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Question 1

7 principles of cultural safety in nursing

Answer 1

1. Reflection on self, ones own culture and profession, power imbalances, attitudes and beliefs
2. Enhanced communication skills including interpreters
3. Understanding of the influence of history on health and health is political and social
4. Develop trust
5. Negotiation of knowledge and outcomes
6. Understand the influence of power imbalances on care

Question 2

Cycle of prejudice

Answer 2

Cultural baggage (values, beliefs and attitudes)
Stereotyping
Prejudice
Discrimination

Question 3

Achieving cultural safety

Answer 3

1. Cultural awareness (understanding there is difference)
2. Cultural sensitivity (impact of beliefs and actions have on others)
3. Cultural safety (safe service is defined by those who receive the service)

Question 4

12 activities

Answer 4

1. Maintaining a safe environment; 2. Communication; 3. Breathing; 4. Eating and drinking; 5. Elimination; 6. Washing and dressing; 7. Thermoergulation; 8. Mobilisation; 9. Work and play; 10. Expressing sexuality; 11. Sleeping; 12. Death

Question 5

4 stages of sleep

Answer 5

1: transition and light sleep- muscle, brain, eye activity decrease
2: eye movement and muscle activity stop, brain waves slow
3: brain produces slow delta waves - sleep may be disorientated if wakened
4: REM- heart breathing and BP rise, body paralysed, eye movement rapid - dreams

Question 6

Chain of infection

Answer 6

Infectious agent
Reservoir 
Portal of exit
Mode of transportation 
Portal of entry
Host
Repeat

Question 7

Health care associated infections

Answer 7

Iatrogenic infections
Exogenous infection
Endogenous infection

Question 8

Iatrogenic infections

Answer 8

Result from a diagnostic and therapeutic procedure

Question 9

Exogenous infection

Answer 9

Arise from microorganisms external to the individual that do not exist as the person’s normal flora

Question 10

Endogenous infection

Answer 10

Occur when part of the patients flora becomes altered and overgrowth results

Question 11

Sequence of putting on

Answer 11

1. Hand hygiene
2. Gown
3. Mask/ goggled/ eyewear
4. Gloves

Question 12

Sequence of removing

Answer 12

1. Gloves
2. Hand hygiene
3. Eyewear / face shield
4. Gown
5. Mask
6. Hand hygiene

Question 13

Nociceptive pain

Answer 13

Physiological pain sustained by ongoing activation of the sensory system that perceived a noxious stimuli
Damage to somatic or visceral tissue

Question 14

Neuropathic pain

Answer 14

Pathophysiological pain sustained by injury or dysfunction of the peripheral or central NS

Question 15

Transduction

Answer 15

Noxious stimuli activate nociceptors

Question 16

Transmission

Answer 16

Action potentials move along A delta and C fibres to synapse in the dorsal horn of spinal cord

Question 17

Perception

Answer 17

The point at which a person is consciously aware of pain

Question 18

Modulation

Answer 18

Inhibition or facilitation I’d afferent input which can also occur anywhere along nociceptive pathways

Question 19

Pain assessment (PQRSTU)

Answer 19

P: Provoking/Palliative factors- what makes the pain better/worse?
Q: Quality- describe what the pain feels like
R: Region and radiation- where is it? Does it radiate? Does it occur anywhere else?
S: Severity- have the patient rate their pain intensity using a pain rating scale. How much pain at rest vs moving/ coughing?
T: Time of onset/ duration- where did the begin? How long does the pain last?
U: patients understanding- cause of pain and what treatments did they try?

Question 20

Principles of Skin Assessment

Answer 20

Step 1 Prepare the environment - private room, good lighting, quiet, adequate exposure of skin
Step 2 Gather relevant information - explain what you are going to do and the purpose of assessing skin, obtain appropriate history
Step 3 Observe and palpate the skin - head to toe, left to right

Question 21

Phases of wound healing

Answer 21

1. Haemostasis
2. Inflammation
3. Proliferation or reconstruction
4. Maturation or remodelling of the scar tissue

Question 22

Wound exudate types

Answer 22

Serous: clear fluid
Haemoserous: slightly blood stained serous fluid
Sanguineous: frank or heavily blood-stained
Purulent: containing pus

Question 23

Wound assessment TIME

Answer 23

Tissue
Inflammation
Moisture
Edge

Question 24

4 main groups of factors that affect oxygenation

Answer 24

1. Physiological (anaemia, airway obstruction, high altitude)
2. Developmental (premature infants, elderly)
3. Behavioural (nutrition, smoking, anxiety)
4. Environmental (pollution, dust, work related exposure)

Question 25

Bristol Stool Scale

Answer 25

``` Type 1: separate hard lumps like nuts Type 2: sausage but lumpy Type 3: sausage with cracks Type 4: smooth/ soft snake Type 5: soft blobs with clear edges Type 6: fluffy pieces with ragged edges, mushy Type 7: watery, no solid pieces ```

Question 26

Urinalysis

Answer 26

Specific gravity - higher the number the more dehydrated you are, shows kidneys are functioning normally pH - high pH = UTI or kidney related infections. Low pH = kidney stones Leukocytes - WBC = bladder infection Blood - surgery Nitrate - urinary tract infection (bacteria) Ketones - body is burning fat for energy > anorexia or diabetes Bilirubin- sign of liver disease Urobilinogen - also related to liver Protein - kidney disease Glucose - diabetes

Question 27

Wound bed preparation

Answer 27

1. Tissue: removal of non-viable tissue or replacement of deficient tissue 2. Control of infection or inflammation 3. Moisture imbalance: correction of excessive moisture and prevention of desiccation 4. Revision of the edge of wound to stimulate healing

Question 28

STAR classification

Answer 28

Stop bleeding Tissue alignment Assess and dress Review

Question 29

Theories of pain

Answer 29

``` Gate control theory (doesn’t explain phantom limb) Neuromatrix theory (multiple parts of brain work together) Neuroplasticity (neurone change function according to past experiences and environment) Biopsychosocial model of pain (influence of age, culture, coping style etc) ```

Question 30

7 principles of asepsis

Answer 30

1. Sterile object remains sterile only when touched by more sterile 2. Only sterile objects allowed in sterile field 3. Sterile things kept in view - below waist level is unsterile 4. Sterile things become contaminated by prolonged exposure to air 5. Wicking action- sterile things are wet and contaminated 6. 2.5cm boarder of sterile field is unsterile 7. Fluid flows in direction of gravity

Question 31

DRSABCD

Answer 31

``` Danger Response Send for help Airway Breathing CPR Defibrillation ```

Question 32

Stages of pressure injuries

Answer 32

1- persist, non blanchable redness, itchy, firm, boggy, warmer or cooler to touch 2- partial thickness loss of dermis 3- full thickness skin loss; subcutaneous fat may be visible. Yellow slough 4- full thickness tissue loss; exposed bone, tendon or muscle. Hollow slough or black necrotic tissue