Mi 116 Unit 4 Flashcards
Social determinants of health ( sodh)
The conditions in the environment where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and qualify of life outcomes and risks
5 domains of SODH
Economic stability
Education access and quality
Health care access and quality
Neighborhood and built environment
Social and community context
Homeostasis
Relative constancy in the internal environment of the body
Naturally maintained by adaptive responses that promote healthy survival
( heartbeat, bp, body temp, electrolyte balance )
When are vital signs needed for RTs
Change in condition, suspected dye reaction, following a fall
What are the oral, rectal, and axillary tempts
Oral- 98. 6
Rectal- 99.6
Axillary - 97.6
Thermoregulation
Body’s maintenance of heat production and loss
Hypothalamus plays a role in preservation of heat and heat loss
5 routes for taking temperatures
Oral, axillary, rectal, tympanic, temporal
Hyperthermia, hypothermia, and medically induced
Hyper- oral temp higher than 99.5
Hypo - temp fall below normal range
Med induced - therapeutically decrease body’s need for oxygen
Ventilation
Mechanical movement of air into and out of the lungs
The gas exchange is needed for survival
Inspiration (rise) and expiration (fall)
Adult, children, and new born beats per minute
Adult- 12-20
Children - 20-30
Babies- 30-60
Significance of respiratory rate abnormality
Cellular metabolism increases= demand for O 2 increases= production of CO2 increase= increase respiratory rate
Tachypnea - respiratory rates greater than 20 breaths per minute ( exercise, fever, anxiety )
Bradyphea- decrease in the respiratory rate
Dyspnea
Difficulty breathing
Orthophea
Difficulty breathing unless sitting up or standing erect
Apnea
Absence of spontaneous ventilation
Usually suddenly
Common palpation for pulse
Radial artery, brachial artery, carotid artery
How to measure pulse
2nd and 3rd digits placed over pulse point ( can’t use thumb)
Normal adult rate is 60-100
Children rate is 70-120
In critical care setting what do you use
Use pulse oximeter
use probe
normal value- 95%-100%
Systolic and diastolic
Systolic- contraction of heart
Diastolic - relaxation of heart
Sphygmomanometer
Cuff, tubing, a valve, a bulb and a manometer attached to the cuff
How to read bpm
Recorded in millimeters of mercury
Systolic/ diastolic
Adult normal values: systolic less then 120 mm HG
Diastolic less then 80 mm HG
Hypertension
Persistent elevation of blood pressure above 140/90 mm HG
Moderate degree of hypertension can cause damage to heart, brain, kidneys, lungs, and other organ system
Higher in men then women
Symptoms may not exist
Hypotension
Low blood pressure
Less than 95/60 mm HG
Concerns: dizziness, confusion, or blurred vision
Usually not problematic
Could be from shock
Orthostatic hypotension
BP that falls 20 mm Hg or more when a patient sits or stands
Pain
Pain is protective - warning us of a potential problem/ injury of the body
My pain is different from your pain
Oxygen
Oxygen is a drug
Physician must prescribe
Order in liters per minute
Concentration such as 24%
Under no circumstance should O2 be completely removed to take an X-ray
Oxygen delivery devices
Too much oxygen is not good
Oxygen flow mete - reducing valve that permits flows safe for patient use
Flowmeter- operate the rate of O2 flow in liters per minute to the patient
pressure manometer- indicates pressure or volume of O2 inside the canister
<1000 PSI has to be replaced with a new tank
Low flow and high flow
Low flow (variable oxygen concentration) - amount of inhaled O2 varies with patient respirations, more concentrated with short shallow breaths
High flow (fixed or precise oxygen concentration)- meets or exceeds oxygen needs of patient
Low flow devices, nasal cannula and mask
Nasal cannula- short prongs inserted into the nares, usual rates 1-4 LPM, delivers 24%-36% O2-
Mask- simple, nonrebreathing and partial rebreathing, may have to add humidity once we add level 4, delivers 60-80% oxygen (reservoir bag has to be inflated at all times)
Nebulizer
Aerosol mist with precise O2 concentration
At least 8 LPM (28%-100%)
Can. E used to administer meds
Tent and oxyhood
Pediatrics
Tent- difficult controlling O2 concentrations (opening and closing )
Oxyhood- used on infants, box that fits over infants head (21%-100%)
Ventilator
Artificial airway due to a patient being unable to supply adequate O2 to tissues
Delivers a minimum said, respiratory rate present inspiratory, volume inconsistent FiO2
Do you not dislodge airway what position patient do not silence alarms or alter them
Oxygen placements
Oxygen tanks cannot be stored within 5 feet of an electrical outlet. Tanks
must be secured on a rack or portable carrier,
dropping or cracking tint could be dangerous & never take regular oxygen tank into MRI
Blood urea nitrogen (BUN)
Reveals important information about how well your kidneys and liver are working
Normal adult range: 10-20 mg/dL
Elderly: slightly higher than adult
Infant: 5-18 mg/dL
Newborn: 3-12 mg/dL
Creatinine
Chemical waste product that’s produced by your muscle metabolism into a smaller extent by eating meat
How much kidney damage there is
Normal: 0.6-1.2 mg/ dL
Critical value >4 mg/dL
Glomerular filtration rate (GFR)
Test use to check how well the kidneys work
Normal: 90-120 mL/min
GFR is used to stage renal disease- less than 15 GFR
Hemoglobin
Males higher then females
A protein in red blood cells that carries oxygen
Red blood cells
What does that tells how many red blood cells do you have
Male: 4.7 to 6.1 million cells
Female: 4.2-5.4 million cells
Oxygen saturation
Arterial blood gas test involves inserting a in the needle artery, most of the one in your wrist
Prothrombin
Test measures how quickly your blood clots
Associate with warfarin if it’s was working properly
Vitamin k
Normal range : 11-13.5
Partial thromboplastin time
Basically prothrombin
associate with heperin
blood test that looks at how long it takes for a blood to clot it can help tell if you have bleeding or clotting problems 
Kidney or renal function
How efficiently the kidneys filter blood

Cardiac output
Vital event necessary to maintain blood flow throughout the cardiovascular system
Need accurate blood volume 
Intravenous administration
Advantage: instantaneous effect of drug is wanted
Disadvantage: most hazardous route.. difficult to retrieve from circulatory system, drug can be damaging to body tissue if injected into them
3 methods of intravenous drug administration
Infusion, intermittent infusion, direct injection
Infusion
Infusion of a large volume of fluid over a certain amount of time
Sometimes called drip
Intermittent infusion
Main thing about this is timing
Set a fusion of a volume of fluid medication or a set period of time at prescribed intervals, and then stopped until the next dose is required
May be called : piggyback, secondary med, mini bag med
Direct injection
Used for single administration
Hand injection: pushed in manually by hand
Automatic power injection: used in ct and mri
Site of administration
Peripheral: IV administration is through a short catheter in a peripheral site (short term use)
Central: IV administration is through a longer catheter that it’s tip end in the SVC(long term use)
Veins in antecubital space
Advantage: accessible, large and easy
Disadvantage: frequently used and motion of joint could cause dislodgment and injury
Syringe
Standard hypodermic, insulin, tuberculin , pre-filled syringe
Tip, barrel, and plunger
Needle
Hub, shaft, bevel
Sized according to length and gauge (hub connects to syringe)
Angiocath, venous catheter - used for repeated or continuous IV use; two part stste
Butterfly
Short term use, wings aid with insertion and anchoring
Hypodermic
Single use, small injections
Equipment needed for needles
Alcohol swab, tourniquet , clean gloves, tape, drug to be administered in vial, saline flush if you didn’t venous catheter
Ampules
Sealed glass container with scored neck that is weakened so it breaks open easily
Single dose
Venipuncture procedure
Obtain order, hand hygiene, identify patient, order history, dosage, dose calculation, dose response , patient prep, hold skin taunt and under butterfly needle, release tourniquet, tape needle in place, administer contrast, observe site, remove needle and apply pressure, document all relevant info
Infiltration
The accidental leakage of non vesicant solutions out of the vein into the surrounding time
Phlebitis
Mechanical means we didn’t do as good job with the needle tip
Inflammation of vein: mechanical: imitation of catheter due to unskilled insertion, too large of vein, improper anchoring causes movement
Chemical: imitating medication, solution
Bacterial: poor aseptic technique with hand washing etc
Embolism
A blood clot, or other solid mass, as well as an air bubbles can be delivered into the circulation, do an IV and end up blocking a vessel
Drug incompatibility
Interactions between two or more substances which lead to changes in chemical physical therapeutic properties of the pharmaceutical dosage form
