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Nursing 2230 > Test #2 > Flashcards

Test #2 Flashcards

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1
Q

What types of areas do Germs like?

A

Germs like dark, moist, cold/warm temps

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2
Q

What are some sources of infection?

A
  • hospital elevators
  • toilet seats/stalls
  • door knobs
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3
Q

What is normal flora?

A

Germs that reside in us, and make up our mircrobio. It can be disrupted with antibiotics, etc.

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4
Q

What happens when normal flora is impaired?

A

Gi disruptions

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5
Q

What is our relationship with bugs?

A
  • Symbiotic relationship
  • Bugs help us build our immunity and our microbiome
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6
Q

What are the barriers/facilitators when it comes to germs and infections? (10)

A
  • Immunizations
  • Diet
  • Nutrition
  • Age
  • Virulence
  • Stress
  • Comorbidities
  • Previous exposure
  • Water, sanitation
  • Global context
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7
Q

Describe Colonization:

A

Microorganisms present without host interference or interaction

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8
Q

Describe what occurs when there is an infection:

A

Host interaction with an organism

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9
Q

What is a surgical wound in the context of infection?

A

Sterile 0% exposure to bugs, infection

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10
Q

What is a pressure sore in context of infection?

A

More exposure to bugs, colonization

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11
Q

What are the two definitions of Infectious Disease?

A

Symptomatic: When host displays a decline in wellness due to the infection

Asymptomatic: When host interacts immunologically with an organism but remains symptom free

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12
Q

What is Localized Infectious Disease?

A

Infection that is confined to a certain area, not spreading

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13
Q

What is Systemic Infectious Disease?

A

Infection that affects the entire body, spreading through the rest of the body

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14
Q

What are the phases of Infection? (4)

A
  • Incubation Period
  • Prodromal Stage
  • Illness stage
  • Convalescence
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15
Q

What is the Incubation Period?

A

When a microorganism has entered your body but you have no symptoms

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16
Q

What is the Prodromal Stage?

A

Onset of symptoms, not specific symptoms. ex. cough, not feeling well, myalgia

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17
Q

What is the Illness Stage?

A

Onset of specific symptoms. ex. flu

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18
Q

What is Convalescence?

A

When the symptoms start to dissolve, and we get back to normal base line

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19
Q

When is an infection likely to spread? During which phase of the course of infection?

A

Incubation period - you don’t know you are a risk

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20
Q

What is Surgical Asepsis?

A
  • Surgical tools that go into the body
  • Complete absence of microorganism
    ex. Sterile to Sterile
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21
Q

What is Medical Asepsis?

A

Extremely clean, not 100% sterile

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22
Q

What is Cleaning?

A

When cleaning non-critical items such as bp cuffs

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23
Q

What is Disinfection?

A

Cleaning everything except spores

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24
Q

What is Sterilization?

A

Cleaning everything

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25
Q

What is the Oligodynamic Effect?

A

When materials clean themselves over time
ex. Copper and Brass

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26
Q

How are germs spread?

A
  • Contact
  • Droplets
  • Airborne
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27
Q

What is Nosocomial?

A

Health care associated infections

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28
Q

What are Health Care Associated Infections (HCAI)?

A
  • infections acquired in a hospital, when admitted for a reason other than that infection
  • Includes infections acquired in hospital, but appear after discharge
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29
Q

What are high risk HCAI?

A
  • pneumonia
  • wound/surgical
  • urinary tract infections
  • blood stream infections
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30
Q

What is CBC?

A

Complete Blood Count

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31
Q

What is C&S?

A

Culture and Sensitivity

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32
Q

What does Iron Level indicate?

A

Decreased chronic infection

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33
Q

What is ESR?

A
  • Erythrocyte Sedimentation Rate
  • it shows inflammation in the body
  • Can’t determine where specifically the inflammation is
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34
Q

What is CRP?

A
  • C-Reactive Protein
  • Shows inflammation in the body
  • Can’t determine where specifically the inflammation is
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35
Q

What is the major mode of transmission in health facilities?

A

Indirect contact

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36
Q

What is Resident Hand Bacteria?

A

bacteria that resides on the hand

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37
Q

What is Transient Hand Bacteria?

A

Bacteria that is acquired by healthcare workers from other clients

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38
Q

What are the 5 steps of Transmission as determined by WHO?

A
  1. Organisms present on patients, or have been shed onto objects
  2. Transfer to the hands of HCW
  3. organisms survive more than several minutes on the HWC’s hands
  4. Inadequate or entire omission of handwashing
  5. contaminated hands come into direct contact with patient or object
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39
Q

When did Safety Culture first appear?

A

In 1988 after a really big disaster, Chernobal. Nuclear powerplant

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40
Q

Why are safety protocols mandatory?

A

Because if something was optional, people wouldn’t participate in them, even when it came to safety

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41
Q

What is Safety Culture? (long one)

A

The product of individual and group values, attitudes, competencies and patterns of behaviour that determine the commitment to, and the style and proficiency of, and organization’s health and safety programmes

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42
Q

How does culture (often) trump policy?

A

Policy says wash your hands, but the culture influences if people actually do it

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43
Q

How many adverse events occur in hospitals in Canada?

A

185,000 (injury, disability, death)

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44
Q

How many adverse events are preventable?

A

70,000

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45
Q

What are the most common adverse events?

A
  • Surgical
  • Drug
  • fluid related incidences
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46
Q

What are Never events?

A

A call-to-action, not a demand or an attempt to shame mistakes

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47
Q

What are the Never events for surgery?

A
  • Wrong body part
  • wrong pt
  • wrong procedure
  • foreign object left in pt
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48
Q

What are other Never events that can occur? (4)

A
  • death/harm due to failure to inquire whether a patient has a known allergy to med’n
  • Death/harm as a result of wrong route, IV admin of concentrated K+
  • any stage 3 or 4 pressure ucler acquired after admission to hospital
  • Patient death or serious harm due to uncontrolled movement of ferromagnetic object in an MRI area
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49
Q

What is a Near Miss?

A
  • AKA close call
  • Event that could have resulted in unwanted consequences, but did not because either by chance or through timely intervention the event did not reach the patient
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50
Q

Describe a critical incident report of an error:

A
  1. Describe incident in as much detail as possible
  2. describe thoughts, feelings, concerns
  3. factors that you think contributed directly or indirectly
  4. impact on yourself, family, others
  5. what you have learned
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51
Q

Of 2,455 sentinel event, what precent is due to communication errors?

A

75%

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52
Q

What is SBAR?

A

Tool for communication

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53
Q

Describe SBAR:

A

S - Situation (intro; who you are, provide basic details)
B - Background (relevant info to the current problem)
A - Assessment (why we’re calling; done after looking at the client, this is what is going on)
R - Recommendation (what do we want the physician to do)

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54
Q

What is the most common treatment intervention used in healthcare around the world?

A

Prescription Medications

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55
Q

What is Medication Safety?

A

Freedom from preventable harm with medication use

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56
Q

Are some medications riskier than others?

A

Yes, that is why some medications are over the counter and others prescription

57
Q

What is the major risk/concern of Acetaminophen?

A

Liver damage

58
Q

What are the medications we want to be careful when using? PINCH

A

P - Potassium
I - Insulin
N - Narcotics
C - Chemotherapy
H - Heparin

59
Q

What is the difference between an Adverse Event and an Error?

A

an Adverse event occurs when there is no knowledge of the possible outcome, and the action is completed. ex. medication given, pt has NKA, but an allergic reaction occurs

an Error occurs when there is knowledge of the possible outcome, but the action is still done. ex. medication given, pt has known allx, and a severe reaction occurs

60
Q

What is the impact of bullying in nursing?

A
  • nurses consider leaving profession
  • affects physical and emotional health
  • can threaten patient safety and outcomes
61
Q

Does the amount or type of tissue damage influence pain response?

A

Yes, for example paper cut vs. breaking an arm

62
Q

What is particularly painful?

A

Burns

63
Q

What is the assessment of pain called?

A

the 5th vital sign

64
Q

What is Acute Pain? (4)

A
  • short term
  • Sudden onset (ex. surgery)
  • Resolves
  • Protective
65
Q

What is Chronic Pain? (5)

A
  • long term
  • longer healing time
  • affects quality of life
  • ability of function
  • not serving a physiological purpose
66
Q

What are the different types of pain? (6)

A
  • Acute
  • Break-through
  • Chronic
  • Cancer related
  • Idopathic/incident
  • Procedural: biopsy
67
Q

What is Break-through pain?

A

When we have controlled pain, and then a sudden onset of pain

68
Q

What is Gate Control Theory?

A

You can open and close different pathways of pain. These gates can open and close changing the pain experience. ex. hit your head and rub it/distraction

69
Q

What is Nociceptive pain?

A

Aching or throbbing pain, well localized. Damage to somatic or visceral tissue

70
Q

What is Neuropathic pain?

A
  • More sharpe, sometime described as electoral
  • caused by damage to nerve cells or changes in spinal cord processing
71
Q

How can pain be easy?

A

by being more linear

72
Q

Why can pain be Complex? (9)

A
  • accessibility
  • cultural values
  • medical values
  • medical racism
  • money
  • transportation
  • addiction
  • fear
  • age
73
Q

What are the factors influencing pain response? (7)

A
  • anxiety/depression
  • sleep/fatigue
  • hereditary
  • previous experience
  • culture
  • age
  • meaning you assign to the experience
74
Q

What are the barriers to pain control? (6)

A

beliefs about pain-related practices shaped by:
- past experiences
- age
- education
- culture
- ethnicity
- gender

75
Q

What do nurses and healthcare workers often do when patients self report pain?

A

they doubt the patient

76
Q

What do nurses tend to do when it comes to pain and their patients?

A
  • over-estimate when clients report no pain
  • underestimate when mild to intense
  • nurse’s personal opinion about client’s report of pain affects titration of opioid
77
Q

What are some pain related beliefs/concerns? (6)

A
  • fear of injections
  • fear of addiction or tolerance
  • fatalism about the possibility of achieving pain control
  • belief that “good” patients do not complain about pain
  • fear of distracting physician from treating disease
  • belief that pain signifies disease progression
78
Q

What is Pain?

A

Multidimensional

79
Q

What are some examples of non-pharmacological pain relief? (8)

A
  • environment
  • music
  • lighting
  • temperature
  • positioning
  • tight dressings
  • skin care
  • hygiene
80
Q

What is the safest and cheapest way to administer pain medications?

A

Orally

81
Q

What are the different routes for administering pain medication? (7)

A
  • Oral
  • epidural
  • Transdermal
  • Transmucosal
  • Intraspinal
  • Parenteral
  • Inhalation
82
Q

What is the WHO Analgesic Ladder?

A

A guideline to decide which medication you should use

83
Q

What are the main forms of Analgesic (pain med)?

A
  • NSAIDS/non-opioid
  • Opioids
  • Co-analgesic/adjuvant
84
Q

What are the different types of Analgesic pain medications?

A

Step 1: Over-the-counter, for mild pain
- Tynelol
- Advil
Step 2: for moderate pain. ex. dental procedure
- Codeine
- Oxycodon
Step 3: for severe pain
- Morphine
- Fentanyl
- Hydromorphone
- Dilaudid

85
Q

What should we be aware of when administering pain medications to Pediatric patients? (4)

A
  • newborns can’t report
  • remember assessment scales
  • be cautious around codeine
  • infants older than 1 month of age can metabolize drugs in the same manner as older infants and children
86
Q

What should we be aware of when administering pain medications to Elderly patients? (4)

A
  • “start low and go slow”
  • Comorbidities + drug interactions
  • Use of NSAIDS
  • constipation
87
Q

What are the side effects of Opiates? (5)

A
  • respiratory depression (changes respirations + depths)
  • Drowsiness/lethargy
  • Nausea + vomiting
  • Constipation
  • Tolerance + addiction
88
Q

What is Addiction?

A

Use of a drug, even when we know the adverse effects

89
Q

What is Tolerance?

A

When our body is getting use to the drug/medication

90
Q

What are Opioids?

A

Psychoactive substance derived from the opium poppy, or synthetic analogues ex. morphine and heroin

91
Q

How many people in the world suffer from dependence/addiction on Opioids?

A

15 million

92
Q

How many deaths are estimated around the world per year due to Opioids?

A

69,000

93
Q

What is the percent of people who get help with Opioid dependence/addiction?

A

10%

94
Q

What drug is used to reverse the effects of opioids?

A

Narcan/Naloxone

95
Q

How did we get to an Opioid Crisis? (5)

A
  • misunderstanding of addictive risk
  • Frequent and high amounts of prescribing
  • lack of access to prescriptions leading to illicit use
  • Contamination
  • Stigma towards substance use disorders
96
Q

What is Venipuncture?

A

Technique in which a vein is punctured through the skin by a sharp rigid stylet

97
Q

Why do we not use arteries during venipuncture?

A
  • there is increased pressure
  • they are deeper than veins
98
Q

What is Secondary IV?

A

If you want to piggy back, or run a med with iv fluid

99
Q

What is Bolus IV?

A

Giving volume of meds quicker over a shorter period of time

100
Q

What is Push IV?

A

When you are bolusing a medication, you are using a syringe and push it in, below the drip chamber

101
Q

What is Patent IV?

A

Pre-flowing, no blockage, just flowing normally

102
Q

Why do we use IVs?

A
  • onset is faster
  • some medications can’t be given orally
  • quicker way to give fluids, blood
103
Q

What is TPN?

A

Total Parenteral Nutrition
Supplies all daily nutritional requirements; placed along with a central venous catheter

104
Q

What are Crystalloids?

A
  • Solutions which contain water-soluble electrolytes including Na and Cl
  • Small molecules, and therefore can cross the vein membrane
  • Ex. Glucose, NaCl, Lactated Ringers
105
Q

What are Colloids?

A
  • solution used for fluid replacement (IV)
  • large molecules and therefore stay in the blood longer
  • Albumin, Pentaspan, PRBCs
106
Q

What are some common IV fluids?

A
  • Normal Saline NaCl 0.9%
  • D5W Dextrose 5% in water
  • 2/3 (Dextrose) and 1/3 (NaCl)
107
Q

What joins arteries and veins?

A

Capillaries

108
Q

What are the different types of IV solutions?

A
  • Isotonic
  • Hypotonic
  • Hypertonic
109
Q

What are Isotonic Solutions?

A
  • most common
  • does not cause a fluid shift
  • Used for rehydration, expanding/replacing volume, ECF
110
Q

What is an example of an Isotonic solution?

A

0.9% NaCl normal saline

111
Q

Who is at particular risk for fluid over load with 0.9% NaCl NS?

A

Clients with cardiac problems and kidney problems
Typically older clients

112
Q

What is a Hypertonic Solution?

A
  • solution that causes fluid to shift into intravascular space from intracellular and into the interstitial
  • cell shrinks
113
Q

Why is Hypertonic solution not used for dehydrated patients?

A

Because it pulls water out of our cells; the cell shrinks

114
Q

What is an example of a Hypertonic Solution?

A

3% or 5% NaCl

115
Q

What are some situations we should be cautious of when administering a Hypertonic solution?

A
  • renal failure
  • heart failure
116
Q

What is a Hypotonic solution?

A
  • solution that causes fluid to shift from intravascular into cells and interstitial spaces
  • cell swells
117
Q

What are Hypotonic solutions used for?

A
  • For hydrating intracellular fluid (ICF) and interstitial spaces
  • for if the client had high Na
118
Q

What is one of the most common electrolyte imbalances?

A

Hypokalemia

119
Q

What do we need to ensure our clients have adequate function of when giving them fluids?

A

Renal/kidneys

120
Q

Why can’t we give potassium as a bolus/push IV?

A

Because if we give it fast, it will stop the patients heart

121
Q

Do you need a physician order to initiate an IV?

A

Yes

122
Q

What information is included in a physicians order when initiating an IV?

A
  • type
  • solution
  • rate
  • timing
123
Q

What is the difference between a Peripheral vs. Central IVs?

A

Peripheral:
- increased distance to heart/central circulation
- easier to manage, change, and insert
- inserted to the top of the hand, forearm
Central:
- closer to the heart
- decreased chances of infiltration
- disperse quicker
- longer term

124
Q

What are the different types of Central Lines?

A
  • Peripherally Inserted Central Catheter = PICC
  • Tunneled
  • Portacath
  • Subclavian
125
Q

What is PICC?

A
  • IV inserted in the grove of the arm by the brachial artery, into the superior vena cava of the heart
  • Can be inserted at the bed side, can stay in
126
Q

What is a Tunneled Central Line?

A

Under the skin - protects from infection
- most commonly placed in the neck into the internal jugular vein and extends down to a larger vein just above the heart

127
Q

What is a Portacath Central Line?

A
  • Surgically placed catheter
  • typically right side of the chest
  • super long term
  • for someone who has cystic fibrosis
128
Q

What is a Subclavian Central Line?

A
  • Directly into the vein
  • by the upper part of the shoulder
129
Q

Why is air in an IV line a concern?

A

possibly risk for an embolism

130
Q

Where should a peripheral IV be inserted?

A

the distal site whenever possible, starting with the top of the hand and moving up the forearm

131
Q

Why should we use the distal site whenever possible for an IV insertion?

A

Because you can always move up, but not down

132
Q

What influences the flow rate? (8)

A
  • height of the bag
  • diameter of the tubbing
  • length of tubbing
  • Viscosity of solution
  • position
  • dressing too tight
  • kinked tubing
  • clamp
133
Q

What can Diuretics cause?

A

Loss of electrolytes

134
Q

What can Hypokalemia cause?

A

Metabolic Alkalosis:
- kidneys conserve K+, H excretion increases
- cellular K+ moves out of the cells, H enters

135
Q

What are some complications of IV therapy? (8)

A
  • Inflitration/extravasation
  • Phlebitis (mechanical or chemical)
  • Volume/fluid overload
  • bleeding
  • infection
  • air embolism
  • sepsis
  • hematoma
136
Q

When infiltration occurs, what do you do?

A

Discontinue, resite, reinsert, vein another extremity

137
Q

When Phlebitis develops, what do you do?

A

Discontinue, resite, reinsert, vein another extremity

138
Q

What is the risk r/t phlebitis?

A

clot or embolism forming

139
Q

When should you change the site of an IV?

A

Every 72 hours, depending on the facility policy

Nursing 2230 (3 decks)

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