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NURSING 110 JUST US!!!!! > final exam > Flashcards

final exam Flashcards

1
Q

what is actual loss vs perceived loss

A

Actual loss: can be recognized by others

Perceived loss: is felt by person but intangible to others

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2
Q

Maturational loss vs situational loss

A

Maturational loss:experienced as a result of natural developmental process
Situational loss: experienced as a result of an unpredictable event

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3
Q

anticipatory loss

A

loss has not yet taken place

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4
Q

define grief, bereavement, and mourning

A

Grief: internal emotional reaction to loss
Bereavement: state of grieving from loss of a loved one
Mourning: actions and expressions of grief that make up outward expression of grief

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5
Q

Kubler-Ross’s Five Stages of Grief

A 
Denial and isolation
Anger
Bargaining
Depression
Acceptance
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6
Q

palliative vs hospice care

A

Palliative Care:
holistic view of a normal process
goal is best quality of life

Hospice Care:
holistic care to someone with a limited time
to live

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7
Q

define advanced directive

A

Indicate who will make decisions for the patient in case the patient is unable.
Indicate the kind of medical treatment the patient wants or doesn’t want.
Indicate how comfortable the patient wants to be.
Indicate how the patient wants to be treated by others.
Indicate what the patient wants loved ones to know.

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8
Q

what are special orders regarding death and dying

A

Allow natural death, do-not-resuscitate, or no-code Orders
Terminal weaning
Voluntary cessation of eating and drinking
Active and passive euthanasia
Palliative sedation

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9
Q

physiologic needs of dying patient

A

physical needs, such as hygiene, pain control, nutritional needs

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10
Q

psychological needs of dying patient

A

patient needs control over fear of the unknown, pain, separation, leaving loved ones, loss of dignity, loss of control, unfinished business, isolation

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11
Q

needs for intimacy

A

patient needs ways to be physically intimate that meets needs of both partners

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12
Q

spiritual needs of dying patients

A

patient needs meaning and purpose, love and relatedness, forgiveness and hope

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13
Q

what is involved in providing post mortem care

A 
Care of the body
Care of the family
Discharging legal responsibilities
Death certificate issued and signed
Labeling body
Reviewing organ donation arrangements, if any
Care of other patients
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14
Q

postmortem care for familys

A

Listen to family’s expressions of grief, loss, and helplessness.
Offer solace and support by being an attentive listener.
Arrange for family members to view the body.
In the case of sudden death, provide a private place for family to begin grieving.
It is appropriate for the nurse to attend the funeral and make a follow-up visit to the family.

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15
Q

agnostic vs atheist

A

Agnostic: one who holds that nothing can be known about the existence of a higher power
Atheist: person who denies the existence of a higher power

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16
Q

life affirming vs life denying

A

Life affirming: enhance life, give meaning and purpose to existence, strengthen self, are health giving and life sustaining
Life denying: restrict or enclose life patterns, limit experiences and associations, place burdens of guilt on individuals, are health denying and life inhibiting

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17
Q

Obriens spiritual assessment guide includes

A 
Spiritual pain
Spiritual alienation
Spiritual anxiety
Spiritual guilt
Spiritual anger
Spiritual loss
Spiritual despair
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18
Q

nursing diagnoses for spiritual problems

A

Readiness for enhanced spiritual well-being

Spiritual distress

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19
Q

how can you implement spiritual care

A 
Offering supportive presence
Facilitating patient’s practice of religion
Nurturing spirituality
Praying with a patient
Praying for a patient
Counseling the patient spiritually
Contacting a spiritual counselor
Resolving conflicts between treatment and spiritual activities
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20
Q

acronym for joint pain

A

Joint pain:
S: severity
L: location
I : Intensity
D: Duration
A: Aggravating factors ( and alleviating
factors)

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21
Q

fracture classification

A

Closed or open fracture
Oblique, spiral, avulsion, comminuted, compressed, depressed
Complete or incomplete
Stable or unstable

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22
Q

closed fracture is

A

no broken skin

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23
Q

open fracture

A

: open wound
Grade I– clean wound
Grade II– larger but no soft tissue injury
Grade III- highly contaminated with severe
soft tissue injury

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24
Q

complete vs incomplete fracture

A

Complete: break is across the entire cross section of the bone

Incomplete: “Greenstick” break is only partial

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25
Q

biological sex

A

what you are born with

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26
Q

gender identity

A

what you identify as

27
Q

gender dysphoria

A

unsure which one you are

28
Q

scoliosis

A

Lateral curvature of spine
Etiology: idiopathic and acquired
Risk factors: female and quick growth spurt

29
Q

4 phases of sexual response cycle

A

Excitement
Plateau
Orgasm
Resolution

30
Q

alternate forms of sexual expression

A

Voyeurism(peeping toms), sadism, masochism, sadomasochism(pleasure in hurting someone), pedophilia

31
Q

male sexual dysfunction

A

Erectile dysfunction
Premature ejaculation
Retarded ejaculation

32
Q

female sexual dysfunction

A

Inhibited sexual desire
Dyspareunia
Vaginismus
Vulvodynia

33
Q

general levels of sexual history

A

Level 1: part of the comprehensive health history, obtained by a nurse
Level 2: sexual history, obtained by a nurse trained in sexuality
Level 3: sexual problem history, obtained by a sex therapist
Level 4: psychiatric/psychosocial history, obtained by a psychiatric nurse clinician

34
Q

obtaining sexual information

A

Description of the problem
Onset and cause of the problem
Past attempts at resolution
Goals of the patient

35
Q

the better model acronym to ask about sexuality

A

BRING up the topic of sexuality.
EXPLAIN that you are concerned with all aspects of patients’ lives affected by disease.
TELL patients that sexual dysfunction can happen and that you will address their concerns.
TIMING is important to address sexuality with each visit.
EDUCATE patients about the side effects of their treatments and that side effects may be temporary.
RECORD your assessment and interventions in patients’ medical records (Mick, Hughes and Cohen, 2003).

36
Q

define “Quid pro quo”

A

something withheld in exchange for something else

37
Q

normal serum range for magnesium

A

1.5-2.5mEq/L

38
Q

magnesium regulates

A

muscle contraction

39
Q

hypomagnesemia caused by

A

poor dietary intake, poor GI absorption, excessive GI/urinary losses

40
Q

hypomagnesemia what do you see

A

CNS; altered loc, confusion, hallucinations

Neuromuscular: muscle weakness,foot/leg cramps, hyper deep tendon reflexes, tetany, Chvostek’s & Trousseau’s signs

Cardiovascular: tachycardia, hypertension, ECG changes

GI: dysphagia, anorexia, n/v

41
Q

hypomagnesemia what do you do

A

Mild: dietary replacement

Severe: Iv or IM magnesium sulfate

Monitor: neuro, cardiac status and overall safety

42
Q

hypermagnesemia is

A

not common (renal dysfunction is most common cause)

43
Q

hypermagnesemia what do you see

A

Decreased neuromuscular activity

Hypoactive deep tendon reflexes

Generalized weakness

Occasionally nausea/vomiting

44
Q

hypermagnesemia what do you do

A

Increase fluid if renal function is normal

Loop diuretic if no response to fluids

Calcium gluconate for toxicity

Mechanical ventilation for respiratory depression

Hemodialysis

45
Q

calcium participates in and affects

A

blood clotting and cardiac muscle contraction

46
Q

hypocalcemia serum level

A

less than 8.9mg/dl

47
Q

hypocalcemia caused by

A

inadequate intake, malabsorption, pancreatitis, thyroid or parathyroid surgery, loop diuretics, low magnesium levels

48
Q

hypocalcemia what do you see

A

Neuromuscular: anxiety, confusion, irritability, muscle twitching, paresthesias (mouth, fingers, toes), tetany

Fractures

Diarrhea

Diminished response to digoxin
ECG changes

49
Q

hypocalcemia what do you do

A

Calcium gluconate for postop thyroid or parathyroid patient

Cardiac monitoring

Oral or IV calcium replacement

50
Q

hypercalcemia serum level is

A

10.1mg/dl

51
Q

calcium levels

A

8.9-10.1 mg/dl

52
Q

2 major causes of hypercalcemia

A

cancer

hyperparathyroidism

53
Q

hypercalcemia what do you see

A

Fatigue, confusion, lethargy, coma
Muscle weakness, hyporeflexia

Bradycardia and may lead to cardiac arrest

Anorexia, n/v, decreased bowel sounds, constipation

Polyuria, renal calculi, renal failure

54
Q

hypercalcemia what do you do

A

If asymptomatic, treat underlying cause

Hydrate the patient to encourage diuresis

Loop diuretics

Corticosteroids

55
Q

phosphorus is crucial to

A

cell membrane integrity, muscle function, neurologic function and metabolism of carbs, fats and protein

56
Q

phosphorus range

A

2.5- 4.5 mg/ dl

57
Q

Hypophosphatemia caused by

A

Caused by respiratory alkalosis (hyperventilation), insulin release, malabsorption, diuretics, DKA, elevated parathyroid hormone levels, extensive burns)

58
Q

Hypophosphatemia what do you see

A

Musculoskeletal: muscle weakness, respiratory muscle failure, osteomalacia, pathological fratures

CNS: confusion, anxiety, seizures, coma

Cardiac: hypotension, decreased cardiac output

Hematologic: hemolytic anemia, easy bruising, infection
risk

59
Q

Hypophosphatemia what do you do

A

Treat underlying cause

Oral or IV replacement in a sodium chloride or potassium chloride solution

60
Q

Hyperphosphatemia is caused by

A

impaired kidney function, cell damage, hypoparathyroidism, respiratory acidosis, DKA and increased dietary intake

61
Q

Hyperphosphatemia– What do you see?

A 
Think CHEMO
   C = cardiac irregularities
   H = hyperreflexia
   E = eating poorly
   M = muscle weakness
   O = oliguria
62
Q

Hyperphosphatemia– What do you do

A

Low- phosphorus diet
Decrease absorption with antacids that bind phosphorus
Treat underlying cause of respiratory acidosis or DKA
IV saline for severe hyperphosphatemia in patients with good kidney function.

63
Q

swansons 5 caring behaviors

A 
Maintaining Belief
         Knowing
         Being with
         Doing for
         Enabling

NURSING 110 JUST US!!!!! (14 decks)

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