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Exam One Flashcards

1
Q

What are the goals of healthy people 2030

A

attain high quality, longer lives free of preventable disease, disability, injury, and premature death

achieve health equity, eliminate disparities, and improve the health of all groups

create social and physical environments that promote good health for all

promote quality of life, healthy development and healthy behaviors across all life spans

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2
Q

What are some factors that effect health outcomes?

A

economic stability (employment, income, expenses, debt, medical bills support)

neighborhood and physical environment (housing, transportation, safety, parks, playgrounds, walkability)

education (literacy, language, ECE, vocational training, higher education)

food

community and social context (social integration, support systems, community engagement, discrimination)

health care systems

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3
Q

What are the levels of prevention?

A

primordial (large scale political changes or social changes effecting the community)

primary (prevent disease before it begins)

secondary (early detection/screening)

tertiary (treatment of diagnosed disease)

quaternary (weighing the risks vs. benefits)

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4
Q

What are the ethical principles of community nursing?

A

respect for autonomy

non-maleficence

beneficence

justice

fidelity

veracity

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5
Q

Non-Maleficence

A

do no harm

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6
Q

beneficence

A

risks and benefits

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7
Q

justice

A

equal care for all

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8
Q

fidelity

A

keeping promises

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9
Q

veracity

A

tell the truth

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10
Q

What are some barriers to healthcare access?

A

lack of health insurance

lack of PCP

perception of needs (patient does not think they are sick or need health insurance)

uneven distribution of services

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11
Q

Medicare

A

65+, ERSD, disabilities

Part A: impatient, skilled nursing

Part B: outpatient services

Part C: EXTRA supplemental insurance

Part D: EXTRA prescription drug coverage

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12
Q

Medicaid

A

for low income familites

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13
Q

Affordable Care Act

A

uninsured who do not qualify for other options

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14
Q

Children’s Health Insurance Program

A

19 and younger who do not qualify for Medicaid

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15
Q

What are vulnerable populations?

A

More likely to develop health problems - include poverty, homeless, etc.

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16
Q

What are the levels of Maslow’s hierarchy from bottom to top?

A

Physiological (air, food, shelter, sleep, clothing reproduction)

Safety and Security (health, employment, property, family and social stability)

Love and belonging (friendship, family, intimacy, sense of connection)

Self-esteem (confidence, achievement, respect of others, the need to be a unique individual)

Self-Actualization (morality, creativity, spontaneity, acceptance, experience purpose, meaning and inner potential)

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17
Q

What is the nurses role for somebody experiencing addicition?

A

provide compassionate non-judgmental care

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18
Q

What is the CAGE assessment questions?

A

C: Cut down on drinking (ever felt like you should)

A: Annoyed by people criticizing your drinking?

G: Guilty about drinking?

E: Eye opener (had a drink first thing in the morning?)

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19
Q

What is the limit of drinks per day for males/females?

A

Males: 2 drinks/day

Females: 1 drink/day

12 oz beer or 6 oz wine

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20
Q

Motivational interviewing

A

Client is the driver, nurse is the guide

How ready are you to quit?

How confident are you in your ability to quit?

How would your life look different if alcohol were not a part of it?

What would motivate you to make a change?

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21
Q

Management of addiction

A

1 promote safety

promote participation in treatment

promote healthy coping skills

promote adequate nutrition

provide client education

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22
Q

Who is at risk for human trafficking?

A

unstable living situation

history of domestic violence

family member who has a substance abuse

runaway, juvenile justice system, foster care

undocumented immigrants

facing poverty or economic need

hx of sexual abuse

addicted

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23
Q

Red flags for human trafficking

A

inability to attend school or unexplained absenses

frequently running away

frequent travel

bruises, withdrawn behavior, depression

lack of control over personal schedule or travel documents

hunger, malnourishment, inappropriate dress

tattoos that can’t be explained

hyperarousal/anger

s/o drug addiction

coached responses

sudden change in behavior, material items (expensive)

references to sex beyond age expected

older boyfriend/girlfriend

change in attention to personal hygiene

daydreaming

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24
Q

Trauma informed care

A

1 safety

choice - it’s the clients choice to leave

collaboration

trustworthiness - develop trust

empowerment - to make decision for self

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25
Q

Hypothermia

A

Core body temperature below 35

Usually accidental

Frostbite could be a side effect

Vulnerable is homeless, alcohol, elderly, young

Signs: cyanotic, tingling, itching

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26
Q

Mild hypothermia

A

32-35 degrees

Symptoms are cognitive

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27
Q

Moderate hypothermia

A

28-32 degrees

symptoms are decreased vital signs, possible hallucinations

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28
Q

Severe hypothermia

A

below 28 degrees

symptoms are absent respirations, absent pulse, ventricular fibrillation, coma, dilated pupils

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29
Q

Hypothermia interventions

A

Warm limbs by placing close to body, do NOT rub, may put in warm water if no numbness

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30
Q

What are the benefits of telehealth?

A

improve outcomes, increase access, decrease costs, decrease hospital admissions

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31
Q

What are the barriers to telehealth?

A

reluctance, insurance not covering it, lack of experience with technology, no internet

32
Q

Risk factors for decreased oxygenation

A

smoking - increase risk of COPD

chemical irritants

air pollutants

disease management

33
Q

How much water should somebody drink per day

A

2000-2500 mL/day

34
Q

How to improve oxygenation

A

smoking cessation - most important!

environmental air quality

vaccination against pneumonia and flu

breathing techniques - pursed lip, tripod

hydration (2000-2500 mL/day)

improve activity tolerance (balance rest with activity)

nutrition (SFF, increase protein, no excess carbs)

coping

35
Q

What are nutritional requirements for somebody dealing with oxygenation issues?

A

Eat SFF

high protein (lean meat, fish, beans, eggs)

no excess carbs

36
Q

RULE for motivational interviewing

A

R - resist telling them what to do

U: understand their motives

L: listen with empathy

E: empower them

37
Q

Assessment findings for somebody undergoing a crisis

A

overwhelmed

difficulty concentrating

disorganized thought process

increased emotional reactions

fearfulness

increased sensory output

38
Q

Situational crisis vs maturational crisis

A

Situational is unexpected, daily living event (ex. new diagnosis)

Maturational is an event that occurs as individuals progress through the life cycle (ex. wedding, child, elderly family member)

39
Q

Priorities for crisis

A

1 safety

communication

40
Q

Interventions for crisis

A

coping mechanisms

counseling

crisis intervention (recognize and implement immediate short term soluations)

41
Q

ABCs of crisis counseling

A

A: achieve rappor

B: boil down the problem - help patient identify problem

C: coping with problem - what is necessary to help patient cope?

42
Q

PTSD assessment findings

A

sleep disorder

emotional numbing

flashbacks

nightmares

hypervigilance

diffculty with relationships

aggression

depression

substance abuse

suicide

43
Q

Medications for PTSD

A

Prazosin - helps with nightmares and sleep problems

44
Q

Assessment findings for perfusion issues

A

dyspnea

edema

cyanosis

pallor

mental status changes

JVD

vital sign abnormalities

45
Q

Non-modifiable risk factors for perfusion issues

A

age

gender

race

family hx

personal health hx

46
Q

Modifable risk factors for perfusion issues

A

smoking

high BP

high cholesterol

obesity

physical inactivity

diabetes

stress

alcohol intake

47
Q

Potential outcomes for perfusion problems

A

hyperlipidemia

HTN

stroke

PVD

PAD

48
Q

Total Cholesterol Normal Levels

A

< 200

49
Q

LDL normal level

A

< 129

50
Q

HDL normal level

A

> 50 for females

> 40 for males

51
Q

Triglyerides normal levels

A

< 150

52
Q

HTN crisis assessment findings

A

rapid onset

blurred vision

Systolic > 180

Diastolic > 120

headache

confusion

53
Q

PAD

A

intermittent claudation

NO edema

pallor to normal color

thin, shiny skin

decreased or absent pulses

hair loss

thick toenails

DANGLE legs

54
Q

PVD

A

aching and rest pain

edema

brown pigmentation

thick, fibrous subcutaenous tissue

normal puleses

ELEVATE legs, compression stockings

55
Q

Interventions for perfusion problems

A

maintain normal BMI

maintain normal BP

diet high in vitamin and minerals

exercise aerobic 30 min 5-6 x a week

stop smoking

alcohol in moderation

stress reduction

skin care

education regarding medications

56
Q

Hyperlipidemia Medication

A

statins

bile acid sequestrants

niacin

fibric acid agents

57
Q

Statins

A

1st line treatment for LDL increases

Monitor cholesterol and liver enzymes before and during therapy

Assess for muscle pain D/T rhabdomyolysis

Assess creatinine levels if pain

avoid alcohol

report N/V D/T potential liver involvement

58
Q

Bile Acid Sequestrants

A

lower LDL by binding bile and increasing excretion

can have GI side effects

decreased absorption of vitamins and minerals

report constipation, N/V, black stools, or sudden back pain

59
Q

Niacin

A

decreases total cholesterol and LDL and triglycerides and increases HDL

Used in combination with statins

Take with meals

Use cautiously in patients with active liver disease, gout, DM

monitor glucose, uric acid, AST, ALT

60
Q

Fibric Acid agents

A

lower triglycerides in combination with statins

monitor cholesterol, glucose and liver enzymes

61
Q

Medication management PVD and PAD

A

aspirin, clopidogrel, cliostazol, pentoxifylline

all could take a couple weeks to work

62
Q

Aspirin and Clopidogrel

A

anti-platelet

decrease risk of arterial thrombus

63
Q

Cilostazol

A

vasodilator, helps intermittent claudication

Monitor bleeding times and platelet count

provide patient education on bleeding and brusing

64
Q

Pentoxifylline

A

vasodilator and anti-inflammatory

decreases blood viscosity & increases blood flow

headache is a common side effect

65
Q

Medication for HTN

A

alpha-adrenergic blockers

angiotensin-converting enzyme inhibitors (ACE)

angiotensin receptor blockers (ARB)

beta-adrenergic blockers

calcium channel blockers

alpa-2 adrenergic agonists

direct vasodilators

thiazide diuretics

loop diuretics

potassium-sparing diuretics

66
Q

Alpa-adrenergic blockers

A

All end in ZOSIN

give first dose at bedtime to minimize first dose syncope

S/E of orthostatic hypotension, change positions slowly

67
Q

Angiotensin converting enzymes ACE inhibitors

A

End in PRIL

can have first dose syncope

can have persistent dry cough

can cause hyperkalemia

risk of angioedema

68
Q

angiotensin receptor blockers (ARBS)

A

end in SARTAN

Can cause angioedema

Back up medication for ACE inhibitors

Can cause angioedema

69
Q

Beta Blockers

A

all end in LOL

can cause bronchospasm - contraindicated in ANY respiratory diagnosis

Can cause bradycardia and avoid in patients experiencing bradycardia or heart block

Check apical pulse prior to administering if less than 60 HOLD medication

If BP less than 110/60 HOLD medication

70
Q

Calcium Channel Blockers

A

End in PINE except diltiazem and verapamil

avoid with severe hypotension

NO grapefruit juice

use in caution with digoxin or another beta blocker as it could result in bradycardia

71
Q

Alpha 2 Adrenergic Agonists

A

can cause sedation - administer at bedtime

take with meals to avoid GI upset

can cause decreased mental acuity and depression

72
Q

Direct vasodilators

A

headache, palpitations, and rapid pulse may develop but should resolve within 10 days

73
Q

Thiazide Diuretics

A

hydrocholorothiazide

can deplete potassium, monitor for hypokalemia

74
Q

Loop Diuretics

A

End in MIDES

monitor for hypokalemia, hyponatremia, and hypomagnesmia

75
Q

Potassium Sparing Diuretics

A

spironolactone

can cause hyperkalemia

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