test 2
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| What does Maslow believe drive's human potential? | humans strive for the highest level of consciousness
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| List five levels to Maslow's hierarchy | Bottom-top=Physiological needs, safety/security, love/belonging, self-esteem, self-actualization.
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| normal range for body temperature | 97-99.6
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| When should you always check vitals? | upon admitting, morning assessment, upon return to floor from other department, after surgery, before certain meds and after certain meds, upon any significant change.
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| What part of the brain controls body temperature? | Hypothalamus
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| two types of body temperature | surface and core
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| factors that effect body temperature | age, exercise, hormones, time of day(lowest is early a.m. and highest late afternoon), emotions, environment, disease, drugs, ingestion of hot/cold liquids and smoking
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| procedure for taking rectal temperature | left SIMS position, lubricate probe, 1.5 in. adult/1 in child/.5 in infant insertion, for at least 3 minutes
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| how long to take temp in mouth | 1-3 minutes.
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| most reliable temperature site | rectal
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| normal temp rectal | 99.6
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| normal temp axillary | 97.6
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| normal tympanic | 98.6
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| Afebrile | without fever
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| hyperthermia/pyrexia/febrile | elevated body temp above normal--fever
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| what temp usually gets treated for fever? | anything 101 or above in adults
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| some things nurses can do for fever | cover when shivering, remove when not, increase fluids, promote ventilation, cool cloth, fresh sheets, assess temp for accuracy, limit activity and give sponge bath
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| Hypothermia | (usually below 93.2 orally do not survive)prolonged exposure to cold, puffy skin, pallor, slow pulse/resp., irregular pulse, confusion, inability to feel pain
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| some things a nurse can do for hypothermia | warm blankets, remove wet clothing, warm fluids, eliminate drafts
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| pulse point is | the point at which the artery crosses over a solid surface and can be palpated.
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| pulse rate normals | adult 60-100/min, child 80-110/min, infant 100-160/min, newborn 120-160/min
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| ways to assess pulse | palpation, auscultation, doppler
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| areas to assess pulse | carotid, brachial, radial, apical, popliteal, femoral, pedal (posterior tibial/ dorsalis pedis)
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| only non-peripheral site for pulse assessment | apical
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| three things to note when cheking pulse | rate, rhythm and volume
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| how do you document pulse rhythm? | regular or irregular
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| how do you document pulse volume? | 0-absent, 1+ thready, 2+ Weak, 3+ normal, 4+ bounding
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| tachycardia | fast or increased heart rate (over 100 bpm)
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| bradycardia | slow or below 60 bpm
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| dysrhythmia | irregular pulse
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| pulse deficit | difference between apical and radial pulse. Need two people to check and must be done for one minute.
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| normal respiration ranges | infant 30-80, child 20-40, adult 12-20
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| part of brain responsible for respirations | medula oblongota
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| eupnea | normal respirations; even, regular, quiet and unlabored
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| procedure to assess resp. rate | count inspiration/expiration (breaths) for 30 seconds and multiply by 2. count 1 minute if irregular
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| normal depth of respiration | about 500mL/breath
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| Cheyne-Stokes rhythm | increase, decrease and periods of apnea.
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| Kussmaul rhythm | fast and deep with out power (kin do like hyperventilation but usually associated with a disease)
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| unit of measure for blood pressure | mm Hg (milimeters of mercury)
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| smoking and blood pressure | nicotine causes vasoconstriction and thus higher bp...wait 30 minutes afte smoking to get bp
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| Avg. Bp | 120/80
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| Blood Pressure normal ranges for systolic and diastolic | sys- 100-140
dias- 60-90
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| Hypertension | increased bp; greater than 140/90; at least two reading taken at different times must be obtained to prove hypertension
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| Hypotension | decreased bp; systolic usually less than 90
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| orthostatic hypotension | decrease in bp when changing from a lying to standing position. usually decrease of 25 systolic and 10 diastolic
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| syncope | loss of consciousness
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| pulse pressure | difference between the systolic and diastolic; normal is between 30-50
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| bp assessment sites | brachial and popliteal arteries
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| korotkoff sounds | pulsating sounds you hear when listening to pulse
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| ausculatory gap | temporary disappearance in sound in bp; usually in hypertension patients; may record 3 numbers
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| common causes of errors in taking bp | noise, extremity in strain, extremity above heart level, improper cuff size, cuff too loose, improper working equipment, rapid cuff deflation
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