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What activities will increase the cells’ need for energy?
Where is temperature origination?
Generated in core of body and circulated to peripherial surface by circulating blood
What controls temperature?
What do thermoreceptors do to increase or decrease temperature ?
- conserve heat (goosebumps, decreases surface area)
- Increase heat loss (sweat)
- produce heat (shiver)
Name five locations for core temperature
- – Rectum
- - Tympanic Membrane
- – Esophagus
- – Pulmonary Artery
- – Urinary Bladder
Name some surface temperature locations.
What are acceptable temperature ranges in C and F?
- Temperature Range : 36 – 38 degrees C or 96.8 – 100.4 F
- Average oral/tympanic:37 C (98.6 F)
- Average rectal: 37.5 C (99.5 F)
- Average axillary: 36.5 C (97.7 F)
Factors affecting temperature....
- Age and Sex- old and babies,females fluctuate because of hormones,
- Exercise-increases need for energy in cells
- Circadian Rhythms
Define hyperthermia and hypothermia
- Hyperthermia (high temp because of environment)
- Hypothermia (severely low temp because of environment)
Name four temperature conditions
- Hypothermia-below 35 C or 95 F
- Afebrile-normal body temp
- Pyrexia-with fever 38 C or 100.4 F
- Hyperpyrexia- Above 41 C or 105.8 F
Four types of fevers
- Remittent- fluctuating above normal but never comes down to normal
- Constant-constant temp
- Relapsing-returns to normal for at least 24 hrs then recurs
- Intermittent-alternating between febrile and afebrile
Types of Thermometers (7)
Electronic, Tympanic, Glass, Disposable, Temperature-Sensitive (patches or tape), Automated Monitoring Devices, Temporal Artery Thermometers
After you have determined the correct site to take a temperature, what situations may affect a correct reading?
Exercise, smoking, chewing gum, infection, drinking
What are some interventions for fever?
- – MONITOR!
- – Administer antipyretic meds (Dr’s prescription)
- – Limit physical activity
- – Reduce external covering
- – Keep clothing and bed linen dry
- – Encourage Intake of Oral Fluids/Food
- – Encourage or provide Oral care
- – Control environmental temperature
- - (do not induce shivering)
What are some pulse rate ranges? High, Normal, and Low
- “Normal” (60-100beats/min)
- Tachycardia_ (>100beats/min)
- Bradycardia (<60beats/min)
What are the numbers and descriptions for pulse amplitude?
- – 0 = Absent
- - 1+ = Thready
- – 2+ = Weak
- – 3+ = Normal
- – 4+ = Bounding
Definition of irregular pulse.
Irregular = Dysrhythmia
Where is the most common place to get a pulse? Name three other options.
- 2. Temporal-side of head
- 3. Carotid-neck
- 4. Brachial-elbow
- 5. Radial-wrist
- 6. Femoral-groin
- 7. Popliteal-behind knees, harder to find palpitations
- 8. Posterior tibial-inner aspect of ankle
- 9. Dorsalis Pedis (Pedal)-top of foot
What is the instrument and position one uses to get an apical pulse?
- Need stethoscope to listen
- 5th intercostal space/left mid-clavicular, off apex of heart
How is the sound of the heart described and what is happening physiologically?
(lub-dub) opening and closing of valves S1 (lub-opening of tricuspid) S2 (dub-closed tricuspid, open bicuspid)
What is a pulse deficit?
Pulse deficit (Apical rate – radial rate)
What are the three terms and rates for respiration? (Normal, high, low)
- Eupnea 12-20 breaths/min
- Tachypnea > 24 breaths/min
- Bradypnea < 10 breaths/min
Define hypervetilation, hypoventilation, Cheyne-Stokes, Biot's
- Hyperventilation-increased rate of breathing, deeply
- Hypoventilation-decreased rate and decreased depth
- Cheyne-Stokes- deep rapid breathing with periods of apnea (drug over doses, act of dying)
- Biot’s- same as Cheyne Stokes only a little more irregular
Percentage of oxygen that is normal in a pulse oximetery.
To assess respiratory rate, count breaths the last ____ seconds of taking a pulse.
The Physiology of Movement involves what two systems?
Coordinated functioning of the muscular skeletal and nervous systems
List some correct Application of Body Mechanics
- Erect posture
- Use the biggest and strongest muscles
- Use internal girdle and long midriff
- Work as closely as possible to the object
- Use the weight of the body as a force
- Slide, roll, push or pull rather than lift
- Spread -feet apart, flex knees
- Face in same direction of where you are moving
- Work on level surface;
- move bed flat then move patient, move bed back into place.
What is the maximum weight per person to lift?
Mobility contributes to:
- Self Image
- Healthy functioning of each body system.
What are the hazards of immobility?
- Physiological-build up of secretions in lung, skin breakdown,
- Psychological-depression, decreased appetite, muscle atrophy, urinary (increased calcium from immobile bones)
Terms asscoiated with impaired mobility.
- Paresis- impaired or weak muscle strength
- Hemiparesis-impaired or weak muscle strength on one side
- Paralysis-inability to move
- Hemiplegia-inability to move one side of the body
- Paraplegia- inability to move lower extremities
- Quadriplegia-inability to move lower and top extremeties
Types of joints in the body.
- Ball and socket-shoulder and hip, flexion-extension, abduction adduction, rotation
- Condyloid joint-wrist- flexion-extension, abduction, adduction
- Gliding joint- carpal bones of wrist and tarsal bones of feet
- Hinge joint- only flexion –extension e.g. elbow knee and ankle
- Saddle joint-side to side, back and forth (thumb)
Types of range of motion.
- active –by patient
- passive- nurse does, no increase in muscle tone
Active-Assisted- both nurse and patient
Proper ROM procedures.
- follow proper body mechanics
- provide privacy and warmth
- make eye contact with patient
- ROM to the point of resistance but not pain
- flexion/lateral flexion
- internal/external rotation
- opposition of thumb to fingers
- dorsiflexion/plantar flexion
Common devices to correct improper body alignment.
Pillows, mattresses, adjustable beds, trapeze bars, hand rolls, trochanter rolls, hand-wrist splints, high top sneakers;
Common bed angles and positions.
- Low or Semi-Fowler’s-30 degree
- Fowler’s-45-60 degree
- High Fowler’s-90 degree, breathing problems or dysnea, aspiration precautions
- Protective Supine-laying on back, pillow head, calves, arm
- Protective Sidelying- pillow behind back, between knees,one in front
- Protective Prone- under stomach, shins,
- Protective Sims- not on back not on front, knee up and over a pillow
Procedures for ambulating a patient.
- Dangling-seated on the side of the bed with legs dangling, orthostatic hypertension, prevents fainting, gives body a chance to adjust blood pressure
- nonskid- footwear/Safe environment
- Gait belt-goes around middle of patient
- Walk on affected/weak side slightly behind patient
Name three mechanical aids for walking.
Crutches, cane, walker
How to use a walker.
- the walker should extend from the floor to the patient’s hipjoint
- elbows should be flexed 30’
- Proper use
- – For stability
- – Affected side
- elbows should be flexed 30’
- Proper use: hold on opposite side of affected side
- support of body weight should come primarily on the hands and arms while using the crutchesnot in the axillary area where pressure can damage nerves
- Need to be properly fitted