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101 LEC > TEST 4 > Flashcards

TEST 4 Flashcards

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1
Q

What subjective data do we ask for musculoskeletal?

A

Joint: Pain, stiffness, ROM
Muscles: Pain, cramping, weakness
Bones: Pain, deformity, accident/trauma
*Do you have any limitations in movement

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2
Q

What are you inspecting for on musculoskeletal?

A

Color (fracture- may see brusing)
Swelling
Masses
Deformities

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3
Q

What are you inspecting for on musculoskeletal?

A

Color (fracture- may see brusing)
Swelling
Masses
Deformities

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4
Q

What are you palpating for on musculoskeletal?

A

Extremities - crepitous
Joints - tenderness
Temp (hot = autoimmune disorder)

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5
Q

What is AROM and PROM?

A

ActiveROM - Patient is able to do themselves
PassiveROM - patient is being assisted

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6
Q

What is ROM checking?

A

Joint mobility
Should not cause pain

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7
Q

What is the muscle strength grading scale?

A

5 - FULL ROM/ FULL RESISTANCE
4 - FULL ROM/ LIGHT RESISTANCE
3 - FULL ROM / gravity/no resistance from nurse
2 - FULL ROM / gravity eliminated /only horizontal but not vertical
1 - Slight contraction
0 - no contraction

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8
Q

What is osteoporosis?

A

Loss of bone mass/density resulting in decreased ability to maintain structural integrity of skeleton

Kyphosis present / aging / etiology unknown

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9
Q

What are the treatments for osteoporosis?

A

Biphosphonates - inhibit bone resorption
(fosamax, boniva, actonel) side effect - esophageal ulcers / give 8oz water

Calcitonin - inhibit bone resportion
(Miacalcin, Fortical)

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10
Q

What is Osteomalacia

A

Softening of bone tissue due to inadequate mineralization of osteoid - *calcification does not occur

Caused by Vit D deficiency (lack of sun, dietary, malabsorption - crohns)

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11
Q

What is Osteomyelitis?

A

Infection of the bone
- caused by invasion of microorganisms that stim inflam response in bone tissue

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12
Q

What is definition of a fracture?

A

A break or disruption in the continuity of bone
(not in 2 separate parts)

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13
Q

What is a simple fracture and a compound fracture?

A

Simple - Break but not exposed to the atmosphere // skin intact
Compound - bone sticking out of body - even if skin is broken but bone is not out//still compound

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14
Q

What are these types of fractures?
Comminuted
Displaced
Spiral
Impacted
Greenstick

A

Comminuted - Bone is in several fragments
Displaced - fracture in 2 parts but they are misaligned
Spiral - goes down in spiral
Impacted - bone against bone, (jump off cliff - impact)
Greenstick - bones are not fully formed and it is bowed or bent

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15
Q

Define a strain.

A

Excessive stretching of a muscle or tendon

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16
Q

Define Sprain

A

Excessive stretching of a ligament

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17
Q

What are the classifications of strains and sprains?

A

1st degree - stretched too much
2nd degree - stretched or pulls and tears
3rd degree - big tears, complete disruption, ripped apart

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18
Q

How do you manage strains and sprains?

A

Cold & heat
Activity limitations
Anti inflam drugs
Muscle relaxants
Surgery

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19
Q

How do you manage the different degrees of strains and sprains?

A

1st - Rest, Ice for 24-48, Compression bandage, Elevation

2nd - immobilization, partial weight bearing

3rd - longer immobilization, possible surgery

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20
Q

Sprains or strains are what part of body?

A

Muscle
Tendon
ligament

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21
Q

Define osteoarthritis

A

-Most common type of arthritis
(weight-bearing joints and hands)
-Joint pain and loss of function
-Progressive deterioration

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22
Q

What are Heberdens nodes and Bouchards nodes?

A

Heberdens nodes - enlargement of distal joint
Bouchards nodes - enlargment of proximal joint

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23
Q

What are the clinical manifestation of Osteoarthritis?

A

Pain worsens with activity / better with rest
Hypertrophy of bone joints
50% of hand have heb or bouc nodes

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24
Q

Define Rheumatoid arthritis

A

Chronic progressive systemic inflam autoimmune disease primarily affecting joints

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25
Q

How does rheumatoid arthritis work?

A

Autoantibodies attack healthy tissue (RFacotrs)

Affects synovial tissue of any organ or body system - thickened inflam cells (erode cartilage and bone)

Starts in upper extremities & works down

Not genetic

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26
Q

What are the clinical manifestation of rheumatoid arthritis?

A

Joint deformity
Bilateral and symmertric
25% have subQ nodules - soft tissue growth pop up and go away
**hyper extension of thumb always present

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27
Q

What is the treatment for rheumatoid arthritis?

A

Pain management
Plasmapheresis - take blood out from remove RF and put blood back in
Assistive devices

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28
Q

What is a comparison of Osteo and Rheumatoid?

A

Osteo - Assymetric, pain with movement, hypertrophy - not warm or red

Rheumatoid - symmetric, pain when touched, warm and red

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29
Q

ALtruism

A

Wanting to care for others/help others

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30
Q

Autonomy

A

Ability to make own decisions

31
Q

Human dignity

A

Respect all human life

32
Q

Integrity

A

Follow standards

33
Q

Social justice

A

Treating everyone equal / fairly

34
Q

What are laws vs ethics?

A

Laws - rules establishing society’s behavior, created and enforced by the government, breaking results in a penalty

Ethics - Standards of behavior, based on morals, may or may not be penalized

35
Q

Autonomy

A

Patients choice to make decisions

36
Q

Beneficence

A

do good for patients/prevent harm

37
Q

Fidelity

A

Keeping your word/ promise to care for them

38
Q

Justice

A

Treat fairly

39
Q

Nonmaleficence

A

Do no harm to patient

40
Q

Veracity

A

Tell truth at all times

41
Q

TORTS what are the 2 main categories?

A

Unintentional - negligence/malpractice
Intentional -

42
Q

What are the types of intentional torts?

A

Defamation - ruining someone’s character
False imprisonment - restrict patients freedom of movement
Invasion of privacy - look up info that’s not assigned
Fraud - don’t ID yourself correctly
Assault - verbally threaten to touch someone
Battery - physically touch someone/ doing a procedure w/o consent for invasive procedure such as surgery

43
Q

What are the 2 types of defamation?

A

Slander - verbal
Liable - typing it

44
Q

Informed consent includes

A

-Explanation of treatment
-anticipated risk
-potential benefits
-possible alternatives
-answers to questions
-a statement that consent can be withdrawn at any time

45
Q

Emergency medical treatment and active labor law?

A

Make sure every hospital gives emergency care and stabilizes before kicking out regardless of insurance status

46
Q

Patient safety and quality improvement act?

A

All care provided is of quality and its safe. Protects nurse when report on safe acts or quality and no retaliation

47
Q

americans with disabilities act

A

Everyone gets treated the same - provides accommodations

48
Q

Child abuse and prevention and treatment act

A

Mandatory reporter and protects against retaliation

49
Q

Common incident reports

A

Med errors
Complications from treatment/procedure
Failure to report change in condition
Falls
Break is aseptic technique
Patient refuses treatment/consent

50
Q

HIPAA

A

Health insurance portability and accountability act of 1996

Protects the privacy of pt info / health info can be released for treatment, payment, routine health care operations

51
Q

Nurse practice acts

A

Delegation to LPN/CNA
- Delegate tasks not in nursing process

52
Q

What are the 5 rights of delegation?

A

Right person
Right task
Right circumstance
Right directions
Right supervision

53
Q

What is an advanced directive?

A

to communicate wishes regarding to end of life care should patient become unable to do so

54
Q

What is the patient self-determination act (PSDA)

A

Requires that all patients be asked if they have advanced directives

55
Q

What is a living will?

A

A list of all thing you want or don’t want done. YES OR NO. Does not kick in until the person cannot advocate for self

56
Q

Durable power of attorney for health care

A

name of person who will make health care decisions if patient cannot make own decisions

57
Q

If there is no DNR order what does nurse do

A

Do CPR when a patient has no pulse or respirations

58
Q

What is the food samaritan law?

A

Nurses are held to a different standard, bc your always a nurse -

IF you walk up to someone and tell them your a nurse, it auto creates a nurse/patient relationship

59
Q

What are some purpose of records?

A

Communication
Care plan
Financial reimbursement
Auditing/monitoring
legal documentation

60
Q

What 3 things should always be on my nurses note?

A

What did I observe/assessments findings?
What did I do about the findings?
How did the patient respond?

61
Q

HIPAA violation can result in

A

$250,000 fine
10 years in prison

62
Q

What are 5 guidelines for quality documentation?

A

Factual
Accurate
Complete
Current/timeliness
organized

63
Q

Documenting guidelines for paper charting

A

Pen
Date and Time
Mistakes - no whiteout, no scribbling
only 1 line through mistake with error and signature with credentials
no blank lines

64
Q

When do you document? when you are writing or time of event

A

When you are writing note

65
Q

Initial nursing assessment includes

A

Baseline
Sample narrative note

date time age, admitted for
AAoX3, assessments in head to toe format
name and credentials

66
Q

What is PIE documentation

A

Problem
Intervention
Evaluation

67
Q

What is DAR documentation

A

Data
Action
Response

68
Q

What is SOAP documentation

A

Subjective
Objective
Assessment/analysis
Plan

69
Q

What is SOAPIE documentation?

A

Subjective
Objective
Analysis - nursing diagnosis
Plan/goal
Intervention / what did you do
Evaluation / how did the patient respond

70
Q

What is ISBARR

A

Introduction/introduce self and patient
Situation
Background
Assessment
Recommendation
Read back and verify order from provider

71
Q

What are the aims of patient education

A

Promote health
prevent illness/injury
Restore health
facilitate coping
how to develop self care abilities -knowledge, skills attitudes

72
Q

What are the 3 learning domains

A

Cognitive - knowledge
Psychomotor - skills
Affective - attitudes

73
Q

What are some factors that affect learning?

A

Age & development level
Support & resources
Culture and language
literacy

74
Q

What is the teaching-learning process?

A

Assess
Identify actual learning needs
Develop - plan
Implement teaching plan
Evaluate the learning

101 LEC (15 decks)

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