Chapter 20 - Learning Objectives + Vocal

Question 1

Describe at least 3 symptoms of CHF, COPD, and CVA

Answer 1

CHF - congestive heart failure

1. Edmea - builds accumulate in body (especially feet/ankles)
2. Dyspnea - difficulty breathing due to fluid build up in lungs causing pulmonary or respiratory congestion
3. Fainting, dizziness, confusion - circulation to brain is decreased

COPD - chronic obstructive pulmonary disease (people with bronchitis and/or emphysema - a lung disease)

1. Chronic cough, coughing up mucus/pus/ sometimes blood.
2. SOB upon exertion or even at rest
3. anxiety due to difficulty breathing

CVA - cerebrovascular accident aka stroke aka brain attack. Accident due to blood vessel of the brain.

1. left or right hemiplegia
2. aphasia
3. spatial-perceptual deficits
4. dysphagia (difficulty swallowing making susceptible to deadly aspiration)

Question 2

List at least 3 symptoms of TIA

Answer 2

TIA (transient ischemic attack) - temporary interruption of blood to brain, warning sign of stroke.

One or more may last only a few minutes:

1. Sudden weakness in an arm, hand, or leg
2. Severe headache
3. Difficulty understanding what is said
4. Difficulty speaking
5. Lack of sensation in one side of body
6. Inability to see out of one eye

Question 3

Explain what the possible disabilities may be when a client has right hemiplegia and left hemiplegia due to a CVA

Answer 3

Right hemiplegia: aphasia, speech/language deficits

Left hemiplegia: spatial- perceptual deficits

Question 4

Dysphagia

Answer 4

difficulty swallowing

Question 5

Explain what the NA can do to help take care of client with CHF, diabetes, and COPD.

Answer 5

CHF:

1. Pace activity for rest breaks
2. semi-Fowler’s or Fowler’s for easier breathing
3. compression hose if prescribed
4. follow ordered dietary restrictions (probably low sodium)
5. keep extremities warm

Diabetes:

1. Do not trim toenails
2. Check skin on lower extremities regularly, report all changes
3. Keep feet warm and covered
4. Encourage movement and sticking to ordered diet
5. Notify nurse if complains of blurry vision or any sight issues
6. Observe for signs of hypoglycemia or hyperlycemia

COPD:

1. Pace activities
2. Fowler’s position
3. Watch for signs and symptoms of a respiratory infection such as elevated temperature, listlessness or nosy and congested sounding respirations.
4. Position helpful is sitting up and leaning forward. You may put pillow on bed table in front of them.

Question 6

List at least 3 compilations that can occur due to diabetes

Answer 6

1. blindness - diabetic eye disease or retina apathy is number one cause of blindness in people under 75
2. amputations - 40% of amputations occur to the diabetic bc of diabetic neuropathy (nerve damage in the feet) and poor circulation to the feet and legs
3. heart and blood vessel disease - ppl with diabetes are 2-4 times more likely to develop heart disease and 5 times more likely to have CVA (stroke)
4. kidney disease - 32% of kidney failure cases are due to diabetes

Question 7

List at least 3 warning signs of diabetes

Answer 7

excessive thirst
extreme hunger
frequent urination
weakness, fatigue, irritability
blurred vison or vison change
slow healing of cuts (especially on feet)
tingling or numbness in legs, feet, forgers
frequent infections

Question 8

Explain what osteoporosis is and how it contributes to falls

Answer 8

Osteoporosis is loss of calcium from the bones with reduced amounts of normal bone tissue. This makes bones brittle and very susceptible to fractures. The bones look like a honey comb or sponge and actually weigh less than a normal bone. Severe cases could get fracture even without injury just by rolling over or walking.

Question 9

Describe what a nursing assistant should do if a client has a siezure

Answer 9

• moving person to safe lying position
• moving something soft, like a pillow under the head
• moving anything hard or sharp away from the client such as furniture, equipment etc.
• NOT restraining or inhibiting client’s moment
• turning head to side to allow for drainage of vomitus or saliva
• NEVER putting anything into the mouth of client
• while seizure is happening stay with client and signal charge nurse. Report observations to nurse.
• after contraction state is over, tilt the person’s head back to insure an open airway

Question 10

Explain what rehabilitation services can be helpful to the client who has had a CVA

Answer 10

PT
OT
Speech Therapy

Must start immediately after CVA since most improvement is likely to occur in the first six months

Question 11

List 4 possible signs that a person may be contemplating suicide

Answer 11

• giving away possessions
• talking about being a burden, having nothing to live for or killing themselves
• Isolating
• Calling people to say farewell
• Increased substance abuse