NU 301 Exam 4 Flashcards
What is intersectionality?
Belonging simultaneously to multiple social groups
What can be some determinants of health disparities?
Race and ethnicity, gender, disability status or special health needs, geographic location.
What is a health disparity?
A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.
Define some social determinants of health
Conditions in which people are born, grow, live, work, and age.
What is cultural competence?
Meaningful and useful strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behaviors of those to whom they render care.
- Health disparities are unequal burdens of disease morbidity and mortality rates experienced by racial and ethnic groups. These disparities are often exacerbated by:
A. Bias
B. Stereotyping
C. Prejudice
D. All of the above.
D. All of the above
What are the goals of a cultural encounter?
Communicate in a way that generates a wide variety of responses.
Interact to validate, refine, or modify existing values, beliefs, and practices about a cultural group.
What is cultural desire?
Having the motivation to engage patients so that you understand them from a cultural perspective
List the LEARN model in order
Listen with sympathy and understanding to the patient’s perception of the problem
Explain your perceptions of the problem
Acknowledge and discuss the differences and similarities
Recommend treatment
Negotiate agreement
What is health literacy?
The degree to which individuals have the capacity to obtain, process, and understand basic health information.
What does a health literacy score of 0 indicate?
Third grade and below education.
Will need repeated oral instructions,
Materials composed primarily off illustrations/audio/video tapes
Will not be able to read most low-literacy
What does a health literacy score of 1-3 indicate?
4th-6th grade
Will need low-literacy materials
May not be able to read prescriptions
What does a health literacy score of 4-6 indicate?
7th to 8th grade
Will struggle with most patient education materials
Will not be offended by low-literacy materials.
What does a health literacy score of 7 indicate?
High school
Will be able to read most patient education materials
What does the teach-back method do?
Confirms patient understands teaching
Changing what can guide our thinking?
Demographics
What is culturally congruent care?
Emphasizes the need to provide care based on an individual’s cultural beliefs, values, and practices
What is implicit bias?
We are aware the bias is present
What is unconscious bias
Bias we are unaware of and that happens outside of our control
What is cultural awareness?
A self-examination of one’s biases toward other cultures and in-depth exploration of one’s own culture and backgroun
What is cultural knowledge
The process in which a health care professional seeks and obtains a sound educational base about culturally diverse groups. They most focus on three specific issues: health-related beliefs and cultural values, care practices, and disease incidence and prevalence.
What is cultural skill?
The ability to conduct a cultural assessment of a patient to collect relevant cultural data about a patient’s presenting problem, as well as accurately conducting a culturally based physical assessment.
What is a cultural encounter
A process that encourages health care professional to directly engage in face-to-face cultural interactions and other types of encounters with patients from culturally diverse backgrounds. Main goal is to generate a wide variety of responses and modify beliefs about a group to prevent stereotyping
What are the 12 domains of culture?
Overview, inhabited localities (country of origin and current residence
- Communication
- Family roles and organization
- Workforce issues
- Bicultural ecology
- High-risk behaviors
- Nutrition
- Pregnancy and childbearing practices
- Death rituals
- Spirituality
- Health care practices
- Health care providers
What is plain language?
Makes any info you provide easy to read, understand, and use. Is still grammatically correct language that uses complete sentence structure and accurate word usage.
How to approach a cultural nursing history and physical assessment
Developing a cultural or physical history depends on your knowledge of a patient and their culture. An example physically would be if a patient you know has asthma, you may want to focus more on the lungs than a patient that comes in for a standard check-up. Culturally, if you have an Asian patient who participates in cupping, then you know that the marking/bruising on their skin are not a sign of abuse.
How do you work with an interpreter?
You must notify the patient verbally and in writing of their rights to receive the language assistance. Interpreters must be competent. Start with first person “I” statements, talking directly to the patient. Have interpreter sit next to or slightly behind the patient. Look at the patient. Avoid using things like jargon, jokes, etc. Ask patient for feedback and clarification. Observe nonverbal and verbal behaviors. Thank both the patient and interpreter at the end.
What are s/s of hyperkalemia?
My Cheese Pizza
-Muscle twitches
Cramps
Paresthesia
High potassium affects the what and what?
Heart and muscle groups
s/s of hypokalemia? (A SIC WALT)
-alkalosis
-shallow respirations
- irritability
- confusion and drowsiness
- weakness and fatigue
- arrhythmias (tachycardia, irregular rhythm, and or bradycardia)
- lethargy
- thready pulse
- lower intestinal motility, nausea, vomiting, and ileus
S/s of hypocalcemia?
numbness to fingers and toes
- hyperactive reflexes
- dysrhythmias
- postive chvostek’s and trousseau’s signs
- s/s of tetany (give foods high in calcium and vitamin D)
- bleeding in gums and mucous membranes
- irritability at IV site
S/s of hypercalcemia?
nausea and vomiting
- constipation
- fatigue
- decreased deep tendon reflexes
- decreased level of consciousness
- cardiac arrest
S/s of hypomagnesemia
Hyperactive deep tendon reflexes
- muscle cramps
- twitching
- dysphagia
- tachycardia (dysrythmias)
- hypertension
S/s of hypermagnesemia
Lethargy
- Hypoactive DTR’s
- Bradycardia
- Hypotension
Magnesium is a?
Smooth muscle relaxer (decreased DTR’s)
What do you collect in a patient’s history?
- Linguistic competence
- Provide language assistance resources
- Inform all of the availability of language assistance
- Ensure competence of those providing language assistance
- Provide print/multimedia materials in local languages
What is plain language/what does it do?
Makes any info you provide easy to read, understand, and use. Is still grammatically correct language that uses complete sentence structure and accurate word usage.
You can check electrolyte values via?
CMP or complete metabolic profile
s/s of infiltration?
pallor, edema, cool to touch, damp dressing, slow IV rate
s/s of phlebitis?
edema, throbbing, redness, red line up arm, slowed rate. Treat by stopping infusion, elevating site, applying warm or cold compress, and restarting in different location
s/s of cellulitis?
pain, warmth, edema, induration, red streaking, chills. Treat by stopping infusion, elevating site, apply warm or cold compress, restart in different location, may need antibiotic
s/s of fluid overload?
distended neck veins, HTN, SOB, crackles, edema. Treat by raising HOB, monitoring vitals, and diuretics
How do you prevent IV complications?
monitor site
use pump
rotate site every 72 hrs
good infection control measures
Monitor I&O
What is peak concentration?
this is the highest serum level of a medication and usually occurs just before the last of the med is absorbed (30-60 minutes after administration).
What is trough concentration?
-the lowest amount of a drug detected in the serum. Occurs just prior to the time in which the medication is to be given again.
What are some general things to know about blood transfusion?
- 2 nurses verify prior to admin
- You always draw blood and check vitals prior
- The patient has a blood band
- You have 30 min to start the transfusion and 4 hours to complete
- A lot of patients report a spike in temp
- 18 gauge is best size angio for blood
- First 15 min is the highest rxn time (usually start at 75 ml/hr)
- Biohazard bag for blood bag; angio goes to garbage
When calculating intake and output, what is the formula we need to focus on?
volume/time
If there is a saline lock instead of a continuous running IV, what would you need to add in your calculations?
The flushes; you would flush before and after applying medications
Minimum urine output expected of a patient?
30-60 ml/hr
Why are daily weights important for I and O?
- indicator of fluid status
- use same conditions
What is I and O?
24 hr I&O: compare I&O
Intake includes all liquids eaten, drunk, or received through IV
Output= urine, vomitus, gastric suction, wound drainage
What factors influence sleep?
-drugs and substances
-lifestyle
-usual sleep patterns
-emotional stress
-environment
-exercise and fatigue
-food and caloric intake
What physical illnesses influence sleep?
Respiratory disease
Heart disease, HTN
Nocturia
Restless Leg Syndrome (RLS)
GI disorders
What are some sleep disorders?
Insomnia
Sleep Apnea
Narcolepsy
Sleep Deprivation
Parasomnias
Name some ways to promote sleep
Environmental controls
Bedtime routines
Safety
Comfort
Activity before bed
Stress reduction
Bedtime snacks
Pharmacological approaches
What are some components to assessing pain?
Patient’s expression (pain is individualistic)
- Physical exam
- Characteristics of pain (timing, location, severity)
What are the different types of pain scales?
-Visual Analogue Scale (VAS)
-Numeric Rating Scale (NRS)
-Simple descriptor scale
-Wong-Baker Faces Pain Rating Scale
