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Flashcards in fundies finals Deck (90):
1

what do we know the first five nursing today

---

2

what are some of the things that you have to do to keep your licensure?

CE or continuing education

3

you're taking care of a pt and you are encouraging him to drink more fluids, what concept is that?

autonomy

4

tell me about the nurse practice act?

protects us and the population (patients)

5

you're the charged nurse, a couple of employees called in, another unit has a decreased patient status, they are going to send nurses to your department -- what concept does the situation entail?

select all that apply

autonomy, team work, collaboration, accountability

6

The principles of right and wrong to provide care for the patient

code of ethics

7

why is nursing defined as a profession?

perform specific skills

8

founder of american nursing

florence nightingale

9

why do we need to know this stuff in terms of theory?

explains what nurses do and why they do it

10

which action indicates that the nurse is using the nursing process (ADPIE) in patient care?

critical thinking, doing things in a systemic way.
(systematically, being organized, putting things in order)

11

which action indicates the nurse is using the nursing process?

ADPIE

12

so as a nurse we use the nursing theory and nursing process simultaneously -- how would the nurse use nursing theory and nursing process simultaneosly?

nursing theory can direct how the nurse uses the nursing process

13

which action would the nurse take when teaching family about fall precautions?

keep the pt on fall risk until discharged

14

to do a nursing diagnosis, what is a nursing diagnosis for a pt who is pulling the iv, trying to get out of bed and is confused?

risk for injury

15

pt vitals, which would the nurse address immediately?

--

16

tell me about the national patient safety goals?

set to achieve patient safety (standarized)

17

which indication states that the nurse is following the NPSG?

use medication barcoding when giving medications

18

what are some of the things that you know about restraints?

need a dr order call health care provider, write the type and location of the restrains, they have to come and do a face to face assessment. the healthcare provider has to be notified. he is going to tell you the duration and the circumstance under which the restraints to be used

19

what do you know about transporting a patient under isolation precautions?

he has to wear mask
(PPE)

20

you have a variety of patients to choose from but it asks you what med surg pt is most at risk to develop infection?

somebody who has had surgery (due to open wound)

21

you have a variety of patients to choose from but it asks you what med surg pt is most at risk to develop infection?

somebody who has had surgery (due to open wound)

22

you are teaching a family member about dressing changes, what answer indicates that he understood your directions in terms of changing the dressing?

--

23

you are getting a patient with tuberculosis (select all that apply)

n95 mask, negative pressure private room, put the sign out (communication of airborne precautions)

24

about to help maintain skin integrity in older adults.

--

25

teaching a diabetic pt about proper foot care, which priority goal is the nurse trying to achieve?

prevention of loss of limb (amputation)

26

what is an NAP? nursing assistant personnel. watching them, what action would require the nurse to intervene?

-- there is an injury to the patient and she is trying to move that part

27

how would you do perineal care on a uncircumcised patient

pull back foreskin, clean inside to out, put foreskin back

28

providing hygiene care to a patient, what do we know about individuals?

no two individuals perform hygiene in the same manner

29

what is the purpose of patient medical records?

continuity of care, cover your butts, because the lack of communication

30

if an error is made what do you do?

one line through with black ink and initial

31

what could lead to malpractice
(select all that apply)

falsifying records, charting in advance, documenting incorrect data, not charting the correct date/time, documenting you did something that was not done

32

what action do you think the nurse should take when using critical thinking to make decisions?

prioritize, consider what is more important in any situation

33

the NAP tells you that a patient has very low pulse, what do you do?
(in terms of ADPIE)

evaluation
(evaluate)

34

which action indicates that a registered nurse is being responsible about making clinical decisions?

takes immediate action when one of the patients condition worsens

35

which action indicates that a nurse is using critical thinking skills to make the best decisions?
what do nurses rely on?

(which action by a nurse indicates application of the critical thinking model to make the best clinical decisions?)

ADPIE the nursing process

36

The nursing process always organizes your approach. To provide the best care, the nurse uses the?

nursing process and critical thinking

37

what happens when you become self aware about your biases and attitudes of human behavior?

provide the same care. (equal and standardized)

TRUE (true or false question)

38

health disparities are unequal burdens of disease, morbidity, and mortality rates experienced by racial and ethnic groups. these are often exaggerated by?

showing bias, stereotyping, prejudice

39

providing care to an ethnic group, what is the most important factor?

communication (language barrier)

40

braden scale (skin integrity)
the Braden score that will be the best risk for skin breakdown

higher the score, the better the persons skin integrity is

41

primary, secondary, and tertiary intention? what would an appendectomy be? incision is man made it would be primary.

man made- primary

(secondary is maybe an injury, and bedsore is tertiary)

42

updated careplan you develop for a pt with impaired skin intergiry , which finding indicates achievements of goals and outcome? (select all that apply)

granulation, intact with no redness, blanchable

43

what is the most important lab to look at a patient with pressure ulcer

albumin

44

taking care of a patient who always slides down, immobile. what would you worry about?

shearing

45

highest priotity before giving patient a physical exam

preparing the pt (psychological preparation)

46

when does s2 occur?

aortic and pulmonic valves close during s2

47

tell me about the GCS- rate person in terms of GCS

--

48

doing assessment on a patient, what finding will you record as normal?

--

49

pain is

what the patient says it is

50

you have a patient who is smiling and cooperate but complaints of discomfort

patient is the best judges of their pain

51

what kind of pain management would you envision of care for a patient with an appendectomy (or surgery?)

PCA pump (pain controlled analgesia)

need a higher dose if the pt hit the button too many times, call and inform health care provider

52

how would you evaluate the effectiveness of medication? (PCA)

assess the patients baseline and did it change?

53

select all that apply:
patient has been diagnosed with PNA and is in pain, which of the following would be priority in assessment?

pain level, lung sounds, pulmonary edema, peripheral edema, color of nail bed

54

taking care of pt with hx of arthritis and has sensitivity and the knees are warm, how would u determine the degree of limitations??

ROM

55

taking car of pt with a stroke and pt is unable to move right arm and right leg, while doing passive ROM what would indicate successful goal achievement?
what are you maintaining?

joint mobility

56

care for a group of patients, which patient would you assess first?

heart attack is the correct ans
(not COPD, HTN, Diabetes)

57

how would you assemble the Hoyer lift?
where would you put the long straps?

around the legs

58

asking you about moving a patient, who is able to assist a bit, which principle would the nurse consider when planning safe pt handling?
select all that apply

safe body mechanics, use of legs and arms, use proper body mechanics, face the direction that you are moving the patient to

59

why would you race the height of the bed up for a pt that is bedridden?

so you dont hurt your back, base of support for the nurse,

60

pt with Diabetes mellitus is voicing concerns about kidney disease and asks where is the urine formed?

in the nephron

61

you are a health care provider caring for a pt . you suspect a patient is experiencing urinary retention when the patient shows what signs?

voids small amounts and needs to use the restroom all the time

62

factor influence urination

medications, pathological condition, diagnostics, surgical procedures

63

how do you get a clean catch?

wipe front to back, catch midstream,
--hold the labia apart while voiding into the speciment--

64

who should the nurse see first? (urinary)

highest blood pressure

65

patient is hospitalized for heart attack,

low sodium, low fat, low carbs

66

You are ordered to give enteral tub feeding, the first step is to?

put a small amount of fluid into the tube before feeding

67

you have to choose a pt that is at risk for alteration and nutrition?

3 skinnys and fat ? the answer is fat -- listen to recording. it would be the overweight patient

68

what is choose my plate?

website that tells you about portion control and tells you what you should be eating and how much of

-balance calories

69

select all that apply
pt asks the nurse what is the best way to stay healthy

physical activity, diet, hydrate, maintain body weight

70

when you put the patient on a bed pan, how will the position of the bed be?

lift HOB to 30 degrees
(Semi fowlers)

71

fluid and electrolytes, where do they get absorbed?

small intestines

72

difference between constipation, fecal impaction and fecal incontinence

==

73

pt admitted and is on meds. stool are dry and hard to pass

constipation

74

not passing (BM could be diarrhea like)

fecal impaction

75

why wold u tell the pt that the best time to deficate is an hour after meals. what happens an hour after eating?

mass colonic peristalsis

76

pt with an ileostomy, what would you educate pt about nutrition?

drink a lot of water

77

bowel training

go to bathroom at certain times, activity(maintain normal exercise), choose a time base, document times and help the patient to the toilet at the designated times

78

which of the following would not provide meaningful stimuli for a patient?

TV set on low

79

you have a pt with sensory loss and we need to protect him from injury, you just met him and what is the first thing you are gonna do?

assess the patient, the areas of sensory loss

80

visual alterations and you are assessing the ability to self care -- it gives 4 different scenarios -- which one would be most important?

preparing a meal (fire)

81

caring for an older pt that has sensory deprivation, what would be the most important action?

she doesn't like this question

82

select all that apply,
safety issues, home healthcare nurse inspecting a patients home, which findings would you address in terms of safety?

scattered rugs, poor lit stares, absence of fire alarms

83

roles of a person who prepares and budget, policy in a unit. what is that persons role?

manager

84

the nurse that is involved with the patients and the patients environment. which theorist is involved with the patient and the patient environment?

florence nightingale

85

osmosis

Water moves across cell membranes by osmosis, a process by which water moves through a membrane that separates fluids with different particle concentrations. Cell membranes are semi-permeable, which means that water crosses them easily but they are not freely permeable to many types of particles, including electrolytes such as sodium and potassium. These semi-permeable cell membranes separate interstitial fluid from ICF. The fluid in each of these compartments exerts osmotic pressure, an inward-pulling force caused by particles in the fluid. The particles already inside the cell exert ICF osmotic pressure, which tends to pull water into the cell. The particles in the interstitial fluid exert interstitial fluid osmotic pressure, which tends to pull water out of the cell. Water moves into the compartment that has a higher osmotic pressure (inward-pulling force) until the particle concentration is equal in the two compartments.
If the particle concentration in the interstitial compartment changes, osmosis occurs rapidly and moves water into or out of cells to equalize the osmotic pressures. For example, when a hypotonic solution (more dilute than normal body fluids) is administered intravenously, it dilutes the interstitial fluid, decreasing its osmotic pressure below intracellular osmotic pressure. Water moves rapidly into cells until the two osmotic pressures are equal again. On the other hand, infusion of a hypertonic intravenous (IV) solution (more concentrated than normal body fluids) causes water to leave cells by osmosis to equalize the osmolality between interstitial and intracellular compartments.

86

intracellular fluid (ICF)

inside the cells
2/3 of total body water

87

extracellular fluid (ECF)

outside the cells
1/3 of total body water
two major divisions: intravascular and interstitial fluid
minor division: transcellular fluid

88

Stages of the Sleep Cycle

Stage 1: NREM
• Stage lasts a few minutes.
• It includes lightest level of sleep.
• Decreased physiological activity begins with gradual fall in vital signs and metabolism.
• Sensory stimuli such as noise easily arouse person.
• When awakened, person feels as though daydreaming has occurred.

Stage 2: NREM
• Stage lasts 10 to 20 minutes.
• It is a period of sound sleep.
• Relaxation progresses.
• Body functions continue to slow.
• Arousal remains relatively easy.

Stage 3: NREM
• Stage lasts 15 to 30 minutes.
• It involves initial stages of deep sleep.
• Muscles are completely relaxed.
• Vital signs decline but remain regular.
• Sleeper is difficult to arouse and rarely moves.

Stage 4: NREM
• Stage lasts approximately 15 to 30 minutes.
• It is the deepest stage of sleep.
• If sleep loss has occurred, sleeper spends considerable part of night in this stage.
• Vital signs are significantly lower than during waking hours.
• Sleepwalking and enuresis (bed-wetting) sometimes occur.
• It is very difficult to arouse sleeper.

REM Sleep
• Stage usually begins about 90 minutes after sleep has begun.
• Duration increases with each sleep cycle and averages 20 minutes.
• Vivid, full-color dreaming occurs; less vivid dreaming occurs in other stages.
• Stage is typified by rapidly moving eyes, fluctuating heart and respiratory rates, increased or fluctuating blood pressure, loss of skeletal muscle tone, and increase of gastric secretions.
• It is very difficult to arouse sleeper.
NREM, Nonrapid eye movement; REM, rapid eye movement.

89

stages of death

Denial – The first reaction is denial. In this stage, individuals believe the diagnosis is somehow mistaken, and cling to a false, preferable reality.

Anger – When the individual recognizes that denial cannot continue, they become frustrated, especially at proximate individuals. Certain psychological responses of a person undergoing this phase would be: "Why me? It's not fair!"; "How can this happen to me?"; "Who is to blame?"; "Why would this happen?".

Bargaining – The third stage involves the hope that the individual can avoid a cause of grief. Usually, the negotiation for an extended life is made in exchange for a reformed lifestyle. People facing less serious trauma can bargain or seek compromise. For instance: "I'd give anything to have him back." Or: "If only he'd come back to life, I'd promise to be a better person!"

Depression – "I'm so sad, why bother with anything?"; "I'm going to die soon, so what's the point?"; "I miss my loved one; why go on?"
During the fourth stage, the individual despairs at the recognition of their mortality. In this state, the individual may become silent, refuse visitors and spend much of the time mournful and sullen.

Acceptance – "It's going to be okay."; "I can't fight it; I may as well prepare for it."
In this last stage, individuals embrace mortality or inevitable future, or that of a loved one, or other tragic event. People dying may precede the survivors in this state, which typically comes with a calm, retrospective view for the individual, and a stable condition of emotions.

90

oxygenation devices

NC-
flow: 1/4-6L
use: short or long term use with minimum o2 requirements

non-rebreather-
flow: 6-15L
use: clients in respiratory failure, emergency trauma pt's

venturi-
flow: 4-12L
use: specific flow rate set to deliver specific fi02 humidified oxygen

simple mask-
flow: 5-8L
use: short term with moderate o2 requirements

n95 respirator-
An N95 respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles. The 'N95' designation means that when subjected to careful testing, the respirator blocks at least 95% of very small (0.3 micron) test particles.