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Nursing 142

Final review for N142

Surgical Asepsis? “sterile technique” the complete elimination of microorganisms
Asepsis the absence of pathogenic microorganisms
Aseptic techniques practices that keep a client as free from pathogens as possible by preventing the spread of infection from one person to another
Medical Asepsis: clean technique” prevents the spread of microorganisms, as clean as possible.
Standard Precautions health protecting measures which keep clients and health care works safe, apply to blood, mucous membranes, secretions, body fluids, and non-intact skin
Cleaning physical removal of foreign material from objects and surfaces
Disinfection elimination of all pathogens except for bacterial spores
Sterilization? destruction of all microorganisms including spores
Body Alignment? refers to the relationship of one body part to another along a horizontal or vertical line, correct alignment reduces the strain on muscular-skeletal structures
Body balance? achieved when a relatively low center of gravity is balanced over a wide, stable base of support, enhance by proper posture
STABLE? S: maintain the natural curves of the spine T: avoid trunk twisting A: keep your arms in close B: use a wide base of support L: use your legs E: evaluate the load, environment, and yourself
Verbal communication? words you speak, vocalizations, and tone of voice
Non-verbal communication? body language (posture, gestures, facial expressions etc), under less conscious control
Unconditional Positive Regard? having a general optimistic view of people, an assumption of strengths and acceptance of their weaknesses, patient must feel accepted unconditionally
Empathy? viewing the world from the others inner frame of reference while remained yourself, understanding how he or she views their own world. putting yourself into the patients shoes while remaining yourself
Active listening completely listening to what the person is saying and how they are saying it, you are not distracted and are solely concerned with the persons needs not your own
Facilitation? encourage the patient to say more ie: maintaing eye contact, nodding
Silence? communicates that the person has time to think
reflection? echoing the patients words
Clarification use when the persons word choice is confusing
Confrontation focusing the persons attention on an observed situation
Interpretation links events, makes associations or implies cause
Explanation inform the person using factual and objecting information
Summary final review of what you understand the person has said, condenses facts
Subjective Data information based on what the persons says about himself or herself
Objective Data information gathered from the physical assessment ie: pulse, blood pressure
What are PQRSTU? P: Provocative or Palliative * What brings it on? Q: Quality or Quantity * How does it feel, look or sound? R: Region or Radiation* S: Severity Scale* How bad is it? T: Timing * Onset, Duration U: Understanding patients perception
Nursing Process: based on scientific method, involves? Assessment: collect data Diagnosis: interpret data Outcome Identification: identify expected outcome Planning: establish priorities. Implementation: schedule and coordinate plan of care Evaluation: review plan of care, take corrective action
Critical thinking? means by which we learn to assess and modify before acting, encompasses theoretical, experiential knowledge and intellectual and manual skills
Nursing Diagnosis? clinical judgments about the persons response to an actual or potential health state. * symptoms
Inspection : “concentrated watching”, careful scrutiny of the individual as a whole
Palpation using touch to assess texture, temperature, moisture, organ location, and size. * palpate sensitive areas last, intermittent pressure
Percussion tapping the persons skins with short, sharp strokes to assess underlying structures through vibrations * direct or indirect
Ascultation listening to sounds produced by the body, using a stethoscope * listen before palpating in abdominal cases
Body temperture the difference between the amount of heat produced by the body processes and the amount of heat lost to the external environment
thermoregulation the balance between heat lost and heat produced, controlled by the hypothalamus
Shivering an involuntary response to temperature differences in the body, increases heat production
non- shervering thermogenesis? occurs primarily in newborns, they cannot shiver so they rely on vasoconstriction through an increase in norepinepherine
Fever (Pyrexia)? occurs when heat loss mechanisms are unable to keep pace with the excess heat production resulting in a rise of body temp to an abnormal level.
Febrile Fever
Afebrile : no fever/fever breaks
Hypothermia above normal body temp due to bodies inability to promote heat loss or reduce heat production
Malignant Hypothermia increased temp developed as a response to general anesthetic
Heat Stroke prolonged exposure to the sun or high environmental temperatures depresses the hypothalamic function and overwhelms heat loss mechanisms
Heat Exhaustion profuse diaphoresis that results in excess water and electrolyte balance
Frostbite occurs when the body is exposed to subnormal temps, injured area becomes white, waxy and firm to touch
Pulse bounding of blood flow that is palpable at various points of the body
Pulse rate number of pulsing sensations that occur in one minute
Cardiac output the volume of blood pumped by the heart during one minute (product of heart rate and ventricular stroke volume)
Tachcardia abnormally rapid pulse, more than 100bpm
bradycardia abnormally slow pulse, less than 60 bpm
Respiration the mechanism the body uses to exchange gases between the atmosphere and the blood and the blood to the cells
Ventilation movement of gases in/out of lungs
Diffusion the movement of oxygen and carbon dioxide between the alveoli and the red blood cells
Perfusion the distribution of red blood cells to and from the pulmonary capillaries
Tidal volume amount of inhaled air during normal, relaxed breathing (approx 500 ml)
Eupnea normal rate/depth of respiration
Hypercarbia increased ventilatory effort, removes excess carbon dioxide by increasing exhalation
Hypoxemia low levels of arterial oxygen
Bradypnea abnormally slow breathing rate, below 12 bpm
Tachypnea abnormally fast breathing rate, above 20 bpm
Hyperpnea difficulty breathing, respirations are labored with increased depth & rate
Apnea temporary inability to breath
Orthopnea shortness of breath (dysapnea) when lying flat
Synscope light headedness, fainting
Hyperventilation rate/depth of ventilations increase
Hypoventilation rate/depth of ventilation decrease
Cheyne-stokes respiration rate/depth of ventilations are irregular with alternating periods of apnea and hyperventilation
Kussmauls respiration respirations are abnormally deep, regular and increase in rate
Biots respirtaion respirations are shallow for 2-3 breaths followed by irregular period of
Blood pressure measurement of force against the arterial walls
Sphygmomanometer? device used to measure BP
Systolic pressure maximum amount of pressure felt when ventricles contract
Diastolic pressure maximum amount of pressure felt when ventricles relax
Pulse pressure difference between the systolic and diastolic, reflects the stroke volume (60-70ml)
Mean Arterial pressure forcing blood into the tissues, averaged over the cardiac
Ausculatory Gap? period where Korotkoffs sounds disappear during auscultation
Hypotension abnormally low BP
Orthostatic Hypotension occurs when a person with normal BP develops symtoms of low BP when rising to an upright position
Hypertension abnormally high BP
White Coat Hypertension BP is elevated during a visit with a health care professional
Masked Hypertension BP is normal while the client is with a health care professional but becomes elevated at home
Neuropathic pain pain initiated or caused by a primary lesion or dysfunction of the nervous system, pain can be severe and difficult to manage * burning, soothing, or lancinating Referred Pain: pain that is felt in a particular site but originated from another
Nocioceptive due to tissue injury, resolves as healing takes place. *aching or throbbing
Somatic pain superficial or deep ( skin vs joints/tendons)
Visceral pain originates from larger interior organs
Acute pain short term and self-limiting, ends after injury heals
Persistent Chronic pain pain that has been present for 6 months or longer than the time of expected tissue healing, can be categorized as malignant (cancer related) or non-malignant
Documentation anything written or electronically generated that describes the status of a client or the care or service given to that client. Must be: factual, accurate, complete, current, organized and compliant with standards.
SOAPIE(R) Subjective, Objective, Assessment, Plan, Implementation, Evaluation, (Revision)
PIE Problem, Intervention, Evaluation
Mental illness biological condition of the brain that causes alterations in thinking, mood, or behaviour and is associated with significant distress and impaired functioning
mental consciousness being aware of ones own existence, feelings, thoughts, and environment.
Epidermis thin but tough, stratified outer layer of skin. sheds every 4-6 weeks. Dermis: inner supportive layer consisting mostly of connective tissue and collagen (enables skin to resist tearing)
Hypo-pigmentation the loss of pigmentation
Hyper-pigmentation increase in color
Seborrhea oily skin
Xerosis dry skin
Pruritus ichiness
Alopecia hair loss
Hirsutism shaggy or excessive hair
Vitiligo the complete absence of melanin pigment in patchy areas of white or light skin on the face, neck, hands, feet, body folds, and around orifices. can occurs in all people.
Erythema intense redness of the skin from excess blood (hyperemia) in the dilated superficial capillaries, expected with fever, inflammation or with emotional reactions such as blushing
Cyanosis bluish, mottled discoloration that signifies decreased perfusion. indicates hypoxemia.
Jaundice yellow pigmentation to the skin, indicates rising amounts of bilirubin in the blood
Diaphoresis profuse perspiration
Hypothyroidism skin feels rough, dry, flaky
Edema fluid accumulating in the intercellular spaces, normally not present
Turgor ability for pinched skin to return to place promptly when released, poor turgor is evident in extreme dehydration or weight loss, increases with age. (pinched skin recedes slowly or tents)
Scleroderma “hard skin” chronic connective tissue disorder associated with decreased mobility
Range of motion the maximum amount of movement available at a joint Active: performed by the client unassisted, Passive: the client is unable to move all joints independently, nurse moves each joint
Gait style or manner of walking
Prone Position client lying chest down
Supine position client lying on their back
Side laying (lateral) position Side-Lying (Lateral) Position: client resting on their side with the major portion of the body weight on the dependent hip and shoulder
sims position similar to lateral position however weight distribution is placed more on the ilium, humerus and clavicle
Myalgia muscle pain, cramping or aching
Hemiplegia one-sided paralysis
Hemiparesis one-sided weakness
Dislocation one or more bones in a joint being out of position
Subluxation partial dislocation of a joint
Contracture shortening of a muscle leading to limited ROM of joint
Ankylosis stiffness or fixation of a joint
Crepitation an audible and palpable crunching or grating that accompanies movement
Dyshezia pain may be due to a local condition or constipation
Melena black/tarry stools due to occult blood in the stool
Steartorrhea excessive fat in the stool
Encopresis persistent passing of stools into clothing in a child older than 4yrs
Constipation *symptom, infrequent bowel movements, difficult evacuation of feces, inability to defecate at will, and hard feces
Impaction results from unrelieved constipation
Diarrhea increase in number of stools (several bowel movements per day) and the passage of liquid, unformed feces
urgency feeling as if you can’t wait to urinate
Nocturia the need to get up in the night to urinate
Dysuria pain or burning while urinating
Hesitancy straining, trouble starting to urinate, loss of force, terminal dribbling
Hematuria presence of red blood cells in the urine
True incontinence loss of urine without warning
urgency incontinence sudden loss, as with acute cystitis
stress incontinence : loss of urine with physical strain due to weakness of sphincters
Nocturnal enuresis involuntary passing of urine after an age at which continence is expected
Phimosis unable to retract the foreskin
Paraphimosis unable to return foreskin to original position
cryptorchidism undescended testes, common in premature infants
Menopause cessation of menstruation
Osteoporosis decrease in skeletal bone mass, occurring when rate of bone resorption is greater than bone formation
Rheumatoid Arthritis chronic, systemic inflammatory disease of joints and surrounding connective tissue
Oseoarthritis noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone and formation of new bone
Scoliosis abnormal curing of the spine
Pigeon toed when you tend to walk on the lateral side of the foot and the longitudinal arch looks higher than normal
Striae jagged linear “stretch marks” of silver to pink colour, may not fade
Linea Nigra brownish black line down the midline