317 test 2 Flashcards
(188 cards)
1
Q
Risks factors that can lead to hypertension include
A
Modifiable: Alcohol, tobacco use. Diabetes mellitus Elevated serum lipids, excess dietary sodium Obesity, sedentary lifestyle Stress, sedentary lifestyle Socioeconomic status Non-modifiable: Age, family history, gender Genetics can be due do altered RAAS, stress and increased SNS, Insulin resistance, endothelial dysfunction, water and sodium retention
2
Q
Risk to patients who have hypertension
A
Cardiac: CAD, LV hypertrophy, HF, MI
Cerebrovascular disease: cerebral atherosclerosis, stroke
Peripheral vascular disease
Nephrosclerosis: kidney damage and diseases.
Retinal damage
3
Q
Compare and contrast the values associated with blood pressures
A
Normal SBP <120 and DBP <80
Prehypertension 120-139 or 80-89
Hypertension, stage 1: 140-159 or 90-99
Hypertension, stage 2: ≥160 or ≥100
4
Q
relationship of blood pressure and the concept of perfusion
A
Blood pressure must be adequate to maintain tissue perfusion at rest and during activity. If someone is in a hypotensive state for a long time, this would mean that there is a decrease in perfusion to tissues.
5
Q
primary hypertension
A
elevated BP without an identifying cause 90-95% of HTN cases. may have headache, fatigue, dizziness, dyspnea, and will eventually lead to organ damage
6
Q
secondary hypertension
A
elevated BP resulting from a cause 5-10% of HTN.
7
Q
secondary HTN causes include
A
kidney disease or disruption of BP that stimulates RAAS such as endocrine disorders, hyperthyroidism, high spinal cord injury, stimulants, pregnancy
8
Q
non pharmacological treatment of hypertension
A
weight loss, health diets, sodium restriction, potassium supplements, increase physical activity, limit drinking
9
Q
first line therapy for stage 1 hypertension includes
A
thiazide diuretics, calcium channel blockers, ace inhibitors, and ARBs
10
Q
DASH diet
A
consists of lowering salt intake, increasing potassium, calcium, magnesium, and fiber. The diet should have low concentrated carbohydrates and be low calorie.
11
Q
orthostatic hypertension
A
pt is normotensive and their BP decreased when rising to an upright position causing symptoms of lightheadedness or dizziness
12
Q
what is going on with a patient who has orthostatic hypertension
A
may represent when a pt has a decreased blood volume or overmedicating a patient.
13
Q
MAP (mean arterial pressure)
A
MAP is the average pressure within the arterial system that is felt by organs in the body. MAP of 60 is needed for proper organ perfusion. lower MAP can lead to ischemia and cellular death
14
Q
how to figure out the MAP
A
((systolic) + (diastolic x2))/3
15
Q
treatment of a hypertensive crisis.
A
treatment needs to occur within an hour. BP should be lowered gradually. Cardiac and renal function needs to monitored.
16
Q
peripheral vascular disease
A
PVD is the thickening of the arterial walls which narrows and stiffens the arteries in the UE and the LE or an obstruction of the vein by a thrombus.
17
Q
risks for peripheral vascular disease.
A
high BP, high cholesterol, old age, male, smoking, diabetes
18
Q
relationship of peripheral vascular disease with the concept of perfusion.
A
Peripheral vascular disease makes it harder for blood to travel to these areas. decreases perfusion means decreased O2 to these tissues and muscles.
19
Q
Compare and contrast the peripheral venous disease and peripheral arterial disease
A
PAD: narrowing of the arteries, shows as cramping, pain, tired legs that worsens during walking and subsides with rest
PVD: inadequate return of venous blood from the legs to the heart shows as achy cramping in legs worsens with standing and improves with elevation
20
Q
6 Ps with peripheral arterial disease
A
pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia
21
Q
poikilothermia
A
loss of temperature regulation
22
Q
treatment of a patient with peripheral venous disease
A
exercise, elevating the affected area, bandaging or special compression stockings can help, but in more severe cases blood thinning medication may be prescribed like heparin
23
Q
prophylaxis treatment for PVD
A
early mobilization after surgery, elastic stockings, anticoagulation
24
Q
treatment of a patient with peripheral arterial disease
A
lifestyle modifications: smoking cessation, physical exercise, DASH diet, glucose control, BP control, control hyperlipidemia, antiplatelet agents
25
Bp highest at what part of the day
10 am - 6 pm
26
BP lowest at what part of the day
between midnight and 3 am
27
Nursing Dx with hypertension
```
o Ineffective health management
o Anxiety
o Sexual dysfunction
o Risk for decreased cardiac perfusion
o Risk for ineffective cerebral and renal perfusion
```
28
LDL
bad cholesterol - promote formation of atherosclerosis. want it less than 100
29
HDL
good cholesterol - associated with coronary artery disease want it higher than 35
30
total cholesterol
want less than 200
31
triglycerides
fat storage - associated with coronary artery disease what less than 150
32
BMI that is categorized at obesity
BMI greater than 30
33
Two risk factors for coronary artery disease that increase the workload of the heart and increase myocardial oxygen demand are
hypertension and smoking
34
Microvascular angina
pain with coronary spasm of major coronary artery
35
Care for angina
o Decrease O2 demand and or increase O2 supply
o Short acting nitrates
o Long acting nitrates
o If they feel dizzy or lightheaded they should not take any more or BP will drop too low
o Patient will most likely get a headache
36
If they do not get tingling under tongue then
med most likely outdated
37
cardiac output is determined by
HR, stroke volume, BP
38
perfusion
force of blood movement generated by cardiac output
39
relationship of heart failure with the concept of perfusion.
During heart failure we have a decrease in cardiac output which decreases blood pressure which therefore is an impairment of perfusion. Having a perfusion impairment means we have less blood flow to our brain and tissues which can lead to systemic effects
40
population at risk for heart failure
You are at more risk for developing heart failure if you are of African American descent, are obese, a smoker, have high cholesterol, CAD, HTN, DM, or pulmonary hypertension.
41
Differentiate between clinical signs of right sided and left sided heart failure
left: dyspnea, cough, crackles, wheezes, blood tinged sputum, tachypnea, restlessness, cyanosis, fatigue
right: ascites, enlarged liver or spleen, distended jugular veins, weight gain, edema
42
Differentiate between right sided and left sided heart failure
right occurs when the right ventricle fails to contract effectively and causes back up into systemic
left sided HF results from left ventricular dysfunction and causes back up into the lungs
43
HFrEF
systolic heart failure
44
ejection fraction of systolic heart failure
is lower because the ventricle loses the ability to generate enough pressure to eject blood forward. EF usually less than 45% and can go as low at 10%
45
HFpEF
diastolic heart failure
46
diastolic heart failure
inability of the ventricle to relax and fill during diastole.Is often referred to as heart failure with a normal EF. decrease stroke volume and cardiac output
47
systolic heart failure
inability for the heart to pump blood effectively
48
Ejection Fraction
he amount of blood ejected from the ventricle with each contraction.The normal EF is 55-60%
49
FACES
fatigue, limitation in activity, chest congestion, chest congestion, cough, edema, SOB
50
stages of HF diagnosis
stages A: high risk for developing CHF
stages B: structural disorder of heart
stage C: past or current symptoms of CHF
Stage D is end-stage disease
51
core measure of heart failure
education and documentation on: medications, symptoms worsening, follow up with physician, daily weight, activity, dietary restrictions, smoking cessation
52
Explain the relationship of coronary artery disease and the concept of perfusion
If the lipid deposits in the intima develop to become complicated lesions, blood flow is severely decreased
53
coronary artery disease
type of blood vessel disorder that is included in the general category of atherosclerosis. is characterized by lipid deposits within the intima of the artery
54
population at risk for coronary arterial disease (CAD)
older populations, the ethnicities of Caucasians, African Americans, and Native American, smokers, obese, stress out people, diabetes, and people who do not move that much.
55
diagnostic procedures associated with CAD
chest x-ray, ECG, stress testing, electron beam computed tomography (EBCT), Coronary Computed Tomography Angiography (CCTA)
56
electron beam computed tomography (EBCT
locates and measures coronary calcification
57
Coronary Computed Tomography Angiography (CCTA)
using IV contrast and radiation, CCTA can detect calcified and noncalcified plaques in the artery
58
diagnosis of acute myocardial infarction
12-lead ECG, Serum Cardiac Biomarkers, Coronary Angiography
59
STEMI
usually have a complete coronary occlusion and will have an inverted T wave and pathologic Q waves
60
non-stemi
pt’s usually have transient thrombosis or incomplete coronary occlusion and will have ST depression or an inverted T wave
61
Serum Cardiac Biomarkers
Cardiac specific troponin, creatine kinase MB, and myoglobin are released into blood from necrotic heart muscle after an MI and can be tested fo
62
Coronary Angiography
Opens totally occluded artery
63
treatment associated with acute chest pain
Acute intensive drug therapy: nitroglycerin, antiplatelet therapy (aspirin, glycoprotein IIb/IIIa inhibitors), anticoagulation therapy (heparin, direct thrombin inhibitors)
Coronary angiography: PCI
CABG (coronary artery bypass graft) surgery
64
treatment associated with chronic stable angina
A: antiplatelet/anticoagulant therapy, antianginal therapy, ACE inhibitor, ARB
B: beta blocker, BP control
C: Cigarette smoking cessation, cholesterol management, CCB, cardiac rehabilitation
D: Diet (weight loss), diabetes management, depression screening
E: education
F: flu vaccine
65
treatment associated with Acute coronary syndrome
IV access
O2 therapy
Drug therapy: nitroglycerin, morphine sulfate, aspirin, beta blocker, ACE inhibitor, ARB, high dose statin
66
Nitroglycerine meds
"nitrates" dilate peripheral and coronary blood vessels
67
nitroglycerine administration
take a nitro tablet sublingually If no relief, repeat every 5 minutes for a max of three doses. Tell them of potential symptoms they will fell: headache, dizziness, flushing. you can also take it by ointment and transdermal patches
68
percutaneous coronary intervention
a method of increasing blood flow to the heart when it is at least 70% occluded with plaque. The tip of a catheter with a deflated balloon is inserted to the appropriate coronary artery and then the balloon is inflated and compresses the plaque
69
when is Percutaneous coronary intervention used
used if a coronary block is amenable to treatment. have this procedure done: within 90 minutes of MI symptoms or STEMI
70
thrombolytics
medications to dissolve dangerous clots in blood vessels and improve blood flow and prevent damage to tissues and organs during heart attacks
71
4 modifiable factors that are major contributing factors to CAD
Elevated serum levels
HTN
Tobacco use
Physical inactivity
72
Interpersonal communication
exchange of information between two or more people. uses verbal and nonverbal cues to accomplish personal and relational goals.
73
Transpersonal communication
specific responses that encourage the expression of feelings and ideas and convey acceptance and respect. When you confront someone in a therapeutic way you help them become more aware of inconsistencies in his or her feeling, attitudes, beliefs, and behaviors.
74
role of the message
The message is what is actually said plus nonverbal communication. The role of the message is to clearly communicate some kind of information to the receiver.
75
channels in communication
means of sending and receiving messages through visual, auditory, and tactile senses. Facial expressions send visual messages; spoken words travel through auditory channels. Touch uses tactile channels
76
feedback in communication
Feedback is a response to the message. Feedback can be positive, negative,verbal, or nonverbal.
77
factors that influence communication
psychophysiological context, relational context, situational context, environmental context, and cultural context
78
Psychophysiological Context
physiological status, emotional status, attitudes, values, beliefs
79
relational context
nature of relationship - level of trust, caring, self disclosure, shared history, power and control
80
situational context
reason for communication
81
role of the environment in communication
environment is the setting for sender-receiver interaction. effective communication setting provides participants with physical and emotional comfort and safety
82
zones space and touch
intimate zone, personal zone, socio-consultative zone, public zone
83
intimate zone
(0- 18 inches): holding a crying infant, performing physical assessment, bathing, grooming, dressing, feeding, and toileting a patient
84
personal zone
(18 inches to 4 ft): sitting at a pt’s bedside, taking a pt’s nursing history, teaching an individual pt
85
socio-consultative zone
(4-12ft): giving directions to visitors in the hallway, asking if families need assistance from the pt doorway, giving verbal report to a group of nurses.
86
public zone
(12ft. and more): speaking at a community forum, lecturing to a class of students, testifying at a legislative hearing
87
zones of touch
social zone, consent, vulnerable zone, intimate zone
88
social zone
(permission not needed): hands, arms, shoulders, back
89
consent zone
(permission needed): mouth, wrists, feet
90
vulnerable zone
(special care needed): face,neck, front of body
91
intimate zone
(permission and great sensitivity needed): genitalia, rectum
92
Therapeutic communication techniques
sharing empathy, humor, feelings, using touch, silence, clarifying, focusing, validating
93
non-therapeutic technique
asking personal questions, giving opinions, changing the subject, false reassurance, sympathy, defensive response
94
SOLER
```
s- sitting posture
o- observe an open posture
l- lean toward the patient
e- establish and maintain eye contact
r- relax
```
95
IPASS
I- illness severity
P- patient summary
A- action list
S- situation awareness and contingency planning
S- synthesis by receiver - receiver summarizes what was heard
96
when calling a physician in addition to an SBAR, you need to
Make sure you have assessed the pt yourself
Read the most recent notes
Discussed the pt with the charge
Looked to make sure there is not a protocol in place for the issue
Have the most recent labs, vitals, and meds
Ask others if they need to talk to the doctor
97
high priorities
life-threatening or that could result in harm to the client if they are left untreated are high priorities.
98
intermediate priorities
Non-emergency and non-life-threatening client needs
99
low priorities
needs that are not related directly to the client's illness or prognosis
100
ABCs
airway, breathing, circulation
101
optimal goals of nursing
Ensuring optimal care through objectives, systematic monitoring, criteria based evaluations, goals,needs,values for the patient.
102
patient acuity scale
stable pt, moderate risk pt, complex pt, high risk pt
103
stable pt
A/O x4, room air, normal labs, IVPB/PO meds, etc.
104
moderate risk pt
patient may be less oriented, on NC for O2, receiving TPN or heparin, low grade fever, etc.
105
complex pt
delirious, tracheostomy, blood transfusion, moderate or changing fever, etc.
106
high risk pt
unstable, afib, chemotherapy, serious air therapy, etc.
107
patient acuity tool
RNs can use to assess patients risk level to help create equitable, quantifiable assignments
108
what can be done to minimize risks associated with floating.
Inform your supervisor of any lack of experience
Receive an orientation of the unit
Before accepting a job, ask about floating and have an understanding of what it is - this ensures that you’re protecting yourself and the pt
109
Hospital acquired pneumonia
occurs 48 hours or longer after admission to the hospital, highest mortality rate of nosocomial infections
110
Aspiration pneumonia
abnormal entry of secretions into airway, usually history of a loss of consciousness, gag and cough reflexes suppressed, tube feedings are a risk factor, ventilator support is a risk factor
111
etiology of asthma
asthma is caused by triggers such as allergens, food allergies, obesity, pollutants, occupants, beta blockers, NSAIDS
112
extrinsic
outside the body like pollen and pollutants
113
intrinsic
stress, anxiety, other internal factors
114
clinical manifestations of asthma
accessory muscle use, anxiety, chest pain, costal and sternal retractions, dyspnea, nasal flaring, nonproductive cough, rhonchi, wheezing, and tachypnea.
115
indications of O2 therapy
Oxygen therapy is needed in cases of hypoxemia when the SPO2 of a patient is less than or equal to 88% (w/o comorbidities) and 89%( w/ comorbidiites)
116
methods of delivery of O2
Nasal cannula (1-6L/min), Simple mask (5-10 L/min), Partial rebreather (8-12 L/min), Non-rebreather (10-15 L/min), and the Venturi mask (4-12 L/min).
117
chronic obstructive pulmonary disease (COPD)
COPD is essentially chronic airflow limitation. It encompasses both the diseases of emphysema and chronic bronchitis
118
causes of COPD
inflammation and structural changes of the airway bronchioles with increased mucus blocking airflow, and also the destruction and enlargement of air spaces such as alveoli also limit air movement resulting in COPD.
119
clinical manifestations associated with COPD
Easily fatigued, frequent respiratory infections (pneumonia), use of accessory muscle use, orthopneic, Wheezing, chronic cough, dyspnea, prolonged expiratory time, thin in appearance but can be heavy. Digital clubbing.
120
emphysema
```
pink puffer - Enlargement of the air space distal to the terminal bronchioles.
Increased CO2 retention
No cyanosis
Dyspnea
Ineffective cough
Hyperresonance on percussion
Barrel chest
Usually a smoker
Prolonged respiratory time with accessory muscle usage
Leads to right sided heart failure
```
121
chronic bronchitis
```
blue bloater -
Chronic inflammation further narrowing the small airways. Tendency to hyperventilate and retain co2
Usually dusky to cyanotic
Sputum production
Hypoxia and hypercapnia
Acidosis
Edematous
Increased resp rate
Exertional dyspnea
Digital clubbing
Usually a smoker
Cor pulmonale, cardiac enlargement
```
122
huff coughing
in comfortable sitting position, slightly inhale deeper than usually, activate stomach to blow out air in 3 even breaths while making the sounds huff huff huff. Less tiring than a traditional cough.
123
mild anxiety
shows with slight tension, effective problem solving, and increased alertness, energy, and concentration. Example: a person might show mild anxiety before a test
124
moderate anxiety
may heighten productivity and abilities but also may cause selective inattention. Functional but uncomfortable for short periods of time, as well as short periods of effective problem solving. The person will be tense and alert but have a narrowed perceptual field. Example: giving a presentation in front of the class.
125
severe anxiety
Uncomfortable and not useful. Requires intervention. Consumes energy. The person has a very narrow perceptual field and focuses on details. They do not necessarily see the “big picture”. They will be unaware of behaviors and effect on others. Helpful interventions include decreasing stimuli, giving simple commands or directions, and attending to the person’s physical needs. Interventions that are not helpful include increasing the unknowns and stimuli, letting the person take charge, and substance abuse
126
strategies to decrease stress in patients
time management, meditation, journal writing, yoga, diet, open communication, positive self talk, problem solving
127
Betty Neuman’s Systems Theory
used to describe the concepts of stress and reaction to stress. views a patient, family, or community as constantly changing in response to the environment and stressors.
128
actions that are successful in a crisis
maintain a safe, calm, quiet atmosphere, make slow and deliberate movements, and to ensure the safety of everyone around. Additionally, the nurse can ask the pt to describe the problem and ask about past situations and learn about how the pt coped.
129
responsibilities of a nurse when a legal 2000 is in place
keeping the patient’s safe and should identify when the patient is putting themselves or others at risk
130
indicators of stress
sociocultural indicator, spiritual indicator, emotional indicator, and intellectual indicator
131
Sociocultural indicator
a person avoiding meeting with people, family, friends
132
Spiritual indicator
a person verbalising discontent with a higher being
133
Emotional indicator
anger and crying
134
Intellectual indicator
someone setting unreasonable standards for perfection
135
maturational crisis
Varies with life stages
In preadolescents: puberty, school, and sex
In adults: major life changes including starting a family, losing their parents, and accepting physical changes
136
situational crisis
external sources such as job changes, car crash, illness, caregiver stress
137
General Adaptation System and the responses within the body
alarm stage, resistance stage, exhaustion stage
138
alarm stage
flight-or-fight reaction, Rising hormone levels result in increased blood volume, blood glucose levels, epi and NE amounts, HR, blood flow to muscles, oxygen intake
139
resistance stage
body stabilizes by normalizing and repairing damage, Hormone levels, HR, BP, and cardiac output should return to normal
140
exhaustion stage
body is no longer able to resist effects of stressor and has depleted the energy to maintain adaptation
141
what happens if stressor continues into exhaustion stage
continuous stress causes progressive breakdown of compensatory mechanisms. Chronic demands leads to chronic activation which can lead to excessive wear and tear on bodily organs called allostatic load.
142
diseases that are related to stress responses
Depression, Hypertension, Insomnia, Fibromyalgia, Eating disorder, Low back pain Menstrual irregularities, Infertility
143
type 1 diabetes
disorder of glucose metabolism that is related to absent or insufficient insulin supply and/or poor utilization.
144
type 2 diabetes
the pancreas produces insulin, but the body doesn’t use it efficiently. Thus there is insulin resistance and then there is hyperinsulinemia (or a lot of insulin).
145
symptoms of hyperglycemia
dry mouth, extreme thirst, frequent urge to urinate, drowsiness, frequent bed wetting, abdominal pain
146
symptoms of hypoglycemia
“Cold and clammy, patient needs some candy.”
| sweating, trembling, dizziness, mood changes, hunger, headaches, blurred vision, extreme tiredness and paleness
147
actions for a patient who has hypoglycemia
Consume 15 grams of glucose, in the form of simple carbs for conscious patients. Check after 15 minutes, then repeat 15 grams of glucose if necessary. For unconscious patients: give glucagon D50
148
somogyi effect
High blood sugar in early morning- low blood sugar at night causes rebound high blood sugar in the morning
149
Dawn phenomenon
High blood sugar early in morning. A decrease in insulin with an increase in glucagon and cortisol cause hyperglycemia in morning
150
type of insulin
rapid acting, short acting, intermediate, and long acting
151
rapid acting
15 minute onset, peaks in 1 hour and works 2-4 hours
152
short acting
'regular' - w/in 30 min, peaks 2-3 hrs, works 3-6 hours- Humulin R and Novolin R
153
intermediate acting
2-4 hours, peaks 4-12 hrs, works 12-18 hrs - humulin N
154
long acting
several hrs after, lowers B glucose over course of 24 hrs- Glargine
155
Basal
mimics what pancreas does to keep blood sugar in normal range when a person’s not eating - Lantus/Levemir
156
Bolus
mimics the increase of insulin the pancreases sends out in response to food - Humalog/Novolog
157
Metformin
Oral (used as first line treatment for type II, Type I canNOT take this)
158
what class is metformin
Biguanide
159
normal Hbg A1C
6.5%
160
amount glycosylated hgb depends on
B-glucose level
161
DKA
Increase in ketones (can’t metabolize glucose - using fat, ketones are acidic) causes metabolic acidosis, osmotic diuresis causes hypovolemia and electrolyte depletion. Renal failure is possible. High respiratory rate and fruity breath.
162
HHNKS
hyperosmolar hyperglycemic nonketotic syndrome - there is enough insulin to prevent DKA, but not enough to prevent severe hyperglycemia, osmotic diuresis, fluid depletion/hypovolemia, electrolyte depletion. Older adults with impaired renal function usually, so be mindful of renal function when treating.
163
DKA treatment
fluid and electrolyte replacement - especially K+, insulin to correct hyperglycemia after fluid balance is improved, insulin allows water to enter the cells
164
HHNKS treatment
fluid replacement is key! - then, insulin treatment - then, management of electrolyte levels. Give IV insulin until glucose levels are between 250 and 300 until pt is alert
165
macrovascular effects of Diabetes.
```
Large-medium sized blood vessels
Ischemic heart disease
Cerebrovascular disease
Peripheral vascular disease- atherosclerotic and blood clots
HTN
```
166
microvascular effects of Diabetes
Eyes (retina) -> retinopathy which can lead to glaucoma
Nerve cells -> neuropathy which can lead to injury
Kidney -> nephropathy which leads to renal failure
Skin -> Dermopathy which leads to potential skin impairment
167
Sliding scale
Dosage for the patients glucose levels. It does have have conflicts because it can lead to inconsistent glucose readings
168
Basal bolus insulin
Pt will receive a basal insulin that mimics what the pancreas does to keep the blood sugar within normal range. This is long-lasting insulin injection.
The bosul insulin mimics the increase in insulin that the pancreas will send in response to food. Short lasting.
Correctional insulin is given for high blood sugars in addition to the bolus.
169
educational priorities for patients with Diabetes
```
Take blood glucose 3-4 xday
Know cost of strips (approx. $1 per strip)
Keep strict regime
Maintain med regim
Take fluids and limit simple carbs
Check ketones
```
170
treatment plan for a patient with Diabetes type 1
Insulin regimen developed to coordinate w/ pt’s eating pattern-needs to be stable
Limit alcohol intake
Education!
171
treatment plan for a patient with Diabetes type 2
```
Calorie reduction
Limit alcohol intake
Reduction of total fat, unsaturated fat, and simple carbs
Regular exercise
Monitoring of glucose, A1C, lipds
Education
```
172
HAIs
hospital acquired infection. primary cause of preventable death and disability among hospitalized patients.
173
CLABSI
central line associated bloodstream infection. Microorganisms can enter the bloodstream and contaminate CVCs through 2 mechanisms: extraluminally or intraluminally.
174
extraluminally
most common - patient’s skin organisms at the insertion site migrate into the area surrounding the catheter tip
175
intraluminal
Intraluminal contamination occurs from direct contamination of the catheter through the intravenous (IV) system (needleless systems, hubs, connections).
176
actions to prevent CLABSI
optimal site selection, maximal barrier precautions, hand hygiene, sterile prep of the insertion site, observer monitoring procedure
177
CAUTI
catheter associated urinary tract infection. occurs in a patient who had an indwelling catheter in place 48 hours prior to the UTI diagnosis and up to 30 days post removal or discharge
178
actions to prevent CAUTI
hand hygiene, use smallest bore catheter as possible, indwelling urinary catheter must be secured, date the fully collection bag, check skin condition around the device, remove catheter as soon as possible.
179
signs of UTI
fever, suprapubic tenderness, acute hematuria, alter mental status, dysuria, urgency
180
CAUTION
C- Close system catheter selection consider alternatives
A- Aseptic management
U- Universal standard precautions
T- Tie secure catheter to patient tubing to bed
I- Indication for use and to discontinue
O- Obstruction free specimen from sampling port
N- No dependent loops
181
SSI
surgical site infection. as infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure
182
actions to prevent SSI
Before surgery, patient should shower or bathe, skin preparation, antimicrobial prophylaxis should be administered only when indicated, glycemic control should be implemented, Normothermia should be maintained in all patients, oxygen should be administered during surgery
183
Cognitive teaching method
Discussion- one-on-one. Lecture. Question and Answer
184
affective teaching method
Role Play. Group Discussion. Discussion (one-on-one)
185
psychomotor teaching method
Demonstration.Practice( perform skills in a controlled setting) Independent project and games(requires teaching method)
186
teach back
explain, assess for clarity, clarify, reassess: confirms that your patient clearly understood what you taught. The nurse should ask the patient to demonstrate what they just learned or repeat it in his or her own words
187
3 main purposes of pt education
health promotion and illness prevention, health respiration, and coping
188
FEV1
FEV1 is the maximal amount of air you can forcefully exhale in one second. low in COPD patients
