EXAM 1 Flashcards
Healthy People 2020
-Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
-Achieve health equity, eliminate disparities, and improve the health of all groups.
-Create social and physical environments that promote good health for all.
-Promote quality of life, healthy development, and healthy behaviors across all life stages.
health beliefs
a person’s ideas, convictions, and attitudes about health and illness
(individuals perception about susceptibility, serious of illness, and if they will take preventative action)
positive health behaviors
activities to maintain good health and prevent illness
negative health behaviors
practices potentially harmful to health
Maslow’s Hierarchy of Needs
Self Actualization
Self Esteem
Relationships, Love and Affection
Safety and Security
Physiological Needs
holistic health model
promote health by considering emotional, spiritual, and physical wellbeing.
internal variables that influence health beliefs and practices
developmental
intellectual background
perception off functioning
emotional factors
spiritual factors
external variables that influence health beliefs and practices
family practices
socioeconomic
cultural
what is an example illness prevention?
immunization program
what are some examples of health promotion?
routine exercise, good nutrition, adequate sleep
what are some examples of wellness?
physical awareness, stress management, self-responsibility
primary prevention
True prevention that lowers the chances that a disease will develop
what are some examples of primary prevention?
immunizations, physical activity, health education, nutrition, cleanliness
secondary prevention
individual has health issues/illness, this helps to decrease the chance of worsened conditions and to decrease complications from developing
what are some examples of secondary prevention
-screenings
-diagnostic tests
-medications
tertiary prevention
when a deficit is permanent/irreversible, so preventative cares used to prevent further disability
what are some examples of tertiary prevention?
Teach disease management to a patient with diabetes
Referral of a patient to OT and PT
Support group
what are the stages of the change model?
precontemplation
contemplation
preparation
action
maintenance
precontemplation stage
patient is unaware of problem and/or has no interest in change
contemplation stage
patient is aware of problem and is beginning to think about changing but has not made a commitment to do so (next 6 months)
preparation stage
Patient is making a small change/coming up with a plan
action stage
patient is actively engaging in the plan
maintenance stage
patient integrates newly adopted behavior patterns into his or her lifestyle
normal range for temperature
36-38 degrees c or 96.8-100.4 degrees f
normal temperature range for elderly population
35-36.1 degrees c or 95-97 degrees f
what are the factors that affect temperature
age
exercise
hormone level
circadian rhythm
stress
environment
factors affecting temperature: age
as you age, your temperature tens to run lower
factors affecting temperature: exercise
increase blood supply, increase heat production, increase body temperature
factors affecting temperature: hormone level
women experience increase fluctuation in body temp (progesterone)
factors affecting temperature: circadian rhythm
lowest temperature at 6 am and highest temperature at 4 pm (in healthy people)
factors affecting temperature: stress
Stress increases metabolism, increasing oxygen need
when the body cant meet this demand = hypoxia
factors affecting temperature: environment
room temperature/ temperature outside can lead to increase or decrease body temperature
fever
Abnormally high body temperature
important mechanism and enhances immune system
hyperthermia
abnormally high body temperature due to the body inability to promote heat loss or reduce heat production
hypothermia
Abnormally low body temperature often associated with exposure to cold and the body is unable to compensate
heatstroke
prolonged exposure to the sun or high environmental temperature
overwhelms the heat-loss mechanisms the body
heat exhaustion
condition resulting from exposure to heat and excessive loss of fluid through diaphoresis
results in excess water and electrolyte loss
normal pulse range
60-100 bpm
strong and regular
factors that influence pulse: exercise
short term exercise increases pulse rate
heart conditioned by long term exercise (athlete) will have lower resting pulse
what factors influence pulse
Exercise
Temperature
Acute pain
Emotions
Drugs
Hemorrhage
Position changes
Pulmonary conditions
factors that influence pulse: temperature
fever and heat increase pulse
hypothermia decrease pulse
factors that influence pulse: acute pain
increase in sympathetic activity will increase HR
effects of chronic pain/parasympathetic stimulation increases by unrelieved pain which decreases HR
factors that influence pulse: emotions
SNS increase pulse (anxiety)
PNS decrease pulse
factors that influence pulse: medications
epinephrine- increase HR
beta adrenergic and CC blockers decrease HR
factors that influence pulse: hemorrhage
sympathetic stimulation by loss of blood increases HR
factors that influence pulse: postural changes
stand: increases HR
lying down: decreases HR
factors that influence pulse: pulmonary conditions
(asthma, COPD)–> increased HR due to poor oxygenation
tachycardia
Abnormally rapid HR >100bpm
Bradycardia
abnormally slow HR <60bpm
dysrhythmia
abnormal heart rhythm/missed beats
normal respiration range
12-20 breaths per minute
deep and regular
as you age you need _____ breaths/min
less
factors affecting respiration
acute pain
exercise
anxiety
smoking
body position
medications
neurological injuries
hemoglobin function
factors affecting respiration: acute pain
pain may cause shallow breathing
inhibits chest wall movement with chest/abdominal pain
factors affecting respiration: exercise
increases rate/depth so that the body can meet the oxygen demand and get rid of carbon dioxide
factors affecting respiration: anxiety
increases RR and depth as result of sympathetic stimulation
factors affecting respiration: smoking
changes pulmonary airways
increase RR at rest when not smoking
factors affecting respiration: body position
straight/erect: full chest expansion
stooped/slumped: impaired
lying flat: prevent full chest expansion
factors affecting respiration: medication
opioid, anesthetics and sedatives decrease RR and depth
amphetamines and cocaine increase RR and depth
bronchodilators slow rate by causing dilation
factors affecting respiration: neurological injury
injury to brain stem impairs respiratory center and inhibits RR and rhythm
factors affecting respiration: hemoglobin function
decrease hemoglobin (anemia) –> decreases oxygen carrying capacity–> increase RR
high oxygen levels are _____ for a patient with COPD
FATAL
do NOT over oxygenate
what is a normal SPO2 range
> 95%
what is a normal SPO2 range fro patients with COPD
88%-92%
normal BP range
Systolic: <120 mmHg
Diastolic: <80 mmHg
Normal pulse pressure
30-50 mmHg
what are the factors affecting BP
age
stress
ethnicity and genetics
gender
daily variation
medications
activity and weight
smoking
factors affecting BP: age
BP increases throughout life (larger children will have higher BP than smaller children)
factors affecting BP: stress
increase HR –> increase CO–> increase vcasucalr resistance–> which increase BP
factors affecting BP: ethnicity and genetics
increase BP in African Americans
factors affecting BP: gender
after puberty makes then to have higher BP
menopausal women then o have higher BP
OVERALL no significant differenced in BP
factors affecting BP: daily variation
lower BP during sleep (12am-3am) there will be a slow and steady rise
highest during the day (10am-6pm)
factors affecting BP: medications
antihypertensives & diuretics (any medication made to lower BP)
factors affecting BP: activity and weight
period of exercise can reduce BP for several hours afterward
increase in the O2 demand increases BP
factors affecting BP: smoking
causes vasodilation which increases BP
stage 1 hypertension
Systolic: 130-139
Diastolic: 80-89
stage 2 hypertension
Systolic: > 140mmHg
Diastolic: > 90mmHg
hypotension range
systolic. falls below 90mmHg
What is the nurses role in measuring, analyzing and reporting abnormal vital signs?
the nurses role is to ASSESS, then create a NURSING DIAGNOSIS, develop a PLAN, IMPLEMENT the plan/goals, then EVALUATE the outcomes
What does caring mean in nursing practice?
autonomy
advocate
educator
communicator
(empathy & comfort)
define disease
harmful deviation from normal structure of functional state of an organism, generally associated with certain signs and symptoms
acute disease
symptoms develop rapidly
short term
self limiting
dissipate after injury heals
(trauma, surgery, kidney stone)
chronic disease
when pain continues for 6 months or longer
chain of infection
infectious agent
reservoir
portal of exit
mode of transmission
portal of entry
susceptible host
reservoir
where microorganism survives, multiplies and awaits transfer to host
portal of exit
a way for the infectious agent to escape from the reservoir in which it has been growing so it can find a host to enter and cause disease
mode of transmission
a way that the causative agent can be transmitted to another reservoir or host where it can live (often unwashed hands)
portal of entry
organisms enter the body through the same routes they use for exiting
infectious process
- Incubation period
- Prodromal stage
- Illness stage
- Convalescence
incubation period
time between entrance of pathogen and appearance of first symptoms
prodromal stage
interval from onset of nonspecific signs and symptoms to more specific symptoms
illness stage
the interval when symptoms specific to the infection occur
convalescence
acute symptoms of infection disappear
inflammation
a localized response to an injury or to the destruction of tissues or infection
Signs of inflammation
swelling
redness
heat
pain/tenderness
loss of function
serous exudate
clear, like plasma
normal to the healing process
sanguineous exudate
containing red blood cells
purulent exudate
pus; containing WBCs and bacteria
indicated infection
RACE
Rescue patient
Alarm (pull alarm)
Contain (contain fire, close door, turn off O2)
Extinguish fire
PASS
Pull, Aim, Squeeze, Sweep
what is the importance of quality and safety in client care?
quality and safety minimizes risk of harm to patient and providers through both system effectiveness and individual performance
what are some factors that influence infection susceptibility?
age
nutritional status
stress
disease process
treatments or conditions that compromise the immune system
standard precautions
recommendations that must be followed to prevent transmission of pathogenic organisms by way of blood, blood products, body fluids, secretions, excretions(except sweat), non intact skin, and mucous membranes
standard precautions (for use with all patients)
hand hygiene between each patient
wash hands if soiled
no artificial finger nails
wear gloves when touching body fluids
use appropriate PPE if needed
use of private room (only if needed)
discard all contaminated sharp objects
respiratory hygiene and cough etiquette
what are some methods for providing basic care and comfort to clients?
encouraging health promotion (exercise, healthy diet, relaxation)
basic needs (O2, nutrition, temperature)
maintain proper body mechanics (posture and alignment
assistive devices for walking (cane)
what side of the body should the cane be on
stronger side
direct route
person-to-person (fecal,oral) physical contact between source and susceptible host
indirect route
personal contact of susceptible host with contaminates inanimate object
droplet route
infected person coughs/sneezes, creating droplets that carry germs (w/in 6 feet)
airborne route
organisms are carried droplet nuclei to residue or evaporated droplets suspended in air
vehicle route
contaminated items, water, drugs, solutions, blood, food
vector route
external mechanical transfer (flies)
internal transmission (mosquito, flea, tick)
Barrier precautions
*include the appropriate use of PPE such as gowns, gloves, masks, eyewear, and other protective devices or clothing.
Contact precautions PPE
gown and gloves
Droplet precautions PPE
a surgical mask when within 3 feet of the patient, proper hand hygiene, and some dedicated-care equipment.
Airborne precautions PPE
negative air flow room (airborne infection isolation room)
N95 respirator
Protective environment PPE
a specialized room with positive airflow.
what is the appropriate technique to maintain safe client handling?
widen base of support
increase balance by bringing center of gravity closer to base of support
safe patient handling and mobility (SPHM)
improved assessment, use of mechanical equipment and safety procedures to lift and move patients
what is the importance of proper positioning and movement for promoting clients comfort?
proper positioning and placing them in correct body alignment can help reduce pressure risks
movement is important because immobility can cause many systemic effects
Metabolic System: Effects of Immobility
endocrine (homeostasis is usual function, can decrease wound healing)
calcium absorption (hypercalcemia)
GI function (constipation)
Respiratory System: Effects of Immobility
atelectasis (collapse of alveoli)
hypostatic pneumonia ( inflammation of lung from stasis or pooling secretions
Cardiovascular System: Effects of Immobility
orthostatic hypotension
thrombus
Musculoskeletal System: Effects of Immobility
loss of endurance and muscle mass
decrease stability and balance
Muscular System: Effects of Immobility
loss of muscle mass
muscle atrophy
Skeletal System: Effects of Immobility
impaires calcium absorption
joint abnormalities
Urinary System: Effects of Immobility
urinary stasis
renal calculi (kidney stones)
UTI
Integumentary System: Effects of Immobility
pressure ulcer
ischemia
Safe application of physical restraints
make sure physician knows about this (restraint order) and visits the client within 1 hour of the client receiving physical restraints
restraint should never interfere with treatment
should not be SNUG (2 fingerwidths btwn)
fit properly and be as discreet as possible
be easy to remove or change (every 2 hours for toileting and checking neurovascular status)
only used 4 hrs for adults. for physician prescription, it can go up to 24 hrs.
trochanter roll
prevents external rotation of the hips when a patient is in a supine position
how is a trochanter roll implemented?
fold cotton towel length wise to a width that extends from greater trochanter of the femur to lower border of popliteal space
hand roll
roll placed in the hand to prevent hand contraction
trapeze bar
allows the client to pull with the upper extremities to raise the trunk off the bed, assist in transfer, or to perform exercises increases independence, helps maintain upper body strength, decreases the shearing action
supported fowlers
the head of the bed is elevated 45 to 60 degrees, and the patient’s knees are slightly elevated without pressure to restrict circulation in the lower legs
supine
lying face up
prone
lying face down
side lying
patient rests on the side with the major portion of body weight on the dependent hip and shoulder
Sims
patient places the weight on the anterior ileum, humerus, and clavicle
what are the psychological effects of immobility?
emotional/behavior responses (depression, hostility, fear, anxiety)
sensory alterations
altered sleep patterns
social isolation
what are complementary/alternative therapies that influence metabolism
provide high protein, high calorie diet with vitamin C supplements
what are complementary/alternative therapies that influence respiratory
cough and deep breathe every 1-2 hours
chest physiotherapy (CPT)
what are complementary/alternative therapies that influence integumentary
reposition every 1-2 hours, provide skin care
what are complementary/alternative therapies that influence elimination system
adequate hydration
diet
increase fluid
increase fruit and veg
increase fiber
what are complementary/alternative therapies that influence cardiovascular
leg exercises, hose, compression socks
health promotion and examples
directed at increasing a patients wellbeing routine exercise and good nutrition
active health promotion
individual adopts a specific health program
passive health promotion
individual gains from the activity without acting themselves
disease prevention and example
the process of reducing risks and alleviating disease to promote, preserve, and restore health and minimize suffering and distress
ex: immunization program
what are the factors that affect an individuals health
genetic/physiologic factors
age
environment
lifestyle
