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Nursing 300 > Knowledge Assesment 1 > Flashcards

Knowledge Assesment 1 Flashcards

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1
Q

Communication in nursing practices

A

Helps reduce risk of errors helps patients reach health rated goals

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2
Q

Demonstrating care

A

Being sensitive and supportive
Present and encouraging expression of feelings ( positive or negative)
Developing caring relationships
Instilling faith and hope
Promoting interpersonal teaching and learning
Respecting spiritual expression

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3
Q

Elements of professional communication

A

Appearance, behavior
Use of names
Courtesy
Trustworthiness
Autonomy, responsibility
Assertiveness

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4
Q

Intrapersonal

A

occurs within an individual

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5
Q

Interpersonal

A

One on one reaction between two people

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6
Q

Trans personal

A

Interaction within a persons spiritual domain

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7
Q

Small group

A

Interaction with a few people

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8
Q

Public

A

Interaction with an audience

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9
Q

Circular transactional model

A

Referent - content of the message
Sender and receiver - one who codes and one who decides the message
Messages
Channels - means of conveying and receiving messages
Feedback - the message the receiver returns
Interpersonal variables - factors that influence communication
Environment - setting of sender receiver conversations

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10
Q

Nonverbal communication

A

Personal appearance
Posture and gait
Facial expression
Eye contact
Gestures
Sounds
Territoriality and personal space

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11
Q

Zones of personal space

A

Intimate zone 0-18in
- bathing grooming dressing toileting and physical assessment
Personal zone 18in-4ft
- sitting at bedside, taking pt history, teaching, information exchange
Social zone 4-12ft
- making rounds w physicians, teaching a class, family support group
Public zone 12 ft and greater
- community forum, testifying at a legislative, lectures for class

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12
Q

Motivational interview

A

Encouraging pts to share thoughts, beliefs, fears, and concerns

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13
Q

Assessment measures

A

Physical and emotional
Developmental
Sociocultural
Gender

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14
Q

Therapeutic communication techniques

A

Active listening
Sharing observations, empathy, hope, humor, feelings,
Using touch and silence
Providing information
Clarifying
Focusing
Paraphrasing
Validation
Relevant questions
Summarizing
Self disclosure
Confrontation

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15
Q

Non therapeutic communication

A

Asking personal questions
Giving personal opinions
Changing the subject
Automatic responses
False reassurance
Sympathy
Asking for explanations
Approval/disapproval
Defensive responses
Passive aggressive responses
Arguing

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16
Q

Evaluation

A

Nurses and pts determine whether care plan was successful
Nursing interventions are elevated to see what was effective
Care plan needs to be modified

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17
Q

Nature of pain

A

Subjective
Involves physical emotional and cognitive components
Reduces quality of life

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18
Q

Physiology of pain

A

Transduction: activation of pain receptors
Transmission: conduction along pathways
Modulation: inhibition or modification of pain

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19
Q

Gate control therapy

A

Describes how relationships between pain and emotions - how you think and react to pain
Gating mechanism determines the impulses that reach the brain

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20
Q

Physiological responses

A

Ascending impulses going to the brain stimulate and ANS
Stress response is fight or flight
- increase RR, HR, blood glucose and muscle tension
Vasoconstriction , decreased GI motility, diaphoresis, pupil dilation
Continuous, severe, deep pain activates the parasympathetic NS
- pallor, N/V, decreased HR and BP, rapid irregular breathing

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21
Q

Behavioral responses to pain

A

Clenching teeth
Facial grimacing
Guarding painful area
Bent posture
* lack of pain expression does not mean a pt isn’t experiencing pain

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22
Q

Signs and symptoms of pain

A

Moaning or crying
Biting lips
Pacing
Change of VS
Tightly closed eyes
Wrinkled forehead
Muscle tension
Avoiding others
Rubbing

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23
Q

Somatic pain

A

Joints, bone, muscle, skin, connecting tissue

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24
Q

Visceral pain

A

Comes from major organs
Tumors
Obstructions

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25
Acute/ transient pain
Identifiable, short duration, limited emotional response
26
Chronic episode
Occurs sporadically over an extended duration
27
Chronic/persistent non cancer
May or may not have an identifiable cause
28
Idiopathic
Chronic pain without identifiable cause
29
Common biases of pain
Substance abuses Minor illness Taking pain meds on a continued basis Tissue damage Psychogenic pain is not real Chronic pain is psychological Patient who can’t speak have no pain
30
Factors that influence pain
Physiological Social Spiritual Psychological Pain tolerance Cultural
31
Pain assessment
Palliative or provocative- what makes it better and worse Quality Relief Region Severity Timing How the pain affects you
32
ABCDE’s of pain management
ASK about pain regularly BELIEVE the patient about pain CHOOSE appropriate pain control options DELIVER interventions in a timely manner EMPOWER patients and their families
33
Non pharm pain management
Relaxation Distraction Biofeedback Cuteaneous Herbals Reducing pain perception Control stimuli - loosen clothing, temperatures re positioning
34
Pharm pain management
Analgesics Non opioids, NSAIDS SE: GI bleed, renal insufficiency, liver failure not recommended for elderly Opioids: morphine, codeine, fentanyl, oxycodone, hydrocodone - respiratory depression, N/V, constipation PCA- patient controlled analgesics Patient can give meds by themselves - morphine, fentanyl, dilaudid
35
Analgesia
Local: procedures for loss of sensation- lidocaine Regional: epidural or a nerve block; need to protect from injury Perineurial: infusion at painful sight Topical: EMLA,Z lidocaine, lidoderm patch
36
Epidural catheter care
Prevent displacement Maintain function Prevent infection and complications Monitor VS Maintain urinary and bowel functions
37
Palliative care/ hospice
Assist patients to manage pain when life is limited Patient and family impnvolvement Support and care for patients in their last stage of life Pain controlv
38
Physical dependence
Withdrawal s/s if taken off drug quickly - shaking fever chills cramps joint pain excessive yawning
39
Addiction
Neurobiological disease with genetic, psychosocial, and environment factors influencing the development
40
Drug tolerance
Adaptation to drug that decreases its effects
41
Placebo use
No active ingredients and no therapeutic effect
42
Pseudo addiction
Chronic pain patient seeking out multiple healthcare providers to find relief from pain
43
Barriers to pain management
Fear of addiction, SE, and injections Aging Suffering in silence is noble
44
Pain perceptions
Attitude if health care provider towards pain patients Acknowledgement of pain through patients experiences
45
People are risk for adverse effects
Sleep apnea Obesity Older adults Co-morbidities No prior use Poly pharmacy Recent surgery Prolonged anesthesia Smoker
46
Pathogenic organism
Causes disease; needs specific measures: Ability to survive in host High virulence Strength in numbers And the hosts ability to prevent infection
47
Over use of antibiotics
Pathogens can become resistant to antibiotics
48
Transient organism
Ability of an organism to attach via skin to skin contact
49
Resident flora
Normal bacteria that stays in or on the body (non pathogenic)
50
Asymptomatic/ convulsant carriers
Have disease but do not show signs and symptoms
51
Modes of transmission
Airborne Droplet Contact Vector - insects and animals Vehicles- food, water, air
52
Reservoirs
Live in warm, moist areas, need right nutrition, some need oxygen, pH and acidity of environment, and dark lighting Living: humans, animals, and insects Non living: water,food, equipment, floors
53
Portal of exit
Same ways they came in they can come out
54
Portal of entry
Open wounds, exposure to blood, GI tract, respiratory system, urinary system, most body systems are portals of entry
55
Chain of infections
CAN ONLY OCCUR IN THIS SEQUENCE pathogenic organism Reservoir Portal of exit Modes of transmission Portal of entry Susceptible host We can learn what stage the infection is at and learn how to stop it
56
Stages of infection
Incubation period- pathogen successfully enter the body Prodromal period- nonspecific signs and symptoms begin Illness period- signs and symptoms become more specific Decline period- symptoms start to subside Convalesce- sickness is on the ending stages, feel better and symptoms are gone
57
Defenses against infection
Primary- skin, mucous membranes, cilia in nose, blinking Secondary- fever, inflammation, phagocytosis Tertiary- humoral immunity glob is ( igG, igM)
58
Factors that increase susceptibility
Chronic illness Immunization levels Developmental level Meds/antibiotics that decrease immune response Tobacco and alcohol use Environmental status
59
Factors that support hosts defenses
Nutrition Sleep Exercise Reducing stress Hygiene
60
Signs and symptoms of infection
Patient appearance- sweating, fatigue, pale, SOB, grimacing, change in wound, light sensitivity Vital signs- if no fever, ask if they took Motrin, pulse would be higher, RR and BP would stay the same unless pt anxious or stressed. O2 changes with respiratory infection s Diagnostic testing
61
Preventing infection precaution
PPE, hand hygiene, If airborne: gloves, gown, mask, negative pressure room If droplet: gloves, gown, mask, shield Contact: gloves, gown, mask, shield
62
Pharmacological concepts
Chemical- provides exact description of meds composition Generic- the manufacturer that first develops the drug assigns the name Official name- designated by FDA Trade- also known as brand or proprietary name. It’s the name under which a manufactured markets the medication Classification- effect on body system, relieved symptoms, and desired effect Forms of medication- solid, liquid, topical, parental
63
Drug absorption
Transportation of unmetabolized drug from the administration site to the circulation system Influencing factors Route of administration Ability to dissolve Blood flow at site of administration Body surface area Lipid solubility
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Medication actions
Distribution- protein binding, circulation, membrane permeability Metabolism- medications turn to less potent inactive form. Bio transformation breaks down and remove active chiemicals Excretion- medications exit the body ( kidney(main) , liver, bowels, lungs. Chemical make up determines route of exit
65
Medication actions
Therapeutic effect - predicted outcome Adverse effect - unintended outcome Idiosyncratic reaction - over or under reaction Side effects - unavoidable secondary effects Toxic effects- accumulation of medication in the blood Allergic reactions - unpredictable response to medication
66
Types of medication actions
Interactions- one med modifies another Tolerance- more meds required to treat goal Dependence- physical and psychological
67
Achieving therapeutic effect
Medication dose Route of administration Frequency of administration Function of metabolizing organs ( kidney, liver)
68
Timing of therapeutic effect
Onset- time if meds to produce a response Trough- minimum blood serum concentration before next scheduled dose Plateau- point at which blood serum concentration is reached and maintained Peak- time at which a medication reaches its highest effective concentration Duration- time medication takes to produce greatest results Biological half-life- time odor serum medication concentration to be halved
69
Physiological variables affecting therapeutic effect
Age Gender and body build Chronic diseases result in body organ function Concurrent medication use Nutritional status Pregnancy Genetic factors Health illness beliefs Previous experience with meds Knowledge based Cultural beliefs Developmental stage Social support/ financial status Potential for medication dependence and misuse
70
Routes of administration
Oral- sublingual, buccal Topical- direct, body cavity Parenteral- ID, Sub-Q, IM, IV Inhalation Intraocular
71
Types of orders in acute care settings
Standing orders / routine Single orders Now orders PRN orders STAT orders Prescriptions
72
Nurses role
Determine medications ordered are correct Asses patients ability to self administer Determines medication timing administers medication correctly Closely monitors effects Provides patient teaching Medication errors
73
10 rights of medication administration
Right medication Right dose Right patient Right route Right time Right assessment/ indication Right documentation Right evaluation Right to refuse treatment Right patient education
74
Patient rights
To be informed about a medication To refuse a medication To have medication history To be properly advised about experimental nature of medication To receive labeled medications safely To receive appropriate support therapy To not receive unnecessary medications To be informed if medications are part of a research study
75
Medication reconciliation
Compare past and present medications Verify the list Compare the list Reconcile the list Communicate the updates
76
Guidelines for safe medication administration
Be vigilant Ensure pt receives correct meds Know why the is is taking the meds Verify expiration date Two pt identifiers before administering medications Check MAR check for accuracy 3x Clarify unclear medication orders Use strict aseptic technique Educate pt about each medicine You cannot delegate med administration Follow safety guidelines to prevent needle stick injuries
77
Medical errors
Any preventable event that may cause inappropriate medication use of jeopardize patient safety More people die from medical errors then from lower chronic respiratory disease, accidents, strokes, Alzheimer’s, and diabetes mellitus
78
When a medical error occurs…
Assess patients condition Notify health care provider Report incident Prepare and file an incident report Report near misses and incidents that cause no harm Reconcile meds during transitions of care

Nursing 300 (3 decks)

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