Nur 256 Test #1.docx

BMI Underweight value - correct answer 18.5 BMI Overweight Value - correct answer 25 - 29.9 BMI Obese Value - correct answer 30 Culturally Mediated Characteristics - correct answer Information disclosure, space and distance, eye contact, time, touch, observance of holidays, diet, and biologic variations Causes of Illness - correct answer 1. Biomedical or Scientific- everything has scientific evidence to prove why something has occurred. 2. Naturalistic or Holistic- yin/yang theory; Native Americans and Asians predominantly practice 3. Magico-Religious- Faith healing; voodoo; witchcraft Chronic Conditions - correct answer Medical conditions or health problems with associated symptoms that require long-term (3+ month) management Physiatrist - correct answer A doctor who specializes in the rehabilitation and physiological treatment of patients with an illness or injury that effects movement. Risk Factors for Development of Pressure Ulcers/Pressure Injuries - correct answer Immobility, impaired sensory perception or cognition, decreased tissue perfusion, decreased nutritional status, friction, shear, increased moisture, age related skin changes Cardiovascular Systems Age Related Changes - correct answer 1. Heart disease is the leading cause of death 2. Myocardial hypertrophy- Decreased cardiac output 3. Increased fibrosis, decreased stroke volume 4. Calcium and fat deposits- hypertension and increased workload 5. Slower heart recovery rate to stress 6. Orthostatic hypotension- Decreased BP, increased HR Respiratory System Age Related Changes - correct answer 1. May be subtle and gradual 2. Diminished resp. efficiency 3. Decreased maximal inspiratory and expiratory force 4. Lung mass decreases, residual volume increases 5. Smoking is the most significant risk factor Integumentary System Age Related Changes - correct answer 1. Aging can interrupt all function of skin and effect appearance 2. Epidural proliferation decreases, dermis becomes thinner 3. Elastic fibers are reduced and collagen becomes stiffer 4. Subcutaneous fat diminishes, less likely to conserve body heat 5. Loss of resiliency with wrinkling and sagging of the skin 6. Hair pigmentation changes and balding Reproductive System Age Related Changes - correct answer 1. Sexual activity decreases with loss of partner (most common in women); men- poor health, ED, medications and emotional changes 2. Female- vaginal narrowing, decreased elasticity, decreased vaginal secretions, involution, decreased muscle tone 3. Male- less firm testes, decreased testosterone Genitourinary System Age Related Changes - correct answer 1. Decreased filtration rate 2. Diminished tubular function with decreased efficiency in reabsorption and concentrated urine 3. Slower restoration of acid-base balance in response to stress 4. Male- benign prostatic hyperplasia 5. Female- relaxed perineal muscles, detrusor instability (urge incontinence), urethral dysfunction Gastrointestinal System Age Related Changes - correct answer 1. Decreased sense of smell, thirst, and taste 2. Decreased salivation 3. Difficultly chewing and swallowing food 4. Delayed esophageal and gastric emptying 5. Diminished secretion of gastric acid and pepsin 6. Decreased gastric motility Musculoskeletal System Age Related Changes - correct answer 1. Alterations in bone remodeling 2. Loss of bone density 3. Loss of muscle strength and size 4. Deterioration of muscle fibers and cell membranes 5. Degenerated joint cartilage Nervous System Age Related Changes - correct answer 1. Homeostasis is difficult to maintain 2. Decreased nerve cells- small loss of brain mass 3. Decreased speed in nerve conduction 4. Increased confusion with physical illness, loss of environmental cues 5. Decreased cerebral circulation (becomes faint, loses balance) Nutritional Health Age Related Changes - correct answer 1. Require fewer calories 2. Require more nutrient rich, healthy diet in response to alterations in body mass and more sedentary lifestyle 3. Recommendation- decreased fat intake, increased proteins and vitamins, increased minerals and dietary fiber 4. Budgetary constraints and physical limitations may interfere with food shopping and meal preparation Sleep Age Related Changes - correct answer 1. Respiratory problems, restless leg syndrome, nocturia, pain, dementia 2. Consequences of poor sleep- cognitive decline, increased risk for falls, daytime fatigue, decreased physical and mental health, decreased quality of life Sensory Age Related Changes - correct answer 1. Loss vs. deprivation 2. Vision: diminished ability to focus on close objects, inability to tolerate glare, difficulty adjusting to changes of light intensity, decreased ability to distinguish colors 3. Macular degeneration: primary cause of loss of vision 4. Hearing- decreased ability to hear higher frequency sounds 5. Taste and Smell- decreased ability to taste and smell Presbyopia - correct answer impaired vision as a result of aging presbycusis - correct answer age related hearing loss Polypharmacy - correct answer The use of many different drugs concurrently in treating a patient, who often has several health problems. What should the nurse do for a patient who is experiencing presbyopia? - correct answer Configure the patient's food into a clock pattern on the plate and explain to the patient at which times on the clock they will find different foods. Acute pain - correct answer pain that resolves and is experienced suddenly (fractured arm) Chronic pain - correct answer episode of pain that lasts for 6 months or longer; may be intermittent or continuous Breakthrough pain - correct answer chronic pain with acute exacerbations nociceptive pain - correct answer tissue injury neuropathic pain - correct answer Damage to peripheral nerve or CNS Numbing, hot-burning, shooting, stabbing, or electrical in nature Sudden, intense, short-lived, or lingering Nociceptive Pain Process - correct answer Transduction-Nociceptors, prostaglandins Transmission Perception Modulation- neurochemicals Opiods - correct answer hydrocodone, morphine Non-opioid analgesics - correct answer Acetaminophen NSAIDs physical dependence - correct answer Normal response with 2+ weeks of use Tolerance - correct answer normal response, patient needs to increase dose of pain medication Addiction - correct answer compulsive drug craving and use, despite adverse consequences Gerontologic Considerations: Pain management - correct answer 1. Sensitive to agents that produce sedation and CNS effects 2. Initiate with low dose and titrate slowly 3. Increased risk for NSAID induced GI toxicity 4. Acetaminophen for mild pain 5. Opioid dose should be 25 - 50% of normal adult dose Chemotherapy main side effect - correct answer Anemia Principles of Hospice Care - correct answer #1- Death must be accepted Death is generally preceded by - correct answer - increased intervals between respirations - weakened, irregular pulse - diminished BP - Skin changes and mottling Grief - correct answer refers to the personal feelings that accompany an anticipated or actual loss Mourning - correct answer refers to individual, family, and group and cultural expressions of grief and associated behaviors Bereavement - correct answer refers to the period of time during which mourning for a loss takes place Perioperative phase - correct answer begins when the decision to proceed with surgical intervention is made and ends with the transfer of the patient to the OR bed Intraoperative phase - correct answer begins when the patient is transferred to the OR bed and ends with admission to PACU Postoperative phase - correct answer begins with admission of the patient to PACU and ends with the follow-up visit What is the nurse's responsibility with informed consent? - correct answer To ensure that the patient has signed the paperwork Which team members on the surgical team are considered sterile? - correct answer Surgeon, First Assist, and Scrub nurse Malignant Hyperthermia - correct answer very tachycardic, increased temperature, dantriline should be administered Levels of PACU care - correct answer Phase I- The patient first comes out of OR, most acute Phase II-Intermediate Phase III- discharge or transfer to floor S/Sx of hypovolemic shock (same as hemorrhage) - correct answer •Pallor •Cool, moist skin •Rapid respirations •Cyanosis •Rapid, weak, thready pulse •Decreasing pulse pressure •Low blood pressure •Concentrated urine