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Nursing 101 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Who develops the code of ethics for nurses, which defines the nurse’s responsibilities and set the standard of nursing practice/scope?

A

ANA : American nurse association

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2
Q

What does the NLN do?

A

Conduct nclex and pre entrance testing,
Develops and improve nursing Ed
Provides accreditation

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3
Q

What does the nurse practice act state?

A

It varies by state
Define legal scope
Establish criteria for Ed and licensure nurses

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4
Q

Who over seed the nurse

A

The national council of board

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5
Q

What does the joint commission do?

A

Pt safety goal
Accredits hospital

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6
Q

What’s evidence base practice ?

A

As evidence changes, so must practice

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7
Q

What are the profession values of nursing ?

A

Altruism - concern for others
Human dignity
Integrity : acting in accordance
Social justice

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8
Q

What are some examples of bioethics? (5)

A

Autonomy - pt right to make decison
Nonmaleficence - duty to do no harm
Beneficence- do go, benefit pt
Justice
Fidelity -faithful to agreement /promise
Veracity : telling the truth

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9
Q

List examples of international torts

A

Assault : threat

Battery: carrying out that threat

Defamation: spoken remarks to reputation

In o privacy : Hipa
False imprisonment : preventing movement form another perosn that’s unjustifiable

Fraud

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10
Q

Examples of unintentional torts

A

Negligence: did not mean to inflict harm on pt

Malpractice: negligence that’s applied to a profession ( can be a lawsuit )

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11
Q

What are some examples of malpractice ?

A

Failure to follow standards of care
Use equipment responsible
Assesse and minitor
Communicate
Document
Act as pt advocate

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12
Q

What’s an informed consent?

A

A voluntary written permission by pt to perform specific test/procedure

( not needed in emergency

Pt much me alert and oriented to sign , has write to refuse

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13
Q

Under what circumstances can’t a pt give consent ( 3 M’s)

A

Minors ( varies by state
Mentally I’ll
Medicated with certain medication that disrupts thought process

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14
Q

Advance directives

A

Written directive that gives directions that an individual can act on their behalf either through death or pt not alert and oriented

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15
Q

Living will vs healthcare proxy

A

Written document by a person for directions on the type of healthcare they would like to recieve in a particular End of life situation

Healthy care proxy; document that states who has the right to malt healthcare proxy in the event that pt can’t give consent

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16
Q

What happens when there’s no living will?

A

Next of ken ; spouse if not married parents

No next of ken? Ethics committee makes decisions

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17
Q

Molst

A

Stands for medical order for life sustaining treatment,

Order that stayed pt wishes regarding treatments commonly used in medical crisis

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18
Q

Comorbidity

A

Joint disease that makes things worse

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19
Q

Roles of the nurse?

A

Leader, counselor , caregiver advocate, collaborator delegate , educator

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20
Q

Never event vs sentinel event

A

Unexpected rare medical error that should never happen to a pt

Unexpectedly event involving death or serious physical injury

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21
Q

What is the race accronym

A

Rescue
Alarm
Confine
Evacuate

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22
Q

What’s is the nursing process?

A

A systematic method to guide nursing pratice , use to establish health care plan needs and strengthen

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23
Q

Describe the different process of the nursing process

A

Assemsnt : gather data and review with objective abs subjective data

Diagnose : clinical judgment on situation
Planing: develop goal, desired outcome and action plan

Implement: perform nursing action
Evaluation: we’re Desiree’s outcomes and goals achieved

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24
Q

What does it mean to delegate ?

A

The transfer of responsibility while attaining accountability for the outcome

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25
Q

What are some things that can not be delegated? ( do not eat )

A

Inital and ongoing nursing assessments
Determined of nursing diagnosis
Progress in relation to nursing plan
Supervision and education

Evaluate
Access
Teach

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26
Q

What task can be delegated?

A

Standard , unchanging procedures
Ex height weight, vital signs observing and reporting changes in pt

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27
Q

Therapeutic vs non therapeutic

A

Shows acknowledgement, Claire, focused, feedback , open questions and reflecting

Asking pt why?
Being defensive
Changing subject
Giving advice
Making judgement
Putting pt feelings on hold
Proving false assurance

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28
Q

How to commmunicate with visually impaired

A

Acknowledge presence in room
Identify self
Speak in normal tone
Explain reason for touches
Tell pt when conversations ends and when leaving ,
Keep call bell in easy reach

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29
Q

What are some interviewing techniques ?

A

Identify self, purpose of interview and role
Focus on pt comforbility
Eye contact
Listen attentively
Reflective questions
Open ended questions
Close ended to questions for specific

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30
Q

What do you look for in fall risk safety

A

Assess for any previous accident
Review meds that could put pt at risk for fall
Assess with pt on immediate environment , stairs use of throw rugs , grab bars

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31
Q

What are some risk factors

A

Muscle weakness , especially in the legs
Balance and gait, how one walk
Postulate hypotension
Reflexes may be slower
Foot problem that cause painful feet

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32
Q

Measures to prevent fall

A

Asses the client risk for falling
Print client to sorroundings
Asses client risk for falling
Assess the client frequently
Instruct client to seek assistance when getting up
Use safety devices
Adequate lighting
Eliminate clutter

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33
Q

Setting priorities for nurses

A

A- airway
B- breathing problems
C- cardiac circulation problems
Vital sign
Lab Val that’s life threatening

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34
Q

Musculoskeletal changes that increase risk for accidents

A

Strength and function of muscle decrease
Joints becomes less mobile
Postural changes

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35
Q

Nervous system changes

A

Voluntary and automatic reflexes become slower
Decrease ability to respond to multiple stimuli occurs
Decrease sensitivity to touch occurs

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36
Q

Sensory changes that increase risk accidents

A

Decrease vision and lens accomdation and cataracts
Delayed transmission of hot and cold impulses
I later hearing develops

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37
Q

Types of restraints

A

Wrist
Vest
Mitts
Belt

Risk of skin breakdown and contractures
Restrain must have provider order

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38
Q

Points system for restrain

A

2 points - every 24 h
4 points -every 8 h
Chest/vest every 8h

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39
Q

What must happen when pt is restraint?

A

Check restraint for circulation every 30min
Release every 2h for rom
Incase of emergency pt must be able to exist bed
Offer fluid if clinically indicated every 2 h
Offer bedpan every 2 h

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40
Q

How do you use fire extinguisher (pass)

A

Pull the pin
Aim for the base of fire
Squeeze the handle
Sweep from side to side

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41
Q

Remission vs exacerbation

A

When the disease is present but the person does not experience symptoms

Symptoms of disease reappear

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42
Q

What are some risk factors for illness/injury

A

Age
Genetic
Physiology
Health habits
Lifestyle
Environment

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43
Q

What are the levels of prevention

A

Primary - promoting and preventing the development of disease processes ex : diet, weight list exercise immunization, safe sex

Secondary- screening , people at risk for a Health problem , goal is to identify an illness and reverse or reduce severity

Teritiaty ( treatment, people with a health problem)
Eg, medication, surgical treatment, rehab, physical therapy, ot

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44
Q

Isolation precautions /standard

( blood borne)

A

Must be pratice for All pt in hospital regardless of diagnosis

Hygiene, gloves, mask , eye protection and gown when appropriate

Indication: hiv, hep b and c

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45
Q

Contact precautions

A

Must be in private rooms or cohort pt with same infectious disease
Gloves and gown

MRS WEE
Multi drug resistant
Respiratory Infections
Skin infection ( v chip)
Chicken pox

C diff, wound infection acute diarrhea

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46
Q

Droplet precautions

A

Transmit by droplet expelled via coughing sneezing talking
surgical mask with eye shield for all personnel within 3 feet

Private room, pt only
Surgical mask with eye shields ( 3ft)
Gloves for contact with pt and environment

Indication: spider man
Step throat
Influenza
Rubella
Mumps/ meningitis

Pimp: pretisid,influenza, meningitis, pneumonia)

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47
Q

Airborne precautions ( mtv)

A

Single private room maintained under negative pressure, door remains clues except entering and exiting , room have hepa mask
N95 or higher mask

Surgical mask on pt of leaving room
Ex measles
Chickpox
Herpes zoster
Tb
SARS

( measles tb, vericella )

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48
Q

Types of causative agent

A

Bacterial- most significant
Virus- smallest of all microorganisms
Fungi- plant like organism
Parasites - organism that lives on host and rely on nourishment

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49
Q

What are some ways to break chain of infection with reservoirs

A

Change dressings
Appropriate skin and oral hygiene
Dispositions if damp soiled linens
Deposes if feces and urine
Cover all fluid containers
Empty suction and drainage bottle at in of shift

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50
Q

Modes of transmission for infectious agent ?

A

Direct
Indirect
Ingestion
Inhalation

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51
Q

When should you perform hand hygiene

A

Before touching pt
Before clean procedure
After body fluid exposure risk
After touching pt
After touching pt surroundings

52
Q

Donning PPE

A

Gown
Mask
Googles
Gloves

53
Q

Removing PPE

A

Gloves,
Googles
Gown
Mask

54
Q

Asepsis vs medical

A

Abscencd of disease producing microorganisms, using method to prevent infection

Break the chain of infection in medical procedures
Reduce # and transfer of pathogens

55
Q

Surgical a sepsis

A

Sterile technique
Prevent infection before and after surgery
Pray us that render and keep objects and area free from microorganisms

56
Q

When is surgical asepsis used?

A

Dressing changed
Cathertetization
Surgical procedure

57
Q

When is medical asepsis used?

A

Medication
Enemas
Tube feedings
Daily hygiene

58
Q

Examples of immature immune system

A

Very young and old pt
Chronic diseases ( diabetes, infection hiv)
Autoimmune disease
Pt on medication that suppress immune system

59
Q

Stages of infection

A

Incubation: pathogen invasion
Prodromal : early signs and symptoms
Full stage : specific signs and symptoms
Convalescent- revocery

60
Q

Nosocomial infections

A

Hospital acquired ; pt didn’t come in with infection

Common types:
UTI
Cauti
Pneumonia
C diff

61
Q

Factors that affect mobility

A

Chronic disease
Disease that affect neuro ( Parkinson’s)
Copd ( impact breathing )

62
Q

Complications in immobility pt

A

Nervous: anxiety, isolation confusion and depression

Digestive: decrease appetite, low fluid intake

Skin: pressure ulcers , infections, skin breakdown, poor skin tugor

63
Q

2 types of blood clots

A

Deep vein thrombosis ( dvtt): form in one or more of the deep veins in your body usually in the foot,

Embolism : traveling clot

Prevention: rom,
Anticoagulants
Antiemolosim device

64
Q

Examples of antiembokism device

A

Scd sequential compression device : method that promotes blood flow to the legs, shape like sleeves that wrap around leg inflated with air 1 at a time

Compression socks/stocking: help to improve blood flow and prevent clot to form in legs

65
Q

How does immobility affects the respiratory system?

A

Pneumonia
Decrease respiratory effort
Decrease oxygen of blood
Thickening of respiratory secretion
Respiratory tract infection

66
Q

How does imobility affect urinary

A

Reduces kidney function
Urinary incontinence
UTI
Urinary retention

67
Q

What’s the effects of immobility on the muscular system

A

Brittle bones
Contracture
Muscle weakness
Atrophy
Oeaterpirisis
Joint stiffness , pain impairs rom

68
Q

What are the 3 types of exercise

A

Isotonic : weight lifting , increase muscle tone
Isometric : push ups , muscle length don’t change ( plank)
Isokinetic: resistive exercise ball , walking swimming jogging) rehab

69
Q

Active rom
Passive rom
Active assistive rom

A

Pt independently moves joints
Pt unable to move independently, require total assistance
Pt required minimal assistance with rom

70
Q

Supine /dorsal vs dorsal recumbent

A

Flat in bed; physical examination

Lying on back, hip and knees forced soles of feet flat on bed

71
Q

Prone vs high Fowler

A

Lying on abdomen, head to side , for back massage or im injections

Sitting upright in bed with support , for severe dyspnea

72
Q

Fowler ava semi Fowler

A

Head elevated 45-69 degree angle for dyspnea

Head elevated at 30, dyspnea

73
Q

Chest knee vs lithotomy

A

Rental exam

Vaginal/rectal exam and treatment, vagina delivery

74
Q

What is the control system for sleeping and walking?

A

Hypothalamus

75
Q

Types of sleep

A

Nrem: stage 1-2 light sleep,
Stage 3-4 deep sleep/ slow wave sleep , everything decreases

REM: rapid eye movement,
More difficult to wake , dream takes place, brain highly active

76
Q

What are some sleep disorders

A

Insomnia : difficultly falling asleep
Narcolepsy : uncontrollable desire to sleep anytime
Hypersomnia : excessive day time sleepiness
Sleep apnea: absence of breathing
Sleep deprivation: prolong lack of sleep , can result in loss of concentration, fatigue
Parasomniss: sleep walking

77
Q

What are some nursing interventions for sleep ?

A

Adjust environment
Offer bedtime routine
Perform back rub
Asses pain level
No heavy meals 3 hours prior
Administer medication for sleep
Limit caffeine/smoking in evening
Avoid unnecessary disturbances

78
Q

What are hypnotics

A

Drugs that induce unnatural sleep and manage insomnia

2 types
Short acting : induce sleep allow pt to be awaken wake in the Morninf

Intermediate acting: useful for sustaining sleep, maybe isolated with drowsiness

79
Q

What are sedatives

A

Drugs used to provide sedation , usually prior to procedure

80
Q

Zaleplon, ( sonata )
Eszopiclone ( lunesta)
Zolpidem ( ambien)
Are used to treat what?

A

Insomnia

81
Q

Pallor vs erythema

A

Skin appear yellow brown and ashen gray, observed in mucus membrane, lips nails , ( happens when cutaneous vessels are severely constricted , skin have whitish hue

Rely on palpation, feeling for increase warmth on skin , redness cause by vasodilation

82
Q

Cyanosis vs ecchymosisv

A

Most difficult to observe, lack of oxygen cause blushes tinge of the skin , inspect lips, tongue, conjunctivae Pam’s soles of feet

Medical term for bruise , blood vessels broken

83
Q

Petechia vs jaundice

A

Round pinpoint spots of purplish red color resulting from itradermal bleeding , assess oral mucosa or conjunctivae

Excessive accumulation of bilirubin in the tissue produced a yellow color, check sclera of eye fir yellow discoloration

84
Q

What are some tips on skin care

A

Frequent positioning
Avoid friction and sear ( lift don’t drag )
Use pressure relieving surfaces
Use emollient to hydrate dry skin
Protect from excess moisture

85
Q

Braden scale

A

System used to check risk for pressure ulcer,
1 being the worst change and 4 having the best chance of not having it

86
Q

Stages of pressure ulcer

A

Stage 1: skin intact, non blsnchable redness
Stage 2:
Partial thickness of lord dermis , break in skin
Stage 3: full thickness tissue loss, subq fat may be visible
Stage 4: exposed bone, tendon, muscle slough / dark pigment may be present

87
Q

What kind of patients at risks for pressure ulcers ?

A

Older age
Diabetes
Decrease sensory perception
Dry skin, excessive moisture
Altered nutrition

88
Q

How do we prevent pressure ulcers?

A

Daily skin assessment
Appropriate positioning
Frequent turning
Good nutrition
Maintain a safe bed
Skin care
Massage

89
Q

Contusion vs avulsion

A

Blunt instrument, overlying skin remain intact with injury of underlying soft tissue

Tearing a stractute from Nintendo anatomical position, possibly damage to blood vessels

90
Q

What’s the difference between open and close wounds

A

Skin surface is open proving portal of entry, bleeding tissue damage ( incision or abrasion )

Close: from a blow , force or strain cause by trauma such as a cal assault or motor vehicle crash ( evchymosis and hematomas )

91
Q

Primary intention of wound healing

A

Well approximate ( skin edges tightly together)
Little tissue loss
Minimal scaring occurs
Most surgical wound heal by first intention healing

92
Q

Secondary wound healing

A

Not well approximate
Would allows to granulate
Surgeon may pack wound with guard or use drainage system healing process may be slow

Large open wounds such as burns or major trauma , which require more tissue replacement

93
Q

Tertiary wound healing intentions

A

Wound is intuallt cleaned, devreided and observed, typically 4-5 days before closure ,
Would purposely left open to allow Edna to resolve before closing

94
Q

Types of drainage

A

Serous :clear and watery
Sanguneous :bright red contain RBC
Serosanguineous : clear light pink
Purulent: Ouse, thick, often with foul odor

95
Q

Heparin sodium
Hep sq

A

Inactive thrombin,
Iv or subQ
Rapid onset within minutes
Brief usually for a few hours
Antidote : protamine sulfate
Monitor: aPTT ( activated partial thrombosis)
Side effects:

Low molecular weight

Adverse effect: hematoma anemia bleeding

96
Q

Coumadin ( warfarin)

A

Inhibits synthesis of clotting factor
Po
Slow onset within hours
Prolong usually days
Antidote: vitamin K
Monitor : Pt and inr ( prothrombin time, international normalized ratio)

Adverse reaction: bleeding , purple toes muscle pain

97
Q

Tachypnea vs bradypnea

A

Greater than 20
Lower than 12

Average ( 12-20)

98
Q

What is pca

A

Patient controlled analgesia,
Let’s you decide when you will get a dose of pain medication

99
Q

Diphenhydramine ( Benadryl)

A

Antihistamine, use to treat allergies , can be used as sleeping aid

100
Q

Benzodiazepines Valium
( Ativan)

A

Sedative hypnotic, can be used for anxiety, general anesthesia, sleeping aid

Adverse effect : sleep walk, drowsiness, headache dizziness, vertigo, lethargy

Antidote:

101
Q

Lovenox ( enoxaparin)

A

Used to prevent or treat dvt

102
Q

What labs are important before warfarin /Coumadin

Heparin:

A

PT
INR

PTT

103
Q

What labs are important Benadryl

Benzodiazepines ( Ativan)

A

Red blood cells

Hgb
Hct

104
Q

Azithromycin

Pcn, vancomycin

A

White blood cells : 4500- 11,000

Would culture + sensitivity

105
Q

What are pt, ptt and inr?

A

Activated partial theomboplastin: measure time it takes in secs for recalcifies citrates plasma to clot after partial thromboplastin is added to it

Prothrombin time : produce by liver , nescsay for fibrin clot formation , measure the time it takes in seconds for clot formation and used to monitor response to warfarin

International normalized ratio ( if # too bld clot will not be prevented and if too high there’s an increase in risk of bleeding

106
Q

What are some side effects from warfarin ( Coumadin)

A

Bleeding from gums
Blood in urine
Bloody dark stool
Vomiting blood

107
Q

Active immunity

A

Natural active immunity: antibodies are formed in presence of active infection in the body eg. Measles, mumps and chicken pox ( life long duration)

Artificial active immunity: antigens ( vaccines or toxoids ) stimulate antibody formation

108
Q

Passive immunity

A

Natural passive : mother to baby ( 6m to 1yr

Artificial passive immunity:
Occurs when immune serum ( antibody) from an animal or another human is injected ( 2-3 weeks)

109
Q

Glomerular filtration rates ( gfr)

A

Less than 15 : kidney failure
20-60: kidney disease
60-120 : normal

110
Q

Lungs sounds normal

A

Bronchial : loud pitch heard over treachea/larynx

Bronchovesiculat: medium pitch blowing sounds heard over major bronchi

Vesicular, low pitch soft sound heard over peripheral lung sounds

111
Q

Adventitious lung sounds

A

Crackles: air passing through fluid in airways

Wheezes: continues High pitch , produce as air passes through airway constricted by swelling

Ronchi: heard in expiration , cleared by coughing, heard primarily over treachea and bronchi

Pleural friction rub: rubbing or grating sound

Stridor: harsh loud high pitch sound , heard in inspiration

112
Q

Vital signs (
Bp, hr, rr, oxygen, tempt

A

120/800
60-100 beats
Respiration 12-20
Oxygen 95-100
97.8-99

113
Q

Basal metabolic ( BMP)
Sodium
Potassium
Bun
Creatine male and female
Albumin
Glucose

A

135-145 mEq/L
3.5-5.0
7-20 mg/dl
0.6-1.2mg/dl male 0.5-1.mg female
3.5-5.5g/dl
70-110 mg/dl

114
Q

Complete blood ct
WBC
RBC
PLT
Hemoglobin
Hematocrit

A

4.5-11,00
4.5-5.5
140,00-450,000

Female hemo 12-15 male 13.5-16
Female Hemacrit 36-44% male 41-50%

To remember hct multippy hgb by 3

115
Q

Coags:

Pt
Inr
Pt/inr on Coumadin
APTT ( no iv heparin)
APTT ( on iv heparin )

A

11-13.5 seconds
0.8-1.1 sec no Coumadin
15.5-30 seconds
30-40 sec
45-100 sec

116
Q

Hga1c
Gfr
Urine specific gravity

A

4%-5.6%
90-120 ml/min
1.000-1.030

117
Q

LDL
HDL
Total cholesterol

A

Less than 100 mg ( bad)
40mg or higher
125-200 mg /dl

118
Q

Gen: vancomycin
Trade: firvanq
T;
A:

A

Treatment: acute otitis media

Check wbc
Adverse effect : hepatotoxicity, c diff, Steven Johnson syndrome , philebitis, leukemia

119
Q

Gen: diphenhydramine
Trade: Benadryl

T:
A:

A

Treatment: allergies, cold cough
Adverse effect: dry mouth , dizziness, anorexia, drowsiness

( may decrease skin response)

120
Q

Coumadin ( warfarin)

A

Anticoagulant
Prevent thromboem Bolic events
Treatment : venous thrombosis pulmonary embolism

Adverse: cramps , dermanecrosis calciphylaxis bleeding

Asses for tary back stool fall in hematocrit fall in bp

121
Q

Penicillin: briars spectrum
Ad:
Side effects:
Route

A

Bacterial antibiotics
Adverse effect: rashes, anemia , anxiety

Side effects : diarrhea sore mouth , vagina itches , white patch on mouth and tongue

IM IV

122
Q

Tetracycline: broad spectrum
T:
Side:
Ad:

A

Used to treat Steph throat, std, r infection , acne

Side: photosensitivity, avoid sun, wear sunscreen

Adverse: discoloration of the teeth , fetal retard if taken pregnant

123
Q

Gen: diazepam
Trade : Valium

A

Long lasting route iv,po
Treatment: relief of anxiety, sedation, amnesia, decrease seizure activity

Adverse: rash, constipation , hypotension ( iv only )

124
Q

Ambien

A

Treatment: sedation
Adverse effect: headaches, vertigo , double vision

Prolong use may lead to dependence (7-10 days)

Route: po

125
Q

Gen: lorazepam
Trade: Ativan

A

Intermediate acting sedation
Constipation , diareah fro
Adverse: bradycardia, hypotentis

Iv I’m induce amnesia

126
Q

Standard precautions ( blood borne )

A

Hep b,c hiv

127
Q

3 basic elements of body mechanics

A

Body alignment
Balance
Coordinated body move

Nursing 101 (3 decks)

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