Exam 3

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Exam 3
2011-10-03 15:26:33

Exam 3 for RNSG 1413
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  1. ball-and-socket joint
    rounded head of one bone fits into cuplike cavity of another

    flexion-extension, abduction-adduction, rotation

    ex: shoulder, hip
  2. condyloid joint
    oval head of one bone fits into a shallow cavity of another bone

    flexion-extension, abduction-adduction

    ex: wrist
  3. gliding joint
    articular surfaces are flat

    flexion-extension, abduction-adduction

    ex: carpal bones of wrist
  4. hinge joint
    spool-like surface of one bone fits into a concave surface of another bone


    ex: elbow, knee, ankle
  5. pivot joint
    ringlike structure that turns on a pivot


    ex: wrist turning a doorknob
  6. saddle joint
    bone surfaces are convex on ons side and concave on other

    side to side and back and forth

    ex: carpometacarpal joint of thumb
  7. fibrous joint


    ex: skull
  8. cartilaginous joint
    slightly movable


    ex: pubic symphyis, joints of vertebrae
  9. synovial joint
    freely movable


    ex: gliding, hinge, pivot, condyloid, saddle, ball-and-socket joints
  10. abduction
    lateral movement of a body part away from midline of body
  11. adduction
    lateral movement of body part toward the midline of body
  12. circumduction
    movement of the distal part of the limb to trace a complete circle while the proximal end remains fixed
  13. flexion
    state of being bent
  14. extension
    the state of being in a straight line
  15. hyperextension
    the state of exaggerated extension usually resulting in an angle greater than 180 degrees
  16. dorsiflexion
    backward bending of the hand or foot
  17. plantar flexion
    flexion of the foot
  18. rotation
    the turning of a body part on the axis provided by its joint
  19. internal rotation
    body part turning on its axis toward the midline of the body
  20. external rotation
    body part turning on its axis away from midline of body
  21. pronation
    assumption of the prone position
  22. supination
    assmption of the supine position
  23. inversion
    movement of the sole of the foot inward
  24. eversion
    movement of the sole of the foot outward
  25. labyrinthine sense
    sense of position and movement provided by sensory organs of the inner ear
  26. proprioceptor/kinesthetic sense
    informs the brain of the location of a limb or body part through stimulation of nerves endings in muscles, tendons, and fascia
  27. visual/optic reflexes
    visual impressions contribute to posture by alerting the person to spatial relationships with the environment
  28. extensor or stretch reflexes
    when extensor muscles are stretched beyond a certain point their stimulation causes a reflexion contraction to reestablish erect posture
  29. effects of exercise on cardiovascular system
    increased efficency of heart

    decreased resting heart rate and BP

    increased blood flow and oxygenation of all body parts
  30. effects of immobility on cardiovascular system
    increased cardiac workload

    increased risk for orthostatic hypotension

    increased risk for venous thrombosis
  31. effects of exercise on respiratory system
    increased depth of respiration

    increased respiratory rate

    increased gas exchange at alveolar level

    increased rate of CO2 excretion
  32. effects of immobility on respiratory system
    decreased depth of respiration

    decreased rate of respiration

    pooling of secretions

    impaired gas exchange
  33. effects of exercise on GI system
    increased appetite

    increased intestinal tone
  34. effects of immobility on urinary system
    increased urinary stasis

    increased risk for renal calculi

    decreased bladder muscle tone
  35. effects of immobility on GI system
    disturbance in appetite

    altered protein metabolism

    altered digestion and utilization of nutrients
  36. effects of exercise on urinary system
    increased blood flow to kindeys

    increaed efficiency in mantaining fluid and acid-base balance

    increased efficiency in excreting body wastes
  37. effects of exercise on musculoskeletal system
    increased muscle efficiency

    increased coordination

    increased efficiency of nerve impulse transmission
  38. effects of immobility on musculoskeletal system
    decreased muscle size, tone, strenght

    decreased joint mobility, flexibility

    bone demineralization

    decreased endurance, stability

    increased risk for contracture formation
  39. effects of exercise on integument
    improved tone, color, turgor resulting in improved circulation
  40. effects of immobility on integument
    increased risk for skin breakdown
  41. isotonic exercise
    exercise involving muscle shortening and active movement
  42. isometric exercise
    muscle contraction without shortening
  43. isokinetic exercise
    muscle contractions with resistance
  44. paresis
    impaired muscle strength or weakness
  45. paralysis
    absence of strength secondary to nervous impairment
  46. point of origin
    attachment of muscle to more stationary bone
  47. point of insertion
    atatchment of muscle to more movable bone
  48. afferent nervous system
    info from recptors to brain to CNS to response
  49. efferent nervous system
    CNS to skeletal muscle
  50. orthopedics
    correction or prevention of disorders of body structures used in locomotion
  51. achondrroplasia
    premature bone ossification leading to dwarfism
  52. osteogenesis imperfeccta
    brittle bones at birth
  53. Paget's disease
    excessive bone destruction & abnormal regeneration resulting in pain and deformities
  54. tonus
    state of slight muscle contraction (normal)
  55. contractures
    permanent muscle contraction
  56. atelectasis
    incomplete lung expansion
  57. ankylosis
    consolidation and immobilization of a joint
  58. components of nursing assesment of mobility status
    ease of movement and gait


    joint structure and function (ROM)

    muslce mass, tone, strengthh

  59. types of bones



  60. types of muscles


  61. rest
    condition in which the body is in a decreased state of activity
  62. sleep
    state of rest accompanied by altered consciousness and relative inactivity
  63. circadian rhythms
    complete a full cycle daily
  64. delta sleep
    stages III and IV of NREM

    10% of total sleep time
  65. light sleep
    stages I and II

    50% of total sleep time
  66. REM sleep
    more difficult to awaken


    20-25% of total sleep time

    increase in pulse, resp, BP, metabolic rate, temp

    skeletal muscle tone and deep tendon reflexes depressed

    essential to learning, memory, and adaptation
  67. REM rebound
    after being deprived of REM for several nights, body spends more time in REM
  68. NREM
    stages I-IV

    about 75% of sleep time

    parasympathetic NS dominates - pulse, resp, BP, metabolic rate, temp decrease
  69. sleep cycle
    wake --> stage I NREM --> stage II --> stage III --> stage IV --> stage III --> stage II --> REM --> stage II
  70. insomnia
    difficulty falling asleep, intermittent sleep, or early awakening

  71. dyssomnias
    sleep disorders characterized by insomnia or excessive sleepiness
  72. hypersomnia
    dyssomnia characterized by excessive sleep esp. during the day
  73. narcolepsy
    dyssomnia characterized by an uncontrolable desire to sleep
  74. sleep apnea
    absence of breathing or diminished breathing efforts (hypopnea)

  75. restless leg syndrome
    cannot lie still and report unpleasant creeping, crawling, tingling inlegs

    • Urge to move the legs
    • Rest induced
    • Gets better with activity
    • Evening symptoms more severe
  76. sleep deprivation
    decrease in amount, consistency, or quality of sleep
  77. parasomnia
    patterns of waking behavior that can appear during REM or NREM sleep
  78. somnambulism

  79. bruxism
    parasomnia of teeth grinding
  80. enuresis
    parasomnia of urinating during sleep
  81. nocturnal myoclonus
    marked muscle contractions that result in jerking of one or more legs during sleep
  82. RAS - reticular activting system
    facilitates reflex and voluntary movements

    controls cortical activities related to state of alertness

    wakefullness occurs wehn system stimulated
  83. hypothalamus
    control center for sleeping and waking
  84. neurotransmitters responsible for sleep
    norephineprine, acetylcholine, dopamine, serotonin, histamine

    GABA necessary for inhibition
  85. melatonin
    natural chemical produced at night that decreases wakefulness and promotes sleep
  86. sleep hygiene
    nonpharmacologic approaches to resolve insomnia
  87. sleep-weight link
    leptin - signals brain to stop eating

    ghrelin - promotes eating

    lack of sleep decreaes leptin and raises ghrelin
  88. stereognosis
    sense that perceives the solidity of objects and their size, shape, and texture

    (external sense)
  89. external senses



    gustatory (taste)

    stereogenosis - solidy of objects & size, shape, texture
  90. internal senses
    kinesthesia - awareness of body positioning

    visceral sense - inner organs

    proprioception - body positioning
  91. sensory perception

    receptor or sense organ

    nerve impulse

    activation in brain
  92. sensoristasis
    optimal arousal state of RAS
  93. somnolence
    extreme drowsiness but able to respond normally to stimuli
  94. sensory deprivation
    decreased sensory input or monotonous input

    RAS unable to project normal level of activaton --> hallucinations may result
  95. sensory overload
    too much stimuli

    brain unable to respond meaningfuly or ignore
  96. sensory deficits
    impaired or absent functioning in 1+ senses
  97. genetic theory of aging
    genes control "genetic clocks"
  98. immunity theory of aging
    changes in immune system influence aging

    thymus loses size & function
  99. immunosenescence
    age-associated changes in immune system
  100. cross-linkage theory of aging
    cross-linkage - chemical reaction that produces damage to DNA & cell death

    as one ages, cross links accumulate --> cell damage
  101. free radical theory
    free radicals - molecules formed during cellular metabolism that have adverse effects on adjacent molecules

    irreversible damage results in accumulated effects of this damage
  102. middle adult
  103. Erikson's Theory of Middle Adulthood
    generativity vs stagnation

    establish and guide next generation

    accept middle-age changes

    adjust to needs of aging parents

    reevaluate goals and accomplishments
  104. Havighurst's theory of middle adulthood
    maturation, personal motives and values, civic responsibility

    adjust to physical changes

    maintain a satisfactory occupation

    assist children to become responsible adults

    adjust ot aging parents

    relate to spouse
  105. Levinson's theory of middle adulthood
    choose to either continue an established lifestyle or reorganize one's life ina period of midlife transition
  106. Gould's theory of middle adulthood
    look inward

    accept lifespan as having boundaries

    have special interest in spouse, friends, community

    increase feelings of self-satisfaction

    become more concerned with health
  107. integument changes in older adults
    decreased elasticity


    skin may become pale due to loss of melanocytes

    nails thicken and yellow
  108. musculoskeletal changes in older adults
    decrease in subq tissue and weight

    muscle mass & strength decreases

    bone dimeneralization

    joints stiffen & lose flexibility

    overall mobility slows
  109. neurologic changes in older adults
    CNS responds more slowly

    temp regulation and pain/pressure perception less efficient

    loss of sensation in extremities

    difficulty w/ balance, coordination, fine movements, spatial orientation

    sleep at night shortens, catnaps common
  110. special senses changes in older adult
    diminished visual acuity (presbyopia)

    diminished hearing acuity (presbyacusis)

    taste & smell decreased
  111. cardiopulmonary changes in older adults
    blood vessel less elastic --> venous return less efficient

    less able to increase heart rate and cardiac output with activity

    pulmonary elasticity & ciliary action decrease --> resp rates may increase w/ diminished depth
  112. GI changes in older adult
    digestive juices diminsh & nutrient absorption decreases

    constipation and indigestion due to decreased muscle tone and peristalsis
  113. dentition changes in older adults
    tooth decay & loss
  114. genitourinary changes in older adult
    blood flow to kidneys decreases

    number of functioning nephrons decreases

    fluid and electrolyte balance fragile

    bladder capacity decreases

    hypertrophy of the prostate in men

    atrophy, decrease of secretions and thinning of genital tract in women
  115. disengagement theory of late adulthood
    withdraw from usual roles and become more introspective and self-focused
  116. activity theory of late adulthood
    sucessful aging involves ability to maintain high levels of activity and functioning
  117. identity-continuity theory of late adulthood
    healthy aging related to ability to continue similar patterns of behavior from early & midlle adulthood
  118. Erikson's theory of late adulthood
    ego integrity vs despair & disgust

    life review/reminiscence
  119. Havighurst's theory of late adulthood
    maintenance of social contacts & relationships

    sucessful aging depends on ability to be flexible & adapt to new age related roles
  120. cascade iatrogenesis
    medical or nursing interventin triggers a sequence of adverse events that leads to a downward spiral and decline
  121. delirium
    temporary stae of confusion
  122. dementia
    various organic disorders that progressively affect cognitive functioning
  123. reality orientation
    technique which involves interventions to redirect the patient's attention to what is real in the environment
  124. functional health
    ability to carry out usual & desired daily activities
  125. loss
    when a valued person, object, or situation is changed or inaccessible so that its value is diminshed or removed
  126. actual loss
    loss recoginized by others
  127. perceived loss
    loss experienced by te person but intangible to others
  128. maturational loss
    loss experienced as a result of natural development process
  129. situational loss
    loss experienced as a result of an unpredictable event
  130. anticipatory loss
    person displays loss and grief behaviors for a loss that has yet to take place
  131. grief
    internal emotional reaction to a loss
  132. mourning
    actions and expressions of grief
  133. bereaved
    those in a state of grieving
  134. Engel's stages of grief
    • 1. shock and disbelief
    • 2. developing awareness
    • 3. restitution (rituals)
    • 4. resolving the loss
    • 5. idealization
    • 6. outcome
  135. Kuber-Ross's stages of grief
    • 1. denial & isolation
    • 2. anger
    • 3. bargaining
    • 4. depression
    • 5. acceptance
  136. death according to Uniform Death Act
    • irreversible cessation of all functions of circulatory and respiratory functions
    • OR
    • irreversible cessation of all functions of the entire brain, including the stem
  137. medical criteria to certify death
    cessation of breathing

    no response to deep painful stimuli

    lack of reflexes and spontaneous movement
  138. signs of impending death
    difficulty talking or swallowing

    nausea, flatus, abdominal distention

    urinary and/or bowel incontinence or constipation

    loss of movment, sensation, reflexes

    decreasing temp w/ cold/clammy skin

    weak, slow, or irregular pulse

    decreasing BP

    noisy, irregular respirations

    restlessness and/or agitation

    cooling, molting, and cyanosis of the extremities
  139. palliative care
    taking care of whole person: body, mind, spirit, heart, soul
  140. terminal weaning
    gradual withdrawal of mechanical ventilation
  141. active euthanasia
    taking specific steps to cause a patient's death
  142. passive euthanasia
    withdrawing medical treatment to cause a patient's death