Module 4 Flashcards
(48 cards)
1
Q
Insomnia
A
- Difficulty falling asleep or staying asleep
- The m/c sleep related complaint
2
Q
Narcolepsy
A
- Falling asleep unexpectedly (REM w/in 15 min)
- dysfunction of processes that regulate sleep/wake
- excessive daytime sleepiness = m/c complaint
3
Q
Intracellular Fluid
- def
- fraction & volume
A
- fluid within the cells
- 2/3 of total body water = ~28 L
4
Q
Extracellular Fluid
- def
- fraction & volume
- sub cat (3)
A
- Fluid outside of the cells
- 1/3 of total body water = ~14 L
- Interstitial, intravascular, transcellular
5
Q
Interstitial Fluid
- def
- volume
A
- Fluid between cells and outside blood vessels (included lymph)
- ~11 L
6
Q
Intravascular Fluid
- Def
- volume
A
- blood plasma within vascular system
- ~3 L
7
Q
Transcellular fluids
- def
- ex (5)
A
- Secreted by epithelial cells
- CSF, pleural, peritoneal, pericardial, synovial
8
Q
Hypotonic Solution
- meaning
- effect
- ex of solution
A
- Solution has fewer particles
- Water goes into cell = cell expands
- 0.45 % sodium chloride (anything less than 0.9% NaCl)
9
Q
Hypertonic Solution
- meaning
- effect
- ex. of solution (3)
A
- Solution has more particles
- Water moves out of cells = cell shrinks
- 3% sodium chloride, D10W, 5% dextrose in any type of NaCl
10
Q
Isotonic Solution
- meaning
- effect
- ex. of solution (3*)
A
- equal number of solutes in and out of cell
- equal movement of water in & out of cell = no net change
- 0.9 % sodium chloride, Lactated Ringers, D5W (starts isotonic but dextrose leaves quickly)
11
Q
Extracellular fluid volume deficit
- aka
- meaning
- association with sodium
- treatment
A
- Hypovolemia
- Not enough fluid in extracellular compartment (vascular & interstitial)
- Occurs with hypernatremia
- Tx: normal saline
12
Q
Hypernatremia & ECF Volume Deficit
- why they occur together
A
- Hypernatremia = volume goes down and high level of sodium is left
- Pulls water out of cells = cells shrink
13
Q
Clinical Dehydration
- 2 components
A
- ECF deficit & hypernatremia
14
Q
Manifestations of ECF Volume Deficit/Dehydration
A
- Sudden change in BW (decrease)
- Increase in HR
- Decrease in BP
- Increase in RR
- Decreased cerebral perfusion (check LOC, PERRLA, mm strength, reflexes)
- Skin = cool/moist
15
Q
Respiratory Acidosis
- what’s happening
- causes
A
- lungs are unable to excrete CO2 & H20
- anything that causes hypoventilation (head injury, narcotics, pneumonia)
16
Q
Respiratory alkalosis
- what’s happening
- causes
A
- lungs excrete too much C02 and H20
- anything causing hyperventilation (anxiety, pain, fever = increased metabolic demand)
17
Q
Metabolic Acidosis
- what’s happening
- causes (5)
A
- Increase of metabolic acid or decrease of base
- DKA, renal failure, starvation, APAP OD, diarrhea (lose HCO3)
18
Q
Metabolic Alkalosis
- what’s happening
- causes (3)
A
- Direct increase of base or decrease of metabolic acid
- Vomit, Excess of antacids, gastric suction
19
Q
Respiratory Acidosis
- expected pH: 7.35 - 7.45
- expected PaCO2: 35-45
- expected HCO3: 21-28
- uncompensated v partially compensated
A
- uncompensated: low pH, high PaCO2, no change in HCO3
- partially: low pH, high PaCO2, high HCO3
20
Q
Respiratory Alkalosis
- expected pH: 7.35 - 7.45
- expected PaCO2: 35-45
- expected HCO3: 21-28
- uncompensated v partially compensated
A
- uncompensated: high pH, low PaCO2, no change in HCO3
- partially: high pH, low PaCO2, low HCO3
21
Q
How to decide between respiratory and metabolic acidosis/alkalosis
A
- Respiratory: inverse relationship between pH and PaCO2
(If pH goes up, PaCO2 will go down) - Metabolic: pH and HCO3 will move together
(if pH goes up, HCO3 will go up)
22
Q
Patient 1
pH 7.32
PaCO2 48 mm Hg
HCO3 25 mEq/L
A
Uncompensated respiratory acidosis
23
Q
Patient 2
pH 7.48
PaCO2 32 mm Hg
HCO3 20 mEq/L
A
Partially compensated respiratory alkalosis
24
Q
Metabolic Acidosis
- expected pH: 7.35 - 7.45
- expected PaCO2: 35-45
- expected HCO3: 21-28
- uncompensated v partially compensated
A
- uncompensated: low pH, no change PaCO2, low HCO3
- partially: low pH, low PaCO2, low HCO3
25
Metabolic Alkalosis
- expected pH: 7.35 - 7.45
- expected PaCO2: 35-45
- expected HCO3: 21-28
- uncompensated v partially compensated
- uncompensated: high pH, no change PaCO2, high HCO3
- partially: high pH, high PaCO2, high HCO3
26
S/X of hypercalcemia (7)
- mm weakness
- Constipation
- N/V
- Anorexia
- Kidney Stones
- Diminished reflexes
- Decreased LOC
27
S/X of Hypocalcemia (3)
- Paresthesia
- mm cramps
- Tetany
28
S/X of Hyperkalemia (4)
- Cardiac dysrhythmias (tall T wave)
- mm weakness
- paresthesia
- diarrhea
29
S/X of Hypokalemia (5)
- Anorexia
- N/V
- Cardiac dysrhythmias
- Abdominal distension
- mm weakness, fatigue
30
S/X of Hypermagnesemia (5)
- decreased deep tendon reflex
- flushing/sweating
- HypoTN
- decreased respirations
- dysrhythmias
31
S/X of Hypomagnesemia (7)
- hyperactive reflexes
- seizures
- twitching, tremors
- insomnia
- HTN
- Tachyarrhythmias
32
S/X of hypernatremia (4)
- intense thirst
- oliguria
- decreased LOC
- concentrated urine (>1.03)
33
S/X of hyponatremia (5)
- dilute urine (<1.01)
- N/V
- lethargy
- confusion
- anorexia
34
what perioperative nursing means and what it includes
- peri = around the time of surgery
- care before, during, and after surgery
35
Risk factors r/t surgery
- smoking/drugs/alcohol (risk for withdrawal)
- age
- nutrition
- obesity
- Obstructive sleep apnea (monitor O2 carefully)
- Immunosuppression
- Fluid/electrolyte imbalance
- Post op N/V
- Venous thromboembolism
36
Goal of preop
Establish baseline for particular pt
37
Time Out
- when
- what is covered
- In preanesthesia care unit (PCU)/Presurgical care unit (PSCU)
(holding area)
- Stop before surgery to confirm right patient, right procedure, right site
38
Post Op Teaching
- Discuss how surgery went
- Exercise/rehab routines
- Report s/x of venous thromboemolism (px, tenderness, redness, warmth, swelling)
- Report s/x of pulmonary embolism (SOB)
39
Safety Guidelines Post Surgery
- Coughing/deep breathing (not in cataract or increased ICP)
- Reverse trendelenburg for bariatric
40
presbycusis
- age related hearing loss
- hard to hear high pitched voice
41
Expressive aphasia
- type
- def
- how to help
- motor type of aphasia
- inability to name common objects or express simple ideas in words or writing
- help in any way that works for patient
42
M/C sensory deficits in older adults (5)
- what are they and what changes
- Visual (hard to see up close)
- Hearing (hard to hear high pitch)
- Balance (less balance)
- Taste (food starts to get bland)
- Neurological (forgetfulness)
43
Palliative v Hospice
Palliative
- for life threatening illness
- increase quality of life
- reduce illness symptoms
Hospice
- for terminal illness
- dignified, px free death
44
Information required for EHR r/t end of life care
- time/date of death
- actions taken to respond to impending death
- Verification of death according to agency policy
- Name of provider certifying death
- ppl notified of death
- name of person making request for organ donation
- special preparations of body
- Devices left in body
- Items left on body
- Personal items given to family
- Location of body tags
- Time of body transfer & destination
45
Conversion
- unconsciously repressing an anxiety-producing emotional conflict and transforming it into nonorganic symptoms
- examples: difficulty sleeping, loss of appetite
46
Dissociation
- experiencing a subjective sense of numbing and a reduced awareness of one's surroundings
47
Compensation
- Making up for a deficiency and one aspect of self-image by strongly emphasizing a feature considered an asset
- example: poor communicator relies on organization skills
48
Denial
- avoiding emotional conflict by refusing to consciously acknowledge anything that causes intolerable emotional pain
- example: refusing to acknowledge a loss
