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Test 1

Basic Nursing

QuestionAnswer
What is Antiseptic A substance that inhibits grow of microorganisms (can be used on humans)
What is Asepsis Free of pathogens
What is a Carrier Person or animal harbors and spreads but they may be affected
Define "Contaminate" exposed to harmful material, making the object unsafe
What is Double bagging an infection control practice that involves placing a bag of contaminated items into another, clean bag that is held outside an isolation room by other personal
What is Disinfectant A chemical that can be applied to objects to kill microorganisms
What is the Chain or Cycle of Infection Infectious Agent, Reservoir, Exit Route, Transmission, Entrance, Host
What is Endogenous Growing within the body; such as a disease caused by the structural or functional failure of an organ or system
What is Exogenous Outside the body, such as a disease caused by bacteria or a virus outside the body
What is a Fomite A non-living host of pathogenic microorganisms (bed linen,stethoscope, etc..)
What is a Host A person or group that is at risk for disease or illness, one organism is housing another organism usually parasitic, organism that is harbored and norished
What is Infectious Control The policies and produces in which hospital or treatment center uses to prevent and control infection
What is Isolation Precaution A pratice of the infection control to reduce or elimate the transmission of pathogens
What is Medical Asepsis "Clean Techniques" A group of techniques that inhibit the growth and spread of pathogenic organisms
What is a Microorganism Any tiny entity capable of carrying on living processes (Bacteria, Fungi, Protozoa, and Viruses)
What is a Health Care-Associated Infection infection that manifests at least 48 hrs after hospitalization or contact with another healthcare agency
What is Reservoir Any natural habitat of a microorganism that promotes growth and reproduction
What is a Spore A highly resistant reproductive cell of some microorganisms
What is Standard Precautions A set of guidelines set forth by the CDC to reduce the risk of infection and protect from recognized and unrecognized sources .of infection
What is a Vector A living carrier for the transmission of microorganisms
What is Virulent Having power to produce disease; pertaining to a very pathogenic or rapidly progressive condition.
What year was the first law governing nursing licensure 1903
Who is the primary advocate for the patient The nurse (you)
where was the first school of training practical nursing Brooklyn ,New York
Who sets the standard for LPN/LVN education National Federation of Licensed Practical Nurses and National Association for Practical Nurse Education and Service
What are you signs of inflammation redness, pain, heat, swelling, loss of function
Factors that increase the risk of infection the very young/old, stress, nutritional status, genetics, and radiation
when an antibiotic has not been effective on bacteria has created a _________ to defend itself capsule
who created Patient’s Bill of Rights American Hospital Association
What year was the Patient’s Bill of Rights adopted Adopted in 1972
what is the purpose of the Patient’s Bill of Rights Offers guidance and protection during hospitalization
What is a law Reference of a rule, principle, or regulation established and made known by a government to protect or restrict the people affected
what do laws do Regulate how a person should, behave in society, Sanction acceptable behavior, Prohibit unacceptable behavior
The purpose of criminal law is to punish or deter crimes against society
Civil laws does what Conduct that violates a person's rights
Statutory Law consist of what three parts Federal, State, and Local
what is Contract law written or oral contract
what is Tort law a type of civil law that involves wrongs against a person or property
what are examples of tort law Negligence,False imprisonment, Confidentiality, Defamation of character, Consent, Assault and battery, Fraud
what is Administrative law A third type of law that come from agencies created by the legislature
Define Standards of Care Guidelines developed to identify appropriate levels of professional care
Who defines Scope of Practice the Nurse Practice Act of each state
what is Malpractice practice leading to poor care and patient harm
what are the elements of malpractice Duty exists,Breach of the duty, Harm has occurred, Harm did occur
who can be charged with malpractice All persons involved in patient care are now held responsible
what is Negligence Failing to perform some act that a reasonably prudent person would perform with the same educational and experience level
define Prudent Capable of exercising sound judgment in practical matters
define what assault is Refers to approaching or managing another person in such a way that it poses a threat to touch without permission. An unlawful threat or unsuccessful attempt to do physical harm to another, threat can be verbal.
define what battery is Unlawful touching of another person without informed consent
what is False Imprisonment Confining or restricting against will or consent
what are examples of false imprisonment Restraints in bed or chair and Locking in room
define Confidentiality Making unauthorized disclosure of patient information
what are examples of Confidentiality Physical privacy, Release of information, Confidential information-need to know
what is Defamation of Character Any false or malicious statement that may harm the character or reputation of another
what are the two types of Defamation of Character Slander and Libel
what is Slander Verbal statements that are untrue or injurious to another’s reputation
what is Libel Written or printed statements
Examples of Libel “Patient is a complainer and uncooperative” and “Patient is addicted to drugs”
what are economic factors effecting health care Rising health care cost, Aging population, Advancement in technology, Healthcare insurance, and Malpractice insurance
what is cross-training Individuals are trained to do a variety of duties depending on the needs
Describe a Health Maintenance Organizations (HMO’s) Group insurance plan, Fixed fee for services, Provide ambulatory, hospitalization and home care services, Utilizes “gate keepers” usually a primary physician who must authorize secondary care, Member is responsible for all costs of unauthorized care
Describe a Preferred Provider Organizations (PPO’s) Network of providers who discount their rates for plan members, Members pay higher rates if treatment is provided outside the network
Who is the most restrictive HMO or PPO HMO
Describe Quality Improvement Demand for evidence that hospitals and other healthcare providers provide quality, cost-effective care
what agency regulates hospitals Joint Commission for Accreditation of Healthcare Organizations
what are Ethics Knowledge of right and wrong based on your knowledge and beliefs
what are Principles Concept that this is the implied law of the land
what is Autonomy The right to be independent and make decisions freely
what is Beneficence Doing good or what is right for patients
what is Nonmaleficence not doing the wrong thing (Do no harm)
If a patient asked about his/her procedure after informed consent has been signed who can answer their question? The physician
define code of ethics Provides a means by which standards of practice are established, maintained and improved
The Nurse Practice Act does what governs and is the law for the nurses scope of practice
what is Autocratic leadership leader runs and makes all decisions
what is Democratic leadership People are the center and the emphasized on team nursing
what is Laissez-Faire leadership Allow them to do, free rein
what is Situational leadership different leadership style to accommodate the situational needs
what are the leadership responsibilities of a nurse Assist and guide members, Supervise members, Understand condition and goals for each patient, Monitor progress
describe Team Nursing Patient care accomplished by specific group of nurses and allied health care workers
describe the team structure in the nursing team Team leader, staff nurses, nurse’s assistance, and health unit coordinators
what is patient advocacy Speaking on the patients behalf and ensuring the patient receive the best care.
describe enhanced communication Focuses on relationship between effective communication, successful teamwork and patient safety. Effective communication required to address and meet patient/family goals.
describe evidence based practice Focuses on integrating best available scientific evidence into delivery of patient care
patient centered medical home is what type of healthcare plan “Whole Person” healthcare plan
patient centered medical home is transitioning from healthcare systems to what to a “system of health”
What is Colonization? Presence of microbes on or in a host, No tissue invasion or damage
How often should you switch from “gelling in” to “washing your hands” in a normal patients room? When your hands get a sticky feeling (about 5-8)
What are the three types of agents that cause infection? Biological, Physical, Chemical
What are some examples of portals of exit? Respiratory tract, Genitourinary tract, Gastrointestinal tract, Skin/mucous membrane, Blood
What is the most common mode of transmission for disease? Hands
When do you not use hand gel? When you have a patient with C. difficile
If you are within how many feet of a patient that has been coughing you need a mask? 3 feet
What are the three types of precautions? Airborne, Droplet, Contact
How many times can you use PPE? Once
Most common airborne precautions? (TB) Tuberculosis
Negative pressure room must read at minimum what? -0.002
Droplet precautions are most of the time for what? Influenza
What do droplet precautions protect from? Droplets produced by coughing, sneezing, talking and suctioning
What type of mask do you use with droplet precautions? Surgical Mask
What PPE do you use for patients with contact precautions? Mask and Gown
What is the most common antibiotic resistant pathogen causing HAI? MRSA
How do we test for MRSA? swab of both nares
How is MRSA spread directly? among people in close contact with infected person
How long (min) do you wash your hands for? 15 seconds
IVs must be changed every how many hours? field environment IV sites within 48 hours or hospital IVs must be changed every 96 hours (NO EXTENSIONS)
What do you do for patient with respiratory symptoms? Offered a mask & tissue, Directed to wash their hands, Separated from common waiting areas
What groups are more sensitive to room temperature? Infants, older adults, and the acutely ill
What temperature should you maintain a patient’s room? 68-74 degrees Fahrenheit
Are fans allowed in the hospital and why? No, they can introduce and harbor pathogens.
What is the acceptable range of humidity in the MTF? 30%-50%
What else can we do to help with humidity? Give the patient humidified air
How do you check for allergies? Ask the Patient, check the wristband, and check the chart
What is the biggest way to prevent physical odors in the patient’s room? Remove malodorous items
What does light do to the body? It stimulates the body
Who can see the patient’s chart? Only people with the need to know (nursing team, patient, and doctor)
When giving the patient a bath how do you provide privacy? Cover private parts with towels and tell the patient what you are doing.
How do you move a female patient’s breast? You use the back of your hand
What can we do in order to ease the psychological strain on our patients? Provide hope, cheer & ease grief; provide distractions; patient participation in care
Sleep provides what for the patient? Energy, body recovery and repair
What is Rest? Decrease stimulation to the body
Name two factors affecting sleep? Physical illness, Anxiety and depression, Drugs and substances, Lifestyle, Sleep Patterns, Stress, Environment, Exercise and fatigue, Nutrition
How many stages of sleep are there? 4 stages
How long does each stage of sleep last? Stage1: a few minutes Stage 2: 10-20 mins stage 3: 15-30 mins stage 4: 15-30 mins
What type of sleep when you have colorful dreams and begin 90 mins into the sleep? (REM) Rapid Eye Movement
What are two possible nursing diagnoses related to sleep? Sleep pattern disturbance and disturbed thought process
What are the nursing responsibilities when bed making? Ensure cleanliness and comfort, Make post-op bed before patient returns, Make unoccupied bed whenever possible, Make occupied bed when required
Who complete the initial assessment? The RN
Who completes the ongoing assessment? RN and LVN
How long does the nurse have to complete the initial assessment? 24hrs
What two ways do you observe mood? Verbal and Non-verbal behavior
What is the most often used method of assessment? Inspection is most the frequently used technique
What information is gathered during palpation? Temperature, Texture, Vibration, Pulsations, Masses, Other changes
What is auscultation? Process of listening to sounds produced by the body by using a stethoscope
Percussion measures the density of what? Underlying tissue to aid in location of organs & structures
What is the least used method for assessment? Percussion
What are the 4 techniques used to perform a physical assessment? Inspection, palpation, auscultation and percussion
What are the signs of fatigue in older patients? Slumping, Sighing, Irritability
List three preventive health topics to discuss during the assessment of a patient? Regular exams, periodic diagnostic tests, immunizations, cancer warning signs, and self exams.
What are some Physiological Considerations for elderly patients? May have memory difficulty and Skin is less elastic & drier
Is skin turgor an accurate measurement of hydration on an elderly patient? NO
What are Lentigines? Brown spots or liver spots
Describe what actinic keratoses is? Reddened, flaky precancerous areas
What happens to Muscle strength & joint flexibility in the elderly? It decreases
Describe the admission assessment and who completes it? Formal head-to-toe done when admitted by RN
Describe the Shift-to-shift assessment and who completes it? Performed at the beginning of each shift, RN and LVN
Describe the Focused assessment? Performed when change in condition
What are the three basic types of assessment? Admission, shift-to-shift and focused
DA Form 3888 documents what? Documents baseline nursing history & assessment
Who completes the DA 3888 and how long do they have? RN and 24 hours
What does the DA 3888 form contain? Represents baseline health status information used to plan care
What is the purpose of the SF 510? chronological record of nursing care and Reflects any change in condition & results of treatment
If DA Form 3888 was not completed what must be recorded? Admission note must be recorded
Notes will always end with? Signature, Rank, Title
How do you fix an error on the SF 510? Draw a line through the error, “error” is noted, Reason for the error with the initials of the writer, and Followed by a notation of the correct information
What dictates frequency of charting? Patient acuity, Response to treatment, Judgment of the professional nurse responsible for the care of the patient
Initial screening consists of what? Vital signs, height & weight, brief history, & psychological preparation. Are prerequisite tests completed? Is an informed consent necessary?
Name positions that may be used during a physical examination? Sitting, supine, dorsal recumbent, lithotomy position, Sims’, prone, and knee chest.
Who must signs the informed consent? Patient or next of kin
What does draping do for the patient? Prevents unnecessary exposure, Helps the client relax, Provides warmth & prevents chilling
The patient has the right to a same sex what in the room during their exam? Chaperone
When do you expose a patient? Expose exam area only when necessary
What would a tape measure be used for? To measure the circumference of a baby’s head, the circumference of a client’s arms or legs, a client’s chest circumference, etc.
What are some of the responsibilities the nurse should be familiar with to facilitate the physical examination? Preparing the exam room, preparing the patient, collect samples, etc.
What can be road block in gather information on the patient? Language, AMS, Work load process
What is the job of the Admitting Department? Specifically designated to gather admission demographics
What does empathy mean? The ability to recognized and share the emotions and state of mind and significance of a person’s behavior (put yourself in their shoe and expressing understanding)
Describe Continuity of Care Constant Fair and equal level care for every patient, every time. If possible keep the same head nurse for that patient.
What does an Identification (ID) band do for nurses/patients provide a positive means of identification of the patient (contains Full name and DOB)
What are the nurses’ responsibilities during the initial admission? Greet patient, Check ID band, Assess for immediate/life-threatening needs, and Orient patient to surrounds.
What are the types of transfers? Intra-agency - moving of patient from one unit to another and Interagency - transfer to another hospital or agency
Initial assessment should include what? Level of consciousness, Vital signs, Head-to-toe physical assessment, Range of motion, Condition of skin, Vision, and hearing
What are the steps to prepare for a patient transfer? Give the patient explanation, Communication with receiving unit or facility, Documentation, Transportation Arrangements
What information should be given to the gaining unit or facility when a client is transferred? A brief summary of medical diagnosis, treatment care plan and medications
When does discharge planning begin? Upon admission
In what language should the discharge instructions to the client be written in? One that the client and family members can understand
What should be documented in reference to care after discharge? Follow up appointments and when to seek medical attention
What does the discharge summary contain? Patient's learning needs, how well learning needs have been met, Patient teaching, Short-term and long-term goals of care, and Referral
What do you do if a patient refuses care and want to leave? Request that the patient sign a release form for leaving against medical advice
How many witnesses do you need for an AMA form? At least two witnesses
What should the nurse do if the client refuses to sign the AMA form? Annotate this on the form and have it witnessed by at least two people
What form is used for AMA? The DA form 5009-R
What is critical thinking? Active, organized, cognitive process which carefully examines one’s thinking and thinking of others. It involves the use of the mind in forming conclusions, making decisions, drawing inferences, and reflecting
Good critical thinking starts with a knowledge base. Apply reasoning, inferring, judging, and logic Evaluate alternatives
How do nurses accomplish critical thinking? Learn to be flexible in clinical decision making, Reflect on past experiences and knowledge, Listen to others point of view, Identify the nature of the problem, Select the best solution for improving client’s health
In critical thinking ask yourself questions like: What are the alternatives to my first thoughts? What should I do first and why? Why am I doing this procedure in this way? Did my actions achieve the desired result?
When you don’t understand… Ask for clarification
What are the five steps of the nursing process? (WILL BE A TEST QUESTION) Assessing, Nursing Diagnosis, Planning, Implementation, Evaluating.
Three things to avoid discussing with a patient about? Money, Politics, and Religion
What is Subjective Data? Symptoms, verbal statements that the patient gives you
What is Objective Data? Pertaining to clinical findings, observable and measurable data
What does (NANDA) North American Nursing Diagnosis Association International give us? Statements that describe client’s actual or potential response to a health problem
What are Protocols? Written plan specifying the procedures to be followed during care of a client with a clinical condition or situation
What are Standing Orders? Document containing orders for routine therapies, monitoring guidelines, and/or diagnostic procedure for specific condition
What are some criteria for nursing care plans goals? Be realistic in setting goals, Set goals mutually with client, Goals should be measurable, use measurable, observable verbs
Created by: 68WM6-1350
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