CH 41 Fundamentals of Nursing
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Questions and Answers

What is the method to convert Celsius temperature to Fahrenheit?

  • $(X - 32) / 1.8$
  • $X imes 1.8 - 32$
  • $(X + 32) imes 1.8$
  • $X imes 1.8 + 32$ (correct)

    • Which pulse site is located on the thumb side of the wrist?

  • Ulnar
  • Brachial
  • Popliteal
  • Radial (correct)

    • What pulse strength is described as 'absent'?

  • 3 - Full, Increased
  • 2 - Expected
  • 1 - Diminished
  • 0 - Absent (correct)

    • Which factor does NOT influence respiration rates?

    <p>Heart rate</p> Signup and view all the answers

    What part of the stethoscope is primarily used to hear low-pitched sounds?

    <p>Bell chest piece</p> Signup and view all the answers

    What skin color is typically associated with jaundice?

    <p>Yellow-Orange</p> Signup and view all the answers

    Which thyroid gland examination technique can help visualize an enlarged thyroid?

    <p>Hyperextending the neck</p> Signup and view all the answers

    What is the normal positioning of the trachea in relation to the suprasternal notch?

    <p>Midline above the suprasternal notch</p> Signup and view all the answers

    What is the primary purpose of palpating the trachea during an examination?

    <p>To determine its position and detect any displacement</p> Signup and view all the answers

    Which skin color is indicative of increased blood flow?

    <p>Red</p> Signup and view all the answers

    How many lobes does the right lung have?

    <p>Three</p> Signup and view all the answers

    What does loss of pigmentation in the skin signify?

    <p>Vitiligo</p> Signup and view all the answers

    Which landmark corresponds to the tricuspid area in the cardiac examination?

    <p>Home base</p> Signup and view all the answers

    What is defined as an abnormally slow heart rate below 60 bpm?

    <p>Bradycardia</p> Signup and view all the answers

    Which term describes a respiratory rate that is abnormally rapid, greater than 20 breaths per minute?

    <p>Tachypnea</p> Signup and view all the answers

    What condition is described as the failure of the heart to transmit a pulse wave to peripheral sites?

    <p>Pulse Deficit</p> Signup and view all the answers

    Which type of respiration pattern is characterized by alternating periods of breathing and apnea?

    <p>Cheyne Stokes Respirations</p> Signup and view all the answers

    What term is used to describe an increased blood pressure above 120/80?

    <p>Hypertension</p> Signup and view all the answers

    Which condition can lead to blurred vision and light-headedness due to blood pressure measurement changes in different positions?

    <p>Orthostatic Hypotension</p> Signup and view all the answers

    What is the primary effect of antipyretics?

    <p>Reduce fever</p> Signup and view all the answers

    Which respiratory pattern involves irregular periods of shallow breathing followed by apnea?

    <p>Biot's Respirations</p> Signup and view all the answers

    Where is the apex of the heart located in relation to the chest?

    <p>At the fourth to fifth intercostal space</p> Signup and view all the answers

    What primarily composes the anterior surface of the heart?

    <p>Right ventricle</p> Signup and view all the answers

    Which symptom is indicative of vascular disease?

    <p>Cold hands or feet</p> Signup and view all the answers

    How does pain caused by musculoskeletal conditions typically respond to activity?

    <p>Increases with activity and resolves after rest</p> Signup and view all the answers

    What does the observation of tight-fitting hosiery around the lower extremities suggest?

    <p>Impairment of venous return</p> Signup and view all the answers

    Which condition is NOT a risk factor for vascular disease?

    <p>Increased hydration levels</p> Signup and view all the answers

    What is the typical relationship between activity and vascular pain?

    <p>Pain increases with activity</p> Signup and view all the answers

    What location is described as the PMI (point of maximal impulse)?

    <p>Left midclavicular line</p> Signup and view all the answers

    What is the normal response to painful stimuli when pressure is applied to the root of a patient's fingernail?

    <p>Withdrawal of the body part from the stimulus</p> Signup and view all the answers

    Which cranial nerve is responsible for the sense of smell?

    <p>Olfactory nerve</p> Signup and view all the answers

    To assess visual acuity, which method is recommended for testing the function of the optic nerve?

    <p>Use of Snellen chart or asking the patient to read printed material</p> Signup and view all the answers

    What does a flaccid response indicate when assessing muscle tone?

    <p>Absence of muscle tone and severe brain injury</p> Signup and view all the answers

    Which cranial nerve is assessed by checking for extraocular eye movements?

    <p>Oculomotor nerve</p> Signup and view all the answers

    What is a common method for assessing pupillary reaction to light?

    <p>Shining a light directly into the eye</p> Signup and view all the answers

    Which cranial nerve controls downward and inward movements of the eye?

    <p>Trochlear nerve</p> Signup and view all the answers

    In which scenario would a patient show abnormal posturing in response to pain?

    <p>Severe neurological impairment</p> Signup and view all the answers

    When testing cranial nerve function, what should be assessed for the trigeminal nerve?

    <p>Sensory nerve to the skin of the face</p> Signup and view all the answers

    What is measured to assess accommodation in the eye?

    <p>Pupillary constriction and dilation</p> Signup and view all the answers

    What are the two levels for certification in holistic nursing?

    <p>Holistic Nurse - Board Certified (HN-BC)</p> Signup and view all the answers

    How many hours of continuing education are required every year for holistic nursing certification?

    <p>48 hours</p> Signup and view all the answers

    What is the experience requirement for certification in holistic nursing?

    <p>2000 hours or 1 year of full-time experience in holistic nursing in the past 5 years</p> Signup and view all the answers

    What is a key characteristic of the mindfulness approach?

    <p>Focusing on your breathing pattern and clearing your thoughts</p> Signup and view all the answers

    Homeopathy uses large doses of materials to stimulate the body's healing processes.

    <p>False</p> Signup and view all the answers

    The underlying belief in naturopathy is that the individual is responsible for _____.

    <p>recovery</p> Signup and view all the answers

    Which conditions have mindfulness approaches been useful for?

    <p>Depression, anxiety, and chronic pain</p> Signup and view all the answers

    What is the developmental task during infancy?

    <p>Trust versus Mistrust</p> Signup and view all the answers

    What crisis is faced in early childhood?

    <p>Autonomy versus Shame and Doubt</p> Signup and view all the answers

    Adolescents confront the crisis of identity versus role confusion.

    <p>True</p> Signup and view all the answers

    The stage of moral development focused on obeying rules to avoid punishment is known as stage ______.

    <p>1</p> Signup and view all the answers

    What is the main goal during Gilligan's conventional level of moral development?

    <p>Caring for others</p> Signup and view all the answers

    Which is NOT a patient's right in psychiatric care?

    <p>Right to unlimited visitors</p> Signup and view all the answers

    What does 'milieu' refer to in a therapeutic context?

    <p>Surroundings and physical environment</p> Signup and view all the answers

    Integration of care focuses solely on medication treatment for patients.

    <p>False</p> Signup and view all the answers

    At which stage do people believe that social contracts and individual rights are important?

    <p>Stage 5: Social Contract and Individual Rights</p> Signup and view all the answers

    What is the primary goal of emergency care?

    <p>Triage and stabilization</p> Signup and view all the answers

    What describes the Preconventional level's main goal?

    <p>Individual survival</p> Signup and view all the answers

    What is resilience?

    <p>The ability and capacity for people to secure the resources they need to support their well-being.</p> Signup and view all the answers

    What defines mental illness?

    <p>Psychiatric disorders that have definable diagnoses and exhibit significant dysfunction.</p> Signup and view all the answers

    Stigma refers to the belief that individuals with mental illness are not flawed.

    <p>False</p> Signup and view all the answers

    Which of the following is an attribute of mental health? (Select all that apply)

    <p>Rationale thinking</p> Signup and view all the answers

    What are the two ends of the mental health continuum?

    <p>Mental health and mental illness.</p> Signup and view all the answers

    What does DSM-5 serve as a tool for?

    <p>Collecting epidemiological statistics about the diagnosis of psychiatric disorders</p> Signup and view all the answers

    What does a Psychiatric Mental Health Nurse specialize in?

    <p>Mental health registered nursing.</p> Signup and view all the answers

    Who developed interpersonal theory?

    <p>Harry Stack Sullivan.</p> Signup and view all the answers

    The superego develops after the age of 5.

    <p>False</p> Signup and view all the answers

    Match the following nursing theorists with their focus:

    <p>Patricia Benner = Caring as foundation for nursing Dorothea Orem = Goal of self-care as integral to the practice of nursing Sister Callista Roy = Continual need for people to adapt physically, psychologically, and socially Betty Neuman = Impact of internal and external stressors on the equilibrium of the system</p> Signup and view all the answers

    Which therapy uses concepts such as transference and countertransference?

    <p>Psychodynamic Therapy</p> Signup and view all the answers

    What is the primary goal of interpersonal therapy?

    <p>To reduce or eliminate psychiatric symptoms by improving interpersonal functioning.</p> Signup and view all the answers

    What was one of Freud's major contributions to psychology?

    <p>The structure of personality (id, ego, superego)</p> Signup and view all the answers

    What can happen if the id is too powerful?

    <p>The person will lack control over impulses.</p> Signup and view all the answers

    Classical psychoanalysis is commonly used today.

    <p>False</p> Signup and view all the answers

    What does Vagus Nerve Stimulation (VNS) help with?

    <p>Depression.</p> Signup and view all the answers

    What process involves the exchange of oxygen and carbon dioxide during cellular metabolism?

    <p>Respiration</p> Signup and view all the answers

    What is the first step in the process of oxygenation in the body?

    <p>Ventilation</p> Signup and view all the answers

    Which muscles contract to create a negative pleural pressure during inspiration?

    <p>Diaphragm and external intercostal muscles</p> Signup and view all the answers

    What mechanism is primarily responsible for blood flow returning deoxygenated blood to the lungs?

    <p>Perfusion</p> Signup and view all the answers

    How is air moved into the lungs during inhalation?

    <p>By creating a pressure gradient in the thorax</p> Signup and view all the answers

    Which step in the oxygenation process involves the movement of gases through concentration gradients?

    <p>Diffusion</p> Signup and view all the answers

    What happens to intrapleural pressure during inspiration?

    <p>It decreases and becomes more negative</p> Signup and view all the answers

    Which process is primarily associated with the act of air moving in and out of the lungs?

    <p>Ventilation</p> Signup and view all the answers

    What is the role of surfactant in the lungs?

    <p>Maintains surface tension of the alveoli and prevents collapse</p> Signup and view all the answers

    What process primarily facilitates the exchange of respiratory gases in the lungs?

    <p>Diffusion</p> Signup and view all the answers

    Which of the following is an active process during respiration?

    <p>Inspiration</p> Signup and view all the answers

    What is the function of the pulmonary circulation?

    <p>To exchange gases between the lungs and alveoli</p> Signup and view all the answers

    What is preload in the context of cardiac physiology?

    <p>The volume of blood in the ventricles at the end of diastole</p> Signup and view all the answers

    Which component of the heart contains the valves responsible for unidirectional blood flow?

    <p>Ventricles</p> Signup and view all the answers

    What does the term 'afterload' describe?

    <p>The force resistance against ventricular ejection</p> Signup and view all the answers

    How does a broad QRS complex in an ECG typically present?

    <p>Abnormal depolarization sequence or bundle branch block</p> Signup and view all the answers

    What is a primary function of the cardiac conduction system?

    <p>Transmitting electrical impulses for heart rhythm</p> Signup and view all the answers

    What does a normal adult heart rate typically range from?

    <p>60-100 bpm</p> Signup and view all the answers

    What indicates the presence of a left bundle branch block (LBBB) on an ECG?

    <p>Specific pattern in leads V1 and V6</p> Signup and view all the answers

    What is the primary purpose of pulmonary circulation?

    <p>To facilitate gas exchange in the lungs</p> Signup and view all the answers

    What does myocardial blood flow supply to the heart muscle?

    <p>Nutrients and oxygen</p> Signup and view all the answers

    Which process is primarily responsible for the exchange of respiratory gases in the alveoli?

    <p>Diffusion</p> Signup and view all the answers

    What is the role of intrapleural pressure during inhalation?

    <p>It becomes more negative to create a pressure gradient.</p> Signup and view all the answers

    What anatomical structure contracts to increase the size of the thorax during inspiration?

    <p>Diaphragm</p> Signup and view all the answers

    Which term refers to the ability of the cardiovascular system to supply oxygenated blood to body tissues?

    <p>Perfusion</p> Signup and view all the answers

    What initiates the gas flow during ventilation?

    <p>Pressure changes in the pleural space</p> Signup and view all the answers

    What is the main function of the respiratory muscles during expiration?

    <p>To relax and allow air to escape from the lungs</p> Signup and view all the answers

    What characterizes the process of diffusion in respiration?

    <p>Movement of respiratory gases following concentration gradients</p> Signup and view all the answers

    Which muscles are primarily involved in the process of inspiration?

    <p>Diaphragm and external intercostal muscles</p> Signup and view all the answers

    What is the primary role of surfactant in the lungs?

    <p>Maintains alveolar surface tension.</p> Signup and view all the answers

    Which process primarily drives inspiration during respiration?

    <p>Contraction of the diaphragm.</p> Signup and view all the answers

    What initiates the pulmonary circulation pathway?

    <p>Pulmonary artery receiving blood.</p> Signup and view all the answers

    How does diffusion affect respiratory gas exchange?

    <p>It depends on the thickness of the alveolar membrane.</p> Signup and view all the answers

    What does stroke volume refer to in cardiovascular physiology?

    <p>Volume of blood ejected from the left ventricle during systole.</p> Signup and view all the answers

    What happens during the cardiac cycle's diastole phase?

    <p>Ventricles are filled with blood.</p> Signup and view all the answers

    What does afterload refer to in cardiac physiology?

    <p>Resistance against which the left ventricle must pump.</p> Signup and view all the answers

    Which component primarily regulates the rhythmic contractions of the heart?

    <p>Cardiac conduction system.</p> Signup and view all the answers

    What indicates a broad QRS complex on an electrocardiogram (ECG)?

    <p>Impulse blockage in ventricular conduction.</p> Signup and view all the answers

    What characterizes cardiac output?

    <p>Volume of blood pumped by the left ventricle each minute.</p> Signup and view all the answers

    What is the typical normal range for adult heart rate?

    <p>60-100 bpm.</p> Signup and view all the answers

    How does the body ensure the unidirectional flow of blood through the heart?

    <p>Function of heart valves.</p> Signup and view all the answers

    What is a distinctive feature of bundle branch block observed on an ECG?

    <p>Broad QRS complex.</p> Signup and view all the answers

    Study Notes

    Vital Signs and Assessment Definitions

    • Bradycardia: Heart rate below 60 bpm, indicating a slower than normal heartbeat.
    • Tachycardia: Heart rate exceeding 100 bpm, representing a faster heartbeat.
    • Antipyretics: Medications such as acetaminophen and aspirin that help reduce fever.
    • Dysrhythmia: Irregular heart rhythms marked by early, late, or missed beats.
    • Pulse Deficit: Occurs when the heart fails to transmit a pulse wave to peripheral sites.
    • Bradypnea: Abnormally slow breathing rate, less than 12 breaths per minute.
    • Tachypnea: Abnormally fast breathing rate, exceeding 20 breaths per minute.
    • Hyperpnea: Increased depth and rate of respiration, often due to exercise.
    • Apnea: Cessation of breathing, which can lead to respiratory arrest if persistent.
    • Cheyne-Stokes Respirations: Alternating periods of apnea and hyperventilation.
    • Kussmaul's Respirations: Deep, regular, and increased rate of breathing.
    • Biot's Respirations: Shallow breaths followed by irregular apnea periods.
    • Arteriosclerosis: Loss of elasticity in blood vessels, replaced by fibrous tissue.
    • Hypertension: Blood pressure above 120/80 mmHg, classified as high blood pressure.
    • Hypotension: Low blood pressure, significant if associated with pallor or confusion.
    • Orthostatic Hypotension: Drop in blood pressure upon standing, linked to falls in older adults.

    Temperature Conversion Calculations

    • Celsius to Fahrenheit: Multiply Celsius by 1.8 and add 32.
    • Fahrenheit to Celsius: Subtract 32 from Fahrenheit and divide by 1.8.

    Pulse Sites

    • Temporal: Over the temporal bone, above and lateral to the eye.
    • Carotid: Along the sternocleidomastoid muscle in the neck.
    • Apical: At the 4th to 5th intercostal space, left of the midclavicular line.
    • Brachial: At the antecubital fossa, between biceps and triceps.
    • Radial: On the thumb side of the wrist.
    • Ulnar: On the pinky side of the wrist.
    • Femoral: Below the inguinal ligament, between the pubis and iliac spine.
    • Popliteal: Behind the knee.
    • Posterior tibial: Inner side of the ankle below the medial malleolus.
    • Dorsalis Pedis: Top of the foot between the tendons of the great and first toes.

    Pulse Strength

    • Grade 0: Absent
    • Grade 1: Diminished
    • Grade 2: Expected
    • Grade 3: Full, increased
    • Grade 4: Bounding, aneurysmal

    Stethoscope Components

    • Ear pieces, binaurals, tubing, bell (for low-pitched sounds), diaphragm (for high-pitched sounds).

    Heartbeat Strength Variations

    • Bounding: Strong and forceful heartbeat.
    • Full or strong: Clearly detectable.
    • Normal and expected: Standard strength for resting state.
    • Diminished or barely palpable: Weak but detectable.
    • Absent: No heartbeat felt.

    Factors Influencing Respirations

    • Exercise, acute pain, anxiety, smoking, body position, medications, neurological injuries.
    • Bright pink lips may indicate carbon monoxide poisoning.

    Skin Color Indicators

    • Bluish (cyanosis): Suggests deoxygenated hemoglobin.
    • Pallor: Indicates decreased blood flow.
    • Vitiligo: Loss of pigmentation, often congenital.
    • Yellow-Orange (jaundice): Elevated bilirubin levels.
    • Red (erythema): Increased blood flow.
    • Tan Brown: Elevated melanin levels.

    Thyroid Gland and Trachea Examination

    • Thyroid located in the anterior lower neck, palpating for masses.
    • Swallowing action can help evaluate thyroid enlargement.
    • Trachea normally sits midline above the suprasternal notch; palpate to assess its position.

    Thoracic Anatomy

    • Right lung has 3 lobes; left lung has 2 lobes.

    Heart Anatomical Landmarks

    • Use mnemonic "Pitcher" for heart assessment:
      • Aortic (1st base)
      • Pulmonic (2nd base)
      • Tricuspid (3rd base)
      • Mitral (Home base)
      • Epigastric (Dugout)

    Cardiovascular Assessment

    • Monitor symptoms such as leg cramps, numbness, cold extremities, and swelling, which may indicate vascular disease.
    • Assess history for risk factors including previous heart issues and lifestyle habits.

    Cranial Nerves Overview

    • I: Olfactory - Sense of smell; identify non-irritating aromas.
    • II: Optic - Visual acuity; use Snellen chart or printed material for testing.
    • III: Oculomotor - Extraocular movements; assess gaze directions.
    • IV: Trochlear - Downward eye movements; assess gaze.
    • V: Trigeminal - Sensory and motor; test facial sensation and corneal reflex.

    Definitions of Mental Health

    • Resilience: Ability to secure resources supporting well-being.
    • Mental Illness: Refers to psychiatric disorders with definable diagnoses, linked to dysfunction in mental processes.
    • Stigma: Negative belief leading to social shunning, disgrace, and shame of individuals with mental illness.
    • Milieu Therapy: A structured therapeutic environment that coordinates care among patients, families, and healthcare professionals.

    Attributes of Mental Health

    • Characteristics include rational thinking, effective coping strategies, resiliency, self-control, self-awareness, and spiritual satisfaction.
    • Additional attributes: happiness, joy, self-care, positive self-concept, productive learning, effective communication, and meaningful relationships.

    Mental Health Continuum

    • Individuals may shift across a spectrum from optimal mental health to severe mental illness.
    • Mental Health: High-level functioning, experiencing normal stress without serious impairments.
    • Mental Illness: Range from mild discomfort (insomnia, anxiety) to severe alterations in thinking, mood, and behavior (e.g., schizophrenia).
    • Recovery potential exists across all levels of impairment.

    DSM-5 Categories

    • Neurodevelopmental Disorders
    • Schizophrenia Spectrum Disorders
    • Bipolar and Related Disorders
    • Depressive Disorders
    • Anxiety Disorders
    • OCD and Related Disorders
    • Trauma and Stressor-Related Disorders
    • Dissociative Disorders
    • Somatic Symptom Disorders
    • Eating Disorders
    • Sleep-Wake Disorders
    • Sexual Dysfunction
    • Gender Dysphoria
    • Impulse Control Disorders
    • Substance-Related Disorders
    • Neurocognitive Disorders
    • Personality Disorders
    • Paraphilia Disorders

    Nursing Levels in Mental Health

    • Basic Level Registered Nurse: Qualified to work in various areas post-nursing program.
    • Psychiatric Mental Health Nurse (PMH-RN): Specializes in psychiatric care.
    • Advanced Practice (PMH-APRN): Provides therapy and has diagnostic & prescriptive authority, needing a master's or doctoral degree.

    Advocacy in Nursing

    • Nurses act as patient advocates by reporting abuse and ensuring patients' rights to treatment decisions.

    Theories and Therapies Overview

    • Countertransference: Unconscious feelings of the healthcare worker towards the patient.
    • Psychodynamic Therapy: Involves free association and analysis of dreams, focusing on transference and countertransference.
    • Interpersonal Theory: Focuses on interaction needs; emphasizes the significance of early relationships on personality development.

    Freud’s Psychoanalytic Theories

    • Conscious Mind: Awareness of thoughts and feelings.
    • Preconscious Mind: Easily retrievable material.
    • Unconscious Mind: Repressed memories and urges influencing behavior.

    Personality Structure

    • Id: Unconscious, impulsive, operating on pleasure principle.
    • Ego: Mediates between id and reality, operates on reality principle.
    • Superego: Moral reasoning, balancing conscience and ideal self.

    Defense Mechanisms and Anxiety

    • Anxiety is part of living; defense mechanisms protect from aware threatening feelings, operating mostly unconsciously.

    Freud’s Psychosexual Stages of Development

    • Development occurs in five stages from infancy; early experiences shape lifelong adjustments.

    Psychoanalytic Therapy

    • Classical psychoanalysis is infrequent; lengthy treatment time makes it impractical.

    Interpersonal Therapy Focus Areas

    • Complicated grief, interpersonal disputes, and role transitions are key areas addressed.

    Implications of Interpersonal Theory in Nursing

    • Hildegard Peplau emphasized the nurse-patient relationship and the opportunity for personal growth through illness.

    Selected Nursing Theorists and Contributions

    • Patricia Benner: Emphasizes caring in nursing.
    • Dorothea Orem: Focuses on self-care in nursing practice.
    • Sister Callista Roy: Highlights adaptation to physical and psychological changes.
    • Betty Neuman: Studies stressors' impact on equilibrium.
    • Joyce Travelbee: Stresses the importance of communication in the nurse-patient relationship.

    Behavioral Theories and Therapies

    • Classical Conditioning: Ivan Pavlov's research demonstrated learned responses through pairing stimuli.
    • Behaviorism: John B. Watson's framework explores how adaptive or maladaptive behaviors are learned.
    • Behavioral Therapy: Focuses on changing maladaptive behaviors without needing insight into their causes.

    Biological Theories and Treatments

    • Mental illness is seen as arising from physical issues.
    • Electroconvulsive Therapy (ECT): Used for depression; induces convulsions to relieve symptoms.
    • Repetitive Transcranial Magnetic Stimulation (rTMS): Non-invasive method assisting in depression treatment.
    • Vagus Nerve Stimulation (VNS): Potentially helps with depression.
    • Deep Brain Stimulation (DBS): Targets specific brain areas for conditions like OCD.

    Theory of Psychosocial Development

    • Eric Erikson posits that personal development is influenced by culture and society and evolves throughout life.### Erikson's Eight Stages of Development
    • Infancy (0-1½ years): Trust vs. Mistrust; forming attachment lays foundation for future trust.
    • Early Childhood (1½-3 years): Autonomy vs. Shame and Doubt; developing control leads to self-confidence.
    • Preschool (3-6 years): Initiative vs. Guilt; children gain ability to initiate actions, fostering a sense of purpose.
    • School Age (6-12 years): Industry vs. Inferiority; competence in skills builds a sense of achievement.
    • Adolescence (12-20 years): Identity vs. Role Confusion; forming personal identity and future aspirations is crucial.
    • Early Adulthood (20-35 years): Intimacy vs. Isolation; establishing deep relationships impacts emotional health.
    • Middle Adulthood (35-65 years): Generativity vs. Self-Absorption; focus on nurturing others ensures societal progression.
    • Later Years (65+ years): Integrity vs. Despair; reflecting on life’s meaning fosters acceptance or regret.

    Kohlberg's Stages of Moral Development

    • Preconventional Level: Focus on obedience to avoid punishment; awareness of individual rights and consequences.
    • Conventional Level: Emphasis on relationships and social order; moral reasoning based on conformity and societal expectations.
    • Postconventional Level: Prioritization of universal ethical principles; individuals break unjust laws for ethical justice.

    Gilligan's Stages of Moral Development

    • Preconventional: Individual survival and self-focus; prioritizing self-care.
    • Conventional: Emphasis on self-sacrifice for the welfare of others; balancing responsibility.
    • Postconventional: Nonviolence principle; focusing on the well-being of self and others equally.

    Stigma and Mental Health

    • Stigma: A sense of shame associated with mental disorders.
    • Continuum of Care: Range of services from primary care to state hospitals; aimed at delivering comprehensive support.

    Treatment Modalities

    • Primary Care Physician: First point of contact for health concerns.
    • Specialty Care: Focused on specific psychiatric issues.
    • Patient-Centered Medical Homes: Integrated care addressing physical and mental health needs collaboratively.

    Patient Rights

    • Individuals have rights, including dignity, informed consent, refusal of treatment, and privacy.
    • Rights to participate in treatment planning and maintain personal belongings unless they pose a danger.

    Milieu and Therapeutic Environment

    • Milieu refers to the overall therapeutic context, emphasizing the importance of environment and social interactions in healing processes.

    Emergency Care

    • Immediate goal: Stabilization and assessment of urgent mental health cases, including potential for self-harm or harm to others.

    Multidisciplinary and Intradisciplinary Treatment

    • Multidisciplinary: Involves various health professionals working together for patient care.
    • Intradisciplinary: Engaging patients actively in their treatment processes.

    Holistic and Integrative Care

    • Integrative Care: Focuses on prevention and wellness, considering physical, mental, and spiritual needs.
    • Conventional Care: Treatment centered on symptom relief through traditional medical methods.

    Mindfulness and Alternative Medicine

    • Mindfulness: Techniques like meditation help in managing anxiety and chronic pain.
    • Homeopathy and Naturopathy: Focus on holistic health restoration using natural and alternative therapies.

    Respiratory Physiology

    • Respiration is the exchange of oxygen and carbon dioxide during cellular metabolism.
    • Ventilation is the process of moving gases into and out of the lungs.
    • Perfusion relates to the ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs.
    • Diffusion is responsible for moving the respiratory gases from one area to another by concentration gradients.
    • Inspiration is an active process.
    • Expiration is a passive process.
    • Surfactant is a chemical produced in the lungs to maintain the surface tension of the alveoli and prevent them from collapsing.
    • Tidal volume is the amount of air exhaled following a normal inspiration.

    Diffusion

    • Diffusion is the process for the exchange of respiratory gases in the alveoli of the lungs and the capillaries of the body tissues.
    • A thick alveolar capillary membrane impedes the diffusion process.
    • Factors that can impede diffusion include pulmonary edema, pulmonary infiltrates, pulmonary effusion, chronic diseases such as emphysema, acute diseases such as pneumothorax, and surgical processes such as lobectomy.

    Neural Regulation

    • The cerebral cortex regulates the voluntary control of respiration by delivering impulses to the respiratory motor neurons by way of the spinal cord.

    Cardiovascular Physiology

    • The cardiovascular system delivers oxygen, nutrients, and other substances to the tissues and facilitates the removal of cellular metabolism waste products by way of blood flow through other body systems.

    Order of Cardiac Operation

    • Blood enters the heart through the superior and inferior vena cava into the right atrium.
    • Flows through the tricuspid valve to the right ventricle.
    • Blood is pumped through the pulmonary valve to the pulmonary artery.
    • Blood travels to the lungs to become oxygenated.
    • Returns to the heart via the pulmonary veins into the left atrium.
    • Blood then passes through the mitral valve to the left ventricle.
    • Finally exits the heart through the aortic valve into the aorta, distributing oxygenated blood throughout the body.

    Myocardial Pump

    • The ventricles fill with blood during diastole and empty during systole.
    • The volume of blood ejected from the ventricles during systole is the stroke volume.

    Myocardial Blood Flow

    • To maintain adequate blood flow to the pulmonary and systemic circulation, myocardial blood flow must supply sufficient oxygen and nutrients to the myocardium itself.

    Coronary Artery Circulation

    • The coronary circulation is the branch of the systemic circulation that supplies the myocardium with oxygen and nutrients and removes waste.

    Systemic Circulation

    • The arteries of the systemic circulation deliver nutrients and oxygen to tissues, and the veins remove waste from tissues.

    Cardiac Output

    • The amount of blood ejected from the left ventricle each minute.

    Preload

    • The amount of blood in the left ventricle at the end of diastole before the next contraction.

    Afterload

    • The resistance to the ejection of blood from the left ventricle.

    Conduction System

    • The rhythmic relaxation and contraction of the atria and ventricles depend on continuous, organized transmission of electrical impulses.
    • The cardiac conduction system generates and transmits these impulses.

    Electrocardiogram (ECG)

    • Measures the electrical activity of the conduction system.

    Heart Rate

    • Normal: 60-100 bpm
    • Tachycardia: >100 bpm
    • Bradycardia: <60 bpm

    Intervals

    • PR Interval: Represents the time it takes for the electrical impulse to travel from the SA node to the ventricles and is normally less than 0.20 seconds.
    • QRS Interval: Represents the time it takes for the electrical impulse to travel through the ventricles and is normally less than 0.12 seconds.
    • QT Interval: Represents the time it takes for the ventricles to depolarize and repolarize.

    QRS Complex

    • A narrow QRS complex occurs when the impulse is conducted down the bundle of His and the Purkinje fibers to the ventricles.
    • A broad QRS complex occurs if there is an abnormal depolarization sequence, such as a ventricular ectopic where the impulse spreads slowly across the myocardium from the focus in the ventricle.

    Bundle Branch Block

    • Left Bundle Branch Block (LBBB): deep S wave in V1, which may be notched (“W”) and broad “M” shaped R wave in V6.
    • Right Bundle Branch Block (RBBB): RSR' pattern in V1 (“M”) and broad S wave in V6 (“W”).

    Height

    • Small complexes are defined as those with an amplitude less than 5 mm (0.5 mV) in any limb lead and less than 10 mm (1.0 mV) in any chest lead.
    • Tall complexes are defined as those with an amplitude greater than 25 mm (2.5 mV) in any limb lead and greater than 30 mm (3.0 mV) in any chest lead.

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