Unit 3 Flashcards
(143 cards)
1
Q
3 functions important to daily life that GFHP activity and exercise covers
A
cardiac
respiratory
muscles
2
Q
Energy expenditure requires 4 main support systems
A
neuro
respiratory
cardio
muscles
3
Q
Why is GFHP activity and exercise important?
A
1/5 of the population has some disability involving mobility or self-care
assessment can reveal lack of exercise which leads to poor muscle tone, balance problems, mental and physical fatigue
minimal exercise, sedentary lifestyle, imbalanced nutrition lead to obesity
4
Q
Obesity places clients at risk for
A
CAD CVA DM decreased activity tolerance impaired mobility
5
Q
monitoring activity tolerance and ability to perform them is necessary
A
because it helps us identify client strength and physical ability.
and identify risk factors associated with activity intolerance
6
Q
physiologic responses to activities/exercise
A
assess body’s attempt to meet O2 demands
assess for effective CO
O2 delivery to tissue.
decreased Hgb= not getting enough O2 to tissue
7
Q
signs of decreased Hgb
A
lethargy fatigue anemia depression organ failure
8
Q
Cardiovascular system and activity
A
HR is good indicator of activity tolerance
should return to normal after 5 minutes of exercise
continued increase is abnormal
9
Q
Cardiac Output
A
is the amount of blood ejected from the left ventricle with each contraction
HR x Stroke volume
10
Q
How many liters does the heart pump a minute
A
usually 5
11
Q
Heart: size Base Apex Great vessels attatched
A
size of your fist
base= top of heart
apex= bottom of heart (where you hear the apical pulse
great vessels attached are the aorta, pulmonary artery, superior and inferior venacava and pulmonary vein
12
Q
List the blood flow through the heart
A
S&I venacava, right atria, tricuspid valve, right ventricle, pulmonic valve, pulmonary artery, lungs, pulmonary vein, left atria, mitral valve, left ventricle, aortic valve, aorta to the body
13
Q
Conduction pathway
A
SA node AV node bundle of HIS bundle Branches purkinje fibers contractile fibers (muscle)
14
Q
SA node pace
A
60-100
15
Q
AV node pace
A
40-60
16
Q
Bundle of HIS pace
A
20-40
17
Q
P wave
A
atrial depolarization
18
Q
PR interval
A
allowing ventricles to fill, pause of in AV node
19
Q
QRS complex
A
ventricular depolarization
20
Q
T wave
A
ventricular repolarization
21
Q
Apical pulse techniques
A
rate 60-100 normal
stethoscope diaphragm= hear high pitched sounds
bell- low pitched sounds
22
Q
what heart rhythm can cause a pulse deficit?
A
A-fib
23
Q
First Heart Sound
A
S1, systole, ventricles contract, AV valves close, semilunar valves open (aortic, pulmonic), shorter than diastole, lub sound, with tachycardia less ventricular filling and diastole shortens
24
Q
Second Heart Sound
A
S2, diastole, ventricles relax, SL valves closed, AV valves open, ventricular filling
25
Third heart sound
```
ABNORMAL
S3 heard in diastole
can be heard in kids and young adults
called VENTRICULAR GALLOP
use bell to hear
associated with CHF, AV valve insufficiency with rapid ventricular filling with vibrations
```
26
Fourth Heart Sound
```
S4
heard in late diastole/ early systole
called ATRIAL GALLOP
use bell to hear
associated with CAD, HTN, aortic and pulmonary stenosis, acute MIs
```
27
Heart Valves
Aortic: located right of sternum at 2nd intercostal space
Pulmonic: left of sternum at 2nd intercostal space
Tricuspid: left of sternum 5th ICS
Mitral: 5th ICS medial to midclavicular line
28
Arteries
```
flow away from the heart
high pressure vessels
strong
compliant- they don't give a lot
oxygenated blood
most common used is radial
```
29
List the Artery Pulse sites
```
Temporal
carotid
brachial
radial
femoral
popliteal
posterior tibialis
dorsalis pedis
```
30
Veins
Less sturdy/ expansible- enables them to store blood to decrease the workload of the heart
low pressure
valves in each vein keep blood flowing in forward direction to heart
deoxygenated blood
31
peripheral pulse assessment
```
ease of palpation
rate
time interval between beats
rhythm
elasticity of vessels
ausculatory findings
```
32
Grading pulses
```
0= non palpable
1+= weak
2+= normal
3+= full easy to feel, less pressure
Bounding= may indicate heart condition
```
33
Pulse deficit
difference between apical and radial
34
vasodilation
widening of blood vessels
35
vasoconstriction
narrowing of blood vessels
36
JVD
```
gives us info about R atrial pressure
disappears in upright position
distends when lying
HOB up 30-60 degrees
turn head to the left
need good lighting
distended in Right sided CHF
venous insufficiency
```
37
parasympathetic nervous system
innervates thru vegus nerve, which supplies the SA node, atrial muscle fibers, and AV node
Causes a decrease in HR
rest and digest
38
sympathetic nervous system
supplies all areas of the atria and ventricles
HR increases when stimulated.
Fight or flight.
39
Baroreceptors
located in walls of carotid sinus and aortic arch
detect BP changes and respond
built to detect and notify the brain
40
factors that stimulate the CNS to send messages
stress, trauma, infection, fever, pain, fear, anxiety.
41
Cardiovascular deficits lead to
chest pain, fatigue, weakness
42
Respiratory deficits lead to
dyspnea, cough, SOB, orthopnea, BP to decrease
43
Musculoskeletal deficits lead to
leg cramps, pain
44
Angina definition and signs and symptoms
decreased O2 to heart, precipitated with activities
CP, C tightness, squeezing, pressure,
45
Aortic Aneurysm definition and S&S
dilation of vessel wall
constant intense CP that radiates to back, anterior chest and abdomen
46
Pericarditis definition and S & S
heart sac inflammation
sharp pain aggravated by deep breathing
47
activity tolerance classifications with Heart disease (1-4)
Class 1: has heart disease but asymptomatic. activity isn't a real problem
Class 2: slight limitation of physical activity no distress at rest, activity causes fatigue, dyspnea or angina
Class 3: significant limitation of activity, no distress at rest. low intensity activity causes fatigue, palpitations, dyspnea or angina
Class 4: symptoms at rest angina or dyspnea at rest, any activity aggravates symptoms
48
Pulmonary chest pain description
pleuritic pain (sharp/ knife like) SOB and poor tolerance to activities
49
Claudication
```
not getting good flow
intermittent sharp, cramping, squeezing pain in legs after activity
pain in calf muscle after walking
caused by ischemia, atherosclerosis
pain decreases with rest
```
50
Musculoskeletal pain
caused by direct palpation (rule out ischemia)
localized bone pain
check tendons, joints and muscles
51
fatigue
decreased energy levels
assess for cause (physiologic/psychologic)
physical work, infection, disease
52
Weakness
decreased muscular strength
rarely from psychologic problems
sxplore cause
may require additional testing.
53
SOB/dyspnea
can be cardiac, pulmonary or pschogenic
difficulty lying flat
assess for orthopnea, CHF or COPD
assess if during exertion or at rest.
54
coughing
assess if pulmonary or cardiac
| note if it's productive
55
self care ability rating 0-4
```
0- independent
1- requires use of equipment device
2- assist of 1 person
3- assist of 1 person and equipment
4- dependent on others, does not participate
```
56
CBC
hgb, hct, plt, RBC, WBC.
| anemia if values are decreased
57
Lipid profile
for cholesterol
58
lipoprotein
atherosclerosis or CAD if increased
59
serum enzymes
troponin
| MI
60
Structures within the thorax
```
Mediastinum:
Heart
aortic arch
superior vena cava
lower esophagus
lower trachea
```
61
Right pleural cavity
lung with 3 lobes
62
Left pleural cavity
lung with 2 lobes
63
Primary muscles of inspiration
diaphragm
| intercostal muscles
64
accessory muscles of respiration
```
sternocleidomastoid
scalenus
pectoralis minor
serratus anterior
rectus abdominus muscle
```
65
upper airway structures and functions
nose pharynx larynx trachea
conduct air to lower airway
protect from foreign matter
warm filter humidify inspired air
66
lower airway structures
```
trachea
R/L main stem bronchi
segmental/subsegmental bronchi
terminal bronchioles
alveoli: where gas exchange occurs
```
67
increased compliance respirations
easy lung expansion
68
decreased compliance respirations
difficult to expand increased stiffness of lung more effort to breath
69
surfactant
protein phospholipid that decreases surface tension of alveoli to prevent collapse and decrease breathing efforts
70
external respiration
pressure gradient
71
internal respiration
cellular level with exchange of O2 and CO2
| O2 to cells via diffusion
72
Pons
regulates respiratory rhythm
73
Medulla
controls respiratory rate and depth
| depends on CO2, O2 and HCO3 ion concentration in blood and body tissues
74
Abnormal breath sounds
Crackles
| wheezes
75
Normal lung sounds
Bronchial- normal in child and young adults >40 is abnormal, heard over the trachea. Loudest sound.
Broncho-vesicular- heard over the anterior and posterior area of the bronchi
Vesicular- heard through lung fields.
76
Crackles
heard on inspiration, expiration or both
may or may not clear with coughing
causes atelectasis (alveolar collapse)
heard with smphysema bronchitis, pneumonia, CHF, pulmonary edema, pulmonary fibrosis and COPD
sounds like crackling, bubbling related to fluid in small airways and alveoli
77
Fine Crackles
lower airways, high pitched sound wet.
78
coarse crackles
upper airways louder pitch
79
Wheezes
heard on inspiration, expiration, or both and with or without stethoscope.
heard with asthma, pneumonia, bronchospasms, airway obstruction, foreign body or tumor.
sounds like continuous musical, high pitched rt air rushing in over narrow obstructed airways
80
plural friction rub
heard on inspiration or expiration
does not clear with coughing
painful on inspiration
post pleural effusion removal, MI, pericarditis, pneumonia and pleurisy
sounds like grating.
81
Hypoxemia
blood oxygen levels drop below normal
| PaO2 tells how much O2 the lungs are delivering to blood and tissues
82
mild hypoxemia
PaO2 60-79 mmHg
83
moderate hypoxemia
PaO240-59 mmHg
84
Severe hypoxemia
PaO2 less than 40 mmHg
85
Hypoxia
blood unable to take adequate amount of O2 to tissues
occurs during internal respirations
```
signs and symptoms
agitations
anxiety
change LOC
headache
irritability
restlessness
tachypnea
```
```
late symptoms:
bradycardia
cardiac dysrhythmias
bradypnea
retractions
```
86
pH
7.35-7.45 acid base level of H+ ion
87
PaO2
80-100 mmHg tells how much O2 lungs delivering to blood and tissues
88
PaCO2
35-45 mmHg tells how well lungs getting rid of CO2
| if increased resp acidosis if decreased resp alkalosis
89
HCO3
22-26 mEq/L assesses H ion levels
| bicarb
90
SaO2 saturation
95-100% O2 saturation of hemoglobin
91
respiratory acidosis
low pH high CO2
92
respiratory alkalosis
high pH low CO2
93
metabolic acidosis
low pH low HCO3
94
metabolic alkalosis
high pH high HCO3
95
PROM
passive range of motion
| nurse does for patient
96
AROM
active range of motion
| patient can perform
97
Lordosis
abnormal concave of lumbar spine
| booty pop
98
kyphosis
abnormal increased rounding of the thoracic curve
| hunchback of notre dame
99
scoliosis
lateral deviation of the spine
100
elimination is a _________behavior so it requires
biopschosocial
privacy
appropriateness of location, discussion, disposal of waste.
101
I&Os provide information on
fluid balance
102
Incontinence may cause
anxiety depression and social isolation
103
Urinary retention is common after
surgery
104
factors influencing bowel function
diet, age, activity, exercise, stress, drugs, pathology
105
alimentary tract
```
from mouth to anus
esophagus
stomach
intestines
rectum
anal canal
```
106
functions of GI tract
ingest and digest food
absorb nutrients electrolytes and water
excrete waste
107
oral cavity
mouth and oropharynx
teeth- adults have 28, 32 if wisdom teeth are intact
saliva- 1200 ml/day
digestion
108
liver
```
largest organ
functions:
bile
transfer bilirubin from blood to gallbladder
protein, CHO fat metabolism
glycogen storage
synthesis of plasma proteins
detoxification
storage of iron, vitamin A&B
```
109
gall bladder
concentrates and stores bile
| located in the RUQ
110
pancreas
```
endocrine:
insulin
glycagon
gastrin
exocrine:
bicarb
pancreatic enzyme
```
111
spleen
store RBC and platelets
activates B/T lymphocytes
RBC production
112
abdominal quadrants
RUQ
LUG
RLQ
LLQ
epigastric
periumbelical
suprapubic
113
bowel elimination amount r/t
amount and composition of ingested food
114
absorption
passive process of converting semi liquid chime into formed fecal mass
115
peristalsis
wave like movements that propel feces to sigmoid and rectum
116
borborygmi
audible sounds produced by hyperactive peristalsis
| associated with intestinal obstruction
117
defecation
movement of feces from bowel
reflex initiated when stool enters rectum
internal and external sphincters relax allowing for defecation
if continuously suppressed results in constipation/fecal impaction
118
tarry stool
black
caused by upper GI bleed
bleeding, iron, licorice, peptobismol
119
green stool
spinach, in kids= increase passage of stool thru bowels
120
white/ grey stool
gallbladder problems or antacids
121
yellow stool
increased fat r/t malabsorption
122
Red stool
lower GI bleed
| check for surface bleeding, hemorrhoids or fissures
123
occult
not seen with the naked eye
| possible causes are cancer of the GI tract
124
factors affecting bowel elimination
```
medications:
laxatives
antibiotics
psychological:
boredom
stress
depression
```
125
tenesmus
rectal pain associated with urge to defecate and feeling or incomplete emptying after defecation
126
ulcerative colitis
inflammation of the colon and rectum
| can have up to 30 episodes of diarrhea/day
127
crohns
inflammatory problem of the large or small intestines
| lesion on the intestinal wall, cramping, fever
128
diverticulitis
colon pouching, with constipation abd pain
| + for occult (blood) stools
129
hemorrhoids
dialated veins in rectum
internal or external
can cause pain, bleeding, swelling with stools
130
anal fissures
cracks in the rectum.
131
neurological injuries
can alter GI functioning
132
obstructive problems
block the passage way of stools
| can be serious if not corrected
133
IBS
spasm of the colon with cramping & pain
134
gastroenteritis
viral or bacterial inflammation with diarrhea
135
malabsorption
problems digesting fats, proteins, CHO
| causes rapid emptying and diarrhea with weight loss or malnutrition
136
polyps
wart like growth on the intestinal wall
| can grow in clusters and become cancerous
137
illeostomy
```
surgical diversion of the ileum
stool is liquid or semi liquid
limited control
700-800ml a day is average norm
can do a continent ileostomy with a kock pouch: to help control, has nipple valve for removal of stool
```
138
colostomy
large intestine brought to the abdominal wall
opening on abdominal wall called stoma
location depends on the stool consistency
ascending more loose than descending
control depends on location
may be temp. to rest bowel
has external appliance for stool
correct fitting of appliance is importantn to decrease skin irritation.
139
diet/fluids
need adequate hydration to provide weight, bulk and softness to stools
dehydration-> hard feces, constipation
6-8 glass of water daily, high fiber diet
140
activity/exercise
helps with muscle tone in abdomen and pelvis
helps propel stool
decreased mobility causes weakness and decreased peristalisis
141
laxatives
can become dependent
can be harmful practice especially for the elderly
avoid chronic use
142
four classes of laxatives
lubricants: mineral oil
bulk formers: fiber all, citrual
saline cathartics: MOM, Epsom salts
stimulants: sennekot, correctol, castor oil
143
assessment of abdomen
```
IAPP
inspect: skin, contour
auscultate: listen in 4 quadrants with diaphragm of stethoscope.
palpate in four quadrants
percuss
```
