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280 Cards in this Set
- Front
- Back
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CLIENTS ADMITTED TO ER MAY EXPERIENCE BEHAVIOR CHANGES DUE TO:
A. SENSORY OVERLOAD B. SENSORISTASIS C. STEREOGNOSIS D. SENSORY RECEPTION |
A. SENSORY OVERLOAD
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WHEN PERFORMING A HX THE RN ASSESSES SENSORY PERCEPTION SUCH AS:
A. DEEP TENDON REFLEXES B. KINESTHETIC PERCEPTION C. MENTAL STATUS D. CRANIAL NERVES |
C. MENTAL STATUS
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PERIPHERAL NEUROPATHY AND PARESTHESIS BECOME THE ETIOLOGY FOR OTHER RN DX, AN EXAMPLE WOULD BE:
A. SOCIAL ISOLATION B. RISK FOR INJURY C. FLUID VOLUME OVERLOAD D. IMPAIRED SWALLOWING |
B. RISK FOR INJURY
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RN CAN INCREASE ENVIRONMENTAL STIMULI FOR CLIENTS WITH SENSORY DEFICIT BY:
A. KEEP RADIO PLAYING THROUGHOUT THE DAY FOR AUDITORY STIMULATION B. ESTABLISH A ROUTINE WITH EACH MEAL C. KEEPING BATHROOM LIGHT ON AT NIGHT D. ENSURING CLIENTS SAFETY |
B. ESTABLISH A ROUTINE WITH EACH MEAL...REGULAR MEANINGFUL STIMULI WILL BENEFIT THE CLIENT
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A CLIENT HAS IMPAIRED VISION, INTERVENTION TO HELP ADAPT TO THIS LOSS IS:
A. KEEP ROOM PATHWAYS FREE OF CLUTTER B. ASSIST CLIENT WITH AMBULATION C. PUT SIDE RAILS UP IN BED D. MAINTAIN THE SAME SCHEDULE EVERY DAY |
A. KEEP ROOM PATHWAYS FREE OF CLUTTER
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WHICH STATEMENT BY A CLIENT WITH DECREASED HEARING INDICATES A NEED FOR SENSORY AID IN THE HOME?
A. I TRIPPED OVER THE RUG B. I CANT HEAR PEOPLE KNOCKING AT THE DOOR C. I CAN HEAR THE RADIO WHEN I TURN IT UP D. MY EYESIGHT IS GOOD WHEN I WEAR MY GLASSES |
B. I CANT HEAR PEOPLE KNOCKING AT THE DOOR
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WHICH STATEMENT BY A HOSPITALIZED CLIENT INDICATES SHE NEEDS FURTHER ORIENTATION TO TIME, PEOPLE, PLACE, SITUATION?
A. i DONT REMEMBER THINGS TOO WELL LATELY B. THIS PLACE IS AS BUSY AS A TRAIN STATION C. ARE U THE SAME RN I HAD THIS AM? D. I'M TIRED OF SITTING IN THIS TRAIN STATION |
D. I'M TIRED OF SITTING IN THIS TRAIN STATION
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WHICH CLIENT IS MOST LIKELY TO EXPERIENCE SENSORY DEPRIVATION?
A. A DEAF 88 Y.O. CLIENT WITH +4 EDEMA WHO LIVES UPSTAIRS APT B. A PREMIE IN THE NICU C. A SICK CHILD IN A FOSTER HOME D. A BLIND 93 Y.O BEDRIDDEN IN A NURSING HOME |
A. A DEAF 88 Y.O. CLIENT WITH +4 EDEMA WHO LIVES UPSTAIRS APT
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THE RN IS CARING FOR A CLIENT WITH A TEMP. WHAT UPPER AIRWAY DEFENSE MECHAINISM WOULD THE RN EXPECT?
A. INCREASED NASAL MUCOUS AND SNEEZING B. COUGHING UP YELLOW SPUTUM C. COMPLAINT OF SORE THROAT D. DRY MUCOUS MEMBRANES |
D. DRY MUCOUS MEMBRANES
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THE RN IS CARING FOR A AN ELDERLY CLIENT WHO WAS IN AN MVA. THE RESP RATE IS 10 AND O2 SAT IS 80. WHAT CONDITIONS ARE THE CLIENT SUFFERING?
A. MI AND HYPERVENTILATION B. HYPOXIA AND HYPERVENTILATION C. DYSRHYTHMIAS AND HYPERVENTILATION D. HYPOXIA AND HYPOVENTILATION |
D. HYPOXIA AND HYPOVENTILATION
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TOO MUCH AIR, TAKING 30 BREATHES PER MINUTE IS CALLED:
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HYPERVENTILATION
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TAKING LESS THAN 10 BREATHES PER MINUTE IS CALLED:
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HYPOVENTILATION
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LACK OF O2 AT CELLULAR LEVEL IS CALLED:
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HYPOXIA
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LOW O2 IN THE BLOOD IS CALLED:
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HYPOXEMIA
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HIGH CARBON DIOXIDE IN BLOOD IS CALLED:
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HYPERCAPNIA
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THE RN EXAMINES THE CLIENTS LAB WORK AND NOTES A HEMOGLOBIN OF 10 AND A HEMATOCRIT OF 25. WHICH STATEMENT BY THE CLIENT MIGHT ALERT THE RN THE CLIENT IS HYPOXIC?
A. I REALLY NEED TO GO TO THE BATHROOM B. WOULD YOU GET THOSE SPIDERS OFF THE CEILING PLEASE? C. MY DAUGHTER SAID SHE IS COMING TO VISIT ME TODAY D. I HEARD ALOT OF PEOPLE TALKING IN THE HALL THIS MORNING |
B. WOULD YOU GET THOSE SPIDERS OFF THE CEILING PLEASE?
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HEMOGLOBIN 12-16G PER ML IN WOMEN
14-18G PER ML IN MEN |
FYI
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HEMATOCRIT 37%-48% IN WOMEN 40%-54% IN MEN
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FYI
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THE RN ADMINISTERS AN EXPECTORANT TO AN ELDERLY CLIENT WITH COPD, WHICH IS THE BEST RN INTERVENTION?
A. MONITOR THE FORCE OF THE CLIENTS COUGH B. OBSERVE THE COLOR OF BRONCHIAL SECRETIONS C. MONITOR PULSE AND RESP D. TEACH THE CLIENT TO COUGH AND DEEP BREATHE |
B. OBSERVE THE COLOR OF BRONCHIAL SECRETIONS
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THE RN ADMINISTERS THEOPHYLLINE TO A CLIENT WITH BRONCHIAL ASTHMA, WHICH IS THE BEST RN INTERVENTIONS?
A. MONITOR FOR BRADYCARDIA AND RESTLESSNESS B. TEACH THE CLIENT TO AVOID PRODUCTS WITH CAFFEINE C. PLACE THE CLIENT IN HIGH FOWLERS POSITION D. MONITOR FLUID INTAKE |
B. TEACH THE CLIENT TO AVOID PRODUCTS WITH CAFFEINE
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THE RN ADMINISTERS ALBUTERAL TO AN ELDER WHO HAS HEART DISEASE. NOW CLIENT TELLS RN HIS HEART IS RACING. WHAT RN INTERVENTION IS APPROPRIATE?
A. REASSURE CLIENT IT IS NORMAL SIDE EFFECTS B. TAKE THE CLIENTS VITAL SIGNS C. ENCOURAGE THE CLIENT TO COUGH AND DEEP BREATH D. ASSIST THE CLIENT TO AMBULATE |
B. TAKE THE CLIENTS VITAL SIGNS
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INEFFECTIVE AIRWAY CLEARANCE, CANT COUGH IT OUT, LIKE SECRETIONS IN PNEUMONIA
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FYI
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INPAIRED GAS EXCHANGE: IF SIGNS OF HYPOXEMIA ARE PRESENT, LIKE IN COPD
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FYI
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INEFFECTIVE BREATHING PATTERN: BEATS PER MINUTE ALL WEIRD, LIKE IN HYPOVENTILATION, NAME SOME RN INTERVENTIONS.
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POSITIONING, AMBULATION, PURSED LIPPED BREATHING, NUTRITION, ACTIVITY AND REST
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AMBULATION IS THE BEST INTERVANTION TO INEFFECTIVE BREATHING PATTERN TO GET O2 IN
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FYI
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INEFFECTIVE AIRWAY CLEARANCE: STRIDOR (NOISY BREATHING), COUGH, SPUTUM, FATIGUE, PAIN, ALTERED LOC
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FYI
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CLIENT SOB, ANXIOUS, PULSE OX 86%, RESP 44, YELLOW SPUTUM WITH FOUL ODOR, 130/80, R44, P130
WHAT IS THE BEST RN DX? A. IMPAIRED GAS EXCHANGE B. INEFFECTIVE BREATHING C. INEFFECTIVE AIRWAY CLEARANCE |
C. INEFFECTIVE AIRWAY CLEARANCE
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CLIENT 160/100 P87,R36 SOB, CRACKLES, FATIGUE. WHAT IS THE BEST RN DX?
A. IMPAIRED GAS EXCHANGE B. INEFFECTIVE BREATHING C. INEFFECTIVE AIRWAY CLEARANCE |
A. IMPAIRED GAS EXCHANGE
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DISCRIMINATION AGAINST PEOPLE B/C OF INCREASING AGE IS CALLED:
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AGEISM
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ACUTE CONFUSIONAL STATE IS CALLED:
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DELERIUM
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NOT A NORMAL PART OF AGING, IS TREATABLE
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DEPRESSION
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ACCEPTS THE DESCRIPTION OF TIME/PLACE AS STATED BY THE CONFUSED OLDER ADULT IS CALLED:
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VALIDATION THERAPY
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TRUE OR FALSE
THERE IS NO SINGLE THEORY THAT EXPLAINS AGING |
TRUE
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THREE COMMON CONDITIONS AFFECTING COGNITION IN OLDER ADULTS?
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DELERIUM, DEPRESSION, DEMENTIA
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SEXUALITY IS RECOGNIZED AS A FACTOR IN THE CARE OF OLDER ADULTS, ALL OLDER ADULTS, WHETHER HEALTHY OR FRAIL, NEED TO EXPRESS SEXUAL FEELINGS.
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FYI
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OLDER ADULTS EXPERIENCE A CHANGE IN SEXUAL ACTIVITY, WHICH BEST EXPLAINS THIS CHANGE?
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FREQUENCY AND OPPORTUNITIES FOR SEXUAL ACTIVITY MAY DECLINE
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A PROGRESSIVE DECLINE IN THE ABILITY OF THE EYES TO ACCOMODATE FOR CLOSE DETAILED WORK IS CALLED:
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PRESBYOPIA
VISUAL ACUITY DECLINES WITH AGE |
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A COMMON AGE RELATED CHANGE IN AUDITORY ACUITY IS CALLED:
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PRESYCUSIS
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TASTE BUDS ATROPHY, DECREASE SENSITIVITY AND APPETITE. OLDER ADULT IS LESS ABLE TO DISCERN SALTY, SOUR, BITTER
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FYI
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A CHANGE IN MUSCULOSKELETAL SYSTEM LEADS TO THIS, CHANGES IN THE CONFIGURATION OF THE SPINE THAT AFFECTS THE LUNGS AND THORAX
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KYPHOSIS
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OSTEOPOROSIS VERY IMPORTANT TO TAKE MEDS, DIET WITH CALCIUM, EXERCISE, SAFETY IN ENVIRONMENT, CLOTHING/SHOES THAT FIT
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FYI
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SMOKING LEADS TO RAPID CALCIUM LOSS IN URINE
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FYI
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YOUNG OLD ?
OLD OLD ? OLDEST OLD (FRAIL OLD) ? |
YOUNG OLD 65-74
OLD OLD 75-84 OLDEST OLD 85+ |
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BY 2030 HOW MANY OLDER ADULTS ARE ESTIMATED TO BE IN THE U.S.?
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70 MILLION
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WHICH STATEMENT BEST DEMONSTRATES THE RN AVOIDING AGEISM?
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GLASSES/HEARING AIDS ARE IMPORTANT
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TRUE OR FALSE
SEXUAL DESIRE DOES NOT DIMINISH WITH AGE |
TRUE
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TRUE OR FALSE
UTI's PRESENT AS CONFUSION IN OLDER ADULTS |
TRUE
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3 MOST COMMON CAUSES DEATH IN OLDER ADULTS?
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HEART DISEASE, CANCER, CVA
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72 Y.O MALE COMES TO ER, THE RN EXPECTS TO FIND?
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HYPERTENSION
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ELDERLY CLIENT WITH MENTAL CONFUSION, SUDDEN ONSET DYSPNEA AND ANXIETY. RN SUSPECTS:
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MI
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NURSING PROCESS: EXPLAIN ADPIE
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ASSESS, DX, PLAN, IMPLEMENT, EVALUATE
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NURSING PROCESS IS THE FRAMEWORK FOR CLIENT CARE THAT INVOLVES BOTH GENERAL AND SPECIFIC DECISIONS IN A WAY THAT FOCUSES ON A CLIENTS UNIQUE NEEDS
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FYI
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TYPES OF RN DX: WRAPS
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WELLNESS, RISK, ACTUAL, POSSIBLE, SYNDROME
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A STATE OF COMPLETE PHYSICAL, MENTAL, AND SOCIAL WELL-BEING IS CALLED:
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HEALTH
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HEATLH HUMAN MODEL, PHYSIOLOGICAL NEEDS, SAFETY/SECURITY, LOVE/BELONGING, SELF ESTEEM AND THEN ?
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SELF ACTUALIZING
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TRAVIS'S ILLNESS-WELLNESS MODEL (THE LINE)
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DEATH >DISABILTIY> NEUTRAL NOT SICK, NOT WELL > GROWTH > HIGH LEVEL WELLNESS
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VACCINES, EXERCISE AND NUTRITION ARE WHAT KINDOF PREVENTION:
PRIMARY, SECONDARY OR TERTIARY? |
VACCINES ARE PRIMARY PREVENTIONS
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FASTING BLOOD SUGARS, MAMMOGRAMS AND COLONOSCOPYS ARE WHAT KINDOF PREVENTION:
PRIMARY, SECONDARY OR TERTIARY? |
THEY ARE SECONDARY PREVENTIONS
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REHAB IS WHAT KINDOF PREVENTION:
PRIMARY, SECONDARY OR TERTIARY? |
TERTIARY PREVENTION
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ACUTE CONFUSION IS CALLED:
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DELERIUM
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CHRONIC CONFUSION IS CALLED:
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DEMENTIA
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DRUG TOXICITY, INFECTIONS, NUTRITIONAL DEFICIENCIES POSE AS:
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PSEUDODEMENTIA
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6TH MOST CAUSE OF DEATH
(COGNITIVE D/O) |
ALZHEIMERS
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LOSS OF LANGUAGE
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APHASIA
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LOSS OF PURPOSEFUL MOVEMENT IS CALLED:
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APRAXIA
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LOSS OF SENSORY ABILITY TO RECOGNIZE THINGS IS CALLED:
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AGNOSIA
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TRUE OR FALSE
FOR SKIN INTEGRITY KEEP SKIN MOISTURIZEDD (NOT DRY CRACKING) |
TRUE
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3 STAGES OF PRESSURE ULCERS, STAGE 1 SKIN INTACT, NONBLANCHABLE, PAINFUL, SOFT SKIN
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FYI
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3 STAGES OF PRESSURE ULCERS, STAGE 2 SHALLOW OPEN ULCER WITH RED/PINK WOUND BED WITHOUT SLOUGH
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FYI
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3 STAGES OF PRESSURE ULCERS, STAGE 3 TISSUE LOSS BUT BONE,TENDON, OR MUSCLE ARE NOT EXPOSED, WILL HAVE SLOUGH
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FYI
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KEEP HOB ELEVATED TO WHAT DEGREE?
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30* NO HIGHER
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WHAT IS A KEY FACTOR FOR HEALING??
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NUTRITION (PROTEINS)
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MAINTAINING A MOIST WOUND BED IS IMPORTANT
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FYI
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MULTIPLE SENSORY STIMULI HITTING YOU AT ONE TIME IS CALLED:
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SENSORY OVERLOAD
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REGULAR, SCHEDULED STIMULI WILL BENEFIT CLIENT
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FYI
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SENSORY DEPRIVATION IS WHAT?
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WHEN A PERSON EXPERIENCES AN INADEQUATE AMOUNT OF STIMULI
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IN CORONARY ARTERY DISEASE (CAD) LEFT AND RIGHT SIDED HEART FAILURE SHOWS AS:
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LEFT SIDED HEART FAILURE BUILD UP IN LUNGS (LEFT-LUNGS)
RIGHT SIDED HEART FAILURE BUILDS UP IN EXTREMETIES (EDEMA) |
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MOVEMENT OF AIR FROM ATMOSPHERE IS CALLED:
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VENTILATION
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PROCESS WHEREBY GAS EXCHANGE OCCURS IS CALLED:
(HINT: BREATHING ?) |
RESPIRATION
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IMPORTANT DEFENSE MECHANISM OF THE BODY IS TO MAINTAIN CLEAN, CLEAR AIRWAYS
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FYI
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HYPERTENSION IS 140/90
PREHYPERTENSION IS 120-139/80-89 NORMAL BP <120/ <80 |
FYI
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PATHOPHYSIOLOGY OF PRIMARY HYPERTENSION IS:
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ALTERED RENIN
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WHEN IS BP THE HIGHEST AND WHEN IS IT THE LOWEST?
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BP HIGHEST IN EARLY MORNING AND LOWEST AT NIGHT
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WHAT HEART MEDS DO YOU NOT DRINK GRAPEFRUIT JUICE WITHIN 2 HOURS OF?
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CALCIUM CHANNEL BLOCKERS LIKE
NORVASC, PROCARDIA |
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ACE INHIBITORS (ENDS WITH -PRIL) SIDE EFFECTS COUG, ELDERLY AND AFRICAN AMERICANS DONT RESPOND WELL
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FYI
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LOOK FOR ELECTROLYTE IMBALANCES WITH ALL DIURETICS
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FYI
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CLASSIC SYMPTOM OF PAD (PERIPHERAL ARTERY DISEASE) IS:
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INTERMITTENT CLAUDICATION(LIMPING)
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PAD MANIFESTS AS THIN, SHINY, TAUT SKIN. LOSS OF HAIR, DIMINISHED/ABSENT PEDAL PULSES.
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FYI
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BUERGERS DISEASE, INFLAMMATORY D/S OF ARTERIES, MEN OF MIDDLE EASTERN DESCENT, ABSOLUTELY MUST STOP SMOKING
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FYI
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RAYNAUDS PHENOMENON, YOUNG WOMEN, UNKNOWN ETIOLOGY, COLD, NUMB, THAN ACHING AND TINGLING, SWELLING, PROTECT FROM COLD, NO CAFFEINE, NO SMOKING, CALCIUM CHANNEL BLOCKERS
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FYI
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WHAT IS THE ANTIDOTE TO COUMADIN?
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VITAMIN K
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TRUE OR FALSE
EARLY AMBULATION IS KEY TO PREVENT DVT |
TRUE
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WHAT DO THESE SYMPTOMS REPRESENT? BROWN SCALY LEATHERY SKIN, COMMON IN ELDERLY, PAINFUL, DEBILITATING,
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CVI AND VENOUS LEG ULCERS
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63 T.O PT PAIN WITH WALKING THE RN:
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ATTEMPTS TO PALPATE THE DORSALIS PEDIS AND POSTERIOR TIBIAL PULSES
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RN PERFORMING ASSESSMENT PT WITH CHRONIC PAD OF LEGS, WHAT WOULD YOU EXPECT TO FIND:
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PROLONGED CAPILLARY REFILL
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FACTORS PROMOTING NORMAL BOWEL ELIMINATION PATTERNS ARE:
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INCREASE FLUIDS TO 2500-6000ML DAY, INCREASE FIBERS, INCREASE HOT TEA, INCREASE EXERCISE
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STAY AWAY FROM WHAT FOODS TO PROMOTE BOWEL ELIMINATION:
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CABBAGE, BROCOLLI, CHEESE AND OTHER GAS AGENTS
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IF STOOLS ARE TARRY WHAT PART OF THE GI TRACT IS IN PLAY?
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UPPER GI
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WHAT INFORMATION WOULD BE IMPORTANT TO KNOW, IF PERFORMING A BOWEL ASSESSMENT ON A CLIENT?
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ROUTINES, EXERCISE, CHARACTERISTICS OF STOOL, LAXATIVE USE, DIET HX, RX's, PAIN WHEN GOING, MOBILIZATION
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FACTORS PROMOTING NORMAL BOWEL ELIMINATION:
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INCREASE FLUIDS TO 2500-6000 ML, INCREASE FIBERS, HOT TEA, EXERCISE, MAINTAIN SITTING POSITION, INCREASE FRUITS/VEGS, NO CABBAGE, BROCOLLI, CHEESE, GAS AGENTS
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TRUE OR FALSE
CONSTIPATION IS A SYMPTOM NOT A DISEASE |
TRUE
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NAME MEDS THAT CONTRIBUTE TO CONSTIPATION?
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XANAX, ATTIVAN, VALIUM (CNS DEPRESSANT DRUGS)
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BULK FORMING LAXATIVES ABSORB WATER FRO MGI, STRETCHES WALL, INCREASE PERISTALSIS. WHAT IS THE ONE THING YOU SHOULD MAKE SURE YOU DO WHEN YOU TAKE BULK FORMING LAX's?
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GIVE WATER, FOLLOW UP WITH WATER
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WHAT IS ONE THING YOU SHOW KNOW ABOUT LUBRICANT LAX's?
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NO FLUID ABSORPTION, IT COATS THAT LININGS, DO NOT TAKE LAYING DOWN, ADMIN 2 HRS AFTER MEALS
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SMALL AMOUNTS OF LIQUID BM OR OOZING OF LIQUID STOOL CAN OR CANNOT COME OUT WHEN YOU HAVE FECAL IMPACTION?
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LIQUID BM CAN OOZE OUT WITH FECAL IMPACTION
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TO REDUCE DIARRHEA YOU NEED TO DO WHAT?
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DISCONTINUE SOLID FOODS, AVOID MILK PRODUCTS, WASH HANDS!!
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TRUE OR FALSE
PEPTO BISMOL CAUSES CONSTIPATION WITH LONG TERM USE |
TRUE
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NURSING INTERVENTIONS FOR DIARRHEA?
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INCREASE FLUIDS, LIQUIDS AT ROOM TEMPERATURE, EDUCATE ABOUT DIARRHEA, STOP ANTIDIARRHEAL DRUGS WHEN DIARRHEA IS CONTROLLED, CALL DR IF BLOOD, FOUL ODOR
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IF A CLIENT HAS URINARY INCONTINENCE WHAT WOULD BE AN APPROPRIATE INTERVENTION?
A. TELL THE CLIENT TO GO TO THE BATHROOM WHEN THEY FEEL THE URGE B. REDUCE ENVIRONMENTAL BARRIERS C. TEACH KEGEL EXERCISES |
B. REDUCE ENVIRONMENTAL BARRIERS
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STRESS INCONTINENCE MAY BE CONTRIBUTED TO WHICH OF THE FOLLOWING?
A. COMPLETE LOSS OF CONTROL OF BLADDER FX B. TOILETING TOO FREQUENTLY C. WEAK PELVIC MUSCLES AND STRUCTURAL SUPPORTS |
C. WEAK PELVIC MUSCLES AND STRUCTURAL SUPPORTS
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FOR STRESS INCONTINENCE, WHICH INTERVENTION WOULD THE RN PERFORM FIRST?
A. LIMIT COFFEE, TEA, AND ALCOHOL B. ENCOURAGE TOILETING EVERY 3 HOURS C. KEGEL EXERCISES |
A. LIMIT COFFEE, TEA, AND ALCOHOL (THEY'RE DIURETICS)
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ACTIVITY INTOLERANCE= INABILITY TO BREATHE (SOB), SEVERE SEVERE PAIN
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FYI
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IMPAIRED PHYSICAL MOBILITY= CAN BREATHE, NOT COMPLETELY SEVERE PAIN, AMPUTEE PAIN
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FYI
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YOU ARE CARING FOR AN ELDERLY GENTLEMAN WHO HAS DIFFICULTY WALKING DUE TO JT STIFFNESS AND PAIN. HE REQUIRES ASSISTANCE WITH ALL ADLs AND WITH AMBULATION DOWN THE HALL. WHAT IS AN APPROPRIATE RN DX FOR THIS GENTLEMAN?
A. IMPAIRED PHYSICAL MOBILITY B. ACTIVITY INTOLERANCE C. PAIN AND JOINT STIFFNEES D. OSTEOARTHIRTIS |
A. IMPAIRED PHYSICAL MOBILITY
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YOU ARE CARING FOR AN ELDERLY LADY WHO GETS VERY SOB, EMPHYSEMA, BARREL CHEST, WHEEZES AND CRACKLES IN HER LUNGS. WHAT IS HER RN DX?
A. IMPAIRED PHYSICAL MOBILITY B. SOB C. RISK FOR FALLS D. ACTIVITY INTOLERANCE |
D. ACTIVITY INTOLERANCE
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YOU ARE CARING FOR AN ELDERLY MAN WHO HAD AN MI, HE HAS BEEN CONFINED TO BED FOR 3 DAYS, SCATTERED CRACKLES, TEMP 100, HAS A COUGH. WHAT RN DX?
A. INEFFECTIVE BREATHING PATTERN B. IMPAIRED GAS EXCHANGE C. RISK FOR INFECTION D. FATIGUE |
D. RISK FOR INFECTION
(RISK FOR PNEUMONIA) |
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YOU ARE CARING FOR AN ELDERLY OBESE FEMALE WHO HAD A CHOLECYSTECTOMY. SHE IS UNABLE TO MOVE EASILY DUE TO HER SIZE AND INCISIONAL PAIN. YOU NOTE VARISCOSITIES IN HER L.E. +EDEMA. PEDAL PULSES FAINT, WHAT IS THE RN DX?
A. IMPAIRED BED MOBILITY B. RISK FOR INJURY C. KNOWLEDGE DEFICIT D. RISK FOR ACUTE PAIN |
D. RISK FOR ACUTE PAIN
(RISK FOR DVT, DVTs HURT) |
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ACTIVITY INTOLERANCE= SEVERE SEVERE PAIN, SOB
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FYI
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79 Y.. MALE DXd WITH CHF, SEVERE FATIGUE, RARELY GETS OUT OF BED, SEEMS TO BE SLEEPING, REDDENED ELBOWS AND COCYX, CRACKLES IN BOTH LUNGS, PULSE OX 89%. WHAT RN DX?
A. ACTIVITY INTOLERANCE B. RISK FOR IMPAIRED SKIN INTEGRITY C. RISK FOR LUNG INFECTION D. FATIGUE |
A. ACTIVITY INTOLERANCE
(IF YOU GET HIM UP AND ABOUT THAT WOULD FIX EVERYTHING ELSE) |
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76 Y.O. CLIENT C/O JT PAIN AND STIFFNESS, DIABETIC 14 YEARS, MACHINE OPERATOR AND BENDS AND STANDS ALOT WITH HANDS REPETITIVE MANNER. 140-90, P89, R20. WHAT IS RN DX?
A. IMPAIRED PHYSICAL MOBILITY B. ACTIVITY INTOLERANCE C. PAIN AND JT STIFFNESS D. OSTEOARTHRITIS |
A. IMPAIRED PHYSICAL MOBILITY
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INCREASE STABILITY DURING CLIENT TRANSFER, RN INCREASE BASE SUPPORT BY PERFORMING?
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SPACE FEET FARTHER APART
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PT SUPINE IN BED, RN ASSISTS REG TO BATHROOM?
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PREVENT URINARY STASIS
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RN TEACHES ABOUT KEEPING JTS HEALTHY WHICH IS WT BEARING?
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WALKING
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RN 3 DAY POST OP WOUND INFLAMMED, WHAT SIGNS OF INFLAMMATION WOULD U SEE?
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HEAT, SWELLING, REDNESS, PAIN, AND LOSS OF FX
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5 MINS ACTIVE EXERCISE POST OP VITALS NOT TO BASELINE, RN DX?
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ACTIVITY INTOLERANCE
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SPASTIC PAIN IN ARM. BEST INTERVENTION:
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ADMIN PRN MUSCLE RELAXANTS
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PROCESS IN WHICH THE BODY USES FOOD FOR ENERGY, GROWTH, MAINTENANCE AND REPAIR OF TISSUES IS CALLED:
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NORMAL NUTRITION
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EXCLUSION OF RED MEATS IS CALLED:
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VEGETARIANS
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EAT ONLY PLANTS, LACK VITAMIN B12 IS CALLED:
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VEGANS
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EAT PLANT FOODS, DAIRY AND EGGS IS CALLED:
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LACTO-OVO VEGETARIANS
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HOW WOULD THE RN BEST RESPOND TO A CLIENTS STATEMENT "i AM ALWAYS DIETING, BUT I NEVER SEEM TO BE LOSING WT"
A. WT LOSS IS ONLY MAINTAINED IF YOU REALLY WANT TO LOSE WT B. DIETING IS A WAY OF LIFE AND COMPLIANCE IS REQUIRED TO MAINTAIN WT LOSS C. BY SAYING YOU ARE ALWAYS DIETING, IT SOUNDS LIKE YOU NEED SOME ASSISTANCE IN ATTAIING YOUR WT LOSS GOALS D. I NEED TO KNOW WHICH TYPE OF DIET YOU ARE ON BC IT MAY NOT BE EFFECTIVE |
C. BY SAYING YOU ARE ALWAYS DIETING, IT SOUNDS LIKE YOU NEED SOME ASSISTANCE IN ATTAIING YOUR WT LOSS GOALS
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WHEN THE RN ASSESSES THE INTAKE OF A VEGETARIAN CLIENTS HEALTH AND DIETARY PATTERNS WHICH FINDING DOES THE RN CONCLUDE IS MOST LIKELY TO NEGATIVELY AFFECT HEALTH STATUS?
A. USE OF VIT B12 SUPPLEMENTS B. INTAKE OF MILK AND DAIRY PRODUCTS C. GENETIC TENDENCY TOWARD LACTOSE INTOLERANCE D. REPORTS OF PROBLEMS WITH VISION |
D. REPORTS OF PROBLEMS WITH VISION
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THE RN IS CHECKING THE DIETARY TRAYS THAT HAVE BEEN DELIVERED TO THE RN UNIT. A CLIENT OF ORTHODOX JEWISH FAITH HAS RECEIVIED A TRAY CONTAINING A CHICKEN DINNER WITH VEGETABLES, TEA, AND 2% MILK. WHAT ACTION BY THE RN IS BEST?
A. INSTRUCT THE RN ASSISTANCE TO DELIVER THE MEAL TRAY AFTER REMOVING THE TEA B. CALL THE DIETARY DEPT TO SEND A TRAY WITHOUT CHICKEN C. HAVE THE DIETARY DEPT REPLACE THE ENTIRE MEAL TRAY D. ASK THE CLIENT IF LACTOSE-FREE MILK WOULD BE PREFERRED |
C. HAVE THE DIETARY DEPT REPLACE THE ENTIRE MEAL TRAY
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THE RN DETERMINES THAT A HYPERTENSIVE CLIENT UNDERSTANDS THE D.A.S.H. DIET WHEN THE CLIENT CHOSES WHICH ITEMS FROM A SAMPLE MENU USED IN DIETARY TEACHING?
A. CEASAR SALAD, BREAD STICKS, FROZEN YOGURT B. GRILLED CHICKEN SANDWICH, STRAWBERRIES, AND LETTUCE SALAD C. GRILLED CHEESE SANDWICH, CANNED PINEAPPLE, BROWNIE D. CHICKEN AND VEG STIR FRY, RICE AND EGG ROLL |
B. GRILLED CHICKEN SANDWICH, STRAWBERRIES, AND LETTUCE SALAD
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COMPLEMENTARY AND ALTERNATIVE THERAPIES ARE ADVOCATED BY MANY RN BC THESE THERAPIES?
A. PROMOTE SELFCARE AND SELF DETERMINATION BY PTS B. ARE CONGRUENT WITH A VIEW OF HUMANS AS HOLISTIC BEINGS C. ARE LESS EXPENSIVE FOR PTS THAN CONVENTIONAL THERAPIES D. CAUSE FEW ADVERSE EFFECTS WHILE ACHIEVING POSITIVE OUTCOMES |
B. ARE CONGRUENT WITH A VIEW OF HUMANS AS HOLISTIC BEINGS
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WHEN DISCUSSING HERBAL THERAPY WITH A PT, THE RN SHOULD ADVISE THE PT THAT:
A. PREPARATION SHOULD BE PURCHASED ONLY FROM REPUTABLE MANUFACTURERS B. HERBS RARELY CAUSE HARM OR SIDE EFFECTS BC THEY ARE NATURAL PLANTS C. THERE ARE NO KNOWN CONTRAINDICATIONS FOR HERBAL THERAPIES D. MOST HERBAL PREPARATIONS HAVE BEEN CLINICALLY TESTED FOR SAFETY BEFORE MARKETING |
A. PREPARATION SHOULD BE PURCHASED ONLY FROM REPUTABLE MANUFACTURERS
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ACCUPUNCTURE IS USED TO:
A. RELIEVE PAIN BY CAUSING COUNTER-IRRITATION IN ANOTHER AREA OF THE BODY B. REESTABLISH THE FLOW OF QI THROUGH MERIDIANS TO STIMULATE THE BODYS SELF HEALING MECHANISM C. CREATE AN INFLAMMATORY RESPONSE AT AN ACCUPOINT, INCREASING BLOOD CIRCULATION AND HEALING ENERGY D. STIMULATE THE ELECTRICAL PULSES OF THE CENTRAL NERVOUS SYSTEM |
B. REESTABLISH THE FLOW OF QI THROUGH MERIDIANS TO STIMULATE THE BODYS SELF HEALING MECHANISM
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PROVIDING PAIN RELIEF IS A BASIC HUMAN AND LEGAL RIGHT.
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FYI
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AN 86 Y.O. MAN HAS SEVERE DEGENERTIVE ARTHRITIS. IN PLANNING CARE FOR THE CLIENT, THE RN RECOGNIZES THAT CHRONIC PAIN IN AN OLDER ADULT:
A. IS MORE READILY TOLERATED THAN IN YOUNGER CLIENTS B. DOES NOT REQUIRE THE USE OF NARCOTIC DRUGS TO CONTROL C. IS POORLY TOLERATED BC OF PAST EXPERIENCES WITH PAIN D. IS OFTEN BELIEVED BY THE CLIENT TO BE AN INEVITABLE PART OF AGING. |
D. IS OFTEN BELIEVED BY THE CLIENT TO BE AN INEVITABLE PART OF AGING.
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TRUE OR FALSE
CLIENTS WITH PAIN WILL NOT ALWAYS HAVE CHANGES IN THEIR VITAL SIGNS. |
TRUE, THEIR BODIES ADAPTED TO CHRONIC PAIN
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A CLIENT WITH CHRONIC ABD PAIN HAS LEARNED TO CONTROL THE PAIN WITH USE OF IMAGERY AND HYPNOSIS. WHAT DOES THE RN KNOW ABOUT HOW THESE STRATEGIES WORK?
A. REDUCE SENSORY AND AFFECTIVE COMPONENTS OF PAIN B. PREVENT TRANSMISSION OF NOCICEPTIVE STIMULI TO THE CORTEX C. DECREASE THE INTENSITY OF THE PAIN THAT THE CLIENT IS WILLING TO TOLERATE D. DECREASE SENSITIZATION BY INCREASING THE PRODUCTION OF GLUTAMATE IN THE SPINAL CORD |
A. REDUCE SENSORY AND AFFECTIVE COMPONENTS OF PAIN
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NSAIDs HAVE ANALGESIC AND ANTIINFLAMMATORY PROPERTIES, USED FOR MILD PAIN
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FYI
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OPIUM DRUGS LIKE MORPHINE SULFATES AND CODEINES SUPPRESS RESPIRATIONS AND COUGH
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FYI
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DEMEROL USED 24-72 HOURS AFTER SURGERY. HAVE TO RECHECK BP AFTER ADMINISTER.
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FYI
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NUBAIN= LESS ADDICTING, ACUTE PAIN, TRAUMA PAIN, RESP DEPRESSION IF MIXED WITH ALCOHOL
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FYI
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TRANSDERMAL FENTANYL 100 TIMES PER POTENT THAN MORPHINE, LONG TERM PAIN
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FYI
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THE RN IS CARING FOR A CLIENT WHO HAS A RT SIDED WEAKNESS. THE RN NEEDS TO HELP THE CLIENT WALK. WHAT SHOULD THE RN DO WHILE WALKING WITH THE CLIENT?
A. HOLD THE CLIENTS LEFT HAND WHILE WALKING B. HOLD THE CLIENTS RIGHT HAND WHILE WALKING C. PUT A GAIT BELT ON THE CLIENT AND PROVIDE SUPPORT ON THE LEFT SIDE. D. PUT A GAIT BELT ON THE CLIENT AND PROVIDE SUPPORT ON THE RT SIDE |
D. PUT A GAIT BELT ON THE CLIENT AND PROVIDE SUPPORT ON THE RT SIDE
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CLIENT VOMITTING BLOOD, WHICH PAIN MED WOULD YOU AVOID?
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NSAIDs
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FOR INFECTION CONTROL WHERE DO YOU KEEP THE URINARY CATHETER BAG?
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BELOW THE BLADDER
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Problems with antibiotic therapy-side effects of abx hypersensitivity, organ toxicity, drug toxicity, check for blood levels….allergic reactions if allergic to certain meds notify dr immediately….encourage pts to eat buttermilk, yogurt, cheese, and probiotics. Misuse of abx-improper use of viral infection (cant treat virals, viruses with abx)…early discontinuation of abx (have to finish dose
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)…instability of stored abx (less effective if not properly stored)…potential dangers to children and the elderly (stick to rules on meds, if says do not give to young/old then don’t).
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Penicillin-kills bacteria, bactericidal, broad spectrum….side effects (n/v/d, anxiety, abd pain, less common convulsions, allergic reactions, can take hours or days, may take a few doses before reaction occurs
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)….interventions obtain culture, increase fluids, contact dr immediately if allergic reaction occurs, take entire dose of meds.
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Cephalosporins (kills bacteria, bactericidal, broad spectrum)found in sea water in a sewer plant. Similar to penicillin.
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Third generation cephalosporin-cefixime-suprax=only oral 3rd generation, suprax has structural changes to allow for better oral absorption, best of currently available oral ceph’s against gm –s, tab or suspension.
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Quinolones (ciprofloxacin)-antacids reduce their absorption, bactericidal.
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fyi
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MACROLIDES, ERYTHROMYCIN, FREQUENTLY USED WITH PTS ALLERGIC TO PENICILLIN, TO TREAT LEGIONARES DISEASE (PNEUMONIA), CAN CAUSE RENAL ISSUES, EXCRETED IN BILE AND FESCES, MONITOR I/O, VOIDING, WT LESS, COLOR CHANGES, JAUNDICE, PAINFUL IF GIVEN IM, LIVER FAILURE IN HIGH DOSES WITH TYLENOL, ALLERGIC REACTIONS….SIDE EFFECTS ERYTHROMYCIN N/V/D, HEPATOTOXICITY, JAUNDICE, AND ANOREXIA.
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FYI
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TETRACYCLINES, DOXYCYCLINE-DECREASE EFFECTIVENESS OF ORAL CONTRACEPTIVES (USE CONDOMS NOW)…AVOID TETRACYCLINE FOR CHILDREN UNDER 8, PREGNANT AND NURSING MOTHERS, MAY CAUSE DISCOLORATION OF PERMANENT TEETH.
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FYI
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AMINOGLYCOSIDES-STREPTOMYCIN-KILLS BACTERIA, BACTERICIDAL, PRODUCED FROM STREPTOMYCIN, POOR ORAL ABSORPTION, NO PO FORM, VERY POTENT ABX, SERIOUS TOXICITIES, NEPHRO AND OTO TOXICITY,
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KILLS MOST GM – BUT DOES KILL GM +, COMMONLY USED WITH OTHER ANTIBIOTICS. AMINOGLYCOSIDES-RENAL FAILURE CAN OCCUR WITH HIGH PEAKS, OTOXICITY WITH HIGH TROUGHS (EFFECTS 8TH CRANIAL NERVE), CHECK DRUG BLOOD LEVELS OFTEN TO AVOID TOXICITIES, ONLY USED FOR SERIOUS INFECTIONS, NEPHROTOXIC (URINE OUTPUT)
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AMPHOTERICIN B (FUNGAZONE) IV, INTERACTIONS/PRECAUTIONS (HIGHLY TOXIC SOLUTION, BINDS TO TISSUE RATHER THAN BLOOD, THEREBY INCREASING TISSUE DAMAGE, LONG HALF LIFE BECAUSE NOT EXCRETED WELL, FAT SOLUBLE, USE CAUTION WHEN USED WITH K+ DEPLETING DIURETICS AND DIGITALIS….
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SIDE EFFECTS RENAL DAMAGE, FEVER, HA, N/V, ANEMIA, F&E IMBALANCE, NEPHROTOXICITY, HYPOKALEMIA, CHECK BP ONLY USED IN MOST SERIOUS/SEVERE FUNGUS INFECTIONS, HYPOTENSIVE.
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AZOLE (NYSTANTIN, MYCOSTANTIN) USED MOSTLY FOR THRUSH IN MOUTH (YEAST) SWISH AND SWALLOW OR SPIT, OR ATHLETES FOOT, PO AND TOPICAL, DO NOT GIVE WITHIN 2 HOURS OF ANTACIDS.
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FYI
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FLUORINATED PYRIMIDINE (FLUCYTOSINE, ANCOBON, 5FU) USE CAUTION WITH RENAL DAMAGE, MAY HAVE TO USE HEMODIALYSIS TO REMOVE DRUG FROM SYSTEM, CAUTION WITH BONE MARROW DEPRESSION. SIDE EFFECTS-ANEMIA, THROMBOCYTOPENIA, HEPATOTOXICITY AND BRUISING.
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FYI
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. TOLNAFTATE (TINACTIN) PO, LONG THERAPY, CAUTION WITH ORAL CONTRACEPTIVES AND WARFARIN, MAY PRODUCE BLEEDING…SIDE EFFECTS HA, GI PROBLEMS, NEURITIS, ALLERGIES, HEPATOTOXICITY, COMPLETE ALL OF RXS.
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FYI
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ANTIVIRALS: DON’T STOP MEDS, PERSON ON AZT MONITOR BLOOD CELL COUNTS, NEED TO USE BACKUP CONTRACEPTIVES, SOME CAN PENETRATE BRAIN BLOOD BARRIER, HANDWASHING, AVOID DIRECT SUNLIGHT, GOOD ORAL HYGIENE, CAUTION WITH OTC MEDS, COVER MOUTH AND NOSE WHEN COUGHING, AVOID SEX WITHOUT BARRIER PROTECTION INFECTIOUS WHILE TAKING.
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FYI
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ZIDOVIDINE (AZT, RETROVIR) SUPPRESS HIV VIRUS, PO, NEUROTOXICITY, CAUTION WITH LIVER DAMAGE AND BONE MARROW DEPRESSION…SIDE EFFECTS BLOOD DISORDERS, HA, INSOMNIA, MUSCLE PAIN, N/V, ATAXIA, FATIGUE, NYSTAGMUS, PREGNANT HIV+ CAN TAKE AZT TO DECREASE TRANSMISSION TO INFANTS ACYCLOVIR (ZOVIRAX) PO, IV, IM, SQ, INHALATION, NEPHROTOXICITY, LEUCOPENIA THROMBOCYTOPENIA, HEPATOTOXICITY, NEUROTOXIC, CARDIOPULMONARY TOXICITY, CAUTION WITH EPILEPTICS OR PARKINSONS,
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CAUTION WITH THYROID DYSFUNCTION, DM, CARDIAC PROBLEMS….SIDE EFFECTS-COMA, CONFUSSION, N/V/D, PHLEBITIS, SEIZURES, TREMORS, DIZZINESS, CNS EFFECTS, SLURRED SPEECH, ANOREXIA, CONSTIPATION, DRY MOUTH, HA, FATIGUE, BLOOD DYSCRASIAS, SKIN RASHES, USE TO TX HERPES
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KUBLER-ROSS 5 STAGES OF DYING:
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DENIAL, ANGER, BARGAINING, DEPRESSION, ACCEPTANCE
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NORMAL/UNCOMPLICATED-MOST COMMON REACTION TO DEATH, MOST COMPLEX RESPONSE, EMOTIONAL, COGNITIVE, BEHAVIORAL, SPIRITUAL
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FYI
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COMPLICATED/DYSFUNCTIONAL-PROLONGED OR SIGNIFICANTLY DIFFICULT TIME MOVING FORWARD AFTER A LOSS, CHRONIC LOSS OF LOVED ONE, TROUBLE ACCEPTING DEATH AND TRUSTING OTHERS.
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FYI
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ANTICIPATORY-UNCONSCIOUS PROCESS OF DISENGAGING OR LETTING GO BEFORE ACTUAL LOSS OR DEATH OCCURS, MORE INTENSE RESPONSE TO GRIEF BEFORE DEATH OCCURS AND FEELS RELIEF WHEN IT HAPPENS.
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FYI
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DISENFRANCHISED/MARGINAL/UNSUPPORTED-WHEN THEIR RELATIONSHIP TO THE DECEASED PERSON IS NOT SOCIALLY SANCTIONED, CANNOT BE OPENLY ACKNOWLEDGED OR PUBLICALLY SHARED, OR SEEMS OF LESSER SIGNIFICANCE. DEATH OF A VERY OLD PERSON, AN EXSPOUSE, A GAY PARTNER, OR EVEN A LOVED PET
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FYI
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PALLIATIVE CARE IS THE PREVENTION, RELIEF, REDUCTION, OR SOOTHING OF SYMPTOMS OF DISEASE OR DISORDERS THROUGHOUT THE ENTIRE COURSE OF AN ILLNESS, INCLUDING CARE OF THE DYING, AND BEREAVEMENT F/U FOR THE FAMILY. THE PRIMARY GOAL OF PALLIATIVE CARE IS TO HELP CLIENTS AND FAMILIES ACHIEVE THE BEST POSSIBLE QUALITY OF LIFE. PALLIATIVE CARE IS FOR ANY CLIENT, ANY TIME, ANY DISEASE, IN ANY SETTING.
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FYI
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JON AND MARIE ARE THE PARENTS OF ROCKY A 5 YR OLD WITH LEUKEMIA, ROCKYS DOCTOR HAS TOLD THE PARENTS THAT HIS TXS ARE NO LONGER HELPING AND THAT ROCKY MOST LIKELY WILL NOT RECOVER. WHAT CAN JON AND MARIE EXPECT TO THINK AND FEEL AFTER ROCKYS DEATH? REGARDING THE REQUEST FOR ORGAN AND TISSUE DONATION AT THE TIME OF DEATH, THE NURSE SHOULD BE AWARE THAT:
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SPECIALLY EDUCATED PERSONNEL MAKE REQUESTS.
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THE NURSE NOTES THAT A WOMAN RECENTLY BEGINNING CANCER TX APPEARS QUIET AND WITHDRAWN, STATES SHE DOES NOT BELIEVE THE TXS WILL MAKE A DIFFERENCE, DOES NOT ASK ABOUT HER PROGRESS, AND HAS MISSED 2 CHEMO SESSIONS, BASED ON THE ABOVE ASSESSMENT DATA, THE NURSE WOULD GATHER MORE INFORMATION TO CONSIDER MAKING WHICH OF THE FOLLOWING RN DX?
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POWERLESSNESS
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A HOME CARE RN IS ASKED BY A FAMILY MEMBER WHAT HE SHOULD DO IF THE CLIENTS SERIOUS CHRONIC ILLNESS CONTINUES TO WORSEN EVEN WITH INCREASED MEDICAL INTERVENTIONS, THE RN RECOGNIZES THAT THE FAMILY MEMBER IS POSING A QUESTION ABOUT GOALS OF CARE AT THE END OF LIFE, THE RN SHOULD:
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BEGIN THE DISCUSSION BY ASKING THE FAMILY MEMBER WHAT HE BELIEVES THE GOALS SHOULD BE.
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THE RN SUGGESTS THAT A CLIENT RECEIVE A PALLIATIVE CARE CONSULTATION FOR SYMPTOM MANAGEMENT RELATED TO ANXIETY AND INCREASING PAIN, A FAMILY MEMBER ASKS THE RN IF THIS MEANS THE CLIENT IS DYING AND IS NOW IN HOSPICE, THE RN EXPLAINS:
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PALLIATIVE CARE IS FOR ANY CLIENT, ANY TIME, ANY DISEASE, IN ANY SETTING.
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ETIC VIEWPOINT—OUTSIDER LOOKING IN. EMIC—INSIDER VIEW.
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FYI
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RACE—CLASSIFICATIONS BASED ON SKIN COLOR, BONE STRUCTURE, BLOOD TYPE, HAIR TEXTURE, FACIAL FEATURES TRUE RACES ARE FEW: US CENSUS 2010: 5 CATEGORIES ONLY: WHITE, BLACK, AMERICAN INDIAN/ALASKAN NATIONAL, ASIAN, HAWAIIAN/PACIFIC ISLANDER.
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NOTE: HISPANIC/LATINO/SPANISH IS NOT A RACE, BUT AN ETHNICITY.
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ISLAM: MONTH OF RAMADAN, NO FOOD & AVOID BEVERAGES DURING DAYLIGHT; & MAY EAT AFTER SUNSET
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FYI
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JEWISH: FAST ON YOM KIPPUR (DAY OF ATONEMENT: FASTING AND PRAYER AT END OF ROSH HASHANAH LATE SEPT-EARLY OCT)
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FYI
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DEVOUT CATHOLICS: MAY FAST ON FRIDAYS, LENT MOST LIFT THE REQUIREMENTS FOR ILL OR WEAK PATIENTS
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FYI
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ACCORDING TO CAMPHINA-BACOTE, THE PROCESS OF CULTURAL COMPETENCE BEGINS WITH WHAT CRITICAL COMPONENT?
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CULTURAL DESIRE
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ETHNICITY: A GROUP W/IN THE SOCIAL SYSTEM THAT CLAIMS TO POSSESS VARIABLE TRAITS SUCH AS COMMON RELIGION OR LANGUAGE. DIFFERENT ETHNIC GROUPS CAN BELONG TO SAME RACE. DIFFERENT CULTURES ARE FOUND WITHIN ONE ETHNIC GROUP.
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FYI
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ETHNICITY: A GROUP W/IN THE SOCIAL SYSTEM THAT CLAIMS TO POSSESS VARIABLE TRAITS SUCH AS COMMON RELIGION OR LANGUAGE. DIFFERENT ETHNIC GROUPS CAN BELONG TO SAME RACE. DIFFERENT CULTURES ARE FOUND WITHIN ONE ETHNIC GROUP.
Cultural backlash An emic worldview Enculturation Ethnocentrism |
Ethnocentrism
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The nurse looks at the client’s back and gasps. “Who burned all these circles into you?” The nurse is looking at this situation from a (an)
Etic view point* Stereotypical stance Discriminatory stance Emic viewpoint |
Etic viewpoint—outsider looking in.
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Cultures that are primarily matriarchal include:
Scandinavian and Polish African American and Native American Mexican and Middle-Eastern British and French |
African American and Native American
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What is the definition of a culture-bound syndrome?
An illness that is shared among several cultures. An imaginary illness often used to gain attention An illness used to used to explain the explain the personal and social reactions of the culture’s members. The way a culture’s healers deal with the sick |
An illness used to used to explain the explain the personal and social reactions of the culture’s members
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What does the client experience while undergoing the process of acculturation?
Strong discomfort with the new culture. Borrowing (adopting) selected parts of the new culture. Showing favor to the dominant culture Socializing within the primary cultural group |
Borrowing (adopting) selected parts of the new culture.*
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An example of a nurse imposing her/his cultural beliefs on a client is evident in which if the following scenerios?
Adaptation of the client’s room to accommodate family members. Seeking information on gender-congruent care for an Egyptian client Administering less potent pain medication to an outpatient surgery client. Allowing family members to assist (if they wish) with the client’s feeding and hygiene care. |
Administering less potent pain medication to an outpatient surgery client
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Being cared for by a nurse of the opposite gender would be an especially important issue for women from which of the following cultures?
Filipino Afghan Native American African American |
Afghan
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Which statement made by a client with a terminal illness expresses a sense of hope that the nurse can reinforce?
“My father lived for years with this disease.” “I’ve had a good life, and I’ll live each day as it comes.” “Research is always coming up with new research and cures.” “My daughter is getting married in 3 months, and I’m going to be there for her.” |
“My daughter is getting married in 3 months, and I’m going to be there for her.”
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The nurse is reviewing the chart of a patient who has come in for a pre-op consultation, and sees that the religion is listed as Jehovah’s Witness. What does the nurse anticipate the client to request?
To keep any removed body parts. To have a lengthy prayer in private with the church leader before surgery. To have a religious medal (amulet) with him in surgery. To request that no blood products be transfused. |
To request that no blood products be transfused.
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According to Camphina-Bacote, a nurse is said to possess Cultural Skill when doing what?
1. Collecting relevant cultural detail and conducting an appropriate physical exam with the client. 2. Doing an in depth exploration of the nurse’s own biases and assumptions. 3. Acquiring knowledge by reading about a specific culture. 4. Directly interacting with diverse clients appropriately. |
Collecting relevant cultural detail and conducting an appropriate physical exam with the client.
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The nurse is frustrated because the elderly Vietnamese female won’t walk in the hall or use her incentive spirometer after surgery. What is the nurse advised to do first?
Consider her own cultural background as someone raised in a Western culture. Ask the physician to speak to the client about the importance of movement. Inform the charge nurse of this situation. Enter the room often to gain the client’s trust and coax her a bit at a time. |
Consider her own cultural background as someone raised in a Western culture
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According to Camphina-Bacote, the process of cultural competence begins with what critical component?
1. Cultural knowledge 2. Cultural encounters 3. Cultural desire 4. Cultural skill |
CULTURAL DESIRE
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WHEN WALKING WITH A CANE WHAT IS THE PROPER SEQUENCE?
A. CANE, BAD FOOT, CANE BAD FOOT B. PUT CANE ON SIDE OF BAD FOOT LIKE HOUSE DOES |
A. CANE, BAD FOOT, CANE, BAD FOOT
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CANE GOES ON OPPOSITE SIDE OF INJURED/WEAK LEG
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FYI
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WHERE DOES THE HEIGHT OF WALKING DEVICES GO?
(WHAT BODY PART DOES IT LINE UP WITH?) |
WRIST CREASE
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TRUE OR FALSE
WALKERS ARE THE SAFEST DEVICE FOR PTS |
TRUE
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HOW MANY FINGER WIDTHS DOES THE CRUTCH FIT UNDER THE PTS UNDERARM?
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2-3 FINGERS WIDTH
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WEBERS TEST AND THE RINNE TEST ARE BOTH WHAT KIND OF TESTS?
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HEARING TESTS, USE TUNING FORK
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WHAT QUADRANT ARE THESE PARTS IN?
LIVER AND GALLBLADDER, PYLORUS, DODENUM, HEAD OF PANCREAS, RT ADRENAL GLAND, RT KIDNET, ASCENDING/TRANSVERSE COLON |
RT UPPER QUADRANT
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WHAT QUADRANT ARE THESE PARTS IN:
LT LOBE OF LIVER, SPLEEN, STOMACH, PANCREAS, LT ADRENAL GLAND, LT KIDNEY, TRANSVERSE/ASCENDING COLON |
LT UPPER QUADRANT
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WHAT QUADRANT ARE THESE PARTS IN:
LOWER RT KIDNEY, CECUM AND APPENDIX, ASCENDING COLON, BLADDER, OVARY AND SALPINX, UTERUS, RT SPERMATIC CORD, RT URETER |
RT LOWER QUADRANT
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WHAT QUADRANT ARE THESE PARTS IN:
LOWER LT KIDNEY, SIGMOID COLON, DESCENDING COLON, BLADDER, OVARY AND SALPINX, UTERUS, LT SPERMATIC CORD, LT URETER |
LT LOWER QUADRANT
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WHAT DOES COG MEAN?
(MOBILITY TERM) |
CENTER OF GRAVITY
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WHAT DOES BOS MEAN?
(MOBILITY TERM) |
BASE OF SUPPORT
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WHAT DOES LOG MEAN?
(MOBILITY TERM) |
LINE OF GRAVITY
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NOTE:
THE SINGLE GREATEST GACTOR IMPACTING ASSISTANCE LEVEL IS THE DEGREE TO WHICH A PERSON IS ASKED TO PARTICIPATE IN A TASK!! |
FYI
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IMPORTANT FACTORS TO CONSIDER WHEN GIVING A NONPARENTAL MEDICATION:
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ABLE TO SWALLOW, IS THERE N/V, IMPAIRED GI FX, DIFFICULT TO WAKEN, ALLERGIES TO THIS MED
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NOTE:
THE SMALLER THE DIAMETER OF THE SYRINGE, THE GREATER THE PRESSURE THAT IS EXERTED |
FYI
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NEEDLE GAUGES TO KNOW:
27G-30G INSULIN, PED IV 25G SQ, INTRADERMAL 23G SMALLER NEEDLE FOR ADULT IM INJECTIONS 21-22G STANDARD FOR ADULT IM INJECTIONS 20G FOR THICK MEDS IM (FE+, ESTROGEN) 18G BLOOD ADMINISTRATION (BY VEIN) 14-16G LARGE BORE FOR BLOOD DONATIONS, EMERGENCY IV, DIALYSIS |
KNOW THESE FOR TEST
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NOTE:
INJECT SLOWLY INTO RELAXED MUSCLE, KEEP A GRIP ON SYRINGE |
FYI
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ALWAYS ASPIRATE BEFORE INJECTING WHAT KIND OF SYRINGE?
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IM
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ALWAYS ASPIRATE WITH THIS SYRINGE EXCEPT WITH INSULIN OR HEPERIN?
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SUBQ
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DO OR DO NOT MASSAGE AFTER GIVING INJECTION
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DO NOT MASSAGE AFTER INJECTION
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AT WHAT ANGLE DO YOU ADMINISTER AN INJECTION FOR AN INTRADERMAL INJECTION?
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INJECTION ANGLE OF 10-15*
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INTRADERMAL INJECTION IS THE SLOWEST OR FAST OF ALL INJECTIONS?
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SLOWEST OF ALL, UP TO 72 HOURS
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WHERE DO YOU GIVE INTRADERMAL INJECTIONS?
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INNER ASPECT OF FOREARM, UPPER CHEST, UPPER BACK
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TB INJECTION IS NO MORE THAN 0.5ML WITH A 25-27G NEEDLE AT 1/4 TO 1/2 INCHES
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FYI
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INTRADERMAL TECHNIQUES
STRETCH SKIN WITH RT HAND, GIVE SHOT WITH LEFT HAND, LOOK FOR BLED (WELP) IF NO BLEB WITHDRAW SLIGHTLY AND INJECT AGAIN |
FYI
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SUBCUTANEOUS (SQ) INJECTIONS AT 45-90* ANGLE, SLOWER THAN IM ABSORPTION, NOT MORE THAN 2.5ML
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FYI
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SQ SITES FOR INJECTIONS:
ANTEROLATERAL UPPER ARMS, ANTERIOR THIGHS, LOWER ABD WALL, SCAPULAR REGION ON BACK, UPPER VENTRAL OR DORSAL GLUTEAL AREAS |
FYI
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SQ= INSULIN SYRINGE 25-29G, 3/8 TO 5/8" NEEDLE, USE TB SYRINGE FOR HEPARIN, PINCH UP SKIN
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FYI
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INTRAMUSCULAR INJECTIONS PLACEMENT DEEP WITHIN THE MUSCLE, 90* ANGLE, 2-3ML 21-23G AND 1- 1 1/2"
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FYI
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INTRAMUSCULAR INJECTIONS LARGE MUSCLE UP TO 4ML, SMALL MUSCLE UP TO 1ML
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FYI
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INAPPROPRIATE SITE SELECTION NERVE INJURY, ABSCESS, NECROSIS, CHRONIC PAIN, SKIN SLOUGH
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FYI
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INTRAMUSCULAR INJECTION SITES DELTOID LATERAL ASPECT TI UPPER ARM, 1" NEEDLE UP TO 1ML ABSORPTION ONLY, SMALL MUSCLE CLOSE TO RADIAL NERVE AND ARTERY, NOT USED FOR CHILDREN OR INFANTS
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FYI
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INTRAMUSCULAR INJECTION SITES FOR INFANTS, FIND BY PALPATING LOWER EDGE OF ACROMION PROCESS, AT MIDLINE OF LATERAL ARM, GO 3 FINGERS DOWN
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FYI
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WE NEVER GIVE DORSAL GLUTEAL INJECTIONS
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FYI
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ONLY USE DELTOID WHEN GIVING SMALL VOLUME OF MEDS
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FYI
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INTRAMUSCULAR INJECTION SITES:
VASTUS LATERALIS ANTERIAL ASPECT OF THIGH, WELL DEVELOPED MUSCLE, NO LARGE NERVES OR VESSELS, PREFERRED SITE FOR INFANTS UNDER 7 MOS, ONE HANDSBREATH ABOVE THE KNEE AND ON HANDSBREATH BELOW GREATER TROCHANTER |
FYI
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3 ML SYRINGE USAGE GIVE GREATER THAN 1 ML VOLUME, UNITS INTENTHS ML (0.1 ML)
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FYI
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5 ML SYRINGE USAGE IRRIGATION OR INSTILLATION OF SOLUTIONS, INCREMENTS OF 1.2 ML OFTEN NO NEEDLES USED
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FYI
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INSULIN SYRINGE USED FOR INSULIN ONLY, CALIBRATION IN UNITS, SUBCUTANEOUS ROUTE
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FYI
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TB SYRINGE USED FOR SKIN TESTS, DOSES LESS THAN 1 ML, PEDS MEDS, MARKED IN HUNDREDTHS (0.01 ML) SQ, TRADERMAL, PEDIATRIC IM
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FYI
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SEXUAL DEVELOPMENT:
INFANCY BIRTH TO 18 MONTHS= |
TRUST VS MISTRUST
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SEXUAL DEVELOPMENT:
TODDLER 1-3 YRS= |
AUTONOMY VS SHAME/DOUBT
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SEXUAL DEVELOPMENT:
PRESCHOOLER 4-5 YRS= |
INITIATIVE VS GUILT
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SEXUAL DEVELOPMENT:
SCHOOL AGE 6-12 YRS = |
INDUSTRY VS INFERIORITY
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SEXUAL DEVELOPMENT:
ADOLESCENCE 12-18 YRS= |
IDENTITY VS ROLE CONFUSION
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SEXUAL DEVELOPMENT:
YOUNG ADULTHOOD 18-40 YRS= |
INTIMACY VS ISOLATION
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SEXUAL DEVELOPMENT:
MIDDLE ADULTHOOD 40-65 YRS = |
GENERATIVELY VS STAGNATION
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SEXUAL DEVELOPMENT:
LATE ADULTHOOD 65 YRS + = |
INTEGRITY VS DESPAIR
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MALE CHROMOSOMES ARE:
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XY
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FEMALE CHROMOSOMES ARE:
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XX
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THE INNER SENSE A PERSON HAS OF BEING MALE OR FEMALE, WHICH MAY BE THE SAME OR DIFFERENT FROM HIS OR HER BIOLOGIC GENDER IS CALLED:
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GENDER IDENTITY
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THE BEHAVIOR A PERSON CONVEYS ABOUT BEING MALE OR FEMALE, MAY BE DIFFERENT FROM BIOLOGICAL GENDER OR GENDER IDENTITY IS CALLED:
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GENDER ROLE BEHAVIOR
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REFERS TO THE PREFERRED GENDER OF THE PARTNER OF AN INDIVIDUAL IS CALLED:
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SEXUAL ORIENTATION
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TRUE OR FALSE:
SEXUALITY IS REGULATED BY THE INDIVIDUALS CLTURE. |
TRUE
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WHAT?
MODERATE AMOUNTS IT INCREASED SEXUAL FUNCTIONING, CHRONIC USE IT DECREASED SEXUAL DESIRE, ORGASMIC DYSFUNCTION, AND ED |
ALCOHOL
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WHAT CAUSES INABILITY TO EJACULATE?
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ALPHA BLOCKERS
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WHAT INCREASES SEX DRIVE WITH DELAYED ORGASMS?
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AMPHETAMINES
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WHAT REPORTED ENHANCED ORGASMS, VASODILATION, FAINTING?
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AMYL NITRATES
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WHAT DECREASES SEX DRIVE, SHRINKING OF TESTICLES, AND INFERTILITY IN MEN?
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ANABOLIC STEROIDS
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WHAT DECREASES SEXUAL DESIRE, ORGASMIC DYSFUNCTION IN WOMEN, DELAYED EJACULATION?
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ANTIANXIETY AGENTS
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WHAT DECREASES SEXUAL DESIRE, REDUCED SEXUAL RESPONSE?
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ANTICONVULSANTS
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WHAT DECRESES SEXUAL DESIRE, ORGASMIC DELAY OR DYSFUNCTION IN WOMEN?
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ANTIDEPRESSANTS
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WHAT DECREASES VAGINAL LUBRICATION AND DECREASES DESIRE?
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ANTIHISTAMINES
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WHAT DECREASES SEXUAL DESIRE, ERECTILE FAILURE, AND EJACULATION DYSFUNCTION?
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ANTIHYPERTENSIVES
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WHAT DECREASES SEXUAL DESIRE, ORGASMIC DYSFUNCTION IN WOMEN, DELAYED EJACULATION , EJACULATORY FAILURE?
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ANTIPSYCHOTICS
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WHAT IN LOW DOSES INCREASES SEXUAL PLEASURE BUT IN LARGE DOSES DECREASES SEXUAL DESIRE, ORGASMIC DYSFUNCTION, AND CAUSES ED?
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BARBITURATES
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WHAT DECREAES SEXUAL DESIRE?
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BETA BLOCKERS AND CARDIOTONICS
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WHAT INCREASES INTENSITY OF SEXUAL EXPERIENCE BUT WITH CHRONIC USE DECREASES SEXUAL DESIRE AND SEXUAL DYSFUNCTION?
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COCAINE
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WHAT DECREASES VAGINAL LUBE, DECREASES SEXUAL DESIRE AND CAUSES ED?
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DIURETICS
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WHAT ACTS LIKE COCAINE BUT WITH PROLONGED USE REDUCES TESTOTERONE LEVELS AND REDUCES SPERM PRODUCTIN?
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MARIJUANA
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WHAT INHIBITS SEXUAL DESIRE AND RESPONSE, AND ERECTILE AND EJACULATORY DYSFUNCTIONS?
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NARCOTICS
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THE STATE IN WHICH AN INDIVIDUAL EXPERIENCES OR IS AT RISK FOR A CHANGE IN SEXUAL HEALTH, WHICH RESULTS IN CONCERN REGARDING OWN SEXUALITY?
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INEFFECTIVE SEXUALITY PATTERNS
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THE STATE IN WHICH AN INDIVIDUAL EXPERIENCES OR IS AT RISK FOR CHANGE IN SEXUAL FUNCTION THAT IS VIEWED AS UNSATISFYING, UNREWARDING, OR INADEQUATE?
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SEXUAL DYSFUNCTION
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WHAT CULTURE HAVE HIGHER INCIDENCES OF HIV/AIDS?
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LATINO MEN AND WOMEN
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HIV STAGE 1 FLULIKE SYMPTOMS APPEAR ABOUT A MONTH, AT 6 WKS TO 3 MONTHS ANTIBODIES APPEAR IN BLOOD TESTS, STAGE 3 AIDS. SURVIVAL RATE ABOUT 10 YRS
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FYI
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THE TEXTURED WARTS LOOKS LIKE CAULIFLOWERS MOST COMMON ON PENIS/SCROTUM, VAGINA/CERVIX?
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HPV
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MOST COMMON SPREAD BACTERIAL INFECTION IN U.S., IF NOT TREATED LEADS TO HPV, "SILENT" DISEASE ASYMPTOMATIC.
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CHLAMYDIA
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GONORRHEA, CHLAMYDIA, SYPHILLIS, AND PID ARE CAUSED BY BACTERIA AND ARE USUALLY TREATED WITH WHAT?
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ANTIBIOTICS
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TRUE OR FALSE:
MINOR ILLNESS, MEDS, AND FATIGUE OFTEN DECREASE SEXUAL DESIRE |
TRUE
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PERMISSION TO DISCUSS SEXUALITY, LIMITED INFORMATION RELATED TO SEXUAL HEALTH PROBLEMS BEING EXPERIENCED, SPECIFIC SUGGESTIONS ONLY WHEN THE RN IS CLEAR ABOUT THE PROBLEM AND INTENSIVE THERAPY REFERRAL TO PROFESSIONAL WITH ADVANCED TRAINING IF NECESSARY
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THE PLISSIT MODEL
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THE RN IS PROVIDING EDUCATION TO A NEW MOTHER ABOUT HER INFANT SONS SEXUAL DEVELOPMENT, THE RN KNOWN THE MOTHER UNDERSTANDS WHEN THE MOTHER STATES:
A. AS SOON AS HE BEGINS TO TALK, MY SON WILL HAVE A LOT OF QUESTIONS ABOUT SEX B. MY SON IS BEGINNING TO BE ABLE TO TELL THE DIFFERENCE BW MEN AND WOMEN C. THE RELATIONSHIP MY SON HAS WITH PEERS OF THE SAME SEX WILL INFLUENCE HIS SEXUAL IDENTITY D MY SON IS IN SELFCENTERED, EGOCENTRIC STAGE THAT WILL HELP HIM DETERMINE APPROPRIATE SEXUAL BEHAVIOR |
B. MY SON IS BEGINNING TO BE ABLE TO TELL THE DIFFERENCE BW MEN AND WOMEN
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A 25 Y.O. CLIENT IN ER FOR COUGH/FEVER. RN FINDS SEVERAL BRUISES. THE RN SUSPECTS SEXUAL ABUSE, WHAT IS THE RN FIRST ACTION:
1. REFER THE CLIENT TO A SEXUAL COUNSELOR 2. TELL THE CLIENT ABOUT THE SAFE HOUSE FOR WOMEN 3. ASK THE CLIENT TO DESCRIBE HOW SHE GOT THE BRUISES 4. REPORT THE ABUSE IMMEDIATELY TO THE PROPER AUTHORITIES |
3. ASK THE CLIENT TO DESCRIBE HOW SHE GOT THE BRUISES
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A 17 Y.O. MALE CLIENT STATES THAT HAS BEEN DATING THE SAME GF FOR 6 MONTHS NOW. WHICH OF THE FOLLOWING STATEMENTS MADE BY THE CLIENT INDICATES THAT HE NEEDS FURTHER EDUCATION ABOUT CONTRACEPTIVE AND PREVENTION OF STDs:
A. IF WE DO NOT USE CONDOMS THE RIGHT WAY WE COULD GET PREGNANT AND GET STDs B. IF MY GF HAS A IUD SHE PROBABLY WILL NOT GET PREGNANT BUT WE BOTH MIGHT STILL GET AN STD C. SINCE MY GF IS TAKING A BC PILL, WE DO NOT NEED TO WORRY ABOUT GETTING PREGNANT OR GETTING STDs D. USING CONDOM AND SPERMICIDE WILL KEEP US FROM GETTING PREGNANT AND FROM GETTING STDs |
C. SINCE MY GF IS TAKING A BC PILL, WE DO NOT NEED TO WORRY ABOUT GETTING PREGNANT OR GETTING STDs
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WHICH OF THE FOLLOWING CLIENTS ARE HIGHEST AT RISK FOR DEVELOPING HPV?
A. ON OVERWEIGHT 8 Y.O. BOY B. A SEXUALLY ACTIVE 15 Y.O. GIRL C. A 42 Y.O. DIVORCED WOMAN WITH HYPERTENSION D. A 28 Y.O. MARRIED MAN WHO HAS TYPE II DM |
B. A SEXUALLY ACTIVE 15 Y.O. GIRL
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WHILE ASSESSING FEMALE CLIENT YOU FIND PURULENT D/C, SHE STATES IT BURNS WHEN i URINATE AND I GO PEE ALOT, BASED ON THESE SYMPTOMS THE RN DETERMINES:
A. SHOULD BE TESTED FOR HIV B. MAY HAVE AN STD SUCH AS CHLAMYDIA C. IS EXPERIENCING NORMAL SIGNS OF PREGNANT D. NEEDS EDUCATION ON PROPER PERINEAL HYGIENE |
B. MAY HAVE AN STD SUCH AS CHLAMYDIA
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WHICH OF THE FOLLOWING MALE CLIENTS IS LEAST AT RISK FOR EXPERIENCING SEXUAL DYSFUNCTION?
A. A 50 Y.O. WHO IS TAKING ONE ASPIRIN A DAY B. A 20 Y.O. WHO WAS BORN WITH SPINA BIFIDA C. A 63 Y.O. WHO HAS HAD DM FOR 12 YEARS NOW D. A 72 Y.O. WHO RECEIVES HEMODIALYSIS 3 TIMES A WEEK FOR CHRONIC RENAL FAILURE |
A. A 50 Y.O. WHO IS TAKING ONE ASPIRIN A DAY
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WHEN THE RN IS GATHERING A SEXUAL HISTORY FROM AN OLDER ADULT, THE RN MUST KEEP IN MIND:
A. OLDER MEN LOSE FERTILITY B. OLDER ADULTS MAY NOT REVEAL INTIMATE DETAILS C. OLDER MEN AND WOMEN HAVE SEXUAL DYSFUNCTION D. OLDER ADULTS DO NOT USUALLY PARTICIPATE IN SEXUAL ACTIVITY |
B. OLDER ADULTS MAY NOT REVEAL INTIMATE DETAILS
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A USEFUL FRAMEWORK FOR THE RN I NGUIDING PLANNING AND SETTING PRIORITIES REGARDING SEXUAL ACTIVITY FOR A CLIENT IS THE:
A. PLISSIT MODEL B. NIC AND NOC GUIDELINES C. NANDA INTERNATIONAL GUIDELINES D. THE RNS OWN THEORY OF SEXUAL BEHAVIOR |
A. PLISSIT MODEL
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