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Nursing Chronic Care > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

what is perception?

A

the ability to interpret sensory input from the five senses into one or more meaningful responses

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2
Q

how can medications affect perception?

A

medication can hinder your senses thus affecting your perception

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3
Q

what senses are most common to decline with age?

A

sight and hearing

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4
Q

what are people who has decreased perception at risk for?

A

falls because they cant see well enough to see items in their path

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5
Q

what two diseases can lead to damage of the senses?

A

diabetes and chronic hypertension

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6
Q

what is it called when drugs cause damage to the ears?

A

ototoxicity

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7
Q

what are the most common eye diseases in the older population?

A

glaucoma and cataracts

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8
Q

what is sensory deprivation?

A

a state where you lack sensory stimulation either by natural causes or experimentation

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9
Q

what are natural causes of sensory deprivation?

A

blindness and deafness

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10
Q

what locations may cause sensory deprivation?

A

nursing homes, hospitals, isolation rooms

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11
Q

what body parts may be damaged by trauma that can cause sensory deprivation?

A

spinal cord and brain

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12
Q

what are the symptoms of sensory deprivation?

A

depression, anxiety, and hallucinations

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13
Q

how can you help patients with sensory deprivation?

A

coloring, colorful pictures, music, talking with them, physical touch

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14
Q

what is sensory overload?

A

excessive stimulation to one or more senses?

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15
Q

how can you help with sensory overload?

A

dim the lights…turn the tv off…calm the environment…speak softly and calm…keep them on a schedule

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16
Q

what is the pathophysiology behind glaucoma?

A

damage to the optic nerve angle caused by IOP

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17
Q

if untreated what can glaucoma progress to?

A

blindness

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18
Q

what are the two kinds of glaucoma?

A

wide/open angle and narrow-angle

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19
Q

what would glaucoma look like for the patient?

A

the patient would experience decreased peripheral vision and see halos

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20
Q

what is wide/open-angle glaucoma?

A

Increased IOP

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21
Q

what is the most common type of glaucoma?

A

wide/open angle

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22
Q

is wide/open angle glaucoma a slow or rapid progression?

A

slow progression

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23
Q

does narrow-angle glaucoma progress fast or slow?

A

fast

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24
Q

which type of glaucoma is a medical emergency?

A

narrow-angle

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25
Q

which type of glaucoma may the pupils not be reactive to light?

A

narrow-angle

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26
Q

what are the causes of glaucoma?

A

older age….uncontrolled diabetes…uncontrolled hypertension….eye trauma

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27
Q

what would you find in an assessment of someone who has glaucoma?

A

decreased peripheral vision…decreased distance perception…seeing halos around lights…elevated Intraocular pressure

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28
Q

what interventions do we have for glaucoma other than glaucoma medications?

A

treat symptoms like pain and nausea….Monitor IOP…Dim lights…wear sunglasses

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29
Q

what is done during a glaucoma surgery?

A

the surgeon implants a tiny tube, or shunt, onto the white part of your eye.

The tube helps extra fluid drain out of your eye, lowering your eye pressure

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30
Q

what should you avoid post-glaucoma surgery?

A

exercise…lifting more than 10lbs…bending at the waist…straining

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31
Q

what is cataracts?

A

the lens of the eye that is normally clear becomes dry which leads it to be cloudy

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32
Q

what are the causes of cataracts?

A

trauma…long term steroid abuse…diabetes..hypothyroidism…down syndrome…excessive sunlight without eye protection

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33
Q

what would you see during an assessment for cataracts?

A

pain-free..blurry vision… decreased color perception… developed over time…can lead to blindness

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34
Q

how can you prevent cataracts?

A

protecting your eyes from the sun

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35
Q

what is done during a cataract surgery?

A

doctor removes the cloudy lens and replaces it with an artificial lens

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36
Q

At what point should surgery be considered for cataracts?

A

when it keeps you from performing ADLs

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37
Q

what are common symptoms for people who have had cataract surgery?

A

mild itching…. bloodshot eye…slight swelling…mild pain

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38
Q

what should you avoid post-cataract surgery?

A

aspirin…blood thinners…bending…coughing..sneezing..

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39
Q

what symptoms should you look out for post-cataract surgery?

A

bruising..bleeding..decreased vision…increased tear production…yellow/green drainage

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40
Q

what is macular degeneration?

A

progressive disease where you loose the inner part of your vision

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41
Q

is there a cure for macular degeneration?

A

there is no cure but there is a surgery that provides temporary relief

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42
Q

what are the two kinds of macular degeneration?

A

dry and wet

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43
Q

what is wet macular degeneration?

A

Abnormal growth of blood vessels into the macula

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44
Q

what is dry macular degeneration?

A

Decresed blood flow to retina

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45
Q

who is at risk for developing macular degeneration?

A

people who dont take in enough Vitamin E and Keratin, smoking, diabetes, hypertension

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46
Q

what are the symptoms of macular degeneration?

A

no vision in the middle of their sight and decreased depth perception

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47
Q

what is conductive hearing loss?

A

genetic disorders, infections, head trauma, fluid, foreign objects, allergies, ruptured ear drum, impacted ear way

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48
Q

what is sensorineural hearing loss?

A

genetic disorder, infections, head trauma, aging, noise damage, drug side effects, auditory tumors, explosions

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49
Q

what in your assessment points to hearing loss?

A

the patient can’t hear you…certain pitches/voices can be heard…vertigo… tinnitus…

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50
Q

how can you prevent hearing loss in your old age?

A

not being around loud things…not listening to your music loud…wearing ear protection when in a loud environment…treating ear infections quickly

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51
Q

what are advance directives?

A

Advance directives are legal documents that provide instructions for medical care and only go into effect if you cannot communicate your own wishes.

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52
Q

what are some examples of advance directives?

A

Living will and durable POA

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53
Q

what is a living will?

A

written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preferences for other medical decisions, such as pain management or organ donation

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54
Q

what is a durable POA?

A

appoints a person to make decisions for you

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55
Q

what is palliative care?

A

care for someone with a chronic lifelong illness that will lead to death…..curative treatments are still being performed

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56
Q

what is hospice care?

A

the patient has less than 6 months to live and will no longer receive curative treatment

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57
Q

is hospice part of palliative care?

A

yes

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58
Q

is palliative care part of hospice?

A

no

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59
Q

what is a DNR/AND order?

A

the patient has decided that they do not want to be resuscitated

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60
Q

what does DNR stand for?

A

Do not resuscitate

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61
Q

what does AND stand for?

A

allow natural death

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62
Q

what does DNI stand for?

A

do not intubate

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63
Q

what does POLST stand for?

A

physician order for life-sustaining treatment

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64
Q

xx what does a POLST order mean?

A

this allows the patient to pick and choose what treatments they want under certain conditions if they happen to be not fit for decision-making

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65
Q

what is a slow code?

A

purposefully not doing a code to the full extend

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66
Q

what are some other names for assisted dying?

A

can be called physician aid in dying, medical aid in dying, physician-assisted dying or physician-assisted suicide

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67
Q

what is assisted dying?

A

this happens when the patient is given a lethal dose of a certain medication that they self-administer to end their life

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68
Q

what is active euthanasia?

A

patient action that leads to death….stopping eating or drinking

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69
Q

what is passive euthanasia?

A

allowing patients to die by taking away life-sustaining interventions such as ventilators, feedings tubes etc

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70
Q

what is palliative sedation?

A

administration of sedative medications in monitored settings and is aimed at inducing a state of decreased awareness or absent awareness

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71
Q

what is an actual loss?

A

loss of a person, status, leg, etc

72
Q

what is a perceived loss?

A

unique to the person experiencing it….cant be verified by others…subjective

73
Q

what is an example of a perceived loss?

A

loss of youth, financial independence, a certain environment

74
Q

xx what is maturation/developmental loss?

A

normal loss to aging…kids leaving the home

75
Q

what is situational loss?

A

loss of home in a tornado….loss of car in a car wreck

76
Q

what is anticipatory loss?

A

feeling like you have lost something before it has happened

77
Q

what are the 4 types of greiving?

A

physical, emotional, social, and spiritual

78
Q

what is physical grieving?

A

crying

79
Q

what is emotional grieving?

A

sadness, yearning

80
Q

what is social grieving?

A

detachment and isolation

81
Q

what is spiritual grieving?

A

questioning the reasoning for life and death

82
Q

what is dysfunctional grieving?

A

the grieving types continue on for more than 6 months

83
Q

what should you watch out for in those who are dysfunctional grieving?

A

increased risk of suicide

84
Q

what is complicated grieving?

A

chronic, exaggerated, and taking frustration out on the family…….only focus is on the death of the person

85
Q

what is disenfranchised grieving?

A

grief that you feel like you cant express publicly due negative stigmas on that topic

86
Q

what are some instances where someone may experience disenfranchised grief?

A

abortion, someone committed suicide, the death of a patient, a family member being on drugs

87
Q

what are the 5 stages of Kubler-ross stages of grief?

A

denial…anger…bargaining…depression…acceptance

88
Q

what does denial mean in Kubler-ross stages of grief?

A

wont accept that they are dying…think it is a mistake… do not think the tests/diagnosis is correct

89
Q

what does anger mean in Kubler-ross stages of grief?

A

ask why is this happening or why are they leaving

90
Q

what does bargaining mean in Kubler-ross stages of grief?

A

trying to buy time for a specific event

91
Q

what does depression mean in Kubler-ross stages of grief?

A

typical symptoms

92
Q

what does acceptance mean in Kubler-ross stages of grief?

A

understanding that death is going to occur

93
Q

what are the symptoms that death is about to occur?

A

cold…shallow breaths…apnea..death rattle..anorexic…incontinence… increased sleep

94
Q

what should be done during post-mortem care?

A

remove any jewelry, tubes/ivs should be removed, the patient should be cleaned up, and placed into the body bag.

95
Q

what is the pathophysiology behind diabetes?

A

your pancreas does not produce enough insulin

96
Q

when does your body produce the most insulin?

A

when you are eating

97
Q

when does your body produce the least amount of insulin?

A

when you are fasting

98
Q

what does insulin do?

A

insulin moves the sugar from your blood into your cells

99
Q

what are some symptoms of hyperglycemia?

A

polyuria…polyphagia…polydipsia

100
Q

what is the normal range for blood sugar levels?

A

60-100

101
Q

how can diabetes be diagnosed?

A

signs and symptoms and random check of 200 or above

102
Q

what is a post-load blood sugar and what number indicates diabetes?

A

you ingest a large amount of glucose and if you are over 200 you have diabetes

103
Q

what is a fasted blood glucose and what number indicates diabetes?

A

you can drink water but can not eat for 8 hours and if you are over 126 you have diabetes

104
Q

what are signs and symptoms of uncontrolled diabetes?

A

polyuria….polyphagia…polydipsia…weight loss…delayed wound healing…hyperglycemia…blurred vision…head ache

105
Q

what is polyuria?

A

excessive urination

106
Q

what is polyphagia?

A

extreme hunger

107
Q

what is polydipsia?

A

excessive thirst

108
Q

what does a HBA1C of 6.5 and under mean?

A

that your blood sugar is under control

109
Q

what does an HBA1C over 6.5 mean?

A

that your blood sugar is not under control

110
Q

what does HBA1C measure?

A

blood test that measures you average glucose level over 3 months

111
Q

what are macrovascular complications in diabetics?

A

stroke, heart attack, peripheral artery disease

112
Q

why are diabetics more susceptible to macrovascular/microvascular complications?

A

the high glucose content causes damage to the vessels

113
Q

what is a microvascular complication that diabetics might get?

A

nephropathy, retinopathy, neuropathy

114
Q

if you have a problem with your kidneys what should you avoid when getting an MRI?

A

contrast

115
Q

if you have a problem with your kidneys what medication should you avoid?

A

nephrotoxic meds

116
Q

what kind of diet should you be on if you are having problems with your kidneys?

A

low sodium and low protein

117
Q

what should diabetic patients do?

A

consult with a nutritionist, eat a balanced diet, eat about the same time every day, eat raw vs cooked vegetables, monitor weight, limit alcohol consumption, exercise 3x per week, use your glucometer

118
Q

what should diabetic patients avoid?

A

smoking, excessive alcohol consumption, sweeteners with caloric value

119
Q

what is oxygenation?

A

process of supplying cells with oxygen

120
Q

what should information be gathered in a history when assessing a patient’s lungs?

A

Past conditions….smoking… environment…occupation….trouble breathing…current illnesses…medications

121
Q

what should information be gathered in a history when assessing a family history related to the lungs?

A

genetic problems

122
Q

what is the group of lung sounds that are not normal called?

A

adventitious lung sounds

123
Q

what are some examples of adventitious lung sounds?

A

crackles, wheezes, stridor, friction, wheezing

124
Q

other than auscultation how can you physically assess someone’s lungs?

A

look at vitals signs specifically O2 percentage

125
Q

where in the lung do you hear bronchial lung sounds?

A

upper region

126
Q

where in the lung do you hear bronchovesicular lung sounds?

A

middle region

127
Q

where in the lung do you hear vesicular lung sounds?

A

lower region

128
Q

how can bronchial lung sounds be described?

A

loud and harsh

129
Q

how can a bronchovesicular lung sound be described?

A

mixed between loud and soft

130
Q

how can a vesicular lung sound be described?

A

soft

131
Q

what do crackles in the lungs sound like?

A

popping and rattling

132
Q

what does crackles in the lungs typically point to?

A

pulmonary edema or atelectasis

133
Q

what is atelectasis?

A

collapsed lung

134
Q

what does friction sounds in the lung typically point to?

A

the lungs are rubbing together

135
Q

what does rhonci sound in the lungs typically point to?

A

foreign body and thick secretions

136
Q

what do rhonchi lung sounds sound like?

A

snoring

137
Q

what do wheezing lund sounds typically point to?

A

asthma

138
Q

what do arterial blood gas tests show?

A

measures oxygen, co2, and ph of the blood

139
Q

how is a abg performed?

A

a small proble is placed into the artery

140
Q

what does a sputum specimen show?

A

shows infection

141
Q

what are the guidelines for collecting a sputum specimen?

A

best done in the morning food or drink…not spit..actual mucus…

142
Q

what does a chest x-ray show in relation to the lungs?

A

looking for fluid, tumors, foreign bodies, or other diseases

143
Q

what should a patient do during the chest x-ray?

A

hold their breath

144
Q

what does a ct scan show in relation to the lungs?

A

looking for pulmonary tumors or nodules

145
Q

what is more accurate for lung diagnosis x-ray or CT?

A

ct

146
Q

what should be taken into consideration when sending a patient down to get a CT scan?

A

if the patient has claustrophobia

147
Q

what does a pulmonary function test show in relation to the lungs?

A

it shows the peak flow rate

using a spirometer you can see if the treatment is working

148
Q

what is a bronchoscopy?

A

a scope goes directly into the lungs to look for any abnormalities….biopsy can also be take

149
Q

what should be done when you get a patient post-bronchoscopy?

A

make sure they have gag reflex…start with ice chips to test swallowing abilities

150
Q

what is normal in first 24 hours post bronchoscopy?

A

fever and bloody sputum

151
Q

what is a thorocentesis

A

a procedure done to remove fluid or air in the thoracic cavity

152
Q

what can happen to a patient if the flow rate is too high?

A

oxygen toxicity

153
Q

what can be monitored to prevent oxygen toxicity?

A

ABG

154
Q

what is the flow rate and FiO2 for a nasal cannula?

A

1-6 L/min and 24-44%

155
Q

can a nasal cannula be used long term?

A

yes

156
Q

what is the flow rate and FiO2 for a simple face mask?

A

5-8 L/min and 40-60%

157
Q

can a simple face mask be used long term?

A

no

158
Q

what is the flow rate and FiO2 for a partial rebreather?

A

8-11 L/min and 60 -75%

159
Q

what is the flow rate and FiO2 for a nonrebreather?

A

10 - 15 L/min and above 90%

160
Q

what is a venturi mask used for?

A

it is a high-flow mask which is the most accurate oxygen-delivery device

161
Q

how does a venturi mask work?

A

it uses tips that are put on the oxygen tree and each tip mixes room air and oxygen

162
Q

what is the pathophysiology behind asthma?

A

the smooth muscle rings found in the bronchi and bronchioles contract which constricts the airway the constriction occurs its makes the mucosal lining secrete mucous which makes it even harder for air to pass

163
Q

what can trigger asthma attacks?

A

pollen, smoke, fragrances, dust, exercise, cold weather, stress and common colds

164
Q

what is hyperinflation in asthmatics?

A

it occurs when someone is having an asthma attack and the air becomes trapped inside the lung

165
Q

what are some symptoms of asthma?

A

Shortness of breath
Cough
Chest tightness or pain
Wheeze (a whistling sound when you breathe)
Waking at night due to asthma symptoms
A drop in your peak flow meter reading (if you use one)

166
Q

what can be done to help diagnose asthma?

A

ABGs…to monitor gasses
Physical auscultation
PFT…to monitor treatment effectiveness and find a baseline

167
Q

how can you manage asthma?

A

medications and learning triggers

168
Q

what is status asthmaticus?

A

an extreme asthma attack characterized by hypoxemia, hypercarbia, and respiratory failure

169
Q

what is hypoxemia?

A

low oxygen in the blood

170
Q

what is hypercarbia?

A

increased co2 in the blood

171
Q

what is COPD?

A

the combination of emphysema and bronchitis

172
Q

what is the most common cause of copd?

A

smoking and smoking exposure

173
Q

what genetic disorder can lead to copd?

A

alpha 1 antitrypsin deficiency

174
Q

what interventions can help people with copd

A

oxygen therapy…breathing techniques..positioning…coughing..drug therapy…suctioning..exercise…prevent infection..prevent weight loss

175
Q
A
176
Q
A

Nursing Chronic Care (4 decks)

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