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JBullard
Nursing
| Question | Answer |
|---|---|
| Cultural awareness | Knowing differences & similarities among cultures |
| Cultural sensitivity | Being aware of own culture & of other cultures |
| Cultural competence | set of sklls, knowledge & attitudes |
| cultural competence must include | awarness & acceptance difference, understanding differences, developmental cultural knowledge, ability to adapt & practice skills to culture of client |
| ethnocentrism | interpreting beliefs & behaviors of other n terms of own cultural values & traditions.\ |
| sterotypes | oversimplified conceptions, opinions or beliefts about some aspect of a group of people |
| prejudice | bias based on age, race, gender etc. |
| domain | elements that describe scientific varaible |
| 12 domain Purnell/Paulanka | localities & topography, communication, family roles & organization, workforce issues, biocultural ecology, high risk behavior, nutrition, pregnanacy & childbearing, death rituals, spirituality, healthcare practice, healthcare practioners |
| cultural | consists of socially transmitted values, beliefs, & norms of a particular group that guides their thoughts & behaviors |
| Ethnicity | shared identity related to social & cultureal heritage ie. values, language, geopraphical space, & racial characteristics |
| culturally congruent care | fits person valued life patters & set of meanings. requires specific knowledge, skils, & attitudes to deliver |
| verbal communication | what language used, dialect, spoken or written |
| nonverbal | interpretation of body language differs, differ acceptable touch, personal space varies, gesture, expression, body posture |
| cultural assesessment | systematic & comprehensive examination values, beliefs, & practices of individuals, families & communiteis of different culture |
| what is critical thinking? | reasoned thinking, openness to alternatives, ability to reflect, desire to seek truth; art of thinking about thinking |
| what does critical thinking challenge? | think creatively, search for answer, collect data, make inferences, draw conclusions. |
| Questions about critical thinking or AAPIE | Assesstement-analyze-plan-immplementation-evauluation |
| basic critical thinking | think on basis of set rules or principles & follow step by step process w/out deviating. |
| complex crititcal thinking | analyze & examine choices independently & think beyond synthesize knowledge |
| commitment | anticipate needs & make choices w/out assistance from others |
| theories | ways of looking @ discipline in clear explicit terms that can be communicated;what means to heal guides practice |
| illness-wellness continum | people move across spectrum, hemostasis is optimal maintances, nursing focus on adapatation of nursing |
| health | state of complete physical, mental, & social well being not just abscence of diease. |
| illness | unique response of a person to a disease |
| wellness | active state, oriented toward maximizing potential of individual |
| maslow's hierarachy | self actualization,self esteem-love, security-belonging, physiolocigal-what you need to do first. |
| evidence based practice | problem solving approach to nursing practice, allows to make accurate, timely & appropriate clinical decisions; increased critical thinking abilities & application |
| examples evidence based practice | crossing legs, pathogens & articial finger nails, accurately, feeding tubes, quality care & pressure ulcer risk, saline lock vs. heparin lock |
| subjective data | what person tell you is goin on, can't be measured; pain scale is subjective |
| objective data | signs detectable by observation |
| segregation | physical separation of house & services base on race. |
| discrimination | unfair & unequal treatment or access to sercie based on race, culutre or other bias |
| intercultural comminication | memebers of 2 or more cultures exchange message in manner that is influenced by their different cultural perceptions |
| acculturation | modification of group or individual culture as a resulut of contact w/ another group |
| cultural empathy | involves ability to experience "as" client experiences rather than "how" they experience |
| deductive reasoning | process of moving logically fr. general statement/concept to related specifics; i.e. expreienced several days of vomiting & diarrhea can deduce client to be dehydrated & will confirm generalizations o skin turgor, appearance of eyse & urine color |
| inductive reasoning | process of forming generalizations from individual pieces of data (i.e. client dry skin, poor turgor, sunken eyes, dark amber urine nurse may infer dehydrated |
| environment | internal & external surroundings that affect client |
| 7 steps to decision making | 1. identify 2. set criteria 3. weigh criteria 4. seek alternatives 5. test alternatives 6. troubleshoot 7. evaluate |
| body temperature | reflect the balance between the heat prodcued & the heat lost from body |
| normal temps-mouth, axilliare, rectal, tympanic | normal 98.6 (m), 99.6 (r), 97.6 (a), 99.7(t); most accurate is rectal |
| basal metabolic rate | rate of energy utilization in body required to maintain essential activities; BMR decrease w/ age |
| what affects body heat production | 1. BMR-decrease w/ age 2. muscle activity; increase w/ activity 3. thyroxine output-increased output-increase cellular metabolism increase heat 4. hormones-increase cellular metabolism increase heat 5. fever increase cellular metabolism |
| radiation | trasnfer of heat from one object to another w/ out the object touching |
| conduction | transfer of heat from one molecult to another of lower temperature |
| convection | dispersion of heat by air currents |
| vaporization (evaporation) | continuous change into vapor of moisture from repiratory tract, mouth, & sweat |
| insensible water loss | continuous & unnoticed loss of water from the body |
| regulation to increase body temp | 1. shivering-increase heat production 2. sweating- inhibited to increase heat loss 3. vasoconstriction-pull circulating blood volume away fr. skin to decreas heat loss thru conduction & some extent radiation. |
| regulation to decrease body temp | 1. sweatigng 2. peripheral vasodilation-facilitates cooling |
| factors affecting body temp | 1. age 2. circadian rhythm 3. exercise 4. hormones 5. stress 6. environment 7. medication |
| pyrexia, hyperthermia, or fever | very high fever 105.8 |
| febrile | has fever |
| afebrile | no fever |
| intermittent fever | body temp alternate at regular intervals between periouds of fever & periods of normal/subnormal temps |
| antipyretics | medications that help reduce an elevated temperature |
| remittent fever | temp remains elevated but fluctuates widely over 24 hour period; temp does not return to normal until patient is well |
| relasping fever | fever for a few days & then be afebrile for a few days before the fever returns |
| constant fever | body temp fluctates minimally but always remains above normal |
| hyperpyrexia | greater than 105.8 damage to liver, kidneys, & other organs eventually cause death |
| crisis | excessigve sweating & hot, flushed skn casued by sudden vasodialation |
| resolution by lysis | gradual return to body temp |
| hypothermia | core temp below limit of normal; less than 96.8 |
| pulse | wave of blood flowing thru artery created by contraction of left ventricle |
| stroke volume | amt blood ejected fr. heart w/ each ventricular contraction |
| cardiac volume | stroke volume x pulse rate |
| compliance | ability to contract & expand |
| hypertension | elevated BP |
| periphal pulse | located away from heart |
| apical pulse | taken directly @ heart |
| pulse varies w/ what? | 1. age 2. gender 3. time of day 4. exercise 5. fever 6. medications 7. hemorrage 8. stress 9. position changes |
| carotid | side of neck;infants not accessible, cardiac arrest, and determine circulation to brain |
| brachial | antecubital space;measure BP & cardiac arrest in infants |
| radial | at wrist; readily accessible & easily found; count 30 sec mult by 2 |
| femoral | groin fold;cardiac arrest, infants & children, & to determine circulation to leg |
| dorsalis pedis | top foot;circulation of foot |
| posterior tibial | behind & below ankle;circulation of foot |
| apical | discrepancies w/ radial, infants & children up to 3, conjucntion w/ some medications; count for 1 full minute |
| tachycardia | fast heart rate above 100 BPM pulse |
| bradycardia | 60 or less pulse |
| auscultation | hearing |
| palpation | feeling |
| dysrhythmia or arrhythmia | pusle w/ irregular rhythm; can be random irregular or predicatable pattern. use EKG to define further irregularities |
| diaphragm | high pitched sounds fr. high velocity of air & blood, bowel, lung, heart |
| bell | low pitched sounds fr. low velocity movement of blood; heart murmurs |
| pulse volume | force of blood in artery w/ each heartbeat/ absent =0, bounding (4+), normal (3+) |
| healthy artery | straight smooth & pliable |
| older artery | inelastic arteries that feel twisted (tortous) & irregular palpatation |
| pulse deficit | any diff. between apical & radial report immediately, can indicate thrust blood fr. heart is too feelbe for the wave to be felt or vascular disease |
| bilateral equal | left & right pulses are same |
| treatment hypothermia | remove wet clothes, drink hot liquids, avoid alcohol & caffeine. |
| treatment hyperthermia | water, electrolyte, & cooling |
| hypoxia | low oxygen |
| anoxia | lack of oxygen |
| bounding (4+) | difficult to obliterate |
| strong & reg (3+) | caused by exercise, anxiety, fluid overload, high BP, shock, hemorrhage |
| normal (2+) | normal quality, easily palpitated |
| weak & regular (1+) | heart is pumping small amount of blood w/ each heartbeat |
| Thready | weak & may be irregular |
| absent (0) | pulse cannot be felt |
| respiration | exchange of oxygen & carbon dioxide in body |
| external (ventilation) | intake of oxygen & exhalation of carbon dioxide to outside environmnet |
| internal respiration | exchange oxygen & carbon dioxide @ cellular level throughtout body, exchange gases between capillaries & tissues |
| assessment respiration | compromised-restlessness, confusion, dizziness, change in LOC(level of consciousness) |
| pallor | paleness of skin when compared w/ another part of body;respiration |
| cyanosis | a blusih or grayish discoloration of skin due to excessive carbon dioxide & deficient oxygne in blood (respiration) |
| hyperventilation | very deep, rapid respirations;could be indicator of pain |
| hypoventilaion | very shallow inadequate respirations |
| affects HR | bed rest, sitting around-high HR, HR decrease w/ age, Males HR lower than females, HR lower in morning |
| diffusion | exchange of O2 & CO2 |
| perfusion | delivery of arteral blood to capillaries |
| Oxygen saturation of blood SaO2 | usually 95-100%, lower for COPD 85-89%, abnormal less than 85% |
| bradypnea | less than 12 BPM |
| tachypnea | greater than 20 BPM |
| depth-deep | full expansion of lungs |
| depth-shallow | movement is difficult to see |
| depth-normal | regular intervals between breaths |
| apnea | cessaton of breathing |
| eupnea | normal adult respirations, 12 to 24 depedning on baseline |
| Cheyne-Stokes resprations | gradual increase in depth of respirations, followed by gradual decreas 7 then a period of apnea; "periodic breathing" i.e. morphine, drug overdose, stroke, impending death, heart or kidney failure |
| Kussmaul's | increased rate & depth;hyperventilation, diabetic ketoacidosis, renal failure, fasting |
| Biot's | periods of quick, shallow respirations, alternating w/ periods of apnea; "cluster respirations", stroke, coma, increased cranial pressure |
| dyspnea | difficult & labored breathing during which that is a persistant, unsatisfied need for air & feels distressed |
| orthopnea | ability to breath only in upright sitting or standing position |
| stridor | shrill, harsh sound heard during inspiration w/ laryngeal obstruction |
| stertor | snoring caused by partial obstruction in upper airway |
| wheeze | continous high pitched musical squak or inspiration when air moves thru narrowed or partial obstructed airway |
| bubbling | gurgling sounds heard as air passes thru moist secreations in respiratory tract |
| rales (crackles) | fine, short, interrupted crackling sounds (similar to rub hair in hands by ear), best heard inspiration; use steth |
| rhonchi | continuous rattling heard in throat or bronchial tube on auscultation;use steth |
| intercost retraction | indrawing of cartilage between ribs |
| substernal retraction | indrawing beneath the breastbone |
| suprasternal retraction | indrawing above clavicles & sternum |
| flail chest | ballooning ouf of chest wall thru injured rib spaces, result in paradoxical breathing which the chest wall balloons on expiration but is depressed or sucked inward on inspiration |
| hemoptysis | blood in sputum |
| productive cough | cough accompanied by expectorated secreations |
| non-productive cough | dry, harsh, cough w/out secretions |
| labored breathing | breathing w/ decided effort |
| pulse oximeter | amount of hemoglobin in arteral blood that is saturated w/ O2 |
| blood pressure | masure of force exerted by blood as it flows thru arteries; normal 120/80 |
| systolic pressure | pressure of blood as result of contraction of ventricles |
| Diastolic | prssure when ventricles are at rest |
| pulse pressure | differnece between diastolic & systolic pressues |
| tidal volume | normal quantity of air exchanged w/ each breath |
| peripheral vascular resistance | resistance supplied by the blood vessess as a result of compliance |
| blood volume | quantity of circulating fluid in the blood vessels |
| lumen | channel w/in a tube |
| arteriosclerosis | ealstic & muscular tissues of the arteries are replaced w/ fibrous tissue. |
| hematocrit | proportion of red blood cells to the blood plasma is high |
| factors affect BP | age, exericise, stress, race, obesity, gender, medications, disease process |
| secondary hypertension | elevated blood presuure as a result of known problem (i.e. kidney damage) |
| orthostatic hypotension | blood pressure decreases when client sits or stands |
| korotkoff's sounds | sounds heard thru the steth when measuring BP |
| auscultatory gap | temp disappearance of sounds normally heard over brachal artery when cuff pressure is high followed by reappearance of sounds at lower level |
| acute pain | pain that lasts only thru expected recovery period; can be slow or sudden onset;burns factures, muscle strains, inflamations, infections angina, surgery |
| chronic pain | pain that last beyond typical healing time period & interfers w/ normal functioning; lasts 3-6 months i.e. cancer, headache, back pain, arthritis |
| intactable pain | chronic pain that persists despite theraputic intervention |
| cutaneous pain | orginates in the skin or subcutaneous tissue; paper cut |
| somatic pain | arises from ligaments, tendons, bones, blood vessels, & nerves |
| visceral pain | results from stimulation of pain receptors in abdominal cavity, cranium, & thorax; feels like deep somatic pain burning, aching, or creating feeling of pressure i.e. obstructed bowel syndrome |
| radiating pain | perceived at the source of pain & extends to nearby tissue |
| referred pain | pain felt in part of the body that is consideralbly removed fr. the tissues causing pain; heart attack pain down left arm |
| intractable pain | pain that is highly resistant to relief; i.e. advanced inward malignancy |
| analgesia | pain relief |
| neuropathic pain | result of disturbance of nerve pathways either fr. past or continuing tissue damage that results in pain |
| phantom pain | painful sensation perceived in body part that is missing |
| pain thereshold | amount of pain stimulation a person requires to feel pain |
| pain reaction | includes autonomic nervouse system & behavioral responses to pain |
| behavioral response | learned response used as method of coping to pain |
| pain tolerance | max amount & durationf of pain that an individual is willing to endure |
| psychogenic pain | pain arising in the mind |
| neuropathic pain | distubrance of nerve pathways from past or continuing tissue damage; shooting, stabbing, often severe pain |
| what does pain do to body | increase HR, increase bP, increase RR; temp not affected |
| pain experience | is subjective, what patient says is, nurse must access for pain & must treat it, pain must be documented |
| nursing process & pain | perception of pain, plan of care-assess, diagnosis, planning/outcomes, interventions, evulations |
| key factos in effective pain management | 1. acknowledge 2. assisting-back rub 3. reducing misconceptions 4. reduce fear & anxiety 5. preventing pain-reg intervals, peaks & valleys, breakthru pain |
| cutaneous stimulation | diminishes patient's perception of pain, requires doctors orders for TENS, heat or cold |
| Binders for pain | immobilizes & supports specific body part; arthritis or surgery |
| cognitive-behavioral interventions pain | distraction, sequetial muscle relaxation, guided imagery/meditation, therapeutic touch, humor |
| pharmacological interventios pain | NSAIDs-mild to moderate pain relief, block at PNS, acetaminophen-no anti-inflmmatory or antiplatelet effect, possible effect on liver |
| Opioid analgesics pain | moderate to severe pain, blocks pain at CNS, constipation, nausea, & vomiting side effects; small degree respiratory depression significant if decrease in rate & depth from baseline |
| older adults pain | may respond differently due to normal changes in aging, monitor closely for side effects-excessive sedation & constipation |
| what is pneunomic for pain? | P-precipitation/palliation Q-quality, R-region/radiation, S-severity, T-timing (pretty queens reign some towns) |
| non-pharmalogical treatment for pain | ice-induce vasoconstriction & reduce sensation in pain reduction |
| convert to celsius | (F-32) X 5/9 |
| convert to fahrenheit | (C X 9/5) + 32 |
| Barton | established American Red Cross |
| Wald | founder of public health nursing |
| Dock | campaigned for legislation to allow nurses to control their profession |
| Sanger | promtoed birth control so women could control health & lives |
| Breckinrige | established Frontier Nursing Service |
| Kenny | fought polimyelitis |
| What significance of Hughs Smith Act? | provided federal funds to support practical nurse education |
| Kuster | founded National Federation of Licensed Practical Nurses |
| profession | when a profession organization is in place to oversee the operation of a group |
| consumer | individual, a group of people, or a community that uses a service or cmmodity |
| client | a person who engage the advice or service of someone who is qualified to provide the service |
| Nightengale | improved care of war casualities |
Created by:
jadenikol
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