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Adults III Exam 1 > Foundations > Flashcards

Foundations Flashcards

1
Q

Standards of Care

A

ADPIE

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2
Q

Truth

A

Veracity

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3
Q

Fairness

A

Justice

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4
Q

Self-Determination

A

Autonomy

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5
Q

To do Good

A

Beneficence

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6
Q

To prevent Harm

A

Non-malifiecence

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7
Q

Hold faithful or Confidential

A

Fidelity

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8
Q

Elements of professional negligence

A

Duty
Breath of Duty
Causation
Injury

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9
Q

Living Will

A

Specific requests made by competent clients regarding medical care

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10
Q

DPOA

A

most protective of clients’ interests

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11
Q

10 times more potent than Morphine
Used for hemodynamically unstable (low BP, bradycardia)
SA analgesic, stronger than Morphine

A

Fentanyl

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12
Q

Respiratory Depression
Hypotension
Antidote = Narcan

A

Morphine

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13
Q

Change tubing q12h

Milky appearance

A

Diprivan / Propofol

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14
Q

Given for ICU delirium
Elderly
Acute confusion Psychosis

Need to measure QT interval - can prolong it

A

Haldol / Haloperidol

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15
Q

Depolarizing Muscle Relaxant

A

Succinylcholine

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16
Q

Malignant Hyperthermia

A

genetic HX problem, occurs by gases and succinylcholine
can occur during induction, during or 72 hours after surgery

Emergent situation: Tachycardia, increase CO2, muscle rigidity in jaw (early), hyperthermia with temp of 106 (late)

Treatment: Dantrolene - slows action of muscle rigidity
Cool patient, treat hyperkalemia

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17
Q

Short term sedation
Do not use if head trauma can cause HTN
Antidote = Remazicon

A

Versed / Midazolam

18
Q

Client not able to verbalize pain

A

Neuromuscular blockage agents (Pavulon)

19
Q

Improve oxygenation

A

Give blood / blood products

20
Q

Nutrition for the intubated client

A

Enteral feeding through dobhoff

21
Q

Pre-Operative

A

Assessment: baseline values
NPO
Pre-Meds: atropine or scopaline (dry them up)
GI Meds: pepcid, zantac, nexium (due to increased metabolic rates)
Teaching DONE HERE! - explain what will happen before, during, after

22
Q

Intra-Operative

A

General inhalation anesthetics
IV sedations: barbiturates, narcs, tranquilz (morphine, versed)
Locals: BIER blocks - close reduction (lidocaine)
Manage anesthesia care (MAC)
Muscle Relaxants: depolarizing (succinylchoine) & non-depolarizing (pancuronium)

23
Q

Post-Operative

A

Transfer to floor - always assess!
Report: name age, DX, allergies, HX, old vitals, obtain new vitals, incision/dressing, fluids, IV’s, I&O
Their meds and last pain meds given
Equipment, orders, family, belongings

Receiving Department: assessment and orders with plan of care

24
Q

PAR (Aldrete) Score

A

score patient at admission, 15 min, 15 min, 30 min
Needs to score 8 for discharge

Activity: able to move, voluntarily or on command
Respiration: able to breath deep and cough freely, dyspnea, apnea
Circulation: BP within 20 mmHG of preoperative
Oxygen Saturation: sats >92%, sats

25
Q

PACU

A

focused assessment
ABC’s
Specific assessments for surgery
Pain, safety, incisions, equipment

Aldrete (PAR) score

26
Q

Stressors for Staff

A 
Technology
High Acuity Patients
Dying Patients
Families in crisis
Overtime
Mandatory call time
27
Q

Stressors for Clients

A 
Presence of invasive lines
loss of control (powerless)
sleep deprivation
alterations in circadian rhythms
sensory deprivation
sensory overload
28
Q

ICU Psychosis

A

(occurs 48 hours after admission in ICU & resolves 2 days after leaving ICU)

perceptual distortions - paranoia
decreased attention span
disorientation
memory loss
labil emotions

have family stay to reorient patient
Give HALDOL
When entering room: say name, date, time, location, why here to reorient

29
Q

Response to Acute Illness or Injury

A 
culture
Developmental stage
general health
social support
personality type (A or B)
Financial resources
Previous experiences
30
Q

Alterations in Consciousness

A

alterations in circadian rhythm
sleep pattern disturbances
medications / intoxicants (can affect patients minds)
age over 60 years

31
Q

Nutrition

A

Assessment of Needs: LOC, trauma, N/V, fatigue
pre-illness status
enteral vs parenteral routes (increases BS)
Hasn’t eaten for 3 days - need dobhoff!
Pre-albumin: acute conditions (15-32 g/dL)
serum-albumin: chronic conditions (protein / nutrients) [3.5 - 5 g/dL]

32
Q

Correct Hypoxia

A

administer O2
monitor sats
intubate if needed

33
Q

Improve Cardiac Output

A

optimize preload (volume in) and contractility
Administer anti-dysrhythmic drugs
Give IV fluids
give interpose (increase squeeze, contractions)
Diuretics and Vasodilators
Correct fluids and electrolytes

34
Q

Improve O2 Carrying Capacity

A

give blood or blood products (hemoglobin checks nutrient status

35
Q

Decrease Metabolic Demands

A 
relieve pain and anxiety
keep client warm and dry
control fever
allow clients to rest
suction PRN
36
Q

O2 Demands

A

sedate or use NMB drugs (paralyzes) if needed

need to do both or may increase anxiety due to paralysis!

37
Q

Professional organization

A

American Association of Critical Care Nurses (AACN)

38
Q

CCRN: Critical care Nursing Certification

A

VALIDATES KNOWLEDGE OF CRITICAL CARE NURSING

39
Q

Assessments

A

Assessments done more frequently to q4h
In ICU: head to toe assessments done 3x q4h @ 8, 12, 1600
In PACU / ER: focused assessment - focus on chief complain!

make sure to document assessment at each & every assessment

40
Q

Abandonment

A

UNILATERAL SEVERANCE of a professional relationship while the client is still in need of health care
CC Nurses are responsible for their client’s safe and continuous care
Nurses have a contractual relationship, an agreement on their shift to the patient

41
Q

Elements of informant Consent

A 
competence
voluntaries
disclosure (of information)
understanding (of information)
decision
Authorization

Adults III Exam 1 (8 decks)

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