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Test 1 Flashcards

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1
Q

Nursing

A

Assess individual families, communities, to obtain recover and maintain optimum health

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2
Q

Animism

A

Invisible forces and power causing changes in the body

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3
Q

Early- mother figure and remedies
- nurse slaves by priest , temples were hospitals
- shortage of nurses so they used criminals
-Florence.
Upgrade profession
Broadened and viewed and profession

A

Florence - defined nursing as an art and science separate and distinct. Nursing is different from medicine
Standards for hospital mangy. Opennesstraining schools.. wrote books

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4
Q

Nursing as a profession and discipline - what distinguishes nursing

A

Wide variety of settings, specific body of knowledge, research, role in promoting health, knowledge as base

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5
Q

Nurse nutrix = nourish

A

Fosters nourishes and protects and who is prepared to take care of sick injured and aged

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6
Q

Icn definition

A

Calloborative care of all indiv in all settings promotion of health preventing illness care of ill dying. Promo safe env, research, shaping health policy, education

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7
Q

Ana definitions

A

Protection promotion optimization of health, alleviation . Diagnosis, treatment, advocacy for ppl

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8
Q

Aims of nursing

A

Promote health .. educate
Prevent illness… infection control
Retire health… meds and rehab
Facilitate coping

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9
Q

Qsen

A

Patient centered care
Teamwork and collab
Quality improvement
Safety Ebp informatics

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10
Q

4 essential competencies

A

Cognitive ( make sense of world achieve goals)
Technical.. equipment
Interpersonal..relationship and worth
Ethical.. trust moral

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11
Q

Wellness

A

Active state of being healthy by living a lifestyle that promotes health

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12
Q

Health

A

State of optimal function well being in all areas

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13
Q

Health promotion

A

Facilitates decisions about lifestyle increases health awareness teaches self care activities encourages health promotion by providing info and referrals.

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14
Q

Healthy people 2020

A

12 health indicTors guidelines.. increase quality of life , eliminate desparities, social and env to promote, quality of life for all

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15
Q

Preventing illness

A

Maintain optimal functioning, promote good health habits , reduce risk for illness.

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16
Q

Restoring health

A

Measurements and assessments, direct care ( meds , treatments, collab, programs) referring questions to other health care providers planning and teaching

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17
Q

Profession

Discipline

A

Prof: body of knowledge specific and unique , service orientation, authority, code of ethics, sets standards, research, regulation
Discipline:

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18
Q

Lpn

A

Practical nursing, bedside care. 1 yr.

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19
Q

Reciprocity

A

Allowing nurse to practice in other states

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20
Q

Rn

A

Adn, diploma (3 yrs) or Bsn (4 yrs)

NLN competencies: provider or care, manager if care, member of discipline

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21
Q

DNP

A

Doctor of nursing practice .. terminal degree - doctorate

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22
Q

Continuing education

A

Professional development experiences designed to enrich the nurses contribution to health

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23
Q

NP , educator and Anesthsist

A

Masters degree

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24
Q

Midwife

A

Deliver babies, extra program beyond rn

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25
Q

Icn international council of nurses

A

1899- first one found by women, have all the organizations work together

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26
Q

ANA American nurses associations

A

1800’s for RN only public education, clinical standards, lobbying to advance the practice, Eric’s.
scope and standards of practice 2003- define activities specific to. Nursing

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27
Q

NLN national league of nursing

A
  1. To anyone who is interested . Dev and improvement , testing services , research data
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28
Q

AACN - American association of colleges in nursing

A

Bachelors or higher - quality standards, support, research, national accredited.

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29
Q

NSNA national students nurses association

A

1952, for students, rights and issues

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30
Q

Standards

A

Allow nurses to carry out professional roles and protection for them and patients

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31
Q

Nurse practice act

A

Established in each state to regulate practice. Defines legal scope of it.. protect public. Exclude s unlicensed and untrained , creates a state board of nursing , makes rules and enforces, education like cu: continued education credits.

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32
Q

Professional standards

A

Diagnose, outcomes, planning, implementation

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33
Q

Nursing roles

A

Care giver communicator , teacher, counselor , leader, researcher, advocate, care team member , manager

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34
Q

Nursing process

A

Asses, diagnose, plan, implement, evaluate
Major guideline for practice, helps. Nursesimplement their roles, integrates art and science, use critical thinking, areas that are in their domain, inventory strengths and weaknesss.

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35
Q

Trends in nursing

A

Bay boomers.. more older people (demand) not enough supply because ppl are retiring. Technology.. more educated patients questioning things more. Health cRe costs very expensive.

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36
Q

Institute of medicine

A

First time they mentioned it as a profession. Nurses to achieve higher levels of education. Be full partners with doctors, need better data collection and improved info

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37
Q

Critical thinking

A

Analyzes , facts

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38
Q

Communication

A

Verbal and non

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39
Q

Professional behavior

A

Ethics, standards of practice, laws

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40
Q

Management

A

Time, organization

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41
Q

Teaching and learning

A

Promote health

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42
Q

Evidence based culturally sensitive care

A

Nursing is based on the person, practice based on research

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43
Q

Safety

A

Name and date of birth

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44
Q

Knowledge

A

Awareness of reality acquired through learning and investigation

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45
Q

Nurses social policy statement by Ana addresses:

A

Promotion of health, safety and quality care, self care, care coordination, comfort and pain, adaption to physiologic and pathological processes, emotions, meanings, culture, health literacy, decision making, relationships, social policies, effect on health, env, prevention
F

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46
Q

Traditional knowledge

A

Passed on, from ancient like changing bed everyday just something you do , not challenged

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47
Q

Authoritative knowledge

A

From expert and is accepted as truth based on subjective data

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48
Q

Scientific knowledge

A

Obtained from scientific knowledge tested and measured theories

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49
Q

Science

A

Observing, identifying, describing, investigating, explaining events that are perceived in the world

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50
Q

Philosophy

A

Study of wisdom , fundamental knowledge, processes used to dev and contract ones perceptions of life. View point and system of values. Basis for care

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51
Q

Process

A

Series of actions changes functions to bring about a result

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52
Q

Nightingales contributions to nursing knowledge

A

By demonstrating Efficient knowledge about care, defining the practice as separate and distinct, making health. NUsing and illness different

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53
Q

Societal influences on nursing knowledge

A

Early schools followed nightdales knowledge. Doctors were bosses. Based on traditional ideas about following orders, and common sense. No real curriculum just learning from doctor lectures.
The wars made women work more, more independent. Focus on education more. More accepted, philosophy’s all beliefs and knowledge base created.

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54
Q

Theory

A

Composed of a group of concepts that describe a pattern of reality

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55
Q

Conceptual framework model

A

Group of concepts that follows a understandable pattern

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56
Q

Concepts

A

Abstract impressions organized into syllables of descriptive objects , properties and events and relationships

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57
Q

Theories derived from
Deductive reasoning
Inductive

A

Deductive : general idea to specific details

Indicative: specific details to broad idea

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58
Q

Nursing theory

A

Differentiates nursing from other disciplines . Serves purpose of describing, explaining, predicting, and controlling desired outcomes.

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59
Q

General systems theory

A

How to break whole things into parts and how the pats work together

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60
Q

Adaptation theory

A

Adjustment of living matter to other living things and to environment conditions. Continually occurring, effects change and involves interaction and response . Human adaptation occurs on 3 levels: internal self, social others, physical biochem

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61
Q

Developmental theory

A

Outlines the process of growth and dev of humans, as orderly and predictable . Beginning with conception and ending with death. Progress and behaviors of each person in each stage is unique.
Erickson based his theory of psychosocial dev on the process of socialization .. emphasizing how individual learn to interact and environmental factors . Recognized role of social biological and env factors specific conflicts ppl accomplish during the 8 stages

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62
Q

Maslow

A

Theory of human needs . Physical and psychosocial needs considered essential to human life, rather than by age. 5 levels of hierarchy

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63
Q

About nursing theories

A

Theory based nursing directs nurses toward a commmon goal, knowledge base and rationale for reasons better problem solving skills, prepares them to answer questions, identify and define intercorrelated concepts. Should be simple and general and go on research and knowledge

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64
Q

Descriptive

A

Describe a event or situation, or relationship. Further identify properties and components of each

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65
Q

Prescriptive

A

Address nursing interventions and consequences of them deigned to control, promote and change clinical practice.

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66
Q

Common concepts in the theories

A

The patient, the environment, health, nursing.

Each is defined and described by a theorist

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67
Q

Theory in clinical practice

A

Dev and use of nursing theory provide autonomy in the practice value, respect, expert

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68
Q

Research

A

Process that uses observable and verifiable date collected in a systematic manner to describe e or explain or predict events. To improve healthcare promotes autonomy and strength , changing ways, examine quality of care

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69
Q

NIWR

A

Created by Ana . National center for nursing research .. build foundation for practice, prevent disease and disability, manage and eliminate symptoms caused by illness, enhance end of life

70
Q

Quantitive research

A

Concepts of basic and applied research
Basic: designed to generate and Refine a theory not use directly in practice.
Applied: directly influence and improve clinical setting care.

71
Q

Qualitative research

A

Conducted to gain insight by discovering meanings , reality based on perceptions research analyzes words or narratives not numbers. I differ for each person and change

72
Q

Types of qualitative

A

Phenomenology.. describe experiences as they are lived meaning of experience
Grounded theory.. how people describe their own reality and beliefs related to action
Ethnography.. examine issues of a culture that are of interest to nursing
Historical.. examine events and leaders of past to improve nursing practice today

73
Q

Evidence-based practice

A

Problem-solving approach to making clinical decisions using best evidence available and most current collected from published research national standards and guidelines science and art ..best patient outcomes
The information is collected and analyzed and used to answer questions taking into consideration patient preferences and values and clinical experiences of nurse can include specific interventions or quidelines

74
Q

Challenges for using evidence-based practice

A

There is resistance because of nursing sort shortage no change in culture and nurse skill in leading and evaluating. The environment must support changes made based on EBP. Nurses must have knowledge and skill

75
Q

Why use EBP

A

Based on Institute of medicine report that challenge healthcare professionals to provide care based on scientific evidence and cost.. The people funding the programs or hospitals wanted proof that it was working and being implemented ..most hospitals had departments that conducted research within the hospital to answer clinical practice questions. Now information from databases and articles are being used to change the practice EBP analyzes and reviews the information found from literature

76
Q

Steps and implementing EBP

A
  1. Ask a question about a clinical area of interest or intervention the most common is PICO format P is for patient population or problem I is for intervention of interest C is for comparison of interest to another treatment and other Ois for outcome of interestt
  2. Collects most relevant or best evidence level seven is the best systematic reviews evidence-based practical guidelines. Systematic reviews summarize findings from multiple studies of a specific clinical practice questions and topic recommended practice changes and future directions for Research.
    Evidence-based practice guidelines synthesize info from multiple studies and recommend best practices to treat patients with a disease written by a panel
    Meta-analysis use a statistic school and analysis of the effect of a specific intervention across multiple studies
  3. Critically appraise the evidence ask why their results of the study are the results valid and reliable and will the results improve patient care
  4. Integrate the evidence with clinical expertise patient preferences and values in making a decision to change patient should agree with change
  5. Evaluate the practice decision and change important to determine if changes effective and if expected outcomes is because of change
77
Q

Infection

A

Disease state that results from the presence of pathogens in or on the body

78
Q

Pathogen’s

A

Micro organisms capable of causing disease most are bacteria and viruses and fungi (yeast molds) Uncommon ones are protozoa helminths (worms) prions which caused neurological disease

79
Q

HAI : healthcare associated infections nosocomial

A

Infection that has originated from a hospital setting they did not have it before they came in examples are mrsa and cdiff

80
Q

Endemic

A

Disease that occurs with predictability any specific region or population can appear in adifferent geographical location

81
Q

Sources of infection
Exogenous
Endogenous
Latrogenic

A

Exo: acquired from other people
Endo : acquired from within the person
Latro: From treatment procedure or equipment

82
Q

Infection cycle

A
  1. Infectious agent.. bacteria is most significant and most common examples is antibiotics.. viruses can’t be treated by antibiotics they are the smallest agent.. fungi are spores or on the skin which include mold and yeast
  2. Reservoir where it lives it’s natural habitat carriers are asymptomatic it lives in their body
  3. Portal of exit is point of escape it can be mouth nose hands G.I.
  4. Means of transmission direct contact is touching or kissing indirect is from a fomite which is an inanimateobject airborne or droplet by coughing and sneezing
83
Q

Susceptibility

A

Low immune system must overcome his defenses age and HIV are indicators

84
Q

Factors affecting potential disease

A

Number of organisms of same type
Virulence: disease causing ability
Competence of immune system stress decreases it
Length and intimacy of contact between person in microorganism

85
Q

Factors affecting host susceptibility

A

Intact skin and mucous membranes normal pH and white blood cells age sex heredity and immunization fatigue climate nutrition stress and invasive medical equipment

86
Q

Asepsis

A

Absence of disease producing micro organisms using methods to prevent infection

87
Q

A septic technique

A

All activities to prevent or break chain of infection medical is clean and surgical is sterile

88
Q

CDC guideline

A

Standard use for all patients
Transmission used in addition to standard for patients with suspected infection including neutropenic airborne droplets and contact

89
Q

Basic principles of medical a sepsis

A

Practice good hand hygiene use PPE keep soil items and equipment from touching clothes don’t place soiled things on floor avoid raising dust clean Lisa soiled things first Pour liquids down the drain disinfect and sterilize services and equipment follow precautions read and understand policies be aware of occupational safety and health act OSHA guidelines

90
Q

Surgical a sepsis

A

Operating room labor and delivery areas certain diagnostic testing areas and patient bedside for certain procedures

91
Q

Factors affecting safety

A

Development lifestyle mobility sensory perception knowledge ability to communicate physical and psychosocial health state

92
Q

Safety assessment

A

Individual and environmental specific ricks factors factors contributing to Falls are being 65 and over history of them impaired vision and balance altered gait or posture or impaired mobility medications postural hypotension slow reaction time confusion disorientation and unfamiliar environment

93
Q

Restraints

A

Used as last resort they limit movement they include siderails chairs rope you need a doctor order for them you need to document on them check every 15 minutes and remove every two hours a new order is needed every 24 hours

94
Q

Skeletal system

A

Include bones joints and Cartlidge it’s function is to support soft tissues to create body form and posture to protect crucial components such as brain long heart spinal cord to furnish services for attachment of muscles tendons and ligaments to produce movement it is storage area for minerals such as calcium and fat and produce blood cells which is called hematopoiesis
Includes muscle tissue connective tissue and bones and joints movement occurs from skeletal muscle contracting exerting force on tendon which pulls the bone

95
Q

Types of bones they are classified based on the shape

A

Long are upper and lower extremities height and length of person
Short are for movement they are in wrist and ankle
Flat are for shape they are in the ribs and scull
Irregular are all others especially and spine and Jaw

96
Q

Joints articulation

A

Where two bones me they are classified based on how much movement in material is in between

97
Q

Diarthrosis or synovial joint

A

Freely moving types are
ball and socket which are rounded and copped for flexion extension abduction ad duction and rotation examples are and hips and shoulder
Condyloid: oval had a phone fits into a shallow cavity of another for flexion extension abduction and add duction example is in wrist
Gliding: articular surfaces are flat example in carpal bones of wrist and tarsal of feet
Hinge : for like surface of one bone fifth into concave surface of another one only for flexion and extension examples are elbow knee ankle
Pivot: ring like structure that turns on a pivot movement limited to rotation example is fine and head
Saddle phone services are convex on one side and concave on the other four movements of side to side and back-and-forth example is thumb

98
Q

Cartilla genius joints

A

Slightly movable amphiarthrosis

Examples are between pubic sympysis and in between vertebrae’s

99
Q

Fibrous joints

A

Immovable synartgrosis

No joint cavity just fibrous connective tissue between joints examples are: sutures between bones of scull

100
Q

Abduction

Adduction

A

Ab: away from midline of the body
Add: towards the midline of the body

101
Q

Circumduction

A

Moving end of limb in circle

102
Q

Flexion and extension

A

Bending and straightening

103
Q

Hyper extension and dorsiflexion

A

Exaggerated extension and backwards bending

104
Q

Plantar flexion rotation

A

flexion of the foot

105
Q

Internal and next ternal rotation

A

Rotating toward and away and out of body

106
Q

Pronation

A

Lying on stomach and face down

107
Q

Supination

A

Lying on back

108
Q

In version and E version

A

Soul of foot in word at ankle and soul of foot outward at ankle

109
Q

Ligaments

A

Strength and for flexibility tough fibrous bands of connective tissue that vines joints together and connects bones and cartilage

110
Q

Tendons

A

Strong flexible and elastic fibers bands and flatten sheets of connective tissue that attaches muscle to bone

111
Q

Cartledge

A

Hard nonvascular connective tissue found in joins a shock absorber and reduces friction fat is also padding

112
Q

Muscular system

A

Muscle tissue produces movement by contraction of its cells

113
Q

Types of muscle

A

Skeletal works with tendons and bones to move body
Cardiac is bulk of heart and produces contractions
Smooth or visceral: walls of hollow organs like the stomach and intestine and walls of blood vessels and hollow tubes like the ureters

114
Q

Two different muscle point of attachment

A

To stationary bone which is point of origin and two more movable bone which is point of insertion

115
Q

Factors that allow motion maintenance of posture skeletal muscle contraction and heat production

A

Excitability contractibility extensibility and elasticity

116
Q

Nervous system

A

Nerve impulses stimulate muscle to contract

117
Q

Neurons

A

Nerve cells that conduct impulses from one part of the body to another

118
Q

Afferent nervous system

A

Conveys info from receptors in peripheral of the body to the CNS it’s processed by the CNS and leads to a response

119
Q

Efferent nervous system

A

Conveys response from CNS to skeletal muscles by way of the somatic nervous system

120
Q

Good posture and body alignment

A

A line of body parts up permits optimal musculoskeletal balance and operation and promotes healthy physiologic function correct and no strain

121
Q

Balance

A

It is balanced if incorrect alignment with center of gravity and is close to its base of support the line of gravity go through the base of the support object has a wide base of support when standing in the center of pelvis midway between on bellicose and pubis the wider base of support and lower center of gravity means more balance

122
Q

Postural reflexes

A

Group of body reflexes or automatic movements that keep posture and body up right

123
Q

Pastoral tonus

A

Sustained contraction of skeletal muscles that keeps the body up right

124
Q

Types of postural reflexes

A

Labyrinthine sense: sense of position and movement is provided by sensory organs and inner here it is stimulated by body movement and transmits pulses to cerebellum
Proprioscepter or kinesthetic sense: informs brain of location of limb or body part as a result of joint movements stimulates nerve endings
Visual or optic reflexes visual impressions contribute to pasture by altering the person to spatial relationships with environment
Extensor or stress reflexes when extensor muscles are stretched beyond a certain point there stimulation causes a reflex contraction that aids person to reestablish erect posture

125
Q

Body mechanics

A

Application of mechanical laws to the human body in regard to structure function in the position of body is important for a nurse and patient

126
Q

Patient care ergonomics

A

Practice of designing equipment and work tasks to conform to the capability of the worker in relation to patient care use help when you can patient handling tasks are the primary cause of Mus you low skeletal disorders and nurses 47% back injuries variables that lead to this ware uncoordinated lifting and transferring a patient without assistance lifting when fatigued lifting after the recent injury repented of my friends standing for long periods of time transferring patients and repositioning

127
Q

Orthopedics

A

Correction are prevention of disorders of body structures used in locomotion

128
Q

Contractures

A

Permanent contraction of muscle if body isn’t used or exercised

129
Q

Factors affecting movement in alignment

A

Growth development physical and mental health lifestyle variables attitude values fatigue and stress weather

130
Q

Iso metric iso tonic and isokinetic movement

A

Iso metric is contraction without shortening increase muscle mass and holding poses
Isotonic is shortening in active movement improve the mobility
Isokinetic are contractions with resistance resistance is that a constant rate by an X ternal device examples are rehab or lifting weights

131
Q

Aerobic body movement

A

Sustained rhythmic muscle movement that increase bloodflow heart rate metabolic demand for oxygen overtime from a cardiovascular conditioning examples are swimming walking and jogging

132
Q

Stretching movements

A

Isn’t that a lot muscles and joints to be stressed gently through their full range of motion increasing flexibility

133
Q

Strength and endurance

A

Muscle building programs weight training Cal statics there are isometric

134
Q

Exercise effects on cardiovascular system

A

Rhythmic contraction and relaxation of skeletal muscle groups demand oxygen to meet it increase oxygen to skeletal muscle so they heart rate increases contractile strength of my oh Cardium increases stroke volume which is the volume ejected from the heart systolic arterial blood pressure increases what is shunted from non-exercising tissues to the heart and muscle improves venous return

135
Q

Effects on respiratory system

A

Decreased ventilatory effort increased respiratory secretions decreased depth and rate artelectasis: incomplete expansion or collapse of lung tissue for exchange of carbon dioxide and oxygen which upsets the acid-base talents congestion lead to respiratory tract infections hypostatic pneumonia is from immobility decreased movement or thoracic cage from loss of muscle or pressure

136
Q

Effects on musculoskeletal system

A

Atrophy is decreased tone strength joint mobility flexibility demineralization and limited endurance
Contractures and ankylosis: consolidation and mobilization of a joint contractures from atrophy decrease in strength coordination and endurance there permanently closed

137
Q

Osteoporosis

A

Demineralization of bone from stress and strain normally stimulates bone formation and balance of normal bun distraction loss of phosphorus calcium in bone matrix.
Dissusosteoporosis: brittle or spongy bone with two fractures and Deformation
Arthropathy : joint disease from calcium depletion
Renal calculus: kidney sounds excessive secretion of calcium through kidneys and urinary tract

138
Q

Metabolic processes

A

Resting body requires less energy decreased cellular demand. For oxygen fever trauma or illness increases metabolism cannibalism is muscle wasting nitrogen balance and G.I. problems

139
Q

G.I. system

A

Disturbance an appetite decreased food and take off her protein metabolism poor digestion utilization of food increased food decreased exercise equals weight gain constipation poor defecation reflexes

140
Q

Effects on urinary

A

Can use in your readers are level so you’re in remains and pelvis longer increase bacteria leads to UTI also poor hygiene incontinence catheters increase UTI also increased renal calculi which is stones because of increased level of urinary calcium retention and incontinence alkaline urine decrease volume

141
Q

Skin

A

Impaired circulation . break down , pressure ulcers

142
Q

Psychosocial

A

Decrease sense of self self confidence depression not a social change in thought process

143
Q

The nursing process

A

Assessing is interview and physical assessment about mobility and activity nursing history ask about daily activity level mobility problems and fitness goals physical assessment includes mobility general assessment of gate alignment join structure function muscle mass tone strength endurance and normal day activity functionsg
C a TZ ADL index: points for activities bathing dressing toiletry answering continents and feeding six is. Highest and zero is lowest
Diagnosis includes cues indicating potential and a shovel problem I didn’t five the complications and how to fax other areas outcome identification and planning no problems leads to promotion long-term short-term goals to get their problems are preventing more implementing is proper body mechanics to decrease injury erect posture correct alignment all mobility active exercise independently, passive is moving the body part for them evaluating is evaluating effect enough of care plan and hands retain regain mobility

144
Q

Flaccidity

Spasticity

A

Dead nonmoving ….and Stiff

145
Q

Paresis

Paralysis

A

Impaired muscle strength or weakness

Not being able to move that part

146
Q

Hemiparesis

Hemiplasia

A

Weakness on one side

Paralysis of one half of the body

147
Q

Epidermis

A

Composed of layers of stratified epithelium cells these cells fuse to form protective waterproof layer of keratin material these cells have no blood vessels and depend on underlying tissues for nourishment and waste removal it regenerates quickly and easy

148
Q

Dermis

A

Framework of you elastic connective tissue nerves hair follicles glands and blood vessels are located in the slayer each hair consist of a shaft which Pro jacks through the dermis beyond the surface of the skin and hair follicle.

149
Q

Subcutaneous tissue

A

The underlying layer that anchors the skin layers to the underlying tissues of the body may consist of adipose tissue and connective tissue it’s stores fat for energy insulates the body and print Fides cushioning it contains blood and lymph vessels and nerves and fat cells

150
Q

Functions of skin and mucous membranes

A

Protection temperature regulation psychosocial and sensation vitamin D production immunologic absorption and elimination
Mucous membranes align body cavities and they are also in the digestive tract respiratory passages and and urinary and reproductive tracks epithelial covers the mucous membrane surfaces and contains cells that secrete mucus the mucous membranes have receptors seizing and coughing are protective mechanisms that help rid of a foreign materials they also function to absorb substances from their surface

151
Q

Factors affecting skin integrity

A

Normal healthy skin and mucous membranes serve as the first line of defense against harmful agents resistance to injury of the skin varies among people factors including resistance include the age amount of underlying tissues and illness conditions the body needs to be nourished and hydrated so the cells are resistant adequate circulation is also necessary

152
Q

Developmental considerations

A

In young kids the skin is thinner weaker
An infant skin and mucous membranes are injured easily and are subject to infection as the child grows the skin becomes increasingly resistant to injury an infection in older adults they have thin easily damaged skin circulation and collagen formation are impaired decrease elasticity

153
Q

State of health

A

Very thin and very obese people are more susceptible to skin irritation and injury fluid loss through fever vomiting or diarrhea makes people do you hydrated more and the skin more loose and flabby excessive moisture such as perspiration predisposes the skin to break down especially with incontinence jaundice is itchy and dry and more likely to scratch their skin eczema or any disease of the skin can cause lesions

154
Q

Wound

A

Break or disruption in the normal integrity of the skin and tissues that disruption may range from small to third-degree burn they may result from mechanical forces or physical injury

155
Q

Intentional and unintentional wounds

A

Intentional our plans such as invasive therapy or treatment the wound edges are clean and bleeding is usually controlled it was made under sterile conditions and infection is decreased unintentional wounds are by accident the edges are jagged bleeding is uncontrolled and they are at high risk for infection

156
Q

Open and closed wounds

A

And open occurs from intentional trauma the skin surface is broken and has a portal of entry. There is a delay in bleeding tissue damage and infection closed ones are from a blow force or strain this service is not broken but soft tissue is damaged and in ternal injury or hemorrhage may occur

157
Q

Acute and chronic wounds

A

A cute usually heal within days two weeks the wound edges meet close to the skin surface and are not as much of a risk for infection they usually move through the healing process without difficulty chronic one the healing process is delayed the risk of infection is increased they remain in the inflammatory phase of healing

158
Q

Phases of wound healing

Homostasis

A

Homostasis: occurs immediately after the injury blood vessels constrict and blood clotting begins through platelet activation and clustering then They dilate and capillary permeability increases allowing plasma and blood components to leak out into the area forming exudate- debrise and white blood cells and bacteria , the accumulation of this causes swelling and pain. Increase perfusion results in heat and redness if they want a small declot loses fluid and a scab is formed platelets also release substances that stimulate other cells to migrate to the area

159
Q

Inflammatory phase

A

It lasts about 4 to 6 days white blood cells such as leukocytes and macrophages moved to the area leukocytes arrive first and ingest bacteria and cellular debris’s then 24 hours later macrophages and her they are essential to the healing process they ingesta breeze and release growth factors that are necessary for growth of epithelial cells and new blood vessels the growth factors attracts fibroblast that fill in the wound acute inflammation pain heat and redness are common mild temperature increased white blood cells and not feeling good is also common

160
Q

Maturation phase

A

The final stage begins about three weeks after injury and can continue for longer collagen that was deposited is remodeled making it stronger and more like the tissue around it new college and continues to be deposited which compresses the blood vessels so that it turns into a scar scar tissue is less elastic and less strong One is a hero by secondary intention take longer to remodel and for my scar smaller

161
Q

Factors affecting healing

Local factors

A

Visa card directly in the wound thank would pressure desiccation which is dehydration maceration witches overhydration drama Adema infection excessive bleeding necrosis which is death of tissue in the presence of a biofilm a thick grouping of micro organisms.

162
Q

Systemic factors affecting wound healing these occur throughout the body

A

Age the major skin layers arise from different embryologic origins resulting in Port Huron is between the epidermis and dermis this loose finding causes layers to separate easily during an inflammation process epidermal stripping is the unintentional
removal of epidermis with tape
Circulation and oxygen adequate blood flow to deliver nutrients and oxygen and remove local toxins bacteria is essential for healing
Healing also requires adequate proteins carbs fats vitamins and minerals calories and proteins are necessary to rebuild thousand tissue vitamins a and C are essential for epithelialization and collagen synthesis zinc plays a role in proliferation of cells
Corticosteroid drugs require post operative radiation therapy and are at risk for delayed healing it also decreases the inflammatory process radiation depresses bone marrow function. Which decreases leukocytes and increase risk for infection chemotherapeutic agents and paren or stop proliferation of all growing self antibiotic therapy increases risk for secondary or superinfection

163
Q

Infection

A

Results when the immune system fails to control the growth of microorganisms symptoms usually become apparent 2 to 7 days after the injury drainage increased drainage pain redness and swelling and increased body temperature in increased white blood cell count. Delayed healing and discoloration of granulation tissue and chronic wounds pain and delayed healing may be the only symptom it can lead to Osseo Molite us a bone infection or sepsis presence of pathogenic organisms in the blood or tissues

164
Q

Hemorrhage

A

Can be from infection or he Rosian of a blood vessel by foreign body like a drain check during the first 48 hours and no less than every eight hours after if excessive bleeding does occur additional pressure dressings or packing fluid replacement and surgical intervention internal hemorrhage causes the formation of a hematoma or blood clot if the bleeding leads to a large accumulation of blood I can put pressure on surrounding vessels and cause tissue ischemia which is deficiency of blood to an area

165
Q

Dehiscence and evisceration

A

The most serious post operative complications dehiscence is the partial or total separation of one players as a result of excessive stress on ones that are not healed evisceration is the most serious complication of dehiscent’s the wound completely separate with protrusion of this garage through the incisional area obese and mount nourish smokers anticoagulants or infected wounds excessive coughing vomiting or straining increases the chance for this. Increase in flow of fluid from balloons and postoperative days for in five can be a sign if it does occur cover it with sterile towels moisten with 0.9% sodium chloride solution and notify Dr. once it occurs the wound is likely to open if it is in the abdominal area it is a medical emergency. Place the patient in Fowler’s position and cover the exposed contents

166
Q

Fistula

A

Abnormal passage from an internal organ are vessel to the outside of the body or from one internal organ or vessel to another they may be created purposefully but is often the result of an infection that has developed into an abscess the accumulation of fluid applies pressure to surrounding tissues leading to the formation of an unnatural passage increases risk for delayed healing infection and balances and breakdown

167
Q

Pressure ulcer

A

A runes with a localized area of injury to the skin or underlying tissue can be acute or chronic because this pressure most developed one soft tissue is compressed between a bony prominence and an external surface for a long time or one soft tissue undergoes pressure in combination with sheer or friction

168
Q

Factors and pressure ulcer development

A

What vessel collapse caused by pressure then necrosis occurs external pressure and friction and sharing that Taryn and your blood vessels and abrade the top layer of skin
Major predisposing factor is external pressure which leads to a chignon deficiency of blood in a particular area hypoxia which is an adequate amount of oxygen Adema inflammation and necrosis

169
Q

Friction

A

Occurs when two services rub against each other the injury resembles an abrasion it can damage superficial blood vessels directly under the skin a patient who lives on recalled sheets is likely to sustain this type of friction disk and over the elbows in heels is often injured due to this when patients lift themselves up friction burns can also occur on the back when patients are pulled her slid over sheets

170
Q

Shear

A

Results when one layer of tissue slides over another layer sheer separates the skin from underlying tissues the small blood vessel’s and capillaries in the area are stretched and possibly torn resulting in decreased circulation patients who are pulled are more at risk or when they are sitting operate and slide down

171
Q

Pressure all servers stages

A

The first indication is blanching which pale and white this ischemia makes the skin a more paler where the circulation is in adequate when pressure is relieved it is followed by hyperemia which is rabbiting the body floods the area with blood to nourish and remove Wastes. Reactive hyperemia is not a pressure ulcer it should fade between 60 and 90 minutes if the pressure continues after ichemia occurs a pressure ulcer develops
Deep tissue injury is purple or maroon with a localized area of discolored intact skin or blood filled blister
Stage 1: intact with a non-blanchable redness of a localized area usually over a bony prominence
Stage 2: partial thickness loss of dermis a shallow open ulcer
Stage 3: Full thickness tissue loss subcutaneous fat maybe visible but not bone tendon or muscle sloth may be present can be undermined and tunneled
Stage 4: Full thickness tissue loss with exposed bone tendon or muscle swath or eschar maybe present

172
Q

Types of drainage

A

Serous drainage is primarily clear this theorist portion of the blood and from serious membranes it is clear and watery

Sanguineous drainage consist of large numbers of red blood cells and looks like blood bright red drainages indicate of a fresh bleeding or darker drainage indicates older bleeding

Serosanguineous : mixture of serum and red blood cells it is light pink

Purulent : is made up of white blood cells liquefied dead tissue and both dad and live bacterium it is thick has a foul odor and berries and color such as yellow or green

Nursing 101 (4 decks)

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