Final Exam Flashcards

1
Q

Supporting patients right to make healthcare decisions when they are unable to voice their opinions and protecting patients from harm when they are unable to make decisions.

A

patient’s advocate

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2
Q

Changed the way society thought about nurses. Opened up a nursing school and promoted that hand washing is important.

A

Florence Nightingale

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3
Q

3 elements of “Full Spectrum Nursing”

A
  1. clinical judgement
  2. critical thinking, reflective thinking
  3. problem solving
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4
Q

Define Nursing as defined by ANA (American Nursing Association):

A

protection, promotion, and optimization of health abilities - prevention of illness and injury

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5
Q

Minimize risk of harm to patients and providers through both system effectiveness and individual performance.

A

safety

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6
Q

How can nursing improve its recognition as a profession?

A
  • Standardizing educational requirements
  • Uniform continuing education requirements
  • Increased participation of nurses in professional organizations
  • Educating the public about the true nature of nursing practice
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7
Q

6 things QSEN represents (students should poses all 6 of these things by graduation)

A
  1. patient center care
  2. evidence bases practice
  3. teamwork & collaboration
  4. safety
  5. informatics
  6. quality improvement
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8
Q

Authoritative statements of the duties that all RN regardless of role, specialty or population are expected to perform competently.

A

Nursing Standard of Practice

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9
Q

Laws that regulate nursing practice

  • State Boards of nursing
  • Licensure
  • Guide for Professional standards
A

Nurse Practice Acts

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10
Q

When nurses work on behalf of an individual, group, family, or community to improve their health status

A

Indirect care

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11
Q

all people able to receive health insurance/no one without health insurance

A

Affordable care act

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12
Q

Observing, comparing, contrasting, and evaluating the clients condition.

A

Clinical judgement

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13
Q

Involves collecting and analyzing information and carefully considering options for action.

A

Critical thinking, reflective thinking

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14
Q

Considering issues and attempting to find a satisfactory solution.

A

Problem solving

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15
Q

Wound care, IV antibiotics, educating pts. with diabetes.

A

Skilled Nursing

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16
Q

Which organization is directly responsible for regulating the practice of nursing in each state?

A

The State Board of Nursing

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17
Q

Each person has a role, clear understanding of tasks assigned. Compartmental care.

A

Functional Nursing

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18
Q

Diagnosis and treatment of illness, disease or injury. health restoration.

A

Secondary care

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19
Q

Purposeful, analytical thinking that results in a reasoned decision.

A

critical thinking

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20
Q

A nurse who is newly employed at a hospital questions a standard of patient care that does not seem to follow evidence-based practice. The critical thinking attitude she is exhibiting is termed:

A

independent thinking

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21
Q

Phases of the Nursing Process

A
  1. Assessment
  2. Diagnosis
  3. Planning Outcomes
  4. Interventions
  5. Evaluation
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22
Q

How is the Nursing Process Related to Critical Thinking?

A

Nurses use critical thinking skills to solve the problem by using the nursing process.

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23
Q

A unique blend of thinking, doing, and caring for the purpose of effecting good outcome from a patient situation.

A

Full-Spectrum Nursing

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24
Q

What are the model concepts of Full-Spectrum Nursing?

A
  • Thinking
  • Doing
  • Caring
  • Patient situation
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25
Q

What are the components of a theory?

A

phenomena, assumptions, concepts, definitions, and statements/prepositions

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26
Q

worldview or ideology?

A

Paradigm

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27
Q

Symbolic representation of a framework or concepts?

A

Model

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28
Q

The nurse notes that his patient has pitting pedal edema, crackles, and an elevated blood pressure. He concludes that the pt. has fluid volume excess. This is an example of:

A

Theoretical reasoning

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29
Q

Essential concepts of a Nursing Theory

A

person, environment, health, nursing

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30
Q

The nurse that incorporates Hispanic beliefs about “hot and cold” into her plan of care for her client. This nurse is providing care based on the nursing theory of:

A

Madeleine Leininger

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31
Q

Steps of the Nurse Research Process

A
  1. Identify & state the problem
  2. Clarify the purpose of the study
  3. Perform a Literature Review
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32
Q

Systematic collection of data to determine a client’s current and past health status and function status and to determine the client’s present and past coping patterns.

A

Assessment

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33
Q

Assess overall health status: Observation, Physical assessment, and nursing interview

A

Comprehensive Assessment

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34
Q

Name 3 requirements Joint Commission uses regarding patient assessment

A

ALL PATIENTS ASSESSED FOR PAIN, assessments are written, and agency policies are in place related to reassessment and assessment distribution

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35
Q

Perception/feeling of patient, what the patient states.

A

Subjective data

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36
Q

Observable and measurable can be seen, heard, or felt by another. ex: vital signs, inspection of a wound, description of an observed behavior.

A

Objective Data

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37
Q

A clinical judgement about individual, family or community responses to actual or potential health problems and or life processes that the nurse is licensed and competent to treat.

A

Nursing Diagnosis

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38
Q

An actual or potential physiological complication that nurses monitor to detect the onset of changes in a patient’s status

A

collaborative problem

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39
Q

What is 3 part Actual Dx. Process

A

Diagnostic Label related to contributing factors as evidenced y defining characteristics.

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40
Q

Data that influence your conclusions about the client’s health status. Should alert you to look for other ____ that might be related to it. Usually an unhealthy response.

A

cues (significant data)

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41
Q

A broad statement that describes the desired change in a patients condition or behavior.

A

Goal

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42
Q

Individualized to the patient’s needs, developed with the patient, significant other and nurse (mutually determined), documented and shared with health care team to promote continuity.

A

Interventions

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43
Q

Knowing how, when, and why to perform an activity makes the action _________

A

autonomous (independent)

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44
Q

Your decisions and actions with regard to nursing diagnoses and independent interventions.

A

accountable (answering)

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45
Q

One that is prescribed by the physician or advanced practice nurse but carried out by the bedside nurse.

A

Dependent intervention

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46
Q

A clinicians specific orders for a type/group of patients.

A

Standing Orders

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47
Q

Strategies/measures/activities/action that influence patient response

A

outcomes

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48
Q

Focuses on the setting which care is provided

A

structure evaluation

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49
Q

Is done at a specified time. Ex: Pt. will lose 1 pound per week until weight of 180 pounds is achieved.

A

Intermittent evaluation

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50
Q

When does the evaluation process with a patient begin?

A

Whenever contact with patient occurs

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51
Q

Pathology affecting an organ or body system. Experiences are unique to each individual.

A

Illness

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52
Q

What is the goal of using client history assessment tool to gather data about nutrition, exercise, leisure activities, spirituality, and home environment?

A

To increase the client’s awareness of lifestyle choices and his or her role in wellness

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53
Q

5 Stages of Illness Behavior

A
  1. Experiencing symptoms
  2. sick role behavior
  3. seeking professional care
  4. dependence on others
  5. recovery
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54
Q

Created a health grid that plots a person status on health-illness continuum against environmental conditions.

A

Dunn’s Health Grid

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55
Q

Focus on resolving an issue, making a decision.

A

Task groups

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56
Q

Focuses on a patient achieving optimal personal growth to achieve goals. Consists of a specific time frame, goal directed and high expectation of confidentiality.

A

Therapeutic communication

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57
Q

Recommends skills, and attitudes to promote safety.

A

Quality and Safety Education for Nurses (QSEN)

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58
Q

Prevalent in those older than 65 years old; slippery floors, stairs, tubs; low toilet seat, high bed

A

Falls (Risk For Fall)

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59
Q

Death or serious injury happening in a hospital.

A

Sentinel Events

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60
Q

Most frequent assessment you will do as a nurse.

A

Vital Signs

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61
Q

The nurse would monitor the body temperature most closely/frequently in the care of the client with

a. ) an infection
b. ) an infant
c. ) who has experienced a heat stroke
d. ) with a head injury

A

D. head injry

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62
Q

What are the common pulse points

A

apical, carotid, brachial, radial, femoral, popliteal, temporal, and pedal

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63
Q

The quantity of blood pumped out by each contraction of the left ventricle

A

Stroke volume

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64
Q

The nurse is assessing the dorsalis pedis pulses on an 88 year old client. She notes the feet to be cool and assesses weak, thready pulses. The nurses next action would be to:

A

Assess the popliteal and femoral pulses

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65
Q

Respiration’s that are regular but abnormally deep and increased in rate

A

Kussmaul’s Respirations

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66
Q

Gradual increase in depth of respiration, followed by gradual decrease and then a period of apnea.

A

Cheyne-Stokes Respirations

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67
Q

High pitched continuous musical sounds, usually heard on expiration

A

wheezes

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68
Q

Discontinuous sounds usually heard on inspiration; may be high-pitched popping sounds or low-pitched bubbling sounds

A

crackles

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69
Q

A piercing, high-pitched sound heard primarily during inspiration.

A

Stridor

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70
Q

What should the nurse do if there pt has abnormal respiration’s.

A

check pulse ox

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71
Q

The nurse performs a physical examination to:

A

Establish baseline data, identify nursing diagnoses, collaborative problems or wellness diagnosis.

72
Q

Four major skills used in physical assessment in orders

A
  1. ) Inspection
  2. ) Auscultation
  3. ) Percussion
  4. ) Palpation
73
Q

Identifies nursing responsibilities for administration and client monitoring

A

Nurse practice act

74
Q

Defined as what happens to the drug in the body

A

Pharmacokinetics

75
Q

Defined as how the drug affects the body

A

Pharmacodynamics

76
Q

4 processes of pharmacokinetics

A

Absorption, Distribution, Metabolism, Excretion

77
Q

The client has been on a low-protein diet. This will most likely affect which pharmacokinetic process?

A

Distribution

78
Q

Concentration of a drug in the blood serum that produces the desired effect without toxicity

A

Therapeutic Level

79
Q

Occurs when the drug is at its highest concentration

A

Peak Level

80
Q

Occurs when the drug is at its lowest concentration, right before the next dose is due.

A

Trough level

81
Q

One drug interferes with the actions of another and decreases the resultant drug effect, the combined effect is less than that of one drug given alone.

A

Antagonisitc drug reaction

82
Q

What are the 6 rights?

A

Patient, Drug, time, dose, route, documentation

83
Q

Powerful vasodilator that triggers release of inflammatory chemicals that cause the injured area to become red, swollen, and tender.

A

Bradykinin

84
Q

Number 1 thing to stop transmission

A

hand washing

85
Q

Infections acquired in the hospital. Leading cause of hospital complications.

A

Nosocomial

86
Q

Factors the support host defenses

A

adequate nutrition, balanced hygiene, rest/exercise, reducing stress, immunization

87
Q

Hair loss, can be very stressful and affect self-image. An autoimmune disorder, hormonal imbalance, thyroid disease, stress, fever, certain medications or chemotherapy.

A

Alopecia

88
Q

Affected by light, temperature, social activities, and work routines.

A

Circadian rhythms

89
Q

What part of sleep cycle accounts for about 50% or more?

A

NII

90
Q

Sudden muscle weakness during intense emotions such as anger, sadness, or laughter; it can occur at anytime during the day.

A

Cataplexy

91
Q

Most common sleep disorder; have chronic difficulty falling asleep, frequent awakenings from sleep.

A

Insomnia

92
Q

During rounds on the night shift, you note that a patient stops breathing for 20-30 seconds, along with loud snoring and snorting sounds, several times during the shift. This condition is known as:

A

sleep apnea

93
Q

a 4 year old pediatric pt. resists going to sleep. To assist this patient, the best action to take would be:

A

Maintaining the child’s home sleep routine

94
Q

Sense of awareness of position and movement without seeing it

A

Kinesthetic

95
Q

What is arousal mediated by?

A

Reticular activating system (RAS)

96
Q

The client who has had a stroke states to the nurse, “You know, I can’t even tell where my left leg is.” This reflects lack of response to stimuli by the:

A

Proprioceptors

97
Q

highest priority w/ impaired tactile perception:

A

Risk for injury

98
Q

Immobility of this system effects the endocrine, calcium, resorption, and GI function

A

Metabolic

99
Q
You notice a respiratory change in your immobilized postoperative patient. The change you note is most consistent with:
A. Atelectasis
B. Hypertension
C. Orthostatic hypotension
D. Thrombus formation
A

A. Atelectasis

100
Q

Pacemaker of the heart

A

SA node

101
Q

Regulates cardiac function and blood pressure

A

Brain stem centers

102
Q

What decreases heart rate due to stress?

A

catacholines

103
Q

What lab test shows that there is inflammation in the body?

A

C-reactive protein

104
Q

What exchanges Co2 for O2?

A

alveoli

105
Q

What is the first thing you should do if patient is lying down and not breathing well?

A

Sit patient upright to help open up the airways

106
Q

What is an early sign of hypoxia

A
  1. irritability and then confusion
107
Q

Why is hydration important in oxygenation?

A

To keep hydrated and make secretions thinner

108
Q

What is the primary regulator of fluid volume?

A

Sodium

109
Q

Movement of ions against osmotic pressure to an area of higher pressure; requires energy

A

Active transport

110
Q

Movement of fluid across a membrane, under pressure, from higher to lower pressure

A

Filtration

111
Q

What is the most important indicator of fluid imbalance?

A

Daily weight

112
Q

Arises from alveolar hypoventilation, lungs unable to excrete enough Co2, excess carbonic acid in the blood decreases pH

A

Respiratory acidosis

113
Q

What is the functional unit of the kidney. Responsible for filtration and absorption.

A

Nephron

114
Q

Condition where they don’t know when they have to urinate.

A

hypereflexia

115
Q

What should your lab value be for specific gravity in urine samples?

A

No higher than 0.03

116
Q

After a colostomy what are you looking for?

A

1st stool

117
Q

What are the 4 phases of full thickness wound repair?

A

Hemostatis (stop bleeding)
Inflammatory
proliferative
Maturation (heal by scar formation)

118
Q

Partial or total separation of wound layers?

A

Dehiscence

119
Q

6 major risk factors of pressure ulcers

A

sensory perception, moisture, activity, nutrition, friction & shear

120
Q

removal of nonviable, necrotic tissue so as to provide a clean area for viable cells/fibroblasts to migrate as needed for healing

A

Debridement

121
Q

What is the most important things you should tell your patients when involving there care?

A

Speak up if you have any questions or concerns.

122
Q

Includes memorization, discussion, lecture, question and answer session, role play, discovery, independent project, field experience.

A

Cognitive learning

123
Q

Includes receiving and responding to new ideas, demonstrating commitment to or preference for new ideas. Ex: role play, discussion

A

Affective learning

124
Q

A person’s perceived ability to successfully complete a task

A

Self-efficacy

125
Q

cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health.

A

Health literacy

126
Q

Charting only significant findings or exceptions to norms. Inadvertent omissions are the biggest problem.

A

Charting by Exception

127
Q

For resident assessment and care screening must be completed within 14 days of admission

A

Minimum data set (MDS)

128
Q

What do you have to repeat back in order to confirm accuracy of telephone order?

A

Date, time, med, there name and title, your name and title.

129
Q

What is a primary benefit of Computer Physician order Entry (CPOE) is:

A

reduced medication errors

130
Q

How current does your nursing article have to be?

A

Within the last 5 years unless based on theory

131
Q

Identification of an unethical or illegal situation, can involve one person or an entire organization.

A

Whistleblowing

132
Q

The act is considered right or wrong regardless of consequences, based on moral or religious rules.

A

Deontology

133
Q

Concern for the welfare and well-being of other.

A

Altruism

134
Q

Lacks respect for the patients autonomy, when you think you know best and try to coerce someone to act in a way that you think is best

A

Paternalism

135
Q

Twofold duty to do no harm and to prevent harm.

A

nonmaleficence

136
Q

Ask the patient whether he/she has a living will or durable power of attorney for healthcare

A

Patient Self-Determination Act

137
Q

Standards that define what a reasonable and prudent nurse would do in a practice environment.

A

ANA Standards of Care

138
Q

Any disturbance in a person’s normal balanced state. Can be harmful or motivating.

A

Stress

139
Q

Stress associated with life stages (ex: going to college, college graduation)

A

Developmental stress

140
Q

The student nurse has earned “As” in all of her prerequisite courses. For the first exam in a nursing course, she earns a “D” and now feels that she may not be smart enough to become a nurse. What type of “loss” is the student experiencing?

A

Perceived loss

141
Q

Mourning and adjustment time following a loss

A

Bereavement

142
Q

Who created the phases of grief involving shock, numbness, yearning, searching, disorganization, despair, and reorganization?

A

John Bowlby

143
Q

Occurs when the person is grieving, but expressing the grief through other types of behavior.

A

Masked Grief

144
Q

A young woman’s fiancé died in a car accident one month prior to their wedding day. Since his death, she has become promiscuous. What type of grief if any, is this woman displaying?

A

Masked

145
Q

Loss that is not socially supported or acknowledge by usual rites or ceremonies.

A

Disenfranchised

146
Q

Who created the five psychological stages of dying?

A

Kubler-Ross

147
Q

What are the 5 stages of dying and grief

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
148
Q

What is the main priority for a dying patient?

A

Administer pain medication to keep the patient comfortable

149
Q

An interconnectedness between God or a higher power and other people

A

Spiritual well-being

150
Q

Associated with a specific system of practice associated with denomination, sect, or form of worship

A

Religion

151
Q

Gives an individual a motivation and the resources to achieve

A

Hope

152
Q

Provides a highly reliable means of declaring death for respirator-maintained bodies- loss of brainstem function

A

Uniform Determination of Death Act

153
Q

One who does not believe in the existence of God. Search for meaning in life through their work and their relationships with others.

A

Atheist

154
Q

The belief that a force outside of and greater than the person exists beyond the material world.

A

Transcendence

155
Q

Helping people identify meaning and purpose in life, look beyond the present, and maintain personal relations and perhaps a relationship with a higher being or life force.

A

Spiritual care

156
Q

When caring for patients, the nurse must understand the difference between religion and spirituality. Religious care helps individuals…….

A

Maintain their belief systems and worship practices.

157
Q

To assess, evaluate, and support a patient’s spirituality, the best action a nurse can take is to….

A

Determine the patient’s perceptions and belief system.

158
Q

Patients that has written wishes and to be followed after death is called?

A

Advance Directive

159
Q

Good stress (ex: passionate kiss)

A

Eustress

160
Q

Affect body: structure/function (ex: diseases, mobility problems)

A

Physiological

161
Q

Arise from life events (ex: work pressure, family arguments)

A

Psychological

162
Q

The hospitalized client states, “I need to know when I’m going to be discharged. I’m so upset and worried that I’m missing work.” the nurse knows….

A

This is an example of distress and could affect the client’s health status.

163
Q

What are the 3 general approaches for coping, depending on the situation, what are they?

A

Alter the stressor, adapt to the stressor, avoid the stressor

164
Q

Ability to adapt depends on:

A

intensity of stressor
effectiveness of coping
personal factors

165
Q

Selye’s theoretical model of physiological responses to stress. Nonspecific bodily responses shared by all people. Response to distress as well as eustress

A

General Adaptation Syndrome (GAS)

166
Q

What are the Stage of GAS

A
  • Alarm Stage (Fight or Flight)
  • Resistance Stage/Exhaustion (goal: maintenance of homeostasis)
  • Recovery
167
Q

Response to stress involving specific body part, tissue, or organ. Short-term attempt to restore homeostasis.

A

Local Adaptation Syndrome

168
Q

Local reaction to cell injury, either by pathogens or by physical, chemical, or other agents. 1st is Vascular Response to control bleeding. 2nd Cellular response and then healing.

A

Inflammatory Response

169
Q

Continual stress, repeated CNS stimulation, elevation of certain hormones. Will result in long-term changes in body systems.

A

Stress-Induced Organic

170
Q

Conditions characterized by the presence of physical symptoms with no known organic cause. Believed to result from unconscious denial, repression, and displacement of anxiety.

A

Somatoform Disorders

171
Q

A crisis, burnout, or ptsd patient.

A

Stress-Induced Psychological Responses

172
Q

After assessing the crisis intervention situation what is the first thing you should ensure?

A

Ensure the patient and nurses safety

173
Q

A patient becomes angry and states “I hate this hospital, nobody knows what they are doing. I should be home by now!” What is a good response by the nurse?

A

You seem angry; what is going on that makes you say you hate this place/

174
Q

Who regulates pastoral care within the hospital system?

A

Joint comission

175
Q

Uses synthetic dressings over the wound to allow slough to be self-digested by the action of enzymes that are naturally present in wound fluids

A

Autolytic

176
Q

Devitalized tissue, whitish-yellow, tan, stringy, loose but attached to bed. (Needs debridment)

A

Slough