• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/239

Click to flip

239 Cards in this Set

  • Front
  • Back
(def)

a blood clot (or a substance such as air) that has moved from its place of origin and is causing obstruction to circulation elsewhere
embolus
(def)

abnormally fast respirations; usually more than 24 respirations per minute
tachypnea
(def)

inflammation of a vein followed by formation of a blood clot
thrombophlebitis
(def)

difficult or labored breathing
dyspnea
(def)

insufficient oxygen anywhere in the body
hypoxia
(def)

a decrease in the caliber (lumen) of blood vessels
vasoconstriction
(def)

a solid mass of blood constituents in the circulatory system; a clot
thrombus
(def)

bluish discoloration of the skin and mucous membranes caused by reduced oxygen in the blood
cyanosis
(def)

an abnormally rapid pulse rate; greater than 100 beats per minute
tachycardia
(def)

passage of blood constituents through the vessels of the circulatory system
perfusion
(def)

any activity during which the body takes in more or an equal amount of oxygen than it expands
aerobic exercise
(def)

involves activity in which the muscles cannot draw out enough oxygen from the bloodstream; used in endurance training
anaerobic exercise
(def)

a condition that occurs when ventilation is decreased and pooled secretions accumulate in a dependent area of a bronchiole and block it
atelectasis
(def)

permanent shortening of a muscle and subsequent shortening of tendons and ligaments
contracture
(def)

a toe-down motion of the foot of the ankle
plantar flexion
(def)

pain associated with an inflammation of the parietal pleura of the lungs (stabbing pain characterized by dypsnea)
pleuritic pain
(def)

upward or backward flexion of a part of the body
dorsiflexion
(def)

the ability of a muscle or person to produce or resist a physical force
strength
(def)

the ability to continue an activity despite increasing physical or psychological stress
endurance
(def)

a form of active exercise in which muscles contract and cause movement
isotonic exercise
(def)

a form of active exercise in which muscle tension is increased while pressure is applied against stable resistance
isometric exercise
(def)

a form of exercise in which maximum force is exerted by a muscle at each point throughout the active range of motion as the muscle contracts (combines isotonic and isometric)
isokinetic exercise
(def)

any body exercise involving the muscles, joints and natural movements
range of motion exercises
(def)

a type of pneumonia associated with elderly or debilitated people who remain in the same position for long periods
hypostatic pneumonia
(def)

theory that states "The cause of thrombosis must have 3 contributing factors.....stasis of venous flow, hypercoagulability of blood, and damage to the endothelium"
Virchow's Triad
(def)

a temporary or permanent inability of the external sphincter muscles to control the flow of urine from the bladder
urinary incontinence
(def)

the process of emptying the bladder (3)
urination
micturition
void
(def)

production of abnormally small amounts of urine by the kidney (2)
oliguria
urinary suppression
(def)

the amount of urine remaining in the bladder after a person voids
residual urine
(def)

the accumulation of urine in the bladder and inability of the bladder to empty itself
urinary retention
(def)

the weight or degree of concentration of a substance compared with that of an equal volume of another, such as distilled water, taken as standard
specific gravity
(def)

the production of large amounts of urine by the kidneys without an increased fluid intake (2)
diuresis or polyuria
(def)

excessive thirst
polydipsia
(def)

voiding two or more times at night
nocturia
(def)

the failure of the kidneys to produce urine, resulting in a total lack of urination or output of less than 100 mL per day in an adult
anuria
(def)

painful or difficult voiding
dysuria
(def)

bed-wetting; involuntary passing of urine in children after bladder control is achieved
enuresis
(def)

the feeling that one must urinate
urgency
(def)

an inflammatory condition of the urinary bladder and ureters, characterized by pain, urgency and frequency of urination, and hematuria
cystitis
(def)

the presence of bacteria in the urine
bacteriuria
(def)

a physical, microscopic, or chemical examination of urine
urinalysis
(def)

a decrease in the force of the stream of urine, often with difficulty in beginning the flow
urinary hesitancy
(def)

the presence of an excessive number of WBCs in the urine, typically more than four leukocytes per high-power field count
pyuria
(def)

abnormal presence of a sugar, especially glucose, in the urine
glycosuria
(def)

abnormal presence of blood in the urine
hematuria
(def)

the number of repetitions of any phenomenon within a fixed period
frequency
(def)

the presence in the urine of abnormally large quantities of protein, usually albumin
proteinuria
(def)

passage of small, dry, hard stool or passage of no stool for an abnormally long time
constipation
(def)

a wood resin, formally used as a reagent in laboratory tests for the presence of occult blood
guaiac
(def)

expulsion of feces from the rectum and anus
defecation
(def)

defecation of liquid feces and increased frequency of defecation
diarrhea
(def)

a mass or collection of hardened, putty-like feces in the folds of the rectum
fecal impaction
(def)

loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter
fecal incontinence
(def)

gas or air normally present in the stomach or intestine
flatus
(def)

the presence of excessive amounts of gas in the stomach or intestines
flatulence
(def)

test used to detect hidden blood in the stool using a pre-packaged slide
hemoccult slide (test)
(def)

test used to detect hidden blood in the stool using a tablet
hematest
(def)

abnormal black tarry stool that has a distinctive odor and contains digested blood
melena
(def)

blood that is not obvious on examination but may be detected by means of a chemical test or by microscopic or spectroscopic examination
occult blood
(def)

wavelike movements produced by circular and longitudinal muscle fibers of the intestinal walls; the movement propels the intestinal contents onward
peristalsis
(def)

solid, cone-shaped, medicated substance inserted into the rectum, vagina, or urethra
suppository
(def)

any bodily movement produced by skeletal muscles that results in energy expenditure
physical activity
(def)

a subset of physical activity defined as any planned, structured and repetitive bodily movement
exercise
What are 6 benefits of physical activity/exercise?
1. Reduction of serum triglyceride levels
2. Reduction of BP (at rest)
3. Increase in level of HDL cholesterol
4. Enhancement of glucose tolerance and insulin sensitivity
5. Decrease risk of severe chronic diseases
6. Increase in joint flexibility and ROM
Why is exercise recommended for people with type II diabetes?
because it enhances glucose tolerance and insulin sensitivity
How does physical activity help prevent osteoporosis?
because exercise helps to maintain bone density
(def)

the ability to perform moderate to vigorous levels of physical activity without undue fatigue and to maintain that ability throughout one's life
physical fitness
What are the 4 components of physical fitness?
1. muscle strength and endurance
2. cardio-respiratory fitness
3. joint flexibility
4. body composition
(def)

the ability to use a muscle fully through its maximum range of motion
joint flexibility
Body composition should fall within the range of the recommended proportion of ____ to ____ body tissue.
fat to lean body tissue
Isotonic, Isometric or Isokinetic?

Dynamic exercises; movement
Isotonic
Isotonic, Isometric or Isokinetic?

tightening and loosening a muscle without movement
Isometric
Isotonic, Isometric or Isokinetic?

Muscle tension is constant and the muscle shortens to produce contraction and movement
Isotonic
Isotonic, Isometric or Isokinetic?

Increases muscle tension without changing the length of the muscle or moving the joint
Isometric
Isotonic, Isometric or Isokinetic?

Involves alternatively tightening the muscle as hard as possible and then relaxing the muscle
Isometric
What are 3 benefits of Isotonic exercise?
1. Increases muscle strength and endurance
2. Improves cardio-respiratory function
3. Heart rate and cardiac output increases blood flow systemically (benefits entire body)
Isotonic, Isometric or Isokinetic?

Helpful in maintaining strength of the quadriceps, abdominal and gluteal muscles which are used in ambulation
Isometric
True/False:

Isometric exercises are useful in preventing joint contractures.
False- they are not useful in preventing joint contractures since there is no movement of the joints involved.
Isotonic, Isometric or Isokinetic?

Produces a moderate increase in heart rate and cardiac output, but no appreciable increase in blood flow to other parts of the body
Isometric
True/False:

Isometric exercise does produce an elevation of both systolic and diastolic BP while you are engaged in it.
True
Having a client exhale while performing isometric exercises can prevent the client from doing what?
the Valsalva Maneuver (without proper breathing, the client may unintentionally perform this maneuver during isometric exercises)
Which is more effective systemically, isotonic or isometric exercises?
isotonic
Isotonic, Isometric or Isokinetic?

A combination of resistance and movement
Isokinetic
Isotonic, Isometric or Isokinetic?

Used in physical conditioning to build up specific muscle groups
Isokinetic
Kegal exercises are an example of which type of exercise?
Isometric exercise
Aerobic or Anaerobic exercise?

Improves cardiovascular fitness
Aerobic
Aerobic or Anaerobic exercise?

Walking briskly, swimming
Aerobic
Aerobic or Anaerobic exercise?

used to develop muscle tone and improve cardio-respiratory function
anaerobic
Aerobic or Anaerobic exercise?

running up 3 flights of stairs
anaerobic
According to the American College of Sports Medicine, how frequent should a person exercise?
3-5 days a week
According to the American College of Sports Medicine, the intensity of training should be ____-____% of maximum heart rate or ____-____% of maximum oxygen uptake.
60-90% of maximum heart rate or 50-85% of maximum oxygen uptake
How do you calculate your maximum heart rate?
220 - age = maximum heart rate
According to the American College of Sports Medicine, how long should you exercise during a session? What determines if you will be on the higher or lower end of this range?
20-60 minutes of continuous or intermittent (min. of 10 minute bouts). Time depends on the intensity of the activity
Would lower intensity activity require a shorter or longer duration to meet the requirements set by the American College of Sports medicine?
it would require a longer duration
True/False:

You should be able to carry on a conversation while exercising
True - while your breathing may be labored, you should still be able to carry on a conversation
The _____ Scale is used to measure your sensation of breathlessness during various activities.
Borg
The American College of Sports Medicine recommends what 3 criteria for exercise to be considered effective?
What are examples of exercises that meet this criteria?
1. uses large muscle groups
2. can be maintained continuously
3. is rhythmical and aerobic in nature

(walking/hiking, running, swimming, cycling, rowing, stair climbing, skating, etc.)
What is the recommended guideline(s) for resistance training?
- one set of 8-12 reps of 6-10 different exercises that condition the major muscle groups at least 2 times a week
Why should flexibility exercises be incorporated into an overall fitness program? How often should these exercises be performed per a week?
- incorporated to develop and maintain ROM
- need to be performed a minimum of 2-3 times a week
Adults should accumulate ____ minutes or more of moderate intensity physical on most, preferably all days of the week.
30
Anyone over 35 years and sedentary should obtain what before starting an exercise program?
medical consultation
What is the recommendation for the elderly regarding exercise?
at least 20 minutes of aerobic exercise every 42 hours at 60% intensity
All exercise should begin and end with what?
begin with a warm-up and end with a cool-down
How long after a meal should you wait to exercise?
1 1/2 to 2 1/2 hours
What should you do if you are exercising and feel pain/pressure in the center of the chest, irregular heart beats, dizziness, fainting, light-headedness or blackout occurs?
stop exercising immediately
What can the nurse assist the client with in regards to exercise? What can't the nurse do.
The nurse CAN counsel clients to adopt and maintain regular physical activity, correct misconceptions, and educate regarding recommendations. The nurse can NOT supervise or plan an intense exercise program.
(def)

the ability to move freely in the environment
mobility
(def)

confined to a position, and one is unable to move or change positions independently
immobility
True/False:

Immobility can be partial or complete.
True- partial may be a fractured limb or complete, such as paralysis
What are 5 major reasons for immobility?
1. severe pain
2. impairment of the musculoskeletal or nervous system
3. generalized weakness
4. psychosocial problems (such as depression)
5. infectious process
Is it ever therapeutic for a client to be immobilized?
Yes, for example to stop premature labor. In these instances the physician would order bedrest.
What are 3 benefits of bedrest?
1. reduces the needs of the body cells for oxygen because of reduced metabolism, secondary to reduced activity
2. directs energy resources toward the healing process rather than toward activity
3. reduces pain in some instances, thereby decreasing the need for analgesics
Bedrest is only beneficial if the client is __________ and _________.
comfortable and rested
The greater the extent and duration of immobility, the greater the what?
consequences
What does the abbreviation BRP mean?
Bathroom Privileges
What are 2 effects of immobility on the Psychoneurologic system?
- decrease in the quality and quantity of sensory input
- the client's increasing awareness of the limitations imposed by immobility
Immobility can lead to social, emotional, and intellectual changes. Minimizing the physiological effects of bedrest will also minimize what effects?
psychological effects
What are 4 examples of psychoneurologic symptoms you may observe in a client who is immobilized?
- depression
- behavioral changes
- changes in sleep pattern
- impaired coping
What are 4 effects that immobility has on the metabolic system?
1. decreased metabolic rate
2. negative nitrogen balance
3. anorexia
4. negative calcium balance
(def)

all physical and chemical process in the body
metabolism
(def)

minimal energy expended for the maintenance of physical and chemical processes
Basal metabolism
In regards to metabolism and the immobilized client, ________ exceeds ________.
catabolism exceeds anabolism
In the immobilized client, catabolism exceeds anabolism. What effect does this have on nitrogen and protein?
- creates a negative nitrogen balance
- depletes protein storage (proteins are essential for building muscle tissue and wound healing)
(def)

the breakdown of proteins
catabolism
(def)

the build-up of proteins
anabolism
Negative nitrogen balance reaches it's peak within ___-___ days of immobility.
6-10
Why do you see anorexia in clients who are immobilized?
because of the decreased metabolic rate and increased catabolism
When a greater amount of calcium is extracted from the bone than can be replaced, the result is what?
a negative calcium balance
What effect does a negative calcium balance have on the skeletal system of immobilized clients? What about the urinary system?
skeletal system = greater risk for osteoporosis

urinary system = higher incidence of kidney stones
The process of respiration is comprised of what 3 parts?
- pulmonary ventilation (external respiration)
- diffusion of gases to and from the blood (external respiration)
- transport of gases via the blood to and from the cells (internal respiration)
What 3 negative side effects are seen in the respiratory system due to immobility?
1. decreased expansion of the lungs
2. reduced gas exchange in the alveoli
3. decreases hemoglobin (hbg)
What are 4 causes of decreased expansion of the lungs in the immobilized client?
1. bed presses against the chest and decreases chest movement
2. abdominal organs push against the diaphragm
3. recumbent person rarely sighs
4. muscle atrophy affects respiratory muscles
Osteoporosis caused by immobility is called what?
disuse osteoporosis
What effect does the shallow respirations seen in immobility have on vital capacity?
it reduces vital capacity significantly
(def)

the maximum amount of air that can be expired after a maximum inspiration effort
vital capacity
What are 3 reasons for reduced gas exchange in the alveoli of immobilized clients?
1. blood and mucus pool in dependent areas of the lungs that are less effectively ventilated
2. mucus and secretions are more viscous
3. coughing mechanism is impaired due to weakened muscles, inability to inhale maximally, and decreased ciliary movement
What can a nurse do to decrease the incidence of blood/mucus pooling in the dependent areas of the lungs of immobilized clients?
turn the client frequently
When assessing the respiratory system in an immobilized patient, what specific things should we note?
1. The rate and quality of respirations
2. The use of neck and/or accessory muscles to breath
3. Pulse rate
4. Temperature
5. Cough effort
6. signs of hypoxia
Why would we assess the pulse when reviewing the respiratory system of an immobilized patient?
because a rapid pulse rate is one of the first indicators of a lack of oxygen
Does an increase in temperature ever accompany problems in the lungs?
Yes, an increase in temperature may be indicative of an infection in the lungs and is a result of the inflammatory process
What are some early signs of hypoxia?
- increased pulse
- restlessness
- forgetfulness
Would cyanosis be a late or early sign of hypoxia?
cyanosis is a late sign of hypoxia
What are the 3 goals of the nursing interventions implemented for immobile clients directly related to the respiratory system?
1. Increase alveolar expansion
2. Prevent the stasis of respiratory secretions
3. Maintain a patent airway (promote adequate exchange of gases in alveoli)
When performing deep breathing exercises, the client inhales deeply and breaths out through _______ lips. What is the purpose of this?
pursed lips - this keeps the alveoli from collapsing
How would you demonstrate deep-breathing (diaphragmatic) exercises to a client?
1. place your hands palm down on the border of your rib cage and inhale slowly and evenly through the nose until the greatest chest expansion is reached
2. Hold your breath for 2-3 seconds
3. exhale slowly through the mouth
4. continue exhalation until maximum chest contraction has been achieved
The client should cough voluntarily after performing how many deep breathing exercises?
5
What technique is used if a client has a painful region of the body during coughing/deep breathing exercises?
splinting (holding a pillow in place over an incision site/painful region) to support the area
(def)

cleansing of the respiratory system
respiratory toiletry
What is an incentive spirometer? Does it require a doctor's order?
a visual feedback tool used to encourage deep breathing; yes, a doctor's order is needed
(def)

the use of positioning to drain secretions from specific segments of the bronchi and lungs into the trachea
postural drainage
(def)

method of cupping the hands and striking the body in an attempt to loosen respiratory secretions
percussion
Are doctor's orders required for percussion and postural drainage?
Yes
What is the recommend amount of fluid intake per day? How will this help an immobilized client in regards to respiratory issues?
at least 2000cc - helps to thin mucus secretions making them easier to expectorate
How often should constrictive abdominal or thoracic binders be removed to allow the client to deep breath (if allowed by the doctor)?
at least every 2 hours
In reference to the respiratory system, why should the use of narcotics/sedatives be used cautiously with immobilized clients?
because they depress ventilation
What causes atelectasis? (2)
- blockage of the bronchioles with mucus
- reduction of surfactant
What are the defining characteristics of atelectasis? (6)
- fever (possibly lowgrade)
- increased pulse and respirations
- dyspnea
- cyanosis
- adventitious breath sounds
- abnormal x-rays
What 2 complications may develop in the respiratory system due to immobility?
- atelectasis
- hypostatic pneumonia
What is the treatment method for atelectasis?
- essentially the same as preventative measures but more aggressive
(def)

infection of lung tissue resulting from poor circulation or stagnation of secretions
hypostatic pneumonia
What 3 problems associated with immobility contribute to the development of hypostatic pneumonia?
- poor cough reflex
- limited chest expansion
- pooling of secretions
What are the defining characteristics of hypostatic pneumonia?
- cough
- fever
- pain when breathing
- leukocytosis
- yellowish sputum, may be greenish
- patchy infiltrate on chest x-ray
What are the (2) treatments for hypostatic pneumonia?
1. antibiotics
2. aggressive preventative measures
If atelectasis or pneumonia is not corrected, it can lead to what?
respiratory acidosis and carbon dioxide narcosis
(def)

condition characterized by increased arterial carbon dioxide, excess carbonic acid, and increased plasma hydrogen ion concentration
respiratory acidosis
(def)

condition of severe hypercapnia with symptoms of confusion, tremors, convulsions, and possible coma if blood levels are increased to 70mmHg or higher
carbon dioxide narcosis
Hypostatic pneumonia in the elderly may only produce what 3 symptoms?
1. confusion
2. tremors
3. rapid respirations
Why are the elderly more prone to hypostatic pneumonia?
because they have poor chest expansion
What are the 5 major effects of immobility on the cardiovascular system?
- diminished cardiac reserve
- orthostatic hypotension
- increased use of valsalva maneuver
- dependent edema
- increased incidence of thrombus formation
True/False:

Respiratory acidosis and carbon dioxide narcosis are not compatible with life.
True
The resting heart rate increases approximately ____ beats/minute for each day of immobilization.
0.5 beats per minute
If a person is immobilized for 10 days, you can expect the heart rate to increase how much per minute?
5 beats per minute
What body position makes the heart work 30% harder?
supine
A rapid heart rate decreases what 3 things?
-diastolic pressure
-coronary blood flow
-the capacity to respond to metabolic demands above the basal levels
An immobilized person may experience what 2 things (in regards to the cardiovascular system) with even minimal exertion?
tachycardia and angina
What is the theory for the cause of increased heart rate due to immobilization?
- blood pooling to the torso causes cardiac resistance, which increases the force and rate of contractions
Orthostatic hypotension is described as a drop in blood pressure of ____ mm/Hg or more systolic or ____ mm/Hg or more diastolic when changing from a lying/sitting to a standing position.
20 or more systolic or 10 or more diastolic
What symptoms accompany orthostatic hypotension?
dizziness, lightheadedness, diaphoresis, and possible syncope (fainting)
Why does orthostatic hypotension often occur in immobolized patients?
the sympathetic reflex that automatically causes vasoconstriction of the blood vessels in the lower extremities is absent in the immobilized patient; causes inadequate cerebral perfusion as blood pools to the lower part of the body
What adjunct equipment may be used to prevent pooling of the blood in the legs of immobilized clients?
antiembolic hose
tilt boards
circoelectric beds
What is the purpose of gradually increasing the HOB (head of the bed) in regards to the cardiovascular system and immobility?
to regain peripheral vasoconstriction; this stimulates this reflex
How long should you have a client who has been ambulating lie down before applying antiembolic stockings?
15-30 minutes
Describe the proper method for applying anti-embolic stockings.
- reach inside stocking from the top, grasp heel, and turn the upper portion of the stocking inside out so that the foot portion is inside the stocking leg
- have client point toes and position the stocking on the client's foot (take caution to ensure that the toe and heel portions are on correctly
- grasp the loose portion of the stocking and gently pull the stocking over the leg, turning it right side out in the process
How often should antiembolic stockings be removed? What should be done during this time?
every 8 hours for 30 minutes, inspect the skin and perform skin care during this time
(def)

portion of the antiembolic hose where the material is looser; should be positioned over the interior thigh
gusset
What are 3 things that you should do to prevent falling in a patient who's peripheral vasoconstriction reflex has been impaired by immobility?
- assist the client when changing positions
- teach the client to move slowly when changing positions
- have the client dangle before standing
What should you do if you are assisting a client to stand and you notice that they appear pale suddenly and have begun to sweat?
Return that patient to a lying position immediately. Dizziness, pallor, sweating, drops in BP, and complaints of feeling faint all may indicate orthostatic hypotension.
In regards to the cardiovascular system, we know that we should encourage and assist clients with exercise. What part of the body and what type of exercise do you think we would focus on?
For cardiovascular, we would focus on the lower half of the body to stimulate circulation and venous return. ROM, isometric, and isotonic exercises would all be beneficial.
What 3 things can we do as a nurse to prevent a patient from using the valsalva maneuver?
- prevent constipation (decreases chances of the patient straining)
- teach client to avoid taking a deep breath and holding it while turning, moving or lifting (suggest they sing or count aloud to prevent the glottis from closing)
- teach client to use the overhead trapeze or their legs when moving, not their arms or trunk
What patients are definitely at risk when using the valsalva maneuver?
those with cardiac disease or a weakened heart
Describe the sequence of events that precedes the development of dependent edema. (4)
1. skeletal muscles don't contract sufficiently and the muscle atrophy
2. blood pools in veins, causing vasodilation and engorgement
3. veins no longer work effectively to prevent backward flow of blood and pooling. (incomplete valves)
4. venous pressure is so great that some of the serous portion of blood is forced out of the blood vessel into the interstitial spaces
Where is dependent edema more likely to occur?
in parts of the body positioned below heart level and maintained in that position
True/False:

Edematous tissue is more susceptible to damage, and is uncomfortable.
True
(def)

clot loosely attached to a vein
thrombus
(def)

clot loosely attached to an inflamed vein
thrombophlebitis
(def)

clot that has moved from one part of the body to another part
embolus
What 3 factors must be present for thrombus to occur? What are these three factors called?
1. stasis of venous flow
2. hypercoagulability of blood
3. damage to the endothelium

These 3 factors are called Virchow's Triad.
Stasis of venous flow is more common in which patients? (6)
- elderly
- those with heart disease
- obese clients
- immobilized clients
- pregnant women
- women in postpartum period
Hypercoagulability of blood is most likely to occur in which type of patients?
- those with hematological disorders
- dehydrated patients
- malnutritioned patients
What are factors that contribute to the damage of the endothelium?
- presence of an IV in the same site for more than 48 hours
- fracture that causes damage
- diabetes
- blood pooling
- burns
- external trauma or pressure
Damaged endothelium has ___________ (decreased/increased) fibrinolytic properties. Describe what fibrinolytic property is.
decreased firbrinolytic properties, which is the ability of the endothelium to break down a clot
What are ways to prevent thrombus formation?
- encourage movement (active & passive ROM, isotonic, and isometric)
- encourage client to move ASAP
- position client properly
- avoid crossing of legs and do not place pillows behind the knee
- elevate foot of bed 10-15 degrees to promote venous return
- increase fluid intake
- wear anti-embolic hose, use sequential compression device (need drs orders for these)
- do not massage or rub legs vigorously
- anti-coagulant therapy (heparin, coumadin, lovenox)
What are 3 leg exercises that may prevent DVTs?
- alternate dorsiflexion and plantar flexion of the feet (calf pumping)
- flex and extend the knees into the bed while dorsiflexing the foot
- bend one knee and place foot on bed to serve as the stable leg, extend knee of the other leg and lift

(see page 947 for pics)
A palpabe, firm, subcutaneous cordlike vein is called what?
superficial clot
The area surround a superficial clot may be effected how?
- tender, red and warm
- edema may form in the extremity
What type of systemic effect might you see when a person has a superficial clot?
increased WBC, mild increase in temperature
What are 5 possible indications of a deep vein thrombosis?
1. unilateral leg edema
2. pain in the leg
3. warm skin surrounding the area of the clot
4. increased temperature
5. positive Homan's sign
What are 4 treatment measures for a superficial clot?
1. bedrest with elevation of affected extremity
2. warm, moist heat used to relieve pain and inflammation
3. mild oral analgesic for pain
4. NSAIDS for inflammatory process (motrin, asprin)
What are 2 treatment measures for deep vein thrombosis?
1. anticoagulant therapy
2. surgical intervention
What are some defining characteristics of Pulmonary Embolus (PE)?
- sudden onset of unexplained dyspnea, tachypnea, or tachycardia
- cough
- chest pain
- hemoptysis
- crackles, fever
True/False:

Deep vein thrombosis will always present some, if not all, possible symptoms.
False - a person could have a DVT and be completely asymptomatic
Would a sudden change in the mental status of a client be a result of an early stage of PE or a late stage?
late stage of PE
A massive emboli or progressive disease may result in what symptoms?
- cyanosis
- shock
- pallor
- severe dyspnea
- crushing chest pain
- cardiac arrest
What percent of client's afflicted with DVT will have a positive Homan's sign?
only 20%
Treatment of PE varies according to the severity of the problem. What are some examples of supportive therapy and treatment? (4)
- oxygen
- anticoagulant therapy
- surgical intervention
- thrombolytic agents
(Def)

joint is moved to a right angle

(source: ROM video)
flexion
(def)

joint is straightened

(source: ROM video)
extension
(def)

joint is bent backwards

(source: ROM video)
hyperextension
(def)

moving a joint so that the appendage is moved away from it's normal resting place

(source: ROM video)
abduction
(def)

the return of an abducted appendage to it's normal resting position

(source: ROM video)
adduction
(def)

the circular movement of a joint

(source: ROM video)
circumduction
(def)

the turning of a joint on an axis

(source: ROM video)
rotation
Contractures usually occur in what position?

(source: ROM video)
flexed
Passive ROM is usually performed in what position?

(source: ROM video)
Supine with the palms up
What are 2 purposes of ROM exercises

(source: ROM video)
1. maintain joint mobility
2. prevent complications such as decreased peripheral circulation, skin breakdown, and contractures
True/False:

Contractures are usually reversible.

(source: ROM video)
False - most are irreversible
What causes contractures?

(source: ROM video)
Limitations of joint motion results in a permanent shortening of muscles and tendons
What are 5 causes of contractures?

(source: ROM video)
1. lack of exercise
2. muscle spasticity
3. prolonged joint immobilization
4. edema
5. pain or swelling
Connective tissues can show changes in as little as ____ days.

(source: ROM video)
4
What are 5 benefits of ROM exercises?

(source: ROM video)
1. prevents contractures
2. maintains joint mobility and function of tendons and muscle fibers
3. enhances circulation
4. stimulates sensory nerve endings
5. restores loss of joint function
When implementing ROM exercises, what 3 specific client factors must you consider.

(source: ROM video)
1. age
2. sex (men less flexible than women)
3. muscle mass and fat
(def)

type of ROM performed solely by the client; prevents muscle atrophy, encourages independence

(source: ROM video)
active ROM
(def)

a type of ROM where the client uses a stronger hand or leg to move a weaker limb

(source: ROM video)
self-assisted ROM
(def)

a type of ROM done by another person

(source: ROM video)
passive ROM
True/False:

All major joints should be exercised when doing ROM.

(source: ROM video)
True
When can ROM exercises cause injury?

(source: ROM video)
When a joint is forced beyond it's natural ROM or when it is forced to elongate during a muscle spasm
Should you ever stop ROM exercises early?

(source: ROM video)
Yes, if resistance, fatigue, or pain is experienced
In addition to preventing complications from immobility, what is another benefit of ROM exercises?

(source: ROM video)
psychologically beneficial
What information can you supply the family members regarding ROM?

(source: ROM video)
- information on joint injury
- proper joint positioning
- importance of client participation