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Nursing Practice > Test #2 > Flashcards

Test #2 Flashcards

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1
Q

True or false?

When performing PROM exercises, push the joint a bit further than its capacity.

A

False

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2
Q

True or false?

Support the joint holding the proximal and distal areas adjacent to the joint.

A

True

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3
Q

True or false?

Each ROM exercise should be repeated ten times.

A

2 - 5

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4
Q

True or false?

A flexion contracture of the neck is a serious disability.

A

True

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5
Q

what is difficulty with chewing or oral phase problems.

A

dysphagia

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6
Q

Pharyngeal and esophageal phase problems

A

choking and aspiration

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7
Q

why should we be concerned about swallowing difficulty?

A

aspiration can lead to pneumonia

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8
Q

occurs when food, liquid or secretions enter the airway and descend below the level of the vocal cords

A

aspiration

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9
Q

material entering the airway and remaining above the vocal cords is called this:

A

penetration

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10
Q

frequent aspiration can lead to this potentially fatal health risk, especially in older and/or non-ambulatory patients

A

pneumonia

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11
Q

this type of aspiration is difficult to detect without a chest x-ray

A

silent aspiration

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12
Q

signs of aspiration

A
  • wet sounding voice
  • spiking temperature
  • chest signs
  • subtle throat-clearing
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13
Q

this occurs when food or an object blocks the entrance to the airway and the patient is unable to expel the food by coughing

A

choking

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14
Q

technique required to assist a choking victim

A

heimlich manoevre

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15
Q

assessment of this can prevent aspiration and promote nutrition

A

swallowing ability

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16
Q

swallowing assessment can be done 2 ways

A
  1. bedside (oral mechanism evaluation)

2. x-ray test (videofluoroscopic swallowing study or barium swallow test)

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17
Q

why are liquids the most easily aspirated?

A
  • flow more quickly
  • harder to control in the mouth
  • often end up in the pharynx before swallow has triggered
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18
Q

all patients should be seated ________ for meals, either in chair or with head of bed raised to highest position

A

upright

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19
Q

patient should not ____ ______ directly after swallowing

A

lie down

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20
Q

this safety tip increases airway protection and hels open upper esophageal sphincter

A

tucking chin down toward chest when swallowing

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21
Q

this safety tip helps clear any residue left in pharynx after first swallow

A

swallow twice per mouthful of food/liquid

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22
Q

placing an empty spoon in patients mouth and pressing down on tongue slightly usually triggers this

A

swallow

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23
Q

True or false?

Using a straw is recommended to prevent choking

A

False. When drinking with a straw, the patient usually takes a breath much sooner after swallowing and liquid flows more quickly and is harder to control the rate.

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24
Q

Define dysphasia

A

difficulty swallowing

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25
Q

True or false?

Dysphagia is the most common cause of aspiration in adults during enteral feedings

A

false

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26
Q

4 signs of dysphagia

A
  1. multiple attempts swallowing
  2. poor tongue & lip control
  3. patient coughs
  4. liquids are most difficult to swallow
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27
Q

5 items that can effect appetite

A
  1. illness
  2. need to be fed
  3. odors
  4. pain
  5. need to eliminate
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28
Q

when preparing a patient for his/her meal, you should consider which of the following:

a) type of assistance needed
b) risk of swallowing difficulty
c) risk for aspiration
d) special needs or restrictions
e) all of the above
f) b and c only

A

e

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29
Q

true or false

it is important to promptly and efficiently serve meal trays

A

true

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30
Q

4 important elements/considerations when serving meal trays

A
  1. meal plan
  2. patient preferences
  3. dietary restrictions
  4. assistance needed
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31
Q

4 observations about the patient that should be documented when the patient is finished with the meal

A
  1. amount and type of food
  2. record intake/output
  3. difficulty eating
  4. nausea
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32
Q

true or false

oral hygiene should not be offered after a meal

A

false

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33
Q

true or false

when feeding a patient, offer all solid foods before liquids

A

false

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34
Q

true or false

fill the spoon half ful when feeding patients

A

false

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35
Q

true or false

talking to patient while you are feeding him will interfere with the patients ability to eat

A

false

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36
Q

true or false

when feeding a patient, stand next to the chair or bed

A

false

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37
Q

true or false

do not embarrass patients by allowing them to help feed themselves if they have poor vision or hand movement

A

false

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38
Q

position that is similar to dorsal recumbent

A

supine

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39
Q

position where patient is on their stomach

A

prone

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40
Q

position where patient is elevated 90 degrees

A

high fowlers

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41
Q

position where patient is elevated 45 degrees

A

fowlers

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42
Q

position where patient is elevated 30 degrees

A

low fowlers

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43
Q

position where patient is positioned on left or right side

A

lateral recumbent

44
Q

same as left lateral recumbent

A

sims

45
Q

this positions is used for enemas, rectal, and gynecological examinations and procedures

A

sims

46
Q

this positions is used for patients who are having a difficult time breathing

A

orthopneic

47
Q

true or false

when patients are sitting in a chair or bed, their feet should be left dangling

A

false

48
Q

position where patient’s head is low and the body and legs are elevated

A

trendelenburg

49
Q

position used for treating shock

A

reverse trendelenburg

50
Q

position where patient is lying on back with both feet in stirrups

A

lithotomy

51
Q

the purpose of oral hygiene is to:

a) clean the teeth and mouth
b) prevent mouth odor and infection
c) administer medications by mouth
d) all of the above
e) a and be only
f) c only

A

e

52
Q

4 things to observe when providing mouth care

A

condition of lips, teeth, tongue and gums

53
Q

true or false?
when providing oral hygiene for an unconscious patient, avoid using a padded tongue blad to separate the upper and lower teeth

A

false

54
Q

true or false?

it is not necessary to explain to an unconscious patient the care being given

A

false

55
Q

what position is best for an unconscious patient receiving oral hygiene care?

A

side lying

56
Q

describe what steps (7) you would follow to clean dentures for a patient

A
  1. wear gloves
  2. handle dentures carefully to avoid dropping and breaking
  3. line bottom of sink with towel
  4. use denture cleaner or paste and clean outer surfaces of teeth first, then the inside
  5. take note of cracks, loose teeth, rough edges
  6. store dentures in cup of cool water
  7. label denture cup with patient’s name and room number
57
Q

when caring for a patient’s hair, you should do which of the following:

a) only comb hair when damp
b) comb small sections of hair, beginning at the ends
c) work toward scalp
d) comb from scalp to hair ends once ends are detangled
e) all of the above
f) b and d only
g) b, c, and d

A

g

58
Q

true or false

patients confined to to bed cannot have their hair shampooed

A

false

59
Q

how can a mans beard be softened before shaving

A

apply warm face cloth

60
Q

how should safety razors be disposed after use

A

sharps container

61
Q

true or false?

it is not necessary to wear gloves when shaving a patient

A

false

62
Q

when shaving a male patient, long strokes should be used when shaving the _______. short strokes should be used when shaving the ______ and _______

A

cheeks

jaw and chin

63
Q

4 reasons why nail and foot care is important

A
  1. prevents infection
  2. maintains cleanliness
  3. prevents injury
  4. prevents odor
  5. prevents hangnails
  6. prevents ingrown nails
64
Q

true or false

it is easier to shape nails after soaking

A

true

65
Q

true or false

toenails should be trimmed at an angle on each side

A

false

66
Q

true or false

it is important to soak the feet of a diabetic patient

A

false

67
Q

true or false

patient’s clothing should be changed daily or more often if soiled

A

true

68
Q

3 indications for patient to wear TED hose

A
  1. inactive patients at risk for clot formation
  2. patients with heart disease and circulatory disorders
  3. patients confined to bed
  4. pregnant women
69
Q

name 2 lengths of TED hose

A

thigh high

knee high

70
Q

TED hose worn properly should be:

a) rolled over 2 inches at the top of the thigh
b) free of wrinkles or creases
c) fitted snugly
d) fitted loosely to allow for ease of circulation
e) all of the above
f) a,b,c
g) b and c
h) b and d

A

g

71
Q

4 benefits of bathing

A
  1. cleansing
  2. relaxation
  3. improved circulation
  4. passive exercise
  5. creates close relationship
72
Q

4 steps to prepare for bathing a patient

A
  1. ask patient to void
  2. adjust bed height
  3. arrange supplies
  4. cover patient with bath blanket
  5. fill basin 2/3 with warm water
73
Q

true or false
when giving a bath, the supplies should be on the side of the bed opposite to where you are working to avoid spilling the bath water

A

false

74
Q

true or false

a massage should be offered as part of the bath

A

true

75
Q

describe steps for providing perineal care for female patient

A
  1. ask patient to void first
  2. position patient on her back and drape blanket in diamond
  3. wear gloves
  4. use warm water
  5. separate labia, expose urethra and vagina
  6. cleanse from centre outward
76
Q

making a thorough skinn assessment while giving a patient a bath is important. what would your assessment include when providing perineal care for a female patient

A

observing for skin irritations or breakdown. assessing for pain, redness, swelling or discharge

77
Q

true or false. it is not necessary to wear gloves while bathing a patient because bathing is a normal activity of daily living

A

false

78
Q

a

A

before

79
Q

aa

A

of each

80
Q

AM, am

A

morning

81
Q

cap

A

capsule

82
Q

hs

A

bedtime

83
Q

OD, od

A

right eye

84
Q

PM, pm

A

evening

85
Q

LQ

A

last dose

86
Q

qod

A

every other day

87
Q

q

A

every

88
Q

q4h

A

every 4 hours

89
Q

ss

A

1/2

90
Q

T,P,R,B/P

A

temperature, pulse, respiration, blood pressure

91
Q

stat

A

at once

92
Q

tid

A

three times a day

93
Q

supp

A

supposetory

94
Q

D,B & C

A

deep breathing cough

95
Q

ac

A

before meals

96
Q

bid

A

twice day

97
Q

g

A

gram

98
Q

im

A

intramuscular

99
Q

os

A

left ear

100
Q

po

A

per mouth

101
Q

qod

A

every other day

102
Q

qid

A

4 times a day

103
Q

pc

A

after meal

104
Q

prn

A

as needed

105
Q

qh

A

every hour

106
Q

qs

A

as much as needed

107
Q

qd

A

every day

Nursing Practice (2 decks)

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