Final Exam damelio
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| Primary site of drug excretion | Kidneys
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| the time required for the drug to elicit a therapeutic response | Onset
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| the time required for a drug to reach its maximum therapeutic response | Peak
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| the length of time that the drug concentration is sufficient (without more doses) to elicit a therapeutic response | Duration of drug action
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| the range which that drug is expected to be effective without causing any serious problems to the patient | Therapeutic level
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| maximum concentration of a drug in the blood circulation | Peak Level
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| amount of a drug in the blood circulation at the drug's lowest therapeutic concentration | Trough level
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| the time it takes for a substance to lose half of its pharmacologic, physiologic, or radiologic. | Biological half-life
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| the desired therapeutic effect | Primary effects
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| all other effects beside the desired effect which may be either beneficial or harmful | Secondary effects
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| types of adverse effects that are predictable and which may occur even at therapeutic dosages | Side effects
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| primary nutritional considerations of an infant | (0-6 month) Breast milk bc of colostrum; (1- 2 yr) breast milk + introduction of other food
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| primary nutritional considerations of an adolescent | Increase RF obesity. Time for acquiring lifelong eating habits.
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| primary nutritional considerations for the elderly | Increase RF protein-energy malnutrition. Polypharmacy.
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| Serum sample reveals low albumin | protein depletion → Patient RF malnutrition
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| low creatinine levels in urine sample | loss of lean body mass and protein malnutrition
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| With less than body requirements, how many lb(s) per week of weight gain is desirable? | 1 lb of wt gain per week
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| With more than body requirements, how many lb(s) of weight loss per week is desirable? | 1-2 lbs of weight loss per week
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| teaching in professional nursing, the people in most need of an education? | People with chronic illnesses and disabilities
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| correct use of nursing diagnosis Deficient Knowledge | relates to the specific deficit provides guidance for the development of the teaching plan
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| Deficient Knowledge is not a human factor relating to or causing | the diagnosis
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| Practice that believe the forces of nature must be kept in balance or harmony | Naturalistic or Holistic practices
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| Example of Naturalistic or Holistic practices | Yin and Yang and Hot/Cold theory
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| practice based on the view that the world is an arena in which supernatural forces dominate. | Magico-Religious
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| In the physiology of movement, movement facilitates | return of deoxygenated blood to the right side of the heart by massaging the venous vasculature.
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| the utilization of correct muscles to complete a task safely and efficiently, without undue strain to a muscle or joint. | Body Mechanics
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| five legal issues basic to the nursing practice | signatures, documentation, report signs of abuse, maintain patient privacy(HIPPA), Medication (5 rights)
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| When a physician or other health care provider orders a procedure be done to a patient, it is the nurse's responsibility to | obtain an informed consent signature
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| If the nurse does not obtain signatures, both the nurse and the operating provider can be held liable for | damages incurred
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| - It is the nurse's responsibility to make sure everything that is done in regards to a patient's care is | documented in the chart
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| Federal laws that regulate the nursing practice | Bill of Rights, EMTALA (Emergency Medical Treatment and Active Labor Act), National Practitioner Data Bank, ADA (Americans with Disabilities Act), Patient Self-Determination Act, HIPAA, Newborn/Mothers Protection Act, and National Labor Relations Act
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| Mandatory Reporting, Good Samaritan, Nurse Practice Acts (Credentialing, Licensing, Discipline) | State Laws that regulate nursing practice
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| adherence to informal personal beliefs; modes of conduct | Morals
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| the formal, systematic study of moral beliefs; a theory or system of moral values; the discipline dealing with what is good and bad and with moral duty and obligation. | Ethics
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| a discipline dealing with the ethical implications of biological research and applications especially in medicine. | Bioethics
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| shares many principles with medical ethics, such as beneficence, non-maleficence and respect for autonomy. It can be distinguished by its emphasis on relationships, human dignity and collaborative care. | Nursing Ethics
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| a situation in which there may be competing moral claims or principles, but one claim or principal is more dominate. | Moral Problem
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| entails the ability to make choices free from external constraints. Includes individual rights, privacy, and choice. | Autonomy
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| the duty to do good and the active promotion of benevolent acts (e.g., goodness, kindness, charity). It may also include the injunction not to inflict harm. | Beneficence
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| Information obtained from an individual will not be disclosed to another unless it will benefit the person or there is a direct threat to social good. | Confidentiality
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| is a principle that may morally justify some actions that produce both good and evil effects. | Double Effect
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| Four factors of Double Effect that must be fulfilled | action itself is good or morally neutral,agent sincerely intends the good and not the evil effect, good effect is not achieved by means of the evil effect, proportionate or favorable balance of good over evil
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| the duty to be faithful to one’s commitments | Fidelity
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| like cases should be treated alike. | Justice
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| Within Justice, Distribution of social benefits and burdens should be base on criteria: | Equality, Individual need, Individual Effort, Social Contribution, Individual Merit, Legal Entitlement,
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| - a disruptive condition that occurs in response to adverse influences from the internal or external environments | stress
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| strategies improve functioning. | adaptive coping
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| strategies only reduce symptoms temporarily. They are a short term solution. | maladaptive coping
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| what causes the stress that is occurring | stressors
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| the physical actions that occur because of the stress, and the coping strategies that we employ to deal with the stress | responses
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| when the body is able to function correctly despite the stressor. | adaptation
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| the three stages of Selye’s general adaptation syndrome (GAS) | alarm, resistance, and exhaustion
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| In the alarm stage, what is activated? | sympathetic nervous system (fight or flight)
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| In the alarm stage, what hormones are released? | Catecholamines (Epinephrine and Norepinephrine, Epi and Nor-E, respectively), and adrenocorticotropic (ATCH) hormone
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| Continuous survival in the alarm stage will result in? | death
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| In the resistance stage, what is released? | Cortisol activity
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| What starts to occur in the alarm stage? | Adaptation
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| The exhaustion stage occurs if | stressor is prolonged
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| What increases in the exhaustion stage? | Endocrine activity
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| The exhaustion stage has negative effects on what body systems? | Circulatory, Digestive, and Immune
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| GAS (general adaptation syndrome) affects | the whole body
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| LAS (local adaptation syndrome) affects | certain area of the body
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| If an injury is widespread, what can come into effect? | GAS
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| Example of LAS transitioning into GAS | Full thickness burns over 40% of the body
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| a defensive reaction intended to neutralize, control, or eliminate the offending agent and to prepare the site for repair | inflammatory response
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| The two types of physiological changes in an inflammatory response | Vascular and Cellular changes
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| Vasodilation, increased blood flow, increased capillary permeability, local tissue congestion | Vascular changes in an inflammatory response
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| Phagocytosis (cellular death), Increased Leukocytes (granulocytes and monocytes), Release of chemical mediators (mast cells and macrophages) | Cellular changes in an inflammatory response
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| effects of prolonged stress on various body systems | level of Epi, Nor-E, and ATCH to not decrease
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| Unsuccessful adaptation can result in | tachycardia, hypertension, and glycosuria
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| excretion of glucose into the urine | glycosuria
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| continued application of the stressor, you still have the energy to deal with the stressor, but having been dealing with it for a long time. | crisis
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| you have a stressor applied for so long that you no longer have the energy to deal with it. | Burnout
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| Ways to assess for physiological responses to stress | patient’s blood glucose, heart rate, and respirations
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| Activity for managing stress where a word or phrase that reflects your basic belief system is focused on in a comfortable position, closed eyes, and breathing awareness | Benson's relaxation response
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| Examples of relaxation techniques | Mental vision of a pleasant place, Progressive muscle relaxation, and Benson’s relaxation response
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| a sense of responsibility for the health and welfare of others | Social Health
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| a mind that grows, reasons, and adjusts to life situations (in other words able to learn) | Mental Health
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| feelings and actions that bring one satisfaction | Emotional Health
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| inner peace and security in one’s spiritual faith | Spiritual Health
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| symptom experience stage, assumption of the sick role stage, medical care contact stage, dependent patient role stage, recovery or rehabilitation stage | the five stages of illness behavior
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| the decision that something is wrong | symptom experience stage
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| when the individual accepts that the symptoms are a sign of illness | assumption of the sick role stage
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| when the individual seeks medical care | medical care contact stage
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| when the patient is expected to make every effort to get well | dependent patient role stage
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| acute patients, the process is one of relinquishing the sick role and moving back to normal role obligations | recovery or rehabilitation stage
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| chronic patients, the extent to which prior role obligations may be resumed ranges from those who forsake the sick role to those who will never be able to leave it. | recovery or rehabilitation stage
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| short duration, quick onset, expected resolution or recovery | acute
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| lasting longer than 6 months, often requires lifestyle changes, remissions and exacerbations | chronic
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| Goals set by the federal government based on leading causes of death aimed to increase quality of life and eliminate disparities | Healthy People 2020
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| based on the social learning theory and how cognitive perpetual factors affect the person’s view of the importance of health. | Pender’s Health Promotion Model
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| Pender's health promotion model examines | control of health, self-efficacy, health status, and the benefits and barriers to health promoting behaviors
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| Pender's health promotion model is accomplished by | contemplation, determination, action, and maintenance
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| model focuses on the motivation of a person to make decisions that promote healthy behavior change. | Prochaska and DiClemente’s six stages of change
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| pre-contemplative, contemplative, decision-making, action maintenance and termination. | Prochaska and DiClemente’s six stages of change
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| Self-responsibility, nutritional awareness, stress reduction and management, physical fitness. | specific health promotion strategies across the lifespan
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| Education, lifestyle and behavior change groups, environmental problems, assessment and appraisal services, and state health departments are examples of health promotion activities. | nurse's role in health promotion activities
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| physical environment, economic conditions, sociocultural issues, emotional state, interpersonal relationships, and support systems. | areas of assessment relation to a health promotion plan
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| any situation (actual, potential, or perceived) wherein a valued object or person is changed or is no longer accessible to the individual. | loss
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| the personal feelings that accompany an anticipated or actual loss; physical and psychological responses that occur following a loss. | grief
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| Actual loss, Perceived loss, Physical loss, and psychological loss | four types of loss
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| loss of someone or something | Actual loss
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| felt by an individual but not tangible to others (i.e. loss of self esteem) | Perceived loss
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| loss of part or aspect of the body | Physical loss
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| the emotional loss (i.e. a woman’s feelings after menopause). | Psychological loss
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| sense of intense physical and psychological responses that occur following a loss | Grief
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| period of time when grief is expressed and resolution and integration of loss occur | Mourning
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| period of grief following the death of a loved one | bereavement
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| Kubler-Ross stages of grief | Anger, Denial, Bargaining, Depression, Acceptance
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| Accepting the fact that loss is real, Experience the emotional pain of grief, Adjust to an environment without the deceased, Reinvest emotional energy once directed at the deceased into another relationship | Worden stages to deal w/loss successfully
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| Numbness, Yearning and searching, Disorganization and despair, and Reorganization | Bowlby’s 4 stages of mourning
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| a grief reaction that normally follows a significant loss | Uncomplicated
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| intense grief that does not result in reconciliation of feelings | Complicated/Dysfunctional
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| unexpected behaviors | Masked
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| putting grieving off to focus on other things | Delayed
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| factors that affect grieving | Religious and cultural beliefs, Relationship with the lost object, Cause of death, Amount of support for the bereaved, Previous loss, Developmental stage
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| An individual who has sustained either 1) irreversible cessation of circulatory and respiratory functions or 2) irreversible cessation of all functions of the entire brain stem, is dead | according to the Uniform Determination of Death Act
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| The patient self-determination act- intended to provide individuals with legal means to determine the circumstances under which life-sustaining treatment should or should not be provided to them, Living will, Durable power of attorney/health care proxy | legal issues involved in death and dying
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| Many states also have a health care surrogate law, implemented in the absence of advance directives, DNR orders, Assisted suicide, Euthanasia, Autopsy, Organ donation | legal issues involved in death and dying
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| Client and family goals and expectations, Client’s awareness of terminal nature of illness, Availability of support systems, Current stage of dying, History of previous positive coping skills, Client perception of unfinished business to be completed | Assessment in the dying process
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| stage of dying | Diagnosis in the dying process
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| What to do to make the patient more comfortable | Planning in the dying process
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| Providing patient with care to make them more comfortable | Implementation in the dying process
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| Treat the body with respect and dignity, Bathe and put a clean gown on the body, Remove dressings and tubes, Place the client in body alignment with extremities straight, Place dentures in the mouth, if client normally wore them, Close client’s eyes | responsibilities surrounding post mortem care
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| Informing the family as the circumstances of the death, Providing information about viewing the body, Offering to contact support people, o Sometimes assisting in decision making regarding a funeral home and removal of the dead person’s belongings | nursing interventions to assist clients who are grieving.
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