CONVERSION TABLE OF MEASUREMENTS - COMMONLY USED FOR

MEDICATION AND DRUG COMPUTATIONS

1 gram (g) = 1000 milligrams (mg)
1 kilogram (kg) = 1000 grams (g)
1 microgram (mcg) = .001 milligram (mg)
1 milligram = 1000 microgram (mcg)
1 liter (L) = 1000 milliliters (ml)
1 milliliter (ml) = 1 cubic centimeter (cc)
1 meter = 100 centimeters (cm)
1 meter = 1000 millimeters (mm)
1 cubic centimeter (cc) = 1 milliliter (ml)
1 teaspoon = 5 cubic centimeter (cc) = 5 milliliters (ml)
1 tablespoon = 15 cubic centimeter (cc) = 15 milliliters (ml)
1 tablespoon = 3 teaspoon
1 ounce = 30 cc = 30 ml = 2 tablespoons = 6 teaspoons
8 ounces = 240 cc = 240 ml = 1 cup
1 milliliter (ml) = 15 minims (M) = 15 drops (gtt)
5 milliliters (ml) = 1 fluidram = 1 teaspoon
15 milliliters (ml) = 4 fluidrams = 1 tablespoon
30 milliliters (ml) = 1 ounce (oz) = 2 tablespoons
500 milliliters (ml) = 1 pint (pt)
1000 milliliters (ml) = 1 quart (qt)

Weight
1 kilogram = 2.2 pound (lb)
1 gram (g) = 1000 milligrams = 15 grains (gr)

Length
2.5 centimeters = 1 inch

Centigrade/Fahrenheit Conversions
C = (F - 32) X 5/9
F = (C X 9/5) + 32

CELL AND DISEASE

Understanding cell components
• Organelles — contained in the cytoplasm and surrounded by cell membrane
• Nucleus — responsible for cellular reproduction and division and stores DNA (genetic
material)

• Other cell components:

– adenosine triphosphate
– ribosomes and endoplasmic reticulum
– Golgi apparatus
– lysosomes.

Stages of cell reproduction

• Stage 1 — mitosis
• Stage 2 — cytokinesis

Stages of cell division

• Prophase—chromosomes coil and shorten, the nuclear membrane dissolves, and chromatids
connect to a centromere.
• Metaphase—centromeres divide, pulling the chromosomes apart, and align in the spindle.
• Anaphase—centromeres separate and pull new replicated chromosomes to the opposite sides of
the cell; 46 chromosomes on each side of the cell.
• Telophase—final phase; new membrane forms around 46 chromosomes through cytokinesis
producing two identical new cells.

Types of cell injury

• Toxic injury—endogenous (metabolic errors, gross malformations, hypersensitivity reactions),
exogenous (alcohol, lead, carbon monoxide, drugs).
• Infectious injury—viruses, protozoa, bacteria.
• Physical injury—thermal (electrical, radiation), mechanical (trauma, surgery).
• Deficit injury—lack of basic requirement.

Maintaining homeostasis
• Medulla, pituitary gland, reticular formation are regulators.
• Two types of feedback mechanisms maintain homeostasis:
– negative mechanism senses change and returns it to normal
– positive mechanism exaggerates change.

Differentiating disease and illness

Disease
• Occurs when homeostasis isn’t maintained.
• Influenced by genetic factors, unhealthy behaviors, personality type, and perception of the
disease.
• Manifests in various ways depending on patient’s environment.

Illness
• Occurs when a person is no longer in a state of “normal” health.
• Enables a person’s body to adapt to the disease.

Causes of disease
• Intrinsic—hereditary traits, age, gender
• Extrinsic—infectious agents or behaviors, such as:
– inactivity
– smoking
– using drugs.
• Stressors, such as:
– physiologic
– psychologic.

How diseases develop

Signs and symptoms

• Increase or decrease in metabolism or cell division
• Hypofunction such as constipation
• Hyperfunction such as increased mucus production
• Increased mechanical function such as a seizure.

Stages of disease
• Exposure or injury
• Latent or incubation period
• Prodromal period
• Acute phase
• Remission
• Convalescence
• Recovery

NURSING THEORIST
Anne Boykin and Sarvina O. Schoenhofer
Nursing As Caring Theory

Betty Neuman
Neuman Systems Model and Global Applications

Sister Callista Roy

The Roy Adaptation Model

Dorothea Orem
Self-Care Deficit Nursing Theory

Dorothy Johnson
Behavioral System Model

Ernestine Wiedenbach
The Helping Art of Clinical Nursing
Faye Glenn Abdellah
Twenty-One Nursing Problems

Florence Nightingale
Environmental Adaptation Theory

Hildegard Peplau
Theory of Interpersonal Relations

Ida Jean Orlando

Theory of the Nursing Process Discipline

Imogene King
General System’s Framework
Theory of Goal Attainment

Jean Watson
Theory of Human Caring

Joyce Fitzpatrick
Life Perspective Rhythm Model

Joyce Travelbee
Human-To-Human Relationship Model

Kari Martinsen
Nursing Philosophy

Katharine Kolcaba
Theory of Comfort

Kristen Swanson
Program of Research on Caring

Logan Roper & Tierney

The Elements of Nursing:
A Model for Nursing Based on a Model of Living

Lydia Hall
Core, Care and Cure Model
Madeleine Leininger
Theory of Culture Care Diversity and Universality
Transcultural Nursing Model

Margaret Newman
Theory of Health as Expanding Consciousness

Marilyn Ray
Theory of Bureaucratic Caring

Martha Rogers
The Science of Unitary Human Beings

Myra Estrin Levine

The Conservation Model

Nola J. Pender
Health Promotion Model

Patricia Benner
Novice to Expert Model

Ramona T. Mercer
Maternal Role Attainment

Rosemarie Parse
Theory of Human Becoming

Tomlin Erickson & Swain

Modeling & Role-Modeling Theory

Virginia Henderson
Definition of Nursing

THE NIGHTINGALE PLEDGE

---I solemnly pledge myself before God and in
the presence of this assembly, to
pass my life
in purity and to practice my profession
faithfully.
I
will abstain from whatever is deleterious
and mischievous, and will not take
or
knowingly administer any harmful drug.
I will do all in my power to
maintain and
elevate the standard of my profession, and
will hold in
confidence all personal matters
committed to my keeping and all family
affairs coming to my knowledge in the
practice of my calling.
With
loyalty will I endeavor to aid the
physician, in his work, and devote myself
to
the welfare of those committed to my care.

The Nightingale Pledge was composed by Lystra Gretter, an instructor of

nursing at the old Harper Hospital in Detroit, Michigan, and was first used
by its graduating class in the spring of 1893. It is an adaptation of the
Hippocratic Oath taken by physicians.

BREATH SOUNDS
Normal Breath Sounds

Bronchial Sounds
Bronchial breath sounds consist of a full inspiratory and expiratory phase with the inspiratory phase usually being louder.
They are normally heard over the trachea and larynx. Bronchial sounds are not normally heard over the thorax in resting
animals. They may be heard over the hilar region in normal animals that are breathing hard (i.e. after exercise).
Otherwise, bronchial sounds heard over the thorax suggest lung consolidation and pulmonary disease. Pulmonary
consolidation results in improved transmission of breath sounds originating in the trachea and primary bronchi that are
then heard at increased intensity over the thorax.

Bronchovesicular Sounds
Bronchovesicular breath sounds consist of a full inspiratory phase with a shortened and softer expiratory phase. They are
normally heard over the hilar region in most resting animals and should be quieter than the tracheal breath sounds.
However, in sheep, goats, llamas, and alpacas, they may be heard throughout the full lung field and are often louder than
tracheal breath sounds. Increased intensity of bronchovesicular sounds is most often associated with increased ventilation
or pulmonary consolidation.

Vesicular Sounds
Vesicular breath sounds consist of a quiet, wispy inspiratory phase followed by a short, almost silent expiratory phase.
They are heard over the periphery of the lung field. As stated earlier, these sounds are NOT produced by air moving
through the terminal bronchioles and alveoli but rather are the result of attenuation of breath sounds produced in the
bronchi at the hilar region of the lungs. These sounds may be absent or silent in the periphery of normal resting animals.
They are highly variable in intensity depending on the species, ventilation, and body condition. Increased intensity may be
associated with pulmonary consolidation.
Abnormal Breath Sounds

Crackles
Crackles are discontinuous, explosive, "popping" sounds that originate within the airways. They are heard when an
obstructed airway suddenly opens and the pressures on either side of the obstruction suddenly equilibrates resulting in
transient, distinct vibrations in the airway wall. The dynamic airway obstruction can be caused by either accumulation of
secretions within the airway lumen or by airway collapse caused by pressure from inflammation or edema in surrounding
pulmonary tissue. Crackles can be heard during inspiration when intrathoracic negative pressure results in opening of the
airways or on expiration when thoracic positive pressure forces collapsed or blocked airways open. Crackles are heard
more commonly during inspiration than expiration. They are significant as they imply either accumulation of fluid
secretions or exudate within airways or inflammation and edema in the pulmonary tissue.

Wheezes
Wheezes are continuous musical tones that are most commonly heard at end inspiration or early expiration. They result as
a collapsed airway lumen gradually opens during inspiration or gradually closes during expiration. As the airway lumen
becomes smaller, the air flow velocity increases resulting in harmonic vibration of the airway wall and thus the musical
tonal quality. Wheezes can be classified as either high pitched or low pitched wheezes. It is often inferred that high pitch
wheezes are associated with disease of the small airways and low pitch wheezes are associated with disease of larger
airways. However, this association has not been confirmed. Wheezes may be monophonic (a single pitch and tonal quality
heard over an isolated area) or polyphonic (multiple pitches and tones heard over a variable area of the lung). Wheezes
are significant as they imply decreased airway lumen diameter either due to thickening of reactive airway walls or collapse
of airways due to pressure from surrounding pulmonary disease.

Stridor
Stridor are intense continuous monophonic wheezes heard loudest over extrathoracic airways. They tend to be accentuated
during inspiration when extrathoracic airways collapse due to lower internal lumen pressure. They can often be heard
without the aid of a stethoscope. Careful auscultation with a stethoscope can usually identify an area of maximum intensity
that is associated with the airway obstruction. This is typically either at the larynx or at the thoracic inlet. These
extrathoracic sounds are often referred down the airways and can often be heard over the thorax and are often mistaken
as pulmonary wheezes. Stridor is significant and indicates upper airway obstruction.

Stertor
Stertor is a poorly defined and inconsistently used term to describe harsh discontinuous crackling sounds heard over the
larynx or trachea. It is also described as a sonorous snoring sound heard over extrathoracic airways. Stertor does not have
the musical quality of stridor. Stertor is significant as it is suggestive of accumulation of secretions within extrathoracic
airways.

GLASGOW COMA SCALE

Eye-opening response
Spontaneously - 4 points

To speech - 3 points

To pain - 2 points

No response - 1 point

Verbal response

Oriented - 5 points

Confused - 4 points

Inappropriate words - 3 points

Incomprehensible sounds - 2 points

No response - 1 point
Motor Response
Obeys request- 6 points

Localizes pain - 5 points

Withdraws from painful stimuli - 4 points

Abnormal flexion- decorticate posture - 3 points

Abnormal extension- decerebrate posture - 2 points

No response - 1 point

Total score ranges from 3-15. 

A total of 7 or less indicates severe neurological damage.