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Nursing 300 > Knowledge Assesment 1 > Flashcards

Knowledge Assesment 1 Flashcards

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1
Q

Communication in nursing practices

A

Helps reduce risk of errors helps patients reach health rated goals

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2
Q

Demonstrating care

A

Being sensitive and supportive
Present and encouraging expression of feelings ( positive or negative)
Developing caring relationships
Instilling faith and hope
Promoting interpersonal teaching and learning
Respecting spiritual expression

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3
Q

Elements of professional communication

A

Appearance, behavior
Use of names
Courtesy
Trustworthiness
Autonomy, responsibility
Assertiveness

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4
Q

Intrapersonal

A

occurs within an individual

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5
Q

Interpersonal

A

One on one reaction between two people

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6
Q

Trans personal

A

Interaction within a persons spiritual domain

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7
Q

Small group

A

Interaction with a few people

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8
Q

Public

A

Interaction with an audience

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9
Q

Circular transactional model

A

Referent - content of the message
Sender and receiver - one who codes and one who decides the message
Messages
Channels - means of conveying and receiving messages
Feedback - the message the receiver returns
Interpersonal variables - factors that influence communication
Environment - setting of sender receiver conversations

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10
Q

Nonverbal communication

A

Personal appearance
Posture and gait
Facial expression
Eye contact
Gestures
Sounds
Territoriality and personal space

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11
Q

Zones of personal space

A

Intimate zone 0-18in
- bathing grooming dressing toileting and physical assessment
Personal zone 18in-4ft
- sitting at bedside, taking pt history, teaching, information exchange
Social zone 4-12ft
- making rounds w physicians, teaching a class, family support group
Public zone 12 ft and greater
- community forum, testifying at a legislative, lectures for class

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12
Q

Motivational interview

A

Encouraging pts to share thoughts, beliefs, fears, and concerns

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13
Q

Assessment measures

A

Physical and emotional
Developmental
Sociocultural
Gender

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14
Q

Therapeutic communication techniques

A

Active listening
Sharing observations, empathy, hope, humor, feelings,
Using touch and silence
Providing information
Clarifying
Focusing
Paraphrasing
Validation
Relevant questions
Summarizing
Self disclosure
Confrontation

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15
Q

Non therapeutic communication

A

Asking personal questions
Giving personal opinions
Changing the subject
Automatic responses
False reassurance
Sympathy
Asking for explanations
Approval/disapproval
Defensive responses
Passive aggressive responses
Arguing

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16
Q

Evaluation

A

Nurses and pts determine whether care plan was successful
Nursing interventions are elevated to see what was effective
Care plan needs to be modified

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17
Q

Nature of pain

A

Subjective
Involves physical emotional and cognitive components
Reduces quality of life

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18
Q

Physiology of pain

A

Transduction: activation of pain receptors
Transmission: conduction along pathways
Modulation: inhibition or modification of pain

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19
Q

Gate control therapy

A

Describes how relationships between pain and emotions - how you think and react to pain
Gating mechanism determines the impulses that reach the brain

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20
Q

Physiological responses

A

Ascending impulses going to the brain stimulate and ANS
Stress response is fight or flight
- increase RR, HR, blood glucose and muscle tension
Vasoconstriction , decreased GI motility, diaphoresis, pupil dilation
Continuous, severe, deep pain activates the parasympathetic NS
- pallor, N/V, decreased HR and BP, rapid irregular breathing

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21
Q

Behavioral responses to pain

A

Clenching teeth
Facial grimacing
Guarding painful area
Bent posture
* lack of pain expression does not mean a pt isn’t experiencing pain

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22
Q

Signs and symptoms of pain

A

Moaning or crying
Biting lips
Pacing
Change of VS
Tightly closed eyes
Wrinkled forehead
Muscle tension
Avoiding others
Rubbing

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23
Q

Somatic pain

A

Joints, bone, muscle, skin, connecting tissue

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24
Q

Visceral pain

A

Comes from major organs
Tumors
Obstructions

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25
Q

Acute/ transient pain

A

Identifiable, short duration, limited emotional response

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26
Q

Chronic episode

A

Occurs sporadically over an extended duration

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27
Q

Chronic/persistent non cancer

A

May or may not have an identifiable cause

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28
Q

Idiopathic

A

Chronic pain without identifiable cause

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29
Q

Common biases of pain

A

Substance abuses
Minor illness
Taking pain meds on a continued basis
Tissue damage
Psychogenic pain is not real
Chronic pain is psychological
Patient who can’t speak have no pain

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30
Q

Factors that influence pain

A

Physiological
Social
Spiritual
Psychological
Pain tolerance
Cultural

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31
Q

Pain assessment

A

Palliative or provocative- what makes it better and worse
Quality
Relief
Region
Severity
Timing
How the pain affects you

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32
Q

ABCDE’s of pain management

A

ASK about pain regularly
BELIEVE the patient about pain
CHOOSE appropriate pain control options
DELIVER interventions in a timely manner
EMPOWER patients and their families

33
Q

Non pharm pain management

A

Relaxation
Distraction
Biofeedback
Cuteaneous
Herbals
Reducing pain perception
Control stimuli - loosen clothing, temperatures re positioning

34
Q

Pharm pain management

A

Analgesics
Non opioids, NSAIDS
SE: GI bleed, renal insufficiency, liver failure not recommended for elderly
Opioids: morphine, codeine, fentanyl, oxycodone, hydrocodone
- respiratory depression, N/V, constipation
PCA- patient controlled analgesics
Patient can give meds by themselves
- morphine, fentanyl, dilaudid

35
Q

Analgesia

A

Local: procedures for loss of sensation- lidocaine
Regional: epidural or a nerve block; need to protect from injury
Perineurial: infusion at painful sight
Topical: EMLA,Z lidocaine, lidoderm patch

36
Q

Epidural catheter care

A

Prevent displacement
Maintain function
Prevent infection and complications
Monitor VS
Maintain urinary and bowel functions

37
Q

Palliative care/ hospice

A

Assist patients to manage pain when life is limited
Patient and family impnvolvement
Support and care for patients in their last stage of life
Pain controlv

38
Q

Physical dependence

A

Withdrawal s/s if taken off drug quickly
- shaking fever chills cramps joint pain excessive yawning

39
Q

Addiction

A

Neurobiological disease with genetic, psychosocial, and environment factors influencing the development

40
Q

Drug tolerance

A

Adaptation to drug that decreases its effects

41
Q

Placebo use

A

No active ingredients and no therapeutic effect

42
Q

Pseudo addiction

A

Chronic pain patient seeking out multiple healthcare providers to find relief from pain

43
Q

Barriers to pain management

A

Fear of addiction, SE, and injections
Aging
Suffering in silence is noble

44
Q

Pain perceptions

A

Attitude if health care provider towards pain patients
Acknowledgement of pain through patients experiences

45
Q

People are risk for adverse effects

A

Sleep apnea
Obesity
Older adults
Co-morbidities
No prior use
Poly pharmacy
Recent surgery
Prolonged anesthesia
Smoker

46
Q

Pathogenic organism

A

Causes disease; needs specific measures:
Ability to survive in host
High virulence
Strength in numbers
And the hosts ability to prevent infection

47
Q

Over use of antibiotics

A

Pathogens can become resistant to antibiotics

48
Q

Transient organism

A

Ability of an organism to attach via skin to skin contact

49
Q

Resident flora

A

Normal bacteria that stays in or on the body (non pathogenic)

50
Q

Asymptomatic/ convulsant carriers

A

Have disease but do not show signs and symptoms

51
Q

Modes of transmission

A

Airborne
Droplet
Contact
Vector - insects and animals
Vehicles- food, water, air

52
Q

Reservoirs

A

Live in warm, moist areas, need right nutrition, some need oxygen, pH and acidity of environment, and dark lighting
Living: humans, animals, and insects
Non living: water,food, equipment, floors

53
Q

Portal of exit

A

Same ways they came in they can come out

54
Q

Portal of entry

A

Open wounds, exposure to blood, GI tract, respiratory system, urinary system, most body systems are portals of entry

55
Q

Chain of infections

A

CAN ONLY OCCUR IN THIS SEQUENCE
pathogenic organism
Reservoir
Portal of exit
Modes of transmission
Portal of entry
Susceptible host
We can learn what stage the infection is at and learn how to stop it

56
Q

Stages of infection

A

Incubation period- pathogen successfully enter the body
Prodromal period- nonspecific signs and symptoms begin
Illness period- signs and symptoms become more specific
Decline period- symptoms start to subside
Convalesce- sickness is on the ending stages, feel better and symptoms are gone

57
Q

Defenses against infection

A

Primary- skin, mucous membranes, cilia in nose, blinking
Secondary- fever, inflammation, phagocytosis
Tertiary- humoral immunity glob is ( igG, igM)

58
Q

Factors that increase susceptibility

A

Chronic illness
Immunization levels
Developmental level
Meds/antibiotics that decrease immune response
Tobacco and alcohol use
Environmental status

59
Q

Factors that support hosts defenses

A

Nutrition
Sleep
Exercise
Reducing stress
Hygiene

60
Q

Signs and symptoms of infection

A

Patient appearance- sweating, fatigue, pale, SOB, grimacing, change in wound, light sensitivity
Vital signs- if no fever, ask if they took Motrin, pulse would be higher, RR and BP would stay the same unless pt anxious or stressed. O2 changes with respiratory infection s
Diagnostic testing

61
Q

Preventing infection precaution

A

PPE, hand hygiene,
If airborne: gloves, gown, mask, negative pressure room
If droplet: gloves, gown, mask, shield
Contact: gloves, gown, mask, shield

62
Q

Pharmacological concepts

A

Chemical- provides exact description of meds composition
Generic- the manufacturer that first develops the drug assigns the name
Official name- designated by FDA
Trade- also known as brand or proprietary name. It’s the name under which a manufactured markets the medication
Classification- effect on body system, relieved symptoms, and desired effect
Forms of medication- solid, liquid, topical, parental

63
Q

Drug absorption

A

Transportation of unmetabolized drug from the administration site to the circulation system
Influencing factors
Route of administration
Ability to dissolve
Blood flow at site of administration
Body surface area
Lipid solubility

64
Q

Medication actions

A

Distribution- protein binding, circulation, membrane permeability
Metabolism- medications turn to less potent inactive form. Bio transformation breaks down and remove active chiemicals
Excretion- medications exit the body ( kidney(main) , liver, bowels, lungs. Chemical make up determines route of exit

65
Q

Medication actions

A

Therapeutic effect - predicted outcome
Adverse effect - unintended outcome
Idiosyncratic reaction - over or under reaction
Side effects - unavoidable secondary effects
Toxic effects- accumulation of medication in the blood
Allergic reactions - unpredictable response to medication

66
Q

Types of medication actions

A

Interactions- one med modifies another
Tolerance- more meds required to treat goal
Dependence- physical and psychological

67
Q

Achieving therapeutic effect

A

Medication dose
Route of administration
Frequency of administration
Function of metabolizing organs ( kidney, liver)

68
Q

Timing of therapeutic effect

A

Onset- time if meds to produce a response
Trough- minimum blood serum concentration before next scheduled dose
Plateau- point at which blood serum concentration is reached and maintained
Peak- time at which a medication reaches its highest effective concentration
Duration- time medication takes to produce greatest results
Biological half-life- time odor serum medication concentration to be halved

69
Q

Physiological variables affecting therapeutic effect

A

Age
Gender and body build
Chronic diseases result in body organ function
Concurrent medication use
Nutritional status
Pregnancy
Genetic factors
Health illness beliefs
Previous experience with meds
Knowledge based
Cultural beliefs
Developmental stage
Social support/ financial status
Potential for medication dependence and misuse

70
Q

Routes of administration

A

Oral- sublingual, buccal
Topical- direct, body cavity
Parenteral- ID, Sub-Q, IM, IV
Inhalation
Intraocular

71
Q

Types of orders in acute care settings

A

Standing orders / routine
Single orders
Now orders
PRN orders
STAT orders
Prescriptions

72
Q

Nurses role

A

Determine medications ordered are correct
Asses patients ability to self administer
Determines medication timing
administers medication correctly
Closely monitors effects
Provides patient teaching
Medication errors

73
Q

10 rights of medication administration

A

Right medication
Right dose
Right patient
Right route
Right time
Right assessment/ indication
Right documentation
Right evaluation
Right to refuse treatment
Right patient education

74
Q

Patient rights

A

To be informed about a medication
To refuse a medication
To have medication history
To be properly advised about experimental nature of medication
To receive labeled medications safely
To receive appropriate support therapy
To not receive unnecessary medications
To be informed if medications are part of a research study

75
Q

Medication reconciliation

A

Compare past and present medications
Verify the list
Compare the list
Reconcile the list
Communicate the updates

76
Q

Guidelines for safe medication administration

A

Be vigilant
Ensure pt receives correct meds
Know why the is is taking the meds
Verify expiration date
Two pt identifiers before administering medications
Check MAR
check for accuracy 3x
Clarify unclear medication orders
Use strict aseptic technique
Educate pt about each medicine
You cannot delegate med administration
Follow safety guidelines to prevent needle stick injuries

77
Q

Medical errors

A

Any preventable event that may cause inappropriate medication use of jeopardize patient safety

More people die from medical errors then from lower chronic respiratory disease, accidents, strokes, Alzheimer’s, and diabetes mellitus

78
Q

When a medical error occurs…

A

Assess patients condition
Notify health care provider
Report incident
Prepare and file an incident report
Report near misses and incidents that cause no harm
Reconcile meds during transitions of care

Nursing 300 (3 decks)

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