Chapter 9 Flashcards
(102 cards)
1
Q
Homeostasis
A
the condition in which all of the body’s systems are working together to maintain internal stability.
2
Q
Metabolism:
Disease =
A
physical and chemical processes by which substances are produced or broken down into energy or products for use by the body.
Disease = when metabolism is disturbed, homeostasis is lost
3
Q
Changes in the metabolic processes =
A
signs and symptoms
4
Q
Signs =
A
are what the NA actually sees, hears, feels, or smells. Also known as Objective data.
5
Q
Symptoms =
A
are not directly seen by the NA, but reported by the resident. Also known as Subjective data.
6
Q
Organs
A
structural units in the human body that perform specific functions.
7
Q
Tissues
A
groups of cells that perform similar tasks.
8
Q
Cells
A
basic structural units of the body that divide, develop, and die, renewing tissues and organs.
9
Q
Anterior or ventral
A
front of the body
10
Q
Posterior or dorsal
A
back of the body
11
Q
Superior
A
toward the head
12
Q
Inferior
A
away from the head
13
Q
Medial
A
toward the midline of the body
14
Q
Lateral
A
side of the body
15
Q
Proximal
A
closer to the torso
16
Q
Distal
A
farther away from the torso
17
Q
Integument (integumentary system = the skin )
A
a natural protective covering
18
Q
Dilate
A
to widen
19
Q
Constrict
A
to narrow
20
Q
How are the Levels of skin injury described?
A
by the depth of an injury.
21
Q
Epidermis=
A
superficial
22
Q
Dermis =
A
partial or full thickness
23
Q
Subcutaneous =
A
full thickness into the muscle or bone
24
Q
Hair growth on the skin…
When hair is missing on the lower extremity this may signal…
A
is a sign of healthy blood flow to that area of the skin
lack of proper circulation and nutrients getting to the skin
25
Integumentary system:
Body’s largest organ and system, skin.
Prevents excessive loss of water and injury to internal organs
26
Natural protective covering =
prevents infections
27
When covering is lost =
portal of entry for microbes.
28
Skin made of...
tissue, glands, capillaries and nerves
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Skin is a sense organ =
feels hot, cold, touch, pressure
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Regulates body temperature =
blood vessels will dilate or constrict in response to temperature
31
Normal changes of integumentary system:
*Thinner, drier, more fragile, less elastic skin = need moisture, lotions
*Thinning fatty tissue = less padding, less subcutaneous fat causes a person to feel cooler
*Thinner, gray hair
*Wrinkles and brown spots
*Nails harder and more brittle
*Dry, itchy skin due to lack of oil from sebaceous glands (oil glands)
32
Report these signs and symptoms:
*Pale, white, reddened, or purple areas
*Blisters or bruises
*Complaints of tingling, warmth, or burning
*Changes in moistness/dryness
*Itching or scratching
*Rashes or discoloration
*Swelling
*Cuts, boils, sores, wounds, abrasions
33
Signs and symptoms to report:
*Fluid or blood draining from skin
*Broken skin
*Changes in injury or wound
*Redness or broken skin between toes or around toenails
*Scalp or hair changes
*Skin that appears different from normal
*In darker complexions, look for changes in skin tone, skin temperature, and the feel of the tissue as compared to skin nearby = normal tissue should feel firm, not spongy
34
Remember these principles when caregiving:
*Replace the loss of skin moisture by applying lotion daily, but not over reddened areas. See the care plan for specifics.
*Keep bed linens wrinkle free to eliminate a possible source of irritation that would cause a pressure ulcer to develop.
*Keep your nails short, watch out for rings, watches that could cause the fragile skin of the elderly to get skin tears
*Practice prevention techniques to keep their skin intact
35
Musculoskeletal system:
*Bones
*Joint
*Muscles
36
Bones
rigid connective tissues that make up the skeleton, protect organs, and allow the body to move.
37
Joint
the place at which two bones meet.
38
Muscles
groups of tissues that provide movement of body parts, protection of organs, and creation of body heat.
39
Atrophy
the wasting away, decreasing in size, and weakening of muscles from lack of use.
If you do not use it, you lose it
40
Contracture
the permanent and often painful shortening of a muscle, usually due to lack of activity.
These are largely preventable, with exercise and orthotic devices.
41
Facts about the Musculoskeletal system:
-The human body has 206 bones.
-Two bones meet at joint (for movement). Joints make movement possible in either all directions or in one direction only.
-Muscles provide movement and produce body heat.
-Physical activity/exercise increases circulation= increasing blood flow to organs and tissues.
-Inactivity can cause depression, pneumonia, constipation, UTIs, loss of self-esteem, and blood clots. = every body system is affected negatively by inactivity
-Muscles develop atrophy or contractures from inactivity.
-ROM exercises ( range of motion ) help prevent atrophy or contractures.
42
Normal changes of aging in the musculoskeletal system:
*Muscles weaken, begin to sag and loose tone = increase risk of falls
*Body movement slows.
*Bones lose density and become more brittle = osteoporosis (As name suggests, bones become porous)
*Joints can stiffen/become painful = arthritis
*Height is gradually lost = posture stoops forward, shrinks
43
Report these signs and symptoms:
*Changes in movement and activity
*many report feeling very stiff upon awakening, which sometimes lessens throughout the day-may need frequent rest periods
*Changes in ability to do ROMs
*Pain with movement
*many require around the clock pain patches or analgesics to manage the pain
*New or increased swelling of joints
*White, shiny, red, or warm areas over joints
*Bruising
44
Nervous system:
2 main parts:
-central nervous system (CNS)
*part of the nervous system that is composed of the brain and spinal cord. Page 135 in textbook describes the sections.
-peripheral nervous system (PNS)
*part of the nervous system made up of the nerves that extend throughout the body.
45
Nervous system, what it does:
*Control and message center of body
*Controls and coordinates all body functions
*Senses information from outside the body – interprets information from the eyes, ears, nose, tongue,
46
Normal changes of aging:
*Slower responses and reflexes
*Decrease in sensitivity of nerve endings in skin
*Some memory loss, more often with short-term memory
47
Report these signs and symptoms :
*Fatigue or pain with movement
*Shaking or trembling – Parkinson’s residents
*Inability to move one side of body - hemiplegia
*Difficulty speaking or slurring of speech – from various neurological diseases, but mostly due to stroke or CVA
*Numbness or tingling – remember the acronym F.A.S.T
*Disturbance or change in vision or hearing – double vision or only seeing ½ of the visual field
*Changes in eating or fluid intake
*Difficulty swallowing
*Bowel or bladder changes
*Depression or mood changes
*Memory loss or confusion
*Violent behavior
*Unusual or unexplained change in behavior
*Decreased ability to perform ADLs
48
dysphasia –
difficult speech, or aphasia – loss of speech
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dysphagia –
difficulty chewing and swallowing
50
The body’s major sense organs are part of the CNS –
eyes, ears, nose, tongue and skin
they contain receptors that receive impulses that are relayed to the nerves
51
Normal changes associated with aging:
*Reduced vision and hearing – sense of balance may be affected with inner ear problems
*Decreased senses of taste, touch, and smell = decrease in appetite
*Decreased sensitivity to heat, cold, touch = unable to tell water temperature
*All of these types of sensory changes puts the person at greater risk for safety issues with falls, burns etc.
52
Circulatory system:
*Made up of heart, blood vessels, and blood
*Blood carries food, oxygen, and essential substances such as hormones to cells.
*A healthy circulatory system is essential for life.
53
Heart has how many chambers? And what are they called.
Heart has four chambers: two upper chambers called the left atrium and right atrium, and two lower chambers called ventricles.
54
What is the heart?
\The heart is a muscle made up of three layers: pericardium, myocardium, and endocardium.
55
Heart functions in two phases:
*contracting phase= systole (ventricles pump blood) and
*resting phase= diastole (chambers fill with blood)
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Contracting phase=
systole (ventricles pump blood) and
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Resting phase=
diastole (chambers fill with blood)
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Blood Pressure readings are comprised of two numbers:
Systolic measurement/Diastolic measurement = for example 120/80
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Other major functions of circulatory system:
*Produces and supply antibodies
*Remove waste products from cells
*Control body temperature
60
Normal changes of aging in the circulatory system:
*Heart pumps less efficiently – less oxygen is reaching the body
*Decreased blood flow – again, less oxygen is circulating
*Narrowed blood vessels – more resistance to blood flow = less oxygen is reaching the cells
61
Report these signs and symptoms:
*Changes in pulse rate
*Weakness or fatigue – inability to do ADL’s
*Swelling of hands and feet, weight gain
*Pale or blue hands, feet, or lips
*Chest pain
*Shortness of breath, changes in breathing patterns, inability to catch breath
*Severe headache
*Inactivity, which can lead to circulatory problems
62
Respiration
the process of inhaling air into the lungs and exhaling air out of the lungs.
63
A full respiration consists of both inspiration + expiration.
Inspiration:
Expiration:
Inspiration: the process of breathing into the lungs – brings oxygen into the body
Expiration: the process of breathing out of the lungs – carbon dioxide is sent out of the body
64
Sputum
thick mucus coughed up from the lungs.
65
Normal changes of aging:
*Loss of lung strength – alveoli sacs have lost elasticity, they do not expand and contract as readily
*Decreased lung capacity – less likely to breath with deep, full breaths (shallow breathing)
*Decreased oxygen in the blood – less deep, full breaths results in less oxygen being drawn into the lungs, slower rate of gas exchange
*Weakened voice – larynx changes, voice can be high pitched
*Increased respiratory rates in the elderly – normal adult range is 12-20 respiration/ minutes – they have higher rates
66
Report these signs and symptoms:
*Changes in respiratory rate
*Shallow breathing or breathing through pursed lips
*Coughing or wheezing
*Nasal congestion or discharge
*Sore throat, difficulty swallowing, swollen tonsils
*Need to sit after mild exertion
*Pale, bluish, or gray lips or extremities
*Pain in chest
*Discolored sputum (yellow, green, gray, or bloody)
67
The Urinary system:
Main functions are:
*To eliminate wastes
*To maintain water balance
68
Normal changes of aging in the urinary system:
*Reduced ability of kidneys to filter blood
*Bladder holds less urine causing more frequent urination
*(Bladder may not empty completely, causing greater chance of infection
*UTI’s (urinary tract infection) is a very common infection
69
Weakened bladder muscle tone=
problems with incontinence
70
urinary incontinence =
the inability to control the bladder, which leads to an involuntary loss of urine.
Many older adults take medications known as diuretics, which help the body eliminate fluid.
When a resident takes these meds, they will need to urinate more frequently – thus the need to answer the call light quickly
Residents might be more prone to urinary incontinence while taking these meds, if their bladders fill quickly or overfill.
71
Report these signs and symptoms:
*Weight loss or gain - (signals function of this system may be impaired)
*Swelling in extremities, abdomen or bladder area (water retention is not normal)
*Painful urination or burning during urination = infection
*Changes in urine appearance (cloudy, odor, color)
*Change in frequency or amount of urine – more or less
*Complaints that bladder feels full or painful kidney area
*Urinary incontinence
*Inadequate fluid intake
*Confusion – an atypical but common sign of UTI in the elderly
72
The Gastrointestinal System: (GI System):
*Digestion
*Peristalsis
*Absorption
*Elimination
*Fecal incontinence
*
73
Digestion:
*the process of preparing food physically and chemically so that it can be absorbed into the cells.
*Digestion begins in the mouth with chewing; the body breaks down food into chyme (a semi-liquid substance); then it travels down the digestive tract through the stomach, small intestine, then large intestine then is eliminated from the body through the anus.
*The liver, pancreas, and gallbladder also aid in digestion with juices or enzymes that further breakdown the food.
*Any alteration in the ability to digest food, at any point along the GI tract, causes symptoms of GI dysfunction
74
Peristalsis:
involuntary contractions that move food through the gastrointestinal system.
75
Absorption:
*the transfer of nutrients from the intestines to the cells.
*The small intestine absorbs most of the nutrients through capillaries
*The large intestine absorbs most of the water from the end product of digestion, or solid waste (feces)
*People unable to normally absorb nutrients from food, usually suffer from weight loss and vitamin deficiencies
76
Elimination:
*the process of expelling solid wastes
*waste products of food and fluids that the body has not reabsorbed
77
Fecal Incontinence:
the inability to control the bowels, leading to an involuntary passage of stool or feces
78
Normal changes of aging in the gastrointestinal system:
*Decreased saliva production = affects chewing/swallowing.
*Dulled sense of taste = may result in poor appetite.
*Absorption of vitamins/minerals decreases.
*Vitamin deficiencies and weight loss
*Digestion takes longer, is less efficient.
*Peristalsis is slower, not as hungry between meals
*Body waste moves more slowly through intestines= constipation
*Elderly also tend to drink insufficient water/fluids = constipation
79
Dysphagia =
difficulty swallowing, usually has some neurologic basis, but less saliva adds to the problem
80
Report these signs and symptoms:
*Difficulty swallowing or chewing/choking or coughing while eating
*Fecal incontinence
*Diarrhea = loose watery stools
*Weight gain or loss
*Loss of appetite
*Abdominal pain or cramping
*Nausea and vomiting = “coffee ground” appearance to vomit would indicate some form of bleeding
*Constipation – in LTC there is a great deal of emphasis on record keeping of bowel movements
*fecal impaction = is an extreme form of constipation when hard stool cannot be expelled; requires nursing or medical intervention. Textbook: p.305
*Flatulence = passing of gas
*Hiccups, belching = usually from indigestion
*Bloody, or black stools = can be an indication of internal bleeding(black stools are also common when taking iron tabs)
*Poor nutritional intake = record of food/fluid intake is kept
81
Heartburn =
burning sensation to stomach region
82
Glands
*organs that produce and secrete bio-chemicals called hormones that control various body functions
*The body has 8 major glands
83
Hormones
*chemical substances created by the organs that control numerous body functions.
*Every gland produces and secretes one or more hormones
*the primary hormone to focus on is Insulin, which is produced by the Pancreas
84
Insulin =
hormone that helps cells use glucose (sugar)
85
Gonads:
male (testes) and female(ovaries) sex glands.
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Hormones are carried in the blood to organs in order to achieve the following:
*Maintain homeostasis = master gland = pituitary gland
*Influence growth and development = growth hormone from the pituitary gland
*Regulate blood sugar levels = insulin from the pancreas
*Regulate calcium levels in bones = parathyroid gland
*Regulate body’s ability to reproduce = ovaries produce estrogen and progesterone; testes = testosterone
*Determine how fast cells burn food for energy (metabolism) = thyroid gland hormones
87
Normal changes in the endocrine system:
*In general, decrease in levels of hormones – insulin, estrogen, progesterone
*Less able to handle stress – less adrenaline production from the adrenal glands
*this hormone regulates, muscle power, HR, BP, and energy levels during stressful situations
88
Report these signs and symptoms which could be related to dysfunction of various endocrine systems, but are mostly signs and symptoms that could signal Hyper (high) or Hypo (low) blood sugar issues, which are a constant issue with LTC residents.
*Headache, dizziness, blurred vision, confusion
*Irritability, sweating, change in normal behavior
*Change in mobility, weakness
*Change in sensation, numbness, tingling
*Weight gain/loss; sweet or fruity breath
*Loss of or/increase in appetite
*Increased thirst, frequent urination
*Dry skin, skin breakdown
*Hyperactivity – more related to hyperactive thyroid
89
Males -
produce sperm =
produce =
Males: testes (located in the scrotum)
sperm: male sex cells
Produce: testosterone; which is needed for the male reproductive organ to function properly
90
Females -
ovaries =
ovaries also produce =
Females: ovaries, uterus, fallopian tubes
Ovaries= produce female sex cells (ova)
Ovaries also produce: estrogen and progesterone which are needed for the female reproductive organ to function properly
91
Normal changes of aging in the reproductive system:
Male:
Female:
Male:
*Decrease in sperm production
*Decrease in testosterone
*Enlargement of the prostate gland = difficult urination
Female:
*Menstruation ends = menopause, end of reproductive ability
*Decrease in estrogen may lead to loss of calcium, causing brittle bones = osteoporosis
*Drying and thinning of vaginal walls, lubrication decreases, = more prone to vaginal infections
92
Report these signs and symptoms:
*Discomfort or difficulty with urination
*Discharge from penis or vagina
*Swelling of genitals
*Blood in urine or stool
*Breast changes, lumps, or discharge
*Sores on genitals
*Redness or rash on genitals
*Genital itching
*Reports of erectile dysfunction
*Reports of painful intercourse
93
The Lymphatic System:
*It is closely related to the circulatory system and the immune system
*It has no pump, but is circulated by muscle activity, massage, and breathing = more muscle movement = more lymphatic circulation
94
Functions of the Lymphatic System:
*removes excess fluids and waste products
*helps the immune system fight infections.
*lymph fluid, after being purified in the lymph nodes, flows into the bloodstream.
95
Specific immunity
a type of immunity that protects against a particular disease that is invading the body at a given time.
-the person already has antibodies in the cells from a previous infection or immunization
96
Nonspecific immunity
a types of immunity that protects the body from disease in general.
97
Anatomic =
natural defenses such as tears, saliva, mucus secretions
98
Physiologic =
acidity of stomach; elevated temp
99
Inflammatory =
body sends extra lymphocytes (a type of white blood cell) to the site of an infection
100
Lymph
a clear yellowish fluid that carries disease-fighting cells = lymphocytes.
101
Normal changes in the immune and lymphatic systems:
*Weaker immune system = increased risk of infection
*Takes long to recover from an illness
*Decreased number and size of lymph nodes
*INodes purify the lymph fluid then send it back into the bloodstream
*Decreased response to vaccines
102
Report these signs and symptoms:
*Recurrent infections
*Increased fatigue
*Swelling of lymph nodes – infection often causes swelling of the lymph nodes in the neck, groin, axilla
*Atypical response to an infection = less inflammatory response, pain
*More often will see mental confusion, loss of appetite, weakness, falls
