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Foundations of Nursing > Foundations Exam Four > Flashcards

Foundations Exam Four Flashcards

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1
Q

A person who lives as a member of a gender other than expected based on sex or gender assigned at birth;

A

Transgender

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2
Q

An identity label sometimes adopted by male-to-female trans people to signify that they are women while still affirming their transgender history

A

Trans Women

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3
Q

An identity label sometimes adopted by female-to-male trans people to signify that they are men while still affirming their transgender history

A

Trans Man

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4
Q

A political statement, as well as sexual orientation, which advocates breaking binary thinking and seeing both sexual orientation and gender identity as potentially fluid. The term is a simple label to explain a complex set of sexual behaviors and desires

A

Queer

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5
Q

An individual who is unsure of and/or exploring their gender identity and/or sexual orientation

A

Questioning

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6
Q

A set of medical conditions that feature congenital anomaly of the reproductive and sexual system. Born with sex chromosomes or external genitalia that are not considered standard for either male or female

A

Intersex

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7
Q

An attraction to people regardless of their gender; may be attracted to their own gender as well as other genders

A

Pansexual

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8
Q

Prejudice against individuals and groups who display non-heterosexual behaviors or identities, combined with the majority power to impose such prejudice; usually used to the advantage of the group in power.

A

Heterosexism

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9
Q

Someone who feels comfortable with the gender identity assigned to them based on their sex assigned at birth

A

Cisgender

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10
Q

Gender identity not exclusively male or female

A

Nonbinary

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11
Q

Examples of hormone therapy as medical intervention

A

Estrogen
Testosterone
Gonadotropin-Releasing hormones (block puberty)
Suprellin implant (block puberty)

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12
Q

Normal Cognitive Functions

A

Perception
Consciousness
Thought
Memory

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13
Q

3 things required for perception to occur?

A
  • A functionary sensory system
  • Neurotransmission: receive a stimuli and then a neural impulse is sent to the brain to be interpreted
  • Processing
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14
Q

Three types of sensory receptors?

A
  • Exteroceptors
  • Proprioceptors
  • Interoceptors
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15
Q

The sensory receptor responding to stimuli from external environment (vision, hearing, pain, and somatic receptors)

A

Exteroceptor

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16
Q

The sensory receptor related to body’s physical state, position, and sensation of movement (inner ear, muscles, tendons, and joints)

A

Proprioceptor

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17
Q

The sensory receptor related to change in internal environment (blood pressure, O2 level, viscera and deep tissues)

A

Interoceptor

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18
Q

Consciousness

A

State of awareness and responsiveness

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19
Q

Orientation

A

Person, place, time, situation

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20
Q

Judgement

A

Insight - process of reasoning (determine the stimuli’s meaning)

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21
Q

Memory

A

Ability to store and recall

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22
Q

Comprehension

A

One’s ability to understand

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23
Q

Life span considerations
Newborn - Infant for
Cognitive Processes

A

Sensorimotor

Language not developed

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24
Q

Life span considerations
Toddler - Preschool
Cognitive Processes

A

Object permanence
Verbal language and reasoning develop
Egocentric view
Concrete thinking

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25
Q

Life span considerations
School-age to Adolescent
Cognitive Processes

A

School-age develops abstract thinking

Adolescents being to perform complex mental processes

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26
Q

Life span considerations

Adult-older adult

A

Rational thinking
Increased age - higher likelihood of neurological problems
Cognitive impairments are not considered a normal sign of aging

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27
Q

Factors affecting cognitive function

A 
Oxygenation/circulation
Nutrition
Fluid and electrolyte balance
Medications
Medical
Enviornment
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28
Q

What percentage of oxygen is required for brain functioning?

A

20%

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29
Q

What is the most vital factor affecting cognitive function?

A

Oxygen to the brain

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30
Q

What step comes first in CPR?

A

Circulation - so you can have perfusion of oxygen

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31
Q

What percent of glucose is used by the brain?

A

25% of glucose

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32
Q

What mineral is needed for hemoglobin?

A

Iron

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33
Q

What electrolyte has the biggest influence on water?

A

Sodium

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34
Q

What do you use to remove excess ammonia?

A

Lactulose –> poop out extra ammonia

  • Binds with the ammonia n the blood leading to loose bowel movements
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35
Q

Which medications act directly on the CNS?

A

Anticonvulsants, opiates, antipsychotics

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36
Q

Medical factors affecting cognition

A
  • Head trauma
  • Degenerative processes
  • Infectious processes

(Cancer)

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37
Q

Examples of environmental factors affecting cognition

A

Hearing problems, vision problems, pain, discomfort, no sleep

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38
Q

Acute changes in mentation, consciousness, or the ability to maintain attention

A

Delirium

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39
Q

Where is delirium most common?

A

ICU (but preventable)

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40
Q

Three impacts of delirium

A
  • Increases mortality risk
  • Increases hospital length of stay
  • Can cause long term cognitive impairment
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41
Q

3 Types of Delirium

A

Hyperactive
Hypoactive
Mixed

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42
Q

Hyperactive Delirium

A

the easiest to assess; patient is disruptive and active

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43
Q

Hypoactive Delirium

A

most common form of delirium; patient is sleepy and has highest mortality risk

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44
Q

Risk Factors for delirium

A 
Medications
Anesthesia
ICU on ventilator
Stroke
Dementia
Respiratory Failure
Sepsis
Drug/Alcohol abuse
Isolation
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45
Q

How do you assess a patient’s cognitive baseline when experiencing delirium?

A

Use the family members or past medical charts

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46
Q

Nursing Management of Delirium

A
  • Early ambulation
  • Promote adequate sleep
    (close blinds, prevent noise)
  • Frequent reorientation
    (remind them of time)
  • Enhance sensory stimuli
    (glasses and hearing aids)
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47
Q

Progressive impairment of intellectual function and memory

A

Dementia

- Gradual decline and permanent *

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48
Q

Dementia - cerebral atrophy or shrinking of cortex

A

Alzheimer’s Dementia

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49
Q

Dementia - inadequate blood flow due to plaques or arterial brain lesions (stroke patients higher risk)

A

Vascular Dementia

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50
Q

Dementia - nerve cell loss and impairment of frontal and anterior temporal lobes

A

Frontotemporal Dementia

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51
Q

Dementia - clumps of protein causing neurodegeneration

A

Lewy Body Dementia

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52
Q

Dementia - if dementia occurs greater than 1 year after Parkinson’s

A

Parkinson’s Disease Dementia

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53
Q

Causes of Dementia

A 
Trauma
Circulation
Genetics
Alteration in neurotransmitteres
Infectious agents
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54
Q

Some experiences the aging person may experience that could lead to depression

A 
Loss
Agism
Chronic Pain
Decreased independence (retirement/unable to work)
Decreased health
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55
Q

Symptoms of depression in the elderly

A

Forgetfulness
Fatigue
Changes in behavior or mood

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56
Q

Impaired speech related to motor control, weakness, paralysis, or incoordination of the oral musculature

Can write or select words appropriately/ Hearing not impacted

A

Dysarthria

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57
Q

Complete or partial loss of language abilities

A

Aphasia

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58
Q

Unable to say what they want to say

A

Expressive aphasia

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59
Q

Inability of retrieving words

A

Anomia

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60
Q

Speech is articulated well, but hard time understanding what others are saying or what is written in front of them

A

Receptive Aphasia (Wernicke)

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61
Q

Functional skills, reading, writing, language areas impaired

Speech very poor, meaningless recurrent sounds

A

Global aphasia

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62
Q

What can the nurse use to assess alterations in cognitive function?

A
  • Mini-mental status exam

- Pfeiffer

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63
Q

What is the Pfeiffer exam?

A

10 questions
A correct response gets a 1
Score of 7 or less indicates cognitive impairment

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64
Q

First neurological signs of reduced oxygen?

A

Confusion

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65
Q

What assessment to check reduced oxygen?

A

Pulse Ox & ABGs

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66
Q

What electrolyte is linked to cognitive impairment

A

Sodium

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67
Q

What can you use to orient the patient to date and time?

A

Large calendar and write on white board

- Point out date/time on their own devices

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68
Q

What do we do to help orient patient to day and night?

A

Keep windows and blinds open, lights on

Stimulation during the day to mimic daytime behavior

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69
Q

What sort of recommendation for family support should you give those experiencing progressive cognitive impairment?

A

Educate family members
Observe for signs of caregiver burnout
Observe for signs of elder abuse

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70
Q

Complex process that alters our psychological and physiological systems

A

Stress

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71
Q

Good stress?

A

Eustress

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72
Q

Initial reaction to potential stress; interpretation of situation and determination if it is a stressor

A

Appraisal

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73
Q

Managing stress; can mitigate or reduce the stress of emotion it causes (how stress is handled)

A

Coping

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74
Q

Outcome of coping; when a person successfully adjusts or adapts to stress

A

Adaptation

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75
Q

If a person is unable adapt, what may occur??

A

Pathological manifestations

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76
Q

What does homeostasis balance?

A
  • Blood pressure
  • Glucose regulation
  • Temperature regulation
  • Acid-base balance
  • All vital processes
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77
Q

Restoration of balance in response to stress, through physiological mediators

A

Allostasis

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78
Q

When allostasis is stained and homeostasis is not achieved

A

Allostatic load

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79
Q

Which division of the ANS secretes norepinephrine and epinephrine

A

Sympathetic

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80
Q

Which division of the ANS secretes acetylcholine

A

Parasympathetic

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81
Q

Examples of excitatory actions

A

Pupil dilation, increased heart rate, bronchial dilation, increased glucose

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82
Q

Examples of inhibitory actions

A

Decrease digestive function, inhibit insulin secretion, prevent urination

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83
Q

Where does cortisol come from

A

Adrenal glands on top of kidneys

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84
Q

Does cortisol come before or after SNS response

A

After the initial SNS response

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85
Q

Two physiological affects of cortisol

A

Metabolism &

Immune function

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86
Q

Acute cortisol

A

Protective

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87
Q

Chronic cortisol

A

contributes to problems

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88
Q

What does prolonged stress lead to?

A

Anxiety, depression, and other alterations in health

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89
Q

Neuro reaction to stress

A

pupils dilate

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90
Q

Cardiac reaction to stress

A

tachycardia, hypertension, angina, dysrhythmia

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91
Q

Lung reaction to stress

A

increased RR, hyperventilation

92
Q

GI reaction to stress

A

loss of appetite, N/V, increased hydrochloric acid production

93
Q

Skin reaction to stress

A

diaphoresis, contraction of arrestor pili muscles

94
Q

Musculoskeletal reaction to stress

A

increased muscle tension in large muscles, tremor/shakiness in smaller

95
Q

Problem focused coping

A

deals with the issue/stress

96
Q

Emotion focused coping

A

controls emotions during stress

97
Q

Adaptability to adversity

A

resistance

98
Q

Ability to move forward despite adversity

A

Resilience

99
Q

increase in resiliency and resistance from experiencing and evolving from the past

A

vulnerability

100
Q

Coping across the life span

Newborn and Infant

A

Dependent on care of others to survive

Stressors are typically quickly resolved

Infants need the stress of a nurturing environment

101
Q

Coping across the life span

Toddler and preschooler

A

Still dependent on adults

Social and familial interaction and behavior impacting coping

Stressful issues are perceived more intensely at this age in comparison to adults and may have an impact later in life

102
Q

Coping across the life span

School-age - adolescent

A

Social environment begins to expand

influenced by a balance of home support and an internal sense of self-worth

Younger children may have a hard time distinguishing reality from imaginative thinking

Adolescent children capable of rationalization and are able to utilize more coping mechanisms, but also may use negative coping skills

103
Q

Coping across the life span

Adult-older adult

A

In adulthood, the ability to cope with stress is partly dependent upon how coping developed through the formative years

Life changes and physiological changes compound and add to stress

104
Q

Where is the line drawn for when a legal substance becomes maladaptive coping pattern?

A

The line is drawn when cognitive status is altered and the use of the substance is consistent to get that alteration in cognitive function

105
Q

Refusing to believe or accept something

A

Denial

106
Q

Attributing one’s own thoughts onto another

A

Projection

107
Q

Concealing the motive for behavior by giving a socially acceptable reason for the action

A

Rationalization

108
Q

Consciously dismissing something from the mind and thoughts

A

Suppression

109
Q

Immersing something in the subconscious or unconscious level of thought

A

Repression

110
Q

Nursing Assessment (stress) identification

A
  • Previous experience with coping strategies
  • Is it effective?
  • Identify RF that may affect coping
  • Identify strengths and challenges
  • Educational opportunities related to coping
111
Q

Measurement tools for stress

A

Everyday Hassles scale

Coping self-efficacy scale

112
Q

Some stress management techniques

A 
visualization 
imagery
affirmations
meditation
biofeedback
therapeutic touch
massage
yoga
deep breathing
journaling
113
Q

Framework that consists of a set of concepts related to individuals, groups, situations, and events

A

conceptual framework

114
Q

Nursing concepts (4)

A

person
environment
health
nursing

115
Q

provides the foundation for nursing knowledge and gives direction to nursing practice

A

nursing theory

116
Q

a process to guide decision making during a person’s life / helps to determine what is rights or wrong in a given situation

A

values

117
Q

disposition towards an object or subject

A

attitude

118
Q

ideas that one accepts as true

A

belief

119
Q

values held by a group that determines appropriate conduct for members of the group

A

professional ethics

120
Q

each person has the right to autonomy and the ability to make their own decision

A

respect for persons

121
Q

what is a person’s ability to make decisions based on

A

assessment of their mental and physical functioning

122
Q

doing good / actions should promote an optimal outcome

A

beneficence

123
Q

examples of beneficence

A

giving pain medication

dressing changes to promote wound healing

124
Q

avoid doing harm or remove from harm

A

nonmaleficence

125
Q

examples of nonmalficence

A

medications to stop seizures

teaching a pt how to use a cane when walking to avoid falling

126
Q

nurses providing each patient the same resources they would offer any other patient / fairness with resources

A

justice

127
Q

examples of things offered to provide justice to pts

A 
time
service
education
supplies
care
128
Q

three things pts are entitled to recieve

A

privacy and confientiality
veracity
fidelity

129
Q

being honest

A

veracity

130
Q

patient health information is not shared

A

privacy and confiendtiality

131
Q

honoring commitments

A

fidelity

132
Q

group of individuals that are separate from the incident that help make a ruling

A

ethics committee

133
Q

legally what do nurses have to have

A

a nursing license

134
Q

types of research -

measurable numeric data under conditions of considerable control with statistical procedures to analyze data

A

quantitative

135
Q

types of research -

focuses more on subjective or lived experience; less control and little statistical analysis involved

A

qualitative

136
Q

when the person who collects the data directly is the one who writes up the study on the topic

A

primary research

137
Q

when the initial data is collected by someone else and is analyzed or interpreted by a second person

A

secondary research

138
Q

Scientific process

A 
problem identification
research a solution
develop an implementation plan
implement the plan
evaluate the effectiveness of the solution
139
Q

PICOT method

A 
P = patient or problem
I = intervention 
C = comparison
O = outcome of interest
T = time of interest (not always)
140
Q

sources reviewed by a panel of experts related to the field to determine if they study has used reliable methods for conducting the study

A

peer reviewed resources

141
Q

preventing adverse outcome for patient

A

safety

142
Q

viewed on a continuum from poor to high / measure of excellence

A

quality

143
Q

6 components of quality

A 
safe
effective
patient-centered
timely 
efficient
equitable
144
Q

why does safety matter

A

third leading cause of hospital-related deaths in 2017 was preventable medical errors

145
Q

why is root cause analysis (RCA) used

A

to determine the underlying cause of an event / helps determine if errors are active or latent

146
Q

error that results in death or serious injury

A

sentinel event

147
Q

safety issues in healthcare?

A

medication safety
healthcare worker risks
environmental safety

148
Q

examples of healthcare worker risks

A

needle sticks
back injuries
exposure to toxic chemicals
poor staffing ratios can increase this

149
Q

who measures for quality and safety outcomes

A

centers for medicare and medicaid services (CMS)

150
Q

what does the center for medicare and medicaid service do

A

collects info from every facility and unit to develop benchmarks for hospital to achieve

151
Q

diverse practices that are not considered as part of conventional allopathic medicine

A

complementary and alternative medicines

152
Q

system in which medical doctors and other healthcare professionals treat symptoms and diseases using drugs, radiation or surgery (western medicine)

A

allopathic medicine

153
Q

integrative health combines allopathic medicine, CAM, nutrition, exercise and stress reduction

A

holistic care

154
Q

the mind, body, and spirit are all separate and joining parts that function in the overall environment

A

holism

155
Q

an impaired ability to perform activities of daily living

A

self-care deficit

156
Q

what is the nursing goal

A

interventions focus on reducing risk factors or targeting contributing factors

157
Q

examples of CAM

A

herbs and natural products
massage, relaxation, yoga, mindfulness, progressive muscle relaxation, meditation and guided imagery
acupuncture and chiropractic care

158
Q

what is the primary focus for mindfulness-based stress reduction

A

meditation

159
Q

what does mindfulness-based stress reduction do for the body

A

increases self-awareness

permits a nonjudgemental attitude

160
Q

how does CAM impact nursing

A 
initial assessment (what does the pt use and how will it interact with whats prescribed)
recommendation for non-pharmacological therapy for pts
161
Q

what do nurses need

A

nonjudgemental attitude and to be aware of their own beliefs

162
Q

california poppy (what does it do)

A

pain relief, sedation, anxiety relief

163
Q

what should you not mix California poppy with

A

monoamine oxidase inhibitors

164
Q

what is ginkgo biloba used for

A

alzheimers or memory problems

165
Q

warnings for ginkgo biloba use

A

do not handle or eat fruit/seed

caution when using aspirin or other blood-thinning drugs

166
Q

what is ginseng used for

A

energy increse

167
Q

ginseng warnings

A

may increase glucose and blood pressure

increase tumor growth in estrogen dependent cancer

168
Q

butterbur warnings

A

can contain pyrrolizide alkaloids (PA) that cause liver damage

look for types labeled PA free

169
Q

what can st johns wort be used for

A

depression

170
Q

warnings for st johns wort

A

may interfere with HIV tx
light sensitivity
dangerous w SSRIs, tricyclics, and MAOIs
can lower effects of meds

171
Q

valerian use

A

anxiety and insomnia

172
Q

valerian warnings

A

do not combine with other sedation meds

173
Q

when should you avoid feverfew

A

pregnancy

174
Q

processes herbal remedies go through (3)

A

standardization
regulatory
credentialing

175
Q

standardization of herbal remedies

A

consistent amount per dose

176
Q

practice based on the intentional and compassionate use of energy to promote balance and wellbeing through touch

A

therapeutic touch

177
Q

unpleasant sensory or emotional experience associated with actual or potential tissue damage

A

pain

178
Q

how often should pain be checked

A

as often as vital signs

179
Q

pain that lasts up to 6 months due to actual or threatened damage; considered a protective mechanism

A

acute pain

180
Q

what is present with acute pain

A

inflammatory and (sometimes, not always) sympathetic nervous system reaction

181
Q

example of inflammatory component with acute pain

A

redness, swelling, tenderness

182
Q

example of sympathetic nervous system reaction with acute pain

A

tachycardia, hypertension, tachypnea

183
Q

how is acute pain treated

A

common analgesia and opioids

184
Q

pain lasting longer than 6 months; no longer a protective mechanism and considered. a disease or a condition

A

chronic pain

185
Q

acute pain from surgery, injury, or active disease process

A

nociceptive pain

186
Q

four phases of nociceptive pain

A

transduction
transmission
perception
modulation

187
Q

transduction (nociceptive pain)

A

prostaglandins are released to potentiate an action potential

188
Q

tx of transduction phase

A

NSAIDS or steroids

189
Q

transmission (nociceptive pain)

A

substance P is released: a significant pain messenger

190
Q

tx of transmission phase

A

opioids

191
Q

perception (nociceptive pain)

A

interpret or process pain

192
Q

modulation (nociceptive pain)

A

norepinephrine or serotonin sent to areas of distress and receptors down regulate and pain is reduced

193
Q

aching, throbbing pain in bones, joints or skin

A

somatic pain

194
Q

organ related, poorly localized, cramping, squeezing or heavy

A

visceral pain

195
Q

caused by damage to the somatosensory nervous system

A

neuropathic pain

196
Q

what can cause neuropathic pain (3)

A

nerve damage
chemo
radiation

197
Q

symptoms/ description of neuropathic pain

A

tingling
electric-like
pins and needles
numb characteristic

198
Q

things that cause pain that normally wouldn’t cause pain

A

allodynia

199
Q

heightened feeling of pain

A

hyperalgesia

200
Q

treatment of neuropathic pain

A

antidepressants
SSRIs
anticonvulsants (gabapentin, pregabalin)

201
Q

similar to nociceptive pain that does not have a discernible source

A

nociplastic or central pain

202
Q

example of nociplastic pain

A

fibromyalgia

203
Q

tx for nociplastic pain

A

complex
focused on restoring sleep or activity tolerance
not opioids

204
Q

pain lifespan consideration

newborn and infant

A

neonatal pain, agitation, and sedation scale (N-PASS)

or FLACC behavioral pain scale is used

pain is undertreated

205
Q

pain lifespan consideration

toddler and preschooler

A

Wong-baker FACES scale

Pain causes distrust

206
Q

pain lifespan consideration

School-age and adolescent

A

persistent pain can cause developmental regression
adolescents may hide pain
numeric rating scale (0-10)

207
Q

pain lifespan consideration

older adult

A

associated with conditions like arthritis
checklist of nonverbal pain indicators (CNPI)
critical care pain observation tool (CPOT)

208
Q

when is N-pass used

A

premature infants (1st 100 days of life)

209
Q

FLACC

A

face, legs, activity, cry, countability

greater than 1 indicates pain but not intensity

210
Q

which tool can measure intensity

A

Wong-Baker

211
Q

when is CPOT used

A

18 years or older who are unable to report pain (0-8)

score greater than one indicates potential pain

212
Q

what increases with pain

A 
blood pressure
HR
RR (quality diminished - depth/shallow)
blood glucose
oxygen consumption
lactate
ketones
213
Q

what decreases with pain

A

immune response
ability to think, learn, make decisions,
RR quality

214
Q 
non-pharmacological pain management
Physical ex (4)
A

heat (no longer than 30 mins)
cold
transcutaneous electrical nerve stimulation
massage

215
Q

considerations for non-pharm pain management

A

ensure no signs of skin irritation

216
Q

when is heat contraindicated as tx

A

over areas of bleeding, topical ointments, and over burned or irritated skin

217
Q

when is cold contraindicated as tx

A

areas of poor circulation, Raynaud phenomenon, or irritated skin

218
Q

examples of cognitive and behavioral pain management

A

distraction
relaxation
imagery
mindfulness

219
Q

examples of relaxation for pain management

A

meditation and rhythmic breathing

220
Q

safety parameters for PCA

A

minimum time interval between doses
maximum dose allowed over time period
specific dosing in milligrams or micrograms

221
Q

what monitoring may be added to patients w PCA

A

end-tidal carbon dioxide

oxygen sat and respirations

222
Q

what type of drug scheduling used after a procedure a few days ago

A

PRN - working towards discharge

223
Q

Considerations for Spinal Analgesia

A

Medications given into epidural or intrathecal space
Lower dosage needed
HTN common side effect

Continuous = monitoring what?
- End tidal carbon dioxide

224
Q

What side effects occur from opioids

A

sedation
resp depression
constipation
vasodilation and htn

225
Q

who is at risk for SE from opioids

A

opioid- naive patients
elders
use of other sedation meds
obstructive sleep apnea

226
Q

Pasero Opioid Induced Sedation Scale

A 
S = sleep, easy to arouse
1 = awake and alert
2 = slightly drowsy, easily aroused
3 = frequently drowsy, arousable, drifts to sleep during convo
4 = somnolent, minimal or no response tp physical stimulation

Foundations of Nursing (3 decks)

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