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NURS 356 > Week 13: Pain & Sensory Alterations, Oxygenation, Elder Abuse, Healthcare Economics > Flashcards

Week 13: Pain & Sensory Alterations, Oxygenation, Elder Abuse, Healthcare Economics Flashcards

1
Q

what is healthcare economics

A

behavioral science that addresses how to allocate limited resources

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2
Q

biggest source of hospital expense is what?

A

personnel (59%) (paying staff etc)

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3
Q

new grads cost ___ to train while experienced nurses cost ___

A

50k, 10k

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4
Q

what is a DRG?

A

diagnosis resource group. linked to fixed payment amount based on the type of treatment given

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5
Q

what is the most expensive hospital unit to run?

A

ICU

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6
Q

what is the most common and expensive service of healthcare deliver system?

A

disease management

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7
Q

what is the cheapest area of healthcare services?

A

restorative care (rehab, nursing homes, home health)

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8
Q

what is continuing care?

A

hospice, nursing homes.

patients w disease process that won’t get better, and are functional dependent or disabled.

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9
Q

what are the mechanisms of oxygenation?

A

ventilation, perfusion, and transport of respiratory gasses

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10
Q

when you oxygenate, ___ goes in and ___ goes out

A

O2, CO2

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11
Q

what is ventilation

A

process of moving gasses into and out of lungs

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12
Q

what is perfusion

A

ability of cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood back to the lungs

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13
Q

what is diffusion

A

exchange of respiratory gasses in alveoli and capillaries

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14
Q

what is included in the work of breathing

A

inspiration, expiration, surfactant, atelectasis, accessory muscle use, lung compliance, airway resistance

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15
Q

what is surfactant

A

substance to maintain alveoli surface tension and stop collapse

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16
Q

what is atelectasis

A

when alveoli collapse.

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17
Q

what is lung compliance

A

ability of lungs to expand

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18
Q

what is airway resistance

A

the diameter of airway decreasing from mouth to alveoli

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19
Q

what is tidal lung volume

A

amount of air you can inhale

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20
Q

what is residual volume

A

amount of air left after full expiration

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21
Q

what is forced vital capacity

A

max amount of air that can be removed during forced expiration

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22
Q

what can influence ability of blood to carry oxygen

A

amount of dissolved oxygen in plasma, amount of hemoglobin, binding ability of hemoglobin

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23
Q

how much CO2 is transported in blood and plasma?

A

75% and then 25%

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24
Q

how is respiration regulated?

A

neurally and chemically

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25
Q

neural regulation includes

A

CNS and cerebral cortex regulation

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26
Q

chemical respiration regulation includes

A

chemoreceptors sensing chemical changes in blood.

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27
Q

factors affecting oxygenation

A

decreased oxygen carrying capacity (anemia, toxic inhalation) , hypovolemia, decreased oxygen concentration, increased metabolic rate

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28
Q

conditions affecting chest wall movement

A

pregnancy (less real estate due to fetus), obesity (sleep apnea, increased breathing work, less lung volume), musculoskeletal changes (trauma, neuromuscular disease, CNS alteration)

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29
Q

Chronic disease can ___ oxygenation

A

decrease (lung disease, barrel chest or overinflation, hypoxemia)

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30
Q

what is cyanosis?

A

elite hypoxia (end stage)

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31
Q

what is invasive ventilation?

A

artificial airway (tube down nose or throat) or surgical intervention such as tracheostomy and then put them on a ventilator.

32
Q

what is noninvasive ventilation

A

purpose to maintain positive airway pressure usually through a mask (CPAP or BiPAP)

33
Q

what is a chest tube?

A

tube put in used to drain something (usually a drainage system)

34
Q

what are chest tubes used for?

A

pneumothorax (air buildup causing collapse) or hemothorax (buildup of blood causing collapse

35
Q

special considerations for chest tube

A

they are a closed system, constant bubbling indicates leak in system

36
Q

what category makes up the majority of elder abuse victims?

A

females. around 6 in 10 clients that are mistreated are female.

37
Q

what does the law in Arizona state regarding abuse

A

illegal to abuse, neglect, or exploit a vulnerable adult.

38
Q

if you suspect or are informed of abuse you must ____

A

report it, or face up to 1000 in fines and 6 days in jail

39
Q

why does abuse grow?

A

police and prosecutors do not place priority. abusers often know the victim, elderly victims often make poor witness

40
Q

what is physical abuse?

A

any infliction of physical pain/injury or physical restraint that causes these

41
Q

what other things can cause physical abuse?

A

over/under medication and unexpected deterioration.

42
Q

what is sexual abuse?

A

non consensual sexual contact of any kind with an elderly person or any person incapable of giving consent.

43
Q

what is psychological or emotional abuse?

A

infliction of mental pain, anguish, or distress through verbal or non verbal acts

44
Q

what is financial/material abuse

A

illegal or improper use of funds, property, or assets.

45
Q

what is neglect? (passive and active and self)

A

failure or refusal to fulfill any part of a persons obligations or duties to an elderly person

(active= intentional failure or refusal)
(passive= unintentional failure or refusal to care) 
(self= elder's behaviors result in threat to their own health)
46
Q

what is abandonment

A

desertion of elderly person by an individual who has physical custody of elder or who has assumed responsibility for their care

47
Q

what is nociception

A

noxious stimuli perceived as pain

48
Q

what is neuropathic pain

A

pain that is initiated or caused by a primary lesion or dysfunction in nervous system

49
Q

what is acute pain

A

pain lasting less than 3-6 months and directly related to tissue damage

50
Q

what is chronic pain

A

pain lasting at least 12 weeks. can be sharp or dull, occur in nearly any part of body

51
Q

what is chronic episodic pain

A

pain coming on quickly and severely at irregular intervals

52
Q

what is cancer pain

A

results from treatment of cancer or the cancer itself

53
Q

what is somatic pain

A

pain receptors in tissues are activated

54
Q

what is visceral pain

A

pain stemming from organs

55
Q

what is referred pain

A

pain that is felt in a different area from its actual source

56
Q

what is neuropathic pain

A

damage or disease to the somatosensory nervous system that then causes pain

57
Q

what is idiopathic pain

A

pain of unknown origin

58
Q

when is the FLACC scale used?

A

for non verbal patients (babies, those that are unconscious or unresponsive)

59
Q

what is PQRSTU pain assessment

A

provokes (what causes or makes worse)
Quality (what does it feel like, sharp, dull, stabbing)
Radiates (does it radiate or go anywhere else)
Severity (0-10 scale or faces scale)
Time (when did it start, how long did it last)
understanding (how does the pain effect you)

60
Q

what are some physiologic indicators of pain?

A

increased HR, change in respiratory pattern or rate, increase in BP, decrease in SpO2

61
Q

what are some “weird” pharmacologic drugs used for pain? (specifically in neuropathic pain)

A

antidepressants and anticonvulsants

62
Q

what is pseudo addiction?

A

patient is so desperate because pain is not being relieved that they exhibit addictive signs

63
Q

what is visually impaired

A

20/50 or worse

64
Q

what is legally blind

A

20/200 or worse

65
Q

what is totally blind

A

no light perception

66
Q

what does cataracts look like

A

halos and glare in the vision

67
Q

what does presbyopia look like

A

close objects appear blurry

68
Q

what does macular degeneration look like

A

dark spots in the central vision

69
Q

what does glaucoma look like

A

loss of periphery, tunnel vision

70
Q

what does diabetic retinopathy look like

A

number of dark patches/splotches in the vision

71
Q

what does hypertensive retinopathy look like

A

number of dark patches/splotches in the vision

72
Q

what is conductive vs sensorineural hearing loss

A

problem in transferring soundwaves in the ear outer and middle vs. damage to inner ear/nerves

73
Q

what is presbycusis

A

gradual loss of hearing

74
Q

what is central auditory processing disorder

A

disorder affecting disability to understand speech

75
Q

what is Menieres disease

A

effects membranous labyrinth of the inner ear, causing progressive deafness and attacks of tinnitus and vertigo

76
Q

what is expressive (motor/brocas) aphasia

A

difficulty talking

77
Q

what is receptive (sensory/wernickes) aphasia

A

difficulty undestanding and putting coherent/fluent sentences together

NURS 356 (6 decks)

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