1
Q
What is the main contributor to inactivity?
A
Screen time
2
Q
What is the guideline for physical activity?
A
60 minutes a day
3
Q
What has happened over the years to the range that we allow our children to wander?
A
It has decreased due to:
- environment
- we’ve learned from our mistakes
- Being supervised all the time is not good
4
Q
What do we as nurses do to promote health? (3)
A
- promote healthy eating and physical activity from a young age
- reducing amount of time on electronics
- avoid the “sit disease”
5
Q
What is Bedrest?
A
- Prescription to stay in bed (ex. after surgery)
- It was invented as a form of treatment in the 19th century
6
Q
What is Bedridden? (3)
A
- Formulation that happens due to external factors (culture, values, etc)
- holds a negative connotation, described as the final state that leads to gradual social death
- Involves loss of hope, dulling of senses, slump in cognition
7
Q
What are some barriers to mobility? (4)
A
- cultural values
- belief that bedrest is restful and healing
- implicit biases about the elderly
- not enough knowledge or skills when it comes to ambulating/transferring clients
8
Q
What are different phases of the Phase Model of Being Bedridden?
A
- Instability
- Incident
- Immobility in the Room
- Local Confinement
- Being Bedridden
9
Q
What is Phase 1: Instability? (5)
A
- client has problems walking
- shaky, dizzy
- walking with furniture, unsteady, feeling like you might fall
- use of aids, walker, etc
- not super confident in walking
10
Q
What is Phase 2: Incident?
A
- Incident occurs
- Leads to hospitalization
- ex. pneumonia or falls
11
Q
What is Phase 3: Immobility in the Room? (4)
A
- Increasingly restricted in mobility
- client is instructed to get a hospital bed in their home
- comfortable chair can facilitate mobilization
- positive attitude helps with mobilization
12
Q
What is Phase 4: Local Confinement? (4)
A
- Client feels tied down
- increasingly dependent upon others
- socialization decreases
- mental health disorders
13
Q
What is Phase 5: Being Bedridden? (3)
A
- client is in bed 24 hrs a day
- bed becomes workspace (bathroom and dining room)
- resist talking over client
14
Q
What are some ways to predict if our client is at risk of a fall?
A
- checking their hearing
- Chair test
- looking at clients feet
15
Q
What is the room that is most risky for falls?
A
Bathroom
16
Q
What are some things that make the Elderly more susceptible to falls? (6)
A
- Age
- Medications
- Osteoporosis
- Dementia
- Hearing
- Sight
17
Q
What are some Environmental risks that may cause a fall?
A
- shoes
- handrail
- stairs
- aids
18
Q
What are some medications that might cause a fall?
A
- sleeping pills
- BP pills that make you drowsy
19
Q
What is the Morse Fall Scale?
A
A resource used to determine what risk is a person at for falling
20
Q
What is the Morse Fall Scale made of?
A
- history of falls in the last 3 months
- secondary diagnoses
- aid, furniture walking, etc
- IV lock
- Gait
- Mental status, cognitively aware
21
Q
What is important to remember about cardiac workload?
A
keep client in upright position as heart works less effectively when in supine
22
Q
Why should we avoid the valsalva maneuver?
A
- it increases intrathoracic pressure
- slows blood return, and with release of breath, surge of blood is delivered to the heart
23
Q
What is Orthostatic Hypotension?
A
- blood vessels get lazy
- when bringing someone who has been laying down to an upright position, this can happen, leading to dizziness and potential falls
24
Q
What can happen when someone is immobilized for a long time?
A
Blood clots can form
25
What are preventions and interventions that can be done to avoid blood clots from forming?
- mobilization/ROM
- compression stockings
- anticoagulant meds
26
What is High Fowlers?
a upright sitting position best for breathing
27
What is Atelectasis?
Collapsing of the aveoli
28
What are some preventions and interventions to help with dyspnea?
- deep breathing + coughing exercises
- supplemental O2
29
What are other Hazards of immobility?
- skin care
- decreased ROM
- decreased peristalsis
30
What are Restraints?
physical, environmental, or chemical measures used to control the physical or behavioural activity of a person or a portion of their body
31
What are the types of Restaints?
- Physical
- Environmental
- Chemical
32
What are Adventitious chest sounds?
- Crackles = velcro
- Wheezes = more musical
33
What can a cough mean?
Infection, cold, etc.
34
What do you assess when looking at/listening to a cough?
- wet; productive
- dry; non-productive
35
What can lead to a 'weak' or ineffective cough?
- Surgery
- Medications
- decreased LOC
36
What do we want to look at when it comes to the frequency of a cough?
- if it is a lot, it might be a cold or something else
- if it is only once, it might be a tickle
37
Explain the difference between High Flow and Low Flow oxygen delivery:
High flow = Venti mask
- we know the % of oxygen the client is breathing
Low flow = Nasal prongs
- we do not know the % of oxygen the client is getting
38
What is the normal pH levels?
7.35-7.45
39
How do we test the acid base balance?
- arterial blood gas
- capillary blood gas
40
How does the body maintain the balance between acids and bases?
By maintaining the ratio of HCO3 and H2CO3 via buffer systems
41
What is the major buffer system in the body?
Bicarbonate (HCO3) + Carbonic Acid (H2CO3)
42
What do the Kidneys do in relation to buffer systems?
- Regulates bicarbonate level in ECF (retains or excretes) also hydrogen
- happens over days, very slowly
43
What do the lungs do in relation to buffer systems?
Control levels of CO2 and carbonic acid via ventilation
44
What are the pH levels for Respiratory Acidosis?
pH < 7.35
45
What are the pH levels for Respiratory Alkalosis?
pH > 7.45
46
What are the pH levels for Metabolic Acidosis?
pH < 7.35
47
What are the pH levels for Metabolic Alkalosis?
pH > 7.45
48
What is Respiratory Acidosis?
When respiratory effort is suppressed causing CO2 to build up in the lungs
49
What is Respiratory Alkalosis?
When too much CO2 is expelled out of the lungs, ex. during anxiety and hyperventilation
50
What is Metabolic Acidosis?
When your body does not have enough of something it needs, and starts using something else in substitute.
ex. diabetes, not enough insulin, so body turns to ketones, causing it to go into ketoacidosis
51
What is Metabolic Alkalosis?
Removing too much acid from the body
Ex. ng tube suctioning removing the acid fluid in the stomache
52
What is Ventilation?
Act of inhaling O2 and exhaling CO2
53
What is Perfusion?
Pump oxygen in the blood to the rest of the tissues
54
What is Diffusion?
Movement of molecules, CO2 out O2 in, Gas exchange
55
What is Inspiration?
An active process stimulated by chemical receptors
56
What is Expiration?
A passive process that depends on the elastic recoil of the lungs
57
What is Cilia?
Sweeping your lungs, keeping them clean
58
What makes up oxygen transport?
Consists of lungs and cardiovascular system
59
What transports 99% of O2 in the blood?
Hemoglobin
60
What is Hypoxia?
Inadequate tissue oxygenation at the cellular level
61
What are the interventions for Hypoxia?
- sit them up
- deep breathing and coughing exercises
- Supplemental O2
62
What does SpO2 read?
saturation of oxyhemoglobin
63
What does FiO2 read?
Fraction of inspired O2 concentration
64
What are the Signs and Symptoms of Hypoxia? (7)
- Cyanosis (late)
- Anxiety (early)
- restless
- disorientation
- LOC = decline, altered level
- Dyspnea
- RR + P = could be elevated
65
What acute conditions are considered barriers or facilitators of O2?
- Pneumonia
- COPD
- Asthma
- Cancer
66
What chronic conditions are considered barriers or facilitators of O2?
- COPD
- Asthma
- Cystic Fibrosis
66
What chronic conditions are considered barriers or facilitators of O2?
- COPD
- Asthma
- Cystic Fibrosis
67
What are some occupational barriers/facilitators to O2?
- Mining jobs
- Asbestos
- Radon (home)
68
What are some health promotions for O2? (4)
- not smoking
- infection preventions
- vaccinations
- exercise
69
What is 3rd hand smoke?
When smoke gets into animate objects
70
What are the manifestations of impaired oxygenation? (10)
- chills + fever
- diaphoresis
- feeling unwell
- pleuritic chest pain
- tachypnea
- Dyspnea
- Orthopnea
- fatigue/tires easily
- poor appetite
- cough = productive or non-productive
71
What is COPD?
A chronic, progressive respiratory illness in which air flow to the lungs is limited
72
What are the principal symptoms of COPD?
Dyspnea and fatigue
73
What is the # 1 cause of COPD?
smoking
74
What are the different way to diagnosis a respiratory illness?
- chest x-ray
- airflow testing
- arterial blood gas
75
What is Pneumonia?
inflammation of the lung parenchyma (tissues of your lungs) from microorganisms
76
What are the preventions of pneumonia?
vaccinations and not smoking
77
What are the treatments of Pneumonia?
Antibiotics and steriods
78
What are the medications to help treat Pneumonia?
Corticosteriods and Abx
79
What are the types of Pneumonia? (5)
- Community acquired CAP
- Hospital acquired HAP
- Ventilator associated VAP
- Healthcare associated HCAP
- Aspiration AP
80
What are the responses/interventions for Pneumonia? (9)
- hydrate + humidification
- deep breathing and coughing
- chest physiotherapy - cupped hands
- Rest
- Nutrition
- Oxygen (PRN)
- Smoking (Stop)
- Suctioning
- meds
81
How would one diagnosis Pneumonia?
Blood tests
- CBC = White blood cells, and hemoglobin
- Blood culture and sensitivity
Sputum
- Culture and sensitivity
82
What are the challenges to Inhalers? (7)
- lack of effective communication
- stigmatization
- misperceptions
- side effects
- forgetfulness
- difficulties with device, multiple inhalers
- health literacy
Nursing 2230
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