Unit 1 Exam Flashcards

1
Q

isolation

definition

A

intentional separation & restriction of ill persons with a confirmed contagious, transmittable infection/ disease

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2
Q

basic principles of patient care in isolation

4

A
  • understand how diseases are transmitted and which protective barriers to use
  • proper hand hygiene
  • proper disposal of PPE & supplies to prevent transmission of infection
  • protection of all people at risk of exposure while transporting the pt
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3
Q

PPE

A
  • gowns
  • masks
  • eye protection
  • gloves
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4
Q

how do you choose the correct PPE for a disease/illness?

A

chosen based on the method of transmission

(contact, droplet, or airborne)

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5
Q

what is the most common method of transmission/ isolation precaution?

A

contact

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6
Q

who are tier 1 precautions for?

A

protects all patients in all healthcare settings

standard precautions

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7
Q

who are tier 2 precautions for?

A

for pts who are suspected of being colonized with a contagious, transmissible pathogen

expanded precautions

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8
Q

what are some infectious agents that tier 1 precautions protect workers from?

A
  • blood
  • body fluids
  • non-intact skin
  • mucus membrans
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9
Q

what 2 things must you do when transporting a pt on isolation precautions?

A
  • notify receiving unit
  • cover pt with clean linens & a mask if required
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10
Q

how are infectious agents transmitted in contact precautions?

A
  • direct contact - preson to person
  • indirect contact - person to contaminated object to person (fomite)
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11
Q

diseases associated with contact precautions

A
  • MDRO - acinetobacter, pseudomonas, ESBLs, CREs
  • VRE
  • RSV (resp. illness, but lives on surfaces)
  • shingles (localized)
  • rotavirus (diarrhea)
  • lice
  • scabies
  • wounds (excessive drainange or open wounds)
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12
Q

diseases associated with special contact precautions

A
  • C-DIFF (Clostridium difficile)
  • norovirus
  • diarrhea of unkown origin/ or upon admission
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13
Q

diseases associated with droplet precautions

A
  • influenza (flu)
  • pertussis (whooping cough)
  • bacterial meningitis
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14
Q

diseases associated with airborne precautions

A
  • tuberculosis (TB)
  • varicella (chicken pox)
  • rubeola (measles)
  • disseminated shingles (systemic/widespread or immunocompromised pt)
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15
Q

PPE for contact precautions

A
  • hand hygiene
  • gown
  • gloves
  • clean linens draped if transporting pt
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16
Q

PPE for special precautions

(C-diff)

A
  • hand hygiene (with soap/water after pt care)
  • gown
  • gloves
  • clean linens draped if transporting pt
  • use bleach wipes (3 min wet time)
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17
Q

PPE for droplet precautions

A
  • hand hygiene
  • surgical mask or mask with eye shield
  • clean linens and mask on pt when transporting
  • maintain 6 ft social distance

door can be left open due to the 6 ft rule

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18
Q

PPE for airborne precautions

A
  • hand hygiene
  • N95 mask
  • negative air pressure room, shut at all times
  • clean linens and mask on pt when transporting

doff mask outside the room

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19
Q

which isolation precaution would you doff your mask outside the room? why?

A

airborne precautions

to protect yourself from the contaminated air particles in the room

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20
Q

PPE for contact + droplet precaution

COVID (no aerosolized procedures)

A
  • hand hygiene
  • gown
  • gloves
  • N95
  • face shield/ goggles
  • door closed
  • clean linens and mask on pt when transporting
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21
Q

PPE for special respiratory precaution

COVID (aerosol provedures)

A
  • hand hygiene
  • gown
  • gloves
  • N95
  • face shield/ goggles
  • negative air pressure room with door closed
  • clean linens and mask on pt when transporting
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22
Q

aerosolized procedures

A

breathing treatments, mechanical ventilation, frequent use of suction

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23
Q

3 factors that are required for a respirator to be effective

A
  1. must be worn correctly
  2. must fit snuggly, no gaps
  3. must capture at least 95% of air particles
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24
Q

what’s the difference between negative & positive air pressure rooms?

A
  • negative - keeps germs in, air is not circulated into hallways or other pt rooms (COVID)
  • positive - keeps germs out, air is continuously cycled/replenished (cancer/ immunocompromised)
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25
Q

which isolation precautions only require a gown & gloves for PPE?

A

contact & special contact

also the only ones that do not require the pt to wear a mask when trans

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26
Q

which isolation precautions require an N95 mask?

A
  • airborne
  • COVID non-aerosolized (contact + droplet)
  • COVID aerosolized (special respiratory)
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27
Q

PPE for protective precautions

severly immunoconpromised (cancer)

A
  • hand hygiene
  • standard precautions + doctor’s orders (ex: gown, gloves, mask)
  • staff/visitor screening
  • positive pressure
  • no fresh fruit/veg/flowers (reservoirs for infectious agents)
  • clean linens and mask on pt when transporting
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28
Q

what is the order to DON PPE?

A
  1. gown
  2. mask
  3. goggles
  4. gloves

don and on and on (going up)

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29
Q

infection

A

when a pathogen invades tissues & multiplies within a host

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30
Q

colonization

A

presence & multiplication of microorganisms within a host, but without tissue invasion/ damage

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31
Q

communicable disease

A

that which can be transmitted from one indv. to another

(COVID)

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32
Q

symptomatic infection

A

when pathogens multiply & cause signs and symptoms of disease

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33
Q

asymptomatic infection

A

when pathogens multiply, but no clinical signs or symptoms are present

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34
Q

virulence

A

ability to produce disease

(flu, strep, COVID)

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35
Q

5 methods of infection prevention/ control

A
  • hand hygiene
  • barrier techniques (PPE)
  • antiseptics (skin)/ disinfectants (objects)
  • immunizations/ medications
  • conscientious patient care (clean environment)
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36
Q

what type of infections have the highest mortality rate?

A

healthcare-associated infections

nosocomial infections

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37
Q

7 defense mechanisms against infection

A
  1. skin (1st line of defense)
  2. mouth (saliva breaks down infection, cilia moves particles away)
  3. eyes (eyelashes, tears)
  4. respiratory tract (cilia, cough, secretions, nasal hairs)
  5. urinary tract (excrete things that don’t belong like bacteria, viruses, & chemicals)
  6. gastrointestinal (GI) tract (normal flora, upper: acidic, lower: basic, GI motility)
  7. vagina (pH acidity kills unwanted microbes)
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38
Q

6 links in the chain of infection

A
  1. infectious agent
  2. reservoir
  3. portal of exit
  4. method of transmission
  5. portal of entry
  6. susceptible host
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39
Q

reservoir

A

any natural setting where growth and reproduction of an infectious agent can occur

water, animals/humans, food, wounds

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40
Q

portal of exit

A

anything open or leaving the body that can provide an opportunity of transmission

cough/sneeze, urine, saliva, blood, draining wounds

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41
Q

methods of transmission

A
  • direct contact - person to person
  • indirect contact - person to contaminated fomite (object)
  • respiratory - through air
  • vector - insect transmission
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42
Q

portal of entry

A

any openings that infections can enter

GI-GU tract, skin/wounds, respiratory tract, eyes

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43
Q

susceptible host

A

anyone at high risk for infection

immunocompromised, young/old, trauma, indwelling devices, wounds, low O2

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44
Q

who was the first practicing epidemiologist?

A

Florence Nightingale

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45
Q

what was the first school of nursing? when/where?
who organized it?

A

Nightingale School of Nursing
* St Thomas Hospital – London, England
* July 9, 1860

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46
Q

what was Florence Nightingale known as?

A

lady with the lamp

she made rounds checking on the soldiers at night

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47
Q

what did Florence Nightingale implement?

A

sanitation
* instituted sanitation in the battlefield during the Crimean War

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48
Q

what was the earliest type of formal nursing education?

A

hospital diploma programs

shifted away, now academic nursing degrees are more common

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49
Q

what was the earliest type of formal nursing education?

A

hospital diploma programs

shifted away, now academic nursing degrees are more common

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50
Q

requirements for an RN education

A

education
* 2 yr associate, diploma, or baccalaureate degree

continuing & inservice education

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51
Q

what jobs can a nurse pursue with MSN?

A
  • education
  • management
  • advance practice
52
Q

what doctoral degrees can a nurse pursue?

A
  • PhD - doctor of nursing philosophy
  • DNP - doctor of nursing practice
  • DNS - doctor of nursing sciene
53
Q

what are some hard skills in nursing?

A
  • IV
  • foley
  • critical thinking
  • vitals
54
Q

what are some soft skills in nursing?

A
  • compassion
  • patients
  • empathy
55
Q

qualities of a nurse

7

A
  • knowledge of practice standards
  • compassion
  • critical thinking
  • organization & speaking skills
  • clinical expertise
  • patience
  • physical stamina
56
Q

how can a nurse excell in doing the nursinig job?

A

emphasis on external expectations

57
Q

how can a nurse excell in being a nurse?

A

be kind, patient, professional, & compassionate

58
Q

how can a nurse excell in acting ethically as a nurse?

A

live with integrity

59
Q

how can a nurse flourish in the nursinig job?

A

maintain lifelong transformational growth

form a professional identity

60
Q

who is the nurse responsible and accountable for? how?

A
  • self - be prepared, take care of yourself mentally & physically, live with integrity
  • patients - provide quality care
  • peers - teamwork, what you do/ don’t do will affect your peers
61
Q

why do we define nursing?

A
  • helps the public understand our roles & value
  • differentiate nursing & medicine
  • allow ourselves to understand our expectations
62
Q

what is a professional nurse as an art?

A
  • learning to deliver care with compassion
  • caring & respecting each patient’s dignity
63
Q

what is a professional nurse as a science?

A

a body of knowledge & evidence-based practice

64
Q

what is a professional nurse as an art & science?

A

meets the highest standards & benefits patients (& their families)

65
Q

how does the TBON define nursing?

A

the performance of an act requiring substantial specialized judgment & skill

66
Q

funtions of the BNE

A
  • regulates the practice of nursing in TX
  • protects the public from unsafe practice
  • provides approval for nursing education programs
  • issues licenses to nurses - NCLEX (new grad & renewals)
67
Q

criteria for nursing education programs

A
  • knowledge must be based on technical & scientific knowledge
  • knowledge & competence of the members must be evaluated by a community of peers (Nurse Practice Act NPA, Board of Nursing TX Legislature BNE)
68
Q

criteria for nursing education programs

A
  • knowledge must be based on technical & scientific knowledge
  • knowledge & competence of the members must be evaluated by a community of peers (Nurse Practice Act NPA, Board of Nursing TX Legislature BNE)
  • group must have a service orientation & code of ethics
69
Q

NPA

A

Nurse Practice Act
gives authority to regulate the practice of nursing and the enforcement of law to the BNE

70
Q

ANA code of ethics

A
  • compassion & respect for everyone
  • primary commitment is to the pt (advocate)
  • responsibility, accountability, and authority
  • collaborate with other health professionals & the public
  • articulate nursing values, maintain integrity, & integrate social justice
71
Q

what is the main goal of standard nursing practice?

A

to improve the health and well-being of all individuals, communities, & populations

72
Q

ANA

A

American Nurses Association
* standards of professional nursing practice
* represent the nurse’s process (critical thinking)
* foundation of clinical decision-making for nurses

73
Q

assessment

A

collect comprehensive data pertinent to the pt health/ situation

74
Q

diagnosis

A

analyze the assessment to determine problems

75
Q

outcome identification

A

identify expected outcomes for a plan specialized to the pt/situation

assess & manage pain (plan)

76
Q

outcome identification

A

identify expected outcomes for a plan specialized to the pt/situation

assess & manage pain (plan)

77
Q

planning

A

develops a plan that prescribes strategies & alternatives to attain the expected outcomes

78
Q

implementation

A

applies the identified plan by coorditating care and promoting health & a safe environment

79
Q

evaluation

A

guages progress toward the expected outcomes/goal

80
Q

APRN

A

advanced practice registered nurse
* clinical nurse specialist, NP, midwife, CRNA
* can diagnose, perscribe meds (treat)

81
Q

ethics and advocacy in nursing

A
  • ethics: pricipled nursing practice
  • advocacy: advocate for the pt in all roles & settings
82
Q

communication & collaboration in nursing

A
  • communication: effective with pts & colleagues
  • collaboration: key relationships with pts and team members
83
Q

leadership & education in nursing

A
  • leadership: leads within the professional practice setting
  • education: maintains an attitude & practice of continued learning
84
Q

evidence-based practice & quality of practice in nursing

A
  • evidence-based practice: utilization of best practices
  • quality of pracitce: reviews own practice for meeting quality measures
85
Q

novice nurse

A

experience
* onset of eduction
* student/ nurse in a new practice field

characteristics
* inexperienced
* task-oriented
* learning the rules
* getting acclimated before thinking differently

86
Q

advanced beginner nurse

A

experience
* new grad

characteristics
* focuses more on the situation rather than tasks
* works to acquire in-depth experience

87
Q

competent nurse

A

experience
* 2-3 years experience

characteristics
* focuses more on the situation rather than tasks
* works to acquire in-depth experience

88
Q

proficient nurse

A

experience
* more than 2-3 years

characteristics
* sees the situation as a whole
* performs care faster & more fficiently
* can assist newer nurses

89
Q

expert nurse

A

experience
* diverse skills & knowledge
* several years

characteristics
* recognizes what is needed before conditions worsen
* well develoiped nursing intuition
* determines relevant problems

90
Q

nursing autonomy

A

initial of independent nursing interventions without medical orders

working independently (along with a provider)

90
Q

nursing accountability

A

professionally & legally answerable for the quality of nursing care provided

91
Q

nursing as a caregiver

A

assists patients
* regain health through healing process
* attain max level of functioning (ROM)
* meet needs (physical, emotional/social, spiritual) (soft skills)

92
Q

nursing as an educator

A
  • formal (discharge education) or informal (“this med might make you sleepy, please don’t get up”)
  • patient preference
  • incorporate family
  • you teach everytime you go in the room
93
Q

nurse as an advocate

A
  • protects the pts human & legal rights
  • assists the pt to assert those rights when necessary
  • a doctor’s orders DO NOT cover you if you should’ve nown better
94
Q

health care advocacy groups

A

provides:
* health promotion
* illness prevention
* care for complex needs

95
Q

magnet culture of excellence

A
  • nursing leadership
  • strong nursing representation as management
  • encourage participation
  • empower nurses
  • superior pt outcomes
96
Q

body mechanics

A
  • proper movement & posture
  • coordinated efforts & alignment
97
Q

skeletal muscle innervations

A
  • posture
  • movement

can be voluntary or involuntary

98
Q

smooth muscle innervation

A
  • digestive tract
  • bladder
  • blood vessels

involuntary

99
Q

cardiac muscle innervation

A

involuntary

100
Q

prevention of injury programs

A
  • ANA position statement
  • OSHA
  • safe handling patient programs
101
Q

risk factors for patient injury

A
  • weak/ overweight
  • vision/hearing loss
  • mental status
  • communication barriers
  • pain
102
Q

risk factors for nurse injury

A
  • previous injuries
  • sleep deprived
  • poorly trained/ not compliant with policies
  • poor physical health
103
Q

task-related risk factors

A
  • reaching/lifting far from body
  • twisting while lifting
  • long duration
  • frequency
  • heave lifting
104
Q

foundation of body mechanics

5

A
  • face the direction of movement
  • body alignment
  • center of gravity
  • balance
  • base of support
105
Q

do you need to check doctor’s orders before getting a pt up?

A

yes

the order defines the type & amount of activity the pt may have

106
Q

bed positions

A
  • high fowler’s - HOB 90
  • fowler’s - HOB 45
  • semi fowler’s - HOB 30
  • trendelenburg - entire bed tilted with head of bed tilted down
  • reverse trendelenburg - entire bed tilted with foot of bed tilted down
107
Q

ambulation & gait

A
  • ambulation - the ability to walk
  • gait - the manner of walking
108
Q

theraputic relationships

A
  • the foundation of clinical nursing ptractice
  • protects pt dignity, autonomy, & privacy
  • allows for trust & respect

there are boundaries

108
Q

nurse’s who develop what skill make the best communicator?

A

critical thinking

think through pt communication, see the whole picture

109
Q

why is communicating properly with the pt important?

A
  • gathers relevant & comprehensive information
110
Q

what messages do nurses interpret from others?

A
  • obtain new information (report)
  • correct misinformation (diet purpose)
  • promote pt understanding
  • plan pt-centered care
111
Q

communicaiton skills

A
  • creativity
  • confidence
  • independence
  • integrity
  • knowing limits
  • humility
112
Q

tendencies nurses should control to better their communication skills

A
  • perception influences thinking (observations, culture, education)
  • perceptual bias (stereotypes)
  • emotional intelligence(self awareness, empathy, motivation)
113
Q

components of a message

A
  • subject matter
  • words
  • body language
  • substance of the message (open to interpretation)
114
Q

how messages are perceived

%

A
  • 55% body language
  • 38% tone of voice
  • 7% words
115
Q

referent

A

stimulus that motivates communication

sights, sounds, sensations (smell), ideas

Ex: smelling odor in a room would urge you to communicate toileting needs to your pt

116
Q

effective message characteristics

A
  • complete
  • clear
  • concise
  • organized
  • understood
117
Q

components to avoid when communicating with pts

A
  • medical terms
  • “we” will take your bp
  • consider age, knowledge, primary language
118
Q

ways to encourage expression of feelings

A
  • active listening
  • sharing hope
  • clarifying content of message
  • sharing empathy
  • asking relevant questions
119
Q

ways to damage/hinder professional relationships

A
  • asking personal questions/ giving personal opinions
  • false reassurance
  • sympathy
  • defensive/ passive aggressive responses
120
Q

factors that influence territoriality in conversations

A
  • relationship fo the individuals
  • nature of the conversation
  • setting
  • culture
121
Q

best nursing communication style

A

assertive

  • direct & open
  • rights of the speaker & others respected
  • clear, decisive, positive, professional
  • uses “I” statements, asks open questions & answers honestly
122
Q

phases of the helping relationship

4

A
  1. pre-interaction - gather info prior, anticipate health concerns
  2. orientation - introduce, establish trust, communicate your work, assess pt health
  3. working - provide info that encourages pt undersanding, assist the pt to reach goals
  4. termination - evaluate goals, relinquish responsibility
123
Q

SBAR

A
  • situation - pt details, reason for visit, nurse concern
  • background - pt history, meds, labs, tx
  • assessment - clinical concerns, vitals, warnings
  • recommendations - explain what is needed, suggestions, expectations