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Funds exam 2
exam 2
109
Nursing
Undergraduate 3
04/03/2013

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Cards

Term
How many links are in the chain of infection?
Definition
6
Term
What are the links in the Chain of Infection?
Definition
Agent
Host
Resivor
Mode of Transmission
Portal of entry
Portal of exit
Term
Examples of Mode of trans
Definition
touching hands, side rails
Term
examples of resivors
Definition
tubing, equipment, dressings, moist and bacteria loving environments
Term
What are the stages of illness
Definition
Incubation
Prodomal
Full
Convalescence
Term
What are the signs and symptoms of incubation
Definition
NONE, you don't know you're ill yet
Term
What is prodomal?
Definition
most contagious
non specific symptoms
ex: fever, maliase ect..
Term
what is Full?
Definition
specific symptoms of illness
Term
what is convalenscence
Definition
recovery stage of illness
Term
How do infections get transfered from one area to the next?
Definition
direct/ indirect contact
Term
what are signs of infection?
Definition
fever
tender
purulent drainage
Term
C-DIFFICILE Isolation
Definition
gowns and gloves
no hand sanatizer, must wash hands
Term
4 C's of initial communication
Definition
Concise
Correct
Clear
Complete
Term
what are the 5 rights of delegation?
Definition
RIGHT TASK
RIGHT COMMUNICATION
RIGHT PERSON
RIGHT SUPERVISION
RIGHT CIRCUMSTANCE
Term
Who is in charge of Assessing the patient
Definition
The RN
Term
What are the vital signs? (6)
Definition
Temp
Pulse
Respiration
BP
Pulse oximetry
pain
Term
when are you able to delegate vital signs?
Definition
when the patient is stable
Term
What is a temperature?
Definition
Anything below Normal temp.
96.8-100.4 oF
Term
what is average rectal temp?
Definition
99.5oF
Term
What are the sites where you can take a temperature?
Definition
Oral
Rectal
Temporal
Axillary
Tempanic
Term
What is the difference between oral and rectal temps?
Definition
subtract 0.5 oF
Term
What is the difference between oral and axillary temps?
Definition
add 0.5 oF
Term
What is a normal adult BP?
Definition
119/79
Term
what effects a persons temperature?
Definition
outside temperature
Term
where should the arm be when taking someones BP?
Definition
level with the heart
Term
What happens if the BP cuff is too big?
Definition
BP too low
Term
What happens if the BP cuff is too small?
Definition
BP too high
Term
What type of BP do you not delegate?
Definition
orthostatic BP
Term
What is orthostatic BP?
Definition
lying, sitting and standing
Term
what affects BP?
Definition
Stress, diet, exercise
Term
Normal pulse rate
Definition
60-100
Term
what sites do you find a pulse?
Definition
apical
radial
brachial
Term
Where can you find and apical pulse?
For how long?
Why do you take an apical pulse?
Definition
4th, 5th intercostal space, left midclavicular line
for 1 minute!!
take this pulse if something is irregular with the pulse?
Term
what incresases resp. rate
Definition
pain, anxiety, exercise, infection
Term
How to obtain resp. rate
Definition
watch rise and fall of chest for 1 min
Term
How to position someone in resp. distress
Definition
high fowlers
Term
What is most important when soemone is in resp. distress?
Definition
repositioning the patient
Term
why do people with COPD fall into tripod position
Definition
giving more room to breath
Term
what is our stimulius for us to breath?
Definition
high CO2 levels
Term
COPD stimulus to breath?
Definition
O2 levels
Term
where does gas exchange occur?
Definition
alveoli in the lungs
Term
What is a incentive spirametor
Definition
a breathing tube device used to increase the volume and expand the alveoli
Term
Blood oxygentation: Direct measures
Definition
Artierial blood gases
Term
Blood oxygentation: INDirect measures
Definition
pulse ox
Term
what effect oxygenation
Definition
nail polish
fake nails
Term
define eupnea
Definition
normal respiration
Term
define tachy
Definition
fast
Term
define brady
Definition
slow/decreased
Term
define dysrythmia
Definition
abnormal heart beat
Term
define febrile
Definition
feverish
Term
define afebrile
Definition
not feverish
Term
what is range of motion
Definition
range of joints
Term
why do we do ROM?
Definition
to prevent contractions
Term
how far to you range?
Definition
without causing pain
Term
what is AROM?
Definition
the patient does the ROM
Term
what is PROM?
Definition
nurse performs ROM
Term
Always keep a person in what position?
Definition
anatomically correct position
Term
when ambulating which side do you ambulate them?
Definition
the patients stronger side
Term
what are the 3 steps in Oxygenation
Definition
Diffusion
Perfusion
Ventillation
Term
What % is room air?
Definition
21%
Term
1 L = 4% then what is the room air?
Definition
24%
Term
if 2 L= 8% what is the room air o2?
Definition
28%
Term
what is hypoxia?
Definition
Low O2
Term
what are the clinical signs of hypoxia?
Definition
RESTLESSNESS
anxiety
confusion
cynosis in late stages
Term
Where on the skin and body can you assess for hypoxia?
Definition
palms/ soles of hands and feet
oral mucosa for cyanosis
Term
how many L of O2 can you put on a nasal canula
Definition
up to 6
Term
do you put a partial non-breather on a COPD patient?
Definition
No because they will get too much O2 and they will become machine dependent
Term
what is the average axillary temp?
Definition
97.7oF
Term
what is average pulse pressure?
Definition
30-50 mm Hg
Term
what is the normal resp. rate?
Definition
12-20 bpm
Term
what is considered prehypertension
Definition
120-139/80-89
Term
what is stage 1 hypertension
Definition
140-159/90-99
Term
what is stage 2 hypertension?
Definition
160/100 and above
Term
define oliguria
Definition
low output of urine
Term
define anuria
Definition
no urine output
Term
define nocturia
Definition
wkaing up at night to urinate
Term
define diuresis
Definition
increased output of urine
Term
define dysuria
Definition
painful urination
Term
define UTI
Definition
Urinary Tract Infection
Term
who can get BPH?
Definition
men
Term
define BPH
Definition
Benign prostatic hyperplasia
enlargement of the prostate
Term
what is the minimum fluid intake per day?
Definition
30 ml
Term
what technique must you use when suctioning?
Definition
sterile
Term
is surgical or medical asepsis sterile?
Definition
surgical
Term
How often do you suction a patient?
Definition
based on clinical need
Term
How do you give a patient a break when suctioning?
Definition
Res periods between passes and reapply O2
Term
if your patient is in distension what do you do?
Definition
Assess the patient by checking the distension and asking the patient
Term
what is constipation
Definition
symptom not disease caused by:
improper diet, reduced intake of fluid, lack of exercise, and certian medical conditions
Term
what is fecal impaction
Definition
results from unrelieved constipation, its is a collection of hardened feces wedged into the rectum that a person cannot expel
Term
what would you expect if you see a client has continuous oozing of diarrhea?
Definition
fecal imapction
Term
BRISTOL STOOL FORM SCALE
explain Type 1
Definition
separate hard lumps like nuts
Term
BRISTOL STOOL FORM SCALE
explain Type 2
Definition
sausage shaped but lumpy
Term
BRISTOL STOOL FORM SCALE
explain Type 3
Definition
like a sausage but with cracks on surface
Term
BRISTOL STOOL FORM SCALE
explain Type 4
Definition
like a sausage or snake, smooth and soft
Term
BRISTOL STOOL FORM SCALE
explain Type 5
Definition
soft blobs with clear-cut edges (passed easily)
Term
BRISTOL STOOL FORM SCALE
explain Type 6
Definition
fully pieces with ragged edges, mushy stool
Term
BRISTOL STOOL FORM SCALE
explain Type 7
Definition
watery, no solid pieces
Term
what is a stoma?
Definition
a temp. or perm. artificial opening in the abdominal wall
Term
what is stool like from a colostomy (AC)or a ileostomy?
Definition
frequent and liquid because they are from the ascending colon
Term
how is stool formed in a transverse colostomy?
Definition
more solid and formed
Term
what type of stool does the sigmoid colon produce?
Definition
near normal
Term
what is a loop colostomy and when is it done?
Definition
Done usually in emergencies
surgeon pulls a loop of bowel into the abdomen andd a external supporting device is used to keep the bowels from slipping back
Term
end colostomy (hartmanns pouch)
Definition
one stoma formed from the proximal end of the bowel with the distal portion ofthe GI tract either removed or sewn closed and left in the abd. cavity
Term
double-barrel colostomy
Definition
bowl is surgically severed and the 2 ends are brought out onto the abd.
Term
how many L/min in a venturi mask?
Definition
up to 12
Term
how many L/min in simple face mask?
Definition
8
Term
define diffusion
Definition
the process for the exchange of respiratory gases in the alveoli and the capillaries of the body tissues
Term
define perfusion
Definition
perfusion is the process of delivery of blood to a capillary bed in the biological tissue.
Term
define ventilation
Definition
the rate at which gas enters or leaves the lung
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