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NRSE 260 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is PICOT?

A

P: problem/ patient/population
I: intervention/indicator
- treat diagnose or observe
C: comparison
O: outcome of interest
T: Time

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2
Q

What is Maslow’s Hierarchy of Needs?

A

1: physiological: breathing, food, water, sex, sleep, homestatsis, excretion

2: safety: security of body, employment, resources, family, health, property

3: belonging: friendship, family, sexual intimacy

4: esteem: self-esteem, confidence, achievement, respect for self + other

5: Self-realization: morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of acts

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3
Q

What is an infection?

A

the invasion of a susceptible host by pathogens or microorganisms; results in disease (ex. chlamydia)

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4
Q

What is normal flora?

A

refers to the collection of organisms typically present in any anatomical region (ex. lactobacillus)

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5
Q

What is colonization?

A

presence and growth of microorganism within a host without tissue invasion or damage (ex. Canidida or C. Diff)

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6
Q

What is an infectious agent?

A

bacteria, virus, fungi, parasites

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7
Q

What is a communiable disease?

A

the infectious process transmitted from one person to another (hepaitis A, HIV, flu, TB, malaria)

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8
Q

What is a symptomatic patient?

A

clincial signs and symptoms are present

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9
Q

what is an asymptomatic patient?

A

clinical signs and symptoms are not present (hep C)

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10
Q

What is the chain of infection?

A

infectious agent/pathogen

reservoir or source for pathogen growth

portal of exit

means of transmission

portal of entry

susceptible host

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11
Q

What are factors for a susceptible host?

A

intact skin and mucous membrane

Normal pH levels

body’s white blood cells

age, travel, hereditary, lifestyle factors, occcupation

immunization, natural or acquired

medication (immunosuppresants)

fatigue, climate, nutritional, general health status

stress

use of invasive or indwelling medical devices (ET tube, urinary catheters, IV catheters)

diagnostic procedures, surgical procedures, radiation therapy

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12
Q

What is Endemic?

A

something that belongs to a particular people or country (Malaria)

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13
Q

What is an outbreak?

A

greater-than-anticipated increase in the number of endemic cases

also could be a single case in new area

outbreak can become epidemic

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14
Q

What is an epidemic?

A

disease that affects a large number of people within a community, population, region

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15
Q

What is a pandemic?

A

epidemic that spreads over multiple countries or continents

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16
Q

What is lab data for infection?

A

elevated WBC count: normal = 5- 10,000/mm3

increase in specific types of white blood cells (left shift= an increase in neutrophils)

elevated erythrocyte sedimentation rate (ESR or SED rate)
- 15 mm/hr men
- 20 mm/hr women

presence of pathogen: cultures of sputum, urine, blood, drains

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17
Q

What are the 5 moments for hand hygiene?

A

1: before touching a patient
2: before a clean or aseptic procedure
3: after a body fluid exposure risk
4: after touching a patient and removing gloves
5: after touching patient surrounding

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18
Q

What are health care- associated infection?

A

infections that are a result of health care delivery, not present at admission

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19
Q

What is exogenous source vs endogenous source?

A

Exo: outside the patient: microorganism outside

Endo: inside the client when flora is altered + overgrowth result s

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20
Q

What patients are at greater risk for health care-associated infections (HAIs)?

A

disease processes

older adults, infants

poorly nourished

compromised immune system

stress

ICU

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21
Q

What is sanitizing?

A

a process of washing, cleaning or removing dirt, and eliminates dust, debris, germs on surface

does not kill germs, lowers number and risk of spreading infection

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22
Q

What is disinfection?

A

process that eliminates many or all microorganisms, with exception of bacterial spores, from inanimate objects

disinfection of surfaces

high level disinfection: required for items like endoscopes

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23
Q

what is sterilization?

A

complete elimination/destruction of all microorganism including spores

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24
Q

What are drug resistant organisms infection?

A

Methicillin- Resistant Staphylococcus Aureus (MRSE)

Vancomycin Intermediate Resistant Staphylococcus Aureus (VISA)

Vancomycin Resistant Enterococcus (VRE)

Vancomycin resistant staphylococcus aureus (VRSA)

extended-spectrum beta Lactamase (ESBL)

Acinetobacter Baumannii (CRAB)

Carbapenem-Resistant enterobacteriaceae (CRE)

Multi-drug resistant tuberculosis

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25
Q

What are risk factors for drug resistant infections?

A

compromised immune system (cancer, organ transplant)

recent surgery

invasive devices

prolonged antibiotic use (especially vancomycin)

prolonged hospitalization or long-term care centers

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26
Q

What are defenses against infection?

A

Ear: cerumen inhibits bacterial growth

Mouth cavity: mucous membrane traps microorganism and the mouth is cleaned with saliva

Trachea and bronchi: mucous layer traps microorganism

stomach:
acidic juices kill microorganism

vagina: acidic secretions inhibit growth of pathogen

eyes:cleansed by tears which also contain chemical inhibiting bacterial growth

nasal cavity: hairs and mucus trap microorganism

Skin: an impervious barrier

Urethra: urine flow prevents bacterial growth

Anus: mucous membrane traps microoganisms

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27
Q

What are signs of a local infection?

A

redness
heat
swelling
pain
loss of function

28
Q

what are symptoms of systemic infection?

A

fever
chills, diaphoresis
increased pulse/respiratory rate
malaise
fatigue
anorexia
nausea + vomiting
abdominal cramps/diarrhea
enlarged lymph nodes

29
Q

What is a protective enviroment?

A

Neutropenic precautions for severely immunocompromised people (AIDS, burns, organ transplant, chemotherapy)

No live vaccine
avoid invasive procedures
check WBC + temp
healthy caregiver/visitors (no infectious diseas)
private room
positive airflow
HEPA filtration
no plant/flowers
keep door closed
mask for pt when out of room
no raw/undercooked fruits/veggie
avoid sick people
disinfect equipment between pt
frequent handwashing + gloves

30
Q

Contact precautions:

A

gown and gloves

disposable or dedicated pt care equipment

limit transport ad movement of pt
ensure appropriate pt placement,

private room

protect visitors/caregiver when within 3 feet against direct contact or enviromental contact

Pathogen: ABCDEF (abscess, bronchiolitis, cutaneous- herpes, lice, varicella, decubitus ulcer, diarrhea, eyes- conjunctivits, funky/feisty-MRSA and VRE

Special Contact Precautions: C. Diff (hand sanitzer doesnt kill spores)

31
Q

Droplet precautions:

A

wearing of surgical mask, eye protection, proper hand hyigiene, and some dedicated care equipment

limit transport and movement of pt (wear mask and respiratory hygiene/cough etiquette

private room or cohort

source control: pt wears mask

droplets travel 3-6 feet from client (keep visitors 3ft from infected person)

Pathogens: rubella, mumps, diptheria, adenovirus

32
Q

Airborne Precautions:

A

specially equipped room with private negative air flow

keep door closed

all heath care personnel wear an N95 respirator/PAPR every time they enter room

is splashing/spraying is possible wear full face protection

immunize susceptible people as soon as possible

restrict susceptible healthcare personnel

limit transport and movement of pt

masks and respiratory protection devices for caregiver/visitors

source control: put surgical mask on pt when leaving room

Pathogen: MTV; measles (rubeola), TB, Varicella (chickenpox)

33
Q

Standard precautions:

A

handwashing, use of gloves, PPE, use of gown, safe handling of sharps + waste + soiled linens
enviromental cleaning

34
Q

Medical Vs Surgical asepsis:

A

Medical: clean technique (IM injection)
Key step: hand hygiene, gloves, disinfection
most nursing activites are medical asepsis

Surgical: sterile technique (ex. operating room, foley catheter insertion)
key step: sterilization, sterile gloves, instruments
special technique to prevent contamination

35
Q

Precautions for C. Diff:

A

avoiding use of electronic equipment that is difficult to clean

disinfecting dedicated pt care items and equipment (stethoscopes) between pt

using full barrier contact precautions (gown +gloves)

placing pts in private room; cohort pt with same stain of CDI

performing meticulous hand hygiene (hand sanitzer does not kill spores)

performing enviromental contamination of rooms

educating heath care providers (pts +families) on clinical presentation, transmission, epidemiology of CDI

using antimicrobials at appropriate dose and only when indicated

36
Q

Donning (PPE)

A

(putting on)

1: gown
2: mask/respirator
3: googles/ face shield
4: gloves

37
Q

Doffing (taking off)

A

Example 1: gloves, goggles, gown, mask

Example 2: gown/gloves, goggles, mask/respirator

38
Q

Surgical Asepsis principles

A

Good:
sterile object remains sterile only when touched by another sterile object

open sterile package away from you. outside of package is considered contaminated

only sterile objects may be placed on sterile field

sterile object or field out of range of vision or an object held below a person waist is contaminated

sterile object or field becomes contaminated by prolonged exposure to air

sterile surface comes in contact with wet, contaminated surface, sterile object/field becomes contaminated by capillary action

avoid talking, coughing, sneezing or reaching over sterile field

edge of sterile field or container are considered contamined (1 inch border)

keep all items sterile if: in contact with broken skin, used to penetrate the skin to inject or enter normally sterile body cavities

39
Q

What is the infectious process?

A

Incubation Period: exposure to infection

Prodromal stage: can spread infection; before symptoms fully begin

Illness stage: signs + symptoms are fully showing

Convalescent period: symptoms resolve and people start feeling better

40
Q

Assessment: infection control

A

status of defense mechanisms

client susceptibility

age
nutritional status
stress
disease process
medical therapy
immunizations

clinical appearance (s/s of infection-local/systemic)

vital signs

Lab data

41
Q

Nursing diagnosis: infection control

A

risk of infection

imbalanced nutrition: less than body requirement

impaired oral mucous membrane

risk for impaired skin integrity

social isolation

impaired tissue integrity

readiness for enhanced immunization status

41
Q

Nursing planning:

A

effective hand hygiene + good personal hygiene practices

identify signs of an infection

maintain adequate fluid + nutritional status

demonstrate proper disposal of soiled articles

use appropriate cleansing and disinfecting techniques

awareness of the necessity of proper immunizations

stress reduction technique

adhere to infection control precautions

understanding of health risks associated with latex allergy

42
Q

Acute Care interventions:

A

health promotion (nutrition, hygiene, immunization, rest)

protection of susceptible host

control/elimination of infectious agents

control/elimination of
—-> reservoirs
—–> portals of entry
——> modes of transmission

medical and surgical asepsis (clean vs sterile technique)

hand hygiene (HCP, patient, family) —five moment for hand hyigene)

oral hygiene

meticulous standard precautions

43
Q

What are some safety issues for the nurse?

A

use needles safely (advocate if you dont know how)

handle patients with care

administer drugs carefully

prevent repetitive motion injuries

use ergonomic principles when providing care

report, intervene, and/or escalate unsafe practices of health care personnel (eg. substance abuse, improper

44
Q

What are factors that affect safety?

A

developmental consideration

workplace culture

lifestyle (occupation, social behavior)

social behavior

environment

impaired mobility

sensory, cognitive or communication impairment

knowledge or lack of safety awareness

physical and psychosocial health state

economic resources

45
Q

What is a safety assessment?

A

looking at…

the person

the environment (hospital, workplace, home)

specific risk factors (ex. fall risk)

46
Q

Hourly Rounding 5 Ps:

A

Pain: assess pt pain level; provide pain medication if needed

Personal Needs: offer help using toilet; offer hydration, nutrition, empty commodes/urinals

Position: help the pt get into comfortable position or turn immobile pts to maintain skin integrity

Placement: make sure pt essential needs (call light, phone, reading materials, toileting equipment, etc) within reach

prevent falls: ask patient/family to put on call light if pt needs to get out of bed

47
Q

Incident reports:

A

must be completed after an accident or incident in health care facility that compromise safety

completed by nurse immediately after incident

is NOT PART OF MEDICAL RECORD and should not be mentioned in documentation

48
Q

What is RACE?

A

R: rescue anyone in immediate danger
A: activate alarm and notify appropriate person
C: contain/confine the fire by closing door and window
E: extinguish

49
Q

What is PASS?

A

P: pull
A: aim
S: squeeze
S: sweep

50
Q

Alice Training:

A

A: alert, pay attention to changing sounds ( first notification of danger)

L: lockdown: fortify/barricade your area

I: inform others: call 911 or hospitals emergency number

C: counter: make noise, throw things to cause distraction

E: evacuate: remove yourself from danger

51
Q

Seizure precautions:

A

stay with patient; call for help

protect your airway

suction PRN; in case of aspiration

turn your pt to the side to reduce the risk of choking

provide suppmental oxygen

do not place objects in the mouth

remove hazardous items
——> padded bed frame in case of uncontrollable body movement

do not restain, monitor closely

administer drug therapy to control seizure

assess after seizure, and document

52
Q

Safety considerations for Neonates:

A

avoid behaviors that might harm fetus (alcohol, smoking, drugs)

never leave infant unattended

use crib rails

monitor setting for objects that are choking hazard

use car seats properly

handle infant securely while supporting head

place infant on back to sleep

53
Q

Safety consideration for toddlers/preschoolers:

A

supervise child closely to prevent injury

select toys appropriate for developmental level

use appropriate safety equipment in home

never leave child alone in bathtub

childproof home envronment; prevent poisoning

be alert to manifestations of child maltreatment or abuse— physical, sexual, emotional neglect ( YOU are a mandated reporter)

use car seats properly

teach about fire safety/practice emergeny evacution measures

54
Q

safety considerations for school-aged children

A

help avoid activties that are potentially dangerous

provide interventions for safety at home, school, neighborhood

reinforce teaching about symptoms that require immediate attention

continue immunizations as scheduled

teach bicycle safety

teach about child abduction

wear seatbelts

55
Q

Safety considerations for adolescents:

A

teach safe driving skills and avoiding distracted driving

teach avoidance of tobacco + alcohol

emphasize gun safety

follow healthy lifestyle

teach about sexuality, STI, birth control

get physical exam before participating in sport

teach risk of infection with body piercing and tattoo

teach about guns + violence

discuss dangers associated with internet

56
Q

Safety considerations for adults:

A

remind them of effects of stress on lifestyle and health

enroll in defensive driving course

counsel about unsafe health habits (reliance on drugs and alcohol)

evaluate workplace for safety

counsel about domestic violence

57
Q

Safety consideration for older adults:

A

identify safety hazards in environment

modify the environment as necessary

attend defensive driving course or courses designed for older drivers

encourage regular vision and hearing test

ensure hearing aid and eyeglasses are available and functioning

have operational smoke detectors in place

document and report signs of neglect and abuse

58
Q

Safety plan for victims for domestic abuse:

A

safety plan while living with an abusive partner (remove weapons, have a phone + keys, signal, have safety plan)

safety plan with children

plan for pets

planning during pregnancy (increased risk)

leaving relationship (important documents)

59
Q

Speak Up campain

A

S: speak up if you have questions/concerns

P: pay attention to the care you get

E: educate yourself about illness

A: Ask a trusted family member or friend to be advocate

K: know what medications you take and why you take them

U: use a hospital, clinic, surgery center that has been carefully checked out

P: participate in all decisions about treatment

60
Q

Safety issues:

A

procedure- related accident

equipment- related accident

chemical exposure

falls

restraints

workplace safety

electrical hazards

fires

seizures

disasters

workplace violence + discrimination

61
Q

Nursing History: Safety

A

age

acute/ chronic conditions

surgeries/procedures

visual, hearing, sensory/perceptual

medications

assess for history of falls/accidents

allergies (food, latex, enviromental allergies)

note assistive devices (ex. cane, walkers)

be alert to history of drug or alcohol abuse

obtain knowledge of family support system and home enviroments

62
Q

Risk Factor Assessment:

A

falls

fires

poisoning

suffocation and aspiration/choking

firearm injuries

motor vehicle injury

burns

drownings

social media

play injuries

passive smoking

carbon monoxide

food poisoning

63
Q

physical examination: safety

A

assess mobility status

assess ability to communicate

assess level of awareness or orientation

assess sensory perception

identify potential safety hazards

recognize manifestations of domestic violence or neglect

64
Q
A

NRSE 260 (5 decks)

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