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Fundies Exam 1
| Question | Answer |
|---|---|
| Client identification: what can you use? How many do you use? | Name, DOB, MAR, wristband, and phone number can all be used to identify the patient. - Always use 2 patient identifiers. |
| Fire safety: RACE? Education to prevent? | Rescue and remove all patients in immediate danger ● Activate the alarm. ALWAYS ACTIVATE ALARM BEFORE TRYING TO EXTINGUISH A FIRE. ● Confine a fire by closing doors and windows and turning off oxygen and electrical equipment ● Extinguish a fire with an appropriate extinguisher |
| Remember the word PASS using these steps to use an extinguisher correctly. | ● Pull the pin. Hold the extinguisher with the nozzle pointing away from you and release the locking mechanism. ● Aim low. Point the extinguisher at the base of the fire. ● Squeeze the lever slowly and evenly. ● Sweep the nozzle from side to side |
| SDS: what is it? What can you learn from it? | Safety data sheets. Every chemical listed that is within the facility is required to have a safety data sheet. The risks and methods to take if an exposure to a chemical occurs. |
| Falls: risk factors? | Adults 65 and older, falls in the home are the leading cause of unintentional death. Due to inadequate lighting, stairs and barriers while walking, not having handrails, and loose cords in the way can result in falling. |
| Education to prevent falls? | Prevent falls by; ● Adequate lighting, such as under-bed lighting ● Locking the wheels on the patient’s bed always. ● Patient’s bed should be kept in a low position ● Applied non skid footwear when ambulating ● Lock wheelchairs |
| Events: Sentinel event? Client safety event? Near miss event? What are they? Examples? | Sentinel event is an unexpected event that causes severe or permanent harm to the client and even death. A client safety event is an unexpected event that occurs with or without injury; however, it could have resulted in potential harm to the client. A near miss event is an event that almost occurred but was caught and prevented |
| Hand hygiene: why is it important? | Hand hygiene is important to prevent spreading of microorganisms and transmitting infections. |
| Education for how to properly do hand hygiene? | Use an alcohol-based waterless product such as sanitizer immediately after when hands are not visibly soiled or contaminated with blood or bodily fluids and after the removal of gloves. Wash hands with soap and water if contamination with spores is suspected. Use soap and water for C.difficile. Remove gloves and complete hand hygiene between each patient. Hand hygiene is also required after the removal of a gown. |
| Sterile field: how to set up? Be specific. | Open the covering of the package per the manufacturer’s instruc, ensuring there are no holes before opening. The open by sipping the package onto the center of the workspace with the top flap of the wrapper opening away from the body. Grasp the tip of the top flap, and with the arm away from the sterile field, unfold the top flap away from the body. Next open the side flaps, using the right hand for the right flap and the left hand for the left flap. -Grasp the last flap and turn it down toward the body |
| Masks: when do you use them? When do you change them? | Masks, eye protection, and face shields are required when care might cause splashing or spraying of bodily fluids. N95 masks should be used when treating a COVID patient, tuberculosis, and any other airborne illnesses. Droplet precautions, |
| Airborne precautions: what diseases use it? | A private room ● N95 masks and protection devices for caregivers and visitors ● Negative pressure room of at least 6-12 exchanges per hour. ● Eyes, nose, and mouth protection if splashing is a possibility |
| Hospital acquired infections: what are examples? | central line-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. |
| How do we prevent the most common HAI (think PNA, UTI)? | Hand hygiene is the number one way to prevent HAI. Keeping hands below the elbows while rinsing off the soap so water flows from the least contaminated to the most contaminated area. Wash hands for 15-30 seconds, use a paper towel to turn off the faucet and use soap and water if hands are visibly soiled. |
| Chain of infection: Portal of entry? Host? Vector? Reservoir? Infectious agent? | The portal of entry is the location where the infectious agent entered the body. ● The host is the human, plant or animal. ● Vector transmission is when an insect or animal carries the infectious agent. ● Reservoir is the place where the infectious agent lives, grows, and replicates |
| Airborne precaution. what to wear, examples | private, negative pressure room ● N95 mask ● Eyes, nose, and mouth protection if splashing occurs ● Patients with an airborne illness should wear a mask outside of the room/home. ● Examples: Varicella, measles, rubeola, pulmonary or laryngeal tuberculosis |
| Droplet precaution. what to wear, examples | A private room or a room with other patients who have the same infectious disease. Masks for providers and visitors. Patients who have a droplet infection should wear a mask outside of the room/home. Examples: streptococcal pharyngitis or pneumonia, influenza type B, scarlet fever, rubella, pertussis, mumps, meningococcal pneumonia and sepsis, pneumonic plague. |
| Stages of infection: what are they? What happens in each? | -Incubation: begins at exposure to an infectious agent and lasts until the first manifestations of the infection occur. ● Prodromal: stage begins when the initial manifestations of the infection occur. ● Acute illness stage: begins when significant manifestations of the infection occur. ● Convalescence stage: begins when the manifestations subside, client returns to the previous or new state of health. |
| Labs: what lab indicates infection? What is the normal range for that lab? | Leukocytosis (WBCs greater than 10,000) Normal WBC is 4,500-10,500 (sometimes it will say 11,000) |
| Informatics: definition? Advantages? | Informatics is the use of information and technology to communicate, manage knowledge, mitigate errors, and support decision making. |
| Informatics Disadvantages? | It helps the nurse streamline care, but it does not prevent burnout. |
| Information management technology: what is it? Benefits? | Health information technology is the use of computer hardware and software to store, retrieve, and manage data to reduce errors and improve client safety. Information management technology helps nurses and other health care providers comply with current practice guidelines |
| Information management technology: Disadvantages? Examples? | Disadvantages of information management technology: Electronic documentation decreases the amount of time they have to provide direct care and it is not directly related to the burden of the disease. Examples of health information technology: Using a smart pump to administer IV fluids. |
| Clinical information systems: what is it? Benefits? Disadvantages? Examples? | Clinical information systems examples: Scanning medication barcodes during medication administration, scheduling client appointments. Disadvantage of a client information system is that it can be affected by cyberattacks. |
| Simulation: benefits? | Simulations allow the participant to use clinical decision making in real time and receive feedback on their decisions in a safe environment. |
| HIPAA: what is it? Rules and what are they? | ● Enforcement rule: covers compliance and investigations of HIPAA violations and the administration of financial penalties for those violations. ● Security rule: Addresses the use and disclosure of the ePHI ● Privacy rule: Defines protected health information (PHI) ● Breach Notification rule: covers the process of reporting and responding to breaches of PHI. |
| Medication administration: what are the steps? When do we want to prevent errors? | ● Verifying the 10 medication rights ● We want to prevent medication administration errors during the first three phases of ordering, transcribing, and dispensing before we reach the patient. |
| EHR: what is it? Benefits? Disadvantages? Five pillars? | ● EHR benefits: the ability for the providers to communicate effectively with each other, providing evidence of care provided, significant decrease in paperwork, and reduced number of medication errors. ● EHR disadvantages: Updates needed frequently can lead to periods of time where applications are unavail. Clinical competency can be a challenge. Nurses have less time for direct client care bc their time is consumed by documentation. |
| RPM: what is it? Benefits? Disadvantages? | ● The purpose of remote patient monitoring is the rapid transfer of information and data to the client’s health care provider. ● RPM benefits: Once the device is set up, the data will transfer automatically without client confirmation. ● RPM disadvantages: vulnerable to cyber attacks, data breaches, and various threats. |
| Telehealth: benefits? Disadvantages? | The advantages of telehealth include convenience, generally lower costs, and more consistent management of medical conditions. Disadvantages include a lack of access to technology, a lack of technical literacy, and the cost of telehealth for low-income people |
| Low health literacy: what is it? Disadvantages? Risk factors? | -Low health literacy is associated with patients who are older, have limited education, lower income, chronic conditions, and those who are non-native English speakers. -It leads to a decrease in the use of preventative services, leading to an increase in the use of emergency services. Patients with a low health literacy have higher mortality rates than other patients. |
| Surgery Complications: General risk factors? Higher risk for clots? Higher risk for bleeding? | -Family history of malignant hyperthermia, respiratory disease, cardiac disease, gastric contents (aspiration), alcohol or substance use disorder, pregnancy (fetal risk with anesthesia), DM, liver/kidney disease and endocrine disorders. -A patient who uses tobacco is at a higher risk for clots. A patient with an alcohol disorder is at a higher risk for bleeding. |
| Informed consent: what is the nurse’s role? | The nurse should determine if the client is legally capable of providing consent. The nurse is to witness the informed consent by ensuring that the provider gave the client all necessary information. Notify the PCP if the client has questions or if they don't understand any of the information provided. Have the client sign the informed consent document, document any questions the client has and notify the provider. Document any reinforcement or teaching, and provide a trained medical interpreter if needed. |
| Who is allowed to sign consent? | ● 18 years old or emancipated ● Mentally capable of understanding the risks, reason, and options for surgery and anesthesia. ● Free from the influence of medication that affects decision-making or judgment (Opioids, benzodiazepines, sedatives). |
| Mental status changes: what are the types? What is the most common type post-op? | pain, sepsis or infection, electrolyte imbalance, and whether the patient had invasive lines, restraints, immobility problems or a transfusion |
| Anesthesia: types? Brief description of each? Examples of when each is used? | Regional anesthesia: Used when prevention of postoperative pain is also a desired effect (total joint replacement) Epidural: Anesthetic injection into the epidural space in the thoracic or lumbar areas of the spina to block sensory pathways, but leave motor function intact. The patient will be awake and arousable during regional anesthesia. ● Local anesthesia examples: Procaine and lidocaine. Patients are awake and alert during local anesthesia. |
| Pre-op: skin care (be specific)? Diet? Assessments? | Review a detailed history including allergies. Ensure that the client remains NPO for at least 6 hr for solid foods and 2 hr for clear liquids before surgery with general anesthesia to avoid aspiration. Perform splinting, coughing, and deep breathing. Use antiembolism stockings and pneumatic compression devices to prevent DVT. Perform bowel and skin preparations as prescribed (cleansing enema, preoperative shower with medicated soap). |
| Post-op: priority assessments? | Monitor respiratory rate and oxygen saturation. Intervene if needed with sedatives and opioids. Have Naloxone and flumazenil ready to reverse overdose if needed. Be ready to administer oxygen. |
| Urinary Incontinence: types? What other symptoms might we see? | -Transient: incontinence caused by medical conditions that are usually treatable and reversible. -Functional: loss of continence from causes outside the urinary tract; usually related to functional deficits such as altered mobility, cognitive impairment, or environmental barriers impairing ability to reach or use the toilet. -Overflow: Involuntary loss of urine caused by overdistended bladder. |
| Urinary Incontinence: types? What other symptoms might we see? | Stress: Involuntary leakage of small volumes of urine associated with increased intraabdominal pressure, weakness, or injury to urinary sphincter (weak pelvic floor muscles, trauma after childbirth) Urge: Strong sense of urgency related to overactive bladder involuntary bladder contractions) Reflex: Involuntary loss of urine occuring at predictable intervals when patient reaches specific bladder volume related to spinal cord damage from C1 to C2. |
| Urinary Retention: what is it? What are some signs? | Urinary retention is the inability to partially or completely empty the bladder. Patients usually have no urine output over several hours and sometimes experience frequency, urgency, small-volume voiding, or incontinence of small volumes of urine. |
| Foley catheter: steps for insertion? Complications? How do we prevent complications? | Look over the steps or watch ATI video |
| External catheter: male? Female? How do you set them up? Who uses them? | The nurse should place the external catheter with the soft side against the client between the client's buttocks and labia. The external catheter should not be placed inside a body cavity. The nurse should connect the external urinary catheter to continuous wall suction to facilitate drainage of urine. The nurse shouldn't use barrier cream or moisturizers on the client's perineal skin bc this can increase the risk for a uti. The nurse should replace the external urinary cath every 8 to 12 hr to decrease t |
| Neobladder diversion: what is it? What type has a pouch? No pouch? | A neobladder is a reservoir that stores urine. It connects to the urethra to facilitate voiding. An orthotopic neobladder uses an ileal pouch. |
| Color: what colors could urine be? What could they indicate? | Normal urine ranges from pale yellow (like straw) to amber depending on the concentration. Bleeding from the kidneys or ureters causes urine to become dark red. Bleeding from the bladder or urethra causes bright red urine. Patients taking phenazopyridine, a urinary analgesic, changes urine to bright orange. Eating beets, rhubarb, and blackberries can cause red urine. Patients with a liver disease who have high concentrations of bilirubin (urobilinogen) have dark amber urine. |
| Diarrhea: risks? Complications? Signs? Education to provide? Food to avoid? | Causes of diarrhea: viral gastroenteritis, antibiotic therapy, inflammatory bowel disease, irritable bowel syndrome. Bowel pattern of frequent loose, watery stools. Avoid foods in high fiber, caffeine, raw fruits and veggies when you have diarrhea. Complications of diarrhea are fluid and electrolyte imbalance, skin breakdown around the anal area, dehydration, hypernatremia, and hypokalemia. |
| Constipation: risks? Complications? Signs? Education to provide? Food to avoid? | People who frequently take laxatives, older adults, inadequate fluid or fiber intake, immobilization due to injury, pregnancy, and medication are all at risk for constipation. Avoid ripe bananas, refined flour and white rice when you are constipated. Complications of constipation are hemorrhoids and rectal fissures, bradycardia, hypotension, and syncope. |
| Ostomies: where is each type’s stoma located? What should the stoma look like? What type of stool output will each type have? | ● Ileostomy stoma is placed in the right lower abdomen. ● Sigmoid colostomy is placed in the left lower abdomen. ● Clients should not feel the end of the stoma ● Stoma should be pink/ red intact and healthy. Purple/blue indicates decreased circulation. ● Liquid stool will be produced in an ileostomy. Solid stool will form in a sigmoid colostomy. |
| Rectal screenings: lab? How to take them (be specific)? Diagnostic tests…what are they looking for? | Fecal occult blood (Guaiac) test. Checking for blood in the stool. |
| Enema: types? Steps to take? What to do if client cramping? Education to provide? Position to put patient in? | Have the patient lay left lateral with right leg pulled up to the chest. Warm enema up to prevent cramping. If a patient complains of cramping, lower the enema. |
| Carbs: functions? Sources? | Carbs provide most of the body’s energy and fiber. Remember 4 Kcal for carbs. Whole grain breads, baked potatoes, brown rice. |
| Fats: functions? Sources? | Fat provides energy and vitamins. No more than 35% of caloric intake should be from fat. Each gram of fat provides 9 Kcal. Sources are olive oil, salmon, and egg yolks. |
| Proteins: functions? Sources? Lab? | Proteins contribute to growth, maintenance, and repair of body tissues. Important in wound healing. Remember 4 Kcal in proteins. Labs associated with protein: Albumin (3.4-5.4 g/dL) |
| Vitamins: fat soluble? Water soluble? | A,D,E,K are fat soluble vitamins. |
| Vitamins: Water soluble? | C and B complex |
| Minerals roles and sources: iron, fiber, omega 3, folic acid | Minerals complete essential biochemical reactions in the body (calcium, potassium, sodium, iron). |
| BMI: categories? Formula? | Weight (lb) divided by height (in) squared X 703 Under: <18.5 Normal: 18.5-24.9 Overweight: 25.0-29.9 Obese: 30.0-34.9 Extremely Obese: >35.0 |
| Swallow concerns: who do you consult? What are signs of dysphagia? | Consult a speech therapist for swallow concerns. Drooling, hoarseness, regurgitation, feeling like food is stuck, and coughing. |
| Low sodium diet? | 1 to 2 grams of sodium or no added salt. Read labels. |
| Soft diet? | Low in fiber and easy to digest (dairy products, eggs, ripe bananas) |
| Mechanical soft? | clear and full liquids, diced or ground foods |
| High fiber? | whole grains, raw and dried fruits |
| Low cholesterol? | No more than 300 mg/day of dietary cholesterol (red meat, full fat dairy, butter) |
| Diabetic? | Balanced intake of protein, fats, and carbs of about 1,800 calories |
| Dysphagia? | Pureed food and thickened liquids |
| Regular diet? | No restrictions |
| NPO? | No food or liquid by mouth at all |
| Clear Liquid? | Clear fruit juices, gelatin, broth |
| GERD DIET? | Avoid large meals, consume liquid in between meals, avoid spicy food, caffeine, heavy oils, chocolate and other foods that increase gastric acid secretion |
| Vital Signs: Normal ranges? | Oral temp: 96.8-100.4 Pulse: 60-100/min Respirations: 12-20 B/P: 120/80 Prehypertension: 120-139/80-89, Stage 1 Hypertension: 140-159/90-99, Stage 2: 160/100 O2: 95-100 |
| Vital Signs : Interventions for abnormal findings? How do you know they work? | Call provider Pulse: check pulse deficit Oxidation: put on oxygen Temp: high temp= cold packs low temp= blankets / heating pads |
| Vital Signs: Proper documentation of each? | Order: T,P,R,BP Temp: how temp was taken. Ex: orally Oxidation: what hand oxidation was taken ( left or right) HR: What location it was taken and what side (left or right) BP: location (ex: left or right and on arm) |
| NG tube: insertion steps? Confirmation of placement? | Look over the steps or watch ATI video. Confirm placement by xray |
| EHR: Five pillars? | ● Five pillars: Privacy & security, improve population health, improve safety and quality, engage clients and families, and coordinate care. |
| Anesthesia: Brief description | ● Moderate sedation: Minor procedures; dental, podiatric, cosmetic, ophthalmic procedures |
Created by:
PRO Teacher
Jas123.
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