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basics ch 18- 22

vasodilation increase in size of vessel lumen
phagocytosis white blood cells surround, engulf,& digest microorganisms
metabolism chemical & physical processes required to build & maintain body tissues
vasoconstriction inner lumen of blood vessel becomes smaller
edema excessive intracellular & intravascular fluid
hypothermia body temp below 95°F
contraindication not safe to perform a specific treatment
rebound phenomenon when heat packs are left in place longer than 45 minutes, vessels may constrict rather than dilate
aquathermia pad (k-pad) device with a sm electrically heated water storage tank and 2 tubes connected to a network of tubing w/i a disposable pad (used for heat application)
mottling irregular blotches of bluish-purple discoloration of the skin, sign cold application is too cold
physiological effects of local heat application dilation of veins, relaxation of muscle spasms, increased delivery of oxygen and nutrients to the area
changes in elderly skin that make them more susceptible to burns thinner skin, reduced tactile sensation, cognitive changes
home use heating pad rules timer for 20-30 minutes, never lie on top of, check skin every 10 minutes for excessive redness
maximum time aloud for children in tepid bath 15 minutes
type of heat penetrated best moist heat- better conductor
fever reduction, pain relief, hemostasis, prevention of swelling common uses for cold application
risk associated with sitz bath orthostatic hypotension - due to increased blood flow to the perineum
time maximum vessel dilation achieved when using heat application 20-30 minutes
should heat be used on sprained ankle? Why? heat will increase swelling. do not use heat until swelling has stopped
how does cold help sprained ankle constricts the blood vessels and lessens the swelling
Acute pain pain of a duration less than 6 months
Cutaneous pain more superficial pain of skin & underlying subcutaneous tissue
Chronic pain pain lastinging or deep longer than 6 months
Referred pain pain felt in an area other than where it was produced
Neuropathic pain burning stabbing or deep ache caused by nerve compression/damage as a result of pressure from tumors, edema, or compression factors
Radiating pain pain that begins at a specific & shoots out from or extends to a larger area beyond the origin site
Phantom limb pain type of neuropathic pain that feels as though it is coming from an amputated extremity
Visceral pain simulation of deep internal pain receptors
Intractable pain pain that cannot be relieved, is incurable, or is resistant to treatment.
nociceptive pain caused by stimulation of pain receptors
Holistic view of pts pain thaat includes mental, social, physical, and spiritual aspects as parts of the integrated whole being
PCA (patient controlled analgesia) pt controls the frequency & administration of pain medication within preset boundaries
Nociceptor receptors receptors that are randomly dispersed through-out the skin, subcutaneous tissue, and muscular tissue
2 chemicals released during injury and and damage to tissue substance P or prostaglandins
Adjuvent drugs anti-depressant/anti-convulsants meds that either produce pain relief from a mechanism different than traditional analgesics or by potentiating or increasing the effects of opiates, opiods, & nonopiod drugs
Analgesics pain meds
Effluerage repetitive gentle, gliding stroking of your finger over the the surface of the skin for the purpose of pain relief
Endorphins The natural body chemicals produced by the brain in response to pleasant thoughts or feelings, exercise, laughter, sex, and massage;act similar to morphine; and produce feelings of euphoria, well-being, and pleasure.
Restorative Sleep Rest that allows an individual to awaken feeling rested, refreshed, rejuvenated, energized, and ready to meet new challenges.
98 y/o severe diabetes with left leg amputation states that his left foot hurts. What would he be referring to? Phantom limb pain
Gate Control Theory Transmission of pain impulses, caused by stimulation of the broad nerve fibers by heat, cold, massage, and exercise is thought to open the gate, allowing impulses to be transmitted. It is thought that the thalmus can open the gate when stress/anxiety incr
An individual's thought and emotions are also believed to affect the opening and closing of the gate by stimulating production of? Endorphins
Nociceptive pain Cutaneous pain/paper cut. Soft tissue pain/ injury/thigh muscle/subcutaneous tissue. Deep somatic pain/arthritis/fx.Deep visceral pain/Hysterectomy/post-op pain.
Information to be included on a pain assessment. Characteristics of pain/level of pain/what the patient wants done for the pain.
How can you help a patient in severe pain and waiting for the medication to take effect? explain to the patient what you are going to do. Verbally direct the patient to focus her conscious mind on the sequential tightening/relaxing of muscles/head to feet.
Benefits of PCA? Patient feels in control. Doesn't have to wait for nurse to administer meds.
Discharge planning Working together with the patient and family to systematically plan how to best meet the patient's needs after hospitalization.
Separation anxiety When a child or an older adult who is dependent on a caregiver are separated from their caregiver such as when hospitalized, it can cause severe anxiety and loneliness.
Discharge Instruction form The chart form that is used to list the patient's medications and how to take them, required modifications or restrictions of diet or activity, situations/sighs/symptoms that warrant physician notification.
Transfer Summary form The form used to document the patient's condition and reason for transfer and includes a comprehensive list of the patient's medication.
Leaving AMA A patient leaves the hospital before the physician authorized discharge under any circumstance.
Discharge planning should begin? On admission to the facility
Subjective components of an initial assessment whether or not the patient uses illicit drug/use of sleep aids, cigarettes, alcohol and laxatives. complaints of fatigue/dizziness, insomnia
discharge process/notify Business office, housekeeping.
Loss of control that patients often experience when hospitalized comes under which level of Maslow's heirarchy of patients needs? Safety and security
Aphasia Patient unable to speak intended words.
Auscultation Listening to the sounds produced by the body
Accommodation response Pupils constrict when focusing/close object/dilate when focusing/far object
Orthopnea Difficulty breathing when laying flat.
Excursion Equal chest expansion during inspiration
Dysphasia Difficulty coordinating/organizing words correctly.
Jaundice Yellow/orange skin color/mucous membranes
Ptosis Drooping of the eyelid
retractions Chest wall appears sunken between ribs or under xiphoid process as patient inhales.
sordes dried mucous/food caked on lips/teeth
palpation application/hands to the external surfaces of the body to detect abnormalities/skin/tissues just below the skin.
percussion Assessment technique using middle finger to tap against your other middle finger placed against the body surface.
Adventitious breath sounds abnormal sounds that can be auscultated over the lung fields.
PEARLA pupils equal reactive to light accomodation
paresthesia Numbness to the left side of the face.
halitosis Oral mucosa with a severely unpleasant sour breath.
guarding when a patient flinches and tightens the abdominal muscles when palpated.
lethargic patient drowsy or mentally sluggish.
What type of Assessment is performed on admission? Comprehensive health assessment
How quickly should you reassess a pt with Pneumonia dx with breath sounds/rales in the RLL. 4 hours or less/when the patient complains of dyspnea.
Which lobe/lungs is not accessible for auscultation posteriorly? right middle lobe.
Which lobe/lungs is accessible for auscultation only posteriorly and laterally? right lower lobe.
which lobe/lung accessible for auscultation both anteriorly/posteriorly? left upper lobe/left lower lobe/right upper lobe.
bottom lower lobes/lungs extend down to? 6th intercostal space midclavicular line anteriorly.
rattling auscultation of the lungs cleared after patient coughed is described as? Rhonchi
high pitched crowing sound from a child who has croup is a sign of? stridor.
disinfected cleansed with solutions to kill pathogens
boiling killing non-spore forming organisms on instruments and supplies by boiling in water for 10 minutes
chemical disinfection used to kill pathogens on equipment and supplies that cannot be heated.
ionizing radiation method of killing pathogens on sutures, some plastics, and biological material that cannot be heated
Gaseous disinfection method used to kill pathogens on supplies and equipment that are heat sensitive and must remain dry.
autoclaving sterilization method using steam under pressure
surgical asepsis or relaxation method used to prevent contamination during prodedures that involve entering body cavities.
contamination potential presence of pathogens on a sterile field or sterile object resulting from contact with an unsterile surface
sterile field area free from all microorganisms where additional sterile items can be placed
sterile conscience being aware of potential or certain contamination of the steps to correct the contamnation.
circulating nurse registered nurse who assists in the OR by obtaining needed equipment and supplies.
scrub nurse nurse who assists the physician during surgery.
Created by: mariavaldez77