Exam 3 Flashcards
What is the major cause of tooth loss in adults older than 35 years?
Gum disease
What is the decay of teeth with the formation of cavities called?
Caries
What is gingivitis?
Gingivitis is an inflammation of the gingiva, tissue surrounding the teeth
What is periodontitis?
Periodontitis is a marked inflammation of the gums that also involves degeneration of the dental periosteum and bone
What is stomatitis?
Stomatitis , an inflammation of the oral mucosa, has numerous causes, such as bacteria, viruses, mechanical, trauma, irritants, nutritional deficiencies, and systemic infection. Symptoms include heat, pain, increased flow of saliva, and halitosis.
What is glossitis?
Glossitis, an inflammation of the tongue,can be caused by deficiencies of vitamin B12, folic acid, and iron
What is cheilosis?
Cheilosis, an ulceration of the lips, is most often caused by vitamin B deficiencies (esp. Riboflavin)
What are the symptoms of periodontitis ?
Symptoms include: bleeding gums, swollen, red, painful gum tissue,receding gum lines,, pus that appears when gums are pressed and loose teeth
What is pediculosis?
It means to be infested with lice
What are the 3 common types of lice?
Pediculus humanus capitis: hair/scalp
Pediculus humanus corporis: body
Phthirus pubis: pubic
Where should you store dentures?
Store denture in cold water, leaving dentures to dry can cause warping
True or false
In a patient that wears contacts, the cornea requires more than the normal supply of oxygen because it’s metabolic rate increases
True
What could happens if you don’t pull the foreskin back up after cleansing?
It could cause constriction of the penis,which may result in edema and tissue injury
The nurse observes a marked inflammation of the gums, and recession and bleeding of the gums and documents this using what term?
Periodontitis
Mr. James has an eye infection with a moderate amount of discharge. Which action would be most appropriate for the nurse to use when cleaning his eyes?
Positioning him on the same side as the eye to be cleaned, this helps to discourage contamination of the other eye
Why is adequate oral hygiene an essential part of nursing care?
Adequate oral hygiene is essential for promoting the patients sense of well being and
Preventing deterioration of the oral cavity. Diligent oral hygiene care can also improve oral health and limit the growth of pathogens in the oropharyngeal secretions, decreasing the incidence of aspiration pneumonia
What is the first indication that a pressure ulcer may be developing?
Blanching (pale and white) when pressure is applied to the area
What is reactive hyperemia
It’s a blanchable reddening of the skin that occurs when pressure is removed
True or false
Reactive hyperemia is not a pressure ulcer
True, it is not a pressure ulcer
Describe stage I pressure ulcer
A stage I pressure ulcer is a defined area of intact skin with non-blanchable redness of a localized area usually over a bony prominence. The area may be painful, firm, warmer or cooler compared to other tissue
Describe a stage II pressure ulcer
A stage II pressure ulcer involves partial thickness loss of dermis
Describe a stage III pressure ulcer
A stage III ulcer presents with full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscle is not exposed. Slough that may be present does not obscure the depth of tissue loss. May include undermining and tunneling
Describe a stage IV pressure ulcer
Stage IV ulcers involve full thickness tissue loss with exposed bone, tendon, or muscle. Slough or Escher May be present on some part of the wound and often includes undermining and tunneling
Describe a suspected deep tissue ulcer
A suspected deep tissue injury presents as purple or maroon localized area of discolored intact skin or blood filled blister due to damage of underlying soft tissue
When would pressure ulcers be classified as unstageable?
Pressure also are classified as unstageable when the base of the ulcer is covered by slough ( yellow, tan, green, brown) and or Eschar ( tan, brown, black)
What is Eschar ?
It’s a thick, leathery scab or dry crust that is necrotic tissue and must be removed before the stage can be determined accurately
What is sodium (Na+) normal range?
135-145 mEq/L
What is potassium (K+) normal range?
3.5-5.0 mEq/L
What is calcium (Ca+) normal range?
4.5-5.5 mg/dL
What is bicarbonate (HCO-3) normal range?
In the artery: 22-26
In the vein:25-29
What’s chlorides (Cl-) normal ranges?
95-107 mEq/L
What’s magnesium (Mg2+) normal range?
1.5-2.5 mEq/L
What’s phosphates normal ranges?
2.5-4.5 mg/dL
Describe sodiums role
- most abundant cation
- major factor in maintenance of water balance
Describe potassium role
- major cation in intracellular compartment
- normal cardiac conduction
Describe calciums role
- stored in bone, plasma, and body cells
- necessary for bone formation, blood clotting, muscle contraction
What is sodiums main function?
Controls and regulates volume of body fluids
What is potassiums main function?
Chief regulator of cellular enzyme activity and water content
What is calciums main function?
Calcium is important in nerve impulse, blood clotting, muscle contraction, B12 absorption
What is magnesium so main function?
Metabolism of carbohydrates and proteins, vital actions involving enzymes
What is chlorides main function?
Maintain osmotic pressure in blood, produces hydrochloric acid
What is bicarbonate main function?
It’s the body’s primary buffer system
What is phosphates main function?
Involved in important chemical reactions in body, cell division, and hereditary traits
What is osmosis?
When water passes from area of lesser solute concentration to greater concentration until equilibrium is established
What is diffusion?
The tendency of solutes to move freely throughout a solvent
What is active transport?
Active transport requires energy for movement of substances throughout cell membrane from lesser solute concentration to hire sorry concentration (needs ATP)
What is filtration?
The passage of fluid through permeable membrane from area of higher to lower pressure
I.e. Colloid osmotic pressure
And hydrostatic pressure
What is the average adult intake for fluid?
2200-2700 ml day
What is hypovolemia?
Excessive fluid loss
-vomiting, hemorrhage
What is ADHs role in the regulation of body fluids?
- pituitary gland
- released during times of stress, pain, circulating blood volume
- causes the body to save water
What is angiotensin I & II role in the regulation of body fluids?
-vasoconstriction and kidney perfusion
What is aldosterone’s role in regulating body fluids?
Volume regulator
True or false
ANP acts as a diuretic
True
How much of a person’s weight is water?
50-60%
True or false
Because ECF is more easily lost from the body then ICF, infants are more prone to fluid volume deficit
True
Where is the thirst control Center located
Within the hypothalamus, the thirst control Center is stimulated by intracellular dehydration and decreased blood volume
What are the major cations in the body?
Sodium, potassium, calcium, hydrogen, and magnesium
What are the major anions in the body?
Chloride, bicarbonate, and phosphate
What are solvents?
Solvents are liquids that hold of substance in solution
Water is the primary solvent in the body
What are solutes?
Solutes are substances that are dissolved in a solution.
The primary solutes in the body or electrolytes and nonelectrolyte
What is the major method of transporting body fluids?
Osmosis
What is capillary filtration?
Capillary filtration results from the force of blood pushing against the walls of the capillaries. The pushing force is referred to as hydrostatic pressure. When the hydrostat static pressure inside the Caplerry exceeds the surrounding interstitial space, fluids are forced out of the capillary wall into the interstitial space.
What is an acid?
An acid is a substance containing H+ that can be liberated or released
The strong acid dissociates completely in solution and releases all of it H ions, where as a weak acid releases only a small number
What is the base?
A base is a substance that can accept or trap H+ ions
What is acidosis?
Acidosis is a condition characterized by an excess of H ions or lost based ions in the ECF in which pH falls below 7.35
What is alkalosis?
Alkalosis occurs when there is a lack of H ions or a gain of base ions in the pH exceed 7.45
The narrow range of normal pH is achieved by what three major homeostatic regulators?
- Chemical buffer systems
- Respiratory mechanism
- Renal mechanism
What is the buffer?
A buffer is a substance that prevents body fluids from becoming overly acidic or alkaline.
Buffers work in one of two ways. A buffer can function like a base and bind up free hydrogen ions or a buffer can function like an acid and release hydrogen ions when too few are present.
What are the three buffer systems of the body?
- The carbonic acid sodium bicarbonate buffer system
- The phosphate buffer system
- The protein buffer system
Hypervolemia vs. Hypovolemia
Hypervolemia is excessive retention of water and sodium in ECF
Hypovolemia is excessive fluid loss
What is Edema?
Edema is an accumulation of fluid in the interstitial space. It can be observed around eyes, fingers, ankles, and sacral space
What is hyponatremia?
Hyponatremia refers to as sodium deficit in ECF caused by a loss of sodium Or gain of water. (Less than 135 mEq/L NA)
Symptoms: confusion, hypotension, edema, muscle cramps, weakness, and dry skin
What is hypernatremia?
Hypernatremia refers to a surplus of sodium in ECF caused by excess water loss or an overall excess of sodium. (More than 145 mEq/L NA)
Symptoms: neurological impairment, restlessness, weakness, disorientation, delusion, and hallucinations
What is hypokalemia?
Hypokalemia refers to a potassium deficit and ECF and is a common electrolyte abnormality ( less than 3.5 mEq/L)
Symptoms: muscle weakness, leg cramps, fatigue, paresthesias, and dysrhythmia
What is hyperkalemia?
Hyperkalemia refers to an excess of potassium in ECF ( more than 5 mEq/L)
Symptoms: skeletal muscle weakness, paralysis, cardiac arrest
What is hypocalcemia?
Hypocalcemia refers to a calcium deficit in ECF (serum ca <4.5)
Symptoms: numbness and tingling fingers mouth or feet, muscle cramps, seizures
What is hypercalcemia?
Hypercalcemia refers to an excess of calcium in ECF ( serum ca >10.1, ionized ca >5.1)
Symptoms: nausea, vomiting, constipation, bone pain, excessive urination, thirst, confusion, lethargy, slurred speech
What is hypomagnesemia?
Hypomagnesemia refers to a magnesium deficit in the ECF ( serum mg <1.5 mEq)
Symptoms: muscle weakness, tremors, seizures, heart block, changes in mental status, respiratory paralysis
What is hypermagnesemia?
Hypermagnesemia refers to a magnesium accessing the ECF ( serum mg >2.5 mEq)
Symptoms: nausea, vomiting, weakness, Flushing, lethargy, respiratory depression, coma, cardiac arrest
What is hypophosphatemia?
Hypophosphatemia refers to a below normal concentration of phosphorus in the ECS ( serum <2.5 or 2.8)
Symptoms: irritability, fatigue, confusion, seizures, coma
What is hyperphosphatemia?
Hyperphosphatemia refers to an above normal concentration of phosphorus in the ECF ( serum >4.5 or 2.6)
Symptoms: tetany, anorexia, nausea, muscle weakness, tachycardia
What is hypochloremia?
Hypochloremia refers to a below normal level of chloride in the ECF ( serum <96)
Symptoms: Hyperexcitability of muscles, tetany, weakness, muscle cramp
What is hyperchloremia?
Hyperchloremia refers to the above normal level of chloride in the ECF ( serum >106)
Symptoms: tachpnea, weakness, lethargy, hypertension, decreased cardiac output, dysrhythmias, coma
What is respiratory acidosis?
Respiratory acidosis is a primary excess of carbonic acid in the ECF. The body increases respiratory rate to expel more CO2…. CO2 level in the blood is reduced
What is respiratory alkalosis?
Respiratory alkalosis is a primary deficit of carbonic acid in the ECF. It is the result of alveolar hyperventilation, breathing that it’s faster and deeper, and the consequent increasing the elimination of CO2
What is metabolic acidosis?
Metabolic acidosis (low pH) is a proportionate deficit of bicarbonate in ECF. The lines attempt to increase the carbon dioxide excretion by increasing the rate and depth of respirations. However, respiratory compensation is generally not adequate, and the kidneys attempt to compensate by retaining HCO3 and by excreting more hydrogen
What is metabolic alkalosis?
Metabolic alkalosis( high pH) is associated with an excess of HCO3, a decrease in H+ ions, or both in the ECF. The body attempts to compensate by retaining carbon dioxide. The respirations become slow and shallow, and periods of no breathing may occur. The kidneys attempt to excrete excess H2O and NA ions with the excess bicarbonate and retain H ions
What is the pH of urine?
4.6-8.2 with the normal around 6
What can lower than normal urinary pH indicate?
Metabolic acidosis, diabetic ketosis, and diarrhea
What can higher than normal urinary pH indicate?
Respiratory alkalosis, potassium depletion, and chronic renal failure
What are the normal values for calcium and phosphorous?
Serum calcium: 9.0-11.0
Phosphorous: 3.0-4.5
Describe the calcium/phosphate relationship
Calcium >11.0 = phosphate 4.5
What causes a fluid volume deficit?
Fever, excessive perspiration, burns, hemorrhage, diarrhea, vomiting, use of diuretics
What causes a fluid volume excess?
CHF, renal failure, cirrhosis of deliver
Hyperosmolar/dehydration
Diabetes insipidus, diabetic ketoacidosis, hypertonic parental fluids or to feeding formula
Hypoosmolar/water excess
Syndrome of inappropriate anti diuretic hormone and excess water intake
Describe acidic pH
The more H+ ions….the more acidic….lower the pH
Describe alkaline pH
The less H + ions….more alkaline….higher pH
What is the pH of arterial blood?
7.35-7.45
Describe an arterial blood gas analysis
pH: 7.35-7.45
PaCO2: 35-45 mmhg
HCO3-: 22-26 mEq/L
Respiratory acidosis vs. respiratory alkalosis
Respiratory acidosis is the primary excess of carbonic acid in ECF
Respiratory alkalosis is the primary deficit of carbonic acid in ECF
Metabolic acidosis versus metabolic alkalosis
Metabolic acidosis is proportionate deficit of bicarbonate ECF
Metabolic alkalosis is primary excess of bicarbonate ECF
What causes respiratory acidosis?
Hyperventilation, hypoxemia, hyperkalemia, hypercalcemia
What causes respiratory alkalosis?
Hyperventilation, asthma, overdose of aspirin
What is your BP like in respiratory acidosis and alkalosis?
Respiratory acidosis: low BP (vasodilation)
Respiratory alkalosis: low or normal BP
What can cause metabolic acidosis?
Severe diarrhea, renal disease
What Can cause metabolic alkalosis?
Vomiting, gastric suction
In respiratory acidosis
PH : low
CO2 : high
HCO3: low
In respiratory alkalosis
PH: high
CO2: low
HCO3: high
In metabolic acidosis
PH: low
CO2: low
HCO3: low
In metabolic alkalosis
PH: high
CO2: high
HCO3: high
What is isotonic?
Same concentration of particles of plasma
What Is hypertonic?
Greater concentration of particles in plasma
What is hypotonic?
Lesser concentration of particles in plasma
Examples of isotonic solutions
D5W
0.9% normal saline
Examples of hypotonic solutions
- 45 NS
0. 33 NS
Examples of hypertonic solution
D10W dextrose 10% in water
D5 in 0.9% NS ( NS is normal saline)
D5 in 0.45% NS
D5 in lactated ringers
What is phlebitis?
Inflammation of vein
What are signs you are giving fluids to quickly?
SOB
Crackles
Tachycardia
True or false
70% of water is intracellular
True
What foods have a lot of potassium in them?
Oranges, banana, sweet potato
Compensated versus uncompensated
If pH is abnormal it’s uncompensated
If pH is normal it’s been compensated
Lasix and digoxin together
Lasic increases urine production and does not spare potassium loss
Without a potassium supplement the patient becomes hypokalemic
Increases bricks for digoxin toxicity
Both hypokalemia and hyperkalemia can cause cardiac dysrhythmia
Plasma the liquid constituent of blood, is correctly identified as which of the following?
Intravascular fluid or plasma is extracellular fluid and composes 5% of total body fluid
Potassium functions as which of the following?
The major cation of intracellular fluid
The movement of the solvent water from an area of lesser solute concentration to an area of greater solute concentration until equilibrium is establishes known as what?
Osmosis
Which of the following with the nurse use of the most reliable indicator of a patient’s fluid balance status?
Daily weight
Which acid base in balance with the nurse suspect after assessing the following arterial blood gas values
pH: 7.30
PaCO2: 36 mm hg
HCO3:: 14 mEq
Metabolic acidosis
Hello pH indicates acidosis. This coupled with the low bicarbonate, indicates metabolic acidosis
Which of the following with the nurse need to keep in mind when preparing to assist the physician with insertion of a non- tunneled percutaneous central venous catheter?
A chest radiograph is required to confirm placement for any central venous access device
The nurse overtly assesses the acid-base balance of a patient because she is aware that the patient will be unable to effectively control his carbonic acid supply. This is most likely patient with bad damage to which of the following?
Lungs, The lungs are the primary controller of the bodies carbonic acid supply and thus if damage can affect acid-base balance
True or false
The kidneys are the primary controller of the bodies bicarbonate supply
True
The nurse instructed patient to Kokusai grieving more slowly as the most effective intervention for which acid-base imbalance?
Respiratory alkalosis
Breathing more slowly causes accumulation of carbon dioxide to reverse carbonic acid deficit or respiratory alkalosis
Breathing more slowly would further increase a patient’s respiratory acidosis, due to the increased carbon dioxide
Which of the following is the most common etillogic factor related to nursing diagnosis of excess fluid volume?
Excessive IV infusion is the most common factors associated with excess fluid volume
Which assessment finding would lead to the nurse to suspect that a patient’s IV infiltrated?
If the site is pale, cool, swollen, and painful
When developing a teaching plan for a patient Iris for hyperkalemia which foods with the nurse instructed patient to avoid?
Bananas and apricot, Hyperkalemia is an elevated serum potassium level bananas and apricots or foods high in potassium and should be avoided in the situation
Which site would be most appropriate for initiating IV therapy for patient who has sustained multiple injuries after novelty accident and has a cast on his right arm?
The left forearm is the best site selection because of the condition of the patients right arm
When implementing the plan of care for a patient receiving IV therapy, which intervention would be most appropriate?
Monitoring the flow rate at least every hour
While administering a blood transfusion, when with the nurse assessed the patient for a blood transfusion reaction?
They should closely observed patient for the first 15 minutes and then check the patient thereafter every 15 minutes while they are receiving a blood transfusion
Hypo/hyper- tonic and isotonic
Hypertonic: RBC shrunk
Isotonic: RBC normal
Hypotonic: RBC swelled
