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Patient Care

Chap 15

-a relative constancy in the internal environment of the body that is naturally maintained by adaptive responses that promote healthy survival homeostasis
What are the primary mechanisms that maintain homeostasis? heartbeat, blood pressure, body temperature, respiratory rate, and electrolyte balance
-primary mechanisms that adapt to responses inside or outside the body to maintain homeostasis vital signs
What are the vital signs? body temp, pulse rate,blood pressure, respiratory rate, mental alertness (sensorium)
Why are vital signs important? they often reveal the first clue of adverse reactions associated with treatments and diagnostic procedures
-reflects the degree of heat of the deep tissues of the human body body temp
-the term used to describe the body's maintenance of heat production and heat loss thermoregulation
What plays an important role in regulating heat loss? hypothalamus
What can initiate peripheral vasodilation and sweating to dissipate body heat? hypothalamus
What does diaphoresis mean? sweating
What does shivering do? generates heat
What does vasoconstriction do? conserve heat
The _______ thermometer has a rounded bulb whereas the _______ type has a slender, more pointed tip. rectal / oral
5 routes commonly used to measure body temp: 1. oral 2. axillary 3. tympanic 4. temporal 5. rectal
- temp obtained by placing the thermometer high between the upper arm and the torso axillary
How long must the thermometer stay in place for an accurate axillary reading? 5-10 mins
How long does it take for an accurate rectal reading? 2.5 - 5 mins
-obtained by placing a tympanic membrane thermometer in the ear tympanic
What is believed to be the most accurate way to obtain body temp? rectal
What is a close second to obtaining the most accurate body temp? temporal artery
-when the oral temp is higher than 99.5 a fever exists hyperthermia
A patient with a fever is said to be febrile
-when the patients temperature falls below the normal range hypothermia
What is the normal range for body temp? 97.6 - 100 F
-the depth of breath tidal volume
At rest, what is the normal respiratory rate for an adult? 12-20 breaths / min
What is the normal respiratory rate for a child? infant? 20-30 breaths / min 30-60 breaths / min
During inspiration, the diaphragm contracts and moves? downard, pushing abdominal cavity outward
Downward movment of the diaphragm causes an expansion in the chest cavity and what happens to the pressure? decreases
How is respiratory rate obtained? by observing the rise and fall of the chest
What is the best way to obtain the patient's respiratory rate? without the patient knowing it
-term used to describe rates greater than 20 breaths/min in an adult patient tachypnea
term used to describe a decrease in respiratory rate bradypnea
-results from depression of the respiratory center of the brain-common with drug over doses, head trauma, and hypothermia bradypnea
-difficulty breathing while lying down orthopnea
What is the normal rang for pulse in: an infant? an adult? a child? 110-170 / min 60-100 beats /min 70-120 beats/min
What is considered a normal blood pressure? 120 / 80
What are the three common sites for measuring pulse rate? radial artery in the wrist, brachial artery, carotid artery in neck
What is ausultation? listening to the chest with a stethoscope placed over the heart
How are apical pulses obtained? listening to the heart with a stethoscope placed over the chest and counting each heartbeat
-reflect the rapidity of each heart contraction and are recorded as the number of beats/min pulse rates
How are arterial oxygen saturation levels measured> though a periodic blood-gas analyses
-catheter that is inserted into an artery arterial line
-nonivasive device used to provide ongoing assessment of the hemoglobin oxygen saturation of arterial blood as well as the patient's pulse rate pulse oximeter
How are hemoglobin oxygen saturation and pulse rate determined? by measuring absorption of selected wavelengths of light by the circulating blood
What is the normal pulse oximeter value for a healthy person? 95%-100%
-when heart contractions & pulse rates increase by more than 20 BPM in the resting adult or reach a rate greater than 100 BPM tachycardia
-decrease in heart rate bradycardia
-measure of the force exerted by blood on the arterial walls during contraction and relaxation of the heart blood pressure
-the pressure that is exerted on the arterial vessels by the blood when relaxed diastolic
peak pressure present during contraction of the heart is... systolic
-the persistent elevation of blood pressure above 140/90 hypertension
-low blood pressure, less than 95/60 hypotension
How long does it take for the brain to suffer irreversible damage without oxygen? 6mins
- colorless, tasteless, odorless gas that plays a critical role in efficent cellular metabolism oxygen
-inadequate amt of axygen at the cellular level hypoxia
What are the tissues most sensitive to hypoxia? brain, heart, lungs, liver
Oxygen is given out in what does? Liters per min / LPM
- a reducing valve that permits the flows safe for patient use and serves as the connection btwn the oxygen-delivery device and the gas source oxygen flowmeter
-indicates pressure or the volume of oxygen inside the cylinder or canister and the flowmeter control operates the rate of oxygen flow in LPM to the patient pressure manometer
What two categories of oxygen conservin devices deliver a specifically measured dose to the patient? pulse dose & demand devices
-delivers a fixed volume of oxygen supply during breathing pulsed dose
______ regulators provide a continuous flow of oxygen regardless of the patients phase of breathing conventional
- device does not meet the entire inspiratory needs of the patient low-flow or variable-oxygen
-device does meet or exceed the inspiratory needs of the patient when the device is functioning properly high-flow, fixed or precise oxygen concentration
The most common device used to deliver low concentration of oxygen? nasal cannula
Flow rates up to ____ LPM can be used for the nasal cannula. However only flow rates of ______ are used. 6 LPM / 1-4 LPM
______ is added to the nasal cannula delivery system when flows are greater than 4 LPM are used. humidity
Simple oxygen masks are considered to be what type of device? low-flow
What oxygen rates do the simple mask require? greater than 6 LPM
A ______ mask can deliver a higher percentage of oxygen than the nasal cannula or simple mask. nonrebreathing
_____ are used for infants to deliver oxygen. oxyhoods
What neck position can adversely influence artificial airway placement, particularly in neonatal patients? flexing or bending the neck
What are the 4 uses/needs for endotracheal tubes? 1. need for mechanical ventilation or oxygen delivery 2. upper-airway obstruction 3. impending gastric acid reflux or aspiration 4. provisions for tracheobronchial lavage
- is accomplished most often using a translaryngeal approach via the mouth or nose tracheal intubation
How can you tell if a endotracheal tube has been placed properly? chest radiograph, showing the distal tip 1-2 in superior to the tracheal bifurcation
What is the most common complication of endotracheal tube? overventilation of the right lung and potential airway obstruction of the left
Another word for thoracostomy tubes chest tubes
What are thoracostomy tubes used for? to drain the intrapleural space and the mediastinum
______ are inserted through the chest wall to reestablish negative intrapleural pressure in cases of pneumothorax, hemothorax, pleural effusion and empyema. thoracostomy tubes
-fluid in the pleural cavity pneumothorax
-blood in the pleural cavity hemothorax
excess fluid in the pleural cavity pleural effsion
-pus in the plerual cavity empyema
____ are catheters that are inserted into a large vein CV Lines - central venous
What were CV lines developed for? To administer chemotherapeutic and parenteral nutrition
What are these examples of? Broviac, Hickman, Leonard & Groshong CV catheters
What is the goal of the CV postion? to position the catheter tip in a central vein
What is the preferred location of the CV? The superior vena cava approx 2-3 in above the right atrial junction
What is the superior vena cava the preferred location for CV? bc of the size of the vein
What is the most common insertion site for CV catheters? subclavian vein
Another name for Pulmonary arterial (PA) lines? Swan-Ganz catheters
What are PA lines used for? To estimate left ventricular end-diastolic pressure
What are some examples of complications from CV lines? catheter dislodgment and occlusions resulting from the accumulation of blood clots or drug precipitates
-the product of heart rate and stroke volume and is the vital event necessary to maintain blood flow throughout the cardiovascular system. cardiac output
What do you need to accomplish adequate cardiac output? adequate blood volume and a regular cycle of muscular relaxation and contraction
-events that occur from the beginning of one ventricular contraction until the beginning of another cardiac cycle
-abnormalities within the neural conduction system which will adversely affect cardiac output arrhythmias
Created by: erikasmith28