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Exam 1 Flashcards

1
Q

The fours major areas of nursing practice

A

Promoting Health and wellness

Preventing Illness

Restoring Health

Caring for the Dying

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2
Q

Components of evidence-based practice

A

Clinical Expertise

Best Evidence

Patient Values and Preferences

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3
Q

Nurse Practice Act

A

Protects the public by legally defining the scope of nursing practice

Each state has a nurse practice act

Control practice through licensing requirements

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4
Q

Professional Standards of Nursing Practice

A

ANA standards of practice (17 standards)

Patient Bill of Rights (Hospitals & Nursing Homes)

Facility and certification/accreditation

Institutional policies/procedures

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5
Q

Informed consent

A

An agreement by a client to accept a course of treatment or procedure after being provided complete information.

-Expressed- (Oral/written)

-Implied- (Non-verbal behavior/medical emergency when an individual cannot provide expressed consent)

Exceptions:

-Minors

-Unconscious

-Mentally ill deemed incompetent

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6
Q

The nurse’s role in obtaining informed consent

A

-Responsible for witnessing the client’s signature

-Not responsible for explaining procedure

Signature confirms:

-The client gave consent voluntarily

-The signature is authentic

-The client appears competent to give consent

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7
Q

5 Rights of Delegation

A

Right task

Right circumstance (stable vs unstable)

Right Person (Knowledge, skills, ablities)

Right direction & communication

Right supervision & evaluation

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8
Q

Delegation

A

the process for a nurse to direct another person to perform nursing tasks and activities

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9
Q

MANDATED REPORTERS

A

Required by law to report suspected abuse, neglect, or exploitation.

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10
Q

Negligence

A

misconduct or practice that is below the standard expected of an ordinary, reasonable, and prudent person

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11
Q

Malpractice

A

professional negligence (negligence that occurred while the person was performing as a professional)

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12
Q

Assault

A

stated intent to touch a person in an offensive, insulting, or physically intimidating manner; to threaten someone

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13
Q

Battery

A

the touching of another person without the person’s consent

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14
Q

False Imprisonment

A

Occurs when clients are made to believe they cannot leave a place.

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15
Q

HIPPA

A

the client’s permission is needed before disclosing any information regarding the client, going through the clients’ personal belongings, performing procedures, and photographing the client.

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16
Q

Code of Ethics

A

a formal statement of a group’s ideas and values.

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17
Q

Autonomy

A

right to make one’s own decision

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18
Q

Nonmaleficence

A

do no harm

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19
Q

Beneficence

A

doing good

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20
Q

Justice

A

fairness

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21
Q

Fidelity

A

to be faithful to agreements/promises

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22
Q

Veracity

A

truth-telling

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23
Q

Describe how a nurse acts in the role of the client advocate.

A

Client advocate acts to protect the client.

Represent the client’s needs to other health professionals

Assist clients to speak up for themselves

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24
Q

The Patient Care Partnership

A

High quality hospital care

A clean and safe environment

Involvement in your care

Protection of your privacy

Help when leaving the hospital

Help with your billing claims

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25
interprofessional members
Social worker Dietician Activity Director Occupational Therapist Respiratory Therapist Physical Therapist Chaplain/Pastor Physican Nurse Practioner Physician Assistant Podiatrist Dentist Pharmacist
26
The Nursing Process
ADPIE: Assessment-begins nursing process Nursing Diagnosis-formulates statement of problem Planning-set goals Interventions-carrying out the plan of care Evaluation-reassessing to determine if goal is met
27
Differentiate between a medical and a nursing diagnosis.
Nursing Diagnosis is a statement of nursing judgement and refers to a condition that nurses are licensed to treat
28
LPN
-simple situations predictable, no frequent changes
29
RN
-complex situations not predictable, frequent changes
30
Plan individualized care for client based on need
Set priorities Establish client goals/desired outcomes Make desired outcomes measurable
31
Plan overall strategies to address client problems.
Subject-client Verb-what they are going to do Condition or modifiers Criterion of desired performance Ex: client drinks 2,500 ml of fluid daily.
32
Independent Interventions
Physical care Ongoing assessment Teaching & counseling Emotional Support & Comfort Enviromental management Referrals
33
Dependent Interventions
Orders for medications Intravenous therapy Diagnostic tests & Treatment Diet & activity orders
34
Chain of infection
Infectious agent Reservoir or source Portal of exit Mode of transmission Portal of entry Susceptible Host
35
Increase in Neutrophils
Bacteria
36
Increase in Lymphocytes
Viral
37
How can we ID a infection
Elevated WBC Increase in Neutrophils-bacteria Lymphocytes-viral Elevated erythrocyte sedimentation rate Positive cultures
38
Medical Asepsis (clean technique)
Reduce the number and spread of microorganisms
39
Surgical Asepsis (sterile technique)
Eliminate all microorganisms and spores
40
Modes of Transmission
Contact -Direct- skin to skin -Indirect- contact with contaminated objects Droplet -Sneezing -Coughing -Talking Airborne -Inhaled Vehicle (Contaminated inanimate objects) -Water -Food
41
Antiseptics
inhibit the growth of some microorganisms
42
Disinfectants
destroy pathogens other than spores
43
Sterilization
destroy all microorganisms and spores
44
Skin
Largest organ in the body Genetics, age, health, & medications impact the skin
45
Wounds
Trauma/surgery Pressure Ulcer
46
Wound Cleanliness
Clean wounds – Closed (bruises, surgical wounds) Clean contaminated wounds- GI Tract open up Contaminated Wounds- Intestinal spill Dirty & Infected wound- grass, rocks, bacteria
47
Wound Type
Incision- Straight cut Contusion- bruise Abrasion- scrap Laceration- jagged edge Avulsion- skin tears Puncture- sharp object punctures Penetrating wound- gun shot/stabbing wound
48
Thickness of Wound
Partial thickness- (dermis & epidermis) Full thickness (dermis, epidermis, SQ, Muscle, bone)
49
Burns
1st-4th degree burns, and pressure ulcers have stages 1-4 4 being the worst
50
Pressure Ulcers
Any lesion caused by unrelieved pressure results in damage to underlying tissue.
51
Localized ischemia (lack of blood supply)
Tissue Dies
52
Reactive Hyperemia
After skin is compressed, it appears pale; when pressure is relieved a bright red flush Lasts ½ to ¾ as long as pressure If redness stays, tissue damage has occurred
53
Risk factors which contribute to impaired skin integrity.
Friction & Shearing Immobility Inadequate nutrition Decreased protein, carbs, fluids, Vitamin c & Zinc contribute to pressure ulcers. Fecal & Urinary Incontinence Maceration- tissue softening Excoriation- loss of superficial layer of skin Decreased Mental state- (aren't able to tell us) Diminished sensation- (diabetics) Excessive body heat-(Moist/Sweating) Advanced Age Chronic medical conditions
54
System for staging pressure ulcers.
RAFM Stage 1- Redness Stage 2- Abrasion Stage 3- Into Fat Layer Stage 4- Into Muscle and Bone Suspected Deep Tissue Injury- (Purple or maroon discolored intact skin) Unstageable- Full thickness tissue loss in which the base of the ulcer is covered by slough/Escar
55
Phases of wound healing
Inflammatory (Defensive) 3-5 days -Hemostasis & phagocytosis Proliferative (Reconstructive) 4-21 days (about 3 weeks) -Collagen, new blood vessels & tissue, wound closure Maturation (Up to 2 years) Scar tissue gains strength
56
Types of wound drainage
Serous Exudate -Clear Purulent Exudate - (Blue, green, yellow) Hemorrhagic (Sanguineous) Exudate -Bloody Serosanguineous Exudate -Pink
57
Complications of wound healing
Hemorrhage (Bruise you can feel) -Hematoma Infection Dehiscence (wound opens up) Evisceration (wound opens up & organs come out)
58
Factors affecting wound healing
Developmental considerations Nutrition Lifestyle Medications
59
Factors that are components of the Braden Scale for Predicting Pressure Sore Risk
Sensory Perception Moisture Activity Mobility Nutrition Friction & Shear
60
Effects of Heat
Vasodilation Increases blood flow Promotes soft tissue healing Increases edema & bleeding *(Should not be used in the 1st 24hrs after injury)
61
Effects of Cold
Vasoconstriction Limits postinjury swelling and bleeding Reduces blood flow *(Should not be used on open wounds or impair ed circulation)
62
Urethra -Female
3-5 cm
63
Urethra -Male
20 cm
64
Bladder capacity
300-600mL
65
Desire to void occurs
250-450mL of urine in bladder
66
Usually void _____times per day
5
67
Sitting (female) Standing (male)
Promotes optimal emptying of bladder
68
Fluid intake
1500-2500 mL per day
69
Post void residual
Less than 100 cc
70
Diuretics
Increase urine production
71
COCA
Color, Odor, Consistency, Amount
72
Nocturnal Enuresis
Involuntary voiding during sleep (bed wetting)
73
Constipation
less than 3 BM per week
74
Fecal Impaction
Hard Feces in rectum
75
Diarrhea
loose stool
76
Bowel incontinence
can't hold BM
77
Flatulence
gas
78
Ostomies
Openings on the skin
79
Describe pharmacological and non-pharmacological interventions to treat altered patterns of bowel elimination.
Pharmacological -Bulk forming -Emollient/ softener -Stimulant/irritant -Lubricant -Saline/osmotic Non-Pharmacological -Fiber -Fluids -Exercise
80
Urgency
a feeling of the need to void
81
Dysuria
Painful Urination
82
Frequency
Urinating more times then normal
83
Hesitancy
starting then stopping flow of urine
84
Ployuria
abnormally large quantities of urine
85
Oliguria
a dininshed amount of urine
86
Nocturia
Excessive urination at night
87
Dribbling
to flow in drops or in a thin intermittent stream
88
hematuria
abnormal presence of blood in urine
89
Pyuria
the presence of WBC in the urine
90
Enuresis
incontinence of urine at night
91
Bacteriuria
bacteria in the urine
92
Proteininuria
Protein in the urine
93
Bacteremia
the presence of bacteria in the blood
94
Residual
Urine left in the bladder after urination

Nursing Fundamentals (12 decks)

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