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Intro to Clinicals > Final Examination > Flashcards

Final Examination Flashcards

1
Q

Actual loss

A

can be recognized by others

-loss of spouse or money

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2
Q

Perceived loss

A

felt by person but is intangible to others

-loss of beauty/youth

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3
Q

Maturational loss

A

experienced as a result of natural developmental process

-adding children to the family

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4
Q

Situational loss

A

experienced as a result of an unpredictable event

-terror attack, natural disaster

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5
Q

Anticipatory loss

A

Loss has not yet taken place

-family member on hospice

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6
Q

Grief

A

emotional reaction to loss ( no time frame )

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7
Q

Bereavement

A

state of grieving; person goes through grief reaction.

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8
Q

Mourning

A

acceptance of loss; person learns to deal with loss

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9
Q

Engel’s Six Stages of Grief

A
  • shock and disbelief
  • developing awareness
  • restitution
  • resolving the loss
  • idealization
  • outcome
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10
Q

Definitions of death

A
  1. Traditional heart-lung

2. Brain

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11
Q

Clinical signs of impending death

A
  • inability to swallow
  • pitting edema
  • decreased gi and urinary tract activity
  • loss of motion, sensation, reflexes
  • change in temp, cold/clammy skin, cyanosis
  • lowered bp
  • noisy or irregular respirations “death rattle”
  • cheyne-stokes respirations
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12
Q

Kubler-Ross’ Five stages of grief

A
  • denial and isolation
  • anger
  • bargaining
  • depression
  • acceptance
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13
Q

Components of a good death

A
  • pain and sx management
  • clear decision making
  • preparation for death
  • completion
  • contributing to others (giving things away)
  • affirmation of the whole person
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14
Q

5 principles of palliative care

A
  1. respect goals of dying person and loved ones
  2. look after all needs of dying person
  3. support needs of family members
  4. help gain access to providers
  5. build ways to provide excellent care at end of life
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15
Q

Special orders

A
  • DNR or no-code
  • comfort measures only
  • do not hospitalize
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16
Q

Postmortem care of the body

A

place identification tags on the body
< 24 hours = coroner case
situational death = very hard for family

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17
Q

Functions of the musculoskeletal system

A
  • protect vital organs
  • mobility and movement
  • facilitate return of blood to the heart
  • production of blood cells (hematopoiesis)
  • reservoir for immature blood cells
  • reservoir for vital minerals (98% Ca++ is in bones)
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18
Q

Synarthrosis

A

immovable joints

-skull sutures

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19
Q

amphiarthrosis

A

allow limited movement

-vertebral joints, symph. pubis

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20
Q

diarthrosis

A

freely movable

  • ball/socket: hip, shoulder
  • hinge: elbow, knee
  • saddle: thumb
  • pivot: radius/ulna; turn door knob
  • gliding: carpal tunnel bones in wrist
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21
Q

Muscles

A
  • attached to bones an other structures by tendons
  • encased in a fibrous tissue called fascia
  • contraction of muscle causes movement
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22
Q

Osteoblasts

A

function in bone formation

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23
Q

Osteocytes

A
  • mature bone cells that function in bone maintenance

- located in the lacunae

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24
Q

Osteoclasts

A

-multinuclear cells function in destroying, resorbing, and remodeling bone

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25
Q

Osteogenesis

A

bone formation

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26
Q

ossification

A

process of formation of the bone matrix and deposition of minerals

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27
Q

Bone regulating factors

A
  • stress and weight bearing
  • Vit D: deficiency = bone demineralization
  • parathyroid hormone and calcitonin
  • blood supply
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28
Q

Musculoskeletal Neurovascular Check

A
  1. skin color
  2. skin temperature
  3. capillary refill (blanch test)
  4. edema
  5. pulses
  6. sensation
  7. ability to move
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29
Q

Clonus

A

rhythmic contraction of a muscle

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30
Q

Ballottment test

A

+ when you have patella rebound

Used to test for fluid in the knee

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31
Q

Fasciculation

A

involuntary twitching of muscle

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32
Q

Bone densitometry

A

Determines bone mineral density. Estimates extent of osteoporosis.

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33
Q

Bone lab studies

A

-serum calcium
-serum phosphorus
also thyroid, PTH, vitamin D

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34
Q

Cast

A
  • a rigid, external immobilizing device
    -only a dry cast has full strength. 24-72 hours
    -immobilize a reduced fracture
    -correct a deformity
    Materials:
    -plaster: exothermic reaction x 15 min, wet: dull gray color, dull on percussion, feels damp, smells musty; dry: white, shiny, resonance, odorless, firm
    -fiberglass: hard, stiff, w or w/o water
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35
Q

Signs to report with a cast

A

persistent pain or swelling, changes in sensation, movement, skin color, or temperature, signs of infection or pressure areas.

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36
Q

Cast removal

A

Extremity will take 3 more months to recover to “normal.”

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37
Q

Volkmann’s Contracture

A
  • upper extremity problem
  • form of compartment syndrome that occurs in fingers and wrists.
  • results from obstructed arterial blood flow to forearm & hand
  • cannot extend fingers, decreased circulation, abnormal sensation
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38
Q

Compartment syndrome

A

Unrelieved pain = s/s of compartment syndrome

-lower extremities

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39
Q

Normal cast discomfort

A

-relieved with meds, elevation, ice, and rest

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40
Q

External Fixation Devices

A
  • discomfort is usually minimal, and early mobility may be anticipated with these devices
  • provide pin care
  • patient teaching (neuro check, s/s infection, pin care)
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41
Q

Traction

A

Skin traction: Buck’s; can be interrupted

Skeletal traction: cannot be interrupted

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42
Q

Skin traction

A
  • Buck’s extension traction; most common type; lower leg
  • 5-8 pounds
  • cervical head halter (neck pains)
  • pelvic traction (treat back pain); 10-20 pounds
  • takes 2 nurses to apply
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43
Q

Skeletal traction

A
  • is continuous to immobilize and reduce fractures
  • is never interrupted
  • 15 - 25 pounds
44
Q

Hip joint replacement

A
  • place in abduction to prevent joint from dislocating
  • drainage 200-500mL x 24 hrs then <30 mL q 8 hrs
  • never flex more than 90 degrees use fx bedpan
45
Q

Goals of orhto. surgery

A
  1. Improve function by restoring motion

2. Stability, relieve pain and disability

46
Q

S/S of hip dislocation

A
  1. pain at surgical site, edema, immobilization
  2. acute groin pain in affected hip
  3. shortening of the leg
  4. abnormal rotation
  5. restricted or inability to move the leg
  6. pt reports popping sensation or sound
47
Q

Acute low back pain

A
  • proper body mechanic techniques

- relief of pain

48
Q

Carpal Tunnel Syndrome

A

Entrapment neuropathy; median nerve is compressed

  • Tinel’s Sign
  • tingling, numbness, pain
49
Q

Dupuytren’s Contracture

A

Deformity - slowly progressive
-usually causes flexion of 4/5 digit..sometimes 3rd as well.
S/S: dull,a ching, stiffness, numbness, cramping
Tx: rest
starts as nodule in palmar fascia.

50
Q

Hallux Valgus

A
  • bunion

- great toe deviates laterally

51
Q

Morton’s Neuroma

A

Swelling 3rd branch of median plantar nerve

Tx: intersoles and metatarsal pads

52
Q

Osteoperosis

A
  • loss of total bone mass
  • white, over 40, post menopausal
  • increase Ca, Vit D, wt baring exercise
  • fx common
  • bones weak
53
Q

Osteomalacia

A
  • inadequate bone mineralization
  • bowed legs, pathologic fractures
  • low calcium, low phosphorus
    tx: calcium
  • 3rd world countries
54
Q

Paget’s Disease

A

-“hat doesn’t fit”
-Men more then women; 2-3%, over age 50
-also called osteitis deformans
-pt at risk for fx, arthritis, hearing loss
-cranial nerve compression and dysfunction
-waddling gait
-Incidious: happens gradually
Tx: nsaids, calcitonin, bisphosphonates, pilcamycin

55
Q

Osteomyelitis

A

-infection of the bone
-open or closed fx
- caused 70-80% of time by s. aureus
-use preventive antibiotics
s/s: pain, edema, fever, redness, drainage, low grade fever (pm),

56
Q

Bone Tumors

A
  • osteogenic sarcoma: most common, often fatal

- monitor for hypercalcemia

57
Q

Fat embolism

A

S/S: hypoxia, tachypnea, tachycardia, pyrexia.
Usually occur in men under age 40 with multiple fx.
Onset of s/s is usually rapid
S/S usually present 12/48 hours of injury
S/S may present up to 10 days after injury

58
Q

Rotator cuff tear

A

S/S: pain, limited ROM, joint dysfunction, muscle weakness. Night pain, cannot sleep on torn side.

59
Q

Ca++ requirements

A

9-19…..1300mg
20-50…..1000 mg
51+…..1200mg

60
Q

Comminuted fx

A

produces many bone fragments…aka loose bodies

61
Q

Complications of fx

A
  • *avascular necrosis

- fat embolism

62
Q

Aims of nursing

A
  1. to promote health
  2. to prevent illness
  3. to restore health
  4. to facilitate coping with disability or death
63
Q

Nurses meet the aims of nursing by….

A

C.T.I.E.

cognitive, technical, interpersonal, and ethical/legal skills.

64
Q

Nursing Process

A 
A.D.P.I.E.
assessment
diagnosis
planning
implementation
evaluation
65
Q

Current trends in nursing

A 
nursing shortage
evidence-based practice
community-based nursing
decreased length of hospital stay
aging population
increase in chronic care conditions
66
Q

culture

A

shared system of beliefs, values, behavioral expectations

67
Q

culture assimilation (acculturation)

A

minorities living within a dominant group lose the characteristics that made them different.

68
Q

ethnicity

A

identification with a collective group

69
Q

race

A

specific characteristics

Caucasian, negroid, mongoloid

70
Q

stages of illness behavior

A

experiencing symptoms
assuming the sick role
assuming a dependent role
achieving recovery and rehabilitation

71
Q

Levels of preventive care

A

primary: diet, exercise, immunizations, seat belts, safe sex
secondary: screenings, pap, HIV test
tertiary: medications, surgery

72
Q

Sources of knowledge

A

Traditional: passed down ex: bed making
Authoritative: from expert ex: F/E lecture
Scientific-arrived: scientific method ex: research

73
Q

Reasoning

A

Deductive: general —> specific
Inductive: specific—> general

74
Q

Goal of theoretical frameworks

A
  • holistic patient care
  • individualized care to meet needs of pts
  • promotion of health
  • prevention of treatment of illness
75
Q

Common concepts in nursing theories

A

PERSON (pt)
environment
health
nursing

76
Q

Four functions of ethics committees

A

education
policy making
case review
consultation

77
Q

Types of law

A

public: gov’t directly involved
private: regulates relationships among people
criminal: state/federal criminal statues

78
Q

Four sources of law

A

Constitutions
Statutes: nurse practice act
Administrative: Board of nursing
Common:

79
Q

Standards

A

Two types:

  1. voluntary
  2. legal
80
Q

Tort

A

wrong committed by a person against another person or his or her property

81
Q

Defamation

A

oral –> slander

written –> liable

82
Q

Four elements of liability

A

duty
breech of duty
causation
damages

83
Q

Legal safeguards for nurses

A
  1. competent practice
  2. documentation
  3. pt record
84
Q

Characteristics of the nursing process

A 
systematic
dynamic
interpersonal
outcome oriented
universally applicable
85
Q

Four phases of a nursing interview

A

preparatory phase
introduction
working phase
termination

86
Q

Formulation of a nursing dx

A

Problem: identifies what is unhealthy (NANDA)
Etiology: factors maintaining the unhealthy state
Defining characteristics: “as manifested by”

87
Q

Types of nursing diagnoses

A 
actual
risk
possible
wellness
syndrome
88
Q

Act of micturition

A

urination

89
Q

Basic structure and function unit in the kidneys

A

nephrons

90
Q

Fluid intake

A

2000-2400 mL per day

w/ fiber increase to 3000 mL per day

91
Q

Post void residual

A

50 or less is normal
150 or more needs cath.
post operative void should be at least 30 mL per hour

92
Q

illeal conduit

A

surgical diversion of ureters to ileum as opposed to the bladder

93
Q

Types of enemas

A

Hypotonic: tap water
Isotonic: NaCl
Hypertonic: fleets

94
Q

Post operative stool

A

Colostomy: stool in 2 to 5 days
Illeostomy: stool in 24 to 48 hours

95
Q

Who was the 1st trained nurse in the U.S.?

A

Linda Richards

96
Q

Who was the founder of modern nursing?

A

Florence Nightingale (19th century)

97
Q

Who was the first African American nurse?

A

Mary Elizabeth Mahoney

98
Q

Who founded the American Red Cross?

A

Clara Barton (1882)

99
Q

What was the Benedictine Order?

A

The entry of men into nursing

100
Q

What was the Goldmark Report?

A

Concluded that nursing education needed financial support.

101
Q

What was the Lysaught Report?

A

Called for clarification of nursing roles and responsibilities.

102
Q

Who was Harriet Tubman?

A

A nurse and an abolitionist; active in the Underground Railroad movement before joining the Union Army during the civil war.

103
Q

Who was Lavinia Dock?

A

A nursing leader and women’s rights activist; instrumental in the constitutional amendment giving women the right to vote.

104
Q

What 2 nurses opened up Henry Street Settlement?

A

Mary Burster & Lillian Wald

105
Q

Which nurse is considered the founder of Public Health Nursing?

A

Lillian Wald

106
Q

Who was the 1st professor of Nursing?

A

Mary Nutting

107
Q

What are the 5 functions of the family?

A 
physical
economic
reproductive
affective and coping
socialization

Intro to Clinicals (4 decks)

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