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Nursing Acute Care > Exam # 1 > Flashcards

Exam # 1 Flashcards

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1
Q

what are the two kinds of restraints?

A

physical and chemical restraints

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2
Q

what are some examples of physical restraints?

A

wrist, ankle, vest, having 4 side rails up, vest,

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3
Q

what are the two kinds of quick-release options used on wrist and ankle restraints?

A

quick-release buckle or quick-release knot

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4
Q

what kind of knot is used in a quick release knot?

A

slip knot

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5
Q

what are chemical restraints?

A

medications

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6
Q

what part of the bed do you attach restraints to?

A

unmovable part of the bed

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7
Q

how often should you assess the patient in restraints?

A

30-60 minutes

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8
Q

what are you assessing for a patient in restraints every 30 - 60 minutes?

A

behavior changes

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9
Q

how often should the patient be released from restraints?

A

every two hours

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10
Q

can you take a patient off restraints if the family is present in the room?

A

no

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11
Q

if the patient is sedated can you leave the restraints undone while you get something outside of the room?

A

no

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12
Q

how long is an order for restraints good for?

A

24 hours

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13
Q

can you put the patient in restraints without an order?

A

no

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14
Q

what does reason mean on a informed consent?

A

why the procedure is occuring and what the procedure is

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15
Q

what does “who will be present” on the informed consent mean?

A

it lets the patient know who all will be in the room….medical students, anesthesia, PA, MD/DO, residents, reps, nurses etc

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16
Q

what does “alternatives” on the informed consent mean?

A

the patient must be informed of all of the alternative treatments other than surgery

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17
Q

what does “procedure risks” mean on the informed consent?

A

the risks involed in the procedure such as death, infections, respiratory distress, damage to other organs, errors

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18
Q

what does “anesthesia risks” mean on the informed consent?

A

risk that may follow anesthesia….sore throat, respiratory distress, death, waking up during surgery

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19
Q

what does blood products consent mean?

A

seperate from the informed consent but asks for permission to give blood during surgery if needed

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20
Q

what is the role of the nurse in a informed content?

A

to make sure tha the client is AAO x 4 and that their judgment is not impaired when signing the consent

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21
Q
A
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22
Q

what is the role of the surgeon in a informed consent?

A

to explain the procedure and all of the risks involved

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22
Q

what is the anesthesiologist role in the consent?

A

making sure they know all of the risk involved in the administration of anesthesia…keep the patient asleep during the surgery

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22
Q

can illiterate clients sign an informed consent?

A

yes

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22
Q

how can you help a blind patient with understanding what is on the consent?

A

read it to them and xxxxxxx`

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22
Q

how can you help an illiterate client sign an informed consent?

A

read what is said on the paper

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23
Q

can blind patients sign the consent?

A

yes

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24
Q

who is a court-appointed person in regards to a informed consent?

A

XXXXX for parents found to be un fit to make decisions for their child???????

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25
Q

what happens during a life-threatening situation where a person/family member can not be identified?

A

a doctor must consult with another physician to make the decision on the patients behalf

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25
Q

can you use a family member instead of a translator when signing a legal document?

A

no

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25
Q

what is perfusion?

A

the flow of blood carrying nutrients to the body

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26
Q

what are the factors that affect perfusion quality?

A

heart and pulmonary function

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27
Q

what is the leading cause of death in the USA?

A

coronary artery disease

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28
Q

what is coronary artery disease?

A

the build-up of plaque in the arteries supplying blood to the heart

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29
Q

where are coronary arteries found?

A

on the heart

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30
Q

what happens if the coronary arteries are blocked?

A

the reduction in blood can lead to chest pain or heart attack

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31
Q

what is atherosclerosis?

A

build of plaque in vessels

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32
Q

where does atherosclerosis take place in coronary artery disease?

A

the heart arteries

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33
Q

what are risk factors for coronary artery disease?

A

genetics, age, sex, ethnicity, lipid levels, diabetes, obesity, sedentary life style, smoking, hypertension

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34
Q

what is ischemia?

A

lack of blood flow and oxygen to a certain tissue

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35
Q

what is myocardial ischemia?

A

lack of blood flow and oxygen to the heart

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36
Q

what is angina?

A

chest pain

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37
Q

what causes angina?

A

insufficient coronary blood flow

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38
Q

what are some symptoms of CAD?

A

angina, epigastric distress, gas, pain that radiates in the jar or arm, SOB, MI, HF, or sudden cardiac death

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39
Q

how can you prevent CAD?

A

having regular medical exams, low-fat foods, low cholesterol, exercise, losing weight, quitting smoking

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40
Q

what medications help with the treatment of CAD?

A

atorvastatin…simvastatin…lovastatin…

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41
Q

what cholesterol is considered bad?

A

LDL

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42
Q

what value is wanted for LDL?

A

less than 100 and 70 in high risk patients

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43
Q

what value is wanted for total cholesterol?

A

less than 200

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44
Q

what value is wanted for HDL

A

greater than 40 in males and greater than 50 in females

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45
Q

what value is wanted for triglycerides?

A

less than 150

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46
Q

what is considered good cholesterol?

A

HDL

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47
Q

what are triglycerides?

A

common type of fat used by the body to provide energy for cells

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48
Q

what happens if blood flow is restricted for too long in the heart?

A

can cause irreversible damage to the myocardium

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49
Q

what causes angina?

A

physical activity, stress, or random times depending on the angina the patient has

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50
Q

what is stable angina?

A

caused by exertion…relieved by rest… lasts less than 15 minutes…predictable

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51
Q

what is unstable angina?

A

pain at rest or exertion…causes activity limitations…can progress to MI…unpredictable

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52
Q

what are some symptoms of angina?

A

tightness…choking…heavy sensation in chest…pain in neck…jaw….shoulders…back…left arm…dyspnea…nausea.. vomiting…weakness…numbness

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53
Q

what are the interventions for angina?

A

nitro, morphine, oxygen, baby aspirin

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54
Q

what is myocardial infarction?

A

plaque ruptures and a thrombus forms resulting in the occlusion of an artery….the occlusion leads. ischemia and necrosis of myocardium

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55
Q

what are the symptoms of a MI?

A

constant chest pain….pain radiation…SOB…diaphoresis…COOL,PALE, MOIST SKIN…indigestion…anxiety

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56
Q

what is another term for MI?

A

heart attack

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57
Q

what labs will physicians look at when diagnosing MI?

A

troponin, cardiac enzymes, creatine kinase, myoglobin

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58
Q

what is the normal value for troponin?

A

less than 0.4

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59
Q

what vital sign changes will you see in a patient with MI?

A

increased BP, HR, RR

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60
Q

what diagnostic tests will physicians use to diagnose MI?

A

ECG/EKG and Stress tests

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61
Q

what will an ECG/EKG show for a patient having an MI?

A

ST elevation

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62
Q

what is the goal of MI intervention?

A

to restore adequate blood flow to the heart…. manage symptoms until surgery

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63
Q

what is a stroke?

A

interruption of perfusion to the brain

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64
Q

what makes symptoms vary in a stroke?

A

the location of the ischemic or hemorrhage

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65
Q

what are the two types of CVA/STROKE?

A

ischemic and hemorrhage

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66
Q

what is an ischemic stroke?

A

a stroke where a clot block off blood supply to the area

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67
Q

what is a hemorrhagic stroke?

A

a stroke where a blood vessel ruptures and blood rushes out of the vessel and into the brain

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68
Q

what are non modifiable risk factors for TIA or CVA?

A

heredity, ethnicity, age

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69
Q

what does TIA stand for?

A

transient ischaemic attack

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70
Q

what does CVA stand for?

A

cerbral vascular accident

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71
Q

what are modifiable risk factors for TIA or CVA?

A

hypertension….elevated lipid levels…diabetes…obesity…smoking…sedintary lifestyle…a fib….substance abuse…alcohol use

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72
Q

what are general signs that someone is having a stroke?

A

sensory changes…mobility changes…vision changes..speech changes…behavior

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73
Q

what does the B in the acronym be fast mean?

A

B. Balance…..loss of balance, headache, dizziness

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74
Q

what does the E in the acronym be fast mean?

A

E. Eyes..blurred vision

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75
Q

what does the F in the acronym be fast mean?

A

F. Face…one side of the face is drooping

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76
Q

what does the A in the acronym be fast mean?

A

A. Arms….arm or leg weakness

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77
Q

what does the S in the acronym be fast mean?

A

S. Speech….difficulty

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78
Q

what does the T in the acronym be fast mean?

A

T. Time to call for an ambulance

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79
Q

why are TIA not as severe as CVA?

A

because TIAs are temporary

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80
Q

how long do TIAs last?

A

between 30 to 60 minutes

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81
Q

Do TIA and CVA has the same symptoms?

A

yes

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82
Q

what happens to the brain if you have repeated episodes of TIA?

A

permanent damage

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83
Q

what is a CVA?

A

sudden loss of brain function from disruption of blood flow

84
Q

what are some characteristics of right hemispheric stroke?

A

happy…paralysis of the left side of body…left visual deficit…spacial perceptual deficits…increased distractibility…impulsive behavior…poor judgment

85
Q

what are some characteristics of left hemispheric stroke?

A

paralysis of the right side of body….right visual deficit…aphasia…altered intellectual ability..slow..cautious

86
Q

what is expressive aphasia?

A

xx

87
Q

what is receptive aphasia?

A

xxx

88
Q

what is global aphasia?

A

xx

89
Q

what side of stroke can have ADHD-like tendencies?

A

right sided

90
Q

what type of stroke is caused by thrombosis or embolic?

A

ischemic

91
Q

what type of stroke can have a cryptogenic cause?

A

ischemic

92
Q

what does cryptogenic mean?

A

an unknown cause

93
Q

what are some symptoms of a ischemic stroke?

A

numbness or weakness of the face, arm, leg…especially on one side of the body, aphasia, vision loss

94
Q

what are some sypmtoms of a hemorrhagic stroke?

A

extreme headache, decreased LOC, seizure

95
Q

what stroke is easier to recover from?

A

ischemic

96
Q

when is the majority of recovery gained after an ischemic stroke?

A

3-6 months and smaller steps after one year

97
Q

what stroke is harder/slower to recover from?

A

hemorrhagic

98
Q

what stroke typically leaves the patient with more disability?

A

hemorrhagic

99
Q

why are CTs and MRIs performed on stroke patients?

A

to see the size and location of the clot

100
Q

is contrast used on CTs for stroke patients?`

A

no

101
Q

what is the goal when treating an ischemic stroke?

A

restore perfusion in the brain

102
Q

what is the goal when treating a hemorrhagic stroke?

A

stop the bleed

103
Q

what type of assessment should you do on all stroke patients?

A

neuro

104
Q

what are you looking for in terms of BP for in ischemic stroke patients?

A

prevent drop in BP because this could further the ischemia

prevent sudden rises in BP to prevent hemorrhage and increased ICP

105
Q

what happens to the pressure in the brain if BP increases too much?

A

the intracranial pressure increases

106
Q

what are you looking for in terms of BP for in hemorrhagic stroke patients?

A

preventing sudden rises in BP to prevent further hemorrhage and increased ICP

107
Q

after a stroke occurs what complications should be watched out for?

A

aspiration, skin breakdown, preventing future strokes

108
Q

what is the infection cycle?

A

infectious agent….reservoir…portal of exit…means of transmission….portal of entry…susceptible host

109
Q

what is the infectious agent?

A

the actual virus, funguns, or bacteria

110
Q

what is the reservoir?

A

where the agent goes and grows

111
Q

what is the portal of exit?

A

where the agent exits to the body

112
Q

what is the means of transmission?

A

how the disease is transported…direct..indirect…vector

113
Q

what does direct transmission mean?

A

passing a disease through contact with someone

114
Q

what does indirect transmission mean?

A

passing a disease to someone even though you did not come into direct contact

115
Q

what are some examples of direct transmission?

A

sex, kissing, droplet diseases

116
Q

what are some examples of indirect transmission?

A

fecal-oral transmission….not washing hands after the bathroom and spreading it on surfaces where people touch that surface and touch their mouth

Airborne disease

117
Q

what are some examples of airborne diseases?

A

xx

118
Q

what PPE is required for airborne diseases?

A

xx

119
Q

what are some examples of droplet diseases?

A

xx

120
Q

what PPE is required for droplet diseases?

A

xx

121
Q

what PPE is required for contact precautions

A

xx

122
Q

what diseases fall under contact precautions?

A

xxx

123
Q

what is the portal of entry?

A

where the disease enters the body

124
Q

what is the susceptible host?

A

a person who is at risk for contracting the disease….immunocompromised…open wounds…old age`

125
Q

what are the stages of infection?

A

incubation….prodromal….full stage of illness…convalescent period

126
Q

what is incubation?

A

the infection is growing in the body

127
Q

what is the prodromal stage?

A

period of incubation when they do not have symptoms present

most infection state

128
Q

what is the full stage illness?

A

when the patient has visible symptoms

129
Q

what is the convalescent period?

A

the healing stage…symptoms can be present?

130
Q

what factors put someone at risk for infection?

A

skin integrity…pH level of GI..number of WBC…age…sex…heridity… immunization status…stress.fatigue…indwelling devices

131
Q

how does the body respond to infections?

A

immune and inflammatory

132
Q

what are some examples of bacterial infections commonly found in the hospital?

A

MRSA and CAUITI

133
Q

what are some examples of fungi infections?

A

athletes foot and ringworm

134
Q

what are some examples of viruses?

A

flu, covid, HIV

135
Q

what are the two reasons for the body to have an inflammatory response?

A

infection or injury

136
Q

what are the two parts of the inflammatory response?

A

vascular and cellular

137
Q

what happens during the cellular stage?

A

leukocytes/neutrophils consume debris; damaged cells are repaired

138
Q

what happens during the vascular stage?

A

vasodilation increases blood and results in redness and heat

histamines are then released which makes protein rich blood come to the site

139
Q

what is an antigen?

A

a foreign body

140
Q

what is an antibody?

A

produced by the body to fight off the antigen

141
Q

whose at risk for MRSA?

A

people who have had invasive procedures, repiratory therapy, wounds, immunocompromised, catheters, tubes

142
Q

whose at risk for CAUTI?

A

women, older adults, debilitated patients, malnourished, chronically ill, immunocompromised, diabetes

143
Q

what are the signs and symptoms of CAUTI?

A

fever, chill, hematuria, cloudy urine, malodorus urine, anorexia, malaise

144
Q

what is hematuria?

A

blood in the urine

145
Q

what is malaise?

A

fatigue

146
Q

what s the best way to test for a cauti?

A

urine culture

147
Q

what are hospital acquired infections/HAI?

A

Infections that were not present or incubating at the time of the client’s admission to the healthcare setting

148
Q

what is another name for hospital-acquired infections/HAI?

A

nosocomial infection

149
Q

what is HIV?

A

human immunodeficiency virus

150
Q

how is HIV spread?

A

through sex or blood

151
Q

what should be some goals for treating your HIV patient

A

education…reduce anxiety….help with complications…educate on prevention of spread HIV

152
Q

how can you help reduce anxiety in HIV patients?

A

encourage discussion of feelings, provide education, plan with their partner, refer to social worker if needed

153
Q

what is considered PPE?

A

gloves, gown, mask, protective eyewear

154
Q

how should you don PPE?

A

gown, mask, goggles, gloves

155
Q

how should you doff PPE?

A

Gloves, gown, goggles, mask

156
Q

when are standard precautions used?

A

with every patient even if there are no infections present

157
Q

what are transmission based precautions?

A

for patients with an infection present…could be contact, droplet or airborne

158
Q

when are contact precautions used?

A

MRSA, cauti, c dif

159
Q

what PPE is on contact precautions?

A

gown and gloves

160
Q

when are droplet precautions used?

A

flu, strep, meningitis, pertussis

161
Q

what is PPE is included in droplet precautions?

A

surgical face mask, goggles, gown, gloves

162
Q

when are airborne precautions used?

A

TB, Varicelle, Measles,

163
Q

what is PPE is included in airborne precautions?

A

N95 mask , goggles, gown, gloves

164
Q

what precaution uses a negative pressure room?

A

airborne

165
Q

Is COVID airborne or droplet?

A

droplet unless respiratory care is done then it is airborne

166
Q

what is an open fracture?

A

when the bone has punctured the skin

167
Q

what is a closed fracture?

A

when the bone is broken but the skin is intact

168
Q

what is a complete fracture?

A

when the bone is broken into two parts

169
Q

what is an incomplete fracture?

A

when the bone is not split into two or more parts

170
Q

what are some causes of fractures?

A

MVA…falls…bone disease…trauma..malnutrition

171
Q

what is a common bone for elderly to break?

A

their wrist when catching themselves in falls

172
Q

what are the symptoms of a fracture?

A

pain…inability to use extremities…inflimmation…ecchymotic…poor pulse distal to fracture….parathesia…issue with other systems

173
Q

what is ecchymotic mean?

A

bruising causes by bleeding under the skin

174
Q

what is paresthesia?

A

numbness or tingling

175
Q

how can a fracture lead to issues with other systems?

A

ribs can puncture lungs….hip can damage bladder

176
Q

what labs will they run during a fracture?

A

H and H…ESR…WBC

177
Q

why would physicians run a H and H during a fracture?

A

xxx to see how much blood has been lost and if you need a infusion xxx double check

178
Q

why would physicians run an ESR during a fracture?

A

to check inflammation

179
Q

why would physicians run a WBC during a fracture?

A

to monitor infection

180
Q

what imaging is used for fractures?

A

x ray….CT….MRI

181
Q

what color tattoo prevents you from getting a CT?

A

red

182
Q

what is a closed reduction?

A

putting the bone back in place without opening the patient up

183
Q

what is the immobilization of a fracture?

A

using splints, boots, casts

184
Q

what are the non surgical interventions for a fracture?

A

closed reduction, immobilization, drug therapy, PT

185
Q

what is on the pre op check list?

A

complete history…advance directives..baseline labs…baseline images…NPO status…consent…procedure

186
Q

what are some post operation complications?

A

acute compartment syndrome…. hemorrhage…fat embolism…DVT…..infection….delirium….dislocation

187
Q

what is acute compartment syndrome?

A

bleeding in a certain area that keeps expanding….pain med wont help pain….could be decreased to no pulse….

188
Q

how can you prevent acute compartment syndrome?

A

perform assessments and check pulses

189
Q

what are some symptoms of a non stroke hemorrhage?

A

bruising, swelling, pallor, fatigue, confusion, pain,…..BP goes down HR goes up, pulse ox goes down

190
Q

what is a fat embolism?

A

a blood clot in your fatty tissue that goes off to the rest of your body

191
Q

how can you prevent fat embolism?

A

monitor vitals

192
Q

what happens to vitals during a fat embolism?

A

increase in BP, HR, RR

193
Q

what is DVT?

A

a blood clot in the leg

194
Q

what does DVT do to your vitals?

A

increase in BP, HR, RR

195
Q

what will DVT look like?

A

red, hot, swollen,

196
Q

how can you prevent DVT?

A

ambulation…SCD…TED

197
Q

what is a aka

A

above the knee amputation

198
Q

what is a bka?

A

below the knee amputation

199
Q

is healthy tissue removed during an amputation?

A

yes because they want to make sure to not leave any infected or necrotic tissue behind

200
Q

what do you do for amputee neurovascular checks?

A

pulse at the lowest point….check the color…check the ability to move…ability to feel

201
Q

what do you do for amputee skin integrity checks?

A

make sure the site is clean… infection-free….observe the sutures or staples..temp…drainage

202
Q

why can a amputee h and h be altered?

A

because they lost a limb that creates those things

202
Q

what are some symptoms of hemorrhaging?

A

low bp, increased HR, difficulty breathing, decreased spoo2

203
Q

what are some signs of an infection after surgery?

A

temp greater than 100.5, drainage, confusion

204
Q

what is phantom limb pain?

A

the patient feels pain from the extremity…if patient states that they have pain from it administer the medication

205
Q

what is a neuroma?

A

a benign tumor that grows on the nerves that are bundled together

206
Q

what is a flexion contractor?

A

the joint becomes stiff after not moving it

207
Q

what are nursing priorities for a new amputee?

A

mobility, perfusion, infection, comfort, self esteem

208
Q
A
209
Q
A
210
Q
A
211
Q
A
212
Q
A
213
Q
A

Nursing Acute Care (4 decks)

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