What system has greatly increased the number and types of health care settings?
Health care system
What health care workers help individuals and aggregates (groups) to improve health of the entire community?
Community health nurses
What is the main difference between home health care nursing and public health care nursing?
Direct care to patients
What major health care involves teaching patients and families to care for themselves so as to promote independent functioning?
Home health care
What is a major source of home health care funding?
Medicare
For what do these 4 conditions have to be met for?
1. the physician has determined the need for home care
2. the patient needs intermitted skilled nursing care or physical or speech-language therapy or continued occupational therapy
3. the patient is home
Medicare
What are the high-technology interventions (the provisions of intravenous therapy and ventilator), hospice services, pediatric care, and mental health care for?
Specialty home care services
What is the process of restoring an individual to the best possible health and functioning following a physical or mental impairment and the prevention of further disability?
Rehabilitation
Caring for what type of patient requires the coordinated services of a large number of health care professionals to help patients stay healthy and prevent complications or injuries?
Disabled
As an effective member of a multidisciplinary rehabilitation team, the __________ is a care planner, teacher, caregiver, counselor, coordinator, and advocate
Nurse
________ ________ workers must consider the way a disabled individual functions within the family and the patient and family should be involved from the outset in determining the plan of care
Health care
___________ in activities of daily living is the best indicator of who will need nursing home placement
Dependence
What residential care exists in these 4 levels:
1. domiciliary care
2. sheltered housing
3. intermediate care
4. skilled care
Modern long-term
Care delivered in _____________ residential facility is based on 3 principles:
1. promotion of independence
2. maintenance of function
3. maintenance of autonomy (freedom from external authority to make decisions about one's health and health care)
Long-term care
What is the cornerstone of the healing process?
Nutrition
To support and maintain life for fight disease, the body must be supplied with the proper __________
Nutrients
What process involves enzymes helping break down food particles to their simplest form so that the nutrients can be absorbed by the body?
Digestive
What body system regulates neural control and the secretion of hormones?
Gastrointestinal
Parasympathetic nerves stimulate what?
Digestive activity
What major organ is normally emptied in 1-4 hours, depending on the amount and kinds of food eaten?
Stomach
The primary organ of absorption is the _______ _________
Small intestine
Fluids, vitamins, and minerals are absorbed through the intestinal ___________
Mucosa
The body makes use the energy received through the food that is eaten, and the _________ portion of __________ expenditure occurs during rest to carry out the mechanical activities needed to sustain life processes
Largest/energy
Although ________ are the body's main source of food energy, ________ are the most concentrated source
Carbohydrates/fats
Most of the energy needed to move, perform activities, and live is consumed in the form of _________, which are converted primarily to glucose for immediate use by the body's cells
Carbohydrates
________ are a major source of energy for muscle tissue, even when glucose is available
Lipids
_______ are made of smaller units called amino acids
Proteins
_________ and _________ are micronutrients; they are needed in small amounts for good health
Vitamins/minerals
________ is the largest component of the body and body tissues are essential to all life processes in the body
Water
Maintaining a good diet can help middle-aged and older adults maintain a high level of function and reduce the risks of _______ disease
Chronic
Because of the normal decline in metabolism and physical activity, _______ needs lessen with age
Energy
________ are at risk for megaloblastic anemia if adequate _______ ______ is not added to the diet
Vegetarians/vitamin B12
Anorexia nervosa, bulimia, and binge eating disorder are ______ disorders that often begin in adolescence
Eating
______ disorders are thought to be caused by multiple biologic, psychologic, sociocultural, and spiritual factors
Eating
For patients who cannot take ______ feedings, nutritional support may be provided through enteral tube feedings, or peripheral, or central catheters
Oral
If a subcutaneous injection is to be given at a 90 degree angle, you should choose a needle that is ______ inches in length
1/2
If a subcutaneous injection is to be given at a 45 degree angle, you should choose a needle that is ______ inches in length
5/8
______ ______ is enough of a drug to produce the desired physiological response, but not enough to cause toxicity
Therapeutic response
All ______ should be stored in a locked cabinet
Narcotics
Narcotics should be ______ frequently, during the opening of narcotic drawers, and/or shift change
Counted
Report discrepancies in narcotic counts ______
Immediately
If you give only part of a premeasured dose of a controlled substance, a ______ nurse witnesses' disposal disposal of the unused portion
Second
______ nurses sign their names on the required form
Both
______ is the passage of medication molecules into the blood from the site of administration
Absorption
After a medication is absorbed, it is ______ to tissues and organs and finally to the site of drug action
Distributed
The rate and extent of distribution depends on ______, cell membrane ______, and protein binding. When their is poor perfusion, as in the case of heart failure, this ______ medication distribution
Circulation/permeability/alters
After a medication reaches its site of action, it becomes ______ into a less active or inactive form
Metabolized
Most biotransformation occurs in the _______, although the lungs, kidneys, blood, and intestines also play a role
Liver
Patients (e.g. older adults and those with chronic disease) are at risk for ______ ______ if their organs that metabolize medications do not function correctly
Medication toxicity
The final aspect of pharmacokinetics is ______, the process of medications exiting the body through the lungs, exocrine glands, bowel, kidneys, and liver
Excretion
A medication's ______ ______ determines the organ of excretion.
For example, gaseous and volatile compounds, such as alcohol and nitrous oxide, exit through the ______
Chemical makeup/lungs
In medications that exit through sweat glands, you provide ______ to reduce skin irritation
Hygiene
You must know if a drug is excreted through the ______, because the administration of laxatives or enemas increases ______, accelerates excretion, and thus lessens the time for drug effects
Intestines/peristalsis
When patients have reduced ______ function, they are at risk for medication toxicity
Renal
It is important to know the exact ______ ______ for which a medication is prescribed so you can properly ______ patients about a medication's intended effect and to accurately evaluate the medication's desired effect
Therapeutic effect/teach
Sometimes a single medication have many therapeutic effects.
For example, ______ relieves pain and reduces fever and tissue inflammation
Aspirin
_______ ______ are predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose
Side effects
Some antihypertensive medications cause _______ in male patients
Impotence
If the side effects are serious enough to outweigh the ______ of a medication's therapeutic action, the prescriber will likely ______ the medication
Benefits/discontinue
Patients commonly ______ taking medications because of side effects such as anorexia, nausea, vomiting, dizziness, drowsiness, dry mouth, constipation, and diarrhea
Stop
______ drug effects are unintended, undesirable, and often unpredictable
Adverse
Unfortunately, although ADEs are sometimes immediately apparent, they often take _______ or ______ to develop
Weeks/months
______ recognition and reporting of ADEs will prevent serious injury to patients
Prompt
______ ______ develop after prolonged intake of a medication, when a medication accumulates in the blood because of impaired metabolism or excretion, or when too high a dose is given
Toxic effects
Toxic levels of morphine, an opioid, cause severe ______ ______ and death
Respiratory depression
Medications often cause unpredictable effects such as an ______ ______, in which a patient ______ or ______ to a medication or has a reaction different from normal
Idiosyncratic reaction/overreacts/underreacts
Predicting which patients will have an idiosyncratic response is ______
Impossible
Ativan, an antianxiety medication, which given to an older adult may cause ______ and ______
Agitation/delirium
______ ______ also are unpredictable responses to a medication
Allergic reactions
Exposure to an initial dose of a medication causes a patient to become sensitized ______
Immunologically
The medication acts as an ______, which causes ______ to be produced
Antigen/antibodies
With repeated ______, the patient develops an allergic response to the drug, its chemical preservatives, or a metabolite
Administration
Among the different classes of medications, ______ cause a high incidence of allergic reactions
Antibiotics
______ is fastest, directly into the blood stream
IV
______ is second fastest, injected into muscle then absorbed into the bloodstream
IM
______ is third fastest, injected into subcutaneous tissue, then absorbed slower than IM
SQ
______ is slowest, swallowed by the patient, then goes through the stomach, then the first pass effect, then absorbed by the digestive tract
PO
The highest serum concentration (______ concentration) of a medication usually occurs just before the body absorbs the ______ of the medication
Peak/last
With ______ infusions, the peak concentration occurs quickly, but the serum level also begins to fall ______
IV/immediately
The point at which the lowest amount of drug is in the serum is the _____ concentration
Trough
A patient's trough level is drawn as a blood sample ______ ______ before administering the drug, and the peak level is drawn whenever the drug is expected to reach its peak ______
30 minutes/concentration
What is the right medication, the right dose, the right patient, the right route, the right time, the right documentation?
The 6 rights of medication
______ procedures classified by purpose are:
1. diagnostic
2. exploratory
3. curative
4. palliative
5. cosmetic
Surgical
______ procedure involves the removal and study of tissue to make an accurate diagnosis
Diagnostic
______ procedure includes a more extensive procedure than a biopsy
Exploratory
______ procedure is made to remove diseased tissue or to correct defects
Curative
______ procedure relieves symptoms or improves function without correcting the basic problem
Palliative
______ procedure is performed to correct serious defects that affects appearance
Cosmetic
______ that affect surgical outcomes are age, nutritional status, fluid and electrolyte balance, medical diagnoses, drugs, and habits such as use of tobacco and alcohol
Variables
The ______ of the surgical experience are Preoperative, Intraoperative, and Postoperative
Phases
______ measures to reduce patient anxiety and increase knowledge about the surgical experience may actually decrease complications
Nursing
______ teaching should include surgical preparation; what to expect in the surgical suite and the PACU; what tubes, dressings, or equipment may be in place after surgery; and how patient participation can promote ______
Preoperative/surgery
Before ______, the patient or legal guardian must sign a legal ______ form.
Surgery/consent
Consent forms from the patient must be obtained ______ preoperative medications are given
Before
After preoperative medications are given the patient should ______ in bed
Remain
The ______ team consists of nurses who circulate, nurses who scrub, an RFNA, one or more surgeons, an anesthesiologist or a nurse anesthesiologist, and other technical personnel
Surgical
______ is an ongoing development process that begins at conception and ends at death
Aging
______ is the study of aging
Gerontology
______ is the biomedical science of old age and the application of knowledge related to the biologic, biomedical, behavioral, and social aspects of aging to the prevention, diagnosis, treatment, and care of older people
Geriatrics
______ nursing aims to increase healthy behaviors in the aged, minimize and compensate for health-related losses and impairments of aging, and facilitate the diagnosis, care, and treatment of disease in the aged
Gerontological
Health care providers must recognize myths about the older adult and aging that results in ______ and ______ against older people
Stereotyping/discrimination
Age-related ______ that contribute to a decreased ability to clear drugs through the ______ and renal system place the older adult at risk for adverse drug effects
Changes/liver
What is the normal visual activity range for neonates?
20/100 to 20/400
What is involuntary rapid eye movements common in neonates called?
Nystagmus
What is involuntary turning inward of the eyes also common in neonates called?
Estropia
By ages 2 to 3 most children have a visual acuity of?
20/50
At what age is visual acuity 20/20?
7
By what month is the auditory nerve function mature in the infant?
5
What month are alertness to light and visual stimulus 8-12 inches away, can follow an object 60 degrees horizontally and 30 degrees vertically; blings at an approaching object milestones for a neonate?
1
What month are they can follow a person or object for 180 degrees from 6 feet away; smiles in response to a face; raises head 30 degrees from prone milestones for a neonate?
2
What month are they can track an object through 180 degrees; regards own hand; begins visual motor coordination milestones for a neonate?
3
What month(s) are social smile; reaches for cube 12 inches away; notices a raisin 12 inches away; stares at own hand milestones for a neonate?
4-5
What month(s) are reaches and grasps an object; picks up a raisin by raking; transfers objects from hand to hand milestones for a neonate?
7-8
What month(s) are pokes at holes in a peg board; well-developed pincer grasp; crawls; uncovers toy at seeing it hidden milestones for a neonate?
8-9
What month(s) are stacks blocks; places a peg in a round hole; stands and walks milestones for a neonate?
12-14
What is inflammation of the conjunctiva, the clear membrane that lines the inside of the lid and sclera a symptom of?
Conjunctivitis
What is conjunctivitis in an infant under 30 days of age which is usually acquired from the mother during vaginal birth a symptom of?
Ophthalmia neonatorum
What kind of measure is given into the newborn's eyes soon after birth?
Antibiotics
What is a plugged lacrimal duct, treatment involves massaging the tear duct every 4 hours while infant is awake; after 1 year lacrimal ducts that are still plugged may be surgically opened a symptom of?
Mimic conjuctivitis
What are edema of the eyelid, reddened conjunctiva and enlarged preauricular glands, itching/burning, mild photophobia common complaints in older children symptoms of?
Bacterial conjunctivitis
Conjunctivitis that is normally unilateral is called?
Bacterial conjuctivitis?
Viral conjunctivitis usually occurs ______
Bilaterally
Allergic conjunctivitis is characterized bu itching, reddened eyes with watery discharge and the conjunctiva has what type of appearance?
Cobblestone
What are bacteria and is an uncommon complication of sinusitis symptoms of?
Periorbital cellulitis
Orbital cellulitis can also lead to ______ ______
Bacterial meningitis
What does the "S" stand for in SOAP
Subjective
What does the "O" stand for in SOAP
Objective
What does the "A" stand for in SOAP
Assessment
What does the "P" stand for in SOAP
Plan
What is the kind of pain that includes discomfort that has a short duration (from a few seconds to less than 6 months)
Acute pain
What is a privately experiences, unpleasant sensation usually associated with disease or injury
Pain
What is the kind of pain that includes the noxious stimuli that are transmitted from the point of cellular injury over peripheral sensory nerve to pathways between the spinal cord and thalamus and eventually from the thalamus to the cerebral cortex of the
Nociceptive pain
What is the type of pain that is caused by mechanical, chemical, thermal, or electrical injuries or disorders affecting bones, joints, muscles, skin, or other structures composed of connective tissue
Somatic pain
What is another name for superficial somatic pain
Cutaneous pain
What type of pain is perceived as sharp or burning discomfort; such as that from an insect bite or paper cut
Superficial somatic pain
What is pain such as that caused by trauma procedures; localized sensations that are sharp, throbbing, and intense or like a fracture that is dull, aching, diffuse discomfort and is more common with long term disorders such as arthritis
Deeper somatic pain
What is pain that arises from internal organs such as the heart, kidneys, and intestines that are diseased or injured
Visceral pain
What kind of pain has some of the following causes: ischemia (reduced arterial blood flow to an organ), compression of an organ, and intestinal distention with gas or contraction as occurs with with gallbladder or kidney stones
Visceral pain
What kind of pain usually is diffuse, poorly localized, and accompanied by an autonomic nervous system with symptoms such as nausea, vomiting, pallor, hypotension, and sweating
Visceral pain
What is a term used to describe discomfort that is perceived in a general area of the body but not in the exact site where the organ is and anatomically located
Referred pain
What kind of pain is processed abnormally by the nervous system and results from damage to either the pain pathways in peripheral nerves or pain-processing centers in the brain (ex: phantom limb pain)
Neuropathic pain
What is a term that describes discomfort that lasts longer than 6 months and is almost totally opposite from those of acute pain
Chronic pain
What are periods of acute pain for chronic pain sufferers called
Breakthrough pain
What is the conversion of chemical information in the cellular environment to electrical impulses that move toward the spinal cord
Transduction
What are the chemicals that are released by the damaged cells that stimulate specialized pain receptors located in the free nerve endings of peripheral sensory nerves
Nociceptors
What is the phrase during which peripheral nerve fibers form synapses with neurons in the spinal cord called? The pain impulses move from the spinal cord to sequentially higher levels in the brain. The impulses ascend to the reticular activating system, t
Transmission
What refers to the phrase of impulse transmission during which the brain experiences pain at a conscious level but many concomitant neural activities occur almost simultaneously? In addition to perceiving the pain, the brain structures in the pain pathway
Perception
What is the point at which the pain-transmitting neurochemicals reach the brain, causing conscious awareness?
Pain threshold
What is a lowered pain threshold, that may occur when excitatory neurotransmitters such as glutamate sensitize the spinal cord to nociceptive input? In other words pain signals become amplified
Hyperalgesia
What is the amount of pain a person endures once the threshold has been reached?
Pain tolerance
What is the last phase of pain impulse transmission during which the brain transmits a response down the spinal nerve to the point where the pain transmissions originated to alter the pain experience called?
Modulation
What is an exaggerated pain response due to increased sensitivity to stimuli such as air current, pressure of clothing, and vibration called?
Allodynia
What refers to the techniques used to prevent, reduce, or relieve pain?
Pain management
What is an analgesic?
Painkiller