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HLSC 116 > 50B FINAL! > Flashcards

50B FINAL! Flashcards

1
Q

IgA function

A

“Secretory” antibody that is present in high concentrations in the secretions of mucous membranes and in the intestinal mucosa

Very low circulating levels

Most responsible for preventing infection in the upper and lower respiratory, GI, GU tract

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2
Q

IgD function

A

Present in low blood concentrations in conjunction with IgM

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3
Q

IgE function

A

Variable concentration in blood

Associated with antibody-mediated hypersensitivity reactions

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4
Q

IgG function

A

75% of circulating antibody population

Heavily expressed on second and subsequent exposures to antigens to provide sustained. long-term immunity against invading microorganisms

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5
Q

IgM function

A

FIRST antibody formed by a newly sensitized B lymphocyte plasma cell

10-15% of circulating antibody population

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6
Q

5 manifestations of inflammation

A

redness, warmth, swelling, pain, loss of function

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7
Q

Inflammation leukocytes:

A

Neutrophil

Macrophage

Monocyte

Eosinophil

Basophil

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8
Q

Antibody-mediated immunity leukocyte:

A

B-lymphocyte

Plasma cell

Memory cell

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9
Q

Cell- mediated immunity leukocyte:

A

helper/inducer T-cell

Cytotoxic/cytolytic T-cell

Natural killer cell

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10
Q

WBC count

A

10,000 MM3

100%

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11
Q

Bands count

A

500 MM3

5%

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12
Q

Mono count

A

300 MM3

3%

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13
Q

Lymphs count

A

2800 MM3

28%

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14
Q

Eosins count

A

150 MM3

1.5%

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15
Q

Basos count

A

50 MM3

0.5%

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16
Q

Neutrophil function:

A

provides protection after invaders, especially bacteria, enter the body

destroy by phagocytosis and enzymatic digestion

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17
Q

Self-tolerance:

A

Recognizing self v non self which is necessary to prevent healthy body cells from being destroyed along with invaders

Self tolerance is possible because of different proteins present on cell membranes

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18
Q

HLA’s are

A

found on the surface of all body cells of that person and serve as a universal product code for that person

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19
Q

Antigens are

A

proteins capable of stimulating an immune response

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20
Q

Source of all blood cells, including most immune system cells

A

bone marrow which produces immature undifferentiated cells called stem cells

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21
Q

3 processes needed for human protection through immunity

A

inflammation

antibody mediated immunity

cell mediated immunity

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22
Q

3 examples of inflammation without infection

A

joint sprain injuries

myocardial infarction

blister formation

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23
Q

Segs count

A

6200 MM3

62%

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24
Q

Creatinine clearance for men

A

107-139 ml/min

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25
Q

Creatinine clearance for women

A

97-107 mL/min

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26
Q

Creatinine clearance test measures

A

the glomerular filtration rate of kidneys

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27
Q

Primary depression results from

A

lack of neurotransmitters norepinephrine and serotonin in brain

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28
Q

Secondary depression results from

A

sudden change in person’s life..illness or loss

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29
Q

Primary clinical manifestation of UTI in older adults is

A

acute confusion

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30
Q

Stochastic theory

A

biological theory

based on random events that cause cellular damage that accumulates as organism ages

membranes, nucleic acids and proteins are damaged by free radicals which cause cellular injury and aging

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31
Q

Errors in DNA and RNA synthesis occur with aging (which theory)

A

Stochastic biological theory

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32
Q

Cells wear out and cannot function with aging (which theory)

A

Stochastic biological theory

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33
Q

Non-stochastic theory

A

Biological theory

based on genetically programmed events caused by cellular damage that accelerates aging of the organism

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34
Q

cells divide until they are no longer able to; this triggers apoptosis or cell death (which theory)

A

Non stochastic biological theory

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35
Q

Cells have a genetic programmed aging code (Which theory)

A

Non-Stochastic Biological Theory

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36
Q

Problems with hypothalamus-pituitary-endocrine gland feedback system causes disease; increased insulin growth factor increases aging.

(which theory)

A

Non stochastic biological theory

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37
Q

Fault immunological function causes induces aging

A

Non stochastic biological theory

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38
Q

Disengagement psychosocial

A

Gradual withdrawal from society and relationships serves to maintain social equilibrium and promote internal reflection (Sociological Theory)

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39
Q

Gerotranscendence:

A

Sociological theory

Elderly transform from a materialistic/rational perspective toward oneness with the universe.

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40
Q

Theory of thriving

A

Failure to thrive results from a discord between the individual and their environment/relationships.

To improve patients well-being, nurses strive to identify and modify factors that contribute to disharmony among these elements. (Nursing Theory)

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41
Q

Integumentary common changes in older adults

A

loss of skin elasticity with fat loss in extremities

pigmentation changes

glandular atrophy (oil, moisture, sweat glands)

thinning hair

slower nail growth

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42
Q

Respiratory changes in aging

A

decreased cough reflex

decreased cilia

increased anterior-posterior chest diameter

increased chest wall rigidity

fewer alveoli

increased airway resistance

increased risk of respiratory infections

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43
Q

Immune system changes in aging

A

thymus decreases in size and volume

t-cell function decreases

core temp elevation is lowered

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44
Q

Cognitive appropriate teaching methods

A

Discussion (one on one group)

Lecture

Question-answer session

Role play, discovery

Independent project

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45
Q

Affective appropriate teaching methods

A

role play

discussion group

discussion (one on one)

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46
Q

Psychomotor appropriate teaching methods

A

demonstration

practice

return demonstration

independent project, games

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47
Q

Cognitive learning encompasses

A

thinking and the acquisition of knowledge and intellectual skills

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48
Q

Affective learning deals

A

with the expression of feelings and development of values, attitudes and beliefs

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49
Q

Psychomotor learning involves

A

acquiring motor skills that require coordination and the integration of mental and physical movements such as the ability to walk or use an eating utensil

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50
Q

Teaching method for infant

A

keep routines consistent

hold infant firmly while smiling and speaking softly to convey sense of trust

Have infant touch different textures

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51
Q

Teaching method for toddler

A

use play to teach procedure or activity

offer picture books that describe story of children in hospital or clinic

use simple words

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52
Q

Teaching method for preschooler

A

use role play, imitation and play to make learning fun

encourage questions and offer explanations

encourage children to learn together through pictures and short stories about how to perform hygiene

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53
Q

School-age child teaching method

A

teach psychomotor skills needed to maintain health

offer opportunities to discuss health problems and answer questions

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54
Q

Adolescent teaching method

A

Help adolescent learn about feelings and need for self-expression

use teaching as collaborative activity

allow adolescents to make decisions about health and health promotion (safety, sex education, substance abuse)

PROBLEM SOLVING

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55
Q

Young/middle adult teaching methods

A

participation in teaching plan by setting mutual goals

independent learning

offer info so adult understands effects of health problem

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56
Q

Older adult teaching methods

A

teach when patient is alert and rested

involve adult in discussion or activity

focus on wellness and person’s strength

short teaching sessions

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57
Q

Immobility causes the release of _____ into circulation which can turn into

A

calcium

hypercalcemia

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58
Q

Suprainfection

A

develops when broad spectrum antibiotics eliminate a wide range of normal flora organisms, not just those causing infection

when normal bacterial floras are eliminated, body defenses are reduced, which allows disease producing microorganisms to multiply, causing illness

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59
Q

5 signs of inflammation

A

swelling

redness

heat

pain/tenderness

loss of function in affected body part

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60
Q

Major sites for HAI

A

surgical or traumatic wounds

urinary tract

respiratory tract

bloodstream

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61
Q

Mind-body interventions

A

biofeedback

breathwork

guided imagery

meditation

music therapy

tai chi

yoga

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62
Q

stress response physiological changes

A

increased heart/respiratory rate

tightened muscles

increased metabolic rate

general sense of forebonding

fear

nervousness

irritability

negative mood

elevated blood pressure

dilated pupils

stronger cardiac contractions

increased blood glucose, cholesterol, free fatty acids and triglycerides

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63
Q

research shows relaxation techniques effectively

A

lower blood pressure and heart rate

decrease muscle tension

improve well-being

reduce symptom distress in people experiencing a variety of situations

reduction of hypertension, depression

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64
Q

Aloe vera effects

A

acceleration of wound healing

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65
Q

chamomile effects

A

anti-inflammatory

calming agent

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66
Q

echinacea effects

A

stimulant of immune system

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67
Q

feverfew effects

A

anti-inflammatory

inhibitions serotonin and prostaglandins

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68
Q

garlic effects

A

inhibitions platelet aggregation

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69
Q

ginger effect

A

antiemetic

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70
Q

gingko biloba effect

A

memory improvement

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71
Q

ginseng effect

A

increased physical endurance,

improved immune function

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72
Q

valerian effect

A

CNS depression

73
Q

Saw palmetto effect

A

prevention of conversion of testosterone to dihydrotestosterone

74
Q

bereavement

A

encompasses both grief and mourning and includes the emotional responses and outward behaviors of a person experiencing loss

75
Q

Normal feelings of grief

A

disbelief

yearning

anger

depression

76
Q

examples of disenfranchised grief

A

relationship to deceased cannot be shared openly

death of former spouse

married lover

incarcerated person

terminated pregnancy

77
Q

complicated grief experiences

A

chronic or disruptive yearning for deceased

trouble accepting death and trusting others

feels excessively bitter

emotionally numb

anxious for future

78
Q

Normal feelings of grief

A

sorrow

fear

anger

guilt

anxiety

loneliness

fatigue

helplessness/hopelessness

yearning

relief

79
Q

Cognitions (thought process) feelings of grief

A

disbelief

confusion or memory problems

problems making decisions

inability to concentrate

feeling the presence of the deceased

80
Q

Physical sensations of grief

A

headaches

nausea and appetite disturbances

tightness in chest

insomnia

oversensitivity to noise

SOB, choking

muscle weakness

lack of energy

dry mouth

81
Q

Behaviors of normal grief

A

crying

distancing

absentmindedness

dreams of deceased

loss of interest in regular life events

wearing deceased person’s objects

82
Q

Primary goal of palliative care

A

help patients and families achieve the best quality of life

appropriate for patients of any age, diagnosis, any time, any setting

83
Q

Palliative care focuses on the

A

prevention, relief, reduction or soothing of symptoms of disease or disorders throughout the entire course of an illness

84
Q

Hospice care is

A

a philosophy and model for the care of terminally ill patients and their families at the end of life

priority to managing patient’s pain and other symptoms; comfort; quality of life and attention to physical, psychological

6 months less to live

85
Q

Physical changes hours or days before death

A

increased periods of sleeping/unresponsiveness

coolness and color changes in extremities, nose, fingers (cyanosis, pallor, mottling)

bowel or bladder incontinence

decreased urine output/dark colored urine

restlessness, confusion, disorientation

decreased intake of foods or fluids; inability to swallow

congestion/increased pulmonary secretions; noisy respirations (death rattle)

altered breathing (apnea, labored/irregular breathing, cheyne-stokes pattern)

decreased muscle one, relaxed jaw muscles, aging mouth

weakness and fatigue

86
Q

Documentation of end of life care

A

time and date of death and all actions taken to respond to impending death

name of health care provider certifying death

people notified of death

name of person making request for organ or tissue donation

special preparations of the body

medical tubes, devices or lines left in or on body

personal articles left on and secured to body

personal items given to family with description

location of body ID tags

time of body transfer and destination

verify with healthcare agency

87
Q

four point gait gives

A

stability to the patient but requires weight bearing on both legs

88
Q

3 point alternating is

A

gait requires the patient to bear all of the weight on one foot

patient bears weight on both crutches and then on the uninvolved leg

affected leg does not touch the ground during the early phase

89
Q

2 point gait requires

A

at least partial weight bearing on each foot

90
Q

crutch gait

A

patient bears weight on one or both legs and on the crutches

91
Q

Hypoventilation leads to

A

respiratory acidosis

slow breathing

signs and symptoms include mental status changes

dysrhythmias

potential cardiac arrest

92
Q

Hyperventilation leads to

A

respiratory alkalosis

ventilation in which the lungs remove carbon dioxide faster than it is produced

severe anxiety, infection, drugs or acid base imbalance induce hyperventilation

93
Q

Signs and symptoms of hyperventilation include

A

rapid respirations

sighing breaths

numbness and tingling of hands/feet

light headedness- loss of conscious

94
Q

signs and symptoms of hypoxia

A

apprehesion

restlessness

inability to concentrate

decreased level of consciousness

dizziness

behavioral changes

increased pulse rate and increased rate and depth of respirations

95
Q

bradycardia is

A

less than 60 beats/min

96
Q

tachycardia is

A

greater than 100 beats/min

97
Q

chest pain often radiates to

A

left or both arms

jaw

neck

back

98
Q

bradypnea is

A

less than 12 breaths/min

99
Q

tachypnea is

A

greater than 20 breaths/min

100
Q

pH range

A

7.35-7.45

101
Q

pCO2

A

35-45 mmHg

102
Q

HCO3

A

21-28mEq/L

103
Q

PO2

A

80-100 mmHg

104
Q

SaO2 sat

A

95%-100%

105
Q

best way to maintain thin secretions fluid intake

A

1500-2500mL/day

106
Q

sodium range

A

136-145 mEq/L

107
Q

Potassium range

A

3.5-5.0 mEq/L

108
Q

Chloride range

A

98-106 mEq/L

109
Q

CO2 range

A

22-30 mEq/L

110
Q

Bicarbonate range

A

Arterial 22-26

Venous 24-30

111
Q

Calcium range

A

8/4-10.5mg/dl

112
Q

Magnesium range

A

1.5-2.5 mEq/L

113
Q

Phosphate range

A

2.7-4.5 mg/dL

114
Q

Aldosterone contributes to

A

electrolyte and acid base balance by increasing urinary excretion of potassium and hydrogen ions

115
Q

Ecv deficit is

A

present when there is insufficient isotonic fluid in the extracellular compartment

116
Q

Hypovolemia

A

decreased vascular volume and used to describe ECV

117
Q

ECV excess occurs

A

when there is too much isotonic fluid in the extracellular compartment

118
Q

Hypernatremia is

A

also called a water deficit

hypertonic condition

cells shrivel!!

can occur with ECV deficit which leads to dehydration

119
Q

Hyponatremia is

A

water excess/intoxication

hypotonic condition

cells swell!!!

120
Q

Common causes of hypokalemia

A

increased potassium output through diarrhea

repeated vomiting

use of potassium wasting diuretics

can cause muscle weakness

121
Q

Hyperkalemia can cause

A

muscle weakness

potentially life treating cardiac dysrhythmias

cardiac arrest

122
Q

people who have acute pancreatitis frequently develop what

A

hypocalcemia because calcium binds to undigested fat in their feces and is excreted

123
Q

Hypocalcemia and hypomagnesemia increases

A

neuromuscular excitability

124
Q

Hypercalcemia and Hypermagnesemia decreases

A

neuromuscular excitability

most common symptom is lethargy

125
Q

Hypertonic IV solutions

A

Dextrose 10% in water D10W

3% or 5% sodium chloride NaCl 3%/5%

Dextrose 5% in 0.45% NaCl (D51/2NS)

Dextrose 5% in 0.9% NaCl

Dextrose 5% in LR (D5LR)

126
Q

Isotonic IV solutions

A

Dextrose 5% in water (D5W)

0.9% NS

Lactated ringers (LR)

127
Q

Hypotonic solutions

A

.225% (1/4 NS)

.45% (1/2 NS)

128
Q

infiltration is and what does it cause

A

IV catheter becomes dislodged or a vein ruptures and IV fluids enter subcutaneous tissue around site

causes coolness, paleness, swelling

129
Q

Phlebitis is and causes

A

inflammation of a vein and results from chemical, mechanical or bacterial causes

inflammation occurs along the course of the vein

can cause blood clots

130
Q

Hypercalcemia need an increased

A

fluid intake to prevent renal damage

bowel management for constipation

131
Q

ascending reticular activating system (RAS) contains

A

special cells that maintain alertness and wakefulness

receives visual, auditory, pain, tactile sensory stimuli

activity from the cerebral cortex (emotions, thought processes) also stimulates the ras

132
Q

Hypnotics effects on sleep

A

interfere with reaching deeper sleep stages

provides only temporary (1 week) increase in quantity of sleep)

causes “hangover” during day; excess drowsiness, confusion, decreased energy

Worsens sleep apnea in older adults

133
Q

Antidepressants and stimulants effects on sleep

A

suppress REM sleep

Decrease total sleep time

134
Q

Alcohol effect on sleep

A

Speeds onset of sleep

reduces REM sleep

Awakens person during night and causes difficulty returning to sleep

135
Q

Caffeine effects on sleep

A

prevents person from falling asleep

causes person to awaken during night

interferes with REM sleep

136
Q

Diuretics effect on sleep

A

nighttime awakenings caused by nocturne

137
Q

Beta blockers effect on sleep

A

nightmares

insomnia

awakening from sleep

138
Q

Benzodiazepines effect on sleep

A

alter REM sleep

increase sleep time

increase daytime sleepiness

139
Q

Nicotine effect on sleep

A

decreases total sleep time

decrease REM sleep time

Causes awakening from sleep

difficulty staying asleep

140
Q

Opiates effects on sleep

A

suppress REM sleep

increased daytime drowsiness

141
Q

Anticonvulsants effect on sleep

A

decrease REM sleep time

daytime drowsiness

142
Q

Valerian is effective in

A

mild insomnia and RLS

produces very mild sedation

143
Q

Kava …

A

helps promote sleep in patients with anxiety

used cautiously because of its potential toxic effects on liver

144
Q

Antihistamines for sleep …

A

long duration of action

can cause confusion, constipation, urinary retention and increased risk of falls

145
Q

Benzodiazepine like drugs have become

A

the treatment of choice for insomnia because of improved efficacy and safety of use

cause relaxation, anti anxiety and hypnotic effects

146
Q

Benzodiazepines are contraindicated in

A

older adults because of the tendency of the drugs to remain active in the body for a longer time.

can cause respiratory depression, next-day sedation, amnesia, rebound insomnia, impaired motor functioning and coordination

147
Q

adminiser benzodiazepines cautiously in

A

children under 12 years old

contraindicated in infants less than 6 months

avoid in pregnant and nursing mothers

148
Q

Transient incontinence is

A

caused by medical conditions that in many cases are treatable and reversible

149
Q

Functional incontinence is

A

loss of continence because of causes outside the urinary tract

related to functional deficits such as altered mobility and cognitive impairment

direct result of caregivers not responding in a timely manner to requests for help with toiling

150
Q

Stress urinary incontinence

A

involuntary leakage of small volumes of urine

result of weakness or injury to urinary sphincter or pelvic floor muscles

151
Q

Urge urinary incontinence

A

involuntary passage of urine often associated with strong sense of urgency related to an overactive bladder caused by neurological problems, bladder inflammation

152
Q

Reflex urinary incontinence

A

involuntary loss of urine occurring at somewhat predictable intervals when patient reaches specific bladder volume

153
Q

Dark amber urine is the result of

A

high concentrations of bilirubin in patients with liver disease

154
Q

Urine pH

A

4.6-8.0

urine that stands for several hours becomes alkaline from bacterial growth

155
Q

Protein range in urine

A

up to 8mg/100mL

sensitive indicator of kidney function

156
Q

Glucose in urine

A

not normally present!!!!

patients with poorly controlled diabetes

dehydration, starvation or excessive aspirin ingestion

157
Q

Specific gravity range in urine

A

1.0053-1.030

dehydration, reduced renal blood flow, increase in ADH secretion elevate specific gravity

over hydration, early renal disease reduce specific gravity

158
Q

A person with a sigmoid colostomy will have what kind of stool

A

more formed stool

159
Q

a person with a transverse colostomy will have what kind of stool

A

thick liquid to soft consistency

160
Q

primary intention wound healing includes

A

surgical incision healing

skin edges are approximated, or closed and the risk of infection is low. healing occurs quickly with minimal scar formation

161
Q

secondary intention wound healing includes

A

burn, pressure ulcer, severe laceration

wound is left open until it becomes filled by scar tissue

takes longer to heal

chance of infection is greater

tissue function is often permanent

162
Q

Normal wound healing requires which nutrients

A

PROTEIN

vitamins A & C

zinc, copper

163
Q

Measure serum —– for malnutrition

A

serum albumin

164
Q

risk factors for pressure ulcer

A

decreased sensory perception

moisture

friction and shear

decreased activity and mobility

poor nutrition

165
Q

best position when shifting for prevention of pressure ulcer

A

30 degree lateral position

166
Q

visual deficits include

A

presbyopia

cataract

dry eyes

glaucoma

diabetic retinopathy

macular degeneration

167
Q

Cataract

A

cloudy or opaque areas in lens and interferes with passage of light

GLARE and BLURRED vision

occurs gradually without pain, redness or tearing in the eye

168
Q

Glaucoma

A

progressive increase in intraocular pressure that if left untreated can cause peripheral visual loss

decreased visual acuity with difficulty adapting to darkness and a halo effect around lights

169
Q

Hearing deficits

A

presbycusis (common progressive hearing disorder in older adults)

cerumen accumulation (buildup of earwax)

170
Q

Presbyopia:

A

gradual decline in ability of lens to focus on close objects

CAN’T SEE CLOSE OBJECTS

171
Q

Presbyopia and need for reading glasses start around age

A

40-50

172
Q

hearing changes begin at age

A

30

173
Q

gustatory and olfactory changes begin around age

A

50

174
Q

Proprioceptive changes common after age ___ and include

A

60 and include difficulty with balance, spatial orientation and coordination

175
Q

difference between expressive and sensory aphasia

A

expressive: patient understands but can’t express simple ideas in words or writing

sensory/receptive: patient can’t understand written or spoken language. able to express words but is unable to understand questions or comments from others

176
Q

global aphasia:

A

inability to understand language or communicate orally

177
Q

4 recommended interventions to prevent blindness

A

screen for rubella, syphilis, chlamydia and gonorrhea in women who are considering pregnancy

advocating adequate prenatal care to prevent premature birth (with the danger of exposure of the infant to excessive oxygen)

administering eye prophylaxis in the form of erythromycin ointment apps 1 hr after an infant’s birth

periodic screening of all children, especially newborns through preschoolers for congenital blindness and visual impairment caused by refractive errors

178
Q

individuals at risk for glaucoma:

A

diabetes

hypertension

family history of ocular disease

working in occupations that are highly demanding visually or eye hazardous

take prescription or nonprescription drugs with ocular side effects

wearing contact lenses

179
Q

hearing prevention interventions and those at risk

A

family history

perinatal infection (rubella, herpes)

low birth weight

chronic ear infection

down syndrome

avoid ototoxic drugs and testing for syphilis / rubella!!!

HLSC 116 (4 decks)

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