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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
Lipids
Supply essential nutrients - back up energy source - flavor and satiety - cholesterol functions - 3 types: glycerides, sterols and phospholipids
26
Saturated fats
- raise cholesterol - animal fats - solid at room temp
27
Unsaturated cats
- lower cholesterol - most vegetable fats - liquid at room temp - dietary fats
28
Trans-fatty acids
- raise cholesterol | - artificially created to extend shelf life
29
Sterols
- cholesterol is the most critical sterol - required for cellular membrane structure and sex hormones - made in the liver and ingested
30
Phospholipids
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
31
Fat soluble vitamins
K - synthesis of proteins for clotting A- visual acuity D- calcium and phos metabolism and stimulates Ca absorption E- antioxidant
32
How is energy in food measured
Calories
33
Basal metabolic rate
Determines how much energy is needed to maintain body function
34
List 6 things that can raise BMR
``` Muscle mass Growth Elevated body temp Low environmental temp Disease states Prolonged exertion ```
35
Underweight BMI
18.4 or below
36
Overweight BMI
25-29.9
37
Obese BMI
30 or greater
38
What is the formula for calculating BMI
Weight in kilograms divided by height in meters squared Lbs/2.2 1meter = 39.37inches
39
Normal range of glucose
Hypoglycemia: less than 50 mg/dl Hyperglycemia: greater than 109 (fasting) ; greater than 127 (random)
40
Normal range of BUN
8-21 mg/dl
41
Normal range of hemoglobin in men and women
Men: 13.2-17.3 Women: 11.7-15.4
42
Normal range of albumin and prealbumin
Albumin: 3.4-4.8 g/dl Prealbumin: 12-42 mg/dl
43
List 7 ways to check feeding tube placement
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
44
What is required in order to use feeding tubes
A functioning gi tract
45
Clear liquids diet
Provides fluids to prevent dehydration and supplies simple carbs to help meet energy needs Ex: water, tea, coffee, broth, clear juice, popsicles
46
Full liquids diet
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
47
Mechanical soft diet
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
48
Puréed diet
Blended food
49
What is the order of abdominal assessment
Inspect , auscultation , percuss , palpate
50
Colonoscopy vs sigmoidoscopy
Colonoscopy- examines the entire length of the colon Sigmoidoscopy - examines only the lower third
51
What is the BRAT diet related to diarrhea
Consume Bananas 🍌, rice 🍚, applesauce 🍎 and toast 🍞
52
Hemorrhoids
- dilated, engorged veins in the lining of the rectum | - caused by straining, pregnancy, chf or chronic liver disease
53
What are the 3 types of enemas
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
54
Flatulence
Gas accumulation in the lumen of the intestines
55
Medications that can slow peristalsis
Antacids , antidiarrheals
56
Valsalva maneuver
The effort to breathe out forcibly while the mouth and nose are firmly closed or the vocal cords pressed together - 'bearing down'
57
Why is pregnancy a factor affecting bowel elimination
Because blood volume doubles during pregnancy and can cause constipation
58
Anticholinergic medications related to urine elimination
Urinary retention Ex: antihistamine, anticholinergics/antispasmodics, tricyclic antidepressants
59
Nephrotoxic
Damaging to the kidneys Ex: gentamicin, amphotericin b and long term use of aspirin or ibuprofen
60
Pyridium
Is a bladder analgesic that turns urine orange
61
Elavil
Can turn pee blue or green
62
Levodopa
Can turn urine red, brown or black
63
Anuria
Absence of urine ; urine output less than 100mL in 24hrs
64
Dysuria
Painful or difficult urination
65
Enuresis
Involuntary loss of urine
66
Oliguria
Urine output of less than 400 ml in 24hrs
67
Polyuria
Excessive urination
68
Pyuria
Pus in the urine
69
Urge incontinence
Is the involuntary loss of larger amounts of urine accompanied by a strong urge to void
70
Stress incontinence
Is an involuntary loss of small amounts of urine with activities that increase intraabdominal pressure
71
Overflow incontinence
The loss of urine in combination with a distended bladder
72
Functional incontinence
The untimely loss of urine when no urinary or neurological cause is involved
73
Reflex incontinence
Is the loss of urine when the person doesn't realize the bladder is full and has no urger to void
74
Straight catheter
Is a single lumen tube that is inserted for immediate drainage of the bladder
75
Indwelling catheter
Aka foley or retention catheter Used for continuous bladder drainage
76
Suprapubic catheter
Used for continuous urine drainage when the urethra must be bypassed Ex: after gynecological surgery or where there is a prostatic obstruction
77
What are the 3 uses for bladder irrigation
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
What is the normal range of specific gravity
1.002 - 1.030
79
Oxygenation
How well the cells, tissues and organs of the body are supplies with oxygen
80
Respiration
Gas exchange (co2 and o2) in the lungs or tissues
81
Ventilation
Movement of air in and out of lungs
82
Lung elasticity
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
Lung compliance
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
External respiration
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
Internal respiration
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
Chemoreceptors
Located in the medulla, aorta, carotids Detect changes in pH, O2, CO 2 CO2 levels are primary stimulus
87
High CO2 levels stimulate what
Breathing to eliminate the excess CO2
88
Low blood O2 levels stimulate what
Breathing to get more oxygen into the lungs | Hypoxemia
89
Lung receptors
Located in the lung and chest wall Detect changes in breathing patterns, expansion, compliance, resistance, irritants
90
Voluntary control
Temporary increase or decrease in ventilation
91
List 6 purposes of fluids in our bodies
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
Interstitial fluid
Fluid in the spaces between the body cells Excess interstitial fluid is called edema
93
Intravascular fluid
Plasma within the blood. Main function is to transport blood cells
94
Transcellular fluid
Includes specialized fluids that are contained in body spaces (ex: cerebrospinal , pleural , peritoneal and synovial fluid) and digestive juices
95
Third spacing
Occurs when fluid is trapped in spaces other than ICF or ECF
96
What are the 3 major ICF Electrolytes
K , mg and phosphate
97
What are the three major ECF Electrolytes
Na , Ca and bicarbonate
98
Active transport
Requires energy to move against concentration gradient Molecules moved from low concentration to high concentration Ex: sodium-potassium pump
99
Passive transport
Doesn't require energy to move molecules or fluid Ex: osmosis , diffusion , filtration
100
Hypotonic fluids
Lower osmolality than blood, fluid moves from vessels into cells Cell SWELLS
101
Hypertonic fluids
Higher osmolality than blood, fluid moves from cells into ECF Cells SHRINK
102
Sensible fluid loss
Measurable and perceived Ex: urine, diarrhea, ostomy and gastric drainage
103
Insensible fluid loss
Loss that we don't perceive , is not easily measured Ex: sweat, exhalation
104
Fluid regulation
Kidneys are the principal regulator ``` Antidiuretic hormone Renin-angiotensin system Aldosterone Thyroid hormones ANP, BNP, CNP ```
105
Normal sodium range
135 - 145 Regulates fluid volume, muscle contraction
106
Normal range of Potassium
3.5 - 5 Regulates cardiac conduction, electrical impulse
107
Normal range of Calcium
8.5 - 10.5 Muscle contraction, clot formation
108
Normal range of Magnesium
1.6 - 2.6 Metabolism, cellular DNA synthesis
109
Normal range of Chloride
95 - 105 Acid base balance
110
Normal range of Phosphate
1.7 - 2.6 Intracellular catalyst
111
Normal range of Bicarbonate
22 - 26 Acid base balance , primary buffer
112
List 6 symptoms of hyponatremia
Anorexia, nausea , vomit Weakness Lethargy Confusion Muscle cramp or twitching Seizures
113
Severe low Na can cause what
Hallucinations, irritability , lethargy and seizure
114
Hypovolemia
Proportionate loss of fluid and Electrolytes Caused by trauma , surgery , hemorrhage , sepsis
115
Dehydration
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
Hypervolemia
Retention of fluid and sodium Caused by excessive sodium intake, renal disease, hepatic disease and poor cardiac function
117
Who is at risk for fluid excess
Clients on dialysis Clients with heart failure Clients with hepatitis (can cause decreased albumin; acities) Clients receiving IV fluids SIADH
118
Crystalloids
IV fluids - LR, D5W, NS
119
Colloids
Volume expanders - dextran, amino acids, albumin
120
Hypertonic crystalloid IV fluid
D5NS, D51/2NS, D50, 3% saline
121
Hypotonic crystalloid IV fluid
D5W and 1/2 NS
122
Isotonic crystalloid IV fluid
LR and NS
123
List the 5 types of Central venous access
Nontunneled CVC PICC (peripherally inserted central catheter) Tunneled CVC Implanted port (ex: port-a-cath) Intraosseous (quick IV for large volumes of fluid)
124
Black sputum can signify what
Fire, smoke inhalation
125
Paroxysmal nocturnal dyspnea
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
Hemoptysis
The coughing up of blood or bloody sputum.
127
Pink and frothy sputum signifies what
Associated with pulmonary edema / CHF
128
Peak flow monitoring
Measures the amount of air that can be exhaled with forcible effort **asthmatics should measure peak flow daily
129
Normal range for pulse oximetry
95-100%
130
Which type of client is it best to maintain a pulse oximetry level of 88-92%
COPD CO2 retainers
131
List the 5 types of radiography diagnostic tests
X-ray Angiogram CT scans VQ scan (ventilation perfusion) MRI
132
Partial pressure of oxygen
Amount of oxygen available to combine with hemoglobin Normal range: 80-100
133
Saturation of oxygen
Amount of oxygen actually bound to hemoglobin Normal range: 95-100
134
Partial pressure of carbon dioxide
Amount of carbon dioxide in blood Normal range: 35-45
135
Fraction of inspired air FIO2
Percentage of oxygen inhaled 'Room air' FIO2 is 21%
136
Spirometry
Measurement of how much air is inhaled Can be used as a diagnostic tool or as a prevention measure
137
Nebulizer
A device that turns liquids into an aerosol mist that can be inhaled directly into the lungs
138
BiPAP
Uses patients spontaneous breathing to trigger rate
139
CPAP
Regulates rate
140
What are the 4 types of stressors
- distress/eustress - external/internal - developmental/situational - physiological/psychosocial

Clinical (12 decks)

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