Exam 3 Flashcards
● Nurses help clients build skills to be accountable for their own health, feel empowered and to —— for themselves.
Nurses help clients build skills to be accountable for their own health, feel empowered and to advocate for themselves.
what are the goals of client education
○ Health promotion – any activity that works to improve a client’s health
○ Restoration of health – any activity that works to improve the health of a client with an illness or injury
○ Adaptation to permanent illness or injury – assisting a client to adapt their life to accommodate permanent health alterations
- the most important goal is to prevent illness and disease
cognitive domain
the thinking domain; where a client must think through the information presented to them and be able to comprehend the info
affective domain
the domain involving client’s feelings, precisely their values, attitudes, and beliefs.
psychomotor domain
involving the use of hands-on fine and gross motor skills.
- teaching someone how to use crutches
● Think about ways in which you would facilitate understanding in someone with a sensory deficit (like hearing loss).
○ The nurse should assess the client to determine their strengths and deficit. They should then utilize critical thinking and planning to decide on the best course of action for treatment.
- be facing them, speak at a good rate of voice, limit distractions
■ May need to involve a family member for help.
● How would you teach someone who has impaired cognition? (confused)
○ The client may benefit from family involvement and frequent evaluations. The teach back method could also be good based on the level of confusion.
- include other people who are in the room with them
● What is “return demonstration?”
○ Something allowing the learner to perform the skill with feedback. A way in which after being taught the learner shows their understanding of something like checking blood sugar by doing it themselves.
● What are the different teaching strategies?
- Group instruction – involves two or more clients who are obtaining the same learning material simultaneously
- Individual instruction – occurs when the educational session engages only the learner and the teacher and is the most common form.
- Teach back – a method uses to determine the client’s level of understanding by having the client explain back to the nurse the information that was taught.
● What are ways to facilitate learning in the older adult population?
○ Reducing as many distractions as possible, speaking in a low-tone voice, allowing for extra time for instruction, provide further info if needed but in smaller pieces
● Why is it important to assess a client’s “readiness to learn”?
○ In order for client education to be successful the client needs to demonstrate that they are ready to learn and have the ability to engage in education by being present and active.
common household abbreviations
drop (gtt) 10, 12, 15 or 20 gtt = 1 mL
microdrop (mcgtt) 60 mcgtt = 1 mL
tablespoon (Tbsp or Tbs) 1 Tbsp = 3 tsp = 15 mL
ounce (oz) 1 oz = 30 mL
pound (lb) 1 lb = 16 oz
cup (C) 1 C = 8 oz = 240 mL
teaspoon (tsp) 1 tsp = 5 mL
pint (pt) 1 pt = 2 C
quart (qt) 1 qt = 4 C
gallon (gal) 1 gal = 4 qt
● Food-medication interactions - vitamin C helps absorb what?
○ Vitamin C helps to absorb iron, but iron is poorly absorbed with high calcium or antiacids with magnesium.
● What are the different routes of medication administration?
○ Intravenous is fastest followed by intramuscular. Transdermal is the slowest.
○ Oral – medication taken by mouth, absorbed through GI tract.
○ Topical – medication applied directly to skin or mucous membranes.
○ Transdermal – medication delivered through the skin through patches
○ Intravenous – medications are delivered directly to the bloodstream through a vein
○ Intramuscular – the medication is administered directly into the muscle tissue
○ Subcutaneous – medication is injected into the tissue layer between the skin and mucous layer
buccal - a local anesthetic injection into the soft tissue of the cheek, opposite the mandibular molars.
Which ones are fastest acting and Slowest routes of medication administration?
intravenous followed by intramuscular
slowest - transdermal
● What is an incident report? What all should be included in an incident report? (in ATI module)
○ When a nurse completes an incident report the nurse should explain the situation surrounding the error, including what happened, which actions were taken, who was involved, and what might have played into the error occurring.
■ It is important to only state the facts, and know it is considered a legal document.
● What special considerations and actions should we take prior to administering otic medications?
○ Check the clients ear canal for occlusion due to drainage or ear wax (cerumen). Make sure to clean the pinna and external ear canal prior to administration if needed.
- make sure its at room temp, make sure you irrigate if dirty, shake the drops
● Can OTC and herbal medications interfere with other medications? (refer to medication administration module under the section “client medication education” numbers 5 and 6).
Make sure the maintain a complete list of all medications, and include all over the counter and herbal medications. All health care provides need to know about all medications including over the counter ones to avoid duplication or adverse effects.
- make sure they talk with their provider before they start taking new medications
what are the 6 rights to medication administration? What are the additional rights?
○ Right client, right dose, right medication, right route of administration, right time of delivery, right documentation
■ Right to refuse, right assessment, right education, right response/evaluation
● What is medication reconciliation and when does it occur? Why is it important?
○ Is it performed anytime the care of the client is transferred form one health care professional to another, such as when they return to or come to another location.
■ Upon admission
○ Makes sure to ensure the continuity of care, and making sure to update, coordinate, and communication accurate client medication information
● What are some factors that might play a role in how well the medication is working (or not?)
○ Drug-drug or drug-food interaction, an allergy, a nurse or human error, genetics, multi-drug resistant illness, disease state, culture, ethnicity, diet, etc.
● What is a black box warning? (BBW)
○ Is issued on any medication that might produce lethargic or iatrogenic reactions
what are some examples of black box warning medications
■ Loop diuretics, estrogen, iron supplements, naproxen, birth control, aspirin.
what are some examples of potentially fatal drug reactions
Stevens Johnson Syndrome
anaphylaxis
overdosing
what are teratogenic medications
medications that are known to cause fetal defects, pregnancy loss, developmental disabilities, or prematurity
examples of teratogenic medications
■ Cocaine, alcohol, ACE inhibitors, gentamycin, lithium, NSAIDs, tetracycline
● What are components that must be included in a medication order written by a provider?
○ The client’s name, DOB, date and time the order was written, the providers name and title, the name of the drug, the amount to be given, the frequency to be given, the route of administration
● In Jean Piaget’s stages of cognitive development in the sensorimotor stage, what emerges in infants
object permanence and separation anxiety emerge in infants.
● In Jean Piaget’s stages of cognitive development, children do not do what?
children do not think logically but learn to express themselves through language and symbolic gestures in the preoperational stage.
● In Jean Piaget’s stages of cognitive development, when can children begin to have logical thoughts
children can think logically about concrete objects in the concrete operational stage.
● In Jean Piaget’s stages of cognitive development, adolescents can what?
adolescents can reason abstractly and think in hypothetical terms in the formal operational stage.
● Regarding Kohlberg’s theory of moral development:
○ The stage of punishment and obedience is linked to what motivation?
Is linked to the motivation of rules obeyed to avoiding punishment. Individuals make decisions based on the direct consequences that could happen because of their actions, and believing that if something is wrong it will lead to punishment and if something is right there will be no punishment.
● Regarding Kohlberg’s theory of moral development:
○ he stage good boy—nice girl is linked to what motivation?
Being able to gain social approval and being seen as a good person by other people. Primarily focused on conforming to societal expectations and pleasing others to maintain relationships
● Regarding Kohlberg’s theory of moral development:
○ The stage of social contract is linked to what motivation?
Promoting greater good and upholding individual right within society. The ability to understand laws and rules as special tools that can be adapted in certain situations.
identity in self-concept stressors
Identity stressors are as follows: Life events that can threaten self-concept including gender dysphoria, a feeling of incongruity between one’s gender identity and assigned sex at birth; being laid off, downsized, or losing one’s career; separation, divorce, or death of a spouse; or being marginalized or discriminated against because of race or ethnicity.
define identity confusion
- Identity confusion - An unclear sense of self, individuality, and personality resulting from an inability to adapt to identity stressors.
body image in self-concept stressors
Societal attitudes about physical attributes, appearance, and performance that can impact a client’s self-perception of their body image.
role performance in self-concept stressors
This refers to individuals’ perception of how well they perform in roles. There are four types of this: role conflict, role ambiguity, role overload, role strain.
define role conflict
occurs when individuals are faced with two or more role expectations and find themselves unable to meet these expectations at the same time.
define role ambiguity
Refers to the lack of clarity in understanding the actions that need to be taken to achieve proposed goals. It can affect an individual’s understanding of expectations, generate doubts about the achievement of their objectives, and creates uncertainty as to how their performance will be assessed.
define role overload
Occurs when the roles and responsibilities placed upon an individual are greater than their ability to effectively manage them or when they find themselves pressured to respond to the many roles they hold.
define role strain
Occurs when an individual has difficulty meeting the responsibilities of a particular life role or when incompatible demands are placed upon an individual.
self-esteem in self-concept stressors
Life events such as disability, chronic illness, loss of career, change in financial status, feeling irrelevant due to retirement, loss of social support when a spouse is deceased that can impact a client’s self-esteem.
However, positive self-esteem is a protective factor that contributes to better health and serves as a buffer against the impact of negative stressors.
difference between self-concept congruence and incongruence
o Self-concept congruence – occurs when a person’s ideal self is consistent with their actual life experiences.
o Self-concept incongruence - Occurs when a person’s ideal self is not consistent with their actual life experiences.
advocacy
o Advocacy – speaking up for clients’ needs when the clients are unable to speak for themselves and supporting clients to make choices for their own health.
what is advocacy in specifics with client advocacy
o The nurse’s role in client advocacy is unique. The nurse communicates with the client and/or the client’s caregiver to determine special beliefs or wishes. Some clients, for example, do not want to have treatments, surgery, blood administration, or certain medications. The nurse communicates with health care providers, making them aware of these wishes, and discusses other options.
what is palliative care and its purpose
o A specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness.
o Palliative care can begin at a diagnosis and continue alongside the treatment to manage symptoms, pain, effects, and help people to cope.
Swanson’s theory of caring -> maintaining belief
The recognition of faith, in others, in God, or in a higher power.
- helping them to have a positive outlook
Swanson’s theory of caring -> knowing
Being aware of assessment data, influences on the situation, and even resources, and then translating this knowledge into how the situation fits into the bigger picture
Swanson’s theory of caring -> being with
Being physically and emotionally present with another person provides comfort.
Swanson’s theory of caring -> doing for
An action, a performance of tasks or activities, or an attitude
* Skills -> doing their sheets
Swanson’s theory of caring -> enabling
being a guide through life situations and events
Swansons theory of well being -> client well-being
Emphasizes the role of the connection between the nurse and the patient
G—Mg—Mcg
if you need to move grams to mg move 3 to the right
if you need grams to Mcg move 6 to the right
if you need Mcg to grams move 6 to the left
teaspoon and cup conversion
cup (C) 1 C = 8 oz = 240 mL
teaspoon (tsp) 1 tsp = 5 mL
what is a parental medication
any type of injection
what is a enteral
a GI tract digestion
what is the first thing you do when you administer a wrong medication
assess the patient
- check vital signs
What are health disparities? What are some demographic, health status, and socioeconomic factors that impact vulnerable populations?
health disparities - preventable outcomes that might put a patient at an advantage or disadvantage based on things like SEC or race
- race, ethnicity, culture, genetics, poverty (SEC example)
what is the relationship between health disparities and cultural bias?
cultural biases can lead to or be a cause of health disparities
- thinking a client it drug seeking but actually have a injury or illness
what is the difference between emic and etic knowledge
emic - is a cultural insider’s viewpoint of a culture
etic - is an outsider’s viewpoint of a culture
Conversions
King Henry Died By (base) Drinking Chocolate Milk
Kilo
Hecto
Deka
Base -> meter, liter, gram
Deci
Centi
Milli
When doing conversions for one step up or down how much do we move a decimal
If going bigger the decimal gets moved to the left
If going smaller the decimal gets moved to the right
