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aa Orgo > 406 Midterm > Flashcards

406 Midterm Flashcards

1
Q

Break up the presentation/question into parts (cues) to determine meaning (i.e. normal vs. abnormal). Identify cues.

A

Analyzing

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2
Q

Cluster cues to determine meaning

A

Analyzing

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3
Q

Generates hypotheses

A

Analyzing

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4
Q

Use research based standards/rules to rule in or rule out hypothesis

A

Applying standards

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5
Q

NDX defining characteristics, related factors and risk states; patho

A

Applying standards

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6
Q

Making a judgment as to “fit”

A

Applying standards

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7
Q

Look for differences and similarities

A

Discriminating

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8
Q

Does this help confirm or disconfirm hypothesis

A

Discriminating

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9
Q

Do you need Lab data? Further physical assessment?

A

Information seeking

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10
Q

Draw conclusions

A

Logical reasoning

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11
Q

If this then probably that

A

Logical reasoning

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12
Q

Confirm or disconfirm DX

A

Logical reasoning

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13
Q

Predict potential patient problems and envision a plan & desired outcomes .

A

Predicting

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14
Q

How will this prob/plan affect patient safety? If I do this then….

A

Predicting

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15
Q

How will you recognize this same concept/problem in other situations?

A

Transforming knowledge

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16
Q

Are you confident in your reasoning abilities?

A

Confidence

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17
Q

Have you considered the entire context of this problem? Age, co-morbidities, medication, etc

A

Contextual perspective

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18
Q

Were you creative when you generated or restructured ideas? Did you think of alternatives?

A

Creativity

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19
Q

Did you consider multiple possibilities? Did you get stuck on one train of thought?

A

Flexibility

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20
Q

Were you eager to correctly interpret the situation/problem and did you use observation and thoughtful questioning to explore possibilities?

A

Inquisitiveness

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21
Q

Did you use research-based process and research-based criteria to interpret the situation/problem?

A

Intellectual integrity

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22
Q

Guessing without a basis for deriving meaning does not count

A

Intellectual integrity

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23
Q

Did you recognize anything that seemed familiar from past experiences?

A

Intuition-pattern recognition

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24
Q

Were you open to other possible interpretations of the situation/data?

A

Open-mindedness

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25
Q

Did you constantly reflect on your thinking, assumptions, and decisions to assure accurate interpretation of data

A

Reflection

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26
Q

QSEN: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care

A

Patient-centered Care

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27
Q

QSEN: Honor learning opportunities with patients who represent all aspects of human diversity

A

Patient-centered Care (attitude)

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28
Q

QSEN: Seek to understand one’s personally held attitudes about working with patients from different ethnic, cultural and social backgrounds

A

Patient-centered Care (attitude)

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29
Q

QSEN: Value cultural humility

A

Patient-centered Care (attitude)

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30
Q

QSEN: Respect the boundaries of therapeutic relationships

A

Patient-centered Care (skill)

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31
Q

QSEN: Integrate principles of effective communication with knowledge of quality and safety competencies

A

Patient-centered Care (knowledge)

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32
Q

QSEN: Value consensus

A

Patient-centered Care (attitude)

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33
Q

QSEN: the process of reflective practice

A

Patient-centered Care

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34
Q

QI definition: use

A

data to monitor the outcomes

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35
Q

QSEN: Assure ethical oversight

A

QI

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36
Q

QSEN: Explain common causes of variation in outcomes of care in the practice specialty

A

QI

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37
Q

QSEN: Appreciate how unwanted variation affects outcomes of care processes

A

QI

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38
Q

QSEN: differences between micro-system and macro-system change

A

QI

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39
Q

Informatics

A

Use information and technology to communicate, manage knowledge, mitigate error, and support decision making

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40
Q

What’s wrong with this order: 10 mg morphine, IM, Q4h, prn for pain

A

the dose is too high

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41
Q

Acute cholecystitis: clear liquid diet; progress to low fat as tolerated

A

Wrong. Patient should be NPO until bowel sounds return

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42
Q

What’s wrong with the order: O2 per protocol to maintain POX at 95%

A

not specific; need to know the rate and dose

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43
Q

Cholecystectomy for acute cholecystitis: before the dangle at the side of the bed

A

give pain medication

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44
Q

2 days post op, consideration for temperature

A

Normal for it to be elevated slightly at this point

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45
Q

What is the GI complication of morphine

A

constipation

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46
Q

what is the serious complication that a d-dimer test can rule out

A

PE

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47
Q

MI case: Yes or No: Basal metabolic panel

A

Yes

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48
Q

MI case: Yes or No: PT and PTT

A

Yes

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49
Q

MI case: Yes or No: bilirubin

A

No

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50
Q

MI case: Yes or No: Urinalysis

A

Yes (to assess kidney function)

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51
Q

MI case: Yes or No: Type and crossmatch for 2 units of packed RBCs

A

No

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52
Q

MI case: Yes or No: chest x ray on admission and in morning

A

Yes

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53
Q

MI case: besides pain management, why give morphine?

A

Increases cardiac perfusion (by decreasing O2 demand)

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54
Q

primary MI NDX

A

Alteration in cardiac tissue perfusion r/t myocardial ischemia secondary to coronary artery occlusion

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55
Q

MI NDX: Fear

A

Fear and anxiety related to impending doom secondary to MI

56
Q

MI NDX: Activity

A

Activity intolerance related to decreased cardiac reserve

57
Q

MI NDX: knowledge

A

Deficient knowledge related to lack of information

58
Q

PT range

A

11 to 14

59
Q

PTT range

A

25 to 35

60
Q

INR range

A

0.8 to 1.2

61
Q

hemoglobin range

A

about 12 to about 17

62
Q

hematocrit range

A

about 35 to about 50

63
Q

Lantus

A

long acting insulin

64
Q

What time of day should Lantus (long acting insulin) be taken

A

bedtime

65
Q

Onset of lantus (long acting insulin)

A

5 hours

66
Q

Duration of lantus (long acting insulin)

A

24 hours

67
Q

Hypoglycemic patient with DM: NDX:

A

Alteration in tissue perfusion r/t inadequate supply of glucose in the brain

68
Q

Cold weather can be a precipitating factor in

A

angina

69
Q

MI case: Yes or No: CBC

A

Yes

70
Q

MI case: Yes or No: electroencephalogram

A

No

71
Q

Patient has cigarettes at hospital

A

ask family to take them home

72
Q

MI: decreasing chest pain also decreases ___

A

anxiety

73
Q

MI: patient is instructed not to ___ ___

A

bear down

74
Q

MI: patient is not allowed to g___________ by themselves

A

go to the bathroom

75
Q

MONA

A

morphine, oxygen, nitroglycerine, aspirin

76
Q

nitro has a _____ effect

A

vasodilation

77
Q

action of aspirin in MI:

A

antiplatelet

78
Q

MI: morphine reduces __load

A

preload

79
Q

MI: don’t give morphine if rr is below

A

10

80
Q

MI: check pt ___ min after giving morphine

A

30

81
Q

MI: give morphine over ____ min

A

4 to 5

82
Q

MI: no ____, bed pan with assistance

A

commode

83
Q

MI: put them on __ __

A

bed rest

84
Q

MI: give __ __ for HTN

A

ace inhibitor

85
Q

eject fraction

A

normal is 50 to 70. It’s the amount shot from left vent.

86
Q

CVA case: first order to be carried out

A

administer O2

87
Q

CVA case: Contraindicated for fibrinolytic therapy? taking warfarin and has INR of 2.4

A

Contra

88
Q

CVA case: Contraindicated for fibrinolytic therapy? Major surgery in last 14 days

A

Contra

89
Q

CVA case: Contraindicated for fibrinolytic therapy? Systolic BP 150

A

Not contra

90
Q

CVA case: Contraindicated for fibrinolytic therapy? Platelet less than 100,000

A

Contra

91
Q

CVA case: Contraindicated for fibrinolytic therapy? Blood sugar less than 50

A

Contra

92
Q

CVA case: Contraindicated for fibrinolytic therapy? H/o MI 1 year ago

A

Contra

93
Q

CVA case: The patient had a thrombolytic infusion. How long should you wait before giving anticoagulant or antiplatelet meds?

A

24 hours

94
Q

How does a statin benefit a CVA patient

A
  • Prevents narrowing of vessels

- Prevents platelet aggregation

95
Q

CVA case: modified barium swallow study is to r/o

A

aspiration

96
Q

CVA case: Non contrast CT should be done within __ __ and read within 45 minutes

A

25 min

97
Q

CVA case: you must give the thrombolytic within

A

3 hours

98
Q

How long does it typically take for bowel sounds to return

A

24 to 48 hours

99
Q

Hypoglycemia/DM case: the main dx could be

A

acute confusion

100
Q

Hypoglycemia/DM case: Give 4 ounces of juice of

A

soda (not diet soda)

101
Q

Hypoglycemia/DM case: Give 8 ounces of

A

milk

102
Q

Hypoglycemia/DM case: give 7

A

life savers

103
Q

Hypoglycemia/DM case: 1 tablespoon of

A

sugar

104
Q

Hypoglycemia/DM case: 3

A

glucose tablets

105
Q

Hypoglycemia/DM case: 2 tablespoons of

A

raisins

106
Q

Hypoglycemia/DM case: A safety precaution

A

seizure precautions

107
Q

Hypoglycemia/DM case: offer sugar followed by

A

carb and protein

108
Q

DVT activity level instructions

A

bed rest, but permitted to move about the bed

109
Q

DVT patient should be on bed rest, position legs

A

elevated but don’t put pillows under the knees

110
Q

Where in the hospital is an MI patient given thrombolytics

A

the ED (don’t wait until they get transferred)

111
Q

Can nurses give morphine by IVP

A

only if they certified

112
Q

Pt has an anaphylactic reaction, treat with

A

epinephrine and benedryl

113
Q

Morphine’s half life is approx

A

2 hours

114
Q

Morphine’s onset

A

5 min (IV), 15 min (IM), 20 min (PO)

115
Q

Need to be careful giving morphine to an asthma patient because

A

they already have resp issues

116
Q

Patient has h/o seizures; morphine will

A

worsen it

117
Q

morphine dose for older adults

A

should be smaller

118
Q

Morphine can prolong

A

labor

119
Q

Morphine can show up in

A

breast milk

120
Q

Breathing pattern of morphine OD

A

cheynne stokes

121
Q

DM patient: nervousness and tachycardia are signs of

A

hypOglycemia

122
Q

dose of an IM glucagon

A

1 to 2 mg

123
Q

Glucagon revives the patient rapidly, but they will be

A

confused

124
Q

regular insulin peaks around

A

2 to 3 hours

125
Q

Lantus doesn’t have a very distinct

A

peak (even though the other card says 5 hours)

126
Q

What about cookies and ice cream for a hypo glycemic?

A

not the best because high fat foods slow down absorption

127
Q

CT skill that includes following hospital policies

A

Applying Standards

128
Q

A1C is not used for

A

children

129
Q

A healthy BMI is below

A

30

130
Q

In which part of SPAR do you put the Vitals

A

Assessment

131
Q

What is the criteria for removing an NG tube

A

when nothing else is coming out in the suction

132
Q

Pt has been NPO and needs oral care: one option is

A

glycerin swabs

133
Q

Hallmark sign of atelectasis

A

diminished breath sounds

134
Q

Warfarin: therapeutic INR is

A

2.5

135
Q

A fib can lead to thrombus formation because

A

the blood is stagnant

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