Transitions 216 #2

Nutrition

100

The study of nutrients and how they are handled by the body is called _________________.

Nutrition

200

What is the body mass index (BMI) for a 20-lb man who is 6 ft 3 inches tall?

27.5 (ratio of weight in kgs to height in meters)

300

According to the BMI guidelines published in NHLBI, a person with a BMI >30 indicates ______________.

Obesity

400

A patient with a negative nitrogen balance is in a ____________ state.

Catabolic

500

The nurse teaches patients to avoid, partially hydrogenated liquid oils, referred to as _______________ fats, which raise serum cholesterol.

Trans

600

The fat-soluble vitamins are _______, ________, E, and _________.

A  D  K

Urinary Elimination

100

The process of ______________ is the act of emptying the bladder, urination, or voiding.

Micturation

200

When assessing the urinary system of a newborn, the newborn should have _____ to _____ wet diapers

6 to 8

300

Involuntary loss of urine associated with an abrupt and strong desire 

Urge incontinence

400

A urinary _______________ is a surgical procedure that creates an alternative route for urinary excretion.

Diversion

500

Generally, a clean-catch urine specimen should be collected _______________.

Midstream

600

A patient with an obstruction in the urinary tract may require insertion of a ____________, or thin catheter or tube that provides a pathway for flow of the urine.

Stent

Bowel Elimination

100

Direct visualization of the lining of a hollow body organ using a long flexible tube containing glass fibers that transmit light into the organ, allowing the return of an image that can be viewed.

Endoscopy

200

Use of commercial tape, dipstick, or solution to test for blood in the stool.

Fecal occult blood test

also known as guaiac test

300

Administered to destroy intestinal parasites

Anthelmintic enema

400

Contraction of circular and longitudinal muscles of the intestines

Peristalsis

500

A postoperative patient painful defecation due to hard, dry stools.  List 3 expected outcomes for this.

1. The patient will have soft, formed BMs every 1-2 days without discomfort.

2.  The patient will ambulate, increase intake of fiber and fluid intake.

3.  The patient will relate the importance of timing, positioning, and privacy to healthy BM.

600

Briefly describe the following types of ostomies and the characteristics of stool passed.

Ileostomy____________________________________________________________________________

Colostomy____________________________________________________________________________

Ileostomy--a portion of the ileum is redirected through the abdominal wall and a stoma created.  It allows liquid fecal content to flow through the stoma.

Colostomy--a portion of the colon is redirected through the abdominal wall and a stoma created.  It permits formed feces to pass through the stoma.

Oxygenation

100

The amount of blood pumped per minute, measured in liters per minute is the cardiac __________; this is expressed by the formula CO=SV x HR.

output

200

The mass of tissue in the heart that initiates the transmission of cardiac impulse causing contraction of the heart is the ____________ node.  It is also called the _______________.

Sinoatrial

Pacemaker

300

Infants born before 34 weeks may not have produced sufficient _____________, leading to collapse of the alveoli and poor alveolar exchange.

Surfactant

400

This is a face mask with side vents that permits room air to enter, diluting the oxygen concentration in the mask.  It is connected to oxygen tubing, using an oxygen flow rate greater than 5 l/min; it should be comfortable snug over the face but not 

Venturi mask

500

Describe two ways that oxygen is carried into the body.

1.  Dissolved in plasma (2%)

2.  Carried by red blood cells in the form of oxyhemoglobin (98%)

600

Explain how to best use this device:

The patient exhales, places their lips on the mouth piece, then takes a deep breath and observes the volume registered on the spirometer as the patient improves to maximum inspiration.

Perfusion

100

The amount of blood pumped per minute measured in liters per minute is the cardiac ___________; this is expressed by the formula ___________________.

Output

CO=HR x SV

200

The mass of tissue in the heart that initiates the transmission of the cardiac impulse causing contraction of the heart is the __________ node.  It is also called the ____________ of the heart.

Sinoatrial

Pacemaker

300

The nurse documents a disturbance of the rate and/or rhythm of the heart as a(n) _________________.

Dysrhythmia

400

The nurse documents that a patient under went aspiration of fluid from the pleural space in the electronic health record as a ________________ was performed.

Thoracentesis

500

As with emphysema who is receiving the visiting nurse for a patient with emphysema who is receiving oxygen therapy, list five safety precautions you would initiate and confirm are in place.

1. Avoid open flames in the patient's room

2. Place "No Smoking" signs in conspicuous places in and near the patient

3. Check to see if electrical equipment is in good working order

4.  Avoid using or wearing synthetic fabrics, which build up static electricity

5. Avoid using oils in the area

600

Define the following cardiopulmonary problems and their manifestations:

Angina

Myocardial infarction

Heart Failure

Angina--a type of myocardial ischemia that causes chest pain or discomfort

Myocardial infarction--one type of acute coronary syndrome characterized by death of heart tissue due to lack of oxygen

Heart Failure--occurs when the heart is unable to pump sufficient blood supply, resulting in inadequate perfusion and oxygenation of the tissue.  Chronic HTN, CAD, and heart valve ds are risk factors.  S/S dyspnea, edema, and fatigue.  

Fluids and Electrolytes

100

______________ fluid is the fluid within cells, constituting about 70% of the total body water or 40% of adult body weight

ICF intracellular

200

______________fluid is all the fluid outside the cells, accounting for about 30% of total body water or 20% of adult body weight

ECF extracellular fluid

300

____________________fluid losses cannot be measured of seen and include fluid lost from evaporation through the skin and water as vapor from the lungs during respiration.

Insensible

400

It is the chief regulator of cellular enzyme activity and cellular waste content

It controls and regulates the volume of body fluids

It is the primary regulator of ECF volume

Na⁺ Sodium 135-145 mEq/L

500

It assists the regulation of acid-base balance by exchange with H⁺

Role in transmission of electrical impulses in nerve, heart, skeletal, intestinal, and lung tissue

High levels can cause severe bradycardia and cardiac arrest

K⁺ Potassium  3.5-5.0 mEq/L

600

It is a catalyst for muscle contraction

Helps regulate muscle contraction and relaxation

Has a role in blood coagulation

Major component in bones and teeth

Ca⁺⁺ Calcium 8.6-10.2 mg/dL

                     4.5-5.1 mg/dL ionized (free)

Calcium can bind to proteins especially albumin; if albumin is low, correct before trusting serum level of Ca⁺⁺

Assessment S/SAbnormal Electrolytes

100

Ca⁺⁺ on labs is 6.0 mg/dL

Hypocalcemia  8.6-10.2  mg/dL normal

positive Chvostek's sigh

positive Trousseau's sign

cardiac conduction issues

200

K⁺ on labs is 6.2 mEq/L

 Hyperkalemia 3.5-5.0 mEq/L normal

widened QRS=bradycardia, peaked T waves

some causes: renal failure, acidosis pulls K⁺ out of cells, tissue damage, salt substitutes 

300

Na⁺  on labs is 122 mEq/L

Hyponatremia low sodium 

135-145 m/Eq/L normal

fluid shifts from ECF into ICF causing cell to swell, possibly burst

Increased intracranial pressure c/o headache, hypotension, muscle cramps

400

Na⁺  on labs is 165 mEq/L

Hypernatremia       135-145 mEq/L normal

fluid moves from IC to ECF, cell shrinks

CNS signs most prominent restlessness, agitation, weakness, delusions, hallucinations, seizures

BP increases, edema increases

500

Mg⁺⁺ on labs 4.4 mEq/L

Hypermagnesemia  1.3-2.3 mEq/L normal

N/V, muscle weakness, flushing, hypotension, hypoactive DTRs, respiratory depression

hypotension because of dilation of arterial smooth muscle

seen in renal failure over intake in IV Mg⁺⁺ (in eclampsia during pregnancy) or excess consumption

600

PO⁴ on labs  1.7 mg/dL

Hypophosphatemia 2.5-4.5 mg/dL normal

causes from admin. of calories to malnourished patients, ETOH withdrawal, DKA, hyperventilation, absorption problems, and diuretics

low PO⁴ then high Ca⁺⁺ in blood; go hand-in-hand into the bones

Acid/Base

100

Fill in normal values for

pH

pCO₂

HCO₃^-

PaO₂

SaO₂

pH       7.35-7.45   

pCO₂       35-45 mm Hg

HCO₃^-      22-26 mEq/L

PaO₂         80-100 mm Hg    

SaO₂         >95%

200

pH       7.21

pCO₂    43

HCO₃^-   14

Metabolic acidosis

Ex:  DKA, malnutrition, severe diarrhea (bicarb lost)

300

pH       7.43

PaCO₂    27

HCO₃^-   18

Respiratory alkalosis

Causes:  Hyperventilation, fever

400

pH       7.35

PaCO₂    48

HCO₃^-    31

Compensated Respiratory Acidosis

500

pH       7.25

PaCO₂   53

HCO₃^-   23

Respiratory Acidosis

Causes:  Not breathing/oxygenating, OD, Pulmonary Edema, Pulmonary Embolism, Bronchospasms (asthma)

600

pH       7.48

PaCO₂   47

HCO₃^-   30

Metabolic Alkalosis 

Causes:  too many TUMS, diuretics, excessive vomiting (loss of H⁺), hyperaldosteronism

S/S low K⁺, EKG changes, muscle cramps/weakness