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CHAPTER 21-25; 27; 31; 33-36-39,43,45-46

Development orderly pattern of changes in structure, thoughts, feelings, or behaviors resulting from maturation, experiences, and learning.
Growth increase in body size or changes in body cell structure, function, and complexity.
A nurse examining a toddler in a pediatric office documents that the child is in the 90th percentile for height and weight and has blue eyes. These physical characteristics are primarily determined by which of the following? Genetic information on chromosomes
The nurse caring for infants in a hospital nursery knows that newborns continue to grow and develop according to individual growth patterns and developmental levels. Which terms describe these patterns? Select all that apply. Orderly Sequential Differentiated integrated
A 2-year-old grabs a handful of cake from the table and stuffs it in his mouth. According to Freud, what part of the mind is the child satisfying? Id
A nurse is teaching parents of preschoolers what type of behavior to expect from their children based on developmental theories. Which statements describe this stage of development? Select all that apply. Freud, the child is in the phallic stage. Fowler, imitates religious behavior of others. Kohlberg, defines satisfyg acts as right. Erikson, is in the initiative vs guilt stage. Havighurst, learng sex differences, formg concepts, gettg read to read
A nurse caring for older adults in a long-term care facility encourages an older adult to reminisce about past life events. This life review, according to Erikson, is demonstrating what developmental stage of the later adult years? Ego integrity
The school nurse uses the principles and theories of growth and development when planning programs for high school students. According to Havighurst, what is a developmental task for this age group? Midlife transition
Stages Build on previous stages, bring behavior from previous stage with you you could regress due t stressors(b.newman)
Import with children Safety and bonding is key as the child grows child maltreatment-neglect-abuse
Important with infant Sleep on the back breastfeeding car-sit
Important A school nurse is preparing a talk on safety issues for parents of school-aged children to present at a parent–teacher meeting. Which topics should the nurse include based on the age of the children? Select all that apply. Teaching pedestrian traffic safety Providing swimming lessons and water safety rules Teaching child how to “stop, drop, and roll”
The nurse encourages parents of hospitalized infants and toddlers to stay with their child to help decrease what potential problem? Separation anxiety
A nurse is teaching parents of toddlers how to spend quality time with their children. Which activity would be developmentally appropriate for this age group? Playing in a sand box
A mother tells the nurse that she is worried about her 4-year-old daughter because she is “overly attached to her father and won’t listen to anything I tell her to do.” What would be the nurse’s best response to this parental concern? Tell the mother that this is normal behavior for a preschooler.
A high school nurse is counseling parents of teenagers who are beginning high school. Which issues would be priority topics of discussion for this age group? Select all that apply. Risk-taking behavior The influence of peer groups Bullying eating-disorder
Following assessment of an obese adolescent, a nurse considers nursing diagnoses for the patient. Which diagnosis would be most appropriate? disturbed body image
Most importantly, Teaching based on the level of developmental phases what are their prone to? health issues How do nurse intervene? activities to prevent health issue
A nurse is teaching new mothers about infant care and safety. What would the nurse include as a teaching point? Keep infants younger than 6 months out of direct sunlight.
A nurse working with adolescents in a group home discusses the developmental tasks appropriate for adolescents with the staff. What is an example of a primary developmental task of the adolescent? Spending time developing relationships with peers
Genetic theory Genes within the organism control genetic clocks, determine the occurrence and rate of metabolic processes, including cell division.
Immune theory The neuroendocrine system contains the pituitary and hypothalamus that serve as control mechanisms for the entire body. As age advances, these control mechanisms fail, which leads to failure of the body’s essential pacemaker, and death.
physiological As time passes, gradual internal and external physiologic changes occur. These are not pathologic changes, but normal changes that result from aging.
cognitive- decline as well Problem-solving abilities remain throughout adulthood, although response time may be slightly longer
psychosocial ime of increased personal freedom, economic stability, and social relationships
what is sarcopenia? loss of muscle mass
nursing focus : How do we accommodate based on developmental stage? TEACHING
What is infection? disease state that results from the presence of pathogens
virulence ability of a disease to cause disease
A nurse is following the principles of medical asepsis when performing patient care in a hospital setting. Which nursing action performed by the nurse follows these recommended guidelines? The nurse moves the patient table away from the nurse’s body when wiping it off after a meal
A school nurse is performing an assessment of a student who states, “I’m too tired to keep my head up in class.” The student has a low-grade fever. The nurse would interpret these findings as indicating which stage of infection? Prodromal stage
A nurse is caring for patients in an isolation ward. In which situations would the nurse appropriately use an alcohol-based handrub to decontaminate the hands? Select all that apply. Providing a bed bath for a patient Removing gloves when patient care is completed Removing old magazines from a patient’s table b4 inserting urinary catheters, peripheral vascular catheters, or invasive devices that do not require surgical placement;
The nurse has opened the sterile supplies and put on two sterile gloves to complete a sterile dressing change, a procedure that requires surgical asepsis. Which action by the nurse is appropriate? Consider the outer 1 in of the sterile field as contaminated
The nurse caring for patients in a hospital setting institutes CDC standard precaution recommendations for which category of patients? All patients receiving care in hospitals
A nurse is preparing a sterile field using a packaged sterile drape for a confused patient who is scheduled for a surgical procedure. When setting up the field, the patient accidentally Discard the supplies and prepare a new sterile field with another person holding the patient’s hand
A nurse is finished with patient care. How would the nurse remove PPE when leaving the room? Untie gown waist strings, remove gloves, goggles, gown, mask; perform hand hygiene
A nurse who is caring for a patient diagnosed with HIV/AIDS incurs a needlestick injury when administering the patient’s medications. What would be the first action of the nurse following the exposure? Wash the exposed area with warm water and soap
The nurse assesses patients to determine their risk for HAIs. Which hospitalized patient would the nurse consider most at risk for developing this type of infection? A 65-year-old patient who has an indwelling urinary catheter in place
A nurse is caring for an obese 62-year-old patient with arthritis who has developed an open reddened area over his sacrum. What risk factor would be a priority concern for the nurse when caring for this patient? infecton
A nurse teaches a patient at home to use clean technique when changing a wound dressing. What would be a consideration when preparing this teaching plan? The use of clean technique is safe for the home setting
A nurse is using personal protective equipment (PPE) when bathing a patient diagnosed with C. difficile infection. Which nursing action related to this activity promotes safe, effective patient care? The nurse works from “clean” areas to “dirty” areas during bath
droplet precautions Rubella, diphtheria, and adenovirus infection are illnesses transmitted by large-particle droplets
airborne precaustion who have infections spread through the air with small particles; for example, tuberculosis, varicella, and rubeola.
Contact precautions used for patients who are infected or colonized by a multidrug-resistant organism (MDRO), such as MRSA and c.diff
What affect vital signs? disease
Take rectal temperature on: A child who has pneumonia An adult patient who is newly diagnosed with pancreatitis
A nurse assesses an oral temperature for an adult patient and records that the patient is “afebrile.” What would be the nurse’s best response to this finding? No action is necessary; this is a normal reading.
Upon assessment of a patient, the nurse determines that a patient is at risk of losing body heat through the process of convection. What would be the nurse’s best response? Turn off the overhead fan in the patient’s room.
The rectal temperature, a core temperature, is considered to be one of the most accurate routes. In which cases would taking a rectal temperature be contraindicated? Select all that apply. A newborn who has hypothermia An older adult who is post MI (heart attack) A teenager who has leukemia A patient receiving erythropoietin to replace red blood cells
axillary or rectal is axillary the least accurate temperature check route while rectal is the most accurate
While taking an adult patient’s pulse, a nurse finds the rate to be 140 beats/min. What should the nurse do next? is an abnormal pulse and should be reported to the primary care provider or the nurse in charge of the patient.
A patient reports severe abdominal pain. When assessing the vital signs, the nurse would not be surprised to find what assessments? Select all that apply. An increase in the pulse rate An increase in respiratory rate doesn't affect body temperature decrease respiratory depth
Two nurses are taking an apical–radial pulse and note a difference in pulse rate of 8 beats/min. How will the nurse document this difference? pulse deficit
The nurse instructor is teaching student nurses about the factors that may affect a patient’s blood pressure. Which statements accurately describe these factors? Select all that apply. Blood pressure decreases with age (dcrse elasticity) Women usually have lower blood pressure than men until menopause. Blood pressure tends to be lower in the prone or supine position. Increased blood pressure is more prevalent in African Americans.
A patient is experiencing dyspnea. What is the nurse’s priority action? Elevate the head of the bed. allows the abdominal organs to descend, giving the diaphragm greater room for expansion and facilitating lung expansion.
A nurse assesses orthostatic hypotension in an older adult. What would be an appropriate intervention for this patient? Allowing the patient to “dangle” on the edge of the bed prior to rising might prevent orthostatic hypotension
A patient has a blood pressure reading of 130/90 mm Hg when visiting a clinic. What would the nurse recommend to the patient? Follow-up measurements of blood pressure
A nurse is documenting a blood pressure of 120/80 mm Hg. The nurse interprets the 120 to represent: the highest pressure present on arterial walls while the ventricles contract.
A nurse notices a student is taking a blood pressure measurement on a patient with a cuff that is too large. What should be the nurse’s response to the student? If you use the wrong cuff you will get an incorrect reading.
A patient has intravenous fluids infusing in the right arm. How should the nurse obtain the blood pressure on this patient? Take the blood pressure in the left arm.
what is an example of convection? the heat is disseminated by motion between areas of unequal density, for example, the action of a fan blowing cool air over the body
what is an example of evaporation? Reducing the temperature in the room may decrease heat loss via perspiration (evaporation); increasing the temperature in the room might increase heat loss via evaporation.
wha is an example of conduction? Removing the patient’s ice pack is an intervention to prevent heat loss via conduction.
what is the pressure of a client with blood pressure 132/82? 50 because the difference between the systolic and diastolic pressure = to pulse pressure
In emergency situation, use the? carotid artery as the pulse site
A patient is taking medications to treat dysrhythmia, which site should be assessed? Apical pulse
Is a pulse rate 170 beats/min ok for a patient? Yes, because the younger the infant, the higher the respiration, pulse rate is and the lower blood pressure is.
What s primary and secondary blood pressure? Primary is high blood pressure against arteries walls, while secondary is a symptom of an underlying disease
Why is the temperature of a baby/infants is unstable? because of the immaturity ability to regulate temperature in general but temperature drops as we age
The nurse caring for patients in a long-term care facility knows that there are factors that place certain patients at a higher risk for falls. Which patients would the nurse consider to be in this category? Select all that apply. A patient who has already fallen twice A patient who experiences postural hypotension A 70-year-old patient who is transferred to long-term care diuretic
A school nurse is teaching parents about home safety and fires. What information would be accurate to include in the teaching plan? Select all that apply. Most fatal fires occur when people are sleeping. Most people who die in fires die of smoke inhalation. Fire-related injury and death have declined due to the availability and use of smoke alarms. 80 percent of U.S. fire deaths occur in the home.
A nurse is assessing the following children. Which child would the nurse identify as having the greatest risk for choking and suffocating? A toddler playing with his 9-year-old brother’s construction set
While discussing home safety with the nurse, a patient admits that she always smokes a cigarette in bed before falling asleep at night. Which nursing diagnosis would be the priority for this patient? Impaired gas exchange related to cigarette smoking
A nurse working in a pediatrician’s office receives calls from parents whose children have ingested toxins. What would be the nurse’s best response? Call the PCC immediately before attempting any home remedy.
A nurse is teaching parents in a parenting class about the use of car seats and restraints for infants and children. Which information is accurate and should be included in the teaching plan? Booster seats should be used for children until they are 4′9″ tall and weigh between 80 and 100 lb.
Based on the statistics for the leading cause of hospital admission for trauma in older adults, what would be the nurse’s priority intervention to prevent trauma when caring for older adults in a nursing home? Falls among older adults are the most common cause of hospital admissions for trauma, therefore rooms should be free of clutter.
reasons for falling are? identify-poor vision-shoes-earing-catheter-medication-dzziness
What consideration should the nurse keep in mind regarding the use of side rails for a patient who is confused? A person of small stature is at increased risk for injury from entrapment.
When a fire occurs in a patient’s room, what would be the nurse’s priority action? Rescue the patient.
A nurse is filing a safety event report for a confused patient who fell when getting out of bed. What action is performed appropriately? The nurse records the circumstances and effect on the patient in the medical record.
When discussing emergency preparedness with a group of first responders, what information would be important to include about preparation for a terrorist attack? BLI is a serious consequence following detonation of an explosive device.
An older resident who is disoriented likes to wander the halls of his long-term care facility. Which action would be most appropriate for the nurse to use as an alternative to restraints? Identifying his door with his picture and a balloon
The Joint Commission issues guidelines regarding the use of restraints. In which case is a restraint properly used? The nurse ensures that two fingers can be inserted between the restraint and patient’s ankle.
A nurse orients an older adult to the safety features in her hospital room. What is a priority component of this admission routine? Explain how to operate the call bell.
what are fowler or high fowler degree 45-60 degree high fowler 90 degree
Does placing the client in bed with a bed alarm prevents fall? yes
A nurse is scheduling hygiene for patients on the unit. What is the priority consideration when planning a patient’s personal hygiene? The patient’s usual hygiene practices and preferences
A nurse caring for patients in a critical care unit knows that providing good oral hygiene is an essential part of nursing care. What are some of the benefits of providing this care? Select all that apply. It promotes the patient’s sense of well-being. It prevents deterioration of the oral cavity. decreasing the incidence of aspiration pneumonia and other systemic diseases
A nurse assisting with a patient bed bath observes that an older female adult has dry skin. The patient states that her skin is always “itchy.” Which nursing action would be the nurse’s best response? Use an emollient on the dry skin.
A nurse caring for patients in a skilled nursing facility performs risk assessments on the patients for foot and nail problems. Which patients would be at a higher risk? Select all that apply. A patient diagnosed with type II diabetes A patient who is obese A patient who has a nervous habit of biting his nails A patient whose job involves frequent handwashing
Nurses performing skin assessments on patients must pay careful attention to cleanliness, color, texture, temperature, turgor, moisture, sensation, vascularity, and lesions. Which guidelines should nurses follow when performing these assessments? SATA the nurse should compare bilateral parts for symmetry Proceed in a toe-to-head systematic manner. Use standard terminology to report and record findings. Use good source of light.
A nurse is caring for an adolescent with severe acne. Which recommendations would be most appropriate to include in the teaching plan for this patient? Select all that apply. Wash the skin twice a day with a mild cleanser and warm water. Keep hair off the face and wash hair daily. Avoid sun-tanning booth exposure and use sunscreen.
A nurse is performing oral care on a patient who is in traction. The nurse notes that the mouth is extremely dry with crusts remaining after the oral care. What should be the nurse’s next action? Increase the frequency of the oral hygiene and apply mouth moisturizer to oral mucosa.
A nurse is removing rigid gas-permeable (RGP) contact lenses from the eyes of a patient who is unable to assist with removal. The nurse notices that one of the lenses is not centered over the cornea. What would be the nurse’s first action in this...? Apply gentle pressure on the lower eyelid to center the lens prior to removing it.
A patient has an eye infection with a moderate amount of discharge. Which action is an appropriate step for the nurse to perform when cleaning this patient’s eyes? Cleanse the eye using a different section of the cleaning cloth for each stroke until clean.
A nurse is providing foot care for patients in a long-term care facility. Which actions are recommended guidelines for this procedure? Select all that apply. Bathe the feet thoroughly in a mild soap and tepid water solution. Dry feet thoroughly, including the area between the toes. Use an antifungal foot powder if necessary to prevent fungal infections.
A nurse is assisting a patient with dementia with bathing. Which guideline is recommended in this procedure? Consider using music to soothe anxiety and agitation.
A nurse is teaching a student nurse how to cleanse the perineal area of both male and female patients. What are accurate guidelines when performing this procedure? Select all that apply. Both genders: use a clean portion of the washcloth for each stroke. wash the groin area with a small amount of soap and water and rinse. For a male , clean the tip of the penis first, moving the washcloth in a circular motion from the meatus outward.
A nurse is assisting an older adult with an unsteady gait with a tub bath. Which action is recommended in this procedure? Assist the patient in and out of the tub to prevent falling.
A nurse is about to bathe a female patient who has an intravenous access in place in her forearm. The patient’s gown, which does not have snaps on the sleeves, needs to be removed prior to bathing. What is the appropriate nursing action? Thread the bag and tubing through the gown sleeve, keeping the line intact.
A nurse is caring for a 25-year-old male patient who is comatose following a head injury. The patient has several piercings in his ears and nose. The piercing in his nose appears to be new and is crusted and slightly inflamed. How to proceed? hand hygiene and put on gloves, then cleanse the site of all crusts and debris by rinsing the site with warm water, removing the crusts with a cotton swab
To clean eyes(glasslike appearance), do wear gloves, clean with normal saline or plain water STORE LENSES IN NS
Should the nurse use special perineal skin cleaners and moisture barriers when patient is incontinence? YES
Should a nurse apply gentle pressure to center on the corner when removing hard or gas-permeable lenses? YES
WHAT ARE ORTHOPEDICS? the correction or prevention of disorders of body structures used in locomotion.
THE SKELETAL SYSTEM? The framework of bones, the joints between them, and cartilage that protects our organs and allows us to move -HEAT PRODUCTION-MAINTAIN POSTURE
MUSCULAR SYSTEM? The muscular system is composed of three types of muscles: (1) skeletal, (2) cardiac, and (3) smooth or visceral muscles. Muscle tissue produces movement by contraction of its cells
A nurse is evaluating a patient following the administration of an enteral feeding. Which findings are normal and are criteria that indicate patient tolerance to the feeding? Select all that apply. Absence of nausea, vomiting Bowel sounds within normal range Absence of diarrhea and constipation
A nurse is feeding an older adult patient who has dementia. Which intervention should the nurse perform to facilitate this process? the nurse should stroke the underside of the patient’s chin to promote swallowing, serve meals in the same place and at the same time, provide one food item at a time since a whole tray may be overwhelming, and provide between-meal snacks
A patient who has COPD is refusing to eat. Which intervention would be most helpful in stimulating appetite in this patient? Encouraging food from home when possible.
A nurse is feeding a patient who is experiencing dysphagia. Which nursing intervention would the nurse initiate for this patient? 30-minute rest period prior to mealtime to promote swallowing; alternate solids and liquids when feeding the patient; sit the patient upright or, if on bedrest, elevate the head of the bed at a 90-degree angle(45)
A nurse is evaluating patients to determine their need for parenteral nutrition (PN). Which patients would be the best candidates for this type of nutritional support? Select all that apply. A patient with irritable bowel syndrome who has intractable diarrhea A patient with celiac disease not absorbing nutrients from the GI tract A patient with burns who has not been able to eat adequately for 5 days
A nurse is feeding a patient who states that she is feeling nauseated and can’t eat what is being offered. What would be the most appropriate initial action of the nurse in this situation? The first action of the nurse when a patient has nausea is to remove the tray from the room.
A patient has been admitted to the alcoholic referral unit in the local hospital. Based on an understanding of the effects of alcohol on the GI tract, which is a priority concern related to nutrition? Vitamin B malnutrition
A nurse is assessing a Pt who has been NPO (nothing by mouth) prior to abdominal surgery. The pt is ordered a clear liquid diet for breakfast, 2advance to a house diet as tolerated. Which assessments TELL nurse that the pt’s diet should not be advanced? absence of nausea, vomiting, and diarrhea; absence of feelings of fullness; absence of abdominal pain and distention; feelings of hunger; and the ability to consume at least 50% to 75% of the food on the meal tray.
A pt who is moved to a hospital bed following throat surgery is ordered to receive continuous tube feedings through a small-bore nasogastric tube...placement of the tube, which action would the nurse initiate to ensure correct placement of the tube? Obtain an order for a radiographic examination of the tube.
Which nursing diagnosis would be most appropriate for a patient with a body mass index (BMI) of 18? Imbalanced Nutrition: Less than Body Requirements is appropriate
A nurse nutritionist is collecting assessment data for a patient who complains of “tiredness” and appears malnourished. The nurse orders tests for hemoglobin and hematocrit. What condition might these tests confirm? Anemia
A nurse is administering a tube feeding for a patient who is post bowel surgery. When attempting to aspirate the contents, the nurse notes that the tube is clogged. What would be the nurse’s next action following this assessment? using warm water or air and gentle pressure to unclog it. REPLACE IF UNSUCESSFULL
A hospice nurse is caring for a patient who is dying of pancreatic cancer. The patient tells the nurse “I feel no connection to God” and “I’m worried that I find no real meaning in life.” What would be the nurse’s best response to this patient? Ask if the patient would like to talk about his feelings.
A nurse who was raised as a strict Catholic but who is no longer a practicing Catholic stated she couldn’t assist patients with their spiritual distress because she recognizes only a “field power” She said, “My parents and I hardly talk because I’ve dese an unmet spiritual need to experience love and belonging,
A nurse is performing spirituality assessments of patients living in a long-term care facility. What is the best question the nurse might use to assess for spiritual needs? How can I and the other nurses help you maintain your spiritual practices?
The Roman Catholic family of a baby who was born with hydroencephalitis requests a baptism for their infant. Why is it imperative that the nurse provides for this baptism to be performed? Not having a Baptism for the baby when desired may increase the family’s sorrow and suffering.
A nurse is caring for patients admitted to a long-term care facility. Which nursing actions are appropriate based on the religious beliefs of the individual patients? Select all that apply. - dietitian asks a Buddhist if he has any diet restrictions related to the observance of holy days. -a Christian Scientist who is in traction if she would like to try nonpharmacologic pain measures. -asks a Roman Catholic woman if she would like to atte
A nurse who is caring for patients on a pediatric ward is assessing the children for their spiritual needs. Which is the most important source of learning for a child’s own spirituality? How parents behave in relationship to one another, their children, others, and to God
Even though the nurse performs a detailed nursing history in which spirituality is assessed on admission, problems with spiritual distress may not surface until days after admission. What is the probable explanation? Illness increases spiritual concerns, which may be difficult for patients to express in words.
A nurse who is comfortable with spirituality is caring for patients who need spiritual counseling. Which nursing action would be most appropriate for these patients? Asking whether the patient has a spiritual adviser the patient wishes to consult
A nurse performing a spiritual assessment collects assessment data from a patient who is homebound and unable to participate in religious activities. Which type of spiritual distress is this patient most likely experiencing? Spiritual alienation
A pt feels so isolated from her family and church, and even from God, “in this huge medical center so far from home.” A nurse is preparing nursing goals for this patient. Which is the best goal for the patient to relieve her spiritual distress? The patient will identify spiritual supports available to her in this medical center.
A man who is a declared agnostic is extremely depressed after losing his home, his wife, and his children in a fire. His nursing diagnosis is Spiritual Distress: Spiritual Pain related to inability to find meaning and purpose in his current condition... Explore with the patient what, in addition to his family, has given his life meaning and purpose in the past.
After having an abortion, a patient tells the visiting nurse, “I shouldn’t have had that abortion because I’m Catholic, but what else could I do? I’m afraid I’ll never get close to my mother or back in the Church again.”.. Patient states, “I wish I had talked with the priest sooner. I now know God has forgiven me, and even my mother understands.”
Mr. Brown’s teenage daughter had been involved in shoplifting. He expresses much anger toward her and states he cannot face her, let alone discuss this with her: “I just will not tolerate a thief.” forgiveness deficit? Assist Mr. Brown to identify how unforgiving feelings toward others hurt the person who cannot forgive.
a patient feels pain during intercourse? dyspareunia
a female patient has difficulty with penetration ? VAGINISMUS
Created by: Seka_nurse
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