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___________________ , another form of malnutrition, occurs when the intake of nutrients EXCEEDS the metabolic needs of the body to maintain normal growth, development, and metabolism.
Overnutrition
Overnutrition can actually develop into obesity, increasing risk for cardiovascular disease, type 2 diabetes, hypertension, cancer, gallbladder disease, and sleep apnea which can affect the _________________.
Immune system
Can alcohol or other diuretic fluids like coffee and soft drinks affect hydration?
Yes
Alcohol, diuretic medications, diabetic clients with severe hyperglycemia, high fevers affect _____________?
Hydration
How any OZ of water should you take a day?
8
What is the most beneficial nutrition status which requires a balance of nutrient intake to meet daily metabolic demands?
Optimal status
Will people with optimal nutritional status have an improved immune system, more energy for activities, and will heal more readily?
Yes
What are the two variations from optimal nutritional status that are two forms of malnutrition?
Overnutrition, under nutrition
Several disorders are associated with undernutrition (i.e. psychiatric disorders that lead to chronic dieting, depression, anorexia nervous, bulimia, dementia). Other reasons can be due to illnesses or medical conditions that come from subtle symptoms early in the disease to profound malnutrition due to ________________ demands late in the disease.
increase energy
What are two conditions that often experience undernutruition due to increased energy demands that normal nutrition cannot cover?
HIV/AIDS
There are two forms of hydration which include dehydration and overhydration. Which type affects those with kidney, liver, and cardiac diseases who have fluid dynamic mechanisms impaired?
Overhydration
Name the first symptoms of foodborne disease or poisoning? (4 of them)
Nausea, vomiting, abdominal cramps, diarrhea
Name the most common allergies? (Think of our kahoot game)
Peanuts, tree nuts, cow's milk, egg, wheat, soy, fish , shellfish, sesame
Name the symptoms of a severe or anaphylactic response (allergy) to food (12 of them)
Swelling of lips, tongue, throat, dysphasia, cyanosis, dyspnea, hypotension, syncope, chest pain, confusion, weak pulse, anxiety
Name the symptoms of a mild anaphylactic response (allergy) to food. (There are 16 of them) these symptoms can be nonspecific and difficult to associate with a particular food
Hives, rash, eczema, redness of the skin, itchy mouth or ear canal, nausea, vomiting, diarrhea, abdominal pain, nasal congestion, runny nose, sneezing, slight dry cough, odd taste in mouth, uterine contractions
Food allergy is an immune system response while __________________ results from a digestive system irritation or when the digestive system is unable to break down or properly digest the food. Symptoms include, nausea, stomach pain, gas, bloating, cramps, heartburn, headaches, irritability, nervousness
Food intolerance
Foods such as spices and herbs have side effects that can interfere with _______________ or with conditions such as coagulation (clotting).
Medications
Many spices that are anti-inflammatory such as turmeric, ginger, and cinnamon have an ______________ effect.
Anticoagulating
Other foods and supplements such green leafy vegetables and coenzyme Q10 have a ____________ effect.
Coagulating
When evaluating anthropometric data, extreme shortness is seen in ___________ and Turner syndrome. Extreme tallness is seen in ___________ and in Marian syndrome.
Dwarfism, gigantism
Make sure to know the calculation to find BMI. A high BMI is associated with different disorders (diabetes, hypertension, hyperlipidemia, etc. ). A BMI of 30 or more is considered _______.
Obese
Excess fat deep within the abdominal cavity is known as ____________ and is associated with higher health risks than subcutaneous fat and may be an independent predictor of health risks even when BMI falls within normal range.
Visceral fat
Right Lung has _____ lobes and Left lung has _____ lobes.
3, 2
________ is identified as the portion of the body extending fro the base of the neck superiorly to the level of the diaphragm inferiority.
Thorax
The lungs, distal portion of the trachea, and the bronchi are located IN the Thorax which makes up the __________.
Lower respiratory system
The outer structure of the thorax refers to as the __________. The thoracic cavity contains the respiratory complenents.
Thoracic cage
The ____________ is constructed of the sternum, 12 pairs of ribs, 12 thoracic vertebrae, muscles, and cartilage. It provides support and protection for important organs including lower respiratory system.
Thoracic cage
The _________ or breastbone, lies in the center of the chest anteriorly and is divided into three parts: manubrium, the body, and the diploid process.
Sternum
The manubrium (top part of sternum) connects laterally with the ________ and the first two pairs of ribs. The collarbones extend from the manubrium to the acromion (top pointy edge part) of the scapula (back shoulder blade).
Clavicle
The U-shaped indentation located on the superior border of the manubrium is an important landmark known as the _____________. A few cm below this is a bony ridge that can be palpated at the point where the manubrium articulates (form a joint) with the body of the sternum.
Suprasternal notch
The 12 pairs of ribs constitute the main structure of the _______. They are numbered superior to interior with the supper being number one. Anteriorly, the first seven pairs articulate with the sternum by way of costal cartilages.
Thoracic cage
What is the normal ratio of the anteroposterior to transverse diameter?
1:2
When you palpate the anterior and posterior thorax, what are you looking for?
Fremit us-symmetrical vibration ("say 99", abnormal / asymmetrical can be obstruction), Crepitus (air in subcutaneous tissue = crackling sound, fine hairs rubbing together), Surface characteristics (feeling for any unusual masses)
You need to assess the anterior and posterior thorax expansion, What are you looking for as you do this?
When patient takes a deep breath, observe if entire back moves symmetrically (you would place the palms of your hands along the coastal margins an point them towards each other at different intervels)
When percussing for tone on the thorax, what are you looking for?
Hyperresonance ( trapped air in emphysema or pneumothorax), dullness
When inspecting the respiratory breaths, what are you looking for as the patient breaths?
Nasal flaring, pursed lip breathing
The patient's nails are a ruddy to purple color, what condition would they might have?
COPD/CHF
The patient's nail beds are over 160, what condition is this?
Early clubbing
The patient's nail beds are over 180, what condition is this?
Late clubbing
Pal or cyanotic nails can be due to ________
Hypoxia
When INSPECTING the configuration of anterior and posterior thorax, you are looking for signs of _________? (3 of them)
Scoliosis, Kyphosis (hunchback), barrel chest
When observing the use of accessory muscles and intercostal spaces, you are looking at the __________ position and the _________ expansion.
Tripod, chest
What are the three types of normal breath sounds that may be auscultated?
Bronchial, bronchovesicular, vesicular
When auscutating lung sounds, you would auscultate from the ________ slightly above the clavicles to the bases of the lungs at the sixth rib.
Apices
When auscultating voice sounds, for bronchophony, you would as the patient to repeat the phrase "_________" while the auscultate the chest wall.
Ninety-nine (99)
When auscultating voice sounds, for Egophony, the patient would repeat the letter "________" while you listen over the chest wall.
E
When auscultating voice sounds, for Whispered pectoriloquy, you would ask the patient to whisper the phrase " _________" while you listen to the chest wall.
One-two-three (1,2,3)
In the Trachea and thorax, A bronchial sounds is what pitch?
High
Over the major bronchi, the bronchovesicular sound is what pitch?
Moderate
Over the peripheral lung fields, the vesicular sound is what pitch?
Low
The 11th and 12th Paris of ribs are called "_________" because they do not connect to either the strum or another pair of ribs anteriorly.
Floating ribs
The "floating ribs" or the 11th and 12th pairs of ribs are attached posteriorly to the _______ and their anterior tips are free and palpable.
Vertebra
The spinous process of the seventh cervical vertebra which is also called vertebra primonens can be easily felt with the client's ______ flexed.
Neck
_____________ is seen in starvation and liver disease.
Abdominal ascites
Petechiae are freckle-like spots on skin that what color?
Red (or pink)
_________ is the severe discoloration of skin due to the rupture of blood vessels below the surface of the skin.
Ecchymoses
Why does height begin to wane in the fifth decade of life because the ________________________ and ________________.
Intervertebral discs become thinner, spinal kyphosis increases
(IBW= Ideal Body weight) What is the formula to calculate the client's percentage of IBW?
Actual weight/ IBW * 100 = %IBW
A BMI of 30 or more is considered ________?
Obese
Is it healthier for the human body to be shaped like an apple or a pear?
Pear
Weight gains or losses of 6-10 lbs in 1 week or less indicate a major ________. A change of 2.2lb (1 kg) is equal to a loss or gain of 1 L of fluid.
Fluid shift
When assessing the client's blood pressure, you need to measure in all 3 positions which include lying, sitting, and standing. When moving from lying to standing position, BP drops more than 20 mmHg, this would indicate a ______________, especially if the pulse rate is also elevated.
Fluid volume defecit
Tenting can indicate fluid loss but it is also present in _________ and _________ in older adults. This finding must be correlated with other hydration findings.
Malnutrition, loss of collagen
Pitting edema is a sign of ____________ especially in cardiac and renal diseases.
Fluid retention
Lower the client' arm or leg and observe how long it takes to fill. Then raise the arm or leg and watch how long it takes to empty. This procure is to assess ____________. Veins fill up and empty in 3-5 seconds. Taking more than 6 seconds suggests fluid volume deficit.
Venous filling
Neck veins can be easier to observe in what position?
Supine
In the supine position with the neck being assessed while the head is at 45 degrees, flat veins may indicate ____________.
Dehydration
When inspecting the tongue, the tongue is dry with visible papillae and several longitudinal furrows. This suggests __________ and ___________.
Loss of normal third-space fluid, dehydration
Sunken eyes with deep, dark circles indicate what?
Dehydration, malnutrition
When auscultating lung sounds, loud or harsh breath sounds indicate a decreased ___________. Friction rubs may also be heard, Crackling indicates increased fluid, as in interstitial fluid sequestration (i.e. pulmonary edema)
Pleural fluid
What 4 laboratory tests can help indicate anemia or other nutritional disorders in obese patients?
Hemoglobin, protein levels, cholesterol, triglyceride values
In the thoracic cavity, the mediastinum contains the trachea, bronchi, esophagus, heart, and great vessels and is the space that lies between the _________.
Lungs
The c-shaped rings help to maintain the trachea's shape and prevent its collapse during respiration. What is the c-shaped rings that compose the trachea called?
(Rings of) Hyaline cartilage
Which main bronchi is shorter and more vertical, Laing aspirated objects more likely to enter the right lung than the left?
Right main bronchus
The bronchi and trachea represent what space isn't eh respiratory system where air is transported but no gas exchange takes place?
Dead space
The bronchi and trachea, which makes up the "dead" space, function primarily as a passageway for both _______ and ________ air. They are lined with the mucous membranes containing CILIA (hair-like projections that help sweep dust, foreign bodies, and bacteria that is trapped by the mucus toward the mouth for removal)
Inspired, expired
As inspired air travels through the trachea into the main bronchi and continued through the system, the bronchi repeatedly bifurcate into smaller passageways known as ______________. These will eventually terminate at the alveolar ducts and air is channeled into the alveolar sacs, which continua the alveoli.
Bronchioles
During a comprehensive physical assessment at a home visit, a client reports chest discomfort. What is the first action of the nurse?
Perform a focused assessment
While assessing the thoracic area of an adult client, the nurse plans to auscultate for voice sounds. To assess bronchophony, the nurse should ask the client to _______.
Repeat the phrase "ninety-nine"
A 62-year-old Pt has a chronic cough and occasional shortness of breath that lasted for almost 1 year. The cough has occasional mucus drainage. No chest pain, weight gain, weight loss, fever, or night sweats. Smokes two packs a day for the last 45 years and drinks occasionally. BP is normal and pulse is normal, respirations are normal. The diameter of the chest seems enlarged and breath sounds are decreased throughout all lobes. Rhonchi is heard over all lung fields. What disorder might this most likely be?
COPD (due to smoking, age, diameter of chest might be barrel chest, rhonchi is heard)
A depression in the lower portion of the sternum is called ____________? Do not confuse with barrel chest****
Funnel chest (pectus excavatum)
True or False: A client with lobar pneumonia would have muffled and indistinct spoken voice sounds.
False
The spinous process termed the vertebra prominent is in which cervical vertebra?
seventh (7)
An assessment of the lungs and thorax reveals excess mucus production and chronic cough. What condition is this?
Bronchitis
The client has been admitted through the emergency department with chronic bronchitis, has elevated CO2 levels, and has been placed on O2. What priority assessment would the nurse include?
Evaluate changes in respiratory pattern and rate
What should be the nurse's initial intervention when adventitious sounds are heard during auscultation of a client's lungs?
Have the client cough and listen again
A high-pitched crowing sound from the upper airway results from tracheal or laryngeal spasm and is called what?
Stridor
Pt has shortness of breath and a nocturnal cough. On auscultation of chest, there is decreased air movement and a high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs. PT has past seasonal allergies. What condition is this?
Asthma
An elderly client reports a feeling of displeasure with normal activities of daily living. What is an appropriate action by the nurse?
Observe the client's respiratory rate and pattern
In respiratory, a pain caused by inflammation of parietal pleura is usually described as a sharp, stabbing pain that increases with deep breathing is called?
Plaurisy
True or False. A burning sensation with a cough may be seen in tracheobronchitis.
True
__________ pain is often squeezing or burning, a sharp or tight feeling in the chest as if something is stuck in the throat. If acid reflux is the cause of esophagitis, the pain may be worse after meals or lying flat. Antacids or belching may relieve it.
Esophageal
White or mucous sputum is often seen with __________.
Common colds, viral infections, bronchitis
Yellow or green sputum is often associated with _________.
Bacterial infections
Brown or Black sputum indicates ___________ and is seen with more serious respiratory conditions.
Blood in the sputum (hemoptysis)
Rust-colored sputum is associated with _________.
Tuberculosis (TB), pneuomoccal pneumonia
Pink, frothy sputum may indicate ___________.
Pulmonary edema
What two classes of medications are associated with the side effect of persistent cough and be contraindicated with some respiratory problems like asthma?
Beta-blockers, ACE-inhibitors
Poor _________ status is often seen in clients with COPD and is a predictor of mortality. There appears to be an " obesity paradox" in COPD clients; obesity seems to have a protective effect.
Nutritional
Vaping or electronic cigarettes are a popular alternative to smoking and are a form of _____________ (for teens who never smoked before).
Recreation