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Nursing 1 spring 2016

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front 2	back 2 12 cranial nerves
front 3	back 3 Variations in vital signs
front 4 Normal vital infant	back 4 T - 98.7 -100.5 p- 80-150 rbm - 20-40 bp - 85/37

front 5	back 5 no data
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front 10 Pulse quality	back 10
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front 19 droplet precautions	back 19
front 20 Standard precautions	back 20

front 21 contact precautions	back 21
front 22 Airborne precautions	back 22
front 23 Ppe	back 23
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front 33 A man age 61 years is distraught because he has just learned that his most recent computed tomography (CT) scan shows that his colon cancer has metastasized to his lungs. Which of the following nursing aims should the nurse prioritize in the immediate care of this patient?	back 33 Facilitated Coping
front 34 A student nurse understands that the primary aim of the Healthy People 2020 initiatives is	back 34 health promotion
front 35 The nurse conducts a home safety assessment for a client. Which statement best explains the standard of care being implemented?	back 35 The nurse promotes a safe environment
front 36 The need for university-based nursing education programs was brought to light during which important historical time?	back 36 World War II

front 37 The registered nurse is teaching a community health class about illness prevention. Which of the following statements reflects understanding of this concept?	back 37 "It is important to enroll in a smoking cessation class."
front 38 A: Assessment D: Diagnosis P: Planning I: Implementation E: Evaluation	back 38 Nursing process
front 39 _______—collecting, validating, and communicating of patient data	back 39 Assessing
front 40 ______________—analyzing patient data to identify patient strengths and problems	back 40 Diagnosing

front 41 ________________—specifying patient outcomes and related nursing interventions	back 41 Planning
front 42 ____________________—carrying out the plan of care	back 42 Implementing
front 43 ______________—measuring extent to which patient achieved outcomes	back 43 Evaluating
front 44 Physiologic (Survival): food, fluids, oxygen, elimination, warmth, physical comfort Safety and Security: physical safety and psychological security Love and Belonging: family and significant other Self-esteem: make people feel good about themselves and confident in their abilities Self-actualization: need to grow, change, accomplish goals	back 44 Human Need Maslow

front 45 What is the nurse’s role in the Assessment phase of the Nursing Process? What type of data is collected? What are the different types of Nursing Assessments?	back 45 Assessment
front 46 What is the purpose of the Nursing Diagnosis? How does the nurse develop the Nursing Diagnosis? What is the difference between a Nursing Diagnosis and Medical Diagnosis? What is the difference between an Actual Nursing Diagnosis, Risk Nursing Diagnosis, Possible Nursing Diagnosis, Wellness Diagnosis, and Syndrome Nursing Diagnosis?	back 46 Diagnosis
front 47 Problem --->> Etiology----->> Characteristics OR What is Wrong -------->>Why is Wrong Occurring------->>> How do you Know What is Occurring	back 47 What are the parts of a nursing diagnosis?
front 48 What is the purpose of Planning? How does the nurse prioritize the nursing diagnosis? What is the difference between Short and Long term outcomes (goals)? What is the difference between Cognitive, Psychomotor, and Affective outcomes/goals?	back 48 Planning/Outcome identification

front 49 S: Specific M: Measurable A: Achievable R: Realistic T: Timely	back 49 How are Outcomes/Goals written?
front 50 Assessment is done Diagnosis is developed Goal is identified Now to develop the interventions that will meet the goals	back 50 Implementation
front 51 Determine the patient’s new or continuing need for assistance. Promote self-care. Assist the patient to achieve valued health outcomes.	back 51 Implementing the care plan
front 52 Developmental stage Psychosocial background	back 52 Patient variables

front 53 Resources Current standards of care Research findings Ethical and legal guides to practice	back 53 Nurse variables
front 54 Cognitive—increase in patient knowledge Psychomotor—patient’s achievement of new skills Affective—changes in patient values, beliefs, and attitudes Physiologic—physical changes in the patient	back 54 4 Types of outcomes
front 55 Delete or modify the nursing diagnosis. Make the outcome statement more realistic. Increase the complexity of the outcome statement. Adjust time criteria in outcome statement. Change nursing interventions	back 55 Revisions in the Care Plan
front 56 How do you know the problem is occurring (Hint: objective and subjective data)? Develop (1) SMART goal Try an intervention	back 56 what is the cause (etiology) of the problem?

front 57 no data	back 57 Mr. Smith is a 68 year old male who is post op day 4 from right hip replacement. Prior to surgery Mr. Smith was active and completed all ADLS independently. Mr. Smith’s physician ordered to resume is home medications; Lipitor (cholesterol med) and Lopressor (heart medication) and also added Percocet 4 times a day PRN pain and Protonix (anti ulcer medication). Mr. Smith states that he has not moved his bowels since surgery.
front 58 no data	back 58 You are developing the plan of care for Mr. Smith who was admitted 3 days ago after a stroke. Assessment findings include CN X deficit, hoarse voice, and left sided hemiplegia. Mr. Smith is married, with three adult daughters and is a retired school teacher. Vital signs: BP 128/78 HR 88 RR 16 equal and unlabored and Temp 98.7 F (oral)
front 59 no data	back 59 You are revising the plan of care for Mr. Smith, who had a stroke 5 days ago. Assessment: lung sounds crackles in right lower base, “wet” voice. BP 136/80 RR 22 equal, unlabored, HR 92, T 99.8 F (axillary).
front 60 ______________—a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity	back 60 Health

front 61 _________________—the unique response of a person to a disease; an abnormal process involving changed level of functioning	back 61 Illness
front 62 _____________—an active state of being healthy by living a lifestyle promoting good physical, mental, and emotional health	back 62 Wellness
front 63 Physical: genetic inheritance, age, developmental level, race, gender Emotional: stress, emotional intelligence Intellectual: cognitive abilities, educational background, past experiences Environmental: housing, sanitation, food, water, air Sociocultural: culture, economic level, family Spiritual: beliefs, morals, values	back 63 Interdependent parts that make up the whole person, influences illness and illness behaviors
front 64 Physiological needs Safety and security needs Love and belonging needs Self-esteem needs Self-actualization needs	back 64 Basic human needs

front 65 Answer: C. Pneumonia Rationale: Pneumonia is an acute illness that has a rapid onset of symptoms and lasts only a relatively short time. Diabetes, rheumatoid arthritis, and osteoporosis are chronic illnesses that cause a permanent change, require special patient education for rehabilitation, and require a long period of care or support.	back 65 Which of the following is an example of an acute illness? A. Diabetes B. Rheumatoid arthritis C. Pneumonia D. Osteoporosis
front 66 Generally has a rapid onset of symptoms and lasts only a relatively short time Examples: appendicitis, pneumonia, diarrhea, common cold	back 66 Acute illness
front 67 A broad term that encompasses many different physical and mental alterations in health Examples: diabetes mellitus, lung disease, arthritis, lupus	back 67 Chronic Illness
front 68 It is a permanent change. It causes, or is caused by, irreversible alterations in normal anatomy and physiology. It requires special patient education for rehabilitation. It requires a long period of care or support.	back 68 Characteristics of chronic illness

front 69 Experiencing symptoms Assuming the sick role Assuming a dependent role Achieving recovery and rehabilitation	back 69 Stages of Illness behavior
front 70 Tell whether the following statement is true or false. A person who is experiencing a productive cough and fever takes a sick day to recuperate and decide whether to make an appointment with the doctor. Which stage of illness behavior is the patient experiencing? Experiencing symptoms Assuming the sick role Assuming a dependent role Achieving recovery and rehabilitation	back 70 Answer: B. Assuming the sick role A person who defines himself as sick and self-medicates or visits a doctor is said to be in stage 2 of illness behavior: assuming the sick role.
front 71 Factors that the client cannot change Age Gender Race Family History	back 71 non modifiable risk factors
front 72 Factors that the client can change Health habits Lifestyle Environment Physiologic	back 72 Modifiable risk factors

front 73 ______________: the behavior of an individual that is motivated by a personal desire to increase well-being and health potential. Education is a health promotion activity.	back 73 Health Promotion
front 74 _________________: the behavior motivated by a desire to avoid or detect disease or to maintain functioning with the constraints of illness or disease. A diabetic patient looks at the soles of his feet with a mirror weekly	back 74 Illness Prevention
front 75 _______ directed to health promotion and the preventing the development of disease; interventions that prevent actual occurrence of a specific illness or disease; may focus on individuals or groups.	back 75 Primary
front 76 ______________ focuses on screening for early detection of disease with prompt diagnosis and treatment	back 76 Secondary

front 77 _____________ directed towards recovery or rehabilitation of a disease or illness has developed	back 77 Tertiary
front 78 1.) A nurse is administrating immunizations at a back to school fair. 2.) The nurse is performing a skin assessment for a patient that works outside in the sun. 3.) A nurse is monitoring the progress of a patient participating in Cardiac Rehab.	back 78 Primary Secondary Teriary
front 79 1.) A nurse is teaching a class on Heart Healthy Nutrition to a group of middle aged adults 2.) The nurse is completing the health assessment on a patient that includes cholesterol screening and blood pressure measurements. 3.) The nurse is teaching the patient how to take the prescribed cholesterol medicine and dietary restrictions.	back 79 Primary Secondary Teriary
front 80 ______ Weight loss, diet, exercise, smoking cessation _________ Screenings, examinations, family counseling _________ Medications, surgical treatment, occupational therapy	back 80 Primary Secondary Teriary

front 81 Which of the following is an example of a nursing activity that promotes secondary prevention as a level of preventive care? A. Conducting a smoking cessation class B. Performing a blood pressure screening at a local mall C. Performing range-of-motion exercises on a bedridden patient D. Promoting safer sex practices in school settings	back 81 Answer: B. Performing a blood pressure screening at a local mall Rationale: Secondary preventive care focuses on early detection of disease, such as the heart disease in this example. Primary preventive care is directed toward promoting health and preventing diseases. Tertiary care begins after an illness is diagnosed to reduce disability and rehabilitate patients.
front 82 Care must be sensitive to needs of individuals, families, or groups from diverse cultures. The healthcare system is a culture with customs, rules, values, and a language of its own. Nursing is the largest subculture of the healthcare system.	back 82 culturally competent nursing care
front 83 Cultural background of each participant Expectations and beliefs of each person about healthcare Cultural context of the encounter Degree of agreement between the sets of beliefs and values of the two persons	back 83 Factors That Affect Culturally Diverse Interactions
front 84 Varying cultures Racial and ethnic origin Religion Physical size, age, and gender Sexual orientation Disability Socioeconomic and occupational status Geographical location	back 84 Cultural Diversity

front 85 Shared system of beliefs, values, and behavioral expectations Provides social structure for daily living Defines roles and interactions with others and in families and communities Apparent in the attitudes and institutions unique to the culture	back 85 Culture
front 86 Large group of people who are members of a larger cultural group Have certain ethnic, occupational, or physical characteristics not common to the larger culture	back 86 Subculture
front 87 _________________ (usually largest group) Group has the most authority to control values and sanctions of society _________ (smaller group) A physical or cultural characteristic identifies the people as different than dominant group	back 87 Dominant Group Minority group
front 88 ______________ Minorities living within a dominant group lose the characteristics that made them different Values replaced by those of dominant culture	back 88 Cultural Assimilation (acculturation)

front 89 _____________ The feelings a person experiences when placed in a different culture May result in psychological discomfort or disturbances	back 89 Culture shock
front 90 Belief that everyone should conform to the majority belief system	back 90 Cultural Imposition
front 91 Ignores differences and proceeds as if they did not exist	back 91 Cultural Blindness
front 92 Belief that one’s ideas, beliefs, and practice are the best or superior, or are most preferred to those of others	back 92 Ethnocentrism

front 93 Sense of identification with a collective cultural group Largely based on group’s common heritage Race Typically based on specific characteristics Skin pigmentation, body stature, facial features, hair texture	back 93 Ethnicity
front 94 One assumes that all members of a culture or ethnic group act alike May be positive or negative Negative includes racism, ageism, and sexism	back 94 Stereotyping
front 95 People become aware of differences and feel threatened Response—ridiculing beliefs and traditions of others to make themselves feel more secure	back 95 Culture conflict
front 96 Physiologic variations Reactions to pain Mental health Gender roles Language and communication Orientation to space and time Food and nutrition Family support Socioeconomic factors	back 96 cultural influences in health care

front 97 Develop cultural self-awareness. Develop cultural knowledge. Accommodate cultural practices in healthcare. Respect culturally based family roles. Avoid mandating change. Seek cultural assistance.	back 97 Guidelines for Providing Culturally Competent Nursing Care
front 98 Recognize each person holds various beliefs about pain. Respect the patient’s right to respond to pain in his own fashion. Never stereotype a patient’s responses to pain based on his culture	back 98 Culturally Sensitive Nursing Care—Patient in Pain
front 99 Infectious agent—bacteria, viruses, fungi Reservoir—natural habitat of the organism Portal of exit—point of escape for the organism Means of transmission—direct contact, indirect contact, airborne route Portal of entry—point at which organisms enter a new host Susceptible host—must overcome resistance mounted by host’s defenses	back 99 Components of the Infection Cycle
front 100 Bacteria—most significant and most prevalent in hospital settings Spherical (cocci), rod shaped (bacilli), corkscrew shaped (spirochetes) Gram positive or gram negative—based on reaction to Gram stain Aerobic or anaerobic—based on need for oxygen Virus—smallest of all microorganisms Fungi—plantlike organisms present in air, soil, and water Parasites—live in or on a host	back 100 Infectious Agents

front 101 Number of organisms Virulence Competence of person’s immune system Length and intimacy of contact between person and microorganism Infection VS. Colonization	back 101 Factors Affecting Potential to Produce Disease
front 102 Other humans Animals Soil Food, water, milk Inanimate objects	back 102 Possible Reservoirs for Microorganisms
front 103 Respiratory Gastrointestinal Genitourinary tracts Breaks in skin Blood and tissue	back 103 Common portals of exit
front 104 Contact Direct Indirect Vectors Air	back 104 Means of transmission

front 105 Incubation period—organisms growing and multiplying Prodromal stage—person is most infectious, vague and nonspecific signs of disease Full stage of illness—presence of specific signs and symptoms of disease Convalescent period—recovery from the infection	back 105 Stages of infection
front 106 Body’s normal flora Inflammatory response Immune response	back 106 Body’s Defense Against Infection
front 107 Intact skin and mucous membranes Normal pH levels Body’s white blood cells Age, sex, race, hereditary factors Immunization, natural or acquired Fatigue, climate, nutritional and general health status Stress Use of invasive or indwelling medical devices	back 107 Factors Affecting Host Susceptibility
front 108 Elevated white blood cell count—normal is 5,000 to 10,000/mm3 Increase in specific types of white blood cells Presence of pathogen in urine, blood, sputum, or draining cultures	back 108 Laboratory Data Indicating Infection

front 109 Includes all activities to prevent or break the chain of infection Two categories Medical asepsis—clean technique Surgical asepsis—sterile technique	back 109 Aseptic Technique
front 110 Use of invasive medical devices Antibiotic-resistant organisms developed in hospitals	back 110 Factors Predisposing Patients to Nosocomial Infections
front 111 HAND HYGIENE Constant surveillance by infection-control committees and nurse epidemiologists Written infection-prevention practices for all agency personnel Infection control precaution techniques Keeping patient in best possible physical condition	back 111 Measures to Reduce Incidence of Nosocomial Infections
front 112 what does the state's nurse practice act do?	back 112 establishes the criteria for the education & licensure of its nurses enforces rules for the profession legally determines what who can and cannot do.

front 113 what phenomena underlies the present and predicted nursing shortage in the US?	back 113 aging of the population increased prevalence of chronic illness increased prevalence of disabilities
front 114 Florence Nightingale	back 114 is known as founder of modern nursing created free standing nursing education
front 115 Clara Barton	back 115 is known for organizing hospitals and nurses created the American Red Cross in 1882
front 116 Dorothea Dix	back 116 is known for she reformed treatment for the mentally ill.

front 117 Linda Richards	back 117 is known for the first trained nurse in the USA began the process of record keeping and writing orders
front 118 Lillian Ward	back 118 is Known for the founder of public health nursing
front 119 Marya Elizabeth Mahoney	back 119 is known for the first African-American nurse
front 120 Nora Gertrude Livingston	back 120 is known for established the first 3 year nursing program in North America

front 121 Isabel Hampton Robb	back 121 is known for founder of the ANA -American Nurses Association
front 122 Mary Adelaide Nutting	back 122 is known for: published the History of Nursing
front 123 Mary Breckinridge	back 123 is known for: established the first midwifery school in the US - Frontier Nursing Service
front 124 Margaret Sanger	back 124 is known for: founded Planned Parenthood

front 125 name the 4 essential competencies nurses use:	back 125 cognitive technical interpersonal ethical/legal skills
front 126 define cognitive competency:	back 126 offer a a scientific rationale for a patient's plan of care select interventions that are most likely to yield the desired outcomes use critical thinking to solve problems creatively.
front 127 define technical competency	back 127 the ability to use and creatively adapt technical equipment
front 128 define interpersonal competency	back 128 interact with patients elicit their strengths and abilities work collaboratively with other members of the healthcare team

front 129 In what culture is good health achieved by the proper balance of yin and yang	back 129 Asian
front 130 In what culture do granny women or folk healers provide care and may be consulted even if the patient is also receiving traditional care	back 130 Appalachian
front 131 In what culture is self- diagnosis and use of over the counter medication often used, also dieting and extensive use of exercise are common	back 131 White middle class
front 132 In what culture is the patient's illness viewed as part of the whole. emphasis is placed on preventive medicine	back 132 Hawaiian

front 133 In what culture may a patient refuse to allow the nurse to draw blood for a test- because he believes blood is the body's life force and cannot be regenerate	back 133 Asian
front 134 What is the most basic culturallly competent nursing care	back 134 Treating each person as an individual
front 135 What disorder might you screen for in an African American man	back 135 Keloid formations, hp, stroke and sickle cell anemia
front 136 Held the belief that illness was caused by sin and the gods' displeasure; theory of Animism	back 136 Pre civilized nursing

front 137 The roles of the physician and the nurse were separate and distinct.	back 137 Physician= Medicine man who treated dz with chanting , inspiring fear, opening the skull to release evil spirits. Nurse= the mother who cared for her family during sickness by providing physical care and herbal remedies.
front 138 Theory of Animism	back 138 The belief that everything in nature was alive with invisible forces and endowed power. Good spirits brought health; evil spirits brought sickness and death.
front 139 Early Civilization Nursing	back 139 Temples became centers of medical care because of belief that illness was caused by sin and was the gods' punishment. Religion played a major focus in healthcare Physicians= highly regarded Nurses= slaves; neither women nor human life was valued by society During this time period, the Hebrews developed rules through the Ten Commandments and the Mosaic Health Code for ethical human relationships, mental health and disease control Nurses cared for the sick in the community and in the home, as well as midwives.