inp Flashcards
(155 cards)
1
Q
What is the primary objective for nurses when caring for older adults?
A
Perform comprehensive assessments & interventions for older adults.
This includes understanding their unique needs and health conditions.
2
Q
What are some common myths about older adults?
A
- They are always ill or disabled
- They are confused or forgetful
- They are boring or inflexible
- They are asexual or uninterested in intimacy
Nurses must challenge ageism.
3
Q
What does culturally competent care involve?
A
Respecting each individual’s background and using cultural knowledge to promote health & healing.
This definition is based on the work of Leininger & McFarland (2002).
4
Q
What are some physiological changes associated with aging?
A
- Wrinkles, dry skin
- Less lung elasticity
- Stiff vessels leading to increased blood pressure
- Periodontal disease
- Muscle loss and bone decalcification
These changes can impact daily function and quality of life.
5
Q
What is presbycusis?
A
Age-related hearing loss, especially high frequencies.
It is a common auditory change in older adults.
6
Q
True or False: Older adults do not experience significant cognitive changes.
A
False.
Cognitive disorders such as delirium and dementia are prevalent in older adults.
7
Q
What are common health risks for older adults?
A
- Heart disease
- Cancer
- Arthritis
- Falls
These are leading causes of morbidity and mortality in the elderly.
8
Q
What is the normal range for pulse in adults?
A
60–100 bpm.
Factors such as exercise, temperature, and emotions can influence pulse rate.
9
Q
What is the acceptable SpO₂ range for patients with chronic illness?
A
85–89%.
In conditions like COPD, slightly lower oxygen saturation levels may be considered acceptable.
10
Q
Fill in the blank: The _______ is the primary pacemaker of the heart.
A
Sinoatrial (SA) Node.
It initiates the electrical impulse that regulates heartbeats.
11
Q
What are the components of a comprehensive assessment for older adults?
A
- Mental & sensory status
- Physical function
- Self-care ability
- Support system
- Use of assistive devices
This holistic assessment helps in understanding the overall health of older adults.
12
Q
What is the normal range for respiratory rates in adults?
A
12–20 breaths/min.
This range is considered normal for resting adults.
13
Q
What is the antidote for morphine overdose?
A
Naloxone.
Naloxone is an opioid antagonist that can reverse the effects of opioid overdose.
14
Q
True or False: Documentation in nursing must be accurate, timely, and factual.
A
True.
Accurate documentation is a legal, ethical, and professional responsibility.
15
Q
What are the types of diuretics?
A
- Thiazide
- Loop
- Potassium-sparing
Each type has different mechanisms and considerations for patient management.
16
Q
What are some nursing interventions for patients with vision changes?
A
- Reduce glare
- Provide large-print materials
- Ensure safe walking spaces
These interventions help improve safety and quality of life for older adults with visual impairments.
17
Q
What is Naloxone?
A
Opioid antagonist 💉
Used to reverse opioid overdose.
18
Q
Which medication is a beta-blocker?
A
Metoprolol (B)
Ends in -lol, indicating it’s a beta blocker.
19
Q
Which class of medication conserves potassium?
A
Potassium-sparing diuretics (C)
Example: Spironolactone retains K⁺.
20
Q
What are the learning objectives of Session 3 on Diabetes Care & Insulin Administration?
A
- Safely dispose of sharps
- Assess and care for older adults with diabetes
- Apply BCCNM standards in residential care
- Insert and manage a percutaneous infusion device (PID)
21
Q
What is the pathophysiology of diabetes?
A
Chronic disorder affecting metabolism, leading to vascular & neurologic complications and elevated blood glucose (hyperglycemia).
22
Q
What is the role of insulin in the body?
A
Produced by beta cells in the pancreas, insulin lowers blood glucose.
23
Q
What characterizes Type 1 Diabetes?
A
No endogenous insulin due to autoimmune destruction of beta cells, onset in childhood, requires lifelong exogenous insulin.
24
Q
What characterizes Type 2 Diabetes?
A
Inadequate insulin or insulin resistance, common in adults, managed with diet, exercise, oral medications, and possibly insulin.
25
List microvascular complications of diabetes.
* Retinopathy
* Neuropathy
* Nephropathy
26
List macrovascular complications of diabetes.
* Coronary Artery Disease (CAD)
* Stroke (CVA)
* Peripheral Vascular Disease (PVD)
27
What is Diabetic Ketoacidosis (DKA)?
Severe complication of Type 1 diabetes characterized by hyperglycemia, ketones in urine/serum, acidosis, dehydration, and electrolyte imbalance.
28
What is the normal range for Fasting Blood Sugar (FBS)?
3.9–6.1 mmol/L
29
What is the average blood glucose measurement period for A1C?
3 months
30
What are the types of insulin based on onset?
* Rapid-acting: 15–30 min
* Short-acting: 30 min–1 hr
* Intermediate: 1–3 hrs
* Long-acting: ~60 min
31
What is sliding scale insulin?
Dose based on current blood glucose, used in hospitals and for patients on tube feeds/TPN.
32
What is the 15-15 Rule for treating hypoglycemia?
15g carbs → wait 15 mins → retest.
33
What are the classic signs of hyperglycemia?
* Polyphagia
* Polydipsia
* Polyuria
34
What is the expected therapeutic effect of a medication?
Expected/desired outcome.
35
What is the definition of an adverse effect?
Dangerous, severe reaction to a medication.
36
What is the role of a prescriber in medication administration?
Writes routine, PRN, STAT, now, or single orders.
37
What is the correct order when mixing two types of insulin?
Clear before cloudy.
38
What should the nurse do first if a patient refuses a prescribed medication?
Ask the patient why they are refusing it.
39
Which oral medication is a Biguanide that increases insulin sensitivity?
Metformin (B)
40
What is the main risk associated with diabetes foot care?
Risk from neuropathy and poor circulation.
41
What is the significance of the Controlled Drugs and Substances Act?
Regulates narcotics and controlled substances.
42
What is the definition of medication interactions?
One med affects the action of another.
43
What are the causes of medication errors?
* Distraction
* Illegible orders
* Misinterpreted abbreviations
* Skipping 10 rights
44
What should you never do with enteric-coated medications?
Do NOT crush.
45
What is the main purpose of self-monitoring of blood glucose (SMBG)?
Track blood sugar for food, activity, and medications.
46
What is the duration of rapid-acting insulin?
15–30 minutes.
47
What should the nurse do first if a patient refuses a prescribed medication?
D — Ask the patient why they are refusing it
## Footnote
Always assess why the patient is refusing before taking further action.
48
What is the most appropriate nursing action when preparing to administer an EC (enteric-coated) tablet via an enteral feeding tube?
C — Contact the prescriber or pharmacy for an alternative form
## Footnote
EC tablets should not be crushed; get an alternative form.
49
Which medication route is not within the LPN Scope of Practice in BC?
C — Intrathecal
## Footnote
Intrathecal meds are not within LPN scope.
50
What should you do before giving a PRN dose of morphine?
C — Assess subjective and objective pain data
## Footnote
Always assess pain before administering PRN meds.
51
What is a toxic effect of a medication?
C — An accumulation of the drug in the bloodstream
## Footnote
Toxic effect = drug builds up to harmful levels.
52
What must be documented after medication administration?
C — The medication given, dose, route, and patient response
## Footnote
Document what you gave, how, when, and patient’s response.
53
What does 'peak' mean in pharmacology?
C — When the drug is at its highest concentration in the blood
## Footnote
Peak = highest serum concentration.
54
What is the best action if a medication order is unclear or illegible?
D — Call the prescriber directly to clarify
## Footnote
Never guess. Always verify with the prescriber.
55
Which route would be most appropriate for a fast onset in an emergency?
C — Intravenous
## Footnote
IV = fastest onset, ideal for emergencies.
56
What are the medication routes?
* Oral
* Topical
* Subcutaneous
* Intramuscular
* Intradermal
* Inhalation
## Footnote
Don’t forget: Document and report administration in residential care settings.
57
What should the nurse consider before oral administration?
* GI issues
* Swallowing ability
* Gastric suction
* Proper positioning
## Footnote
Consider these factors to ensure safe oral medication administration.
58
What is important for topical administration?
* Use gloves or applicators
* Clean/prep skin
* Apply correct thickness
## Footnote
Quick Quiz: Best way to avoid contamination? Answer: Wear treatment gloves during the entire process.
59
What should be assessed before nasal instillation?
* Assess nostrils
* Educate for self-administration
* Correct positioning
## Footnote
Proper assessment and education are essential for effective nasal administration.
60
What is important for eye instillation?
* Aseptic technique
* Eye assessment
* Positioning is key
## Footnote
Proper technique prevents injury and maintains sterility during eye administration.
61
What should be assessed for ear instillation?
* Assess ear canal
* Warm solution
* Straighten canal (differs for kids/adults)
## Footnote
Correct positioning matters for effective ear administration.
62
What should be ensured before administering a rectal suppository?
C — Client is in a side-lying position
## Footnote
This position supports comfort and proper retention of medication.
63
What is the purpose of a spacer in MDI use?
B — Reduce medication loss
## Footnote
A spacer helps more of the medication reach the lungs instead of being lost in the mouth/throat.
64
What should be performed with irrigation?
* Sterile water
* Saline
* Antiseptic
## Footnote
Maintain strict asepsis during irrigation to prevent infection.
65
Which action is not within the LPN scope of practice?
B — Administering IV push meds
## Footnote
LPNs are not allowed to give IV push medications.
66
What is required for an LPN to administer Schedule I medications?
C — Client-specific order from an authorized health professional
## Footnote
This is necessary for administering Schedule I, IA, or II medications.
67
What is the maximum volume for intramuscular injections?
Up to 3 mL for VL/VG sites
## Footnote
Deltoid can accommodate 2 mL.
68
What is the injection angle for intramuscular injections?
90°
## Footnote
Correct angle is essential for effective administration.
69
What should be done to prevent needlestick injuries?
* Use needleless systems
* Dispose sharps immediately in approved containers
## Footnote
Follow post-exposure protocols if injured.
70
What are the Ten Rights of Medication Administration?
* Right medication
* Right dose
* Right patient
* Right route
* Right time
* Right documentation
* Right reason
* Right to refuse
* Right education
* Right evaluation
## Footnote
These rights ensure safe medication practices.
71
What should be done if the wrong route is given?
Assess patient, report, and document
## Footnote
Immediate action is necessary to ensure patient safety.
72
What is the fastest absorption route for medications?
Intravenous
## Footnote
Injection routes absorb faster than oral medications.
73
What are the Ten Rights of medication administration?
* Right medication
* Right dose
* Right patient
* Right route
* Right time
* Right documentation
* Right reason
* Right to refuse
* Right patient education
* Right evaluation
## Footnote
These rights ensure safe medication administration practices.
74
What is enteral nutrition?
Nutrients delivered into the GI tract through a feeding tube
## Footnote
Enteral nutrition is used when a patient can’t eat enough by mouth.
75
What are the types of feeding tubes?
* NG (Nasogastric)
* NI (Nasoenteric/Jejunostomy)
* Gastrostomy (G-Tube)
* Jejunostomy (J-Tube)
## Footnote
Each type serves different purposes based on patient needs.
76
What are two critical assessments a nurse must make before administering an injection?
* Condition of the injection site
* Confirm right medication, dose, patient, route, and time
## Footnote
These assessments help prevent complications and ensure patient safety.
77
What nursing action is most important before administering an enteral feed?
Elevate the head of the bed to at least 45°
## Footnote
This position reduces the risk of aspiration during feeding.
78
What is the maximum volume for a deltoid IM injection in an adult?
2 mL
## Footnote
The deltoid muscle can safely absorb up to this volume.
79
What is the proper response if you accidentally administer a subcutaneous medication intramuscularly?
Report the error, monitor the patient, and document the incident
## Footnote
Patient safety and transparency are critical in medication administration.
80
What are the signs of feeding tube displacement or complication?
* Sudden coughing, gagging, or vomiting
* Change in tube length at insertion site
* pH outside expected range (e.g., >6 for stomach)
* Aspiration symptoms (e.g., wheezing, crackles)
## Footnote
Monitoring for these signs is crucial for patient safety.
81
What is the purpose of the Braden Scale?
To assess the risk of developing pressure injuries
## Footnote
The scale evaluates factors such as sensory perception, moisture, activity, mobility, nutrition, and friction & shear.
82
Fill in the blank: The Z-track method is used for _______.
irritating IM medications
## Footnote
This technique helps minimize tissue irritation during injection.
83
True or False: It is safe to reuse a needle for the same patient if it's for a second injection.
False
## Footnote
One needle, one syringe, one time to prevent infection and complications.
84
What are the types of ostomies?
* Colostomy
* Ileostomy
* Urostomy
## Footnote
Each type of ostomy serves different bodily functions.
85
What is the initial method used to verify NG tube placement after insertion?
X-ray
## Footnote
X-ray is the gold standard for confirming correct placement.
86
What actions should be taken if a patient experiences aspiration during tube feeding?
Stop feed, turn pt, suction, notify HCP
## Footnote
Immediate action is necessary to ensure patient safety.
87
What is the normal appearance of a stoma?
Moist and reddish pink
## Footnote
This indicates good blood flow and health of the stoma.
88
What are the stages of pressure injuries?
* Stage I: Non-blanchable redness; skin intact
* Stage II: Partial-thickness skin loss; blister or open wound
* Stage III: Full-thickness loss with visible fat; possible slough/eschar
* Stage IV: Full-thickness loss with exposed bone, tendon, or muscle
## Footnote
Understanding these stages is essential for proper management and treatment.
89
What is Total Parenteral Nutrition (TPN)?
Nutritional support given via central line when GI tract can’t be used
## Footnote
TPN is used for patients who cannot receive enteral nutrition.
90
What are two ways to minimize pain when giving an insulin injection?
* Let alcohol prep dry before injecting
* Use room temperature insulin
## Footnote
These methods help reduce discomfort during administration.
91
What are the primary causes of pressure injuries?
Prolonged pressure and shear
## Footnote
These factors lead to ischemia and tissue damage.
92
What is the description of a Stage I pressure injury?
Non-blanchable redness; skin intact 🔴
## Footnote
This stage indicates early signs of pressure injury.
93
What characterizes a Stage II pressure injury?
Partial-thickness skin loss; blister or open wound 🩸
## Footnote
At this stage, the skin is not intact.
94
What is involved in a Stage III pressure injury?
Full-thickness loss with visible fat; possible slough/eschar 🧽
## Footnote
Tissue loss extends through the dermis.
95
What does a Stage IV pressure injury expose?
Exposed muscle, bone, or tendon; tunneling/undermining 🦴
## Footnote
This stage indicates severe tissue damage.
96
What is a Deep Tissue Injury?
Persistent deep red/purple discoloration; may be intact or not
## Footnote
This indicates potential damage beneath the skin.
97
What is an Unstageable pressure injury?
Covered by slough or eschar; depth unknown ⚫
## Footnote
The wound's depth cannot be determined due to necrotic tissue.
98
What are the types of wound tissue?
Granulation tissue, slough, eschar
## Footnote
Each type has distinct characteristics impacting healing.
99
What is granulation tissue?
Red, moist, healing ❤️🩹
## Footnote
Indicates effective healing of a wound.
100
What is slough?
Stringy yellow/white tissue that must be removed ⚠️
## Footnote
It can impede healing if not addressed.
101
What is eschar?
Black/brown necrotic tissue; nonviable ❌
## Footnote
Must be removed for proper healing.
102
What are the types of wounds?
Pressure ulcers, skin tears, venous ulcers, arterial ulcers, diabetic ulcers, surgical wounds, malignant/fungating wounds
## Footnote
Each type has specific causes and treatments.
103
What is primary intention in wound healing?
Clean edges, closed by sutures/staples
## Footnote
This method allows for the fastest healing.
104
What is secondary intention in wound healing?
Edges not approximated; healing by granulation
## Footnote
Typically takes longer than primary intention.
105
What is tertiary intention in wound healing?
Wound left open, closed later due to infection risk
## Footnote
This method involves delayed closure.
106
What are the phases of wound healing?
Inflammatory phase, proliferative phase, remodeling phase
## Footnote
Each phase has distinct processes and durations.
107
What occurs during the inflammatory phase of wound healing?
Hemostasis & immune response; redness, swelling, pain, warmth 🔥
## Footnote
Lasts from 0 to 3 days.
108
What happens during the proliferative phase of wound healing?
Granulation tissue & collagen formation; epithelial resurfacing 🌱
## Footnote
This phase lasts from 3 to 24 days.
109
What occurs during the remodeling phase of wound healing?
Scar tissue strengthens; less pigment → lighter color scars 🎨
## Footnote
Can last up to 2 years.
110
What are the types of wound drainage?
Serous, sanguineous, serosanguinous, purulent
## Footnote
Each type indicates different conditions of the wound.
111
What does serous drainage look like?
Clear, watery fluid 💧
## Footnote
This is typically a sign of normal healing.
112
What is sanguineous drainage?
Bright red blood ❤️
## Footnote
Indicates active bleeding.
113
What characterizes serosanguinous drainage?
Watery, pale pink fluid 🌸
## Footnote
This indicates a mix of serum and blood.
114
What does purulent drainage indicate?
Thick, yellow/green/brown fluid; indicates infection 🦠
## Footnote
This requires medical intervention.
115
What are common complications of wound healing?
Hemorrhage, infection, dehiscence, evisceration, fistula
## Footnote
These can significantly impact recovery.
116
What is the assessment focus for chronic wounds?
Size, color, depth, drainage type, palpation, pain assessment
## Footnote
Wound culture may be needed for infection.
117
What are examples of nursing diagnoses related to wounds?
Impaired skin integrity, risk for infection, acute/chronic pain, risk of pressure injury, imbalanced nutrition, deficient knowledge
## Footnote
These guide nursing care plans.
118
What are strategies for wound prevention?
Turn patients every 1–2 hours, hygiene, support surfaces, nutrition
## Footnote
Positioning aids and education on lifting techniques are also important.
119
What is the purpose of wound management?
Cleanse wound with sterile technique, debridement, nutrition, pain management
## Footnote
Each step is vital for effective healing.
120
What types of dressings are available?
Gauze, transparent film, foam, alginate, hydrocolloid, silver, etc.
## Footnote
Selection depends on wound type and condition.
121
What are the classifications of burns?
Thermal, electrical, chemical, radiation, friction, cold
## Footnote
Each type has different causes and treatment protocols.
122
What is the first degree burn?
Superficial; affects only the epidermis
## Footnote
Typically results in redness and pain.
123
What characterizes a second degree burn?
Partial thickness; involves epidermis and dermis
## Footnote
Blisters may develop.
124
What is a third degree burn?
Full thickness; extends through the skin layers
## Footnote
This type can damage deeper tissues.
125
What does a fourth degree burn involve?
Down to muscle, bone, etc.
## Footnote
This is the most severe burn classification.
126
What is the Rule of Nines used for?
Estimating the percentage of body surface area affected by burns
## Footnote
It helps guide treatment decisions.
127
What are common topical medications for burn care?
Silvadene, Sulfamylon
## Footnote
These help prevent infection and promote healing.
128
What are the types of oxygen delivery devices?
Nasal cannula, simple mask, partial rebreather, non-rebreather, Venturi mask
## Footnote
Each device has specific flow rates and FiO₂ levels.
129
What is the normal range for SpO₂ on a pulse oximeter?
95–100%
## Footnote
Readings below 70% indicate a medical emergency.
130
What is the purpose of incentive spirometry?
Promote deep breathing and lung expansion
## Footnote
It helps prevent atelectasis.
131
What is the first step before initiating oxygen therapy?
Review the medical order
## Footnote
Ensures the correct therapy is administered.
132
What is the definition of hypoxia?
Inadequate O₂ at tissue level
## Footnote
It can lead to serious complications if not addressed.
133
What are signs of impaired oxygenation?
Hypoxia, cyanosis, hyperventilation, hypoventilation, dyspnea
## Footnote
These symptoms indicate respiratory distress.
134
What is the role of the heart in oxygen transport?
Pumps blood through 4 chambers: right atrium, right ventricle, lungs, left atrium, left ventricle, body 🌍
## Footnote
This process is essential for delivering oxygen to tissues.
135
What is the difference between hypoventilation and hyperventilation?
Hypoventilation: too little CO₂ exhaled; Hyperventilation: too much CO₂ exhaled
## Footnote
Both can lead to respiratory issues.
136
What is the significance of the Braden Scale?
Helps assess risk for pressure injuries
## Footnote
It evaluates factors like moisture and mobility.
137
What are common respiratory conditions?
COPD, asthma, pneumonia, heart failure
## Footnote
Each condition has unique characteristics and treatment needs.
138
What allows the patient to re-inhale some exhaled gas?
Partial rebreather mask
## Footnote
A partial rebreather mask allows for the re-inhalation of some exhaled gases, which can increase oxygen intake.
139
What does the left ventricle pump blood into?
Systemic circulation
## Footnote
The left ventricle is responsible for pumping oxygenated blood into the systemic circulation, not pulmonary circulation.
140
What pulse oximeter reading is considered life-threatening?
Below 70%
## Footnote
A pulse oximeter reading below 70% indicates severe hypoxia and requires immediate medical attention.
141
Is cyanosis a reliable early sign of hypoxia?
False
## Footnote
Cyanosis is considered a late sign of hypoxia, indicating severe oxygen deprivation.
142
What can impact oxygenation and respiratory effort?
Chest deformities
## Footnote
Conditions such as kyphosis or barrel chest can impair effective breathing and oxygenation.
143
Name three signs or symptoms of hypoxia.
* Restlessness or anxiety
* Tachycardia
* Shortness of breath (dyspnea)
## Footnote
Cyanosis is also a sign but is considered a late indicator.
144
List four types of oxygen delivery devices and their typical flow rates or FiO₂.
* Nasal cannula: 1–6 L/min (24–40% FiO₂)
* Simple mask: 6–10 L/min (35–55% FiO₂)
* Partial rebreather: 6–10 L/min (35–60% FiO₂)
* Venturi mask: precise FiO₂ (24–50%)
## Footnote
Each device is used for different clinical situations based on the patient's needs.
145
What are three nursing assessments before starting oxygen therapy?
* Respiratory rate and pattern
* Pulse oximeter (SpO₂) reading
* Lung sounds
## Footnote
Additional assessments include reviewing medical orders and checking for contraindications.
146
Describe the difference between hypoventilation and hyperventilation.
* Hypoventilation: ↓ ventilation → CO₂ retention
* Hyperventilation: ↑ ventilation → CO₂ loss
## Footnote
Understanding these terms is crucial for managing respiratory conditions.
147
What are two LPN responsibilities regarding suctioning or oxygenation, according to BCCNM?
* Provide oxygen therapy with proper education & DST use
* Suction nasal passages (if trained)
## Footnote
LPNs may also provide care for well-established tracheostomies with appropriate education.
148
Gas exchange happens in the _______.
Alveoli
## Footnote
The alveoli are tiny air sacs in the lungs where oxygen and carbon dioxide are exchanged.
149
What should be done before starting oxygen therapy?
Review the medical order
## Footnote
Verification of the medical order is a critical step to ensure appropriate treatment.
150
Excessive breathing removes too much CO₂, resulting in _______.
Hyperventilation
## Footnote
Hyperventilation can lead to respiratory alkalosis and other complications.
151
Which oxygen delivery device delivers the most accurate and controlled FiO₂?
Venturi mask
## Footnote
The Venturi mask is designed to provide specific concentrations of oxygen, making it useful for patients requiring precise FiO₂.
152
What is the normal pulse oximeter SpO₂ range?
95–100%
## Footnote
A reading below 90% is considered a red flag and requires further investigation.
153
What device encourages deep breathing to expand the lungs?
Incentive spirometer
## Footnote
Incentive spirometry is often used post-operatively to prevent atelectasis.
154
Dependent edema is seen in ________ due to systemic congestion.
Right-sided heart failure
## Footnote
This condition occurs when the right side of the heart cannot effectively pump blood, leading to fluid accumulation.
155
True or False: LPNs may provide care to well-established trachs with additional education.
True
## Footnote
According to BCCNM scope of practice, LPNs can manage tracheostomies with appropriate training.
