Nursing Process Overview Quiz

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Questions and Answers

Which step in the nursing process is focused on establishing clear objectives for patient care?

Assessment

Diagnosis

Planning (correct)

Evaluation

What is the primary focus of the Implementation phase in nursing?

Determining treatment effectiveness

Identifying health issues

Carrying out nursing interventions (correct)

Measuring patient outcomes

During which phase of the nursing process would a nurse evaluate if a specific intervention was effective?

Diagnosis

Planning

Evaluation (correct)

Assessment

In the nursing process, what does ADPIE stand for?

Assess, Diagnose, Plan, Implement, Evaluate Signup and view all the answers

What is typically the first action a nurse takes in the ADPIE process?

Conducting a patient assessment Signup and view all the answers

What best defines the Diagnosis phase in the nursing process?

Identifying and prioritizing patient problems Signup and view all the answers

What action occurs during the Evaluation phase of the nursing process?

Assessing patient responses to interventions Signup and view all the answers

In nursing, which step directly follows the Implementation phase?

Evaluation Signup and view all the answers

What is NOT a component of the nursing process?

Application Signup and view all the answers

What is the ultimate goal of the nursing process as represented by ADPIE?

To improve patient health outcomes Signup and view all the answers

What should be monitored when administering diabetic medications?

Blood sugar Signup and view all the answers

Which of the following conditions is a contraindication for immune globulin administration?

Acute infection Signup and view all the answers

What is one of the purposes of Aspirin?

Blood thinner Signup and view all the answers

What symptom is NOT associated with serum sickness?

Nausea Signup and view all the answers

What should be verified with the provider before administering treatment?

Allergies to medications Signup and view all the answers

What should be avoided when administering medication to children?

Giving aspirin Signup and view all the answers

Which of the following is considered a mild pain score?

0-1 Signup and view all the answers

What is a potential complication of combining aspirin and warfarin?

Risk of bleeding Signup and view all the answers

What is the significance of enteric coated medications?

They prevent gastrointestinal irritation Signup and view all the answers

Which of the following is an adverse effect of Aspirin?

Upper abdominal pain Signup and view all the answers

When is it important to use pictures for pain assessment?

When numeric scales cannot be used Signup and view all the answers

What does toxicity of a medication commonly present with?

Tinnitus and confusion Signup and view all the answers

When should medication administration be stopped before surgery?

5-7 hours before surgery Signup and view all the answers

What effect does Aspirin have as an antipyretic?

Reduces fever Signup and view all the answers

Which of the following is true regarding the administration of immune globulin?

It is ineffective for those who have received it in the past three months. Signup and view all the answers

Which blood pressure condition should be monitored to avoid complications?

Hypotension Signup and view all the answers

What side effect is NOT associated with high medication toxicity?

Weight gain Signup and view all the answers

What should be a primary concern when administering non-steroidal medications?

Gastrointestinal issues Signup and view all the answers

Symptoms such as hemodynamics being high would indicate what?

Medication overdose Signup and view all the answers

Which aspect of medication should be cautious about in pediatrics?

Dosage calculations are critical Signup and view all the answers

Study Notes

Nursing Process: ADPIE

Assessment, Diagnosis, Planning, Implementation, Evaluation are the steps in the nursing process.
Unclear Orders: Verify with provider, don't assume.
Patient education: Adverse effects of medication (BP meds, diabetic meds). Monitor BP and blood sugar.

Vaccines

Purpose of titers: Shows the amount of antibodies in the blood to prove immunity to disease.
Vaccine Contraindications: Allergies, immunodeficiency, recent immune globulin administration (past 3 months), and acute infections.

Serum Sickness

Symptoms: Fever, arthritis, flank pain, muscle pain, joint pain.
Immune reaction to injected antibodies.

Pain Assessment

Pain Score: 0-5 mild, 6-8 moderate, 9-10 severe.
Use pictures or facial expressions/hemodynamics if numeric score isn't possible.

Aspirin

Purpose: Antipyretic, analgesic, anti-inflammatory. Reduces risk of blood clots.
Adverse Effects: GI upset (nausea, epigastric pain, heartburn), bleeding, nephrotoxicity.
Patient teaching: Do not give to children, stop 5-7 days before surgery, do not crush/chew enteric-coated tablets and check blood pressure.

pH teaching

Don't give to children.
Stop 5-7 days before surgery.
Check blood pressure.
Enteric coated cannot be crushed/chewed.
Risk of bleeding with warfarin.

Toxicity

Symptoms include tinnitus, confusion, nausea/vomiting/diarrhea, high blood pressure/heart rate, seizures.

NSAIDs (Motrin):

Monitor renal function (BUN/Creatinine).
Do not give to patients with renal injury.
Ketorolac (Toradol) is a non-narcotic option.
No possibility of addiction with non-narcotic options.

Opiates

Morphine, Codeine, Fentanyl, Hydrocodone, Oxycodone.
Worry about respiratory depression, especially in hospice patients and older adults.
Take vitals before giving, and monitor hemodynamics.
Not a first-line treatment.

Acetaminophen (Tylenol)

Purpose: Non-narcotic analgesic (pain reliever), non-anti-platelet.
No anti-inflammatory qualities.
Maximum daily dose: 4000mg.
Enteric coated, do not crush/chew.
Do not exceed maximum dose.
Adverse Effects: Hepatotoxicity (jaundice), Nephrotoxicity (BUN/creatinine), Integumentary issues.
Take every 3-4 hours.

Anti-tussives

Dextromethorphan, Benzonatate.
Purpose: Suppress cough.
Excessive suppression can cause inability to cough, hallucinations, risk of falls.

Tamsulosin (Flomax)

Purpose: For benign prostatic hyperplasia (BPH).
Teaching/Precautions: Worry about postural hypotension.
Medication affects blood pressure, do not give to hypotensive patients.

Glaucoma

Prostaglandin analogs, beta-adrenergic blockers, alpha2-adrenergic agonists.
Special Concerns: Affects blood pressure.

Acid Controlling Drugs (PPIs)

Purpose: Suppress acid secretions.
Drug interactions: Increases levels of diazepam and phenytoin.

Antiemetics

Purpose: Relieve nausea and vomiting.
Used prophylactically, for example, before chemotherapy.

IV Fluids

Therapeutic effects: Increased urine output & vital signs.
Adverse effects: Edema, fluid in the lungs (listen for crackles).

Corticosteroids

Therapeutic effects: Reduce inflammation, helps with pain.
Adverse effects: Hyperglycemia, immunosuppression, decrease in immunity.
Patient teaching: Taper off, avoid large crowds, and check blood sugars.

Constipation/Diarrhea relief

Prevention includes increasing fiber intake, fluid intake, exercise.
Consider suppositories or enemas for fecal impaction.
Avoid giving magnesium to renal patients.
Bismuth salicylate (Pepto Bismol) for diarrhea.
Allergies to aspirin could be a concern for various treatment approaches.

Levothyroxine (Synthroid)

Therapeutic effects: Increase weight, increase respiration rate, weight loss, increase energy levels.
Take in the morning on an empty stomach, do not take with iron or antacids.

Short-acting insulin

Purpose: Taken during meals to reduce blood glucose levels.

Long-acting insulin

Taken at the same time every day.
Side effects include shakiness, sweating, increased heart rate, hunger, blurred vision.
Check blood sugar when showing signs.

A1C Check

Check A1C with oral meds.
Metformin should be stopped 24-48 hours before diagnostic testing.

Antidepressants

Stabilize mood, takes 3-4 weeks to see improvement.
Do not stop taking medication abruptly.

Anxiolytics

Examples: Diazepam, Lorazepam, Alprazolam.
Promote relaxation/calming.
Avoid combining with opioids; do not abruptly stop.
Fall risk.

Immunosuppressants (Methotrexate)

Use for conditions like rheumatoid arthritis, psoriasis, and cancer.
Can accumulate to toxic levels, causing kidney or liver damage.
Should be taken with food and not with citrus juices.

Statins

Decreases low-density lipoprotein (LDL), increases high-density lipoprotein (HDL), and decreases triglycerides.
Monitor liver function tests (ALT, AST).

Potassium Channel Blockers (Amiodarone)

Risks: dysrhythmias, hypotension, bradycardia, hepatotoxicity and pulmonary toxicity.
Monitor lung sounds (resp rate).

Digoxin

Adverse effects: hypotension, bradycardia, PVCs, digoxin toxicity.
If toxicity occurs, discontinue the medication. Digibind is the antidote.

Hypertension Meds (ARBs) -Sartan

Losartan is an example
Teaching: Check blood pressure at home before taking drug.
Log blood pressure in journal.

Losartan Teaching

Rebound hypertension.
ARBs MOA: decreases vasoconstriction, lowers blood pressure, increases renal flow.

Nitrates

Nitroglycerin, isosorbide mononitrate, isosorbide dinitrate.
Purpose: Treats angina.
Contraindications: Erectile dysfunction medications (cause hypotension)

Diuretics

Loop diuretics (furosemide), potassium-sparing diuretics (spironolactone).
Loop Diuretics (furosemide): Risk for hypokalemia (monitor potassium levels).
Potassium sparing diuretics (spironolactone): Risk for hyperkalemia (monitor potassium levels).

Heparin

Routes: Subcutaneous (SQ) or intravenous (IV).
Monitoring: Hemoglobin levels (Hgb), activated partial thromboplastin time (aPTT), platelets.
Antidote: Protamine sulfate
Heparin-induced thrombocytopenia (HIT): Stop heparin, assess, and notify the provider.

Warfarin (Coumadin)

Dietary concern: Vitamin K (salads).
Monitor for bleeding.
General anticoagulant concerns: Don't destroy clots, just prevent formation.

Phenytoin (Dilantin)

Teaching: Do not switch between generic and brand versions.
Adverse effects: Gingival hyperplasia, osteoporosis, liver toxicity, Steven Johnson Syndrome.

Bone marrow suppression

Oldest drug class: Phenobarbital.
Adverse effects: Central nervous system depression (fatigue, drowsiness, sedation), risk of status epilepticus, and risk of suicidal ideation.

Benzos (Diazepam, Lorazepam)

Used during tonic-clonic seizures.

Carbamazepine (Tegretol)

Adverse effects: Heart block, respiratory depression, hepatitis, and risk of suicidal ideation
Avoid driving for several months if using this medication.

Alzheimer's drugs (Aricept)

Slows the progression of Alzheimer's, enhances memory and learning.

Parkinson's drugs (Sinemet, Amantadine)

Treats symptoms of Parkinson's, improves mobility, posture, speech and mood.
Levodopa effects can decrease; need to adjust doses accordingly.

Antibiotics (e.g, Tetracycline, Vancomycin)

Considerations: Do not take with dairy products, antacids, or iron; 6-8 oz of water with tetracycline and other antibiotics to flush out kidneys.

Antiviral (e.g, Oseltamivir (Tamiflu))

Should be taken within 2 days of symptom.

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Description

Test your knowledge on the nursing process with a focus on the steps involved in ADPIE. This quiz covers the essential phases including Assessment, Diagnosis, Planning, Implementation, and Evaluation. Assess your understanding of objectives, interventions, and the ultimate goals in patient care.