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NUR 111 Test 2
NUR 111 Test 2 Review
| Types of fever | Intermittent - febrile/afebrile cycles. Remittent - fluctuates but stays febrile. Constant - constantly febrile Relapsing - febrile/afebrile with days in between. Crisis - sudden resolution of fever. Lysis gradual resolution of fever. |
| Fever affect on VS | Increase HR, RR, and BP. |
| Hyperthermia | High fever with ineffective thermoregulation. May treat with cooling blanket, remove excess clothing, blankets, sheets. Cool washcloth, etc. |
| Hypothermia | Core temp < 95. May treat with warming blanket, warmed blanket, put warmed bags of fluids in axilla/groin, french fry lights. |
| Hyperthermia with total loss of thermoregulation | Heat stroke |
| Agonal breathing | apnea with gasps of breath once in a while |
| Orthpnea | Difficulty breathing when lying flat. Must sit up, prop up on pillows, or stand. A sign of pulmonary edema / CHF |
| Biot's respiration | Deep breathing alternating with apnea |
| Cheyne-Stokes respiration | apnea -crescendo/decrescendo - apnea cycles |
| Korotkoff sounds | 1- snapping first heard at the SBP. Clear tapping, repetitive sounds for >= 2 beats. 2 murmurs heard b/t SBD & DBP loud, crisp tapping. 4 10 mmHg above DBP thumping & muting. 5 silence. Disappearance of sound, considered DBP – 2 mmHg below last heard. |
| Somatic vs visceral pain | Musculoskeletal vs internal organ pain. Visceral if often from intestines and pain comes in waves (due to perstaltic contractions) - often poorly localized. |
| Neuropathic, intractable, phantom, and psychogenic pain. | Neuropathic nerve pain. Intractible - unable to control. Phantom - pain in amputated limb (onset within a few days of amputation). Psychogenic pain - cause of pain is unknown. |
| Acute pain | Acute in onset. Mild to severe. Correlates with cause. Protective - keeps you from hurting the area even more. Incr HR, RR, BP, diaphoresis, dilated pupils, restless/anxious. Pain behaviors. |
| Chronic pain | Long term pain. Pt accommodated to pain. mild - severe with normal vitals and skin. Pupils normal or dilated. Pt may not mention pain, or be depressed/withdrawn. May not display pain behaviors. |
| Nociceptors | Nerves that carry pain signal |
| Allodynia | Pain on the skin, caused by something that wouldn't normally cause pain. fibromyalgia pain that can be caused by a simple touch or pressure from clothing |
| The Pain Process | Transduction. Nociceptors. Modulation. Endorphins. Enkephalins. |
| The Gate Control Theory | Gate opened by: Physical factors, emotional factors, behavioral factors. Gate closed by: Physical pain, emotional pain, behavioral factors. |
| Common Responses to Pain | Behavioral Voluntary. Physiologic Sympathetic Involuntary Response. Affective (Psychological) Response. Physiological Parasympathetic Involuntary Response. |
| Behavioral Involuntary Response | Moving away from stimulus. Grimacing, moaning, crying. Restlessness & protecting painful area. |
| Physiologic Sympathetic Involuntary | Increased adrenaline. Increased VS. Muscle tension/rigidity. Pallor. |
| Affective (Psychological) Response | Exaggerated crying, withdrawal, stoicism, anxiety, depression, fear, anger anorexia, fatigue, hopelessness. |
| Physiologic Parasympathetic Involuntary Response | Severe/Deep Pain, nausea/vomiting, fainting, decreased BP & pulse, prostration, rapid/irregular breathing. |
| Pain Radiation | Spread or extends to other areas. Ex: heart attack pain may radiate to left arm. |
| Referred Pain | Seems to arise in different areas, perceived in one area & generated in a distant area. |
| Types of Pain Scales | 0-10 Numeric Pain Scale, Wong-Baker FACES Scale, FLACC Pain Scale. |
| Dysomnia. Parasomnia. | Dysomnia - difficulty getting sleep (broad term for many causes). Parasomnia - involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. |
| Hypersomnia | Adequate sleep but still sleepy. Can be caused by medical conditions such as hypothyroidism. |
| Sleep Apnea | Frequent short breathing pauses during sleep. May cause hypertension, abnormal heart beats, heart failure, cardiac arrest. |
| Bruxism | Teeth grinding |
| Enuresis | Bed wetting |
| Medications for sleep | Ambien (zolpidem), Lunesta (eszopiclone), Rozerem (ramelteon), Sonata (zaleplon), Silenor (doxepine), & Benodiazepines, Anitidepressants, & Antihistamines |
| Group Dynamics | Group Identity, Cohesiveness, Patterns of Interaction, Decision Making, Responsibility, Leadership, Power |
| Group identity | Effective Group: Members value & "own" aims of group; aims are clearly articulated. Ineffective Group Group's aims are not of major importance. |
| Cohesiveness | Effective Group: Members generally trust & like one another; loyal to group; highly committed; high degree of cooperation. Ineffective Group: Members feel alienated from group & from one another; low commitment; members tend to work better alone. |
| Pattern of interaction | Effective Group: Honest, direct communication lows freely; members support, praise, & critic one another. Ineffective Group: Communication is sparing; little self-disclosure; self-serving roles (ex: dominator, blocker, or aggressor) may be unchecked. |
| Decision making | Effective Group: Problems are identified; appropriate method of decision making is used; decision implemented & followed through; group commitment to decision is high. Ineffective group: Problems are allowed to build w/o resolution; little responsibility |
| Responsibility | Effective group: Members feel strong sense of responsibility for group outcomes. Ineffective group: Little responsibility for group felt by group members. |
| Leadership | Effective group: Effective style of leadership to meet desired aims. Ineffective group: Ineffective leadership styles. |
| Power | Effective group: Sources of power are recognized & used appropriately; needs or interest of those w/ little power are considered. Ineffective group: Power is used & abused to "fix" immediate problems; little attention to needs of powerless. |
| Intrapersonal communication | Self-talk, communication that happens within the individual. |
| Interpersonal communication | Occurs between two or more people w/ a goal to exchange messages. |
| Small-group communication | Occurs when nurses interact w/ two or more individuals. |
| Organizational communication | Occurs when individuals & groups within an organization communicate to acheive established goals. |
| Define: Pedagogy, Andragogy, & Geragogy | Pedagogy- teaching children; Andragogy- teaching adults; Geragogy- teaching older adults. |
| Areas for client education | Health promotion; Illness/injury prevention; Health restoration; Coping w/ altered health function. |
| Adult Learning Theory | Move from dependence to independence; Previous experience can be used as a resource for learning; Readiness to learn related to perceived need in life situation; More interest when useful immediately. |
| Behaviorist Theory | Learning occurs when reaction to stimulus (response) is either positively or negatively reinforced; Use positive reinforcement (pleasant experience or praise) to increase probability. |
| Cognitive Theory | Recognizes developmental level of learnes; Acknowledges learner's motivation & environment- the "teachable moment" |
| Bloom's Learning Domains: | 1. Cognitive domain: Thinking- knowing, ompreh1ending, applying, analysis, synthesis, evaluation. 2. Affective domain: Feeling- Feelings, emotions, interests, attitudes. 3. Psychomotor doamin: Doing a skill- motor skills. |
| Social Learning Theory | Learning process involves 3 interdependent factors: Characteristics of the person; Person's behavior; Environment. (Most learning is observational. Now called social cognitive theory) |
| Maslow's Hierarchy of Needs | 1. Physiologic 2. Safety & security 3. Love & belonging 4. Self-esteem 5. Self-actualization |
| Teaching Process | Assessment/Data Collection; Planning; Implementation; Evaluation; Documentation. |
| T.E.A.C.H. | T: tune into the client. E: edit client information. A: act on every teachable moment. C: clarify often. H: honor the client as a partner in the process. |
| Define: Aphasia | Loss of speech. |
| Q S E N | Quality & Safety Education for Nurses |
| Risk factors for falls | Poor vision; cognitive dysfunction; difficulty getting out of bed of chairs; Orthostatic hypotension; Urinary frequency; Weakness; medications. |
| Categories of Fire: Class A. Class B. Class C. | Class A: Paper, wood, upholstery, rags, ordinary rubbish. Class B: Flammable liquids & gases. Class C: Electrical |
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