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Nsg 200 > NSG 200 test #1 > Flashcards

NSG 200 test #1 Flashcards

1
Q

why is health promotion important

A

Improves the health status of individuals, families, communities, states, and the nation.
Enhances the quality of life for all people.
Reduces premature deaths.
Reduces costs

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2
Q

the nurses role in health promotion

A

Get the patient involved
Educate/Teaching
Strategies to improving health:
Improve nutrition
Exercise
Manage stress
Understanding disease process
Identify Unhealthy habits
Smoking, excessive ETOH use, other drugs use

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3
Q

health promotion in pregnancies

A

Taking prenatal vitamins/folic acid
Talking to your healthcare provider about current medications
Avoiding alcohol and other drugs
Healthy diet
Exercise
Limiting caffeine

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4
Q

health promotion in infancy

A

Bonding
Breast feeding
Sleep patterns
Playful/stimulating activity (developmental stages)
IMMUNIZATIONS
Safety

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5
Q

health promotion in children and adolescents

A

Nutrition
Dental Checkups
Exercise
Immunizations
Safety
Peer influences
Body Image
Sexuality
Safety promotion and accidental prevention

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6
Q

health promotion in the elderly

A

Nutrition
Dental Checkups
Exercise
Immunizations
Safety
Safety promotion and accidental prevention
falls
restful sleep

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7
Q

modifiable risk factors

A

smoking, diabetes, high bp, nutrition, exercise, high cholesterol

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8
Q

nonmodifiable risk factors

A

ethnicity, age, gender, family history

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9
Q

primary prevention

A

when you are preventing disease, condition, or injury

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10
Q

secondary prevention

A

early detection of a potential of a disease before it begins

measuring blood pressure, newborn screening, mammography

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11
Q

tertiary prevention

A

treating a disease already present, to defeat its affects and progress

physical therapy, stroke rehab, diabetic treatment, chemo therapy

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12
Q

healthy people 2020 determinants

A

health services, biology and genetics, individual environment, social environment, physical environment

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13
Q

risks of smoking in pregnancy

A

Risks of Smoking
Birth defects
Premature birth
SIDS
Respiratory issues (both mother and baby)
Infertility issues
Bleeding

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14
Q

bad diet and pregnancy

A

Lack key nutrients (both overweight and underweight)
Low birth weight
Obesity (mother & baby)
Diabetes ( mother & baby)
Cardiac disease
Hypertension
Constipation

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15
Q

what vitamins should pregnant women be encouraged to take?

A

Folic acid and prenatels

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16
Q

risks of children and adolescents smoking

A

More addictive
Affect brain development
Lung impairment-asthma
Decreased physical fitness
Mental health issues
Peer pressure

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17
Q

poor diet and exercise in children and adolescents

A

Underweight/overweight
Dental problems
Constipation
Type 2 diabetes

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18
Q

older adults risks of smoking

A

Cancer
Diabetes
Cardiovascular disease
Lung disease

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19
Q

poor diet and exercise in the elderly

A

Type 2 diabetes
Heart disease
High cholesterol
Osteoporosis
Cancer
Falls

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20
Q

common side effects of vaccines

A

Mild swelling & tenderness at the site (can apply a warm or cool compress)
Low grade fever
Mild fatigue
Decreased appetite
Mild headache
Muscle or joint aches
Irritability in children

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21
Q

active natural immunity

A

immunity occurs after getting sick or an infection

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22
Q

artificial active immunity

A

immunity from a vaccine

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23
Q

natural passive immunity

A

Immunity passed on the child from the mother and breastmilk

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24
Q

explain the contraindications of live vaccines

A

it is compromised in the immunocompromised such as pregnant women, chemo patients, or radiation.

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25
Q

live vaccines

A

MMR, VAR, HZV, live attenuated flu vaccine

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26
Q

contraindications in the live influenza vaccine

A

egg allergy or guillian barre syndrome

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27
Q

gelatin or neomycin allergy

A

MMR, VRE, HZV

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28
Q

phases of the nursing process

A

Assessment
Diagnosis
Planning
Implementation
Evaluation

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29
Q

collecting subjective data

A

A complete health History
Biographical data
Reasons why they are seeking medical attention
Present health concern
Personal Health History
Family Health History
Review of systems for current health problem (subjective data)
Lifestyle and health practices
description of pain

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30
Q

collecting objective data

A

HR, pulse, respirations, pulse ox, appearance, dress, hygiene, behavior, mood, physical charecteristics, skin color, posture

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31
Q

the 4 assessment techniques

A

inspection, palpation, percussion, auscultation.

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32
Q

health history

A

biographical data
reasons for seeking health care
history of present health concern
past health history
family health history
review of systems
lifestyle and health practices
developmental health

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33
Q

COLDSPA

A

Character, Onset, Locations, Duration, Pattern, Associated factors

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34
Q

types of assessment

A

initial comprehensive assessment, ongoing or partial assessment, focused problem oriented, emergency assessment

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35
Q

initial comprehensive assessment

A

Collection of data about the client’s perception of health of all body parts or systems, past medical history, family history, and lifestyle and health practices.

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36
Q

ongoing partial assessment

A

Utilized when focusing on a certain complaint identified in a comprehensive assessment, after the comprehensive data has been established

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37
Q

focused/problem oriented assessment

A

Thorough assessment of a particular client problem, which does not cover areas not related to the problem

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38
Q

emergency assessment

A

Very rapid assessment performed in life-threatening situations.

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39
Q

client approach and preparation

A

Establish nurse–client relationship.
Explain the procedure and the physical assessment that will follow, describing the steps of the examination.
Respect client’s requests and desires.
Explain the importance of the examination.
Leave room while client changes clothes.
Provide necessary container in case of need for sample.
Begin exam with less intrusive procedures.
Explain procedure being performed.
Explain to client why position changes are necessary.

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40
Q

pre-introductory phase

A

In the preintroductory phase the nurse reviews the medical record which may reveal the client’s past health history and reason for seeking health care before meeting with the client to assist with conducting the interview.

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41
Q

phases of the interview

A

pre-intorductory
introductory
working
closing

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42
Q

normal blood sugar

A

70-110

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43
Q

introductory phase

A

Introduction of yourself
Explaining the purpose of the interview
Discussing the types of questions that will be asked
Explaining the reason for taking notes
Assuring the client that confidential information will remain confidential
Making sure that the client is comfortable and has privacy
Developing trust and rapport using verbal and nonverbal skills

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44
Q

working phase

A

Collaborating with the client to identify the client’s problems and goals
Listening, observing cues, and using critical thinking skills to interpret and validate information received from the client
Lifestyle and health practices and developmental level
Review of body systems for current health problems
Family history
Past health history
biographical data
History of present health concern
reason for seeking healthcare

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45
Q

vaccine recommendations for pregnant women

A

Tdap 27-36 weeks, flu vaccines, covid vaccines

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46
Q

nonverbal communication

A

Nonverbal Communication
Appearance
Demeanor
Facial Expressions
Attitude
Silence
Listening

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47
Q

verbal communication

A

Verbal Communication
Open-ended questions
Closed-ended questions
Laundry List
Rephrasing
Well-placed phrases
Interfering
Providing Information

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48
Q

documentation

A

Outlines the client’s course of care
Makes accessing this information more easy- for healthcare works, patients and families.
Helps determine eligibility for health reimbursements
Offers a basis for determining the educational needs of the client, family and SO’s
Permanent legal record

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49
Q

what vaccine do 12-15 year olds need

A

Human paploma virus

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50
Q

SBAR

A

S SITUATION: A concise statement of the problem or what is going on now. “Kelly is a 24 year old female who is experiencing sudden onset of headache.”
B Background: Describe events leading up to the situation. “Patient woke up in the middle of the night at 3:00am with the headache. No other complaints prior to that.”
A Assessment: State the subjective and objective data you have collected. “Patient rates pain a 7 on 1-10 scale. Has vomited 3-4 times and continues with nausea. Unable to eat or drink anything. She is lying face down holding her head. She is awake, alert and oriented but does not want to communicate.” Continue on with assessment findings…..
R Recommendation: Suggest what you believe needs to be done for the patient based on your assessment. “Have the physician come see the patient to re-evaluate? Transfer the patient to ICU? Recheck potassium level in 2 hours?” Be specific about patient needs.

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51
Q

ages over 65nshould recieve what vaccines

A

Covid, flu, pneumonia, shingles

52
Q

examination techniques for ABDOMINAL

A

inspection, auscultation, palpation, percussion

53
Q

what do you need in order to do a good assessment

A

Room at comfortable
temperature Good lighting
Look and observe
before touching
Completely expose
part being examined
while draping the rest
of client as appropriate
Note characteristics Compare appearance

54
Q

always proceed from —— to ———- palpation

A

light - deep

55
Q

light palpation

A

Light palpation – less then 1cm depression in a circular
motion. Very light touch to assess for tenderness,
warmth, moisture, etc.

56
Q

moderate palpation

A

1-2cm depth

57
Q

deep palpation

A

Deep palpation – depress 2.5 or more cm to feel deep
organs

58
Q

bimanuel palpation

A

Bimanual palpation – utilizing both hands to compress a
body organ
◦ ONE CM IS EQUAL TO THE DIAMETER OF ONE AAA
BATTERY!

59
Q

Palpation consists of using parts of the hand
to touch and feel for the following
characteristics

A

• Texture (rough/smooth)
• Temperature (warm/cold)
• Moisture (dry/wet)
• Mobility (fixed/movable/still/vibrating)
• Consistency (soft/hard/fluid filled)
• Strength of pulses
(strong/weak/thready/bounding)
• Size (small/medium/large)
• Shape (well defined/irregular)
• Degree of tenderness

60
Q

percussion purposes

A

Utilizing tapping to:
Elicit pain
Determining location, size, and shape
Determining density
Detecting abnormal masses
Eliciting reflexes
Used in advanced health assessment – we will discuss
further later on.

61
Q

auscultation purposes

A

Auscultation is using a stethoscope to elicit sounds such as breath
sounds, heart sounds or bowel sounds.
•Eliminate distracting noise.
•Expose the body part being auscultated.
We will review use of stethoscope with Assessment Techniques!
•Diaphragm, high-pitched sounds (heart/breath/bowel) ;
•Bell, low-pitched sounds (abnormal heart sounds / bruits). Most
likely you will use the diaphragm – it is the larger part of the
stethoscope.
•Place earpieces into outer ear canal angled towards your nose.
•Warm the stethoscope with your hand prior to placing on the
patient.
•NEVER LISTEN THROUGH CLOTHING!

62
Q

vital signs

A

• Temperature (T)
• Pulse (P)
• Respiratory rate (R or RR)
• Blood pressure (BP)
• Oxygen saturation (O2 sat)
• Pain

63
Q

frequency of assessment

A

• Admission
• Per policy or orders
• Change in condition
• When medications are given that affect cardiac rate and rhythm
• Pre- and post-op surgery (or invasive procedure)
• In emergency situations

64
Q

normal adult vital signs

A

T: 36.1-37.2 C or 97-99 F (98.6F “afebrile”)
T: 100.4 or greater = fever
P: 60-100 bpm (beats per minute)
RR: 12-20 bpm (breaths per minute)
BP: 120/80 mm Hg
O2 sats: 95-100%

65
Q

reasons for hyperthermia

A

 Temperature (Hyperthermia)
• Infection
• Heat exhaustion
• Sunburn
• Inflammatory conditions
• Immunizations
• Illicit drugs
• Autoimmune conditions
• Teething
ovulation
exercise

66
Q

hypothermia

A

 Temperature (Hypothermia)
• Inadequate clothing
• Exposure to cold
• Wet clothing
• Aging

67
Q

children and adolescents need what vitamin and mineral

A

calcium and vitamin D, dairy

68
Q

treat overheating

A

Increased temperature
• Cool, damp cloth
• Fan, open windows
• Remove clothing/blankets
• Cool bath/shower
• Ice packs
• Administer antipyretics

69
Q

treat decrease in temp

A

Decreased temperature
• Apply clothing/blankets
• Activity
• Warm bath/shower
• Change damp clothing
• Warming device

70
Q

oral temperature

A

place in posterior sublingual pocket, hold in place,

71
Q

tympanic temp

A

hold in the ear, pull the pinna up and back,

72
Q

temporal

A

scan across forehead

73
Q

rectal

A

most accurate, used in red only, do not use if patient has diarrhea, colon surgery, heart surgery, heart attack.

74
Q

difference between temps

A

Tympanic: 0.5-1°F HIGHER than ORAL route
• Normal: 98.0 F-100.9° F (36.7-38.3° C)
Rectal: 0.5-1°F HIGHER than ORAL route
• Normal: 97.4-100.3° F ( 36.3-37.9° C)
Axillary: 0.5-1°F LOWER than ORAL route
• Normal: 95.6-98.5° F (35.4-.7.0° C)
Temporal: 0.5-1° F Lower than ORAL route
• Normal: 97.4-100.3° F (36.3-37.9° C)

75
Q

body temp is the lowest between

A

4-6am

76
Q

body temp is highest between

A

in the evening

77
Q

location of pulses

A

• Temporal
• Carotid
• Brachial
• Radial
• Femoral
• Popliteal
• Posterior tibial
• Dorsalis pedis

78
Q

brachial pulse site

A

used for babies and small children

79
Q

radial pulse

A

older pediatrics and adults

80
Q

apical pulse

A

very accurate, always count for one full minute, best site for newborns, check with an irregular pulse

81
Q

a 12 year old girl is in your office, what kind of vaccinations would you talk to her about

A

Human paplomma virus

82
Q

carotid pulse

A

only used in emergencies

83
Q

detecting pulse

A

• Once you find the pulse, count for 30 seconds and
multiply x 2. This will be your pulse rate per minute. If
the rhythm is irregular, count for a full minute then
verify by assessing the apical pulse.

84
Q

tachycardia

A

Tachycardia = >100bpm, may occur with fever and certain medications

85
Q

bradycardia

A

Bradycardia = <60bpm, heart block or dropped rates, may need to auscultate

86
Q

stages of hypertension

A

• Normal = 120/80
• Elevated = 120-129/greater than 80mmHg
• Stage I hypertension = 130-139/80-89mmHg
• Stage ii = 140/90
Hypertensive = 180/120mmHg

87
Q

what is pulse pressure

A

• Pulse pressure = systolic minus diastolic
Higher than 50mmHg may indicate cardiovascular disease

88
Q

when measuring pulse you should assess

A

• Several characteristics should be assessed when measuring radial pulse :
• Pulse rate, rhythm, amplitude, contour, and elasticity
Amplitude is measured as: weak +1, normal +2, bounding +3, 0=no pulse.

89
Q

tachycardia

A

Tachycardia
• 100-180 BPM

90
Q

bradycardia

A

• Bradycardia
• Pulse rate below 60 BPM

91
Q

tachypnea

A

respiration greater than 20

92
Q

bradypnea

A

less than 12 breaths

93
Q

apnea

A

less than 10 breaths per minute

94
Q

apical pulse site

A

Infants & children <2years
old:
4th intercostal space
midclavicular line
Adults: 5th intercostal space
midclavicular line

95
Q

Lub-Dub

A

“Lub”….
• Closure of the atrial and ventricular heart valves
“Dub”……
• Closure of the pulmonic and aortic valves

96
Q

heart murmur?

A

Heart Murmur…..
• Defective valves causing hissing sounds when blood squirts blood back through the valves

97
Q

diffusion

A

• Diffusion• Exchange of oxygen and carbon dioxide
between the alveoli of lungs and circulating
blood

98
Q

perfusion

A

• Perfusion•
Exchange of oxygen and carbon dioxide
between circulating blood and tissue cells

99
Q

assess for respirations

A

Observe chest rise and fall to count respirations. (look at chest or lower neck area)
Count for 30 seconds and multiply x 2.
Count respirations while you still have your fingers on pulse assessment. This way the patient is unaware you are
assessing breathing. Respirations have autonomic and voluntary control.
Assess for equal rise and fall of the chest. Both sides should rise and fall symmetrically.
Assess for depth of breathing. (shallow,deep)
Document respirations over one minute. Ex: 16 breath per minute

100
Q

eupnea

A

Eupnea: normal, unlabored respiration

101
Q

orthopnea

A

difficulty breathing while laying down

102
Q

dyspnea

A

difficulty or labored breathing

103
Q

factors affecting blood pressure

A

• Age, gender, race – African Americans @ highest
risk for hypertension
• Food intake : high sodium intake related to high
blood pressure (hypertension)
• Exercise
• Weight
• Emotional state
• Body position
• Drugs/medications

104
Q

systolic bp

A

• Age, gender, race – African Americans @ highest
risk for hypertension
• Food intake : high sodium intake related to high
blood pressure (hypertension)
• Exercise
• Weight
• Emotional state
• Body position
• Drugs/medications

105
Q

diastolic bp

A

A measurement of the pressure of
the blood in the arteries when the
ventricles are relaxed

106
Q

hypotension bp

A

<90/60
• Orthostatic hypotension
• Symptomatic vs asymptomatic
• What is the biggest safety risk???

107
Q

hypertension is

A

the silent killer

108
Q

hypotension

A

• Blood loss
• Dehydration
• Infection
• Pregnancy
• Medications
• Sometimes asymptomatic

109
Q

getting a good bp

A

• Rest
• Proper position
• Proper cuff size and position
• Estimate systolic pressure
• Pump up cuff to 20-30 mm Hg
above estimate
• Release pressure slowly 2 mm
Hg/second
• First sound=systolic number
• Last sound=diastolic
• Release cuff pressure

110
Q

do not take a blood pressure on a

A

• Difference between arms
• Avoid
• Stroke side
• Mastectomy
• IV/PICC
• AV fistula
• Hx of DVT in arm
• Open wounds/drainage

111
Q

orthostatic hypotension

A

Orthostatic hypotension is low blood pressure when standing.
Orthostatic vital signs may be ordered if the patient presents with syncope (fainting) or dizziness.
These patients are at high risk of falls!
1. Lay patient flat for 2-3 minutes then take BP and Pulse.
2. Move the patient to the sitting position and repeat BP / Pulse after 1 minute. Document patient
complaint of dizziness.
3. Move the patient to the standing position and repeat BP / Pulse after 1 minute. Be aware of the patient
becoming dizzy and falling! Stop test if patient feels like they are going to pass out.
Decrease in Systolic BP of 20 mmHg and increase in pulse by 20 bpm is a POSITIVE finding.

112
Q

the fifth vital sign

A

pain!
Observe posture, facial expression
and general impression. Does the
patient look like they are in pain?
Ask the patient to rate their pain on a
0-10 scale. 0 is no pain, 10 is the worst
pain of their life.
Use COLDSPA

113
Q

measuring infants

A

Length (Lying)
 Use Birth – 24 months
WHO growth chart
 Unable to stand
without assistance

114
Q

measuring infants

A

 Able to stand without
assistance
 Use 2 – 20 years
CDC growth chart

115
Q

infants weights should double and triple when?

A

Infants should
double their birth weight @ 6 months weight @ 6 months
and and triple their birth
weight @ 1 year

116
Q

average infant head cm

A

35cm at birth, HC increases 1cm per month for the first year, 2cm per first 3 months.

117
Q

microcephaly

A

smaller head

118
Q

macrocephaly

A

larger head

119
Q

newborn P and R

A

p: 120-140
r: 30-60

120
Q

infant p and r

A

p: 100-160
r: 25-35

121
Q

toddler p and r

A

p: 100-160

122
Q

toddler resp.

A

20-30

123
Q

preschooler p and r

A

p: 80-120
r:20-25

124
Q

school age p and r

A

70-110

r 18-22

125
Q

adolescent p and r

A

p: 60-90
r:16-20

126
Q

APGAR

A

appearance, pulse, grimace, activity, respiration

score 0-3 = low
score 4-6 = below normal
score 7+ = normal

127
Q

FLACC SCALE pain

A

face, legs, activity, cry, consolability

Nsg 200 (9 decks)

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