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NURS 1505- Units 1-3- Exam 1 > Exam 1 material > Flashcards

Exam 1 material Flashcards

1
Q

What should be included in your assessment of a patient?

A
  • Pt. History
  • Physical Assessment
  • Pt’s. Perceived needs
  • Pt’s current and past health practices
  • Values and Lifestyle
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2
Q

When setting priorities on your pt’s care, they should be based on what 5 things?

A
  • Urgency of health problem
  • Tx Plan
  • Pt’s priorities
  • Pt’s values and beliefs
  • Resources avail.
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3
Q

What are the ABCs of oxygenation?

A

Airway, Breathing, and Circulation

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4
Q

What all is included in a CBC Test?

A

RBC, Hgb, Hct, RBC Indices, WBC, and Diff. WBC

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5
Q

What are the possible causes of an increased RBC?

A

Dehydration, Polycythemia vera, High Altitude, and Cardiovascular Disease

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6
Q

What could be the cause of a decrease in RBC?

A

Blood loss, Anemias, over-hydration, Leukemias, Chronic renal failure, and pregnancy

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7
Q

What could be the cause of increased Hgb?

A

Polycythemia, Dehydration, COPD, Heart Failure

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8
Q

What could be the cause for a decrease in Hgb?

A

Blood loss, Anemias, Kidney disease, and Cancer

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9
Q

What could be the cause for an increase in Hct?

A

Dehydration, burns, and hypovolemia

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10
Q

What could be the cause for a decrease in Hct?

A

Acute blood loss, pregnancy, dietary deficiencies, and anemias

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11
Q

What are the possible causes for an increase in WBC?

A

Acute Infections, Tissue necrosis, and collagen disease

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12
Q

What are the possible causes of a decrease in WBC?

A

Viral infections, hematopoietic disease, and rheumatoid arthritis

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13
Q

What are the possible causes for an increase in platelet count?

A

Infections, Polycythemia vera, Acute blood loss, and splenectomy

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14
Q

What are the possible causes of a decrease in platelets?

A
  • ITP (Idiopathic Thrombocytopenic Purpa)
  • Cancer
  • Systemic Lupus Erythematosus
  • Some type of anemias
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15
Q

What are the possible causes for an increase in ALT?

A
  • Hepatitis
  • Mono
  • Acute Pancreatitis
  • Acute MI
  • Heart Failure
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16
Q

What are the possible causes for an increase in AST?

A
  • Liver diseases
  • Acute MI
  • Anemias
  • Skeletal Muscle Disease
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17
Q

Steps to Preparing for Diagnostic Testing

A
  • Instruct the pt and family about the procedure for the diagnostic test (Prep, NPO?, Length of test)
  • Explain purpose of test
  • Instruct the pt and family about activity restrictions related to the testing.
  • Instruct the pt and family on the reaction the diagnostic test may produce (flushing of dye, increase fluids after barium contrast, etc.)
  • Provide the pt. with detailed information about the diagnostic testing equipment.
  • Inform the pt and family about the time frame for when the results will be available.
  • Instruct the client and family to ask an questions so that the health care provider can clarify information and allay any fears.
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18
Q

What are the 3 phases of the diagnostic process?

A

Pre-test, Intratest, and Post-test

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19
Q

A thorough assessment and data collection assists the nurse in determining communication and teaching strategies in which phase of diagnostic testing?

A

Pre-Test

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20
Q

What must a nurse ask a female pt prior to having radiologic studies?

A

the potential for pregnancy

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21
Q

What phase of the diagnostic process focuses on specimen collection and performing/assisting with certain diagnostic testing?

A

Intratest

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22
Q

What phase of the diagnostic testing does the nurse provide emotional and physical support while monitoring the pt as needed?

A

Intratest

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23
Q

What phase of the diagnostic testing does the nurse ensure correct labeling, storage and transportation of a specimen?

A

Intratest

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24
Q

What phase of the diagnostic testing does the nurse focus on the pt care of follow-up activities and observations?

A

Post-test

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25
Q

What phase of the diagnostic testing does the nurse compare previous and current test results and modifies NIs as needed?

A

Post-Test

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26
Q

After testing for arterial blood gases (ABGs) on a patient, how long must the nurse assure pressure is held on the site after removing the needle?

A

5-10 min.

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27
Q

When testing for fecal occult blood, what foods and medicines can cause a false-positive?

A
  • Red meats
  • Raw veggies or fruits (radishes, turnips, horseradish and melons)
  • Meds that irritate the gastric mucosa and cause bleeding (NSAIDs, aspirin, steroids, iron preps, and anticoagulants)
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28
Q

If ingested, what can cause a false negative on a fecal occult blood test?

A

Vitamin C

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29
Q

Clients with ______ cannot undergo an MRI because of the strong magnetic field.

A

Implanted metal devices (Pacemaker, metal hip, etc.)

30
Q

Red dye in tattoos, permanent cosmetics, and people wearing transdermal patches w/ foil backing can be problematic during which diagnostic test?

A

MRI

31
Q

After a liver biopsy, the pt is typically placed on what side? Why?

A

Positioning the client on the biopsy site to apply pressure to prevent bleeding

32
Q

If test results from ____ & _____ are abnormal, the liver biopsy from a client may be contraindicated.

A

PT and Platelet count

33
Q

Morphine sulfate or aspirin, prescribed for pain, is what type of therapeutic drug?

A

Palliative

34
Q

What does a palliative drug do?

A

Relieves the symptoms of a disease but does not affect the disease itself.

35
Q

What does a curative drug do?

A

Cures a disease or condition

36
Q

What does a supportive drug do?

A

Supports body function until other txs or the body’s response can take over.

37
Q

What does a substitutive drug do?

A

Replaces body fluids or substances

38
Q

What does a chemotherapeutic drug do?

A

Destroys malignant cells

39
Q

What do Restorative drugs do?

A

Returns the body to health

40
Q

What is pruritus?

A

Itching of the skin with our without a rash

41
Q

What is angioedema?

A

Edema due to increased permeability of the blood capillaries

42
Q

What it rhinitis?

A

Excessive watery discharge from the nose

43
Q

What is lacrimal tearing?

A

Excessive tearing

44
Q

What are 8 symptoms a common mild allergic response?

A
  • Skin rash
  • Pruritus
  • Angioedema
  • Rhinitis
  • Lacrimal tearing (eye watering)
  • Nausea, Vomitting
  • Wheezing, Dyspnea
  • Diarrhea
45
Q

What are the 7 essential parts of a drug order?

A
  • Full name of client
  • Date and Time the order is written
  • Name of the drug to be administered
  • Dosage of the drug
  • Frequency of administration
  • Route of administration
  • Signature of person writing order
46
Q

What are the 9 parts of a prescription?

A
  • Descriptive information about the client; name, address, and sometimes age
  • Date on which the prescription was written
  • The Rx symbol
  • Medication name, dosage and strength
  • Route of admin.
  • Dispensing instructions for pharmacist
  • Directions for admin to be given to the pt.
  • Refill and/or special labeling
  • Prescriber’s signature
47
Q

Practice Guidelines- Administering Meds

A
  • Question any order that is illegible or that you consider incorrect. Call the person who prescribed the medications for clarification.
  • Be knowledgeable about the medication you administer; know WHY the client is taking them
  • Do not use liquid medications that are cloudy or have changed color
  • If a pt vomits after taking an oral med, report to the charge nurse.
48
Q

What are the 6 “Rights” of Med Administration?

A
  • Right Medication
  • Right Dose
  • Right Time
  • Right Route
  • Right Client
  • Right Documentation
49
Q

What are some of the physiological changes associated with aging that influences medication admin and effectiveness?

A
  • Altered memory
  • Decreased visual acuity
  • Decrease in renal and liver function
  • Less complete and slower absorption from the GI tract
  • Higher portion of fat to lean body mass
  • Decreased organ sensitivity
  • Altered quality of organ responsiveness
  • Decrease in manual dexterity
50
Q

What types of medication cannot be administered by NG or Gastrostomy tube?

A
  • Enteric-coated (EC)
  • Sustained-action
  • Buccal
  • Sublingual
51
Q

What should you do before giving medications through an NG or Gastrostomy tube?

A

Aspirate all the stomach contents and measure the residual volume

52
Q

What is the process of administering medications through an NG or Gastrostomy tube?

A
  • Remove the plunger from the syringe and connect syringe to a pinched or kinked tube.
  • Put 15-30 mL of sterile water into barrel to flush the tube before admin. first medication
  • Pinch or clamp the using before all the water is instilled to avoid excess air entering the stomach
  • Pour liquid or dissolved med into barrel and allow to flow by gravity into the internal tube.
  • If more than one med, administer separately & flush in between.
  • When all medications have been administered, flush with 15-30 mL of warm water to clear the tube.
53
Q

What is the typical size needle for an adult requiring a subq injection?

A

24-26 gauge & 3/8-5/8” long (up to 1” for obese pts)

54
Q

What is the correct size needle for the pt’s requiring an intramuscular injection?

A

20-22 gauge & 1-1 1/2”

55
Q

What are 5 factors that influence the flow rate of IV fluids?

A
  • The position of the forearm
  • The position and patency of the tubing
  • The height of the infusion bottle
  • Possible infiltration or fluid leakage
  • Relationship of the size of the angiocath to the vein
56
Q

What are the 5 QSEN competencies?

A
  • Provide pt- centered care
  • Collaborate with the interdisciplinary team
  • Implement EBP
  • Use quality improvement in Pt care
  • Use informatics in pt care
57
Q

_____ uses data to monitor outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.

A

Quality improvement

58
Q

What ways can nursing students participate in Quality Improvement in the clinical setting?

A
  • Survey completion for clinical sites
  • Assisting w/ chart audits
  • Having a question in mind
59
Q

_____ refers to all errors caused by all members of the health care team or system that lead to pt injury or death.

A

medical harm

60
Q

_____ is the ethical principle that implies a person’s self-determination and self-management.

A

autonomy

61
Q

_____ promotes positive actions to help others; “Do good”

A

beneficence

62
Q

____ emphasizes the importance of preventing harm and ensuring the pt’s well-being; “Do no harm”

A

Nonmaleficence

63
Q

_____ refers to the agreement that nurses will keep their obligations or promises to patients to follow through with care.

A

fidelity

64
Q

______ is the principle in which the nurse is obligated to tell the truth to the best of his/her knowledge.

A

veracity

65
Q

What is SBAR, and what does it stand for?

A
  • SBAR is a formal method of communication between 2 or more members of the healthcare team.
  • Situation, Background, Assessment, Recommendation
66
Q

What are the 5 “Rights” of delegation?

A
  • Right Task
  • Right Circumstance
  • Right Person
  • Right Communication
  • Right Supervision
67
Q

What are some things to note on a patient before activation RRT?

A
  • Increase in HR
  • Decrease in BP
  • Increase in Pain
  • Change in AAO status
68
Q

What is the prioritization of needs?

A

(Red)- Oxygenation
(Orange)- Nutrition, Elimination, Safety, and Fluid/Electrolytes
(Yellow)- Comfort, Sensory, Rest and Activity
(Green)- Sexuality, Spirituality, Learning, and Human Interaction

69
Q

What are the 5 components of the nursing process?

A

Assessing, Diagnosing, Planning, Intervention, and Evaluation

70
Q

What are the 3 types of nursing diagnoses?

A
  • Actual
  • Risk
  • Health Promotion/Wellness
71
Q

The TJC creates what every year?

A

NPSG- National Patient Safety Goals

72
Q

What does QSEN stand for?

A

Quality and Safety Education for Nurses

NURS 1505- Units 1-3- Exam 1 (2 decks)

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