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Patient Care
Chap 15
| Question | Answer |
|---|---|
| -a relative constancy in the internal environment of the body that is naturally maintained by adaptive responses that promote healthy survival | homeostasis |
| What are the primary mechanisms that maintain homeostasis? | heartbeat, blood pressure, body temperature, respiratory rate, and electrolyte balance |
| -primary mechanisms that adapt to responses inside or outside the body to maintain homeostasis | vital signs |
| What are the vital signs? | body temp, pulse rate,blood pressure, respiratory rate, mental alertness (sensorium) |
| Why are vital signs important? | they often reveal the first clue of adverse reactions associated with treatments and diagnostic procedures |
| -reflects the degree of heat of the deep tissues of the human body | body temp |
| -the term used to describe the body's maintenance of heat production and heat loss | thermoregulation |
| What plays an important role in regulating heat loss? | hypothalamus |
| What can initiate peripheral vasodilation and sweating to dissipate body heat? | hypothalamus |
| What does diaphoresis mean? | sweating |
| What does shivering do? | generates heat |
| What does vasoconstriction do? | conserve heat |
| The _______ thermometer has a rounded bulb whereas the _______ type has a slender, more pointed tip. | rectal / oral |
| 5 routes commonly used to measure body temp: | 1. oral 2. axillary 3. tympanic 4. temporal 5. rectal |
| - temp obtained by placing the thermometer high between the upper arm and the torso | axillary |
| How long must the thermometer stay in place for an accurate axillary reading? | 5-10 mins |
| How long does it take for an accurate rectal reading? | 2.5 - 5 mins |
| -obtained by placing a tympanic membrane thermometer in the ear | tympanic |
| What is believed to be the most accurate way to obtain body temp? | rectal |
| What is a close second to obtaining the most accurate body temp? | temporal artery |
| -when the oral temp is higher than 99.5 a fever exists | hyperthermia |
| A patient with a fever is said to be | febrile |
| -when the patients temperature falls below the normal range | hypothermia |
| What is the normal range for body temp? | 97.6 - 100 F |
| -the depth of breath | tidal volume |
| At rest, what is the normal respiratory rate for an adult? | 12-20 breaths / min |
| What is the normal respiratory rate for a child? infant? | 20-30 breaths / min 30-60 breaths / min |
| During inspiration, the diaphragm contracts and moves? | downard, pushing abdominal cavity outward |
| Downward movment of the diaphragm causes an expansion in the chest cavity and what happens to the pressure? | decreases |
| How is respiratory rate obtained? | by observing the rise and fall of the chest |
| What is the best way to obtain the patient's respiratory rate? | without the patient knowing it |
| -term used to describe rates greater than 20 breaths/min in an adult patient | tachypnea |
| term used to describe a decrease in respiratory rate | bradypnea |
| -results from depression of the respiratory center of the brain-common with drug over doses, head trauma, and hypothermia | bradypnea |
| -difficulty breathing while lying down | orthopnea |
| What is the normal rang for pulse in: an infant? an adult? a child? | 110-170 / min 60-100 beats /min 70-120 beats/min |
| What is considered a normal blood pressure? | 120 / 80 |
| What are the three common sites for measuring pulse rate? | radial artery in the wrist, brachial artery, carotid artery in neck |
| What is ausultation? | listening to the chest with a stethoscope placed over the heart |
| How are apical pulses obtained? | listening to the heart with a stethoscope placed over the chest and counting each heartbeat |
| -reflect the rapidity of each heart contraction and are recorded as the number of beats/min | pulse rates |
| How are arterial oxygen saturation levels measured> | though a periodic blood-gas analyses |
| -catheter that is inserted into an artery | arterial line |
| -nonivasive device used to provide ongoing assessment of the hemoglobin oxygen saturation of arterial blood as well as the patient's pulse rate | pulse oximeter |
| How are hemoglobin oxygen saturation and pulse rate determined? | by measuring absorption of selected wavelengths of light by the circulating blood |
| What is the normal pulse oximeter value for a healthy person? | 95%-100% |
| -when heart contractions & pulse rates increase by more than 20 BPM in the resting adult or reach a rate greater than 100 BPM | tachycardia |
| -decrease in heart rate | bradycardia |
| -measure of the force exerted by blood on the arterial walls during contraction and relaxation of the heart | blood pressure |
| -the pressure that is exerted on the arterial vessels by the blood when relaxed | diastolic |
| peak pressure present during contraction of the heart is... | systolic |
| -the persistent elevation of blood pressure above 140/90 | hypertension |
| -low blood pressure, less than 95/60 | hypotension |
| How long does it take for the brain to suffer irreversible damage without oxygen? | 6mins |
| - colorless, tasteless, odorless gas that plays a critical role in efficent cellular metabolism | oxygen |
| -inadequate amt of axygen at the cellular level | hypoxia |
| What are the tissues most sensitive to hypoxia? | brain, heart, lungs, liver |
| Oxygen is given out in what does? | Liters per min / LPM |
| - a reducing valve that permits the flows safe for patient use and serves as the connection btwn the oxygen-delivery device and the gas source | oxygen flowmeter |
| -indicates pressure or the volume of oxygen inside the cylinder or canister and the flowmeter control operates the rate of oxygen flow in LPM to the patient | pressure manometer |
| What two categories of oxygen conservin devices deliver a specifically measured dose to the patient? | pulse dose & demand devices |
| -delivers a fixed volume of oxygen supply during breathing | pulsed dose |
| ______ regulators provide a continuous flow of oxygen regardless of the patients phase of breathing | conventional |
| - device does not meet the entire inspiratory needs of the patient | low-flow or variable-oxygen |
| -device does meet or exceed the inspiratory needs of the patient when the device is functioning properly | high-flow, fixed or precise oxygen concentration |
| The most common device used to deliver low concentration of oxygen? | nasal cannula |
| Flow rates up to ____ LPM can be used for the nasal cannula. However only flow rates of ______ are used. | 6 LPM / 1-4 LPM |
| ______ is added to the nasal cannula delivery system when flows are greater than 4 LPM are used. | humidity |
| Simple oxygen masks are considered to be what type of device? | low-flow |
| What oxygen rates do the simple mask require? | greater than 6 LPM |
| A ______ mask can deliver a higher percentage of oxygen than the nasal cannula or simple mask. | nonrebreathing |
| _____ are used for infants to deliver oxygen. | oxyhoods |
| What neck position can adversely influence artificial airway placement, particularly in neonatal patients? | flexing or bending the neck |
| What are the 4 uses/needs for endotracheal tubes? | 1. need for mechanical ventilation or oxygen delivery 2. upper-airway obstruction 3. impending gastric acid reflux or aspiration 4. provisions for tracheobronchial lavage |
| - is accomplished most often using a translaryngeal approach via the mouth or nose | tracheal intubation |
| How can you tell if a endotracheal tube has been placed properly? | chest radiograph, showing the distal tip 1-2 in superior to the tracheal bifurcation |
| What is the most common complication of endotracheal tube? | overventilation of the right lung and potential airway obstruction of the left |
| Another word for thoracostomy tubes | chest tubes |
| What are thoracostomy tubes used for? | to drain the intrapleural space and the mediastinum |
| ______ are inserted through the chest wall to reestablish negative intrapleural pressure in cases of pneumothorax, hemothorax, pleural effusion and empyema. | thoracostomy tubes |
| -fluid in the pleural cavity | pneumothorax |
| -blood in the pleural cavity | hemothorax |
| excess fluid in the pleural cavity | pleural effsion |
| -pus in the plerual cavity | empyema |
| ____ are catheters that are inserted into a large vein | CV Lines - central venous |
| What were CV lines developed for? | To administer chemotherapeutic and parenteral nutrition |
| What are these examples of? Broviac, Hickman, Leonard & Groshong | CV catheters |
| What is the goal of the CV postion? | to position the catheter tip in a central vein |
| What is the preferred location of the CV? | The superior vena cava approx 2-3 in above the right atrial junction |
| What is the superior vena cava the preferred location for CV? | bc of the size of the vein |
| What is the most common insertion site for CV catheters? | subclavian vein |
| Another name for Pulmonary arterial (PA) lines? | Swan-Ganz catheters |
| What are PA lines used for? | To estimate left ventricular end-diastolic pressure |
| What are some examples of complications from CV lines? | catheter dislodgment and occlusions resulting from the accumulation of blood clots or drug precipitates |
| -the product of heart rate and stroke volume and is the vital event necessary to maintain blood flow throughout the cardiovascular system. | cardiac output |
| What do you need to accomplish adequate cardiac output? | adequate blood volume and a regular cycle of muscular relaxation and contraction |
| -events that occur from the beginning of one ventricular contraction until the beginning of another | cardiac cycle |
| -abnormalities within the neural conduction system which will adversely affect cardiac output | arrhythmias |
Created by:
erikasmith28
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