Adult Health 6
Complete List of Terms and Definitions for Adult Health 6
| Terms | Definitions |
|---|---|
| hypertension | |
| Angina | |
| Myocardial infarction | |
| dysphagia | difficulty swallowing |
|
peripheral vascular disease arterial |
|
| Congestive Heart failure | |
| prehypertention | 120-139 / 80-89 |
| osteomalacia | uncommon metabolic disease characterized by inadequate and delayed mineralization, resulting in compact and spongy bone. mineral calcification and deposition do not occur. replaced bone consists of soft material rather than rigid bone |
| serous exudate | clear, like plasma |
| Normal Adult Blood Pressure | 120/80 |
| Normal Temperature Range (C) | 36-38 |
| Normal oxygen saturation percentages | 95-100% |
| What helps regulate blood pressure? |
Baroreceptors Renin-angiotensin Regulation fluid volume Vascular auto regulation |
| convection | heat transfer by air movement |
| stage 1 hypertension | 140-159 / 90-99 |
| Hypothalamus location | between the cerebral hemispheres |
| Heat Loss controlled by: | Anterior Hypothalamus |
| Anthrax | spore forming gram+ bacillusinfected by skin contact, ingestion, or inhalationRespiratory: flulike symptoms, brief improvement, then abrupt onset of respiratory failure, shock, hemodynamic collapse, and death within 24-36 hoursCutaneous: head, forearms, hands, localized itching followed by lesion that gets worseGI: ab pain, N&V, fever, bloody diarrhea, symptoms begin 1-8 days depending on route of exposure and dose |
| functions of the skin | protectionsensationtemperature regulationexcretion and secretion |
| Shivering | involuntary response to temp differences in the body |
| Bradycardia | abnormally slow heart ratebelow 60 beats per minute |
| Range of Moderate Hypothermia | 30-34 C86-93.2 F |
| hyperthermia | elevated body temperature related to the body's inability to promote heat loss or reduce heat production |
| Biot's respiration | respirations are abnormally shallow for two to three breaths followed by irregular period of apnea |
| intimate zone | 0-18 incheszone of personal space |
| plague | bioterrorism outbreak may be airborne fever, cough, chest pain, hemoptysis w/in 24 hr of symptom onset. Mucopurulent of watery sputum with gram negative rods in a gram stain test. Xray film shows bronchopneumonia. person to person transmission is possible via large aerosol droplets. symptoms appear within 1-3 days |
| how to calculate maximum heart rate | 220-age |
| suprainfection | caused by use of broad-spectrum antibiotics to treat an infection |
| pathogen | infectious agent (presence does NOT necessarily mean infection will occur) |
| hyperventilation | rate and depth of respirations increaseHypocarbia (Less than the normal level of carbon dioxide in the blood) sometimes occurs |
| hyperpnea | respirations are labored, increased in depth, and increased in rate (greater than 20 breaths per minute)Occurs normally during exercise |
| therapeutic communication techniques | active listening, sharing observations, sharing empathy,sharing hope, sharing humor, sharing feelings, using touch, using silence, providing information, clarifying, focusing, paraphrasing, asking relevant questions, summarizing, self-disclosure, confrontation |
| Pulse sites | Temporal, Carotid, Apical, Brachial, Radial, Ulnar, Femoral, Popliteal |
| recommended daily intake of vegetables | 2.5 C |
| What are the two types of hypertension? |
essential secondary |
| What is arteriosclerosis? |
Thickening/hardening of arterial wall as someone ages the arteries become narrowed and blood flow decreases |
| What are symptoms of hypertension? |
none at first headache dissiness visual disturbance confusion |
| ligaments | white shiny flexible bands of fibrous and elastic that bind joints. Connect bones and cartilage |
| Cheyne-Stokes respiration | respiratory rate and depth are irregular, characterized by alternating periods of apnea and hyperventilation.Respiratory cycle begins with slow, shallow breaths that gradually increase to abnormal rate and depth, the pattern reverses, breathing slows and becomes shallow, climaxing in apnea before respiration resumes |
| alternatives to restraints | orient clients/family to envirnoment, provide companionship and supervision, ofer music or distracting activities, put disoriented clients near nurses station, use calm, simple statements, use time out, de-escalation,promote relaxation, camouflage IV lines with clothing, ensure effective pain management |
| dysrhythmia | an interval interrupted by and early or late beat of a missed beat that indicates an abnormal rhythm |
| machine used to measure arterial oxygen saturation: | pulse oximeter |
| bradypnea | rate of breathing is regular but abnormally slow less than 12 breaths per minute |
| intimate zone of touch | genitalia, rectumgreat sensitivity needed |
| carriers | persons who show no symptoms of illness buy who have pathogens in their bodies that can be transferred to others |
| Iatrogenic infections | type of health care associated infection from a diagnostic or therapeutic procedure |
| colonization | microorganism is present or invades a host, grows and/or multiplies but does not cause an infection |
| isometric contraction | tightening or tensing of muscles without moving body parts |
| consent zone of touch | mouth, wrists, feetpermission needed |
| anthropometry | measurement system of the size and makeup of the body |
| Newborn temperature range (when protected from environmental extremes) | 35.5-37.5 C95.9-99.5 F |
| REM sleep | vivid, full color dreaming occursless vivid dreaming occurs in other stagesstage usually begins 90 min. after sleep has beguntypified by autonomic response of rapidly moving eyes, fluctuating HR and RR, and increased or fluctuating BPloss of skeletal muscle tonegastric secretions increasevery difficult to arouse sleeperduration of REM sleep increases with each cycle and averages 20 min |
| narcotics:effects on sleep | suppress REM sleepcause increased daytime drowsiness |
| SIDS | thought to be related to apnea, hypoxia, and cardiac arrhythmias caused by abnormalities in the autonomic nervous system that are manifested during sleep |
| Acceptable Adult Pulse Range | 60-100 beats per minute |
| What should be taught about postoperative procedures? |
Breathing exercises incentive spirometry coughing and splinting leg procedures and exercises early ambulation ROM |
| Non-modifiable risk factors of MI and angina |
age sex race family history |
| social zone of touch | hands, arms, shoulders, backpermission not needed |
| normal iron levels | 60-90 g/L decreased in chronic infection |
| nonshivering thermogenesis | occurs in neonates because they cannot shiver.Vascular brown tissue is metabolized for heat production |
| Isotonic contraction | muscle contraction with a change in muscle length |
| 4 phases of bioterrorism attack management | Mitigation-determine hazard vulnerability for the hospitals service area. ID types of situations that are most likely to occurPreparedness- improve ability to manage attack, have supplies and staff who can use them, have backup communication, and conduct drillsresponse- steps taken in the event of an attack, report to predetermined areas, issue alerts, and decontaminaterecovery- restore essential services and resume normal operations asap |
| communicable disease | if the infectious disease can be transmitted directly from one person to another |
| sleep promotion in elderly | maintain regular scheduleno napswarm bathminimal noisekeep path to bathroom free and illuminateduse meds only as a last resortlimit alcohol, caffeine, and nicotine in late afternoon and eveningelevate head of bedpain relief 30 minutes before bedtime |
| cartilaginous joints | have little movement but are elastic and use cartilage to unite separate body surfaces such as the synchondrosis that attaches the ribs to the costal cartilage |
| nasogastric tube insertion | does not require sterile technique uncomfortable procedure for the client, irritate the nasal mucosas. maintain patency |
| alcohol:effect on sleep | speeds onset of sleepreduces REM sleepawakens person during night and difficult to return to sleep |
| recommended frequency of aerobic exercise | 3-5 times per week |
| synovial joints | true jointsare freely movable and are the most mobile, numerous, and anatomically complex of the body's joints. Ex: hinge joint at the elbow |
| fibrous joints | fit closely together and are fixed, permitting little, if any, movement such as the syndesmosis between the tibia and fibula |
| What to touch on during patient education |
Informed concent dietary restriction home meds (what to take, what not to take) specific preparation for surgery (special scrub) postop exercises plans for pain management |
| What additional things should be done the second day after surgery? |
anti-emboli stockings AAT diet change to oral meds discontinue morphine Tylox for pain control Lasix for diuresis- take foley out last start ASA once chest tubes are removed and transfer to step-down unit for increased ambulation |
| What is the etiology of secondary hypertension? |
renal vascular disease aldonteronism phoechromocytoma- adrenal tumor, release of angiotensin (once you remove tumor HTN goes away) cushings coarctation of aorta- narrow and more rigid (genetic) brain tumors- impact serotonin medications renal carcinoma |
| activity tolerance | the kind and amount of activity or exercise that the person is able to perform |
| Stage 3 NREM sleep | involves initial stages of deep sleepsleeper is difficult to arouse and rarely movesmuscles are completely relaxedvital signs decline but remain regularstage lasts 15-30 minutes |
| Christianity : Religious Dietary Regulations | Some Baptists, Evangelicals, and Pentecostals discourage the use of alcohol and caffeine. Roman Catholics fast on Ash Wednesday, Good Friday, and 1 hour before receiving Communion; do not eat meat on Fridays during Lent. |
| sustained pattern of fever | constant body temp continuously above 38 C (100.4 F) that has little fluctuation |
| relapsing pattern of fever | periods of febrile episodes and periods with acceptable temp values. Febrile episodes and periods of normothermia are often longer than 24 hours |
| Class of drugs that are used to reduce fever | Antipyretics |
| endogenous infection | can occur when part of the client's flora becomes altered and an overgrowth results |
| asymptomatic infection | if clinical signs and symptoms are not present (common example is hepatitis C) |
| course of infection by stage | incubation period- entrance of pathogen to appearance of symptomsprodromal stage- interval from onset of nonspecific s/sx to more specific symptomsillness stage-client manifests s/sx specific to type of infectionconvalescence- acute symptoms disappear, recovery |
| when to measure vital signs | admission to health care facilityassessing client during home care visitson a routine schedule according to ordersbefore and after surgery or invasive procedurebefore, during, and after blood transfusionsbefore, during and after admin. of cardiac drugswhen general physical condition changesbefore and after nursing interventions influencing a vital signwhen client reports non-specific symptoms of physical distress (feeling funny or different) |
| What are interventions for heart failure? |
head of bed 45 degrees oxygen measures to reduce fluid overload meds to improve contractility- digoxin elevate feet and legs to improve venous return anti-emboli stockings reduce fluid volume overload daily weights input and output electrolytes pulses |
| What do you encourage patients to do when they have arterial insufficiency/athersclerosis? |
Encourage walking discontinue cigarette smoking control weight, hypertension, hyperlipidemia, and diabetes ensure good foot care |
| What do you teach a patient with valvular heart disease? |
meds- anticoagulantss prophaylactic antibiotics dietary restrictions of food with vit K, dont eat green leafy veges |
| what do Ca channel blockers do after MI | enhance myocardial perfusion |
| How can you tell if its a thoracic aneurysm? |
back pain dyspnea hoarseness dysphagia- diff swallowing rupture is also an emergency acute and profound shock (first sign is restlessness) chest x-ray shows it CT scan-determines size and location |
| What is the etiology of essential hypertension? |
No known cause > age 60 family history obesity sedentary lifestyle alcohol > > lipids- high lipid intake Aferican american smoking |
| Stage 1 NREM sleep | lightest level of sleeplasts a few minutesdecreased physiological activity begins with gradual fall in vital signs and metabolismsensory stimuli (noise) easily awakes the personawakened, person feels as though day dreaming has occurred |
| serious complication of enteral feedings | aspiration of formula into the tracheobronchial tree. results in reduced blood supply to affected pulmonary tissue |
| breastmilk provides sufficient nutrition for how long? | the first 4-6 months of life |
| normal lymphocyte % of total WBCs | 20-40%increased in chronic bacterial and viral infection, decreased in sepsis |
| Mormonism : Religious Dietary Regulations | Members abstain from alcohol and caffeine |
| What will you see with left sided heart failure? |
decreased cardiac output fatifue, weakness oliguria, angina, confusion, dizziness tachycardia, cool extremities weak pulses pulm congestion, cough, dyspnea crackles, pink frothy sputum S3-4 gallop |
| When is someone diagnosed with hypertension? |
Someone is diagnosed with hypertension when they have a consistent high blood pressure SBP > 140 diastolic > 90 (the more problematice- when heart is at rest) they treat it the most aggressively cause it could damage the lumen |
| What is systolic heart failure | heart is unable to contract forcefully enough during systole to eject adequate amts of blood into the circulation |
| What do you teach in the perioperative stage (checklist)? |
fears and anxieties surgical procedure preop routines (NPO, enemas...) invasive procedures ( caths, lines) coughing, turning, deep breathing incentive spirometer lower extremity exercises stockings and pneumonic compression devices splinting pain management |
| What are symptoms of pericarditis? |
pain radiating to left side of neck crating and oppressive pain aggrivated by breathing, coughing, swallowing pain worse when supine susides when sitting and leaning forward may hear precordial friction rub- squeeky sound ST wave elevation |
| Location of the Point of Maximal Impulse (PMI) | 5th intercostal space and mid-clavicular line |
| Basal Metabolic Rate (BMR) | accounts for the heat produced by the body at absolute rest.Depends on body surface area |
| what should a patient do the second day after surgery before noon? |
up in chair remove mediastinal tubes changes chest and leg dressings discontinue foley cath discontinue Swan ganz cath- make sure supine when taking it out Hep lock IVs take NG out |
| What do beta bloekrs do after an MI | reduce muscle damage to heart |
| How can you tell if a patient is having Angina? |
substernal chest discomfort it radiates precipitated by stress or exertion relieved by nitro (NTG)- take sublingually every 5 min, up to 3, if not releived cal EMS, or exertion lasts <15 min 5 E's: exertion, elimination, extreme changes in temp, eating a heavy meal, and emotion |
| Who is likely to get peripheral artery disease? |
10% >70 men > 45 post-menopausal women |
| What additional treatment is needed for management on an MI? |
IV access vital signs, BP every 5 min EKG Labs- cardiac cath in first hour |
| What is MIDCAB and what does it do? |
minimally invasive direct coronary artery bypass doesnt require the heart lung machine avoids splitting sternum because it is a small incision designed to bypass one or two coronary arteries |
| Buddhism : Religious Dietary Regulations | Some are vegetarians and will not use alcohol. Many will fast on Holy Days |
| type of patients at risk for negative nitrogen balance | weak, immobile, muscle atrophy, nutritional intake due to anorexia and/or restrictions |
| How do you know if someone is having a myocardial infarction? |
substernal chest pressure (elephant) radiates to arms and jaw occurs without cause relieved only by opiods 30 min or more nause (may be vomiting) diaphoresis, dyspnea, (cold and clammy) fear of empending doom initially they may deny anything is wrong since it is just pressure (esp women) |
| What interventions should be done for a patient with athersclerosis? |
Diet low fat <30% total intake Low sat. fat stop smoking exercise weight reduction drugs: Questran, Lipitor, Mevacor |
| Russian Orthodox Church : Religious Dietary Regulations | Followers observe fast days as well as a no meat rule on Wednesdays and Fridays. During Lent all animal products, including dairy products and butter, are forbidden. |
| How can you tell if the blood flow has been restored after an MI? |
chest pain subsides abruptly sudden onset of PVC's resolution of ST changes- the elevate one will return markers (enzymes) of myocardial damage peak at 12 hours and will return back down blood flow reestablished by tPa or by angioplasty |
| what needs to be included in an exercise program no matter what? | warm up and cool downabout 5-10 minutes each |
| What do you do to care for a patient after surgery for arterial insufficiency? |
Risk for occlusion- 24 hours check pulses every 15 min for first hour, then every hour along with color and temp mark location of pulses assess for pain keep leg straight |
| what to do if BP is above acceptable range | repeat BP measurements on other arm, verify correct positioning of cuffask nurse or colleague to repeat measurement in 1-2 minutesreport elevated BP to nurse in charge or health care provideradminister antihypertensive medications as ordered |
