Nursing Exam #5
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| LPN can generally do many care activities except: | 1) Those items in the RN scope of practice
2) IV push drugs
3) IV meds and transfusion
4) Hanging and regulating medicated IV
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| RN protected scope of practice- They can not delegate... | 1) Assessment
2) Evaluation
3) Nursing Judgment
4) Initial client and family education
5) Care planning
6) Health counseling and therapeutic communication
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| Who has liscensure? | RN and the LPN
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| Supervision | 1) RN-to-RN delegation: No supervision involve
2) RN-to-LPN delegation: The LPN is under the guidance of RN
3) RN-to-UAP delegation: Supervision is needed by the RN
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| The five rights of delegation? | 1) The right task (which tasks are appropiate)
2) The right circumstance
3) The right person (health care worker)
4) The right direction (communication is clear and concise)
5) The right supervision
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| What can a UAP do? | 1) Feeding
2) Ambulating
3) Grooming
4) Transporting
5) Collecting data
6) Reporting
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| Factors influencing the trend of increasing home care? | 1) Cost
2) People like it better
3) Family not staying in the same region
4) The aging population
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| NREM | Non rapid eye movement: Sleep produced by withdrawn neurotransmitter
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| REM | Rapid eye movement: Brain is high sctive in sleep and its difficult to awake in this stage
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| NREM 1 | Starting to fall asleep
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| NREM 2 | Light sleep but the vital signs will start to lower
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| NREM 3 | Deeper sleep (relaxed) no eye movement
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| NREM 4 | Deepest Sleep (heart rate drops) and physical restoration is restored
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| REM | Vital signs start to go up and mental and emotional restoration happens
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| Stages of Sleep | NREM 1- NREM 2- NREM 3- NREM 4- NREM 3- NREM 2-REM-brief waking
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| REM rebound | Continous deprivation of sleep eventually you will knock out
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| Dreams | It can occur from stage 2 to REM and dreams are remembered in REM
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| Factors Affecting Sleep | 1) Age
2) Lifestyle
3) Illness
4) Environmental factor
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| Why does age affect sleep? | 1) Newborns and young children- Increased REM and they have sleep related problems (nightmare and bed wetting)
2) Adolescent- Sleep related problem
3) Young adult- All nighter, work, stress
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| Why does lifestyle affect sleep? | 1) Exercise increase sleep
2) Some food can help sleep (milk)
3) Caffeine is a CNS stimulant (no sleep)
4) Anxiety can disrupt sleep
5) Alcohol can disrupt sleep
6) Medications can go both ways
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| Why does illness affect sleep? | Illness can lead to an increase of sleep needed in order to recoup
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| Why does environmental factor affect sleep? | Temperature, light and noise can affect sleep
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| Insomnia | Short term (it can last a month) or it can be chronic- this is the most common where inability to fall asleep or remain asleep
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| Circadian Disorders | Abnormality of sleep/ wake times (rotating shifts and jet lag)
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| Restless Leg Syndrome | Uncontrollable movement of leg during sleep (has to do with the nervous system)
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| Hypersomnia | Excessive sleeping especially during the day time
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| Sleep Apnea | Periodic breathing cessation for at least 10 seconds during sleep
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| Parasomnia | Patterns of waking behavior that occurs during sleep
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| Bruxism | Grinding of the teeth
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| Enuresis | Bed wetting
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| What are the ways to measure sleep? | 1) Polysomnographyy (PSG)- Sleep study
2) Eectroencephalogram (EEG)- Brain waves
3) Electro-oculogram (EOG)- Measures the eye
4) Electromyogram (EMG)- Record of resting and voluntary muscle activity
5) Wrist actigraph- Monitor activity
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| Erikson First Stage-Infancy | Trust VS. Mistrust
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| What are the ways parents can enhance trust in infants? | 1) Predictable environment
2) Consistent caregiver
3) Responding consistently to needs
4) Rhythm to care
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| What are the concerns with propping bottles? | 1) Infants is unable to push the bottle away
2) Leads to tooth decay
3) Decreased physical contact
4) CHOCKING
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| SIDs | Sudden Infant Death Syndrome- Unexplained death of an infant usually 2-4 months so place the baby on their back
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| How can you tell when the infant is sastified after feeding? | When the baby falls asleep
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| When can infant digest starch? | 4-6 months
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| Extrusion Reflex | 3-4 months
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| Erikson Second Stage-Toddlers | Autonomy VS. Shame and doubt
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| What are the three developmental task for toddlers? | 1) Learning to control large and small muscles
2) Learnign to control elimination of bowel and bladder
3) Expanding verbal communication
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| List ways hospitalization can affect basic needs? | 1) Separation anxiety
2) Routine disruption
3) Fear of the unknown
4) Confinement
5) Pain
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| What intervention can be taken for toddlers in the hospital? | 1) Comfort items from home
2) Talk at a eye level
3) Take time for plays and walks
4) Support the parents and explain everything to them
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| Erikson Third Stage- Preschool | Initiative VS. Guilt
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| What are the developmental tasks to be learned by preschoolers? | 1) Learning sex differences and developing sex modesty
2) Begin to interact with age mates
3) Learning to identify with male-female roles
4) Learning to give and share affection
5) Learning to distinguish right from wrong
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| How would hospitalization affect the basic needs and developmental tasks of a toddler and preschool child? | 1) Separation anxiety-especially from parents
2) Lack of routine-disruption of schedule
3)Eating habits
4) Fear of unknown
5) Confinement
6) Pain
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| Erikson Fourth Stage- School-Age | Industry VS. Inferiority
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| What are the developmental tasks to be learned by school-age children? | 1) Learning academic skills
2) Expaning social boundaries
3) Developing sensitivity and respect for others
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| What are the healthcare issues concerning school age children? | 1) Privacy and modesty
2) Security/family
3) Separation from peers
4) Industry
5) Regression
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| ADHD | Attention Deficit Hyperactivity Disorder characterized by inability to focus, attention, lack of impulsive control and hyperactivity
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| Erikson Fifth Stage- Adolescents | Identity VS. Role Confusion
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| What are the developmental tasks for adolescents? | 1) Accepting changing body
2) Developing a sastifying male or female role
3) Achieving more adult relationship
4) Preparing for independence
5) Developing workable set of values and ideas
6) Desiring and achieving socially responsible behavior
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| What are the sexual development in males? | 1) Enlargement of testes, scrotum and penisn
2) Pubic hair
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| What are the sexual development in females? | 1) Hair
2) Breast enlargement
3) Menses begin
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| What are the teens issues? | 1) Puberty (capable of reproduction)
2) Masturbation
3) Acne (most common skin disorder)
4) Inactivity (less real exercise)
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| What are health concerns with teens? | 1) Obesity
2) Anorexia
3) Bulimia
4) Pregnancy
5) STD's/Aids
6) Dysmenorrhea (pain with period)
7) Choking games/Huffing
8) Accidents
9) Drug/alcohol
10) Suicide/Homicide
11) Piercings/Tattoos
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| What are some conflicts with hospitalization? | 1) Separated from friends
2) Modesty
3) Exercise
4) Independence
5) Appearance
6) Smoking/drugs
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| Erikson Sixth Stage- Young Adults | Intimacy VS. Isolation
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| What are the common health problems lifestyle risks? | 1) Injuries (motor vehicle)
2) Relationships (sexual experimentation)
3) Drug/alcohol abuse
4) Diet/exercise (fast food and busy schedule)
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| Erikson Seventh Stage- Middle-aged adults | Generativity VS. Stagnation
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| What are the leading cause of death in middle aged adults? | 1) Motor vehicle accidents
2) Occupational injuries
3) Suicide
4) Chronic disease
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| What are the 3 stages of fetal development? | 1) Pre-embryonic- first 2 weeks
2) Embryonic stage- Week 3 to 8
3) Fetal Stage- Week 9 to birth
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| Union if the sperm and the egg depend on these 3 factors? | 1) Equal maturation of the egg and the sperm
2) Ability of the sperm to reach
3) Ability of the sperm to penetrate
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| What are the amniotic membranes? | 1) Chorionic membrane: Outermost fetal membrane and it forms the sac and holds the amniotic fluid
2) Amniotic membrane- form beneath the chorion and adheres to it and produces the amniotic fluid
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| What is the purpose of amniotic fluid? | 1) Protection
2) Aids in muscular development
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| What does the umbilical cord contain? | 1) 1 vein (Carries rich oxygenated blood from placenta to the fetus)
2) 2 Arteries (Carries blood containing waste from the fetus to the placenta)
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| What are the 3 germ layers? | 1) Ectoderm (responsible for nervous system)
2) Mesoderm (responsible for muscular/skeletal system)
3) Endoderm (responsible for digestive/gland and everything else)
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| Naegle's Rule | 1st day of last menstrual period-3 months+7 days+1 year=EDD
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| Mcdonald's Rule | The distance from the uterine fundus to the symphysis pubis in centimeters equal the week of gestation
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| What are the presumptive signs of pregnancy? | 1) Amenorrhea
2) Morning sickness
3) Excessive fatigue
4) Urinary frequency
5) Breast changes
6) Quickening
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| What are the probable sign you are pregnant? | 1) Pregnancy test
2) Changes in pelvic organs (vagina,cervix,uterus)
3) Enlargement of abdomen
4) Ballottement
5) Braxton Hicks Contractions (false labors)
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| What are the positive signs you are pregnant? | 1) Fetal heartbeat
2) Fetal movement palpable by the examiner
3) Visualization of the fetus through ultrasound
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