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N112 > N112 Quiz 1: chapter 8 > Flashcards

N112 Quiz 1: chapter 8 Flashcards

1
Q

Define Patient Centered Care

A

identifies, respects, and addresses patients’ differences, values, preferences, and expressed needs.

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2
Q

What are the 3 relationships included in Relationship Based Care?

A
  1. Patient/Family
    2 Self
  2. Team
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3
Q

What is the World Health Organizations main agenda?

A 
leadership on global health matters
health research agenda
norms and standards
evidence-based policy options
technical support to countries
health trends
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4
Q

What are the 8 categories included in Healthy Populations by the CDC?

A

Diseases & Conditions - Birth Defects, Cancer, Flu, HIV/AIDS
Emergency Preparedness & Response - Bioterroism, Chem/Rad Emergencies, Severe Weather
Environmental Health - Air Pollution, Carbon Monoxide, Lead, Mold, Water Quality, Climate Change
Life Stages & Populations - Infant & Child, Men, Minorities, Pregnancy
Healthy Living - Food Safety, Bone Health, Physical Activity, Immunizations, Genetics, Smoking Prevention
Injury, Violence & Safety - Brain Injury, Child Abuse, Falls, Violence
Travelers’ Health - Destinations, Outbreaks, Travel Vaccinations
Workplace Safety & Health - Asbestos, Chemical Safety, Construction

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5
Q

What are the leading health indicators of healthy populations 2010/2020?

A 
Physical Activity 
Overweight and Obesity 
Tobacco Use 
Substance Abuse 
Responsible Sexual Behavior 
Mental Health 
Injury and Violence 
Environmental Quality 
Immunization 
Access to Health Care
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6
Q

What are the overarching goals of healthy populations 2010/2020?

A

Increase quality and years of healthy life


Eliminate health disparities

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7
Q

Define health “screening”

A

preventative health on a group of people

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8
Q

Name the 3 types of screening and provide examples of each.

A

Individual Screening – at risk, breast cancer
Screening by Law – PKU, lead screening
Mass Screening – BP

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9
Q

What are the advantages to health screening?

A

People are more informed

Early detection,

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10
Q

What are disadvantages of health screening?

A

Costly Ex. cystic fibrosis: people live longer
Possible discrimination based on results
accessibility
Insurance won’t cover it, uninsured go to ER.
False positives and negatives. False negatives cause anxiety so patients don’t f/u.

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11
Q

What are the 3 types of prevention? Describe each type.

A 
Primary Prevention (Protection): Environmental sanitation and Immunizations, wearing a seat belt
Secondary Prevention (Early Diagnosis & Prompt Treatment): Cure & prevent disease process, Prevent complications
Tertiary Prevention (Restoration & Rehabilitation): Rehabilitation to attain optimal level of functioning
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12
Q

Where does Health Assessment begin?

A

at the point of initial contact

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13
Q

What are two types of assessment? Define each.

A

Subjective: what the patient tells you.
Objective: what you observe. includes lab results.

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14
Q

What are the 6 steps of the nursing process?

A

ADOPIE

  1. Assessment
  2. Diagnosis (not medical diagnosis, IS nursing diagnosis)
  3. Outcome Identification
  4. Planning
  5. Implementation
  6. Evaluation
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15
Q

What is the 1st Priority when assessing patient status?

A

ABC
Airway
Breathing
Cardiac/Circulation

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16
Q

What is the 2nd Priority when assessing patient status?

A 
Mental status change
acute pain
acute urinary elimination problems
Untreated med probs
Abnormal lab values
risks of infection 
safety or security
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17
Q

What is the 3rd Priority when assessing patient status?

A

Activity/Rest (Ex. insulin instructions)

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18
Q

What are the four nursing assessment techniques we use in the clinical setting?

A 
sight, smell, touch, hear
Inspection
Palpation
Percussion
Auscultation
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19
Q

When does inspection begin and what does it require?

A

BEGINS AT MOMENT OF CONTACT: concentrated watching of individual as whole and then of each specific body system, just looking!
Requires: good lighting, adequate exposure (ie disrobe for abd assessm), right instruments (ie otoscope, penlight etc).

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20
Q

What is palpation?

A

applies sense of touch to assess factors of:

texture, temp, moisture, organ size and location, swelling (edema), crepitus, lumps/masses, pain or tenderness.

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21
Q

What part of your hand would you use to palpate for texture, swelling, pulsatin or lumps?

A

Fingertips are best for fine tactile needs.

22
Q

What part of your hand would you use to detect position, shape of organ or mass consistency?

A

Grasping of fingers/thumb

23
Q

What part of your hand would you use to detect temperature?

A

back of hand ( thinnest part of skin)

24
Q

What part of your hand would you use to feel vibrations?

A

base of fingers, ulnar surface of hand

25
Q

What is percussion and why perform?

A

Tapping a persons skin with short, sharp strokes to assess underlying structure in a systemic way; tap right below nail bed of other hand

26
Q

Name 4 characteristics of percussion. What body structure would heard with each type?

A

Resonant (hollow)- medium loud, low pitch lungs
Hyperresonant louder and lower than resonant (abnormal: found in lungs with emphysema)
Tympany-loud, high pitched air sound (stomach, intestines)
Dull-thud: soft, high pitched: Relatively dense organ like liver or spleen
flat-thud (muscles) Very soft, high pitched: When no air is present, over thigh muscles, bone, or over tumor

27
Q

Will a dense structure produce deep and long sounds or soft, high and short sounds?

A

a denser, more solid structure (e.g., the liver) gives a softer, higher, shorter sound because it does not vibrate as easilty as one with more air.
a structure with relatively more air (e.g., the lungs) produces a louder, deeper, and longer sound because it vibrates freely.

28
Q

What does auscultation mean and how is it performed?

A

listening w/ a stethoscope.

29
Q

Do stethoscopes magnify sound?

A

Stethoscopes do not magnify sound. They block out external sounds.

30
Q

When should the bell side of a stethoscope be used? Diaphragm?

A

Diaphragm: for high pitched sounds (breath, bowel, normal heart sounds).
Bell: use for soft, low pitch sounds ie murmurs (heart), or Bruit.

31
Q

What is a Bruit?

A

Unusual sound that blood makes when it rushes past an obstruction (called turbulent flow) in an artery when the sound is auscultated with the bell portion of a stethoscope.

32
Q

What patient characteristics can influence data collection during a subjective or objective assessment?

A 
Developmental stage Ex. teenager grunting
Culture: respect cultural beliefs
Beliefs
Alternative Healing Practices
Pain
33
Q

What is the acronym used for “problem oriented notes”

A 
SOAP-IE (how we chart)
Subjective
Objective (what we observe/measure)
Assessment
Plan (goal)  
Intervention (how we implement plan) 
Evaluation (did plan work?)
34
Q

Define Amplitude

A

or intensity, a loud or soft sound. Loudness depends on the force of the blow and the structure’s ability to vibrate.

35
Q

Define Pitch

A

or frequency, the number of vibrations per second. More rapid vibrations produce a high-pitched tone; slower vibrations yield a low-pitched tone.

36
Q

Define Quality

A

(timbre), a subjective difference due to a sound’s distinctive overtones. Variations within a sound wave produce overtones. Overtones allow you to distinguish a C on a piano from a C on a violin.

37
Q

Define Duration

A

the length of time the note lingers.

38
Q

What is a nosocomial infection?

A

an infection acquired during hospitalization

39
Q

What key aspects included in Erickson’s stages of development should be considered for the infant, toddler, preschool child, school age, adolescent and aging adult?

A 
Infant: Establishing Trust
Toddler: autonomy
Preschool: initiative
School Age: industry
Adolescent: Self-identity
Aging Adult: developing the meaning of life and one's own existence and adjusting to changes in physical strength and health.
40
Q

To examine a toddler, the nurse should:
A. allow the child to sit on the parent’s lap.
B. remove the child’s clothing at the beginning of the examination.
C. ask the child to decide whether parents or siblings should be present.
D. perform the assessment from head to toes.

A

A. allow the child to sit on the parent’s lap.

41
Q 
Deep palpation is used to:
A.	identify abdominal contents.
B.	evaluate surface characteristics.
C.	elicit deep tendon reflexes.
D.	determine the density of a structure.
A

A. identify abdominal contents.

42
Q

Amplitude is:
A. the intensity (soft or loud) of sound.
B. the length of time the note lingers.
C. the number of vibrations per second.
D. the subjective difference in a sound’s distinctive overtones.

A

A. the intensity (soft or loud) of sound.

43
Q 
The dorsa of the hands are used to determine:
A.	vibration.
B.	temperature.
C.	an organ's position.
D.	fine tactile discrimination.
A

B. temperature.

44
Q 
Fine tactile discrimination is best achieved with the:
A.	opposition of the fingers and thumb.
B.	fingertips.
C.	back of the hands and fingers.
D.	base of the fingers.
A

B. fingertips.

45
Q 
A funduscopic examination is an examination of the:
A.	inner ear.
B.	pharynx.
C.	internal structures of the eye.
D.	nasal turbinates.
A

C. internal structures of the eye.

46
Q

Which of the following is considered when preparing to examine an older adult?
A. Base the pace of the examination on the patient’s needs and abilities.
B. Avoid physical touch to offset making the older adult uncomfortable.
C. Be aware that loss will result in poor coping mechanisms.
D. Confusion is a normal, expected finding in an older adult.

A

A. Base the pace of the examination on the patient’s needs and abilities.

47
Q

When performing percussion, the examiner:
A. strikes the flank area with the palm of the hand.
B. strikes the stationary finger at the distal interphalangeal joint.
C. strikes the stationary finger at the proximal interphalangeal joint.
D. taps fingertips over bony processes.

A

B. strikes the stationary finger at the distal interphalangeal joint.

48
Q

At the end of the examination, the examiner should:
A. complete documentation before leaving the examination room.
B. have findings confirmed by another provider.
C. compare objective and subjective data for discrepancies.
D. review the findings with the patient.

A

D. review the findings with the patient.

49
Q

When should the examiner use hand washing instead of an alcohol-based hand rub?
A. if the patient has an infection with Mycobacterium tuberculosis
B. if the patient has an infection with Clostridium difficile
C. if the patient has an infection with hepatitis B virus
D. if the patient is HIV positive

A

B. if the patient has an infection with Clostridium difficile

50
Q

Name subjective health history questions for the skin.

A 
Previous history of skin disease 
Change in mole
Change in pigmentation (size or color)
Excessive dryness or moisture
Pruritus
Excessive bruising
Rash or lesion
Medications
Hair loss
Change in nails
Environmental or occupational hazards
Self-care behaviors

N112 (6 decks)

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