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NP&P Unit 1
NP&P Unit 1 (Vital Signs, Mobility, Collaboration and Teamwork, Hygiene.)
| Term | Definition |
|---|---|
| Blood Pressure | A measurement of the force circulating blood exerts on the interior walls of blood vessels. |
| Systole | The contraction phase of the cardiac cycle. During this phase blood is driven into the aorta and pulmonary arteries. |
| Diastole | The relaxation phase of the cardiac cycle where the heart muscle is relaxed and the chambers of the heart fill with blood. |
| Cardiac Output | The volume of blood ejected by the heart ventricles in one minute; calculated by multiplying the stroke volume and pulse rate of the heart. |
| Stroke Volume | Volume of blood ejected by the left ventricle during one contraction. |
| Viscosity | The resistance of a liquid to flow. |
| Peripheral Vascular Resistance | The total resistance to flow of blood in the vascular bed. |
| Contractility | The force required to eject blood from the left ventricle. |
| Cardiac Output Formula | Cardiac Output = Stroke Volume * Heart Rate |
| Preload | The blood remaining in the left ventricle at the end of diastole causing it to stretch. |
| Sphygmomanometer | Instrument used to measure arterial blood pressure. |
| Stethoscope | An instrument used to listen to sounds produced by the body. |
| Korotkoff Sounds | A series sounds created by movement of blood through a partially compressed vessel during a manual blood pressure assessment. |
| Hypertension | A blood pressure that is above the expected reference range. |
| Hypotension | A blood pressure that is below the expected reference range. |
| Normal BP | <120/80 |
| Hypertension Stage 1 | 120-130 Systole 80-89 Diastole |
| Hypertension Stage 2 | >140 Systole >90 Diastole |
| Hypertension Stage 3 | >180 Systole > 120 Diastole |
| Orthostatic Hypotension | A decrease in blood pressure that occurs upon standing, especially from a lying or sitting position. A significant drop in the blood pressure caused by a change in position. |
| Pulse | Rhythmic throbbing or beating caused by the expansion and contraction of the arteries in response to the ejection of blood from the left ventricle. |
| Newborn (Full Term; Birth - 28 weeks) Pulse Range | 110 - 160bpm |
| Infant (1 month - 1 year) Pulse Range | 90 - 160bpm |
| Toddler (1 - 3 years) Pulse Range | 80 - 140bpm |
| Preschooler (3 - 6 years) Pulse Range | 70 - 120bpm |
| School-age (6 - 12 years) Pulse Range | 60 - 110bpm |
| Adolescent (12 - 20 years) Pulse Range | 50 - 100bpm |
| Adult (20+ Years) Pulse Range | 60 - 100bpm |
| Tachycardia | Heart rate above the expected reference range. (Usually >100bpm) |
| Bradycardia | A heart rate that is less than the expected reference range. (Usually <60bpm) |
| Apical Pulse | The heart rate that is heard or felt at the apex of the heart, which is located medially to the midclavicular line at the fifth intercostal space. |
| Temporal Pulse | Beating or throbbing palpated over the temporal artery located on the temple. |
| Brachial Pulse | Beating or throbbing felt over the brachial artery, usually palpated in the antecubital space; it is used to assess the quality of perfusion. |
| Radial Pulse | Beating of throbbing felt over the radial artery, usually palpated over the groove along the thumb side of the inner wrist. |
| Femoral Pulse | Beating or throbbing palpated over the femoral artery, located in the groin on either side of the genitals; it is used to assess the quality of perfusion. |
| Popliteal Pulse | Beating of throbbing palpated over the popliteal artery located behind the knee; it is used to assess the quality of perfusion. |
| Dorsalis Pedis Pulse | Beating or throbbing palpated or heard with a doppler over the dorsalis pedis artery located on the dorsal side of the foot; it is used to assess quality of perfusion. |
| Posterior Tibial Pulse | Beating or throbbing palpated or heard with a doppler over the posterior tibial artery, located on the medial side of the ankle; it is used to assess the quality of perfusion. |
| Pulse Deficit | A difference between the apical and radial pulse rates. This difference indicates a decrease in ventricular contraction or peripheral perfusion. |
| Doppler Ultrasound Stethoscope | A stethoscope fitted with an audio unit and a transducer that amplifies the vascular or other sounds of the body. |
| Body Temperature | The degree of heat of the human body. |
| Normal Body Temperature | 36° C to 38° C (96.8° F to 100.4° F) |
| Hyperthermia | An uncontrolled elevation in body temperature where the body cannot lose heat as fast as it is gained, usually caused by environmental or metabolic factors. |
| S/Sx of Hyperthermia | Dizziness, weakness, thirst, and nausea. If left untreated, hypotension, syncope (fainting), confusion, tachycardia, and impaired coordination can occur. If the body temperature continues to rise, organ failure and death can follow. |
| Hypothermia | Condition in which the body temperature is abnormally low due to the body losing heat faster than it is produced. |
| S/Sx of Hypothermia | Shivering, decreased motor skills, and impaired peripheral perfusion, confusion, poor concentration, dilated pupils, and loss of consciousness can occur. Then loss of deep tendon reflexes, coma, and a high risk for cardiac arrest. |
| Temperature Sites | Oral, Temporal, Axillary, Tympanic, Rectal |
| Tympanic Thermometer | A thermometer that uses infrared scanning of the tympanic membrane (eardrum) to determine body temperature. |
| Temporal Thermometer | A thermometer that uses infrared scanning of the temporal artery to determine body temperature. |
| Oral Thermometer | Body temperature obtained sublingually. |
| Sublingual | Below the Tongue |
| Axillary Thermometer | Body temperature obtained in the axilla with arm held to side of body. |
| Rectal Temperature | Body temperature obtained via the rectum, or anus. |
| Tympanic Temperature | Body temperature obtained via the tympanic membrane (eardrum). |
| Temporal Temperature | Body temperature obtained via a temporal artery scan thermometer. |
| Respiratory Rate | The number of breaths taken per minute. (Inhalation and Exhalation.) |
| Eupnea | Respiratory rate and rhythm that are within the expected reference range. |
| Newborn (Full Term; Birth to 28 Days) Respiratory Rate | 30 to 60/min |
| Infant (1 month to 1 year) Respiratory Rate | 25 to 30/min |
| Toddler (1 to 3 years) Respiratory Rate | 25 to 30/min |
| Preschooler (3 to 6 years) Respiratory Rate | 20 to 25/min |
| School-age (6 to 12 years) Respiratory Rate | 20 to 25/min |
| Adolescent (12 to 20 years) Respiratory Rate | 16 to 20/min |
| Adult (20 years and older) Respiratory Rate | 12 to 20/min |
| Tachypnea | Respiratory rate greater than expected range. |
| Bradypnea | Respiratory rate less than expected range. |
| Apnea | Absence of spontaneous respirations. |
| Cheyne-Strokes | Breathing pattern of cycles that begin with rapid, shallow breaths, increase to deep breaths, ending with periods of apnea. |
| Kussmaul Respirations | Deep, rapid respirations |
| Oxygen Saturation | The percentage of hemoglobin that is saturated with oxygen. |
| Pulse Oximeter | A noninvasive device used to measure oxygen saturation. |
| Dyspnea | The sensation of difficult or labored breathing. |
| Hypoxia | Below normal level of oxygen in body tissue. |
| Mobility | The capacity to move about without restrictions. |
| Remodeling | The process of bone breakdown and replacement that occurs throughout a lifespan. |
| Disuse Osteoporosis | Loss of skeletal mass, density, and strength caused by immobility. |
| Fragility Fractures | Fractures that occur following stress on a bone that would not typically result in a break. |
| Atrophy | Become smaller and weaker often from disuse. |
| Sarcopenia | Loss of lean muscle caused by immobility. |
| Joint Contractures | An abnormal fixation of a joint due to changes in muscles and connective tissue. |
| Foot Drop | A type of joint contracture that results in the foot and toes permanently pointing downward. |
| Cardiac Deconditioning | Atrophy of the heart muscle that results in a decreased amount of blood being ejected from the heart during contraction. |
| Orthostatic Hypotension | A decrease in blood pressure that occurs upon standing, especially from a lying or sitting position. A significant drop in the blood pressure caused by a change in position. |
| Deep Vein Thrombosis (DVT) | A condition that results from a blood clot inside a deep vein, usually within the extremities. |
| Pulmonary Embolism (PE) | An obstruction of blood flow in a pulmonary artery due to the movement of blood clot from an extremity to the lungs. |
| Cerebrovascular Accident (CVA) | Death of brain cells due to a blood clot or the rupture of a blood level within the brain. |
| Myocardial Infarction (MI) | A condition in which arterial blood flow to the heart muscle is blocked resulting in death of cardiac muscle cells. |
| Atelectasis | Collapse of airways and small sections of the lung as a result of shallow breathing. The collapsing of the lung during expansion. |
| Pneumonia | An infection in the lung tissue. |
| Malnutrition | Imbalance in a client's intake that can include deficiencies or excesses in nutrients, vitamins, or calories. |
| Constipation | A condition in which the client has infrequent bowel movements where the stool is hard, lumpy, and difficult to pass. |
| Fecal Impaction | A hardened mass of stool that creates a blockage in the intestines. |
| Gastroesophageal Reflux | A backflow of gastric fluids into the esophagus that can result in irritation of the tissue. |
| Urinary Retention | A condition in which the bladder does not completely empty with urination. |
| Renal Calculi | Stones that develop in the kidney and usually related to dehydration or an increase of stone-forming substances. |
| Self Concept | The beliefs one holds regarding their qualities and attributes formed through experiences. |
| Gait | Manner or style of ambulation. |
| Splint | Rigid or semirigid device designed to support or stretch an injured or altered part of the body. |
| Incentive Spirometer | A device utilized to encourage the client to inhale slow, deep breaths. |
| Activity Intolerance | Inadequate amount of physical or psychological energy to undergo or complete a necessary activity. |
| Activities of Daily Living | Basic essential skills, usually related to personal care, that a person performs every day. |
| Kyphosis | Excessive outward curvature of the upper area of the spine. |
| Mobility Assessment | An objective assessment to determine the amount of assistance required for ambulation and transfers based upon the client's ability to move. |
| Gross Motor Skills | The use of large muscle groups to perform whole body movements. |
| Infancy Mobility Development | During the first year of life, the infant must at first develop the muscles and coordination necessary to hold an erect posture. This is first noted when the infant achieves the ability to lift the chest and then sit independently. |
| Childhood Mobility Development | During childhood, continued practice and development of gross motor skills lead to changes in gait and stance. The fine-tuning of the gait is typically achieved between ages 5 and 7, as the child learns to narrow the base and lengthen the stride. |
| Adulthood Mobility Development | During early adulthood, muscle mass and strength reach their maximum, but there is a slight decline in mobility when performing challenging tasks. |
| Older Adulthood Mobility Development | When an adult reaches the seventh decade of life, changes to body systems can result in a significant decline in the ability to move. Age-related changes that affect mobility include changes in muscle, posture, joint mobility, reflexes, and vision. |
| Dangling | The act of having a client sit on the edge of the bed before moving to a standing position. |
| Gait Belt | A wide, strong belt that allows the caregiver to assist the client with stability. It is placed over the top of the client’s clothing, generally at the waistline. |
| Cane | Canes increase stability and improve gait mechanics. They can be single-point or four-point models. |
| Walker | Walkers can assist with ambulation of clients who experience balance or weakness difficulties. These devices provide a wide, stable base and are available in several varieties. |
| Crutches | Crutches are typically used by younger clients who possess the upper extremity strength needed to use them. |
| Prone | Lying on abdomen with the head turned to one side; hips are unflexed |
| Supine or Dorsal Recumbant | Lying flat on the back, possibly with knees bent |
| Lateral | Side-lying; the hips and knees are flexed with a pillow separating the knees/legs. |
| Low Fowler | Semi-seated or reclined position with the head of the bed elevated 45 degrees; knees may be flexed |
| Semi-Fowler | Head of the bed is elevated 15 to 30 degrees |
| High-Fowler | Head of the bead is elevated 60 to 90 degrees |
| Lateral Semi-Prone Recumbent | Placed between the prone and lateral positions, with the top leg flexed up toward the chest and supported with a pillow; the bottom arm is placed to the side of the torso, not underneath |
| Trendelenburg | Lying flat on the back, with the foot of the bed above the head of the bed |
| Reverse Trendelenburg | The foot of the bed is lower than the head of the bed |
| Maximum Assistance Client | The client cannot bear weight, assist, or maintain a seated position. Use a total mechanical lift or sling. |
| Moderate Assistance Client | The client can maintain a seated position and has some upper extremity strength but lacks enough lower extremity strength to transfer safely. Use sit-to-stand powered lifts and assistive devices. |
| Minimum Assistance Client | The client can rise from a seated position and sustain a steady stand. Use a gait belt and ambulation assistive devices as indicated. |
| No Assistance Client | The client can stand, march or step in place, and walk without any help. |
| Slide Board | A slide board allows the lateral transfer of a client without imposing the physical exertion of lifting on the staff member. |
| Pivot Disc | A pivot disc is used for sitting or standing transfers for clients who are cooperative and have weight-bearing capabilities. |
| Mechanical Sit-to-Stand | A sit-to-stand lift can be used to assist the client in rising from a seated to a standing position. |
| Mechanical Lift | A mechanical lift is required for clients who are unable to support their own weight. These devices are used to lift and move a client from one place to another, such as from the bed to the chair. |
| Range of Motion | The manipulation of a joint within its range of flexion and extension. |
| Passive Range of Motion | The movement of a joint by another individual. |
| Active Range of Motion | Voluntary movement of a joint. |
| Flexion | Bend; reduce the angle between the bones |
| Extension | Straighten the limb |
| Abduction | Move away from baseline/center line |
| Adduction | Bring closer to baseline/center line |
| Pronation | Turning to face backward |
| Supination | Turning to face forward |
| Circumduction | To move in a circular motion |
| Rotation | To move side-to-side |
| Inversion | To turn inward |
| Eversion | To turn outward |
| Benefits of Exercise | Improve health outcomes and reduce the risk of chronic disease, strengthens bones and muscles, can reduce the risk of heart disease, diabetes, and some types of cancer, also improves a client’s overall quality of life and reduces the risk of falls. |
| Collaborative Health Care | A client-centered approach where different health care teams come together and work toward a common goal. |
| Campaign for Action goals | -Expand accessibility to health care -Promote collaboration and teamwork -Encourage nursing roles in leadership -Transform education for nurses -Diversify nursing -Collect workforce data |
| Interprofessional Teams | A setting in which two or more professionals work together. |
| Benefits of the Interprofessional Team pt.1 | -Improved access to and coordination of health care services -Greater efficiency of client referral and client-care services |
| Benefits of the Interprofessional Team pt.2 | -Increased quality of community health services -Decrease in complications, length of stay, sentinel events, mortality, and staff turnover |
| Primary Teamwork Skills presented in TeamSTEPPS pt.1 | -Team structure: Identify who is on the team or who should be included in the team. -Communication: Utilize strategies to communicate effectively among the identified team. |
| Primary Teamwork Skills presented in TeamSTEPPS pt.2 | Leadership: Identify strategies to effectively lead teams and support the team’s use of these strategies. Situation monitoring: Encourage team members to be aware of and understand the teams’ performance and the impact it has on the clients’ outcomes. |
| Primary Teamwork Skills presented in TeamSTEPPS pt.3 | Mutual support: Support the team by providing feedback to assist them to function better as a team (distribute workload, manage conflict) |
| Consultation | The act of a provider formally proposing treatment with another provider, in a different specialty area, to determine best practices in client care. |
| Referral | The act of directing a client from a provider to a specialist provider with delegation of responsibilities for responsibility of care. |
| Discharge Planning | Coordinating detailed planning for client's discharging, or leaving a facility, or level of care, to alleviate gaps, or oversights in treatments or care. |
| Interpersonal Communication | Person-to person communication skills within personal and professional relationships. |
| Silos | Groups within an organization's infrastructure that work with their own area of responsibility and create a division of labor. |
| The Joint Commission | An independent, not-for-profit, unbiased accreditation and certification agency, for assessing quality client safety and care of health care organizations. |
| Closed Loop Communication | Is the use of standardized terminology and procedures to ensure the message between sender and receiver is received, clarified and has been correctly interpreted. |
| I-SBAR-R | Standardized communication tool that delivers uniform information via the acronym I-SBAR-R, meaning introductions, situations, background assessment, recommendation and readback. |
| I-SBAR-R in depth pt.1 | Introductions: Give your name and client care role, ask the receiver for their name and client care role. Situation: Describe what is currently happening to the client that needs to be addressed. Background: Provide pertinent clinical background. |
| I-SBAR-R in depth pt.2 | Assessment: Give a brief evaluation of the situation. Recommendation: Give suggestion(s) for care. Read back/Repeat: Summarize, allow time for questions, and repeat or reread information, as needed. |
| Handoff Report | A communication technique where one provider hands-off care of a client to another provider by a detailed and structured reporting method. |
| Transcribing Orders | Upon receiving a provider's prescription (order) for a client, verify or read back the information, and then document the information correctly in the client's EHR. |
| Verbal Prescriptions | Provider verbally prescribing treatment, for a client, to another provider or nurse. |
| Care Transitions | The transfer of care of a client to or between different health care providers or settings. |
| Comorbidities | The concomitant occurrence of two or more disease processes in the same client. |
| Incivility | Behaviors in the workplace that negatively affect others such as gossiping, spreading rumors, rudeness, or refusing to help a coworker. It can be peer to peer, supervisor to employee, and includes behaviors meant to harm, humiliate or distress another. |
| Bullying | Recurring behavior of unwelcome action(s) intended to harm, humiliate, or distress another. |
| Uncivil Behaviors pt.1 | Someone embarrassing you in front of others; rudeness; gossiping -Someone rolling their eyes at you -Inappropriate tone used when speaking to you -Someone avoiding taking a handoff report from you -Sarcastic remarks made to or about you |
| Uncivil Behaviors pt.2 | -Someone raising their voice when speaking to you -Not involving you in a client care decision -Being told that you were incompetent -Someone refusing to help you |
| Lateral Violence | Incivility that is peer-to-peer, also known as horizontal violence. |
| Vertical Violence | Incivility from supervisor to employee, or vice versa. |
| Zero-Tolerance Policy | A policy adopted by many organizations to describe null, or an absolute, no tolerance for incivility, bullying, harassment, or other acts of intimidation or violence in the workplace. |
| Facility Changes for Effective Prevention of Incivility pt.1 | -Leadership responsibility for zero-tolerance -New-employee onboarding to include information on acceptable language, behaviors, and reporting procedures -Formal training for all employees |
| Facility Changes for Effective Prevention of Incivility pt.2 | -Culture of accountability with reporting procedures in place -Take action on reports of these behaviors -Share results of actions taken -Communicate the organization’s commitment |
| Conflict Management | A method to settle disagreements peacefully and respectfully, through compromise, and accommodation to each other s needs, sharing goals, and avoiding competition with the other party. |
| Cognitive Rehearsal | An intellectual therapeutic technique where one envisions or visualizes an overwhelming, or an anxiety-producing situation. |
| Domination | have a high concern for oneself and low concern for others. |
| Obliging | avoiding while demonstrating low concern for oneself and for others |
| Compromising | both parties collaborate to create a solution that is mutually acceptable and satisfying. |
| Conflict Resolution Skills | -Empathy -Facilitation -Assertiveness -Meditation -Accountability -Interviewing & Active Listening -Creative Problem Solving |
| Emotional Intelligence (EQ) | Multifactorial qualities of emotional and social skills where the ability to recognize, understand, manage emotions and adapt to change are related to personal problem solving. |
| Dermis | The layer under the epidermis that is composed mainly of connective tissue and provides strength and flexibility of the skin. |
| Epidermis | the outermost layer, is made of squamous epithelial cells that are organized into four layers, thereby providing strength to the skin. |
| Hypodermis | Also known as the subcutaneous layer, is beneath the dermis and separates the dermis from the underlying organs; acts as a cushion from any physical trauma; insulates as it serves as fat storage. |
| Mucous Membranes | Act as a physical barrier blocking pathogens from invading the body. |
| The Order of the Epidermis (superficial to deep) | Stratum Coreneum, Stratum Lucidum, Stratum Granulosum, Stratum Spinosum, Stratum Basale. |
| Enamel | First line of defense, a coating that protects the teeth from plaque and pathogens. |
| Hygiene | Actions the client takes and health practices the client engages in that decrease the spread or transmission of pathogens, thereby decreasing the risk of illness. |
| Healthcare Associated Infections | Infections that are acquired in a health care facility (ex. hospital, nursing home, ambulatory care facility). |
| Alcohol Based Sanitizers | A solution that can often be used in place of soap and water that contains 60% alcohol. |
| Health Promotion | The process of enabling people to increase control over and improvement of all aspects of their general health. |
| Diaper Dermatitis | A condition in which the skin becomes inflamed in response to various substances such as urine, feces, fungal and bacterial infections, and allergic reaction to substances in the diaper. |
| Noncomedogenic | Solutions that can hinder the clogging of pores. |
| Hemiplegia | Paralysis that affects one side of the body. |
| Skin Folds | Areas of excessive skin that fold onto themselves creating folds. |
| Complete Bed Bath | Bathing a client who remains in the bed, usually required for those clients who are unable to ambulate to the bathroom and bathe themselves. |
| Perineal Care | Cleaning the perineum, the area located between the tail bone and pubic arch. |
| Tooth Decay | Permanent damage to the teeth caused by inadequate oral hygiene. |
| Gingivitis | An inflammation of the gums caused by plaque that forms on the teeth from poor oral hygiene habits. |
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