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Nursing 232 > MODULE 1 PART 2: DIAGNOSTICS > Flashcards

MODULE 1 PART 2: DIAGNOSTICS Flashcards

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1
Q

Define informed consent

A

a focused communication process in which the professional nurse or physician discloses all relevant information related to a procedure or treatment, with full opportunity for dialogue, questions, and expressions of concern, before asking the client or health care agent for the client to sign a legal consent form

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2
Q

3 elements to obtaining informed consent in order for consent to be legal.

A

1) Voluntariness
2) Disclosure
3) Capacity

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3
Q

Voluntariness (with regard to consent)

A

No coercion, manipulation

* One of 3 elements of obtaining legal consent

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4
Q

Disclosure w/regard to consent

A

Client provided with full disclosure about:

  • risks
  • benefits
  • cost
  • potential side effects or adverse rxns
  • given info about alternatives
  • Effects + risks of no tx
  • One of 3 elements of obtaining legal consent
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5
Q

Capacity = ?

w/regard to informed consent

A

Client must have capacity and competency to understand info and make informed choice, understand consequences of decision
* One of 3 elements of obtaining informed consent

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6
Q

Before beginning the consent process, what should nurses assess?

A

Hearing, sight, mental status, literacy level, ability to understand procedure

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7
Q

Essential aspects of disclosure that must be included to ensure consent is informed?

A
  • Nature + purpose of treatment
  • What pt can expect to experience/feel
  • Risks and benefits of not receiving the treatment
  • Clients right to refuse w/o penalty
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8
Q

T/F: Consent is legal requirement

A

T

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9
Q

Should a nurse be the one to receive consent for a medical or surgical procedure?

A

No, typically physician.

- Having nurse get consent is not good practice

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10
Q

What aspects of a getting consent for medical procedures is a nurse a part of/not part of?

A
  • *Nurse is NOT responsible for filling in gaps in physician’s info!
  • nurse may be asked to witness exchange b/t dr. + pt
  • Has responsibility to “ensure that when information gaps occur, the physician is alerted in time to put things right”
  • Establishes that client really did understand (was truly informed)
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11
Q

Important question to ask right before getting consent?

A

“Is there anything else that might help you making your decision?”

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12
Q

Which demographics are allowed/not able to give consent?

A

Only legally competent adults can sign

  • cannot be mentally retarded, developmentally disabled, or cognitively impaired
  • Cannot be confused, sedated, or sedated (not considered functionally competent)
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13
Q

Can minors give consent?

A

Decided on individual basis
Most provinces have own age of minors (
Minors can also give consent in emergency situations (in Arnold + Boggs…may be referring to USA)

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14
Q

Are those with mental illness able to give consent?

A

Evaluated on individual basis - depends on: ability to appreciate nature, quality, and consequences of treatment

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15
Q

Once a patient has given consent, is that the final word?

A

No, have the right to revoke consent at any time.

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16
Q

What is express consent

A

Clear statement by patient - either written or verbal.

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17
Q

Implied consent =

Examples?

A

When individual’s nonverbal behaviour indicates willingness.

examples:
- In emergency when cannot speak for self
- during surgery when additional procedures necessary
- in therapy when person continues to participate without withdrawing consent

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18
Q

Special consideration for obtaining informed consent in home care setting?

A

Plan may affect others, so they also need to be consulted

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19
Q

For those unable to give own consent…If no court-appointed substitute decision maker is determined, who does decision fall to?

A

Spouse, then to various members of family in accordance with statutory list.

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20
Q

What does RBC diagnostic measure?
RBC lifespan?
Produced/broken down in?
What regulates production?

A

1) # of RBC’s in 1mm3 of periopheral venous blood
- 120 days
- produced in bone marrow, destroyed by spleen and liver
- production regulated by erythropoietin (produced by kidneys)

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21
Q

Purpose of WBC in CBC test?

A

1) Screen for wide variety of diseases and conditions
2) Help diagnose an infection or inflammatory response, or other conditions such as allergies, leukemia, or immune responses
3) monitor progression of conditions or body’s response to treatments; bone marrow fx

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22
Q

Hgb

A

→ measure of total amount of Hgb in the peripheral blood, which reflects # of RBCs

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23
Q

Ave life span of an WBC?

A

13-20 days

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24
Q

WBC’s: destroyed by? Excreted in?

A

Destroyed by lymphatic system

Excreted in feces

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25
Q

WBC Differential shows elevated neutrophils. Indicates?

A

Bacterial infection

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26
Q

Eosinophils elevated in?

A

Allergic disorders & Parasitic infections

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27
Q

Basophils elevated in?

A

Parasitic infections + some allergic disorders

28
Q

Lymphocytes elevated in?

A

Viral infections

29
Q

Monocytes elevated in?

A

Severe infections

30
Q

What is the “shift to the left”

A

Common saying to indicate inc in very immature WBC’s = initial sign of infection

31
Q

Which three diagnostic tests are typically analyzed as a triad?

A

RBC, Hct, Hb

32
Q

In which conditions does polycythemia occur?

A

COPD
Dehydration
High altitude
Polycythemia Vera

33
Q

In what conditions does anemia occur?

A
  • Acute or chronic blood loss
  • Leukemia
  • Nutritional deficit
  • Chronic inflm
  • Inadequate RBC production
34
Q

What does anemia look like?

A

Pale, SOB, fatigue, inc HR, inc RR, possible chest pain (if very low Hgb)

35
Q

Which blood tests look at hemostasis + coagulation?

A

1) PTT (Partial Thromboplastin time)

2) PT-INR (Prothrombin Time/International Normalized Ratio

36
Q

3 Renal Function tests?

A

GFR
BUN
Creatinine

37
Q

Sodium

1) high in ICF or EFC?
2) Serum concentration affected by?
3) Fx’s?

A

1) ECF
2) Dietary intake, reanl excretion (based on hormones aldosterone (inc) + ANP (dec)
3) EC osmolality; Transmembrane potential; Acid:base balance; Numerous chemical reactions

38
Q

Potassium

1) High in?
2) Important for?
3) Role in body?

A

1) Major cation within cells - very high [ ] in cells in comparison to serum
2) Important for muscle, therefore affects heart rate + contractility
3) Transmembrane potential; Intracellular osmolalty; Acid:base balance
Intracellular enzyme reactions

39
Q

BUN =

  • What is it measuring?
  • Relates to organ or what functions?
A

= Blood Urea Nitrogen

  • Measuring urea in blood, which comes from ammonia, which is the waste product of breakdown of proteins by the liver.
  • R/t renal and kidney fx (kidney responsible for excretion, so if high in serum, either kidney or liver not working)
40
Q

Creatinine

  • What is it?
  • Indicates?
A

Is product of metabolism of creatine (found in muscle)

- Is normally filtered by kidneys, so if abnormal indicates dysfx of kidneys

41
Q

PTT =

A

Partial Thromboblastin Time

- reflects speed of clotting

42
Q

Abnormally high Na+? Abnormally low?

A

Hypernatremia

Hyponatremia

43
Q

INR is measure of?

A

PT (Prothrombin Time) - clotting time

44
Q

FOBT =

- Affected by?

A

Fecal Occult Blood Test
1) detect as little as 5ml lost blood/day; affected by exercise, bleeding gums, ingestion of red meat w/in 3 days, fish, turnips + horseradish

45
Q

X-Ray: what do areas of black and white indicate?

A 
White = solid mass
Black = hollow air-filled
46
Q

CAT (CT) Scan =

A

Computed Tomography

  • uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body (2D imagine)
  • Gives more detailed image than x-ray
  • Contrast agents used to highlight tissues, organs, blood vessels
  • *Watch for allergies!
47
Q

Ultrasound

A

An imaging technique that uses high-frequency sound waves to acquire real time images

Useful for viewing abdominal contents, pelvis, muscles, pregnancies, vessels, the heart and other soft tissue structures

48
Q

Angiogram:

A

Allows x-ray visualization of arteries following the injection of contrast medium.

49
Q

MRI

fMRI

A

Uses powerful magnetic field - transmits radio frequencies to computer
Does NOT use ionizing radiation
Provides very detailed picture
fMRI shows functioning of brain

50
Q

ECG vs. echocardiogram?

A

Echocardiogram - uses sound waves to produce image of the heart (structure)
ECG: shows fx of heart

51
Q

What is seen on a routine urinalysis?

A
  • See characteristics & chemical testing:

Leukocytes, nitrites, urobilinogen, protein, pH, blood, specific gracity, Ketone, bilirubin, blucose

52
Q

Microscopic urinalysis?

A

Examination of sediment under microscope (can see bacteria, particles, etc.)

53
Q

RBC normal range?

A

4.5-5.9 x10^12/L

54
Q

Hgb Normal range?

A

136-170 g/L

55
Q

Hct normal range?

A

0.40-0.52

56
Q

Neurtrophil normal range?

A

2-6 x10^9/L

57
Q

Na+ normal range?

A

135-145 mmol/L

58
Q

K+ Normal range?

A

3.5-5.0 mmol/L

59
Q

eGFR normal range?

A

> 60 ml/min

60
Q

Creatinine normal range?

A

60-100 umol/L

61
Q

PTT normal range?

PR-INR?

A 
PTT = 23-32
INR = 0.9-1.1
62
Q

Which lab values for pt on diuretic therapy?

A

Kidney fx: GFR, Creatinine + BUN

& Electrolytes

63
Q

Which lab values for: post-surgical bleed?

A

RBC’s, Hct, Hgb

64
Q

Which diagnostics for: resp infeciton?

A

Sputum (microbiology), WBC, Hbg (to check O2 carrying capacity)

65
Q

5 days nausea, vomiting, diarrhea → which lab values would you assess?

A
  • Stool sample: occult blood, bacteria + parasites

- Electrolytes: sodium, potassium

Nursing 232 (12 decks)

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