What is a deformity that results from shortening of a muscle, resulting in a rigid joint highly resistant to extending?
contracture
Where is the apical pulse found?
Midclavicular line, 5th intercostal space
Name a respiratory complication of immobility that can be caused by either bacteria or a virus
Pneumonia
(most commonly caused by streptococcus pneumoniae)
What does TCDB stand for?
Turn, cough, deep breathe
dehydration and pooling in the kidneys and bladder can lead to a....
UTI >:-(
What is the inability to dorsiflex/flatten the foot caused by peroneal nerve damage?
Footdrop
What is the difference between a thrombus and an embolus?
a thrombus is a blood clot attached to a vessel wall, an embolus detaches and travels to damage other areas
What is a potentially life-threatening occlusion of blood flow in the lungs?
Pulmonary embolism
What is the normal range for an oral temperature?
96.8 - 100.4 F
Name 3 things that would help relieve constipation in the immobile patient
1. pushing more fluids
2. increasing fiber intake
3. stool softeners, laxatives if needed
A dry, dark scab or falling away of dead skin
Eschar
Name 3 signs of a DVT
1. redness
2. swelling
3. pain
What is a modifiable factor that causes extra thick sputum?
decreased fluid intake
A patient with a LOW Braden scale should be turned/repositioned how often?
every 2 hours
Define anorexia
decrease in appetite
You are assigned to an elderly female patient who is in the hospital after a fall in her nursing home. She had a left mastectomy and there is a dressing covering the wound on her right upper arm/elbow. Where can you take her blood pressure?
Calf or right forearm
What tool can be used to confirm a thrombus?
venous doppler (ultrasound)
How is an incentive spirometer used?
Slowly inhale a deep breath and hold it
What will happen to a blood pressure reading after using a cuff that is too large or loose?
Inaccurately low blood pressure reading
A flexible tube that is lubricated and inserted into the bladder intermittently to drain once into a collection container (there is no drainage bag)
straight or intermittent catheter
Name 4 methods for practicing good body mechanics as a nurse
1. bend at the knees
2. tighten abdomen and tuck pelvis
3. broaden base of support
4. hug the load
5. avoid twisting and bending at the waist
6. avoid locking knees
7. lift with arm and leg muscles instead of the back
What is Virchow's Triad? (3 factors of clot formation)
1. damage to a vessel wall
2. alterations in blood flow (decreased venous return from legs)
3. alterations in blood constituents (dehydration or increased clotting factors)
Define atelectasis
a build-up of mucus blocks bronchioles, deflating alveoli and causing a complete or partial lung collapse
Name the 6 risk factors that the Braden scale considers when determining who is at risk for pressure ulcers
1. sensory perception
2. moisture
3. activity
4. mobility
5. nutrition
6. friction and shear
What 4 characteristics are you taking note of when examining urine?
1. amount
2. color
3. odor
4. cloudiness