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151 Cards in this Set

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Statutory Law
Created by elected legislative bodies. Ex: State Nurse Practice Acts
Nurse Practice Acts
describe and define the legal boundaries of nursing practice in each state
Regulatory or Administrative Law
created by adm bodies such as State Boards of Nursing when they pass rules and regulations
Common Law
created by judicial decisions made in courts when individual cases are decided. Ex: Informed consent; Client's right to refuse treatment
Criminal Law
prevents harm to society and provides punishment for crimes.
Criminal Law: Felony
Serious nature; penalty of imprisonment > 1 yr or death
Criminal Law: Misdeameanor
Less serious; Penalty fine or imprisonment < 1 yr
Civil law
protects rights of individual persons and encourage fair and equitable treatment
Standards of Care
legal guidelines for nursing practice
Fiduciary relationship
one in which a professional provides services which by their nature cause the client to trust in the specialized knowledge, integrity, and fidelity of the professional.
Living Will
Directs treatment in accordance with client's wishes in event of terminal illness or condition
Patient Self Determination Act
Requires health care institutions to provide written info to clients concerning client's rights under state law to mkae decisions, incl right to refuse treatment and formulate advance directives.
HIPPA
limits extent to which health plans can impose preexisting limits & prohibits discrimination in health plans against ind participants based on health status.
Tort
civil wrong against a person or property
Unintentional Tort
Negligence or Malpractice
Intentional Tort
assault, battery, invasion of privacy, defamation
Negligence
Failure to use that degree of skill or learning ordinarily used under same/similar circumstances by member os the nursing profession
Statutory Law
Created by elected legislative bodies. Ex: State Nurse Practice Acts
Nurse Practice Acts
describe and define the legal boundaries of nursing practice in each state
Regulatory or Administrative Law
created by adm bodies such as State Boards of Nursing when they pass rules and regulations
Common Law
created by judicial decisions made in courts when individual cases are decided. Ex: Informed consent; Client's right to refuse treatment
Criminal Law
prevents harm to society and provides punishment for crimes.
Criminal Law: Felony
Serious nature; penalty of imprisonment > 1 yr or death
Criminal Law: Misdeameanor
Less serious; Penalty fine or imprisonment < 1 yr
Civil law
protects rights of individual persons and encourage fair and equitable treatment
Standards of Care
legal guidelines for nursing practice
Fiduciary relationship
one in which a professional provides services which by their nature cause the client to trust in the specialized knowledge, integrity, and fidelity of the professional.
Living Will
Directs treatment in accordance with client's wishes in event of terminal illness or condition
Patient Self Determination Act
Requires health care institutions to provide written info to clients concerning client's rights under state law to mkae decisions, incl right to refuse treatment and formulate advance directives.
HIPPA
limits extent to which health plans can impose preexisting limits & prohibits discrimination in health plans against ind participants based on health status.
Tort
civil wrong against a person or property
Unintentional Tort
Negligence or Malpractice
Nightingale
Facilitate the body's reparative process by manipulating environment
Peplau
Develop interaction between nurse and client
Henderson
Wk w/ other health care workers to assist client in gaining INDEPENDENCE
Abdellah
svc to whole person to meet phys, emotional, and spiritual needs of client & family
Rogers
Unitary man; Coexists w/ env
Orem
Total self-care deficit theory
King
interaction betw client, nurse, env (health care sys)
Neuman
strengthen resistance to stressors
Leininger
cultural caring
Roy
Adaption to demands
Watson
Phil of caring
Brenner/Wrubel
Caring is central
What is energy requirement of a body at rest?
basal metabolic rate -- energy needed to maintain life sustaining activities like breathing, circulation, heart rate, temp
What is resting energy expenditure?
measurement accounting for BMR + energy to digest meals and perform mild activity; a baseline of energy requirements accounting for approx 60-70% of daily needs
How can energy requirements be estimated in hospital?
measuring O2 consumption, CO2 production, and Nitrogen excretion by means of metabolic chart
What are elements neccesary for body processes and functions?
nutrients
What is a solvent for metabolic processes?
water
What are vitamins and minerals used by body for?
Not energy but metabolic processes like acid-base balance
What is nutrient density
Proportion of essential nutrients to number of kcalories.
Give ex of high nutrient density and low nutrient density foods
High: fruits and vegetables
Low: sugars, alcohol
What is main source of energy in diet?
carbs. Each has 4 kcal as is main source of glucose,erthrocyte and leucocyte production, cell function of renal medulla; obtained primarily FROM PLANT FOODS (p1273) except for lactose
How are carbs classified?
According to their carb units, or saccharides
define monosaccharide
glucose/dextrose, fructose cannot be broken down into simplier carb units
define disaccharide
sucrose, lactose, maltose composed of 2 monosaccharides and water
define simple carbs
mono- and disaccharides found primarily in sugars
what is a polysaccharide
glycogen; composed of many carb units; complex carbs; insoluable in water; digested to varying degrees; starches
What is fiber
polysacch; humans cannot digest insoluable (cellulose, hemicellulose, lignin); factor in disease prevention and treatment and prevention of diarrhea in tube-fed clients; soluable-pectin, guar gum, mucilage
What are proteins used for?
Can be used for energy (4kcal)but mainly for building body tissues in growth, maint, and repair. Ex: collagen, hormones, enzymes, immune cells, DNA, RNA. Blood clotting, fluid reg, Acid-base bal all req proteins
Simpliest protein:
amino acid
Essential:those that body cannot synthesize but must have in diet
Nonessential: Can be made by body
Albumin and insulin...
are proteins containing only amino acids or their derivatives
Combining a simple protein and a nonprotein produces...
a complex protein (eg lipoprotein)
a complete protein...
(high-quality proteins) contains all essential amino acids in sufficient quantity to support growth and maintain nitrogen balance
Ingestion of proteins is most important for ...
maintaining nitrogen balance
Incomplete proteins...
lack one or more of the nine essential amino acids and include cereals, legumes (peas, beans) and vegetables.
Complementary proteins...
are pairs of incomplete proteins that when combined supply the total amt of protein provided by complete protein sources
Nitrogen balance is achieved when...
the intake and output of N2 are equal. When intake of N2>output, body is positive N2 bal which is req for growth, normal preg, maint of lean muscle mass and vital organs, and wound healing. N2 retained used to build, repair, and repl body tissues. Neg N2 bal occurs w/ infection, sepsis, burns, fever, starvation, head injury, trauma. (Body tissue destruction or loss of N2 containing body fluids)
Should protein be used to provide energy?
Protein can be used, but because of its role in growth, maint, repair, kcal should be provided in diet from nonprotein sources; protein is spared when sufficient carbs are in diet to meet energy needs
What are the most caloric-dense nutrient? How many kcal do they provide?
Fats, 9kcal/g
Triglycerides...
circulate in blood; make of 3 fatty acids attached to a glycerol
What are fatty acids composed of?
chains of carbon and hydrogen atoms with an acid group on one end of chain and methyl group on other end
What are 2 types of fatty acids? Describe.
1- Saturated: each carbon in chain has TWO attached Hydrogen atoms

2- Unsaturated - an unequal number of H atoms are attached and the carbon atoms attach to each other with a double (COVALENT) bond
1 - What are monounsaturated fatty acids? 2- What are polyunsaturated fatty acids?
1 have one double bond

2 have two or more double bonds
How much cholesterol (mg/tbsp) does the following have? 1) lard 2) beef fat
3) butter fat
1) 12 2) 14 3) 33
Fatty acids are classified as...
essential or nonessential
What is the onlly essential fatty acid in humans?
Linoleic acid, an unsaturated fatty acid.

Linolenic acid and arachidonic acid (also unsat fa) are impt for metabolic processes but can be made by the body when linoleic acid is available. Deficiency occurs when fat intake falls below 10% of daily nutrition.
Water is what % of total body weight?
60-70%
Body water is greater in lean people. T/F

Infants have greatest % of total body water. T/F

Old people have lowest % of total body water. T/F
T
T
T
Water is produced during digestion when food is oxidized. T/F
T
Name the fat-soluable vitamins.

What is hypervitaminosis?
A D E K

megadoses of supplemental vitamins, excessive amts in fortified food, and large intakes of fish oils
What are the water-soluable vitamins?
vitamins C and Bcomplex (8 vitamins)

Cannot be stored in body
Organic element essential to body as catalysts in biochem reactions are . . .
Minerals
Macrominerals are ...

Microminerals (trace) are ...
Give an example
Daily req 100 mg or more

Daily req < 100 mg
Selenium
What enzyme in saliva breaks down starches into sugars?
amylase
Saliva is neutral/alkaline/acidic

Gastric juice is neutral/alkaline/acidic

Secretions of small intestine are neutral/alkaline/acidic
neutral
acidic
alkaline
Ptyalin is ...
enzyme in saliva (salivary amylase); acts on cooked starch to convert to maltose
Proteins and fats are broken down physically but not chemically in mouth -- no enzymes in mouth to react. T/F
T
Dysphagia is ...
difficulty swallowing
pepsinogen is secreted by ____ in the stomach
chief cells
pepsinogen is actived by ...
HCl to convert pepsinogen to pepsin, an enzyme splitting protein
pyloric glands secrete...
gastrin - hormone that triggers parietal cells to secrete HCl and IF (absorbs B12)
Gastric lipase and amylase are produced to ...
begin fat and starch digestion
secreted by small intestine mucosa
secretin (activates bicarbonate from pancreas) and CCK (cholecystokinin)- inhibits further gastrin secretion and initiates release of additional digestive enzymes from pancreas and gallbladder
Pancreatic secretions contain 6 enzymes:
amylase - digest starches
lipase - break down emulsified fats
trypsin, elastase, chymotrypsin, carboxypeptidase to break down proteins
epitheral cells in small intestine villi secrete enzymes to facilitate digestion:
sucrase, lactase, maltase, lipase, peptidase.

SI produces glucose, fructose, galactose, amino acids, dipeptides, fatty acids, glycerides, glyercol
How are nutrients absorbed in small intestine?
passive diffusion, osmosis, active transport, pinocytosis
Main source of water absorption is via intestine. T/F
T
Bacteria in colon synthesize vit K and some B complexes. T/F
T
Vitamin B12 is ...
cynocobalamin
Deficiency effects of B12:
Deficiency causes macrocytic anemia, elevated homocysteine, peripheral neuropathy, memory loss and other cognitive deficits. It is most likely to occur among elderly people as absorption through the gut declines with age; the autommune disease pernicious anemia is another common cause. In rare extreme cases, paralysis can result
folic acid is...
Vitamin B8

A water-soluble vitamin belonging to the vitamin B complex that is necessary for the formation of red blood cells and important in embryonic development. It is also the parent compound of coenzymes in various metabolic reactions. Folic acid is found especially in green leafy vegetables, liver, and fresh fruit. Deficiency of folic acid in the diet results in anemia.
Deficiency effects of B8 (folic acid)
Deficiency results in a macrocytic anemia, and elevated levels of homocysteine. Deficiency in pregnant women can lead to birth defects. Supplementation is often recommended during pregnancy. Researchers have shown that folic acid might also slow the insidious effects of age on the brain.
What is B7 and its deficiency?
BIOTIN-Deficiency does not typically cause symptoms in adults but may lead to impaired growth and neurological disorders in infants.
What is B6 and its deficiency?
Pyroxidine: Deficiency may lead to anemia, depression, dermatitis, high blood pressure (hypertension), water retention, and elevated levels of homocysteine.
what is B5 and its defiency?
PANTHOTHENIC ACID: deficiency can result in acne and Paresthesia, although it is uncommon
What is B3 and its defiency?
NIACIN-Deficiency, along with a deficiency of tryptophan causes Pellagra. Symptoms include aggression, dermatitis, insomnia, weakness, mental confusion, and diarrhea. In advanced cases, pellagra may lead to dementia and death
What is B2 and its defiency?
RIBOFLAVIN:Deficiency causes Ariboflavinosis. Symptoms may include cheilosis (cracks in the lips), high sensitivity to sunlight, angular cheilitis, glossitis (inflammation of the tongue), seborrheic dermatitis or pseudo-syphilis (particularly affecting the scrotum or labia majora and the mouth), pharyngitis, hyperemia, and edema of the pharyngeal and oral mucosa
What is B1 and its defiency?
THIAMIN: Deficiency causes Beriberi. Symptoms of this disease of the nervous system include weight loss, emotional disturbances, Wernicke's encephalopathy (impaired sensory perception), weakness and pain in the limbs, periods of irregular heartbeat, and edema (swelling of bodily tissues). Heart failure and death may occur in advanced cases. Chronic thiamine deficiency can also cause Korsakoff's syndrome, an irreversible psychosis characterized by amnesia and confabulation.
Acronym for B complexes:
Turn (TRN) PP Bowels Free Chuck!
Which group has a gradual decline in energy requirements per unit of body weight?
school age children
Which group needs fewer kcalories but an increased amt of protein in relation to body weight?
toddlers (1-3 yrs)
Which group's energy needs increase to meet greater metabolic demands of growth? Also increase in daily protein needs.
adolescents
which group may have decreased appetite?

Which group needs small frequent meals and 3 interspersed hi-nutrient snaks?
toddlers
Preschoolers (3-5) have diet req similar to toddlers. They consume more and nutrient density is more impt than quantity. T/F
T
Snack foods from the diary and fruit & veg groups are good choices. To counter obesity, incr phys activity is more impt than curbing intake. T/F
T
What condition does this describe?

A. Refusal to maintain body weight over a minimal normal weight for age & height (eg weight loss leading to maint of body weight at less than 85% of IBW; or failure to make body weight less than 85% of expected)
D. The absence of 3 consec cycles when otherwise expected to occur
Anorexia Nervosa
Bulimia Nervosa
Recurrent episodes of binge eating (rapid-consumption of a large amt of food in a discrete period of time)

D- a min or avg 2 binge eating episodes a wk for 3 mos.
Lactating women need 500 kcal/day above usual allowance. T/F

Protein req for lactation exceeds protein req for pregnancy. T/F
T
T
Pregancy: Increased need for Vit A,C. Daily intake of B,C (water-sol vit) needed to ensure adequate levels of breast milk. t/f

Tobacco can increase levels of breast milk. t/f
t
f
Vit and mineral req remain unchanged from middle adult to older adulthood. t/f
t
ovoloctovegetarian
avoid meat, fish, poultry but eat eggs, milk, ves
vegans
eat only vegetables
lacovegetarians
drink milk, avoid eggs
zen macrobiotic
fruitarian
eat brown rice, other grains, herb teas

eat only fruits, nuts, honey, olive oil
Lactose intolerance from high to low:
Asian-Pacific
African and African Americans
Native American
Mexican-American
Middle Eastern
whites
Hot foods:
rice, grain, cereals, alcohol, beef, lamb, chili peppers, chocolate, cheese, temperate zone fruits, eggs, peas, goat's milk, cornhusks, oils, onions, pork, radishes, tamales
cold foods:
beans, citrus fruits, tropical fruits, dairy products, most veggies, honey, raisins, chicken, fish, goat
some specific conditions req hot foods. Menstruation, cancer, pnemonia, earache, colds, paralysis, headache, rheumatism are cold illnesses requiring hot foods. t/f
t
Pregnancy, fever, infection, diarrhea, rashes, ulcers, liver problems, constipation, kidney problems, sore throats are hot conditions requirning cold foods. t/f
t
Assessment of nutritional status: 1) Anthropometry is ...
a measurement system of the size and makeup of the body
one pint or 500 ml of fluid equals ...
one pound
BMI
weight in kg divided by height in meters squared:

weight (kg) / height2 (m2)

> 25 is upper boundary for healthy weight; places client at risk for resp disease, tb, digestive disease, some cancer

>35 risk of Coronary heart disease, some cancer, diabetes mellitus, and HBP

BMI between 25 and 30=overweight

BMI > 30 = obese
dfd
dfd
Nitrogen intake- impt to est serum protein status. Intake=total grams of protein ingested in24 hrs / 6.25

Nitrogen output: Lab analysis of 24-hr urinary urea nitrogen UUN.

Nit bal = nit input - nit output
n/a
parathesia is ...
burning and tingling of hands and feet
fissures or scars at lips
red swollen lips
tongue beefiness
mottled teeth
red eye membrane
fissure of eyelid corners
dryness of eye membrane
dull appearance of cornea
soft cornea
spoon shaped nails
stomatitis
cheilosis
glossitis
flourosis
conjunctival injection
angular palpebritis
conjunctival xerosis
corneal xerosis
kertaomalacia
koilonychia
Improperly home-canned foods, smoked sausage, salted fish, ham, sausage, shellfish

Symptoms vary from mild discomfort to death in 24 hrs, initially nausea and dizziness, progressing to motor (resp) paralysis
Botulism (c. botulinum)
Undercooked meat (ground beef)

Severe cramps, nausea, vomiting, diarrhea (maybe bloody), renal failure. Appears 1-8 days after eating; last 1-7 days
E.Coli
Soft cheese, meat (hot dogs, pate, lunch meats), unpasteurized milk, poultry, seafood

severe diarrhea, fever, headache, pneumonia, meningitis, endocarditis. appears 3-21 days after infection
Listeriosis
Listeria
L. monocytogenes
Cooked meats, meat dishes held at room or warm temps

Mild diarrhea, vomiting; appears 8-24 hours after eating; lasts 1-2 days
Perfringens enteritis
Clostridium (C. perfringens)
Milk, custards, egg dishes, salad dressings, sandwich fillings, polluted shellfish

mild to severe diarrhea, cramps, vomiting; appears 12-24 hrs after ingestion; last 1-7 days
Salmonellosis
Salmonela
S.typhi
S.paratyphi
milk, milk products, seafood, salads

mild diarrhea to fatal dysentery. Appears 7-36 hrs after ingestion; lasts 3-14 days
Shigellosis
Shigela
S. dysenteriae
Custards, creams fillings, processed meats, ham, cheese, ice cream, potatoe sald, sauces, casseroles

severe abd cramps, pain, vomiting, diarrhea, perspiration, headache, fever, prostration. Appears 1-6 hrs after ingestion, lasts 1-2 days
Staph
S. aureus
Pharmocological agents to stim appetite:
cyproheptadine (periactin)
megestrol (megace)
dronabinol (marinol)
Immune system: Antibodies
Malnutrition effect: decreased amount
Vital nutrient(s) are:...
proteini, a,c,b12,b6,folic acid, thiamin, biotin, riboflavin, niacin
immune sys: GI tract
malnutrition effect: translocation of bacteria to systemic bodily areas
vital nutrient needed:...
arginine, glutamine, omega-3 fa
Immune sys: Granulocytes and macrocytes

Malnutrition effect:longer time for phagocytosis kill time and lymphocyte activation
protein, a,c,b12,b6, folic acid, thiamin, riboflavin, niacin, zinc, iron
immune sys: Mucus
malnutrition effect: flat microvilli in GI tract, decreased antibody secretion
b12, b6, c, biotin
immune sys: skin
malnutrion effect: integrity compromised, density reduced, wound healing slowed. what are vital nutrients?
protein, a, b12, c, niacin, copper, zinc
Immune sys: T-lymphoctyes
malnutrion effect: depressed t-cell distribution
vital nutrients needed:...
protein, arginine, iron, zinc, omega-3 fa, a, b12, b6, folic acid, thiamine, riboflavin, niacin, pantothenic acid