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212 Cards in this Set
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Defintion of Nursing
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Protection, promotion and optimization of health
Prevention of illness and injury Alleviation of suffering Advocate for individuals, families, communities and populations |
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Aims of Nursing/Scope
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To promote health, prevent illness, restore health and facilitate coping with disability or death
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4 Skills to meeting Aims of Nursing
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Cignitive, Technical, Interpersonal, Eithical/Legal
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Nursing 20th and 21st Century
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Explosion in healthcare, nursing informatics
Longer lifespan of the population, increased incidence of chronic illnesses |
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Florence Nightingale
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Founder of Modern Nursing
First nurse theorist/researcher Clean air,water, environment |
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Lillian Wald
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NY Visiting Nursing Services
Pioneer in Public Health Nursing |
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Mary Elizabeth Mahoney
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1st Colored trained nurse
Sought equality and voting rights for women of color |
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Nurse Training Act
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1941
All nursing education to take place at institutions of higher learning |
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Mildred Montag
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Associate Degree Nursing
Dissertation 1948 |
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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 |
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Nursing Thoery
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attempts to explain, predict and/or describe an issue or phenomenon
Clarifies belief, values and goals Provides EBP |
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Concept
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Abstract impressions organized into symbols of reality, can describe objects, ideas or events
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Metaparadigm of Nursing
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Four major concepts- person, environment, health, nursing
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Conceptual framework/Model
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Concrete model of a theory or philosophy
ie: Maslows Hierarchy of needs |
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Benners Clinical Ladders
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Novice, Advanced Beginner, Competent, Proficient, Expert
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WHO
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World Health Organization
defines health as a state of complete physical, mental and social well-being |
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Self Concept
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an individuals perception of self and is what helps make each individual unique. Affects the ability to function and greatly influences health status
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Components of Self-Concept
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Body Image, Self-Ideal, Self-esteem, Identity, Role
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The Human Dimensions
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Physical, Emotional, Intellectual, Environmental, Sociocultural, Spiritual
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Stages of Illness Behavior
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Experiencing symptoms, assuming the sick role, assuming a dependent role, achieving recovery and rehabilitation
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Agent-Host Environment
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Risk factors
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Health-Illness Continuum
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measures a persons level of health. Health is a constantly changing state. High-level wellness and death on opposite sides
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Health Belief Model
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Percieved susceptibilty, percieved seriousness, percieved barriers/benefits, self-efficacy
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Healthy People 2010
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To increase quality and years of a healthy lifespan, to eliminate disparities, assist with risk identification (10 indicators)
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Primary Preventative Care
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Promoting health and disease prevention. Health risk assessments, immunizations
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Seconday Prevention
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Early detection, prompt intervention and health maintenance. To lessen or reduce severity of an illness or disease. Mammograms, testicular exams
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Tertiary Prevention
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Begins after an illness has occurred to help rehabilitate and assist patients to their maximum potential.
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Fcators Affecting Delivery of Care
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Cost, access, Quality, and Vulnerable populations
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Levels of Care
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Primary-health promotion and illness prevention, Secondary-diagnosis and treatment (acute care or hospitals), Tertiary-rehab
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Goals of heathcare reform
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Cost containment, improved access to care, increased quality of services for all.
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Characteristics of the Nursing Process
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Systematic, Dynamic, Interpersonal, Outcome oriented and Universally applicable
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Problem Solving
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Trial & Error-# of solutions until one works
Scientific-hypothesis, testing, evaluation Intuitive-instinct Critical Thinking-* independent, open-minded,creative, realistic |
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Steps to perform critical thinking
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Purpose of thinking, adequacy of knowledge, potential problems, helpful resources, critique of judgement/decision
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Critcal Thinking and Clinical Reasoning
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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
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Nursing Process vs. critical thinking
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Nursing Process is the tool and critical thinking is how you use the tool
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Assessment
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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 |
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Phases of a Nursing Interview
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Preparatory-read charts, privacy, introduction
Working-gather all information Termination-conclude by highlighting key points, let client know what to expect |
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Comprehensive Initial Assessment
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shortly after admittance, to establish a database, all aspects of patients health
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Focused assessment
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during initial or for routine ingoing data collection. for a specific problem already identified or to identify new,overlooked problems
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Time-lapsed assessment
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to compare current status to baseline data
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Emergency assessment
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physiologic or psychological crisis. to identify life-threatening problems
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Quick-Priority assessment
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highloghts existing problems and risks. SBAR format for notifying MD
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Fcators Affecting Microorganism to produce disease
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Pathogencity-potency
Virulence- ability to survive in or outside the body Invasiveness-number present Immune status of host Length and intimacy of contact |
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Six links in the Chain of Infection
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Infectious Agent, Reservoir (natural habitat), Portal of exit, Means of Transmission, Portal of Entry, Susceptible host
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Stages of Infections
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Incubation-invaded and growing, Prodromal-early s/s-contagious, Full Stage-manifests itself, Covalescent-recovery
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Primary defenses
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normal flora, prevents organisms from entering the body
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Secondary defenses
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inflammatory response, WBCs, Complement cascade, Fever
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Tertiary defenses
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Natural active-chickenpox develops immunity
Passive-mom to fetus via milk and placenta Vaccinations Immune globin-injectable anyibodies ex: hep, allergy shots |
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Inflammatory Response
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1. Vascular and Cellular response-redness, warmth, histamine release, phagocytosis
2. Inflammatory exudate 3. Reparative-tissue and scar formation |
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Clinical manifestations of infection
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fever, malaise/lethargy, leukocytosis, anorexia, nausea, lymph node enlargement, tachycardia, HTN, tachypnea, purulent sputum
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4 E's of preventing injury
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Engineering, enforcement, education, economics
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What to do in a fire
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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 |
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Cultural assimilation
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minorities living within a dominant group lose the characteristics that made them different
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Cultural imposition
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belief that everyone should conform to the majoruty belief system
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Cultural conflict
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people become aware of differences and feel threatened
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4 Phases of safety testing in Clinical Trials
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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 |
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Standing order vs. Protocol
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SO-carried out until cancelled by another order
Protocol-specific meds for specific situations |
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Pharmacokinetics
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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 |
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Serum drug levels
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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) |
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Pharmacodynamics
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process by which a drug changes the body by interacting with receptors or targets. Drug-receptor interaction, drug-enzyme interaction.
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Agonist
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stimulates a response/reaction
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Antagonist
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blocks or inhibits a reaction
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Synergistic
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two drugs work togther to increase the effect of one or both meds (Tylenol with codeine)
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Iatrogenic
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med itself unintentionally causes a disease process
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Drug tolerance
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body becomes accustomed over a period of time, larger dose may be necessary
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Toxic Effect
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reversible and.or irreversible damage to an organ
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Cumulative effect
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dose not completely metabolized before another dose administered
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Idiosyncratic effect
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an unusual or peculiar response, unpredictable
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Conditions that decrease metabolism of meds
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Dehydration, hyperthermia, immobility, kidney disease, liver disease
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Growth and development
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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
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Principle of G&D
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cephalocaudal-growth and development starts at head, moving to trunk and legs
proximodistal-occur from center of body outward |
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Factors affecting G&D
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genetics, temperament, family, nutrition, health, culture, environment
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Freud
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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 |
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Erikson
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Psychosocial development-based on Freud but incudes culture and social influences-Eight stages.
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Havinghurst
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developmental tasks. Tasks arise from maturation, personal motives, vallues, choice of occupation, family choices,civic responsibilty
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Roger Gould
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transformation-central theme during adulthood.
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Kohlberg
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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
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Gilligan
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conception of morality from female point of view. They develop morality from needs of others and caring.
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Fowler
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theory of faith. Unifying factor=trust. Development of spirituality is an ongoing, lifelong process.
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Theories of Aging
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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
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Disengagement theory
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Older adults often withdraw from roels and become more introspective and self-focused, usually beneficial for the individual
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Activity Theory
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Older adults should deny the existence of old age as long as possible
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Role of the Gerontological Nurse
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Caregiver, Healer, Educator, Advocate, Innovator
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Stress
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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
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Anxiety
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a vague, nonspecific, uncomfortable, subjective rsponse as the result of a percieved or actual threat. A pervasive feeling of dread or apprehension.
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Adaptation, homeostasis and coping
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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 |
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Developmental stress
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occurs when person progresses through stages of G&D ie: beginning school, marriage, retirement
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Situational stress
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Does not occur in predictable patterns, illness, purchasing a home, divorce
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Physiological stress
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chemical agenst,infections,nutritional imbalances
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Psychosocial
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real and percieved, PTSD, agoraphobia
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Family stressors
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changes in family structure and roles, finances
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Change
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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.
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General Adaptation Syndrome
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biochemical model of stress. 3 stages: Alarm Reaction, resistance and exhaustion.
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Alarm Reaction
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person percieves stress, defense mechanisms activated. Fight or flight. Hormone levels rise,^ O2 intake, pupil dilation,^ energy
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Resistance
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body attempts to adapt to stressor. Vital signs, hormone levels and energy production return to normal. Body regains homeostasis or adaptive mechanism fail
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Exhaustion
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results when adaptive mechanisms are depleted. Body either rests and mobilizes its defense to return to normal, collapses or death occurs.
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Local Adaptation Syndrom
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the physiological response to a stressor affecting a specific body part. Local inflammation
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Crisis
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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
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Types of exercise
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Isokinetic-contraction with resistance (wt lifting)
Isotonic-shortening and active movement (jogging) Isometric-muscle contraction only |
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Functions of Sleep
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restores normal levels of activity and balance to the nervous system, necessary for protein synthesis, psychological well-being
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Stages of Sleep
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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 |
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Older Adults and sleep disturbances
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Sundown syndrome, nocturia, delcine in stages 3/4 of sleep sometimes stage 4 is absent, chronic insomnia, sleep apnea, nocturnal myoclonus
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Religious Influences
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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 |
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Spritual pain
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feel hurt or pain associated with the spiritual or religious beliefs that are held
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Spiritual alienation
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feel far away from God,far removed from your everyday life
Separated from “faith community” |
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Spiritual anxiety
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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 |
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Spiritual guilt
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feeling badly about things that you have done or failed to do in your life
Failure to live according to religious rules |
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Spiritual anger
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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?
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Spiritual loss
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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?
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Spiritual despair
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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 |
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Implementing Spiritual Care
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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
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Fcators Affecting Cardiovascular functioning
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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 |
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lterations in cardiovascular function and O2 transport
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Decreased CO leads to MI, heart failure-pulmonary congestion, pulmonary edema, cardiomyopathy
Impaired tissue perfusion-ischemia-lack of blood supply,PVD |
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Upper Airway
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Function-warm, filter, humidify air
Components-Nose, Pharynx, Larynx, Epiglottis |
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Lower Airway
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Functions-conduction of air, mucociliary clearance, production of pulmonary surfactant
Components:Trachea, rt and lt mainstem bronchi, segmental bronchi, terminal bronchioles |
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Functioin of Respiratory System
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Ventilation, Gas diffusion, Gas transport, Control of ventilation, defenses of the respiratory system
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Mechanics of Breathing
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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 |
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Boyles Law
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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)
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Transport of respiratory gases
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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 |
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Resonance
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loud, hoolow low-pitched sound heard over normal lungs
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Hyper resonance
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loud, low booming sound heard over emphysematous lungs
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Breath Sounds
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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
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Adventitious Lung Sounds
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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 |
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Pursed Lip Breathing
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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.
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Complications of suctioning
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Hypoxemia, infection, cardiac dysrhymias, hypoxia, mucosal trauma, death
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Inhaled Medications
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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 |
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Payen pain scale
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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.
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Gate Control Theory of Pain
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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 |
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Bradykinin
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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. |
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Prostaglandins
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hormone-like substances that send additional pain stimuli to the CNS
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Substance P
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sensitizes receptors on nerves to feel pain and also increases the rate of firing of nerves
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nociceptors
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The peripheral nerve fibers that transmit pain
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The Pain Process
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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 |
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Neuromodulators
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naturally occurring opiioids and their receptors:
Endorphins-produce euphoria Dynorphin-most potent analgesic effect Enkephalins-reduce pain by releasing substance P |
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Origin of Pain
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Physical, Psychogenic/idiopathic, Referred, Phantom
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Common responses to pain
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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 |
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Nociceptive Pain
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unconscious activity induced by a harmful stimulus such as chemical or mechanical event that has potential to damage body tissue
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Neuropathic pain
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abnormal nerve functioning or injury to nerves,often described as burning or stabbing. Allodynia
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Visceral pain
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referred to the skin or areas distant from orgin of pain. Resulst from body areas that have been stretched or ischemic.
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Somatic
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deep or superficial nerve stimulation, originates in skin, bone, muscles or connective tissue and joints. DJD
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Analgesic Ladder
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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 |
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Adverse Effects of Opioids
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respiratory depression, constipation, nausea, orthostatic hypotension, cough suppression, urinary retention, biliary colic, euphoria, sedation
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Nervous System Control of Urinating
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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) |
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Autonomic bladder
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void by reflex only-from spinal cord injury or disease
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Diuretics
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prevent reabsorption of water and certain electrolytes in tubules
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Cholinergic medications
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stimulate contraction of detrusor muscle, producing urination
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Effects of medication
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Pyridium-orange-orange red
Elavil-green or blue-green Levadopa-black |
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Urinary Tract Infection
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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 |
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Reasons for Catheterization
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Relieve Urinary retention, obtain a sterile urine specimen, measurement of PVR, Emptying bladder pre, post and during surgery, monitoring criticslly ill patients
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Neurogenic bladder
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injury to the CNS causing urinary incontinence
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Effects of Aging on Urinary Elimination
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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. |
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Functions of the Large Intestine
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completion of absorption of water and nutrients, manufacture of some viatmins, formation of stool, expulsion of feces from body
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Peristalsis
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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.
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Foods Affecting Bowel Elimination
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Constipating=cheese, lean meats, eggs, pasta
Laxative=fruits, veggies, bran, chocolate, ETOH, coffee Gas-producing=onions, cabbage, beans, cauliflower |
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Effects of Meds on Stool
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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 |
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Physical Assessment of Abdomen
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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 |
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Physical Assessment of Rectum and Anal Canal
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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
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Patients High risk for Constipation
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Bed rest, reduced fluid intake or bulk in diet, depression, CNS disease or local lesions, narcotic use
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Loss-definition
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Any situation in which a valued object is changed or is no longer accessible to the individual
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Grief/Bereavement/Mourning
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Grief-emotional reaction to loss
Bereavement-subjective response experience by surviving loved ones after death Mourning-acceptance of loss |
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Actual Loss
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can be recognized by other
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Percieved loss
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is felt by the person but intangible to others, ie: loss of youth
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Physical Loss vs.psychological loss
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Directly r/t actual/percieved. Physical loss would be loss of arm, psychological would be altered self image
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Maturational Loss
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experienced as a result of natural developmental process, Ex: 1st child loses status when sibling is born
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Situational Loss
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experienced as a result of an unpredictable event, ex: illness, natural disaster, death
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Anticipatory Loss
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loss has not taken place but display grieving behaviors, ie: spouse of a terminally ill client
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Types of Grief
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Dysfunctional-extended lenght and severity, can be inhibited or unresponsive
Inhibited-normal symptoms of grief which are suppressed Abbreviated-short duration but genuine |
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Engel's stages of grief
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1. shock and disbelief
2. developing awareness 3. restitution 4. resolving the loss 5. idealization 6. Outcome |
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Kubler-Ross stages of Dying
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1. Denial and isolation
2. Anger 3. Bargaining 4. Depression 5. Acceptance |
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Palliative Care
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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
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Hospice Care
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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)
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Brain death
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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 |
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Biological death
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Cessation of heart rate and respirations
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Dying with Dignity
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Pain and symptom management, clear decision making, preperation for death, completion, contributing to others, affirmation of the whole person
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Needs of the Dying Patient
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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 |
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Physiological Changes during dying process
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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 |
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Cumulative Loss
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succession of losses common to nurses. May not have time to resolve losses before another loss occurs
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Stages of Adaptation
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1. Intellectualization
2. Emotional Survival 3. Depression 4. Emotional Arrival 5. Deep compassion |
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In what stage of the GAS energy levels increase,oxygen intake increases,and you become more mentally aware
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Alarm reaction
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During this stage of the GAS, the body attempts to adapt to the stressor
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Resistance
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In this phase of the inflammatory response vasoconstriction occurs to control bleeding and inflmmation, swelling and redness appear
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Phase I
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during this stage of the inflammatory response wbcs produce exudate
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Phase II
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this is the ability of an organism to cause a disease
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Virulence
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During this stage of the infection process signs and symptoms disappear
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Convalescent period
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what are the 3 types of extracellular fluid
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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 |
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What is the total body water of a healthy person?
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50-60%
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What two types of people have less body water and why?
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Women and obese people. Because fat cells contain less water.
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What are four ways fluid moves through each compartment?
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Diffusion, Osmosis, Active transport and Filtration
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This type of solution has a greater concentration of particles than plasma.
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Hypertonic solution
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This type of solution has a lesser concentration of particles thanplasma
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Hyoptonic
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This type of solution cause cells to shrink by pulling fluid from the cell and the extracellular compartment
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Hypertonic
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This type of solution causes cells to swell
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Hypotonic
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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
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Osmosis
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This transport system has the tendency of solutes ot move freely throughout a solvent "downhill" CO2 transported this way.
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Diffusion
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This transport mechanism requires energy (ATP) to move substances through cell membranes from a lesser solute concentration to higher solute concentration
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Active Transport
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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
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Filtration
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Cations
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positively charged ions, include K, Na, Mg, Ca
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Anions
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negatively charged ions, include Cl, HCO3, PO4
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Anion gap
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difference of concentration between cations and anions. Useful in determining ekectrolyte imbalance.
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Sodium
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Extracellular, controls and regulates volume of body fluids, most abundant electolyte
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Chloride
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Extracellular, maintains osmotc pressure in blood,produces hydrochloric acid
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Bicarbonate
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Extracellular, body's primary buffer, maintains acid base balance
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Potassium
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Intracellular, chief regulator of cellular enzyme activity and water content, cardiac and skeletal muscle contraction
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Magnesium
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Intracellular, regulates muscle contraction, transmits nerve impulses
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Calcium
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Intracellular, formation of bones and teeth, nerve impulse, blood clotting, muscle contraction, B12 absorption
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Phosphate
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Intracellular, formation of bones and teeth, regular calcium level
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Osmolality
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the concentration of solutes in the body fluids, (specific gravity)
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Hyponatremia (s/s)
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Acute: n/v, anorexia, headache irritability, disoriented, muscle twitching, tremors, weakness, LOC
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Hypovalemia
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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
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Hypovalemia (s/s)
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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
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Hypervolemia
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excess of isotoic fluid in the extracellular compartment.. Results from excessive fluid or sodium intake.
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Hypervolemia (ss)
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Cardiac output decreases to compensate for excess volume, pulse is rapid/bounding, BP increases, distended veins, edema, wt gain
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