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151 Cards in this Set
- Front
- Back
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Statutory Law
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Created by elected legislative bodies. Ex: State Nurse Practice Acts
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Nurse Practice Acts
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describe and define the legal boundaries of nursing practice in each state
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Regulatory or Administrative Law
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created by adm bodies such as State Boards of Nursing when they pass rules and regulations
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Common Law
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created by judicial decisions made in courts when individual cases are decided. Ex: Informed consent; Client's right to refuse treatment
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Criminal Law
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prevents harm to society and provides punishment for crimes.
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Criminal Law: Felony
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Serious nature; penalty of imprisonment > 1 yr or death
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Criminal Law: Misdeameanor
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Less serious; Penalty fine or imprisonment < 1 yr
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Civil law
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protects rights of individual persons and encourage fair and equitable treatment
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Standards of Care
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legal guidelines for nursing practice
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Fiduciary relationship
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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.
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Living Will
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Directs treatment in accordance with client's wishes in event of terminal illness or condition
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Patient Self Determination Act
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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.
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HIPPA
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limits extent to which health plans can impose preexisting limits & prohibits discrimination in health plans against ind participants based on health status.
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Tort
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civil wrong against a person or property
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Unintentional Tort
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Negligence or Malpractice
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Intentional Tort
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assault, battery, invasion of privacy, defamation
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Negligence
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Failure to use that degree of skill or learning ordinarily used under same/similar circumstances by member os the nursing profession
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Statutory Law
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Created by elected legislative bodies. Ex: State Nurse Practice Acts
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Nurse Practice Acts
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describe and define the legal boundaries of nursing practice in each state
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Regulatory or Administrative Law
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created by adm bodies such as State Boards of Nursing when they pass rules and regulations
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Common Law
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created by judicial decisions made in courts when individual cases are decided. Ex: Informed consent; Client's right to refuse treatment
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Criminal Law
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prevents harm to society and provides punishment for crimes.
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Criminal Law: Felony
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Serious nature; penalty of imprisonment > 1 yr or death
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Criminal Law: Misdeameanor
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Less serious; Penalty fine or imprisonment < 1 yr
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Civil law
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protects rights of individual persons and encourage fair and equitable treatment
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Standards of Care
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legal guidelines for nursing practice
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Fiduciary relationship
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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.
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Living Will
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Directs treatment in accordance with client's wishes in event of terminal illness or condition
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Patient Self Determination Act
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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.
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HIPPA
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limits extent to which health plans can impose preexisting limits & prohibits discrimination in health plans against ind participants based on health status.
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Tort
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civil wrong against a person or property
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Unintentional Tort
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Negligence or Malpractice
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Nightingale
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Facilitate the body's reparative process by manipulating environment
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Peplau
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Develop interaction between nurse and client
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Henderson
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Wk w/ other health care workers to assist client in gaining INDEPENDENCE
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Abdellah
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svc to whole person to meet phys, emotional, and spiritual needs of client & family
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Rogers
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Unitary man; Coexists w/ env
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Orem
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Total self-care deficit theory
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King
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interaction betw client, nurse, env (health care sys)
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Neuman
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strengthen resistance to stressors
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Leininger
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cultural caring
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Roy
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Adaption to demands
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Watson
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Phil of caring
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Brenner/Wrubel
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Caring is central
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What is energy requirement of a body at rest?
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basal metabolic rate -- energy needed to maintain life sustaining activities like breathing, circulation, heart rate, temp
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What is resting energy expenditure?
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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
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How can energy requirements be estimated in hospital?
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measuring O2 consumption, CO2 production, and Nitrogen excretion by means of metabolic chart
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What are elements neccesary for body processes and functions?
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nutrients
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What is a solvent for metabolic processes?
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water
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What are vitamins and minerals used by body for?
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Not energy but metabolic processes like acid-base balance
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What is nutrient density
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Proportion of essential nutrients to number of kcalories.
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Give ex of high nutrient density and low nutrient density foods
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High: fruits and vegetables
Low: sugars, alcohol |
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What is main source of energy in diet?
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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
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How are carbs classified?
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According to their carb units, or saccharides
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define monosaccharide
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glucose/dextrose, fructose cannot be broken down into simplier carb units
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define disaccharide
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sucrose, lactose, maltose composed of 2 monosaccharides and water
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define simple carbs
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mono- and disaccharides found primarily in sugars
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what is a polysaccharide
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glycogen; composed of many carb units; complex carbs; insoluable in water; digested to varying degrees; starches
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What is fiber
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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
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What are proteins used for?
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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
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Simpliest protein:
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amino acid
Essential:those that body cannot synthesize but must have in diet Nonessential: Can be made by body |
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Albumin and insulin...
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are proteins containing only amino acids or their derivatives
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Combining a simple protein and a nonprotein produces...
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a complex protein (eg lipoprotein)
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a complete protein...
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(high-quality proteins) contains all essential amino acids in sufficient quantity to support growth and maintain nitrogen balance
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Ingestion of proteins is most important for ...
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maintaining nitrogen balance
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Incomplete proteins...
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lack one or more of the nine essential amino acids and include cereals, legumes (peas, beans) and vegetables.
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Complementary proteins...
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are pairs of incomplete proteins that when combined supply the total amt of protein provided by complete protein sources
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Nitrogen balance is achieved when...
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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)
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Should protein be used to provide energy?
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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
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What are the most caloric-dense nutrient? How many kcal do they provide?
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Fats, 9kcal/g
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Triglycerides...
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circulate in blood; make of 3 fatty acids attached to a glycerol
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What are fatty acids composed of?
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chains of carbon and hydrogen atoms with an acid group on one end of chain and methyl group on other end
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What are 2 types of fatty acids? Describe.
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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 |
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1 - What are monounsaturated fatty acids? 2- What are polyunsaturated fatty acids?
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1 have one double bond
2 have two or more double bonds |
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How much cholesterol (mg/tbsp) does the following have? 1) lard 2) beef fat
3) butter fat |
1) 12 2) 14 3) 33
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Fatty acids are classified as...
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essential or nonessential
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What is the onlly essential fatty acid in humans?
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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. |
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Water is what % of total body weight?
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60-70%
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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 |
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Water is produced during digestion when food is oxidized. T/F
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T
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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 |
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What are the water-soluable vitamins?
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vitamins C and Bcomplex (8 vitamins)
Cannot be stored in body |
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Organic element essential to body as catalysts in biochem reactions are . . .
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Minerals
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Macrominerals are ...
Microminerals (trace) are ... Give an example |
Daily req 100 mg or more
Daily req < 100 mg Selenium |
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What enzyme in saliva breaks down starches into sugars?
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amylase
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Saliva is neutral/alkaline/acidic
Gastric juice is neutral/alkaline/acidic Secretions of small intestine are neutral/alkaline/acidic |
neutral
acidic alkaline |
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Ptyalin is ...
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enzyme in saliva (salivary amylase); acts on cooked starch to convert to maltose
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Proteins and fats are broken down physically but not chemically in mouth -- no enzymes in mouth to react. T/F
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T
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Dysphagia is ...
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difficulty swallowing
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pepsinogen is secreted by ____ in the stomach
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chief cells
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pepsinogen is actived by ...
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HCl to convert pepsinogen to pepsin, an enzyme splitting protein
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pyloric glands secrete...
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gastrin - hormone that triggers parietal cells to secrete HCl and IF (absorbs B12)
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Gastric lipase and amylase are produced to ...
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begin fat and starch digestion
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secreted by small intestine mucosa
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secretin (activates bicarbonate from pancreas) and CCK (cholecystokinin)- inhibits further gastrin secretion and initiates release of additional digestive enzymes from pancreas and gallbladder
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Pancreatic secretions contain 6 enzymes:
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amylase - digest starches
lipase - break down emulsified fats trypsin, elastase, chymotrypsin, carboxypeptidase to break down proteins |
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epitheral cells in small intestine villi secrete enzymes to facilitate digestion:
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sucrase, lactase, maltase, lipase, peptidase.
SI produces glucose, fructose, galactose, amino acids, dipeptides, fatty acids, glycerides, glyercol |
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How are nutrients absorbed in small intestine?
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passive diffusion, osmosis, active transport, pinocytosis
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Main source of water absorption is via intestine. T/F
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T
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Bacteria in colon synthesize vit K and some B complexes. T/F
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T
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Vitamin B12 is ...
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cynocobalamin
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Deficiency effects of B12:
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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
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folic acid is...
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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. |
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Deficiency effects of B8 (folic acid)
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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.
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What is B7 and its deficiency?
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BIOTIN-Deficiency does not typically cause symptoms in adults but may lead to impaired growth and neurological disorders in infants.
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What is B6 and its deficiency?
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Pyroxidine: Deficiency may lead to anemia, depression, dermatitis, high blood pressure (hypertension), water retention, and elevated levels of homocysteine.
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what is B5 and its defiency?
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PANTHOTHENIC ACID: deficiency can result in acne and Paresthesia, although it is uncommon
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What is B3 and its defiency?
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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
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What is B2 and its defiency?
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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
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What is B1 and its defiency?
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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.
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Acronym for B complexes:
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Turn (TRN) PP Bowels Free Chuck!
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Which group has a gradual decline in energy requirements per unit of body weight?
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school age children
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Which group needs fewer kcalories but an increased amt of protein in relation to body weight?
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toddlers (1-3 yrs)
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Which group's energy needs increase to meet greater metabolic demands of growth? Also increase in daily protein needs.
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adolescents
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which group may have decreased appetite?
Which group needs small frequent meals and 3 interspersed hi-nutrient snaks? |
toddlers
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Preschoolers (3-5) have diet req similar to toddlers. They consume more and nutrient density is more impt than quantity. T/F
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T
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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
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T
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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
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Bulimia Nervosa
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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. |
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Lactating women need 500 kcal/day above usual allowance. T/F
Protein req for lactation exceeds protein req for pregnancy. T/F |
T
T |
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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
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Vit and mineral req remain unchanged from middle adult to older adulthood. t/f
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t
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ovoloctovegetarian
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avoid meat, fish, poultry but eat eggs, milk, ves
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vegans
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eat only vegetables
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lacovegetarians
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drink milk, avoid eggs
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zen macrobiotic
fruitarian |
eat brown rice, other grains, herb teas
eat only fruits, nuts, honey, olive oil |
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Lactose intolerance from high to low:
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Asian-Pacific
African and African Americans Native American Mexican-American Middle Eastern whites |
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Hot foods:
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rice, grain, cereals, alcohol, beef, lamb, chili peppers, chocolate, cheese, temperate zone fruits, eggs, peas, goat's milk, cornhusks, oils, onions, pork, radishes, tamales
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cold foods:
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beans, citrus fruits, tropical fruits, dairy products, most veggies, honey, raisins, chicken, fish, goat
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some specific conditions req hot foods. Menstruation, cancer, pnemonia, earache, colds, paralysis, headache, rheumatism are cold illnesses requiring hot foods. t/f
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t
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Pregnancy, fever, infection, diarrhea, rashes, ulcers, liver problems, constipation, kidney problems, sore throats are hot conditions requirning cold foods. t/f
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t
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Assessment of nutritional status: 1) Anthropometry is ...
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a measurement system of the size and makeup of the body
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one pint or 500 ml of fluid equals ...
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one pound
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BMI
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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 |
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dfd
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dfd
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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
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parathesia is ...
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burning and tingling of hands and feet
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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 |
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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)
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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
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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 |
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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) |
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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 |
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milk, milk products, seafood, salads
mild diarrhea to fatal dysentery. Appears 7-36 hrs after ingestion; lasts 3-14 days |
Shigellosis
Shigela S. dysenteriae |
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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 |
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Pharmocological agents to stim appetite:
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cyproheptadine (periactin)
megestrol (megace) dronabinol (marinol) |
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Immune system: Antibodies
Malnutrition effect: decreased amount Vital nutrient(s) are:... |
proteini, a,c,b12,b6,folic acid, thiamin, biotin, riboflavin, niacin
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immune sys: GI tract
malnutrition effect: translocation of bacteria to systemic bodily areas vital nutrient needed:... |
arginine, glutamine, omega-3 fa
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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
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immune sys: Mucus
malnutrition effect: flat microvilli in GI tract, decreased antibody secretion |
b12, b6, c, biotin
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immune sys: skin
malnutrion effect: integrity compromised, density reduced, wound healing slowed. what are vital nutrients? |
protein, a, b12, c, niacin, copper, zinc
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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
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