221 Exam 2

define "Law of minimum dose":

"Law of minimum dose": the notion that the lower the dose of the medication, the greater its effectiveness; many homeopathic remedies are so diluted that no molecules of the original substance remain

define "Like cures like":

"Like cures like": the notion that a disease can be cured by a substance that produces similar symptoms in healthy people

2 types of management structures

Centralized - Senior managers generally make decisions with little input from the group. doesn't work in health care very well. Decentralized - Decisions are made by those who are most knowledgeable about the issues being decided. Nurses are thus intimately involved in decisions concerning patient care.

Angles of insertion (3)

Intramuscular 90degrees Subcutaneous 90 or 45 degrees Intradermal 5 to 15 degrees

5 Roles of the nurse manager

Planning Organizing Staffing Directing Controlling

Four Scientific Premises of Therapeutic Touch:

-A human being is an open energy system. -Anatomically, a human being is bilaterally symmetrical. -Illness is an imbalance in an individual's energy field. -Human beings have a natural ability to transform and transcend their conditions of living.

Helping vs Social Relationship

-Helping Not spontaneous; with a specific purpose and person (purposeful/timelimited) Unequal sharing of info Built on patients needs Dynamic Person providing assistance is responsible for outcomes -Social Spontaneous Info sharing is more similar in quantity and type Needs of both participants are important

define Qi gong

-System of posture -Exercise—gentle and dynamic -Breathing techniques -Visualization that regulates the qi gong -Has been suggested to hold potential as an intervention to improve balance and reduce falls in older adults and has been used successfully to promote balance and coordination in other age groups

5 ANA principles for delegating care:

-The nursing profession determines the scope of nursing practice. -The nursing profession defines and supervises UAPs involved in providing direct nursing care. -The RN is responsible and accountable for nursing practice. -The RN supervises any assistant providing direct patient care. -The purpose of UAP is to work in a supportive role to the RN. (not in addition)

5 reasons for resistance to change

-Threat to self- (biggest reason for resistance) -Lack of understanding -Limited tolerance for change -Disagreements about the benefits of change -Fear of increased responsibility

11 rights to medication administration

1. Right patient 2. Right time 3. Right reason 4. Right meds 5. Right dosage 6. Right route 7. Right assessment 8. Right documentation 9. Right response 10. Right education 11. Right to refuse

3 Learning Domains and types of teaching strategies

> Cognitive- storing/recalling new info in the brain; lecture, panel, discovery, written materials > Psychomotor - acquisition of physical skills ; role modeling, discussion, audiovisual materials > Affective - changes in attitude, values, and feelings ; demonstration, discovery, printed materials

4 Factors affecting patient learning:

> Patient's age and developmental level > Family support networks and financial resources > Cultural influences and language deficits > Health literacy level - learning barrier - don't use jargon - explain what u say

A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and dehydration. During the admission interview, the nurse should implement which communication techniques to elicit the most information from the parents? a) The use of reflective questions b) The use of closed questions c) The use of assertive questions d) The use of clarifying questions

A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and dehydration. During the admission interview, the nurse should implement which communication techniques to elicit the most information from the parents? a) The use of reflective questions b) The use of closed questions c) The use of assertive questions d) The use of clarifying questions

A nurse is providing a lecture on CHAs to a group of patients in a rehabilitation facility. Which teaching point should the nurse include? a) CHAs are safe interventions used to supplement traditional care. b) Many patients use CHA as outpatients but do not wish to continue as inpatients. c) Many nurses are expanding their clinical practice by incorporating CHA to meet the demands of patients. d) Most complementary and alternative therapies are relatively new and their efficacy has not been established.

A nurse is providing a lecture on CHAs to a group of patients in a rehabilitation facility. Which teaching point should the nurse include? a) CHAs are safe interventions used to supplement traditional care. b) Many patients use CHA as outpatients but do not wish to continue as inpatients. c) Many nurses are expanding their clinical practice by incorporating CHA to meet the demands of patients. d) Most complementary and alternative therapies are relatively new and their efficacy has not been established.

A nurse is teaching first aid to counselors of a summer camp for children with asthma. This is an example of what aim of health teaching? a) Promoting health b) Preventing illness c) Restoring health d) Facilitating coping

A nurse is teaching first aid to counselors of a summer camp for children with asthma. This is an example of what aim of health teaching? a) Promoting health b) Preventing illness c) Restoring health d) Facilitating coping

Define Interoperability

Ability of a system to exchange electronic health information with and use electronic health information from other systems without special effort on the part of the user

5 types of drug-drug interactions

Addictive effect Drugs with similar pharmacologic actions Results in an increase in the overall effect Syngergistic effect Drugs with different sites or mechanism of action Results in greator effects when taken together (one drug potentiates the other) Antagonistic effect Combined drugs alter the overall sum effect or negate each other; results in an effect less than that of each drug alone Interference One drug interferes with the metabolism of another Leads to the buildup of a medication (that cannot be metabolized) and can result in toxicity or an adverse drug reaction Displacement One drug binds to protein-binding sites and forces another drug to be displaced Results in the released drug becoming pharmacologically active and can lead to an increase in the effect of the unbound drug

Define Allopathic medicine, holism, & integrative health care

Allopathic medicine: traditional medical care Holism: connection and interactions between parts of the whole Integrative health care: combination of allopathic and complementary and alternative modalities

4 types of yoga

Ashtanga: focuses on synchronizing breath with a fast-paced series of postures Bikram: is done in a 105-degree studio with 26 set postures Iyengar: focuses on proper alignment and holding poses for a relatively longer time Kripaula, or "gentle yoga": focuses on relaxation and coming into balance

Describe the 7 leadership styles:

Autocratic - Leadership style in which the leader assumes complete control over the decisions and activities of the group (communist nations) Democratic - Leadership style characterized by a sense of equality between the leader and followers Laissez-Faire - Leadership style in which the leader relinquishes all power to the group (choose to do this- laid back leaders; good or bad) Servant - Philosophy and set of practices that begins with the natural feeling of wanting to serve; its aim is to enrich the lives of individuals, build better organizations, and ultimately creates a more just and caring world (Pastors , nurses ) Quantum - Leadership that moves beyond the traditional modes previously experienced by all levels of workers; spawned by the impact of the information age on work and the worker Transactional - Leadership style based on maintaining control by rewarding good behavior and punishing negative or detrimental behavior (degrading to adults maybe) Transformational - Type of leadership in which the person creates revolutionary change and commits to the personal and professional growth of self and others ; transparent leaders; want to work together; build on the strengths of team

What does CHA stand for?

Complementary Health Approaches (CHA) CHA refers to interventions that can be used with conventional medical interventions and thus complement them. The term integrative health (IH) refers to the combination of complementary health and conventional health approaches in a coorinated way.

Define therapeutic range (1)

Concentration of drug in the blood serum that produces the desired effect without causing toxicity

3 types of health care analytics techniques

Data visualization Presentation of data in a pictorial or graphical format Predictive Analytics Variety of statistical techniques that analyze current and historical facts to make predictions about future or otherwise unknown events Big Data Accumulation of data from various sources, combined with new technologies that allow for the transformation of data to information

8 factors influencing communication

Developmental level Gender Sociocultural differences Roles and responsibilities Space and territoriality Physical-mental-emotional state Values Environment

Encoder vs Decoder

Encoder is the sender Decoder is the receiver

Pharmacokinetics - The study of how medications (6):

Enter the body Are absorbed and distributed into cells, tissues, or organs Reach their site of action Alter physiological function Are metabolized Exit the body

Explicit vs Implied Power

Explicit Power - Power obtained by virtue of a person's position Implied Power - Power obtained by force of a person's personality that might enable that person to have more power to influence others than designated leaders

Pharmacogenomics vs Genomics

Genomics (1) study of the structure and interactions of all genes in the human body, including their interactions with each other as well as the environment Pharmacogenomics Use of information about a person's genetic makeup, or genome, to choose the drugs and drug doses that are likely to work best for that person

7 Factors influencing group effectiveness:

Group identity Cohesiveness (cooperation) Patterns of interactions Decision making Responsibility Leadership (style) Power (used appropriately)

Define peak level (4)

Highest plasma concentration of a drug Measured when absorption is complete May be affected by factors that affect drug absorption as well as route of administration Typically drawn one hour after a drug has been administered (depending on the route)

Activities that are likely to occur during each of the 4 space zones include:

Intimate zone: interaction between parents and children or people who desire close personal contact - (assessment ) Personal zone: distance when interacting with close friends - (interviews ) Social zone: space when interacting with acquaintances such as in a work or social setting - initial interview (depends) Public zone: communication when speaking to an audience or small groups

5 types of parental medications (that u dont know)

Intradermal injection: corium (under epidermis) (longest absorption time 25 or 27 gauge) Intra-arterial injection: artery Intracardial injection: heart tissue Intraperitoneal injection: peritoneal cavity Intraosseous injection: bone

5 Levels of communication

Intrapersonal - Communication within a person Interpersonal - Communication between two or more people with a goal to exchange messages Small group - Communication that occurs when two or more nurses interact with two or more individuals, allowing the members to achieve a goal through communication Organizational - Process of communication that involves individuals and groups to achieve established goals Group dynamics - Study of a group's characteristics and ways of functioning

Meaningful use compliance will result in:

Meaningful use compliance will result in: -better clinical outcomes -Improved population health outcomes -Increased transparency and efficiency -Empowered people -More robust research data on health systems

Meaningful use is....: (4)

Meaningful use is using certified EHR technology to: -Improve quality, safety, efficiency, and reduce health disparities -Engage patients and family -Improve care coordination and population and public health -Maintain privacy and security of patient health information

Describe an Anaphylactic reaction (anaphylaxis) (3)

Most serious allergic effect Life threatening and results in respiratory distress, sudden severe bronchospasm, and cardiovascular collapse Treated with vasopressors, bronchodilators, corticosteroids, oxygen therapy, IV fluids, antihistamines

Naturopaths believe that health is a ________ state of being that provides abundant _________ for people to deal with ______ ______ ______ _______..

Naturopaths believe that health is a dynamic state of being that provides abundant energy for people to deal with life in our complex society.

ANA definition of nursing informatics

Nursing informatics ensures that technology used by nurses supports improvement in patient care delivery

Describe the 3 phases of the helping relationship:

Orientation Phase - The patient will call the nurse by name. The patient will accurately describe the roles of the participants in the relationship. The patient and nurse will establish an agreement about: goals of the relationship Location, frequency, and length of the contacts Duration of the relationship Working Phase - The patient will actively participate in the relationship. The patient will cooperate in activities that work toward achieving mutually acceptable goals. The patient will express feelings and concerns to the nurse. Termination Phase - The patient will participate in identifying the goals accomplished or the progress made toward goals. The patient will verbalize feelings about the termination of the relationship.

Define Trough level (3)

Point when the drug is at its lowest concentration Indicating the rate of elimination Typically drawn 30 minutes prior to the next scheduled dose

define: Pharmacodynamics

Process by which drugs alter cell physiology and affect the body Represents what a drug does to the body

Describe acupuncture

Qi flows vertically through body through 12 meridians Places thin, short, sterile needles at particular acupoints to change flow of energy and restore the balance of yin and yang Acupuncture either increases or decreases the flow of qi along the meridian, restoring the balance of yin and yang

Define System Optimization

Strategies to improve processes, maximize effective use, reduce errors, reduce costs, eliminate workflow inefficiencies -, improve clinical decision support, and improve end-user skills and satisfaction with the system

define SDLC and list the 7 steps

System Development Lifecycle Development cycle for an information technology system that includes the following phases: (1) analyze and plan (2) design (3) test (4) train (5) implement (6) maintain (7) evaluate

Teach Acronym

T- tune into the patient E- edit the patient info (reteach wats accurate) A- Act on every teaching moment C- Clarify often H- Honor the patient as a partner in the education process

Define System Usability

The extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction in a specified context of use

Lewin's Theory of Change

Unfreezing - The need for change is recognized. Moving - Change is initiated after a careful process of planning. Refreezing - Change becomes operational (what we do).

Describe an idiosyncratic effect

Unusual, unexpected response to a drug that may manifest itself by over-response, under-response, or response different from the expected outcome

3 Sites for Intramuscular Injections

Ventrogluteal site (up to 2mL) adults Vastus lateralis site (up to 2mL) (infants) Deltoid muscle site (no more than half a mL)

Describe the" 3 checks"

When the nurse reaches for the unit dose package or container After retrieval from the drawer and compared with the eMAR/MAR, or compared with the eMAR/MAR immediately before pouring from a multidose container Before giving the unit dose medication to the patient, or when replacing the multidose container in the drawer or shelf