Final Exam objectives Flashcards
Describe the physical activity recommended for health promotion, cardiovascular fitness, and maintenance of healthy weight
- 150 minutes per week of exercise for adults (brisk walking coupled with increasing activity everyday)
- 3 to 5 days per week.
Factors that affect mobility an activity throughout the lifespan.
- infants and children: genetic disorders or congenital malformations
young adults: trauma from sports, drug alcohol abuse, motor vehicle accidents
Older adults: wear and tear
Identify the types of exercise and how they benefit the body
isometric: muscle contraction without motion
Isotonic: movement of joint during muscle contraction
Isokinetic: performed with workout machines with resistance
Aerobic: acquires energy from metabolic pathways that use O2
Anaerobic: no O2 needed
Discuss the effects of exercise and immobility on the body
improves cardiovascular health, increases muscle tone and flexibility, enhances immune system, promotes weight loss, decreases stress
Immobility: pressure ulcers, DVT, pneumonia, weak and aching joints/ muscles/ limbs
identify patients who are at risk for immobility or activity intolerance
decreased in circulation/ sensation
trauma
CNS: stroke, brain or spinal injuries
respiratory disease, fatigue, bed rest, scoliosis, vitamin deficiencies
Communication styles
passive, aggressive, assertive
Assertive is best in healthcare
FActors of therapeutic communication include:
empathy, respiect, genuineness, concreteness, and confrontation
With adolescents and above use what type of questions
open ended
identify individual factors that create safety risk
developmental stages, lifestyle, cognition, sensory status, mobility, physical and emotional health
identify client safety equipment
gait belt, lower bed, no slip socks, walker, cane, wheelchair, mechanical lift, personal alarm
identify factors that contribute to falls
mobility, malnutrition, cognitive level, illness, generalized weakness
describe and give examples of hazards that occur in healthcare
falls, alarm fatigue, equipment related, fires, electrical, restraints, mercury poisoning
safety nursing assessments
client environment, home safety, risk for violence
plan and implement nursing care to promote safety and prevent injury in clients who are at risk
assessing, educating, evaluating, removing hazards, establish goals, reporting accidents, considering patients as members of the healthcare team
discuss methods in which safety can be promoted in the client’s home environment
clear pathways, turing light on at night, having access to assistive devices when walking
discuss issues surrounding automobile safety and driving throughout the lifespan
Education on drinking and driving, as well as texting and driving
Discuss the purpose of a nursing assessment
analyzing patient data to make clinical judgments about the patient’s response to health problems and interventions
understand physiological processes involved in regulating the temperature, pulse, respirations, and blood pressure
temperature: the hypothalamus is responsible for controlling body temperature
pulse: pertains to concept of perfusion, continuous supply of oxygenated blood through the blood vessels
respirations: in response to minute changes in concentrations of oxygen and carbon dioxide
blood pressure: indications of the volume output of the left ventricle
recognize client vital signs that should be reported the health care provider
temperature: above 100F or less than 95F
pulse: above 100 or below 60
respirations: above 20 or below 12
O2: below 90%
blood pressure: above 140/90 or below 90/60
describe nursing interventions for the client with abnormal vital signs
temperature: blankets, ice packs, certain medications
pulse: calming the situation down, and the patient
respirations: breathing exercises, check for a cleared airway
O2: apply oxygen, incentive spirometer, taking breaks between activities
Blood pressure: medications, low sodium diets, proper diet, exercise, lifestyle changes
identify a teaching plan for a client with hypertension
a proper lifestyle: no smoking, exercise daily, heart healthy diet, limiting stressors
differentiate between chemical, generic, and brand names
chemical: chemistry name chemical composition formula
generic: shortened chemical name, never capitalized
brand: trademark name, always capitalized
describe resources for researching medications
drug guide book, MAR, electronic databases
identify methods used to classify drugs
Schedule 1-5: 1 is the worst (meth, cocaine)
5 is the least harmful (ibuprofen)
discuss the difference between prescription and nonprescription drugs
prescription: must be ordered by a physician
non prescription: can be bought over the counter
recite the seven rights of medication administration
person, drug, dosage, time, route, right, reason
identify precautions to ensure the right medication is prepared for the right patient
similar spelling
abbreviations, measurements, handwriting
perform the three checked of the label against the MAR
discuss safety measures in preparation and administration of medications
before the pour
after the pour
at the bedside
describe safety precautions the nurse should follow calculating drug dosage
double check fractional dose, scoring a tablet and alternate dose
use the correct measuring device, never administer drugs prepared by someone else, and without proper knowledge
describe methods the nurse should use the ensure the correct medication, route, amount, and time are used
double check the MAR
make sure it is given with 30 minutes of scheduled period
identify which medications are commonly checked by two qualified of medications
date/ time, med name, dose/ route/ site, therapeutic effect, adverse effect, document patient teaching and understanding, right to refuse
identify what conditions allow medication to be left at the bedside
if the physician ordered it to leave it at its bedside
theories of development
Eriksons: 8 stages, personality develops through a lifetime
Jean Piaget: assimilation, accomodation, adaptation
sigmund freud: developed, by instinctual drives (psychosexual development)
growth and development throughout the lifespan
theories of aging (wear and tear, genetic, cellular malfunction, and autoimmune reactions)
age related physical changes involve all body systems
psychosocial development
leading cause of death in old adults are heart disease, cancer, unintentional injuries
growth includes height, weight, muscle mass, and sexual maturation
recognizing right from wrong, career path, closer to end of life
identify common health problems seen in each age group
infant: colic, failure ot thrive, dental caries, abuse/ neglect
toddler: infections, immunizations, delayed toilet training
preschooler: communication disease, poisoning, enuresis, abuse
school ager: bullying, obesity, hyperlipidemia, asthma
adolescents: substance abuse, depression, suicide, eating disorders, sti, pregnancy
discuss definitions of family
function, may or may not be blood relatives and non- traditional
assess impact of change on family systems
poverty, unemployment, infectious disease, chronic illness, disabilities, homelessness, family violence, and neglect
compare and contrast community- based care, community health nursing, public health nursing, and community- oriented nursing
community based: allows medical professionals to address the needs of individual members of a community
community health: is a combination of primary health care and nursing practice in a community setting
public: focuses on the results of the community habits
community oriented: focuses on health promotion and disease prevention in the community
identify pioneer nurses in the field of community nursing and their contributions
florence nightingale: making hospitals cleaner and nursing the whole person
lillian wald: public health nursing
clara barton: red rocc
margaret sanger: planned parenthood, women’s advocate for reproductive rights
describe the roles of nurses in the community setting
client advocate, educator, collaborator, counselor, and case manager
identify the primary goals of home care
promoting self care by fostering client independence, completing client/ family teaching, demonstrating skill techniques, and explaining all aspects of care
describe ways in which home healthcare differs from hospital nursing
home health differs by one being at your home setting, allows more family to see them, increases autonomy, flexibility, holistic care
outline the steps required to prepare for a home visit, including considerations for the nurses safety
determine purpose of visit, gather supplies, aware of needed information, make appointment, assess safety considerations
explain the role of the nurse in helping clients and and families manage medications and treatments in the home setting
make sure all medications are labeled, in the proper area, know the family history, mental status, functionable activities
describe how infection control measures differ in the home and in the hospital
in the hospital teh area is clearer than at home. at home there are more possibilities of infections
describe the nurses role in treating caregiver strain
the nurse must remain a patient advocate to prevent injury to the care recipient and strain on the caregiver
define health, health promotion, and health protection.
-health is the condition of your well-being
-health promotion is motivated by the desire to increase well-being
-heath protection is motivated by the desire to avoid illness
Identify specific health promotion strategies (including immunizations and screenings) across the lifespan.
-primary (healthy eating, exercising, and immunization)
-secondary (annual physical exams, and diabetes screening)
-tertiary (rehab)
Discuss the nurse’s role in health promotion, and list health promotion activities that a nurse may conduct in acute care facilities, the workplace, local communities, and schools.
-health history/ physical assessment and physical fitness (cardiorespiratory fitness, muscular fitness, and flexibility)
Identify the areas of assessment in relation to developing a health promotion plan.
Personal responsibility for health, physical activity, nutrition, interpersonal relation, spiritual growth, stress management, and health risk appraisal tools
types of nursing knowledge
(theoretical, practical, self, ethical)
Ineffective clinical reasoning skills
major factor in the failure of nurses to respond appropriately to deteriorating client conditions.
The practice of professional nursing
requires strong clinical reasoning skills due to a rapidly changing complex healthcare environment.
Identify and apply the phases of the nursing process.
-Nursing process is a systematic problem-solving process that guides all nursing actions
-purpose is to help the nurse provide goal-directed, client-centered care
Discuss the four components of assessment.
-physical, mental, spiritual, socioeconomic, and cultural status
Identify the following types of data: subjective, objective, primary source, and secondary source.
subjective is what the patient says
-objective is hard concrete data
-primary is straight from the patient
-secondary is from anyone else like a family member
Differentiate between nursing diagnoses, medical diagnoses, and collaborative problems.
-nursing diagnosis is what the nurse can diagnosis and treat
-medical diagnosis is a description of a disease, illness or injury
-collaborative problem requires a combination of medical and independent nursing intervention to prevent or minimize complication
Describe the diagnostic process.
-priortize the problems, analyze and interpret data, draw conclusions about health status, verify conclusion with patient, write the diagnostic statement
Differentiate between short-term and long-term goals
short term is within hours to a couple days
-long term is over a week, month, or more
Compare and contrast independent, dependent, and interdependent (collaborative) nursing interventions.
-independent interventions are based off nursing knowledge and skills
-dependent prescribed from the healthcare provider but carried out by bedside nurse
-interdependent is carried out in collaboration with other health team members
Discuss factors affecting urinary and bowel elimination.
Pathological factors: bladder/ kidney infections, kidney stones, mobility problems, decreased blood flow, neurological conditions
Personal, hydration, activity level, medications, nutrition
Describe interventions that promote urinary and bowel elimination.
Privacy, correct positioning, toileting routines
Discuss and utilize proper medical/surgical asepsis with urinary and bowel elimination procedures.
Clean touches clean, dirty touches dirty.
Check expiration dates, horizontal plane within site, do not touch anything
Identify common diagnostic/laboratory tests utilized with urinary and bowel elimination.
Different types of specimens: freshly voided specimen, clean catch, sterile specimen, 24- hour, urinalysis, dipstick testing, specific gravity
Discuss factors that affect skin integrity.
Impaired mobility, nutrition and hydration, diminished sensation, impaired circulation, medication, fever, infection, lifestyle, moisture
Demonstrate use of Braden scale to assess risk of pressure ulcer
Less than 18 higher risk for skin breakdown, lower the number higher the risk
Identify nursing interventions to prevent pressure ulcers.
Reposition every 2 hours, avoid friction and shear, limit layers under patient, specialty beds, waffle pads, moisture barrier cream
Explain the factors involved in the development of pressure ulcers.
Immobility, impaired sensation, dehydration, agining, fever, infection, edema, friction, pressure, shear, moisture
Categorize pressure ulcers based on the pressure ulcer staging system.
Stage one: intact discoloration remains for more than 30 minutes. Temperature change, color change, soft or firmness change may occur
Stage Two: partial- thickness loss of skin,wound bed is viable, deep tissue not visible, slough and eschar are not present
Stage Three: full thickness loss of skin, adipose is visible, undermining and tunneling may occur, bone/ tendon not visible or exposed.
Stage Four: full thickness and tissue loss, slough and or eschar may be visible, undermining and tunneling occur
Differentiate other types of ulcers.
Deep tissue Injury: intact or non intact skin, pain and temperature change often precede skin color changes, occurs due to damage of underlying soft tissue from pressure or shear
Unstageable: full thickness skin and tissue loss, stable eschar, necrosis may occur
Describe three types of wound drainage.
Serous exudate (watery plasma)
Sanguineous (bloody)
Serosanguineous (watery and bloody)
Purulent: pus
Purosanguineous exudate (blood and pus)
Identify what to assess when assessing a wound
Location, size, appearance, drainage, redness, swelling
Ways to close a wound
Adhesive strips, sutures, surgical staples, surgical glue
Differentiate Between sleep and rest.
Sleep: selective response to external stimuli, decreased motor activity
Rest: mild to no activity, relaxation, stress free, leads to feeling refreshed
Explain circadian rhythms and how they relate to sleep
Circadian rhythm is your internal clock, affecting overall level of functioning. 24 hour day- night wake and sleep cycle
Identify factors that influence rest and sleep.
Age, lifestyle factories (physical activity, food, medications), illness, environmental (temperature, noise, light)
Identify and describe common sleep disorders.
Insomnia: inability to fall or remain asleep or go back to sleep
Circadian disorders: abnormality in sleep/ wake disorders
Restless leg syndrome: uncontrollable movement of legs during sleep/ rest
Hypersomnia: excessive sleeping
Sleep apnea: periodic breathing cessation for at least 10 sec during sleep
Narcolepsy: chronic disorder caused by the brain’s ineffectiveness in regulating sleep- wake cycles normally.
Discuss nursing interventions that will address specific sleep problems.
Teach about sleep hygiene, sleep- inducing medications, create a comfortable environment, promote relaxation, support bedtime rituals.
Review factors that affect normal nutrition.
Lifestyle, ethnicity, religious, disease, functional limitations
Explore methods for assessing a client’s nutritional status.
24 hour recall, food frequency, food record, skinfold measurements, circumferences, physical examination, laboratory results
Discuss the epidemiology of Diabetes Mellitus.
Commonly diagnosed below age 30
Previously referred to as juvenile- onset diabetes
Describe the pathophysiology of type I and type II Diabetes Mellitus.
Type 1: Triggered by an autoimmune process, insulin- producing beta cells of the pancreas are destroyed
Type 2: defects at the cell membrane prevent the normal action of insulin
Compare and Contrast the clinical manifestations of type I and type II Diabetes Mellitus.
Type 1: polyuria, polydipsia, polyphagia, fatigue, weight loss
Type 2: fatigue, polyuria, polydipsia, polyphagia, poor wound healing, recurring infections
Discuss therapeutic interventions to improve glucose control.
Medications/ insulin
Define sexuality, gender identity, sexual identity, gender role
Sexuality: being human throughout life, intimacy reproduction
Gender identity: perception of gender and role
Sexual identity: perception of sexual orientation
Gender role: society norms for gender appropriate behavior
Factors that affect sexuality
Culture, religion, lifestyle, sexual knowledge, health and illness
Nursing interventions for sexual health
Teaching about sexual health
Counseling for sexual problems
Identify components of the sensory experience.
Stimulus: trigger that stimulates receptor
Reception: process of receiving stimuli from nerve endings
Perception: ability to interpret sensory impulses
Arousal: composed of consciousness and alertness
Discuss factors that affect sensory function.
Developmental stages
Culture, illness, medications, stress, personality, lifestyle
Compare and contrast sensory deprivation and sensory overload.
Sensory deprivation: lack of meaningful stimuli, when environmental stimuli is lacking, other stimuli can become overtly noticeable.
Sensory overload: overwhelmed by environmental and internal stimuli. Often due to a combination of physical discomfort, anxiety, and separation. Mental health conditions can be exacerbated
Discuss the hazards of sensory deficits in vision, hearing, taste, smell, touch, and proprioception.
Vision: affects all aspects of daily living adn may severely limit mobility and interaction
Hearing: interfere with patients ability to understand instructions from healthcare professionals and create a safety hazard due to inability to hear warnings
Taste: deficits may lead to malnutrition
Smell: loss of appetite, and nutritional deficits may result
Touch: may not be able to sense a pain or pressure, which can lead to further bodily harm
Proprioception: creates a risk with balance and coordination
Describe nursing interventions to prevent sensory deprivation and sensory overload.
Deprivation: support senses, provide stimuli (contacts, glasses, hearing aids, television, light, radio)
Overload: limit stimuli, close the window, turn tv off, provide less light, minimize noise
Describe nursing interventions to prevent sensory deprivation and sensory overload.
Deprivation: support senses, provide stimuli (contacts, glasses, hearing aids, television, light, radio)
Overload: limit stimuli, close the window, turn tv off, provide less light, minimize noise
Describe nursing intervention for common sensory alterations.
Vision: glasses, sufficient light
Hearing: hearing aid, CC television, inspection of ear canals
Taste: frequent oral hygiene, sores or open areas in mouth, meals visually appealing
Smell: aromatherapy, have home appliances regularly checked
Touch: bath thermometer, change position frequently, properly fitting clothing
Explain the purposes of documentation.
Communication, continuity of care, education and research, legal record, quality improvement, planning and evaluation of client outcomes, professional standards, reimbursement and utilization review
Identify a variety of charting formats and their purposes.
Narrative: story of care in chronological order, tracks the clients changing status
PIE: Problem, Interventions, Evaluation; used only in problem- orientated charting. Establishes an ongoing plan of care.
SOAP(IER): subjective data, objective data, assessment, plan, intervention, evaluation, revision
Focus: Time and date, focus or problem being addressed, charting in DAR (data, action, response)
Charting by exception (CBE): chart only significant findings or exceptions to norms
Identify approved abbreviations to use in charting.
Any abbreviations we learned in class
Explain and utilize military time.
24 hour time clock, 1300= 1:00 pm
Discuss key elements of giving an oral patient report.
SBAR: situation, background, assessment, recommendations
Communication of vital information related to the client’s status/ plan of care
Explain the process for receiving, verifying, and/or questioning a medical order.
Example of Telephone:
11/30 1033: Tylenol 325 mg PO q4h prn for pain or fever. TORB Dr. Dru/ Brooklyn Mace, RN
Example of verbal order:
11/30 1033: Tylenol 325 mg PO q4h prn for pain or fever. VORB Dr. Dru/ Brooklyn Mace, RN
Define pain
Physical suffering or discomfort caused by illness or injury
Classify pain according to origin, cause, duration, and quality
Duration: acute, chronic, intractable
Origin: location of onset pain
Cause: what triggered the pain
Quality: intensity and type
Describe physiological changes occurring with pain
Anger, anxiety, exhaustion, fear, irritability
Identify factors that influence pain
Emotions, past experience with pain, developmental stage, sociocultural factors, communication skills, cognitive impairments
Identify measures to assess pain, verbal and nonverbal, throughout the lifespan
Nonverbal: moaning, crying, irritability, restlessness, inability to sleep, nausea
Verbal: pain scale 1-10, type of pain
Crying infant, patient with dementia, cognitive impairment in an individual, reluctance to report pain
Discuss the effects of unrelieved pain on body systems
Depression, anxiety, decreased socialization, sleep disturbances, impaired ambulation, prolonged recovery, increased use and cost of health care.
Identify nursing diagnosis commonly used when pain is the focus problem
Ability to perform ADL’s. Mobility, pain relief
Discuss pharmacological, chemical, and nonpharmacological pain relief measures
Pharmacological: medications
Chemical: epidural, anesthesia, topical, nerve blocks
Nonpharmacological: heat and cold, repositioning
Discuss management of pain in clients with addictions
Difference between tolerance, physical dependence, and addiction
Behaviors that may indicate substance abuse or addiction
Reliable substance use history is important to provide a foundation for good pain management
Discuss use of placebos in pain management
Operant conditioning, faith, anxiety reduction, and endorphin release
Discuss the six links in the chain of infection.
Infectious Agent: pathogens (bacteria, viruses, fungi, protozoa)
Reservoir: where pathogens live (humans, animals, insects/floors, foods, water)
Portal of exit: leaving the body (sneezing, bodily fluids, tubes, IV lines)
Mode of transmission: contact (kissing, touching, cough, air conditioning)
Portal of entry: entering the body (eye, mouth, cuts, IV lines, bite from vector)
Susceptible host: a person with inadequate defense (age, immunity, illness)
Describe the stages of a typical infectious process.
Incubation: from the time of infection until the manifestation of symptoms; can infect others
Prodromal: the appearance of vague signs and symptoms (not all diseases have this stage)
Illness: signs and symptoms are fully present
Decline: number of pathogens decline
Convalescence: tissue repair, return to health
Discuss the factors that place an individual at increased risk for infection.
Age of individual, illness, immune deficiency, breaks in skin, substance abuse, multiple sex partners, specific medications
Identify proper hand hygiene technique
Washing hands with soap and water for at LEAST 15-20 seconds
Differentiate between medical and surgical asepsis
Medical asepsis: a state of cleanliness that decreases the potential for the spread of infections (clean environment, CDC, clean hands)
Surgical asepsis: sterile technique, requires the creation of a sterile environment and the use of sterile equipment (sterile field)
Identify proper use of standard precautions.
Proper PPE, using a shaped container, covering your mouth, hands away from the face, adequate hand hygiene, etc.
Describe additional precautions that must be taken when there is a concern about contact, droplet, or airborne disease transmission.
Droplet: mask, gown, gloves
Contact: gown and gloves
Airborne disease transmission: special maks, special room
Describe the basic structure & function of the respiratory system
Structure: nasal canals, mouth, pharynx, trachea, bronchi, bronchioles, lungs
Function: move air in and out, moisten the airway, warm air, filter the air
Identify individual, environmental, and pathological factors that decrease oxygenation and perfusion.
Working around toxic fumes, substance abuse, smoking, immune deficiency
Describe common manifestations of altered respiratory function
decreased/increased respiratory rate, airway resistance (congestion, foreign body, inflammation, asthma), depth of breath
Discuss the different types of oxygen therapy & safe administration.
Cough and deep breath, nasal cannula, masks, IS, venturi mask, artificial airways
When to use humidified, properly putting in the nasal cannula
