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Nursing 300 > Knowledge assessment 2 > Flashcards

Knowledge assessment 2 Flashcards

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1
Q

expected results for urinary characteristics

A

space gravity: 1.005-1.030
pH: 6
Protein: negative
Glucose: absent or low
Ketones: negative
Microscopic analysis: negative for RBC

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2
Q

Urinary function testing

A

ultrasound, KUB study, intravenous pyelography, computed tomography, cytoscopy, contrast medium ice imaging

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3
Q

Kidney failure

A

prerenal: insufficent blood flow,
interrenal: damage to kidney structures such as glomerlus
post renal: obstruction to urine outflow, s/s of decreased urine output, fluid retension, weakness, confusion, fluid electrolyte balances, and cardiac arrhythmias

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4
Q

alterations in urinary elimination:

A

nocturia- urination at night
dysuria- pain while urination
urinary hesitancy- delay in start of urination
urinary frequency- urinating a lot
urinary retention- cannot urinate
incontinence- loss of bladder control

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5
Q

types of urinary incontiences

A

stress
urge
temporary
overflow
functional
mixed

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6
Q

Que analysis can be organized by:

A

disease, physical or psychological barriers to normal elimination, and protentional concerns

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7
Q

urinary elimination

A

kidneys: filter waste products, fluid and electrolyte balances, red blood cell formation, blood pressure regulation, maintains calcium and phosphate levels

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8
Q

if the urinary system fails..

A

all other organs will be affected

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9
Q

common urinary problems

A

urinary retention, UTI, urinary incontience, and urinary diversions

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10
Q

factors that can affect urination

A

developmental considerations, food and fluid intake, sociocultural/pschological variables, actiity and muscle tone, surgical procedures, diagnostic procedures, pathological conditions, pain, and medications

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11
Q

infants, children and elderly urination

A

infants: 15-60mL/kg/day ( no voluntary control
children: cannot control until 18-24 months
elderly: changes in kidney and bladder functions, urgency and frequency increase, elasticty and muscle tone decrease leading to nocturia and incomplete urine elimination

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12
Q

What increases and decreases urine output

A

increase: coffee, tea, alcohol
decrease: foods high in sodium

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13
Q

sociocultural and psychological factors of urination

A

sociocultural: privacy, facillities, proper positioning
psychological: anxiety and stress

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14
Q

Surgical procedures affecting urinary system

A

NPO- anesthetics and narcotic: slow the glomerular filtration rate and impair sensory and motor impulses
- lower abdominal and pelvic area- trauma causes edema and inflammation

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15
Q

pathological urination

A

immobility, communication, cognition in alterations, nuerological conditions, cardiovascular metabolic disorders, bladder/kidney infections, kidney stones, and pain with urination that supresses the urge to void

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16
Q

medications that effect urinary

A

duieretics prevnt reabsrobtion and antichlolinergnic meds cause urinary retention

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17
Q

color of urine

A

Normal- pale
kidney or ureter bleeding- dark red
- bladder or urethra bleeding- bright red
dehydration- dark amber

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18
Q

in and out ratios for adults

A

0.5mL-1mL/kg/hr
normal capacity: 500mL-600mL
normal void- 300mL
urge to void- 150-200mL

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19
Q

common test of urinary systems

A

urinalysis: clean, to the lab within 2 hrs, first void is best midstream
urine culture and sensitvity: sterile and clean void midstream
timed: test renal function and urine composition for 2, 12, or 24 hrs

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20
Q

common blood tests for urine

A

BUN: 7-20mL/dL- elevated levels indicate kidney damage of disease
Creatinine: M: 0.8-1.4mg/dL F 0.6-1.2mg/dL and is byproduct of muscle metabolism. elevated levels indicate kidney damage

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21
Q

homeostasis

A

the bodies ability to maintain that balance. Kidney’s excrete fluid cardiovascular can circulate fluiid if not working well, GI needs to be able to take fluids in

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22
Q

water and the human body: functions of water

A

hydration –> digestion
medium for transporting electrolytes, nutrients, cellular metabolism, chemical functions, maintains body temperature, and is a lubricant for joints

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23
Q

potassium, sodium hemoglobin, and BUN for fluid and electrolyte balance

A
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24
Q

Bodily systems: support homeostasis

A

Thirst – kidneys: controls excerton of fluids – antidieueric hormone: water absorbtion and renin angiotensin aldosterone systems– cardiovascular systems: atrial nutrietic peptide (ANP) and brain natrieutic peptide and lymphatic system helps excessive protein and fluid losses in blood vessels

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25
Q

sources of fluid loss and intake

A

intake sources of water: 1100-1400mL food: 800-1000mL and cell metabolism 300mL
I + O measures kidney functions
causes: inadequate fluid intake, insensible losses: cannot be measured ( sweat, respiratory, GI tract) and sensible losses ( urine output, wound drainage, gastric drainage)

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26
Q

fluid volume excess

A

Edema, BP goes up, pulse boudning, LOC, dizzinesss, headache, lab findings: BUN, hematocrit, hemoglobin, and urine specific gravity all decrease
Causes: over hydration, poor kidney function, heart failure,

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27
Q

body water components

A

intracellular: 40% of our body K+ down
extracellular: 20% of our body Na+ down

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28
Q

sodium function

A

balance the amount and distribution of water in our bodies, playing a key role in the control of our blood pressure

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29
Q

potassium function

A

Potassium is a mineral and an electrolyte that your body needs in the proper amount to be able to function its best. It helps your muscles contract, your nerves to function correctly, your heartbeat to stay regular, and certain nutrients get into your cells and waste products to get out.

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30
Q

fluid requirement calculation

A

35-45mL/kg/day ( use 40)

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31
Q

basic functions of electrolytes

A

fluid balance, acid base balance, basic nerve, muscle, heart and brain functions

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32
Q

transport of fluid and electrolytes

A

osmosis: the concentration
active transport: energy to move a fluid from one area to the next

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33
Q

isotonic

A

equal in fluid movement from one space to another. fluid is normal saline (0.9) or lactated ringers

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34
Q

hypotonic

A

lower concentration of solids in blood, they move water causing the cell to expand. Fluid is 1/2 normal saline (0.45)

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35
Q

Hypertonic

A

high concentration solids in blood, they move water away causing cell to shrink. fluid is dextrose 10 and 3% normal saline

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36
Q

lines of defense

A

normal pH 7.35-7.45: power of hydrogen in our bodies, a high concentration of hydrogen ions results results in states of acidosis (7.35) low concentration of hydrogen ions results in a state of alkalosis
PaO2- 80-100mmHg
SaO2 > 95%
Co2: 35-45: greater then 45 indication of acidosis, more indicates alkalosis
chemical : ingestion of food, respiratory renal, respiratory equated with Co2, renal equated with bicarbonate

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37
Q

respiratory alkalosis

A

Respiratory alkalosis occurs when low carbon dioxide levels disrupt your blood’s acid-base balance. Co2 is down, H+ goes up
- from severe anxiety and no not enough o2

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38
Q

respiratory acidosis

A

Respiratory acidosis is when your lungs can’t remove enough carbon dioxide from your body. Co2 is up, H+ is down
-symptoms include anxiety, fatigue and memory loss. Could be a sign to a respiratory infection

39
Q

metabolic alkalosis

A

In metabolic alkalosis there is excess of bicarbonate in the body fluids and hydrogen is down. It can occur in a variety of conditions.
- vomiting

40
Q

metabolic acidosis

A

Metabolic acidosis can develop if you have too many acids in your blood that wipe out bicarbonate and an increase in H+
- ketoacidosis
- excessive alc intake

41
Q

shear

A

a gravity force pushing down on the patients body with resistance between the patient and the chair or bed

42
Q

why bed rest

A

reduces oxygen needs
decreases pain level
helps in regaining of strength
uninterupted rest has psychological and emotional benefits

43
Q

immobility may be

A

temporary, such as following a surgery for a total knee replacement
permanent, such as paraplegia
sudden onset- such as a fractured arm and leg
slow onset- such as multiple sclerosis

44
Q

metabolic changes

A

changes in mobility alter
endocrine metabolism
calcium resorption
functioning of the GI system
- endocrine system helps maintain homeostasis
immobility disrupts normal metabolic functioning
decreases metabolic rate
alters metabolism
causes GI disturbances

45
Q

Endocrine system helps maintain homeostasis

A

decreases in BMR which causes
- altered metabolism of carbohydrates, fats, and proteins which causes
- fluid, electrolytes and calcium imbalances which causes
- GI disturbances which causes
- decrease in appetite and decrease in peristalsis

46
Q

nutrition and metabolism: assessment

A

height, weight, skin folds
fluid intake and output measurements
lab test for electrolytes imbalances /nutritional status
assess alibity to heal and fight infection
assess urinary and bowel elimination status
ascultate bowel sounds

47
Q

nursing intervention: nutrional metabolism

A

provide a high calorie and high protein
supplemental B and C
monitor and evaluate I & O
assess food intake

48
Q

effects of immobility on the respiratory system

A

decreased respiratory movement resulting in decreased exchange
pooling (stasis) of secretions
decreased and weakened respiratory muscles resulting in atelectasis and hypostatic pneumonia
decreased cough response

49
Q

respiratory system assessment

A

observe chest movement
auscultate fro pulmonary secretions
check 02 saturation
observe for respiratory difficulties

50
Q

nursing assesment: respiratory system

A

maintain a patent airway
- assess the client ability to expectorate secretion
- assess secretions for color, amount, and consistency
- use suction if the client is unable to expectorate secretion

51
Q

nursing interventions: respiratory systems

A

repositions every 1-2 hrs
each client to turn, cough, and deep breath
yawn every hour
use incentive spirometer
implement chest physiotherapy
consume 2000mL

52
Q

effects of immobility of cardiovascular system

A

orthostatic hypotension
increased cardiac workload BUT decreases cardiac output leading to poor cardiac effectiveness
- increases oxygen requirement
- less fluid volume in circulatory system
- stasis of blood in the legs
- thrombus formation
- most dangerous complication in immobility

53
Q

cardiovascular system: assessment

A

BP measurement with postural changes
monitor pulse
monitor for edema
increase activity as soon as possible
dangling feet before standing

54
Q

nursing interventions: cardiovascular system

A

prevent venous stasis
- anti embolic stockings
never massage extremities
- observe for S&S deep vein thrombosis
- compression devices
- avoid placing pillows under knees or lower extremities, crossing the legs or sitting for long

55
Q

nursing interventions for cardiovascular

A

increase acttivity as soon as possible
chnage position as often as possible
perform isometric exercises to increase activity tolerance
ROM
increase fluid intake
give low dose heparin

56
Q

mobility assessment

A

gait, exercise, activity tolerance, physiological, emotional, developmental
Body allignment: identifies deviations, posture, trauma, muscle damage, or nerve function

57
Q

ROM

A

contractures: develop in joints not moved periodically through their full ROM
- neck, shoulders, elbow, forearm, wrist, fingers and thumb, hip, knee, ankle, foot, and toes

58
Q

effects of mobility on elimination

A

urinary stasis, UTI’s
- decreased fluid intake, poor perineal care, indwelling catheters
renal calculi- chnage in calcium metabolism with hypercalcemia resulting in renal calculi
constipation
fecal impaction

59
Q

interventions of elimination

A

force fluids, record I + O, provide perineal care
- insert catheter of bladder is distended

60
Q

nursing interventions for GI

A

asses bowel sounds, hydration, record BM, add fruit veg and fiber to diet, give stool softener, remove fecal impactions

61
Q

effects of immobility on the integumentary system

A

pressure ulcers, inflammation, ischemia
higher risk in older adults: break in skin is difficult to heal, can lead to more immobilization

62
Q

integumentary assessment

A

nutritional status, assess positions and the risk with each position, identify clients at risk, observe for skin breakdown

63
Q

integumentary interventions

A

identify clients as risk, assess nutritional status, daily skin exam, provide daily skin and perineal care, turn patient every 1-2 hrs, use support devices, teach client how to shift weight, increase proteins, calories, and vitamins

64
Q

effects of immobility psychosocial issues

A

hostility, giddiness, fear, anxiety, altered sleep patterns, frequent dozing disrupts nighttime sleep patterns, sleep in an unfamiliar, nosy place, depression, difficulty understanding directions, crying, confusion

65
Q

psychosocial assessment

A

knowledge of exercise or activity, readiness to change behavior, program customized to meet personalized needs, culture and ethics, family support

66
Q

psychosocial nursing interventions

A

socialization, meaningful stimuli, maintain body image, avoid sleep interruptions, remain oreinted time, person, place, semi private room with alert roommate, involve client in daily care, daily stimuli

67
Q

reception

A

stimulation to. a single nerve cell of group of cells to create an impulse sen to the brain

68
Q

perception

A

brain interprets the stimuli based on past experiences or newness

69
Q

reaction/response

A

only the most important stimuli will elicit a reaction
- intensity, contrast, adaptation, and previous experience

70
Q

stimuli

A

infants need stimuli to grow, adults reduce their stimuli with age

71
Q

decrease of senses with age

A

30-hearing
40- visual
50- smell, taste
60 - balance, coordination

72
Q

culture for senses

A

differeing amounts of eye contact, persoonal space, and touch
family presence- may perfer have family or be alone
vision and hearing deficits impact health literacy and understanding

73
Q

sensory deficit

A

deficit in the normal functioning of sensory reception and perception

74
Q

sensory deprivation

A

inadequate quantity or quality of stimulation

75
Q

sensory overload

A

recpetion of multiple sensory stimuli

76
Q

interventions for sensory

A

frequent orientation, encourage visitors, organize care, quiet times, dim lights at night, avoid excessive conversation outside the room, cannot turn off alarms

77
Q

vision assessment

A

squinting, blurred vision, glasses, difficulty distinguishing colors, difficulty reading, decreased ability for ADL’s. decreased socialization, falls

78
Q

implementing vision

A

good lighting, good eye contact, large print, decrease glare, sunglasses, color contrast

79
Q

driving safe tips for blurred vision

A

drive in familiar areas, no night driving, avoid highways, have a phone with you, drive slow, keep car in good repair

80
Q

assesment for presbycusis (hearing loss)

A

patient asks you to repeat yourself, inattentive, has a hearing aid, responds inappropriately, speaks too loud of too soft, doesnt follow directions, turn shead one direction, smiles and nods

81
Q

implementation for hearing loss

A

ask about hearing aids
talk slow and clear
get pateints attention
speak to good ear
sign language, lip reading, pad pad and pencil, quiet environment, amplified phone, move to personal space.

82
Q

assessment for smell and taste

A

increased bod odor, weight change, appetite change, excess use of seasonings or sugar,

83
Q

implenmentation for smell and taste losses

A

oral hygiene, good hydration, seasonings, remove unpleasant odors, no blending or mixing foods, different textures, check expiration dates

84
Q

touch assesment

A

clumsiness, failure to respond to touch, numbness, tingling, decreased grip, over or under reaction to pain

85
Q

touch implementation

A

massage, check temperature, firm, label faucets, be careful with hot and cold items, no heating pads, loosen linens on bed, check skin

86
Q

special communication needs

A

use pictures, paper, no shouting, be patient, vibrator voice box

87
Q

aphasia

A

inability to speak, intrepret, or understand langauge

88
Q

expressive aphasia

A

inability to name common objects or express simple ideas in words or writing
bonica

89
Q

sensory or receptive aphasia

A

inability to understand written or spoken langauge
- wernicke

90
Q

sensory implementation in community

A

vision and hearing screenings
home risk assessment
alternative communication
use of assistive devices

91
Q

home risk assesment

A

cracked sidewalks, scatter rugs, extension cords, clutter, labeled faucets, lighting, grab bars

92
Q

delirium vs dementia

A

delirium is a period of confusion, can be reversed
dementia is forever

93
Q

interventions for confused patients

A

promote orientation, do not offer too many choices, face patient while speaking, relieve anxiety

Nursing 300 (3 decks)

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