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Fundamentals > WEEK 6 > Flashcards

WEEK 6 Flashcards

1
Q

clinical judgment

A

the decision made regarding a course of action based on a critical analysis of data when nursing knowledge is applied to a clinical setting

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2
Q

what do sound clinical judgments help ensure?

A

safe care
high-quality care
client-centered care

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3
Q

communication

A

transfer of information

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4
Q

Shannon-Weaver communication model (1948)

A

sender
encoder
channel
decoder
receiver
noise

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5
Q

ABX model (Theodore Newcomb)

A

message sender
topic
message receiver

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6
Q

David K Berlo’s model

A

S-M-C-R model

sender
message
channel
reciever

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7
Q

define channel

A

method of medium used to deliver a message

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8
Q

what are the five levels of communication

A

emotional
energetic
verbal
auditory
physical

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9
Q

verbal and physical communication in nursing

A

use therapeutic communication with both verbal and nonverbal communication

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10
Q

auditory communication

A

what the receiver hears when the sender speaks a message.

included the speed and tone of voice the receiver perceives

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11
Q

emotional communication

A

A form of communication that expresses feelings and emotions.

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12
Q

energetic communication

A

The speaker’s presence or vibration that is expressed when communicating.

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13
Q

what are the four models of communication

A

verbal
nonverbal
electronic
written

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14
Q

verbal communication

A

commonly refers to oral communication. This mode can occur through face-to-face communications and via telephone

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15
Q

what communication style do baby boomers rely on

A

verbal to convey messages

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16
Q

nonverbal communication

A

body language. Actions such as eye contact, facial gestures, posture, and overall appearance send messages to the receiver in addition to what the sender is saying.

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17
Q

example of nonverbal communication

A

is the nurse placing the computer on wheels between them and the client as they ask questions. This blocks the ability of the nurse to make eye contact with the client, and the client may perceive this as the nurse not being compassionate or empathetic.

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18
Q

electronic communication

A

This mode includes email, texting, video conferencing, and social media. This technology can allow health care team members to communicate with each other and their clients more efficiently, but also can lead to privacy violations, mistakes from typographic errors, and distractions

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19
Q

written communication

A

includes electronic communication and can be in the form of a letter, handwritten or typed, or an email or computer-based post.

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20
Q

what does written communication lack?

A

nonverbal cues that face to face interaction possess, leading some users to view them as detached

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21
Q

what are the four communication styles

A

aggressive
assertive
passive
passive-aggressive

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22
Q

what is the most effective type of communication styles

A

assertive, due to its cooperative and straightforward style

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23
Q

passive communication

A

communication style have developed a pattern to avoid conflict, expressing feelings or opinions, or standing up for themselves when boundaries are crossed

Communication style that does not act or openly express discomfort.

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24
Q

assertive communication

A

viewed as most effective because they communicate clearly and honestly. They advocate for their opinions, rights, and needs without violating the rights of others.

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25
Q

what is assertive communication fundamental for?

A

good communication
mental health
healthy relationships

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26
Q

aggressive communication

A

developed a pattern of expression that is verbally, and sometimes physically, abusive, such as “This is all your fault. I will make you pay.”

uses “you” statements to blame others

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27
Q

passive aggressive communication

A

appear passive on the surface but are angry deep down

Communication style that finds indirect ways to protest or express unhappiness with a situation.

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28
Q

example of passive aggressive communication style

A

A nurse using an aggressive communication style might tell a new nurse, “It’s your fault the client fell. You never listen to me.”

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29
Q

nontherapeutic communication

A

Techniques that hinder communication, such as stating the person is wrong.

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30
Q

therapeutic communication

A

nurses use listening skills, empathy, and a desire to build a professional relationship with the client to provide holistic and patient-centered care.

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31
Q

therapeutic communication: open-ended questions

A

Questions that require more than a yes or no answer.

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32
Q

therapeutic communication: restating

A

A therapeutic communication technique where the receiver summarizes or paraphrase the message back to the sender to ensure understanding.

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33
Q

therapeutic communication: reflection

A

instead of repeating the client’s message back to them, the nurse attempts to reveal the client’s feelings behind the message.

most used when clients are asking nurses for advice

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34
Q

therapeutic communication: active listening

A

focusing on the client’s verbal and nonverbal cues

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35
Q

OARS

A

open-ended questions

affirmations (which are positive comments that help build the receiver’s confidence)

reflective listening

summarizing

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36
Q

TJC: National Patient Safety Goals (NPSG)

A

Goals designed to focus on client safety, safe and effective delivery of health care, and recommendations to avoid adverse outcomes.

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37
Q

NPSG: Identify Clients Correctly

A

The goal of identifying clients accurately has two components:

use two client identifiers

ensure that the medication, treatment, procedure, or care is intended for that specific client.

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38
Q

what are some client identifiers

A

the client’s name, date of birth, designated hospital number, telephone number, or alternative client-specific documentation.

NEED TWO

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39
Q

NPSG: Improve Staff Communication

A

critical results:

Lab or diagnostic procedure results that are outside the expected reference range and can be life-threatening or potentially fatal if not immediately improved.

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40
Q

NPSG: Use Medications Safely

A

This is a three-pronged goal:

label all medications, especially before a procedure

decrease the possibility of medication errors with anticoagulant (blood-thinning) medications

establish an accurate and current medications list for the client and have the provider reconcile the list with the new drugs ordered.

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41
Q

Using Medications Safely: Label all Medications

A

A medication should be discarded if it is found without a label on it, including the date and time it was mixed and the medication name and dose.

The nurse should never assume what the medication is.

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42
Q

Using Medications Safely: Decrease Errors Associated with Anticoagulant Medications

A

Pharmacists, providers, and nurses should review all of these elements. Clients should be informed of the risks and benefits of the medication, along with any precautions they need to take

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43
Q

Using Medications Safely: Reconcile the Client’s Medications

A

The process when the physician assesses the current home medications with the newly prescribed drugs. It must be completed on client admission, transfer, or discharge from the hospital.

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44
Q

NPSG: Use Alarms Safely

A

NPSG promotes using clinical alarm systems in health care settings. These audible alert devices, which are built into medical equipment, are intended to warn health care providers that a potentially serious event may be occurring

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45
Q

examples of clinical alarm systems

A

bed and chair alarms
feeding and IV infusion pumps
heart monitors
ventilators

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46
Q

NPSG: Prevent HAIs

A

main four:

CLABSIs
CAUTIs
VAPs
SSIs

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47
Q

how many people a year get HAIs

A

he Healthy People 2030 initiative reports that more than 500,000 persons acquire HAIs in health care facilities each year.

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48
Q

NPSG: Identify Client Safety Risks: Reduce the Risk of Suicide

A

This NPSG requires screening of clients who may be at risk for suicide or who have intentions of suicide. Clients who are at risk for suicide, as determined by the provider, are placed on round-the-clock surveillance while in a nonpsychiatric hospital

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49
Q

what is suicide ranked in numbers of deaths

A

10th leading cause of death in 2019 in USA

2nd leading cause of death in persons age 10 to 34 in USA

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50
Q

NPSG: Universal Protocol: Prevention of Adverse Events in Surgery

A

TJC mandates that a time-out—that is, a pause in all personnel activities within the operating or procedure room—take place before each surgery.

This brief suspension allows for the confirmation of the correct client, site, and procedure to be performed.

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51
Q

Safety: Infants and Preschools (0-4 Years)

A

is prone to burn injuries related to hot liquids or steam.

Preventive measures include keeping foods being cooked out of the reach of the child, setting water heaters no higher than 120°F (48.9°C), and ensuring homes have functional smoke and carbon dioxide alarms.

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52
Q

safety: school-age children (5-12 years)

A

sports injuries

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53
Q

safety: adolescents (12-19)

A

peer bullying and violence

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54
Q

safety: middle-aged adults

A

workplace accidents

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55
Q

safety: older adults

A

falls

56
Q

R.A.C.E.

A

Rescue
Alarm
Contain
Extinguish

57
Q

P.A.S.S.

A

Pull
Aim
Squeeze
Sweep

58
Q

what 3 elements does fire need

A

oxygen
combustion material (wood, kerosene, alcohol)
heat

59
Q

types of fire extinguishers

A

Class A: A water-based fire extinguisher for general combustible materials such as paper, wood, plastics, rubber, and cloth.

Class B: A carbon dioxide (CO2)–based fire extinguisher for oils, gasoline, paints, grease, and other caustic materials.

Class C: A dry chemical-based fire extinguisher specific for electrical fires, including those involving wiring, fuse boxes, computers, and other electrical devices.

Class D: A fire extinguisher for fires involving metals or flammable metal shavings from elements such as titanium, magnesium, potassium, and sodium.

Class K: A fire extinguisher specific for kitchen fires involving flammable oils and fats.

Class A, B, C: A multipurpose fire extinguisher that contain a dry chemical suitable for use on flammable materials and liquids or electric equipment.

60
Q

What theory does the nursing school at Cumberlands use?

A

JEAN WATSONS THEORY OF HUMAN CARING

EXAM Q

61
Q

communication styles by generations

A

gen Y: flexible, may use technology, frequent feedback

gen X: direct, to the point

silent gen: face to face, written, formal

gen X/post millennial: text/digital, short pieces of info, positive reinforcement

baby boomer: meeting face to face, sincere

62
Q

what are the four main regions of the brain

A

cerebrum
cerebellum
diencephalon
brainstem

63
Q

cerebral cortex

A

outer layer of the cerebrum

controls the perception of sensory information and process information to transfer it from short-term memory to long-term memory

64
Q

brainstem

A

located at the base of the brain, consists of the midbrain, pons, and medulla oblongata.

65
Q

midbrain

A

controls many of the motor functions.

66
Q

diacenphalon

A

controls body temperature and the autonomic nervous system

located above the brainstem between the cerebral hemispheres and consists of the thalamus, hypothalamus, and pineal gland

67
Q

thalamus

A

primary function is to process sensory information and regulate sleep.

Also development of dreams

68
Q

hypothalamus

A

acts as the control center for the autonomic motor system.

It is responsible for releasing hormones and regulating the body’s temperature

69
Q

suprachiasmatic nucleus

A

located inside of hypothalamus

assists in the regulation of the circadian rhythm.

70
Q

pineal gland

A

produces melatonin, a sleep hormone.

71
Q

two internal biological mechanisms

A

circadian rhythm
sleep-wake homeostasis

72
Q

circadian rhythm

A

Natural internal process that regulates the sleep–wake cycle within a 24-hour period.

sleepy at night, awake in the morning

73
Q

what does the circadian rhythm synchronize to?

A

environmental cues such as light and temperature; however, the body can generally maintain circadian rhythms without prompts

74
Q

sleep-wake homeostasis

A

Assists the body to remember to sleep after a given time.

The level of sleep is also controlled by, and will deepen according to, the amount of sleep deprivation that a client experiences.

75
Q

what are the main structures of the brain that regulate sleep?

A

hypothalamus (deep sleep)

suprachiasmatic nucleus (SCN) (controls a client’s behavioral rhythm directly from the eyes through light exposure)

brainstem (shift between wake and sleep) (pons and medulla oblongata influence REM)

thalamus (block out external distractions)

pineal gland (melatonin)

76
Q

Stages of Sleep: Stage 1

A

wake stage/lightest stage of sleep

alpha and beta waves

normal breathing and skeletal muscle tone is present

can last 1-5 minutes and approx. 5% of total sleep cycle

77
Q

alpha waves

A

electrical brain waves in the freq range of 8-12 hertz

when a person closes their eyes and become drowsy, that is alpha waves dominating beta waves

78
Q

beta waves

A

electrical brain waves in the freq ranges of 12-30 hertz

79
Q

Stages of Sleep: Stage 2

A

deeper sleep

sleep spindles

becomes challenging to wake client up in the stage

heart rate and temp decrease

50% of total sleep cycle

80
Q

do the number of cycles increase with age (stage 2)

A

yes

81
Q

sleep spindles (stage 2)

A

or K-complex electrical waveforms that trigger

the superior temporal gyri

anterior cingulate

insular cortices

the thalamus.

82
Q

Stages of Sleep: Stage 3

A

deepest sleep

consists of delta waves

if awoken in stage 3, clients may have a mental cloudiness for 30-60 minutes

immune systems strengths, muscles/tissues/bones repair and regenerate

can last up to 40 mins

15% of total sleep time

83
Q

do number of stage 3 cycles decrease with age?

A

yes

84
Q

delta waves

A

electrical brain waves, which are slower frequency, higher-amplitude signals.

85
Q

Stages of Sleep: Stage 4

A

REM, dreaming stage

looks like an awake stage of sleep on an EEG, however there is a loss of skeletal muscles tone

breathing is irregular and erratic, and the HR may be elevated

lasts about 10 and will become longer as the night progresses

typically begins after 90 mins of falling asleep

can last up to 1 hour

20-25% of total sleeping time

86
Q

Sleep Patterns: Newborns and Infants

A

NREM and REM occur every 45-60 mins

mostly remain in stage 3

up until 3 months of age, approx. 50% is REM cycle

after 1 year, the infant begins to progress towards an adult pattern of sleep

87
Q

Sleep Patterns: Adults

A

age 20-35

spend 2-5% of sleep in stage 1, 45-55% in stage 2, 10-20% in stage 3, and 20-25% in stage 4

occur approx. 4-5 times while the client is asleep

88
Q

Sleep Patterns: Older Adults

A

65+

have a decrease in stage 3 and an increase in stage 2

wake up more freq and have longer to fall asleep

89
Q

Recommended Hours of Sleep: Newborns (birth to 28 days)

A

14-17 hours

90
Q

Recommended Hours of Sleep: Infants (1 month to 1 year)

A

12-15 hours

91
Q

Recommended Hours of Sleep: Toddlers (1 year to 3 years)

A

11-14 hours

92
Q

Recommended Hours of Sleep: Preschool (3-6 years)

A

10-13 hours

93
Q

Recommended Hours of Sleep: School-Age Children (6-12)

A

9-11 hours

94
Q

Recommended Hours of Sleep: Adolescents (12-20)

A

8-10 hours

95
Q

Recommended Hours of Sleep: Young Adults (20-35)

A

7-9 hours

96
Q

Recommended Hours of Sleep: Middle Adults (35-65)

A

7-9 hours

97
Q

Recommended Hours of Sleep: Older Adults (65+)

A

7-8 hours

98
Q

Sleep Deprivation

A

When the body does not meet its biological sleep requirement, either chronically or acutely.

99
Q

What can sleep deprivation affect?

A

higher-order cognitive projects

impair judgment

decrease response time

trigger seizure disorders

migraines

tension headaches

high blood sugar in people with type 2 diabetes

obesity

100
Q

keep naps what?

A

short and before 3pm

101
Q

Sleep Disorders: Insomnia

A

ongoing ability to sleep despite having the opportunity to do so

102
Q

Sleep Disorders: Apnea

A

condition in which there is an absence of inspiratory airflow for a minimum of 10 seconds

103
Q

Sleep Disorders: Hypopnea

A

associated w/a decrease in O2 saturation and lasts 10 seconds or longer

104
Q

Sleep Disorders: Obstructive sleep apnea (OSA)

A

related to the recurrent episodes of upper airway collapse and obstruction while sleeping combined with waking from sleep

105
Q

Sleep Disorders: Narcolepsy

A

chronic sleep condition characterized by sudden sleepiness and sudden periods of sleep.

106
Q

Sleep Disorders: Hypersomnia

A

disorder of excessive daytime fatigue without improvement after more sleep.

107
Q

Sleep Disorders: Restless Leg Syndrome (RLS)

A

aka Willis-Ekbom disease

uncontrollable urge to move the legs during sleep.

108
Q

how is obstructive sleep apnea diagnosed?

A

polysomnography

109
Q

Which class of sleep medications is the most commonly prescribed?

A

Nonbenzodiazepine hypnotics (also known as the z-drugs) are the most commonly prescribed sleep medications

110
Q

what is sleep essential for?

A

healing

EXAM Q

111
Q

What year was The Joint Commission established?

A

1951

EXAM Q

112
Q

is touch an effective technique?

A

yes

113
Q

effective techniques for therapeutic communication

A

silence
active listening
presenting reality
asking questions
open-ended questions
clarifying techniques (restating, reflection, paraphrasing, exploring)
offering general leads, broad opening statements
showing acceptance and recongition
focusing
giving information
summarizing
offering self
TOUCH
sharing feelings

EXAM Q

114
Q

why do older adults have an increased risk of falling?

A

decreased strength, impaired mobility and balance, improper use of mobility aids, unsafe clothing,

115
Q

A nurse is caring for a client who has a history of falls. Which of the following actions is the nurse’s priority?

A

complete a fall risk assessment

116
Q

what should clients who are at high risk for generalized seizures have?

A

a saline lock in place for immediate IV access

117
Q

A nurse manager is reviewing with nurses on the unit in the care of a client who has had a seizure. Which of the following statements by a nurse requires further instruction?

A

“I will go to the nurse’s station for assisstance”

Never leave your client, use the call light to summon assistance

118
Q

classes of fire extinguishers

A

class A: combustibles (paper wood rads, trash fires)

class B: flammable liquids or gases

class C: electrical fires

class D: metals/metal shavings

class K: kitchen fires (fats and oils)

119
Q

Class A, B, C fire extinguishers

A

a multipurpose fire extinguisher that can be used for fires involving combustibles, flammable liquids, and electrical equipment.

120
Q

A nurse observes smoke coming from under the door of the staff’s lounge. Which of the following actions is the nurse’s priority?

A

move all clients who are nearby

121
Q

gen Y communication style preference

A

gen Y: flexible, may use technology, frequent feedback

122
Q

gen X communication style preference

A

gen X: direct, to the point

123
Q

silent gen communication style preference

A

silent gen: face to face, written, formal

124
Q

gen Z/post millennial communication style preference

A

gen X/post millennial: text/digital, short pieces of info, positive reinforcement

125
Q

baby boom generation communication style preference

A

baby boomer: meeting face to face, sincere

126
Q

medical futility

A

doing treatments that are not helpful and will not extend a client’s life

127
Q

narcolepsy (NT1) with cataplexy

A

caused by a lack of hypocretin

hypocretin is a hormone produced in the hypothalamus and is responsible for maintaining altertness

128
Q

which part of brain TRANSMITS SENSORY DATA and include is used to develop dreams?

A

thalamus

129
Q

fire-line sleep aid for older adults - medications?

A

controlled-release melatonin

130
Q

potential adverse effect of OTC sleep aid medications

A

urinary retention

131
Q

benefit of increased sleep that could prevent weight gain in someone who has insomnia

A

increased leptin production

132
Q

what adverse effects of nonbenzodiazepine hypnotic

A

hallucinations

133
Q

risk factor for developing obstructive sleep apnea

A

obesity

134
Q

nurse is preparing to admin meds to a client. what is considered ototoxic?

A

loop diuretics

NSAIDS

aminoglycoside antibiotics

135
Q

refraction test

A

preformed using lenses of various prescriptions strengths

136
Q

diabetic neuropathy

A

inspect feet every day
wear close toed shoes
manage blood glucose

Fundamentals (20 decks)

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