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Nursing Exam 4 > Terms and Knowledge > Flashcards

Terms and Knowledge Flashcards

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0
Q

Extracellular fluid is ____ of total body water

A

1/3

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1
Q

Intracellular fluid is ______ of total body water

A

2/3

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2
Q

ECF contains these three divisions

A

Interstitial
Intravascular
Transcellular

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3
Q

Compounds that separate into ions when they are dissolved into water

A

Electrolytes

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4
Q

Needed to maintain and/or regulate fluid balance, nerve impulse transmission, acid-base balance, and cellular chemical reactions.

A

Sodium (Na2+)

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5
Q

Normal sodium level:

A

136-145 mEq/L

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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+)

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7
Q

Normal potassium range:

A

3.5 - 5.0 mEq/L

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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+)

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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+)

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10
Q

The major anion in ECF, always follows sodium, and is regulated through dietary intake and kidneys.

A

Chloride (Cl-)

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11
Q

Major chemical base buffer in body, found in ECF and ICF, and regulated by the kidneys

A

Bicarbonate (HCO3-)

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12
Q

Normal HCO3- (Bicarbonate) Levels:

A

22- 26 mEq/L

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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)

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14
Q

Normal CO2 Levels:

A

22- 30 mEq/L

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15
Q

Normal ABG pH:

A

7.35- 7.45

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16
Q

Normal PaCO2 level:

A

35- 45 mm Hg

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17
Q

Normal PaO2 level:

A

80- 100 mm Hg

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18
Q

Normal O2 Sat.

A

95- 100%

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19
Q

The liquid portion of the blood (plasma)

A

Intravascular fluid

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20
Q

Located between the cells and outside the blood vessels

A

Interstitial fluid

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21
Q

Cerebrospinal fluid, pleural fluid, peritoneal fluid, and synovial fluids that are secreted by epithelial cells.

A

Transcellular fluids

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22
Q

Mineral salts contained in the fluid of the body compartments.

A

Electrolytes

Balance: Cations= Anions

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23
Q

Cations and Anions combine to make ______.

A

Salts

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24
Q

A measure of the number of particles per kilogram of water.

A

Osmolality

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25
Q

A fluid with the same concentration of nonpermeant particles as normal blood.

A

Isotonic solution (Normal saline)

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26
Q

A solution more dilute than blood

A

Hypotonic solution (Sodium Chloride containing- 0.45%)

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27
Q

A solution more concentrated than normal blood.

A

Hypertonic Solution (containing sodium chloride- 3%)

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28
Q

Concentrations of Na+, Cl-, and HCO3- are higher in the ________.

A

ECF

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29
Q

Concentrations of K+, Mg2+, and PO43- are higher in the _______.

A

ICF

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30
Q

Four processes that move water and electrolytes between body compartments to maintain equal osmolality.

A

Active Transport
Diffusion
Osmosis
Filtration

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31
Q

Movement of ions against osmotic pressure to an area of higher pressure, requires energy

A

Active Transport

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32
Q

Passive movement of electrolytes or other particles down the concentration gradient, Higher to lower concentrations. Fluids and Ions move

A

Diffusion

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33
Q

Movement of water (or other solute) from an area of less to one of greater concentration (low- high). Only fluids move

A

Osmosis

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34
Q

Movement across a membrane, under pressure, from higher to lower pressure

A

Filtration

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35
Q

Total fluid balance (Homeostasis) involves:

A

Fluid intake and absorption
Fluid distribution
Fluid output

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36
Q

An inward-pulling force that is caused by particles in the fluid- Greater at venous end

A

osmotic pressure

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37
Q

The force of the fluid pressing outward against a surface- Greater at arterial end

A

hydrostatic pressure

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38
Q

Albumin and other proteins contained in blood; much larger than electrolytes, glucose, and other molecules that dissolve easily.

A

Colloids

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39
Q

An inward-pulling force caused by blood proteins that helps move fluids.

A

Oncotic pressure (colloid osmotic pressure)

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40
Q

Sources of fluid intake:

A

Eating (absorption)
Drinking (Includes ice cream, ice chips, and jello)
IV
Rectal enema
Irrigation (of body cavities able to absorb fluids)

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41
Q

Fluid intake regulation:

A

Thirst (hypothalamus)
Habit
Social reasons

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42
Q

Patients at risk for dehydration related to thirst:

A

Infants
Neurological/psychological problems
Older adults
(Those unable to perceive or communicate thirst)

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43
Q

Movement of fluid among its various compartments

A

Fluid Distribution

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44
Q

Fluid intake range:

A

2200- 2700 mL

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45
Q

Fluid output range: Total

A

2200- 2700 mL

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46
Q

Fluid output range: Skin (insensible and sweat)

A

500- 600 mL

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47
Q

Fluid output range: Insensible (lungs)

A

400mL

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48
Q

Fluid output range: GI:

A

100- 200 mL

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49
Q

Fluid output range: Urine

A

1200- 1500 mL

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50
Q

Fluid output occurs in these four organs (Normal)

A

Skin, Lungs, GI, Kidneys

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51
Q

Abnormal routes of fluid output:

A

Vomiting
wound drainage
Hemorrhage

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52
Q

Fluid output that is not perceived, such as in the skin or the lungs.

A

Insensible (Burns, fever)

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53
Q

Approximately __ to ___ L of fluid moves into the GI tract daily then returns to the ECF.

A

3, 6

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54
Q

Angiotensin II does this:

A 
releases aldosterone from adrenal cortex
increases thirst
causes vasoconstriction (increases BP)
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55
Q

Fluid output is affected by these hormones:

A

ADH
Hormones in the RAAS (Angiotensin system)
ANP

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56
Q

_____ regulates the Osmolality of the body fluids by influencing how much water is excreted in the urine.

A

ADH (antidiuretic hormone)

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57
Q

Factors that increase ADH:

A 
Severely decreased blood volume
Dehydration
Hemorrhage
Pain
Stressors
Medications
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58
Q

Factors that increase RAAS activity:

A

Hemorrhage

Vomiting

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59
Q

Influences how much sodium and water are excreted n the urine.

A

RAAS

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60
Q

Insufficient isotonic fluid in the extracellular compartment

A

ECV deficit

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61
Q

Decreased vascular volume

A

Hypovolemia

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62
Q

Occurs when there is too much isotonic fluid in the extracellular compartment.

A

ECV excess

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63
Q

An imbalance in which the body fluids become hypo or hyper tonic

A

Osmolality imbalance (Hyper or hypo natremia)

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64
Q

Water deficit, loss of relatively more water than salt, or gain of relatively more salt than water.

A

Hypernatremia

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65
Q

Water excess/water intoxication, gain of relatively more water than salt, or loss of relatively more salt than water

A

Hyponatremia

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66
Q

Clinical dehydration is a combination of _________ and ________.

A

ECV deficit and hypernatremia

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67
Q

Release of ADH causes:

A

Increase in volume

excreted from posterior pituitary—> kidney, H2O is returned to the blood, less H2O is excreted in the urine

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68
Q

Release of Aldosterone causes:

A

Increase in volume

Adrenal cortex—> Kidneys, Na+, Cl-, and H2O returned to the blood and K+ and H+ are excreted in the urine

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69
Q

Release of ANP causes:

A

Decrease in volume

Heart—-> kidneys, Na+, Cl-, and H2O are excreted in the urine

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70
Q

ECV volume excess: definition

A

Body fluids increased in volume, but normal tonicity

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71
Q

Hypernatremia: definition

A

Hypertonic (more salt than water)– Loss of relatively more water than salt OR gain of relatively more salt than water

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72
Q

Hyponatremia: Definition

A

Hypotonic (more water than salt)– Gain of relatively more water than salt OR loss of relatively more salt than water

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73
Q

Decreased vascular volume

A

Hypovolemia

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74
Q

Intake of Potassium (K+) (FOODS)

A 
Fruits
Potatoes
Instant coffee
Molasses
Brazil Nuts
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75
Q

Intake of Calcium (Ca2+) (Foods)

A

Dairy Products
Canned fish with bones
Broccoli
Oranges

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76
Q

Intake of Magnesium (Mg2+) (Foods)

A

Dark green leafy vegetables
Whole grains
Mg2+ containing laxatives/Antacids

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77
Q

Phosphate (PO4) Intake (Foods)

A

Milk

Processed Foods

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78
Q

Maintains resting membrane potential of skeletal smooth and cardiac muscle allowing for normal muscle function

A

Potassium

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79
Q

Influences excitability of nerve and muscle cells and is necessary for muscle contraction

A

Calcium

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80
Q

Influences function of neuromuscular junctions and is a cofactor for numerous enzymes

A

Magnesium

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81
Q

Necessary for production of ATP (energy source for metabolism)

A

Phosphate

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82
Q

Which hormones are released when fluid volume is too low?

A

ADH, Aldosterone (RAAS)

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83
Q

Which hormones are released when fluid is in excess?

A

ANP

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84
Q

Electrolyte output occurs in:

A 
Urine
Feces
Sweat
Vomiting
Drainage of tubes/fistulas
-- Must increase intake --
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85
Q

Electrolyte excess occurs in:

A 
Oliguria
Endocrine disorders
Medications
Shift of electrolytes from bone into ECF 
-- Must decrease intake --
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86
Q

Hypokalmeia: definition

A

Abnormally low potassium concentration in the blood

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87
Q

Hyperkalemia: definition

A

Abnormally high potassium ion concentration in the blood

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88
Q

Hypocalcemia definition:

A

Abnormally low calcium concentration in the blood

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89
Q

hypercalcemia definition:

A

abnormally high calcium concentration in the blood

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90
Q

Hypomagnesemia definition:

A

Abnormally low magnesium concentration in the blood

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91
Q

Hypermagnemesia definition:

A

Abnormally high magnesium concentration in the blood

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92
Q

Three processes of acid-base balance:

A

Acid production
Acid buffering
Acid excretion

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93
Q

Laboratory tests of a sample of arterial blood

A

ABGs (Arterial blood gases)

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94
Q

major regulator of fluid output:

A

kidneys

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95
Q

Arises from alveolar hypoventilation

A

Respiratory Acidosis

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95
Q

Arises from alveolar hyperventilation

A

Respiratory Alkalosis

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95
Q

Occurs from an increase of metabolic acid or decrease in bicarbonate

A

Metabolic Acidosis

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95
Q

Occurs from a increase of bicarbonate or a decrease of metabolic acid

A

Metabolic Alkalosis

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96
Q

A pH of greater than 7.45 in an ABG

A

Alkalosis

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96
Q

A pH of less than 7.35 in an ABG

A

Acidosis

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97
Q

Blood administered faster than circulation can accommodate

A

Circulatory Overload

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98
Q

Bacterial contamination of transfused blood components

A

Sepsis

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99
Q

People with these two electrolyte imbalances need bowel management for constipation.

A

Hypokalemia, Hypercalcemia

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100
Q

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

A

order, assessment, baseline, Two, 15

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101
Q

Collection and reinfusion of a patient’s own blood

A

Autologous transfusion

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102
Q

An immune response to transfused blood/blood components

A

Transfusion reaction s

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103
Q

Blood transfusions can be used for these 3 reasons:

A
  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)
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104
Q

Signs of hematoma

A

bruising

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105
Q

Blood enters tissue at venipuncture site

A

Hematoma

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106
Q

Signs of Phlebitis

A

Redness, Inflammation, Heat, Tenderness

*along the course of the vein and can cause thrombophlebitis (blood clots)

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107
Q

Inflammation of the vein resulting from chemical, mechanical or bacterial causes

A

Phelebitis

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108
Q

Signs and symptoms: Extravasation/Infiltration

A

Coolness, paleness, swelling

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109
Q

IV fluid that contains additives enters subcutaneous tissue and cause damage

A

Extravasation

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110
Q

When an IV catheter becomes dislodged or a vein ruptures and IV fluids enter subcutaneous tissue

A

Infiltration

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111
Q

A technique in which a vein is punctured through the skin by a sharp rigid stylet

A

Venipuncture

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112
Q

CRBSI

A

Catheter related bloodstream infection

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113
Q

Enter through a peripheral arm vein and extend through the venous system to the superior vena cava where they terminate.

A

PICC (Peripherally inserted central catheters)

central lines more effective for large volumes of fluid

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114
Q

Catheters or infusion ports designed for repeated access to the vascular system.

A

VADs (Vascular access devices)

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115
Q

Never administer ____ additive IV solution via IV push

A

KCl (Potassium containing)

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116
Q

These solutions have a greater osmolality than body fluids and have higher sodium concentrations; they increase osmolality rapidly and pull water out of cells

A

Hypertonic

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117
Q

These solutions have an osmolality less than body fluids, causing dilution of the body fluid and moving water into cells

A

Hypotonic Solutions

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118
Q

A low osmolality fluid is administered through a _________ catheter.

A

Peripheral

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119
Q

A high osmolality fluid is administered through a _______ catheter

A

Central

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120
Q

Parenteral replacement includes:

A

PN (parenteral nutrition)
IV fluids
Electrolyte therapy (Crystalloids)
Blood/blood component administration (colloids)

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121
Q

Patients who have _____ and very severe _______ require fluid restrictions.

A

Hyponatremia

ECV excess

122
Q

When a patient has diarrhea, fluids containing ____, ______, and have low ______ content are not appropriate .

A

Lactose, Caffeine, Sodium

123
Q

Record _____ the volume of ice chips in I&O.

A

half

124
Q

Oral replacement of fluids is contraindicated when the patient has a mechanical _______ of the GI tract, is at high risk for _________, or has impaired ____________.

A

Obstruction, aspiration, swallowing

125
Q

Hypertonic solutions cause cells to:

A

Shrink, shrivel

126
Q

Hypotonic solutions cause cells to:

A

Expand, Swell

127
Q

Isotonic solutions cause cells to:

A

stay the same size

128
Q

When treating a nursing diagnosis, it is important to treat the: Diagnosis itself or the Related to cause?

A

Related to cause

129
Q

Oliguric Renal Disease, which prevents normal excretion of fluid, electrolytes and metabolic acids, can result in many imbalances. Name 2 of them.

A 
ECV excess
Hyperkalemia
Hypermagnesemia
Hyperphosphatemia
Metabolic Acidosis
130
Q

Physical Assessment for fluid imbalances should always include which three things?

A

Daily weight (1 kg= 1 L of fluid, gained or lost)
I&O measurements
Laboratory Values

131
Q

Due to increased aldosterone secretion, patients with Chronic Heart Failure experience ____________ and an increased risk for _________.

A

ECV excess, hypokalemia

132
Q

Patients with cancer often develop which electrolyte imbalance?

A

Hypercalcemia

133
Q

Head injuries often cause diabetes insipidus OR can cause SIADH which are related to which electrolyte imbalances?

A

Hypernatremia

Hyponatremia

134
Q

Crush injuries often cause which electrolyte imbalance?

A

Hyperkalemia

135
Q

Blood loss (Hemorrhage) from any type of trauma causes which imbalance?

A

ECV deficit

136
Q

Burns place patients at a high risk for which imbalance?

A

ECV deficit

*Patients also often develop metabolic acidosis due to increased cellular metabolism

137
Q

Bacterial pneumonia can lead to which acid-base balance?

A

Respiratory Acidosis

138
Q

Many respiratory disorders predispose patients to which acid-base balance?

A

Respiratory Acidosis

139
Q

Because of increased ADH and Aldosterone secretion, Surgery can increase risk for what imbalances, especially second-fifth postoperative days?

A

ECV excess
Hyponatremia
Hypokalmeia

140
Q

Chronic alcohol abuse is commonly associated with what imbalance?

A

Hypomagnesemia

141
Q

Starvation and diets with high fat and no carbohydrates can lead to which imbalance?

A

Metabolic Acidosis

142
Q

.What environment would increase fluid output, and put a patient at risk for ECV deficit, hypernatremia, and clinical dehydration?

A

Hot Environment (physical work, vigorous exercise in warm environments)

143
Q

What age groups are at greater risk for imbalances?

A

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
Q

Six components of ABGs

A 
pH
paCO2
paO2
O2 Sat
Base Excess
Bicarbonate (HCO3-)
*Blood is taken from the arteries*
145
Q

Most effective way to evaluate acid-base balance and oxygenation

A

ABGs

146
Q

Body fluids decreased in volume with normal tonicity

A

ECV deficit

147
Q

A state of physical, emotional, mental and social well-being in relation to sexuality; not merely the absence of disease, dysfunction or infirmity.

A

Sexual Health

148
Q

The first 3 years of life are crucial to develop…

A

Gender identity

149
Q

Perimenoposal women have issues with:

A

Diminished vaginal lubrication

Decreased vaginal elasticity

150
Q

Dyspareunia

A

Occurrence of pain during intercourse

151
Q

Nonprescription methods for contraception

A

Abstinence
Barrier Methods
Timing of Intercourse

152
Q

Prescription Methods for contraception: Hormonal

A 
Oral pills
Vaginal rings
Hormonal injections
Sub-dermal Implants
Transdermal skin patches
IUDs
153
Q

Prescription methods for contraception: Non-hormonal

A

Diaphragm (must be fitted)
Cervical cap
Sterilization (Tubal Ligation and Vasectomy)

154
Q

Common bacterial/curable STIs

A

Chlamydia
Syphilis
PID
Gonorrhea

155
Q

Common non-curable/Viral STIs

A

HIV
HPV
Genital Herpes

156
Q

Common symptoms of a STI

A

Discharge from Vagina, Penis, or Anus
Pain during sex or when urinating
Blisters or sores in genital area
Fever

157
Q

Primary routes of transmission for HIV

A

IV needles
Anal or vaginal intercourse
Oral sex
Transfusion of blood/blood products

158
Q

Populations at risk for HIV

A

Use of illicit IV drugs and share needles
Hemophilia
Unprotected sexual contact

159
Q

Stage 1 HIV length and symptoms

A

About 1 month after contracting

Flulike symptoms

160
Q

Stage 2 of HIV length and symptoms

A

6weeks- 3 months after infection

No symptoms

161
Q

Stage 3 of HIV

A

AIDS

162
Q

Most common STI in the US

A

HPV

163
Q

Most commonly reported bacterial STI

A

Chlamydia

164
Q

Effects of untreated chlamydia

A

PID
Ectopic pregnancy
Infertility
Neonatal complications

165
Q

Symptoms of chlamydia

A

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
Q

Infertility

A

Inability to conceive after 1 year of unprotected intercourse

167
Q

Cues for possible sexual abuse

A

Extreme Jealousy

Refusal to leave woman’s presence

168
Q

Absence of complete sexual functioning

A

Sexual dysfunction

169
Q

Risk factors for ED (erectile dysfunction)

A 
Diabetes Mellitus
Hyperlipidemia
Hypertension
Hypothyroidism
Chronic Renal Failure
Smoking
Obesity
Alcohol Abuse
Lack of Exercise
170
Q

PLISSIT

A

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
Q

Offer HPV vaccine to patients between ___ and ___ years of age.

A

9, 26

172
Q

The most effective way to diagnose STIs

A

Regular screening (of sexually active individuals)

173
Q

HAART

A

Highly active antiretroviral therapy

-Greatly increases survival time of persons with HIV/AIDS

174
Q

Name the senses

A

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
Q

Stimulation of a receptor such as light, touch, or sound

A

Reception

176
Q

Integration and interpretation of stimuli

A

Perception

177
Q

Only the most important stimuli will elicit

A

Reaction

178
Q

Three Sensory Alteration

A

Sensory deficits
Sensory deprivation
Sensory overload

179
Q

Lacking a normal function of sensory reception and perception.

A

Sensory deficit

180
Q

Turning a better-hearing ear towards a speaker is an example of:

A

sensory deficit

181
Q

Inadequate quality or quantity of stimulation

A

Sensory deprivation

182
Q

Exposure to strange environments, hearing loss, and bed rest can all cause

A

Sensory deprivation

183
Q

Reception of multiple sensory stimuli

A

Sensory overload

184
Q

A patient who is hospitalized in ICU is at risk for

A

Sensory overload

185
Q

Symptoms of sensory overload

A 
Racing thoughts
Scattered attention
Restlessness
Anxiety
Constant fingering of tubes and dressings
186
Q

Sensory risk factors: Infants and children

A

Visual and hearing impairments (genetic, prenatal, and postnatal)

187
Q

Visual changes usually occur…

A

Age 40-50

188
Q

Hearing changes begin at age…

A

30

189
Q

Gustatory and olfactory changes begin around age…

A

50

190
Q

Proprioceptive changes are common after age…

A

60

191
Q

Proprioceptive changes

A

Difficulty with balance
Spatial disorientation
Decreased coordination

192
Q

Meaningful stimuli include

A 
pets
music
tv
pictures
calendars
clocks
*need to be available in hospital setting
193
Q

Assessment of Sensory Alterations includes:

A 
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
Q

Damage to the auditory nerve by antibiotics

A

Ototoxicity

Opiod analgesics, sedatives ,antidepressants

195
Q

Nurses role in Health promotion:

A

Detection
Education
Referral

196
Q

Second leading cause of blindness in the US and primary for African Amerians

A

Glaucoma

197
Q

American Academy of Ophthalmology suggests eye exam with measurement of Intraocular pressure every ___ years for those over ___ years old .

A

2, 40

198
Q

Hearing loss caused by excessive cerumen occluding the ear canal

A

Conductive hearing loss

199
Q

An individual’s view of self.

A

Self- concept

200
Q

A sense of meaning, wholeness, and consistency in a person

A

Identity or Self-awareness (caused by a positive self-concept)

201
Q

Being oneself or living an authentic life

A

Identity

202
Q

Attitudes related to the body- includes physical appearance, structure, or function

A

Body image

203
Q

A wife incorporating “ugly” into her self-concept due to a controlling abusive husband is an example of a changed:

A

body image

204
Q

The way in which individuals perceive their ability to carry out significant roles

A

Role performance (roles include parent, supervisor, friend)

205
Q

An individual’s overall feeling of self-worth or the emotional appraisal of self-concept.

A

Self-esteem

206
Q

Results when people do not maintain a clear, consistent and continuous consciousness of personal identity

A

Identity confusion

207
Q

Individuals who are particularly vulnerable to indentity stressors

A

adolescence

208
Q

A change in appearance, structure, or function of a body part requires an adjustment in:

A

body image

209
Q

When a person has to simultaneously assume two or more roles that are inconsistent, contradictory, or mutually exclusive.

A

Role conflict

210
Q

A middle-age woman with children assumes responsibility of care for her older parents. This is an example of

A

role conflict

211
Q

involves the expectations of others and society regarding how an individual behaves whens sick.

A

Sick role

212
Q

Involves unclear role expectations which makes people unsure about what to do or how to do it, creating stress and confusion

A

Role ambiguity

*common in adolesence and employment

213
Q

When a person feels inadequate or unsuited to a role

A

Role strain

214
Q

A person experiences frustration when having to provide for a family member with Alzheimer’s disease. this is an example of

A

Role strain

215
Q

Having more roles or responsibilities within a role than are manageable.

A

Role overload

216
Q

A person struggles meeting the demands of work, family, and personal time. This is an example of

A

Role overload

217
Q

An awareness of one’s inner self and a sense of connection to a higher being, nature, or some purpose greater than oneself

A

Spirtuality

218
Q

Research shows that spirituality positively affects and enhances:

A

Health
quality of life
health promotion behaviors
disease prevention activities

219
Q

5 Components of Spirituality

A 
Connectedness
Meaning and purpose of life
Inner strength and peace
Transcendence and self transcendence
Faith and hope
220
Q

A sense of authentically connecting to one’s inner self

A

Self-transcendence

221
Q

The belief that a force outside of and greater than the person exists beyond the material world

A

Transcendence

222
Q

One who believes that there is no known ultimate reality

A

Agnostic

223
Q

One who does not believe in the existence of a God

A

Atheist

224
Q

Associated with a specific system of practice associated with denomination, sect, or form of worship

A

Religion

225
Q

Gives an individual motivation and the resources to achieve

A

Hope

226
Q

A system of organized beliefs and worship that a person practices to outwardly express spirituality

A

Religion

227
Q

When a person has something to live for and look forward to

A

Hope

228
Q

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

A

Spiritual distress

229
Q

NDE

A

near death experience- A psychological phenomenon of people who have either been close to clinical death or have recovered after being declared dead

230
Q

HOPE spiritual assessment

A

H Hope- Spiritual Resources
O organized religion
P Personal Spirituality
E effects on care

231
Q

FICA spiritual assessment

A

F Faith or Beliefs
I Importance and Influence
C community
A address

232
Q

Interventions of the Nurse in Spirituality

A 
Establishing presence
Supporting a healing relationship
Diet therapies
Supporting rituals
Prayer
Meditation
Supporting grief work
233
Q

The emotional response to a loss, manifested in ways unique to an individual and based on personal experiences, cultural expectations, and spiritual beliefs.

A

Grief

234
Q

The outward, social expressions of grief and the behaviors associated with loss

A

Mourning

235
Q

Includes the emotional responses and outward behaviours of a person experiencing loss

A

Bereavement (both grief and mourning)

236
Q

Losses that are part of life, eventually replaced by something different or better

A

Necessary loss

237
Q

Form of necessary loss and includes all normally expected life changes across the lifespan

A

Maturational loss

238
Q

Divorce is an example of which type of loss?

A

Necessary Loss

239
Q

A child leaving home for college is an example of which type of loss

A

Maturational loss

240
Q

Sudden, Unpredicatble external events bring about

A

Situational loss

241
Q

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

A

Situational loss

242
Q

Occurs when a person can no longer feel, hear, see, or know a person or object.

A

Actual loss

243
Q

Death of a family member is an example of

A

Actual loss

244
Q

Amputation is an example of which type of loss

A

Actual loss

245
Q

Loss defined by the person experiencing the loss, but is less obvious to others

A

Perceived loss

246
Q

Rejection is an example of which type of loss?

A

Perceived

247
Q

A common, universal reaction characterized by complex emotional, cognitive, social, physical, behavioral, and spiritual responses to loss and death.

A

Normal Grief

248
Q

The unconscious process of disengaging and letting go before the actual loss or death occurs.

A

Anticipatory grief

249
Q

Unsupported grief when relationship to the deceased person is not socially sanctioned, cannot be openly shared, or seems of lesser significance.

A

Disenfranchised grief

250
Q

Death of a pet is an example of

A

Disenfranchised grief

251
Q

Occurs when lost person is physically present but not psychologically available.

A

Ambiguous loss

252
Q

Alzheimer’s is an example of which type of loss?

A

Ambiguous

253
Q

A person has prolonged or significantly difficult time moving forward after a loss.

A

Complicated grief

254
Q

Loss associated with suicide or homicide results in which type of grief

A

Complicated grief

255
Q

Death of a child or sudden death results in which type of grief

A

Complicated grief

256
Q

grief Response that often exhibits self-destructive or maladaptive behaviors, obsessions, psychiatric disorders.

A

Exaggerated grief

** risk of suicide

257
Q

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.

A

Delayed grief

258
Q

Stages of Dying

A 
Denial
Anger
Bargaining
Depression
Acceptance
259
Q

Disruptive behavior as a result of a loss and ineffective grief resolution

A

Masked grief

260
Q

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.

A

Palliative care

261
Q

Primary goal of palliative care

A

To help patients and families achieve the best possible quality of life

262
Q

A philosophy and a model for the care of terminally ill patients and their families.

A

Hospice care

263
Q

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.

A

Place, family, patient, pain, comfort, life, Physical, Psychological, Social, Spiritual

264
Q

Criteria for hospice care

A
  • 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
Q

Name steps on how a nurse helps facilitate mourning (7)

A
  • 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
Q

Physical, emotional, and spiritual exhaustion resulting from seeing patients suffer or frequent, intense, or prolonged exposure to grief and loss.

A

Compassion Fatigue

267
Q

Tension producing stimuli operating within or on any system.

A

Stressor

268
Q

Arousal of the sympathetic nervous system, preparing the person for action

A

Fight or Flight response

269
Q

Three structures that control bodies response to a stressor

A

Reticular formation
Pituitary gland
Medulla oblongata

270
Q

Name some body changes associated with the fight-or-flight response

A 
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
Q

A three-stage reaction to stress involving the endocrine an autonomic nervous systems and initiating at the pituitary gland.

A

GAS (general adaptation syndrome)

272
Q

Three stages of GAS

A

Alarm reaction
Resistance stage
Exhaustion stage

273
Q 
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
A

Alarm reaction

274
Q 
Which stage of GAS is this? 
Body repairs damage occurred and the following return to normal:
Heart rate
Hormone levels
Cardiac output
Blood pressure
A

resistance Stage

275
Q

The chronic arousal with the presence of powerful hormones causing excessive wear and tear on a person

A

Allostatic load

276
Q

When body is no long able to resist the effects of the stressor and has depleted the energy necessary to maintain adaptation.

A

Exhaustion stage

277
Q

Evaluating an event for its personal meaning

A

Primary appraisal

278
Q

Focuses on possible coping strategies when an event causes stress

A

Secondary appraisal

279
Q

A person’s effort to manage psychological stress.

A

Coping

280
Q

Regulate emotional distress and give a person protection from anxiety and stress.

A

Ego-defense mechanisms

281
Q

When a person experiences, witnesses, or is confronted with a traumatic event and responds with intense fear or helplessness.

A

PTSD (post-traumatic stress disorder)

282
Q

Traumatic events that lead to PTSD

A

Motor vehicle crashes
Natural disasters
Violent personal assault
Military combat

283
Q

Crisis that occur as a person moves through life, such as marriage, birth of a child, or retirement.

A

Developmental Crises

284
Q

Crisis that arise from external sources such as job changes, vehicle accidents, death, or severe illness

A

situational crisis

285
Q

Crisis that are a result of a major natural disaster, man-made disaster, or crime of violence

A

Adventitious crisis

286
Q

Frequently results from intense caregiving, and manifests as emotional exhaustion, loss of a sense of personal identity, and feelings of failure.

A

Nursing Burnout

287
Q

Three primary modes of intervention for stress:

A

Decrease stress-producing situations
Increase resistance to stress
Learn skills that reduce physiological response to stress

288
Q

A specific type of brief psychotherapy with prescribed steps- more directive than traditional psychotherapy or counseling.

A

Crisis intervention

289
Q

Carbonic acid is excreted by the…

A

Lungs

290
Q

Metabolic acid is excreted by the…

A

Kidneys

291
Q

Signs and symptoms: ECV Deficit

A 
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
Q

Signs and symptoms: ECV Excess

A

SUDDEN WEIGHT GAIN (OVERNIGHT)
EDEMA (INCLUDING PULMONARY EDEMA)
NECK VEINS FULL WHEN UPRIGHT
CRACKLES IN LUNGS (DEPENDENT PORTION)

293
Q

Signs and symptoms: Hypernatremia

A 
EXTREME THIRST
DRY AND FLUSHED SKIN
FEVER
AGITATION 
Postural hypotension
Restlessness
Confusion
Coma
Seizures (if severe/rapid)
294
Q

Signs and Symptoms: Hyponatremia

A

APPREHENSION
HEADACHE
DECREASED LOC
NAUSEA AND VOMITING

295
Q

Signs and Symptoms: Hypokalemia

A

WEAKNESS OF RESPIRATORY MUSCLES
ABDOMINAL DISTENTION
DECREASED BOWEL SOUNDS
Constipation

296
Q

Signs and Symptoms: Hyperkalemia

A

BILATERAL MUSCLE WEAKNESS IN QUADRICEPS
TRANSIENT ABDOMINAL CRAMPS AND DIARRHEA
CARDIAC DYSRHYTHMIAS
CARDIAC ARREST

297
Q

Signs and Symptoms: Hypocalcemia

A

NUMBNESS AND TINGLING OF FINGERS AND CIRCUMORAL AREA
LARYNGOSPASM
Positive Chvostek’s and Trousseau’s signs

298
Q

Signs and Symptoms: hypercalcemia

A 
ANOREXIA 
NAUSEA AND VOMITING
PERSONALITY CHANGE
LETHARGY
Constipation
Fatigue
Diminished reflexes
Decreased LOC
299
Q

Signs and Symptoms: Hypomagnesemia

A 
INSOMNIA 
GRIMACING
DYSPHAGIA
TACHYCARDIA
HYPERTENSION
Positive Chvostek's and Trousseau's signs
Hyperactive deep tendon reflexes
Muscle cramps and twitching
Tetany
Seizures
300
Q

Signs and Symptoms: Hypermagnesemia

A 
BRADYCARDIA
HYPOTENSION
FLUSHING AND SENSATION OF WARMTH
Lethargy
Hypoactive deep tendon reflexes
Flaccid muscle paralysis (if severe)
301
Q

Signs and Symptoms: Respiratory Acidosis

A 
HEADACHE
DECREASED LOC
WARM AND FLUSHED SKIN
MUSCULAR TWITCHING
Light-headedness
302
Q

Signs and Symptoms: Respiratory Alkalosis

A

NUMBNESS AND TINGLING OF EXTREMITIES AND CIRCUMORAL AREA
HYPERVENTILATION (INCREASED RATE AND DEPTH)
Light-headedness
Excitement and confusion possible followed by decreased LOC

303
Q

Signs and Symptoms: Metabolic Acidosis

A

DECREASED LOC
ABDOMINAL PAIN
Increased rate and depth of respirations (compensatory hyperventilation)

304
Q

Signs and Symptoms: Metabolic Alkalosis

A

LIGHT HEADEDNESS
NUMBNESS AND TINGLING OF EXTREMITIES AND CIRCUMORAL AREA
Possible excitement and confusion followed by decreased LOC

305
Q

Causes: respiratory Acidosis

A

Lung problems
(COPD, pneumonia, asthma, airway obstruction, OSA/CSA, Extensive atelectasis, chest injury, respiratory muscle weakness, fatigue or failure)
*Alveolar Hypoventilation

306
Q

Causes: Respiratory Alkalosis

A 
Hypoxemia
Acute pain
Anxiety
Psychological distress 
Prolonged sobbing
Inappropriate mechanical ventilator settings
Head injuries, meningitis, gram-negative sepsis, salicylate overdose 
*Alveolar Hyperventilation
307
Q

Causes: Metabolic Acidosis

A

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
Q

Causes: Metabolic Alkalosis

A 
Excessive administration of Sodium Bicarbonate (NaHCO3)
Massive blood transfusion 
Mild or moderate ECV deficit 
Excessive or prolonged vomiting
Prolonged gastric suctioning
Hypokalemia
Excess aldosterone

Nursing Exam 4 (2 decks)

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