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Nursing Fundamentals > Fundamentals Final Exam > Flashcards

Fundamentals Final Exam Flashcards

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1
Q

How does an insulin pump work?

A

An individualized insulin therapy devise that delivers continuous and intermittent subcutaneous insulin.

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2
Q

How long can the infusion set on an insulin pump be used before before it needs to be changed out?

A

48-72 hours.

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3
Q

What are the most common types of insulin used in an insulin pump?

A

Rapid acting insulin (lispro, aspart, and glulisine)

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4
Q

What is glyburide?

A

An antidiabetic used in type two diabetes.

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5
Q

How does glyburide work?

A

Caused functioning B cells to release more insulin, lowing BG and potentially improving insulin binding to insulin receptors.

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6
Q

What are some important notes to make about glyburide?

A

I can be used in gestational diabetes. It should be taken in the morning to prevent night time hypoglycemia, monitor BP before taking medication, watch for Jaundice (kidney failure is a contraindication).

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7
Q

What is the other name for metformin?

A

Glucaphage

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8
Q

What is metformin and how does it work?

A

An antidiabetic used in type two diabetes patients. It inhibits hepatic glucose production and increased sensitivity of peripheral tissue to insulin.

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9
Q

What are some notable teaching about metformin?

A

Don’t take if pregnant, report GI upset, monitor BG.

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10
Q

What type of interaction does metformin have with prednisone?

A

Prednisone may reduce the effectiveness of metformin.

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11
Q

What is Chvosteck’s sign and what does it indicate?

A

Contraction of the facial muscles when facial nerve is tapped. It indicates hypocalcemia.

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12
Q

What could cause a false A1C reading?

A

Low iron levels, kidney failure, or liver disease.

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13
Q

What can falsely raise BG levels?

A

Steroids and anti-psychotic medications, stress

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14
Q

What is hyperosmolar hyperglycemia syndrom (HHS)?

A

Occurring mostly in type two diabetic patients, HHS is what happens when your body is experincing an excessive amount of BG and tries to rid of it via urine. This leads to severe dehydration if left untreated.

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15
Q

What is the BG for a typical hyperosmolic hyperglycemic patient?

A

600mg/dL

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16
Q

What are some symptoms for a hyperosmolic hyperglycemic patient?

A

Drowsiness, confusion, fever, vision loss, convulsions, coma, excessive thirst, increased urination.

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17
Q

Explain how to teach a patient to preform BG readings.

A

Advise patient to take reading before giving insulin dose. Provider will indicate when other BG are needed. Preform hand hygiene, prick finger, wipe first blood droplet, take second blood droplet that forms with test strip.

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18
Q

How does illness affect BG?

A

The body releases hormones to fight illness that can raise blood surgar levels. (glucagone, cortisol, epinephrine).

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19
Q

What is the Somogyi effect?

A

When a person’s BG drops too low in the early morning hours and hormones are released to help reverse the low BG but may lead to BGs that are too high. (someone who takes insulin doesn’t eat their night time snack. BG drops too low at night and their body may increase hormones to counter-act low BG.)

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20
Q

What are priority interventions what treating diabetic ketoacidosis (DKA)?

A

Hydrate, decrease BG, monitor potassium levels and cerebral edema, correct acid-base imbalance. Administer IV fluids (usually starting with 0.9% NS and 0.45% NS. 5% dextrose may be added then.) Administer regular insulin (usually starts with an IV bolus then infusion.)

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21
Q

What are some examples of prolonged stress affects on the body?

A

Can lead to distress causing poor work productivity, impaired decision making and communication. Reduces ability to cope with clinical decision.

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22
Q

Give an example of rapid-acting insulin, its peak, and duration.

A

Lispro; peak 12-15 minutes, duration 2-3 hours.

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23
Q

Give an example of short acting insulin (regular), its peak, and duration.

A

Novalin-R, Humalin-R; peak 2.5 hours, duration 6-10 hours.

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24
Q

Give an example of intermediate acting insulin, its peak, and duration.

A

Isophane suspention (NPH); peak 4-8 hours, duration, 10-18 hours.

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25
Q

What are some quick acting carbohydrates that can be used to treat hypoglycemia?

A

Hard candy, orange juice, jelly

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26
Q

What would foot care consist of for a patient with nephropathy or peripheral vascular disease (PVD)?

A

Do not wash feet in hot water, have a podiatrist trim toe nails, not cut corns off feet, wear closed-toed, well fitting shoes, do not walk bear footed, inspect feed daily, dry feet thoroughly after washing.

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27
Q

How does gabapentin help with patient foot pain and what it it’s primary use?

A

Gabapentin has on off labeled use for treating neuropathic pain. It is primarily an anti-convulsive medication.

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28
Q

How does amitriptyline help with foot pain and what is its primary used?

A

IT has an unlabled used to help treat neuropathic pain by blocking nerve impulses to the brain. It’s primary use is an antidepressant.

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29
Q

What are some examples of adventitious lung sounds?

A

Weezing, rhonchi, stridor, crackles,

30
Q

What are some nursing interventions for adventitious lung sounds?

A

Encourage deep breathing, incentive spriometer, encourage fluid intake, controlled coughing, postural drainage, percussion, medication.

31
Q

What is an example of an isotonic IV solution?

A

Lactated ringers, 0.9% NS, 5DW (5% dextrose in water)

32
Q

What is an example of a hypertonic solution?

A

D5 (5% dextrose) in NaCl, D5 (5% dextrose) in lactated ringers, D5 (5% dextrose) 0.45% NaCl

33
Q

What is an example of a hypotonic solution?

A

D5W in the body, 0.25 NaCl, 0.45% NaCl (half normal saline), 2.5% Dextrose.

34
Q

What is basal metabolic rate?

A

Accounts for the heat produced by the body at absolute rest. It depends on the body surface area, thyroid hormones, and testosterone.

35
Q

What is a kilocalorie (KCAL)?

A

The amount of heat required to raise the temperature of one kilogram of water one degree Celsius.

36
Q

What is primary intention healing and secondary intention healing?

A
  1. Primary intention healing occurs when the edges of a clean surgical incision remain close together. The wound heals quickly, and tissue loss is minimal or absent.
  2. Secondary intention healing occurs when the edges of a wound are left open and allowed to heal by scar formation. There is tissue loss and open wound edges. Granulation tissue gradually fills in the are of the defect.
37
Q

What is cardiac output and how is it calculated?

A

Cardiac output is the volume of blood the heart pumps per minute. It is calculated by multiplying the stroke volume (preload, contractility, and afterload) and beats per minute (heart rate).

38
Q

How is pain assessed?

A

Remember PQRST. Provocation (cause of pain), Quality (pain described: i.e. dull, sharp, etc.), Radiate/Refers (where else can pain be felt), Severity (usually rating pain out of 10 on a pain scale), Time (what did it start, when is it the worst, when does it stop).

39
Q

What are the signs and symptoms of cataracts?

A

Cataracts are clouding of the lens that prevents the passage of light through the eye, overtime causing blindness. Signs/symptoms include clouded or blurred vision, squinting or closing of eyes in response to bright light, headache from bright lights, halos and glare in field of vision.

40
Q

What is the role of a transplant coordinator?

A

Coordinating of the evaluation and preparation of patients for organ transplantation and long-term management of patients after transplant. They coordinate between transplant office, outpatient clinic, the inpatient unit and community.

41
Q

What is the nurses role in clinical decision making?

A

Choosing between alternatives. It requires quality of judgment including critical thinking. Also involves analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting and transferring knowledge.

42
Q

What is tachypnea?

A

Rapid breathing (more than 20 breaths per minute)

43
Q

What is tachycardia?

A

Rapid heart beat (greater than 100 BPM)

44
Q

What are the normal vital sign ranges for BP, HR, Respiration, SpO2, and Temp?

A 
BP range: less than 120/80
HR: 60-100 BPM
Temp: 97-99 degrees F
Spo2: 95-100
Respirations: 12-20
45
Q

What are the phases in a helping relationship?

A

There are 4 phases: Preinteraction (before meeting pateint), Orientation (when patient and nurse meet and get to know one another), Working Phase (when nurse and patient work together to solve problems), and Termination phase (ending of the helping relationship).

46
Q

What are the risk factors and warning signs of colon cancer?

A

Age, African American decent, obesity, sedentary life-style, diabetes, smoking, alcohol, low-fiber high-fat diet, family history, and inflammatory intestinal conditions are all risk factors for developing colon cancer. Some warming signs include change in bowl habits, rectal bleeding, weakness/fatigue, abdominal discomfort, unexplained weight loss.

47
Q

What are cathartics?

A

They are administered for bowl cleaning and relief from constipation. Some examples are saline cathartics (magnesium cirate, magnesium sulfate, sodium sulfate, and magnesium hydroxide) and disaccharides (sobitol).

48
Q

Reasons a patient may have a low HR (Bradycardia)?

A

High stroke volume, under active thyroid gland, sleep apnea, medications for high BP.

49
Q

What is informed consent in nursing?

A

Patient’s choice to have a treatment or procedure based on their full understanding of the treatment procedure, benefits, risks, and alternatives.

50
Q

What does malpractice insurance cover?

A

Provides defense for a nurse that is in lawsuit. It covers cost, attorney fees, settlement. When insurance is provided by the employer, it is important to remember that insurance is in favor of the hospital, not the nurse them self, and while they are working under their scope of practice.

51
Q

Define “libel” and “slander” and give an example of each.

A

Libel is written defamation of character (charting false entries on a medical record). Slander is when one speaks falsely about another person (Nurse falsely tells someone else that a patient has gonorrhea and affects the patient’s business).

52
Q

Discuss the policy on organ donation.

A

According to federal law, a specially trained profession requests organ or tissue donation at time of every death. The person making the request give information on which organs or tissues can be donated, associated costs, and how donation affects burial or cremation.

53
Q

What is nursing malpractice?

A

When care falls below standard of care.

  1. The nurse (defendant) owed a duty of care to the patient (plaintiff).
  2. The nurse did not carry out or breached the duty.
  3. The patient was injured.
  4. The nurse’s failure to carry out the duty caused the injury.
54
Q

What is a living will?

A

A document that directs treatment in accordance with a patient’s wishes in the event of terminal illness or death.

55
Q

Explain the reason for autopsy and impact on post-mortem care.

A

Some statutes specify that, when there are reasonable grounds to believe that a patent died as a result of violence, homicide, suicide, accident, or death in an unusual or suspicious manner, you need to notify the medical examiner. Other than that, a consent needs to be obtained. Priority of consent goes 1. the paitent (in writing before death), 2. durable power of attorney, 3. living spouse, 4. living child, parent, or sibling in the order named.

56
Q

Discuss priority setting.

A

The ordering of nursing diagnosis or patient problems using notions of urgent and importance to establish a preferential order for nursing interventions.

57
Q

What are the steps of the nursing process?

A

ADPIE! Assessment, diagnosis, planning, implementing, evaluation.

58
Q

Explain Gesell, Thomas, and Chess’s developmental theory.

A

Gesell’s theory of development is that each child’s pattern of growth is unique and this pattern is directed by gene activity. Thomas and Chess conducted a 20-year longitudinal study that identified three basic classes of temperament: the easy child, the difficult child, and the slow-to-warm up child.

59
Q

Explain isotonic vs isometric exercises.

A

Isotonic exercises cause muscle contraction that change in muscle length (walking, swimming, dancing, etc.) and promote osteoblastic activity. Isometric exercises involve tightening or tensing muscles without moving body parts (quadriceps set exercises and contraction of the gluteal muscles.

60
Q

Explain the use of antimuscarinic drugs (oxybutynin), side effects, therapeutic effects.

A

Antispasmodic for neurogenic bladder, overactive bladder in females. Can cause anxiety, palpitations, burred vision, nausea, etc.

61
Q

Differentiate between cystitis, dysuria, and pyelonephritis.

A

Cystitis is urgency, frequency, incontinence, foul-smelling cloudy urine. Dysuria is irritation of the bladder., pyelonephritis is a serious upper UTI.

62
Q

Causes of decreased cardiac output.

A

MI, hypertension, valvular heart disease, congenital heart disease, HF, pulmonary disease, arrhythmia, fluid overload, decreased fluid volume, electrolyte imbalances.

63
Q

Spiritual well-being (SWB) and the FICA assessment tool.

A

The SWB scale has 20 questions that assess a patient’s relationship with God and his or her sense of like purpose and life satisfaction. FICA assessment tool evaluates spirituality and is closely correlated to quality of life. It stands for Faith, Importance, Community, and Address (interventions to address).

64
Q

Discuss protective enviroements (isolation) for patients who have undergone transplants and gene therapy.

A

They are placed in a protective environment category. This focuses on a very limited patient population requiring a specialized room with positive airflow set at greater than 12 air exchanges per hour and filtered through a HEPA filter. Patients must wear masks when they are out of their room.

65
Q

Patient prep for a patient having MRI, CT scan, and IVP.

A

CT scan: bowel cleanse, restrict food and fluid up to 4 hours before test. IVP: Assess for allergies, and dehydration, clease bowel, restrict food and water up to 4 hours before test. MRI: NPO 4 to 6 hours before examination.

66
Q

Gate control theory.

A

Gating mechanisms located along the contral nervous system regulate or block impulses. Pain impulses pass through when a gate is open and are blocked when gate is closed. Closing the gate is basis for nonpharmacological pain-relief interventions.

67
Q

Discuss normal age related changes in the cardiac and respiratory system of older adults that will impact oxygenation.

A

Respiratory: Ribcage cannot expand and contract as well during breathing, diaphragm weakens, aiway easily closes, ait sacs become baggy. Cardiac: SA node loses some of its cells resulting in a lower HR, increased size of heart may decrease the amount of blood the heart can hold, arrythmias occur, heart cells degenerate slightly. Capillary walls thicken, anemia, decreased BV.

68
Q

Explain the following nursing care delivery models: Team nursing, total patient care, primary nursing, and case-management.

A
  1. team nursing: ?
  2. total patient care: was original care delivery where the RN is responsible for all aspects of care for one or more patients during a shift of care, working directly with patients, family, and health team members.
  3. case management: coordinates and links health care services across all levels of care for patients and their families while streamlining costs and maintaining quality. Achieving patient outcomes within effective time frames and with available resources.
69
Q

Name four different types of incontinence.

A

Stress incontinence, urge incontinence, overflow incontinence, functional incontinence, mixed incontinence

70
Q

Place the steps of resolving an ethical dilemma in order. (7 steps)

A
  1. Ask the question: Is this an ethical dilema?
  2. Gather information relevant to the case.
  3. Clarify values. (fact vs. opinion)
  4. Verbalize the problem.
  5. Identify possible causes of action.
  6. Negotiate a plan.
  7. Evaluate the plan over time.
71
Q

Explain the following ethical theories: Feminist, utilitarianism, deontology, teleolgy.

A

Feminist: Scholars who focus on differences between genders, especially women’s point of view, developed a critique of conventional ethical philosophies.
Utilitarianism: Value of something is determined by its usefulness.
Deontology: Defines actions as right or wrong on the basis of their “right-making characteristics” such as fidelity to promises, truthfulness, and justice.
Teleogy: The study of ends of final causes.

72
Q

Define futile interventions.

A

Interventions unlikely to produce benefit for a patient.

Nursing Fundamentals (3 decks)

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