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236 Cards in this Set

  • Front
  • Back
What are the fat soluble vitamins?
A
D
E
K
What are the water soluble vitamins?
B complex (Thiamin, Riboflavin, Niacin, B6, Folate, B12)
C
What is the function of vitamin C?
collagen formation
antioxidant
enhances iron absorption
What are the s/s of vitamin C deficiency?
scurvy
hemorrhaging
delayed wound healing
What are the s/s of vitamin C excess?
kidney stones
N/V
What are the food sources of thiamin?
pork
liver
whole/enriched grains
What is the function of thiamin?
it is a coenzyme in key energy reactions
What are the s/s of thiamin deficiency?
beriberi
fatigue
mental confusion
What are the food sources of riboflavin?
dairy products
organ meats
What is the function of riboflavin?
nutrient metabolism
What are the s/s of riboflavin deficiency?
inflammation
poor healing
What are the food sources of niacin?
grains
lean meat
What is the function of niacin?
nutrient metabolism
What are the s/s of niacin deficiency?
pellagra
dermatitis
What are the s/s of niacin excess?
flushing
itching
N/V
vitamin found in fruits and dark green vegetables

functions as a coenzyme in metabolism

s/s of deficiency: anemia, CNS problems, confusion

s/s of excess: difficulty walking
B6 (pyridoxine)
vitamin found in green leafy vegetables and liver

functions in RNA and DNA synthesis; and the formation and maturation of RBCs

s/s of deficiency: macrocytic anemia (fatigue, weaknes, pallor)
folate
vitamin found in only animal and fortified foods - organ meats, meat, seafood

functions as a coenzyme in protein metabolism and the formation of the heme portion of hemoglobin

s/s of deficiency: pernicious anemia due to lack of intrinsic factor or alcoholism
B12 (cobalamin)
vitamin found in fruits and dark green vegetables

functions as a coenzyme in metabolism

s/s of deficiency: anemia, CNS problems, confusion

s/s of excess: difficulty walking
B6 (pyridoxine)
vitamin found in green leafy vegetables and liver

functions in RNA and DNA synthesis; and the formation and maturation of RBCs

s/s of deficiency: macrocytic anemia (fatigue, weaknes, pallor)
folate
vitamin found in only animal and fortified foods - organ meats, meat, seafood

functions as a coenzyme in protein metabolism and the formation of the heme portion of hemoglobin

s/s of deficiency: pernicious anemia due to lack of intrinsic factor or alcoholism
B12 (cobalamin)
vitamin found in liver, carrots, and egg yolk

functions in visual acuity and healthy skin

s/s of deficiency: night blindness, rough skin

s/s of excess: anorexia, loss of hair, dry skin
vitamin A (retinol)
vitamin found in fortified milk and sunlight

functions in calcium and phosphorus metablism, stimulates calcium absorption

s/s of deficiency: retarded bone growth

s/s of excess: excessive calcification of bones, renal calculi
vitamin D
vitamin found in liver, carrots, and egg yolk

functions in visual acuity and healthy skin

s/s of deficiency: night blindness, rough skin

s/s of excess: anorexia, loss of hair, dry skin
vitamin A (retinol)
vitamin found in fortified milk and sunlight

functions in calcium and phosphorus metablism, stimulates calcium absorption

s/s of deficiency: retarded bone growth

s/s of excess: excessive calcification of bones, renal calculi
vitamin D
vitamin found in liver, carrots, and egg yolk

functions in visual acuity and healthy skin

s/s of deficiency: night blindness, rough skin

s/s of excess: anorexia, loss of hair, dry skin
vitamin A (retinol)
vitamin found in fortified milk and sunlight

functions in calcium and phosphorus metablism, stimulates calcium absorption

s/s of deficiency: retarded bone growth

s/s of excess: excessive calcification of bones, renal calculi
vitamin D
vitamin found in vegetable oils and whole grain products

functions as an antioxidant, protects vitamin A, heme synthesis

s/s of deficiency: anemia

s/s of excess: fatigue, diarrhea
vitamin E
vitamin found in dark, green leafy vegetables

synthesized in intestines from gut bacteria

functions in blood clotting

s/s of deficiency: delayed blood clotting

s/s of excess: hemolytic anemia and liver damage
vitamin K
mineral found in dairy products and green

functions in bone/tooth formation and nerve transmission

s/s of deficiency: tetany, osteoporosis

s/s of excess: renal calculi
calcium
mineral found in soft drinks, processed foods

function in bone/tooth formation and acid-base balance

s/s of deficiency: muscle weakness

s/s of excess: symptoms of hypocalcemic tetany
phosphorus
mineral found in green leafy vegetables, nuts, beans

function in bone/tooth formation, protein synthesis

s/s of deficiency: poor heart function, torsade de pointe

s/s of excess: CNS depression
magnesium
mineral found in salt and IV saline

major ion of extracellular fluid

s/s of deficiency: clammy skin, confusion, leg cramps

s/s of excess: edema, thirst, pattern of weight gain, high BP
sodium
mineral found in whole grains, fruits

major ion of intracellular fluid

s/s of deficiency: muscle cramps, weaknes, u-wave on EKG

s/s of excess: irritability, tall/tented T's on EKG
potassium
micromineral found in lean and organ meats

functions in oxygen transport by way of hemoglobin

s/s of deficiency: microcytic anemia, pallor fatigue

s/s of excess: GI symptoms, possible shock
iron
micromineral found in seafood and food additives

functions as a component of thyroid hormones

s/s of deficiency: goiter

s/s of exces: acne-like lesions
iodine
Polysaccharides which cannot be digested and provide no energy
fiber
component of bile salts that aids in digestion; component of cell membranes, required for hormone production, produced in liver of all mammals in response to genetic tendency, saturated and total fat intake
cholesterol
What vegetables are high in fat?
avocado
coconut
olives
What is the primary role of nurses r/t nutrition?
keep patients from starving
A serving/exchange of carbohydrates in a diabetic diet equals _______ grams or ____ calories.
15 grams
60 calories
lipoprotein that transports triglycerides drom the liver to the tissues
very-low-density lipoprotein (VLDL)
plasma protein with triglyceride components that carries cholesterol to cells
low-density lipoprotein (LDL)
plasma protein that carries fat in bloodstream to tissue or to liver to be excreted
high-density lipoprotein (HDL)
What is the diet for gastric bypass?
small meals: low fat, high protein
NO carbonated beverages
type of diet that minimizes elimination, restricts high fiber food, fried food, pepper, alcohol, and heavy seasonings
low-residue diet
type of diet for malabsorption, chronic pancreatitis, gallbladder disease, or patients with CVD, CHF
fat-controlled diet
type of diet for patients with renal disease or liver disease
protein-controlled diet
What is restricted in patients with celiac disease?
gluten (wheat, barley)
type of diet used for patients with gout, tumor lysis syndrome, or multiple myeloma

use dairy products; restrict organ meats, anchovies, alcohol, and seafood
purine-controlled diet
type of diet used for patients with renal failure (treats hypertension, fluid restrictions, CVD)
sodium-controlled diet
type of diet used for patients with diabetes
carbohydrate-controlled diet
type of diet that promotes normal bowel function (complex carbs, low fat, whole grains, vegetables, fruits)
high-fiber diet
type of diet used for patients with potassium losses (ex. ppl on diuretics)

contains orange juice, apricots, cantaloupes, and bananas
high-potassium diet
type of diet used for patients with osteoporosis or kidney failure
high-calcium diet
type of diet used specifically by some athletes

dietician or MD needs to prescribe this
high-protein diet
type of diet used by patients with impaired immune function

restricts fresh fruits, raw veggies, nuts, seeds, dried fruits, black pepper, any foods that carry pseudomonas

heat treat all foods to destroy bacteria
neutropenic diet
What nutrition care should be used for patient with cancer?
small frequent meals (nutrient DENSE --> high calorie and high protein)

add extra nutrient dense foods such as honey, powdered skim milk, peanut butter, and cheese

limit liquids with meals - they contribute to nausea
What are some nutrition interventions nurses can do with HIV/AIDs patients?
Monitor weight and protein status (albumin, transferrin, total lymphocyte count)

Good handwashing, food safety, low-fat diets, and small frequent nutrient dense meals

possible neutropenic diet
What is the BRAT diet?
bananas, rice, applesauce, and toast

used for clients with GI upset (esp. used after flu or other virus)
used for provide essential fatty acids

exist in different concentrations (10-30%)

considered isotonic

clients allergic to ________ should not get this solution
IV lipids

eggs
type of diet that consists of broth, bouillon, coffee, tea, carbonated beverages, clear fruit juice, gelatin, and popsicles
clear liquid diet
type of diet that consists of clear liquids as well as smooth-textured dairy products, custards, refined cooked cereals, vegetable juice, pureed vegetables and all fruit juices
full liquid diet
type of diet that consists of all liquids plus scrambled eggs, pureed meats, vegetables, fruits, mashed potatoes, and gravy
pureed diet
type of diet that consists of all liquids, pureed foods, and also ground/finely diced meats, flaked fish, cottage cheese, rice, potatoes, pancakes, light breads, cooked veggies, cooked/canned fruits, bananas, soup, and peanut butter
mechanical soft diet
type of diet that includes liquids, pureed, soft foods, as well as low-fiber, easily digested foods (pasta, casseroles, moist meats, desserts, cakes, and cookies without nuts/coconut)
soft/low residue
A low cholesterol diet limits cholesterol to:
300 mg/day
If the patient's ABGs and O2 sat are normal, the problem is NOT with _________________.
gas exchange
the sticky pads/tabs that attach to skin and pick up electrical energy for transmission on an EKG
electrodes
the wires that connect electrode to the EKG equipment

also the standardized patterns of electrode placement; they provide an electrical view of the heart
leads

each lead has a negative and positive pole
On EKG paper, the smallest vertical squares represent:
1 mm voltage (measure height and depth of a wave)
On EKG paper, the smallest horizontal squares represent:
0.04 seconds
a clinical syndrome resulting in decreased blood flow to body tissues causing cellular dysfunction and eventual organ failure
shock
acute and possibly life threatening allergic reaction that results in increased capillary permeability and dilation of arterioles due to severe Type I hypersensitivity response

can cause SOB, bronchospasm, laryngeal edema, hypotension, and rash
anaphylaxis
the effective delivery of oxygen-rich blood to the tissues

OR

treating with oxygen
oxygenation
term that refers to the cardiovascular element of oxygenation
tissue perfusion
the molecular exchange of gases (oxygen and carbon dioxide) in the respiratory system
respiration (breathing independently)
the process of moving air into and out of the lungs; the act of breathing which include inhalation and exhalation
ventilation (assisted breathing)
What are the earliest signs of hypoxia?

What are later signs of hypoxia?
anxiety
restlessness

diminished mental acuity or LOC
The nurse should change the sensor site for pulse oximetry how often?
q4h
If peripheral tissue perfusion is poor, what type of pulse oximetry probe should be used?
nasal or earlobe
What is the normal PaO2?
80-100 mmHg
What is the normal PaCO2?
35-45 mm Hg
What is the normal HC03?
22-26
What is the normal H+/H2CO3?
1:20
What is the normal base excess?
-2 to +2
What is the normal O2 saturation?
90-100%
If pH is above 7.40, you should next check:
to see if HCO3 is above 26 (metabolic alkalosis)
If pH is below 7.40, you should next check:
to see if pCO2 is above 45 (respiratory acidosis)
occurs when exhalation of CO2 is inhibited (carbonic acid excess)
respiratory acidosis
occur with excessive exhalation of CO2 (hyperventilation)
respiratory alkalosis
occurs with heavy acid losses or increased bicarbonate levels
metabolic alkalosis
occurs with excessive acid production or increased loss of bicarbonate
metabolic acidosis
tests that assess a client's range of respiratory volumes and respiratory capacity

provide a yardstick to measure the amt of disease or disability in the course of a pulmonary disease
pulmonary function tests
volume of gas moved in and out of the lungs during eupnea per breath
tidal volume
volume of gas in the lung at the end of maximum inspiration (5000-6000 cc)
total lung capacity
maximum amount of air that can be expired at normal breathing rates after a maximum inspiratory effort (4500-4800 cc)
vital capacity
the volume of air that can be forcefully exhaled in one second after full inspiration

(2.5-3.5 L/first sec)
forced expiratory volume (FEV-1)
What correlates closely to the measurement of peak flow (max flow rate during exhalation)?
forced expiratory volume (FEV-1)
What parts of the lung should air movement be present in?
ALL parts!
the volume of air that can be forcefully exhaled in one second after full inspiration

(2.5-3.5 L/first sec)
forced expiratory volume (FEV-1)
What correlates closely to the measurement of peak flow (max flow rate during exhalation)?
forced expiratory volume (FEV-1)
What parts of the lung should air movement be present in?
ALL parts!
What patients are oral airways used in?
unconcious or semi-conscious clients or clients with noisy breathing, gurgling, or tongue obstruction
Insert an oral airway with the curved side facing:
up!

(flip it over once inside)
Oropharyngeal suctioning is a _______ procedure.

Endotracheal or tracheostomy suctioning is a ____________ procedure.
clean

sterile
Back off 1-2 cm on suction catheter insertion when:
you reach resistance at the carina
What should you do before airway suctioning?
maximize ventilation
What are the s/s of oxygen toxicity?
red skin
red mucous membranes
headache
Why should the nurse check the nasal cannula every 6 hours?
there is an increased risk for skin breakdown
What are the s/s of carbon monoxide poisoning?
throbbing headache = first!

N/V, cherry red color, death
100% oxygen delivered under pressure
hyperbaric oxygen
What is the primary purpose of incentive spirometry?
prevent atelectasis in the immobile and/or post-op client

atelectasis precedes post-op pneumonia!
acute inflammation/infection of the lung parenchyma

s/s: sputum, fever, dry cough, painful breathing
pneumonia
complete or partial collapse of the lung due to air in the pleural space

can be closed or open
pneumothorax
What is the first sign of pneumothorax?
difficult, painful breathing that is abrupt in onset
pleural pus pocket due to infection
empyema
frank bleeding in the pleural space causing lung collapse
hemothorax
What should the nurse do if a chest tube is pulled out?
FIRST, apply pressure to the site.

Have someone call MD.
What are some pulmonary medications that relieve symptoms/rescue?
beta 2 agonists
methlyxanthines
oral/IV corticosteroids
ipratropium
What are some pulmonary medications that maintain (prevent/control)?
Cromolyn and Nedocromil
Leukotriene modifiers
inhaled steroids
inflammation of the mucosal lining of the tracheobronchial tree

caused by repeated infections and/or long-term inhaled irritants
COPD: bronchitis
What are 3 ways to use an inhaler?
open mouth
spacer
in the mouth
What position should a patient be in to use a peak flow meter?
standing or sitting up tall
disease characterized by alveolar dilation and eventual collapse
emphysema
a bacterial infectious disease that usually involves the lungs but can also infect the kidneys, bones, lymph nodes, and meninges
pulmonary tuberculosis
What is a major problem with patients who have tuberculosis?
the medicines have many side effects, so most patients are noncompliant!
What are the s/s of tuberculosis?
asymptomatic at first

later:
fatigue
malaise
weight loss
fever
night sweats
bloody cough
chest pain
Never run a nasal cannula above _____ LPM.
6
Never run a simple oxygen mask above _____ LPM.
12
Never run a pediatric oxygen mask above ____ LPM.
4
A non-rebreathing oxygen mask should be run between ____ and _____ LPM.

It is for what percentages?
10
15

80-99%
A partial rebreather mask should be run between ____ and _____ LPM.

It is for what percentages?
10
12

60-80%
What is the major muscle used in breathing?
the diaphragm
COPD causes the diaphragm to become ____________.
weak and flattened
With diaphragmatic breathing, the abdomen should be pushed ____ during inhalation and _____ during exhalation.
out

in
How does pursed lip breathing help patients with COPD?
it creates a back pressure in the lungs that helps the airway to stay open
How long does the PR interval normally last?
0.12 - 0.20 sec
How long does the QRS complex normally last?
< 0.12 sec
How long does the QT interval normally last?
0.36 - 0.40 sec
What causes artifact to show up on an EKG?
some type of problems with the electrodes (loose connections, broken leads)
What are the 4 lethal dysrhythmias?
3rd degree block
ventricular tachycardia
ventricular fibrillation
asystole
part of the sensory experience which includes receiving the stimulus and converting it into a nerve impulse
reception
integration and interpretation of a stimulus based on a person's experiences
perception
A person will usually react to stimuli that:
are the most meaningful at the time
a change in the ability to receive or perceive sensations
sensory alteration
impaired function in one or more senses (visual, auditory, gustatory, olfactory, tactile, or kinesthetic)
sensory deficit
a decrease or lack of meaningful stimuli, such as monotonous or meaningless stimuli
sensory deprivation
What are some examples of sensory deprivation?
isolation
institutionalized patients
patients confined to a small living space
impaired vision or hearing
patients with bandages/casts
patients with bipolar or depression
spinal cord injury
confusion or disorientation
patients on drugs
excessive stimuli over which an individual feels little control; the brain is unable to meaningfully respond to or ignore stimuli
sensory overload
What are some examples of sensory overload?
patients in pain
patients with intrusive monitoring or treatment/equipment
patients in critical care settings
ring of light around the visual field
halo
perceived flashes of light
photopsia
spots perceived in the visual field
floaters
double vision
diplopia
excess secretion of tears
epiphora
decreased accomodation with aging
presbyopia
opacity that develops in the lens of the eye or its envelope
cataract
loss of peripheral vision, then progressive

caused by increased intraocular pressure
glaucoma
malfunction of the light sensing cells in the macula
macular degeneration
half-blindness

bitemporal sight in lost in the outer half of each eye
hemianopsia
common form of sensorineural hearing loss in older adults
presbycusis
What are some causes of increased intracranial pressure?
tumors
intracranial hemorrhage
blocked CSF reabsorption
inflammation (meningitis)
concussion/contusion
What are some early indicators of increased ICP?

What are some late indicators of increased ICP?
change in LOC --> drowsiness
headache

change in LOC --> stupor and coma
projectile vomiting
For a patient with IICP, why should you limit suctioning to 10-15 seconds?
it will increase pressure even more
How should a patient with IICP be positioned?
HOB 30-45 degrees (promotes venous drainage)
What happens if IICP goes untreated?
the brain will herniate, causing irreversible damage and possible death
alteration in respiration, phonation, resonance, articulation, or movements of the jaw/tongue
dysarthria
loss of ability to recognize objects, people, sounds, shapes, or smells while the specific sense is NOT defective
agnosia
continuous repetition of a word or phrase
perseveration
type of aphasia in which patients can understand but have difficulty speaking
expressive
type of aphasia in which patients have difficulty comprehending what you are trying to communicate
receptive
complete loss of sense of smell
anosmia
overly sensitive to tactile stimuli
hyperesthesia
a lack of cultural assistance, supportive or facilitative acts
cultural deprivation
characterized by personality disintegration and loss of contact with reality
ICU psychosis
What is the normal albumin level?
3.5-5 g/dL
What is the normal total lymphocyte count?
1800-3000

can indicate poor nutrition
What is the normal total iron-binding capacity?
250-460 ug/dl
What is the normal prealbumin level?
15-36 mg/dl
What lab value is useful in telling us whether a patient has acute starvation (ex. in the hospital?
prealbumin
How much fiber should you eat per day?
20-35 g
type of fiber that slow gastric empyting and lowers serum cholesterol

adds weight to stool but NO bulk to aid elimination
water soluble
type of fiber that increases fecal bulk in the large intestine and aids elimination
water insoluble
A patient should be on a clear liquid diet for NO LONGER THAN ____ days.
3
What is the RDA for Vitamin C?
60 mg

60-100 mg for smokers
What is the RDA for folate?
180-200 micrograms
What is the RDA for Vitamin A?
800-1000 mg
What is the RDA for Vitamin K?
65-80 micrograms
What is the RDA for calcium?
at least 800 mg
What is the normal serum calcium level?
9.5 - 10.5 mg/dL
What is the normal serum phosphorus level?
3 - 4.5 mg/L
What is the normal magnesium level?
1.3 - 2.1 mEq/L
What is the RDA for sodium?
500 mg
What is the normal serum sodium level?
136 - 145 mEq/L
What is the RDA for potassium?
1600-2000 mg
What is the normal serum potassium level?
3.5 - 5 mEq/L
What is the RDA for iron?
10-15 mg
What is the normal range for LDL cholesterol?
60-100 mg/dl
What is the normal range for HDL cholesterol?
above 35 mg/dl
How old should an infant be before food (other than formula/breast milk) is introduced to him/her?
4 months

foods should be introduced one at a time
What foods should not be given before age 1?
cows milk
corn syrup
honey

*risk of botulism
any loss or abnormality of psychological, physical, or anatomical structure or function; change at the organic level
impairment
an impairment severe enough to cause a change in functioning
disability
What type of bones contribute to height?
long
What type of bones occur in cluster and permit more fine motor movement in hands/feet?
short
What type of bones are found in the vertebral column, skull, and mandible for specialized movements?
irregular
What type of bones provide structure, contour, and protection?
flat
bones jointed to bones
synstotic
joint with little movement; uses cartilage to unite body surfaces
cartilaginous
2 bony surfaces joined by a ligament or membrane
fibrous joint
freely movable ball and socket, pivot, or hinge joint
synovial (true) joint
bind joints together and connect bones and cartilage
ligaments
connect muscle to bone
tendons
injury to tendons and ligaments
sprain
injury to muscle
strain
When does the benefit of bedrest outweigh the risk of immobility?
*after significant trauma to allow healing
*in unstable CV diseases to reduce oxygen demand
*in patients with an unstable thrombus to reduce risk of emboli
How does immobility affect the cardiovascular system?
orthostatic hypotension
increased cardiac workload
thrombus formation
How does immobility affect the respiratory system?
decreased respiratory movement
stasis of secretions in the lungs
O2/CO2 exchange
How does immobility affect the musculoskeletal system?
osteoporosis
contractures
pressure ulcers
How does immobility affect the GI system?
inhibits ingestion
constipation
affects diet
How does immobility affect the urinary system?
urinary stasis
increased formation of renal calculi
increased risk of urinary infection
localized area of tissue necrosis that develops when soft tissue is compressed between a bony prominence and an external surface for a prolonged period of time
pressure ulcer
pressure ulcer where the skin is intact with observable changes in color, temp, consistency, and sensation

a defined area of persistent redness, or red/blue/purple hues in dark pigment skin
stage I
pressure ulcer where the skin is broken and there is partial thickness skin loss involving damage to the epidermis and/or dermis

superficial, and clinically appears like an abrasion, blister, or shallow crater
stage II
pressure ulcer where the skin in not intact with full thickness skin loss and damage/necrosis of subcutaneous tissue that may extend down to, but not through the underlying fascia

deep crater with/without undermining of adjacent tissue
stage III
pressure ulcer that presents with necrosis, full thickness skin loss and extensive destruction to the underlying fascia through to the muscle, support structures, and/or bone

there may be undermining and sinus tracts/tunneling present

osteomyelitis is a risk
stage IV
healing of a surgical wound where the skin edges are approximated
primary intention
healing of a wound with loss of tissue: burn, pressure ulcer, or severe laceration
secondary intention
How often do you change a dressing on a wound that is using a wound vac?
q48h
Do you hold a cane on your weaker side or your stronger side?
stronger side

*but it moves with the weaker extremity
How far should a cane or crutches be in front of a patient's feet?
6-10 inches
How should the elbows be when using crutches?
15-30 degrees of flexion
How far below the axilla should the axillary pad of the crutches be?
3-4 fingerbreadths
If a patient is paralyzed from C8 up, he is:
quadriplegic
If a patient is paralyzed from T1 down, he is:
paraplegic