final!!! Flashcards
1
Q
Explain the aims of nursing as they interrelate to facilitate maximal health & quality of life for patients
A
patient centered care in order to promote better health care based upon their needs
2
Q
Discuss professional behaviors that are consistent with those of a professional nurse
A
No gossip, be courteous, kind, dress appropriately, respectful, respect privacy, cultural awareness, advocate, responsibility, and accountability
Clear communication, Nursing organization (ANA), correct body language & word choice, Certifications
3
Q
Referent (describe comm.process)
A
the incentive or motivation for comm. between 2 people
4
Q
Sender (describe comm.process)
A
The person who initiates & transmits the message
5
Q
Receiver (describe comm.process)
A
The person to whom the sender aims the message & who interprets the senders message
6
Q
Message (describe comm.process)
A
The verbal & nonverbal information the sender expresses & intends for the receiver
7
Q
Channel (describe comm.process)
A
the method of transmitting & receiving a message
Ex: sight, hearing, touch, facial expression, & body language
8
Q
Environment (describe comm.process)
A
The emotional & physical climate in which the comm. takes place
9
Q
Feedback (describe comm.process)
A
Can be verbal, nonverbal, + or -
The message the receiver returns to the sender that indicates the receipt of the message
An essential component of ongoing communication
10
Q
Interpersonal variables (describe comm.process)
A
Factors that influence comm. between the sender & receiver (educational & developmental levels)
11
Q
Factors that influence communication
A
Dementia
Hearing loss (sensory deficit)
Cultural diff
Language barrier
environmental
12
Q
Identify ways individuals send messages through nonverbal communication
A
Body language (posture & gait)
Facial expression, eye contact (varies with culture) & gestures.
Personal space
13
Q
Barriers of communication & how to combat
A
Cultural: cultural competence
Language barriers: interpreter, address pt directly
Speech/Hearing: use uncomplicated words, avoid med term, speak at slower pace, make sure room is well lit & limited noise & distractions. Face the pt & make sure they have their assistive devices.
14
Q
Time (discuss therapeutic communication techniques)
A
Plan & allow adequate time to communicate with others
15
Q
Active Listening (discuss therapeutic communication techniques)
A
convey intrest, trust & acceptance
16
Q
Caring attitude (discuss therapeutic communication techniques)
A
show concern & facilitate an emotional connection among nurses, pts, families, & significant others
17
Q
Honesty (discuss therapeutic communication techniques)
A
be open, direct, truthful, & sincere
18
Q
Trust (discuss therapeutic communication techniques)
A
demonstrate to clients, families, & significant others that they can rely on nurses without doubt, question, or judgement
19
Q
Empathy (discuss therapeutic communication techniques)
A
Convey an objective awareness & understanding of feelings, emotions, & behavior of clients, families & significant others, including trying to envision what it must be like to be in their position
20
Q
Nonjudgemental attitude (discuss therapeutic communication techniques)
A
A display of acceptance of pts, families, & significant others encourages open, honest communication
21
Q
Describe the role that communication plays in planning pt centered care
A
keeps the client involved in their own care
Not social or reciprocal
22
Q
Describe the role that communication plays in planning client centered care
A
It incorporates the whole patient, we learn about cultural beliefs & practices and also express how we feel through communication
23
Q
Describe effective communication interventions for clients with impairments in communication
A
Medical interpreters, Make sure assistive devices are working and available.
24
Q
SOLER
A
S: encourages the listener to sit (if possible) facing the patient
O: reminds the nurse to maintain an open stance or posture while listening
L: suggests that the listener lean toward the speaker, positioning the body in an open stance
E: refers to maintaining eye contact without standing
R: reminds the nurse to relax. Demonstrating relaxation during a conversation encourages the person sharing to continue. It also conveys a sense of attention, interest, & comfort with the subject being shared
25
Receive-Record-Readback
When receiving a prescription or order....
Record it
read it
do not just repeat it
read it back as written to the prescriber
verify
26
ISBARR (introductions, situation, background, assessment, recommendation, and readback)
Standardized communication tool to establish uniform delivery of information from one provider to another during transfer of care
27
ISBARR (cont)
Introductions: give your name & client care role, ask the receiver for their name & client care role
Situation: describe what is currently happening to the client that needs to be addressed
Background: provide pertinent clinical background
Assessment: give a brief eval. of the situation
Recommendation: give suggestions for care
Readback/repeat: summarize, allow time for questions, & repeat or reread info as needed
28
Discuss clinical decision making in professional nursing practice
Evidence based practice
Clinical reasoning to make clinical judgements
29
Discuss steps of the nursing process as they relate to the care of clients
30
Assessment (Discuss steps of the nursing process as they relate to the care of clients)
Recognizing cues!
Separate from a med assessment, focuses on response to health condition
Identify S&S
Gathering accurate info
interview, observation & physical assessment skills
Object & subjective data!!
31
Analyze (Discuss steps of the nursing process as they relate to the care of clients)
Diagnosis
What potential or actual problems that can be prevented or resolved by nursing interventions?
What needs to be addressed?
Identifies a nursing problem: actual or potential
can be prevented or resolved by nursing interventions
provides a defintion of a patients response to health problems
32
Planning
determine patient goals
SMART GOALS
Prioritize
33
Implementation
take action!
review/readvise care
promote self care
carry out planned nursing interventions BUT FIRST REASSESS
clinical decision making
set priorities
time management
delegation
34
Evaluation
Eval. Outcomes
determine if the pt condition. has improved, if client met outcomes
examine results, supporting data
revise plan of care
35
Objective
Vital signs
medications
what the nurse observes, be descriptive without judgement
Ex: client noted in hallway with stack of books, pacing back and fourth in front of classroom. appears tearful & avoids eye contact
Measured, observed through 5 senses
Heart rate & bleeding
Measurable
Data the nurse obtains through observation & examination.
Facial expressions, i & o, pa findings, & VS
EX: *Client grimaces when attempting to brush their hair with their left arm*
36
Subjective
WHAT THE PATIENT SAYS
direct quotes (quotation marks), summarize info and attribute to client
opinions
pain & feelings
EX: "Im so stressed out about this test"
What the client tells the nurse
EX: “My shoulder is really, really sore
37
Apply basic principles of diagnostic reasoning to identify actual & potential problems in clinical settings
identifies a nursing problem: actual or potential can be prevented by nursing interventions
using the nursing process to identify and analyze & specific cues relating to potential problems in a clinical setting
38
describes the steps of the nursing diagnostic process
Assessment
analyze
planning
implementation
eval.
39
Explain how defining characteristics & the etiological factors individualize a nursing diagnosis
each persons symptoms are not the same
nursing diagnosis must be tailored to a specific pt with specific problems. Patients may have chest congestion, but they both may have diff. lung sounds
40
Describe person centered care
care that encompasses the whole patient, their entire well being
treating pt with dignity & respect
involving them in their on care & decisions
41
Explain the importance of reassessment after implementing interventions
we reassess b/c we need to know if the goals were met, & if not then restructure goals and make new interventions
42
describe the principals associated with effective delegation in nursing practice
43
5 rights of delegation (describe the principals associated with effective delegation in nursing practice)
44
Right task
repetitive, little supervision, and noninvasive
Delegate an AP to assist a client who has pneumonia to use a bedpan
45
Right circumstance
determine the health status & complexity of care
Delegate an AP to measure the VS of a client who is post op & stable
46
Right Person
determine & verify the competence of the delegatee. Task must be within scope of practice for the delgatee.
Delegate a PN to admin enteral feedings to a client who has a head injury
47
Right communication/direction
communicate what data to collect
Delegate an AP to assist Mr.Martin in room 312 with a shower before 0900
48
Right eval/supervision
provide indirect or direct supervision, monitor performance, and intervene if necessary
Delegate an AP to assist with ambulating a client after the RN completes the admission assessment
48
Prioritize the delivery of client care based on priority frameworks
writing down
ABCDE, maslow, least invansive/least restrictive. nursing process, safety & risk reducrt
49
Describe the nurse's role when providing & managing client care
Advocating, care fiver, delegator, educator, change agent
50
Discuss the nurse's responsibility surrounding delegation of nursing care
Do not delegate: nursing process, pt education, nursing judgement tasks, med admin, doc. of a task that the rn performed. V/S on unstable pt,
51
Describe ethical principles & their role in ethical decision making
52
Autonomy
patients have the right to make informed decisions for themselves, include clients in making decisions. Even when those decisions may not be in their best interest
EX: right to refuse blood transfusion for religion reasons
53
Beneficence
commitment to helping patients & seeking best possible outcomes; taking positive actions to help others. Without any self interest.
54
Fidelity
faithfulness to promises & responsibilities, agreement to keep promises
loyal!
55
Justice
treat all pt fairly
provide treatment, care & resources for all pt regardless of age, sex, race & economic status
56
nonmaleficence
do not cause intentional harm
avoidance of harm
57
veracity
telling the truth
truthfulness
provide truth & accurate info to the patient
58
Confidentiality
protection of privacy without diminishing access to high quality care
HIPAA
59
Good samaritian laws
Protect health care workers when they give aid to people in emergency situations
If they help someone in the field they are not held liable
only applies to volunteers and in good faith
60
Mandatory reporting
legal obligation to report findings in accordance with state law
report abuse, neglect, sexual assault, incidents & sentinel events & communicable diseases
Reportable diseases
COVID-19, varicella, syphilis, chlamydia, gonorrhea, Lyme’s disease, mumps, measles, pertussis, rabies (human illness)
61
Discuss the legal considerations of nursing practice
must be accountable for practicing nursing within the confines of the law to shield from liability. advocating for clients rights, providing care within scope of practice, follow state nurse practice acts
62
discuss the ethical considerations of nursing practice
advocate for patients if when not agreed with them
63
Discuss guidelines legal & accurate for documentation in the health record
always include date/time, signature & intials, black ink, single line cross out. If it wasnt documented you didnt do it. Document asap after care is given
never doc. care given by someone else, or ask someone to doc for care you have given
64
SOAP note
S: subjective
O: objective
A: assessment
P: plan
65
PIE
P: problem
I: intervention
E: evalulation
66
Charting by exception
focused on unusual/unexpected findings
usually a checklist/ flowsheet
67
DAR
D: data
A: action
R: response
68
Identify wats to maintain confidentiality of electronic & written records
only use your own login info
password should be unique & changed freq.
Log off when doc. is complete
log off computer each time you leave the station
computer screen should be protected from others
never leave written doc.
ensure your name is correct
faceup
69
Identify commonly used abbreviations & symbols in documentation
see ati....
70
Explain the nurse's role surrounding the maintenance of client safety in the home & clinical settings
Home: educate on safety with clutter, throw rugs, o2 safety if needed, ramps, fire extinguishers and exits
Clinical: makes sure no wires/tubing on floor, decrease clutter, fall risk assessment
71
Describe personal environmental hazards that pose a risk to a clients safety
open wires, clutter, stairs, throw rugs
72
Discuss methods to reduce the risk of pt injury
fall precautions, risk assessment tools, area clean, call light within reach, & keep personal items within reach. Bed in lowest position. Prevent infection. Identify pt correctly, use med safely. COMMUNICATE WITH STAFF CORRECTLY
73
Discuss risk factors associated with client falls & how to identify clients at risk for falling
Age, med conditions, incontinence, balance, vertigo, medications
Use morse fall scale
74
Discuss methods to prevent falls in the home & clinical setting
Provide education on the use of a call light (return demonstration), use color coded wristbands for fall risk, provide adequate lighting, hourly rounding, keep things close to pt, decrease clutter
Sedated, unconscious,: side rails up. Remove scatter rugs
clear path to bathroom
75
Identify potential safety hazards in the health care agency
Falls
procedure accidents
equipment accidents
patient inherent accidents
76
Describe nursing interventions to maintaining pt safety
move pt closer to the nurses station
one on one if available
call light within reach
hourly rounding
fall risk assessments (morse scale)
bed low position & lock brakes
non skid footwear
respond to call bells
77
Chain of infection
Sequence of necessary pieces for an infection to occur
how bacteria, viruses, fungi, parasites & prions move from place to place
includes: Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, & susceptible host
78
Transmission of infection
airborne, droplet, contact, vector borne
79
Normal defenses of the body
skin as a barrier, cilia in the nasal passages, gastric acid in stomach, low ph in vagina, peristalsis, flora of large intestine, & tears
80
Explain conditions that promote the transmission of HAI's
no hand washing, coughing and not covering mouth, medical asepsis not done,
overuse of antibiotics
81
Medical Asepsis
clean technique
reduce the present of disease causing microorganisms
*isolation precautions
82
Surgical asepsis
Sterile technique!
no microorganisms present
*use for surgical procedures*
83
Discuss the principles of hand hygiene
decreases the evidence of microorganisms
any type of cleansing of the hands
wash hands for 20 sec
soap & water: normal handwashing
alcohol based sanitizers
antispetic handwash & handrub
84
Standard precautions
gloves, gown, mask, & eye cover
handwashing
protects from blood, body fluids, secretions & excretions,
85
contact precautions
PPE: glove & gown
private room, no sharing of pt care equipment
cdiff, VRE, RSV, MRSA, shigella, impetigo
86
droplet precautions
PPE: surgical mask*minimum*
Gown & gloves if secretions are likely
Influenza, pneumonia, rhinovirus, rubella, mumps, adenovirus, diphtheria
mask outside of room
private room
mask for provider & visitors
87
Airborne precautions
private room, - air room 12 exchanges per hr
N95 mask
tb, varicella, measles, & COVID 19
pt must wear mask outside of room
spraying/splashing: full face mask
88
explain nursing interventions which protect both the client & the nurse from infection
HAND HYGIENE, oral hygiene, gloves, proper ppe,
89
discuss pt teaching surrounding infection prevention
hand hygiene, education on self care & hand hygiene, respiratory hygiene, cough etiquette, importance of vaccines (flu)
reasons for transmission precautions
nutrition
90
Identify clients most at risk for infection
Elderly: slow response to antibiotic therapy & immune response, thinning of skin, dementia, bladder incontinence,
Immunocompromised
poor nutrition
90
Blood pressure
120/80
a measurement of force, of the ciruluating blood on the interior walls of the blood vessels
91
determine & discuss risk factors for infection
poor nutrition, smoker, stress, alcohol, immunocompromised, chronic/acute disease like diabetes & lung disease, old age, a break in the skin, indwelling devices, poor oxygenation, impaired circulation, surgery, poor hygiene, living in crowded environment, & older adult
92
Pulse
60-100
the rhythmic dilation of the arteries that occurs with the beating of the heart
93
Respiratory rate
12-20
the number of breaths taken per minute
93
Body temp
96.8-100.4
the balance of heat produced by the body & the heat lost to the environment
94
Oxygen sat
95-100%
the estimated amt of oxygen bound to the hemoglobin molecule in the rbc, indicating the amt of oxygen being transported to body tissues
95
Identify factors that cause variations in Temperature & the management
infection/illness, environment, exercise, tod ,stress, hydration, & medications
antipyretics, tepid bath, cooler environment/compress
Hydration: sips of cool fluids
96
Identify factors that cause variations in Pulse & the management
body position, age, emotion, activity level, health cond, body temp, pain, meds, caffeine
protect from injury, deep breathing & fluids
97
Identify factors that cause variations in RR & the management
age, exercise, anxiety, meds, pain, smoking, body position, emotion, resp diseases
deep breathing & fluids
98
Identify factors that cause variations in O2 sat & the management
movement, hypothermia, jaundice, pvd, peripheral edema, nail polish
oxygen via NC & deep breathing
99
Identify factors that cause variations in BP & the management
age, gender, race, food intake, excercise, weight, emotional state, drugs/meds, body position, circadian rhythm, fluid level
antihypertensive meds
100
Identify when to measure VS
admission, pt status change, once every shift, & discharge
101
describe assessment techniques used to obtain each vs across varying clinical scenarios, & accurate documentations of each
check ati
102
analyze alt. in BP & plan interventions to response to alts
High BP: low calorie & low fat diet, weight loss, limit alcohol & salt, exercise, stress reduction
Low BP: + fluids, upright position, eval. meds, educate pt on dizziness & falling, change positions slowly, avoid extreme temps, stay well hydrated
103
analyze alt. in temp rate & plan interventions to response to alts
fever/hyperthermia: rest, fluids, remove excess clothing, antipyretics, cooler environment, tepid bath
104
discuss the steps to assess for orthohypo
have pt lay down & assess bp, move to sitting position & wait 1 min, reassess BP in sitting position, move to standing position, after 1 min reassess BP in sitting position,
diagnosed with orthobp when SBP drops by 20 or DBP drops by 10 within 3 minutes after taking bp
105
eval. the effectiveness of interventions on vs assessment
reassess vitals
106
Explain hypertension & the risk factors associated with this cond.
elevated bp, leading caus of cv disorder,
the heart is working too hard
thickening of walls & loss of elasticity
RF: NM: family history/race, older adults, diabetes. M: obesity, smoking, excessive alcohol use, high sodium intake,
weight, stress, anxiety/fear
107
Describe clinical manifestations & management of hypertension
headaches, shortness of breath, lightheadness, nausea, vision problems, & palpitations
management: low cal/fat diet, weight loss, limit salt & alcohol, excercise, antihypertensive, and manage stress
108
Explain hypotension & postural hypotension & the risk factors associated with these cond.
Hypotension: low bp, sbp less than 90 or dbp less than 60
dizziness, nausea, blurred vision, increased pulse, & fatigue
Management: increase fluids, upright pos, change pos. slowly, avoid extreme temps, HYDRATION
Postural hypotension (ortho): sudden drop in bp when a pt changes position.
dizziness, blurred vision, weakness, fatigue, headache, palpitations
managment: change positions slowly, dangle before moving, hydration!
109
Discuss conditions that place pt at risk for impaired oral mucous membranes
medications, exposure to radiation, mouth breathing which impairs salivary secretion
XEROSTOMIA: dry mouth
gingivitis: inflammation of gums
Dental caries: tooth decay
110
Differentiate between expected findings, typical variations, & unexpected findings when performing a physical assessment of the skin
Integrity: Expected: smooth & intact. Unexpected: lesions, rashes
Temperature: Expected: warm as hands. Variations: temp outside cold. Cooler if in cast or immbolized. Unexpected: hypothermia & hyperthermia
Skin mobility & turgor: Expected: rise easily & rapidly returns. Variation: older pt. Unexpected: tenting (dehydration), Edema (accumulation of fluid)
Brusing? cyanosis? jaundice? erythema?
111
Differentiate between expected findings, typical variations, & unexpected findings when performing a physical assessment of the nails
transparent, smooth, convex, with a pink nail bed & translucent white tip
Clubbing? nail bed color? Brittleness?
112
Differentiate between expected findings, typical variations, & unexpected findings when performing a physical assessment of the Hair
Lesions, dandruff, ticks, alopecia, lice, color? distribution, texture, lubrication. Hirsutism?
113
Describe the steps for providing pt hygiene including giving a bed bath
start at top and work down. Only uncover what is needed. Always clean from clean to dirty
113
Describe the components of performing a wound assessment & interpret the findings
Wound assessment: measure entire wound (ht, width& depth) Tunneling? Undermining?. Note drainage: amt, color, consistency, & odor. Note any slough, exudate or necrotic tissue. Palpate for appearance & pain.
114
Discuss the risk factors that contribute to impairment in skin integrity
Very thin & obese
Excessive perspiration *sweating*
Diseases of the skin
Dehydration
Developmental level
State of health
115
Explain factors which promote wound healing
Keep skin clean & intact
keep wound free of foreign material (exudate, debris, dead tissue)
Proper nutrition
encourage protein: meat, fish poultry, eggs, dairy products, beans, nuts, & whole grains
116
Describe complications of wound healing & the management of each
Local/Systemic Infection: erythema, purlent drainage, pain, swelling warmth around skin.
Treatment: antibiotics, irrigation of wound. Rest. Aspetic technique, & nutrition
Dehiscence: a partial or total rupture (separation) of a sutured wound, usually with separation of underlying skin layer
Treatment: cover with sterile towel, keep pt supine with hips & knees bent, keep npo,
Evisceration: total separation of the tissue layers, allowing the protrusion of visceral organs through the incision.
Treatment: cover with sterile dressing, contact surgical team, keep pt NPO, observe for shock, prepare pt for surgery, call for help. Low fowlers position
117
Explain factors that impede wound healing
Vascular disease, diabetes, malnutrition, meds, excessive mositure, external forces, and the aging process
118
Pressure Injury Stage 2
partial-thickness loss of skin with exposed dermis
wound bed is pink/red and is moist
appears as an intact or ruptured serum filled blister
Is shallow & superficial with a pink wound bed
no slough, eschar, granulation tissue, or adipose tissue
118
Pressure Injury Stage 1
intact skin with a localized area of nonblanchable
erythema
119
Pressure Injury Stage 3
full thickness skin loss. Visible adipose with granulation tissue & epibolen(rolled wound edges)
Possible undermining & tunneling
Fascia, muscle, tendon, ligament, cartilage are not exposed!!!
120
Pressure injury stage 4
Full thickness skin & tissue loss with exposed fascia, muscle, tendon, ligament, cartilage, and bone.
121
Unstageable pressure injury
obscured full thickness skin & tissue loss. Full thickness skin & tissue loss cannot be confirmed b/c it is obscured by slough or eschar
if slough or eschar is removed stage 3 or 4 pressure injury will reveal
122
Deep tissue pressure injury
intact/nonintact skin with localized area of persistent nonblanchable deep red, maroon, or purple discoloration. Tissue is boggy
shearing, intense and prolonged pressure
true depth is not apparent, but can progress rapidly which exposes deeper layers of tissue
123
Identify risk factors for the development of pressure injury using the Braden scale
sensory perception, moisture, activity, mobility, friction & shear
124
Braden scale
lowest score: 6
max: 23
the lower the overall score equals the greater risk the pt has for alts. in skin & tissue integrity
125
Identify nursing interventions to minimize trauma to the skin
keep skin clean & dry, reposition every 2hr, supportive surfaces/devices for transfers, dressings, toileting schedules, hydration
126
Describe methods for assessing risk for impairment in the integrity of the skin
examine bony prominences for erythema, blanchable or non?
Temp changes: inflammation= hot. Cooler: - blood flow.
Edema?
Check skin folds
Check skin underneath pressure devices
Braden scale
nutritional status
immobility
reduced skin perfusion
127
Discuss nursing roles & responsibilities in med admin
Having knowledge of federal, state (nurse practice acts), and local laws, & facilities policies that govern the prescribing, dispensing, & admin of meds
Preparing & administering medications, and evaluate clients responses to medications
Developing & maintaining an up to date knowledge base of medications they administer, including uses, mechanisms of action, routes of admin, safe dosage range, adverse effects, precautions, contraindications, & interactions.
Maintaining knowledge of acceptable practice & skills competency
Determining the access of medication prescriptions
Reporting all medication errors
Safeguarding & storing medication
128
Recognize nursing actions to prevent med errors
3 checks
1. mar & order
2. actual med & mar
3. mar & pt id band
Second nurse check with high alert meds
129
compare & contrast the various routes by which medication can be admin
Oral: PO, Sublingual: under the tongue, Buccal: between cheek & gum
Enteral: through enteral/gtube
Parenteral: ID (under epidermis), SUB (subcutaneous tissue) , IM (into the muscle) , & IV (into the vein)
Topical: skin/mucous membranes
Instillation: directly onto skin, drops, ointments, & sprays
130
Describe factors to consider when choosing routes of med admin
consider absorption, metabolism & excretion. Do you want it to be absorbed metabolized or excreted faster or slower?
IV: fast
Oral: slower
131
Interpret med orders to prevent med errors & ensure pt safety
Must contain
PT name
Date.time order written
drug name (generic)
dosage
route of admin
route
freq
indication for use
providers signature
132
Perform dosage calculations needed for med admin
practice on ati & hienkes book
133
use clinical decision making when calculating dosages
check ati/hienkes book
134
Correctly & safely prepare & admin meds for oral, parenteral routes, topical, inhalation & intraocular routes
Oral: place med cup on flat surface before pouring & ensure base of meniscus (lowest fluid line) is at the level of the dose
Parenteral: use needle size & length that is appropriate for the injection.
Topical: wear gloves no bare hand, skin application: soap & water. Open wound: surgical asepsis
Check ati for more
135
Compare & contrast the types of insulin
Rapid acting (clear): onset: 5-15 min, peak 1-2hr, duration 2-4hr. ex: humalog
Short acting/regular (clear): onset 30 min, peak 105hr, duration 3-7hr, Ex: Humulin R
Intermediate: (cloudy): onset 1-4hr, peak 4-12 hr, duration 12-24 hr Ex; NPH
Long Acting: duration 24hr, no peak, Ex Lantus DO NOT MIX
clear to cloudy
136
Discuss proper technique for calculating & admin insulin to a pt
mix insulin: NPH, Reg, Reg, NPH (air, air, med, med)
Give sub fatty areas, (abdomen & back of arms)
remove air bubbles
clear to cloudy
draw regular insulin first
137
Identify complications of IV therapy & nursing interventions
Phlebitis: inflammation of vein. Intervention: discontinue IV, contact provider, warm compress & elevation
Infiltration/Extravasation: meds/fluids move to surrounding tissues. S/S: coolness of skin, edema, pain, burning, Intervention: stop iv & discontinue, skin marker to outline area
Circulatory Overload: infusion of excessive amt of fluids that occurs too quickly. S/S: tachycardia, + bp, increase wt, edema, cough, tachypnea, crackles in lungs. Interventions: stop infusion, semi high fowler position, daily weight, VS, I&O, O2 therapy
Air Embolism: air in vessel. S/S abrupt onset, diff. breathing, cough, wheezing, decrease bp, tachycardia, chest & shoulder pain, Intervention: stop/clamp, call rr, provide o2
138
Describe nursing interventions when recognizing a med error
check pt immediately & observe for adverse effects
VS & assessment
incident report
139
Demonstrate techniques used to perform musculoskeletal & neuromuscular assessments
ROM, cranial nerves, dtr, tone & strength of muscles/extremities, morse fall scale, symmetry, contour, gait, balance & spine
140
Assess pt mobility status
morse fall scale
141
Discuss the physiological & influences on mobility
muscle weakness, - rom, high bp, trauma/injury, poor posture, impaired CNS, health status & age
developmental
mental health & physical
life style
fatigue & stress
142
Discuss the pathological influences on mobility
Ischemia: reduced blood flow
Hemiparesis: weakness on one side of the body
Paraplegia: lower body paralysis
Quadriplegia: inability to move all 4 extremities
143
Assess body alignment, mobility, & activity tolerance, using appropriate interview & assessment skills
check ati
144
Use safe pt handling & movement techniques & equipment when positioning, moving, lifting, & ambulating pt
gait belt, wedges, hoyer lift, grab pants to lift pt to standing position, draw sheet, transfer boards, crutches, walker, wheel chair, & cane
145
Identify factors which impact a pt nutritional status
Religious/Cultural practices: guides food prep & choices
financial issues:
appetite
negative experiences
environmental factors
disease & illness: can affect funct. ability to prepare & eat food
medications: alters taste & appetite and interferes with the absorption of certain nutrients
age
146
Describe the proper technique for drawing up & admin insulin
Wash your hands and don gloves
Roll the rounds and do loverween the palms of the hands to mix the ingredients because if you don't mix the contents it can alter how much cloudy insulin you are actually drawing up. DON'T SHAKE the vial because this will cause air bubbles!
Clean off tops of vials with alcohol prep for 5 to 10 seconds.
Remove cap from syringe.
Inject_ units of air into the Humulin-N vial & then remove syringe from vial.
Inject_ units of air into the Humulin-R vial & turn bottle upside down (while syringe still inserted into the bottle) and then withdraw _ units of clear insulin... REMOVE SYRINGE.
147
Describe assessments related to nutrtitonal status
weight, lab results, number of meals per day, allergies, appetite, meds, & activity level
148
Describe the procedure for initiating & maintaining enteral feedings
NG: nose to ear, ear to xiphoid process. Nose to stomach. Short term use.
Nasointestinal tube: nose to ear, ear to xiphoid process, add 8-10 in,
G/J & Peg tube: surgical procedure
149
Discuss interventions to prevent aspiration during feeding
high fowler position or in chair. 90 degrees
support upper back, neck, & heaf
tuck chin when swallowing. Look down
avoid straw
check for pocketing in cheeks
keep hob semi fowler elevated for 1 hr after eating.
provide good oral hygiene after
no rushing & reduce distraction
150
Describe how to assist pt with eating in specific circumstances
Vision impairment: explain placement of foods on tray/plate using clock pattern
151
Type 1 diabetes
pancreas doesnt produce insulin
dependent on insulin
genetic/born with it
cannot be prevented/cured
requires insulin injections for life
152
Type 2
developed, insulin resistance
Obesity
can be prevented through lifestyle modifications
the body does nor create enough insulin or develops resistance
manage by: exercise, diet, hydration, glucose monitor
153
Discuss patient centered management of NPO pt
restricts pt from eating or drinking until the diet is advanced
154
Signs and Symptoms of Hyperglycemia
greater than 100-125mg/dl
dry mouth, increased thirst, blurred vision, weakness, headache, freq. urination
155
S/S hypoglycemia
less than 70mg/dl
sleepiness, sweating, pallor, lack of coordination, irritability, hunger,
15 g of carbs,
4oz of soda or juice
1tb od honey
5-6 candies
156
Clear liquid diet
liquids that leave little residue. What ever you can see through
broth, gelatin, water,tea, fruit juices, sport drinks
157
Full Liquid
clear liquid plus liquid diary products & all juices. Liquid @ room temp
ice cream, juices, tea, soups, geltain, protein shakes, pudding
158
pureed
clear & full liquids plus pureed meats, fruits & scrambled eggs
doesnt need to be chewed
soft & smooth
pudding, mashed potatoes, yogurt, juices no pulp, baby food, pureed meats, broths, icecream
158
cardiac diet
heart healthy
limit sodium
consume more fruits & veggies, whole grains, limit unhealthy fats, low fat protein, control portion
lean meats, skim milk & fish
159
renal diet
limit potassium & sodium
160
Calculate I&O
check ati & henke book
161
Discuss principles surrounding abdominal assessment of a pt
Inspection: look for distention, contour,symmetry, abnormalities, skin changes & umbilicus (belly button)
Auscultation: listen for hyper/hypoactive bowel sounds. RLQ to RUQ, to LUQ & LLQ
Palpation: press 1 inch down on the abdomen to check for massess, tenderness, any abnormalities starting from RLQ to RUQ, to LUQ & LLQ
162
Describe & perform a physical assessment focused on urinary elimination
Palpate/ percuss bladder or use a bedside scanner
Check for infection, discharge or odor
Assess color, texture, turgor & excretion of wastes
Assess urine for color, odor, clarity & sediment
Incontience?
Self Care/ADLs?
163
Normal urine
clear, light yellow odorless
164
Discuss anatomical & physiological factors that influence urinary elimination
age, food, fluids, anxiety, stress, diabetes, surgical procedures, obstructions (kidney/bladder stones), & medications (direutics).
165
Discuss anatomical & physiological factors that influence bowel elimination
age, diet, fluid intake, physical activity, personal habits, pain, pregnancy, surgery & anesthesia, meds, stress, anxiety, obstructions
166
Expected/Unexpected in Urinary elimination
Expected: normal patterns/freq, normal color & consistency
Unexpected: cloudy, pinkish/reddish tint, burning during urination, diff. urination, feeling of pressure, & strong odor
167
Expected/Unexpected in Bowel Elimination
Blood, diarrhea, constipation, hemmorrhoids, incontinence, impaction, flatulence,
168
Discuss cond. that alter a pt elimination patterns
Bowel
Diverticulitis
IBS
ulcerative colitis
chrons disease
169
Urgency
immediate & strong desire to void
uti & full bladder
170
dysuria
pain or diff. urination
uti, enlarged prostate, lower urinary tract trauma
171
frequency
increased incidence of voiding
caffeine, uti, pregnancy, high fluid intake
172
polyuria
voiding excess amts or urine (diuresis)
high volumes of fluid intake & uncontrolled diabetes
173
Oliguria
small amt of urine
f&E imbalance
kidney dysfunction
urinary tract obstruction
174
nocturia
awakened from sleep b/c of urge to void
meds, excess intake of fluids
uti, overactive bladder
175
Hematuria
blood in urine
tumors, trauma, & uti
176
retention
inability to completely empty the bladder
obstruction, meds, absent or weak bladder contractlity
177
discuss nursing care measures required for pt with a bowel diversion
change appliance as needed or prescribed, empty when 1/3-1/2 full, warm water only, keep free of odor, keep skin around site dry, monitor for infection
education
178
Describe nursing interventions to promote normal bowel elimination
increase fluids, exercise, diet mod, increase fiber in diet, physical activity,
179
Identify diagnostic tests related to urinary elimination & the nurse's role in obtaining specimens (urinalysis, c&s)
Urinalysis: random, sterile specimen. Eval for disorders, bladder infections or UTI, kidney infection, kidney disease, & diabetes. Visual examination or urine, dipstick testing, & microscopic examination
Urine Culture: eval urine for presence of bacteria & yeast for caus of UTI. BActeria on test strip?
180
Describe nursing interventions for the client with different types of urinary incontience
Keep skin dry, toliet schedule, monitor intake, good perineal care, incontient garments
lifestyle modifications: improving diet & excercising, reducing caffeine/alcohol intake, avoiding meds that cause incontinence. Quit smoking. Pelvic floor excersises, bladder retaining, meds, cathether last resort, & surgery
181
Stress incontinence
loss of urine after increased abdominal pressure
Cough/sneeze/laughing
Females: childbirth & menopause
males: alts in urethra following prostatectomy
182
Urge incontinence
Overactive detrusor muscle & increased bladder pressure = inability to hold urine long enough to make it to the bathroom
bladder irritation from uti, or overactive bladder
183
Overflow
Results from urinary retention/ bladder overdistention- frequent loss of small amounts of urine; usually results from neurologic dysfunction or enlarged prostate
184
Reflex
Involuntary loss of moderate amount of urine; hyperreflexia of detrusor muscle from spinal cord dysfunction, or impairment of CNS (MS, CVA, cord lesion)
185
Functional
Loss of continence due to outside factors (cognitive, environmental, mobility)
186
Transient
Temporary, reversible incontinence (UTI, medications, temporary cognitive impairment, disease processes (hyperglycemia)
187
Identify how the nurse assess for urinary retention
have the pt void no more than 10 min before assessment, bladder scanner, 30ml every hr
188
Perform an assessment of the resp cardiac systems
Respiratory: Listen to lung sounds., measure rr, assess rate, rhythm & depth
Cardiac: listen to heart sounds (aortic, pulmonic, erbs point, tricuspid, mitral), assess hr, rhythm, cap refill, check peripheral pulses & check for edema
188
Insert & maintain urinary cath
check ati
188
Dyspnea
shortness of breath, diff/labored breathing
causes: exercise, sedentary lifestyle, & med cond.
189
Examine assessment findings related to cardiopulmonary functioning
breathing pattern, pulses (peripheral & aortic), breath sounds & heart sounds, edema, cap refill, skin turgor, & skin color
190
Hypoxia
below the expect level of oxygen in body tissue
decrease amt of oxygen in blood
191
Crackles
caused by fluid filling the air sacs, sound like popping & crackling
Pneumonia & infection
192
Wheezes
high pitched noise creating a whistling sound due to air going through narrowed airways
whistling or musical note
193
Rhonchi
rattling & is caused by obstruction of airway
asthma & copd
194
Stridor
sounds like wheezing, caused by constriction in the upper airways.
med emergency
195
Pleural friction rub
low pitched, coarse, grating tone like rubbing 2 pieces of leather together, caused b inflammation of pleura
196
Assess for risk factors affecting a clients oxygenation
smoking
environmental hazards (dust & fumes)
diet
exercise
stress
age
genetics
pregnancy, obesity, nm disease, trauma, musculoskeletal abnormalities, cns
197
Identify methods to prevent atelectasis
Incentive spirometer (deep breathing)
Flutter valve: clears mucous and makes breathing more comfortable
coughing & deep breathing
mobility
198
Assess for the physical manifestations that occur with alt in oxygenation
Hyperventilation: weakness, dizziness, headache, anxiety, increased hr, diff. breathing, numbness & tingling in fingers
Hypoventilation: anxiety, dyspnea with exertion, confused, disturbed sleep pattern, weakness, & impaired cough
Hypoxia: tachypnea, tachycardia, restlessness, anxiety, smoking, clubbing, pale skin/mucous membranes, elevated bp, accessory muscles, nasal flaring, advenitious lung sounds, stupor, cyanotic skin & mucous membranes, bradypnea, bradycardia, hypotension, cardia dysrhythmias
199
Describe nursing intervention used to promote oxygenation in the primary care, acute care, & restorative & continuing care settings
Elevated HOB, o2 therapy, IS, deep breathing, forced coughing, pursed lip breathing, meds, monitor o2 abgs, sputum collection, sputum collection, chest physiotherapy, & suctioning
200
Describe the processes involved in regulating fluid & electrolyte balance in the body
Electrolytes: balance the amt of water in the body, balance body ph,move nutrients into cells & move waste out of cells.Maintain funct. of muscles, heart, nerves & brain
Promotes homeostatsis
201
Identify risks factors for fluid & electrolyte imbalances
dehydration
hypovolemia
over hydration
certain meds
heart/kidney/liver disorders
incorrect IV fluids/feedings
profuse sweating
vomiting & diarrhea
202
Discuss management & nursing interventions for fluid volume overload
manage the cause, diuretics, limit fluid & sodium intake, daily weights, & fluid removal
interventions: obtain diet history, educate on fluid, sodium & pot. intake, diuretic info, monitor weight daily, monitor for jvd, hyper tension, bounding pulse, dyspena, abnormal lung sounds, Monitor I&Os
203
S/S of dehydration & nursing interventions
altered cognitive & nm funct. thirst, lethargy, dry mucosa, oliguira, tachycardia, hypotension, coma, seizures,
Interventions: restoration of fluid balance, oral hydration & iv fluids, monitor I&O
204
S/S of hypovolemia & nursing interventions
thirst, dryness of mucous membranes, fatigue, increase in hr, syncope, weakness, ortho hypo, tachycardia, oliguria,
Interventions: control fluid/blood loss, replace lost, restore circulation in body. oral hydration & IV fluids, monitor I&Os
205
apply the nursing process to caring for patients with fluid & electrolyte imbalance sodium, calcium, magnesium, and potassium
check ati/ slideshow & notes
206
Discuss the purpose & procedure for initiation & maintenance of iv therapy
replace fluids that have been lost, hydration or medications that cannot be taken by mouth
207
calculate input & output
intake: anything that goes in (ice chips are cut in half)
Output: anything that comes out (urine, vomit, & wound drainage
207
calculate flow rate
check ati
208
Assess the client experiencing pain
pain scale
FACEs:
Numeric scale
cries
flacc
Nonverbal scale visual analog
assess quality, quantity, when it started, what makes it better/worst, how long its been there
209
Explain factors which influence the pt's experience with pain
Age
Fatigue
Genetic sensitivity
cognitive funct
prior experience
anxiety & fear
support systems & coping styles
culture
210
Describe applications for use of nonpharmacological pain interventions
Distraction
Massage
cold/hot therapy
acupuncture
tens unit
aroma therapy
deep breathing
pet & music therapy
211
Identify nursing implications when treating clients with pain
pain is what the patient says. Treat all pt pain. Whatever they say it is, it is what it is. provide med as ordered
212
Eval. a pt response to pain interventions
reevaulate pt pain level after receiving meds or nonpharmacological therapies
213
Identify alt. in sleep patterns
Insomnia: inability to sleep
Narcolepsy: sudden attacks of uncontrollable sleep
Hypersomnia: excessive daytime sleepiness lasting at least 3 months
Nocturia: waking up to urinate
Environment: too hot.cold, sounds & lights
214
Discuss S/S of obstructive sleep apnea & nursing considerations
snoring, periods of apnea when sleeping, morning headaches, easily irritable, depression, diff remembering things
Avoid caffeine, no exercise before bedtime, cpap, & sleep study
215
Assess a pt sensory status
assess eyes, ears, neuro (cranial nerves)
216
Sensory deficit
deficit in the normal funct. of sensory reception & perception
217
Sensory deprivation
inadequate quality or quantity of stimulation.
ex: blindness
218
Sensory overload
reception of multiple sensory stimuli
caus pt to feel anxious, restless, & confused
219
Identify factors & cond, which interfere with the pt ability to process sensory input & perception
injury, illness, infection, head injury/trauma, cavities, meds, aging, nasal sinus disorders, & smoking
220
Describe nursing interventions for facilitating and/or maintaining a pt sensory perception
SAFETY, orient to room, call light, keep personal items within reach, learn preferred method of communication, keep objects in same position, tablets, rom, sensory stimulation
221
Cataracts
cloudy area on the eye lens (visible opacity) caused by proteins in the eye breaking down & clumping together
interventions: routine eye exams, sunglasses, mangifying glasses, & large print
222
Diabetic retinopathy
leakage & blockage of the retinal blood vessels, which can lead to retinal hypoxia, retinal hemorrhages, & blindness. Blurred vision, seeing spots & floaters
irreversible
- Control & monitor glucose level
- low sodium diet
223
Glaucoma
increase in intraocular pressure, primary more common,
outflow of fluid is decreased due to progressive blockages in drainage system.
progressive & painless
monitor eye pressure, med admin education
224
Macular degeneration
Wet: leaky overgrown vessels, any age
Dry: most common, macula becomes ischemia & necrotic from blockage of cap flow in retina
assist with adl, driving & eating
225
Hearing loss
conductive: structual issue, cerumen, foreign body
Sensorineural loss: damage to cranial nerve VIII
assessing for hearing loss, inflamed tympanic membrane, tinnitus, dizzy, issues with balance
Interventions—safety – falls
226
Describe common physiological changes of aging
skin elasticity decreases, decrease in skin turgor, loss of sub fat which makes it diff. to adjust to cold temp, thinning & graying of hair, thickening of finger&toenail. Decrease ability of eyes to adjust to light & dark (night blindness). Decreased visual acuity, decrease senses to touch, smell, & taste sensation. decrease ability to hear high pitched sounds, constipation, slow reaction time, decrease salvia production, healing decreases, reduce in CO, high bp, risk for infection, bowel & urinary incontinence, decreased chest wall movement, decrease in peripheral pulses
227
Delirium
state of temporary but acute mental confusion
causes
surgery, drug & drug interactions, infection, hypoglycemia, fever, pain, emotional stress, chf, pneumonia
228
Dementia
Chronic & gradual onset
progressive loss of intellectual functioning impairment of memory, & abstract thinking, personality changes
chronic, progressive cognitive disorder (Alzheimer’s, vascular dementia); sudden onset possible after stroke; characterized by memory loss, disorientation, and/ or impaired reasoning, language, judgment; may involve personality changes & behavioral problems (delusions, hallucinations) and affect ability to interact with others, work, perform ADLs
229
Describe the clinical manifestations, diagnostic studies, & collaborative management of Alzheimers disease
Chronic, progressive, neurodegenerative disease of the brain
Early signs:
Memory loss, forgetfulness
Difficulting completing familiar tasks
Disorientation to time and place
Misplacing belongings
Changes in mood or behavior
Personality changes; social withdrawal
Progression:
Mild
Forgetfulness
Depression
Moderate
Confusion, memory gaps
Self-care gaps
Wandering, behavioral problems
Severe
Unable to identify familiar objects
Cannot perform ADLs
Difficulty eating, immobility
230
Describe nursing assessment & nursing interventions for caring with Alzheimers disease
Assess: safety, orientation, adls, bowel/bladder, & head to toe
Interventions
Reassure pt, speak slowly, face-face contact, allow pt to keep control, and keep a routine
231
Discuss issues related to psychosocial changes of aging
Depression, suicide, adjusting to lifestyle changes, mulitple losses (spouse), body image changes, social development
232
Describe common health concerns of older adults
Pneumonia, shingles, skin breakdown, diabetes, CAD, heart failure, stroke, decreased perfusion to tissues, Malnutrition, arthritis, osteoporosis, falls, cataracts, chronic pain, glaucoma, dry eye
233
Identify nursing interventions related to the physiological, cognitive, & psychosocial changes of aging
assist with
ambulation
reorientation
consuling family members
health screenings
nutritional education
therapeutic communication
assist with adl & self care
safety precaution
med management
234
Health Promotion
the process of enabling people to increase control over & improve their health
235
Wellness
positive state of health
actions taken by individuals to achieve their fullest potential for complete holistic health
236
Disease prevention
encompasses measures taken to limit exposure or effects of illness or disease.
ex: hand hygiene & immunizations
237
Primary prevention
risk reduction
decrease risk for developing medical cond. by changing behaviors or minimizing exposure
ex: vaccines, smoking cessation, & seatbelt education
238
Secondary
early screening to detect a disease process b/f it progresses to cause symptoms or complications to a pt
screening tests
bp for hypertension
blood wrong
pap test
239
Tertiary
control of chronic effects of disease that has occurred
Ex:
self care for diabetics, cardiac rehab, support groups
240
Diversity
broad range of individual, population, social charactersitc, age, ethnicity, gender identity, geographic location, language, religious belief, socioeconmic status
241
cultural awareness
being able & willing to investigate & understand differences between perceptions
241
Cultural competence
appreciating, accepting & respecting all individuals cultural influences, beliefs, customs & values
being able to incorporate effective nursing care with emic & etic knowledge
242
Describe cultural influences on health & illness
view of medication & remedies, language barriers, cultural bias, end of life practices & decisions on procedures based on cultural practice
243
Explain the role of the nurse when providing care to clients from diverse populations
cultural health assessments
medical interpreter
learn their culture
respect their wishes
244
Discuss the influence of spirituality on pt health practices
decisions on procedures based on spirituality, end of life practices, & forms of comfort
245
Complementary therapy
combination of complementary therapy & conventional therapy. Focuses on optimal health of the whole person
enhances medical care
246
Alternative therapy
treatment approaches that become the primary treatment replaces allopathic care. use instead of complementary therapy
247
Integrative medicine
an approach to health using conventional, complementary, & alt medicine approaches
248
Discuss nonpharmacologic therapies (mind-body) & how these can be used in nursing practice
distractions
acupuncture
aromatherapy
imagery
music therapy
relaxation, theraputic touch, pet therapy, hypnosis, biofeedback, mind body technique: indivduals learn how to modify their physiology for the purpose of improving physical, mental, emotional, & spirtual health, reflexology
249
Aloe
wound healing
but can reduce efficacy of some oral meds
250
Echinacea
enhances immunity
250
chamomile
antinflammatory & calming
can trigger allergic reactions
negative interactions with cyclosporine & warfarin
251
Garlic
inhibits platelet aggregation
252
Ginger
antiemetic
253
Ginkgo biloba
improves memory
interfers with anticoag
253
Ginseng
improves physical endurance
anticoag?
254
Valerian
promotes sleep & reduces anxiety
dont use with alcohol or sedatives due to increase in drowsiness
255
Describe the physiological & psychological response to natural products
benefical effect on physical & psychological being
256
Describe safe & unsafe herbal therapies
ginkgo biloba cannot be used with blood thinners
natural does not equal safe
check for USP
herbal medicines are not regulated by fda
some can interact with prescription & otc meds
257
Palliative care
comfort care with/without intent to cure
improve quality of life for pt
258
Hospice care
comfort care without curative treatment or intent, pt has no other treatment options. Side effects of treatment outweighs the benefits
259
Discuss the physiological alt. of a client at the end of life & nursing interventions
Dyspnea
Death rattle: secretion build up in throat
cheyne stokes breathing: rapid, slow with periods of apena that gets longer
still feel pain, temp decreases
vision
hearing is the last to go
Nursing interventions
Turning the clients head to the side or rolling the client to the side can assist with drainage of the secretions from the throat & lungs
using a fan
warm blanket
260
Discuss end of life goals for the pt & family
we want the pt to die in dignity & comfort
261
Discuss grief & stages of kubler ross
the feelings or reactions an individual has to a loss in ones loss.
262
Denial
pt refuses to believe reality
Avoidance, Confusion, Elation, Shock, & Fear
The mind is trying to adjust to a loss of someone or something and wonders how life will continue in this altered state.
terminal diagnosis
263
Anger
in which the client is trying to adjust to the loss and is feeling severe emotional distress. **The client thinks, “Why me?” and “It’s not fair.”**
divorce
- **Frustration, Irritation, and Anxiety**
264
Bargaining
as the client tries a different approach in an attempt to relieve or minimize the pain felt from the loss.
Struggling to find meaning, Reaching out to others, & Telling ones story
I promise to do this
265
Depression
the stage where reality sets in, and the loss of the loved one or thing is deeply felt.
overwhelmed, hosility, fight,helplessness,
266
acceptance
It is the point at which the person still feels the pain of the loss but realizes that all will eventually be well.
exploring
moving on
new plan in place
267
Describe characteristics & response of a pt experiencing grief & lost
shock
anger
anxiety
with draw
numbness
denial
guild
sadness
relief
depression
268
explore factors that influence an individuals response to grief & lost
situations
disenfranchised grief
269
Nursing interventions for post mortem care
washing of body, account for positions, remove invasive devices, give pt family time, id tags in 2 areas toe arm & outside body bag
270
Identify the role of the nurse in relation to pt education
truthful
knowledgable about education you are providing within your scope of practice
271
Explore domains of learning & basic principles of learning
Cognitive: thinking domain, thinking through info & being able to comprehend it
Affective: the feeling domain involves the pt feelings regarding values, attitudes, & beliefs
Psychomotor: doing domain, the physical or mental activity required to learn skills
Principles
Motivation: the pt ability to engage in the learning process by deciding when, where, & how they will learn
Relevance: pt understanding of why they should be learning the info being provided to them
272
