exam 3 Flashcards
kubler-ross stages of grief
1) denial: avoidance, confusion, elation, shock
2) anger: frustration, irritation, anxiety
3) bargaining: overwhelmed, helplessness, hostility
4) depression: struggling to find meaning, reaching out to others, telling ones story
5) acceptance: exploring options, new plans, moving on
hospice care:
support the client who has a terminal illness, so they can live the last days of their life as best as they can, as long as they can, terminal cancer but has grown to include any client with a life-limiting illness
palliative care:
holistic care provided throughout the lifespan for clients experiencing
severe medical illness and particularly for clients approaching end of life
classes of nutrients:
macronutrients: protein, carbs, fats, provide body with energy, it needs to function
micronutrients: vitamins and minerals, small amounts, optimal growth, development and body function
weight loss:
1-2 pounds per week, implementing exercise regimen, increase fiber allows fewer calories, if weight loss unintentional need to find the cause, 5-10% of body weight
BMI:
< 18.5: underweight
18.5-24.9: normal (healthy)
25-29.9: overweight
>30: obese
multiply your weight in pounds by 703, divide by your height in inches, then divide again by your height in inches
malnutrtion:
condition that occurs when the body doesn’t get enough or the right nutrients, or when nutrients are not used properly
vitamins and sources
water soluble: vitamins C, B, carried to tissues not stored in body
fat soluble: vitamins A, D, E, K, liver and fatty tissues
intake of fluids, calories
2.7-3 liters of water for women, 3.5-3.7 liters of water for men, brain function, hydrates and flushes out wastes from body, regulates body temperature, acts as lubricant in body
my plate food guide
a simple visual reminder to choose a variety of foods throughout the day and throughout the week, fruits, grains, dairy, veggies, protein
anorexia
an eating disorder causing people to obsess about weight and what they eat, not eating at all
supplements
should not be a replacement of a healthy diet, toxicity can occur
different types of therapeutic diets
NPO, Regular, Soft, Pureed, Liquid, Cardiovascular, Renal
TPN
total parenteral nutrition, used in patients without a functioning GI tract, IV, pts who cannot tolerate adequate nutrition by mouth
NGT feedings
a method of providing nutrition, fluids, or medication to a patient through a thin, soft tube that is inserted into the nose and runs down into the stomach
Dysphagia
difficulty swallowing
constipation
infrequent bowel movements, fewer than 3 per week, stools are hard, lumpy,
and difficult to pass, high fiber diet, hydration, exercise, bowel training,
medication to soften stool
diarrhea
frequent loose, watery stools
throughout the day, dehydration, abdominal cramping, bloating, and
nausea
daily diet
diet can influence stool production
stool sample tests
fecal occult blood test: presence of blood
stool culture: organisms in stool,
ostomies and stool output
ileostomy: Temporary or permanent fecal diversion that uses terminal end of small intestine called the ileum
colostomy: Fecal diversion in which part of the colon is used to form a stoma through the abdominal wall allowing for passage of body waste
j-pouch: Internal pouch formed within the ileum
kock pouch: Using the ileum an internal pouch with a valve is formed so that intestinal contents do not escape the ileostomy
stomas
an opening in the body that can be natural or artificial, and can be used to divert bodily waste into a bag
stages of pressure ulcers:
Stage 1: Reddened area, unbroken skin, intact skin
Stage 2: Shallow open area, partial thickness loss, exposed dermis
Stage 3: Open area with adipose tissue exposed, full thickness skin loss, not involve fascia
Stage 4: Open area with muscle and bone exposed, full thickness loss, tissue loss
unstageable: obscured full-thickness skin and tissue loss
where can pressure injuries be found?
bony prominences such as elbows, hips, knees, heels or ears (from O2 tubing), sacrum, from pts who are immobile
what are the stages of braden scale?
- Sensory Perception
- Moisture
- Activity
- Mobility
- Nutrition
- Friction and Shear
higher the score, the less likely the patient is to develop a pressure injury. The Braden Scale score is part of the assessment in the hospital
what is the largest organ of body
skin
what is our skin functions?
Body temp regulation
Vitamin D production
Immunologic
Absorption
Elimination
serous:
having to do with serum, the clear liquid part of blood, clear pale yellow
four stages of wound healing:
hemostasis: immediately after intial injury, exudate is formed, swelling, pain
inflammatory: follows hemostasis, 2-3 days, WBC move to wound, pain, redness, swelling, generalized body reponse
proliferation: several weeks, new tissue is built, capillary grow, thin layer
maturation: final stage, 3 weeks after injury, continue for months or years, collagen remodeled, scarring
complications of wound healing examples:
Infection, Hemorrhage, Dehiscence and Evisceration and Fistula formation
serosanguineous:
containing or relating to both blood and serum, the liquid part of blood, light pink to red
sanguineous:
relating to, containing, or being the color of blood, bright red or pink
what is the key to wound healing?
hand washing
purulent:
containing or producing pus, white, yellow, green, pink, or brown
protein:
major building block of body, amino acids, structure, function, modulation, sources include beans, soy, nuts, meats, eggs, fish, 2-6.5oz
carbohydrates:
macronutrient provides bodys cells, organs, tissues, turns into sugar, 45-65% total daily calories, sources in veggies, fruits, milk, grain, nuts, grains, legumes, seeds, potatoes, white bread,
fats:
helps body absorb vitamins while providing energy, mjor role in cholesterol, trans and saturated should be limited, healthy fats preferred, nuts, olives, olive oil, seeds, avocados
macrominerals
calcium: milk
phosphorus: eggs
magnesium: spinach
sodium: salt
chloride: lamb chops
potassium: banana
sulfur: sushi
bronchi:
__ are the two main branches of the trachea that lead
into the lungs
alveoli
are tiny air sacs in the lungs where gas exchange
occurs
main function of the respiratory system is to take in_____ and remove ___ from the body?
oxygen and carbon dioxide
diaphragm
is a muscular organ that separates the chest cavity from the abdominal cavity and aids in breathing
nasal cannula
Nasal prongs that sit in the nares
o 1-6 L/min
o 24-44% FiO2
o Indication – mild shortness of breath, asthma, COPD, CF,
pneumonia
o Risks – mucosal drying, skin breakdown at nares and ears
simple face mask
Standard face mask that covers the nose and mouth
o 6-10 L/min
o 40-60% FiO2
o If it has a reservoir bag on it, it is called a partial rebreather mask
o Indication – if nasal cannula is insufficient
o Risks – CO2 buildup, cannot eat or drink while wearing
Nonrebreather Mask
Has a valve on the exhalation port and between the reservoir
bag and mask
o The valves prevent room air from coming in
o Make sure reservoir remains at least 1/3 full on inhalation
o 10-15 L/min
o FiO2 up to 95%
o Indication - if simple mask is insufficient, traumatic injury, or
smoke inhalation
o Risks – uncomfortable, impedes ability to communicate, eat, or
drink
High Flow Nasal Cannula
Thicker nasal cannula, includes air/oxygen blender, humidifier,
heater, and nasal cannula
o 30-60 L/min
o 21-100% FiO2
o Indication – pneumonia, post extubation, preoxygenation prior to
intubation
o Risks – expensive, not typically available for home use
bag valve mask
Face mask and reservoir bag, positioned over the patient’s nose
and mouth, forces air into the lungs when squeezing the bag
o 12-15 L/min
o 60-100% FiO2
o Indication – emergent resuscitation, hypercapnia, respiratory
failure, apnea, altered mental status with inability to protect
airway
o Risks – requires effective seal, provider fatigue, short term
ventilation only
pulmonary function test (PFT)
non-invasive test that measures the amount of air a
person can exhale after a deep breath in, as well as how fast they can
do so
computed tomography scan (CT)
procedure that uses a special camera to take pictures
of the lungs and can help diagnose conditions such as pneumonia, lung
cancer, or chronic obstructive pulmonary disease (
Arterial Blood Gas (ABG) Test
test that measures the levels of oxygen and carbon
dioxide in the blood, as well as the blood’s pH balance, to assess how
well the lungs are functioning
right lung has how many lobes, and left lung has how many lobes?
right lung: 3
left lung: 2
perfusion
process by
which oxygenated capillary
blood passes through body
tissues
forced vital capacity (FVC)
The total amount of air exhaled during a maximal expiration effort
Forced Expiratory Volume in 1 second (FEV1)
The percentage of the FVC that is exhaled in the first second of
forced expiration
FEV1/FVC ratio
The ratio of FEV1 to FVC, often expressed as a percentage
Total Lung Capacity (TLC)
The volume of air in the lungs at the end of a maximal inspiration
Peak Expiratory Flow Rate (PEFR
The maximum flow rate of air during a forced expiration, starting
from full lung inflation.
Residual Volume (RV)
The volume of air remaining in the lungs after a maximal expiration
Functional Residual Capacity (FRC)
The volume of air in the lungs at the end of a normal expiration
Nasal Cannula:
A small tube with two prongs that are inserted into
the nostrils. It delivers oxygen directly into the nasal passages.
Forced Expiratory Flow (FEF)
The maximum amount of air exhaled forcefully after a deep
inhalation
Oxygen Mask
A mask that covers the nose and mouth and delivers
oxygen from an oxygen source. It is often used when higher
concentrations of oxygen are needed
Non-Rebreather Mask:
A mask that delivers high concentrations of
oxygen. It has a reservoir bag that allows the patient to breathe in
oxygen from the bag without breathing in room air
