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NUR 355: Med Surg I > Exam 1 Study Guide: Q > Flashcards

Exam 1 Study Guide: Q Flashcards

1
Q

preventing harm and ensuring the patient’s well-being

A

non-malficence

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2
Q

self-determination or self-management

the right to make ones own decisions

A

autonomy

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3
Q

promotes positive actions to help others

A

beneficence

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4
Q

the nurse’s obligation to tell the truth to the best of their knowledge

A

veracity

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5
Q

the nurse will keep obligations or promises to patients and family

A

fidelity

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6
Q

equality and fairness, all patients should be treated equally and fairly

A

social justice

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7
Q

what is one sign of age related hearing loss?

A

answering questions incorrectly on a consistent basis

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8
Q

caused when sound waves are blocked to the inner ear, due to an obstruction of the external or middle ear, or disorders of these areas

can be d/t otitis media and impacted cerumen

A

conductive hearing loss

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9
Q

exposure to loud noice

A

sensorineural hearing loss

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10
Q

what is the snellen chart used for?

A

visual acuity

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11
Q

what is the ishihara chart used for?

A

assess color vision

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12
Q

what are measures to prevent hearing loss?

A
  • wear earplugs or ear muffs when exposed to loud noise

i.e. shooting guns, concerts, heavy machinery, airport employees, etc.

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13
Q

what are techniques for communicating with the hearing impaired?

A

use a lower tone of enhance reception

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14
Q

loss of central vision

  • affects the part of the eye responsible for central vision, fine detailed vision, and blindness.
A

macular degeneration

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15
Q

what are risk factors for macular degeneration?

A

high cholesterol
diabetes

hypertension
obesity
decreased zinc levels
smoking
age older than 60
female
Caucasian
family hx

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16
Q

s/s of cataracts

A

blurry vision

halo vision around light sources
fading or yellowing of colors
double vision in a single eye

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17
Q

risk factors of cataracts

A

diabetes
sun exposure

other chronic medical conditions at higher risk for cataracts
patients with autoimmune diseases have higher risk from chronic steroid use

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18
Q

what are important points about cataract surgery?

A
  • decreased vision is an unexpected finding and could indicated infection
  • slight eyelid swelling, mild eye itching, and scant drainage and normal
  • sleep on the unoperated side/back to promote drainage of IOP

mydriatic drops will dilate and be prescribed for surgery prep.
wear a prescribed eye patch to reduce eye movement, decrease discomfort, and for eye protection

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19
Q

how should a patient be positioned post-op following eye surgery?

A

positioned 30 - 45 degrees post-op to reduce intraocular pressure

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20
Q

what are important points following middle ear surgery?

A

rapid bending from waist should be avoided for 3 weeks (no mopping, vacuuming, etc)

  • patient will not be able to hear for several weeks after surgery
  • dr will remove dressing at f/u appointment
  • wait till POD1 to wash their hair
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21
Q

what is one way to prevent cataracts?

A

wearing sunglasses

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22
Q

what are precautions for a client with glaucoma?

A
  • increased intraocular pressure, client should avoid/minimize activities that further increase IOP

i.e. heavy lifting, straining during a bowel movement, sneezing, coughing and bending over

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23
Q

increased IOP that causes damage to optic nerve - loss of vision and blindness in sever cases

A

glaucoma

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24
Q

treatment for glaucoma

A

use eye drops daily for life

  • including miotics to constrict the pupils, carbonic anhydrase inhibitors to decrease aqueous humor production, and beta-blockers to decrease IOP
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25
Q

what are important points around glaucoma screening?

A

55+ recommended to have glaucoma screening every 1-2 years

tonometer - measures ocular pressure in clients with glaucoma

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26
Q

what are important points when administering eye drops?

A
  • wash hands
  • pull bottom eyelid down and instill the prescribed number of drops
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27
Q

what is an expected finding with Meniere’s disease?

A

bilateral or unilateral hearing loss

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28
Q

what are important points for a patient with vertigo?

A

change positions slowly with these patients - dangle legs

  • may require nausea medication
  • should evenly space out fluid intake throughout the day
  • fall precautions
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29
Q

what are important points with ototoxic medications?

A

gentamycin:
monitor peak and trough levels because gentamycin may be ototoxic and cause tinnitus/hearing loss

ototoxic meds are commonly associated with inner ear disorders (tinnitus)

have patient’s with tinnitus keep diary of what they were doing when it occurred, including date/time/symptoms experienced

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30
Q

what does a sudden onset of floaters in the field of vision indicate?

A

retinal detachment

31
Q

s/s of bacterial conjunctivitis

A

purulent eye drainage

  • feeling of sand in the eye
32
Q

s/s of viral conjunctivitis

A

pink and inflamed sclera and conjunctiva

  • pink eye
  • tearing, often bilateral
33
Q

s/s of chlamydial conjunctivitis

A

photophobia

sticky eye, mucous discharge, tearing

34
Q

what are important points about collaborating care?

A

the patient is the center of the team, and our goal is to facilitate healing

there are always other options to consider to reach that goal, and it is important to involve the patient and family in these options

35
Q

what is the process for choosing a rehab hospital for the patients?

A

case management will provide options for the patient and they will choose the venue

36
Q

what is the role of speech therapist?

A

assesses, diagnoses, and treats patients with disorders relating to speech, language, swallowing, voice, and cognitive - communication

common in stroke patients

develops specific exercises and recommends food consistencies for patients with dysphagia, dysarthria, and a tracheostomy to help prevent complications

37
Q

what are the 6 cultural specifics that influence health?

A

communication
space
time orientation
social organization
environmental control
biological variations

38
Q

cultural language

A
  • language differences present one of the most difficult obstacles to providing individualized, patient-centered care
39
Q

biological orientation

A

include ways in which people are different genetically and physiologically, including body variations and drug metabolism

create susceptibility to certain diseases and injuries and explain differences in response to treatment

40
Q

cultural space

A

person’s personal space, or the boundaries that determine how close another person can be to another person

41
Q

time orientation

A

two dimensions:

  1. related to clock time versus social time
  2. relates to whether the culture is predominantly concerned with the past, present, or future
42
Q

important points about the right to informed consent?

A
  • during pre-op teaching if the client has questions about the procedure, you need to contact the doctor who will be performing the procedure

0 do not let a patient sign a consent form if they have not spoken to the doctor or if they have questions for the doctor

43
Q

HIPAA?

A

health insurance portability and accountability act

standards that protect the confidentiality, integrity, and availability of data as well as standards that define appropriate disclosures of identifiable health information and patient rights protection

44
Q

classification system that considers the size of the tumor, burden of the disease, and extent of disease

A

staging

45
Q

tumor, node, and metastasis x-unable to evaluate

0 - no evidence
1-4 severity

i.e. T1N3Mx

A

TNM staging

46
Q

s/s of bladder cancer

A

hematuria
abdominal discomfort
distended abdomen
low back pain

47
Q

ways to prevent skin cancer

A

SPF 30
dark/UV protected clothing

stay of of the sun between 1000 - 1600

48
Q

at what ages should women get annual breast exams?

A

40+:
should have an annual clinical breast examination because of the increased risk after age 40

20 - 39yo:
should have clinical breast examinations every 3 years

49
Q

important points following a skin biopsy

A
  • erythema, edema, increased pain, or drainage develops, clean the site with hydrogen peroxide
  • bandage should be changed daily
  • showering is allowed the day after the biopsy
  • small amount of red drainage is normal
  • may take one or two weeks for the site to heal
50
Q

who is at increased risk of obesity related chronic disease?

A

increased risk for type 2 DM, heart disease, and high blood pressure

BMI: 25 to 34.9
waist circumference in men >102cm (40 in)
waist circumference in women > 88cm (35 in)

51
Q

what are signs of alcohol withdrawal syndrome?

A

tachycardia
irritability
tremors

52
Q

how do you determine which patient to see second?
MAAUAR

A

M = mental status change
A = acute pain
A = acute impaired urinary elimination (< 30ml/hr or 6hrs since foley removal and anuria occurs)
U = untreated
A = abnormal labs
R = risks

53
Q

what are examples of negligence and malpractice?

A
  • failure to document
  • failure to assess and monitor patient
  • not following standards of care
  • improper delegation
  • failure to communicate critical labs
54
Q

what are patients rights?

A
  • refuse care or meds
  • right to medical records
  • continuity of care
  • confidentiality
  • privacy
  • explanation of their bill
55
Q

5 primary documentation guidelines

A

factual
accurate
current
organized
complete

56
Q

5 primary documentation guidelines

A

factual
accurate
current
organized
complete

57
Q

tuning fork on the head tests for what?

A

bone conduction

58
Q

hardening of the inner ear bones
can lead to conductive hearing loss

A

otosclerosis

59
Q

what condition causes tunnel vision?

A

Glaucoma

60
Q

important points for post-op glaucoma surgery?

A

use stool softeners to prevent straining and increased IOP

keep head of bed elevated 35045 degrees to reduce IOP

61
Q

who evaluates a patient who had a stroke, difficulty swallowing, and failed swallow study

A

speech therapist

determine diet order, liquids

62
Q

can HIPAA protect patient and prevent provider from reporting STD test results to the state?

A

No

63
Q

in TNM staging, how do we know if there is lymph node involvement?

A

indicated by the N-N3-3 nodes involved

64
Q

s/s of bladder cancer

A

lower abdominal pain
hematuria

65
Q

is a patient who takes opioids daily for chronic pain/long term that experiences tremors when a dosed is missed addiction?

A

No

physical dependence
strong genetic component w/addiction for alcohol, nicotine, hard drugs

66
Q

what is a long-term effect of macular degeneration and untreated glaucoma?

A

blindness

67
Q

what condition is a 65 yo women with high cholesterol at risk for?

A

macular degeneration

68
Q

how do we administer ear drops to an adult?

A

pull pinna up and back

69
Q

patient with stage four T3, N3, M1 - are there lymph nodes involved? has it metastasized?

A

yes - 3 lymph nodes
yes - metastasized

70
Q

macular degeneration:
modifiable risk factors

A

high cholesterol
diabetes
obesity
decreased zinc levels
smoking

71
Q

macular degeneration:
non-modifiable risk factors

A

age older than 60
female gender
caucasian race
family hx

72
Q

primary prevention initiatives include:

A

risk factor modification (avoiding carcinogens)
immunization
chemoprevention

73
Q

continued use leads to a breakdown in patters of daily living

A

addiction

74
Q

increasing frequency and amount of use

A

drug dependency

NUR 355: Med Surg I (6 decks)

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