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Nursing Foundations Lab > 106Lab Test Prep Exam 3 > Flashcards

106Lab Test Prep Exam 3 Flashcards

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1
Q

What PPE is needed for contact precautions

A

gown and gloves

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2
Q

What PPE is needed for droplet precautions?

A

gown, gloves, surgical grade mask and face shield

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3
Q

What PPE is needed for airborne precautions?

A

gown, gloves and N95 mask

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4
Q

Give examples of illnesses requiring contact precautions

A

MRSA, CDIFF, lice, scabies

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4
Q

What PPE do visitors need to wear?

A

the same as nurse. gown and gloves only if providing direct care

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5
Q

Give examples of illnesses requiring droplet precautions

A

N meningitidis, mumps, pertussis, norovirus, vomiting, influenze, invasive Group A strepococcus

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6
Q

Give examples of illnesses requiring airborne precautions

A

Pulmonary tuberculosis, measles, chickenpox, disseminated Zoster, Corona Virus

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7
Q

What is the equipment needed for a nasal swab?

A

nasal swab, sterile water, nonsterile gloves, goggle and face mask, or face shield, addl PPE as indicated, biohazard bag, appropriate label for specimen

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8
Q

A nasal swab provides a sample of cells from the nostril that ________

A

can be cultured, which can aid in the detection of viruses and bacteria that cause respiratory infections, such as influenza, Covid-19, and RSV (respiratory syncytial virus)

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9
Q

A nasal swab can be part of the screening process to detect infection with _______

A

drug-resistant microorganisms such as MRSA and coronavirus

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10
Q

Pain may be classified according to its….

A

duration
localization/location
etiology

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11
Q

Acute pain

A

rapid in onset and varies in intensity from mild to severe - protective in nature - warns the person of tissue damage or organ disease and triggers autonomic responses such as increased heart rate, the fight-or-flight response, and increased blood pressure

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12
Q

Chronic pain

A

maladaptive pain that persists or is recurrent for more than 3 months

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13
Q

Chronic primary pain

A

the chronic pain itself is considered the disease - such as fibromyalgia or back pain

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14
Q

Cutaneous pain

A

superficial pain that usually involves the skin or subcutaneous tissue - paper cut

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15
Q

Visceral pain

A

splanchnic pain - poorly localized and originates in body organs in the thorax, cranium and abdomen

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16
Q

Somatic pain

A

diffuse or scattered and originates in tendons, ligaments, bones, blood vessels, and nerves

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17
Q

Nociceptive pain

A

initiated by nociceptors that are activated by actual or threatened damage to nonneural tissue and is representative of the normal pain process

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17
Q

Referred pain

A

pain can originate in one part of the body but be perceived in an area distant from its point of origin

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18
Q

Nociceptors

A

the peripheral somatosensory nerve fibers that transduce and encode noxious stimuli

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19
Q

Neuropathic pain

A

pain caused by a lesion or disease of the peripheral or central somatosensory nervous system

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20
Q

Nociplastic pain

A

pain that is not classified as nociceptive or neuropathic in nature

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21
Q

What are the 3 levels of severity of pain?

A

Severe or excruciating
Moderate
Slight or mild

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21
Q

Intractable pain

A

pain that is resistant to therapy and persists despite a variety of interventions

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22
Q

Phantom pain

A

phantom limb pain - receptors and nerves are clearly absent yet pain occurs as a real experience for the patient

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23
Q

Common responses to pain

A

Behavioral (voluntary) responses
Physiologic (involuntary) responses
Affective (psychological) responses

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24
Q

What are the 4 main qualities of pain?

A

sharp, dull, diffuse, shifting

25
Q

Nurse’s responsibility when assessing vital signs

A

ensure the accuracy of data, interpret vital sign findings, report abnormal findings, follow principles of delegation, validate abnormal findings and further assess the patient

25
Q

What are the periodicities of pain?

A

continuous, intermittent, brief or transient

26
Q

What are the respiratory signs of distress?

A

breathing rate, color changes, grunting, nose flaring, retractions, sweating, wheezing, body positions, Levine’s sign, shortness of breath or unexplained wheezing, pain, weakness or lightheadedness, nausea or vomiting, papitations (heart racing, fluttering or skipping)

27
Q

Normal temperature range

A

96.4-99.5 F / 35.8-37.5 C

28
Q

Normal heart rate/pulse

A

60-100 bpm

29
Q

Normal blood pressure

A

120/80

29
Q

Normal respirations

A

12-20 breaths/min

30
Q

Normal pulse oximetry / O2

A

95-100 %

31
Q

Sites for measuring core temperatures

A

Tympanic and rectal
Esophagus and pulmonary (invasive monitoring devices)

32
Q

3 methods to assess pulse

A

Palpating the peripheral arteries
Auscultating the apical pulse with a stethoscope
Using a portable Doppler ultrasound

33
Q

Sites for measuring surface body temperatures

A

Oral (sublingual)
Axillary

34
Q

What is the pattern of the pulsations and the pauses between them called?

A

pulse rhythm

35
Q

What is the quality of the pulse called?

A

pulse amplitude

36
Q

Common pulse sites

A

`Temporal, Carotid, Brachial, Radial, Ulnar, Femoral, Popliteal, Posterior tibial, Dorsalis pedis

37
Q

Pulse Scale

A

0 - pulse is absent
1 - diminished
2 - normal
3 - full
4 - bounding/strong

37
Q

What is the most reliable method to get pulse in children less than two years of age?

A

apical pulse

38
Q

What is orthopnea?

A

breathing more easily in an upright position

39
Q

What is tachypnea?

A

Rapid respirations

40
Q

Blood pressure is measured in ___

A

mm of Hg

41
Q

What is blood pressure?

A

The force of blood against the arterial walls

42
Q

L + OPQRST

A

Location plus
Onset
Provacative/Palliative
Quality
Radiation
Severity
Timing

43
Q

What are Karotkoff sounds?

A

The sounds the blood pressure makes using a stethoscope and sphygmomanometer

44
Q

Pain assessment scale 0-10

A

0 - none
1-3 mild
4-6 moderate
7-10 severe

45
Q

Radiating pain

A

radicular pain - starts in one place but travels to another, usually along the path of a nerve - sciatica

46
Q

Referred pain

A

reflective pain - pain that is felt in a different part of the body than where the stimulus is actually coming from

47
Q

Physical assessment techniques

A

Inspection, palpation, percussion, auscultation

48
Q

Characteristics of sound

A

Pitch: low to high
Loudness: soft to loud
Quality: gurgling or swishing
Duration: short, medium, or long

49
Q

S1

A

first heart sound - closing of the mitral and tricuspid valves - clinically corresponds to the pulse

49
Q

S2

A

second heart sound - closure of the semilunar (aortic and pulmonary) valves

50
Q

A/O x4

A

Alert and Orientated to person, place, time, and situation

51
Q

S4

A

fourth heart sound - atrial gallop - occurs just before s1 when the atria contract to force blood into the left ventricle

51
Q

S3

A

third heart sound - ventricular gallop - occurs just after s2 when the mitral valve opens, allowing passive filling of the left ventricle

52
Q

In what order do we examine the abdomen

A

inspect – auscultate – percuss – palpate

53
Q

bowel sound

A

absent - must listen for at least 5 minutes
Hypoactive - one bower sound every 3-5 minutes
Normoactive - Gurgles 5-30 times per minute
Hyperactive - constant bowel sounds >30 sounds per minute

53
Q

The sensation of pain and/or burning, stinging, or itching of the urethra or urethral meatus associated with urination

A

Dysuria

54
Q

When auscilating the abdomen, where do you start?

A

Right Lower Quadrant (RLQ) and clockwise from there

55
Q

Dorsiflexion and plantar flexion

A

Dorsiflexion - toe up towards sky
plantar flexion - foot stretched out straight in line with leg

56
Q

What are the two types of nasal swabs?

A

nasopharyngeal
mid-turbinate

Nursing Foundations Lab (9 decks)

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