Inter 3

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jskunz
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311034
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Inter 3
Updated:
2015-11-07 11:10:51
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interventions
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Interventions exam 3
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  1. sensoristasis
    state of optimal arousal
  2. xerostomia
    excessively dry mouth
  3. anosmia
    loss of sense of smell
  4. kinesthesia
    muscle sense
  5. hyperalgesia
    extreme sensitivity to pain
  6. PCA
    • pt controlled analgesia
    • pain control pumps
  7. Parenteral meds
    • meds that are injected or infused 
    • includes intradermal, sub-q, IM and IV
  8. Enteral meds
    • meds that are absorbed in GI tract
    • PO
  9. types of pain
    • Cutaneous/superficial
    • Visceral
    • deep somatic pain
    • radiating
    • referred
    • phantom
    • psychogenic
  10. Visceral vs deep somatic pain
    • Visceral pain is caused by stimulation of deep internal pain receptors (organ pain) (ex: menstrual cramps, labor pain, GI discomfort)
    • Deep somatic pain is similar to visceral in being deep, but it originates in ligaments, tendons, nerves, blood vessels and bones.
  11. radiating vs referred
    radiating starts at origin but extends to other locations

    referred occurs in area distal from original site
  12. psychogenic pain
    • pain that is believed to arise from the mind
    • no physiological cause can be found
  13. types of duration of pain
    • acute
    • chronic
    • Intractable pain is both chronic and highly resistant to relief
  14. how is pain classified
    according to origin, cause, duration and quality
  15. what should be included in complete pain assessment
    • Location
    • Quality
    • Rating
    • Duration
    • Exacerbating factors
    • relieving factors
    • pt goal 
    • follow up

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  16. types of stressors
    • distress/eustress
    • external/internal
    • developmental/situational
    • physiological/psychosocial
  17. define distress & eustress stressors
    distress threatens health

    eustress is "good stress"
  18. examples of external & internal stressors
    External would a death in the family, a hurricane, etc. 

    Internal stressors would be a disease, anxiety, negative self-talk
  19. Examples of developmental and situational stressors
    developmental are those that can be predicted to occur at various stages of a person's life

    situational stressors are unpredictable, such as a car accident, natural disaster or an illness.
  20. Physiological stressors
    • chemical - poison, meds
    • physical - trauma, cold
    • nutritional - vitamin def, high fat diet
    • biological - viruses, bacteria
    • genetic - inborn errors of metabolism
    • lifestyle - obesity, sedentary lifestyle

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  21. define psychosocial stressors
    external stressors that arise from work, family dynamics, living situations, social relationships, etc.
  22. major cations in body
    • Na 
    • K
    • Ca
    • Mg
  23. major anions
    • chloride (Cl)
    • phosphate (PO) 
    • Bicarbonate (HCO)
  24. Cations/anions ICF and ECF
    ICF is potassium (K), magnesium (Mg) and phosphate (PO)

    ECF is sodium, chloride (Cl) and bicarbonate (HCO)
  25. how do fluids move in the body
    active transport (requires energy)

    Passive transport
  26. types of passive transport
    osmosis ~ movement of fluids across membrane to dilute high concentration of solutes to low concentration

    Diffusion ~ movement of molecules, from high concentration to low concentration

    Filtration ~ Movement of water and crystalloids going from high pressure to low pressure (pressure in kidneys)
  27. types of solutes
    crystalloids ~ small molecules, easily dissolved (electrolytes)

    colloids ~ large molecules, don't dissolve easily (proteins)
  28. types of osmolality fluids
    • isotonic ~ same osmolality as blood (low blood volume)
    • hypotonic ~ water moves from vascular system into cells  (dehydration)
    • hypertonic ~ water moves from cells into ECF (edema)
  29. How does body regulate fluids
    Intake: water/fluids, thirst is major regulator. Includes IV fluid, PO and irrigation

    • Output: Urine, feces, perspiration, wound vac, emisis
    • *sensible fluid loss is measurable and perceived
    • Insensible fluid loss we do not perceive, not easily measured (occurs primarily by diffusion and evaporation through skin and lungs)
  30. define fluid volume deficit
    • hypovolemia
    • S/S:
    • dry mouth, skin, mucous membranes
    • pallor, cool
    • ↓ BP, HR and urine output
    • ↑ constipation
    • hypotension, dizziness, thirst
  31. define fluid volume excess
    • hypervolemia
    • S/S:
    • ↑ BP and urinary output
    • bounding pulse, neck veins distention
    • edema
    • pulmonary edema (crackles)
  32. Pulmonary ventilation vs. respiration
    Ventilation is breathing in and out

    Respiration is exchange of gases in lungs (Oand CO2)
  33. define perfusion
    supply of O2 to tissues and organs through circulation
  34. Factors that influence oxygenation
    • developmental stage
    • environment (pollution, allergies, stress)
    • Lifestyle (obese, prego)
    • Medications
  35. Hypoxia vs hypoxemia
    Hypoxia is low oxygen in body tissues. will show low LOC.  Low SPOisnt necessarily hypoxia

    Hypoxemia is low oxygen in blood, caused by poor circulation, diffusion into blood or other disorders. (Think blood)
  36. nursing interventions to promote effective breathing
    • admin meds as ordered
    • Prevent resp infections (URI's, flu & pneumonia)
    • support smoking cessation
    • position for max ventilation
    • assist with I.S. (Incentive spirometer)
    • Take aspiration precautions
    • Mobilize secretions: teach coughing/deep coughing, maintain hydration, perform chest physiotherapy
    • Ambulation
    • HYDRATION
  37. Function of carbs
    • primary energy source
    • supply energy for muscle and organ function
    • Spare protein
    • enhance insulin secretion
    • increase satiety
    • improves absorption of Na and excretion of Ca
  38. Function of proteins
    • tissue building
    • metabolism
    • immune system function
    • fluid balance
    • acid-base balance
    • secondary energy source
  39. function of lipids
    • supply essential nutrients
    • energy source
    • flavor and satiety
    • body fat provides insulation, protests vital organs, aids in temp regulation, enables accurate nerve-impulse transmission
    • also helps with cholesterol function
  40. function of vitamins
    • necessary for metabolism or preventing a particular deficiency disease 
    • critical in building and maintaining body tissues
    • supporting immune system
    • ensuring healthy vision
    • help use energy from carbs, protein and lipid
  41. function of minerals
    • assist in fluid regulation, nerve impulse transmission and energy production
    • essential to health of bones
    • help rid body of by-products of metabolism
    • play key roles in disease prevention and treatment
  42. special diets
    • diets modified by consistency
    • diets modified for disease:
    • calorie, fat or sodium restriction
    • diabetic
    • renal diet
    • protein controlled
    • antigen-avoidance diets (allergies)
    • Calorie-protein push
  43. explain structure and function of urinary system
    • Kidneys filter and regulate
    • Nephrons form urine
    • ureters transport
    • bladder stores urine
    • urethra transports urine
  44. common urinary problems
    • UTI
    • Urinary retention ~ an inability to empty the bladder completely. could be from obstruction, inflammation, neurological, meds and anxiety

    Urinary incontinence ~ lack of control over urination
  45. types of urinary incontinence
    • urge incontinence ~ involuntary loss of urine accompanied by strong urge. also called overactive bladder
    • stress incontinence ~ invol loss of small amounts w activities that increase intraabd pressure: coughing, laughing, sneezing
    • Mixed ~ combo of urge and stress
    • Overflow ~ loss of urine in combination with distended bladder (could be caused by fecal impaction, enlarged prostate, neuro disorder)
    • Functional incontinence: untimely loss of urine when no urinary or neuro cause is involved
    • Reflex ~ loss of urine when person doesn't realize bladder is full & no urge to void
  46. promoting normal urination
    • provide privacy
    • assist w positioning
    • facilitate toileting routines
    • promote adequate fluids and nutrition
    • assist w hygiene
  47. structure and function of bowel
    • smooth-muscle tube, running through body from mouth to anus
    • digest and absorb nutrients present in food
    • elimiate food waste products as feces
  48. common bowel problems
    • diarrhea
    • constipation
    • fecal impaction
    • flatulence
    • incontinence
  49. promoting normal defecation
    • provide privacy
    • assist w positioning
    • consider timing
    • support healthful intake of food/fluids
    • encourage exercise
    • manage flatulence
  50. assessing a stoma
    • healthy stoma ranges in color from deep pink to brick red; pallow or blud indicates ischemia, dark brown-black indicates necrosis.
    • Need to monitor output in amt and type
    • pay close attention to skin surrounding stoma for signs of irritation or breakdown
  51. ethnicity
    • similar to culture as it refers to groups whose members share common social/cultural heritage passed down from gen to gen
    • an ethnic group have some characteristics in common (race, ancestry, phys characteristics, geographic, lifestyle, religion) that isn't shared or understood by outsiders
  52. socialization
    • process of learning to become a member of a society or group
    • person becomes socialized by learning social rules and roles, behaviors, values, norms
  53. cultural assimilation
    occurs when new members gradually lean and take on the essential values, beliefs, and behaviors of the dominant culture
  54. acculturation
    • process in which immigrants (new members of group) assume the characteristics of that culture through a learning process
    • person accepts both his own and new culture, adopting both elements
  55. health & illness practices of native american
    • rituals and ceremonies
    • chanting
    • purification
    • meds
    • herbs
  56. health & illness practices of Asian/pacific islander
    • acupuncture
    • amulets
    • moxibustion
    • meditation
    • herbs
  57. health/illness practices of black/AA
    • prayer
    • laying on of hands
    • magic rituals
    • voodoo
    • herbs
  58. health/illness practices of hispanic
    • prayer
    • belief in miracles
    • wearing religious metals/amulets
    • religious relics in home
    • herbs/spices
    • rituals
    • hot/cold therapy
  59. health/illness practices of white
    • biomedical care
    • home remedies
    • religious traditions
    • diet/exercise
  60. verbal forms of communication
    • vocabulary
    • denotation meaning of word(literal meaning of word)
    • connotative meaning (implied or emotional meaning)
    • pacing
    • intonation (tone of voice)
    • clarity and brevity (fewest words poss)
    • timing & relevance
    • credibility
    • Humor
  61. nonverbal forms of communication
    • facial expression
    • posture and gait
    • personal appearance
    • gestures
    • touch
  62. 5 key elements of therapeutic communication
    • empathy
    • respect
    • genuineness
    • concreteness
    • confrontation (assertive)
  63. promoting therapeutic communication
    • active listening
    • establishing trust
    • being assertive (able to express yourself while still respecting others veiwpoints)
    • restating, clarifying, and validating messages
    • interpreting body language & sharing observation
    • exploring issues
    • using silence
    • summarizing the conversation
    • process recordings
  64. barriers to communication
    • asking too many questions
    • asking why
    • fire-hosing info (too much info too fast)
    • changing the subject inappropriately
    • failing to probe
    • offering advice
    • providing false reassurance
    • stereotyping 
    • using patronizing language (you know better)

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