TEST 6 Flashcards
What are the stages of NREM sleep?
N1 - Light sleep - muscle tone present and breathing regular (1-5mins)
N2 - Deeper sleep - HR and temp drop (25 mins in first cycle and lengthens with each cycle) **Teeth grinding occurs
N3 - Deepest NREM sleep - not easily awoken. Body repairs and regrows tissues, builds bone, muscle and strengthen immune system.
*Sleep walking, night terrors and bedwetting
What happens during REM sleep?
Assoc with dreaming, not considered a restful sleep stage. Skeletal muscles are atonic & without movement. Breathing becomes erratic and irregular. Usually last 90 mins….First period lasts 10 min and adds up
What are the 4 functions of sleep?
-Physiological and psychological restorations
-Preserves cardiac function
-Release of Human growth hormone
-Brain restoration
What are the effects of sleep deprivation?
Irritability
Cognitive impairment
Memory loss
Severe yawning
Hallucinations
ADHD symptoms
Impaired immune system
Risk of Type II DM
^HR
Tremors
AChes
Hypersomnia
Excess sleep that is not restful sleep
Narcolepsy
Just falls asleep in middle of activites
Obstructive sleep apnea
Airway collapes while they are asleep
Parasomnias
Unique sleep disorders
–Sleepwalking
–Sleep eating
–Nightmares
What are some factors that affect sleep?
Medications
Lifestyle
Emotional stress
Environment
Exercise & fatigue
Food and caloric intake
What do you assess for sleep problems?
Description - onset & duration
Usual pattern
illness
Current life events
Mental status
Environement
What are some interventions for sleep problems?
Environment controls - lights, noise
Promote routines
Promote comfort
Stress reduction - no school work before bed
Warm milk
avoid caffeine
What are 2 meds they use for sleep?
Hypnotics - induce sleep
Sedatives - not meant for sleep but has a calming effect
**Effective only a few weeks
What are the functions of body fluids?
-Transports nutrients, hormones, enzymes, blood
-Cellular metabolism and chemical functioning
-Solvent for electrolytes and non-electrolytes
-Maintains body temp
-Digestions and promotes elimination
-Tissue lubricant
Where is most water in the body found?
inside the cell
How much of an adults weight is water?
50-60%
How much fluid is inside and outside the cell?
Intracellular fluid - 70%
Extracellular fluid - 30%
What are solvents & solutes?
Solvents - liquids that hold a substance in a solution
Solutes - substances dissolved in a solation
What are electrolytes?
Charged substance used to conduct electrical impulses across cells//Important for normal body function
Cations are what kind of charge?
Anions are what kind of charge?
Cations - positively charged
Anions - negatively charged
What are the major cations?
Sodium
Potassium
Calcium
Magnesium
What are the major Anions?
Chloride
Phosphate
What is the main function of sodium?
Controls and regulates volume of body fluids
What is the main function of potassium?
Cheif regulator of cellular enzyme activity and water content
What is the main function of calcium?
Nerve impulse, blood clotting, muscle contraction, B12 absorption
What is the main function of Magnesium?
Metabolism of carbs and proteins, vital actions involving enzymes
What is the main action of chloride?
Maintains osmotic pressure in blood, produces hydrochloric acid
What is the main actions of phosphate?
Involved in important chemical reactions in the body, cell division and hereditary traits
aids in bone development, muscle contraction, kidney function, nerve conduction, heartbeat regularity
What are the normal electrolyte levels for Sodium & Potassium?
Sodium - 135-145 mEg/L
Potassium - 3.5-5.0 mEg/L
What are the normal electrolyte levels for Calcium?
Calcium - 8.6-10.2 mg/dl
–4.5-5.1 mg/dl (ionized)
What are the normal electrolyte levels for Magnesium?
Magnesium - 1.3-2.3 mEg/l
What are the normal electrolyte levels for Chloride and Phosphate?
Chloride - 97-107 mEq/L
Phosphate 2.5-4.5 mg/dL
What are the 4 processes by which fluid and solutes move across membranes?
Osmosis -water
Diffusion - higher to lower
Filtration - pressure
Active transport - requires energy/ lower to higher
What is isotonic
hypertonic
hypotonic
Isotonic - same concentration of particles as plasma - NS(0.9% sodium chloride)
Hypertonic - <concentration of particles than plasma
Hypotonic - >concentration of particles than plasma
How is fluid lost in the body
Kidneys: Urine
Intestinal tract: feces
Skin: sweat
lungs: perspiration
What is Hyponatremia & Hypernatremia?
Hypo - Sodium BELOW 135
*Confusion/seizures/hypotension/muscle cramps
Hyper - Sodium ABOVE 145
*Weak/confused/hallucinations/>urine output
What is hypokalemia and hyperkalemia?
**Concerned more with cardiac
HYPO - Potassium BELOW 3.5
*Weak/cramps/fatigue/dysrhythmias
HYPER - Potassium ABOVE 5.0
*Weak/cramps/dysrhythmias, decreased contractility, cardiac arrest
What is hypocalcemia and hypercalcemia?
HYPO - calcium BELOW 8.6
*numbness/tingle of fingers/mouth, tetany, cramps/ CHVOSTEKS & TROUSSEAU
HYPER - ABOVE 10.2
*Nausea,vomit, bone pain, flank pain- kidney stones
What is hypomagnesemia and hypermagnesemia?
HYPO magnesium BELOW 1.3
*weak/tremors/tetany/seizures/mental changes
HYPER - ABOVE 2.3
*nausea/vomit/weakness/lathargy
What is hypophosphatemia? and hyperphosphatemia?
HYPO - Phosphate BELOW 2.5
*Fatique/weakness/confusions/seizure
HYPER - ABOVE 4.5
*Tetany, nausea, weakness
What are acids and bases?
Acids - substances that release hydrogen ions in a solution
Bases - substances that remove hydrogen ions from a solution
What does pH measure?
level of acids and bases in a solution that is determined by the amount of hydrogen ions in the solution
What is normal level for pH, PaCO2, HCO3-
pH - 7.35-7.45
PaCO2 - 35-45mmHg
HCO3- 22-26 mEq/L
Acid/base balance are retain or excreted by?
Lungs - retain/excrete Co2
Kidneys - retain/excrete bicarb
What Respiratory acidosis?
From decreased gas exchange that leads to hypercapnia
-Kidneys compensate
What is respiratory alkalosis?
From hyperventilation and excess exhalation of C02
-Kidneys compensate
What is metabolic acidosis?
Due to loss of bicarbonate ions and or increase in acids produced as byproducts of a metabolic process
What is metabolic alkalosis?
Due to excessive intake of bicarbonate-containing medications or loss of gastric acids
–lungs compensate
What are the organs function to maintain fluids?
KIDNEYS
CARDIOVASCULAR
Kidneys - filter plasma and excrete urine
Cardiovascular - carries nutrients and water
What are the organs function for maintaining fluids?
LUNGS
ADRENAL GLANDS
Lungs - regulate oxygen and carbon dioxide levels
Adrenal glands - conserve (sodium, chloride, water) excrete potassium
What are the organs function to maintain fluids?
PITUITARY GLAND
THYROID GLAND
Pituitary gland - stores and release ADH
Thyroid gland - increases blood flow and increases renal circulation
What are the organs function to maintain fluids?
PARATHYROID GLAND
GI TRACTS
Parathyroid gland - regulate levels of calcium
GI - absorb waster and nutrients
What are the signs of hypovolemia?
Tachycardia
Hypotension
Thready pulse
Decreased skin tugor
Orthostatic hypotension
Dry mucous membranes
What are signs of hypervolemia?
Bounding pulse
Crackles
Distended neck veins
Edema
Hypertension
For weight, a change of 1 kg (2.2lbs) is equal to how much in fluid?
1 L (1000ml) of fluid
What are the functions of the skin?
Protection
Sensation
Vit D production
Elimination
Body temp reg
Psychosocial
what leads to thin, easily damaged skin?
Prolonged maturation of epidermal cells
What are the 3 wound classifications?
Intentional - surgery / Unintentional
Open or Closed
Acute or Chronic
What are the 6 types of wounds?
Incision - a surgical cut
Contusion - bruise
Laceration - tearing of soft tissue, jagged
Abrasion - scrape
Puncture - small hole
Pressure ulcer
What are the 4 phased of wound healing?
- Hemostasis - blood vessels constrict/clot formation
- Inflammatory - WBC, phago
- Proliferation - fibroblast create new granulation - pink/beefy red
- Maturation/remodeling - scar formation
what is desiccation
dehydration
What is maceration?
over-hydration
Fistula?
When a wound goes all the way to an organ
What is dehiscence?
When the edges of a surgical wound separate
What is evisceration?
When internal contents spill out
what are some factors that lead to pressure ulcers?
Aging skin
Chronic illness - circulatory issues
immobility
malnutrition
incontinence
What is serous and sanguineous drainage?
Serous - clear
Sanguineous - bloody
What is serosanguineous and purulent draninage?
Serosanguineous - watered down blood
Purulent - thick yellow, green, tan, brown
What are the 6 stages of pressure ulcers?
stage 1 - persistent redness skin intact
stage 2 - skin is broken
stage 3- into subQ fat layer
Stage 4 - deep into muscle and possible bone
Unstagable - base of ulcer covered by slough
How to document the amount of drainage?
none -
scant -
small - dressing 25% saturated
moderate - dressing is 50%
large - 75-100% saturated
CARBOHYDRATES
- Supplies body with how many kcal?
-Purpose
-Classified as
-4 kilocal per gram
-Major supplier of energy
-Simple - broken down/absorbed quickly
-Complex - longer to break down/absorb
PROTEINS
-Supplies body with how many kcal?
-Purpose
-Classified as
-4kilocal per gram
-Develop, maintenance and repair of bodys tissues
-complete - all 9 essential amino acids
-incomplete - lacking 1 or more amino acids
LIPIDS
-Supplies body with how many kcal?
-Purpose
-Classified as
-9kilocal per gram
-energy, insulation, lubrication, vitamin absorption (DAKE), develop of cell membrane
-Cholesterol - fat like found in animal products
-Triglyceride - abundant found in foods
What kid of fats raises cholesterol levels?
Saturated fats will raise cholesterol levels
What are the water soluable vitamins?
What are the fat soluble vitamins?
Water - C. B
Fat - DAKE
What does Vitamin A do?
Deficiency?
Resistance to infection and night vision
Helps grow epithelial tissue and bones/teeth
*Deficiency can cause night blindness, decreased immunity, impaired growth
What does vitamin D do?
development of bones and teeth
What does Vitamin E do?
Antioxidant that protects cells from free redicals, promotes healthy immune system
WHat does vitamin K do?
essential for synthesis of proteins that promote clotting of blood
*deficiency produces bruising and bleeding
What does Vitmanin C do?
Antioxidant
synthesizing collagen and development of strong immune system
What does vitmanin B do?
Facilitate energy production
Help form RBC
What is water necessary for?
Body temp
Maintaining acid-base balance
Regulating fluid and electrolytes
transporting nutrient and waste
Anabolism
Use of energy to change simple materials into complex body substances
Catabolism
Breaking down of substances from complex to simple resulting in release of energy
Basal metabolic rate (BMR)
Minimum amount of energy required to maintain bodily function at rest while awake
What are the 4 ways to remove necrotic tissue?
-Autolytic debridement - allowing body natural enzymes to eat away dead tissue
-Mechanical debridement - wet to dry dressing, maggots
-Enzymatic debridement - ointment/creams with chemical properties / days to weeks
-Sharps debridement - scapel
What are open system drainage and closed system drainage
Open - Penrose
Closed - jackson pratt & Hemovac
When PaCo2 abnormal? what does that indicate?
lung problem / respiratory
When HCO3 abnormal..what does that mean?
Kidney problem / metabolic
