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Therapeutic of Nursing Care > Test 1 > Flashcards

Test 1 Flashcards

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1
Q

Nosocomial Infection

A

Hospital acquired infection

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2
Q

Iatrogenic Infection

A

An infection that occurs after medical or surgical procedure

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3
Q

Medical Asepsis

A

clean technique
disinfection

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4
Q

Surgical Asepsis

A

sterile technique
sterilization

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5
Q

Disinfection

A

cleaning something to destroy bacteria

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6
Q

Sterilization

A

A procedure to kill all organisms

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7
Q

How does the Infection Cycle work?

A

infectious agent
reservoir
portal of exit
means of transmission
portal of entry
susceptible host

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8
Q

Which of the following is the most significant and commonly found infection-causing agent in healthcare institutions?
Bacteria
Fungi
Viruses
Mold

A

Bacteria

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9
Q

Virus

A

smallest microorganism
infections: common cold and do not respond to antibiotics

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10
Q

Fungi (molds and yeasts)

A

plantlike organisms
can cause infection and are present in the air, soil, and water

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11
Q

What are factors that affect an organisms potential to produce disease?

A

number of microorganisms
Virulence of microorganisms
Competence of persons immune system
Length and intimacy of contact between person and microorganism

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12
Q

What are possible reservoirs for microorganisms?

A

humans-carriers
animals- vectors
soil- vehicles
food, water, milk- vehicles
inanimate objects- vehicles or fomites

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13
Q

Which one of the following infectious agents or diseases may be spread by touching a contaminated inanimate article?
Rabies
Giardia
E. Coli
Influenza

A

Influenza

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14
Q

What are common portals of exit?

A

respiratory
gastrointestinal
genitourinary tracts
breaks in skin
blood and tissue

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15
Q

What is direct contact?

A

close proximity with susceptible host
EX: touching, kissing, and sexual intercourse

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16
Q

What is indirect contact?

A

vectors: nonhuman organisms
fomites: inanimate objects

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17
Q

Airborne vs Droplet transmission

A

Airborne: less than 5
Droplet: greater than 5

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18
Q

Body’s defense against infection

A

body’s normal flora (help to keep harmful bacteria from invading the body)
inflammatory response
immune response

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19
Q

Factors affecting host susceptibility

A

intact skin and mucus membranes
normal ph levels
body’s wbc
age, sex, race. hereditary factors
immunization, natural, or acquired
fatigue, climate, nutritional, and general health status
stress
use of invasive or indwelling medical devices

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20
Q

In which of the following stages of infection is the patient most contagious?
incubation
prodromal
full stage
convalescent

A

prodromal stage

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21
Q

Stages of infection

A

1.Incubation Period: organisms growing and multiplying

2.Prodromal Stage: person is most infectious, vague and non specific signs of disease
patient unaware
Malaise (discomfort)
Fatigue (low fever)

3.Full stage of illness: presence of signs and symptoms

4.Convalescent Period: recovery from the infection

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22
Q

Laboratory Data Indicating Infection

A

elevated WBC
-4,500 to 10,000
increase in specific types of WBC
elevated erythrocyte sedimentation rate
0-15mm/hr for males
0-20mm/hr for females
presence of pathogen in urine, blood, sputum, or draining cultures

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23
Q

What are antibiotic resistant organisms?

A

have contact transmission

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24
Q

What are factors predisposing patients to nosocomial infection?

A

use of invasive medical devices
-urinary catheter or venous access catheter

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25
Q

What are some antibiotic resistant organisms developed in hospitals?

A

c diff
mrsa
visa
vrsa
vre

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26
Q

Transient Flora

A

attached loosely on skin
removed with relative ease

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27
Q

Resident Flora

A

found in creases in skin
requires friction with brush to remove

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28
Q

T or F
After inserting nasogastric tubes, a nurse found that the gloves remained clean. Bc her hands were clean when she put her gloves on and the gloves werentt dirty, it is not necessary to preform hand hygiene on nonsoiled hands

A

f

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29
Q

What to do for clean technique?

A

routine hand washing
using non sterile gloves when touching intact skin, intact mucus membranes or dirty items

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30
Q

When is clean technique appropriate for?

A

taking BP
examining patients
feeding patients

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31
Q

What to use for aseptic technique?

A

sterile gloves
used for invasive procedures
antiseptic on patients skin
used in clean and dedicated area

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32
Q

When is aseptic technique appropriate?

A

placing an intravenous catheter
placing a urinary catheter

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33
Q

What are some standard precautions used in care of all hospitalized patients?

A

hand hygiene
wear nonsterile gloves when touch blood, body fluids, secretions, non-intact skin
wear PPE
respiratory hygiene
use safe injection practices
avoid recapping used needles

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34
Q

What are some PPE?

A

gloves, gowns, masks, protective eye gear

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35
Q

Which one should be removed first?

A

gloves

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36
Q

Last action after removing ppes?

A

N95

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37
Q

Transmission Based Precautions?

A

Contact: private room, PPE
Droplet: Private room, PPE
Airborne: private room , PPE, negative air pressure, N95

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38
Q

Contact precautions

A

infections by multidrug resistant organism

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39
Q

Droplet is used for what precautions

A

mumps, rubella, diphtheria, adenovirus infection

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40
Q

Airborne is used for what precautions

A

Tuberculosis, measles, varicella

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41
Q

When caring for a patient who has an infection such as rubella, mumps, or diptheria, which of the following precautions would be appropriate?
Contact
droplet
airborne
exposure

A

droplet

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42
Q

Carriers that transmit organisms from one living thing to another, such as mosquitos, ticks, lice, are known as:

A

vectors

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42
Q

Infection control measures supported evidence that when implemented together improve patient outcomes are known as:
policies
standards
requirements
bundles

A

bundles

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43
Q

Acquiring disease via a vector or fomite is an example of:

A

indirect contact

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44
Q

What does the skeletal system do?

A

Supports soft tissues of body
Protects crucial components of the body
Provides storage areas for minerals and fats
Produce blood cells

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45
Q

Which of the following classifications describes the bones located in the wrist?
Long bones
Short bones
Flat bones
Irregular bone

A

Short bones

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46
Q

What are long bones used for?

A

height and length

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47
Q

What are flat bones used for?

A

for structural contour/ shape

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48
Q

What are short bones used for?

A

for movement

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49
Q

What are irregular bones used for?

A

for protecting nervous tissue and bringing support to the pharnyx and trachea

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50
Q

What are sesamoid bones?

A

protects tendons from stress and tear

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51
Q

What is flexion?

A

bending

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52
Q

Extension

A

state of being straight lined

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53
Q

Hyperextension

A

exaggerated extension

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54
Q

Abduction

A

Movement away from midling

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55
Q

Adduction

A

movement toward midline

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56
Q

Circumduction

A

turning in a circular motion

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57
Q

Dorsiflexion

A

Backward bending of the foot

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58
Q

Plantar flexion

A

flexion of the foot

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59
Q

Internal rotation

A

a body part turning on its axis toward the midline

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60
Q

External rotation

A

a body part turning on its axis away from the midline

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61
Q

Pronation

A

lying on the abdomen, turning hands down

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62
Q

Supination

A

assumption of spine position

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63
Q

Inversion

A

inward movement of foot

64
Q

Eversion

A

outward movement of foot

65
Q

Hinge Joint

A

flexion/extension
EX: knees and elbow

66
Q

Pivot joint

A

rotation
EX: neck

67
Q

Ball and socket joint

A

Flexion/extension/hyperextension/abduction/adduction/internal and external rotation/circumduction
EX: shoulder and hip

68
Q

Saddle joint

A

Flexion/extension/abduction/adduction/circumduction
EX: Carpometacarpal joint (thumb)

69
Q

Condyloid joint

A

Flexion/extension/abduction/adduction/circumduction
EX: metacarpophlangeal (wrist)

70
Q

Gliding joint

A

gliding movements
EX:intercarpal joints (palm)

71
Q

A nurse stretches out a patients leg and moves it away from the body. This is an example of what type of body movement?
A. Abduction
B. Flexion
C. Circumduction
D. Dorsiflexion

A

A. Abduction

72
Q

What is skeletal muscle?

A

framework that supports soft tissues
provides protection
furnishes attachment surfaces
stores minerals/fats
produces blood cells

73
Q

What is a cardiac muscle?

A

forms bulk of heart
produces heart contraction

74
Q

What is smooth or visceral muscle?

A

forms walls of hollow organs, bvs, and tubes

75
Q

What are the 4 skeletal muscles function?

A

motion
maintenance of posture
protection
heat production

76
Q

What is isotonic exercise?

A

same tension: muscle contracts and muscle length changes

77
Q

What is isometric exercise?

A

same length: muscle contracts but muscle length does not change

78
Q

What is isokinetic exercise?

A

same speed: muscle contracts and shortens with a constant speed and resistance

79
Q

Isotonic example

A

swimming, bicycling, walking, jogging

80
Q

Isometric example

A

yoga, squats

81
Q

isokinetic exercise

A

weight lifting, stationary bike

82
Q

Jogging is an example of isokinetic exercise. T or F

A

False

83
Q

Supine positon

A

on back

84
Q

Prone position

A

face down

85
Q

Right and Left lateral recumbent

A

lying down on side

86
Q

Fowler’s positon

A

head is upright

87
Q

Trendelenburg position

A

-lie in supine
-head is lower than legs
-used when BP is low

88
Q

Reverse Trendelenberg Position

A

head higher than legs
-used to reduce blood in brain

89
Q

High fowlers position degree

A

80-90 degrees

90
Q

Standard Fowler’s Position Degree

A

45-60

91
Q

Semi-Fowlers Degree

A

30-45
-most pts in hospital

92
Q

Low-Fowlers degree

A

15-30 degrees

93
Q

Dorsal recumbent position

A

pt lies flat on the back with head and shoulders slightly elevated with a pillow

94
Q

Lithotomy position

A

used for pelvic exams or child birth

95
Q

Sims position

A

pt lies on stomach but lower arm is behind the pt and upper arm is flexed
-middle of prone and lateral

96
Q

Oblique Position

A

places less pressure on trochanter and saccrococcygeal area
-middle of supine and lateral

97
Q

Atrophy Vs Hypertrophy

A

-loss of muscle mass
-increase in muscle mass

98
Q

Hypotonicity or Flaccidity VS Hypertonicity or spacisty

A

-muscles feel soft and weak
-decreased tone
VS.
-tight
-increased tone

99
Q

Paresis VS Paralysis

A

-partial weakness
VS
-complete loss of strength

100
Q

What are factors influencing mobility>

A

developmental considerations
physical health
mental health
lifestyle
attitude
fatigue and stress
external factors

101
Q

Complications of immobility

A

respiratory system : pneumonia
circulatory system: DVT
integumentary system: pressure ulcers
muscular system: atrophy
skeletal system: osteoporosis
genitourinary system: UTI and kidney stones
gastrointestinal: indigestions, constipstion
nervous: insomnia
mental: depression

102
Q

What do range of motion exercises do?

A

prevent muscle atrophy and joint contractures
maintain muscle strength and mass, and normal joint mobility and flexibility
passive vs active

103
Q

How should we do range of motion exercises?

A

-using a cupped hand to support join
-supporting the joint by holding the distal and proximal areas adjacent to the joint
-cradling the distal portion of a lower extremity

104
Q

What is the importance of protective positioning?

A

they need to change positions at least 2 hours
-position change
-extremities exercise
-assess and massage pressure area

105
Q

What are common devices to promote correct alignment?

A

pillows
mattresses
adjustable beds
bed side rails
trochanter rolls
high-top sneakers
a hand roll
trapeze bar

106
Q

What does a trochanter roll do?

A

support hips and legs to prevent external rotation of the hips

107
Q

What do high-top sneakers prevent?

A

foot drop

108
Q

What does a hand roll help with?

A

keep hand in a functional position

109
Q

What does a trapeze roll help with?

A

makes moving and turning easy

110
Q

How do we prevent deep vein thrombosis?

A

-antiembolism stockings
-graduated compression stockings
-pneumatic compression stockings

111
Q

What are some physical conditioning to use?

A

-quadriceps and gluteal setting drills
-pushups
-dangling

112
Q

What are the two types of crutches?

A

Forearm crutches
-long term support with permanent limitations

Axillary crutches
-temporary restrictions
-significant strength to use

113
Q

When walking on crutches, what are some key things to remember?

A

prevent pressure on the axillae
keep elbows close to sides
prevent crutches from getting close than 12 inches to feet

114
Q

What are 4 categories of pain?

A

duration
source
mode of transmission
etiology

115
Q

What is cutaneous pain?

A

involves skin or subcutaneous tissue
EX: papercut or sunburn

116
Q

What is deep somatic pain?

A

orginates in tendons, ligaments, bones, blood
EX: sprained ankle

117
Q

What is visceral/somatic pain?

A

originates in body organs in thorax, cranium, abdoment
EX: appendicitis, IBS, Migraine

118
Q

A patient who has bone cancer is most likely experiencing which of the following types of pain?
A. cutaneous
B. Somatic
C. Visceral
D. Referred

A

Somatic

119
Q

What is the pain process?

A

Transduction
transmission
Perception of pain
Modulation of pain

120
Q

Trandsuction

A

The initial recognition of pain via pain receptors
key ideas:
nociceptors
convergence of stimulus to electric signals

121
Q

Transmission

A

The transmission pathway of pain electrical signals to brain
Key ideas:
affferent pathways
adelta fibers
c fibers

122
Q

perception of pain

A

sensory process of how a person interprets pain
key ideas:
pain characteristics
pain threshold

123
Q

Modulation of pain

A

how a pain sensation is inhibited or modified
key ideas:
endorphins
modulators

124
Q

What is the gate control theory of pain?

A

how the brain decides to feel or not to feel pain

125
Q

What does TENS do?

A

it reduces postoperative pain and improves mobility after surgery

126
Q

What are stimulator of nociceptors or pain receptors?

A

respond selectively to mechanical, thermal, chemical stimuli that are noxious
EX: bradykinins
prostaglandins
substance P

127
Q

What are pain modulators?

A

morphine like chemical regulation in spinal cord and brain
EX:
endorphins, dynorphins, enkephalins

128
Q

A client comes to the emergency department complaining of a shooting pain in his chest. When assessing the clients pain, which behavioral response would the nurse expect to find?
A. decreased heart rate
B Guarding of the chest area
C. Increased respiratory rate
D. High BP

A

B

129
Q

What are some examples of a sympathetic response?

A

-increased BP, pulse, respirations
-pupil dilation
-muscle tension and rigidity
-pallor
-increased glucose

130
Q

What are some examples of parasympathetic responses?

A

a. nausea + vomitting
b. decreased BP
c. decreased pulse rate
d. rapid and irregular breathing
e. fainting and unconsciousness

130
Q

Behavioral response (voluntary) reflect what?

A

reflect body movements
-posture
-gross motor activities
-facial features
-verbal expression

131
Q

Affective Response (Psychological) reflects what?

A

mood and emotions
-anxiety, depression, insomnia
-hopelessness, fear, anger
-fatigue, withdrawal from others
-anorexia

132
Q

What are factors that can affect pain experience?

A

culture
ethnic variables
family, gender, and age variables
religious beliefs
environment and support people
anxiety
past pain experience

133
Q

T or F. The best judge of the existence and severity of a patients pain is the physician or nurse caring for the patient.

A

False

134
Q

CRIES pain scale

A

from 0-6 months

135
Q

FLACC scale

A

infant to children (7 years)

136
Q

Wong-Baker Faces

A

less than three years old

137
Q

Beyer Oucher pain scale

A

combines 0-100 scale with 6 photographic images

138
Q

PAINAD scale

A

dementia patients
-breathing (normal to noisy labored breathing)
-negative vocalization (moan, groan)
-facial expression (inexpressive, frown)
-body language (relaxed, tense, rigid)
-consolability

139
Q

COMFORT scale

A

used in unconscious and ventilated infants, children, and adolescents

140
Q

Which of the following pain assessment tools is recommended for use with neonates ages 0 to 6 months?

A

CRIES pain scale

141
Q

What are 3 pharmacologic pain relief measures?

A

1.nonopiod analgestics
2. opiod analgesics
3. adjuvant drugs

142
Q

What are examples of nonopiod analgestics?

A

acetaminophen, NSAIDS

143
Q

What is the mechanism of nonopiod analgestics?

A

reduce inflammation and pain by inhibiting the cyclooxygenase enzymes that are involved in prostaglandins

144
Q

What to consider about nonopiod analgestics?

A

lower risk of addiction, but potential for gastrointesinal issues with prolonged use

145
Q

EXAMPLES of opiod analgestics

A

morphine
codeine

146
Q

Mechanism of opiod analgestics

A

bind to opiod receptors in the CNS to block pain signals

147
Q

Consideration for opiod analgesics

A

effective for severe pain but carries risk of addidction, tolerance, and respiratory depression

148
Q

Adjuvant drugs example

A

anticonvulsants
antidepressants
corticosteroids

149
Q

Anticonvulsants

A

stabilize nerve cell membranes to reduce neuropathic pain

150
Q

Antidepressants

A

enhance serotonin and norepinephrine levels in the brain which can modulate pain perception

151
Q

Corticosteroids

A

reduce inflammation by suppressing the immune response leading to pain relief

152
Q

Side effects of opioid use

A

sedation
nausea
constipation
physical dependence
tolerance
addiction

153
Q

A sedated patient is frequently drowsy and drifts off during his convo with the nurse. What number on the sedation scale best describes the patient?

A

3

154
Q

Numeric Sedation Scale

A

1: awake and alert
2: Occasionally drowsy, but easy to arouse: no action necessary
3: frequently drowsy, driffs off to sleep during conv.: reduce dosage
4: somnolent with minimal or no response to stimuli: discontinue opiod, consider use of naloxone

155
Q

Cold therapy

A

reduce swelling
reduce inflammation
relieves pain
immediately after an injury
may continue to use for 3-5 days

156
Q

Hot therapy

A

increase blood circulation
promote healing process
relax stiff muscles
increase ROM
soother sore muscles

DO NOT APPLY COLD OR HEAT FOR LONGER than 20 minutes

Therapeutic of Nursing Care (4 decks)

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