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Practical and vocational nurse level flashcards for [[Anatomy and Physiology]]. These emphasize normal structure and function, expected versus unexpected findings, and what to report to the registered nurse.

== Normal Values and Basic Function ==

;Normal adult resting heart rate, respiratory rate, and adequate urine output.
:Heart rate 60 to 100 beats per minute. Respiratory rate 12 to 20 breaths per minute. Urine output at least 30 mL per hour, or about 240 mL over 8 hours. Report values outside these ranges to the registered nurse.

;Normal adult oxygen saturation range.
:95% to 100% on room air. Report a sustained reading below 90%, or any drop from the patient's usual baseline, to the registered nurse.

;What is homeostasis?
:The body's ability to keep its internal conditions, such as temperature, fluid volume, blood glucose, and pH, within a narrow normal range. Illness and injury disrupt homeostasis, and nursing care supports the body's efforts to restore it.

;Name the three layers of the skin.
:The epidermis (outer layer, no blood vessels), the dermis (contains blood vessels, nerve endings, hair follicles, and sweat glands), and the subcutaneous layer (fat and connective tissue that cushions and insulates).

== Cardiovascular and Respiratory ==

;Trace the flow of blood through the heart.
:Body to the vena cava, right atrium, tricuspid valve, right ventricle, pulmonic valve, lungs, then pulmonary veins to the left atrium, mitral valve, left ventricle, aortic valve, and out to the body.

;Which chamber of the heart has the thickest wall, and why?
:The left ventricle, because it must pump blood out to the entire body against high pressure. The right ventricle only pumps to the lungs, which is a lower pressure system.

;What is the heart's natural pacemaker and its normal rate?
:The sinoatrial node, located in the right atrium, which normally fires 60 to 100 times per minute.

;Difference between arteries, veins, and capillaries.
:Arteries carry blood away from the heart and have thick muscular walls. Veins carry blood back to the heart, have thinner walls, and contain valves to prevent backflow. Capillaries are one cell thick and are where oxygen, nutrients, and wastes are exchanged with the tissues.

;What signs suggest fluid overload, and what should be reported?
:New crackles in the lungs, shortness of breath that worsens when lying flat, distended neck veins, swelling of the legs or sacrum, and rapid weight gain. Report a gain of about 1 kilogram (2 pounds) in a day or 2.3 kilograms (5 pounds) in a week to the registered nurse.

;What signs suggest dehydration?
:Dry mucous membranes, a coated or furrowed tongue, decreased and concentrated urine, thirst, weight loss, fast weak pulse, low blood pressure, and confusion in older adults. Report these findings and monitor intake and output.

;Where does gas exchange take place in the lungs?
:In the alveoli, tiny air sacs surrounded by capillaries. Oxygen moves from the alveoli into the blood and carbon dioxide moves from the blood into the alveoli to be exhaled.

;What are the early signs of low oxygen, and what are the late signs?
:Early signs are restlessness, anxiety, confusion, increased heart rate, and increased respiratory rate. Late signs are cyanosis, a slowing heart rate, and decreased level of consciousness. Never wait for cyanosis to report a concern.

;How does raising the head of the bed help a patient breathe?
:It allows the abdominal organs to drop away from the diaphragm so the diaphragm can move down more fully, increasing lung expansion. Semi-Fowler and Fowler positions are standard for patients with shortness of breath.

== Nervous, Musculoskeletal, and Mobility ==

;What is the earliest sign of a worsening neurologic problem?
:A change in level of consciousness, such as new drowsiness, confusion, restlessness, or difficulty being aroused. Report any change from the patient's baseline right away.

;What are the neurovascular checks performed distal to a cast or an injured limb?
:Color, temperature, capillary refill, pulses, movement, sensation, and pain. Report coolness, pallor or bluish color, capillary refill longer than 3 seconds, numbness or tingling, inability to move the fingers or toes, or pain that increases with movement.

;Name three complications of immobility and one prevention measure for each.
:Pressure injury, prevented by repositioning at least every 2 hours; pneumonia and atelectasis, prevented by deep breathing and incentive spirometry; muscle atrophy and contractures, prevented by range-of-motion exercises. Immobility also causes constipation, blood clots, and bone calcium loss.

;What is the difference between active and passive range of motion?
:In active range of motion the patient moves the joint independently. In passive range of motion the nurse moves the joint for a patient who cannot move it. Move joints slowly and stop at the point of resistance or pain.

;How do you stage a pressure injury with intact skin and nonblanchable redness?
:Stage 1. The redness does not fade when pressed. Relieve pressure immediately and report the finding so a treatment plan can be started before skin breakdown occurs.

== Digestive, Urinary, and Electrolytes ==

;What is the main job of the small intestine?
:Absorption of nutrients. Its lining is covered with tiny projections called villi that greatly increase surface area for absorption.

;What is the main job of the large intestine?
:Reabsorption of water and electrolytes and the formation of stool. This is why prolonged diarrhea leads to dehydration and electrolyte loss.

;Name four functions of the liver.
:Producing albumin that keeps fluid inside blood vessels, producing clotting factors, breaking down medications and toxins, and converting ammonia from protein breakdown into urea. It also makes bile and stores glycogen.

;What does bile do, and where is it stored?
:Bile breaks up fat into small droplets so it can be digested and absorbed, along with the fat-soluble vitamins A, D, E, and K. It is made by the liver and stored and concentrated in the gallbladder.

;List four jobs of the kidneys.
:Removing waste products in urine, balancing fluid and electrolytes, helping control blood pressure, and producing erythropoietin, which tells the bone marrow to make red blood cells. The kidneys also help activate vitamin D.

;About how much urine does the bladder hold before a person feels a strong urge to void?
:Roughly 300 to 500 mL. A patient who has not voided within about 6 to 8 hours after surgery or catheter removal, or who has a firm distended lower abdomen, may have urinary retention and should be reported.

;Which electrolyte most affects the heart rhythm, and what is its normal range?
:Potassium, normally 3.5 to 5.0 mEq/L in adults. Both low and high potassium can cause dangerous heart rhythms, so report abnormal values promptly. Potassium is never given by intravenous push.

;What is the normal serum sodium range, and what symptoms suggest a sodium problem?
:135 to 145 mEq/L. Because sodium controls where water goes in the body, sodium problems show up as brain symptoms: confusion, headache, restlessness, weakness, and in severe cases seizures. Report any new confusion.

;What symptoms suggest a low calcium level?
:Tingling around the mouth and in the fingertips, muscle twitching or cramping, and positive Chvostek and Trousseau signs. Report hoarseness or noisy breathing immediately, because severe low calcium can cause spasm of the airway. Normal total calcium is about 9.0 to 10.5 mg/dL.

== Life Span and Safety ==

;Name four changes of aging that increase fall risk.
:Slower blood pressure adjustment when standing, reduced muscle strength and balance, decreased vision and hearing, and slower reaction time. Medications and unfamiliar surroundings add further risk.

;Why is confusion an important finding in an older adult?
:In older adults, new confusion is often the first and sometimes the only sign of a physical problem such as infection, low oxygen, dehydration, low blood sugar, or a medication effect. Report it rather than assuming it is normal aging.

;Where should skin turgor be checked in an older adult, and why?
:Over the sternum or forehead. Skin on the back of the hand loses elasticity with age, so it stays tented even when the patient is well hydrated and gives a false result.

[[Category:Anatomy and Physiology]]
[[Category:Licensed Practical Nurse (NCLEX-PN)]]
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