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NRS 210 exam 1 > SI exam review > Flashcards

SI exam review Flashcards

1
Q

what is the nurses role in informed consent

A

witnessing

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2
Q

list the principles of basic aseptic technique

A

inch border
chest to table level, up 2 inches above elbow
all materials entering sterile field must be sterile
can’t cross over field with a contaminated object

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3
Q

what is malignant hyperthermia

A

rare metabolic disease that causes rigidity of muscles

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4
Q

what medication would the nurse give if the patient is experiencing malignant hyperthermia during surgery

A

dantrolene

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5
Q

you are caring for a patient who is coming out of anesthesia what are your priority assessments

A

airway
breathing
circulation

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6
Q

what is steroteyping

A

viewing member of a culture, race or ethnic group as being alike and sharing all the same beliefs

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7
Q

what is the most reliable indicator of pain

A

patients self report

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8
Q

post surgery drainage is expected to change from

A

sanguinous to serosanginus to serous

red to pink to clear

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9
Q

what if your patient is a chinese women and you re unsure of their cultural preference what do you do

A

ask

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10
Q

what four things does cultural competence consist of

A

skill
knowledge
awareness
encounter

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11
Q

in community based nursing care is directed to

A

individuals, families, and communities

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12
Q

in prochaska change theory, if a person is planning for a change they are in stage

A

preparation

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13
Q

if a person is deomstrating a newly learned task what learning domain in blooms taxonomy is this

A

psychomotor

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14
Q

what is a communicating fracture

A

open fracture with external envionrment

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15
Q

what is a comminuted fracture

A

2 or more fragment from a crushing injury

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16
Q

what is the cardinal sign of a fracture

A

deformity

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17
Q

what is traction

A

pulling force on a distal fragment to maintain it with a proximal fragment

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18
Q

what are the 6 ps of compartment syndrom

A 
pain 
pressure
pallor
pulselessness
peristhesia
paralysis
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19
Q

what are some s/s of a hip fracture

A 
external rotation
tenderness/severe pian
limited mobility
leg could be shorter
muscle spasms
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20
Q

what are two medication that my be used for anticoagulant therapy

A

warfarin

enoxapairin

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21
Q

if the use is suspecting a fat embolism in her patent what is one s/s that sets it apart from a pulmonary embolisms

A

petechiae

neck and chest

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22
Q

if your patient is expierincg compartment syndrome would you elevate the extremity

A

no

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23
Q

what role does enoxaparin (lovenox) play in clotting cascade

A

prevent the conversion of fibrinogen to fibrin

prothrombin to thrombin

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24
Q

warfarin (coumadin) mediation is to be taken at what part of the day

A

afternoon around 4 p.m same time every day

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25
Q

what vitamin would a patient on warfarin not want to consume too much of

A 
vitamin K
leafy greens
green tear
prunes 
blueberries
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26
Q

if your patient is on both enoxaparin and warfarin and their INR is 2.o what will you do

A

stop the enoxaparin

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27
Q

what is an INR

A

person ability to clot

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28
Q

what is the normal range of an INR

A

less than 1.1

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29
Q

what are the 3 phases of wound care

A

inflammatory
proliferative
remodeling

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30
Q

which phase of wound care is the retraction and scarring phase

A

remodeling

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31
Q

_____ and the _____ are both part of the inflammation phase

A

vascular response and cellular response

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32
Q

the vascular response begins ____ minutes after an acute injury occurs

A

10

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33
Q

T/F the growth facts are the most important cell of the vascular response

A

false, platelets are the most important because they stimulate growth factor

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34
Q

does histamine vasodilate or vasocontrict

A

vasodilate

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35
Q

what creates pus, this usually occurs 6-8 hours post injury

A

neutrophils

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36
Q

what is a shift to the left

A

a lot of immature neutrophils

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37
Q

what are the two kinds of healing processes and which is easier of the body to do

A

regenreation and repair

regeneration is easiest t

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38
Q

what is an example of a body part that goes under regenration

A

tongue

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39
Q

a partient has just come out of knee replacement surgery and has staples holding the incision closed, what type of intention is the patients would healing by

A

primary

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40
Q

what kind of intention is used when a wound that is brought together once and infection has cleared

A

tertiary

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41
Q

a patient presents to the emergency room with a gunshot wound in his arm, how ill the nurse anticipate this would will heal in terms of intention

A

secondary

42
Q

T/F when a wound is healing in the proliferative stage, new capillary networks are being formed this a a very fragile stage

A

true

43
Q

you should asses your patients ____ 30 mins prior to doing wound care

A

pain

44
Q

you notice in your patients labs that he has a WBC count of 15,000 what is this called

A

leukocytosis

45
Q

what is the norma range for white blood cells

A

5,000 to 11,000

46
Q

what is is called if your patient WBC count is below 5,000

A

leukopenia

47
Q

when is a wound consider chronic

A

no specfic time frame of healing

48
Q

a ______ is when a disruption occurs in previously joined wound edges

A

dishescense

49
Q

what are things that can cause a dehiscence

A 
infection
obesity
coughing
albumin levels under 3. 5
jerky movments
poor nutritional status
50
Q

what is an evisceration

A

medical emergecny

bowel protrude through incision

51
Q

what are the steps to take with evisceration

A

ask for sterile dressing and normal saline
put heat of bed up to relieve pressure
call surgeon
pour saline on top, put dressing on abdomen
put ABD on top keep it moist
patient have IV and NPO

52
Q

how many stages of pressure ulcers are there

A

6

53
Q

what is normal albumin levels

A

3.5-5

54
Q

what is one of the most important roles of the nurse

A

prevent tissue injury

55
Q

the c reactive protein is indicative of infection what is a normal range

A

0-10

56
Q

wounds can be classified by 3 colors

A

red yellow black

57
Q

does your patient understand his discharge teaching when he states “ my wound is classified as red meaning at home i should use hydrogen peroxide to keep it free of infection

A

no too harsh, red wound very delicate use saline or tape water

58
Q

you are getting ready to care for a patient with a yellow wound and 75% slough on it, what can the nurse anticipate she will use

A

vinegar or acidic acid if 60% or greater slough

59
Q

T/F your patient has a black found on his right elbow with eschar on it. you should lan to clean the wound first then remove the eschar

A

true

60
Q

what body part would you not want to remove eschar from

A

the heel because is already has less circulation

61
Q

your patient is using leech therapy on a wound, this is a form of ______debridement

A

biological

62
Q

if you are planning to use shape debridement on a wound, what will you expect to see. when would a nurse anticipate using this method

A

blood, only use if wound is chronic

63
Q

T/F a culture is required prior to using antimicrobial

A

false

64
Q

a _______dressing forms a soft, gel that absorbs when it comes into contact with would exudate

A

calcium aginate

65
Q

your patient ate breakfast 5 hours ago and has a blood glucose reading of 135mg/dL

A

normal

66
Q

fed state with a blood glucose reading of 210mg/dL

A

diabetes

67
Q

fasting state with a blood glucose of 92 mg/dL

A

normal

68
Q

fed state with a blood glcouse of 110mg/dL

A

normal

69
Q

fasting state with BG of 135 mg/dL

A

diabetes

70
Q

fasting state with BG 119mg/dL

A

pre diabetes

71
Q

your patient ate dinner at 7pm the next morning at 7 am she checks her blood sugar prior to eating breakfast and has a reading of 105 mg/dl

A

pre diabetes

72
Q

what is normal fasting state BG

A

less than 100

73
Q

what is pre diabetes fasting state BG

A

greater than or equal to 100

less than 126

74
Q

what is diabetes fasting state BG

A

greater than or equal to 126

75
Q

what is normal fed state BG

A

less than 140

76
Q

what is pre diabetes fed state BG

A

less than 200

greater than or equal to 140

77
Q

what is diabetes fed state BG

A

greater than or equal to 200

78
Q

during morning rounds you notice your patient is showing sign of reduced condition and very grumpy, he is sweating, without taking his blood sugar what do you anticipate your patient is expiericngin

A

hyporglycemia

79
Q

what are the s/s of hyperglycemia

A 
the polys
dehydration
weightloss
fatigue
fruity odor to breath
poor wound healing
80
Q

insulin resistance starts at a BMI of ___ what race is an exception to this and why

A

25

asian is 23 bc due to where they carry adipose tissue

81
Q

what 3 anabolic things happen in the body after a meal

A

stimulates storage of flcuose as glycogen in liver/muscle
enhances fat deposit in adipose tissue
promotes protein syntheis

82
Q

what is the purpose of the counter regularly hormones

A

oppostie action of insulin

83
Q

what are the count regulatory hormones

A

glucagon
epinephrine
growth hormone
cortisol

84
Q

T/F counterregulatory hormones decrease glucose levels

A

false

85
Q

what are incretins and why are they important

A

hormones that secrete insulin secretion in repose to meal

type 2 have a deficiency

86
Q

taking what we know about incretins, why would carbohydrates taken orally work quicker to secrete insulin than when given IV

A

because IV drugs bypass the GI tract

87
Q

type1/type2 will experience the honeymoon period

A

type 1

88
Q

type 1/type2 require exogenous insulin to live

A

type 1

89
Q

what are some characteristics of type 2

A

delayed onset, geneticc, obesity

90
Q

what are some symptoms of type 2

A

poly plus fatigue, visual changes because dehydrated

91
Q

T/F the higher someone blood sugar the more dehydrated they are

A

true

92
Q

is type 1/type2 ketosis resistance

A

type 2

93
Q

recommendaton to prevent or delay the onset of type 2

A

150 min/week physical activity
weight loss of 7% body weight
healhty diet

94
Q

health belief model predicts behavior based on what 4 factors

A

precieved illnes from a threat
belief threat has serious or nonserious consequences
belief is that required recommendation will be effective
belief that there are a few barriers

95
Q

what are the 5 goals of nutritional therapy

A 
near normal blood sugars
optinmum serum lipid levels
reasonable weight
revention/treatment of acute/chronic complications 
improvemnnts of overall health
96
Q

which type of diabetes should not drink alochol

A

they both care but people with type 1 should eat while drinking

97
Q

exercise can lead to hypoglycemia if your patient has type 1 what should you recommend they do prior to working out

A

check BG levels and if low eat 15 g of carbs before

98
Q

the goal of diabetes is

A

euglycemia

99
Q

what are some SMBG goal for control

A

80-130 before meals
100-140 bedtime
goal of A1C is 7%

100
Q

you go into your patients room and notice that she is displaying shakiness, is confused and irritable with slurred speech what you doh suspect is happening g

A

hypoglycemia

101
Q

risk factor for diabetes

A

overwight
physical inactive
high risk race
first degree relative

102
Q

s/s of hypoglycemia

A 
tremors,
reducted cognition
diaphysis- sweating
hunger
weakness
heacache 
seizure 
iritabiltly 
coma/death

NRS 210 exam 1 (8 decks)

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