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Clinical > 💉- Stress, Nutrition, Fluid & Electrolyte Test > Flashcards

💉- Stress, Nutrition, Fluid & Electrolyte Test Flashcards

1
Q

Distress vs eustress

A

Distress- threatens health

Eustress- ‘good stress’ is protective

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2
Q

External vs internal

A

External stressor- stressors may be external to the person ex: death of a family member

Internal- ex: disease, anxiety or nervous anticipation of an event

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3
Q

Developmental stressors vs situational stressors

A

Developmental- those that can be predicted to occur at various stages of a persons life

Situational- unpredictable , ex: you can’t predict if you will experience a car accident

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4
Q

Physiological stressor vs psychosocial stressor

A

Physiological- those that affect body structure or function

Psychosocial - are external stressors that arose from work, family dynamics, living situation, social relationships and other aspects of our daily lives

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5
Q

Adaptive (effective) coping

A

Consists of making healthy choices that reduce the negative effects of stress

Ex: exercising to relieve tension , etc

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6
Q

Maladaptive (ineffective) coping

A

Does not promote adaption

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7
Q

General adaptation syndrome

A

Selye’s name for the group of nonspecific responses that all people share in the face of stressors

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8
Q

What are the 3 stages of GAS

A
  1. Alarm stage
  2. Resistance (adaptation)
  3. Final stage either recovery or exhaustion
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9
Q

What are the two phases of the alarm stage

A

Shock - begins when the cerebral cortex first perceives a stressor and sends out messages to activate the endocrine and sympathetic nervous systems

Countershock - all the changes produced in the shock phase are reversed , person becomes less able to deal with the immediate threat

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10
Q

Resistance stage

A

The body tries to cope, protect itself against the stressor and maintain homeostasis through the use of physiological and psychological coping mechanisms

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11
Q

Reflex pain response

A

Protective reflex to pain

Ex: moving hand from a hot stove

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12
Q

Inflammatory response

A

Local reaction to cell injury

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13
Q

List 4 emotional responses to stress

A

Anxiety
Fear
Anger
Depression

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14
Q

Conversion

Ego defense mechanism

A

Emotional conflict is changed into physical symptoms that have no physical basis. The symptoms often disappear after the threat is over

Ex: developing nausea that causes the person to miss a major exam

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15
Q

What 3 types of disorders can develop when adaptation fails

A
  • stress induced organic responses
  • somatoform disorders
  • stress induced psychological responses
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16
Q

Stress-induced organic responses

A

Continual stress brings about long-term changes in various body systems

Ex: overeating, substance abuse

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17
Q

Somatoform disorders

A

Conditions characterized by the presence of physical symptoms with no known organic cause

Ex: hypochondriasis, somatization, pain disorder, malingering

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18
Q

Somatization

A

Anxiety and emotional turmoil are expressed in physical symptoms, loss of physical function, pain that changes location often and depression

Unable to control the symptoms and behaviors, and complaints are vague or exaggerated

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19
Q

Pain disorder

A

Emotional pain that manifests physically

Level of pain the person states is inconsistent with the physical condition- the pain doesn’t change location

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20
Q

Malingering

A

Conscious effort to escape unpleasant situations

Patient pretends to have the symptoms for personal or tangible gain

Ex: calling in sick because the person doesn’t want to go to work

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21
Q

Stress-induced psychological responses

A

Long-term stress leads to exhaustion and mechanisms begin to fail.

Person may try maladaptive wAys to cope

Ex: crisis, burnout, ptsd

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22
Q

Carbohydrates CHO

A

The primary energy source for the body

  • increase satiety
  • spare proteins
  • enhance insulin secretion
  • improve absorption of Na and excretion of Ca
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23
Q

Nitrogen balance

A

Occurs when intake and output of nitrogen are equal

Positive - nitrogen intake exceeds output , making a pool of amino acids available for growth , pregnancy , tissue maintenance and repair

Negative- intake lower than loss. Occurs in illness, injury (burns) and malnutrition

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24
Q

Proteins

A

Secondary energy source

  • fluid balance (attract water)
  • immune system function
  • acid/base balance
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25
Q

Lipids

A

Supply essential nutrients

  • back up energy source
  • flavor and satiety
  • cholesterol functions
  • 3 types: glycerides, sterols and phospholipids
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26
Q

Saturated fats

A
  • raise cholesterol
  • animal fats
  • solid at room temp
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27
Q

Unsaturated cats

A
  • lower cholesterol
  • most vegetable fats
  • liquid at room temp
  • dietary fats
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28
Q

Trans-fatty acids

A
  • raise cholesterol

- artificially created to extend shelf life

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29
Q

Sterols

A
  • cholesterol is the most critical sterol
  • required for cellular membrane structure and sex hormones
  • made in the liver and ingested
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30
Q

Phospholipids

A

Lipoproteins (phospholipid + protein) transport lipid in blood ; soluble in water

ldl- bad cholesterol (brings fat to body cells)
Hdl- good cholesterol (removes fat from blood stream and brings to liver)
Vldl- Carey triglycerides to the cell

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31
Q

Fat soluble vitamins

A

K - synthesis of proteins for clotting

A- visual acuity

D- calcium and phos metabolism and stimulates Ca absorption

E- antioxidant

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32
Q

How is energy in food measured

A

Calories

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33
Q

Basal metabolic rate

A

Determines how much energy is needed to maintain body function

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34
Q

List 6 things that can raise BMR

A 
Muscle mass 
Growth 
Elevated body temp 
Low environmental temp 
Disease states 
Prolonged exertion
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35
Q

Underweight BMI

A

18.4 or below

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36
Q

Overweight BMI

A

25-29.9

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37
Q

Obese BMI

A

30 or greater

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38
Q

What is the formula for calculating BMI

A

Weight in kilograms divided by height in meters squared

Lbs/2.2
1meter = 39.37inches

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39
Q

Normal range of glucose

A

Hypoglycemia: less than 50 mg/dl

Hyperglycemia: greater than 109 (fasting) ; greater than 127 (random)

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40
Q

Normal range of BUN

A

8-21 mg/dl

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41
Q

Normal range of hemoglobin in men and women

A

Men: 13.2-17.3

Women: 11.7-15.4

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42
Q

Normal range of albumin and prealbumin

A

Albumin: 3.4-4.8 g/dl

Prealbumin: 12-42 mg/dl

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43
Q

List 7 ways to check feeding tube placement

A

1 radiographic verification - most accurate and must be done b4 feeding takes place
2 measuring ph
3 measuring residual
4 whoosh test
5 measure tube outside the body
6 capnometry - measures CO2 levels , if positive in the wrong place
7 measuring the aspirate

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44
Q

What is required in order to use feeding tubes

A

A functioning gi tract

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45
Q

Clear liquids diet

A

Provides fluids to prevent dehydration and supplies simple carbs to help meet energy needs

Ex: water, tea, coffee, broth, clear juice, popsicles

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46
Q

Full liquids diet

A

Contains all the liquids included in the clear liquid diet plus any food items that are liquid at room temp

Ex: soup, milk, shakes, pudding

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47
Q

Mechanical soft diet

A

Diet of choice for people with chewing difficulties resulting from missing teeth, jaw problems or extensive fatigue

Ex: full liquid diet plus soft vegetables, shredded meat, eggs etc

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48
Q

Puréed diet

A

Blended food

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49
Q

What is the order of abdominal assessment

A

Inspect , auscultation , percuss , palpate

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50
Q

Colonoscopy vs sigmoidoscopy

A

Colonoscopy- examines the entire length of the colon

Sigmoidoscopy - examines only the lower third

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51
Q

What is the BRAT diet related to diarrhea

A

Consume Bananas 🍌, rice 🍚, applesauce 🍎 and toast 🍞

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52
Q

Hemorrhoids

A
  • dilated, engorged veins in the lining of the rectum

- caused by straining, pregnancy, chf or chronic liver disease

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53
Q

What are the 3 types of enemas

A

1 cleansing - promote removal of feces from the colon

2 retention - introduce a solution into the colon that is meant to be retained for a prolonged period

3 return-flow - ‘harris flush’ may be ordered to help a patient expel flatus and relieve abdominal distention

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54
Q

Flatulence

A

Gas accumulation in the lumen of the intestines

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55
Q

Medications that can slow peristalsis

A

Antacids , antidiarrheals

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56
Q

Valsalva maneuver

A

The effort to breathe out forcibly while the mouth and nose are firmly closed or the vocal cords pressed together - ‘bearing down’

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57
Q

Why is pregnancy a factor affecting bowel elimination

A

Because blood volume doubles during pregnancy and can cause constipation

58
Q

Anticholinergic medications related to urine elimination

A

Urinary retention

Ex: antihistamine, anticholinergics/antispasmodics, tricyclic antidepressants

59
Q

Nephrotoxic

A

Damaging to the kidneys

Ex: gentamicin, amphotericin b and long term use of aspirin or ibuprofen

60
Q

Pyridium

A

Is a bladder analgesic that turns urine orange

61
Q

Elavil

A

Can turn pee blue or green

62
Q

Levodopa

A

Can turn urine red, brown or black

63
Q

Anuria

A

Absence of urine ; urine output less than 100mL in 24hrs

64
Q

Dysuria

A

Painful or difficult urination

65
Q

Enuresis

A

Involuntary loss of urine

66
Q

Oliguria

A

Urine output of less than 400 ml in 24hrs

67
Q

Polyuria

A

Excessive urination

68
Q

Pyuria

A

Pus in the urine

69
Q

Urge incontinence

A

Is the involuntary loss of larger amounts of urine accompanied by a strong urge to void

70
Q

Stress incontinence

A

Is an involuntary loss of small amounts of urine with activities that increase intraabdominal pressure

71
Q

Overflow incontinence

A

The loss of urine in combination with a distended bladder

72
Q

Functional incontinence

A

The untimely loss of urine when no urinary or neurological cause is involved

73
Q

Reflex incontinence

A

Is the loss of urine when the person doesn’t realize the bladder is full and has no urger to void

74
Q

Straight catheter

A

Is a single lumen tube that is inserted for immediate drainage of the bladder

75
Q

Indwelling catheter

A

Aka foley or retention catheter

Used for continuous bladder drainage

76
Q

Suprapubic catheter

A

Used for continuous urine drainage when the urethra must be bypassed

Ex: after gynecological surgery or where there is a prostatic obstruction

77
Q

What are the 3 uses for bladder irrigation

A

To maintain patency of a urinary catheter, to wash out the bladder (remove blood clots in the bladder after surgery) or to instill medications into the bladder

78
Q

What is the normal range of specific gravity

A

1.002 - 1.030

79
Q

Oxygenation

A

How well the cells, tissues and organs of the body are supplies with oxygen

80
Q

Respiration

A

Gas exchange (co2 and o2) in the lungs or tissues

81
Q

Ventilation

A

Movement of air in and out of lungs

82
Q

Lung elasticity

A

Refers to the tendency of the elastin fibers to return to their original position away from the chest wall after being stretched

(Think of stretching a rubber band, then letting go of it

83
Q

Lung compliance

A

Refers to the ease of killing inflation

Lung compliance is reduced by increased edema, loss of surfactant or conditions that cause elastin fibers to be replaced with scar tissue (collagen)

84
Q

External respiration

A

alveolar/capillary membrane

Affected by surface area of alveoli available for gas exchange

Conditions that slow diffusion are: pulmonary effusion (fluid around the lung), pneumothorax, bronchospasms, vascular compromise in lungs and loss of lung tissue

85
Q

Internal respiration

A

Occurs in body organs and tissues

Examples of conditions affecting: vascular compromise in tissue , arterial or venous disease, edema, pressure trauma

Affected by integrity of vessels within body tissues

86
Q

Chemoreceptors

A

Located in the medulla, aorta, carotids

Detect changes in pH, O2, CO 2

CO2 levels are primary stimulus

87
Q

High CO2 levels stimulate what

A

Breathing to eliminate the excess CO2

88
Q

Low blood O2 levels stimulate what

A

Breathing to get more oxygen into the lungs

Hypoxemia

89
Q

Lung receptors

A

Located in the lung and chest wall

Detect changes in breathing patterns, expansion, compliance, resistance, irritants

90
Q

Voluntary control

A

Temporary increase or decrease in ventilation

91
Q

List 6 purposes of fluids in our bodies

A
  1. Maintain old volume
  2. Regulate body temperature
  3. Transport material to and from cells
  4. Serve as a medium for cellular metabolism
  5. Assist with digestion of food
  6. Serve as a medium for excreting waste
92
Q

Interstitial fluid

A

Fluid in the spaces between the body cells

Excess interstitial fluid is called edema

93
Q

Intravascular fluid

A

Plasma within the blood.

Main function is to transport blood cells

94
Q

Transcellular fluid

A

Includes specialized fluids that are contained in body spaces (ex: cerebrospinal , pleural , peritoneal and synovial fluid) and digestive juices

95
Q

Third spacing

A

Occurs when fluid is trapped in spaces other than ICF or ECF

96
Q

What are the 3 major ICF Electrolytes

A

K , mg and phosphate

97
Q

What are the three major ECF Electrolytes

A

Na , Ca and bicarbonate

98
Q

Active transport

A

Requires energy to move against concentration gradient

Molecules moved from low concentration to high concentration

Ex: sodium-potassium pump

99
Q

Passive transport

A

Doesn’t require energy to move molecules or fluid

Ex: osmosis , diffusion , filtration

100
Q

Hypotonic fluids

A

Lower osmolality than blood, fluid moves from vessels into cells

Cell SWELLS

101
Q

Hypertonic fluids

A

Higher osmolality than blood, fluid moves from cells into ECF

Cells SHRINK

102
Q

Sensible fluid loss

A

Measurable and perceived

Ex: urine, diarrhea, ostomy and gastric drainage

103
Q

Insensible fluid loss

A

Loss that we don’t perceive , is not easily measured

Ex: sweat, exhalation

104
Q

Fluid regulation

A

Kidneys are the principal regulator

Antidiuretic hormone 
Renin-angiotensin system 
Aldosterone 
Thyroid hormones 
ANP, BNP, CNP
105
Q

Normal sodium range

A

135 - 145

Regulates fluid volume, muscle contraction

106
Q

Normal range of Potassium

A

3.5 - 5

Regulates cardiac conduction, electrical impulse

107
Q

Normal range of Calcium

A

8.5 - 10.5

Muscle contraction, clot formation

108
Q

Normal range of Magnesium

A

1.6 - 2.6

Metabolism, cellular DNA synthesis

109
Q

Normal range of Chloride

A

95 - 105

Acid base balance

110
Q

Normal range of Phosphate

A

1.7 - 2.6

Intracellular catalyst

111
Q

Normal range of Bicarbonate

A

22 - 26

Acid base balance , primary buffer

112
Q

List 6 symptoms of hyponatremia

A

Anorexia, nausea , vomit

Weakness

Lethargy

Confusion

Muscle cramp or twitching

Seizures

113
Q

Severe low Na can cause what

A

Hallucinations, irritability , lethargy and seizure

114
Q

Hypovolemia

A

Proportionate loss of fluid and Electrolytes

Caused by trauma , surgery , hemorrhage , sepsis

115
Q

Dehydration

A

Loss of water resulting in state of negative fluid balance

Caused by insufficient fluid intake, vomiting, diarrhea, sweating, diuresis, burns, fluid shifts and sepsis

116
Q

Hypervolemia

A

Retention of fluid and sodium

Caused by excessive sodium intake, renal disease, hepatic disease and poor cardiac function

117
Q

Who is at risk for fluid excess

A

Clients on dialysis

Clients with heart failure

Clients with hepatitis (can cause decreased albumin; acities)

Clients receiving IV fluids

SIADH

118
Q

Crystalloids

A

IV fluids - LR, D5W, NS

119
Q

Colloids

A

Volume expanders - dextran, amino acids, albumin

120
Q

Hypertonic crystalloid IV fluid

A

D5NS, D51/2NS, D50, 3% saline

121
Q

Hypotonic crystalloid IV fluid

A

D5W and 1/2 NS

122
Q

Isotonic crystalloid IV fluid

A

LR and NS

123
Q

List the 5 types of Central venous access

A

Nontunneled CVC

PICC (peripherally inserted central catheter)

Tunneled CVC

Implanted port (ex: port-a-cath)

Intraosseous (quick IV for large volumes of fluid)

124
Q

Black sputum can signify what

A

Fire, smoke inhalation

125
Q

Paroxysmal nocturnal dyspnea

A

Sudden awakening due to shortness of breath that begins during sleep.

The patient feels panic and extreme dyspnea and must sit upright to ease breathing

126
Q

Hemoptysis

A

The coughing up of blood or bloody sputum.

127
Q

Pink and frothy sputum signifies what

A

Associated with pulmonary edema / CHF

128
Q

Peak flow monitoring

A

Measures the amount of air that can be exhaled with forcible effort

**asthmatics should measure peak flow daily

129
Q

Normal range for pulse oximetry

A

95-100%

130
Q

Which type of client is it best to maintain a pulse oximetry level of 88-92%

A

COPD

CO2 retainers

131
Q

List the 5 types of radiography diagnostic tests

A

X-ray

Angiogram

CT scans

VQ scan (ventilation perfusion)

MRI

132
Q

Partial pressure of oxygen

A

Amount of oxygen available to combine with hemoglobin

Normal range: 80-100

133
Q

Saturation of oxygen

A

Amount of oxygen actually bound to hemoglobin

Normal range: 95-100

134
Q

Partial pressure of carbon dioxide

A

Amount of carbon dioxide in blood

Normal range: 35-45

135
Q

Fraction of inspired air FIO2

A

Percentage of oxygen inhaled

‘Room air’ FIO2 is 21%

136
Q

Spirometry

A

Measurement of how much air is inhaled

Can be used as a diagnostic tool or as a prevention measure

137
Q

Nebulizer

A

A device that turns liquids into an aerosol mist that can be inhaled directly into the lungs

138
Q

BiPAP

A

Uses patients spontaneous breathing to trigger rate

139
Q

CPAP

A

Regulates rate

140
Q

What are the 4 types of stressors

A
  • distress/eustress
  • external/internal
  • developmental/situational
  • physiological/psychosocial

Clinical (12 decks)

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