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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 Pt may not mention pain, or be depressed/withdrawn.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
Created by: mojoshare