COMP4

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Author:
vanwin
ID:
215240
Filename:
COMP4
Updated:
2013-04-22 23:52:08
Tags:
fundamentals competencies
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Description:
nursing
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  1. Total Body H2O
    • 50-60%
    • newborns: skin turgor test inaccurate because their skin is very elastic regardless
    • women & obese patients have less water concentration due to adipose tissue
  2. Function of H2O
    • Transport to & from cells
    • lube joints
    • temperature regulation
    • medium for food digestion
  3. Movements of H2O & electrolytes
    • Active Transport
    • Diffusion
    • Osmossis
    • Filtration
  4. Fluid Spaces
    • 1st: normal
    • 2nd: edema
    • 3rd: ascites
  5. Hyponatremia causes
    • excess sweating
    • vomitting
    • low sodium diet
    • excess fluid intake
    • diuretics
    • syndrome of inappropriate ADH
    • Renal failure
  6. Hypernatremia causes
    • watery diarrhea
    • diabetes insipidus
    • hyperventilation
    • excess aldosterone
  7. Hyponatremia & hypernatremia signs & symptoms
    • Hypo: CNS
    • Hyper: thirst, dehydration, CNS
  8. Hypo/Hyper natremia interventions
    • Hypo: fluid restriction, hypertonic IV, diuretics
    • Hyper: fluid restriction, salt restriction, diuretics, IV NS wi/o salt

    both: monitor neuro, bp, pulse, I&O, daily weights
  9. Hypokalemia causes
    • decrease intake
    • vomit
    • too much aldosterone
    • potassium wasting diuretics
    • potassium goes into cells (insulin & alkalosis)
  10. Hyperkalemia
    • increased intake
    • kidney failure
    • potassium sparing diuretics
    • potassium leaving cells ( glucagon/ acidosis)
  11. Hyper/Hypokalemia S&S
    • Hypo: shallow respiration, weak pulses
    • Hyper: diarrhea, abd cramps

    both: weak muscles, parathesia, paralytic ilieus, disrythmias,
  12. Potassium Imbalance Interventions
    Hypo: give potassium (PO/IV) (use lidocane for IV). change diuretics to potassium sparing

    hyper: give insulin, glucose, bicarb (to raise pH),

    both: monitor heart, digoxin, magnesium lvls
  13. Hypocalcemia causes
    • Blood transfusions
    • celiac's/crohn's disease
    • endocrine dysfunction
  14. Hypercalcemia causes
    • excess intake
    • bone resorption
    • endocrine dysfunction
    • immobility
  15. Hypocalcemia S&S
    • numbness
    • tingling
    • tetany
    • weak heart contractions
    • positive chvostek & trouseau's signs
  16. Hypercalcemia S&S
    • sluggish
    • lethargy
    • stupor
    • kidney stones (renal calculi)
    • cardiac arrest
  17. Calcium imbalance Interventions
    Hypocalcemia: give Ca PO/IV, give Vitamin D, monitor Ca levels

    Hypercalcemia: IV isotonic solution, Ca binding agents, dialysis, diuretics
  18. Hypomagnesium
    malnutrition/malabsorption

    S&S: similar to Hypocalcemia, CNS irritability, dysrythmias
  19. Hypermagnesia
    tocolytic therapy & decrase renal excretion

    s&S: similar to hypercalcemia, decreased CNS
  20. Complications of IV Therapy
    • infection
    • fluid overload
    • infiltration
    • phlebitis
    • extravasion
  21. Hemolytic reactions
    • d/c transfusion
    • flush w/ saline
    • contact doctor
    • get Urine sample
  22. Blood transfusion
    • normally given over 2-4hrs
    • needs 2 RNs to check it over
    • nurse needs to stay with pt first 15mins
    • possible reactions: cihlls, fever, fatigue, headache, muscle pain
  23. Buffer System
    • immediate: chemicals in your body
    • rapid: pulmonary response
    • slow: kidneys
  24. Respiratory acidosis
    causes: hypoventilation,

    S&S: flushed skin, lethargy, hypotension, confusion
  25. Respiratory Alkalosis
    hyperventilation

    S&S: numbness, tingling, tetany, lethargy, light headed, nausea, vomiting
  26. Metabolic acidosis
    DKA, shock, Potassium out of cells, kidney failure

    S&S: flushed skin, lethargy, hypotension, confusion, kusmaul respiration
  27. metabolic alkalosis
    vomitting, diarrhea, NG suctioning

    S&S: lethargy, numbness, tingling, tetany, lightheadedness, hypoventilation
  28. Psychological symptoms of stress
    • anger
    • helpless
    • nervous
    • confusion
    • indecision
    • excitability
    • withdrawl
    • demanding
    • alcohol abuse
    • drug abuse
    • resistant to treatment
  29. Physical symptoms of Stress
    • irritability
    • insomnia
    • headache
    • fatigue
    • GI upset
    • restlessness
    • fast heart rate
    • tension
    • crying
    • stomach ulcers
  30. Nursing Interventions for Stress
    • Investigate
    • Listen

    • Identify
    • Remove
    • PPI Prophylaxis
  31. General Adaptation Syndrome
    • Alarm
    • Resistance
    • Exhaustion
  32. Laughter's Benefits
    • Immune: Bcells & Tcells
    • cardiopulmonary
    • musculoskeletal
  33. Coping Mechanisms & Activities
    • Pray
    • Talk
    • Cry
    • sleep
    • laughter
    • breathe
    • smile
    • positive thinking
    • exercise
    • good diet
  34. Factors Affecting Coping
    • Perception
    • Reillience
    • Hardiness
  35. Mediating/Modifying Stress
    • Exercise
    • Nutritional Diet
    • Support Groups
    • relaxation techiques
    • rest & Sleep
    • Time management
  36. Defense Mechanisms
    • Denial
    • Compensation
    • Conversion
    • Projection
    • Rationalizatin
    • Displacement
  37. Characteristics of Crisis
    • developmental vs situational
    • self limiting
    • loss
    • overwhelming
    • highlights unresolved conflicts
  38. Benefits of Crisis
    • calls for intervention
    • pt open to change
    • follows predictable pattern
  39. Factors Affecting Pain
    • Physical
    • Psychological
    • social
    • Cultural
    • Tolerance
  40. Nature of Pain
    • Emotional, Physical, Cognitive
    • decrease quality of life
    • physical/ mental stimuli
    • subjective & individualized
  41. Sensory Fibers
    A: fast, localized, sharp, distinct

    C: slow, burning, persistent, poorly localized
  42. Pain Pathway
    • Transduction: converting stimulus into Energy
    • Transmission: transfering of energy to brain by nociceptors
    • Perception: how pt feels pain
    • Modulation: fixing the pain
  43. Pain Classification
    Nociceptors: visercal (body cavities, organs) Somatic ( skin, bones, muscles, joints)

    Nonnociceptors: PNS & CNS perception( neuron malfunction)
  44. Types of Pain
    • Acute: identifiable cause, short duration, limited emotional response, protective
    • Chronic: may/not have identifiable cause, lasts 6months or longer, no longer protective
    • Chronic Episodic
    • Inferred pain
    • Cancer
    • idiopathic pain
  45. Characteristics of Pain
    • timing
    • quality
    • quanity
    • pattern
    • relieving factors
    • location
    • how it affect ┬áthe patient
    • associated factors
  46. ABCDE's of pain management
    • Ask
    • Believe
    • Choice
    • Deliver
    • Empower
  47. Barriers of Effective Pain Management
    • physical dependence
    • drug tolerance
    • addiction
    • placebo
  48. Normal rest & sleep
    • State of physical & mentla relaxation while being alert & awake
    • -mental
    • -physical
    • -individualized
  49. Normal sleep
    reversible state of decrease perception & response

    normal = 7-8 hrs

    circadian = normal 24 hrs
  50. Coma vs sleep EEG
    coma: flat, decreased O2 consumption

    sleep: active, increased O2 consumption
  51. REM vs NREM sleep
    • REM:
    • -brain active
    • -decrease musculature
    • -25% of sleep
    • -physiologically unstable

    • NREM:
    • - quiet brain
    • - busy body
    • - 75% of sleep
    • - decrease VS
    • - 4-5 cycles per night
  52. Stages of Sleep
    • I: few minutes, easily aroused
    • II: 10 - 20 minutes
    • III: 15 - 30 minutes, delta waves
    • IV: 15 - 30 minutes, not easily aroused
  53. Functions of Sleep
    • restoration
    • preservation
    • REM: brain restoration & emotional healing
    • NREM: physical growth & healing
  54. Intrinsic Sleep Disturbances
    • Insomnia: difficulty attaining & maintaining sleep
    • Narcolepsy: abnormal sleep tendency/ excessive daytime sleepiness
    • Restless leg syndrom
    • Sleep Apnea/ obstructive sleep apnea
  55. Extrinsic Sleep Disturbances
    • Circadian changes
    • Bruxism - grinding teeth
    • sleep enuresis
    • parasomnia - arousal disorder; night terrors
  56. Developmental factors
    newborns: need 10-16 hrs, have long REM sleep but not deep sleep

    young adults: long REM sleep but not deep sleep as the night goes on

    elderly: more prone to have lseep disturbances
  57. Factors affecting sleep
    • Nutrion
    • Exercise
    • Smoking
    • Lifestyle changes
    • environmental factors
    • hospitalizatino

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