maintenance of a stable internal environment
temperature, pulse, respiration's, and blood pressure also known as cardinal signs
measures of height, weight, and skin-fold thickness to evaluate muscle atrophy
patterns of activity or behavior that follow day-night cycles
relating to a fever (elevated temperature)
fever or febrile condition
rises and falls only slightly during the 24 hour period
fever that alternates between elevated and normal or subnormal body temperatures
Fever that alternately rises and drops, but which has no interval of normal body temperature
slow heart rate, usually below 60 beats per minute
abnormally rapid heartbeat (over 100 beats per minute)
condition in which the radial pulse is less than the apical pulse; may indicate peripheral vascular abnormality
the number of pulse beats per minute
abnormal rhythm; irregular heartbeat
pulse in which beats are occasionally skipped
irregular heartbeat originating in the sinoatrial node
a pulse with an increased volume that feels very strong and full
A PULSE WHICH IS SCARCELY PALPABLE; SMALL, FINE
a single complete act of breathing in and out
instrument that measures the volume of inhaled and exhaled air
difficult or painful breathing
respiration's that are regular in rhythm but slower than normal in rate
absence of breathing, cessation of breathing
Rapid Shallow breathing
increase in depth and rate of breathing
EXCESSIVE DEEP AND FREQUENT BREATHING, USUALLY ASSOCIATED WITH EMOTIONAL TENSION OR ANXIETY
Abnormal respiratory symptom in which a person must sit or stand to breathe deeply or comfortably.
a high pitched sound heard on expiration; it indicates obstruction or narrowing of respiratory passages
abnormal crackling sound made during inspiration
Abnormal rumbling sounds on expiration that indicate airway obstruction by thick secretions or spasms.
Strenuous respiratory effort marked by a snoring sound.
Highest pressure level that occurs when the heart is contracting and the first pulse beat is heard.
The lowest pressure level when the heart is relaxed and the last sound is heard.
the pressure of the circulating blood against the walls of the blood vessels
difference between systolic and diastolic pressure
elevated blood pressure of unknown cause that develops for no apparent reason; sometimes called primary hypertension
high blood pressure caused by the effects of another disease (e.g., kidney disease)
high blood pressure
low blood pressure
abnormally low blood pressure when the person suddenly stands up.
instrument to measure blood pressure
Factors that influence vital signs
nervousness, drinking hot or cold beverages before taking temperature, being angry, fearful, anxious, or apprehensive.
Correct method of taking vital signs
Accuracy is vital
Signs of fever
loss of appetite, headache, thirst, flushed face, hot skin, and general malaise, person experiences chills, shivers, feels cold
Symptoms of lack of oxygen
blue finger tips, blue lips, vertigo, chest pain, and numbness in fingers and toes.
Symptoms of hypertension
Can be a silent killer with no symptoms, but some symptoms may include blurred vision, angina, vertigo, dyspnea, fatigue, headaches, flushing, nosebleeds, and palpitations.
Common causes of errors in BP readings
incorrect calibration, limb used for calibration is not at heart level, pressure is released to rapidly, cuff is improperly applied, cuff is wrong size.
Guidelines for ordering or developing educational materials
material should be written in any language at a 6th-8th grade level to promote pt. understanding. info should be organized and clearly described, all materials should be checked for accuracy. handouts should be attractive and professional. copies should be available in other languages when possible and in large print for visually impaired clients.
substances in food that your body needs to grow, to repair itself, and to supply you with energy
Types of carbohydrates and examples
SIMPLE SUGARS (table sugar, molasses, honey candy baked goods, and milk), COMPLEX CARBOHYDRATES ie. STARCH (whole grain products, cereal, pasta, rice, grain, potatoes, legumes, fruits, vegetables, and seeds), and DIETARY FIBER (bran, oatmeal, whole grain breads, beans, fruits, vegetables, seeds, and dried fruit).
Functions of vitamins
regulate synthesis of body tissue/ helps metabolize macronutrients/prevents deficiencies/serves as antioxidants
emphasis good nutritional balance.
the process in which nutrients are used at the cellular level for growth and energy production as well as excretion of waste.
rates the foods on how quickly they affect blood glucose levels
come from transfatty acids; fatty acids man-made; unsaturated fatty acid molecule are altered structurally.
Functions of protein
Important for growth ,tissue growth and healing and repairing our tissue.protein foods make up muscle,blood,bone,cell membrane and enzymes.
Functions of water
helps body tissues absorb nutrients, helps move waste material through the body Our body is made up of 80% of this substance
Organic food guidelines
must have been produced without exposure to pesticies, chemical fertilizers, or sewage sludge. Animals cannot be given antibiotics or growth hormones must be fed organic fees and have access to the outdoors.
Food-borne illness symptoms
Nausea, vomiting, stomach pain, and diarrhea
Febrile rectal, temporal, or Aural temperature
anything over 100.4
Febrile oral temperature
anything over 99.5
Febrile Axillary Temperature
anything over 98.6
FUO "Fever of Unknown Origin
anything over 100.9 that last 3 weeks in a n adult or 1 week in children without a relater known diagnosis.
the sounds heard in the stethoscope while taking blood pressure
Korotkoff phase one
a sharp thump or tapping sound
Korotkoff phase two
a blowing or whooshing sound
Korotkoff phase three
a crisp, intense tapping
Korotkoff phase four
a softer blowing sound that fades
Korotkoff phase five
Normal body temperature for newborn
Normal body temperature for 1 year
Normal body temperature for 6 years to adult
Normal body temperature for elderly over age 70
Hand-held, battery-operated device that registers temperature and displays reading as numbers. Can be used whenever but not recommended if the pt. has recently been drinking something.
Device for measuring the temperature using the blood flow through the tympanic membrane, or eardrum. If the pt. has an earache another method for taking temperature should be used.
Temporal artery scanner
uses an infrared beam to assess the temperature of the blood flowing through the temporal artery of the lateral forehead.
take body temp. through armpit
Only used once reading obtained by heat sensitive material that changes color according to the elevation of temperature.
Pulse on each side of temple: temporal artery
pulse located in the neck
pulse taken with a stethoscope and near the apex of the heart
pulse found on the inner aspect of the elbow
pulse of the radial artery (felt in the wrist)
Over the femoral artery in the groin
Pulse felt at the back of either knee; lower part of femoral artery
dorsalis pedis pulse
Pulse on the top of the foot lateral to the large tendon of the big toe.
What are three characteristics of respiration?
rate, rhythm, and depth
Three factors that affect body temperature
age, stress, gender
Five stages of grief
Denial & isolation, anger, bargaining, depression, acceptance. "DABDA"
The following factors affect the patients response to a diagnosis. "Holistic model"
emotional, social impact, intellectual impact, economic impact, spiritual impact.
Perceived susceptibility / how to handle it
patient's opinion on the chance of getting the disorder / supply info on the risk level; individual risk is based on health habits and family history.
perceived severity / how to handle it
patient's opinion on the seriousness of the condition and it's health risks. / outline the potential complications of the disease.
perceived benefits / how to handle it
Patient's belief in the value of altering lifestyle factors and complying with treatment. / Emphasize the positive results than can occur if the patient complies with healthcare recommendations.
Perceived barriers / how to handle it
Patient's opinion on the financial and psychological costs of compliance. / Identify patient barriers and work ro reduce them through patient education, family outreach, and us of community resources.
Cues to action / How to handle it
Methods developed to activate patient compliance. / one on one education interventions; detailed handouts; family involvement in education efforts; follow up at subsequent office visits; referral to community resources.
Self-efficacy / how to handle it
Patient has the confidence to take action to achieve a healthier state. / ongoing education and support.
Guidelines for patient education
Provide knowledge and skills to promote recovery and health.
Encourage pt. ownership and participation in the teaching process.
Include the family and significant others in education interventions, with the pts. approval.
Promote safe, appropriate use of medications and treatment.
Encourage pt. adaptation to healthy behaviors.
Provide information about accessing community resources.
Approaches for language barriers
Address pt. by his/her last name. use a formal approach to communication, use gestures tone of voice and eye contact emphasize appropriate parts of the discussion. use pictures, handouts, models, and other aids that visually depict the material, monitor pt. body language to see if they are confused. use simple everyday words. demonstrate all procedures and have them return demonstration. teach in small manageable steps. give written instructions and use interpreter if possible.
Potential learning barriers for pts.
individual learning style, age and developmental level, use of defense mechanisms, language, motivation to learn, physical limitations or disabilities, emotional or mental state, cultural or ethnic background, pain, time limitations.
Perform and assessment
consider pertinent patient factors, identify learning barriers, prioritize patient information.
Determine pts immediate and long term needs
Decide on the appropriate teaching materials and methods, demonstrate techniques that will be used at home. provide positive feedback.
Maintain an adequate pace while teaching
don't move too quickly through the material/information
Repeatedly ask for pt. feedback because
learning barriers eliminated, immediate learning needs can be addressed. repetition and rephrasing promote understanding.
document teaching intervention
materials covered, pt. response and skill level, plan for next meeting, community referrals.
evaluate teaching plan
was there enough time? was the pt. ready to listen and understand info? were all goals reached?
Go over everything again quickly just to make sure they understand.
Substances that must be obtained in the diet because the body either cannot make them or cannot make adequate amounts of them.
nutrients the body can produce on its own and doesn't need from the outside.
Seven food constituents
carbohydrates, proteins, fats, water, minerals, vitamins, and fiber.
total Cholesterol levels for ages 2-20
anything less than 170 is acceptable
170-199 is borderline
above 200 is high
total Cholesterol levels for ages 20 and up
anything less than 200 is acceptable
200-239 is borderline
240 and up is high
LDL Cholesterol levels for ages 2-20
under 110 is acceptable
110-129 is borderline
130 and up is high
LDL Cholesterol levels for ages 20 and up
anything less than 130 is acceptable
130-159 is borderline
160 and up is high
Fat soluble vitamins
A, D, E, K, vitamins that dissolve in and are stored in fat
Water soluble vitamins
absorbed with water, excreted through urine, cannot be stored, C, B complex
Viscous fiber found in oats, barley, peas, and citrus fruits. lowers cholesterol and reduces risk of heart disease.
passes through intestine unchanged, cleans them out and encourages mucus production, wheat bran, fruit, vegtables decrease risk of colon cancer and diverticulitis, increase GI mobility
Plant material that cannot be digested or absorbed. also called "roughage"
Is the building phase it builds large molecules from simple ones; requires energy
Is the breaking down phase it breaks down more complex substances into simpler ones with release of energy
combination of mechanical and chemical processes that occur in the mouth, stomach, and small intestine.
High fiber diets
When the amount or bulk of fiber is increased.
Low Fiber diets
When the amount or bulk of fiber is decreased.
A fat that is solid at room temperature and found in animal fats, lards, and dairy products.
A fat that is liquid at room temperature and found in vegetable oils, nuts, and seeds.
Proteins containing all the essential amino acids; found only in soy and animal foods (meats and dairy products)
Proteins that are missing one or more of the essential amino acids; found in plant sources such as nuts and legumes
extreme eating behaviors that can lead to serious illness or even death
lack or loss of appetite for food. Self starvation to obtain thinner body
eating disorder characterized by excessive eating followed by purging
excessive body weight; corpulence 60 % of the American population is affected by this.
Heart healthy Diet
1. decrease fat and cholesterol intake
2.low fat protein source
3. avoid salt
4. increase fiber
5. decrease alcohol intake
6. DASH ( dietary aproaches to stop hypertension)
include both clear liquids and full liquids. Patients with acute infections or digestive problems use this diet A clear liquid diets only allows for clear liquids, while a full diet also allows for milk and creamed liquids
Soft or Light diet
No roughage (raw fruits or vegetable), No strongly flavored or gas forming vegetables and spices are limited. used after surgery.
Mechanical soft diet
Foods that are prepared with blender, food processors, or cutting utensils. Does not limit spices, fat, & other fiber. Only texture of food changes.
a diet of foods that are not irritating, this includes spicy foods & citrus juices, used for people who have intestinal problems or condition such as Crohn's disease or irritable bowel syndrome.
an investigational short term, or possible life long, eating plan that omits one or more foods suspected or known to cause an adverse food reaction or allergic response
a diet designed to help control the symptoms of diabetes
Must be at least 1/3 fewer calories then in regular product
raw, never frozen, processed or preserved
less than 5 calories per serving
less than .5 grams of sugar
less than 5mg of sodium per serving
less than .5 grams of fat per serving
saturated fat free
less then 2 grams of saturated fat per serving
provides more than 20% of the recommended daily consumption of the nutrient.
cooked meat or poultry with less than 10.5 grams of fat of which less than 3.5 grams is saturated fat.
cooked meat or poultry with less than 4.9 grams of fat which less than 1.8 grams is saturated fat.
less than 140 mg of sodium
less than 40 calories
3 grams or less of fat.
Vitamin A - carotene
fat soluble, helps with skin/ vision and reproduction & makes white blood cells, sources= dairy, liver, dark fruits and veggies
Vitamin B1 - thiamine
helps brain and nerve cells stay healthy- found in brown rice, whole grains, cereals, milk, meat, fish, eggs and potatoes.
a vitamin found in fresh fruits (especially citrus fruits) and vegetables
fortified milk, sunlight, fish, eggs, butter, fortified margarine
fortified and multi-grain cereals; nuts; wheat germ; vegetable oils' green, leafy vegetables.
Green, leafy vegetables; fruit; dairy and grain products.
Sitting upright, Semi-sitting position in which head of bed is raised to an angle of at least 45 degrees. Knees may be flexed or horizontal
Patient lies flat on back with arms at their sides
Dorsal recumbant position
pt is flat on back with knees and hips bent sharply and feet flat on table
lying on the back with the feet and legs raised and supported in stirrups
on left side, right leg drawn up high and forward, left arm along back, chest forward resting on bed. Used for kidney and uterine surgery
lying face down
left lateral position
lying down on the left side
knee chest position
on knees, head and upper chest on table, arms crossed above head
abnormal sound or murmur heard on auscultation
a person's manner of walking
located between cells
A physical injury or wound caused by external force or violence.
white of eye
movement of the body by applied force
the rhythmic contractions of muscles causing wavelike motions that move food down the GI tract
Use observation to detect significant physical features or objective data
use the sense of touch to feel any condition or irregularity.
Tapping or striking he body with fingers or small hammer
Use stethoscope to listen to sounds arising from body
Measuring height, weight, length, and diameter of head, size of wound etc...
What to note in vitals regarding Nutrition and stature
Any immediately obvious deformities, body build and proportions
What to note in vitals regarding speech
No voice, loss of speech expression, lack of coordination or ability to put words together correctly to form sentences, slurred or incoherent speech, or jumbled speech.
What to note in vitals regarding skin
skin turgor, (pinching the skin to see how quickly it returns to normal), extreme dryness, scaling, extended time for wound healing, frequent breaks in the skin, brittle grooved nails or lined nails fingertip clubbing, spooning of the nail.
What to note in vitals regarding Breath odors
poor oral hygiene or dental care. acetone odor, which is sweet and fruity musty odors or ammonia smells
What to note in vitals regarding head
skull, scalp, and face are palpated for size, shape, and symmetry. excessive hair on face or nodules masses or signs of trauma
What to note in vitals regarding Eyes
pupils reaction to light, color of sclera, movement of eye, damaged blood vessels.
What to note in vitals regarding ears
inflammation, ear wax, tympanic membrane, color of eardrum movement of tympanic membrane.
What to note in vitals regarding nose and sinuses
color, texture, transillumination of maxillary and frontal sinuses. palpation of sinus
What to note in vitals regarding mouth and throat
teeth and gums, pallatine tonsils, floor of mouth, check for enlarged lymph nodes.salivary gland function, and ulcerations.
What to note in vitals regarding neck
movement, thyroid gland is checked,swallowing, carotid artery checked, lymph nodes
What to note in vitals regarding reflexes
biceps, knee jerk, ankle jerk, plantar reflexes
What to note in vitals regarding chest
chest, heart, and lungs.
fainting or losing conciousness
rumbling sounds on expiration
cracking sounds during inspiration
What to note in vitals regarding abdomen
ausculate the abdomen in all four quadrants to check for complete bowel sounds palpates for any abnormalities. percussion may be used to check for density, position, and size of underlying abdominal organs.
how to check Breast and testicles
visually and by palpation.
How to check rectum
visual inspections using light