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Funds 1 Final
ch 1-3, 5-10, 14, 16-21, 23, 40-41
| Lincoln Tech’s Nursing Theorists | Betty Neumann Jean Watson |
| Evidence base practice | Using the best care by researching and getting more information |
| Different levels of health care | Prevention, Primary, Secondary, Tertiary, Restorative, Convalescent |
| Prevention health care | education, health promotion, exercise classes |
| Primary health care | annual checkups, vision screening, dentist |
| Secondary health care | radiology, labs, surgery, emergency, physical therapy |
| Tertiary health care | extended long term care, nursing home |
| Restorative health care | follow ups, rehabilitation |
| Convalescent health care | hospice |
| Stages of Illness | Transition, Acceptance, Convalescence, Adaptation |
| Transition stage | onset of illness, vague symptoms, self-medicate |
| Acceptance stage | denial stops, person stops doing daily activities, may go to the doctor or pharmacy |
| Convalescence stage | recovering and regaining health |
| Adaptation stage (maybe) | if illness is chronic, person learns how to cope and live with the illness, changes lifestyle |
| Nurse Practice Act | State licensure is required, each state has its own laws and regulations regarding licensure- the laws define the scope of nursing practice and provide the regulation of the profession |
| Acute vs chronic illnesses vs terminal | Acute: develops suddenly and resolves in a short time- flu, chicken pox Chronic: develops slowly over a long period of time and lasts throughout life- COPD Terminal: no cure, death- cancer |
| Primary Illness | diabetes- original illness |
| Secondary Illness | neuropathy- illness from the primary illness |
| Maslow’s hierarchy physiological vs higher level needs | Higher needs: essential to maintaining life- safety, security, love, belonging, self-esteem, and self-actualization Physiological: airway, respiratory effort, hearth rate’s rhythm and strength, nutrition, elimination PRIORITZES NURSING CARE |
| Physiological signs of stress | Depression, quick to anger, anxiety, irritability, confusion and forgetfulness |
| Sympathetic nervous system – fight vs flight | When the brain perceives a situation a threatening the person becomes more alert, breathing gets heavier, heart starts pounding, muscles poised for fight or flight |
| What is rationalization | Unconsciously falsifying an experience by giving contrived, socially acceptable, and logical explanation to justify an unpleasant experience or questionable behavior- student doesn’t study and fails then blames the teacher |
| Domains of learning | Cognitive- reading, listening Affective- material is presented that appeals to learners’ beliefs and values Psychomotor- doing |
| Advanced directives | Allow a person to plan medical wishes if unable to do so there selves |
| False imprisonment | Keeping patient against their will, using restraints |
| Occurrence screening report | Used to document an incident that is out of the ordinary, witnesses, what happened, facts, and who was involved Not filed in patient charting |
| National Safety Goals beneficence | Provide evidence and expert based solution to problem areas in terms of patient safety Determining how to identify a patient correctly Sentinel event: unexpected death of patient |
| HIPPA | Can’t talk about patients Access to records are confidential Public viewing of patients on display (white board) Civil penalties |
| Informed consent | Permission gave by patient or health care proxy- what will happen, what happens if rejecting Nurses only responsibility is witnessing the signature |
| Negligence | doing or not doing something that a reasonable prudent person would do or not do |
| Malpractice | negligence on a patient |
| Assault | threat |
| Battery | actual physical contact |
| Florence Nightingale | Influential to nursing, studied in Germany, trained women to care for soldiers during war, 60% to 1% death rate Nutrition, fresh air, occupational and recreational therapy, providing support, should be taught by nurses |
| Standards of Practice for an LPN | LPNs work under RNs that are supervising the unit |
| Morse Scale/Braden Scale | Fall risk/prevention of pressure ulcers |
| What are precautions for TB? HIV/ Pertussis? Influenza? | TB- airborne HIV/Pertussis- contact Influenza- droplet |
| What diseases need contact precaution? Airborne precaution? | Airborne: in the air, breathing Droplet: coughing, sneezing, mucus |
| What is sterile technique? | For procedures and surgery (surgical asepsis), sealed package, expiration dates, if you contaminate it then start over, hands are above the waist |
| 4 stages of infection | 1: incubation, when it first enters the body 2: prodromal, vague symptoms 3: illness: severity of infection, systemic symptoms appear 4: covalence: symptoms subside, person regains health |
| Health care associated infection | Transmitted while receiving health care services, health care workers can also contract a HAI (more in ICU) |
| Atypical signs of infection in the elderly? | Confusion, AMS |
| Palliative care | Reduce or relieve the symptoms of a disease without attempting to find a cure, preserves life while accepting death, no IVs, tubes, tests, chemo |
| Disenfranchised grieving | Cannot be publicized, suicide |
| Types of charting and notes POMR/SOAP | Problem oriented medical recording subjective, objective, assessment, plan |
| What are the domains of learning? | Cognitive (reading), visual (seeing), kinesthetic (doing) |
| Glucometers | Side of finger, wipe away first drop |
| S&S hypoglycemia | Sweating, clammy, dizzy, weak |
| What number is considered hyperglycemia? Hypoglycemia? | 200+, less then 70 |
| What are signs of approaching death? | Cheyenne stokes breath sounds |
| Name the serum electrolytes | Sodium, calcium, potassium, and chloride |
| Lines of defense against infections | 1st- intact skin 2nd- helps destroy pathogens- fever, swelling 3rd- immune response, foreign invaders trigger a response, specific to the type of invader |
| Natural acquired immunity | body produces antibodies to fight against infection and never let it occur again |
| Passive acquired immunity | person is given an antitoxin or antiserum that contains antibodies that developed in another person |
| Artificially acquired immunity | achieved through injection of vaccines that contain dead or inactive microorganisms or their toxins |
| What does prodromal mean? | Symptoms not specific |
| Vectors | Route of infection from tick, bug |
| Pneumonia risk factors for the elderly | Immobility, sedentary, decreased lung capacity, fluid in lungs, decreased cilia in lungs |
| Dangling and orthostatic hypotension | Lying to sitting, sitting to standing- dangle patient |
| Bed position for hypovolemic shock | Trendelenburg position- feet up head down |
| What position should the pat stay in for 30 mins after eating | High fowlers |
| Logrolling | turn the patient as a single unit, to change bed linen, requires two people |
| Prone positioning devices | Pillows- support body Boots- dorsiflexion Footboards- dorsiflexion Trochanter rolls- prevent external rotation of leg |
| Positions for a pt with a g-tube feeding | Sims’ position, various side laying |
| Where does the pulse originate from? | Cardiac contractions causing pressure waves against the walls of arteries |
| Harmful fever | 102.2 |
| Snellen eye test | Eyes tested with chart |
| pain vital sign | 5th |
| Hypothalamus and head injuries | Regulates body temp, will increase with head injury |
| Olfaction | smelling |
| Orthopnea | Used with patients with cardiac issues Position- sitting up, table w pillow and arms on pillow |
| Normal pulse ox reading | 95-100 |
| How to take a B/P | Pressure excreted on arterial walls by pumping action of the heart Systolic: top- force excreted on arterial wall during cardiac contraction Diastolic: bottom- relaxation 120/70 |
| Initial B/P reading | Both arms Anxiety, fear, and stress elevate BP, take twice if needed |
| B/P cuff size | 3/4 of the arm circumference Inaccurate reading if wrong side |
| Korotkoff Sounds | Related to the effect of the blood pressure cuff 1- Tapping 2- swishing 3- knocking 4- muffling 5- silence |
| What does hypovolemia make vital signs look like? | BP- decreases Pulse- increases |
| Role of the thyroid gland | Metabolism regulation Hypothyroid: metabolism rate decreases Hyperthyroidism: metabolism rate increases |
| Breath sounds | Crackles: abnormal, nonmusical Rhonchi: continuous dry, rattling sounds Stertor: snoring sound when patient is unable to cough up secretions Stridor: crowing sound on inspiration caused by obstruction of upper air passages Wheeze: whistling sound |
| What is an unexpected heart sound? | murmur |
| Pulse | Produced by cardiac contractions causing a pressure wave against the walls of arteries Rate affected by fever, pain, hypoxia, anxiety, exercise, and cardiac disease |
| Pulse Origins | Radial (wrist- thumb side), Apical (5th intercostal space), Dorsal/Pedal (top of foot), Temporal (front of ear), Carotid (front of neck), Femoral (groin), Popliteal (behind the knee) |
| Respirations | Involuntary autonomic function |
| Pulse Characteristics | Rate, rhythm, and volume Arrythmia: normal rhythm broken by irregular skipped beats |
| Pulse strengths | 1+ weak 2+ strong regular 3+ full and bounding Irregular: strong and weak Thready: weak and irregular Absent: dead |
| Respiratory Patterns | eupnea, dyspnea, apnea, hyperventilation, cheyne-stokes, kussmaul's, biot's |
| Eupnea | normal, relaxed |
| Apnea | no breathing |
| Hyperventilation | breathing where there is an increase in rate and depths |
| Cheyne-Stokes | dyspnea followed by short period of apnea |
| Kussmaul’s | increased rate and depth with panting and long, grunting exhalation |
| Biot’s | shallow for two or three breaths with variable apnea |
| dyspnea | difficult, labored breathing |
| vVit K food sources that affect warfarin | Dark green leavy vegetables |
| Protein ad ESKD- end stage kidney disease | Protein increase from .6- 1 g/kg or 1.2- 1.5 g/kg before dialysis 50% should come from eggs, milk, meat, fish, poultry soy (biologic sources) Protein and amino acids are lost during dialysis |
| NANDA nursing diagnoses | Diagnostic labels are formulated by NANDA and revised every 2 years Only a nurse can diagnose a patient with the problems listed in NANDA |
| Collection of subjective and objective data | Subjective- what patient says Objective- what you observe |
| Scurvy | Lacking vitamin C |
| Clear liquid diet | Anything you can see through |
| Night Blindness | Lacking vitamin A |
| Grapefruit juice | Can affect medications |
| Food sources low in potassium | Oranges and grapefruits |
| Water Soluble Vitamins | C, B1 |
| Fat Soluble Vitamins | A, D, E, K |
| Order of the nursing process | - assessment - diagnosis - planning - implementation - evaluation |
| Functions of protein | Tissue building and maintenance, balance of nitrogen and water, backup energy, transportation of nutrients, support immune system, facilitate acid base, fluid, and electrolyte balance, and forms neurotransmitters, enzymes, antibodies, peptide hormones |
| Types of cholesterol | Good HDL Bad LDL |
| Calories | Carbs- 4 Fat- 9 Protein- 4 |
| Complete and incomplete proteins | Incomplete- plant, beans Complete- rice/beans |
| Chiropractor | Spinal manipulation for healing |
| How to assess for edema | vGeneralized edema- assess weight gain over a short period of time, ask about shoe and ring tightness, sock patterns left on ankles, look for eye and hand puffiness, abdominal fullness |
| Dependent edema | press fingers into the tissue over the tibia just above the ankle (if indentation remains, it is classified as pitting edema and is classified on its depth) |
| depth of edema | 1+ 2mm (trace) rapid skin response 2+ 4mm (mild) 10-15 second 3+ 6mm (moderate) prolonged 4+ 8mm (severe) prolonged |
| Potassium and the heart | Deficiency or excess can cause a dysrhythmia |
| Romberg Test | balance |
| Changes with aging | Temperature, lower metabolic rate, respiratory rates, blood pressure, eyes, taste |
| Positions | Fowlers: 60-90 degrees Mid Fowlers: 30-60 degrees Low Fowlers: 15-30 degrees Prone: face down |
| More positions | Knee to Chest: face down, chest, knees, and elbows resting on bed Lateral: lying on side Oblique: removes pressure from shoulder and hip Sims: side lying used for rectal or insertions of tubes |
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