Interv 2

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Author:
jskunz
ID:
309341
Filename:
Interv 2
Updated:
2015-10-10 00:39:22
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Interventins
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Description:
Interventions Test #2
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  1. Xerosis
    • itchy, red, dry, scaly, cracked or fissured skin
    • is a problem for 85% of older adults
    • can be threat to integrity of skin
  2. Maceration
    • softening of skin
    • caused by excessive moisture
  3. Granulation tissue
    form of connective tissue w abundant blood supply
  4. exudate
    • fluid from a wound or cavity
    • results from inflammation
  5. dehiscence
    • rupture of one or more layers of a wound
    • most likely occur during inflammatory phase
  6. Fistula
    abnormal passage connecting 2 body cavities or cavity & skin
  7. Eschar
    unstageable pressure ulcer, is thick, hard and black or brown
  8. How are wounds classified
    • according to length of time the wound has existed as well as condition of would:
    • Skin integrity
    • length of time for healing
    • level of contamination
    • Depth of wound
  9. Types of skin integrity
    • Closed: in there are no skin breaks
    • Open: break in skin or mucous membrane
  10. Length of time for healing classification
    • Acute wounds are expected to be of short duration
    • Chronic wounds exceed the expected length of recovery
  11. Level of contamination classification
    • Clean: uninfected w minimal inflammation. No involvement w GI, respiratory, GU tracts. Very low infection risk
    • Clean/contaminated: surgical incisions that enter GI, Respiratory or GU tracts. increased risk
    • Contaminated: open, traumatic/surgical incisions w/ major break in asepsis. ↑ infection risk
    • Infected: when bacteria counts >100,000 per gram of tissue
  12. Depth of wound classification
    • Superficial: involve epidermal
    • Partial-thickness: extend through epi into dermis, but not completely through dermis
    • Full-thickness: through sub-q and beyond
    • Penetrating: sometimes added if wound involves internal organs
  13. Stages of wound healing
    Inflammatory, proliferative, and maturation
  14. Inflammatory phase
    • "cleaning phase"
    • lasts 1-5 days
    • involves 2 processes:
    • Hemostasis: vessels constrict to limit blood loss, platelets aggregate, clotting activated
    • Inflammation
  15. Proliferative phase
    • Granulation or healing stage
    • occurs days 5-21
  16. Maturation phase
    • epithelialization
    • "remodeling"
    • final healing phase
    • begins 2-3 weeks and even continues after wound has closed
  17. Types of wound closures
    • Adhesive strips
    • sutures
    • surgical staples
    • surgical glue
  18. types of wound drainage
    • serous exudate
    • sanguineous exudate
    • serosanguineous
    • purulent exudate
    • purosanguineous exudate
  19. serous exudate
    • watery in consistency
    • contains very little cellular matter
    • consists of serum
  20. sanguineous exudate
    • seen w deep wounds & highly vascular areas
    • bloody drainage indicated damage to capillaries
  21. serosanguineous
    seen in new wounds, combination of bloody and serous drainage
  22. purulent exudate
    • thick, often malodorous, seen in infected wounds
    • contains pus
    • commonly caused by infection from pyogenic (pus forming) bacteria
  23. purosanguineous exudate
    • red-tinged pus
    • indicated small vessels in wound have ruptured
  24. Types of wound healing
    • regenerative 
    • primary
    • secondary
    • tertiary
  25. regenerative healing
    • occurs when wound affects only epidermis & dermis
    • no scars
    • Ex: partial thickness wound
  26. primary intention
    • wound involves no tissue loss & has edges that are well approximated
    • Little scarring expected
    • healing from outside in
    • Ex: surgical incision
  27. Secondary intention
    • occurs when wound:
    • involves extensive tissue loss preventing wound edges from aproximating 
    • OR
    • should not be closed (ex: infection) 
    • Because wound is left open, heals from inner layer to surface, filling with granulation tissue (red, beefy tissue w abundant blood supply)
    • takes time, big scaring expected
  28. Tertiary intention
    • also called delayed primary closure
    • initially heals by secondary and later sutured:
    • when 2 surfaces of granulation tissue are brought together. 
    • Prone to infection
    • creates less scarring than secondary, but more than first
  29. Complications of wound healing
    • Hemorrhage   
    • infection
    • dehiscence
    • evisceration
    • fistula
  30. dehiscence
    rupture of 1 or more layers of a wound
  31. evisceration
    • total separation of layers of wound w internal viscera protruding through incision
    • only occurs in abdominal
  32. CHAPTER 5
    HALF WAY THERE
  33. Scoliosis
    a LATERAL curvature of the spine
  34. osteoarthritis
    • most prevalent type of degenerative joint disease
    • involves loss of articular cartilage oin joint, with pain and stiffness as the primary symptoms
  35. crepitus
    creaking or grating sound, with joint motion
  36. rheumatoid arthritis
    a systemic autoimmune disease involving chronic inflammation of joints and surrounding connective tissue, frequently resulting in difficulty performing ADLs
  37. Gout
    • an inflammatory response to high levels of uric acid
    • crystals form in synovial fluid
    • produce painful joints and severely limits activity during acute flare-ups
  38. osteoporosis
    • a decrease in total bone density
    • occurs when osteoclast activity outpaces that of osteoblasts
  39. osteomyelitis
    • infection of the bone
    • may develop after bone injury or surgery
  40. sprain
    a stretch injury of a ligament that cause the ligament to tear
  41. strain
    an injury to muscle caused by excessive stress on muscle
  42. atrophy
    a decrease in size of muscle tissue due to lack of use or loss of innervation
  43. paresthesia
    numbness, tingling, or burning due to injury of the nerve innervating the affected area
  44. spasticity
    a motor disorder characterized by increased muscle tone, exaggerated tendon jerks, and clonus
  45. clonus
    spasmodic contraction of opposing muscles resulting in tremorous movement
  46. Types of exercise
    • Isometric : muscle contraction w/o motion
    • Isotonic: muscle contraction w/ movement
    • Isokinetic: done w machines the provide variable resistance to movement. Basically combines isometric and isotonic
    • Aerobic: duration, can bring in enuf O2 to continue exercise
    • Anaerobic: short duration, cant bring in enuf O2 to continue long periods (sprinting, lifting weights)
  47. hazards of immobility
    • contractures or ankylosis (fusion of joints)
    • kidney stones
    • decreased ventilation
    • increases workload on heart
    • slows peristalsis
    • leads to isolation and mood changes
  48. postoperative complications in respiratory system:
    • aspiration pneumonia
    • atelectasis (collapse of alveoli)
    • pneumonia
    • PE
  49. postoperative complications in cardio
    • thrombophlebitis
    • embolus
    • hemorrhage
    • hypovolemia
  50. postoperative complications in GI
    • N/V
    • Abdominal distention (excess gas)
    • constipation
    • ileus (loss of forward flow of intestinal contents because of decreased peristalsis)
  51. postoperative complications in GU
    • renal failure
    • urinary retention
    • urinary tract infection
  52. Postoperative complication with surgical incision
    • dehiscence
    • evisceration (abdomen ONLY)
    • wound infection
  53. pharmacokinetics
    • refers to absorption, distribution, metabolism, and excretion of a drug
    • Those 4 processes determines intensity & duration of drug action
  54. drug effectiveness
    • Onset - time needed for drug concentration to reach a high enuf blood level for effects to appear
    • Peak action - when concentration of med is highest in blood
    • Duration of action - period of time med has pharmacological effect before metabolizing & being excreted
  55. Pharamacodynamics
    • HOW meds achieve their effects at various sites in body
    • Primary effects: effects that are predicted, intended and desired
    • Secondary effects: unintended, nontherapeutic effects
  56. types of primary effects
    • palliative effects
    • supportive
    • substitutive
    • chemotherapeutic
    • restorative
  57. palliative effects
    • a primary effect
    • relieves s/s of disease
    • has no effect on disease itself
  58. supportive effects
    • a primary effect
    • support integrity of body function until other meds become effective
  59. substitutive effects
    • a primary effect
    • replace either body fluids or a chemical required by the body for improved functioning
  60. chemotherapeutic effect
    • a primary effect
    • destroy disease-producing microorganisms or body cells
  61. restorative effects
    • a primary effect
    • return body to or maintain the body at optimal levels of health
  62. Secondary effects
    • side effects
    • adverse reactions
    • toxic reactions
    • allergic reactions
    • idiosyncratic reactions
    • cumulative effect
  63. side effects
    • secondary 
    • unintended, often predictable, physiological effects of med to which pt is prescribed
  64. adverse reaction
    • secondary
    • harmful, unintended, usually unpredicted reaction to drug at normal dosage
    • more severe than side effects
    • often requires discontinuation of drug
  65. toxic reactions
    • secondary
    • dangerous, damaging effects to an organ or tissue
    • more severe than AE
    • sometimes even causing permanent damage or death
    • OD
  66. Allergic reaction
    • secondary
    • immune system ID's med as foreign substance that should be neutralized or destroyed
  67. Idiosyncratic reaction
    • secondary
    • unexpected, abnormal, or peculiar response to a med
    • may take form of extreme sensitivity, lack of response, or paradoxical (opposite) of expected response
  68. cumulative effects
    • secondary
    • increased response to repeated doses of a drug that occurs when rate of administration is greater than rate of metabolism and excretion
  69. Medication interactions
    • "drug interactions" - when one drug alters or modifies another
    • *antagonistic drug
    • *synergistic drug
    • *drug incompatibilities
  70. antagonistic drug relationship
    one drug interferes w the actions of another and decreased the result and effectiveness
  71. synergistic drug relationship
    • is an additive effect
    • effect of both drugs together is greater than individual effects
  72. drug incompatibilities
    occur when multiple drugs are mixed together, causing a chemical deterioration
  73. what should be on med orders/prescriptions
    • pt full name
    • date & time order was written
    • name of med
    • dosage
    • route
    • reason
    • signature of prescriber
  74. types of medication storage
    • medication room
    • stock supply (bulk quantity)
    • unit dose system (locked mobile cart)

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