Iowa Nab Exam Part 1 Flashcards
Significant Weight Loss Percentages
1 Month: 5% 3 Month: 7.5% 6 Month: 10%
Risk Factors for Residents to become Dehydrated
- Coma/Decreased Sensorism
- Fluid loss due to diarrhea/fever
- Fluid restriction secondary to renal dialysis
- Dementia resident forgets to drink
- Refusal of fluids
Risk factors for decreased R.O.M
- Immbolization (bedfast)
- Deformities arising out of neuro deficits (stroke, MS, CP, polio)
- pains, spasms, and immobility assoc. with arthritis or late stages Alzheimer’s disease
3 Stages of Alzheimer’s Disease (the most common form of dementia is persons 60+/intellectual impairment that is irreversible/also known as primary degenerative dementia/aging is the greatest risk factor).
1st Stage: Forgetfulness or early stages
2nd Stage: Confusion or mild stage
3rd Stage: Dementia or terminal stage
Three major causes of senile dementia
60% Alzheimer Type
25% Infraction of brain tissue due to cerebrovascula disease
15% to other diseases: Paresis, Huntingtons, Picks Disease, Parkinson’s
Arteriosclerosis
Disease that may lead to dementia in the elderly, may also be referred to as a multi infarct dementia
Aphasia
Inability to interpret and formulate language
Excessive Aphasia
inability to express in words what the individual really wants to communiate
Contractures
a deformity that results when the muscle has shortened and pulls the adjacent joint into a flexed position. Foot, hips, legs, hand and wrist areas effected. Best form of treatment: exercise the joints of those who are unable to do so for themselves (passive range of motion)
Drug Error
60 minutes earlier or later than scheduled but only if that wrong time error can causde the resident discomfort or jeopardize the residents health and safety. 5% or higher error rate on survey to be cited.
Lower Tract UTI
Infection of the uretha or bladder
Upper Tract UTI
Infection of the Ureter or kidney
Urosepsis
systematic inflammatory response to infection that originates from a urinary tract source may present with symptoms such as fever, hypotension, reduces urine output or acute change in mental status.
Two most common causes of organic brain syndrome
Alzheimer’s and Cerebrovacular insufficiency or reduced blood flow to the brain
Registered Nurse
8 Consecutive hours per day/ 7 days per week
Director of Nursing
may serve as charge nurse for a building that has an average census of 60 or less
Physician
Doesn’t need to review the total plan of care each visit but must review the plan at least once every 30 days for the first 90 days and at least once every 60 days there after. There is a 10 day grace period. Each visit review residents total program of care including medications and treatments and also write, sign and date progress notes for each visit. Sign and date all orders.
Five Essential ADL’s
Eating, Dressing, Toileting, Bathing, Transferring
Comp. Assess
Dietary, drugs and routine care to maintain or improve residents functional abilities until a comp assess and care plan are written. Discharge potential=within 3 months-must conduct assessment within 14 days of admission then at least quarterly.
Significant Changes (2 or more)
Decline on ADL’s, Increase in # of area’s for behavioral symptoms, decision making changes, incontinence pattern changes or placing an indwelling cath, sad or anxious mood, unplanned weightloss, use of trunk restraint, disease/condition in which resident is judged to be unstable, stage 2 pressure ulcer.
Maintain 15 months of assessment data in the active records and MDS.
Care Plans
Needs to have measureable objectives and timetables to meet a residents medical, nursing, mental health and psychosocial needs that are identified in the assessment. The plan should describe services that will be provided to attain or maintain the residents highest practicable, physical, mental and psychosocial well being. SHOULD BE DEVELOPED WITHIN 7 DAYS AFTER THE COMPLETION OF THE ASSESSMENT and be prepared by the IDT which includes attending DOC, RN with responsibility of the resident and other appropriate disciplines and can also include resident family and legal representative.
Discharge Summary
Recapitulation of stay and final summary of residents status. (MDS orginiated thru OBRA of 1987)
Facility must post daily:
Facility name, date, total number and actual hours worked by all nurses and aides, census. (Keep records for 18 months)
Qualified Dietician
8 Hours/Month at minimum.
