Principles-Exam 3

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Cognitive:

______ learning includes all intellectual behaviors and requires thinking.

Affective:

_____ learning deals with expression of feelings and acceptance of attitudes, opinions or values; willingness to learn.

Psychomotor:

_____ learning involves acquiring skills that require integration of mental and muscular activity.

Psychosocial adapatation:

____ ____ includes the stages of denial, anger, bargaining, resolution and acceptance.

600 mL:

The bladder normally holds as much as _____ of urine.

150 / 200:

Adults sense the desire to urinate when the bladder has ____ to ____ mL of urine.

50 /100:

A child senses the desire to urinate when the bladder has ____ to ____ mL of urine.

Kidneys:

____ remove waste from the blood to form urine.

Ureters:

____ transport urine from the kednesy to the bladder; sterile, tubular.

Bladder:

The ____ is a reservoir for urine until the urge to urinate develops.

Urethra:

The ____ carries urine from the bladder, through the pelvic floor, and exits through the urethral meatus.

Loop of Henle:

The ___ __ ____ concentrates the urine

Glomerulus:

The _____ is the filtering system.

Bowman's capsule:

____ ____ is the membrane covering the capillary network.

Nephron:

The ____ is the functional unit of kidney.

Prerenal / renal / postrenal:

Conditions that affect urine volume and quality are generally categorized as ____, ____ or _____.

End-stage renal disease:

Diseases that cause irreversible damage to kidney tissue result in ___-___ ____ ____.

Large proteins / blood cells:

Glomerular capillaries do not filter ____ ____ and ____ ____.

125 mL:

Glomerulus filters ____ mL per minute; excretes 1% as urine; major player in F & E balance.

Cystitis:

An irritated bladder that causes frequent and urgent sensations to voice is called _____.

Hematuria:

____ is blood-tinged urine.

Dysuria:

____ is burining during urination and is caused as urine flows over irritated tissue.

Pyelonephritis:

______ is an infection of the kidney and the ureters, the
ducts that carry urine away from the kidney.

Nocturia:

_____ is awakening to void one or more times at night.

Polyuria:

An excess output of urine is ______.

Oliguria:

A urine output that is decreased despite normal intake is called _____.

Anuria:

When no urine is produced it is called _____.

Diuresis:

____ is urine formation.

Vitamin D:

_____ __ is needed to absorb calcium.

Stoma:

____ is an artificial opening.

Prerenal:

Diseases with decreased blood flow to and through the kidneys is classified as ______.

Renal:

Disease conditions of the renal tissue is classified as _____.

Postrenal:

Obstructions in the lower UT that prevents urine flow from the kidneys is classified as ______.

Nocturnal enuresis:

____ ____ is nighttime voiding without awakening.

Nerve:

Diabetes mellitus and multiple sclerosis affect ____ function.

Urinary retention:

BPH causes affects _____ ______.

Sensation:

Alzheimer's disease affects _______.

Mobility:

Parkinson's & degenerative joint diseases affect _____.

Hemodialysis:

_____ is when a machine acts as membrane to filter wastes.

Suprapubic:

____ catheterization involves surgical placement of a catheter through the abdominal wall above the symphysis pubis and into the urinary bladder.

Anuria:

When no urine is produced by dehydration, hemorrhage, CHF or renal failure is called ____.

Polyuria:

Excessive urine output is called _____ and can be caused by diabetes, diuretics, or diuresis (fluids that increase output).

Oliguria:

Decreased urine output is called ____ and can be caused by renal blood flow (shock) or obstruction of flow (prostrate hypertrophy).

Diuretics:

____ increase urine output and potassium loss.

Urinary retention:

Examples of medications that may cause ____ ____ are antihypertensives, antihistamines and anticholenergics.

Diversions:

Urinary _____ of urine to external source.

Urosepsis:

____ is also called bacteremia, which is an infection in the blood stream.

Urinary stoma:

A ___ ____ may be used in the case of bladder cancer, fistulas and chronic cystitis.

Ureterostomy:

_____ is when ureters are brought to abdominal surface.

Transureterostomy:

____ is where 2 ureters are connected into one.

Nephrostomy:

____ is an artificial opening where a tube is placed directly into the renal pelvis.

30 mL:

Abnormal urine output is less than ____ ____in 2 hours.

1.010 - 1.030:

The normal range of a specific gravity test is:

2000-2500:

Adequate fluid intake and output is between ____- ____ ml per day.

Ventilation:

____ is the rate at which gas enters or leaves the lungs.

Perfusion:

_____ is the process of nutritive delivery of arterial blood to a capillary bed in the biological tissue.

S1 sound:

____ ____ is the sound of the mitral & tricuspid valves opening.

S2 sound:

____ ____ is the sound of the aortic & pulmonic valves closing.

Deoxygneated:

_____ blood is delivered to the right side of the heart and to the pulmonary circulation.

Oxygenated:

Blood is ____ through the mechanisms of ventilation, perfusion, and transport of respiratory gases.

Right:

The ____ ventricle pumps blood through pulmonary circulation.

Left:

The ____ ventricle pumps blood through the systemic circulation.

Fill / empty:

The chambers of the heart ____ during diastole and ____ during systole.

Decreased / decrease:

Coronary artery disease and cardiomyopathy result in ____ pumping action and a ____ in the volume of blood ejected from the ventricles.

Cardiomyopathy:

An enlarged heart.

Aorta:

The ____ fills coronary arteries

Stroke volume:

____ ____ is the amount of blood ejected from the left ventricle w/each contraction.

Preload:

The end of diastolic volume.

Starling's law:

Increased stretch on ventricular muscle, causes increased contraction which increases the stroke volume.

Afterload:

____ is the resistance to left ventricular ejection.

Afterload resistance:

____ _____ can be caused by blood vessels, hypertension, atherosclerosis, and hypervolemia.

Autonomic:

____ nervous system influences the rate of impulse generation and speed of conduction pathways.

Sympathetic:

____ nervous system increases the rate of impulse transmission and innervates all parts of atria and ventricle

Conduction:

The cardiac ____ system generates the electrical impulses that control the rhythmic relaxation and contraction of the atria and ventricles.

Parasympahtetic:

The ____ system decreases the rate and innevates atria, ventricles, sinoatrial and atrioventricular nodes.

Conducion:

The ____ system originates with the SA node or pacemaker, transmitted to the AV node, bundle of his and purkinje fibers.

SA:

____ node begins conduction.

P wave:

The ___ ___ represents electrical conduction through both atria.

QRS complex:

The ___ ____ is the duration of electrical impulses as they travel through the ventricles; ventricular contraction.

QT interval:

The ____ ____ describes ventricular depolarization and repolarization.

Inspiration:

The active process stimulated by chemical receptors in the aorta.

Expiration:

The passive process from elastic recoil.

Pulmonary circulation:

Moves blood to and from the alveolar capillary membranes for gas exchange.

Gas exchange of O2 & CO2:

O2 - lungs to blood
CO2 - blood to alveoli and exhaled

Tidal volume:

Amount of Air exhaled in normal breath.

Cardiac output:

The amount of blood ejected from teh left ventricle each minute.

Stroke volume:

The amount of blood ejected from the left ventricle with each contraction.

Cardiac Index:

Cardiac output divided by Body surface area; normal range is 2.5 to 4.0 L/min.

Electrocardiogram (ECG):

Reflects the electrical activity of the conduction system; monitors the regularity and path of electrical impulses.

P-wave:

Represents the electrical conduction through both atria: Atrial conduction follows the P wave.

PR interval:

Represents the travel time of the electrical impulse from SA node to Purkinje fibers.

QRS Complex:

Represents teh electrical impulse traveled through the ventricles.

QT Interval:

Represents the time needed for ventricular depolarization and repolarization.

Ventilation:

The process of moving gases into and out of the lungs.

Diaphragm:

The major inspiratory muscle of respiration.

Perfusion:

The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blodd to the lungs.

Diffusion:

Exchange of respiratory gases in the alveoli and the capillaries of body tissues.

Chronic obstructive pulmonary disease:

COPD

Spirometry:

Measures the volume of air entering or leaving the lungs.

Anemia and CO2 poisoning:

Are examples of physiological factors that decreased oxygen-carrying capacity of blood.

High altitudes and drug overdoses:

Are examples of decreased inspired oxygen concentration.

Hypovolemia:

Reduced circulating blood volume.

Shock & severe dehydration:

Two causes of extracellular fluid loss and reduced circulating blood volume.

Fever, pregnancy, wound healing & exercies:

Are examples of increased metabolic activity that increases oxygen demand.

Dysrhythmias:

Disturbances in conduction caused by electrical impulses that do not originate from the SA node.

Valvular stenosis:

Abnormal narrowing of heart valves.

Valvular regurgitation:

Causes the backflow of blood into adjacent chamber.

Myocardial Ischemia:

Myocardium does not receive sufficent blood flow from coronary arteries.

Normal sinus rhythm:

There is a P wave for every QRS.

PR Interval:

0.12 - 0.20 and constant

QRS duration:

< 0.10

V-Fib:

Fibrillation is an uncontrolled twitching or quivering of muscle fibers and occurs in the lower chambers of the heart. During ventricular fibrillation, blood is not removed from the heart. Sudden cardiac death results.

V-Tach:

A pulse rate of more than 100 beats per minute, with at least three irregular heartbeats in a row; can develop as an early or late complication of a heart attack.

Increased BNP:

An indicator of heart failure when in the thousands.

60% or more:

The amount of blood ejected from a healthy heart.

40% or less:

The amount of blood ejected from heart in failure.

Stress Echo:

Looks for thickening of muscles in response to exercises; no thickening indicates a potential problem.

Hypoxia:

Inadequate tissue oxygenation at the cellular level.

Hypoventilation:

Alveolar ventilation is inadequate to meet O2 demands or eliminate sufficient C02.

Atelectasis:

A collapse of the alveoli, preventing normal gas exchange.

Cardiac cath:

Visualizes cardiac chambers, valves, the great vessels and coronary arteries. Measures presures and volumes within four chambers.

ECG Exercise stress test:

Evaluates cardiac response to physical stress.

Right-sided Heart failure:

Right ventricle cannot empty completely, blood pools and backs up, pressure and systemic blood flow congestion result, capillary pressure forces fluid into interstitial spaces.

Right-sided Heart failure Symptoms:

Jugular vein distension, enlarged liver & spleen, dependent edema, distended abdomen, anorexia & nausea, weight gain.

Diastolic Left-sided Heart Failure:

L ventricle is unable to relax (called stiffening) and ventricle cannot fill completely; cardiac output decreases.

Systolic Left-sided Heart Failure:

Heart is unable to contract forcefully, preload increases, afterload increases, ejection fraction decreases, tissue perfusion decreases, blood accumulates in pulmonary vessels

Left-sided Heart Failure Symptoms:

Cardiac Output-Oliguria, angina, tachycardia, palpitations, pallor, weak peripheral pulses, cool extremities
Pulmonary: hacking cough, dyspnes & breathless, crackles & wheezes, frothy pink-tinged sputumn, tachypnea

Pursed-lip breathing:

Deep inspiration and prolonged expiration through pursed lips to prevent alveolar collapse.

Chest Tubes:

Catheter placed through thorax, removes air & fluids from pleural space, prevents air re-entry, restablishes intrapleural & intrapulmonic pressures.

Oxygen Therapy:

COPD - 3 L Humidified Air (bubbler) - 4 L

Coughing Techniques:

Cascade-slow,deep breath, hold for 2 sec, cough as exhale
Huff-during exhale, says huff-allows more inhalation
Quad-breathes out max while nurse pushes inward/upward

Diaphragmatic breathing:

Deep breathing

Oropharyngeal suctioning:

Oral suctioning is used when the patient is able to cough effectively but is unable to clear secretions by expectorating or swallowing.

Nasotracheal suctioning:

Necessary when the patient with pulmonary secretions is unable to cough and does not have an artificial airway.

Orotracheal suctioning:

Accomplished through an artificial airway. The artificial airway may be an endotracheal or nasotracheal tube or it may be a tracheostomy tube.

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