Test Five Flashcards
Signs and Symptoms of Pain
Grimacing, restlessness, increased heart rate, increased blood pressure, crying, guarding of painful area, decreased activity.
Example sentence: The patient was grimacing and crying, indicating signs of pain.
Nursing Measures for Comfort and Pain Relief
Administering medications, positioning for comfort, applying heat/cold, therapeutic touch, distraction techniques.
Additional information: These measures aim to provide comfort and alleviate pain for the patient.
Define Pain
Unpleasant sensory and emotional experience linked to actual or potential tissue damage.
Example sentence: The patient described the pain as sharp and located in the lower back.
Define Comfort
State of physical ease, psychological well-being, feeling safe, meeting personal needs.
Additional information: Comfort is essential for promoting healing and overall well-being.
Safety Rules for Oxygen Therapy
Correct flow rate, no open flames/smoking, monitor for oxygen toxicity, secure tanks, educate patients.
Example sentence: Always ensure that oxygen tanks are securely stored to prevent accidents.
Define Apnea
Temporary cessation of breathing, especially during sleep.
Example sentence: The patient experienced episodes of apnea during the night.
Define Cyanosis
Bluish discoloration due to deoxygenated hemoglobin in blood.
Example sentence: The nurse noticed cyanosis in the patient’s lips, indicating a lack of oxygen.
Define Dyspnea
Difficulty or discomfort in breathing, often described as shortness of breath.
Additional information: Dyspnea can be a symptom of various respiratory conditions.
Define Sputum
Mucous coughed up from the respiratory system.
Example sentence: The nurse collected a sputum sample for analysis.
What can a nurse aide assist with? (Oxygen Therapy through Nasal Cannula)
Ensuring cannula comfort and placement.
Additional information: Nurse aides play a crucial role in ensuring patient comfort and safety.
What a nurse aide should NOT assist with? (Oxygen Therapy through Nasal Cannula)
Adjusting oxygen flow or equipment.
Additional information: Only qualified healthcare professionals should adjust oxygen settings.
Areas a nasal cannula may irritate and comfort promotion
Ears and nostrils; ensure proper fit, use padding, and keep nasal passages moist.
Example sentence: The nurse applied padding to prevent irritation from the nasal cannula.
Temperature Sites and Normal Body Temperatures
Oral (95.9-99.5), rectal (97.9-100.2), axillary (97.8-99.5).
Additional information: Different temperature sites may yield slightly different readings.
Taking a Radial Pulse
Feel wrist (thumb side), count beats for 60 secs or 30 secs x 2, normal rate 60-100 beats/min.
Example sentence: The nurse found the patient’s radial pulse to be within the normal range.
Counting Respirations
Watch chest rise, count breaths for 60 secs, normal rate 12-20 breaths/min.
Example sentence: The patient’s respiratory rate was slightly elevated at 22 breaths per minute.
Factors affecting Blood Pressure
Age, gender, stress, exercise, medications, obesity, smoking, medical conditions.
Additional information: These factors can influence blood pressure readings.
Guidelines for Measuring Blood Pressure
Patient seated, feet flat, arm supported at heart level, quiet environment, wait 5 mins before measurement.
Example sentence: The nurse followed the guidelines for measuring the patient’s blood pressure accurately.
Measuring Blood Pressure
Inflate cuff, note systolic (first sound) and diastolic (last sound) pressures in mmHg.
Example sentence: The nurse recorded the patient’s blood pressure as 120/80 mmHg.
Bradycardia
Slow heart rate (<60 beats/min).
Example sentence: The patient’s bradycardia required further monitoring by the medical team.