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NURSING School > 317 Final > Flashcards

317 Final Flashcards

1
Q

types of grief

A

normal, prolonged, anticipatory, disenfranchised, complicated, exaggerated, delayed, masked, ambiguous

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2
Q

normal grief

A

common universal reaction characterized by complex emotional, cognitive, social, physical, behavioral, and spiritual response to loss and death.

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3
Q

prolonged grief

A

causes distress and intrusive thoughts

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4
Q

anticipatory greif

A

when a person experiences an unconscious process of disengaging or letting go before the actual loss of death occurs, especially in a situation of predicted or prolonged loss.

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5
Q

disenfranchised grief

A

occurs when the relationship to the deceased person is not socially sanctioned, cannot be openly shared, or seems of lesser significance (her examples were death of a gay partner or ex-partner).

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6
Q

complicated grief

A

prolonged significantly difficult time moving forward after the loss. It is a chronic and disruptive yearning for the deceased. It is characterized by trouble accepting death. It might be seen when the loss is from homicide, suicide, or accident

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7
Q

exaggerated grief

A

self destructive or maladaptive behavior, obsession, or psychiatric disorder

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8
Q

delayed grief

A

may be caused by loss being so overwhelming that the person must avoid the full realization of the loss

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9
Q

masked grief

A

interferes with the normal functioning but the person is unaware of the disruptive behavior as a result of the loss or ineffective grief resolution.

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10
Q

ambiguous grief

A

loss occurs when the lost person is [physically present, but not psychologically available (kidnap, brain injury, dementia).

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11
Q

mourning

A

time in which the outward social expression of grief takes place

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12
Q

bereavement

A

encompasses both grief and mourning and includes the emotional responses and outward behaviors of the person experiencing loss

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13
Q

patient symptomology in the last few hours of life

A 
Noisy breathing
Urinary incontinence or retention 
Pain 
Restlessness
Dyspnea 
nausea/ vomiting 
Sweating 
Twitching/ jerking
Confusion
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14
Q

4 goals of symptom management at end of life

A

comfort, dignity, quality of life, and support

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15
Q

admission criteria for hospice

A

pt desires service and only has 6 months or less to live

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16
Q

palliative care

A

for a person suffering from a life threatening illness and the care aims to prevent and relieve suffering by early identification, assessment, and pain treatment

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17
Q

goal of palliative care

A

decrease severities of symptoms and focus on trying to help family cope

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18
Q

hospice

A

curing measures and further medical care are stopped. focus is to enhance quality of life

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19
Q

kubler ross’s stages of grief

A

denial, anger, bargaining, depression, acceptance

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20
Q

describe the criteria for coroner’s case

A

cases in which the patient dies after 12 hours of being admitted into the hospital, in surgery, procedure, or if thought to be caused by malpractice. Also patients that seem to be neglected, malnutrienced, or under 18

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21
Q

what cannot happen if a patient dies and is on a coroner’s case?

A

nothing can be removed from the body until the body is released

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22
Q

dementia

A

decline in brain function and difficulties with skills such as memory and attention, orientation, place or person, and regulating emotions

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23
Q

delirium

A

is a sudden deterioration of mental functioning, due to an acute illness

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24
Q

depression

A

a low mood and or loss of interest in activities

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25
Q

cognitive impairment vs dementia

A

dementia has a much worse severity. example cognitive impairment person might forget where they put their keys but a dementia patient may put their keys in the freezer

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26
Q

nursing care for patients with dementia

A

safety! protect wandering and falling, protect others from inappropriate behaviors, help them use their brain, assist with ADLs, sticky notes

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27
Q

nursing diagnosis of patient with dementia

A

Ineffective coping related to changes in life situation as evidenced by inattention to personal hygiene, and health seeking behaviors.

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28
Q

A’s of dementia

A

Anogosnia - ignorance of the presence of disease
Agnesia - inability to recognize objects using the senses
Aphasia - loss of the ability to speak or understand spoken, written, or sign language
Apraxia - inability to make purposeful movements
Altered perception - misinterpretation of information from senses
Amnesia - memory loss
Apathy - lack of interest in activities

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29
Q

sundown phenomenon

A

Sundowning syndrome is a set of symptoms that can be seen in patients with dementia in which they become confused and agitated late afternoon and in the evenings. The closer to evening the “sundown,” the more confused and agitated the client becomes. Causes can be fatigue, unfamiliar environment, noise, medications, lighting, and disruption of circadian rhythms.

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30
Q

understand the use of diversion with a patient with cognitive changes

A

You do not want to make the patient get more agitated about the situation with arguing. In order to help, one must divert this by giving them something to do with their hands. Validate, reassure, and distract them with something that promotes comfortability.

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31
Q

relationship between aging and chronic illness

A

aging does not automatically lead to disability and dependence. most older people remain functionally independent despite the fact that most older adults have at least one chronic disease

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32
Q

identify safety measures that are appropriate to put in place for aging client

A

prevent falling by wearing nonslip foot wear, encourage them to use cane, walker… keep medication in original container, buy special alarm necklace incase of falls

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33
Q

3 top causes of death

A

heart disease, neoplasm (tumor/cancer), lower respiratory disease

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34
Q

theories of aging

A

biological - stochastic and nonstochastic.

psychosocial - disengagement, activity, and continuity/developmental

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35
Q

stochastic

A

views the effects of biological aging as results from random cellular damage that occurs over time from both the internal and external environment; nurture

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36
Q

non stochastic

A

views biological aging as the result from complex, genetic, and predetermined processes within the body; nature

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37
Q

disengagement theory

A

Aging individuals withdraw from customary roles and engage in more introspective, self-focused activities.

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38
Q

activity theory

A

older people continue to live healthy and satisfying lives when they continue to be actively engaged in social roles and exercise their physical and mental capacities.

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39
Q

continuity/developmental theory

A

suggests that as people age, personality remains stable and behavior becomes more predictable.

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40
Q

difference between men and women as they age

A

men are more likely to live with spouse, have health insurance, fewer chronic health problems, and less likely to be involved with caregiving
woman more likely to live alone, have loss of spouse, and more likely to suffer from chronic illness

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41
Q

how is dementia diagnosed

A

if a pt can not perform two ADLs and possibly on CAT scan or MRI

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42
Q

most types of dementia can only be

A

found on autopsy

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43
Q

brain death shows as

A

ventilator dependent and no brain stem reflexes

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44
Q

brain death test and procedures

A

multimodality evoked potentials (MEP), electroretinography (ERG), and the use of an EEF

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45
Q

2 interventions to decrease chance of developing pneumonia

A

IS and early ambulation

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46
Q

a pt with DKA or HHNS will be

A

severely dehydrated

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47
Q

Hemoglobin A1C levels

A

the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher chance of getting diabetes. Levels of 6.5% or higher mean you have diabetes.

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48
Q

microvascular complication of diabetes in eyes

A

retinopathy

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49
Q

What is the upper limit of PNA vaccines a pt should get in their lifetime

A

2

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50
Q

NG feeding, what type of PNA is he at risk for

A

aspiration

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51
Q

Has PNA, needs antibiotics, what do we do first?

A

sputum culture

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52
Q

Cold and clammy

A

need some candy - hypoglycemic

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53
Q

Receive report that patient is having nightmares and flashbacks after a car accident what is wrong with them

A

PTSD

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54
Q

Betty Neuman’s primary prevention promotes patient’s wellness by stress prevention and reduction of _____ _____

A

risk factors

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55
Q

3 assessments that you would observe during ALARM stage of GAS

A

Increased HR, BP and respirations, glucose levels, oxygen requirements

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56
Q

patient with Stroke on comfort care, has distended abdomen and pressure on lungs. patient dies. is this a coroner’s case?

A

no

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57
Q

Deontological

A

People are worthy of respect

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58
Q

Fidelity

A

Faithfulness to responsibilities

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59
Q

Values

A

Personal belief about worth of given idea or behavior

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60
Q

Rules with Title IV ACT of 1964 and related antidiscrimination ACT of 2003

A

Free translator, verbal and written notification of right to receive services

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61
Q

patient on pain meds, muscle relaxer and sleep aide; becomes confused and combative; what caused it?

A

medication interaction

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62
Q

Total knee replacement, 2 days post op and still needs oxygen, why is he still requiring oxygen?

A

Decreased chest expansion

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63
Q

Nociceptive pain that can be superficial or deep

A

somatic

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64
Q

Nonpharmacological treatment with electrical stimulation

A

TENS unit

65
Q

Screening test is useful in determine presence of neurological impairment

A

clock test

66
Q

what do patients want from health care and providers

A

access, safety, outcomes, and respect

67
Q

never events and examples

A

serious and preventable events that should never occur in hospital setting. example: pressure ulcer or wrong site surgery

68
Q

sentinel events and examples

A

unexpected outcomes or risk involving death or serious physical or psychological injury. example is patient suicide, medication error, or delay in treatment

69
Q

dependent nursing actions

A

doing something in guidance of the physician. example: medication administration

70
Q

independent nursing action

A

part of the nursing process. you challenge the ways others think and look for rational and logical answers to problems.

71
Q

domain

A

It is the knowledge of nursing practice and nursing history, nursing theory, education, and research. Gives nurses a comprehensive perspective that allows you to identify and treat patients’

72
Q

theory

A

a set of concepts,definitions,and assumptions in order to explain a particular phenomenon.

73
Q

paradigm

A

is a pattern of beliefs used to describe the domain of a discipline

74
Q

Henderson’s theory

A

there are 14 basic life activities a patient needs assistance with, help with these needs until patient is able to do them alone.

75
Q

Leininger’s theory

A

focusing on culture

76
Q

Nightingale’s theory

A

based on bringing patient closer to nature

77
Q

Orem’s theory

A

teaching patients to be self sufficient, practice self care, Goal: teaching patient to manage own health problems

78
Q

Neuman’s theory

A

role of nurse is to stabilize patient, identify stressors, and assess the whole

79
Q

Roger’s theory

A

unitary beings. Nurses role is to be truly present with patient and accept the patient’s view on reality

80
Q

Watson’s theory

A

Caring

81
Q

Roy’s theory

A

adaptation

82
Q

Roy’s theory

A

adaptation

83
Q

4 Cs

A

comfort, connection, confirmation, courtesy

84
Q

maslows hierarchy of basic needs

A 
At the base is physiological needs
Then safety
Then love/beloging
Esteem
And at the top (which means it is the least important) is self actualization
85
Q

dreyfus model

A

shows how students acquire skills through formal instruction and practicing. students move through 5 stages.

86
Q

karaoke-yahiro and saylor model

A

three levels of things as you grow as a nurse from a beginner to expert

87
Q

respite care

A

provides short term relief or time off for people providing home care to an individual who is ill, disabled, or frail.

88
Q

enculturation

A

experiences, observations, and norms that an individual learns and develops as their primary culture.

89
Q

acculturation

A

adoption of a second culture which replaces the primary culture

90
Q

multiculturalism

A

being aware of the different cultures, and has an impact due to cultural values, health beliefs and practice

91
Q

ethnocentrism

A

a person’s belief that their own culture is superior over others

92
Q

emic worldview

A

is an insider’s perspective into their own native culture

93
Q

etic worldview

A

An etic worldview is an outsider’s perspective. In other words, an etic perspective is the perspective from an observer

94
Q

morals vs ethics vs values

A

morals- standard of right and wrong, ethics- behavior, values - beliefs

95
Q

altruism

A

a concern for the welfare and well being of a patient

96
Q

autonomy

A

is the right to self determination. A person’s right to choose and ability to act on that choice (based on respect for human dignity), even when it is not in their best interest

97
Q

justice

A

being fair to all people

98
Q

fidelity

A

the obligation to be loyal to commitments made to oneself and to others

99
Q

paternalism

A

occurs when health care providers decide what is “best” for clients. Can be a negative outcome of beneficence

100
Q

veracity

A

the duty to tell the truth

101
Q

nonmaleficence

A

the obligation of the health care provider to do no harm

102
Q

AIDET

A

acknowledge, introduce, duration, explanation, thank you

103
Q

using LAST in conflict resolution

A

Listen, advice/apologize, solve, thank you

104
Q

4 Ps

A

4 P’s pain, potty, position, and possessions

105
Q

CUS

A

I am concerned. I am uncomfortable. Stop there is a safety issue

106
Q

medicare part A

A

hospital insurance

107
Q

medicare part B

A

covers some preventative and primary care

108
Q

medicare part C

A

medicare advantage plan

109
Q

five rights of delegation

A

right person, right task, right supervision, right communication, and right circumstance
pneumonic - please take sue cold cuts

110
Q

Compare and contrast the values associated with blood pressures

A

Normal SBP <120 and DBP <80
Prehypertension 120-139 or 80-89
Hypertension, stage 1: 140-159 or 90-99
Hypertension, stage 2: ≥160 or ≥100

111
Q

primary vs secondary hypertension

A

primary is an unknown cause and secondary is resulting from a cause

112
Q

first line therapy for stage 1 hypertension includes

A

diuretics, calcium channel blockers, ace inhibitors, and ARBs

113
Q

DASH diet

A

consists of lowering salt intake, increasing potassium, calcium, magnesium, and fiber. The diet should have low concentrated carbohydrates and be low calorie.

114
Q

how to figure out the MAP

A

((systolic) + (diastolic x2))/3

115
Q

6 Ps with peripheral arterial disease

A

pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia

116
Q

poikilothermia

A

loss of temperature regulation

117
Q

Bp highest at what part of the day

A

10 am - 6 pm

118
Q

BP lowest at what part of the day

A

between midnight and 3 am

119
Q

LDL

A

bad cholesterol - promote formation of atherosclerosis. want it less than 100

120
Q

HDL

A

good cholesterol - associated with coronary artery disease want it higher than 35

121
Q

total cholesterol

A

want less than 200

122
Q

Two risk factors for coronary artery disease

A

hypertension and smoking

123
Q

ejection fraction of systolic heart failure

A

is lower because the ventricle loses the ability to generate enough pressure to eject blood forward. EF usually less than 45% and can go as low at 10%

124
Q

FACES

A

fatigue, limitation in activity, chest congestion, chest congestion, cough, edema, SOB

125
Q

electron beam computed tomography (EBCT

A

locates and measures coronary calcification

126
Q

Coronary Computed Tomography Angiography (CCTA)

A

using IV contrast and radiation, CCTA can detect calcified and noncalcified plaques in the artery

127
Q

diagnosis of acute myocardial infarction

A

12-lead ECG, Serum Cardiac Biomarkers, Coronary Angiography

128
Q

Serum Cardiac Biomarkers

A

Cardiac specific troponin, creatine kinase MB, and myoglobin are released into blood from necrotic heart muscle after an MI and can be tested fo

129
Q

Interpersonal communication

A

exchange of information between two or more people. uses verbal and nonverbal cues to accomplish personal and relational goals.

130
Q

Transpersonal communication

A

specific responses that encourage the expression of feelings and ideas and convey acceptance and respect.

131
Q

feedback in communication

A

Feedback is a response to the message. Feedback can be positive, negative,verbal, or nonverbal.

132
Q

intimate zone of space

A

(0- 18 inches): holding a crying infant, performing physical assessment, bathing, grooming, dressing, feeding, and toileting a patient

133
Q

personal zone

A

(18 inches to 4 ft): sitting at a pt’s bedside, taking a pt’s nursing history, teaching an individual pt

134
Q

socio-consultative zone

A

(4-12ft): giving directions to visitors in the hallway, asking if families need assistance from the pt doorway, giving verbal report to a group of nurses.

135
Q

public zone

A

(12ft. and more): speaking at a community forum, lecturing to a class of students, testifying at a legislative hearing

136
Q

social zone

A

(permission not needed): hands, arms, shoulders, back

137
Q

consent zone

A

(permission needed): mouth, wrists, feet

138
Q

vulnerable zone

A

(special care needed): face,neck, front of body

139
Q

intimate zone of touch

A

(permission and great sensitivity needed): genitalia, rectum

140
Q

SOLER

A 
s- sitting posture
o- observe an open posture 
l- lean toward the patient 
e- establish and maintain eye contact
r- relax
141
Q

methods of delivery of O2

A

Nasal cannula (1-6L/min), Simple mask (5-10 L/min), Partial rebreather (8-12 L/min), Non-rebreather (10-15 L/min), and the Venturi mask (4-12 L/min).

142
Q

Betty Neuman’s Systems Theory

A

used to describe the concepts of stress and reaction to stress. views a patient, family, or community as constantly changing in response to the environment and stressors.

143
Q

Intellectual indicator

A

someone setting unreasonable standards for perfection

144
Q

maturational crisis

A

Varies with life stages
In preadolescents: puberty, school, and sex
In adults: major life changes including starting a family, losing their parents, and accepting physical changes

145
Q

situational crisis

A

external sources such as job changes, car crash, illness, caregiver stress

146
Q

General Adaptation System and the responses within the body

A

alarm stage, resistance stage, exhaustion stage

147
Q

alarm stage

A

flight-or-fight reaction, Rising hormone levels result in increased blood volume, blood glucose levels, epi and NE amounts, HR, blood flow to muscles, oxygen intake

148
Q

resistance stage

A

body stabilizes by normalizing and repairing damage, Hormone levels, HR, BP, and cardiac output should return to normal

149
Q

exhaustion stage

A

body is no longer able to resist effects of stressor and has depleted the energy to maintain adaptation

150
Q

symptoms of hyperglycemia

A

dry mouth, extreme thirst, frequent urge to urinate, drowsiness, frequent bed wetting, abdominal pain

151
Q

symptoms of hypoglycemia

A

“Cold and clammy, patient needs some candy.”

sweating, trembling, dizziness, mood changes, hunger, headaches, blurred vision, extreme tiredness and paleness

152
Q

somogyi effect

A

High blood sugar in early morning- low blood sugar at night causes rebound high blood sugar in the morning

153
Q

Dawn phenomenon

A

High blood sugar early in morning. A decrease in insulin with an increase in glucagon and cortisol cause hyperglycemia in morning

154
Q

Basal

A

mimics what pancreas does to keep blood sugar in normal range when a person’s not eating - Lantus/Levemir

155
Q

Bolus

A

mimics the increase of insulin the pancreases sends out in response to food - Humalog/Novolog

156
Q

CLABSI

A

central line associated bloodstream infection. Microorganisms can enter the bloodstream and contaminate CVCs through 2 mechanisms: extraluminally or intraluminally.

157
Q

HAIs

A

hospital acquired infection. primary cause of preventable death and disability among hospitalized patients.

158
Q

CAUTION

A

C- Close system catheter selection consider alternatives
A- Aseptic management
U- Universal standard precautions
T- Tie secure catheter to patient tubing to bed
I- Indication for use and to discontinue
O- Obstruction free specimen from sampling port
N- No dependent loops

159
Q

FEV1

A

FEV1 is the maximal amount of air you can forcefully exhale in one second. low in COPD patients

NURSING School (17 decks)

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