Midterm Prep Flashcards

1
Q

What is the main contributor to inactivity?

A

Screen time

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2
Q

What is the guideline for physical activity?

A

60 minutes a day

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3
Q

What has happened over the years to the range that we allow our children to wander?

A

It has decreased due to:
- environment
- we’ve learned from our mistakes
- Being supervised all the time is not good

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4
Q

What do we as nurses do to promote health? (3)

A
  • promote healthy eating and physical activity from a young age
  • reducing amount of time on electronics
  • avoid the “sit disease”
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5
Q

What is Bedrest?

A
  • Prescription to stay in bed (ex. after surgery)
  • It was invented as a form of treatment in the 19th century
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6
Q

What is Bedridden? (3)

A
  • Formulation that happens due to external factors (culture, values, etc)
  • holds a negative connotation, described as the final state that leads to gradual social death
  • Involves loss of hope, dulling of senses, slump in cognition
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7
Q

What are some barriers to mobility? (4)

A
  • cultural values
  • belief that bedrest is restful and healing
  • implicit biases about the elderly
  • not enough knowledge or skills when it comes to ambulating/transferring clients
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8
Q

What are different phases of the Phase Model of Being Bedridden?

A
  • Instability
  • Incident
  • Immobility in the Room
  • Local Confinement
  • Being Bedridden
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9
Q

What is Phase 1: Instability? (5)

A
  • client has problems walking
  • shaky, dizzy
  • walking with furniture, unsteady, feeling like you might fall
  • use of aids, walker, etc
  • not super confident in walking
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10
Q

What is Phase 2: Incident?

A
  • Incident occurs
  • Leads to hospitalization
  • ex. pneumonia or falls
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11
Q

What is Phase 3: Immobility in the Room? (4)

A
  • Increasingly restricted in mobility
  • client is instructed to get a hospital bed in their home
  • comfortable chair can facilitate mobilization
  • positive attitude helps with mobilization
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12
Q

What is Phase 4: Local Confinement? (4)

A
  • Client feels tied down
  • increasingly dependent upon others
  • socialization decreases
  • mental health disorders
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13
Q

What is Phase 5: Being Bedridden? (3)

A
  • client is in bed 24 hrs a day
  • bed becomes workspace (bathroom and dining room)
  • resist talking over client
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14
Q

What are some ways to predict if our client is at risk of a fall?

A
  • checking their hearing
  • Chair test
  • looking at clients feet
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15
Q

What is the room that is most risky for falls?

A

Bathroom

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16
Q

What are some things that make the Elderly more susceptible to falls? (6)

A
  • Age
  • Medications
  • Osteoporosis
  • Dementia
  • Hearing
  • Sight
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17
Q

What are some Environmental risks that may cause a fall?

A
  • shoes
  • handrail
  • stairs
  • aids
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18
Q

What are some medications that might cause a fall?

A
  • sleeping pills
  • BP pills that make you drowsy
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19
Q

What is the Morse Fall Scale?

A

A resource used to determine what risk is a person at for falling

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20
Q

What is the Morse Fall Scale made of?

A
  • history of falls in the last 3 months
  • secondary diagnoses
  • aid, furniture walking, etc
  • IV lock
  • Gait
  • Mental status, cognitively aware
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21
Q

What is important to remember about cardiac workload?

A

keep client in upright position as heart works less effectively when in supine

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22
Q

Why should we avoid the valsalva maneuver?

A
  • it increases intrathoracic pressure
  • slows blood return, and with release of breath, surge of blood is delivered to the heart
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23
Q

What is Orthostatic Hypotension?

A
  • blood vessels get lazy
  • when bringing someone who has been laying down to an upright position, this can happen, leading to dizziness and potential falls
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24
Q

What can happen when someone is immobilized for a long time?

A

Blood clots can form

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25
Q

What are preventions and interventions that can be done to avoid blood clots from forming?

A
  • mobilization/ROM
  • compression stockings
  • anticoagulant meds
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26
Q

What is High Fowlers?

A

a upright sitting position best for breathing

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27
Q

What is Atelectasis?

A

Collapsing of the aveoli

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28
Q

What are some preventions and interventions to help with dyspnea?

A
  • deep breathing + coughing exercises
  • supplemental O2
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29
Q

What are other Hazards of immobility?

A
  • skin care
  • decreased ROM
  • decreased peristalsis
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30
Q

What are Restraints?

A

physical, environmental, or chemical measures used to control the physical or behavioural activity of a person or a portion of their body

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31
Q

What are the types of Restaints?

A
  • Physical
  • Environmental
  • Chemical
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32
Q

What are Adventitious chest sounds?

A
  • Crackles = velcro
  • Wheezes = more musical
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33
Q

What can a cough mean?

A

Infection, cold, etc.

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34
Q

What do you assess when looking at/listening to a cough?

A
  • wet; productive
  • dry; non-productive
35
Q

What can lead to a ‘weak’ or ineffective cough?

A
  • Surgery
  • Medications
  • decreased LOC
36
Q

What do we want to look at when it comes to the frequency of a cough?

A
  • if it is a lot, it might be a cold or something else
  • if it is only once, it might be a tickle
37
Q

Explain the difference between High Flow and Low Flow oxygen delivery:

A

High flow = Venti mask
- we know the % of oxygen the client is breathing
Low flow = Nasal prongs
- we do not know the % of oxygen the client is getting

38
Q

What is the normal pH levels?

A

7.35-7.45

39
Q

How do we test the acid base balance?

A
  • arterial blood gas
  • capillary blood gas
40
Q

How does the body maintain the balance between acids and bases?

A

By maintaining the ratio of HCO3 and H2CO3 via buffer systems

41
Q

What is the major buffer system in the body?

A

Bicarbonate (HCO3) + Carbonic Acid (H2CO3)

42
Q

What do the Kidneys do in relation to buffer systems?

A
  • Regulates bicarbonate level in ECF (retains or excretes) also hydrogen
  • happens over days, very slowly
43
Q

What do the lungs do in relation to buffer systems?

A

Control levels of CO2 and carbonic acid via ventilation

44
Q

What are the pH levels for Respiratory Acidosis?

A

pH < 7.35

45
Q

What are the pH levels for Respiratory Alkalosis?

A

pH > 7.45

46
Q

What are the pH levels for Metabolic Acidosis?

A

pH < 7.35

47
Q

What are the pH levels for Metabolic Alkalosis?

A

pH > 7.45

48
Q

What is Respiratory Acidosis?

A

When respiratory effort is suppressed causing CO2 to build up in the lungs

49
Q

What is Respiratory Alkalosis?

A

When too much CO2 is expelled out of the lungs, ex. during anxiety and hyperventilation

50
Q

What is Metabolic Acidosis?

A

When your body does not have enough of something it needs, and starts using something else in substitute.
ex. diabetes, not enough insulin, so body turns to ketones, causing it to go into ketoacidosis

51
Q

What is Metabolic Alkalosis?

A

Removing too much acid from the body
Ex. ng tube suctioning removing the acid fluid in the stomache

52
Q

What is Ventilation?

A

Act of inhaling O2 and exhaling CO2

53
Q

What is Perfusion?

A

Pump oxygen in the blood to the rest of the tissues

54
Q

What is Diffusion?

A

Movement of molecules, CO2 out O2 in, Gas exchange

55
Q

What is Inspiration?

A

An active process stimulated by chemical receptors

56
Q

What is Expiration?

A

A passive process that depends on the elastic recoil of the lungs

57
Q

What is Cilia?

A

Sweeping your lungs, keeping them clean

58
Q

What makes up oxygen transport?

A

Consists of lungs and cardiovascular system

59
Q

What transports 99% of O2 in the blood?

A

Hemoglobin

60
Q

What is Hypoxia?

A

Inadequate tissue oxygenation at the cellular level

61
Q

What are the interventions for Hypoxia?

A
  • sit them up
  • deep breathing and coughing exercises
  • Supplemental O2
62
Q

What does SpO2 read?

A

saturation of oxyhemoglobin

63
Q

What does FiO2 read?

A

Fraction of inspired O2 concentration

64
Q

What are the Signs and Symptoms of Hypoxia? (7)

A
  • Cyanosis (late)
  • Anxiety (early)
  • restless
  • disorientation
  • LOC = decline, altered level
  • Dyspnea
  • RR + P = could be elevated
65
Q

What acute conditions are considered barriers or facilitators of O2?

A
  • Pneumonia
  • COPD
  • Asthma
  • Cancer
66
Q

What chronic conditions are considered barriers or facilitators of O2?

A
  • COPD
  • Asthma
  • Cystic Fibrosis
66
Q

What chronic conditions are considered barriers or facilitators of O2?

A
  • COPD
  • Asthma
  • Cystic Fibrosis
67
Q

What are some occupational barriers/facilitators to O2?

A
  • Mining jobs
  • Asbestos
  • Radon (home)
68
Q

What are some health promotions for O2? (4)

A
  • not smoking
  • infection preventions
  • vaccinations
  • exercise
69
Q

What is 3rd hand smoke?

A

When smoke gets into animate objects

70
Q

What are the manifestations of impaired oxygenation? (10)

A
  • chills + fever
  • diaphoresis
  • feeling unwell
  • pleuritic chest pain
  • tachypnea
  • Dyspnea
  • Orthopnea
  • fatigue/tires easily
  • poor appetite
  • cough = productive or non-productive
71
Q

What is COPD?

A

A chronic, progressive respiratory illness in which air flow to the lungs is limited

72
Q

What are the principal symptoms of COPD?

A

Dyspnea and fatigue

73
Q

What is the # 1 cause of COPD?

A

smoking

74
Q

What are the different way to diagnosis a respiratory illness?

A
  • chest x-ray
  • airflow testing
  • arterial blood gas
75
Q

What is Pneumonia?

A

inflammation of the lung parenchyma (tissues of your lungs) from microorganisms

76
Q

What are the preventions of pneumonia?

A

vaccinations and not smoking

77
Q

What are the treatments of Pneumonia?

A

Antibiotics and steriods

78
Q

What are the medications to help treat Pneumonia?

A

Corticosteriods and Abx

79
Q

What are the types of Pneumonia? (5)

A
  • Community acquired CAP
  • Hospital acquired HAP
  • Ventilator associated VAP
  • Healthcare associated HCAP
  • Aspiration AP
80
Q

What are the responses/interventions for Pneumonia? (9)

A
  • hydrate + humidification
  • deep breathing and coughing
  • chest physiotherapy - cupped hands
  • Rest
  • Nutrition
  • Oxygen (PRN)
  • Smoking (Stop)
  • Suctioning
  • meds
81
Q

How would one diagnosis Pneumonia?

A

Blood tests
- CBC = White blood cells, and hemoglobin
- Blood culture and sensitivity
Sputum
- Culture and sensitivity

82
Q

What are the challenges to Inhalers? (7)

A
  • lack of effective communication
  • stigmatization
  • misperceptions
  • side effects
  • forgetfulness
  • difficulties with device, multiple inhalers
  • health literacy