Exam 5 Material

Question 1

Why is Patient education important?

Answer 1

• essential component of safe, patient-centered care
• standard for professional nursing practice
• falls within the scope of nursing practive

Question 2

what do we teach?

Answer 2

• health analogies
  -resortation of health
• coping with impaired functions
• promotion of health and illness and prevention

Question 3

The nurses role

Answer 3

• Determine ~ what pts/families need to know
• provide the time to teach

Question 4

identify patients

Answer 4

exisiting knowledge
learning preferences
readiness to learn

Question 5

Nursing goals

Answer 5

assist the pt
promote pt understanding

Question 6

three domains of learning

Answer 6

Cognitive
affective
psychomotor

Question 7

Cognitive learning

Answer 7

• requires thinking
• 1 on 1 or group
• intellectual behaviors

Question 8

Affective learning

Answer 8

• expression of feelings
• attitudes, opinions, or values
• 1 on 1
• role play

Question 9

psychomotor learning

Answer 9

• “hands on” skills
• Demostration
  -Practice

Question 10

Basic learning principles (4)

Answer 10

• stimulus to learn
• readiness to learn
• Ability to learn
• learning environment

Question 11

Motivation to learn

Answer 11

Acts on or within a person to cause the person to behave in a particular way

Question 12

Theory to learn

Answer 12

matches a persons learning needs

Question 13

culture to learn

Answer 13

respect ps identity and needs

Question 14

active participation to learn

Answer 14

implies an eagerness

Question 15

Attentional Set

Answer 15

• mental and physically
• positive factors
• obstacles

Question 16

Psychosocial adaption

Answer 16

assist the patient after an incident

Question 17

Grieving

Answer 17

allows the patient
- accept the reality of their illness/injury
- new normal

Question 18

Developmental capability

Answer 18

affects the persons ability to learn

Question 19

The developmental stage of a child determines…

Answer 19

capability to learn

Question 20

infant learning

Answer 20

hold infant firmly while smiling and speaking

Question 21

toddler learning

Answer 21

use play to teach

Question 22

preschooler learn

Answer 22

simple explanations and demostrations

Question 23

school-age learn

Answer 23

psychomotor skills
discuss health problems

Question 24

adolescent learn

Answer 24

use teaching as collaborative activity
allow to make decisions about health

Question 25

Adults- self directed learn

Answer 25

critically think direct own learning

Question 26

adults- pt centered

Answer 26

collaborate with adults

Question 27

young and middle-aged adults learn

Answer 27

-effects of health problem - encourage participation

Question 28

older adults learn

Answer 28

- teach when alert and rested - discussion or activity - individualize

Question 29

phycial capability influences on learning

Answer 29

- level of personal involvement - energy - physical health

Question 30

Neurosensory issues

Answer 30

- feel - see - hear -grasp

Question 31

health literacy affects the patients ability to

Answer 31

understand basic health care information - read and write

Question 32

conflicting schedules - teacher

Answer 32

nurses time pt availablility lack of space and privacy

Question 33

teacher not seen as a

Answer 33

priority

Question 34

Teaching tactics

Answer 34

entrusting reinforcing

Question 35

one to one

Answer 35

teacher presents to an indiviual patient

Question 36

Group

Answer 36

effiecent ~ more then one student

Question 37

Preparatory

Answer 37

provides inforamtion prior to a procedure

Question 38

most effective when

Answer 38

the patient observes the nurse

Question 39

Analogy

Answer 39

familiar images make complex ones understandable

Question 40

Simulation

Answer 40

problem- solving, application, and thinking

Question 41

Printed materials

Answer 41

patients literacy be assessed beforehand

Question 42

Follow with reinforcement

Answer 42

- question and answer session - discussion of the material - printed materal

Question 43

teaching strategies

Answer 43

-establish trust - short sessions

Question 44

teaching strategies are important why?

Answer 44

important to figure out at the beginning of the session

Question 45

Behaviors

Answer 45

observe abd evaluate pt abilities to perform desired behaviors

Question 46

Guildelines for older adults

Answer 46

only present most significant info

Question 47

types of tubes

Answer 47

- NG tube - PEG tube - Button

Question 48

closed system

Answer 48

Nutritional solution added during manufacturing system cannot be opened safely hang for 24-36hours more common

Question 49

open system

Answer 49

empty bag , can of nutrition to pour in bag prepared by nurse at bedside administered by enteral pump

Question 50

types of infusions

Answer 50

continuous cyclic intermittent bolus

Question 51

contunuous nutrition

Answer 51

given over 24hour period using an enteral pump - initial dose full strength at slow rate -rate increased every 8-12 hours until goal reached - HOB @ 30 degrees ALL TIMES ***risk for aspirations

Question 52

Cyclic Nutrition

Answer 52

-given in less than 24 hours - pt may eat during day - HOB @ least 30 degrees

Question 53

Intermittent Nutrition

Answer 53

- Begin at full strength with specified volume - 5-8 feedings a day - given over 30 mins via enteric pump or syringe - GOAL** to provide needed calories and volume in 4-6 feedings - keep HOB up at least 1 hour after each feeding

Question 54

Bolus nutrition

Answer 54

Syringe is used to deliver forumla into stomach by gravity - raising or lowering syringe regulates flow - delivered more rapidily than intermittent feeding - keep HOB 30 degree for at least 1 hour - flush with 30ml of sterile water

Question 55

Enteral Nutrition

Answer 55

high risk for - Diarrhea - N/V - Gas/bloating/cramping - constipation - dehydration - hyperglycemia BIGGEST RISK *** ASPIRATION

Question 56

signs of aspiration

Answer 56

- cough - SOB - Gurgling - Raspy voice

Question 57

what should you do if aspiration is suspected

Answer 57

** Stop the feeding** make sure the bed is elevated turn pt on their right side notify doc check placement with order

Question 58

Assess before feeding - abdominal signs

Answer 58

- Distenstion - Firm - Tense - Guarding - Discomfort

Question 59

Nausea

Answer 59

- antiemetics - minimize narcotics - check for constipation - notify doc

Question 60

emesis

Answer 60

hold feeding check for constipation notify doctor

Question 61

Gastric residular checks in what pt populations?

Answer 61

- critically ill surgery pts -critically ill trauma pts - head injury - postop abdominal surgery - Obtunded/vegetative state

Question 62

Gastric residual checks - to dos

Answer 62

1st put pt on right side for 20mins - elevation 30 degrees discontinue after 48-72hrs if <500ml and no abdominal signs present

Question 63

before proceeding with a feed

Answer 63

- assess bowel sounds , presentation of abdominal, correct label on enteral tube - HOB @ 30 degrees or higher - is prepared feeding room temp? - is tubing primed?

Question 64

Checking tube placement steps

Answer 64

- verify tube placement with xray - aspirate to assess tube patency - measure contents and return - flush with 30mL sterile water - Document findings

Question 65

DO NOT PROCEED IF....

Answer 65

if > 500 mL residual - return resdual and flush 30mL sterile water - recheck in 4hrs - if still > 500 mL, hold tube feedings

Question 66

Gravity administration feedings

Answer 66

- ensure HOB 30 degrees - Connect device and administer via gravity flow ~ slowly - flush with 30mL sterile water - keep HOB up at least 1 hour