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Fundamentals of Nursing > EXAM 1 Main Points > Flashcards

EXAM 1 Main Points Flashcards

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1
Q

how do we get from tablespoon to mL

A

tablespoon amount x 3 (teaspoons) x 5 (mL)

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2
Q

6 competencies of QSEN

A

patient centered care
teamwork and collaboration
evidence based practice
quality improvement
informatics
saftey

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3
Q

informed consent 4 rights

A

right to not be harmed
right to full disclosure
right to self determination
right to privacy

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4
Q

goals of EBP (RAPPA)

A

reduce variations
achieve clinical excellence
promote effective interventions and care
provide nurses with EBP
assist in clinical decision making

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5
Q

3 points of EBP

A

individual clinical expertise
patients values and expectaions
best available clinical evidence

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6
Q

QSEN

A

quality and safety of the education for nursing

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7
Q

KSA

A

knowledge, skills, attitiude

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8
Q

report vitals

A

T, P, R, BP + MAP, SpO2 + FiO2, Pain

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9
Q

nursing process ADPIE

A

assessment
diagnosis
planning
inteplementation
evaluation

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10
Q

elevated BP

A

120-129 AND 80-89

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11
Q

stage 1 BP

A

130-139 OR 80-89

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12
Q

stage 2 BP

A

> 140 OR >90

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13
Q

hypertensive crisis

A

> 180 AND OR >120

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14
Q

infection cycle

A

infectious agent
reservoir
portal of exit
means of transmission
portal of entry
Susceptible host

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15
Q

means of transmission

A

direct, indirect, contact, droplet, airborne

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16
Q

neutrophils

A

acute bacterial

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17
Q

lymphocytes

A

chronic bacterial and viral

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18
Q

eosinophils

A

parasitic infections, fungus, allergic reactions

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19
Q

3 bloodborne pathogens

A

HBV
HCV
HIV

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20
Q

top infections

A

UTI
surgical site infection
bloodstream infection
pneumonia

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21
Q

hospitals will not be paid for

A

CAUTI
vascular catheter infection
surgical site infection

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22
Q

contact viruses

A

C. Diff, MRSA

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23
Q

droplet viruses

A

Pertusis
Influenza
Meningitis
pneumonia

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24
Q

airborne

A

MMR
TB
Varicella
Covid

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25
Q

3 failures that decrease patient outcome

A

failure to recognize
failure to rescue
failure to plan

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26
Q

adequate _________ and ____________ of cells help to prevent skin injury

A

nutrition, hydration

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27
Q

adequate _________________ is needed to maintain skin cell life

A

circulaiton

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28
Q

yellow on wipe warmer

A

not warm yet

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29
Q

blinking green on wipe warmer

A

cloth is aging, use first

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30
Q

solid green on wipe warmer

A

cloth is ready

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31
Q

red on wipe warmer

A

cloth is expired, do not use and dispose

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32
Q

skin in elderly

A

thinning of subq and demerla layer
longer time for cell renewal
nail changes (thicker)
decrease activity of sebaceous glands
decrease collagen fiber
predisposed to skin breakdown

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33
Q

6 scores for braden

A

sensory
moisture
activity
mobility
nutrition
friction/shear

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34
Q

gold standard for patient care

A

brushing teeth

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35
Q

diabetic foot care

A

wash with lukewarm water and soap daily
dry feet and in between toes
applying moisturizing lotion but not between toes
check feet daily for blisters, cuts, redness
trim toenails (best to file)
change socks daily
never walk barefoot
examine shoes daily for cracks, stones, nails

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36
Q

one nurse assist

A

stand on weak side

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37
Q

how to walk with cane

A

hold cane on strong side
advance cane
advance weak leg
advance strong leg

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38
Q

second hand smoke

A

heart disease

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39
Q

oxygen + ventilation =

A

perfusion

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40
Q

ABG measures

A

oxygenation and ventilation

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41
Q

wheezes

A

high pitch
bronchoconstriction
Asthma, obstruction, tumor
asthma treatment is bronchodilator
ventilation issue

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42
Q

crackles

A

fine, course
discontinuous
collapsing alveloar sacs
pneumonia
treatment: diuretics, chest percusion

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43
Q

rhonchi

A

secretions in larger airway
Continuous
treatment: deep breath, cough 3 small times, deep breath, 1 big cough
if cannot cough then use suction

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44
Q

normal PaO2

A

60-80

45
Q

if you have a SpO2 of 95% what’s the PaO2

A

80%

46
Q

if you have a SpO2 of 90% what’s the PaO2

A

60%

47
Q

if you have a SpO2 of 80% what’s the PaO2

A

50%

48
Q

if you have a SpO2 of 70% what’s the PaO2

A

40%

49
Q

we need a MAP of at least 60 mmHG to

A

perfuse vital organs

50
Q

cough suppressants

A

give for nonproductive cough

51
Q

cough expectorants

A

give for productive cough

52
Q

what does pressed lip breathing do

A

make exhalation time longer than inhalation by providing resistance

53
Q

nasal cannula is measured in

A

liters/min

54
Q

nasal cannula delivers how many liters

A

1-6

55
Q

over how many liters of o2 should we humidify

A

2L

56
Q

venturi mask delivers how much FiO2

A

24-40%

57
Q

nonrebreather mask delivers how much FiO2

A

80-100%

58
Q

nebulizer

A

fine particles of medications into deeper passages of the respiratory tract where absorption occur

59
Q

bronchodilators can cause

A

tachycardia

60
Q

after we give nebulizer we need to assess

A

heart rate

61
Q

WHAT IS THE FIRST THING WE ALWAYS DO

A

ASSESS

62
Q

if we go into a patients room and we notice change what do we need to do

A

ASSESS

63
Q

room air FiO2

A

21%

64
Q

1L FiO2

A

24%

65
Q

2L FiO2

A

28%

66
Q

3L FiO2

A

32%

67
Q

4L FiO2

A

36%

68
Q

5L FiO2

A

40%

69
Q

6L FiO2

A

44%

70
Q

10L FiO2

A

60%

71
Q

15L FiO2

A

80%

72
Q

20L FiO2

A

90%

73
Q

30L FiO2

A

98%

74
Q

why do we want adequate fluid intake (2-3L)

A

thins mucus and makes easier to cough up

75
Q

calculate C

A

(F-32)/1.8

76
Q

calculate F

A

(Cx1.8)+32

77
Q

smoking is measured in

A

PACK YEAR

78
Q

pulse ox

A

ARTERIAL hemoglobin saturation of oxygen

79
Q

do not use SpO2 in

A

carbon monoxide posioning patients and arrest

80
Q

SMILE incentive spirometry

A

sustained maximum inspiratory lung expander

81
Q

things that interfere with light transmission on a pulse ox

A

outside light sources
carbon monoxide
patient motion
jaundice
dark skin = over estimation

82
Q

things that interfere with arterial pulsations

A

peripheral vascular disease
hypothermia at assessment site
low cardiac output
hypotension
peripheral edema
tight probe
arrhythmias
edema

83
Q

we use CHG baths on patients with

A

central IV lines
PICC lines
mid lines
hemodialysis catheters

84
Q

foley care

A

cleaning perineal area
cleaning 6 inches down tube
tube must be secured to thigh
green clip is clamped
tubing is off floor and no dependent loops

85
Q

do we put up 4 bed rails

A

NO

86
Q

variables leading to back injury in health care workers

A

manual lifts
uncoordinated lifts
exceeding recommended lift weight limits
using out dated techniques
transferring/repositioning uncooperative or confused patients

87
Q

will immobility cause a decrease or increase in cardiac workload

A

increase

88
Q

will immobility cause a decrease or increase in endurance, stability, coordination

A

decrease

89
Q

will immobility cause a decrease or increase in muscle size, tone, and strength

A

decrease

90
Q

will immobility cause a decrease or increase in risk for venous thrombosis

A

increase

91
Q

will immobility cause a decrease or increase in depth and rate of respiration

A

decrease

92
Q

will immobility cause a decrease or increase in urinary statis

A

increase

93
Q

will immobility cause a decrease or increase in risk for contractures

A

increase

94
Q

will immobility cause a decrease or increase in bladder muscle tone

A

decrease

95
Q

will immobility cause a decrease or increase in risk for skin breakdown

A

increase

96
Q

will immobility cause a decrease or increase in sense of powerlessness

A

increase

97
Q

will immobility cause a decrease or increase in sensory stimulation

A

decrease

98
Q

will immobility cause a decrease or increase in bone loss

A

increase

99
Q

will immobility cause a decrease or increase in work of breathing

A

increase

100
Q

clinical site progressive exclusion criteria

A

Physiologically unstable patients
hypotensive
new EKG changes or elevated cardiac enzymes
INR >5 PTT> 100
patient who does not respond to verbal stimuli
suspected spinal trauma and unstable fractues
presence in femoral sheath
thrombolytic administration

101
Q

fowlers degree

A

45-60

102
Q

semi fowlers degree

A

30-45

103
Q

high fowlers degree

A

90

104
Q

low fowlers

A

15-30

105
Q

foot drop is

A

plantar flexion

106
Q

BP cuff length

A

75-100% pts arm circumference

107
Q

BP cuff width

A

37-50% of patients arm circumference

108
Q

cuff is too narrow

A

increased reading

109
Q

cuff is too wide

A

decreased reading

Fundamentals of Nursing (23 decks)

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