Exam 1 Fundamentals Flashcards

1
Q

semi-fowlers

A

30-45 degrees, normally 30
Used for feeding, lung expansion, cardiac or respiratory conditions, for pts with a nasogastric tube

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2
Q

hypokalemia

A

symptoms: muscle weakness, chronic fatigue, and cardiac dysrhythmias

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3
Q

Leukopenia

A

condition where a person has a reduced number of white blood cells. This increases their risk of infections

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4
Q

leukocytosis

A

high WBC count

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5
Q

Z-track method of drug injection

A

for intramuscular injections to prevent leakage of medication into the needle track into subcutaneous tissue, thus minimizing discomfort.

procedure: attach a clean needle to the syringe after the syringe is filled with the medication to prevent the injection of any residual medication on the needle into superficial tissues. Pull the skin down or to one side 1 to 2cm (Yilmaz et al., 2016; Karch, 2020), spread the skin taut at the injection site, and hold in this position with the nondominant hand. Insert the needle and inject the medication slowly. After 10 seconds, withdraw the needle steadily and release the displaced tissue to allow it to return to its normal position. Massage of the site is not recommended because it may cause irritation by forcing the medication to leak back into the needle track. However, gentle pressure may be applied with a dry sponge.

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6
Q

gr (grains) to mg conversion

A

__ gr x 64 (conversino factor)= mg

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7
Q

ELISA test stands for and detects

A

Stands for: enzyme-linked immunosorbent assay
Uses what? Antibodies to detect the presence of a disease agent (bacteria, virus, or parasites) in your blood or body fluid

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8
Q

Thrombophlebitis typically develops in patients with which of the following conditions?

A

An impaired or traumatized blood vessel wall

The three factors of Virchow’s triad include intravascular vessel wall damage, stasis of flow, and the presence of a hypercoagulable state.

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9
Q

Immobility impairs bladder elimination, resulting in such disorders as:

A

Urine retention, bladder distention, and infection

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10
Q

Sources of Pain

A

cutaneous, somatic, visceral, referred, nociceptive, neuropathic

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11
Q

Cutaneous pain

A

superficial pain to the epidermis, dermis, or subcutaneous (burn, paper cut)

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12
Q

somatic pain

A

pain originating in structures in the body’s external wall
nerve, tendon, bones, muscles

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13
Q

visceral pain

A

pain originating in the internal organs in the thorax, cranium (migraine), or abdomen
poorly localized –> generalized

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14
Q

referred pain

A

the pain you feel in one part of your body is actually caused by pain or injury in another part of your body
heart attack causes pain in arm/shoulder/back

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15
Q

Nociceptive pain

A

type of pain caused by damage to body tissue

pain from a normal process that results in noxious stimuli being perceived as painful

feels like sharp, aching, throbbing
ex. stubbing your toe, sports injury, dental procedure

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16
Q

Neuropathic pain

A

my definition: abnormal processing of pain message

pain that results as a direct consequence of a lesion or disease affecting abnormal functioning of the peripheral nervous system (PNS) or central nervous system (CNS)
ex. phantom pain
described as burning, electric, tingling or stabbing

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17
Q

origins of pain

A

physical- can be identified
psychogenic- cause cannot be identified

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18
Q

the pain process

A

receive pain stimulus- activate the receptors(transduction)-
send a message via nerve fibers (transmission) to the thalamus- sensory center- heat, cold, pain, and touch are first perceived.
Then the cerebral cortex identify the intensity and location of the pain (perception)
brain messages to release endorphins & neuromodulators which are sent to diminish pain messages(modulation).

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19
Q

transduction

A

activation of pain receptors

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20
Q

transmission

A

conduction along pathways (A-delta and C-delta)

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21
Q

perception of pain

A

awareness of the characteristics of pain

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22
Q

modulation

A

inhibition or modification of pain

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23
Q

Bradykinin

A

a powerful vasodilator that increases capillary permeability and constricts smooth muscle

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24
Q

prostaglandins

A

important hormone like substance that sends additional pain stimuli to the CNS

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25
Q

substance P

A

sensitizes receptors on nerves to feel pain and also increases the rate of firing nerves

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26
Q

gate control theory of pain

A

describes the transmission of painful stimuli and recognizes a relationship between pain and emotions

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27
Q

sedation scale

A

S: sleep, easy to arouse: no action necessary
1: awake and alert; no action necessary
2: occasionally drowsy, but easy to arouse; no action necessary
3: frequently drowsy, drifts off to sleep during conversation; reduce dosage
4: somnolent with minimal or no response to stimuli; discontinue opioid, consider use of naloxone

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28
Q

sources of knowledge

A

traditional- passed down from generation to generation
authoritative- comes from an expert, accepted as truth based on persons perceived expertise
scientific- obtained through scientific method

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29
Q

deductive reasoning

A

examines general ideas and considers specific actions or ideas

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30
Q

inductive reasoning

A

builds from specific ideas or actions to conclusions about general ideas

nursing process follows this

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31
Q

general systems theory

A

theory for universal application; break whole things into parts to see how they work together in systems

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32
Q

adaptation theory

A

adjustment of living matter to other living things and environment (fluid)

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33
Q

developmental theory

A

orderly and predictable growth and development from conception to death

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34
Q

types of quantitative research

A

Descriptive
Correlational
Quasi-experimental
Experimental

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35
Q

qualitative research method

A

Phenomenology
Grounded theory
Ethnography
Historical

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36
Q

PICOT

A

P = patient, population, or problem of interest
I = intervention of interest
C = comparison of interest
O = outcome of interest
T = time

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37
Q

the helping relationship

A

orientation phase- establish goal of relationship, location frequency and length of contract, duration of relationship

working phase- longest phase, pt actively participates , works towards achieving mutually acceptable goals, pt will express feelings and concerns

termination phase- begins at hello, pt will participate in identifying the goals accomplished and progress made towards goals

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38
Q

aims of teaching and conseling

A

Maintaining and promoting health
Preventing illness
Restoring health
Facilitating coping

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39
Q

three learning domains

A

Cognitive: storing and recalling of new knowledge in the brain

Psychomotor: learning a physical skill, integration of mental and muscular activity

Affective: changing attitudes, values, and feelings

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40
Q

Knowles Assumptions about Adult Learners

A

most adults orientation to learning is that material should be useful immediately, rather than at some point in the future

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41
Q

teaching plans for older adults

A

Identify learning barriers.
Allow extra time.
Plan short teaching sessions.
Accommodate for sensory deficits.
Reduce environmental distractions.
Relate new information to familiar activities or information.

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42
Q

cognitive domain examples

A

lecture, panel, discovery, written materials

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43
Q

affective domain

A

role modeling, discussion, audiovisual materials

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44
Q

psychomotor domain

A

demonstration, discovery, printed materials

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45
Q

nursing process

A

ADPIE
A- assess
D- diagnosis
P- plan
I- implementation
E- evaluation

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46
Q

vital signs

A

Temperature (T)
Pulse (P)
Respiration (R)
Blood pressure (BP)
Pain (often included as fifth sign)

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47
Q

oral temp

A

35.8-37.5 C (or 96.4-99.5 F)

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48
Q

types of fever

A

intermittent, remittent, sustained or continuous, relapsing or recurrent

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49
Q

intermittent

A

temperature returns to normal at least one every 25 hours

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50
Q

remittent

A

temp does not return to normal and fluctuates a few degrees up and down

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51
Q

primary source of heat

A

metabolism

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52
Q

heat production

A

metabolism
hormones, muscle movements, exercise (all increase metabolism)
epi and norepi
thyroid hormone and shivering (increase heat production)

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53
Q

sources of heat loss

A

skin (primary source)
evaporation of sweat
warming and humidifying inspired air
eliminating urine and feces

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54
Q

transfer of body heat to external environment

A

radiation, convection, evaporation, conduction

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55
Q

radiation

A

Loss of heat by indirect contact
ex. placing a cold object inside incubator.

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56
Q

convection

A

Loss of heat from warm body to cooler air currents.

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57
Q

evaporation

A

Loss of heat due to conversion of water to vapor.
ex. sweating

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58
Q

conduction

A

Loss of heat by direct touch.
ex. ice pack on knee

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59
Q

pulse rate

A

number of contractions over a peripheral artery in 1 minute

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60
Q

pulse is regulated by

A

the autonomic nervous system through cardiac sinoatrial node

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61
Q

ventilation

A

movement of air in and out of lungs

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62
Q

diffusion

A

exchange of oxygen and carbon dioxide between the alveoli of lungs and circulating blood

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63
Q

perfusion

A

exchange of oxygen and carbon dioxide between circulating blood and tissue cells

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64
Q

most powerful respiratory stimulant

A

increase in carbon dioxide

65
Q

Tachypnea

A

increased respiratory rate; may occur in response to an increased metabolic rate

66
Q

eupnea

A

normal, unlabored respiration

67
Q

most common blood pressure spot

A

brachial artery and popliteal artery

68
Q

primary hypertension

A

characterized by an increase above normal in both systolic and diastolic pressure

69
Q

secondary hypertension

A

caused by another disease conditions
commonly: kidney disease, adrenal cortex disorders, and aorta disorders

70
Q

diuretics

A

decrease fluid volume (and blood pressure) by helping the body eliminate sodium and water through the urine. However, some diuretics can also cause the body to eliminate more potassium in the urine.

71
Q

antihypertensive medications

A

diuretics, beta-adrenergic blockers, vasodilators and calcium channel blockers, ACE inhibitors

72
Q

beta-adrenergic blockers

A

to block sympathetic stimulation and decrease cardiac output

73
Q

vasodilators and calcium channel blockers

A

to relax smooth muscles of arterioles and decrease peripheral vascular resistance

74
Q

ACE inhibitors

A

to prevent vasoconstriction by angiotensin II and decrease circulatory fluid volume by reducing aldosterone production

75
Q

safety assessments

A

review EMR, watch their gate, fluidity of movement, weakness on one side

76
Q

morse fall rating

A

tool to assess risk for fall
includes: history of falling
ambulatory aids
more than one diagnosis/mental status

76
Q

Among adults older, falls are the leading cause of injury fatality

A

true

77
Q

chain of infection

A

● Infectious agent: bacteria, viruses, fungi
● Reservoir: natural habitat of the organism
● Portal of exit: point of escape for the organism
● Means of transmission: direct contact, indirect contact, airborne route
● Portal of entry: point at which organisms enter a new host
● Susceptible host: must overcome resistance mounted by host’s defenses

78
Q

quantitative research: descriptive

A

To explore and describe events in real-life situations, describing concepts and identifying relationships between and among events; often used to generate new knowledge about topics with little or no prior research

79
Q

quantitative research: Correlational

A

To examine the type and degree of relationships between two or more variables; the strength of the relationship varies from a –1 (perfect negative correlation, in which one increases as the other decreases) to a +1 (perfect positive correlation, with both variables increasing or decreasing together)

80
Q

quantitative research: Quasi-experimental

A

To examine cause-and-effect relationships between selected variables; often conducted in clinical settings to examine the effects of nursing interventions on patient outcomes

81
Q

quantitative research: experimental

A

To examine cause-and-effect relationships between variables under highly controlled conditions; often conducted in a laboratory setting

82
Q

qualitative research method: Phenomenology

A

Analysis of data provides information about the meaning of the experience within each person’s own reality (e.g., the experience of health or of having a heart attack).

83
Q

qualitative research method: Grounded theory

A

how people describe their own reality and how their beliefs are related to their actions in a social scene. (e.g., coping with a seriously ill child).

84
Q

qualitative research method: Ethnography

A

Developed by the discipline of anthropology, ethnographic research is used to examine issues of a culture that are of interest to nursing.

85
Q

qualitative research method: historical

A

Historical research examines events of the past to increase understanding of the nursing profession today. Many historical studies focus on nursing leaders, but there is increasing interest in the historical patterns of nursing practice.

86
Q

example of affective learning

A

Pt expresses renewed self confidence after physical therapy
Pt values good nutrition and hydration and rest at home

87
Q

ex of cognitive learning

A

Pt can list the signs of thrush
Pt describes measures to prevent nipple cracking
Pt describes the correct procedure for breastfeeding
Pt describes how salt intake affects blood pressure’s

88
Q

ex of psychomotor learning

A

Pt begins protective measures immediately
Pt demonstrates correct procedure for breastfeeding
Pt demonstrates how to change dressing using clean technique

89
Q

eriksons theory

A

Trust vs mistrust (infant)
- need warmth food comfort and trust
Autonomy vs shame and doubt (toddler)
- ages 1-3 years
- gains independence but feeding, dressing and toileting themselves
Initiative vs guilt (pre-school)
- ages 4-6 years
- seeks out new experiences and explores the how and why
Industry vs inferiority (school-aged children)
- gains pleasure by finishing projects and receiving recognition
Identity vs role confusion (adolescence)
- hormonal changes
- acquires sense of self and decides what direction to take in life
Intimacy vs isolation (young adult)
- establish close honest loving relationships
Generativity vs stagnation (middle adulthood)
- involvement in family friends and community
- desire to make contribution to the world
Ego integrity vs despair (late adulthood)
- reminiscence about life provides sense of fulfillment
- fear of dying

90
Q

maslows hierarchy

A

1 Physiologic needs
2 Safety needs
3 Love and belonging needs
4 Self-esteem needs
5 Self-actualization needs

91
Q

cultural assimilation

A

When a minority group lives within a dominant group, many members may lose the cultural characteristics that once made them different, and they may take on the values of the dominant culture.
ie. when people immigrate and encounter a new dominant culture as they work, go to school, and learn the dominant language, they often move closer to the dominant culture. The process and the rate of assimilation are individualized.

92
Q

culture shock

A

when placed in a different culture they perceive as strange.
Culture shock may result in psychological discomfort or disturbances, because the patterns of behavior a person found acceptable and effective in their own culture may not be adequate or even acceptable in the new culture.
The person may then feel foolish, fearful, incompetent, inadequate, or humiliated. These feelings can eventually lead to frustration, anxiety, and loss of self-esteem

93
Q

cultural imposition

A

the belief that everyone else should conform to your own belief system

94
Q

7 rights

A

Right medication
Right patient
Right dosage
Right route
Right time
Right reason
Right documentation

95
Q

cycle of infection

A
96
Q

how to break cycle of infection

A

hand washing
PPE in isolation
keeping skin intact
disposing of sharps properly
immunization
sterilization

97
Q

3 checks for medication administration

A

When the nurse reaches for the container or unit dose package

After retrieval from the drawer and compared with the eMAR/MAR, or compared with the eMAR/MAR immediately before pouring from a multidose container

Before giving the unit dose medication to the patient or when replacing the multi-dose container in the drawer or shelf

98
Q

what is included in a physician order (7)

A

Patient’s name
● Date and time order is written
● Name of drug to be administered
● Dosage of drug
● Route by which drug is to be administered
● Frequency of administration of the drug
● Signature of person writing the order

99
Q

how to clip toenails

A

straight across, do not clip a diabetic pts toenails

100
Q

stages of infection

A

incubation period
prodomal period
full stage illness
convalescent

101
Q

incubation period

A

Organisms growing and multiplying

102
Q

prodomal period

A

person is most infectious, vague and
nonspecific signs of disease

103
Q

full stage illness

A

presence of specific signs and symptoms of disease

104
Q

convalescent period

A

period of recovery from infection

105
Q

types of knowledge

A

traditional
authoritative
scientific
instinctive

106
Q

general system theory (nurse report)

A

This theory describes how to break whole things into parts and to learn how the parts work together in a system
Emphasizes relationships between the whole and the parts and how they function and behave

107
Q

developmental theory

A

Outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death

108
Q

isotonic

A

Muscle shortening and active movement (tone)
Ex. Squats, lunges, push ups

109
Q

isometric

A

Muscle contraction without shortening (no movement)
Ex. Planks and wall sits

110
Q

isokinetic

A

Muscle contraction with resistance
Ex. Bicep curls

111
Q

stages of sleep

A

Non rapid eye movements (NREM)
rapid eye movement (REM)

112
Q

deepest stage of sleep

A

Stage 4

113
Q

obstructive sleep apnea

A

Too much relaxation of muscles cause disruption of air flow
The absence of breathing (apnea)
Diminished breathing efforts (hypopnea)

114
Q

Fowlers position

A

Bed angle between 45-60 degrees

115
Q

Low fowlers

A

15-30 degrees

116
Q

High fowlers

A

60-90 degrees

117
Q

CPAP in obstructive sleep apnea

A

Continuous positive air pressure
Holds airway open

118
Q

Cultural blindness

A

occurs when one ignores differences and proceeds as though they do not exist

119
Q

Common portal of exit

A

● Respiratory
● Gastrointestinal
● Genitourinary tracts
● Breaks in skin
● Blood and tissue

120
Q

Adaptation theory

A

Defines adaptation as the adjustment of living matter to other living things and to environmental conditions
Human adaptation occurs on three levels: self, social (others), and the physical (biochemical rxns)

121
Q

Reticular activating system

A

Facilitates reflex and voluntary movements
Controls cortical activities related to state of alertness

122
Q

Control center for sleeping and waking

A

Hypothalamus

123
Q

Non rapid eye movement (NREM)

A

Four stages
Stages I and II: light sleep, 5%-50%

124
Q

Rapid eye movement (REM)

A

Deepest sleep
20-25% of nightly sleep
HR, RR, BP, metabolic rate, and body temp increases
Skeletal muscle tone and deep tendon reflexes depressed
Dreaming is essential to mental and emotional health

125
Q

Amount of sleep in aging adults

A

Less sleep needed

126
Q

Narcolepsy

A

Excessive daytime sleepiness
70% of people with narcolepsy also experience cataplexy (involuntary loss of skeletal muscle tone lasting from seconds to minutes)

127
Q

what happens if a person is deprived of REM sleep for multiple nights

A

REM rebound- person will spend more time in REM sleep on successive nights, allows the total amount of REM sleep to remain fairly constant over time.

128
Q

more deep sleep occurs in the delta stage (NREM stages III and IV) in the first half of the night, especially if one is tired or has lost sleep

A
129
Q

average amount of sleep for adults

A

8 hours

130
Q

how many REM cycles occur in one night sleep

A

4-5 cycles typically lasting for 90-100 mins

131
Q

recommended amount of sleep time for adults

A

more than 7 hours

132
Q

amount of sleep for older adults and sleep patterns

A

recommendation: 7 to 8 or 9 hours
less sound sleep occurs- shortened periods of REM sleep
stage IV is decreased or absent completely

133
Q

percent of REM sleep in sleep cycle

A

20-25%

134
Q

factors affecting sleep patterns

A

enlarged prostate- may have to urinate more frequently
caffeine
nicotine
alcohol

135
Q

A person’s cultural beliefs and practices can influence rest and sleep

A
136
Q

excessive exercise or exhaustion can decrease the quality of sleep.

A
137
Q

Combining foods that are high in tryptophan (small protein-containing snack) with healthy, complex carbohydrates improves sleep.

A
138
Q

large quantities of alcohol reduce rem and delta sleep

A
139
Q

T/F: lack of sleep is a safety concern

A

true

140
Q

Barbiturates, amphetamines, and antidepressants decrease REM sleep.

A

people with depression are more likely to develop insomnia

141
Q

illnesses associated with sleep disturbances

A

Gastroesophageal reflux (GERD)
Coronary artery diseases
Epilepsy
Liver failure and encephalitis
Hypothyroidism
End-stage renal disease

142
Q

insomnia is chronic when lasting for

A

over 6 months

143
Q

drugs that affect sleep

A

Diuretics
antiparkinsonian drugs,
some antidepressants
antihypertensives
steroids
decongestants
caffeine
asthma medications
Barbiturates,
amphetamines

144
Q

sleep diary key points

A

*Time patient retires

*Time patient tries to fall asleep

*Approximate time patient falls asleep

*Time of any awakenings during the night and when sleep was resumed

*Time of awakening in the morning

*Presence of any stressors the patient believes are affecting their sleep

*A record of any food, drink, or medication the patient believes has positively or negatively influenced their sleep (include time of ingestion)

*Record of physical activities—type, duration, and time

*Record of mental activities—type, duration, and time

*Record of activities performed 2 to 3 hours before bedtime, bedtime rituals, changes in sleep environment

*Presence of any worries or anxieties the patient believes are affecting their sleep

145
Q

sleep hygiene methods

A

dark room, no night light,
cool temp
Quiet,
go to bed same time,
avoid taking diuretics/stimulation meds/foods/coffee/monster or lots of fluids- drink after certain time of day
Avoid napping during the day

146
Q

treatment for dyssomnias: nonpharm therapy

A

Cognitive Behavioral Therapy (CBT):
Progressive muscle relaxation measures
Stimulus control
Sleep restriction; sleep hygiene measures
Biofeedback and relaxation therapy

147
Q

tools to assess sleep disturbances

A

The Epworth Sleepiness Scale
The Pittsburgh Sleep Quality Index (PSQI)
Sleep Disturbance Questionnaire

148
Q

lab data indicating infection

A

elevated WBC count- norm is 5,000-10,000
increased lymphocytes and neutrophil levels
increase eosinophils= allergic response or parasitic infection
elevated ESR= inflammation is present

149
Q

5 moments of hand hygiene

A

before touching patient
before a clean or aseptic technique
after a body fluid exposure risk
after touching a patient
after touching pt surroundings

150
Q

four common hospital acquired infections

Nocicomial time frame- 48 hours

A

catheter-associated UTI (CAUTI)
Surgical site infection (SSI)
central-line associated bloodstream infection (CLABSI)
ventilator-associated pneumonia (VAP)

151
Q

infections that require contact isolation

A

vancomycin-resistant enterococci (VRE)
C. Diff
MRSA

152
Q

infections that require airborne precautions

A

TB
varicella
rubeola
covid

153
Q

infections that require droplet precautions

A

influenza
ubella,
mumps,
diphtheria
adenovirus infection

154
Q

body’s defense against infection

A

body’s normal flora
inflammatory response
immune response

155
Q

C Diff is not killed by alcohol-based handrubs, so soap and water are required.

A
156
Q

correct order to DON PPE

A

gown
mask
glasses/face shield
gloves

157
Q

correct order to doff PPE

A

untie gown
remove gloves
remove goggles
remove gown
remove mask

158
Q

Freuds developmental stages

A

oral stage- 0 to 18 months
anal stage- 8 m to 4 years
phallic stage- 3-7 years
latency stage- 7 to 12 years
genital stage- 12-20 years