What are positive health behaviors?
Immunizations, proper sleep patterns, adequate exercise and nutrition. Activities that relating to maintaining, attaining, or retaining good health or preventing illness.
Hinduism Dietary Regulations
Some sects are vegetarians. Belief is not to kill any living creature.
Buddhism Dietary Regulations
Some are vegetarians and will not use alcohol. Many will fast on holy days.
Islam Dietary Regulations
Prohibit the consumption of pork and alcohol. Fasts during the month of Ramadan.
Judaism Dietary Regulations
Some observe the kosher dietary restrictions(Avoid pork and shellfish, do not prepare milk and meat at the same time)
Christianity Dietary Regulations
Some discourage the use of alcohol and caffeine. Roman catholics fast on Ash Wednesday, good Friday and 1 hr s/p communion; do not eat meat on Fridays during lent.
Jehovah's Witness Dietary Regulations
Members avoid food prepared with or containing blood
Mormonism Dietary Regulations
Members abstain from alcohol and caffeine.
Russian Orthodox Church Dietary Regulations
Followers observe fast days as well as "no meal" rule on Wednesdays and Fridays. During lent all animal products including dairy products, are forbidden.
Native Americans Regulations
Individual tribal beliefs influence food practices
Trust Vs Mistrust
Birth to 1yr
Develops trust following consistency in care giving and nurturing interactions. Distinguishes self from environment
Autonomy Vs Shame and Doubt
1 to 3 yrs
Begins to communicate likes and dislikes. Increasingly independent in thoughts and actions. Appreciates body appearance and function (dressing, feeding, talking, walking)
Initiative Vs Guilt
3 to 6 yrs
Id with a gender. Enhances self awareness. Increases language skills, including identification of feelings
Industry Vs Inferiority
6 to 12 yrs
Incorporates feedback from peers and teachers. Increases self-esteem with new skills mastery(i.e. reading, math, sports, music) Aware of strengths and limitations
Identity Vs Role confusion
12 to 20 yrs
Accepts body changes/maturation. Examines attitudes, values, and beliefs; establishes goals for the future. Feels positive about expanded sense of self
Intimacy Vs Isolation
Mid 20's to Mid 40's
Has stable, positive feelings about self. Experiences successful role transitions and increased responsibilities
Generativity Vs Self-Absorption
Mid 40's to Mid 60's
Able to accept changes in appearance and physical endurance. Reassess life goals. Shows contentment with aging
Ego Integrity Vs Despair
Late 60's to Death
Feels positive about life and its meaning. Interested in providing a legacy for the next generation
What is Primary Prevention?
Prevention; health promotion efforts, education, maintaining and improving health
What is Secondary Prevention?
Individuals that are experiencing health problems or illness and who are at risk for developing complications or worsening conditions. Screening techniques, tx early stages of dz, delay the consequences of advanced dz.
What is Tertiary Prevention?
Occurs when a defect or disability is permanent and irreversible. Rehabilitation rather than dx and tx.
Flat, non-palpable change in skin color, smaller than 1 cm
(I.e. Freckle, petechia)
Palpable, circumscribed, solid elevation in skin, smaller than 1 cm
(I.e. Elevated nevus)
Elevated solid mass, deeper and firmer than papule. 1-2 cm
Solid mass that extends deep through subcutaneous tissue, larger than 1-2 cm
Irregularly shaped, elevated area or superficial localized edema; Varies in size
(I.e. Hives, mosquito bite)
Circumscribed elevation of skin filled with serous fluid, smaller than 1 cm
(I.e. Herpes simplex, chickenpox)
Circumscribed elevation of skin similar to vesicle but filled with pus; varies in size
(I.e. acne, staphylococcal Inf)
Deep loss of Skin surface that extends to dermis and frequently bleeds and scars; Varies in size
(I.e. Venous Stasis Ulcer)
Thinning of skin with loss of normal skin furrow, with skin appearing shiny and translucent; Varies in size
(I.e. Arterial insufficiency)
Approx 160 degree angle between nail plate and nail
Change in angle between nail and nail base (eventually larger more than 180 degrees)Nail bed softening with nail flattening; often enlargement of fingertips
Cx: Chronic lack of oxygen, Heart or pulmonary dz
Transverse depressions in nails indicating temporary disturbance of nail growth
Cx: Systemic illness such as severe inf; nail injury
Koilonychia (Spoon Nail)
Cx: Anemia, Syphilis, use of strong detergents
Red or brown linear streaks in nail bed
Cx: Minor trauma, subacute bacterial endocarditis, trichinosis
Inflammation of skin at base of nail
Cx: Local inf, trauma
What do normal Vesicular breath sounds, sound like?
Soft, breezy, and low pitched. Inspiratory phase is 3 times longer than expiratory (Best heard over lungs, except scapula)
What do normal Bronchovesicular sounds, sound like?
Blowing sounds that are medium pitched and of medium based intensity. Inspiratory phase=expiratory phase
What do normal Bronchial sounds, sound like?
Loud and high pitched with hollow quality. Expiration is longer than inspiration (heard only over trachea)
Normal VS for an Adult
T:96.8 to 100.4 F
What is Bradypnea?
Regular breathing, abn slow less than 12 per min
What is Tachypnea?
Regular breathing, abn rapid more than 20 per min
What is Hyperpnea?
Respirations are labored, increased in depth and rate, more than 20 per min (like with exercise)
What is Apnea?
Respirations cease for several secs.
What is Cheyne-Stokes Respiration?
Respiratory rate and depth is irregular characterized by alternating periods of apnea and hyperventilation
What is Kussmaul's Respiration?
Respirations are abn deep, regular and increased in rate.
What is Biot's Respiration?
Respirations are abn shallow for 2-3 breaths then an irregular period of apnea
What is role Conflict?
When a person has to simultaneously assume two or more roles that are inconsistent, contradictory or mutually exclusive.
What is role ambiguity?
Unclear role expectations, which makes people unsure about what to do and how to do it, creating stress and confusion. Common in adolescent years
What is role strain?
Combines role conflict and role ambiguity.
What is GAS?
A three stage reaction to stress, alarm reaction, resistance stage, and exhaustion stage
What is the alarm stage of GAS ?
Rising hormone levels result in increased blood volume, blood glucose levels, epinephrine and norepinephrine amounts, heart rate, blood flow to muscles, oxygen intake, and mental alertness.
What is the resistance stage of GAS?
The body stabilizes and responds in an opposite manner to the alarm stage. Hormone levels, heart rate, BP, and cardiac output return to normal, and the body repairs the damage that has occurred.
What is the exhaustion stage of GAS?
Occurs when the body is no longer able to resist the effects of the stressor and when the body has depleted the energy necessary to maintain adaption.
What is cardiac output?
Volume of blood pumped by the heart per min
What is peripheral resistance?
The resistance of the peripheral vasculature
What is blood volume?
The volume of blood circulating within the vascular system
What is viscosity?
The thickness of the blood
What is elasticity?
Stretchiness of the artery walls
Korotkoff Phase 1
A sharp thump
Korotkoff Phase 2
A blowing or whooshing sound
Korotkoff Phase 3
A crisp, intense tapping
Korotkoff Phase 4
A softer blowing sound that fades
Korotkoff Phase 5
What do Fine crackles sound like?
Fine crackles are high-pitched and fine, short, interuppted crackling sound heard during end of inspiration not cleared with coughing
What does Rhonchi sound like?
Loud, low-pitched, rumbling coarse sounds heard during either inspiration/expiration and sometimes cleared with coughing
What do Medium crackles sound like?
Medium crackles are are lower, more moist sounds heard during middle of inspiration, not cleared with coughing
What do coarse crackles sound like?
Coarse crackles are loud, bubbly sounds heard during inspiration; not cleared with coughing
What do wheezes sound like?
High-pitched, continous musical sounds like a squeak heard continuously during inspiration/expiration; usually louder with expiration
What does pleural friction rub sound like?
Has dry, rubbing, or grating quality heard during inspiration/expiration; does not clear with coughing; heard loudest over lower lateral anterior surface.
What is the Romberg test?
What is the chain of Inf?
-Infectious agent or pathogen
-Reservoir- source for pathogen growth
-Portal of exit from reservoir
-Mode of transmission
-Portal of entry to a host
What are some modes of transmission?
Direct/indirect, droplet, airborne, vehicle(contaminated items), vector(host)
What is the incubation period ?
From initial contact with infectious material to onset of sx
What is the Prodromal Stage ?
Interval from onset of non-specific s/s (malaise, low-grade fever, fatigue) to more specific sx. During this stage microorganisms grow and multiply, and pt may be able to spread dz to others.
What is the illness stage?
Interval when pt manifests s/s specific to type of infection.
What is covalescence stage?
Interval when acute sx of infection disappear.
What is the normal WBC lab value?
(Increased in acute inf, decreased in certain viral/ overwhelming infs)
What is the normal Erythrocyte sedimentation rate?
Up to 15 mm/hr Men
20 mm/hr Women
(Elevated in inflammatory process)
What is the normal lab value for iron levels?
60-90 g/100 mL
(Decreased in chronic Inf)
What is the normal lab value for cultures of urine and blood?
Normally sterile w/o microorganism growth
(Presence of microorganism growth)
What is the normal lab value for culture and gram stain of wounds, sputum or throat?
No WBC's on gram stain poss normal flora
(Presence of microorganism growth and WBC's)
What is the normal lab value for Neutrophils?
(increased in pus-forming inf, decreased in bacterial/overwhelming inf)
What is the normal lab value for Lymphocytes?
(Increased in chronic bacterial/viral, decreased in sepsis)
What is the normal lab value for Monocytes?
(increased in some infs)
What is the normal lab value for Eosinophils?
(Increased in parasitic infs)
What is the normal lab value for Basophils?
(Normal during inf)
What is an example of a Isotonic IV solution?
Dextrose 5% in water, 0.9% sodium chloride(normal saline), Lactated Ringers
What is an example of a Hypertonic IV solution?
Dextrose 10% in water, 3%-5% sodium chloride, Dextrose 5% in 0.9% sodium chloride, Dextrose 5% in 0.45% Nacl sodium chloride, Dextrose 5%in lactated ringers
What is an example of a Hypotonic IV solution?
0.45% sodium chloride 9half normal saline), 0.33%sodium chloride (1/3 normal saline)
What is normal urine output per Hr?
What is the purpose of a tap water enema?
Hypertonic and exerts a lower osmotic pressure than fluid in interstitial spaces. Tap water escapes from bowel lumen into interstitial spaces.
What is the purpose of a normal saline enema?
Exerts the same osmotic pressure as interstitial fluid, stimulates peristalsis.
What is the purpose of Hypertonic solutions for an enema?
Exert osmotic pressure that pulls fluids out of interstitial spaces. The colon fills with fluid thus cx defecation.
What is the purpose of a soapsuds enema?
Intestinal irritation to stimulate peristalsis
What is the purpose of an oil retention enema?
Lubricate the rectum and colon. feces absorb the oil and become softer and easier to pass.
What is a Carminative enema?
Provides relief from gaseous distention.
What is a Kayexalate enema?
Used to tx pts with dangerously high serum potassium levels
What is a neomycin enema?
An antibiotic - Used to reduce bacteria in the colon s/p bowel surgery.
When are airborne precautions used?
Airborne infectious agents of 5 micrometers or smaller
When are droplet precautions used?
Used for infectious agents lager than 5 micrometers. Droplets contracted with in less than 3 feet
What is Edema?
assess for trauma, mummer, thrid heart sound
What is Diaphoresis
Assess for pain, fever, anxiety, insulin reaction
What is Bromhidrosis?
Assess for Inf, poor hygiene
What is Hirsutism?
Assess for adrenal function
What is petechiae?
Assess for Hepatic function, drug interactions
What is Alopecia?
Assess for Hypopituitarism, medications, fever, starvation
Is Type I diabetes IDDM or NIDDM? What are the s/s?
IDDM AKA Juvenile diabetes,
S/S: weight loss, increased hunger, excessive thirst, increased urinary frequency,poss ketoacdosis, prone to ketosis, no endogenous insulin
Is type II diabetes IDDM or NIDDM? What are the S/S?
NIDDM AKA Adult onset
S/S: Fatigue, drowsiness, increased hunger, blurred vision, increased thirst, urinary frequency, no ketoacidosis, no ketosis, has endogenous insulin
What is the normal specific gravity of urine?
What are some examples of a carbohydrate?
Simple: Sugars, fruits, nuts
Complex: grains, potatoes, milk
What are some examples of Protein?
Meat, fish, eggs, milk, polutry, beans, peas, nuts
What are some examples of a fat?
Animal fat, meat, nuts, milk, fish and poultry