Chapter 30

Question 1

Alopecia

Answer 1

Hair loss or baldness. Can’t be partial or complete local or generalized loss of hair. Patchy hair loss can result from infections of the scalp. Excessive generalized hair loss may occur with infection, especially with half fever, nutritional deficiencies, hormonal disorders, childbirth, general anesthesia, drug toxicity, chemotherapy, thyroid disease, liver disease, he Paddick and renal failure, and radiation. Also occurs as part of the aging process. Alopecia related to aging is more common in men than women. There is no current cure. Rogaine helps.

Question 2

pediculosis

Answer 2

Lice infestation spread by direct contact.
Frequent scratching and scratch marks on the hair and scalp
three common types-
pediculus Humanus capitus= infects hair and scalp
Pediculus humanis corporis= infects the body
Phthirus pubis= infects shorter hair (Pubic/axillary)

Question 3

Cheilosis

Answer 3

Ulceration and dry scaling of the lips with fissures at the angles of the mouth. most often caused by a vitamin B complex deficiencies (especially riboflavin)

Question 4

Glossitis

Answer 4

Information of the tongue. Can be caused by deficiencies of vitamin B 12, folic acid, and iron.

Question 5

Stomatitis

Answer 5

Inflammation of the oral mucosa. (mucous membrane lining the inside of the mouth
(stratified squamous epithelium and underlying connective tissue termed lamina propria)
Causes: bacteria, virus, mechanical trauma, irritants, nutritional deficiencies, systemic infection.
Symptoms: Heat, pain, increased flow of saliva, and halitosis.

Question 6

Other oral problems

Answer 6

Dry oral mucosa may be simply related to dehydration or may be caused by mouth breathing, and alteration in salivary functioning, or certain medications
-oral malignancies, appearing as lumps or ulcers may be distinguished from benign mouth problems because early detection may lead to cure.

Question 7

Cerumen

Answer 7

Wax in the external ear canal- heavy oil and brown pigment. Older adults can have a build up of cerumen that can calls impaired hearing. This is a result of harder dryer cerumen and decreased motility of the cilia in the ear canal.

Question 8

Caries

Answer 8

Cavities of the teeth. Decaying of teeth with the formation of cavities resulting from failure to remove plaque

Question 9

Plaque

Answer 9

And invisible destructive bacterial film that builds up on teeth and eventually leads to distraction of tooth enamel.

Question 10

periodontitis

Answer 10

Periodontal disease, Marked inflammation of the gums that involves degeneration of the dental periosteum (tissues) and bone.
Symptoms include bleeding gums, swollen, red, painful gum tissues, receding gum lines with the formation of pockets between the teeth and gums, pus that appears when gums are pressed, and loose teeth.
Periodontal disease – major cause of tooth loss in adults over 35

Question 11

Tartar

Answer 11

Hard deposits formed by plaque buildup and dad bacteria on the teeth near gum line. Charter attacks the fibers that fast in the teeth to the gums and eventually attacks bone tissue. The teeth then loosen and fall out.

Question 12

Halitosis

Answer 12

Bad breath. (Offensive)

Strong mouth odor or persistent bad taste in the mouth. May be the first indication of Periodontal disease.

Question 13

Gingivitis

Answer 13

Inflammation of the gums, gingiva. The tissue that surrounds the teeth.

Question 14

Hygiene

Answer 14

• hygiene practices- personal cleanliness and grooming promotes physical and psychological well-being.
• Hygiene practices include caring for the skin, hair, nails, mouth, teeth, Perineal area. The skin, or integument, is the largest organ of the body.
• respect individual patient preferences, providing only the care that patients cannot, or should not, provide for themselves.
• consider the patient’s physical, mental, and emotional state of being while providing care.

Question 15

Factors affecting personal hygiene

Answer 15

Culture
Socio economic class
Spiritual practices
Developmental level
Health state
Personal preferences

Question 16

Culture

Answer 16

It is important to identify cultural variations that could affect a patient’s personal hygiene preferences, such as typical bathing habits, and behaviors, such as use of various hygiene related products. For example, some cultures wash once a week vs every day.

Question 17

Socioeconomic class

Answer 17

Financial resources often define the hygiene options available for people. Limited access to showers, limited finances to buy soap. Homeless people

Question 18

Spiritual practices

Answer 18

Religious believes may dictate ceremonial washings in purifications, sometimes as a prelude to prayer or eating. Orthodox Jews require ritual baths for women after childbirth in ministration. Contact with a deceased person or a dead animal may makeA person unclean. Amish people per Hebert having modern facilities in homes such as toilets and running water.

Question 19

Developmental level

Answer 19

• Family practices often dictate hygiene habits.
• Children learn hygiene while growing up from their family - morning or evening baths, the frequency of washing hair, toothbrushing, and clothes changing, feelings about nudity and so on. •Adolescents become more concerned about their personal appearance and develop new hygiene chains like taking showers more frequently and wearing deodorant.
• bathing frequency commonly decreases with age Due to limitations in mobility and the natural tendency of drier skin.

Question 20

Health state

Answer 20

Disease, surgery, or injury reduce a persons ability to perform hygiene, or motivation to follow usual hygiene habits.
•weakness, dizziness, and fear of falling may prevent a person from getting into a tub or shower or from bending down to wash their lower extremities.
•Illness may also create a demand for new or modified hygiene measures-Peripheral vascular complications that company diabetes mellitus require meticulous footcare

Question 21

Personal preferences

Answer 21

• people have different preferences with regard to hygiene practices such as taking a shower or taking a bath, using a bar of soap versus liquid soap and washing to wake up yourself or to relax before sleep.
• A person self-concept and sexuality also influence personal hygiene practices.
• Older adults may use skin care products to prevent wrinkles to diminish the sign of aging.
• Women who are sexually active use hygiene products following intercourse to promote Cleanliness

Question 22

Factors to consider when examining the skin.

Answer 22

Cleanliness
Color
Temperature
Texture
Tugor (Pinch skin on back of hand for a couple of seconds, if it doesn't return to its original state-sign of dehydration
Moisture
Sensation
Vascularity
Evidence of lesions-pre-cancerous moles are fatal and early detection is important

Question 23

Skin integument

Answer 23

Integument system or skin is the largest organ of the body.
• consists of skin, subcutaneous layer directly under skin, and appendages of skin, (hair nails)
guidelines for assessing the skin….
• describe what is observed/palpated
- note appearance, texture, size, location, distribution, and characteristics of findings.

•systematically in ahead to toe sequence
•Use a good source of light, preferably daylight
•Compare bilateral parts for symmetry
•Use standard terminology to report and record findings
• data obtained from nursing history is used to direct skin assessment
•Identify variables known to cause skin problems
-Immobility, malnutrition, decreased hydration, decreased sensation, sun exposure, vascular problems- altered tissue perfusion/venous return.
- Presence of irritants - secretions/excretions of skin
Dry skin, acne, rash
•Petichiae- Brown or purple spots due to bleeding under the skin
•Exorication- picking disorder
Macular rash-flat red area on skin with small confluence bumps

Question 24

Interview questions/skill alterations for skin

Answer 24

History of skin/mucus membrane problems- nature, onset, frequency, causes, severity, symptoms, interventions excepted, results.
•Describe any skin problems with rashes, lumps itching, dryness, lesions, eccymosis(discoloration of skin from bleeding underneath, caused by bruising) or masses.

• How long have you had this problem?
• Does it bother you?
• How does it bother you? (Itching)
• What have you done to relieve the symptoms?

Question 25

Daily and weekly bathing habits

Answer 25

Tell me about your daily and weekly bathing habits. Are there any special bathing or hygiene products you use or can't use? How can the nurses best help you to meet your hygiene needs?

Question 26

Factors interfering with hygiene practices. | Sensory, cognitive, endurance, mobility, or motivation

Answer 26

What recently or in the past has interfered with your hygiene practices? Does anything interfere with your ability to be as clean as you would like?

Question 27

Pain

Answer 27

* Do you have pain? * Describe characteristics, onset, location, duration, associated symptoms, and intensity. * Does the paint interfere with your ability to perform personal hygiene task? * Does caring for yourself cause pain or discomfort

Question 28

Exposure history

Answer 28

* Do you sunbathe? * How much sun or tanning booth exposure to you get? * Do you use sunscreen? * Does your job or daily activities/hobbies expose you to chemicals, such as bleach, petroleum, paint, Incesticide, or cleaning products?

Question 29

Hygiene practices for mouth questions

Answer 29

How do you clean your teeth and gums How often do you have a dental exam? Do you have any dental appliances? Are there any tender areas or lesions in your mouth?

Question 30

Eyes ears and nose hygiene practices

Answer 30

Do you wear glasses or contact lenses? Do you wear hearing aid? Have you experienced any discharge or bleeding from or swelling of your eyes, ears, or nose

Question 31

Hair questions

Answer 31

Have you notice any unusual dryness of the scout or changes in hair texture and amount?

Question 32

Feet and nails questions

Answer 32

Is the appearance of the nail normal? How do you normally care for and clean your nails? Is the skin intact on the feet? Have you noticed any swelling of one or both feet? Do you wear any special shoes?

Question 33

Perineum

Answer 33

Have you notice any unusual discharge, swelling, itching, or inflammation? Are you able to complete your own care? Do you follow any special hygiene practices during menstruation? What type of Feeman hygiene products such as pads tampons or douches do you use

Question 34

Teeth/oral cavity

Answer 34

Need a diet sufficient in calcium, phosphorous, vitamin D -->necessary for body to make use of these minerals. •aesthetic value --intact body image •Beginning of digestive process and •tasting pleasure enhanced by good teeth/mouth condition •Risk factors for bad oral health Poor nutrition, excessive intake of refined sugars, family history of periodontal disease, or ingestion of chemotherapeutic agents that produce oral lesions, seriously ill, comatose, dehydrated, confused, depressed, paralyzed mouth breathers, no oral intake of nutrition or fluids, nasogastric tube's or oral airway in place, oral surgery--- increased risk

Question 35

Assessment and care of the oral cavity

Answer 35

Dental caries, periodontal disease Color of gum/surface lesions, bleeding, edema, exudate •Lips color, moisture, lumps, ulcers, lesions, edema •buccal mucosa- (inside lining of the cheeks) Color, moisture, lesions, modules, bleeding • teeth- loose, missing, Carius/decayed, dentures, orthodontic devices • tongue- Color, symmetry, movement, texture, lesions • hard and soft palate's- intact, color, patches, lesions, petichiae (purple brown spots on your skin due to bleeding) • oropharynx-movement of uvula and condition of tonsils if present • halitosis-unusual mouth odor •Adequacy of mastication/swallowing • identify actual or potential oral problems that nurses can treat • identify appropriate nursing measures • Carry out the plan of care

Question 36

Self-care deficit diagnosis

Answer 36

Activities necessary to meet daily needs such as feeding, bathing and hiding, dressing and grooming, toileting. Etiology of problem directs nursing interventions

Question 37

Eyes ears and nose

Answer 37

Note position, alignment/general appearance eyes-eyelashes distributed evenly -curb outward? •Eyelids-lesions, nodules, redness, swelling, crusting, flaking, excessive tearing, discharge of lachrymal gland. Check color of conjunctivae and test patients blink reflex •Ears- position, alignment, appearance, cerumen •Nose-position, appearance, patency of nostrils, tenderness, dryness, Edema, bleeding, discharge, secretions

Question 38

Hair care accessory skin structure

Answer 38

Illness affects hair – endocrine(hormone) abnormalities, increased body temperature, poor nutrition, Anxiety, stress-- Changes in color/condition of hair -- shaft – changes in hormones or blood supply to hair follicle Note hair texture, cleanliness, conditions, oiliness. Scalp – scaling, lesions, inflammation, infection, dandruff – itching/flaking of scalp, hair loss, infestations. (Alopecia, pediculosis,ticks-Lyme disease, rocky Mountain spotted fever, Colorado tick fever) - African Americans have dry scalp and fragile hair - asians straight hair • identify patients usual hair and scalp care practices and styling preferences • note any history of hair or scout problems, such as dandruff, hair loss, baldness • read any infestations sisters pediculosis and ticks • groom and shampoo hair •Care for beards and mustaches • assist with unwanted hair removal

Question 39

Nail & feet care

Answer 39

Epithelial tissue makes up nails – covers body surfaces or lines body cavities. •Healthy nailbeds are pink and convex, and evenly curved • age and pathogen's – rigid concave Hygiene includes trimming and cleaning •Assess nails for color and shape, intactness and cleaness, and tenderness. •Check for history of nail or foot problems – diabetes mellitus , Peripheral vascular disease • soak nails and feet and assist with cleaning and trimming nails if not contradicted • massage the feet to promote relaxation and comfort • provide diabetic foot care if indicated Assess capillary refill in the contour of the nailbed Observe nail base for redness, swelling, bleeding, discharge and tenderness Examine feet for cleanliness and intactness of skin, and note any swelling, inflammation, lesions, tenderness, or orthopedic problems Examine carefully between toes

Question 40

Perineal

Answer 40

Characteristics – dark, warm, moist equals perfect area for bacterial growth • male and female – note lesions, swelling, inflammation, tenderness, discharge •Mail – lesions, swelling, inflammation, exorication, tenderness and discharge – amount, color odor source • female- Color, size, lesions, masses, swelling, information, excoriation, tenderness, discharge •Anal area-cracks, nodules, distended veins, polyps and odors

Question 41

Age-related changes related to hygiene

Answer 41

•Impaired oral mucous membranes - loss of elasticity, atrophy ofepithelial cells, diminished blood supply to connective tissue - Decreased salivation - Use of medications for chronic conditions that may cause dry mouth - - floss and brush teeth with fluoride toothpaste twice a day, brush dentures twice today rinse with cold water, avoid mouthwashes it with alcohol, inspect mouth daily for lesions and information, use lubricant on lips, suck on sugar-free candies, chew sugarless gum dental exams every six months •Impaired physical mobility - decreased range of motion - Presence of chronic conditions that compromise functional ability - decreased muscle strength and agility - -use adaptive devices for hygiene such as toothbrush with a large handle or extended handle, long handled body sponge, shower chair, grab bars. Provide for safety in the bathroom – use nonslip mats, grab bars •Risk for impaired skin integrity - diminished secretion of natural Oils and perspiration - loss of elasticity - thinning of epidermis, loss of elastin and subcutaneous fat - -use safe water temperatures to bathe, avoid soap use pH balance skin cleansers, shower not babe, you skin moisturizer is any moly it's at least daily, bathe regularly but less often not every day

Question 42

Purpose of bathing

Answer 42

Cleanses the skin, acts as a skin conditioner, helps to relax a person, promote circulation – stimulates peripheral nerve endings and underlying tissue – serves as musculoskeletal exercise, stimulates the rate and depth of respirations, promotes comfort through muscle relaxation and skin stimulation, provides person with sensory input, helps improve self image, strengthens nurse – patient relationship, Allows nurse to thoroughly assess integument, physiological /emotional status

Question 43

Early-morning care

Answer 43

Shortly after patient wakes up assist with toileting and provide comfort measures to refresh patient Prepare patient for breakfast or diagnostic test. Nursing measures include washing face and hands/providing mouth care

Question 44

Morning care - a.m. care

Answer 44

Depending on patient self-care abilities, assist with toileting, oral care, bathing, back massage, skin care (pressure ulcers ) haircare, cosmetics, dressing and positioning for comfort. Categorize as self-care, partial care, or complete care Self-care patients are capable of managing their own personal hygiene independently Partial care patients most often receive morning hygiene care at the bedside or seated near the sink in the bathroom. They usually require assistance with body areas that are difficult to reach Complete care patients require nursing assistance with all aspects of personal hygiene. A complete bed bath is done

Question 45

Afternoon care – p.m. care

Answer 45

Receive visitors in this town or use time to rest when not scheduled for therapies. Injured comfort offer assistance do not ambulatory patients with toileting hand washing and oral care

Question 46

Hours of sleep care – HS care

Answer 46

Right before patient goes to sleep offer assistance with toileting washing face hands and oral care back massages help patients relax and fall asleep change Soiled bed linens or clothing position patient comfortably ensure call light and any other objects the patient desires are within reach

Question 47

As needed care – PRN care

Answer 47

Individual hygiene measures as needed. Some require oral care every two hours. Diaphoretic patients may need clothing in bed linens changed several times a shift.

Question 48

Shower and tub baths

Answer 48

Shower should have mats or nonskid strips to prevent patient from slipping and falling Provide place for a week or physically disabled patient to see it in shower This patient to shower or bathroom as indicated Check to see the water temperature is safe and comfortable – 100°F to listen 120°F – 125°F the lower temperature is recommended for children and adults over 65 years old Ensure privacy for patients who can shower alone Neil first in the tub and then sit Hydraulic lift Bathroom door unlocked Special procedures for patients with dementia

Question 49

Denture care

Answer 49

Brushed injures twice a day remove and rinse dentures in mouth after meals Line sink with a washcloth or soft towel so that they don't slip and fall and break Hold them with a piece of gauze to help prevent them from slipping out your hands use cold or Luke warm water to cleans them. Store dentures in cold water when not in patient's mouth

Question 50

Contact lens care

Answer 50

Rigid hard or soft contacts are brutal when dehydrated and absorb water when placed in a solution, Nate usually normal saline or with contact with tears Hard lenses should not be worn for more than 12 to 16 hours and should be removed before sleeping Extended wear soft lenses can be left in place for 1 to 30 days depending on the manufacturer should be cleaned once a week Leaving contact lenses in place for long periods of time could result in permanent Eye damage The cornea, trans parent I covering, consist of dense connective tissue and does not have its own blood supply. It is nursed primarily by oxygen from the atmosphere and from tears. In a patient who wears contact lenses, big cornea requires more than its normal supply of oxygen because it's my metabolic rate increases Removing rigid lenses – use gentle pressure to center the lens on the cornea -removing soft lenses – he's gentle pressure to move the Lansdowne to the Scalera and pinch to remove glare is white part of eye Suction device can be used in emergency situation to remove gas permeable or hard lenses

Question 51

Disease

Answer 51

Alteration and state of health

Question 52

Illness

Answer 52

Sick from pathogen

Question 53

Acute illness

Answer 53

Rapid onset of symptoms and last a short time usually goes away with treatment examples are appendicitis pneumonia diarrhea or the common cold

Question 54

Chronic illness

Answer 54

A broad term that encompasses many different physical and mental alterations are usually has a slow onset and may have periods of remission and exacerbation remission is when the disease is still present but the symptoms go away exacerbation is when the symptoms come back you have to cope and adapt

Question 55

Characteristics of a chronic illness

Answer 55

A permanent change irreversible alterations and normal anatomy and physiology special education free habilitation long period of care or support create stress and frequent fliers to the hospital

Question 56

Stages of illness behavior

Answer 56

Experiencing symptoms then assuming the sick role and then assuming a dependent roll and then finally achieving recovery and rehabilitation

Question 57

Factors affecting health and illness

Answer 57

Basic human needs Maslows hierarchy in the human dimensions self-concept risk factors for illness or injury

Question 58

Maslow's basic human needs

Answer 58

Physiological (food water warm, rest) Safety --(security and safety) Belongingness and love (intimate relationships and friends) Esteem (Prestidge and feeling of accomplishment) Self actualization achieving one's full potential including creative activities

Question 59

The human dimensions

Answer 59

Physical emotional intellectual environmental socio-cultural and spiritual

Question 60

Health promotion

Answer 60

Behavior of an individual that is motivated by personal desire to increase well-being and health potential

Question 61

Primary health and illness prevention

Answer 61

Immunization clinics family-planning services information. Health risk assessments

Question 62

Secondary health promotion and illness prevention

Answer 62

Screening for early detection

Question 63

Tertiary

Answer 63

After an illness is diagnose it is treated to reduce the disability and help rehabilitate examples are physical therapy medications and preventing from getting worse

Question 64

Health believe model

Answer 64

Concerned with what people perceive to be true about themselves related to health such as perceived susceptibility seriousness of disease and benefits of action

Question 65

Health promotion model- pender

Answer 65

Incorporates individual characteristics experiences and behavior specific knowledge and beliefs to motivate health promoting activity

Question 66

The health illness continuum

Answer 66

Measures a person's level of health health is a constant changing state with high-level wellness and death on opposite ends of the continuum state of health is dynamic

Question 67

The agent host environmental model

Answer 67

Examines the causes of disease and agent is a environmental factor or stressor that must be present or absent the host reaction is influenced by factors they ought to form a triangle and affect each other. Can explain why some people are more susceptible than others