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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
Created by: giannamenairji
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