NURS 505 Exam 1 Study Guide (1).docx

Exam 1 +-----------------------+-----------------------+-----------------------+ | Name | Topic | Information | +=======================+=======================+=======================+ | Katie | **Nursing Actions | - - - - -...

Exam 1 +-----------------------+-----------------------+-----------------------+ | Name | Topic | Information | +=======================+=======================+=======================+ | Katie | **Nursing Actions | - - - - - - | | | when functioning in | | | | the role of a nurse | | | | advocate** | | +-----------------------+-----------------------+-----------------------+ | Katie | **Goal of a new | - - - - - - | | | nursing graduate | - | | | before taking on the | | | | role of a registered | | | | nurse** | | +-----------------------+-----------------------+-----------------------+ | Katie | **Levels of health | - - - - | | | care: what are they, | | | | and their | | | | description** | | | | | - | | | **Preventative, | | | | Primary, Secondary, | | | | Tertiary, | | | | Restorative, | - | | | Continuing Care** | | | | | | | | | | | | | - | | | | | | | | | | | | | | | | - | | | | | | | | | | | | | | | | - | +-----------------------+-----------------------+-----------------------+ | Katie | **The role of the | - - | | | nurse as an educator, | | | | communicator, | - - - - - | | | caregiver, advocate** | | +-----------------------+-----------------------+-----------------------+ | Katie | **Discharge planning: | - - | | | when it begins, what | | | | is involved** | - - - - - | | | | | | | | - - | | | | | | | | | | | | | | | | - | | | | | | | | | | | | | | | | - - | +-----------------------+-----------------------+-----------------------+ | Renee | **Barriers to | - - - - - | | | effective discharge | | | | planning** | | +-----------------------+-----------------------+-----------------------+ | Renee | **Description and | - - - - | | | purpose of assisted | | | | living, extended | | | | care, continuing | | | | care, hospice** | | +-----------------------+-----------------------+-----------------------+ | Renee | **Critical thinking | **Critical | | | and application to | thinking**- Critical | | | care** | thinking in nursing | | | | involves identifying | | | | a problem, | | | | determining the best | | | | solution, and | | | | implementing an | | | | effective method to | | | | resolve the issue | | | | using clinical | | | | decision-making | | | | skills, acting | | | | professionally, and | | | | using critical | | | | thinking (see Chapter | | | | 15) to administer | | | | high-quality, | | | | evidence-based, | | | | patient-centered care | | | | in a safe, prudent, | | | | and knowledgeable | | | | manner. You are | | | | responsible and | | | | accountable to | | | | yourself, your | | | | patients, and your | | | | peers. Critical | | | | thinking and | | | | knowledge will help | | | | you to make a | | | | difference in | | | | improving patient | | | | care. Critical | | | | thinking is essential | | | | to deliver safe, | | | | high-quality patient | | | | care in a changing | | | | healthcare | | | | environment. Critical | | | | thinking and clinical | | | | judgment to integrate | | | | knowledge, | | | | experience, | | | | attitudes, and | | | | standards into the | | | | individualized care | | | | plan for each of your | | | | patients. Critical | | | | thinking in nursing | | | | involves assessing, | | | | diagnosing, planning, | | | | implementing, and | | | | evaluating patient | | | | care. | | | | | | | | (pg 8, 15, 47, | +-----------------------+-----------------------+-----------------------+ | Savanna | **Pain and pain | Pain is a distressing | | | relief management for | symptom that signals | | | a client - nursing | something is wrong, | | | actions** | commonly experienced | | | | by older adults as | | | | either acute or | | | | chronic. Persistent | | | | pain can lead to | | | | issues like | | | | depression, appetite | | | | loss, sleep problems, | | | | mobility changes, and | | | | reduced social | | | | interaction. Various | | | | factors affect pain | | | | management in this | | | | population, including | | | | cultural perceptions | | | | of pain, fears about | | | | analgesics, and | | | | challenges in | | | | assessing pain in | | | | cognitively impaired | | | | individuals. Nurses | | | | play a crucial role | | | | in advocating for | | | | effective pain | | | | management, aiming to | | | | enhance function and | | | | improve the quality | | | | of life for older | | | | adults. | | | | | | | | Pain relief | | | | management nursing | | | | actions: | | | | | | | | 1. 2. 3. 4. 5. 6 | | | |. 7. 8. | +-----------------------+-----------------------+-----------------------+ | Savanna | **Patients most at | Patients at risk for | | | risk for infection** | infection include | | | | those who are | | | | immunocompromised, | | | | such as individuals | | | | with HIV or cancer, | | | | as well as those with | | | | chronic illnesses | | | | like diabetes or lung | | | | disease. Surgical | | | | patients are also at | | | | risk due to potential | | | | wound infections, | | | | along with older | | | | adults whose immune | | | | responses may be | | | | weakened by age. | | | | Infants and young | | | | children are | | | | vulnerable as their | | | | immune systems are | | | | still developing. | | | | Additionally, | | | | patients with | | | | invasive devices, | | | | such as catheters or | | | | ventilators, and | | | | those on | | | | immunosuppressive | | | | therapies face a | | | | higher risk. Careful | | | | monitoring and | | | | proactive infection | | | | control measures are | | | | essential for these | | | | individuals. | +-----------------------+-----------------------+-----------------------+ | Jae | **Standard | **Standard | | | precautions, contact | Precautions:** | | | precautions, airborne | Applies to care for | | | precautions, droplet | all patients, in all | | | precautions - actions | settings. prevention | | | needed** | of infection | | | | transmission and | | | | apply to contact with | | | | blood, body fluids, | | | | non intact skin, | | | | mucous membranes, and | | | | equipment or surfaces | | | | contaminated with | | | | potentially | | | | infectious materials. | | | | This includes barrier | | | | precautions and the | | | | appropriate use of | | | | PPE such as gowns, | | | | gloves, masks, | | | | eyewear, and other | | | | protective devices or | | | | clothing. | | | | | | | | -Apply to blood, | | | | blood products, all | | | | body fluids, | | | | secretions, | | | | excretions (except | | | | seat), nonintact | | | | skin, and mucous | | | | membranes. | | | | | | | | -Perform hand hygiene | | | | before direct contact | | | | with patients; | | | | between patient | | | | contacts; after | | | | contact with blood, | | | | body fluids, | | | | secretions, and | | | | excretions and with | | | | equipment or articles | | | | contaminated by them | | | | and immediately after | | | | gloves are removed. | | | | | | | | -when hands are | | | | visibly soiled or | | | | contaminated with | | | | blood or body fluids, | | | | wash them with soap | | | | (nonantimicrobial or | | | | antimicrobial) and | | | | water. | | | | | | | | -do not wear | | | | artificial | | | | fingernails or | | | | extenders if duties | | | | include direct | | | | contact with patients | | | | at high risk for | | | | infection and | | | | associated adverse | | | | outcomes. | | | | | | | | -wear gloves when | | | | coming in contact | | | | with body fluids, non | | | | intact skin, mucous | | | | membranes, | | | | contaminated items or | | | | surfaces. Change | | | | gloves between | | | | patient care | | | | encounters and when | | | | going from | | | | contaminated to clean | | | | body site. | | | | | | | | -wear ppe when | | | | anticipated patient | | | | interaction is likely | | | | to involve contact | | | | with blood or body | | | | fluids. | | | | | | | | -private room is not | | | | necessary. | | | | | | | | **Contact | | | | Precautions:** Used | | | | for direct and | | | | indirect contact with | | | | patients and their | | | | environment. Direct | | | | contact refers to the | | | | care and handling of | | | | contaminated body | | | | fluids. Contact | | | | Precautions require a | | | | gown and gloves. | | | | Indirect contact | | | | involves the transfer | | | | of an infectious | | | | agent through a | | | | contaminated | | | | intermediate object | | | | such as contaminated | | | | instruments or hands | | | | of health care | | | | workers. The health | | | | care worker may | | | | transmit | | | | microorganisms from | | | | one patient site to | | | | another if hand | | | | hygiene is not | | | | performed between | | | | patients. Private | | | | room, negative | | | | pressure. | | | | | | | | **Droplet | | | | Precautions:** | | | | Droplet Precautions | | | | require the wearing | | | | of a surgical mask | | | | when within 3 feet of | | | | the patient, proper | | | | hand hygiene, and | | | | some dedicated-care | | | | equipment. Private | | | | room or cohort. | | | | | | | | **Airborne | | | | Precautions:** | | | | Airborne Precautions | | | | require a specially | | | | equipped room with a | | | | negative airflow | | | | referred to as an | | | | airborne infection | | | | isolation room. Air | | | | is not returned to | | | | the inside | | | | ventilation system | | | | but is filtered | | | | through a | | | | high-efficiency | | | | particulate air | | | | (HEPA) filter and | | | | exhausted directly to | | | | the outside. For | | | | example, all health | | | | care personnel wear | | | | an N95 respirator | | | | every time they enter | | | | the room of a patient | | | | with TB. Private room | | | | or cohort. | +-----------------------+-----------------------+-----------------------+ | Jae | **Patient health | **Standard: all | | | problems that require | patients** | | | contact precautions, | | | | airborne precautions, | **Contact:** patient | | | droplet precautions, | blood or other body | | | standard | fluids from an | | | precautions** | infected patient that | | | | enter the healthcare | | | | worker's body through | | | | direct contact with | | | | compromised skin or | | | | mucous membranes. | | | | Colonization or | | | | infection with | | | | multi-drug resistant | | | | organisms, such as | | | | VRE and MRSA, C. | | | | diff, shigella and | | | | other enteric | | | | pathogens, major | | | | would infections, | | | | herpes simplex, | | | | scabies, varicella | | | | zoster | | | | (disseminated), | | | | respiratory syncytial | | | | virus. | | | | | | | | **Airborne**: | | | | diseases that are | | | | transmitted by | | | | smaller droplets, | | | | which remain in the | | | | air for longer | | | | periods of time. | | | | Measles, chickenpox | | | | (varicella), | | | | disseminated herpes | | | | zoster, Mtb, rubeola. | | | | | | | | **Droplet:** | | | | influenza, diseases | | | | that are transmitted | | | | by large droplets | | | | (greater than 5 | | | | microns) expelled | | | | into the air and by | | | | being within 3 feet | | | | of a patient. | | | | Influenza, | | | | adenovirus, group A | | | | strep, N. | | | | meningitides, | | | | pertussis, | | | | rhinovirus, | | | | mycoplasma | | | | pneumoniae, | | | | diphtheria, pneumonic | | | | plague, rubella, | | | | mumps, RSV | +-----------------------+-----------------------+-----------------------+ | Jae | **Precautions for | Contact precautions, | | | *Clostridium | wash hands with soap | | | difficile*** | and water. Gloves and | | | | gown required. Spores | | | | are not affected by | | | | alcohol based hand | | | | sanitizers. | +-----------------------+-----------------------+-----------------------+ | Nae | **Nursing care for a | -In addition to | | | patient on contact | standard precautions, | | | precautions** | Wear a gown & gloves | | | | upon room entry of | | | | patients on contact | | | | precautions. | | | | | | | | -Use disposable/ | | | | resident dedicated | | | | noncritical care | | | | equipment. (BP cuffs, | | | | Stethoscopes.) | +-----------------------+-----------------------+-----------------------+ | Nae | **Steps/procedure for | 1.Remove outer glove | | | applying sterile | package wrapper by | | | gloves** | carefully separating | | | | & peeling apart sides | | | | (see illustration). | | | | | | | | 2. Grasp the inner | | | | package and place it | | | | on a clean, dry, flat | | | | surface at waist | | | | level. | | | | | | | | Open package, keeping | | | | gloves on inside | | | | surface of wrapper | | | | (see illustration). | | | | | | | | 3\. Identify right & | | | | left gloves. Each | | | | glove has a cuff | | | | approximately 5 cm | | | | (2 inches) wide. | | | | | | | | Glove dominant hand | | | | first. | | | | | | | | 4\. With the thumb & | | | | first two fingers | | | | of the nondominant | | | | hand, grasp the | | | | glove for the | | | | dominant hand by | | | | touching only the | | | | inside surface of | | | | the cuff. | | | | | | | | 5\. Carefully pull | | | | the glove over the | | | | dominant hand, | | | | leaving a cuff and | | | | being sure that the | | | | cuff does not roll | | | | up wrist. Be sure | | | | that your thumb & | | | | fingers are in | | | | proper spaces (see | | | | illustration). 6. | | | | With gloved | | | | dominant hand, slip | | | | fingers underneath | | | | cuff of 2nd glove | | | | (see illustration). | | | | | | | | 7\. Carefully pull | | | | the second glove | | | | over fingers of the | | | | nondominant hand | | | | (see illustration). | | | | | | | | 8\. After second | | | | glove is on, | | | | interlock hands | | | | together & hold | | | | away from body | | | | above waist level | | | | until beginning | | | | procedure | +-----------------------+-----------------------+-----------------------+ | Nae | **Vulnerable | -People who live in | | | populations - risk | poverty are more | | | factors making this | likely to have health | | | population more | disparities because | | | likely for developing | they are at a higher | | | health problems** | risk of living in | | | | hazardous | | | | environments, working | | | | at high-risk jobs, | | | | eating less | | | | nutritious diets, | | | | having multiple | | | | stressors in their | | | | lives, lacking | | | | adequate | | | | transportation, & | | | | being homeless. | | | | | | | | -Patients who are | | | | experiencing | | | | homelessness have | | | | even fewer resources | | | | than people who are | | | | poor. \[ | | | | | | | | -Chronic health | | | | problems tend to | | | | worsen because of | | | | poor nutrition and | | | | the inability to | | | | store nutritional | | | | foods. In addition, | | | | people who are | | | | experiencing | | | | homelessness usually | | | | have barriers to | | | | accessing health | | | | care, causing them to | | | | seek health care in | | | | emergency | | | | departments. | | | | | | | | -More likely to | | | | develop health | | | | problems as a result | | | | of excess health | | | | risks, who have | | | | limited access to | | | | health care services, | | | | or who depend on | | | | others for care. | | | | Individuals living in | | | | poverty, older | | | | adults, people who | | | | are homeless, | | | | immigrant | | | | populations, | | | | individuals in | | | | abusive | | | | relationships, people | | | | living with substance | | | | abuse, and people | | | | with mental illness. | | | | | | | | \*Vulnerable | | | | populations have | | | | problems accessing | | | | care and | | | | participating in | | | | interventions | | | | | | | | due to costs, | | | | distance, and | | | | language. | | | | | | | | \*Transportation or | | | | childcare may not be | | | | available. | | | | | | | | \*Lack of bilingual | | | | support | +-----------------------+-----------------------+-----------------------+ | Savanna | **Characteristics of | Identifying practice, | | | theory that make | means, and goals of | | | theory essential to | practice. Helps | | | nursing practice** | define an aspect of | | | | nursing by | | | | describing, | | | | explaining, | | | | predicting, or | | | | guiding care. These | | | | theories provide a | | | | framework for | | | | evaluating patients\' | | | | situations and help | | | | identify important | | | | cues from data | | | | | | | | - - - - | +-----------------------+-----------------------+-----------------------+ | Nae | **Evidence based | -Helps us demonstrate | | | practice change and | knowledge of basic | | | measuring behavioral | scientific methods. | | | outcomes** | Appreciate strengths | | | | & weaknesses of | | | | scientific bases for | | | | practice with | | | | clinical expertise & | | | | judgment. It helps | | | | promote positive | | | | patient outcomes | | | | through the evidence | | | | findings from | | | | research, clinical | | | | expertise, | | | | information gathered, | | | | and patient history. | | | | | | | | -Clinical judgment- | | | | involving application | | | | of knowledge, ethics, | | | | evidence based | | | | practices, and | | | | clinical experience | | | | resulting in outcomes | | | | and decisions. | | | | Specific process used | | | | by therapists, nurses | | | | and other health care | | | | providers when they | | | | arrive at a final | | | | belief, decision, or | | | | conclusion. | | | | | | | | \***Evidence-based | | | | practice (EBP)** is a | | | | problem-solving | | | | approach to clinical | | | | practice that | | | | combines the | | | | deliberate and | | | | systematic use of | | | | best evidence in | | | | combination with a | | | | clinician's | | | | expertise, patient | | | | preferences & values, | | | | & available health | | | | care resources in | | | | making decisions | | | | about patient care. | | | | | | | | **Steps to EBP.** | | | | | | | | \*Cultivate a spirit | | | | of inquiry within an | | | | EBP culture and | | | | environment. | | | | | | | | \*Ask a clinical | | | | question in PICOT | | | | format. | | | | | | | | \*Search for the most | | | | relevant and best | | | | evidence. | | | | | | | | \*Critically appraise | | | | the evidence you | | | | gather. | | | | | | | | \*Integrate the best | | | | evidence with your | | | | clinical expertise & | | | | patient preferences & | | | | values | | | | | | | | to make the best | | | | clinical decision. | | | | | | | | \*Evaluate the | | | | outcomes of practice | | | | changes based on | | | | evidence. | | | | | | | | \*Communicate the | | | | outcomes of EBP | | | | decisions or changes. | +-----------------------+-----------------------+-----------------------+ | Christine | **Breast cancer and | Risk increases with | | | risk factors for | age; about 12% of | | | developing** | cases are diagnosed | | | | in women younger than | | | | 45; 66% | | | | | | | | of new cases are | | | | diagnosed among 55 | | | | and older | | | | | | | | -White women are most | | | | at risk | | | | | | | | -2 genes account for | | | | 5%-10% of breast | | | | cancer in women and | | | | 5%-20% in men | | | | | | | | \- Breast cancer in a | | | | first-degree family | | | | relative especially | | | | before age 50 | | | | increases risk; risk | | | | | | | | is highest if | | | | relative is mother or | | | | sister | | | | | | | | \- history of breast | | | | cancer have increased | | | | risk or subsequent | | | | episode | | | | | | | | \- Exposure to | | | | ionizing radiation to | | | | the chest area as a | | | | child or young adult | | | | increases risk. | | | | | | | | \- Before 12 and | | | | after 55) increased | | | | risk | | | | | | | | -increased breast | | | | density is associated | | | | with higher risk of | | | | breast cancer | | | | | | | | \- increased alcohol | | | | intake (two - five | | | | drinks a day) is | | | | associated with | | | | increased risk | +-----------------------+-----------------------+-----------------------+ | Christine | **Normal vital signs | **Temperature Normal | | | (temperature, heart | Ranges** | | | rate, respiratory | | | | rate, oxygen | -Average temperature | | | saturation, BP for an | range: 36° to 38°C | | | adult** | (96.8° to 100.4°F) | | | | | | | **Positive outcomes | \- Average | | | of values following | oral/tympanic: 37°C | | | interventions** | (98.6°F) | | | | | | | | -Average rectal: | | | | 37.5°C (99.5°F) | | | | | | | | \- Axillary: 36.5°C | | | | (97.7°F) | | | | | | | | -Fever and infection | | | | can influence it, if | | | | the ambient temp is | | | | hot or cold. & | | | | | | | | Also ask if the | | | | patient drank | | | | something hot or | | | | cold. | | | | | | | | **Heart Rate Range** | | | | | | | | -60-100 beats per min | | | | with beats being | | | | strong and regular | | | | | | | | \- Can also be | | | | checked through PMI | | | | (carotid artery. Mid | | | | Clavicular on left | | | | side, 5 | | | | | | | | intercostal spaces | | | | down) | | | | | | | | -Stress, anxiety, | | | | caffeine, and fear | | | | can influence the | | | | rate | | | | | | | | **Respiratory rate | | | | range:** | | | | | | | | -12-20 breaths per | | | | min, deep and regular | | | | | | | | \- In Older patients | | | | respiratory declines | | | | around age 25 | | | | | | | | \- Pain and infection | | | | can increase it | | | | | | | | -Apnea- absence of | | | | breathing | | | | | | | | **Oxygen Saturation** | | | | | | | | -95%-100% is regular | | | | | | | | -Capnography range | | | | (CO2) -- 35-45 mmHG | | | | (amount of CO2 | | | | exhaled) | | | | | | | | -People with COPD | | | | (chronic obstructive | | | | pulmonary disease | | | | range 88%-92%) | | | | | | | | **Blood Pressure | | | | Range for adults | | | | -Measures arterial | | | | walls pressure** | | | | | | | | -Systolic \