CNA: Exam 4 Study Guide

Thoracic Lymph duct collects from what part of the body? Right Lymph Duct? Thoracic: Left side and lower right (below chest). Right: Rt. side from chest up. COPD & CAD Chronic Obstructive Pulmonary Disease / Coronary Artery Disease Hypertension Numbers? Prehypertension Numbers? Normal Numbers? Hypertension: 140+/90+ Prehypertension: 120-139/80-89 Normal: -120/ -80 During a Myocardial Infarction... what is the BP usually? Pulse? BP: Low / Pulse: weak or irregular Pulmonary Edema is what? Fluid in the lungs. Emergency!!! What position is preferred for person's with CAD and pneumonia? Semi-fowlers Cardioversion is the same as ______ Defibrillation to treat dysrhythmia, areas of heart sending abnormal rhythms are destroyed.... a process called_______ Ablation COPD involves what 2 diseases? Chronic Bronchitis and Emphysema Soft tissues of the throat relax and close airway when sleeping Obstructive Sleep Apnea Brain doesn't send signals to the muscles to breathe when sleeping Central Sleep Apnea Most common complication of flu in older persons Pneumonia In pneumonia, Breathing and Pulse will appear to be ______ Breathing: rapid , shortness of breath / Pulse: rapid Can an asymptomatic person with TB spread the disease? How long can a person possibly stay asymptomatic? No / many years Blood in sputum may be a sign of ____ TB Apical pulse is where? Chest Pulse at wrist Radial Pulse Pulse at fold in arm Brachial Pulse Slow heart rate, less than 60/min, is called____ Bradycardia difference between the apical pulse and the radial pulse is called the _______ Pulse deficit Rapid heart rate, 100+/min, is called ____ Tachycardia Vital Signs consist of _____(4) BP, Temp, Pulse, Respiration DUS stands for ______ Doppler Ultrasound Stethescope Normal temperatures for: Oral, Rectal, Axillary, Tympanic Membrane, Temporal Artery Oral: 89.6 / Rectal: 99.6 / Axillary: 97.6 / Tympanic: 98.6 / Temporal Artery: 99.6 Oral glass thermometers are left in place for how many minutes 2-3 minutes For confused patients, what 2 thermometers are best? Temporal or Tympanic What position is used for a rectal thermometer? How far is the insertion? What color are they? Sim's Position / 1/2 inch / Red What pulse is taken during CPR and other emergencies? Carotid Pulse What pulse site is used for children and infants under 2 years Apical Pulse In general pulse rate decreases as we age... normal pulse rate for 12+ years is between _____ 60-100 In order to measure the FORCE of pulse you use____ Your touch. Equipment doesn't measure this. Apical pulses are taken for how long? 1 minute What is used to check a pedal pulse? Why is a pedal pulse taken? Doppler Ultrasound Stethoscope (DUS) / To check foot circulation Respiration rate decreases as we age... Healthy adult respiration is between _____ /minute 12-20 breaths Children respiratory rate and percieved abnormal respiration should be counted for how long? 1 minute After menopause, women's BP tends to ____ Rise In a state of shock, BP tends to be _______ seriously low When lying down, BP tends to be _____. When standing suddenly or changing positions, it tends to be _________ Higher / Lower Alcohol does what to BP Raises it Change in BP due to sudden change in position is called ______ Orthostatic Hypotension Person's with bariatric needs may require this type of BP measuring device Wrist Monitor A person should rest how long before BP is taken? How long if a 2nd test is needed? 10-20 minutes / 30-60 seconds Infants temperature should be taken how? Rectally Atelectasis is _________ Collapse of a portion of a lung Rapid and deep respirations followed by 10-30 seconds of Apnea that occurs with nervous system disorders is called ____ Biot's Respirations Gradual increase in rate and depth of respirations and then become shallow and slow; 10-20 seconds of Apnea may occur. Usually death is near. This is called Cheyne-Stokes Respirations Bluish color to the skin, lips, mucous membranes and nail beds Cyanosis Hemoptysis is ____ Blood in sputum Difference between hypoxemia and hypoxia Hypoxemia, is reduced amount of 02 in blood, Hypoxia is not enough O2 in the cells Very deep an rapid respirations and a signal of diabetic coma. Kussmaul Respirations Breathing deeply and comfortably only when sitting up is called______ ,and this position is called ______ Orthopnea / Orthopneaic Position When breathing stops Respiratory Arrest Slow, weak respirations of fewer that 12 per minute is called._____ . If it is only slow and not weak it is called ____ Respiratory Depression / Bradypnea Tachypnea is how many respirations? 20+ / minute SpO2 means ______ Saturation of Peripheral Oxygen An open airway.... term meaning 'open' Patent measures the amount of oxygen concentration in the blood. Pulse Oximetry What is the normal range of pulse oximetry? 95-100% Bright light, fake nails, nail polish and movements may adversely affect what test? Pulse Oximetry machine that measures that amount of air inhaled Spirometer Flow rate of O2 is in what units? Who sets the rate?(2) Low flow rates- humidified or not? L/min. Nurse or Resp. Therapist / Low flow rates are not humidified Do you give Oxygen? Can you set up oxygen? If no bubbling or water level is low, do you fill it? No / Yes / No (tell nurse) Should oxygen devices be tightly secured? If there are signs of hypoxia, should you turn oxygen up? No, secure but not tight / No...tell the nurse at once blood in the pleural space hemothorax the escape and collection of fluid in the pleural space pleural effusion air in the pleural space pneumothorax ET stands for _____, RT stands for ______ Endotracheal / Respiratory Therapist Obturators should be where after they have inserted the tracheostomy tube? within easy reach for reinsertion if necessary A tracheostomy tube comes out, and hypoxia signs are present. Do you reinsert the tube? No, call for the nurse With a trach tube...shower or tub? Med-alert jewelry or no? Scarf or shirt that would cover the stoma when outside? tub / Med-Alert Jewelry, yes / Yes T/F Hypoxia is not enough oxygen in the blood? False..... in the CELLS trach care is done how often? Daily or every 8-12 hours Tracheostomy secureness shoult be how tight? when is too loose? Fingertip, is right / whole finger is too loose when providing trach care, what 3 things are done? Who does this? Inner tube cleaned, stoma area cleaned, clean ties replace dirty ones (only removed after clean in place) / The Nurse Before suctioning a person with an ET or Tracheostomy tube what must be done? Who does this? hyperventilation of lungs using an Ambu bag / Nurse or RT T/F.... Oxygen is treated like a drug Yes, ....and you do not give drugs Who does suctioning? How long is a suction cycle for an adult? Children? How long between cycles? Nurses...you assist / 10-15 seconds/cycle (adult), 5 seconds/cycle (children) / 20-30 seconds between cycles For mechanical ventilation, what type of tube is needed? (2) ET or Trach Mechanical Ventilation: 1 alarm means what? What do you do? Then what? Reset alarm? Person is disconnected from machine / reconnect the tube / tell the nurse about all alarms / No, only nurses reset alarms T/F.... you can assist a Dr. when he is inserting a chest tube F..... nurse does this Is saliva sputum? Explain No....it comes from salivary glands, sputum comes from respiratory tract Best time of the day for sputum collection? What should the person do first Morning / Rinse mouth with water in older persons postural drainage can assist in sputum cough up using gravity? Can a CNA do this? No....nurses and RT how much sputum is needed for a good sample? 1-2 teaspoons life-threatening sensitivity to an antigen anaphylaxis SCA stands for ________ Sudden Cardiac Arrest BLS stands for _______ Basic Life Support RRT's include what health care professionals? What does it stand for? Doctor, RT, or RN / Rapid Response Team What is EMS? In a nursing home, who activates this? Emergency Medical Services / A nurse According the the AHA... what is the first thing in the Chain of Survival actions for adults Recognizing cardiac arrest and activating EMS at once Agonal breaths/breathing is a sign of what? Sudden Cardiac Arrest abnormal heart rhythm ventricular fibrillation When are rescue breaths given? I breath ever ___seconds for adults, every ____ for children. Check pulse every _____ minutes. If no pulse ___ When there IS a pulse but NO breathing / 5-6 seconds / 3-5 seconds / 2 minutes / begin CPR During possible SCA....check pulse for ____seconds but not longer than ______ seconds 5 / 10 Chest compression rate should be ____ /minute 100 2 breaths are given after how many compressions? If two rescuers, how many compressions? 30 / 15 After 1 shock with a defibrillator, what should you do? resume CPR at once for 5 cycles (30/2) If a person faints, then should wait how long after they feel better before they get up? Should they stand or sit? 5 minutes / Sit Hemiplegia is _____ Aphasia is _____ paralized on one side / unable to speak What color is skin if heat is applied to long? Red or Pale? Pale....blood vessels constrict. What temperature is considered very hot? hot? warm? tepid? cool? cold? Very Hot: 106+ / Hot: 98-106 / Warm: 93-98 / Tepid: 80-93 / Cool: 65-80 / Cold: 50-65 Who applies Very hot applications? How often should you check an application? What is the longest an application should be left on? The Nurse / every 5 minutes / 15-20 minutes Should a heating pad be place under a person or body part? No....heat cannot escape Hyperthermia is what temperature? Hypothermia is what temperature? What blanket is used for each to treat? Hyper: 103+ use a Hypothermia blanket / Hypo: <95, use a hypertherma blanket Incentive spirometry, Coughing and deep breathing prevent Circulatory and Respiratory complications TED hose should be removed every ___ hours for ___ minutes 8 hours for 30 minutes When applying an elastic bandage start at the ____ part of the body and finish at the ____ part of the body. Check every ______ Distal / Proximal / hour Digital removal of a fecal impaction is dangerous how? Stimulation of Vagus nerve can slow heart rate oil-retention enemas should be held in for how long? 30-60 minutes The 5th Vital sign Pain What stage of REM and NREM occurs only once during a nights sleep? How many stages are in NREM? How many cycles occur in a 7-8 hour sleep? NREM Stage 1 / 4 Stages / 4-6 cycles Why are sleeping aids and alcohol bad for your sleep if they promote drowsiness and sleep? They interfere with REM Do TV, talking, bedtime snacks, and flexible bedtimes promote sleep? Yes Who protects a patients interests? Ombudsman During admission, who explains the person's rights to the person and family? The nurse