Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nur 3010 exams > Healthcare Delivery/foundations + Stress > Flashcards

Healthcare Delivery/foundations + Stress Flashcards

1
Q

what are the 5 basic needs of Maslow Hierarchy?

A
  1. physiological needs
  2. safety & security
  3. belongingness and affection
  4. esteem and self-respect
  5. self actualization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 3 levels of care?

A

primary care, secondary care, tertiary care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is primary care?

A

focus is on health promotion and prevention of illness or disease.
interventions include: teaching about healthy lifestyles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is secondary care?

A

centers on health maintenance and is aimed at early detection.
prompt intervention to prevent/minimize the loss of function and independence
interventions include: health screening (ex: BP for HTN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is tertiary care?

A

focuses on minimizing deterioration.
improving quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the nursing process?

A

assessment, diagnosis, planning, implementation/intervention, evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe assessment?

A

health history
physical assessment
“ongoing”
relevant information from family, health care team, MR
recording of data to EHR (electronic health record)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe diagnoses?

A

based on collection and analysis of assessment data
actual or potential health problems
collaborative problems
NOT MEDICAL DIAGNOSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what materials are used for nursing diagnoses?

A

ANA’s scope and standards of practice
NANDA International (NANDA-I)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

describe planning

A

prioritization (Maslow’s hierarchy)
established expected outcomes: attainable and quantifiable
establish goals: immediate, intermediate, long term
determine nursing action: planned interventions
standardized intervention: NIC system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe implementation?

A

carry out plan of care
nurse assumes responsibility
goals are used as a focus
“ongoing” assessment
revisions when necessary
all interventions should be patient focused and outcome directed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe evaluation?

A

allows nurse to determine patient’s response to interventions
“have outcomes been met?”
DOCUMENTATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

assessment begins with initial patient contact. which nursing activity is included during this component of the nursing process?
a. interviewing and obtaining a nurse hx
b. choosing a nursing dx
c. established expected outcomes
d. determining nursing actions

A

a. interviewing and obtaining a nursing hx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 7 components of health history?

A

biographical data
chief complaint
present health concern/illness
past health history
family history
review of systems
patient profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are components of the physical exam?

A

general observations (posture, bosy movements, speech patterns)
vital signs and pain (bp, pulse, RR, temp., pain)
focused assessment of body systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is stress

A

any change in the environment perceived as challenging, threatening, or damaging to the persons balance/equilibrium
- can be internal or external
- usually felt by the person who experiences the insult first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is homeostasis?

A

steady state within a system, the degree to which we experience equilibrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is adaptation?

A

adjustment to the change so that the person is in equilibrium again

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is coping

A

a compensatory process that has physiologic and psychological components

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the 3 types of stressors?

A

physical: cold, heat, chemical agents
physiologic: pain, fatigue
psychosocial: fear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

describe the HPA axis

A

hypothalamic, pituitary, adrenal connection
- fight or flight response
- stimulated by SNS
- releases epinephrine and norepinephrine into bloodstream
- these hormones stimulate the nervous system and produce metabolic effects that increase glucose levels + metabolic rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are catecholamines?

A

primary epinephrine and norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the equation for cardiac output

A

HR x stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the equation for BP

A

CO x PVR (peripheral vascular resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how does stress affect out stomach?

A

blood goes to critical organs and away from the stomach when stressed, leading to feelings of nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how does stress affect out skin?

A

similar to stomach (blood goes away from it), leading to acne/pimples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is negative feedback?

A

mechanisms throughout the body monitor the internal environment and restore homeostasis (goal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how does negative feedback work?

A

mechanisms sense deviations and trigger a response to offset it (compensates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are the compensatory mechanisms of negative feedback?

A

blood pressure, acid-base balance, blood glucose, fluid and electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what major organs are affected from negative feedback

A

heart, lungs, kidneys, liver, GI tract, skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the net result of negative feedback

A

homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the connection between negative feedback and steady state

A

equilibrium is achieved by continuous, variable action of organs involved in making adjustments and by continuous exchange of chemical substances among cells, interstitial fluid, and blood (adjustment for homeostasis)
- ex: increased CO2 in extracellular fluid -> increased pulmonary ventilation -> decreased CO2 levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the best indicator of metabolic imbalance?

A

accurate RR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

cellular adaptation in response to stress

A

hypertrophy (increase cell size)/hyperplasia (increase cell #)
atrophy (decrease cell size)
dysplasia (malignancies or cancer cells)
metaplasia (scar tissue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what are the early identification of stressors

A

vital signs
emotional distress
problems in movement/sensation
problems with affect, behavior, speech, cognitive ability, orientation, or memory
obvious impairments or lesions
diagnostic studies (labs, CT scans, MRI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

describe intracellular fluid

A

fluid within cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

describe extracellular fluid

A

circulating plasma (within blood vessels)
interstitial (between cells)
lymphatic system
pleural/pericardial/peritoneal cavities, synovial (joint spaces), CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what do movement of fluid through capillary walls depend on?

A

hydrostatic pressure: exerted on walls of blood vessels
osmotic pressure: exerted by protein (albumin) in plasma

39
Q

describe osmosis

A

low solute concentration to area of high solute concentration
TIP: focuses on solution (liquid)

40
Q

describe diffusion

A

solutes move from area of high concentration to low concentration
TIP: focuses on solutes across membrane

41
Q

describe filtration

A

movement of water, solutes occurs from area of high hydrostatic pressure to area of low hydrostatic pressure (glomeruli filtration)
- occurs in kidneys

42
Q

describe active transport

A

sodium-potassium pump
- maintains higher concentration of extracellular sodium, intracellular potassium

43
Q

examples of fluid gains

A

eating/drinking
IV fluid
TPN, parenteral nutrition
*fluid retention: HF, kidney failure, cirrhosis, hypernatremia (doesn’t cause gain, BUT prevents elimination)

44
Q

examples of fluid losses

A

kidney: urine output of 1 mL/kg/hr
skin loss: sensible -> sweating, insensible -> fever, exercise, burns
lungs: 300-500mL everyday, more with increased RR
GI tract: large losses -> diarrhea, fistulas
third spacing
pathologic -> DI, bleeding

45
Q

clinical manifestations of fluid volume deficit?

A

tachycardia
poor skin turgor
weakness
low/absent urine output
sweating
anxiety
confusion/AMS
tachypnea

46
Q

clinical manifestations of fluid volume excess (ex: CHF)

A

edema
jugular vein distention
pulmonary crackles (third spacing)
SOB
high BP
*weight gain: important in community care but not some much hospital
nausea

47
Q

normal sodium levels

A

135 - 145

48
Q

normal potassium levels

A

3.5 - 5.0

49
Q

HYPO-natremia (<135) causes

A

fluid overload: imbalance of water, losses by vomiting, diarrhea, sweating, diuretics, adrenal insufficiency, certain medications, SIADH

50
Q

HYPO-natremia manifestations

A

largely depends on fluid status
nausea, abdominal cramping, neurologic changes (AMS)

51
Q

HYPO-natremia management

A

follow up w/ nephrology
manage underlying condition
Na replacement (symptomatic)
free water restriction (pee excess water allows for sodium retention)

52
Q

HYPER-natremia (>145) causes

A

fluid deprivation
excess sodium administration
DI (diabetes insipidus)
heat stroke
hypertonic IV solutions

53
Q

HYPER-natremia manifestations

A

thirst
elevated temp
low BP
tachycardia
neurologic changes

54
Q

HYPER-natremia management

A

gradual lowering of Na level with hypotonic solution
*in hyperosmolar patient, 0.9% would be relatively hypotonic -> key to drop Na slowly

55
Q

HYPO-kalemia (<3.5) causes

A

GI losses
medications (lasixs)
prolonged intestinal suctioning
recent ileostomy
tumor of the intestine
alterations of acid-base balance
poor dietary intake
hyperaldosteronism

56
Q

HYPO-kalemia manifestations

A

ECG changes
dysrhythmias
dilute urine
excessive thirst
fatigue
anorexia
muscle weakness
decreased bowel motility
paresthesias

57
Q

HYPO-kalemia management

A

K+ replacement IV (no faster than 10 meq/L) or PO
monitor ECG
assess medications

58
Q

why is it important to not PUSH IV K+

A

burns IV
can cause cardiac arrest

59
Q

HYPER-kalemia causes

A

rarely occurs in patients with normal renal function
main: impaired renal function
rapid administration of potassium
hypoaldosteronism
medications
tissue trauma
acidosis

60
Q

HYPER-kalemia manifestations

A

cardiac changes
dysrhythmias
muscle weakness
parethesia’s
anxiety
GI manifestations

61
Q

HYPER-kalemia management

A

meds: insulin (causes intracellular shift of potassium and glucose), dextrose (supplements glucose), calcium gluconate (stabilize myocardium, makes heart resistance to electrolyte change)
monitor ECG
emergent dialysis

62
Q

calcium values

A

<8.6 mg/dL, >10.2 mg/dL (9-11 mg/dL)

63
Q

HYPO-calcemia causes

A

hypoparathyroidism, malabsorption, osteoporosis, pancreatitis, alkalosis, transfusion of citrated blood, kidney injury, medications

64
Q

HYPO-calcemia manifestations

A

Trousseau signs, Chvostek sign, seizures, tetany, numbness, paresthesias, hyperactive DTRs, resp. symptoms of abnormal clotting, anxiety

65
Q

HYPO-calcemia treatment

A

oral calcium
vitamin D
IV calcium gluconate

66
Q

HYPER-calcemia causes

A

rarely occurs in patients with normal renal function
- malignancy and hyperparathyroidism, bone loss r/t immobility, diuretics

67
Q

HYPER-calcemia manifestations

A

polyuria, thirst, muscle weakness, intractable nausea, abdominal cramps, diarrhea, peptic ulcer, bone pain,
ECG changes, dysrhythmias

68
Q

HYPER-calcemia management

A

treat underlying cause
- administer IV fluids, furosemide, phosphates, calcitonin, bisphosphonates

69
Q

magnesium values

A

1.3-3.0 m/dL

70
Q

HYPO-magnesemia causes (<1.3)

A
  • associated w/ hypokalemia & hypocalcemia
  • alcoholism, GI losses, internal/parenteral feeding deficient in magnesium, medications, rapid administration of citrated blood
71
Q

HYPO-magnesemia manifestations

A
  • chvostek & trousseau signs
  • apathy
  • depressed moods
  • psychosis
  • neuromuscular irritability
  • muscle weakness
  • tremors
  • ECG changes & dysrhythmias
72
Q

HYPO-magnesemia treatment

A

IV or PO magnesium supplements

73
Q

HYPER-magnesemia causes (>3.0)

A

rarely occurs in patients with normal renal functions
- kidney injury, DKA, excessive administration of magnesium, extensive soft tissue injury

74
Q

HYPER-magnesemia manifestations

A

hypoactive reflexes, drowsiness, muscle weakness, depressed respirations, ECG changes, dysrhythmias, cardiac arrest

75
Q

HYPER-magnesemia management

A
  • IV calcium gluconate
  • Administer IV fluids, hemodialysis
  • observe for decreased respirations, decreased DTRs and changes in LOC
76
Q

phosphate values

A

2.5-4.5 mg/dL

77
Q

HYPO-phosphatemia (<2.5) causes

A

alcoholism, referring of patients after starvation, pain, heat stroke, resp. alkalosis, hyperventilation, DKA, hepatic encephalopathy, major burns, hyperparathyroidism, low mag., low pot., diarrhea, vitamin D deficiency, use of diuretics and antacids

78
Q

HYPO-phoaphatemia manifestations

A

neurological symptoms, confusion, muscle weakness, tissue hypoxia, muscle and bone pain, increased susceptibility to infection

79
Q

HYPO-phosphatemia management

A

IV or PO replacement

80
Q

HYPER-phosphatemia causes

A

rarely occurs in patients with normal renal function
- kidney injury, excess phosphorus, excess vitamin D, acidosis, hypoparathyroidism, chemotherapy

81
Q

HYPER-phosphatemia manifestations

A

few sx., soft tissue calcifications, sx. occur due to associated hypocalcemia

82
Q

HYPER-phosphatemia mangement

A

phosphate binding agents
dialysis

83
Q

chloride values

A

97 - 107 mEq/L

84
Q

HYPO-chloremia causes

A

Addison disease, reduced chloride intake, GI loss, DKA, excessive sweating, fever, burns, medications, metabolic alkalosis

85
Q

HYPO-chloremia manifestations

A

agitation, irritability, weakness, hyperexcitability of muscles, dysrhythmias, seizures, coma

86
Q

HYPO-chloremia medical management

A

replace chloride IV NS oe 0.45% NS

87
Q

HYPO-chloremia nursing management

A

assessment, avoid free water, encourage high-chloride foods, patient teaching r/t high chloride foods

88
Q

HYPER-chloremia (>107 mEq/L) causes

A

excess sodium chloride infusions w/ water loss, heatd injury, hypernatremia, dehydration, severe diarrhea, resp. alkalosis, metabolic acidosis, hyperparathyroidism, medications

89
Q

HYPER-chloremia manifestations

A

tachypnea, lethargy, weakness, rapid deep respirations, hypertension, cognitive changes

90
Q

HYPER-chloremia medical management

A

restore electrolyte and fluid balance, LR, sodium bicarbonate, diuretics

91
Q

PaO2 value

A

80 - 100 mmhg
- measure of partial pressure oxygen in blood

92
Q

PaCO2 vale

A

35 - 45 mmhg
- ventilation (lungs) in blood

93
Q

pH

A

7.35 - 7.45

94
Q

HCO3

A

22 - 26 mEq/L
- kidney function

Nur 3010 exams (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions