MIX Flashcards by Jade Ring

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

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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

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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

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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

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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

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The nurse must follow guidelines identified in the ______ and agency’s ______ when delivering care

Nurse practice act

Policies

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Legally, a nurse doesn’t have to accept a FLOAT assignment.

False

Nurse must accept a float assignment unless specific stated in Union Contract

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Which organs can only be donated if the client is on mechanical ventilation

Heart, Lungs, liver

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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

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What is usually the nurses role in informed consent for procedures

Witness the signing of the document

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Which is consent not needed in a minor

Emergency
Substance Abuse
STD
Birth control / Pregnancy
Psychiatric services

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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

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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

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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

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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

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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

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____ involves consultation and collaboration with interprofessional health care team

Case management

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____ is a professional nurse who assumes responsibility for coordination of client care at admission & after discharge

Case manager

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___ is a critical management care plan for providing client centered care

Planning & Monitoring progress within an established time frame

Critical pathway

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____ is a written guideline & communication tool that IDs
Assessment Data
Problems & Nursing Diagnosis
Goals
Intervention
Outcomes

Careplan

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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

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RN (Leader) assess clients, data, planning, and evaluation.

Assigns staff members specif clients based on their skills

This type of nursing

Team nursing

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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

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(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)

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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

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

1. Heart failure with a 4 lb weight gain in 24 hrs, SOB 2. 24-HR Post-op had wedge resection (removal small part of lung- less than a lobectomy) and client has a chest tube 3. Absent bowel sounds 4. Hysterectomy the following day

What contains the following information 1. Clients name, age, HCP, diagnoses 2. Current health status & plan of care 3. Clients needs and priority for care 4. Lab test, med administration, dressing changes needed 5. Need for special equipment 6. Allergies, resurrection status, precautions considerations, cultural/ religious issues, family issues.

Transfer report

List 6 parts of a transfer report

1. Clients name, age, HCP, diagnoses 2. Current health status & plan of care 3. Clients needs and priority for care 4. Lab test, med administration, dressing changes needed 5. Need for special equipment 6. Allergies, resurrection status, precautions considerations, cultural/ religious issues, family issues.

Describes the following 1. How to admin prescribed medication 2. SE & Adverse reaction that need to be reported to HCP 3. Prescribed dietary & activity measures 4. Complications that need to be reported to HCP 5. How to preform prescribed treatments 6. How to use special equipment 7. Schedule home care services 8. How to access community resources 9. When to obtain follow-up care

Discharge teaching

Discharge teaching (9)

1. How to admin prescribed medication 2. SE & Adverse reaction that need to be reported to HCP 3. Prescribed dietary & activity measures 4. Complications that need to be reported to HCP 5. How to preform prescribed treatments 6. How to use special equipment 7. Schedule home care services 8. How to access community resources 9. 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. 1. Client ambulatory demonstrating steady Gait. 2. Post-op client just recieved morphine 3. Client scheduled for first PT crutch walking session 4. Client with WBC 14,000 and fever of 101.

4. Client with WBC 14,000 and fever of 101. Post-op will be best to evaluate when medication takes effect

Match 1. Each staff member is assigned specific task for a group of clients 2. Determine clients needs at home and begin discharge planning 3. Single RN is provides care to 6 patients with help of an AP 4. 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 1. Acuity level of client 2. Specific request from staff 3. Clustering rooms in the unit 4. Number of anticipated discharge 5. Clients needs and workers needs and abilities

1. Acuity level of client 5. 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 1. Muscle twitching 2. Decrease urine output 3. Hyperactive bowel sounds 4. Increased specific gravity urine

3. Hyperactive bowel sounds

Client has 1.8 Phosphate. Which condition most likely caused this serum phosphorus (phosphate) level? 1. Malnutrition 2. Renal insufficiency 3. Hypoparathoidism 4. 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

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