CNA CH 27, 29,12,14,15,16,17, 18,19, 27,29,31

nucleus

"brain" of cell, contains all the information the cell needs to do its job, grow, and reproduce

hypertension

If a person has a blood pressure that is constantly higher that 140/90 mm Hg. Hypertension is often called the "silent killer"

What do you do if a seizure begins?

If a person is standing or sitting when a seizure begins, she could be injured when she falls from losing consciousness and the violent jerking of the muscles can put the person at risk for injuring themselves. Thus, protect the person until the seizure is over and keep the airways open during the period of unconsciousness afterward. If they are standing or sitting when it begins, gently help the person to the floor and move furniture or other objects that might cause injury out of the way. Protect the persons head by placing a pillow or folded towel underneath it and call for help while allowing the seizure to run its course. ( it is common for the person having a gran mal seizure to lose control of her bladder or bowels or drool) After the seizure is over, turn the person to her side and allow and secretions to drain from her mouth to prevent choking. Provide warmth and a quiet environment. A person who just had a seizure may be disoriented, tired, or both and she may have no memory of the episode at all.

Connective Tissue

connects other tissues together. Connective tissue supports and forms the framework for all of the parts of the body. Examples of connective tissue include bone, cartilage, ligaments, tendons, and fatty tissues. Blood is also considered a form of connective tissue.

eupnea

a normal respiratory rate

unit

a patient or residents room

musculoskeletal heat production

contraction of the skeletal muscles produces heat and helps to maintain a constant body temperature. Shivering occurs when the skeletal muscles contract rapidly in unison. The involuntary contractions help to increase the heat output of the muscles, raising the body temperature and making us feel warmer.

Epithelial tissue

covers the outside of the body, lines its internal structures, and forms glands. The purpose of epithelial tissue is protection. Epithelial forms the outer part of the skin. It forms mucous membranes that line our digestive, respiratory, urinary, and reproductive systems. It also covers organs such as the lungs and heart, and lines the inside of blood vessels, abdominal cavity, and chest cavity

Procedure for using a stethoscope

clean both the earpieces and the amplifying devices with an alcohol wipe. Tap lightly on the diaphragm to make sure it works. Next, the stethoscope must be placed under the person's clothing directly on their skin.

Nervous Tissue

conducts information. The brain, spinal cord, and nerves are made up of nervous tissue. Nerves carry information to the brain to be processed and interpreted. In addition, the brain sends commands to other parts of the body through the nerves.

Degenerative diseases

"break down" Degenerative diseases occur when the tissues of the body wear out or break down. (arthritis, muscular dystrophy, osteoporosis, and Alzheimer's disease are examples of degenerative diseases. These diseases can be inherited, or they can be caused by infection, injury, or aging. Sometimes there is no known cause.

Neoplastic disease

("new growth" ) Many people use the word "cancer" or "tumor" when talking about neoplastic disease. Neoplasms cause problems by invading otherwise healthy tissues. The presence of new growth prevents the tissues from functioning properly.

Signs of a stroke

(CAN VARY) -Person is unconscious or difficult to arouse from sleep -Person suddenly seems confused or disoriented -Person slurs his speech or is unable to speak clearly -Person is drooling -A corner of eyelid or a corner of the mouth is drooping -Person complains of the sudden onset of a severe headache -Person complains of weakness, paralysis, tingling, or numbness of an arm or leg or the side of the face -A change in the person's vital signs, especially the blood pressure or pulse

What are signs and symptoms of a heart attack

(CAN VARY) pain, pressure, or tightness in the chest, which may extend to the neck, back, or arm. Pale or grayish skin excessive sweating trouble breathing nausea or heartburn-like pain

Greenstick fracture

(like trying to snap a green twig) It bends and splinters, but it will not break all the way through. Greenstick fractures occur most commonly in children because their bones are still quite flexible.

Hypotension

(low blood pressure) a person who has a blood pressure that is consistently lower than 90 mm Hg (systolic) and/or 60 mm Hg (diastolic)

subacute care

(skilled nursing) units for patients who are not quite well enough to go home but not quite sick enough to be in a typical hospital room. Is more home-like.

If a persons weight is to be measured on a regular basis, make sure that the weight is

- measured at the same time of day each time -measured with the person wearing the same type of clothing and no shoes -measured after the person has emptied their bladder

Things you can do to help minimize the noise

-encourage patients/residents to use headsets or earphones when using tv or radio -answer telephones promptly -report noisy equipment -be aware of the volume of your voice

Things you can do to help minimize odors and maintain a pleasant environment:

-follow policy of handling of waste and soiled linens -keep lids of laundry and waste receptacles closed -empty and clean emesis basins, urinals, bedside commodes, and bedpans promptly -facility approved air freshener -assist patients/residents with routine personal care (clean skin and good oral hygiene) - pay attention to your personal hygiene, use scented products sparingly

Guidelines for taking a persons blood pressure

-let them relax for 5 minutes -do not place cuff over clothing -have patient comfortably sit or lie down with the forearm supported at the level of the heart and the palm of the hand upward. -do not take blood pressure of the are with and IV line or arm that is injured -do not take blood pressure on side of mastectomy - don not use arm that is used for hemodialysis access

Common special care needs for a person in tractionn

-range of motion exercises -fracture bedpan -watch for pressure ulcers. Keep skin clean and dry and monitor for signs of skin breakdown -two people usually work to change the linens which are changed from top to bottom rather than from side to side. Be very careful not to disturb or remove the weights attached to the traction unit. When you lower the bed, make sure the weights do not touch the floor. They must hang freely!

The following aspects of the resident's environment are regulated by OBRA:

-size of room -lighting that must be available -temperature at which the facility must be maintained -the measures that must be taken to maintain air quality' -measures that must be taken to control noise -types of furnishings and equipment that must be present -the types of modifications to the room that must be present to ensure safety (handrails or intercom) -the minimal amount of personal space for storage of belongings that each resident is allowed to have -the ability to provide privacy for each resident

Process of Pulmonary Circulation

-the largest veins in the body, the superior and inferior vena cava, empty into the right atrium of the heart. The blood in these veins is returning from its journey to the tissues, so it has given up most of its oxygen and taken on a load to carbon dioxide. -the right atrium pumps the oxygen poor blood into the right ventricle -the right ventricle pumps the oxygen poor blood into the pulmonary artery. The pulmonary artery branches into the right pulmonary artery and the the left which foes to the left and right lung. -Once in the lungs, the pulmonary arteries quickly branch into small arteries and arterioles to carry the oxygen poor blood to the capillary beds surrounding the alveoli. Gas exchange takes place in the alveoli. The oxygen in the alveolus moves into the blood, and the carbon dioxide in the blood moves into the alveolus. -The now oxygen rich blood is carried by the network of venules, then veins, to the pulmonary veins (right and left), which empty into the the left atrium of the heart.

Process of Systematic Circulation

-the left atrium pumps the oxygen rich blood into the left ventricle. -The left ventricle pumps the oxygen rich blood into the largest artery of the body, the aorta. -The aorta branches very quickly into the coronary arteries to carry oxygen rich blood to the heart muscle, and then into large branches of arteries that carry oxygen rich blood to the rest of the body. -THe arteries branch into arterioles and then into capillaries, which join together to form a capillary bed. In the capillary bed, oxygen and nutrients move out of the blood and into the tissues and carbon dioxide moves out of the tissues and into the blood. -the blood, which now contains less oxygen, is carried by the network of venules, then veins, back to the right atrium.

Life's Simple 7 according to the American Heart Association

1. Manage blood pressure. High blood pressure is a major risk factor for heart disease and stroke. Medication, exercise, a diet lower in sodium (salt), and weight control can help to keep blood pressure in a healthy range. 2. Control Cholesterol: High cholesterol contributes to the formation of plaque which can clog arteries and lead to heart disease. A healthy diet and medications can help control cholesterol. 3. Reduce Blood Sugar. Diets high in sugar and uncontrolled diabetes can lead to high blood sugar levels. Over time, this can cause damage to your heart, kidneys, eyes, and nerves. 4. Get active: daily physical activity helps to keep the heart muscle strong, enhances the function of almost all body systems and can increase your length and quality of life 5. Eat better: a healthy diet that is low in saturated (unhealthy fats) is one of your best weapons to fight cardiovascular disease 6. Lose Weight: By loosing extra fat and unnecessary pounds, you reduce the workload places on your heart, lungs, blood vessels, and skeleton. 7. Stop smoking: chemicals in tobacco smoke cause the arterioles and capillaries to constrict, depriving tissues of vital blood flow.

In an emergency situation, your responsibilities as a nursing assistant are to :

1. Recognize that an emergency situation exists. 2. Decide to act. Stay calm and organize your thoughts. Check the scene for danger. (acting hastily can make things worse) 3. Check for consciousness. If is is safe, gently shake the person and call to him. If fainted/passed out, call the nurse for help. Keep the person lying down, and stay until nurse arrives. If person does not respond.... 4. Activate the emergency response system. 5. Provide appropriate care until the emergency response personnel arrive. Provide first aid (the care given to an injured or sick person while waiting for more advanced help to arrive) according to the situation and your level of training. (only what is in your scope of practice). Speak gently and calmly to the person and reassure him that more help is on the way. 6. Record the care you provided. as always when you provide care, you must accurately record your observations and care that you provided.

the admission process

1. begins in a doctors office (unless an emergency). Doctor writes orders regarding the specific needs of the person. The order usually include doctor's diagnosis of the person's condition, dietary orders, activity status, medications, diagnostic tests, and the type of room required by the person 2. Person goes to admissions office, they are helped to complete an admission sheet, which gathers standard information about the person. They also must sign a consent, giving permission to the facility to treat their condition. The person is then provided with a way of being identified. In a hospital, an identification bracelet will be issued. In a long term care facility, a photograph of the person will be taken for identification purposes. 3. Upon the completion of admissions paperwork, the person is escorted to his room 4. Nursing assistant is usually responsible for helping the person to unpack and for taking and recording the person's vital signs, height, and weight. If youre in a hospital, may need to help the person change into a hospital gown or PJs. Make sure that the person is comfortable by helping them into a bed or chair. Next a nurse will come to the room to complete the nursing history

OBRA regulations require the temperature in a long term care facility to be kept between

71 and 81 ˚F (elderly, or inactive may prefer a warmer temperature)

What are the accepted adult ranges for systolic and diastolic pressure?

90 to 120 mm Hg 40 to 80 mm Hg

external fixation

A cast is a method of external fixation, or fixation that is achieved without surgery. (thing layer of cotton on the skin then the casting material)

Organ

A group of tissues functioning together for a similar purpose ( Ex: the heart is made of all four tissue types, and its main function is to pump blood through the body)

bradycardia

A heart rate slower than normal. Certain illnesses or conditions can cause bradycardia. Bradycardia may also be a normal finding in a young athletic person who is very physically fit because the person's physical conditioning allows the heart to pump stronger and more effectively which slows the heart rate.

cytoplasm

A jellylike fluid inside the cell in which the organelles are suspended

Chronic diseases

A person who has a chronic disease, such as diabetes or high blood pressure, is at an increased risk for developing another disease. (Ex; a person who does not manage his diabetes well is likely to develop heart disease, blindness, or kidney failure.. ) In addition, a person who has a chronic disease is often more likely to experience more severe problems from something that would not really affect a healthy person (Ex; an ingrown toenail will discomfort a healthy person, but for a person with diabetes, the ingrown toenail could cause a severe infection because diabetes changes the internal environment of the body, placing the person more at risk for infection)

Emotional health

A person's emotional health can directly affect her physical health. Emotional stress can create physical problems such as headaches, digestive disorders, and muscle strain. In addition, stress makes the body more at risk for infection.

gender

A person's gender can put the person at risk for certain diseases. For instance, breast cancer is much more common in women than in men. Women are also more likely to develop diabetes. However, men are more likely to have heart disease.

Lifestyle

A person's living conditions and health habits play a major role in the person's overall health status.

Temporal Temperature

A person's temporal artery has branches that run very close underneath the skin across the forehead and in front of the ear. The reading is very accurate! however, if a person is sweating, the evaporation can lower the temperature and give a false reading. If the person has anything covering the forehead, the reading can be inaccurate because of this as well (hair, hat, wig, bandage,)

Factors that can causes changes in a person's vital sign measurements

A person's vital sign measurements may vary over the course of a day (due to physical or emotional stress or a change i position) while staying within the range of "normal"... however a major or long lasting change in one or more of a person's vital signs may be a response to illness or injury

What is the leading cause of disability in older adults?

Age related changes affecting the musculoskeletal system. It is now known that participating in regular physical exercise and eating properly are measures that can delay or decrease the effects of aging on the musculoskeletal system. The normal age-related changes that affect the musculoskeletal system include loss of bone tissues, loss of muscle mass, and wear and tear on the joints.

ABC's of good body mechanics

Alignment: good posture, proper alignment to ensure no excess strain on joints and muscles Balance: even distribution of weight, involving holding your center of gravity close to base of support (can increase your base of support by spreading your feet farther apart and can bring your center of gravity closer to your base of support/feet by bending at the knees and hips so that your torso is closer to your feet) Coordinated body Movement: using weight of your body to help with movement

Infectious disease

An infectious disease is caused by pathogens (germs). Infections are believed to play a role in approximately half of all illnesses.

What do common blood disorders include?

Anemia, Leukemia, and Bleeding disorders

Irregular bones

Are oddly shaped bones that are not flat. Irregular bones are found in the spinal column and face.

arteries vs veins

Arteries contain more smooth muscle, because arteries receive blood that is being pumped from the heart under great force and pressure. The tunica intima of the veins contains valves, which help blood to flow back to the heart. This is especially important in the arms and legs where blood would tend to flow away from the heart, due to the effects of gravity. The valves are assisted by contraction of nearby skeletal muscles. For example, when we walk, contraction of the leg muscles compresses the veins, pushing blood toward the heart.

(effects of aging) wear and tear on the joints

As we age, we lose the proteins that make the ligaments, tendons, and cartilage elastic and flexible, which can lead to stiffness and pain in the joints. Overuse or injury of a joint, or being overweight, places extra strain on certain joints and will make the normal changes associated with aging more severe. Joint pain can make simple activities difficult and make a person more likely to fall.

Tympanic Temperature

Because a tympanic thermometer measure the temperature of the blood in the small vessels in the eardrum, the temperature is very accurate. If a patient/resident has an earache, or drainage from the ear, use the other ear to prevent discomfort. If the person has been sleeping with one side of his head against a pillow (heat increase on one side), use the other ear.

Why do most health care settings not use glass thermometers?

Because mercury is toxic and there are dangers associated with breakage and spiller mercury

How is blood pressure recorded?

Blood pressure is measured in millimeters of mercury (mm Hg) and is recorded as a fraction. Systolic pressure is recorded first, then the diastolic.

Normal and abnormal changes in blood pressure

Blood pressure readings usually lowest in the morning and can increase up to 10 mm Hg later in the day. Blood pressure is generally slightly higher when a person is lying down compared to standing/sitting Blood pressure readings usually slightly higher after a mean. Wait at least an hour after eating . Exercise will temporarily increase systolic pressure Stress, anxiety, fear, and pain will also temporarily raise a person's blood pressure IF a persons blood pressure rises/falls 20-30 mm Hg REPORT IMMEDIATELY even if it is still considered within normal!!

Musculoskeletal production of blood cells

Bones function as a factory for the production of blood cells. There are many different types of blood cells, with many different functions. (Ex: some apart of immune response, others carry oxygen to tissues of the body) Blood cells form in red bone marrow, which is found in flat bones and the ends of the long bones. In young children, the shaft of the long bones also contains red bone marrow, but that red bond marrow is gradually replaced by yellow bone marrow as the person grows older. Yellow bone marrow is made up of mostly fatty tissue that can be used by the body for energy if necessary.

Cardiovascular system : Transport

Bringing oxygen, nutrients, and other necessary substances (ex. hormones) to the cells and taking waste materials away from them is one of the most important functions of the cardiovascular system.

Musculoskeletal calcium storgage

Calcium is an important mineral necessary for the proper functioning of skeletal and cardiac muscles. Calcium is also what makes the bone tissue card and strong. (calcium rich foods: milk, cheese, yogurt broccoli, leafy greens, tofu, and calcium fortified orange juice) If we do not take in enough calcium, then calcium is released from the bones as it is needed. *this is why is is very important to intake calcium, especially when a person in young! Consuming enough calcium early on in life builds up the calcium stores in the bones. As we grow older, our intestines become less effective at absorbing the calcium that we eat, so calcium is released from the bones to keep the levels in our bloodstream constant. If the amount of calcium stored in the bones is not adequate, the bones become brittle and weak. Consuming enough calcium while you are young is like putting money in the bank to use after you retire.

What do you do is a person is hemorrhaging?

Call for help and make sure the person is lying down. Stake standard precautions to protect yourself from exposure to blood borne pathogens. Apply firm, steady pressure directly to the wound using a sterile dressing, a clean towel, or whatever else is clean and available for use as a compress. Continue to apply pressure to the wound until more advanced medical help comes. IF the direct pressure does not stop or slow the flow of blood, raise the affected body part (if it is an arm or leg) and apply pressure to a pulse point between the wound and the heart.

What three factors control blood pressure?

Cardiac output, blood volume, resistance to blood flow, age, gender, and race

What are the different types of shock?

Cariogenic, Hemorrhagic, Septic, and Anaphylactic

What are the 6 types of fractures

Closed, open (compound), greenstick, impacted, comminuted, and spiral.

When taking the blood pressure, to what pressure do you pump the cuff?

Continue pumping the bulb until the pressure in the cuff is 30 mm Hg higher than the systolic pressure. Can do this by either listening for the systolic pressure , then continue until you hear it stop, and continue inflating the cuff 30 mm Hg more. OR feel the persons brachial or radial pulse, and inflate until you no longer feel the pulse. Continue inflating the cuff 30 mm Hg more

What are the four main types of tissue in the human body?

Epithelial, Connective, Muscle, and Nervous tissue

Syncope

Fainting occurs when the blood supply to the brain suddenly decreases, resulting in a temporary loss of consciousness. Although, fainting may be an early sign of a serious medical condition, such as a heart problem, it can also be a result of hunger ("low blood sugar"), pain, extreme emotion, fatigue, medication side effects, a "stuffy" room (poor ventilation), excessive heat, or standing for a long time. Fainting is not life threatening, in and of itself, but because a person who faints is at risk for injury from falling, it is important to act quickly if you believe a person is about to faint. A person who is about to fain may complain of dizziness or a temporary loss of vision. His skin may be pale and clammy and he may sweat excessively. He may breathe shallowly, and his pulse may be weak.

3 classifications of joints

Fixed, slightly moveable, freely movable

Preventing fires

For a fire to occur, there must be three elements present: fuel (something that burns), heat (something to ignite the fuel), and oxygen... by removing one of these elements you take out the fire Heat can be provided by an electrical spark, lighted smoking materials, lighted candles, stoves Some patients receive oxygen therapy, which puts at higher risk: patients receiving oxygen therapy should not have wool or mohair blankets. Watch smoking materials. keep electrical equipment in good order. Do not use flammable substances near a heat source.

Smooth Muscle

Found in the walls of organs such as the intestines, stomach, and blood vessels. Movement provided by smooth muscle is involuntary (out of your control). For example, peristalsis occurs due to the smooth muscle in the walls of the intestines. (peristalsis is the wave like movements that pass digested food through the intestines)

What do you do if you think a person is about to faint?

Have the person lie down in the supine position and elevate his legs 12 inches, or ask him to sit down and bend forward placing his head between his knees. These actions will increase blood flow to the brain, which may prevent the person from losing consciousness. Loosen and restraints or tight clothing (such as a belt or necktie), and have the person remain in the supine or sitting position (head between knees) for at least five minutes. Do not leave the person unattended during this time.

Heart Block & treatment

Heart block is a common type of dysrhythmia. Heart block can result from a myocardial infarction that damages the conduction pathway, or it may occur as part of the normal aging process. A heart block causes the heart to slow down significantly, leasing to dizziness or fainting episodes. Heart block is usually treated with a pacemaker, an electrical device that stimulated the heart to contract.

what to do during aspiration

If the person is choking with a partial airway obstruction and has good color, have the person sit up. Stay with the person and allow him to continue to cough. Airway obstruction in which the person turns blue (cyanosis), has a weak ineffective coughing effort need immediate help. The person will loose consciousness quickly if the object that is blocking airflow is not removed The Heimlich maneuver is used to clear an obstructed airway in an adult or a child older than 1 year. Use less force on a child. For pregnant women and very heavy people, the procedure is modified so that chest thrusts rather than abdominal thrusts are used. Perform abdominal thrusts repeatedly until the airway is open again. If the person becomes unresponsive, lower them to the ground and begin CPR starting with compressions (do not check pulse).

What are situations in which an oral temperature should not be taken?

If they are unconscious, cant keep mouth closed, can't breathe through nose, is likely to bite the thermometer (child under 5, disoriented person, or a person with a history of seizures), is coughing or sneezing, has recently had mouth surgery/an injury to the mouth, is receiving oxygen by a face mask.

What are important plasma proteins in the blood and what does each do?

Important plasma proteins include albumin, fibrinogen and globulins. Albumin plays a role in moving fluid in and out of the bloodstream Fibrinogen is used as part of the blood clotting process Globulins help to fight infection

Osteoarthritis

In osteoarthritis, the cartilage that covers the ends of the bones wears away, making the movement of the joint difficult and painful. it is the leading cause of physical disability among elderly. Osteoarthritis appears to be the result of normal wear and tear on the joint (obesity, previous injury, or family history of the disease may increase a person's risk of developing osteoarthritis earlier in life and more severely.) Osteoarthritis usually affects weight-bearing joints, such as the knees, hips, and joints of the spinal column. Osteoarthritiis begins when the smooth cartilage on the ends of the bones becomes rough, due to normal use of the joint. The rough area then becomes inflamed , and the bony deposits build up. These bony deposits rub against the cartilage, causing even more damage. This cycle repeats until the cartilage has been worn down to the point where bone is actually rubbing against bone as the joint move. The joint becomes swollen, stiff, and very painful.

Internal fixation

Involves the use of metal plates, screws, rods, pins, or wires to hole the broken ends of the bone in place until the bone is healed.

Hemorrhage

Is sever uncontrolled bleeding caused by trauma to a blood vessel or by certain illnesses. Note that people who are taking medications to prevent blood clotting are at higher risk for hemorrhage. Hemorrhage can be internal or external. Internal hemorrhage may be hidden unless the person vomits blood or passes blood through the rectum. Hemorrhage can be either be venous or arterial, depending on the type of blood vessel that is injured. Venous hemorrhage flows steadily. Arterial hemorrhage spurts or pulses with the heartbeat. If hemorrhage is not controlled quickly death will result.

Leg exercises

Leg exercises help to move blood back to the heart and prevent the formation of clots.

How to make people feel less stressed during the admission process

Make an effort to treat each as a guest! Ask what they preferred to be called. Have them include their loved ones in the admission process and welcome them.

Occupation

Many jobs put a person at risk for certain diseases (ex. constant exposure to coal dust puts coat miners at risk for developing "black lung disease" or health workers who do not take care to protect themselves)

Axillary temperature

Measured by placing the thermometer under the person's arm, directly in contact with the person's skin, and then having the person hold his arm close to his body. The auxiliary method is the least reliable method. If the person has just washed under their arms, or applied deodorant/antiperspirant then you must wait at least 15 minuted before taking the axillary temperature. Also, if the person has recently had chest or breast surgery, and it is necessary to take the persons axillary temperature, the thermometer should be placed on the unaffected side of the body.

Treatments for Coronary artery disease (CAD)

Medications are available that help to keep the arteries open, permitting maximum blood flow. Balloon angioplasty is a technique that involves inserting a catheter with a small balloon on the tip into the narrow part of the affected artery. The balloon is inflated, pressing the plaque against the arterial wall to create a larger opening for the blood to flow through. Then the balloon is deflated and the catheter is removed. Sometimes done with the placement of a small coiled wire called a stent, which supports the artery walls helping to keep the artery open. When the blockage is severe, surgery may be performed to bypass the blocked arteries and reestablish blood flow. The medical term for this type of surgery is coronary artery bypass graft (CABG) surgery. Conditions that are closely related to CAD include angina pectoris and MI

Phychiatric disorders

Mental disorders that affect a persons ability to function normally, such as depression, are also considered diseases.

Metabolic disorders

Metabolic disorders, such as diabetes, occur when the body is unable to metabolize or absorb certain nutrients. Metabolic disorders often occur when the body secretes either too much of one type of hormone, or not enough. B/c the hormone is responsible for controlling the function of a particular organ., the organ does not function properly and an imbalance in homeostasis occurs.

mitered corners

Mitering is a way of folding and tucking the sheet so that it lies flat and neat. When a flat sheet is used as the bottom sheet, the mitered corners are made at the top of the bed. Mitered corners are made at the foot of the bed to hold the top sheet, blanket, and bedspread in place.

Plasma

More than half of the total blood volume is plasma. Plasma is the liquid part of the blood as it is 90% water and the other 10 % us made up of substances that are dissolved in the water (such as glucose, amino acids, fats, and salts) and proteins.

Oral temperature

Mouth is not an entirely enclosed space, in which the temperature reading may not be as accurate. If a person eats, drinks, smokes, or chews gum within 15 minutes of having an oral temperature taken, the measurement may not be accurate. If your patient/resident has done any of these things shortly, you should use another method to take temperature ore wait (usually 15-30 minutes)

What is actually occurring in the body during a heart attack?

Myocardial infarction (MI) . The myocardium is the muscular wall of the heart. An infarction occurs when the blood flow to a part of the body is blocked, depriving the cells of oxygen and causing them to die. So when a person has an MI, blood flow to the muscular wall of the heart is blocked, and part of the heart muscle dies. As a result the heart is unable to pump blood effectively throughout the body, creating an emergency situation. If the damaged area of the heart is large enough, cardiac arrest can occur.

OBRA regulations for storage space

OBRA require long term care facilitated to provide each resident with enough storage space for his or her clothing and other personal items. the resident must have free access to this storage space and the items it contains. The residents closet, wardrobe, or chest of drawers is considered private personal property and you must have the persons permission to remove items from it Occasionally, you will need to inspect a residents personal storage area, you must inform the resident and they must be present when you do so or another staff member

against medical advice (AMA)

Occasionally a person will insist on leaving a health care setting without a doctor's order. A person who is competent may choose to leave a facility if she wants to, but they must sign documents stating that they understand that leaving the facility without doctor's order releases the health care providers from any legal responsibility regarding their health status. [increasing costs of health care has created situations where patients are discharged before they are fully recovered]

pulse deficit

Occasionally, the heart does not pump strongly enough to send enough blood through the arteries with each beat. This means the beat of the heart may be heard but not felt through the wrist. This difference between the apical pulse rate and the radial pulse rate is known as the pulse deficit. The pulse deficit is measured by having one member of the nursing team take the person's apical pulse while another team member takes the person's radial pulse. apical pulse rate-radial pulse rate = pulse deficit

ORIF

Open Reduction, Internal Fixation

What are the basic qualities that make a living thing different from a nonliving thing?

Organization, metabolism, growth, and reproduction

Hemoglobin

Oxygen molecules attach to the hemoglobin for transport to the tissues. When combined with oxygen, hemoglobin is bright red. This is what gives red blood cells their color and name. The hemoglobin molecule on each red blood cell can carry many oxygen molecules. The hemoglobin on red blood cells that have just received a full load of oxygen from the lungs is filled to capacity with oxygen. As the blood circulates through the body, giving off oxygen and taking on carbon dioxide, the number of oxygen molecules on the hemoglobin molecule decreases, and the blood becomes darker red in color.

privacy curtains/room divider

PBRA regulations require long term care facilities to use privacy curtains or room dividers to protect the privacy of each resident. Pay attention to the cleanliness of privacy curtains/room dividers. Ensure they stay clean and report any stains.

The affects of race on blood pressure

People of certain races (african americans) tend to have higher blood pressure than people of other races.

resident independence

Per OBRA regulations, long term care facilities are expected to provide care in a manner that promotes residents' independence. Being able to do as much as possible independently helps any person in a health care setting reach the important goal of attaining/maintaining their highest level of function and well being.

supportive devices

Pillows, rolled sheets, towels or blankets used to position the person to maintain proper body alignment

Temporal artery thermometers

Placed on the middle of the persons forehead and swept towards the ear, stopping in front of the ear. even more accurate than a tympanic thermometer and considered the least invasive

What are the two main components of the blood?

Plasma and Blood Cells

Thrombocytes

Platelets, or thrombocytes are responsible for clotting (coagulation) of the blood. When injury occurs, the platelets stick together to form a temporary plug over the site of injury. They also release chemicals that react with the plasma protein fibrinogen, causing a more permanent clot (scab) to develop. This process, known as hemostasis stops the loss of blood from the circulatory system. Platelets are not actually whole cells but they are pinched off pieces of large cells that are formed in the red bone marrow.

Using electric thermometers

Probe is covered with a disposable sheath. a blue probe is used for taking oral or axillary temperatures while a red probe is used for taking rectal temperatures.

Radiography

Radiographs are commonly known as "X-rays", and are often used in the diagnosis of cardiovascular disease. a chest x-ray can show enlargement of the ventricles. Sometimes, a special dye is injected into the veins and then an x-ray is taken. The dye allows the doctor to see any abnormalities in the vessels of the heart or other parts of the body.

What are the 3 main types of blood cells?

Red Blood Cells (Erythrocytes) White Blood Cells (Leukocytes) Platelets (thrombocytes)

Erythrocytes

Red blood cells, or erythrocytes, carry oxygen. Red blood cells are made in the red bone marrow and are continuously replaced as old ones wear out. Red blood cells are tiny, disc shaped cells that are thinner in the center than at the edges. The "dent" in the center of the red blood cell contains a protein called hemoglobin.

Treatment for Fractures

Reduction and Fixation: For a fractured bone to heal properly, the broken ends of the bone must be brought together (aligned) and then held in that position until the fracture heals.

RACE fire response plan

Remove any patients or residents who are immediate danger to safety. People who cannot get out of bed should be moved in their beds. Alarm Activate alarm Contain the fire by closing doors and windows to slow the spread of the fire. Extinguish the fire is possible or, if the fire is too large, Evacuate the building

Resistance to blood flow

Resistance is how hard it is for the blood flow through the vessels. If the vessels are narrowed (ex. result of arteriosclerosis), then the resistance will be high and so will the blood pressure. Resistance is also increased when the blood is thick, for ex. if a person is dehydrated.

Traction

Some fractured bones cannot be repaired surgically for a period of time, especially if the person's overall medical condition is unstable. In these cases, traction is used to keep the broken ends of the bone in alignment until the fracture can be permanently repaired by surgery or casting. IN traction the ends of the bones are placed in the proper alignment and then weight is applied to exert a constant pull and keep the bone in alignment. In skin traction, weight is suspended from a traction unit that is attached to the person's skin. In skeletal traction, weight is suspended from pins that are driven through the bone.

Open reduction

Sometimes is is neccessary to surgically expose the bone to line up the broken ends of the bone. Open reduction is often followed by internal fixation.

Echocardiography

Sound waves are bounced against the body to produce an image. A computer translates the sound waves into an image. Echocardiography can provide the doctor with much helpful information, including the size and shape of the heart, its pumping strength, and the location and extent of any damages to the tissues.

Doppler Ultrasound

Sound waves are used to check the blood flow in the large arteries and veins of the arms and legs.

Electrocardiography

Test: sensors are attached to the person's chest. These sensors pick up the electrical activity of the heart and record it on a piece of paper. The tracing is called and electrocardiogram (EKG, ECG). An EKG shows abnormalities in the conduction system of the heart. Some people have ab EKG done while they are exercising. This is called a stress test.

Which rates should be the same in any single person?

The apical pulse rate and the radial pulse rate!

cardiac cycle

The atria contract (atrial systole), sending the blood into the relaxed ventricles (ventricular diastole). Next, the atria relax (atrial diastole) while the ventricles contact (ventricular systole), sending the blood out to the body. The heart is able to perform more efficiently when the ventricles are filled because less force is required to send the maximum amount of blood out to the body.

Blood Vessels

The blood vessels carry blood to and from all of the tissues in the body. The walls of the blood vessels have three layers. 1. Tunica intima (endothelium): smooth lining that helps blood to flow smoothly through the vessel. 2. Tunica media (smooth muscle): is formed of smooth muscle tissue allowing blood vessels to constrict or dilate according to the body's needs. 3. Tunica externa (connective tissue): is a tough protective layer of connective tissue

Spiral fracture

The break circles around the bone in a winding fashion. Spiral fractures are common when the bone has been subjected to a twisting force.

Cardiovascular systems: Protection

The cardiovascular system helps to protect the body in two major ways. First, white blood cells, which play an important role in helping us to fight off disease, are circulated throughout the body in the blood. Second, when injury to the body occurs, the blood has the ability to form a clot. The clot helps to protect us against excessive blood loss. IT also helps to prevent microbes from gaining access to the body.

Bone cells & vessels

The cells that form the bones are constantly broken down and replaced with new cells in a lifetime. A complex network of blood vessels supply the bone cells with oxygen and nutrients they need.

When listening to the heart beat by a stethoscope what are the first and second sounds?

The first sound, is the sound of the tricuspid and mitral valves snapping shut during ventricular systole. The second sound is the sound of the pulmonary and aortic valves closing during ventricular diastole.

Trendelenburg position

The foot of the mattress is raised to that the persons head is lower than their feet (sometimes used for a person who has gone into shock and has very low blood pressure to encourage blood flow to the heart)

heredity

The genes that we inherit from our parents may put us at risk for developing certain diseases. For example, scientists now know that some types of cancer, diabetes, and hear disease are inherited.

Fowlers position

The head of the bed is elevated between 45-60 degrees.

Atria and Ventricles

The hollow interior of the heart is divided into four chambers. A thick wall of muscle, called the septum, separates the left side of the heart from the right side. Flaps of tissues, valves prevent blood from flowing in the opposite direction. The upper chambers are called the left atrium and right atrium, or the atria. The atria receive the blood that is being brought back to the heart from the body and send it into the lower chambers of the the heart called the ventricles. When the ventricles contract, they send blood from the heart to other parts of the body. Because the ventricles must send the blood much further with each contraction, they are larger than the atria, and have thicker, more muscular walls.

Long bones

The long bones are found in the arms and the legs. Long bones consist of a shaft and two rounded ends.

Heart's Conduction system

The muscle cells that make up the myocardium are very specialized, so that they contract as a unit. This unified contraction is what allows the heart to work efficiently as a pump, moving blood continuously through the body. A small mass of special tissue in the heart, called the sinoatrial node (pacemaker), sets the pace for contraction by generating an electrical impulse. The electrical impulse travels through the myocardium via a special pathway called the conduction system. As is passes through, the electrical energy causes the cardiac muscle cells in the myocardium to contract. First the atria contract, there is a pause, and then the ventricles contract. The heart rests briefly and then the pacemaker generates another impulse, starting the cycle again.

(effects of aging) loss of muscle mass

The number of muscle cells also starts to gradually decreases when a person is in his or hers 40s, resulting in a decrease in the size and strength of each individual muscle.

Pacemaker

The pacemaker is an electrical device that stimulates the heart to contract. The pacemaker consists of a small, battery-operated device implanted under the skin below the collarbone and two wires that connect to the right side of the heart. When the person's heart rate drops below a programmed rate, the battery operated device send a small electrical impulse through the wired that stimulates the heart muscles to contract.

ergonomic

The practice of designing equipment and work tasks to conform to the capability of the worker. This entails adjusting the work environment and how workers perform work-related practices so that injuries are prevented. (nursing assistants must face force, repetition, and awkward postures) OSHA recommends that manual lifting of residents in long term facilities be minimized and eliminated when available by using mechanical lifts.

What is the process of breathing controlled by?

The process of breathing is controlled mainly by the central nervous system in a part of the brain called the medulla. Chemoreceptors are the control centers located in the medulla and in some major arteries. The chemoreceptors monitor the CO2 and O2 content of the blood and adjust the rate and depth of breathing accordingly.

Importance of measuring height and weight (even though it is not considered a vital sign)

The relationship of a persons weight to his height can provide insight into the persons overall health and nutritional status. A persons weight is also often used to calculate medication doses. -weight is and indicator of nutritional status -weight is an indicator of heart and kidney function (if heat/kidney no functioning well, the person will retain fluid, causing an increase in weight) -changes in weight can be a sign of disease -medication dosages are determined according to wieght

arterioles

The smallest arteries are called arterioles. Arterioles divide into branches called capillaries, which form a network in the tissues called the capillary bed. As blood passes though the capillary bed, the oxygen and nutrients in the blood pass into the tissues, and carbon dioxide and other waste materials from the tissues pass into the blood. This transfer of substances in and out of the blood is possible because the walls of the capillaries have only one thin layer, as opposed to the three layers in the walls of the arteries and veins. After blood passes through the capillary bed, it starts its journey back to the heart by way of very tiny veins called venules. Venules drain into small veins, which become larger in diameter as they approach the heart.

When we evaluate a person's vital signs, what are we evaluating?

Their body temperature, heartbeat (pulse) , breathing (respirations), and blood pressure. (height and weight not a vital sign but often included)

Immune disorders

These disorders change the way the immune system behaves. Sometimes, as in acquires immunodeficiency syndrome (AIDS), the disease reduces the immune system's ability to fight off infection. Other times, the disease causes the immune system to start attacking the body's own tissues.

Nutritional disorders

These disorders occur when a person's diet lacks certain nutrients. Consuming too much of any one nutrient or too many calories can also cause nutritional disorders. (ex. obesity is a nutritional disorder)

Venous (stasis) ulcers

These ulcers are seen on the lower legs, usually in the ankle area. The pressure of the pooled blood in the veins forces plasma out of the blood vessels and into the surrounding tissues. Swelling occurs and the skin becomes fragile and inflamed. Eventually, the skin breaks down resulting in an open sore. Doctor may order use of leg exercises, antiembolism, (TED) stockings, or both to treat/prevent venous disorders.

How to do treat shock?

To treat shock, the underlying cause of the shock must be addressed. For example, if it is because of hemorrhage, the bleeding must be stopped and the fluid replaced intravenously to prevent death. If the pumping action of the heart is too weak or erratic to circulate blood to the organs and tissues, the heart''s ability to pump must be restored through medications or other measures, such as the implantation of a pacemaker.

3 Functions of the Cardiovascular system

Transport, regulation, protection

What does Nitroglycerin pills treat? and cautions?

Treats Angia Pectoris by relaxing the arteries and increases blood flow. Avoid touching pills with your hands because the drug can be absorbed through the skin which can cause a decrease in your blood pressure and a pounding headache.

How many layers do bones have?

Two. The outside is hard and solid while the inside is sponge-like and airy... this combination results in very strong yet lightweight bones.

what do we do when we measure a persons respirations?

We look at a persons respiratory rate, respiratory rhythm, and depth of respirations. *also listen for any abnormal sounds such as wheezing or coughing

Tissue

When cells that are similar in structure and specialized to perform a specific function join together, they form tissue

Leukocytes

White blood cells, or leukocytes fight infection. There are five different types of white blood cells. Each type of white blood cell has a different function ALL related to fighting infection. Some destroy pathogens by surrounding them and "eating" them in a process called phagocytosis. Others secrete substances that cause the pathogen to die. Still others make proteins called antibodies, which prevent us from getting some diseases twice. White blood cells are formed in the red bone marrow and the lymphatic system. An infection causes white blood cell production to increase, sending more "troops" into the bloodstream to battle the invading pathogen.

The affects of gender on blood pressure

Women tend to have lower blood pressures than men. However, women who take oral contraceptives ("birth control pills") may have a slightly increased blood pressure.

trapeze bar

a bar attached to the overhead frame of the person's bead. The person grasps the trapeze bar to assist with movement.

embolus

a blood clot that moves from one place to another. Can be life threatening.

Treatments of osteoporosis

a drug that helps to slow the progression of osteoporosis has been developed. Additionally, the use of calcium and vitamin D supplements can also help. Resistance training (lifting weights) slows the progression of the disease by helping to promote bone strength. However, prevention is the best medicine! Osteoporosis can be prevented in many cases by exercising regularly and eating a diet rich in calcium, protein, and vitamin D, starting in early life .

Dysrhythmias

a dysrhythmia is an irregular heart rate, rhythm, or both. There are many different types of dysrhythmias. They can occur when the conduction system of the heart is not working properly. They can cause a person to experience heart palpitations, fatigue, dizziness, or fainting. They can also increase the person's risk for a heart attack or stroke. (many will take medication for this) Heart block is a common type of dysrhythmia.

Muscular dystrophy

a group of disorders that cause the skeletal muscles to become progressively weaker over time. These disorders are inherited. ....

symptoms of shock

a person entering a state of shock will have low blood pressure that continues to decrease. His pulse will be rapid and weak. His skin will be cool, clammy, and pale. He will be confused or disoriented. He will breathe rapidly, and if he is conscious, he may complain of thirst. Make sure that advanced emergency medical care has been called and keep the person warm and calm. The treatment for anaphylactic shock is the immediate administration of a medication called epinephrine (adrenaline). A person in this shock needs someone to administer it for them.

lateral position

a person in lateral position is lying on their side (often used for people with back pain and in a body cast). Upper leg is bent. Pillow goes between legs and under upper arm. [for people who cant move themselves, person is moved from lateral position to supine position every two hours]

Tachycardia

a rapid heart rate, or a pulse rate of more that 100 beats per minute for an adult (Normally, pulse rate tend to be faster in infant and small children)

tachypnea

a respiratory rate that is higher than normal (greater than 24 breaths per minute in an adult)

bradypnea

a respiratory rate that is lower than normal (less than 10 breaths per minute)

draw sheet

a small, flat sheet that is placed over the middle of the bottom sheet, covering the area of the bed from above the person's shoulders to below his or her buttocks In the case of a rubberized mattress, draw sheets can be used instead of a mattress pad.

Cartilage

a tough, fibrous substance, fills in the space between the bones in the slightly moveable joint. The cartilage permits limited movement and acts as a "shock absorber" between the bones

Gout

a type of arthritis that is caused by a disturbance in the body's metabolism. Uric acid is a waste product of metabolism that is usually eliminated from the body in the urine. If the body produces too much uric acid, or the kidneys are unable to properly process uric acid, the uric acid builds up in the body, forming crystals that are deposited within the joints. These uric acid crystals are extremely irritating to the tissues in the joint, and as a result, the joint becomes inflamed and painful. While gout can affect any joint, the big toe is most commonly affected. Men past middle age are more commonly affected than women. Gout may be treated with a combination of diet modifications and medication.

Clearing the airways in infants

abdominal thrusts ARE NOT used. Instead, a combination of backslaps and chest thrusts is used.

assisted living facilitiees

are a type of long term care facility however the residents are usually still somewhat independent. Dont have as many nursing units (or nurses) because do not need as much care!

Rectal temperature

accurate because taken in an enclosed space. Thermometer must be lubricated and inserted carefully. No more than 1/2 inch in a child or 1 inch in an adult. The thermometer could stimulate the vagus nerve, an important nerve that begins in the brain that may temporarily decrease the person's heart rate and blood pressure which can be dangerous. A different method should be used if the person has hemorrhoids, rectal bleeding, or a rectal disease, diarrhea, has had rectal surgery, or has certain heart conditions

Risk factors for disease include..

age, gender, heredity, lifestyle, occupation, chronic disease, and emotional health

(effects of aging) Loss of bone tissue

aging decreases the body's ability to absorb calcium as a critical nutrient. When the body cannot get the amount of calcium it needs from the diet alone, it begins to draw on the calcium stored in the bones. The continuous gradual loss of calcium causes the bones to lose their strength and hardness, making them more fragile and prone to breaking. If other conditions such as poor nutrition, poor circulation, or a lack of physical activity are present, the loss of strong bone tissue occurs much more rapidly.

Freely moveable joints

allow for a wide range of movement (ex; knees, shoulders, elbows, finger, and toes joints) .. think ligaments AND cartilage... The ends of the bones that form the freely moveable joint are covered with cartilage, which provides a smooth surface for the other bones to move against. A capsule formed of connective tissue encloses the ends of the bones, forming a joint cavity. The lining of the capsule secretes a think fluid called synovial fluid into the joint cavity. The synovial fluid lubricates the joint, which helps the joint to move smoothly. Ligaments cross over the joint capsule, attaching one bone to another and stabilizing the joint. (If the ligament is torn or weak, the joint may be able to move too much in any one direction)

Slightly movable joints

allow for limited movement (Ex; between the vertebrae and spine, and where the ribs attach to the sternum) Cartilage responsible.

reproductive system

allows the human body to produce new life. Without a means of reproduction, human life would cease to exist.

Skeletal muscle

allows you to move your arms, legs, and other parts of the body. Skeletal muscle is said to be "voluntary" or under control of the individual since you decide how to move the parts of your body. It is also striated.

long term care facilities

also called nursing homes, provide care for people who are not able to care for themselves independently. Usually have common rooms where residents gather to socialize.

Stroke

also known as "brain attacks" or cerebrovascular accidents (CVAs). A stroke can be caused by a blocked blood vessel in the brain or by a blood vessel that suddenly ruptures. In either circumstance, blood supply to a part of the brain is cut off, causing that part of the brain to die from lack of oxygen.

Seizure

also known as convulsions, occur when the brain activity is interrupted. Seizures can result from head injuries (either recent or past), strokes, infections, high fevers, low blood sugar, poisonings, brain tumors, and epilepsy

closed bed

an empty bed

dysrhythmia

an irregular pulse rhythm

What are the two types of manometers?

aneroid : small round dial with a needle mercury: column of mercury that may be mounted on wall or on a table

organism

any living thing

Grand mal seizures

are characterized by violent jerking of the muscles all over the body. An emergency situation. Cause a loss of consciousness, and because of the violent jerking of muscles, place the person who is having the seizure at risk for injuring herself. Can last for a few seconds or for 5 to 10 minutes.

over bed table

are considered a clean area, items placed there should be either sterile or clean (you would never place dirts items there!!)

Antiembolism (TED) stockings

are made of a snug elastic. The stockings can be knee high or thigh high are specially fitted. The fabric applies pressure, compressing the veins and helping blood return to the heart. This helps to prevent pooling of blood in the legs. The TED stockings are usually applied before the person gets out of bed, before they stand up and blood flows to the veins in the lower legs.

Flat bones

are relatively thin and may be curved. Examples of flat bones include the ribs and the bones that form the skull.

short bones

are round or cube-shaped. Short bones are found in the wrists and ankles

organelles

are structures in the cell that help to make the energy it needs to stay alive and to rid itself of waste products

Pulse points

are the points where large arteries run close enough to the surface of the skin to be felt as a pulse. At these points, the artery can be compressed against a bone by applying direct pressure, helping to slow blood loss from a wound. (A tourniquet is a devise that is placed tightly around an arm or leg to cut off nearly all blood supply and is only used as a last resort to control bleeding and should always be applied by a specially trained emergency responder. )

homesostasis

balance that keeps certain condition in the body remaining the same with a range of normal limits to keep the organism alive. (Ex: temperature, blood pressure, PH of fluids, oxygen&nutrients in blood) All of the organ systems are constantly working together to maintain a state of balance, when the external or internal environment changes, the organ systems must make adjustments to compensate fo the change. The body's ability to maintain balance is an indicator of good health.

Tendons

bands of connective tissue that connect muscles to bones (occasionally, skeletal muscles are attacched to other muscles by a broad, flat sheet of tendon called aponeurosis)

cell

basic unit of life, can only be seen with a microscope, capable of organization (joining with other similar cells to perform a common function), capable of metabolism (takes raw materials and converts them into the energy it needs to stay alive), capable of growth, and capable of reproduction (making a copy of itself)

Heart valves

blood can only flow through the heart in one direction. To keep blood flowing in the proper direction, the heart has four valves. Valves are flaps of tissue that snap shut after the blood passes through to prevent backflow. 1. Tricuspid valve separates the right atrium from the right ventricle 2. Mitral (bicuspid) valve separates the left atrium from the left ventricle 3. Pulmonary (pulmonic) valve is located where the pulmonary artery leaves the right ventricle 4. Aortic valve is located where the aorta leaves the left ventricle The valves may become diseased. For example a type of infection called rheumatic fever can cause the valves to become thickened and scarred. Damages valves are unable to create a seal when they close causing blood to flow back. This condition is called valvular insufficiency. A person with this may need surgery to repair or replace the defective valve.

thrombi

blood clots

Venous Thrombosis

blood clots (thrombi) form in the veins where the blood pools because the blood is moving slowly. When the blood clots cause inflammation of the lining of the vein, you may hear this condition referred to as thrombophlebitis. Blood clots can form in the superficial veins or in the deep veins. When blot clots occurring the deep veins, the condition is called deep venous thrombosis (DVT). Pain, redness, swelling, and warmth in the lower leg are all possible signs of DVT and should be reported to the nurse immediately. People with DVT are at high risk for pulmonary embolism, a life threatening condition that occurs when an embolus becomes stuck in the pulmonary artery, the artery that carries unoxygenated blood from the heart to the lungs. Leaving the rest of the body deprived of oxygen.

Veins

blood vessels that carry blood to the heart

Arteries

blood vessels that cary blood away from the heart. As the arteries get further away from the heart, they branch into a network, becoming smaller and smaller in diameter.

artery

blood vessels that cary oxygen containing blood away from the heart to all the tissues of the body.

Cardiogenic shock

can occur when the heart is unable to pump enough blood throughout the body to meet the tissues need for oxygen

peripheral vascular disease

decreased blood flow to the leg muscles causes pain and cramping when the person walks. The pain and cramping, called claudication, occurs because the muscles are not receiving enough oxygen. In severe cases, the tissues in the leg die from lack of oxygen and amputation may be necessary.

hypoventilation

decreased rate and depth of breathing

kyphosis

deformity that is the curvature of the upper back caused by the crumbling of the bones (osteoporosis) of the spinal column

metabolism

describes the physical and chemical changes that occur when he cells of the body convert the food we eat into energy

Fixed joints

do not permit any movement at all. (Ex. The joints between the bones of the skull)

Parts of a stethoscope

earpieces, binaurals, brace, and amplifying devices the amplifying device, is usually two sided. The larger flat side is the diaphragm that is used to hear loud, harsh sounds like an apical pulse, blood rushing through arteries, or respiratory sounds. The other side is the bell, small rounded surface designed to pick up soft sounds like heart murmurs or difficult to hear blood pressures. Also commonly used to listen to apical pulses in infants and small children.

Three layers of tissues in the heart

endocardium, myocardium, and the epicardium. 1. Endocardium: is the smooth inner layer of the heart 2. Myocardium: is the middle layer formed of cardiac muscle 3. Epicardium: is the smooth outermost layer of the heart The epicardium forms part of the pericardium, a double layered protective sac that surrounds the heart. A thin film of fluid between the epicardium and the outer layer of the pericardium allows the pericardial layers to slide smoothly against each other each time the heart pumps.

When making an occupied bed

explain the procedure, that the person will roll over a "bump" of linens. Remember to ensure their privacy

Phantom pain

feeling that the amputated body part is still present after an amputation. The sensations are caused by the healing of the nerves that were cut when the body part was removed.

Febrile

fever, or increased body temperature. Fever can be caused by chemicals that the body releases when tissues are injured (ex. after a heart attack, traumatic injury, surgery, and cancer) However, an elderly person's temperature may actually decrease or only slightly increase in response to illness or infection. For this reason, even a very slight change in an older person's temperature should be reported to the nurse.

fire extinguisher and PASS

fire extinguishers use carbon dioxide to remover the oxygen from the fire. This smothers the fire. PASS stands for pull the safety pin out, aim the hose towards the base of the fire, squeeze the handle, spray the contents of the fire extinguisher at the base of the fire sweeping from side to side

Cardiac muscle

forms the heart, contraction and relaxation of the cardiac muscle pumps blood throughout the body. Cardiac muscle is also involuntary.

Organ system

group of organs that work together to perform a specific function for the body

What do you do if you observe that a person is having signs or symptoms of a heart attack?

have the person lie down, raise the person's head to help make breathing easier, and call the nurse or activate the emergency response system immediately. Prompt medical intervention can help to minimize damage to the heart muscle. If cardiac or respiratory arrest occurs, you will need to begin BLS.

cardiac arrest

heart stops beating

Hip fractures

hip fractures are fractures that occur at the top of the femur (common in elderly folk). A person who has experienced a hip fracture is often at risk for another.

Apical puse

i measures by listening over the apex of the heart (lower tip of the heart or between the sternum and left nipple then 2 inches below) with a stethoscope. An apical .pulse is taken when a person has a weak or irregular pulse that may be difficult to feel in the radial artery. An apical pulse may also nee used to measure heart rate in infants and in people with known heart disease.

unresponsive

if she is unconscious and cannot be aroused, or conscious but not responsive when spoken to or touched. (either of these should be reported to the nurse immediately)

How to check for alignment

imagine a line connecting through the center of body. This line should be straight

Where will patients who are recovering from an illness or surgery will most likely stay?

in private, single occupancy rooms

skeletal system

includes the bones, the function of the skeletal system is to provide a frame for the body and to give it its body shape.

nervous system

includes the brain, spinal cord, and nerves. The nervous system controls the functioning of other organ systems. It also allows us to interact with our environment

urinary system

includes the kidneys, bladder, ureters, and the urethra. The urinary system removes liquid waste from the body in the form of urine.

respiratory system

includes the lungs and the airways. The respiratory system allows us to take in oxygen and omit carbon dioxide, a waste product of cellular metabolism

muscular system

includes the muscles, the muscular system works along with the skeletal system to enable the body to move. Sometimes the muscular system and the skeletal system together are called the musculoskeletal system.

integumentary system

includes the skin and its glands, the hair, and the nails. The function of the integumentary system is to protect the body.

digestive system

includes the teeth, salivary glands, tongue, esophagus, stomach, small intestine, large intestine, liver, pancreas, and gallbladder. The digestive system allows us to take in food and water, digest the food into nutrients, and absorb the nutrients into the bloodstream. The digestive system also removes solid waste from the body in the form of feces.

hyperventilation

increased rate and depth of breathing

What are the common categories of disease?

infections, degenerative, nutritional, metabolic (endocrine), immune, neoplastic, and psychiatric

What are the ten main organ systems?

integumentary, skeletal, muscular, respiratory, cardiovascular, nervous, endocrine, digestive, urinary, and reproductive

Joint replacement surgery or total joint replacement

involves removing the ends of the bones in the affected joint and replacing them with parts made from metal and plastic. People who have had a joint replaced may not be allowed to bear weight on the affected joint for a period of time after the surgery, they need help with transfers.

Myocardial Infarction (MI)

is a "heart attack". Occurs when one or more of the coronary arteries become completely blocked, preventing blood from reaching the parts of the heart that are fed by the affected arteries. The lack of blood (and vital oxygen) causes the tissue to die. The dead tissue is called an infarct. The severity of the myocardial infraction depends on the extent of the tissue damages and the part of the heart affected. Although a myocardial infarction that affects the atria may not be life threatening, one that severely damages the ventricles can reduce the heart's ability to pump blood to vital organs and cause death.

transfer/gait belt

is a belt with a buckle that is used to assist a weak or unsteady person with standing, walking, or transferring. DO NOT use on people with heart disorders or someone recovering from abdominal surgery.

fracture

is a broken bone. Fractures are usually caused by trauma (ex. fall or car accident) While some are caused when a bone is put under constant and repeated stress. older people are especially at risk for fractures because the bones become more fragile w age. Older people are also more likely to have diseases that put them at risk for fractures. Bones of older people also take longer to heal and they may heal improperly.

surgical bed (and preparation)

is a closed bed that has been opened to receive a patient/resident who will be arriving by a stretcher. When preparing a surgical bed, loosen the linens from the bottom of the bed and fold them toward the side open to receive a person. Raise the bed so that the stretcher will be level with the bed. Make sure the bed wheels are locked., and ensure clear path by moving any furniture in the way.

cardiac output

is the amount of blood that the heart is able to pump in a minute ( if the heart is able to pump more blood into the blood vessels with each beat, then blood flow increases, leading to an increase in blood pressure. On the other hand, if the cardiac output is lower, then blood flow decreases, leading to a decrease in blood pressure.)

Rheumatoid Arthritis

is a crippling condition that can cause severe joint deformities. Unlike osteoarthritis, rheumatoid arthritis affects people much younger in life often between the ages 20-40. (disease is more common in women) It is believed to be an autoimmune disorder in which the body's immune system begins to attack the body's own tissues. In rheumatoid arthritis, the immune system attacks and destroys the cartilage that covers the ends of the bones. Scar tissue develops within the joints, causing them to become stiff and useless. It tends to seam to seem under control for months, then flare up. During acute phases of the disease, the person may begin to experience pain, swelling, redness, and heat in the joints, as well as fever and general weakness.

resident inventory sheet

is a document that lists and briefly describes all of the residents personal belongings. Describe their items objectively Ex. "yellow metal ring with two blue stones". The sheet is used to help make sure that a resident leaves the facility with all of her belongings.

lift sheet

is a draw sheet that is used to help lift or reposition a person who needs assistance with moving in bed.

Sphygmomanometer

is a flat instrument used to measure pressure. It consists of a cuff, bulb, and a manometer (device that measures the air pressure)

Anemia

is a general term for a group of disorders affecting the red blood cells. Anemia decreases the bloods ability to transport oxygen to the cells. These people become tired very easily. Anemia can result when the number of red blood cells is decreased, either bc red blood cell production is impaired or the person is losing blood. Or the red blood cells may not contain enough hemoglobin.

bath blanket

is a lightweight cotton blanket or flannel sheet that is used to provide modesty and warmth during a bed bath or a linen change.

bed craddle

is a metal frame that is placed between the bottom and top sheets to keep the top sheet, blanket, and bedspread away from the person's feet. Bed cradles are often used for people who are recovering from burns to prevent the top sheet from touching the burned skin.

Atherosclerosis

is a narrowing of the arteries that can result in blockage. Blood is unable to flow freely through the arteries because plaque (a fatty deposit) builds up on the inside of the vessel wall. As a result, less oxygen and nutrients are delivered to the tissues of the body. In addition, plaque makes the normally smooth inner lining of the artery rough which can cause blood clots to form. Sometimes the clots break off and become emboli. Finally, the plaque interferes with the elasticity of the arterial walls, making them brittle and prone to breaking (arteriosclerosis). This hardening of the arteries can lead to hemorrhages (bleeding) in the small vessels. Atherosclerosis can have serious consequences depending on which arteries are affected. -affecting arteries that supply the brain, can cause a stroke -affecting the arteries that supply the heart can cause myocardial infarction -in arteries that supply the kidneys, can cause renal failure -in arteries that supply the legs can cause peripheral vascular disease the cause of atherosclerosis are unknown. Factors contributing to the development of the disease includes diabetes, hypertension, and obesity. Smoking and having a fatty diet/lack of physical exercise can also increase a persons chances of developing atherosclerosis.

Emergency response system

is a network of resources (people, equipment, facilities) that is organized to respond to an emergency. Know your facilities policy (may be 911 or another number) Early activation is important. When you call, be prepared to give accurate information about your location and the condition of your patient.

footboard

is a padded board that is placed upright at the foot of the bed. helps to keep the feet in proper alignment.

automated external defibrillator (AED)

is a small, portable device that automatically detects a person's heart rhythm and delivers an electrical shock to the heart, to stop fast abnormal heartbeats and restore the heart's normal rhythm. Always know where it is located!

bed protector

is a square of quilted absorbent fabric backed with waterproof material. Often used for people who are incontinent or draining wound

Anaphylactic shock

is caused by a severe allergic reaction. In septic shock, widening of the blood vessel occurs, causing the blood to pool away from the heart. In addition, the tiniest tubes in the lungs (bronchioles) close off, preventing the oxygen in the air from passing into the lungs and reaching the blood.

Septic shock

is caused by severe bacterial infection that involves the entire body. The toxins produced by the bacteria cause the blood vessels to dilate (widen), leading to pooling of blood away from the heart and poor circulation.

Arthritis

is inflammation of the joints, usually associated with pain and stiffness. Arthritis is the most common disorder of the musculoskeletal system affecting all ages. There are more than 20 different types of arthritides.

endocrine system

is made up of glands found in specific locations throughout the body. These glands secrete chemical substances called hormones, which control the function of certain organs.

cardiovascular system

is made up of the blood, the heart, and the blood vessels. The cardiovascular system transports nutrients and oxygen to the cells of the body and carries wastes products away

medication room

is sued to store medications and the supplies for administering medications. Often apart of, or located close to the nurses' station.

Angina Pectoris

is the classic chest pain that is felt as a result of the heart muscle being deprived of oxygen. (some describe as a pain in the center of the chest, others experience pain that starts in the chest and extends to the arm or neck, they may feel as though they are suffocating) Many people experience angia frequently and will often keep nitro glycerin pills on hand to relieve the pain when it occurs. Nitroglycerin relaxes the arteries, increasing the blood flow.

Osteoporosis

is the excessive loss of bone tissue causing the bones to become crumble and very fragile. The bones most commonly affected by osteoporosis are the bones of the spine, the pelvis, and the long bones in the arms and legs. Osteoporosis is most common in older women who have gone through menopause. This is because estrogen, a hormone that is present in the bodies of women who are still having menstrual periods, helps to prevent bone loss. However, when a woman's period stops, her body stops producing estrogen which puts her at more risk for bone loss. Other risk factors for the development of osteoporosis include : white race, "small bones", smoking, inactivity/immobility, diseases of the thyroid and adrenal glands, a diet lacking in calcium& vitamin D (necessary for the absorption of calcium) and protein, certain drugs (ex. steroids) Can become so brittle a person breaks their bones by bumping into a piece of furniture.

Leukemia

is the excessive production of white blood cells. The white blood cells are abnormal in structure and they cannot perform their job of protecting the body from infection. Leukemia can be caused by cancer of the bone marrow or by cancer of the lymphatic tissue. Leukemia occurs in people of all ages and can cause death if treatment is started too late/not effective. People who have leukemia are at higher risk for developing infections. They may also have bleeding disorders, which can cause them to bruise very easily or bleed from their gums during oral care.

admission

is the official entry of a person into a health care setting. A person who needs health care must be formally admitted to the health care facility that will be providing the care, whether the length of the stay is a few hours, days, weeks, months, or the res of their life Even in the case of home health care agency there is still an admissions process. This is because admission is a time of orientation for everybody involved. During the admission process, the patient/resident/client is informed of their rights and the policies of the facility or agency, and introduced to people who will be caring for them. Members of the the health care team may consider it routine but to the person being admitted the "routine" can be very stressful. It's stressful because most people are used to thinking of themselves as independent, unique individuals, not as dependent people in need of services.

nursing history

is used to gather information about the person's preferences, abilities, disabilities, and habits. They complete the document by interviewing the person or family member.

gatches

joints of adjustable beds allowing the mattress to bend

dyspnea

labored or difficult respirations

ischemia

lack of oxygen to the tissues. Prolonged ischemia causes the tissue to die, resulting in permanent damage to the heart muscle.

congestive heart failure

left sided heart failure causes blood to back up in the lung because the left ventricle's ability to pump blood into the systemic circulation is impaired.

Effects of aging on the cardiovascular system

less efficient contraction: affects the ability of the heart to contract forcefully, takes heart longer to complete the cycle of filling or emptying decreased elasticity of arteries and veins: as we age, walls of the blood vessels lose some of their elasticity. This decreases the body's ability to control blood pressure and flow b/c the arteries aren't able to expand and "bounce back" as easily. This age related change are especially noticeable when an older person gets up quickly after lying down decreased numbers of blood cells: blood cell production slows as a person ages affecting the bloods ability to deliver oxygen to the tissues.

chronic

long term

What are the four classifications of bones?

long, short, flat, irregular

List the 3 effects of aging on the musculoskeletal system

loss of bone tissue, loss of muscle mass, wear and tear on the joints

Venous disorders

loss of elasticity and decreased efficiency of the valves in the walls of the veins cause blood to "pool" in the legs. Which can put the person at risk for several disorders.

What do you do if a person has fainted?

lower them to the floor or other flat surface. Position the person on his back with his head turned to the side, in case he vomits. If you are sure that the person has no injuries to the head, neck, or spinal cord, raise his legs 12 inches, and loosen any tight clothing or restraints. Make sure the person is breathing and call for help. Then check the persons vital signs. Even if the person recovers from the episode quickly, have hime continue to lie down until the nurse arrives.

supine (dorsal recumbent) position

lying on the back

Safety Data Sheets (SDSs)

manufacturer communicates information about chemicals. The SDS summarized key information about the chemical, such as what is it made from, which exposures may be dangerous, what to do if exposure occurs, and how to clean up spills.

Lymph Nodes

masses of lymphatic tissue that "clean" the lymph by removing bacteria and other large particles. Eventually, all of the lymphatics empty into the large veins in the shoulder region, returning the fluid to the general circulation.

petit mal (absence) seizure

may simple stop speaking in mid sentence and stare into space. May not be an emergency situation.

Respiratory arrest

means that breathing has stopped ( heart may beat initially, but if breathing doesn't start again soon..his heart will stop beating)

Basic life support (BLS)

measures are taken to prevent respiratory/cardiac arrest. BLS is used to keep person alive until advanced medical assistance arrives. BLS measures include rescue breathing, cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED).

Importance of vital signs

measuring and recording vital sign measurements accurately is critical because many people rely on this information to make important decisions about their care, OR a problem can go unnoticed if i vital sign is measured/recorded inaccurately.

Treatment for osteoarthritis

medication to decreases the pain and swelling. Heat and cold applications. Mild exercise that places the affected joints through their range of motions helps to diminish stiffness and maintain joint function. Very severe osteoarthritis may need surgery to replace the joint. (Hips and knees most common)

Contegial heart disorders

most heart disorders in children are congenital, which means that they were present at birth. Many babies who are born with congenital heart disorders grow up to live long and healthy lives following surgery to correct the heart defect.

feedback mechanism

mostly controlled by the nervous and endocrine systems.

Logrolling

necessary to move a person who has had back surgery or an injury to the neck or spine. In logrolling, the person is rolled in one fluid motion to that the head torso and legs more as one unit and the body is kept in alignment without twisting or bending. At least three assistants, plus a lift sheet are necessary

respiratory rate

number of times a person inhales and exhales in 1 minute

pathologic fractures

occur in bones that have been weakened by a disease process, such as osteoporosis or bone cancer

Coronary artery disease

occurs when the coronary arteries narrow as a result of atherosclerosis. (recall coronary arteries supply the heard muscle w blood). Eventually, one or more of the coronary arteries may becomes so narrow that no blood gets through, causing areas of the hear muscle to die.

Heart Failure

occurs when the heart is unable to pump enough blood to meet the body's needs. Heart failure has many causes. (ex. disorders that cause the ventricle to lose muscle tone/ become large and flabby. Can also occur as a result of an MI that leaves the ventricles unable to function properly) medications may be used to help increase the heart ability to pump for effectively and pull excess fluid from the tissues. Many people with severe heart failure have their fluids restricted and their intake and output very carefully measured and monitored. A heart transplant may be necessary.

diastolic pressure

occurs when the heart muscle relaxed, although the heart is relaxed there is still pressure as the blood flows through the arteries

Hemorrhagic shock

results from massive blood loss, which means that there is not enough blood in the vessels to supply the tissues of the body.

shock

results when the organs and tissues of the body do not receive enough oxygen-containing blood. There are many different causes and types of shock

tansfer

occurs whenever a patient or resident is moved within or between health care settings. (can be from a room to another, from one unit to another [ICU to standard care floor], from one health care facility to another [long term care facility to a hospital]. Transfers can occur when a person's medical condition improves or worsens. In a hospital, you are responsible for packing their belongings. You may need to assist the nurse in transporting the person. May need to report. In a long term care facility, the assistance you provide will be more personal. Will be responsible for reporting personal care information about the resident to the receiving nursing assistant.

birthing suite

on the maternity ware, where new mothers and babies may receive care before, during, and after the birthing process. A birthing suite is typically very home-like

radial pulse

on the thumb side. Place two/three fingers lightly over the radial artery and count the number of pulses for 30 seconds or 1 minute.

Methods by which the body temperature can be measured

orally rectal axillary (armpit) tympanic temporal (forehead)

What are the 3 most common types of arthritides?

osteoarthritis, rheumatoid arthritis, and gout

Thymus gland & speels

other parts of the lymphatic system. The thymus gland is located in the chest and secretes a chemical that stimulates the production of certain white blood cells (T cells) in the event of an infection. [HIV attacks the T cells]. The spleen is located int he abdomen, and helps to filter blood and break down worn-out red blood cells. The spleen also acts as a reservoir where extra blood is stores. The body draws on this "extra" blood supply during times of massive blood loss, such as following a major injury.

What do cells need to function properly ?

oxygen, water, nutrition, and the ability to eliminate waste products

what is often considered the "fifth" vital sign

pain, because the presence of pain is another indicator that the body is out of balance

pulse rhythm

pattern of the pulsations and the pauses between the,. Normally, the pulse rhythm is smooth and regualr, with the same amount of time in between each pulsation.

clinically dead

person has no pulse or is not breathing. (if clinical death is not promptly reversed, allowing oxygen containing blood to reach the brain and the heart, biological death soon follows and is not reversible)

prone position

person is lying on his abdomen with head turned to side. Small pillow under lower abdomen and pelvis to allow room for chest to expand when breathing. A pillow is also placed under the person's shins. (most aren't comfortable with this position, check with nurse before doing so)

Varicose veins

pooling of blood in the superficial veins (veins just underneath the skin) causes the veins to become swollen and "knotty" in appearance. A person with varicose veins may experience pain, aching, swelling, or a feeling of heaviness in the legs. Varicose veins also put the person at risk for developing other venous disorders such as phlebitis or venous (stasis) ulcers.

Phlebitis

pooling of the blood in the vein causes the lining of the vein to become inflames. The skin over the affected vein is reddened, and the area feels hard and hot to the touch. Phlebitis is often very painful.

Treatment for rheumatoid arthritis

possibly bed rest, splints can decreases joint deformity, and gentle use of active and active-assistive range of motion exercises to maintain joint mobility.

Lymphatic system

pressure of blood through the capillaries forces some of the blood plasma to leak out into circulating tissues. (approx 10 % of circulating plasma) The lymphatic system helps to return the fluid that leaks into the tissues to the bloodstream. It also produces some of the white blood cells that fight invading pathogens. The lymphatic system is actually a one-way, open-ended circulatory system. Lymph capillaries absorb excess fluid from the surrounding tissues. Once the fluid enters the lymph capillaries it is called Lymph). The lymph capillaries join together to form larger vessels, called lymphatics. At certain points along the way, the lymph in the lymphatics passes through the lymph nodes.

systolic pressure

pressure that is caused by the blood hen the heart muscle contacts, sending a wave of blood through the artery

Issues that arise from the lack of repositioning patients

pressure ulcers (bed sores) form when bony areas press against the mattress. The pressure slows the blood flow to the tissues pressed between the bone and mattress. (the sore is difficult to heal and can be fatal) Contractures occur when a joint is held in the same position for too long. Contractures cause stiffening and shortening of tendons, leading to the loss of motion in the joint that can be permanent. Longer term immobility can also cause loss of muscle mass and strength.. and finally immobility can cause loss of calcium from bones (making them brittle and more likely to break). Lying in one position for a long period of time can prevent the lungs from completely filling with air when the person breathes. This causes the small air sacs in the lungs, called alveoli, to close. Causing less oxygen to get to the bloodstream. Moreover, decreased filling of the lungs with air allows fluids and mucus to collect in the lungs. This fluid and mucus creates an environment favorable for types of bacteria that cause pneumonia. Formation of blood clots due to lack of movement and thus lack of blood flow

Using tympanic thermometers

probe is inserted into the ear canal where it rests near the eardrum. Are often used for children because they allow a temperature to be measured in a safe, quick, and relatively painless manner.

Muscle Tissue

produces movement

What are the functions of the musculoskeletal system?

protection, support, movement, heat production, calcium storage, and the production of blood cells

two circuits that the patten of circulation involves

pulmonary and systemic circulation. Pulmonary: The right side of the heart pumps blood to the lungs, where the blood releases carbon dioxide and picks up oxygen Systemic: the left side of the heart pumps the newly oxygenated blood to the body

weight bearing

refers to a persons ability to stand on one or both legs

respiratory rhythm

regularity with which the person breathes

What to do if you think a person is having or has had a stroke

report observations to nurse, and activate the emergency response system. Keep the person lying down and watch for signs of respiratory arrest until advanced care arrives.

Cardiopulmonary resuscitation (CPR)

rescuer uses a combination of rescue breathing and chest compressions to sustain breathing and circulation for a person who has gone into respiratory or cardiac arrest.

Using a glass thermometer

right before using a glass thermometer, the liquid must be shaken down to below the 94˚ mark (˚F) or 34˚ mark (˚C). To read a glass thermometer, hold it horizontally by the stem (top) at eye level and rotate it until the line of liquid becomes visible, it will show as a thin silvery or red line. Glass thermometers are not disposable and need to be cleaned well, or a plastic sheath is used over it. NEVER wash thermometer in hot water or it can shatter!!! ONLY cool water and soap

cor pulmonale

right-sided heart failure that causes blood to back up in the venous system (bc the right ventricles ability to pump the blood into the pulmonary circulation is impaired)

procedure

series of steps followed in a particular order.

nurses' station

serves as the central base of operations for the nursing staff. Staff members use the nurses' station to complete documentation and other paperwork, receive and make telephone calls, and monitor activity in that particular care area. It is usually centrally located so staff members can see hallways and other patient/resident areas from the station.

Sims position

side lying position that is almost prone. Knee is bent sharply and supported by a pillow. Elbow bent with hand in front of face, palm down resting on a pillow. Lower arm extends out side. Sims position is used for people who are receiving enemas and to relive pressure on areas that may be prone to developing pressure ulcers

When considering side rails and bed wheels

side rails can be considered a form of restraint and should only be used according to your facilities policies and the person's individual care plan ALWAYS make sure the bed's wheels are locked, unless you are moving it

hopper

sink-like fixture that flushes like a toilet and is connected to a sewer line. The hopper is used for tasks such as cleaning bedpans and rinsing clothing or linens that have been soiled with feces. In many facilities, liquids that contain body fluids are disposed of in the hopper.

Three types of muscle tissue in the body

skeletal, smooth, and cardiac muscle

What is the largest organ in the body?

skin

nourishment room

snacks and beverages are stored and prepared for patients/residents.

age

some disorders are more likely to occur in certain age groups. (ex. chickenpox in children) Age can also influence how a person reacts to a disease. ( ex. when an adult gets chickenpox, it is often more severe) In general, older people are more at risk for certain diseases because the process of aging causes a lot of wear and tear on the body's tissues and organs.

cell membrane

surrounds the cell and gives it its shape

What do you do if you take a person's vital sign and het a measurement that is abnormal?

take the measurement again for the sake of accuracy and report to the nurse immediately

If the person complains of dizziness, nausea, pain, or acting strange, what do you do?

take vital signs and alert nurse

acute

temporary

aspiration

the accidental inhalation of foreign material into the airway (dentures or people with missing teeth are at higher risk for this) Children are at high risk for aspiration. Children often do not chew their food well and they can choke.

systole

the active phase, the myocardium contracts sending blood out of the heart. *the atria are in systole when the ventricles are in diastole, and vise versa

blood volume

the amount of blood in the vessels at any given time influences the blood pressure. ( ex. if blood volume is low, as a result of hemorrhage, then the blood pressure will decrease. In some people, a salty meal is enough to increase blood pressure because the salt causes the body to store water, which increases the blood volume)

joints

the areas where two bones join together

Impacted fracture

the bone is broken all of the way through, and the broken ends of the bone are jammed into each other.

open (compound) fracture

the bone is broken, and the sharp ends of the broken bone have broken through the skin. Because the skin is broken, open fractures carry a very high risk of infection.

closed fracture

the bone is broken, but the broken ends do not protrude through the over-lying skin

comminuted fracture

the bone is splintered into several little pieces. This type of fracture is common when a bone has been crushed by a lot of force. (automobile accident)

Two common places to measure a person's blood pressure

the brachial artery in the upper arm or the popliteal artery which can be felt at the back of the person's knee. Use the arm/leg with the stronger pulse.

What is the basic unit of life

the cell

range of motion

the complete extent of movement that the joint is normally capable of without causing pain.

pulse pressure

the difference between he systolic and diastolic pressures (ex. 110-72 = 38)

closed reduction

the doctor lines up the broken ends of the bone by simply pushing or pulling them back into place. In a closed reduction, it is not necessary to create a surgical incision to access the broken bone. Following a closed reduction, a cast (fiberglass or plaster of Paris) or splint is applied to keep the bone in the proper alignment until healing occurs.

stump

the end of an amputated limb. Positioning is used to keep the muscles and tendons from shortening and nearby joints are put through range of motion exercises to help maintain normal joint function and mobility. Wrapping the end of the stump with elastic bandages helps to shrink and shape the stump properly. Observe the stump for any drainage, bleeding, or paun.

blood pressure

the force of the blood pushing against the arterial walls. there are two pressure levels that are measured when taking a persons blood pressure measurement and they are diastolic and systolic. Adequate blood pressure is necessary to keep blood flow (oxygen & nutrients) constant to all of the tissues of the body. High blood pressure also places stress on the kidneys, which can lead to kidney failure, and the blood vessels, which can lead to stroke.

pulse amplitude

the force or quality of the pulse. Each pulse should be strong and easy to feel. Pulses that are difficult to feel may be described as "weak" or "thready". A weak or thready pulse usually means that the heart is having trouble circulating blood throughout the body.

Skeleton

the framework formed by the 206 bones in the human body. The skeleton gives structure and shape to the body and protects key vital organs, such as the heart and the brain from injury.

reverse trendelenburg position

the head of the mattress is raised so the person's head is higher than her feet (useful for people recovering from spinal cord injury or back surgery who are in traction)

Coronary Circulation

the hearts demand for oxygen and nutrients is very high because it works continuously. (the heart cant stop to rest when it's tired!) The coronary circulation meets this demand. The tissues of the heart have their own special network of arteries and veins. Coronary arteries carry oxygen rich blood to the heart tissue while coronary veins remove carbon dioxide and other waste products. Any disruption of oxygen rich blood to the tissues of the heart can cause ischemia.

atrophy

the loss os muscle size and strength. If a person is poorly nourished, is not physically active, or has a chronic medical condition, muscle atrophy progresses at a much faster rate. Loss of muscles can leave a person too weak to carry out routine activities, loss of muscle tissue also affects the body's ability to produce heat.

Special care for hip joint replacement

the muscles and ligaments that normally hold the hip joint in place are weak making is very easy for the head of the femur to dislocate. To prevent this, the person's legs must be spread apart (abducted) when the person is in the supine or lateral position. (abduction pillow helps keeps legs spread apart) when sitting, they need a straight backed chair. Hips shouldn't be flexed more than 90˚ and feet flat on floor. watch physical therapist for tips

pulse rate

the number of pulsations that can be felt in 1 minute. The pulse rate tells use how fast the heart is beating.

passive range of motion exercises

the nursing assistant or nurse moves the patient's or resident's joints through the exercises, without active involvement on the part of the person. (ex. for a person who is unconscious) This can cause injury to the joints if they are not performed properly. ALWAYS follow the care plan.

discharge

the official release of a patient or a resident from a health care facility to their home. Discharge is ordered by a doctor.

active range of motion exercises

the patient or resident performs the exercises independently, with verbal guidance from the nursing assistant or nurse

active assistive range of motion exercises

the patient/resident performs the exercises with some hands on assistance from the nursing assistants/nurse.

Rubber mattress coating with no mattress pad

the person can become warm and start to sweat because the rubber retains the person's body heat. Can also cause the bottom sheet to become damp and stay damp. This causes discomfort and skin irritation-skin breakdown and pressure ulcers.

discharge planning

the process used by the members of the health care team to help prepare a patient/resident to leave the facility. Discharge planning helps to make sure that the person continues to receive quality care, either from a home health care agency or from family members. Purpose is to identify the need that a person will have after his discharge and to make arrangements for meeting these needs after the person goes home. (planning a special diet, family member learns how to change a wound dressing). The ultimate goal of discharge planning is to help the patient/resident achieve the best health status possible after he leaves the health care facility..

depth of respiration

the quality of each breath (deep or shallow?)

Factors affecting the pulse

the rate at which the heart beats is controlled automatically by the body's central nervous system. When the nervous system sensed that the tissues need more oxygen and nutrients (exercising), it increases the heart rate so that blood reaches the tissues faster. A person's heart rate will also increase during times of anger and anxiety, illness, pain, fever, and excitement, and when taking certain medications.

amputation

the removal of all or part of an arm or leg

rescue breathing

the rescuer blows air into the persons mouth to perform the function of breathing for the person until the person begins breathing again on her own.

diastole

the resting phase, the myocardium relaxes allowing the chambers to fill with blood. *the atria are in systole when the ventricles are in diastole, and vise versa

Muscle tone

the steady contraction of the skeletal muscles, helps us to maintain an upright posture, such as sitting or standing.

orthostatic hypotension

the sudden decrease in blood pressure that occurs when a person stands up from a sitting or lying position. When a person is sitting or lying down, the heart does not need to work as hard to pump blood through the body and the blood vessels are relaxed so resistance is low. However, when the person stands up, the body needs to make up for the change in position. The heart pumps harder and the vessels constrict to bring the blood pressure bake up to a normal level. Until the body manages to make up for the sudden change in position, the person may feel lightheaded and faint. (lack of blood to the bran can cause the person to feel dizzy)

Bleeding disorders

there are two types of bleeding disorders. Either the blood clots too much or not enough. In some, blood clots close to easily which can cause clots to from in small blood vessels, blocking the flow of blood and depriving the tissues of oxygen and nutrients. The clots can also break loose and travel to other parts of the body such as the brain, lungs, and heart. Others blood does not form clots when they're suppose to. These people may lack fibrinogen, the protein in the blood plasma that assists with clotting. Or, the may have a low platelet count. (recall that platelets are the blood cells that participate in clot formation)

what is the nursing assistants jobs when is comes to the personal belongings of patients/residents?

to keep them neat and clean. Excessive clutter can be a safety hazard

ambulate

to walk

disoriented

unable to answer basic questions

clean utility room

use to store clean and sterile supplies (ex. packaged personal care products and supplies and supplies for medical treatments and procedures)

Where do patients who are very ill stay?

usually in private rooms in the intensive care unit (ICU) or critical care unit (CCU). These rooms contain special equipment that helps the health care team monitor and care for very ill patients

Ligament

very strong bands of fibrous tissue

musculoskeletal movement

voluntary movement occurs when a skeletal muscle contracts (shortens) or relaxes (lengthens) across a freely moveable joint. In freely moveable joints, each skeletal muscle attaches to the bone in two places, the origin and the intersection. Skeletal muscles usually work in groups to provide body movement.

pulse

wave sent by a beating heart

body temperature

what we are measuring is the difference between the head produced by the person's body and the heat lost - heat loss occurs normally through the skin, passing of urine and feces, breathing, and sweating

open bed

when the top sheet, blanket, and bedspread are fan folded and ready to receive a patient

When does a disease occur?

when then structure or function of an organ or an organ system is abnormal

soiled utility room

where dirty items are handled or stored. Bins for trash/soiled linens/ used equipment to be cleaned

Factors affecting the body temperature

while regularly constant, small changes may occur as a result of physical or emotional stress, environmental temp, or time of day. It is typical for a person's body temp to be lower in the morning and increase throughout the day Stress causes release of hormones that increase metabolism and heart rate, "fight or flight" response (can increase body temp) Increase in heart rate and metabolism can increase body temps Exposure to very hot or cold environments A persons age and gender also play a role in determining body temperature. Very young people and very old people tend to be more sensitive to environmental temperature changes. Infants often have immature control centers, which means that their bodies are slower to adjust to changes in temperature. Infants also often lose body heat through their skin more easily. While an elderly person may not produce as much heat due to muscle loss and normal aging. Finally, a woman's body temperature tends to change more frequently than a man's because of hormonal changes that occur during the menstrual cycle, pregnancy, and menopause.

Importance of keeping sheets wrinkle free

wrinkled sheets are uncomfortable and can create areas of pressure on a persons skin which can lean to skin breakdown.

When collecting linens

you should always collect the linens in the order that they will be used (mattress pad, bottom sheet, draw sheet, bed protector, top sheet, blanket, bedspread, pillowcases). Once you have collected your stack of linens, flip the stack over so that the item you will need first is on the top of the stack. (this makes it more efficient, and helps remember which linens you need to collect) Remember linens can act as fomites, or objects capable of spreading infection. Always use infection control practices when handling linens. Always perform hand hygiene before collecting clean linens, and avoid letting clean linens come into contact with dirty surfaces, such as your uniform or the floor. When removing used linens, wear gloves and roll the linens toward the center of the bed to confine any soiled areas on the inside.

The affects of age on blood pressure

young people tend to have lower blood pressures than older people. Aging causes a decrease in the elasticity of the blood vessels (that is, the blood vessels' ability to stretch and bounce back as the blood pulses through) Decreased elasticity results in increased resistance and a higher blood pressure.