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Fundamentals > Exam 4 Fundamentals > Flashcards

Exam 4 Fundamentals Flashcards

1
Q

examples of therapeutic vs. non therapeutic non-verbal communication

A

therapeutic- head nodding, eye contact, face the pt, silence, active listening, touch, empathy (understand the pt)

non therapeutic- hands on hips, arms crossed, invading their personal space, bad facial expressions, personal opinions, false reassurance, sympathy (sorrow or pity for a pt)

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2
Q

how to talk to a pt that is hearing impaired

A

-talk in a normal tone, speak a little more slowly but not excessively slow

-let them see your lips! speak clearly & at eye level

-well lit, quiet room w/ no distractions

-provide interpreter if asked

-keep it short and simple, one question at a time

-give them time to ask questions

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3
Q

model used for active listening

A

SURETY

Sit at angle facing pt
Uncross legs/arms
Relax
Eye contact
Touch
Your intuition

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4
Q

how to talk to unconscious pt

A

-say their name during interactions

-communicate verbally & by touch

-speak to pt as if they can hear

-explain all procedures

-provide orientation to pt, place, time

-avoid talking about the pt to others in front of them

***hearing is the last thing to go!

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5
Q

how to talk to a pt

A

-simple short sentences
-give one step at a time
-non medical language
-refer to the same body part names they use as well as the proper term

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6
Q

never ask a pt this (therapeutic communication)

A

never ask a pt “why”
.. instead, say “can you tell me the reason you do this…” for example

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7
Q

open ended questions, avoid yes/no questions

A

therapeutic communication

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8
Q

this is a great question to ask your pt

A

“how dow that make you feel?”
**allow pts to express their feelings/share their concerns.

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9
Q

SBAR (communication tool)

A

Situation
Background
Assessment
Recommendation

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10
Q

what is an advantage of SBAR communication tool?

A

-you don’t miss any information in shift report, very detailed.
-reduces med errors & erros
-reduces loss of information
**be clear and concise!

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11
Q

difference between report to provider vs night shift nurse

A

provider- very specific to the problem

nurse- all details

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12
Q

how to make an environment more inducing to learn

A

-quiet, free of distractions
-normal comfortable temp
-well it room
-make sure pt is comfortable (ex: not in any pain)

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13
Q

first thing to teach a pt when teaching them about a dressing change

A

Wash their hands FIRST!
then remove old dressing
then clean it
then apply new dressing

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14
Q

what are the 3 teaching methods based on domains of learning

A
  1. cognitive (occurs when an individual gains info to further develop intellectual abilities, mental capacities, understanding, & thinking processes)
  2. affective (deals w/ learning how to express feelings & emotions & to develop values, attitudes, beliefs needed toward improving health)
  3. psychomotor (involves the development of manual or physical skills, such as leaning how to walk or how to type on a computer)
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15
Q

which type of teaching method has to do with demonstration, practice, returning demonstration, independent projects/games

A

psychomotor

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16
Q

which type of teaching method has to do with group discussion, role play, one on one discussion

A

Affective

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17
Q

which type of teaching method has to do with one on one discussion, group discussion, lecture, role play, independent project/field experience

A

cognitive

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18
Q

what teaching method occurs when an individual gains info to further develop intellectual abilities, mental capacities, understanding, & thinking processes

A

cognitive

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19
Q

what teaching method involves the development of manual or physical skills, such as leaning how to walk or how to type on a computer

A

pyschomotor

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20
Q

what teaching method deals w/ learning how to express feelings & emotions & to develop values, attitudes, beliefs needed toward improving health

A

affective

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21
Q

a pt demonstrating how to give themselves insulin is an example of what?

A

psychomotor teaching method

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22
Q

what type of teaching method is bloom’s taxonomy?

A

cognitive

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23
Q

this involves 6 cognitive behaviors in a hierarchy that increase in complexity.

**used to assess learning at a variety of cognitive levels & strategies to promote higher order thought in students by building on lower level cognitive skills.

A

Bloom’s taxonomy

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24
Q

this is the highest level of cognitive domain in Bloom’s taxonomy, used to be synthesis before it was revived to the newest Bloom’s taxonomy

*give example as well!

A

create

ex: pt will create a meal that will follow their new diet (nutrition)

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25
Q

order of bloom’s taxonomy starting from bottom of the pyramid

A

(bottom) Remember, Understand, Apply, Analyze, Evaluate, Create (top of pyramid)

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26
Q

what is the purpose of client education?

A

to prevent disease and help promotion/coping

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27
Q

what is the first part of the teaching process?

A

Assess the pt’s physical & emotional needs aka their baseline.
THEN plan goals & evaluate the effectiveness of their learning rate aka how much they retained

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28
Q

we do this to evaluate our pt’s learning

A

Teach back- we have the pt teach us back verbally how to do the task

& return demonstration where the pt physically does the task in front of you.

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29
Q

having the pt verbalizing the s/s of infection is an example of what?

A

teach back!

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30
Q

When is teaching most effective?

A

when you’re responding to the learners needs

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31
Q

what to do if you can’t read handwritten provider’s orders or if you don’t understand the order

A

call provider to clarify

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32
Q

this is when most of the medication is in your system

A

the peak

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33
Q

this is when the least amount of medication is in your system

A

trough, so it’s time for the next dose

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34
Q

why do we take peaks & troughs?

A

to make sure medication is at a constant blood level within a safe, therapeutic range

35
Q

when do we check a pt’s trough level?

A

immediately before the next dose (about 30 mins)

36
Q

when do we check for a peak of the medication?

A

it varies, specific to the medication

37
Q

what level of bloom’s taxonomy is the basic level where one recognizes & recalls facts, pt recalls dates

A

Remember

38
Q

what level of bloom’s taxonomy is understanding what the facts mean, the 2nd level

A

Understand

39
Q

what level of bloom’s taxonomy is applying the facts, rules, concepts, & ideas… the 3rd level

A

Apply

40
Q

what level of bloom’s taxonomy is breaking down information into component parts, the 4th level

A

Analyze

41
Q

what level of bloom’s taxonomy is judging the value of information or ideas, the 5th level

A

Evaluate

42
Q

what level of bloom’s taxonomy is combining parts to make a new whole, the 6th / highest level

A

create

43
Q

side effect vs adverse effect of meds

A

side effect: predictable/expected from meds (n/v, diarrhea, dizziness, constipation)

adverse effect: unpredictable/unexpected from the meds (rash, anaphylaxis)

44
Q

this is the opposite of what you expect out of medication, kids are most susceptible to this

ex: child takes Benadryl (antihistamine) which is supposed to make them sleepy, but becomes hyper instead

A

idiosyncratic effect

45
Q

this is when two medications are taken together and the effect is greater (heightened) than when taken 1 med separately

A

synergistic effect

46
Q

if the wrong dose is ordered & the nurse gives the medication, who is responsible?

A

the nurse bc she didn’t ask for clarification from the provider

47
Q

what do you do if a pt refuses a med?

A

document it, find out why they don’t want to take it (don’t ask why!!! Say “tell me the reason…”

notify the provider depending on the med (ex: if it’s a bp med then notify, if it’s a vitamin then don’t notify provider)

48
Q

what would increase our pt’s risk of med toxicity?

A

if the pt has any renal or haptic insufficiency / problems

**kidney disease is a concern bc they can’t excrete the med so all the meds build up in their system

49
Q

what to do with a med that the pt refuses to make?

A

discard it rather than returning it to the original container (unit-dose meds can be saved if they aren’t opened)

** If pt refuses opioid or any controlled substance, follow proper agency procedure by having someone else witness the “wasted” medication.

50
Q

when does a pt need to eat if getting insulin

A

pt needs to eat within 15-30 mins after taking insulin

(Aspart = rapid acting, “get your ass parts moving!”)

51
Q

what are the 7 rights of medication administration?

A
  1. right med
  2. right dose
  3. right pt
  4. right route
  5. right time
  6. right documentation
  7. right indication
52
Q

what to teach a pt about insulin?

A

make sure to rotate site of injection!

53
Q

what is alternative medication besides pharmacology?

A

-herbals / supplements
-Massage, chiropractor, acupuncture, reiki, meditation & breathing, pilates/yoga, art music, biofeedback, guided imagery, dance, tai chi, cupping, moxibustion (burning moxi)

54
Q

what is the herbal medication that can interfere with Coumadin (warfarin)?

what does the med do?

A

Ginseng (herbal that lowers blood sugar, cholesterol, stress)

55
Q

what is the principle behind therapeutic touch?

A

energy of provider brings positive influence into the pt’s energy field

**use a simple touch but make sure it’s ok to touch them .. hand on their hand or hand on their shoulder & listen to what they have to say

56
Q

traditional Chinese medicine

A

yin & yang (opposing yet complementary phenomena that exist in a state of dynamic equilibrium (ex: night/day, hot/cold, and shady/sunny)

57
Q

cold, shade, inhibition, inner part of body (viscera, liver, heart, spleen, lung, kidney)

A

Yin

58
Q

fire, light, and excitement, outer part of body (bowels, stomach, and bladder)

A

Yang

59
Q

what do practitioners believe when it comes to traditional Chinese medicine yin/yang

A

they believe disease occurs with an imbalance in the opposites

60
Q

What is the difference between herbs/supplements vs pharmacological meds?

A

herbs/supplements are NOT FDA regulated and NOT FDA approved.. so herbals are controversial (you can look to see if it’s tested by a third party to make sure it has correct amount in it)

61
Q

evaluate effectiveness of relaxation techniques

A

-lowered HR, RR, BP
-decreased muscle tension
-increased alpha brain activity
-increased peripheral skin temperature
-reduced neural impulses sent to brain (decreased activity of brain & other body systems)

62
Q

what type of pain is sudden, short duration
(ex: incisional pain after surgery, acute injury, disease; maybe
worse when sitting up vs laying down)

A

acute/transient pain

63
Q

what type of pain lasts longer than 3-6 months; always there/doesn’t go away
(ex: back pain from an car accident)

A

chronic/persistent non cancerous pain

64
Q

what type of pain occurs sporadically over extended time period
(ex: migraines, arthritis)

A

chronic episodic pain

65
Q

what type of pain has no identifiable physical or psychological cause
(ex: complex regional pain syndrome (CRPS)
*might be called somatic pain in psych pts

A

idiopathic pain

66
Q

type of pain usually caused by tumor progression, invasive procedures, toxicities of chemotherapy, infection, and physical limitations

A

cancer pain

67
Q

what type of data is pain?

A

subjective! bc nobody has the same pain

68
Q

how to assess pain

A

scale 0-10, called Wong-Baker FACES (provides a pictorial representation of pain intensity, usually used w/ kids)

69
Q

how to assess pain in nonverbal pts

A

FLACC Scale (Face, legs, activity, cry, consolability)

70
Q

who can push a PCA pump?

A

only the patient (watch RR if pt has opioids in pump)

71
Q

what do you monitor if pt has an epidural?

A

RR is priority!!!! also HR.

72
Q

what is a non pharmacological that you can use for back pain?

A

heat, ice, TENS unit (electrical stimulator), relaxation

**adjuvants are pharmacological meds to give w/ main meds to increase the effect aka a synergistic effect

73
Q

what do you do if you’re giving a pt morphine?

A

assess the pt before & after med, check vitals! Hold the morphine if RR is 10… normal RR is 12-20.

74
Q

what are modifiable contributors to pain

A

attention, fear, fatigue, anxiety, coping style

75
Q

what diet will a pt without teeth be on?

A

mechanical soft diet

76
Q

what diet will a pt that is pregnant with no allergies be on?

A

regular diet

77
Q

what diet will the pt be on with constipation and high blood pressure?

A

high fiber diet

78
Q

symptoms of malnutrition?

A

nails will be spoon shaped (koilonychia), brittle, ridged

hair will be stringy, dull, brittle, dry, thin, sparse, depigmented

lips will be dry, cracked

79
Q

A pt this is on this diet could have potential nutritional deficit of protein

A

vegan or vegetarian diet

80
Q

what is the purpose of choose my plate

A

it’s a basic food guide to make healthy, balanced food choices

81
Q

how to tell a blind pt to feed themself?

A

use clock face method, describe where the food is at on the plate according to a clock

82
Q

what is enteral nutrition (feeding)

A

Receive formula via the nasoenteral route (nasogastric, nasoduodenal, and nasojejunal) or
through gastric (GI) tubes inserted into the stomach

** Parenteral nutrition (TPN) = feeding intravenously (through a vein). “Parenteral” means “outside of the digestive tract

83
Q

cultural/religious dietary restrictions for muslims

A

-no pork
-no alcohol
-Ramadan fasting sunrise to sunset for a month; Ritualized methods of animal slaughter required for meat ingestion

84
Q

cultural/religious dietary restrictions for judaism (jewish)

A

-no pork
-no predatory fowl
-no shellfish (eat only fish w/ scales)
-no rare meats, blood (blood sausage)
-no mixing of milk/dairy products w/ meat dishes
-must adhere to kosher food preparation methods
-24 hr fasting of Yom Kippur, a day of atonement
-no leavened bread eaten during passover (8 days)
-no cooking on the sabbath from sundown Friday to sundown

Fundamentals (5 decks)

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