bio Genetics is the study of heredity and how traits are passed from parents to offspring. Gregor Mendel is known as the “Father of Genetics.” Why did Mendel use pea plants? * Easy to grow * Short generation time * Many visible traits * Can self-pollinate or cross-pollinate * Produce many offspring Examples of traits studied: * Flower colour * Seed shape * Plant height ⸻ VOCABULARY Gene * A segment of DNA that controls a trait. Allele * Different forms of the same gene. Example: P = purple flowers p = white flowers Dominant Allele * Expressed whenever it is present. * Represented by a capital letter. Example: P = purple Recessive Allele * Only expressed when two copies are present. * Represented by a lowercase letter. Example: p = white Genotype * Genetic makeup of an organism. Examples: PP Pp pp Phenotype * Physical appearance of an organism. Examples: Purple flower White flower Homozygous * Two identical alleles. Examples: PP pp Heterozygous * Two different alleles. Example: Pp Pure Breeding * Homozygous for a trait. Gamete * Sex cell (sperm or egg). ⸻ MENDEL’S LAWS Law of Dominance * A dominant allele masks a recessive allele. Example: Pp = Purple flower Law of Segregation * Alleles separate during gamete formation. * Each gamete receives only one allele. Example: Parent = Pp Gametes: P p Law of Independent Assortment * Different genes assort independently during meiosis. ⸻ MONOHYBRID CROSSES A monohybrid cross studies one trait. Example: P = Purple p = White Cross: Pp × Pp Punnett Square INCOMPLETE DOMINANCE Neither allele completely dominates. Example: Snapdragons RR = Red WW = White RW = Pink Cross: RW × RW Genotype Ratio: 1 RR : 2 RW : 1 WW Phenotype Ratio: 1 Red : 2 Pink : 1 White CODOMINANCE Both alleles are expressed equally. Example: AB Blood Type Genotype: IAIB Phenotype: AB MULTIPLE ALLELES More than two alleles exist in a population. Example: ABO Blood Group Alleles: IA IB i BLOOD TYPES Type A Genotypes: IAIA or IAi Type B Genotypes: IBIB or IBi Type AB Genotype: IAIB Type O Genotype: ii Can Type A and Type B Parents Have a Type O Child? Yes. If: Father = IAi Mother = IBi Possible Blood Types: AB A B O CELL CYCLE Purpose: * Growth * Repair * Replacement of cells Stages: G1 S G2 Mitosis Cytokinesis INTERPHASE G1 Phase Cell grows and carries out normal functions. S Phase DNA replication occurs. G2 Phase Cell prepares for division. MITOSIS Purpose: Growth and repair. Produces: 2 genetically identical diploid cells. PROPHASE Events: * Chromosomes condense * Nuclear membrane disappears * Nucleolus disappears * Spindle fibres form METAPHASE Events: * Chromosomes line up at the equator ANAPHASE Events: * Sister chromatids separate TELOPHASE Events: * Nuclear membranes reform * Chromosomes uncoil CYTOKINESIS Division of the cytoplasm. Animal Cells: Cleavage furrow forms. Plant Cells: Cell plate forms. CHROMOSOME STRUCTURE Chromosome consists of: * Two sister chromatids * One centromere DIPLOID VS HAPLOID Diploid (2n) * Two sets of chromosomes * Human body cells * 46 chromosomes Haploid (n) * One set of chromosomes * Human gametes * 23 chromosomes HOMOLOGOUS CHROMOSOMES Chromosome pairs that: * Carry the same genes * One comes from the mother * One comes from the father Humans have 23 homologous pairs. MEIOSIS Purpose: Produce gametes. Produces: 4 genetically unique haploid cells. MEIOSIS I Separates homologous chromosomes. CROSSING OVER Occurs during Prophase I. Definition: Exchange of DNA between homologous chromosomes. Importance: Creates genetic variation. RANDOM ASSORTMENT Occurs during Metaphase I. Definition: Homologous pairs line up randomly. Importance: Creates unique chromosome combinations. MEIOSIS II Separates sister chromatids. MITOSIS VS MEIOSIS Mitosis * 2 cells produced * Diploid * Genetically identical * Growth and repair Meiosis * 4 cells produced * Haploid * Genetically different * Produces gametes NONDISJUNCTION Failure of chromosomes to separate properly during meiosis. Can result in extra or missing chromosomes. DOWN SYNDROME Cause: Extra chromosome 21. Chromosome Number: 47 Usually caused by nondisjunction during meiosis. DNA DNA = Deoxyribonucleic Acid Shape: Double Helix Function: Stores genetic information. NUCLEOTIDE Three Components: * Phosphate Group * Deoxyribose Sugar * Nitrogenous Base NITROGENOUS BASES Adenine (A) Thymine (T) Cytosine (C) Guanine (G) COMPLEMENTARY BASE PAIRING A pairs with T C pairs with G DNA REPLICATION Purpose: Make identical copies of DNA. Location: Nucleus Result: Two identical DNA molecules. TRANSCRIPTION Purpose: Create mRNA from DNA. Location: Nucleus DNA → mRNA Remember: RNA uses Uracil (U) instead of Thymine (T). TRANSLATION Purpose: Make proteins. Location: Ribosome mRNA is read and amino acids are joined together to form a protein. MUTATIONS A mutation is a change in DNA sequence. Types: * Deletion * Duplication * Inversion * Translocation DELETION DNA segment removed. DUPLICATION DNA segment repeated. INVERSION DNA segment reversed. TRANSLOCATION DNA segment moves to another chromosome. SEX-LINKED TRAITS Traits located on sex chromosomes. Most are located on the X chromosome. RED-GREEN COLOUR BLINDNESS Inheritance: X-linked recessive. XC = Normal Vision Xc = Colour Blind Male: XcY Colour blind boys inherit the allele from their mother because fathers pass a Y chromosome to their sons. TAY-SACHS DISEASE Cause: Missing enzyme that breaks down lipids in nerve cells. Inheritance: Autosomal recessive. Treatment: No cure currently available. SICKLE CELL ANEMIA Cause: Mutation in hemoglobin gene. Effects: * Sickle-shaped red blood cells * Reduced oxygen transport * Blocked blood vessels Inheritance: Autosomal recessive. HUNTINGTON’S DISEASE Cause: Dominant mutation. Effects: * Nervous system degeneration * Loss of motor control * Cognitive decline Inheritance: Autosomal dominant. KARYOTYPE A photograph of chromosomes arranged in pairs. Used to: * Determine sex * Detect chromosome abnormalities * Diagnose genetic disorders PEDIGREE A family tree used to track inheritance patterns. Symbols: Square = Male Circle = Female Shaded = Has trait CLONING Producing genetically identical organisms. Uses: * Research * Agriculture * Medicine * Conservation GENETIC COUNSELLING Provides information about: * Inherited disorders * Family risk * Testing options AMNIOCENTESIS Prenatal test in which amniotic fluid is sampled and fetal cells are analyzed. Can detect: * Genetic disorders * Chromosomal disorders GMOs Genetically Modified Organisms. Definition: Organisms whose DNA has been altered through biotechnology. Advantages: * Increased crop yield * Disease resistance * Pest resistance Disadvantages: * Ethical concerns * Environmental concerns DNA REPLICATION → TRANSCRIPTION → TRANSLATION DNA (Nucleus) ↓ Replication DNA Copy DNA ↓ Transcription mRNA mRNA ↓ Translation Protein Final Product: Protein RESPIRATORY SYSTEM Function: * Brings oxygen into the body * Removes carbon dioxide * Works with the circulatory system to supply cells with oxygen Why do organisms require oxygen and produce carbon dioxide? Oxygen is required for cellular respiration. Cellular Respiration: Glucose + Oxygen → Energy (ATP) + Carbon Dioxide + Water Cells use oxygen to release energy from food. Carbon dioxide is produced as a waste product and must be removed. ⸻ PATHWAY OF AIR Nasal Cavity ↓ Pharynx ↓ Larynx ↓ Trachea ↓ Bronchi ↓ Bronchioles ↓ Alveoli ⸻ NASAL CAVITY Functions: * Warms air * Moistens air * Filters air Nasal Hairs: * Trap large particles Mucus: * Traps dust and microorganisms Blood Capillaries: * Warm incoming air ⸻ PHARYNX Common passageway for: * Air * Food Also called the throat. ⸻ UVULA Functions: * Prevents food from entering nasal cavity * Helps with speech ⸻ EPIGLOTTIS Functions: * Covers trachea during swallowing * Prevents choking ⸻ LARYNX Also called the voice box. Contains vocal cords. ⸻ TRACHEA Also called the windpipe. Contains cartilage rings that prevent collapse. Lined with: * Cilia * Mucus ⸻ CILIA Tiny hair-like structures. Function: * Sweep mucus upward toward throat ⸻ BRONCHI Two branches of the trachea leading to lungs. Right Bronchus → Right Lung Left Bronchus → Left Lung ⸻ BRONCHIOLES Smaller branches inside lungs. Lead to alveoli. ⸻ ALVEOLI Tiny air sacs. Site of gas exchange. Adaptations: * Thin walls * Moist surface * Large surface area * Rich blood supply Gas Exchange: Oxygen moves: Alveoli → Blood Carbon Dioxide moves: Blood → Alveoli By diffusion. ⸻ BREATHING MECHANICS Two main muscles: 1. Diaphragm 2. Intercostal Muscles ⸻ INHALATION (INSPIRATION) Diaphragm: * Contracts * Moves downward Intercostal Muscles: * Contract * Lift ribs upward Result: * Chest cavity volume increases * Pressure decreases * Air enters lungs ⸻ EXHALATION (EXPIRATION) Diaphragm: * Relaxes * Moves upward Intercostal Muscles: * Relax Result: * Chest cavity volume decreases * Pressure increases * Air leaves lungs ⸻ MEDULLA OBLONGATA Located in the brainstem. Function: * Controls breathing rate Responds to: * Carbon dioxide levels More CO₂: * Faster breathing Less CO₂: * Slower breathing ⸻ LUNG VOLUMES Tidal Volume * Normal amount of air breathed in and out Inspiratory Reserve Volume * Extra air inhaled after normal breath Expiratory Reserve Volume * Extra air exhaled after normal breath Residual Volume * Air remaining in lungs after maximum exhalation Vital Capacity * Maximum amount of air exhaled after deepest breath Total Lung Capacity * Total amount of air lungs can hold ⸻ CIRCULATORY SYSTEM Functions: * Transport oxygen * Transport nutrients * Remove wastes * Maintain homeostasis * Transport hormones Humans have a CLOSED circulatory system. Blood remains inside vessels. ⸻ BLOOD VESSELS ARTERIES Function: * Carry blood away from heart Characteristics: * Thick walls * High pressure * Small lumen * No valves Usually oxygen-rich Exception: Pulmonary artery ⸻ VEINS Function: * Carry blood toward heart Characteristics: * Thin walls * Low pressure * Large lumen * Valves present Usually oxygen-poor Exception: Pulmonary vein ⸻ CAPILLARIES Smallest blood vessels. Functions: * Gas exchange * Nutrient exchange * Waste exchange Walls are one cell thick. ⸻ HEART STRUCTURE Blood Flow: Body ↓ Vena Cava ↓ Right Atrium ↓ Right Ventricle ↓ Pulmonary Artery ↓ Lungs ↓ Pulmonary Vein ↓ Left Atrium ↓ Left Ventricle ↓ Aorta ↓ Body ⸻ HEART CHAMBERS Right Atrium * Receives deoxygenated blood Right Ventricle * Pumps blood to lungs Left Atrium * Receives oxygenated blood Left Ventricle * Pumps blood to body ⸻ SEPTUM Wall separating left and right sides of heart. Prevents mixing of blood. ⸻ HEART VALVES Function: * Prevent backflow of blood Types: Atrioventricular (AV) Valves Pulmonary Semilunar Valve Aortic Semilunar Valve ⸻ SA NODE Sinoatrial Node Known as: * Natural pacemaker Initiates heartbeat. ⸻ AV NODE Atrioventricular Node Receives signal from SA node. Delays impulse slightly. Allows ventricles to fill before contraction. ⸻ BLOOD Components: 1. Plasma 2. Red Blood Cells 3. White Blood Cells 4. Platelets ⸻ PLASMA Liquid component of blood. Functions: * Transport nutrients * Transport hormones * Transport wastes ⸻ RED BLOOD CELLS (ERYTHROCYTES) Function: * Carry oxygen Contain: * Hemoglobin ⸻ HEMOGLOBIN Protein in red blood cells. Function: * Binds oxygen Allows oxygen transport. ⸻ WHITE BLOOD CELLS (LEUKOCYTES) Function: * Fight infection * Defend body Part of immune system. ⸻ PLATELETS Function: * Blood clotting Prevent blood loss. ⸻ BLOOD PRESSURE Force of blood against artery walls. Measured using: Sphygmomanometer Example: 120/80 120 = Systolic Pressure 80 = Diastolic Pressure ⸻ SYSTOLIC PRESSURE Pressure when heart contracts. ⸻ DIASTOLIC PRESSURE Pressure when heart relaxes. ⸻ HYPERTENSION High blood pressure. Can increase risk of: * Stroke * Heart attack * Kidney disease ⸻ STROKE VOLUME Amount of blood pumped per heartbeat. ⸻ CARDIAC OUTPUT Amount of blood pumped per minute. Formula: Cardiac Output = Heart Rate × Stroke Volume ⸻ ECG Electrocardiogram Measures electrical activity of heart. Used to detect: * Irregular heartbeat * Heart damage ⸻ PULMONARY CIRCULATION Heart → Lungs → Heart Purpose: * Oxygenate blood ⸻ SYSTEMIC CIRCULATION Heart → Body → Heart Purpose: * Deliver oxygen to tissues ⸻ HOMEOSTASIS DURING EXERCISE Body responds by: * Increasing heart rate * Increasing breathing rate * Increasing cardiac output * Redirecting blood to muscles * Sweating to cool body Purpose: Maintain stable internal conditions. ⸻ DIGESTIVE SYSTEM Functions: * Break down food * Absorb nutrients * Eliminate waste ⸻ DIGESTIVE TRACT Mouth ↓ Pharynx ↓ Esophagus ↓ Stomach ↓ Small Intestine ↓ Large Intestine ↓ Rectum ↓ Anus ⸻ MECHANICAL DIGESTION Physical breakdown of food. Examples: * Chewing * Churning ⸻ CHEMICAL DIGESTION Chemical breakdown of food using enzymes. Examples: * Amylase * Pepsin ⸻ SALIVA Functions: 1. Moistens food 2. Contains amylase Amylase begins carbohydrate digestion. ⸻ TONGUE Functions: 1. Forms bolus 2. Pushes food for swallowing ⸻ ESOPHAGUS Moves food to stomach. Uses: Peristalsis ⸻ PERISTALSIS Wave-like muscular contractions. Move food through digestive tract. ⸻ STOMACH Functions: * Stores food * Mixes food * Begins protein digestion Produces: * HCl * Pepsin * Mucus ⸻ HCl Hydrochloric Acid Functions: * Kills bacteria * Activates pepsin ⸻ PEPSIN Function: * Digests proteins ⸻ MUCUS Function: * Protects stomach lining ⸻ CHYME Semi-liquid food mixture leaving stomach. ⸻ HEARTBURN Cause: Stomach acid enters esophagus. Usually caused by weakened cardiac sphincter. ⸻ SMALL INTESTINE Main site of: * Digestion * Absorption Adaptations: * Long length * Folds * Villi * Microvilli Large surface area increases absorption. ⸻ DUODENUM First section. Functions: * Receives bile * Receives pancreatic enzymes * Most chemical digestion ⸻ JEJUNUM Main nutrient absorption. ⸻ ILEUM Final nutrient absorption. ⸻ VILLI Finger-like projections. Function: Increase surface area. ⸻ LIVER Functions: * Produces bile * Processes nutrients * Detoxifies blood ⸻ GALL BLADDER Functions: * Stores bile * Releases bile into small intestine ⸻ PANCREAS Functions: * Produces digestive enzymes * Produces bicarbonate ⸻ BILE Function: Emulsifies fats. Breaks large fat droplets into smaller droplets. Makes fat digestion easier. ⸻ DIGESTION OF CARBOHYDRATES Mouth: * Amylase begins digestion Small Intestine: * Pancreatic amylase continues digestion End Product: Glucose ⸻ DIGESTION OF PROTEINS Stomach: * Pepsin begins digestion Small Intestine: * Trypsin continues digestion End Product: Amino Acids ⸻ DIGESTION OF LIPIDS Small Intestine: * Bile emulsifies fats * Lipase digests fats End Product: Fatty Acids + Glycerol ⸻ EVOLUTION Evolution: Change in populations over time. Individuals do NOT evolve. Populations evolve. ⸻ DARWIN Proposed: Natural Selection Book: On the Origin of Species ⸻ WALLACE Independently developed theory of natural selection. ⸻ LAMARCK Proposed: Inheritance of acquired characteristics Example: Giraffes stretch necks and pass longer necks to offspring. This theory is incorrect. ⸻ NATURAL SELECTION Requirements: 1. Variation 2. Overproduction 3. Competition 4. Differential Survival 5. Reproduction Result: Adaptation ⸻ ADAPTATION Inherited characteristic that increases survival and reproduction. ⸻ SELECTIVE ADVANTAGE A characteristic that improves survival or reproduction. Example: Antibiotic resistance ⸻ SELECTIVE PRESSURE Environmental factor that influences survival. Examples: * Predators * Disease * Climate * Competition ⸻ VARIATION Differences among individuals in a population. Sources: * Mutation * Crossing Over * Random Assortment ⸻ MUTATION Ultimate source of new alleles. Creates genetic variation. ⸻ FOSSIL Preserved remains or traces of organisms. ⸻ FOSSIL RECORD Collection of fossils showing evolutionary history. Provides evidence for evolution. ⸻ RADIOACTIVE DATING Uses radioactive isotopes to determine fossil age. ⸻ UNIFORMITARIANISM Proposed by Lyell. Earth changes gradually over long periods of time. ⸻ CATASTROPHISM Proposed by Cuvier. Earth shaped by sudden catastrophic events. ⸻ BIOGEOGRAPHY Study of species distribution around Earth. Provides evidence for evolution. ⸻ EMBRYOLOGY Study of embryos. Similar embryos suggest common ancestry. ⸻ HOMOLOGOUS STRUCTURES Same evolutionary origin. Different functions. Example: Human arm Whale flipper Bat wing Evidence of common ancestry. ⸻ ANALOGOUS STRUCTURES Different origins. Same function. Example: Bird wing Insect wing Not evidence of close ancestry. ⸻ VESTIGIAL STRUCTURES Structures with little or no function. Examples: * Human appendix * Whale pelvis Evidence of evolution. ⸻ MIMICRY One species resembles another. Example: Syrphid fly resembles wasp. Provides protection. ⸻ ARTIFICIAL SELECTION Humans select traits. Examples: * Dog breeding * Crop breeding ⸻ DIRECTIONAL SELECTION One extreme phenotype favored. Graph shifts in one direction. ⸻ STABILIZING SELECTION Average phenotype favored. Extremes selected against. ⸻ DISRUPTIVE SELECTION Both extremes favored. Middle selected against. ⸻ GENETIC DRIFT Random change in allele frequencies. Most significant in small populations. ⸻ FOUNDER EFFECT Small group starts new population. Different allele frequencies from original population. ⸻ BOTTLENECK EFFECT Population drastically reduced. Loss of genetic variation. ⸻ GENE FLOW Movement of alleles between populations. Occurs through migration. ⸻ NON-RANDOM MATING Individuals choose specific mates. Can reduce variation. ⸻ SPECIES A group of organisms that can interbreed in nature and produce fertile offspring. ⸻ SPECIATION Formation of new species. ⸻ ALLOPATRIC SPECIATION Requires: Geographic isolation Example: Mountain separates populations. ⸻ SYMPATRIC SPECIATION Occurs without geographic isolation. ⸻ PRE-ZYGOTIC ISOLATION Prevents fertilization. Examples: * Different mating seasons * Different mating songs * Different habitats ⸻ POST-ZYGOTIC ISOLATION Occurs after fertilization. Example: Sterile hybrids Example: Mule DIVERSITY Prokaryotes vs Eukaryotes PROKARYOTES * No nucleus * No membrane-bound organelles * Circular DNA * Smaller * Examples: Eubacteria, Archaebacteria EUKARYOTES * Nucleus present * Membrane-bound organelles * Linear chromosomes * Larger * Examples: Protists, Fungi, Plants, Animals Three Differences: 1. Nucleus vs no nucleus 2. Organelles vs no organelles 3. Larger vs smaller ⸻ Taxonomy Kingdom Phylum Class Order Family Genus Species Mnemonic: King Philip Came Over For Good Soup ⸻ Binomial Nomenclature Genus + Species Example: Homo sapiens Rules: * Genus capitalized * Species lowercase * Italicized Purpose: * Universal naming system * Avoids confusion * Shows relationships ⸻ Dichotomous Key Used to identify organisms using paired choices. Example: 1a Has wings → Step 2 1b No wings → Step 3 ⸻ Six Kingdoms 1. Archaebacteria 2. Eubacteria 3. Protista 4. Fungi 5. Plantae 6. Animalia ⸻ VIRUSES Virus Structure: * DNA or RNA * Capsid * Attachment proteins * Sometimes envelope Why Viruses Are Not Living: * Not made of cells * Cannot reproduce independently * No metabolism * Need host cell ⸻ DNA Virus vs RNA Virus DNA Virus: * Contains DNA * More stable RNA Virus: * Contains RNA * Mutates faster ⸻ Lytic Cycle Attachment ↓ Penetration ↓ Replication ↓ Assembly ↓ Lysis Host cell bursts. ⸻ Lysogenic Cycle Attachment ↓ Penetration ↓ Integration into host DNA ↓ Host reproduces ↓ Virus DNA copied Cell survives initially. ⸻ ARCHAEBACTERIA Characteristics: * Prokaryotic * Unicellular * Extreme environments Three Groups: Methanogens * Produce methane Halophiles * Salt-loving Thermoacidophiles * Hot acidic environments ⸻ EUBACTERIA Characteristics: * Prokaryotic * Peptidoglycan cell wall * Binary fission Examples: * E. coli * Streptococcus ⸻ Binary Fission DNA Replication ↓ Cell Growth ↓ Cell Division ↓ Two Identical Cells ⸻ Conjugation DNA transfer through pilus. Importance: * Genetic variation * Antibiotic resistance ⸻ Antibiotic Resistance Mutation ↓ Antibiotic kills susceptible bacteria ↓ Resistant bacteria survive ↓ Resistant bacteria reproduce Natural Selection ⸻ PROTISTS Characteristics: * Eukaryotic * Mostly unicellular * Aquatic Three Groups: Animal-like * Amoeba * Paramecium Plant-like * Algae * Euglena Fungus-like * Slime molds ⸻ Amoeba * Uses pseudopods * Phagocytosis ⸻ Algae * Photosynthetic * Oxygen producer ⸻ Euglena * Chloroplasts * Flagellum * Photosynthesis * Can also feed heterotrophically ⸻ Malaria Cause: Plasmodium Kingdom: Protista ⸻ FUNGI Characteristics: * Eukaryotic * Heterotrophic * Chitin cell walls * Reproduce with spores Examples: * Mushrooms * Mold * Yeast ⸻ External Digestion Release enzymes ↓ Digest food outside body ↓ Absorb nutrients ⸻ Fungi vs Plants FUNGI * Heterotrophic * Chitin * No chloroplasts PLANTS * Autotrophic * Cellulose * Chloroplasts ⸻ PLANTS Biodiversity vs Monoculture BIODIVERSITY * Many species * Stable ecosystem * Disease resistance MONOCULTURE * One crop species * Low diversity * Disease risk ⸻ Bryophytes Definition: Nonvascular plants Examples: * Mosses * Liverworts Characteristics: * No xylem * No phloem * Need water for reproduction ⸻ Vascular Plants Contain: * Xylem * Phloem ⸻ Xylem Function: Water and minerals Direction: Roots → Leaves ⸻ Phloem Function: Sugars Direction: Throughout plant ⸻ Alternation of Generations Sporophyte (2n) ↓ meiosis Spores (n) ↓ Gametophyte (n) ↓ Gametes ↓ fertilization Zygote (2n) ↓ Sporophyte ⸻ Moss Life Cycle Spores ↓ Gametophyte ↓ Egg + Sperm ↓ Zygote ↓ Sporophyte ↓ Capsule ↓ Spores Know: * Capsule * Sporophyte * Gametophyte * Spores ⸻ Fern Life Cycle Fern ↓ Sori ↓ Spores ↓ Prothallus ↓ Gametes ↓ Fertilization ↓ Young Fern Know: * Frond * Sori * Sporangia * Prothallus ⸻ Gymnosperms Characteristics: * Naked seeds * Cones * Wind pollination * Evergreen Examples: * Pine * Spruce * Fir ⸻ Angiosperms Characteristics: * Flowers * Fruit * Seeds enclosed Examples: * Apple tree * Rose * Maple ⸻ Flower Structure Anther * Produces pollen Pollen Grain * Male gamete Stigma * Receives pollen Style * Connects stigma and ovary Ovary * Contains ovules Ovule * Female gamete Petals * Attract pollinators ⸻ Plant Tissues Meristematic * Growth Dermal * Protection Ground * Photosynthesis * Storage Vascular * Transport ⸻ Leaf Structure Blade * Main leaf surface Petiole * Connects leaf to stem Cuticle * Reduces water loss Palisade Mesophyll * Photosynthesis Spongy Mesophyll * Gas exchange Veins * Xylem + Phloem ⸻ Stomata Openings in leaves. Functions: * Gas exchange * Water loss ⸻ Guard Cells Control opening and closing of stomata. ⸻ Transpiration Water loss from leaves. Functions: * Pulls water upward * Cools plant * Moves minerals ⸻ Simple vs Compound Leaves Simple: * One blade Compound: * Multiple leaflets ⸻ Monocots vs Dicots MONOCOTS * 1 cotyledon * Parallel veins * Fibrous roots * Flower parts in 3s Examples: Corn Grass DICOTS * 2 cotyledons * Net veins * Taproot * Flower parts in 4s or 5s Examples: Bean Maple ⸻ Seeds Contain: * Embryo * Stored food * Seed coat Functions: * Protection * Survival * Dispersal ⸻ Seed Dispersal Wind * Dandelion Water * Coconut Animals * Burrs Explosive * Touch-me-not ⸻ Fruit vs Vegetable Fruit: * Comes from ovary * Contains seeds Examples: Tomato Apple Pepper Vegetable: * Root, stem, leaf, or flower Examples: Carrot Celery Broccoli ⸻ Factors Affecting Plant Growth 1. Light 2. Water 3. Carbon dioxide 4. Temperature 5. Soil nutrients 6. Oxygen 7. Soil pH 8. Space 9. Pollinators 10. Disease and pests

: What is the common name for the clavicle?
A: Collarbone Q: What is the common name for the scapula?
A: Shoulder blade Q: What bone is located in the upper arm?
A: Humerus Q: Which forearm bone is lateral (thumb side)?
A: Radius Q: Which forearm bone is medial (pinky side)?
A: Ulna Q: What structure forms the point of the elbow?
A: Olecranon process of the ulna Q: What fossa does the olecranon process fit into?
A: Olecranon fossa Carpal Bones Q: How many carpal bones are there?
A: 8 Q: Name the proximal row of carpal bones.
A: Scaphoid, Lunate, Triquetrum, Pisiform Q: Name the distal row of carpal bones.
A: Trapezium, Trapezoid, Capitate, Hamate Q: What mnemonic helps remember the carpal bones?
A: Some Lovers Try Positions That They Can't Handle Hand Bones Q: What are the hand bones called?
A: Metacarpals Q: What are the three parts of a metacarpal?
A: Base, Shaft, Head Q: How many phalanges does the thumb have?
A: 2 (Proximal and Distal) Q: How many phalanges do the other fingers have?
A: 3 (Proximal, Middle, Distal) Pelvis & Lower Extremity Q: What is the superior portion of the pelvis?
A: Ilium Q: What is the anterior pelvic bone?
A: Pubis Q: What is the posterior-inferior pelvic bone?
A: Ischium Q: What is the large opening in the pelvis called?
A: Obturator foramen Q: What is the thigh bone?
A: Femur Q: What is the medial lower leg bone?
A: Tibia Q: What is the lateral lower leg bone?
A: Fibula Q: What is the distal tibia called?
A: Medial malleolus Q: What is the distal fibula called?
A: Lateral malleolus Q: What ankle bone articulates with both malleoli?
A: Talus Q: What is the heel bone called?
A: Calcaneus Anatomy Terms Q: What is osteology?
A: Study of bones Q: What is arthrology?
A: Study of joints Q: What is kinesiology?
A: Study of body movement Q: What is another name for a joint?
A: Articulation Joints Q: What is a synarthrosis?
A: Nonmovable joint Q: Give an example of a synarthrosis.
A: Skull suture Q: What type of joint is a tooth?
A: Gomphosis Q: What is an amphiarthrosis?
A: Slightly movable joint Q: Give an example of an amphiarthrosis.
A: Pubic symphysis Q: What is a diarthrosis?
A: Freely movable joint Q: What fluid is found inside synovial joints?
A: Synovial fluid Q: What type of joint is the shoulder?
A: Ball-and-socket Q: What type of joint is the hip?
A: Ball-and-socket Q: What type of joint is the elbow?
A: Hinge joint Q: What type of joint is the knee?
A: Hinge joint Q: What type of joint is the wrist?
A: Condyloid joint Q: What type of joint is the thumb?
A: Saddle joint Q: What type of joint is found between tarsal bones?
A: Gliding joint Ligaments Q: What ligament stabilizes the medial side of the elbow?
A: Ulnar collateral ligament Q: What ligament stabilizes the lateral side of the elbow?
A: Radial collateral ligament Q: What does ACL stand for?
A: Anterior Cruciate Ligament Q: What does PCL stand for?
A: Posterior Cruciate Ligament Muscle Tissue Q: What is the muscle cell membrane called?
A: Sarcolemma Q: What is the muscle cell cytoplasm called?
A: Sarcoplasm Q: What are the contractile organelles called?
A: Myofibrils Q: What is the functional unit of muscle contraction?
A: Sarcomere Q: What is the thick filament?
A: Myosin Q: What is the thin filament?
A: Actin Q: What regulatory proteins control contraction?
A: Troponin and Tropomyosin Connective Tissue Coverings Q: What surrounds an individual muscle fiber?
A: Endomysium Q: What surrounds a fascicle?
A: Perimysium Q: What surrounds the entire muscle?
A: Epimysium Q: What surrounds groups of muscles?
A: Fascia Facial Muscles Q: What muscle closes the eye?
A: Orbicularis oculi Q: What muscle opens the eye?
A: Levator palpebrae superioris Q: What muscle wrinkles the nose?
A: Nasalis Q: What muscle closes the lips?
A: Orbicularis oris Q: What muscle is known as the "kissing muscle"?
A: Buccinator Q: What muscle causes smiling?
A: Zygomaticus major and minor Q: What muscle causes pouting?
A: Mentalis Muscle Actions Q: What are muscles that work together called?
A: Synergists Q: What are muscles that oppose each other called?
A: Antagonists Q: What are muscles that stabilize joints called?
A: Fixators (Stabilizers) Q: What is the main muscle performing an action called?
A: Prime mover Q: Where does a muscle begin?
A: Origin Q: Where does a muscle attach?
A: Insertion Q: What is the thick middle portion of a muscle?
A: Belly Mastication (Chewing) Muscles Q: What mnemonic helps remember the muscles of mastication?
A: TIME Q: What does T stand for in TIME?
A: Temporalis Q: What does M stand for in TIME?
A: Masseter Q: What does I stand for in TIME?
A: Internal (Medial) Pterygoid Q: What does E stand for in TIME?
A: External (Lateral) Pterygoid Tongue Muscles Q: What muscle sticks the tongue out?
A: Genioglossus Q: What muscle pulls the tongue in?
A: Styloglossus Q: What muscle elevates the tongue?
A: Palatoglossus Q: What muscle depresses the tongue?
A: Hyoglossus Rotator Cuff Q: What mnemonic helps remember the rotator cuff muscles?
A: SITS Q: What does S stand for?
A: Supraspinatus Q: What does I stand for?
A: Infraspinatus Q: What does T stand for?
A: Teres Minor Q: What does the second S stand for?
A: Subscapularis Q: Which rotator cuff muscle initiates abduction?
A: Supraspinatus Lower Limb Muscles Q: What muscle extends the thigh at the hip?
A: Gluteus maximus Q: What muscles flex the thigh at the hip?
A: Iliacus and Psoas muscles Q: What muscles abduct the thigh?
A: Tensor fasciae latae, Gluteus medius, Gluteus minimus Q: What muscles adduct the thigh?
A: Adductor longus, brevis, magnus, gracilis, pectineus Quadriceps Q: What is the function of the quadriceps?
A: Extend the knee Q: Name the four quadriceps muscles.
A: Rectus femoris, Vastus lateralis, Vastus intermedius, Vastus medialis Hamstrings Q: What is the function of the hamstrings?
A: Flex the knee Q: Name the hamstring muscles.
A: Biceps femoris, Semitendinosus, Semimembranosus Lower Leg Q: What muscle dorsiflexes the foot?
A: Tibialis anterior Q: What muscles plantar flex the foot?
A: Gastrocnemius and Soleus Q: What tendon is formed by gastrocnemius and soleus?
A: Achilles (Calcaneal) tendon Trunk & Breathing Q: What muscle flexes the trunk?
A: Rectus abdominis Q: What muscle extends the trunk?
A: Quadratus lumborum Q: What is the primary muscle of breathing?
A: Diaphragm Q: What muscles help with inhalation?
A: External intercostals Q: What muscles help with exhalation?
A: Internal intercostals Muscle Fiber Types Q: Which muscle fibers are best for posture?
A: Slow-twitch fibers Q: Which muscle fibers resist fatigue?
A: Slow-twitch fibers Q: Which muscle fibers are best for sprinting?
A: Fast-twitch A fibers Q: Which muscle fibers contract the fastest?
A: Fast-twitch B fibers Blood Q: What is the study of blood called?
A: Hematology Q: What is the normal blood pH?
A: 7.35–7.45 Q: What percentage of blood is plasma?
A: 55% Q: What percentage of blood is formed elements?
A: 45% Q: What are red blood cells called?
A: Erythrocytes Q: What is the function of red blood cells?
A: Transport oxygen and carbon dioxide Q: How long do red blood cells live?
A: 120 days Q: What are white blood cells called?
A: Leukocytes Q: What is the function of white blood cells?
A: Fight infection Q: What are platelets also called?
A: Thrombocytes Q: What is the function of platelets?
A: Blood clotting Q: How long do platelets live?
A: 5–9 days Blood Clotting Q: What is hemostasis?
A: Stoppage of blood loss Q: What is a thrombus?
A: A blood clot Q: What is thrombosis?
A: Formation of a clot in an unbroken vessel Q: What is an embolus?
A: A traveling clot Q: What is an embolism?
A: Blockage caused by an embolus Blood Types Q: What antigens are found on Type A blood?
A: A antigens Q: What antibodies are found in Type A blood?
A: Anti-B antibodies Q: What antigens are found on Type B blood?
A: B antigens Q: What antibodies are found in Type B blood?
A: Anti-A antibodies Q: What antigens are found on Type AB blood?
A: A and B antigens Q: What antibodies are found in Type AB blood?
A: None Q: What antigens are found on Type O blood?
A: None Q: What antibodies are found in Type O blood?
A: Anti-A and Anti-B Q: What is the universal donor?
A: O Negative Q: What is the universal receiver?
A: AB Positive Last-Minute Memorization Set Q: Radius = ?
A: Thumb side Q: Ulna = ?
A: Pinky side Q: Heel bone = ?
A: Calcaneus Q: Study of bones = ?
A: Osteology Q: Study of joints = ?
A: Arthrology Q: Study of movement = ?
A: Kinesiology Q: Rotator cuff mnemonic = ?
A: SITS Q: Chewing muscles mnemonic = ?
A: TIME Q: Universal donor = ?
A: O- Q: Universal receiver = ?
A: AB+ Q: Blood pH = ?
A: 7.35–7.45 Q: RBC lifespan = ?
A: 120 days Q: Platelet lifespan = ?
A: 5–9 days Q: Main breathing muscle = ?
A: Diaphragm Q: Knee extensors = ?
A: Quadriceps Q: Knee flexors = ?
A: Hamstrings

Ilium Push & Pull

1. Cell Transport Brownian Movement Definition: Random movement of particles caused by their inherent kinetic energy. Occurs above freezing temperatures. Passive process (requires no energy/ATP). Responsible for constant molecular motion. Diffusion Definition: Movement of molecules or ions from an area of higher concentration to lower concentration. Passive transport Moves down the concentration gradient No energy required Facilitated Diffusion Definition: Diffusion through a selectively permeable membrane using membrane proteins. Passive transport High → Low concentration Only certain substances can pass Filtration Definition: Movement of water and dissolved substances through a membrane from higher pressure to lower pressure. Driven by pressure differences Dialysis Definition: Separation of small molecules from larger molecules. Used in dialysis machines Not a normal transport process in the body 2. Active Transport Active Transport Definition: Transport requiring cellular energy (ATP). Endocytosis ("Into the Cell") Phagocytosis Cell Eating Engulfs solid particles Example: White blood cells engulfing bacteria Pinocytosis Cell Drinking Engulfs fluids Exocytosis Definition: Movement of substances out of the cell. 3. Epithelial Tissue Characteristics Covers body surfaces Lines organs and cavities Cells are tightly packed High mitotic rate Connected to connective tissue by a basement membrane Classification by Shape Shape Name Flat Squamous Cube-shaped Cuboidal Tall/elongated Columnar Classification by Layers Layers Name One layer Simple Two or more layers Stratified Example: Simple Columnar Epithelium = One layer of elongated cells 4. Connective Tissue Components Connective tissue contains: Cells Fibers Ground substance Fibers + Ground Substance = Matrix Loose Connective Tissue Areolar Tissue Supports organs Widely spaced fibers Adipose Tissue Fat tissue Insulation Energy storage Reticular Tissue Found in lymph nodes and spleen Acts as a filtering framework Dense Connective Tissue Dense Regular Fibers run in one direction Found in: Tendons Ligaments Aponeuroses Dense Irregular Fibers run in multiple directions Found in: Dermis of skin Elastic Connective Tissue Allows stretching Found in: Walls of arteries Elastic structures 5. Cartilage Hyaline Cartilage Found in: Articular cartilage (joint surfaces) Costal cartilage (ribs) Fibrocartilage Strongest cartilage Found in: Intervertebral discs Pubic symphysis Meniscus of knee Elastic Cartilage Provides flexibility Found in: External ear 6. Skin (Integumentary System) Epidermal Cells Keratinocytes Produce keratin Waterproofing protein Melanocytes Produce melanin Protect from UV radiation Langerhans Cells Immune defense Fight infection Merkel Cells Touch receptors 7. Layers of the Epidermis Deepest → Most Superficial Stratum Basale Stratum Spinosum Stratum Granulosum Stratum Lucidum (only thick skin) Stratum Corneum Thick Skin Found on: Palms Soles Contains: Stratum Lucidum Dead Layers Stratum Lucidum Stratum Corneum Filled with keratin. 8. Skin Glands Sudoriferous Glands Sweat glands Eccrine glands Apocrine glands Sebaceous Glands Produce sebum (oil) Ceruminous Glands Produce earwax Mammary Glands Modified sweat glands Produce milk 9. Skeletal System Upper Extremity Humerus Arm bone Radius Lateral forearm bone Thumb side Ulna Medial forearm bone Forms elbow joint Carpals Wrist bones 8 bones Metacarpals Hand bones Phalanges Finger bones Thumb: 2 phalanges Other fingers: 3 phalanges Pelvis Ilium Superior portion Pubis Anterior portion Ischium Posterior/inferior portion "Sit bones" Lower Extremity Femur Thigh bone Tibia Shin bone Medial Fibula Lateral lower leg bone Tarsals Ankle bones Metatarsals Foot bones Phalanges Toe bones Big toe: 2 phalanges Other toes: 3 phalanges High-Yield Exam Questions 1. What is Brownian movement? Random movement of particles caused by kinetic energy. 2. Does diffusion require energy? No. It is passive transport. 3. Difference between diffusion and facilitated diffusion? Facilitated diffusion requires a selectively permeable membrane protein. 4. What is phagocytosis? Cell eating (engulfing solids). 5. What is pinocytosis? Cell drinking (engulfing fluids). 6. Which epithelial tissue has one layer of column-shaped cells? Simple columnar epithelium. 7. What is the matrix of connective tissue? Fibers + ground substance. 8. Which cartilage is found in intervertebral discs? Fibrocartilage. 9. Which epidermal cells produce melanin? Melanocytes. 10. What are the five epidermal layers? Basale → Spinosum → Granulosum → Lucidum → Corneum. 11. Which bone is on the thumb side of the forearm? Radius. 12. Which bone forms the shin? Tibia. 13. What are the wrist bones called? Carpals. 14. What are the ankle bones called? Tarsals. 15. What are the hand and foot bones called? Metacarpals and Metatarsals. Quick Memorization Tips Pino = Sip → Pinocytosis = cell drinking Phago = Eat → Phagocytosis = cell eating Radius = Radio to Thumb → Radius is lateral Simple = One Layer Stratified = Many Layers Melanocytes = Melanin Keratinocytes = Keratin Sebaceous = Sebum (Oil) Sudoriferous = Sweat Carpals = Wrist Tarsals = Ankle This covers the major concepts your instructor specifically reviewed for the exam

4.5 - Co-transport of Glucose in the Ileum

LumboPelvic- Midterm- When to Adjust Sacrum versus Ilium

LumboPelvic- Midterm- Side Posture Ilium Procedures, Push or Pull

Lab Three - Rat Ileum

Tuščioji žarna, jejunum, ir klubinė žarna, ileum: svarbiausi anatominiai ypatumai

Small Intestine Ileum

new vocabulary in iium

Lab #2 (The Pelvic Girdle - Ilium)

Chapter 8 – The Appendicular Skeleton chPectoral (Shoulder) Girdle • Bones: Clavicle & Scapula • Functions: Connects upper limb to axial skeleton; provides attachment for muscles; allows wide range of motion. • Principal Markings of Scapula: • Acromion: Shoulder tip; articulates with clavicle. • Coracoid Process: Muscle attachment. • Glenoid Cavity: Articulates with humerus (shoulder joint). • Borders: Lateral & Medial. • Spine of Scapula: Muscle attachment. • Angles: Superior & Inferior. • Fossae: Supraspinous & Infraspinous; for muscle attachment. • Principal Markings of Clavicle: • Sternal End: Articulates with sternum (sternoclavicular joint). • Acromial End: Articulates with scapula. Upper Limb (Extremity) Humerus • Head: Articulates with glenoid cavity. • Greater & Lesser Tubercle: Muscle attachment. • Capitulum: Articulates with radius. • Trochlea: Articulates with ulna. • Fossae: Coronoid & Olecranon for ulna movement. • Epicondyles: Medial & Lateral; muscle attachment. Radius & Ulna • Ulna: • Olecranon & Coronoid Process form elbow hinge. • Radial Notch: articulates with radius. • Styloid Process: wrist attachment. • Radius: • Head: articulates with humerus & ulna. • Radial Tuberosity: biceps attachment. • Styloid Process: wrist attachment. Carpals, Metacarpals, Phalanges • Carpals (wrist): Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate. • Metacarpals I–V: Base, shaft, head. • Phalanges I–V: Proximal, middle, distal. Pelvic (Hip) Girdle • Bones: 2 Os Coxa (Ilium, Ischium, Pubis). • Acetabulum: Socket for femur. • Ilium Markings: Iliac crest, ASIS, PSIS, Auricular surface, Iliac fossa. • Ischium: Ischial tuberosity (sits bones). • Pubis: Pubic symphysis (joins 2 hip bones). False vs True Pelves • False Pelvis: Superior portion; supports abdominal organs. • True Pelvis: Inferior portion; surrounds pelvic cavity & birth canal. Female vs Male Pelvis • Female: Wider, shallower, larger pelvic inlet/outlet. • Male: Narrower, deeper, smaller pelvic inlet/outlet. Lower Limb (Extremity) Thigh – Femur & Patella • Femur Markings: • Head & Neck, Greater & Lesser Trochanter. • Medial & Lateral Condyles and Epicondyles. • Intercondylar Fossa: posterior notch between condyles. • Patella: Base, Apex, Articular facets. Tibia & Fibula • Tibia: Medial & Lateral Condyles, Tibial Tuberosity, Medial Malleolus. • Fibula: Head, Lateral Malleolus. Foot • Tarsals: Talus, Navicular, Calcaneus, Cuboid, 1st–3rd Cuneiforms. • Metatarsals I–V: Base, shaft, head. • Phalanges I–V: Proximal, Middle, Distal. • Arches: Longitudinal & Transverse; support weight & absorb shock. Disorders & Homeostasis • Skeletal Homeostasis: Supports body, protects organs, stores minerals, produces blood cells. • Appendicular Disorders: • Fractures, dislocations, arthritis, osteoporosis. • Can affect mobility, strength, and posture

Week 5 Absolutely — here’s a condensed study guide that keeps the major concepts (the stuff most likely to be tested), without all the extra detail. Infection Control & Body Defenses — Condensed Study Guide (Major Concepts) Chain of Infection (6 Links + how to break them) 1. Infectious agent (bacteria, viruses, fungi, parasites, prions) ○ Break it: disinfect/sterilize/clean; antimicrobials as ordered 2. Reservoir (where it lives: people/animals/insects; soil, water, food, equipment, IV fluids, feces) ○ Break it: hand hygiene, pre-op skin prep, environmental cleaning 3. Portal of exit (blood/body fluids, respiratory/GI tract, mouth/nose/ears, skin) ○ Break it: contain drainage/secretions (dressings, drains) 4. Mode of transmission ○ Main: contact, droplet, airborne (also vehicle, vector) ○ Break it: hand hygiene + PPE + disinfect shared equipment 5. Portal of entry (orifices, mucous membranes, breaks in skin; invasive devices) ○ Break it: aseptic technique, protect skin, sterile technique when needed 6. Susceptible host (risk depends on immunity/health) ○ Break it: immunizations, nutrition, hygiene, blood sugar control Virulence: how efficient an organism is at making people ill. Modes of Transmission (what to recognize) Contact ● Direct: person-to-person (ex: blood to open abrasion) ● Indirect: contaminated objects/PPE/equipment (ex: bed rails, shared devices) Droplet ● From coughing/sneezing/singing/talking; some procedures (CPR, intubation) ● Examples: influenza, pertussis, RSV, adenovirus, rhinovirus ● Respiratory etiquette + masking when out of room Airborne ● Small particles remain suspended; travel farther ● Requires private room; negative pressure (AIIR) preferred ● Examples: TB, measles (rubeola), varicella Vehicle / Vector ● Vehicle: contaminated food/water (ex: E. coli produce) ● Vector: insects/rodents (mosquitoes, rats) Body Defenses (3 Types) 1. Physical & chemical barriers ○ Skin (primary defense), mucous membranes/mucus, tears/sweat, cilia + cough, stomach acid, normal flora 2. Nonspecific immunity ○ Neutrophils + macrophages (phagocytes “eat and destroy”) 3. Specific immunity ○ Antibodies (immunoglobulins) + lymphocytes Inflammatory Response (key steps + signs) Steps: ● Pattern receptors recognize harmful stimuli ● Inflammatory pathway activated ● Markers released (ex: CRP) ● Inflammatory cells recruited (leukocytes → monocytes/lymphocytes) Signs of inflammation (local tissue): ● heat, redness, swelling, pain, loss of function Triggers can be infectious (viruses/bacteria) or noninfectious (trauma, burns, irritants, toxins, radiation, etc.). Stages of Infection (in order) 1. Incubation (exposure → first symptom; may have lab changes) 2. Prodromal (vague symptoms: malaise, fever, aches) 3. Acute illness (most severe; specific symptoms) 4. Decline (symptoms decrease) 5. Convalescence (recover/return to baseline) Local vs Systemic Infection ● Local: confined to one area (often topical/oral treatment) ● Systemic: enters bloodstream, affects whole body (often IV antibiotics + monitoring) Diagnostic Tests (high-yield) ● UA for UTI symptoms → if WBCs present, culture & sensitivity ● CXR confirms pneumonia/atelectasis but doesn’t tell viral vs bacterial ● CBC + differential ○ Expected WBC: 5,000–10,000/mm³ ○ “Left shift” = increased bands (immature neutrophils) → infection ● Nonspecific markers: CRP, ESR, Procalcitonin Asepsis & Precautions Hand hygiene (most important) ● Soap/water when visibly soiled and for C. diff spores ● Alcohol sanitizer works unless hands visibly soiled Medical asepsis (clean technique) ● reduces microbes; includes isolation precautions Surgical asepsis (sterile technique) ● prevents introducing microbes during invasive procedures; uses sterile supplies/fields Isolation Precautions (major takeaways) Standard precautions ● For all clients ● Protect from blood/body fluids, secretions, excretions, nonintact skin, mucous membranes ● PPE based on expected exposure Contact precautions ● Gown + gloves ● Examples: C. diff, VRE, norovirus, RSV, large draining wounds ● Remove PPE inside room Droplet precautions ● Surgical mask ● Examples: influenza, pertussis, RSV Airborne precautions ● N95 or higher, private room; AIIR/negative pressure preferred ● Examples: TB, measles, varicella Protective isolation (protective environment) ● For severely immunocompromised (ex: post-allogenic HSCT) ● Positive airflow + HEPA (goal: protect the client) Health Care–Associated Infections (HAIs) — the “big 4” ● CLABSI ● CAUTI ● SSI ● VAP Devices/lines/wounds create portals of entry → strict asepsis reduces risk. MDROs (major concept) MDROs = resistant bacteria (hard to treat) Examples: MRSA, VRE, VRSA, VISA, ESBL, MDRSP Prevention: hand hygiene, contact precautions per policy. If you want, I can turn this condensed guide into a 20-question practice quiz (ATI/NCLEX-style) focusing on chain links, precautions, PPE, labs, and transmission. Week 6 Here is a more condensed study guide that keeps all main concepts from your content (no major topics removed), just simplified and streamlined for studying. Condensed Study Guide: Novice to Expert + Nursing Communication I. Novice to Expert Nursing (Benner Model) Lifelong Learning & Collaboration ● Learning occurs through study and working with others ● Nurses grow by: ○ observing experienced nurses ○ sharing knowledge and best practices ● Respect all experience levels (years ≠ only indicator of knowledge) ● Leaders promote: ○ collaboration ○ mutual respect ○ teamwork culture Benner’s 5 Stages of Competence 1. Novice – no experience; relies on rules; struggles to prioritize 2. Advanced Beginner – recognizes patterns; still rule-focused; needs help setting priorities 3. Competent – uses past experience to prioritize; more organized but slower than proficient 4. Proficient – sees the big picture; adapts to changing situations 5. Expert – intuitive, confident, and highly skilled with complex care II. Communication Foundations Definition Communication = transfer of information that is always occurring, even without speaking. Includes: verbal words, body language, emotions, and technology. Why Communication Matters ● Key to client safety (Joint Commission goal) ● Miscommunication → medical errors ● Nurses must detect when clients don’t understand III. Communication Models (Core Concepts) Shannon–Weaver Model (Linear) Sender → Encoder → Channel → Decoder → Receiver + Noise (distractions interfering with message) Schramm Model (Feedback) ● Sender and receiver exchange messages ● Feedback confirms understanding ● No feedback = communication incomplete Newcomb ABX Model (Social) ● A (sender), B (receiver), X (topic affecting interaction) ● Focus on relationships and shared topic Berlo S-M-C-R Model (One-way) ● Sender → Message → Channel → Receiver ● No feedback loop IV. Forms of Communication Verbal Spoken communication (face-to-face or phone) Nonverbal (Body Language) ● Eye contact, posture, facial expressions ● When verbal and nonverbal conflict → nonverbal dominates Auditory What the receiver hears (tone, speed, clarity) Emotional Speaker’s emotional state influences how message is received Energetic Speaker’s presence/empathy affects perception of message V. Modes of Communication (4 Types) 1. Verbal – spoken conversation 2. Nonverbal – gestures, posture, appearance 3. Electronic – email, text, video (must be secure/HIPAA compliant) 4. Written – letters, emails, documents (may lack tone/body language) HIPAA & Electronic Communication Must include: ● secure messaging ● unique logins ● auto logoff ● encrypted/indecipherable PHI VI. Communication Styles Most effective: Assertive ● Passive: avoids conflict; agrees despite concerns ● Assertive: clear, respectful, confident; uses “I” statements ● Aggressive: blaming, hostile, controlling ● Passive-aggressive: indirect expression (sarcasm, avoidance) VII. Therapeutic Communication Purpose Build trust and provide patient-centered, empathetic care Cornerstones ● Compassion ● Caring ● Empathy Peplau’s Nurse-Client Relationship Phases 1. Orientation – client seeks help 2. Identification – relationship forms 3. Exploitation – active teaching/working phase 4. Resolution – issue resolved; relationship ends Watson’s Theory of Human Caring ● Authentic presence ● Protect dignity ● Loving-kindness ● “Healing moment” interactions VIII. Therapeutic Communication Techniques (Must Know) ● Active listening – attend to verbal + nonverbal cues ● Open-ended questions – encourage discussion (“Tell me more…”) ● Silence – allows client to reflect and share more ● Restating / summarizing – repeat message to confirm understanding ● Reflection – mirror feelings (“What do you think you should do?”) ● Accepting – acknowledge message without judgment ● Giving recognition – note change without compliment ● Focusing – gently redirect to important topic ● Offering self – sit with client and be present IX. Nontherapeutic Communication (Avoid) ● Giving advice ● False reassurance (“You’ll be fine”) ● Criticizing or challenging ● Asking “Why” questions ● Rejecting or disagreeing ● Probing irrelevant topics ● Changing the subject Effects: ● increased stress ● damaged trust ● poor outcomes X. Interprofessional Communication Importance Effective teamwork improves: ● client outcomes ● safety ● efficiency ● reduces errors IPEC Core Competencies 1. Mutual respect among team members 2. Use shared knowledge collaboratively 3. Communicate effectively as a team 4. Support team values and client-centered care XI. Motivational Interviewing (MI) Purpose Encourage behavior change (diabetes, obesity, substance use) OARS Technique ● Open-ended questions ● Affirmations (positive encouragement) ● Reflective listening ● Summarizing XII. Group vs Individual Communication ● Individual: new diagnosis, personal teaching ● Group: ongoing education, support groups XIII. Communication Barriers (Major Categories) Cognitive/Developmental ● dementia, stroke, autism Physiological ● hearing loss, vision impairment Cultural & Language ● language differences, cultural beliefs, lack of cultural competence Environmental/Situational ● noise, lighting, temperature ● fear, anxiety, fatigue, stress Technological ● poor reception, distractions, electronic errors XIV. Strategies to Overcome Barriers Universal Strategies ● show empathy and respect ● avoid interrupting ● use simple, clear language ● confirm understanding (summarize/reflect) Language Barriers (CLAS Standards) ● Use qualified medical interpreter ● Do NOT use family members or translation apps ● Required for federally funded facilities Hearing Impairment Strategies ● face the client ● speak clearly/moderate pace ● reduce background noise ● use written info or visual aids ● ensure hearing aids in place ● speak to client (not interpreter) if interpreter present Vision Impairment Strategies ● introduce yourself ● give clear directions (“door at 10 o’clock”) ● allow client to hold your arm ● provide large print/audio/Braille materials Cognitive/Developmental Strategies ● use simple words ● avoid jargon/slang ● speak slowly and clearly ● reduce noise/bright distractions ● ensure glasses/hearing aids available Key Takeaways (Exam Focus) ● Benner’s stages: Novice → Advanced Beginner → Competent → Proficient → Expert ● Communication must include feedback to be effective ● Nonverbal cues often outweigh verbal messages ● Best communication style = Assertive ● Core therapeutic techniques = active listening, open-ended questions, silence, reflection, summarizing ● Use qualified interpreter for language barriers (CLAS standard) ● Barriers include cognitive, physical, cultural, environmental, and emotional factors ● Effective communication improves client safety and outcomes Here is a condensed but complete study guide that keeps all concepts from the Safety lesson while removing extra wording. SAFETY & PATIENT PROTECTION – CONDENSED STUDY GUIDE I. Joint Commission National Patient Safety Goals (NPSGs) Purpose Annual goals to improve: ● Client safety ● Safe, effective care ● Prevention of adverse outcomes 1. Identify Clients Correctly ● Use two identifiers (name, DOB, MRN, etc.) ● Confirm before meds, procedures, treatments ● Ask open-ended questions ● Verify ID band & EMR ● Use barcode scanning ● ❌ Never use room number 2. Improve Staff Communication ● Report critical results immediately ● Critical results = life-threatening abnormal labs/diagnostics ● Facility policies define: ○ critical result criteria ○ reporting timeframe ○ documentation requirements ● Communicate directly (in person/phone), not voicemail (HIPAA) 3. Use Medications Safely Label medications ● Label all syringes/containers with name, dose, date/time ● Discard unlabeled meds Anticoagulant safety ● Examples: warfarin, heparin, enoxaparin ● Monitor labs, weight, interactions, dosing ● Educate on risks, food interactions, follow-up labs Medication reconciliation ● Compare home meds with new prescriptions ● Done on admission, transfer, discharge ● Resolve discrepancies 4. Use Alarms Safely ● Clinical alarms warn of patient events or equipment malfunction ● Examples: IV pumps, ventilators, monitors, bed/chair alarms ● Risk: alarm fatigue ● Nurse role: ○ know alarm priorities ○ respond promptly ○ help develop alarm policies 5. Prevent Hospital-Acquired Infections (HAIs) Common HAIs: ● CLABSI ● CAUTI ● SSI ● VAP Concern: MDROs (MRSA, VRE, C. diff) ⭐ Hand hygiene = most important prevention Compliance required with monitoring and action plans. 6. Identify Safety Risks: Suicide Prevention ● Screen behavioral health clients ≥12 yrs ● Positive screen → detailed suicide assessment ● Implement: ○ constant observation ○ removal of harmful items ○ environmental safety checks ○ staff competency training 7. Universal Protocol (Surgery Safety) Prevent wrong-site/procedure/client: 1. Two identifiers 2. Mark surgical site (if applicable) 3. Time-out before procedure 4. Verify consent & procedure with client 8. Improve Health Care Equity (2024 Goal) Assess social determinants: ● literacy ● housing ● transportation ● food access Continue assessment throughout hospitalization and discharge planning. II. Standards of Compliance Former NPSGs now routine standards: ● Medical error prevention ● Staff competency verification ● Client rights & education ● Infection control ● Medication management ● Emergency preparedness III. Culture of Safety Promotes: ● open communication ● reporting of errors & near misses ● nonpunitive environment ● improved outcomes & staff satisfaction Nurses play key role due to frequent client contact. IV. Transforming Care at the Bedside Initiative 1. Spend 70% of time in direct bedside care 2. Leadership development 3. Rapid Response Team (RRT) 4. Standardized communication (ISBARR) Benefits: ● fewer falls, HAIs, med errors ● improved outcomes and satisfaction V. Rapid Response Team (RRT) Interdisciplinary team (ICU nurse, RT, provider) for sudden deterioration. Call RRT for: ● sudden vital sign changes ● low O₂ despite intervention ● chest pain after nitro ● seizure ● sudden mental status change ● serious clinical concern VI. ISBARR Communication Tool 1. Identity 2. Situation 3. Background 4. Assessment 5. Recommendation 6. Read-back VII. Types of Unexpected Events ● Near miss: error caught before harm ● Client safety event: event with potential harm ● Adverse event: unexpected harm occurred ● Sentinel event: severe harm/death (never event) Examples sentinel: ● wrong-site surgery ● suicide in facility ● serious fall injury VIII. Occurrence (Incident) Reporting Purpose: improve systems, prevent future errors (not punishment) Report: ● falls/injuries ● wrong meds ● adverse reactions ● blood/body fluid exposure ● property damage ● unsafe behaviors/events IX. Safety Assessment & Agencies Regulated by: ● TJC ● CMS ● OSHA ● State boards & local agencies Nursing safety focus: ● falls ● meds & allergies ● restraints ● pressure injury prevention ● infection control ● sharps & pathogen exposure ● body mechanics ● fire, chemical, radiation safety X. Electrical Safety Check: ● frayed cords ● grounded 3-prong plugs ● GFCI outlets ● no wet handling ● avoid extension cords ● tag/remove faulty equipment XI. Chemical Safety Exposure routes: ● inhalation ● skin/eyes ● ingestion ● injection (needlestick) Use: ● SDS sheets ● PPE (gloves, masks, gowns, goggles) ● ventilation systems ● emergency eye wash/showers XII. Radiation Safety Risk proportional to: ● exposure time ● distance from source Principles: 1. Reduce time 2. Increase distance 3. Shield (lead aprons, barriers) Types: ● Alpha (least risk, short travel) ● Beta (moderate risk, small distance) ● Gamma (highest risk, penetrates tissue) Initial symptoms: ● nausea, vomiting, diarrhea ● burns, alopecia ● immunocompromise ● psychological effects XIII. Age-Related Safety Risks Infants/Preschoolers ● burns, poisonings, choking, drowning ● car seat safety ● smoke detectors & safe storage of toxins School-Age ● sports injuries, firearm safety, internet risks Adolescents ● substance use, risky driving, violence, suicide risk Adults/Older Adults ● chronic illness, frailty, mobility decline ● ⭐ Major risk: falls ● frailty → poorer outcomes XIV. Hospital-Acquired Injuries Include: ● SSIs, CAUTIs, CLABSIs ● falls, trauma ● pressure injuries ● DVT ● insulin errors ● transfusion reactions ● burns/electrical shock High-risk clients: ● neurologic disorders (stroke, MS, Parkinson’s) ● cognitive impairment, dementia ● communication disabilities ● visual deficits ● behavioral disorders XV. Screening Tools Used to identify early risk: ● Morse Fall Scale (fall risk) ● Braden Scale (pressure injury risk) ● Tools must be valid/reliable Positive results → detailed assessment + individualized care plan. XVI. Home Hazard Safety Bathroom: ● grab bars, non-slip mats, raised toilet, step-free showers Bedroom: ● low bed, alarms, hospital bed if needed Kitchen: ● reachable items, automatic stove shut-off, secure chemicals General: ● good lighting, remove loose rugs, secure cords, install handrails ● cordless blinds for child safety ● emergency numbers accessible XVII. Fire Safety RACE ● Rescue ● Alarm ● Contain (close doors/windows) ● Extinguish PASS ● Pull pin ● Aim at base ● Squeeze ● Sweep Fire extinguisher types: ● A: paper/wood ● B: liquids/oils ● C: electrical ● D: metals ● K: kitchen grease ● ABC: multipurpose Evacuation: ● Lateral = same floor (preferred) ● Vertical = different floor XVIII. Workplace Safety Bullying ● Repeated harassment/belittlement ● Leads to burnout, errors, poor retention Workplace Violence Includes verbal abuse to homicide Risk factors: ● violent clients ● staff shortages ● long wait times ● lack of training/security Active Shooter Response 1. Run 2. Hide 3. Fight (last resort) XIX. Emergency Preparedness Facilities must have: ● disaster plans ● staff training & drills ● defined staff roles Types of mass exposure: ● Radiation ● Biological (anthrax, Ebola, COVID) ● Chemical toxins Response: ● PPE ● decontamination (remove clothing, shower) ● monitor vitals & mental status XX. Injury Prevention Strategies ● hourly rounding ● video monitoring ● bedside sitters ● individualized safety plans ● prompt call-light response XXI. Fall Prevention Risk factors: ● weakness, gait issues, vision problems ● confusion, dementia, impulsiveness ● clutter, poor lighting ● high-risk meds (antihypertensives, antidepressants) ● incontinence, age Universal precautions: ● nonskid footwear ● low bed & locked wheels ● clutter-free room ● call light within reach ● hourly rounding & quick response Movement alarms = warning device Siderails: ● 2 rails for safety ● 4 rails = restraint (intent matters) XXII. Restraints & Seclusion Types: ● Physical: manual holding ● Mechanical: mitts, wrist, vest, 4-point ● Chemical: sedatives/antipsychotics ● Barrier: enclosures, lapboards, 4 rails ● Seclusion: locked room Use ONLY as last resort when: ● danger to self/others ● removing life-saving devices ● severe aggression Care of restrained client: ● frequent circulation, skin, respiratory checks ● ROM, hygiene, fluids, elimination ● reevaluate every 24 hrs ● discontinue ASAP XXIII. Seizure Precautions Preseizure ● suction & oxygen ready ● padded rails ● IV access ● remove restrictive clothing/jewelry During seizure ● call for help ● side-lying position ● protect head ● do NOT restrain ● monitor duration & movements ● give benzodiazepine if ordered Postseizure ● assess gag reflex before oral intake ● reassure client ● labs, EEG, imaging as ordered XXIV. Musculoskeletal Injury Prevention (Nurse Safety) Use assistive devices: ● Hoyer lift (ground lift) ● ceiling lift ● slide sheets ● sit-to-stand lift Safe handling: ● clear area ● use correct sling size ● have 2 staff assist ● lock brakes ● never leave client unattended XXV. Patient-Centered Care Focus: ● client as center of care ● collaboration & shared decision-making ● respect cultural, spiritual, religious needs ● holistic & individualized care ● include pastoral care support FINAL MEMORY CHECK (High-Yield Core Concepts) ● Two identifiers before any care ● Hand hygiene prevents HAIs ● Time-out before surgery ● ISBARR improves communication ● RRT for sudden deterioration ● Fall prevention + restraints last resort ● RACE & PASS fire response ● Run–Hide–Fight for active shooter ● Time–distance–shielding for radiation safety ● Screening tools identify early risks Here is a fully condensed study guide that includes ALL major topics and concepts from your lesson (patient-centered care, caring theories, cultural care, spirituality, advocacy, sleep & rest) without leaving anything out. CONDENSED STUDY GUIDE: PATIENT-CENTERED CARE, CARING, CULTURE, ADVOCACY & SLEEP I. Patient-Centered Care Definition Patient-centered care = placing the client at the center of all care, focusing on preferences, culture, and holistic needs rather than just tasks or documentation. Key Concepts ● Improves client satisfaction and outcomes ● Involves caring, preferences, cultural respect, and shared decision-making ● Holistic care: physical, emotional, spiritual needs II. Caring in Nursing Definition Caring = nurturing another person with responsibility and commitment; core of professionalism. Holistic Caring Includes ● Healing environment ● Kindness, empathy, compassion ● Addressing physical, emotional, and spiritual needs III. Caring Theories A. Watson’s Theory of Human Caring Holistic model focusing on mind-body-spirit harmony through transpersonal (human-to-human) caring relationships. Core Ideas ● Caring moments foster healing and self-restoration ● Nurse must achieve inner balance and spirituality ● Establish trusting presence and relationships 10 Caritas Processes 1. Loving-kindness and compassion 2. Authentic presence and honoring beliefs 3. Sensitivity to self and others 4. Trusting caring relationships 5. Expression of feelings 6. Creative problem-solving through caring 7. Transpersonal teaching/learning 8. Healing environment (comfort, dignity, peace) 9. Reverent assistance with basic needs 10. Openness to spirituality and miracles B. Swanson’s Theory of Caring Caring improves well-being through empowerment, dignity, and respect. Five Caring Processes 1. Maintaining belief – instill hope and meaning 2. Knowing – understand client’s situation/perception 3. Being with – emotional and physical presence 4. Doing for – perform needed tasks for client 5. Enabling – guide and support through events/transitions IV. Caring Behaviors 1. Listening ● Active, empathetic listening ● Observe verbal and nonverbal cues ● Key for holistic assessment and trust 2. Touch ● Used for procedures and expressive caring ● Requires permission; consider culture, trauma, gender ● Can reduce anxiety and increase well-being 3. Being Present ● Physical and emotional availability ● Reduces loneliness and improves comfort ● Reflects “being with” (Swanson) 4. Providing Comfort ● Pharmacologic and nonpharmacologic comfort measures ● Examples: pillows, blankets, hygiene, music, temperature control ● Represents “doing for” 5. Showing Compassion ● Recognize suffering and act to relieve it ● View client as person, not diagnosis ● Requires self-awareness and adequate staffing V. Client Preferences in Care Clients are full members of the health care team and experts on their own experiences. Benefits ● Increased trust and satisfaction ● Improved healing and outcomes ● Greater sense of control Ways to Include Preferences 1. Endorsing participation – empower involvement 2. Promoting understanding – correct misinformation 3. Sharing information – two-way communication Barriers ● Power imbalance ● Medical jargon ● Weakness, fatigue, cognitive impairment ● Poor collaboration and language barriers VI. Cultural Competence Definition Evidence-based care aligned with client’s cultural values, beliefs, and practices. Influencing Factors ● Socioeconomic status ● Health literacy ● Racism experiences ● Sexual orientation ● Acculturation (adapting to another culture) Five Elements of Cultural Competence 1. Cultural awareness – self-examine biases 2. Cultural knowledge – learn client values/beliefs 3. Cultural skill – assess cultural needs accurately 4. Cultural encounters – interact with diverse cultures 5. Cultural desire – motivation to connect with cultures Cultural Assessment Includes ● Cultural/spiritual affiliation ● Health beliefs and practices ● Spiritual rituals ● Dietary preferences/prohibitions ● Care preferences to increase comfort VII. Age-Related (Generational) Care Preferences Generation Preferences Silent (1928–1945) Formal, face-to-face, written communication Baby Boomers Team-oriented, sincere, in-person communication Gen X Direct, independent, questions providers Millennials Tech-based communication, frequent feedback Gen Z Digital natives, prefer texting/email Gen Alpha Tech-savvy children; family-centered care VIII. Spiritual Nursing Care Spiritual Well-Being Feeling of meaning, purpose, and connection to higher power → improves quality of life. Spiritual Assessment Questions ● Source of spiritual strength? ● Meaning-of-life concerns? ● Relationship with higher power? ● Spiritual practices? ● Fear of dying? ● Relationship concerns? Assessment Tools FICA: ● Faith ● Importance ● Community ● Address in care HOPE: ● Hope sources ● Organized religion ● Personal spirituality/practices ● Effects on care/end-of-life issues IX. Spiritual Distress Definition Questioning life meaning or beliefs causing despair, anger, fear, uncertainty. Nursing Interventions ● Listen and be present ● Encourage spiritual expression ● Provide prayer, texts, pastoral referral ● Address emotional and spiritual needs X. Pastoral Care Provides: ● Ethical, religious, and spiritual support ● Counseling, prayer, rituals ● End-of-life and grief support ● Support for families and staff Chaplains assist all clients regardless of religion. XI. Access to Care Barriers ● Lack of insurance ● Transportation problems ● Limited providers/facilities (rural areas) ● Restricted clinic hours ● Medication cost barriers Solutions ● Telemedicine: remote diagnosis/testing ● Telehealth: broader remote clinical and nonclinical services ● Improves access, especially rural areas XII. Client Advocacy Definition Protect client autonomy, rights, and safety; act as client’s voice. Clients Needing Advocacy ● Unconscious ● Children ● Fearful/intimidated clients ● Uninformed about diagnosis/rights Advocacy Steps 1. Assess needs, values, cognition, resources 2. Verify client goals/preferences 3. Implement plan and communicate with team 4. Evaluate outcomes and self-determination Related Concepts ● Medically futile: treatment unlikely to cure or extend life ● Potentially inappropriate treatment: works but may not improve quality of life ● Palliative care: symptom relief + quality of life ● Quality of life: personal meaning, independence, relationships XIII. Sleep and Rest Importance of Sleep Supports: ● Memory, learning, concentration ● Immune system and tissue repair ● Hormone balance (ghrelin, leptin, cortisol) ● Mood, reaction time, coordination ● Prevention of obesity, diabetes, cardiovascular disease XIV. Physiology of Sleep Key Brain Structures ● Cerebral cortex: sensory processing & memory ● Brainstem: controls REM and muscle relaxation ● Hypothalamus: autonomic control, circadian rhythm (SCN) ● Thalamus: sensory filtering during sleep ● Pineal gland: produces melatonin XV. Sleep Regulation Mechanisms 1. Circadian rhythm – 24-hour internal sleep–wake cycle influenced by light and temperature 2. Sleep–wake homeostasis – pressure to sleep increases with sleep deprivation Factors affecting sleep: ● Light exposure ● Stress ● Medications ● Caffeine/food ● Environment XVI. Stages of Sleep NREM Sleep Stage 1: Light sleep; easily awakened (5%) Stage 2: Deeper sleep; decreased HR/temp; memory consolidation (50%) Stage 3: Deep sleep; delta waves; immune strengthening and tissue repair (15%) REM Sleep ● Dream stage ● Irregular breathing and increased HR ● Muscle atonia (prevents acting out dreams) ● Occurs ~90 minutes after sleep onset Sleep cycles repeat 4–6 times per night. XVII. Sleep Patterns by Age ● Newborns: multiple cycles, high REM ● Adults: 2–5% stage 1, 45–55% stage 2, 10–20% stage 3, 20–25% REM ● Older adults: less deep sleep, more awakenings XVIII. Sleep Deprivation Types ● Total: no sleep for extended period ● Partial: reduced sleep hours ● Chronic: ongoing insufficient sleep ● Selective: loss of specific sleep stage Effects ● Impaired judgment and memory ● Mood swings, depression ● Increased accidents and chronic illness risk ● Poor glucose control and obesity XIX. Promoting Sleep Nonpharmacologic Interventions ● Avoid caffeine, nicotine, alcohol before bed ● Keep room dark, quiet, cool ● Establish bedtime routine ● Consistent sleep schedule ● Exercise regularly (not right before bed) ● Limit naps (<30 minutes) ● Remove electronics/TV from bedroom XX. Sensory Overload in Hospital Definition: Excess stimuli beyond brain’s processing ability → sleep disruption. Nursing Interventions ● Lower noise and alarms ● Dim lights ● Provide earplugs/eye masks ● Cluster care tasks ● Control pain and medication effects XXI. Sleep Disorders Insomnia Difficulty falling/staying asleep → fatigue, poor concentration, mood changes Sleep Apnea ● Central: brain fails to signal breathing ● Obstructive: airway collapse; snoring; daytime sleepiness Treatment: CPAP, weight loss, avoid alcohol/smoking Narcolepsy Sudden sleep attacks; possible cataplexy (loss of muscle tone) Hypersomnia Excessive daytime sleepiness despite adequate sleep Restless Legs Syndrome (RLS) Urge to move legs; worsens at night; disrupts sleep Night Terrors Non-REM parasomnia causing panic and no recall; common in children XXII. Pharmacologic Sleep Therapies ● Benzodiazepines (GABA agonists): sedative but dependency risk ● Nonbenzodiazepine hypnotics (most common) ● Melatonin: low-risk first-line option ● Antihistamines: OTC but cause side effects XXIII. Nonpharmacologic Sleep Therapies ● Massage, acupuncture, thermotherapy ● Guided imagery, meditation, music therapy ● Yoga and relaxation techniques ● Sleep diaries to identify patterns and personalize care FINAL KEY POINT Patient-centered nursing integrates: ● Caring theories ● Cultural competence ● Spiritual support ● Client advocacy ● Sleep and comfort promotion Goal: provide holistic care that supports physical healing, emotional well-being, spiritual meaning, autonomy, and optimal quality of life. Week 7 Absolutely—here’s a more condensed study guide that still includes every concept you were given. CONDENSED STUDY GUIDE: ELIMINATION (ALL CONCEPTS) 1) Big Picture ● Elimination (urine + stool) is continuous and essential. Patterns vary, but changes require assessment + intervention to restore usual patterns or establish a new baseline. 2) Urinary System Basics Functions: excrete waste/fluid → urine, regulate electrolytes, support RBC production, help regulate BP, support bone health. Pathway: kidneys → ureters → bladder → urethra → urination. Control: internal sphincter + external sphincter + pelvic floor muscles prevent leakage. Urination: elimination of urine via urethra. 3) Urine Production & Assessment Normal: clear, light yellow, minimal odor. Typical daily amount: ~1–2 quarts/day (varies). Expected output by age: infant ~2 mL/kg/hr; toddler ~1.5; teen ~1; adult ~0.5. Color clues: ● Dark yellow/amber = need fluids ● Dark brown = dehydration/kidney/liver concern ● Red/pink = blood or foods (beets, blackberries, rhubarb) Diet/med effects: ● Fluids ↑ volume, lighter color ● Asparagus ↑ odor ● Dyes can turn blue/green ● Alcohol + caffeine ↑ urine output (can dehydrate if not balanced) Aging urinary changes: ↓ nephrons/kidney function, ↓ bladder tone → incontinence/retention risks. 4) GI System Basics Organs: mouth → esophagus → stomach → small intestine → large intestine → rectum → anus. Peristalsis: contractions that move contents through GI tract. Feces formation: digestion + absorption (small intestine), water absorption + stool formation (large intestine), bacteria help + make vitamin K, rectum stores stool until BM. Bristol Stool Chart: ● Types 1–2 = constipation ● Types 3–4 = expected ● Types 5–7 = diarrhea Aging GI changes: ↓ peristalsis/muscle tone → constipation; ↑ PUD risk (NSAIDs), ↓ elasticity/emptying changes, possible ↓ absorption/bacterial overgrowth, ↓ lactase → lactose intolerance; lifestyle factors (inactivity, low fiber/fluids, meds) contribute. 5) Expected Elimination ● Urine: clear, light yellow, varies with intake/activity/diuretics. ● Stool: frequency varies widely; should be soft/formed, easy to pass without straining. 6) Altered Urinary Elimination Urinary Incontinence (UI) Involuntary urine loss. Can cause skin breakdown + distress. Types: ● Stress: cough/sneeze/exertion ● Urge: sudden urge, leak before toilet ● Reflex: nerve damage, no warning ● Overflow: incomplete emptying → overfill/leak ● Functional: can’t reach toilet (mobility/dexterity issues) ● Nocturnal enuresis: nighttime (kids; adults w alcohol/caffeine/meds) Management: lifestyle changes (↓ caffeine/alcohol, smoking cessation, address constipation), pelvic floor exercises, bladder training, meds/devices/surgery; skin protection (pads/briefs, cleanser, barrier cream). Urinary Retention Incomplete bladder emptying (acute or chronic). Causes: BPH, cystocele/prolapse, obstruction (stones/lesions). Findings: hesitancy, weak stream, frequency, distention, pain, leakage. Risks: UTI, bladder/kidney damage. 7) Altered Bowel Elimination Constipation <3 BMs/week + hard/lumpy stools, difficult to pass. Risks: pregnancy/postpartum, older adults, low fiber/fluids, meds, GI disorders, immobility. Red flags: fever, GI bleeding, severe pain, vomiting, weight loss. Complication: fecal impaction/obstruction (liquid stool may leak around impaction). Tx: fiber + fluids + exercise + bowel training; meds; enema/manual removal; surgery if complete obstruction. Diarrhea Frequent loose/watery stools: acute (1–2d), persistent (>2w <4w), chronic (>4w). Risks: infection, meds, GI disorders, diet. Dangers: dehydration, malabsorption. Adult urgent follow-up: fever ≥102°F, >2 days, ≥6/day, severe pain, blood/black stool. Tx: rehydration; OTC (loperamide/bismuth) if appropriate; antibiotics/probiotics if infectious cause. Bowel Incontinence Urge (can’t reach toilet) most common; passive (unaware leakage). Leads to skin issues + reduced self-esteem. Children: encopresis. 8) Medications That Affect Elimination Constipation: antacids (Al/Ca), anticholinergics/antispasmodics, antiseizure meds, Ca-channel blockers, diuretics, iron, antiparkinsonian, opiates, antidepressants. Diarrhea: antibiotics, magnesium antacids; consider C. diff if severe/persistent after antibiotics. 9) Conditions Altering Urinary Patterns ● Dehydration: thirst, dry mouth, fatigue, dizziness, dark urine; severe needs IV fluids. ● UTI: dysuria, urgency/frequency; can progress to pyelonephritis (fever, flank pain, N/V, hematuria). Tx antibiotics + fluids. Higher risk: females, retention, obstruction, catheters, diabetes, menopause. ● Kidney stones: severe flank pain radiating to groin, hematuria, dysuria, fever/chills, N/V. Tx fluids, pain meds, strain urine, ESWL/surgery. ● Kidney failure: waste/fluid buildup → ↓ urine, HTN, anemia, itching; Tx dialysis or transplant. ● BPH: urethral constriction → retention, nocturia, weak stream; can cause UTIs/damage; Tx meds/surgery. 10) Conditions Altering Bowel Patterns ● Diverticulosis: pouches; Diverticulitis: inflamed/infected pouch → pain/bleeding; risk perforation → peritonitis. Prevent: fiber; nuts/seeds no longer restricted. Tx antibiotics + liquid/soft diet. ● IBS: pain + diarrhea/constipation (IBS-C, IBS-D, IBS-M); Tx diet (fiber/probiotics, avoid triggers), stress reduction, sleep/exercise, meds. ● Bowel obstruction: blockage → N/V, distention, severe constipation; NG decompression + surgical consult. ● Ileus: decreased/absent motility (often post-op/illness/meds) → absent bowel sounds, distention, N/V; Tx NPO, NG tube, IV fluids; consider TPN if prolonged. ● Ulcerative colitis: colon inflammation/ulcers → bloody diarrhea, fatigue, anemia; Tx meds; surgery if refractory/cancer risk. ● Crohn’s: inflammation anywhere (often small intestine) → diarrhea, weight loss, anemia; complications fistulas/abscess/obstruction; Tx meds + possible surgery. 11) Diversions & Ostomies Urinary Diversions ● Catheterization (temporary) ● Ureteral stent ● Ileal conduit/urostomy (stoma + pouch) ● Nephrostomy (kidney → external bag) ● Neobladder (internal reservoir, may need catheter) ● Continent cutaneous reservoir (internal pouch + valve; catheter to empty) ● Cystostomy (catheter directly into bladder) Complications: UTIs, kidney infection, skin breakdown; psychosocial concerns. Fecal Diversions ● Ileostomy ● Colostomy (+ irrigation option for some permanent colostomies) ● J-pouch (internal ileal reservoir connected to anus; often temporary ileostomy first) ● Kock pouch (continent ileostomy; catheter to empty) Complications: skin irritation, hernia/prolapse/stenosis, blockage, diarrhea, bleeding, electrolyte imbalance, infection, leakage. WOC nurse supports education + supplies + skin/stoma care. 12) Diagnostics & Specimen Collection Urinary ● Urodynamics: uroflowmetry, postvoid residual, cystometric test, leak point pressure, EMG, video urodynamics, pressure-flow study ● Scopes: cystoscopy, ureteroscopy ● Urinalysis: visual + dipstick + microscopic (WBC, RBC, bacteria, casts, crystals) ● Urine culture: clean catch midstream; grows organism + susceptibility testing (correct antibiotic; reduces resistance) ● 24-hour urine: collect all urine, refrigerate, avoid certain foods/meds Urine collection methods: clean catch vs catheter (sterile technique for intermittent/indwelling). GI ● Tests: celiac testing, colonoscopy, ERCP, sigmoidoscopy, upper/lower GI series, upper endoscopy ● FOBT: dietary/med restrictions to prevent false positives (ex: beets, red meat, some veggies; aspirin/ibuprofen/Vit C) ● Stool culture: for severe/persistent diarrhea (travel, contaminated food/water, antibiotics) 13) Nursing Interventions Promote Urinary Elimination ● Bedpan/urinal assistance + measure output + privacy + skin check ● Bladder irrigation (ordered; pain is NOT expected → report) ● Lifestyle: avoid bladder irritants; appropriate fluids; weight loss; stop smoking ● Bladder training + elimination journal ● Bladder scan to avoid unnecessary catheterization ● Catheters: intermittent, indwelling, external male condom, external female wick ● CAUTI prevention: sterile insertion for indwelling/intermittent; daily hygiene; handwashing; keep system clean Promote Bowel Elimination ● Fiber, hydration, activity, respond to urge, stress management ● Bowel training (may use laxatives) ● Enemas: cleansing vs retention; solutions hypotonic/isotonic/hypertonic (tap water can cause electrolyte shifts) ● Laxatives: ○ Bulk-forming ○ Surfactant (stool softener) ○ Stimulant ○ Osmotic ● Rectal tubes/fecal management systems for severe incontinence Skin Care for Incontinence ● Clean promptly, rinse, pat dry ● Moisturize (alcohol-free) ● Barrier ointments/pastes/sealants ● Assess for nonblanchable redness, blisters, wounds/ulcers NG Decompression (for obstruction/ileus) Measure nose → ear tragus → xiphoid, advance with swallowing, confirm placement (x-ray/capnography/pH per policy), secure + suction as ordered. If you want, I can also turn this into a 1-page “exam cram” sheet (still including every concept, just in ultra-compact bullets). Condensed Study Guide: Main Concepts (Elimination + Sensory Perception) 1) ELIMINATION (URINARY + BOWEL) Urinary system basics ● Organs: kidneys → ureters → bladder → urethra ● Kidneys: filter blood, remove waste/fluid, regulate electrolytes & BP hormones, support RBC production. ● Normal urine: clear, light yellow, minimal odor. ○ Dark yellow/amber: dehydration. ○ Red/pink: blood or foods (beets). ○ Brown: severe dehydration/liver/kidney issues or certain foods. Expected urine output (high-yield) ● Adults: ~0.5 mL/kg/hr ● Output generally decreases with age (↓ nephrons, ↓ renal blood flow). Urinary alterations Urinary incontinence = can’t control urination Types: ● Stress: cough/sneeze/exertion → leak ● Urge: sudden strong urge → can’t reach toilet ● Overflow: bladder overfills from incomplete emptying → dribbling/leak ● Reflex: nerve damage → unpredictable leakage ● Functional: can’t get to toilet in time (mobility/dexterity issues) ● Nocturnal enuresis: nighttime bedwetting Key nursing focus: skin protection (barrier creams, briefs/pads), reduce irritants, bladder training, pelvic floor exercises. Urinary retention = can’t empty bladder fully ● Causes: BPH, prolapse (cystocele), obstruction (stones), neuro issues. ● Findings: hesitancy, weak stream, frequency, distention, pain, leakage. ● Risks: UTI, bladder/kidney damage. ● Interventions: identify cause, drain bladder if needed, bladder scan, catheterization if ordered. Common urinary conditions ● Dehydration: thirst, dry mouth, dizziness, dark urine, low urine; severe → IV fluids. ● UTI: dysuria, urgency/frequency; untreated → pyelonephritis (fever, flank pain, N/V). Treat: antibiotics + fluids. ● Kidney stones: severe flank pain radiating to groin, hematuria, N/V; treat pain + fluids, strain urine, possible lithotripsy/surgery. ● Kidney failure: ↓ urine, HTN, anemia, itching; treat dialysis/transplant. ● BPH: frequency/nocturia, weak stream, retention/incontinence; treat meds/surgery. Bowel system basics ● GI tract: mouth → esophagus → stomach → small intestine → large intestine → rectum → anus ● Peristalsis moves contents forward. ● Stool: should be soft/formed, easy to pass (no straining). Bristol Stool Chart (quick) ● 1–2: constipation (hard/lumpy) ● 3–4: ideal/normal ● 5–7: diarrhea (loose/watery) Bowel alterations ● Constipation: <3 BMs/week + hard stool/straining ○ Risks: impaction/obstruction (esp immobile/neuro injury). ○ Tx: fiber, fluids, activity, bowel training, stool softeners/laxatives; impaction → enema/manual removal. ● Diarrhea: frequent loose watery stools ○ Danger: dehydration, electrolyte imbalance; red flags: blood/black stool, fever, severe pain, lasts >2 days. ○ Tx: rehydration, remove irritants; meds like loperamide (if appropriate); infection → meds/probiotics as ordered. ● Bowel incontinence: urge (can’t reach toilet) vs passive (leak without awareness). ○ Nursing: skin care, scheduled toileting, bowel training, protect dignity. Diversions (know names + purpose) Urinary diversions ● Catheterization: intermittent or indwelling ● Ureteral stent: keeps ureter open ● Urostomy/ileal conduit: urine exits through stoma into pouch ● Nephrostomy: kidney → external drainage ● Cystostomy (suprapubic): catheter directly into bladder ● Neobladder/continent reservoir: internal storage; may need catheter to empty Complications: infection, skin breakdown, psychosocial stress. Fecal diversions ● Ileostomy: ileum → stoma (often liquid stool) ● Colostomy: colon → stoma (more formed depending on location) ● J-pouch: internal ileal reservoir connected to anus ● Kock pouch: continent ileostomy; catheter to empty Complications: skin irritation, leaks, hernia/prolapse, blockage, diarrhea, electrolyte issues. Diagnostic tests/specimens (high-yield) Urinary ● Urinalysis: dipstick + microscopic ● Urine culture: clean catch; susceptibility testing picks the right antibiotic ● 24-hr urine: measures substances over time ● Urodynamics: bladder function (uroflowmetry, PVR, cystometrics, etc.) ● Cystoscopy/ureteroscopy: visualize urinary tract GI ● FOBT: check hidden blood (avoid foods/meds that cause false positives) ● Stool culture: severe/persistent diarrhea, travel, prolonged antibiotics ● Colonoscopy, sigmoidoscopy, upper GI endoscopy, ERCP, GI series as indicated Nursing priorities (elimination) ● Assess: amount, frequency, color/odor, pain, stool type. ● Prevent skin breakdown: cleanse, dry, barrier creams, frequent checks. ● Promote normal patterns: hydration, fiber, activity, timed toileting, privacy, proper equipment (bedpan/urinal). ● Reduce infection risk: sterile technique for invasive catheters; minimize indwelling catheter days (CAUTI prevention). 2) SENSORY PERCEPTION (ALL MAIN CONCEPTS) Big picture ● Stimulus → sensory organ → CNS/cranial nerves → brain interprets → response ● Problems can be in reception, perception, or response. Key terms ● Sensory deficit: reduced function (vision/hearing/touch/etc.) ● Sensory deprivation: too little stimulation ● Sensory overload: too much stimulation → anxiety/confusion ● SPD: detects stimuli but brain misprocesses → oversensitive/overwhelmed Cranial nerves (only what’s essential) ● I smell, II vision, III/IV/VI eye movement ● V facial sensation/jaw ● VII facial expression + taste (front tongue) ● VIII hearing/balance ● IX/X swallowing/gag/voice ● XI shoulder shrug/head turn ● XII tongue movement Vision: most tested disorders ● Refractive errors: myopia, hyperopia, astigmatism, presbyopia ● Cataracts: cloudy lens → blurry/hazy, ↓ color ● Diabetic retinopathy: retinal vessel damage → floaters/blur → blindness risk ● Glaucoma: ↑ intraocular pressure → loss of peripheral vision (irreversible) ● Macular degeneration: loss of central vision (older adults) Tests: Snellen/Tumbling E; slit lamp; fluorescein angiography; visual field test; intraocular pressure; Amsler grid. Hearing ● Anatomy: outer → middle (ossicles) → inner (cochlea) → CN VIII. ● Tinnitus: ringing/buzzing without sound. ● Types of loss: ○ Sensorineural: inner ear/nerve (aging = presbycusis, loud noise, ototoxic meds) ○ Conductive: sound can’t travel (wax, otitis media, perforation, otosclerosis) ○ Mixed: both Tests: Rinne, pure-tone audiometry; ABR/OAE (screening). Speech/Aphasia (stroke-related high yield) ● Broca/expressive: understands but can’t produce words well (“telegraphic” speech) ● Wernicke/fluent: lots of words, no meaning; poor comprehension ● Global: severe impairment of both Touch ● Hypersensitivity / defensiveness (painful to normal touch) vs hyposensitivity (reduced pain/temp). ● Major causes: peripheral neuropathy (diabetic), spinal cord injury. ● Testing: neuro exam, sensation checks, nerve conduction, EMG, MRI. Smell & taste (often linked) ● Taste disorders: hypogeusia (↓ taste), ageusia (no taste), dysgeusia (metallic/rancid), phantom taste ● Smell disorders: anosmia (no smell), hyposmia (reduced), parosmia (distorted), phantosmia (smell not real) ● Causes: URIs, sinus disease, head injury, smoking, meds, zinc deficiency, neuro disorders. Aging effects (must know) ● Vision & hearing decline most. ● Vision: smaller pupils, less lens flexibility, weaker extraocular muscles, ↓ tears/dry eyes. ● Hearing: high-frequency loss, cerumen impaction, tinnitus. ● Taste/smell: ↓ taste buds + ↓ saliva → ↓ appetite → malnutrition risk. ● Touch: ↓ circulation → ↓ temperature/pain sensitivity. Nursing priorities (sensory) ● Safety + independence + emotional support ● Vision: lighting, corrective lenses, remove clutter, orient to room, fall prevention. ● Hearing: face client, reduce background noise, check hearing aids, use written info/interpreter. ● Speech: allow time, don’t finish sentences, use boards/paper/tablet. ● Touch: injury prevention (diabetic foot care, protective footwear, daily inspection). ● Smell/taste: oral hygiene, season foods, smoke/CO detectors, avoid smoking. If you want, I can turn this into a one-page “test-ready” version (even shorter, like only definitions + red flags + key interventions). Condensed Study Guide: Complementary & Integrative Health (CIH) / CAM / Holistic Nursing 1) Key Terms (know the differences) ● Conventional (Western) medicine: Evidence-based diagnosis & treatment (meds, surgery, radiation). Also called mainstream, allopathic, biomedicine, orthodox. ● Complementary therapy: Used with conventional care (ex: aloe + NSAID for sunburn). ● Alternative therapy: Used instead of conventional care. ● Integrative health: Combines conventional + complementary + alternative in a coordinated plan (mind–body–spirit). ● Holistic nursing: Client-centered care treating the whole person (physical, emotional, spiritual, social, cultural, environment). Focus is healing + wellness, not just curing disease. 2) NCCIH Categories (how CIH is “delivered”) Nutritional approaches ● Herbs/botanicals, supplements, vitamins/minerals, probiotics, dietary therapies ● Usually OTC and labeled as dietary supplements Psychological (mind–body) approaches ● Relaxation, meditation, mindfulness/MBSR, guided imagery, biofeedback, hypnosis, prayer Physical approaches ● Hands-on body structures/systems: massage, chiropractic, osteopathy, spinal manipulation, heat/cold, reflexology Bioenergetic (energy) therapies ● Veritable energy = measurable EM fields/light/magnets ● Putative energy (biofields) = subtle energy concepts ● Examples: Healing Touch, Therapeutic Touch, Reiki, Tai Chi, qi gong, acupressure Whole medical systems ● Complete systems separate from Western medicine: ○ Ayurveda, Traditional Chinese Medicine (TCM), Unani, Kampo ○ Also: Homeopathy, Naturopathy, Functional medicine (root-cause focus) Combined approaches ● Blends multiple categories: yoga, mindfulness eating, dance/art/music therapy 3) Why it matters (nursing relevance) ● Many clients use CIH (often alongside prescriptions). Nurses must: ○ Assess what clients use ○ Prevent interactions/harms ○ Provide culturally congruent care ○ Support self-care + empowerment ● Holistic nursing priorities ○ Promote wellness, honor caring–healing relationship ○ Respect subjective experience of illness/healing ○ Encourage informed decisions + active participation ○ Incorporate cultural beliefs/folk practices safely 4) High-yield Mind–Body Therapies (what they do) ● Deep breathing: control rate/depth → ↓ anxiety/stress ● Meditation: quiet mind/focused attention → ↓ BP/HR, ↓ stress effects ● Mindfulness: present-moment awareness; can reduce stress and improve coping ● Guided imagery: mental visualization → relaxation, pain/anxiety reduction ● Prayer: spiritual coping/connection (client-defined) ● Progressive relaxation: systematically tense/relax muscle groups ● Yoga (meditative movement): poses + breathing ± meditation → stress, sleep, anxiety; also pain (back/neck) support ● Aromatherapy: essential oils (inhaled/topical) → relaxation, anxiety relief; some evidence for nausea (ex: ginger/lavender/peppermint blends) ● Acupuncture/acupressure: stimulates points/meridians → pain, nausea, fatigue, anxiety support ● Hypnotherapy: focused attention + suggestion → phobias, anxiety, pain, habits (smoking) ● Biofeedback: device-assisted control of body functions (HR, tension) → stress, headaches, rehab, pain 5) Manual Therapies (hands-on) ● Massage: manipulates soft tissues → pain/anxiety/insomnia support ○ Precautions: avoid over clots/tumors/prostheses; caution with anticoagulants/low platelets (bruising/bleeding); older adults risk (rare) fractures ● Reflexology: foot/hand zones thought to correspond to body functions ● Chiropractic: spinal manipulation + structural focus; no surgery/Rx meds ● Osteopathic medicine: structure-function relationship; osteopathic manipulation used by trained physicians 6) Bioenergetic / Movement Therapies ● Tai Chi / Qi gong: meditative movement; balance, function, stress reduction ● Alexander Technique: posture/neck-spine alignment awareness → chronic pain support ● Feldenkrais: mindful movement retraining → pain + mobility ● Rolfing/Structural integration: deep tissue/fascia work → posture/function ● Pilates: core/torso control, posture → balance, flexibility, pain relief ● Therapeutic Touch / Healing Touch / Reiki: energy-based touch; may support relaxation, pain reduction, agitation (ex: dementia) 7) Traditional / Indigenous Practices (cultural competence) ● Traditional medicine (WHO concept): culture-based knowledge/practices for prevention/diagnosis/treatment—often includes spirituality. ● Examples: Native healing practices (prayer, drumming, storytelling, sacred rituals), herbal use, cupping, etc. ● Nursing: respect beliefs, ask what practices are important, integrate safely. 8) Whole Medical Systems (quick ID) ● Ayurveda: balance mind–body–spirit; doshas; cleansing + diet + herbs + yoga/meditation ● TCM: acupuncture, Tai Chi/qi gong, herbs; balance yin/yang + qi flow ● Naturopathy: “body heals itself” supported by diet, lifestyle, herbs, supplements, homeopathy, etc. ● Homeopathy: “like cures like,” highly diluted remedies ● Functional medicine: root-cause, systems-based approach 9) Natural Products: BIG SAFETY POINTS (test favorites) FDA/supplements ● FDA regulates supplements, but manufacturers are responsible for quality/claims → variability exists. ● “Natural” ≠ safe. Must-do nursing action ● Always ask about herbs/supplements/vitamins OTC. ● Encourage a current med + supplement list shared with provider/pharmacist before starting anything new. Common interaction themes ● Bleeding risk (esp with anticoagulants like warfarin): ○ Garlic, ginger, ginkgo, cranberry (large amounts), evening primrose oil, etc. ● Serotonin syndrome risk when mixing certain herbs with antidepressants: ○ St. John’s wort + antidepressants (ex: duloxetine) ● CNS depression/sedation combos: ○ Valerian + sedatives/alcohol/antihistamines ● Vitamin K decreases warfarin effect: ○ Leafy greens (consistency matters) Specific high-yield herbal cautions ● Ephedra (ma huang): banned in U.S. supplements → serious CVA/MI risk (worse with caffeine) ● Kava: can cause liver damage ● Black cohosh: possible liver injury risk ● Tea tree oil: toxic if ingested ● Licorice root: ↑ BP, can lower K+ (esp with diuretics); avoid in pregnancy ● St. John’s wort: many interactions (reduces effectiveness of multiple meds) + photosensitivity Probiotics (basic) ● Support healthy gut flora; can help inhibit harmful bacteria (ex: Lactobacillus) 10) Vitamins & Minerals (core test facts) Vitamins ● Water-soluble: B-complex + C (not stored well → need regular intake) ● Fat-soluble: A, D, E, K (stored in fat/liver → toxicity risk if too much) Vitamin K newborn note: doesn’t cross placenta well; newborns get IM vitamin K to prevent bleeding. B-complex quick purpose (big picture) ● Mostly metabolism/energy, neuro function, RBC formation ● B12: neuro + RBCs (deficiency → anemia, fatigue, neuro changes) Minerals (core roles) ● Needed for: enzyme function, nerve/muscle contraction, fluid balance, bone/teeth ● Examples: ○ Calcium: bones + clotting + nerve impulses ○ Sodium: extracellular fluid, nerve/muscle ○ Potassium: nerve/muscle; high/low can cause arrhythmias ○ Magnesium: metabolic processes; low with alcohol use disorder/DM ○ Iron: oxygen transport; deficiency → anemia Food-drug/nutrient interactions (quick) ● Vitamin C ↑ non-heme iron absorption ● Coffee/tea/wine (polyphenols) + phytic acid (legumes/nuts) ↓ iron absorption Quick “Exam-Style” Reminders ● Complementary = with conventional; Alternative = instead; Integrative = coordinated blend. ● Nursing role: assess use, prevent interactions, educate, support self-care, respect culture. ● Biggest safety issue: herb/supplement interactions (bleeding, serotonin syndrome, sedation, warfarin/vit K). If you want, paste any practice questions from this lesson and I’ll answer them using only what’s in your notes

Lateral and Medial Views of the Ilium

Ilium

ilium, ischium, pubis

Ilium - Lower Extremity

pelvic girdle, sacrum, os coxae, ilium, pubis, ischium

Ilium