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Fundamentals of Nursing > FINAL EXAM > Flashcards

FINAL EXAM Flashcards

1
Q

elder speak

A

infantilizing
message that the receiver is incompetent and dominance of the speaker
results in resistance to care

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2
Q

when to assess VS

A

admission
order
change in condition
before procedures (so we know baseline before and able to compare after)
medications (meds change vs and we don’t want to push out of normal)
before/after activity

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3
Q

vs are part of what ADPIE

A

assessment

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4
Q

normal VS

A

35.8-37.5
60-100
12-20
<120/80
>95%

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5
Q

how to calculate temp

A

heat produced-heat lost

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6
Q

things that affect temp

A

circadian rhythm
age
gender
physical activity
environmental temp

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7
Q

primary source of heat production

A

metabolism

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8
Q

heat loss

A

skin

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9
Q

sites for temp

A

rectal, tympanic, temporal, bladder, oral, axillary

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10
Q

who not to take rectal in

A

heart problems
kids
low WBC
low platelets

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11
Q

probe colors

A

red-rectal
blue-oral and axillary

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12
Q

interventions for fever

A

maximize heat loss
minimize heat production

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13
Q

convection

A

wind/fan blowing

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14
Q

conduction

A

hot transferred to cold

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15
Q

what to report with pulse

A

rate/rhytum
amplitude

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16
Q

pulse deficit

A

difference between apical and peripheral

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17
Q

orthopnea

A

difficulty breathing laying flat

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18
Q

korokoff sounds

A

systolic 1
diastolic 5

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19
Q

blood pressure parameters

A

elevated 120-129/80-89
stage 1 130-139 OR 80-89
stage 2 >140 OR >90
crisis 180 AND/OR 120

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20
Q

factors affecting BP

A

age
race
circadian rhythum
food intake
exercise
weight
emotional state
body position
drugs
disease process
cig smoking

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21
Q

2 step is for

A

auscultory gap

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22
Q

where not to take BP

A

lymphedema, fistula, mastectomy, IV

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23
Q

hypotension

A

90/60 with symptoms

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24
Q

orthostatic hypotension

A

20 systolic
10 diastolic

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25
Q

MAP

A

mean arterial pressure
>60 to perfuse organs

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26
Q

SpO2

A

amount of hemoglobin saturated with oxygen in arterial blood

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27
Q

abnormal SpO2 in everyone

A

<85%

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28
Q

FiO2

A

fraction of inspired oxygen

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29
Q

factors affecting pulse ox for false low

A

outside light
carbon monoxide
patient motion
jaundice

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30
Q

factors affecting pulse ox high

A

dark skin

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31
Q

HAI

A

healthcare associated infections, develop during course of treatment
- CAUTI
- surgical site infection
- vascular catheter infection
- blood stream infection
- pneumonia

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32
Q

nosocomial and predisposing factors

A

something that originated or occurred inside a hospital setting
- invasive medical devices
- antibiotic resistant organisms
- poor hand hygiene

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33
Q

iatrogenic

A

something that wasn’t supposed to happen that happened under our care that resulted in infection

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34
Q

infection cycle and how to break

A

infectious agent
reservoir
portal of exit
means of transmission
portal entry
susceptible host

hand hygiene

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35
Q

what makes someone a susceptible host

A

intact skin
WBC
splenectomy
age
immunization
nutritional status
drugs
stress
indwelling medical devices

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36
Q

stages of infection

A

incubation: growing/multiplying
prodromal: most infectious, vague nonspecific signs
full stage: specific signs
convalescent: recovery

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37
Q

types of infection and apperence

A

local: swelling, heat, redness, loss of function
systematic: increase temp, HR, RR, enlarged lympnodes, confusion in elderly

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38
Q

labs for infection

A

WBC >10,000
- neutrophils (bands=immature) acute bacterial infection
- bands = >10%
lymphocytes: chronic bacterial, and viral
Eosinophil: parastitic, fungus, allergic
C reactive protein: nonspecific, indicates inflammation

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39
Q

blood borne pathogens/standard precautions/ tier 1

A

hep b, hep c, HIV
- hand hygiene
- PPE
- safe work practice (never recap dirty needles, cough ettiqute, needless system)

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40
Q

PPE

A

not sterile
- gloves
- gown
- mask
- goggle

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41
Q

Masks

A

N95: inhaled air
PPE: exhaled air

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42
Q

never recap what

A

dirty needles

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43
Q

transmission/tier 2

A

used in addition to standard
contact: C.diff, MRSA
- indirect and direct
droplet: influenza, pertussis
airborne: COVID, TB, measles, chicken pox
neutropenic

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44
Q

medical asepsis vs surgical asepsis

A

clean technique: hand hygiene, PPE
surgical: sterile

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45
Q

sterile/surgical asepsis

A

waist to shoulder
do not turn back on sterile field
allow only other sterile objects to touch eachother
avoid talking, coughing, reaching over sterile field, solutions expire in 24 hours
pour fluids with label in palm of hand
w/o sterile gloves handle outer 1 inch

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46
Q

cleanliness and grooming promotes what and enhances what process

A

physical, psychological
healing

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47
Q

what does the skin need

A

nutrition, hydration, circulation

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48
Q

braden scale

A

sensory perception
moisture
activity
mobility
nutrition
friction and shear

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49
Q

elderly

A

thinning of subq and dermal layer
decrease activity of glands
longer time window for cell renewal
decrease in collagen fiber
nail changes

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50
Q

first thing to ask patient for AM care

A

bathroom

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51
Q

goldstandard oral care and unconscious patient and who to do it more in

A

brushing teeth
put on side with suction
supplemental oxygen, NG tube, meds, infection, mechanical ventilation

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52
Q

types of baths

A

CHG: reduces pathogens on skin, cumulative affect, bathe first and then CHG
do not use on face and perineal
warming helps activate

bag bath: no rinse, not soap, good for elderly

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53
Q

wipe warmer

A

yellow: not ready
solid green: ready
blinking green: going to expire
red: expired

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54
Q

purewick

A

low suction
change Q8
do not use barrier cream (impedes suction)
don’t clean vaginal area with soap, use non rinse cleanser

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55
Q

condom cath

A

change q24
clean least (head) to most (scrotum) dirty
retract foreskin to clean and then replace
leave 1 inch from penis to end of cath

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56
Q

foley care

A

good peri care
cleaning 6 inch down tubing
tube must be secured to thigh
green clamp on bed sheets
tubing is off floor
no dependent loops
tubing off floor
bag on non moveable part of bed

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57
Q

when to get mepiplex

A

<18 braden, red sacrum, history of sacral ulcer, cannot reposition, ICU, older than 65, mechanical ventilation, surgery longer than 4 hours

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58
Q

diabetic foot care

A

wash in lukewarm water
apply lotion but not in-between toes
file nails straight across
cotton socs

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59
Q

body mechanics

A

work close
broad base of support
flex knees and straight back
strong core
low center of gravity
use legs

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60
Q

weight limit

A

35lbs

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61
Q

no manual lift laws

A

have lift machines in each hospital

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62
Q

movement exclusion

A

physiologically unstable: hypotension, uncontrolled blood sugar, Brady/tachy cardiac
ekg changes/ cardiac enzymes
INR and PTT
doesn’t respond to verbal stimuli
spinal trauma

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63
Q

positioning

A

fowlers: 45-60
semi fowlers: 30
low fowlers: 15
high fowlers: 90
orthopedic: 90 and laying on table
prone: COVID perfusion
lateral side lying: protect bony prominences
sims: laying flat/side
lithotomy: legs in stirups

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64
Q

protection

A

hand rolls: protect from contractures
trochanter rolls: protect from external rotation
log rolling: keep spine, neck, align
boots: protect from plantar flexion and pressure

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65
Q

when moving ask patient to

A

cross arms and put knees up and push

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66
Q

one nurse assist

A

stand on weak side

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67
Q

cane

A

hold on strong side
advance cane
advance weak leg
advance strong leg

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68
Q

oxygenation and ventilation

A

oxygenation: ability to transport gases
ventilation: ability to transport air

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69
Q

meds and lifestyle that affect pulmonary

A

opioids: depress
obesity: hypoventilator
smoking: vasoontrictor

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70
Q

smoking

A

pack year

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71
Q

adventitious sounds

A

wheeze: narrow airway, high pitch, asthma and obstruction, TX: bronchodilator and removal
crackle: discontinuous, TX: diuretics, chest perfusion, fluid in alveoli, collapsed alveoli
rhonci: course continuous, increase secretions in larger airways, TX: suction or 3 small cough and 1 big cough

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72
Q

noninvasive ways to assess pulmonary

A

pulse ox:
oxygenation, arterial hemoglobin saturation, continuous <90%
CXR
PFT

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73
Q

invasive pulmonary assessment

A

arterial blood gas analysis: used in code, assess oxygenation and ventilation
bronchoscopy

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74
Q

PaO2 and SpO2 numbers

A

PaO2 SpO2
40%. 70%
50%. 80%
60%. 90%
80%. 95%

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75
Q

nursing interventions for pulmonary

A

position: up
pursed lip breathing: exhalation longer than inhalation
fluids losen secretions
humidify over 3L
SMILLE

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76
Q

who to do pulmonary toilet and who to not

A

don’t: osteoporosis, broken rib, surgical scars
do: atelectasis, pneumonia, cystic fibrosis

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77
Q

meds

A

suppressants: non productive
expectorant: productive
bronchodilator: tachycardia
corticosteroids: reduce inflamation

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78
Q

3 develiver

A

nebulizer: fine particles, med gets into deeper passages
MID: controlled dose, spacer, inhale when releasing, rinse after steroid could cause thrush
dry powder: activated by pateint inspiration

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79
Q

nasal canula percent in L and FiO2

A

RA: 21%
1L: 24%
2L: 28%
3L: 32%
4L: 36%
5L: 40%
6L: 44%

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80
Q

high flow NC percents

A

10L: 60%
15L: 80%
20L 90%
30L: 98%

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81
Q

venturi mask percent

A

24-40%

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82
Q

nonrebreather percent

A

80-100%
set on full flow, % depends on patient depth and rate

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83
Q

oxygen and air color

A

oxygen=green
air= yellow

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84
Q

drug kidney and liver

A

liver is metabolized
kidney is excreted

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85
Q

adverse effect vs allegric effect

A

adverse is a side effect (ex: opioid causes consitipation, normally causes it in a lot of people)
allergic reaction
- mild
- anaphylactic
individual for the patient

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86
Q

idiosyncratic

A

opposite effect of anticipated affect

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87
Q

drug ranges

A

therapeutic range: concentration in blood that produces the desired effect
peak: point when drug is at highest (60 min after given)
trough: point when drug is lowest concentration, indicates the rate of elimination (60 min before next dose)
half life: amount of time it takes for 50% of blood concentration of a drug to be eliminated from body

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88
Q

aging adult with meds

A

decreased gastric motility: meds stay in gastric region longer, increased N/V and aspiration
decreased total water and lipid content: absorption, exaggerated reation
kidney/liver: wont be metabolized excreted, can result in cumulative affect
altered peripheral vascular tone: extemely reactive to anti hypertensive= orthostatic hypotension

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89
Q

5 rights

A

pt, drug, time, route, med

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90
Q

orders

A

verbal: mandatory write down and read back
standing: written in chart, stand until discontinoued
PRN: as needed
STAT: immediately
one: one dose only

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91
Q

2 pt identifiers

A

name
birthday
medical record number

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92
Q

late meds

A

more frequently Q6/rapid short acting insulin: 30 mins within time
Q6 or less: 60 mins
daily/weekly/monthly: 2 hours

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93
Q

half time

A

late dose can be giver up to half way to next scheduled dose and continue with the schedule
given later than halfway between doses give the med, skip next dose and resume schedule

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94
Q

what not to cut/ crush

A

SR: sustained release
XL: extended released
CR: controlled release
Enteric coated: special coating to decrease gastric irritation, med released in small intestine

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95
Q

eye drops

A

aim for conjunctival sac
tell pt to look up
put tissue pressure over inner corner to prevent med from leaking down

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96
Q

direct and indirect syringe contaimination

A

direct: use of same syringe for more than 1 patient
indirect: accessing vials with used syringe followed by reuse of the vial

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97
Q

intradermal parameters

A

degree: 5-15
inch: 1/4-1/2
gauge: 25, 27
max amount: 0.5mL
no aspiration/massage

98
Q

subq parameters

A

degree: 45-90
inch: 3/8-5/8
gauge: 25-30
max volume: 1mL
pinch on people with decrease subq and release before injection
no massage/aspiration
rotate sites
sites: backs of arm, abdomen, fronts of thighs, above butt, scapular region

99
Q

IM

A

degree: 90
Inch: 5/8-1 1/2
gauge: 20-25
max volume: 3mL, 1mL in deltoid
sites: deltoid, ventral gluteal, vastus lateralis
Z track: pull skin to side to avoid med uptake
pressure no massage
no aspiration

100
Q

3 big safety errors

A

med error
falls
improper use of restraints

101
Q

QSEN
IOM
TJC
= safety of clinical excellence

A

sen: quality and safety of education of nurses
IOM: institute meds
TJC: the joint commission

102
Q

QSEN competencies

A

patient centered care
teamwork and collaboration
EBP
quality improvement
informatics
safety

103
Q

3 healthcare failures

A

failure to recognize, rescue, plan

104
Q

fire safety

A

r: resuce
A: activate
C: confine
E: evacuate

105
Q

3 med errors

A

omission: missed/didnt do something (most common student)
communication
commission: did something wrong

106
Q

what increases fall risk

A

females
>65
history of falls
cognitive impairment
altered gait
meds
incontinice
unsafe environment
sensory deficit
orthostatic hypotension
depression
assistive devices
confusion
new environment

107
Q

most falls are released to

A

toilet

108
Q

restraints recommended use

A

physical safety and prevent interruption of therapy

109
Q

exceptions to half time rule

A

aminoglycosides and chemo

110
Q

hazards to restraints

A

impaired circulation
altered skin integrity
altered nutrition/hydration
aspiration
incontience
depression
anxiety
death

111
Q

do restraints decrease fall risk

A

no

112
Q

non violent and violent checks

A

non voilent: visual, physical comfort, circulation= Q2
violent: visual, physical comfort, circulation= 15 min
ROM/fluid: 2 hours
food: 4 hours

113
Q

clinical vs critical thinking

A

critical: mental process of recognizing, analyzing, applying and evaluating information
clinical: critical thinking in clinical setting

114
Q

ADPIE

A

assessment
diagnosis
planning
intervention
evaluation

115
Q

assessments

A

initial:
- admission: 8 hours of admission, baseline for hospitalization
shift: beginning of shift, baseline for day
focused: one system, not planned return
time lapsed: purposefully come back after certain time to assess

116
Q

diagnosis

A

clinical judgment about an individual responses to actual or potential health problems

117
Q

problem
etiology
defining characteristics

A

problem RT evidence AEB defining characteristics
problem drives outcome
etiology drives nursing interventions

118
Q

maslows

A

physiologic
safety
love
self esteem
self actualization

119
Q

outcomes

A

cognitive: increase knowledge (EX: teaching)
psychomotor: new skill (EX: show us what was taught)
affective: change values, beliefs, attitudes (anti vax)
physiologic: physical changes

120
Q

direct future care

A

terminate: plan of care when expected outcome is achieved
modify: if difficulties arise
continue: need more time

121
Q

never events

A

stage 3-4 injury
falls
trauma
surgical site infection
vascular catheter associated infection
CAUTI
administration of wrong blood

122
Q

wound types

A

closed/open
clean: surgical
dirty: pressure

123
Q

incision
contusion
abrasion
puncture
laceration

A

incision: edges well approximated, no gapping
contusion: bruise
abrasion: rug burn
puncture: IV
laceration: injury to skin or soft tissue resulting in tearing of tissue

124
Q

classification

A

partical thickness: epidermis/dermis
full thickness: subq muscle
acute: heals in expected time
chronic: extended time to heal
intentional: surgery
unintentional: trauma

125
Q

normal healing requires

A

circulation
nutrition
hydration
clean environment

126
Q

ability to heal depends on the extent of the

A

wound and persons general health

127
Q

intentions
primary, secondary, tertiary

A

primary: edges well approximated, clean cut, closed by stapes or stitches
secondary: edges are not approximated, tissue loss, scarring, increase risk of infection since left open, wound builds up from base
tertiary: wounds left open for 3-5 days and then closed with sutures, allows drainage

128
Q

phases of healing

A

hemostasis: immediately, clot formation
inflammatory: wound redness, swelling, pain, macrophages enter wound, up to 4 days
proliferation: new capillaries and epithelial cells, 4-21 days
remolding: structure wound remodels, scar forms, collagen remodels

129
Q

exudate

A

serous: plasma, clear, yellowish
sanguineous: blood
- bright: fresh bleeding
- dark: older
serosanguineous: pink, blood and plasma
purulent: pus, green, yellow, brown, indicates pathogens (indicate color when charting)

130
Q

complication of wounds

A

biofilms: inhibits wound healing, chronic wound inflammation and infection, CAUTI
hemorrhage: bleeding, hemostatisis didn’t occur
dehiscence: rip open to muscle
eviseration: rip through muscle, organs visible
fistula: 2 things connected that aren’t supposed to be
psychological effects: body image

131
Q

nutrition affecting wind healing

A

vit a, c, copper, iron, zinc

132
Q

desiccation

A

dry skin

133
Q

maceration

A

pruning of skin

134
Q

RYB color code

A

red= protect
yellow= clean
black=debride

135
Q

albumin and prealbumin

A

albumin: protein 6 wks ago
pre albumin: now

136
Q

lavine method

A

clean wound first
Z shape on wound

137
Q

drains

A

Penrose: passive, not sutured in
JP: active
Hemovac: active

138
Q

cold vs hot

A

cold: initial, decreases blood flow, decreased cellular metabolism
hot: few days after, increases blood flow, increase cellular metabolism

139
Q

3 ways to debride

A

surgical: cut out
chemical: dakins bleach solution on dressing
mechanical: 4x4 gauze wet to dry

140
Q

mepliex

A

waterproof, 7 days, never use for infection, prevents friction and sheer

141
Q

what is always safe to use in wounds

A

.9NS

142
Q

silvadine cream
hydrogel

A

silvadine cream: antibacterial, burns
hydrogel: water goop, pink granulation

143
Q

pressure and time for pressure injury

A

30 mmHg over 2 hours

144
Q

shear

A

inner and outer layer separate

145
Q

risk factors for pressure injury

A

age
immobility
moisture
nutrition/hydration
previous pressure injury
diseases affecting blood flow

146
Q

slough

A

nectroic tissue that is moist, stringy, yellow/grey

147
Q

eschar

A

devitalized dermis that has become leathery or thick and black

148
Q

undermining

A

area of ulcer beneath the skin that extends under edge of wound

149
Q

tunneling

A

narrow extensions into surrounding tissue from slides of ulcer

150
Q

stage 1 pressure injury

A

partical thickness
intact skin
non blanch able redness
protect from moisture, pressure, further injury

151
Q

stage 2 pressure injury

A

partical thickness
exposed dermis
red/pink
open ruptured blister

152
Q

stage 3

A

full thickness
subq visible
epibole
slough and eschar
undermining and tunneling

153
Q

stage 4

A

full thickness
exposed bone, ligament, tendon, muscle
slough and eschar
undermining and tunneling
epibole

154
Q

unstageable

A

full thickness= 3 and 4
base is predominately covered by eschar/slough

155
Q

deep tissue

A

purple maroon
discolored intact skin
blood filled blister
due to damage of underlying soft tissue from pressure/shear

156
Q

stage is named by what even when healing

A

highest stage (EX: healing stage 3)

157
Q

underweight
normal
overweight
BMI

A

under: <18.5
normal: 18.5-24.9
overweight: >25

158
Q

alcohol inhibits vit B absorption

A

decrease B12

159
Q

diets

A

NPO: nothing by mouth
clear liquid: yellow, clear at room temp
full liquid: milk
free water: increase water

160
Q

NG tube

A

aspiration, swallow fine but need more nutrients, decompress stomach
LIS: low intermittent suction so you don’t damage mucosa

161
Q

when to not aspirate tube

A

J tube

162
Q

feeding

A

bolus: all at once
gravity: hold up and let gravity do it
continuous

163
Q

signs pt is not tolerating

A

cramping, gas, diarrhea, pain, bloating, N/V, increase residual

164
Q

gold standard for checking patient

A

gold standard

165
Q

HOB for feeding

A

30-45

166
Q

when to flush

A

Q4
before, between, after meds
before, after bolus feeding
before after residuals

167
Q

how to flush, what syringe

A

> 30mL syringe
30mL warm sterile water

168
Q

how to unclog a tube

A

activated pancreatic enzymes to unclog
activate with sodium bicarb

169
Q

minimum urine production

A

30mL

170
Q

fluid intake

A

2-3L

171
Q

post void residual

A

normal is less than 50mL
urinary retention: >150

172
Q

UA

A

urine analysis
gross: WBC, RBC, sugar, protein
10mL

173
Q

urine culture sensitivity

A

3mL
sterile

174
Q

CCMS

A

peri care
start
stop
start=colllect
stop
finish

175
Q

lab value for urine

A

BUN
8-23
blood urea nitrogen

creatine
0.6-1.2

GFR
>60

176
Q

incontinence

A

stress: weak pelvic floor and or deficient urethral spinchter, loss of urine during increased abdominal pressure (kegal)
urge: involuntary loss of urine that occurs soon after feeling an urgent need to void (bladder training)
overflow: chronic retention of urine (kegal)
functional: inability to reach toilet (bladder training)
reflex: spinal cord injuries emptying with no signal (bladder training)

177
Q

urinary diversions

A

ileal conduit: urter illium bag
uretostomy: urter to surface
neobladder: small intestine to make fake bladder

178
Q

UTI

A

dysuria, frequency, cloudy urine with foul odor, back pain
urine analysis/urine culture
increase temp
increase WBC
change in LOC

179
Q

increase risk of UTI

A

females
age
indwelling caths
diabetics

180
Q

urinary retention meds

A

anticholinergics, tricyclic antidepresants, calcium channel blockers, narcotics, anesthetics

181
Q

catheters

A

straight: intermitten
indwelling: stays in
suprapubic

182
Q

foley care

A

clean clean to dirty
6 inch down tube
keep off floor
secure to thigh
green clip on bed
no dependent loops
never higher than bladder

183
Q

pure wick change and suction

A

8hr
low suction

184
Q

parts of catheter

A

drain, ballon, bifurcation, ballon port, seal, specimen port, clamp,

185
Q

fiber amount

A

25-30

186
Q

stool culture and sensitivity

A

1 inch/15-30mL

187
Q

occult blood/guaiac

A

blood that cannot be seen
no red meat diet before

188
Q

what do we want to give after barium and contrast

A

fluids and laxatives bc it hardens

189
Q

impaction

A

hard and immovable
upper GI: fluid/water as a bowel movement
can cause urinary incontinence
can be in all parts of bowel

190
Q

laxative

A

irritates bowel lining to get peristalsis

191
Q

treatment for impaction

A

disimpaction: rectum only, double glove, lubrication
enema: left side lying, room temp. lubricate tube, assess for perforation

192
Q

enema

A

tap, NS, soap suds, lactulose, kaexelate, oil retention

193
Q

signs and symptoms of perforation

A

abdominal pain, rectal pain and bleeding, back pain, fever,

194
Q

bowel diversion

A

sigmoid: formed
descending: formed
transverse: pastey
ascending: liquid
ileostomy: total liquid

195
Q

colorectal cancer

A

ribbon like stool
changes in habits
blood in stool
constant need to evaluate bowels
weakness and fatigue
cramping/adbmoinal pain
weight loss

196
Q

3 phases of periop

A

pre
intra
post

197
Q

urgency, risk and purpose of bowel

A

elective: scheduled
urgent: perform soon
emergency: stat
increase risk the longer the surgery is
diagnostic: not curative, find out what’s wrong
ablative: organ removal
palliative: reduce intensity
reconstructive: restore function
transplantation: organ

198
Q

ambulatory surgery

A

stay at home night before
elderly woundnt be good candidate

199
Q

preop

A

screening and teaching

200
Q

intraop

A

safety monitoring

201
Q

anesthesia

A

general: LOC, analegsia, relaxation, loss of reflexes, amnesia
greatest risk
regional: analgesia, relaxation, loss of reflexes, below site of injection
conscious: analgesic, relaxation, loss of reflexes, amnesia
topical: analgesia

202
Q

malignant hyperthermia

A

autosomal dominant
dantrolene

203
Q

post op

A

assessment and prevention

204
Q

vitals post op

A

Q15x4
Q30x4
Q1x4
Q4x4

205
Q

sickle cell

A

fluids, oxygen, pain meds

206
Q

process of pain

A

transduction: activation of pain receptors
- nociceptors: peripheral pain receptors
transmission: impuse travling up spinal cord to higher center
perception: awareness of characteristics of pain
modulation: inhibition or modification of pain

207
Q

threshold vs tolerance

A

threshold: lowest intensity of stimulus that causes you to recognize pain
- same in everyone
tolerance: greatest level of pain that a subject is able to endure
- different

208
Q

gate control

A

relationship between pain and meds
determines impulse that reach the brain
blocks pain receptors from reaching brain

209
Q

acute vs chronic pain

A

acute: heals with the cause
chronic: pain lasts beyond normal healing

210
Q

responses to pain

A

physiologic: pulse BP, HR
behavioral: voluntary, protecting, grimacing
affective: psychological, pain causes… fear, anger, depression

211
Q

when assessing pain also assess

A

sedation

212
Q

somatic feeling

A

aching, deep, dull, gnawing, throbbing, sharp, stabbing

213
Q

visceral feeling

A

cramping, squeezing, pressure, referred

214
Q

neuropathic

A

burning, numbness, radiation, shooting, tingling, touch

215
Q

referred pain

A

pain perceived at another location other than site of painful stimulus

216
Q

atractable sigh

A

severe constant, relentless, debilitating, incurable, early death

217
Q

3 step ladder

A
  1. nonopoiid and adjuvant
  2. opioid, nonopoid and adjuvant
  3. increase dose and frequency
    goal: freedom from pain
218
Q

opoids:

A

morphine: gold standard, N/V, itch, decrease reps
codeine: stomach issues
hydromorphone: delauded
methadone: dolphins
fentnyal: 12 hours to activate, 8-10x stronger than morphine

219
Q

breakthrough pain

A

flare up of moderate-severe pain that occurs in-between around the clock meds

220
Q

physical dependence

A

body physiologically adapts to presence and suffers withdraws

221
Q

psycholigcla dependence

A

addiction
craving
need for effects other than pain

222
Q

tolerance

A

need larger dose to reach and maintain analgesic levek

223
Q

sleep vs rest

A

rest: decrease state of decreased activity and result is feeling refreshed
sleep: altered LOC state of rest and relative inactivity

224
Q

NREM

A

non rapid eye movement
1. transition stage between wakefulness and sleep, very light sleep
2. light sleep, easily aroused 50%, go in and out of REM through this stage
3. deep sleep
4 deep sleep (delta sleep)

225
Q

REM

A

dreaming
5-45 mins
20-25% of nightly sleep
increase pulse, blood pressure, metabolic rate, body temp
decrease skeletal muscle tone, deep tendon reflexes

226
Q

deep sleep

A

growth, physical renewal, hormonal regulation

227
Q

REM

A

storing memories, learning mood

228
Q

illness affecting sleep

A

GERD: increase gastric secretions in REM
coronary artery disease: increase angina in REM
epilepsy: increase seizers in NREM
liver failure: total disruption
end stage renal: day time sleep

229
Q

insomnia

A

difficulty falling asleep, intermitten sleep early wakefulness, >60yo, post menopause, depression, meds (antihypertensive, ADD, cold and allergy)

230
Q

narcolepsy
cataplexy

A

sudden loss of muscle tone

231
Q

what is an example of direct transmission

A

contact and droplet

232
Q

what is an example of indirect transmission

A

airborne
vehicle bound (fomites)

233
Q

PPE donning and doffing order

A

hand hygiene, gown, mask/respirator, goggles, gloves
gloves, goggles, gown, mask respirator, hand hygiene

234
Q

research practice gap

A

we have the evidence but is not implemented into practice

235
Q

goals of EBP

A

Reduce variations in care
Achieve clinical excellence
Promote effective interventions
Provide nurses with the best EBP
Assist with clinical decision making

236
Q

informed consent

A

Right not to be harmed
Right to full disclosure
Right to self determination
Right to privacy

237
Q

EBP is surrounded by

A

Evidence
Clinical expertise
Patient/family preferences and values

238
Q

sentinle event

A

Suicide in a staffed setting or in 72 hours of discharge
Unanticipated death of a full-term infant
Discharge of an infant to the wrong family
Abduction of any patient receiving care, treatment, or services

239
Q

how to promote safe culture

A

Leadership - everyone should feel safe to speak up
Human factors - teamwork & communication
Reliability - policies & procedures

240
Q

ISBAR

A

Introduction - of yourself
Situation - 5-10 seconds
Background - how did we get here
Assessment - what do you think the problem is
recommendations - what you think needs to be done

241
Q

pre albumin

A

15-35

242
Q

albumin

A

<3.5

Fundamentals of Nursing (23 decks)

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