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NSG 300 7-9 EXAM 11/9 > TOPIC 3 > Flashcards

TOPIC 3 Flashcards

1
Q

body mechanics

A

coordinated efforts of the musculoskeletal and nervous systems

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2
Q

Alignment and balance

A

posture

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3
Q

gravity

A

weight force exerted on the body

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4
Q

friction

A

force that occurs in a direction opposite to movement

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5
Q

skeletal system

A

provides attachments for muscles and ligaments, protects vital organs, aids in calcium regulation

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6
Q

joints

A

Areas where two or more bones join together

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7
Q

ligaments

A

Connect bone to bone

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8
Q

Tendons

A

connect muscle to bone

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9
Q

cartilage

A

strong connective tissue that supports the body and is softer and more flexible than bone

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10
Q

skeletal muscles are…

A

working elements of movement because of their ability to contract and relax (activity practice)

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11
Q

Postural abnormalities

A

can cause pain, impair alignment or mobility to both

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12
Q

Torticollis

A

head tilt due to shortening or spasm of one sternomastoid muscle

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13
Q

lordosis

A

exaggeration of anterior convex of lumbar spine

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14
Q

kyphosis

A

excessive outward curvature of the spine, causing hunching of the back.

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15
Q

scoliosis

A

Lateral S- or C-shaped spinal column with vertebral rotation, unequal heights of hips and shoulders

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16
Q

Congenital Hip Dysplasia

A

Hip instability with limited abduction of hips and occasionally adduction contractures

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17
Q

Knock-knee (genu valgum)

A

Legs curved inward so knees come together as person walks

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18
Q

Bowlegs (genu varum)

A

One or both legs bent outward at knee, which is normal until 2 to 3 years of age

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19
Q

clubfoot

A

95%: medial deviation and plantar flexion of foot (equinovarus) 5%: lateral deviation and dorsiflexion (calcaneovalgus)

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20
Q

footdrop

A

Inability to dorsiflex and invert foot because of peroneal nerve damage

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21
Q

mobility

A

refers to a person’s ability to move about freely

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22
Q

bed rest

A

an intervention that restricts patients to bed for therapeutic reasons

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23
Q

what are the hazards of immobility? (effects of muscular deconditioning?)

A

disuse atrophy
physiological
psychological
social

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24
Q

disuse atrophy

A

tendency of cells and tissue to reduce in size and function in response to prolonged inactivity resulting from bed rest, trauma, casting, or local nerve damage

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25
Q

Immobility: Metabolic Changes

A

-Decreased metabolic rate
-Altered metabolism of carbs, fats, and proteins
-Fluid, electrolyte, and calcium imbalances
-Calcium reabsorption, release of calcium into circulation leads to hypocalcemia with increased chance of renal calculi
-Negative nitrogen balance

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26
Q

calcium reabsorption and immobility

A

immobility causes the release of calcium into the circulation (usually the kidneys excrete calcium but are unable to do so)
so hypercalcemia results

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27
Q

GI system and immobility

A

can cause constipation due to slowing peristalsis

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28
Q

immobility can alter metabolism which alters_______?

A

wound healing

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29
Q

metabolic effects of immobility

A

Endocrine, calcium absorption (hypercalcemia), and GI function(constipation)

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30
Q

Respiratory effects of immobility

A

Atelectasis and hypostatic pneumonia

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31
Q

cardiovascular effects of immobility

A

orthostatic hypotension, thrombus

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32
Q

musculoskeletal effects of immobility

A

loss of endurance and muscle mass, decrease in stability and balance

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33
Q

muscle effects of immobility

A

loss of muscle mass
muscle atrophy

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34
Q

skeletal effects of immobility

A

Impaired calcium absorption
Joint abnormalities

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35
Q

urinary effects of immobility

A

urinary stasis, renal calculi, UTI

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36
Q

integumentary effects of immobility

A

Pressure ulcer
Ischemia

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37
Q

atelectasis

A

collapsed lung; incomplete expansion of alveoli

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38
Q

hypostatic pneumonia

A

inflammation of the lung from stasis or pooling of secretions
-decrease oxygenation and prolonged recovery ass to the patients discomfort

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39
Q

why do respiratory changes happen due to immobility?

A

decline in the patients ability to cough productively
so mucus in bronchi increases (especially in supine, prone and lateral position)
resulting in hypostatic pneumonia

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40
Q

orthostatic hypotension

A

a drop of blood pressure greater than 20 mmHg systolic or 10 mmHg diastolic

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41
Q

increased cardiac workload due to immobility

A

the immobile patients has decreased circulating fluid volume and pooling of blood in the lower extremities
therefore the workload of the heart increases and so does oxygen consumption

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42
Q

thrombus

A

Accumulation of platelets, fibrin, clotting factors, and the cellular elements of the blood attached to the interior wall of a vein or artery, sometimes occluding the lumen of the vessel.

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43
Q

what are the three factors that contribute to venous thrombus formation?

A
  1. damage to vessel wall
  2. alterations of blood flow
  3. alteration in blood constituents
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44
Q

disuse osteoporosis

A

Because immobilization results in bone resorption, bone tissue is less dense or atrophied.

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45
Q

joint contracture

A

an abnormal and possibly permanent condition characterized by fixation of the joint (flexor muscles are stronger that extensor muscles )

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46
Q

urinary stasis and immobility

A

when the patient is recumbent (lying flat) the kidneys and ureters are on a more level plane so gravity is not helping urine into the bladder
so the renal pelvis fills before urine enters the ureters

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47
Q

urinary stasis can cause

A

renal calculi and UTI

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48
Q

renal calculi

A

calcium stones that lodge in the renal pelvis or pass through the ureters (kidney stones)

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49
Q

concentrated urine formation

A

increases risk of calculi and infection

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50
Q

pressure ulcers

A

an impairment of the skin that results from prolonged ischemia (decreased blood supply) in tissues

51
Q

pressure ulcers and inflammation

A

ulcer is characterized initially by inflammation and usually forms over a bony prominence

52
Q

psychological effects of immobility

A

Depression
Anxiety
Hostility
Fear
Isolation
Restriction of self-image and independence
Sensory deprivation
Difficulty sleeping

53
Q

assessment of patient mobility

A

focuses on ROM, gait, exercise and activity tolerance and body alignment
(movement assessment starts while the patient is lying and proceeds to assessing sitting positions, transfer to chair, finally walking)

54
Q

gait

A

a person’s manner/style of walking

55
Q

exercise

A

physical activity for conditioning the body, improving health, and maintaining fitness

56
Q

activity tolerance

A

type and amount of exercise or work that a person is able to perform

57
Q

physiological activity tolerance

A

monitor patients for s/s such as dyspnea, fatigue, chest pain or change in VS

58
Q

emotional activity tolerance

A

people who are depressed, worried, or anxious are frequently unable to tolerate exercise

59
Q

developmental activity tolerance

A

as a person grows older, activity tolerance changes, muscle mass is reduced,
posture and bone composition change,
decreased maxim heart rate and lung compliance

60
Q

sagittal plane

A

vertical division of the body into right and left portions

61
Q

sagittal plane movements

A

flexion and extension

62
Q

frontal plane

A

Divides the body into front and back portions.

63
Q

frontal plane movement

A

abduction and adduction

64
Q

transverse plane

A

horizontal division of the body into upper and lower portions

65
Q

transverse plane movement

A

pronation, supination

66
Q

planning and immobility.

A

develop plan and goals and expected outcomes in achieving his or her highest level of mobility and reducing hazards of immobility
individualize plan for the patients developmental stage, level of health and lifestyle

67
Q

health promotion for immobility

A

education and early detection
prevent work related musculoskeletal injuries
exercise
bone health in patients with osteoporosis

68
Q

implementation of acute care; metabolic

A

Provide high-protein, high-calorie diet with vitamin B and C supplements

69
Q

implementation of acute care; respiratory

A

-cough and deep breathe every 1 to 2 hours
-provide chest physiotherapy

70
Q

implementation of acute care; cardiovascular

A

reducing orthostatic
reducing cardiac workload
preventing thrombus formation

71
Q

implementation of acute care; integumentary

A

reposition every 1 to 2 hours
provide skin care

72
Q

implementation of acute care; elimination system

A

-provide adequate hydration
-serve a diet rich in fluids, fruits, vegetables, and fiber

73
Q

what is trochanter roll used for

A

prevents external rotation of the hips when a patient is in a supine position

74
Q

how is trochanter roll implemented?

A

fold cotton towel length wise to a width that extends from greater trochanter of the femur to lower border of popliteal space

75
Q

hand roll

A

roll placed in the hand to prevent hand contraction

76
Q

trapeze bar

A

allows the client to pull with the upper extremities to raise the trunk off the bed, assist in transfer, or to perform exercises
increases independence

77
Q

supported fowlers

A

the head of the bed is elevated 45 to 60 degrees, and the patient’s knees are slightly elevated without pressure to restrict circulation in the lower legs

78
Q

supine

A

lying face up

79
Q

prone

A

lying face down

80
Q

side-lying

A

patient rests on the side with the major portion of body weight on the dependent hip and shoulder

81
Q

Sims position

A

patient places the weight on the anterior ileum, humerus, and clavicle

82
Q

when moving a patient….

A

safety is first priority
ask patient to help as much as possible
determine if patient comprehends what is expected
determine patients comfort level
determine if you need assistance moving the patient

83
Q

what is the importance of hygiene?

A

is good for infection prevention

84
Q

proper hygiene care requires an understanding of the anatomy and physiology of…

A

skin, nails, oral cavity, eyes, ears, and nose

85
Q

to resist injury and disease cells require…

A

adequate nutrition, hydration, and circulation

86
Q

what are the functions of skin

A

Protection, secretion, excretion, temperature regulation, and sensation

87
Q

epidermis

A

shields underlying tissue against water loss and injury and prevent entry of disease-producing microorganisms.
-Bacteria commonly reside on the outer epidermis

88
Q

dermis

A

contains bundles of collagen, nerve fibers, blood vessels, sweat glands, sebaceous glands, and hair follicles

89
Q

subcutaneous tissue

A

Lies just beneath the skin; contains blood vessels, nerves, lymph, and loose connective tissue filled with fat cells

90
Q

sebaceous glands secrete

A

sebum

91
Q

sebum has

A

bactericidal action

92
Q

disease of the nail has what characteristics?

A

changes in the shape, thickness, and curvature of the nail

93
Q

foot pain can cause..

A

change in the patients gait causing strain other muscles and joints

94
Q

Medications, exposure to radiation, and mouth breathing can cause

A

impaires salivary secretions (often dry mouth)

95
Q

xerostomia

A

dry mouth

96
Q

gingivitis

A

inflammation of the gums

97
Q

dental caries

A

tooth decay

98
Q

what are the functions of saliva?

A

-cleanses the mouth
-dissolves food chemicals to promote taste
-moistens food to facilitate bolus formation
-contains enzymes that start the breakdown of starchy foods.

99
Q

what can affect hair characteristics

A

Hormonal changes, nutrition, emotional stress, physical stress, aging, infection, and other illnesses

100
Q

why is individualized hygiene care important?

A

Because no two individuals perform hygiene care in the same manner, patient care is individualized on the basis of learning about his or her unique hygiene practices and preferences.

101
Q

During hygiene, assess:

A

-emotional status
-health promotion practices
-health care education needs

102
Q

social practices and hygiene

A

Social groups influence hygiene preferences and practices, use of hygiene products used and the nature and frequency of personal care practices.

103
Q

body image and hygiene

A

Surgery, illness, or a change in emotional or functional status often affects a patient’s hygiene

104
Q

socioeconomic status and hygiene

A

resources may not be available to attain hygiene

105
Q

developmental stage: adult and hygiene

A

bathing practices and environmental exposure determine driness/hydration of the skin
skin loses resiliency with age

106
Q

physical condition and hygiene

A

Discomfort and pain, emotional stress, and fatigue diminish the ability or desire to perform hygiene self-care and require extra effort to promote hygiene and grooming.

107
Q

assessment and hygiene

A

-Explore a patient’s viewpoint regarding hygiene care asking them about preferred practices
-Assess a patient’s physical and cognitive ability to perform basic hygiene measures.
-Perform an assessment of the skin, feet, nails, oral cavity, eyes, nose, ears

108
Q

Nursing Diagnosis for hygiene

A

o Activity intolerance
o Bathing self-care deficit
o Dressing self-care deficit
o Impaired physical mobility
o Impaired oral mucous membrane
o Ineffective health maintenance
o Risk for infection

109
Q

what is important when performing hygiene measures on a patient?

A

reduce the patient’s anxiety and promote comfort and relaxation.
o A soft, gentle voice while conversing with patients relieves fears or concerns.
o Some patients fear pain or are frightened about falling or sustaining injury associated with hygiene care.

110
Q

always use _______ during hygiene instruction to confirm patients understanding

A

teach back

111
Q

Therapeutic: sitz, medicated

A

A sitz bath cleans and reduces pain and inflammation of perineal and anal areas.

112
Q

complete bed bath, shower

A

-A complete bed bath often exhausts a patient.
-Assessing heart rate before, during, and after the bath provides a measure of a patient’s physical tolerance.
-In a shower, implement safety measures to prevent fall injuries.

113
Q

partial bed bath

A

-Provide a partial bed bath to patients who are aging, dependent, in need of only partial hygiene, or bedridden and unable to reach all body parts.

114
Q

Soap and water vs. Chlorhexidine Gluconate (CHG)

A

The use of Chlorhexidine Gluconate (CHG) 4% solution in place of standard soap and water in wash basins has been shown to decrease bacterial growth in basins and reduce critical care unit acquired methicillin-resistant Staphylococcus aureus.

115
Q

perineal care

A

Patients most in need of perineal care include those at greatest risk for acquiring an infection. Encourage patients to perform their own perineal care.

116
Q

bath guidelines

A
  1. Provide privacy
  2. Maintain safety
  3. Maintain warmth
  4. Promote independence
  5. Anticipate needs
117
Q

Patients with decreased levels of consciousness

A

need special attention because they often do not have a gag reflex. Proper oral hygiene requires keeping the mucosa moist and removing secretions that contribute to infection.

118
Q

When providing oral hygiene to an unconscious patient

A

you need to protect him or her from choking and aspiration.

119
Q

stomatitis

A

inflammation of the mouth

120
Q

what can stomatitis cause

A

burning, pain, and change in food and fluid tolerance.

121
Q

denture care

A

-Everyday cleaning to help maintain good dental health.
-Keep dentures covered in water when they are not worn
-Store in an enclosed, labeled cup with the cup placed on patient’s bedside stand

122
Q

braiding

A

· helps to avoid repeated tangles; however, patients need to unbraid hair periodically and comb it to ensure good hygiene.

123
Q

shave the hair in

A

direction of hair growth

NSG 300 7-9 EXAM 11/9 (10 decks)

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