Exam 3 Fundamentals Flashcards

1
Q

What is PICOT?

A

format to state a foreground question, the more focused your question, the easier it becomes to search for evidence in the scientific literature.

P: pt population of interest (identify pt age, gender, ethnicity, disease or health problem)

I: intervention or area of interest (which intervention is worthwhile to use in practice.. treatment/diagnostic test/prognostic factor)

C: Comparison intervention or area of interest (what is the usual standard of care or current intervention used now in practice??

O: Outcome

T: Time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the levels of research?

A

Level 1: systematic review or meta-analysis of randomized controlled trials (RCTs). evidence based clinical practice guidelines based on systematic reviews (top of pyramid)

Level 2: a well designed randomized controlled trial (RCT)

Level 3: controlled trial without randomization (quasi experimental study(

Level 4: Single non experimental study (case control, correlational, cohort studies)

Level 5: systematic reviews of descriptive & qualitative studies

Level 6: single descriptive or qualitative study

Level 7: opinion of authorities and/or reports of expert committees (bottom of period)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which level of research is a systematic review or meta-analysis of randomized controlled trials (RCTs). evidence based clinical practice guidelines based on systematic reviews (top of pyramid)

A

Level 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which level research is a well designed randomized controlled trial (RCT)

A

Level 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which level of research is a controlled trial without randomization (quasiexperimental study)

A

Level 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which level of research is a single non experimental study (case control, correlational, cohort studies)

A

Level 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

which level of research is systematic reviews of descriptive & qualitative studies

A

Level 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which level of research is a single descriptive or qualitative study

A

Level 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which level of research is an opinion of authorities and/or reports of expert committees (bottom of period)

A

Level 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what can change a pt’s oxygen level?

A

-anxiety
-hypoventilation
-smoking / COPD
-sleep apnea
-nutrition / low iron (anemic)
-hypovolemia (bleeding out)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is a s/s of decreased oxygen?

A

confusion, drowsiness, air hungry aka anxious … so check pulsox!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how to position unconscious vs conscious pt when suctioning?

A

conscious pt: make sure they are not lying down. Have them sit in upright position.

unconscious: have pt lay on their side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

commonly used to promote deep breathing & prevents/treats atelectasis (collapse of alveoli) in a post op pt

A

incentive spirometer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how to prevent respiratory infection after post op?

A

use incentive spirometer, get up & moving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

collection of air in the pleural space, collapse of lung

A

pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how to prevent alveoli collapse?

A

teach pursed lip breathing to pts which involves deep inspiration and prolonged expiration (blowing out candle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what to do if pt has orthopnea?

A

elevate bed to 45 degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

early signs of hypoxia?

A

restlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

signs of hypoxia?

A

clubbing, cyanosis, O2 stat dropping, increased HR and RR at first then declines as it worsens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

modifiable sleep factors?

A

adjust temperature, decrease lights, no alcohol, no spicy food, reduce noise by closing door in the hospital & cluster pt care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How to promote sleep across all age groups?

A

maintain a sleep wake cycle (inside & outside of hospital), establish a nightly routine and maintain it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what to monitor for in a pt w/ narcolepsy?

A

SAFETY!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what causes difficulty sleeping?

A

alcohol, blue light (computer/phone), exercising before sleep, stress, nicotine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

therapeutic communication

A

never ask the pt “why”… use open ended questions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

who will be the best source of info regarding sleep assessment?

A

the patient! unless it involves snoring, then the partner will be a better source

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How can you tell if a pt is resting well?

A

slow & even RR, pt’s eyes will be closed, pt will be still (not tossing/turning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

major sleep center of body?

A

hypothalamus (controls body temp)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

before sending a pt to get a pyelogram, what should you check?

A

their allergies, see if they’re allergic to shellfish/iodine because the test test uses iodine dye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what does a pt need to do after a pyelogram test?

A

drink fluids!!! it will flush the dye out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is a pyelogram? (IVP = intravenous pyelogram)

A

x-ray that uses dye to take pics of urinary tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how to prevent UTIs

A

-clean front to back
-good hygiene
-stay hydrated 6-8 glasses of water per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

how to care for a urinary indwelling catheter?

A

-insert using sterile technique & use smallest size
-Peri care once a shift
-keep bag below bladder
-maintain unobstructed flow/no kinks in tubing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

how to prevent CAUTIs?

A

remove foley as soon as it’s no longer needed, use securing device, no kinks in tubing, keep bag below bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

how to help pt urinate?

A

give privacy so ease the anxiety so their muscles can relax to urinate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

how to insert foley in uncircumcised pt?

A

retract foreskin for insertion then unretract the foreskin back over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what do you do if a pt is unable to empty bladder within 6 hrs of foley removal?

A

bladder scan!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what does incontinence put a pt at risk for?

A

skin breakdown/irritation due to moisture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

how to prevent or help stress incontinence?

A

pelvic muscle exercises AKA Kegels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what info do we need to report for a UA?

A

-glucose in urina
-ketones in urine
-bacteria in urine
-RBC/WBC in urine
-crystals in urine
-protein (up to 8mg/100mL can be normal) but not usually present in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What to do for a pt that needs to use a bed pan?

A

Change HOB to 30-45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

signs of dehydration?

A

-thirst
-less frequent urination, -dark-colored urine
-dry skin
-fatigue
-dizziness
-light-headedness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

common causes of constipation?

A

-ignoring the urge to defecate
-chronic illnesses (Parkinson’s, MS, RA, depression, eating disorders, chronic bowel diseases)
-low-fiber diet high in animal fats (meats, carbs)
-low fluid intake
-stress
-physical inactivity
-meds, like opiates
-changes in routine or life (pregnancy, aging, travel)
-neurological conditions that block nerve impulses to colon (stroke, spinal cord injury, tumor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what causes a pt to be at risk for bowel incontinence?

A

confused/disoriented pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

stool will be more liquid in which type of ostomy? (colostomy or ileostomy)

A

ileostomy because of location (right side aka stool doesn’t have enough time to fully form yet due to location)
**this makes it harder for meds to absorb so pts w/ an ileostomy cannot have coated tablets bc there is not enough time for med to absorb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

a pt w/ an ileostomy cannot have what?

A

coated tablets or extended release meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

when to empty an ostomy?

A

when it’s 1/3 to 1/2 full

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what should the stoma look like?

A

pinkish red, moist (bc it’s the inside of intestine!)

48
Q

what type of NG tube will help with stomach DECOMPRESSION for post op abdominal surgery?

A

Salem sump, Levin, Miller-Abbott

49
Q

what type of NG tube is for enteral feeding?

A

Duo, Dobhoff, Levin

50
Q

what type of NG tube is for compression? (pressure to prevent internal esophageal or GI hemorrhage)

A

Sengstaken-Blakemore

51
Q

what type of NG tube is used for lavage? (irrigation of stomach)

A

Levin, Ewald, Salem Sump

52
Q

what is a pt at risk for w/ diarrhea?

A

fluid and electrolyte imbalances

53
Q

how to position a pt during enema?

A

lying on left side aka left sims position

54
Q

what is a complication for pt’s with an ileostomy?

A

at risk for dehydration due to liquid stool

55
Q

this is a common cause of abdominal fullness, pain, cramping. AKA gas.

A

flatulence

56
Q

what 4 things must be in an APA reference?

A

author, book title, date, publisher

57
Q

signs of constipation?

A

-infrequent bowel movements (fewer than 3 per week)
-hard, dry stools that are difficult to pass

58
Q

carries out gas exchange

A

alveoli

59
Q

Collection of air in the pleural space causing lung to collapse

A

pneumothorax

60
Q

collection of blood and fluid in the pleural space preventing full lung expansion

A

hemothorax

61
Q

2 inhalers

A

-budesonide w/ formoterol (Symbicort)

-salmeterol w/ fluticasone (Advair)

62
Q

Sudden muscle weakness during intense emotions (anger, laughter), can occur at any time during day. Sleep paralysis is a symptom of this.

A

cataplexy

63
Q

Dysfunction of the processes that regulate sleep/waking states. During the day a person suddenly feels overwhelming wave of sleepiness & falls asleep; REM sleep occurs within 15 mins. Take meds such as modafinil to keep person awake

A

narcolepsy

64
Q

Abnormal events occurring during sleep, found to be more common in children than adults.

A

parasomnias

65
Q

type of parasomnia that is sleep walking

A

Somnambulism

66
Q

type of parasomnia that is night time bedwetting

A

nocturnal enuresis

67
Q

type of parasomnia that is teeth grinding

A

bruxism

68
Q

QSEN

A

Quality & Safety Education for Nurses

69
Q

2 sleep aids for insomnia

A
  • eszopiclone (Lunesta)
  • zolpidem (Ambien)
70
Q

the act of urinating voluntarily

A

micturition

71
Q

excessive urine output

A

polyuria

72
Q

decreased urine output

A

oliguria

73
Q

no urine output

A

anuria

74
Q

an increased rate of formation & excretion of urine

A

diuresis

75
Q

An irritated bladder causing a frequent and urgent sensation of the need to void

A

cystitis

76
Q

life threatening bloodstream infection

A

Bacteremia

77
Q

bacteria in urine

A

Bacteriuria

78
Q

medication that relaxes the bladder, treats OAB

A

VESIcare (solifenacin)

79
Q

this medication is a loop diuretic that can decrease edema in lungs and decrease BP. used to treat pulmonary edema, CHF, ascites (extra fluid in abdomen), HTN, etc. **Potassium can drop when taking this, so usually take a potassium supplement

A

Lasix (Furosemide)

80
Q

this has 3 sections: duodenum, the jejunum, and the ileum.

A

small intestine

81
Q

duodenum, jejunum, ileum (small intestine)

A

-duodenum: continues to process chyme from the stomach

-jejunum: absorbs carbohydrates and protein.

-ileum: absorbs water, fats, certain vitamins, iron, and bile salts.

82
Q

these parts of the small intestines absorb most of the nutrients and electrolytes

A

duodenum & jejunum

83
Q

this intestine has the ascending, transverse, and descending colon

A

large intestine

84
Q

this intestine absorbs water, sodium, chloride from digested food that has passed from the other intestine

A

large intestine

85
Q

primary organ of bowel elimination

A

large intestine

86
Q

what helps with flatulence? (gas)

A

massaging, lying on left side, moving around, warm compress

87
Q

this is a method people use to “bear down” to assist in stool passage

(pts w/ cardiovascular disease, glaucoma, increased intracranial pressure, or new surgical wounds are at greater risk fro cardiac dysrhythmias and high bp with this method so they should NOT use this method)

A

valsalva maneuver

88
Q

what your Diet should be like for bowel elimination

A

high fiber (spinach, salads, apples, beans) and staying hydrated! hot fluids are good as well to help w/ constipation/diarrhea

89
Q

what is the greatest danger from diarrhea?

A

fluid & electrolyte imbalances!!!

90
Q

drugs that are used to promote bowel evacuation.

A

laxatives/cathartics

91
Q

the introduction of a solution into the rectum for therapeutic or diagnostic reasons

A

enema

92
Q

this might occur after the bowel is manipulated during surgery. It is the temporary stop of peristalsis.

A

ileus (blockage in bowel)

93
Q

medications that slows everything in the GI tract

A

GLP-1s (ozempic, monjaro,etc) & opiates

94
Q

causes of constipation

A

-Irregular bowel habits
-ignoring the urge to defecate
-Chronic illness
-Diet: low fiber, high animal fats, low fluid intake
-Stress
-Physical inactivity
-Meds, especially opiates, GLP-1
-Changes in life; pregnancy (told to take iron which gives you constipation), travel,
-aging
-Neuro conditions that block nerve impulse to the colon
-Chronic bowel dysfunction

95
Q

signs of dehydration

A

Thirst (you are already 10% dehydrated when you think to take a sip of water

Less urine than usual

Dark colored urine

Dry skin

Fatigue, Dizziness, Light-headedness

96
Q

Due to location, _______ will contain loose stool and a _________ will contain formed stool.

A

ileostomy loose stool
colostomy formed stool

97
Q

pts with these need to be monitored due to loss of fluids & sodium

A

ileostomies (pts w/ colostomies do not have a fluid/sodium loss)

98
Q

how to asses the abdomen

A
  1. inspect
  2. auscultate
  3. percuss
  4. palpate

**must listen for 5 mins in each quadrant to say no bowel sounds heard

99
Q

this can cause black stools

A

iron

100
Q

what should a pt do before taking stool softeners?

A

increase fluids and fiber!

101
Q

how to give enema

A

Use the Left Sims position so the enema solution goes down into the sigmoid section and does not have to fight gravity and go uphill. (sodium polystyrene sulfonate aka kayexalate is a medicated edema)

102
Q

how to see if NG tube is in the right location

A

use X-ray, listen to sounds, check fluid!

103
Q

preferred NG tube for stomach decompression

A

Salem sump

104
Q

how to care for pt w/ NG tube

A

maintain comfort, perform good oral care due to mouth breathing, keep HOB elevated to prevent aspiration

105
Q

when should you poop to maintain normal elimination pattern in the hospital?

A

1 hr after meal bc mass colonic peristalsis occurs at this time

106
Q

this medication is used to treat GERD

A

Nexium (esomeprazole)

107
Q

medications used to treat constipation

A

-colace (docusate sodium)

-ex-lax (Senna) which can increase HR so be careful w/ cardiac pts

-metamucil (psyllium): bulk forming

108
Q

when to obtain stool species for fecal occult?

A

routine exam for colon cancer for ppl over 50

109
Q

which meds causes GI bleeding?

A

NSAIDS
ASPIRIN

110
Q

why do nurses discourage straining?

A

hemorrhoids & dysrhythmia (abnormal heart beat)

111
Q

this is a method used to help poop by holding breath and bearing down. ***can result in life threatening dysrhythmia!! so avoid in stroke/cardiac pts

A

valsalva maneuver

112
Q

GI bleeds (upper and lower)

A

upper GI bleed: more black

lower GI bleed (red)

113
Q

the most important thing to look for w/ pts w/ diarrhea

A

dehydration

114
Q

bulk forming laxative (high fiber absorbs water & increases intestinal bulk which stretches the intestinal wall to stimulate peristalsis. Also used to mild diarrhea)

A

psyllium (Metamucil)

115
Q

this is a type of emollient or wetting aka stool softeners that are detergent and lower surface tension of fevers allowing water to be absorbed

A

docusate (colace)

116
Q

these pull fluid into the bowel to help soften aka osmotics

A

Saline
Magnesium citrate
Magnesium hydroxide
Sodium phosphate (fleet)

117
Q

s/s of GI bleed

A

dark, black tarry stool, vomit will look like used coffee grounds (partially digested blood)