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230 Cards in this Set

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The type of pain that is highly resistant to relief is an example of what type of pain?
Intractable pain
A verbal descriptor scale consists of a line with 3-5 word descriptors equally spaced along the line. The descriptors are ranked from
No pain to unbearable pain
Wong and Baker developed the faces scale to assess the pain in children. What does the scale consist of?
Six cartoon faces ranging from happy and smiling to crying which indicates severe pain.
What is the Gate Control theory?
According to this theory, peripheral nerve fibers have their pain modulated at the spinal cord level before transmission to the brain.
Give an example of using the Gate Control theory.
Backrub
What are endorphins?
The body's natural morphine-like substances.
What is bradykinin?
A substance released from plasma that leaks at tissue injury site which binds to receptors on peripheral nerves increasing pain stimuli.
What age group has the ability to describe pain?
Toddler
NSAIDS include which meds?
Ibuprofen and Naprosyn.
Common opioid side effects include...
Constipation, N/V, and respiratory depression.
Describe guided imagery.
Ask the client to close eyes and imagine and describe something pleasurable. Was effective if patient says he visualized a peaceful, happy time.
Who is not a candidate for patient controlled analgesics?
Confused and unresponsive clients.
What are the instructions you're going to give a client with PCA?
Instruct on the purpose of the PCA, operating instructions, expected pain relief, and possible side effects.
What is a placebo?
Any form of treatment or medication where there is a treatment from intent rather than the physical or chemical properties of the element.
What is the function of estrogen?
Stimulates growth of the ovaries and graffian follicles, promotes retention of fluid during menstrual cycle and pregnancy, stimulates prolactin secretion during lactation.
What is the function of progeserone?
Maintains pregnancy by inhibiting motility of fallopian tubes in uterus.
The inability of a woman to achieve orgasm is called
Orgasmic dysfunction
The urge or desire for sexual activity is called
Libido
Name three ways to decrease exposure to STDs.
Limit the number of sexual partners, use a condom, abstain from sexual activity with a partner who has symptoms of an STD.
What are the major side effects of oral contraceptives?
Severe headaches, severe abdominal pains, blurred vision, thrombophlebitis, hypertension.
The difference among people of different population groups is called
Cultural Diversity
Define stereotyping
Assuming that all members of a culture or ethnic group are alike
Describe Leninger's "Sunrise Model"
This model emphasizes that health care is influenced by elements of the social structure such as technology, religion, philosophical factors, kinship and social systems.
What is acute illness?
Any disease where there is a rapid onset of signs and symptoms and is of less than six months duration.
What is chronic illness?
Produces symptoms and signs of variable periods of time that runs a long course, generally over six months.
What is the chronic illness trajectory framework?
In this framework, the term trajectory refers to the course of action taken by a chronically ill patient, their family and health professionals to manage the chronic illness and its management on every day life activities and the individual's sense of identity.
Define community health nursing.
A synthesis of nursing knowledge and practice of public health implemented via systematic use of the nursing process or other processes, designed to promote health and prevent illness in population groups.
What is a population at risk?
This refers to a group of people who are at greatest risk of developing a particular health problem.
What is the primary concern of the community health nurse?
The health of the general public rather than an individual or family.
The inability to achieve or maintain an erection is known as
Erectile dysfunction (avoid using the term "impotent")
What is the level of prevention that measures of designed to promote general optimum health or the specific protection of man against disease agents?
Primary prevention (true prevention such as immunization, stop smoking, etc.)
What are examples of secondary prevention?
Early detection such as a chest X-ray, PPD, breast self exam, testicular self exam.
What is tertiary prevention?
Where you try to restore the person back to health, to the greatest degree of health you can achieve.
What are the leading health problems of elementary age school children?
Injuries, influenza, pneumonia, infection, malnutrition, dental disease, and cancer.
What are the leading problems of high school students?
Alcohol and drug abuse, injuries, homicide, STDs, sports injuries.
What is the ideal school health program?
A program which would have an interdisciplinary health team consisting of a physician, nurse, dentist, social worker, counselor and school administrator.
The primary agency dealing with health concerns at the international level is
World Health Organization
What is the official agency at the state level that deals with health issues?
The State Department (the state has primary authority in matters related to health, such as SSI and AFDC)
Describe the Social Security Administration
This agency is responsible for the administration of supplemental social security income for the aged, blind and disabled persons which is also known as SSI and is the administrator of AFDC
What is epidemiology?
The study of the distribution of health and illness within the population and the factors that determine the population health status.
What are the purposes of epidemiology?
To search for causal relationships in health and illness and to control illness through the resultant understanding of causality.
What is the ultimate concern of epidemiology in any of its uses?
Preventing disease and maintaining health.
What are the specific uses of the epidemiologic process?
Studying contributing factors, diagnosing health status, evaluating the effectiveness of health programs, establishing indicies of risk or the statistical probabilities of a particular condition occurring, and providing information to assist clinical decision making.
What are mortality rates of interest in community health nursing (5)? How is each calculated?
It includes the overall or crude death rate, cause specific death rates, infant/neonatal mortality rates, fetal and prenatal mortality rates and maternal death rates. Each rate is calculated from the number of events during a specific period and the average population at risk during the same period.
What is "morbidity rate"?
It reflects the number of cases of particular health conditions in a group or community. This is described in terms of incidents or prevalence rates.
Describe prevalence
The total number of people affected by a particular condition at a specific point in time.
What is the nurse's educational role?
This involves educating the general public about means to prevent communicable diseases, signs and symptoms of existing diseases, and where to seek help for possible communicable diseases.
What is the antidote for magnesium sufate?
Calcium gluconate, 10%
A pregnant teenager should be advised regarding
Picking out food in a cafeteria and choose food high in protein and iron.
What is the drug action of metagine?
Stimulate uterine contractions.
On the second day post partum, the nurse observes the patient with dark red blood with odor of menstruation, this will indicate
Normal involution
Patient teaching to the parents of a newborn umbilical care is
Clean with alcohol.
What should the nurse observe for with post-circumcision?
Bleeding
What is the nursing measure on a breast feeding mother with breast engorgement?
Warm compresses on the breast to improve comfort.
What is the nursing measure on a bottle feeding mother with breast engorgement?
Cold compresses on the breast to provide comfort.
Polidel is
A lactation suppressant
The hormone that determines pregnanacy is
Human Chorionic Gonadatrophin (HCG)
Painless vaginal bleeding in the last trimester is a clinical sign of
Placenta previa
Alpha Fetal Protein Test would indicate
Neural tube defect
The phase of labor where the woman will be irritable and restless is the
Transition phase.
Monitoring the woman during and following amniocentesis procedures for
Signs of premature labor or bleeding
The Lecithin/Sphingomyelin (L/S) Ratio measures
Fetal lung maturity
What Lecithin/Sphingomyelin (L/S) Ratio is sufficient to sustain extrauterine life?
2:1 or greater
Meconium is usually passed
In the first 24 hours
Constipation in the 3rd trimester of pregnancy is due to
increased progesterone and decreased peristalsis due to increased gravis uterus
Esterol levels are used primarily in pregnancies complicated by
Diabetes
A disorder occurring during pregnancy after the 20th week of gestation involving edema, protein urea and hypertension is
Pregnancy induced hypertension
The treatment to prevent eclampsia is
Magnesium sulfate
Magnesium sulfate is used to
Prevent seizures
When is physiologic jaundice most likely to occur?
Beginning on the second day of birth, peaking at one week and disappearing by the second week.
Pathologic jaundice occurs
In the first 24 hours.
Never perform a vaginal examination on a woman who is bleeding because it may
Result in puncturing the placenta.
In postpartum hemmorage due to uteratine atony (lacking tone), the nurse should adminster
Oxytocin as prescribed.
Describe the bleeding of laceratin of the vagina, cervix or perineum
Bleeding is bright red, continuous and often in spurts
To stimulate feeding of a newborn, the nurse should teach the mother to
Stroke the infant's cheek to stimulate the rooting reflex.
Vaginal discharge in a female neonate which we call pseudomenstruation is associated with
High levels of maternal hormone in the neonate
A patient recieving an IV drip in the postpartum asks, "Whay am I receiving Oxytocin?" The correct response is
To stimulate uterine contractions. Do NOT pick "stimulate lactation" because she might not be breast feeding.
In fetal distress, what is the initial finding?
The heart rate will increase first (also signs of restlessness).
The best position for a mother diagnosed with abruptio placentae is
Left lateral with head elevated.
A drug that induces labor is
Oxytocin
Define abrupto placentae
Separation of the placenta implanted in normal position in a pregnancy of 20 weeks or more during labor before delivery of the fetus. Often results in severe hemorrhage.
Natrosine turns paper blue, this means
That the fluid being discharged from the female is amniotic fluid.
When a nurse is administering magnesium sulfate, she should monitor the
Respiratory rate.
The stage of labor in which engagement occurs is the
First stage of labor
For a baby in phototherapy, the nurse should remember to
Turn the baby frequently.
The first stage of labor ends with
Complete cervical dilation. Crowning is occurring
What begins the second stage of labor?
Crowning
What ends the second stage of labor?
Delivery of the baby.
What is the third stage of labor?
Delivery of the placenta.
What is the fourth stage of labor?
Postpartum stabilization.
The umbilical cord is bleeding. The nurse should
Place another clamp on the umbilical cord. Do NOT pick reclamp, it's always add a clamp.
Maternal smoking is responsible for causing infants to
Have a decreased birth weight of at least 6 oz.
Normal hemoglobin for an infant is
11.2-16.5g/dL
In a neonate, what is a sign of pyloric stenosis?
Projectile vomiting.
When teaching the parent of a newborn care of cleaning the umbilical cord with an alcohol pad, you should teach her to
Do this with each diaper change.
If the mother is Rh negative and the baby is Rh positive, the nurse should
Give the Rhogam.
Why is the patient receiving pitocin IV every 4 hours after delivery?
To increase contractions.
A 32 week old fetus is born. The reason there is a decreased oxygen consumption is
Decreased surfactant
A newborn who has jaundice for 2 weeks, the diagnosis is
Physiologic jaundice
In a postpartum patient, what is the initial reason for massaging the fundus?
Contraction of the uterus decreases hemorrhage.
8-12 hours postpartum, you notice malodorus menstrual-like dark red discharge. It is most likely
Lochia rubra
When is lochia rubra vs. lochia serosa?
Lochia rubra for the first 3 days, lochia serosa for 3-7 days, lochia aba after that.
A pregnant mother is in the latent phase, complains of dizziness in a supine position. The nurse should
Lay the patient on the left side (part of supine hypertensive syndrome).
What would the nurse tell the preganant patient who smokes 20 cigarettes a day?
Smoking raises chances of retarded growth.
A pregnant woman drinks three alcohol coctails every day after work. The nurse should advise
If she knows the risks to fetal reaction to alcohol.
If a neonate is born with fetal alcohol syndrome (FAS), it is expected that you would see signs and symptoms of FAS
Within the first 24 hours.
The drug that's adminstered for C-section prep has been administered to a patient. The nurse should monitor the patient for
Hypertension.
When is the fetus most susceptible to the effects of rubiola?
2-9 weeks.
What is the maximum of Narcan that can be administered to a neonate
0.2mg
In a 10 lb. newborn, the nurse should check for
Serum glucose level.
A neonate born to a diabetic is most likely to have
Hypoglycemia
How do you keep a neonate warm in reagards to heat loss due to evaporation?
Dry thoroughly after bathing.
What is the best way to bathe a newborn?
Bathe one extremity at a time and keep the infant covered. Do NOT do a submersion bath with a newborn!
How do you maintain skin integrity on a premature infant?
Use non-alkaline soap with plain water.
What are the characteristics of uterine contractions?
The duration increases and the interval decreases. They are involuntary.
What are the three phases of uterine contractions?
Increment, acme and decrement.
When measuring the frequency of a contraction, you should measure it
From the beginning of one to the beginning of the next.
Uterine contraction duration should be measured
From the moment the uterine muscle begins to tense to full relaxation.
Describe how frequency and duration are measured.
Frequency is measured in minutes while duration is measured in seconds.
A pregancy is accepted when the patient says
"I always wanted to get pregnant someday."
The most important thing for a pregnant teen is
Prenatal care
During a vaginal examof a woman in labor, what three things are assessed?
Dilation, effacement and station
Define effacement and how is it measured?
Shortening of the cervical canal, measured from 0-100
What is another term for effacement?
Thinning of the cervix.
Which of the following is a sign that the mother is bonding well with the baby?
When she places the baby in an N-face position, plays, looks and shows bonding signs.
A baby with a pink body but blue extremeties has
Acrocyanosis
An HIV positive mother delivers an infant. She should be told not to
Breastfeed
A patient is 18 weeks in gestation, has had a spontaenous abortion 2 years ago, and she has a 3 year old child at home. What is the nursing term?
Gravida 3, para 1. T1, P0, A1, L1
What is TPAL?
Term, Premature, Abortion, Live births.
What is a nursing goal for a newborn male after circumcision?
No hemorrhage.
Amniotic fluid is leaking, what color would the litmus paper turn?
Blue
What is laminaria?
It lines the cervical opening.
A baby has blackish-greenish stools 24 hours after birth, what should the nurse do?
Record data in nursing notes, this is completely normal.
To prevent heat loss due to evaporation on the baby, the nurse should
Wash and quickly dry.
A baby is 28 weeks old, weighing three pounds. What is the health teaching the nurse should give the parent?
Teach the mother to express the milk and feed by gavage.
Physiology of pyloric stenosis is
Hypertrophy of the pylorus.
What is the reason for uterine atony?
Prolonged labor
When do you stop pitocin?
If a contraction lasts 90 seconds.
A baby is born weighing 10 lbs, 4 oz. and is shaking.
The nurse should check glucose level, this may indicate hypoglycemia.
If you have to choose between checking the clucose level and feeding the infant, choose
Feed the infant.
How do you feed a baby with pyloric stenosis?
Small, frequent feedings given slowly. Prop the baby upright slightly on the right side.
During a home delivery, what is the priority for the baby?
Keeping the baby warm (known as an extramural delivery)
What is the most evident sign of postmaturity?
Scaly, flaky skin.
What is the sign of a term infant?
Smooth skin, heel crease is greater than 2/3rds, breast tissue that's greater than 3mm.
Signs of a premature infant is
Wrinkled skin.
After vaginal delivery, what discharge instructions would you give the mother?
Do kagle exercises.
What is the nursing intervention for a baby who is undergoing phototherapy?
Cover the eyes and genitals, changle position frequently, keep baby hydrated.
A baby is delivered prematurely and is having difficulty breathing. This is most likely due to
A low L/S ratio.
A mother who is bottle feeding her infant is having trouble getting her infant to drink. She should be taught
The rooting reflex.
What would be most at risk for problems in preganancy, a 15 year old or a 40 year old prima para?
The 15 year old. The younger they are, the more difficulty they will have.
The clinical manifestation of pyloric stenosis is (3)
A paristolic wave that goes from right to left, weight loss and projectile vomiting.
A pregnant patient is at increased risk of infection if
Her water has broken over 24 hours ago.
What is the nursing priority for a healthy neonate?
Bonding with the mother.
What is the nursing measure for an infant with pyloric stenosis to retain feeding?
Turn the infant to the right side with the head elevated.
A distended bladder during delivery can interfere with
The progress of labor.
A distended bladder after delivery can cause
Subinvolution
What is a nursing intervention that is a priority before the mother and baby leave the delivery room?
Positive identification.
Why is erythromycin given to an infant?
To prevent gonorrhea.
Following an amniotomy on a pregnant patient, the nurse should check
The fetal heart rate.
What is an indication that involution didn't occur?
Palpable uterus
A patient is at -2, this indicates
The patient is in imminent labor and the fetus' head is 2cm above station zero.
If the patient is having late decelerations, the nurse should
Place patient on left side and put the patient on 8-12 liters of oxygen.
24 hours after delivery, the mother complains of pain in the perineal. What is the nursing action?
Check the site.
What is the best method to check the color of the baby?
A natural light, also a white fluorescent.
You know there's bonding when
The mother holds the baby in the N-face position.
The infant is born to a drug addicted mother who has a high-pitched shrill cry and is irritable. The nurse should
Rock the infant.
Cold stress on a newborn will affect which system?
Respiratory system.
Infants born through C-sections will have an increased risk of (2)
Respiratory distress and infections due to fluid in the lungs not being expelled during the birth process.
The mother has accomplished her first maternal task when she states
"I am pregnant."
Which of the following clinical manifestations indicates that a 6 week old infant has pyloric stenosis?
Visible gastric peristalic wave.
A newborn has a pink body, pale extremeties, loud cry, heart rate of 140, respiratory rate of 40, flexed legs when foot it tapped with a finger. What is the Apgar score?
9
What are the initial symptoms of otitis media?
Pain, infant may only have the capacity to tap or slap at his ear, so it may be red in color.
A progressive bilateral perceptive hearing loss in older individuals usually involves high frequencies that occur with the aging process. This is called
Presbycusis
What are the factors that may contribute to decreased sexual motivation?
Drugs, depression, disease, preganancy and aging.
Generally a nurse conducts a sexual hsitory on what categories of the clients?
Those receiving care for pregnancy and fertility, contracpetion or STDs.
What are the nursing interventions to meet sexual needs?
Teaching, discussing fears and concerns, providing support and encouragement, enhancing the client's body image and self-esteem.
The nurse charts complaints of continuous abdominal pain in an incisional area where the pain is an 8 out of 10. Which characteristic of pain is omitted from this note?
Onset
The antidote to morphine is
Narcan
For how long should you place an ice pack against a patient's skin?
20 minutes, also wrap the ice pack to prevent ice burn.
How far away from the treatment area should you use a heat lamp?
20 inches, advise client not to move the extremity once therapy has begun.
When would it incidate that you have burned the client?
When the skin is mild pink in color.
How long should a patient sit in a sitz bath?
20 minutes.
Whan you are going to give a patient IV push of morphine, you should give approximately 1-2mg over what period of time?
1 minute
Prior to giving morphine, you should check the respiratory rate for how long of a period?
1 minute
What are the phases of the sexual response cycle? (4)
Exitation, plateau, orgasm and resolution
A patient reports difficulty achieving and sustaining erections. It is important for the nurse to ask which question?
"Have you been checked for any diseases such as diabetes?"
Which observation indicates that the analgesic adminstered postoperatively to a 7 year old is effective?
He tells his parents that he feels better.
By which mechanism do noradrenergic drug agonists relieve pain?
Modulation of the ascending pain signal from the dorsal horns.
Which diagnostic test provides a definitive diagnosis for a female patient who presents with symptoms of gonorrhea?
Culture of cervical discharge. (Remember most women with gonorrhea are asymptomatic)
A male patient with gonorrhea would normally develop signs and symptoms in what period of time?
7-10 days.
Gonorrhea and syphylis are
Reportable disases.
The simple screening test for syphilis is the
RPR (Rapid Plasma Reagent)
Which is a nursing priority for a patient in the acute phase of the rape trauma syndrome?
Establishing a safe environment.
Which nursing action demonstrates cultural competency in patient care?
Provides an interpreter for patients who do not speak english.
A native american patient is admitted to the hospital with a rash, cough and fever. Which is the most important information for the nurse to gather from the patient?
Immunization history.
If a native american family brings their 2 year old child into the hospital and they want a faith healer, the nurse should ask them
What the tribal healer is going to do.
As the patient advocate, the nurse should make which of the following a priority action in the care of a chronically ill patient?
Ensure the patient's access to knowledge and respectful treatment.
The primary purpose of a hospice unit is to
Provide palliative care for a dying patient.
Which action should the nurse include in a plan of care to enable patients with a chronic illness to develop a realistic plan for daily living?
Assist patient to set priorities for important self-care activities.
Which goal of Healthy People 2000 National Health Promotion and Disease Prevention objectives is the United States?
Health care for populations will be equalized.
Which resource best provides for the immediate safety for a battered woman?
Shelter. *Choose safety over injury if no details on injury are given.
What is the priority diagnostic category for a home care hospice patient?
Anticipatory grieving.
What are three positive signs of pregnancy?
Asculatation of fetal heart tones, ultrasound and feeling the fetal movement by an examiner.
Name 3 presumptive signs of pregnancy.
The sensation of fetal movement by the mother, breast enlargement and increase in the size of the abdomen.
Which observation of a patient during the second stage of labor indicates that delivery is imminent?
The fetal head is crowning.
What is the priority when a baby is born?
Suctioning the mouth.
A postpartum patient whose breasts are engorged is having difficulty breast feeding her neonate. Which nursing action should facilitate the feeding?
Teach the patient to express some milk manually before each feeding.
Which normal physiologic change occurs during the antepartal period of pregnancy?
Increased blood volume.
What is characteristic of both the first and third trimesters in pregnancy?
Increased urinary frequency.
In the early stages of pregnancy, the woman has sugar in her urine. This could be associated with
Increased levels of glucose being shunted to the developing placenta without an increase in tubular reabsorption. *Do glucose tolerance test to determine whether she has diabetes.
Gestational diabetes occurs at what stage of pregnancy?
20 weeks.
A sign of hydidaform mole is
The fundus is greater than you would expect at a particular stage of pregnancy.
Where should the fundus be at 12 weeks? 20 weeks? 28 weeks?
12 weeks: the symphysis pubis
20 weeks: the umbilicus
28 weeks: base of ribs
Which neonatal system is affected with the kernicterus results from untreated hyperbilirubinemia?
The nervous system.
Which factor can cause a neonate to develop hemorraghic fever?
Absence of intestinal flora.
To prevent hemorragic fever, the neonate should be administered
Vitimin K
A woman has been diagnosed as having endometriosis. What is the pathological process that occurs with this disease?
Endometrial tissue proliferates on abdominal organs and supporting structures.
An example of radiating pain is
Pain of angina (radiates down arm or neck)
An example of referred pain is
Apendicitis pain (felt in epigastric region but pain is in RLQ). Also cholysistitis pain which is felt in the right scaplula.
Phantom pain is
Pain that is felt in an extremity that has been amputated.
The treatment for phantom pain is
Contralateral simulation.
The definition of pain threshold is
The point at which a person experiences pain.
Another term for pain threshold is
Pain sensation.
When a person is administered and analgesic, does it raise or lower the pain threshold?
It raises the pain threshold.
Pain tolerance is
The maximum amount of pain a person is willing to endure before seeking treatment.
The national health survey defines chronic conditions as
1) The conditions which were first noticed three months or more before the date of the interview,
2) They belong to a group of conditions including heart disease, diabetes and others that are considered chronic regardless of when they began.
Race is based on what characteristics?
Physical. *Pick culture on the test!
Differentiate between ethics and morals.
Ethics occur in the workplace, whereas morals occur outside of the workplace. Morals helps us develop ethics.
A woman who is post menopausal is considering estrogen replacement therapy. An increase in which serum laboratory data contraindicates therapy?
Bilirubin.
Define TENS
Transcutaneous Electrical Nerve Stimuation