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Fundamentals > Exam 2 > Flashcards

Exam 2 Flashcards

0
Q

1T = tsp

A

3tsp

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1
Q

1t = mL

A

5mL

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2
Q

mL = 1ounce

A

30 mL

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3
Q

1 kg = lb

A

2.2 lb

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4
Q

1000 mcg = mg

A

1 mg

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5
Q

1,000 mg = g

A

1 g

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6
Q

1,000 g = kg

A

1 kg

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7
Q

1,000 mL = L

A

1 L

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8
Q

Nurses spend ____ of their time giving Meds

A

40%

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9
Q

JC national patient safety goal #3

A

Improve safety of using medication

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10
Q

Medication order must contain

A

Pt full name, date and time written, name of drug, dosage, route, how often, reason for drug, signature of prescriber

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11
Q

6 rights

A

Pt, drug, route, time, dose, documentation

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12
Q

Right pt

A

Check pt ID against MAR, 2 pt identifiers

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13
Q

Right drug

A

By generic or trade name, should check label 3 times, know why pt is on Meds, always know what drug giving

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14
Q

Right route

A

Must be stated in order, never assume

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15
Q

Right time

A

Normally by institution, have an hour before or after time to administer, q6h (round the clock 6 12 6 12) QID (4 times while awake 9 1 4 8)

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16
Q

Exceptions for times

A

STAT (w/in 30 minutes), PRN, when peak and trough ordered (blood test before and after drug given)

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17
Q

Right dose

A

Must be on order, nurse should know recommended dose, accurately calculate any drug calculations, never use trailing zeros, always use leading zeros

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18
Q

Right documentation

A

Must document when given, when in doubt call previous nurse to make sure Meds were given, document in MAR

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19
Q

If patient is concerned

A

Recheck med and order

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20
Q

Always watch

A

Patient take Meds

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21
Q

Never give

A

Meds prepared by someone else, Meds from unlabeled container

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22
Q

Never leave ____ or try to ____

A

Meds unattended or try to multitask

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23
Q

Safety is

A

Freedom from danger, harm or risk; underlies all nursing care; responsibility for all healthcare provider

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24
Q

Medical errors are the ____ leading cause of death in the US (CDC)

A

6th

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25
Q

Many people die each year from medical errors that could have

A

Been prevented

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26
Q

Joint commission safety goals (1-4)

A
  1. Improve accuracy of patient identification
  2. Improve effectiveness of communication among caregivers
  3. Improve safety of using medications
  4. complete medication reconciliation
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27
Q

Joint commission safety goals 5-9

A
  1. Reduce risk of health care associated infections
  2. Reduce risk of patient harm resulting from falls
  3. Prevent health care associated pressure ulcers
  4. Identifies safety risks inherent in its patient population
  5. Universal protocol for preventing wrong site, wrong procedure, wrong person surgery
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28
Q
  1. Improve accuracy of patient identification
A

Use 2 identifiers (name, DOB, hospital assigned medical number), be aware of confused patients

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29
Q
  1. Improve effectiveness of communication among caregivers
A

Repeat and verify orders, use standard abbreviation list, timely reporting of critical lab/test results, use reporting off guide like ISBARR

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30
Q

ISBARR

A

Identity, situation, back ground info, assessment findings, recomendation, repeat and verify orders

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31
Q
  1. Improve safety of using medications
A

Reduce risk of med error, use the 6 rights

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32
Q

Reporting a medication error

A

Assess VS LOC and labs, assess for effects of Meds, contact the prescriber charge nurse and nursing supervisor, fill out paper work, monitor client, modify practice to prevent error

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33
Q
  1. complete medication reconciliation
A

Procedure that prevents med error through ongoing assessment and updating the patients med list, verification (collect all of current Meds) clarification (professional review of Meds), reconciliation ( investigation of discrepancies and doc changes

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34
Q

complete medication reconciliation should be done on

A

Admission, status change, transfers, and at discharge patients should be given accurate list

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35
Q
  1. Reduce risk of patient harm resulting from falls
A

Complete fall-risk assessment (various tools, pt assessment rounds), administer the “get up and go test”, identify high fall risk patients on door chart and armband

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36
Q

Interventions for 6. Reduce risk of patient harm resulting from falls

A

Assisting w/ activities, bed/ chair alarm, non skid socks, 3 rails up, bed in low, call light within reach and restraint as a last resort.

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37
Q

What do we do if a patient falls?

A

Call MD, fill out report

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38
Q

Fire safety RACE

A

R- rescue an remove all patients in immediate danger
A- activate fire alarm
C- contain the fire, close doors and windows turn off o2 supply and electrical equipment
E- evacuate patients and others to safe area/ extinguish the fire if trained to do so

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39
Q

QSEN

A

Quality and safety education for nurses

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40
Q

QSEN competencies

A
  1. Patient centered care
  2. Teamwork and collaboration
  3. Evidence based practice
  4. Quality improvement
  5. Safety
  6. Informatics
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41
Q

Patient centered care

A

Be the patient advocate, encourage family and patient to be involved in care, listen to patient and family concerns

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42
Q

Teamwork and collaboration

A

Communication is key to preventing medical errors, patient safety is a responsibility of all healthcare teams and members including MD residents radiology specialists nutrition nursing

43
Q

Safety includes both

A

System and human errors

44
Q

Sentinel events

A

An unexpected occurrence involving death or serious injury

Sentinel because they require immediate investigation and response

45
Q

Root cause analysis

A

A process for identifying the factors that underlie variation in performance; a reactive response

46
Q

FEMA

A

Failure modes and effects analysis

A systemic evaluation of a process and a look at each step in the process that can fail; a proactive approach

47
Q

Evidence based practice

A

Using the best current evidence with clinical expertise and patient/ family preferences and values for optimal care

48
Q

Quality improvement

A

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

49
Q

Informatics

A

Use information and technology to communicate, manage knowledge, mitigate error, and support decision making

50
Q

Nurse diagnosing

A

Refers to the reasoning process, statement regarding the nature of a phenomenon, consists of problem statement with diagnostic label plus etiology (cause)

51
Q

NANDA

A

Part of the diagnostic label, North American Nursing Diagnostic Association

52
Q

Actual Diagnostic

A

Problems at the time of the assessment, presence of associated sign and symptoms

54
Q

Risk diagnosis

A

Problem doesn’t exist, has risk factors, weak and dizzy=fall risk; doesn’t normally include “as evidence by”

55
Q

health promotion diagnosis

A

preparedness to implement behaviors to improve their health condition; beginning phrase “readiness for enhanced”

56
Q

wellness diagnosis

A

describes human responses to levels of wellness in an individual family or community; beginning phrase “Readiness for enhanced”

57
Q

syndrome diagnosis

A

used when diagnosis is associated with a cluster of diagnoses; example: disuse syndrome rape-trauma syndrome

58
Q

problem statement in nursing diagnosis

A

describes pt response to health problem, leads to outcome

59
Q

Etiology of nursing diagnosis

A

all related factors and risk factors included; identifies one or more probable causes of health problem

60
Q

As evidence by statement in nursing diagnosis

A

signs and symptoms, evidence that supports diagnosis

61
Q

the three main parts of a nursing diagnosis

A

NANDA (diagnostic label), Etiology, as evidence by statement

62
Q

tips for writing outcomes and goals

A

client centered, clear, measurable, time limited, realistic, blue print for evaluation

63
Q

measurable terms

A

identify, describe, demonstrate, verbalize, discuss

64
Q

nursing interventions

A

can be independent or dependent (from md)

65
Q

steps of the implementation

A

reassessing client, determine nurse’s need for assistance, implementing nursing intervention, supervising delegated care, documenting nursing activities

66
Q

evaluation of nursing intervention

A

collect data for outcomes, draw conclusion about problem, modify or terminate care plan

67
Q

parts of the nursing process

A

assessment, analysis, planning, implementation, evaluation

68
Q

assessment

A

collecting all pt data

69
Q

analysis

A

nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs; the nursing diagnosis; always prioritized

70
Q

planning

A

Based on the assessment and diagnosis, the nurse sets measurable and achievable short- and long-range goals for this patient; the goals and outcomes

71
Q

implementation

A

Nursing care is implemented according to the care plan Care is documented in the patient’s record; interventions or actions; only includes one assessment (normally first)

72
Q

evaluation

A

Both the patient’s status and the effectiveness of the nursing care must be continuously evaluated, and the care plan modified as needed

73
Q

learning is

A

the rearrangement of neural pathways resulting in a temporary or permanent change in behavior, can occur without teaching

74
Q

cognitive learning

A

knowing

75
Q

psychomotor learning

A

doing

76
Q

affective learning

A

feeling

77
Q

adult learners

A

independent, rises from life challenges, like problem solving, are doers, resistant to learning when conflicts with self concepts

78
Q

child learner

A

little experience to draw on, passive, learn in authority guided situations, subject centered, rely on others to decide what’s important

79
Q

adragogy

A

adult learning

80
Q

pedagogy

A

child learning

81
Q

assess before client education

A

motivation (how it benefits), stages of behavioral change (pre-contemplation, contemplation, preparation, action, maintenance, termination)

82
Q

pre-contemplation

A

I know it’s good but..

83
Q

contemplation

A

I do need to

84
Q

preparation

A

make a plan

85
Q

action

A

doing it

86
Q

maintenance

A

6 months- lifetime

87
Q

termination

A

old behavior is gone

88
Q

self efficacy

A

believing you can do it

89
Q

5 rights of teaching

A

right time, right context, right goal, right content, right method

90
Q

the education process

A

ASSURE model, A-assess S-state objectives S-select media methods materials U- utilize media methods and materials R-require participation E- evaluate

91
Q

ABCD of good objective writing

A

A- include audience(client will…) B-behavior(demonstrate) C-condition(for nurse) D- degree (with 100% accuracy)

92
Q

we remember

A

80% of what we say and do

93
Q

We are ____ for teaching and documenting teaching.

A

legally responsible

94
Q

Body mechanics

A

The efficient use of the body as a machine and means of locomotion

95
Q

Nurse can improve balance by

A

Feet apart (base of support) and flexing hips and knees (lower center of gravity)

96
Q

Factors that affect body alignment

A

Congenital postural abnormalities, problem with bone formation or joint mobility, problem with CNS, trauma, nutrition, mental health

97
Q

Cardiovascular system with exercise

A

Increase efficiency of heart and blow flow through the body, decrease heart rate and BP

98
Q

Cardiovascular system with immobility

A

Increase in cardiac workload pulse rate orthostatic hypotension vein thrombosis (DVT) and valsalva maneuver

99
Q

Virchow triad

A

Part oF DVT- damage to vessel wall

100
Q

For DVT

A

Check thigh and calf measurement

101
Q

Musculoskeletal system with immobility causes decrease flexibility or

A

Contractures (freeze in position) or foot drop (permanent plantar flexion)

102
Q

Shearing force

A

Skin sticks to object and tears

103
Q

Adequate hydration is

A

2-3 L

104
Q

What to document when using restraints

A

Document the need to restrain, alternative attempted, observation every hour

105
Q

Must release the restraint every ____

A

2 hours

Fundamentals (4 decks)

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