Term
| Briefly discuss and define Cystic Fibrosis. |
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Definition
| Cystic fibrosis is a generalized malfunction of the exocrine glands. Individuals with cystic fibrosis will produce excessive amounts of viscous mucous that blocks the respiratory passage ways causing respiratory distress, and failure. Cystic fibrosis is an autosomal-recessive disorder. As the infant ages disease progression causes obstruction of the alveoli and production of atelectasis. The individual will suffer multiple bouts of pneumonia, and right-sided heart failure. The pancreatic ducts may become obstructed as well with tenacious secretions that do not allow for the digestive enzymes (trypsin, lipase, and amylase) to reach the duodenum resulting in impaired fat absorption. The sweat of individuals with cystic fibrosis has increased amounts of sodium and chloride. Individuals with cystic fibrosis may also experience liver failure due to biliary duct obstruction. |
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Term
| Discuss the attributes of personal and social development of children ages 12 to 36 months. |
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Definition
| The fifteen month old child tolerates periods of separation from the mother without difficulty, may imitate the parent, might have episodes of temperament or unwanted behavior, and may chose to not use a bottle. At eighteen months the child will designate items as belonging to them or us the word mine, may develop a need for security objects such as blankets, bottles, and special toys, and may begin to test his/her limit of actions. At twenty-four months the child will begin to separate from the mother and display attributes of independence. At 24 months a child might have an imaginary play mate, help undress themselves, realize right from wrong, and begin to ritualize events such as bedtime, nap time or story time. |
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Term
| Briefly discuss the attributes of language for school age children. |
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Definition
| At age six a child has a vocabulary of approximately 2,500 words, reads simple sentences, and is beginning to sound out words. The six year old will count by ones, fives and tens, can distinguish right and left, and knows morning, noon, and night. Children age seven are able to name dates, months, years, and seasons, can tell time, add and subtract and use simple logic. At age eight a child has developed an increased memory and vocabulary, and can define words. The nine year old child has an increased attention span, and can use practical knowledge in activities. Ten year olds like memorization, are interested in society, and continue to have difficulty making connections with facts. At age eleven a child wants to know the mechanism of things, and likes to read. The twelve year old may enjoy science and social studies, and can explain abstract thoughts. |
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Term
| Briefly discuss work and play for the adolescent. |
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Definition
| Characteristically the adolescent spends more time involved in peer activities and less time involved in family activities or activities with the parents. Adolescents have and enjoy employment. The adolescent is partial to team activities and cooperative play where physical skills are demonstrated and utilized. Adolescents begin to develop an interest in social activities and functions. Adolescents are typically involved in the following activities, clubs, sports (in or out of school), arts, crafts, reading, movies, music, socialization with friends, self-improvement activities, and some are involved in religious activities such as church, and youth organizations. |
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Term
| Briefly discuss clinical manifestations of Rh system incompatibility and treatment. |
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Definition
| Signs and symptoms of Rh incompatibility include healthy appearing neonates or neonates who are slightly pale in appearance. Minimal hepatomegaly and splenomegaly is apparent in the neonate. If the neonate has an enlarged liver or spleen this is an indicator of anemia and places the neonate at an increased risk for cardiovascular disease and shock. Hyperbilirubinemia and icterus neonatorum (neonatal jaundice) may appear following birth related to the destruction of erythrocytes and maternal antibodies that remain in the circulatory system of the neonate for several weeks post birth. This neonate will require transfusion with the needed Rh factor antibodies. If no antibodies are transfused bilirubin will deposit in the brain of the neonate causing kernicterus and cerebral damage. Neonates with incompatibility issues are given Rh immune globulin or RhoGAM which is an antibody that works against Rh antigen D; this immune globulin should be given within the first 3 days (72 hours) of exposure to Rh positive erythrocytes. |
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Term
| Discuss and explain Total Parenteral Nutrition (TPN). |
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Definition
| Total Parenteral Nutrition is nutrition that is maintained totally by central intravenous routes, or nongastrointestinal routes. The purpose of total parenteral nutrition is to provide calories, nutrients, lipids, and protein to the body. Total parenteral nutrition maintains a positive nitrogen balance that will allow for healing. Total parenteral nutrition is a mechanism to replace lost electrolytes, vitamins, and minerals to the body. Total parenteral nutrition can be administered via a peripherally inserted catheter (termed a picc line), or a centrally inserted catheter (central line). The nurse is responsible to assess the site for possible infections that may occur, tissue damage such as infiltration, and phlebitis or inflammation. |
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Term
| Briefly describe the developmental tasks of the middle adult years (ages 40 to 64). |
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Definition
| Erickson's Psychosocial Theory of Development states that the individual age forty to sixty-four is focused on productivity, creativity, and generativity. The individual age forty to sixty-four traditionally tries to maintain a profitable and enjoyable occupation. The middle-age adult is typically concerned with the amount of time they have left to live. Stagnation vs. self-absorption is the developmental task of the middle-aged adult. If the individual is unable to accept the changes in ones life they may feel sorry for themselves, cease to be productive, become depressed, or become ill with psychosomatic illness. |
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Term
| Briefly discuss hiatus hernia. |
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Definition
| Hiatus hernia is an opening in the diaphragm that becomes enlarged allowing part of the stomach to descend upward into the esophagus. Hiatus hernia causes a reflux of gastric content into the lung, esophagus, and or larynx. A hiatus hernia may or may-not have inflammation. Signs and symptoms of hiatus hernia include but are not limited to heartburn (pyrosis), regurgitation, dysphagia (difficulty swallowing), angina like chest discomfort and pain, bronchospasms, exacerbations of asthma, laryngitis, and chronic cough due to gastric juices entering the oral cavity, and pharynx causing irritation. |
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Term
| Briefly discuss the developmental tasks of the older adult (age 65 and over) according to Erickson. |
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Definition
| Erikson's Psychosocial Theory of Development states that the older adult is concerned with maintaining his or her identity or ego integrity. The older adult is adjusting to new situations including economic, social, familial, and sexual changes that occur with age. The older adult may experience a fear of death, as well as fear of becoming an invalid or a burden to their family. Older adults fear loss of self as they age and the ability to function as they once did. The older adult may experience feeling of despair related to the increased age and attributes of his or her increased age and the normal aging process. The older adult may feel apprehension related to body image changes due to age. The older adult often feels worthless, as they are unable to perform tasks as they once did. |
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Term
| Briefly discuss Parkinson's disease. |
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Definition
| Parkinson's disease is a neurological disorder characterized by a lack of dopamine (a neurotransmitter). The deficiency of dopamine may occur related to degeneration, vascular disorders or inflammatory changes. Parkinson's is characterized by rhythmic muscle tremors, rigidity with movement, festination (gait in which the trunk, legs, knees, and hips are flexed, but remain stiff), droopy posture, tremors of the hands, pill rolling may also be present. Other signs and symptoms may include a mask like facial expression, and weight loss. The individual with Parkinson's disease may be unable to enunciate words properly. Treatment for Parkinson's consists of medications, treatment of associated depression, and therapies that will include physical, occupational and speech. Education should be given to the patient related to disease, and disease process. The nurse should explain the benefits of small frequent meals, increased amounts of liquid in the diet and increased fiber in the diet. The nurse should also educate the client on support systems available. |
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Term
| Briefly discuss confidentiality and nursing. |
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Definition
| Confidentiality relates to maintaining privacy with client information, client status, client chart, and client condition. The nurse should be aware confidentiality is protecting the patients information that he or she may not want divulged to other individuals. Confidentiality respects the patients/clients autonomy and privacy, supports a trusting relationship between the nurse and the client, and assists in preventing harm to the patient. Confidentiality is based on the premise it will promote the greater good of society. Exceptions to patient confidentiality include testifying in court, reporting communicable diseases, reporting child abuse, spouse abuse and or elder abuse. The nurse is responsible for reporting suspicious or gunshot wounds if they are believed to have occurred as the result of a crime. Information relating to workers compensation issues is also an exception to the confidentiality of clients. |
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Term
| Briefly discuss the most common problems with maintaining an intravenous access site. |
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Definition
| Infiltration: Infiltration occurs when a substance is penetrated into a cell or tissue. The nurse should assess an IV site for infiltration with each assessment. Common signs and symptoms of infiltration include swelling, tenderness at site, decreased or no infusion rate, blanching of the skin at the IV site and surrounding tissue, and the site of an infiltration may be warm to touch. Treatment of an infiltration includes discontinuing the IV, and application of warm compresses to the area. Phlebitis: Phlebitis is inflammation of a vein. The nurse should assess an IV site for phlebitis with each assessment. Common signs of phlebitis include a red line of irritation along the course of the vein. Additional signs of phlebitis include erythema (redness), heat, swelling (edema), and tenderness. Treatment of phlebitis includes discontinuation of the IV, and application of warm compresses. |
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Term
| Briefly discuss the pathophysiology of gastric ulcers. |
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Definition
| Gastric ulcers form in the antral region of the stomach, adjacent to the acid-secreting mucosa of the body. Gastric ulcers are formed related to a defect within the permeability of the mucosa increasing the permeability to hydrogen ions. Gastric secretions are often altered. Frequent chronic gastritis causes the mucosa to have a decreased ability to secrete protective mucous. Reflux that causes chronic irritation to the gastric mucosa also is a factor for gastric ulcers. Increased amounts of bile salts disrupt the gastric mucosa and decrease the electrical potential of the gastric mucosal membrane causing hydrogen ions to diffuse into the gastric mucosa and cause erosion. |
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Term
| Briefly discuss CAT (computed axial tomography)/CT (computed tomography) scans. |
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Definition
| The computed tomography (CT) scan offers imaging of sections of the body from various angles. Computed tomography will assist in early diagnosis of disease and disease processes. The CT is approximately 100 times more sensitive than the normal x-ray. Computed tomography can be performed with or without contrast dye (media). Contrast offers enhanced views of the organs and structures being examined; an example is increased visibility of small tumors or abnormalities. The computed tomography is utilized for viewing the brain, head, chest, abdomen, pelvis, spine, and bones of the body. Computed tomography (CT) is utilized most often in determining coronary artery disease, lesions of the head, liver, and kidney. CT also assists in the diagnosis of tumors, edema, abscesses, infection, metastatic diseases, vascular disorders, stroke, and bone destruction and deformity. CT is also used to locate and identify foreign object within soft tissue. |
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Term
| Briefly discuss pressure ulcers (decubitus ulcers) and the most frequent location of occurrence. |
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Definition
| Pressure ulcers are a chronic ulcer that appears in an area of pressure on the human body. Pressure ulcers are the end result of pressure on overlying skin of bony prominences in patients who are debilitated, have restricted or limited motion, are confined to bed or chair, or are immobilized for any reason. Circulatory compromise or deficiency is a leading contributor of pressure ulcers. Pressure ulcers are also termed bedsores, decubital gangrene, pressure sores, and hospital gangrene. The most frequent location of pressure ulcers is the occiput at the base of the skull, the scapula, the sacrum, the elbows, the ischial tuberosity, the trochanter, the calcaneus, and the lateral malleolus. |
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Term
| Briefly define the term dietary standards. |
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Definition
| Dietary standards are a set of guidelines in which an individual can understand essential nutrients, food consumption and the relationship they possess. Not only do dietary standards increase understanding of foods and their nutritional values they offer a mechanism of comparison. Recommended Dietary Allowances (RDA) is a set of standards the federal government mandates each individual needs on a daily bases to maintain balanced and adequate nutrition. Reference Dietary Intake (RDI) is a combination of recommended daily allowances and mechanisms of risk reduction for diseases such as coronary artery disease, obesity, cancer, and osteoporosis. Dietary standard of RDA, and RDI are used today with meal preparation for our military personnel, groups such as WIC (Women, Infants, and Children), and meals on wheels programs through out the country. |
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Term
| Briefly discuss the body mass index (BMI). |
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Definition
| The body mass index is a method of measurement that includes the height and weight of an individual to determine body fat as it relates to nutritional status. The body mass index is determined by dividing the weight in kilograms by the height in meters squared. The preferred range for BMI for the adult is 18-25 kg/m2. A body mass index of less than 18 is considered malnourished. A body mass index of greater than 25 designates the individual as overweight. A body mass index of greater than 30 is considered obese. Body mass index is calculated by dividing the weight in kilograms by the height in meter squared. |
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Term
| Briefly discuss opioid analgesics. |
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Definition
| Opioid analgesics include drugs such as heroin, and morphine. Opioids are derived from opium and opium is harvested from poppy. Opioids are highly addictive, cause emotional lability and decrease the ability to learn and memorize. The most common opioids used today are morphine, methadone, fentanyl, naloxone, and butorphanol. The effects of opioids include pain relief (analgesia), elevated mood, and euphoria, decreased respiratory status, decreased cardiovascular status, and altered gastrointestinal and endocrine function. Opioids act in the forebrain to cause an analgesic effect. Respiratory depression that often accompanies opioid use involves a reduction of responses from the brainstem or respiratory center. Morphine an opioid is often used in treating pain accompanying an MI. The action of morphine is treating angina pectoris by decreasing preload, inotropy and chronotropy relieving ischemia and allowing oxygen to return to the myocardium. |
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Term
| TSH (Thyroid stimulating hormone): The normal TSH values are: Adult 0.35-5.5 uIU/ml. Newborn: <25 uIU/ml. |
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Definition
| Thyroid stimulating hormone is secreted by the anterior pituitary gland (anterior hypophysis) in response to thyroid releasing hormone (TRH) from the hypothalamus. Thyroid stimulating hormone (TSH) is a catalyst (stimulates) the production of T4 (thyroxine) from the thyroid gland. TSH is dependent upon the negative feedback mechanism of the body; decreased levels of T4 cause the release of TRH and in turn stimulate the production of TSH. Thyroid stimulating hormone (TSH), and T4 (thyroxine) measurements are utilized to differentiate thyroid and pituitary functions among individuals with hormonal irregularities, and suspect disease states. Thyroid stimulating hormone is often utilized to determine hypothyroidism caused by the pituitary. Decreased levels of TSH may indicate secondary hypothyroidism related to pituitary problems. The nurse should keep in mind that ASA (aspirin), steroids, dopamine and heparin will alter the results of TSH and may cause false readings. |
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Term
| Explain enteral nutrition. |
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Definition
| Enteral feedings require a tube to be placed into the stomach or jejunum via the abdominal wall; this feeding tube provides liquid nutrition while maintaining the functionality of the gastrointestinal system. Enteral feedings can be temporary or permanent and provide 100% of the daily nutritional requirement of individuals in multiple situations. Feedings are specific to disease process as with the pulmonary, renal and cardiovascular systems, and often contain milk products. It is common to begin enteral feeding at a slow rate and graduate hourly intake to a maintenance goal. Enteral feedings often cause diarrhea upon initial usage, but this does clear with time and gastrointestinal adjustment. Keep in mind feeding tube should be kept patent and placement checked per facility policy at minimum every shift. |
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Term
| Briefly explain Dumping Syndrome. |
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Definition
| Dumping syndrome is a term used to describe a rapid cycle of gastric emptying. Symptoms associated with dumping syndrome include flushing, diaphoresis, weakness, dizziness, nausea, abdominal cramping, diarrhea, and potential vasomotor failure (tachycardia, orthostatic or positional hypertension). When large volumes of food are placed into the small intestine too quickly, fluid is pulled from within the cells to accommodate digestion and hypovolemia occurs causing the symptoms associated with dumping syndrome. Dumping syndrome occurs most often after ingestion of a large meal (post-prandially). It is common for a client to experience both intestinal and vascular symptoms together or have a mono reaction of the intestinal symptoms or the vascular symptoms. |
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Term
| Briefly discuss the pathogenesis of acute respiratory syndrome. |
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Definition
| The hallmark of acute respiratory distress syndrome (ARDS) is inflammation of the lungs. Early in acute respiratory distress syndrome the pulmonary neutrophils gather in great amounts at the site of inflammation, intraluminal fibrin and platelets also aggregate at the site of inflammation. Injuries from inflammation lead to edema from capillary leaks. This fluid contains plasma proteins that can inactivate the surfactant of the alveoli and cause lack of elasticity with respiration and lead to alveolar collapse. Fibrin clotting then causes obstructed airspaces. The result is decreased respiratory compliance, decreased function, decreased residual volumes, and dead airspace. The end result for the client is ventilation perfusion mismatching, intrapulmonary shunting, and hypoxemia, thrombus, and hypertension, and death. |
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Term
| Briefly discuss the nurses rights and responsibilities. |
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Definition
| The primary responsibility of the nurse is to provide safety in healthcare for all individuals. Therefore nurses have the right to refuse assignments that jeopardize the client or the nurse, or place the client in immediate or serious danger. Nurses have the right to refuse to treat patients that are beyond their scope of practice. Nurses have the right to not be abused by clients, co-workers or employers. Nurses have the right to ask for clarity with assignments, assess his or her personal abilities as they relate to clients and client situations, and assist in identifying options that will fulfill the assignment. Nurses are responsible to know their scope of practice, the patient's rights, hospital policies and procedures, as well as standards of care and community norms. |
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Term
| Briefly discuss causes and treatment of pulmonary edema. |
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Definition
| Pulmonary edema is characteristically caused by left heart failure, ischemic disease of the heart, acute myocardial infarction (MI or heart attack), aortic mitral valve disease, hypertensive heart disease, cardiomyopathy, fluid overload, arrhythmias, endocarditis, myocarditis, congenital heart disease, rheumatic fever, septal defects, shock, trauma, infection, sepsis, pneumonia, pulmonary obstruction, embolism and pancreatitis. Treatment of pulmonary edema consists of treating the underlying condition or cause of pulmonary edema. Other treatment measures include having the patient sit up and allow the legs to dangle, the use of oxygen, rotating tourniquets, mechanical ventilation that may include a ventilator with positive end expiratory pressure (PEEP). Low sodium diet, bedrest, fluid restriction, and education on the disease process are all part of treatment of pulmonary edema. Medications utilized to treat pulmonary edema include morphine sulfate, furosemide, nitroglycerin, and angiotensin converting enzymes. Patients who experience pulmonary edema on a chronic basis are often treated with digoxin, beta-blockers, and isosorbide dinitrates. |
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Term
| Discuss and explain the purpose of amniotic fluid. |
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Definition
| Amniotic fluid is a protective mechanism for the fetus. Amniotic fluid also functions to maintain a constant temperature for the fetus. Amniotic fluid increases in amount as the pregnancy matures. The fetus typically ingests 600 ml of amniotic fluid every 24 hour period and produces urine that is part of the total amount of amniotic fluid. Amniotic fluid consists of albumin, creatinine, urea, uric acid, lecithin, sphingomyelin, bilirubin, fat, fructose, leukocytes, protein, enzymes, and epithelial cells. Amniotic fluid flows freely throughout the fetal lungs at a rate of 400 ml daily. Ruptured membranes or leaking of amniotic fluid is one of the first signs of impending labor and birth. |
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Term
| Discuss and describe the attributes of a child's behavior who has experienced abuse. |
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Definition
| Children who have experienced abuse may exhibit behaviors such as aggression, and/or pulling back. Abused children often express fright with the home environment and/or the individual who is abusing them. Abused children display apprehensive behavior when they witness episodes of weeping among other children. Abused children often display no emotion with parents. With any display of affection the abused child may become friendly, and interested in the individual. Abused children often avoid eye contact. Children who are abused will also show signs of rigidity when they are approached, and may have inappropriate responses to painful procedures. |
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Term
| Explain the purpose and attributes of informed consent. |
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Definition
| Informed consent is intended to facilitate appropriate, knowledgeable decision making among clients who are hospitalized, receiving specialty services and/or making any type of decision regarding health care. Informed consent should be directed toward the educational and cognitive level of the client. All possible outcomes and consequences of the procedure or treatment should be explained in as much detail as needed to ensure the client fully understands what is to be done and the potential outcomes. Informed consent must be signed and acknowledged by both the physician and the patient; nurses are no longer responsible for the information on and for obtaining informed consent, but do function as the witness to informed consent. |
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Term
| Briefly discuss language development in the infant stages of life. |
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Definition
| At 2 months the infant will make noises in his/her throat, and have a variation of cries depending upon the situation. At age 3 or 4 months the infant will laugh out loud, respond with coos and gurgles when spoken to, vocalize with a familiar voice, and be able to pronounce consonants such as n, k, g, p, and b. During age five or six months the infant will begin to make vowel sounds such as ah, eh, and uh, and vocalize syllables that may be well defined. At seven to eight months the infant will begin to make sounds such as da, and ba, will imitate sounds, combine syllables, and make consonant sounds such as t, d, and w. An infant age nine and ten months will say mama or dada and realize who they are speaking of, will have a vocabulary of approximately 3 to 5 words, understand bye, and may begin to respond to simple one step commands. At age eleven and twelve months the infant will have a 5+ word vocabulary, and will begin to imitate animal sounds. |
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Term
| Discuss attributes of active listening, and how it pertains to nursing. |
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Definition
| Attributes of active listeners include conveying warmth and respect, and offering acceptance of the client. The nurse must acknowledge all behavior of the client and realize it has meaning. The nurse must set boundaries and abide by them when taking part in a conversation. Do not lead the client in a direction; allow ample time for expression making head gestures, and using body language. The nurse should ask questions related to the topic of discussion, maintain eye contact with the client, and face the client, lean in as listening intently, nod, smile, and frown to show agreement or disagreement. The nurse must be aware of his or her own experiences and how they can alter the relationship with the client. |
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Term
| Briefly discuss mastitis and treatment for mastitis. |
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Definition
| Mastitis may also be identified as mastadenenitis. Mastitis may be more specific in name to the type of breast tissue involved. Mastitis is characterized by an inflammation in the breast tissue and occurs most often in women who are lactating. Organisms associated with mastitis include staphylococcus aureus, Escherichia coli, and streptococcus. Predisposing factors for mastitis include breast fissures, cracked nipples, overfilling, manipulation or milk stasis. Nurses should be aware that the lactating mother may have developed mastitis from the upper respiratory tract of the infant who is breast feeding. Good hygiene should be taught to lactating mothers to prevent the event of mastitis. Treatment for mastitis includes supporting undergarments (bra), breast feeding more often, warm and cool compresses to assist with pain, and mild analgesics. Non-steroid anti-inflammatory medications may also be utilized to aid in the discomfort and inflammation associated with mastitis. |
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Term
| Briefly discuss cocaine/crack and pregnancy. |
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Definition
| Cocaine and/or crack have a systemic effect on the nervous system which blocks the use of dopamine and norepinephrine. The result of a lack of dopamine and norepinephrine is noted with vasoconstriction, causing elevated blood pressure (hypertension), and elevated heart rate (tachycardia). Vasoconstriction is a narrowing of any artery or vessel. The umbilical cord that supplies nutrients and oxygen to the fetus via the blood is made of arteries and vessels that are a direct route from mother to fetus. A natural constriction of the umbilical cord takes place with ingestion of crack/cocaine resulting in a decreased supply of blood to the fetus. A decreased blood supply decreases the amount of nutrients and oxygen to the fetus causing growth and mental retardation. Women who continue to abuse crack/cocaine during pregnancy have an increased risk for abruptio placenta, abortion in the first trimester, growth limitations, premature, and non-living births. Babies who are born to mothers who ingest crack/cocaine have a tendency to have lower APGAR scores, neurological problems, irritability, increased startle reflexes, altered emotions (labile-easily altered), mental retardation, and an increased risk for sudden infant death syndrome (SIDS). |
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Term
| Briefly discuss the attributes of a vegetarian diet. |
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Definition
| The vegetarian diet consists of primarily fruits, and vegetables and no meat. Among the various types of vegetarian diets is the lacto-ovovegetarian diet in which the individual does allow for the consumption of dairy and eggs in their diet. Lactovegetarians on the other hand do not allow egg in the diet but do consume dairy products. The vegan diet does not allow for the consumption of animals. Ethnic vegetarians do not include any products that have any association with animals, animal by-products or that have been tested on animals. A fruitarian vegetarian consumes only fruits, nuts, berries and seeds. A living food diet vegetarian consumes only fruits and vegetables that are raw. A semi-vegetarian consumes dairy, eggs, poultry, and fish. |
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Term
| Briefly discuss the attributes of battered women. |
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Definition
Thank you for signing up for Test Prep Review's NCLEX Question of the Day email service. These questions are provided by Morrison Media, who publishes the NCLEX Secrets Study Guide and NCLEX Flashcard Secrets, both proven methods to help you get the results you want on the NCLEX.
Today's question concerns Abuse.
The question/task is below:
Briefly discuss the attributes of battered women.
Scroll down for the answer:
Answer:
Women who have experienced abuse will often feel they themselves have failed as a mother, wife, or caregiver and accept the abuse as a normal healthy relationship. Often abused women do not have close family relationships or friendships. Abused women display low self-esteem, prefer isolation, show lack of independence in decision making skills, and express fear or anxiety related to confronting or upsetting the abuser. Battered women often are abusers themselves of their children, and exhibit risqué behaviors. Women who suffer abuse may feel shame and deny any abuse has occurred. Conflicting stories related to injuries, the spouse who dominates the questioning and unexplained injuries are all red flags for abuse. (Clinical note: It is very appropriate for the nurse to first interview a couple, and then do a single interview with the individual they feel is being abused.) |
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Term
| Briefly discuss the cultural attributes of the Chinese diet. |
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Definition
| Traditionally the Chinese diet consists of a variety of rice, corn and wheat products. Among the vegetables consumed by the Chinese most often are roots, bamboo shoots, cabbage, Chinese celery, green leafy vegetables and other leaves such as the amaranth green, chard, okra, peas, and the white radish. The Kumquat is the major fruit consumed among the Chinese culture. The Chinese consume fair amounts of fat and oils such as peanut, soy, sesame, rice and lard. Among the meats consumed are fish, seafood, legumes, nuts, pork, and organ meats. Traditionally the Chinese culture does not have an increased amount of dairy products in their diet. |
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Term
| Briefly discuss the 4 areas of the nutritional assessment. |
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Definition
1. Take a history of the dietary intake over the past several days to ensure the period extends beyond 24 or 48 hours. The diet assessment history gives insight into the individuals' daily routine, dietary habits, and patterns. Evaluate the diet to note areas of deficiency.
2. Perform a physical examination of the individual to determine height, weight, BMI, overall hydration status, and general condition.
3. Anthropometric (comparing measurements of the individual from previous exams) examination will establish normal growth and alert the health care provider to abnormalities in growth.
4. Biochemical analysis or evaluation of the individual's molecular findings. |
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Term
| Briefly discuss fatty liver. |
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Definition
| Fatty liver is also referred to as hepatic steatosis and is characterized by greater than 30% of liver cells having fat deposits. The condition of fatty liver occurs as the result of alcohol intake, increased amounts of kilocalories in the diet, obesity, the use of corticosteroids, elevated triglycerides are also linked to fatty liver. The majority of patients remain asymptomatic while some develop localized pain over the area of the liver, hepatomegaly, splenomegaly, fatigue, ascites, and edema. Treatments include weight reduction, maintenance of triglyceride levels, control diabetes if this is a factor, discontinue use of alcohol, and daily physical exercise. |
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Term
| Discuss Multiple Organ Dysfunction Syndrome (MODS) and nutritional requirement needed. |
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Definition
| Multiple organ dysfunction syndrome is the progressive malfunction of two or more organ systems within the body occurring consecutively. Patients who suffer multi-organ failure require an increased number of kilocalories to maintain the high rate of metabolism (hypermetabolic state) needed to produce the required amounts of energy for cell function to take place. An individual with multiple organ dysfunction syndrome may exhibit symptoms such as lethargy, altered level of consciousness, an elevated body temperature, have lower than normal lymphocyte counts, lack energy, experience ascites, and may experience an alteration in bowel pattern or decreased peristalsis. |
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Term
| Discuss tertiary prevention as it pertains to nutrition. |
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Definition
| Methods of tertiary prevention occur once the disease is established in the body. Mechanisms of prevention at this stage are aimed at decreasing further complications as well as production of the best possible outcome. Education on disease processes and treatment are part of tertiary prevention. Maintaining a diet that will produce the most effective outcome of the treatment prescribed is a mechanism of tertiary prevention. Nutritional therapy is often a main prevention mechanism with disease processes such as gastric ulcer, ulcerative colitis, diverticulitis, and coronary artery disease (CAD). Tertiary prevention is relevant with cancer patients that may no longer be able to tolerate foods they once chose to consume, and need to be reeducated (counseled) on the benefits of a well balanced diet and their disease process. |
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Term
| Briefly discuss Diabetic Ketoacidosis (DKA). |
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Definition
| Diabetic Ketoacidosis can be fatal and should be dealt with in a rapid and responsible manner. With diabetic ketoacidosis the body does not have an adequate supply of insulin to meet the demand for the amount on nutrient intake that is present. Ketones are present with diabetic ketoacidosis; the body is utilizing fatty acids for energy thus producing an abnormal amount of ketones (ketosis). With ketoacidosis the glucose level is elevated and the patient is suffering life-threatening hyperglycemia. Symptoms include Kussmaul respirations; this is a respiratory rate that is deep and shallow. The individual with DKA will have fruity odor to the breath, dry mucous membranes related to the dehydration occurring within the cells, anorexia or polyphagia, polydipsia, hypotension, hypothermia, confusion, tachycardia, tachypnea, hypothermia, weakness, malaise, lethargy, nausea, and/or vomiting. Patients suffering DKA will need immediate fluids (1000ml the first hour is standard) and intravenous insulin, blood glucose monitoring. |
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Term
| Briefly discuss oogenesis. |
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Definition
| Oogenesis is the method for the creation of the female haploid (oocyte) that contains 23 of the 46 needed chromosomes for a normal human cell to develop. The oocyte develops from the oogonial cells of the ovary. When a female is born she possesses all the female eggs (ova) that she will ever produce. The process of meiosis begins prior to birth and ceases until puberty begins. The process of meiotic division continues in the fallopian tube of the pubescent female. The oocyte undergoes 2 cell divisions, the first produces a microscopic polar body or an X chromosome (female chromosome), and a secondary oocyte. The second cell division occurs at the time of ovulation and completes cell division upon fertilization. The end product is 4 haploid cells, three microscopic polar bodies that will eventually dissipate, and a female egg. |
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Term
| Explain and discuss the fetal, and neonatal risks of diabetes and pregnancy. |
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Definition
| Elevated maternal serum glucose levels with increased production of ketones in the mother cause a fifty percent increase in fetal death. Fetal congenital abnormalities include cardiological defects that include septal anomalies, coarctation of the aorta, lesions, and transposition of the great vessels. Hydrocephalus (increased size of the ventricles due to an increased amount of cerebral spinal fluid), meningomyelocele (a protrusion of the spinal cord related to a flaw in the formation of the vertebral column), and anencephaly (absence of portions of the brain). Sacral Agenesis is also a congenital anomaly that is characteristic for diabetic mothers. These babies are born with defects in the lower region of the spinal column. Mother's with diabetes have abnormally large babies. Respiratory distress syndrome and polycythemia are also seen in babies born to mothers who have diabetes. As nurses it is important to counsel and educate those at risk prior to conception to avoid birth related anomalies as much as possible. |
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Term
| Briefly discuss attributes of health promotion in infancy. |
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Definition
| Health promotion of infants includes meeting the physiological needs of the infant. These physiological needs include sleep, fresh air, and adequate amounts of natural sunlight, skin care, appropriate dress, and promotion of regular elimination patterns. Solid foods should be added to the diet slowly during infancy. Finger foods at approximately six months, soft table foods at 12 months, diluted juices at 6 months, new foods one at a time, and avoid egg whites until 12 months related to the potential for allergic reactions. Safety issues of infants include accident prevention mechanisms. Immunizations begin during infancy as a prevention mechanism. And routine practitioner visits are done during infancy to monitor health status, growth and development. |
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Term
| Briefly discuss fine motor development at age one to three years. |
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Definition
| At approximately fifteen months of age a child is able to stack 2 blocks, scribble, open packages, and use a cup without difficulty. At approximately eighteen months a child is capable of using a spoon with little or no difficulty, build a tower with several blocks, and turn pages. At 24 months a child can manipulate 6 or 7 blocks, copy lines, open doors by turning a knob, open lids with a twist motion, and use scissors. A child of 30 months can build a tower with eight or greater blocks, and copy pictures such as arrows, crosses or large outline prints. |
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Term
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Definition
| Asthma is an obstruction of the bronchioles, characterized by inflammation and constriction. With asthma the airways constrict causing airway obstruction. This constriction can be caused by spasms, edema to the respiratory mucosa, bacterial or viral infections, and mucous from allergic responses. The clinical hallmark sign of asthma is expiratory wheezes. Other signs of asthma include inspiratory wheezing, cough, and chest discomfort that is described as a tight feeling or pressure. Signs and symptoms of asthma include difficulty breathing (dyspnea), wheezing, productive cough, diaphoresis, neck vein distention, tachycardia, increased respirations, cyanosis, and anxiety. Asthma may be induced by strenuous physical exercise or activity. The nurse should be aware and educate the client on the causes of asthma including pollens found in the air, mold, dust mites, cockroaches, dander, and feather pillows. Tobacco smoke, air pollutants, infections, aspirin products, cold air, respiratory infections, and GERD (Gastroesophageal reflux disease) are also causes of asthma and acute asthma exacerbations. |
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Term
| Briefly discuss attributes of language for the 3 to 5 year-old. |
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Definition
| Three year old children have a vocabulary of approximately 900 words and may speak in complete sentences using three or four words. The three year-old will use plurals in his/her speech. The three year-old is aware of his/her family name. A three year old will constantly ask questions and may sing simple songs. Four year old children have a vocabulary of approximately 1,500 words. At age four a child may begin to use profane words they have heard and exhibit name calling behavior. The four year-old likes to exaggerate his/her stories. The four year old can understand simple analogies, and will repeat four numbers. Age 4 is the peak questioning age for children. The vocabulary of a five year old child consists of 2,100 words. The five year old speaks in sentences using five or six words, utilizes all parts of speech, and asks relevant questions. |
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Term
| Briefly discuss the motor development, and language of the adolescent. |
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Definition
| Early adolescence is described as the thirteenth and fourteenth year. At this age the individual will enjoy being involved in sports, and dance. The adolescent at age 13 and 14 will begin to become more graceful with movement, but continue to have episodes of clumsiness. The term late adolescence is used to describe the years between ages fifteen and eighteen. The adolescent age fifteen to eighteen will have adult levels of motor function and control and be able to move without episodes of clumsiness. The adolescent will experience a very fast increase in vocabulary that will include slang and teenage jargon. |
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Term
| A septic client with hypotension is being treated with dopamine hydrochloride (Inotropin). The nurse asks a colleague to double-check the dosage that the client is receiving. There are 400 mg of dopamine hydrochloride in 250 ml, the infusion pump is running at 23 ml/hour, and the client weighs 79.5 kg. How many micrograms per kilogram per minute is the client receiving? |
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Definition
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Term
| A client returns from the operating room after receiving extensive abdominal surgery. He has 1,000 ml of lactated Ringer's solution infusing via a central line. The physician orders the I.V. fluid to be infused at 125 ml/hour plus the total output of the previous hour. The drip factor of the tubing is 15 gtt/minute and the output for the previous hour was 75 ml via Foley catheter, 50 ml via nasogastric tube, and 10 ml via Jackson Pratt tube. For how many drops per minute should the nurse set the I.V. flow rate to deliver the correct amount of fluid? |
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Definition
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