Med Surg Test 1 PDF

Med Surg test 1 1. Educational ways for a nurse to maintain clinical competence? Through ongoing forma continuing education courses via workshops Obtaining certification in specialized areas Participating in professional networks Simulation Training 2. What is profes...

Med Surg test 1 1. Educational ways for a nurse to maintain clinical competence? Through ongoing forma continuing education courses via workshops Obtaining certification in specialized areas Participating in professional networks Simulation Training 2. What is professional Communication between a nurse and a Client: Establishing trust and rapport Clear and concise communication Active listening Empathy and cultural sensitivity 3. What is the key term professional comportment and what is an example of this? Is how a person conducts themselves by displaying professional behaviors. Example : Use appropriate and respectful language especially during difficult situations. 4. What are characteristics of an effective nurse leader? Strong Communication skills/critical thinking skills Empathy/Integrity Adaptability Commitment to continuous learning and improvement 5. What are examples of interprofessional collaboration? Healthcare professionals from different disciplines working together to provide Comprehensive and coordinated care for patients. Multidisciplinary team meetings Collaborative rounds Care conference Case management coordination 6. What are some strategies to prevent Nurse Burnout? Practice and promote self care Adequate rest  Establishing a supportive work environment Nurse support groups 7. What are ways to handle bullying/harassment in the workplace? Recognize and acknowledge it is occurring in the workplace Establish clear policies outlining what behaviors are considered unacceptable and the consequences for such actions. Educate employees on recognizing, preventing and reporting through training programs Encourage reporting Investigate complaints thoroughly. 8. What are the causes of the current nursing shortage? Aging population, retiring nurses Insufficient faculty in nursing schools. Co-vid 19 High-stress working conditions causing burnout 9. What are some ways to social determinants of health for clients? Providing access to affordable healthcare services Educational programs on living practices Create job training and placement initiatives Community infrastructure such as public Transportation systems or recreational facilities Advocating for policies that reduce income inequality 10. When should a client admitted to a hospital setting receive teaching? Assess clients readiness and ability to learn Should begin at time of admission and continue through to time of discharge. 11. What are the steps to evidence-based practice? Ask a Clinical question Acquire evidence Appraise the evidence Apply the evidence Access outcomes 12. What is the level of evidence? Level A-Most Trustworthy, because it comes from randomized trials Level B- Gathered via case-controlled, epidemiological Qualitative/Quantitative investigation. Clinical Cohort studies Level C- Taken from Meta-Synthesis-expert opinion and consensus viewpoint Multi-Level- Evidence is gathered from many levels of rating system for more complicated situations. 13. What are the national patient safety goals? Identify patient correctly Improve staff communication Administer Medication safely Utilize alarms safely Prevent infection Identify patient safety risk 14. Why is Clinical judgment important in positive client outcomes? Allows healthcare professionals to understands patients unique needs, preferences and circumstances Allows to be able to create personalized treatment plans based on their medical history and current condition. Allows to be able to make critical decisions about diagnosis, interventions and on going care based on a combination of evidence based-practice and personal expertise Allows for assessment of patients progress during treatment and helps with making necessary adjustments as needed for better outcomes. 15. What are the Characteristics of each step of the nursing process?  1. Assessment: Nurse collects comprehensive data about a patient's health status. Includes gathering information through interview, physical exam, and review of medical history. 2. Diagnosis: After collecting assessment data, the nurse analyzes it to identify actual or potential health problems. Diagnosis is formulated based on patterns identified in Assessment data. 3. Planning: Once a diagnosis is made the nurse develops an individualized care plan that outlines specific interventions to address health issues. This includes setting achievable goals and determining appropriate outcomes for evaluation. 4. Implementation: Executes their planned interventions while considering factors such as safety measures and ethical considerations. They also document all actions taken during implementation for future references 5. Evaluation: Finally both assessment and implementation plans are evaluated by comparing achieved results against predetermined goals. The overall progress towards optimal wellness will be determined at this stage. Wellness to Illness Continuum 16. What are factors to achieving Wellness? Physical activity Healthy eating habits Stress management Adequate sleep Social connections/ support systems 17. What are examples of social determinants of health? Socioeconomic status- income level, education,occupation Physical Environment- quality of housing, exposure to pollutants, access to clean water Social support Network- strong support systems contribute positively towards mental wellness While isolation may lead to adverse effects on physical and mental health  Access to Healthcare services: Availability of medical care including preventive services like vaccinations greatly influence population level outcomes related to diseases 18. What is the goal of Healthy people 2030? To attain healthy, thriving lives and well-being free of preventable diseases, disability, injury, and premature death. To achieve health equity, create social ,physical, and economic environments that promote the highest level of health, and engage leaders to transform policies. 19. Why are vaccines recommended? Prevention of diseases Herd immunity Reduce healthcare cost Eradication of diseases 20. What are some examples of public health policies that contribute to disease prevention? Vaccination programs Tobacco control measures Food safety regulations Environmental protection 21. What is the Acronym for common signs of stroke? F.A.S.T F- Face drooping one side uneven, especially when asked to smile A- Arm weakness, or numbness, make it difficult to raise both arms S- Speech difficulties, slurred or difficulty speaking T- Time to call emergency services 22. What are some risks for Alzheimer's disease? Age- Advancing age, risk doubles every 5 years after 65 Genetics- Family History of Alzheimers especially if multiple family members Lifestyle factors- smoking, obesity, lack of exercise and poor diet Medical conditions- Diabetes, HBP, Heart Disease 23. What are resources for clients experiencing economic social determinants of Health? Income support- financial assistance through programs ( TANF, Social Security(ssi)(ssdi) Unemployment benefits. Employment services- Job training programs ( government funded training programs) Career Counseling services- professional career counselors can assist in exploring different career options Housing resources: Section 8 Homeless prevention programs: offer temporary shelter, transitional housing. 24. What are treatment options for Acute Pain? Medication- anti-inflammatory drugs (NSAIDs) Physical Therapy- Can aid in relieving acute pain and improving mobility. Rest and Ice/Hot Therapy- Can reduce swelling,soothe discomfort, and promote healing Injections- Corticosteroid injections may provide relief from severe Acute pain 25. What are realistic goals for a clients rehabilitation: Regaining Mobility- improving mobility to move independently or with minimal assistance. Increasing Strength/Endurance- To improve muscle strength and stamina. Restoring functional abilities- To regain skills necessary for daily activities Managing Pain Effectively- To reduce pain levels Improving Balance and coordination- Enhance stability while standing/walking/performing task requiring fine motor control 26. What type of clients are appropriate for Hospice care? Terminal Illness-( advance cancer, HF, Lung disease) or other not responding to curative Clients with prognosis of 6 months or less 27. What are the Dietary recommendations for a plan of care for diabetic? Managing Carbohydrates- choosing complex carbs over simple sugars Include adequate fiber, through high fiber foods Lean protein sources vs fatty meats Consuming healthy fats from plant based -(oils/nuts/seed/fish) Limit saturated fat consumption 28. What are lifestyle modifications to prevent Atherosclerotic Cardiovascular Disease? Healthy diet Regular Exercise Quit smoking Illness 29. What is the hormone that is released under stress? Cortisol 30. What medications cause a decrease in libido? Selective serotonin Reuptake inhibitors Antihypertensive drugs (beta blockers and diuretics) Hormone contraceptives containing progestin 31. What are the long term effects of Chronic Hypoxia? 1. Cardiovascular system- increase resistance in pulmonary blood vessels, causing Pulmonary Hypertension. Also remodeling and thickening of these blood vessels, leading to Right Ventricular Hypertrophy (enlargement) These changes can lead to Heart failure 2. Respiratory System- May cause Structural changes such as Alveolar wall thickening and fibrosis. Respiratory muscles may become weaker due to decrease oxygen availability. Resulting in Reduced Lung Function. 3. CNS- Cognitive impairment including memory loss, difficulty concentrating or thinking clearly. Mood disturbances (depression or anxiety) or even Neurological disorders such as Dementia or stroke-like symptoms if severe enough.  4. Musculoskeletal system- Effects Muscle Metabolism which cause fatigue, reduced exercise capacity and muscle wasting. 32. What are possible Manifestations of dehydration? Physical symptoms- dry mouth, decreased urine output,sunken eyes, dizziness Cognitive effects- confusion, irritability and difficulty concentrating Vital signs Changes- Increased HR, (Tachycardia) Low BP( Hypotension) Skin Changes- Reduced Elasticity or turgor. 33. What are the effects of heavy Alcohol use? Liver disease-Cirrhosis Pancreatitis Cardiovascular problems Cancer Mental health problems-depression/anxiety Cognitive impairments Social behaviors 34. What are some clients' teachings for Alcohol recovery? Coping Mechanisms Developing relapse prevention strategies Encouraging participation in Support groups Promoting healthy lifestyle changes Provide resources for continue education on alcohol recovery 35. What Chronic illnesses that could lead to Dementia? Alzheimer's Disease Vascular Diseases- (Stroke, Atherosclerosis(brain blood vessels)  Parkinson's disease Huntington's disease 36. What is the medical venue that helps clients with care coordination and prevention screenings? 37. Manifestations of Graves Disease? Weight loss Rapid Heart beat Nervousness Goiter Exophthalmos-Bulging eyes Pretibial myxedema- Affects skin causes swelling and plaques of scaly lesions on shins 38. What is medication treatment for sickle cell crisis? Hydroxyurea - Reduces the frequency of sickle cell by increasing the production of fetal hemoglobin, which helps prevent formation of sickle cells. 39. What are life threatening issues that could result from immobility? DVT- blood clots from deep veins (usually legs) travel to lungs causing PE Pulmonary Embolism(PE) Pneumonia Muscle atrophy Pressure ulcers 40. What chronic illnesses increase risk for sepsis? Diabetes Chronic Kidney disease Chronic liver disease COPD Cancer Autoimmune Disease 41. What are the different types of Prevention for client care? Primary Prevention- Aims to prevent the onset of disease before it occurs by reducing risk factors, and promoting healthy behaviors Secondary Prevention- Focuses on early detection and prompt intervention to halt the progression of disease ( involves regular screening, monitoring for early signs) Tertiary Prevention- To manage and reduce complications in individuals already diagnosed with chronic diseases. (includes ongoing treatment, rehab, and support to improve quality of life and prevent further deterioration) 42. What are the components of the Dash diet? 1. Fruits- rich in potassium, fiber,and vitamins 2. Vegetables- High in potassium, magnesium, and fiber 3. Whole grains-provide energy and essential nutrients like fiber and B Vitamins 4. Lean proteins- such as poultry, fish, and bean which are low in saturated fats 5. Low-Fat Dairy products- Sources of calcium. Protein and Vitamin D 6. Nuts, Seeds, Legumes- Provide healthy fats, Protein, and fiber 7. Limited Sodium intake-Reducing salt intake to manage blood pressure  8. Reduced saturated Fat and Cholesterol- Emphasizing healthy fats from sources like olive oil and avocados. End of Life 43. What is the difference between brain death and clinical death? Brain death is not reversible permanent Clinical death can be potentially be reversed with timely medical interventions 44. What are the stages of dying? Denial- Refusal to accept the reality of the situation Anger- Frustration and anger about situation Bargaining- Attempting to negotiate for more time or a way out Acceptance- Coming to terms with the reality of the situation 45. What is the nursing action of a client who has had a clinical death? 1. Immediate response- Initiate CPR 2. Call for help- Simultaneously the nurse should call for emergency medical assistance to ensure advance life support measures can be administered as soon as possible 3. If available use AED- to analyze the heart rhythm and deliver a shock if necessary 4. Monitor and Support- Continue CPR until emergency medical services arrive or the client shows signs of life 46. What is Respite care? Short-Term, Temporary care provided to individuals with disabilities or chronic illnesses to give their primary caregivers a break 47. What is the protocol for getting consent for palliative sedation? 1. Identify need for consent -Crucial because sedation involves significant ethical considerations including the patients autonomy and potential impact of their quality of life 2. Determine who can give consent- Ideally the patient should, but if unable a legally authorized representative or surrogate decision maker must provide consent 3. Ensure informed consent- The patient or their representative understands the nature of palliative sedation, its purpose, potential risks, benefits, and alternatives 4. Document the consent process- proper documentation of the consent process is essential, including the discussion held. The information provided, and the final decision made by the patient of the Representative. 48. How to provide culturally competent clients with diverse backgrounds? Understanding cultural competency Educating yourself on different cultures Communicating effectively Building trust and Rapport Adapting services to meet cultural needs 49. What are the Characteristics of a DNR prescription? Formal medical order Requiring informed consent Adhering to legal and ethical standards Necessitating clear documentation Specifically addressing the withholding of CPR while allowing other treatments to continue unless otherwise stated. 50. Nursing care during treatment, withdrawal/withdrawal of care? Nursing care during withdrawal of treatment- Nursing care shifts to palliative care , which includes managing pain, providing emotional support, and ensuring the patients dignity and comfort in their final moments. Nursing care during withdrawal of Care- Means stopping all medical interventions and focusing solely on comfort measures such as pain management and emotional support for patient and their families. 51. What is the process for organ donation in the hospital? Identify potential donor- Patient is identified as a potential organ donor, typically in cases of severe brain injury or other injuries leading to brain death. Evaluation and consent- Patients medical history and condition to determine suitability for organ donation. Consent is obtained from patients family or through prior registration by the patient Maintenance of Donor- Donor body maintained on life support to ensure organs remain viable until retrieval. This includes monitoring Vital signs and administering necessary medications. Matching and Allocation- Hospital coordinates with a organ procurement organization to match donors organs with recipients based on factors like blood type, tissue compatibility and urgency Surgical Retrieval- Surgical team Retrieves organs, each organ is carefully removed and preserved for transplantation Transportation/Transplantation- The retrieved organs are transported to the recipient hospital where transplant surgery is performed. 52. Why is there a death rattle at the end of life? As the body begins to shut down, the muscles responsible for swallowing and coughing become less effective. This leads to pooling of secretions in the throat and airways creating a rattling or gurgling sound during breathing. 53. What is the difference between hospice care and palliative care? Hospice Care- Focused on providing comfort and support to patients who are in the final stages of a terminal illness and who are expected to have 6 months or less to live. And has forgo curative treatments Palliative care- Is specialized medical care aimed at providing relief from the symptoms and stress of a serious illness. It can be provided alongside curative treatments and not limited to end of life care. 54. What are the Interventions for a patient with a DNR? Comfort care measures, symptom management, emotional support and respecting the patients wishes.