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125 Cards in this Set
- Front
- Back
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Words That Reflect Assessment |
Ascertain, Assess, Check, Collect, Determine, Find out, Gather. Identify, Monitor, Observe, Obtain information, Recognize. |
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Words That Indicate the Need to Prioritize:
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Best, Early or late, Essential, First, Highest priority Immediate, Initial, Next, Most, Most appropriate or least, appropriate, Most important, Most likely or least likely, Primary, Vital. |
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accountability
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Moral concept that involves acceptance by a professional nurse of the consequences of a decision or action. |
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acculturation
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Process of learning norms, beliefs, and behavioral expectations of a group other than one’s own group. |
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advance directive
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Written document recognized by state law that provides directions concerning the provision of care when a client is unable to make his or her own treatment choices; the two basic.
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types of advance directives
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include living wills and durable powers of attorney.
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advocacy
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Acting on behalf of the client and protecting the client’s right to make his or her own decisions. |
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Client’s Bill of Rights
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The rights and responsibilities of clients receiving care.
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confidentiality/information security In the health care system,
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refers to the protection of privacy of the client’s personal health information. |
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consent
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Voluntary act whereby a person agrees to allow someone else to do something.
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cultural assimilation
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Process in which individuals from a minority group are absorbed by the dominant culture and take on the characteristics of the dominant culture.
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cultural competence
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Acquisition of knowledge, understanding, and appreciation of a culture that facilitates provision of culturally appropriate health care. |
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cultural diversity
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Differences among groups of people that result from ethnic, racial, and cultural variables.
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cultural imposition
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Tendency to impose one’s own beliefs, values, and patterns of behavior on individuals from another culture.
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culture
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The knowledge, beliefs, patterns of behavior, ideas, attitudes, values, and norms that are unique to a particular group of people.
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delegation
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Process of transferring a selected nursing task in a situation to an individual who is competent to perform that specific task.
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disaster
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Any human-made or natural event that causes destruction and devastation that cannot be alleviated without assistance; internal disasters are events that occur within a health care agency, whereas external disasters are events that occur outside the health care agency. |
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dominant culture
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Group whose values prevail within a society.
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emergency response plan
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A health care agency’s preparedness and response plan in the event of a disaster.
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ethics
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The ideals of right and wrong; guiding principles that individuals may use to make decisions.
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ethnic group
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People within a culture who share characteristics based on race, religion, color, national origin, or language.
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ethnicity
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An individual’s identification of self as part of an ethnic group.
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evidence-based practice
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Approach to client care in which the nurse integrates the client’s preferences, clinical expertise, and the best research evidence to deliver quality care.
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informed consent
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A client’s understanding of the reason for the proposed intervention, with its benefits and risks, and agreement with the treatment by signing a consent form.
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interprofessional collaboration
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Promotes sharing of expertise from health care professionals to create a plan of care that will restore and maintain a client’s health.
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leadership Interpersonal
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process that involves influencing others (followers) to achieve goals.
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malpractice
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Type of negligence; failure to meet the standards of acceptable care, which results in harm to another person.
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management
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Accomplishment of tasks or goals by oneself or by directing others.
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minority group
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Ethnic, cultural, racial, or religious group that constitutes less than a numerical majority of the population. |
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negligence
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Conduct that falls below a standard of care; failure to meet a client’s needs either willfully or by omission or failure to act.
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prioritizing
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Deciding which needs or problems require immediate action and which ones could tolerate a delay in action until a later time because they are not urgent.
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race
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A grouping of people based on biological similarities; members of a racial group may have similar physical characteristics, such as blood group; facial features; and color of skin, hair, and eyes.
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racism
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Discrimination directed toward individuals or groups who are perceived to be inferior.
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stereotyping
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Expectation that all people within the same racial, ethnic, or cultural group act alike and share the same beliefs and attitudes.
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triage
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Classifying procedure that ranks clients according to their need for medical care. |
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Seventh-Day Adventist (Church of God)
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Alcohol and caffeinated beverages are usually prohibited. Many are lacto-ovo vegetarians; those who eat meat avoid pork. Overeating is prohibited; 5 to 6 hours between meals without snacking is practiced.
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Buddhism
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Alcohol is usually prohibited. Many are lacto-ovo vegetarians. Some eat fish, and some avoid only beef.
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Roman Catholicism
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They avoid meat on Ash Wednesday and Fridays of Lent. They practice optional fasting during Lent season. Children, pregnant women, and ill individuals are exempt from fasting. |
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Church of Jesus Christ of Latter-Day Saints (Mormon)
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Alcohol, coffee, and tea are usually prohibited. Consumption of meat is limited. The first Sunday of the month is optional for fasting.
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Hinduism
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Many are vegetarians; those who eat meat do not eat beef or pork. Fasting rituals vary. Children are not allowed to participate in fasting.
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Islam
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Pork, birds of prey, alcohol, and any meat product not ritually slaughtered are prohibited. During the month of Ramadan, fasting occurs during the daytime; some individuals may be exempt from fasting, such as pregnant women.
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Jehovah’s Witnesses
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Any foods to which blood has been added are prohibited. They can eat animal flesh that has been drained. |
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Judaism |
Orthodox believers need to adhere to dietary kosher laws: ■ Meats allowed include animals that are vegetable eaters, cloven-hoofed animals, and |
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Pentecostal (Assembly of God)
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Alcohol is usually prohibited. Members avoid consumption of anything to which blood has been added. Some individuals avoid pork.
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Eastern Orthodox
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During Lent, all animal products, including dairy products, are forbidden. Fasting occurs during Advent. Exceptions from fasting include illness and pregnancy; children may also be exempt
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Aloe:
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Antiinflammatory and antimicrobial effect; accelerates wound healing
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Angelica:
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Antispasmodic and vasodilator; balances the effects of estrogen
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Bilberry:
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Improves microcirculation in the eyes
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Black cohosh:
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Produces estrogen-like effects
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Cat’s claw:
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Antioxidant; stimulates the immune system, lowers blood pressure
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Chamomile:
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Antispasmodic and antiinflammatory; produces mild sedative effect
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Dehydroepiandrosterone (DHEA):
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Converts to androgens and estrogen; slows the effects of aging; used for erectile dysfunction
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Echinacea:
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Stimulates the immune system
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Evening primrose:
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Assists with metabolism of fatty acids
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Feverfew:
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Antiinflammatory; used for migraine headaches, arthritis, and fever
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Garlic:
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Antioxidant; used to lower cholesterol levels
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Ginger:
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Antiemetic; used for nausea and vomiting
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Ginkgo biloba:
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Antioxidant; used to improve memory
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Ginseng:
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Increases physical endurance and stamina; used for stress and fatigue
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Glucosamine:
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Amino acid that assists in the synthesis of cartilage
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Goldenseal:
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Antiinflammatory and antimicrobial used to stimulate the immune system; has an anticoagulant effect and may increase blood pressure
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Kava:
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Antianxiety and skeletal muscle relaxant; produces a sedative effect
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Melatonin:
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A hormone that regulates sleep; used for insomnia
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Milk thistle:
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Antioxidant; stimulates the production of new liver cells, reduces liver inflammation; used for liver and gallbladder disease
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Peppermint oil:
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Antispasmodic; used for irritable bowel syndrome
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Saw palmetto:
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Antiestrogen activity; used for urinary tract infections and benign prostatic hypertrophy
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St. John’s wort:
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Antibacterial, antiviral, antidepressant
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Valerian:
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Used to treat nervous disorders such as anxiety, restlessness, and insomnia
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Zinc:
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Antiviral; stimulates the immune system
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Autonomy:
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Respect for an individual’s right to self-determination
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Nonmaleficence:
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The obligation to do or cause no harm to another
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Beneficence:
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The duty to do good to others and to maintain a balance between benefits and harms; paternalism is an undesirable outcome of beneficence, in which the health care provider decides what is best for the client and encourages the client to act against his or her own choices |
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Justice:
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The equitable distribution of potential benefits and tasks determining the order in which clients should be cared for
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Veracity:
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The obligation to tell the truth
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Fidelity:
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The duty to do what one has promised |
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Contract law
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is concerned with enforcement of agreements among private individuals. |
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Civil Law
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concerned with relationships among persons and the protection of a person’s rights. Violation may cause harm to an individual or property, but no grave threat to society exists. |
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Criminal law
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is concerned with relationships between individuals and governments, and with acts that threaten society and its order; a crime is an offense against society that violates a law and is defined as a misdemeanor (less serious nature) or felony (serious nature). |
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Tort Law
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is a civil wrong, other than a breach in contract, in which the law allows an injured person to seek damages from a person who caused the injury. |
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Examples of Negligent Acts
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■ Medication errors that result in injury to the client ■ Intravenous administration errors, such as incorrect flow rates or failure to monitor a flow rate, that result in injury to the client ■ Falls that occur as a result of failure to provide safety to the client ■ Failure to use sterile technique when indicated ■ Failure to check equipment for proper functioning ■ Burns sustained by the client as a result of failure to monitor bath temperature or equipment ■ Failure to monitor a client’s condition ■ Failure to report changes in the client’s condition to the health care provider ■ Failure to provide a complete report to the oncoming nursing staff. |
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Delegating to UAP:
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noninvasive interventions, such as skin care, range-of-motion exercises, ambulation, grooming, and hygiene measures.
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Delegating to LPN:
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dressing changes, suctioning, urinary catheterization, and medication administration (oral, subcutaneous, intramuscular, and selected piggyback medications).
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Emergency Department Triage Emergent (Red): Priority 1 (Highest)
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This classification is assigned to clients who have life-threatening injuries and need immediate. attention and continuous evaluation, but have a high probability for survival when stabilized. Such clients include trauma victims, clients with chest pain, clients with severe respiratory distress or cardiac arrest, clients with limb amputation, clients with acute neurological deficits, and clients who have sustained chemical splashes to the eyes.
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Urgent (Yellow): Priority 2
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This classification is assigned to clients who require treatment and whose injuries have complications that are not life-threatening, provided that they are treated within 1 to 2 hours; these clients require continuous evaluation every 30 to 60 minutes thereafter. Such clients include clients with a simple fracture, asthma without respiratory distress, fever, hypertension, abdominal pain, or a renal stone.
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Nonurgent (Green): Priority 3
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This classification is assigned to clients with local injuries who do not have immediate complications and who can wait several hours for medical treatment; these clients require evaluation every 1 to 2 hours thereafter. Such clients include clients with conditions such as a minor laceration, sprain, or cold symptoms. Note: Some triage systems include tagging a client “Black” if the victim is dead or who soon will be deceased because of severe injuries; these are victims that would not benefit from any care because of the severity of injuries.
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ABO
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A type of antigen system. The ABO type of the donor should be compatible with the recipient’s. Type A can match with type A or O; type B can match with type B or O; type O can match only with type O; type AB can match with type A, B, AB, or O.
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air embolism
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An obstruction caused by a bolus of air that enters the vein through an inadequately primed intravenous (IV) line, from a loose connection, during a tubing change, or during removal of an IV line.
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Allen’s test
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A test to assess for collateral circulation to the hand by evaluating the patency of the radial and ulnar arteries.
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blood
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The liquid pumped by the heart through the arteries, veins, and capillaries. Blood is composed of a clear yellow fluid (plasma), formed elements, and cell types with various functions.
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blood cell
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Any of the formed elements of the blood, including red cells (erythrocytes), white cells (leukocytes), and platelets (thrombocytes).
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calcium
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A mineral element needed for the process of bone formation, coagulation of blood, excitation of cardiac and skeletal muscle, maintenance of muscle tone, conduction of neuromuscular impulses, and the synthesis and regulation of the endocrine and exocrine glands. the normal adult level is 9.5 to 10 mg/dL.
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catheter embolism
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An obstruction caused by breakage of the catheter tip during IV line insertion or removal.
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circulatory overload
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A complication resulting from the infusion of blood at a rate too rapid for the size, age, cardiac status, or clinical condition of the recipient.
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compatibility
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Matching of blood from two persons by two different types of antigen systems, ABO and Rh, present on the membrane surface of the red blood cells, to prevent a transfusion reaction. |
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compensation
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refers to the body processes that occur to counterbalance an acid-base disturbance. When compensation has occurred, the pH will be within normal limits. |
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crossmatching
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The testing of the donor’s blood and the recipient’s blood for compatibility.
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enteral nutrition
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Administration of nutrition with liquefied foods into the gastrointestinal tract via a tube.
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fat emulsion (lipids)
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A white, opaque solution administered intravenously during parenteral nutrition therapy to prevent fatty acid deficiency.
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fluid volume deficit
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Dehydration, in which the fluid intake of the body is not sufficient to meet the fluid needs of the body.
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fluid volume excess
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Fluid intake or fluid retention that exceeds the fluid needs of the body. Also called overhydration or fluid overload.
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fresh-frozen plasma
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A blood product administered to increase the level of clotting factors in clients with such a deficiency.
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homeostasis
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The tendency of a biological system to maintain relatively constant conditions in the internal environment while continuously interacting with and adjusting to changes originating within or outside the system.
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infiltration
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Seepage of IV fluid out of the vein and into the surrounding interstitial spaces. |
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magnesium
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Concentrated in the bone, cartilage, and within the cell itself; required for the use of adenosine triphosphate as a source of energy. It is necessary for the action of numerous enzyme systems such as those involved in carbohydrate metabolism, protein synthesis, nucleic acid synthesis, and contraction of muscular tissue. It also regulates neuromuscular activity and the clotting mechanism. The normal adult level is 1.6 to 2.6 mg/dL.
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malnutrition
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Deficiency of the nutrients required for development and maintenance of the human body.
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metabolic acidosis
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A total concentration of buffer base that is lower than normal, with a relative increase in the hydrogen ion concentration. This results from loss of buffer bases or retention of too many acids without sufficient bases, and occurs in conditions such as kidney failure and diabetic ketoacidosis, from the production of lactic acid, and from the ingestion of toxins, such as acetylsalicylic acid (aspirin). |
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metabolic alkalosis
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A deficit or loss of hydrogen ions or acids or an excess of base (bicarbonate) that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions resulting in hypovolemia, the loss of gastric fluid, excessive bicarbonate intake, the massive transfusion of whole blood, and hyperaldosteronism.
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metabolism
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Ongoing chemical process within the body that converts digested nutrients into energy for the functioning of body cells.
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nutrients
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Carbohydrates, fats or lipids, proteins, vitamins, minerals, electrolytes, and water that must be supplied in adequate amounts to provide energy, growth, development, and maintenance of the human body.
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packed red blood cells
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A blood product used to replace erythrocytes lost as a result of trauma or surgical interventions or in clients with bone marrow suppression. |
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parenteral nutrition
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(PN) Administration of a nutritionally complete formula through a central or
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peripheral intravenous
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(IV) catheter. In the clinical setting, the term PN may be used interchangeably with the term total parenteral nutrition (TPN) or hyperalimentation.
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phlebitis
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An inflammation of the vein that can occur from mechanical or chemical (medication) trauma or from a local infection.
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phosphorus
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Needed for generation of bony tissue. It functions in the metabolism of glucose and lipids, in the maintenance of acid-base balance, and in the storage and transfer of energy from one site in the body to another. Phosphorus levels are evaluated in relation to calcium levels because of their inverse relationship; when calcium levels are decreased, phosphorus levels are increased, and when phosphorus levels are decreased, calcium levels are increased. The normal adult level is 2.7 to 4.5 mg/dL. |
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plasma
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The watery, straw-colored, fluid part of lymph and the blood in which the formed elements (blood cells) are suspended. Plasma is made up of water, electrolytes, protein, glucose, fats, bilirubin, and gases and is essential for carrying the cellular elements of the blood through the circulation.
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platelet transfusion
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A blood product administered to clients with low platelet counts and to thrombocytopenic clients who are bleeding actively or are scheduled for an invasive procedure.
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potassium
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A principal electrolyte of intracellular fluid and the primary buffer within the cell itself. It is needed for nerve conduction, muscle function, acid-base balance, and osmotic pressure. Along with calcium and magnesium, potassium controls the rate and force of contraction of the heart and thus cardiac output. The normal adult level is 3.5 to 5.0 mEq/L.
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respiratory acidosis
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A total concentration of buffer base that is lower than normal, with a relative increase in hydrogen ion concentration; thus a greater number of hydrogen ions is circulating in the blood than the buffer system can absorb. This is caused by primary defects in the function of the lungs or by changes in normal respiratory patterns as a result of secondary problems. Any condition that causes an obstruction of the airway or depresses respiratory status can cause respiratory acidosis.
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respiratory alkalosis
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A deficit of carbonic acid or a decrease in hydrogen ion concentration that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions that cause overstimulation of the respiratory system. Rh factor Rh stands for rhesus factor. A person having the factor is Rh positive; a person lacking the factor is Rh negative. The presence or absence of Rh antigens on the surface of red blood cells determines the classification as Rh positive or Rh negative.
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septicemia
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The presence of infective agents or their toxins in the bloodstream. Septicemia is a serious infection and must be treated promptly; otherwise, the infection leads to circulatory collapse, profound shock, and death.
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serum
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The clear and thin fluid part of blood that remains after coagulation. Serum contains no blood cells, platelets, or fibrinogen.
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sodium
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An abundant electrolyte that maintains osmotic pressure and acid-base balance and transmits nerve impulses. The normal adult level is 135 to 145 mEq/L.
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transfusion reaction
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A hemolytic reaction caused by blood type or Rh incompatibility. An allergic transfusion reaction most often occurs in clients with a history of an allergy. A febrile transfusion reaction most commonly occurs in clients with antibodies directed against the transfused white blood cells. A bacterial transfusion reaction occurs after transfusion of contaminated blood products.
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venipuncture Puncture
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into a vein to obtain a blood specimen for testing; the antecubital veins are the veins of choice because of ease of access |
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Fluid Volume Deficit Assessment |
Thready, increased pulse rate, Decreased blood pressure and orthostatic (postural) hypotension, Flat neck and hand veins in dependent positions, Diminished peripheral pulses, Decreased CVP, Dysrhythmias, Increased rate and depth of respirations, Dyspnea, Decreased central nervous system activity, from lethargy to coma, Fever (depending on the amount of fluid loss), Skeletal muscle weakness, Decreased urine output, Dry skin, Poor turgor (tenting), Dry mouth, Decreased motility and diminished bowel sounds, Constipation, Thirst, Increased serum osmolality |
