Chapters 41, 24 & 25 Flashcards
1
Q
What is the significance of oxygenation?
A
Understanding oxygenation’s role in sustaining life and supporting cellular metabolism.
2
Q
How do the respiratory and cardiovascular systems collaborate?
A
They collaborate to deliver oxygen and remove carbon dioxide.
3
Q
What are the main cardiac structures involved in oxygenation?
A
- Right atrium
- Left atrium
- Right ventricle
- Left ventricle
- Tricuspid valve
- Pulmonic valve
- Mitral valve
- Aortic valve
4
Q
What is the function of heart valves?
A
To ensure unidirectional blood flow.
5
Q
What is the sequence of the electrical pathway in the heart?
A
- Sinoatrial (SA) node
- Atrioventricular (AV) node
- Bundle of His
- Purkinje fibers
6
Q
What are the key pulmonary structures involved in oxygenation?
A
- Nasal passages
- Pharynx
- Larynx
- Trachea
- Bronchi
- Bronchioles
- Alveoli
7
Q
What are the roles of the diaphragm and intercostal muscles?
A
They are involved in the mechanics of breathing, specifically in inspiration and expiration.
8
Q
What factors influence lung compliance and airway resistance?
A
Factors influencing breathing efficiency.
9
Q
Define ventilation.
A
Movement of air into and out of the lungs.
10
Q
What regulates ventilation?
A
Neural and chemical controls maintaining respiratory rate and depth.
11
Q
Define perfusion.
A
Blood flow to the pulmonary capillaries.
12
Q
What factors affect perfusion?
A
- Cardiac output
- Blood pressure
- Vascular resistance
13
Q
Define diffusion in the context of oxygenation.
A
Exchange of gases (O₂ and CO₂) between alveoli and blood.
14
Q
What factors influence diffusion?
A
- Partial pressure gradients
- Alveolar surface area
- Membrane thickness
15
Q
What physiological factors can decrease oxygen-carrying capacity?
A
- Anemia
- Carbon monoxide poisoning
16
Q
What is hypovolemia?
A
Impact of reduced blood volume on oxygen delivery.
17
Q
How does increased metabolic rate affect oxygen demand?
A
Conditions like fever, pregnancy, and hyperthyroidism increase oxygen demand.
18
Q
What conditions can alter chest wall movement?
A
- Pregnancy
- Obesity
- Musculoskeletal abnormalities (e.g., kyphosis)
- Trauma (e.g., rib fractures)
- Neuromuscular diseases
19
Q
What are examples of chronic diseases that impact oxygenation?
A
- Chronic obstructive pulmonary disease (COPD)
- Heart failure
20
Q
What does a health history assessment for oxygenation include?
A
- Smoking history
- Occupational exposures
- Respiratory symptoms
21
Q
What does physical examination for oxygenation assessment include?
A
- Inspection
- Palpation
- Percussion
- Auscultation
22
Q
What is measured by pulse oximetry?
A
Arterial oxygen saturation (SpO₂).
23
Q
What do arterial blood gases (ABGs) analyze?
A
- pH
- PaO₂
- PaCO₂
- HCO₃⁻ levels
24
Q
What do pulmonary function tests (PFTs) assess?
A
Lung volumes and capacities.
25
What diagnostic imaging is used for structural evaluation of the lungs?
* Chest X-rays
* CT scans
26
What are indicators of impaired gas exchange?
* Abnormal ABGs
* Hypoxemia
* Dyspnea
27
What are indicators of ineffective airway clearance?
* Inability to clear secretions
* Diminished breath sounds
28
What are indicators of an ineffective breathing pattern?
* Altered respiratory rate or depth
* Use of accessory muscles
29
What are indicators of activity intolerance?
* Dyspnea on exertion
* Fatigue
* Changes in vital signs with activity
30
What does SMART stand for in goal setting?
* Specific
* Measurable
* Achievable
* Relevant
* Time-bound
31
What is a key intervention for improving oxygenation?
Positioning: Elevating the head of the bed, encouraging ambulation.
32
What airway management techniques are used?
* Suctioning
* Use of artificial airways (e.g., oropharyngeal, nasopharyngeal)
33
34
What is the significance of communication in nursing practice?
Essential for establishing nurse-patient relationships and delivering patient-centered care
## Footnote
Communication is a lifelong learning process.
35
How does effective communication impact interpersonal relationships in nursing?
Fosters trust, promotes healing, and enhances patient outcomes.
36
What is the impact of clear communication on patient safety?
Reduces errors and ensures continuity of care.
37
What role does critical thinking play in developing communication skills for nurses?
Interprets messages, analyzes content, makes inferences, evaluates effects, and explains rationales.
38
What are perceptual biases?
Stereotypes that can hinder accurate message interpretation.
39
Define emotional intelligence in the context of nursing communication.
The ability to understand and manage one’s own emotions and those of others.
40
What is intrapersonal communication?
Self-talk that influences perceptions, feelings, behavior, and self-esteem.
41
Describe interpersonal communication.
One-on-one interactions between a nurse and another person, often face-to-face.
42
What characterizes small-group communication?
Interactions within a small number of people, aiming for effective problem-solving and decision-making.
43
What is public communication?
Communication directed at an audience, such as health education sessions.
44
Define electronic communication in nursing.
Utilizing technology, like emails and electronic health records, to communicate and document patient information.
45
What is the referent in the communication process?
The motivating factor prompting communication.
46
Who are the sender and receiver in communication?
Individuals who encode and decode messages, respectively.
47
What is the message in the communication process?
The content being conveyed.
48
What are channels in communication?
Mediums through which messages are transmitted (e.g., visual, auditory, tactile).
49
What does feedback represent in communication?
The receiver’s response, indicating whether the message was understood.
50
What are interpersonal variables?
Factors such as perceptions, values, and emotions that influence communication.
51
How does the environment affect communication?
It provides the physical and emotional context in which communication occurs.
52
List the key elements of verbal communication.
* Vocabulary
* Denotative and connotative meaning
* Pacing
* Intonation
* Clarity and brevity
* Timing and relevance
53
What are the components of nonverbal communication?
* Personal appearance
* Posture and gait
* Facial expressions
* Eye contact
* Gestures
* Sounds
* Territoriality and personal space
* Metacommunication
54
What is the preinteraction phase in nurse-patient relationships?
Gathering information before meeting the patient.
55
What occurs during the orientation phase of a nurse-patient relationship?
Introducing oneself and establishing trust.
56
What is the working phase in a nurse-patient relationship?
Collaborating to address patient needs and goals.
57
Define the termination phase of a nurse-patient relationship.
Concluding the relationship and summarizing care provided.
58
What is the role of courtesy in professional communication?
Polite interactions that show respect.
59
Why is the use of names important in communication?
Addressing individuals appropriately conveys respect.
60
What does trustworthiness mean in professional communication?
Being reliable and honest in communications.
61
What are therapeutic communication techniques?
* Active listening
* Sharing observations
* Empathy
62
What is the definition and purpose of patient education?
Involves providing information and support to help patients manage their health effectively.
63
What are the aims of patient education?
* Promote health maintenance
* Disease prevention
* Restoration of health
* Coping with impaired functions
64
What role do nurses play in patient education?
Nurses serve as educators, facilitating learning and empowering patients to make informed health decisions.
65
What does the cognitive domain of learning involve?
Intellectual activities such as thinking, understanding, and remembering.
66
What are some teaching methods used in the cognitive domain?
* Lectures
* Discussions
* Reading materials
67
What does the affective domain of learning pertain to?
Emotions, attitudes, and values.
68
What are some teaching methods used in the affective domain?
* Role-playing
* Group discussions
* Expressing feelings
69
What does the psychomotor domain relate to?
Physical skills and actions.
70
What are some teaching methods used in the psychomotor domain?
* Demonstrations
* Practice sessions
* Return demonstrations
71
What is motivation to learn?
Internal drive influenced by the belief in the need to know something.
72
What factors influence motivation to learn?
* Perceived benefit
* Self-efficacy
* Readiness to learn
73
What does readiness to learn reflect?
When a person is receptive to learning.
74
What factors influence readiness to learn?
* Physical and emotional states
* Developmental stage
75
What does the ability to learn depend on?
Cognitive development, physical capability, and developmental level.
76
What is an optimal learning environment?
Quiet, comfortable, and free from distractions.
77
What is the first step in the teaching process?
Assessment.
78
What does the assessment step involve?
Identify the patient’s learning needs, preferences, and readiness.
79
What is the diagnosis step in the teaching process?
Formulate nursing diagnoses related to learning needs.
80
What is involved in the planning step of the teaching process?
Set measurable learning objectives in collaboration with the patient.
81
What is the implementation step in the teaching process?
Carry out the teaching plan using chosen strategies.
82
What is the evaluation step of the teaching process?
Assess the patient’s understanding and ability to apply the information.
83
What is one-on-one discussion in teaching methods?
Personalized instruction tailored to the individual’s needs.
84
What is group instruction?
Educating multiple patients simultaneously, encouraging peer support.
85
What are demonstrations in teaching methods?
Showing how to perform a task or procedure.
86
What are analogies used for in teaching?
Using familiar concepts to explain unfamiliar ones.
87
What is role-playing in patient education?
Simulating scenarios to practice responses and behaviors.
88
What is simulation in teaching methods?
Utilizing models or virtual environments to replicate real-life situations.
89
What are cultural influences in patient education?
Respecting and integrating cultural beliefs and practices into education.
90
What is health literacy?
Ensuring the patient can understand and act upon health information.
91
What is a key consideration when teaching older adults?
Adjusting for sensory changes, cognitive abilities, and learning pace.
92
What are methods of evaluation in patient education?
* Observing return demonstrations
* Asking open-ended questions
* Using teach-back methods
93
What does documentation in patient education involve?
Recording the teaching provided and the patient’s response.
94
What are the main cardiac structures involved in the cardiopulmonary system?
Heart chambers: Right and left atria; right and left ventricles. Valves: Tricuspid, pulmonic, mitral, and aortic valves.
95
What is the role of the conduction system in the heart?
It provides an electrical pathway for impulse generation and propagation, ensuring coordinated heart contractions.
96
What are the primary pulmonary structures involved in the respiratory system?
Airways: Nasal passages, pharynx, larynx, trachea, bronchi, and bronchioles; Alveoli: Sites of gas exchange.
97
What muscles are primarily involved in the mechanics of breathing?
Diaphragm and intercostal muscles.
98
What factors influence breathing efficiency?
Lung compliance and airway resistance.
99
Define ventilation in the context of the respiratory system.
The movement of air into and out of the lungs.
100
What regulates the respiratory rate and depth?
Neural and chemical controls.
101
What does perfusion refer to in the cardiopulmonary system?
Blood flow to the pulmonary capillaries.
102
List factors affecting perfusion.
* Cardiac output
* Blood pressure
* Vascular resistance
103
What is diffusion in relation to gas exchange?
The exchange of gases (O2 and CO2) between alveoli and blood.
104
What influences the diffusion process?
* Partial pressure gradients
* Alveolar surface area
* Membrane thickness
105
What is cardiac output (CO) and its significance?
The total amount of blood the heart pumps per minute; more blood pumped means better oxygen delivery.
106
What factors affect cardiac output?
* Heart Rate (HR)
* Stroke Volume (SV)
107
Define preload in the context of cardiac function.
The amount of blood filling the heart before it pumps.
108
What is afterload?
The resistance the heart has to push against to send blood out.
109
What does contractility refer to?
The strength of the heart's contraction.
110
True or False: High afterload can reduce oxygen delivery.
True.
111
What are disturbances in conduction and their clinical outcomes?
Arrhythmias; outcomes include dizziness, fainting, palpitations, decreased oxygen to organs, and risk of cardiac arrest.
112
What are the clinical outcomes of altered cardiac output?
* Fatigue
* Low blood pressure
* Shortness of breath
* Swelling (edema)
* Organ damage
113
What happens with impaired valvular function?
Blood flow is disrupted due to narrowed or leaky heart valves.
114
List clinical outcomes of impaired valvular function.
* Shortness of breath
* Swelling in legs
* Fatigue
* Dizziness
* Heart failure
115
What is myocardial ischemia?
Reduced blood flow to the heart or an increase in myocardial oxygen demand without adequate coronary perfusion.
116
What are the clinical outcomes of myocardial ischemia?
* Chest pain (angina)
* Shortness of breath
* Sweating
* Nausea
* Potential heart failure or cardiac arrest
117
What unique symptoms do women experience during myocardial infarction?
* Fatigue
* Indigestion
* Shortness of breath
* Back or jaw pain
118
What are the clinical outcomes of impaired tissue perfusion?
* Cold, pale skin
* Slow wound healing
* Confusion
* Organ failure
* Shock in severe cases
119
Fill in the blank: Oxygenation depends on how well the heart pumps _______ blood to the body.
oxygen-rich
120
What factors affect a patient's oxygenation?
Patient's level of health, age, lifestyle, and environment
## Footnote
Includes risk factors like exposure to secondhand smoke, diet, exercise, and substance use.
121
What are the risks for infants regarding oxygenation?
Higher infection rates, airway obstruction, and exposure to secondhand smoke
## Footnote
Infants have smaller airways and are more susceptible to respiratory tract infections.
122
What lifestyle choices can reduce the risk of cardiopulmonary diseases in adults?
Nutrition, hydration, exercise, smoking cessation, substance abuse avoidance, and stress management
## Footnote
Important for establishing lifelong healthy habits.
123
What physiological changes occur in older adults affecting oxygenation?
Calcification of heart valves, vascular stiffening, increased left ventricular wall stiffness, impaired SA node function, costal cartilage stiffening
## Footnote
These changes increase the risk for respiratory infections.
124
What is the impact of environmental pollutants on oxygenation?
Increased risk for lung cancer and interstitial fibrosis
## Footnote
Occupations exposing individuals to asbestos or fungus spores increase these risks.
125
What conditions decrease oxygen-carrying capacity?
Anemia and carbon monoxide poisoning
## Footnote
These conditions impair the blood's ability to transport oxygen.
126
How does hypovolemia affect oxygen delivery?
Reduces blood volume, impacting oxygen delivery to tissues
## Footnote
This can lead to inadequate oxygenation.
127
What factors can increase metabolic rate, thereby affecting oxygen demand?
Fever, pregnancy, and hyperthyroidism
## Footnote
These conditions require more oxygen for metabolic processes.
128
What are some alterations in chest wall movement that can affect oxygenation?
Pregnancy, obesity, musculoskeletal abnormalities, trauma, and neuromuscular diseases
## Footnote
These conditions can restrict lung expansion and airflow.
129
What are examples of chronic diseases that impact oxygenation?
Chronic obstructive pulmonary disease (COPD) and heart failure
## Footnote
These diseases have long-term effects on gas exchange.
130
What are early signs of hypoxia?
Restlessness, anxiety, confusion
## Footnote
These symptoms indicate a need for immediate intervention.
131
What symptoms indicate prolonged oxygen deprivation?
Fatigue, weakness, decreased level of consciousness (LOC)
## Footnote
These are signs of inadequate oxygenation over time.
132
What are signs of respiratory distress?
Use of accessory muscles, nasal flaring, and altered breathing patterns
## Footnote
These symptoms require assessment for potential respiratory failure.
133
What is tachypnea and what does it indicate?
Rapid breathing; indicates hypoxia or metabolic acidosis
## Footnote
This symptom can signal severe underlying issues.
134
What types of respiration patterns may be seen in heart failure or acidosis?
Cheyne-Stokes respiration and Kussmaul's respiration
## Footnote
These patterns reflect abnormal respiratory responses to metabolic demands.
135
What might a cough with sputum or hemoptysis indicate?
Possible infection or lung disease
## Footnote
These symptoms necessitate further evaluation for underlying issues.
136
What are cardiovascular symptoms of chronic or severe hypoxia?
Cyanosis, pallor, clubbing of fingers
## Footnote
These signs reflect long-term oxygen deprivation.
137
What PaO2 level requires intervention?
pO2 < 90%
## Footnote
This indicates significant hypoxemia that needs immediate action.
138
What does low PaO2 and high/low PaCO2 suggest?
Respiratory failure
## Footnote
Low PaO2 indicates hypoxemia, while abnormal PaCO2 levels indicate respiratory acidosis or alkalosis.
139
What are signs of poor oxygen delivery in skin and circulation?
Delayed capillary refill, edema, diaphoresis
## Footnote
These symptoms may indicate cardiovascular or respiratory distress.
140
What symptoms indicate insufficient cerebral oxygenation?
Headache, dizziness, fainting, seizures
## Footnote
These symptoms reflect inadequate blood flow and oxygen to the brain.
141
What might diminished breath sounds indicate?
Airway obstruction or atelectasis
## Footnote
These findings require prompt assessment and intervention.
142
What respiratory sounds are common in lung conditions?
Crackles, wheezing, stridor
## Footnote
These sounds indicate fluid in the lungs, airway narrowing, or upper airway obstruction.
143
What vaccinations are encouraged in primary care to promote oxygenation?
Flu and pneumonia vaccines
## Footnote
These vaccines prevent respiratory infections.
144
What lifestyle changes are promoted in primary care to improve oxygenation?
Exercise, good nutrition, and hydration
## Footnote
Encouragement of a healthy lifestyle is vital for overall lung health.
145
What intervention is suggested to avoid exposure to harmful substances in primary care?
Smoking cessation and reducing exposure to air pollution
## Footnote
Avoiding harmful substances is crucial for respiratory health.
146
What breathing techniques are taught in primary care to improve lung function?
Pursed-lip and diaphragmatic breathing
## Footnote
These techniques help improve lung function.
147
What positioning is recommended in acute care to improve lung expansion?
Semi-Fowler's or high-Fowler's position
## Footnote
Sitting upright enhances lung expansion.
148
What type of therapy is provided in acute care for patients needing oxygen?
Oxygen therapy through nasal cannulas or masks
## Footnote
Oxygen is administered as prescribed by healthcare providers.
149
What airway clearance technique involves coughing and deep breathing?
Coughing & Deep Breathing
## Footnote
This technique helps remove mucus and improve lung function.
150
What technique encourages deep breathing to prevent lung collapse?
Incentive spirometry
## Footnote
This technique is used to promote lung expansion.
151
What medications are administered to open airways in conditions like asthma?
Bronchodilators
## Footnote
These medications help improve airflow.
152
What type of medication is used to reduce lung inflammation?
Steroids
## Footnote
Steroids can help manage inflammatory conditions affecting the lungs.
153
What is the purpose of antibiotics in acute care?
Treat infections like pneumonia
## Footnote
Antibiotics are crucial for managing bacterial infections.
154
What programs are included in restorative and continuing care for lung disease patients?
Pulmonary rehabilitation programs
## Footnote
These programs aim to improve breathing and endurance.
155
What education is provided regarding home oxygen therapy?
Safe use of oxygen at home
## Footnote
Patients are educated on proper oxygen use to prevent complications.
156
What strategies are taught to conserve energy in restorative care?
Energy conservation strategies
## Footnote
Patients learn to pace activities and rest to avoid breathlessness.
157
What type of support is provided to help patients cope with chronic conditions?
Psychosocial support
## Footnote
This support encourages adherence to treatment plans.
158
What is a helping relationship in nursing?
A professional, goal-directed partnership between a nurse and a patient that promotes health, healing, and well-being.
159
List the features of the Nurse-Patient Helping Relationship.
* Professionalism
* Empathy and Respect
* Trust and Confidentiality
* Goal-Oriented
160
What are the phases of the Nurse-Patient Helping Relationship?
* Preinteraction Phase
* Orientation Phase
* Working Phase
* Termination Phase
161
What occurs during the Preinteraction Phase?
The nurse reviews records and prepares for interaction before meeting the patient.
162
Define the Orientation Phase in the Nurse-Patient Helping Relationship.
The nurse and patient meet, establish rapport, discuss goals, and set expectations.
163
What is the focus of the Working Phase?
The nurse provides care, supports patient needs, and encourages self-care.
164
When does the Termination Phase occur?
The relationship ends when goals are met, or care is transferred/discontinued.
165
What are some therapeutic outcomes of the Nurse-Patient Helping Relationship?
* Improved patient understanding of their health
* Enhanced coping skills and emotional support
* Stronger adherence to treatment and self-care behaviors
* Better overall health and well-being
166
What are the qualities of professional communication?
* Courtesy
* Use of Names
* Trustworthiness
* Autonomy & Responsibility
* Assertiveness
167
What behaviors promote effective communication?
* Active listening
* Using open-ended questions
* Providing clear, concise explanations
* Showing empathy and validation
* Respecting cultural and personal differences
168
Name some communication techniques used in nursing.
* Therapeutic Communication
* Nonverbal Communication
* Clarification & Validation
169
How should nurses communicate with older patients?
* Speak clearly and slowly
* Face the patient and maintain eye contact
* Use simple, direct language
* Check for hearing or vision impairments
* Use written or visual aids
* Encourage reminiscence
170
What strategies should be used for patients with hearing impairments?
* Use written communication or sign language interpreters
* Speak slowly, facing the patient
* Reduce background noise
171
What are the recommended practices for patients with vision impairments?
* Announce your presence and explain procedures
* Provide large-print materials or audiobooks
* Use braille or talking devices
172
How should nurses communicate with patients who have speech disorders?
* Be patient and allow extra time for responses
* Use communication boards or electronic devices
* Encourage nonverbal gestures
173
What are the communication strategies for patients with cognitive impairments?
* Use simple words and short sentences
* Maintain routine and consistency
* Reassure and redirect if confusion occurs
174
What should be done for patients with language barriers?
* Use professional interpreters
* Utilize translation apps or picture boards
* Learn key phrases in the patient's language
175
True or False: Trust and patient safety are essential in nurse-patient communication.
True
176
What is the role of the nurse in patient education?
Teacher & Advocate, Assess Learning Needs, Use Effective Teaching Strategies, Promote Health Literacy, Evaluate Understanding
## Footnote
Nurses provide evidence-based education to help patients manage their health.
177
What are the purposes of patient education?
Health Promotion & Disease Prevention, Restoration of Health, Coping with Impaired Functioning
## Footnote
These purposes include encouraging healthy behaviors and educating about illnesses and treatments.
178
What is cognitive learning?
Understanding facts, concepts, and applying knowledge
## Footnote
It involves the intellectual understanding and application of information.
179
What is affective learning?
Changing attitudes, values, and emotional responses to health
## Footnote
It focuses on the emotional aspect of learning.
180
What is psychomotor learning?
Developing physical skills (e.g., insulin injection, dressing wounds)
## Footnote
This type of learning involves hands-on skills and physical tasks.
181
What factors contribute to readiness to learn?
* Emotional state (motivated, not anxious or stressed)
* Willingness to engage in learning
* Perceived need or relevance of the topic
## Footnote
Readiness indicates a patient's preparedness to learn effectively.
182
What factors contribute to ability to learn?
* Cognitive function (age, literacy, mental status)
* Physical ability (vision, hearing, fine motor skills)
* Developmental level (children vs. adults)
## Footnote
Ability to learn is influenced by various cognitive and physical aspects.
183
What is the Teach-Back Method?
Ask the patient to explain or demonstrate what they learned
## Footnote
This method assesses the patient's understanding of the material taught.
184
What is Return Demonstration?
Have the patient perform a skill (e.g., using an inhaler)
## Footnote
This method evaluates a patient's ability to apply learned skills.
185
What methods can be used to evaluate learning?
* Ask Questions
* Use Written or Visual Assessments
* Follow-Up
## Footnote
These methods help assess comprehension and reinforce learning.
186
True or False: Nurses play a key role in educating patients to promote self-care.
True
## Footnote
Effective patient education enhances health outcomes and quality of life.
187
What is the first phase of the Helping Relationship?
Preinteraction Phase
## Footnote
In this phase, caregivers prepare for the interaction by reviewing data and anticipating health concerns.
188
What should be reviewed during the Preinteraction Phase?
Available data, including the medical and nursing history
## Footnote
This includes communication ability, pathology, medications affecting mood, and previous behavior problems.
189
What is a key activity in the Preinteraction Phase?
Talk to other caregivers who have information about the patient
## Footnote
This helps in understanding the patient's background and current needs.
190
What should be identified in the Preinteraction Phase?
A location and setting that fosters comfortable, private interaction
## Footnote
The environment can significantly impact the effectiveness of the helping relationship.
191
What is the focus of the Orientation Phase?
When you and a patient meet and get to know each other
## Footnote
This phase establishes the foundation for the helping relationship.
192
What tone should be set during the Orientation Phase?
A warm, empathetic, caring manner
## Footnote
This helps build trust and rapport with the patient.
193
What should be expected from the patient during the Orientation Phase?
To test your competence and commitment
## Footnote
This is a natural part of establishing a trusting relationship.
194
What should be clarified during the Orientation Phase?
The patient's and your roles
## Footnote
Clear roles help in establishing boundaries and expectations.
195
What is the primary activity during the Working Phase?
Encourage and help the patient express feelings about health
## Footnote
This phase focuses on collaboration to solve problems.
196
What is an important aspect of observing the patient in the Orientation Phase?
Closely observe the patient and expect to be closely observed by the patient
## Footnote
Mutual observation is crucial for understanding and trust.
197
What should be established with the patient during the Orientation Phase?
Contracts that specify who will do what
## Footnote
Contracts help clarify responsibilities and expectations.
198
During which phase do you assess the patient's health status?
Orientation Phase
## Footnote
This assessment helps prioritize problems and identify expected outcomes.
199
What should be anticipated in the Preinteraction Phase?
Health concerns or issues that arise
## Footnote
Anticipating issues allows for better preparation and response.
200
What is the nature of the initial relationship with a patient?
Often superficial, uncertain, and tentative.
## Footnote
This highlights the need for building trust and rapport.
201
What should a nurse expect from a patient during the initial phase?
The patient will test your competence and commitment.
## Footnote
This is a common behavior as patients seek reassurance.
202
When should a nurse inform the patient about the relationship?
When to expect the relationship to be terminated.
## Footnote
Clear communication about termination helps in managing patient expectations.
203
What should a nurse closely observe during the initial phase?
The patient and expect to be closely observed by the patient.
## Footnote
Mutual observation can enhance trust and understanding.
204
What actions should a nurse take regarding patient messages and behaviors?
Begin to make inferences and form judgments.
## Footnote
This is important for understanding the patient's needs and concerns.
205
What is the first step in assessing a patient’s situation?
Assess the patient's health status.
## Footnote
This assessment informs the care plan and interventions.
206
What should a nurse prioritize after assessing a patient?
Prioritize the patient's problems and identify expected outcomes.
## Footnote
This helps in focusing care on the most critical issues.
207
What roles must be clarified between the nurse and patient?
The patient's and your roles.
## Footnote
Clear role definition aids in collaborative care.
208
What is the purpose of forming contracts with the patient?
To specify who will do what.
## Footnote
Contracts enhance accountability and clarity in the therapeutic relationship.
209
What is the focus of the Working Phase in patient care?
Working together to solve problems and accomplish outcomes.
## Footnote
Collaboration is key to effective patient care.
210
What should a nurse encourage a patient to express during the Working Phase?
Feelings about health.
## Footnote
This expression is crucial for emotional and psychological support.
211
What type of information should be provided to the patient?
Information needed to understand and change behavior.
## Footnote
Education empowers patients to make informed decisions.
212
What should a nurse collaborate with the patient on?
Set individualized outcomes.
## Footnote
Individualized care plans enhance patient engagement and success.
213
What actions should a nurse take to meet set outcomes?
Take action to meet the outcomes set with the patient.
## Footnote
Active involvement is essential for achieving health goals.
214
What skills should be used to facilitate successful interactions?
Therapeutic communication skills.
## Footnote
These skills are critical for effective nurse-patient relationships.
215
What types of communication may be appropriate during the Working Phase?
Self-disclosure and confrontation.
## Footnote
These techniques should be used judiciously to enhance understanding.
216
What should a nurse remind the patient of during the Termination Phase?
That termination is near.
## Footnote
This prepares the patient emotionally for the end of the relationship.
217
What should be evaluated with the patient during the Termination Phase?
Achievement of expected outcomes.
## Footnote
This helps in assessing the effectiveness of the care provided.
218
What should a nurse do when reminiscing about the relationship?
Reminisce about the relationship with the patient.
## Footnote
Reflecting can provide closure for both the nurse and the patient.
219
What is the nurse's responsibility during the separation from the patient?
Relinquishing responsibility for care.
## Footnote
This is essential for a smooth transition to other caregivers.
220
What should be achieved for the patient during the transition to other caregivers?
A smooth transition.
## Footnote
Ensures continuity of care and support for the patient.
221
What is intrapersonal communication
Self talk
222
What condition is suspected with increased blood pressure, tachycardia, dizziness, and decreased level of consciousness?
Hypoxia
## Footnote
Clinical signs of hypoxia include apprehension, restlessness, inability to concentrate, and behavioral changes.
223
Which position might a patient with hypoxia need to sit in?
High Fowler's position
## Footnote
Patients with hypoxia are unable to lie flat and appear fatigued and agitated.
224
What are common clinical signs of hypoxia?
* Apprehension
* Restlessness
* Inability to concentrate
* Decreased level of consciousness
* Dizziness
* Behavioral changes
## Footnote
These symptoms can indicate worsening hypoxia and require immediate attention.
225
True or False: A patient with hypoxia may show an increased pulse rate.
True
## Footnote
Vital signs in hypoxia often include tachycardia.
226
Fill in the blank: The patient with hypoxia appears both _______ and _______.
fatigued, agitated
## Footnote
These characteristics are often observed in patients experiencing hypoxia.
227
228
What is the serum carbon dioxide level that indicates a normal finding?
23 to 30 mEq/L
## Footnote
A serum carbon dioxide level of 24 mEq/L is within the normal range.
229
What is the PaO2 level that indicates a need for home oxygen therapy?
55 mm Hg or less
## Footnote
This level is a critical threshold for determining the necessity of oxygen therapy.
230
What is a normal heart rate?
72 beats per minute
## Footnote
This heart rate is considered a normal physiological finding.
231
What is a normal respiratory rate?
24 breaths/min
## Footnote
A respiratory rate of 24 breaths per minute is also within the normal range.
232
True or False: A serum carbon dioxide level of 24 mEq/L indicates a need for home oxygen therapy.
False
## Footnote
A level of 24 mEq/L is a normal finding and does not warrant oxygen therapy.
233
What is Cardiac Tamponade?
Blood rapidly collects in the pericardial sac, compresses myocardium because the pericardium does not stretch, and prevents ventricles from filling.
234
What are the manifestations of Cardiac Tamponade?
Muffled, distant heart sounds, hypotension, neck vein distention, increased central venous pressure.
235
What is the intervention for Cardiac Tamponade?
Medical emergency. Pericardiocentesis with surgical repair as appropriate. O2 as needed to maintain O2 saturation, analgesia.
236
What is Flail Chest?
Fracture of 2 or more adjacent ribs in 2 or more places with loss of chest wall stability.
237
What are the manifestations of Flail Chest?
Paradoxical movement of chest wall, respiratory distress. May be associated with hemothorax, pneumothorax, pulmonary contusion.
238
What is the intervention for Flail Chest?
Stabilize flail segment with positive pressure ventilation (intubation and mechanical ventilation as needed). Treat associated injuries. Possible surgical fixation.
239
What is Hemothorax?
Blood in the pleural space, may or may not occur in conjunction with pneumothorax.
240
What are the manifestations of Hemothorax?
Dyspnea, decreased or absent breath sounds, dullness to percussion, decreased Hgb, shock (depending on blood volume lost).
241
What is the intervention for Hemothorax?
Chest tube insertion with chest drainage system. Autotransfusion of collected blood, treatment of hypovolemia as needed with IV fluid, packed red blood cells.
242
What is Pneumothorax?
Air in pleural space.
243
What are the manifestations of Pneumothorax?
Dyspnea, decreased movement of involved chest wall, decreased or absent breath sounds on the affected side, hyperresonance to percussion.
244
What is the intervention for Pneumothorax?
Chest tube insertion with chest drainage system.
245
What is Tension Pneumothorax?
Air in pleural space that does not escape, increasing intrathoracic pressure.
246
What are the manifestations of Tension Pneumothorax?
Cyanosis, air hunger, extreme agitation, subcutaneous emphysema, neck vein distention, hyperresonance to percussion, tracheal deviation away from affected side (late sign).
247
What is the intervention for Tension Pneumothorax?
Medical emergency: needle decompression followed by chest tube insertion with chest drainage system.
