NRSG200 > QUIZ 6 > Flashcards
QUIZ 6 Flashcards
MAP
mean arterial pressure
MAR
medication administration record
mcg
microgram
MDI
metered-dose-inhaler
mEq
miliequivalent(s)
mg
milligram
MI
myocardial infarction
MICU
medical intensive care unit
min
minute
mL
milliliter
mmol
millimole(s)
MMR
measles, mumps, rubella
MOM
milk of magnesia
MRI
magnetic resonance imaging
MRSA
Methicillin-resistant Staphylococcus aureus
MS
mental status, multiple sclerosis, mitral stenosis
MVA
motor vehicle accident
MVR
mitral valve repair/replacement
Na
sodium
NAD
no acute distress
neg/-
negative
NG
nasogastric
NICU
neonatal intensive care unit
NIDDM
non-insulin dependent diabetes mellitus
NKA
no known allergies
NPO
nothing by mouth
NS
normal saline
NSAID
nonsteroidal anti-inflammatory drug
NSR
normal sinus rhythm
NTG
nitroglycerin
N/V
nausea, vomiting
NVD
nausea, vomiting, diarrhea
NWB
non-weight bearing
abdominal paracentesis
using strict sterile technique, a primary care provider with the assistance of a nurse makes a small incision with a scalpel, inserts the trocar and cannula, withdraws the trocar which is inside the cannula, attaches tubing to the cannula, and the fluid in the abdomen (ascites) flows out into a receptacle. the fluid specimen is used for laboratory study and to relieve pressure on the abdominal organs from excess fluid.
angiography
an invasive procedure requiring informed consent of the client. a radiopaque dye is injected into the vessels to be examined. using fluoroscopy and x-rays, the flow through the vessels is assessed and areas of narrowing or blockage can be observed. coronary angiography is performed to eval the extent of CAD; pulmonary angiography assesses pulmonary vascular system (for pulmonary emboli), may also study carotid and cerebral arteries, renal arteries, vessels of lower extremities
ascites
normally the body would only create enough peritoneal fluid for lubrication, continuously formed and absorbed into the lymph system. but in some disease processes, a large amount of fluid accumulates in the abdominal cavity = ascites.
normal ascitic fluid is serous, clear, light yellow.
use abdominal paracentesis to obtain specimen/relieve pressure from the excess fluid.
colonoscopy
direct visualization technique allowing viewing of the large intestine.
complete blood count
specimens of venous blood are taken for a CBC which includes hemoglobin and hematocrit, erythrocyte count, red blood cell indices, leukocyte count, and a differential white cell count. it is a basic screening test and one of the most frequently ordered tests.
computed tomography
aka CT scan aka computerized axial tomography (CAT). painless, noninvasive xray. uniquely can distinguish minor differences in density of tissues. produces a 3D image of the organ or structure. more sensitive than xray machines.
cystoscopy
the bladder, ureteral orifices, and urethra can be directly visualized using a cystoscope, a lighted instrument inserted through the urethra.
echocardiogram
noninvasive test. uses US to visualize structures of heart and evaluate left ventricular function. images are produced as ultrasound waves and reflected back to a transducer after striking cardiac structures. the nurse should tell the client there will be no discomfort, but the gel may be cold.
expectorate
cough up.
ask the client to expectorate sputum into a specimen container.
HbA1c
HbA1c = glycosylated hemoglobin.
common lab test is the HbA1c test, which measures blood glucose that is bound to hemoglobin. it is a reflection of how well blood glucose levels have been controlled during the prior 3-4 months. normal range 4-5.5%
elevated HbA1c = hyperglycemia in patient with diabetes.
hemoglobin
(Hgb).
it is the main intracellular protein of erythrocytes. it is the iron-containing protein in the red blood cells that transports o2 through the body.
a hemoglobin test (different from HbA1c test) measures the total amount of hemoglobin in blood.
normal values vary, males are higher than females.
hemoglobin and hematocrit together are known as H&H
men: 13.5-18g/dL
women: 12-15g/dL
hematocrit
measures the percentage of RBCs in the total blood volume. normal values vary, males higher than females.
hemoglobin and hematocrit together are known as H&H
men: 40-54%
women: 36-46%
guaiac test
guaiac test is the test for occult blood (occult blood is hidden blood that can result from GI ulcers, inflammatory disease, tumors).
the test can be readily performed by the nurse in the clinical area or by the client at home. guaiac paper used in the test is sensitive to fecal blood content.
hemoptysis
blood in the sputum (found in a sputum specimen)
lumbar puncture
aka LP, aka spinal tap. cerebrospinal fluid (CSF) is withdrawn through needle. needle is inserted into subarachnoid space of spinal canal between third and fourth lumbar vertebrae or between fourth and fifth lumbar vertebrae. at this level, needle avoids damaging spinal cord/major nerve roots. client is positioned laterally with head bent toward chest, knees flexed on abdomen, and back at edge of bed or examining table. with the back arched this way, the spaces between vertebrae are increased so spinal needle can be inserted. primary care provider frequently takes CSF pressure readings using a manometer during LP.
magnetic resonance imaging
noninvasive diagnostic scanning technique. client is placed in a magnetic field. clients with implanted metal (pacemaker, metal hip prosthesis) cannot undergo it because of magnetism. no radiation used. if a contrast media is injected before, it is not iodine. MRI provides a better contrast between normal and abnormal tissue than CT. but it is more costly.
polycythemia
a higher than normal RBC count. clients with chronic hypoxia may develop this higher than normal cell count.
peak level
therapeutic drug monitoring is used when a client is taking a medication with a narrow therapeutic range (ie digoxin, theophylline, aminoglycosides). for this monitoring, they draw blood samples to determine peak and trough levels to see if a drug is at a therapeutic level and not subtherapeutic or toxic. peak level indicates the highest concentration of the drug in the blood serum
occult blood
occult blood is hidden blood that can result from GI ulcers, inflammatory disease, tumors.
found in a guaiac test.
serum osmolality
a measure of the solute concentration of the blood. the particles induced are sodium ions, glucose, urea (BUN).
can be estimated by doubling serum sodium because sodium and its associated chloride ions are the major determinants of serum osmolality.
these values are primarily used to evaluate fluid balance. normal = 280-300mOsm/kg.
increase indicates fluid volume deficit, decrease reflects fluid volume excess.
steatorrhea
an excessive amount of fat in the stool.
can indicate faulty absorption of fat from the small intestine.
a decreased amount of bile can indicate obstruction of bile flow from the liver and gallbladder into the intestine. nurse needs to collect and send the total quantity of stool expelled at one time instead of a small sample to test for steatorrhea.
thoracentesis
a primary provider with a nurse assisting using strict sterile technique tells the client to assume a position that allows easy access to the intercostal spaces (usually sitting with armbs above head to spread the ribs and enlarge intercostal space). they also commonly use elevated arm and stretched forward, or clean leaning over a pillow. the primary care provider palpates and percusses the chest to select the site for insertion of the needle into the pleural sac to ensure they are not inserted below the fluid level (or above fluid if air is being removed). they then remove the excess fluid or air to ease breathing. it is performed in pneumothorax or to introduce chemotherapeutic drugs intrapleurally. often use a site on lower posterior chest to remove fluid, and upper anterior chest for air. chest x-ray prior helps pinpoint insertion site.
trough level
therapeutic drug monitoring is used when a client is taking a medication with a narrow therapeutic range (ie digoxin, theophylline, aminoglycosides). for this monitoring, they draw blood samples to determine peak and trough levels to see if a drug is at a therapeutic level and not subtherapeutic or toxic. trough level represents the lowest concentration of the drug in blood serum
urine specific gravity
an indicator of urine concentration, or the amount of solutes (metabolic wastes and electrolytes) present in the urine.
normal 1.010-1.025
as urine becomes more concentrated, specific gravity increases. excess fluid intake or diseases affecting ability of kidneys to concentrate urine can result in low specific gravity. high = fluid deficit or dehydration, or excess solutes such as glucose in urine.
measured with multiple-test dipstick that has a separate reagent area for specific gravity.
venipuncture
puncture of a vein for collection of a blood specimen.
can be performed by various members of health care team. a phlebotomist usually collects the blood specimen for tests ordered.
atelectasis
collapse of a portion of the lung - there is increased risk for this as lung compliance decreases with aging, making it more difficult to expand alveoli
Biot’s respirations
aka cluster respirations. it is an irregular breathing rhythm.
they are shallow breaths interrupted by apnea; may be seen in clients with CNS disorders
Cheyne-Stokes respirations
irregular breathing rhythm.
it is a marked rhythmic waxing and waning of respirations from very deep to very shallow with short periods of apnea commonly caused by chronic diseases, increased intracranial pressure, or drug overdose
diffusion
the movement of gases or other particles from an area of greater pressure or concentration to an area of lower pressure or concentration. pressure differences in the gases on each side of the respiratory membrane obviously affect diffusion. when the pressure of oxygen is greater in the alveoli than in blood, oxygen diffuses into blood.
dyspnea
difficulty breathing or feeling SOB. it may occur with varying levels of exertion or at rest. the client with dyspnea will have observable/objective signs: flaring, labored-appearing breathing, increased HR, cyanosis, diaphoresis.
it has many causes, mostly from cardiac or respiratory disorders.
treatment is aimed at removing underlying cause: nurse must conduct thorough history of onset, duration, precipitating and relieving factors to dyspnea and also do a comprehensive physical exam.
emphysema
a chronic lung ailment where oxygen concentrations, not carbon dioxide concentrations, play a major role in regulating respiration.
for some clients with this disease, decreased oxygen concentrations are the main stimuli for respiration because the chronically elevated carbon dioxide levels that occur desensitize the central chemoreceptors, creating a hypoxic drive. increasing oxygen on these patients decreases the respiration rate, so oxygen must be administered cautiously to these clients at low flow. however only a small percent are thought to actually have depressed chemoreceptors, and low flow may not be enough for survival and quality of life for many clients with COPD
hypercarbia
aka hypercapnia.
increased levels of carbon dioxide.
can be caused by hypoventilation.
intrapleural pressure
pressure in the pleural cavity surrounding the lungs.
intrapleural pressure is always slightly negative in relation to atmospheric pressure. this negative pressure is essential because it creates the suction that holds the visceral pleura and the parietal pleura together as the chest cage expands and contracts. recoil tendency is a major factor in this negative pressure. intrapleural fluid also contributes by causing pleura to adhere together.
intrapulmonary pressure
pressure within the lungs.
it always equalizes with the atmospheric pressure. when volume of lungs increase on inspiration, intrapulmonary pressure is decreased and air rushes into lungs to equalize the pressure with atmospheric pressure. when the diaphragm and intercostal muscles relax, the volume of the lungs decreases > intrapulmonary pressure rises > air is expelled.
normal elastic recoil of thorax/lungs is essential to exhaling.
diseases such as COPD that reduce elasticity result in forced expirations and may impair ability to expel co2.
hypoxemia
reduced oxygen levels in the blood. may be caused by conditions that impair diffusion at alveolar capillary level such as pulmonary edema or atelectasis or by low hemoglobin levels.
CV system compensates by increasing HR and CO to attempt to transport adequate o2 to tissues. if unable to compensate or hypoxemia is severe»_space;> tissue hypoxia
hypoxia
insufficient oxygen anywhere in the blood.
tissue hypoxia results in potential cellular injury or death.
Kussmaul’s breathing
a type of hyperventilation that accompanies metabolic acidosis.
the body attempts to compensate for increased metabolic acids by blowing off acid in the form of CO2.
lung compliance
the expansibility or stretchability of lung tissue. plays a significant role in the ease of ventilation. at birth, the fluid filled lungs are stiff and resistant to expansion, but with each breath, alveoli become more compliant and easier to inflate. lung compliance tends to decrease with aging, increasing risk for atelectasis.
orthopnea
the inability to breathe unless sitting upright or standing.
postural drainage
this is the drainage by gravity of secretions from various lung segments. secretions that remain in the lungs or airways promote bacterial growth and subsequent infection and obstruct smaller airways and cause atelectasis. a wide variety of positions is necessary to drain all segments of the lungs but not all positions are required for every client. lower lobes require drainage most frequently because the upper lobes drain by gravity.
before drainage, patient may be given bronchodilator or nebulization therapy to loosen secretions. postural drainage is done 2-3 times/day before breakfast/lunch, late afternoon, and before bed. drainage can be tiring, may induce vomiting.
sequence for postural drainage: position, percussion, vibration, removal of secretions by cough/suction.
assess patient’s tolerance for all positions: ex, some do not tolerate trendelenburg’s very well and require a moderate tilt or shorter time in the position.
stridor
harsh, high pitched sound that may be heard on inspiration. caused by disrupted airflow
