"STUDY GUIDE - FINAL" PDF

1\. What is Separation anxiety? - Great worry when faced with ordinary separation - Worry for parental safety and the child's safety - Normal, but declines between 3 and 5 - Nursing management - Find reason behind anxiety: Separation due to death, divorce, military deployment? New...

1\. What is Separation anxiety? - Great worry when faced with ordinary separation - Worry for parental safety and the child's safety - Normal, but declines between 3 and 5 - Nursing management - Find reason behind anxiety: Separation due to death, divorce, military deployment? New family member? - Use SSRIs 2\. Erikson's 8 stages **STAGE** **BASIC CONFLICT** **VIRTUE** **DESCRIPTION** ----------------------- ---------------------------- ------------ -------------------------------------------------------------------------------------------------- Infancy (0-1) Trust VS Mistrust Hope Trust (or mistrust) that basic needs like nourishment and affection will be met Early Childhood (1-3) Autonomy VS Shame/doubt Will Develop a sense of independence in many tasks Play age (3-6) Initiative VS Guilt Purpose Takes initiative on activities but may develop guilt when unsuccessful or boundaries overstepped School age (7-11) Industry VS Inferiority Competence Develop self-confidence in abilities when competent or sense of inferiority when not Adolescent (12-18) Identity VS Confusion Fidelity Experiment with and develop identity and roles Early Adult (19-29) Intimacy VS Isolation Love Establish intimacy and relationships with others Middle Adult (20-64) Generativity VS Stagnation Care Contribute to society and be part of a family Older Adult (65-on) Integrity VS Despair Wisdom Assess and make sense of life and meaning of contributions 3\. Maslow's hierarchy Self-Actualization is the desire to become the most that one can 4\. Ask questions for Assessment for alcoholism: - how much or how often - when was your last drink - when did you start - do you binge drink - Ask questions to understand if DT's are about to start - DT's can happen 24-36 hrs. after last drink. 5\. Signs and symptoms of alcohol withdrawals: - Headaches. - Anxiety - Tremors - Insomnia - Fatigue - Mood changes - Gastrointestinal disturbances - Heart palpitations - Increased blood pressure or heart rate - Hyperthermia - Rapid abnormal breathing - Hallucinations - Seizures 6\. What can you do to reduce a patient\'s ICP? - Management of increased ICP - decrease Cerebral edema - lowering volume of CSF - Decreasing cerebral blood flow while maintaining perfusion - You can meet these goals by - Administering osmotic diuretics (Mannitol) - Restricting fluids - Draining CSF - Controlling fever and decreasing metabolic demands - Maintain systolic BP and oxygenation - Elevating head of bed to 30 degrees     7\. Medications that might likely precipitate (cause) Stephen Johnson\'s syndrome include:   - **Anti-Epileptic meds** (Lamotrigine/Lamictal, Carbamazepine/Tegretol, Phenytoin/Dilantin, Phenobarbital - **Anti-Gout Meds** (allopurinol) - **Antibacterial Sulfa Drugs** - **Pain relievers** (Tylenol, ibuprofen, Naproxen) - **Antibiotics** (Minocycline)   8\. What do you know about the shingles virus?    - You have a higher chance of getting shingles virus if you have had chickenpox. - It follows the nerve pathways. - Often seen more prominently in older adults. - One specific thing is you must be careful if they have shingles around the eyes, because it can cause some blindness if it gets into the eye.       9\. Tell me what you know about scabies.   - You must treat everything in the house separate from others such as Laundry. - Do not share towels - It\'s not necessarily spread by scratching, but it is very contagious.   - A magnifying glass and a penlight are held at an oblique angle to the skin while a search is made for the small, raised burrows created by the mites. The burrows may be multiple, straight, or wavy, brown or black, thread-like lesions, most commonly observed between the fingers and on the wrists. - One classic sign of scabies is the increased itching that occurs during the overnight hours - It is advisable to treat all residents, staff, and families of patients at the same time to prevent reinfection. - The patient is instructed to take a warm, soapy bath or shower to remove the scaling debris from the crusts and then to dry thoroughly and allow the skin to cool. A prescription scabicide, such as lindane, crotamiton, or 5% permethrin, is applied thinly to the entire skin from the neck down, sparing only the face and scalp (which are not affected in scabies). The medication is left on for 12 to 24 hours, after which the patient is instructed to wash thoroughly. One application may be curative, but it is advisable to repeat the treatment in 1 week.     10\. Tell me how you might diagnose scabies, what might they look like? What might you see?   - A red rash. Typically, you\'ll find it in between the fingers and toes. Usually dry areas.   - A sample of superficial epidermis is scraped from the top of the burrows or papules with a small scalpel blade.  - May see the burrows if light held right   11\. How do you identify vascularization in the nail bed?  How do you tell there\'s good blood flow to the nail bed?   - Look for the pinkish color associated with the nail bed - Can check by cap refill    12\. What would you see with a vascular ulcer?  - More common than arterial. Due to impaired return of venous blood from the tissue to the heart. - S/S: Edema to lower extremity, moist wound bed often with heavy exudate - Treatment and Nursing Care: reduction of edema, preventing complications and topical therapy and dressings.      13\. What do you see with an arterial ulcer?   - Poor arterial blood flow - Painful, dry wound bed - Little to no edema - Pale surrounding tissue   14\. You have a patient with a seizure. What\'s your priority?   - Safety is \#1 - You might turn on their side.   - Protect their head.   - you might move furniture, whatever is in the way           15\. Tell me what the Romberg test is.  - Test for balance. - You have them stand, and they can lift their foot, close their eyes, if they sway it would be a positive test. Used to look for problems with Inner ear issues or equilibrium.     16\. How do you assess cranial nerve III?   - It\'s the movement of the eye up and down.  - Assess during the H pattern assessment that the eyes follow   17\. What are some things that would put a patient at risk for MS?   - Low vitamin D - it\'s more prominent in females - autoimmune genetic disorder  - Live in northern cities - Epstein-Barr virus can trigger   18\. Give me signs and symptoms of MS that you might see.   - Loss of balance - possibly can cause dizziness.  - Muscle weakness in limbs  - **UNILATERAL VISION CHANGES** - One of the key things that you can differentiate MS from the rest of it is MS is Remitting.    19\. Give me interventions or treatments for MS. - Fluid and Fiber - Physical therapy and steroid infusions.   - We want to make sure they go to the bathroom. Enhance their urine and bowel functions by giving them MiraLAX or stool softeners.  - sexual functions  - communication.  - Check for swallowing difficulties   20\. Tell me one or two things that you can do for a patient that has aphasia.   - You can give them a signboard for communication. - Work with speech therapy.    21\. Tell me if you were to have more than one eye drop to give, what would you do?   - Wait five minutes in between them.      22\. Give me a couple of risk factors for skin cancer.    - People that live in areas where the sun is closer to the earth  - Fair-skinned people - If people have scars from previous burns, is this something you should teach your burn patients about  - People with a history, who\'ve had a history of x-ray treatment.  - Accutane usage for acne   23\. You need to place warm compress on a patient\'s eye. What can the CNA, an unlicensed place do?  - They can get supplies  - They can apply the warm compress.  24\. What you would teach your patient with a newly diagnosed with glaucoma? - Educate on appointment follow-ups (and keeping the appointments)  - Make sure they know how to apply eye drops, if they can\'t make sure family members know how to do it.     25\. Narassistic personality - Grandiose, inexhaustible need for admiration, and lack of empathy  - Believe that they are superior, special, and unique - Handle criticism poorly - Believe they are entitled to be served and receive special considerations  - Ambitious for fame and fortune  - Cannot show empathy - Feign sympathy for their own benefit 26\. Histrionic personality - excessive needs for admiration - Attention seeking, excitable, and emotional   - Insatiable need for attention and approval  - Appearance is provocative and speech is dramatic - Strong dependency, sexually seductive, uncomfortable in a single relationship - Innate sensitivity to the moods and thoughts of those they wish to please  - Depressed when not center of attention 27\. Antisocial personality - Disregard for and violation of rights of others - Do not believe society's rules are made for them - Arrogant, self-centered, feel privileged and entitled - Seek to exploit others - Lack empathy and remorse, unable to express human compassion - Behaviorally impulsive - Repeatedly perform acts that are grounds for arrest - Aggressive and shortsighted - Some get arrested, but not all 28\. Borderline personality disorder - \#1 disorder, mood swings, outburst, extreme fear of abandonment, impulsivity, unstable relationships - A: Abandonment - M: Mood instability - S: Suicidal or self-mutilating - U: Unstable and intense relationships - I: Impulsive - C: Control of anger (or lack of it!) - I: Identity disturbance - D: dissociative or paranoid (transient and stress-related) - E: Emptiness (chronic feelings of it) - 29\. Questions to assess for suicide - do you want to hurt yourself - do you have a plan, - have you acted on a plan - have you ever done this before 30\. Antipsychotics block dopamine and reduce hallucinations. used for ? and side effects 31\. Erik Erikson's 8 Stages of Psychological Development - In this psychological theory, each phase puts us into a specific state of conflict, which we either overcome and develop an important psychological quality or fail to overcome and don't develop the psychological quality 32\. Industry vs. Inferiority - School-age children develop a sense of competence and mastery in this stage, according to Erikson, but may feel inferior if they fail to meet societal expectations or standards. 33\. In this final stage of psychosocial development, older adults reflect on their lives and experiences, seeking to find a sense of fulfillment and acceptance of one\'s life choices and achievements? - Integrity vs. Despair 34\. According to Maslow, once lower-level needs are met, individuals strive for recognition, respect, and a sense of accomplishment in this level of the hierarchy? - Esteem needs 35\. At the pinnacle of Maslow\'s hierarchy is this concept, representing the realization of one\'s full potential, personal growth, and the pursuit of self-fulfillment - Self-Actualization 36\. This type of therapy guides patients in identifying automatic negative thoughts and distorted thinking? - Cognitive Behavioral Therapy 37\. This therapy is effective in reducing symptoms of PTSD and involves the rhythmic stimulation of the brain's hemispheres, known as bilateral stimulation? - EMDR (Eye Movement Desensitization and Reprocessing) Therapy 38\. EPS refers to a group of movement disorders including dystonia, akathisia, and this involuntary repetitive movement often seen in patients that have used antipsychotics long term? - Tardive dyskinesia 39\. Antipsychotics treat these symptoms, such as hallucinations and delusions - Positive symptoms 40\. What are the Negative symptoms? - 41\. To ensure optimal effectiveness and minimize toxicity, healthcare providers monitor lithium levels in the blood, typically aiming for concentrations within this narrow range? - 0.6 to 1.2 mEq/L 42\. These medications, such as lorazepam and alprazolam, are sometimes prescribed for the short-term management of anxiety symptoms due to their rapid onset of action and calming effects, but they also carry a risk of dependence and tolerance? - Benzodiazepines 43\. Research has shown that SSRIs, a common class of antidepressants, may increase the risk of suicidal thoughts, particularly in individuals under this age? - Patients under 25 years old 44\. This eating disorder is characterized by extreme food restriction, an intense fear of gaining weight, and a distorted body image? - Anorexia Nervosa 45\. Patients with certain eating disorders can experience complications such as electrolyte imbalances and dental erosion because of this disordered behavior? - Purging 46\. Individuals with this disorder have been exposed to a traumatic event and have intrusive symptoms, avoidance behaviors, negative alterations in mood and cognition, and heightened arousal and reactivity? - PTSD 47\. This symptom of depression is defined as the inability to experience joy or pleasure? - Anhedonia 48\. Children who experience depression and anxiety are more likely than adults to report this type of symptom? - Somatic Symptoms 49\. Patients who take this class of antidepressants cannot eat any food containing tyramine? - MAOI's 50\. This type of precaution is necessary for patients at inpatient psychiatric hospitals that report feelings of "hopelessness."? - Suicide Precautions 51\. Overdosing on medications such as SSRIs and SNRIs can cause this syndrome? - Serotonin Syndrome 52\. A patient with this condition will display little eye contact and exhibit few facial expressions? - Autism Spectrum Disorder 53\. A child with this condition will require few distractions during homework time, clear directions, and consistent rules? - Attention-deficit/hyperactivity disorder 54\. A teenager who receives many detentions for bullying others likely has this disorder? - Contact Disorder 55\. A child who continually checks his parents in the middle of the night due to fears that he is sick may have this anxiety disorder? - Obsessive-compulsive disorder 56\. A child with this disorder will display argumentative behaviors against authority figures? - Oppositional Defiant Disorder 57\. A patient experiencing mania may find it difficult to find time to eat, drink, or sleep due to this symptom? - Distractibility, Impulsivity, Flight of Ideas, Increased Activity 58\. What are the signs and symptoms of a cystocele? - A bulge of tissue that can be seen or felt through the vaginal opening  - A feeling of fullness, heaviness, or pain in the pelvic area  - Difficulty fully emptying the bladder  - Frequent urinary tract infections (UTIs)  - Difficulty inserting period products  - Urine leakage, also known as urinary incontinence  - Difficulty starting the flow of urine, also known as hesitancy  - A slow urine stream  - Feeling the need to urinate after finishing urination  - Frequent or urgent urination  - Pelvic pressure that increases with standing, lifting, or coughing  - Lower back pain  - Pain during sexual intercourse  59\. Pt with ectopic pregnancy has heavy bleeding after surgery, what is your priority for this client? - fluid status is priority - Followed by a cbc to determine if blood is needed 60\. Signs and symptoms of a baby born to a mother with substance abuse problems. - High pitched cry - Irritable - needs low stimulation - not easy calmed. - Not to be sent to room in with just mom. - Still need bonding so dad can do skin to skin. 61\. APGAR score is only 10 pt. A table with text on it Description automatically generated 62\. Contraindications for oral contraceptives? - Blood clots - Stroke - Pregnancy - Cancer - 63\. Teaching about breast exams to younger women? - Need to check every month at the same time before period 64\. Teaching for breastfeeding mom before leaving hospital? 65\. Best Birth control for client with multiple partners? - Condoms. IUD can allow an entry point for bacteria 66\. Contraindication of giving postmenopausal women estrogen? - Hx of Blood clots - hx of strokes 67\. What to do for Mastastitis? - Continue breastfeeding - Use cool or warm packs - Take all antibiotics - 68\. Teaching for young girls about the menstrual cycle? - Bleeding only last 5-7 days - myth of not getting pregnant on period - may be emotional 69\. What are some signs and symptoms of peri menopause? - Hot flashes - vaginal dryness - irregular periods - Menopause is when no period for 12 months 70\. What do you need to teach for mammogram? - No deodorants - No lotion 71\. Assessment questions for infertility? - Hx of infection (childhood and STD) - 72\. Teaching for couple with infertility? - Track ovulation - tell them how to check sperm counts - No hot tubs - no alcohol or drugs 73\. Priority for burn pt? - is fluid status if neck or face is not burned. - If face or neck is burned airway is priority. 74\. Rule of nine for adults? - 75\. Parkland burn formula - 4ml x kg x bsa% give ½ in 1^st^ 8 hrs and rest over 16 hrs 76\. Acute burns priorities other than fluids? - Prevent infection - nutritional support - wound care 77\. What can we do to help prevent scarring? - Compression wraps 78\. What is autonomic dysreflexia? - 79\. What do they look like? - Diaphoretic - pounding headache - elevated blood pressure 80\. Priority for autonomic dysreflexia? - Sit them up first, then check to see other causes 81\. Most significant safety concern with myasthenia gravitas? - Risk for falls due to muscle weakness - They have dipoplia (double vision) - Ptosis (drooping eyelid) - Aspiration risk 82\. Order for stroke treatment priorities: - IV - Blood pressure meds if extremely high - CT 83\. What could be complication of a spinal tap? - Infection 84\. What are the stages of Labor? - Stage 1 is - Stage 2 is - Stage 3 is - Stage 4 is 85\. What is Meniere's Disease? Risk? Treatments? CONCEPT MAPS TO STUDY