Download BSNC 1000: Solutions for Mobility, Osteoporosis, Cognition, Stress, and Atherosclerosis and more Exams Nursing in PDF only on Docsity!
BSNC 1000- Final Questions with solved
solutions
What warrants a comprehensive risk assessment for mobility? - ANSWER>>- Older person who presents with acute fall (with injury)
- Has difficulty with gait or balance
- Reports two or more falls in last 12 months
Risk of falls assessment - ANSWER>>- Medial hx, physical exam, cognitive and functional assessment
- Hx of falls, medications, problems with gait, balance, mobility, vision, neurological impairments
- Reduced muscle strength with HR, footwear, environmental hazards
Interventions for poor mobility - ANSWER>>- Assisted devices, protective equipment
- Clinical disease management
- Education
- Environmental modification
- Exercise
- Med review
- Nutrition review
- Vision referral
What is the impact of osteoporosis on mobility in older adults? - ANSWER>>
How do nurses health clients manage osteoporosis? - ANSWER>>
How do nurses promote mobility? - ANSWER>>
How do nurses prevent complications of impaired mobility? - ANSWER>>
Mobility definition - ANSWER>>State of being mobile/moveable
What ADLS does mobility involve? - ANSWER>>Eating, transferring, dressing, bathing, walking, toileting
What systems effect mobility? - ANSWER>>Nervous and musculoskeletal system
Risk factors for older adults and mobility - ANSWER>>- Age
- Falls= more hip fractures among women
- Stroke, head injury, illness, nutrition deficiencies
Assessment hx cues - ANSWER>>- Pain with movements, mobility/balance impairment, fatigue, falls, ADL changes
Primary Prevention for impaired mobility - ANSWER>>- regular physical activity, nutrition, body weight, rest, environment safer, lighting, footwear, vision impairment
Secondary prevention for impaired mobility - ANSWER>>- Osteoporosis screening, fall assessment, gait and balance assessment
Osteoporosis definition - ANSWER>>- A systemic disorder characterized by low bone density and micro-architectural deterioration
Non modifiable risks for osteoporosis - ANSWER>>- Age, female genetics, ethnicity
Modifiable risks for osteoporosis - ANSWER>>- Peak bone mass
- Alcohol
- Smoking
- Low ca or vit d
- Poor activity
- Women= poor health status, dependency, lack of social support, insomnia
- Men= Hx of stroke or diabetes
Risk factors for cognitive impairments - ANSWER>>Personal behaviours, environmental exposures, congenital or genetic conditions, health related conditions
Dementia definition - ANSWER>>- A syndrome: a collection of signs and symptoms associated with cognitive impairments severe enough to reduce a persons ADLs
- Acquired, involves more than one domain
Epidemiology of dementia - ANSWER>>- Not a normal part of aging
Vascular dementia - ANSWER>>- Group of brain disorders primarily caused by cerebrovascular disease
Non-modifiable risk factors of vascular dementia - ANSWER>>- Age
Modifiable risk factors of vascular dementia - ANSWER>>- Cardiovascular disease
- Recurrent strokes
- Diabetes mellitus
- Dyslipidemia
- Lifestyle
Pathogenesis of vascular dementia - ANSWER>>- Ischemic or infect injuries to part of the brain leading to brain damage
Hemorrhagic - ANSWER>>- Disease or weakened blood vessel can rupture or bleed into brain
Ischemic - ANSWER>>Narrowed or blocked blood vessel can impede blood flow or systemic hypoperfusion
Clinical manifestation of vascular dementia - ANSWER>>- Nature of vascular pathology
- Number of blood vessels involved
- Location and degree of damage
6 domains neurocognitive domains - ANSWER>>1. Perceptual-motor function
- Language
- Executive function
- Complex attention
- Learning and memory
- Social cognition
Populations at risk for stress - ANSWER>>- women
- 45-64 years old
- Hispanics
- Lower income, young adults
Risk factors for stress - ANSWER>>- Financial strain
- Leads to stressful relationships, occupational stress, strained family relationships
- Caregivers= chronic stress
- Brain disease or impaired cognition
Signs and symptoms of stress - ANSWER>>- Irritability, nervousness, anxiousness, fatigue, overwhelmed, depressed, sad
- Hair loss, lack of concentration, dizziness, sweating, back pain, tightening of chest, palpitations
Adaptive coping practices for stress - ANSWER>>lifestyle chances, relaxations, exercise, medication
Causes of endothelial cell injury - ANSWER>>-HTN
- Chemicals, toxins
- Hypoxia, stress
- Elevated glucose or lipid levels
- Cell aging
- Inflammation and infection
Lipoproteins - ANSWER>>- Spherical particles composed of lipids ands surface proteins
- Transport cholesterol and triglyceride in body
- Classified by size and density
LDL - ANSWER>>- Transport cholestrol
- High serum level
- Metabolized from liver
HDL - ANSWER>>- Synthesized by the liver and intestines
- Revise cholesterol transport
- Lower serum levels of atherosclerosis
Pathogenesis of atherosclerosis - ANSWER>>- An injury to the endothelium vascular intimacy triggers inflammatory process
- Vasodilation
- Increased permeablility
Increase permeability in atherosclerosis - ANSWER>>- Allows infiltration of immune cells such as macrophages and LDL
non-modfiable risk factors of atherosclerosis - ANSWER>>- Age
- Sex (males)
- Family history of HTN, cardiovascular diseases
Modifiable risk factors of atherosclerosis - ANSWER>>- Dyslipidemia
- HTN
- Obesity
- Diabetes
- Diet, smoking, stress, alcohol, activity
Clinical manifestation of atherosclerosis - ANSWER>>- Fatty streak
- Thin, flat, yellow discolouration
- Don't block lumen or blood flow
- Seen in early childhood
- Can be referable depending on risk factors
Fatty streak progression - ANSWER>>- Progress into advanced lesions or plaques
- Protrude arteries
- Development is slow
Stable plaque - ANSWER>>- Can regress, remain static, or continue to grow
Unstable plaques - ANSWER>>- Thin fibrous cap vulnerable to random erosion or rupture
- Compensatory increase in local vessel size causing dilation of arterial wall
Consequences of stable plaque - ANSWER>>- Asymptomatic
Consequences of plaque erosion or rupture - ANSWER>>- Thrombus formation
- Impaired blood flow
- Embolus formation, occluding downstream vessels
Consequences of arterial wall dilation - ANSWER>>- Aneurysm
Exudate - ANSWER>>A fluid that contains leukocytes, plasma proteins and inflammatory mediatory
Serous exudate - ANSWER>>Clear, watery
Sanguineous exudate - ANSWER>>Bloody
Purulent exudate - ANSWER>>Thick, brown
Exudate - ANSWER>>Fluid that Leakes from vasculature due to increased permeability of endothelial cells during inflammation
Transudate - ANSWER>>Fluid that squeezes through the vascular barrier due to imbalance of fluid pressure
Cellular stage - ANSWER>>- Primary WBC types during acute inflammation are neutrophils and macrophages
- Brought to site by recruitment and chemotaxis
- Promote resolution of inflammation through phagocytosis
Recruitment and chemotaxis - ANSWER>>- Circulating immune cells are recruited and attracted to the site of injury due to release of inflammatory mediators known as chemoattractants
Timeline of acute inflammation and broken wrist - ANSWER>>1. Injury
- Mast cells and tissue release histamine, nitric oxide, and inflammatory mediatory
- Inflammatory mediators cause vasodilation=redness and heat, edema
- Inflammatory mediators increase vascular permeability and allow leukocytes and plasma proteins to enter tissue=osmotic pressure increase=edema
- Edema compresses pain receptors causing pain
- WBC adhere to blood vessel wall
- Increase permeability allows WBC to transmigrate to injury
- WBC move by chemotaxis to injury
- Phagocytosis removes bacteria and debris
Acute phase response - ANSWER>>- Facilitated by cytokines
Systemic manifestations - ANSWER>>- Fever
- Reduced appetite
- Production of acute-phase proteins
- RBC stacking
- Increase leukocytes production
- Muscle metabolism- breakdown
How to assess acute-phase response? - ANSWER>>- Fever= body temp
- Production of proteins= CRP level
- RBC staking= ESR
- Muscle weakness
- Total WBC count
- Neutrophil count
Acute phase proteins - ANSWER>>- Liver proteins
- Produce fever and inflammation
Mast cells - ANSWER>>- Cell-derived (preformed)
Neutrophils - ANSWER>>- Cell derived (preformed)
- Produce lysosomal enzymes
