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131 terms

Principles Exam 2

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Normal Temperature Range:
96.8 - 100.4 Fahrenheit
36 - 38 Celsius
Normal Pulse Range:
60 - 100 Beats Per Minute
Normal Blood Pressure:
120/80
Normal Respiratory Rate:
12 - 20 breaths per minute
Normal Oxygen Saturation Range:
95 % or greater
Body Temperature:
Heat produced minus Heat Loss
Core Temperature can be measured by:
Rectum, Tympanic Membrane, Temporal Artery, Esophagus, Pulmonary Artery, Urinary Bladder
Surface Temperature can be measured by:
Skin, Oral, Axillary
Hypothalmus
Anterior Hypothalmus
Posterior Hypothalmus
Controls body temperature
Regulates Heat Loss
Regulates Heat Production
Vasodilation:
Widening of blood vessels that inhibits heat production
Vasoconstriction:
Reduces blood flow by narrowing of blood vessels
Heat production occurs through:
Basal Metabolic Rate
Voluntary movement (exercise/activity)
Shivering
Nonshivering thermogensis (in neonates)
Heat loss occurs through:
Radiation-transfer w/out contact (vasodilation)
Conduction-transfer w/direct contact (hot or cold object)
Convection- transfer w/air movement (fan)
Evaporation-transfer from liquit to gas (sweat)
Thermoregulation:
Controlled by hypothalamus; located between cerebral hemispheres
Skin temperature regulation:
Subcutaneous tissue & fat insulates, keeping heat inside body
Factors affecting body temperature:
Age-
newborns- loose up to 30 % heat through head
child-until puberty temp regulation unstable
Elderly-tends to be lower
Hormonal Level-
Woman experience greater fluctuations
Variations during menstrual cycle & menopause
Hot flashes:
Are caused by inability to control vasodilation and vasoconstriction
Exercise increases temperature by:
Stimulating muscle activity, requiring increased blood supply and increased carbohydrate & fat breakdown
Circadian rhythm:
Changes body temperature
Temperature maxes out by 6 pm
Temperature is lowest between 1 -4 am
Can be changed by people working night shift-takes 3 wks
Pyrexia:
Fever (temperatures above 100.4 / 38 c)
Causes of Pyrexia (fever):
Hypothalamus unable to keep "set point"
Pyrogens
Dehydration
Ambient temperature/humidity
FUO-fever of unknown origin
Fever has the ability to:
Increase Oxygen demands
Increase metabolism
Stress cardiac & respiratory systems
(is an important defense mechanism)
Sustained Fever:
Temp over 100.4 w/ NO fluctuation
Intermittent Fever:
Fluctuation between febrile & afebrile
One afebrile reading in 24 hr period
Remittent Fever:
Fluctuation of temperature but always febrile
No return to afebrile at any time
Relapsing Fever:
Periods of febrile and afebrile temperatures; periods often longer than 24 hrs each
How mild temperatures help immune system:
WBC production is increased, iron concentration is reduced, suppressing growth of bacteria
Hyperthermia:
Temperature over 104 (may go as high as 113)
Malignant Hyperthermia:
Rapid rise in core body temperature that happens when anesthesia is administered;
Caused by hereditary
Heat stroke:
Heat depresses hypothalmic function;
If patient becomes unconscious w/non-reactive pupils, permanent neurological will occur if cooling measures aren't started immediately.
Causes of Heat Stroke:
Prolonged exposure to sun or high environmental temperatures; most common in high humidity
Signs of Heat Stroke:
Giddiness, Muscle Cramps, Confusion, hot-dry skin, delirium, dry mucous membranes, excessive thirst, increased Heart Rate, Nausea, Decreased Blood pressure
Heat Exhaustion:
Loss of water and electrolytes by profuse diaphoresis (profuse sweating) from heat exposure
Symptoms of heat exhaustion:
Rapid thready (weak) pulse
Postural hypotension (low bp)
Dry mucous membranes, poor skin turgor, thirst,
confusion, Rapid weight loss, slow vein filling,
Flat neck veins, lethargy & Oliguria (decreased urine output >30L/hr)
Heat Emergency managment:
Cooler environment, remove excess clothing,
cool wet towels on skin, fan, IV fluids,
Hypothermia blankets, cool slowly
Hypothermia:
Prolonged exposure to cold
Body temperature from 86 - 96.8 F
Uncontrolled shivering at 95 F
Symptoms of hypothermia at 94 degrees:
Decreased HR, Resp rate, BP, cyanotic skin,
Progressive-cardiac dysrhythmias, unconsciousness, decreased response to painful stimuli
Frostbite:
Ice crystals from inside cell, causing permanent damage
Susceptable areas to frostbite:
Earlobes
Tip of the nose
Fingers
Toes
Appearance of Frostbite:
White, waxy, firm to touch
Loss of sensation in area
Cold Emergency Management:
Gradual warming, protect injured area, warmed fluids
prevent further heat loss-remove wet cloths, layer clothing, body to body heat
Celsius to Fahrenheit conversion factor:
°C x 9/5 + 32 = °F
Fahrenheit to celsius conversion factor:
(°F - 32) x 5/9 = °C
Axilla temperatures:
Safe for newborns and unconscious
Pulse:
The indicator of circulatory status
What causes the pulse:
Electrical impulses originate in the SA Node and travel to heart muscle to stimulate contraction
Ventricular contraction:
60-70 mL of blood enter aorta
Stroke Volume:
Volume of blood pumped from one ventricle of the heart with each beat
Cardiac Output:
The amount of blood pumped by heart per minute
Pulse rate x stroke volume
Average 5000 mLs per minute
Dyspnea:
Difficulty breathing
Infant range pulse:
120 to 160 bpm
Apical pulse:
Provides most accurate assessment of heart function
Infant/child pulse locations:
Brachial or apical
Pulse strength:
Bounding 4 +
Strong 3+
Weak 2+
Thready 1+
Absent 0
Heart sounds are:
High pitched (use diaphragm)
Bowel, lung & heart sounds are:
High pitched
Heart & vascular sounds:
are low pitched (use bell)
Tachycardia:
Pulse over 100 BPM
Bradycardia:
Pulse under 60 BPM (except in infants)
Factors that effect pulse:
Exercise, temperature, emotions, drugs, hemorhage, postural changes, pulmonary conditions
Pulse deficit:
Difference between apical & radial pulse (ineffective contraction)
Irregular rate:
Arrhythmia or dysrhythmia
Ventilation:
Movement of gases in and out of lung
Diffusion:
O2 & CO 2 exchange between alveoli & RBC's
Perfusion:
Distribution of RBC's to and from pulmonary capillaries
Tidal Volume:
Air inhaled (500 mL)
Factors affecting respiration:
Exercise, pain, anxiety, smoking, body position, medications, neurological injury, hemoglobin
Blood Pressure:
Force exerted on walls of artery measured in mm/Hg
Systolic:
Peak of maximum pressure when ejection occurs
Diastolic:
Minimal pressure exerted against arterial walls at all times
Hematocrit:
Percentage of RBC's in blood
Hypotension:
<90/60
Decreased blood flow to vital organs
Dilation of arteries
Decreased Urine output
Hypertension:
Asymptomatic
Thickening of walls
Loss of elasticity
False Low Pressures:
Cuff to wide
False High Pressures:
Cuff to narrow, cuff to loose,
Auscultatory Gap:
The interval of pressure where Korotkoff sounds indicating true systolic pressure fade away and reappear at a lower pressure point during the manual measurement of blood pressure
Every day of non-movement:
Results in 3% of daily loss of muscle strength
Body Balance:
Achieved by low center of gravity & wide base of support
Friction:
A force that occures in a direction opposite to the movement
Isotonic:
Normal contraction & flexion
Walking, swimming, dance,etc.
Isometric:
Tighten muscles without movement of parts
Bones:
Support framework
Mineral storage
Blood cell formation
Fibrous joints:
Closed and fixed
Synovial joints:
Move freely
Cartilaginous joints:
Little movement, elastic, separate surfaces
Synostotic joints:
No movement; bone to bone
Ligaments:
Bind joints
Connect bones and cartilage
Joint flexibility and support
Tendons:
Connect muscles to bones
Cartilage:
Nonvascular
Supportive tissue
Shock absorber between articulating bones
Movement:
Muscle group- lever system of bones causing movement
Posture:
Muscle group-
Muscles excert pull on bones in opposite direction;
Gravity continually pulls on parts of body
Synergistic:
Muscle group-
Working muscles (biceps, brachialis)
Two active movers-one antagonistic
Antigravity:
Muscle group-
Stabilizes joints & allow standing & sitting
Antagonistic:
Muscle group-
Work against each other
Movement at the joint
Active mover contracts with antagonistic relexes
Nervous System:
Regulates movement and posture
Major voluntary motor area:
Located in cerebral cortex
called Precentral Gyrus or Motor Strip
Left motor strip fibers initate voluntary movement on right side of body; right side initates left...
Proprioception:
Awareness of the position of the body and its parts
Nerve endings in muscles, tendons, joints
Balance:
Cerebellum (controls voluntary movement)
Inner Ear
Disorders of bones, joints and muscles:
Osteoporosis, arthritis, degenerative changes
Stratum Corneum:
Outermost layer of epidermis
Protects
Maintains hydration
Epidermis:
Top layer of skin
Functions to restore skin
Dermis:
Inner layer of skin
Strength & elasticity
collagen, blood vessels & nerves
Largest organ of body:
Skin
15 % of body weight
Pressure Ulcers:
Also called a decubitus ulcer
Localized Injury
Bony Prominence
Pathogenesis:
Step by step development of a disease and the chain of events leading to that disease due to a series of changes in the structure and/or function of a cell/tissue/organ being caused by a microbial, chemical or physical agent.
Risk Factors for pressure ulcer development:
Impaired sensory perception, imparied mobility, friction, moisture, shear, alterations in LOC
4 common spots for pressure ulcers:
Elbows, sacrum, hip and heels
Areas w/little fat over bony prominences are common sites
Stage 1:
Persistent red, blue, or purple area of skin; no open areas
Stage 2:
Partial thickness skin loss; looks like an abrasion or blister
Stage 3:
Full thickness skin loss
Damage and/or necrosis of subcutaneous tissue
Deep crater
Stage 4:
Full thickness skin loss w/extensive destruction, necrosis or damage to muscle, bone and other structures
Granulation tissue:
New tissue, young, fragile cells
Slough:
Stringy material attached to wound bed
Eschar:
Necrotic tissue which must be removed before healing can occur.
Edema:
Abnormal accumulation of fluid under skin
Exudate:
Any fluid that filters from the circulatory system into lesions or areas of inflammation.
Primary Intention:
Wound is approximated, clean edges, mainimal risk for infection and scarring
Secondary Intention:
Tissue loss, gaping, irregular wound, epithelium heals over scar; wound is left open until it becomes filled by a scar.
Tertiary intention:
Delayed closure, wide scar; heals from base of wound
Concomitant medical conditions:
Concurrent medical condtions; existing at same time
Polypharmacy:
The use of two or more drugs together, usually to treat a single condition or disease
Ischemia:
A restriction in the supply of blood to a body part (ex: tissue) that is due to obstruction of the inflow of arterial blood
Sheer:
Causes damage to the Dermis by stretching and angulation of tissue capillaries
Friction:
Causes damage to the Epidermis from mechanical force when skin is dragged across a coarse surface
Serous:
Clear, watery plasma
purulent:
Thick, yellow, green, tan or brown
Serosanguineous:
Pale, red, watery: Mixture of clear and red fluid
Sanguineous:
Bright red, indicating active bleeding
Hematoma:
Localized collection of blood underneath tissue
Dehiscence:
Partial or total separation of wound layers
Evisceration:
Protrusion of visceral organs through wound openin.