NURS 255 Exam 6 Flashcards
What are 4 interventions to help young-old adults?
- Regular aerobic physical activity
- Muscle- strengthening activities
- Balance promoting activities
- Adapted physical activity
What are 4 interventions to help Middle-Old adults?
- Health crisis may lead to decreased functional ability
- Encouragement
- Support
- Planned programs of activity
What are 3 Interventions that can be done with Oldest-old adults?
- Supportive environment
- Modified adapted activity
- Nutrition
What are 4 Health problems Young-Old adults face?
- Lack of supplemental insurance for health screening or physical exams not covered by medicare
- Perception of self as “getting old”
- Changes in physical activity
- Being in a deconditioned state as a result of not participating in exercise before retirement.
What are Middle-old adults most prone to in terms of health problems and what program can help older adults through this?
- Middle-old adults are prone to a sedentary lifestyle and spend only 3% of their time doing sports or other physical activity
- One program that can help this is APA which helps older adults stay active in settings like retirement homes.
What are the 4 Health problems Oldest-Old adults face?
- Sensory loss such as vision and hearing
- Oral health (losing teeth 31% have no teeth)
- Inadequate nutrition intake
- Functional limitations (ability to perform tasks)
What are the 4 MAIN Health problems ALL older adults face?
- Physical declines (in the body systems)
- Cognitive declines (reflexes, memory)
- Psychosocial decline (inability to have smooth conversations)
- Chronic diseases (osteoporosis, dementia, polypharmacy, depression, elder abuse, ageism)
What 5 things should be included in an assessment of a Young-Old Adult?
- Daily routines
- Level of Fitness
- Chronic conditions
- Barriers to exercise
- Client self confidence.
What 5 things should be included in an assessment of a Middle-Old Adult?
- Functional abilities (ADL’S)
- Support-systems
- Social Networks
- Mental health
- Spiral vulnerability
What 5 Things should be included in an assessment of an Oldest-old adult?
- Physical condition
- Psychosocial condition
- Cognitive abilities
- Social engagement
- Living conditions
What are the 3 Factors contributing to the expanding role of nurse teaching?
- Patients participate in healthcare decisions (discussing options with them allows them to be more informed)
- Hospital stays are brief (so education must be quick)
- Healthcare is expensive (So teaching can help reduce this cost)
What are the 6 benefits of patient learning?
- Empowers patient to make choices over their care
- Improves patient adherence
- Reduces health complications
- Promotes safety with medication usage
- improves patient satisfaction
- increases (nursing) satisfaction
What are the 3 Theorys of learning (Psychology theories)
- Behavioural learning theory (rewards for learning)
- Cognitive theory (learning is learning with acknowledgment of developmental level)
- Humanism (Learning is thought to be self motivated Intrinsic)
What is Blooms cognitive domain of learning and 5 examples of it?
- Cognitive (thinking): memorization, recall, comprehension.
- Reports names and doses of medications
- Explains expected effects of medications
- Designs plans or schedules for health
- Describes difference between processes
- Recognizes need for behavioural changes
What is Blooms Psychomotor domain of learning and 6 examples of it?
- Psychomotor (skills): includes sensory awareness, imitation and performance of skills
- Identifies need to read directions
- Brings equipment to teaching session
- Follows the instructor
- Performs skill after learning it
- Independently performs skills
- Creates a new approach to giving injections
What is Blooms Affective domain of learning and what are 4 examples of it?
- Affective (feelings): receiving and responding to new ideas and demonstrating commitment to them
- Making eye contact as things are explained to them
- Asks questions about what to expect
- Commits to staying with someone
- Overcoming drug addiction presents story to others
What are the 12 factors that affect learning?
- Motivation
- Readiness
- Timing
- Active Involvement
- Feedback
- Repetition
- Learning Environment
- Scheduling of the session
- Amount and complexity of content
- Communication
- Special populations
- Developmental stage of patient
What are 7 Barriers Nurse teachers can face?
- Competing demands
- Conflicting schedules
- Ineffective coordination
- Lack of space and privacy
- Teaching not seen as a priority
- No third party reimbursement
- Frustration with documentation
What are 13 Learning barriers for patients?
- Illness, fatigue, other physical conditions
- Anxiety, personal stress
- Low literacy
- Environment not conducive to learn
- lack of time to learn
- Overwhelming amount of behavioural change
- Overwhelming complexity
- Lack of support and positive reinforcement
- Lack of motivation
- Language barrier
- Teaching not for learning style
- Provider use of jargon
- Doesn’t see need for information
What are things we should do to perform culturally accepting teaching?
- Assess whether the family is past present or future oriented
- Do they prefer same sex nurses
- Admit unfamiliarity with clients culture
- Speak slowly and clearly
- Use short sentences
- Use pictures and visual aids
- Provide teaching materials
- Avoid joking with patient
- Obtain feedback do not just accept a nod
- Encourage question asking
What 9 Things should be assessed for in a learning assessment?
- Learning needs (special accommodation’s)
- Client’s knowledge level
- Health benefits and practices
- Physical readiness
- Emotional readiness
- Ability to learn
- Literacy level
- Neurosensory factors
- Learning styles
What are 4 ways to perform evaluations after Patient teaching?
- Oral questions
- Direct observations of client performance (Watch the person perform the teaching)
- Client’s report and client records (looking at client records for improvements)
- Test and written exercises
What are the 8 reasons we DOCUMENT?
- Communication
- Continuity of care
- Quality improvement
- Planning and evaluation of client outcomes
- Legal record
- Professional standards
- Reimbursement and utilization review
- Education and research
4 Advantages and 5 Disadvantages of Written Health records
Advantages
- Little learning curve
- No large networks to function
- No downtime for system updates
- It is inexpensive
Disadvantages
- Access is delayed
- Time consuming
- Risk for error
- Confidentiality isn’t great
5 Advantages and 4 Disadvantages of Electronic health records?
Advantages
- Enhanced communication and speed
- Improved access to information
- Time savings
- Improved quality of care
- Information is safe and private
Disadvantages
- Expensive
- Downtime
- Big learning curve
- Lack of integration between departments
PIE Charting (What is it and what are its 3 components and its main disadvantage?)
- Problem: Use data from assessment to identify appropriate problem.
- Intervention: Document the nursing actions you take for each nursing diagnosis.
- Evaluation: Document the clients response to interventions and treatments.
(THE MAIN ISSUE WITH THIS TYPE IS THE LACK OF PLANNING PORTION IN THE NURSING PROCESS)
SOAPIER Charting (What is it and its 7 components and its main disadvantages)
- Subjective data: what client or family tells
- Objective data: Factual and measured data
- Assessment: Conclusions drawn from subjective and objective data and conclusions along with your hypothesis
- Plan: Short term and long term goals and strategies to improve condition
- Interventions: actions taken to improve
- Evaluation: Analysis of effective interventions
- Revision: Changes made to the original care plan
(DISADVANTAGE OF THIS FORM IS THAT IT IS INEFFICIENT AND INEFFECTIVE AND INTERVENTIONS MAY HAVE TO BE REPEATED)
Focus charting (What is it and what are its disadvantages?)
- A from of charting that allows you to focus in on one specific problem. Focus is often on:
- A nursing diagnosis
- A sign or symptom
- A client behaviour
- A special need
- An acute change in condition
- A significant event
Works well in acute care
Document:
- Data
- Action: (interventions performed)
- Responses: (Client response to interventions performed)
(DISADVANTAGES OF THIS TYPE ARE COMMON PROBLEMS BEING OVERLOOKED AND DISMISSED)
FACT system charting (What is it and what are its disadvantages?)
- Includes 4 key elements to assess specific areas of the body and only documents abnormal findings
- Flowsheets: individualized to specific services
- Assessment: features standardized with baseline parameters.
-Concise: Integrates flow sheets and progress notes - Timely Entries: Documented when care is given
(BIGGEST DISADVANTAGE IS IT ONLY INCLUDES ABNORMALITIES SO IT IS EASY TO MISS SOME COMPONENTS OF CLIENT CARE)
Electronic entry charting (What is it and what are its disadvantages?)
- Putting information into a computer database.
- Changes documenting from the nursing station to the bedside
- May use SOAP, PIE, Focus and FACT systems to document electronic records.
- Decision making process changes from gradual to immediate
(THE MAIN DISADVANTAGE OF THIS SYSTEM IS THAT IT TAKES SOME TIME TO LEARN)
Narrative Charting (What is it and what are its disadvantages?)
- Creating a story of the patients condition that follows chronological order and can help to track client changes in status.
(MAIN DISADVANTAGES ARE THAT THEY CAN BE LENGTHY AND OFTEN DISORGANIZED)
What does SBARQ stand for?
- Situation
- Background
- Assessment
- Recommendations
- Questions (if any)
How to question a prescription 3 ways?
- Follow organization policy
- If written wrong or illegible, contact the provider directly.
- If after contacting there is a refusal, inform a chain of command and document the refusal. YOU ARE LEGALLY OBLIGATED TO
What does OOB stand for?
- Out of bed
What does abd stand for?
- abdomen
What does NDKA stand for?
- Normoglycemic Diabetic Ketoacidosis
What does BRP stand for?
- Bed rest with Bathroom privileges
What does pc stand for?
- Present Complaint
What does tid stand for?
- three times a day
What does DM stand for?
Diabetes Mellitus
What does prn stand for?
As needed (pro re nata)
What does q mean?
- q means every as in q2h or every two hours
What does fx mean?
- Fracture
What does STI stand for?
- Sexually transmitted infection
What does LUQ stand for?
- Left upper quadrant
