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Ms V #5 study guide
Ms V Exam #5 Study Guide
| Question | Answer |
|---|---|
| What are the different subjective data that can collected in assessing pain? | characteristics, description, site, severity, duration, location of pain, intensity of pain, and what makes it better or worse |
| What are the different non-invasive pain relief techniques? | Cutaneous stimulation (heat, cold, massage, and TENS), distraction, relaxation, guided imagery, hypnosis, and biofeedback. |
| How does TENS (transcutaneous electrical nerve stimulation) relieves the pain of a patient with chronic pain? | Electrodes are placed on or near the painful site, which can be adjusted, and blocks pain impulses.. As with other forms of cutaneous stimulation, it is thought that TENS “close the gate” in the spinal cord and may stimulate endorphin production. |
| What specific cardiac apparatus does TENS interferes with in terms of functioning? | cardiac pacemaker device |
| What is the common gastrointestinal side effect of OPIOID? | Constipation |
| What is wound dehiscence? | The separation of a surgical incision or rupture of a wound closure. |
| What is wound evisceration? | Protrusion of an internal organ through a wound or surgical incision, especially in the abdominal wall. |
| What is a major surgical procedure? | Involves extensive reconstruction or alteration in body parts; poses great risks to well-being (e.g., coronary artery bypass, colon resection, gastric resection) |
| What is a minor surgical procedure? | Involves minimal alteration in body parts; often designed to correct deformities; involves minimal risks compared with those of major procedures (e.g., cataract extraction, skin graft, tooth extraction) |
| How would you define a surgery with an Urgency classified as "elective"? | Performed on basis of patient's choice (e.g., bunionectomy, plastic surgery) |
| What vital sign should be closely monitored to a patient with epidural analgesics that will suggest respiratory depression? | Respiratory Rate |
| What are the components of a legal informed consent and what is your responsibility as a nurse? | In signing the consent the pt is competent and agrees to have the procedure that is stated on the form. Info is to be clear, the risks explained, expected benefits identified, and consequences or alternatives for the presenting problem stated. |
| How does conscious sedation effect the individual? | Administration of central nervous system depressant drugs and/or analgesia to relieve anxiety and this patiet will independently retain a patent airway and reflexes and will be able to respond appropriately to physical and verbal stimuli. |
| To prevent post-operative respiratory complications such as Pneumonia identify the activities included in your pre-operative teaching? | Before surgery the nurse should assist the patient to practice coughing, turning, deep breathing and how to use an incentive spirometer. |
| How would you define a surgery with an Urgency classified as "emergency"? | Must be done immediately to save life or preserve function of body part (e.g., removal of perforated appendix, repair of traumatic amputation, control of internal hemorrhaging) |
| The rationale why the very young and older patients are considered risk groups for surgical complications? | Their altered metabolic needs may not respond to physiologic changes quickly. Of specific concern in these age groups is the body's response to temperature changes, cardiovascular shifts, respiratory needs, and renal function. |
| Define synergistic relationship | the action of two or more substances or organs to achieve an effect of which each is individually incapable |
| With synergitic relationship, what combination of factors can affect the individual’s perception of pain? | The combination of fatigue, sleep disturbance, and depression can change a person's perception of pain. |
| What are the types of anesthesia available? | General, regional, local and conscious sedation |
| How does general anesthesia effect the individual? | General anesthesia results in an immobile, quiet patient who does not recall the surgical procedure. The patient's amnesia acts as a protective measure from the unpleasant events of the procedure. |
| Identify the cardiovascular considerations to prevent venous stasis and eventually thrombus formation? | Antiembolism stockings (thromboembolic disease stockings [TEDS]), Jobst pump, or sequential compression devices (SCDs) with intermittent external pneumonic compression system |
| Which type of anesthesia depresses the CNS but still allows the patient to follow simple basic commands? | Conscious sedation |
| What are the signs and symptoms of pulmonary embolism? | Sudden chest pain combined with dyspnea, tachycardia, cyanosis, diaphoresis, and hypotension. |
| How does local anesthesia effect the individual. | It involves loss of sensation at the desired site. The agent inhibits nerve conduction until the drug diffuses into the circulation. It may be injected or applied topically. The pt has a loss in pain sensation,touch, and in motor and autonomic activities |
| When should be coughing exercises be contraindicated ? | In cranial and spinal-related surgeries or for patients having cataract surgery |
| What are the physiological signs and symptoms of sleep deprivation? | Hand tremors, decreased reflexes, slowed response time, reduction in word memory, decreased reasoning and judgment, and cardiac dysrhythmias. |
| What is the difference between a localized pain and referred pain. | Localized pain is when the exact site of pain can be identified. Referred pain is felt at a site other than the injured or diseased organ or part of the body. |
| What type of pain does the cardiac patient manifest when they felt it to the L chest and radiate to the L arm? | This is an example of referred pain is the pain of coronary artery |
| What are the psychological signs and symptoms of sleep deprivation? | Mood swings, disorientation, irritability, decreased motivation, fatigue, sleepiness, and hyperexcitability |
| Examples of activities that support the Gate theory. | A back rub, the heat of a warm compress, the cold from ice applications, Auditory or visual stimuli. |
| An electrolyte that should be evaluated prior to surgery to prevent cardiac dysrrythmia? | Potassium |
| A drug classification that should be stopped prior to surgery to prevent intra or post-operative bleeding. | Anticoagulants |
| What specific system should be assessed after an abdominal surgery? | GI System |
| How many normal bowel sounds heard per minute? | 5 to 30 gurgles per minute |
| What are the different objective data that can collected in assessing pain? | tachycardia, increased rate and depth of respirations, diaphoresis, increased systolic or diastolic blood pressure, pallor, dilated pupils, and increased muscle tension, nausea, weakness, facial expressions, crying, moaning, etc. |
| What is your responsibility as a nurse regarding a legal informed consent? | Allow more time to explain surgery to the pt who does not see or hear well, an interpreter for those who do not understand English or are deaf, contact the physician if the pt does not understand the surgery and know the policy on informed consent. |
| A classification of drug given to relieve anxiety to patients that affects the REM stage of sleep. | Hypnotics and most medications used to promote sleep, relieve anxiety, and overcome depression interfere with REM sleep. A person may sleep but not feel rested. |
| What is the Gate Theory? | The gate theory suggests that pain impulses can be regulated or blocked by gating mechanisms located along the central nervous system (CNS). The proposed location of the gates is in the dorsal horn of the spinal cord. |
| How would you define a surgery with an Urgency classified as "urgent"? | Necessary for patient's health (e.g., excision of cancerous tumor, removal of gallbladder for stones, vascular repair for obstructed artery [e.g., coronary artery bypass]) |
| What effect does regional anesthesia have on the individual? | Regional anesthesia results in loss of sensation in an area of the body. There is no loss of consciousness with regional anesthesia, but the patient is usually sedated. |
| What should be your independent nursing interventions for the most common gastrointestinal side effect of OPIOD? | Most patients should be directed to take a stool softener with a mild peristaltic stimulant regularly. |
| What are the appropriate immediate nursing interventions for wound dehiscence and evisceration? | Contact physician immediately, cover the wound with a sterile towel moistened with warm, sterile saline, place the patient in Fowler's position, advise pt that surgery will be required and prepare the patient for surgery |
| Be familiar with the different cultural influences that affects the individual’s perception with pain. | Review pg 409 of ch 16 |
| Who proposed the Gate Theory? | It was proposed by Melzack |
| What are endorphins? | A natural supply of morphinelike substances contained in the body activated by stress and pain |
| What is the definition of Pain | Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. |
| Examples of activities that release Endorphins | Transcutaneous electrical nerve stimulation (TENS), acupuncture, and placebos Pain relief measures, such as transcutaneous electrical nerve stimulation (TENS), acupuncture, and placebos, are believed to cause the release of endorphins |
Created by:
bsmymicareo
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