Block #1 / Exam #1

Front 1

Who is Florence Nightingale?

Back 1

-the founder of modern nursing
-1st to use "evidence based practice"

Front 2

What did her theory include?

Back 2

-Infection Control
-Health restoration
-Washing Hands
-Therapeutic Environment
-Empathetic care
-Confidential care
-Care though vital signs

Front 3

Therapeutic Environment:

Back 3

-clean sheets
-consideration of noise
-light and nutritional status

Front 4

Health Restoration:

Back 4

-Help them do things on their own.

Front 5

What is critical thinking in nursing?

Back 5

-looking at the situation objectively
-determine what’s important
-recognize problems that need prioritizing
-consider various actions and probable outcomes
-making informed decisions
-evaluate info and making conclusions

Front 6

Critical Thinking:

Back 6

-is an organized, active, decision making process that examines situations and vales all available options
-involves using one’s mind in forming conclusions, making decisions, drawing inferences, and reflecting

Front 7

What are the 3 levels of critical thinking?

Back 7

-Basic
-Complex
-Commitment

Front 8

Basic:

Back 8

-trust the experts
-follow policies and procedures without individualizing the patient

Front 9

Complex:

Back 9

-analyze and examine things more independently
-realize alternatives so exist
-weigh benefits and risks
-be creative
-think outside the box

Front 10

Commitment:

Back 10

-able to make choices without assistance
-take accountability for actions

Front 11

Assessment:

Back 11

-gather data
-collects comprehensive data to the patients health and situation

Front 12

Systematic data collection to determine clients needs:

Back 12

-current and past health status
-medications
-functional status (physical and mental)
-coping patterns
-response to therapy
-risk for potential problems
-desire for higher level of wellness

Front 13

Data Collection Methods:

Back 13

-client & family history
- Physical exam
-observation
-collaboration with colleagues
-review of records and diagnostics studies

Front 14

Effective Communication:

Back 14

-verbal and nonverbal skills, empathy, sense of caring, active listening

Front 15

Systematic Observations:

Back 15

-dependent on knowledge base what causes or contributes to problem

Front 16

Accurate Interpretation of Data:

Back 16

-accurate & validated signs and symptoms

Front 17

Diagnosis:

Back 17

-analyses the assessment data to determine the diagnosis or issues (NANDA’S)
- Id problem, formulate nursing diagnosis

Front 18

What is the purpose of Nursing Diagnosis?

Back 18

-identify and label client responses to health problems
-meets need for common, consistent language
-basis for choosing nursing interventions
-defines body of knowledge for which nurse is held accountable
-improves quality of care

Front 19

Outcomes identification:

Back 19

-identifies expected outcomes for a plan individualized to the patient or situation

Front 20

Planning:

Back 20

-develops a plan that prescribes strategies and alternatives to attain expected outcomes
-write care plan to meet goals

Front 21

Implementations:

Back 21

-implements the identified plan
-carry out the plan

Front 22

Evaluation:

Back 22

-evaluates progress toward attainment of outcomes
-collect objective data to determine the extent to which goals were achieved
-revise plan as needed

Front 23

What is the nursing process?

Back 23

-systematic approach to identification & treatment of client needs in response to illness
-client centered, goal oriented method of providing care

Front 24

What is the difference between medical practice and nursing practice?

Back 24

-medical= they diagnose
-nursing= they treat based off of diagnosis

Front 25

What is the difference between subjective and objective data?

Back 25

-subjective is not measureable and objective is measurable

Front 26

Assault:

Back 26

-deliberate attempt or threat to inflict bodily injury on another person, with apparent ability to do so

Front 27

Battery:

Back 27

-illegal touching of another person

Front 28

Fraud:

Back 28

-deliberate deception intended to produce unlawful gain

Front 29

Liability:

Back 29

-the state of being justly or legally responsible

Front 30

Malpractice:

Back 30

-improper or illegal practice in medicine or law
-out of scope of practice

Front 31

Negligence:

Back 31

-failure to take reasonable precautions to protect others from the risk of harm

Front 32

Libel:

Back 32

-anything written, published, or publicly circulated, that damages a person’s reputation

Front 33

Slander:

Back 33

-speaking of a false charge that damages another’s reputation

Front 34

Autonomy:

Back 34

-a client’s right to self-determination without outside control
-client can make their own decisions

Front 35

Beneficence:

Back 35

-duty to actively do good for the clients

Front 36

Nonmaleficence:

Back 36

-duty to prevent or avoid doing harm, whether intentional or unintentional

Front 37

Fidelity:

Back 37

-the duty to be faithful to commitments

Front 38

Justice:

Back 38

-the duty to treat all clients fairly, without regard to age

Front 39

Veracity:

Back 39

-telling the truth

Front 40

Confidentiality:

Back 40

-HIPAA guidelines to protect patient information

Front 41

Accountability:

Back 41

-take responsibility for your actions

Front 42

Standards of care:

Back 42

-minimum level of care accepted to ensure high quality of client care

Front 43

Five right of Delegation:

Back 43

-right task
-right circumstance
-right person
-right direction/communication
-right supervision

Front 44

Right Task:

Back 44

-is one that is delegable for a specific task that are repetitive, require little supervision, are relatively noninvasive, have results that are predictable and the potential risk is minimal

Front 45

Right Circumstance:

Back 45

-the appropriate client setting, available resources, and other relevant factors are considered.

Front 46

Right Person:

Back 46

-the right person is delegating the right tasks to the right person to be performed on the right person

Front 47

Right Direction/Communication:

Back 47

-a clear, concise description of the task, including its objective, limits, and expectations is given

Front 48

Right Supervision:

Back 48

-appropriate monitoring, evaluation, intervention as needed, and feedback are provided

Front 49

Interpretation:

Back 49

-systematic data collection, clustering data in an organized manner

Front 50

Analysis:

Back 50

-review data with an open mind
-what is the data telling you

Front 51

Evaluation:

Back 51

-utilize criteria to determine results of nursing actions

Front 52

Inference:

Back 52

-review evidence
-is there a relationship there?
-does the evidence indicate a client’s problem?

Front 53

Explanation:

Back 53

-support findings and conclusions
-justify procedures and present arguments

Front 54

Self-Regulation:

Back 54

-reflect on experience
-identify how you can improve performance

Front 55

Responsibilities of a Nurse:

Back 55

-autonomy & accountability
-caregiver
-advocate
-educator
-communicator
-manager
-member of the nursing discipline

Front 56

Autonomy & Accountability:

Back 56

-independent nursing interventions and being responsible

Front 57

Caregiver:

Back 57

-help the client regain health and maximal level of independent of function
-restore emotional, spiritual, and social well being

Front 58

Advocate:

Back 58

-protect your client’s human and legal rights

Front 59

Educator:

Back 59

-explain concepts and facts about health, demonstrate procedures

Front 60

Communicator:

Back 60

-essential for all nursing roles and activates

Front 61

Manager:

Back 61

-establish an environment for collaborative care

Front 62

Patient Self-Determination Act:

Back 62

-requires that all health care institutions have a written P&P related to advance directives and give information to all patients on admission

Front 63

Advance Directives:

Back 63

-gives an individual a right to accept or refuse treatment in advance of their imminent death

Front 64

Living Will:

Back 64

-patients make their wishes known regarding the use of life-sustaining measures if they become incapacitated (CPR, ventilators, feeding tubes, IV fluids)

Front 65

Informed Consent:

Back 65

-is obtained when client agrees to an invasive or hazardous procedure
-full explanation of procedure, risks vs. benefits, alternatives, and consequences of refusal should be given
-Nurse can witness the signature

Front 66

Fire hazards:

Back 66

-RACE- Rescue, Alarm, Contain, Extinguish
-PASS- Pull Pin, Aim, Squeeze, Sweep

Front 67

Chemical:

Back 67

-drug’s chemical composition and molecular structure (2-p-isobutylphenylpropionic acid)

Front 68

Generic name:

Back 68

-nonproprietary name
-name given by the United States Adopted Name Council (ibuprofen)

Front 69

Trade/Brand/Proprietary Name:

Back 69

-the drug has a registered trade mark (Advil, Motrin)

Front 70

Pharmacokinetics:

Back 70

-drug movement
-the study of what the body does to the drug

Front 71

Absorption:

Back 71

-rate at which drug leaves site of administration
-usually in the stomach or small intestine

Front 72

Factors that influence absorption:

Back 72

-route of administration
-ability to dissolve
-blood flow to site of administration
-body surface area
-lipid solubility of medication
-presence of food or other drugs

Front 73

Distribution:

Back 73

-drug is transported where it’s needed

Front 74

Metabolism:

Back 74

-Usually in the liver
-drug is broken down

Front 75

Excretion:

Back 75

-leftover drug is excreted
-kidneys, liver, bowels, lungs, exocrine glands

Front 76

Onset:

Back 76

-time it takes for the medication to produce a response

Front 77

Peak:

Back 77

-time at which a medication reaches its highest effective concentration
-if too high may have toxic effects.

Front 78

Serum Half-Life:

Back 78

-time for serum drug concentration to be halved
-time for half of the original or remaining amount drug to be eliminated from the body

Front 79

Trough:

Back 79

-lowest amount
-minimum blood serum concentration (checked before next scheduled dose)

Front 80

Duration:

Back 80

-time medication concentration is sufficient to produce therapeutic response

Front 81

Plateau or steady state:

Back 81

-blood serum concentration is reached and maintained after repeated fixed doses

Front 82

Bioavailability:

Back 82

-amount of drug available for therapeutic effect
-decreases after passage through liver

Front 83

Bioequivalent:

Back 83

-2 medications have the same bioavailability or med has same bioavailability by different roles
-example: Cipro has the same bioavailability by IV or oral route

Front 84

Synergistic:

Back 84

-work better together
-occurs when combined effect of two medications is greater than effect of medications separately

Front 85

Idiosyncratic:

Back 85

-opposite effect
-example: given a sleeping pill and they become hipper

Front 86

Therapeutic Effect:

Back 86

-expected or predictable desired response

Front 87

Adverse Effect:

Back 87

-severe, unexpected, undesirable response

Front 88

Side Effect:

Back 88

-predictable, often unavoidable secondary effect

Front 89

Toxic effect:

Back 89

-medication accumulates in the blood stream

Front 90

Allergic Reaction:

Back 90

-unpredictable hypersensitivity response to the medication

Front 91

Antagonistic Effect:

Back 91

-second drug diminishes or cancels effect of the first drug
-example: birth control pills ineffective with certain antibiotics

Front 92

Incompatibility:

Back 92

-two drugs cannot be given together or adverse effect may occur

Front 93

Acute:

Back 93

-treat a short-term or critical problem

Front 94

Maintenance:

Back 94

-treat a long-term disease

Front 95

Palliative:

Back 95

-makes client more comfortable in terminally ill patients

Front 96

Supportive:

Back 96

-hydration, anti-emetics, blood products

Front 97

Prophylactic:

Back 97

-preventative

Front 98

Supplemental:

Back 98

-herbals, vitamins, iron

Front 99

Pharmacodynamics:

Back 99

-what drug does to body

Front 100

Therapeutic Index:

Back 100

-the ratio between a drugs therapeutic benefits and its toxic effects
-drugs are good unless you get too much

Front 101

Tolerance:

Back 101

-a decreasing response to repetitive drug doses
-require higher does to achieve a therapeutic effect

Front 102

Intolerance:

Back 102

-inability to absorb a metabolize a drug

Front 103

Cumulative effects:

Back 103

-occurs when a drug is metabolized or excreted more slowly than the rate at which it is being administered

Front 104

Dependence:

Back 104

-a physiologic or psychological need for a drug

Front 105

Addiction:

Back 105

-client displays drug-seeking behavior
-consistently uses more drug than what is needed or ordered
-Hoards medications
-Lies or steals to get it

Front 106

Warnings & Precautions:

Back 106

-list of conditions or types of clients that need close observation while on a specific drug
-example: person with lover impairment

Front 107

Interactions:

Back 107

-list of other drugs or foods that may alter the effect of the drug

Front 108

Contraindications:

Back 108

-conditions for which a drug should not be given

Front 109

6 Rights of Medication Administrations:

Back 109

-right drug
-right dose
-right time
-right route
-right client
-right documentation

Front 110

MAR:

Back 110

-Medication Administration Record

Front 111

2 other rights to drug administration:

Back 111

-right to refuse
-right knowledge

Front 112

3 Checks of Medication Administration:

Back 112

-check MAR against the physician orders
-check meds against MAR while preparing (check expiration date)
-check meds against Mar in client room

Front 113

Drug Routes:

Back 113

-Oral
-Inhalation
-Intraocular
-Parenteral
-Epidural
-Intrathecal
-Intraosseous
-Intraperitoneal
Intrapleural
-Intraarterial
-Topical
-Transdermal patch

Front 114

Pharmacological Classification:

Back 114

-grouped by physiologic activity and mechanisms of action
-example: beta blocker

Front 115

Therapeutic Classifications:

Back 115

-Grouped by similar therapeutic indications
-example: anti-coagulants

Front 116

Chemical Classifications:

Back 116

-grouped by chemical structure regardless or differences in pharmacologic activity

Front 117

Oral Route:

Back 117

-absorbed in the gastric mucosa or small intestine
-passes through portal (liver) circulation before going into blood stream
-known as first pass effect

Front 118

HIPAA:

Back 118

-Health Insurance Portability and Accountability Act

Front 119

What must be included in a Physician’s drug orders?

Back 119

-date and time
-name of the drug
-dose
-form to be given (tablet, syrup)
-route
-frequency
-duration if limited
-if drug is PRN, must include reason (pain, sleep)
-signature

Front 120

Which drugs should never be broken or crushed?

Back 120

-enteric coated
-sublingual
-extended release

Front 121

Prepare liquid Meds:

Back 121

-Shake or mix liquids
-pour on a flat surface
-measure at the meniscus
-wipe lip of bottle with a paper towel after
-if less then 5mL use syringe without needle

Front 122

What meds require assessment prior to giving?

Back 122

-blood pressure
-heart meds
-pain meds

Front 123

Meds on an empty stomach:

Back 123

-1 hour before meal or 2 hours after a meal

Front 124

What order should you give meds?

Back 124

-tablets and capsules first
-sublingual and buccal meds last
-avoid administering liquids again until buccal or sublingual meds has dissolved

Front 125

What are the 4 parts of a written diagnosis?

Back 125

-NANDA
-Related to
-Secondary to
-As evidenced by (AEB)

Front 126

Related to (R/T):

Back 126

-condition or etiology which can be changed by nursing intervention

Front 127

Secondary to (S/T):

Back 127

-medical diagnosis

Front 128

As evidenced by (AEB):

Back 128

-signs and symptoms

Front 129

What may cause errors in diagnostic statements?

Back 129

-lack of knowledge, inaccurate data, missing data, data disorganized
-inaccurate interpretation, failure to consider conflicting cues
-incorrect clustering, premature or early closure
-wrong diagnostic label selected
-failure to seek guidance

Front 130

How do you prioritize nursing diagnosis?

Back 130

-what might kill or harm client first
-ABCs (airway, breathing, circulation)
-Maslow’s hierarchy
-client driven (what’s most important to client)

Front 131

Maslow’s Hierarchy:

Back 131

-Physiological Needs: breathing, food, water, shelter, clothing, sleep
-Safety & Security: health, employment
-Love & Belonging: friendship, family
-Self-Esteem: confidence
-Self-Actualization: meaning, morality

Front 132

Established Desired Goals/Outcomes:

Back 132

-Realistic RUMBA
-Understandable to client
-Measureable
-Believable
-Achievable

Front 133

Interventions:

Back 133

-are actions performed to resolve problem and achieve client outcomes

Front 134

Outcomes:

Back 134

-measureable criteria it determine if goals are being met

Front 135

Cluster Data:

Back 135

-organizing collected data in a logical manner