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Fundamentals of Nursing Test #1

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Auscultatory gap

absence of audible sounds during blood pressure measurement that may cause inaccurate readings

blood Pressure

force the blood exerts against the walls of the blood vessels


 -Abnormally slow respiratory rate (usually less than 10 breaths per minute in adults)

Core Temperature

-Internal body temperature

Stroke Volume

- amount of blood ejected from each cardiac ventricle with each heart contraction


- difficulty breathing (breathing that requires marked effort)


- normal breathing


- absence of respiration


-abnormally high blood pressure


-abnormally low blood pressure


-abnormally slow heart rate (usually less than 60 beats per minute in adults)

Korotkoff Sounds

-sounds heard during auscultation that indicate the systolic & diastolic pressure

Orthostatic Hypotension

-fall in blood pressure associated with a change in position (e.g., from lying to sitting to standing)

Paradoxical Blood Pressure

- significant decrease in systolic blood pressure with inspiration


-blood pressure between 120/80 and 139/89 for adults of any age

Pulse Deficit

- mathematical difference between apical and radial pulse

Pulse Pressure

- mathematical difference between systolic and diastolic pressure

Medical Asepsis

-measures taken to control and reduce the  # of pathogens present also known as "clean technique;  measures include hand washing, gloving, gowning &  disinfecting to help contain microbial growth.

Systolic Blood Pressure

- amount of blood ejected from each cardiac ventricle with each heart contraction


- abnormally rapid heart rate, usually above 100 BPM in an adult


- abnormally rapid RR, usually more than 20 breaths per minute in an adult

Tidal Volume

- amount of air moving in and out with each breath

Decision Making

- method of analyzing a problem. Determining alternatives, and selecting and selecting the appropriate action

Diagnostic Reasoning Process

- skills used to make nursing diagnoses

Functional Health Pattern

- a framework for collecting and organizing nursing assessment data to ascertain the client's strengths and any actual or potential dysfunctional patterns

Information-processing Theory

- Method of organizing information to use cues to make accurate diagnoses


- information that enters a system

Nursing Process

- generally defined as a systematic problem solving approach toward giving individualized nursing care


- End product of a system

Primary Source

-the client

Problem-solving Process

- Systematic process that involves identifying and analyzing the problem, determining and weighing the possible solutions, choosing and implementing a solution, and evaluating the results.

Secondary Source

- Family, significant others, other healthcare professionals, health records, and literature review

Diastolic BP

-pressure in the blood vessels during cardiac ventricular relaxation

Systems Theory

- Way of reviewing the world or an organization in which the parts are seen in relation to the whole


- Process by which a system transforms, creates, and organizes input, resulting in a reorganization of the input


antiseptic-agent that stops or slows the growth of  microorganisms on living tissue, commonly used  for hand washing, skin preparation, and wound packing  or irrigation


-absence of disease-producing microorganisms


-supersaturated steam under pressure; the most widely used and dependable method of sterilization


-able to kill bacteria


-able to inhibit the growth of bacteria


-person from whom a microorganism can be cultured but who shows no sign of a disease


-Chemical used to kill microorganisms on  lifeless objects.

Hand Hygiene

-hand washing with soap and water or cleansing  the hands with a waterless alcohol -based cleanser to prevent the spread of infection.

Infectious Disease

-process resulting from infection that produces  manifestations such as fever, leukocytes's inflammation  or tissue damage


-techniques used to prevent or to limit the spread of  infection.

Nosocomial Infections

-infection acquired during receipt of  healthcare

Opportunistic Infections

-organisms that invade the tissues when the body's defenses are suppressed.


-vigor with which an organism can grow  and multiply


- Hair loss


- cavities in the tooth enamel


- earwax


- portable chair with a toilet seat and a waste receptacle beneath that can be emptied so a client who cannot walk to the bathroom can manage toileting

Condom Catheter

- Noninvasive urinary collection device for incontinent male clients; consists of a thin, flexible sheath placed over the penis and attached to tubing and a collection bag (external, Texas)


- difficulty swallowing (inability to swallow)


-oral mucosa

Standard Precautions

-the latest CDC isolation system that  combines the major features of Universal Precautions  (blood-borne transmission) and body substance isolation  (moist body substance transmission), thus protecting against  blood and body-fluid transmission of potentially, infective agents.


-mouth odor


-observance of health rules as related to self-care-activities (bathing, dressing, feeding, and toileting)


-organism's attraction to a specific host, which  may include humans.




-metal or plastic receptacle into which the penis can be placed to facilitate urinating without spilling


-poisoning of body tissues; usually refers to blood-borne organisms or their toxic products


-(1) Destruction of all bacteria, Spores, fungi and  viruses on an item, accomplished by heat, chemicals, or gas; (2) Rendered unable to reproduce biologically


-a person's ability to perform primary care functions in the four areas of bathing, feeding, toileting, and dressing without the help of others


-infestation with lice


-substance that forms and hardens on the teeth and is composed primarily of bacteria and saliva


-awareness of the position and movements of body parts in space, sensed by sensory nerve terminals in muscles, tendons, and the labyrinth of the ear


-plaque that remains and hardens on the teeth, which cannot be removed by simply brushing

Table 26-1 Normal Vital Sign Ranges Across the Lifespan  PulseRespirationsTemperature (°F)Blood Pressure (mm Hg) SystolicDiastolic Newborn (>96 h) 70–190 30–60 96–99.5 60–90 20–60 Infant (>1 mo) 80–160 30–60 99.4–99.7 74–100 50–70 Toddler 80–130 24–40 99–99.7 80–112 50–80 Preschooler 80–120 22–34 98.6–99 82–110 50–78 School-age 75–110 18–30 98–98.6 84–120 54–80 Adolescent 60–90 12–20 97–99 94–120 62–80 Adult 60–100 12–20 97–99 90–120 60–80 Older adult (>70 yr) 60–100 12–20 95–99 90–120 60–80

Table 27-1 INFECTIOUS CONDITIONS REQUIRING WORK RESTRICTION Infectious ConditionDirect Client Care Restrictions and Duration Conjunctivitis Until discharge ceases Diarrhea (with other acute symptoms) Until symptoms resolve and Salmonella infection is ruled out Hepatitis A Until 7 days after the onset of jaundice Hepatitis B (acute) Partial client care restriction with gloves worn for procedures involving tissue trauma and mucous membrane or nonintact skin contact Hepatitis B (chronic) Until antigenemia resolves Group A streptococcal infection Until 24 hours after the start of treatment Herpes simplex (hands) Until lesions resolve Herpes zoster (acute) Exclusion from care of clients at high risk for infection with use of appropriate barriers Herpes zoster (postexposure) From days 10 to 21 after exposure or until all lesions dry and crust Measles (active) Until 7 days after rash appears Measles (postexposure) From days 5 to 21 after exposure Mumps (active) Until 9 days after onset of parotitis Mumps (postexposure) From days 12 to 26 after exposure Norovirus Until 3 days after symptoms resolve Rubella (active) Until 5 days after rash appears Rubella (postexposure) From days 7 to 21 after exposure Scabies Until treated Staphylococcus aureus skin lesions Until lesions resolve Upper respiratory tract infections Until acute symptoms resolve with exclusion from care of clients at high risk for infection Varicella (acute) Until all lesions dry and crust Varicella (postexposure) From days 10 to 21 after exposure

Table 27-2 Transmission-Based Precautions  PrecautionsIndications Airborne Private, negative-airflow room with adequate filtration; mask; mask worn by client during transport out of room Transmission via airborne route (small-particle droplets); tuberculosis, measles, varicella Droplet Private room or cohabitation with client infected with same organism; mask required when working within 3 feet of client; mask worn by client during transport Transmission of large droplets through sneezing, coughing, or talking. Haemophilus influenzae, multidrug-resistant strains, Neisseria meningitidis, diphtheria, rubella, Mycoplasma pneumoniae Contact Private room or cohabitation with client infected with same organism; gloves at all times (don before entering room and remove before leaving) with change after exposure to organism; handwashing immediately after removal of gloves; gown and protective barriers when direct contact with organism occurs; daily cleaning of bedside equipment and client care items; exclusive use of items such as stethoscope and sphygmomanometer for infected client with terminal disinfection when precautions are no longer necessary Serious infections easily transmitted through direct contact. Any multidrug-resistant strains, Clostridium difficile, Shigella, impetigo, and others