Funda midterms Flashcards
Infection Prevention and Control
Diagnostic Testing
Safety, Security and Emergency Preparedness
Vital Signs
Medication Administration
Complementary and Alternative Therapies
Hygiene
Activity, Exercise and Immobility
Skin Integrity
Oxygenation
Fluid, Electrolyte and Acid-Base Balance
Patient Safety and Quality
Often defined as freedom from psychological and physical injury, is a basic human need
Safety
____ is the key factor in providing care
Partnership
What are The Joint Commission 2020 Hospital National Patient Safety Goals?
- Identify patients correctly
- Improve staff communication
- use medicines safely
-prevent infection - identify patient safety risks
- prevent mistakes in surgery
What are the key features of a culture of safety
- Acknowledgment of the high-risk nature of an organization’s activities
and the determination to achieve consistently safe operations - A blame-free environment where individuals are able to report errors
or near misses without fear of reprimand or punishment - Encouragement of collaboration across levels of employees and
disciplines to seek solutions to patient safety problems - Organizational commitment of resources to address safety concerns
Scientific Knowledge Base
Environmental Safety, Basic Human Needs, Oxygen, Nutrition, Temperature, Physical Hazards
What is the risk of a patient who require supplemental oxygen in health care setting?
Because oxygen is highly flammable
Exposure to severe cold for prolonged periods can cause
Frostbite and accidental hypothermia
Ways to promote safety among older adult drivers are?
- Exercising regularly to increase strength and flexibility.
- Asking the doctor or pharmacist to review medications—both
prescription and over-the counter—to reduce side effects and
interactions. - Having eyes checked by an eye doctor at least once a year and wearing
glasses and corrective lenses as required. - Driving during daylight and in good weather.
- Finding the safest route, with well-lit streets, intersections with left-turn
arrows, and easy parking.
Is any substance that impairs health or results in death when ingested, inhaled, injected, or absorbed into the body, also often impairs the function of every major organ system
Poison
Is an event that results in a person coming to rest inadvertently on the ground or floor or other lower levels
Falls
The leading cause of fire-related death is ______
Careless smoking
Floods, tsunamis, hurricanes, tornadoes, and wildfires
Natural Disasters
Is another cause of disaster and refers to biological agents used as weapons to further personal or political agendas
Bioterrorism
Could be caused by virtually any pathogenic microorganism
Bioterrorist attack
Is not communicable from direct contact but is transmitted in spores that become aerosolized
Anthrax
Is readily transmitted from person-to-person contact
Small pox
Internal and external to community care partners,
state/federal agencies
Communications
Adequate levels and appropriateness to hazard
vulnerabilities
Supplies
Enabling normal hospital operations and protection of staff
and property
Security
Roles and responsibilities within a standard hospital incident
command structure
Staff
Enabling self-sufficiency for as long as possible, with a goal of
96 hours
Utilities
Maintaining care, supporting vulnerable populations,
and alternate standards of care
Clinical activity
Is any microorganism capable of producing an illness
Pathogen
The most common means of transmission of pathogens is by the
Hands
When a patient acquires an infection in a health care setting, it is called a
Nosocomial infection or health care-acquired infection (HAI)
Is one not present in the patient at the time of admission to the health care agency but that develops during the course of the stay
HAI
This is one of the most effective methods for limiting the transmission of pathogens in health care is the
Medically aseptic practice of hand hygiene
Reduces, and in some cases prevents, the transmission of disease from person to person
Immunization
What are the risk factors for violence
- history of victimization
- disabilities
- emotional problems
- substance abuse
- low iq
- authoritarian parenting
- low family involvement and low income
- gang involvement
-school failure - diminished economic opportunities
What are risk factors for adolescents?
- recent or serious loss
- psychiatric disorder
- Alcohol and other substance abuse disorders
- struggling with sexual orientation
- history of suicide, domestic violence, child abuse, or neglect
- lack of social support
- bullying
- access to lethal means
The threats to an adult’s safety are frequently related to _______
Lifestyle Habits
What are risk factors of Older adults?
- physiological changes associated with aging
- the effects of multiple medications
- psychological and cognitive factors
- effects of acute or chronic disease
Is a clinical syndrome caused by neurodegeneration and characterized by progressive deterioration in cognitive ability and capacity for independent living
Dementia
Poses threats to safety including:
- impaired mobility
- sensory or communication impairment
- limited economic resources
- lack of safety awareness
Individual Risk Factors
A patient with this has many kinds of safety risk like:
- muscle weakness
- paralysis
- abnormal gait
- poor coordination or balance
Impaired Mobility
This is associated with delirium, dementia, and depression alter concentration and attention span and cause impaired memory and orientation changes
Cognitive impairments
People with lower incomes are more likely to have behavioral health issues, such as depression or substances use problems, that place them at risk for injury
Economic Resources
This occurs when planned actions are not completed as intended or wrong plans of care are used
Medical errors
National Quality Forum Serious Reportable Events in Health care:
A. Surgery or other invasive procedure performed on the wrong
site (updated)
B. Surgery or other invasive procedure performed on the wrong
patient
C. Wrong surgical or other invasive procedure performed on a
patient (updated)
D. Unintended retention of a foreign object in a patient after
surgery or other invasive procedure (updated)
E. Intraoperative or immediately postoperative/postprocedure
death in an ASA Class 1 patient (updated)
Surgical or invasive procedure events
National Quality Forum Serious Reportable Events in Health care:
A. Patient death or serious injury associated with the use of
contaminated drugs, devices, or biologics provided by the
health care seing (updated)
B. Patient death or serious injury associated with the use or
function of a device in patient care, in which the device is
used or functions other as intended (updated)
C. Patient death or serious injury associated with intravascular
air embolism that occurs while being cared for in a health care
seing (updated)
Product or Device Events
National Quality Forum Serious Reportable Events in Health care:
A. Discharge or release of a patient/resident of any age who is
unable to make decisions to other than an authorized person
(updated)
B. Patient death or serious injury associated with patient
elopement (disappearance) (updated)
C. Patient suicide, aempted suicide, or self-harm that results in
serious injury, while being cared for in a health care seing
(updated)
Patient Protection Events
National Quality Forum Serious Reportable Events in Health care:
A. Patient death or serious injury associated with a medication
error (e.g., errors involving the wrong drug, wrong dose,
wrong patient, wrong time, wrong rate, wrong preparation,
or wrong route of administration) (updated)
B. Patient death or serious injury associated with unsafe
administration of blood products (updated)
C. Maternal death or serious injury associated with labor or
delivery in a low-risk pregnancy while being cared for in a
health care seing (updated)
D. Death or serious injury of a neonate associated with labor or
delivery in a low-risk pregnancy (new)
E. Patient death or serious injury associated with a fall while
being cared for in a health care seing (updated)
F. Any Stage 3, Stage 4, and unstageable pressure ulcers acquired
after admission/presentation to a health care seing (updated)
G. Artificial insemination with the wrong donor sperm or wrong
egg (updated)
H. Patient death or serious injury resulting from the irretrievable
loss of an irreplaceable biological specimen (new)
I. Patient death or serious injury resulting from failure to follow
up or communicate laboratory, pathology, or radiology test
results (new)
Care Management Events
National Quality Forum Serious Reportable Events in Health care:
A. Patient or staff death or serious injury associated with an
electric shock in the course of a patient care process in a
health care seing (updated)
B. Any incident in which systems designated for oxygen or other
gas to be delivered to a patient contain no gas, the wrong gas,
or are contaminated by toxic substances (updated)
C. Patient or staff death or serious injury associated with a burn
incurred from any source in the course of a patient care
process in a health care seing (updated)
D. Patient death or serious injury associated with the use of
physical restraints or bedrails while being cared for in a
health care seing (updated)
Environmental Events
National Quality Forum Serious Reportable Events in Health care:
A. Death or serious injury of a patient or staff associated with the
introduction of a metallic object into the MRI area (new)
Radiological Events
National Quality Forum Serious Reportable Events in Health care:
A. Any instance of care ordered by or provided by someone
impersonating a physician, nurse, pharmacist, or other
licensed health care provider (updated)
B. Abduction of a patient/resident of any age (updated)
C. Sexual abuse/assault on a patient or staff member within or on
the grounds of a health care seing (updated)
D. Death or serious injury of a patient or staff member resulting
from a physical assault (i.e., baery) that occurs within or on
the grounds of a health care seing (updated)
Potential Criminal Events
Risk to health care workers from _____ exposure found in some medication
Chemical Exposure
Accidents in which a patient is the primary reason for the accident
Patient-Inherent Accidents
Caused by health care providers and include medication and fluid administration errors, improper application of external devices, and accidents related to improper performance of procedures
Procedure-related accidents
Result from an electrical hazard or malfunction, disrepair, or misuse of equipment
Equipment-related accidents
National Institute for Occupational Safety and Health defines this as the act or threat of violence, ranging from verbal abuse to physical assault, directed toward persons at work or on duty
Workplace violence
This requires a synthesis of knowledge, experience, critical thinking attitudes, reflective reasoning, and adherence to professional standards
Successful critical thinking
Are based on critical thinking requires nurses to anticipate necessary information, analyze the data, and make decisions regarding patient care
Clinical judgements
A patient asks a nurse to provide instruction on how to perform
a breast self-exam. Which domains are required to learn this
skill? (Select all that apply.)
1. Affective domain
2. Sensory domain
3. Cognitive domain
4. Attentional domain
5. Psychomotor domain
3,5
- A patient suddenly experiences a severe headache with
numbness and decreased movement in the left arm. The
emergency room physician suspects a stroke and is going to
have the patient undergo an emergent angiogram to remove the
clot. Which teaching approach is most appropriate? - Selling approach
- Telling approach
- Entrusting approach
- Participating approach
2
A nurse is caring for a young patient who has been told he has
multiple sclerosis. The nurse has planned time to conduct a
teaching session that will focus on the disease and principles of
management. The nurse chooses to use the EDUCATE model to
proceed with instruction. Which of the following are
components of the model? (Select all that apply.)
1. State goals of the session for the patient.
2. Repeat the most important information.
3. Practice empathetic skills.
4. Be aware of nonverbal messages.
5. Use a standard question list for the chosen topic.
2,3,4
A nurse is teaching an older adult patient about ways to detect a
melanoma. Which of the following are age-appropriate teaching
techniques for this patient? (Select all that apply.)
1. Speak in a low tone.
2. Begin and end the session with the most important
information regarding melanoma.
3. Provide a pamphlet about melanoma with large font in blues
and greens.
4. Provide specific information in frequent, small amounts for
older adult patients.
5. Speak quickly so that you do not take up much of the
patient’s time.
1,2,4
A 55-year-old adult male has been in the hospital over a week
following surgical complications. The patient has had limited
activity but is now finally ordered to begin a mobility program.
The patient just returned from several diagnostic tests and tells
the nurse he is feeling quite fatigued. The nurse prepares to
instruct the patient on the mobility program protocol. Which of
the following learning principles will likely be affected by this
patient’s condition?
1. Motivation to learn
2. Developmental stage
3. Stage of grief
4. Readiness to learn
4
A patient recovering from open heart surgery is taught how to
cough and deep breathe using a pillow to support or splint the
chest incision. Following the teaching session, which of the
following is the best way for the nurse to evaluate whether
learning has taken place?
1. Verbalization of steps to use in splinting
2. Selecting from a series of flash cards the images showing the
correct technique
3. Return demonstration
4. Cloze test
3
. A 63-year-old woman is a family caregiver for her 88-year-old
mother who has dementia. The caregiver asked the home health
nurse how to manage her mother when she becomes confused
and violent. The best instructional method a nurse can use for
this situation is:
1. Demonstration
2. Preparatory instruction
3. Role-playing
4. Group instruction with other family caregivers
3
A nurse is preparing to teach a patient who has sleep apnea how
to use a CPAP machine at night. Which action is most
appropriate for the nurse to perform first?
1. Allow patient to manipulate machine and look at parts.
2. Provide a teach-back session.
3. Set mutual goals for the education session.
4. Discuss the purpose of the machine and how it works.
3
Which of the following scenarios demonstrate that learning has
taken place? (Select all that apply.)
1. A patient listens to a nurse’s review of the warning signs of a
stroke.
2. A patient describes how to set up a pill organizer for newly
ordered medicines.
3. A patient aends a spinal cord injury support group.
4. A patient demonstrates how to take his blood pressure at
home.
5. A patient reviews written information about resources for
cancer survivors
2,4
Match the ACCESS model component to the Nursing approach
ACCESS model component
1. Assessment
2. Communication
3. Cultural
4. Establishment
5. Sensitivity
6. Safety
Nursing Approach
a. Help patients feel culturally secure and able to maintain their cultural identity
b. remain aware of verbal and nonverbal responses
c. be aware of how patients from diverse backgrounds perceive their care needs
d. become aware of your patient’s culture and your own cultural biases
e. Learn about the patient’s health beliefs and practices
f. show respect by creating a caring rapport
1E
2B
3D
4F
5C
6A
A pathogen invades tissues and begins growing within a host
infection
Is the presence and growth of microorganisms within a host but without tissue invasion or damage
Colonization
Meningitis and pneumonia are infectious diseases that?
have a low risk or no risk for transmission
If an infectious disease can be transmitted directly from one person to another, it is termed a
Communicable disease
If the pathogens multiple and cause clinical signs and symptoms, the infection is
Symptomatic
If clinical signs and symptoms are not present, the illness is termed as
Asymptomatic
This is an example of a communicable disease that can be asymptomatic
HCV
Infection occurs in a cycle that depends on the presence of all of what of the following elements?
- an infectious agent or pathogen
- a reservoir or source for pathogen growth
- a port of exit from the reservoir
- a mode of transmission
- a port of entry to a host
- a susceptible host
Are permanent residents of the skin and within the body, where they survive and multiply without causing illness
Resident organisms (normal flora)
Ability to produce disease; their ability to enter and survive in a host; and the susceptibility of the host
Virulence
This is when a patient has an impaired immune system
Immunocompromised
_____ are not virulent but can cause serious infection when surgery or other invasive procedures allow them to enter deep tissues or when a patient is severely immunocompromised
Resident skin microorganisms
Attach to the skin when a person has contact with another person or object during normal activities
Transient microorganisms
Is a place where microorganisms survive, multiply, and await transfer to a susceptible host
Reservoir
Consume undigested foodstuff in the bowel
Escherichia coli
Require oxygen for survival and for multiplication sufficient to cause disease and causes more infection in humans than anaerobic organisms
Aerobic bacteria
Thrive where little or no free oxygen is available and cause infections deep within the pleural cavity, in a joint, or in a deep sinus tract
Anaerobic
A bacteria can assume a form like this that is resistant to drying and can live on inanimate surfaces for long periods
Spore
____ temperatures tend to prevent growth and reproduction of bacteria
Cold (Bacteriostasis)
A temperature or chemical that destroys bacteria
Bactericidal
The acidity of an environment determines the ____ of microorganisms
Viability
Most microorganisms prefer an environment within a ph range of
5.0-7.0
The skin is considered a _____ because any break in the integrity of the skin and mucous membrane allows pathogens to exit the body
Portal of exit
Is one of the most bacterially contaminated sites of the human body, most being normal floras
Mouth
This common flora is found in the stomach and can cause peptic ulcers
Helicobacter pylori
These two bacteria are found in the duodenum
Lactobacillus and Enterococcus
Identify the Mode of transmission:
Person-to-person physical contact between source and susceptible host
Direct Contact
Identify the Mode of transmission:
Personal contact of susceptible host with contaminated inanimate object
Indirect contact
Identify the Mode of transmission:
Creating droplets that carry germs short distances
Droplet contact
Identify the Mode of transmission:
Carried in droplet nuclei or residue or evaporated droplets suspended in air during coughing or sneezing
Airborne contact
Identify the Mode of transmission:
Contaminated items
Vehicles
Identify the Mode of transmission:
External mechanical transfer (insects)
Vector
______ to an infectious agent depends on an individual’s degree of resistance to pathogens
Susceptibility
What are the courses of infection by stage?
Incubation, Prodromal, illness, convalescence stage
Interval between entrance of pathogen into body and appearance of first symptoms
Incubation period
Interval from onset nonspecific signs and symptoms to more specific symptoms
Prodromal stage
Interval when patient manifests signs and symptoms specific to type of infection
Illness stage
Interval when acute symptoms of infection disappear
Convalescence
If an infection is ____, a patient usually experiences pain at the wound site. White an infection that affects the entire body is _____
Localized, Systemic
