MIX Flashcards
Client complains of anorexia, N/V, which medication from home would you be most concerned about
A. Digoxin
B. Catopril
C. Losartan
D. Furosemide
Digoxin
Anorexia, N/V are common signs over digonxin OD
Which special population should be targeted for breast cancer screening via mammogram SATA
1.Male to Female
2. Female to male
3. Men who have sex with Men
4. Women who have sex with women
5. Women who have sex with men
1,2,4,5
Which medication should be determined that there is Need For Follow Up, if prescribed to a homeless person
A. Glipizide
B. Lisinopril
C. Metformin
D. Beclomethasone
A. Glipizide
It’s a Sulfonylureas (DM) amd can cause hypoglycemia
Female presents to ED with fatigue & SOB. WHICH FINDING REQUIRES FOLLOW UP
A. reddened sclera
B. Dry flaking on scalp
C. Reddish-purple mark on neck
D. Scaly rash on knees and elbows
C. Reddish mark on neck can be an indication of ABUSE
Caring for refugees which health care need is the priority
A. Housing
B. Clean water
C. Transportation
D. Mental health services
D. They are coming from places of violence & war
The nurse must follow guidelines identified in the ______ and agency’s ______ when delivering care
Nurse practice act
Policies
Legally, a nurse doesn’t have to accept a FLOAT assignment.
False
Nurse must accept a float assignment unless specific stated in Union Contract
Which organs can only be donated if the client is on mechanical ventilation
Heart, Lungs, liver
Jewish people can donate organs
Jewish people can accept donated organs
Can a jehova witness accept an organ
Jewish people can donate organs. FALSE
Jewish people can accept donated organs. TRUE
Can a jehova witness accept an organ
TRUE, but only if cleansed with non-blood solution before hand
What is usually the nurses role in informed consent for procedures
Witness the signing of the document
Which is consent not needed in a minor
Emergency
Substance Abuse
STD
Birth control / Pregnancy
Psychiatric services
After a fall, you (the nurse) & HCP determine that the patient was uninjured. After completing the occurrence report, what should be the next action?
- Reassess client
- Conduct staff meeting to describe the fall
- Contact nursing supervisor to update information regarding fall
- Document in nursing notes that an occurrence report was completed
- Reassess often after falls
Client needs you (the nurse) to serve as a witness to a document.
What is the most appropriate response to the client
A. I will sign as a witness to your signature
B. You will need to find a witness on your own.
C. Whoever is available at the time will sign as a witness for you
D. I will call the nursing supervisor and seek assistance regarding your request.
D. I will call the nursing supervisor and seek assistance regarding your request.
Often institutions dint want nurses acting as witnesses
Which are not necessary when amending a mistake in the documentation of “Wasted Morphine”
- Complete & File an occurrence report
- Right click & modify entry on MAR
- Document correct information & end with signature & title
- Obtain cosignature from RN who witnessed the “Wasting” of morphine
- Document in nurses notes the clients record detailing correct information
All correct except 1
Which are accurate nursing documentation: SATA
1.Client slept through the night
2. Abdominal wound dressing dry & intact, no drainage
3. Client seemed angry when awaked for VS @ 0500
4. Client appears anxious before respitory treatments
5. Client left lower medial leg wound is 3 cm in length, no redness, drainage, edema
3 & 4 INCORRECT
Don’t use opnion words like: SEEMES / APPEARS
Nurse calls HCP due to prescription being a higher dose than the recommended dose. Unable to get in contact with HCP. What to do next?
- Contact nursing supervisor
- Administer prescribed dose
- Hold meds until HCP is contactes
- Administer recommended dose until HCP can be located
Contact nursing supervisor
____ involves consultation and collaboration with interprofessional health care team
Case management
____ is a professional nurse who assumes responsibility for coordination of client care at admission & after discharge
Case manager
___ is a critical management care plan for providing client centered care
Planning & Monitoring progress within an established time frame
Critical pathway
____ is a written guideline & communication tool that IDs
Assessment Data
Problems & Nursing Diagnosis
Goals
Intervention
Outcomes
Careplan
Type of nursing where charge nurse delegates tasks to team members, rather than the whole client.
Crears lack of accountability by team members
Functional nursing
RN (Leader) assess clients, data, planning, and evaluation.
Assigns staff members specif clients based on their skills
This type of nursing
Team nursing
This type of nursing is concerned with keeping the nurse at the bedside and actively involved in patient care
Individualized care
Primary nursing (Relationship-based) Nursing
(Leadership or Management)
Accomplishment of tasks or goals by oneself or by direction of others
Interpersonal process that involves influencing others to achieve goals
Accomplishment of tasks or goals by oneself or by direction of others (Management)
Interpersonal process that involves influencing others to achieve goals (Leadership)
Laissez-faire leadership is…
When the leader takes a passive role
Bureaucratic leadership assumes that team members are motivates by …
External forces
Polices & Procedures
This leadership style focuses on
Building relationships
Staff members have a shares vision
Encourage and praises staff members
Transformational leadership
This leadership style
Build relationships
Develop skills of team members
Meet needs of team mates
Servant leadership
_____ are guidelines that define an organization directives on course of action
____ are based on policy and define methods for tasks
_____ prescribe a specific course of action for a specific type of client of problem
Policies
Procedures
Protocols
Maslows hierarchy of needs
Start with most basic
(5)
Physiological needs
Safety / Security
Love & Belonging
Self-esteem
Self-Actualization
FEMA has 4 disaster management phases
Mitigation, preparedness, response, recovery
Which pulses to check during CPR
How long?
Carotid or femoral
5 - 10 seconds
Non-invasive interventions, skin care, ROM exercises, ambulation, grooming, hygine
Delegated to this team member
Assisting personal
Dressing changes, suctioning, urinary Catheterization, Med Administration (Oral, SQ, intramuscular, SELECT IVPB)
Collect Data & Review teaching plans initiated by RN
Delegated to this team member
LPN
This health care team member
Responsible for assessment & planning care
Initiating teaching
Administration IV meds
RN
Can an LPN care for unstable clients
No
Only, an RN
Nurse Management
Which nurse manger:
unit manager/ Supervisor
Prepares work schedule, write & implementation of polices for client care and unit operations, maintain quality of client services.
Charge nurse
Supervision of multi departments and works closely with administration.
DON
Supervisory role of client care and may temporarily assume client care role
List in order of priority
Hysterectomy the following day
24-HR Post-op had wedge resection (removal small part of lung- less than a lobectomy) and client has a chest tube
Absent bowel sounds
Heart failure with a 4 lb weight gain in 24 hrs, SOB
- Heart failure with a 4 lb weight gain in 24 hrs, SOB
- 24-HR Post-op had wedge resection (removal small part of lung- less than a lobectomy) and client has a chest tube
- Absent bowel sounds
- Hysterectomy the following day
What contains the following information
- Clients name, age, HCP, diagnoses
- Current health status & plan of care
- Clients needs and priority for care
- Lab test, med administration, dressing changes needed
- Need for special equipment
- Allergies, resurrection status, precautions considerations, cultural/ religious issues, family issues.
Transfer report
List 6 parts of a transfer report
- Clients name, age, HCP, diagnoses
- Current health status & plan of care
- Clients needs and priority for care
- Lab test, med administration, dressing changes needed
- Need for special equipment
- Allergies, resurrection status, precautions considerations, cultural/ religious issues, family issues.
Describes the following
- How to admin prescribed medication
- SE & Adverse reaction that need to be reported to HCP
- Prescribed dietary & activity measures
- Complications that need to be reported to HCP
- How to preform prescribed treatments
- How to use special equipment
- Schedule home care services
- How to access community resources
- When to obtain follow-up care
Discharge teaching
Discharge teaching (9)
- How to admin prescribed medication
- SE & Adverse reaction that need to be reported to HCP
- Prescribed dietary & activity measures
- Complications that need to be reported to HCP
- How to preform prescribed treatments
- How to use special equipment
- Schedule home care services
- How to access community resources
- When to obtain follow-up care
How can prioritizing be different in a disaster situation for a nurse.
Action may need to be taken before assessment
Which should the nurse evaluate first.
- Client ambulatory demonstrating steady Gait.
- Post-op client just recieved morphine
- Client scheduled for first PT crutch walking session
- Client with WBC 14,000 and fever of 101.
- Client with WBC 14,000 and fever of 101.
Post-op will be best to evaluate when medication takes effect
Match
- Each staff member is assigned specific task for a group of clients
- Determine clients needs at home and begin discharge planning
- Single RN is provides care to 6 patients with help of an AP
- RN leads 2 LPNs & 3 AP provide care to 12 members
Team-based, Functional, Case Management, Primary/ Task based
Functional
1. Each staff member is assigned specific task for a group of clients
Case Management
2. Determine clients needs at home and begin discharge planning
Primary
3. Single RN is provides care to 6 patients with help of an AP
Team
4. RN leads 2 LPNs & 3 AP provide care to 12 members
Which factors should a nurse be mindful of when delegating assignments
- Acuity level of client
- Specific request from staff
- Clustering rooms in the unit
- Number of anticipated discharge
- Clients needs and workers needs and abilities
- Acuity level of client
- Clients’ needs and workers’ needs and abilities
Guidelines for delegación include: Safety, appropriate task based on nurse practice act and posistion of designee, provide clear,concise, accurate, complete instructions.
Staff request, convenience as in clustering rooms, and anticipate change in unit census are NOT specific Guidelines when delegating tasks.
Hypertonic Dehydration/ Hypotonic Dehydration
Water loss exceeds electrolyte loss
Electrolyte loss exceeds Water loss
Fluid moves from intracellular compartment into plasma, causing shrinkage of cell
Fluid moves from plasma & interstitial Fluid into the cell
Hypertonic Dehydration
Water loss exceeds electrolyte loss
Fluid moves from intracellular compartment into plasma, causing shrinkage of cell
Hypotonic Dehydration
Electrolyte loss exceeds Water loss
Fluid moves from plasma & interstitial Fluid into the cell
Causes of Hypertonic/ Hypotonic Dehydration
Diaphoresis, hyperventilation, DKA, fever, diarrhea, early kidney disease, diabetes insipidus
Chronic illness, Kidney disease, Chronic malnutrition
Hypertonic Dehydration
Diaphoresis, hyperventilation, DKA, fever, diarrhea, early kidney disease, diabetes insipidus
Hypotonic Dehydration
Chronic illness, Kidney disease, Chronic malnutrition
Hypo/Hypernatremia precipitates Lithium toxicity
Hyponatremia
Hyponatremia/ Hypernatremia
Corticosteroids
Cushings syndrome
Kidney disease
Hyperaldosteronism
Diuretics
Vomiting
Diarrhea
Wound drainage
Kidney disease
Hypernatremia
Corticosteroids
Cushings syndrome
Kidney disease
Hyperaldosteronism
Hyponatremia
Diuretics
Vomiting
Diarrhea
Wound drainage
Kidney disease
Aluminum hydroxide reduces ____ levels & increases ____ levels
Aluminum hydroxide reduces phosphorus levels & increases calcium levels
Provide quiete environment and reduce stimuli
Initiate seizure precautions
Move client carefully and monitor for signs of pathological fractures
Describes this electrolyte imbalance
Hypocalcemia
____ is the antidote for magnesium overdose
Calcium Gluconate
ECG & ELECTROLYTES
ST depression
Shallow,flat, inverted T waves
Prominent U wave
Hypokalemia
ECG & ELECTROLYTES
Tall T wave
Flat P wave
Widened QRS
Prolonged PR interval
Hyperkalemia
ECG & ELECTROLYTES
Prolonged ST segment
Prolonged QT interval
Hypocalcemia
ECG & ELECTROLYTES
Shortened ST
Widened T wave
Heart block
Hypercalcemia
Give potassium via these routes
Oral / IV
NEVER IV PUSH, IM, SQ
Max infusion rate for potassium
5 -10 mEq/hr
Never more than 20
Hyponatremic patient has flat neck veins, generalized muscle weakness, diminished tendon reflexes.
Which of the following is also a sign of Hyponatremia
- Muscle twitching
- Decrease urine output
- Hyperactive bowel sounds
- Increased specific gravity urine
- Hyperactive bowel sounds
Client has 1.8 Phosphate. Which condition most likely caused this serum phosphorus (phosphate) level?
- Malnutrition
- Renal insufficiency
- Hypoparathoidism
- Tumor lysis syndrome
Malnutrition
2.5 to 4.5 mg
Dilution of no more than 1 mEq/10 mL is recommended before giving this electrolyte
K
Ibuprofen (NSAID) may have this affect if taken with a oral diabetic agent?
Ibuprofen (NSAID) & CCB together will have this effect?
Hypoglycemia
Increased BP / Kidney Damage
DKA sodium / K levels
Hyponatremia / Hyperkalemia
