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Nursing 280 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Role

A

person’s unique function in relation to others’ functions

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2
Q

Role development

A

growth that occurs when you learn the functions, expectations and behaviors for a role

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3
Q

Ascribed roles

A

not chosen
genetic
social

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4
Q

Acquired roles

A

role taken on over lifetime
sometimes by choice
ex: person, societal, professional roles

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5
Q

Role of the RN

A

provider and manager of care

member of the discipline

Plan and implement care

Health promotion and prevention

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6
Q

SBAR

A

situation
background
assessment
reccomendation

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7
Q

ANA standards of care

A 
assessment
diagnosis
outcome identification
planning
implementation
evaluation
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8
Q

Assessment

A

The nurse collects patient health data

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9
Q

Diagnosis

A

The nurse analyzes the assessment data in determining diagnoses

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10
Q

Outcome identification

A

The nurse identifies expected outcomes individualized to the patient

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11
Q

Planning

A

The nurse develops a plan of care that prescribes interventions to attain expected outcome

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12
Q

Implementation

A

The nurse implements the interventions identified in the plan of care

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13
Q

Evaluation

A

The nurse evaluates the patient’s progress toward attainment of outcomes

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14
Q

ANA standards of professional performance

A 
quality of care
performance appraisal
education
collegiality
ethics
collaboration
research
resource utilization
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15
Q

Types of conflict

A 
role
communication
goal
personality
ethical or value
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16
Q

Role conflict

A

clash between two or more of a person’s roles or incompatible features within the same role

most common is work/family

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17
Q

1st priority

A

airway, breathing, cardiac status circulation and vital signs (ABC plus V)

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18
Q

2nd priority

A

changes in mental status, untreated medical issues, acute pain, acute elimination problems, abnormal lab results

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19
Q

3rd priority

A

more long term care issues - health education, rest, coping, spirituality

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20
Q

5 rights of delegation

A 
Right Task
Right Circumstances
Right Person
Right Direction/Communication
Right Supervision/Evaluation
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21
Q

Research

A

A systematic inquiry to describe, explain, predict and control the observed phenomenon

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22
Q

Inductive reasoning

A

examine phenomenon and identify general principles, structures, or processes underlying

develops explinations

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23
Q

Deductive reasoning

A

verify the hypothesized principles through observations

tests validity of explanations

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24
Q

Qualitative research

A

studies the whole
subjective
collects words, images or objects
groups are smaller and not random

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25
Q

Quantitative research

A

tests hypothesis
larger random groups
objective
collects numbers and statistics

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26
Q

Bias

A

Any tendency that prevents unprejudiced consideration of a question
causes error

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27
Q

Case study

A

The collection of detailed information about a particular participant or small group, frequently including the accounts of subjects themselves

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28
Q

Hypotheses

A

Predictions about the relationships between variables

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29
Q

Probability

A

The chance that a phenomenon has a of occurring randomly. As a statistical measure, it shown asp(the “p” factor)
p<0.05 to be valid

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30
Q

Variable

A

Observable characteristics that vary among individuals

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31
Q

Dependent variable

A

The variable or outcome that is influenced or caused by the independent variable

change you want to see

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32
Q

Independent variable

A

The variable that is influencing the dependent variable or outcome

treatment given

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33
Q

Confounding variable

A

variables or factors that interfere with the relationship between the independent variable and the dependent variable
you must control for these variables

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34
Q

Research process

A 
Make a prediction: hypothesis
Define the study
Defining population
Selecting a sample
Data collection plan
Checking reliability and validity
Collect data
Interpret the results
Communicating the results
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35
Q

Evidence based practice

A

uses current evidence with clinician expertise in decision making

not the same as research but is based on research

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36
Q

Steps for EBP

A

Asking the right question (PICO)
Searching the evidence
Evaluating the evidence
Integrating findings with clinical expertise
Implementing the change Evaluating performance

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37
Q

“FINER”

A 
F= Feasible				 
I=Interesting
N= Novel
E= Ethical			
R=Relevant
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38
Q

PICO

A 
P = patient or problem
I = intervention
C= comparison intervention
O = outcome
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39
Q

Reasons for conducting a literature review

A

To direct the planning and execution of a specific research study

To define the state of the science in a given area of nursing practice

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40
Q

Barriers to EBP

A 
time
lack of database understanding
lack of research
lack of computer skills
difficulty understanding research articles
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41
Q

Levels of evidence

A

levels 1-6 rank evidence

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42
Q

Level 1 evidence

A

systematic reviews, integrative analysis, large clinical trials

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43
Q

Level 2 evidence

A

single experimental study

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44
Q

Level 3 evidence

A

quasi-experimental studies

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45
Q

Level 4 evidence

A

non-experimental studies

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46
Q

Level 5 evidence

A

case reports, program evaluations, narrative literature reviews

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47
Q

Level 6 evidence

A

opinions of respected authorities

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48
Q

Clinical practice guidelines

A

official recommendation

preliminary evidence to answer a clinical question

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49
Q

Models for implementing EBP

A

Iowa model
Ready and Tavernier model
ARCC model

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50
Q

Iowa model

A

goal is to help healthcare professionals use evidence to improve patient outcomes

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51
Q

ARCC model

A

advancing research and clinical practice through close collaboration

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52
Q

EBPI

A

evidence based practice improvement

uses PDSA

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53
Q

PDSA

A

plan
do
study
analysis

54
Q

Body weight from fluid

A

50-60%

55
Q

Intracellular fluid weight

A

40%

56
Q

Extracellular fluid weight and breakdown

A

20%
14% interstitial
5% plasma
1% transcellular

57
Q

Osmosis

A

water molecules move from an area of high concentration to low concentration

58
Q

Hydrostatic pressure

A

pressing of water molecules on cell membranes

59
Q

gradient

A

difference in pressure

60
Q

Osmolarity

A

of miliosmoles per L

61
Q

Osmolality

A

of miliosmoles per Kg

62
Q

Natriuretic peptides (regulate sodium)

A

Hormone produced in response to fluid overload.

Increased renal blood flow & GFR, decreased sodium resorption & diuresis

63
Q

Lymph

A

controlled with skeletal muscle

fluids moving into and out of the vascular compartment

64
Q

Arterial end of capillary

A

fluid movement out of the vascular compartment

65
Q

Venule end of capillary

A

fluid movement into the vascular compartment

66
Q

CBC Hgb lab

A

Male 14-18 g/dL

Female 12-16 g/dL

67
Q

CBC HCT lab

A

Male 42-52%

Female 37-47%

68
Q

CMP

A

NA 136-145 mEq/L

BUN 10-20 mg/dL

69
Q

UA Specific gravity

A

1.005-1.030

70
Q

Urine osmolality

A

used in kidney failure PT’s

Random specimen 50-1200 mOsm/kg H20

71
Q

S/Sx for dehydration

A 
pallor 
increased RR
increased HR
decreased BP
dry membranes
poor turgor
72
Q

S/Sx for overhydration

A

SOB
increase bounding pulse
weight gain

73
Q

Endocrine system

A

helps control fluid and electrolyte balance using aldosterone, ADH and naturinic peptide

74
Q

Aldosterone

A

secreted by the adrenal cortex
prevents water and sodium loss through kidney re- absorption
prevents blood K+ from getting too high

75
Q

Angiotensin receptor blockers

A

ARB’s
BP drug
disrupts the renin-angiotensin II pathway by blocking receptors that bind with angiotensin II

76
Q

Isotonic dehydration

A

most common type
fluid only lost in ECF
causes decreased blood volume (hypovolemia)

77
Q

Crystalloids

A

IV fluid for replacement and maintenance

can see through them

78
Q

Colloids

A

IV fluid
volume expanders
ex: dextran, plasmanate

79
Q

Lipids

A

nutritional IV fluid

80
Q

Hypertonic solution

A

> 300mOsm

pulls fluid from the cell

81
Q

Isotonic solution

A

270-210 mOsm

82
Q

Hypotonic solution

A

<270 mOsm
puts fluid into cell
can cause lysis

83
Q

Lab changes seen in hypovolemia

A

elevated H&H, serum osmolarity, protein and BUN

84
Q

Fluid overlaod symptoms

A

edema, weight gain, bounding pulse, crackles, neck vein distention
specific gravity < 1.005

85
Q

Fluid overload causes

A

HF
CRF
Cirrosis
Steroids

86
Q

Fluid overload tx

A

I&O, diuretics, diet

87
Q

Sodium

A 
Na+
135-145 mEq/L
found in ECF
maintains ECF osmolarity
determines if water is excreted or retained
stored in kidneys
88
Q

Hyponatremia causes

A

diuretics and Na+ restrictions

89
Q

Hyponatremia S/Sx

A 
increased motility causing nausea, diarrhea and cramping
BP changes
tachycardia
confusion
weakness
decreased deep tendon reflexes
90
Q

Hyponatremia interventions

A

D/C diuretic
IV Na+ or nutrition therapy
do not increase Na+ levels by more than 1 mOsm per hour to avoid complications

91
Q

Hypernatremia causes

A

kidney failure
excessive ingestion
steroids
cushing’s syndrome

92
Q

Hypernatremia S/Sx

A 
muscle twitching
confusion
weakness
decreased deep tendon reflexes
decreased heart contractility
increased BP and HR
93
Q

Hypernatremia interventions

A

treated with medication and diet
diuretics
fluid replacement

94
Q

Potassium

A 
K+
3.5-5 mEq/L (ECF)
mostly in ICF (about 140 mEq/L)
ICF and ECF levels are different to keep tissues excitable and generate action potentials
found in meat, fish vegetables and fruit
95
Q

Hypokalemia causes

A 
diuretics
corticosteroids
diarrhea/vomiting
kidney disease
increased aldosterone secretion
96
Q

Hypokalemia S/Sx

A 
Respiratory changes
muscle weakness
weak, thready pulse
hypo-tension
neurological changes
97
Q

Hypokalemia interventions

A

K+ IV in severe cases
oral K+ replacements
D/C diuretics that cause K+ excretion
monitor muscle weakness and respiratory status

98
Q

Hyperkalemia causes

A

Over ingestion of K+ foods
kidney disease
whole blood transfusion

99
Q

Hyperkalemia S/Sx

A

palpitations
muscle twitching/weakness
tingling in hands, feet or face
increased GI motility

100
Q

Hyperkalemia interventions

A

use K+ excreting diuretics
insulin may help move K+ from ECF to ICF
cardiac monitoring

101
Q

Calcium

A 
Ca2+
steep gradient between ICF and ECF
9-10 mg/dL
ionized=free form
bound=attached to serum proetins
102
Q

Hypocalcemia causes

A

inadequate Ca2+ intake
diarrhea
kidney failure

103
Q

Hypocalcemia S/Sx

A

Trousseau and Chvostek’s signs
muscle spasms
increased paristalsis
chronic=osteoperosis

104
Q

Hypocalcemia interventions

A

increased Ca
seizure precautions
increase Ca intake

105
Q

Hypercalcemia causes

A

increased Ca intake
increased vitamin D intake
kidney failure
thiazide diuretics

106
Q

Hypercalcemia S/Sx

A 
excitable tissues become less excitable
increased BP and HR in mild case
decreased HR in severe case
blood clots
constipation, anorexia, N/V
muscle weakness
107
Q

Hypercalcemia interventions

A

D/C thiazide and replace w/ lasix
dialysis
cardiac monitoring

108
Q

Phosphorus

A

Much higher levels in ICF than ECF
3-45 mg/dl
found in meat fish dairy and nuts
P and Ca2+ have an inverse relationship

109
Q

Hypophosphatemia causes

A

malnutrition
kidney failure
hyperglycemia
alcohol abuse

110
Q

Hypophosphatemia S/Sx

A 
no impairment in rapid changes
decreased energy
decreased stroke volume and CO
rhabdomyolysis: muscle breakdown
chronic: decreased bone density
111
Q

Hypophosphatemia interventions

A

oral P suppliment and vitamin D
IV P when level is <1mg/dl
diet teaching

112
Q

Hyperphosphatemia causes

A

kidney disease
cancer tx
hypoparathyroidism
increased P intake

113
Q

Hyperphosphatemia S/Sx

A

high levels tolerated well
increased membrane excitability
problems come from hypocalcemia

114
Q

Hyperphosphatemia interventions

A

need to manage hypocalcemia in conjunction with hyperphosphatemia

115
Q

Magnesium

A 
Mg+
mostly in ICF
1.3-2.1 mg/dl
found in most foods 
regulated by kidneys and intestines
116
Q

Hypomagnesemia causes

A 
malnutrition
diarrhea
celiac disease
crohn's disease
diuretics
117
Q

Hypomagnesemia S/Sx

A 
increased membrane excitability
common with Ca2+ and P imbalance
hyperactive deep tendon reflexes
numbness/tingling
painful muscle contractions
CNS changes
skeletal muscle weakness
118
Q

Hypomagnesemia interventions

A

Mg replaced by IV
oral causes diarrhea
IM causes pain/damage

119
Q

Hypermagnesemia causes

A

decreased kidney excretion

increased Mg intake

120
Q

Hypermagnesemia S/Sx

A 
usually seen in levels >4mg/dl
bradycardia
hypotension
peripheral vasodilation
decreased or absent deep tendon reflexes
drowsiness/lethagry
121
Q

Hypermagnesemia interventions

A

IV fluids and diuretics

122
Q

Chloride

A

Cl-
mainly in ECF
98-106 mEq/L
sourced from the diet

123
Q

Cl- functions

A

works with Na+ to maintain ECF osmotic pressure

helps form HCl in the stomach

124
Q

Cl- imbalance interventions

A

usually occur as a result of imbalances in other electrolytes
use interventions to correct other imbalances to treat

125
Q

Mg functions

A 
skeletal muscle contraction
carbohydrate metabolism
ATP formation
vitamin activation
cell growth
126
Q

P functions

A

provide mineral strength to bone
DNA and RNA component
found in ATP
buffer in bone, serum and urine

127
Q

Na2+ functions

A

high ECF and low ICF levels cause skeletal muscle contraction, cardiac nerve conduction and nerve impulse transmission
normalize osmolarity and volume of ECF

128
Q

Ca 2+ functions

A 
maintain bone strength and density
activation of enzymes
cardiac and skeletal muscle contraction
controlling nerve impulse transmission
blood clotting
129
Q

K+ functions

A

generate action potentials to keep tissues excitable

large differance between ECF and ICF to allow for depolarization

130
Q

Anti-diuretic hormone

A 
AKA Vasopressin
produced in brain
stored in posterior pituitary
release controlled by hypothalamus
increased blood osmolarity triggers release

Nursing 280 (3 decks)

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