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Exam 4 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Recommended separation of education from hospital service. Increase admission standards, and strengthen collegiate nursing schools

A

Goldmark report

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2
Q

Stated that nursing education should be in colleges with the right accreditation, not in hospitals. Encourage recruitment of men and minorities.

A

the Brown Report

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3
Q

Minimum preparation for beginning professional nursing practice is baccalaureate degree education.

A

ANA position paper

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4
Q

• People couldn’t afford hospital costs, so they opted for private duty nurses because it was cheaper or free if provided by nursing students
• After the closure of hospital-based nursing schools, many nurses faced unemployment. Government cope by;
o Forming Federal Healthcare Programs: hospital hired started to paid minimal wages to nurses
o Nurses’ performance lead to a greater respect for the profession

A

The great depression on nursing

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5
Q

What are the four factors that changed nursing?

A
    1. Religious Ideals and Humanitarian Aims
      1. Technology & Advancements in Medicine
      2. War:
      3. Traditional Role of Women and Feminism
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6
Q

What nursing theory did Florence Nightingale?

A

environmental thery

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7
Q

What nursing theory did Jean Watson have?

A

caring theory

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8
Q

what nursing theory did hildegard pelau have?

A

interpersonal theory

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9
Q

what nursing theory did Virginia Henderson?

A

need theory

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10
Q

what nursing theory did betty neuman have?

A

systems theory

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11
Q

what nursing theory did sister callista roy have?

A

adaptive model

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12
Q

what nursing theory did madeleine leininger?

A

transcultural care

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13
Q

Focuses on the environment alterations; ventilation, warmth, light, diet, cleanliness, noise.

A

environmental theory

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14
Q

Effective caring promotes health and individuals & family growth.

A

caring theory

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15
Q

The relationship between nurse, patient, and family is necessary to meet goals

A

interpersonal theory

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16
Q

Assist patient with their 14 human needs while they recover and achieve independence

A

need theory

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17
Q

If one area does NOT work, it can affect the whole system because everything is connected

A

systems theory

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18
Q

Environmental stimuli results in human response, which could be adaptive or ineffective

A

adaptive model

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19
Q

Patient should always be provided with cultural-specific nursing care

A

Transcultural Care

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20
Q

The activity used to minimize the spread of pathogens

A

infection control

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21
Q

Applies to contact with infected patients or their environment. Must wear gloves and gown.

A

contact isolation

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22
Q

Applies to patients infected with a pathogen (respiratory infections- pneumonia, influenza, whooping cough, bacterial meningitis) that is transmitted by droplets (3-6 fee). Must wear gloves, gown, & mask. Patient with mask when out of room.

A

droplet isolation

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23
Q

Applied to patients infected with an airborne pathogen (Measles, Varicella, Tuberculosis, chikenpox). Must wear gloves, gown, and N95 respirator. Patient with a mask when out of the room. Room equipped with negative air flow.

A

airborne isolation

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24
Q

(clean technique) measures taken to control and reduce the number of pathogens.

A

medical aseptic technique

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25
Q

(sterile technique) measures used to eliminate any pathogens from the area.

A

surgical aseptic technique

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26
Q

Underlying soft tissue & blood vessels damage without edges or epidermis torn (bruises/contusion, suspected deep issue injury)

A

closed wound

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27
Q

There is a break in the skin or mucous membrane.

A

open wound

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28
Q

tearing injury, irregular edges

A

laceration

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29
Q

superficial, involving scraping or rubbing of superficial layers of skin

A

abrasion

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30
Q

penetrating injury due to pointed object

A

puncture

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31
Q

Wounds are shallow, involving loss of epidermis, and partial loss of dermis
o Heals by regenerations

A

partial thickness wound

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32
Q

Wound extends into the dermis and into deeper tissues (subcutaneous fat and muscle)
o Heals by scar formation b/c deeper structures do not generate

A

full thickness wound

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33
Q

what are the stages of the full thickness wound healing?

A
  • homeostasis
  • inflammation phase
  • proliferation phase
  • remodeling
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34
Q

Injured blood vessels constrict, platelets stop bleeding, clot forms

A

homeostasis

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35
Q

begins in 3 min after injury, last up to 3 days. Damage tissue and mast cells secrete histamine, results in vasodilatation of capillaries where WBC get to damaged tissue.

A

inflammation phase

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36
Q

from the 3rd to the last 24 days; filling of the wound with granulation tissue and contraction of the wound.

A

proliferation phase

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37
Q

(maturation) the final stage of healing, which could take up to a year. The collagen scar continues to gain strength (but will never return to the original strength).

A

remodeling

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38
Q

Wound with NO pathogenic organisms. Are primeval closed wounds.

A

clean

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39
Q

Wound made under aseptic conditions (medical surgery), which involves a body cavity that normally harbors microorganism like the respiratory tract, gastrointestinal tract, the genital or urinary tract.

A

clean contaminated

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40
Q

Open wound, traumatic or surgical wounds involving a major break in sterile technique. Shows evidence of inflammation

A

contaminated

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41
Q

Old, traumatic wounds containing dead tissue, bacteria, and evidence of clinical infection (i.e. purulent drainage)

A

infected

42
Q

Multiple organisms in wound. Not necessarily a bad thing.

A

colonized

43
Q

Skin edges are approximated or closed together. Wound closure restores barrier against infection.

A

primary intention

44
Q

Skin layers are NOT approximated. Wound left open until scar tissue or granulation tissue forms. Wound closure takes time, these wounds lack protective epidermal barrier, and are more subject to infection.

A

secondary intention

45
Q

Healing occurs when a wound surface begins to granulate and then it is closed at a later time. May be used when wounds are deep or until no more signs of infections.

A

tertiary intention

46
Q

total or partial disruption in wound edges

A

• Dehiscence

47
Q

Protrusion of viscera through a wound opening

A

evisceration

48
Q

abnormal tube like, passageway that form between 2 organs, or 1 organ and the skin

A

fistula

49
Q

clear, watery plasma. This is what the body should be doing.

A

serous drainage

50
Q

capillary damage, larger number of RBC, severe inflammation, bright red indicates active bleeding

A

sanguineous drainage

51
Q

Drainage in mixture of serous and some blood. Pale pink, watery mixture of clear and red fluid
o Purulent: “pus”, severe inflammation with infection, contains leukocytes, liquefied dead cells, and dead/living bacteria. Is thick, yellow, green, tan, brown (it also smells).

A

serosanguineous drainage

52
Q

closed suction drainage system, empty when ½ full

A

JP drain

53
Q

closed suction drainage system. Bigger than the J.P. Drain

A

hemovac

54
Q

Rubber type tube with opening on both ends, drainage accumulates on gauze.

A

penrose

55
Q

redness develop from pressure, skin is unbroken
Treatment/dressing:
Transparent film or Hydrocolloid, can be left on for up to 7 days

A

stage 1 pressure ulcer

56
Q

(partial thickness) broken skin involving the epidermis & dermis with a shallow open ulcer without slough or the formation of blisters
Treatment/dressing:
Hydrogen and foam dressing
*If shallow (partial thickness) without eschar use Hydrocolloid for 7 days

A

stage 2 pressure ulcer

57
Q

(full-thickness) subcutaneous fat may be visible, slough may be present, bone, tendon and muscle are not exposed
Treatment/dressing:
*Irrigation of wound to remove debris
*If dry, hydrogel covered with foam dressing
*if heavy drainage, Calcium Laginate and gauze

A

stage 3 pressure ulcer

58
Q

(full-thickness) tissue and muscle loss where bone or tendons can be seen. Slough or eschar (black/brown necrotic tissue) may be present. Includes tunneling or undermining

A

stage 4 pressure ulcer

59
Q

Treatment/dressing:

  • Debridement: -Both eschar and slough are removed by chemicals, or surgical procedure. May require reconstructive surgery.
  • If dry, hydrogel covered with foam dressing
  • If heavy drainage, calcium alginate and gauze
  • If very deep, use gauze to fill dead-space
A

stage 4 pressure ulcer

60
Q

full-thickness) base of wound obscured by slough, and depth is unknown.

A

unstageable pressure ulcer

61
Q

Intact skin or blood filled blister caused by damage to soft tissue. Purple and maroon areas

A

Suspected Deep Tissue Injury (SDTI):

62
Q

Closes a wound and prevents it from being exposed to the air.

A

occlusive dressing

63
Q

Provides moisture to the wound yet allows drainage by absorbing it.

A

gauze dressing

64
Q

It is shiny, non-adherent surface, does NOT stick to incision, and allows drainage to pass through the gauze topper. It is used over clean wounds. Ex. surgical incisions with little to no drainage.

A

tefla-gauze dressing (non-adherent)

65
Q

It adheres to undamaged skin trapping moisture over wound for a faster healing. Also, serves as a barrier.

A

transparent film

66
Q

Absorbs wound’s exudate and provides a barrier. It molds to uneven surface, easy peel back and replace, and permits easy access to assess a wound without causing damage

A

mepilex

67
Q

It is impregnated with water/glycerin based amorphous gel. It hydrates dry wound, soften dry necrotic tissue, and relieving pain. It does not adhere to the wound bed

A

hydrogen

68
Q

Absorbs exudates, maintains moisture, & break down necrotic tissue by liquefying it. It is adhesive and occlusive.

A

hydrocolloid

69
Q

Provides soft support and barrier to prevent further damage to the wound Ex. stage 1 pressure ulcer, skin tears.

A

foam dressing

70
Q

combine with wound drainage to form a gel in the moist wound bed.

A

calcium alginate

71
Q

Due to prolonged use, bacterial species
which synthesize enzyme – counteracts
effects of PCN.

A

penicillinase

72
Q

 PCN indicated for the treatment of:

A 
 Streptococcal infections – pharyngitis, tonsillitis, scarlet
fever, endocarditis
 Pneumococcal infections
 Staphylococcal infections
 Fusospirochetal infections
73
Q

 Adverse effects:
 Nausea, vomiting, diarrhea, abdominal pain, glossitis,
stomatitis, gastritis, sore mouth, furry tongue
 Superinfections – yeast (very common)
 Hypersensitivity reactions – rash, fever, wheezing,
anaphylaxis

A

Penicillins & Penicillinase resistant Antibiotics

74
Q

 Powerful antibiotics used to treat serious infections caused
by GRAM-NEGATIVE AEROBIC BACILLI
 Used to treat serious gram-negative infections such as:
 E. coli, Klebsiella-Enterobacter-Serratia group, Staphylococcus
species such as S. aureus.
 Gentamycin, Neomycin, Streptomycin, Tobramycin

A

Aminoglycosides

75
Q

 Serious adverse effects:
 Ototoxicity with possible irreversible deafness
 Nephrotoxicity – may progress to renal failure
 Superinfections

A

Aminoglycosides

76
Q 
 Assess for possible contraindications or cautions
such as:
 Allergies to this drug
 Increase fluid intake
 Monitor labs
 Use sun block
 Daily assessments
 Monitor for s/s superinfections
A

Aminoglycosides

77
Q

 Both bactericidal AND bacteriostatic, similar to
PCN’s in structure and activity
 Interfere with ability of bacterial cell wall-building
 How med is chosen from this class depends on:
 the sensitivity of the organism; route of choice; cost

A

cephalosporins

78
Q

 Adverse effects:
 Nausea, vomiting, diarrhea, anorexia, abdominal pain,
flatulence
 D/C immediately with signs of violent, bloody diarrhea
or abdominal pain
 CNS – h/a, dizziness, lethargy, paresthesias,
nephrotoxicity
 Superinfections-C. diff

A

cephalosporins

79
Q

 Assess for possible contraindications or cautions
such as:
 Allergies to this drug or penicillin
 Monitor labs
 Monitor INR – decrease blood clotting time

A

Cephalosporins

80
Q

 Synthetic class of broad-spectrum antibiotics
 Commonly used to treat UTI, respiratory tract infections,
skin infections
 Treats infections caused by susceptible strains of gramnegative
bacteria such as: E.coli, P. mirabilis, K.
pneumoniae, Enterobacter cloacae, H. influenzae, H.
parainfluenzae, S. aureus, Staphylococcus epidermidis,
some Neisseria gonorrhoeae, and group D strep.
(Cipro, Levaquin, Maxaquin, Avelox, Moroxin, Floxin)

A

Fluoroquinolones

81
Q

 Assess for possible contraindications or cautions
such as:
 Allergy to drug
 Give with full glass of water
 No driving or operating machinery
 Caution patient about risk of photosensitivity
reactions
 Teach patient med absorption is decreased with
antacids

A

Nursing implications: Fluoroquinolones

82
Q

 Inhibit bacterial synthesis of folic acid
 Used to treat gram-negative & gram-positive
bacteria such as: Chlamydia trachomatis,
Nocardia, H. influenzae, E. coli (Gantrisin, Septra,
Bactrim)
 No longer used much
 Inexpensive & effective tx for UTIs and trachoma
(leading cause of blindness) in developing
countries & when cost is an issue

A

Sulfonamides (sulfa drugs)

83
Q

 Adverse effects:
 Nausea, vomiting, diarrhea, abdominal pain,
anorexia, stomatitis, hepatic injury, renal failure,
thrombocytopenia
 Superinfections

A

Sulfonamides (sulfa drugs)

84
Q

 Assess for possible contraindications or cautions
such as:
 Allergy to drugs
 Instruct patient to report bruising or bleeding
 Check labs
 Take with full glass of water
 Use sun block

A

Nursing implications: Sulfonamides

85
Q

 Developed as semi-synthetic antibiotic; 1st broadspectrum
abx
 Inhibit protein synthesis and prevent bacteria from
multiplying
 Used to treat: Rickettsiae, H. influenzae, E. coli,
Spirochetes, Klebsiella, S. aureus, Chlamydia

A

Tetracyclines

86
Q

 Adverse effects:
 Hepatotoxicity
 Nephrotoxicity
 Superinfections

A

Tetracyclines

87
Q 
 Assess for possible allergy 
 Caution women that it may make
oral contraceptives ineffective
 Give 1 hour before meals or 2 hours after with a
full glass of water
 Use sun block, sun glasses and wear protective
clothing
 Monitor for GI effects
A

NURSING INTERVENTIONS: TETRACYCLINE

88
Q

 Interfere with protein synthesis in susceptible
bacteria
 Used to treat: Mycoplasmal pneumoniae,
Legionnaire’s disease, PID (Erythromycin,
Azithromycin, Clarithromycin)

A

Macrolides

89
Q

 Adverse effects:
 Hepatotoxicity
 Anaphylaxis
 Superinfections

A

Macrolides

90
Q

 Assess for possible allergy
 Give PO med 1 hour before meals or 2 hours after
 If GI upset take with food
 Monitor labs
 Carefully monitor pts on digoxin and anticoagulants
when taking this anti-infective

A

Nursing interventions: Macrolides

91
Q

a Glycopeptide antibiotic. These antibiotics are large, rigid molecules that inhibit a late stage in bacterial cell wall synthesis.
• Used to treat:
• Staphylococcal infections
• Methicillin-resistant staphyloccal aureus (MRSA)
• C. diff
• Cellulitis if allergic to PCN or MRSA suspected/confirmed

A

Vancomycin

92
Q
  • Adverse reactions:
  • Ototoxicity
  • Nephrotoxicity
  • Red-man syndrome
A

Vancomycin

93
Q

 Assess for allergies
 Monitor lab levels
 Peak action is 30 minutes after the END of the
infusion
 Carefully observe for hypersensitivity reactions:
 Red-man syndrome: s/s that would appear 4-10
minutes after initiation of infusion or soon after
completion: pruritus (erythematous rash) of the
face, neck, upper torso
 Anaphylaxis

A

Nursing interventions: Vancomycin

94
Q

acute bacterial infection of the dermis
and subcutaneous tissue
 Is an “opportunistic” infection, commonly occurring
through breaks in the skin
 Most often caused by streptococci or
staphylococci
 Diagnosis is by appearance
 cultures are sometimes helpful, but awaiting these
results should not delay empiric therapy
 Affects people of all races and ages; men and
women equally affected
 Most common in middle-aged and elderly people
 Is NOT contagious

A

Cellulitis

95
Q

 Risk factors: skin abnormalities, trauma, ulceration,
fungal infection, pts with chronic venous
insufficiency, lymphedema, insect bites,
microscopic cracks in skin
 Appears near ulcers or surgical wounds
 Frequently

A

Cellulitis

96
Q

 S/S include: pain, rapidly spreading erythema,
edema; fever may occur, regional lymph nodes
may enlarge
 Presenting site: lower leg, (tibia, shinbone, foot), is
unilateral; bilateral - extremely rare (stasis dermatitis
closely mimics cellulitis but is usually bilateral)

A

Cellulitis

97
Q

 Mild infections: treatment for cellulitis

A

PCN

98
Q

If allergic to PCN use, for cellulitis treatment

A

 Macrolides – Clarithromycin, Azithromycin

99
Q

 For patients who are unlikely to adhere to multiple

daily dosing schedules:

A

 Fluoroquinolones – Levofloxacin, Moxifloxacin

100
Q

 For serious infections requiring hospitalization:

A

 Penicillinase-resistant antibiotics – Nafcillin, Oxacillin

 Cephalosporins – Cephalexin

101
Q

 For penicillin-allergic patients or those with

suspected or confirmed MRSA:

A

 Glycopeptide - Vancomycin

Exam 4 (7 decks)

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