NUR 110 > Test 1 > Flashcards

Test 1 Flashcards

(79 cards)

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1
Q

Visceral

A

Internal organs

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2
Q

Kinesthetic/proprioception

A

Awareness of body parts and movement

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3
Q

Gustatory

A

Taste

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4
Q

Proprioception

A

Maintains balance;impacts mobility
Dependent on structures of inner ear and central nervous system
Common decline after 60- increased difficulty of balance, spatial orientation and coordination
Decline in proprioception increase risk for falls

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5
Q

Reticular activating system

A

In the brain stem maintaining sensoristasis
Monitors and regulates incoming sensory stimuli

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6
Q

Adaptation

A

Sensory getting “blind” to a reoccurring stimuli

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7
Q
A
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8
Q

Reticular activating system

A

Maintains sensoristasis
Monitors and regulates incoming sensory stimuli with adaptation and memory

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9
Q

Aphasia

A

Language ability disorder

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10
Q

Expressive

A

Broca
Understands written and spoken words but cannot write or speak to communicate effectively
Trouble to find words or speak in short phrases
Aware of speech difficulty

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11
Q

Receptive/comprehensive aphasia

A

Wernicke’s
Cannot understand written or spoken words
Use long sentences with no meaning (word salad)
Unaware of others not comprehending

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12
Q

Global aphasia

A

Person understands little or no spoken language and cannot produce recognizable words

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13
Q

Sensory deprivation

A

Decrease in sensory input
(Risk for in plain rooms)

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14
Q

Sensory overload

A

Too much sensory stimuli where the brain cannot respond

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15
Q

Sensory deficits

A

Impairment or total loss of sensory input
Can lead to sensory deprivation

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16
Q

Sensory processing disorder

A

When can appropriately detect stimuli but brain cannot appropriately respond

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17
Q

Physical behaviors of sensory deprivation or overload

A

Drowsiness
Excessive yawning

Escape behaviors- eating, exercising, sleeping, running away

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18
Q

Perception changes with sensory overload or deprivation

A

Unusual body sensations
Preoccupation with somatic complaints
Change in body image
Illusions and hallucinations

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19
Q

Cognitive behavior changes with impact of sensory overload or deprivation

A

Decreased attention span
Inability to concentrate
Decreased problem solving and task performance

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20
Q

Emotional behavior changes due to sensory deprivation or overload

A

Crying
Increased irritability
Confusion
Panic
Depression

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21
Q

Myopia

A

Nearsightedness
Can’t see things far away

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22
Q

Hyperopia

A

Inability to see objects close

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23
Q

Astigmatism

A

Objects near and far are distorted

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24
Q

Presbyopia

A

Age related far sightedness

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25
Cataracts
Closing of the lenses
26
Diabetes retinopathy
Damage to the blood vessels of the retina causing blood to leak into the area. Pt will notice floaters
27
Glaucoma
Increase in pressure — compresses optic nerve. First sign is loss of peripheral vision
28
Macular degeneration
Irreversibly diminishing of macular — loss of central vision. Can’t recognize people bc faces are blacked out
29
Diagnostic vision test
Snellen or tumbling e
30
Tinnitus
Hearing ringing but no external sound. Can be age related, injury, wax buildup, high pressure
31
Sensorineural hearing loss
Hearing loss occurs in inner ear or vestibulovocular nerve In newborns with chromosomal abnormalities. Induced by loud noises, trauma
32
Presbycusis
Age related hearing loss. Bilaterally. Half of adults over 75
33
Conductive hearing loss
Inability of sound to travel from outer ear to middle or inner Perforated eardrum, foreign body, trauma, inflammation Otitis media — fluid or inflammation in middle hear Otosclerosis — abnormal growth of bone that causes blockage
34
Diagnostic hearing test
Rinne — tuning fork placed on mastoid bone Audiometry — client wears headphones with sounds at different decibels Bone oscillator — oscillator against bone to monitor auditory nerve
35
Tactile hypersensitivity
Individuals are overly sensitive to touch
36
Tactile defensiveness
Physical pain with touch
37
Tactile hyposensitivity
Not feeling. Can lead to I jury
38
Peripheral neuropathy
CNs nerve damaged and experience number in limbs
39
Idiopathic neuropathy
Damage due to unknown kind
40
Diabetic neuropathy
Damage to nerve causes by high glucose levels
41
Diagnostic tactile alterations
Tactile stimulation testing - different materials and texture exposure Electromyograohy - needles in muscle MRI/CT - evaluate spinal abormalities or compression
42
Phantom taste perception
Persistent foul taste in mouth
43
Hypogeusia
Decreased ability to taste
44
Ageusia
No ability to taste
45
Dysgeusia
Foul taste
46
Anosmia
No ability to smell
47
Hyposmia
Reduced ability to smell
48
Parosmia
Alteration in odor perception. Previously able to smell
49
Phantosmia
Smelling odor that isn’t there
50
Diagnostic smell and taste
Smell or taste test Ent consult - examine structures Xray/mri Nasal endoscopy
51
Safety interventions
Call light accessible Orientation to room Path clear Personal items within reach Bed in low position Devices easy to maneuver Educate in fall risk Hourly rounding
52
Communicating with hearing loss
Sit and face Minimize background noise Avoid covering mouth Encourage hearing devices Speak slowly and clearly Loading vocal pitch before increasing volume Brief sentences with simple words Write down what clients don’t understand Asl interpreter
53
Communication for vision loss
Call patient by name Identify self Stay within visual field Give info about location of things Explain interventions before touch Inform patient of departure Describe arrangement of food Large print
54
Communication with confused
Maintain eye contact Speak calmly simple and directly and allow for time to think and respond Orient to environment and fill space with personal objects Use watches clocks and calendars Emphasize pt strengths Adequate sleep and pain management
55
Communication with unconscious
Assume they can hear you Be respectful Speak to patient befor touching Keep environmental noises at low level Teach SOs to do the same
56
Teaching for hearing
Avoid loud noises concentrated in canal Use earplugs Regular ENT or audiologist exams Do not insert objects Have ear pain evaluated Signs and symptoms of hearing loss
57
Teaching vision
Protect from UV Adequate light Large print Annual eye exam and prescription lens No tubing Chems in well ventilated area meter protection No nonprescription eye drops
58
Teaching taste
Practice oral care twice a day Regular dentist Avoid smoking or tobacco Notice dentist abt pain and sensitivity to hot or cold Enhance taste with use of spices
59
Teaching smell
Protect nose from noxious fumes Have nasal congestion or diminished smell evaluated No heavy colognes Install smoke and co2 detectors
60
Teaching touch
Injury prevention Protect skin from extreme temps Instruct all aspects of invasive procedures
61
Teaching sensory overload
Reduce the number and type of stimuli Provide periods of rest Provide explanation of sounds Relaxing techniques
62
Teaching sensory deprivation
Orient Audiovisual activities Encourage visitors, phone call, email Therapeutic touch Encourage use of assistive devices Provide radio or tv
63
Normal respiratory rate
12-20
64
Normal o2 sat
95-100
65
Normal body temp
96.8 to 100.4
66
Normal pulse
60-100
67
Normal blood pressure
90-120/60-79
68
Joint contracture
Consolidation and immobilization of joint. Result from atrophy of muscles.
69
Bone demineralization
Disuse osteoporosis
70
Cardiovascular immobility
Increased cardiac workload
71
Venous stasis
Blood is puddling in the veins and results in venous thrombosis (blood clot)
72
Orthostatic hypotension
Drop in blood pressure when moving positions from immobility in bed. Sit up and dangle!
73
Issues with respiratory with immobilization
Decreased ventilation causing increased secretions and risk for pneumonia
74
Atelectis
I complete expansion or collapse of alveoli resulting in poor gas exchange
75
Gastro and urinsry issues with immobilization
Changes in appetite, decreased protein absorption Decreased motility = constipation Urinary stasis > retention > uti Gastroesophegeal reflux from laying flat Renal calculi (kidney stones)
76
Integumentary immobility issues
Risk for skin breakdown (pressure wounds)
77
Psychosocial immobility issues
Feeling of worthlessness and diminished self esteem Changes in self concept and body image Apathy Isolated from social support Coping difficulties Depression and anxiety
78
Safety interventions of immobility
Call light accessible Oreient Clear path Personal items within reach Bed low Accessories easy to maneuver Educate on fall risk Hourly rounding
79
Teaching and interventions for prolonged bed rest P
Proper body mechanics Maximize tolerated activity Consult pt ot Control pain Use assistive decided and extra personnel as needed Teach ROM Sequential compression devices or TED hose Turn cough and deep breathe; incentive spirometer Hydration stool softeners and high fiber diet Frequent toileting Encourage pt family involvement
NUR 110
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