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nursing 101 exam 3


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an example of diagnostic surgery is:
a biopsy or invasive testing (cardiac cath)
improve appearance
If a patient is not capable of giving informed consent or if the client is a minor, who can give consent?
a family member, conservator or legal guardian
joint replacement surgery is classified as what kind of surgery?
List the 4 parts included in a surgical consent form:
1. type of surgery performed 2. the name and qualifications of the doctor 3. A statement that the risks and benefits have been explained 4. A statement that the client has the right to refuse surgery or withdraw consent at any time.
Procurement surgery:
when an organ or tissue is harvested from someone pronounced brain dead for transplantation itno another person
This involves the care of clients before, during, and after surgery
perioperative nursing
This is done to alleviate discomfort or other disease symptoms without producing a cure
palliative surgery
this phase beings when the patient enters the operating suite and ends when they are admitted to PACU
intraoperative phase
this surgery involves the removal of a diseased body part
ablative surgery
this surgery is performed to restore function
this surgery replaces a malfunctioning body part, tissue or organ
transplant surgery
this type of anesthesia produces rapid, unconsciousness and loss of sensation.
general anesthesia
urgent surgery is scheduled:
24-48 hours to alleviate symptoms or repair/restore
what are antiembolism stockings?
elastic stockings that compress the veins of the legs and increase venous return to the heart
what body systems have a higher risk of infection postop?
GI, GU, respiratory tracts or repair of any penetrating injury
what duties is the circulating nurse in charge of?
assessing the client in the holding area, developing diagnoses, prepping the skin, positioning the client, ensuring client safety
what factors affect surgical risk?
age, type of wound, prexisting conditions, mental status, medications, personal habits, allergies
what is informed consent?
proof the physician presented information about the surgery and that the patient understood it and was not pressured to give consent.
what must accompany the patient to surgery?
the preop checklist and medical chart
when does the preoperative phase begin and end?
begins with the client's decision to have surgery and ends when the client enters the operating room
why do anticoagulants increase surgical risk?
they increase the risk for bleeding
why do antihypertensives increase surgical risk?
they increase the risk for hypotension during surgery and may interact with anesthetic agents
why do opioids increase surgical risk?
increases the risk of respiratory depression
why does aspirin and NSAIDs increase surgical risk
increase the risk for bleeding
Why is it important to be NPO 8 hours before surgery?
to decrease the risk of nausea and vomitting
some advantages of general anesthesia are:
patient is unconscious, muscles are relaxed, anesthesia can be adjusted
some disadvantages of general anesthesia are
respiratory and circulatory muscles are depressed, so mechanical ventilation is often needed, it creates a risk for death, MI, stroke, and malignant hyperthermia.
This is a rare, often fatal, metabolic condition that occurs during the use of muscle relaxants and inhalation anesthesia. The metabolism increases and temperature rises rapidly.
malignnt hyperthermia
this is an alternative form of anesthesia that provides IV sedation and analgesia without producing unconsciousness.
conscious sedation
this type of anesthesia prevents pain the the area of the procedure by interrupting nerve impulses to and from the area
regional anesthesia
this anesthesia produces loss of pain sensation at the desired site and used for minor procedures
local anesthesia
this in an injection of an anesthetic into and around a nerve or group of nerves
nerve block
this is a nerve block technique where there is a tourniquet on an arm or leg, local anesthesia is injected IV below the tourniquet level.
Bier block
where is spinal anesthesia injected?
into the CSF in subarachnoid space.
what might a headache in a patient who has had spinal anesthesia mean?
CSF is leaking
this requires a thin catheter to provide anesthesia
epidural anesthesia
what are the 5 variables that determine the position of the patient in the OR?
the surgical site, access to airway, need to monitor vitals, comfort and safety
to prevent shearing during operation, how should you move a patient?
lift, not slide
this phase begins when the client enters the PACU and ends when the client has healed from the surgical procedure
postoperative phase
the 3 phases of perioperative nursing are:
preoperative, intraoperative, postoperative
what 2 parts does the postop phase consist of?
recovery from anesthesia and recovery from surgery
how often do you assess the patient in the PACU?
every 5-15 minutes
Atelectasis: (and clinical symptoms)
collapse of alveoli - decreased or absent breath sounds, decreased oxygen saturation, fever, tachypnea, dyspnea, tachycardia, diaphoresis, pleural pain
What are the clinical signs of a PE?
sudden onset of dyspnea, SOB, chest pain, hypotension, tachycardia, decreased oxygen sat, cyanosis
thrombophlebitis: (and clinical symptoms)
blood clot and inflammation of the vein, usually in the legs - vein is red, hard, and hot to touch, limb is pale and edematous, aching, cramping in the limb, Homans' sign
what is Homans' sign?
pain in the calf when it is dorsiflexed
this is decreased blood volume
this is the loss of the forward flow of intestinal contents due to decreased peristalsis
If a patient has less than 30 mL urine output and has rising BUN and creatinine levels, what might be happening?
renal failure
separation of one or more layers of a wound
protrusion of organs or tissues through the separated incision
which is more important during preop period: A. administering preop meds B. assess NPO status
B. NPO status - if they have not been NPO, they are at a higher risk for aspiration during surgery
TRUE OR FALSE: Malignant hypertension is a rare, inherited complication of regional anesthesia.
FALSE: it is a complication of general anesthesia.
TRUE OR FALSE: all patients having surgery will undergo preop shaving of the hair covering the surgical site
What are the 4 ways surgeries may be classified?
by body system, by purpose, by degree of urgency, by degree of risk
what type of assessment is performed as part of the preoperative assessment?
a brief head-to-toe, unless specific concerns have been identified.
who is responsible for obtaining informed consent?
the surgeon
Why are sequential compression devices used?
for clients at a high risk of thrombophlebitis - they compress the veins, promote venous return and decrease venous stasis.
these are small, fluid-filled sac that act as cushions to reduce friction
accentuated thoracic curve
a lateral "S" deviation of the spine
accentuated lumbar curve of the spine
the average base of support is
5-10 cm, 2-4 in
the average stride length is
30-35 cm, 12-14 in
what 4 things can you do to assess balance?
tandem walking (heel to toe), deep knee bends, hopping in place, Romberg test
2 ways to assess coordination are:
finger-thumb opposition and running the heel of one foot down the shin of the other
clicking or grating at a joint
Genu varum
A wide base of support and a shortened stride length reflect:
a balance problem
the best way to test muscle strength is:
repeating ROM against resistance
what do the Lovett/s Scale scores mean?
5 - normal, full ROM against resistance 4 - good, most ROM against resistance 3 - fair, ROM against gravity 2 - poor - ROM with help against gravity 1 - trace - no joint movement 0 - no muscle contraction
this allows for 360 degrees of movement
decrease in muscle to to disuse
decrease of muscle tone
the elbow is this type of joint
the shoulder is this type of joint
to avoid injury while moving, you should:
have proper alignment, wide base of support, avoid bending and twisting, squat to lift, keep objects close when lifting, raise the beds, push vs. lift, get help!
a strain is:
the muscle
a sprain is:
tear of a ligament
this type of exervise is muscle contraction with no motion (like pushing a wall)
this exercise is shortening and lengthening the muscle
this exercise is using machine weights at the gym
this type of exercise is using oxygen
this type of exercise is not using oxygen
what are some effects of immobility?
atrophy, joint dysfunction, pneumonia, venous stasis, increased coagulability, orthostatic hypotension, glucose intolerance
how much muscle do you lose for every week you are immobile?
What is Birchow's Triad?
says that venous stasis + vessel injury + coagulation = perfect for blood clots
what will you hear with a paralytic ileus?
a person with 2 cultures is
an area of many different cultures is called
the attitude that your ethnicity is the best is called
is the dominant culture always the largest group?
males, females, nurses, doctors, people who speak German, the homeless - these are all examples of
what are vulnerable subcultures?
the homeless, poor, mentally ill, people with disabilities, young, elderly, some ethnic and racial minority groups
these are the values, beliefs, and practices that people from all cultures share
cultural universals
these are the values, beliefs and practices that are special or unique to a culture
cultural specifics
what are some cultural specifics that affect health?
communication, space, time orientation, social organization, environmental control, biological variations, religions and philosophy, politics and law, economy, education
fold medicine, OTC and self care would fall under which health care system?
indigenous health care system
physicians and nurses are part of which health care system?
this health care system is science based and takes aggressive action for illness or disease and is primary the US system
accupuncture, going to the chiropractor or a dietician are parts of what health care system
alternative health care
the magico-religious group belives that what controls our health?
supernatural forces
this type of practice believes that you must have harmony in the body to achieve health
characteristics of our north american health system are:
biomedical system, value of technology, desire to conquer disease
how do we in north american define health?
the absence or minimization of disease
what is the largest subculture in health care culture in the US
some common nursing values are:
silent suffering as a response to pain, objective reporting and description of pain, use of nursing process, nursing autonomy, caring, knowledge, critical thinking
barriers to giving culturally competent care are
lack of knowledge, emotional responses, ethnocentrism, cultural stereotypes, prejudice, discrimination, racism, sexism, language barrier, street talk/slang/jargon
what 3 aspects are part of Purnell and Paulanka's culturally competent care?
cultural awareness, cultural sensitivity, cultural competency
this is what people in a group have in common, but it changes over time; also the behavior patterns, arts, beliefs, values, customs, lifeways that guide a person's worldview and decision making
this refers to groups whose members share a common social and cultural heritage that is passed down from generation to generation
members of an ethnic group have what in common?
some characteristics - it can be race, ancestry, physical characteristics, geographic region, lifestyle, religion
an example of an ethnic group would be
french canadiants, midwesterners, roman catholics, latinos
hispanic americans are people who originally came from
any spanish-speaking country
the term "latino" refers to people from
latin america
race is strictly related to
this refers to an ordered system of beliefs regarding the cause, nature, and purpose of the universe
this is the process of learning to become a member of a society or a group
immigrants assume the characteristics of that culture through a learning process called
this occurs when the new members gradually learn and take on the dominant culture's essential values, beliefs, and behaviors
cultural assimilation
how long do experts believe it takes for an immigrant group to become acculturated?
3 generations
alternative medicine is defind as therapies used
instead of the conventional medicines, whose reliability has not been validated through clinical testing in the US
the campinha-bacote model of culturally competent care views cultural competence as a ______, not an ___ ______ and used the mnemonic ASKED:
as a PROCESS, not an END POINT Awareness Skills Knowledge Encounters Desire
TRUE OR FALSE: A stereotype is a preconceived and untested belief about people or groups of people
TRUE OR FALSE: Race is defined as the physical characteristics that are shared by a specific ethnic group
Which cultural group is at high risk for sickle-cell anemia?
what are the 4 components of the sensory experience?
stimulus, reception, perception, arousal
the trigger that stimulates a receptor is called
the process of receiving stimuli from nerve endings
the ability to interpret sensory impulses and the ability to give meaning to impulses is
this is composed of consciousness and alertness that is mediated by the RAS is
this sensory disorder can have the following symptoms: irritability, confusion, reduced attention span, drowsiness, depression, delusions, hallucinations, preoccupation with somatic complaints
sensory deprivation
this sensory disorder can have the following symptoms: irritability, confusion, reduced attention span, drowsiness, muscle tension, anxiety, inability to concentrate, restlessness, disorientation
sensory overload
this is caused by an irregular curvature of the cornea or lens that scatters light rays and blurs the image on the retina
this is the loss of central vision due to damage to the central portion of the retina
macular degeneration
this is the term for crossed eyes
this occurs when one of the structures that transmits vibrations is affected
conduction deafness
this is the progressive sensorineural loss associated with aging
a term used to describe ringing in the ears
the hardening of the bones of the middle ear
a middle ear infection
otitis media
the age group that sleeps the most is
newborns (16-20 hours a day)
stage I of sleep usually lasts
5-10 min
stage 2 of sleep usually lasts
10-15 min
stage 3 of sleep usually lasts
5-15 min
stage 4 of sleep usually lasts
20-50 minutes
stage 5 of sleep usually lasts
5-30 min
this sleep stage is characterized by light sleep and can be awakened easily with regular, deep breathing
stage 1
this sleep stage is characterized by light sleep, easily roused, temperature, heart rate and BP decreases and accounts for 50% of sleep
stage 2
this sleep stage is characterized by deep sleep, person is difficult to rouse, muscles are very relaxed
stage 3
this sleep stage is characterized by very deep sleep, the person is difficult to awaken, body systems are slow in rate
stage 4
this sleep stage is characterized by dreaming, muscles and tendons are depressed, pulse is rapid and irregular
stage 5 (REM)
what are the 5 rights of teaching clients?
right time right context right goal right content right method
what are the 3 domains of learning
cognitive, psychomotor, affective
this type of learning includes memorization, recall, comprehension, ability to analyze and evaluate ideas
this method of learning includes sensory awareness, imitation, performance of skills
this type of learning involves responding to new ideas, demonstrating commitment to new ideas, integrating new ideas into a value system
what are some examples of teaching strategies?
simulation, role-playing, role-modeling, self-instruction, distance learning, CAI, gaming
the average infant needs how much sleep?
14-16 hours
the average older adult needs how much sleep?
5-7 hours
kids 6-12 need how much sleep?
10-11 hours
young adults need how much sleep?
7-8 hours
what are the 5 stages of illness behavior?
experiencing symptoms, sick role behavior, seeking professional care, dependence on others, recovery
this is your overall view of yourself
self concept
the inner voice people have that influences their self concept is called
internal locus of control
someone who lets external factors control their life is
external locus of control
true or false: mild anxiety is normal
a person with this stage of anxiety can only focus on one particular detail or will shift the focus to extraneous details
severe anxiety
someone with this kind of anxiety becomes unreasonable and irrational and is unable to focus on even one detail in the environment
panic anxiety
depressive disorders are more common in
spiritual distress is associated with
a person who is depressed most of the day for at least 2 weeks and has diminished interest in activities likely has
major depressive disorder
anhedonia is
the loss of interest or pleasure to previously enjoyable activities
this is referred to the physical changes that occur over time
this is the process of adapting to one's environment over time
growth follows a _____ pattern
cephalocaudal pattern
the healthiest stage of life is
19-40 years
any disturbance in a person's normal balanced state is
good stress is called
what are the 3 major coping strategies for stress?
alter the stressor, adapt to the stressor, avoid the stressor
what is GAS
general adaptation syndrome - responses that all people share in the face of stressors
what are the 3 stages of GAS
alarm, resistance, recovery OR exhaustion
the fight or flight response occurs in this stage of G.A.S.
the goal of the resistance stage is to
maintain homeostasis
if adaptation is successful, GAS will end in what stage?
hypochondriasis is when a person
is preoccupied with the idea that they will become seriously ill
in this disorder, anxiety and emotional turmoil are expressed in physical symptoms
a disorder in which emotional pain manifests physically is called
somatoform pain disorder
malingering is when a person will
make a conscious effort to escape unpleasant situations by pretending to have symptoms
somatoform disorders are conditions characterized by the presence of
physical symptoms with no apparent cause, more likely from denial, repression, displacement of anxiety
this exists when an event in a person's life drastically changes the person's routine and he preceives it as a threat to the self
a crisis
when you can't cope effectively with the physical and emotional demands of the workplace you are experiencing:
longevity is
living a long life
gerontology is the
study of aging
the 3 components of a human being are
body, mind, spirit
characteristics of a healthy personality include:
self concept, identity, role performance, body image, self ideal, self esteem
our identity emerges from our
self concept
continuity confirms that:
as people grow, their basic personality does not change - spenders will be spenders, hoarders will be hoarders
which cohort makes up the largest segment of the population?
baby boomers - they have the largest birth rate
which current cohort is most rapidly increasing in size?
the old-old (WWI generation)
which cohort first experienced being "sandwiched" between their kids and their parents?
young-old (WW2)
the purpose of growth and development is to reach
when does aging begin?
when does physical maturity end?
when humans reach early adulthood
when does mental/emotional maturity end?
with death
death is caused by
disease or injury, NOT old age
the core issues of spirituality are
faith, hope, love
forgiveness is a part of
this is the physical, psychological and spiritual response to a loss
this is the action associated with grief
this is the period of mourning and adjustment time following a loss
Rando's 6 "R's" of grieving are:
recognize the loss react to the loss recollect memories relinquish the old attachment readjust to the new environment reinvest the self
worden's 4 tasks of grieving are:
accept the loss work through the pain and grief adjust to the new environment emotionally relocat the deceased
what are the bowlby phases of grief?
shock and numbness yearning and searching disorganization and despair reorganization
an example of disenfranchised grief is:
someone mourning his mistress
the historical definition of death was
cessation of the flow of body fluids

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