Exam 3 Intro

RBC
hemoglobin

turn them
encourage them to cough
incentive spirometer

wash your hands with soap and water

you should check on their respiratory status
C4 allows you to breath without thinking so injury calls for you to need to check respiratory status

antibiotics kill bacteria

have the patient clear throat/cough and relisten

having social determinants - what determines that they have disparities

culture
someone from different culture may look down and not make eye contact with you -> you may think they aren't listening

before you leave the patients room

rapid heart rate, going up and down
heart is quivering
beating so quickly doesn't have time to get oxygen
beating so fast it doesn't fill fully

their chest wall and respiratory muscles don't work as well as they increase in age
become more pliable

Atelectasis is collapse of alveoli and is prevented by moving around

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantages
consequence of social determinants of health
homeless pt, black women higher risk for complications w pregnancy

the conditions in which people are born, grow, live, work, and age
predict health disparities
income, neighborhood

gay, lesbian, bisexual, or transgender; people of color; people who are physically and/ or mentally challenged; and people who are not college educated

being present with the patient and not being disracted by your own thoughts

listen to all 5 lobes
whole front and back

hypercalcemia -> kidney stones

patient performs movement by themself

nurse performs movement for the patient

11,000
anything above 11,000 is high

blue mouth
eyes

1-6 L/min
24-44%

8 L/min
30-50%

6-12 L/min
35-50%

10-15 L/min
60-90%
make sure has a tight fit

24-50%

up to 6- L/min

21-100%

infectious agent (bacteria, viruses, fungi, protozoa) ->
reservoir (place where microorganisms survive, multiply, and await transfer to a susceptible host) ->
portal of exit (how they enter another host and cause disease) ->
modes of transmission (route of how disease is aquired such as coughing or sneezing) ->
portal of entry (organisms enter the body such as breathing it in) ->
susceptible host (depends on an individual's degree of resistance to pathogens

control or elimination of infectious agents by cleaning and disinfection and sterilization
hand hygiene, PPE, and routine environmental cleaning

patient preparation for a sterile fprocedure (foley or wound care)
clean gloves for removal
sterile gloves for packing wound

designed to be used for the care of all patients in all settings regardless of risk or presumed infection status

use for direct and indirect contact with patients and their environment
direct contact refers to the care and handling of contaminated body fluids
contact precautions require a gown and gloves
examples: blood or other body fluids from an infected patient that enter health care worker's body through direct contact with compromised skin or mucous membrane

focus on diseases that are transmitted by large droplets (greater then 5 microns) expelled into the air and by being within 3 feet of a patient
require the wearing of a surgical mask when within 3 feet of the patient, proper hand hygiene, and some dedicated-care equipment
influenza, MRSA, pneumonia

focus on diseases that are transmitted by smaller droplets, which remain in the air for longer periods of time
required to be in specially equipped room with a negative airflow referred to as airborne infection isolation room
air is not returned to the inside ventilation system but is filtered through a high-efficiency particulate air (HEPA) filter and gos directly outside
must wear N95 respirator every time they enter the room of a patient w TB

focuses on a very limited patient population all of whom are highly susceptible to infection bc of an underlying condition or treatment
requires isolation in a specialized room with with positive airflow set to rate greater than 12 air exchanges per hour and all air is filtered through HEPA
ex: pt who recieved kidney transplant - must wear mask leaving hospital and to x-ray

gowns, masls, eye protection (protect eyes during specimen collection from foley bag), gloves

put PPE on to transfer

comes from microorganisms found outside the individual
salmonella, clostridium tetani, aspergillus
obtained outside the hospital

occurs when part of the patient's flora becomes altered and an overgrowth occurs
staphylococci, enterococci, yeasts
obtained inside the hosptial

elderly
young children
surgical pt

caring is higly relational -> have to develop relationship quickly
it is very obvious when caring is absent -> negligence, feel like "just a pt"
enabling is an aspect of caring

caring is an interaction of mutual respect and trust
right and wrong behavior
relationships between people and with a nurse's character and attitude toward others

being there and being with patient
not thinking about personal issues
presence is the connectedness between a nurse and a patient
strengthens your ability to provide effective patient-centered care

provides comfort
creats a connection
because touch conveys many messages, use it with discretion
always ask permission if the situation allows

IV, vitals
performing a task or procedure

pat on back, hug, allow to squeeze hand when in pain
nonverbal communication influences a patient's comfort and security, enhances self-esteem

gait belt, steady pt, restraints if you need to
touch that helps protct a nurse and/or patient

meds, massage, acupressure, giving cold compress
can do without dr
holistic, evidenced-based therapy, complimentary or alternative

continuity of care
clinical expertise

time
continuity of care
teamwork of the nursing staff
trust
experience

does not mean religion
fulfilling a wish for the patient regardless of how you feel

intercultural encounter there is an insider perspective
your culture and how you go about it

an outsider perspective
how an outsider would look at your culture

the way in which individuals and families react to disease
culture affects how an individual defines the meaning of illness

malfunctioning of biological and psychological processes

confirms patient understands teaching

process of moving gases into and out of the lungs, with air flowing into the lungs during inhalation and out of the lungs during exhalation

relates to the ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs

responsible for mvoing the respiratory gases from one area to another by concentration gradients

the effort required to expand and contract the lungs

responsible for air exchange

O2 goes in blood and hemaglobin carries
CO2 goes into lungs to be blown out

occurs when alveolar ventilation is inadequate to meet the oxygen demand of the body or to eliminate sufficient carbon dioxide

state of ventilation in which the lungs remove carbon dioxide faster than it is produced by cellular metabolism

inadequate tissue oxygenation at the cellular level
deficiency in oxygen delivery or oxygen use at the cellular level

crackles, fatigue, breathlessness, dizziness, and confusion from tissue hypoxia from the diminished cardiac output
decreased functionig of left ventricle

weight gain, distended neck veins, hepatomegaly and splenomegaly, peripheral edema
impaired functioning of right ventricle
commonly results from pulmonary or long-term left-sided failure

results when the supply of blood to the myocardium from the coronary arteries is insufficient to meet myocardial oxygen demands

chest pain that can be fixed

results from sudden decreases in coronary blood flow or an increase in myocardial oxygen demand without adequate coronary perfusion

dyspnea management -> HOB up
airway maintenance -> cough and deep breathing
mobilization of pulmonary secretions -> get up and moving by moving secretion can get pneumonia so you need to turn them and use incentive spirometer
hydration
humidification
nebulization
coughing and deep-breathing techniques
chest physiotherapy

reduces strain on musculoskeletal structures, aids in maintaining adequate muscle tone, promotes comfort and contributes to balanced and conservation of energy

Age
Meaningful stimuli
Amount of stimuli
Social interaction
Environmental factors
Cultural factors

cannot understand written or verbal speech

person understand written or verbal speech but cannot write or speak appropriately when trying to communicate

you would dress the left side of the patient first and vice versa

assess how much they can help with the lift

cardiovascular -> BP, heart rate
musculoskeletal
respiratory -> respirations
mental/emotional

you measure the calf with a measuring tape

exaggeration of anterior convex curve of lumbar spine

increased convexity in curvature of thoracic spine

lateral S- or C-shaped column with vertebral rotation
unequal heights of hips and shoulders

upper extremities flexed at the elbows and held close to the body
lower extremities externally rotated and extended

increased tone in extensor muscles and trunk muscles, with active tonic neck reflexes

maintenance of an abnormal posture through muscular contractions may last several seconds to weeks
long term, can cause permanent, fixed contractures

stooped, hyperflexed posture with a narrow-based, short-stepped gait
due to loss of normal postural reflexes