The FINAL!!! Flashcards
1
Q
Who focused on caring as cultural competence or using knowledge of culture to implement in patient care?
A
Dr. Madeline Leininger
2
Q
Who explored caring by the nurse as an intentional presence, personal ownership, and a respect for human dignity?
A
Dr. Dingman
3
Q
Who was considered the first nursing theorist?
A
Florence Nightingale
4
Q
Who looked at nursing as being an individual practice separate from assisting physicians in providing medical care?
A
Florence Nightingale
5
Q
Who developed the nursing theory called “The Science of Human Caring?”
A
Dr. Jean Watson
6
Q
What are the 10 caritas processes?
A
- Sustaining human dignity
- Providing an authentic presence
- Using authentic listening
- Enabling the patient’s faith, hope, and belief system
- Using all ways of doing, being, and knowing
- Using artistic versions of self
- Being sensitive to your own spiritual beliefs
- Display loving and kindness to patients
- Create a healing environment
- Be mindful of presence of energies
7
Q
What are the five realm’s of Swanson’s Caring Theory?
A
- Knowing
- Doing for
- Being with
- Enabling
- Maintaining belief
8
Q
A form of bias that is the tendency to think your own group is superior to others
A
Ethnocentrism
9
Q
Assumption that members of one sex are superior to those of another
A
Sexism
10
Q
A behavioral manifestation of a prejudice
A
Discrimination
11
Q
A feeling of unfair dislike directed against an individual or a group because of some characteristic
A
Prejudice
12
Q
What are the six aspects of Joyce Giger’s Transcultural model?
A
- Communication
- Time
- Environmental Controls
- Space
- Social organization
- Biological variations
13
Q
What part of the Giger model includes verbal and nonverbal language that includes: spoken language, gestures, eye contact and silence?
A
Communication
14
Q
What part of the Giger model refers to a person’s personal space or how that person relates to the stored space around him or her?
A
Space
15
Q
What part of the Giger model measures a person’s perception of time?
A
Time orientation
16
Q
What part of the Giger model includes a patient’s family unit or other organizations in with the patient identifies with?
A
Social organization
17
Q
What part of the Giger model refers to a person’s perception of his or her ability to plan activities that control nature or direct environmental factors?
A
Environmental control
18
Q
What part of the Giger model includes ways in which people are different genetically and physiologically?
A
Biological variation
19
Q
What is the best practice to working around a language barrier when providing care to a patient who speaks another language?
A
Using a translator
20
Q
When should a patient’s family member be used as a translator?
A
As the VERY last resort
21
Q
What is CAM?
A
Complimentary and Alternative Medicine
22
Q
What does complementary medicine do?
A
Seeks to enhance western medicine
23
Q
What does alternative medicine do?
A
Intends to replace or bypass traditional medicine (allopathy) by other means
24
Q
Who most likely uses CAM?
A
Women with higher education, income, and those with two or more chronic conditions (Usually white women)
25
What are some examples of energy therapy modalities?
- Tai Chi (nonaggressive martial arts)
- QI Gong (breathing and meditation)
- Reiki (energy balance to promote healing)
- Magnet therapy (magnetism)
26
What are the factors that influence health?
- Biological factors
- Diet
- Lifestyle
- Culture
- Finances
- Substance abuse
27
What are the five stages of illness?
1. Symptoms
2. Sick Role Behavior
3. Seeking professional care
4. Dependence on others
5. Recovery
28
Knowledge that is akin to the knowledge found in our textbook. What to do and why we do it.
Theoretical knowledge
29
Knowledge that involves knowing what to do and how to do it safely
Practical knowledge
30
Knowledge that includes our own preferences or biases that may influence our thinking (experiences)
Self-knowledge
31
Knowledge that helps decipher between what is right or wrong
Ethical knowledge
32
A type of assessment that is continuing the plan of care (Ex: a head to toe performed at the start of every shift)
Ongoing
33
A type of assessment that explores a patient's complaint or symptom
Focused
34
Whatever the patient says or reports and cannot be easily verified by the nurse
Subjective Data
35
Quantitative data or observable data that is measured and accepted as factual
Objective Data
36
Checking the accuracy and quality of source data before using, importing or otherwise processing data.
Data validation
37
What is the top priority of Maslow's hierarchy of needs?
Physiological
38
What is the second priority of Maslow's hierarchy of needs?
Safety
39
What is the third priority of Maslow's hierarchy of needs?
Love and Belonging
40
What is the fourth priority of Maslow's hierarchy of needs?
Self-Esteem
41
What is the fifth priority of Maslow's hierarchy of needs?
Self-actualization
42
What is the PES statement?
Problem, Etiology, Symptoms
| Problem r/t etiology aeb symptoms
43
A statement of client health status that nurses can identify, prevent, or treatment independently
Nursing diagnosis
44
What are the two ways to prioritize a patient's nursing diagnosis?
ABC's
| Maslow's Hierarchy of Needs
45
What is the SMART in an ECO?
```
Specific
Measurable
Achievable/Attainable
Realistic
Time bound
```
46
What type of interventions are those put in place by nurses without the guidance of a provider?
Independent intervention
47
What type of interventions involve collaboration with ancillary staff?
Interdependent intervention
48
What type of intervention requires a provider's order?
Dependent intervention
49
What are the benefits of standardized care plans?
- Prepopulated in the EHR
- Includes every possible intervention for each dx
- Includes suggested ECOS
- Saves time
50
What is the risk of standardized care plans?
Not ideal because they are not personalized to the patient's specific needs
51
What are the five steps of evaluation?
1. Review outcomes
2. Collect reassessment data
3. Make a judgment
4. Document the evaluation
5. Revise if necessary
52
What are the 5 rights to delegation?
1. Right Task
2. Right Circumstance
3. Right Person
4. Right Communication
5. Right Supervision
53
A goal that is something the nurse can generally measure themselves that is within the next few hours, days, by end of shift or discharge
Short term goal
54
A goal that may require a follow up by another person, longer than a few days
Long term goal
55
What are 5 interventions for aspiration risk
1. No straw
2. Cut up patient's food
3. Thicken liquids
4. Chin forward flexed
5. Check mouth for pocketing
6. Keep suction nearby
7. Keep in upgrade position
8. Assist with feeding
9. Monitor for coughing
10. Assess breathing
56
What does a clear liquid diet include?
- Water
- Black coffee
- Tea w/no cream
- Chicken broth
- Clear juices or carbonated beverages
- Popsicles
- Jell-O
57
What does a full liquid diet include?
* all liquids in a clear liquid*
| - PLUS: dairy and foods that are liquid at room temp
58
What does a pureed diet include?
* all foods in a liquid diet*
- PLUS: soft veggies/fruits, chopped or ground meat. soft bread, cheese and eggs
--> DIET LOW IN FIBER
59
Which tube feeding goes through the stomach?
Enteral
60
How long can a closed system feeding system be run?
24 hours
61
How long can an open feeding system be run?
4 hours max
62
When should a feeding tube be flushed?
Before and after a feeding and before and after a medication
63
How long should an NG be placed?
6 weeks or less
64
What are the six categories of the Braden Scale?
1. Sensory perception
2. Moisture
3. Activity
4. Mobility
5. Nutrition
6. Friction/Shear
65
How soon can a pressure injury begin?
2 hours
66
Pressure wound that only involves the epidermis and is nonblanchable.
Stage 1
67
Pressure wound that has broken the skin but only effects the dermis
Stage 2
68
Pressure wound that has gone beyond the dermis and into the Sub-Q layer into the muscular layer, sometimes exposing bone
Stage 4
69
Pressure would that is beyond the dermis and extends into the Sub-Q tissue
Stage 3
70
Which stages of pressure wound are full thickness
Stages 3 and 4
71
Yellow wound drainage
Serous
72
Bright read wound drainage
Sanguineous
73
Pink and Watery wound drainage
Sero-sanguineous
74
Creamy and yellow wound drainage (pus)
Purulent
75
Thick and stringy, waxy yellow substance
Slough
76
Necrotic, black wound tissue
Eschar
77
Pain that is caused from tissue damage as a result of trauma, surgery, or inflammation
Nociceptive pain
78
Pain that arises from a nerve injury or damage to the neurological pathway transmitting the nerve signals
Neuropathic pain
79
Pain that comes from injuries that in the skin or subcutaneous tissue
Superficial pain
80
Pain that often comes from visceral pain
Referred pain
81
Shooting pain
Radiating
82
What are six nonpharmacological pain management techniques?
1. Massages
2. Hot/cold therapy
3. Immobilization and rest
4. Acupuncture/Acupressure
5. TENS or PENS
6. Humor/Distraction
83
What type of pain does not respond well to opoids?
Neuropathic
84
When should a person's pain be reassessed after administering narcotics?
Within 1 hour
85
What does pain do to the endocrine system?
Release of stress hormones (insulin and testosterone levels decrease)
86
What does pain do to the cardiovascular system?
Increase in HR, BP, CO, and oxygen demand
87
What does pain do to the MSK?
Impaired muscle function, fatigue, and immobility
88
What does pain do to the respiratory system?
Shallow breaths
89
What does pain do to the GU system?
Excessive amount of stress hormones, such as: cortisol and aldosterone, and ADH
90
What does pain do to the GI system?
Causes nausea and constipation
91
Proper body mechanics for a nurse
1. proper spinal alignment
2. lift with knees
3. don't twist
4. use assistive aids if needed (ie: gait belt)
5. raise the bed
6. push or pull; don't lift
92
What is the last Erikson's stage of development?
Ego Integrity vs Despair
93
What is a normal specific gravity?
1.002-1.030
94
A painful or burning upon urination
Dysuria
95
Normal values for protein, glucose, and ketones in urine
Negative
96
Excessive or frequent urination
Polyuria
97
The lack of Urine
Anuria
98
Blood in the urine
Hematuria
99
Too little urine (Less than 400 mL over 24 hrs)
Oliguria
100
Normal BUN levels
8-21 mg/dl
101
Increase in intra-abdominal pressure causing loss of urine
Stress incontinence
102
Occurs when the urgency to urinate is so strong, there is involuntary loss of urine
Urge incontinence
103
No urinary problem, pt just can't make it to the bathroom in time due to external circumstances
Functional incontinence
104
When the bladder overfills and urine leaks out
Overflow incontinence
105
What foods should a person with an ostomy bag avoid?
Avoid gas-producing foods (Ex: cauliflower, peas, brussels sprouts, garlic, onions, beans, peas, or dairy)
106
What should a patient do prior to a colonoscopy?
Prepare by being NPO or at least clear liquid diet for a full day before procedure.
Use a bowel prep
107
What is the primary nursing intervention for someone with diarrhea?
```
Supportive care
(increase fluid intake, BRAT diet, bedside commode, probiotics, medication Lomotil)
```
108
Problems falling asleep or staying asleep
Dyssomnia
109
What are some examples of dyssomnia?
- insomnia
- sleep apnea
- hypersomnia
- circadian disorders (jet lag)
- restless leg syndrome
- narcolepsy
110
Patterns of waking behaviors during sleep
Parasomnia
111
Examples of parasomnias
- sleepwalking
- nocturnal enuresis
- night terrors
- Rem disordered behavior
112
Characterized by the difficulty of falling asleep, staying asleep, or inability to fall back to sleep once prematurely awakened
Insomnia
113
Somnambulism
sleepwalking
114
A condition characterized by an extreme tendency to fall asleep whenever in relaxing surroundings.
narcolepsy
115
What are interventions to promote sleep hygiene
- restful environment
- promote comfort
- allow 30 min to fall asleep
- darken room
- limit alcohol/caffeine intake before bed
- complete exercise 2 hours before bed
- warm interventions
- set schedule
116
What is a SOAPIE?
```
S-Subjective data
O-Objective data
A-Assessment
P-Planning (documenting ECO)
I-Intervention (nursing care)
E-Evaluation
```
117
What does the SOAPIE do?
Allows nurses to organize assessment data on the nursing care plan in a streamlined way
118
If an error is made in the a medical chart, how should it be corrected?
Single line and initial (black ink)
119
How can patient orders be given?
1. Verbal (emergency situation only!)
2. Written
3. Telephone (provider must sign in 24 hours)
120
The Six Rights of Medication
1. Drug
2. Dose
3. Route
4. Time
5. Patient
6. Documentation
121
When should a medication be checked before given to the patient?
1. When reviewing the record
2. When pulling the medication
3. At patient's bedside
122
What should be included on a medication order?
- Medication name
- Route of administration
- Dosage
- Time it should be given
- How frequently it should be given
123
What are the normal creatinine levels?
0.5-1.2 mg/dL
124
What restraint is the standard of care?
None Restraint Free!
125
- Maintain a consistent environment
- Review pt's medication profile
- Relieve anxiety
- Frequently reassess the patient
- Properly communicate
- Make environment comfortable
- Anticipate pt's needs
Can help do what?
Prevent the need for restraints
126
What is the RACE response?
Rescue
Alarm
Contain
Extinguish
127
How do you prevent sharps injuries?
- Maintain sharp awareness
- Never recap a needle
- Use of a needleless system
128
Increase of WBCs is indicative of what?
Infection
129
What does a culture look for?
Presence of specific bacteria
130
What does CRP or ESR indicate?
Chronic inflammation
131
Which precaution uses gloves and a gown?
Contact precaution
132
Which precaution uses a mask?
Droplet precaution
133
Which precaution uses a N95 and negative pressure?
Airborne precaution
134
What type of precaution does TB require?
Airborne
135
What type of precaution does meningitis require?
Droplet
136
What type of precaution do the measles require?
Airborne
137
What type of precaution does pertussis require?
Droplet
138
What type of precaution does MRSA require?
Contact
139
What type of precaution does the flu require?
Droplet
140
Protects a patient's person information from being share with any person or organization that does not need to have information about that person's medical status
HIPAA
141
Who has access to a patient's medical records?
1. The Patient
2. The care provider
3. The insurance company paying the bill
142
The duty to keep promises or the virtue of loyalty
Fidelity
143
Refers to a person's right to make choices
Autonomy
144
The duty to tell the truth
Veracity
145
The value of doing what benefits the patient the best
Beneficence
146
The hallmark value or virtue of "Do No Harm"
Non-maleficence
147
Refers to the equal treatment of all patients
Justice
148
The state of being held against without legal authorization (includes by use of medication)
False imprisonment
149
Creating a fearful situation
Assault
150
Unauthorized physical contact
Battery
151
Interference with personal data
Invasion of privacy
152
What are the goals of care at end of life
- give dying pt autonomy and control over dying choices
- support and hope for the family
- remain comfortable (pain free)
- support loved ones and family
153
Cyclic breathing marked by a gradual increase in the rapidity of respiration followed by a gradual decrease and total cessation for from 5 to 50 seconds
Cheyne-Stokes Respirations
154
Which theorist focused on the Cognitive Stages of Development?
Piaget
155
Which theorist focused on the Psychosexual stages of Development?
Freud
156
Which theorist developed basic needs throughout the lifetime?
Erikson
157
An infant should have breast milk/formula exclusively for how long?
First six months of life
158
How often can new foods be introduced to an infant on solids?
One every 3-4 days
159
Which foods should an infant avoid?
- Honey
- Egg yolks/meat
- Hard, small food
- Foods likely to cause allergic reactions
160
How much fat content should a toddler consume?
20-30%
161
How much milk should a toddler drink a day?
16 oz
162
What extra nutrients does an adolescent need?
Zinc, calcium, and iron
163
What is the balanced diet requirement for an adolescent?
45-65% carbs
10-30% proteins
25-35% fats
164
When do kids typically begin to lie?
2-4 years old
165
Who is the father of modern Psychology?
Sigmund Freud
166
Who believed all behavior has meaning?
Freud
167
Who believed all behavior is learned?
Skinner and Pavlov
168
Who developed operant conditioning?
Pavlov
169
Who developed the Superego, ID, and Ego?
Freud
170
Who believed in the Interpersonal theories?
Sullivan and Peplau
171
Who was the biggest nurse influence in Psych?
Peplau
172
Who developed the cognitive model?
Beck and Ellis
173
Believed the role of culture and society emphasized on personality development
Erikson
174
Intervening before health effects occur, (i.e. through education or manipulation of environment)
Primary prevention
175
Screening to identify early
Secondary prevention
176
Managing the disease to slow or stop.
Tertiary prevention
177
What are the key components to informed consent?
- Patient is alert and oriented
- Patient is voluntarily consenting
- Patient has been given all the pertinent information
178
What are a Psych patients rights?
- Right to receive tx
- Right to refuse tx
- Right to confidentiality
- Right to informed consent
179
What are the 4 S's of a milieu?
Safety
Structure
Support
Social
180
Process one undertakes to deal with the void that is now left
mourning
181
Total environment or surroundings that the patient is in
milieu
182
Factors that influence grief
1. Mourning
2. Culture
3. Spiritual
4. Gender
5. Economic Support
183
What are the five stages of grief?
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
184
What type of grief happens when a loss can be anticipated?
Anticipatory grief
185
What type of grief happens when nothing in particular makes the loss difficult?
Uncomplicated grief
186
What type of grief relates to the kind relationship a person had with the loss and type of loss that was?
Complicated grief
187
An example of a disenfranchised grief
Suicide
188
Risk factors for complicated grief
- Dependency
- Unresolved conflicts
- Death of a child
- Support systems gone
- Death associated with stigma: Heroin overdose
- Alcoholism
- Suicide
- History of abuse with deceased
- Death unexpected or associated with violence
- Unresolved losses
- History of depression, substance use or psychiatric illness
- Stress of grief can impact the person
- Bereaved is young
189
Nursing interventions for grief
- Control over death and dying → choices
- Plan funeral
- Support with will and hope
- Time availability with family → visiting
- Privilege of nursing
- Support family/ Loved ones
190
What are five forms of nontherapeutic communication?
1. Asking "why?"
2. Giving advice
3. False reassurance
4. Minimizing feelings
5. Showing sympathy
191
What are five forms of therapeutic communication?
1. Restating
2. Active listening
3. Using silence
4. Giving recognition
5. Giving broad openings
192
What are the four phases of Peplau's Nurse-Patient Relationship?
1. Preorientation
2. Orientation
3. Working phase
4. Termination phase
193
What phase during Peplau's Nurse Patient Relationship includes:
- summarizing achieved goals and objectives
- discusses ways to incorporate new techniques
- reviews situations
- exchanges memories
Termination phase
194
What phase during Peplau's Nurse Patient Relationship includes:
- Preparing your assignment
- Researching your patient's condition and learning about medication usages
- Recognizing one's own thoughts and feelings
Preorientation
195
What phase during Peplau's Nurse Patient Relationship includes:
- establishing rapport
- specifying a contract
- establishing privacy
Orientation phase
196
What phase during Peplau's Nurse Patient Relationship includes:
- gathering data
- providing dx education
- providing medication education
- identifying problems
- promoting symptom management
- evaluating progress
Working phase
197
What type of anxiety is characterized by:
- dilated pupils
- sweaty palms
- increased HP
- dry mouth
- cool/clammy hands
Mild anxiety
198
What type of anxiety is characterized by:
- panic attacks
- shortness of breath
- trembling and shaking
- accelerated HR
- dizziness
- chest pain
- hot flashes
- impending doom
Panic
199
What type of anxiety is characterized by:
- inability to concentrate
- profuse sweating
- increase HR and RR
- shaking/shivering
- behavioral changes/altered perceptions
- purposeless movements
- confusion (speech grumbled)
- uncontrollable crying
Severe anxiety
200
What type of anxiety is characterized by:
- decreased perception
- increased HR and RR
- perspiration
- muscle tension
- irritability
- pacing
Moderate anxiety
