EXAM 1 THINGS Flashcards by Tisha Liim

young old

65-74

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middle old

75-84

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old old

85-99

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elite old

100+ y/o

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proprioception

sense of time and space

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what does presbycusis mean?

high frequency hearing loss

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b/c older adults have decreased sensitivity of baroreceptors, what should you be careful of?

when shifting positions from sitting to standing; pt may also have high BP so they will be taking anti HTN drugs -> together, these two things can lead to higher risk of fall/injury

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is incontinence a normal part of aging?

NOPE it has a cause

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does respiratory rate change when adults become older?

nope

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what are the most frequently diagnosed conditions?

arthritis
HTN
heart disease
cancer

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iatrogenesis

interventions that lead to further complications and disease

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SPICES (measures healthcare issues among hospitalized older adults)

sleep disorders
problems with eating 
incontinence
confusion 
evidence of falls 
skin breakdown

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Katz Index of Independence in Activities of Daily Life (ADLs)

bathing 
feeding 
toiletting 
dressing 
transferring 
continence

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Geriatric Cascade

phenomenon of rapid decline resulting from :
frailty
acute illness
stress of institutional care

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If you see a patient with delirium:

try to reorient the patient to:

Person
Place
Time

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critical thinking concept model characteristics (5)

knowledge
standards
attitude
experience

competencies

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nearly __ of older adults in the community reports a fall every year

1/3

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__ to __% of older adults living in long term care settings experience a fall every year

50-75

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examples of extrinsic/environmental factors for sustaining a fall:

polypharmacy
loose carpets
inadequate lighting

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DELIRIUM: (common causes of delirium)

drugs
elimination (constipation) 
liver and other organs 
infection 
respiratory 
injury 
unfamiliar environment 
metabolic

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Braden Scale

Sensory perception (4) 
Moisture (4) 
Nutrition (4) 
Mobility (4) 
Activity (4) 
Friction/Shear (3)

15-18 At risk
13-14 Moderate risk
10-12 High risk
Less than or equal to 9 VERY high risk

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If restraints are used,

assess the related extremity every 30 minutes to see if color has changed
must document that you saw that extremity
evaluate every 30 minutes
must release patient from restraint every 1-2 hours

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IADLs (instrumental)

includes things like chopping

making a phone call, etc

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systemic effects of immobility -> hypostatic PNA

fluid pools in lungs and can cause inflammation

results from atelectasis

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risk factors for pressure ulcer include:

1. intensity of pressure 2. duration of pressure 3. tolerance of tissue to duration and pressure

A pressure ulcer can form in only _ - _ hours, which is why we reposition every __ hours.

2-6; 2

Albumin level

3.5 grams/dL or greater

Pre-Albumin level

16-30 mg/dL

Significant weight loss constitutes:

5% in 1 month | 10% in 6 months

SMART = | to assess client outcomes when making nursing diagnoses

``` Specific Measurable Attainable Realistic Timed ```

PES

problem etiology symptoms

STEEEP measures

patient safety ``` Safe Timely Efficient Effective Equitable Patient-centered ```

Latent failure

1. from organizational policies 2. procedures 3. allocation of resources (blunt end)

Active failure

1. direct contact with patient | sharp end

sentinel

unexpected event that leads to death/physical injury

Medications: Lipid solubility of medication

med can be absorbed faster if it's lipid soluble

QSEN (quality and safety education in nursing) addresses six competencies

``` E vidence-based practice Q uality improvement I nformatics P atient-centered care S aftey T eamwork and collaboration ```

Medication can bind to __, which limits the amount of __ _ in the blood. Less __ can contribute to __ __.

albumin free albumin albumin; medicine toxicity

Excretion of medications (KBELL)

``` Kidney Bowel Exocrine Glands Liver Lungs ```

idiosyncratic rxn:

over- or under- reaction to a medication

Therapeutic range:

narrow range btwn minimum effective concentration (MEC) and toxic concentration

What do you need for a complete medication order?

1. med name 2. dosage 3. type of administration 4. frequency of administration 5. reason for administration

Errors of Omission when talking about medications:

basically errors which the patient either never saw the drug or did not take the drug

valvular stenosis

hardened valve that cannot close or open properly your cardiac output will decrease ; you will see heart failure b/c the heart muscle tries to compensate for this decreased cardiac output

Early signs of hypoxia

cognitive signs irritability restlessness

Hgb values for males: | for females:

14-18 g/100 mL males | 12-16 g/100 mL females

Hct values for males: | for females:

42-52% males | 37-47% females

RBC count males: | for females:

4. 7-6.1 million/mm3 males | 4. 2-5.4 million/mm3 females

WBC

5,000-10,000/ cubic millimeter

Troponin I value elevates as early as

3 hours after myocardial injury

Troponin I value remains elevated for

7-10 days

Plasma cardiac Troponin I

Plasma Cardiac Troponin T

Troponin T value remains elevated for

10-14 days

CK male

55-170 units/L

CK female

30-135 units/L

Myoglobin

nl range for fasting cholesterol

less than 200 mg/dL OR less than 5.2 mmol/L

nl range of LDL

nl range of VLDLs

7-32 mg/dl

nl range of HDLs

Male: >45 mg/dL Female: >55 mg/dL

nl range of Triglycerides

Male: 40-160 mg/dL Female: 35-135 mg/dL

Nursing responsibilities for Thoracentesis:

``` Monitor vital signs CXR after the procedure Auscultate breath sounds Check puncture site for bleeding or leakage Document procedure ```

A PPD induration of more than 5 mm is considered positive for person

with or at risk for HIV infection; those who had close, recent contact with someone who has infectious TB, or who has CXR that show old, healed TB

A PPD induration of greater than 10 mm is considered positive for

foreign born persons from high prevalence countries, IV drug users, medically underserved, low-income populations, residents of long term care facilities, people with chronic illnesses, and all children and adolescents

A PPD induration of greater than 15 mm is considered positive for

all persons

Persons with vaccinated with BCG vaccine has a

positive reaction to TB test

For the nasal cannula, if you administer more than 4-5 L , you should

humidify the oxygen before the patient breathes it in

Venturi mask delivers what?

fraction of inspired oxygen (FiO2) from 24-60% ; delivers oxygen with humidity

pharmacological agents of dyspnea

Bronchodilators Inhaled Steroids Mucolytics: can liquefy secretions

For suctioning, you shouldn't leave the suctioning in for longer than

10-15 seconds | you're suctioning oxygen out when you do this

Postural drainage can be taken out by:

chest physiotherapy - > chest percussion be careful with someone with osteoporosis: can be at risk for fractures during percussions; contraindicated in pts with bleeding disorders, burns, open wounds, skin infections of the thorax

___ is a more gentle alternative to chest percussion. It is a gentle, shaking pressure applied to the chest wall to shake secretions into larger airways

Vibration