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131 Cards in this Set
- Front
- Back
What is the prefered injection site for a 1 year old child?
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ventrogluteal
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morphine
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respritory depression and decreased urinary output
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intradermal
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TB Test
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Sub Q
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insulin
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factors to consider when choosing routes of med admin.
ex. client is nauseated, vomiting for several hrs., & needs antiemetic med. the nurserecognizes... |
a parenteral route is the route of choice
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Order:6mg morphine sulfate ever 3-4 hrs prn for a client's post-op pain. the unit does of the med dispenser has 15 mg in 1 ml. how much sol. should be given
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dose ordered/dose on hand * amt on hand
6mg/15mg * 1ml = 2/5 ml |
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the nurse is teaching the client how to prepare 10U of regular insulin and 5U of NPH insulin for injection. the nurse instructs the patient to
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inject into both vials withdraw the regular insulin first
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the client has an order for 30U of U-500 insulin. the nurse is using a U-100 syringe and will draw up and admin...
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5 times as strong as U-100 insulin. 30 units of U-500 insulin/6
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prescriber
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must be a documented Dx, condition, or indication for each med ordered
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Pharmacist
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responsible for filling prescriptions acurately and for being sure the are valid
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the 6 rights
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med
dose client route time and documentation |
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10:00, 2:00, and 6:00
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TID (3 times a day)
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If you have blood when you aspirate you
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throw away the needle in the sharps container & start over
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which documentation method would the phrase "Client is wheezing and experiencing some dyspnea on exertion
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P for PIE
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how much time does it take for regular insulin to take effect
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2-4 hours
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where to inject heparin?
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abdomen
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calculate a medication order from 80mg/tsp to the correct amount of ml
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5ml
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interpret an order that reads ii gtts OD
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2 drops to the right eye
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where patient teaching is documented
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discharge summary form
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how to correct a documentation error
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draw a straight line through error and initial it
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Can an LPN take a telephone order from a physician?
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no
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53-year-old client is seen at the clinic for a yearly physical exam, that evaluating the client's weight, the nurse also considers the age and height
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comparing data with normal health patterns
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how would I calculate an insulin order of 30U of U500 and convert that to a dosage in a U100 syringe
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6U
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the long-term goal would be for a tailor who is admitted for eye surgery
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returning to sewing
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during an admission history you have a client that has trouble breathing at night. In obtaining data for a problem-oriented database, the nurse should first question the client about
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The onset and duration of his present breathing problem
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how to recognize a nurses statement that reflects the scientific method
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"The client doesn't look the same today. I think something is wrong"
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aspects of critical thinking
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religion
language intuition |
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levels of critical thinking
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basic
complex commitment |
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components of critical thinking
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knowledge base
experience competence attitudes standards |
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nursing process
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assessment
diagnosis planning implementation evaluation |
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assessment steps
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approach
collection and verification of data analysis of data documentation |
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types of data
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objective data
subjective data |
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objective data
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what you and see and measure
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subjective data
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what the patient says
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nursing is about
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thinking
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cognitive
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what you know
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psychomotor
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what you do
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effective
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what you feel
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5 types of nurses
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1.novice
2.advaced beginner 3.competent 4.proficient 5.expert |
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reflection
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when you think about something you gain insight
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language
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communication is essential
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intuition
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innersensing-art of nursing- takes skill and knowledge
can;t havbe with out science |
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basic
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you so specifically
becomes second nature |
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complex
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analyze, be creative
make decisions about what you want by weighing optins |
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commitment
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choose action and accept accountability for it
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purpose of the scientific method
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to fin whats real and what is truth
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problem solving
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use information to develop a solution
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diagnostic reasoning and inference
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determine health status from patient symptoms
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clinical decision making
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drawing a conclusion based on pieces of evidence
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attitudes
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must convey confidence
think independently and interdependently be humble |
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skills
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interpretation
analysis evaluation inference explanation self-regulation |
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Source Records
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patients chart is organized so that each discipline has a section
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current
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timely immediate documentation
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utilization review
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people that look at medical record and check to see if it meets the standards
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Charting by exception
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used to eliminate redundancy, ensure concise documentation of routine care, emphasize abnormal findings, and identify trends in care
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Acuity recrd
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provides a method of determining the hours of care and staff required
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Nursing Documentation must be: ACFCTSO
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Accurate, Concise, Factual, Complete, Timely, Specific, Organized
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critical pathways
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tool used in managed care that incorporates the treatment interventions from all disciplines.
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unit dose
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current system, uses portable carts containing 24 hour supply of patients medications
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what affects circulation?
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hypertension in diabetes
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1 reason for toxic effects (accumulation of a med beyond therapeutic index):
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hydration level
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medication formed determines
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route of administration and there are 20 diff. forms
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meds have 3 classifications
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1. systemic 2. organ 3. symptom
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drug names
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1. generic -- official name 2. chemical 3. trade -- pharmaceutical co has a patent of the name
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gather data
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subjective=what the patient says; what can't be measured objective=measurable
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care plan
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to-do list
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nursing diagnosis
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to tell you why you need to do the things in your care plan
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Neuman
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systems model: we are a system of parts, all parts important, if one part goes wrong, the whole system is affected; primary, secondary, tertiary care
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benner
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personal experience; 5 nursing competencies
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watson
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connecting patient caring
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Leinninger's sunrise model
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culturally congruent care
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common method of selecting priorities
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Maslow's Hierarchy of basic human needs is a:
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components of critical thinking
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1. specific knowledge base 2. experience 3. competencies 4. attitudes 5. standards
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assessment
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systematic data collection, validation, and interpretation
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purpose of a nursing process
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to provide individualized, holistic, safe, quality, effective, and efficient care to clients
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process
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a series of steps or acts that leads to accomplishment of some goal or purpose
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nursing process
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a systematic and scientifically based process used by nurses to identify and make decisions about client needs
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five types of nurse levels
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. novice 2. advanced beginner 3. competent 4. proficient 5. expert
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skills that are necessary of a nurse
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1. interpretation 2. analysis 3. evaluation 4. inference 5. explanation 6. self regulation
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self regulation
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reflecting on experiences and how to improve
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explanation
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presenting arguments
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inference
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considering alternatives
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evaluation
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assessing results
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analysis
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critiquing
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interpretation
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assess
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three parts of a diagnosis
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1. nanda 2. related to 3. as evidenced by
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drawing a conclusion based on pieces of evidence
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clinical decision making
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determine health status from patient's symptoms
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diagnostic reasoning and inference
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using info to develop a solution
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problem solving
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scientifin method
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to find out what's real and what's truth
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when a client-centered goal has not been met in a projected time frame, the most appropriate action would be to:
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repeat the entire sequence of the nursing process to discover needed changes
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the primary source of data for elevation is the:
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client
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medications used to wash out a body cavity delivered with a stream of solution
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Irrigation
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tetrogenetic effect
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adverse affect on fetus
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computer controlled
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automated medicine dispensing systems used primarily for narcotics
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unit dose
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current system, uses portable carts containing 24 hour supply of patients medications
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stock supply
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historical, medications are available in large multidose containers
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single orders
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only once
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standing orders
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til dr. changes it or has stop order
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nurse
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responsible for knowing what medications are prescribed, their therapeutic and nontherapeutic effects, and the associated nursing implications
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presaline
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antihypertensive
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Pharmacodynamics
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the drug's action on body
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Pharmacokinetics
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the body's action on drugs -absorption -distribution -metabolism -excretion
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proprietary patent (good for how long?)
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7 days
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synergistic effect
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two meds combines better than 1
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what would a patient who's toxic on morphine look like?
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respiratory depression and decreased urinary output 0.675
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how is insulin administered?
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subQ
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subQ
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15 degrees
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client is nauseated, has been vomiting for several hours, and needs to receive an antiemetic medication. the nurse recognizes that which is accurate?
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parenteral route is the route of choice -parenteral=intradermal, subQ, intramuscular, intravenous
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given mass dissolved in a known volume
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solution
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preprinted, established guidelines that are used to care for patients with similar health problems
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standardized care plan
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provides a method of determining the hours of care and staff required
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Acuity recrd
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provides current orders, treatments, and diagnostic testing that are ongoing
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Client care summary or KARDEX
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allow quick and easy assessment of patient status
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Flow Sheets and graphic record
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tool used in managed care that incorporates the treatment interventions from all disciplines
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critical pathways
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the case manager advises nursing staff on specific nursing care issues, coordinates the referral to services provided by other disciplines, and ensures client education is completed
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Case Management
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used to eliminate redundancy, ensure concise documentation of routine care, emphasize abnormal findings, and identify trends in care
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Charting by exception
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patients chart is organized so that each discipline has a section
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Source Records
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logical order
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organized
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timely immediate documentation
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Current
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thorough communication
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complete
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exact, precise, concise, spelling, and abbreviations
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Accurate
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objective and subjective data are:
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Factual
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an effective way to learn the nature of an illness and the patients response is to read the medical record
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Education
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how is the patient's needs and progress communicated?
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through progress notes and nurse's notes
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a confidential, permanent legal documentation of information relevant to a patients health care
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Medical Record
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Nursing Documentation must be: ACFCTSO
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Accurate, Concise, Factual, Complete, Timely, Specific, Organized
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people that look at medical record and check to see if it meets the standards
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utilization review
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non governmental or legal agency/professional organization that gives recognition to an institution
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Accredidation
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Permanent document of all information relevant to health care
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Record
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anything written/printed that can be used as record or proof for authorization
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Documentation
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