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Nursing Exam 3 > Terms and Knowledge > Flashcards

Terms and Knowledge Flashcards

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0
Q

The exchange of _____________ ___________ occurs between the environment and the ______.

A

Respiratory gases, blood

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1
Q

Which two systems supply the oxygen demands of the body?

A

Cardiac and Respiratory

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2
Q

The exchange of oxygen and carbon dioxide during cellular metabolism

A

Respiration

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3
Q

Medical problems that affect oxygenation:

A 
COPD
Asthma
Bronchitis
Cancer (lung)
Pregnancy
Exercise
MI
Allergies
Obesity
Croup
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4
Q

What is an MI?

A

A myocardial infarction is irreversible tissue death because of absence or diminished blood supply.

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5
Q

What is COPD?

A

A non-curable combination of emphysema and bronchitis (Chronic Obstructive Pulmonary Disease)

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6
Q

Ineffective ______ and Ineffective _____ _______ are two problems with meeting oxygen needs.

A

Heart (pump), Gas exchange

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7
Q

Primary function of the lungs:

A

Transfer oxygen from the atmosphere into the alveoli and carbon dioxide out of the body.

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8
Q

Airways of lung transfer oxygen from the _________ to the _______ where oxygen is exchanged for ______ _______

A

Atmosphere, Alveoli, Carbon Dioxide

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9
Q

Through the _____ ________ membrane, ______ transfers to the _______ and _____ ______ transfers from the ______ to the ______

A

alveolar capillary, oxygen, blood, carbon dioxide, blood, alveoli

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10
Q

Causes gases to move into and out of the lungs

A

Pressure change

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11
Q

________ pressure is ______, (less than ______ pressure which is ____ mm Hg at sea level).

A

Intrapleural, negative, atmospheric, 760

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12
Q

The major inspiratory muscle of respiration

A

Diaphram

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13
Q

The diaphragm and external intercostal muscle contract to creat negative pleural pressure and increase size of thorax.

A

Inspiration

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14
Q

The process of moving gases into and out of the lungs

A

Ventilation

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15
Q

The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs.

A

Perfusion

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16
Q

Exchange of respiratory gases in the alveoli and capillaries

A

Difussion

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17
Q

The effort required to expand and contract the lungs

A

Work of Breathing

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18
Q

The amount of energy expended on breathing depends on:

A

Depth of breathing
Rate of breathing
Compliance
Airway Resistance

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19
Q

An active process, stimulated by chemical receptors in the aorta

A

Inspiration

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20
Q

A passive process that depends on the elastic recoil properties of the lungs, requiring little or no muscle work

A

Expiration

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21
Q

Chemical produced in the lungs to maintain the surface tention of the alveoli and keep them from collapsing

A

Surfactant

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22
Q

Collapse of the alveoli that prevents the normal exchange of oxygen and carbon dioxide

A

Atelectasis

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23
Q

The ability o the lungs to distend or expand in response to increased intra-alveolar pressure

A

Compliance

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24
Q

Compliance decreases in:

A

Pulmonary Edema
Interstitial Fibrosis
Pleural Fibrosis
Congenital Structural Abnormalities (Kyphosis)
Traumatic Structural Abnormalities (Fractured ribs)

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25
Q

The increase in pressure that occurs as the diameter of the airways decreases from mouth/nose to alveoli

A

Airway resistance

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26
Q

Diseases that cause airway obstruction:

A

Asthma

Tracheal edema

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27
Q

The amount of air exhaled after normal inspiration

A

Tidal Volume

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28
Q

The amount of air left in the alveoli after a full expiration

A

Residual volume

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29
Q

The maximum amount of air that can be removed from the lungs during forced expiration

A

Forced Vital Capacity

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30
Q

Measures the volume of air entering or leaving the lungs

A

Spirometry

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31
Q

Primary function is to move blood to and from the alveolar capillary membranes for gas exchange

A

Pulmonary Circulation

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32
Q

Flow of Pulmonary circulation:

A

Right ventricle–Pulmonary Artery–Pulmonary arterioles–Pulmonary capillaries–Alveolar capillary membranes(Exchange of gases/Diffusion)–Pulmonary venules– Pulmonary veins–Left atrium

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33
Q

Delivery of oxygen depends on:

A

Ventilation (Amount of oxygen entering the blood)
Perfusion (blood flow tot he lungs and tissues
Rate of Diffusion
Oxygen-carrying cappacity

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34
Q

Carrier for oxygen and carbon dioxide, transports 97% of oxygen

A

Hemoglobin

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35
Q

Carbon dioxide diffuses into red blood cells and is hydrated into ________ _____.

A

Carbonic Acid

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36
Q

Carbonic acid dissociates into ______ and ________.

A

Hydrogen (H)

Bicarbonate (HCO3-)

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37
Q

_________ blood transports majority of carbon dioxide back to the lungs to be exhaled.

A

Venous

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38
Q

_______ and _________ regulators control the process of respiration

A

Neural and Chemical

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39
Q

Neural regulation controls:

A 
Respiratory rate
Respiratory Depth
Respiratory rhythm
(CNS)
Voluntary control of respiration (Cerebral cortex)
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40
Q

Maintains rate and depth of respirations based on changes in the blood concentrations of CO2 and O2 and hydrogen ion concentration (pH)

A

Chemical regulation

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41
Q

Cardiovascular flow:

A

Deoxygenated blood—- right side of heart—– lungs—– left side of heart (DR.LL)

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42
Q

The right ventricle pumps blood through the ________ circulation

A

Pulmonary

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43
Q

The left ventricle pumps blood through the ________ circulation

A

Systemic

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44
Q

As the myocardium stretches, the strength of the subsequent contraction increases.

A

Starling’s law

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45
Q

S1 sounds are the closing of:

A

Mitral and tricuspid valves

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46
Q

S2 sounds are the closing of:

A

Aortic and pulmonic valves

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47
Q

Branch of systemic circulation that supplies the myocardium with oxygen and nutrients and removes wastes

A

Coronary artery circulation

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48
Q

Arteries and veins that deliver nutrients and oxygen to the tissues and remove waste products

A

Systemic circulation

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49
Q

Amount of blood ejected from the left ventricle each minute

A

Cardiac output

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50
Q

Amount of blood ejected from the left ventricle with each contraction

A

Stroke volume

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51
Q

Cardiac output=

A

Stroke volume x Heart rate

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52
Q

Normal cardiac output

A

4-6L/min

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53
Q

Amount of blood in the left ventricle at the end of diastole

A

Preload

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54
Q

Resistrance to the left ventricular ejection

A

Afterload

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55
Q

Generates electrical impulses that are needed for a normal heartbeat

A

Conduction system (of the heart)

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56
Q

Normal sinus rhythm originates at the ___ ______ and follow the normal sequence through the conductive system

A

SA node (pacemaker of the heart)

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57
Q

Normal Sinus rhythm

A

75bpm (NSR)

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58
Q

Rate at which impulses are initiated at the SA node

A

Normal Sinus Rhythm

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59
Q

Sinus rhythm of 40-60bpm

A

AV is transmitting impulses

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60
Q

Mediates impulses between the atria and the ventricles

A

AV node

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61
Q

Reflects the electrical activity of the conduction system

A

Electrocardiogram (ECG)

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62
Q

Influences the rate of impulse generation and the speed of conduction pathways; two systems: sympathetic and parasympathetic

A

Autonomic nervous system

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63
Q

Increases the rate of impulse generation and impulse transmission and innervates all parts of the atria and ventricle

A

Sympathetic nervous system (fight or flight)

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64
Q

Decreases the rate and innervates atria, ventricles, and sinoatrial and atrioventricular nodes

A

Parasympathetic System (Digestion)

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65
Q

Flow of conduction system

A

Sinoatrial node–atrioventricular node–bundle of His–Bundle branches–Purkinje fibers

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66
Q

Deoxygenated blood goes to the ______ side of the heart

A

right

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67
Q

Oxygenated blood goes to the _____ side of the heart

A

left

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68
Q

Physiological factors that affect oxygenation:

A

Decreased oxygen-carrying capacity
Hypovolemia
Decreased inspired oxygen concentration
Conditions affecting chest wall movement (pregnancy, obesity)
Musculoskeletal abnormalities (trauma, neuromuscular disease, CNS alterations)
Influences of chronic disease

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69
Q

Factors affecting oxygenation:

A

Physiological factors
Developmental factors
Lifestyle
Environmental

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70
Q

Representation of electrical conduction through both atria.

A

P wave

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71
Q

Representation and average travel time of impulse through the conduction system

A

PR interval- 0.12-0.2 seconds

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72
Q

Increase in PR wave indicates:

A

a block in the impulse transmission through the AV node (greater than 0.2seconds)

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73
Q

Decrease in PR wave indicates:

A

the initiation of the electrical impulse from a source other than the SA node (less than 0.12 seconds)

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74
Q

Indicates that the electrical impulse traveled through the ventricles (and average time)

A

QRS complex (0.06-0.1 seconds)

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75
Q

Atrial contraction follows the ________ and ventricular contraction follows the ________.

A

P wave, QRS complex

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76
Q

Increase in QRS duration indicates:

A

delay in conduction time trough the ventricles.

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77
Q

Representation and average time needed for ventricular depolarization and repolarization

A

QT interval (0.12-0.42seconds)

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78
Q

_______ varies inversely with changes in the heart rate

A

QT interval

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79
Q

increase in QT interval is caused by:

A

changes in electrolyte values, hypocalcemia, therapy with drugs (disopyramide/Norpace, amiodarone/Cordarone)

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80
Q

Decrease in QT interval occurs when:

A

Digitalis therapy, hyperkalemia, hypercalcemia

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81
Q

Alterations is respiratory functioning

A

Hypoventilation
Hyperventilation
Hypoxia

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82
Q

Alveolar ventilation is inadequate to meet the oxygen demand of the body or eliminate sufficient carbon dioxide.

A

Hypoventilation

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83
Q 
Signs and symptoms:
Mental status change
Dysrhythmias 
Potential Cardiac Arrest
Convulsions 
Unconsciousness
A

Hypoventilation

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84
Q

State of ventilation in which the lungs remove carbon dioxide faster than it is produced by cellular metabolism

A

Hyperventilation

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85
Q 
Signs and symptoms:
Rapid respirations
Sighing breaths
Numbness
Tingling of hands/feet
Light-headedness
Loss of consciousness
A

Hyperventilation

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86
Q

Inadequate tissue oxygenation at the cellular level

A

Hypoxia

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87
Q

Causes of Hypoxia

A

Decreased hemoglobin level and lowered oxygen-carrying capacity of the blood
A diminished concentration of inspired oxygen (high-altitudes)
The inability of the tissues to extract oxygen from the blood (cyanide poisoning)
Decreased diffusion of oxygen from the alveoli to the blood (pneumonia)
Poor tissue perfussion with oxygenated blood (shock)
Impaired ventilation (rib fractures/chest trauma)

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88
Q

Sites of cyanosis for hypoxemia

A

Central cyanosis: tongue, soft palate, conjunctiva

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89
Q

Peripheral cyanosis

A

extremities, nail beds, earlobes

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90
Q

Alterations in cardiac functioning:

A 
Disturbances in conduction (Dysrhythmias)
Tachycardia
Bradycardia
Atrial Fibrillation
Paroxysmal supra ventricular tachycardia
Ventricular Dysrhythmias
VENTRICULAR TACHYCARDIA
VENTRICULAR FIBRILLATION 
(REQUIRE IMMEDIATE INTERVENTION-LIFE-THREATENING)
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91
Q

Rhythm disturbances caused by electrical impulses that do not originate from the SA node.

A

Dysrhythmias

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92
Q

Signs and symptoms of left-sided heart failure

A 
Fatigue
Breathlessness
Dizziness
Confusion
Crackles in the base of lungs
Hypoxia
Shortness of breath on exertion
Cough
Paroxysmal nocturnal dyspnea
*Left sided lungs*
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93
Q

Signs and symptoms of right-sided heart failure:

A 
Weight gain
Distended neck veins
Hepatomegaly
Splenomegaly
Dependent peripheral edema
*Right sided=body*
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94
Q

acquired or congenital disorder of a cardiac valve by stenosis or regurgitation

A

Impaired valvular function

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95
Q

Coronary artery flow to the myocardium insufficient to meet myocardial oxygen demands- results in angina, or MI/ACS(acute coronary syndrome)

A

Myocardial ischemia

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96
Q

Failure of the myocardium to eject sufficient volume to the systemic and pulmonary circulations- results in right or left sided heart failure

A

Altered cardiac output

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97
Q

Transient imbalance between myocardial oxygen supply and demand

A

Angina

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98
Q

Signs and symptoms:
Chest pain: aching, sharp, tingling, burning, or feels like pressure
Left-sided or substernal
Can Radiate to left or both arms, jaw, neck and back
Relieved with rest and coronary vasodilators (nitroglycerin)
Lasts 3 to 5 minutes

A

Angina

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99
Q

Results from sudden decreases in coronary blood flow or an increase in myocardial oxygen demand without adequate coronary perfusion

A

MI (myocardial infarction)/ ACS (acute coronary syndrome)

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100
Q

Signs and symptoms:
Chest pain: crushing, squeezing or stabbing
Left chest and sternal area and maybe back
May radiate down the left arm, neck, jaw, teeth, epigastric area, and back
Lasts more than 20 minutes

A

Male MI

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101
Q 
Signs and symptoms:
Angina
Fatigue
Indigestion
Shortness of breath
Back or jaw pain
A

Female MI

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102
Q

Subjective sensation of difficult or uncomfortable breathing. Sign of hypoxia

A

Dyspnea

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103
Q

An abnormal condition in which a patient uses multiple pillows when reclining to breathe easier or sits leaning forward with arms elevated

A

Orthopnea

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104
Q

Bloody sputum

A

Hemoptysis

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105
Q

Signs and symptoms of CO poisoning

A

Malaise
Flulike symptoms
Excessive sleepiness

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106
Q

Dyspnea management includes:

A 
Airways maintenance 
Mobilization of pulmonary secretions
Hydration
Humidification
Nebulization
Coughing and deep-breathing techniques
Chest physiotherapy (postural drainage- SYSTIC FIBROSIS)
Splinting w/ pillow
Percussion sequence
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107
Q

If oxygen is greater than _______, humidification is needed

A

4L/minute

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108
Q

Cardio protective nutrition

A

Diets rich in fiber

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109
Q

The goal of oxygen therapy is to use the ______ ______ ____ _______ ______ for an acceptable blood oxygen level without causing harmful side effects

A

Lowest Fraction of Inspired Oxygen (FiO2)

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110
Q

Purpose of oxygen therapy:

A

Prevent or relieve hypoxia

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111
Q

Oxygen therapy is for patients with an arterial partial pressure (PaO2) of _____ mm Hg or less OR arterial oxygen saturation (SaO2) of ____% or less on room air at rest, on exertion or with exercise

A

55, 88

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112
Q

Determines ability of the lungs to efficiently exchange oxygen and carbon dioxide

A

Pulmonary Function tests

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113
Q

Patient walks on a treadmill at a specified speed and duration of time. test evaluates the cardiac response to physical stress.

A

ECG exercise stress test

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114
Q

This is a noninvasive measure of heart structure and heart wall motion. It graphically demonstrates overall cardiac performance

A

Echocardiography

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115
Q

Portable ECG worn by patient. The test produces a continuous ECG tracing over a period of time. Evaluation of ECG goes along with diary patient keeps of ADLs.

A

Holter monitor

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116
Q

Used to visualize cardiac chambers, valves, the great vessels, and coronary arteries. Pressures and volumes within the four chambers of the heart are also measured

A

Cardiac catheterization and Angiography

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117
Q

Visual examination of the tracheobronchial tree through a narrow flexible fiberoptic bronchoscope

A

Bronchoscopy

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118
Q

Surgical perforation of chest wall and pleural space with a needle to aspirate fluid for diagnostic or therapeutic purposes or to remove a specimen for biopsy

A

Thoracentesis

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119
Q

Obtained to identify a specific microorganism or organism growing in the sputum

A

Sputum specimens

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120
Q

Provide important information for assessment of patient’s respiratory and metabolic acid/base balance and adequacy of oxygenation

A

Arterial blood gases

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121
Q

ECG stress test with the addition of thallium-201 injected intravenously. Determines coronary blood flow changes with increased activity

A

Thallium stress test

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122
Q

A slow heartbeat marked by a pulse rate below 60 beats per minute

A

Bradycardia

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123
Q

Abnormally rapid respirations

A

tachypnea

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124
Q

Abnormally slow breathing

A

bradypnea

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125
Q

absence of oxygen

A

Anoxia

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126
Q

Air hunger resulting in labored or difficult breathing, sometimes accompanied by pain. It is normal when due to vigorous work or athletic activity, but should quickly return to normal when the activity ceases.

A

Dyspnea

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127
Q

An abnormally rapid heart rate, greater than 100 beats per minute

A

Tachycardia

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128
Q

An oxygen deficiency in body tissues. A decreased concentration of oxygen in inspired air

A

Hypoxia

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129
Q

Increased minute volume ventilation, which results in a lowered CO2 level (hypocapnia). Frequent finding in many disease processes such as asthma, metabolic acidosis, pulmonary embolism, and pulmonary edema, and also in anxiety-induced states

A

Hyperventillation

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130
Q

Labored breathing that occurs when lying flat and improves when standing or sitting up.One of the classic symptoms of left ventricular heart failure, although occasionally occurs in other cardiac or respiratory illnesses

A

Orthopnea

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131
Q

Reduced rate and depth of breathing that causes an increase in carbon dioxide

A

Hypoventilation

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132
Q

The expectoration of blood that arises from the larynx, trachea, bronchi, or lungs

A

Hemotypsis

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133
Q

Used when a patient can cough effectively but is not able to clear secretions

A

Oropharyngeal and nasopharyngeal suctioning

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134
Q

Used when the patient is unable to manage secretions

A

Orotracheal and nasotracheal suctioning

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135
Q

A component of pulmonary hygiene, consists of drainage, positioning and turning and is sometimes accompanied by chest percussion and vibration

A

Postural drainage

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136
Q

Group of therapies for mobilizing pulmonary secretions

A

Chest Physiotherapy (CPT)

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137
Q

Adds moisture or medications to inspired air by mixing particles of varying sizes with air

A

Nebulization

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138
Q

Prevents obstruction of the trachea by displacement of the tongue into the oropharynx

A

Oral airways

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139
Q

Short-term use to ventilate, relieve upper airway obstruction, protect against aspiration, clear secretions

A

Endotracheal and tracheal airways

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140
Q

Long-term assistance, surgical incision made into trachea

A

Trachostomy

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141
Q

Maintainence and promotion of lung expansion includes:

A

Ambulation
Positioning (45degrees semi-fowlers- reduces pulmonary stasis, maintains ventilation and oxygenation)
Incentive spirometry (encourages voluntary deep breathing)
Noninvasive ventilation (maintains positive airway pressure and improves alveolar ventilation)
CPAP

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142
Q

Restoration of Cardiopulmonary Functioning: CPR:

A

C irculation
A irway
B reathing
(Defibrillation/AED)

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143
Q

Restorative and Continuing Care:

A

Rehabilitation
Incentive Spirometer
Pursed Lip Breathing
Diaphragmatic breathing

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144
Q

Carbon dioxide transport

A

diffused into red blood cells–hydrated into carbonic acid (H2CO3)–dissociates into hydrogen (H) and bicarbonate (HCO3-)–Hemoglobin buffers the hydrogen ion (deoxyhemoglobin),bicarbonate diffuses into plasma–deoxyhemoglobin combines with carbon dioxide and venous transports back to lungs–exhaled

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145
Q

Access to sufficient, safe and nutritious food to maintain a healthy lifestyle.

A

Food security

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146
Q

Diet therapy

A

Diets used for disease control (such as Diabetes 1 (DM) or mild hypertension)

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147
Q

Energy needed to maintain life-sustaining activities (breathing, circulation, heart rate, and temperature)

A

BMR- Basal metabolic rate

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148
Q

Factors affecting energy requirements

A 
Gender
Body mass
Menstruation 
Illness
Fever
Starvation
Injury
Infection
Age
Thyroid
Activity
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149
Q

Amount of energy that an individual needs to consume over a 24-hour period for the body to maintain all of its internal working activities while at rest.

A

REE- Resting energy expenditure

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150
Q

Factors influencing metabolism

A

illness
pregnancy
lactation
activity level

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151
Q

If energy requirements are completely met by kcal intake in food, weight ___________. If exceeded, weight _________. If not met, weight ______.

A

Remains the same, goes up, goes down

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152
Q

The elements necessary for the normal function of numerous body processes. Carbohydrates, proteins, fats, water, vitamins and minerals are all examples.

A

Nutrients

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153
Q

Proportion of essential nutrients to the number of kilocalories

A

Nutrient density

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154
Q

Produces 4kcal/g
main source of fuel
Glucose for the brain
Consists of complex and simple saccharides

A

Carbohydrate

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155
Q

A polysaccharide that is the structural part of plants and is not broken down by human digestive enzymes

A

Fiber

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156
Q

Produces 4kcal/g
Essential for building of body tissue, maintenance, and repair
Collagen, hormones, enzymes, immune cells, DNA and RNA
Amino Acids
Necessary for nitrogen balance

A

Protein

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157
Q

Achieved when the intake and output of nitrogen are equal.

A

Nitrogen balance

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158
Q

Produces 9kcal/g
Consists of triglycerides and fatty acids
Saturated, polyunsaturated and monounsaturated
Linolenic acid
Calorie dense

A

Fats

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159
Q

Makes up 60-70% of body weight
Greater percentage for lean people (because more is in the muscle)
All cell function depends on a fluid environment

A

Water

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160
Q

Organic substances present in small amounts
Chemicals that act as catalysts in biochemical reactions
Essential for metabolism
Water-soluble or fat-soluble

A

Vitamins
Fat-soluble: A, D, E, K
water-soluble: C, B (8 B vitamins)

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161
Q

Inorganic elements essential as Catalysts for enzymatic reactions
Macro-minerals(100mg or more per day) (balance pH)
Trace elements (less than 100mg per day)

A

Minerals

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162
Q 
Begins in the mouth and ends in the small and large intestines.
Uses enzymes (protein-like substances that act as catalysts to speed up chemical reactions)
A

Digestion

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163
Q

Wavelike muscular contractions that move fod

A

Peristalsis

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164
Q

Villi increase surface area for this
Works by means of passive diffusion, osmosis, active transprt, and pinocytosis
Intestine is primary area

A

Absorption

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165
Q

Refers to all of the biochemical reactions within the cells of the body

A

Metabolism

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166
Q

building of more complex biochemical substances by synthesis of nutrients

A

Anabolism

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167
Q

Breaking down of biochemical substances into simpler substances and occurs during physiological states of negative nitrogen balance (starvation) when wasting of body tissues occurs

A

Catabolism

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168
Q

Chyme is moved through peristalsis and is changed into feces

A

Elminiation

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169
Q

Acceptable range of quantities of vitamins and minerals for each gender and age group

A

DRIs- Dietary Reference Intakes

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170
Q

The average needs of 98% of the population (not exact individual needs)

A

RDA- Recommended Dietary Allowance

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171
Q

Amounts of nutrients on a food label

A

Daily values

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172
Q

Keep total fat intake between ____ and ____ % of total calories

A

20, 35

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173
Q

A measurement system of the size and makeup of the body

A

Anthropometry

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174
Q

Provides an estimate of what a person should weight

A

Ideal body weight

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175
Q

Measures weight corrected for height and serves as an alternative to traditional height-weight relationships. Calculated by dividing the patient’s weight in kilograms by height in meters squared (kg/m^2)

A

BMI (body mass index) 25-30=overweight

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176
Q

Included in Health Assessment:

A 
Health status
Age
Cultural background
Religious food pattern
Socioeconomic status
Personal food preferences
Psychological factors 
Use of alcohol/illegal drugs
Use of OTC supplements or drugs
Prescription drugs
General nutrition knowledge
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177
Q

Difficulty swallowing

A

Dysphagia

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178
Q

Nursing diagnosis for Nutrition

A 
Risk for aspiration
Readiness for enhanced nutrition
Imbalanced nutrition (more or less than body requirements)
Feeding self-care deficit
Diarrhea
Deficient knowledge
Impaired swallowing
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179
Q

Causes of Anorexia

A

Pain
Fatigue
Medications

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180
Q

Preferred method of meeting nutritional needs if a patient is unable to swallow or take in nutrients orally, but has a functioning GI. Provides nutrients right to the GI.

A

Enteral Nutrition (EN)

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181
Q

Form of specialized nutrition support in which nutrients are provided intravenously. Uses peripheral or central line

A

Parenteral nutrition (PN)

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182
Q

Patients for PN

A

Patients unable to digest or absorb into the GI (EN)
Patients in highly stressed physiological states
Sepsis
Head injuries
Burns

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183
Q

Sometimes added to PN to provide supplemental kilocalories, prevent essential fatty acid deficiencies, and help control hyperglycemia during periods of stress

A

Intravenous fat emulsions

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184
Q

Enteral Feeding Complications

A 
Pulmonary Aspiration
Diarrhea
Constipation
Tube occlusion
Tube displacement
Abdominal cramping
Nausea/vomiting
Delayed gastric emptying
Serum Electrolyte imbalance
Fluid overload
Hyperosmolar dehydration
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185
Q

Complications (metabolic) of PN

A 
Electrolyte imbalance
Hypercapnia
Hypoglycemia
Hyperglycemia
Hyperglycemic hyperosmolar nonketotic coma (HHNKC)
Hyperglycemic nonketotic syndrome (HHNS)
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186
Q

The use of specific nutritional therapies to treat an illness, injury, or condition

A

MNT- medical nutrition therapy

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187
Q

MNT is necessary for:

A

metabolizing certain nutrients
Correcting nutritional deficiencies
Eliminating foods that worsen disease states

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188
Q

Malabsorption syndromes

A

Celiac disease, diverticulitis,

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189
Q

Gastrointestinal diseases:

A 
Peptic ulcer
Inflammatory Bowel disease
Crohn's 
Idiopathic ulcerative colitis
Malabsorption (Celiacs)
Short bowel syndrome (Lifetime EN or PN)
Diverticulitis
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190
Q

Treatment for diabetes type 1

A

Insulin and dietary restrictions

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191
Q

Treatment for diabetes type 2

A 
Exercise
Diet therapy 
Carbohydrate consistency and monitoring
Saturated fat less than 7%
Cholesterol less than 200mg/dL
Protein intake 15-20% of diet
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192
Q

Goals of diabetes mellitus

A

Normal to near-normal glucose levels
less than 100mg/dL LDLs
Less than 130/85 mm Hg
Avoidance of hypoglycemia

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193
Q

AHA dietary guidelines for Cardiovascular disease

A

balance caloric intake and exercise
Maintain healthy body weight
Eat diet rich in fruits, vegetables, complex carbohydrates
Eat fish twice per week
Limit foods/beverages high in sugar and salt
Limit trans-fat to less than 1%

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194
Q

Cancer and nutrition

A

Malignant cells compete with normal cells for nutrients
Anorexia, vomiting, nausea, and taste distortions are common
Malnutrition associated with cancer increases morbidity and mortality
Radiation causes anorexia, stomatitis, severe diarrhea, intestinal strictures, pain

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195
Q

Management of nutrition in cancer patients

A

Maximize fluid and nutrient intake
Individualize diet choices to patient’s needs, symptoms, and situation
Encourage small, frequent meals and snacks easy to digest

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196
Q

Nutrition and HIV/AIDS

A

Body wasting and severe weight loss
Severe diarrhea, GI malabsorption, altered nutrient metabolism
hypermetabolism as a result of cytokine elevation
Maximize calories and nutrients
Encourage small, frequent, nutrient-dense meals with fluid in between

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197
Q

Freedom from physiological and physical injury. A basic human need.

A

Safety

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198
Q

Developed to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health care systems within which they work

A

QSEN- Quality and Safety Education for Nurses

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199
Q

QSEN minimizes the risk of harm to patients and providers by :

A

System effectiveness

Individual performance

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200
Q

What are the three basic needs?

A

Oxygen, Nutrition, Temperature

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201
Q

What are the signs and symptoms of carbon dioxide poisoning?

A

Nausea
Dizziness
Headache
Fatigue

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202
Q

Responsible for the enforcement of federal regulations regarding the manufacture, processing, and distribution of foods, drugs, and cosmetics to consumers against the sale of impure or dangerous substances.

A

FDA- Food and Drug Administration

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203
Q

Safety in Health Care Organizations includes;

A 
Performance Improvement
Risk management and safety reports
Current reliable technology 
Evidence-based practice
Safe work environment
Adequate staff education
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204
Q

The standards for safety have been developed by

A

The ANA- American Nurses Association

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205
Q

Safety in health care settings helps by:

A

Reducing the incidence of illness and injury
Prevents extended length of treatment/stay
Improves or maintains functionally status
Increases patient’s sense of well-being

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206
Q

A safe environment includes meeting patients’ _______ and _________ needs, applies to all places where patients receive ______ ,includes patients’ and health care providers’ __________; reduces risk of _______ and ________ of pathogens; maintains _______ and reduces _______.

A

physical, psychosocial, care, well-being, injury, transmission, sanitation, pollution

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207
Q

Occurs when the core body temperature is 35C or below (95F)

A

Hypothermia

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208
Q

Safety of food includes: Proper ______, Proper _____, and a clean _______ area.

A

Storage, refrigeration, preparation

209
Q

Any substance that impairs health or destroys life when ingested, inhaled, or absorbed by the body.

A

Poison

210
Q

The leading cause of unintentional death among adults 64 years and older

A

Falls

211
Q

Any microorganism capable of producing an illness

A

Pathogen

212
Q

Reduces, and in some cases prevents, the transmission of disease from person to person

A

Immunization

213
Q

A harmful chemical or waste material discharged into the water, soil, or air.

A

Pollutant

214
Q

Highest safety risk for Infants, toddlers, and preschoolers

A

Injuries

215
Q

Highest safety risk for School-Age children

A

Head injuries, vehicular accidents

216
Q

Highest safety risk for adolescents

A

Drinking, drugs, smoking, vehicular accidents, STIs

217
Q

Highest safety risk for Adults

A

Lifestyle habits: smoking, drinking, drugs, stress

218
Q

Highest safety risk for older adults

A

Falls and accidents

219
Q

The _______ and _____- have placed increased emphasis on error prevention and patient safety

A

TJC (Joint Commission) and CMS (Centers for Medicare and Medicaid Services)

220
Q

The ______ ______ ____ _______ of the Joint Commission are specifically directed to reduce the risk of medical errors

A

National Patient Safety Goals

221
Q

Adverse events that should never occur in the health care setting. The CMS names them based on SREs (Serious Reportable Events)

A

Never Events

222
Q

Presence of a Never Event can cause the CMS to deny _______ to hospitals

A

Payment

223
Q

Provides detailed information abut chemicals, health hazards imposed, first aid guidelines, and precautions for safe handling and use of chemicals.

A

MSDS- Material Safety Data Sheet

224
Q

Accidents (other than falls) in which the patient is the primary reason for the accident.

A

Patient-inherent accident

225
Q

Accidents that are caused by health care providers

A

Procedure-related accident

226
Q

Accidents resulting from the malfunction, disrepair, or misuse of equipment or from an electrical hazard.

A

Equipment-related accidents.

227
Q

Nursing Diagnoses for patients with safety risk:

A 
Risk for falls
Impaired home Maintainence 
Risk for injury
Deficient knowledge
Risk for poisoning 
Risk for suffocation 
Risk for trauma
228
Q

Any manual method, physical or mechanical device, material or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body or head freely

A

Restraing

229
Q

The ____ and _____ enforces standards for the use of restraints

A

Joint Commission and CMS

230
Q

RACE in fire intervention:

A

R escue and remove all patients in immediate danger
A ctivate the alarm. Do this BEFORE attempting to extinguish even minor fires
C onfine the fire by closing doors and windows and turning off oxygen and electrical equipment
E xtinguish the fire using an appropriate extinguisher

231
Q

PASS (for correct use with a fire extinguisher)

A

P ull pin
A im at the base of the fire
S queeze handles
S weep from side to side

232
Q

Hyper-excitation and disorderly discharge of neurons in the brain leading to a sudden, violent, involuntary series of muscle contractions that is paroxysmal and episodic, causing loss of consciousness, falling, tonicity, and clonicity.

A

Seizure

233
Q

A bright light, smell or taste

A

Aura (warning sign to a seizure)

234
Q

Prolonged or repeated seizures indicate….

A

Status Epilepticus (a medical emergency and requires intensive monitoring and treatment)

235
Q

Acute care safety includes:

A 
Seizures
Poisoning 
Electrical hazards
Radiation 
Disasters
236
Q

Hospitals must have an ______ _____ plan

A

Emergency management

237
Q

The coordinated efforts of the musculoskeletal and nervous systems maintain _____, ______, and body _____ during lifting, bending, moving, and performing ADLs

A

Balance, Posture, Alignment

238
Q

The relationship of one body part to another along a horizontal or vertical line.

A

Body Alignment

239
Q

Occurs when a relatively low center of gravity is balanced over a wide, stable base of support and a vertical line falls from the center of gravity through the base of support

A

Body Balance

240
Q

Raising the height of a bed when performing procedures is an example of

A

Body balance

241
Q

Result of weight, center of gravity, and balance.

A

Coordinated Body Movement

242
Q

The force exerted on a body by gravity

A

weight

243
Q

Centers of gravity are usually ______ at ____ to ____% of standing height

A

midline, 55-57%

244
Q

A force that occurs in a direction to oppose movement

A

Friction

245
Q

To reduce friction, you need to…..

A

decrease surface area

246
Q

Having a patient cross their arms over their chest when helping them move up in bed is an example of….

A

Reducing friction

247
Q

Physical activity used to condition the body, improve health, and maintain fitness

A

exercise

248
Q

the type and amount of exercise or activity a patient is able to perform

A

Activity tolerance

249
Q

Three categories of exercise:

A

Isotonic
Isometric
Resistive isometric

250
Q

Exercises that cause muscle contraction and change in muscle length. Combats osteoporosis

A

Isotonic exercise

251
Q

Walking, swimming, dance aerobics, jogging, bicycling, moving arms and legs with light resistance are examples of :

A

Isotonic exercise

252
Q

Exercises that involve tightening or tensing muscles without moving body parts. Decreases muscles wasting, increases circulation, increases osteoblastic activity.

A

Isometric Exercises

253
Q

Contraction of gluteal muscles is an example of

A

Isometric exercise

254
Q

Exercises in which the individual contracts the muscles while pushing against a stationary object. Promote muscle strength, provide sufficient stress against bone to promote osteoblastic activity

A

Resistive isometric exercises

255
Q

Push-ups and hip lifting are examples of

A

Resistive isometric exercises

256
Q

Bones perform which five functions in the body

A 
Support
Protection
Movement
Mineral storage
Hematopoiesis (blood cell formation)
257
Q

An articulation that connects bones

A

Joint

258
Q

Three classifications of joints

A

Synovial
Cartilaginous
Fibrous

259
Q

Joints that fit closely together and are fixed, permitting little (if any) movement. Example- Tibia and Fibula

A

Fibrous joint

260
Q

Joints that have little movement but are elastic and use cartilage to unite separate body surfaces. Example: Ribs to costal cartilage

A

Cartilaginous joints

261
Q

True joints that are freely movable and the most mobile, numerous, and anatomically complex body joints. Example: elbow, knee

A

Synovial joints

262
Q

Three things that support the musculoskeletal system

A

Ligaments
Tendons
Cartilage

263
Q

White, shiny, flexible bands of fibrous tissue that bind joints and connect bones and cartilage

A

Ligaments

264
Q

White, glistening, fibrous bands of tissue that connect muscle to bone

A

Tendons

265
Q

Nonvascular, supporting connective tissue with the flexibility of a firm, plastic material

A

Cartilage

266
Q

Contraction of _____ ______ allows people to walk, talk, run, breathe, and participate in physical activity

A

Skeletal Muscle

267
Q

Muscles that cause joint movement

A

Antagonistic muscles

268
Q

Muscles that contract to accomplish the same movement

A

Synergistic muscles

269
Q

Muscles that stabilize joints

A

Antigravity muscles

270
Q

The _______ system regulates movement and posture

A

Nervous

271
Q

The major voluntary motor area of the nervous system that regulates movement and posture is located in the _______ ______ and is called the _____ ____.

A

Cerebral cortex, Precentral gyrus (OR motor strip)

272
Q

Awareness of the position of the body and its parts

A

Proprioception

273
Q

Balance is controlled by the nervous system, specifically the _____ and the inner _____.

A

cerebellum, ear

274
Q

Assessment of sitting patient:
_____ is erect
Neck and vertebral column are _______
body weight is distributed on the _____ and ______
Thighs are _____ and _______
Feet are _____ on the floor
_______ are supported on the armrest, in the lap, or on the table.

A

Head, straight, buttocks, thighs, parallel, horizontal, supported, forearms

275
Q 
Assessment of standing:
Head is \_\_\_\_\_\_
Body parts are \_\_\_\_\_\_\_
Spine is \_\_\_\_\_\_\_\_ with normal \_\_\_\_\_\_\_\_
Abdomen is \_\_\_\_\_ 
Knees are in a straight line between \_\_\_\_\_ and \_\_\_\_\_, slightly \_\_\_\_\_\_
Feet are \_\_\_\_ on the floor and pointed \_\_\_\_\_\_\_
Arms hang comfortably by side
A

erect, symmetrical, straight, curvatures, tucked, hips, ankles, flexed, flat, forward

276
Q

When the patient is placed in lateral position with all supports removed except one pillow.

A

Recumbent

277
Q

Three components of mobility assessment:

A

ROM, Gait, Exercise

278
Q

An assessment technique used to determine the degree of damage or injury o a joint. Answers questions about joint stiffness, swelling, pain, and limited and unequal movement.

A

ROM

279
Q

The manner or style of walking, including rhythm, cadence, and speed

A

Gait

280
Q

Nursing diagnosis for activity and exercise;

A 
Activity intolerance
Ineffective coping
Impaired gas exchange
risk for injury
Impaired physical mobility
Imbalanced nutrition: more than body requirements
acute or chronic pain
281
Q

Before starting an exercise program, you must teach a patient to calculate their ____ ____ _____.

A

maximum heart rate

282
Q

Calculation for maximum heart rate

A

Subtract current age in years from 220. (Obtain TARGET heart rate by determining 60-90% of maximum)

283
Q

Lasts 5-10 minutes, includes stretching, calisthenics, and/or aerobic activity performed at lower intensities

A

Warm-up

284
Q

Last 5-10 minutes, allows body to readjust gradually to baseline functioning and provides and opportunity to combine movement such as stretching with relaxation-enhancing mind-body awareness.

A

cool-down

285
Q

______ released federal ergonomic guidelines to prevent musculoskeletal injuries in the workplace (Good body mechanics)

A

OSHA

286
Q

A drop in blood pressure that occurs when a patient changes from a horizontal to a vertical position. Relieved by dangling.

A

Orthostatic Hypotention

287
Q

How long should a cane be?

A

Equal to distance between the greater trochanter and the floor

288
Q

How far forward should the patient move the cane before stepping?

A

6-10inches (15-25cm)

289
Q

How do you measure for crutches?

A

Measure patient’s heigh, angle of elbow flexion, and distance between crutch pad and axilla (armpit).
Should be 3-4 finger widths from axilla
30 degree elbow flexion (measured with a goniometer)

290
Q

Four types of crutch gait

A

Four-point alternating gait (weight on both legs)
Three-point alternating gait (weight on one foot)
Two-point gait (partial weight on both feet)
Swing-through gait (no weight on feet)

291
Q

In what ways does exercise help people with CHD (chronic heart disease)?

A 
Reduced mortality and morbidity
Improved quality of life
Improved left ventricular function
Increased functional capacity
Decreased blood lipids and apolipoproteins 
Psychological well-being
292
Q

How does exercise help patients with hypertension?

A

Lowers blood pressure (low to moderate intensity aerobic exercise- walking/bicycling— high-intensity aerobics/weight training have minimal benefits)

293
Q

How does exercise help those with COPD?

A

Pulmonary rehabilitation helps patients reach an optimal level of functioning

294
Q

How does exercise help patients with diabetes mellitus?

A

Improved glucose control
Cardiovascular fitness
Psychological well-being
Lowers blood sugar levels (at least 24hours)
(low to moderate intensity exercises, carry carbohydrates(sugar/candy) and wear med. alert bracelet)

295
Q

A cyclical physiological process that alternates with longer periods of wakefulness.

A

Sleep

296
Q

24-hour day-night cycle.

A

Circadian rhythm

297
Q

Factors that affect circadian rhythms:

A

light
temperature
social activities
work

298
Q

_____ _____ synchronize a person’s sleep cycles.

A

Biological clocks

299
Q

Sleep is regulated by the ______

A

CNS- central nervous system

300
Q

The major sleep center in the body.

A

Hypothalamus

301
Q

RAS

A

Reticular Activating System
Located in upper brainstem and maintains alertness and wakefulness by visual, auditory, pain and tactile sensory stiumuli.

302
Q

BSR

A

Bulbar synchronizing region

Takes over as stimuli to RAS decline to cause sleep

303
Q

Two phases of normal sleep:

A

Nonrapid eye movement
Rapid eye movement
NREM and REM

304
Q

A person usually passes through _____ complete sleep cycles each night.

A

4-5

305
Q

Four stages of sleep:

A

NREM Stage 1—NREM stage 2— NREM stage 3—NREM stage 4— NREM stage 3—-NREM stage 2— REM sleep— NREM stage 2–>

306
Q

Complete sleep cycles (Stages 2-3-4-3-2-REM) lasts _________ minutes with REM ______ each cycle, with the last REM sleep being _____ during the last sleep cycle.

A

90-100, lengthening, 60 minutes.

307
Q

Although the purpose of sleep is unclear, it contributes to ______ and ______ restoration. NREM sleep contributes to _____ restoration and maintenance of ________ functions (such as heart rate dropping to 60bpm or less, blood pressure, and muscle tone)

A

Physiological, psychological, body tissue, biological

308
Q

_______ occur in both REM and NREM sleep are are important to learning, memory processing, and adaption to stress

A

Dreams

309
Q

________ causes early-morning awakening and fatigue

A

Hypertension

310
Q

Urination during the night

A

Nocturia

311
Q

Caused by low levels of iron, pregnancy, renal failure or an itching sensation deep in the muscles.

A

RLS- Restless leg syndrome

312
Q

Inadequacies in either quality or quantity of sleep on a daily basis. Excessive sleepiness.

A

Hypersomnolence

313
Q

Involves the use of EEG, EMG, and EOG to monitor stages of sleep and wakefulness during nighttime sleeping

A

Polyosmnogram

314
Q

Symptom patients experience when they have chronic difficulty falling asleep, frequent awakening from sleep, and/or a short sleep or nonrestorative sleep

A

Insomnia

315
Q

Practices associated with sleep

A

Sleep hygiene

316
Q

Sudden muscle weakness during intense emotions such as anger, sadness, or laughter. Can occur at any time.

A

Cataplexy.

317
Q

Feeling of being unable to move or talk just before waking or falling asleep

A

Sleep paralysis

318
Q

OSA

A

obstructive sleep apnea
obesity and hypertension as risk factors
Excessive daytime sleepiness
Stopping breathing for up to 30 seconds

319
Q

Dysfunction of mechanisms that regulate sleep and wake states.

A

Narcolepsy

320
Q

_____ ______ is caused by emotional stress, medications, and environmental disturbances

A

Sleep deprivation

321
Q

Signs and symptoms of sleep deprivation

A

Fever
Difficulty breathing
Pain

322
Q

Signs and symptoms of Narcolepsy

A

REM sleep within 15 minutes of falling asleep
EDS
Cataplexy
Falling asleep uncontrollably at inappropriate times
Sleep paralysis

323
Q

Types of sleep apnea

A

Primary central
Central
Obstructive

324
Q

Sleep problems that are more common in children than adults. Include sleepwalking, night terrors, SIDS, nightmares, bed-wetting, teeth grinding, body rocking.

A

Parasomnias

325
Q

Feeling mentally relaxed, free from anxiety, and physically calm.

A

Rest

326
Q

Sleep needed: Neonates

A

16 hours/day

327
Q

Sleep needed: toddlers

A

12 hours/day

328
Q

Sleep needed: School age children

A

9-10 hours/day

329
Q

Sleep needed: Young adults

A

6-8.5 hours/day

330
Q

Sleep needed: Infants

A

8-10 hours/night (15 hours/day)

331
Q

Sleep Needed: Preschoolers

A

12 hours/night

332
Q

Sleep needed: Adolescents

A

7.5Hours/night

333
Q

Sleep needed: Middle and older adults

A

Declines with age (from 6.5-8hours/night)

334
Q

Physical Illnesses affecting sleep:

A 
Hypertension
Respiratory
Musculoskeletal
Chronic Illness
GI 
Nausea
335
Q

Drugs and Substances affecting sleep:

A 
Hypnotics
Diuretics
Narcotics
Antidepressants
Alcohol
Caffeine 
Beta-blockers
Anticonvulsants
336
Q

Nursing Diagnosis for Sleep Pattrn

A 
Anxiety
Ineffective breathing pattern
Acute confusion
Compromised family coping
Ineffective coping
Insomnia
Fatigue
Sleep deprivation 
Readiness for enhanced sleep
337
Q

Two subjective measures of sleep:

A

Epworth Sleepiness Scale (evaluates severity of EDS)

Pittsburgh Sleep Quality Index (assess sleep quality and sleep patterns)

338
Q

Things to include in Sleep History

A 
Description of problems
Usual Sleep pattern
Physical and Psychological Illness
Current Life Events
Emotional and Mental status
Bedtime routines
Bedtime environment
Behaviors of sleep deprivation
339
Q

Pain involves _____, _____, and _____ components

A

Physical, emotional, cognitive

340
Q

Pain results from ______ and/or ______ stimulus

A

Physical, Mental

341
Q

Four physiological processes of nociceptive (normal) pain:

A

Transduction
Transmission
Perception
Modulation

342
Q

Converts energy produced by stimuli into electrical energy.

A

Transduction

343
Q

A sensory peripheral pain nerve fiber that receives an impulse that is sent from pain-producing stimuli and results in an action potential

A

Nociceptor

344
Q

Cellular damage caused by stimuli results in the release of excitatory neurotransmitters (prostaglandins) which surround the pain fibers in the extracellular fluid, spreading the pain message and causing an inflammatory response.

A

Transmission

345
Q

A symptom, not a disease. Symptoms include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feces

A

Constipation

346
Q

Results from unrelieved constipation, A collection of hardened feces wedged in the rectum that a person cannot expel

A

Impaction

347
Q

An increase in the number of stools and the passage of liquid, unformed feces.

A

Diarrhea

348
Q

Constipation is a greater health risk for these people due to straining. Caused by feces passing through the intestines too quickly to allow for absorption of fluid and nutrients.

A

Recent abdominal, gynecological, or rectal surgery (effort to pass stool causes sutures to separate)

349
Q

Factors influencing bowel elimination: Age

A

Infants digest food quickly because of rapid peristalsis.

Older adults experience changes in the GI system that impair digestion and elimination

350
Q

Factors influencing bowel elimination: Diet

A

Fiber- provides bulk of fecal material (whole grains, fruit, veg)
Diets high in veg and fruit decrease risk of colorectal cancer
Gas-producing foods (onions, cauliflower, beans) stimulate peristalsis
Food intolerance increases peristalsis (lactose, gluten)

351
Q

Factors influencing elimination: Fluid Intake

A

Inadequate fluid intake or fluid loss affect the character of feces
Reduced fluid slows passage of food (constipation)
Increased fluid increases peristalsis (diarrhea)
Adults need 1100-1400mL/day

352
Q

Factors influencing elimination: Physical Activity

A

Exercise/Activity promote peristalsis

Immobilization depresses peristalsis

353
Q

Factors influencing elimination: Psychological

A

Stress- peristalsis increases (diarrhea and gaseous distention)
Stress is associated with ulcerative colitis, IBS, gastric/duadenal ulcers, Crohn’s disease
Depression slows peristalsis (constipation)

354
Q

Factors influencing elimination: Personal habits

A

Work schedules
Forgetting to go
Chronic illness affects physical activity

355
Q

Factors influencing elimination: Position

A

Immobilized in bed- defecation difficult

Supine position- impossible to contract muscles for defecation

356
Q

Factors influencing elimination: Pain

A

Hemorrhoids
Rectal surgery
Rectal fistulas
Abdominal surgery

357
Q

Factors influencing elimination: Pregnancy

A

Size of fetus increases and pressure is exerted on the rectum
Slowing of peristalsis during third trimester (constipation)
Pregnant women frequently strain during defecation or delivery and results in hemorrhoids

358
Q

Factors influencing elimination: Surgery/Anesthesia

A

General anesthetics- cease peristalsis (paralytic ileus: lasts 24-48hrs)

359
Q

Factors influencing elimination: Medication

A

Laxatives and cathartics: soften stools and promote peristalsis
—Chronic use causes intestines to become less responsive to stimulation of laxatives. Can cause serious diarrhea leading to dehydration and electrolyte depletion

360
Q

Patients at risk for impaction:

A

Patients who are:
debilitated
confused
unconscious

361
Q

Signs of impaction

A

Inability to pass a stool for several days despite repeated urge to defecate. Continuous oozing diarrhea. Anorexia, nausea, vomiting, abdominal distention, cramping, rectal pain.

362
Q

Results of prolonged diarrhea

A

Excess loss of colonic fluid, serious fluid and electrolyte or acid-base imbalances
Infants and older adults are susceptible
Skin breakdown

363
Q

the inability to control passage of feces and gas from the anus.

A

Incontinence

364
Q

When the bowel wall stretches and distends. Common cause of abdominal fullness, pain and cramping. Dispelled through mouth or anus.

A

Flatulence

365
Q

Dilated, engorged veins in the lining of the rectum. Internal or external. People at risk include patients who are pregnant, with heart failure, and chronic liver disease.

A

Hemorrhoids

366
Q

A temporary or permanent artificial opening in the abdominal wall

A

Stoma.

367
Q

A temporary or permanent artificial opening in the ileum

A

Ileostomy

368
Q

A temporary or permanent artificial opening in the colon

A

Colostomy

369
Q

Fecal Occult Blood Testing: Purpose and Results

A

To detect blood in the stool and screen for colon cancer

Bluish color- positive/ No color- negative

370
Q

Examination of the upper GI tract allows more direct visualization through a lighted fiber-optic tube that contains a lens, forceps, and brushes for biopsy. Patient has nothing by mouth, removes all jewelry, Light sedation required.

A

Endoscopy

371
Q

Uses high-frequency sound waves to echo off body organs creating a picture. Preparation depends on the organ to be visualized and includes NPO or no preparation

A

Ultrasound

372
Q

X-ray film examination of the body from many angles uses a scanner analyzed by a computer. Preparation is usually NPO. Patient needs to lie very still, if claustrophobia is a problem, use light sedation.

A

Computerized Tomography Scan

373
Q

A noninvasive examination uses magnet and radio waves to produce a picture of the inside of the body. Preparation includes NPO 4-6hrs before. No metallic objects.

A

Magnetic Resonance Imaging (MRI)

374
Q

Nursing diagnosis for elimination:

A 
Bowel Incontinence
Constipation 
Risk for constipation 
Perceived constipation 
Diarrhea
Toileting self-care deficit
375
Q

Types of Enemas

A 
Cleansing
Tap water
Normal saline
Hypertonic Solutions
Soapsuds
Oil Retention 
Carminative
Medicated
376
Q

Oral, tablet, powder, or suppositories that empty the bowel short-term.

A

Cathartics and Laxatives (Cathartics are more powerful)

377
Q

Instillation of a solution into the rectum and sigmoid colon. Used as temporary relief of constipation and emptying bowel before diagnostic tests or surgery.

A

Enema

378
Q

Cleansing enemas

A
  • Promote complete evacuation of feces from colon
  • Stimulate peristalsis through the infusion of large volume of solution or through local irritation of the mucosa of the colon.
  • Includes tap water, normal saline, soapsuds solution, and low-volume hypertonic saline
379
Q

Tap Water Enemas

A
  • Hypotonic and exerts osmotic pressure lower than fluid in interstitial spaces
  • Net movement of water is low
  • Do not repeat tap-water enemas because of water toxicity or circulatory overload
380
Q

Normal Saline Enema

A
  • Safest solution (Best for Infants/Children because of risk for fluid imbalance)
  • Stimulates peristalsis
  • Does not create danger of excess fluid absoption
381
Q

Hypertonic Solutions Enema

A
  • Exert osmotic pressure that pulls fluids out of interstitial spaces.
  • Best for patients unable to tolerate large volumes of fluid
  • Not for dehydrated patients or young infants
  • 120-180mL
  • Fleet enema is most common
382
Q

Soapsuds enema

A
  • Add soapsuds to tap water or saline (Use pure liquid castile soap)
  • Creates intestinal irritation to stimulate peristalsis
  • Caution in pregnant women and older adults because of electrolyte imbalance or damage to intestinal mucosa
  • Either high or low pressure
383
Q

Oil retention enemas

A
  • Lubricate rectum and colon
  • Feces absorb the oil and become softer/easier to pass
  • Retained for several hours
384
Q

Carminative enemas

A
  • Provide relief from gaseous distention
  • Improve ability to pass flatus
  • MGW solution (30mL magnesium, 60mL glycerin, 90mL water)
385
Q

Medicated enema

A
  • Contain drugs
  • Used to treat patients with dangerously high serum potassium levels
  • Kayexalate (sodium polystyrene sulfonate: contains a resin that exchanges sodium ions for potassium ions in the large intestine)
  • Neomycin solution (an antibiotic used to reduce bacteria in the colon before bowel surgery)
386
Q

A pliable hollow tube that is inserted through the patient’s nasopharynx into the stomach.

A

NG tube (nasogastric tube)

387
Q

Position and conditions for enema

A

Left side, right knee flexed (because intestines curve left)
May elevate head of bed for difficulty breathing
Lukewarm water
Expel air from tubing over sink or trashcan
VERIFY ORDER
Insert correct distance (Infant- 1-1.5in, Child- 2-3in, Adult- 3-4in.)
Ask patient to take slow deep breathes and relax

388
Q

The functional unit of the kidney, forms the urine.

A

Nephron (composed of the glomerulus, bowman’s capsule proximal convoluted tubule, loop of Henle, distal tubule, and collecting duct)

389
Q

Kidneys are responsible for maintaining a normal RBC volume by producing ___________.

A

Erythropoietin

390
Q

Loss of voluntary control of urination caused by damage to the spinal cord above the sacral region. Urination occurs without the urge to void.

A

Reflex incontinence

391
Q

Occurs when a bladder is overly full and bladder pressure exceeds sphincter pressure, resulting in involuntary leakage of urine.

A

Overflow incontinence

392
Q

Causes of overflow incontinence

A

Head injury, spinal injury, multiple sclerosis, diabetes, trauma to urinary system, post anesthetic sedatives/hypnotics, tricyclics, and analgesia.

393
Q

A life-threatening problem affecting the heart rate and blood pressure, is caused by an overly full bladder.

A

Hyperflexia

Paralyzed patients

394
Q

Decreased blood flow to and through the kidney

A

Prerenal

395
Q

Disease conditions of the renal tissue

A

renal

396
Q

Obstruction in the lower urinary tract that prevents urine flow from the kidneys

A

postrenal

397
Q

BPH

A

Benign prostatic hyperplasia- enlargement of the bladder- Older men suffer this, making them prone to urinary retention and incontinence.

398
Q

An indirect method of cleaning the blood of waste products using osmosis and diffusion, with the peritoneum functioning as a semipermeable membrane. Removes excess fluid and waste products from the bloodstream when a sterile electrolyte solution.

A

Peritoneal dialysis

399
Q

Factors influencing urination

A 
Diseases
Sociocultural factors
Psychological factors
Fluid imbalance
Surgical procedures
Medications
Diagnostic examinations
400
Q

Awakening to void one or more times at night- a sign of renal alteration.

A

Nocturia

401
Q

An excessive output of urine.

A

Polyuria

402
Q

A urine output that is decreased despite normal intake

A

Oliguria

*400mL/24hr

403
Q

No urine produced

A

Anuria

404
Q

Promoting increased urine formation

A

Diuresis

405
Q

An accumulation of urine resulting from an inability of the bladder to empty properly. Bladder unable to respond to the micturition reflex.

A

Urinary retention

406
Q

Urinary retention signs and symptoms

A

pressure, discomfort, tenderness over the symphysis pubis, restlessness, diaphoresis

407
Q

Occurs if a patient has urinary retention or cannot empty the bladder completely.

A

Residual urine

* >= 100mL

408
Q

Bacteria in the urine caused by UTI

A

Bacteriuria

409
Q

Bacteria in the blood stream caused by bacteriuria to spread to kidneys

A

Bacteremia (urosepsis)

410
Q

Causes of UTI:

A 
Residual urine in the bladder
Urinary retention (caused by obstructed catheters)
Poor perineal hygiene (inadequate handwashing, failure to wipe front to back, frequent sexual intercourse) 
*Women more susceptible (shorter urethra, closer to anus)
411
Q

Pain or burning during urination (symptom of UTI)

A

Dysuria

412
Q

Irritated bladder causing frequent and urgent sensation of the need to void (symptom of UTI)

A

Cystitis

413
Q

Blood-tinged urine caused by irritation to bladder and urethral mucosa

A

Hematuria

414
Q

UTI that spreads to upper urinary tract and kidneys. Adds symptoms of fever and chills.

A

Pyelonephritis

415
Q

The involuntary leakage of urine that is sufficient to be a problem. Can be temporary, permanent, continuous, or intermittent

A

Urinary incontinence

416
Q

when the intra abdominal pressure exceeds urethral resistance. Muscles around urethra become weak and a small amount of urine may be leaked spontaneously

A

Stress incontinence (occurs more often in older women)

417
Q

Sudden, involuntary contraction of the muscles of the urinary bladder, resulting in an urge to urinate.

A

OAB- Overactive bladder

all ages, older adults more likely incontinent

418
Q

Conditions for urinary diversion to drain urine from a diseased or dysfunctional bladder

A

Cancer, radiation injury to bladder, chronic urinary infection

419
Q

Created from a distal portion of the ileum and proximal portion of the colon. Ureters are embedded, situated under the abdominal wall and has a narrow ileal segment brought through the abdominal wall to form a smal stoma.

A

Continent Urinary Reservoir

*Refer to ostomy nurse

420
Q

Uses an ileal pouch to replace the bladder. Anatomically the pouch is in the same position where the bladder was before removal, allowing patients to void normally.

A

Orthotopic neobladder

*Refer to ostomy nurse

421
Q

Urine drains continuously because a patient has not sensation or control over urinary output, requiring the application of a collection pouch at all times.

A

Incontinent urinary diversions

*Refer to ostomy nurse

422
Q

Urinary drainage directly from one or both kidneys- tube placed directly into the renal pelvis.

A

Nephrostomy

423
Q

Nighttime voiding without awakening

A

Nocturnal enuresis

424
Q

Most people void ____ or more times a day.

A

5

425
Q

Patients who void frequently during the night may have:

A

Renal disease
Prostate enlargement
Cardiac disease

426
Q

Feeling of need to void immediately

A

Urgency

427
Q

Painful or difficult urination

A

Dysuria

428
Q

Voiding at frequent intervals- less than 2 hours

A

Frequency

429
Q

Difficulty initiating urination

A

Hesitancy

430
Q

Leakage of urine despite voluntary control of urination

A

dribbling

431
Q

Physical Assessment of Urinary system

A

Skin/Mucosal mebranes
Kidneys
Bladder
Urethral Meatus

432
Q

Assessment of Urine

A

Intake and Output
Color, Clarity and Odor
Urine testing

433
Q

Urine output ranges

A

1200-1500 mL

*Hourly output of less than 30mL for more than 2 consecutive hours is cause for concern

434
Q

Normal and Abnormal Urine color

A

Pale, straw color- amber color
Abnormal: Red (bleeding; Dark- kidneys or ureters, Light- bladder or urethra), Orange (phenazopyridine, uniary analgesic), Red (beets, rhubard, blackberries), Dark Amber (high concentrations of bilirubin caused by liver dysfunction)

435
Q

Normal and abnormal Urine Clarity

A

Transparent
Abnormal: cloudy (from standing in container), Cloudy/foamy (high protein concentrations), thick and cloudy (bacteria or WBCs)

436
Q

Normal and abnormal odor:

A

Characteristic odor

Abnormal: Stagnant/ammonia (incontinent), Sweet/fruity (diabetes mellitus or starvation), Foul odor (infection)

437
Q

Weight or degree of concentration of a substance compared with an equal volume of water.

A

Specific Gravity

  • Uses a urinometer
  • part of urinalysis
438
Q

Suggested daily fluid intake

A

1200-1500mL

439
Q

Involved introducing a latex or plastic tube through the urethra and into the bladder. Provides a continuous flow of urine in the patients unable to control micturition or those with obstructions

A

Catheterization

*Requires a health care providers order, ASEPTIC TECHNIQUE

440
Q

Catheter patient fluid intake

A

2000-2500mL

441
Q

Involves surgical placement of catheter through the abdominal wall above the symphysis pubis into the urinary bladder

A

Suprapubic catheterization

442
Q

Soft, pliable, latex sheath that slips over the penis. Suitable for incontinent or comatose men who still have complete and spontaneous bladder emptying

A

Condom catheter

443
Q

Introduce a straight single-use catheter long enough to drain the bladder; when the bladder is empty, immediately withdraw the catheter; repeat as necessary

A

Intermittent

444
Q

Remains in place for longer period until patient is able to void voluntarily or continuous accurate urine measurements are no longer needed

A

Indwelling/Foley catheter

445
Q

Initiating an exercise program

A
  1. Assess fitness level
  2. Design the fitness program
  3. Assemble equipment
  4. Get started
  5. Monitor progress
446
Q

The point at which a person is aware of the pain.

A

Perception

*no single pain center in brain

447
Q

Release of inhibitory neurotransmitters which work to hinder the transmission of pain

A

Modulation

448
Q

Pain has emotional/cognitive components in addition to physical sensation

A

Gate-control theory of pain (Melzack and Wall-1965)

449
Q

Point at which a person feels pain

A

Pain threshold

450
Q

Level of pain a person is willing to accept

A

Pain toleranc

451
Q

Protective, has an identifiable cause, is of short duration, and has limited tissue damage and emotional response. Eventually resolved, once injured area heals. Treated aggressively

A

Acute pain

*unrelieved can progress to chronic pain

452
Q

Not protective, serves no purpose. Lasts longer than 6 months and is constant or recurring with a mild-to-severe intensity

A

Chronic pain

*Arthritis, back pain, myofascial pain, headache, peripheral neuropathy

453
Q

When a person with chronic pain who consults with numerous health care providers and is labeled a drug seeker when he/she is actually seeking pain relief

A

Pseudoaddiction

454
Q

Chronic pain in the absence of an identifiable physical or psychological cause or pain perceived as excessive for the extent of an organic pathological condition.

A

Idiopathic pain

*complex regional pain syndrome (CRPS)

455
Q

usually caused by tumor progression and related treatments/infections/physical limitations

A

Cancer pain

456
Q

Pain that occurs sporadically over an extended period of time, may last for hours, day, or weeks.

A

Chronic episode pain

*migraine headaches, sickle cell disease

457
Q

Factors influencing pain: psychological

A

Age (particularly in infants and older adults)
Fatigue (heightens perception of pain and decreases coping)
Genes (increase/decrease sensitivity to pain)
Neurological function (interrupts normal pain reception or perception)

458
Q

Nursing Diagnosis: Pain

A 
Activity intolerance
Anxiety
Ineffective coping
Fatigue
Fear
Hopelessness
Impaired physical mobility
Imbalanced nutrition: less than body requirements
Insomnia
Powerlessness
Chronic low self-esteem
Impaired social interaction
Spiritual distress
459
Q

Nonpharmacological pain-relief interventions

A

Relaxation and Guided imagery (decreases pulse, bp, respirations)
Distractions (inhibits painful stimuli)
Music (treats stress, pain, anxiety, depression)
Cutaneous Stimulation (massage, warm bath, ice bag, TENS)
Herbals (May interact with analgesics, lack of evidence)
Reducing pain perception (Remove or prevent painful stimuli)

460
Q

Pain Assessment

A

OLD CARTS (onset, location, duration, characteristics, aggravating, relieving, timing, severity)

461
Q

A variety of medications that enhance analgesics or have analgesic properties

A

Adjuvants

462
Q

The coordinated efforts of the musculoskeletal and nervous systems

A

Body mechanics

463
Q

The force exerted against the skin while the skin remains stationary and the boney structures move

A

Shear

464
Q

Fractures caused by weakened bone tissue

A

Pathological fractures

465
Q

Increased muscle contraction causes muscle shortening, resulting in movement such as when a patient uses an overhead trapeze to pull up in bed

A

Concentric tension

466
Q

Helps control the speed and direction of movement

A

Eccentric tension

467
Q

Combination of concentric tension and eccentric muscle actions

A

Isotonic contraction

468
Q

Static contraction, causes an increase in muscle tension or muscle work but no shortening or active movement of the muscle (Instructing a patient to tighten and relax a muscle group)

A

Isometric contraction

469
Q

An inducing or compelling force and occurs when specific bones such as humerus, ulna, and radius and the associated joint (such as the elbow) act together as a lever

A

LEverage

470
Q

The position of the body in relation to the surrounding space

A

Posture

471
Q

Normal state of balanced muscle tension

A

Muscle tone

472
Q

Inclining of head to affected side, in which sternocleidomastoid muscle is contracted

A

Torticollis

473
Q

Exaggeration of anterior convex curve of lumbar spine

A

Lordosis

474
Q

Increased convexity in curvature of thoracic spine

A

Kyphosis

475
Q

Lateral S or C shaped spinal column with vertebral rotation, unequal height of hips and shoulders

A

Scoliosis

476
Q

Hip instability with limited abduction of hips and occasionally adduction contractures

A

Congenital hip dysplasia

477
Q

Legs curved inward so knees come together as person walks

A

Knock-knee (genu valgum)

478
Q

One or both legs bent outward at knee, normal until 2-3yrs

A

Bowlegs

479
Q

95% medial deviation and plantar flexion of food

5% lateral deviation and dorsiflexion

A

Clubfoot

480
Q

Inability to dorsiflex and invert foot because of peroneal nerve damage

A

Footdrop

481
Q

Internal rotation of forefoot or entire foot, common in infants

A

Pigeon toes

482
Q

Loss of muscle tone and joint stiffness

A

Muscle atrophy

483
Q

An intervention that restricts patients to bed for therapeutic reasons

A

bed rest

484
Q

When a patient is immobile and his/her body excretes more nitrogen (from amino acid breakdown) than it ingests (in proteins)

A

Negative nitrogen balance

485
Q

Collapse of lung

A

Atelectasis

486
Q

Inflammation of the lung from stasis or pooling of secretion

A

Hypostatic pneumonia

487
Q

Increase in heart rate of more than 15% and a drop of 15mmHg+ in systolic and drop of 10mmHg+ diastolic BP when patient changes from supine to standing position

A

Orthostatic Hypotention

488
Q

An accumulation of platelets, fibrin, clotting factors, and the cellular elements of the blood attached to the interior wall of a vein or artery, which sometimes occludes the lumen of th evessel.

A

Thrombus

489
Q

When bone tissue is less dense or atrophied due to immobilization

A

Disuse osteoporosis

490
Q

An abnormal and possibly permanent condition characterized by fixation of the joint

A

Joint Contracture

491
Q

Food permanently fixed in plantar flexion

A

Footdrop

492
Q

Renal pelvis fills before urine enters ureters due to insufficient (to overcome gravity) peristaltic contractions of the ureters

A

Urinary stasis

493
Q

Calcium stones that lodge in the renal pelvis or pass through the ureters

A

Renal calculi

494
Q

An impairment of the skin as a result of prolonged ischemia (decreased blood supply) in tissues. Characterized by inflammation and forms over a bony prominence

A

Pressure Ulcer

495
Q

Maximum amount of movement available at a joint in one of the three planes of the body: Saggital, Transverse, Frontal

A

ROM- Range of Motion

496
Q

Measures height, weight, and skinfold thickness; used to assess metabolic functioning and to evaluate muscle atrophy

A

Anthropometric measurements

497
Q

A dislodged venous thrombus that travels through the circulatory system to the lungs and impairs circulation and oxygenation, resulting in tachycardia and shortness of breath

A

Embolus

498
Q

Nursing Diagnosis for Mobility/Immobility

A 
Ineffective airway clearance 
Ineffective coping
Risk for injury
Risk for impaired skin integrity
Insomnia
Social isolation
499
Q

Percussion and positioning used to effectively prevent pneumonia and keep airways clear. Helps patient drain secretions from specific segments of the bronchi and lungs into the trachea so he or she is able to cough and expel them.

A

CPT- Chest physiotherapy

500
Q

One-sided paralysis

A

Hemiplegia

501
Q

One-sided weakness

A

Hemiparesis (less serious than hemiplegia)

502
Q

What is the primary function of the cardiopulmonary system?

A

To deliver oxygen, nutrients, and other substances to the tissues and facilitate the removal of cellular metabolism waste products by way of blood flow through other body systems (respiratory, digestive, renal)

503
Q

What is the flow of the cardiopulmonay system?

A

Delivery of deoxygenated blood (blood high in CO2, low in O2) to the right side of the heart, then the lungs, where it is oxygenated. Then travels from lungs to left side of the heart and pumped through the tissues.

504
Q

Process of moving gases into and out of the lungs

  1. Perfusion
  2. Diffusion
  3. Compliance
  4. Ventilation
  5. Surfactant
  6. Atelectasis
A
  1. Ventilation
505
Q

T or F: Neural and chemical regulators control the process of respiration

A

T

506
Q

Which two body systems are primarily responsible for supplying the oxygen demands of the body?

  1. Endocrine and cardiac
  2. Cardiac and respiratory
  3. Respiratory and peripheral vascular
  4. Hepatic and cardiac
A

2.

507
Q

Primary function of the lungs is:

  1. Transfer CO2 from the alveoli and O2 out of the body
  2. Exchange CO2 for O2
  3. Transfer O2 from the atmosphere into the alveoli and CO2 out of the body as waste
  4. Transfer Co2
A

3

508
Q

Cardiopulmonary physiology involves delivery of deoxygenated blood to the ___ side of the heart and then to the ___ where it is oxygenated

  1. left, heart
  2. right lungs
  3. left lungs
  4. right heart
A

2

509
Q

The left ventricle pumps blood through _____ circulation

  1. ventricular
  2. pulmonary
  3. systemic
  4. cyanotic
A

3.

510
Q

The amount of energy expended on breathing depends on the (Select all that apply)

  1. rate of breathing
  2. compliance
  3. depth of breathing
  4. color of their shirt
  5. airway resistance
A

all but .4

511
Q

Measures the volume of air entering or leaving the lungs

  1. tidal volume
  2. residual volume
  3. forced vital capacity
  4. Spirometry
A

4

512
Q

Ability of the lungs to distend or expand in response to increase intra-alveolar pressure

  1. surfactant
  2. atelectasis
  3. compliance
  4. airway resistance
A

3

513
Q

Amount of air exhaled after normal inspiration

  1. tidal volume
  2. residual volume
  3. forced vital capacity
  4. compliance
A

1.

514
Q

Increase in pressure that occurs as the diameter of the airways decreases from the mouth/nose to alveoli

  1. atelectasis
  2. Airway resistance
  3. Compliance
  4. Forced vital capacity
A

2

515
Q

T or F

Humidification is never administered with oxygen

A

F (if over 4%)

516
Q

_____ articles which can produce ______

  1. secure, open flame
  2. remove, oxygen
  3. remove, spark/open flame
  4. remove, humidification
A

3

517
Q

Place ___ ____ in view

  1. christmas tree adapters
  2. Open flames
  3. Cigarettes
  4. Caution signs
A

4.

518
Q 
Secures and maintains \_\_\_\_ of \_\_\_\_\_\_ used for flow of oxygen
1. integrity, devices
2 .spark, fire
3. integrity, skin
4. Flow, oxygen
A

1.

519
Q

Describe CO2 transport:

A

CO2 diffuses into RBCs— hydrated into carbonic acid— dissociates into hydrogen and bicarbonate— hemoglobin buffers hydrogen, bicarbonate diffuses into plasma— deoxyhemoglobin combines with co2 and venous blood transports back to lungs to be exhaled

520
Q

Define stoke volume

A

The volume of blood ejected from the ventricles during systole

Nursing Exam 3 (1 decks)

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