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Hondros- Nursing 160 exam 1 Questions and Answers 100% correct
3 routes of drug administration 1. Enteral 2. percutaneous 3. Parenteral Enteral referring to a route of medication administration that uses the... [Show More] GI tract *oral *rectal *NG tube Parenteral bypasses the GI tract *subQ *IM *IV Percutaneous absorbed through skin or mucous membranes *inhalation *topical *sublingual Absorption The process by which nutrient molecules pass through the wall of the digestive system into the blood. Distribution drug is transported through the body by body fluids (bloodstream) or lymphatic system Metabolism where your body is going to breakdown and inactivate drugs *primary site is the liver Excretion elimination of the drug *GI tract(feces) *Renal tubules into the urine *skin, lungs, saliva, breastmilk half-life The amount of time it takes for 50% of elimination from the body why do we use opioids? *acute pain=surgery *chronic pain=cancer *use only in moderate to severe pain *can lead to addiction Opiate side effects constipation, dry mouth, N/V, sweating, confusion, orthostatic hypotension Serious Adverse effects respiratory depression, excessive use/abuse, CNS depression how to monitor pts that take opioids? *pain assessments *goals *observe resp rate *adm small dose just culture seeks to find a balance between the need to learn from mistakes and the need for disciplinary action against employees morphine(G) mscontin(T) *opiate *schedule 2 *side effects: drowsiness, dizziness, anxiety, itching *binds to receptors in the brain to decrease pain. Oxycodone(G) Percoet(T) *opiate *schedule 2 *side effects: drowsiness, dizziness, anxiety, itching *binds to receptors in the brain to decrease pain. Acetaminophen(G) Tylenol(T) *analgesis , antipyretic *BBW: liver failure *side effects: hepatic, jaundice acetaminophen & hydrocodone(G) Norco(T) *opiate *schedule 2 *side effects: drowsiness, dizziness, anxiety, itching *binds to receptors in the brain to decrease pain. what to be aware of with ppl with poor vision? *safety *quality of life *delays in school Cataracts *Clouding of the lens of the eye. *caused by toxins, trauma, drugs Cataracts symptoms blurred vision, diplopia, cant read fine print; Glaucoma increased intraocular pressure results in damage to the retina and optic nerve with loss of vision open angle glaucoma 90% of cases; drainage channels become clogged (slow) closed angle glaucoma related to a medication that has been take and its a rapid vision loss Glaucoma symptoms headaches, eye pain, seeing halos around lights, blurred vision, high IOP Glaucoma treatment beta blockers to reduce IOP, medical marjuania *tonometry testing (small puff of air) age-related macular degeneration condition in which the center of the retina gradually loses its ability to discern fine details; risk factors for ARMD Family history. Long term exposure to UV light, females, obesity, caucasian, Smoking, light colored eyes. Opthalmascopy magnifying tool that allows doctors to see inside back of eye. diabetic retinopathy caused when high blood sugar levels cause damage to the blood vessels of the retina parethesia feeling of numbness and tingling in the hands and feet. what are some steps we can take to lower our risk of developing cancer? primary 1. smoking 2. change our diet 3. UV radiation 4. alcohol 5. environmental & chemical carcinogens cancer secondary prevention *mammograms *prostate exam *colonscopy neoplasm new growth (of abnormal tissue, benign or malignant) benign mild, not cancerous *slow and steady *resembles pavent tissue *rarely fatal Malignant abnormal cells that are dividing uncontrollably & destroying body tissues. *metastasize *immobile when palpated TNM classification T: primary tumor N: reginal lymph nodes M: distant metastasis Stage 0 cancer cancer in situ Stage 1 cancer localized to one region stage 2 cancer limited local spread stage 3 cancer excessive local spread stage 4 cancer metastasis- gone to other areas of the body tissue biopsy removing a small piece of tissue for microscopic exam Diagnostic imaging xray, CT, MRI, mammograms lab work specially called tumor markers. Not a normal part of routine lab work. [Show Less]
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HONDROS NUR 150 - EXAM 1 Questions and Answers 100% correct
(S) in SBAR Situation (B) in SBAR Background (A) in SBAR Assessment (R) in SBAR Recommendation The single most important an... [Show More] d preventative technique that healthcare workers can use to interrupt the infectious process is doing what? Handwashing PPE stands for? personal protective equipment A type bath used to reduce inflammation in the perineal/anal area Sits Bath A type of bath that is used to reduce fever. Tepid bath A type of bath that is used to reduce tension and to relax patient, as well as to relieve priorities caused by certain skin conditions Medicated Bath First sequence in DONNING PPE Gown Second sequence in DONNING PPE Mask Third sequence in DONNING PPE Goggles Fourth sequence in DONNING PPE Gloves What is the full Sequence of DONNING PPE Gown, Mask, Goggles, Gloves What is the full sequence of DOFFING PPE Gloves, Goggles, Gown, Mask First sequence in DOFFING PPE Gloves Second sequence in DOFFING PP Goggles Third sequence in DOFFING PPE Gown Fourth sequence in DOFFING PPE Mask Standard precautions should be used for ________ patients. ALL patients National Patient Safety Goals: Long Term Care Facilities 1. Identify Residents Correctly 2. Use Medicine Safely 3. Prevent Infections 4. Prevent Residents From Falling 5. Prevent Bed Sores National Patient Safety Goals: Hospital 1. Identify patients correctly 2. Improve Staff Communication 3. Use medications safely 4. Use alarms safely 5. Prevent Infection 6. Identify patient safety risks 7. prevent mistakes in surgery bottom blood pressure number diastolic top blood pressure number systolic HAI stands for what? hospital acquired infection CAUTI stands for what? Catheter Associated Urinary Tract Infection Chain of Infection: First Sequence Infectious Agent Chain of Infection: Second Sequence Resevoir Chain of Infection: Third Sequence Portal of Exit Chain of Infection: Fourth Sequence Mode of transmission Chain of Infection: Fifth Sequence Portal of Entry Chain of Infection: Sixth Sequence Susceptible Host Remove patient restraints every... 2 hours Where is the preferred place to take a pulse on an unresponsive patient? Carotid Where is the preferred place to take a pulse in a routine situation? Radial What is patient centered care? providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions Ohio Nurse Practice Act It authorizes the OBN (Ohio Board Of Nursing) to make and enforce rules and regulations HIPPA (Health Insurance Portability and Accountability Act) a federal law that sets standards for protecting the privacy of patients' health information Normal pulse/HR rate 60-100 beats per minute [Show Less]
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Nursing 155 final hondros Questions and Answers 100% correct
Checking accuracy and reliability realizing that something doesn't seem quite right and taking action to determine if it is accurate or not, sounds suspic... [Show More] ious and looking further into it Nursing Process step by step approach directed at planning and providing pt care. Data collection(assessment), Planning, Implementation, Evaluation Nursing process D Data collection- gather and review info about the pt, assessment Nursing process P Planning- development of a nursing dx, goals, and interventions for a pt plan of care. Nursing process I implementation of planned interventions actually carrying out the orders Nursing process E Evaluation- comparing actual outcomes with expected outcomes Tanner's Model of Clinical Judgement A model based on how a nurse thinks, it explains the 4 steps in the critical thinking process that nurses use to solve any problem: Noticing Interpereting Responding Reflecting Step 1 Noticing -Identifying signs and symptoms -gathering complete and accurate data -assessing systematically and comprehensivly -predicting and (managing) potential complications -identifying assumptions Identifying signs and symptoms Indicates when a situation is normal, abnormal, or has changed, something is different than expected Gathering complete and accurate data Data collected from all available sources is used as the basis for identifying issues, problems, concerns. Must verify that data is complete and accurate Assessing systematically and comprehensively A method of assessing information or data so nothing is omitted or forgotten. Focused, head to toe, body systems Predicting (and managing) potential complications Look at the big picture to prepare for potential future complications for an individual pt, you are predicting complications which means you are identifying possible problems. What will put our pt at risk ex.recognize that all pt have risk for atelectasis after surgery Identifying assumptions Recognize information taken for granted, hastily arriving at a conclusion without supporting evidence, a misconception. EVIDENCE ex. all thin people are healthy Step 2- Interpreting -clustering related information -recognizing inconsistencies -checking accuracy and reliability -Distinguishing relevant from irrelevant -determining the importance of information -comparing and contrasting -(predicting) and managing potential complications -judging how much ambiguity is acceptable -using legal, ethical and professional HERE WE- PLANNING, PRIORITIZE, DESICIONS WHAT ARE YOU GOING DO WITH THE DATA YOU RECIEVE, MAKE SENCE OF THE DATA* Clustering related information Grouping together information with a common theme. A method of organizing data so that you put .things together in order to understand the situation, what is alike ex. headache-clustering orther related sx-sleepy, hit head, dizziness Recognizing inconsistencies does the objective data match the subjective data ex. pt says they aren't in pain but face is telling you diff. they are grimacing, clinching fists, tearful, holding their side Distinguishing relevant from irrelevant decidingco what information is pertinent or connects to the matter at hand, sort out what info relates to the current problem ex. pt tells cardiologist my back hurts may be important to pt overall care but not the current problem Comparing and contrasting looking at 2 similar cases, identifying the subtle differences, and acting on them ex. pts both have arthritis look at similarities and subtle differences (Predicting) and managing potential complications look at big picture figure our possible complications for and individual pt. must know common complications and consider individual differences. Interpreting- you are planning interventions to help manage or reduce the risk of complications ex. plan interventions to reduce atelectasis and pneumonia- encourage use of incentive spirometer, ambulation schedule. ex. pt fall risk. plan for bed down, toileting assisted, socks with grips Judging how much ambiguity is acceptable - unclear, uncertain, or vague situation. how much wiggle room do you have when applying a rule to a particular situation. look at pt situations and assessment data to determine if assessment measures are acceptable for that particular pt ex. pt flu and temp 100.2, although temp above norm, this temp is ok based on the specific situation Using legal ethical professional guidelines nurses must consider legal ethical and professional guidline when providing care. work in guidelines of the states nurse practice act as well as make judgments that are ethical and professional ex. HIPAA Step 3- Responding -setting priorities -delegating what a nurse does*, hand on Setting priorities comparing and sorting through information, ranking it in order of importance to decide what needs to be done first and what can wait ex. triage, prioritize who is in greater more emergent need at that time. pt needs dressing change, bp checked, give bp med, go to toilet 1.toilet- maslow basic need 2.vitals 3. bp med 4. change dressing Delegating asking someone to do part of your job that is not part of their expected job assignment. delegating to a competent UAP make sure willing and able to do the task 5 rights of delegation right task right circumstance ex. no rx for UAP right person ex. competent, experience right direction ex. exact directions right supervision ex check if task done an done correctly 1.Evaluating data (Step 4- Reflecting) after actions and interventions are preformed, assessment data is collected again to determine if the interventions were effective. helps determine what further actions are needed REFLECTION IN ACTION ex. pt 8/10 pain Demerol given at 3;30 IM 25mg, check back 45-1hr, check pain level again and maybe vitals Evaluating and correcting thinking reflecting on what just happened , how the situation was handled,, what lessons can be learned for use in similar situations in the future. how were the results, what could be done better. REFLECTION ON ACTION ex.code blue, came back to life, sent to icu, reflection on this what could have been done better, what was done good Brenners stages of clinical competance 1. novice 2. advanced beginner 3. competent 4. proficient 5. the expert Novice beginner no experience in situation, lack confidence to demonstrate safe practice and requires continual verbal and physical cues Advanced beginner demonstrate marginally acceptable performance because nurse has had prior experience in actual situations, efficient and skillfull in parts of the practice with occasional supportive cues,, knowledge developing Competant nurse on the job who has been on the same or similar situations for 2-3 years, demonstrates efficiency and has confidence in her actions Proficient perceives situations as a whole rather than chopped up parts the expert intuitive grasp of each situation , deep understanding of the total picture, fluid and flexible and highly proficient Maslow's Hierarchy of Needs (level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization physiological needs the most basic human needs to be satisfied- water, food, shelter, and clothing Safety and security security, freedom from harm, and protection love and belonging love, effection and companionship ex, does pt have support for when leave hospital [Show Less]
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Hondros 200 rn quiz 2 questions and answers 100% correct
Checking accuracy and reliability Actions based on inaccurate or unreliable information could cause patient harm Comparing and Contrasting the pro... [Show More] cess of looking for similarities and differences between situations Clustering related information Grouping together information with a common theme to determine issues, problems, or concerns. Recognizing inconsistencies realizing when pieces of information contradict each other Distinguishing relevant from irrelevant Deciding what information is pertinent to the patient Determining the importance of information Ability to determine importance or significance of patient information to current situation Judging how much ambiguity is acceptable Nursing judgement based on acceptable normal ranges may vary depending on a patient situation Determining legal, ethical, and professional guidelines Made with ethical, legal and professional guidelines Managing potential complications Planned nursing interventions to decrease the risk of future complications. Identifying signs and symptoms Indicates when a situation is normal, abnormal, or has changed. Gathering complete and accurate data Data collected from all available sources is used as the basis for identifying issues, problems, and concerns Assessing systematically and comprehensively Use a systematic method of assessment so no important information is missed Predicting (and managing) potential complications Look at the big picture to prepare for potential future complications Identifying assumptions Arriving at a conclusion without supporting evidence Nursing Process five-step systematic method for giving patient care; involves assessing, diagnosing, planning, implementing, and evaluating Aces tool Assess function/expectation Coordinate/manage care use Evolving knowledge make Situational decisions Planning matches with? Interpreting Diagnosing matches with? Interpreting Assessing matches with? Noticing (recognizing cues) Evaluating matches with? Reflecting (evaluate the outcome) Competent nurse has been practicing for 2-3 years; can prioritize and cope with various contingencies; requires assistance working through various situations not yet experienced proficient nurse understands a patient situation as a whole rather than as a list of tasks, attends to an assessment data pattern, and acts without consciously labeling it PQRST provocative quality region/radiation severity timing Responding aligns with? Implementing (carry out the plan) Interpreting aligns with? Diagnosing/planning Noticing aligns with? Assessment Expert nurse They make decisions using an advanced level of intuition and analytical ability. They do not need to rely on rules to comprehend a situation and take action. impartial Principle of justice, what is ethically right! Reflecting aligns with? Evaluating SBAR Situation Background Assessment Recommendation Six types of coordination Care coordination Case management Care management Discharged planning Integrated care Medical home care KATZ tool Used for lower function of patients similar to adls self-management Patient engagement (plan of care) prioritize things. SPICES tool Sleep disorders Problems with eating or feeding Incontinence Confusion Evidence of falls Skin breakdown Types of Assessment -the patient-centered interview during a nursing health history. -a physical examination. -the periodic assessments you make during rounding or administering care. American Nurses Association (ANA) Professional organization that represents all registered nurses. emanating Any substance that flows out/ comes from a source of origin. Implementing match with? Responding (take action) Diagnosing match with? Interpreting 4 effective communication skills (4 c's) Courtesy Comfort Connection Confirm 9 parts of interpreting Interpreting: thinking skills 1. Comparing and Contrasting 2. Clustering Related Information 3. Recognizing Inconsistencies 4. Checking Accuracy and Reliability 5. Distinguishing Relevant From Irrelevant 6. Determining the Importance of Information 7. Judging How Much Ambiguity Is Acceptable 8. Determining Legal, Ethical, Professional Guidelines 9. (Predicting and) *Managing Potential Complications nursing scope of practice Tasks or procedures that the nurse can perform within the state the nurse is working in. clinical judgement an interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response clinical thinking the ability to interpret arguments, evidence, raw information in a logical and unbiased fashion (problem solve) Attributes of a nurse [Show Less]
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Hondros Nurse 172 IV Therapy First exam Questions and Answers 100% correct
Beneficence Doing good for all patients Gauge Size of cannula opening; standard of measurement PICC Peripherally inserted central catheter... [Show More] . (LPN's can monitor but cannot flush) Micro drip Administration set that delivers small amounts of I.V solutions; Drop factor of 60 gtt/ml Filter A special porous device used for eliminating certain elements, as in particles of a certain size in solution. Fidelity Obligation to be faithful Drip Chamber Area of intravenous administration set usually found under the spike where the solution drips and collects before running through the tubing. Veracity Truthfulness Autonomy Right of self determination independence Justice Obligation to be fair to patients PCA pump Patient controlled analgesia (Pain pump) only the patient can push the button. Radiopaque Material used in IV catheter identified by radiographic Non-Maleficence Avoidance of harm Confidentiality Protecting privacy What do you need to do to a nitroglycerine bottle before administering? Vent the bottle Where is an IVPB( Iv piggyback) located ? Above primary infusion, also called secondary bag Which line is longer, primary or secondary ? Primary is much longer What is a gravity hook? What is it used for? Used to hang IVPB, looks like a coat hanger Back Filter purpose? Prevents IV fluid from traveling backwards Stop gauge/ Stop cock purpose? Stops IV fluids. When do you change blood tubing, TPN, and Lipids? 24 hours What is priming the line? Removing air bubbles from line to decrease the chance of air embolism What is the standard IV changing time? 72 hours 5 reasons that the IV pump alarm would be going off? 1. Air in line 2. occlusion 3. Infusion complete 4. dead battery 5. kinked What does NS stand for? Normal Saline IV 1000ml of LR (lactated ringer) infused over 12 hours, gtt factor is 20gtt/ml. what is the ml/hr? 83 ml/hr 3 goals of parenteral therapy? 1. Replacement 2. maintenance 3.restore electrolytes A pt has low potassium and getting 20meq K+ IV, someone with burns? Look at cardiac, look at veins. Check IV site, check tissue integrity around site Doc orders D5W, IV is way behind, Pt did not get required amount. What do you do ? Check IV site, Check pump, Call doc and explain Solution ordered to replace fluid loss? Lactated ringer Pt with IV running at 125ml/hr, begin to experience SOB, pulse of 91%. What do you do? Slow down IV and Call doc Pt with a PCA pump, respirations 8 and still dropping what do you do? STOP Iv and call doc. Pt 17 years old comes through the ED, RN asks you to start an IV, what do you say? NO , pt is to young During spiking and priming, your finger touches the spike, what do you do? Change everything Micro drip Little wire, small drips around 60gtt/ml MAcro drip No wire, easy to see drops, drops around 15-20 gtt/ml The UAP can do what when it comes to IV pump? Tell LPN when pump alarm is alarming Searching for scope of practice, where do you look? Ohio board of nursing (OBN) What is Y tubing? Blood tubing, we do not use this. IVPB or primary tubing is how long? 30-36 inches MOST COMMON NEEDLE? Over the needle catheter Autonomy means.. You are responsible for any med given by you. What health care law give the pt the right to chose if they want to have surgery or not? Patient determination Which needle gauge is smaller, 28 or 18? 18 gauge If not familiar with an electronic infusion pump, what should you do? Look up instructions in manual, ask RN for directions 1. put in IV and got blood flash back, 2. advance catheter and release tourniquet, 3rd...? TAKE THE NEEDLE OUT** 4 NPSG (National patient safety goals) 1. Identify pt correctly before med/IV (2 identifiers) 2. Improve staff communication 3. Use meds safely 4. Prevent infection Malpractice 1. Duty to Pt 2. Pt suffered actual hard 3. casual relationship between care 4. breech of care was established What are 3 purposes of the Electro metric pump, metric infusion system? 1. Antibiotic therapy 2. Chemo 3. Analgesic Back check valve (Function and Location) Prevents backflow of solution, located on primary line of drip chamber The percentage of fluid in total body weight in men? 60% The percentage of fluid in total body weight in women? 50-55% The 2 main electrolytes in the body ? Na + and K + Electrolyte that retains fluid, causes CHF? Sodium [Show Less]
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Hondros Nur 205 Exam 1Questions and Answers 2023
Care Coordination a process connecting both services and resources involving patient, providers and families with the goals of optimal patient outcomes ... [Show More] Classification of safety events Never miss event-error that could have caused harm but didn't Adverse event-error that results in moderate to sever harm (medication administration) Sentinel event- serious error that results in patient death Fidelity Act in ways that are loyal keeping promises doing what is expected of you performing your duties and being trustworthy Justice treating people equitably fairly and appropriately Beneficence obligation to do good by acting in ways the promote the welfare and best interest of others Nonmaleficence Act to avoid harm to others inflicting the least harm possible to reach a beneficial outcome. Respect for person's treat with respect dignity and value, always tell the truth Leadership interactive process that provides necessary guidance and direction three attributes are leader follower and situation Attributes of a leader vision-statement of desired goal communication-function to be effective on going conversation decision making-critical feature of a good leader social power-influence over another collaboration-teamwork ethical-right vs wrong Forms of Leaders autocratic-makes all decisions wants to accomplish goal democratic-involve their followers in decisions Laissez faire- do not interfere with followers transactional-focus on daily operations of organization authentic-helps followers adjust to follow new roles shared- followers share leadership responsibilities Code of Ethics concepts of right and wrong foundation for morality and moral behavior Influenced by families, beliefs,values and ideas Ethical Principals respect for persons nonmaleficence beneficence justice and fidelity Clinical Judgement a conclusion or interpretation about a patients need, concerns,or problems and the response taken to modify the issue RN decides what data is to be collected, makes interpretation of data, arrives at a nursing diagnosis and identifies appropriate nursing actions Health Care Quality those who want healthcare should have access to healthcare Attributes- safe, effective, timely,patient centered, efficient, and equitable Professional Identity sense of self influenced by characteristics, norms, and values of the nursing discipline that result in individual thinking acting and feeling like a RN Attributes of professional identity doing, being, acting ethically, flourishing, changing identifies Prioritization to decide which patient needs or problems require immediate attention and what can be delayed 3 levels of priority ABC's, VS, mental status, other health problems 4 P's of delegation purpose for the care picture of the patients current condition plan or envision outcomes of care Part played by each team member Delegation Transferring a selected nursing task to a competent individual that falls within their scope of practice. The RN retains accountability for delegation of the task and care provided RN obligated to delegate based on prioritization of clinical situation, pt situation, personnel available and must provide ongoing assessment Negligence Failure to use reasonable prudent care in the smart to similar circumstances ties in with healthcare law or tort law Elements that must occur to establish liability of negligence Duty-professional duty of reasonable care to pt that a reasonable prudent nurse would perform in same circumstance Breach of Duty-falling below standard of care causing injury Causation-breach of care causing direct harm Injury/harm- may be physical or combination of physical mental emotional or financial Nurse Practice Act Permits individual to obtain licensure to perform professional duties based on demonstrated qualifications and competency to perform actions which are illegal without a license Scope of Practice Range of permissible activity defined by law or defines what a RN can or cannot do Ex- Ohio board of nursing writes scope of practice for nurses in Ohio Tort Law Most common basis for liability of nurses, physicians, and other health care providers Civil tort is an action or omission that results in harm to a person Unintentional- negligence Intentional-intentionally harming or violating rights Healthcare Law collection of laws having direct impact on delivery of healthcare or between deliverers and recipients of healthcare EX HIPAA 1996 Development complex process of physical, psychological, cognitive and developmental changes through life from birth to death Culture pattern of shared attributes or beliefs self definitions, norms, roles and values that can occur among those who speak a particular language or live in a defined geographical region Spirituality A belief, principle, experience or attitude Nurse should assess and integrate in care by communication and listening skills Involves recognizing honoring beliefs and practices of others Communication Process of interaction using symbols to create, exchange and interpret messages Learned skin develops overtime Complementary exchange-a sender transmitting a message to a receiver Collaboration development of partnerships to achieve best possible outcomes that reflects the particular needs of a patient [Show Less]
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Hondros Nur 176 exam 1 Questions and Answers 100% correct
Interventions to prevent diabetes Maintain healthy weight, diet and exercise Signs of type 1 diabetes 3 polys, blurred vision, cold feet, numbness... [Show More] , shiny thin skin w/ no hair, age 30 and under, sudden onset, underweight, Signs of type 2 diabetes No symptoms at first , later develop the 3 polys, obesity, Nigricans (black line on back of neck) skin tags S/S of hypoglycemia Fatigue, weakness, irritability, reduce cognition, tremors, seizures, diaphoresis( sweating) S/S of hyperglycemia 3 polys, fruity breath S/S of diabetic ketoacidosis and treatment High BS, high HR, restlessness, weight loss, fruity breath, kussmaul(fast deep RR) -- treatments; IV regular insulin First intervention if a pt. Presents with s/s of hypo/hyperglycemia Check blood sugar Prevention of long term complications of diabetes Takes meds, daily feet care, yearly renal test, eye exams every 6 months, LDL less than 150 Dietary teaching for a diabetic patient Meals at the same time every day, decrease saturated fats, increase exercise , refer pt. To MyPlate learning tool, Diabetic Pt. should never increase carbs unless... Sugar is low before exercising Discharge teaching for diabetic pt. Know hypo/hyperglycemia s/s, know that stress and illness increase BS , see a diabetic educator, know what the effect of Exercise can have on Bs Diabetic foot care Clean w/ soap and warm water, clean socks everyday, cut toe nails straight across, keep feet dry, no powder or lotion b/t toes , wear shoes , inspect feet daily, no gardners Lipid analysis LDL-less than 100 HDL- more than 40 Triglycerides- more than 150 What are low and high levels of HDL indicative of High- insulin resistance, low- insulin sensitivity What insulins can not be mixed? Levemir and Lantus ( detemir and glargine ) How to mix insulin Short acting to long acting, regular to NPH, Clear to cloudy Should a nurse hold a patients insulin before consulting a dr? No No insulin, beta cells are destroyed is a result of ? Diabetes type 1 Beta cells exhaustion , insulin resistance is a result of ? Diabetes type 2 Rapid acting insulin Lispro(Humalog) aspart(Novolog) glulisine(Apidra) Onset, peak and duration of Novolog and Apidra Onset-15-30, Peak-1-3hr, duration-3-5hr onset, peak and duration of humalog Onset-15-30, Peak-1-2hr, duration-3-4hr Short acting insulin( regular) Humulin R, Novolin R, ReliOn R, Onset-30-60 , Peak-2-4hr, duration-6-8hr Intermediate insulin (NPH) Humulin N, Novolin N, ReliOn N, Onset-1-4hr Peak-4-12hr, duration-12-16hr Long acting insulin Lantus and levemir Onset-1-2hr, Peak- none, duration-24hr Which insulin is the only one that can be given through IV ? Regular What is glucagon used for? Makes glucose. Received if BS is low If a pt. Is lethargic, what form of glucose should be administered? Glucagon gel in cheek What is Lipohypotrophy and the prevention ? Lump under subcut tissue due to repeated injections at the same site. Rotate sites S/s of brain tumor Vision changes, confusion and headache S/S of traumatic brain injury Blurred vision, personality changes, altered level of consciousness, slurred speech, confusion, headache, uncoordinated, weakness / numbness of legs and arms If someone hit their head, which test should be completed? CT scan to make sure there's no head bleeding Early signs of IICP Altered levels of consciousness Nursing interventions for mannitol & lasix Monitor I&O and electrolytes Nursing interventions for prednisone Monitor blood glucose and daily weight Glasgow coma scale measures .. Eye opening, verbal and motor response. A score less than 8 is considered in a coma S/S of Ischemic strokes 80% have these, trouble talking, Face droop? Arm drift, Slurred speech S/S of hemorrhagic stroke Serve headache, aneurysm rupture from hypertension , *never administer TPA for these strokes What is Aphasia Trouble speaking, expressive, receptive and global Dysphagia precautions No straws , thicken liquids, Steps before administering TPA Do CT scan to verify Ischemic stroke, neurological assessment, make sure they aren't on blood thinners, history of blood disorders Side effects of Lovenox (enoxaparin) Bruising at injection site, dark loose stools , GI bleeding Is Delirium a disease of the CNS ? No S/S of early stage dementia Gradual onset of memory loss, difficulty focusing attention, depression Main goal for dementia patients Maintain self care abilities and prevent injuries Nursing interventions for dementia patients Large clock and calendar, decreased distractions during meals, decreased stimuli, monitor weight How many pain assess menus are done for pt with dementia? 2 Interventions for an agitated dementia pt. Move pt. To a calm environment Reality orientation for dementia pts Be honest, call by preferred name, eye contact, set a routine , simple tasks and directions, familiar objects Safety interventions in the Alzheimer's pt. Calm environment, encourage supervision, allow social and physical activity Med for multiple sclerosis Copaxone Generalized tonic-clonic seizures (grand mal) Most common, stiffening of body for 10-20 sec. then jerking extremities for another 30-40 secs Absence seizures ( petit mal) Occurs during childhood, stares off with little to no tonic-clonic movement Psychomotor (partial seizures) Occurs at any age, pt. Behaves in a drunk manner, doesn't remember Jacksonian-focal seizures ( local or partial) Occur in pts. With structural brain disease, starts in the hands or feet, can turn into tonic-clonic Myoclonic seizures Sudden jerking of body Akinetic seizures Not common, falls in flaccid state, unconscious for 1 or 2 minutes What med will a pt get with new onset seizures? Broad spectrum anti-seizure med Pt education related to seizures Keep long and recorded time and duration, any drowsiness , nausea and vomiting. Discharge education for a pt taking Dilantin Mouth care, avoid alcohol, no driving, use soft tooth brush Seizure disorder interventions Stay with them while they seize, lower them to floor, observe and record, keep them safe, don't force mouth open , turn on side if excessive sputum accumulates What should be determined when assessing meningitis? Viral or bacterial, the specific organism that caused it Bacterial meningitis labs Increase protein, increase WBC , decrease glucose Isolation for meningitis Respiratory droplet, 24 hour isolation after first treatment Age of onset for type 1 diabetes 30 years or younger Age of onset for type 2 diabetes 35 years or older but increasing in children Hyperglycemia Blood glucose levels Higher than 100-140mg/dl Hypoglycemia blood glucose levels Less than 70mg/dl Euglycemia blood glucose level ( normal) 70-100mg/dl Level of Consciousness oriented to 1. Person 2. Person and Place 3. Person Place and Time. 4. Person Place Time and Purpose S/S Intracranial Pressure Increase in systolic b/p widening pulse pressure, bradycardia, irregular breathing pattern page 302 (cooper) Insulin Peptide hormone commonly absorb into patients blood stream. Given subcutaneously. (Also IV mixed with NS) When giving Insulin be careful to only inject into Subcutaneous tissue (between fat and muscle layer) page 1758 (cooper) Intractable Pain that is described as unbearable and does not respond to treatment. Diplopia Double vision NIHSS Stroke scale Characteristics of Parkinson's Disease Blank facial expression, Forward tilt to posture, slow monotonous slurred speech, tremor, short shuffle gait Ischemic Stroke Deficient blood flow to the brain from a partial or complete occlusion of an artery. Either thrombotic or embolic account for 90% of all strokes (cooper 1938) Postictal Period Rest period of a seizures varies in length Epilepsy Chronic two or more unprovoked seizures Seizure A disorder in which nerve cell activity in the brain is disturbed, causing seizures. What is the action of glucagon? Increases blood sugar (blood glucose) What does the nurse record after a seizure? Duration and time, degree of drowsiness afterward, SE of N/V Can we restrain a pt having a seizure? No Can we place something in a pt's mouth to protect their airway? No Phenytoin and pt teaching? Avoid alcohol, good oral hygiene, may have driving restrictions, pt needs to take meds even when seizures stop Why is it important to find pathogen that caused Meningitis? So it can be treated properly meningitis Inflammation of brain and spinal cord membranes, typically caused by an infection. What test is usually done to determine the type of organism in Meningitis? Lumbar puncture Pt teaching about Meningitis? Vaccinations are important; bacterial treated with antibiotics, viral treated with comfort measures If there is suspected bacterial meningitis? Respiratory isolation (droplet) until antibiotic runs for 24 hours Alzheimer's pt and safety Offer social or physical activity as distraction, encourage family and staff supervision, do Not restrain - physically or chemically, maintain calm environment Dementia pt and reality orientation Wall clock and calendar, do not overstimulate, decrees distraction during meals, do NOT put up rails as restraints, monitor weight for changes What do we monitor while pt on Mannitol (osmitrol)? I/O electrolytes [Show Less]
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Hondros Nursing 212 Exam 1 Q uestions and Answers 100% correct
What are the differences of cancer in men than women? -More men than women die from cancer-related deaths each year. -Mortality rate from lung cancer is ... [Show More] higher in men (26%.) -Cancer with the highest incidence among men is prostate cancer (19%.) -Men are more likely to develop liver cancer. -Head and neck cancers occur more often in men. What are the differences of cancer in women than men? -Cancer with the highest death rate among women is lung cancer (25%.) -Cancer with the highest incidence among women is breast cancer (30%.) -Thyroid cancer is more prevalent in women. -Women are less likely to have colon cancer screenings. What does it mean if a tumor has a Grade I Histologic rating? Cells differ slightly from normal cells (mild dysplasia) and are well differentiated (low grade.) What does it mean if a tumor has a Grade II Histologic rating? Cells are more abnormal (moderate dysplasia) and moderately differentiated (intermediate grade.) What does it mean if a tumor has a Grade III Histologic rating? Cells are very abnormal (severe dysplasia) and poorly differentiated (high grade.) What does it mean if a tumor has a Grade IV Histologic rating? Cells are immature, primitive (anaplasia), and undifferentiated; cell of origin is hard to determine (high grade.) What does it mean if a tumor has a Grade X Histologic rating? Grade cannot be assessed. What does a Stage 0 cancer indicate? Cancer in situ. What does a Stage I cancer indicate? Tumor limited to the tissue of origin; localized tumor growth. What does a Stage II cancer indicate? Limited local spread. What does a Stage III cancer indicate? Extensive local and regional spread. What does a Stage IV cancer indicate? Metastasis (spread of the cancer to a distant site.) What should you teach patients and the public about cancer prevention and early detection? -Limit alcohol use. -Get regular physical activity (e.g., 30 minutes or more of moderate physical activity 5 times weekly.) -Maintain a normal body weight. -Have regular physical examinations. -Obtain regular colorectal screenings. -Avoid cigarette smoking and other tobacco use. -Get regular mammography screening and Pap tests. -Be familiar with your own family history and risk factors for cancer. -Obtain adequate, consistent periods of rest (at least 6 to 8 hours per night.) -Use sunscreen with a sun protection factor of 15 or higher. Avoid the use of tanning beds. -Eliminate, reduce or change the perception of stressors and enhance the ability to effectively cope with stress. -Eat a balanced diet that includes vegetables and fresh fruits, whole grains, and adequate amounts of fiber. Reduce dietary fat and preservatives, including smoked and salt-cured meats with high nitrate concentrations. What are the warning signs of cancer? -Change in bowel or bladder habits. -A sore that does not heal. -Unusual bleeding or discharge from any body orifice. -Thickening or a lump in the breast or elsewhere. -Indigestion or difficulty in swallowing. -Obvious change in a wart or mole. -Nagging cough or hoarseness. What are some problems caused by chemotherapy and radiation therapy? -Hyperuricemia -Cardiotoxicity -Pericarditis and Myocarditis -Fatigue -Anorexia -Constipation -Diarrhea -Hepatotoxicty -Nausea and Vomiting -Stomatitis, Mucositis, and Esophagitis -Hemorrhagic Cystitis -Nephrotoxicity -Reproductive Problems -Anemia -Leukopenia -Thrombocytopenia -Alopecia -Chemotherapy-Induced Skin Changes -Radiation Skin Changes (dry to moist desquamation) -Cognitive Changes ("chemo brain") -Intracranial Pressure -Peripheral Neuropathy -Pneumonitis What are some examples of oncologic emergencies? -Spinal Cord Compression -Superior Vena Cava Syndrome (SVCS) -Third Space Syndrome -Hypercalcemia -Syndrome of Inappropriate Antidiuretic Hormone (SIADH) -Tumor Lysis Syndrome (TLS) -Cardiac Tamponade -Carotid Artery Rupture What are the manifestations of Superior Vena Cava Syndrome? -Facial edema, periorbital edema -Distention of veins of head, neck, and chest -Headache- seizures -Mediastinal mass on chest x-ray What are factors that affect how patients cope with cancer? -Ability to cope with stressful events in the past. -Ability to express feelings and concerns. -Age at the time of diagnosis. -Attitude associated with the cancer. -Availability of significant other. -Disruption of body image. -Extent of disease. -Past experiences with cancer. -Symptoms. In the TNM Classification System, what does TX indicate? Tumor cannot be measured. In the TNM Classification System, what does T0 indicate? No evidence of primary tumor (tumor cannot be found.) In the TNM Classification System, what does Tis indicate? Tumor in situ, meaning only malignant cells only within superficial layer of tissue; no extension into deeper tissue. In the TNM Classification System, what does T1/T2/T3/T4 indicate? A description of primary tumor based on size and/or invasion into nearby structures; the higher the T number, the larger the tumor and/or the more it has grown into nearby tissues. In the TNM Classification System, what does NX indicate? Nearby lymph nodes cannot be evaluated. In the TNM Classification System, what does N0 indicate? No evidence of cancer cells in regional lymph nodes. In the TNM Classification System, what does N1/N2/N3 indicate? A description of size, location, and/or number of lymph nodes involved; the higher the N number, the more extensive the lymph node involvement. In the TNM Classification System, what does MX indicate? Metastasis cannot be evaluated. In the TNM Classification System, what does M0 indicate? No evidence of metastasis can be found. In the TNM Classification System, what does M1/M2/M3/M4 indicate? A description of extent of metastasis; the higher the M number, the more extensive the metastasis. What is palliative care? A holistic approach to care or treatment that focuses on reducing the severity of disease symptoms, rather than trying to delay or reverse the progression of the disease itself or provide a cure. What are the goals of palliative care? -Regard dying as a normal process. -Provide relief from symptoms, including pain. -Affirm life and neither hasten nor postpone death. -Support holistic patient care and enhance quality of life. -Offer support to patients to live as actively as possible until death. -Offer support to the family during the patient's illness and in their own bereavement. What are the main goals of hospice care? To assist the patient to live as fully and comfortably as possible while dying with dignity. What is the major difference between palliative care and hospice care? Palliative care allows a person to simultaneously receive curative and palliative treatments. When does hospice care become an option? When the physician determines a person has 6 months or less to live and that person or health care proxy decides to forgo curative treatments. What are the goals of end of life care? -Provide comfort and supportive care during the dying process. -Improve quality of the patient's remaining life. -Help ensure a dignified death. -Provide emotional support to the family. What are the physical manifestations at end of life related to the cardiovascular system? -Increased heart rate, later slowing and weakening of pulse -Irregular rhythm -Decreased BP -Delayed absorption of drugs given IM or subcutaneously [Show Less]
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Hondros Nurse 150 Final Questions and Answers 100% correct
What are the Hospital National Patient Safety Goals 1. Identify pt's correctly 2. Improve staff communication 3. Use Meds safely 4. Use alarms safely 5. P... [Show More] revent Infection 6. ID pt safety risks 7. Prevent mistakes in Surgery What are the Long Term Care National Patient Safety Goals 1. ID Residents correctly 2. Use meds safely 3. Prevent Infection 3. Prevent residents from falling 4. Prevent bed sores Procedure for fecal Impaction Removal 1. Verify physician written order, Introduce self, hand hygiene, ID patient, explain procedure and provide privacy. Fecal impaction cont'd...after explaining procedure, what's next? Raise bed and lower side rail, position pt to Sim's position Fecal impaction cont'd...after putting pt in Sim's, what do you do next? Drape pt's trunk and lower extremities with bath blankets, put waterproof pad under buttocks/hips. Place bedpan next to pt. Fecal Impaction cont'd...after placing bedpan next to pt, what is next? Hand hygiene and don clean gloves, lubricate gloved index finger and middle finger of dominant hand and tell pt to take deep, slow breaths, in and out during procedure. Fecal impaction cont'd... after instructing pt to breathe deeply, what is the next step? Insert gloved index finger, gradually and gently, feel anus relax and insert middle finger. Move fingers gradually towards wall of rectum towards umbilicus and loosen mass by moving fingers in a scissor like motion. Work stool downward and remove small pieces of feces into bedpan. Fecal impaction cont'd....what signs to observe during removal Pt response, heart rate, dyspnea or heart palpitations fecal impaction cont'd...after observing pt response, what do u do next? Continue to clear feces and allow pt to rest at intervals. Perineal hygiene and Inspect feces color and consistency. Properly dispose of feces and gloves. Hand hygiene, position pt to comfortable position and call light within reach. Sequence for med admin via NG tube... 1. Check proper placement 2. Check residual 3. Flush 30 mL 4. Give med 5. Flush 30 mL Define SOAPIER with examples Subjective-what pt says their pain is Objective-facts u can measure like a temperature Assessment-head to toe assessment Plan-plan patient care Intervention-implementation Evaluation-reflecting on what was done Revision-what would I have done differently Define Professionalism Behavior and attitude patterns exhibiting standards and character marked by pride in oneself and one's career, respect for the people served and commitment to the continued development of skills in the pursuit of excellence. Define ethics A principle of right or good behavior, a system of moral principles or values, a study of moral philosophy, or the rules and standards of conduct governing the members of a profession. Subjective data information perceived only by the affected person objective data information that is seen, heard, felt, or smelled by an observer; signs that can be measured SBAR S: Situation B: Background A: Assessment R: Recommendation-effective communication between staff Ohio Nurse Practice Act Providing and practicing safe nursing care with satisfaction and established standards, we cannot teach the practice of nursing, supervise, evaluate nursing practice, cannot IV push (SCOPE OF PRACTICE) What is the proper sequence to remove PPE? (DOFFING) Gloves, goggles, gown, mask What is the proper sequence to put on PPE? (DONNING) Gown, mask, goggles, gloves What can you do to prevent injuries from heat and cold packs? Place a barrier How do ineffective coping affects one health? They might start drinking, doing drugs, or doing risky behaviors which effects the person in a negative way. How do you properly apply wrist restrains? Inspect skin, attach wrist restraint to a movable part of bed, attach other end to pt's wrist and be sure two fingers can fit between restraint and pt's skin. Where is the preferred place to take pulse on an unresponsive patient? Carotid What is the z-track method? This is used for IM injections. Use nondominant hand to pull skin laterally and hold it in position while giving injection. Release skin immediately after withdrawing needle to seal off the injection site. This prevents the medication from leaking through the more sensitive subcutaneous tissue from the muscle. Done at the ventrogluteal or dorsogluteal sites. What is CAUTI and how can you minimize the patient's risk? catheter-associated urinary tract infection: only if necessary, don't keep in place longer than necessary, hand hygiene and gloves, clean genital area every shift, chg drainage bag and keep below patient. Define dysphagia difficulty swallowing Define dysphasia Difficulty speaking How do you draw regular (clear) and NPH (cloudy) insulin in syringe? Air in cloudy, air in clear, draw up the clear, draw up the cloudy What are the normal values for temperature 97.0-99.7 What is normal blood pressure? BP: 90-140/50-90 What is normal pulse? 60-100 Normal respiration 12-20 Define HIPPA Health insurance portable accountability act = takes care of the privacy of a patient. What is the cognitive impairment and list some factors that put a patient at higher risk for it? People that are at higher risk: elderly, trauma, very young, born that way, people with infections, and strokes. Stage I pressure ulcer Nonblanchable redness of a localized, area of intact skin Stage II pressure ulcer partial thickness skin loss Stage III pressure ulcer full thickness tissue loss with visible fat Stage IV pressure ulcer Full-thickness tissue loss with exposed bone, tendon, or muscle How often should you turn/reposition a patient? bed: 2 hours wheelchair: 1 hour Define HAI and give some examples including who is at higher risk? Hospital Acquired Infection: the elders, the very young, people who live in group homes, the immunocomplex. Define AMA. What actions are the responsibility of the nurse in this instance? Against Medical Advice: if your patient tries to leave, educate them. If they are mentally ill or mentally unstable other precautions are taken. How do you find the apical heart rate and for how long should you listen to the apex? Midclavicular, 5th intercostal, listen for 60 seconds. How would the nurse position the patient to administer rectal enema? Sims How would the nurse position the patient to administer a feed via NG tube? Fowlers or semi fowlers How would the nurse position a patient to administer vaginal foam? Dorsal recombinant (10 mins) What are some of the benefits and disadvantages of electronic health records? + (easily accessible for all team members, easier than hand writing, cuts down on errors, used for research and studies, efficient and legible) - (system goes down and then unable to access info, possibility of unauthorized access, system crash) What angle do you hold the needle when administering an IM injection? 90 degrees (for vaccines, antibiotics, steroids, deltoid) What angel do you hold the needle when administering an sub-q injection? 45 degrees (insulin, allergy shots, MMR, Varicella, abdomen) What angel do you hold the needle when administering an ID injection? 15 degrees (TB skin test) Which injection do you have to aspirate, or "pull back" before injecting the medication? IM Define "Patient centered care" Providing care that is respectful of and responsible individual patient preference, needs and values, and insuring that patients values guide all clinical decisions. How does the nurse properly administer nitroglycerin ointment? Wear gloves, remove previous dose, wipe, date time and initial new paper, apply amount of inches per physicians order, apply different location then last time (not on hair or scars) then secure with tape. What are the two basic categories of functional ability? ADL's-grooming bathing and dressing and IADL's-managing finances and shopping How do you administer a MDI (metered dose inhaler)? Shake inhaler and spray during inhalation, wait 20-30 seconds (same medication) and wait 2-5mins (different medication)-rinse with water when finished to avoid yeast in mouth Define clostridium difficile. How can you prevent it? CDIFF: a bacterial infection of spores found in feces. Symptoms include: diarrhea, rapid heart failure, dehydration, nausea, blood in stool (CONTACT ISLOLATION PREVENTS THE SPREAD OF CDIFF) [Show Less]
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NUR 160-Hondros Exam 1, HONDROS NUR 160 EXAM 1, Spring hondros college
just culture workers are protected from disciplinary action when they report injuries, errors, or near misses close-ended question What is your na... [Show More] me? false reassurance Everything will be fine Why Assess? To identify changes in pt condition, to help foresee areas of concern RN who does the initial assessment? Within 24 hours When should an initial assessment be done? discharge planning What should we pay attention to when a pt is post op knee replacement and they live on 2nd floor Steps of an assessment 1. Introduce self 2. Explain procedure 3. wash hands 4. Identify pt 5. Provide privacy 6. Inspect, auscultate, palpate Correct, then continue If a concern arises during assessment (Ex: pt c/o SOB. Sit up, apply O2 or check tubing, teach inhale through nose, exhale through mouth) Order of assessmet Subjective then Objective (helps to identify ares of focus) Inspect airway, auscultate lungs If pt c/o sore throat or recent cold Serous Drainage Clear(Good or indifferent) Sanginous Drainage Blood-red(a little is ok, alot is bad) Serosanginous Drainage Pink-mix of blood and serous(This is ok) Purulent Drainage Puss (assess for infection and notify MD) Absent Bowel Sounds Auscultate 5 mins per quadrant (Silence means NOTHING) (20 minute total) assess for an obstruction and notify MD Normal IM injection reaction Burning at site, itching at site, bruising Abnormal IM injection Reaction vomiting, constipation, dry mouth, rash (systemic) TB testing 1. Must be read 48-72 hrs (assessed) 2. Document date, time of injection and reading, as well as result 3. Mild swelling is normal TB result-negative 10mm- healthcare workers are a strict 10 TB result-positive red, raised (induration) Positive TB result This means that the person has been exposed to TB At risk for TB nursing homes, jails, homeless, certain meds, some other countries, healthcare workers Hyperglycemia hot and dry-sugar high Hypoglycemia cold and clammy-needs some candy Symptoms of Hyperglycemia extreme thirst, frequent urination, dry skin, hunger, blurred vision, drowsiness, nausea Symptoms of Hypoglycemia shaking, tachycardia, sweating, anxious, dizzy, hunger, impaired vision, weakness, fatigue, headaches, irritable insulin NPH-longer lasting (cloudy) Regular- faster acting (clear) Order of Insulin Draw cloudy(air), clear(air),clear(insulin), cloudy(insulin) 70-110 Normal BS Vision Intervention Annual Eye Exam Vision Assessment PERRLA, peripheral testing, snellen chart, Hx (changes in vision?, dark spots?, flashes?, issues in certain lighting?) [Show Less]
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