Exam 2 Flashcards
(176 cards)
1
Q
what is perception?
A
the ability to interpret sensory input from the five senses into one or more meaningful responses
2
Q
how can medications affect perception?
A
medication can hinder your senses thus affecting your perception
3
Q
what senses are most common to decline with age?
A
sight and hearing
4
Q
what are people who has decreased perception at risk for?
A
falls because they cant see well enough to see items in their path
5
Q
what two diseases can lead to damage of the senses?
A
diabetes and chronic hypertension
6
Q
what is it called when drugs cause damage to the ears?
A
ototoxicity
7
Q
what are the most common eye diseases in the older population?
A
glaucoma and cataracts
8
Q
what is sensory deprivation?
A
a state where you lack sensory stimulation either by natural causes or experimentation
9
Q
what are natural causes of sensory deprivation?
A
blindness and deafness
10
Q
what locations may cause sensory deprivation?
A
nursing homes, hospitals, isolation rooms
11
Q
what body parts may be damaged by trauma that can cause sensory deprivation?
A
spinal cord and brain
12
Q
what are the symptoms of sensory deprivation?
A
depression, anxiety, and hallucinations
13
Q
how can you help patients with sensory deprivation?
A
coloring, colorful pictures, music, talking with them, physical touch
14
Q
what is sensory overload?
A
excessive stimulation to one or more senses?
15
Q
how can you help with sensory overload?
A
dim the lights…turn the tv off…calm the environment…speak softly and calm…keep them on a schedule
16
Q
what is the pathophysiology behind glaucoma?
A
damage to the optic nerve angle caused by IOP
17
Q
if untreated what can glaucoma progress to?
A
blindness
18
Q
what are the two kinds of glaucoma?
A
wide/open angle and narrow-angle
19
Q
what would glaucoma look like for the patient?
A
the patient would experience decreased peripheral vision and see halos
20
Q
what is wide/open-angle glaucoma?
A
Increased IOP
21
Q
what is the most common type of glaucoma?
A
wide/open angle
22
Q
is wide/open angle glaucoma a slow or rapid progression?
A
slow progression
23
Q
does narrow-angle glaucoma progress fast or slow?
A
fast
24
Q
which type of glaucoma is a medical emergency?
A
narrow-angle
25
which type of glaucoma may the pupils not be reactive to light?
narrow-angle
26
what are the causes of glaucoma?
older age....uncontrolled diabetes...uncontrolled hypertension....eye trauma
27
what would you find in an assessment of someone who has glaucoma?
decreased peripheral vision...decreased distance perception...seeing halos around lights...elevated Intraocular pressure
28
what interventions do we have for glaucoma other than glaucoma medications?
treat symptoms like pain and nausea....Monitor IOP...Dim lights...wear sunglasses
29
what is done during a glaucoma surgery?
the surgeon implants a tiny tube, or shunt, onto the white part of your eye.
The tube helps extra fluid drain out of your eye, lowering your eye pressure
30
what should you avoid post-glaucoma surgery?
exercise...lifting more than 10lbs...bending at the waist...straining
31
what is cataracts?
the lens of the eye that is normally clear becomes dry which leads it to be cloudy
32
what are the causes of cataracts?
trauma...long term steroid abuse...diabetes..hypothyroidism...down syndrome...excessive sunlight without eye protection
33
what would you see during an assessment for cataracts?
pain-free..blurry vision... decreased color perception... developed over time...can lead to blindness
34
how can you prevent cataracts?
protecting your eyes from the sun
35
what is done during a cataract surgery?
doctor removes the cloudy lens and replaces it with an artificial lens
36
At what point should surgery be considered for cataracts?
when it keeps you from performing ADLs
37
what are common symptoms for people who have had cataract surgery?
mild itching.... bloodshot eye...slight swelling...mild pain
38
what should you avoid post-cataract surgery?
aspirin...blood thinners...bending...coughing..sneezing..
39
what symptoms should you look out for post-cataract surgery?
bruising..bleeding..decreased vision...increased tear production...yellow/green drainage
40
what is macular degeneration?
progressive disease where you loose the inner part of your vision
41
is there a cure for macular degeneration?
there is no cure but there is a surgery that provides temporary relief
42
what are the two kinds of macular degeneration?
dry and wet
43
what is wet macular degeneration?
Abnormal growth of blood vessels into the macula
44
what is dry macular degeneration?
Decresed blood flow to retina
45
who is at risk for developing macular degeneration?
people who dont take in enough Vitamin E and Keratin, smoking, diabetes, hypertension
46
what are the symptoms of macular degeneration?
no vision in the middle of their sight and decreased depth perception
47
what is conductive hearing loss?
genetic disorders, infections, head trauma, fluid, foreign objects, allergies, ruptured ear drum, impacted ear way
48
what is sensorineural hearing loss?
genetic disorder, infections, head trauma, aging, noise damage, drug side effects, auditory tumors, explosions
49
what in your assessment points to hearing loss?
the patient can't hear you...certain pitches/voices can be heard...vertigo... tinnitus...
50
how can you prevent hearing loss in your old age?
not being around loud things...not listening to your music loud...wearing ear protection when in a loud environment...treating ear infections quickly
51
what are advance directives?
Advance directives are legal documents that provide instructions for medical care and only go into effect if you cannot communicate your own wishes.
52
what are some examples of advance directives?
Living will and durable POA
53
what is a living will?
written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preferences for other medical decisions, such as pain management or organ donation
54
what is a durable POA?
appoints a person to make decisions for you
55
what is palliative care?
care for someone with a chronic lifelong illness that will lead to death.....curative treatments are still being performed
56
what is hospice care?
the patient has less than 6 months to live and will no longer receive curative treatment
57
is hospice part of palliative care?
yes
58
is palliative care part of hospice?
no
59
what is a DNR/AND order?
the patient has decided that they do not want to be resuscitated
60
what does DNR stand for?
Do not resuscitate
61
what does AND stand for?
allow natural death
62
what does DNI stand for?
do not intubate
63
what does POLST stand for?
physician order for life-sustaining treatment
64
xx what does a POLST order mean?
this allows the patient to pick and choose what treatments they want under certain conditions if they happen to be not fit for decision-making
65
what is a slow code?
purposefully not doing a code to the full extend
66
what are some other names for assisted dying?
can be called physician aid in dying, medical aid in dying, physician-assisted dying or physician-assisted suicide
67
what is assisted dying?
this happens when the patient is given a lethal dose of a certain medication that they self-administer to end their life
68
what is active euthanasia?
patient action that leads to death....stopping eating or drinking
69
what is passive euthanasia?
allowing patients to die by taking away life-sustaining interventions such as ventilators, feedings tubes etc
70
what is palliative sedation?
administration of sedative medications in monitored settings and is aimed at inducing a state of decreased awareness or absent awareness
71
what is an actual loss?
loss of a person, status, leg, etc
72
what is a perceived loss?
unique to the person experiencing it....cant be verified by others...subjective
73
what is an example of a perceived loss?
loss of youth, financial independence, a certain environment
74
xx what is maturation/developmental loss?
normal loss to aging...kids leaving the home
75
what is situational loss?
loss of home in a tornado....loss of car in a car wreck
76
what is anticipatory loss?
feeling like you have lost something before it has happened
77
what are the 4 types of greiving?
physical, emotional, social, and spiritual
78
what is physical grieving?
crying
79
what is emotional grieving?
sadness, yearning
80
what is social grieving?
detachment and isolation
81
what is spiritual grieving?
questioning the reasoning for life and death
82
what is dysfunctional grieving?
the grieving types continue on for more than 6 months
83
what should you watch out for in those who are dysfunctional grieving?
increased risk of suicide
84
what is complicated grieving?
chronic, exaggerated, and taking frustration out on the family.......only focus is on the death of the person
85
what is disenfranchised grieving?
grief that you feel like you cant express publicly due negative stigmas on that topic
86
what are some instances where someone may experience disenfranchised grief?
abortion, someone committed suicide, the death of a patient, a family member being on drugs
87
what are the 5 stages of Kubler-ross stages of grief?
denial...anger...bargaining...depression...acceptance
88
what does denial mean in Kubler-ross stages of grief?
wont accept that they are dying...think it is a mistake... do not think the tests/diagnosis is correct
89
what does anger mean in Kubler-ross stages of grief?
ask why is this happening or why are they leaving
90
what does bargaining mean in Kubler-ross stages of grief?
trying to buy time for a specific event
91
what does depression mean in Kubler-ross stages of grief?
typical symptoms
92
what does acceptance mean in Kubler-ross stages of grief?
understanding that death is going to occur
93
what are the symptoms that death is about to occur?
cold...shallow breaths...apnea..death rattle..anorexic...incontinence... increased sleep
94
what should be done during post-mortem care?
remove any jewelry, tubes/ivs should be removed, the patient should be cleaned up, and placed into the body bag.
95
what is the pathophysiology behind diabetes?
your pancreas does not produce enough insulin
96
when does your body produce the most insulin?
when you are eating
97
when does your body produce the least amount of insulin?
when you are fasting
98
what does insulin do?
insulin moves the sugar from your blood into your cells
99
what are some symptoms of hyperglycemia?
polyuria...polyphagia...polydipsia
100
what is the normal range for blood sugar levels?
60-100
101
how can diabetes be diagnosed?
signs and symptoms and random check of 200 or above
102
what is a post-load blood sugar and what number indicates diabetes?
you ingest a large amount of glucose and if you are over 200 you have diabetes
103
what is a fasted blood glucose and what number indicates diabetes?
you can drink water but can not eat for 8 hours and if you are over 126 you have diabetes
104
what are signs and symptoms of uncontrolled diabetes?
polyuria....polyphagia...polydipsia...weight loss...delayed wound healing...hyperglycemia...blurred vision...head ache
105
what is polyuria?
excessive urination
106
what is polyphagia?
extreme hunger
107
what is polydipsia?
excessive thirst
108
what does a HBA1C of 6.5 and under mean?
that your blood sugar is under control
109
what does an HBA1C over 6.5 mean?
that your blood sugar is not under control
110
what does HBA1C measure?
blood test that measures you average glucose level over 3 months
111
what are macrovascular complications in diabetics?
stroke, heart attack, peripheral artery disease
112
why are diabetics more susceptible to macrovascular/microvascular complications?
the high glucose content causes damage to the vessels
113
what is a microvascular complication that diabetics might get?
nephropathy, retinopathy, neuropathy
114
if you have a problem with your kidneys what should you avoid when getting an MRI?
contrast
115
if you have a problem with your kidneys what medication should you avoid?
nephrotoxic meds
116
what kind of diet should you be on if you are having problems with your kidneys?
low sodium and low protein
117
what should diabetic patients do?
consult with a nutritionist, eat a balanced diet, eat about the same time every day, eat raw vs cooked vegetables, monitor weight, limit alcohol consumption, exercise 3x per week, use your glucometer
118
what should diabetic patients avoid?
smoking, excessive alcohol consumption, sweeteners with caloric value
119
what is oxygenation?
process of supplying cells with oxygen
120
what should information be gathered in a history when assessing a patient's lungs?
Past conditions....smoking... environment...occupation....trouble breathing...current illnesses...medications
121
what should information be gathered in a history when assessing a family history related to the lungs?
genetic problems
122
what is the group of lung sounds that are not normal called?
adventitious lung sounds
123
what are some examples of adventitious lung sounds?
crackles, wheezes, stridor, friction, wheezing
124
other than auscultation how can you physically assess someone's lungs?
look at vitals signs specifically O2 percentage
125
where in the lung do you hear bronchial lung sounds?
upper region
126
where in the lung do you hear bronchovesicular lung sounds?
middle region
127
where in the lung do you hear vesicular lung sounds?
lower region
128
how can bronchial lung sounds be described?
loud and harsh
129
how can a bronchovesicular lung sound be described?
mixed between loud and soft
130
how can a vesicular lung sound be described?
soft
131
what do crackles in the lungs sound like?
popping and rattling
132
what does crackles in the lungs typically point to?
pulmonary edema or atelectasis
133
what is atelectasis?
collapsed lung
134
what does friction sounds in the lung typically point to?
the lungs are rubbing together
135
what does rhonci sound in the lungs typically point to?
foreign body and thick secretions
136
what do rhonchi lung sounds sound like?
snoring
137
what do wheezing lund sounds typically point to?
asthma
138
what do arterial blood gas tests show?
measures oxygen, co2, and ph of the blood
139
how is a abg performed?
a small proble is placed into the artery
140
what does a sputum specimen show?
shows infection
141
what are the guidelines for collecting a sputum specimen?
best done in the morning food or drink...not spit..actual mucus...
142
what does a chest x-ray show in relation to the lungs?
looking for fluid, tumors, foreign bodies, or other diseases
143
what should a patient do during the chest x-ray?
hold their breath
144
what does a ct scan show in relation to the lungs?
looking for pulmonary tumors or nodules
145
what is more accurate for lung diagnosis x-ray or CT?
ct
146
what should be taken into consideration when sending a patient down to get a CT scan?
if the patient has claustrophobia
147
what does a pulmonary function test show in relation to the lungs?
it shows the peak flow rate
using a spirometer you can see if the treatment is working
148
what is a bronchoscopy?
a scope goes directly into the lungs to look for any abnormalities....biopsy can also be take
149
what should be done when you get a patient post-bronchoscopy?
make sure they have gag reflex...start with ice chips to test swallowing abilities
150
what is normal in first 24 hours post bronchoscopy?
fever and bloody sputum
151
what is a thorocentesis
a procedure done to remove fluid or air in the thoracic cavity
152
what can happen to a patient if the flow rate is too high?
oxygen toxicity
153
what can be monitored to prevent oxygen toxicity?
ABG
154
what is the flow rate and FiO2 for a nasal cannula?
1-6 L/min and 24-44%
155
can a nasal cannula be used long term?
yes
156
what is the flow rate and FiO2 for a simple face mask?
5-8 L/min and 40-60%
157
can a simple face mask be used long term?
no
158
what is the flow rate and FiO2 for a partial rebreather?
8-11 L/min and 60 -75%
159
what is the flow rate and FiO2 for a nonrebreather?
10 - 15 L/min and above 90%
160
what is a venturi mask used for?
it is a high-flow mask which is the most accurate oxygen-delivery device
161
how does a venturi mask work?
it uses tips that are put on the oxygen tree and each tip mixes room air and oxygen
162
what is the pathophysiology behind asthma?
the smooth muscle rings found in the bronchi and bronchioles contract which constricts the airway the constriction occurs its makes the mucosal lining secrete mucous which makes it even harder for air to pass
163
what can trigger asthma attacks?
pollen, smoke, fragrances, dust, exercise, cold weather, stress and common colds
164
what is hyperinflation in asthmatics?
it occurs when someone is having an asthma attack and the air becomes trapped inside the lung
165
what are some symptoms of asthma?
Shortness of breath
Cough
Chest tightness or pain
Wheeze (a whistling sound when you breathe)
Waking at night due to asthma symptoms
A drop in your peak flow meter reading (if you use one)
166
what can be done to help diagnose asthma?
ABGs...to monitor gasses
Physical auscultation
PFT...to monitor treatment effectiveness and find a baseline
167
how can you manage asthma?
medications and learning triggers
168
what is status asthmaticus?
an extreme asthma attack characterized by hypoxemia, hypercarbia, and respiratory failure
169
what is hypoxemia?
low oxygen in the blood
170
what is hypercarbia?
increased co2 in the blood
171
what is COPD?
the combination of emphysema and bronchitis
172
what is the most common cause of copd?
smoking and smoking exposure
173
what genetic disorder can lead to copd?
alpha 1 antitrypsin deficiency
174
what interventions can help people with copd
oxygen therapy...breathing techniques..positioning...coughing..drug therapy...suctioning..exercise...prevent infection..prevent weight loss
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