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Concepts of Nursing
Unit 2 Test
| Question | Answer |
|---|---|
| ADLs | Activities of daily life |
| What are the activities of daily life? | Bathing, washing & styling hair, brushing teeth & flossing, dressing, shaving |
| How often should you give oral care on patient or NPO patient | Every 2 hours |
| When giving oral care to unconscious patient, you put them on their side, so they won't choke | True |
| What to do if patient gets lice? | Everyone has to get treated including the staff |
| Unoccupied bed: | Open,surgical,closed |
| Open bed: | Sheet are folded for patient or pull back easily |
| Surgical bed: | Open to the side patient is coming through door from surgery |
| Flat Position: | Used for resting or sleeping |
| Fowler's Position: | Knees slightly elevated to prevent sliding down |
| Semi-Fowler's Position: | Used for patients on continuous tube feedings to prevent aspiration |
| Trendelenburh: | Used for patients who have very low blood pressure (shock) to return blood to the brain and vital organs |
| Known as shock position: | Trendelenburg |
| Reverse Trendelenburg position: | Used to elevate patient's head without bending at the waist |
| What are the 5 objective measurements with a 6th subjective measurement? | Temperature, Pulse, Respirations, Blood Pressure, Oxygen Saturation & pain |
| Temperature abbreviation: | T |
| Pulse abbreviation: | P |
| Respirations abbreveation: | R |
| Blood Pressure abbreviation: | BP |
| Oxygen Saturation abbreviation: | SpO2 |
| Basal Metabolic Rate | BMR |
| Diaphoresis | sweating |
| 99-102 Temperature | Heat stroke or high fever |
| 96-98 Temperature | Normal |
| 95-80 Temperature | Hypothermia |
| Thermoregulation: | Regulation of body temperature |
| Primarily controlled by the part of the brain | Hypothalamus |
| Heat causes ___ | basal dilation |
| If patient temperature keeps changing, what is the bed way to check temperature? | Rectal |
| The more accurate and easiest accessible | Oral |
| The most accurate, provides core temperature | Rectal |
| Afebrile | absent of fever |
| Hypothermia: | Core temperature below 95 degrees Fahrenheit (30 degrees Celsius) |
| Hyperthermia: | 105+ degrees Fahrenheit |
| Phagocytes: | Specialized white blood cells |
| After surgery, patients may run a fever but it's mostly based on the bodies reaction to the trauma of surgery and not an infection | True |
| Signs of fever? | flushed face, elevated pulse rate, glassy or droopy eyes, lethargy, irritable seizures (especially in infants & children) |
| Thermogenesis: | The production of heat |
| What are the 4 chambers of the heart? | Left Ventricle, Right Ventricle, Right Atrium and Left Atrium |
| What chamber does the pumping? | Left ventricle |
| Stroke Volume: | The amount of blood discharged from the left ventricle with each contraction |
| When checking the pulse you are checking the heart rate | True |
| How many literw of blood are pumped per minute? | 5 liters |
| Cardiac Output: | The volume of blood pumped from the heart in 1 minute |
| PMI: | Point of maximum impulse |
| PMI: | Apex of heart, cone shaped end of the left ventricle touches the anterior chest wall at or near the 5th intercostal space |
| Heart Sound: | Lubb-dupp |
| Pulse Deficit: | apical pulse and radial pulse is not the same |
| Rate: | The normal range of pulse rate for adults is 60-100bpm |
| Bradycardia: | under 60 bpm |
| Tachycardia | Over 100 bpm |
| Adults normal bpm? | 60-100 |
| Bounding sound: | A normal strong pulse |
| Thready sound: | Weak, faint pulse |
| Absent: | No pulse |
| Respiration: | Interchange of oxygen and carbon dioxide |
| inhalation & exhalation = one respiration | True |
| External Respiration: | The exchange of gases between the lungs’ alveoli and the blood found in the capillaries surrounding |
| Internal Respiration: | The process of exchanging gases between the circulating blood and the tissue cells of the body |
| Act of breathing is part of respiratory system, but it is regulated by nervous system specifically by the medulla oblongata | True |
| How long do you assess respiration? | 30 seconds if normal, 1 minute if abnormal |
| Normal Respiratory rate is 12-20 | True |
| Eupnea: | Normal respiratory rate |
| Bradypnea: | Under 12 respiratory rate |
| Tachypnea: | Over 20 respiratory rate |
| Apnea: | No breathing at all |
| What are the factors Affecting Respiratory Rate? | Age, Smoking, Environmental temperature, exercise, rest |
| Hypoxemia: | a decreased oxygen level in the blood |
| A sign of difficulty breathing? | Retracting of the neck and abdominal muscles |
| Orthopnae: | Patient find too difficult to breath unless positioned in an upright position such as sitting or standing |
| Stertorous breathing: | Noisy, snoring |
| Adventitious sounds: | abnormal sounds |
| Wheezes: | Musical, whistling sounds |
| Stridor: | Audible, high pitched crowing sound that results from partial obstruction of the airways |
| Blood Pressure: | the measurement of the pressure or tension of the blood pushing against the walls of the arteries in the vascular system |
| Stroke Volume: | The amount of blood ejected from the heart in one contraction |
| Cardiac Output: | The volume of blood pumped from the heart in a full minute |
| What's wrong if patient heart contraction is weaker or blood volume is decreased? | possible dehydration |
| What are factors affecting blood pressure? | age, race, obesity, nicotine and caffeine |
| Normal blood pressure? | 120/80 |
| Systolic: | When the ventricle is attracting (top number) |
| Diastolic: | When ventricles are a t rest (bottom number) |
| Pulse pressure: | The measurement of systolic and diastolic pressure (subtract the diastolic from the systolic |
| What is the normal pulse pressure? | 30-50 points |
| Hypertension: | Systolic is consistently above 130 and diastolic is over 80 |
| Korotkoff's sounds: | Deflate the cuff and allow the return of blood flow, you hear tapping sounds |
| Hypertension: | The heart is working harder to pump blood through the cardiovascular system |
| Treatment of hypertension? | dietary intake of salt and fat, weight loss, medications, stress reduction, |
| If hypertension untreated, what can happen? | can cause permanent damage to brain-stroke, heart-heart failure, kidneys-kidney failure, retinas of the eyes - vision loss |
| Hypotension: | BP falls under 100/60 |
| Oxygen Saturation: | 96-100 of hemoglobin bound with oxygen molecules |
| How many liters of oxygen should a patient with COPD have? | no more than 2-3 liters of oxygen |
Created by:
erinco
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