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knowledge for practice > module one > Flashcards

module one Flashcards

1
Q

define the term health

A

a state of optimal functioning or wellbeing.

A state of complete physical, mental and social wellbeing and not merely the absence of disease.

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2
Q

define the term illness

A

the response of a person to a disease, an abnormal process where their level of functioning has changed when compared to their previous level of functioning

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3
Q

define the term wellbeing

A

the state of being comfortable, healthy or happy

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4
Q

chronic illness

A
  • slow onset
  • may have periods of remission and exacerbation
    relate to;
  • ageing population
  • lifestyle choices
  • environmental factors
    3 or more months
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5
Q

maslow’s heirarchy of needs from the bottom as most need

A

physiological needs- air, water, food, shelter, sleep, clothing, reproduction
safety needs- personal security, employment, resources
love and belonging- friendship, intimacy, family
esteem- respect, self esteem, strength
self- actualisation- desire to become the most one can be

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6
Q

what are the four stages of peplau’s therapeutic relationship model

A

pre interaction phase- read notes, personal protection, talk to other nurses about the patient to clarify information
orientation/ introductory period- introduce yourself to the patient and listen to the patient and say what you can do to help them
working phase- longest phase where you are working with the patient to help solve the problem
termination phase- the end of the shift, end of the long term relationship with the patient

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7
Q

what are the key features of the te whare tapa wha/ four cornerstones model of health

A

optimal health is achieved when all four components are balanced

  • physical (taha tinana)
  • mental/ emotional (taha hinengaro)
  • spiritual (taha wairua)
  • family/ social (taha whanau)
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8
Q

key aspects of therapeutic communication and the process of care

A

purposeful and time limited, respects professional boundaries, always asks permission, gather verbal and non verbal information

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9
Q

the nursing process ADPIE

A 
A- assessment 
D- diagnosis 
P- plan 
I- implementation 
E- evaluation
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10
Q

what are the different types of health Assessments (ADPIE)

A

initial assessment, comprehensive assessment, focused assessment, time lapsed assessment

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11
Q

the process of obtaining a health history (ADPIE)

A

health history- bio data, main complaint, history of main complaint, past medical history, social history, family history, systems review
physical examination- inspection, vital signs checked

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12
Q

what are the sources of information used in a health Assessment (ADPIE)

A

the patient, family and significant others, health care team, medical/ nursing record

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13
Q

what is subjective and objective data

A

subjective data- data known only by the person e.g experience of problem, pain, feelings
objective- information directly observed by the nurse that the patient is showing e.g grimacing, holding stomach, bruise on face

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14
Q

diagnosis (ADPIE)

A

validate your data, recognition of abnormality, document your data then make your nursing diagnosis

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15
Q

plan (ADPIE)

A

based on your assessment and diagnosis goals are

specific, measurable, achievable, realistic, timely

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16
Q

implementation (ADPIE)

A

direct care, counselling, education/ health promotion, health maintenance, rehabilitation, referral, coordination

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17
Q

evaluation (ADPIE)

A

how is the client progressing towards expected outcomes and the effectiveness of nursing care?
gather data, reassess, redefine the problem, reflect on your actions, adjust the plan?

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18
Q

when would you check vital signs

A
  • on admission to healthcare facility
  • any time there is a change in the patients condition
  • any time there is a loss of consciousness
  • before and after surgical or invasive procedures
  • before administration of medication
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19
Q

what are the normal vital signs for an adult

A 
T= 36.5-37 degrees
P= 60-100 
R= 12-20 
BP= 120/80
SP02- 94% and above
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20
Q

how is the core body temperature maintained

A

the thermoregulatory centre in the hypothalamus in the body makes sure the temperature stays in the set point range. it receives hot or cold thermoreceptors located throughout the body and in turn, initiates effectors to either conserve body heat or increase heat loss.

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21
Q

factors that may increase or decrease body temperature

A

environmental temperature, age and gender, core body temperature is warmer than the skin surface

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22
Q

where is core body temperature measured

A

at tympanic (eardrum) or rectal sites.

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23
Q

where is surface temperature taken

A

oral (mouth) or sublingual (under tongue)

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24
Q

how is the normal pulse rate maintained

A

it is regulated by the autonomic nervous system through the cardiac sinoatrial node (pacemaker).

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25
Q

what factors can increase or decrease pulse rate

A

mechanical, neural and chemical factors regulate ventricular contraction and stroke volume

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26
Q

what is stroke volume

A

the volume of blood pumped per beat

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27
Q

how does the body maintain respiration rate

A

the respiration rate changes by the stimulation of respiratory muscles by respiratory centres in the medulla and pons

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28
Q

factors affecting respiration

A

age, gender, exercise, trauma, infection, acute pain, anxiety, altitude

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29
Q

what is inspiration and expiration of respiration

A 
inspiration= breathing in 
expiration= breathing out
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30
Q

blood pressure physiology

A

the force exerted on the walls of blood vessels under the pressure of the heart contracting

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31
Q

factors influencing blood pressure

A

age, stress, medications, diet/ exercise, gender

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32
Q

systolic blood pressure

A

peak pressure during cardiac contraction

33
Q

diastolic blood pressure

A

pressure in the arteries with ventricular relaxation

34
Q

describe pain

A

pain is whatever the experiencing person says it is, existing when they say it does

35
Q

acute limited duration (pain category)

A

seconds to 3 months

36
Q

chronic ongoing duration (pain category)

A

more than 3 months

37
Q

origin of pain

A

physical- cause can be identified
psychogenic- cause cannot be identified
referred- pain is perceived in an area distant from its point of origin, pain is transmitted to a cutaneous site different from where it originated, pain can travel to other areas of the body innervated by the affected nerve root

38
Q

factors that affect pain

A

culture, anxiety, family, gender, age, environment

39
Q

types of responses to pain

A

behavioural- moving away, moaning, crying
physiological-
- sympathetic pathway- moderate and superficial pupil dilation, increased blood pressure, heart rate and respiration rate
- parasympathetic pathway- severe and deep, vomiting, fainting, decreased blood pressure and heart rate
affective- exaggerated weeping and restlessness, anxiety, depression, anger

40
Q

pain assessment tools

A

self report, COLDSPA, numeric rating (1-10), verbal descriptors, visual pain scale

41
Q

terms to describe pain

A

quality- sharp, dull, shifting
severity- severe, excruciating, moderate, mild
duration- brief, continuous, intermittent

42
Q

3 P’s of pain

A

practical- positioning, pillows, elevating, relocation of dislocation
psychological- distraction, play, reassurance, explanation
pharmaceutical- nerve blocks, opiates, local anaesthetic

43
Q

non pharmacological pain relief

A

distraction, humour, music, relaxation, imagery

44
Q

pharmacological pain relief

A

non- opioid analgesics, opioids or narcotic analgesics, adjuvant drugs

45
Q

what does COLDSPA stand for

A

C- character (describe symptom)
O-onset (when did it begin)
L- location (where on the body)
D- duration (how long does it last)
S- severity (how bad is it)
P- pattern (what makes it better and worse)
A- associated factors (what other symptoms occur)

46
Q

what is a neurological assessment?

A

useful in recognising neurological deterioration. assesses motor and sensory function and reflexes

47
Q

causes of neurological deterioration

A

injury, sedation, stroke, seizure

48
Q

components of neurological assessment

A

general survey- appearance, mood, behaviour
health history- useful in obtaining information about daily living, dizziness, loss of sensation, headaches ability to see, taste and hear
physical examination- level of consciousness, pupil reaction, motor function and sensory function

49
Q

assessment; level of awareness

A

ask them
person- what is your name, how old are you
place- what is the name of this city, where are you now
time- what day of the week is it, what month is it

50
Q

assessment; level of consciousness

A

the degree of wakefulness or ability of a person to be aroused

  • awake and alert
  • lethargic
  • stuporous
  • comatose
51
Q

what is a glasgow coma scale

A

a neurological assessment. scored in 3 areas- eye response, verbal response and motor response. highest score is 15 which is the awake and alert

52
Q

how to assess; motor and sensory function

A
  • evaluate motor ability by assessing balance, gait and coordination
  • assess sensory function by testing sensory reflex towards pain, light touch and vibrations
53
Q

what is a EWS (early warning score)

A

an assessment done on a patient to check their vital signs and level of consciousness. they add up to score at the end and if they have a higher score that 0 then intervention may need to happen or more regular check ups of the patient

54
Q

what is primary prevention

A

improving the overall health of the community and preventing the development of disease processes (vaccination, health promotion)

55
Q

what is secondary prevention

A

early detection of disease to stop it from getting worse, prompt intervention and health maintenance, screening for exisiting conditions (getting tests done, seeing a doctor)

56
Q

what is tertiary prevention

A

begins after an illness is diagnosed and treated to reduce disability and to help rehabilitate (medication, surgeries, lifestyle changes)

57
Q

nurses that provide primary health care

A

public health nurses, community nurses, plunket, rural nurses, pasifika health provider nurses, district nurses, indepenant nurse practitioner

58
Q

Different ways nurses work with families

A

as a context- focus on one individual within the family
as a client- family functioning is the focus of care
as a system- family viewed as a system whose parts all interact

59
Q

purpose of family assessment

A
  • health history of family
  • to get family support and know if they have enough
  • provide resources and advocacy
  • if the patient is unable to give information themself
  • know if the patient is safe in their environment
60
Q

family assessment questions

A
  • what roles does each person take on?
  • childcare arrangements?
  • socioeconomic status? are they comfortably living?
  • family structure?
  • ethnic backgrounds and religious affirmations
  • family violence
  • coping strategies
61
Q

what is the first sound you hear when assessing blood pressure through the stethoscope

A

systolic pressure

62
Q

what is systolic pressure

A

the maximum pressure that is exerted when the left ventricle ejects blood into the aorta (first korotkoff sound you hear)

63
Q

what is diastolic pressure

A

the minimum pressure that is exerted when the heart rate rests between beats (when the sound stops)

64
Q

how it blood pressure measured

A

in millimetres of mercury (mmHg)

65
Q

what is an initial assessment

A

performed shortly after the person is admitted. to establish a comprehensive data base for identifying health problems and planning for care. things like their values, social or family beliefs about health and illness

66
Q

what is a comprehensive assessment

A

has 2 stages

  • primary assessment to identify life threatening conditions requiring medical care. danger, response, send for help, airway, breathing, circulation and disability
  • secondary assessment collects data on the persons health. a comprehensive health history and physical assessment is taken
67
Q

what is a focused assessment

A

data is taken about a specific problem that has already been identified. also to identify new or overlooked health problems.

68
Q

what is a time lapsed assessment

A

to compare current health status to previous health status taken last time they visited health care

69
Q

someone who is suffering from acute shortness of breath would benefit from which position

A

high fowlers

70
Q

how do nebulisers work

A

It is designed to deliver liquid medication to the lungs. it turns liquid into fine droplets that can be inhaled

71
Q

what 2 ways can nebuliser medication be given to a patient

A
  • a face mask that the patient breathes through

-

72
Q

why should people use a spacer when using their inhaler

A

the lungs absorb the medication more slowly and smoother

73
Q

what colour are ‘preventer’ asthma medications

A

blue

74
Q

what does ‘priming’ mean in relation to use of the spacer

A

used in a new spacer, you prime the spacer by pumping at least 10 puffs to help reduce the static build up inside

75
Q

what is the recommended flow rate and oxygen concentration of nasal prongs

A
  • flow rate- 1-4L/ min
  • 22-45% oxygen concentration
    nasal prongs and recommended for long time oxygen administration
76
Q

what is the recommended flow rate and oxygen concentration of simple masks

A
  • flow rate- 6-15 L/min

- 35-60% oxygen concentration

77
Q

what is the recommended flow rate and oxygen concentration of non-rebreather

A
  • flow rate 8-15L mask

- 95-100% oxygen concentration

78
Q

what is the recommended flow rate and oxygen concentration of venturi masks

A
  • flow rate 6-15L/ min

- 24-60% oxygen concentration

79
Q

what position is best if you have shortness of breath

A

high fowlers

knowledge for practice (2 decks)

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