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Nursing Practice 2 > learning activity 4 & 5 > Flashcards

learning activity 4 & 5 Flashcards

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1
Q

What are the three different types of blood cells:

A
  • Erythrocytes- first type of red blood cells
  • Leukocytes – second type, white blood cells
  • Thrombocytes- are the third type, these are clotting cells
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2
Q

LEUKOCYTES have two mononuclear cells. What are they?

A

•1. Granulocytes- formed in bone marrow, there are three types
oEosinophils – are active and increased in number in allergic conditions such as asthma
oBasophils – increase the healing
oNeutrophils – disease fighting
•2. Mononuclear leukocytes
oLymphocytes
oMonocytes

Never (Neutrophils) 
Let (Lymphocytes)
Monkeys (Monocytes)
Eat (Eosinophils)
Bananas (Basophils
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3
Q

What are the functions of skin and mucosa?

A

Skins function is protection, secretion, excretion, temperature regulation, and sensation. Mucosa’s function is to protect against infection.

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4
Q

What are the factors affecting skin tissue integrity

A

Reduced sensation, vascular insufficiency, immobility

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5
Q

What is erythema?

A

Abnormal redness of the skin due to infection.

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6
Q

What is cyanosis?

A

Blueness of the skin

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7
Q

What is pallor?

A

Unusual or extreme paleness

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8
Q

What is jaundice?

A

Yellow discoloration of the skin, due to increase of bile pigments in the blood.

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9
Q

What is hyper-pigmentation?

A

The darkening of the skin

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10
Q

What is hypo-pigmentation?

A

The loss of colour of the skin

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11
Q

What is ecchymosis?

A

A bruise

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12
Q

What is petechiae?

A

Non- raised hemorrhage in the skin or mucous membrane

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13
Q

What is a primary lesion?

A

And pathological or traumatic discontinuity of tissue

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14
Q

What is a secondary lesion?

A

Are changes in the skin that result from primary lesions

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15
Q

What is diaphoresis?

A

Perspiration, especially when artificially

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16
Q

What is hyperhidrosis?

A

Excessive sweating

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17
Q

What is bromhidrosis?

A

Secretion of foul-smelling sweat

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18
Q

How do you rate edema?

A

Edema is rated by the length of time the skin stays pitted after you press on it.

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19
Q

What is decubitus ulcers?

A

It is a pressure sore

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20
Q

Describe normal urine.

A

Normal urine is clear, light yellow or straw coloured

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21
Q

Identify factors that commonly influence urinary and bowel elimination.

A

Adequate fluid intake, medication, diagnostic exam, surgical procedures, psychological factors

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22
Q

What is the primary purpose of urinary catheterization?

A

After a surgical procedure

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23
Q

What ongoing assessments of clients with retention catheters should be made?

A

Volume & frequency of voiding, the absence of urine, bladder distension, restlessness, diaphoresis & abdominal discomfort

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24
Q

List the factors affecting bowel functioning.

A

Age, diet, fluid intake, physical activities, psychological factors, personal habits, position during, pain, pregnancy and labour, surgery, medications, diagnostic tests

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25
Q

Describe the characteristics of abnormal stool: CLAY, BLACK , TERRY, RED, GREEN & PUS

A

,clay-coloured –absence of bile, black – iron ingestion or upper gastro bleeding, tarry – same as black, red – lower gastro bleeding, green –food has passed through the intestines too quickly or it could be disease or food poisoning , pus - infection

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26
Q

What aids are available to assist clients to eliminate when they cannot go to the bathroom.

A

The commode or bed pans

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27
Q

What are the Skin’s function?

A
  • Protection
  • Secretion
  • Excretion
  • Temperature regulation
  • Sensation
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28
Q

What is the Oral Cavity function/ appearance

A
  • Mucous membranes
  • Salivary gland
  • Teeth
  • Gums
29
Q

What are the Individual Factors

A
  • Social practices
  • Personal preferences
  • Body image
  • Socio-economic factors
  • Health beliefs & motivation
  • Cultural variables
  • Physical condition
30
Q

What Assessment: physical examination would you check for on the face and head?

A
  • Integument: skin, hair, nails
  • Oral cavity
  • Eyes, ears, & nose
31
Q

What are some Common Skin Problems?

A
  • Acne
  • Rashes
  • Contact dermatitis
  • Abrasions
32
Q

What are Common Foot & Nail Problems

A
  • Callus
  • Corns
  • Plantar warts
  • Tinea Pedis (athlete`s foot)
  • Ingrown nails
  • Paronychia
  • odors
33
Q

What are some Hair & Scalp Problems

A 
•Dandruff
•Ticks
•Lice
-Pediculosis capitis
-         “         corporis
-         “         pubis
•Alopecia
34
Q

What are Risk Factors for Skin Impairment?

A
  • Immobilization
  • Reduced sensation
  • Nutrition & hydration alterations
  • Secretions & excretions on the skin
  • Vascular insufficiency
  • External devices
35
Q

Use of Sensory Aids include?

A
  • Eyeglasses
  • Contact lenses
  • Artificial eyes
  • Hearing aids
36
Q

ASSESSMENT of:

A
  • Self-care ability
  • Hygiene practices
  • Cultural factors
  • Clients at risk for problems
  • Special considerations
  • Client exceptions
37
Q

NURSING DIAGNOSIS

(NANDA) The North American Nursing Diagnosis Association

A
  • Ineffective health maintenance
  • Impaired mobility
  • Bathing/Hygiene self-care
  • Risk for impaired skin Integrity
38
Q

Bathing Benefits include:

A
  • Makes a person feel relaxed & refreshed
  • Cleans the skin & eliminates odors
  • Exercises muscles
  • Stimulates blood flow
  • Meets needs of love & belonging & esteem
  • Observes skin problems, builds trust, & connection with patient
39
Q

Additional Hygienic Care Considerations are:

A

•Perineal care

  • self-care ability
  • reduction of embarrassment
  • asepsis
40
Q

Massage: Precautions include:

A
  • Check care plan first
  • Not on back injury or fractured ribs
  • Not on a person who had recent back surgery
41
Q

Steps for Perineal Care for Female

A
  • Provided once daily, & PRN
  • Drape with blanket
  • Place washcloth at top of vulva & stroke to anus
  • First clean each side & then middle
  • Clean anal area by placing washcloth at the front of body & stroke down to back
42
Q

Perineal Care for Males

A
  • Provided once daily, & PRN
  • Drape with blanket
  • Pass washcloth in a circular motion, moving from tip of penis to base
  • If uncircumcised, retract foreskin to wash, then return foreskin
  • Anal area same as female
43
Q

Foot & Nail Care Guidelines

A
  • Careful inspection
  • Lukewarm water temp
  • No soaking
  • Cutting of nails, if indicated
  • Application of lotion
  • Proper socks, stockings, & shoes
44
Q

Oral Care for an Unconscious Person

A
  • Breathing through open mouth leads to drying & cracking of the lips & mucous membranes
  • Explain procedure to person
  • Guard against aspiration by turn head to side
45
Q

When BATHING BABIES what temp should the water be at?

A

•Water should be about 37.8-40.6

46
Q

BATHING: List four benefits of bathing a patient

A
  • Cleansing
  • Relaxation
  • Improves circulation
  • Passive or active exercises
  • Creates close relationship
47
Q

List four steps to complete when preparing to give a complete bed bath.

A
  • Ask the patient to void first
  • Adjust bed height to promote good body mechanics
  • Arrange supplies
  • Cover patient with bath blanket
  • Fill basin two thirds full with warm water
48
Q

What order would you use when bathing a patient

A
  • Eyes
  • Face, ears, neck
  • Arm- from fingers up to shoulders
  • Chest
  • Abdomen
  • Legs
  • Peineal area- genital, groin, pelvis, scrotum
  • Shoulders
  • Back
  • Buttocks and anus
49
Q

When giving a bath, the bath supplies should be on the side of the bed opposite to where you are working to avoid spilling of the bath water?

A

False

50
Q

A massage shold be offered as part of the bath

A

True

51
Q

Describe the steps for providing perineal care for a female patient.

A
  • Ask patient to void first.
  • Position patient on her back and drape the pelvis and legs with a bath blanket
  • Wear gloves
  • Use warm water
  • Separate the labia, expose urethra and vagina
  • Cleanse from the center of the urethra outward.
52
Q

When providing perineal care for a female, what assessment would you make?

A
  • Observe the skin for breakdown or irritation

* Assess for pain, redness, swelling, or discharge.

53
Q

Is it necessary to wear gloves while bathing a patient?

A

TRUE

54
Q

PERSONAL HYGIENE AND GROOMING
ORAL HYGIENE
The purpose of oral hygiene is it:

A

Clean the teeth and mouth

Prevent mouth odor and infection

55
Q

When providing mouth care, you should observe what three things?

A

•Condition of lips, teeth, tongue, and gums

56
Q

When providing oral care to an unconscious person, you separate the upper and lower teeth with?

A

A padded tongue blade is appropriate.

57
Q

Which position is best for an unconscious person?

A

Lateral (position on the side)

58
Q

What are the steps for cleaning dentures for a patient

A
  • Wear gloves
  • Handle dentures carefully to avoid dropping and breaking
  • Line sink with paper towel
  • Use denture cleaner or paste, clean outer teeth then inside
  • Take note on cracks, loose teeth or rough edges
  • Store dentures in a cup of cool water
  • Label denture cup with patient’s name and room number
59
Q

HAIR CARE

When caring for a patient’s hair, you should do which of the following?

A
  • Comb small sections of hair, beginning at the ends
  • Work towards the scalp
  • Comb from scalp to hair ends once ends are detangled
60
Q

SHAVING

How do you soften a man’s beard before shaving?

A

Apply warm towel compress.

61
Q

How should safety razors be disposed after use?

A

Sharps container

62
Q

When shaving a male patient, long strokes should be used when shaving the _____. Short strokes should be used when shaving the _____, _____ &______.

A

cheeks, jaw, lips and chin

63
Q

NAIL & FOOT CARE

List four reasons why nail and foot care is important

A
  • Prevents infection
  • Maintains cleanliness
  • Prevents injury
  • Prevents odor
  • Prevents hangnails
  • Prevent ingrown nails
64
Q

Should toe nails be trimmed at an angle on the side?

A

False

65
Q

Should you soak the feet of a diabetic client

A

NO

66
Q

DRESSING

List three indications for a patient to wear TED hose (elastic stockings).

A
  • Inactive patients at risk for clot formation & thrombi
  • Patient with heart disease and circulatory disorders who would benefit from improved venous return
  • Patients confined to bed
  • Women who are pregnant
67
Q

What are the two lengths of TED hose?

A

Thigh-high TED hose & Knee-high TED hose

68
Q

Ted hose worn properly should be:

A
  • Free of wrinkles or creases

* Fitted snugly

Nursing Practice 2 (4 decks)

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