Nur_110_Chapter_42

Front 1

whats the difference in a thrombus and emolus?

Back 1

-a thrombus is a blood clot attached to a vein wall.
-an embolus is an object, usually but not always a thrombus, which moves from one part of the blood stream to another, causing an obstruction which reduces or occludes blood flow

Front 2

which type of excercise is used by athletes for endurance training? (aerobic or anaerobic)

Back 2

anaerobic

Front 3

what's the effect on bone density when pressure is regularly placed on the bone?

Back 3

bone density is maintained by weight bearing. disuse osteoporosis occurs when no weight is placed on the bone for an extended period.

Front 4

what's the most common cause of postural changes in adults between the ages of 20-40?

Back 4

pregnancy

Front 5

In an infant's motor development, how does gross and fine motor development occur in relation to each other?

Back 5

gross motor development occurs before fine motor development

Front 6

in an infant's motor development, how does motor development occur in regards to the child's body regions?

Back 6

it procedes from the head down to the toes. the infant develops coordination in the neck first, then arms, then legs.

Front 7

excercise patterns for a persons life is generally determined during what age group?

Back 7

6-12yrs old

Front 8

postural habits of the adult are many times established during what age period?

Back 8

adolescence

Front 9

a newborn's extremities are usually in this position

Back 9

all the extremities are generally flexed, but can be passively moved through their range of motion

Front 10

what is atelectasis?

Back 10

partial or total collapse of a lobe or of an entire lung

Front 11

what is vital capacity?

Back 11

the maximum amount of air that can be exhaled after a maximum inhalation

Front 12

what causes the stiffness and pain in joints that have been immobilized?

Back 12

the collagen fibers become ankylosed, and calcium may be deposited in the joint

Front 13

when muscle fibers are not able to allowed to shorten or lengthen, there is a permanent shortening of the muscle. this is called a ________.

Back 13

contracture

Front 14

unused muscles atrophy. what does atrophy mean?

Back 14

to decrease in size

Front 15

a spastic muscle has too much of what?

Back 15

muscle tone

Front 16

a flaccid muscle has very little of what?

Back 16

muscle tone

Front 17

the talk test keeps most people's heart rate at this percentage of maximum heart rate.

Back 17

at about 60%

Front 18

a 7 on the borg scale of perceived exertion indicates what?

Back 18

very, very light exertion

Front 19

how do you determine your maximum heart rate?

Back 19

subtract your age in years from 220

Front 20

what percentage is your target heart rate (during exercise) of your maximum heart rate?

Back 20

60%-85%

Front 21

how do you flex your hip?

Back 21

move a leg forward and up as though you are going to kick something directly in front of your foot

Front 22

what determines a person's activity tolerance?

Back 22

both the type and amount of exercise able to be done without adverse effects

Front 23

when muscles increase in size, they are said to _______.

Back 23

hypertrophy

Front 24

in strenuous exercise, the intake of oxygen increases by how much?

Back 24

by as much as 20 times the normal intake

Front 25

normal resting tidal volume is how much?

Back 25

about 5 or 6L/min

Front 26

what does excercise do for diaphragmatic excursion?

Back 26

it improves diaphragmatic excursion

Front 27

how is serum triglycerides and cholesterol affected by exercise?

Back 27

the metabolic rate will increase which increases the use of triglycerides and fatty acids, resulting in lower serum triglyceride and cholesterol.

Front 28

by how much can the metabolic rate increase with exercise?

Back 28

it can increase by as much as 20 times the normal resting rate

Front 29

how does excercise influence blood glucose levels?

Back 29

it enhances the effectiveness of insulin, lowering blood sugar.

Front 30

in the borg scale of perceived exertion, what does a score of 15 indicate?

Back 30

the exercise is "hard"

Front 31

how can the Valsalva maneuver be dangerous to someone with cardiac disease?

Back 31

straining against a glottis can build up pressure on the large veins in the thorax and interfere with venous return. when the client exhales, pressure is released and a sudden surge of blood may cause tachycardia and cardiac arrhythmias

Front 32

how does innactivity cause dependent edema?

Back 32

a lack of skeletal muscle activity makes venous return more difficult. this increases venous pressure. the venous walls may become more dilated, causing insufficient valves and even worse venous return. fluid seeps out of veins, becoming interstitial fluid.

Front 33

what is vital capacity?

Back 33

the maximum amount of air that can be exhaled after a maximum inhalation

Front 34

what effect does immobility have on the basal metabolic rate?

Back 34

it decreases the basal metabolic rate

Front 35

what does "patent" mean?

Back 35

unblocked and open

Front 36

why is an immobile person more susceptible to renal calculi?

Back 36

because of the negative calcium balance due to decreased use of calcium to remodel bones, there occurs an abundance of calcium in the urine, making the urine more alkyline and leading to the development of calculi.

Front 37

what causes the negative nitrogen balance common in immobile people?

Back 37

immobility results in a preponderance of catabolism (breaking down proteins) over anabolism (synthesizing proteins). this rusults in more nitrogen being excreted than is ingested, and a depletion of protein stores.

Front 38

why is constipation a frequent problem for an immobilized person?

Back 38

lack of muscle movement contributes to decreased peristalsis, and the overall skeletal muscle weakness affects the abdominal and perineal muscles used in defecation.

Front 39

why is it more difficult to defecate on a bedpan than sitting upright?

Back 39

the backward-leaning posture does not promote effective use of the muscles used in defecation. some find it embarrasing also.

Front 40

what is lordosis?

Back 40

an exaggerated inward-curvature of the lumbar spine

Front 41

what effects are common due to poor posture?

Back 41

lower back pain and being easily fatigued

Front 42

what are the two phases of a normal gait?

Back 42

the stance phase and the swing phase

Front 43

when using the nursing diagnosis "impaired physical mobility", what should you specify?

Back 43

always specify the type of physical ability which is impaired (i.e. "impaired bed mobility" or "impaired walking")

Front 44

if a person can walk no more than 50 feet on level ground without stopping or experiencing other adverse effects, what levle are they?

Back 44

Activity Tolerance: Level 3

Front 45

if a client experiences dyspnea and fatigue at rest, what is her level of activity intolerance?

Back 45

level 4

Front 46

assessment of what region of the body is especially important for those clients using walkers and crutches?

Back 46

the muscle strength of the upper body

Front 47

what are the most useful measures for determining activity tolerance?

Back 47

heart rate, strength, rhythm; respiratory rate, depth, and rhythm; BP

Front 48

when should vital signs be taken when assessing activity tolerance?

Back 48

-before activity starts
-during the activity
-immediately after the activity stops
-3 minutes after the activity stops and client has rested

Front 49

what findings would indicate that the activity was safe, when assessing activity tolerance?

Back 49

if heart rate returns to baseline within 5 minutes after the activity ceases and if the client tolerated it well

Front 50

immobility causes pooling of secretions in dependent parts of the lungs. how does this affect the client?

Back 50

secretions around alveoli interfere with O2 and CO2 diffusion. poor oxygenation and retension of CO2 can lead to respiratory acidosis. these secretions also contribute to possible atelectasis and hypostatic pneumonia

Front 51

the organism most commonly found to cause urinary tract infections if normally found in the colon. what is it?

Back 51

escherichia coli

Front 52

what causes urinary retention in the immobile client?

Back 52

decreased muscle tone of the urinary bladder and the inability to relax the perineal muscles while lying in bed may lead to urinary retention

Front 53

repeatedly postponing the urge for defecation might lead to what effects?

Back 53

repeated postponement eventually suppresses the urge and weakens the defecation reflex

Front 54

a normal walking pace is how many steps per minute?

Back 54

70-100 steps per minute, however the pace of an older person might slow to 40 steps per minute

Front 55

a client in shock or with hypotension should be put into what position?

Back 55

lying flat with legs elevated 45 degrees

Front 56

a client with a head injury should be placed in what position?

Back 56

reverse trendelenburg to prevent increased intracranial pressure

Front 57

why does anorexia occur in an immobile person?

Back 57

because of the decreased metabolic rate and increased catabolism that accompany immobility

Front 58

some factors which put clients at a higher risk for complications due to immobility

Back 58

-poor nutrition
-decreased sensitivity to pain, temp., or pressure
-cardiovascular, pulmonary, or neuromuscular problems
-altered state of consciousness

Front 59

which signs are indications that an activity is too strenuous or prolonged and should be stopped immediately?

Back 59

-sudden facial pallor
-feelings of dizziness or weakness
-change in level of consciousness
-heart rate or resp rate that significantly exceeds baseline
-change in heart rate or resp rate to irregular
-weakening of pulse
-dyspnea, SOB, or chest pain
-diastolic BP change of 10mm Hg or more

Front 60

when problems with mobility affect other areas of functioning, the problem becomes the etiology of the diagnosis. some examples of this:

Back 60

-fear (of falling)
-ineffective coping
-low self-esteem
-powerlessness
-risk for injury (falls)
-self-care deficit

Front 61

people with sensory or motor deficits on one side of the body, usually prefer to lie on which side?

Back 61

they usually prefer to lie on the unaffected side

Front 62

what are some things that you should assess before attempting to transfer a client from the bed to a chair?

Back 62

-client's body size
-ability to follow instructions
-activity tolerance
-muscle strength
-joint mobility
-prescence of paralysis
-level of comfort
-presence of orthostatic hypotension
-the technique with which the family is familiar
-the space which will be needed to maneuver
-the # of assistants needed
-skill and strength of nurse

Front 63

what should the goal for clients be who require passive ROM exercises after a disability?

Back 63

a progression to active-assistive ROM, and later, to active ROM excercises

Front 64

these crutch gaits are used by clients with paralysis of the legs and hips

Back 64

the swing gaits

Front 65

which of the two crutch "swing" gaits are easier to do?

Back 65

the swing-to gait

Front 66

this is the most elementary and safest of the crutch gaits

Back 66

the four-point alternate gait

Front 67

the proper standing position with crutches is called ________.

Back 67

the tripod (triangle) position

Front 68

describe the tripod position

Back 68

the crutches are placed about 6" in front of the feet and about 6" laterally from the feet

Front 69

some safety measures to consider when using crutches are:

Back 69

-keep crutch tips dry and clean
-inspect crutch tips regularly and replace them if worn
-maintain an erect posture as much as possible
-bear the weight on your hands instead of on your axillae
-follow the pattern of exercise developed for you to strengthen your arm muscles before beginning crutch walking
-take steps of a comfortable distance
-wear a shoe with a low heel that grips the floor and adjust shoelaces to appropriate length

-

Front 70

what is crutch palsy?

Back 70

a weakness of the muscles of the forearm, wrist, and hand

Front 71

the shoulder rest on crutches should be adjusted to what height in relation to the client?

Back 71

you should be able to fit 3 finger widths between the crutch and the axilla, that is 2.5-5 cm

Front 72

in what position should the client be standing with crutches to determine proper height of the shoulder rests and the hand grips?

Back 72

the client stands upright and grasps the hand grips with arms bent at 30 degrees and with the crutches about 4" in front of feet and 6" lateral to feet

Front 73

when doing passive ROM with people with flaccid paralysis, what is particularly important to avoid?

Back 73

avoid moving or forcing a body part beyond the existing range of motion because joints can be dislocated without their awareness

Front 74

if muscle spasticity occurs while providing passive ROM exercises, what should you do?

Back 74

stop the movement temporarily, but continue to apply slow, gently pressure on the part until the muscle relaxes; then proceed with motion

Front 75

if a contracture is present, how should you provide passive ROM exercises?

Back 75

apply slow firm pressure, without causing pain

Front 76

why should the use of seat belts on wheelchairs be used with caution?

Back 76

they are a form of restraint and must be used in accordance with policies and procedures that apply to rules of restraints

Front 77

how should you move a wheelchair into an elevator?

Back 77

back the wheelchair into the elevator, rear large wheels first

Front 78

when transfering a client into a wheelchair, what safety precautions should be used?

Back 78

-always lock brakes when transfering
-raise the footplates before transfer
-lower the footplates and place client's feet on them after tranfer
-ensure the client is positioned well back in the seat of the wheelchair

Front 79

when using a wheelchair on an incline, what precaution should be taken?

Back 79

place your body between the wheelchair and the bottom of the incline

Front 80

how often should the skin surfaces of infants and children who are confined to bed be checked?

Back 80

at least 3 times in each 24 hour period

Front 81

habitually poor standing and sitting posture might produce an exaggerated curvature of the spine. this is known as______.

Back 81

lordosis

Front 82

how is someone's center of gravity affected when they lift an object?

Back 82

it is shifted in the direction of the object lifted

Front 83

you should maintain a distance of at least ______ between the feet in all positions while lifting.

Back 83

12"

Front 84

vital capacity may be reduced in an inactive person. why is that?

Back 84

-while lying down, the body presses against the rigid bed which curtails chest movement.
-the abdominal organs press against the diaphram, further restricting lung movement.
-muscle atrophy might also contribute to it.
-without periodic stretching, the intercostal joints may become fixed in an expiratory phase of respiration

Front 85

normal resting ventilation is how much?

Back 85

5-6L/min

Front 86

what type of joint is the neck?

Back 86

a pivot joint

Front 87

where are your ball-and-socket joints found?

Back 87

in the hips and shoulders

Front 88

what type of joint is the thumb?

Back 88

a saddle joint

Front 89

what type of joint is the wrist?

Back 89

a condyloid joint

Front 90

where are your gliding joints found?

Back 90

in the trunk, the foot, and the intertarsal joints