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CRRN test
Questions complied from ARN practice tests
| Question | Answer |
|---|---|
| Ashworth scale | measurement of muscle tone |
| VAMSST | veterans mobility screening and solutions tool determines mobility and needed transfer tools |
| Family Focused therapy (FFT) | psychoeducative; increase communication/problem solving best used with TBIs in veterans |
| What does Medicare Part B cover? | doctor/ out patient care and medical equipment -covers some inpatient physician services (not stay itself) |
| Medicare premiums | determined each year based on Social Security Act |
| Saint Johns Wart | mild moderate depression |
| Chromium | role in how insulin regulates the body's blood sugar levels |
| Tumeric/ Curcumin | NSAID alterative- manage inflammatory conditions, arthritis, HLD, anxiety |
| Stress Incontinence | bladder leaks from increased abdominal pressure ex: sneezing, laughing, coughing |
| Urge Incontinence | sensation followed by involuntary bladder contractions |
| Overflow incontinence | dribbling of urine because bladder doesn't empty completely - may not feel like you have to go |
| Functional incontinence | physically cannot get to the bathroom quick enough because of your disability |
| Focal seziure | only happens in a specific part of the brain - symptoms are dependent on which part of the brain is effected |
| Auras | associated with focal seizures |
| Generalized seizures | bilateral networks are effected -tonic, clonic, absent, atonic |
| Total incontinence | brian does not connect to bladder and constantly leaks urine |
| Six sigma | reduce error and variation; more for long term goals - define, measure, analyze, improve, control (existing processes) -define, measure, analyze, design, verify (new processes) |
| What are TBI patients at risk for? | Obesity |
| How many stages are in non-REM sleep | 3, quiet sleep - fully regulating brain ad fully moveable,but inactive body |
| Stage 1 Non-REM | light sleep muscle activity slows Theta waves are present |
| Stage 2 Non-REM | moderate sleep longest stage heart/breathing slows |
| Stage 3 Non-REM sleep | deep sleep delta waves present |
| How many cycles of sleep do people go through? | 4-6 |
| How is severe TBI classified | LOC more than 24 hours |
| How is moderate TBI classified | 30min-24 hours |
| Homonymous hemiplasia | loss of half of field of vision in both eyes on the same side |
| What are interventions for hemiplasia? | scan the room, place items on unaffected side |
| Plavix | anti platelet medication |
| How do you treat thrombocytopenia? | use corticosteroids- helps increase platelet counts |
| Generativity vs stagnation | 40-65yo |
| Integrity vs despair | 65+ yo |
| What are SNF qualification requirements (2) | - 100 days not fulfilled - qualifying hospital stay for 3 days - if you are discharged from a SNF within 30 days, you may reenter without a qualifying hospital stay |
| how do you qualify for medicare? (3) | -65 yo OR received SSDI for at least 24 months - qualifying diagnosis- ESRD, maybe ALS - need to be a resident for at least 5 years in USA |
| Post Traumatic hydrocephalus | occurs after TBIs d/t increased CSF (overproduction, blockage, inefficient absorption) |
| Tetraplegia | paralysis in all four lies (Quadraplegia) |
| Skin functions (5) | -protection - communication (non-verbal) -thermoregulation -sensation -metabolism (vitamin D synthesis) |
| Sarcopenia | loss of muscle mass and strength d/t aging |
| Frailty | age associated decline across multiple physiologic systems |
| digoxin toxicity | yellow/green halo around lights |
| Myasthenia Gravis can develop? | more likely to have sleep apnea due to decreased muscle strength |
| S2-S4 injury effect | bladder contraction and relaxation of internal sphincter |
| Medicaid | low income individuals |
| Medicare part C | Medicare advantage - allows enrollment in private health plans by private companies |
| Neuromatrix pain theory | pain is produced by a network of neurons and pain is produced as a result of their interactions |
| What pain theory describes phantom pain | neuromatrix theory |
| Edinburg scale | post partum depression scale |
| PRIME-MD 2 question screen | for depression 1. are you feeling hopeless/ depressed 2. do you have little pleasure in doing things |
| How are medicare applications processed | through social security |
| Glosspharangeal nerve(3) | 9 -swallowing -hearing: can cause deficit from fluid buildup -taste: posterior 1/3 of tongue |
| Hypoglossal nerve | 12 tongue movement |
| Vagus nerve | 10 parasympathetic nervous system- internal organ function -pharynx control when swallowing |
| Accessory nerve | 11 shoulder shrugs |
| Quality reporting programs | pay for report programs for acute hospitals, required to submit data if they are funded by PPS - available for the public -reiceve fines if they do not report |
| afferent nerves | sensory information |
| efferent nerves | motor function, muscle contractions |
| Post traumatic amnesia | confusion/memory loss after TBI, part of recovery |
| TBI recovery phases (5) | - acute -early recovery (PTA) -rehabilitation -long term recovery -chronic phase |
| Virtue ethics | less specific on rules, more on being good person |
| Medicare part A coverage | inpatient, hospital, SNF, Home health, hospice |
| Gate control teory | gate mechanism in the spine that allows or blocks pain signals - nociceptive fibers: transmit pain; non-nociceptive fibers: non-painful touch - when nociceptive are more acute, they can block non-nocicptive - closed gate decreases pain perception |
| Mood disorder questionnaire | assess for bipolar mood disorders |
| What section of spine effects erection? | sacral nerves |
| Crutch sequence for stairs | well foot --> crutches --> injured foot follows |
| Multidisciplinary | each person communicate and suggest goals |
| Interdisciplinary | whole team works together to create goals - improves patient safety, communication, and outcomes |
| Medicare part D coverage | drugs |
| Home oxygen qualification | oxygen pressure less or equal to 55mmHg |
| Justice | fair distribution |
| Beneficence | performing actions to benefit others |
| Nonmaleficence | do no harm |
| What is Functional Independence measure (FIM) | uniform documentation of level of disability |
| OASIS | Outcome and assessment information set- home health |
| lean six | process improvement, making strategic goals; long term goals with cost/waste reduction |
| deontonology | right and wrong, duty based ethics |
| utilitarianism | what is right for one is right for all, maximize overall utility/benefits |
| Olfactory nerve | 1 smell |
| Occularmotor nerve | 3 pupilary |
| Trochlear nerve | 4 eye movement |
| Trigeminal nerve | 5 -facial sensation and chewing |
| Abducens nerve | 6 lateral eye movement |
| facial nerve | 7 move forehead, smile, frown |
| vestiluo-cochlear nerve | 8 hearing |
| Frontal lobe (4) | - motor function (general) - problem solving - speech production - judgement/impulse control |
| What is Broacs aphasia? | speech production, controlled by frontal lobe - can comprehend words |
| Temporal lobe (3) | - auditory - language comprehension - memory/ information retrieval |
| What is Wernikes aphasia? | speech comprehension, temporal lobe -verbal, reading, and writing |
| parietal lobe | touch/body orientation |
| occipital lobe | sight and visual perception |
| cerebellum | balance/ coordination -fine tunes motor movements |
| brain stem | involuntary, cardiac/ respiratory functions |
| Hemorrhagic stroke frequency | 20% of all |
| Ischemic stroke frequency | 80% of all |
| Stroke recovery chance | 10% |
| Lacunar infarct | high risk for patients with DM/HTN |
| Right hemisphere stroke symptoms (4) | -left sided weakness -fine motor skills -impulsive/poor judgement -difficulty following instructions |
| Left hemisphere stroke symptoms (4) | - right sided deficit -slow/cautious -require repeat instructions for tasks -aphasia |
| cerebellum | ataxia, balance, heartaches, vertigo |
| conduction aphasia | repetitive language production |
| Dysarthria | difficulty articulating speech (slowed, soft, slurred) |
| GCS 9-12 | moderate head injury |
| GCS 3-8 | coma |
| GCS 13-15 | mild head injury |
| RLA 1-3 | total assist -1= no response -2= generalized response -3= localized response |
| RLA 4-6 | maximal assist 4= confused/agitated 5= confused, inappropriate, non-agitated 6= confused appropriate |
| RLA 7 | moderate assist automatic appropriate |
| RLA 8 | minimal assist purposeful appropriate |
| RLA 9 | standby assist purposeful appropriate |
| RLA 10 | modified independence purposeful appropriate |
| Somatic pain | cutaneous and skeletal |
| visceral pain | internal organs |
| neuropathic pain | injury to the nervous system |
| Central cord syndrome | c-level injury - upper extremities are stronger than lower -has control over bowel and bladder |
| anterior cord injury | sensitive to pain and temperature |
| Posterior cord injury | lack of all dorsal column function |
| ASIA impairment scale | diagnosed using light touch vs pin pricks, 0= absent, 2= normal |
| ASIA A | complete - no sensory/motor function |
| ASIA B | sensory incomplete - sensory intact, but no motor below level of injury |
| ASIA C | motor incomplete - less than 1/2 the muscles below the level of injury less than 3 |
| ASIA D | motor incomplete - half or more muscles below level of injury greater or equal to 3 |
| ASIA E | normal |
| C1-C3 injuries | ventilator dependent |
| C4 injury | (turning point C) may have diaphragm function, shoulder movement, may be able to feed themselves |
| C5-C6 injury | - sensation OK to upper extremities -impairment of hand/wrist control -fine motor tasks are hard -may have mobility of shoulders/elbows |
| C7-C8 injury | -able to straighten arm and flex elbows - limited grasp |
| T1-T5 injury | full control upper extremities, can feel to midcoast, wheelchair OK |
| T6-T10 | more control of trunk |
| T11-L5 | motor function of hip/knee/ foot returns, no sensation of butt/genetalia |
| S1-S5 injury | can eventually control lower extremity |
| BMI levels (4) | -underweight <18.5 - normal 18.5-24.9 -overweight 25-29.9 -obese 30+ |
| Scheduled/timed voiding | schedule toileting despite urge -start urination diary to determine usual frequency of urination - start timed toileting at shorter length than usual frequency - lengthen until continent every 3-4 hours |
| Habit toilet training | match toileting to normal habits |
| prompted voiding | asses if voiding has happened and prompt for toileting every 2 hours |
| Knack | kegel to prevent incontinence |
| How is FIM measured | 13 motor and 5 cognitive (18 total) - each rated 1-7 - lowest score= most assistance, 18 -highest score 126= complete independence |
| Reflex incontinence | bladder contracts and urine leaks without urge - damage to nerves signaling full bladder |
| Hypothalamus (2) | controls awake sleep cycle, maintain homeostasis |
| Hippocampus | memory and emotion |
| medulla oblogata | controls respirations/heart |
| atonic bladder | underactive -muscles are weakened and have reduced contraction and emptying |
| what type of incontinence is associated with atonic bladder? | overflow incontinence- urine builds up since cant empty completely so causes overflow |
| overactive bladder | depressor overactivity/ hyperreflexia - involuntary contractions even when bladder is not full -sensation intact |
| what type of incontinence is associated with overactive baldder? | urge incontience- contracting even when not full causing leaking and urges to void |
| what causes dysarthria? | damage to motor centers in cortex that controls speech |
| Apraxia | unable to complete specific task, understand and are willing, but are unable to complete |
| what are the types of apraxia? (4) | - speech: -ideomotor -ideational -constructional |
| Speech apraxia | unable to coordinate muscles to speak |
| ideomotor apraxia | cannot do simple tasks on command (waving, brushing hair) |
| ideational apraxia | difficulty with sequencing tasks |
| constructional apraxia | difficulty with spacial tasks like drawing |
| anarthria | loss of speech |
| ALS | maintain cognitive function with weakening muscles |
| Assistive technology barrier | funding |
| fishbone diagram | explore visual possible causes and effects of a problem |
| health promotion activities | improve health/wellbeing -education, screening, exercise, nutrition, mental health, substance abuse, disease management, environmental |
| rheumatoid arthritis | joint deformation and ulnar deviation |
| Patient Safety Organization | privately hired to help with quality improvement, not public information |
| What are the types of heminopsia (2) | homonymous: same side on both eyes heteronomymous: opposite side of both eyes |
| Social security disability insurance (SSDI) | assistance to people who cannot work due to a disability |
| how do you qualify for SSDI? (2) | - must have work credits (differ based on age) -must meet disability criteria |
| What is the SSDI payout? | depends on average lifetime earnings before disability began |
| When can you qualify for medicare if you are younger than 65? | if you have been receiving SSDI for 24 months |
| food stamps: qualification and distribution | distributed by pubic health - income, nutrition risk |
| Social Security qualification (2) | - paid taxes for at least 10 years - reaches 62 yo |
| Supplemental social security income (SSSI) | available if low income or resources despite work injury |
| recovery model | ability to live a fulfilling life despite mental health disorder |
| psychosocial model | integration of social and physiological factors in understanding health/welness |
| industry vs inferiority | 6-11 yo -achievement of tasks make you feel sense of industry, if not then you feel inferior |
| National Quality Forum (NQF) | nonprofit in washington that is dedicated to improving quality of healthcare in the US |
| Medical Model | physician directed approach, top down decision making - focus is disease and treatments |
| Telecommunication Act, section 255 | products must be designed to be accessible to people with disabilities - adjustable volume, screen readers, TTY, easy to use |
| American with Disabilities Act (1990) | prevents discrimination against people with disabilities in public life |
| ADA Title I | employment |
| ADA Title II | public services |
| ADA Title III | reasonable accommodations in public life |
| ADA Title IV | telecommunications- requires telecommunication relay services |
| Rehabilitation act (1973) | prevent discrimination for people with disabilities from programs funded by federal agencies |
| Section 504 rehabilitation act | education is accessible to children |
| Section 508 rehabilitation act | electronic information technology is available (websites, documents, hardware, software) |
| Extended Glasgow come scale | determine functional outcomes after a brain injury; higher the score the higher the outcome (1=dead, 8=recovered) |
| Individuals with disability education act (IDEA) | mandates inclusion of dibbled children in public school |
| Vocational rehabilitation act | provide services so people with disabilities gain and maintain employment |
| Upper Motor neurons | originate in brain stem/spinal cord an connect to lower motor neurons - Spinal cord injury above T12-L1 |
| Upper Motor neuron disorder symptoms (5) | -weakness/paralysis -spasicity -hypertonia (increased muscle tone) -hyperreflexia - positive babinski sign |
| Lower Motor neuron | come from spinal cord to muscles -spinal cord injury below T12-L1 |
| Lower motor neuron disorder symptoms (5) | -muscle weakness/paralysis -decreased muscle tone -decreased reflexes -muscle twitches -muscle atrophy |
| Peak flow meter | measure how well air moves out of the lungs with forceful expiration |
| Ethnography | study of cultural group/community to understand social norms/ behaviors |
| Left sided heart failure | accumulation of fluid in the lungs |
| Right sided heart failure | fluid backs up into the body |
| National Database of Nursing Quality Indicators (NDNQI) | Parent organization is Press Ganey Nursing sensitive measures for assessing nursing care Process indicators, structure, outcomes |
| How many years does CARF accredidate? | 3 years |
| REM sleep | occurs after 90 mins most active brain, but paralyzed body |
| Spastic Bladder | hypertonic bladder- involves the nerves -increased muscle tone and involuntary contractions |
| How is overactive bladder different than spastic bladder? | spastic bladder involves the nerves, control, and muscle regulation overactive bladder involves abnormal bladder muscle function |
| Flaccid bladder | areflexic bladder- reduced or absent muscle tone leading to inadequate emptying |
| How is flaccid and atonic bladder different? | flaccid involves nerves effecting muscle tone Atonic bladder involves weakened muscles, but may still have tone (still may have spontaneous voiding) |
| Biguamides | help with blood sugar levels (Metformin) |
| Describe level of assistance needed for each FIM score | 1- total assist <25% 2- maximal assist 25-49% 3- moderate assist 50-74% 4- minimal assist 75-90% 5- supervision/set up 6- modified independent 7- complete independent |
| internal barriers | originate within the person |
| Where do most aneurysms occur? | Circle of Willis |
| spastic bowel | increase in spontaneous contractions (motility) -can empty by reface through digital stimulation or suppositories |
| Flaccid bowel | weakened muscles, unable to contract d/t not responding to reflexes -digital stimulation and manual removal |
| What symptom can happen from flaccid bowel? | constipation, difficult to evacuate |
| Osteoarthritis interventions | -promote protein for adequate muscle strength - glucosamine with chondritin -low impact weight bearing activities |
| Brown-Sequard syndrome | incomplete spinal cord injury by damaging one side |
| What are the three symptoms of Brown-Sequard syndrome | - ipsilateral motor loss: weakness on the side of the damage -ipsilateral proprioception and vibration loss: loss of sense of position on side of damage -contralateral loss of pain/temperature: |
| Cauda equina | lower spinal cord damage; medical emergency |
| Cauda equina symptoms | - sever back pain -saddle anesthesia -B&B dysfucntion -lower extremity weakness |
| Conus Medularis syndrome | injury around L1 vertebrae; medical emergency -symptoms similar to caudal equine, but different origin |
| Manual Muscle test | determine strength of muscles -position, stabilize to isolate the muscles, instruct, and apply resistance -graded 0-5 |
| Leninger | transcultural nursing mode- understanding and integrating cultures into practice |
| Middle cerebral artery (MCA) | supplies large amounts of blood to areas responsible for motor/language/ vision (frontal, parietal, temporal) |
| Anterior Caroid Artery (ACA) | supples frontal lobe |
| posterior communicating artery | includes the circle of Willis |
| SIADH | excessive release of antidiuretic hormone so kidneys retain water and dilute sodium -common after TBis |
| Frazier free water protocol | oral care before giving fluids -reduce the risk of aspiration pneumonia by making sure mouth is clean |
| Braden scale | risk for pressure injury |
| Braden score 10-12 | high risk |
| Braden score 13-14 | moderate risk |
| Braden score 15-18 | low risk |
| Living will | legal document that makes the persons wishes known regarding medical care and illnesses that result in ncompetence |
| DPOA | financial assest |
| What is first line of medicine for neuropathic pain? | anticonvulsants (gabapentin) |
| Sickle Cell disease risk | stroke d/t deformation of red blood cells that may cause ischemia -most common cause for pediatric patients |
| Arteriovenous Malformation (AVM) | most common cause of hemorrhagic strokes in pediatric patients |
| Who distributes medicare? | CMS |
| qualitative research | interprets meaning/ experiences from individuls/groups (focus groups etc.) -study social/human behaviro |
| What makes qualitative research trustworthy? | transferability |
| Scoop plate/bowl | used to help get food onto fork -usually has suction cup on bottom -plate guard has same purpose |
| what is most effective coping strategy for change? | communication |
| What implementation model is good for small projects | Plan, Do, Check, Act |
| Respiratory acidosis | hypoventilation r/t lung diseases -lungs are unable to expel CO2 which is acidic |
| what is the purpose of rehabilitation | restoration |
| Soft diet | does not require a knife to cut, tender and moist |
| minced and moist diet | able to eat with fork/chopstick/spoon, can be scooped and shaped, doesn't seperate |
| Pureed diet | spoon/fork, cannot be drunk, doesn't require chewing, can't pour |
| Chubon board | assistive keyboard for people who only have one hand or typing stick |
| Standards of professional performance (7) | -quality -performance appraisal -education -conegiality -ethics/advocasy -collaboration -research |
| Donut cushions con (2) | - may decrease flow to perianal region - increases swelling where open |
| Difficult part of therapy after a fall? | fear of falling, may cause more sedentary behavior |
| sensorineural hearing loss | damage to cochlea - difficult hearing high and low pitches/ in noisy environment |
| conductive hearing loss | sound waves don't enter d/t defect - decreased sounds and inability to hear soft sounds |
| auditory neuropathy spectrum disorder | sound gets into the inner ear, but transmits incorrectly to the brain - may have difficulty understanding, but hearing tests are normal |
| Standing frame | can be posterior (along back) or anterior (along front) - may obstruct vision |
| PVR normal value | <100mL -check within 10mins of peeing |
| what drugs increase PVR (6) | - anticholinergics - Parkinson medications - Tricyclic antidepressants -antispasmodics -opioids -anesthetics |
| anticholinergics | block acetylcholine which inhibits the parasympathetic nervous system |
| what are examples of anticholinergic drugs | ipatropium, oxybutinin, Benadryl, atropine, meclizine, quetiapine etc. |
| Service animal questions | - is this service animal required for a disability? - What is this service animal trained to do? |
| How do you coach communication with dysarthria? | speak slowly, over pronounce words |
| Nephrons | filter blood, reabsorb water and salts, absorb glucose |
| What has calcium? | - tofu - fortified juices/milk |
| how do you prevent hip contractors for transtibial and transferal amputation | prone lying, start 5-10 minus and progress to 20 mins 3-4 times daily |
| Crede maneuver | lean forward and apply manual pressure to bladder area |
| Intermittent catheterization | 4-6 hours while awake clean procedure at home |
| Rapid cycle improvement method | testing interventions on a small scale, one problem at a time -plan, do, check, act |
| Agency for Healthcare Research and Quality (AHRQ) | produce evidence to improve healthcare by improving its quality, safety, and efficiency - supports initiatives to improve, funds research -develops and disseminates assessment tools |
| behavior chain | complex behaviors that comprise of two or more components in a sequence ex: setback, blame, self hatred, refusal |
| how to break behavior chain | identify each component and deal with the beginning of the chain and move onto the next |
| Bristol stool chart 1 and 2 | may need stool softener/laxitive |
| Bristol stool chart 3 and 4 | normal |
| Bristol stool chart 5 | need more fiber |
| Bristol stool chart 6-7 | antidiarrheal |
| National Academy of Medicine (NAM) | provide advice regarding healthcare to influence national and international policies (health equity, vaccines, emerging science) |
| Morris Rosenberg theory of self esteem | develops through perceptions of personal worthiness and competence -scale developed to determine self esteem |
| T score | bone scan for bone density - normal 0-0.99 - Osteopenia -1 to -2.49 - Osteoporosis less or equal to -2.5 - severe osteoporosis, same but with a fracture |
| Moisture management with prosthesis (3) | - antiperspirant to stump - powders if mild - stump socks may have moisture management |
| Botox | reduce spasticity, last 3-4 months |
| Autonomic dysreflexia | can occur with injury above T6 - exaggerated response to stimulus below level of injury |
| Hospice medicare benefit for caregivers | - allow respite period (inpatient care up to 5 days in an approved facility) once during each benefit period which lasts 90 days - after 90 days needs to be rectified |
| Adenosine | increases sleepiness as the day progresses |
| Melatonin | influenced by light and dark, increasing when it is dark outside and decreasing when there is light |
| Which implant is closest to erect penis | three piece inflatable penile implant, most complex surgery |
| Four square step test | assess risk for falls, if score is greater than 15 seconds its consistent with history of two or more falls |
| Attention seeking behavior intervention | ignore them, use labeled praise |
| Multiple sclerosis incontinence | urge d/t overactivity of detrusor muscle |
| AV fibula maturation signs (4) | rule of 6s - within 6 weeks - flow should exceed 600mL/minute - vessel diameter should be at least 6mm - vessel should be less than 6mm from skin |
| Case manager | assess needs, help coordinate care with different providers, ensure patient keeps appointments and follow-ups -link with resources in community -reduce hospital readmissions |
| phases of swallowing (4) | -oral prepatory: closing mouth and chewing - oral propulsive: propulsion of bolus to back of mouth - Pharyngeal: voluntary swallow through pharynx - Esophageal: relaxes to allow food to flow through |
| Christian Scientists | do not seek medical care or often refuse certain aspects of treatment |
| Heterotrophic ossification | abnormal growth of bone in soft tissue- traumatic injuries, neurogenic disorders, THA (53%) - pain, stiffness, edema, low grade fever, redness |
| What drug helps prevent heterotrophic ossification? | Indomethacin 1 month before and 3 months after |
| Vocational rehabilitation counselor (4) | - helps determine interests, knowledge, skills, and limitations and can help explore career options - may introduce adaptive technologies - may provide mobility/skill training - help with job placement |
| difficulty communicating techniques | - offer time - avoid answering question unless patient becoming frustrated or reluctant to continue trying |
| Sleep state misperception | patient experiences normal sleep patters, but person believes opposite |
| LVAD qualification | - NY heart association classificaition stage III or IV OR - AHA stage D |
| Biofeedback | mind-body technique to to use some control over your body functions - use electrical pads to get information on body and help patient change feeback |
| Performance-oriented mobility assessment tool (tinetti) | balance and gait |
| CBT | patient and therapist come up with problem list and reframe them with achievable goals |
| AHRQ model for quality improvement | start with microsystems (small unit within a hospital, staff members that work together routinely etc. ) |
| PLISST | addressing sexual function Permission Limited Information Specific Suggestions Intensive Therapy |
| Nursing Process Theory | nursing processes include behavior of the individual, nurse reactions dn the subsequent nursing actions |
| Crisis Theory | stress related events that are turning points that might lead to danger or opportunity |
| Stopping elder accidents by CDC- interventions in preventing falls | Screen: have you fallen, are you scared of falling, unsteady Assess: multidisciplinary assessments Intervene: fall prevention |
| TENs unit placement | place in X configuration with electrodes for channels crisscrossing from one side to another - impulses should be felt, but not painful |
| Therapy time coding frequency | bill for every 15 minutes |
| Clinical Quality Measures (CQM) | asses the quality of the care provided |
| Required CQMs for IRFs (5) | - fall with minor injury -discharge self-care/mobility score -drug regimen review with follow up - functional improvement - flu and COVID vaccines for patients and healthcare workers |
| Reflexic bowel | injury above T11-T12 (UMN) muscles are tight which can lead to retention nd constipation |
| areflexic bowel | injury below T11-T12 (LMN) muscles are flaccid, slow transit time, leakage of stool, increased risk for incontinence |
| What is the difference between reflexic and spastic bowel? | reflexic is neurogenic, spastic is muscles -digital stimulation and suppositories |
| What is the difference between areflexic bowel and flaccid bowel? | Areflexic is neurogenic and flaccid is muscles - manual removal of stool |
| Epworth Sleepiness scale | how likely a person will fall asleep during certain activities - 0-6: adequate sleep - 7-8: average sleep - greater than 9= high sleepiness (needs further testing) |
| Mini-mental state exam | orientation is the highest weighted score |
| Dyslexia learning | multi sensory approach: visual, auditory, kinesthetic, tactile give time |
| Central sleep apnea | no obstruction, develops from impairment of ventilation associated with cardiac or neurological disorders |
| General power of attorney | broad range of power to handle patient affairs, business, finances, property - no longer in effect if individual is incapacitated |
| How to prevent fullness in abdomen with sleep apnea | place two pillows under the head to bring chin towards chest to close of esophagus and prevent air swallowing |
| Knowledge deficit | prioritize so nurse knows what the patient doesn't know to be able to develop plan of care |
| Passy Muir valve | speaking valve- allows air in but closes during expiration so air can flow out around tracheostomy and through vocal cords -before attaching, the trash must be secured and the cuff deflated |
| Optic nerve | 2 vision |
| How does diabetes effect sleep patterns? | if diabetes is under control, then there will be reduction of fluctuating blood sugar levels, neuropathy, etc. which could improve sleep |
| When should equipment be assessed for discharge? | before discharge, not necessarily on day 1 |
| dysgraphia | inability to write |
| Who is the primary manager of care in the community? | the nurse |
| interventions to prevent DVT | - elevate leg: reduce venous stasis - medications - early mobilization |
| Suicidal behavior | exists on a continuum from ideation to completion-- includes feelings and thoughts related to death wishes and potential suicide |
| lean process improvement | reduce waste |
| Transdisciplinary | one team member is primary and other team members consult |
| Metalloprotien | byproduct of metabolism that occurs with age |
| Lipoprotein | carries fat through blood system (HDL, LDL) |
| How to quantify Fatigue? | -Visual Analog scale for Fatigue: various questions with ranging severity to visually depict frequency of fatigue - Fatigue severity scale: questions about agreeing or disagreeing that are added up to determine fatigue severity |
| Importance of rehabilitation nurse on a team | has unique body of knowledge- anyone in the care team can be a teacher |
| Hyperalimentation | nutrition that is served into vein, people who have absorption disorders |
| What is respite care? | temporary institutional care of dependent person providing relief for their caregiver |
| How is medicare funded? | taxes from employees and employers- payroll taxes and automatic deductions from payroll |
| Long term care insurance | covers assistance with every day tasks (ADLs) at home, in the community or at an ALF - not typically covered by medicare |
| Orthopnea | difficulty breathing while lying flat- indicator of heart failure |
| Goal of national quality frameworks? | engaging patients and their families in their care |
| Vitamin K | fat soluble vitamin essential for clotting factor/blood coagulation |
| concussion | requires cognitive rest |
| What does high flow oxygen do to COPD patients? | causes loss of stimulus to breathe |
| What is dysphagia level 1 | pureed |
| What is dysphasia level 2 | mechanically altered |
| What is dysphagia level 3 | dysphagia advanced: food of nearly regular textures (like advanced diet) |
| Pareto chart | bar graphs that focus and determine which problems to solve and in which order |
| Who may serve as deeming authority for CMS? | The joint commission |
| What type of motor neuron injury is associated with UTI, constipation, weakens, loss of muscle mass, hydornephresis? | LMN |
| Insurance based case manager | CM employed by a third party payor |
| What is a PAC? | Post acute care setting |
| Complementary Alternative Medicine (CAM) | - alternative practices that are not considered a part of traditional medicine - used along side traditional medicine, does not replace |
| Self assisted cough | used for people whose cough is not strong enough - sifted position, wrap arms around ribs and lean forward while coughing |
Created by:
kailey.kelley
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