• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/212

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

212 Cards in this Set

  • Front
  • Back
Defintion of Nursing
Protection, promotion and optimization of health
Prevention of illness and injury
Alleviation of suffering
Advocate for individuals, families, communities and populations
Aims of Nursing/Scope
To promote health, prevent illness, restore health and facilitate coping with disability or death
4 Skills to meeting Aims of Nursing
Cignitive, Technical, Interpersonal, Eithical/Legal
Nursing 20th and 21st Century
Explosion in healthcare, nursing informatics
Longer lifespan of the population, increased incidence of chronic illnesses
Florence Nightingale
Founder of Modern Nursing
First nurse theorist/researcher
Clean air,water, environment
Lillian Wald
NY Visiting Nursing Services
Pioneer in Public Health Nursing
Mary Elizabeth Mahoney
1st Colored trained nurse
Sought equality and voting rights for women of color
Nurse Training Act
1941
All nursing education to take place at institutions of higher learning
Mildred Montag
Associate Degree Nursing
Dissertation 1948
ANA Nursing Scope and Standard

Nurse Practice Acts
provides guidelines and standards of professional nursing practice and accountability

Laws established in each state regulating nursing practice
Nursing Thoery
attempts to explain, predict and/or describe an issue or phenomenon
Clarifies belief, values and goals
Provides EBP
Concept
Abstract impressions organized into symbols of reality, can describe objects, ideas or events
Metaparadigm of Nursing
Four major concepts- person, environment, health, nursing
Conceptual framework/Model
Concrete model of a theory or philosophy
ie: Maslows Hierarchy of needs
Benners Clinical Ladders
Novice, Advanced Beginner, Competent, Proficient, Expert
WHO
World Health Organization
defines health as a state of complete physical, mental and social well-being
Self Concept
an individuals perception of self and is what helps make each individual unique. Affects the ability to function and greatly influences health status
Components of Self-Concept
Body Image, Self-Ideal, Self-esteem, Identity, Role
The Human Dimensions
Physical, Emotional, Intellectual, Environmental, Sociocultural, Spiritual
Stages of Illness Behavior
Experiencing symptoms, assuming the sick role, assuming a dependent role, achieving recovery and rehabilitation
Agent-Host Environment
Risk factors
Health-Illness Continuum
measures a persons level of health. Health is a constantly changing state. High-level wellness and death on opposite sides
Health Belief Model
Percieved susceptibilty, percieved seriousness, percieved barriers/benefits, self-efficacy
Healthy People 2010
To increase quality and years of a healthy lifespan, to eliminate disparities, assist with risk identification (10 indicators)
Primary Preventative Care
Promoting health and disease prevention. Health risk assessments, immunizations
Seconday Prevention
Early detection, prompt intervention and health maintenance. To lessen or reduce severity of an illness or disease. Mammograms, testicular exams
Tertiary Prevention
Begins after an illness has occurred to help rehabilitate and assist patients to their maximum potential.
Fcators Affecting Delivery of Care
Cost, access, Quality, and Vulnerable populations
Levels of Care
Primary-health promotion and illness prevention, Secondary-diagnosis and treatment (acute care or hospitals), Tertiary-rehab
Goals of heathcare reform
Cost containment, improved access to care, increased quality of services for all.
Characteristics of the Nursing Process
Systematic, Dynamic, Interpersonal, Outcome oriented and Universally applicable
Problem Solving
Trial & Error-# of solutions until one works
Scientific-hypothesis, testing, evaluation
Intuitive-instinct
Critical Thinking-* independent, open-minded,creative, realistic
Steps to perform critical thinking
Purpose of thinking, adequacy of knowledge, potential problems, helpful resources, critique of judgement/decision
Critcal Thinking and Clinical Reasoning
is purposeful, informed, outcome-oriented. Is driven by patient, family and community. Is based on scientifc method. Uses both intuition and logic. Is constantly reevaluating, self-correcting and striving to improve
Nursing Process vs. critical thinking
Nursing Process is the tool and critical thinking is how you use the tool
Assessment
the systematic and continuous collection, validation and communication of patient data. Obtain database by interview and physical exam

Coolect data, organize data, validate data, communicate data, document
Phases of a Nursing Interview
Preparatory-read charts, privacy, introduction
Working-gather all information
Termination-conclude by highlighting key points, let client know what to expect
Comprehensive Initial Assessment
shortly after admittance, to establish a database, all aspects of patients health
Focused assessment
during initial or for routine ingoing data collection. for a specific problem already identified or to identify new,overlooked problems
Time-lapsed assessment
to compare current status to baseline data
Emergency assessment
physiologic or psychological crisis. to identify life-threatening problems
Quick-Priority assessment
highloghts existing problems and risks. SBAR format for notifying MD
Fcators Affecting Microorganism to produce disease
Pathogencity-potency
Virulence- ability to survive in or outside the body
Invasiveness-number present
Immune status of host
Length and intimacy of contact
Six links in the Chain of Infection
Infectious Agent, Reservoir (natural habitat), Portal of exit, Means of Transmission, Portal of Entry, Susceptible host
Stages of Infections
Incubation-invaded and growing, Prodromal-early s/s-contagious, Full Stage-manifests itself, Covalescent-recovery
Primary defenses
normal flora, prevents organisms from entering the body
Secondary defenses
inflammatory response, WBCs, Complement cascade, Fever
Tertiary defenses
Natural active-chickenpox develops immunity
Passive-mom to fetus via milk and placenta
Vaccinations
Immune globin-injectable anyibodies ex: hep, allergy shots
Inflammatory Response
1. Vascular and Cellular response-redness, warmth, histamine release, phagocytosis
2. Inflammatory exudate
3. Reparative-tissue and scar formation
Clinical manifestations of infection
fever, malaise/lethargy, leukocytosis, anorexia, nausea, lymph node enlargement, tachycardia, HTN, tachypnea, purulent sputum
4 E's of preventing injury
Engineering, enforcement, education, economics
What to do in a fire
R-rescue anyone in immediate danger
A-activate fire codes and notify appropriate person
C-Confine fire
E-Evacuate patients and others to safe area
Cultural assimilation
minorities living within a dominant group lose the characteristics that made them different
Cultural imposition
belief that everyone should conform to the majoruty belief system
Cultural conflict
people become aware of differences and feel threatened
4 Phases of safety testing in Clinical Trials
I-determines safety and dosage
II-evaluates effectiveness and side effects
III-confirms effectiveness, monitor adverse reactions for long term use
IV-after market testing
Standing order vs. Protocol
SO-carried out until cancelled by another order
Protocol-specific meds for specific situations
Pharmacokinetics
Absorption-from site entry to bloodstream
Distribution-drug is distributed throughout body to target cells and tissues
Metabolism-drug is broken down to inactive form (metabolites)
Excretion-excreted from the body, mainly by kidneys
Serum drug levels
Therapeutic range-desired effect
Peak-highest concentration
Trough-lowest concentration (30 min prior to next dose)
Half-Life-time for 50% of med to be eliminated(sleepers have long 1/2 life)
Pharmacodynamics
process by which a drug changes the body by interacting with receptors or targets. Drug-receptor interaction, drug-enzyme interaction.
Agonist
stimulates a response/reaction
Antagonist
blocks or inhibits a reaction
Synergistic
two drugs work togther to increase the effect of one or both meds (Tylenol with codeine)
Iatrogenic
med itself unintentionally causes a disease process
Drug tolerance
body becomes accustomed over a period of time, larger dose may be necessary
Toxic Effect
reversible and.or irreversible damage to an organ
Cumulative effect
dose not completely metabolized before another dose administered
Idiosyncratic effect
an unusual or peculiar response, unpredictable
Conditions that decrease metabolism of meds
Dehydration, hyperthermia, immobility, kidney disease, liver disease
Growth and development
are orderly and sequential as well as continuous and complex. each stage is predictable, onset, length and effects vary. pace of G&D specific for each person
Principle of G&D
cephalocaudal-growth and development starts at head, moving to trunk and legs
proximodistal-occur from center of body outward
Factors affecting G&D
genetics, temperament, family, nutrition, health, culture, environment
Freud
theory of psychoanalytical development.
Personality=the unconscious(memories, fantasies), the Id-(self-gratification,sexual energy), the Ego(conscious mind, realistic part), Superego-(learn morals,values)
Personality develops by late adolescents
Erikson
Psychosocial development-based on Freud but incudes culture and social influences-Eight stages.
Havinghurst
developmental tasks. Tasks arise from maturation, personal motives, vallues, choice of occupation, family choices,civic responsibilty
Roger Gould
transformation-central theme during adulthood.
Kohlberg
moral development is influenced by culture, caregivers and communication. Preconventional stage-conform to rukes. Conventional-abstract thinking, respect, values. Post-conventional-approriate behavior determined by society. few meet this level
Gilligan
conception of morality from female point of view. They develop morality from needs of others and caring.
Fowler
theory of faith. Unifying factor=trust. Development of spirituality is an ongoing, lifelong process.
Theories of Aging
genetic-genes control genetic clocks, cross-linkage-chemical reaction produces damagae to the DNA and cell death, Immunity-focuses on functions of immune system, Free- radical-mmolecules with seperated high-energy electrons have adverse effects on adjacent molecules
Disengagement theory
Older adults often withdraw from roels and become more introspective and self-focused, usually beneficial for the individual
Activity Theory
Older adults should deny the existence of old age as long as possible
Role of the Gerontological Nurse
Caregiver, Healer, Educator, Advocate, Innovator
Stress
any condition which the human system responds to changes in its normal balanced state, rsults from change in the environment that is percieved as a challenge,threat or danger
Anxiety
a vague, nonspecific, uncomfortable, subjective rsponse as the result of a percieved or actual threat. A pervasive feeling of dread or apprehension.
Adaptation, homeostasis and coping
Adaptation-an ongoing process by which individuals adjust to stressors in order to achieve homeostasis
Coping-a complex of behvaioral, cognitive, and physiological response that aims to prevent or minimize unpleasant or harmful experiences
Developmental stress
occurs when person progresses through stages of G&D ie: beginning school, marriage, retirement
Situational stress
Does not occur in predictable patterns, illness, purchasing a home, divorce
Physiological stress
chemical agenst,infections,nutritional imbalances
Psychosocial
real and percieved, PTSD, agoraphobia
Family stressors
changes in family structure and roles, finances
Change
a dynamic process in which an individuals behavior is altered in response to a stressor, its both inevitable and constant. Can be constructive or destructive.
General Adaptation Syndrome
biochemical model of stress. 3 stages: Alarm Reaction, resistance and exhaustion.
Alarm Reaction
person percieves stress, defense mechanisms activated. Fight or flight. Hormone levels rise,^ O2 intake, pupil dilation,^ energy
Resistance
body attempts to adapt to stressor. Vital signs, hormone levels and energy production return to normal. Body regains homeostasis or adaptive mechanism fail
Exhaustion
results when adaptive mechanisms are depleted. Body either rests and mobilizes its defense to return to normal, collapses or death occurs.
Local Adaptation Syndrom
the physiological response to a stressor affecting a specific body part. Local inflammation
Crisis
an acute state of disorganization occurring when the individuals usual coping mechanisms are no longer effective. Characterized by extreme anxiety, inability to function, experienced as a sudden event, has identifiable precipitating event, percieved as overwhelning, Intervention is required
Types of exercise
Isokinetic-contraction with resistance (wt lifting)
Isotonic-shortening and active movement (jogging)
Isometric-muscle contraction only
Functions of Sleep
restores normal levels of activity and balance to the nervous system, necessary for protein synthesis, psychological well-being
Stages of Sleep
Stage 1-very light sleep, last a few minutes, drwsiness
Stage 2-light sleep, awakens easily
Stage 3/4-deep sleep, difficult to arouse, muscles relaxed, important for restoring energy, realse of serotonin and grwoth hormone
Stage 5-REM-vital signs fluctuate, vivid dreams, occurs q 90 minutes last 5-30 minutes
Older Adults and sleep disturbances
Sundown syndrome, nocturia, delcine in stages 3/4 of sleep sometimes stage 4 is absent, chronic insomnia, sleep apnea, nocturnal myoclonus
Religious Influences
life affirming-enhance life, give meaning and purpose to existence, strengthen self, health giving and life sustaining
Life denying-restrict or enclose life patterns, limit experiences and associations,place burdens of guilt on individuals, health denying and life inhibiting
Spritual pain
feel hurt or pain associated with the spiritual or religious beliefs that are held
Spiritual alienation
feel far away from God,far removed from your everyday life
Separated from “faith community”
Spiritual anxiety
Are you afraid that God might not take care of your needs? That He might not be there when you need Him?
Challenged belief and value system
Spiritual guilt
feeling badly about things that you have done or failed to do in your life
Failure to live according to religious rules
Spiritual anger
angry at God for allowing you to be ill? Do you ever feel like blaming God for your illness? Do you think God is unfair to you?
Spiritual loss
Do you ever feel that you have lost God's love? That you have broken or weakened your relationship with God? Has God turned his back on you?
Spiritual despair
there is no hope of having God's love? Of pleasing him? That God does not love you anymore?
Feeling that no one (not even God) cares
Implementing Spiritual Care
Offering supportive presence, facilitating patients practice of religion, nurturing spirituality, praying with a patient, praying for a patient, couseling the patient spiritually, contacting a spiritual counselor
Fcators Affecting Cardiovascular functioning
Modifiable=Hyperlipidemia, HTN, Cigarettes, DM, Obesity, Sedentary lifestyle, Stress and coping, Diet, ETOH,Response to heat/cold
Nonmodifiable=heredity, age, gender>womens risk^ after menopause
lterations in cardiovascular function and O2 transport
Decreased CO leads to MI, heart failure-pulmonary congestion, pulmonary edema, cardiomyopathy
Impaired tissue perfusion-ischemia-lack of blood supply,PVD
Upper Airway
Function-warm, filter, humidify air
Components-Nose, Pharynx, Larynx, Epiglottis
Lower Airway
Functions-conduction of air, mucociliary clearance, production of pulmonary surfactant
Components:Trachea, rt and lt mainstem bronchi, segmental bronchi, terminal bronchioles
Functioin of Respiratory System
Ventilation, Gas diffusion, Gas transport, Control of ventilation, defenses of the respiratory system
Mechanics of Breathing
Mechanical-thoracic cage pressure changes
Neurologic-medulla is the resp. center, a rise in CO2 stimulates medulla to increase RR and depth
Biochemical-chemoreceptors in the aortic arch/carotid bodies sensitive to rises in CO2 and H+ ions
Boyles Law
when the volume increases, the pressure decreases. When the lungs expand, the diaphragm contracts,volume of the lungs increase, pressure decreases. Air moves from an area of higher pressure (atmosphere) to an area of lower pressure (the lungs)
Transport of respiratory gases
O2 is carried in the body via plasma and RBCs.
Most O2 is carried by RBC called oxyhemoglobin
Internal respiration b/w the circulating blood and tissue cells must occur
Anemia=low erythrocytes, causing low hemoglobin
Resonance
loud, hoolow low-pitched sound heard over normal lungs
Hyper resonance
loud, low booming sound heard over emphysematous lungs
Breath Sounds
Vesicular-low-pitched soft sound during expiration heard over most of lungs, Bronchial-hugh pitched and loner, primarily over trachea, Bronchovesicular-medium pitch and sound during expiration, heard over upper anterior chest and intercostal area
Adventitious Lung Sounds
Crackles-intermittent, when air moves through airways that contain fluid
Wheezes-continous, heard on expiration and sometimes inspiration as air passes through constricted airways
Rhonchi-low pitched snoring, from secretions
Pursed Lip Breathing
Patients who experience dyspnea and feelings of panic can often reduce these symptoms by using pursed-lip breathing. Exhaling through pursed lips creates a smaller opening for air movement, effectively slowing and prolonging expiration. Prolonged expiration is thought to result in decreased airway narrowing during expiration and prevent the collapse of small airways.
Complications of suctioning
Hypoxemia, infection, cardiac dysrhymias, hypoxia, mucosal trauma, death
Inhaled Medications
Bronchodilators-open narrowed airways
Mucolytics-liquefy or loosen thick secretions
Corticosterois-reduce inflammation in airways
Nebulizers-disperse fine particles of medication into deeper passages of respiratory tract where absorption occurs
Payen pain scale
for patients who cannot communicate like elderly who are cognitively imapired. Rates 3-12 by patients facial expression, upperlimb movement and compliance, medicate critically ill and mechanically ventilated pateits before procedures.
Gate Control Theory of Pain
a relation between pain and emotions. The theory states that certain nerve fibers, those of small diameter, conduct excitatory pain stimuli toward the brain, but nerve fibers of a large diameter appear to inhibit the transmission of pain impulses from the spinal cord to the brain
massage or a warm compress to a painful lower back area, stimulate large nerve fibers to close the gate, thus blocking pain impulses from that area
Bradykinin
a powerful vasodilator that increases capillary permeability and constricts smooth muscle, plays an important role in the chemistry of pain at the site of an injury even before the pain message gets to the brain. It also triggers the release of histamine and, in combination with histamine,
P.1373
produces the redness, swelling, and pain typically observed when an inflammation is present.
Prostaglandins
hormone-like substances that send additional pain stimuli to the CNS
Substance P
sensitizes receptors on nerves to feel pain and also increases the rate of firing of nerves
nociceptors
The peripheral nerve fibers that transmit pain
The Pain Process
1. transduction-activation of pain receptors
2. Transmission-conduction along pathways
3. Perception-awareness of characteristics of pain and includes the patients interpretation of pain
4. Modulation-initiation of the protective reflex response, sensation of pain is inhibited or modified
Neuromodulators
naturally occurring opiioids and their receptors:
Endorphins-produce euphoria
Dynorphin-most potent analgesic effect
Enkephalins-reduce pain by releasing substance P
Origin of Pain
Physical, Psychogenic/idiopathic, Referred, Phantom
Common responses to pain
Physiologic-elecated BP, RR,HR, pupil dilation, elevated glucose
Behavior-withdrawal, grimacing, moaning, protective
Affective-exaggerated weeping, anxiety, anger, fear
Parasympathetic-nausea, vomiting, Decreased blood pressure, Decreased pulse rate, Prostration,Rapid and irregular breathing
Nociceptive Pain
unconscious activity induced by a harmful stimulus such as chemical or mechanical event that has potential to damage body tissue
Neuropathic pain
abnormal nerve functioning or injury to nerves,often described as burning or stabbing. Allodynia
Visceral pain
referred to the skin or areas distant from orgin of pain. Resulst from body areas that have been stretched or ischemic.
Somatic
deep or superficial nerve stimulation, originates in skin, bone, muscles or connective tissue and joints. DJD
Analgesic Ladder
Mild to Moderate Pain-use one non-opioid medication
Moderate-use non-opioid adding opioid
Moderate to severe-use morphine, oxycodone, may add non-opioid
Adverse Effects of Opioids
respiratory depression, constipation, nausea, orthostatic hypotension, cough suppression, urinary retention, biliary colic, euphoria, sedation
Nervous System Control of Urinating
Sympathetic-carries impulses to internal sphincter causing constriction
Parasympathetic-causes internal sphincter to relax
Stretch recpetors transmit impulses to spinal cord causing urge to void (approx 150ml-250 ml full)
Autonomic bladder
void by reflex only-from spinal cord injury or disease
Diuretics
prevent reabsorption of water and certain electrolytes in tubules
Cholinergic medications
stimulate contraction of detrusor muscle, producing urination
Effects of medication
Pyridium-orange-orange red
Elavil-green or blue-green
Levadopa-black
Urinary Tract Infection
E.Coli, Prevention:8-10 flasses H2O, cranberry juice, showers vs. baths, cotton undies
s/s-flank pain, dysuria,concentrated/foul smelling urine, frequency, hematuria, fever/chills
Reasons for Catheterization
Relieve Urinary retention, obtain a sterile urine specimen, measurement of PVR, Emptying bladder pre, post and during surgery, monitoring criticslly ill patients
Neurogenic bladder
injury to the CNS causing urinary incontinence
Effects of Aging on Urinary Elimination
The diminished ability of the kidneys to concentrate urine may result in nocturia.
Decreased bladder muscle tone may reduce the capacity of the bladder to hold urine, resulting in increased frequency of urination.
Decreased bladder contractility may lead to urine retention and stasis, which increase the likelihood of urinary tract infection.
Neuromuscular problems, degenerative joint problems, alterations in thought processes, and weakness may interfere with voluntary control and the ability to reach a toilet in time.
Functions of the Large Intestine
completion of absorption of water and nutrients, manufacture of some viatmins, formation of stool, expulsion of feces from body
Peristalsis
Nervous System control, contractions q 3-12 minutes. The contents of the colon represent ingested food over 4 days, most are excreted within 48 hours.
Foods Affecting Bowel Elimination
Constipating=cheese, lean meats, eggs, pasta
Laxative=fruits, veggies, bran, chocolate, ETOH, coffee
Gas-producing=onions, cabbage, beans, cauliflower
Effects of Meds on Stool
aspirin-pink to red to black
iron-black
antacids-white or speckling
antibiotics-green-gray
laxative-stimultae bowel activity
suppressants-pepto bismol, imodium
narcotics-constipate
Physical Assessment of Abdomen
Inspection-contour, masses, scars or distention
Auscultation-bowel sounds, note frequency, character,audible, flatus
Percussion-resonant sound or tympany-can be caused by fluid, massess, or tumor
Palpation-not any muscular resistance, tenderness, enlargement of organs, masses* Always auscultate 1st
Physical Assessment of Rectum and Anal Canal
Inspect & Palpate-examine for cracks, nodules, distended veins, massess,fecal mass. Insert gloved finger to assess sphincter tone and smoothness of mucosal lining. Inspect perineal area for skin irritation, measurement of abdominal girth
Patients High risk for Constipation
Bed rest, reduced fluid intake or bulk in diet, depression, CNS disease or local lesions, narcotic use
Loss-definition
Any situation in which a valued object is changed or is no longer accessible to the individual
Grief/Bereavement/Mourning
Grief-emotional reaction to loss
Bereavement-subjective response experience by surviving loved ones after death
Mourning-acceptance of loss
Actual Loss
can be recognized by other
Percieved loss
is felt by the person but intangible to others, ie: loss of youth
Physical Loss vs.psychological loss
Directly r/t actual/percieved. Physical loss would be loss of arm, psychological would be altered self image
Maturational Loss
experienced as a result of natural developmental process, Ex: 1st child loses status when sibling is born
Situational Loss
experienced as a result of an unpredictable event, ex: illness, natural disaster, death
Anticipatory Loss
loss has not taken place but display grieving behaviors, ie: spouse of a terminally ill client
Types of Grief
Dysfunctional-extended lenght and severity, can be inhibited or unresponsive
Inhibited-normal symptoms of grief which are suppressed
Abbreviated-short duration but genuine
Engel's stages of grief
1. shock and disbelief
2. developing awareness
3. restitution
4. resolving the loss
5. idealization
6. Outcome
Kubler-Ross stages of Dying
1. Denial and isolation
2. Anger
3. Bargaining
4. Depression
5. Acceptance
Palliative Care
taking care of the whole person. prevents and relieves suffering by early assessment and tx of pain and other physical, psychosocial,and spiritual needs. Bereavement care, continuation of care to family following death of a patient
Hospice Care
Comprehensive and coordinated care for patients with a limited life expectancy provided both at home and in health care setting, philosophy being is death with dignity and comfort. Care normally 6 months lor less left to love (palliative earlier in the disease)
Brain death
cessation of all brain function. Lack of receptivity and responsiveness, Lack of movement or breathing, Lack of reflexes, Flat encephalogram
2 neuro exams, no response to pain
Biological death
Cessation of heart rate and respirations
Dying with Dignity
Pain and symptom management, clear decision making, preperation for death, completion, contributing to others, affirmation of the whole person
Needs of the Dying Patient
Physiologic-physical needs, hygiene, pain control, nutrition
Psychological-control over fear of unknown, pain, seperation, loss of dignity, loss of control
Sexual-need ways to be physically intimate
Spiritual-needs to practice religious faith, spirituality and rituals
Physiological Changes during dying process
Inability to swallow,Pitting edema,Decreased gastrointestinal and urinary tract activity,Bowel and bladder incontinence,Loss of motion, sensation, and reflexes. Pain, anxiety, depression,anorexia, cachexia, hypotension, renal failure
Elevated temperature, but cold or clammy skin; cyanosis
Lowered blood pressure
Noisy or irregular respiration
Cheyne-Stokes respirations
Cumulative Loss
succession of losses common to nurses. May not have time to resolve losses before another loss occurs
Stages of Adaptation
1. Intellectualization
2. Emotional Survival
3. Depression
4. Emotional Arrival
5. Deep compassion
In what stage of the GAS energy levels increase,oxygen intake increases,and you become more mentally aware
Alarm reaction
During this stage of the GAS, the body attempts to adapt to the stressor
Resistance
In this phase of the inflammatory response vasoconstriction occurs to control bleeding and inflmmation, swelling and redness appear
Phase I
during this stage of the inflammatory response wbcs produce exudate
Phase II
this is the ability of an organism to cause a disease
Virulence
During this stage of the infection process signs and symptoms disappear
Convalescent period
what are the 3 types of extracellular fluid
1. Intravascular- fluid within the blood vessels (plasma)
2. Interstitial fluid- fluid between the cells and blood vessels
3. Lymphatic and transcellular fluid- pleural, cerebrospinal, intraocular and synovial fluid
What is the total body water of a healthy person?
50-60%
What two types of people have less body water and why?
Women and obese people. Because fat cells contain less water.
What are four ways fluid moves through each compartment?
Diffusion, Osmosis, Active transport and Filtration
This type of solution has a greater concentration of particles than plasma.
Hypertonic solution
This type of solution has a lesser concentration of particles thanplasma
Hyoptonic
This type of solution cause cells to shrink by pulling fluid from the cell and the extracellular compartment
Hypertonic
This type of solution causes cells to swell
Hypotonic
This allows H2O molecules to pass from an area of lesser solute concentration to a greater concentration. This is also the major transport system of body fluids
Osmosis
This transport system has the tendency of solutes ot move freely throughout a solvent "downhill" CO2 transported this way.
Diffusion
This transport mechanism requires energy (ATP) to move substances through cell membranes from a lesser solute concentration to higher solute concentration
Active Transport
This transport mechanism works by the passafe of fluid through permeable membranes in which solute and solutions move together in response to fluid pressure to create equilibrium. Ex: Kidney
Filtration
Cations
positively charged ions, include K, Na, Mg, Ca
Anions
negatively charged ions, include Cl, HCO3, PO4
Anion gap
difference of concentration between cations and anions. Useful in determining ekectrolyte imbalance.
Sodium
Extracellular, controls and regulates volume of body fluids, most abundant electolyte
Chloride
Extracellular, maintains osmotc pressure in blood,produces hydrochloric acid
Bicarbonate
Extracellular, body's primary buffer, maintains acid base balance
Potassium
Intracellular, chief regulator of cellular enzyme activity and water content, cardiac and skeletal muscle contraction
Magnesium
Intracellular, regulates muscle contraction, transmits nerve impulses
Calcium
Intracellular, formation of bones and teeth, nerve impulse, blood clotting, muscle contraction, B12 absorption
Phosphate
Intracellular, formation of bones and teeth, regular calcium level
Osmolality
the concentration of solutes in the body fluids, (specific gravity)
Hyponatremia (s/s)
Acute: n/v, anorexia, headache irritability, disoriented, muscle twitching, tremors, weakness, LOC
Hypovalemia
isotonic fluid loss from the extracellular fluid. Can result from excessive diuretc use,DM, excessive sweating,fever or 3rd-space fluid shifts including: burns, crush injuries, heart failure, hip fx, liver failure, pleural effusion
Hypovalemia (s/s)
increased HR, orthostatic hypotension, restlessness, anxiety, increased urine output, cool/pale skin,weight loss, dizzy, nausea, thirsty, rapid/thready pulse, Sever:unconscious, CO drops, tahcycardia,cyanosis, urine output drops
Hypervolemia
excess of isotoic fluid in the extracellular compartment.. Results from excessive fluid or sodium intake.
Hypervolemia (ss)
Cardiac output decreases to compensate for excess volume, pulse is rapid/bounding, BP increases, distended veins, edema, wt gain