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101 LEC > 101 FINAL > Flashcards

101 FINAL Flashcards

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1
Q

Different responsibilities of different members of the healthcare team?
Physical therapist?
Occupational Therapist?

A

Physical therapist - musculoskeletal strength and conditioning
Occupational therapist - ADL, how to use and adapt to limitations for daily life

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2
Q

How many years is the RN license in NV good for?
How many hours or credits need to renew license?

A

2 years
30 credits

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3
Q

Where can you find the laws and regulations for nurses in each state?

A

Nurse practice act - defined by state board of nursing

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4
Q

What is an incident report?
When do you fill one out?

A

Incident report is Agency record of unusual occurrence

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5
Q

What are ranges for
PULSE RATE
RESPIRATIONS
BLOOD PRESSURE

A

Pulse - 60-100
Respir - 12-20
Bp 120/80

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6
Q

What is the normal range for blood glucose level?

A

70-100

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7
Q

What are the 4 different ways in which you can normally lose heat?

A

Radiation- exposure to cold
Conduction - lose through contact
Convection - blowing air
Evaporation - sweat

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8
Q

What are the different sites for palpating pulses?

A

Temporal
Carotid -ER
Apical
Brachial - inside elbow
Radial
Femoral - inside thigh
Popliteal - behind knee / bp
Posterior tibial - behind medial maleoulous / ankle
Dorsalis pedis - top of foot between big toe and little toe

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9
Q

Where do you place cuff when taking bp?

A

around upper arm
1 in above antecubital space/elbow

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10
Q

When do you use a diaphragm?
When do you use a bell?

A

Diaphragm - high-frequency sounds
Bell - Low-frequency sounds / murmur

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11
Q

What are the 5 steps of nursing process?

A

Assess
Diagnosis
Plan
Implement
Evaluate

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12
Q

What is the clinical judgment model in relation to ADPIE?

A

ASSESS - Recognize clues
ANALYZE/DIAG - Analyze Clues, Prioritize hypothesis
PLAN - generate solutions
IMPLEMENT - Take action
EVALUATE - Eval outcomes

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13
Q

What is IPPA
What system does not follow this?

A

Inspection
Palpate
Percuss
Auscultate

*abdomen = IAPP

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14
Q

What is the difference between medical asepsis and surgical asepsis?

A

Medical asepsis -not wearing sterile gloves, starting an IV
Surgical asepsis - sterile technique, wearing sterile gloves, inserting a catheter

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15
Q

What is difference between acitve ROM and PASSVE ROM

A

active - ppt able to do it themselves
Passive - ppt being assisted through motions

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16
Q

What does patient autonomy mean?

A

ability to make own decisions

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17
Q

Difference between arterial and venous problems?

A

ARTERY - relief with rest, plae. cynaotic , shiny, pulseless, cool, ISCHEMIC ULCER

VEIN - Relief with walking, brown, red, warm, STATSIS ULCER

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18
Q

What is receptive aphasia?
What is expressive aphasia?

A

Receptive - cant understand what ppl are saying/writing
Expressive - cant talk at all or doesn’t make sense

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19
Q

What is range of glascow coma scale?
What score is coma?

A

1-15
7 or less is coma

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20
Q

What order do you put on PPE and take off?

A

ON: Gown, Mask, Goggles, gloves
OFF: Gloves, goggles, gown, mask

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21
Q

What are the standard precautions?
Airborne?
Droplet?
Contact?

A

Standard - everyone gets. Handwashing PPE
Airborne - TB N95
Droplet - mumps/pertussis. MASK
Contact - CDIFF, gloves

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22
Q

How does blood flow through the heart?

A

Deoxygenated > Veins > RIGHT Atrium> RIGHT ventricle>Pulmonary artery> LUNGS> Pulmonary veins> LEFT atrium> LEFT ventricle>AORTA>arteries>System

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23
Q

What is the natural pacemaker of the heart?

A

SA node

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24
Q

what is the electrical pathway in the heart?

A

SA NODE>AV NODE>BUNDLE of HIS» Purkinje Fibers

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25
What causes the bruit sound in carotid artery?
buildup of plaque. Atherosclerosis
26
What is the z pattern of the heart?
apical, pulmonic, erbs point, tricuspid, mitral
27
Where is S 2 the loudest? and what valves are you hearing?
Closure of Semilunar valves loudest at base end of systole
28
Where is S1 the loudest? and what valves are you hearing?
closure of AV valves loudest at apex - top beginning of systole
29
What is the formula to measure cardiac output?
SvXHR= C/O
30
What are the signs of LEFT sided HEART failure?
Pulmonary congestion, Dyspnea, orthopnea
31
What are the signs of RIGHT sided heart failure?
extremities edema Venous distention
32
what is atelectasis
collapse of aveloi
33
What is the correct technique for listening to lung sounds?
Side to side 18 on back, 10 on front DEEP breathes in and out through the mouth Use diaphragm - high frequency sound
34
What are CRACKLES lung sounds?
Non-musical, popping sound/bubbling Fine: roll hair between fingers by ear Coarse: opening Velcro Due to fluid, mucus or pus
35
What are WHEEZING lung sounds?
High pitched - like whistling Due to airway narrowing/constriction
36
What are STRIDOR sounds?
in trachea High-pitched during inspiration/trachea Due to obstruction of upper airway/narrowing
37
What are RONCHI lung sounds?
Low-pitched, snore-like Due to airway narrowing and secretions
38
What are the 2 different types of advanced directives?
Living Will - a list of all the things you want or dont want done, YES or NO. does not kick in until person cannot tell what Durable Power of Attorney for Health Care - name of person who will make health care decisions if patient cannot make own decisions
39
What are the different ways to do nursing documentation?
ISBARR- DAR
40
What does ISBARR stand for
Identification or intro/ Situation (why calling or telling)- what is going on right now - breathing Background- COPD & surgery Assessment - vital signs Recommendation - breathing treatments repeat (verbal order)
41
What are the risk factors for skin breakdown?
age health nutrition hydration
42
What are the stages of pressure ulcers?
Stage I: redness - skin intact Stage II: skin is broken Stage III: into subQ fat layer Stage IV: damage to muscle - deep into muscle and possibly bone Unstageable: base of ulcer covered by slough and/or eschar in wound bed
43
What are the principles of pressure ulcer therapy?
Protect the wound Provide a moist environment Absorb excess exudate Prevent maceration of wound edges Remove necrotic tissue
44
What are 4 ways we can remove necrotic tissue?
-Autolytic debridement - self/the body natural enzymes to eat away at any dead tissue/ slough -Mechanical debridement - wet to dry dressing (wet gauze/wring out/pack) ./ maggot -Enzymatic debridement - use ointments or creams that have chemical properties / takes days to weeks -Sharp debridement -scalpel
45
What are the 4 types of wound drainage?
Serous - clear Sanguineous - bloody Serosanguineous - watered-down blood Purulent - thick yellow, green, tan, brown
46
What is Dehiscence? Evisceration?
-Dehiscence - when a surgical wound comes apart -- could be from coughing, sneezing, pulling -Evisceration - when contents spill out of a open wound
47
What does the P, QRS, T Wave indicate?
P Wave - atrial depolarization QRS Complex - ventricular depolarization T Wave - ventricular repolarization
48
What is the PR interval?
PR Interval Amount of time for the impulse to travel through the AV node to the bundle of His
49
In relation to oxygenation, what is diffusion? where does it occur?
Exchange of respiratory gases in the alveoli and capillaries (occurs at the alveolocapillary membrane) Moving of molecules (CO₂ & O₂) from an area of higher concentration to an area of lower concentration
50
why would a patient who is hyperventilation develop paresthesia
Hyperventilation causes increased blood pH which causes a decrease in free ionized calcium (Hypocalcaemia), which causes paresthesia
51
What are early signs of hypoxia?
(Mental status ∆’s early sign) Change in LOC Restlessness Apprehension Inability to concentrate Dizziness Behavioral Changes Cyanosis: Late sign of hypoxia
52
What is the proper technique for an incentive spirometer? and whats purpose?
Lips should completely cover mouthpiece Have patient inhale slowly, attempting to reach goal volume Encourage 5-10 breaths per session every hour -Helps prevent atelectasis
53
Whats the different between low floe and high flow oxygen delivery systems?
Low-Flow Systems amount of O2 delivered is variable and depends on the patient’s respiratory rate & breathing pattern Nasal Cannula Simple Mask Nonrebreather High-Flow Systems patient’s entire inspired gas volume is consistently & predictably delivered by the system Venturi Mask
54
What are the normal levels for SODIUM POTASSIUM CALCIUM MAGNESIUM CHLORIDE PHOSPHATE
Sodium: 135-145 mEq/L Potassium: 3.5-5.0 mEq/L Calcium: 8.6-10.2 mg/dL 4.5-5.1 mg/dL (ionized) Magnesium: 1.3-2.3 mEq/L Chloride: 97-107 mEq/L Phosphate: 2.5-4.5 mg/dL
55
What are some signs of HYPO and HYPER volemia?
Hypovolemia Tachycardia Hypotension -Thready Pulse Decreased Skin Turgor Orthostatic Hypotension Dry Mucous membranes Hypervolemia Bounding Pulse Crackles Distended Neck Veins Edema Hypertension
56
what is normal PH PAcO2 HCO2
PH - 7.35-7.45 PAcO2 - 35-45 HCO3 - 22-26
57
What are examples of complete and incomplete proteins?
Complete- meat, animal products, soy Incomplete - beans, legumes
58
What is difference between saturated and unsaturated fats?
Most animal fats are saturated (limit to <7-10% of total calories) Most vegetable fats are unsaturated
59
What is systole? what is Diastole?
Systole - a period of ventricular contraction Diastole - a period of ventricular filling
60
What happens during S1?
AV valves close - beginning of systole blood flows from ventricles into pulmonary artery and aorta
61
What happens during S2?
Close of Semilunar valves- end of systole AV valves open and blood flows from atria into ventricles
62
What is coronary circulation What are the 2 main coronary arteries?
Coronary circulation - circulation into the myocardium Right and left coronary arteries
63
What is creatine phosphokinase (CPK) and troponin?
CPK (CK-MB)- enzyme will increase if MI Troponin - protein gets released when damage to cardiac tissue *Only elevated for a short time after MI
64
How can we treat an arterial occlusion?
Thrombolytic drugs Angioplasty- cardiac catheter/groin/inflate balloon Stent placement
65
How many BPM does SA node, AV node and bundle of his fire off?
SA - 60-100 AV - 40-60 Bundle - 20-40
66
What happens during Polarization, Depolarization and repolarization?
Polarization - K+ leak out of cell/makes it - Depolarization - Inflow of Na+ & Ca+/makes it +//TRIGGERS Contraction Repolarization - Return to resting / makes it -
67
What does the P, QRS, T wave mean?
P - Atrial depolarization QRS - Ventricular depolarization T - Ventricular repolarization
68
What is definition of cardiac output?
Volume of blood pumped by heart each minute
69
Contractility is affected by what 2 things?
-Venous return (starling law)- more volume = more stretch=greater contraction -Inotropic effect - SNS - brain triggered to squeeze harder
70
What is the ejection fraction?
How much blood is ejected out of the left ventricle with each beat AVG for adults is 55-65%
71
What are the 3 steps of respiratory physiology?
-Ventilation - moving gases in and out of lungs -Diffusion - exchange of respiratory gases in alveoli and capillaries -Perfusion- Pumping oxygenated blood into tissues and returning de-ox blood to lungs
72
What is the goal of ventilation for Co2 and O2?
Co2 - 35-45 mmHg O2 - 95-100 mmHg *Brain is triggered by Co2 levels
73
What are the 2 parts of the brain responsible for breathing?
Medulla - automatic/sensitive to narcotics Cerebral cortex - voluntary
74
What is hyperventilation? Caused by...
Excess exhaling of Co2 causes - anxiety, infection, hypoxia, compensation for metabolic acidosis
75
What is Hypoventilation? Caused by..
Decrease in the amount of air entering alveoli Inadequate amount of O2 Caused by an obstruction, atelectasis, too much o2 in COPD
76
Holter monitor/event monitor
Holter - Records for 24 hours Event monitor - 1 month
77
Nasal Cannula Delivers concentration of ? Flow rates from ?
Concentrations 22-44% Flow rate 1/2 to 6L/min *usually admin humidified at 3L
78
2L/MIN of oxygen is what FiO2? *every 1/2 L is what FiO2?
28% every 1/2 L is 2%
79
A simple mask delivers what oxygen concentration? and flows between?
Delivers 40-60% Flows between 5-8L/min
80
Nonrebreather delievers oxygen concentrations of ? and flows from?
Oxygen concentration 80-95% Flows from 10-15L/Min *used for respiratory distress, severe asthma, trauma
81
Venturi Mask Delivers what specific oxygen concentration?
Specific - 24-40%
82
When would you use oropharyngeal suctioning?
When able to cough but unable to clear secretions
83
What is the autonomic bladder?
From injury or disease - just forms urine no control - incontinent
84
What is stress incontinence?
Increased abdominal pressure *Wearing tight clothing *If coughing, sneezing, laugh may cause them to dribble urine
85
What is stress incontinence?
Increased abdominal pressure *Wearing tight clothing *If coughing, sneezing, laugh may cause them to dribble urine
86
Alcohol inhibits the release of
ADH
87
What is the primary organ of bowel elimination?
The large intestine
88
The large intestine extends from
Ileocecal valve to anus
89
What are the functions of the large intestine?
Absorption of water Formation of feces Expulsion of feces
90
What is peristalsis?
Contractions under control of autonomic nervous system *Parasympathetic stimulates movement *Sympathetic inhibits movement
91
How does hypertonic solution work?
Draws water into colon to extend it
92
What kind of solution is saline?
Isotonic
93
What is a colostomy? Stoma? Ostomy?
Colostomy - section of bowel surgically removed Stoma - artificial opening Ostomy - surgical procedure where artificial opening is created

101 LEC (15 decks)

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