Health Alterations 1 Modules 5, 6, & 7
what is the function of tap water enemas?
shoots water into GI tract to stimulate the muscles
what are two important risk factors for osteoporosis?
small-framed, nonobese Caucasian women, and diet poor in calcium and vit D
state of muscle readiness produced by maintenance of some muscle fibers in a contracted state
tone
a fracture that is straight across the bone shaft
transverse
what is the difference between TPN and PPN?
TPN = central line, PPN = peripheral IV (not PICC line?)
what does CPAP stand for?
continuous positive airway pressure
what type of catheter is used for BPH patients?
coude catheters (curved tip to go around prostate)
the three most common manifestations of asthma are
cough, dyspnea, and wheezing in a pattern of exacerbations
what lung sounds will be heard if the patient has aspirated?
crackles at the bases of lungs
what are the six manifestations of atelectasis?
dyspnea, cough, leukocytosis, diminished breath sounds, sputum production, and fever
examples of long bones
femur, tibia, humerus
someone with iron-deficient anemia would have what signs and symptoms?
lack of energy, SOB, dizzy/lightheaded, brittle nails, pica, paleness
when the hip is fractured, what will the nurse notice about the affected leg?
leg is shorter than the other, away from the body, and externally rotated
what organ does parenteral nutrition affect?
liver
how long can a tracheostomy be used?
long-term, over 21 days
example of antidiarrheal
loperamide
someone with osteoporosis would present with
loss of height from vertebral collapse, progressive kyphosis
soft diet
low in fiber, easy to digest
what is hypoxemia?
low levels of O2 in the blood
what is hypoxia?
low levels of cellular O2
with atelectasis, what is the first symptom noticed?
low-grade fever
example of osmotic stimulants
magnesium citrate
what two things are used to manage osteoarthritis?
medications for inflammation and OT for physical function
an example of absorptive atelectasis is
ARDS (acute respiratory distress syndrome)
what is dead space?
areas where no O2 and CO2 exchange is happening
where does skin breakdown occur with NG tubes?
around the nose, back of throat
allows direct visualization of a joint to diagnose joint disorders
arthroscopy
example of salicylates
aspirin
collapse of alveoli, leading to loss of lung volume
atelectasis
what is the function of surfactant?
coats the alveoli and decreases surface tension to prevent collapse of alveoli
what can be used to unclog a feeding tube?
coca-cola or cranberry juice
fracture in which bone has splintered into several fragments
comminuted
fracture in which bone has been compressed
compression
after a joint replacement, what is important to assess?
range of motion
what is the maximum amount of acetaminophen in 24 hours?
4000 mg
less than ____ with the incentive spirometer is a risk for atelectasis and pneumonia
500
what dose of aspirin is antiplatelet?
81 mg
what are five symptoms of clostridium difficile?
abdominal cramping, watery diarrhea, fever, dehydration, increased WBC
what is benign prostatic hypertrophy?
abnormal growth of the prostate that may obstruct urethra, causing incomple emptying of bladder and urinary retention
McBurney's sign is used to rule out
appendicitis
what are solid tumors?
abnormal mass of tissue that does not contain cysts or liquid areas
process by which a substance incorporated in one state is transferred into another substance of a different state
absorption
_____ atelectasis occurs by surfactant inactivation
absorptive
what are the three types of atelectasis?
absorptive, obstructive, and compressive
two other common names for GERD are
acid reflux, heartburn
short-acting bronchodilators are used for
acute exacerbations
what is needed for maximum effect of biphosphonates?
adequate calcium and vit D
what are three weight-loss medications?
adipex, mounjaro, ozempic
what medications are appetite supressants?
adipex, mounjaro, ozempic
what is chronic obstructive pulmonary disease?
a disease state characterized by chronic airflow limitation that is not fully reversible; airflow limitation is associated with inflammatory response of the lungs
how do COX2 inhibitors differ from NSAIDs?
affect only COX2, with less GI upset and bleeding
what are six risk factors for BPH?
african-american, smoking, heavy alcohol use, hypertension, heart disease, diabetes
acute inflammation with asthma leads to
airflow limitation, hyperresponsiveness, airway edema, and mucus hypersecretion
what lab value only changes with severe malnutrition?
albumin
how is malnutrition diagnosed?
albumin and prealbumin levels
what lab values should be assessed in someone with malnutrition?
albumin, electrolytes
examples of beta-adrenergic agonists
albuterol, salmeterol (-terol)
examples of biphosphonates
alendronate, ibadronate
why do broad spectrum antibiotics have a risk for c-difficile?
all the good bacteria in the gut are destroyed
a deficiency in ______ is a risk factor for COPD
alpha1-antitrypsin
what are the three interventions to prevent post-surgical complications?
ambulate ASAP, coughing/deep breathing, incentive spirometer use
the nurse hears wheezing/stridor, and suspects _______.
an obstruction in the lungs
what is clostridium difficile?
an opportunistic bacteria that causes infection in the large intestine
what are the function of opioids?
analgesic
when should the flu vaccine be given?
annually
what is the function of salicylates?
anti-pain, anti-fever, anti-inflammation, anti-platelet
what are the six symptoms of obstructive sleep apnea?
frequent, loud snoring; breathing cessation for 10 seconds or longer; at least 5 episodes of sleep apnea per hour; awakening with loud snort as O2 level drops; excessive daytime sleepiness; insomnia
where is CO2 exchanged?
from the blood to the lungs
where is oxygen exchanged?
from the lungs to the blood
mechanical diet
full liquid and diced/ground food
loss of urine due to cognitive, mobility, or environmental barriers
functional incontinence
what is the most common identifiable predisposing factor for asthma?
genetic predisposition for development of IgE-mediated response to allergens (atopy)
TPN typically has a high concentration of
glucose
fracture in which one side of a bone is broken and the other side is bent
greenstick
what is the function of a BiPAP?
has a higher pressure on inspiration and lower pressure with expiration to keep the alveoli open
why is oral care important for NG tube patients?
helps keep the mouth moist and prevent thrush, tooth decay, etc.
why is iron important in the body?
helps transport oxygen in the form of hemoglobin
a low level of transferrin indicates
hemolytic anemia
what are the four steps of healing bone fractures?
hemotoma formation, inflammation, reparative, remodeling
what is the function of a saline enema?
high sodium to pull water into the GI tract
what is the most common injury in older adults?
hip fractures
osteoarthritis particularly affects what joints?
hips, knees, fingers
some risk factors for malnutrition include
hospitalization, chronic illness, dental problems, physical disability
what type of bowel sounds are present with diarrhea?
hyperactive, constant motion in the bowels
the nurse is teaching a client about the risk factors for developing osteoporosis. what is the most important information for the nurse to include? select all that apply. inadequate dietary intake of calcium blood pressure meds family history smoking oral hypoglycemics
inadequate dietary intake of calcium smoking family history
deep breathing with visual feedback to patient to inhale slowly and deeply
incentive spirometry
what are three nursing interventions to prevent atelectasis?
incentive spirometry, turning immobile patients frequently, ambulate post-op patients ASAP
what are the three causes of GERD?
incompetent lower esophogeal sphincter, pyloric stenosis, or a motility disorder
what are the two main causes of diarrhea?
increased production and secretion of water from intestinal mucosa or unabsorbed product in the stool like bacteria that pulls excess water into the gut
what is the action of GI stimulants?
increases motility of the GI smooth muscle without acting as a purgative
dyspepsia
indigestion
what is the function of antispasmodics?
muscle relaxants that block nerve impulses/pain sensations
what medications can be used with dysphagia?
muscle relaxants, botox to freeze the muscles and decrease muscle tone
what is important with hand hygiene when caring for a c-diff patient?
must mechanically wash hands with soap and water
what medications are used for atelectasis?
nebulized bronchodilators, mucolytics
what is the action of antacids?
neutralize the acid in the stomach
when placing a patient on oxygen, the nurse knows to educate on what two important points?
no smoking, no use of vaseline
what is a benign tumor?
noncancerous cell growth that grows slowly and does not spread
______ is the only noninvasive method of oxygen delivery that can give 100% FiO2
nonrebreather mask
what are two examples of an opioid combo medication?
norco, percocet
too much feeding residual indicates
not tolerating feed, can increase risk for aspiration
NPO diet
nothing by mouth
what is parenteral nutrition?
nutrition through a peripheral or central IV, because the GI tract cannot be used
what four things are vital to note with any disease process?
nutrition, hydration, mobility, skin integrity
_____ atelectasis occurs from mechanical obstruction of the airways
obstructive
loss of bone mass
osteoporosis
reduction in bone density and change in bone structure
osteoporosis
what are five risk factors for hip fractures?
osteoporosis, falls, MVC, diseases like bone cancer and Paget's, advanced age
anabolic medications also facilitate
overall calcium absorption
retention from bladder overdistention & frequent loss of small amounts of urine due to obstruction
overflow incontinence
what are six risk factors for GERD?
overweight, pregnant, excess alcohol use, weakened muscle diseases, hiatal hernia, smoking
the addition of oxygen to a system, especially in the human body
oxygenation
odynophagia
pain with swallowing
what is the function of biphosphonates?
reduce spine and hip fractures associated w/osteoporosis by inhibiting osteoclast activity
what is the action of histamine-2 antagonists?
reduce the amount of stomach acid secreted by glands in the lining of the stomach
someone with malnutrition would show what manifestations?
reduced appetite and lack of interest in foods/drinks
what is compression used for?
reduces edema and provides support for injured tissues
what occurs if osteoclast activity is inhibited?
reductions in skeletal turnover and bone loss
involuntary loss of moderate amount of urine r/t CNS impairment
reflex incontinence
what is the action of alpha-adrenergic blockers?
relax smooth muscle of bladder neck and prostrate to improve urine flow
what is the function of bronchodilators?
relieve bronchospasms, reduce airway obstruction, and aid in secretion clearance
what is the funtion of antidiarrheals?
relieve the diarrhea symptoms, do not eliminate the cause
what is disimpaction?
removal of impaction with gloved, lubricated finger; ensure no vagal nerve stimulation
what is primary surgery treatment of cancer?
removing entirety or as much of tumor as possible and any involved surrounding tissue
amount of air left in the lungs after a maximum inhalation
residual volume
nursing interventions for asthma focus on
resolving the exacerbation and preventing complications
what acid-base imbalance occurs with shunting?
respiratory alkalosis
what two systems are used to assess the growth of tumors?
staging system and grading system
is tracheostomy care sterile or nonsterile?
sterile
example of flat bone
sternum
what is the function of anabolic medications?
stimulates osteoblasts to build bone matrix
how does fiber help with constipation?
stimulates the muscles in GI tract to push bowel movements through
where does enteral nutrition enter the body?
stomach, small intestines
a fracture that results from repeated loading of bone and muscle
stress
loss of small amounts of urine from increased abdominal pressure with laughing, sneezing, or lifting
stress incontinence
what three things can be used to manage malnutrition?
supplements, enteral nutrition, education on proper nutrition
how is dysphagia diagnosed?
swallow study with barium contrast
why are musculoskeletal diseases a risk factor for dysphagia?
swallowing requires muscles and neurological functions, so any changes in those can affect swallowing ability
side effects of bronchodilators include
tachycardia, nervousness, and heart palpitations
what is ferritin?
tells the amount of iron in the blood
what connects muscle to bone?
tendons
example of anabolic medication
teriparatide
why is a pleural effusion a risk factor for atelectasis?
the buildup of fluid between layers of lung tissue puts pressure on the lungs leading to compressive atelectasis
the patient with GERD should avoid eating or drinking __ hours before bedtime
two
why are post-op patients, immobile patients, obese patients, and those with chronic lung disease at risk for atelectasis?
unable to take deep breaths to fully expand the lungs
obstructive sleep apnea is characterized by
upper airway obstruction and a reduction in ventilation
inability to stop urine flow long enough to reach bathroom
urge incontinence
what three things are used to assess for BPH?
urinalysis, renal function tests, urinary retention
unintentional leaking of urine
urinary incontinence
all manifestations of BPH surround
urine incontinence
why are recurrent UTIs an issue with BPH?
urine stasis leads to bacteria build-up in warm, moist, dark places
does ice vasoconstrict or vasodilate?
vasoconstrict to decrease bleeding, edema, discomfort
does noninvasive pulse oximetry read from a vein or artery?
venous O2 reading
movement of air from the atmosphere to the alveoli
ventilation
example of irregular bones
vertebrae
what is tactile fremitus?
vibrations of the chest wall
what vitamin helps iron to better absorb in the body?
vitamin C
what are micronutrients?
vitamins, minerals
what test identifies size, shape, support, and function of bladder, obstruction (ex BPH), residual urine?
voiding cystourethrography
what is most important to assess before interventions for BPH or urine incontinence?
voiding pattern of patient to get a baseline
what is the function of acetaminophen?
anti-pain, anti-pyretic
what are three risk factors for clostridium difficile?
antibiotic therapy, loss of gut flora, and impaired immune system
what is chemotherapy?
antineoplastic agents used to destroy tumor cells by interfering with cellular functions like replication
clear liquids diet
apple/cranberry juice, jello, clear broth
what is obstructive sleep apnea?
cessation of breathing during sleep
what is the priority treatment for pneumothorax and hemothorax?
chest tube
how is NG tube placement confirmed?
chest xray
Murphy's sign is used to rule out
cholecystitis
full liquid diet
clears + dairy products, all juices
____ atelectasis is the result of external forces compressing pleural and/or lung tissues
compressive
a decrease in the frequency of bowel movements or stool that is hard, dry, and of smaller volume than normal
constipation
what is the sign that the drainage system for chest tube is leaking?
continuous bubbling in the water seal chamber
someone with atelectasis would have what manifestations over a small area of the lungs?
crackles, decreased breath sounds, and decreased tactile fremitus
example of mast cell stabilizers
cromolyn
what is an example of an antispasmodic?
cyclobenzaprine
examples of histamine-2 antagonists
famotidine, cimetidine (-tidine)
are females or males more at risk for urine incontinence?
females
what iron has fewer GI side effects?
ferrous gluconate
PO iron is typically
ferrous sulfate
what are two treatments for constipation other than medications?
fiber-rich diet, increase PO fluids
example of 5-alpha-reductase inhibitors
finasteride
the ____ number is the dosage of the opioid the ______ number is the dosage of the acetaminophen
first ; second
physiologically, what can malnutrition lead to?
fluid volume deficit, electrolyte imbalance, poor wound healing/infections
what two things can occur from diarrhea?
fluid volume deficit, impaired skin integrity around rectum/sacrum
when giving IV fluids, what should the nurse assess for?
fluid volume excess
what are three common causes of constipation?
frequent laxative use, inadequate fluid and fiber intake
example of anticholinergics
ipratropium
what is in hemoglobin that helps transport oxygen?
iron
a high level of transferrin indicates
iron deficiency anemia
what iron is given IV?
iron sucrose (venofer)
what three things are used to manage iron-deficiency anemia?
iron supplement, diet change, education on condition
what is the most common type of anemia in all age groups?
iron-deficient
what is the action of proton pump inhibitors?
irreversibly inhibits proton pumps in stomach, most potent
what two disease processes are risk factors for diarrhea?
irritable bowel syndrome and inflammatory bowel disease (ulcerative colitis, Crohn's)
what is the function of soap suds enema?
irritates the mucosa of the GI tract
if the patient is at risk for aspiration pneumonia, what type of feeding tube will they have?
jejunostomy is preferred
junction of two or more bones
joint
surgical openings into stomach or jejunum are often preferred for
prolonged enteral nutrition support; comatose patients
amount of forced expiratory volume in the 1st second
FEV1
what are the diagnostic criteria for COPD?
FEV1 of less than 80%, FEV1/FVC ratio of less than 70%
how long should an endotracheal tube be used?
10 days or less
who is responsible for ordering/changing a patient diet?
MD
what is the most effective treatment for obstructive sleep apnea?
CPAP
what is transferrin?
protein to regulate absorption of iron into the body
what is the action of osmotic stimulants?
pulls water from surrounding tissue to soften stools
what is GERD?
backflow of gastric or duodenal contents into the esophagus
where should the chest tube drainage system be kept?
below the level of the chest at all times
what are the three classes of bronchodilators?
beta-adrenergic agonists, anticholinergics, and methylxanthines
what does BiPAP stand for?
bilevel positive airway pressure
examples of stimulant laxatives
bisacodyl
what kills the c-diff spores?
bleach
what is the action of NSAIDs?
blocks action of COX1 and COX2
osteogenesis
bone formation
how does fiber help with diarrhea?
bulks up loose stool, soaks up excess water
conditions that often require the use of parenteral nutrition include
burn victims, severe malnutrition, Crohn's, paralytic ileus
pyrosis
burning sensation in the esophagus
what foods should be avoided with GERD?
caffeine, tobocco, alcohol, milk, peppermint/spearmint, carbonated beverages
examples of antacids
calcium carbonate, sodium bicarbonate
what is a malignant tumor?
cancerous cell growth that grows rapidly, invades and destroys normal tissues, and spreads throughout body
what can be used to test perfusion?
capillary refill, skin color/temperature, numbness/tingling
what are macronutrients?
carbs, fats, proteins
osteoarthritis is the end result of what three factors?
cartilage degradation, bone stiffening, reactive inflammation of synovium
rigid, external immobilizing device used for variety of med/surg disorders including fractures and deformities
casts
example of COX2 inhibitors
celecoxib
the process during which young, immature (unspecialized) cells take on individual characteristics and reach their mature (specialized) form and function.
cellular differentiation, creates diversity in cells
an increase in the total mass of a cell: cytoplasmic, nuclear, and organelle volume
cellular growth
any process that controls the series of events by which a cell goes through the cell cycle
cellular regulation
process by which cells duplicate their contents and then divide to yield multiple cells with similar if not duplicate contents
cellular reproduction
what is status asthmaticus?
a severe ongoing asthma attack that can lead to respiratory failure or multi-organ failure
what is a tracheostomy?
a surgical opening made into the trachea, used to bypass upper airway obstruction
what is an endotracheal tube?
a temporary airway placed into the trachea between vocal cords
what is the function of NSAIDs?
anti-pain, anti-fever, anti-inflammatory
what does obstructive sleep apnea result in?
hypoxia and hypercapnia
examples of NSAIDs
ibuprofen
who is the most at risk for osteoporosis?
immobile, elderly
important side effects of corticosteroids are
immune supressions, hyperglycemia, mood swings, hunger
what is the action of stimulant laxatives?
increases muscle contractions along intestinal wall to move stool mass
what is the key underlying feature of asthma?
inflammation that obstructs the airway
what is aspiration?
inhalation of foreign substances into airway
how do salicylates reduce inflammation?
inhibiting COX1 and COX2
who performs a swallow test on those with risk for aspiration?
initital swallow test by RN, in-depth exam by SLP
to ensure stable glucose levels, how should parenteral nutrition be given?
inititate slowly, advance gradually, and discontinue slowly
assessment sequence for abdomen
inspect, auscultate, percuss, palpate
what is the action for 5-alpha-reductase inhibitors?
interferes with conversion of testosterone to dihydrotestosterone to decrease prostate size
do ligaments or tendons take longer to heal?
ligaments
what connects bone to bone?
ligaments
why does diarrhea often occur with tube feedings?
liquid food = liquid stool
salicylates should not be given to patients with what disease?
liver
long-acting bronchodilators are used for
maintenance
ferritin levels
male = 24 to 336 female = 11 to 307
what are the three risk factors for obstructive sleep apnea?
males, neck obesity, alteration in upper airway
what medication is an appetite stimulant for those with chronic illnesses?
megace
what medication is an appetite stimulant?
megaze
example of short bones
metacarpals
example of GI stimulants
metoclopramide
what three foods should iron NOT be taken with?
milk, antacids, whole grain cereals
example of leukotriene modifiers
montelukast
examples of opioids
morphine, oxycodone, hydrocodone
why is chemotherapy repeated multiple times?
only a percentage of the tumor cells are destroyed each time, so multiple sessions are necessary
what would appear on the x-ray of someone with atelectasis?
opacity or patchy infiltrates underlying affected tissue
fracture in which damage also involve the skin and mucous membranes, also called a compound fracture
open
what medication can cause constipation?
opioid pain meds
progressive deterioration of articular cartilage
osteoarthritis
what cell types make the bones, secrete bone matrix, and repair the bone?
osteoblasts
what cell types destroy or dissolve old bone, so the blasts can make new bone?
osteoclasts
what cell types are mature bone cells involved in maintenence?
osteocytes
why is it important for those with COPD to stay up-to-date on vaccinations?
respiratory infections like cold or influenza tend to be more deadly and lead to worse outcomes
what does RICE stand for?
rest, ice, compression, elevation
why should indwelling urine catheters be avoided?
risk for infection is high
what herbal supplement is used to treat BPH?
saw palmetto
conditions in which ventilation is impaired and perfusion is adequate
shunting ex: pulmonary embolism
fracture that remains contained with no disruption of the skin integrity
simple
what is the number one risk factor for COPD?
smoking
what is the priority in managing COPD?
smoking cessation
what are six risk factors for dysphagia?
smoking, obesity, pregnancy, hiatal hernia, musculoskeletal disease, and alcohol consumption
how should the nurse educate the patient regarding use of incentive spirometer?
take a deep dreath and let it out, place incentive spirometer in mouth, inhale in, hold for 3 counts, exhale out
what is diagnostic surgery used for?
take a sample of tissue to confirm diagnosis ex biopsy
why are vegetarians at risk for iron-deficient anemia?
their diet might be inadequate in iron because they don't eat red meat or liver
how does asthma affect lung volumes and capacities?
theoretically, numbers can reverse, because disease is restrictive, not permanent
why do antibiotics often cause diarrhea?
they kill the good bacteria in the gut as well as the bad
what three things can be used to manage dysphagia?
thickened liquids, pureed foods, education
manifestations of fluid volume deficit
thirst, low BP, decreased urine, dry skin, skin tenting, weak pulses
how is obesity diagnosed?
through body weight and lab values
because COPD is a permanent disease, how does this affect lung volumes and capacities?
volumes may never change, will only decrease or remain the same
what is dumping syndrome?
when the body receives too much feeding at one time and does not digest it, just pushes it through the body
should iron be taken on an empty stomach or with food?
with food, on an empty stomach can cause GI effects
osteoarthritis pain is
worsened by activity and relieved by rest
what is the gold standard for assessing osteoarthritis?
xrays
what are major side effects for opioids?
dependence/addiction, respiratory depression
why should sedative medications be avoided in those with respiratory illness?
depresses respiratory system, causing less breathing
an abnormal increase in the frequency of bowel movements and liquidity of the stool or in daily stool weight or volume
diarrhea
what are three major risk factors for iron-deficient anemia?
diet low in iron, intestinal disorders, menstruation/pregnancy
what three things are used to manage obesity?
diet, exercise, education on condition
what is dysphagia?
difficulty swallowing
exchange of O2 and CO2 at the alveolar-capillary membrane
diffusion
mechanically and enzymatically breaking down food in the body
digestion
examples of antihistamines
dipenhydramine, loratadine, cetirizine
how does radiation therapy work?
disrupts malignant cell proliferation through altering DNA of the malignant tumor
what is proper education on antibiotic use?
don't take unnecessarily, take the full course of antibiotics
examples of alpha-adrenergic blockers
doxazosin, tamulosin
specific side effects for anticholinergics are
dry mouth, dry eyes, dry mucus membranes, constipation
what is the most common symptom of esophogeal disease?
dysphagia
the patient complains of "having something stuck in their throat," and you notice that they gag, cough, drool, and have regurgitation and frequent heartburn. what does the nurse suspect?
dysphagia - classic s/s
what are the five manifestations of COPD?
dyspnea, chronic cough, sputum production, barrel chest, clubbing of nails
what is tidaling in relation to chest tubes?
elevation of the water level in drainage system with inhalation
expulsion of waste matter from the body
elimination
the expulsion of waste matter from the body; urine or stool
elimination
what two disease fall under COPD?
emphysema (damaged alveoli) and chronic bronchitis (inflammation that narrows the bronchioles)
is enteral or parental healthier for the body?
enteral
nasogastric, gastrostomy, and jejunostomy tubes are ______ nutrition
enteral
what are the functions of an NG tube?
enteral feedings; stomach decompression, lavage, and pumping
providing nutrients to the body by delivery to the stomach and small intestines via feeding tube
enteral nutrition
how long should the patient sit upright after a bolus feeding?
1 hr minimum
why do manifestations of solid tumors vary?
entirely dependent on the tissue where the tumor has grown
prealbumin level
16-30mg/dL
when should the pneumonia vaccine be given?
2 injections one year apart = lifetime protection
solid tumors often result from
errors in DNA replication or exposure to carcinogens
how many bones are in the body?
206
what percentage of oxygen is in the air?
21%
transferrin level
215-380
what is considered morbid obesity?
2x IBW or BMI > 30kg/m^2
albumin level
3.5-5.4
how many mls should the feeding tube be flushed with?
30 mls
what dose of aspirin is used for pain?
324 mg
when should pertussis vaccine be given?
every ten years
what is a major complication of GERD?
Barrett's esophagus - tissue change that can lead to esophogeal cancer
what is impaction with constipation?
occurs when an accumulated mass of dry feces cannot be expelled
what are side effects of salicylates?
GI ulcers and hepatotoxicity, risk for bleeding because anti-platelet
what are the two most common side effects of iron supplements?
GI upset and dark, tarry stools
four risk factors for diarrhea include
GI infections, food intolerance (ex lactose), stimulants (caffeine), and antibiotics
the nodes that form with osteoarthritis are called?
Heberden's or Bouchard's
what are three other treatments for diarrhea?
IV fluids, fiber-rich diet, probiotics
what is used to treat c-diff?
IV vancomycin, probiotics like lactobacillus
are regurgitation/aspiration more likely in NG tubes or gastrostomies?
NG tubes
what IV fluid will be used to treat diarrhea?
NS or LR
what is the function of mast cell stabilizers?
to help treat airway inflammation
why are casts needed for bone fractures?
to immobilize the bone and prevent misalignment during healing
what is palliative surgery for cancer?
to improve comfort when a cure isn't possible
why should the HOB be elevated 30 degrees during feedings/med adminstration?
to prevent aspiration
what is the function of glucocorticoids?
to reduce airway inflammation
what is the function of leukotriene modifiers?
to reduce airway inflammation
why are probiotics used to treat diarrhea?
to replenish the gut biome
the volume of air in the lungs after maximum inhalation
total lung capacity
can osteoarthritis be treated?
degenerative process with no treatment
what is the cause of constipation?
contents move so slowly through intestine and stool dries up before being excreted
what is the function of corticosteroids?
decrease inflammation and supress the immune system
what would an ABG show in someone with atelectasis?
decreased PaO2, possibly respiratory alkalosis from hyperventilation
what is diaphragmatic breathing?
deep breathing from the diaphragm
examples of obstructive atelectasis
mucus plug, foreign object
examples of proton-pump inhibitors
pantoprazole, omeprazole (-prazole)
loss of movement, possibly from nerve damage
paralysis
why is it important to asess recent travel?
parasites in water can cause diarrhea, cholera, malaria
providing nutrients to the body by peripheral or central IV route
parenteral nutrition
fracture that occur through an area of disease bone
pathologic
what does PEG stand for?
percutaeneous endoscopic gastrostomy
blood flow to tissues and organs
perfusion
examples of compressive atelectasis
pleural effusion, pneumothorax
atelectasis is a precursor to what respiratory disease?
pneumonia
what is the difference between a pneumothorax and atelectasis?
pneumothorax - collapsed lung atelectasis - collapsed alveoli
people with osteoporosis have bones that progressively become
porous, brittle, and fragile; fracture easily under stress
following surgery, when is the patient most at risk for developing atelectasis?
post-op day 3
chest physiotherapy includes
postural drainage, chest percussion, vibration, and breathing retraining
what level is the preferred lab value for malnutrition?
prealbumin, the earliest indicator of nutritional status
example of corticosteroids
prednisone
examples of glucocorticoids
prednisone, beclomethasone
____ and _____ are symptoms required to diagnose chronic bronchitis.
presence of cough (usually productive) and sputum production for at least 3 months in 2 consecutive years
what is a major occurrence with urine incontinence?
pressure ulcers
what is the function of a CPAP?
provides positive pressure to prevent collapse of alveoli on exhalation, splints the upper airway and trachea open to allow for airflow
what bone is fractured in hip fractures?
proximal femur
someone with atelectasis would have what manifestations over large areas of the lungs?
tracheal deviation toward atelectatic area, decreased fremitus, bronchial breath sounds, egophony, and asymmetrical chest
how is iron-deficiency anemia diagnosed?
transferrin and ferritin levels
reversible incontinence due to inflammation, UTI, meds, disease process, etc.
transient incontinence
what is the patient education for biphosphonates?
take on empty stomach with full glass of water first thing in the morning, sit upright for 30-60 mins
how is parenteral nutrition given?
through a central or PICC line, 2-3L of solution over 24 hours
where does parenteral nutrition enter the body?
through peripheral or central line
amount of air inhaled and exhaled with each breath
tidal volume
how are NG tubes measured for placement?
tip of nose to earlobe to xiphoid process
why is physical activity important with osteoporosis?
to build strength and increase bone density
why should the NG tube be assessed before every use?
to ensure tube is still in stomach and not lungs
what is the function of antihistamines?
to help dry up mucus secretions