Terms and Knowledge Flashcards
0
Q
Extracellular fluid is ____ of total body water
A
1/3
1
Q
Intracellular fluid is ______ of total body water
A
2/3
2
Q
ECF contains these three divisions
A
Interstitial
Intravascular
Transcellular
3
Q
Compounds that separate into ions when they are dissolved into water
A
Electrolytes
4
Q
Needed to maintain and/or regulate fluid balance, nerve impulse transmission, acid-base balance, and cellular chemical reactions.
A
Sodium (Na2+)
5
Q
Normal sodium level:
A
136-145 mEq/L
6
Q
Necessary for glycogen deposits in the liver and skeletal muscle, transmission, and conduction of nerve impulses, cardiac conduction, and smooth and skeletal contraction. (Maintains resting potential of skeletal, smooth, and cardiac muscle allowing for normal function)
A
Potassium (K+)
7
Q
Normal potassium range:
A
3.5 - 5.0 mEq/L
8
Q
Necessary for bone and tooth formation, blood clotting, hormone secretion, cell membrane integrity, cardiac conduction, transmission of nerve impulses, and muscle contraction. (Influences excitability of nerve and muscle cells, necessary for muscle contraction)
A
Calcium (Ca2+)
9
Q
Essential for enzyme activities (cofactor for enzymes), neurochemical activities, and cardiac and skeletal excitability. About 50- 60% is found in the bone.
A
Magnesium (Mg2+)
10
Q
The major anion in ECF, always follows sodium, and is regulated through dietary intake and kidneys.
A
Chloride (Cl-)
11
Q
Major chemical base buffer in body, found in ECF and ICF, and regulated by the kidneys
A
Bicarbonate (HCO3-)
12
Q
Normal HCO3- (Bicarbonate) Levels:
A
22- 26 mEq/L
13
Q
Found in ICF with a small amount in ECF, assists in acid-base balance, helps in addition to calcium to develop and maintain bones and teeth, and is inversely proportional to calcium (one rises, other falls)
(Necessary for production of ATP)
A
Phosphorus/Phosphate (PO4)
14
Q
Normal CO2 Levels:
A
22- 30 mEq/L
15
Q
Normal ABG pH:
A
7.35- 7.45
16
Q
Normal PaCO2 level:
A
35- 45 mm Hg
17
Q
Normal PaO2 level:
A
80- 100 mm Hg
18
Q
Normal O2 Sat.
A
95- 100%
19
Q
The liquid portion of the blood (plasma)
A
Intravascular fluid
20
Q
Located between the cells and outside the blood vessels
A
Interstitial fluid
21
Q
Cerebrospinal fluid, pleural fluid, peritoneal fluid, and synovial fluids that are secreted by epithelial cells.
A
Transcellular fluids
22
Q
Mineral salts contained in the fluid of the body compartments.
A
Electrolytes
Balance: Cations= Anions
23
Q
Cations and Anions combine to make ______.
A
Salts
24
A measure of the number of particles per kilogram of water.
Osmolality
25
A fluid with the same concentration of nonpermeant particles as normal blood.
Isotonic solution (Normal saline)
26
A solution more dilute than blood
Hypotonic solution (Sodium Chloride containing- 0.45%)
27
A solution more concentrated than normal blood.
Hypertonic Solution (containing sodium chloride- 3%)
28
Concentrations of Na+, Cl-, and HCO3- are higher in the ________.
ECF
29
Concentrations of K+, Mg2+, and PO43- are higher in the _______.
ICF
30
Four processes that move water and electrolytes between body compartments to maintain equal osmolality.
Active Transport
Diffusion
Osmosis
Filtration
31
Movement of ions against osmotic pressure to an area of higher pressure, requires energy
Active Transport
32
Passive movement of electrolytes or other particles down the concentration gradient, Higher to lower concentrations. Fluids and Ions move
Diffusion
33
Movement of water (or other solute) from an area of less to one of greater concentration (low- high). Only fluids move
Osmosis
34
Movement across a membrane, under pressure, from higher to lower pressure
Filtration
35
Total fluid balance (Homeostasis) involves:
Fluid intake and absorption
Fluid distribution
Fluid output
36
An inward-pulling force that is caused by particles in the fluid- Greater at venous end
osmotic pressure
37
The force of the fluid pressing outward against a surface- Greater at arterial end
hydrostatic pressure
38
Albumin and other proteins contained in blood; much larger than electrolytes, glucose, and other molecules that dissolve easily.
Colloids
39
An inward-pulling force caused by blood proteins that helps move fluids.
Oncotic pressure (colloid osmotic pressure)
40
Sources of fluid intake:
Eating (absorption)
Drinking (Includes ice cream, ice chips, and jello)
IV
Rectal enema
Irrigation (of body cavities able to absorb fluids)
41
Fluid intake regulation:
Thirst (hypothalamus)
Habit
Social reasons
42
Patients at risk for dehydration related to thirst:
Infants
Neurological/psychological problems
Older adults
(Those unable to perceive or communicate thirst)
43
Movement of fluid among its various compartments
Fluid Distribution
44
Fluid intake range:
2200- 2700 mL
45
Fluid output range: Total
2200- 2700 mL
46
Fluid output range: Skin (insensible and sweat)
500- 600 mL
47
Fluid output range: Insensible (lungs)
400mL
48
Fluid output range: GI:
100- 200 mL
49
Fluid output range: Urine
1200- 1500 mL
50
Fluid output occurs in these four organs (Normal)
Skin, Lungs, GI, Kidneys
51
Abnormal routes of fluid output:
Vomiting
wound drainage
Hemorrhage
52
Fluid output that is not perceived, such as in the skin or the lungs.
Insensible (Burns, fever)
53
Approximately __ to ___ L of fluid moves into the GI tract daily then returns to the ECF.
3, 6
54
Angiotensin II does this:
```
releases aldosterone from adrenal cortex
increases thirst
causes vasoconstriction (increases BP)
```
55
Fluid output is affected by these hormones:
ADH
Hormones in the RAAS (Angiotensin system)
ANP
56
_____ regulates the Osmolality of the body fluids by influencing how much water is excreted in the urine.
ADH (antidiuretic hormone)
57
Factors that increase ADH:
```
Severely decreased blood volume
Dehydration
Hemorrhage
Pain
Stressors
Medications
```
58
Factors that increase RAAS activity:
Hemorrhage
| Vomiting
59
Influences how much sodium and water are excreted n the urine.
RAAS
60
Insufficient isotonic fluid in the extracellular compartment
ECV deficit
61
Decreased vascular volume
Hypovolemia
62
Occurs when there is too much isotonic fluid in the extracellular compartment.
ECV excess
63
An imbalance in which the body fluids become hypo or hyper tonic
Osmolality imbalance (Hyper or hypo natremia)
64
Water deficit, loss of relatively more water than salt, or gain of relatively more salt than water.
Hypernatremia
65
Water excess/water intoxication, gain of relatively more water than salt, or loss of relatively more salt than water
Hyponatremia
66
Clinical dehydration is a combination of _________ and ________.
ECV deficit and hypernatremia
67
Release of ADH causes:
Increase in volume
| excreted from posterior pituitary---> kidney, H2O is returned to the blood, less H2O is excreted in the urine
68
Release of Aldosterone causes:
Increase in volume
| Adrenal cortex---> Kidneys, Na+, Cl-, and H2O returned to the blood and K+ and H+ are excreted in the urine
69
Release of ANP causes:
Decrease in volume
| Heart----> kidneys, Na+, Cl-, and H2O are excreted in the urine
70
ECV volume excess: definition
Body fluids increased in volume, but normal tonicity
71
Hypernatremia: definition
Hypertonic (more salt than water)-- Loss of relatively more water than salt OR gain of relatively more salt than water
72
Hyponatremia: Definition
Hypotonic (more water than salt)-- Gain of relatively more water than salt OR loss of relatively more salt than water
73
Decreased vascular volume
Hypovolemia
74
Intake of Potassium (K+) (FOODS)
```
Fruits
Potatoes
Instant coffee
Molasses
Brazil Nuts
```
75
Intake of Calcium (Ca2+) (Foods)
Dairy Products
Canned fish with bones
Broccoli
Oranges
76
Intake of Magnesium (Mg2+) (Foods)
Dark green leafy vegetables
Whole grains
Mg2+ containing laxatives/Antacids
77
Phosphate (PO4) Intake (Foods)
Milk
| Processed Foods
78
Maintains resting membrane potential of skeletal smooth and cardiac muscle allowing for normal muscle function
Potassium
79
Influences excitability of nerve and muscle cells and is necessary for muscle contraction
Calcium
80
Influences function of neuromuscular junctions and is a cofactor for numerous enzymes
Magnesium
81
Necessary for production of ATP (energy source for metabolism)
Phosphate
82
Which hormones are released when fluid volume is too low?
ADH, Aldosterone (RAAS)
83
Which hormones are released when fluid is in excess?
ANP
84
Electrolyte output occurs in:
```
Urine
Feces
Sweat
Vomiting
Drainage of tubes/fistulas
-- Must increase intake --
```
85
Electrolyte excess occurs in:
```
Oliguria
Endocrine disorders
Medications
Shift of electrolytes from bone into ECF
-- Must decrease intake --
```
86
Hypokalmeia: definition
Abnormally low potassium concentration in the blood
87
Hyperkalemia: definition
Abnormally high potassium ion concentration in the blood
88
Hypocalcemia definition:
Abnormally low calcium concentration in the blood
89
hypercalcemia definition:
abnormally high calcium concentration in the blood
90
Hypomagnesemia definition:
Abnormally low magnesium concentration in the blood
91
Hypermagnemesia definition:
Abnormally high magnesium concentration in the blood
92
Three processes of acid-base balance:
Acid production
Acid buffering
Acid excretion
93
Laboratory tests of a sample of arterial blood
ABGs (Arterial blood gases)
94
major regulator of fluid output:
kidneys
95
Arises from alveolar hypoventilation
Respiratory Acidosis
95
Arises from alveolar hyperventilation
Respiratory Alkalosis
95
Occurs from an increase of metabolic acid or decrease in bicarbonate
Metabolic Acidosis
95
Occurs from a increase of bicarbonate or a decrease of metabolic acid
Metabolic Alkalosis
96
A pH of greater than 7.45 in an ABG
Alkalosis
96
A pH of less than 7.35 in an ABG
Acidosis
97
Blood administered faster than circulation can accommodate
Circulatory Overload
98
Bacterial contamination of transfused blood components
Sepsis
99
People with these two electrolyte imbalances need bowel management for constipation.
Hypokalemia, Hypercalcemia
100
When giving a blood transfusion, ensure you have an _______ from the provider, perform a thorough ________, include a patients ______ vital signs, ensure everything is checked by _____ nurses, and stay with the patient for the first _____ minutes of the transfusion
order, assessment, baseline, Two, 15
101
Collection and reinfusion of a patient's own blood
Autologous transfusion
102
An immune response to transfused blood/blood components
Transfusion reaction s
103
Blood transfusions can be used for these 3 reasons:
1. Increasing blood volume after surgery, trauma, or hemorrhage
2. Increasing RBCs and maintaining hemoglobin levels (severe anemia)
3. Providing selected cellular components in replacement therapy (clotting factors, platelets, albumin)
104
Signs of hematoma
bruising
105
Blood enters tissue at venipuncture site
Hematoma
106
Signs of Phlebitis
Redness, Inflammation, Heat, Tenderness
| *along the course of the vein and can cause thrombophlebitis (blood clots)
107
Inflammation of the vein resulting from chemical, mechanical or bacterial causes
Phelebitis
108
Signs and symptoms: Extravasation/Infiltration
Coolness, paleness, swelling
109
IV fluid that contains additives enters subcutaneous tissue and cause damage
Extravasation
110
When an IV catheter becomes dislodged or a vein ruptures and IV fluids enter subcutaneous tissue
Infiltration
111
A technique in which a vein is punctured through the skin by a sharp rigid stylet
Venipuncture
112
CRBSI
Catheter related bloodstream infection
113
Enter through a peripheral arm vein and extend through the venous system to the superior vena cava where they terminate.
PICC (Peripherally inserted central catheters)
| *central lines more effective for large volumes of fluid*
114
Catheters or infusion ports designed for repeated access to the vascular system.
VADs (Vascular access devices)
115
Never administer ____ additive IV solution via IV push
KCl (Potassium containing)
116
These solutions have a greater osmolality than body fluids and have higher sodium concentrations; they increase osmolality rapidly and pull water out of cells
Hypertonic
117
These solutions have an osmolality less than body fluids, causing dilution of the body fluid and moving water into cells
Hypotonic Solutions
118
A low osmolality fluid is administered through a _________ catheter.
Peripheral
119
A high osmolality fluid is administered through a _______ catheter
Central
120
Parenteral replacement includes:
PN (parenteral nutrition)
IV fluids
Electrolyte therapy (Crystalloids)
Blood/blood component administration (colloids)
121
Patients who have _____ and very severe _______ require fluid restrictions.
Hyponatremia
| ECV excess
122
When a patient has diarrhea, fluids containing ____, ______, and have low ______ content are not appropriate .
Lactose, Caffeine, Sodium
123
Record _____ the volume of ice chips in I&O.
half
124
Oral replacement of fluids is contraindicated when the patient has a mechanical _______ of the GI tract, is at high risk for _________, or has impaired ____________.
Obstruction, aspiration, swallowing
125
Hypertonic solutions cause cells to:
Shrink, shrivel
126
Hypotonic solutions cause cells to:
Expand, Swell
127
Isotonic solutions cause cells to:
stay the same size
128
When treating a nursing diagnosis, it is important to treat the: Diagnosis itself or the Related to cause?
Related to cause
129
Oliguric Renal Disease, which prevents normal excretion of fluid, electrolytes and metabolic acids, can result in many imbalances. Name 2 of them.
```
ECV excess
Hyperkalemia
Hypermagnesemia
Hyperphosphatemia
Metabolic Acidosis
```
130
Physical Assessment for fluid imbalances should always include which three things?
Daily weight (1 kg= 1 L of fluid, gained or lost)
I&O measurements
Laboratory Values
131
Due to increased aldosterone secretion, patients with Chronic Heart Failure experience ____________ and an increased risk for _________.
ECV excess, hypokalemia
132
Patients with cancer often develop which electrolyte imbalance?
Hypercalcemia
133
Head injuries often cause diabetes insipidus OR can cause SIADH which are related to which electrolyte imbalances?
Hypernatremia
| Hyponatremia
134
Crush injuries often cause which electrolyte imbalance?
Hyperkalemia
135
Blood loss (Hemorrhage) from any type of trauma causes which imbalance?
ECV deficit
136
Burns place patients at a high risk for which imbalance?
ECV deficit
| *Patients also often develop metabolic acidosis due to increased cellular metabolism
137
Bacterial pneumonia can lead to which acid-base balance?
Respiratory Acidosis
138
Many respiratory disorders predispose patients to which acid-base balance?
Respiratory Acidosis
139
Because of increased ADH and Aldosterone secretion, Surgery can increase risk for what imbalances, especially second-fifth postoperative days?
ECV excess
Hyponatremia
Hypokalmeia
140
Chronic alcohol abuse is commonly associated with what imbalance?
Hypomagnesemia
141
Starvation and diets with high fat and no carbohydrates can lead to which imbalance?
Metabolic Acidosis
142
.What environment would increase fluid output, and put a patient at risk for ECV deficit, hypernatremia, and clinical dehydration?
Hot Environment (physical work, vigorous exercise in warm environments)
143
What age groups are at greater risk for imbalances?
Infants (greater water weight)
Young children/Infants (Greater water needs, immature kidneys, more fevers)
Adolescents (increased metabolism, increased water production)
Older adults (box 41-2)
144
Six components of ABGs
```
pH
paCO2
paO2
O2 Sat
Base Excess
Bicarbonate (HCO3-)
*Blood is taken from the arteries*
```
145
Most effective way to evaluate acid-base balance and oxygenation
ABGs
146
Body fluids decreased in volume with normal tonicity
ECV deficit
147
A state of physical, emotional, mental and social well-being in relation to sexuality; not merely the absence of disease, dysfunction or infirmity.
Sexual Health
148
The first 3 years of life are crucial to develop...
Gender identity
149
Perimenoposal women have issues with:
Diminished vaginal lubrication
| Decreased vaginal elasticity
150
Dyspareunia
Occurrence of pain during intercourse
151
Nonprescription methods for contraception
Abstinence
Barrier Methods
Timing of Intercourse
152
Prescription Methods for contraception: Hormonal
```
Oral pills
Vaginal rings
Hormonal injections
Sub-dermal Implants
Transdermal skin patches
IUDs
```
153
Prescription methods for contraception: Non-hormonal
Diaphragm (must be fitted)
Cervical cap
Sterilization (Tubal Ligation and Vasectomy)
154
Common bacterial/curable STIs
Chlamydia
Syphilis
PID
Gonorrhea
155
Common non-curable/Viral STIs
HIV
HPV
Genital Herpes
156
Common symptoms of a STI
Discharge from Vagina, Penis, or Anus
Pain during sex or when urinating
Blisters or sores in genital area
Fever
157
Primary routes of transmission for HIV
IV needles
Anal or vaginal intercourse
Oral sex
Transfusion of blood/blood products
158
Populations at risk for HIV
Use of illicit IV drugs and share needles
Hemophilia
Unprotected sexual contact
159
Stage 1 HIV length and symptoms
About 1 month after contracting
| Flulike symptoms
160
Stage 2 of HIV length and symptoms
6weeks- 3 months after infection
| No symptoms
161
Stage 3 of HIV
AIDS
162
Most common STI in the US
HPV
163
Most commonly reported bacterial STI
Chlamydia
164
Effects of untreated chlamydia
PID
Ectopic pregnancy
Infertility
Neonatal complications
165
Symptoms of chlamydia
Dysuria
Urinary frequency
Purulent vaginal discahrge
NGU (for men- Nongonococcal urethritis: dysuria and urethral discharge)
** 75% of women, 50% of men show no symptoms
166
Infertility
Inability to conceive after 1 year of unprotected intercourse
167
Cues for possible sexual abuse
Extreme Jealousy
| Refusal to leave woman's presence
168
Absence of complete sexual functioning
Sexual dysfunction
169
Risk factors for ED (erectile dysfunction)
```
Diabetes Mellitus
Hyperlipidemia
Hypertension
Hypothyroidism
Chronic Renal Failure
Smoking
Obesity
Alcohol Abuse
Lack of Exercise
```
170
PLISSIT
P ermission to discus sexuality issues
L imited
I information related to sexual health problems
S pecific
S uggestions- only when nurse is clear about problem
I ntensive
T herapy- referal to profession with advanced training (if necessary)
171
Offer HPV vaccine to patients between ___ and ___ years of age.
9, 26
172
The most effective way to diagnose STIs
Regular screening (of sexually active individuals)
173
HAART
Highly active antiretroviral therapy
| -Greatly increases survival time of persons with HIV/AIDS
174
Name the senses
Sight (visual)
Hearing (auditory)
Touch (tactile)
Smell (olfactory)
Taste (Gustatory)
Kinesthetic (sense of awareness of position and movement)
Stereognosis (recognize size, shape, texture of object)
175
Stimulation of a receptor such as light, touch, or sound
Reception
176
Integration and interpretation of stimuli
Perception
177
Only the most important stimuli will elicit
Reaction
178
Three Sensory Alteration
Sensory deficits
Sensory deprivation
Sensory overload
179
Lacking a normal function of sensory reception and perception.
Sensory deficit
180
Turning a better-hearing ear towards a speaker is an example of:
sensory deficit
181
Inadequate quality or quantity of stimulation
Sensory deprivation
182
Exposure to strange environments, hearing loss, and bed rest can all cause
Sensory deprivation
183
Reception of multiple sensory stimuli
Sensory overload
184
A patient who is hospitalized in ICU is at risk for
Sensory overload
185
Symptoms of sensory overload
```
Racing thoughts
Scattered attention
Restlessness
Anxiety
Constant fingering of tubes and dressings
```
186
Sensory risk factors: Infants and children
Visual and hearing impairments (genetic, prenatal, and postnatal)
187
Visual changes usually occur...
Age 40-50
188
Hearing changes begin at age...
30
189
Gustatory and olfactory changes begin around age...
50
190
Proprioceptive changes are common after age...
60
191
Proprioceptive changes
Difficulty with balance
Spatial disorientation
Decreased coordination
192
Meaningful stimuli include
```
pets
music
tv
pictures
calendars
clocks
*need to be available in hospital setting
```
193
Assessment of Sensory Alterations includes:
```
Persons at risk (older adults)
Sensory alterations history (ask family)
Mental status (observation)
Physical assessment
Ability to perform self-care (affected by alterations?)
Health promotion habits (screening, devices)
Environmental hazards (in the home)
Communication methods (aphasia)
Social support
```
194
Damage to the auditory nerve by antibiotics
Ototoxicity
| Opiod analgesics, sedatives ,antidepressants
195
Nurses role in Health promotion:
Detection
Education
Referral
196
Second leading cause of blindness in the US and primary for African Amerians
Glaucoma
197
American Academy of Ophthalmology suggests eye exam with measurement of Intraocular pressure every ___ years for those over ___ years old .
2, 40
198
Hearing loss caused by excessive cerumen occluding the ear canal
Conductive hearing loss
199
An individual's view of self.
Self- concept
200
A sense of meaning, wholeness, and consistency in a person
Identity or Self-awareness (caused by a positive self-concept)
201
Being oneself or living an authentic life
Identity
202
Attitudes related to the body- includes physical appearance, structure, or function
Body image
203
A wife incorporating "ugly" into her self-concept due to a controlling abusive husband is an example of a changed:
body image
204
The way in which individuals perceive their ability to carry out significant roles
Role performance (roles include parent, supervisor, friend)
205
An individual's overall feeling of self-worth or the emotional appraisal of self-concept.
Self-esteem
206
Results when people do not maintain a clear, consistent and continuous consciousness of personal identity
Identity confusion
207
Individuals who are particularly vulnerable to indentity stressors
adolescence
208
A change in appearance, structure, or function of a body part requires an adjustment in:
body image
209
When a person has to simultaneously assume two or more roles that are inconsistent, contradictory, or mutually exclusive.
Role conflict
210
A middle-age woman with children assumes responsibility of care for her older parents. This is an example of
role conflict
211
involves the expectations of others and society regarding how an individual behaves whens sick.
Sick role
212
Involves unclear role expectations which makes people unsure about what to do or how to do it, creating stress and confusion
Role ambiguity
| *common in adolesence and employment
213
When a person feels inadequate or unsuited to a role
Role strain
214
A person experiences frustration when having to provide for a family member with Alzheimer's disease. this is an example of
Role strain
215
Having more roles or responsibilities within a role than are manageable.
Role overload
216
A person struggles meeting the demands of work, family, and personal time. This is an example of
Role overload
217
An awareness of one's inner self and a sense of connection to a higher being, nature, or some purpose greater than oneself
Spirtuality
218
Research shows that spirituality positively affects and enhances:
Health
quality of life
health promotion behaviors
disease prevention activities
219
5 Components of Spirituality
```
Connectedness
Meaning and purpose of life
Inner strength and peace
Transcendence and self transcendence
Faith and hope
```
220
A sense of authentically connecting to one's inner self
Self-transcendence
221
The belief that a force outside of and greater than the person exists beyond the material world
Transcendence
222
One who believes that there is no known ultimate reality
Agnostic
223
One who does not believe in the existence of a God
Atheist
224
Associated with a specific system of practice associated with denomination, sect, or form of worship
Religion
225
Gives an individual motivation and the resources to achieve
Hope
226
A system of organized beliefs and worship that a person practices to outwardly express spirituality
Religion
227
When a person has something to live for and look forward to
Hope
228
Impaired ability to experience and integrate meaning and purpose in life through connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself
Spiritual distress
229
NDE
near death experience- A psychological phenomenon of people who have either been close to clinical death or have recovered after being declared dead
230
HOPE spiritual assessment
H Hope- Spiritual Resources
O organized religion
P Personal Spirituality
E effects on care
231
FICA spiritual assessment
F Faith or Beliefs
I Importance and Influence
C community
A address
232
Interventions of the Nurse in Spirituality
```
Establishing presence
Supporting a healing relationship
Diet therapies
Supporting rituals
Prayer
Meditation
Supporting grief work
```
233
The emotional response to a loss, manifested in ways unique to an individual and based on personal experiences, cultural expectations, and spiritual beliefs.
Grief
234
The outward, social expressions of grief and the behaviors associated with loss
Mourning
235
Includes the emotional responses and outward behaviours of a person experiencing loss
Bereavement (both grief and mourning)
236
Losses that are part of life, eventually replaced by something different or better
Necessary loss
237
Form of necessary loss and includes all normally expected life changes across the lifespan
Maturational loss
238
Divorce is an example of which type of loss?
Necessary Loss
239
A child leaving home for college is an example of which type of loss
Maturational loss
240
Sudden, Unpredicatble external events bring about
Situational loss
241
A person in an automobile accident sustains an injury with physical changes and cannot return to work or school and losses function, self-esteem, and goals. This is an example of
Situational loss
242
Occurs when a person can no longer feel, hear, see, or know a person or object.
Actual loss
243
Death of a family member is an example of
Actual loss
244
Amputation is an example of which type of loss
Actual loss
245
Loss defined by the person experiencing the loss, but is less obvious to others
Perceived loss
246
Rejection is an example of which type of loss?
Perceived
247
A common, universal reaction characterized by complex emotional, cognitive, social, physical, behavioral, and spiritual responses to loss and death.
Normal Grief
248
The unconscious process of disengaging and letting go before the actual loss or death occurs.
Anticipatory grief
249
Unsupported grief when relationship to the deceased person is not socially sanctioned, cannot be openly shared, or seems of lesser significance.
Disenfranchised grief
250
Death of a pet is an example of
Disenfranchised grief
251
Occurs when lost person is physically present but not psychologically available.
Ambiguous loss
252
Alzheimer's is an example of which type of loss?
Ambiguous
253
A person has prolonged or significantly difficult time moving forward after a loss.
Complicated grief
254
Loss associated with suicide or homicide results in which type of grief
Complicated grief
255
Death of a child or sudden death results in which type of grief
Complicated grief
256
grief Response that often exhibits self-destructive or maladaptive behaviors, obsessions, psychiatric disorders.
Exaggerated grief
| ** risk of suicide
257
When a person's grief response is postponed because the loss is so overwhelming that a person must avoid the full realization of the loss.
Delayed grief
258
Stages of Dying
```
Denial
Anger
Bargaining
Depression
Acceptance
```
259
Disruptive behavior as a result of a loss and ineffective grief resolution
Masked grief
260
Focuses on the prevention, relief, reduction, or soothing of symptoms of disease or disorders throughout the entire course of an illness, including care of the dying and bereavement follow-up of the family.
Palliative care
261
Primary goal of palliative care
To help patients and families achieve the best possible quality of life
262
A philosophy and a model for the care of terminally ill patients and their families.
Hospice care
263
HOpsice is not a _______ but rather a ____ and _____ centered approach to care. It give priority to managing a patient's _____ and other symptoms, _____, quality of _____, and attention to ______, ______, ________, and _______ needs and resources.
Place, family, patient, pain, comfort, life, Physical, Psychological, Social, Spiritual
264
Criteria for hospice care
- Have less than 6-12 months to live (per doctor's written order- Certification of terminal illness)
- Have a family caregiver to provide care
- DNR
265
Name steps on how a nurse helps facilitate mourning (7)
- Help survivor accept that the loss is real
- Support efforts to adjust to the lost
- Encourage establishment of new relationships
- Allow time to grieve
- Interpret "normal" behavior
- Provide continuing support
- Be alert for signs of ineffective, potentially harmful coping mechanisms
266
Physical, emotional, and spiritual exhaustion resulting from seeing patients suffer or frequent, intense, or prolonged exposure to grief and loss.
Compassion Fatigue
267
Tension producing stimuli operating within or on any system.
Stressor
268
Arousal of the sympathetic nervous system, preparing the person for action
Fight or Flight response
269
Three structures that control bodies response to a stressor
Reticular formation
Pituitary gland
Medulla oblongata
270
Name some body changes associated with the fight-or-flight response
```
Increased mental activity
Dilated pupils
Bronchiolar dilation
Increased respiratory Rate
Increased glucose and fatty acids
Increased blood flow to skeletal muscles
Increased heart rate and cardiac output
Increased arterial blood pressure
```
271
A three-stage reaction to stress involving the endocrine an autonomic nervous systems and initiating at the pituitary gland.
GAS (general adaptation syndrome)
272
Three stages of GAS
Alarm reaction
Resistance stage
Exhaustion stage
273
```
Which stage of GAS is this?
Increased:
Blood volume
Blood glucose levels
Epinephrine and Norepinephrine amounts
Heart Rate
Blood flow to muscles
Oxygen intake
Mental Alertness
```
Alarm reaction
274
```
Which stage of GAS is this?
Body repairs damage occurred and the following return to normal:
Heart rate
Hormone levels
Cardiac output
Blood pressure
```
resistance Stage
275
The chronic arousal with the presence of powerful hormones causing excessive wear and tear on a person
Allostatic load
276
When body is no long able to resist the effects of the stressor and has depleted the energy necessary to maintain adaptation.
Exhaustion stage
277
Evaluating an event for its personal meaning
Primary appraisal
278
Focuses on possible coping strategies when an event causes stress
Secondary appraisal
279
A person's effort to manage psychological stress.
Coping
280
Regulate emotional distress and give a person protection from anxiety and stress.
Ego-defense mechanisms
281
When a person experiences, witnesses, or is confronted with a traumatic event and responds with intense fear or helplessness.
PTSD (post-traumatic stress disorder)
282
Traumatic events that lead to PTSD
Motor vehicle crashes
Natural disasters
Violent personal assault
Military combat
283
Crisis that occur as a person moves through life, such as marriage, birth of a child, or retirement.
Developmental Crises
284
Crisis that arise from external sources such as job changes, vehicle accidents, death, or severe illness
situational crisis
285
Crisis that are a result of a major natural disaster, man-made disaster, or crime of violence
Adventitious crisis
286
Frequently results from intense caregiving, and manifests as emotional exhaustion, loss of a sense of personal identity, and feelings of failure.
Nursing Burnout
287
Three primary modes of intervention for stress:
Decrease stress-producing situations
Increase resistance to stress
Learn skills that reduce physiological response to stress
288
A specific type of brief psychotherapy with prescribed steps- more directive than traditional psychotherapy or counseling.
Crisis intervention
289
Carbonic acid is excreted by the...
Lungs
290
Metabolic acid is excreted by the...
Kidneys
291
Signs and symptoms: ECV Deficit
```
SUDDEN WEIGHT LOSS (OVERNIGHT)
NECK VEINS FLAT/COLLAPSING WITH INHALATION (SUPINE)
SLOW VEIN FILLING
DRY MUCOUS MEMBRANES
INELASTIC SKIN TURGOR
ABSENCE OF TEARS AND SWEAT
LONGITUDINAL FURROWS IN TONGUE
COLD CLAMMY SKIN
DARK YELLOW URINE
OLIGURIA (<30ML/HR)
THREADY PULSE
Postural hypotension
tachycardia
```
292
Signs and symptoms: ECV Excess
SUDDEN WEIGHT GAIN (OVERNIGHT)
EDEMA (INCLUDING PULMONARY EDEMA)
NECK VEINS FULL WHEN UPRIGHT
CRACKLES IN LUNGS (DEPENDENT PORTION)
293
Signs and symptoms: Hypernatremia
```
EXTREME THIRST
DRY AND FLUSHED SKIN
FEVER
AGITATION
Postural hypotension
Restlessness
Confusion
Coma
Seizures (if severe/rapid)
```
294
Signs and Symptoms: Hyponatremia
APPREHENSION
HEADACHE
DECREASED LOC
NAUSEA AND VOMITING
295
Signs and Symptoms: Hypokalemia
WEAKNESS OF RESPIRATORY MUSCLES
ABDOMINAL DISTENTION
DECREASED BOWEL SOUNDS
Constipation
296
Signs and Symptoms: Hyperkalemia
BILATERAL MUSCLE WEAKNESS IN QUADRICEPS
TRANSIENT ABDOMINAL CRAMPS AND DIARRHEA
CARDIAC DYSRHYTHMIAS
CARDIAC ARREST
297
Signs and Symptoms: Hypocalcemia
NUMBNESS AND TINGLING OF FINGERS AND CIRCUMORAL AREA
LARYNGOSPASM
Positive Chvostek's and Trousseau's signs
298
Signs and Symptoms: hypercalcemia
```
ANOREXIA
NAUSEA AND VOMITING
PERSONALITY CHANGE
LETHARGY
Constipation
Fatigue
Diminished reflexes
Decreased LOC
```
299
Signs and Symptoms: Hypomagnesemia
```
INSOMNIA
GRIMACING
DYSPHAGIA
TACHYCARDIA
HYPERTENSION
Positive Chvostek's and Trousseau's signs
Hyperactive deep tendon reflexes
Muscle cramps and twitching
Tetany
Seizures
```
300
Signs and Symptoms: Hypermagnesemia
```
BRADYCARDIA
HYPOTENSION
FLUSHING AND SENSATION OF WARMTH
Lethargy
Hypoactive deep tendon reflexes
Flaccid muscle paralysis (if severe)
```
301
Signs and Symptoms: Respiratory Acidosis
```
HEADACHE
DECREASED LOC
WARM AND FLUSHED SKIN
MUSCULAR TWITCHING
Light-headedness
```
302
Signs and Symptoms: Respiratory Alkalosis
NUMBNESS AND TINGLING OF EXTREMITIES AND CIRCUMORAL AREA
HYPERVENTILATION (INCREASED RATE AND DEPTH)
Light-headedness
Excitement and confusion possible followed by decreased LOC
303
Signs and Symptoms: Metabolic Acidosis
DECREASED LOC
ABDOMINAL PAIN
Increased rate and depth of respirations (compensatory hyperventilation)
304
Signs and Symptoms: Metabolic Alkalosis
LIGHT HEADEDNESS
NUMBNESS AND TINGLING OF EXTREMITIES AND CIRCUMORAL AREA
Possible excitement and confusion followed by decreased LOC
305
Causes: respiratory Acidosis
Lung problems
(COPD, pneumonia, asthma, airway obstruction, OSA/CSA, Extensive atelectasis, chest injury, respiratory muscle weakness, fatigue or failure)
*Alveolar Hypoventilation
306
Causes: Respiratory Alkalosis
```
Hypoxemia
Acute pain
Anxiety
Psychological distress
Prolonged sobbing
Inappropriate mechanical ventilator settings
Head injuries, meningitis, gram-negative sepsis, salicylate overdose
*Alveolar Hyperventilation
```
307
Causes: Metabolic Acidosis
Metabolic Issues:
Ketoacidosis (Diabetes, starvation, alcoholism)
Hypermetabolic state (Hyperthyroidism, burns, severe infection)
Oliguric renal disease (kidney injury, end-stage renal disease)
Circulatory shock (lactic acidosis)
Ingestion of acid/acid precursors
Diarrhea
Pancreatic fistula or intestinal decompression
Renal tubular acidosis
308
Causes: Metabolic Alkalosis
```
Excessive administration of Sodium Bicarbonate (NaHCO3)
Massive blood transfusion
Mild or moderate ECV deficit
Excessive or prolonged vomiting
Prolonged gastric suctioning
Hypokalemia
Excess aldosterone
```
