Test review

What is an upper GI bleed indicated by?

Black tarry stool.

What does hemorrhoid stool look like?

It contains red streaks in the stool.

What indicates a lower GI bleed?

Dark red melena stool.

What can lead to hemorrhoids?

Constipation.

How often are fecal occult blood tests recommended for older adults?

Annually.

How frequently should Pap exams and pelvic exams be performed?

At least every 3 years.

What is the recommended interval for colonoscopy or sigmoidoscopy?

Every 3 to 5 years.

How often should a tetanus booster be administered?

Every 10 years.

What does a healthy stoma look like?

It is pink or red.

What does a dark purplish stoma indicate?

It suggests that the vascular supply may be compromised.

What is generalized edema known as?

Anasarca.

What does periorbital edema refer to?

Puffiness around the eyes.

What is uremic frost?

A precipitate that forms on the skin in clients with chronic renal failure.

What does hydronephrosis refer to?

Distention of the renal pelvis.

What infections can lead to glomerulonephritis?

Group A beta-hemolytic streptococcal infections, bacterial endocarditis, or viral infections like hepatitis B or C and HIV.

What history might increase the risk for developing renal calculi?

A history of hyperparathyroidism or osteoporosis.

What is the predominant symptom of ulcerative colitis?

Diarrhea, which is watery with blood and mucus, alongside abdominal pain.

What is TURP?

Transurethral resection of the prostate, the most common procedure used for prostate issues, performed through endoscopy.

What is hypospadias?

A condition where the opening of the urethra is on the underside of the penis instead of at the tip.

What is dumping syndrome?

A condition where food moves too quickly from the stomach to the small bowel, especially high in sugar, leading to various GI symptoms.

What is a major risk factor for acute glomerulonephritis?

It peaks in incidence in children ages 6 to 7 years, being twice as common in males.

What does a 1-kg weight gain represent?

1,000 mL of retained fluid.

In what position should the anus and rectum be assessed for better accessibility and comfort?

Left side-lying position.

What is the standing position used for in physical examinations?

Assessment of male genitalia.

What digestive enzymes are secreted by the pancreas?

Trypsin (for protein), amylase (for starch), and lipase (for fats).

What are brush border enzymes responsible for?

The metabolism of carbohydrates and proteins.

When should niacin supplements be taken to reduce stomach irritation?

At bedtime.

What should a client do after taking niacin supplements?

Sit or lie down for 30 minutes to prevent dizziness.

What should you measure when aspirating fluid from a tube?

The volume and pH of the fluid, and then flush the tube with water.

What are nociceptors?

Peripheral nerve endings that detect tissue damage and transmit pain signals to the central nervous system (CNS).

What are the types of nociceptors?

Mechanosensitive, thermosensitive, and polymodal.

What do mechanosensitive nociceptors respond to?

Intense mechanical stimuli, transmitted via A-delta fibers.

What do thermosensitive nociceptors respond to?

Intense heat and cold, transmitted via A-delta fibers.

What do polymodal nociceptors respond to?

Mechanical, thermal, and chemical stimuli, transmitted via C fibers.

What is transduction in the context of pain?

The process where tissue damage stimulates nociceptors to initiate the sensation of pain.

How does inflammation affect pain perception?

Cytokines and neuropeptides are released, enhancing pain and causing vasodilation, increased blood flow, and edema.

What is the role of A-delta fibers in pain transmission?

They carry sharp, fast pain signals to the spinal cord.

What is the role of C fibers in pain transmission?

They carry slow, throbbing pain signals to the spinal cord.

What occurs at the dorsal horn during pain transmission?

Neurotransmitters are released, activating ascending pain pathways.

How do emotional states influence pain perception?

Emotional states like depression and anxiety can affect pain perception via the hypothalamus and limbic system.

What are endogenous opioids?

Neurotransmitters like endorphins and enkephalins that help modulate (decrease) pain.

What is psychological pain?

Emotional or mental pain that can lead to suicidal behavior; it can be separate from depression.

What is psychosomatic/psychogenic pain?

Emotional pain that manifests as physical symptoms, such as limb paralysis or pseudoseizures, known as somatization.

What is nociceptive pain?

Pain caused by the activation of nerve receptors by harmful stimuli like pressure, heat, or chemicals; can be somatic, visceral, or radicular depending on location.

What is neuropathic pain?

Pain resulting from nerve damage or dysfunction in the peripheral nerves, spinal cord, or brain.

What is inflammatory pain?

Pain caused by inflammation and immune responses, often seen in conditions like arthritis and migraines.

What is somatic pain?

Pain from stimulation of receptors in skin, muscles, joints, or connective tissue; described as cramping, aching, or sharp pain.

What is visceral pain?

Pain from internal organs; vague and deep, often described as squeezing or pressure.

What is radicular pain?

Pain originating from the nerve root where it connects to the spinal nerves.

What is referred pain?

Pain felt in a different area from the source of the stimulus.

What is phantom pain?

Pain experienced in an amputated part of the body.

What is cancer pain?

Pain that can be acute or chronic, caused by tumor pressure on nerves or organs, and cancer treatments like chemotherapy; includes nociceptive and neuropathic pain.

What is Complex Regional Pain Syndrome (CRPS)?

Burning, severe, persistent pain from partial nerve injury that worsens with touch/movement; often seen post-injury.

What is postherpetic neuralgia?

Pain following herpes zoster (shingles) that can last for months or years, characterized by burning pain along the torso.

What is trigeminal neuralgia?

Sudden, severe, stabbing facial pain triggered by activities like eating or brushing teeth.

What is diabetic neuropathy?

Nerve damage from diabetes leading to numbness, tingling, and sensory loss.

What defines acute pain?

Sudden onset pain lasting less than 6 months.

What defines chronic pain?

Persistent pain lasting longer than 6 months.

What is central pain?

Pain originating from the spinal cord or brain due to injury, stroke, or multiple sclerosis.

What is peripheral pain?

Pain originating from the peripheral nervous system, like trigeminal neuralgia and polyneuropathies.

How is pain assessed in older adults without cognitive impairment?

Using the Visual Analog Scale (VAS) and Numeric Pain Intensity Scale (NPIS).

What pain scale is better for cognitively impaired patients?

The Faces Pain Scale – Revised (FPS-R), as it relies on facial expressions.

What are gender differences in pain perception?

Women are generally more sensitive to pain and have lower pain tolerance due to estrogen, while men generally have higher pain tolerance due to testosterone.

What is the prevalence of pain in older adults?

60-75% report persistent pain, with 30% experiencing chronic pain.

What genetic factors affect pain sensitivity?

Pain sensitivity varies based on genetics and ethnicity, with studies showing differences in pain perception.

What is the importance of nurse self-awareness in pain perception?

Nurses should reflect on personal pain beliefs to avoid bias in pain assessment.

What does culturally competent pain care involve?

Awareness of personal biases and understanding cultural differences in pain assessment and management.

What barriers can affect pain assessment from clients’ beliefs?

Clients may perceive pain as weakness, a punishment, or fear addiction, affecting how they report it.

What can affect pain assessment from the provider's side?

Provider bias may lead nurses to incorrectly assume clients exaggerate pain or that certain groups do not feel pain.

What are misconceptions about pain in aging?

Pain is not a normal part of aging and should be addressed rather than ignored.

Why is it important to explain pain assessment to patients?

Patients should understand the purpose of pain assessment for treatment adjustments.

What are alternative pain treatments that patients might use?

Herbs, teas, acupuncture, or other methods alongside standard medical treatments.

Why is individualized pain treatment necessary?

Respecting variations in pain expectations and treatment preferences is key in providing effective nursing care.

How does pain control impact health outcomes?

Managing pain effectively can improve mobility and prevent complications like pneumonia after surgery.

What is the COLDSPA mnemonic used for?

Assessing pain comprehensively: Character, Onset, Location, Duration, Severity, Pattern, Associated factors.

What are the levels of comfort regarding pain?

Intolerable, Tolerable with discomfort, Comfortably manageable, Negligible pain.

How is change in pain assessed?

Asking if pain is getting worse, about the same, or getting better.

What does pain control refer to?

The effectiveness of pain relief treatments as inadequate, partially effective, or fully effective.

How does pain impact functioning?

Assessing whether pain prevents activities, interferes, or if they can do everything despite the pain.

How does sleep relate to pain assessment?

Assessing sleep patterns: Awake most of the night, awake with occasional pain, normal sleep.

What are behavioral (voluntary) responses to pain?

Moving away from pain, grimacing, moaning, crying, restlessness, and protecting the painful area (e.g., pulling hand away from a hot surface).

What are sympathetic (moderate/superficial pain) physiologic responses?

Increased blood pressure, heart rate, respiratory rate, pupil dilation, muscle tension, pallor, high adrenaline, and blood glucose levels (e.g., increased heart rate when touching a hot object).

What are parasympathetic (severe/deep pain) physiologic responses?

Nausea, vomiting, fainting, low blood pressure and heart rate, prostration, and rapid/irregular breathing (e.g., feeling faint from severe stomach pain).

What are affective (psychological) responses to pain?

Weeping, withdrawal, stoicism, anxiety, depression, fear, anger, anorexia, fatigue, hopelessness, insomnia, and powerlessness (e.g., feeling anxious and hopeless from chronic pain).

When do metabolic demands increase?

During high exercise levels, fever, and certain diseases.

What factors affect nutrition?

Development, cultural behaviors, and economic status.

What are the benefits of optimal nutrition?

Stronger immune system, increased energy, and faster healing.

What can lead to poor nutrition?

Low socioeconomic status, busy lifestyles relying on fast food, poor food choices, chronic dieting, chronic diseases affecting absorption, dental issues, limited food access, and eating disorders.

What is overnutrition?

Occurs when nutrient intake exceeds the body's metabolic needs, leading to obesity and increased risk for chronic diseases like cardiovascular disease and type 2 diabetes.

How is being overweight defined?

A person 10% over their ideal body weight (IBW) is considered overweight; 20% over IBW is considered obese.

Why do athletes with high muscle mass sometimes get inaccurately categorized?

They may be classified as overweight based solely on weight without considering muscle mass; a more thorough evaluation is needed.

What factors can affect hydration?

High environmental temperatures, limited fluid access, alcohol intake, diuretic use, impaired thirst mechanisms, certain medications, severe hyperglycemia, and high fevers.

What does optimal hydration support?

Maintaining functions like urination, bowel elimination, sweating, temperature regulation, toxin elimination, metabolism, nutrient absorption, immune efficiency, and skin health.

What is the usual recommendation for daily water consumption?

Eight 8-ounce glasses of water per day, with fluids and foods (especially plants) contributing to hydration.

How is obesity defined?

Weight 20% or more above normal body weight, with a BMI over 30, now considered a global health crisis.

What health risks are linked to obesity?

Cardiovascular disease, diabetes, stroke, sleep apnea, and certain cancers; caused by genetic, behavioral, and societal factors.

What are some obesity risk factors?

Inactivity, unhealthy eating, certain medications, genetics, and lack of sleep.

What is the aim of Healthy People 2020 regarding obesity?

To reduce obesity rates by promoting healthy diets and weight management for adults and children.

What can significantly affect body cells and functions?

Dehydration, which often goes unnoticed due to the underdeveloped thirst mechanism.

What can cause overhydration?

Usually in those with kidney, liver, or cardiac diseases, or seriously ill clients receiving excessive fluids without monitoring.