Supplemental Questions: Exam 2 Flashcards
Thanks Tucker, Matt, and Kaitlyn!
1
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Question
A
Answer
2
Q
The act of breaking down food into simple substances is […]
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The act of breaking down food into simple substances is digestion
3
Q
Muscular contractions moving food through the intestines is called […]
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Muscular contractions moving food through the intestines is called peristalsis
4
Q
Food remains in the stomach for […] hours
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Food remains in the stomach for 2-8 hours
5
Q
Bile is produced by the liver and stored in the […]
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Bile is produced by the liver and stored in the gallbladder
6
Q
Bile is produced by the […] and stored in the gallbladder
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Bile is produced by the liver and stored in the gallbladder
7
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Nutrients are absorbed into the bloodstream in the […] intestine
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Nutrients are absorbed into the bloodstream in the small intestine
8
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The […] intestine is primarily responsible for removing water and electrolytes
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The large intestine is primarily responsible for removing water and electrolytes
9
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The […] is a storage area for feces
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The rectum is a storage area for feces
10
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Remaining food is converted to feces in the […]
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Remaining food is converted to feces in the large intestine
11
Q
Macronutrients are consumed in large amounts and include […]
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Macronutrients are consumed in large amounts and include protein, carbs, and fat
12
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Micronutrients are […]
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Micronutrients are vitamins and minerals
13
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Proteins provide the body essential […] neede for repair
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Proteins provide the body essential amino acids neede for repair
14
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Carbohydrates are converted to […] and provide energy for the body
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Carbohydrates are converted to sugar and provide energy for the body
15
Q
The ability of a food to raise the body’s blood sugar is […]
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The ability of a food to raise the body’s blood sugar is glycemic index
16
Q
[…] help the body absorb vitamins while providing energy
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Fats help the body absorb vitamins while providing energy
17
Q
Trans fats are generally found in […]
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Trans fats are generally found in processed foods
18
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Saturated fats are found in […]
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Saturated fats are found in animal products
19
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Nuts, olives, olive oil, and avocados contain […] fats
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Nuts, olives, olive oil, and avocados contain monounsaturated fats
20
Q
[…] are not produced by the body and must be obtained by diet
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Vitamins are not produced by the body and must be obtained by diet
21
Q
2 hours after a meal a CBG should be […] mg/dL
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2 hours after a meal a CBG should be 140-180 mg/dL
22
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A normal BMI is […]
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A normal BMI is 18.5-24.9
23
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A BMI over […] is considered obese
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A BMI over 30 is considered obese
24
Q
[…] protect cells against free radicals
A
Antioxidants protect cells against free radicals
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A [...] contains foods that are easy to digest, low in fiber, and can be swallowed easily
A soft diet contains foods that are easy to digest, low in fiber, and can be swallowed easily
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A [...] is foods that do not need to be chewed
A pureed diet is foods that do not need to be chewed
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A [...] contains only fluid
A full liquid diet contains only fluid
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[...] contains only foods that can be seen through
Clear liquid diets contains only foods that can be seen through
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Decreased sodium, portions, and unhealthy fats while increasing fruits and veg, whole grains, and low fat protein is a [...]
Decreased sodium, portions, and unhealthy fats while increasing fruits and veg, whole grains, and low fat protein is a heart healthy diet
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A healthy adults should not consume more than [...] of sodium
A healthy adults should not consume more than 2300 mg of sodium
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A [...] encouraged pt's to monitor intake of potassium, phosphorous, and sodium
A renal diet encouraged pt's to monitor intake of potassium, phosphorous, and sodium
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Folic acid supplements lower [...]
Folic acid supplements lower birth defects
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[...] aspiration presents with obvious symptoms such as cough or dyspnea
Overt aspiration presents with obvious symptoms such as cough or dyspnea
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[...] aspiration has no obvious symptoms
Silent aspiration has no obvious symptoms
35
Stage 1 [...] fluid will freely run off a spoon and leave a coating
Stage 1 Nectar like fluid will freely run off a spoon and leave a coating
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Stage 2 [...] fluid will slowly drip off a spoon
Stage 2 Honey like fluid will slowly drip off a spoon
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Stage 3 [...] fluid will not run off a spoon
Stage 3 spoon-thick fluid will not run off a spoon
38
[...] are tools or equipment that help a client perform activities more easily
Assistive devices are tools or equipment that help a client perform activities more easily
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Insulin is created by the [...] in the pancreas
Insulin is created by the beta cells in the pancreas
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Insulin should be given at least [...] away from the umbilicus
Insulin should be given at least two inches away from the umbilicus
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[...] are primarily used for feeding
Nasoduodenal tubes are primarily used for feeding
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[...] are used when pt's cant tolerate food in the stomach or have delayed gastric emptying
Nasojejunal tubes are used when pt's cant tolerate food in the stomach or have delayed gastric emptying
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pH of stomach contents should be below [...]
pH of stomach contents should be below 6.0
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Parenteral nutrition is provided [...]
Parenteral nutrition is provided IV
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Total parenteral nutrition patients need frequent [...]
Total parenteral nutrition patients need frequent CBG checks
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Net Carbs = Carbs - [...]
Net Carbs = Carbs - fiber and sugar alcohol
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Tube feedings should be administered with the HOB at an angle of [...] degrees
Tube feedings should be administered with the HOB at an angle of 30-45 degrees
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Placement of a feeding tube should be checked every [...]
Placement of a feeding tube should be checked every four hours
49
A BMI opf less than [...] is underweight
A BMI opf less than 18.5 is underweight
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Woman should consume [...] of fiber and 38g for men
Woman should consume 20g of fiber and 38g for men
51
Woman should consume 20g of fiber and [...] for men
Woman should consume 20g of fiber and 38g for men
52
NG tube lower border is the [...]
NG tube lower border is the Xiphoid process
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Whole grain food is high in [...]
Whole grain food is high in Phosporous
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Brittle hair and hair loss can be cause by [...] deficiencies
Brittle hair and hair loss can be cause by protein intake deficiencies
55
Pt's should not be on a [...] for more than a few days due to inadequate nutrition
Pt's should not be on a clears diet for more than a few days due to inadequate nutrition
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Enabling control over clients general health is [...]
Enabling control over clients general health is health promotion
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Decreased anxiety, self-managed care, feelings of empowerment, and fewer unpleasant hospital experiences are all benefits of [...]
Decreased anxiety, self-managed care, feelings of empowerment, and fewer unpleasant hospital experiences are all benefits of client education
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The thinking domain is knows as the [...] domain
The thinking domain is knows as the cognitive domain
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The six stages of the cognitive domain are KCA & ASE knowledge, comprehension, application and [...]
The six stages of the cognitive domain are KCA & ASE knowledge, comprehension, application and analysis, synthesis, evaluation
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The six stages of the cognitive domain are KCA & ASE [...] and analysis, synthesis, evaluation
The six stages of the cognitive domain are KCA & ASE knowledge, comprehension, application and analysis, synthesis, evaluation
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Recalling prior learned knowledge [...]
Recalling prior learned knowledge Knowledge
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Understanding and interpretation of information [...]
Understanding and interpretation of information Comprehension
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The ability to use data [...]
The ability to use data application
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The breakdown of information to understand it's structure [...]
The breakdown of information to understand it's structure Analysis
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Putting the elements together to create a new whole [...]
Putting the elements together to create a new whole synthesis
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Deciding the ideal of the ideas [...]
Deciding the ideal of the ideas evaluation
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The [...] domain is based on emotions and involves the clients feelings
The affective domain is based on emotions and involves the clients feelings
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The [...] domain is based on action
The psychomotor domain is based on action
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Relevance, Self-directed, Life-experience, Readiness, Task-Centered, and motivation are [...]
Relevance, Self-directed, Life-experience, Readiness, Task-Centered, and motivation are Knowles fundamental prinicipals of learning
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[...] is the clients ability to obtain, read, and understand the health information necessary to support decisions regarding their care
Health Literacy is the clients ability to obtain, read, and understand the health information necessary to support decisions regarding their care
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Impaired cognition, language barriers, visusal and hearing impairements, emotional concerns, and cultural differences are examples of [...]
Impaired cognition, language barriers, visusal and hearing impairements, emotional concerns, and cultural differences are examples of barriers to learning
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The affective domain stages are RR VOC [...] Valuing, Organization, Characterization
The affective domain stages are RR VOC Receiving, Responding Valuing, Organization, Characterization
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The affective domain stages are RR VOC Receiving, Responding [...]
The affective domain stages are RR VOC Receiving, Responding Valuing, Organization, Characterization
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The psychomotor domain has seven stages PSG MCAO Perception, Set, Guided response [...]
The psychomotor domain has seven stages PSG MCAO Perception, Set, Guided response Mechanism, Complex overt response, Adaptation, Origination
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The psychomotor domain has seven stages PSG MCAO [...] Mechanism, Complex overt response, Adaptation, Origination
The psychomotor domain has seven stages PSG MCAO Perception, Set, Guided response Mechanism, Complex overt response, Adaptation, Origination
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Elements of the teaching process are AAPIE Assessment, Analysis (RN only) [...]
Elements of the teaching process are AAPIE Assessment, Analysis (RN only) Planning, Implementation, Evaluation
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Elements of the teaching process are AAPIE [...] Planning, Implementation, Evaluation
Elements of the teaching process are AAPIE Assessment, Analysis (RN only) Planning, Implementation, Evaluation
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[...] includes identifyinf expected outcomes, goals, or client education
Planning phase includes identifyinf expected outcomes, goals, or client education
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SMART Goals are [...]
SMART Goals are Specific, Measurable, Achievable, Relevant, Timed
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Client understanding of why education is needed and how they will benefit is [...]
Client understanding of why education is needed and how they will benefit is relevance
81
Something that hinders learning is a [...]
Something that hinders learning is a Barrier to entry
82
The optimal learning environment is [...]
The optimal learning environment is low stimulus
83
Helpful information provided to the client to aid in the improvement of client education is [...]
Helpful information provided to the client to aid in the improvement of client education is feedback
84
Personal perception or sterotype regarding situations, people, or actions is [...]
Personal perception or sterotype regarding situations, people, or actions is self-bias
85
[...] care is involving and educating the client through the nursing process
Client centered care is involving and educating the client through the nursing process
86
Cells formed in the basal layer of the skin that function to protect the skin from the external environment are [...]
Cells formed in the basal layer of the skin that function to protect the skin from the external environment are keratinocytes
87
[...] absorb radiant energy from the sun and protect skin from UV light
Melanin absorb radiant energy from the sun and protect skin from UV light
88
[...] in the skin detect light touch
Merkel cells in the skin detect light touch
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[...] in the skin ingest and package foreign antigens to be presented to lymphocytes
Langerhans cells in the skin ingest and package foreign antigens to be presented to lymphocytes
90
The [...] is composed of connective tissue, blood, and lymph vessels
The Dermis is composed of connective tissue, blood, and lymph vessels
91
The [...] layer contains blood vessels and nerves
The Subcutaneous layer contains blood vessels and nerves
92
The skin helps to produce vitamins [...]
The skin helps to produce vitamins A&D
93
Irritation of the skin caused by moisture is [...]
Irritation of the skin caused by moisture is Maceration
94
Localized damage to the skin or the soft underlying tissue is a [...]
Localized damage to the skin or the soft underlying tissue is a pressure injury
95
Redness of the skin due to dilation of blood vessels is [...]
Redness of the skin due to dilation of blood vessels is erythema
96
Erythema is classified as either [...]
Erythema is classified as either Blanchable or Non-blanchable
97
Surgical incisions should be red on days 1-4, [...] on days 5-14, and pale pink from there out
Surgical incisions should be red on days 1-4, Bright pink on days 5-14, and pale pink from there out
98
Surgical incisions should be red on days 1-4, Bright pink on days 5-14, and [...] from there out
Surgical incisions should be red on days 1-4, Bright pink on days 5-14, and pale pink from there out
99
Surgical incisions should be [...] on days 1-4, Bright pink on days 5-14, and pale pink from there out
Surgical incisions should be red on days 1-4, Bright pink on days 5-14, and pale pink from there out
100
[...] is fluid consisting of plasma that is secreted by the body during the inflammatory phase of healing
Exudate is fluid consisting of plasma that is secreted by the body during the inflammatory phase of healing
101
MASD is [...]
MASD is Moisture associated skin damage
102
Wounds are classified as [...]
Wounds are classified as Acute or Chronic
103
Older adults, smokers, undernourished, immunosupressed, imobilized, or infected pts are risk factors for [...]
Older adults, smokers, undernourished, immunosupressed, imobilized, or infected pts are risk factors for wounds
104
Three major categories of chronic lower extremity wounds: venous disease, [...] and neuropathic disease
Three major categories of chronic lower extremity wounds: venous disease, arterial disease, and neuropathic disease
105
Three major categories of chronic lower extremity wounds: venous disease, arterial disease, and [...]
Three major categories of chronic lower extremity wounds: venous disease, arterial disease, and neuropathic disease
106
Three major categories of chronic lower extremity wounds: [...] arterial disease, and neuropathic disease
Three major categories of chronic lower extremity wounds: venous disease, arterial disease, and neuropathic disease
107
[...] would drainage indicates infection
purulent would drainage indicates infection
108
[...] is force exerted parallel to the skin
Shear is force exerted parallel to the skin
109
Risk factors for [...] are immobility, malnutrition, reduced perfusion, altered sensation, and decreased LOC
Risk factors for pressure injuries are immobility, malnutrition, reduced perfusion, altered sensation, and decreased LOC
110
The [...] is used to assess risk for tissue integrity
The Braden scale is used to assess risk for tissue integrity
111
Stage: [...] Non blanchable erythema
Stage: 1 Non blanchable erythema
112
Stage: [...] Partial thickness skin loss
Stage: 2 Partial thickness skin loss Pink or red viable tissue in the wound bed
113
Stage: [...] Full-thickness skin loss, visible adipose tissue, granulation tissue.
Stage: 3 Full-thickness skin loss, visible adipose tissue, granulation tissue. Fascia, muscles, tendons, bone, ligament, and cartilage not visible
114
Stage: [...] Full thickness skin and tissue loss.
Stage: 4 Full thickness skin and tissue loss. Fascia, muscles, tendons, ligaments, cartilage, bone may be visible
115
Stage: [...] Obscured by slough of eschar
Stage: unstageable Obscured by slough of eschar Eschar is either stage 3 or 4
116
[...] has a localized, non-blanchable, deep red, maroon/purple discoleration
Deep tissue pressure injury has a localized, non-blanchable, deep red, maroon/purple discoleration
117
Injuries cause by medical devices is called [...]
Injuries cause by medical devices is called Medical device-related pressure injury
118
ET tubes, feeding tubes, and urinary catheters can cause [...]
ET tubes, feeding tubes, and urinary catheters can cause mucosal membrane pressure injury
119
In darker skin skin temp and level of moisture may be the first sign of [...]
In darker skin skin temp and level of moisture may be the first sign of pressure injury
120
Surgically removing dead tissue and other debris from a wound is [...]
Surgically removing dead tissue and other debris from a wound is debridement
121
Biological debridement with [...] can be used when pt's are not surgical candidates
Biological debridement with collagenase or larvae can be used when pt's are not surgical candidates
122
Wound require a [...] wound bed for healing
Wound require a moist wound bed for healing
123
Wound drains are normally removed when the 24 hours drainage is between [...]
Wound drains are normally removed when the 24 hours drainage is between 30 and 100 mL
124
Drains are classified as [...]
Drains are classified as open or closed Penrose is open
125
Wound drainage should be sanguineous after placement, and progressively become more [...]
Wound drainage should be sanguineous after placement, and progressively become more Serosanguineous
126
Wound drainage should be [...] after placement, and progressively become more Serosanguineous
Wound drainage should be sanguineous after placement, and progressively become more Serosanguineous
127
Risk minimizing for pressure injuries: Bed lower than [...], pressure relieving beds, protection of bony prominences
Risk minimizing for pressure injuries: Bed lower than 30 degrees, pressure relieving beds, protection of bony prominences
128
Risk minimizing for pressure injuries: Bed lower than 30 degrees, pressure relieving beds, protection of [...]
Risk minimizing for pressure injuries: Bed lower than 30 degrees, pressure relieving beds, protection of bony prominences
129
Protein, Omega 3 and 6 FA, vitamins A&C are essential for [...]
Protein, Omega 3 and 6 FA, vitamins A&C are essential for wound healing
130
Hydration, nutrition, hygeine, circulation are [...]
Hydration, nutrition, hygeine, circulation are universal skin care measures
131
Wound healing that occurs in clean lacerations and surgical incisions is [...]
Wound healing that occurs in clean lacerations and surgical incisions is primary healing
132
Wounds left open to heal and granulation tissue forms from the bottom up is [...]
Wounds left open to heal and granulation tissue forms from the bottom up is secondary healing
133
Wounds left open for a period of time before a suture is placed is [...]
Wounds left open for a period of time before a suture is placed is delayed primary closure
134
Three phases of wound healing: hemostatic/imflammatory phase, proliferative phase, and [...]
Three phases of wound healing: hemostatic/imflammatory phase, proliferative phase, and remodeling phase
135
Three phases of wound healing: [...] proliferative phase, and remodeling phase
Three phases of wound healing: hemostatic/imflammatory phase, proliferative phase, and remodeling phase
136
Three phases of wound healing: hemostatic/imflammatory phase, [...] and remodeling phase
Three phases of wound healing: hemostatic/imflammatory phase, proliferative phase, and remodeling phase
137
Phase of wounding healing that begins immediately and lasts 3-6 days is [...]
Phase of wounding healing that begins immediately and lasts 3-6 days is hemostatic/imflammatory
138
The [...] phase of wound healing begins 3 days after injury and can last for 24 days
The proliferative phase of wound healing begins 3 days after injury and can last for 24 days
139
The [...] phase of wound healing begins at day 21 and can last for years
The remodeling phase of wound healing begins at day 21 and can last for years
140
Antibiotics are recommended only for wounds that look [...]
Antibiotics are recommended only for wounds that look clincally infected All wounds contain microbes but not all wounds are infected
141
[...] are related to operative procedures that occur within 30 days
Surgical site infections are related to operative procedures that occur within 30 days
142
SSIs are commonly caused by [...] on the skin and can be reduced with chlorhexidine gluconate
SSIs are commonly caused by S. aureus on the skin and can be reduced with chlorhexidine gluconate
143
SSIs are commonly caused by S. aureus on the skin and can be reduced with [...]
SSIs are commonly caused by S. aureus on the skin and can be reduced with chlorhexidine gluconate
144
Sensory perception, moisture, activity, mobility, nutrition and shear are parts of the [...]
Sensory perception, moisture, activity, mobility, nutrition and shear are parts of the braden scale
145
[...] dressings are used for debridement of wounds with necrotized tissue and eschar
Hydrogel dressings are used for debridement of wounds with necrotized tissue and eschar
146
Phases of nursing process AD OPIE: [...] Outcome and Planning, Implementation, Evaluation
Phases of nursing process AD OPIE: Assessment, diagnosis Outcome and Planning, Implementation, Evaluation
147
Phases of nursing process AD OPIE: Assessment, diagnosis [...]
Phases of nursing process AD OPIE: Assessment, diagnosis Outcome and Planning, Implementation, Evaluation
148
The four phases of interview: PI MC [...] Maintenance, Concluding
The four phases of interview: PI MC Prepatory, Introductory Maintenance, Concluding
149
The four phases of interview: PI MC Prepatory, Introductory [...]
The four phases of interview: PI MC Prepatory, Introductory Maintenance, Concluding
150
Nursing diagnosis three parts: Diagnostic label, [...] definining characteristic (as evidence by)
Nursing diagnosis three parts: Diagnostic label, related factors (related to/Associated with, definining characteristic (as evidence by)
151
Nursing diagnosis three parts: [...] related factors (related to/Associated with, definining characteristic (as evidence by)
Nursing diagnosis three parts: Diagnostic label, related factors (related to/Associated with, definining characteristic (as evidence by)
152
Nursing diagnosis three parts: Diagnostic label, related factors (related to/Associated with, [...]
Nursing diagnosis three parts: Diagnostic label, related factors (related to/Associated with, definining characteristic (as evidence by)
153
Types of interventions: Cognitive i.e. delegation, [...] technical - Skills and nursing activity
Types of interventions: Cognitive i.e. delegation, Interpersonal - caregiving coordinating, technical - Skills and nursing activity
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Types of interventions: [...] Interpersonal - caregiving coordinating, technical - Skills and nursing activity
Types of interventions: Cognitive i.e. delegation, Interpersonal - caregiving coordinating, technical - Skills and nursing activity
155
Types of interventions: Cognitive i.e. delegation, Interpersonal - caregiving coordinating, [...]
Types of interventions: Cognitive i.e. delegation, Interpersonal - caregiving coordinating, technical - Skills and nursing activity
156
The joint commission puts out [...] every year
The joint commission puts out National Patient Safety Goals NPSG every year
157
VRE infection [...]
VRE infection Vancomycin resistant enterococci
158
A [...] is a potential error that was caught
A Near miss is a potential error that was caught
159
A [...] is an unexpected event that occured with or without pt harm
A client safety event is an unexpected event that occured with or without pt harm
160
A [...] is a critical adverse event that caused serious harm
A sentinel event is a critical adverse event that caused serious harm
161
Central Line Associated bloodstream infection (CLABSI), CAUTI, SSI, and Vent associated pneumonia are the four hosputal acquired infections [...]
Central Line Associated bloodstream infection (CLABSI), CAUTI, SSI, and Vent associated pneumonia are the four hosputal acquired infections monitored by the CDC
162
[...] Reduce tim, increase distance, implement shielding
Raditation Safety Reduce tim, increase distance, implement shielding
163
Placing a client alone in a secure room to prevent harm is [...]
Placing a client alone in a secure room to prevent harm is seclusion
164
Circulatory, respiratory, and skin integrity checks should be performed when [...]
Circulatory, respiratory, and skin integrity checks should be performed when patients are restrained
165
Melatonin is produced by the [...]
Melatonin is produced by the pineal gland
166
The two internal mechanisms that control sleep are [...] and sleep-wake homeostasis
The two internal mechanisms that control sleep are circadian rhythm and sleep-wake homeostasis
167
The two internal mechanisms that control sleep are circadian rhythm and [...]
The two internal mechanisms that control sleep are circadian rhythm and sleep-wake homeostasis
168
[...] is increased sleep latency and decreased total sleep
Insomnia is increased sleep latency and decreased total sleep
169
[...] is an autoimmune sleep disorder
Narcolepsy is an autoimmune sleep disorder
170
[...] is profound weakness when falling asleep
cataplexy is profound weakness when falling asleep
171
[...] is necessary for developing and maintaining new pathways for learning and memorization
Sleep is necessary for developing and maintaining new pathways for learning and memorization
172
Stage 2 NREM sleep accounts for [...] of sleep
Stage 2 NREM sleep accounts for 50% of sleep
173
Stage 4 REM sleep accounts for [...] of all sleep
Stage 4 REM sleep accounts for 20-25% of all sleep
174
[...] is receiving stimuli at a rate and intesity beyond the brains ability to process the stimuli in a meaningful way
Sensory overload is receiving stimuli at a rate and intesity beyond the brains ability to process the stimuli in a meaningful way
175
Heart disease, hypertension, endocrine dysfunction, and arthritis are all associated with [...]
Heart disease, hypertension, endocrine dysfunction, and arthritis are all associated with insomnia
176
Sleep apnea is classified as [...]
Sleep apnea is classified as central and obstructive
177
[...] is a brief loss of voluntary muscle tonetriggered by an emotional stimulus
Cataplexy is a brief loss of voluntary muscle tonetriggered by an emotional stimulus
178
RLS can occur in pts with [...] deficiencies
RLS can occur in pts with iron or vitamin deficiencies
179
[...] is defined as obtaining relief from pain, negativity, and emotional/physical distress
Comfort is defined as obtaining relief from pain, negativity, and emotional/physical distress
180
Sleep and arousal commands come from the [...]
Sleep and arousal commands come from the hypothalmus
181
Narcolepsy with cataplexy (NTI) is cause by low production of [...]
Narcolepsy with cataplexy (NTI) is cause by low production of hypocretin
182
The Thalmus tranmits images, sounds, and sensations to the [...] which is used for dreams during REM
The Thalmus tranmits images, sounds, and sensations to the cerebral cortex which is used for dreams during REM
183
The [...] tranmits images, sounds, and sensations to the cerebral cortex which is used for dreams during REM
The Thalmus tranmits images, sounds, and sensations to the cerebral cortex which is used for dreams during REM
184
Clients woken out of [...] sleep will be cloudy
Clients woken out of stage 3 sleep will be cloudy
185
Irregular breathing and increased HR are a part of [...] sleep
Irregular breathing and increased HR are a part of stage 4/REM sleep
186
The hunger reducing hormone is [...]
The hunger reducing hormone is leptin
187
A reduction of absence of stimuli to one or more of the five senses is [...]
A reduction of absence of stimuli to one or more of the five senses is Sensory deprivation
188
[...] pts are oversensitive to normal stimuli
Sensory processing disorder pts are oversensitive to normal stimuli
189
[...] is the most common cause of impaired vision in adulthood
Diabetic retinopathy is the most common cause of impaired vision in adulthood
190
[...] is the leading cause of blindness for pts over 65
Macular degeneration is the leading cause of blindness for pts over 65
191
Hearing loss is categorized as [...]
Hearing loss is categorized as Sensorineural, conductive, and mixed loss
192
[...] pt's may be able to understand speech but will not be able to speal the words they want to say
Expressive aphasia pt's may be able to understand speech but will not be able to speal the words they want to say Broca's or nonfluent aphasia
193
[...] pt's will often speak long sentences with no meaning and made up word
Comprehensive Aphasia pt's will often speak long sentences with no meaning and made up word Fluent aphasia or Wernicke's aphasia
194
[...] pts have poor comprehension of language and will be unable to form words or sentences
Global aphashia pts have poor comprehension of language and will be unable to form words or sentences
195
Stimuli from sensors in the skin is sent to the [...]
Stimuli from sensors in the skin is sent to the thalamus
196
Pain signals are sent directly to the [...]
Pain signals are sent directly to the brain
197
[...] are responsible for taste
Gustatory cells are responsible for taste
198
[...] is decreased ability to taste
Hypogeusia is decreased ability to taste
199
[...] is decreased ability to smell
Hyposmia is decreased ability to smell
200
Smell and taste disorders often occur [...]
Smell and taste disorders often occur concurrently
201
[...] is loss of hearing that occurs due to aging
Presbycusis is loss of hearing that occurs due to aging
202
[...] is inflammation or fluid in the middle ear and can result in conductive hearing loss
Otitis media is inflammation or fluid in the middle ear and can result in conductive hearing loss
203
Increased intraocular pressure that compresses the optic nerve is [...]
Increased intraocular pressure that compresses the optic nerve is glaucoma
204
[...] makes pts hypersensitive to normal stimuli
Sensory Processing disorder makes pts hypersensitive to normal stimuli
205
Aging reduces the ability to taste [...] flavors
Aging reduces the ability to taste sour, bitter, and salty flavors
206
Disease prevention can be categorized as [...]
Disease prevention can be categorized as primary, secondary, or tertiary
207
Primary prevention is used to [...] problems
Primary prevention is used to prevent problems
208
Secondary prevention is [...] for disease
Secondary prevention is screening for disease
209
Tertiary prevention aims to [...] a disease process
Tertiary prevention aims to halt a disease process
210
Rickets is a lack of [...]
Rickets is a lack of vitamin D
211
B1 (thiamine) deficiency is [...]
B1 (thiamine) deficiency is beri beri Affects cardiac and muscles
212
B2 deficiency is called [...]
B2 deficiency is called cheilosis Vision and cracked lips
213
B3 (niacin) deficiency is [...]
B3 (niacin) deficiency is pellagra Dementia, dermatitis, diarrhea
214
B9 (folic acid) deficiency is [...]
B9 (folic acid) deficiency is neural tube defects, big red tongue
215
B12 defficiency is [...]
B12 defficiency is pernicious anemia
216
Vitamin C deficiency is [...]
Vitamin C deficiency is scurvy & poor wound healing
217
Calcium deificiency is [...]
Calcium deificiency is rickets
218
Calcium aids clotting by converting [...]
Calcium aids clotting by converting prothrombin to thrombin
219
Mechanical process of digestion MDC CPS [...] Churning (small instestine, peristalsis, Stored until evacuation
Mechanical process of digestion MDC CPS Mastication, deglutition, churning (stomach) Churning (small instestine, peristalsis, Stored until evacuation
220
Mechanical process of digestion MDC CPS Mastication, deglutition, churning (stomach) [...]
Mechanical process of digestion MDC CPS Mastication, deglutition, churning (stomach) Churning (small instestine, peristalsis, Stored until evacuation
221
Fats are absorbed into the [...]
Fats are absorbed into the lymphatic system
222
[...] is a sensetive and specific marker for fnutritional status
prealbumin is a sensetive and specific marker for fnutritional status
223
Chemical and electrical fires are sprayed with [...]
Chemical and electrical fires are sprayed with CO2 and dry chemical
224
Metal fires are sprayed with [...]
Metal fires are sprayed with powder
225
Sensory perception is facilitated by the [...]
Sensory perception is facilitated by the reticular activating system
226
Insomnia, anxiety, restlessness, decreased concentration are all signs of [...]
Insomnia, anxiety, restlessness, decreased concentration are all signs of sensory overload
227
Confusion, depression, delerium, and hallucinations are signs of [...]
Confusion, depression, delerium, and hallucinations are signs of sensory deprevation
228
When helping a blind person ambulate, stand on the [...] side
When helping a blind person ambulate, stand on the non dominant side
229
Erythema, edema, warmth, pain, and functional impairment are signs of [...]
Erythema, edema, warmth, pain, and functional impairment are signs of local inflammation
230
Increase WBC, fever, malaise, muscle aches, anorexia, and sepsis are signs of [...]
Increase WBC, fever, malaise, muscle aches, anorexia, and sepsis are signs of systemic inflammation
231
Endotoxins are released by [...]
Endotoxins are released by bacteria
232
SIRS criteria notes WBC counts [...]
SIRS criteria notes WBC counts >12,000 or <4,000
233
Levels of discharge planning are [...]
Levels of discharge planning are basic/universal, simple referral, complex referral
234
Patients are not involved in [...] referrals
Patients are not involved in complex referrals
235
There are [...] levels of dyspnea
There are 4 levels of dyspnea
236
Level [...] dyspnea is SOB while performing daily activities
Level 3 dyspnea is SOB while performing daily activities
237
Moderate hypoxemia is a PaO2 of [...] mmHG
Moderate hypoxemia is a PaO2 of 40-60 mmHG
238
Formula for NC FiO2: [...]
Formula for NC FiO2: 1LPM = 24%, add 4% for every additional LPM
239
Acute Oxygen toxicity wll present as [...]
Acute Oxygen toxicity wll present as CNS and vision problems
240
[...] When verbal and non verbal comms match
Congruence: When verbal and non verbal comms match
241
[...] Putting yourself in someone elses shoes
Empathy: Putting yourself in someone elses shoes
242
[...] Avoiding judgment and labels
Positive regard: Avoiding judgment and labels
243
[...] Alter perception of event - switch from reactive to proactive
Cognitive reframing: Alter perception of event - switch from reactive to proactive
244
immunizations, birth control an drug education falls into which category of disease prevention?
primary (prevention!)
245
physicals, breast exams, vision exams and other screening tests fall into which category of disease prevention?
secondary
246
support groups + rehab fall into which category of disease prevention?
tertiary
247
possible indications of low literacy level
incomplete forms, inability to name meds, missed appointments
248
tips for successful teaching session tips
avoid medical terms, keep it 15-30 mins, have organized plan + keep it patient-focused
249
example of cognitive domain of learning
lecture
250
examples of affective domain of learning
simulation, role play
251
example of psychomotor domain of learning
demonstrating skill or task (ex: testing blood glucose)
252
in infant stage, learning is through _____
parents
253
in toddler stage, learning is through ____
play
254
in school age stage, learning is through _____
rewards
255
in adolescent stage, learning is through _____
autonomy
256
what macronutrient helps to synthesize vitamin K and vitamin B12?
carbohydrates
257
which nutrient promotes peristalsis and healthy bowel movements?
fiber
258
what is a normal fasting blood glucose?
60-80
259
functions of proteins
wound healing, hemoglobin, insulin, albumin, growth, energy
260
you would see _____ nitrogen balance with periods of growth
positive
261
you would see _____ nitrogen balance with periods of disease state, wounds, immobility
negative
262
fat soluble vitamins
ADEK
263
deficiency of vitamin A
keratinization, xeropthalmia
264
which vitamin helps with absorption of calcium?
vitamin D
265
deficiency of vitamin D leads to what 3 things?
rickets, osteomalacia, tetany (low Ca)
266
which vitamin protects vitamin A?
vitamin E
267
deficiency of vitamin E causes what?
hemolysis of RBCs --> anemia
268
vitamin K helps with what?
clotting factors (so a deficiency can lead to increased clotting time / bleeding issues)
269
which 2 vitamins are concerning for falls in patients re: injury?
vitamin E + K
270
what are the water soluble vitamins?
vitamin C + B vitamins
271
B1 =
thiamine
272
B2 =
riboflavin
273
B3 =
niacin
274
B9 =
folic acid
275
B12 =
cyanocobalamin
276
deficiency of thiamine is called
beri beri (affects cardiac + muscle)
277
deficiency of riboflavin is called
cheilosis (cracking/fissures in mouth)
278
deficiency of niacin is called
pellagra
279
pellagra causes what s+s?
3 D's - dementia, diarrhea, dermatitis
280
deficiency of folic acid can cause what?
birth defects
281
deficiency of B12 can cause what?
pernicious / macrocytic anemia
282
which population/eating style is most at risk for B12 deficiency?
vegetarians or vegans
283
which vitamin assists with iron absorption?
vitamin C
284
deficiency of vitamin C is called what? what else can it cause?
scurvy can also cause poor wound healing, anemia, infection risk
285
calcium assist with what 3 things?
1. cardiac function2. prothrombin --> thrombin3. nerve impulse
286
deficiency of calcium is called what?
rickets (bowed legs)
287
digestion steps
mastication, deglutition, churning in stomach, churning in small intestine, peristalsis in large intestine
288
which nutritional components are absorbed through intestinal capillaries?
proteins, carbs, simple sugars
289
which nutritional components are absorbed through lymphatic capillaries?
fats
290
where is glucose stored short term?
liver
291
where is glucose stored long term?
adipose tissue
292
what is excreted through lungs?
H2O + CO2
293
signs of poor nutrition with swollen gums and bleeding could be from deficiency of what nutrient?
vitamin C
294
what is a very sensitive and specific marker for nutritional status? (lab)
pre-albumin
295
for enteral feedings, HOB should be at what degree?
30-45, but 90 is OPTIMAL
296
only definitive way to test placement of feeding tube?
xray
297
clinical reasoning involves using what?
evidence based practice
298
what happens during assessment?
collecting data on client's health status
299
what are the 3 components of the assessment?
interview, physical exam, observation
300
objective vs subjective?
objective = observable/measurable subjective = "I feel" statements by client
301
establishing rapport and clarifying roles happens during what phase of interview process?
introductory phase
302
encouraging expression of feelings happens during what phase of interview process?
concluding phase
303
components of physical assessment?
inspection, palpation, percussion, auscultation
304
nursing diagnosis definition; give example
a human response to an actual or potential healthcare problem; ex: constipation, risk for infection
305
components of complete nursing diagnosis statement
diagnostic label, r/t factors and defining characteristics (AEB)
306
what is the PES version of nursing diagnosis statement?
Problem, Etiology, Signs+Symptoms
307
re: nursing process, outcomes need to be what? (3 things)
measurable, realistic, patient-focused
308
which component of the nursing process helps to guide nursing activities and where you establish priority?
planning
309
which component of the nursing process is the action phase and where nursing care is provided?
implementation
310
if during evaluation, you determine the intervention was UNsuccessful, what should happen?
reassess patient and create new plan/try again
311
which tasks can be delegated ? what kind of tasks should never be delegated ?
CAN be delegated - psychomotorCANNOT - anything involving teaching, assessment, evaluation, clinical judgment
312
describe stage 1 pressure ulcer
non-blanchable redness, skin intact
313
describe stage 2 pressure ulcer
top layer of epidermis is gone; partial thickness loss, open ulcer
314
describe stage 3 pressure ulcer
full thickness loss; subcutaneous tissue visible, slough + eschar may be present
315
describe stage 4 pressure ulcer
tendon, muscle, bone visible
316
describe what an unstageable pressure ulcer means
base of wound cannot be seen and therefore not staged
317
how often should people be repositioned?
q 2 hour
318
what are the phases of wound healing + times?
1. hemostasis (immediate clot) - STAT2. inflammatory (dilation) - up to day 33. proliferation (new skin - epithelialization and granulation) - 3 days - weeks4. maturation - weeks - years
319
what is it called when an incision has separated?
dehiscence
320
what is it called when organs have protruded through abdomen?
evisceration
321
what is a tube like pathway between 2 organs or to outside of body called?
fistula
322
if there is a surgical wound, who is the only person that can remove the dressing?
surgeon!!
323
which fire extinguisher should you use for chemical or electrical fires?
CO2 + dry chemical
324
which fire extinguisher should you use for metals?
powder
325
how long it takes to fall asleep refers to what?
sleep latency
326
most vital signs and brain activity DECREASES during which cycle of sleep?
NON-REM
327
when does an infant's circadian rhythm develop?
2-3 months
328
increased sleep latency and decreased overall time of sleep could be indicative of what?
insomnia
329
what is the autoimmune disorder marked by cataplexy + sleep attacks?
narcolepsy
330
what nutrient is extremely important to maintain with restless leg syndrome and periodic limb movement disorder?
iron :)
331
sensory perception is facilitated by which system?
reticular activating system
332
the reticular activating system facilitates what?
sensory perception
333
insomnia, restlessness, decreased ability to concentrate and anxiety could be caused by what?
sensory overload
334
confusion, depression, hallucinations, delirium could be caused by what?
sensory deprivation
335
describe how you would help a visually impaired person ambulate in the hospital
stand on their non-dominant side and have them use their non-dominant hand to hold onto your arm. keep their dominant hand free to explore environment
336
inflammatory response goal = ?
contain the microbe and limit the injury
337
5 signs of local inflammation
erythema, edema, pain, heat, functional impairment
338
5 signs of systemic inflammation
increased WBCs, fever, malaise, muscle aches, anorexia
339
what vital sign changes would you see with inflammatory response?
increased HR, RR, temp
340
endotoxins are released by which microbe? what do they do?
bacteriathey exacerbate the inflammatory response
341
with a compromised immune system, you may see what happen to the WBCs?
decreased level - this means they may not mount an expected immune response
342
re: infection, why do we worry about chronic stress (hyperglycemia)?
it's a perfect environment for bacterial growth
343
re: stages of infection, when do you see non-specific symptoms and when do you see specific symptoms and lab tests would be ordered?
non-specific : prodromalspecific/labs: acute
344
what is sepsis?
systemic inflammatory response that can cause shock and decreased perfusion
345
s + s of SIRS? *need 2 to call it*
hyper or hypothermia, >90HR, >20RR, >12k or <4k WBC
346
what is leukocytosis?
increase in WBCs
347
a shift to the left is referring to what? when do we see this?
more immature granulocytes trying to fight infection b/c not enough neutrophils can be produced. we see this with prolonged/chronic infection
348
what's an early sepsis indicator? this level will rise? (>4)
lactate
349
primary goal of home health care?
self-care and help them function on their own :)
350
home health care is all about what?
maintaining ADLs
351
re: discharge planning, what is basic/universal?
self care and illness teaching
352
re: discharge planning, what is simple referral?
referring to community resources
353
re: discharge planning, what is complex referral?
referring to discharge planner, LTCF, rehab facility
354
what is the priority (easiest/quickest) intervention for oxygenation issues?
raise HOB :)
355
what would you see clinically with elevated CO2 in the body?
tachypnea
356
what moves from the pulmonary artery to the alveoli?
CO2
357
what moves from the alveoli to the pulmonary atery?
O2
358
what is the reflexive response to airway irritation?
cough
359
level 1 SOB = ?
after walking self-paced mile
360
level 2 SOB = ?
after walking flight of stairs / 100 yds
361
level 3 SOB = ?
impacts ADLs***
362
level 4 SOB = ?
no activity
363
what is orthopnea?
SOB while lying down
364
what is tactile fremitus?
being able to hear the vibration of air against chest wall
365
what can increase tactile fremitus?
consolidation / fluid in the lungs
366
what can decrease tactile fremitus?
fluid in the pleural space
367
describe crackles
short, popping sounds - alveoli popping open - caused by fluid build up from pneumonia, CHF, pulmonary edema *can't be cleared by coughing*
368
describe rhonchi
snoring, moaning sound - caused by obstruction or bronchitis - *may be cleared by couching*
369
describe wheeze
musical, high-pitched sound - caused by asthma or obstruction or emphysema
370
describe pleural friction rub
scratchy, grating sound - caused by inflammation of the pleura of lungs
371
O2 saturation goal for healthy person
> 95%
372
describe end tidal carbon monoxide monitoring
more accurate than pulse oximetry; real time data; attached to nasal cannula
373
are pulmonary functioning tests better for acute or chronic breathing issues?
chronic
374
for mild level of hypoxemia, what would you see for PaO2?
60-80
375
for mild level of hypoxemia, what would you see for SpO2?
91-95
376
for moderate level of hypoxemia, what would you see for PaO2?
40-60
377
for moderate level of hypoxemia, what would you see for SpO2?
74-91
378
for severe level of hypoxemia, what would you see for PaO2?
<40
379
for severe level of hypoxemia, what would you see for SpO2?
<74
380
what is the normal pH value?
3.5-4.5
381
what is the normal PaCO2 value?
35-45
382
what is the normal HCO3 value?
22-26
383
what is the normal PaO2 value?
80-100
384
what is the normal SpO2 value?
95-100%
385
what is the normal ETCO2? (end tidal)
35-45
386
re: oxygenation, if client has one bad lung, how should they be positioned?
bad lung UP, so it can perfuse and work some :)
387
ambulation + incentive spirometer can help to prevent what?
pneumonia and atelectasis
388
re: nasal cannula, what is % of O2 for 1L?
24%
389
re: nasal cannula, what is % of O2 for 2L?
28%
390
re: nasal cannula, what is % of O2 for 3L?
32%
391
re: nasal cannula, what is % of O2 for 4L?
36%
392
at how many liters of O2 therapy should you add humidifier?
at 4L
393
most common cause of stridor + intervention for it
tongue obstruction --> lay on side
394
The nurse is caring for a client with the following vital signs: Blood pressure 128 / 72 mm Hg Heart Rate 110 beats per minute Respiratory Rate 22 breaths per minute Oxygen saturation 98% Pain level: headache reported at a 2/10 Temperature: 40 degrees Celcius The PRN orders for the client include acetaminophen for fever, metoprolol for tachycardia, oxygen for hypoxia, and oxycodone for pain. Which intervention takes priority?
Acetaminophen The client has a fever, tachycardia, tachypnea and pain at a 2/10. A fever correlates with tachycardia and tachypnea and correcting the fever will address all of these concerns in addition to the headache. Metoprolol would only address the heart rate. Oxycodone would address pain and decrease respiratory rate. Oxygen may help with respiratory rate but with saturation of 98% oxygen is not indicated.
395
sleep latency [...]
sleep latency how long it takes to fall asleep
396
sleep health (3) elements [...]
sleep health (3) elements ∙Sleep latency ∙How often one wakes up ∙Is it easy to wake up
397
3 physical Consequences of poor sleep (what 3 things increase) [...]
3 physical Consequences of poor sleep (what 3 things increase) ∙Increased blood pressure ∙Increased cortisol ∙Increased levels of cytokines
398
NREM vs REM NREM : tissue restorative processes REM: [...]
NREM vs REM NREM : tissue restorative processes REM: cognitive restoration and memory
399
NREM vs REM NREM : [...] REM: cognitive restoration and memory
NREM vs REM NREM : tissue restorative processes REM: cognitive restoration and memory
400
how long does it take average adult to reach REM? [...]
how long does it take average adult to reach REM? 90 minutes
401
NREM VS REM and brain activity: [...]
NREM VS REM and brain activity: NREM: decreases from awake. REM: increases in some areas compared to NREM
402
NREM vs REM HR and BP: NREM both decrease from wakefullness REM [...]
NREM vs REM HR and BP: NREM both decrease from wakefullness REM increases compared to NREM and BP highly variable
403
NREM vs REM HR and BP: NREM [...] REM increases compared to NREM and BP highly variable
NREM vs REM HR and BP: NREM both decrease from wakefullness REM increases compared to NREM and BP highly variable
404
What physiologic variabes decrease in NREM and which increase (when compared to wakefulness) ? Decrease (9): [...] increase: (1) airway resistance
What physiologic variabes decrease in NREM and which increase (when compared to wakefulness) ? Decrease (9): brain activity, HR and BP, SNS activity, Muscle tone, Blood flow to the brain, respirations, body temp, swallowing increase: (1) airway resistance
405
What physiologic variabes decrease in NREM and which increase (when compared to wakefulness) ? Decrease (9): brain activity, HR and BP, SNS activity, Muscle tone, Blood flow to the brain, respirations, body temp, swallowing increase: (1) [...]
What physiologic variabes decrease in NREM and which increase (when compared to wakefulness) ? Decrease (9): brain activity, HR and BP, SNS activity, Muscle tone, Blood flow to the brain, respirations, body temp, swallowing increase: (1) airway resistance
406
congruent communication vs incongruent communication [...]
congruent communication vs incongruent communication when the verbal and the non verbal align is congruent and incongruent is when they don't
407
What are some situations where communication may not occur? ∙When the patient is‚Ķ [...]
What are some situations where communication may not occur? ∙When the patient is‚Ķ highly emotional, asleep, too many visits from HCP, defensive, showing manipulative or impulsive behaviors
408
3 phases of the nurse patient relationship [...]
3 phases of the nurse patient relationship ∙Orientation ∙Working ∙Termination
409
What are the three elements of orientation, when/where does it occur? [...]
What are the three elements of orientation, when/where does it occur? ∙Introduction occurs during report which should always be given at the bedside. ∙Agreements ∙Goal
410
Aspects of the working phase of nurse-pt relationship: [...]
Aspects of the working phase of nurse-pt relationship: develop solution, nurse is advocate, nurse is coach,
411
aspects of the termination phase of the nurse pt relationship and when does it occur: [...]
aspects of the termination phase of the nurse pt relationship and when does it occur: ∙Evaluate patient response to solutions ∙Discharge planning ∙when? end-of-shift or discharge
412
advocacy in the nurse pt relationship: [...]
advocacy in the nurse pt relationship: AVOID "your doctor is right" mentality make sure pt has the needed knowledge facilitate communication between doctor and patient. make sure pt has access to other disciplines or treatments
413
what is empathy [...]
what is empathy putting yourself in their shoes. feeling what they feel from their frame of reference
414
positive regard in nurse pt relationship: [...]
positive regard in nurse pt relationship: accepting a patient as they are in a non judgemental way. IE the pt is not their disease.
415
3 elements of therapeutic communication: [...]
3 elements of therapeutic communication: ∙Empathy Self Awareness and Self-Reflection ∙Positive regard
416
cognitive reframing: [...]
cognitive reframing: alter your perception of something to a more positive light ie: instead of - what if I mess up med admin? think of : what can I do to prepare for med admin?
417
therapeutic techniques: offering self: [...] open ended questions: [...] opening remarks: [...] restatement: repeating to ensure you understand reflection: a question directed at a patient to clarify what they mean. ie: this medicine is icky! You don't like the way it tastes focusing: asking goal directed questions to direct the pt's train of thought.
therapeutic techniques: offering self: making oneself available to listen to the patient ie, I will walk with you for awhile open ended questions: asking questions that envorage the patient to express concerns opening remarks: using general staements based upon observations to initiate dialogue restatement: repeating to ensure you understand reflection: a question directed at a patient to clarify what they mean. ie: this medicine is icky! You don't like the way it tastes focusing: asking goal directed questions to direct the pt's train of thought.
418
therapeutic techniques: offering self: making oneself available to listen to the patient ie, I will walk with you for awhile open ended questions: asking questions that envorage the patient to express concerns opening remarks: using general staements based upon observations to initiate dialogue restatement: [...] reflection: [...] focusing: [...]
therapeutic techniques: offering self: making oneself available to listen to the patient ie, I will walk with you for awhile open ended questions: asking questions that envorage the patient to express concerns opening remarks: using general staements based upon observations to initiate dialogue restatement: repeating to ensure you understand reflection: a question directed at a patient to clarify what they mean. ie: this medicine is icky! You don't like the way it tastes focusing: asking goal directed questions to direct the pt's train of thought.
419
encouraging elaboration: [...]
encouraging elaboration: helping patient to describe more fully their concerns or the thing you're discussing
420
therapeutic techniques seeking clarification: [...] silence:[...] summarizing: [...] looking at alternatives: [...]
therapeutic techniques seeking clarification: when you don't understand what the pt is saying silence:allowing for a pause that gives nurse and patient time to think about convo summarizing: summarizing the important parts of a convo by condensing what was said. looking at alternatives: helps the patient see options. ie what will we do differently next tiem you feel sad?
421
Tips for communication with children and adolescents [...]
Tips for communication with children and adolescents ∙Eye level ∙Speak gently and calm ∙Control body movements
422
tips for using an interpreter: [...]
tips for using an interpreter: speak to patient directly, avoid using family member, allow plenty of time to have discussion
423
what to NOT do in pt communication(4) and relationships(2) [...]
what to NOT do in pt communication(4) and relationships(2) false reassurances "you will be fine" giving advice changing the subject "lets stop talking about your past traume being moralistic "you are a good patient" non professional involvement in their lives savior menatlity, that the patient needs you to recieve the best care possible.
424
nonspecific natural defenses: [...]
nonspecific natural defenses: skin, cilia, secretions(tears, gastric juice), inflammation, fever and phagocytosis
425
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, [...] b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
426
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do [...] basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
427
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? [...] monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
428
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of [...] t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
429
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? [...]
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
430
what is the action of each WBC neutrophils: what do they do, what do they kill [...] eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
what is the action of each WBC neutrophils: what do they do, what do they kill phagocytes, generate fever. break down bacteria and parasites. eosinophils:what do they do increase in allergic reactions and parasitic conditions basophils: what do they do, what are they made of heparin and histamine in their granules unkown purpose t-lymphocytes: types? what do they do, what do they destroy, synthesis of antibodies. recognize antigens. destroy bacteria, viruses and cancer cells. stimulate b lymphcotes and macrophages. three types of them: helper, killer and supperssor. b- lymphocytes: what do they do ? make antibodies, humoral immunity, memory cells to produce lasting immunity to an antigen monocytes: what do they do ? cells that dispose of cell debris rise in late stage of acute infections
431
Inflammatory Response ∙What is the goal? [...] ∙What are the five signs of local inflammation? ∙pain, edema, erythema, heat, func. impairment. HEP FE ∙What are the five signs of systemic inflammation? fever, leukocytosis, malaise, anorexia, sepsis, MFALS
Inflammatory Response ∙What is the goal? ∙isolate infectionand contain microorganisms ∙What are the five signs of local inflammation? ∙pain, edema, erythema, heat, func. impairment. HEP FE ∙What are the five signs of systemic inflammation? fever, leukocytosis, malaise, anorexia, sepsis, MFALS
432
Inflammatory Response ∙What is the goal? ∙isolate infectionand contain microorganisms ∙What are the five signs of local inflammation? ∙pain, edema, erythema, heat, func. impairment. HEP FE ∙What are the five signs of systemic inflammation? [...]
Inflammatory Response ∙What is the goal? ∙isolate infectionand contain microorganisms ∙What are the five signs of local inflammation? ∙pain, edema, erythema, heat, func. impairment. HEP FE ∙What are the five signs of systemic inflammation? fever, leukocytosis, malaise, anorexia, sepsis, MFALS
433
Inflammatory Response ∙What is the goal? ∙isolate infectionand contain microorganisms ∙What are the five signs of local inflammation? [...] ∙What are the five signs of systemic inflammation? fever, leukocytosis, malaise, anorexia, sepsis, MFALS
Inflammatory Response ∙What is the goal? ∙isolate infectionand contain microorganisms ∙What are the five signs of local inflammation? ∙pain, edema, erythema, heat, func. impairment. HEP FE ∙What are the five signs of systemic inflammation? fever, leukocytosis, malaise, anorexia, sepsis, MFALS
434
•What changes in our routine vital signs may we see with the inflammatory response? [...]
•What changes in our routine vital signs may we see with the inflammatory response? increase HR, RR, temp
435
types of immunity ∙Cellular Immunity [...] ∙Humoral Immunity ∙B lymphocytes have a memory and remain in lymphoid tissue to respond
types of immunity ∙Cellular Immunity ∙T cells have a memory of an antigen for a rapid response ∙Humoral Immunity ∙B lymphocytes have a memory and remain in lymphoid tissue to respond
436
types of immunity ∙Cellular Immunity ∙T cells have a memory of an antigen for a rapid response ∙Humoral Immunity [...]
types of immunity ∙Cellular Immunity ∙T cells have a memory of an antigen for a rapid response ∙Humoral Immunity ∙B lymphocytes have a memory and remain in lymphoid tissue to respond
437
active vs passive immunity ∙Active Immunity (types) [...] ∙Passive Immunity (types) [...]
active vs passive immunity ∙Active Immunity (types) ∙Natural:get virus and body fights it off ∙Vaccination ∙Passive Immunity (types) ∙Placenta to fetus ∙Breast milk to newborn ∙Direct transfusion of antibodies
438
‚Ä¢Opportunistic infection ∙What type of antigen does this refer to? [...]
‚Ä¢Opportunistic infection ∙What type of antigen does this refer to? an antigen that normally wouldn't affect a healthy host
439
‚Ä¢Endotoxins ∙Released by which antigen?[...]
‚Ä¢Endotoxins ∙Released by which antigen?gram negative bacteria
440
•What does a compromised immune system mean? [...]
•What does a compromised immune system mean? decrease in WBC count and the body can no longer effectively fight off infections
441
what can compromise a host? (5) [...]
what can compromise a host? (5) ∙Impaired skin integrity ∙Impaired body function ∙Inadequate nutrition ∙Prolonged stress ∙Medicine or medical problems
442
Four Stages of an Infection [...]
Four Stages of an Infection 1.Incubation: Pathogen enters, Initial symptoms 2. Prodromal: Vague nonspecific symptoms ie Nausea, fever, weakness, aches, pains 3. Acute Phase: Specific symptoms. Lab tests. Symptom resolution 4.Convalescence. Antibodies formed. Body returns to normal
443
sepsis: [...]
sepsis: severe infection in the blood stream
444
what do endotoxins do in sepsis? [...]
what do endotoxins do in sepsis? they induce septic shock
445
what is SIRS and what are its symptoms? [...]
what is SIRS and what are its symptoms? sytemic inflammatory response two or more of these sxs in order to be SIRS fever or hypothermia tachycardia tachypnea change in WBC outside of normal range
446
consideration with fever in children: [...]
consideration with fever in children: high fevers are more common in children because they can't thermoregulate as well.
447
fever considerations in older adults : [...]
fever considerations in older adults : fevers will rarely happen or not at all because hypothalamus function is more likely impaired.
448
fever after surgery, is it ok? [...]
fever after surgery, is it ok? one day after surgery it's normal, two days or more after surgery it's thought to be abnormal
449
what happens during the flush/crisis phase of fever? [...]
what happens during the flush/crisis phase of fever? shiver is decreasing and diaphoresis increasing
450
Pain and what the pain type may indicate when swallowing? [...] when peeing? [...] when breathing? [...] at surg site? [...]
Pain and what the pain type may indicate when swallowing? strep when peeing? UTI when breathing? resp infection at surg site? surg infection
451
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452
Urinary or Gastrointestinal Symptoms ∙What appearance might urine or sputum have with an infection? white/yellowish,cloudy ∙What symptoms occur when the small or large intestine is inflamed from a pathogen? [...]
Urinary or Gastrointestinal Symptoms ∙What appearance might urine or sputum have with an infection? white/yellowish,cloudy ∙What symptoms occur when the small or large intestine is inflamed from a pathogen? diarrhea, increased perstalsis, hyperactive bowel sounds
453
Urinary or Gastrointestinal Symptoms ∙What appearance might urine or sputum have with an infection? [...] ∙What symptoms occur when the small or large intestine is inflamed from a pathogen? diarrhea, increased perstalsis, hyperactive bowel sounds
Urinary or Gastrointestinal Symptoms ∙What appearance might urine or sputum have with an infection? white/yellowish,cloudy ∙What symptoms occur when the small or large intestine is inflamed from a pathogen? diarrhea, increased perstalsis, hyperactive bowel sounds
454
what is an abcess? [...]
what is an abcess? pocket of purulent drainage
455
what is leukocytosis? [...]
what is leukocytosis? increase in WBC count
456
‚Ä¢Neutrophils ∙Normally about [...]% of WBCS ∙Higher number means [...]
‚Ä¢Neutrophils ∙Normally about 50% of WBCS ∙Higher number means body is fighting infection well
457
‚Ä¢Shift to the left meaning? [...] ∙Sign of [...] [...]
‚Ä¢Shift to the left meaning? ∙More immature granulocytes (bands) used to fight infection ∙Sign of persistent or severe infection mature neutrophils have depleted
458
‚Ä¢Absolute Neutrophil Count (ANC) ∙Reduced with what patients? [...]
‚Ä¢Absolute Neutrophil Count (ANC) ∙Reduced with what patients? chemotherapy pt
459
Neutropenic Precautions , why? [...]
Neutropenic Precautions , why? (ANC too low)
460
Neutropenic Precautions what to do? [...]
Neutropenic Precautions what to do? - hand hygiene ∙Limit visitors and avoid crowds ∙If a visitor is coming ∙Visitors will wear mask, gloves and gown to be able to enter the room ∙When patient leaves the room, they have to wear a mask ∙Gentle oral care, avoid flossing, Avoid razors, no rectal temperatures ∙Remove stagnant water, fresh flowers, or potted plants
461
what do low neutrophil levels indicate? [...]
what do low neutrophil levels indicate? persistent infection
462
‚Ä¢Erythrocyte Sedimentation Rate --Increased with infection --Can be impacted by other factors, so not used alone for diagnosis ∙Lactate [...]
‚Ä¢Erythrocyte Sedimentation Rate --Increased with infection --Can be impacted by other factors, so not used alone for diagnosis ∙Lactate ∙from Anerobic metabolism ∙Decreased oxygen to tissues ∙Sepsis indicator ∙Lactate changes occur before hypotension sets in from shock
463
‚Ä¢Erythrocyte Sedimentation Rate [...] ∙Lactate ∙from Anerobic metabolism ∙Decreased oxygen to tissues ∙Sepsis indicator ∙Lactate changes occur before hypotension sets in from shock
‚Ä¢Erythrocyte Sedimentation Rate --Increased with infection --Can be impacted by other factors, so not used alone for diagnosis ∙Lactate ∙from Anerobic metabolism ∙Decreased oxygen to tissues ∙Sepsis indicator ∙Lactate changes occur before hypotension sets in from shock
464
types of cultures: [...]
types of cultures: ∙Blood, nasal swab, sputum, throat, wound, body cavity, stool
465
•Situations that call for obtaining cultures when an infection is suspected [...]
‚Ä¢Situations that call for obtaining cultures when an infection is suspected ∙Productive cough ∙Invasive line ∙Purulent drainage ∙Parasites
466
if you administer abx at 800, what level is drawn at 730? peak or trough? [...]
if you administer abx at 800, what level is drawn at 730? peak or trough? trough
467
what should you do if you find edema in the extremeties? [...]
what should you do if you find edema in the extremeties? elevate extremeties
468
how often should a person be turned? [...]
how often should a person be turned? every 2 hrs
469
can you give aspirin to kids? NO risk of [...] must be older than [...]
can you give aspirin to kids? NO risk of reyes syndrome must be older than 3 yrs
470
how do you manage a fever? [...]
how do you manage a fever? increase fluids and give antipyretics
471
some examples of comfort measures for a patient: [...]
some examples of comfort measures for a patient: warm blankets, analgesics, tepid bath
472
when treating a fever, do you want to make a patient shiver more? [...]
when treating a fever, do you want to make a patient shiver more? no! try not to make them shiver more. IE dont' give them cold water if thye're hot.
473
where does community health take place? [...]
where does community health take place? anywhere outside of the hospital
474
What factors into the functional ability of patients in home health? [...]
What factors into the functional ability of patients in home health? ∙Developmental stage ∙ ∙Health promotion and safety ∙ ∙Cognitive and sensory deficits ∙ ∙Decreased mobility ∙Altered elimination ∙ ∙Altered nutrition
475
what does a nurse need to function in community health? [...]
what does a nurse need to function in community health? a generalist background, knowledge of resources to connect pt with what they need.
476
‚Ä¢Initiation [...] ∙Pre-visit [...] ∙In-home [...] ∙Termination [...] ∙Post-visit [...]
‚Ä¢Initiation Figure out the reason or purpose Contact family ∙Pre-visit Set up initial visit Communicate purpose to family ∙In-home Build rapport Set goals Nursing process ∙Termination Summarize visit Plan future visits ∙Post-visit Documentation Plan for next visit
477
Information home health collects about the home [...]
Information home health collects about the home is it clean, safe, is it kept up, infestation?, functioning utilities, adequate food storage
478
what level of discharge plan is each? refer someone to skilled nursing facility [...] referring someone to a support group[...] teaching a pt with diabetes [...]
what level of discharge plan is each? refer someone to skilled nursing facility complex referring someone to a support groupsimple teaching a pt with diabetes basic, universal
479
who can be a case manager: [...]
who can be a case manager: social worker, nurse, other member of HC team
480
home health or case management, which takes into account ability to pay for care? [...] home health or case management, which is focused on promote optimal health [...]
home health or case management, which takes into account ability to pay for care? case management home health or case management, which is focused on promote optimal health home health
481
Safety concerns for Newborn and Infant ∙Sleep? [...] ∙Dangerous objects ∙Cords, tablecloths, plastic bags, bottles, cans ∙In the hospital ∙Bulb syringe and suction device
Safety concerns for Newborn and Infant ∙Sleep? ∙On the back to prevent sudden infant death syndrome (SIDS) ∙Dangerous objects ∙Cords, tablecloths, plastic bags, bottles, cans ∙In the hospital ∙Bulb syringe and suction device
482
Safety concerns for Newborn and Infant ∙Sleep? ∙On the back to prevent sudden infant death syndrome (SIDS) ∙Dangerous objects [...] ∙In the hospital ∙Bulb syringe and suction device
Safety concerns for Newborn and Infant ∙Sleep? ∙On the back to prevent sudden infant death syndrome (SIDS) ∙Dangerous objects ∙Cords, tablecloths, plastic bags, bottles, cans ∙In the hospital ∙Bulb syringe and suction device
483
Safety concerns for Newborn and Infant ∙Sleep? ∙On the back to prevent sudden infant death syndrome (SIDS) ∙Dangerous objects ∙Cords, tablecloths, plastic bags, bottles, cans ∙In the hospital [...]
Safety concerns for Newborn and Infant ∙Sleep? ∙On the back to prevent sudden infant death syndrome (SIDS) ∙Dangerous objects ∙Cords, tablecloths, plastic bags, bottles, cans ∙In the hospital ∙Bulb syringe and suction device
484
Safety concerns for Toddler and Preschooler bathtub? inlcude nonslip mats safety zones: [...]
Safety concerns for Toddler and Preschooler bathtub? inlcude nonslip mats safety zones: zones where kids can safely be in the kitchen for example
485
Safety concerns for Toddler and Preschooler bathtub? [...] safety zones: zones where kids can safely be in the kitchen for example
Safety concerns for Toddler and Preschooler bathtub? inlcude nonslip mats safety zones: zones where kids can safely be in the kitchen for example
486
safety teachings for school age and adolescent children: [...]
safety teachings for school age and adolescent children: buddy sytem, peer pressure, sexual health, appropriate equipment for the activity
487
Safety concerns for Adults and Older Adults [...]
Safety concerns for Adults and Older Adults vehicle accidents functional changes related to injuries medication related injuries (like falling)
488
Consequences of Falls [...]
Consequences of Falls ∙Pain ∙ ∙Disability ∙ ∙Financial ∙ ∙Death
489
Neurological Assessments related to Safety [...]
Neurological Assessments related to Safety ∙Judgment ∙Sensory ∙Vision and Hearing ∙Orientation? Are they confused? ∙Mental Status
490
do you need an order to impose a restraint? [...]
do you need an order to impose a restraint? yes!
491
how do you know when to remove a restraint? [...]
how do you know when to remove a restraint? theyre only ordered for a specific time period
492
Principles with Restraints restraints must be ordered before they are applied T or F? T ∙Nurses must go through training to use restraints ∙Specific documentation is required for restraints (4) ∙Behavior leading to restraint, alternatives to restraints attempted, release from restraints, patient needs being met ∙Nursing Considerations with restraints [...]
Principles with Restraints restraints must be ordered before they are applied T or F? T ∙Nurses must go through training to use restraints ∙Specific documentation is required for restraints (4) ∙Behavior leading to restraint, alternatives to restraints attempted, release from restraints, patient needs being met ∙Nursing Considerations with restraints Ensure restraints do not cause injury Facilitate ADLs and comfort
493
Principles with Restraints restraints must be ordered before they are applied T or F? [...] ∙Nurses must [...] to use restraints ∙Specific documentation is required for restraints (4) ∙Behavior leading to restraint, alternatives to restraints attempted, release from restraints, patient needs being met ∙Nursing Considerations with restraints Ensure restraints do not cause injury Facilitate ADLs and comfort
Principles with Restraints restraints must be ordered before they are applied T or F? T ∙Nurses must go through training to use restraints ∙Specific documentation is required for restraints (4) ∙Behavior leading to restraint, alternatives to restraints attempted, release from restraints, patient needs being met ∙Nursing Considerations with restraints Ensure restraints do not cause injury Facilitate ADLs and comfort
494
Principles with Restraints restraints must be ordered before they are applied T or F? T ∙Nurses must go through training to use restraints ∙Specific documentation is required for restraints (4) [...] ∙Nursing Considerations with restraints Ensure restraints do not cause injury Facilitate ADLs and comfort
Principles with Restraints restraints must be ordered before they are applied T or F? T ∙Nurses must go through training to use restraints ∙Specific documentation is required for restraints (4) ∙Behavior leading to restraint, alternatives to restraints attempted, release from restraints, patient needs being met ∙Nursing Considerations with restraints Ensure restraints do not cause injury Facilitate ADLs and comfort
495
can a student nurse apply restraints? [...]
can a student nurse apply restraints? NO NO NO
496
RACE and PASS (Fire Safety) RACE: [...] PASS: [...]
RACE and PASS (Fire Safety) RACE: rescue the pt pull the alarm confine the fire evacuate PASS: pull the pin aim the nozzle squeeze the handle sweep back and forth
497
three ways to protect yourself from radiation? [...]
three ways to protect yourself from radiation? minimize time of exposure maximize distance from source use appropriate shielding
498
what to do when caring for a pt that is exposed to radiation [...]
what to do when caring for a pt that is exposed to radiation wear lead shield or apron use gloves (even when handling bodily fluids) have patient provide self care as much as possible
499
levels of disease prevention seeks to prevent a disease or condition [...]
levels of disease prevention seeks to prevent a disease or condition primary prevention
500
immunizations are an example of [...] prevention
immunizations are an example of primary prevention
