Bates Chapter 4 Flashcards - Quizlet

Bates Chapter 4 Flashcards | Quizlet
Bates Chapter 4
9/28/16, 10:13 PM
65 terms by quizlette888466
Causes of weight loss
GI diseases, endocrine disorders (DM,

hyperthyroidism, adrenal insuciency);
chronic infections; malignancy; chronic
cardiac, pulmonary or renal failure;
depression; and anorexia nervosa or
bulimia,
Fatigue
Common sx of despression and anxiety

states, but also consider infections (such
as hepatitis, infectious mononucleosis)
endocrine disorders( hypothyroidism,
adrenal insuciency, DM); heart failure;
chronic disease of the lungs, kidneys, or
liver; electrolyte imbalance; moderate to
severe anemia; malignancies; nutritional
defects, and medications.
Weakness
Dierent from fatigue, especially if

localized in a neuroanatomical pattern,
suggests possible neuropathy or
myopathy
Fever, chills, & night sweats
Recurrent skaking chills suggest more

extreme swings in temperature and
systemic bacteremia
Night sweats
Feelings of heat and sweating also

accompany menopause; also occurs in TB
and malignancy
Cardiac or respiratory distress
Clutching the chest, pallor, diaphoresis,

labored breathing, wheezing, cough
Pain
Wincing, sweating, protectiveness of

painful area
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Anxiety
anxious face, fidgety movements, cold

and moist palms, inexpressive or flat
aect, poor eye contact
Dress
excess clothing may reflect cold

intolerance of hypothyroidism, hide skin
rash or needle marks, mask anorexia, or
signal personal lifestyle preferences
Facial expression
the stare of hyperthyroidism; the immobile

face of parkinsonism; the flat or sad aect
of depression
Odors of body/breath
alcohol, acetone (diabetes), pulmoanary

infections, uremia, or liver failure
Preferred posture
preference for sitting up in left-sided heart

failure, and leaning foward with arms
braced in chronic obstructive pulmonary
disease
Movements
fast, frequent movements of

hyperthyroidism, slowed activity of
hypothyroidism
Height
short stature in Turner's syndrome,

childhood renal failure, achondroplastic
and hypopituaritary dwarfism, long limbs
in hypogonadism and Marfan's syndrome,
height loss in osteoporosis and vertebral
compression fractures.
Weight
truncal fat with relatively thin limbs in

cusing's syndrome and metabolic
syndrome
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Causes of weight loss
malignancy, diabetes mellitus,

hyperthyroidism, chronic infections,
depressions, diuersis, and successful
dieting, weight change of >5% body
weight in 6 month period, drugs can
cause weight loss: anticonvulsants,
antidepressants, levodopa, digoxin,
metformin, and thyroid medication.
Ausculatory gap
a silent internal that may be present

between the systolic and diastolic
pressures; may lead to serious
underestimation of systolic pressure; can
be associated with arterial stiness and
atherosclerotic disease
Isolated systolic hypertension
Treatment in pts 60 years or older reduces

total mortality and both mortality and
complications from CV disease, 110/70
could be normal but could also indicated
significant hypotension if past pressures
have been high.
Coarctation of the aorta
Narrowing of thoracic aorta, usually

proximal but sometimes distal to left
subclavian artery
Coractation of aorta and occlusive aortic

disease
Distinguished by hypertension in the

upper extremities and low bp in the legs
and by diminished or delayed femoral
pulses
COPD
prolonged expiration
Orthostatic (postural) hypotension
A fall in systolic pressure of 20 mmHg or

more, especially when accompanied by
symptoms and tachycardia; causes
includes drugs, moderate or severe
weight loss, prolonged bed rest, and
diseases of the ANS.
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Cause of fever
infections, trauma such as surgery or crush

injuries, malignancy, blood disorders such
as acute hemolytic anemia, drug
reactions, and immune disorders such as
collagen vascular disease
Atrial fibrillation
Palpations of an irregularly irregular

rhythm
Four A's to monitor pt outcomes
Analgescia, Activities of daily living,

Adverse eects, Aberrant drug-related
behaviors
Turner's syndrome
very short stature
Marfan's syndrome
long limbs in comparasion with trunk
Osteoporosis
height loss
Fast frequent movement
hyperthyroidism
slowed activity
hypothyroidism
COPD
leaning forward with arms braced
Left sided heart failure
preference for sitting up
Cardiac distress
clutching the chest, pallow, diaphoresis,

labored breathing, wheezing, cough
Pain
wincing, sweating, protectiveness of

painful areas, facial grimacing, unusual
posture favoring one limb over the other
Anxiety or depresssion
anxious face, fidgety movements, cold

and moist palms, flat aect, poor eye
contact, teary, weepy, anxious looking, at
risk for hurting self or others
Parkinson's
masked face (immobile)
Narrow cu size
BP will read high
Larger cu size
the bp will read low on a small arm and

high on a large arm
Tachycardia
>100 bpm
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Brachycardia
<60 bpm
Subclavian steel syndrome, aortic

dissection
Pressure dierence >10-15 mmHg
Isolated systolic hypertension
systolic bp >140 mmHg and diastolic <90

mmHg
Hyperpyexia
extreme elevation in temperature >106

degrees Faren.
Hypothermia
abnormally low temperature below 95

degrees
Causes of fever
infection, trauma, injuries, malignancy,

blood disorders, drug rxns, and immune
disorders such as collagen vascular
disease
Causes of weight gain
edema- extravascular fluid retention from

conditions like heart failure, nephrotic
syndrome, and liver failure. Many drugs
cause weight gain: tricyclic
antidepressants, insulin and sulonylurea,
contraceptives, glucocorticoids, and pre
gestational steroids; mirtazapine and
parozetine; gabapentin and valproate,
and propranolol.
malnutrition
poverty, old age, social isolation, physical

disability, emotional or mental impairment
lack of teeth, ill fitting dentures,
alcoholism and drug abuse
Four steps to promote optimal weight and

nutrition
1. measure BMI and waist circumference,

identify risk of overweight and obesity and
establish additional risk factors for heart
disease and obesity-related diseases 2.
assess dietary intake 3. assess the patient's
motivation to change (Prochaska model)
4. provide counseling about nutrition and
exercise.
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BMI ranges
<18.5 underweight
18.5-24.9 - healthy weight
25-29.9- overweight
Obesity I- 30-34.9
Obesity II-35-39.9
Extreme obesity III- >40
Sodium intake
My plate <2300 mg/day

AHA Institute of medicine <1,500 mg/day
10 tips to a great plate
balance calories, eat less, avoid oversized

portions, eat nutrient-densefoods more
often, make half the plate fruits and
vegetables, switch to fat-free or low-fat
milk, make half of grain intake whole
grains, eat foods high in solids fats, salt
and added sugars less often.
Problems taking BP
cu too large- low BP

cu too small- high BP
arm too high- lower BP
arm too low- higher BP
pulseless due to occlusive diseaseTakayasu arteritis, giant cell arteritis, or
atherosclerosis
Abnormal Korotko sounds
sounds never disappear- aortic

regurgitation
diminished sounds- venous congestion,
gives high or low BP readings
Dierence between arm and leg BP- steal
syndrome and aortic dissection.
BP readings
Normal <120/<80
Prehypertension 120-139/80-89
Stage 1 hypertension 140-159/90-99
Stage 2 hypertension >160/>100
If diabetes or renal disease <130/<80
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hypothermia
exposure to cold, other predisposing

causes paralysis, interference with
vasoconstriction from sepsis or excess
alcohol, starvation, hypothyroidism, and
hypoglycemia. Older adults are more
susceptible.
Nociceptive (somatic pain)
painlinked to tissue damage to the skin

musculoskeletal system or viscera
Neuropathic pain
is a direct consequence of a lesion or

disease aecting the somatosensory
system
central sensitization
alteration of the CNS processing of

seastion leading to amplification of pain
signals
psychogenic
involved the many factors that influence

the patient's report of pain- psychiatric
conditions, cultural norms, social support
idiopathic pain
pain without an identifiable etiology
stages of change model and assessing

readiness
1. pre-contemplation- unaware of problem

no interest in change
2. contemplation- aware of problem
beginning to think of changing
3. preparation- realizes benefits of making
changes and thinking about how to
change
4. action- actively taking steps toward
change
maintenance- initial treatment goals
reached.
recommended diet change for pt with

HTN
increase foods high in potassiumpotatoes, whit beans, beet greens,

spinach, bananas, plantains, tomato sauce
decrease foods high in sodium- canned
food, pretzels, potato chips, processed
foods, batter fried foods, table salt
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Cheyne-stokes breathing
periods of deep breathing alternate with

periods of apnea. Children and aging
people show this pattern while sleeping.
Other causes heart failure, uremia, drug
induced respiratory depression nd brain
damage.
Obstructive breathing
prolonged expiration- COPD patients
ataxic breathing (biot's breathing)
characterized by unpredictable
irregularity. Shallow/deep/apenic periods
etc. Caused by respiratory depression and
brain damage.
Page 8 of 8

Bates Chapter 4 Flashcards - Quizlet

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Bates Chapter 4 Flashcards | Quizlet

Causes of weight loss

GI diseases, endocrine disorders (DM,

Common sx of despression and anxiety

Dierent from fatigue, especially if

Fever, chills, & night sweats

Recurrent skaking chills suggest more

Feelings of heat and sweating also

Cardiac or respiratory distress

Clutching the chest, pallor, diaphoresis,

Wincing, sweating, protectiveness of