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Fundamentals > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Eight critical characteristics of complaints

A

Location
Character of quality
Quantity or severity
Timing
Setting
Aggravating and relieving factors
Associated factors
Patient’s perception

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2
Q

PQRSTU

A

Provocative or palliative
Quality or quantity
region or radiation
severity scale
timing
understanding patient’s perception

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3
Q

Orientation phase of nurse-patient relationship

A

Introductions and an agreement between the nurse and patient about their mutual roles and responsibilities

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4
Q

Working phase of the nurse-patient relationship

A

Exploring and developing solutions that are enacted and evaluated in subsequent interactions; advocating

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5
Q

Termination phase of the nurse-patient relationship

A

Review of health changes and how the patient has dealt with physical and emotional responses; includes discharge planning

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6
Q

Expressive (Broca’s) aphasia

A

Short but meaningful sentences

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7
Q

Receptive (Wernicke’s) aphasia

A

Long but unmeaningful sentences

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8
Q

Global aphasia

A

The worst. 1 word sentences and barely understood

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9
Q

Dysarthria

A

Difficulty speaking caused by brain damage

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10
Q

Avoid ecchymotic areas in which 2 meds

A

Warfarin and coumadin

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11
Q

How does vasoconstriction regulate temperature

A

Warms the body up (shivering)

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12
Q

How does vasodilation regulate temperature

A

Cools us down (sweating)

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13
Q

What vitamin does skin synthesize

A

Vitamin D

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14
Q

Ulcers come from

A

Venous insufficiency

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15
Q

What does peripheral neuropathy do with wounds

A

Slow healing

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16
Q

Acute wound

A

Injury such as a knife, gunshot, burn, or surgical incision; heals within 6 months

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17
Q

Chronic wound

A

Wound that persists beyond usual healing time (>6 months) or occurs without new injury to the area

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18
Q

Open wound

A

Break present in the skin; tissue damage present

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19
Q

Closed wound

A

No break seen in the skin, but soft tissue damage evident

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20
Q

Abrasion

A

Wound involving friction of the skin; superficial; dermatologic procedure for scar tissue removal

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21
Q

Puncture

A

Intentional or unintentional penetrating trauma by sharp or pointed instrument that penetrated skin and underlying tissue

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22
Q

Laceration

A

Cut in the skin; smooth or jagged; shallow or deep; object possibly contaminated; infection risk

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23
Q

Contusion

A

Closed wound; bleeding in underlying tissues from blunt blow; bruising

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24
Q

Clean wound

A

Closed surgical wound that did not enter GI, GU, or respiratory systems; low infection risk

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25
Q

Clean/contaminated wound

A

Wound entering the GI, GU, or respiratory systems; infection risk

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26
Q

Contaminated wound

A

Open, traumatic wound; surgical wound with break in asepsis; high infection risk

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27
Q

Infected wound

A

Wound site with pathogens present; signs of infection

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28
Q

Vascular injury color

A

Brown or shiny

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29
Q

Hemostasis

A

Chilling

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30
Q

Inflammatory phase

A

Control bleeding
Deliver O2, WBC, and nutrients
WBC engulfs cells
Prolonged when there is too little/much inflammation
3-6 days

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31
Q

Proliferative phase

A

Replace tissue with collagen and connective tissue. Resurface new epithelial cells
3-24 days

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32
Q

Maturation of a wound

A

Can take over a year depending on the extent of the wound
Makes the wound look back to normal
No granulation tissue, barely any scarring, low infection risk
21st day

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33
Q

Secondary intention healing

A

A pressure injury healing by indirect closure. Tissue heals from underneath. Open burns, pressure injuries. Gaping, irregular wound. Wound gets filled with granulation tissue. Heals internally, nothing on epidermis. Deeper, wire scar is common

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34
Q

Tertiary intention

A

widely separated, deep. Closure of wounds occurs when there is no infection or edema. Lots of drainage and closes later. Called delayed closure. Purposefully left open to let infections resolve

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35
Q

Obesity and wound healing

A

slow wound healing because of weak defense against vascular invasion. Potential for wound dehiscence or evisceration (sutures popping)

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36
Q

Smoking and wound healing

A

vasoconstriction, tissue oxygenation impaired, not good enough clotting

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37
Q

Medications and wound healing

A

corticosteroids, anti-inflammatory delays closure, NSAIDS, anticoagulants

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38
Q

Heat application 3 effects

A

Promotes healing and suppuration (consolidation of pus)
Decreases inflammation by accelerating inflammatory process
Decreases musculoskeletal discomfort

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39
Q

3 physiologic mechanisms of heat application

A

-Results in vasodilation leading to increased blood flow, this increasing oxygen and nutrients to the area and promoting removal of waste products
-Increases capillary wall permeability, increases leukocytes and antibody flow to the area and action of phagocytes
-Increases sensory nerve conduction, promotes muscle relaxation, and decreases viscosity of synovial fluid

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40
Q

Select uses of heat application

A

Surgical and infected wounds, hemorrhoids, and episiotomies
Phlebitis and IV infiltration
Low back pain, menstrual cramps, contractures, arthritis, and muscle spasms

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41
Q

3 effects of cold application

A

Controls bleeding
Decreases edema
Relieves pain

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42
Q

3 physiologic mechanisms of cold application

A

Vasoconstriction which decreases blood flow, metabolic tissue demand, and supply of oxygen and nutrients
Decreases capillary permeability
Decreases nerve conduction velocity, induces numbness or paresthesia

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43
Q

Selected uses of cold application

A

Fractures, trauma, superficial lacerations, and puncture wounds
Sprains, muscle strains, and sports injuries
Arthritis, trauma, and musculoskeletal injuries

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44
Q

what 2 system impairments affect operative positioning

A

Respiratory and CV

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45
Q

What does anesthesia do to 2 body functions

A

Can’t regulate temp or do urinary stuff

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46
Q

Epidural anesthesia is for what and what is important

A

c section, catheterization because bladder becomes neurogenic, risk for CAUTI, catheter needs to be DC and patient needs to void

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47
Q

Bowel stuff after surgery and NPO status

A

Introduce foods back slowly
Delayed bowel movements
Flatulence then bowel movements

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48
Q

What 2 organ dysfunctions decrease tolerance of anesthesia or meds

A

Liver and kidneys

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49
Q

What are narcotics given with

A

Something to make you poop

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50
Q

Rationale of turning and getting out of bed

A

Improves post-op mobility to minimize impact of immobility

51
Q

Rationale for deep breathing, coughing, incentive spirometer

A

Improves post-op gas exchange and prevents resp complications
Most important

52
Q

Rationale of leg exercises and SCDs

A

Improves venous return and prevents deep venous thrombosis post-op

53
Q

Rationale of using a PCA

A

Provides optimal pain control post-op

54
Q

PCA

A

Continuous dose of meds. Bolus where you push button for meds

55
Q

Atelectasis

A

Complete or partial lung collapse

56
Q

Symptoms of pulmonary embolism (9)

A

Chest pain
Dyspnea
increased RR
Tachy
Increased anxiety
diaphoresis
Decreased orientation
decreased BP
blood gas changes

57
Q

Symptoms of hypovolemic shock

A

decreased urine
decreased BP
Weak pulse
Cool and clammy
Restless
Increased bleeding
Increased thirst
decreased CVP

58
Q

Symptoms of infection

A

Redness
Purulent drainage
Fever
Tachy
Leukocytosis

59
Q

2 symptoms of evisceration

A

Evidence of bowel through incision
Pain

60
Q

Symptoms of gastric dilation

A

Nausea and vomiting
abdominal distention

61
Q

Symptoms of paralytic ileus

A

decreased bowel sounds
No stool or flatus
nausea
vomiting
abd distention
abd tenderness

62
Q

Symptoms of atelectasis

A

Dyspnea
tachypnea
decreased breath sounds
asymmetrical chest movement
Tachy
Restlessness

63
Q

Symptoms of pneumonia

A

Rapid respirations
shallow respirations
fever
wet breath sounds
asymmetrical chest movement
productive cough
hypoxia
tachy
leukocytosis

64
Q

Symptoms of urinary retention

A

Unable to void 8-10 hrs post-op
Palpable bladder
frequent,small amount voiding
Pain in suprapubic area

65
Q

Stage 1 pressure injury

A

intact skin with non-blanchable redness of a localized area over a bony prominence

66
Q

Stage 2 pressure injury

A

partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough

67
Q

Stage 3 pressure ulcer

A

Full thickness tissue loss. Fat may be visible but not bone or muscle. Slough may be present and may include tunneling

68
Q

Stage 4 pressure injury

A

Full thickness tissue loss with exposed bone, tendon, or muscle. Slough and eschar may be present. Often include tunneling.

69
Q

Unstageable pressure injury

A

Full thickness tissue loss covered in slough
MARSI

70
Q

Mucosal membrane pressure injury (MMPI)

A

Caused by medical device, don’t stage

71
Q

Deep tissue injury (DTI)

A

Purple or maroon localized area of discolored intact skin or blood-filled blisters. May be preceded by tissue that is painful, firm, bushy, boggy, warm, or cool

72
Q

Intertrigo

A

Friction between folds

73
Q

What does lymph do

A

Made of WBC, attacks bacteria in tissues and blood

74
Q

Where does the right lymphatic duct empty into

A

The right subclavian vein

75
Q

What does the thoracic duct do

A

Drains the rest of the body and empties into the left subclav vein

76
Q

Where does the right lymphatic duct drain (6)

A

Right side of:
Head and neck
Arm
Thorax
Lung and pleura
Heart
Upper right liver

77
Q

Function of the lymphatic system (3)

A

Convert fluid and plasma protein that leak out of the capillaries
Form a major part of the immune system that defends the body against disease
Absorbs lipids from small intestine

78
Q

What do lymph nodes do

A

Filters harmful microorganisms out of the bloodstream

79
Q

Temporomandibular joint

A

Joint we use to open mouth, should be smooth

80
Q

Cranial nerve V motor test

A

Clench teeth

81
Q

Cranial nerve VII motor test

A

Puff cheeks, smile, frown

82
Q

Normal lymph nodes palpation

A

Gentle circular motion
Shouldn’t be able to palpate
>1cm is lymphadenopathy

83
Q

Cranial nerve XI test

A

Push shoulders up

84
Q

What are normal superficial cervical nodes in a young adult like

A

Palpable if small, moveable, discrete, soft, and non-tender

85
Q

Acromegaly

A

Large face/head

86
Q

Thyroid gland (3)

A

2 lobes fixed to trachea
Should not be visible
Moves up when you swallow

87
Q

When can you auscultate a thyroid gland

A

When it’s enlarged

88
Q

When can you hear a bruit in a thyroid gland

A

When it’s overactive (increased BF to area)

89
Q

Enlarged parotid gland

A

Parotid gland=between jaw and ears
Could be from viruses (mumps, herpes, epstein-barr) or bacteria

90
Q

Parotitis and treatment

A

From infected tooth, infects whole gland
Tx is water and warm compress

91
Q

Bell’s palsy patho

A

Clot in facial nerve

92
Q

Normal hearing intensity and frequency

A

0-25 dB intensity
125-8,000 cycles per second

93
Q

Camphoraceous smell

A

Like moth balls

94
Q

Ethereal smells

A

Like detergent

95
Q

Sight in older adults (5)

A

Decreased visual acuity
Decreased peripheral vision
Presbyopia (hard to read)
Hard to distinguish color
Delayed pupillary reaction

96
Q

Macular degeneration

A

Blurs central vision (normally age-related, damages macula- part of retina that controls sharp vision)

97
Q

2 types of macular degeneration

A

Dry- distorted and fuzzy
Wet- blind spot in the middle

98
Q

What decreases in the eyes >40 (3 things)

A

Tear production
Power of accommodation
Adaptation to darkness

99
Q

What increases in the eyes >40

A

floaters

100
Q

Low vision vs legally blind

A

Low: 20/70
LB: 20/200

101
Q

Presbycusis

A

Age-related hearing loss

102
Q

What does the confrontation test examine

A

Peripheral vision

103
Q

Exophthalmos

A

Swelling of eyes related to thyroid (eyes bulging out)

104
Q

Sbismus

A

Cross-eyed

105
Q

Red reflex

A

Reflection of light off retina

106
Q

Sensorineural loss

A

signals pathology of CN VIII, inner ear or auditory area of cerebral cortex
May be presbycusis (nerve degeneration with aging) or ototoxic medications (affect hair cells in cochlea)

107
Q

Should the weber test be + or -

A

(-)

108
Q

How to assess ventral surface of tongue for lesions

A

Touch roof of mouth with tongue

109
Q

What part of the tongue does the facial nerve control

A

Anterior

110
Q

What part of the tongue do the glossopharyngeal and vagus nerves control

A

Posterior

111
Q

Tympanic membrane in older adults

A

Thick

112
Q

Saliva production in older adult

A

decreased

113
Q

Alginate dressing

A

Provides a moist environment
Highly absorbent of exudate
Establishes hemostasis
Placed inside the wound
Good for treating wounds with lots of exudate/deep wounds
NOT used in dry or tunneling wounds
Contact with wound activates gel
Secondary dressing required
For moderately draining wounds

114
Q

Hydrogel dressing

A

Mild absorption
Needs a secondary dressing
Used in wounds with necrosis, infection, and need for moisture
Rehydrates dry wound beds
Partial-thickness wounds (pressure ulcers II-IV with secure dressing and gauze)
Minor debridement, burns, something about grafts

115
Q

Transparent film dressings

A

Thin layer of plastic that covers wound
No absorption, creates a barrier
Allows some oxygen exchange and a moist environment
Used for necrotic tissue or superficial skin tears
Removal can cause damage to underlying skin
Uniform application can cause maceration of wound edges
Can be used instead of tape over intact skin to secure a gauze or dressing in place

116
Q

Hydrocolloid dressings

A

mild-moderate absorption
NOT recommended for infected wounds, but used for wounds that are VULNERABLE to infection
Partial-thickness wounds
Shallow, full-thickness wounds
Minor debridement

117
Q

Gauze

A

Non Adhesive, allowing environmental oxygen to reach the wound surface
Absorbent
May be moistened with sterile saline to create a moist packing
Newly created surgical incisions or wounds acquiring pressure for hemostasis
Packing or filling of deep wounds

118
Q

Foam dressings

A

Moderately absorbent depending on thickness
Provide moist environment
Used over bony prominence on partial-thickness wounds for protection
Also used for deep wounds that have been packed with primary dressing

119
Q

Silver wound dressings

A

Contains ionic silver-immediate or controlled release of silver into the wound bed
Used for infected or highly colonized wounds
Can be used with nearly any other dressing
Slow-release dressings can stay for up to 7 days

120
Q

Hydrofiber dressings

A

Consists of sodium carbsomethingsomething fibers
Forms a gel as it absorbs exudates
Moderately to heavily draining wounds
Needs less frequent changes because it’s highly absorbent and maintains moist wound bed

121
Q

What can patient’s odor POSSIBLY mean (2)

A

Metabolic or kidney issues

122
Q

What kind of sore could mean syphillis

A

Canker

123
Q

Self-skin exam ABCDE

A

Asymmetry
Border
Color & change
Diameter (6mm)
Elevation & enlargement

Fundamentals (5 decks)

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