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165 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Kidneys |
Filter waste collected in the blood |
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Nephron |
Functional unit of the kidney; urine is formed |
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Ureters |
tubular structures that connect kidneys to bladder |
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Bladder
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Hollow, dispensable muscle that stores urine
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Urethra
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Urine exits the bladder and passes out the urethral meatus
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Who is more susceptible to UTIs?
Why? |
Women's urethra is 4 to 6.5 cm long Mens urethra is about 20 cm long |
Women |
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Erythropoietin |
Stimulates bone marrow to produce RBCs which is essential to maintaining normal RBS volume |
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Renin
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Causes water retention--> increases blood volume
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Prostaglandin E2 & Prostacyclin
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Aid vasodilation
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Renin- Angiotensin Mechanism
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Renin functions as an enzyme to convert angotensinogen into angiotensin I
Angiotensin I -> Angiotensin II in lungsAngiotensin II causes vasoconstriction and stimulates the release of aldosterone |
Angiotensin I -> Angiotensin II in lungs Angiotensin II causes vasoconstriction and stimulates the release of aldosterone Aldosterone causes retention of water= increased blood volume |
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Bladder capacity |
600-1000ml of urine; adults normally void every 2-4 hours
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Stress incontinence |
Increase in intra-abdomial pressure |
When you squeeze you sneeze |
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Urge Incontinence |
Urine lost during abrupt desire to void
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Mixed Incontinence |
Symptoms of urge and stress |
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Overflow Incontinence |
Over distention and overflow of urine in the bladder
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Functional Incontinence |
Caused by factors outside of urinary tract; usually neurological
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Reflex Incontinence
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Emptying of bladder without sensation to go
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Total incontinence |
Continuous, unpredictable loss of urine
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Age does not cause urinary_____ |
Incontinence |
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Nocturia |
Waking up to urinate one or more times at night |
Nocturnal |
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Polyuria
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Excessive output of urine
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Poly= many |
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Oliguria |
Decreased urinary output despite a full bladder and adequate fluid intake
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O= full bladder |
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Anuria |
Kidneys produce no urine
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Diuresis
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Increased urine formation
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What does a diuretic do? |
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Fever can can urine to be.. |
In smaller amounts and highly concentrated
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Pre-renal condition |
Usually a neurological issue or decreased blood flow to kidneys
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Renal condition |
Kidney stone, trauma
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Post-renal Condition
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ureter, urethra, bladder
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Incontinence |
Involuntary leaking
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Urinary Retention
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Inability to empty bladder; bladder distention and pt. may void 2-3 times an hour with no relief
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UTI |
Can result from catheterization and is the most common HAI
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Caused by E. coli |
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Urinary Diversion |
Diversion of urine to external source
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ileal loop, continent pouch, nephrostomy |
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Nephrostomy tubes |
Placed to drain renal pelvis if ureter is obstructed
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S & S of UTI |
Pain or burning with urination (dysuria)
Fever, chills, nausea Irritated bladder (cystitis) Hematuria (blood in urine) Cloudy due to increase WBC |
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Pyelonephritis |
Infection in the urinary tract, flank pain; test by fist percussion on back where kidneys are |
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Urinalysis |
Physical, chemical and microscopic examination of urine
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Specific gravity Test
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Weight of urine compared to equal volume of water
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Culture |
Clean-voided urine specimen does not contain bacteria from urethral meatus
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Stimulate micturition reflex |
Maintain elimination habits
Maintain fluid intake Promote complete bladder-emptying ( double voiding) |
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Crede method |
Manual compression of bladder; should not b implemented until HCP has been consulted |
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Single lumen catheter |
Intermittent or straight catheter |
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Double-lumer catheter |
indwelling catheter One lumen for draining urine Second used to inflate ballon to keep catheter in place |
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Triple-lumen Catheter |
Continuous bladder irrigation Can instill medications into bladder One lumen drains One lumen inflates ballon One lumen deliver irrigation |
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Catheter drain bag should be hung.... |
On bedframe or chair so urine will drain down. If urine back flows that could cause infection |
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If no urine is draining you should? |
Check to make sure there are no kinks or occlusions of drainage tube or catheter
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The GI tract is composed of |
hollow mucous membrane organs
Absorb fluid and nutrients, prepare food for absorption and store feces |
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Duodenum |
Processes chyme form stomach and absorbs nutrients
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First section Duodenum & jejunum absorb most ofnutrients & electrolytes |
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Jejunum
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Absorbs carbohydrates and proteins |
Second section
Duodenum & jejunum absorb most ofnutrients & electrolytes |
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Ileum
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Absorbs water fats, vitamins iron and bile salts
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Colon |
Ascending, transverse, descending and sigmoid colons Absorb (water, NA & chloride), secrete and eliminate |
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Fast peristalsis |
less time for water to be absorbed= watery stool
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Slow peristalsis
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Water continues to be absorbed= constipation
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Mouth
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Begins digestion
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Esophagus
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Peristalsis moves food into stomach
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Stomach
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Stores food, mixes it and moves it into small intestines
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Small intestines |
Duodenum, jejunum and ileum |
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Large intestine |
Organ of bowel elimination |
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Anus |
Expels feces and flatus from rectum |
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Constipation |
Infrequent stool and/or hard,dry small stools that are difficult to eliminate |
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Diarrhea |
Increased number of stools that are liquid and unformed |
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Flatulence |
Accumulation of gas causing walls of intestine to strech |
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Impaction |
Hardened feces wedged in the rectum |
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Incontinence |
Inability to control feces and gas |
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Hemmorrhoids |
Dilated , engorged veins in lining of anus and rectum |
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Bowel Diversion |
Temporary or permanent artificial opening (stoma) in abdominal wall to pass feces |
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Location of ostomy determines quality and consistency of output |
The farther in the intestines the ostomy is the more formed stool Sigmoid colonostomy- formed Ileostomy-liquid |
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Normal stoma should be |
Bright red, moist, round and beefy |
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Cathartics and laxatives |
Cathartics and laxatives have short-term action of emptying the bowel Cathartics are stronger |
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Tap water enema |
Tap water escapes from bowel lumen into interstitial space. Tap water drawn to salt Do not repeat tap water enema because of water toxicity |
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Normal saline enema |
Safest solution to use because it exerts the same osmotic pressure. The volume of saline stimulates peristalsis |
Infants and children |
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Hypertonic solutions |
Osmotic pressure that pulls fluid out of interstitial spaces Patients unable to tolerate large volumes benefit from this because it is low volume |
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Soapsuds |
Crate effect of irritation to stimulate peristalsis Can cause electrolyte imbalance and damage to mucosa in pregnant women and older adults |
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Oil retention enema |
Lubricate rectum and colon |
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BMR- basic metabolic rate |
Energy needed to main LIFE- SUSTAINING ACTIVITIES |
Breathing, HR, circulation |
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REE- resting energy expenditure |
Energy an individual needs to consume to maintain all of its INTERNAL WORKING ACTIVITIES |
Digestion |
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Carbohydrates |
4 kcal/g Main source of fuel and energy |
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Protein |
4 kcal/g Necessary for nitrogen balance, tissue growth, maintenance and repair |
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Fats |
9 kcal/g |
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Water |
60-70% of our body weight |
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Vitamins |
Water soluble- B, C Fats soluble- A, D, E, K |
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Minerals |
Catalysts in biochemical rxns |
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Anabolism Catabolism |
Building by synthesis of nutrients Breakdown of substances in to simpler substances |
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U.S. department of Agriculture and USDOH published dietary guiltiness |
DRI- acceptable range based on age and gender EAR- amount of nutrients to maintain body funx for 50% of population based on age and gender RDA- average needs of 98% of pop. AI- Suggested intake when there are no RDA UL- highest level that poses no risk for people |
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MyPlate |
Created by USDA |
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Food desert |
Don't have a full service grocery store nearby |
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Kcal requirements by age |
0-1= 90-120kcal/kg/day 1-7= 75-90 kcal/kg/day 7-12= 60-75 kcal/kg/day 12-18= 40-60 " " 18-60= 38- 45 " " 60+ = 30-42 " " |
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Infants feeding |
Formula the first 6 months Should not have cows mil the first year |
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Pregnancy require an extra___ calories Lactation requires an extra ____ calories |
300 500 |
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Enteral Feeding |
Administered into stomach or intestines via a tube when patient can't meet nutritional needs by mouth 30-50 degrees at all times |
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Parenteral Nutrition |
Parenteral nutrition is glucose, AA, lipids electrolytes and vitamins through peripheral or central catheter PPN- day or two TPN- longer term in patients |
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Medical nutrition therapy (MNT) |
Specific nutritional therapy usagefor treating illness, injury, or a certain condition |
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Saturated fat Cholesterol Protein Trans fat |
Less than 7% Less than 200mg/dL 15-20% of diet Less than 1% |
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Diabetes |
Type 1: insulin and dietary restriction Type 2: exercise and diet initially |
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Cancer/ HIV patients |
Maximize kilocalories and nutrients and encourage small, frequent nutrient dense meal with fluid |
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Chemical Generic drug name Trade name |
Ex. N-acetyl-para-aminophenol Ex. Acetaminophen Ex. Tylenol |
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Classification of drugs |
Drugs that share similar characteristics and effect the body the same way |
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Pharmokinetics |
How medication: -Enter the body -Are absorbed -Reach their site of action -Alter the body -Are metabolized - Exit the body |
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Absorption Fastest to slowest |
IV, Mucous membranes, Oral,Topical |
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Protein Binding |
If bound it is not active, the unbound or “free” medication is itsactive form. |
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Metabolism |
Biotransformation - occurs under the influence of enzymes that detoxify, break down, and remove active chemicals. This occurs in liver and also lungs, kidneys, blood and intestines |
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Medications can be exerted by |
Kidneys, Liver, Bowels, Lungs and exocrine glands |
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Oral meds |
Sublingual, or buccal |
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Topical |
Direct, body cavity |
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Inhalation |
Nasal/ Oral passages of endotracheal or trach tubs |
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Parenteral |
ID,Sub-Q, IM, IV (epidural, intrathecal, intraosseous,intraperitoneal, intrapleural, intra-arterial) |
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Large- volume infusion (500-1000mL) |
Safest and easiest If infused to quickly patient can over and be at risk for fluid overload |
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Intravenous Bolus |
Smaller amount of medications Pushed all at once Very concentrated |
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Piggyback |
Asmall (25 to 250 mL) IV bag or bottle connected to a short tubing line thatconnects to the upper Y-port of a primary infusion line or to an intermittentvenous access |
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Therapeutic effect |
Expected response |
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Adverse effect |
Unintended effect |
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Idiosyncratic reaction |
Over/under rxn or opposite rxn |
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Side effect |
unavoidable secondary effect |
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Toxic effect |
Accumulation of meds in the blood stream |
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Allergic rxn |
Unpredictable response |
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Onset |
Time it takes to produce a response |
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Through |
Minimum blood serum concentration before next scheduled does |
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Plateau |
Which blood serum concentration is reached and maintained |
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Peak |
Meds reach highest effective concentration |
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Duration |
Time to produce greatest result |
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Bio Half-life |
Timefor serum medication concentration to be halved |
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6 rights |
1. Medication 2. Dose 3. Patient 4. Route 5. Time 6. Documentation |
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Polypharmacy |
When a patient takes two or more medications to treat the same illness,takes two or more medications from the same chemical class, uses two or moremedications with the same or similar actions to treat several disorderssimultaneously, or mixes nutritional supplements or herbal products withmedications. |
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Observe client every 1-2 hours and observe IV site for |
Patency, bleeding, infiltration, phlebitis |
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Friction vs. shear |
Friction is force that occurs in a direction opposite to movement Shear is force exerted against the skin while skin is stationary and bony structures move |
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Long bones |
contribute to height (femur, fib tib.) and length (fingers and toes)
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Short bones
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occur in clusters and permit movement when combined with ligaments and cartilage (patella, carpal bones)
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Flat bones
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provide structural contour(some skull bones and ribs)
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Irregular bones |
Vertebral column and some bones of the skull such as the mandible
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Joints connect _________ |
Bones
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Synostotic joints
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Bones jointed by bones; these don't move; bony tissue between bones provide strength and stability (skull)
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Cartilaginous joints |
Cartilage unites bony components; allows for bone growth while providing stability when growth ceases the joints ossify
(first sternocostal joint) |
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Fibrous joints |
Ligament or membrane unites 2 bony surfaces ; fibers of ligament are flexible and stretch to allow limited movement (tib and fib) |
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Synovial joints
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Freely moveable; connected by ligaments lined with a synovial membrane ( humeral radius and ulnar, hip joint, interphalangeal joints of fingers)
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Ligaments |
bind joints and connect bones and cartilage |
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Tendons |
Connect muscle to bone |
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Cartilage |
Supportive tissue; can be temporary or permanent |
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Temporary cartilage |
replaced by bone developed during infancy |
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Respiratory changes r/t immobility |
Atelectasis- collapse of alveoli Hypostatic pneumonia- inflammation of the lungs from stasis or pooling of secretions |
If you don't use it you lose it |
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Metabolic changes r/t immobility |
Decreased metabolic rate, alters metabolism Calcium reabsorption- release of calcium into circulation; hypercalcemia results; pathological fx can occur |
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GI changes r/t immobility |
constipation or pseudo-diarrhearesult from fecal impaction |
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Psychosocial effects r/t immobility |
Changes in sleep; sadness, depression, fear, anxiety; patient withdrawl |
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Cardiovascular effects r/t on immobility |
Orthostatic hypotension Increased cardiac workload- when immobilization increases cardiac output falls |
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Thrombus formation |
Virchow's Triad 1. damage to vessel wall 2. alterations in blood flow 3. Alterations in blood constituents |
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Musculoskeletal changes r/t immobility |
-Lean body mass loss -muscle atrophy -disuse osteoporosis -Joint contacture -footdrop |
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Urinary changes r/t immobility |
-Urinary stasis-person is flat gravity can't pull urine down -Renal calculi: calcium stones lodge in renal pelvis -Infection r/t poor perineal care |
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Skin changes r/t immobility |
Pressure Ulcers r/t prolonged ischemia |
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Isotonic exercise |
Muscle contractions & change in length (swimming, biking, walking) |
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Isometric exercise |
Tightening or tensing muscle w/o moving body parts (pushing against an end board in the bed) |
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QSEN |
developed to help nurses improve the quality and safety of healthcare |
Quality & Safety Education for Nurses |
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Motor Vehicle Accidents |
Child rear facing till 2 and the greatest risk for an MVA is 16-19 yo |
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Falls in adults 64 and older is... |
leading cause of unintentional death |
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Active Immunity |
Attenuated or dead organism |
A is for.... |
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Passive Immunity |
Antibodies produced by other people or animals is introduced into the blood stream |
Passing |
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People aged 3-63 can't receive flu mist. True or False |
False |
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Never Events |
Adverse events that should never occur in a health care setting |
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Medical errors are the ___ leading cause of death |
8th |
These include medication errors, infections, bed sores, failure to diagnose and treat in time |
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Surgical Never Event |
-performed on wrong body part -performed on wrong patient -wrong procedure -retention of foreign object after surgery -intraoperative or post op death in a normal pt |
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Product or device event |
-Pt death or disability associated with contaminated devices or drugs -Pt death or disability associated with the use or function of a device other than intended -IV air embolism |
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Patient Protection Event |
-Infant discharged to the wrong person -Death or disability of a missing pt for more than 4 hours -Pt suicide or attempt that resulted in disability |
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Care Management Event |
- Wrong med. that led to death or disability -D or D associated with blood products -Maternal D or D -D or D associated with hypoglycemia -Failure to treat hyperbilirubinemia in neonates -Stage 3 or 4 pressure ulcers - Pt. D or D r/t spinal manipulation |
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Environmental Event |
-Pt. D or D associated with electric shock -Wrong gas or line contaminated by toxic substance -Pt. D or D r/t burn - Pt. death associated with a fall -Pt. D or D associated with restraints |
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Criminal event |
- Impersonating a doctor, nurse, pharmacist etc. -Abduction of pt. -Sexual assault of patient on grounds of hospital -Death or significant injury resulting from a physical assault |
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Patient- inherent Accidents |
Self induced |
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Check restraints every ___ and take them off every_____ |
30 minutes.... 2 hours |
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RACE |
Rescue pts. Activate alarm Confine fire Extinguish |
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