Quiz Unit 1 Flashcards
What does SBAR stand for?
Situation, Background, Assessment, Recommendation
What are the 5 rights of delegation?
Right task, circumstances, person, communication, supervision.
What does IHI stand for?
Institute for Healthcare Improvement
What are some IHI objectives?
Save 100,000 lives, Protect 5 million from harm, and to Develop Rapid Response Teams
What are the 6 interventions developed by the IHI to prevent death/harm?
Deploy RRT’s, provide reliable evidence based care for acute MIs, prevent central line infections, prevent adverse drug events (ADE’s), prevent surgical site infections (SSI’s), prevent vent associated pneumonia (VAP)
What are the 5 core competencies developed by the IOM for health care professionals?
Provide patient centered care, Collaborating with the interdisciplinary health care team, implement evidence based practice, use quality control, use informatics.
How do we provide patient centered care?
Through collaborative and independent nursing, patient education, advocacy, ethical principles (autonomy, beneficience, justice).
Who publishes national patient safety goals and requires its members to meet them? Why?
The joint commission. To address high risk issues such as drug interactions, falls, pressure ulcers, etc.
Define CAM.
Complimentary and Alternative Medicine. Complimentary is used with traditional medicine and alternative is used INSTEAD of traditional medicine
What is NCCAM and what does it do?
National Center for Complementary and Alternative Medicine. They act as a clearinghouse for information, fund studies, and advance knowledge about CAM
What is Ginko Biloba used for?
Memory problems, dementia, PVD, antioxidant, vasodilator.
What are some precautions for Ginko?
Bleeding, dizziness, HA, GI upset
What are some uses for Garlic?
Lowers cholesterol and BP, antibiotic, antiplatelet.
What are some cautions with garlic use?
Losing friends, bleeding, potentiates action of antidiabetic drugs, avoid before surgery (bleeding).
Name the 4 subgroups of late adulthood and their age ranges.
Young old (65-74), Middle old (75-84), Old old (85-99) & Elite old (100+).
Name the 7 common health issues associated with aging.
Nutrition, mobility, stress/loss, safety, drug use/misuse, mental/behavioral health, elder neglect/abuse.
Name some causes of adult malnutrition.
Inflation/reduced income, lack of transportation, unbalanced foods, heavy bags/packages, loneliness, diminished taste/smell, tooth loss/dentures
What is the best way to maintain mobility and what are some of its other benefits?
Regular exercise. Decreased falls, increased sleep, reduce weight, improve well-being/self-esteem, fewer depression symptoms, improved longevity, reduce DM and CAD.
Name some frequent sources of stress the elderly often incur.
Rapid changes in environment/lifestyle, illness, loss of others, financial hardships, relocation stress syndrome.
What is fallophobia?
The fear of falling is so strong that it causes a person to not leave home
What are some factors that increase the likelihood of accidents?
Eyesight, reduced sense of touch, decreased reaction time, peripheral neuropathy, arthritis.
How can falls be prevented?
Home modification, exercise, Tai chi.
What is the leading cause of death in the young old (65-74) population?
MVA
What liver changes in the elderly affect drug metabolism?
Changes in size, enzyme activity, and blood flow
What can affect the absorption of drugs via the oral route as we age?
Decreased GI motility/blood flow, and an increase in pH.
What can affect drug distribution as we age?
Increased adipose tissue, decreased cardiac output/albumin/water all decrease amounts of a drug in plasma, and increase it in tissues.
What policy should we apply when administering drugs to the elderly?
Start low and go slow.
What is a good way to find and fix drug problems in the elderly?
By compiling a complete list of all meds/supplement taken and analyzing them using the “BEERS criteria” at least every 6 months.
What is the normal creatinine clearance range for men and women at age 20 and how does age affect these numbers?
107-139 (Men) and 87-107 (Women). These numbers decrease by 6.5 mL/min per decade.
Name some common drugs/supplements listed in the BEERS criteria.
Iron, digoxin (Lanoxin), meperidine (Demerol), cyclobenzaprine (Flexeril), fluoxetine (Prozac), diazepam (Valium), promethazine (Phenergan), amitriptyline (Elavil).
What are the differences between dementia and delirium?
Dementia is long term, slow onset, chronic, with unknown etiology and we treat the symptoms by reorienting in early stages and validation in the late stages…Delirium is acute, its onset is fast (hours to 1 month), usually reversible, can be caused by surgery/infection/drugs, and is treated by reorienting to reality and keeping them safe.
Define neglect.
Failure to provide basic needs.
What are the 3 types of abuse mentioned in the PowerPoint?
Physical, financial, and emotional.
When are physical restraints used?
When chemical restraints and warnings fail.
Who defined transcultural nursing?
Madeline Leininger.
Define culture.
Patterns of behavior acquired over time (beliefs/values/customs/norms/habits/language) primarily learned within the family unit or other social organizations.
Not letting your own biases affect how you treat others is called _____ _____.
Cultural competence.
What is the goal of Healthy People 2020 in regards to culture?
To achieve health equity, eliminate disparities, and improve the health of all.
What diseases are the homeless more prone to?
1 is cardiovascular disease, often caused by smoking/alcohol/drug use. Also DM, hypertension, and hyperlipidemia.
What is triage?
Sorting patients into priority levels for treatment.
Explain the 3 tiers of triage.
Emergent (life threatening), urgent (needs quick treatment) (pneumonia), non-urgent (sprains, strains, simple fractures)
What does a forensic nurse examiner do?
Obtain hx, collect forensic evidence, and offer counseling.
What does a psychiatric crisis nurse do?
Interacts with patients and families in crisis.
What do case managers do?
Screen ED patients and intervene when necessary to arrange appropriate follow-up, and to determine why recurrent issues occur.
What is a level IV trauma center’s main function?
To provide advanced life support, and to stabilize and transport patients with serious issues.
What is the primary purpose of a level III trauma center?
Injury stabilization and transport to a level I or II hospital.
What are vesicular breath sounds?
Normal breath sounds.
Why are sequentials removed during bathing?
The skin should be inspected at least once per shift.
Sensory alterations may occur in an _____ _____ due to _____ _____.
Unresponsive patient. Touch deprivation.
Who is least vulnerable to lack of resources?
Transplant patients
What can be delegated, whether to an LAP or UAP?
Only measures that the nurse knows that the other person is prepared, licensed, and qualified to do.
What are Suchman’s 5 stages of illness?
Shock/disbelief, denial, awareness, restitution, resolution
What is the #1 reason for sepsis?
Infected PICC lines.
In what cultures are the elderly revered?
Asian and Mexican cultures.
What is the difference between race, ethnicity, and culture?
Race is what you look like, ethnicity is a group of racially similar people of common origin, and culture is shared values/ideals/beliefs (or how you were raised).
What is the nurses objective during the shock/denial stage of illness?
Provide honest and matter-of-fact information
What nursing measure is most important during the awareness phase of illness?
Consistency, good communication.
What nursing measure is most important during the resolution phase of illness?
Promote self care and independence. Assess family needs.
What nursing measures are most important during the restitution phase of illness?
Assist patient with problem solving and bridging relationships.
How does the ANA define delegation?
Transferring responsibility for the performance of an activity to another, while retaining responsibility for the outcome.
What is the difference between a code team and an RRT?
Code Blue is called when a medical emergency is happening. The rapid response team is called before a patient’s condition becomes a medical emergency.
Which of the following should nurses be prepared to provide? (select all that apply) A) Teaching B) Advocacy C) Spiritual counseling and support D) Rehab strategies and methods E) Administrative scheduling and budgeting F) Coordination of care.
A, B, C & F
What should you teach a patient taking Garlic supplements?
It may potentiate antidiabetic drugs.
What should you teach someone taking Ginko Biloba supplements?
Use carefully with anticoagulant therapy. May increase bleeding.
What herbal remedy requires frequent INR monitoring if the patient is taking Warfarin?
Ginseng
What warning is taught with Saw Palmetto use?
Discontinue 2 weeks before surgery
For what purposes is imagery used?
To decrease pain/fatigue/nausea/anxiety
What are the benefits of massage therapy? (select all that apply) A) Relaxation B) Eliminates bruising with injury C) Lessens aggressive behaviors D) Reduces pain E) Eliminates need for drug therapy
A, C & D
If a patient develops a reddened area on her coccyx, what type of massage therapy is used?
None! Break out the Calazyme and leave her on her side.
Can essential oils used in aromatherapy come in direct contact with the skin, such as in bathing or compresses?
Yes.
What essential oils promote relaxation and sleep?
Lavender and rose oils.
What essential oil is used as a stimulant and to increase concentration?
Peppermint
What 3 essential oils improve mood?
Lavendar, jasmine, and sandalwood
T/F Using various stroke techniques of massage will produce relaxation.
True
We know that garlic can interfere with antidiabetic meds. What is another possible side effect?
It can interfere with platelet aggregation, causing bruising.
Name 4 facts about probiotic therapy for antibiotic associated diarrhea.
They can be found in yogurt, may increase gas and bloating, should be taken with meals, they are live organisms that may stabilize the GI mucosal barrier.
Which of these statements is true? (select all that apply) A) The fastest growing age group in the US is the 85-95 group B) Only 5% of older adults are in nursing homes C) Older adults are at risk for poor nutrition D) The 85-95 age group are often wrongly referred to as the “Frail Elderly” E) Men live longer than women
A, B, C & D
How can relocation anxiety be addressed?
Explain, reorient, allow input in decision making, keepsakes at bedside
What is the most important aspect of culture that a nurse must consider?
Cultural shock
In some cultures, hypertension is referred to as _____ _____?
High blood
Who offers a higher level of expertise in emergency care, an EMT or a paramedic?
Paramedics can perform advanced life support such as intubation, cardiac monitoring, and giving IV drugs.
If you, as an ED nurse, were calling the Med Surg floor to transfer a pt, & the receiving nurse said, “You people are always dumping on us at shift change,” what would be the appropriate response?
I apologize for the timing. I will call back in 15 minutes.
For med admin, how would you handle an unidentified person brought in to the ED?
Designate them as John/Jane Doe and use 2 unique identifiers.
Which of these is a s/s of cardiac tamponade? Decreased cardiac output, flat jugular veins, BP of 189/95.
Decreased cardiac output.
What is the fastest way to check systolic BP in a patient being resuscitated?
Check radial pulse - If present, systolic is at least 80 bpm. Check femoral pulse - If present, systolic is at least 70 bpm. Check carotid pulse - If present, systolic is at least 60 bpm
What are some s/s of a tension pneumothorax?
Severe respiratory distress, hypotension, JVD, tracheal deviation
What would you, as an ED nurse, get immediately if a patient comes in with a pneumothorax?
Chest tube insertion tray
If a patient’s BP is dropping and you initiate IV fluids, how many liters of fluid would be given before blood products are given?
2 Liters
If a patient has a Glasgow coma scale of 3, how would he respond to painful stimuli?
He would be totally unresponsive
What 3 things would you do for a patient who has had a boating accident and is at risk for hypothermia?
Remove wet clothing, infuse warm fluids, use a warming lamp
How would you assess lung compliance in a patient that requires intubation?
Compliance is the ability to expand, so you would sense the degree of difficulty in ventilating with a bag-valve-mask.
Name 2 s/s of a flail chest.
Dyspnea and paradoxical chest movement.
