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NURS 356 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Preventing alterations in skin integrity? (IINHPA)

Ice is not hot, poop ass

A 
identification 
inspection
nutrition
hydration 
protection 
assessment
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2
Q

Risk factors for skin integrity are:

IM DD AR M
Im DD, alright mate?

A 
impaired circulation 
medication 
dehydration 
decreased sensation 
age
reduced mobility 
malnourished
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3
Q

alteration in skin integrity is a ___

A

wound

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4
Q

how to classify wounds?

CSCS D

classify scrapes, classify scrapes, duh

A 
cause of wound 
status of skin integrity 
cleanliness of wound 
severity of tissue injury 
descriptive qualities
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5
Q

how to assess the wound?

WWW HTTOP

www. hot topic

A 
what type of dressing 
what the periwound looks like 
what the wound bed looks like 
how much drainage on dressing 
type/amount of drainage
tunneling/undermining 
pain
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6
Q

types of drainage

SSSP

(sss, pus) (sounds like its leaking, get it from a wound?

A

serous
serosanguineous
sanguineous
purulent

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7
Q

where is the top of the wound?

A

towards the head

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8
Q

what unit of measure is used to measure a wound?

A

centimeters

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9
Q

longest part is ___ to___ and widest part is ____ to the length

A

top to bottom

perpendicular

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10
Q

steps to first aid of a wound:

A

stop the bleeding
clean the wound
protect the wound w bandage

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11
Q

function of dressings

A

absorbs drainage

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12
Q

dressings need frequent ___ and ___

A

changing and monitoring

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13
Q

dressings must always have a

A

date, time and initial

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14
Q

pressure ulcers are over ___

A

bony prominence

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15
Q

pressure ulcers are ____ in health facilities

A

prevalent

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16
Q

pressure ulcers can cause:

A

extended stays, sepsis, mortality, cost increase

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17
Q

risk factors for pressure ulcers : AMFS (AMF’s can make you pass out and be immobile)

A

alteration in LOC
moisture
friction
shearing

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18
Q

Braden scale assesses risk in six categories: MF MANS

A 
moisture 
friction/shear
mobility 
activity 
nutrition 
sensory perception
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19
Q

what are the stages of pressure ulcers

A 
unstageable 
stage 1 
stage 2 
stage 3 
stage 4
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20
Q

what is an unstageable pressure ulcer

A

cannot see wound base
full thickness loss
completely obscured by slough or eschar (necrotic tissue)

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21
Q

characteristics of stage 1 pressure ulcer

A

skin is intact
does not blanch
(goal to prevent breakdown)

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22
Q

characteristic of stage 2 pressure ulcer

A

shallow, open ulcer
can be a blister filled w serosanguineous fluid
partial thickness loss of epidermis
red pink wound bed

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23
Q

characteristic of stage 3 pressure ulcer

A 
full thickness loss 
may see subcutaneous fat 
sloughing could be present
eschar could be present (scab)
possible undermining or tunneling
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24
Q

stage 4 pressure ulcer characteristics

A

full thickness loss
exposed bone tendon or muscle
possible slough/eschar
often undermining and tunneling

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25
Q

what is a suspected deep tissue injury?

A

purple or maroon non blanching area or blood blister

can rapidly evolve into ulcer involving all tissue layers

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26
Q

Wound management steps

PERM, KK?

A 
protect wound/periwound 
eliminate dead space 
removed nonviable tissue 
minimize pain 
keep moist 
keep clean, no infection
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27
Q

what must you do when packing a wound?

A 
fill dead space
proper material 
don't over/under moisten
don't leave moist dressing outside wound bed 
fluff material, no tight packing
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28
Q

what is irritant contact dermatitis

A

can occur with soiling
tender and painful
inflammation/erythema
crusting possibly present

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29
Q

diabetic wounds can range from __ to ___

A

superficial ulcers to gangrene of whole foot

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30
Q

complications of wound healing

HIDE from healing

A

hemorrhage
infection
dehiscence (layers of skin and tissue separating)
evisceration (visceral organs through wound opening)

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31
Q

would prevention includes:

PIMO (pima college)

A

pressure reduction
incontinence care
mobility
optimal nutrition

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32
Q

Triangle of safety, from most basic to self fulfilling

PSBES

A 
psio needs (food, water, rest)
safety (security, safety )
belonging/love (relations, friends)
esteem (prestige and accomplishment)
self actualization (creativeness
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33
Q

basic needs of safety triangle (Maslow)

A

physiological (food/water) and safety (safety/security)

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34
Q

psychological needs of triangle (Maslow)

A

belongingness and love (relationships, friends) esteem needs (prestige and accomplishments)

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35
Q

self fulfillment of triangle

A

self actualization (creativeness, recognizing full potential)

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36
Q

injury deaths per year in US

A

193k

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37
Q

leading COD for death ages 1-44 is what?

A

accidental injury

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38
Q

what is the leading type of accidental injury death?

A

drug overdose

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39
Q

what are the top 5 leading causes of death

A

heart disease, cancer, COPD, accidents, stroke

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40
Q

what are physical hazards to injury?

MPD FF

A 
motor vehicle accident 
poison 
disaster 
fire
falls
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41
Q

what factors influence patient safety?

MK LP

A

mobility, sensory, cognitive status
knowledge of safety precautions
lifestyle
patient development level

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42
Q

examples of lifestyle risk factors

A

substance use, dangerous job, risk taker

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43
Q

examples of impaired mobility safety risk factors

A

muscle weakness, paralysis, poor coordination, lack of balance, emotional hazard

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44
Q

examples of sensory or cognitive impairment safety risk factors

A

unable to feel injuries, confusion, can’t perceive danger, unable to express need for assistance

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45
Q

examples for “lack of safety awareness” safety risk factors

A

expiration dates on food or medicine, locking medicines away, firearm safety

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46
Q

common injuries for ages 0-5

A

poison, choking, fire, fall, drowning, head trauma, MVA

47
Q

how to prevent injuries for age 0-5

A

parental education, removal of danger, immunizations

48
Q

common injuries for a school age child:

A

home injury, school injury, traveling between

49
Q

prevention for school age child injury:

A

stranger danger, sports safety, safety equipment, immunizations.

50
Q

common adolescent injuries:

A

MVA, homicide, suicide, substance abuse, risk taking behavior

51
Q

common adult injuries:

A

MVA, suicide, homicide, lifestyle, childbirth, bad nutrition, firearms, substance use or abuse

52
Q

prevention for adult injury:

A

immunization, lifestyle modification, healthy diet, relax techniques, adequate sleep

53
Q

common older adult injuries

A

falls, multiple meds, psychological and cognitive factors, effects of acute and chronic disease

54
Q

prevention of older adult injury?

A

immunization, fall education, environment changes, community resources, safe driving

55
Q

causes of work related musculoskeletal injury:

NON BIT

A

not using assistance
overexertion
not using lift/transfer device
bending, twisting, lifting, pushing beds

improper lifting/bending
transferring patients

56
Q

how to prevent work related musculoskeletal injuries:

KKG, KTFB

A

know capabilities
know patients capabilities
gather right amount of ppl

know facility policy
take advantage of equipment training
follow EBP
body mechanics

57
Q

what is the definition of workplace violence?

A

incidents where staff are abused, threatened, or assaulted in circumstances related to work which includes the commute to and from work

58
Q

What are the types of workplace violence?

A

criminal intent
client on worker
worker on worker
personal relationship

59
Q

___ percent of nurses do not feel safe in the workplace

A

80

60
Q

___ of ER nurses have been physically assaulted at work in one year

A

82

61
Q

___ percent of psychiatric nurses experience disabling injuries from patient assault

A

25

62
Q

__ to __ percent of hospital staff have been physically assaulted at least once in their career

A

35 to 80

63
Q

what can contribute to worker on worker violence

short people stress over work and fear of a powerful hierarch against them

A 
short staffed 
overworked 
stressful patient situation 
fear of litigation 
hierarchies 
floating 
power (nurses eat their young)
64
Q

___ of student nurses report being put down by staff

A

half

65
Q

___ of nurses report having been threatened or experiencing verbal abuse from coworkers

A

half

66
Q

___ percent experience one episode of verbal abuse in the last year

A

90

67
Q

what is QSEN

A

quality and safety education for nurses

68
Q

what is a fall?

A

movement downward, typically rapid and without control from a higher to lower level

losing balance and collapsing

69
Q

intrinsic risk factors for falls in older adults

A

history, impaired vision, postural hypotension/syncope, conditions affecting mobility or balance and gait, alterations on bladder function, cognitive impairment, adverse reactions to meds, slow reaction times

70
Q

extrinsic risk factors for falls in older adults

A

environment hazards, inappropriate footwear, unfamiliar environment, improper use of assistive devices

71
Q

potential results of fall injury:

A

hospitalization, rehab/long term care placement, death

72
Q

how to decrease fall risk in older adults

A

exercise, tai chi, med review, eye exam, decreasing hazards, relaxing, companions, teaching

73
Q

what does the nutritional assessment consist of?

PDMSDPG

A

physical signs, diet history, measurements, self care ability, dietary education, physical environment, general eating patter

74
Q

what is the physical signs of nutrition assessment

A

trouble chewin, poor dentition, muscle wasting

75
Q

what is the diet histroy of nutrition assessment

A

what they eat, preferences, allergies

76
Q

what is the measurements of nutrition assessment

A

height weight, BMI, lab values

77
Q

what is the self care abilities of nutrition assessment

A

trouble preparing food, keeping it safe, feeding themself

78
Q

what is the dietary education of nutrition assessment

A

do they know about nutrition

79
Q

what is the physical environment of nutrition assessment

A

do they have a fridge, are groceries close

80
Q

what is the general eating patterns of nutrition assessment

A

do they eat one meal, or snack all day

81
Q

what are therapeutic diets from most normal to most modified?

A

regular, diabetic, low cholesterol, low sodium, high fiber, soft/low residue, mechanical soft, pureed, full liquid, clear liquid

82
Q

what is enteral nutrition (EN)

A

feeding through a tube directly into GI tract. nasogastric tubes, jejunal tubes, gastric tubes

83
Q

what is parenteral nutrition (PN)

A

intravenous nutrition. lipid and fat emulsions. do not connect any other IV lines to the PN IV line

always use infusion line

84
Q

what does the sleep wake cycle do?

A

influences and regulates physiologic functions and behavior

85
Q

what does the circadian rhythm do?

A

influence pattern biological and behavior functions

86
Q

what does the biological clock do

A

synchronizes sleep schedule

87
Q

stage 1 of sleep:

A

NREM, lightest level

88
Q

stage 2 of sleep:

A

NREM, period of sound sleep where relaxation progresses

89
Q

stage 3 of sleep:

A

NREM, initial stages of deep sleep

90
Q

stage 4 of sleep:

A

NREM, deepest and most difficult to awake from

91
Q

stage 5 of sleep:

A

REM, hard to arouse, dreaming.

92
Q

how many cycles of sleep per night?

A

4-5, REM increases each time

93
Q

what does REM sleep help with?

A

changes in cerebral blood flow and more O2 consumption

helps w memory storage and learning

94
Q

what happens to biologic functions in NREM sleep?

A

HR down
respirations, BP, and muscle tone goes down
basal metabolic rate lowers

95
Q

functions of sleep:

A

increase mental performance
repairs and restores body
improves coping ability
strengthens immune system

96
Q

what can sleep deprivation cause?

OH, CDC?

A

obesity
heart disease

change in immune function
diabetes
cancer

97
Q

what is insomnia

A

difficulty falling and staying asleep

98
Q

what is sleep apnea

A

blockage of breathing occurring for 10 sec 5 or more times in one hour

99
Q

what is narcolepsy

A

fall asleep uncontrollably

100
Q

what is parasomnia

A

undesirable behavior in sleep

101
Q

what is restless leg syndrome

A

desire to move legs while laying down

102
Q

___ percent of workforce is fatigued

A

38

103
Q

more than ___ million Americans suffer from sleep disorder

A

40

104
Q

what are some interventions to help sleep?

A

high carb foods, decaf teas, warm milk. medications are last resort

105
Q

what is the start of “old age”

A

65 years

106
Q

what is the biggest fear of the older population?

A

loss of independence

107
Q

what is delirium?

A

acute and confusional state that may be reversible.

108
Q

what is typically the cause of delirium?

A

physiologic in some form. medication, electrolyte imbalance, infection, untreated pain

109
Q

symptoms of delirium

A

sudden change in LOC, change in speech

110
Q

what is dementia?

A

generalized impairment of intellectual functioning , cerebral dysfunction, syndrome of cognitive and functional decline

111
Q

what percent of older Americans does dementia affect?

A

15 percent

112
Q

___ of the patients in long term care have dementia

A

1/2

113
Q

what is the most common psychiatric disorder in the general population

A

depression

114
Q

what is the number 1 cause of lost quality of life at a global level

A

depression

NURS 356 (6 decks)

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