Flashcards in Interventions Exam 3 Only Important Deck (102):
In stage 4 of NREM, do newborns spend more or less time? Elderly?
What happens to cerebral blood flow and O2 consumption during REM sleep?
What happens to respirations, BP, pulse, and muscle tone during REM sleep?
Respirations become even; BP and pulse INCREASE, and muscle tone decreases
What happens to the muscles in Stage 3 of NREM sleep?
The relax, but tone remains
What role does serotonin play in sleep?
decrease activity and induce sleep
What role does Ach and NE play in sleep?
required for REM sleep to occur
How many hours a night do infants need to sleep? Adults?
Infants: 16 hours
What is stereognosis?
knowing what an object is by touching it
What is presbyopia?
Decline in vision after the age of 40
What is cataracts?
Cloudy lens, caused by smoking, ETOH use, and DM; can be removed by laser
What is glaucoma?
lost periphery vision, caused by pressure; first leading cause of preventable blindness
What is diabetic retinopathy?
Changes in blood vessels caused by years of uncontrolled blood glucose
What is macular degeneration?
Loss of central vision, caused by smoking and sunlight exposure, first leading cause of blindness
What is presbycusis?
Loss of hearing in people over the age of 75
What are the 3 causes of strokes?
Clots, hemorrhage, and emboli
What are the risk factors of strokes?
HTN, age, family hx smoking, DM, high cholesterol, oral contraceptives, and anticoagulants
What is expressive aphasia?
Broca's: inability to express words one wants to say
What is receptive aphasia?
Wernicke's: difficulty understanding verbal OR written words
What is dysarthria?
motor speech disorder, often resulting from a stroke or brain injury
What is the difference between delirium and dementia?
Delirium is acute and often goes away when physiologic cause is treated; dementia is gradual, and irreversible
What are the stages of symptoms for Alzheimer's?
Loss of memory (amnesia), loss of sensation (agnosia), loss of purposeful actions (apraxia), and loss of speech (aphasia)
What may occur if sodium levels are less than 135 or higher than 145?
What can happen if calcium levels are greater than 14?
What is osmolarity and what is the normal range?
proportion of dissolved particles in a VOLUME of fluid, normal is 280-300
What happens when there is a change in the normal composition of fluid?
Hypothalamus secretes aldosterone
What is potassium essential for?
cardiac, neural, and muscle function
What is magnesium important for?
regulating neuromuscular function and cardiac activity
What is the normal value for chloride?
What does osmotic pressure do?
keeps fluid inside of the blood vessels
What does hydrostatic pressure do?
What is filtration pressure and what happens if it is (+)? (-)?
Difference between osmotic and hydrostatic pressure.
if +: fluid LEAVES vessels
if -: fluid ENTERS vessels
What is isotonic fluid imbalance and what is it caused by?
loss in same concentrations as they are in the body, so electrolyte levels may be normal.
causes: GI loss, wound drainage, burns, sweating
What are the SE of an isotonic deficit? Excess?
Deficit: dry membranes, hypotension, tachycardia
Excess: heart and renal failure, weight gain, edema, HTN, crackles
What are the causes of water deficit or HYPERosmolarity?
decrease H2O intake, increase H20 loss and solute intake
What lab values will be seen with hyperosmolarity?
Os: >300, Na: >145 (often called hypernatremia)
What are the causes of water excess or HYPOosmolarity?
increased H2O intake, decreased urine H2O output, abnormal ADH secretions
What regulates carbon dioxide?
What regulates bicarbonate?
What are the normal ranges for pH, pCO2, and HCO3?
In order for ABGs to show that it is respiratory, what must there be?
an INVERSE relationship between pH and pCO2
In order for ABGs to show that it is metabolic, what must there be?
no inverse relationship between pH and pCO2
either pCO2 or HCO3 is abnormal, but the other is normal
if BOTH pCO2 and HCO3 are abnormal, but the pH is not normal
if BOTH pCO2 and HCO3 are abnormal, AND pH is normal
What compensates metabolic imbalances?
respiratory, reacts quickly
What compensates respiratory imbalances?
renal, takes hours to days
What are two hypotonic solutions?
0.25% NS and 0.45% NS
What are hypotonic solutions used to treat
What are two isotonic solutions?
0.9 NS, lactated ringers
What are isotonic solutions used to treat?
GI loss, H20 and electrolyte
What are three hypertonic solutions?
3% NaCl, protein solutions, TPN
What are hypertonic solutions used to treat?
hypotonic fluid imbalances
What is the normal CO for adults?
4-6 L/min at rest
How does cardiac dysfunction effect the respiratory system?
RR and effort increases, SOB can occur
A productive cough with frothy sputum is a common manifestation of what?
What are two signs of diminished CO?
Low BP and diminished oxygenation
What is hyperventilation, and what causes it?
ventilation in excess of that required to eliminate normal CO2; caused by hypoxia, aspirin overdose, ketoacidosis
What is hypoventilation?
ventilation inadequate to meet body's oxygen demands or eliminate sufficient O2 (pH drops-more acidic)
What is special about COPD patients?
have adapted to high CO2 levels (often hypoventilate), stimulus to breathe is low O2 levels (not high CO2 levels), cannot have to much oxygen and normal pulse ox will be lower
Signs of hypoxia?
restlessness, apprehension, changes in LOC, behavioral changes, dizziness, cyanosis
When are fine and coarse crackles heard?
Coarse: inspiration to expiration
When are rhonchi (snoring) heard? Causes?
Expiration; airway narrowing, COPD, tumors, mucous
When are wheezes (muscial) heard? Causes?
Expiration; airway obstructed, lung cancer
What is the cause of pleural effusion?
fluid in the pleural space
What is atelectasis?
collapse of alveoli
What is hypovolemia?
Reduction in circulating blood volume
What is asthma sputum like?
What is pulmonary edema sputum like?
What increases with hypoxia?
pulse rate, rate and depth of respirations, BP
What is the max level of oxygen that can be given to a COPD patient?
What is the difference between a low flow and high flow oxygen system?
Low: provides PART of total inspired air, O2 delivery varies with breathing
High: provides TOTAL inspired air, O2 delivery does not vary with breathing
Which artificial airway works best on a comatose patient? Noncomatose patient?
Coma: oropharnygeal (oral)
Non-coma: nasal trumpet (nose)
Lubricate with water soluble gel!
Oxygen limits for nasal cannula?
1-6 L/min (though 2-3 is normally used), 22-44% O2
Oxygen limits for simple face mask?
6-10 L/min, 40-60% O2 *NOT for COPD patients*
Oxygen limits for non-rebreather mask?
10-15 L/min, 80-90% O2
Oxygen limit for rebreather mask?
10-15 L/min, 70% O2,
Oxygen limit for venturi mask?
3-8 L/min, 24-50% O2 *oxygen mixes with air*
How does BiPAP work?
triggered by client's inspiration, pushes air into lungs to prevent atelectasis
How does CPAP work?
oxygen under continuous pressure, used at night to prevent sleep apnea
How long after abdominal surgery are hypoactive bowel sounds normal?
1-3 days, after that, suspect paralytic ileus
What temp should enema solution be heated to?
How often should post op stomas be assessed?
every 2 hours for 24 hours
every 4 hours for 28-72 hours
every 4-8 hours or PRN
What is an ileostomy?
empties from the end of the SMALL intestines
What is a colonstomy?
located anywhere on the LARGE intestine
What is an ileoloop?
ureter drains into portion of ileum, which forms a psuedo bladder, straight catheter can be used and avoids the need for an external pouch
What is an ureterostomy?
permanent fistula for drainage of ureter through abdominal wall
What is lavage?
removal of stomach content
What is decompression?
enteral tube connected to low wall suction for bowel obstruction, paralytic ileus
What can a Levin NG tube be used for?
feeding and decompression
What can a Corpak NG tube be used for?
What is the difference between a gastrostomy and PEG tube?
Gastrostomy: inserted surgically
PEG: endoscopic procedure
What is a jejunostomy used for?
bypassing the stomach to prevent regurgitation and aspiration
How long after administering meds should the enteral tube section be turned off?
30 minutes after med admin
At what residual volume should you notify the MD?
greater than 400-500ml
What is hyperalimentation?
TPN- feeding through a central line with a HYPERTONIC solution
What does BUN measure?
urea nitrogen in the blood (normal 5-20)
Where is creatinine made?
skeletal muscle breakdown
What are the normal ranges for creatinine in males and females?
When should a foley bag be emptied?
AT LEAST every 8 hours
What is algor mortis?
cooling of the body after death
What is livor mortis?
skin discoloration after death