Unit 1 Exam Flashcards

Question

Surgery is classified as minor and major based on?

Answer 1

Conscious sedation

Answer 2

* Ensure is signed before pre-op meds given. * Often witnesses signature. * Answer questions. * Contact MD PRN based on patient questions/concerns.

Answer 3

``` o Answer questions o Good patient education o Therapeutic communication o Listen o Nonpharm measures – distraction, imagery, music o Meds – anti-anxiety as indicated ```

Answer 4

Improves the patient’s functional ability

Answer 5

Resolves a health problem by repairing or removing the cause

Answer 6

Determines the origin or cause of a disorder

Answer 7

Relieves symptoms of a disease but does not cure it

Answer 8

palliative

Answer 9

restorative

Answer 10

* Language barriers – intrepretor, materials in language patient can read * Ask about specific cultural requests – ie: no blood transfusions

Answer 11

o Better pain control o Use less narcotics o Do not have to wait for nurse o Time savings for nurse

Answer 12

* Increase fluids if able * Position changes – up to void * Run water * Flush toilet * Water over perineum

Answer 13

* Resp complications * Cardiac complications * Wound dehiscence

Answer 14

Obesity • Diabetes • Steroids • any disorder that decreases immune function

Answer 15

• Genetic metabolic disease - rare • Rxn to inhalation anesthesia • Hyperthermia with rigidity of skeletal muscles - life threatening • S&S: temp, tachypnea, tachycardia, muscle contractions It usually occurs about 10 to 20 minutes after surgery begins, but it can occur up to 24 hours after surgery.

Answer 16

• Hyperthermia with rigidity of skeletal muscles - life threatening • S&S: temp, tachypnea, tachycardia, muscle contractions It usually occurs about 10 to 20 minutes after surgery begins, but it can occur up to 24 hours after surgery.

Answer 17

Emergent measures are implemented such as giving 100% O2 and regaining fluid and electrolyte balance. The medication dantrolene sodium is given to inhibits muscular pathology.

Answer 18

Fever, chills, chest pain, difficulty breathing, SOB, productive cough, crackles in lungs, wheezes Use of IS, C & DB, early ambulation, good pain control

Answer 19

Injection of anesthetic agent into the epidural space, the spinal cord is never entered. Epidural anesthesia – used surgeries lower 1⁄2 body =hip, perineum. legs

Answer 20

Injection of anesthetic agent into or around a nerve or group of nerves, results in blocked sensation and motor impulse transmission. Nerve block limb surgery, for chronic pain

Answer 21

Agents applied directly to an area of skins or mucous membrane Topical Lidocaine, EMLA Stitches

Answer 22

Injection of anesthetic agent directly into tissue around an incision, wound or lesion. Local infiltration - biopsy, wound sutures

Answer 23

Also called intrathecal block, injection of anesthetic agent into cerebrospinal fluid in the subarachnoid space. Spinal anesthesia - lower abd, hip, perineal, leg surgery

Answer 24

to promote complete lung expansion and to prevent pulmonary problems. the patient must be able to seal the lips tightly around the mouthpiece, inhale spontaneously, and hold his or her breath for 3 to 5 seconds for effective lung expansion. Goals (e.g., attaining specific volumes) can be set according to the patient's ability and the type of incentive spirometer.

Answer 25

Coughing and splinting may be performed along with deep breathing every 1 to 2 hours after surgery. The purposes of coughing are to expel secretions, keep the lungs clear, allow full aeration, and prevent pneumonia and atelectasis. Coughing may be uncomfortable for the patient, but when performed correctly, it should not harm the incision. Splinting (i.e., holding) the incision area provides support, promotes a feeling 231of security, and reduces pain during coughing.

Answer 26

``` Planned for correction of a nonacute problem Ex. Cataract removal Hernia repair Hemorrhoidectomy Total joint replacement ```

Answer 27

``` Requires prompt intervention; may be life threatening if treatment is delayed more than 24 to 48 hr Ex. Intestinal obstruction Bladder obstruction Kidney or ureteral stones Bone fracture Eye injury Acute chocystitis ```

Answer 28

``` Requires immediate intervention because of life-threatening consequences Ex. Gunshot or stab wound Severe bleeding Abdominal aortic aneurysm Compound fracture Appendectomy ```

Answer 29

Only the most overtly affected areas involved in the surgery | Simple/partial mastectomy

Answer 30

Extensive surgery beyond the area obviously involved; is directed at finding a root cause Radical prostatectomy Radical hysterectomy

Answer 31

Surgery performed in a body cavity or body area through one or more endoscopes; can correct problems, remove organs, take tissue for biopsy, re-route blood vessels and drainage systems; is a fast-growing and ever-changing type of surgery Arthroscopy; Tubal ligation; Hysterectomy; Lung lobectomy; Coronary artery bypass; Cholecystectomy

Answer 32

patient comfort and therefore satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, a reduced risk of deep vein thrombosis, faster recovery with less likelihood of the development of neuropathic pain, and reduced cost of care.

Answer 33

Type of surgery and reason Who is present during surgery Available options and risks – risks & benefits Risks with surgery – potential outcomes Risks of anesthesia Review consent form in book for more details

Answer 34

Male – RBC 4.9, Hct 50%, Hgb 16% Female – RBC 3.8, Hct 34%, Hgb 9.8 Female normal RBC 4.2, Hct 37-47%, Hbg 12-16 Male normal 4.7 – 6.1, Hct 45-52, Hgb 14-18

Answer 35

Resp, smokers, immobile

Answer 36

Poor nutrition, diabetics, obese

Answer 37

child under 16, patient who received pre-op vistaril and demoral,

Answer 38

Decrease secretions, prevent post op complications

Answer 39

Pre-dose assessment Start low, go slow Pain assessment pre/post Non-pharm

Answer 40

Insulin, seizure, steroids, HTN, cardiac, resp

Answer 41

``` Headache, hypotension, urine retention Nursing implications Lay flat (decrease headache) Increase fluids Pressure to site Monitor output Caution narcotics ```

Answer 42

IV and inhalation meds give together Advantages Less general anesthesia; Decrease complications Faster recovery from anesthetic ; Medications Hypnotic evening before; Premedicate about 1 hr preop; Short acting barbiturate (Penthothal) Inhaled gas; Muscle relaxant PRN

Answer 43

``` Cough and deep breath IS Ambulation and reposition Splinting incision – ie:abd. Preop meds and NPO pre-op to prevent aspiration ```

Answer 44

``` Ambulation and position changes Leg exercises Teds SCDs Anticoagulants – prophylactic ```

Answer 45

S&S | ↑HR ↑R ↓ BP narrow pulse pressure ↓ O2 sats, cool, clammy, pale skin, concentrated urine

Answer 46

Decompress stomach, Assess COCA, comfort measures

Answer 47

Fluids, tricks to void, bladder scan, may need straight cath

Answer 48

``` Breath in – do not blow into device 10 times per hour when awake Do every time you are in room Set goals Assess compliance ```

Answer 49

Antiemetics Bland foods – soda, crackers Aromatherapy Do not advance diet too fast

Answer 50

Surgeon Serous: clear yellow Serosanguinous: pink Sanguineous: red Purulent

Answer 51

Start clear liquids, to full, and continue as patient tolerates back to normal diet

Answer 52

Team leader makes assignments – is responsible to ensure tasks are done Functional defined by facility roles/job descriptions – for example LPN is med nurse, aides give baths

Answer 53

The transfer of responsibility for the performance of an activity from one individual to another while retaining accountability for the outcome” ANA

Answer 54

Task, supervision, person, circumstance, directions (communication)

Answer 55

``` Assessment – no Diagnosis – no Define outcomes – no Plan interventions - no Evaluate – no ```

Answer 56

Admin. infusions of Blood, TPN, chemo; Admin. of IV therapy to neonates; Admin. of IV push medications; Mixing IV medications; Initiation of TPN; Ongoing administration of TPN in central lines; Discontinuing central or arterial lines. Arterial puncture & management of arterial lines; Advanced Cardiac Life Support (ACLS); Leading group therapy

Answer 57

Call for help and instruct the person that responds to call the surgeon or Rapid Response Team

Answer 58

Functional Nursing

Answer 59

The patient’s clinical condition is predictable

Answer 60

``` Routine oral medications Bed baths and oral care Evaluating the patient's progress Transporting a patient to dialysis Evaluating the patient's progress ```

Answer 61

Witnessing the patient's signature

Answer 62

Patient's self report of pain

Answer 63

A process of interaction in which the leader influences others towards goal achievement

Answer 64

Skin Integrity Impairment

Answer 65

Hemoglobin Female – 12 -16 g/dL Male – 14 – 18 g/dL

Answer 66

Hematocrit Female – 37% - 47% Male – 42% - 52%

Answer 67

Right TASK Right CIRCUMSTANCES Right PERSON Right DIRECTION/COMMUNICATION Right LEVEL of SUPEREVISION (evaluation, feedback, watching, directing, and correcting)

Answer 68

One important concept to consider is that LPNs do not assess – they can collect data to add to organizational assessment forms, but the act of assessment – as defined in the nursing process – is an RN function. The RN is responsible for developing and evaluating the POC.

Answer 69

allows "mutual recognition" of a nursing license between member states in the United States of America.

Answer 70

Assessment process Dx of nursing or collaborative problems Creating a plan of care Defining outcomes Selection of nursing interventions Choosing who will complete nursing interventions (delegation) Evaluation of POC Joined an “Nurse Licensure Compact” (27 states)

Answer 71

``` Created to “Protect the Public” Defines “scope of nursing practice” Oversees the licensing process & fees Responds to ?s RT practice issues Conducts disciplinary proceedings Certifies APRN Reviews nursing education & clinical enrichment programs Declares new rules and regulations. ```

Answer 72

Delegation is not: Not an abdication of responsibility for overall outcomes or Not a way to “get out of” doing work yourself.

Answer 73

According the ANA definition delegation is “The transfer of responsibility for the performance of an activity from one individual to another while retaining accountability for the outcome”

Answer 74

``` Time Management Strategies  Avoid priority traps – Doing whatever hits first – Taking the path of least resistance – Responding to the squeaky wheel – Completing tasks by default – Relying on misguided inspiration ```

Answer 75

* Plan and prioritize | * Complete priority first, finish before starting next task • Reprioritize as needed

Answer 76

``` Advantages Most convenient for patients Involves patient and family Expedites services Disadvantages Cost May be perceived as having less RNs ```

Answer 77

focus is on the patient’s needs vs staff needs. The required care and services are available on the unit for the patient instead of the patient leaving unit for needed care. One hospital I have clinical at has their joint camp, a classroom for joint replacement patients on the unit. Another example is expanded dining room services, for example if a patient wants dinner at 7 pm even though it is usually served at 6 pm and the staff offer flexible meal times this is patient focused vs staff focused. The goal is increased flexibility for the patient vs. rigid timelines imposed by the organization and the way things are always done.

Answer 78

Collaborative process to meet the health needs of a patient in a cost effective manner – Assessment, planning, facilitiation, advocacy – Critical pathways & Multidisciplinary action plans guide care & decisions – Inpatient and community resources

Answer 79

``` primary nursing Advantages Develop trusting relationship with nurse Holistic vs shift approach Nurses like if adequate time Patients like Disadvantages High cost More difficult to schedule Perform tasks that others could do New or inexperienced nurses may lack skills needed for success in this model ```

Answer 80

In primary nursing the RN cares for patient and retains 24 hour accountability for the plan of care through out the patient's admission. This type of model is often used in home health settings, but is not seen as frequently in hospitals as it was in the past.

Answer 81

Disadvantages Communication | Care can feel disorganized, depersonalized to the patient

Answer 82

Advantages More cost effective Meet needs of large group More flexibility for the RN team leader to meet the needs of the patients

Answer 83

Modular nursing or a mini team is a variation of of team nursing. In this module the unit has small teams, each including at least one RN, that cover the care for a set group of patients. Some organizations might call this “care pairs”.

Answer 84

Team nursing is different from functional nursing because the team leader can assign tasks beyond strictly defined roles, although the team leader still needs to ensure that tasks are within the staff member’s scope of practice. Team models are common on med/surg units and each unit often have several teams.

Answer 85

A team is a group of healthcare professionals responsible to provide care to a group of patients. The teams are headed by RN team leaders. The RN team leader is responsible for a group of patients and this RN is responsible for coordinating the cares of the patients on his or her team. The team members maybe RNs, LPNs, nursing assistants and other unlicensed assistive personnel.

Answer 86

Disadvantage Can feel disjointed for patient Fragmented care Communication can be an issue Miss subtle changes in condition of the patient

Answer 87

Advantages Serve large numbers of patients Efficient Staff become good at assigned tasks Good if RN shortage Less costly

Answer 88

In functional nursing work divided into functional roles such as giving baths, passing meds, completing assessments. In the type of assignment the scope of practice highly determines the tasks each staff person performs.

Answer 89

``` advantages Consistency More RNs Good rapport More likely to notice condition changes Disadvantages If nurse is not well prepared or inexperienced care could be unsafe More RNs – more costly ```

Answer 90

the nurse responsible for total care. This is a type of staffing that works well in specialized areas such as hospice or more acute settings such as ICU. There are advantages and disadvantages to total patient care.

Answer 91

Total patient care Functional nursing Team nursing (modular) Primary nursing Case management

Answer 92

Authoritarian, Democratic, Laissez-faire

Answer 93

– Epidural anesthesia – Spinal anesthesia – Field block – Nerve block

Answer 94

``` • Local • Nerve blocks – Epidural anesthesia – Spinal anesthesia – Field block – Nerve block ```

Answer 95

``` – Lay flat (decrease headache) – Increase fluids – Pressure to site – Monitor output – Caution narcotics ```

Answer 96

Complications – Often associated with leakage of spinal fluid into epidural space – Others allergic rxn, incorrect delivery, overdose • Side effects – Headache, hypotension, urine retention

Answer 97

local anesthesia in which an anesthetic agent is injected around nerves so that the area supplied by these nerves is anesthetized. produces analgesia, relaxation, and reduces reflexes. The patient is awake and alert unless given other meds. Used surgeries arm, shoulder, abd, pelvis, legs Advantages: Less risk of adverse rxn, no headache that can occur with spinal

Unit 1 Exam Flashcards

(133 cards)