Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing 1080 > Final Review > Flashcards

Final Review Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Pharmacology flashcards NCLEX-RN® flashcards Nursing Mental Health flashcards Nursing Fundamentals flashcards Nursing Safety & Infection flashcards Nursing Adult Health flashcards NCLEX-PN® flashcards Nursing Management of Care flashcards Nursing Pediatrics flashcards Nursing Maternity flashcards
1
Q

holistic health assessment

A

assessing patient as a whole- incorporating mind, body, and spirit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

purpose of physical assessment

A
  1. determine level of client functioning (ability to participate in ADL’s)
  2. identify signs and symptoms that indicate changes in health status
  3. determine nursing interventions
  4. determine effectiveness of nursing interventions
  5. determine health promo opportunities
  6. determine baseline data
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

physical assessment techniques

A

inspection
palpation
percussion
auscultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

inspection

A
  • first step when you meet patient

- using senses (eyes, ears, nose) to observe body parts and notice deviations from normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

inspection techniques

A
  1. look before touching
  2. use good lighting
  3. only expose area being inspected
  4. provide warm, private enviornment
  5. look for size, shape, moisture, color, swelling, odor, sounds, movement, etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

general survey

A
  • noticing client as whole to get an idea of the client
  • helps guide further assessment to determine health issues/needs
  • helps develop a care plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

characteristics of general survey

A 
A- airway 
B- breathing 
C- circulation 
D- disability 
E- exposure 
A- appearance 
S- speech 
E- emotion/ affect 
P- perception 
I- insight 
C- cognition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

palpation

A

technique used to assess for edema, moisture, temperature, and tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

palpation technique

A
  • clean, warm hands
  • short, clean fingernails
  • palpate tender areas last
  • wear gloves if coming into contact with bodily fluids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

light palpation

A
  • around 1 cm deep

- tells you about skin and structures directly below the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

deep palpation

A
  • 3 to 4 cm deep

- tells you about deeper structures under the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

fingertips

A
  1. moisture
  2. contour
  3. conscitency
  4. pulsations
  5. texture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

palm

A

vibrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ulnar edge

A
  1. vibrations

2. temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

dorsal side

A

temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

circular motion palpation

A

place fingers together and move skin surface over underlying structures in a circular motion
-assessing for consistency, size, shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

dipping motion palpation

A

place fingers together and make gentle, quick depressing movements over abdomen
-assess for feces, pregnant uterus, tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

direct palpation

A

place fingers together and apply direct preassure on skin

  • used to palpate blood vessels, skin lesions, masses, muscles
  • assess pulse, tenderness, fluid content, blanching
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

grasping (pincher) motion palpation

A

pinch skin with index finger & thumb

  • used to assess masses
  • assess turgor, thickness, consistency, size, shape, pulsations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

percussion

A
  • tapping over body structures to elicit a sound with a specific pitch, quality, duration, and intensity
  • tells you about density, location, size, tenderness of organs
  • most commonly used on abdomen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ausculation

A
  • assess pitch, intensity, timing, rate, duration of body sounds with stethoscope
  • can ausculate pulse, chest cavity, abdomen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

diaphragm use

A

high pitched sounds (heart rate, pulse)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

bell use

A

low pitched sounds (heart murmurs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tanner’s Clinical Judgement Model

A
  1. Noticing
  2. Interpreting
  3. Responding
  4. Reflecting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Clinical Judgment

A

Interpreting clients needs, wishes, and challenges and using previous knowledge, experience, ethical belifs, critical thinking to determine actions that would provide best care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

family- Potter & Perry

A

set of relationships/ network of indiviuals who influence each others lives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

family- Vanier Institute

A

two/ more people who are bound together by mutal ties of consent, birth/ adoption, and share the following future obligations:

  1. care/ support of family members
  2. addition to family through procreation/ adoption
  3. socialization of children
  4. love & nurture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

T or F: family is whoever the patient says it is

A

true
- have to consider how other people view family and how your own biases/ belifs about family may impact the care you provide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how are families changing?

A
  • aging population: “sandwiched” generation
  • increased diversity in families (cultural blending, interacial families, same- sex couples)
  • gender roles in families have changed due to social, political, economic factors
  • nuclear family on decline
  • multigeneritational households
  • more single parent households
  • more lone person households
  • more couples not having kids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

characteritics of healthy families

A
  • incorporate the need for stability for growth and change
  • show hardiness and resiliance in coping
  • influence their enviornment
  • act as a cohesive unit
  • flexible
  • willing to accept outside help
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how does family influence health

A
  • views on health and lifestyle behaviours (what was normalized in your family is what your normalize)
  • generational views on health and healthcare are passed down
  • relationships in healthcare settings (ex. mom with sick child)
  • embedded in SDOH (housing, socioeconomic status)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what makes up a community?

A
  • people (members of community)
  • place (geographic location)
  • function (collective interest/ purpose)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

characteristics of healthy community

A
  • supportive
  • lies on stable economy
  • safe
  • has sustainable resources
  • access to social services (health care, education)
  • celebrates culture & history
  • adequate housing
  • acts as cohesive unit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are routine practices

A

IPAC practices that are followed with every patient in every health care setting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

chain of transmission

A
  1. infectious agent
  2. resevoir
  3. portal of exit
  4. mode of transmission
  5. portal of entry
  6. susceptiable host
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

infectious agent

A

virus, bacteria, fungi- any microorganism that can make somebody sick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

resevoir

A

where infectious agents live

-people, animals, food, water, surfaces, equipment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

portal of exit

A

how infectious agent leaves resevoir

  • bodily openings (mouth, vagina, urethra, skin)
  • bodily fluids (blood, mucus, excretions)
  • open wounds (lesions, surgical wounds, cuts)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

mode of transmission

A

how infectious agents spread from one host to another

  • contact
  • airborne (droplets)
  • vectors (mosquitoes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

portal of entry

A

how infectious agent enters new host

  • sex
  • respiratory tract
  • GI tract
  • mucous membrane (eyes, ears, mouth)
  • broken skin
  • artifical openings
  • contaminated food/ instruments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

susceptible host

A

people who can get infections easily

-old people, babies, immunocomprimised people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

whats the best way to break the chain of transmission?

A

handwashing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

whats the most important part about proper handwashing

A

friction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

why is understanding growth and development important?

A
  • allows you to be able to understand & recognize normal

- allows nurses to promote health oppurtunities and provide indiviualized care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

is growth quantitative or qualitative

A

quantitative- easily measured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

T or F: development is quantitative

A

False, development is qualitative (not easily measured) and looks different in different indiviuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what influences growth & development

A
  • family: if you recieved love and nurture growing up
  • socioeconomic status
  • quality and accessibility to health care
  • nutrition
  • genetics
  • childhood trauma
  • choices mothers make during pregnancy (ex. drug use, drinking)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Erikson’s Developmental Theory

A
  • 8 stages covering lifespan that include differenet psychosocial tasks
  • indiviual must move onto next stage even if tasks in previous one have not been completed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Trust vs. Mistrust

A

Stage 1: infancy to 18 months

- gaining trust in people around me

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Autonomy vs Shame & Doubt

A

Stage 2: infancy- 3 years

-how can I control myself?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Initative vs Guilt

A

Stage 3: 2- 5 years

-how do I control myself in my enviornment?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Industry vs Inferiority

A

Stage 4: 5- 13 years

- learning skills necessary to survive and be successful in life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Identity vs Role confusion

A

Stage 5: 13- 21 years

  • where do I belong in the world?
  • what is my purpose?
  • finding out/ exploring who you are
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Intimacy vs Isolation

A

Stage 6: 21- 39 years

- looking to partner up, form meaningful connections, and start families

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Generavitity vs Stagnation

A

Stage 5: 39- 65 years

  • giving back to community, younger generations
  • nurturing all the other stages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Ego Integrity vs Despair

A

Stage 6: 65+

-looking back on life and feeling fulfillment/ regret

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Piaget’s Development Theory

A
  • 4 stages: infancy- 18
  • indiviual must complete tasks in previous stage to move onto next stage
  • using previous experiences to move stages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Stage 1: infancy- 2 years

A

Sosiomotor stage

  • exploring the world using sensory and motor skills
  • object permanance and seperation anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Stage 2: 2- 6 years

A

Preoperational Stage

  • able to use symbols (words and images) to represent objects
  • doesn’t reason logically
  • child is still egocentric
  • develops ability to pretend
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Stage 3: 7-12 years

A

Concrete operational stage

  • develops ability to think logically
  • understands conversation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Stage 4: 12- 18 years

A

Formal operational stage

-develops ability to think abstractally and hypothetically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Infancy (0-1 years) growth & development

A
  • weight gain & grow in lenght
  • hold head up at 2 months
  • roll over at 4-5
  • crawl and babble at 9 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

assessing infants

A
  • reliant on caregiver for information
  • observe child- caregiver intercations, note strenghts & challenges, and offer advice/ help
  • no head to toe: just assess as quick as possible & whatever is necessary
  • least to most invasive so baby doesn’t get fussy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Early childhood (1-3 years) growth & development

A 
Growth: 
-exponential growth 
-baby teeth grow in 
Development: 
- 2-3 word sentances 
- potty training 
- fine & gross motor skills develop 
- more control over motor skills (running, jumping, skipping)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

assessing early childhood

A
  • still reliant on caregiver
  • scared of HCP
  • show them what you’re doing on a teddy bear, parent, yourself
  • let them see & touch things that aren’t dangerous
  • incorporate play & be creative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Late childhood (3-6 years) growth & development

A
  • psychosocial tasks: creating relationships (friends at pre- school)
  • want for privacy: become more self- aware
  • know when its appropriate/ not appropriate to do things like go to the bathroom
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

considerations late childhood

A
  • constipation: become self- aware might be embarassed to use bathroom at school
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

assessing late childhood

A
  • involve them in assessment
  • explain what you’re doing
  • don’t lie to them
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

School age (6-11 years) growth & development

A

Growth:

  • weight gain and growth
  • skeletal growth happens before muscle growth: lanky

Developmental:

  • fine motor skills (shoe tying, playing instruments)
  • peers at school have big influence on them
  • begin to understand discipline, boundaries, consequences
  • begin teaching them about healthy lifestyle choices
  • increased body- awarness: increased need for privacy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

assessing school aged

A
  • can begin to rely on them more for information and less on caregivers
  • involve them in assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Adolescents (12- 18 years) growth & development

A

Growth:

  • growth spurts
  • weight gain
  • puberty
  • sex specific changes

Development:

  • independce
  • begin exploring relationships
  • impulsivness
  • risk taking
  • big need for privacy
  • begin exploring sexuality
  • peers and belonging are important
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

considerations adolescents

A
  • mental health issues

- promoting safe sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

assessing adolescents

A
  • privacy and confidentiality is particularly important
  • rely primairly on them for information
  • don’t avoid important questions because they’re uncomfortable topics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Young adults (18- 35 years)growth & development

A

Growth:
-bodily systems continue growing and developing to fit adult body size

Development:

  • forming interdependence on another person
  • finding purpose to make life meaningful
  • starting families
  • building foundations for good health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

assessing young adults

A
  • prevention of chronic illness

- health promotion for healthy behaviours and lifestyle choices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Middle age (35-65 years) growth & development

A

Growth:

  • aging (hair, skin changes)
  • metabolism slows

Development:

  • mental health/ self-image changes
  • role changes (children moving out of home)
  • life reflection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

assessing middle age

A
  • screening for and preventing chronic illness
  • promote sense of fulfillment by giving back to community\
  • Osteoperosis screenings at 65
  • Mamograms at 50
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Older people (65+) growth & development

A

Growth:

  • body systems age
  • immune system diminishes
  • more health complications
  • impaired cognition is NOT a normal sign of aging

Development:

  • loss of autonomy/ independence
  • loss of role
  • reflecting upon life
  • dealing with loss of spouse/ friends/ family
  • isolation/ loneliness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

assessing older people

A
  • hearing impaired: speak slowly, loudly, clearly
  • if completley deaf position yourself so they can lip read/ write things down
  • vision impaired: explain your actions so you don’t startle them & provide therapeutic touch
  • if cognitively sharp speak to them in assessment, rely on caregiver if cognitive issues are present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

ineffective communication consequences

A
  • poor patient outcomes
  • misscommunications regarding patient needs, health status, and plan of care
  • decreased professional credibility
  • increased adverse incidents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

therapeutic interviewing

A

interviewing with specific purpose with focus on specific content area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

active listening

A

finding meaning behind patients words by noticing non- verbal cues, emotions, word choice, and being fully present in conversation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

subjective data

A

what patient tell you

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

objective data

A

data you collect by assessing (ASEPTIC, physical assessment, vital signs)

85
Q

comprehensive assessment

A
  • head to toe
  • pre-op
  • admission
  • non- emergant situations
  • seeing patient for first time
86
Q

focused assessment

A

only assessing body systems releated to symptoms

87
Q

emergent assessment

A
  • emergency situations

- only focusing on assessing what is necessary

88
Q

purpose of health history

A

to collect subjective data

89
Q

components of health history

A
  • demographics (age, sex, gender)
  • past medical history
  • family history
  • surgical history
  • medications
  • allergies
  • reason for seeking care
  • sexual history/ sexuality (if relevant)
  • human violence history (if relevant)
  • lifestyle
  • related symptoms
90
Q

what is OLDCARTSS?

A 
-used for collecting health history 
O: onset
L: location
D: duration
C: character
A: alleviating/ aggrevating factors 
R: radiation 
T: timing 
S: severity 
S: self- perception
91
Q

Privacy

A

patients right to decide how their information is collected, used, and disclosed
-about patient

92
Q

Confidentiality

A

About information

-includes spoken information and written (charting, records, files, etc.)

93
Q

circle of care

A

people directly caring for patient who have the right to confidential information

94
Q

personal health information

A

identifying information about clients

  • name, age
  • past medical history
  • eligibility for health care/ payment
  • body part/ substance donation
  • health card number
  • name of patients substitue decision maker
95
Q

T or F: healthcare facilities own personal health information

A

False

-patient owns this info but it is safeguarded in health care facilities

96
Q

T or F: domestic violence can be reported without patient consent

A

False

97
Q

T or F: child abuse can be reported without consulting patient

A

True

98
Q

When can elderly abuse be reported?

A

Only when it occurs in health care facilities (LTC, hospital, retirement centre)

99
Q

T or F: you should immedietly share patient information with the police when asked to do so

A

False

-need to follow process to obtain information on patient

100
Q

T or F: Illicit drug use can not be reported

A

True

101
Q

T or F: Suicidal ideations can be shared if the person is a danger to themselves/ others

A

True

102
Q

T or F: You are concerned with a seniors eligibility to drive; you allowed to voice your concerns to somone outside of the circle of care

A

True

-driving concerns can always be reported as they are a public threat

103
Q

Why do we document?

A
  • communicate patient needs/ health status
  • communicate changes in health status
  • communicate care plan
  • quality assurance
104
Q

good documentation is:

A 
factual (avoid using generalized terms)
accurate 
conscise 
clear 
organized 
relevant 
complete
105
Q

What to do if you make a mistake when charting?:
A) erase it/ white it out
B)draw a line through the mistake and inital
C) start all over again
D) leave it and hope no one notices

A

B

106
Q

What do we do with blank spaces on notes?

A

Draw a line through them so no one can add to your entry

107
Q

What do soap notes have to include?

A

Time in milatary time
Date
Title
Bottom right: first inital, last, designation

108
Q

SOAP

A

S- subjective
O- objective (ASEPTIC)
A- problem/ diagnosis
P- plan/ next steps

109
Q

T or F: You can have good mental health while having mental illness?

A

True

110
Q

T or F: The absence of mental illness= good mental health

A

False, you can have poor mental health w/o having mental illness- mental health is a continum

111
Q

Normal adult HR

A

60-100 BPM

112
Q

Normal adult BP

A

120/80 mmHg

113
Q

Normal adult RR

A

12- 20

114
Q

Normal O2 saturation

A

92- 98%

115
Q

Normal temp range- oral

A

36.5- 37.5

116
Q

Temp range- axillary

A

35.9- 37.2

117
Q

Temp range- tympanic

A

36.0- 37.5

118
Q

Temp range- temporal

A

36.5- 37.5

119
Q

Bradycardia

A

Slower than usual heart beat

120
Q

Tachycardia

A

faster than usual heart beat

121
Q

asystole

A

no heart beat

122
Q

arrhythmia

A

extra heart beat

123
Q

factors that increase HR

A
  • exercise
  • cardiac/ respiratory illness
  • gender (female)
  • age (younger)
  • pain
  • fever
  • stress
  • hemorrhaging
  • meds
124
Q

Apical pulse

A
  • apex of the heart
  • located between 4th and 5th intercoastal space mid-lateral line (between 4th/ 5th rib)
  • under left nipple (right where bra band is for women)
125
Q

when do we listen for apical pulse

A
  • having trouble hearing radial pulse
  • children under 2
  • when unusual findings are found at radial pulse
  • when we want to double check
126
Q

how to listen for pulse- if regular

A

count “dub” sounds for 30 seconds- multiply by 2

127
Q

how to listen for pulse- if irregular

A

go to apical pulse listen for full 60 secs

128
Q

hypertension

A

high BP

- 140/90

129
Q

hypotension

A

low BP

-90/60

130
Q

orthostatic BP

A

dramatic changes in BP from changing positions

131
Q

pulse preassure

A

difference in systolic and diastolic BP

  • usually around 40
  • not a good sign if increasing
132
Q

factors that increase BP

A
  • age
  • gender (men)
  • chronic conditions
  • stress
  • medications
  • higher in the morning
133
Q

Febrile

A

Has fever

134
Q

Afebrile

A

no fever

135
Q

pyrogen

A

something that causes fever

136
Q

antipyretic

A

something that alleivates fever (tylenol, advil)

137
Q

diaphoresis

A

sweating

138
Q

diaphoretic

A

act of sweating

139
Q

rigors

A

shivering caused by fever

140
Q

hypothermia

A

body temp below 35

141
Q

hyperthermia

A

body temp above 38

142
Q

bradypnea

A

slow breathing

143
Q

tachypnea

A

fast breathing

144
Q

dyspnea

A

difficulty breathing

145
Q

apnea

A

absence of breath

146
Q

factors that increase RR

A
  • age (younger= faster RR)
  • exercise
  • smoking
  • anxiety
  • hypothermia
  • medical conditions (ex. anemia)
147
Q

factors that decrease HR

A
  • medications (opiods)

- upright body position

148
Q

what is oxygen saturation

A

indirect measurement of oxygen in blood

149
Q

normal oxygen saturation

A

92- 98%

150
Q

psychiatric nursing vs mental health nursing

A

you can specialize in psychiatric nursing but mental health nursing is a part of every speciality of nursing

151
Q

Major mental disorders in Canada

A
  • Anxiety
  • Mood disorders
  • Personality disorders
  • Addicition
  • Self harm
  • Schizophrenia
152
Q

3 D’s of mental health

A
  1. disability
  2. duration
  3. distress
153
Q

7 characteristics of good mental health

A
  1. interpret reality correctly
  2. have ability to control your own behaviour
  3. have a healthy self- concept
  4. find a sense of meaning/ purpose in life
  5. have ability to relate to others
  6. have ability to cope/ adapt with change & challenges
  7. demonstrate creativity/ productivity
154
Q

DSM-V

A

book used to diagnosis mental disorders

-standard set of criteria so people aren’t uneccessairly diagnosed with mental illness

155
Q

components of mental health history

A
  • personal health history
  • family history
  • medications
  • suicidal ideations
  • violence/ trauma
  • substance abuse
  • mood
  • hallucinations/ psychosis
156
Q

structual stigma

A

limitations/ restrictions on a population scale (ex. policies) that disadvantage mentally ill people

157
Q

social stigma

A

stigmatization of mentally ill people in society

-leads to higher levels of illness, incarcination, unemployment of mentally ill people

158
Q

self- stigma

A

internalization of stigma and negative comments, feelings, thoughts

159
Q

3 pillars of recovery

A
  1. choice
  2. community
  3. integration
160
Q

principals of recovery

A
  1. fostering hope
  2. enabling choice
  3. encouraging responsability
  4. promoting dignity and respect
161
Q

normal cognitive changes

A
  • processes become slower
  • may take longer to process new info
  • slight decline in short term memory
  • long term memory & decision making abilities should remain in-tact
162
Q

atypical cognitive changes

A
  • personality changes
  • no recall of recent events
  • confusion
  • dementia
  • lack of insight
  • impaired judgement
163
Q

3 D’s of cognitive decline in elderly

A
  1. Dementia
  2. Delerium
  3. Depression
164
Q

ADLs

A

Activities of daily living

- basic functions (bathing, eating, dressing yourself)

165
Q

IADLs

A

Instrumental activities of daily living

-executive functions (cleaning, cooking, grocery shopping)

166
Q

T or F: Dementia is reversible and has a definite pathological/ emotional cause

A

False

  • deleium is reversible and has a cause
  • dementia is irreverisble and progresses in a step-like manner
167
Q

T or F: Delerium, dementia, and depression can coexist

A

True

168
Q

Cognition screening tools

A

Mini- Mental State Exam (MMSE)
3- min mini cog
MOCA

169
Q

What do you need to score on MMSE to be diagnosed with dementia

A

below 27

  • 20 to 26 is mild dementia
  • 10 to 19 is moderate dementia
  • below 10 is severe dementia
170
Q

when to screen for dementia

A
  • over 80 yrs old
  • after a stroke
  • after head trauma
  • if indications of cognitive decline are present
  • after treatment for delerium/ depression
171
Q

components of cognitive assessment

A
  • medical history
  • family history
  • review of ADLs & IADLs
  • meds
  • lab results
  • head scans
  • functional ability
  • related symptoms
  • onset
  • mood
  • hallucinations/ psychosis?
  • cognitive screening
  • substance abuse
172
Q

When communicating with someone with cognitive impairment:

A
  • repeat instructions if not understood
  • sit directly in front of them where they can see you and hear you
  • be patient
  • don’t argue with them
  • limit enviormental stimuli
  • simple instructions
173
Q

Risks for people with cognitive impairment:

A
  • hygeine
  • nutrition
  • abuse
  • targeted scams
  • fires
  • driving
  • wandering/ getting lost
174
Q

What does the body use proteins for

A

Muscle growth & repair

175
Q

What does the body use carbs for

A

energy

176
Q

What does the body uses fats for

A

insulation/ protection

177
Q

factors influencing nutrition

A
  • medications
  • family
  • lifestyle choices
  • socioeconomic status
  • geographical location
  • education
  • culture
  • religion
  • ability to go get food
178
Q

infant nutrition recommedations

A
  • breast is best
  • vitamin D supplements
  • introduction of solid food at 6 months
  • whole dairy (fat for brain development)
179
Q

pregnancy nutrition recommedations

A
  • prenatal supplements
  • folic acid to prevent neural tube defects
  • iron to provide oxygen to baby through RBC
  • calcium to promote healthy bones & gums
180
Q

early childhood nutrition recommedations

A
  • transition from breast milk to actual meals

- introducing a variety of new foods

181
Q

teen nutrition recommedations

A
  • require more protein due to rapid growth

- SCOFF questionnaire: eating disorder screening

182
Q

nutrition screening tools

A

SCOFF questionnaire: eating disorders
24- hour food recall
Food diary
Nutrition questionnaires

183
Q

what makes up the integumentary system

A

hair, skin, nails, sweat glands

184
Q

why is assessing the integumentary system important

A

reflects the patient’s hydration, nutrition, and emotional status

185
Q

risk factors for integumentary system

A

Vitamin/ mineral deficiency
UV exposure
Preassure ulcers
Infectious diseases

186
Q

health promotion integumentary assessment

A
  • edcuate patients on difference between cancerous and non- cancerous moles
  • emphasize steps in skin self- examination
  • importance of protection from UV rays (limiting exposure, wearing sunscreen, etc.)
  • ABCDE’s of skin cancer
187
Q

what is the most common skin disease

A

melanoma (skin cancer)

188
Q

ABCDE’s of melanoma

A 
A: asymmetry
B: border 
C: colour 
D: diameter 
E: evolution
189
Q

Vesicle

A
  • fluid filled
  • blister
  • on top of skin
  • ex: chicken pox
190
Q

Pustule

A
  • puss filled
  • generally raised
  • on top of skin
  • ex: acne
191
Q

cyst

A
  • under the skin
  • can be fluid filled, puss filled, cell- filled, infection filled
  • ex: cystic acne
192
Q

Macule

A
  • flat
  • less than 1cm in diameter
  • ex) freckles
193
Q

Papule

A
  • raised
  • less than 1cm in diameter
  • ex) insect bite
194
Q

Wheal

A
  • slighty raised
  • varies in size and shape
  • can be flesh coloured/ red
  • ex) rash
195
Q

Scar

A

-replacement of skin during healing

196
Q

Excoriation

A
  • lesion from scartching

- ex) cat scratches

197
Q

Ulcers

A
  • loss of skin surface that can extend to dermis

- ex) preassure ulcers

198
Q

what are secondary lesions

A

lesions resulting from primary lesions

199
Q

preassure ulcers

A

breaks in skin caused by extended periods of time where preassure is being put on one area of the body and oxygen, nutrients, circulation are unable to reach it
-usually in boney prominances (elbows, hells, skull)

200
Q

how to prevent preassure ulcers

A

-frequent repositioning

201
Q

Rule of 9’s

A

-used to estimate how much tissue is affected in people who have suffered burns

202
Q

when describing lesions include:

A
  • colour
  • texture
  • shape
  • borders
  • fluid/ solid/ semi-solid
  • surface/ under the surface
  • location
  • morphology
  • distribution (localized, regional, generalized)
  • size
203
Q

Jaundice

A

yellow tint to skin

-may indicate liver disease

204
Q

edema

A

swelling

205
Q

erythema

A

redness

206
Q

cyanosis

A

blue tint to skin

-indicates deoxygenation

207
Q

pallor

A

paleness

-may indicate anemia

208
Q

phototoxicity

A

drug toxicity resulting from medication

209
Q

photosensitivity

A

redness/ blistering resulting from medication

Nursing 1080 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions