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nur 225 exam 2 > everything > Flashcards

everything Flashcards

1
Q

If protein is + in urine, what should you do?

A

test kidney function (24hr urine test)

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2
Q

What does increased levels of BUN indicate?

A

renal disease and dehydration

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3
Q

What does increased levels of Creatinine indicate?

A

pyelonephritis (kidney dysfunction with UTI)

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4
Q

What does decreased levels of Creatinine indicate?

A

decreased muscle mass (rare

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5
Q

What is the normal amount of residual urine?

A

50-100mL

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6
Q

Why do we do urine cultures?

A

to find out what bacteria is in the urine and what antibiotics will work

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7
Q

What are some causes of urinary retention?

A

anesthesia, surgery, obstruction (enlarged prostate), childbirth, medication (antihistamines), kidney stones, removal of catheter, STIs, constipation, sacral nerve damage

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8
Q

What is Crede’s method?

A

manually pressing on bladder to empty it

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9
Q

What are some causes of urinary incontinence?

A

decreased cognition, confusion, diabetes, depression, increased age, pregnancy, obesity, enlarged prostate

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10
Q

What do sedatives promote when dealing with urinary incontinence?

A

relaxation

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11
Q

What type of incontinence is often associated with a spinal cord injury, and causes incontinence at predictable intervals?

A

reflex

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12
Q

What type of incontinence causes the release of urine when coughing, sneezing, or laughing?

A

stress

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13
Q

What type of incontinence involves the ongoing unpredictable loss of urine?

A

continuous

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14
Q

What type of incontinence has a small time window to void?

A

urge

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15
Q

What should nursing care be like for acute incontinence?

A

change sheets/clothes, prevent skin breakdown

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16
Q

you can give estrogen to post-menopausal women to deal with incontinence

A

t

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17
Q

Body’s Defenses against a UTI

A

acidic pH of urine, one-way valves, bladder muscles, prostate gland secretions (M), vaginal pH (F)

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18
Q

What is the most common bacteria that causes UTI’s?

A

E-coil

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19
Q

What is “HARD TO VOID”?

A

Causes of UTIs

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20
Q

H in “HARD TO VOID”

A

Hormone changes (pregnancy, menopause, birth control)

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21
Q

A in “HARD TO VOID

A

Antibiotics

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22
Q

R in “HARD TO VOID”

A

Renal stones

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23
Q

D in “HARD TO VOID”

A

Diabetes (glucose in urine)

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24
Q

T in “HARD TO VOID”

A

Toiletries (baths, powders, perfumes)

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25
Q

O in “HARD TO VOID” (1st

A

Obstruction (enlarged prostate, kidney stones)

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26
Q

V in “HARD TO VOID”

A

VUR (backflow into kidneys)

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27
Q

O in “HARD TO VOID” (2nd)

A

Overextended bladder

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28
Q

I in “HARD TO VOID”

A

indwelling catheters, invasive procedures, intercourse

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29
Q

D in “HARD TO VOID” (2nd)

A

decreased immune system

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30
Q

What two things are elevated in a simple UTI?

A

leukocytes and nitrites

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31
Q

S/s of pyleonephritis are the same as UTI except for… (2)

A

fever, nausea

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32
Q

What is CVA tenderness? When is it seen (2)?

A

back pain (karate chop), pyleonephritis and renal calculi

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33
Q

What 4 things are increased with pyleonephritis?

A

leukocytes, nitrites, WBC, RBC

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34
Q

What is a warm sitz bath used in treatment for?

A

UTI

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35
Q

What are renal calculi?

A

kidney stones

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36
Q

What is the pneumonic CRYSTAL used for?

A

causes of kidney stones

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37
Q

Causes of renal calculi

A

increased protein, increased salt, recurrent infections, hypercalemia, structural blockage of urine, increased uric acid, family history of stones, low activity (immobile)

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38
Q

What is a stone lithotripsy?

A

use of ultrasound shock waves to break apart a kidney stone from the inside through warm water

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39
Q

use of ultrasound shock waves to break apart a kidney stone from the inside through warm water

A

2x, soap and water

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40
Q

OBjective data for urinary assessment

A

inspect skin (breakdown, edema), abdomen (distention), weight gain, palpate for contour/masses/tenderness, percuss bladder, ausculatate for bruit, urine testing, I&O, labs, bladder scan

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41
Q

What are ingestion risks?nutritional risks

A

nausea, vomiting, anorexia, dysphagia, NPO

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42
Q

What are digestion risks?

A

IBD, celiac, CF, lactose intolerance

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43
Q

What are metabolism risks?

A

liver diseases (increases metabolism), older adults (decreased metabolism)

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44
Q

T/F: Nutritional requirements change as you age

A

f

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45
Q

Reasons older adults are at risk for nutritional deficits…

A

decreased saliva, decreased taste, decreased thirst, decreased gag reflex, decreased peristalsis, chronic illness, medications, cognitive impairments, fixed income, decreased access to transportation

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46
Q

Name a screening tool for nutrition

A

BMI

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47
Q

BMI 25-29.9

A

overweight

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48
Q

BMI >30

A

obese

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49
Q

BMI < 18.5

A

underweight

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50
Q

underweight

A

18.5-24.9

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51
Q

Does albumin have a long or short half life?

A

long (21 days)

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52
Q

What lab shows chronic protein depletion?

A

albumin

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53
Q

What is an albumin level of < 2.8 indicative of?

A

edema

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54
Q

What lab indicates acute nutritional problems?

A

prealbumin

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55
Q

Does prealbumin have a long or short half life?

A

short (2 days)

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56
Q

decreased Hgb leads to.

A

decreased gas exchange

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57
Q

Name some iron rich foods

A

meat, fish, soy, eggs, dry fruit, broccoli, kale, spinach, nuts, seeds, PB

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58
Q

What is a high cholesterol level indicative of?

A

poor cardiovascular health

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59
Q

What should the total cholesterol level be below?

A

200 mg/dL

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60
Q

What should LDL be below?

A

100 mg/dL

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61
Q

What should triglyceride levels be below?

A

150 mg/dL

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62
Q

HDL levels for MEN should be above…

A

40 mg/dL

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63
Q

HDL levels for WOMEN should be above…

A

50 mg/dL

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64
Q

Diet history includes…

A

habits, frequency, types of food, amount of food, allergies, preferences, intolerances, symptoms, cultural factors, health factors, medications

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65
Q

Cachectic

A

sunken ribs

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66
Q

Bad nutrition shown in POSTURE

A

sunken chest, hump back

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67
Q

Bad nutrition shown in NEURO

A

irritable, weak, decreased relfexes, fatigue, confusion

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68
Q

Edema in lower extremities (regarding nutrition) is caused by a decreased intake of…

A

protein

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69
Q

Who is at risk for dysphagia?

A

stroke pts, older adults, trauma (HFN), radiation, choking, spasms

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70
Q

S/S of dysphagia

A

choking, coughing, weak voice, aspiration, increased saliva, difficulty chewing, food sticks in throat, food pocketing, facial weakness

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71
Q

intake is recorded for foods that become..

A

liquid at room temp

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72
Q

T/F: a mechanical soft diet has INCREASED fiber

A

F

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73
Q

SATA: What can be included in a mechanical soft diet?
a. mashed potatoes
b. raw fruits
c. milk
d. tender meat
e. nuts

A

a. mashed potatoes

c. milk
d. tender meat

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74
Q

What is considered the “starting diet”?

A

clear liquid diet

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75
Q

SATA: What can be included in a clear liquid diet?
a. coffee
b. clear broth
c. ice cream
d. popsicles
e. gelatin

A

a, b,d,e

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76
Q

SATA: which of the following CANNOT be included in a low sodium diet?
a. caffiene
b. smoked meats
c. juice
d. canned vegetables
e. soups

A

b, d, e

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77
Q

What is a fat restrictive diet used to treat?

A

GI disorders and obesity

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78
Q

how many days NPO is considered to be a nutritional risk?

A

4-7

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79
Q

How do you know when to advance a pt to the next diet?

A

when they are tolerant of their current diet (no nausea/vomiting/diarrhea)

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80
Q

Name some interventions of dysphagia

A

sitting upright, chin tuck, double swallowing, no talking, plenty of time

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81
Q

Order the following foods from BEST to WORST to consume for a pt struggling with dysphagia.
a. pudding
b. tomatoes
c. water
d. smoothies

A

a, d, b, c

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82
Q

Name some gas-producing foods

A

carbonated drinks, fiber, chewing gum

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83
Q

What is celiac?

A

autoimmune related intolerance to gluten

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84
Q

T/F: IBS is an inflammatory condition

A

T

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85
Q

how to diagnose IBS

A

stool analysis

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86
Q

mucous in a stool sample is indicative of…

A

intestinal wall inflammation (lower GI disorder)

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87
Q

blood in stool is indicative of..

A

colon cancer, hemorrhoids, intestinal wall irritation

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88
Q

frothy/bulky stool is indicative of..

A

malabsorption

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89
Q

ribbonlike stool is a telltale sign of these two things…

A

obstruction, colon cancer

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90
Q

What is Occult Blood?

A

“hidden” blood (inside stool)

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91
Q

occult blood in stool is indicative of…

A

hemorrhoids, IBS, infectious diarrhea, tumors, ulcers, anal fissure

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92
Q

epithelial cells in stool is indicative of…

A

inflammatory bowel disorders

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93
Q

Nocturnal BMs are associated with what disease?

A

IBS

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94
Q

What is tenismus?

A

constant feeling of needing to have a BM

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95
Q

SATA: Red flags for Colorectal Cancer
a. change in bowel habits
b. vomiting
c. blood in stool
d. tenismus
e. cramping
f. unexplained weight los

A

a, c, d, e, f

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96
Q

Risk factors for Colorectal Cancer…

A

> 50 y.o., family history (IBS), jewish, black, decreased fiber diet, obesity, smoking, alcohol use, Type 2 Diabetes

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97
Q

Treatments for Paralytic Ileus

A

NG tube, exercise, increase food and fluids

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98
Q

T/F: With C Diff, you will see blood and pus in stool

A

t

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99
Q

Toxic Megacolon

A

swelling and inflammation of colon (UC)

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100
Q

Treatments for C Diff

A

Flagyl, Vancomycin, probiotics, surgery, fecal transplant, colonoscopy

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101
Q

Causes for hemorrhoids

A

straining, constipation, on toilet for a long time, pregnancy, heart failure, liver disease

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102
Q

How are mild cases of hemorrhoids treated?

A

steroids

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103
Q

What is a stoma?

A

artificial opening in the abdominal wall

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104
Q

BRAT diet

A

bananas, rice, applesauce, toast

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105
Q

T/F: stimulant laxatives are safe for long-term use

A

f

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106
Q

What type of laxative is used short term for a whole bowel cleanse?

A

saline laxatives

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107
Q

SATA: large volume enemas
a. fleet
b. soapsuds
c. tap water
d. saline

A

c, d

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108
Q

which type of enema puts the pt at risk for electrolyte imbalance?

A

tap water

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109
Q

Which type of enema is an irritant that stimulates peristalsis?

A

soapsuds enema

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110
Q

Which type of enema is OTC?

A

fleet enema

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111
Q

What is Kayexelate used to treat?

A

hyperkalemia

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112
Q

What is Lactulose used for?

A

liver failure

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113
Q

Complications of enema

A

electrolyte imbalance, tissue trauma, vagal nerve stimulation, rigid abdomen, cramping, bleeding

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114
Q

When should you stop an enema?

A

rigid abdomen/bleeding

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115
Q

What should a healthy stoma look like?

A

pink, red, moist, some edema

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116
Q

Pallor in a stoma indicates…

A

decreased blood supply

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117
Q

An irritation of a stoma is caused by the leakage of..

A

An irritation of a stoma is caused by the leakage of..

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118
Q

Name the Sleep Stage:
right after you fall asleep, short, light sleep, easily awoken

A

N1 (Non-REM)

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119
Q

Name the Sleep Stage:
muscles relax (30-60 min)

A

N2 (Non-REM)

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120
Q

Name the Sleep Stage:
deep sleep, some body movements, extremely hard to wake

A

N3 (Non-REM)

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121
Q

Polysomnography

A

sleep study (diagnostic tests, pulse oximetry, electrocardiogram, tests for apnea/restless leg syndrome/bruxism)

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122
Q

When is a sleep study NOT done at home?

A

CHF or Central Sleep Apnea (CNS involvement)

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123
Q

How many hours is it recommended to exercise before sleep?

A

4-6 hours

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5
Perfectly
124
Q

SUBjective data for sleep

A

exercise patterns, alcohol, smoking, medications, daytime sleepiness, stressors, time went to sleep, how long it took, duration, frequency of awakenings, sleep partner reports

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125
Q

Absense of sleep

A

insomnia

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126
Q

complications of insomnia

A

daytime sleepiness, irritability, decreased LOC

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127
Q

those at increased risk for insomnia

A

geriatric pts, hospitalization

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128
Q

segmented sleep

A

keep getting woken up

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129
Q

failure to stay awake during the day

A

hypersomnia

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130
Q

Hypersomnia is common with…

A

depression, hypothyroidism, type 1 diabetes

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131
Q

parasomnia

A

anything that interferes with sleep (sleep walking/talking, bruxism, nocturnal enuresis, restless leg syndrome)

132
Q

Bruxism

A

teeth grinding

133
Q

Obstructive Sleep Apnea

A

apnea caused by large anatomical structures (neck, tongue, obese, smokers)

134
Q

Central Sleep Apnea

A

common in kids, severe. CNS disturbs sleep frequency per minute

135
Q

complications with sleep apnea

A

HTN and cardiac arrhythmias

136
Q

How can you test mobility for someone who is bed-bound?

A

move in bed, positioning, strength and ROM (shrug shoulders, dorsiflex, plantarflex, hand grasp)

137
Q

negative nitrogen balance can lead to…

A

muscle wasting, anorexia

138
Q

What effect does immobility have on the urinary system?

A

increased risk for kidney stones, incontinence, UTI, retention

139
Q

What effect does immobility have on the MSK system?

A

osteoporosis, fractures, joint stiffness, decreased weight bearing abilities, foot drop

140
Q

What effect does immobility have on the respiratory system?

A

thickening/pooling of secretions, decreased cough, shallow breathing, decreased VC, can cause atelectasis/pneumonia/infections

141
Q

What effect does immobility have on the circulatory system?

A

venous stasis, decreased BP, edema, clot formation, DVT, varicose veins (spider), PE (clot in lungs)

142
Q

What are normal cardiovascular changes associated with aging?

A

decreased CO/SV/venous return (can lead to HTN, syncope, MI, stroke, PVD, renal failure, vericose veins)

143
Q

What causes a decrease in height for geriatric patients?

A

decreased spaces between vetebral discs

144
Q

Normal changes to kidney and liver associated with aging

A

decreased blood supply, decreased functioning

145
Q

Screening tool for Melanoma

A

ABCDE

146
Q

What is the most common type of skin cancer?

A

melanoma

147
Q

What are two AE from polyuria?

A

dehydration, electrolyte imbalance

148
Q

What is the feeling of needing to urinate all the time?

A

frequency

149
Q

What is the intense and sudden need to go urinate?

A

urgency

150
Q

If urine is cloudy, you can expect these things to show up in the lab. SATA
a. RBC
b. Protein
c. WBC
d. Bacteria
e. Mucus
f. Pus

A

a, c, d, f

151
Q

Does lemon juice, cranberry juice, and increased protein raise or lower the pH of urine?

A

lowers

152
Q

What color do anticoagulants make urine?

A

red

153
Q

If ketones are + in urine, what does this indicate?

A

type 1 diabetes (kids), strenuous exercise

154
Q

If there are + RBCs in urine, what does this indicate?

A

kidney stones, muscle breakdown, menstrual cycle

155
Q

What does BUN measure?

A

urea

156
Q

What is a normal BUN?

A

10-20 mg/dL

157
Q

What does decreased levels of BUN indicate?

A

overhydration

158
Q

What does Creatinine measure?

A

kidney function (polynephritis)

159
Q

What do diuretics increase?

A

urine production

160
Q

What type of incontinence is associated with not getting to the toilet in time due to decreated mobility?

A

functional

161
Q

What is polynephritis?

A

kidney infection (UTI)

162
Q

T/F: you can do a urine culture when a patient is on antibiotics

A

f

163
Q

How should you wipe a patient’s perineal area?

A

front to back

164
Q

T/F: renal calculi can ONLY form in the kidneys

A

f

165
Q

A renal calculi can be passed independently if it is less than ___mm

A

5

166
Q

How are most kidney stones passed?

A

hydration and pain management

167
Q

T/F: a Foley/Retention catheter is used short term

A

t

168
Q

T/F: A Straight/In and Out Catheter can be used multiple times

A

F (one-time use)

169
Q

T/F: A suprapubic catheter is used long-term

A

t

170
Q

Should the urine collection bag be below or above the bladder?

A

below

171
Q

Dysphagia

A

difficulty swallowing

172
Q

Who should you consult with for pts with dysphagia?

A

speech and language

173
Q

Type 1 Bristol

A

constipation

174
Q

Type 2-4

A

normal

175
Q

Type 5-7

A

diarrhea

176
Q

does stress increase or decrease peristalsis?

A

increase

177
Q

a chronic use of laxatives can lead to…

A

less responsive intestine

178
Q

overuse of laxatives can lead to

A

dehydration, electrolyte imbalances

179
Q

T/F: Antibiotics cause diarrhea

A

t

180
Q

What do NSAIDS increase the risk for (GI)?

A

GI bleeding

181
Q

What is a good SUBjective question to ask when you are concerned about paralytic ileus for a patient who recently underwent anesthesia?

A

“have you passed gas yet?”

182
Q

leukocytes in stool is indicative of…

A

traveler’s diarrhea (bacterial infection)

183
Q

unintentional weight loss is a red flag for…

A

cancer

184
Q

High pitched tinking upon auscultation of the abdomen is indicative of…

A

obstruction

185
Q

T/F: Constipation is a diagnosis

A

f

186
Q

constipation is defined as having LESS THAN ____ BMs per week

A

3

187
Q

what can cause a vagal response?

A

straining when defacating

188
Q

treatments for constipation…

A

increase fluid, increase fiber, exercise, laxatives, enemas

189
Q

Encopresis

A

holding onto feces too long (bathroom in school); causes impaction

190
Q

S/S of impaction

A

oozing, diarrhea, anorexia, nausea, vomiting, distention, cramping

191
Q

how do you assess impaction?

A

digital rectal exam

192
Q

2 treatments for impaction:

A

enema, digital removal (orders)

193
Q

SATA: Mechanical Obstuction
a. paralytic ileus
b. tumors
c. diverticular disease
d. decreased motility

A

b, c

194
Q

SATA: Non-Mechanical Obstuction
a. paralytic ileus
b. tumors
c. diverticular disease
d. decreased motility

A

a,d

195
Q

What type of precautions for C Diff?

A

contact

196
Q

What disease is an overgrowth of bacteria that attacks the lining of the intestines?

A

C Diff

197
Q

What are dilated engorged veins in the rectal lining?

A

hemorrhoids

198
Q

Match the stool description with the location of the colostomy.
1. ascending
2. transverse
3. descending
a. 1/2 formed stool
b. normal stool
c. semi-formed stool

A

1c, 2a, 3b

199
Q

Which laxative can be used long term?

A

bulk forming

200
Q

What is used as a lubricant for stool?

A

mineral oil

201
Q

Emollients

A

stool softener lubricant

202
Q

T/F: you CAN give anti-diarrheal medications with C Diff

A

f

203
Q

Which position is best to give an enema?

A

sim’s left side lying

204
Q

T/F: when performing an enema, open the clamp fast for the best effects

A

f

205
Q

a black stoma indicates..

A

necrosis

206
Q

What is considered the “body clock”

A

circadian rhythm

207
Q

Which stage of sleep does dreaming occur?

A

REM

208
Q

What is considered your “restorative sleep”?

A

REM

209
Q

Nocturnal Enuresis

A

bed wetting

210
Q

What effect does immobility have on the GI system?

A

constipation, impaction (decreased exercise, decreased peristalsis)

211
Q

What effect does immobility have on the integumentary system?

A

skin breakdown, pressure ulcers, friction/shearing (moist)

212
Q

What three things can you use to help move a patient?

A

trapeze bar, gait belt, lifts

213
Q

Nursing Care for Respiratory system with Immobility

A

turn, cough. deep breathing. postural drainage, Incentive Spirometer, increase hydration, chest x-ray

214
Q

What bony prominences should you check when assessing an immobile patient?

A

coccyx, heels, elbows

215
Q

How often should you re-position an immobile patient?

A

every 2 hours

216
Q

SCDs

A

pump air to prevent clots in lower extremities (immobile)

217
Q

Which two medications are given to prevent DVT?

A

Lovenox and Heparin

218
Q

Geriatric patients are above the age of…

A

65

219
Q

Patients that are above this age are more likely to die in the hospital

A

85

220
Q

Presbyopia

A

age-related farsightedness (decreased accomodation)

221
Q

Presbycusis

A

age related hearing loss

222
Q

Around what age does the size and number of neurons decrease?

A

mid 20s

223
Q

Which population has the decreased ability to respond to multiple stimuli at once?

A

geriatric

224
Q

syncope

A

passing out

225
Q

T/F: geriatric patients have moist mucous membranes

A

f

226
Q

Why do we give lower doses to the geriatric population?

A

decreased metabolism

227
Q

T/F: turgor increases with age

A

f

228
Q

What is the process of emptying the bladder?

A

micturition

229
Q

How many mL does the average adult urinate per day?

A

250-450

230
Q

What is excessive urine production

A

polyuria

231
Q

Which of the following can cause polyuria? SATA
a. renal disease
b. diuretics
c. diabetes
d. decreased fluid intake
e. sickle cell anemia

A

a, b, c, e

232
Q

What is diminished urine production called?

A

oliguria

233
Q

What is no urine production?

A

anuria

234
Q

What is urination at night?

A

nocturia

235
Q

What is dysuria?

A

painful urination

236
Q

What is difficulty starting urination

A

hesitancy

237
Q

What is the medical term for bed-wetting?

A

enuresis

238
Q

T/F: to promote urination, have the patient lay down comfortably

A

f

239
Q

How many reps/hour should Kegel exercises be done?

A

10

240
Q

SUBjective data for urinary assessment

A

past health history, medications, surgery, diet, urinary patterns, exercise, sleep, cognitive abilities

241
Q

Upon urinary assessment, you percuss the bladder and there is a DULL sound. Does this tell you there is increased/decreased fluid in the bladder?

A

increased (full)

242
Q

What is hematuria?

A

blood in urine

243
Q

Describe the normal clarity characteristics of urine

A

clear/translucent

244
Q

If urine has a strong ammonia smell, what does this indicate?

A

infection

245
Q

What measures the kidney’s ability to concentrate urine/measures renal function?

A

specific gravity

246
Q

Is the normal pH of urine more acidic, basic, or neutral?

A

acidic (4.6-8.0)

247
Q

What color does pyridium make urine?

A

orange/reddish

247
Q

What color do diuretics make urine?

A

pale yellow

248
Q

Does dairy, veggies, and beans raise or lower the pH of urine?

A

raise

249
Q

What color does B-Complex Vitamins make urine?

A

green/bluish

249
Q

What color does iron make urine?

A

brown/black

250
Q

Is urine dark/clear with dehydration?

A

dark

251
Q

If urine pH is >8, what does this indicate?

A

infection

252
Q

If urine pH is <4.6, what does this put the pt at risk for?

A

kidney stones

253
Q

What is a normal specific gravity

A

1.010-1.025

254
Q

If specific gravity is > 1.025, does this indicate dehydration or overhydration?

A

dehydration][\

255
Q

If specific gravity is < 1.010, does this indicate dehydration or overhydration?

A

overhydration

256
Q

What is the normal result for Leukocytes in urine?

A

negative

257
Q

What is the normal result for ketones in urine?

A

negative

258
Q

If leukocytes are + in urine, what does this indicate?

A

inflammation

259
Q

What is the normal result for bilirubin in urine?

A

negative

260
Q

What should you do if bilirubin is + in urine?

A

test liver and gallbladder function

261
Q

What is the normal result for glucose in urine?

A

negative

262
Q

If glucose is + in urine, what does this indicate

A

type 2 diabetes

263
Q

What is the normal result for nitrites in urine?

A

negative

264
Q

If there are + nitrites in urine, what does this indicate?

A

infection of kidneys

265
Q

T/F: When doing a 24-hour urine test, collect the first voided sample

A

f

266
Q

T/F: If your pt misses a urination when doing a 24-hour urine test, you can just guess the past void and move on with the collection.

A

f

267
Q

What is the deadliest skin cancer for geriatric patients?

A

basal cell carcinoma

268
Q

T/F: libido decreases with increasing age

A

f

269
Q

What should we teach the geriatric population concerning sexual health?

A

STD/STI prevention, ED

270
Q

T/F: Cognitive impairment is normal with aging

A

f

271
Q

T/F: Delirium is reversible

A

t

272
Q

Causes of Delirium

A

infection, anesthesia, stress, environment, dehydration, sleep deprivation

273
Q

T/F: For a delirious patient, increase the amount of choices they have about their care

A

f

274
Q

What can you use instead of restraints on an older adult who is showing S/S of delirium?

A

distracting activities (stacking towels)

275
Q

Dementia has a (quick/gradual) onset, and is (reversible/irreversible)

A

gradual, irreversible

276
Q

Nursing Care for a patient with Dementia

A

frequently orient, positive attitude, explain things simply, decrease paranoia, do not lie to pt, observe closely (close to nursing station)

277
Q

What is the most common, yet most untreated disease in the geriatric population

A

depression

278
Q

What are early indicators for acute illness in the elderly?

A

mental status change, falls, dehydration, anorexia

279
Q

What is an early indicator of a UTI/Pneumonia/MI in the geriatric population?

A

confusion

280
Q

What are geriatric LGBTQ+ patients at risk for?

A

isolation, depression, alcohol abuse, smoking

281
Q

T/F: you are obligated to report any signs of elder abuse

A

t

282
Q

Education strategies for the older adult

A

decrease distractions, involve pt directly, speak clear/slow, one idea at a time, relate to past experiences

283
Q

Dysfunctional Complicated Grief

A

prolonged

284
Q

Anticipatory grief

A

grief prior to loss (terminal illness/amputation

285
Q

Disenfranchised grief

A

don’t share grief because the cause of death is deemed socially unacceptable

286
Q

Public Tragedy

A

9/11, COVID, flood, fire

287
Q

Actual loss

A

occurs from an actual event

288
Q

Perceived loss

A

event perceived by client, not based in reality

289
Q

Situational loss

A

loss of a loved one

290
Q

Maturational loss

A

“developmental”; loss of youth

291
Q

Necessary loss

A

expected at the end of life

292
Q

Order the Kubler-Ross Grief Cycle
a. bargaining
b. acceptance
c. depression
d. anger
e. denial

A

e, d, a, c, b

293
Q

S/S of grief

A

decreased immune response, anger, sleep disturbances, blame, withdrawal pain, panic, decreased neuroendocrine function

294
Q

Nursing Care for a grieving person

A

establish trust, employ coping strategies, refer to support groups

295
Q

1st Phase of the Dying Process includes…

A

respiratory congestion, change in respiratory pattern (Cheyne-Stokes), decreased orientation, pallor, increased sleep, anorexia, incontinence, restlessnesss, social withdrawal, hallucinations, saying “goodbye”

296
Q

Palliative Care or Hospice Care?
Relieving symptoms with active treatment

A

Palliative Care or Hospice Care?
Relieving symptoms with active treatment

297
Q

Palliative Care or Hospice Care?
provide comfort, non-curing

A

Hospice Care

298
Q

Someone can turn to hospice care if they have less than ___ months to live

A

6

299
Q

What is Haldol used for?

A

severe delirium

300
Q

What are anticholinergics used for?

A

dry secretions

301
Q

Last Will and Testament

A

states what you want to happen to your assets after you die

302
Q

Power of Attorney

A

states a person to act on your behalf and handle your finances

303
Q

Medical Power of Attorney

A

states a person to make medical decisions on your behalf

304
Q

Living Will

A

describes your wishes for medical treatment (life suport, ventilator, feeding tube, DNR, organ donation)

305
Q

When does the process of discharge begin?
a. when the patient feels better
b. after surgery
c. upon admission
d. after their first round of meds

A

c

306
Q

T/F: home health is continuous care

A

f

307
Q

What do Case Managers do?

A

help with discharge, coordinate patient care and follow-up appointments

308
Q

If a person has chosen not to follow the prescribed treatment, what is this called

A

Nonadherance

309
Q

Discharge process:

A

educate, communicate, document

310
Q

What teaching method should you use if a patient has a low health literacy and you want to make sure they understoon their discharge instructions?

A

teach-back

311
Q

What is discharge disposition?

A

the patient’s anticipated status after discharge/transfer (stable, unstable, or dead)

312
Q

What department normally assesses the patient’s home environment concerning discharge?

A

Physical Therapy

313
Q

What is the most important implementation for discharging a patient?

A

teaching

314
Q

If a patient is readmitted to the hospital after being discharged, would you consider the discharge to be a success or failure?

A

failure

315
Q

Payor Sources

A

Insurance

316
Q

What is Blue Cross Blue Shield

A

Private Insurance

317
Q

T/F: with private insurance, you get less choices for care

A

f

318
Q

With what type of insurance is a co-pay or a precertification needed?

A

private insurance

319
Q

What is mediCAID dependent on?

A

income

320
Q

Who does mediCAID serve

A

low income people (based on monthly income

321
Q

low income people (based on monthly income

A

mediCARE

322
Q

What does the home and community based waiver program do (HCB

A

keeps people in their homes (homelessness prevention)

323
Q

keeps people in their homes (homelessness prevention)

A

a, b, c, e

324
Q

T/F insurance covers bathroom equipment

A

F

325
Q

T/F: insurance CANNOT pay for BOTH a wheelchair and a walker

A

nur 225 exam 2 (3 decks)

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