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Nursing Fall 2023 > NUR 200 Final > Flashcards

NUR 200 Final Flashcards

1
Q

Florence Nightingale

A

Cleanliness and Environment
-Professional Nursing

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2
Q

Clara Barton

A

Founder of the American Red Cross

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3
Q

Dorothea Dix

A

Advocate for Mental Health nursing/asylums

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4
Q

Lavinia Dock

A

Pioneer in nursing education

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5
Q

Mary Breckenridge

A

Frontier in field of Nurse Midwifery

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6
Q

Margaret Sanger

A

Established Planned Parenthood

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7
Q

Patricia Benner

A

Theory of Nursing Caring from Novice to Expert

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8
Q

Peplau

A

Theory of Interpersonal Relationships
-You need to have communication with your patients

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9
Q

Virginia Henderson

A

Nursing Theory of Needs
-Created because she had 14 needs

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10
Q

Dorothy Johnson

A

Behavioral System Model
-Focused on behavior function

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11
Q

Dorothea Orem

A

You need to be able to fulfill biological, psychological, developmental, or social needs to be healthy

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12
Q

Imogene King

A

Patient environment and nurse-patient relationship is part of the nurse for meeting pt goals towards good health

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13
Q

Betty Neuman

A

Reduce stress of the patient

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14
Q

Sr. Castilla Roy

A

Viewed individual as a set of interrelated systems who strive to maintain the balance between these various stimuli

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15
Q

Jean Watson

A

Caring Theory
-You need to be caring and humanistic

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16
Q

What are the phases of Nursing? (Benner)

A

1) Novice
2) Advanced Beginner
3) Competent
4) Proficient
5) Expert

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17
Q

What does Novice level Nursing mean?

A

-Task Oriented
-Focused on learning rules
-Follows written sequential process

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18
Q

What does Advanced Beginner level Nursing mean?

A

Focuses on more aspects of a clinical situation and applies more facts

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19
Q

What does Competent level Nursing mean?

A

-Have additional experience
-Can handle patient load
-Can deal with complex situations
-Can prioritize

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20
Q

What does Proficient level Nursing mean?

A

-Quickly taken in all aspects of a situation and given meaning to the data
-“Sees the bigger picture”

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21
Q

What does Expert level Nursing mean?

A

Can see what needs achieved and how to do it

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22
Q

ANA

A

National professional organizations
-Set nursing standards of care

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23
Q

National League for Nursing (NLN)

A

Establishes and maintains a universal standard of education

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24
Q

International Council of Nursing (ICN)

A

Federation of national nursing organizations

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25
Q

National Student Nurses’ Association (NSNA)

A

Represents nursing students

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26
Q

Sigma Theta Tau International (STTI)

A

National Honor Society for Nursing

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27
Q

What is the Case Method Model of Nursing?

A

1:1 care for entire shift, needs are quickly met, greater degree of autonomy

Ex: ICU, L&D, private duty

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28
Q

What is the Functional Nursing Model of Nursing?

A

Clear understanding of tasks each member performs; Compartmentalized; Specific knowledge and skills

Ex: RN educates,, LPN passes meds, CNA make beds

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29
Q

What is the Team Nursing Model of Nursing?

A

Efficient; Cost Saving; Limits the fragmentation of functional nursing

Ex: RN paired with CNA and are assigned a group of pts

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30
Q

What is the Primary Nursing Model of Nursing?

A

One RN cares for group of pts; Other RNs continue the primary RNs plan when the primary is not present

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31
Q

What is primary healthcare?

A

-Health promotion
-Preventive services
-Health Education
-Lobbying for a ban to eliminate smoking in local restaurants
-Promoting Immunizations

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32
Q

What is secondary healthcare?

A

Diagnoses and treat illness, disease, and injury
-Reduce impact of disease and early prevention
-Outreach screening (mammograms, lipid testing, X-rays, CT)
-STI screening (asymptomatic)

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33
Q

What is tertiary healthcare?

A

-Restore functioning to a pre-disease status or prevent exasperation (worsening)
- High school student involved in unprotected sex
- Diabetic following diet plan
-Long term rehabilitation services
-End of life care

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34
Q

What is critical thinking?

A

A combination of:
-Reasoned thinking
-Openness to alternatives
-Ability to reflect
-A desire to seek truth

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35
Q

What are complex thinking processes?

A

Use a combination of critical-thinking skills and attitudes:
-Problem solving
-Decision making
-Clinical reasoning
-Clinical judgement

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36
Q

What is the Critical-Thinking Model

A

1) Contextual awareness
2) Inquiry
3) Considering alternatives
4) Analyzing assumptions
5) Reflecting skeptically and deciding what to do

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37
Q

What are the full nursing spectrum concepts?

A

-Thinking
-Doing
-Caring
-Patient Situation

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38
Q

What is the responsibility of the nurse when delegating tasks?

A

-Assign tasks to those who have an understanding of their skills limit
-Validate the data collected
-Conduct the interview
Complete the physical assessment

*RNs must perform the assessment portion of the nursing process!

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39
Q

What can CNAs, UAPs, and LPNs do?

A

Collect info including:
-Vital signs
-Pain reports
-Fingerstick blood glucose levels

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40
Q

What is subjective data?

A

What the patient says

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41
Q

What is objective data?

A

What can be observed or measured

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42
Q

What is primary data?

A

Obtained directly from the patient

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43
Q

What is secondary data?

A

Obtained secondhand through the medical record or another person

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44
Q

What is direct interviewing?

A

To obtain factual, easily categorized information

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45
Q

What is nondirective interviewing?

A

Allows the client to control the subject matter; nurse’s role is to clarify and summarize

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46
Q

What are the components of the NANDA-I Nursing Diagnosis?

A

-Diagnostic label
-Definition
-Defining characteristics
-Related factors
-Risk factors

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47
Q

What format is primarily used when writing Nursing Care Plans?

A

(PES) –> Problem, Etiology, and Symptom

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48
Q

What are the 5 Rights of Delegation?

A

1) Right task - make sure it is in their right scope of practice
2) Right circumstance
3) Right person
4) Right direction/communication - on how to obtain what you need
5) Right supervision

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49
Q

What does the Joint Commission do in regards to safety?

A

Publishes national public safety goals

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50
Q

What does the ANA do in regards to safety?

A

-Advocate for healthcare reform
-Priority is for everyone to have high quality care & access to it

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51
Q

What does the Quality and Safety Education for Nurses do? (QSEN)

A

-Task force for improving nursing education
-Focus on graduate nurses being confident with safety

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52
Q

What are factors effecting safety for an Infant/Toddler?

A

-Completely dependent
-Walk and manipulate objects before recognizing danger
-Curious/explorers
-Puts objects in mouth

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53
Q

What are factors effecting safety for a Preschooler?

A

Play outside more, but better gross and fine motor skills, coordination, and balance

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54
Q

What are factors effecting safety for a School Aged Child?

A

-More outside activities that lead to broken bones and muscle injuries
-Less fearful and more ready to try anything new
-Wider school/neighborhood environments

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55
Q

What are factors effecting safety for an Adolescent?

A

-Peak physical, sensory, and psychomotor skills given feeling of strength and confidence
-Feel indestructible, risky behaviors

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56
Q

What are factors effecting safety for an Adult?

A

-Workplace injury or lifestyle related

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57
Q

What are factors effecting safety for an Older Adult?

A

Physiological changes:
-Reduced muscle strength
-Slowed reflexes
-Increased risk for falls

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58
Q

When identifying specials risks for falls at home, what can a UAP do, and what is the RNs responsibility?

A

UAP can:
-Walk with pt at home
-Put on skid socks
-Make a clutter free zone

RNs:
-Must be the one to assess pt home

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59
Q

What are preventative actions for take home toxins?

A

-Clothing removal
-Shower
-Gloves/handling
-Check with workplace

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60
Q

What is a pathogen, and what are the different kinds?

A

A microorganism capable of causing an illness
-Foodborne pathogens
-Vector-borne pathogens
-Waterborne pathogens

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61
Q

What are Never Events?

A

(Serious Reportable Events)
Healthcare acquired complications that cause serious injury or death to a and should have never happened in the hospital

-Clearly identifiable and measurable
-Serious
-Usually preventable

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62
Q

What does the CUS model stand for?

A

C- State your concern
U- Say why you’re uncomfortable
S- State why this is a safety issue

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63
Q

What are hazards to healthcare?

A

-Back injury
-Needle sticks
-Radiation (CT/PET scans)
-Violence

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64
Q

Mobility

A

Body movement

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65
Q

Fitness

A

Ability to carry out ALDs with vigor and alertness

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66
Q

Physical Activity

A

Bodily movement produced by the contraction of skeletal muscle that increases expenditure above baseline

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67
Q

Exercise

A

Planned, structured, and repetitive purposeful for improving or maintaining physical fitness, performance, or health

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68
Q

What are the musculoskeletal components required for movement?

A

Bones, Muscles, Tendons, Ligaments

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69
Q

What is the neurological component required for movement?

A

Nerves
-Control the movement of the musculoskeletal system

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70
Q

Ligaments

A

Fibrous tissues that connect most movable joints

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71
Q

Tendons

A

Fibrous tissues that connect muscle to bone

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72
Q

Osteoclasts

A

-Housekeepers
-Clean out the old or damaged tissue

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73
Q

Osteoblasts

A

-The construction crew
-Build and repair new bone

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74
Q

Isometric Exercise

A

-Against an immovable surface
-Involves muscle contraction without motion

Ex: Wall sits

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75
Q

Isotonic Exercise

A

-Weight training with free weights
-Involves movement of the joint during the muscle contraction

Ex: Pull ups, push ups, bicep curls with dumbbells

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76
Q

Isokinetic Exercise

A

-Machine that is a constant preset speed
-Performed with specialized apparatuses that provide variable resistance to movement

Ex: Treadmill, leg press

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77
Q

Aerobic Exercise

A

-Brisk walking, jogging, bicycling
-Acquires energy from metabolic pathways that use oxygen - amt taken in exceeds amt required to perform the activity
-Large muscle groups with continuous movement

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78
Q

Anaerobic Exercise

A

-Occurs when the amt of oxygen taken into the body does not meet the amt of ixygen required to perform the activity

Ex: crossfit, HIIT, sprinting

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79
Q

What are the parts of the pulmonary system?

A

-Nasal passages
-Mouth
-Larynx
-Trachea
-Bronchi
-Bronchioles

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80
Q

True or False:
Lower airway is not sterile

A

False, lower airway is considered sterile

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81
Q

What is external respiration?

A

Alveolar-Capillary gas exchange
-O2 travels across membrane into the blood of the pulmonary capillaries
-CO2 diffuses out of blood into the alveoli to be exhaled

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82
Q

What is internal respiration?

A

Capillary-tissue gas exchange
-O2 diffuse from the blood to the tissues and cells
-CO2 waste product - transported to lungs and exhaled

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83
Q

What factors influence pulmonary function for Infants?

A

-Respiratory Distress Syndrome
-Smaller and narrower airway structure
-Immature immune system
-Can choke on small objects

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84
Q

What factors influence pulmonary function for Toddlers?

A

-Upper respiratory infections (d/t large tonsils and adenoids)
-Exposure to new infectious agents (daycare)

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85
Q

What factors influence pulmonary function for Preschool/school-aged children?

A

-Upper respiratory infections
-Asthma
-Tobacco use

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86
Q

What factors influence pulmonary function for Adolescents?

A

-Smoking
-E cigs
-Less healthcare visits
-Asthma

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87
Q

What factors influence pulmonary function for Adults?

A

-Unhealthy choices (sedentary, smoking)
-Organ declines as age increases

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88
Q

What factors influence pulmonary function for Older Adults?

A

-Reduced lung expansion
-Less effective cough
-Declining immune system
-GERD

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89
Q

What is hypoxia?

A

Occurs when there is inadequate oxygenation of organs and tissues

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90
Q

Eupnea

A

Normal breathing
12-20 RR

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91
Q

Tachypnea

A

Fast breathing
>24 RR

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92
Q

Bradypnea

A

Slow breathing
<10 RR

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93
Q

Kussmaul’s

A

Regular RR, but increased

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94
Q

Apnea

A

Absence of breathing

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95
Q

Cheyne-Stokes

A

-Increase in depth
-Gradual decrease in depth
-Apnea (brain injury)

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96
Q

Stridor

A

High-pitched, harsh, crowing inspiratory sound that occurs due to partial obstruction of the larynx

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97
Q

Orthopnea

A

Difficulty breathing laying down

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98
Q

What do you assess with a pt’s Sputum?

A

-Appearance
-odor
-Amount timing

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99
Q

What do you asses for a pt’s cough?

A

-Dry
-Productive
-Better or worse?

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100
Q

Nutrition

A

Study of food and how it affects the body and influences health

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101
Q

Metabolism

A

The process by which the body changes food into energy

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102
Q

Standards (of nutrition)

A

Reference for nutrient intake thought to meet the nutritional needs of most healthy population groups

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103
Q

Food Guides

A

Specify the number of daily servings of foods needed to make healthy food choices

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104
Q

DRIs (Dietary Reference Intakes)

A

Promote the consumption of micronutrients and macronutrients
-Estimate avg requirement
-Recommended dietary allowance
-Adequate intake
-Tolerable upper intake level
-Acceptable macronutrient distribution range

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105
Q

USDA Dietary Guidelines

A

Provide information on choosing a nutritious diet, maintaining healthy weight, achieve adequate exercise, and good safety

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106
Q

Who requires Nutrition Facts Labels to be on all packaged foods?

A

US Food and Drug Administration

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107
Q

What are nutrients?

A

Micro and Macro
-Building blocks for cells and tissues
-Allow for growth, maintenance, and functioning

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108
Q

Anabolism

A

Formation of larger molecules into smaller ones

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109
Q

Catabolism

A

The breakdown of larger molecules into smaller components

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110
Q

Carbohydrates

A

-Primary energy source
-Sugars

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111
Q

Proteins

A

-Tissue building
-Nitrogen balance
-Amino acids

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112
Q

Lipids

A

“Fats”
-Key component of lipoproteins
-Back up energy source
-Organ insulation/protection

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113
Q

True or False:
Micronutrients are needed in large amounts

A

False, they are needed in small amounts to regulate body functions

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114
Q

Vitamins

A

ORGANIC substances necessary for metabolism or preventing a particular deficiency disease

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115
Q

Minerals

A

INORGANIC elements found in nature that occur naturally in foods or as additives/supplements

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116
Q

What is water’s purpose in the body?

A

-Solvent for chemical processes
-Transports substances
-Form for tissues
-Lubricant
-Temp control

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117
Q

What are sources of Vitamin A?

A

-Eggs
-Leafy green vegetables
-Milk

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118
Q

What are sources of Vitamin D?

A

-Fish
-Milk
-Sunlight

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119
Q

What are sources of Vitamin E?

A

-Vegetable oils
-Nuts
-Fish
-Green leafy vegetables

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120
Q

What are sources of Vitamin K?

A

-Green leafy vegetables
-Liver

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121
Q

What are sources of calcium?

A

-Dairy products
-Green leafy vegetables
-Legumes
-Nuts

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122
Q

What are sources of Magnesium?

A

-Whole grain
-Nuts
-Legumes
-Green leafy vegetables

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123
Q

What are sources of Potassium?

A

-Fruits
-Vegetables
-Meats
-Legumes
-Shellfish

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124
Q

What are sources of Sodium?

A

-Table salt
-Baking Soda
-Baking Powder

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125
Q

What is BMR?

A

Basal Metabolic Rate
-Amount of energy required at rest

126
Q

What are factors that affect nutrition for Infants to 1 yr olds?

A

-Higher protein and carbs
-More fluid

127
Q

What are factors that affect nutrition for Toddlers?

A

-Diets are deficient in nutrients
-Picky eaters
-Offer them a variety of foods

128
Q

What are factors that affect nutrition for Preschoolers?

A

Concern that they will learn bad habits:
-No vegetables
-Less milk
-One food for several days
-Need nutritious snacks between

129
Q

What are factors that affect nutrition for School Aged Children?

A

-Must get adequate vitamins and minerals; low fat/salt/sugar foods
-Commercials and outside life

130
Q

What are factors that affect nutrition for Adolescents?

A

-Active and eat a lot of “ready to go” meals

131
Q

What are factors that affect nutrition for Young and Middle Adults?

A

-Tend to follow habits learned earlier in life
-BMR decreases in middle adults

132
Q

What are factors that affect nutrition for Older Adults?

A

-Need fewer kcal due to lean body mass, physical activity, and decreased BMR
-Need more dairy, fiber, and water

133
Q

What BMI is considered overweight?

A

25-29.9

134
Q

What BMI is considered Class I Obesity?

A

30-34.9

135
Q

What BMI is considered Class II Obesity?

A

35-39.9

136
Q

What BMI is considered Class III Obesity?

A

40 and higher

137
Q

What is Enteral Nutrition?

A

Delivery of liquid nutrition in upper intestinal tract via tube (NG tube or G tube)

138
Q

What is Parenteral Nutrition?

A

Delivery of nutrition intravenously into a large, central vein (TPN)

139
Q

What does the GI Tract do?

A

Digests and absorbs nutrients from our food and eliminates waste through feces

140
Q

Flatulence

A

Gas in the intestines causes walls to stretch

141
Q

Hemorrhoids

A

Dilates, engorged veins in the lining of the rectum (can be internal or external)

142
Q

What are the structures of the GI Tract?

A

-Upper GI Tract
-Small intestine
-Large intestine (colon)
-Rectum and anus

143
Q

What are the structures of the Upper GI Tract?

A

-Mouth
-Pharynx (includes epiglottis)
-Esophagus
-Stomach

144
Q

How long does food stay in the stomach?

A

4 hours

145
Q

Where does most of the digestion and absorption of food occur?

A

Small intestine

146
Q

What is the process of bowel elimination?

A

-Starts at mouth and moves through Upper GI Tract down to small intestine
-At small intestine: Food is digested and absorbed, peristalsis halts for food absorption, moves through – duodenum, jejunum, and ileum to large intestine
-At large intestine: mucus secreted to help facilitate passage of feces; water, vitamins, and minerals are absorbed; moves to rectum and anus
-Poop reaches rectum, stretch receptors initiate contraction of sigmoid colon/rectal muscles
-Internal sphincter relaxes
-Sensory impulses causes voluntary “bearing down”
-External sphincter relaxes

147
Q

Stoma

A

Can be temporary or permanent
-Allows intestine to rest or heal and then do a reanastomosis

148
Q

Illeostomy

A

Portion of the illeum through a surgical opening; bypasses the large intestine so poop will be liquid and continuous

149
Q

Colostomy

A

Portion of colon (large intestine)
-Consistency is based on location (further down you are, the more firm it will be

150
Q

Bowel Diversion

A

Surgically created opening for elimination of digestive waste

151
Q

True or False:
A stoma should be a pale pink and dry

A

False, it should be red meaning that oxygen is getting to it, and it should be moist and painless

152
Q

How do you care for a pt with a stoma?

A

-Assess the stoma
-Assess the output
-Assess the skin

153
Q

What is normal for bowel sounds?

A

5-30 gurgles or high pitched noises every minute

154
Q

How do you know if bowel sounds are absent?

A

You will not hear bowel sounds for 3-5 minutes per quadrant

155
Q

What are considered sterile in the urinary system?

A

Bladder and urethra

156
Q

What are the function of the kidneys?

A

-Filter metabolic waste from the blood stream as urine
-Help regulate BV, BP electrolytes, and acid-base balance

157
Q

What is the sequential anatomy of the urinary system?

A

-Kidney
-Ureter
-Bladder
-Urethra

158
Q

What do ureters do?

A

Transport Urine through ureters

159
Q

What does the bladder do?

A

Stores urine

160
Q

Why are women more likely to get UTIs?

A

They have smaller urethras

161
Q

What do urethras do?

A

Transport urine out of the body

162
Q

Micturition?

A

-To start the stream of urine
-To urinate
-To release urine from the bladder

163
Q

What inhibits micturition?

A

-Anxiety
-Lack of time
-Lack of privacy
-Loss of dignity due to need for assistance
-Cultural influences such as same gender

164
Q

What is the process of urinary elimination?

A

-Internal urethral sphincter closes while bladder fills
-Distention activates stretch receptors in bladder wall
-Signaling to the voiding reflex center the urge to void
-Contraction of detrusor muscle, internal sphincter relaxes
-Once ready to urinate, conscious relaxation of external urethral sphincter occurs
-Detrusor muscle relaxes and bladder begins to fill again

165
Q

What is the typical volume of urine that the bladder holds before urination in adults?

A

200-450 mL

166
Q

What is the typical volume of urine that the bladder holds before urination in children?

A

50-200 mL

167
Q

How much urine do kidneys typically produce in a day?

A

About 1500 mL

168
Q

What does diluted urine look like?

A

Below 1.002
-Pale, yellow color
-No significant odor
-This is due to a sufficient amount of water intake

169
Q

What does concentrated urine look like?

A

Above 1.030
-Severely dehydrated
-Cloudy
-Dark yellow
-Odoress

170
Q

Enuresis

A

Incontinence; occasional involuntary passage of urine
-Normal up to early school years
-Occurs more often when they are absorbed in activity (distracted)

171
Q

Nocturnal Enuresis

A

Bed Wetting
-Occurs in some children age 6-7 (most control between 3-5)
-Caused by insufficient levels of ADG, pressure on the bladder, urinary infection, and emotional stress

172
Q

Nocturia

A

Older adults
-Frequent urination after going to bed (waking up and going to the bathroom)

173
Q

If pt is post op, what is the time frame for them to urinate?

A

6-8 hrs

174
Q

True or False:
Pts on diuretics become major fall risks

A

True, d/t pts urgency to urinate

175
Q

True or False:
Caffeine is a diuretic

A

True, increases urine production

176
Q

How does alcohol consumption affect ADH?

A

It impairs release of ADH, resulting in increased urine production

177
Q

True or False:
Physical activity/dehydration cause kidneys to hold water

A

True

178
Q

Dysuria

A

Painful or difficult urination d/t infection, obstruction, or meds

179
Q

Frequency (urination)

A

Need to urinate at short intervals

180
Q

Hematuria

A

Blood in urine d/t trauma, kidney stones, infection, or menstruation

181
Q

Anuria

A

Absence of urine
-UO is < 100 mL/24 hrs
-Common in pts with chronic kidney disease or on dialysis

182
Q

Oliguria

A

UO < 400 mL/24 hrs (small or few)
-D/t dehydration

183
Q

Polyuria

A

Excessive urination d/t overhydration or diabetes

184
Q

What is the first option for urine analysis?

A

Freshly voided specimen

185
Q

How would a UTI be indicated on a urine analysis?

A

Show up with:
-Blood
-Glucose
-Bacteria
-Positive WBC

186
Q

How is a clean catch urine sample obtained?

A

-Cleanse genitalia appropriately
-Collect midstream sample
-Free from contamination

187
Q

How is a sterile specimen collected?

A

-Obtained through catheter insertion
-More traumatic and can cause pain
-Only used if someone cannot urinate or if previous specimens are contaminated

188
Q

How is a 24 hr urine sample collected?

A

-Large container in refrigerator, keep adding all urine for 24 hr period
-Dump first urine out and the collect second urine
-Check levels and kidney functions, etc

189
Q

Urge incontinence

A

Involuntary loss of urine with a strong urge to void

190
Q

Stress incontinence

A

Involuntary loss of urine with increases intra-abdominal pressure in the absence of overactive bladder (pregnancy, obesity, constipation/straining, sneezing)

191
Q

Mixed incontinence

A

Combination of urge and stressed incontinence

192
Q

Unconscious (reflex) incontinence

A

Loss of urine when person doesn’t realize the bladder is full and has no urge to void (people w/ neurological disorders or bladder inflammation)

193
Q

Functional incontinence

A

Untimely loss of urine with no cause

194
Q

Transient (comes and goes) incontinence

A

Short term and resolves spontaneously (from UTI or diuretics)

195
Q

Source-Oriented System

A

-Disciplines document in separate sections of the chart
-Brings problems of scattered data which can lead to fragmentation

196
Q

Problem-Oriented System

A

-Organized around client medical problems (Not Wholistic)
-Four components: Database, problem list, plan of care, progress notes
-Promotes collaboration between disciplines
-Does not work if people are not communicating

197
Q

Charting by Exception

A

-Only significant findings or exceptions are documented
-use preprinted flow sheets
-Reduces time spent on documenting
-Can lead to omission of information and errors in care
-Doesn’t allow for skilled nursing judgment

197
Q

Electronic Health Record

A

-Records entered via computer
-Combination of problem & source oriented systems
-Promotes greater collaboration and communication, improved quality of care, time saving, private and safe
-Expensive and can have unplanned downtimes

198
Q

PIE

A

Problem-Intervention-Evaluation
-Not holistic, only looking at problem, not pt

198
Q

SOAP (SOAPIE, SOAPIER)

A

Subjective-Objective-Assessment-Plan (-Intervention-Evaluation-Revision)

199
Q

Fact System

A

-Flowsheet
-Assessment
-Concise notes
-Timely

200
Q

Occurrence Reports

A

Formal record of unusual occurrence or accident - helps with quality improvement in the future

-Not part of pt health record- keep off legal chart, do not reference report was filed in chart

201
Q

Integrated plans of care

A

Combined charting and care plan form
-Maps out on a day by day, from admission to discharge

-Used for determining length of stay
-Monitor costs
-Eliminate duplicate documentation
-Increases teamwork

202
Q

Kardex/Client Care Summary

A

In chart, but not part of legal record (always updating)
-Demographic data
-Safety precautions
-Allergies
-Medical dx
-Special instructions

203
Q

How long do nurses have to complete assessment and care screenings upon arrival at a long term care facility?

A

14 days

204
Q

True or False:
Hospitals are for acute conditions

A

True

205
Q

True or False:
Nursing homes & long term care facilities are for chronic conditions

A

True

206
Q

What is included in oral reporting?

A

Nurse to Nurse or Nurse to Provider
-Communication of vital info related to pt’s status/plan of care
-Bedside report preferred to have pt involved in their own care

207
Q

What is included in Handoff Report?

A

-Pt demographics and dx
-Relevant medical history
-Significant assessment findings
-Treatments
-Upcoming diagnostics or procedures
-Restrictions
-Plan of care for pt
-Concerns

208
Q

When is SBAR used?

A

Used for interprofessional communication between doctors and other nurses

209
Q

What is keeping it “CUBAN” and when is it used?

A

Used when doing SBAR
C- Confidential
U- Uninterrupted
B- Brief
A- Accurate
N- Named Nurse

210
Q

What does SBAR stand for?

A

S- Situation
B- Background
A- Assessment
R- Recommendation

211
Q

What needs to be given during transfer reports?

A

-Your contact info
-Pt demographics, dx, reason for transfer
-Family contact info
-Summary of Care
-Current status
-Presence of open wounds or areas of skin
-Special directives regarding care
-Ask if receiver has any questions

212
Q

Verbal Orders

A

-Can be given by Dr
-Spoken to you - usually during emergency
-Should be made for critical change in client condition ONLY
-Shouldn’t really occur

213
Q

Telephone Orders

A

-Received by phone and transcribed onto the provider order sheet
-Should be made for sudden change in pt condition, inability to transmit electronically, or life threatening emergencies

-Increased risk for errors
-Dr must sign off on order within 24 hrs

214
Q

What do you do if an order or prescription is written illegibly?

A

Contact the provider

215
Q

What do you do if you are uncomfortable following a prescription?

A

Follow the chain of command

216
Q

What are the guidelines for paper health records?

A

-Write legibly
-Use black ink
-Do not leave blank lines, draw line through empty space
-Draw a line through incorrect charting and initial
-Sign all docs with first name, last name, and RN
-Don’t write shorthand or use non-approved abbreviations

217
Q

What is the order of Maslow’s Hierarchy?

A

-Physiological needs
-Safety Needs
-Love and Belonging
-Esteem
-Self-actualization

218
Q

What are physiological needs?

A

Air, water, food, shelter, sleep, clothing, reproduction

219
Q

What are safety needs?

A

Personal security, employment, resources, health, property

220
Q

What is included in love and belonging?

A

Friendship, intimacy, family, sense of connection

221
Q

What is included in esteem?

A

Respect, self-esteem, status, recognition, strength, freedom

222
Q

What is self-actualization?

A

Desire to become the most that one can be

223
Q

Self Concept

A

One’s overall view of themselves
“Who do you think you are?”

224
Q

What factors affect self concept?

A

-Gender (roles and expectations)
-Developmental level (More mature = self concept is more intra guided)
-Family and peer relationships
-Illness and hospitalization
-Locus of control

225
Q

What factors influence body image?

A

-Family, social, ethnic & cultural norms
-Education (Higher education = better image of yourself, same with higher position at work)
-Exposure to alternative values
-Developmental/loss
-Social media

226
Q

Role Strain

A

A mismatch between role expectations and performance

227
Q

Interpersonal Role Conflict

A

How individuals carry out their significant roles vs expectation by others

228
Q

Interrole conflict

A

Two roles make competing demands

Ex: Nursing school vs significant other

229
Q

What are the components of personal identity?

A

-How you view yourself as a unique human being
-Develops over time
-Becomes consistent as a person ages
-Content with who they are

230
Q

Self-Esteem

A

How well a person likes one’s self

“What I think I should be” vs “What I think I am” (Ideal self vs Actual self)

231
Q

What stressors affect self concept?

A

-Identity stressors
-Role performance stressors
-Role overload (expectations are too high)
-Body image stressors

232
Q

What is Family Centered Nursing?

A

Nursing care that is holistically directed toward the whole family as well as to individual members

Promotes:
-Health and wellness
-Communication
-Unity and conflict resolution

Prevents:
-Disease
-Conflict
-Maladaptive coping

**Assess coping mechanisms and their effectiveness

233
Q

What are traditional nuclear families?

A

-Traditional married couple
-Have a child
-One parent working, one stays at home

234
Q

What are grandparent families?

A

Parents may be unable to raise children, so children are raised by their grandparents

235
Q

What are blended families?

A

Two single people come together with children from previous relationships, and family blends together

236
Q

What are extended families?

A

Aunts, uncles, cousins, all living under the same roof

237
Q

What are sandwich families

A

-Have a mother with children
-Mother’s parents are dependent on her
-Mother is caring for her children, as well as her parents

238
Q

What is the most important question to ask in family nursing?

A

Ask/Determine who is the primary decision maker of the family

239
Q

What is the concept of community?

A

A body of like minded people or the inhabitants of a town

-Share a common language, rituals, etc
-Group of people of a particular race or class in a specified place

240
Q

Who are the vulnerable populations?

A

-Limited economic resources
-Limited social resources
-Very young and very old
-Chronic disease & obesity
-History of abuse/trauma
-Disabled
-Those with substance abuse problems
-Untreated mentally ill

241
Q

What is Community Health Nursing?

A

Health of an individual, family, or group, and its affects on the community as a whole

242
Q

What is public health nursing?

A

Health of a community and how it affects individuals

243
Q

What is community-oriented nursing?

A

Focuses on both public and community health

244
Q

Health-Illness Continuum

A

-See health and illness as a graduated spectrum that cannot be divided into parts
-People will move back and forth on this spectrum

245
Q

Dunn’s Health Grid

A

Plots a person’s status on the health-illness continuum against environmental conditions (family support, peers)

246
Q

Neuman’s Continuum

A

-View health as an expression of living energy available to an individual
-High energy = wellness
-Low energy = illness

247
Q

What are the 5 Stages of Illness Behavior

A

1) Experiencing Symptoms
2) Sick Role Behavior (symptoms progress & require relief from normal duties)
3) Seeking Professional Care (getting dx)
4) Dependence on Others (How to use crutches, therapy, etc)
5) Recovery

248
Q

What factors influence Illness Behavior?

A

-Nature of Illness
-Hardiness
-Intensity, Duration, and Multiplicity of the Disruption

249
Q

What did Jean Watson define health as?

A

High overall functioning; a state of mind

250
Q

How did Betty Neuman define health?

A

Continuum of energy

251
Q

How did Myers, Sweeney, and Witmer define health?

A

Integration of mind, body, spirit
-Those with disease can be healthy

252
Q

What is Pender’s Health Promotion Model?

A

-Individual Characteristics and experiences
-Behavior-specific cognitions and affect
-Behavioral outcome

253
Q

What is the Wheel of Wellness?

A

-If one of the spokes on a wheel is weak, the whole wheel is weak
-Center of wheel is least well
-Outer spokes are optimal wellness

254
Q

What do the spokes on the Wheel of Wellness represent?

A

-Emotional
-Social/Family
-Occupational
-Spiritual
-Physical
-Mental

255
Q

What is the Transtheoretical Model of Change?

A

-Helps to alter unhealthy behaviors
-Change to pt’s response to illness or change in environment to decrease stimuli of what is causing a person to engage in unhealthy behaviors

256
Q

What are the 6 Stages of the Transtheoretical Model of Change

A

1) Precontemplation - no plan for change, unaware there is a problem
2) Contemplation - recognizes there is a problem, no commitment to solution yet
3) Preparation - Intending to take action within a month or so, small changes in prep
4) Action - plan is implemented
5) Maintenance - working to prevent relapse
6) Termination - no concern of relapse OR they relapse

257
Q

What are the Stages of Erikson’s Developmental Theory?

A

1) Trust vs Mistrust (Birth to 18 mo) - relies on parent for care
2) Autonomy vs Shame and Doubt (18 mo - 3)- begin to feel separation from parents, can talk on their own
3) Initiative vs Guilt (3-5) - Develop conscious and right vs wrong
4) Industry vs Inferiority (6-11) - Seek recognition for individual accomplishments, solve more complex problems; if parents doubt them or shame them, they will feel inferior
5) Identity vs Role Confusion (11-21) - Personal identity begins to form, attachment shifts from parents to peers
6) Intimacy vs Isolation (21-40) - Develop long lasting relationships/friendships, or isolate
7) Generativity vs Stagnation (40-65) - guide the next generation on how to live productively, or development stops
8) Ego Integrity vs Despair (65+) - Reflecting on life, accept if they’ve lived a good life & achieved their goals, or if they have regrets

258
Q

What is Young Adulthood in the Stages of Development?

A

19-40 yrs old
-Healthiest Stage
-May experience self-eval around 30
-Function independently
-Think rationally, predict outcomes, hypothesize about future

259
Q

What are common health problems for Young Adults?

A

-More prone to STIs d/t most sexually active group
-Unplanned pregnancies
-Abuse/neglect
-Obesity d/t stress, alcohol, convenience eating

260
Q

What is the leading cause of death for Young Adults?

A

Unintentional injuries because they partake in more risky behaviors

261
Q

What is Middle Adulthood in the Stages of Development?

A

40-64 yrs old
-Menopause
-Andropause
-Decreased elasticity of blood vessels, muscle tone, and skin moisture
-More prone to constipation
-Graying/thinning hair
-Rxn times decrease
-More prone to experiencing mid-life crisis

262
Q

Menopause

A

-Woman has no menstrual cycle for 12 consecutive months
-Usually around 51 yrs old
-Mood changes
-Hot flashes
-Vaginal dryness
-Smaller breasts
-Frequent night time wakenings

263
Q

Andropause

A

-Decreased production in semen
-Decreased ability to gain or maintain an erection
*related to decrease in testosterone

264
Q

What is Older Adulthood in the Stages of Development?

A

65+
-Fastest growing age group
-Retirement
-Chronic illnesses
-Lack of self-care and ability to maintain independence
-Sedentary lifestyle
-Sensory impairments
-Inadequate nutrition

265
Q

What is the leading cause of death for Older Adults?

A

In hospitals = falls
-Heart disease
-Cancer
-Chronic lower respiratory diseases
-Stroke
-Alzheimer’s
-DM
-Accidents
-Influenza and Pneumonia

266
Q

Disengagement Theory

A

-Older adult and society gradually and mutually withdraw from each other
-Isolation r/t retirement, chronic illness, death of loved ones, poverty

267
Q

Active Theory

A

The individual should stay active and engages as possible to enjoy the highest life satisfaction

268
Q

Havighurst’s Theory

A

-Counterpart of disengagement theory
-Physical, cognitive, and social development tasks change
-Have to adjust to decreased strength and physical health

269
Q

Psychosocial Development Theory

A

-Erikson’s theory - ego integrity vs despair
-Acceptance of one’s life has had meaning and that death is a part of the continuum of life
-Making sure life goals have been met and there are no regrets

270
Q

What age group in dementia most prominent in?

A

85+
-Memory declines, intelligence does not

271
Q

Where do the standards of teaching come from?

A

-ANA
-Joint Commission
-Nurse Practice Acts

271
Q

What are the 5 Rights of Teaching?

A

-Right time
-Right context
-Right goal
-Right content
-Right method

272
Q

What do nurses teach?

A

-Disease info
-Info about meds
-Procedures/psychomotor skills
-Disease prevention and health promotion
-Clinical processes

273
Q

Behavioral Learning Theory

A

-Characterized by explicit identification of information to be taught and immediate reward for correct responses

Ex: Pavlov, Skinner, Bandura

274
Q

Cognitive Theory of Learning

A

Sees learning as a complex cognitive activity; an intellectual or thinking process in which the learner structures and processes info

275
Q

Humanism Theory of Learning

A

-Focuses on the learner’s affective (emotional), cognitive (intellectual), and attitudinal qualities
-Emphasizes learner’s active participation and responsibility in the learning process
-Self motivated, self initiated, self evaluated

276
Q

What are the 6 Levels of Bloom’s Taxonomy

A

1) Create
2) Evaluate
3) Analyze
4) Apply
5) Understand
6) Remember

277
Q

What is Cognitive Mental Activities?

A

Storage and recall of information

278
Q

What is psychomotor “hands-on” skill?

A

Requires thinking and doing
-Teach back (mannequins/sim)

Ex: Self-administration of insulin

279
Q

What are Affective-Feeling activities?

A

Changing feelings, beliefs, attitudes, and values
-Role modeling, group work, story telling
Ex: Changing a belief about a diet

280
Q

What are SMART goals?

A

Specific
Measurable
Achievable
Relevant
Time-bound

281
Q

Sexual identity

A

Person’s perception of gender, gender identity, gender role, and sexual orientation

*Part of overall self-concept

282
Q

Androgyny

A

Blending of traditions of “feminine” and “masculine” role

283
Q

Transsexual

A

A gender description for someone who has transitioned (or is transitional) from living as one gender to another

*Medically, surgically

284
Q

Transgender

A

A person whose gender identity is not the same as his/her assigned gender

285
Q

What are sexual characteristics of a newborn to 2 yr old?

A

Touch genitals
Enjoy being nude

286
Q

What are sexual characteristics of a 3 yr old?

A

Interested in their bodies and curious to see others

287
Q

What are the sexual characteristics of a 5 yr old?

A

-Masturbate
-Mimic adults affection for one another
-Play house, doctor, getting married
-Begin to wonder where babies come from

288
Q

When do VS and muscle tension increase during sex?

A

Excitement/plateau phase

289
Q

When does the peak of VS and loss of voluntary muscle tone occur during sex?

A

Orgasm- peak of plateau phase

290
Q

What was the goal of Healthy People 2020?

A

To eliminate disparities and improve the health of all groups

291
Q

Ethnicity

A

Refers to cultural factors including: nationality, biographical, regional culture, ancestry, and language

292
Q

What are examples of race?

A

-White
-Black African American
-American Indian
-Korean
-Vietnamese
-Chinese
-Samoan

293
Q

Socialization

A

The process of learning to become a member of society or a group

294
Q

Acculturation

A

A learning process through immigrants assume the characteristics off that culture

-Accepts both own and new culture, adopting elements of each

295
Q

Assimilation

A

Occurs when the new members gradually learn and take on essential values & beliefs of the dominant culture

296
Q

Ethnocentrism

A

Tendency to think your own group is superior to others, and to view behaviors and beliefs that differ from yours as wrong, strange, or unenlightened

297
Q

What are the 3 general approaches for coping with stress?

A

-Alter the stressor
-Adapt to the stressor
-Avoid the stressor

298
Q

What are factors that influence adaption of stress?

A

-Personal perception of stressor
-Overall health status
-Support System
-Hardiness

299
Q

What are the 3 stages of stress?

A

-Alarm
-Resistance (adaptation)
-Exhaustion/Recovery

300
Q

What is the alarm stage of stress?

A

2 Phases:
-Shock (rush of adrenaline to prepare for fight or flight)
-Countershock (changes from shock are reversed, less able to deal with threat)

301
Q

What is the Resistance/Adaptation stage of stress?

A

-Body attempts to cope, protect itself against stressor, maintain homeostasis
-Involves psychological and physical coping mechanisms

302
Q

What is the Exhaustion stage of stress?

A

-Occurs when stress continues and coping mechanisms become ineffective
-Energy is depleted
-Decreased BP, increased HR & RR

Recovery stage replaces exhaustion if coping mechanisms are effective

303
Q

What are psychological response to stress?

A

-Anxiety
-Fear
-Denial, rationalization, projection
-Anger
-Depression

304
Q

Assault

A

Occurs when a nurse intentionally places a patient in immediate fear of personal violence or offensive contact

*Verbal, must include words expressing an intention to cause harm and some type of action

Ex: If you keep acting like that, I’m gonna restrain you

305
Q

Battery

A

Physical contact/touch (hitting/pushing)
-Committed when an offensive or harmful physical contact is made to the client without his consent, or there is unauthorized touching of a person’s body by another person

306
Q

What do all religions have in common?

A

Theology
-Discussions and theories related to God and God’s relation to the world

307
Q
A

Nursing Fall 2023 (7 decks)

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