Nursing Health Differences Flashcards

1
Q

What are the 6 six foundational concepts for nursing care?

A

1) Nutrition
2) Elimination
3) Oxygen
4) Fluid and Electrolyte Balance
5) Activity and Mobility
6) Rest and Sleep

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2
Q

Define the Nursing Process, and identify the steps in the nursing process. How do they relate to the ANA Standards of Practice?

A

The nursing process is an ongoing and systematic cycle of six sequential steps: assessment, diagnosis, outcomes identification, planning, implementation (interventions or strategies), and evaluation. The ANA considers the nursing process to be foundational to the practice of competent nursing care; the first six ANA standards incorporate basic nursing process steps.

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3
Q

Identify nine other import. standards of care expected of the registered professional nurse in the ANA Standards of Practice.

A

1) pursuing educational opportunities.
2) collaborating with pt., family, signif. other, other health care.
3) integrating experience, up-to-date research findings to ensure evidence-based nursing practice.
4) acting on behalf of pt/clients in ethical manner.
5) providing leadership.
6) effective communication with everyone involved.
7) evaluating own practice in regards to standards/statutes/regulations.
8) utilizing appropriate resources in a financially responsible manner.
9) promoting a safe health care environment.

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4
Q

What are the 3 categories of identified outcomes related to the nursing process?

A

The 3 categories of identified outcomes are health restoration, health maintenance, and health promotion.

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5
Q

What 3 basic components does a nursing diagnosis generally include?

A

In most cases, a nursing diagnosis will include an actual or potential problem and the etiology (probable cause) of the problem or potential condition of risk. Defining characteristics (known as signs or symptoms) which are derived from subjective and objective data obtained during assessment by the nurse.

3 basic components: acronym PIE (problem, etiology, signs/symptoms).

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6
Q

What are the macro-minerals found in the body?

A

The macrominerals are calcium (Ca), phosphorus (P), potassium (K), sodium (Na), sulfur (S), magnesium (Mg), and chlorine (Cl).

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7
Q

What are the microminerals found in the body?

A

The microminerals are iron (Fe), zinc (Zn), manganese (Mn), fluorine (F), copper (Cu), cobalt (Co), iodine (I), selenium (Se), chromium (Cr), and molybdenum (Mo).

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8
Q

What are the alkaline forming minerals?

A

Sodium (Na), magnesium (Mg), potassium (K), iron (Fe), and calcium (Ca) are the minerals that produce an alkaline (base) residue (ash). The foods that are base (alkaline) producing, with high levels of these minerals, include most fruits and vegetables. The exceptions are plums, prunes, and cranberries, which are acid-producing fruits.

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9
Q

What are the acid forming minerals?

A

The acid-forming elements are sulfur (S), phosphorus (P), and chlorine (Cl). The foods containing the largest amounts of these minerals are the grains and protein foods (milk, cheese, meats, and eggs).

Minerals are found in water & in natural foods, as well as supplemental minerals.

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10
Q

What is Kwashiorkor?

A

Kwashiorkor – a severe deficiency of energy with an adequate supply of calories. Onset is usually between 1 – 4 years of age. Symptoms include thin, wasted extremities, prominent abdomen (ascites). Fatal deterioration may be caused by recurrent diarrhea, infection or circulatory failure.

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11
Q

What is Marasmus?

A

Marasmus – results from decreased intake of protein & calories – a syndrome of physical & emotional deprivation & is not confined to geographic areas where food is inadequate.

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12
Q

How are dextrose and fat emulsions administered?

A

Dextrose–protein solutions are given through an in-line filter. Fat emulsions should not be filtered; they are “piggybacked” into the IV line beyond the filter.

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13
Q

Why should large doses of vitamin C be avoided in pt’s with ARF?

A

Large doses of vitamin with should be avoided because urinary excretion is impaired. In addition, oxalate (a product of vitamin C catabolism) may precipitate in renal tubules or form calcium oxalate stones, obstruct urine flow, and worsen renal function.

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14
Q

What is given to CRF (Chronic renal failure) pt’s to prevent iron deficiency anemia?

A

In patients with CRF who are on hemodialysis and receiving supplemental erythropoietin therapy, sodium ferric gluconate complex (Ferrlecit) may be given IV during dialysis to treat iron deficiency anemia.

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15
Q

Regarding UTI’s, what is the antispasmodic given to children for which ages?

A

If an antispasmodic is needed, oxybutynin is indicated for children older than 5 years of age, and flavoxate can be used in children older than 12 years of age. Phenazopyridine is indicated as a urinary tract analgesic for children 6 to12 years of age.

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16
Q

Regarding pregnancy and antibiotics for UTI’s, what is the drug of choice for them and why?

A

If an antibiotic is needed, the one-dose fosfomycin might be the drug of choice because of the limited exposure to the drug.

17
Q

Regarding UTI’s, what juices should be avoided and why?

What juice should be consumed?

A

alkaline ash juices such as orange or grapefruit juice because they leave an alkaline ash residue in the bloodstream for renal excretion which contributes to an alkaline urethra.

Cranberry juice is the choice for combating UTI’s as well as prevention.

18
Q

Alveolar Gas Exchange:

A

Alveolar Gas Exchange – the diffusion of O2 from the alveoli & into the pulmonary blood vessels. Diffusion – movement of gases or other particles from an area of greater (>) pressure or concentration to one of lesser (

19
Q

Transport of O2 and CO2 -

A

Transport of O2 & CO2 - Normally most the O2 (97%) combines loosely with hemoglobin in the red blood cells & is carried to the tissues as oxyhemoglobin. The remaining oxygen is dissolved & transported in the fluid of the plasma & cells.

20
Q

Factors affecting the rate of O2 and CO2 transport?

A

Factors affecting the rate of transport -

  1. Cardiac Output - amount of blood pumped by the heart is 5Lpm
  2. Number of erythrocytes & blood hematocrit (hematocrit is the percentage of blood that is erythrocytes (red blood cells)) Males (♂) average 5 million per cubic mL, and females ( ♀ ) 4.5 million.
  3. Exercise
21
Q

Carbon dioxide is transported from the cells to the lungs in three ways;

A

Carbon dioxide is transported from the cells to the lungs in three ways;

  1. Bicarbonate (@65%) carried inside the red blood cells (RBCs)
  2. Carbaminohemoglobin (30%) carbon dioxide combined with hemoglobin
  3. Carbonic acid (5%) CO2 combined with water
22
Q

Respiratory Regulation?

A

Respiratory Regulation

  1. Respiratory center- a number of groups of neurons located in the medulla oblongata & pons of the brain.
  2. Chemosensitive center in the medulla oblongata is responsive to increases in blood CO2 or hydrogen ions.
  3. Carotid bodies; special neural receptors sensitive to decrease ( ↓ ) in oxygen (O2) concentration. ( located above (↑) the bifurcation of the common carotid arteries).
  4. Hypoxic drive; oxygen concentrations, not carbon dioxide (CO2 ) concentrations regulate respiration – as in Emphysema.
23
Q

Cardiac Output?

A

Cardiac Output is the amount of blood pumped by the ventricles in 1 minute. Calculated as SV x HR = CO Cardiac output is affected by Heart rate (HR) and Preload (the degree muscle fibers in the ventricle are stretched) and depends on amount of blood returning to heart from the veins; Contractility - Afterload – Systemic vasoconstriction; increase in arterial blood pressure & afterload – vasodilation decreases workload & afterload

24
Q

FACTORS INFLUENCING RESPIRATORY & CARDIOVASCULAR FUNCTION -

A
  1. Environmental Factors; The higher the altitude, the lower the partial pressure (PO2) of oxygen. Air pollution (smog) cause altered respiratory function. Room ventilation, overcrowded conditions, humidity. Occupation (pollutants in the work place) fumes, sand (silicosis), coal (anthracosis), asbestos (asbestosis), working with birds (sarcoidosis)
  2. Lifestyle (individual preferences/patterns); Physical exercise increases the rate & depth. Cigarette smoking causes vasoconstriction & can cause impaired tissue oxygenation. Excessive alcohol intake is a respiratory depressant, slowing respirations. Increases the risk of hypertension, anemia & infection.
  3. Health status (physical condition);
  4. Narcotics (Opioids) – such as morphine & meperidine HCl ↓ rate & depth of respirations.
  5. Stress & coping- hyperventilation in response to stress. Emotional status, anxiety
  6. Gender; predominance of abdominal breathing in males
25
Q

Respiratory alterations -

A
  1. Hypoxia; insufficient oxygen anywhere in the body. Signs and symptoms (S/SX)- rapid pulse, rapid, shallow respirations & Dyspnea, increased restlessness/light-headedness, flared nares, substernal/intercostal retractions, cyanosis.
  2. Hypoventilation inadequate alveolar ventilation.
  3. Hypercarbia- accumulation of carbon dioxide in the blood.
  4. Hypoxemia – reduced oxygen in the blood & is characterized by a low PaO 2 or low hemoglobin.
  5. Cyanosis- bluish discoloration of the skin, nail beds, & mucous membranes.
26
Q

Altered breathing patterns;

A

Dyspnea – difficult or labored breathing,

Orthopnea – inability to breathe when lying down. Place patient in an upright or standing position.

Kussmaul’s breathing- body attempts to compensate for metabolic acidosis by blowing off CO 2 with deep & rapid breathing.

Cheyne-stokes- marked waxing & waning of respirations from very deep to very shallow. (CHF, ICP & drug overdose).

Apneusis- prolonged gasping inspiration followed by a very short inefficient expiration (CNS disorders).

Biot’s (cluster) respirations- shallow breaths interrupted by apnea. (CNS disorders)

Obstructed Airway;

Stridor- a harsh, high-pitched sound, heard on inspiration.

Adventitious breath sounds

27
Q

Normal respiratory rates -

A

Normal respiratory rate

o newborns- 35 (30-80)

o 1-3yrs 30 (20-40)

o 6-8yrs 20 (15-25)

o 10yrs 19 (15-25)

o teen years 18 (15-25)

o adult 16 (12-20)

o older adult 16 (15-20)

28
Q

Differentiating lung sounds:

A

Differentiating lung sounds:

  • Adventitious breath sounds are abnormal breath sounds occurring when air passes through narrowed airways or airways filled with fluid or mucus or when pleural linings are inflamed.
  • Bronchial breath sounds are high pitched, Blowing, Muffled, Expiratory sound slightly longer than inspiratory sound
  • Bronchovesicular breath sounds are louder & harsher than vesicular sounds; Muffled vesicular sound combined with loud guttural sound; Equal on inspiration & expi9ration
  • Vesicular breath sounds are Soft & low-pitched; Rustling or breezy; 3 x longer on inspiration than expiration
  • Tracheal breath sounds are High pitched; Loud; Harsh; Hollow sounding; Equal on inspiration & expiration
  • Fine crackles (Rales) are typically a popping sound, like slurping through a straw in Patients with pulmonary edema
  • Coarse crackles (Rhonchi) are Bubbling or gurgling and Usually clear or lessen after coughing
  • Friction Rub is a superficial grating or creaking that is not relieved by coughing
  • Sibilant wheezes are High pitched musical or whistling sounds-Usually heard during or at the end of expiration
  • Sonorous wheezes are Deep low pitched rumbling sounds, Usually heard during expiration
29
Q

Metered Dose Inhaler (MDI) Instructions -

A

Metered Dose Inhaler (MDI) Instructions

  1. Inhale/exhale several breaths – slowly & deeply through the nose
  2. Inhale slowly/deeply thru the mouth while pressing down once on the canister – continue to inhale 2-3 seconds
  3. Hold breath for 5-10 seconds
  4. Exhale slowly through pursed lips
  5. If another puff is prescribed – wait 1-3 minutes
  6. Rinse mouth with tap water & blow nose to remove remaining medication
  7. Clean the mouthpiece after each use
  8. Disinfect weekly using water / vinegar solution
  9. Store at room temp.
  10. Report adverse reactions such as restlessness, palpitation, nervousness or rash after use.
30
Q

Why is water vital to health & normal cellular function?

A

Water is vital to health & normal cellular function. It is a medium for metabolic reactions in cells, transports nutrients, waste products, & other substances. It serves as a lubricant, insulator & shock absorber. It is one means of regulating body temp.

31
Q

ELECTROLYTES;

A

ELECTROLYTES; major cations in body fluid are sodium, potassium, calcium, magnesium & hydrogen ions. Major anions are chloride, bicarbonate, phosphate, sulfate, & proteinate ions. Sodium (Na+) out numbers other cations in ECF. It affects overall concentration of & is important in regulating the volume of body fluid. Measured in mEq/L

32
Q

Serum electrolyte levels:

A

sodium 135-145 mEq/L, Potassium 3.5-5.0 mEq/L, Chloride 95-105 mEq/L, Calcium (total) 4.5-5.5 mEq/L, 8.5-10.5 mg/dl. (ionized) 56% of total calcium, Magnesium 1.5-2.5 mEq/L or 1.6- 2.5 mg/dl, Phosphate 1.8-2.6 mEq/L, and Serum osmolality 280-300 mOsm/kg water.

33
Q

Types of joints

Synarthrodial -

A

Immovable joints -Examples: Skull sutures, epiphyseal plates, joint between first Rib & manubrium of sternum.

34
Q

Types of joints

Amphiarthrodial -

A

Slightly moveable joints - Examples: Vertebral joints, joint of the symphysis pubis.

35
Q

Types of Joints -

Diarthrodial -

A

Freely movable joint, Consistent features of diarthrodial joints

Ability to move freely; A fibrous joint capsule; A joint cavity; A synovial membrane that lines the inner surface of the joint capsule; Lubricating synovial fluid secreted by the synovial membrane; Articular cartilage that covers the bony surfaces.

Types of diarthrodial joints - Examples: Hip joint between the femur & pelvis.