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63 Cards in this Set

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If you have someone who has been sexually assaulted, admitted to ER; what would be your first priority as a nurse (major nursing goal)?
If you have someone who has been sexually assaulted, admitted to ER; what would be your first priority as a nurse (major nursing goal)?

- Assist her in the crisis

- Assist the client during the acute phase of rape trauma syndrome to prepare for thoughts, symptoms, and emotions that may occur during the long term phase of the syndrome

- Perform a rapid physical assessment of injuries

- Treat any injuries and document care given

- Assist the specialist with the physical examination and the collection, documentation, and preservation of forensic evidence

- Support the client while legal evidence is being collected

- Evaluate for and treat sexually transmitted disease by following the Centers for Disease Control and Prevention Guidelines

- Evaluate for pregnancy risk and provide for prevention

- Call the client’s available personal support system, such as a partner or parents, if the client gives permission

- Encourage the client to verbalize her story and her emotions

- Listen and let the survivor talk; use therapeutic technique of reflection, open ended questions, and active listening

- Counseling begins in the emergency department and may continue with referral

- Ongoing care: 24 hour hotlines for rape survivors, promotions of self-care activities (written format), referrals for needed resources and support services (individual psychotherapy and group therapy), nursing case management
What is the definition of rape?
What is the definition of rape?

- Sex against one’s will by intimidation or by physical force

- Rape is a crime of violence, aggression, anger, and power
If you have a child admitted to hospital with partial thickness burns around the genitalia; the nurse is required by law to do what?
If you have a child admitted to hospital with partial thickness burns around the genitalia; the nurse is required by law to do what?

- The nurse is required by law to report it as suspected child abuse despite what the mother may say

- All states have mandatory reporting laws that require nurses to report suspected abuse; there are civil and criminal penalties for not reporting suspicions of abuse
What is the treatment goal for anger management?
What is the treatment goal for anger management?

- for patient to accept responsibility for his own hostile behavior then control it

- Initial goal of anger management therapy is for the client to accept responsibility for his own hostile behavior

- reinforces acceptable behaviors, identifies triggers for anger

- teach new ways to cope with anger
If you have a person who attempts suicide coming to your hospital; what is your nursing priority?
If you have a person who attempts suicide coming to your hospital; what is your nursing priority?

- provide safety to pt. by institute continuous observation of the patient.

- increasing level of supervision, one on one

- closer observation within arm length

- restrain pt. so he can’t hurt himself

- Limit amount of time at risk client spends alone

- If client goes from sad and depressed to happy and peaceful, high risk for suicide

- Assign staff to observe the client closely or consider one on one constant supervision

- Remove all glass, metal silverware, electrical cords, vases, belts, shoe laces, nail files, tweezers, razors, perfume, shampoo, bags
If you are evaluating a patient for suicide, what are you really trying to figure/find out?
If you are evaluating a patient for suicide, what are you really trying to figure/find out?

- trying to decide if the patient is going to hurt themselves (are they serious)

- Ask the client if he is thinking about hurting himself; always use a follow-up question if first answer was negative

- Determine the lethality of the suicidal plan; the more specific, the more lethal, and access to the planned method, the greater the risk

- On admission find out potential for suicide

- if he considering suicide

- or actually danger to himself or others
Patient admitted to psychiatric hospital and you are able to identify the sign of self-injuries from over the last month, what question do you ask?
Patient admitted to psychiatric hospital and you are able to identify the sign of self-injuries from over the last month, what question do you ask?

- “How did you get those wounds”
Patient admitted to psychiatric hospital and you are able to identify the sign of self-injuries from over the last month (wounds at different stages of healing); these might be considered what?
Patient admitted to psychiatric hospital and you are able to identify the sign of self-injuries from over the last month (wounds at different stages of healing); these might be considered what?

- suicidal gesture

- Parasuicide is inflicting a nonlethal injury to oneself with the intent to die or commit bodily harm (suicidal gestures)
What would be a main goal when planning care for patient that’s in crisis?
What would be a main goal when planning care for patient that’s in crisis?

- to restore them to a stable psychological equilibrium stage so they can cope with problems

- Assisting the client to regain a normal level of functioning; psychologic equilibrium
If you are dealing with a patient that is referred to hospice, what are the criteria for hospice care?
If you are dealing with a patient that is referred to hospice, what are the criteria for hospice care?

- within 6 months of expected death

- Hospice care can be given within 6 months of expected death; family bereavement services
Who has to verify the hospice care services requirements?
Who has to verify the hospice care services requirements?

- doctor

- Hospice care services are directed by the primary care provider (doctor) and managed by the nurse; volunteers are used for nonmedical care
What is the best approach to hospice end of life care?
What is the best approach to hospice end of life care?

- Inter-disciplinary team approach, priority is symptom control

- Care is provided for the terminally ill client as well as the family

- Hospice services may be provided in a facility or at home
Which phrase most correctly describes palliative care?
Which phrase most correctly describes palliative care?

- Palliative care is a management approach for end of life issues that prevents, relieves, reduces, and/or eases the symptoms of the disease without compromising medical interventions

- Palliative care is provided for the dying client but also the family and support network

- Palliative care provides for a “good death”
What are the S/S of the effects of marijuana (cannabis)? – 4 questions
- intended effects:
- S/S:
- Toxic effects:
- In high doses:
- Withdrawal symptoms:
What are the S/S of the effects of marijuana (cannabis)? – 4 questions

- Intended effects: Euphoria, Sedation & Hallucinations

- S/S: amotivational syndrome (apathy), red eyes, compulsive eating/laughing, impaired memory (long term use)

- Toxic effects: lung cancer (rare), chronic bronchitis, other respiratory effects; reproductive problems, such as fetal defects

-In high doses: paranoid and other psychotic behavior that can linger for weeks

- Withdrawal symptoms: possible depression
A patient with poly substance abuse is admitted and complaining of various symptoms; which substance is this patient withdrawing from? (pick from a list of 4 drugs) (N/V is one of the S/S)

- Alcohol:
- Nicotine:
- Opioids:
- Barbiturates:
- Benzodiazepines:
- Amphetamines:
- Cocaine:
- Cannabis:
- Inhalants:
- Psychedelics:
A patient with poly substance abuse is admitted and complaining of various symptoms; which substance is this patient withdrawing from? (pick from a list of 4 drugs) (N/V is one of the S/S)

- Alcohol: Withdrawal from low degree of alcohol dependence: Nausea, anxiety, and tremors

- Withdrawal from high degree of alcohol dependence: Can be life-threatening and require hospitalization

- Effects start within 12-72 hours of the last intake of alcohol and continue for 5-7 days

- S/S: abdominal cramping, vomiting, tremors, restlessness, inability to sleep, increased heart rate, increased BP, increased respiratory rate, and increased temperature; and tonic and clonic seizures

- Delirium Tremens (DTs) – Most serious symptoms of alcohol withdrawal

- Occur after the early symptoms, and last at least 10 days

- S/S: all of the previous symptoms plus severe disorientation, psychotic symptoms (ex. Delusions and hallucinations), severe HTN, cardiac dysrhythmias, delirium; may progress to death; requires acute hospitalization

- Nicotine: Abstinence syndrome: irritability, craving, nervousness, restlessness, anxiety, insomnia, increased appetite, and difficulty concentrating

- Opioids: Abstinence syndrome: sweating, rhinorrhea, piloerection, tremors, irritability, severe weakness, N/V, dilated pupils, muscle and bone pain, muscle spasms (self-limiting in 7-10 day, not life threatening)

- Barbiturates: Mild withdrawal symptoms: nausea, anxiety, and tremors similar to alcohol withdrawal

- Severe withdrawal symptoms: possibly life threatening convulsions, delirium, and cardiovascular collapse similar to that of alcohol withdrawal

- Benzodiazepines: Withdrawal symptoms are milder than for barbiturates and include: anxiety, insomnia, diaphoresis, HTN, possible psychotic reactions, and sometimes convulsions

- Amphetamines: Withdrawal symptoms: craving, depression, fatigue, sleeping (similar to those of cocaine) withdrawal is not life threatening

- Cocaine: Withdrawal symptoms: depression, craving, excess sleeping, not life threatening, suicidal ideation may occur

- Cannabis: Withdrawal symptoms: possibly depression

- Inhalants: No withdrawal symptoms

- Psychedelics: No withdrawal symptoms
What are the effects, toxic effects, and withdrawal symptoms of opioids?
What are the effects, toxic effects, and withdrawal symptoms of opioids?

- Intended effects: rush of euphoria, relief from pain, pupil constriction, constipation

- Toxic effects: decreased respirations and LOC, which may cause death

- An antidote, naloxone (Narcan), is used to relieve overdose

- Abstinence syndrome: sweating, rhinorrhea, piloerection, tremors, irritability, severe weakness, N/V, dilated pupils, muscle and bone pain, muscle spasms (self-limiting in 7-10 day, not life threatening)
What is the withdrawal S/S for alcohol? (check all that apply)
What is the withdrawal S/S for alcohol? (check all that apply)

- Withdrawal from low degree of alcohol dependence: Nausea, anxiety, and tremors

- Withdrawal from high degree of alcohol dependence: Can be life-threatening and require hospitalization

- Effects start within 12-72 hours of the last intake of alcohol and continue for 5-7 days

- S/S: abdominal cramping, vomiting, tremors, restlessness, inability to sleep, increased heart rate, increased BP, increased respiratory rate, and increased temperature; and tonic and clonic seizures

- Delirium Tremens (DTs) – Most serious symptoms of alcohol withdrawal

- Occur after the early symptoms, and last at least 10 days

- S/S: all of the previous symptoms plus severe disorientation, psychotic symptoms (ex. Delusions and hallucinations), severe HTN, cardiac dysrhythmias, delirium; may progress to death; requires acute hospitalization
What are the S/S of marijuana intoxication?
What are the S/S of marijuana intoxication?

- Toxic effects:

- lung cancer (rare), chronic bronchitis, other respiratory effects; reproductive problems, such as fetal defects

-In high doses:

- paranoid and other psychotic behavior that can linger for weeks
If you have patient with delirium (or dementia, alcohol intoxicated, mentally ill and suicidal) what is your primary responsibility?
If you have patient with delirium (or dementia, alcohol intoxicated, mentally ill and suicidal) what is your primary responsibility?

- safety
If you have patient that is alcohol intoxicated (or any other drug intoxication), what is your primary responsibility?
If you have patient that is alcohol intoxicated (or any other drug intoxication), what is your primary responsibility?

- Safety is the primary focus during acute stage of abuse

- Maintain a safe environment to prevent falls; implement seizure precautions
What is Delirium?
What is Delirium?

- Rapid onset over a short period of time (hours to days)

- Caused secondary to another medical condition, such as infection, or to substance abuse

- Reversible if diagnosis and treatment are prompt

- Impairments in: memory, judgment, ability to focus, and ability to calculate; impairments may fluctuate throughout the day

- LOC is usually altered

- Restlessness and agitation are common; sundowning may occur; behaviors may increase or decrease daily

- Personality change is rapid

- May have perceptual disturbances

- VS may be unstable and abnormal due to illness

- Ensure environmental safety: lowered bed, removal of scatter rugs
What is Dementia?
What is Dementia?

- Gradual deterioration of function over months or years; exact onset is difficult to determine

- Generally caused by a chronic disease, such as Alzheimer’s, or is the result of chronic alcohol abuse (Wernicke or Korsakoff)

- May be caused by permanent trauma, such as head injury

- Irreversible and progressive

- Impairments in memory, judgment, ability to focus, and ability to calculate; impairments do not change throughout the day

- LOC is usually unchanged

- Restlessness and agitation are common; sundowning may occur; behaviors usually remain stable

- Personality change is gradual

- VS are stable unless other illness is present

- Ensure environmental safety: lowered bed, removal of scatter rugs
What is nursing primary responsibility for Alzheimer patient?
What is nursing primary responsibility for Alzheimer patient?

- Safety
Patient with mild cognitive impairment; what might be a good therapy?
Patient with mild cognitive impairment; what might be a good therapy?

- First priority: safety

- Second priority: reality, orientation as treatment because patient is not demented and there is a hope of returning to reality

*** this treatment only work with delirium not dementia
What should you do to cure delirium?
Why do you have to cure delirium

- Have to treat the underlying condition (the thing causing it) (ex. Infection)
What would cause delirium
What would cause delirium

- Substance abuse

- Infection

- Fever

- Head trauma

*** reversible if diagnosis and treatment are prompt
What does confabulation mean in a patient suffering from alcohol abuse?
What does confabulation mean in a patient suffering from alcohol abuse?

- Client may make up stories about events or activities that she may not remember

- make up stories about events or activities to fill in the blank when they can’t remember
What would be an appropriate behavior modification to reward an appropriate conduct if you have a child with ADHD?
What would be an appropriate behavior modification to reward an appropriate conduct if you have a child with ADHD?

- Identify desired behaviors and reward them

- Limit self-stimulating and ritualistic behaviors by providing alternative play activities

(FROM INTERNET)



- praise is especially important for children who have ADHD because they typically get so little of it.

These children receive correction, remediation and complains about their behavior, but little positive reinforcement
Withdrawal S/S of Nicotine?
Withdrawal S/S of Nicotine?

- Nicotine: Abstinence syndrome: irritability, craving, nervousness, restlessness, anxiety, insomnia, increased appetite, and difficulty concentrating
Withdrawal S/S of Opioids?
Withdrawal S/S of Opioids?

- Opioids: Abstinence syndrome: sweating, rhinorrhea, piloerection, tremors, irritability, severe weakness, N/V, dilated pupils, muscle and bone pain, muscle spasms (self-limiting in 7-10 day, not life threatening)
Withdrawal S/S of Barbiturates?
Withdrawal S/S of Barbiturates?

- Barbiturates: Mild withdrawal symptoms: nausea, anxiety, and tremors similar to alcohol withdrawal

- Severe withdrawal symptoms: possibly life threatening convulsions, delirium, and cardiovascular collapse similar to that of alcohol withdrawal
Withdrawal S/S of Benzodiazepines?
Withdrawal S/S of Benzodiazepines?

- Benzodiazepines: Withdrawal symptoms are milder than for barbiturates and include: anxiety, insomnia, diaphoresis, HTN, possible psychotic reactions, and sometimes convulsions
Withdrawal S/S of Amphetamines?
Withdrawal S/S of Amphetamines?

- Amphetamines: Withdrawal symptoms: craving, depression, fatigue, sleeping (similar to those of cocaine) withdrawal is not life threatening
Withdrawal S/S of Cocaine?
Withdrawal S/S of Cocaine?

- Cocaine: Withdrawal symptoms: depression, craving, excess sleeping, not life threatening, suicidal ideation may occur
Withdrawal S/S of Cannabis?
Withdrawal S/S of Cannabis?

- Cannabis: Withdrawal symptoms: possibly depression
Withdrawal S/S of Inhalants?
Withdrawal S/S of Inhalants?

- Inhalants: No withdrawal symptoms
Withdrawal S/S of Psychedelics?
Withdrawal S/S of Psychedelics?

- Psychedelics: No withdrawal symptoms
The nurse is caring for a patient with delirium, which statement is true?
The nurse is caring for a patient with delirium, which statement is true?

- Acute (rapid) onset; lasts hours to days
What is your priority with providing Alzheimer’s care?
What is your priority with providing Alzheimer’s care?

- Safe Environment and structured safe environment (one answer is for delirium)
What is your priority with a patient with delirium?
What is your priority with a patient with delirium?

- Safe Environment and structured safe environment (one of these answers)
If you are working with Alzheimer’s patients, what can they be caught up and occupied with?
If you are working with Alzheimer’s patients, what can they be caught up and occupied with?

- Folding towels and pillowcases
If you have somebody who is a relative taking care of an Alzheimer’s patient, and they express ambivalence and frustration, what would be the best response?
If you have somebody who is a relative taking care of an Alzheimer’s patient, and they express ambivalence and frustration, what would be the best response?

- Supportive
- Being responsible for an Alzheimer’s patient must be very difficult
When you are trying to establish a therapeutic relationship with an Autistic child, what symptoms would you expect the child to display?
When you are trying to establish a therapeutic relationship with an Autistic child, what symptoms would you expect the child to display?

- Stereotypical behaviors – rigid adherence to routines, bizarre behaviors such as hand or finger flapping, clapping, rocking, swaying, head banging, hand biting, preoccupation with certain repetitive activities
- Music and visual spatial skills often enhanced
- Usually observed before 3 years of age
- More common in males than in females
- Abnormal brain function affection language, logic, and reasoning
- Impaired communication – Language delay, echolalia, failure to imitate
- Impaired social interactions – Lack of responsiveness and interest in others (content to be alone, does not become upset when parent leaves), avoidance of contact, lack of eye to eye contact, failure to cuddle or be comforted, avoidance of touch, lack of friendship
When you are trying to establish a relationship with a child with autism, what would be the best approach?
When you are trying to establish a relationship with a child with autism, what would be the best approach?

- Sitting with the child
If you have a 3 year old child diagnosed with autism, what would you expect the child’s response to their parents be?
If you have a 3 year old child diagnosed with autism, what would you expect the child’s response to their parents be?

- Indifferent
- Impaired social interactions – Lack of responsiveness and interest in others (content to be alone, does not become upset when parent leaves), avoidance of contact, lack of eye to eye contact, failure to cuddle or be comforted, avoidance of touch, lack of friendship
Child diagnosed with ADHD, what strategies do you teach the parents to assist the child in their attempt to cope?
Child diagnosed with ADHD, what strategies do you teach the parents to assist the child in their attempt to cope?

- Always reward appropriate or positive behavior
- Praise would be good
If you have a child with Oppositional Defiant Disorder, what would you expect the behavior to be?
If you have a child with Oppositional Defiant Disorder, what would you expect the behavior to be?

- Argue with adults, caregiver, or person they are closest too
- Behaviors usually seen at home and directed toward person best known
If you are taking care of a child with a diagnosis of Conduct Disorder, what are you going to particularly emphasize with this child?
If you are taking care of a child with a diagnosis of Conduct Disorder, what are you going to particularly emphasize with this child?

- Don’t violate social norms
- Don’t injure other children or torture small animals
- Have a respect for the rights of others
If you have a person who is telling you they do not have a problem with drugs and alcohol, yet they have a history of using this substance for over 10 years, what is the defense mechanism used by this person?
If you have a person who is telling you they do not have a problem with drugs and alcohol, yet they have a history of using this substance for over 10 years, what is the defense mechanism used by this person?

- Denial
Why would a person use the defense mechanism denial?
Why would a person use the defense mechanism denial?

- To reduce their feelings of guilt
- They are trying to fool themselves
What is the most important thing for the patient to have if they are going to be successful in their rehab of alcohol?
What is the most important thing for the patient to have if they are going to be successful in their rehab of alcohol?

- Person must have the readiness to learn
- An emotional or motivational readiness
- They must be susceptible to change
When you first start working with a poly substance abuser (court ordered), what would be the outcome criteria that the nurse would like to achieve?
When you first start working with a poly substance abuser (court ordered), what would be the outcome criteria that the nurse would like to achieve?

- Hope that the client would recognize that they have a substance abuse problem
When you admit a client with alcoholism, what is the most important question that you need to ask?
When you admit a client with alcoholism, what is the most important question that you need to ask?

- When was your last drink?
- What is your age
If you have someone who asks you, what is the best advice to dealing with alcoholism?
If you have someone who asks you, what is the best advice to dealing with alcoholism?

- Total Abstinence (no alcohol or drugs)
- Clean and sober
If you have a patient who is withdrawing from alcohol and they start showing S/S of restlessness, tremors, and agitation, what would be your first action?
If you have a patient who is withdrawing from alcohol and they start showing S/S of restlessness, tremors, and agitation, what would be your first action?

- Watching for change in LOC and Seizures (they can just die)
Have a patient who has agreed to take Antabuse (disulfiram), what patient teaching is the nurse going to do?
Have a patient who has agreed to take Antabuse (disulfiram), what patient teaching is the nurse going to do?

- Avoid all alcohol (drinking, in food, mouthwash, aftershave, and Medications)
The nurse is caring for a patient who is taking Antabuse, and they lift a bunch of containers, which one of these containers should they avoid?
The nurse is caring for a patient who is taking Antabuse, and they lift a bunch of containers, which one of these containers should they avoid?

- Read the label and avoid all products with alcohol
A patient with Oxycontin, the nurse expects the patient is abusing the drug, what would be the S/S?
A patient with Oxycontin, the nurse expects the patient is abusing the drug, what would be the S/S?

- Constricted pupils, constipation, decreased LOC and respirations, and slurred speech
We need the S/S of withdrawal from opiates? (must be able to differentiate withdrawal of opiates and cocaine)
We need the S/S of withdrawal from opiates? (must be able to differentiate withdrawal of opiates and cocaine)

- Opioids: Abstinence syndrome: sweating, rhinorrhea, piloerection, tremors, irritability, severe weakness, N/V, dilated pupils, muscle and bone pain, muscle spasms (self-limiting in 7-10 day, not life threatening)
- Cocaine: Withdrawal symptoms: depression, craving, excess sleeping, not life threatening, suicidal ideation may occur
Know the difference of withdrawal symptoms in alcohol and cannabis?
Know the difference of withdrawal symptoms in alcohol and cannabis?

- Alcohol: Withdrawal from low degree of alcohol dependence: Nausea, anxiety, and tremors
- Withdrawal from high degree of alcohol dependence: Can be life-threatening and require hospitalization
- Effects start within 12-72 hours of the last intake of alcohol and continue for 5-7 days
- S/S: abdominal cramping, vomiting, tremors, restlessness, inability to sleep, increased heart rate, increased BP, increased respiratory rate, and increased temperature; and tonic and clonic seizures
- Delirium Tremens (DTs) – Most serious symptoms of alcohol withdrawal
- Occur after the early symptoms, and last at least 10 days
- S/S: all of the previous symptoms plus severe disorientation, psychotic symptoms (ex. Delusions and hallucinations), severe HTN, cardiac dysrhythmias, delirium; may progress to death; requires acute hospitalization
- Cannabis: Withdrawal symptoms: possibly depression
You have a patient using marijuana, what are some of the physical symptoms you would recognize?
You have a patient using marijuana, what are some of the physical symptoms you would recognize?

- Red Eyes, Increased appetite/laughter, suppressed motivation, impaired memory, drowsiness
If person uses marijuana on a long term basis, some S/S are?
If person uses marijuana on a long term basis, some S/S are?

- Impaired memory, drowsiness
What is the antidote for Benzodiazepine overdose?
What is the antidote for Benzodiazepine overdose?

flumazenil (Romazicon)