Unit 1 Exam Flashcards
1
Q
isolation
definition
A
intentional separation & restriction of ill persons with a confirmed contagious, transmittable infection/ disease
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
3
Q
PPE
A
- gowns
- masks
- eye protection
- gloves
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)
5
Q
what is the most common method of transmission/ isolation precaution?
A
contact
6
Q
who are tier 1 precautions for?
A
protects all patients in all healthcare settings
standard precautions
7
Q
who are tier 2 precautions for?
A
for pts who are suspected of being colonized with a contagious, transmissible pathogen
expanded precautions
8
Q
what are some infectious agents that tier 1 precautions protect workers from?
A
- blood
- body fluids
- non-intact skin
- mucus membrans
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
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)
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)
12
Q
diseases associated with special contact precautions
A
- C-DIFF (Clostridium difficile)
- norovirus
- diarrhea of unkown origin/ or upon admission
13
Q
diseases associated with droplet precautions
A
- influenza (flu)
- pertussis (whooping cough)
- bacterial meningitis
14
Q
diseases associated with airborne precautions
A
- tuberculosis (TB)
- varicella (chicken pox)
- rubeola (measles)
- disseminated shingles (systemic/widespread or immunocompromised pt)
15
Q
PPE for contact precautions
A
- hand hygiene
- gown
- gloves
- clean linens draped if transporting pt
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)
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
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
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
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
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
22
Q
aerosolized procedures
A
breathing treatments, mechanical ventilation, frequent use of suction
23
Q
3 factors that are required for a respirator to be effective
A
- must be worn correctly
- must fit snuggly, no gaps
- must capture at least 95% of air particles
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)
25
which isolation precautions only require a gown & gloves for PPE?
contact & special contact
| also the only ones that do not require the pt to wear a mask when trans
26
which isolation precautions require an N95 mask?
* airborne
* COVID non-aerosolized (contact + droplet)
* COVID aerosolized (special respiratory)
27
PPE for protective precautions
| severly immunoconpromised (cancer)
* 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
28
what is the order to DON PPE?
1. gown
2. mask
3. goggles
4. gloves
| don and on and on (going up)
29
infection
when a pathogen **invades tissues** & multiplies within a host
30
colonization
presence & multiplication of microorganisms within a host, but **without tissue invasion/ damage**
31
communicable disease
that which can be transmitted from one indv. to another
| (COVID)
32
symptomatic infection
when pathogens multiply & **cause signs and symptoms** of disease
33
asymptomatic infection
when pathogens multiply, but **no clinical signs or symptoms** are present
34
virulence
ability to produce disease
| (flu, strep, COVID)
35
5 methods of infection prevention/ control
* hand hygiene
* barrier techniques (PPE)
* antiseptics (skin)/ disinfectants (objects)
* immunizations/ medications
* conscientious patient care (clean environment)
36
what type of infections have the highest mortality rate?
healthcare-associated infections
| nosocomial infections
37
7 defense mechanisms against infection
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)
38
6 links in the chain of infection
1. infectious agent
2. reservoir
3. portal of exit
4. method of transmission
5. portal of entry
6. susceptible host
39
reservoir
any **natural setting** where **growth** and **reproduction** of an infectious agent can occur
| water, animals/humans, food, wounds
40
portal of exit
anything **open** or **leaving the body** that can provide an opportunity of transmission
| cough/sneeze, urine, saliva, blood, draining wounds
41
methods of transmission
* **direct contact** - person to person
* **indirect contact** - person to contaminated fomite (object)
* **respiratory** - through air
* **vector** - insect transmission
42
portal of entry
any openings that infections can enter
| GI-GU tract, skin/wounds, respiratory tract, eyes
43
susceptible host
anyone at high risk for infection
| immunocompromised, young/old, trauma, indwelling devices, wounds, low O2
44
who was the first practicing epidemiologist?
Florence Nightingale
45
what was the first school of nursing? when/where?
who organized it?
**Nightingale School of Nursing**
* St Thomas Hospital – London, England
* July 9, 1860
46
what was Florence Nightingale known as?
lady with the lamp
| she made rounds checking on the soldiers at night
47
what did Florence Nightingale implement?
**sanitation**
* instituted sanitation in the battlefield during the Crimean War
48
what was the earliest type of formal nursing education?
hospital diploma programs
| shifted away, now academic nursing degrees are more common
49
what was the earliest type of formal nursing education?
hospital diploma programs
| shifted away, now academic nursing degrees are more common
50
requirements for an RN education
education
* 2 yr associate, diploma, or baccalaureate degree
continuing & inservice education
51
what jobs can a nurse pursue with MSN?
* education
* management
* advance practice
52
what doctoral degrees can a nurse pursue?
* **PhD** - doctor of nursing philosophy
* **DNP** - doctor of nursing practice
* **DNS** - doctor of nursing sciene
53
what are some hard skills in nursing?
* IV
* foley
* critical thinking
* vitals
54
what are some soft skills in nursing?
* compassion
* patients
* empathy
55
qualities of a nurse
| 7
* knowledge of practice standards
* compassion
* critical thinking
* organization & speaking skills
* clinical expertise
* patience
* physical stamina
56
how can a nurse excell in **doing** the nursinig job?
emphasis on external expectations
57
how can a nurse excell in **being** a nurse?
be kind, patient, professional, & compassionate
58
how can a nurse excell in **acting ethically** as a nurse?
live with integrity
59
how can a nurse **flourish** in the nursinig job?
maintain lifelong transformational growth
form a professional identity
60
who is the nurse responsible and accountable for? how?
* **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
why do we define nursing?
* helps the public understand our **roles** & **value**
* **differentiate** nursing & medicine
* allow ourselves to understand our **expectations**
62
what is a professional nurse as an **art**?
* learning to deliver care with compassion
* caring & respecting each patient's dignity
63
what is a professional nurse as a **science**?
a body of knowledge & evidence-based practice
64
what is a professional nurse as an **art & science**?
meets the highest standards & benefits patients (& their families)
65
how does the TBON define nursing?
the performance of an act requiring **substantial specialized *judgment* & skill**
66
funtions of the BNE
* **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
criteria for nursing education programs
* **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
criteria for nursing education programs
* **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
NPA
Nurse Practice Act
gives **authority to regulate the practice of nursing** and the enforcement of law to the BNE
70
ANA code of ethics
* 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
what is the main goal of standard nursing practice?
to improve the health and well-being of all individuals, communities, & populations
72
ANA
American Nurses Association
* standards of professional nursing practice
* represent the nurse's process (critical thinking)
* foundation of clinical decision-making for nurses
73
assessment
**collect comprehensive data** pertinent to the pt health/ situation
74
diagnosis
**analyze** the assessment to determine problems
75
outcome identification
**identify expected outcomes for a plan** specialized to the pt/situation
| assess & manage pain (plan)
76
outcome identification
**identify expected outcomes for a plan** specialized to the pt/situation
| assess & manage pain (plan)
77
planning
**develops a plan** that prescribes strategies & alternatives to attain the expected outcomes
78
implementation
**applies the identified plan** by coorditating care and promoting health & a safe environment
79
evaluation
**guages progress** toward the expected outcomes/goal
80
APRN
advanced practice registered nurse
* clinical nurse specialist, NP, midwife, CRNA
* can diagnose, perscribe meds (treat)
81
**ethics** and **advocacy** in nursing
* **ethics**: pricipled *nursing practice*
* **advocacy**: *advocate* for the pt in *all* roles & settings
82
**communication** & **collaboration** in nursing
* **communication**: *effective* with pts & colleagues
* **collaboration**: *key relationships* with pts and team members
83
**leadership** & **education** in nursing
* **leadership**: *leads* within the professional practice setting
* **education**: maintains an attitude & practice of *continued learning*
84
**evidence-based practice** & **quality of practice** in nursing
* **evidence-based practice**: utilization of *best practices*
* **quality of pracitce**: reviews *own* practice for meeting *quality measures*
85
novice nurse
**experience**
* onset of eduction
* student/ nurse in a new practice field
**characteristics**
* inexperienced
* task-oriented
* learning the rules
* getting acclimated before thinking differently
86
advanced beginner nurse
**experience**
* new grad
**characteristics**
* focuses more on the situation rather than tasks
* works to acquire in-depth experience
87
competent nurse
**experience**
* 2-3 years experience
**characteristics**
* focuses more on the situation rather than tasks
* works to acquire in-depth experience
88
proficient nurse
**experience**
* more than 2-3 years
**characteristics**
* sees the situation as a whole
* performs care faster & more fficiently
* can assist newer nurses
89
expert nurse
**experience**
* diverse skills & knowledge
* several years
**characteristics**
* recognizes what is needed before conditions worsen
* well develoiped nursing intuition
* determines relevant problems
90
nursing autonomy
initial of **independent** nursing interventions without medical orders
| working independently (along with a provider)
90
nursing accountability
professionally & legally **answerable** for the quality of nursing care provided
91
nursing as a caregiver
assists patients
* regain health through **healing process**
* attain **max level of functioning** (ROM)
* **meet needs** (physical, emotional/social, spiritual) (soft skills)
92
nursing as an educator
* **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
nurse as an advocate
* **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
health care advocacy groups
provides:
* health promotion
* illness prevention
* care for complex needs
95
magnet culture of excellence
* nursing leadership
* strong nursing representation as management
* encourage participation
* empower nurses
* superior pt outcomes
96
body mechanics
* proper movement & posture
* coordinated efforts & alignment
97
skeletal muscle innervations
* posture
* movement
can be **voluntary** or **involuntary**
98
smooth muscle innervation
* digestive tract
* bladder
* blood vessels
**involuntary**
99
cardiac muscle innervation
**involuntary**
100
prevention of injury programs
* ANA position statement
* OSHA
* safe handling patient programs
101
risk factors for patient injury
* weak/ overweight
* vision/hearing loss
* mental status
* communication barriers
* pain
102
risk factors for nurse injury
* previous injuries
* sleep deprived
* poorly trained/ not compliant with policies
* poor physical health
103
task-related risk factors
* reaching/lifting far from body
* twisting while lifting
* long duration
* frequency
* heave lifting
104
foundation of body mechanics
| 5
* face the direction of movement
* body alignment
* center of gravity
* balance
* base of support
105
do you need to check doctor's orders before getting a pt up?
yes
| the order defines the type & amount of activity the pt may have
106
bed positions
* **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
ambulation & gait
* **ambulation** - the ability to walk
* **gait** - the manner of walking
108
theraputic relationships
* the **foundation** of clinical nursing ptractice
* protects pt dignity, autonomy, & privacy
* allows for trust & respect
| there are boundaries
108
nurse's who develop what skill make the best communicator?
critical thinking
| think through pt communication, see the whole picture
109
why is communicating properly with the pt important?
* gathers relevant & comprehensive information
110
what messages do nurses interpret from others?
* obtain new information (report)
* correct misinformation (diet purpose)
* promote pt understanding
* plan pt-centered care
111
communicaiton skills
* creativity
* confidence
* independence
* integrity
* knowing limits
* humility
112
tendencies nurses should control to better their communication skills
* **perception influences thinking** (observations, culture, education)
* **perceptual bias** (stereotypes)
* **emotional intelligence**(self awareness, empathy, motivation)
113
components of a message
* subject matter
* words
* body language
* substance of the message (open to interpretation)
114
how messages are perceived
| %
* **55%** body language
* **38%** tone of voice
* **7%** words
115
referent
stimulus that **motivates** communication
| sights, sounds, sensations (smell), ideas
## Footnote
Ex: smelling odor in a room would urge you to communicate toileting needs to your pt
116
effective message characteristics
* complete
* clear
* concise
* organized
* understood
117
components to avoid when communicating with pts
* medical terms
* "we" will take your bp
* consider age, knowledge, primary language
118
ways to encourage expression of feelings
* active listening
* sharing hope
* clarifying content of message
* sharing empathy
* asking relevant questions
119
ways to damage/hinder professional relationships
* asking personal questions/ giving personal opinions
* false reassurance
* sympathy
* defensive/ passive aggressive responses
120
factors that influence territoriality in conversations
* relationship fo the individuals
* nature of the conversation
* setting
* culture
121
best nursing communication style
**assertive**
* **direct & open**
* **rights** of the speaker & others respected
* **clear, decisive, positive, professional**
* uses **"I" statements**, asks **open questions** & answers **honestly**
122
phases of the helping relationship
| 4
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
SBAR
* **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
