NUR-220 Exam 2

Question 1

Adverse effects

Answer 1

Do the benefits of the drug outweigh the AE?

Question 2

If a patient is constipated as a result of opioids and a med is given to help that effect do the benefits outweigh the AE?

Answer 2

yes

Question 3

Mild allergic reaction

Answer 3

Itching

Question 4

Anaphylaxis

Answer 4

Airway is closing and is a medical emergency.

Question 5

Tolerance

Answer 5

When a patient requires more drug to gain benefit patients with sickle cell and cancer are examples

Question 6

Toxic effect of medication

Answer 6

There is to much drug given to patients, causing a toxic effect. it is a nursing failure

Question 7

idiosyncratic reaction

Answer 7

the drug has an opposite fx

Question 8

Therapeutic range

Answer 8

concentration of drug in the blood serum that produces the desired effect without causing toxicity

Question 9

peak level

Answer 9

The point when the drug its at its highest. it is important to draw peak levels 30-60 mins after it is given

Question 10

half-life

Answer 10

is the amount of time it takes for 50% of blood concentration of a drug to be eliminated from the body.

Question 11

failure to recognize

Answer 11

the nurse saw nothing wrong

Question 12

failure to rescue

Answer 12

thought it was wrong did nothing

Question 13

failure to plan

Answer 13

nurse did not prepare

Question 14

QSEN Competencies

Answer 14

“Patient tells everyone quiet im sleeping”

Patient-centered care

teamwork and collaboration

Evidence based practice

quality improvement

informatics

safety

Question 15

QSEN defines safety as?

Answer 15

Minimizing risk of harm to patients and providers through both system effectiveness and individual performance.

Question 16

TJC Patient safety goals for hospitals

Answer 16

Identify patients - name & DOB

Improve staff communications- staff hand offs

Use medication safety- label meds and use medication reconciliation (what was the patient on at home?)

Use alarms safety- alarm fatigue

prevent infection- hand hygiene

patient safety risks

Question 17

Fire Safety

Answer 17

RACE

R- rescue

A- Activate

C- confine

E- Evacuate

Question 18

What is the #1 safety error

Answer 18

It is a medication error is a breakdown or failure at any point in the medication use process.

Question 19

Medication errors

Answer 19

Omission- Drug not prescribed, dispensed, administered, or taken.

Communication- vague instructions

Commission- wrong patient, dose drug, time, or route.

Question 20

Safety errors #2

Answer 20

Falls it is one of the never events

Question 21

who ate the people at risk for falls

Answer 21

People 65 and older, History of falls, cognitive impairment, altered gait, medications, unsafe environments, sensory deficits, orthostatic hypotension, and New environments.

Question 22

how often should we offer assistance to the toilet?

Answer 22

Q2

Question 23

3 in safety errors is?

Answer 23

Improper use of restraints

Question 24

what is the recommended use of restraints

Answer 24

Ensure physical safety of the patient, staff or others

prevent interruption of therapy

prevent the confused or combative patient from removing life support equipment or unsafe attempts at mobility.

Question 25

if all 4 side rails are up what is this considered

Answer 25

Restraint

Question 26

what are some of the hazards of restraints

Answer 26

Impaired circulation, friction and shear, altered nutrition, aspiration/difficulty breathing
incontinence
falling
depression
anxiety
death

Question 27

do restraints add to the risk of falls

Answer 27

yes

Question 28

in nonviolent restraints how often do we check our patients?

Answer 28

Q2 and food Q4

Question 29

in violent restraints how often do we check out patient

Answer 29

Q 15 mins, ROM/Fluid elimination Q2
and Q4 for Food

Question 30

do we chart safety event reports?

Answer 30

no

Question 31

What is nociception

Answer 31

it it basically feeling pain

Question 32

What are the steps to nociception

Answer 32

Transduction
Transmission
Perception
Modulation

Question 33

Transduction

Answer 33

Activation of the pain receptors

Question 34

Transmission

Answer 34

The movement of pain up the spinal cord

Question 35

Perception

Answer 35

Is the awareness of the characteristics of pain.

Question 36

Pain Threshold

Answer 36

lowest intensity of a stimulus that causes you to recognize pain

Question 37

Modulation

Answer 37

Inhibition or modification of pain

Question 38

Non verbal pain indicators

Answer 38

Moaning, crying, grimacing, guarding position, INC VS but not always in chronic pain, social isolation, irritability, changes in eating and sleeping.

Question 39

When should pain be assessed?

Answer 39

at regular intervals, with each new report of pain after each pharmacological and non pharmacological intervention
-assess pain and sedation

Question 40

What are the Pain scales

Answer 40

FLACC
Numerical
PAINAD

Question 41

Somatic Pain

Answer 41

Muscle, tendon, bone: described as aching, deep, dull, gnawing, throbbing, sharp, stabbing.

Question 42

Visceral Pain

Answer 42

Organ Pain: Cramping, squeezing, pressure (referred to distant sites) Examples: gallstones, kidney stones, pancreatitis.

Question 43

Neuropathic Pain

Answer 43

Nerve Pain: Burning, pins and needles, radiation, shooting, tingling, touch-sensitive. Examples: Herpes Zoster, peripheral neuropathy.

Question 44

Cutaneous Pain

Answer 44

Skin Pain: Sharp w/ burning sensation

Question 45

According to the WHO 3-step analgesic ladder, how do we treat increasing pain?

Answer 45

(+/- adjuvant) step 1, (+/- adjuvant +/- Opioid) mild moderate step 2, and (+/- adjuvant +/- Opioid) moderate to severe step 3.

Question 46

Morphine

Answer 46

is considered the gold standard S/E include nausea and vomiting

Question 47

Fentanyl

Answer 47

Transdermal patches take up to 12 hours to reach effectiveness. 8-10 times more powerful than morphine