Foundations of Nursing Final Exam Flashcards
What are the different types of grief?
Normal (Which is subjective): Complex emotional, cognitive, social, physical, behavioral and spiritual response to loss
Anticipatory: Unconscious process of letting go before any loss occurs
Disenfranchised: Marginal/unsupported grief
Complicated: Prolonged grief/Difficulty moving past loss
What are the different types of complicated grief ?
Exaggerated: Intense and/or prolonged with no signs of healing
Delayed: Grief later than expected
Masked: Grief (emotionally, physically or both) that go unrecognized by the patient
What are the Kubler-Ross 5 Stages of Grief?
Denial: Not accepting loss as protection
Anger: Resistance/Anger toward loss
Bargaining: Trying to prevent loss
Depression: Realizing the full weight of the loss
Acceptance: Able to find a way forward after loss and incorporates it into life
What is the difference between palliative and hospice care?
Palliative: Can still be performed with curative treatment; focused on prevention, relief and symptom management
Hospice Cannot be performed with curative treatment; focused on quality of life, pain and symptom management
Can nurses pronounce death?
Yes. It should be confirmed with at least one more provider.
What are the different sleep cycles?
Circadian: Individual gets 8-9 hrs of sleep; characterized by sleep and hormone release (cortisol)
Infradian: Individual needs more than 8-9 hrs of sleep; often in teens
Ultradian: Frequent short cycles of sleep thorough 24 hrs
What are the 4 Non-REM Stages of sleep?
Stage 1: Lightest level of sleep occurring in the first few minutes, easily aroused by sensory stimulation
Stage 2: Sound sleep within the first 10-20 min; progressive slowing and relaxation of the body
Stage 3: Initial deep lasting 15-30 min; the body is relaxed and difficult to arouse
Stage 4: Deepest sleep for 15-20 min where sleepwalking or enuresis (bed-wetting), difficult to arouse
What is the REM Stage of sleep?
Stage 5: Dreaming occurs 90 minutes into sleep, the body is very difficult to arouse, fluctuating activity of body systems, lasts 20 min
What are the sleep requirements for younger people?
Neonate: 16 hrs
3+ month Infants: 15 hrs
Toddlers (2 yrs): 12 hrs
Pre-schooler: 12 hrs
What are the sleep requirements for older people?
School age: Varies
Adolescent: 8-9 hrs; usually get 7.5
Adult: 6-8.5 hrs
Older Adults: 6-8.5 hrs; usually napping throughout the day
What are visual sensory deficits?
Presbyopia: Gradual decline of near sight
Cataract: Cloudy/opaque areas in lens causing glares and blurred vision
Dry Eyes: Too few tears causing itching and burning
Glaucoma: Slowly progressive intraocular pressure on the optic nerve causing peripheral vis. loss, halo effect, issues with vision in the dark
Diabetic Retinopathy: retinal blood vessel changes causing decreased vision
Macular Degeneration: Macula function loss which blurs reading material, distortion/loss of central vision, distortion of vertcial lines
What are visual hearing deficits?
Presbycusis: Common progressive hearing loss in older adults
Cerumen Accumulation: Earwax build-up causing conduction deadness
What are balance and taste sensory deficits?
Dizziness/Disequilibrium (Balance): Change in head position provokes vertigo/disequilibrium
Xerostomia (Taste): Decreased salivary production leading to thicker mucus/dry mouth
What are neurological sensory deficits?
Peripheral Neuropathy: Numbness/tingling in different areas
Stroke: CVA caused by a clot, hemorrhage, or emboli
What are the different purposes for gastric tubes?
Decompression: Removal of secretions and gas in GI tract (ex. Bowel obstruction)
Compression: Internal application of pressure by means of an inflated balloon (ex. Esophageal varices bleed)
Lavage: Irrigation of stomach (ex. Overdose of medication)
Enteral Feedings: Instillation of liquid nutritional supplements or feedings into the GI tract (ex. Any issue that does not allow patient to swallow properly)
What are important care instructions for enteral feedings?
Head of Bed (HOB) stays at 30-45 degrees at all times and 1 hr after feedings
Measure gastric residuals q 4-6 hrs for continuous feelings
Flush enteral feeding tubes every 4 hrs w/ > 30 mL
Verify placement every 4-6 hrs using gastric contents
Start feedings slow and increase rate every 8-12 hrs if no signs of intolerance
What are the different pH levels for gastric contents and what do they mean?
Gastric: 0-4
Jejunum: 6
Lung: 7
What are forms of parenteral routes?
Subcutaneous (SQ), Intradermal (ID), Intramuscular (IM) and Intravenous (IV)
What are forms of non-parenteral routes?
(Anything other than parenteral/injections)
Oral, Enteral, Topical, Nasal, Eye, Ear, Vaginal, Rectal and Inhalation
Which medications CAN NOT be crushed?
Sustained-release, enteric-coated tablets, buccal or sublingual medications
What is the best practice for using Metered-Dose Inhalers (MDI)?
Using spacers
When administering bronchodilators and corticosteroids, which should go first?
Bronchodilators to maximize airway 5 minutes before steroids
What are the 6 rights of medication administration?
- Right Medication
- Right Dose
- Right Patient
- Right Route
- Right Time
- Right Documentation
How many mL is the average adult intaking and outputting?
2200-2700 mL
What is the normal value for Na (Sodium) and what does it mainly affect?
135-145; affects the Central Nervous System (CNS)
What are the symptoms of hypernatremia?
Extreme thirst, fever, confusion/agitation, coma, SEIZURES, dry/flushed skin, postural hypotension
What are the symptoms of hyponatremia?
Decreased LOC, possible coma, SEIZURES, Nausea and Vomiting, Apprehension
What is the normal value of K (Potassium) and what does it mainly affect?
3.5-5.0; mainly affects the cardiac system
What are the symptoms of hypokalemia?
Fatigue, muscle weakness, nausea and vomiting, CARDIAC DYSRHYTHMIAS
What are the symptoms of hyperkalemia?
Anxiety, ABDOMINAL CRAMPS, diarrhea, muscle weakness, CARDIAC DISRHYTHMIAS and CARDIAC ARREST
What is the normal value for Ca (Calcium) and what does it mainly affect?
8.4-10.5; mainly affects neuro and bones
What are the symptoms of hypocalcemia?
NUMBNESS AND TINGLING of fingers and mouth, HYPERACTIVE REFLEXES, muscle twitching, tetany, seizures, Laryngospasm, cardiac dysrhythmias
What are the symptoms of hypercalcemia?
Anorexia, nausea and vomiting, constipation, Fatigue, DIMINISHED REFLEXES, changed LOC, cardiac dysrhythmias, POSSIBLE FLANK PAIN from renal calculi, PATHOLOGICAL FRACTURES
What is the normal value for Magnesium (Mg) and what does it normally affect?
1.5-2.5; mainly affects neuro
What are the symptoms of hypomagnesemia?
Basically hypocalcemia (HYPERACTIVE REFLEXES) with INSOMNIA
What are the symptoms of hypermagnesemia?
Lethargy, HYPOACTIVE REFLEXES, bradycardia, hypotension, FLUSHING/SENSATION OF WARMTH, hypoventilation, MUSCLE PARALYSIS, cardiac dysrhythmias/arrest
What is the degree, range of gauges, range of volume, and list of sites for intramuscular injections?
Degree: 90 Range of Gauges: 18-25 (5/8-1 inch long) Range of Volume: 1-3 mL Sites: Ventrogluteal, Vastus Lateralis, Deltoid USE Z-TRACK
What is the degree, range of gauges, range of volume, and list of sites for subcutaneous injections?
Degree: 90 or 45
Range of Gauges: 25-30 (3/8-5/8 inch long)
Range of Volume: 1 mL or less
Sites: Outer posterior upper arm, Lower abdomen 2 inches away from the umbilicus
What is the degree, range of gauges, range of volume, and list of sites for intradermal injections?
Degree: 5-15
Range of Gauges: 27-31 (1/2 inch long)
Range of Volume: less than 0.5 mL
Sites: Inner forearm, upper back
What is the normal oxygen saturation (SaO2) range?
95-100%
What are the low flow options for oxygen delivery?
Nasal Cannula: 24-44%, 1-6 L/min
Simple Face Mask: 35-50%, 5-8 L/min
Nonrebreather mask: 60-80%, 10-15 L/min
What is the high flow option for oxygen delivery?
Venturi mask: 24-60%, 4-12 L/min
How do you calculate pack years?
How many packs a day X How many years the patient has smoked
What are the normal diagnostic values for a Complete Blood Count (CBC) including white blood cells, hemoglobin, hematocrit, and platelets?
White blood cells: 5,000-10,000 mm3
Hemoglobin (complete range): 12-18 g dL
Hematocrit (complete range): 37-52%
Platelets: 150,000-400,000 mm3
What are the symptoms with high and low Complete Blood Count values?
What are the normal diagnostic values for Coagulation Studies including Prothrombin Time (PT), International Normalized Ratio (INR), and Partial Thromboplastin (PTT)
PT: 11-12.5 sec.
INR: 0.76-1.27
PTT: 60-70 sec
What are the symptoms with high and low “Coagulation Studies” values?
