Med Surg Cha 11,12,14

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plwtn
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Med Surg Cha 11,12,14
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2011-03-19 21:10:03
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Med Surg Cha
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Med Surg Cha 11,12,14
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  1. privately experienced, unpleasant sensation usually associated with disease or injury, #1 complaint of older Americans and one in five take analgesics regularly is the definition of?
    Pain
  2. Oral, rectal, transdermal or parenteral (injected) routes, including a continuous infusion that may be instilled into the spinal canal or self-administered intravenously by clients Are ways that _________ are administered.
    Narcotics (whether PO or IV)
  3. How to access and document _______ Assessment includes the client’s description of its onset, quality, intensity, location and duration, access for accompanying symptoms (nausea or dizziness), is pain better or worse.
    pain
  4. Pain is what the patient says it is
    Ex: id pt is jumping up and down on the bed saying pain is a 10 then a 10 is what we have to treat. Chart pt c/o pain scale 10 while jumping on bed.

    True or False
    True
  5. Know different type of assessment tools.
    1. Scale 0-10 0-no pain 5-moderate pain 10-worst possible pain is called __________.
    2. No pain to pain as bad as it could possibly be is __________.
    3. No pain, mild pain, moderate pain, severe pain, very severe pain, worst possible pain is __________.
    4. Faces No hurt, hurts little bit, hurts little more, hurts even more, hurts whole lot, hurts worst is __________
    • 1. (numeric pain intensity scale)
    • 2. (visual analog scale VAS)
    • 3. (simple descriptive pain intensity scale)
    • 4. (Wong-Baker Faces)
  6. ________ refers to a repetitive pattern of drug seeking and drug use to satisfy a craving for a drug’s, mind-altering or mood-altering effects, the fear of addiction causes many clients to refuse or self-limit prescribed drug therapy
    Addiction
  7. ________ is a condition in which a client needs increasingly larger doses of a drug to achieve the same effect as when the drug was first administered. Development of this is not an indication of addiction.
    Tolerance
  8. _______ means that a person experiences physical discomfort known as withdrawal symptoms when a drug that has been taken for some time is abruptly discontinued.
    Physical dependence
  9. Know Non-Pharmacological thing you can do as a nurse to assist with pain.
    (Ex: ice, elevate extremity) Applications of heat and cold, transcutaneous (TENS) and percutaneous electrical nerve (PENS), stimulation, acupuncture and acupressure, distraction, relaxation, and imagery, breathing exercises, hypnosis
  10. Non-Narcotic Analgesics (ex:Tylenol) When to use and how to use these
    NSAIDs, Motrin, Naprosyn, Indocin- inhibit the production of prostaglandins that increase sensitivity to pain are referred to as ___________.
    Nonopioid analgesics
  11. Analgesics are not narcotics; they relieve pain by altering neurotransmission at the peripheral level (site of injury) and are referred to as _________.
    nonopioid analgesics
  12. Aspirin- inhibits prostaglandin synthesis, producing analgesic effects Tylenol- analgesic for mild to moderate pain;
    nonNSAIDs used for pain management Not narcotics they relieve pain by altering neurotransmission at the peripheral level (site of injury)
  13. One of a number of hormone-like substances that participate in a wide range of body functions such as the contraction and relaxation of smooth muscle, the dilation and constriction of blood vessels, control of blood pressure, and modulation of inflammation. Prostaglandins are derived from a chemical called arachidonic acid is ________.
    Prostaglandin
  14. Opioids and opiate ___________ such as morphine and meperidine (Demerol) are controlled substances referred to as narcotics, interfere with pain perception centrally (at the brain) are referred to as.
    Analgesics
  15. _______ pain- arises from internal organs such as the heart, kidneys, and intestine that are diseased or injured, causes vary and include ischemia, compression of an organ, intestinal distention with gas, or contraction as occurs with gallbladder or kidney stones
    Visceral
  16. _______ pain- caused by mechanical, chemical, thermal, or electrical injuries or disorders affecting bones, joints, muscles, skin, or other structures composed of connective tissue
    Somatic
  17. _________ pain- the noxious stimuli that are transmitted from the point of cellular injury over peripheral sensory nerves to pathways between the spinal cord and thalamus, from the thalamus to the cerebral cortex of the brain
    Nociceptive
  18. ________ pain- pain that is processed abnormally by the nervous system. Results from damage to either the pain pathways in peripheral nerves or pain processing center in the brain.
    ex. phantom limb pain or phantom limb sensation, shingles, (herpes zoster), spinal cord injuries, strokes, diabetes
    Neuropathic
  19. Know 4 Phases of Pain Transmission
    __________ the conversion of chemical information in the cellular environment to electrical impulses that move toward the spinal cord, cellular disruption during which affected cells release various chemical mediators- prostaglandins, bradykinin, serotonin, histamine, and substance P
    Transduction
  20. Know 4 Phases of Pain Transmission
    ________ phase during which peripheral nerve fibers form synapses with neurons in the spinal cord. Impulses ascend to the reticular activating system, the limbic system, the thalamus, and cerebral cortex
    Transmission
  21. Know 4 Phases of Pain Transmission
    ________ phase of impulse transmission during which the brain experiences pain at a conscious level, but many concomitant neural activities occur almost simultaneously
    Perception
  22. Know 4 Phases of Pain Transmission
    ___________ is the last phase of pain impulse transmission, which the brain transmits a response down the spinal nerves to the point where the pain transmission originated to alter the pain experience
    Modulation
  23. Know 4 Phases of Pain Transmission
    ___________ is the last phase of pain impulse transmission, which the brain transmits a response down the spinal nerves to the point where the pain transmission originated to alter the pain experience
    Modulation
  24. Be familiar with Nursing Diagnosis used for Pain
    pain, acute;
    pain, chronic;
  25. What pt are at risk due to being on medication: Know susceptible population?
    • elderly
    • infant
    • immunocompromised individuals
  26. True or False
    Administering pain meds 30 to 45 minutes before meals may relieve pain and enable the client to consume an adequate nutritional intake
    True
  27. True or False
    Small, frequent meals may help maximize intake in clients with drug-related or pain-related anorexia
    True
  28. True or False
    High-fiber diet along with increased fluids may help ease constipation, possible side effect of opioids
    True
  29. ____________ is discomfort that has a short duration (from a few seconds to less than 6 months). Associated with tissue trauma- surgery, identifiable etiology.
    Acute pain
  30. _________ is discomfort that last longer than 6 months, almost totally opposite from those of acute pain. Suffers may have periods of acute pain, referred to as breakthrough pain
    Chronic pain
  31. Infections acquired while receiving care in a healthcare agency that were not active, incubatory or chronic at admission- hospital patients more susceptible to infection. Acquired in hospital not present before admission.
    Nosocomial Infections
  32. The best way to prevent infection is proper?
    handwashing
  33. Patients with Sepsis (severe illness in which the bloodstream is overwhelmed by bacteria) what are some of the complications?
    • 1. intravascular coagulation)-temperature greater than 100.4 or less than 96.8;
    • 2. Heart rate greater than 90 bpm;
    • 3. Respiratory rate greater than 20 bpm
    • 3. Paco2( partial pressure of carbon dioxide in the blood) less than 32 mm Hg;
    • 4. WBC count greater than 12000 cells/mm3 or 10 % immature (band) forms
  34. Needle sticks: what do you do in case of a needle stick
    1st thing wash it out immediately before reporting it
    2. Document the injury in writing
    3. Identify the person or source of blood
    4. Obtain HIV and HBV statuses of the source of blood
    5. Obtain counseling on the potential for infection
    6. Receive the most appropriate postexposure prophylaxis
    7. Be tested for disease antibodies at intervals
    8. Receive instructions on monitoring potential symptoms and medical follow-up.
  35. If someone has infection and they are experiencing diarrhea and vomiting what nutritional things should they do?
    Lots of fluids, avoid caffeine
  36. If giving someone a suppository, what kind of teaching would you do?
    deep breathing, holding it in for at least 20 minutes up to 2 hrs
  37. Dietary: If someone has a cold, what would you recommend?
    vitamin C, fluids
  38. Spongiform Encephalopathies (TSEs), also known as _________?
    prion diseases
  39. What germ causes mono?
    Infection with the ___________, virus, direct contact with saliva and pharyngeal secretions from infected person. Kissing, oral spraying during coughing, talking or sneezing, shared food, cigarettes
    Epstein-Barr virus (EBV)
  40. Characteristics of the _______ _______ that must be present include the ability to move or be moved from one place to another, virulence (power to produce disease), an adequate
    number of agents, and the ability to invade a host.
    Infectious Agent
  41. A ________ is the environment in which the infectious agent can survive and reproduce. It may be human or animal.
    reservoir
  42. Chain of infection
    1. Infectious agent- bacteria, viruses, fungi, rickettsiae, protozoans, mycoplasmas, helminths, prions
    2. Reservoirs- people, equipment, water
    3. Portal of exit- excretions, secretions, skin, droplets
    4. Means of transmission- direct contact, ingestion, fomites, airborne
    5. Portal of entry- mucous membrane, gi tract, gu tract, respiratory tract, broken skin
    6. Susceptible host-immunosuppression, diabetes, surgery, burns, old age
  43. The __________is the route by which the infectious agent escapes from the reservoir. Examples include the respiratory tract.
    portal of exit
  44. A microorganism's _______refers to how it transferred or moved from its reservoir to the susceptiable host.
    means of transmission
  45. An infectious agent gains access to a susceptible host through a ________.
    portal of entry
  46. A _______ is the person on or in whom the infectious agent will reside.
    Susceptible Host
  47. The first line of defense against invading microorganisms is __________ and ________, which separate underlying body tissues from environmental microorganisms.
    • 1. unbroken skin
    • 2. mucous membranes
  48. _______ defense mechanisms are physical barriers that prevent microorganisms from gaining entry
    or expel microorganisms before they multiply. or expel microorganisms before they multiply. Ex. sneezing, coughing, vomiting), and macrophages. Chemical
    Mechanical Defense Mechanisms
  49. ___________ destroy or incapacitate microorganisms with naturally produced biologic substances.
    Ex. enzymes, antibodies, and secretions.
    chemicals defense mechanisms
  50. Septic clients do not always have a _______?
    fever

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