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Flashcards in Interventions Exam 3 Only Important Deck (102):
1

In stage 4 of NREM, do newborns spend more or less time? Elderly?

Newborns: more
Elderly: less

2

What happens to cerebral blood flow and O2 consumption during REM sleep?

both INCREASE

3

What happens to respirations, BP, pulse, and muscle tone during REM sleep?

Respirations become even; BP and pulse INCREASE, and muscle tone decreases

4

What happens to the muscles in Stage 3 of NREM sleep?

The relax, but tone remains

5

What role does serotonin play in sleep?

decrease activity and induce sleep

6

What role does Ach and NE play in sleep?

required for REM sleep to occur

7

How many hours a night do infants need to sleep? Adults?

Infants: 16 hours
Adults: 6-8

8

What is stereognosis?

knowing what an object is by touching it

9

What is presbyopia?

Decline in vision after the age of 40

10

What is cataracts?

Cloudy lens, caused by smoking, ETOH use, and DM; can be removed by laser

11

What is glaucoma?

lost periphery vision, caused by pressure; first leading cause of preventable blindness

12

What is diabetic retinopathy?

Changes in blood vessels caused by years of uncontrolled blood glucose

13

What is macular degeneration?

Loss of central vision, caused by smoking and sunlight exposure, first leading cause of blindness

14

What is presbycusis?

Loss of hearing in people over the age of 75

15

What are the 3 causes of strokes?

Clots, hemorrhage, and emboli

16

What are the risk factors of strokes?

HTN, age, family hx smoking, DM, high cholesterol, oral contraceptives, and anticoagulants

17

What is expressive aphasia?

Broca's: inability to express words one wants to say

18

What is receptive aphasia?

Wernicke's: difficulty understanding verbal OR written words

19

What is dysarthria?

motor speech disorder, often resulting from a stroke or brain injury

20

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

21

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)

22

What may occur if sodium levels are less than 135 or higher than 145?

cognitive alteration

23

What can happen if calcium levels are greater than 14?

confusion

24

What is osmolarity and what is the normal range?

proportion of dissolved particles in a VOLUME of fluid, normal is 280-300

25

What happens when there is a change in the normal composition of fluid?

Hypothalamus secretes aldosterone

26

What is potassium essential for?

cardiac, neural, and muscle function

27

What is magnesium important for?

regulating neuromuscular function and cardiac activity

28

What is the normal value for chloride?

95-105

29

What does osmotic pressure do?

keeps fluid inside of the blood vessels

30

What does hydrostatic pressure do?

causes filtration

31

What is filtration pressure and what happens if it is (+)? (-)?

Difference between osmotic and hydrostatic pressure.
if +: fluid LEAVES vessels
if -: fluid ENTERS vessels

32

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

33

What are the SE of an isotonic deficit? Excess?

Deficit: dry membranes, hypotension, tachycardia
Excess: heart and renal failure, weight gain, edema, HTN, crackles

34

What are the causes of water deficit or HYPERosmolarity?

decrease H2O intake, increase H20 loss and solute intake

35

What lab values will be seen with hyperosmolarity?

Os: >300, Na: >145 (often called hypernatremia)

36

What are the causes of water excess or HYPOosmolarity?

increased H2O intake, decreased urine H2O output, abnormal ADH secretions

37

What regulates carbon dioxide?

lungs

38

What regulates bicarbonate?

kidneys

39

What are the normal ranges for pH, pCO2, and HCO3?

ph: 7.35-7.45
pCO2: 35-45
HCO3: 22-26

40

In order for ABGs to show that it is respiratory, what must there be?

an INVERSE relationship between pH and pCO2

41

In order for ABGs to show that it is metabolic, what must there be?

no inverse relationship between pH and pCO2

42

No compensation

either pCO2 or HCO3 is abnormal, but the other is normal

43

Partially compensated

if BOTH pCO2 and HCO3 are abnormal, but the pH is not normal

44

Totally compensated

if BOTH pCO2 and HCO3 are abnormal, AND pH is normal

45

What compensates metabolic imbalances?

respiratory, reacts quickly

46

What compensates respiratory imbalances?

renal, takes hours to days

47

What are two hypotonic solutions?

0.25% NS and 0.45% NS

48

What are hypotonic solutions used to treat

Hypertonic inbalances

49

What are two isotonic solutions?

0.9 NS, lactated ringers

50

What are isotonic solutions used to treat?

GI loss, H20 and electrolyte

51

What are three hypertonic solutions?

3% NaCl, protein solutions, TPN

52

What are hypertonic solutions used to treat?

hypotonic fluid imbalances

53

What is the normal CO for adults?

4-6 L/min at rest

54

How does cardiac dysfunction effect the respiratory system?

RR and effort increases, SOB can occur

55

A productive cough with frothy sputum is a common manifestation of what?

heart failure

56

What are two signs of diminished CO?

Low BP and diminished oxygenation

57

What is hyperventilation, and what causes it?

ventilation in excess of that required to eliminate normal CO2; caused by hypoxia, aspirin overdose, ketoacidosis

58

What is hypoventilation?

ventilation inadequate to meet body's oxygen demands or eliminate sufficient O2 (pH drops-more acidic)

59

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

60

Signs of hypoxia?

restlessness, apprehension, changes in LOC, behavioral changes, dizziness, cyanosis

61

When are fine and coarse crackles heard?

Fine: inspiration
Coarse: inspiration to expiration

62

When are rhonchi (snoring) heard? Causes?

Expiration; airway narrowing, COPD, tumors, mucous

63

When are wheezes (muscial) heard? Causes?

Expiration; airway obstructed, lung cancer

64

What is the cause of pleural effusion?

fluid in the pleural space

65

What is atelectasis?

collapse of alveoli

66

What is hypovolemia?

Reduction in circulating blood volume

67

What is asthma sputum like?

Stringy

68

What is pulmonary edema sputum like?

frothy pink

69

What increases with hypoxia?

pulse rate, rate and depth of respirations, BP

70

What is the max level of oxygen that can be given to a COPD patient?

2-3 L

71

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

72

Which artificial airway works best on a comatose patient? Noncomatose patient?

Coma: oropharnygeal (oral)
Non-coma: nasal trumpet (nose)
Lubricate with water soluble gel!

73

Oxygen limits for nasal cannula?

1-6 L/min (though 2-3 is normally used), 22-44% O2

74

Oxygen limits for simple face mask?

6-10 L/min, 40-60% O2 *NOT for COPD patients*

75

Oxygen limits for non-rebreather mask?

10-15 L/min, 80-90% O2

76

Oxygen limit for rebreather mask?

10-15 L/min, 70% O2,

77

Oxygen limit for venturi mask?

3-8 L/min, 24-50% O2 *oxygen mixes with air*

78

How does BiPAP work?

triggered by client's inspiration, pushes air into lungs to prevent atelectasis

79

How does CPAP work?

oxygen under continuous pressure, used at night to prevent sleep apnea

80

How long after abdominal surgery are hypoactive bowel sounds normal?

1-3 days, after that, suspect paralytic ileus

81

What temp should enema solution be heated to?

100-105 degrees

82

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

83

What is an ileostomy?

empties from the end of the SMALL intestines

84

What is a colonstomy?

located anywhere on the LARGE intestine

85

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

86

What is an ureterostomy?

permanent fistula for drainage of ureter through abdominal wall

87

What is lavage?

removal of stomach content

88

What is decompression?

enteral tube connected to low wall suction for bowel obstruction, paralytic ileus

89

What can a Levin NG tube be used for?

feeding and decompression

90

What can a Corpak NG tube be used for?

feeding only

91

What is the difference between a gastrostomy and PEG tube?

Gastrostomy: inserted surgically
PEG: endoscopic procedure

92

What is a jejunostomy used for?

bypassing the stomach to prevent regurgitation and aspiration

93

How long after administering meds should the enteral tube section be turned off?

30 minutes after med admin

94

At what residual volume should you notify the MD?

greater than 400-500ml

95

What is hyperalimentation?

TPN- feeding through a central line with a HYPERTONIC solution

96

What does BUN measure?

urea nitrogen in the blood (normal 5-20)

97

Where is creatinine made?

skeletal muscle breakdown

98

What are the normal ranges for creatinine in males and females?

F: 0.5-1.0
M: 0.6-1.3

99

When should a foley bag be emptied?

AT LEAST every 8 hours

100

What is algor mortis?

cooling of the body after death

101

What is livor mortis?

skin discoloration after death

102

What should NOT be done on a DNR patient?

chest compression, intubation, crash cart drugs, shock