Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Foundations > Test #5 > Flashcards

Test #5 Flashcards

1
Q

Chain of Infecton

A
  1. Infectious Agent: bacteria, virus, fungi
  2. Reservoir: humans, animals, cdiff on table, wound bed
  3. Portal of exit: sputum, emesis, stool, needle stick
  4. mode of transmission: direct contact, droplet, airborn, vector born
  5. portal of entry: mucous, non-intact skin, GI tract, respiration
  6. Host: chronically ill, surgical pt, transplant, immunocompromised elderly, HIV/ADIS
    * * If you break the chain at any point it will stop the infection **
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Modes of Transmission

A
  • Direct: person-to-person (fecal, oral). Exp. hepatitis, staph
  • Indirect: contact with contaminated object. Exp. Hep B and C, HIV, RSV, MRSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Droplet Transmission

A
  • large particles
  • can travel up to 3 feet
  • exp: influenza, Rubella, Bacterial Meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Airborne

A
  • droplets suspended in air after coughing and sneezing or carried on dust particles
  • exp: TB, chicken pox, measles, apsergillus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Vector

A
  • external mechanical transfer
  • mosquito, louse, flea, tick, fly
  • exp: west nile virus, malaria, lyme disease, hanta virus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Normal Defenses

A
  • inflammatory response
  • normal body flora
  • cilia in lungs
  • intact skin
  • PH of body fluids (acidic gastric secretions, acidic vagina secretions, semen, alkaline)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of Infections

A
  • Health Care Associated Infections: nosocomial, result from delivery of heatlh services in a health care facility
  • Iatrogenic: a type of HAI from a diagnostic or therapueitc procedure
  • exogenous: an infection that is present outside the client, ie a post op nfeciton (MRSA)
  • endogenous: an infection that occurs when part of the client’s flora becomes altered or overgrowth results ie. cdiff, vaginal yeast infection, catheter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Medical Asepsis

A
  • clean technique that limits the number of pathogens that could cause infections
  • assists in reducing the risk for infection
  • 3 components to the technique: hand washing, barriers of PPE, routine environmental cleaning
  • contaminated area is one suspected of containing pathogens (bedpan, wet gauze, soiled linen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Disinfection/Sterilization

A

*Disinfection: the process that eliminates many or all microorganisms, with the exception of bacterial spores, fro inanimate objects
- disinfection of surfaces
High level disinfection: alcohol, chlorine, hyrdogen, peroxide

  • Sterilization: complete elimination or destruction of all microorganism, including spores
  • steam under pressure, ethylene oxide gas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Standard Precautions apply to:

A
  • blood
  • all body fluids and secretions (except sweat)
  • non-intact skin
  • mucous membranes
  • respiratory secretions
  • 60% of emerging infectious diseases are zootonic (originate in animals)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tier 1 Standard Precautions

A
  • hand hygeine
  • gloves: blood, body fluids, secretions, excretions, non-intact skin, mucous membranes, contaminated areas
  • Masks, eye protection, face shields: if in contact with sprays or splashes of body fluids
  • Gowns: protect clothing
  • Contaminated Linen: place in leak-proof bag so no contact with skin or mucous membranes
  • Respiratory hygeine/cough ettiquete: provide client with tissues and containers for disposal; stand 3 feet away from coughing; use masks prn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hand Hygeine

A
  • number 1 defense against infection
  • soap and water if hands are visibly soiled (friction for 15 seconds, after 3-5 uses of hand gel)
  • Alcohol-based hand procuts are accepted if hands not visibly soiled (before and after client care, before eating, after contact with body fluids, after contact with inanimate objects, before procedures, after removing gloves)
  • NOT effective against Cdiff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tier 2 Isolation Precautions

A
  • contact: private room or cohort clients, gloves and gowns (multi-drug-resistent organism, cdiff, RSV)
  • droplet: private room or cohort clients, mask is required (strep, pertusis, mumps, flu)
  • airborne: private room, negative airflow, N95 resiprator required (TB, chickenpox, measles)
  • Protective Environment: private room, positive pressure room, hepa filtration, gloves, gowns, mask, NO glowers or plants (stem cell transplant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

standard precautions

A
  • handwashing
  • gloves
  • masks
  • eye protection
  • gowns
  • leak-proof linen bags
  • puncture proof containers for sharps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

standard precautions

A
  • handwashing
  • gloves
  • masks
  • eye protection
  • gowns
  • leak-proof linen bags
  • puncture proof containers for sharps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Surgical Asepsis

A
  • sterile technique, prevents contamination of an open wound
  • isoaltes the operative area from the unsterile environment
  • eliminates all microorganisms, including pathogens and spores from an object or area
  • used in the following situations: procedures requiring perforation of skin, when skin is broken as a result of trauma, surgery or burns
  • during procedures that involve insertion of catheter or surgical instruments into sterile body cavities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Principles of Surgical Asepsis

A
  • sterile objects remain sterile only when touched by another sterile object
  • only sterile objects can be placed on sterile field
  • if out of range of bision or held below waist it is contaminated
  • prolonged exposure to air can cause contamination of a sterile field
  • wetness can contaminate sterile field (capillary action)
  • if gravity causes contaminated fluid to flow over steile field it is no longer sterile
  • 1 inch edge of sterile field is considered contaminated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cardio/Respiratory Connection

A
  • both systems must be functioning for either system to work
  • heart structure/fxn
  • lung structure/fxn
  • CNS innervation to ches, diaphragm
  • peripheral and cardiac circulation
  • adequate volume and hemoglobi
  • acid-base balance and regulation
  • CO2/O2 response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

lung anatomy

A
  • constant negative pressure keeps lungs inflated
  • pleural space: is between the two lung layers
  • visceral pleura: surrounds lungs
  • right lobe = 3
  • left lobe = 2
  • alveoli: surface area for gas exchange, can take 2500ml of air, 300 ml in avg adult
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

hematocrit

A
  • volume percentage (%) of red blood cells in blood.
  • percentage of RBCs related to plasma
  • It is normally 45% for men and 40% for women.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

hemoglobin

A
  • Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues back to the lungs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

physiological alterations in oxygen - decrease in o2 carry capacity

A
  • decrease transport hematocrit/hemoglobin
  • decrease volume r/t blood loss
  • decrease binding of 02 (CO)
  • decrease intake in O2
  • increased demand (exercise, fever, illness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

psychiological alterations in oxygen - decreased chest wall movement

A
  • pregnancy (crushes cavity)
  • obesity (SOB)
  • Musculoskeletal changes (kyphosis)
  • trauma (rib fracture)
  • CNS abnormalities (spinal trauam)
  • scoliosis (lateral curvature)
24
Q

physiological alterations in oxygen - changes in o2 delivery

A
  1. diffusion in lungs:
    - atelectasis (collapsed lung)
    - decreased surface area (deflated alveoli)
    - decreased blood supply
    - secretions (pneumonia, COPD)
25
Q

physiological alterations in oxygen - chronic disease

A
  • COPD: co2 drive is absent, too much co2 stays in body, decreased clearance of airways
  • polycythemia: response to chronic hypoxemia, decreased o2 in arteries, increases RBCs for more oxygen
  • conduction disturbances: irregular, slow, fast
  • heart failure
26
Q

alterations in respiratory functioning

A
  • hyperventilation: in excess of waht is needed to eliminate co2
  • hypoventilation: inadequate to meet 02 needs to eliminate co2
  • hypoxia: inadequate tissue oxygenation
  • hypoxemia: decreased oxygen concentration in the arterial blood
27
Q

Factors affecting respiratory function

A
  • body position: upright allows better expansion
  • tripod: COPD
  • supine is hardest on the lungs for breathing
  • environment: heat, humidity, altitude, pollution, allergens make it harder to breath
  • lifestyle: drugs/alcohol, nutritonal status
  • increased work of breathing: muscles for breathing work harder and require more O2 to work, limits amount of 02 available for other tissues
28
Q

special respiratory considerations - life span

A
  • infants and toddlers:
  • surfactant (newborn): formed b/n 34-36 weeks
  • irregular breathing up to 3 months
  • risk for URI higher
  • shorter airways (abdominal breathers)
  • risk of choking
  • breathing rates; infants 30-60/minute; 1-5 yrs 20-40/min; 6-12 yrs 15-25/min; adult 12-20/min
  • older adults:
  • degenerative processes affect: compliance, chest wall movement, accumulated pollutants, cardiac and perfusion changes, alveolar changes, cilia decrease
  • chronic diseases: HTN, Respiratory, cardiac, renal
29
Q

Assessing Respiratory

A
  • normal patterns: find baseline; discuss activity tolerance
  • risk factors: lifestyle, occupation, illness (chemo workers)
  • new/problem: onset, severity, duration, symptoms, OPQRST
  • cough?
  • SOB/dyspnea
  • chest pain?
30
Q

Physical Assessment respiratory

A
  • inspection:
    general appearance (equal rise and fall, barrel chest)
    LOC
    systemic cirulation (resp rate and rhythm)
    chest wall movement (use of accessory muscles)
    focused assesment for 1 minute if abnormal
  • palpation:
    thoracic excursion (thumbs move 5-8cm
    areas of tenderness
    extremeities
    cap refill
  • percussion:
    areas of consolidation
  • auscultation: normal vs. abnormal breath sounds
31
Q

Breath Sounds

A
  • Pleural friction rub: paper or leather rubbind
  • sonorous: deep, snoring sound
  • crackles: velcrow, find or course
  • wheezes: musical, where do you hear them, on inspir or expir?
  • vesicular: low pitch, sodt sounds in lung fields
  • brochial: tracea, loud
  • rales: ratteling, clicking, bubbling
  • rhonchi: bronchial airways, course/rattling, snoring
32
Q

diagnostic tests for respiratory

A
  • pulse ox
  • peak expiratory flow rate (highest flow during forces expiration)
  • arterial blood gases (o2 levels; acid/base resp or metabolic issue)
  • chest xray
  • sputum speciment (get a deep sample)
  • pulmonary function testing
  • bronchoscopy: scope of bronchi
  • ventilation-perfusion lung scan (V/Q) (looks for pulmonary embolism, flow of air vs. perfusion, breath in mist and put solution in)
  • thoracentesis: puncture through chest with needle and aspirate pleural fluid
  • CT/MRI
33
Q

sinus tachycardia

A

normal rhythm but fast

34
Q

respiratory nursing goals

A
  • maintain airway
  • clear secretions effectively
  • increase hydrations ( mobilize secretions)
  • improve 02 (sp02)
  • increase activity tolerance
  • report decreased dyspena
  • decrease risk factor
  • show resolution/improvement in underlying cause
35
Q

respiratory interventions

A
  • health promotion: vaccinations, healthy lifestyle behavior, environmental awareness, education
36
Q

post operative internventions

A
  • to prevent pneumonia: Turn and cough every 2 hours
  • nasal o2 to keep o2 sat <90%
  • pain meds
  • o2 can cause blindness in newborns, be careful!
  • nasal canula less than 6l
37
Q

nasal canula

A
  • up to 6l/m
  • humidified is best
  • room air 21% o2
  • room air 3l 02 = 32% o2
  • potential trauama to nares, ears
38
Q

oximeizer

A
  • 8-10 l/min
  • do not humidify
  • contains a filter that already humidifies
39
Q

simple face mask

A
  • delivers o2 cocentration at 40-60%
  • controleld by liter flow
  • 5-8 l/min
  • short term
  • not for pts with co2 retention
40
Q

non-rebreather mask

A
  • delivers the highest level of 02 possible with a mask
  • 95-100%
  • liter flow 10-15 l per min
  • one way valve between resevoir and mask
  • prevents room air from mixing with 02
41
Q

venturi mask

A
  • delivers 02 from 24-50%
  • can dial in oxygen leve
  • 4l/min 24%
  • 8L/min 35%
42
Q

oxygen face tent

A

for people who are clostrophobic (chidlren)

43
Q

christmas tree

A

the thing you put the end of the tube on

44
Q

incentive spirometer

A
  • An incentive spirometer is a device used to help you keep your lungs healthy after surgery or when you have a lung illness, such as pneumonia. The incentive spirometer teaches you how to take slow deep breaths.
  • By using the incentive spirometer every 1 to 2 hours, or as instructed by your nurse or doctor, you can take an active role in your recovery and keep your lungs healthy.
45
Q

normal sodium levels

A

135-145

46
Q

hematocrit

A
  • males higher than females 45-50%
47
Q

artificial oral airway

A
  • maintains an open airway
  • during decreased level of consciousness
  • sedation
  • seizures
  • made of hard plastic
  • attend to any pressure areas
  • hollow so you can suction
48
Q

nasotracheal, nasopharyngeal, oropharyngeal, orotracheal suctioning

A
  • when pt is unable to cough up secretions

- pass cathere through nose or mouth

49
Q

care of patient with an endotrachial tube

A
  • oral care is primary concern for nurse caring for pt with tracheal tube
  • tube must be secure, no pressure areas
  • tube MUST be clear of seretions
  • suction PRN to keep tuve patent (limit time to 15 seconds)
  • nurses CANNOT instill saline, RTs can
  • change tape and reposition tube every 24 hours
  • raise head of bed 30 degrees
  • always keep 2 sizes for trachea (can get tight and need smaller one)
50
Q

sleep apnea

A
  • obese patients
    Obstructive Sleep Apnea:
  • one or more pauses in breathing or shallow breaths while you sleep
  • can last from a few seconds to minutes
  • occurs 5-30 times or more an hour
  • normal breathing then strats again, sometimes with a loud snort or choking sound

Central Sleep Apnea:

  • less common type of sleep apnea
  • area of your brain that controls breathing doesn’t send correct signals
  • no effort to breathe for brief periods
  • brain signals not sending correct signals to breath
51
Q

CPAP/BIPAP

A
  • CHF
  • lung disorders resulting in high co2
  • patients for whom intubation is not possible
  • sleep apnea
  • surfactant defdiciency/stelectasis
  • less invasive than intubation, trach
  • CPAP: continuous positive air pressure (nose only)
  • BIPAP: nose and mouth, reminds you to breath every so often
52
Q

care of patient with a chest tube

A
  • purpose: reexpand the lung
  • how: release air, drain fluid
  • occlusive dressing, don’t pull or take dressings on/off
  • assess: resp rate, chest excursion, symmetry, pulse ox, breath sounds, crepitius
  • system assessment: drainage, dressing, tuve, verify suction, NEVER raise collection chamber above chest
  • Evaluation: ask patient to demonstrate coughing and breathing, assess dyspnea, cough, sputum, spo2, respiratory rate/depth/effort
53
Q

conditions requiring a chest tube

A
  • pneumothorax: air in pleural space
  • spontanious, tension, trauma, post chest surgery
  • hemothorax: fluid/blood in pleural space that collapses lungs
  • infection
  • bleeding into pleural cavity
54
Q

heimlich valve

A
  • one way rubber flutter valve
  • proximal end attaches to the chest tube
  • distal end connects to a suction devise or is left open to the atmosphere
  • allows outpatient treatment of pneumothorax
  • lugn self-heals after pneumothroax
  • chest tube stays in about a week
  • can have more than 1 chest tube to expand the lungs
55
Q

pleur-evac

A
  • suctions fluid out of chest

Foundations (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions