Test 2 Review Flashcards
1
Q
KiloCalorie (also known as calorie)
A
- Energy Measured in Units
- Amount of heat required to raise 1 gram of water 1 degree centigrade
2
Q
Carbohydrates
A
- Major source of energy
- Each gram contains 4 calories
-Should be 50% to 60% of daily caloric intake to prevent ketosis and protein breakdown
- Help form ATP
- Supply fiber and assist in utilization of fat
3
Q
Carbohydrate Deficiency
A
-Electrolyte imbalance, fatigue and depression
4
Q
Carbohydrate Excess
A
Obesity, tooth decay, affects diabetic
5
Q
Sources of Carbohydrates
A
Bread, Potatoes, pasta, corn, rice, beans, and fruits
6
Q
LDL
A
- Low-density lipoproteins – carries cholesterol toward cells and tissues and deposit it there
- Strong association between high levels of LDL and CORONARY ARTERY DISEASE
7
Q
HDL
A
High-density lipoproteins – carries cholesterol TOWARD LIVER
-High HDL protects against Coronary Artery disease
8
Q
High Fiber Diet
A
- Beneficial in disease prevention
- Decreased weight
-Decreased risk of colon cancer, rectal cancer, heart disease, dental caries, constipation, and diverticulosis
9
Q
Monounsaturated Fats
A
Olive & canola oil
Lowers LDL doesn’t lower HDL
10
Q
Saturated Fats
A
- Animal (butter) & vegetable (nuts, oils)
- Raises cholesterol
11
Q
PICA
A
-Craving non-food substances (dirt, clay, starch, ice, etc) increased risk for ANEMIA
12
Q
Signs and Symptoms of Poor Nutritional Status
-SUBJECTIVE DATA
A
Subjective data:
- Fatigue
- Delayed wound healing
- Brittle hair, nails
- Mouth sores
- Changes in appetite
- Mood changes
13
Q
Signs and Symptoms of Poor Nutritional Status
-Objective data
A
Objective data
- Weight changes
- Dry, rough, scaly skin
- Edema
- Dry, cracked lips
- Swollen, bleeding gums
- Decreased muscle tone
14
Q
Folic Acid
A
Function: Synthesis of RBCs
Animal sources
-Liver
Plants:
-Green, leafy veggies, spinach, asparagus, broccoli, kidney beans
15
Q
Folic Acid Deficiency
A
Neural tube deficits of fetus in pregnant females
Glossitis
16
Q
Infant Feeding Guidelines
A
- Introduce foods one at a time
- Begin w/ foods that are least allergenic
- Avoid egg whites and citrus fruits until 12 months old
- Avoid honey in infants under 12 months (botulism)
17
Q
Respiratory Rate
A
Position self and observe
-Count for one full minute
Adult rate 12-20 per minute
18
Q
Respiration (one cycle)
A
One Cycle
- 1 inspiration – breathing air into lungs
- 1 expiration – exhaling
19
Q
Tachypnea
A
> 20 respirations
20
Q
Bradypnea
A
<12 respirations a minute
21
Q
Apnea
A
absence of spontaneous breathing for 10 or more seconds
22
Q
Newborn respirations
A
30 - 50
23
Q
3 yr old child respirations
A
20-30
24
Q
Pulse
A
Normal range for adults is 60 - 100 bpm
> 100 is Tachycardia
<60 is bradycardia
25
Factors affecting Heart Rate
```
Age -- decreased w/ age
Gender -- female is higher
Activity -- increased, athletes lower
Emotional status -- increased w/ anxiety
Pain - increased
```
26
Common errors in Blood Pressure measurements
Incorrect Cuff Size
- Too small increases BP reading
- Too large decreases BP reading
Unrecognized auscultatory gap
Incorrect cuff placement
27
Hypertension
Consistently 120/80 on two consecutive visits after initial screening
28
Pulse deficit
Apical pulse is greater than radial pulse
| -listen and feel at the same time
29
Orthostatic Hypotension
The drop in blood pressure when you transition from a lying to a standing position
30
Pulse Pressure
The difference between the diastolic and systolic blood pressures
31
Taking a temperature
Ask if the client has had anything hot or cold in the past 15 minutes
- Place thermometer at the base of the tongue, left of frenulum
- Don't bite
32
Layers of the Skin
Epidermis - superficial layer
Dermis - middle layer
Hypodermis - (subcutaneous tissue)
33
Epidermis
4 layers
-Hands and feet = 5 layers
Basal layer
- Columnar shaped cells
- Continuous mitosis for new cells
- Skin tone, melanocytes
34
Dermis
Corium - 2nd layer of skin
- 20X thicker than epidermis
- Connective tissue, elastic fibers, CAPILLARIES
- Structural support of skin
- Hair follicles
- Sweat glands
- Sebaceous glands
- Adipose tissue
35
Hypodermis - subcutaneous layer
The subcutaneous layer also known as the HYPODERMIS, performing transition and storage functions (WATER AND FAT)
- AKA superficial fascia
- Loose connective tissue and adipose
- Attaches skin to bone
- Temperature insulator/ regulates heat
- Mast cells which release histamine & trigger body's reaction to allergen
36
Skin Cancer Risk Factors
- UV LIGHT exposure
- Second-degree burns before age 18
- Acute sunburns
-Outdoor employment
37
Albinism
A defect of melanin production that results in little or no color (pigment) in the skin, hair, and eyes
- Absence of color in hair, skin, or iris
- Lighter than normal skin and hair
- Patchy, missing skin color
38
Jaundice
Yellow-green to orange cast or color in skin, sclera, mucous membranes, fingernails, and palmar or plantar surfaces in the light skinned
Increase in serum bilirubin
> 2mg/dL
Associate with
- Liver disease
- Hemolytic disease
39
Petechiae
Pinpoint, round sports that appear on the skin as a result of bleeding under the skin
- violaceous (red-purple) discolorations of less than 0.5 cm in diameter
- Do not blanch
- Causes include intravascular defects or infections
40
Purpura
Purple-colored spots and patches that occur on the skin, organs, and in mucus membranes
-Purpura occurs when small blood vessels join together and leak blood under the skin.
- Very small spots called PETECHIAE
- Large purpura are called ECCYMOSES
41
Ecchymoses
Large purpura
- Bruise/Trauma
- Extravation of blood into the skin
-Can occur with Heparin, Coumadin, and liver dysfunction
42
Excoriation
Loss of epidermal layers exposing the dermis
-Ex. Abrasion
43
Lichenification
Layers of skin become thickened and rough as a result of rubbing over a prolonged period of time
Ex. Chronic contact dermatitis
44
Contact Dermatitis
Affects surfaces in contact w/ irritating agents
-Poison oak, metals, nickel, detergents, cosmetics, rubber, food, shampoo, clothing
45
Decubitis Ulcer Stages
Stage 1:
-In light skinned pt's, the area is reddened, but skin is not broken
-In dark skinned pt's, the picmentation is enhanced
Stage 2:
-Epidermal and dermal layers have sustained injury
Stage 3:
-Subcutaneous tissues have sustained injury
Stage 4:
-Muscle tissue and perhaps bone have sustained injury
46
Pitting Edema
4 Point Scale:
0+ - No pitting edema
1+ - Mild pitting edema. 2mm depression that disappears rapidly
2+ - Moderate pitting edema. 4 mm depression that disappears in 10-15 seconds
3+ - Moderately severe pitting edema. 6 mm depression that may last more than 1 minute
4+ - Severe pitting edema. 8 mm depression that can last more than 2 minutes
47
Capillary refill
Pressure is applied to nail bed until it turns white then blood is returned to tissue when pressure is released
- Indicator of peripheral circulation
- Should return to normal in 2-3 seconds
48
Clubbing of the nails
Clubbing of the nails can result from long-standing HYPOXIA and LUNG CANCER
49
Central Cyanosis
- Lack of Oxygen in the blood
- > 5g/dL of deoxygenated hemoglobin in the blood
- pulmonary embolism
- Bronchiolitis
- COPD, Asthma
- High Altitudes
- Pneumonia
- Choking
- Croup, epiglottitis
- Heart defects that are present at birth (congenital)
- Heart failure (cardiac arrest)
50
Tinea Capitis
(RINGWORM)
- Fungal infection of the scalp
- Easily spread -- contagious
- Combs, hats, or clothing that have been used by someone w/ ringworm
-Spread by pets particularly CATS
51
Cheilosis
Cracks around the lips usually attributed to deficiency of RIBOFLAVIN, VITAMIN B-2 OR B-6.
Usually fixed with a balanced nutritional diet
52
Sclera
Outer layer of the Internal structure of the eye
| -white opaque (the white of the eye)
53
Iris
Part of the middle layer of the internal structure of the eye.
-colorful part of the eye
54
Pupil
Part of the middle layer of the internal structure of the eye.
-Opening in the center of the iris, regulates the amount of light entering the eye
55
Retina
Part of the INNER LAYER of the internal structure of the eye
- Innermost layer of the eyeball
- Extension of the optic nerve
56
Glaucoma
Occurs when aqueous fluid pressure increases in the anterior chamber due to inadequate drainage of fluid.
57
Risk factors for Glaucoma
- Older adults
- Family history of glaucoma
- Ethnicity (especially African Americans, asians, and hispanics)
- Elevated intraocular pressure
- hypertension
- Diabetes mellitus
- Myopia
- Prolonged steroid use
58
Hordeolum
Acute localized inflammation, tenderness, and redness, w/ the pt complaining of pain in the infected area
- Bumps
- Stye
- Inflammation
- Infection of sebaceous gland
STAPH infection usually
59
Exotropia
Outward turning of eye
60
Esotropia
Inward turning of eyes
61
6 fields of gaze assessment
MIDLINE
1. left lateral
2. left lateral inferior
3. right lateral inferior
4. right lateral
5. right lateral superior
6. left lateral superior
62
Retina Assessment (NORMAL FINDINGS)
- Red reflex is present
- Optic disc is pinkish-orange in color, w/ a yellow-white excavated center known as the physiologic cup
- Ratio of cup diameter to that of the entire disk is 1:3
4 main vascular branches emanating from the disc, each consisting of an arteriole and a venule
- Light often produces a "light reflex" glistening from the arteriolar vessel.
- Normal arterial-to-venous width is a ration of 2:3 or 4:5
63
Corneal Ulceration
A grayish, well-circumscribed ulcerated area on the cornea is most commonly caused by a bacterial invasion.
- A TREELIKE configuration on the corneal surface is identified.
- This type of ulceration is caused by HERPES SIMPLEX VIRUS
64
Assessing for "accommodation"
Instruct Pt to shift gaze to distant object for 30 seconds
Instruct Pt to then look at your finger or an object held 10 cm from pt.
Note the reaction and size of the pupils.
ACCOMMODATION occurs when pupils constrict and converge to focus on objects at close range
65
Lacrimal Sac Assessment
Inspect for:
- Swelling, enlargement, tearing, exudate
- Compare to other eye
- Pain?
- Gently palpate
- Note discharge
- Tears overflowing
66
Lacrimal Sac Abnormal findings
Dacryoadenitis
-Trauma, measles, mumps, mononucleosis, painful swelling beside nose, near inner canthus
Dacryocystitis
-Inflammatory obstruction of lacrimal duct
67
Ptosis
Drooping of the eye lid
| -Can either be congenital or acquired
68
Congenital Ptosis
- Failure of the levator muscle to develop.
| - Condition may be associated w/ pathology of the superior rectus muscle as well
69
Acquired Ptosis
If Ptosis is acquired it is related to one of three factors
1. Mechanical:
- Heavy lids from lesions, adipose tissue, swelling, edema
2. Myogenic
- Muscular diseases such as myasthenia gravis or multiple sclerosis
3. Neurogenic
- Paralysis from damage of neural pathways
70
External Ear Assessment
Inspection
-Note position, size, color, and shape
Palpation
-Auricle
71
External Ear Assessment (NORMAL FINDINGS)
- Flesh Color
- Positioned centrally and in proportion to the head
- No foreign bodies, redness, drainage, deformities, nodules, or lesions
72
External Ear Assessment (ABNORMAL FINDINGS)
- Pale, red, cyanotic
- Small-size or large-size ears
- Purulent drainage
- Clear or bloody drainage
- Hematoma behind ear over mastoid
- Pain or tenderness on palpation
73
Conditions (ABNORMALITIES) of External Ear
```
Perichondrial Hematoma
-Cauliflower ear - blunt trauma
Perichondritis
-inflammation of fibrous connective tissue over cartilage of ear
Carcinoma
-Basal and squamous cell carcinoma
Battle's sign
-Head trauma to temporal bone // bruise behind the ear
Tophi
-Uric acid nodules
-may indicate gout
```
74
Perforated Nasal Septum
May be caused by nasal insufflation (snorting) of COCAINE, which can lead to necrosis of the septal cartilage
75
Frequency Range of Humans
Human ear is capable of hearing w/in a frequency range of: -20 to 20,000 Hz
Hearing a decibel range of:
- 0 to 140
76
Weber Test
1. Strike tuning fork
2. place firmly on middle of pt forehead, on top of head at midline, or on the front teeth
3. Ask if sound is heard centrally or towards one side
Normal Finding:
-Able to hear sound equally in both ears
77
Weber Test
| -Unilateral Conductive Hearing Loss
Sound Lateralize's to AFFECTED ear
-Sound is conducted directly through bone to the ear
Occurs when there are external or middle ear disorders such as:
1. Impacted Cerumen
2. Perforation of Tympanic membrane
3. Serum or pus in ear
4. Fusion of ossicles
78
Webber Test
| -Sensorineural Loss
- Sound lateralize's to UNAFFECTED EAR
- Can't hear sound in damaged ear
- Nerve damage in impaired ear
Disorder in inner ear, auditory nerve, or the brain
- Congenital defects
- Effects of ototoxic drugs
- Prolonged exposure to loud noise
79
Rinne Test
1. Stand behind pt and strike tuning fork
2. Place stem of fork against pt mastoid process
3. Ask pt to tell you when sound stops
4. when sound stops, put fork next to ear
5. note length of time pt hears the sound in the air
80
Rinne Test Results
-Air conduction is heard twice as long as bone conduction
-Air conduction > bone conduction
AC > BC = + RINNE TEST
If pt hears sound longer through bone conduction it is a
(- RINNE TEST)
-could mean disease or damage to outer or middle ear
81
Transillumination of Sinuses
If sinusitis is suspected:
- Observe red glow over sinuses
- observe symmetry between two sides
-Absence of illumination suggests sinus congestion
82
Breath smells
The breath should smell fresh
1. Breath is FOUL
- Halitosis can be a symptom of tooth decay, poor oral hygiene, or diseases of the gums, tonsils, or sinuses
2. Breath is ACETONE
- common in pt's who are malnourished or who have diabetic ketoacidosis. Low carb diet
3. Breath smells MUSTY
- Pt may have liver failure and caused by breakdown of nitrogen compounds
4. Breath smells like Ammonia
- Pt in end-stage renal failure due to inability to eliminate urea
83
Streptococcal pharyngitis
Tonsils, pillars, and uvula are very red and swollen, w/ patches of white or yellow exude on the tonsils. The posterior pharynx is bright red. Pt reports soreness of the throat w/ swallowing
84
Tonsillitis
Posterior pharynx is red w/ white patches. Tonsils are large and red w/ white patches, and the uvula is red and swollen
85
Dacryadenitis
Lacrimal sac abnormal finding
| -trauma, measles, mumps, mononucleosis, painful swelling beside nose, near inner canthus
86
Dacryocystitis
Lacrimal sac abnormal finding
| -inflammatory obstruction of lacrimal duct
87
Foul Breath Smell
Halitosis
| -can be a symptom of tooth decay, poor oral hygiene, or diseases of the gums, tonsils, or sinuses
88
Acetone Breath Smell
Common in pt's who are malnourished or who have diabetic KETOACIDOSIS
-low carb diet
89
Musty breath Smells
Pt may have liver failure
| -caused by breakdown of nitrogen compounds
90
Ammonia Breath smells
Pt in end-stage renal failure due to inability to eliminate urea
91
Perichondrial Hematoma
-Cauliflower ear / blunt trauma
92
Perichondritis
Inflammation of fibrous connective tissue over cartilage of ear
93
Carcinoma
basal and squamous cell carcinoma
94
Battle's Sign
Head trauma to temporal bone
| -bruise behind the ear
95
Tophi
Uric acid nodules
| -May indicate gout
