PN1 Final Exam 1. Best Practice (Pg.5) a. To promote client safety and continuity of care excellent practice is for a nurse to use I-SBAR-R when
... [Show More] contacting a health care provider for an order i. I=Identification of self and client ii. S=Situation iii. B=Background iv. A=Assessment v. R= Recommendation vi. R=Read back 2. Inter-Generational Families (Pg. 18) a. Also called multigenerational families b. 2 or more related generations living together as a functioning family. (Sometimes 3-4 generations) c. Reasons- economic support, child care, emotional support 3. Lab data for malnutrition (Pg. 675) a. Have a BMI of less than 20 when undernourished b. Decreased Albumin level of <3.8 g/dL is seen with protein deficiency c. Serum proteins (most widely used) d. Serum Albumin, creatnine and BUN 4. How to assist a patient and family through a crisis (Pg. 843) a. Be an active listener b. Assist family to cope with situation in positive manner c. Keep family informed d. Prepare family to cope with an unwanted outcome e. Help family understand clients condition so they understand 5. Parenting styles (Pg. 25-26) a. Authoritarian: i. Most common ii. Clear division of who is in control and who must obey. iii. Parents set the rules and distribute consequences and rewards depending on child’s adherence to parents rules and guide lines b. Authoritative i. Democratic or active parenting ii. Provides behavioral guidelines and encourages children to think about the consequences of behavior iii. Parents actively reinforce child’s positive behavior and are significantly involved in monitoring child’s behavior and explain expectations c. Permissive: i. “Hands off” parenting technique, thought as neglectful bc of minimal parental interventions ii. Freedom to learn from their own mistakes iii. Children raised this way struggle as adults because they do not recognize boundaries or limits 6. Distress family and communication (Pg. 26 Box 2-3) a. Poor communication between members, including dishonesty, hostility, sarcasm, silent treatment and frequent misunderstandings b. Neglect of basic needs c. Anger control issues d. Unrealistic expectations of family members 7. Acidosis/Alkalosis (know the change in pH) (Pg. 222 Figure 11-1) a. Normal is 7.35-7.45 b. Acidosis: <7.35 (7.0 Neutral, 6.8 Death) c. Alkalosis: >7.45 (7.8 Death) 8. Therapeutic communication (Pg. 32) a. Active listening: Really listening to what client is saying and attempting to understand. Take in voice tone, pitch and inflections, watch body language and explore and clarify to ensure accurate understanding. At times humor, touch, silence or confrontation maybe appropriate. b. Show empathy, be able to imagine one’s self in their circumstances c. An offer of sympathy may hinder therapeutic communication because the client may not feel comfortable when someone “feels sorry for them” 9. Communication challenges (Pg. 33) a. Language barriers, cultural barriers, vision and hearing impairment b. Lack of time to talk with patient because nurse is so busy, jump to conclusions about what clients’ needs are based on past interactions c. Divorced families: Unresolved issues of anger that complicate communication d. Domestic Violence: Issues of domestic violence present an extremely difficult communicative climate 10. Confrontation (Pg. 33) a. Negative meaning, angry feelings, harsh words and conflict b. Productive confrontation i. Can be used as a technique in a respectful, tactful and nonthreatening manner, doing this can help facilitate the client’s move toward self-examination and opportunities for growth ii. This can be used when patient is engaging in maladaptive or poor defense mechanisms such as denial iii. Should be productive, respectful, tactful and non-threatening 11. Prodromal- incubation- convalescence (Pg. 74) a. Incubation: Time between entry of infectious agent in the host and the onset of symptoms. b. Prodromal: Time from the onset of nonspecific symptoms until specific symptoms begin to manifest. Host maybe infectious c. Convalescent: The beginning of the disappearance of acute symptoms until the client returns to previous state of health 12. What are the risk factors for an infection (Pg. 77) a. Imbalanced Nutrition: Less than body requirements or more b. Ineffective protection c. Impaired tissue integrity d. Impaired oral mucous membrane e. Impaired skin integrity f. Deficient knowledge 13. What is the meaning of systemic infection (Pg. 74) a. Affect entire body and involve multiple organs, such as AIDS 14. Alkalosis and OTC medications (Pg. 233 Table 11-4) a. Antianxiety: Ativan & Xanax b. Benzo’s/Sedatives/Hypotics: Ambein, Restoril, Halcion & ProSom c. Centrally acting skeletal muscle relaxants: Valium, Lioresal & Dantrium d. Electrolyte Supplements: Calcium plus vitamin D, Potassium chloride (K-Dur) 15. Look up (All ready answered on question 80) a. Respiratory Acidosis b. Respiratory Alkalosis c. Metabolic acidosis d. Metabolic Alkalosis 16. Osmosis and diffusion (Pg. 203-204) a. Osmosis: is diffusion of water through a semipermeable membrane from a region of higher water concentration to a region of lower water concentration. Only water (solvent) molecules move through the membrane; the dissolved molecules do not b. Diffusion: Tendency of molecules of gases, liquids or solids move from a region of higher molecular concentration to a region of lower molecular concentration until an equilibrium is reached. This movement is caused by kinetic energy in molecules. For example Carbon dioxide moves by diffusion from the blood stream where the concentration is higher, into the lungs for elimination 17. IV therapy, what to react to first (jugular and hand distention) a. Jugular- pneumothorax b. Hand distention- phlebitis, dislodgement 18. Drops per min on an IV (Pg. 253) total fluid volume Drop factor Drop per min Total time ( min) 19. Infusion related infection (Pg. 257) a. Phlebitis 20. Look up signs and symptoms of TB (Pg. 351) a. Low grade fever that recurs in a specific pattern b. Persistent cough c. Hemoptysis d. Hoarseness e. Dyspnea on exertion f. Night sweats/ fatigue g. Weight loss and enlarged lymph nodes 21. What to teach a patient about Lasix a. Take in AM b. Do not take if planned activities in AM 22. What are common medication for asthmatics (Pg. 364) a. Aminophyline b. Steriods Bronchodilators c. Theophylline d. Histamine Corticosteroids e. Mucolytics f. Anticholinergics 23. What does a patient with pneumothorax look like? (Pg. 386) a. Pneumothorax occurs when blunt trauma to chest causes a broken rib that pierces the pleura and lung, allowing air to enter between the pleura. b. Short of breath, shifted trachea, Dyspnea and cyanosis, Cough is forceful and unproductive, Resp and heart rate are elevated [Show Less]