Nur 101 Unit 2 Flashcards

Question

Macronutrients Vitamins Pg.W81

Answer 1

Water soluble Fat soluble

Answer 2

Major Essential

Answer 3

Process of producing and using energy within the body's cells. The final process of nutrition Fueled by nutrients : - Energy produced - energy used - needs to be balanced for health Thyroid hormone players a major role

Answer 4

To maintain essential life processes (BMR) - breathing, circulation, NS function To support non essential life activities - running, working, handling stress, some energy is used for digestion and absorption

Answer 5

The amount of energy required for essential life processes It's measures when the body is physically, metabolically, and emotionally at rest Influenced by activity, hormonal imbalance, temp. Stress, illness

Answer 6

Blood channeled to the liver is where metabolic process occur Anabolism Catabolism

Answer 7

- cell building - excess stored as fat and can be used for body needs if nutritional intake isn't sufficient - fat excess= weight gain (Lab assessment = positive balance )

Answer 8

- break down of cells and tissues - necessary for a constant source of energy - excess= decreased weight -cont. excess = muscle wasting (ex diarrhea) (Lab assessment = negative balance )

Answer 9

More consumed than excreted - increased demand during pregnancy, growing, kids - anabolic state

Answer 10

Intake less than output -loss of protein in the form of muscle and other tissue. - metabolic demands are not met ( catabolic state)

Answer 11

24 hr urine 24 hr calorie counting, looking at the protein and nitrogen intake. BUN blood test Albumin and protein blood test to ck for deficiencies ( nessary for wound healing)

Answer 12

- Blood stasis - Redness not relieved by massage or pressure relief - warm to touch

Answer 13

- Epidermal loss, possible damage to the dermis - moist and depressed skin, erosion, abrasions, blister, shallow crater - can heal ok R/t no blood vessel damage

Answer 14

- full thickness skin loss - ulcer can extend to subcutaneous layer - drainage is common( suro-sanguinous or purulent) - healing time is longer and needs regranulation

Answer 15

- full thickness deep into CT, muscle, bone. - may have necrosis - need adequate protein and albumin levels for healing( attn nutrition. Pt put on special diet) - healing time is longer - may need debridement

Answer 16

Cut away necrotic tissue Wet to dry dressing changes

Answer 17

Palpation: roll up and down b/t fingers. Only visible if inflamed

Answer 18

- Inflammation of lymph nodes | - painful

Answer 19

Inflammation along the course of the lymph vessel

Answer 20

Tissue swelling

Answer 21

T3 T4 Calcitonin

Answer 22

Increases BMR with increase oxygen consumption Increases chem rxn rates Stimulates metabolism of essential nutrients Promotes human growth Short lifespan

Answer 23

Same functions as T3 Can be converted into T3 Secreted in larger amounts Longer life span than T3

Answer 24

Calcium metabolism

Answer 25

Located on the posterior surface of the thyroid gland Regulates calcium phosphorus metabolism

Answer 26

- Exophthalmos - weakness, fatigue - diaphoresis(sweating) - tachycardia, chest pain, dysrhythmias, increased BP - weight loss, increases appetite, diarrhea or constipation - restlessness, nervousness, insomnia, irritable, hyperactivity

Answer 27

Myxedema - decreased cardiac output and condition, enlarged heart, decreased BP - atherosclerosis, increased colesterol - lethargy, fatigue, slow speech, thick tongue, deep voice - weight gain, decreased appetite, decreased peristalsis, constipation - dry brittle hair - facial edema - memory impairment - cold tolerance, cold extremities

Answer 28

``` Use inspection and palpitation Good lighting Evaluate areas at risk(pressure points) Inspect all wounds, under skin folds Compare right to left Investigate any abn new finding and describe throughly ```

Answer 29

chronic skin infections with ulcerations (especially on the feet), poor wound healing, yeast infection under breasts, between fingers and toes, axilla and genital area

Answer 30

jaundice, edema, ascites (fluid in abdomen), impaired protein metabolism with ETOH (alcohol), red palms and spider veins all over.

Answer 31

pallor (pale), platelet disfunction, jaundice, edema

Answer 32

of the skin

Answer 33

edema if excess; decreased turgor, dryness, wrinkles, brittle skin and nails if fluid intake inadequate.

Answer 34

pallor, cyanosis (blue lips, mouth, fingertips, toes), flushing, mottling (patches of blue/black areas), cold, clammy

Answer 35

not enough blood and O2; pale, mottling, necrosis, cold, ulcerations

Answer 36

fungal vs viral, herpes, cold sores, ringworms, scales, scabies, flaking, eggs, lice, nits, vesicles (blisters)

Answer 37

``` Diet Weight problems Ingestion problems Food and fluid intake N/V Preferences Activity level Psychosocial, cultural and personal influence Nutrition knowledge (can they read food lables) Physical change ```

Answer 38

``` Subcutaneous fat (palpitation) Muscle mass Hight and weight Skin integrity Hair Nails Oral cavity Abdomen (palpitation) Thyroid gland(palpitation) Body temperature (palpitation) ```

Answer 39

``` Color pigment moisture Temp Thickness Texture Turgor Mobility Hygiene Lesions ```

Answer 40

``` Color Pigment Quantity Texture Distribution Hygiene ```

Answer 41

``` Shape Configuration Color Lesions Thickness Capillary refill -160 degree angle -clubbing( lack of O2) -spooning(illness and sickness) -cyanosis ```

Answer 42

``` Excess fluid in tissue. Assess for pitting and timing to return back to normal positioning. Assessment and documentation of edema -trace -1+ =2mm -2+ =4mm -3+ =6mm -4+ =8mm Brawny = warm, shiney, tight, weeping ```

Answer 43

Elasticity(dehydration) - brisk - sluggish(ck for tenting of the skin)

Answer 44

Ability to collect and use information Decision making and other cognitive processes

Answer 45

Major biological support system | - neuro pathology affects this system

Answer 46

``` The process of knowledge Involves: Intellectual function Learning Motivation Thinking Thought processes Problem solving ```

Answer 47

The process of acquiring info Involves: Using senses Meaningful interpretation

Answer 48

Note status of all senses Note awareness of self-surroundings ID risk factors Note ability and knowledge to manage health

Answer 49

Possible tissue damage

Answer 50

Is whatever the client says it is and exist wherever they say it is(subjective) Interferes with life activities Results in stress and anxiety Need to be documented per TJC Identification and tx is important criterion of quality of care

Answer 51

Is a protective mechanism -Vision hearing and touch contributes to Enjoyment of people Relationships Appreciation of the world -provides information used in higher cognitive processes

Answer 52

Degree of wakefulness Arousability

Answer 53

Ability to Understand Think Feel emotions

Answer 54

``` Abstract thinking Problem solving Insight Memory Judgment Attn span Understanding language Ability to follow directions ```

Answer 55

``` Speech Comprehension of language Ability to Hear Answer simple questions Follow simple commands ```

Answer 56

Adequate senses( hearing, taste, touch, smell, vision) Compensation( glasses, hearing aids) Pain management Cognitive functional abilities (orientation, memory, reasoning, judgment, decision making)

Answer 57

``` Standardized assessment tool for assessing LOC Cerebral dysfunction -assess eyes opening -Motor and verbal responses Burton p.430 ```

Answer 58

``` Fully awake Alert Lethargic Obtuned Stuporous/ semicomatose Comatose ```

Answer 59

Highest level

Answer 60

Awake and oriented | Responds to verbal commands

Answer 61

``` Not fully alert Drowsy/sleepy Arousable Looses train of thought( disoriented ) Spontaneous movements ```

Answer 62

Sleep most of the time Few spontaneous movements More rigorous stimulation to arouse Decrease in appropriate responses to verbal commands

Answer 63

``` Unconscious most of the time No spontaneous motor activity Strong stimuli to arouse(pain) Verbal responses limited or absent( moans and groans) Rarely awake or oriented ```

Answer 64

Unable to arouse with painful stimuli + gag reflex + cough If no reflexes, in deep coma

Answer 65

Decorticate Flexor Decerebrate Extension Flaccid

Answer 66

Abn FLEXION posturing May be in response to pain or may me spontaneous Brain damage above the brainstem

Answer 67

Abn EXTENSION posturing To stimulus or spontaneous Damage IN brainstem Ominous sign

Answer 68

Limp | without muscle tone

Answer 69

Decreased LOC and reflexes HA, restless Change in respiratory status Increase or decrease in pulse Increase in BP Widening pulse pressure

Answer 70

Inability to express oneself properly thru speech 2 kinds Expressive- can't form words Receptive- confused with words coming out.

Answer 71

``` Puples Equal Round React to Light Accommodation ```

Answer 72

Pupils constrict as objects come closer

Answer 73

Eye cross as objects come close

Answer 74

Point at which pain is felt

Answer 75

Pain endurance

Answer 76

Significant, severe Recent onset Damage or injury has occurred

Answer 77

Consistent or intermittent Persistent beyond expected healing time Poorly defined Problematic

Answer 78

``` Somatic Visceral Phantom Neuralgia Causalgia ```

Answer 79

Can be localized originates in trunk, skin, or bone(external)

Answer 80

Internal organs ( ischemia, spasms, radiates from origin like with chest pain(referred) can't be sharply localized( internal)

Answer 81

Intense pain after trauma that involves peripheral nerves of an extremity

Answer 82

``` Traumatic injury CVA fluid and electrolyte Imbalance Hypoxia Medications ```

Answer 83

``` Blood sugar Blood urea nitrogen (BUN) Arterial blood gases (ABG's) Electrolytes Calcium Toxic substances (drug, ETOH) ```

Answer 84

Fractures Motor dysfunction Degenerative joint disease (DJD)

Answer 85

Trauma Meligancy Cerebral / spinal cord Infractions

Answer 86

Lesions | Malignancies

Answer 87

Dye test for blood vessel evaluation

Answer 88

Assess nurse and muscle response to electrical stimulation

Answer 89

Recording of brain activity to do brain death or epilepsy

Answer 90

``` Acute pain Chronic pain Disturbed sensory perception Unilateral neglect Deficient knowledge Disturbed thought process Acute confusion Readiness for enhanced decision making Impaired environmental interpretation syndrome( common in CVA pt) Chronic confusion Readiness for enhanced knowledge Decision all conflict Impaired memory ```

Answer 91

``` Failure to thrive(adult) Imbalance nutrition: less than/ more than Breastfeeding - interrupted -ineffective -effective Impaired swallowing Nausea ```

Nur 101 Unit 2 Flashcards

(116 cards)