FUNDIES EXAM 3
Dysrhythmias
(alterations in heart rate or rhythm) Lower cardiac output and decrease tissue oxygenation
How does diverticululitis stool appear
(inverted pockets form in the intestine, hard particles get lodged into the pockets, causes inflammation of the colon, and can cause stress on the body) -DIARRHEA MAY FORM
Common types of yoga
-Ashtanga -Bikram -Iyengar -Kripaula
Ostomy patients should do what to their diet
-Decrease their fiber intake -avoid greasy foods (can cause gas, irritant, exterior part of the skin can be irritated)
When one component of holism is not working it causes a strain on the other components
-Ex: emotionn of sadness, have a physical response of crying -Ex: angry, may have a physical response of redness of the face
Protective Positioning
-Fowler's position -Protective supine position -Protective side-lying or lateral position -Protective Sims' position -Protective prone position
Benefits of Relaxation for Patients (mind and body modality)
-GOAL IS TO: Reduces anxiety -Reduces muscle tension and pain -Improves function of immune system -Enhances sleep and rest -Improves sense of well-being
Heat
-Generally causes vasodilatation, which increases cardiac output and oxygenation -Increases metabolism
Heart failure
-Heart becomes an inefficient pump and is unable to meet the body's demands. -Blood is oxygenated when it passes through the lungs, but it is not well circulated to the organs and tissues. -Impaired circulation leads to systemic and pulmonary edema, which further impairs gas exchange.
Factors that influence cardiac function -Cardiovascular abnormalities
-Heart failure -Cardiomyopathy -Cardiac ischemia -Coronary artery disease -Dysrhythmias -Heart valve abnormalities
Safety Considerations for School-Aged Children
-Help to avoid activities that are potentially dangerous. -Provide interventions for safety at home, school, and neighborhood. -Reinforce teaching about symptoms the require immediate attention. -Continue immunizations as scheduled. -Teach bicycle safety. -Teach about child abduction. -Wear seatbelts.
What are nontraditional supplement
-Herbs -Recognized as a part of nursing practice
Manage anxiety Anxiety activates the sympathetic nervous system and triggers the stress response.
-Hormone changes occur, including the release of aldosterone, which promotes fluid retention and increases blood pressure. -The heart rate and contraction force increase, peripheral and visceral vessels constrict, and the blood clots more readily. -All of these make a cardiac or vascular condition more serious.
Factors that influence cardiac function -Tobacco
-Major risk factor in several chronic cardiovascular conditions: stroke, peripheral arterial disease, aortic aneurysm, and heart disease -Implicated in atherosclerosis (fatty buildups in the arteries), hypertension, and decreased HDL (good) cholesterol—all of which lead to coronary heart disease and heart attack.
Bowel-Training Programs
-Manipulate factors within the patient's control -Food and fluid intake, exercise, and time for defecation -Eliminate a soft, formed stool at regular intervals without laxatives -When achieved, discontinue use of suppository if one was used
Chemicals Used for Mass Destruction #2
-Metals -Nerve agents -Organic solvents -Riot control agents/tear gas -Toxic alcohols -Vomiting agents
Three Categories of Complementary Health Approaches
-Mind-body practices -Natural products -Other CHAs
Complementary and Integrative Health Approaches that Work on Pain
-Mind-body practices that are movement-based -natural products -other mind body approaches -energy healing -Physical manipulation -Lifestyle changes
Safety Event Reports
-Must be completed after any accident or incident in a health care facility that compromises safety -Describes the circumstances of the accident or incident -Details the patient's response to the examination and treatment of the patient after the incident -Completed by the nurse immediately after the incident -Is not part of the medical record and should not be mentioned in documentation
Safety Event Reports
-Must be completed after any accident or incident in a health care facility that compromises safety Describes the circumstances of the accident or incident Details the patient's response to the examination and treatment of the patient after the incident Completed by the nurse immediately after the incident Is not part of the medical record and should not be mentioned in documentation
Effect of Nervous System on Muscle Contraction
-Neurons conduct impulses from one part of the body to another. -The afferent nervous system conveys information to the CNS. -Information is processed by the CNS leading to a response. -The efferent neurons convey the response from the CNS to skeletal muscles by way of the somatic nervous system . When your finger touches the eye of the stove -move finger fast -process that takes place -Brain sends a signal to remove your finger
Most Frequently Used Complementary Health Approaches
-Nonvitamin, nonmineral, natural products (17.7%) -Deep breathing exercises (10.9%) -Yoga (9.5%) -Chiropractic or osteopathic manipulation (8.4%) -Meditation (8%) -Massage (6.9%) (Clarke et al., 2015) -Among U.S. adults, the use of some mind-body therapies involving gentle physical activity, specifically yoga, tai chi, and qi gong, increased between 2007 and 2012
What medications can decrease GI motility (peristalsis)
-Opioids -anticholinergic -antacids that contain aluminum -patients on iron sulfate
Factors that influence cardiac function -Pregnancy
-Oxygen demand increases dramatically. -To compensate, the mother's blood volume increases by 30%. -The woman requires additional iron to produce this blood as well as to meet fetal requirements.
Cardiac ischemia
-Oxygen requirements of the heart are unmet. -Prolonged ischemia leads to myocardial infarction (MI) as parts of the heart necrose (die) from inadequate oxygen.
Eight principles to analyze symptoms and categorize conditions:
-cold/heat, interior/exterior, excess/deficiency, yin/yang
Aryuvitic medicine also includes Yoga
-compases mind and body -can be used across the life span
Neglect of child
-key indicator is malnutrition (Severely underweight, anything under the 20th percentile is considered underweight) -Extreme circumstances (unless they have a failure to thrive) -looking for extra food at school -do not receive food other than at school
Adolescents and parents should be educated on laxatives
-laxative use can hyper stimulate the peristalsis effect and cause dehydration
Child abuse and neglect assessment
-look for bruises (various stages of healing, and unexplained) -multiple bruises (different story for every bruise) -child relies on the parent to answer question
is a colorless, odorless gas produced by the combustion of flammable materials and fuels. When inhaled, carbon monoxide binds tightly to hemoglobin at the oxygen receptor sites, making it impossible for hemoglobin to carry oxygen.
Carbon monoxide
The muscle that is needed to pump throughout the body
Cardiac cycle
variables influencing bowel elimination
Developmental considerations Daily patterns Food and fluid Activity and muscle tone Lifestyle Psychological variables Pathologic conditions Medications Diagnostic studies Surgery and anesthesia
What is the main considerations during devlopment
Developmental level and assessment priority
Maintaining Emergency Preparedness
Addressing biological threats Addressing chemical threats Addressing radiation threats Addressing cyber terror Preparing for mass trauma terrorism Identifying disaster resources Addressing psychological aspects of disasters
Procedure-Related Accidents/Possible Errors
Administering medications or intravenous solutions -violated any medication rights Transferring a patient -improper body mechanics, know your body limitation Changing a dressing -preventing infection Applying external heat to a patient's extremity -want some type of covering, do not want directly on the skin -assess the skin at regular intervals
Benefits of qi gong
Bone health Cardiapulmonary thickness Mental focus
Integrate feedback from baroreceptors and chemoreceptors in the body to regulate cardiac function and blood pressure.
Brain stem centers
School aged children are more at risk for
Burns Drowning Broken bones Inhalation and ingestion substance abuse concussions
Hand hygiene for stool collection
CDC says wash hands for 20 seconds before and after glove use, this is essential
Complementary Health Approaches (CHA)
CHA Refers to interventions that can be used with conventional medical interventions and thus complement them.
CHA and IH are not "medicines" and people without medical degrees practice what?
CHA/IH
If a nurse makes a mistake and causes death to a patient
CONTROVERSIAL -implement prevemtion -or do we punish the person who made the human error
Indirect Visualization Studies- radiography
Can detect obstructions, stricturs (abnormal passages), inflammation, tumors, ulcers, lesions, high attle hernias (portion of the stomach pushes through the diaphragm)
More safety considerations for Neonates
Never leave the infant unattended Use crib rails Monitor setting for objects that are choking hazard Use car seats properly Handle infant securely while supporting the head Place infant on back to sleep
Arterial abnormalities disrupt flow of oxygenated blood to tissues.
Pallor, pain, weak or absent pulses, poor capillary refill, cool skin, and tissue dysfunction
What part of holism is continuously interacting and changing
Parts of the organism, whether they are systems, subsystems, or cells, are also continuously interacting and changing.
Patient Outcomes for Normal Bowel Elimination
Patient has a soft, formed bowel movement every 1 to 3 days without discomfort. The relationship between bowel elimination and diet, fluid, and exercise is explained. Patient should seek medical evaluation if changes in stool color or consistency persist.
White, pale, and pasty stoma
Patient has formed anemia (not a good blood supply, hemoglobin could be low)
Dangling
Patient sits on the edge of the bed and allows the legs to dangle -promotes circulation, helps us assess for orthostatic hypotention (look for: color change, light headedness, nasuea, tachycardia when sitting up)
Recommendation for bowel elimination
Patients who have 2000 t0 3000 ml daily High fiber diet (Whole grain, vegtables, fresh fruits, and potatoes)
Indications of a Concussion- symptoms
Physical -headache, vomitting, problems with balance, fatigue, dazed or stunned appearence Cognitive -mentally foggy, difficulty concentratinf and remebering, confussion, forgets recent activities Emotional -Irrability, nervousness, very emotional behavior Sleep -Drowsiness, difficulty staying awake, sleeping more or less than usual CAN NOT SLEEP FOR AT LEAST 1 HOUR AFTER THE HEAD INJURY
Developmental considerations for toddlers
Physiologic maturity is the first priority for bowel training.
Positioning patients
Pillows -helps support, elevate a body part Mattresses -supports body alignment Adjustable beds Bed side rails Trapeze bar Additional equipment
Acupuncture
Places thin, short, sterile needles at particular acupoints to change flow of energy and restore the balance of yin and yang
Factors that influence cardiac function -Lifestyle
Pregnancy Nutrition Obesity Exercise Tobacco use Substance abuse
Stand-Assist and Repositioning Aids
Pull bars
What are some question you may ask a parent of an adolescent if substance abuse is suspected
Questions: emotional state (aggression), do they go through periods of aggressions, academic changes, dress changes, overall attitude changes (monitor for)
If a nurse makes a mistake and causes injury to the patient they must
REPORT WHAT INJURY WAS CAUSED -do not document in the patients record
Emphasis is on disease and high technology (drugs, surgery, and radiation are key tools).
Referring to our tradition medical approach
Mind-Body Practices
Relaxation Meditation Guided imagery Yoga Qi Gong and Tai Chi Acupuncture Chiropractic health care Aromatherapy
Stress
Release of catecholamines from the sympathetic nervous system. -Increased heart rate and contractility, vasoconstriction, and increased tendency of blood to clot
One third to one half of food waste is excreted in stool within 24 hours
Remainder is excreted 24-48 hrs
Safety Consideration for Adults
Remind them of effects of stress on lifestyle and health. -people with babies (can be a new stress, new routine, and new lifestyle) -Educate on what to expect as a parent Enroll in defensive driving course. Counsel about unsafe health habits (reliance on drugs and alcohol). Evaluate workplace for safety. Counsel about domestic violence.
What should be done in an emergency situation and a restraint is needed
Restrain the patient -then call for an order
Internal rotation
Rotation of a joint toward the middle of the body. -turning the leg inward
RACE -fire safety
R—Rescue anyone in immediate danger. A—Activate the fire code and notify appropriate person. C—Confine the fire by closing doors and windows. E—Evacuate patients and other people to safe area.
Safety Plan for Victims of Domestic Abuse
Safety while living with an abusive partner Safety planning with children Safety planning for pets Safety planning during pregnancy Leaving a relationship -Victims do not want to leave because they love their abuser -abuse is a cycle, they do not abuse 24/7 -may be financial security
What can also contribute to cardiovascular disorders in young and middle adults
Sedentary lifestyle, lack of aerobic exercise, and tobaccoo use
Reasons for Using Complementary Health Approaches
Seeking ways to improve health and well-being or relieve symptoms associated with chronic, even terminal illnesses or the side effects of conventional treatments for them Having a holistic health philosophy or a transformational experience that changes one's worldview and wanting greater control over one's own health
Acupuncture is beneficial to
Severe inflammation Nausea or vomitting Tightness of the muscle (Trigger points) Be used to relieve pain
Sexual abuse in a child
Sexual abuse -mimics behavior with classmates or objects -do not know that it is wrong, body tells them that it feels good and they like it -abusers have convinced them that its their fault that it happened -child carries the burden of blame -fear (if you tell this will happen) -statistically abusers are not strangers (level of trust is established before abuse takes place)
What is the most widely practices medical system
Shamanism
Types of Ostomies
Sigmoid colostomy Descending colostomy Transverse colostomy Ascending colostomy Ileostomy
Why are incident reports (accident reports or safety even report) written
Some error has occured resulting in injury or could have resulted in injury
Extension
Straightening of a joint -leaning head slighty back
Factors that influence cardiac function -Environment
Stress -allergic reactions and air quality -heat and cold
Adults are more at risk for
Stress Domestic violence
Qi gong consist of
System of posture Exercise Breathing technique Visualization that regulated the qi gong
Focus of Safety Assessments
The individual The environment Specific risk factors
Hands-Only CPR—Hands-OnlyTM CPR:
The method is recommended for people who see an adult collapse suddenly in the community. It has only two steps -Call 911, or send someone to make the call. -Push hard and fast in the center of the victim's chest.
Energy-Healing Therapies
Therapeutic touch Healing touch Sound healing
Energy medicine modalities
Therapeutic touch Healing touch Sound healing
Cardiac myopathy
This is a heart muscle disorder that results in heart enlargement and impaired cardiac contractility.
Promoting Regular Bowel Habits
Timing- have a regular schedule Positioning- up right position, elevate the head of the bed Privacy Nutrition- high fiber diet, fluid needed is 2,000-3,000 mL Exercise- promotes peristalsis
Inversion
Turning the sole of the foot inward
Verbal abuse
Verbal abuse -no evidence of it -verbal, mental, and emotional -takes longer to suspect that
Yin-yang theory
Yin (cool, moist and dark therapy) yang (Hot, dry and light)
Perform CPR
You must be prepared to perform cardiopulmonary resuscitation (CPR) in the event your patient experiences a respiratory, cardiac, or cardiopulmonary arrest.
Theories of Homeopathy Symptoms are suppressed deep within the body
a cure is more difficult to achieve
Venous system
a holding tank for fluctuations in blood volume
Electrocardiogram (ECG),
a rendering of the electrical activity of the heart -Three to five electrodes placed on the skin of the chest display a waveform on a monitor screen or printout. -Illustrates electrical activity, but not mechanical activity. In other words, the ECG reflects what the nerves are telling the heart muscle to do, but not what the heart muscle is actually doing in response.
Development considerations of Infant 3 to 6 months
ability to sit and control their head
Developmental considerations of toddlers
ability to walk, run, and jump
Holism
connection and interactions between parts of the whole
How does spinal cord injury bowel eliminations look
constant constipation, medulla and spinal cord control defecation, brain does not recieve the signal
Abdominal CT scan-
contrasts is given to the patient via IV, can also be orraly, allows radioactive beams to appear on the computer screen, real time images
The cardioinhibitory center
controls parasympathetic slowing of the heart rate.
The vasomotor center
controls sympathetic stimulation of the heart and vascular system.
The ______ sinus is located just above the aortic valve, fills with blood during diastole
coranry
The heart has its own blood supply through the _______ arteries
coronary
What can lead to sudden cardiac failure in young and middle adults
crack cocaine and methamphetamine abuse
Friction reducing sheets
decreases skin shearing
Veins
deoxygenated blood back to heart/lungs
Anthelmintic:
destroy intestinal parasites
Anthelmintic enema
destroys intestinal perisites
The coronary arteries are the only arteries in the body that fills during _______
diastole
Health is the absence of disease
disease is not present
Always wear what type of gloves during stool collection
disposable gloves
Rectal suppositories-
dissolvable placed in the rectum, that softens/soothes the colon
Nursing diagnosis for colostomy
disturbed body image (worried about how they will function with what they consider a deformity)
When taking a stool collection what should you make sure to do with the outside of the container
do not contaminate the outside of the container with stool
Constipation
dry hard stool that is difficult to pass
Naturopaths believe that health is a __________state of being that provides abundant energy for people to deal with life in our complex society.
dynamic
Hinge joint
elbow and knee
Atrioventricular (AV) node
electrical activity passes through the AV node into the left and right bundles of HIS and into Purkinje fibers to the ventricles.
Electrical conduction
electrical activity that initiates contraction of the myocardium
Defication
emptying of the large intestine, controlled by the reflex of the medulla and controlled by the spinal cord
Cardiovascular medications are used to
enhance cardiac output, thus providing increased blood flow and oxygenation to organs and tissues.
Qi gong
enhances the systemic health of a person, restores healing, promotes balance and coordination
Peristalsis contractions occur
every 3 to 12 minutes
Sigmoidoscopy
examine the sigmoid, rectum, and anal cavity
Exercise improves muscle ability to pull oxygen out of the blood which reduces the need for the heart to pump more blood to the muscles
exercise decreases the workload of the heart
Hyperextension
extension beyond anatomical position -leaning head all the way back
What is another risk factor for young and middle adults
family history of cardiovascular disease
Mass peristalsis sweeps occur one to four times each 24 hour period
feel the urge to defecate
Developmental condsiderations of school aged children
fine motor skills (holding a pencil)
What is the leading cause of intentional deaths in children
firearms
The sequence for abdominal assessment proceeds from
inspection, auscultation, and percussion to palpation.
The aim of Ayurvedic medicine is to
integrate and balance the body, mind, and spirit.
Complementary and Integrative health refers to
interventions
Healing techniques of shamanism
involve native plants and herbs, animals, rituals, ceremonies, and purification techniques.
Oral intestinal lavage-
irrigation of the stomach or colon
embolus
is a clot that travels in the bloodstream. -Clots can form after injury to vessels, or in response to hypercoagulability. -All the strategies to promote venous return also help prevent clot formation.
thrombus
is a stationary clot adhering to the wall of a vessel.
Bikram
is done in a 105-degree studio with 26 set postures -includes two breathing exercises, only 40% humidity within the studio
Smooth or visceral muscle
is nonstriated -involuntary -protects the internal organs
Cardiac arrest
is the cessation of heart function.
Manipulative and Body-Based Practices the goal:
is to break up tension held in body structures, promote communication between mind-body structures, promote detoxification, and generally improve body functioning
Vascular system -Chemo receptors main function
is to regulate ventilation, but they also send information to the vasomotor center in response to lack of oxygen.
Fatigue and stress developmental considerations
lack of exercise or injury of exerting ones self
Striated muscle tissue
light and dark bands
Bright red indicates what
lower GI bleed (there is an active bleed)
Oil-retention:
lubricate the stool and intestinal mucosa, easing defecation
Vascular system -ANS
maintain vascular tone
Digital removal of stool-
manual removal of fecal matter
When taking a stool collection what technique is used
medical aseptic technique (clean technique) is imperative
Physical manipulation
messages, anything that releases tension, promote detox, and improve oxygenation and circulation MANIPULATIVE AND BODY BASED THERAPY
Holism has 4 components
mind body emotion spirit
Ascending stoma:
more watery stool
Skeletal muscles help prosuce what
movement
Parasympathetic system stimulates
movement in peristalsis
How can activity and muscle tone influence bowel elimination
movement stimulates peristalsis which stimulates defecation
Supination
movement that turns the palm up -palm pointing upward
Isokinetic exercise
muscle contraction with resistance -weight lifting
Isometric exercise
muscle contraction without shortening -Yoga
Isotonic exercise
muscle shortening and active movement -ADL's (swimming, walking, jogging, bicycling)
Shamanism uses what to assess ones spiritual state
myths and dreams -interpret your dreams -spiritual approach
Finance developmental considerations
no money= depression
isotonic solution for enemas
normal saline, soap suds
Natural products include
nutritional and herbal remedies
Botanicals and nutritional supplements
oCaution: some herbs and supplements may inteact to prescription o"Ginkgo" taken to promote memory function, people who take anticoagulants should not take together, causes a disfunction in platelet function/formation Nutritional therapy
Other CHAs
oEnergy healing, lifestyle changes, physical stimulation
Inspection and palpation of the anus and rectum
oLesions, ulcers, fissures (linear break on the margin of the anus), inflammation, and external hemorrhoids oAsk the patient to bear down as though having a bowel movement (expands the opening of the rectum). Assess for the appearance of internal hemorrhoids or fissures and fecal masses. oInspect perineal area for skin irritation secondary to diarrhea or fecal incontinence.
Focus of Safety Assessments -The person
oMore at risk is age of 65 oHistory of falls oMental health commission oChildren
Natural products
oNutrition, herbal
Mind-body practices
oRelaxation oGuided imagery oYoga oAcupuntioner oChiropractor oAroma therapy
Focus of Safety Assessments -Specific risk factors
oSensory impairment oPatient who has impaired vision, not able to keep their balance oCertain medication
Inspection of the abdomen
observe contour, any masses, scars, or distention
When taking a stool collection what sould you do before transporting
obtain stool and package, label, and transport according to agency policy
Ayurveda Originated in Vedic civilization of India
one of world's oldest medical systems.
Gas producing foods
onions cabbage beans cauliflower
How many safety rails can be put up?
only 3 safety rails, the 4 rail is considered a restraint
Ileostomy
ostomy is at the ileocecal valve
Hypertonic solution for enemas
over the counter commercial brand enema
Arteries
oxygenated blood to the tissues
Sinoatrial (SA) node
pacemaker of the heart
Acupuncture reduces what
pain, promotes adherence to substance abuse programs, minimizes nausea and vomiting
Pronation
palm pointing downward
hemorrhoids
part of the rectum of the colon protrudes outside the anus
Small bowel series-
patient drinks a barium solution, provides a coding that enhances visualization
Upper gastrointestinal (UGI)-
patient drinks a barium solution, provides a coding that enhances visualization
How can a diuretic cause a safety issue with a patient
patient has to continually keep up to urinate
Wireless capsule endoscopy:
patient takes a pill/capsule (camera) takes 2 pictures every second of the entire digestive process.
Percussion and palpations of the abdomen
performed by advanced practice professionals
Sympathetic system inhibits the movement of
peristalsis
What leads to defication
peristalsis
Magnetic resonance imaging (MRI)-
sectional images of tissues,
Ball and socket joint
shoulder and hip
When cleansing a patient what position should the patient be in
sims position
Motion of msucles
skeletal muscle contracts and pulls the ttendons causing the bones to move creating movement
Heat production of muscle
skeletal muscle helps to maintain body temperature
Support of the skeletal muscles
skeletal muscle protects the abdominal wall and the pelvic floor
What is the leading cause of house fires
smoking in the home
Enemas-
solutions introduced to the small intestine
The skeletal muscles are controlled by hwat system
somatic nervous system
Mechanical lateral assist device
specialized stretcher
When baroreceptors sense even a small drop in pressure
they send messages to the brain stem centers to stimulate the sympathetic nervous system to increase heart rate and induce vasoconstriction.
Factors that influence cardiac function for older adults
thicker and more rigid valves, decreased myocardial strength, lower exercise tolerance, other health problems
Beefy red stoma
this is what we want, getting circulated and has blood supply
What can nasogastric tubes also be inserted for
to monitor gastrointestinal bleeding
The shaman or medicine man/woman accesses the spirit world to do what
to obtain information on the proper treatment
Medicarted enema
to provide medications
What is more prevalent at the age of adolescents
tobacoo and alcohol
Qi
traditional chinese medicine
Allopathic medicine
traditional medical care
Factors that influence cardiac function Infants
transition to life outside of the uterus, congenital heart
External rotation
turning outwardly or away from the midline of the body -turning the leg outward
Eversion
turning the sole of the foot outward
Endoscopy
type of diagnostic, direct visualization of body organ, long tube goes into the body
Saddle joint
type of joint found at the base of each thumb; allows grasping and rotation
Ayurveda Key concepts include
universal interconnectedness among people, their health, and the universe; and the body's constitution and life forces.
Black stool indicates what
upper GI bleed (indicator of an old bleed)
Long bones
upper and lower extremities
lateral assist devices
used to decrease the friction during transfers
Log rolling
usses a draw sheet or friction reducing sheet to facilitate smooth movement -specifically used for patients with spinal cord injuries
Carminative:
help expel flatus from the rectum
Oil retention enema
helps lubricate the stool
What is peristalsis
helps with the movement of stool that is formed of stool, worm like movement
Ayurvedic practitioners prescribe individualized treatments that include
herbs, metals, minerals, and other materials; diet and exercise; and lifestyle recommendations.
Retention enema
hold the stool in the bowel for a long period of time
Small volume enema
hypertonic solution
Large volume enema
hypotinic and isotonic solutions
Shamanism _______ is though to originate in the spirit world
illness
During acupuncture this change in the flow of energy contributes in what
in healing
Naturopathic practitioners use many different treatment approaches
including dietary and lifestyle changes, stress reduction, herbs and other dietary supplements, manipulative therapies, and practitioner-guided detoxification.
Preschool and school age have body systems mature enough to adapt to moderate stress and change
including the heart and circulatory systems
The purposes of cardiac monitoring are to
ØIdentify the patient's baseline rhythm and rate. ØRecognize significant changes in the baseline rhythm and rate. ØRecognize lethal dysrhythmias that require immediate intervention.
JOB OF A NURSE IS TO REPORT A SUSPECTION OF ABUSE OR NEGLECT (do not have to have evidence)
Do not have to tell anyone you have repoted abuse or neglect
Domestic violence in adults
Domestic violence on adults -get the patient by them selves -do you need help; are you being abused? -fear -have to be tactical -mandated reporters Safety plan
Safety Considerations for Neonates -Avoid behaviors that might harm the fetus
Drugs, alcohol, fetal drug syndrome, smoking (effect low birth weight), certain activities Babies addicted to drugs -Transition to methadone (less side effects for the new born, they have to be wheened, go through withdrawl syndrome)
Venous abnormalities disrupt blood return to the heart.
Edema, brown skin discoloration, and tissue dysfunction (e.g., stasis ulcers)
The electrical impulses that stimulated the muscle known as the myocardium
Electrical conduction
powered full-body lifts
Hoier lift -seen alot in the hosptial -obessed patients or patients with contractors
Nasogastric Tubes
Inserted to decompress or drain the stomach of fluid or unwanted stomach contents Ingestions of poison, certain medication that needs to be extracted, to much air, or peristalsis is absent
Cardiac is what type of muscle
Involuntary striated muscle -make up the main tissue of the heart (walls of the heart)
Assess pain -ask the patient to describe the pain
Location Duration Frequency Radiation
Improtant functions of muscles
Motion Maintenance of posture Support Heat production
Adolescents are more at risk for
Motor vehicle acidents Gun violence Drowning Inhalation and inhestions (getting high)
Older adults are more at risk for
Motor vehilce accidents -sensory inpairments Elder abuse
Abduction
Movement away from the midline of the body
Opposition
Movement of the thumb to touch the fingertips
Adduction
Movement toward the midline of the body
Phyaical health (illness or trauma)
Muscular, skeletal, or nervous system problems Problems involving other body systems
Preventing Food Poisoning #1
Never buy food with damaged packaging. Take items requiring refrigeration home immediately. Wash hands and surfaces often. Use separate cutting boards for foods. Thoroughly wash all fruits and vegetables before eating. Do not wash meat, poultry, or eggs to prevent spreading microorganisms to sink and other kitchen surfaces. Never use raw eggs in any form. Do not eat seafood raw or if it has an unpleasant odor.
Theories of Homeopathy
-Like cures like -Law of minimum dose
Mind body practices that are movement based
relaxation, meditation, prayer
Thrushed stoma
requires intervention stoma is trying to return back inside
The vasomotor center
responds by activating sympathetic stimulation
False Imprisonment
restraining an individual or restricting an individual's freedom (4th safety rail)
Flat bones
ribs and skull bones
Barium enema-
same solution as above but inserted through the rectum
Developemtal considerations of adolescents
scholiosis
Cardiovascular assessment (assessing risk factors) -Physical Exam
-Assess pain -Assess fatigue -Assess dyspnea -Assess peripheral circulation
Coronary arteries
-Blood supply to the heart -Fill during diastole
Factors that influence cardiac function -Obesity
-Body mass index (BMI) above 30 -Causes multiple health problems, many of which affect the heart and circulation -Increases the risk of developing atherosclerosis and hypertension -Excess fat stores in and around the heart itself reduce its effectiveness as a pump -Workload of the heart is increased by the need to perfuse the excess body tissues
Respiratory (pulmonary) arrest is cessation of breathing.
-Caused by a blocked airway or occurs after a cardiac arrest -May be sudden or preceded by increasingly labored breathing
Coronary artery disease
-Condition in which plaque builds up inside the coronary arteries -Plaque narrows the arteries, reducing blood flow to the heart muscle and making it more likely that clots will form and block the arteries.
Safety Considerations for Older Adults
-Identify safety hazards in the environment. -Modify the environment as necessary. -Attend defensive driving courses or courses designed for older drivers. -Encourage regular vision and hearing tests. -Ensure hearing aids and eyeglasses are available and functioning. -Have operational smoke detectors in place. -Objective document and report any signs of neglect and abuse.
allopathic medicine (biomedicine)
-Illness occurs in either the mind or body, which are separate entities. -Health is the absence of disease. -The main causes of illness are pathogens. -Curing seeks to destroy the invading organism or repair the affected part. -Emphasis is on disease and high technology (drugs, surgery, and radiation are key tools).
Factors that influence cardiac function -Exercise
-Improves blood circulation and delivery of oxygen to tissues and cells -Increases metabolic demands -Body responds by increasing the heart rate and the rate and depth of breathing -Like skeletal muscles, heart muscle is strengthened with regular aerobic exercise.
Benefits of Exercise to Cardiovascular System
-Increased efficiency of the heart -Decreased heart rate and blood pressure -Increased blood flow to all body parts -Improved venous return -Increased circulating fibrinolysin (substance that breaks up small clots)
Postural Reflexes
-Labyrinthine sense -Proprioceptor or kinesthetic sense -Visual or optic reflexes -Extensor or stretch reflexes
Factors that influence cardiac function -substance abuse
-Large amounts of alcohol depress respiratory, cardiac, and vasomotor centers of the brain. -Chronic alcohol abuse causes fatty infiltration of the heart muscle, thrombi in the coronary arteries, heart enlargement, and dysrhythmias, all of which can ultimately lead to heart failure. -Illicit drugs, including stimulants (e.g., methamphetamine, cocaine), hallucinogens [e.g., LSD (acid), mescaline (buttons)], and cannabinoids (e.g., marijuana) also have adverse effects on the cardiovascular system.
Assess peripheral circulation
-Palpate the peripheral pulses, assess skin color and temperature, and note the distribution of hair on the extremities. -Weak pulses, cool feet, lack of hair, and shiny skin on lower legs and feet usually accompany peripheral vascular disease. -Look for skin ulcers that often accompany severe venous or arterial disease. -Check for edema of the feet and ankles; this is one symptom of heart failure.
Individuals at High Risk for Constipation
-Patients on bed rest taking constipating medicines -Patients with reduced fluids or bulk in their diet -Patients who are depressed -Patients with central nervous system disease or local lesions that cause pain while defecating
Why nurses need to know complementary health approach
-Patients, families, physicians, and institutions increasingly expect practicing nurses to be knowledgeable about CHA. -Many patients use these types of therapies as outpatients and want to continue their use as inpatients. -Patients/family members may expect nurses to administer herbal preparations/nutritional supplements. -Many nurses are expanding their clinical practice by incorporating CHA. -Many institutions now provide complementary therapies to inpatients as part of total patient care in an effort to provide integrative health care.
Safety Improvement Strategies
-Preventing Falls Targeted Solutions Tool® (TST®) -Falls Toolkit -Falls Prevention Training Program -Root Cause Analysis (RCA)
Tests of blood oxygenation
-Pulse oximetry -Capnography -Arterial blood gases
Physical Conditioning
-Quadriceps and gluteal setting drills -Push-ups -Dangling Increases physical conditioning in preperation of ambulation
Assess dyspnea
-Sign of hypoxia, which can be associated with cardiovascular diseases and anemia as well as with respiratory problems. -As with pain, dyspnea provokes anxiety.
Cold
-Slows cell metabolism, reducing O2 demand -Causes vasoconstriction, and slows the heart rate -Induced hypothermia used in some surgical procedures
Assess fatigue
-Subjective experience -Patient feels tired and lacks endurance -Fatigue is a common symptom of various oxygenation problems, including anemia and heart failure. -Ask your patient to rate his or her fatigue on a 0 to 10 scale, as you do for pain.
Safety Considerations for Toddlers/Preschoolers
-Supervise child closely to prevent injury. -Select toys appropriate for developmental level. -Use appropriate safety equipment in the home. -Never leave child alone in bathtub. -Childproof home environment; prevent poisoning. -Be alert to manifestations of child maltreatment or abuse. -Use car seats properly. -Teach about fire safety/practice emergency evacuation measures.
Role of Skeletal System in Movement
-Supports soft tissues of the body -Protects delicate structures of the body -Furnishes surfaces for the attachment of muscles, tendons, and ligaments -Provides storage areas for minerals, salts, and fat -Produces blood cells (hematopiesis)
Safety Considerations for Adolescents
-Teach safe driving skills and avoiding distracted driving. -Teach avoidance of tobacco and alcohol. -Emphasize gun safety. -Follow healthy lifestyle. -Teach about sexuality, STIs, and birth control. -Get physical examination before participating in sports. -Teach risk of infection with body piercing and tattoos. -Teach about guns and violence. -Discuss dangers associated with the Internet.
Heart valve abnormalities
-They create turbulent flow, leading to a decrease in cardiac output and compromised tissue oxygenation. -Often there is an audible murmur. -Valves most commonly affected are the mitral and aortic valves.
Variables Leading to Back Injury in Health Care Workers
-Uncoordinated lifts -Manual lifting and transferring of patients without assistive devices -Lifting when fatigued or after recent back injury recovery -Repetitive movements such as lifting, transferring, and repositioning patients -Standing for long periods of time -Transferring patients -Repetitive tasks -Transferring/repositioning uncooperative or confused patients
Patient Guidelines for Stool Collection
-Void first so that urine is not in stool sample. -Defecate into the container rather than toilet bowl. -Do not place toilet tissue in the bedpan or specimen container. -Avoid contact with soaps, detergents, and disinfectants as these may affect test results. -Notify nurse when specimen is available.
Holistic Nursing: 3 Questions to Explore
-What do we know about the meaning of healing? -What do we do each day to facilitate healing? -How can we be an instrument in the healing process?
Chest pain may also be caused by musculoskeletal or respiratory conditions, for example, a fractured rib or pleuritis (inflammation in the pleural space).
-You can differentiate cardiac pain because it is usually in the center or on the left side of the chest and radiates to the left arm, at least in men. -The pain typically lasts several minutes; it may go away and come back.
Deep breathing exercise
-allowing the patient to benefit relaxation -relaxation promotes the parasympathetic activity by decreasing sympathetic activity and restoring the balance between the two
Naturopathy is a system of medicine in a way of life
-also promotes the patient to be responsible for their own health -promotes education to the patient -minimize harmful side effects -helps avoid the suppression of certain symptoms -assess for risk factors -helps remove the barriers to promote wellness
Older adult constipation
-medication side effects can also cause loss of appetite -fecal incontinence: where elderly patients revert to child like state, do not have control of the sphincter muscle
Complementary Health Approach (CHA)
-mind, body, and the spirit -balance of body systems (mental, social, spiritual) -helictical approach -healing is done by the patient -care is individualized
Ayurveda uses a combination of things
-nutrition -herbs -exercise -breathing techniques -meditation -purification
Practice of "like cures like"
-patient with hives and rash (poison ivy) tradional medicine would be epi pen, but homeopathy you treat with more exposure of posion ivy (with a causative agent)
Assessment for pine worms
-put patient in dark room -flashlight at the opening of the anus -pinworms are gravitated to the light -stick tape to the anus and pull the worm out
Stress can cause a child to regress
-sick will naturally cause the child to regress will cause the child not to defecate
Babies who are bottle fed
-stool is firmer -less frequent -1 to 2 stools a day
Babies who are breast fed
-stools between 2-10 times a day -more frequent because the breast milk is natural
Breathing exercises is beneficial to what type of patients
-surgical patients -chronic illness patients
cause of diarrhea
-viral or bacterial -certain medication -alteration in diet
Four Scientific Premises of Therapeutic Touch
1. A human being is an open energy system. 2. Anatomically, a human being is bilaterally symmetrical. 3. Illness is an imbalance in an individual's energy field. 4. Human beings have a natural ability to transform and transcend their conditions of living.
10 ways to protect the muscoloskeltal system (protect yourself from injury)
1.Correct alignment 2.Use the muscles in the arms and legs vs your back 3.Contract the muscles in your butt and abdomen to stabilize your pelvis and protect the abdominal viseral (smooth muscle that protects the organs, smooth muscles) 4.Hold the object close to your body 5.Face the direction of movement 6.Use your body weight to move the object 7.Slide, roll, push or pull instead of lifting if possible 8.Body weight should be balanced between the width of your legs (legs should be wide as shoulders) 9.Make sure you are bending at the knees 10.Lift small loads instead of large loads if possible
National center for complementary and alternative medicine: gives you 10 principles for complementary and alternative therapies -most reliable therapy that is beneficial
1.Whole ness orientation in heathcare delivery 2.Evidence of safety and effecitiency 3.Healing capacity of a person 4.Respect for individuality 5.Right to chose treatment 6.Emphasize on health promotion and self care 7.Partnerships 8.Education 9.Comprehensive and timely information 10.Envolvement
Qi flows vertically through body through _____ meridians
12
Scheduling Diagnostic Tests
1: fecal occult blood test- stool is red or black, might be a upper or lower GI bleed 2: barium studies (should precede UGI) 3: endoscopic examinations Noninvasive procedures take precedence over invasive procedures (want to do what we can on the outside of the body before we put any instrument inside of the body)
How should a patient with restraints be cared for
2 fingers should be able to fit under the restraint - must check on the patient frequently
In the event of cardiac arrest, you have only how many min before the brain is damaged by lack of oxygen.
4 to 6 min
Eight risk factors for fall risk
8 risk factors -is the patient confused or disoriented -do they have symptomatic depression (crying, physical evidence of depression) -do they have altered elimination (on diuretic, urinary incontinence or bowel) -dizziness or vertigo -is the patient male (more at risk) -have they been administered seizure medications -administered benzos? -do they have limited mobility
How much water does the large intestine absorb
800 to 1000 mL of liquid daily
What should you always have before applying a restraint to the patient
A ORDER
Factors that influence cardiac function -Nutrition (heart healthy diet)
A diet high in saturated fat predisposes to the development of atherosclerosis, coronary artery disease, and hypertension, all of which can compromise circulation and oxygenation. A low-fat, low-cholesterol, low-sodium diet is considered "heart healthy." Vitamins, minerals (especially iron), and protein are important to prevent anemia, which reduces blood oxygen-carrying capacity.
What are some examples of suffocation and choking being a risk factor of safety
AIR DOES NOT REAH THE LUNGS -sleeping with a child -SIDS -Aspiration -Children are at a high risk of drowning
Coordinates the top of the heart and controls the electrical activity
AV node
What are some functions of the colon
Absorbs water formation of feces expulsion of feces from the body
Hypersensitivity, or over-response, to an antigen
Allergy
Pivot joint
Allows for rotation around the length of a bone, and only allows for rotation.
is an abnormally low level of red blood cells, hemoglobin, or both.
Anemia
Nursing Measures for the Patient With Diarrhea
Answer call bells immediately. Remove the cause of diarrhea whenever possible (e.g., not needed medication). If there is impaction, obtain physician order for rectal examination. Give special care to the region around the anus. Drink plenty of fluids, electrolytes, avoid certain foods (spicy foods, raw veggies, raw fruits can cause GI upset)
Tell whether the following statement is true or false. Healing touch can be used to stimulate wound healing. A. True B. False
Answer: A. True Rationale: Healing touch can be used to stimulate wound healing.
Tell whether the following statement is true or false. The oblique position, a variation of the side-lying position, is recommended as an alternative to the side-lying position because it places significantly less pressure on the trochanter region. A. True B. False
Answer: A. True Rationale: The oblique position, a variation of the side-lying position, is recommended as an alternative to the side-lying position because it places significantly less pressure on the trochanter region.
Tell whether the following statement is true or false. When collecting stool using the technique "timed specimen," the nurse should consider the first stool passed by the patient as the start of the collection period. A. True B. False
Answer: A. True Rationale: When collecting stool using the technique "timed specimen," the nurse should consider the first stool passed by the patient as the start of the collection period.
Which of the following direct visualization tests uses a long, flexible, fiberoptic-lighted scope to visualize the rectum, colon, and distal small bowel? A. Esophagogastroduodenoscopy B. Colonoscopy C. Sigmoidoscopy D. UGI series
Answer: B. Colonoscopy Rationale: A colonoscopy visualizes the rectum, colon, and bowel using a lighted scope. An esophagogastroduodenoscopy examines the esophagus, stomach, and upper duodenum through an optic scope. A sigmoidoscopy examines the distal sigmoid colon, rectum, and anal canal through a flexible or rigid sigmoidoscope. UGI series involves fluoroscopic examination of the esophagus, stomach, and small intestine after ingestion of barium sulfate.
Tell whether the following statement is true or false. Allopathic medical care has been totally effective in dealing with chronic illnesses. A. True B. False
Answer: B. False Allopathic medical care has not been totally effective in dealing with chronic illnesses.
Tell whether the following statement is true or false. A nurse whose behavior is reasonable and prudent and similar to the behavior that would be expected of another nurse in similar circumstances is still likely to be found liable if a patient falls. A. True B. False
Answer: B. False Rationale: A nurse whose behavior is reasonable and prudent and similar to the behavior that would be expected of another nurse in similar circumstances is unlikely to be found liable if a patient falls, even if injury occurs.
Tell whether the following statement is true or false. A side rail is considered a restraint even if the patient asks for it to be raised to assist in getting into and out of bed. A. True B. False
Answer: B. False Rationale: A side rail is not considered a restraint if the patient requests that it be raised to aid in getting in or out of bed. Some patients may request that side rails be used at night while they sleep so that they may feel more secure. The patient must be able to raise and lower the side rail on one's own.
Tell whether the following statement is true or false. Among older adults, fires are the leading cause of injury fatality. A. True B. False
Answer: B. False Rationale: Among adults older, falls are the leading cause of injury fatality.
Tell whether the following statement is true or false: Jogging is an example of isometric exercise. A. True B. False
Answer: B. False Rationale: Jogging is an example of isotonic exercise.
Which food is a recommended for an older adult who is constipated? A. Cheese B. Fruit C. Cabbage D. Eggs
Answer: B. Fruit Rationale: Fruits and vegetables have a laxative effect on the system. Cheese and eggs have a constipating effect and cabbage, although a vegetable, produces gas in the system.
Which classification describes the bones located in the wrist? A. Long bones B. Short bones C. Flat bones D. Irregular bones
Answer: B. Short bones Rationale: Short bones located in the wrist and ankle contribute to movement. Long bones found in the upper and lower extremities contribute to height and length. Flat bones (ribs, skull) are thin and contribute to shape. Irregular bones are all the remaining bones not included in the previous classifications (e.g., jaw and spinal column).
A nurse stretches out a patient's leg and moves it in a circle. This is an example of what type of body movement? A. Abduction B. Flexion C. Circumduction D. Dorsiflexion
Answer: C. Circumduction Rationale: Circumduction occurs when the distal part of the limb is moved to trace a circle while the proximal end of the bone remains fixed. Abduction occurs with the lateral movement of a body part away from the midline of the body. Flexion is the state of being bent. Dorsiflexion is the backward bending of the hand or foot.
Which enema would be used for a patient with intestinal parasites? A. Oil-retention enema B. Carminative enema C. Nutritive enema D. Anthelmintic enema
Answer: D. Anthelmintic enema Rationale: Antihelmintic enemas destroy intestinal parasites. Oil-retention enemas lubricate the stool and intestinal mucosa, making defecation easier. Carminative enemas help expel flatus from the rectum. Nutritive enemas administer fluids and nutrition rectally.
Which action is a priority emphasized in the RACE acronym guide to fire safety? A. Run to the nearest fire alarm. B. Act in a calm manner to prevent panic. C. Confine the fire by opening doors and windows. D. Evacuate patients and other people to a safe area.
Answer: D. Evacuate patients and other people to a safe area Rationale: The RACE acronym includes the following priorities: Rescue anyone in immediate danger. Activate the fire code and notify appropriate person. Confine the fire by closing doors and windows. Evacuate patients and other people to a safe area.
Nursing history when looking at safety
Assess for history of falls or accidents -How did you fall, was it reported, were you injured? Note assistive devices -Walkers, canes, crutches, wheelchairs Be alert to history of drug or alcohol abuse Ovtain knowledge of family support systems and home enviornment -Imprortant: the fmaily is the primary care giver, there when the fall occured, may be able to give more factors that lead to the fall
Physical examination for safety
Assess mobility status. Assess ability to communicate. Assess level of awareness or orientation. -alert and oriented x3? Assess sensory perception -glassess, contacts, hearing aid? Identify potential safety hazards -clutter -assess the condition we are sending them home to -educate the family -home enviornment may need to be modified for the safety of the patient Recognize manifestations of domestiv violence or neglect
Developmetal consideration of an older adult
Assessing muscle mass, muscle tone, and muscle strength
Neonates are at a high risk of
At risk for -infection (immune system is not developed) -falls (rolling around, not secured they can fall) -SIDS (sudden infant death syndrome, sleeping with parents or sleeping with blankets and stuffed animals, family needs to be educated)
Postural reflex
Automatic movements that maintain body postion, and equilibrium either during periods of rest or periods of movement
Dorsiflexion
Backward flexion, as in bending backward either a hand or foot -pointing toes upward
Located in the walls of the heart and blood vessels; are sensitive to pressure changes
Baroreceptors
What allows us to change positions and maintain blood pressure
Baroreceptors
In-hospital arrest
Begin CPR immediately after activating the alert. Use an automatic external defibrillator (AED) or manual defibrillator as soon as one is available. -For a manual defibrillator, use a dose of 2 J/kg for the first shock and a dose of 4 J/kg for the second and subsequent shocks. Before beginning CPR, you are responsible for knowing whether your patient has an advance directive stating whether or not he would want CPR.
Chemicals Used for Mass Destruction #1
Biotoxins Blister agents/vesicants Blood agents Choking/lung/pulmonary agents Blood agents Incapacitating agents Long-acting anticoagulants
Chemoreceptors located in the aortic arch and the carotid arteries are sensitive to changes in
Blood pH Oxygen levels Carbon dioxide levels
How does a sedative medication affect the safety of a patient
Causes drowsiness, not alert, patient is at risk for falls
Developmental considerations for infants
Characteristics of stool and frequency depend on formula or breast feedings.
Constipating foods
Cheese Lean meat Eggs Pasta
Developmental Considerations for older adult
Constipation is often a chronic problem; diarrhea and fecal incontinence may result from physiologic or lifestyle changes.
In caring for a client with a blockage of the coronary arteries, the nurse would give priority to the nursing diagnosis of a.Risk for ineffective airway clearance b.Anxiety related to suctioning c.Social isolation related to altered body image d.Decreased cardiac output
Correct answer: D Decreased cardiac output is the appropriate diagnosis when the heart is unable to pump adequate amounts of blood to meet the metabolic demands of the body. Definitive interventions for this problem are collaborative.
How is posioning a risk factor for safety
Half of childhood deaths are due to ingesting toxins (cleaning products, medication)
If you walk in and your patient is on the floor, what should you document on the safety event report
DOCUMENT WHAT WAS WHITTNESSED AND WHAT YOU DID
Developmental considerations for Child, adolescent, adult:
Defecation patterns vary in quantity, frequency, and rhythmicity.
Factors Affecting Safety
Developmental considerations -enviornment is safe and ensured Lifestyle Mobility Sensory perception -visual, auditory, touch, smell test Knowledge -impaired cognitive abilities (dementia) Ability to communicate -recovering and sensing information Physical health state Psychosocial health state -stress and axiety
Comfort Measures for those with oostomys
Encourage recommended diet and exercise. Use medications only as needed. oDo not take fiber supplements oPreferable medications: liquid, chewable, injectable Apply ointments or astringent (witch hazel). Use suppositories that contain anesthetics.
What are some factors that influence cardiac function
Enviornment Stress -allergic reactions and air quality -heat and cold Medications
Oxygen transport abnormalities
Even if the heart is functioning well and arterial blood flow is intact, tissues can become hypoxic if the blood is unable to carry adequate amounts of oxygen.
Patient Teaching for Colostomies
Explain the reason for bowel diversion and the rationale for treatment. Demonstrate self-care behaviors that effectively manage the ostomy. Describe follow-up care and existing support resources. Report where supplies may be obtained in the community. Verbalize related fears and concerns. Demonstrate a positive body image.
Focus of Safety Assessments -The enviornnment
Hazardous Unfamilliar
The large intestine (colon)
Extends from the ileocecal valve (controls what goes into the large intestine, barrier so nothing can regurgitate can not go back into the small intestine) to the anus
Risk Factor Assessment
Falls (65 and older) Fires (smoking in bed, faulty wires, space heaters) Poisoning (overdose, medications) Suffocation & Choking (cosleeping, asphyxiation) Firearm injuries
The atrioventricular (AV) node is the pacemaker of the heart True or False
False Located in the right atrium, the sinoatrial (SA) node acts as the pacemaker. It initiates an impulse that triggers each heartbeat. The impulse travels rapidly down the atrial conduction system so that both atria contract as a unit.
Therory of five elements
Fire Earth Metal Water Wood
Foods with laxative effects
Fruits Vegtebles Bran Chocolate Alcohol Coffee
Patient Outcomes for Safety
Identify real and potential unsafe environmental situations. Implement safety measures in the environment. -gun safe, declutter, household supplies out of reach, no smoking in the home, electrical cords, checking outlets Use available resources for safety information. Incorporate accident prevention practices into ADLs. Remain free of injury.
Peripheral vascular abnormalities
Impair blood flow to and from organs and tissues
Benefits of Exercise to Respiratory System
Improved alveolar ventilation Decreased work of breathing Improved diaphragmatic excursion -Exercise improves the lung compacity -increases blood flow to the lungs -allows the lungs to deliever more oxygen into the blood
Benefits of Exercise to Musculoskeletal System
Increased muscle efficiency (strength) and flexibility Increased coordination Reduced bone loss Increased efficiency of nerve impulse transmission -Increases blood supply and makes muscles more flexible
Physiologic Hazards Associated With Restraints
Increased possibility of serious injury due to fall Skin breakdown Contractures Incontinence Depression Delirium Anxiety Aspiration and respiratory difficulties Death
Colostomy care: Stay away from gassy foods, no way to control passing gas (diarrhea) and can cause severe anxiety
Keep stoma clean and dry -adhesive may come off, the bag comes off -measure how wide the stoma is, so they can cut the size of the colostomy bag (prevents leakage)
Colostomy Care
Keep the patient as free of odors as possible; empty the appliance frequently. Inspect the patient's stoma regularly. Note the size, which should stabilize within 6 to 8 weeks. Keep the skin around the stoma site clean and dry. Measure the patient's fluid intake and output. Explain each aspect of care to the patient and self-care role. Encourage patient to care for and look at ostomy.
Factors that influence cardiac function for adults
Lifestyle, stress, hereditiy, diet, exercise, obesity
Auscultation of the abdomen
Listen for bowel sounds in all quadrants -note frequency and character, audible clicks, and flatus -describe bowel sounds as hypoactive, hyperactive, absent or infrequent
Factors That Contribute to Falls
Lower body weakness Poor vision Gait &/or balance issue Problems with feet/shoes -diabetic patients loose feeling in the feet, can contribute to falls Use of psychoactive medications -alters the cognitive function Postural dizziness -orthostatic hypotension Hazards in the hom
What are some other factors that influence cardiac function in older adults
Lower exercise tolerance Need for rest after exercise Are more prone to orthostatic hypotension (blood pressure becomes low from sitting to standing )
Physical Assessment for Mobility
MAKE SURE PATIENT IS COORDINATED AND BALANCED General ease of movement and gait Alignment -affected by pain or fatigue Joint structure and function -range of motion exercises Muscle mass, tone, and strength -assess tissues through inspection and palpation -supports movement Endurance -can our patient rotate their self in the bed, stand, or perform ADLs?
Manage anxiety Provide clear factual information and keep the patient and family informed about treatments being given.
Many patients are reassured by the presence of a family member.
Promote circulation (venous and arterial)
Measures that promote venous return increase the flow of blood back to the vena cava and the right side of the heart.
Most common procedure-related accidents/possible errors
Medication administration errors -1.3 billion people annually injured or have fatalieties due to this
concussion
Mild form of a traumatic brain injury -temporary -brain can shift or rotate during impact -no long term complications
Health Teaching in the Schools (primary role of the school nurse)
Monitor the child's use of the Internet. -Internet is influential, making sure we monitor age appropriate -Can promote positive teachings Get involved in school activities and ask pertinent questions. Volunteer for safety committees that include staff and parents. Ensure that the school's emergency preparedness plan is current.
Ambularm device
Type of restraint used in hospital -goes off when patient stands -see fall risk mats mostly
Preventing Food Poisoning #2
Use a food thermometer to ensure cooking food to safe internal temperature. Keep food hot after cooking; maintain safe temperature of 140°F or above. Give only pasteurized fruit juices to small children.
Proper Body Mechanics
Use of proper body movement in daily activities The prevention and correction of problems associated with posture The enhancement of coordination and endurance
Nasogastric tubes are used to allow
Used to allow the gastrointestinal tract to rest before or after abdominal surgery to promote healing Patients who have exploratory surgery or colostomies, placed for 2 or 3 days
Hendrich II Fall Risk Model
Used to assess patient who are at risk for falls -Fall Scene Investigations (FSI) -Hourly patient rounding -Root cause analysis (RCA) -Get Up and Go Test
Mechanical Aids for Walking
Walker Cane Braces Crutches
Attitude and values developmental considerations
active vs. inactive lifestyle
At what age should a child be able to control their bowel elimination
age 2 to 5
Holism and the enviornment
all living organisms, including humans, are continuosuly connecting and interacting with their environment
Maintenance of pusture
also skeletal muscle that contract and holds the body in a stationary position
If there is a non-mainstream practice that is used instead of conventional medical care, it is considered an _____________
alternative modality -it is rare that people use only alternative approaches
Manipulative and Body-Based Practices This group of therapies includes therapeutic massage
an assortment of techniques that involve manipulation of soft tissues of the body through pressure and movement, as well as a variety of techniques such as Rolfing, shiatsu, Feldenkrais, Alexander, myofascial release, and others.
when blood volume is low
the veins contract to provide a smaller space for smaller volume of blood
Capillaries
are microscopic vessels, created as arterioles branch into smaller and smaller vessels. -They are one cell thick. -They facilitate the exchange of gases, nutrients, and wastes between the tissue cells and the blood.
Signs of cardiac arrest
are pale, cool, grayish skin; absence of femoral or carotid pulses; apnea; and pupil dilation.
The aortic arch and carotid artery baroreceptors
are particularly important in the regulation of heart rate and vascular tone.
Arterioles
are smaller branches of arteries -They are primarily smooth muscle and are thinner than arteries. -Under control by the sympathetic nervous system, the arterioles constrict or dilate to vary the amount of blood flowing into capillaries and help maintain blood pressure.
Veins and venules
are thin, muscular, but inelastic walls that collapse easily.
Beta-adrenergic blocking agents (e.g., bisoprolol fumarate [Zebeta])
are used therapeutically to reduce the workload of the heart, to control abnormal heart rhythms (dysrhythmias), and to control hypertension. Drugs that block beta-1 receptors slow the heart rate and decrease the strength of myocardial contraction.
Cardiovascular depressants
are used therapeutically to slow the heart rate or reduce the force of myocardial contraction.
When does sphincter control happen in a toddler
around the age of 2
Developmental consideration of an adult
assessing activity balance with lifestyle balance
Mental health considerations
assessing for depression
gait belts
assists with ambulation
Worlds oldest medical system
ayurveda
stool culture is indicated when
bacteria, virus, or fungi is present
Qi gong has been suggested to hold potential as an intervention to improve........
balance and reduce falls in older adults and has been used successfully to promote balance and coordination in other age groups
What is sensitive to pressure changes
baroreceptors
When should a culture be taken
before any medication is administered
Flexion
bending a joint -bending over and touching toes
Plantar flexion
bending of the sole of the foot by curling the toes toward the ground -pointing toes downward
sound healing
beneficial to mental health or hospice
Allopathic medicine spearheaded remarkable advances in
biotechnology, surgical interventions, pharmaceutical approaches, and diagnostic tools
Iron salts stool
black stool
Calcium channel blocking agents (e.g., nifedipine [Procardia])
block the flow of calcium into cells of the heart and blood vessels. They decrease blood pressure and the strength of myocardial contraction, slow the heart rate, and dilate the arteries and arterioles.
Aculte blood cultrures
blood in the stool
Foot drop
board at the end of the bed, prevents the feet from dropping in the downward position
Skeletal syste is crucial for what
brain heart lungs spinal cord
Skeletal muscles are attached to the bones by what
by the tendons
How can stress influence bowel elimination
can cause diarrhea or constipation
The complete heart beat
cardiac cycle
Cardiovascular depressants may reduce _________ and impair tissue oxygenation.
cardiac output
Sustained stimulation of the sympathetic nervous system which can lead to
cardiovascular disease
Gliding joint
carpals bones of the wrist, tarsal bones of the feet
Bismuth subsalicylate used to treat diarrhea can turn stool what color
cause black stools
Naturopathy focus in on the cause of what
cause of the disease apposed to treating the disease
Transfer chairs
chairs that can be converted into a stretcher
What type of medicine is accupunture
chinese medicine
Circumduction
circular movement of a limb at the far end -combination of abduction and adduction
Sigmoid
closer too the rectum, stool is firmer compared to stool beginning to form in the ascending colon
Adolescents are developmentally are risk for heart or circulatory disorders, although some athletes can be at risk for
collapse and sudden cardiac dysrhythmia
Time specimen
collecting the entire first stool, or a sample of the very first stool that is passed
Integrative health care
combination of allopathic and complementary and alternative modalities -traditional and nontraditional
ANS -heart
regulate heart rate and contractility
Holism is the theory and philosophy that focuses on what
focuses on connections and interactions between parts of the whole
Iyengar
focuses on proper alignment and holding poses for a relatively longer time -uses anatomical detail
Kripaula or "gentle yoga"
focuses on relaxation and coming into balance -do at your own pace, most ideal for beginers
Asthanga
focuses on synchronizing breath with a fast paced series of postures -produces internal heat to purify the body
Allopathic medicine is dominant for about 100 years
foundation to many
How does cystic fibrosis stool appear
frequently bulky with a greasy texture with a foul odor
Carminative enema
given to relieve gas
Chinese medicine
goal is to identify the disharmony of the person, that is the part of you
What type of patients is bowel training programs good for
good for chronic constipation, fecal impaction, or fecal incontinence
Antibiotics turn stool what color
green-gray color
Factors that influence cardiac function Preschool/school-age
growth diet obesity
Therapeutic touc
hands on, patient feels centered, balanced and restored
Diarhea
have frequent stools, typically watery 3 or more in a day
Arteries
have thick, elastic walls that allow them to stretch during cardiac contraction (systole) and to recoil when the heart relaxes (diastole).
Energy healing includes
healing with touch, also sound healing
Brain stem center
regulates cardiac function and blood pressure
What type of touch benefits patients
physical touch
Aspirin, anticoagulants stool
pink to red to black stool
Stoma-
portion of the colon is pulled outside of the ostomy and is turns inside out, the part turned inside out is the stoma
What is the goal of ayurveda
prevent illness and promote wellness
Skeletal muscle does what for the body parts
produces all movement of body parts in relation to each other
Medicated enemas
provide medications absorbed through the rectal mucosa
Skeletal system provides what type of storage
provides storage for certain minerals like calcium and fat
Acupuncture either increases or decreases the flow of ______ along the meridian, restoring the balance of yin and yang
qi
integrative health (IH)
refers to the combination of complementary health and conventional health approaches in a coordinated way.
Irregular bones
spinal column and jaw
Healing touch
stimulated wound healing
fecal impactions
stool becomes a blockage inside the colon, CAN NOT PASS, abdominal muscles can become weak, cause severe dehydration, result of unrelieved constipation, must physically removed (have to be careful with the vagus nerve, can cause a vagal response causing the patient to faint)
If someone has an intestinal tumor, how may their stool appear?
stool can be narrow or ribbon like
The skeletal muscle is made up of ______ muscle tissue
striated
Factors that influence cardiac function Adolescents
substance use/abuse, diet and obesity
Factors that influence cardiac function for adolescents
substance use/abuse, diet and obesity
Children as young as school age sometimes begins social habits
such as tobacco use, that can have long term adverse effects on the cardiovascular system
Special movements
supination, pronation, dorsiflexion, plantar flexion, inversion, eversion, protraction, retraction, elevation, depression, opposition
Cardiac monitoring
supraventricular, junctional, ventricular rhythms
Ostomy-
surgical opening form the inside to the outside of the organ
Veins and venules walls contract or relax in response to feedback from the _________ nervous system
sympathetic
Autonomic nervous system
sympathetic and parasympathetic fibers
hypotonic solution for enema
tap water
Elder abuse
the abuse or neglect of older family members -financial abuse ( takes in patient, keeps financial from the elder, abuse and neglects the elder)
Ayurveda promotes what
the body mind and spirit
The P wave represents
the firing of the SA node and conduction of the impulse through the atria. In the healthy heart, this leads to atrial contraction.
What is the primary organ of bowel elimination (the lower part)
the large intestine (colon)
Cardiac muscle is refered to as
the myocardium
Peristalsis is under control of the what
the nervous system
"Like cures like"
the notion that a disease can be cured by a substance that produces similar symptoms in healthy people
"Law of minimum dose"
the notion that the lower the dose of the medication, the greater its effectiveness; many homeopathic remedies are so diluted that no molecules of the original substance remain
The T wave represents
the return of the ventricles to an electrical resting state so they can be stimulated again (ventricular repolarization). The atria also repolarize, but they do so during the time of ventricular depolarization; thus, they are obscured by the QRS complex and cannot be seen on the ECG complex.
What is sensitive to blood pH, oxygen levels, and CO2
vascular system
Cardiovascular medications includes
vasodilators, beta-adrenergic blocking agents, diuretics, and positive inotropes.
When blood volume is high
veins relax and enlarge to accomodate increased volume of blood
The QRS complex represents
ventricular depolarization and leads to ventricular contraction
Abdominal ultrasound-
view solid upper abdominal organs (liver, bile ducts, appendix, pancrease, spleen)
Colonoscopy
visual examination of the colon
Skeletal muscleshas what type of control
voluntary control
Shamanism treatment
vretrieving lost soul energy, restoring the individual to right relationship with the spirit world, and treating symptoms.
External factor development considerations
weather (Arthritis)
About half of the adults who use tobacco
were regular smokers by their 18th birthday
Allopathic medicine is effective when treating what
when treating an acute illness or emergency -less effective with chronic illness
Stress -Suppression of the immune and inflammatory responses
which decreases resistance to infection
A chronically suppressed immune and inflammatory response
which increases the risk for all infections
Stress -Release of cortisol from the adrenal cortex,
which results in altered glucose, fat, and protein metabolism
Antacids turn stool what color
white discoloration or speckling in stool
Short bones
wrist and ankle
Condyloid joint
wrist and joints connecting fingers to the palms
Holistic nursing
you are healing the person as a whole
Systemic and pulmonary blood vessels
•Arteries •Arterioles •Capillaries •Veins and venules
Cardiovascular Nursing Diagnosis
•Decreased cardiac output •Ineffective tissue perfusion •Risk for shock
Cardiopulmonary Resuscitation
•In-hospital arrest •Hands-Only™ CPR
Cardiovascular Nursing Planning and Interventions
•Manage anxiety •Promote circulation (venous and arterial) •Prevent clot formation •Administer medication •Perform CPR
Cardiac cycle
•simultaneous contraction of the two atria, followed a fraction of a second later by the simultaneous contraction of the ventricles
