Final review 2 Flashcards
Pain tolerance
amount of pain one is willing to endure. need to take pain before it gets really bad - harder to get down when it’s so high.
lower respiratory infections
*Pneumonia is RESPIRATION (increases secretion in airways, affects respiration and gas exchange in alveoli), Respiratory Syncytial Virus (RSV),
tuberculosis
respiratory assessment
- BODY POSITIONING
Tripod breathing (leaning forward) – sign of respiratory distress - CONVERSATIONAL DYSPNEA
Inability or difficulty to speak complete sentences
without stopping to breath, pausing for breath
**7. STRIDOR
High-pitched whistling sound (hear a lot in babies, if in adult, very serious. ALWAYS go to stridor patient first, everything else can wait)
Caused by partial obstruction of larynx or trachea - WHEEZE
Musical sound produced by air passing through
narrow airways
Characteristics of stoma - pale = ? and purple = ?
pink/red normal (pale-anemia, maroon/purple-ischemia)
Hypercapnia/hypercarbia
(extra CO2)
COPD - Avoid high levels of
Avoid high levels of O2 (keep between 85-90% O2 sat if no
overt respiratory distress or COPD exacerbation)
COPD - cause of what?
Cor Pulmonale (cause of right side heart failure pulmonary disease. constant increased pressure in right heart, heart has to pump harder, chronic edema)
* Thin appearance
sputum colors
SPUTUM COLORS
COLOR/APPEARANCE SIGNIFICANCE
WHITE OR CLEAR Viral infection; common cold, viral bronchitis – supportive care
YELLOW OR GREEN Sign of infection
HEMOPTYSIS Lung damage, lung injury, TB
PINK AND FROTHY Pulmonary edema
causes of hypoxia (think - shutting off the pathway)
-Altered internal respiration: severe sepsis
-Shunting: septum foramen ovale (baby)
-Circulatory compromise: severe heart failure, cardiogenic shock
***lactic acid - excess in aerobic respiration
Airway inflammation
COPD
airway restiction
asthma
ventilation is movement of____respiration is exchange of____
air, gases (O2 and CO2) in the lungs
in ER, if a patient is tripoding, should you see them first, or last?
first, they are in disress - trying to bend over to expand lung volume
good O2 % level for ppl with COPD
90 - 92%
Intrapersonal:
self talk. Communication that occurs within
an individual.
Interpersonal:
Between 2 or more people. Assessment, teaching, providing
comfort and support
Transpersonal:
spiritual
Pre-interaction Phase:
reviewing chart, patient handoff
Orientation Phase: hi, how are you?
Goal – establish rapport and trust using verbal and non-
verbal communication;
Working Phase: (just the majority)
Bulk of therapeutic relationship occurs in this phase – active part, active listening
Termination Phase:
Prepares for future interaction
Share Observations (share questions and silence)
“You seem quiet today. What’s in your mind?
Connotative Meaning -
implied
denote
literal
when does orientation phase end? (I’m oriented to the role)
Once relationship/ role is defined, orientation phase ends
joint commission is
teaching
SMART
Specific
Measurable
Attainable
Relevant
Time Frame
observation or assessment - HELP acronym
H = Help: Observe the first signs patient may need help. Signs of distress? e.g. pain,
labored breathing
E = Environmental equipment: Safety hazards? Is equipment working?
L = Look: Examine patient - quick survey of patient - USE This for critical thinking worksheet
P = People: Who is in the room and what are they doing?
diagnostic reasoning (Mina can diagnose)
higher level skills and experience.
relevance of critical thinking (I’m critically thinking about the what ifs)
the what ifs
6 steps in critical thinking
1.recognize and define the problem or situation
2. assess all options
3. weigh each option
4. test possible options
5. consider the consequences of the decision
6. make the final decision
ex. temp is 38.3 - assess temp in 1 hour.
clinical judgement (the judge decides the outcome)
“the observed outcome of critical thinking and decision-making.”
clinical reasoning (reasoning and applying are verbs)
the process of applying (this is the application part) critical thinking to a clinical scenario
Epidermis and dermis - which immune cells
Epidermis: Langerhan cells
Dermis: macrophages and mast cell
acute wounds heal within
Heal within days to week
chronic wounds heal
> 30 days
phases of wound healing (BIPR wound)
bleeding, inflammatory, proliferative, remodeling
phases of wound healing - hemostasis (hemo = blood)
Occurs immediately after tissue injury
Vasoconstriction and blood clotting via platelet and fibrin aggregation
Inflammation (followed by what?) The flame became white and macros attracted the growth
(main point - redness, heat, pain)
Followed by vasodilation (heat and redness) → ↑capillary permeability leaking of plasma→ exudate→ swelling→ loss of function
Chemicals on tissues attract WBCs
WBC and macrophages migrate to injured site
Macrophages also attract growth factors for regeneration of epithelial cells and fibroblasts to fill in wound
Systemic Response during inflammation
fever
5 cardinal signs of inflammation***(flaming cardinals swap roles - SWP RL)
Redness, warmth, swelling, pain, loss of function
Proliferation - how long does it last? (prolif several weeks)
several weeks