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Krystan: Semester One Nursing School > Nursing 2700 Fundamentals: Exam One > Flashcards

Nursing 2700 Fundamentals: Exam One Flashcards

1
Q

List some possible language barriers?

A

Not speaking the language well
Brain injury
Stroke
Developmental disorders

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2
Q

What are the three basic levels of communication?

A

Intrapersonal
Interpersonal
Group communication

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3
Q

What are the four levels of personal space?

A

Intimidate distances
Personal distances
Social distances
Public distances

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4
Q

What does SOLER pertain to and what does it stand for?

A

It pertains to therapeutic communication with a patient
Stands for:

Sit facing patient
Observe open posture
Lean in towards patient
Establish eye contact
Relax and show that you are comfortable
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5
Q

What are some barriers to therapeutic communication?

A 
Too many questions
Closed ended questions
Asking why
Abrupt subject change
Expressing approval or disapproval
False reassurance
Stereotyping
Patronizing
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6
Q

What are the four phases of the therapeutic relationship?

A

Pre-interaction
Orientation
Working phase
Termination

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7
Q

What happens in the pre-interaction phase of therapeutic communication?

A

The nurse gathers relevant information to prepare for interaction

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8
Q

What happens in the orientation phase of therapeutic communication?

A

Nurse and patient meet, rapport is established, relationship is defined

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9
Q

What happens in the working phase of therapeutic communication?

A

This is the active communication phase, in which the patient can freely and clearly express thoughts and concerns and the nurse can support, educate, provide care, and listen

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10
Q

What happens in the termination phase of therapeutic communication?

A

Ending of the nurse/patient relationship, either upon discharge, transfer, or shift change

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11
Q

What are some techniques that enhance therapeutic communication?

A 
Empathy
Respect 
Genuineness
Ability to be clear and be confronted
Eye contact
Open body language
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12
Q

Explain the defense mechanism of denial

A

A refusal to acknowledge anything that causes emotional pain, such as a hard diagnosis or the death of a loved one

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13
Q

Explain the defense mechanism of displacement

A

Anger directed at someone or something other than what the anger is stemming from (taking it out on whoever is present, not necessary whoever did the offending)

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14
Q

Explain the defense mechanism of regression

A

Acting out in behavior that is inappropriate for the developmental stage of that patient (acting like a child)

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15
Q

How is non-verbal communication especially important in therapeutic communication?

A

It often more clearly portrays what the sender is feeling

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16
Q

Therapeutic communication happens in the context of what kind of relationship?

A

A helping relationship, such as the nurse-patient relationship

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17
Q

Healthcare infection acquired in a hospital

A

Nosocomial infection

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18
Q

What are risk factors for healthcare-related infections?

A

Weakened immune systems of patients
Healthcare workers moving between lots of patients
Close patient quarters
Procedures making portals of entry
Poor nutrition status
Potentially contaminated medical equipment

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19
Q

What are some agencies that regulate standards and guidelines in healthcare?

A

CDC
Joint Commission
American Nurses Association

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20
Q

What are the six links in the chain of infection?

A 
Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
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21
Q

What are some things pathogens need to survive and multiply?

A 
Nutrients
Moisture
Warm temps
Oxygen
Preferable pH of 5-8
Prefer low light
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22
Q

What is the most common reservoir for pathogens?

A

The human body

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23
Q

What is the most common portal of exit for pathogens?

A

Body fluids

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24
Q

What are some modes of pathogen transmission?

A

Direct or indirect contact
Droplet
Airborne
Vector

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25
Q

What are some possible portals of entry for a pathogen?

A

Any normal or abnormal body opening

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26
Q

A contaminated object is also called a…

A

Fomite

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27
Q

What are the stages of the infectious process?

A 
Incubation
Prodromal
Illness
Decline
Convalescence
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28
Q

What happens in the incubation period?

A

This is the stage from first pathogen entry to symptom exhibition

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29
Q

What happens in the prodromal stage?

A

Patient experiences the appearance of the first vague symptoms

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30
Q

What happens in the illness phase?

A

Patient shows signs and symptoms characteristic of the disease

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31
Q

What happens in the decline phase of illness?

A

Immune defenses and medical therapies reduce the number of pathogens present

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32
Q

What happens in the convalescence phase of illness?

A

Tissue repair, return to health, pathogen count approaches/reaches zero

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33
Q

What are the six primary defenses against infection

A 
Skin
Respiratory tree
Eyes
Mouth
GI tract
Genitourinary (GU) tract
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34
Q

What about skin protects against infection?

A

Tough intact barrier

Normal bacterial flora

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35
Q

What about the respiratory tree protects against infection?

A

Mucous membranes and cilia

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36
Q

What about the eyes protects against infection?

A

Lysozyme in tears

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37
Q

What about the mouth protects against infection?

A

Saliva contains lysozyme

Highly vascular, so lots of WBCs in mouth

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38
Q

What about the GI tract helps protect against infection?

A

Acidity

Normal bacterial flora

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39
Q

What about the genitourinary tract protects against infection?

A

High acidity (urine and vagina)
Mucous membranes
Lysozyme

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40
Q

How does tobacco use increase susceptibility to infection?

A

Paralyzes respiratory cilia, making it easy for bacteria to proliferate in respiratory tract

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41
Q

What about substance abuse increases infection susceptibility?

A

Drugs can cause skin lesions and changes mental orientation, energy levels, and normal body rhythms
Alcohol is toxic to intestinal mucosa and decreases appetite (possible malnutrition)

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42
Q

What kind of medications can put a person at higher risk for infection?

A

Immunosuppressants for transplants

Anti-inflammatory medications

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43
Q

What are six wellness promotion factors to support defenses against infection?

A 
Nutrition
Hygiene 
Sleep
Exercise
Stress reduction
Immunization
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44
Q

What is the most likely infectious agent in HAIs?

A

Staphylococcus aureus

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45
Q

What is medical asepsis?

A

Procedures that decrease potential for spread of infection

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46
Q

What are some examples of medical asepsis that can be used?

A

Hand washing
Cleaning visible soil in rooms
Disinfecting
Sterilizing

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47
Q

What is an alternative modality?

A

Range of philosophies and practices not used in conventional healthcare settings

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48
Q

What is a complementary modality?

A

Non-conventional treatment that is used to supplement conventional medicine

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49
Q

What is integrative medicine/modality?

A

Coordination of safe and effective CAM therapies into allopathic healthcare

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50
Q

What does CAM stand for?

A

Complementary and alternative modalities

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51
Q

What is the focus of allopathic medicine?

A

Treatment of symptoms

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52
Q

What is the focus of holistic healthcare?

A

Making the patient feel better, taking into account the mental, emotional, and spiritual, not just the physical

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53
Q

What kind of medicine allows for everything in the human condition to be part of the growth process?

A

Holistic

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54
Q

What types of people are most likely to use holism?

A

Women
Those in higher income bracket
Those who are frequently hospitalized
Those in pain

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55
Q

What are the five recognized categories of CAM?

A 
Alternative medicine
Mind-body interventions
Biologically based therapies
Manipulation/body-based methods
Energy therapy
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56
Q

What are some commonly used CAM therapies?

A 
Non-vitamin natural supplements
Deep breathing
Meditation
Chiropractic
Massage
Yoga
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57
Q

What is the core focus of alternative medicine?

A

Restoring balance to the body

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58
Q

What alternative method involves giving medicine in very small doses?

A

Homeopathy

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59
Q

Which alternative practice seeks to balance the three forces of life?

A

Ayurveda

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60
Q

Which alternative practice seeks a single remedy to aid the body in healing itself?

A

Homeopathy

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61
Q

What alternative medicine system seeks to balance yin and yang and the 5 elemental forces?

A

Traditional Chinese medicine

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62
Q

What is acupressure?

A

Application of pressure to reflex zones in the body

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63
Q

What is the focus of chiropractic medicine?

A

Manipulation of spine and body structures to improve health and promote self-healing

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64
Q

What is the focus of tai chi?

A

Non-aggressive martial arts to decrease pain and improve strength and balance

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65
Q

What are some benefits of massage?

A

Decreased stress
Decreased inflammation
Improved circulation
Sinus fluid drainage

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66
Q

What is the focus of simple touch therapies?

A

Decreasing stress and inflammation and promoting healing

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67
Q

What are some examples of mind-body interventions?

A 
Meditation 
Yoga
Art, dance, or music therapy
Breath therapy
Guided imagery
Biofeedback
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68
Q

What are some examples of manipulative/body based methods?

A

Chiropractic
Massage
Tai chi
Simple touch

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69
Q

What are some examples of alternative modalities?

A

Ayurveda
Traditional Chinese medicine
Homeopathy
Acupuncture

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70
Q

What are biologically based therapies?

A

Diet therapies
Herbs
Aromatherapy
Supplements

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71
Q

What are some examples of energy therapies?

A

Therapeutic touch
Tai chi
Magnet therapy

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72
Q

What is meant by “therapeutic use of self”?

A

Being present for one’s patient

Role modeling behaviors that one hopes to see in patient

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73
Q

Which nursing theorist advocated for optimal health by way of touch and environmental influences?

A

Florence Nightingale

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74
Q

Which nursing theorist said that disease is disequilibrium?

A

Margaret Newman

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75
Q

Which nursing theorist said that caring should be the focus of nursing?

A

Jean Watson

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76
Q

Hyperventilation

A

Breathing too quickly and deeply, causing low CO2 levels at first and increased CO2 after a long time

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77
Q

What can cause hyperventilation?

A

Medication
Panic
Fear
Running at high altitude

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78
Q

What is the difference between hypoxia and hypoxemia?

A

Hypoxia is oxygen being too low for normal life functions
Hypoxemia is low arterial oxygen levels
(Not a ton of difference, some use interchangeably)

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79
Q

How can a nurse help a hyperventilating patient?

A

Coach them through deep and slow breathing
Reduce environmental stressors and calm patient
Administer oxygen

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80
Q

What are some effects of respiratory alkalosis on the body?

A

Tissue damage
Low hemoglobin levels
Cyanosis

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81
Q

What is hypoventilation?

A

Decreased and shallow breathing that might also lead to hypoxia

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82
Q

What is cyanosis?

A

Blue appearance of skin at late stages of hypoxia

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83
Q

Describe what happens in the lungs during inhalation?

A

Diaphragm contracts, moving down. Volume expands, pressure gets more negative so air goes in.
Intercostals go up and out to help with expansion

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84
Q

Explain what happens in the chest cavity during exhalation?

A

Diaphragm relaxes, going up, volume decreases, creating pressure that pushed air out. No other muscles used unless exhalation is forced

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85
Q

How does hypoventilation increase the risk for hypoxemia/hypoxia?

A

Less air reaches the alveoli, so there is less gas exchange and less oxygen in the blood

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86
Q

What will hypoxia do to the brain?

A

Abnormal brain function/level of consciousness

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87
Q

What will hypoxia do to renal tissue?

A

Decrease urine output

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88
Q

What will hypoxia do to tissues of the limbs?

A

Cause muscle weakness and pain

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89
Q

What is a common oxygenation problem for vent patients?

A

High CO2 in the blood

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90
Q

What are some major risks to oxygenation in older adults?

A 
Reduced lung expansion
Decreased O2 demand
Less alveolar elasticity 
Lots of medications
Weaker cough reflex
Cardiovascular changes
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91
Q

What are some environmental and lifestyle factors that influence ventilation that can be avoided/minimized?

A 
Choking
Smoking
Lack of exercise 
Poor nutrition
Obesity
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92
Q

What are some indirect things that affect tissue oxygenation?

A

Environment (altitude, air quality)
Lifestyle (obesity, pregnancy, substance abuse)
Medication

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93
Q

Hypocarbia

A

Low CO2 levels

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94
Q

Hypercarbia

A

High CO2 levels

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95
Q

What is the effect of high CO2 levels on the nervous system?

A

Anesthetic effect, can lead to coma and death

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96
Q

What is death caused by high CO2 called?

A

Carbon dioxide narcosis

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97
Q

What are the effects of low carbon dioxide on the nervous system?

A

Acts as a stimulant, so twitching and spasming will occur

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98
Q

Dsypnea

A

Difficulty breathing

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99
Q

Orthopnea

A

Difficulty breathing when lying down flat

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100
Q

Wheezing

A

High pitched and musical breathing sounds

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101
Q

What is different about patients with COPD?

A

Can survive with way lower oxygen sat (okay in 80s usually)

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102
Q

What are the four categories of conditions that can affect ventilation and oxygenation?

A

Pulmonary system abnormalities
Pulmonary circulation abnormalities
CNS disorders
Neuromuscular abnormalities

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103
Q

Give some examples of pulmonary system abnormalities

A

Inflammation
Infection
Obstruction
Structural changes to chest cavity

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104
Q

What are some examples of pulmonary circulation abnormalities?

A 
Air embolus
Pulmonary hypertension (leads to right sided heart failure)
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105
Q

What are some examples of CNS disorders that affect ventilation?

A

Trauma
Stroke
Effects of medications

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106
Q

What are some examples of neuromuscular abnormalities that affect ventilation/oxygenation?

A

Myasthenia Travis

Guillain-Barré syndrome

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107
Q

What are the different ways in which ventilation and oxygenation can be hindered (general)?

A

Gas exchange, gas transport, or ability to inhale can be affected

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108
Q

What types of injuries are most likely to cause oxygenation problems?

A

Spinal cord/CNS injuries
Chest injuries
Embolus formation

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109
Q

When doing a comprehensive assessment on a patient with oxygenation concerns, what areas should the nurse include?

A

Demographics
History of health, respiration, cardiovascular function, environment
Lifestyle

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110
Q

When is a cough considered significant?

A

When persistent, reoccurring, or productive

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111
Q

What are some signs that a patient is experiencing dyspnea?

A 
Using accessory muscles to breathe
Nasal flaring
Grunting
Body positioning to help breathing
Wheezing
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112
Q

What kinds of questions need to be asked about a cough?

A 
Type
Duration
Timing
Appearance
Sputum
Alleviating factors
Associated symptoms
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113
Q

What does a pulse oximetry reading tell you?

A

Arterial blood oxygen saturation

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114
Q

What is the difference between arterial PO2 and SaO2?

A

PO2 is the amount of oxygen available to combine with hemoglobin
SaO2 is how much is actually bound to hemoglobin in the arterial blood

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115
Q

What are normal PO2 levels?

A

80-100 mmHg

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116
Q

What are normal SaO2 readings?

A

Between 95-100% saturated

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117
Q

What are normal PCO2 levels?

A

35-45 mmHg

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118
Q

How is PCO2 related to oxygenation?

A

It is inversely related, so as PCO2 goes up, PO2 is going down or vice versa

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119
Q

What are three nursing interventions to promote optimal respiratory function in a hospitalized patient?

A

Optimal patient positioning
Flu/pneumonia vaccinations
Incentive spirometry

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120
Q

What characterizes respiratory acidosis?

A

Increased levels of PCO2

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121
Q

What characterizes respiratory alkalosis?

A

Decreased levels of PCO2

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122
Q

What is a possible cause of respiratory acidosis?

A

Hypoventilation

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123
Q

What is a possible cause of respiratory alkalosis?

A

Hyperventilation

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124
Q

What would compensation for respiratory acidosis look like?

A

Renal compensation: Increased bicarbonate levels

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125
Q

What would compensation for respiratory alkalosis look like?

A

Renal compensation: decreased bicarbonate

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126
Q

What characterizes metabolic acidosis?

A

Low bicarbonate levels

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127
Q

What characterizes metabolic alkalosis?

A

Increased bicarbonate levels

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128
Q

What would compensation for metabolic acidosis look like?

A

Respiratory compensation: decreased CO2 levels (breathing faster)

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129
Q

What would compensation for metabolic alkalosis look like?

A

Respiratory compensation: increased CO2 (slow and shallow breathing to retain CO2)

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130
Q

Angel of Mercy nurse image

A

Serene and content
Religious overtones
Provide relief to suffering

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131
Q

Battle ax nurse image

A

Hardened/abusive authority figure

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132
Q

Nurse as Professional: image and origin

A

Came about from Florence Nightingale’s reforms to nursing profession
Made nursing into a valid and respectable profession

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133
Q

Naughty nurse image

A

20th century idea, nurse is sexy/mindless/looking for rich doctor to marry

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134
Q

Military image of nursing

A

Nurses portrayed as warriors fighting diseases

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135
Q

Handmaiden image

A

views nurse as female assistant to male doctor or as emotional support to the patient. Limited scope of practice

136
Q

What factors make it difficult to define nursing?

A

Nursing roles and healthcare systems are constantly changing

Many different cultural views on what a nurse is an done

137
Q

Why is it important to define nursing?

A

Public understanding
To differentiate nursing and medical roles
To help students know what is expected of them as a nurse

138
Q

How long is the diploma program path to licensure?

A

3 years

139
Q

What is the value of an advanced practice nursing degree?

A

To be able to teach and function more independently

140
Q

What can a DNP do and not do?

A

A DNP gets clinical expertise but cannot do research. Only PhDs can do nursing research

141
Q

Give examples of health promotion activities?

A

Eating healthy
Drinking water
Getting adequate sleep

142
Q

Give examples of illness prevention strategies?

A

Sequestering sick people
Hand washing
Keeping immunocompromised people away from sick people

143
Q

What are some health restoration activities?

A

Sleep
Increased fluids
Adhering to prescribed medicines

144
Q

How does private healthcare insurance work?

A

Purchased directly by a person or for a person by a third party
Premiums paid directly to insurance company
Employee portion deducted directly fro paycheck

145
Q

How does government-funded health insurance work?

A

Funded by tax collection

Federal (medicare) or federal/state collaboration (Medicaid)

146
Q

How does being uninsured affect health status?

A

Illness or injury is likely to last longer and spiral into other issues because of hesitation to seek medical care

147
Q

What is the role of a Nurse Practitioner?

A

Can work autonomously or with physician
Treat across lifespan
APRNs can prescribe medications

148
Q

What can the clinical nurse specialist (CNS) do?

A

Able to advice as a clinical expert and resource in the practice area
Has a lot of knowledge in specialized area

149
Q

What can the certified registered nurse anesthetist do?

A

Administer anesthesia for surgery/diagnostic practices

150
Q

What is a SWOT analysis?

A 
A system for analyzing professional development that takes into account
Strengths
Weaknesses
Opportunities
Threats
151
Q

What are some good attributes for a mentor?

A 
Listening skills
Communication
Sensitive to needs
Encourages excellence 
Good decision making
Trustworthy
152
Q

What are some good traits for a mentee?

A 
Eagerness to learn
Participation 
Seeks feedback
Flexible
Open
Moves towards independence
Evaluates choices and outcomes
153
Q

What are three common leadership styles in the behavioral theories of leadership?

A

Authoritarian
Democratic
Laissez-faire

154
Q

What is transformative leadership?

A 
Participative
Bottom up
Future oriented
Directed towards sense of vision/mission
Promotes accountability
All about inspiring and motivating followers
155
Q

How does Frederick Taylors scientific theory of management work?

A

People should be paid by the item or task done, rather than the hours worked

156
Q

What are the four sources of power available to nurses and managers?

A

Authority
Reward
Expert
Coercion

157
Q

What are the steps of conflict resolution?

A 
Identify the problem or issue
Generate possible solutions
Evaluate suggested solutions
Choose the best solutions
Implement chosen solutions
Evaluate outcomes
158
Q

What is included in full spectrum nursing?

A

Thinking skills
Problem solving
Clinical judgement

159
Q

What allows nursing to be defined as an occupation?

A

It is what one does on a regular/daily basis and has set tasks

160
Q

What allows nursing to be defined as a discipline?

A

It is a domain of knowledge with theoretical and practical boundaries and requires continued and current knowledge

161
Q

What allows nursing to be defined as a profession?

A

It has technical and scientific knowledge requirements
Has a code of ethics
Involves service

162
Q

What makes it hard to define nursing as a profession?

A

Professions are the most autonomous domains, and the lack of autonomy in registered nursing makes labeling it as a profession challenging

163
Q

Describe Benner’s scale of Nursing

A
  1. Novice: student
  2. Advanced beginner: new grad nurse
  3. Competence: 2-3 years in same area
  4. Proficient: able to see big picture
  5. Expert: sees what needs to be done and knows how to do it
164
Q

What is leadership?

A

The ability to influence others and set goals

165
Q

According to trait theories, what makes a good leader?

A 
Intelligence
Initiative
Interpersonal skills 
Self esteem
Willingness to take risks
166
Q

What is the difference between task and relationship theories of leadership?

A

Task focuses on what needs to be accomplished, often to the detriment of interpersonal relationships. Relationship theory focuses on interpersonal relationships, often at the detriment of tasks needing accomplished

167
Q

How does situational leadership work?

A

Leader recognizes factors that are at play in a group and a particular environment and is able to adjust/adapt to meet those needs

168
Q

What is the operating premise of transactional leadership?

A

People are motivated by reward and punishment. Employees are closely monitored and there are strict disciplinary guidelines in place

169
Q

What are the two major schools of thought as pertains to management?

A

Scientific management and human-relations approach

170
Q

What are the essential qualities for an effective manager?

A

Leadership
Clinical expertise
Business sense

171
Q

What does SOAR stand for in strategic career planning?

A

strengths
Opportunities
Aspirations
Results

172
Q

How is followership defined?

A

Willingness to work with others to accomplish the group goal

173
Q

How is power defined?

A

Ability to influence others in spite of resistance from them

174
Q

What is empowerment?

A

Feeling of competence, control, and entitlement that a person experiences
In nursing: self determination, caring about work, confidence in abilities, and knowing you can make a difference

175
Q

What are the three domains of a managers activities?

A

Organizational
Interpersonal
Informational

176
Q

Which leadership responsibility reinforces constructive behavior and discourages undesirable behavior while providing recognition and developing employee skills?

A

Evaluative feedback

177
Q

What are some things that have strongly influenced the recent changes in nursing?

A 
Economy
Technology
An aging population
Consumer involvement in healthcare
Women’s movement
Changes in nursing role
178
Q

List a few professional nurse organizations

A

ANA
NLN
ICN
NSNA

179
Q

What are the QSEN quality and safety competencies for nurses?

A 
Patient centered care
Teamwork and collaboration
Evidence based practice
Quality improvement
Safety
Informatics
180
Q

What are the five main nursing models of care?

A 
Case method
Functional nursing
Team nursing
Primary nursing
Differentiated practice
181
Q

How does the case method of nursing work?

A

One to one care, where nurse does all aspects of care for one patient over the course of a shift

182
Q

How does functional nursing work?

A

Care is compartmentalized, with each task assigned to a staff member with the right knowledge and skills

183
Q

How does team nursing work?

A

A licensed nurse and some nursing assistants team up to care for a group of patients

184
Q

How does primary nursing work?

A

One nurse manages the care for a group of patients. Develops a plan of care and provides the care

185
Q

How does differentiated practice work?

A

Variation on primary nursing. Each unit outlines the needed skills to work on that unit, and nurses must demonstrate competency to be able to care for patients.

186
Q

The managing and processing of information necessary to make decisions

A

Informatics

187
Q

In what ways is informatics applied to nursing?

A

In practice, education, and research

188
Q

What are the four components of informatics?

A

Data
Information
Knowledge
Wisdom

189
Q

Why was wisdom added as a component of informatics?

A

Because its crucial to know how to use information appropriately

190
Q

How is telehealth defined?

A

Using telecommunication to talk between patients and providers across multiple sites

191
Q

What are the benefits of EHRs?

A 
Efficiency
Privacy
Accessibility
Error Reduction
Research
Planning Care made simpler
192
Q

What does NANDA stand for?

A

North American Nursing Diagnosis Association

193
Q

What does NANDA do?

A

Nursing diagnoses, definitions, and classifications

Emphasis is on independent practice

194
Q

What does NIC stand for?

A

Nursing Interventions Classification

195
Q

What is the focus of the NIC system?

A

Standardized Nursing Interrventions

196
Q

What does NOC stand for?

A

Nursing outcomes classification

197
Q

What is the focus of NOC?

A

Standardized outcomes in nursing

198
Q

How does the Omaha taxonomy system work?

A

Research based standardized taxonomy that includes assessment, intervention, and evaluation

199
Q

What are some reasons for why we need documentation in nursing?

A 
Planning
Evaluation
Communication
Legal document 
Quality improvement
Reimbursement review
Education research
200
Q

What are the steps in the process of evidence based practice?

A 
Ask an answerable question 
Review published evidence
Evaluate quality of evidence 
Analyze data and prepare report
Turn evidence into a guideline
Integrate guidelines into patient care
201
Q

What are background questions?

A

General knowledge questions that focus more on “what is?” Or “why do?” Questions.

202
Q

What are foreground questions?

A

Questions that answer specific, pointed questions

203
Q

What does the PICO method do?

A

Give a way to ask foreground questions for evidence based practice

204
Q

What does PICO stand for?

A

Patient Problem (what is it?)
Intervention
Comparison (this vs that or this vs no action)
Outcome

205
Q

When it comes to evidence for nursing research, what is the very best kinds of evidence?

A

Meta-analysis

206
Q

Systematic reviews of clinical topics to provide evidence for guidelines and quality measures

A

Evidence reports

207
Q

Statements developed from review of evidence and benefits or harms to patients?

A

Clinical practice guidelines

208
Q

What are some key factors of quantitative research?

A 
Numerical data
Hypothesis
Controlled setting 
Objective
Large test population
209
Q

What are some key factors of qualitative research?

A

Non-numerical
Small participant pool
Subjective
Natural setting

210
Q

What are the four rights of informed consent?

A

Right to not be harmed
Right to full disclosure
Right to self-determination
Rights of privacy and confidentiality

211
Q

What are the responsibilities of institutional review boards?

A

Protect participants

Ensure quality research

212
Q

What are some distinguishing factors of a research article?

A

Trustworthy source
Peer reviewed
Published in a medical journal

213
Q

What are some possible causes of respiratory acidosis?

A

Hypoventilation (could be from COPD, obesity, drugs, sleep apnea)

214
Q

What are some possible causes of respiratory alkalosis?

A

Hyperventilation (could be from fever, overventilation, hepatic failure, hysteria, fever)

215
Q

What are some possible causes of metabolic acidosis?

A

Increase of acid in the body from lactic acid, diabetes, or acid ingestion

216
Q

What are some possible causes of metabolic alkalosis?

A

Excess gastric drainages, vomiting, potassium depletion, diuretic therapy, burns

217
Q

What sort of questions are good for getting specific information in a timely manner?

A

Close ended questions

218
Q

What sort of information is gathered through a directive interview?

A

Age, gender, pain level, anything immediately pertinent

219
Q

How does a non-directive interview work?

A

Patient controls the interaction

Nurse summarizes, listens, and clarifies

220
Q

What does the FOLK acronym help with?

A

Active listening

221
Q

What does FOLK stand for?

A

Face the patient
Open, relaxed posture
Lean towards patient
Keep eye contact

222
Q

What are the elements of a nursing health history?

A 
Biographical data
Patient’s perception of health
Past health history
Family health history
Social history
Medications 
Review of body systems
223
Q

During a general health survey, the nurses main task is to…

A

Observe

224
Q

What are the things a nurse will observe in a general health survey?

A 
Appearance and behavior
Body type and posture
Speech
Dress, grooming, hygiene
Mental state
225
Q

What specific things will a nurse assess for mental status?

A

Awake, alert, and oriented times three (person, place, and time)

226
Q

What are activities of daily living?

A 
Bathing
Dressing
Using restroom
Continence
Feeding oneself
227
Q

What are instrumental activities of daily living?

A 
Tasks needed to maintain immediate environment:
Shopping
Managing money
Using phone
Cooking
Managing medications
228
Q

What does a functional ability assessment look at?

A

ADLs and IADLs

229
Q

What does Katz’s functional ability tool look at?

A

Independence in ADLs

230
Q

What does Lawton’s functional ability tool look at

A

Ability to perform IADLs

231
Q

What is the HSI?

A

The Home Safety Inventory for adults with dementia

232
Q

What does the Hendreich II model look at?

A

Fall risk

233
Q

What is the SPICES tool?

A

An overall assessment tool for older adults that helps flag areas for further assessment

234
Q

What does SPICES stand for?

A 
Sleep Disorders
Problems with eating or feeding
Incontinence 
Confusion
Evidence of falls
Skin breakdown
235
Q

What is meant by the wellness-illness continuum?

A

A portrayal of health and illness that ranges from high-level wellness to complete depletion of health

236
Q

What is high-level wellness?

A

A sense of well-being, life satisfaction, and quality of life

237
Q

What kind of interactions can exist between health and wellness?

A

They can exist together or change independently. For example, someone can have high health but low wellness, or vice versa. They don’t have to progress together

238
Q

Definition: the idea of health being an outcome of ongoing patterns of person and environment interactions

A

Developmental perspective of health

239
Q

How does the ecological approach to health work?

A

It is comprehensive and multidimensional, and takes into account all the environmental factors that play a role in health. Also looks at what the options are for people in that environment

240
Q

Which approach to health is useful for promoting health at many levels, such as individual, family, community, and society?

A

Ecological approach to health

241
Q

What are the four models of health most commonly used?

A

Clinical model
Role performance model
Adaptive model
Eudaemonistic model

242
Q

How does the clinical model of health define health and illness?

A

Health is the absence of signs and symptoms of disease

Illness is the presence of S/S of disease

243
Q

What is the problem with the clinical model of health?

A

Lack of preventative care

244
Q

How does the role performance model define health and illness?

A

Health is an individual’s ability to perform social roles.

Illness is failure to perform roles at the same level as others in society

245
Q

What are some areas that use the role performance model as their basis for examination?

A

Occupational health exams

School physicals

246
Q

How does the adaptive model of health define health and illness?

A

Health is ability to adjust positively to social, mental, or physiological change
Illness is failure to adapt or becoming maladaptive

247
Q

What is an example of the adaptive model of health?

A

Using spirituality to adapt to changes

248
Q

What is the emphasis of the eudaemonistic model of health?

A

The interaction of spiritual, physical, social, and psychological aspects of life as pertains to achieving goals and attaining meaning for the individual

249
Q

How would illness be defined in the eudaemonistic model of health?

A

Languishing and a lack of involvement in life

250
Q

How could an ill patient still be considered healthy under the eudaemonistic model?

A

If the ill person could still find meaning in life, they would be considered healthy by this model

251
Q

What is the meaning of functional health?

A

Ability to function in one’s environment

252
Q

What might be included in environmental functioning?

A

Being present or absent
High or low level wellness
Societal influence

253
Q

What are the different realms or levels of function?

A

Physical
Mental
Social

254
Q

Loss of function would warrant what nursing intervention from an ecological perspective?

A

Assessment of environmental aspects that could be causing loss of function

255
Q

What four components comprise the metaparadigm for nursing?

A

Person
Health
Environment
Nursing

256
Q

What is the difference between disease and illness?

A

Disease is the failure of adaptive mechanisms in the body

Illness is the subjective experience of the individual and the physical manifestation of the disease

257
Q

What are the three components of illness?

A

Psychological
Spiritual
Social

258
Q

What are some benefits of physical activity?

A

Maintain and improve mobility
Positive mental health (stress reduction)
Lowered risk of cardiovascular disease

259
Q

What are some barriers to participation in physical activity?

A

Current physical condition
No access to a doctor to okay exercise
Pre-existing beliefs or attitudes towards exercise

260
Q

How do health disparities impact the development of disease?

A

People of minority groups or lower SES exercise less/eat more unhealthily than their wealthier white counterparts, increasing the number of people who develop diseases. This leads to more diseases and a culture where disease is normal, perpetuating the cycle

261
Q

What is one requirement of the Patient Protection and Affordable Care Act?

A

PCP’s must provide free wellness services to older adults to promote wellness

262
Q

How can community partnerships better serve the needs of the community?

A

Partnerships can provide screenings, referral, and education to underserved populations without the need to incentivize doctors and hospitals to provide that care

263
Q

What is primordial prevention?

A

Prevention that occurs before a risk factor develops

264
Q

What is an example of primordial prevention?

A

Reduction of sodium in food supply

265
Q

What are the two general aspects of primary prevention?

A

Education

Specific prevention

266
Q

What is the purpose of primary prevention?

A

Decreasing vulnerability of person or population to disease or dysfunction

267
Q

How does primary prevention go beyond the individual?

A

Because health promoting policies for institutions and public health can be primary prevention things

268
Q

What is the difference between active and passive health promotion?

A

Passive: individual participates inactively (things like clean water or sanitary sewage movements)
Active: individual actively chooses, like exercise and healthy eating

269
Q

What is the key factor to remember with the Transtheoretical Model of Change (TTM)?

A

People often need repeated opportunities to change before they can succeed at the desired change

270
Q

What are the six stages of change according to the Transtheoretical Model of Change?

A
  1. Not considering change
  2. Aware but not considering it soon
  3. Planning to act soon
  4. Has recently begun to make changes
  5. Continued commitment to long-term change
  6. Reverted to old behavior
271
Q

How do the TTM stages of change provide opportunities for the nurse?

A

The nurse can provide information, support, and encouragement at each stage

272
Q

What is meant by late secondary prevention?

A

Delayed recognition of a disease

273
Q

What are the main goals of tertiary prevention?

A

Minimize effects of disease

Maximize remaining capacity

274
Q

What are the responsibilities of the nurse in tertiary prevention?

A

Making sure the patient has services and resources to live and work to the fullest extent possible

275
Q

What are some of the functions of a nurse in the role of advocate?

A

Help patient get what they are entitled to in healthcare system
Works to make system more responsive to patient needs
Teach people to advocate for themselves
Making sure all people receive high-quality, appropriate, cost-effective care

276
Q

In what ways does the nurse act as a care manager?

A

Maintain quality and safety
Reduce costs
Prevent duplication of services
Facilitate communication between different parties

277
Q

How might a nurse act as a consultant?

A

By providing specialized knowledge about something like health promotion or disease prevention

278
Q

What might it look like for a nurse to act as a deliverer of services?

A

Delivering things like flu shots, health education, and counseling in health promotion

279
Q

What does it mean for a nurse to act as a healer?

A

Nurse helps to realize what is important to the patient and implement a care strategy to maximize patient’s ability for healing

280
Q

How does the nurse function as a researcher?

A

Must use evidence based findings in clinical decision making, so they must be good researchers

281
Q

How is the ethnic landscape supposed to change in the US by 2050?

A

Those of white European descent will no longer be the majority

282
Q

In what two ways is age distribution changing in the US?

A

Considerable increase in those over 65 in the next decade

Lower birth rate (but offset by immigration)

283
Q

What are some current environmental threats to health?

A

Environmental pollution
Psychological conditions due to fast paced/stressful society
Ingestion of unhealthy foods
Drug abuse/alcoholism

284
Q

What is detrimental about treating disease through the application of complex technology?

A

It is very costly

It does little to improve health because it focuses on effects, not causes

285
Q

What are the major causes of death in the US today?

A

Chronic diseases
Heart disease
Stroke
Cancer

286
Q

What are the two major directions that can be the focus of health solutions?

A

Individual involvement

Government involvement

287
Q

What are two examples of government mandates that are primary prevention strategies?

A

Increased physical activity time in schools

Mandating seatbelt use

288
Q

How is asset planning defined?

A

A planning approach that looks at the reality of the current situation and gives realistic building blocks for the future

289
Q

What is the focus of asset planning?

A

How to use the assets of the individual, the family, and the community

290
Q

What is a person able to do well when they have a high quality interaction between their inner and outer worlds?

A

Respond to the demands and stressors of the biological, psychological, and environmental systems internally and externally

291
Q

What are some reasons why patient education is becoming more important?

A

Patients are participating more in their own care
Hospital stays are usually very brief, and patients need to know what to do upon discharge
Education helps decrease readmittance and reduce overall cost

292
Q

Definition: an interactive process that involves planning and implementing instruction to meet outcomes or provide information

A

Teaching

293
Q

Definition: a change in behavior, skills, or attitude that occurs because of planned or unplanned education

A

Learning

294
Q

What are the five rights of learning?

A 
Right time
Right context
Right goal
Right content
Right method
295
Q

What is cognitive learning?

A

Storing and recalling information in the brain

296
Q

What are some strategies and tools that can help support cognitive content?

A 
Lectures
Reading materials
Discussions
AV materials
Problem based learning
Visual aids
297
Q

What is psychomotor learning?

A

Learning something that requires mental and physical activity: DOING something

298
Q

What are some good strategies and tools for psychomotor skills?

A

Demonstration and return demonstration
Simulation
Printed/AV materials

299
Q

What is affective learning?

A

A change in feelings, beliefs, attitudes, or values

300
Q

What are some good ways to help and support affective learning?

A 
Positive reinforcement
Role modeling
Mentoring
Counseling
Discussion
301
Q

How is motivation to learn created?

A

A desire within a person that stems from an idea, a need, an emotion, or a belief

302
Q

What are some principles for motivating learners?

A

Show interest in them and the learning process
Create a warm and friendly environment
Establish rapport and respect
Help them identify a need
Incentivize learner
Make sure they believe that health is important

303
Q

What is readiness to learn?

A

Demonstration that behaviors that shows the learner is ready and able to learn at the specific time

304
Q

What physical factors might impact readiness to learn?

A

Pain
Energy level
Impaired cognition, vision, or hearing

305
Q

What emotional factors can impact readiness to learn?

A

Anxiety
Stress
Emotional pain

306
Q

IF POSSIBLE, LET PATIENT WORK THROUGH EMOTIONS BEFORE TEACHING

A

..

307
Q

Explain a key concept for how teaching and timing are related

A

People learn better when they will have a chance to use their knowledge in the near future

308
Q

How much of what people do vs read do they retain?

A

They retain 90% of what they do and speak, but only 10% of what they read

309
Q

What is an example of active involvement by a patient?

A

Having a patient do a return demonstration

310
Q

When is positive feedback especially important?

A

When trying to learn something that involves a behavior change

311
Q

How should a nurse go about pointing out errors made by a patient?

A

Be positive and encouraging

Try to not seem judgmental

312
Q

REPETITION IS IMPORTANT TO PATIENT TEACHING

A

..

313
Q

What are some factors in a positive learning environment?

A 
Good lighting 
Comfortable seating
Good teaching materials
Quiet space/no distractions
Good temperature
314
Q

What should scheduling look like for teaching sessions?

A

Shorter sessions, especially with higher pain levels or complex material

315
Q

What should be taken into consideration when teaching complex subject matter?

A

Reduce medical jargon
Shorter sessions
Be comfortable with content
Repeat exposure

316
Q

What are some general barriers to communication/teaching?

A 
Pain
Anxiety 
Fatigue
Illness
Hunger
Relationship stress
Language/culture differences 
Distractions
317
Q

What special needs might need other considerations when planning a teaching session?

A

Learning disabilities
Mental illness
Brain injury
Communication disorders

318
Q

Who should be present when teaching a patient with special needs?

A

Family member, caregiver, or other significant person

319
Q

What are Piagets stages of cognitive development?

A

Preoperational stage
Stage of concrete operations
Formal operational stage

320
Q

When planning to teach older adults, what considerations should be made?

A 
Pain
Vision/hearing issues
Medication effects
Chaotic environment
Need for extra time
321
Q

What are some good strategies for teaching children?

A

Gain trust
Reduce anxiety
Promote cooperation
Enhance emotional readiness to learn

322
Q

What is health literacy?

A

Capacity to obtain, process, and understand basic health information to be able to make good healthcare decisions

323
Q

Who are some groups that may have limited health literacy?

A

Limited English proficiency
Medically underserved population
Minority populations
Older adults

324
Q

What are some barriers to the teacher for good education?

A

Time factors

Lack of space/privacy

325
Q

What are some barriers to learning for a learner?

A

Physical condition

Language barriers

326
Q

What are the steps of the teaching process?

A 
Assessment
Nursing diagnosis
Planning outcomes
Teaching plans
Implementation
Evaluation
327
Q

What is important for planning outcomes?

A

Always have the objectives in mind

328
Q

What is meant by a contractual agreement

A

Statement of understanding between teacher and learner about how to achieve a goal. Both parties agree on it

329
Q

What is a teaching goal?

A

Broad goal that outlines the expected final outcome

330
Q

What is a learning objective?

A

A short term, measurable, specific behavior change that must be accomplished to meet the goal

331
Q

What are three things that might be included in teaching content?

A

Facts
Skills
Emotions

332
Q

What are some guidelines regarding scheduling and sequencing of content?

A

Simple topics before complex topics
Non-threatening topics before controversial ones
Schedule in advance if it will take a while

333
Q

Why is it essential to evaluate the effectiveness of teaching?

A

There is no way to know how it worked or how to improve it if we do not evaluate it

334
Q

Who is the best source for providing feedback on teaching effectiveness?

A

The client

335
Q

What are some methods to evaluate client learning?

A

Questions/interviews
Direct observation of client performance
Reports/records
Tests

336
Q

What are two reasons to document teaching and learning?

A

Legal evidence

Communication to other healthcare professionals

337
Q

What should be included when documenting teaching and learning?

A

What was taught
Skills and behaviors demonstrating learning
Nursing notes on informal teaching

Krystan: Semester One Nursing School (6 decks)

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