Brainscape's Knowledge GenomeTM

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


See full index

Nursing-Sem 1 > Foundations Exam 3 > Flashcards

Foundations Exam 3 Flashcards

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

What is the AORN?

A

Association of periOperative Registered Nurses; 1950s

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

What are some benefits of ambulatory surgery?

A

rapidly metabolizing anesthetics
cost-saving (less time in care setting)
reduce risk of HAIs
minimally invasive

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

What are the purposes of surgery? (8)

A 
(A Curious Colorful Caterpillar Plays Pretty Rad Tunes)
ablative
constructive
cosmetic
curative
palliative
preventive
reconstructive
transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the different classifications for surgery?

A

1) seriousness (major, minor)
2) urgency (emergency, urgent, elective)
3) purposes (ablative, palliative, diagnostic, reconstructive, procurement, transplant, cosmetic)

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

Phases of surgery?

A

preoperative, intra-operative, postoperative,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the purpose of assessment during the preoperative phase?

A

to establish “normal” or baseline functioning to use as comparison during post-op phase to help recognize/prevent complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what should be included in the pre-op assessment?

A

nursing hx (smoking, alcohol, pain, religion)
medical hx (allergies, meds, surgeries)
labs
risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are some of the risk factors for surgical complications?

A 
age
medical conditions
nutrition
sleep apnea
medications/allergies
immunocompetence
fluid/electrolyte imbalance
pregnancy
personal habits (alcohol, smoking)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some specific surgical risk factors associated with age?

A 
skin more prone to ulcers, tears
delayed GI emptying
increased risk for infection
increased risk for confusion/delirium
falls risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some specific surgical risk factors associated with obesity?

A

embolus, atelectasis, pneumonia
poor wound healing (low blood supply)
dehiscence and evisceration

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

implications of anticoagulants before/during surgery?

A

must d/c at least 48 hours before surgery b/c alter normal clotting and increase risk of hemorrhage

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

implications of insulin before/during/after surgery?

A

the need for insulin changes post-op b/c stress, IV admin of insulin, and decreased nutritional intake decrease insulin requirements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

implications of NSAIDS before/during/after surgery?

A

NSAIDs inhibit platelet aggregation and prolong bleeding times, increasing susceptibility to post-op bleeding

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

implications of ginseng and surgery?

A

Ginseng increases risk of hypoglycemia in patients on insulin therapy

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

ASA classes for surgical patients?

A 
I: normally healthy
II: mild symptomatic disease
III: severe disease, not threatening
IV: severe disease, constant threat to life
V: not expected to survive w/o operation
VI: brain dead, awaiting organ harvest
I-III = ambulatory surgery candidate
IV-VI = inpatient surgery only
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

preoperative teaching includes preparing patient for what?

A

expectations before, during, and after surgery

and physically prepping patient (NPO, jewelry, meds)

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

what is the nurses role in informed consent?

A

witnessing the signature, making sure patient is competent, making sure it’s signed by the right person, and assuring patient knows their right to refuse

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

different types of anesthesia?

A

general
conscious sedation
regional
local/topical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

primary focus during intra-operative phase?

A

prevent injury/complications related to anesthesia, positioning, surgery, and equipment use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

malignant hyperthermia

A

life-threatening complication related to anesthesia (genetic–hx important!)

s/s inc CO2, HR, RR, PVCs, unstable BP, cyanosis, mottling, muscle rigidity, late sign = 106-107 deg hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

recovery phase I

A

movement from OR to PACU
q15min assessment of airway, LOC, vitals, mobility, sensation, fluid balance, dressing (Aldrete score/post-anesthesia recovery score)

handoff communication
nursing focus on maintaining airway, respiratory, circulation, neurological functions and managing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

recovery phase II

A

after ambulatory surgery

modified Aldrete score. need 8-10 to be discharged home. PARSAP scoring in addition to Aldrete. Need 18+ to go home.

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

t/f: never assume pain is incisional

A

true. always check for location, intensity, and character of pain.

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

pain

A

unpleasant, subjective sensory and emotional response to actual or potential tissue damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

pain control influences what other factors?

A

QOL, early mobilization, fewer hospitalizations, shorter length of stay, and decreased costs

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

nociception

A

process by which painful stimulus is transmitted to CNS and perceived as pain

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

the process of pain includes what phases?

A

transduction, transmission, perception, modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

transduction

A

conversion of a painful stimuli into an action potential

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

transmission

A

action potential signals release of 2nd messengers into synapses to further the impulse to spinal cord, brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

perception

A

recognition of pain stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

modulation

A

body inhibits pain by releasing chemical messengers the send signal back to pain site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

gate-control theory of pain

A

two painful stimuli cannot be transmitted at the same time, will compete for transmission, so painful stimuli can be blocked by other somatic stimuli (e.g. toe stubbing, rubbing example)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what stimulated the activation of the ANS and parasympatheic nervous system?

A

ANS: stress (fight/flight)
PSNS: continuous, severe, deep pain

34
Q

sympathetic responses to pain

A

dilate respiratory tubes, increase HR, peripheral vasoconstriction, increase BGC, diaphoresis, increased muscle tension, pupil dilation, decreased GI motility

35
Q

parasympathetic responses to pain

A

pallor (blood to vital organs), muscle tension (fatigue), decreased HR & BP (vagal stimulation), rapid/irregular breathing (bodys defenses fail under prolonged stress)

36
Q

behavioral responses to pain

A

body movements: clenched teeth, guarding, bent posture, grimacing, crying, moaning, restlessness, frequent requests for nurse

lack of pain expression does not mean patient is not experiencing pain

37
Q

types of pain

A

acute, chronic, chronic episodic, cancer, inferred pathological, idiopathic

38
Q

acute pain

A 
protective
identifiable cause
limited tissue damage, emotional response
seen with injury or surgery
lasts up to 6 months
39
Q

chronic pain

A 
lasts longer than 6 mo
lasts longer than expected recovery time
in response to progressive illness
may not have visible injury (neuropathic)
no adaptive purpose
frequently results in depression
40
Q

physiological factors influencing pain

A

age
fatigue
genes
neurological function

41
Q

social factors influencing pain

A

attention
previous experience
family or social support
spiritual factors

42
Q

psychological factors influencing pain

A

anxiety
coping style
cultural factors (expectations, roles, ideas about healing/suffering, etc.)

43
Q

burning, crushing, piercing, sharp are examples of what kind of words that describe pain?

A

sensory words

44
Q

agonizing, exhausting, miserable, punishing are examples of what kind of words that describe pain?

A

affective words

45
Q

what is the goal of pain management?

A

anticipate and prevent pain, not treat it

46
Q

what are some non-pharmacologic interventions for pain?

A

cognitive-behavioral
physical
CAM

47
Q

cutaneous stimulation for pain

A

TENS

massage

48
Q

what does TENS stand for?

A

transcutaneous electrical nerve stimulation

49
Q

what are some pharmacologic interventions for pain?

A 
analgesics (opioid, non-opioid, adjuvants)
PCA (patient-controlled)
perineurial local anesthetic infusion
topical analgesics
local/regional analgesics
50
Q

what are some benefits of PCA?

A

safe (avoids peaks, troughs)
patient in control
relief does not depend on nurse availability
decreases anxiety and medication use

51
Q

describe perineurial local anesthetic infusion

A

anesthetic agent infused through un-sutured catheter placed at surgical site

52
Q

what are some considerations with local anesthetics?

A

prolonged use may lead to “caine allergy”

53
Q

what are some considerations for caring for patients with epidural infusions?

A 
prevent catheter displacement
maintain catheter function
prevent infection (q24h tube change)
monitor for respiratory depression
prevent complications (itching, nausea)
maintain urinary/bowel function
54
Q

guidelines for use of analgesics

A

1) know patient’s previous response to analgesics
2) select proper med when have multiple orders
3) know accurate dosage
4) assess right time, interval for admin

55
Q

pain relief ladder

A

1) start with non-opioids such as NSAIDs, acetaminophen, +/- adjuvants
2) if persists/develops to mild-moderate pain, use opioids +/- non-opioids and adjuvants
3) if persists/develops to severe pain, use higher dose of opioids +/- non-opioids and adjuvants

56
Q

cautions with analgesic use

A

avoid use of multiple opioids, esp. w/ elderly

avoid IM analgesics, esp. in elderly

57
Q

what is used for long-term management of chronic pain?

A

fentanyl patches, morphine, and hydro-morphone
and
SR formulatons ATC

58
Q

what is a benefit of IV analgesics?

A

quicker acting

59
Q

patient barriers to effective pain management

A

fear of addiction
worries about side effects
“noble” suffering
need to suffer to earn healing

60
Q

provider barriers to effective pain mangement

A

inadequate pain assessment skills
addiction concerns
fear of legal repercussions
thinks pain is part of aging process (false)

61
Q

differences between physical dependence, addiction, and tolerance

A

dependence: withdrawal symptoms w/ stop
addiction: disease. impaired control, cravings

tolerance: over time requires more to achieve same effects

62
Q

palliative care vs. hospice

A

palliative care helps coordinate care and live life fully

hospice is end of life care (quality of life over quantity of time)

63
Q

allodynia

A

sensation of pain in response to a normally non-painful stimulus

64
Q

analgesia

A

absence of pain in response to a normally painful stimulus

65
Q

dysthesia

A

unpleasant but normal sensation, either spontaneous or evoked

unpleasant, normal

66
Q

paresthesia

A

abnormal but not unpleasant sensation, spontaneous or evokes

not-unpleasant, abnormal

67
Q

neuroalgesia

A

pain in distribution of nerve or nerves

68
Q

hyper/hypoalgesia

A

increased or decreased response to normally painful stimuli

69
Q

pain threshold vs. tolerance

A 
threshold = minimal experience of pain
tolerance = greatest level of pain
70
Q

nociceptive pain state

A

evidenced by painful stimulus

pain localized to area of stimulus damage

71
Q

inflammatory pain state

A

evidence of inflammation

redness, swelling, heat

72
Q

neuropathic pain state

A

evidence of sensory or nerve damage

burning, tingling, shock-like pain, paresthesias or dysthesias

73
Q

dysfunctional/centralized pain state

A

pain without detectable pathology; evidence of increased amplification and/or decreased inhibition

74
Q

pain mechanisms include…

A 
nociceptive transduction
peripheral sensitization
exotic activity
central sensitization
central disinhibition
75
Q

what to acquire about during nursing assessment for pain?

A

intensity
location
quality
modifying factors

76
Q

what to observe for during nursing assessment for pain?

A 
level of distress
movement
posture
consistency with story
vitals
TOUCH/physical exam
77
Q

pain red flags include…

A

outside expected location
out or proportion with diagnosis
“something’s not right”

78
Q

multimodal management of pain

A 
M = medications
I = interventions
P = PT
S = pSychoSocial
79
Q

treatment of nociceptive pain

A

opioids
NSAIDS
acetaminophen
antidepressants (TCAs)

80
Q

treatment of inflammatory pain

A

steroids
NSAIDs
COX2 inhibitors

81
Q

treatment of neuropathic pain

A

CCBs

sodium channel blockers

82
Q

treatment of dysfunctional/centralized pain

A

SNRI antidepressants

CCBs

Nursing-Sem 1 (13 decks)

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