Powerpoints and Notes Flashcards
(217 cards)
1
Q
For negligence to be charged, ____________ must occur.
A
Actual Harm
2
Q
What are compact agreements?
A
Multi-state licensure
3
Q
What are the Nurse Practice Acts?
A
Defines what your scope of practice is, which thereby protects the public.
4
Q
What is negligence?
A
Failure to act in a reasonable and prudent matter (misconduct of practice below the standard.)
5
Q
What is malpractice?
A
Type of negligence. Failure of a professional, a person with specialized education and training, to act in a reasonable and prudent matter.
6
Q
What is the difference between negligence and malpractice?
A
Negligence can occur with UAP’s and professionals, but Malpractice is when a professional (Dr., lawyer, dentist, & generally nurses) is negligent.
7
Q
What 6 things need to occur for malpractice to be charged?
A
Duty, Breach of Duty, Foreseeability, Causation, Harm or Injury, & Damages.
8
Q
What is duty?
A
The nurse must have (or should have had) a relationship with the client that involves providing care and following an acceptable standard of care.
9
Q
What is breach of duty?
A
A standard of care that is expected in the specific situation, but that the nurse did not observe; This is the failure to act as a reasonable, prudent nurse under the circumstances.
10
Q
What is foreseeability?
A
A link that must exist between the nurse’s act and the injury suffered.
11
Q
What is causation?
A
A fact that must be proven that the harm occurred as a direct result of the nurse’s failure to follow the standard of care and the nurse could have (or should have) known that failure to follow the standard of care could result in such harm.
12
Q
What is harm (injury)?
A
The client or plaintiff must demonstrate some type of harm or injury (physical, financial, or emotional) as a result of the breach of duty owed the client; the plaintiff will be asked to document physical injury, medical cost, loss of wages, “pain and suffering,” and any other damages.
13
Q
What is damage?
A
If malpractice caused the injury, the nurse is held liable for damages that may be compensated.
14
Q
What is the most frequent allegation of nursing negligence?
A
Medication errors!!! (Wrong dose, wrong route, not clearly identifying the patient, etc.)
15
Q
What is liability?
A
Asserts that every person is responsible for the wrong or injury done to another resulting from carelessness.
16
Q
What is personal liability?
A
Requires the nurse to assume responsibility for patient harm or injury that is a result of his/her negligent acts. Nurses cannot be relieved of liability by another professional such as a physician or nurse manager.
17
Q
What are the three types of consent?
A
Informed, Express, and Implied.
18
Q
What is informed consent?
A
An agreement by a client to accept a course of treatment or procedure after being provided complete information, including benefits and risks of Tx; alternatives to Tx; and prognosis/outcome.
19
Q
What is express consent?
A
Oral or written.
20
Q
What is implied consent?
A
Exists when the client’s nonverbal behavior indicates agreement.
21
Q
What three groups cannot provide consent?
A
Minors, unconscious clients, and the mentally ill.
22
Q
What is the nurse’s role in obtaining consent?
A
The provider CANNOT delegate the duty to the RN.
If a nurse has reason to believe that the pt has not been given informed consent, the provider should be immediately notified.
In NO CASE should the nurse attempt to convey information required for informed consent.
23
Q
What does the nurse’s signature confirm?
A
The client gave consent voluntarily.
The signature is authentic.
The client appears competent to give consent.
24
Q
What act requires that federally funded hospitals (medicare, medicaid) inform adult pts in writing about their right to make treatment choices and to ask pts if they have a living will or durable power of attorney for health care?
A
Patient Self-Determination Act of 1990.
25
The intent of this act is to ensure confidentiality of the patient's medical records; the statute sets guidelines for maintaining the privacy of health data.
HIPPA (Health Insurance Portability and Accountability Act of 1996.)
26
What are advance directives?
Statutes that grant adults the right to refuse extraordinary medical treatment when there is no hope of recovery.
27
What is a living will?
A formal document that provides specific instructions about what medical treatment the client chooses to omit or refuse in the event that the client is unable to make those decisions.
28
What is the health care proxy (durable power of attorney for health care?)
A notarized or witnessed statement appointing someone else to manage health care treatment decisions when the client is unable to do so.
29
Who writes the DNR orders?
Written by the physician based on directives by the patient.
30
What four specific areas does HIPAA include?
Standardized Electronic transfer of information
Standardized Numbers (standard formats for identification)
Security Rule (the uniform level of protection of all electronic protected health information)
Privacy Rule (How much information you can disclose and to whom it can be disclosed to)
31
What are some tips to follow HIPAA and protect yourself?
Shred documents, turn papers away from lookers, don't discuss pt's ever, don't share your I.D codes, sign off of computers.
32
A pt has the right to refuse treatment if they are ________ and ____________.
Alert and competent.
33
If a pt is refusing treatment, the nurse should FIRST do what?
ASSESS the pt and find out why they are refusing and document it...then notify the provider.
34
What is AMA?
The act of leaving Against Medical Advice.
35
What are the nurse's responsibilities when a patient chooses to leave AMA?
Notify the provider.
Clearly articulate to the pt with the danger associated with leaving.
Thorough charting must occur.
36
When charting an AMA, what must the nurse explain to the client and document in the note?
Leaving AMA could result in the following:
Aggravate the current condition and complicate future care.
Result in permanent physical or mental impairment or disability.
Result in complications leading to death.
37
Holistic is composed of what 5 variables?
Physiological, Psychological, Socio-cultural, Developmental, Spiritual.
38
What describes the concept of the client according to the Neuman Systems Model?
The client is the center of the system
Can be an individual, family, or community
Interacts with the environment
Energy resources are Physiological, psychological, socio-cultural, developmental, spiritual
39
What does the physiological variable mean?
Being concerned with the person's physical needs or stressors and meeting the basic and physical needs, which are an important aspect of holistic care.
40
What is the most basic need from Maslow's Hierarchy of Needs?
Physiological needs are the most basic. Unless these basic needs are met (breathing, eating, etc.) a person will die or be injured and cannot move on to higher needs.
41
What is homeostasis?
A balanced state maintained by physiological & psychological body responses to internal &/or external environmental change.
Maintaining wellness or as well as a person can be.
42
What are the general approaches to assessing physiological variable?
Head to toe (Look at them, take pulse, are they breathing?)
General to specific (general appearance like color to more specific)
Nurse looks for actual &/or potential stressors or threats to homeostasis (any impending tests/procedures, family/visitors)
43
What are the 8 physiological variable subconcepts?
Safety, Comfort, Mobility/neurological, Nutrition, Elimination, Circulation, Oxygenation, Sexuality.
44
What is included under the safety category of the physiological variable?
Physical properties like:
Rugs, cords, steps, temperature, injury, etc.
Concerns within health care facilities
ID band, bed position, side rails, microbiological hazards like infection, medical errors, thermal hazards.
45
What is included under the comfort subconcept of the physiological variable?
Pain, hygiene, skin assessment, sleep patterns.
46
What is included under the mobility/neurological subconcept of the physiological variable?
General movement and gait, muscle tone, mass, and strength, posture/alignment, ROM and joint assessment, LOC and orientation, memory status, cranial nerve function, PEARL.
47
What is included under the nutrition subconcept of the physiological variable?
Height, weight, body build, patterns of weight gain or loss, patterns of daily food intake, oral care, abdomen (inspection and auscultation) and altered feeding methods.
48
What is included under the elimination subconcept of the physiological variable?
Factors affecting urination, color and characteristics of urine, factors affecting the bowel, color and characteristics of stool, frequency and amount of stool.
49
What is included under the circulation subconcept of the physiological variable?
Fatigue, weakness, SOB, pain in chest or extremities, peripheral pulses, heart sounds, capillary refill, edema, pulse, BP.
50
What is included under the oxygenation subconcept of the physiological variable?
Respiratory rate, rhythm, depth, cough, use of accessory muscles, posture and chest contour, breath sounds, smoking history, SOB, pursed lip breathing.
51
What is included under the sexuality subconcept of the physiological variable?
Evidence of and/or concerns regarding:
sexual identity, sexual role, sexual function
Women: date of onset of menarche, LMP, # of pregnancies.
Men: erectile dysfunction issues.
52
What is a person's normal line of defense?
Something that a person has lived with for 6 months or more, where it becomes their homeostasis.
53
What stressors can also be considered a normal line of defense?
Smoking, case of beer a day, etc.
54
What three categories are threats to someone's safety?
Infection, Injury, and Us.
55
How do nurses gather information?
By first assessing the pt:
| Head to toe assessment (vital signs, read chart, etc.)
56
What is the definition of Infection?
Introduction of a pathogen (fungus, bacteria, virus) into the body where it grows and duplicates.
57
What is an example of a normal line of defense?
Our normal flora on our skin
58
What are 2 examples of a flexible line of defense?
When temperature increases due to pathogen (fever.)
When swelling occurs.
59
How does our body protect us from pathogens?
Skin is the biggest protectant
Temperature increases
Saliva, tears, vomiting, diarrhea, stomach acid, normal flora, urinating, body hair, mucus membranes, etc.
60
What 6 steps are included in the chain of infection?
1. Etiologic agent (microorganism)
2. Reservoir (sources of microorganisms)
3. Portal of exit from reservoir
4. Method of transmission (direct, indirect, airborne)
5. Portal of entry to the susceptible host
6. Susceptible host
61
If a patient is low on RBC's then what can be said about that patient?
Patient is anemic.
62
What are WBC's responsible for?
Fighting infections.
63
What factors are included in a patient's CBC? (complete blood count)
RBC + WBC + Platelets = CBC
64
What cells are usually the 1st responders on the scene of an infection AND have the highest percentage as a type of WBC?
Neutrophils
65
What are nonspecific defenses?
Bodily defenses that protect a person against all microorganisms, regardless of prior exposure.
66
What are some examples of nonspecific immunity?
Intact skin and mucous membranes
Nasal passages with cilia
Lungs have phagocytes
Oral cavity
GI Tract
67
What can increase risk for infection?
Age (increased risk for infants & elderly due to compromised immunity)
Steroids (decrease inflammation and thus immune response)
Chemotherapy (Kills off WBC's& decreases immune response)
Prolonged stress (can cause colds, bronchitis, etc)
Compromised skin or mucous membranes
Increase in number/type of organisms (ex: yeast infections)
Instrumentation (non-sterile materials)
Poor nutrition
Existing disease
68
How do we help clients avoid infections? (Nursing interventions)
Help normal flora to remain normal andhelp keep mucus membranes intact
Wearing PPE
Wash hands, have pt. wash hands
Insert sterile instruments
Educate pt, feed pt, give water, tender loving care, turn them in bed, etc.
69
What are the 3 most common types of infectious organisms?
Viruses, Bacteria, and Fungi (includes yeast)
70
What is a local infection?
A local infection is limited to the specific part of the body where the microorganisms remain.
71
What are symptoms of local infection?
Heat, edema, exudate (purulent drainage,) redness, pain.
72
What is a systemic infection?
When the microorganisms spread and damage different parts of the body.
73
What are symptoms of a systemic infection?
Bacteremia:
Fever, Leukocytosis (high WBC count,) Arthralgias, Myalgias, Malaise, confusion
Septicemia (bacteria in bldstream)
Septic shock ( body starts to shut down from overwhelming bacteria and from toxins)
74
What is MRSA?
methicillin-resistant Staphylococcus aureus
75
What is VRE?
vancomycin-resistant enterococci
76
What do nurses do to help clients who have infections?
Monitor and report anything new or persistent
fever or low temp <96
labwork results
any new symptoms (ex: confusion)
Give meds (antibiotics)
Provide basic care (food, drink, toileting, hygiene, exercise, emotional support)
77
What can be one of the most leading symptoms for infection?
Confusion
78
Which is more commonly used, Tylenol or Motrin, for reducing a fever?
Tylenol.
Even though Motrin lasts longer it can cause G.I bleeding.
79
What are ways, besides administering medicine, to help reduce a fever?
Cool compresses in armpits & groin
| Limit clothing being worn
80
What is isolation?
Isolation refers to measures designed to prevent the spread of infections or potentially infectious microorganisms to health personnel, clients, and visitors.
81
What are the 5 different levels of isolation?
Standard, contact, droplet, airborne, reverse isolation.
82
Identify risk factors & common injuries for infants.
Falls, choking, overdoses, burns, suffocation, drowning.
83
Identify risk factors & common injuries for toddlers.
Head injuries, lack of supervision, falls, etc.
84
Identify risk factors & common injuries for school-age kids.
Falls from bikes, run over by cars, sports, sharp objects, firearms.
85
Identify risk factors & common injuries for teens.
Alcohol and drug abuse, suicide, trauma, diving accidents, etc.
86
Identify risk factors & common injuries for adults.
Work related injuries, car accidents, etc.
87
Identify risk factors & common injuries for elders.
Falls, neglect, overdose, burns, UTI's, loss of sensation
88
What are injuries caused by us?
Nosocomial infections (ex: not using gloves)
Medication erros
Falls (cords left on floor, bed left raised, etc.)
Wrong site surgery (leaving instruments in pts.
Burns (in OR, by not using sanctioned heating materials)
Pressure ulcers (not turning the pt)
Mistaken identity (2 forms of I.D are required)
89
What is the BEST way to reduce infection?
Wash hands
90
What are two of the biggest national safety goals?
Reducing nosocomial infections and reducing falls
91
What is telehealth?
The delivery of health services over distances and is used to describe the wide range of services delivered by all health related disciplines
92
What are standards of care?
The skills and learning commonly possessed by members of a profession. They evaluate the quality of care that nurses provide and are legal guidelines
93
Nursing standards of care can be separated into what two categories?
Internal and external standards
94
What are internal standards of care?
Nurses' job description, education, and expertise as well as individual institutional policies and procedures.
95
What are the external standards of care?
Nurse practice acts, professional organizations, federal organizations, etc
96
What was Einstein's theory of relativity about?
Concepts of physics: mass, energy, and speed of light
97
What was Freud's theory of unconsciousness about?
Dreams, wishes, decisions, behaviors, feelings, anxieties, and sexuality. Ego, id, and the superego
98
What are the four concepts central to nursing?
Person/client (recipient of care)
Environment (internal and external surroundings that affect the client including people
Health (degree of wellness that the client experiences
Nursing ( attributes, characteristics, and actions of the nurse on behalf of the client)
99
What is the Neuman's System
| Model?
A model based on the individuals relationship to stress, the reaction to it, and reconstitution (adaption) factors that are dynamic in nature
100
Body movement requires coordinated muscle activity and neurological integration. What are the four basic elements of body movement?
Body alignment (posture), joint mobility, balance, and coordinated movement
101
Why are mobility and neurological systems combined in the Neuman's system model?
Balance (mobility) is partially regulated by the brain (neuro.)
Many neurological diseases have a profound effect on mobility.
102
What are the three important elements of optimal balance and body function?
Line of gravity
Center of gravity
Base of gravity
103
What is line of gravity?
An imaginary vertical line drawn through the body's center of gravity.
104
What is the center of gravity?
The point at which all the mass (weight) of an object is centered.
105
What is base of gravity/support?
The foundation on which an object rests
106
What is range of motion?
The ROM of a joint is the maximum movement that is possible for that joint
107
Balanced, smooth, purposeful movement is the result of proper functioning of the _______, _______, and _______.
Cerebral cortex (voluntary motor activity)
Cerebellum (coordinates motor activities of movement)
Basal Ganglia (maintains posture)
108
What is proprioception?
Position sense: ability to detect the position of body parts in relation to the environment.
109
What is flexion?
Decreasing angle of joint
Ex: bending the elbow
110
What is extension?
Increasing angle of joint
Ex: straightening arm at the elbow
111
What is hyperextension?
Further straightening of the joint
Ex: bending the head backward
112
What is abduction?
Movement of the bone away from the midline of the body
113
What is adduction?
Movement of the bone toward the midline of the body
114
What is rotation?
Movement of the bone around its central axis
115
What is circumduction?
Movement of the distal part of the bone in a circle while the proximal end remains fixed
116
What is eversion?
Turning the sole of the foot outward by moving the ankle joint
117
What is inversion?
Turning the sole of the foot inward by moving the ankle joint
118
What is pronation?
Moving the bones of the forearm so that the palm of the hand faces downward when held in front of the body
119
What is supination?
Moving the bones of the forearm so that the palm of the hand faces upward when held in front of the body.
120
What is active range of motion?
Isotonic exercises in which the client independently moves each joint in the body through its complete range of movement.
121
What is passive range of motion?
Exercise in which another person moves each of the clients joints through their complete range of movement
122
Physical activity requires energy expenditure and produces ______ __________
Health benefits
123
Exercise is physical activity that improves/maintains ________ ___________
Physical fitness
124
What is activity tolerance?
Amount of activity one can endure without adverse effects
125
What are isotonic exercises?
Those in which the muscle shortens to produce muscle contraction and active movement (which increases muscle tone, mass, and strength)
Ex: walking, running, ADL's
126
What are isometric exercises?
Those in which there is muscle contraction without moving the joint, which involves exerting pressure against a solid object.
Ex: kegels, quad sets
127
What are isokinetic exercises?
Muscle contraction or tension against resistance.
Ex: special machines or devices provide resistance to movement
128
What is areobic exercise?
Exercise where amount of 02 one takes in is > than used during the activity. (Used large muscles) cardiovascular conditioning and physical fitness.
129
What is anaerobic exercise?
Exercise where muscles can't get enough 02 and anaerobic pathways are used for short time (Endurance training like weight lifting and sprinting)
130
What are the benefits of exercise on the musculoskeletal system?
Increases joint flexibility, stability, and ROM
Reduces weakness, frailty, depression, and incidence of falling
Bone density and strength are maintained.
131
What are the benefits of exercise on the cardiovascular system?
Prevents stroke and CVD
Lowers BP, stress
Increases oxygen uptake, improves circulation
132
What are the benefits of exercise on the respiratory system?
Improves gas exchange, immune function, increases stamina, good for people with COPD
133
What are the benefits of exercise on the gastrointestinal system?
Improves appetite, facilitates peristalsis, helps relieve constipation, good for people with IBS
134
What are the benefits of exercise on the metabolic system?
Elevates metabolic rate, increases production of body heat, waste products, and calorie use.
Stabilizes blood sugar and makes cells more responsive to insulin
135
What are the benefits of exercise on the urinary system?
Body excretes wasted more effectively, stasis of urine is prevented, decreases risk for UTI's
136
What are the benefits of exercise on the psychoneurologic system?
Increase norepinephrine and serotonin levels, improves sleep, induces euphoria, elevates mood, relieves stress and anxiety
137
What are some nursing interventions r/ t exercise?
Help client begin general exercise program
Assist, do, teach, supervise exercises
Evaluate progress
138
What are 4 physiological changes in the elderly that affect mobility?
Degenerative joint disease (decreases ROM)
Skeletal mass and strength reduced
Bones more brittle and fragile (osteoporosis)
Greater flexion of cervical vertebrae
139
What does greater flexion of cervical vertebrae mean?
Walk slower (Parkinson's disease)
Balance unstable (greater risk for falls)
140
What is osteoporosis?
Bones become brittle and fragile due to calcium depletion
141
How can fractures occur?
Slowly and painlessly
Suddenly and painfully
142
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Medical treatment for ___________ includes (prevention is best)
Dietary calcium
Calcium/bit D supplements
Fosamax
Calcitonin nasal spray
Weight bearing exercise
```
Osteoporosis
143
Nursing treatment for ___________requires prevention, decrease med SE's (esp. Fosamax), pain control, prevent injury, weight bearing exercise
Osteoporosis
144
What is it and what are common side effects of Fosamax?
Treats osteoporosis by inhibiting osteoclast bone reabsorption
SE's: GI/abd pain, diarrhea, vomiting, gas, indigestion
headache, fever, flu like system.
Bone pain, myalgia, arthralgia, necrosis of bone of jaw
Hypersensitivity reaction
145
What are common medications for osteoporosis?
NSAIDS for pain management
146
What is Parkinson's disease?
A neurodegenerative disease caused by depletion of dopamine producing cells in the substantia nigra
147
What are the 4 cardinal features of Parkinson's disease?
The 4 cardinal features of _______are resting tremors, rigidity, bradykinesia (slow movement), diminished postural stability
148
What are the two kinds of tremors?
Intention tremors: involuntary trembling when an individual attempts a voluntary movement
Resting tremors: a tremor that is apparent when the client is at rest and diminishes with activity
149
What is the gold standard ;
| (Pharmacologic) for PD?
The gold standard (pharmacologic) for ________is Sinemet (combination of Carbidopa and Levodopa)
150
What does Sinemet do?
Increases the amount of dopamine available in the brain and inhibits the increase in the peripheral circulation.
151
What are the effects of immobility on the musculoskeletal system?
Bones demineralize
Unused muscles atrophy
Contractures form
Joints become painful and stiff
152
What are the effects of immobility on the cardiovascular system?
Diminished cardiac reserve
Increased use of the Valsalva maneuver
Orthostatic hypotension
Venous vasodilation and stasis
Dependent edema
Thrombus formation
153
What are the effects of immobility on the respiratory system?
Decreased respiratory movement: without periodic stretching movements intercostal joints may become fixed producing shallow respirations and reducing vital capacity
Pooling of respiratory secretions: normally expelled by changing positions or posture, and by coughing
Atelectasis: collapse of lobe or entire lung
Hypostactic pneumonia: Pooled secretions=bacteria growth=upper respiratory infection becoming severe lower respiratory infection
154
What are the effects of immobility on the metabolic system?
Decreased metabolic rate
Negative nitrogen balance: depletion in protein stores that are essential for building muscle tissue
Anorexia
Negative calcium balance: greater amounts of calcium are extracted from bone than can be replaced.
155
What are the effects of immobility on the urinary system?
Urinary stasis: when a client is in a horizontal position, gravity impedes the emptying of urine from the kidneys and the urinary bladder. Decreases tone of the detrusor muscle
Renal calculi
Urinary retention: accumulation, distention, and occasional urinary incontinence
Urinary infection: static urine=bacterial growth
156
What are the effects of immobility on the gastrointestinal system?
Constipation: decreased peristalsis, decreased strength may lead to impaction, and colon motility
157
What are the effects of immobility on the integumentary system?
Reduced skin turgor: skin atrophy due to fluid shifting
Skin breakdown: due to decreased circulation
158
What are the effects of immobility on the psychoneurologic system?
Immobility=a decline in production of mood-elevating substances such as endorphins
159
Body movement requires coordinated muscle activity and neurological integration. What are the four basic elements of body movement?
Body alignment (posture), joint mobility, balance, and coordinated movement
160
Why are mobility and neurological systems combined in the Neuman's system model?
Balance (mobility) is partially regulated by the brain (neuro.)
Many neurological diseases have a profound effect on mobility.
161
What are the three important elements of optimal balance and body function?
Line of gravity
Center of gravity
Base of gravity
162
What is line of gravity?
An imaginary vertical line drawn through the body's center of gravity.
163
What is the center of gravity?
The point at which all the mass (weight) of an object is centered.
164
What is base of gravity/support?
The foundation on which an object rests
165
What is range of motion?
The ROM of a joint is the maximum movement that is possible for that joint
166
Balanced, smooth, purposeful movement is the result of proper functioning of the _______, _______, and _______.
Cerebral cortex (voluntary motor activity)
Cerebellum (coordinates motor activities of movement)
Basal Ganglia (maintains posture)
167
What is proprioception?
Position sense: ability to detect the position of body parts in relation to the environment.
168
What is flexion?
Decreasing angle of joint
Ex: bending the elbow
169
What is extension?
Increasing angle of joint
Ex: straightening arm at the elbow
170
What is hyperextension?
Further straightening of the joint
Ex: bending the head backward
171
What is abduction?
Movement of the bone away from the midline of the body
172
What is adduction?
Movement of the bone toward the midline of the body
173
What is rotation?
Movement of the bone around its central axis
174
What is circumduction?
Movement of the distal part of the bone in a circle while the proximal end remains fixed
175
What is eversion?
Turning the sole of the foot outward by moving the ankle joint
176
What is inversion?
Turning the sole of the foot inward by moving the ankle joint
177
What is pronation?
Moving the bones of the forearm so that the palm of the hand faces downward when held in front of the body
178
What is supination?
Moving the bones of the forearm so that the palm of the hand faces upward when held in front of the body.
179
What is active range of motion?
Isotonic exercises in which the client independently moves each joint in the body through its complete range of movement.
180
What is passive range of motion?
Exercise in which another person moves each of the clients joints through their complete range of movement
181
Physical activity requires energy expenditure and produces ______ __________
Health benefits
182
Exercise is physical activity that improves/maintains ________ ___________
Physical fitness
183
What is activity tolerance?
Amount of activity one can endure without adverse effects
184
What are isotonic exercises?
Those in which the muscle shortens to produce muscle contraction and active movement (which increases muscle tone, mass, and strength)
Ex: walking, running, ADL's
185
What are isometric exercises?
Those in which there is muscle contraction without moving the joint, which involves exerting pressure against a solid object.
Ex: kegels, quad sets
186
What are isokinetic exercises?
Muscle contraction or tension against resistance.
Ex: special machines or devices provide resistance to movement
187
What is areobic exercise?
Exercise where amount of 02 one takes in is > than used during the activity. (Used large muscles) cardiovascular conditioning and physical fitness.
188
What is anaerobic exercise?
Exercise where muscles can't get enough 02 and anaerobic pathways are used for short time (Endurance training like weight lifting and sprinting)
189
What are the benefits of exercise on the musculoskeletal system?
Increases joint flexibility, stability, and ROM
Reduces weakness, frailty, depression, and incidence of falling
Bone density and strength are maintained.
190
What are the benefits of exercise on the cardiovascular system?
Prevents stroke and CVD
Lowers BP, stress
Increases oxygen uptake, improves circulation
191
What are the benefits of exercise on the respiratory system?
Improves gas exchange, immune function, increases stamina, good for people with COPD
192
What are the benefits of exercise on the gastrointestinal system?
Improves appetite, facilitates peristalsis, helps relieve constipation, good for people with IBS
193
What are the benefits of exercise on the metabolic system?
Elevates metabolic rate, increases production of body heat, waste products, and calorie use.
Stabilizes blood sugar and makes cells more responsive to insulin
194
What are the benefits of exercise on the urinary system?
Body excretes wasted more effectively, stasis of urine is prevented, decreases risk for UTI's
195
What are the benefits of exercise on the psychoneurologic system?
Increase norepinephrine and serotonin levels, improves sleep, induces euphoria, elevates mood, relieves stress and anxiety
196
What are some nursing interventions r/ t exercise?
Help client begin general exercise program
Assist, do, teach, supervise exercises
Evaluate progress
197
What are 4 physiological changes in the elderly that affect mobility?
Degenerative joint disease (decreases ROM)
Skeletal mass and strength reduced
Bones more brittle and fragile (osteoporosis)
Greater flexion of cervical vertebrae
198
What does greater flexion of cervical vertebrae mean?
Walk slower (Parkinson's disease)
Balance unstable (greater risk for falls)
199
What is osteoporosis?
Bones become brittle and fragile due to calcium depletion
200
How can fractures occur?
Slowly and painlessly
Suddenly and painfully
201
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Medical treatment for ___________ includes (prevention is best)
Dietary calcium
Calcium/bit D supplements
Fosamax
Calcitonin nasal spray
Weight bearing exercise
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Osteoporosis
202
Nursing treatment for ___________requires prevention, decrease med SE's (esp. Fosamax), pain control, prevent injury, weight bearing exercise
Osteoporosis
203
What is it and what are common side effects of Fosamax?
Treats osteoporosis by inhibiting osteoclast bone reabsorption
SE's: GI/abd pain, diarrhea, vomiting, gas, indigestion
headache, fever, flu like system.
Bone pain, myalgia, arthralgia, necrosis of bone of jaw
Hypersensitivity reaction
204
What are common medications for osteoporosis?
NSAIDS for pain management
205
What is Parkinson's disease?
A neurodegenerative disease caused by depletion of dopamine producing cells in the substantia nigra
206
What are the 4 cardinal features of Parkinson's disease?
The 4 cardinal features of _______are resting tremors, rigidity, bradykinesia (slow movement), diminished postural stability
207
What are the two kinds of tremors?
Intention tremors: involuntary trembling when an individual attempts a voluntary movement
Resting tremors: a tremor that is apparent when the client is at rest and diminishes with activity
208
What is the gold standard ;
| (Pharmacologic) for PD?
The gold standard (pharmacologic) for ________is Sinemet (combination of Carbidopa and Levodopa)
209
What does Sinemet do?
Increases the amount of dopamine available in the brain and inhibits the increase in the peripheral circulation.
210
What are the effects of immobility on the musculoskeletal system?
Bones demineralize
Unused muscles atrophy
Contractures form
Joints become painful and stiff
211
What are the effects of immobility on the cardiovascular system?
Diminished cardiac reserve
Increased use of the Valsalva maneuver
Orthostatic hypotension
Venous vasodilation and stasis
Dependent edema
Thrombus formation
212
What are the effects of immobility on the respiratory system?
Decreased respiratory movement: without periodic stretching movements intercostal joints may become fixed producing shallow respirations and reducing vital capacity
Pooling of respiratory secretions: normally expelled by changing positions or posture, and by coughing
Atelectasis: collapse of lobe or entire lung
Hypostactic pneumonia: Pooled secretions=bacteria growth=upper respiratory infection becoming severe lower respiratory infection
213
What are the effects of immobility on the metabolic system?
Decreased metabolic rate
Negative nitrogen balance: depletion in protein stores that are essential for building muscle tissue
Anorexia
Negative calcium balance: greater amounts of calcium are extracted from bone than can be replaced.
214
What are the effects of immobility on the urinary system?
Urinary stasis: when a client is in a horizontal position, gravity impedes the emptying of urine from the kidneys and the urinary bladder. Decreases tone of the detrusor muscle
Renal calculi
Urinary retention: accumulation, distention, and occasional urinary incontinence
Urinary infection: static urine=bacterial growth
215
What are the effects of immobility on the gastrointestinal system?
Constipation: decreased peristalsis, decreased strength may lead to impaction, and colon motility
216
What are the effects of immobility on the integumentary system?
Reduced skin turgor: skin atrophy due to fluid shifting
Skin breakdown: due to decreased circulation
217
What are the effects of immobility on the psychoneurologic system?
Immobility=a decline in production of mood-elevating substances such as endorphins
