blood urea nitrogen (BUN)/creatinine

42
Q

What is the test for ischemic cardiac changes?

A

EKG

43
Q

What is stasis dermatitis?

A

skin inflammation in the lower legs caused by blood/fluid pooling in the veins of the leg

44
Q

What is Herpes zoster?

A

Shingles: reactivation of the chickenpox virus which affects the nerves.

45
Q

Define ectropion.

A

an eyelid, typically the lower lid, that turns out leaving the inner eyelid surface exposed and prone to irritation

46
Q

Define entropion.

A

eyelid that turns inward so that eyelashes and skin rub against the eye surface, causing irritation and discomfort

47
Q

What are Bouchard nodes?

A

hard, nontender bony growths or gelatinous cysts on the proximal interphalangeal joints. A sign of osteoarthritis.

48
Q

What are Heberden nodes?

A

hard, nontender bony growths on the distal intraphalangeal joint (end of the fingers or toes)

49
Q

What does the Morse scale assess for?

A

Fall risk

50
Q

What is the costovertebral angle?

A

the acute angle formed on either side of the human back between the twelfth rib and the vertebral column.

51
Q

How long must a central line be in prior to a bloodstream infection for it to be deemed a central-line associated infection?

A

2 days

52
Q

Define surgical infection.

A

infection that occurs 30-90 days after the operative procedure with purulent drainage

53
Q

Define dehiscence.

A

separations of the side of a suture, especially when tissues protrude

54
Q

What is VAP?

A

Ventilator associated pneumonia (VAP)- hospital-acquired pneumonia which occurs in patients who are receiving mechanical ventilation. Fever, Leukopenia (WBC count

55
Q

What are the signs of ventilator associated pneumonia in patients over 70?

A

Altered mental status with no other recognized cause and at least two of the following:
new onset of increased respiratory secretions, New onset or worsening cough, dyspnea, or tachypnea

56
Q

What are the common signs of systemic infection (sepsis)?

A

documented or suspected infection, heart rate greater than 90 beats/min, temperature less than 36C or greater than 38.3C, respiratory rate more than 20 breaths per minute or PaCO2 less than 32 mmhg, altered mental status

57
Q

What are the 5 P’s of nurses’ rounds?

A

Pain, Personal needs, Position, Placement (of essential items like call light, phone), and Prevent Falls

58
Q

Define ptosis.

A

drooping upper eyelid

59
Q

Enlarged bones or tissue could be a sign of __________.

A

acromegaly

60
Q

“Moon face” could be a sign of __________.

A

Cushing syndrome

61
Q

Weak blink could mean

A

damage to CN V or VII

62
Q

What is malocclusion?

A

imperfect positioning of the teeth when the jaws are closed.

63
Q

tongue that deviates to one side could be a sign of

A

stroke or damage to CN XII (hypoglossal)

64
Q

What could it indicate if the iris looks pushed forward?

A

glaucoma

65
Q

What 2 findings in an eye assessment are urgent?

A

white pupil reflex(leukocoria) and lack of red reflex

66
Q

What assessment can be done for Vestibulocochlear nerve VIII?

A

ability to repeat whispered words

67
Q

What indicates a positive Rinne test?

A

positive for hearing loss if bone conduction longer or the same as air conduction

68
Q

Define obtunded.

A

deadened or dulled

69
Q

What is decorticate rigidity?

A

arms flexed, or bent inward on the chest, the hands are clenched into fists, and the legs extended and feet turned inward

70
Q

What is a possible abnormal finding about the liver that could be observed in an abdominal assessment?

A

Liver is palpable below rib

71
Q

What is a possible abnormal finding about the spleen that could be observed in an abdominal assessment?

A

Spleen that deviated downward or medially

72
Q

What do you assess for on heels?

A

blanching

73
Q

What could hyperresonance in the chest be a sign of?

A

COPD

74
Q

lack of coordination is called _______________________

A

adiadochokinesia

75
Q

What is a stereognosis test?

A

ability to perceive the form of solid objects by touch

76
Q

What is the Braden scale? What factors does it score?

A

Scores patients from a 1-4 in six subscales based on:

sensory perception, moisture, activity, mobility, nutrition, and friction

77
Q

What Braden scale score range indicates no risk? What score indicates high risk?

A

19 and above indicates no risk. 10 and below indicate high risk.

78
Q

What is the safety alert for serum potassium levels

A

Serum potassium levels may affect neural or cardiac cell conduction, leading to arrhythmias and potentially to cardiac arrest. Potassium must be maintained within normal limits and abnormalities must be corrected promptly.

Health Assessment, Jensen 2nd ed. (5 decks)

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