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Foundations > final exam > Flashcards

final exam Flashcards

1
Q

what is the average daily fluid intake

A

2200-2700 mL if not contraindicated e.g. kidney/heart disease

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2
Q

what is the minimum daily fluid intake in patients without h/x of UTI

A

1200-1500 mL

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3
Q

what is the average daily output

A

1200-1500 mL

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4
Q

as a nurse if a patient has less than 1200 mL of fluid output you should consider what?

A

renal failure

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5
Q

as a nurse if a patient has greater than 1500 mL of fluid output you should consider what?

A

fluid intake (they need more fluids)

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6
Q

what is the desired hourly urinary output for an adult

A

30-60 mL/hr

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7
Q

term for less than 100 mL urine output in 24 hours

A

anuria

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8
Q

term for 100-500 mL urine output in 24 hours

A

oliguria

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9
Q

what is the term for painful urination

A

dysuria

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10
Q

what is the term for blood in the urine

A

hematuria

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11
Q

what is the term for frequent bladder leakage

A

urinary incontinence

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12
Q

what is the term for waking up in the middle of the night multiple times to urinate

A

nocturia

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13
Q

what is the term for sudden and extreme urge to urinate

A

urgency

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14
Q

what is the term for lower abdominal pain that is below the umbilicus and above the pubic bone

A

suprapubic pain

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15
Q

what is the term for a urinary output of over 2000 mL in 24 hours

A

polyuria

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16
Q

what is the term for the accumulation of urine and being unable to void urine (fully or partially)

A

urinary rentention

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17
Q

what is the term for urine that remains in the bladder after urination

A

residual urine

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18
Q

a UTI can result from

A

an infection entering the urethra such as by catheterization or during a procedure

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19
Q

what intervention is the most important to implement for a patient with urinary retention

A

assess for bladder distention

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20
Q

a nurse might suspect urinary retention if a patient has _____

A

small amounts of urine voided 2 or 3 times an hour

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21
Q

what situation would the nurse administer diuretics?

A

diuretics increase urinary output so the nurse would give diuretics to a patient who is experiencing urinary retention

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22
Q

normal urine pH

A

4.6-8.0

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23
Q

generic name

A

named after the drug’s active ingredient

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24
Q

trade name

A

named after the company
has trade mark

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25
Q

medications can exit the body through (5)

A

kidney
liver
bowel
lungs
exocrine glands

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26
Q

what determines the organ of medication secretion

A

the chemical makeup of the medication

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27
Q

therapeutic reaction meaning

A

expected or predicted psychological response

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28
Q

adverse reaction meaning

A

unintended, undesired, unpredictable effects

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29
Q

side effect meaning

A

prediciable, unavoidable secondary effect

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30
Q

toxic effect meaning

A

accumulation of the medication in the blood

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31
Q

idiosyncratic reaction meaning

A

underreaction, overreaction, or different than normal reaction

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32
Q

medication administration routes (broad) (5)

A

injection
oral
topical
inhalation
intraocular

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33
Q

kinds of oral medication administration

A

buccal, sublingual, swallowing

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34
Q

what are the 4 major kinds of injection

A

intramuscular
intradermal
subcutaneous
intravenous

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35
Q

what are the 2 ways of topical medication administration

A

skin
mucous membranes

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36
Q

what are the 7 RIGHTS to medication administration

A
  1. patient
  2. dose
  3. route
  4. reason
  5. documentation
  6. time
  7. medication
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37
Q

what patient history questions should the nurse ask during the assessment before giving a medication

A

allergies
medications
diet
perception and coordination problems

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38
Q

what should you never do when administering ear drops

A

never occlude the ear canal

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39
Q

what kind of inhaler may be used with a spacer

A

pressure metered dose inhalers (PMDI)

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40
Q

what type of inhaler is activated by the patient’s breath

A

dry powder inhalers (DPIs)

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41
Q

rapid acting insulin:
rapid onset is ______minutes
peak _____hours
make sure they eat within ______minutes

A

rapid onset is 15 minutes
peak 2 hours
make sure they eat within 15 minutes

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42
Q

short acting insulin:
onset is _____minutes
peak is ______ hours

A

onset is 30-60 minutes
peak is 2-5 hours

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43
Q

short acting insulin is given by what routes?

A

IV bolus
IV infusion
IM
SQ

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44
Q

intermediate acting insulin:
onset_____hours
peak______hours

A

onset is 1-2 hours
peak is 4-8 hours

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45
Q

what is an example of intermediate active insulin

A

NPH (cloudy)

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46
Q

know the injection sheet

A

know the injection sheet

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47
Q

ways to administer narcotics

A

IV & oral
just oral

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48
Q

PCA

A

Patient Controlled Analgesia
pain medication is controlled by the patient

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49
Q

temp measurement sites

A

oral
rectal
temporal
tympanic
axillary

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50
Q

normal temp range

A

96.8-100.4 F

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51
Q

F=

A

(9/5 x C) + 32

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52
Q

C=

A

(F-32) x 5/9

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53
Q

normal HR

A

60-100 bpm

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54
Q

what 2 things slow the respiratory rate

A

narcotics
hypothermia

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55
Q

what is something that increases respiratory rate

A

reduction of hemoglobin from the blood

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56
Q

cessitation of breathing term

A

apnea

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57
Q

abnormally slow breathing term

A

bradypenea

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58
Q

abnormally fast breathing term

A

tachypnea

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59
Q

normal RR

A

12-20

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60
Q

normal BP

A

120/80

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61
Q

normal O2 sat

A

95%-100%
less than 90% is emergent

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62
Q

ABCs of nursing assessment (prioritizing)

A

Airway- is there an airway obstruction?
Breathing- is the pt breathing?
Circulation- is the pt HR and rhythm normal?

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63
Q

What things can an RN delegate to an LPN? What is in the LPN’s scope of practice

A

-administer non-high risk medications
-administer NG tube feedings
-wound changes
-insert catheter

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64
Q

What things can an RN delegate to an NA? What is in the NA’s scope of practice

A

-bed baths
-taking vital signs
-serving pt meals
-ADLs

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65
Q

what are the steps for stoma care

A
  1. wash hands
  2. warm water and washcloth
  3. remove all adhesive from skin
  4. dry skin well before putting pouch back on
  5. measure and cut the patch to the correct size to prevent leakage
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66
Q

normal electrolyte ranges: sodium

A

136-145

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67
Q

normal electrolyte ranges: potassium

A

3.5-5.0

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68
Q

normal electrolyte ranges: chloride

A

98-106

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69
Q

normal electrolyte ranges: magnesium

A

1.3-2.1

70
Q

normal electrolyte ranges: calcium

A

9.0-10.5

71
Q

when giving a bath what direction do you go

A

distal to proximal

72
Q

what do you never do regarding the legs when bathing a patient

A

never massage legs

73
Q

what do you do with dentures when they are not in the pt mouth

A

keep them in a cup of water

74
Q

what is the appropriate position to use for an unresponsive patient during oral care to prevent aspiration?

a. prone position
b. Sims’ position
c. Semi-Fowler’s with head to the side
d. Supine

A

sims’
semi fowler’s with head to the side

75
Q

which safety precautions are important for foot care of a diabetic patient to prevent infection?

a. cut nails frequently
b. assess skin for redness, abrasions, and open areas daily
c. soak feet in water for at least 10 min before nail care
d. apply lotion to feet daily
e. clean between toes after bathing

A

b. assess skin for redness, abrasions, and open areas daily
d. apply lotion to feet daily
e. clean between toes after bathing

76
Q

which factors impairs salivary secretion?

a. use cough drops
b. immunosuppression
c. radiation therapy
d. dehydration
e. presence of oral airway

A

c. radiation therapy
d. dehydration

77
Q

which patient is most at risk for developing skin problems and requires thorough bathing and skin care?

a. 44 yo female who had a removal of a breast lesion and is on her period
b. 56 yo homeless male who was admitted to the ER with malnutrition and dehydration and has an intravenous line
c. 60 yo female who had a stroke with right-sided paralysis and has an orthopedic brace on the left leg
d. 70 yo who has diabetes and dementia and has been incontinent of stool

A

d. 70 yo who has diabetes and dementia and has been incontinent of stool

78
Q

patient has reduced level of consciousness and requires mouth care, which physical assessment should the nurse perform before the procedure?

a. O2 Sat
b. HR
c. RR
d. gag reflex
e. response to painful stimulus

A

RR and gag reflex

79
Q

when planning morning care, which patient should be bathed first?

a. patient who just returned to the nursing unit from a diagnostic test
b. patient who prefers a bath in the evening so his wife could help
c. patient who experiences frequent and incontinent diarrhea and urine
d. patient who has been awake all night due to 8/10 pain

A

c. patient who experiences frequent and incontinent diarrhea and urine

80
Q

the nurse delegates hygiene care of an elderly pt who had a stroke. what should the nursing assistant accomplish during the bath?

a. check distal pulses
b. ROM exercises
c. determine t/x to stage 1 pressure injury
d. change dressing over IV site
e. provide special skin care

A

ROM exercises
provide special skin care

81
Q

cultural encounter goal

A

communicate in a way that can generate a wide variety of responses

82
Q

what does the LEARN model mean

A

LISTEN with sympathy and understanding of the patient’s problem
EXPLAIN your perceptions of the problem
ACKNOWLEDGE the similarities and differences of the problem
RECOMMEND treatment
NEGOTIATE agreement

83
Q

health literacy score of a 0 means

A

3rd grade level or below

84
Q

health literacy score of 1-3 means

A

4th to 6th grade level

85
Q

health literacy score of 4-6 means

A

7th-8th grade level

86
Q

health literacy score of 7 means

A

high school level

87
Q

when working with patients with language barriers the nurse should do what?

A

get an interpreter
look at the patient not the interpreter
do not use the family as the interpreter

88
Q
A
89
Q

cognitive domain

A

when the patient gains information to further their education

90
Q

affective domain

A

expression of feelings and emotions

91
Q

psychomotor domain

A

development of manual/physical skills like learning how to walk

92
Q

which domains are required to learn how to perform a breast self-exam

A

cognitive and psychomotor domains

93
Q

assessing wounds: questions to ask yourself as the nurse (5)

A
  1. open or closed
  2. acute or chronic
  3. clean or contaminated
  4. infected
  5. superficial/partial or full thickness
94
Q

stage 1 pressure injury

A

skin is intact
red or purple
inflamed

95
Q

stage 2 pressure injury

A

partial thickness skin loss
dermis is exposed

96
Q

stage 3 pressure injury

A

full thickness skin loss
slough and eschar may be visible
necrosis of the subq tissue
may appear like a crater

97
Q

stage 4 pressure injury

A

full thickness skin and tissue loss
slough and eschar
tissue necrosis
muscle/bone damage

98
Q

unstageable pressure injury

A

too much slough and eschar to be properly staged

99
Q

serous exudate drainage color

A

straw colored

100
Q

sanguineous drainage color

A

bloody drainage

101
Q

serosanguineous drainage color

A

mix of bloody and straw colored drainage

102
Q

purulent drainage color

A

yellow, contains pus

103
Q

what is the function of a wound vac

A

provides negative pressure and foam to help the wound close; airtight seal with suction

104
Q

wound vac is used for what type of wound

A

wet; mostly chronic but sometimes acute

105
Q

what does the nurse do first if there is a wound evisceration (organs out)

A

put saline and sterile gauze

106
Q

what are important things to eat when you have a wound that is trying to heal

A

calories
protein
vitamin A & C
zinc

107
Q

how to care for an immobile patient

A

ROM exercises
TCBD
circulatory stockings
ambulate
dangle legs prior to walking
I & O
turning patient
nutrition
elevate legs

108
Q

SOAP note

A

SUBJECTIVE- what patient states
OBJECTIVE- what is observed (vitals)
ASSESSMENT- what you think is wrong using sub and obj data
PLAN- the patient goals

109
Q

ISBAR

A

IDENTIFY- Introduce yourself and pt
SITUATION- Here are the vitals, I’m calling because,
BACKGROUND- Diagnosis, previous illnesses, allergies
ASSESSMENT- “I think the problem is this” “idk what the problem is”
RECOMMENDATION- “i suggest this, what is your recommendation?”

110
Q

what are advanced directives

A

legal documents that provide instructions for care such as DNR or medical power of attorney

111
Q

how to care for a dying patient

A

make them comfortable

112
Q

symptoms 1-3 months prior death

A

withdrawal
decreased food intake
increased sleep
increased pain

113
Q

symptoms 1-2 weeks prior death

A

disorientation
increased perspiration
decreased BP
respiratory changes
erratic pulse
changes in skin color

114
Q

symptoms 1-2 days or hours prior death

A

death rattle
decreased output
restless
glassy gaze
talking to the unknown
mottling of skin
decreased LOC
surge of energy

115
Q

as a nurse it is important to _____ before going in to care for a dying patient

A

develop a personal understanding of your emotions about grief and death

116
Q

characteristics of pain

A

location
timing
severity

117
Q

what pain scale would be used in children

A

Wong-Baker pain scale

118
Q

non-pharmacological pain management

A

acupuncture
acupressure
massage
heat/cold
distraction

119
Q

non opioid analgesics

A

NSAIDS
acetaminophen

120
Q

opioid analgesics

A

morphine
hydrocodone
oxycodone

121
Q

narcotics side effects

A

n/v
constipation
CNS depression
respiratory depression

122
Q

narcotics respiratory depression antidote

A

narcan

123
Q

when a smiling cooperative patient complains of discomfort, nurses caring for this patient often harbor misconceptions about the patient’s pain. which of the following are true?

a. chronic pain is psychological in nature
b. patients are the best judges of their pain
c. regular use of narcotic analgesics leads to drug addiction
d. amount of pain is reflective of actual tissue damage

A

patients are the best judges of their pain

124
Q

a patient has just undergone an appendectomy. when discussing with the patient, several pain relief interventions, the most appropriate recommendation would be?

a. adjunctive therapy
b. nonopioids
c. NSAIDS
d. PCA pain management

A

PCA pain management

125
Q

a post-op patient is using PCA. you will evaluate the effectiveness of the medication when:

a. you compare assessed pain with baseline pain
b. body language is incongruent with reports of pain relief
c. family members report that pain has subsided
d. vital signs have returned to normal baseline

A

you compare assessed pain with baseline pain

126
Q

airborne infection prevention methods

A

PPE like N95 mask
negative pressure room with door closed

127
Q

droplet infection prevention methods

A

surgical masks within 3 feet of the patient
goggles, gloves
hand hygiene
put mask on patient during transport

128
Q

contact infection prevention methods

A

gloves, gown

129
Q

how is MRSA transmitted

A

person to person contact
contaminated objects

130
Q

what is reverse isolation

A

positive pressure room
no flowers or fruit
goal is to protect patient from exposure to microorganisms

131
Q

what is medical asepsis

A

clean technique like handwashing
eliminates most microorganisms

132
Q

what is surgical asepsis

A

sterile technique eliminates all microorganisms

133
Q

what are the 5 moments for hand washing

A
  1. before touching patient
  2. before procedure
  3. after body fluid exposure risk
  4. after touching patient
  5. after touching patient’s surroundings
134
Q

PPE for splash risk

A

gown
mask
gloves
goggles

135
Q

infant HR

A

120-160

136
Q

toddler HR

A

90-140

137
Q

preschool age HR

A

80-110

138
Q

school aged child HR

A

75-100

139
Q

adolescent HR

A

60-90

140
Q

adult HR

A

60-100

141
Q

new born RR

A

30-60

142
Q

infant RR

A

30-50

143
Q

toddler RR

A

25-32

144
Q

child RR

A

20-30

145
Q

adolescent RR

A

16-20

146
Q

adult RR

A

12-20

147
Q

general adaptation syndrome (GAS) and what are the 3 stages

A

describes the process your body goes through when experiencing stress
1. alarm stage (flight or flight)
2. resistance stage
3. exhaustion stage

148
Q

reaction to psychological stress (2)

A

coping
defense mechanisms

149
Q

chronic stress:
occurs where?
results from?

A

occurs in stable conditions
results from stressful roles

150
Q

acute stress

A

time-limited events that threaten a person for a relatively brief period provoke acute stress

151
Q

crisis characteristics

A

developmental, situational, adventitious

152
Q

3 factors influencing stress

A

situational factors
maturational factors
sociocultural factors

153
Q

situational factors leading to stress

A

job
illness
caregiver stress

154
Q

maturational factors

A

genetics, temperament, learning style, etc

they vary with life stages

155
Q

sociocultural factors

A

environmental, social, and cultural stressor perceived by children, adolescents, and adults

156
Q

Neuman systems model uses what approach

A

systems approach based on the concepts and reactions of stress

157
Q

Roy’s adaptation model

A

a person has the ability to modify external stimuli to allow for adaptation to occur

158
Q

Pender’s health promotion model focuses on

A

promoting health and managing stress

159
Q

what is compassion fatigue

A

when you are exhausted for caring for others
burnout from stress
emotional exhaustion

160
Q

second victim syndrome

A

when a medical error occurs that inflicts significant harm to the patient and the patient’s family

161
Q

nursing dx for stress

A

anxiety
despair
difficulty coping
risk for post trauma response
stress overload

162
Q

normal BP for a 1 mo old

A

85/54

163
Q

normal BP for a 1 yr old

A

95/65

164
Q

normal BP for a 6 yr old

A

105/65

165
Q

normal BP for a 10-13 yr old

A

110/65

166
Q

normal BP for a 14-17 yr old

A

119/75

167
Q

normal BP for 18+ yr old

A

120/80

168
Q

elevated BP for 18+

A

systolic= 120-129
and
diastolic= less than 80

169
Q

HTN stage 1 for 18+

A

systolic=130-139
or
diastolic= 80-89

170
Q

HTN stage 2 for 18+

A

systolic= 140-180
or
diastolic= 90-120

171
Q

hypertensive crisis for 18+

A

systolic= 180+
and/or
diastolic= 120+

Foundations (4 decks)

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