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Fundamentals > Exam 3 > Flashcards

Exam 3 Flashcards

0
Q

Transduction of the pain process

A

Activation of pain receptors, nocieptors- peripheral nerve fibers that transmit pain

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1
Q

The pain experience order

A

1) detect sensation
2) in spinal cord sends message to brain
3) in the brain forms response

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2
Q

Transmission of the pain process

A

Pain sensations travel along pathways to the spinal cord to higher centers, a delta fibers or c delta fibers

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3
Q

A delta fibers

A

Transmit acute, well-localized pain, sharp stabbing= quick response

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4
Q

C delta fibers

A

Conduct diffuse, visceral pain, general ache

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5
Q

Once pain stimulus reaches the brain it interprets _____ of pain and _____ with information from past pain experiences

A

Quality, processes

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6
Q

Perception of pain process

A

The point of which the person is aware of the pain, starts to hurt so person can react

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7
Q

Modulation of the pain process

A

Process by which the sensation of pain is inhibited or modified, neuromodulators (release once brain perceives pain), have analgesic activity and alter perception of pain

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8
Q

Acute pain

A

Sudden onset short duration

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9
Q

Chronic pain

A

Greater than 3 months

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10
Q

Cutaneous superficial pain

A

Skin cut

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11
Q

Somatic pain

A

Muscle pain

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12
Q

Visceral pain

A

Organ pain

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13
Q

Referred pain

A

Starts in one place felt somewhere else

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14
Q

Neuropathic pain

A

Nerve pain

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15
Q

Intractable pain

A

No cure nonstop

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16
Q

Phantom pain

A

Pain in missing limb

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17
Q

Pain assessment

A

Duration location quantity/intensity quality aggravating factors alleviating factors physiological responses behavioral factors effect on lifestyle expectations for pain relief

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18
Q

Interventions for pain

A

Opioid analgesic, nonopioid analgesic, adjuvant

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19
Q

Opioid analgesic

A

Moderate to severe pain, attach to opioid receptors in the brain, side effects respiratory depression sedation nausea constipation, examples: morphine diaudid

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20
Q

Nonopioid analgesics

A

Mild to moderate pain, many OTC, NSAIDS, Tylenol, aspirin

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21
Q

Adjuvant

A

Used for other purposes but can also enhance the effects of opioids, examples: corticosteroids antidepressants antiepileptic

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22
Q

Gate control theory of pain

A
  1. Actual existence and intensity of pain depends on transmission of pain
  2. Gate mechanisms along the nervous system control transmission of pain
  3. If the gate is open the pain impulses reach the conscious level
  4. If the gate is closed the pain impulses don’t reach the conscious level and the sensation of pain is not experienced
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23
Q

Pain travels along ____ nerve fibers. _____ nerve fibers close the gate.

A

Small, large

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24
Q

Cutaneous simulation

A

Many large fibers present, help close the gate

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25
Q

Interventions to close gate

A

TENS (low voltage electro therapy) accupressure massage hot and cold, distraction, imagery, PCA (patient controlled analgesic), epidural, Q pump (goes into site for 3-5 days to go home)

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26
Q

Hot intervention

A

Dilates vessels, decrease blood viscosity, relieves spasms, dry( pads), moist (compress, sitzbath)

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27
Q

Cold interventions

A

20 minutes on hour off, constricts blood vessels

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28
Q

Complementary pain relief measures

A

Distractions humor listen music relaxation cutaneous stimulation hypnosis biofeedback therap

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29
Q

Nurse practice act

A

Most important law affecting nurses, differ by state, protects public by defining scope of nursing practice, practice beyond scope is a violation of the nurse practice act

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30
Q

Accreditation

A

Educational program is evaluated and recognized as having met criteria, legally required to be state accredited KBN ( sets minimum standards), voluntary agencies accredit schools when they met criteria (NLNAC AACN)

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31
Q

Licensure

A

Legal document which permits person to practice nursing (NCLEX-RN exam), determines entry level competence

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32
Q

Certification

A

Validates specialty, examples: American association of critical care nurses and certified pediatric nurse

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33
Q

Torts

A

Wrong committed by person against another person or his belongings

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34
Q

Intentional legal issues

A

Assault battery fraud false imprisonment invasion of privacy

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35
Q

Assault/ battery

A

Restraining an alert oriented client in order to administer Meds

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36
Q

False imprisonment

A

Forcing someone to stay in the hospital (if they are of sound mind) AMA(against medical advice)

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37
Q

Negligence

A

Unintentional tort, preforming(or not) act that a reasonable prudent person would not(or would) have done, example: don’t give Meds or don’t report sore

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38
Q

Malpractice

A

Negligence by a professional

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39
Q

Liability (6 elements to prove malpractice or negligence)

A

Duty (obligation to do care), breach of duty( failure to meet standards of care), foreseeability (link between nurses act and injury), causation (failure to meet SOC caused injury), harm or injury (physical emotional financial), damages (awarded if malpractice caused injury)

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40
Q

Standards of care (SOC)

A

Differ for each patient or unit, skills and learning commonly possessed by members of a profession, legal guidelines for nursing practice

41
Q

Disposition

A

Formal interview of an expert witness or anyone with relevant information

42
Q

Nurse can be used as a

A

Defendant fact witness or expert witness

43
Q

Student liability

A

Responsible for own actions, legal responsible to prep for clinical, instructors must provide supervision, notify instructor right away if changes in pt occur, only perform jobs in description

44
Q

HIPPA

A

Health insurance portability and accountability act, passed in 1996 enacted in 2002, PHI, patient rights, public health activities, judicial and law proceedings, deceased individuals, permitted disclosure of PHI

45
Q

PHI

A

Protected health information

46
Q

Patient rights

A

See and copy health record, update health record, to get a list if disclosures, choose how to receive health information

47
Q

Public health activities PHI

A

Tracking disease outbreaks, infection control

48
Q

Law and judicial proceedings PHI

A

Information necessary for investigation or prosecution of a crime, example: abuse cases

49
Q

Deceased individuals PHI

A

Funeral arrangements, organ donations, coroner cases

50
Q

Nursing documentation

A

Record of all patient interactions, promotes communication between members, shows quality of client care

51
Q

Purpose of client records

A

Communication between disciplines, diagnostic orders, care plan, quality review(SOC are met), research, education, legal documentation, reimbursements, provide medical history

52
Q

Telephone orders

A

Must verify, includes: date time, T.O. With physicians name and title, signed with nurses name and title, later cosigned by dr

53
Q

Verbal orders

A

Used during emergency, must be verified, recorded with date and time with STAT physicians name VO and nurses name

54
Q

Kardex

A

Written documentation of allergies diet activity IV and test

55
Q

ISBARR

A

I=identify self and pt
S=situation (why calling)
B=background ( are they familiar?, VS, diagnosis, date admitted, IV labs and metal status
A=assessment(what you think is going on)
R=recommendation (what you need from the physician)
R=read back any orders

56
Q

Consultations

A

With a specialist

57
Q

Referral

A

PT OT hospice home health or social services(doesn’t need order)

58
Q

Ventilation

A

Process of moving gas in and out of lung

59
Q

Inspiration expiration

A

Active process stimulated by chemical receptors in aorta and a passive process for expiration

60
Q

Pulmonary circulation

A

Moves blood to and from the alveolar capillary membranes for has exchange

61
Q

Diffusion

A

Exchange of respiratory gases in the alveoli and capillaries

62
Q

Oxygen transport is done by

A

Lungs and cadiovascular system

63
Q

Carbon dioxide transport

A

Diffuses into red blood cells and is hydrated into carbonic acid

64
Q

Physiological factors affecting oxygenation

A

Decreased oxygen carrying capacity and inspired oxygen, hypovolemia, increased metabolic rate

65
Q

Conditions affecting chest wall movement

A

Pregnancy obesity musculoskeletal abnormalities trauma neuromuscular disease CNS alterations

67
Q

Hyperventilation

A

Ventilation in excess of that required to eliminate carbon dioxide produce by cellular metabolism, trachypnea

67
Q

Hypoxia

A

Inadequate tissue o2 at cellular level

68
Q

Hypoventilation

A

Alveolar ventilation inadequate to meet the body’s o2 demand or to eliminate sufficient carbon dioxide, bradypnea

70
Q

Cyanosis

A

Blue discoloration of skin and mucous membrane

71
Q

hypoxia

A

insufficient o2 anywhere in the body,early signs: increased pulse rapid shallow breathing, later signs: decrease pulse and BP cough

72
Q

hypoxemia

A

reduced o2 in blood

73
Q

chronic hypoxia

A

fatigue lethargy clubbing of fingers

74
Q

orthopnea

A

when laying flat, difficulty breathing

75
Q

APNEA

A

no breathing

76
Q

healthy people do NOT produce

A

sputum (mucous secretion from lungs or bronchi)

77
Q

small intestine

A

from stomach to large intestine, for digestion and absorption, 3 divisions: duodenum jejunum ileum, interior highly folded with villi

78
Q

large intestine

A

last 5 ft of GI not coiled, chime from the small intestine moves through the ileocecal valve (prevents from entering large intestine too soon) into the cecum (first part of the large)

79
Q

resident bacteria in the large intestine act on food as it passes through which produces

A

vitamin A and some B-complex

80
Q

sigmoid colon empties into the

A

rectum

81
Q

feces from the rectum go through the _____ via the ____ and then the waste is called _____

A

anal canal, anus, stool

82
Q

internal sphincter control in the anal canal

A

involuntary control

83
Q

external sphincter control at the anus

A

voluntary control

84
Q

factors that affect bowel elimination

A

development, daily patterns, food and fluid intake, activity, lifestyle, psychological variables (stress), pathologic conditions, medications, diagnostic studies, surgery

85
Q

stool color for adults, infants, barium or bile obstruction, iron or upper GI bleed, lower GI bleed, and colitis or fat malabsorption

A

brown, yellow, clay or white, black, red, pale or frothy

86
Q

infant frequency of stool

A

1-6 per day

87
Q

bulk forming laxatives

A

Metamucil, increase h2o absorption, safer, onset 24 hours

88
Q

stool softeners

A

Colace, safer, lowers surface tension of feces to allow water and fat to penetrate stool, prevent straining

89
Q

lubricant laxatives

A

mineral oil, safe, absorbed from the intestinal tract and soften stool, onset w/in 8 hrs

90
Q

stimulant laxative

A

Dulcolax, not safe, direct irritant effect on mucosa, faster onset and longer duration, most abused laxative

91
Q

saline and osmotic agents

A

quick acting, draws H2O into intestines and stimulates peristalsis, can produce dehydration, ex: MOM fleet magnesium phosphate, miralax

92
Q

cleansing enemas Hypotonic

A

tap water, large volume enema, water moves from bowel to interstitial tissues, can cause imbalance if used frequently

93
Q

cleansing enemas Hypertonic

A

fleets, water moves from interstitial tissue into bowel, can cause Na retention

94
Q

isotonic enema

A

equal balance of particles, large volume, no fluid shift, best type for infants

95
Q

soap suds enema

A

large volume enema, may cause mucosal irritation or injury

96
Q

retention enemas

A

oil retention (lubricates stool and mucosa to ease) carminative enema (relieve gaseous distention) medicated enema (absorption of medications through intestinal mucosa)

97
Q

anti diarrheal medications

A

immodium paregoric lomotil (increase smooth muscle tone decrease GI motility and secretion can be addictive or cause drowsiness) kaopectate (absorbs and soothes) Pepto-Bismol (contains aspirin cant give to children, decreases secretions)

98
Q

biological sex

A

denotes chromosomal sexual development XX/ XY, internal and external genitalia, secondary sex characteristics, and hormones

99
Q

gender identity

A

inner sense of being male or female, can be different from biological sex

100
Q

factors influencing sexuality

A

developmental cultural religious and ethics, lifestyle, childbearing, STD

101
Q

counseling for altered sexual function

A

P-permission giving LI- limited information SS- specific suggestions IT- intensive therapy

Fundamentals (4 decks)

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