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Adult Health
TEST #2
| Question | Answer |
|---|---|
| Soul food is very? | high in fat |
| Vegetarians lack? | cobalamin (B12) and iron |
| What should you as a nurse know about diets? | Cultrual aspects- Nutrtion, fasting, know if they follow traditional diet |
| What is malnutrtion? | deficit, excess or imbalance of the essential components of a balanced diet |
| What is protein calorie malnutrtion? | where there is not enought protein, not enough food |
| What are the 2 types of malnutrtion? | marasmus and kwashiorkor |
| What is marasmus defined by? | skin and bones, very thin, normal protein levels |
| What are used to meet metabolic needs from liver and muscles? | carbs |
| What happens when carbs are depleted? | gluconeogenesis, which leads to negative nitrogen balance |
| What happends when pt is under stress? | there is increased energy expenditure, metabolic rate, and energy requirements |
| What does the stress lead to? | Impaired liver function and decreased synthesis of proteins, decrease oncotic pressure |
| What happends with decrease oncotic presssure? | body fluids move from vascular to interstitial fluids (edema) |
| What is cellular edema? | Na goes into cell and K outside of cell |
| What are some S/S of malnutrtion? | decreased skin done, dry skin, loss of hair, raw red mucous membrances, increased ulcer, diarrhea, increased incidence of parasitic disease, decrease BP and CO, anemia..... |
| What are lab results for malnutrtion? | Decreased albumin (3.8-4.5) Decrease prealbumin (20), increased K |
| What are nursing interventions of malnutrtion? | health promotion, assess weight, supplements, small feeding, appetite stimulants, Parenteral/enteral feedings |
| How do you measure for obesity? | BMI, waist circumference, Waist to hip ratio (waist/ by hip measurement) |
| What are nursing implementation for obesity? | nonjudgemental, assessing motivation, nutrtion therapy, identify fad diets, excersice, increase sleep |
| What are meds for obesity? | appetite suppressive, block nutrtion absorption |
| What are the appetite suppressive drugs? | noradrenergic (mimic norepinephrine), serotonergic mechanism, Mix noradrenergic-sertonergic (meridia) Nutrtion absorption blocking (Xenical) |
| What does restrictive surgery do? | decrease size of stomach to 30 ml |
| What are the 2 types of restrictive surgery? | vertical banded gastroplasty and adjustable gastric banding |
| What is malabsorptive surgery? | bypass various lengths of small intestine |
| What is a type of malabsorptive surgery? | biliopancreatic diversion |
| What is a type of restrictive and malabsorptive surgery? | Roux en Y |
| What happens in Roux en Y? | decrease stomach size with stomach pouch, anastomosis to jejunum |
| What are the 2 types of cosmetic surgery? | lipectomy, liposuction |
| What is a lipectomy? | removal of adipose tissue |
| What is liposucton? | suction assisted lipectomy |
| What is altruism? | doing the right thing because it's the right thing, not for reward |
| What is human dignity? | treating all people with dignity |
| What is integrity? | honesty |
| What is veracity? | truth |
| What is a decision focused problems? | ethical dilemma |
| What is an ethical dilemma? | two bad outcomes |
| What are action focused problems? | moral distress |
| What is moral distress? | decision to make and you know the right thing to do, but it's hard to do, like turning someone in |
| What are morals? | fundamentals of right and wrong |
| What is ethics? | declaration of right and wrong and what ought to be-action based, individualized |
| What are values? | concepts, ideals, and themes that give meaning to life |
| What are laws? | external rules of conduct |
| What is utilitarianism? | teleology, situational, consequentialism ethics |
| What are the two principles of utilitarianism? | the greatest good for the greatest number and the end justifies the means (vaccinations, couple bad but overall good) |
| What is eontological? | The categorical imperative: act only on the maxim whereby thou canst at the same time will that it would become a univeral law |
| How do we get behavoiral control? | mentally incompetent, chemical strait jeckets |
| Allocation of scarce resources? | dialysis, living doners and xeno transplants, commodity vs. altruistic donor |
| What is cybernetics? | brain chips and implants, brain internet access, human enhancement |
| What is BP? | force exerted by the blood against the walls of the blood vessel |
| What is Arterial Blood Pressure? | CO x Systemic Vacular Resistance (SVR) |
| What is CO? | total blood flow through circulation per minute |
| CO + | SV x HR |
| What is SV? | amount of blood pumped out of left ventrivle per beat |
| What is SVR? | force opposing movement of blood |
| What does the SNS do to regulate the BP? | Increase CO and SVR, Increase HR and cardiac contractility, peripheral vasoconstriction, and promotes release of renin from kidney |
| Where are baroreceptors located? | carotid artery and arch of the aorta |
| What do baroreceptors do? | maintain BP during normal activities |
| Baroreceptors are? | sensitive to strech and increase BP |
| What does the SNS do to decrease BP? | withdraw |
| To decrease BP what is stimulated? | PNS |
| What does the PNS do to decrease BP? | decrease HR and CO |
| What is a1? | adrenergic receptor |
| What do a1 receptors do? | peripheral vasculature, vasoconstriction |
| What is B1? | adrenergic receptor |
| What does B1 do? | Located in heart, increase HR, force of contraction and conduction |
| What is A2? | adrendergic receptor |
| What does A2 do? | peripheral vasculature and vasoconstriction |
| What is B2? | adrenergic receptor |
| What does B2 do? | activated by epinephrine from adrenal medulla, cause vasodilation |
| What does the vascular endothelium do? | produces vasoactive substances and growth factors |
| What does vasactive substances and growth factors do? | maintain low arterial tone at rest, inhibits growth of smooth muslce layer, inhibits platelet aggregation |
| What does the endothelin do? | it is a potent vasoconstrictor |
| How do renal processes? | Control Na excretion and extracellular fluid volume |
| Sodium leads to water rentention which leads to? | Increased ECF, vensou return to heart, SV, CO and BP |
| What does the renin-angiotensin-aldosterone system do to regulate BP? | Renin goes to angiotensin to angiotensin 1 with ACE to angiotension 2 (potent vasocontrictor, increase vascular resistance, increase BP |
| The renin angiotensin aldosterone system stimulates? | adrenal cortex to secret aldosterone (Na and water retention, increase blood volume and CO) |
| What do releases of epinephrine and small amount of norepinephrine do? | increase HR and myocardial contraction, Activates B2-adregergic receptor in peripheral arterioles of skeletal muscles, vasoconstriction |
| Aldosterone released by Angiotensin 2 and by low Na levels stimulates? | kidneys to retain Na and water, Increase BP by Increased CO, Increase Na and osmolarity level (stimulated release of ADH, Increase ECF volume, and increase BP) |
| What is primary hypertension? | increased BP without identified cause |
| What type of hypertension causes increased SNS activity? | Primary |
| Overproduction of Na retaining hormones and vasoconstrictors increase Na and weight is what type of hypertension? | primary |
| Diabetes mellitus and excessive alchol consumption is what type of hypertension? | Primary |
| What is secondary hypertension? | Increase BP with a specific cause |
| How do you increase arterial pressure? | increase CO or Increase SVR |
| What contributes to hypertension? | age, gender, alcohol, smoking, obesity, increase serum lipids, increase Na, family hx, ethnicity, stress |
| Hypertension is? | asymptomatic |
| Severe hypertension causes? | faigue, dizzy, palpitation, angina, dyspnea, headache, nosebleeds |
| What are target organ diseases? | hypertensive heart disease, coronary artery disease |
| Disruption of Coronary artery endothelium means? | intimal layer exposed to WBCs and platelets |
| What is a prob with cardiovascular disease? | atherosclerosis |
| What is nephrosclerosis? | ischemia by narrowed lumen of vessels, atrophy of tubules, destruction of glomeruli, eventual death of nephrons |
| What is retinal damage? | damage to retinal blood vessels- concurrent vessel damage in heart, brain, kidney |
| What are lifestyle changes with hypertension? | weight reduction, DASH, Na reduction, moderation of alcohol reduction, physical activity, avoidence of tobacco (Nicotine causes vasoconstriction) stress management |
| What do diuretics do? | promote Na and water excretion |
| What do adrenergic inhibitors do? | diminish SNS effects |
| What do direct vasodilators do? | relax vascular smooth muscle reducing SVR |
| What do angiotension inhibitors do? | prevent Angiotensin 1 to angiotensin 2, ACE blocker |
| What do Ca channel blockers do? | increase Na excretion, decrease SVR |
| What are side effects of hypertension drugs? | orthostatic hypotension, sexual dysfunction, dry mouth, frequent voiding, some meds are better taken at specific times of day |
| What is pain? | whatever the person says it is, when they say it |
| What are affective dimensions of pain? | emotional response to experience, can cause suffering (state of severe distress associated with events that threaten the intactness of the person) |
| What are the behavior component of pain? | facial expression, change in behavior |
| What are the cognitive components of pain? | referring to beliefs, attitudes, memories, and meaning attributed to the pain |
| What are the sociocultural dimensions of pain? | demographics, family and caregivers incluence pt's response to pain through beliefs and behaviors |
| What are the four processes of pain? | transduction, transmission, perception, and modulation |
| Injuries = | the release of chemicals (mechical, thermal, chemical) |
| What do mast cells release? | serotonin, histamine, bradykinin, prostaglandins |
| What do macrophages release? | bradykinin, interleukins, nerve growth factor, tumor necrosis factor |
| What do NSAIDS do? | block pain sensitizing chemicals and interfere with production of prostaglandins |
| What do corticosteroids do? | block phospholipase reducing prostaglandins and leukotrienes |
| What do analgesics and antiseizure drugs do? | stabilize the neuronal membrane and inactivate peripheral Na channels inhibit production of the nerve impulse |
| What is transmission? | impulses from the site of transduction to the brain |
| What are the three segments of transmission? | transmission along peripheral nerve fibers to the spinal cord, dorsal horn processing (releaase of neurotransmitters, bind to receptors on nerby cells, activation of sub. P and inhibit activation) and tranmission to the thalamus and cerebral cortex |
| Peripheral tissue damage or nerve injury can cause? | central sensitization |
| What is central sensitization? | hyperalgesia, allodynia, persistent pain, and referred pain |
| What are drugs for tranmission? | opioids, and endogenous opioids |
| What do opioids do? | block the release of neurotransmitters |
| What are endogenous opioids? | lamaze for labor, excercise |
| What is perception? | recognition of pain and individual response |
| Brain perceives stimuli as pain in what step? | perception |
| Reticular activating systems do what for perception? | warns |
| Somatosensory system does what for perception? | localization and characterization |
| What does the limbic system do for pain? | emotional and bahavior |
| What do cortical structures do for pain? | meaning of pain |
| What is therapy for perception? | distraction and relaxation |
| What happens in modulation? | activation of descending pathways |
| Descending fibers release? | chemicals that inhibit pain tranmission |
| What chemicals inhibit pain transmission? | serotonin, nerepinephrine, and GABA |
| What is therapy for modulation? | antidepressants |
| What do antidepressants do? | decrease uptake of serotonin and noepinephrine |
| What is somatic pain? | deep, aching, throbbing, well localized, arises from bone, joint, muscle, skin or connective tissue |
| What is visceral pain? | from tumor involvement or obstruction from internal organs |
| What is trauma? | damage to peripheral nervous system or CNS |
| Trauma is? | numbing, burning, shooting, stabbing, electrical, sudden, intense, short lived |
| What is treatment for trauma? | opioids plus adjuvant therapy |
| Acute pain is? | sudden, less than 3 months, mild to severe, warning sign of tissue damage, decreases over time |
| What is chronic pain? | sudden or gradual, more than 3 months, mild to severe, may not be know, no adaptive role, does not go away |
| PAIN= | patter, area, intensity, nature |
| What are nonopioids? | ASA, acetaminophen, NSAIDS |
| nonopioids do not produce? | tolerance |
| Opioids do what? | bind to receptors in the CNS |
| What are types of opioids? | morphine, oxycodone, codeine, dilaudid |
| What are the side effects of opioids? | resp depression, constipation |
| Constant pain is? | medicated around the clock |
| Long acting drugs are used for? | constant pain |
| Fast acting drugs are used for? | breakthrough pain |
| Therapeutic nerve blocks do what? | local anesthetics into a particular area to produce pain relief block all afferent and efferent transmissio local infiltration of anesthetics injection of anesthetic into specific nerve nerve plexus neuroablative interventions for severe pain |
| What is neuroaugmentation? | electrical stimulation of the brain and spinal cord |
| What are nondrug therapies for pain? | massage, exercise, TENS, PENS, acupuncture, heat and cold therapy |
| What is distraction? | redirection of attention |
| What is hypnosis? | heightened awareness and focused concentration |
| What are relaxation strategies? | to reach a state free from anxiety and muslce tension |
| Do not believe pain is? | a normal part of aging |
Created by:
alicia.rennaker
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