Nursing 115 Comprehensive Study Guide

What is the function of sodium?

Osmolality in check

How does Na+ control water distribution?

Osmosis (movement in & out of the cell)

Specialty certificates

Over and above the NCLEX test

Treatment for for Anaphylactic Shock

Oxygen Administration medications Discontinue agent monitor CV and Respiratory Status

Ca+ opposes ________

P-

Following the completion of a basic program for practical nurses, graduates allowed to take what licensing exam?

PN-NCLEX

Ca+ is synergistic with ________

PTH

Low Mg+ impairs the action of which hormone?

PTH

Hyperventilation value

PaCO2 (dissolved CO2 in arteries) < 35

Ventilatory Failure value (dissolved CO2 in arteries)

PaCO2 (dissolved CO2 in arteries) > 50

Hypoxia value

PaO2 (dissolved O2 in arteries) < 60

Hyperoxia value

PaO2 (dissolved O2 in arteries) > 100

Dorothea Orem: Health

Identifies levels of independence; self-care deficit requires nursing dependent on patients ability to care for him/herself

Where is K+ located?

Intracellular

Where is Ca+ located

Intracellular & Extracellular

Where is Mg+ located?

Intracellular ONLY

Is P- inversely or synergistically related to Ca+ ?

Inversely (decreased P- = increased Ca+)

Patient Centered Care

Involve family and friends in care. Elicit patient values and preferences. Provide care with respect for diversity

RBC's carry Heme... what does Heme carry?

Iron

When you experience blood loss anemia, you also experience _______ deficiency.

Iron

Hemoglobin (Hgb)

Iron-rich protein found in RBC's

Responsibilities of Hospital-based nursing

Identifying very sick patients Help stabilize sick patients Prepare them for transport Care for patients who have medical or surgical conditions Care for a variety of patients

How will you assess a clients language if they are having difficulty speaking

If a client is having difficulty speaking you can assess their language by pointing to familiar objects and asking the patient to name it, ask the patient to respond to simple verbal and written commands such as "sit" or "stand," ask the patient to read simple sentences out loud. Assess for asphasia is English their second language or is there a developmental delay. Assess tone volume and inflections.

What if I have an old health care power of attorney or living will. or signed one in another state?

If you previously signed a living will or health care power of attorney, even in another state, it is probably valid. However, it may be a good idea to sign the most current forms. For example, the current South Carolina living will form covers artificial nutrition and hydration whereas older forms did not.

What is released in anaphylaxis?

IgE is released which then releases histamine

What is the most abundant Immunoglobulin?

IgG

Which Immunoglobulin is transferred across the placenta? (Baby to Mother)

IgG

What immunoglobulins are responsible in Type II?

IgG AND IgM

What the first antibody to develop in a newborn?

IgM

How does edema occur?

Imbalance of Na+ and H2O which causes diruption of the pushing-pulling pressures of the vessel

How does one's "personal value system" affect nursing practice and how a nurse responds to ethical dilemmas?

It can affect nursing practice by what she believes and it may cause her to not want to do a procedure that is granted. The workplace that she works at may allow abortions but she does not agree so that will cause conflict within the practice. The nurse may respond to an ethical dilemma by not practicing what should be practiced because what they believe/ culture/ or educational level.

How does the SNS effect renal function?

It causes vasoconstriction which keeps pressure up but can inhibit renal blood flow at time

Where is strep found and how can it turn bad?

It found in the mouth and is bad if it finds a break in the skin

What function does calcium have in the cell membrane?

It gives it, its shape and allows for transmission for a nerve impulse for one to another.

How does ATP help the sodium potassium pump work?

It gives up a phosphate

How does dopamine aid in renal function?

It is a neural vasodilator which helps keep blood pressure and renal perfusion up.

Why should we define nursing?

It provides a framework for nursing

How does HIV work?

It rewrites messages in our body to destroy CD-4 cells meaning we have lost CD-8

How does CD-8 identify injured cells?

It uses MCH-1 in order to tag cells that need to be removed

What happens when we have high levels of phosphorus?

It will bind to calcium thus lowering calcium levels

Where is IgE found and whats its function?

Its found in the lungs, skin and mucous membrane and plays a role in allergic reaction and release histamine

What is HLA-MHC?

Its when the body recognizes self and see that they can work together

What aspect of autoregulation helps maintain pressure within the organ itself?

Juxtaglomerular Complex

treatment of hypokalemia

K+ tablets (If severe give K+ IV) **K+ is very lethal (be careful)

Where should I keep my health care power of attorney or living will?

Keep the original in a safe place where your family members can get it. You also should give a copy to as many of the following people as your are comfortable with: your family members, your doctor, your lawyer, your minister or priest, or your agent. Do not put you only copy o these documents in your safe deposit box.

What activates vitamin D?

Kidneys

80% of K+ that leaves the body leaves through which organ?

Kidneys (ie. urine)

what is the 4th technological development? Genetics, Biomedical, Information and

Knowledge

Hildegarde Peplau: Nursing

Knowledge; nursing different from medicine; strong

Megaloblastic Anemia

LARGE, floppy RBC's with short life spans resulting from abnormal nucleic acid synthesis

What is ischemia and what can it lead to?

Lack of oxygen which can turn into infarction.

Florence Nightingale

Lady with the lamp. Cared for soldiers during the Crimean War

What is the treatment for neurogenic shock?

Large volumes atropine- to increase hr vasopressor- Nor epi Treat the underlying cause

which trend is NOT a cause of the current nursing shortage?

Larger numbers of young, inexperienced nursing educators in schools of nursing

What is the most important statutory law affecting nurses in each state?

Law established through formal legislative processes • Nurse Practice Act: Defines the authority of the State Board of Nursing • Defines the practice of nursing • Sets educational qualifications/requirements for licensure • Legal titles/abbreviations that nurses can use • Provides disciplinary action for licensees

Efferent

Leads away from the hypothalamus

Spanish American War Contribution on the nursing profession

Led to the development of a permanent Army Nurse corps (1901) and Navy Nurse Corps (1908)

Civil War Contribution on the nursing profession

Led to the first training schools for nurses after the this war

What pump in the heart propels blood to the body?

Left Heart

Advance Directives

Legal documents that indicate the wishes of adult individuals in regards to end of life issues In SC there are 2 advanced directives 1. Health Care Power of Attorney 2. Living Will Other types of advanced directives 1. Organ donation EMS DNR (do not resuscitate) order

What are "advance directives?"

Legal documents that indicate the wishes of adult individuals in regards to end of life issues In SC there are 2 advanced directives 1. Health Care Power of Attorney 2. Living Will Other types of advanced directives 1. Organ donation EMS DNR (do not resuscitate) order

Name an example of a Parasite

Lice

What is the impact of "continuing education" on the nursing practice?

Life-Long Learning Continuing Education Informal ways that nurses maintain expertise during their professional careers Conferences, short courses, workshops, etc. are examples

the founder of public health nursing in the U.S. was

Lillian Wald

first educated nurse in the united states

Linda Richards

New England Hospital School of Nursing

Linda Richards- first trained nurse Mary Mahoney- first black nurse

Where is IgD found?

Lining of the chest on B cells

Type of Short Acting Insulin

Lispro

What is the most effective diuretic agent and what does it do?

Loop Diuretic (Lasix): Inhibit the ascending portion of the loop of Henle which reduces nutrient reabsorption.

Where doe reabsorption take place in order to maintain homeostasis and pressure?

Loop of henle and distal convoluted tubule

Functio Lasio means

Loss of Function

With regard to the following Nursing Diagnosis that can be stated for Vivian Bearing in Wit, which best describes the "Signs and Symptoms" - Chronic sorrow related to life threatening illness as evidenced by verbalization of loss of academic role and recurrent expressions of sadness.

Loss of academic role and recurrent expressions of sadness

If the specific gravity of urine is low, what does this mean?

Low renal function

Name an example of a Spirochetes

Lyme disease/Syphilis

RBC's in Megaloblastic Anemia are _____cytic; _____chromic.

MACROcytic; HYPOchromic

How do T cells identify cells that he needs to rid of due to damage or infection?

MCH-1 and MCH-2

MCV in Megaloblastic Anemia

MCV > 100

How does MHC-1 and CD-8 work together?

MHC tags and CD-8 sees MCH-1 and DESTROYSSSSS

Theme of fluid and electrolyte balance

MOVEMENT

Who is the master regulator of the immune system?

CD-4

Who is MCH-2 paired with?

CD-4 (Helper T)

Who is MHC-1 paired with?

CD-8

is CO2 or O2 more soluble?

CO2 is 20x more soluble

what is the leading cause of morbidity/mortality worldwide?

COPD

Treatment for Anemia

CORRECT UNDERLYING CAUSE

If your parathyroid hormone goes down what also goes down?

Calcium

Spanish American War Contribution on the nursing profession

Call for trained nurses

What are the two types of shock

Cardiogenic Shock Circulatory Failure

Settlement House Nursing

Care for immigrants

National League of Nursing definition of nursing

Caring, Integrity, Diversity, and Excellence

Spanish American War Contribution on the nursing profession

Catholic women responded again because there were not enough trained nurses

Civil War Contribution on the nursing profession

Catholic women responded because they had a long history of providing for the sick - they were skillful and devoted

Is Calcium a cation or anion

Cation

Is Magnesium a cation or anion?

Cation

Is Sodium a cation or anion

Cation

is Potassium an anion or cation?

Cation

What are the two types of Electrolytes?

Cations and Anions

What are the two types of Circulation?

Central and Peripheral

Locus Ceruleus

Central integrating site in the brain stem for ANS response to stress

delegating task: certified nursing assistants

Checking vital signs Hygiene requests Food/drink requests

Chemotaxis

Chemicals are released at the site to "call" or "signal" the location to the WBCs, like a flar.

Third Stage of Illness

Chemotaxis

What is the most abundant anion in ECF?

Chloride

With regard to the following Nursing Diagnosis that can be stated for Vivian Bearing in Wit, which best describes the "Etiology" - Chronic sorrow related to life threatening illness as evidenced by verbalization of loss of academic role and recurrent expressions of sadness.

Chronic Sorrow

Why define nursing?

Clarify purposes and functions Establishes parameters or boundaries of profession Differentiates from other occupations Influences health policy at local, state, and national levels Aid in developing educational cirricula and research agendas Definitions will continue to evolve

Ethical decision-making model - 6 steps:

Clarify the dilemma Gather additional data Identify options Make a decision Act upon that decision Evaluate

ethical decision making model

Clarify the ethical dilemma Gather additional data Identify options Make a decision Act upon that decision Evaluate

What might you need to inquire about prior to performing a neurological assessment

Clients chief complaints their physical condition and willingness to participate/cooperate Medication list family history Inquire with family about changes to the client Cultural beliefs Past injuries Look for delirium, congenital abnormalities, spinal cord injuries Any changes in hearing, vision, smell, taste, tingling in the body, headaches or dizziness Serious infections or anemia

Stage 4 of Hemostasis

Clot Retraction

What is a platelets job?

Clot formation

Stage 5 of Hemostasis

Clot is dissolved & vessel wall edges are sealed

Code of ethics to guide decision making and conduct of its members

Code of ethics to guide decision making and conduct of its members- code of ethics provides profession standards and a framework decision making -The Nightinggale pledge was the first code of ethics

Sister Callista Roy: Person

Cognator/Regulator processes; areas of adaptation - physiologic, self-concept, role function, & interdependence

Sister Callista Roy: Environment

Cognator/Regulator; internal and external environment

"Chromic"

Color

What organization was created in 1996 as the national accrediting body for baccalaureate and higher degree nursing programs?

Commission of Collegiate Nursing Education (CCNE)

List various nursing occupations

Community Health Nursing Hospital-based nursing School Nursing Case Management Nursing Hospice and Palliative Care nursing Occupational Nursing Office-based nursing Military nursing Telehealth nursing Faith Community nursing Informatics nursing Travel nursing Nurse Entrepreneurs

Secondary Polycythemia Vera

Compensatory mechanism for oxygen loss... - Kidneys send Erythropoietin hormone to bone marrow & make the bone marrow produce more carrier proteins.

Second Stage of Hypovolemic Shock

Compensatory mechanisms are able to maintain blood pressure and tissue perfusion at a level succedent to prevent cell damage

Describe the role of a Nurse Practitioner

Conduct physical exams; diagnose and treat common and acute illnesses; manage chronic problems; order and interpret lab tests and counsel/teach patients

Kate Cummings

Confederate Army nurse who kept a diary of her nursing experiences at Confederate hospitals

The Great Depression and World War 2 Contribution on the nursing profession

Congress appropriated 1 million dollars for the training of nurses (1943).

WWI

Congress approved military rank for nurses

WWII

Congress made a budget for nursing education

Patient's Rights

Considerate and respectful care Understandable information regarding diagnosis, treatment, and prognosis Know the identity of health care team members Know the financial implications Make decisions about the plan of care Advance directive Privacy - conversations and records Review his (her) own record and have it explained, except when restricted by law Hospital will make a reasonable response to the request of the patient Ask and be informed of business relationships with the hospitals/educational institutions, etc Consent to or decline in research studies Reasonable continuity of care Informed of hospital policies and practices relative to patient care

What is the Incubation Period?

Contagious but no Symptoms

What does potassium do?

Controls cell excitability such as heartbeat and nerves.

Regulating System

Cooperating mechanisms that act to maintain homeostasis

What is hypersensitivity?

Immune system gone wrong

What is the third line of defense?

Immunity

Primary Prevention Example

Immunizations, health promotion education

What is it called when your body can recognize self vs. non-self but doesn't have the tools to fight it?

Immunodeficiency

What is the division of antibodies?

Immunoglobulin

How do you fight Graft vs. Host?

Immunosuppression Therapy

Pica

Craving for non-nutritional things to eat - ICE - dirt/clay - ashes - wood

Mary Ann Bickerdyke

Created cleaner conditions for those injured in the war, had no nurse training

Commission of Collegiate Nursing Education (CCNE)

Created in 1996 by the American Association of Colleges in Nursing Nationally accrediting body for bachelor and higher degree programs, it began in 1998

Madeleine Leininger Theory

Cultural Care Diversity and Universality

which of the following characteristics is a social determinant of health a. technical skills b. religion c. political affiliation d. cultural influences

D

What is Production Anemia?

Impaired production of RBC's

Responsibilities of Community Health Nurses

Improve the overall health of communities by planning and implementing health programs delivering care for individuals with chronic health problems Provide education programs in health maintenance, disease prevention, nutrition and child care Immunization clinics and health screenings and work with teachers, parents, physicians and community leaders toward a healthier community

What is the significance of critical thinking in nursing?

Improves patient outcomes, think on your feet, good problem solving skills, increases sufficiency

1947

In ____ segregation of African-American nurses was ended.

Johnson & Johnson Campaign for Nursing's Future

In partnership with National Student Nurses Association (NSNA), NLN, ANA, Sigma Theta Tau International (STTI)

Where would fluid build up in Right sided congested heart failure and why?

In the body and because the right side of the heart receives blood from the body

Where would fluid build up in Left sided congested heart failure and why?

In the lungs and then possibly back into the body being the left side receives oxygenated blood from the lungs.

Both Sides What are the reasons for the projected nursing shortage?

Inadequate supply of nursing educators, people living together, growing population, less graduates

Martha Rogers

Includes the "nursing process" in her definition. "Nursing aims to assist people in achieving their maximum health potential. Maintenance and promotion of health, prevention of disease, nursing diagnosis, intervention, and rehabilitation encompass the scope of nursing's goals." The first definition to mention the "Nursing Process." Professional Association's Definitions of Nursing

Prostaglandins role in inflammatory response

Increase in histamine, increase in inflammation (aspirin?)

What is the result of anaphylaxis?

Increased Vasodilation and capillary permeability, and bronchi constriction

Neuroendocrine Responses during Stress

Increased communication = between neurological and endocrine systems Cerebral Cortex = cognition and increased alertness Limbic System = emotional center Thalamus = Sorts out sensory input Hypothalamus = coordinates responses from the endocrine system and ANS Pituitary Gland = secretes TSH (goal: secretion of T3 and T4, both of which are necessary for metabolism regulation in every cell of the body) and ACTH (goal: secretion of adrenal hormones) Reticular Activating System (RAS) = increases mental alertness, skeletal muscle tone; responsible for circadian rhythm

Alpha 1

Increased glycogenolysis and smooth muscle contraction (blood vessels) and breakdown of glycogen

Beta 2

Increased hepatic gluconeogenesis, glycogenolysis, and muscular glycogenolysis

How have wars influenced the world of nursing?

Increased skills and technology. Saw the need for more trained nurses; ended discriminations and barriars

With regard to the following Nursing Diagnosis that can be stated for Vivian Bearing in Wit, which best describes the "Defining characteristics" - Hyperthermia related to Infection as evidenced by temperature of 102 degrees, pulse of 120, and low white blood cells (neutropenia).

Increased temperature and pulse, and neutropenia

With regard to the following Nursing Diagnosis that can be stated for Vivian Bearing in Wit, which best describes the "Signs and Symptoms" - Hyperthermia related to Infection as evidenced by temperature of 102 degrees, pulse of 120, and low white blood cells (neutropenia).

Increased temperature and pulse, and neutropenia

What function does Vitamin D play?

Increasing calcium absorption which increases phosphate

Basis of Pender's Health Promotion Model

Individual Characteristics, experiences, and personal factors

Primary open angle glaucoma (called simple)

" Accounts for 90% cases - Onset is gradual " Flow of Aqueous Humor (AH) is slowed/stopped by obstruction leading to increased intraocular pressure = damage to optic nerve.

cataract risk factors

" Aging " High doses or long term use of steroids " Smoking " Diabetes " Renal disease " Disorders r/t lipid metabolism

Ototoxicity risk factors

" Aspirin " Quinine " IV - aminogly-cosides and furose-mide (Lasix) are the most common

Retinal Detachment treatment

" Bed rest " Prevent and minimize eye stress o Cover both eyes to prevent further detachment o Protect patient from injury o Avoid jerky head movements " Prepare for surgical intervention o Laser photocoagulation - used to seal the area if complete detachment has not occurred To reattach retina and restore vision

Otitis Media (Middle Ear) Diagnostic Findings

" Bulging Tympanic Membrane (TM) " Purulent drainage if TM ruptures (pain de-creases temporarily).

Otosclerosis assessment

" Can involve one or both ears " Presents as progressive conductive and/or sensorineural hearing loss " Loud sounds when chewing " Ringing or roaring " Constant tinnitus

Otosclerosis risk factors

" Cause un-known but could be hereditary

Eye Infections Conjunctivitis - nursing care

" Cold compresses to alleviate symptoms " Avoid nosocomial infections - hand washing.

cataract Diagnostic Findings

" Decrease in visual acuity " Opthalmoscopic exam " Slit lamp exam

chemical burns nursing care

" Determine if solution is acidic or alkaline. " Check with poison control who often can provide insight as to chemical make-up of substance and treatment.

Meniere's Disease treatment

" Diet - low sodium diet (2000 mg/day) " Medication therapy o meclizine (Antivert) treatment of vertigo o diazepam (Valium) - vertigo o Antiemetics-promethazine (Phenergan) - for n/v and vertigo. o Diuretic therapy (hydrochlorothiazide) - decreases circulating volume o Niacin - for vasodilatory effect Surgical treatment performed when above therapy ineffective or patient's functional level extremely diminished. Shunt may be performed to assist with drainage of excess fluid.

Macular Degeneration assessment

" Distortion of vision " Loss of central vision

glaucoma risk factors

" Family history " Over 40 " Diabetic

Meniere's Disease assessment

" Feeling of fullness in ear " Tinnitus (constant or intermittent) " Incapacitating vertigo " Hearing loss " N/V " Severe headaches " Nystagmus (during attacks)

cataract Post-op Nursing:

" HOB elevated 30 - 45 degrees. " Position supine or on non-operated side the night after surgery. " Eye patch at all times (until returns for post-op visit about 24hrs.). " Put personal belongings on non-operative side. " Assist with ambulation. " Teaching/Learning o Avoid eye straining, rubbing, or pressure on eyes. o Avoid bending over to pick up objects, coughing, sneezing, straining, lifting objects over 5 pounds. o Administer eye drops and medications as prescribed. (Mild pressure on lacrimal puncta to decrease system absorption and side effects). o Eye shield at bedtime for 1-4 weeks. o If lens implant not performed, must wear glasses at all times. o Notify physician for decrease in vision, severe eye pain, or increase in eye discharge.

Foreign bodies Nursing Care

" Have patient look upward and expose lower lid. " Use wet cotton-tipped applicator with sterile NS and gently twist swab over particle to remove it. " If unable to see, have patient look downward, use cotton tipped applicator to invert upper lid to expose particle; then remove. Penetrating objects (BBs, pencil lead, metal from drilling) " Never remove! " Cover object with a cup. " Do not allow patient to bend over. " No pressure on eye. " Patient seen immediately by physician to remove object.

Macular Degeneration risk factors

" Hypertension " Increased age " Smoking " Overweight

Hearing Loss risk factors

" Impacted cerumen " Otitis Media " Otosclerosis " Damage to inner ear structures " Recurrent ear infections " Chronic exposure to loud noise " Ototoxic meds " Low birth weight " Family history

chemical burns treatment

" In ED, irrigate with NS or an ophthalmic irrigation solution " Antibiotic ointment and patch " Visual acuity and follow-up

Foreign Bodies of the External Ear - Risk factors

" Insects " Peas " Beans " Pebbles " Toys " Beads " Impacted cerumen

Foreign Bodies of the External Ear treatment

" Irrigation, suction or instrumentation " Irrigation contra-indicated with insects or dry beans (anything that may swell) " Use mineral oil if insect - kills insect and allows it to be removed

External Otitis (External Ear) Nursing care

" Local heat 20 minutes TID " Bed rest to assist in reducing pain " Medications as prescribed " Keep ears clean and dry. " Ear plugs for swimming " Discontinue hair products or headphones that may be irritating.

Chemical Burns risk factors

" Mace, " household cleaners

cataract treatment

" New studies investigating ways to slow cataract progression- Vit. C & E " Surgical removal of lens - (15% pts) one eye at a time, allow for healing " Intracapsular extraction - lens is removed intact in the lens capsule " Extracapsular extraction -lens material is removed without removing the posterior lens capsule " OP surgery - only use lidocaine gel " Lens implantation may be necessary and done at time of surgery " Contact lens corrects vision but is difficult for the elderly " Eyeglasses - very thick and do not provide as high a quality of vision correction

cataract assessment

" Opaque or cloudy white pupil " Gradual loss of vision " Painless blurry vision " Decreased color perception " Photophobia " Vision that is better in dim lighting " Absence of red reflex " Diplopia (double vision)

cataract Pre-op Nursing:

" Orient patient to surroundings and sounds. " Anticoagulation therapy is withheld. " No aspirin or NSAIDS for 3-7 days prior. " Instruct patient about measures to decrease or prevent intraocular pressure (IOP). " Administer preoperative eye medications - mydriatics (dilate pupils) and cycloplegics (dilate pupils and paralyze ciliary function).

External Otitis (External Ear) assessment

" Pain " Discharge " Aural tenderness " Fever " Cellulitis " Lymphadenopathy " Pruritis " Hearing loss " Feeling of fullness

Otitis Media (Middle Ear) assessment

" Pain " Pressure in ear " Hearing loss " Tinnitus " Vertigo " Fever " Headache " Malaise " N/V " Infant = irritable, pulls at ears, sucking ag-gravates pain

External Otitis (External Ear) treatment

" Pain relief and decreasing inflammation with analgesics for 48 - 92 hours " Antibiotics and/or corticosteroid drops " Oral antibiotics if cellulitis or systemic involvement

Meniere's Disease nursing care

" Prevent injury during vertigo. " Bed rest in quiet environment " Assistance with walking. " Instruct to move slowly to prevent worsening of vertigo. " Salt and fluid restrictions as prescribed. " No smoking (vasoconstriction). " Administer/teach meds as ordered. Nursing interventions - post-op: " Assess packing and dressing on ear. " Speak on unaffected ear. " Neuro assessments " Side rails up " Assist with ambulation. " Beside commode " Administer antiemetics and meclizine (Antivert) as prescribed.

Foreign Bodies of the External Ear nursing care

" Procedure for irrigation: o Use warm tap water. o Fill syringe with warm water. o Place a basin under ear to be irrigated. o Place tip of syringe at an angle so fluid pushes at one side of impaction or Foreign Body. o Watch fluid return and for signs of removal of cerumen or Foreign Body. o If doesn't drain out, wait 10 minutes and try again. o Monitor for nausea, if nausea - stop.

glaucoma assessment

" Progressive loss of peripheral vision " Vision worsening in the evening and difficulty adjusting to dark rooms " Blurred vision " Halos around white lights " Photophobia " Eye pain " Progressive loss of central vision

hearing loss nursing care

" Provide information concerning a TDD (telephone device for the deaf), which transmits typed words over the phone line. " Suggest light activated devices rather than sound activated (doorbells, smoke alarms, etc.). " Avoid crowded, noisy environments. " Teach how to use hearing aids.

Eye Infections Conjunctivitis - assessment

" Redness " Drainage " Matting " Itching and scratchy feeling " Photophobia

Otitis Media (Middle Ear) treatment

" Rest " Analgesics " Antibiotics - ear drops " Oral and Nasal antihistamines Chronic Otitis Media (OM) = tubes often placed in ears

Cataracts nursing diagnosis risks

" Risk of falls r/t opacity of lens " Risk for injury r/t accidents " Social isolation r/t impaired vision " Anxiety r/t to surgery

Retinal Detachment Risk Factors

" Severe myopia " Diabetic retinopathy " Trauma " Macular degeneration " Previous cataract surgery

Hearing Loss assessment

" Speech problems " Tinnitus " Increasing inability to hear in groups " Need to turn up volume on TV " Straining to hear

Retinal Detachment assessment

" Sudden onset " Flashes of light " Floaters " Blurred vision " Sense of a curtain being pulled over visual field " Loss of portion of visual field " Typically is unilateral

Otosclerosis nursing care

" Teach patient he/she is not allowed to have MRI is prosthesis contains metal

Macular Degeneration nursing care

" Teach to use visual aids (ex., large print books, magnifying glass).

Glaucoma nursing diagnosis

" The nerve damage is r/t increased intraocular pressure (IOP) due to congestion of aqueous humor. " Pain r/t sudden increase in IOP " Risk for injury r/t blindness " Risk for falls " Social isolation

Eye Infections Conjunctivitis - treatment

" Topical antibiotics, eye drops or ointment " For severe cases may need oral antibiotics

Meniere's Disease risk factors

" Unknown " Possibly viral and bacterial infections " Allergic reactions " Smoking " Vascular disturbance resulting in microcir-culation in the labyrinth " Ear infections

Acute closed angle (medical emergency)

" Usually affects 1 eye " Abrupt onset of severe eye pain, headache, N/V, fixed pupil, blurry vision, cloudy cornea " Meds: decrease IOP:Mannitol;Surgery to help drain Aq.H.

External Otitis (External Ear) risk factors

" Water in ear canal (Swimmer's ear) " Trauma to ear canal " Bacterial invasion

evidence-based practice

"An approach to the delivery of health care that integrates the best evidence of research studies and patient care data with clinical expertise and patient preferences and values." Nurses need to be aware of the research that supports the specific nursing interventions.

Jean Watson: Nursing

"Carative Factors" care as essential nursing knowledge and something to be learned; its not just an action or want we do; nurses need to be fully present; create positive conditions for patients

Ethical decision-making

"Decisions that are consistent with one's personal or organizational value system".

ethical dilemma

"Involves the need to choose from among two or more morally acceptable options or between equally unacceptable courses of action".

Homeostasis

"The orderly stepwise process for stopping bleeding" (5 cascading events to stop bleeding)

the first nurse practice acts passed in the U.S.

"permissive" laws

beneficence

"the doing of good." Determining what is "good" for the patient.

Virginia Henderson: Nursing

"the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge"

What two groups include promotion of health, patient advocacy, and safety in patient-centered environments?

(ANA) American nurses association and (ICN) international council of nurses

What is a myocardial infarction?

(Heart Attack) Death of the myocardium tissue which results from lack of O2 because of a blockage in the coronary arteries.

5 types of WBC's

(Never Let Monkeys Eat Bananas) 1. Neutrophils 2. Lymphocytes 3. Monocytes 4. Eosinophils 5. Basophils

What does CFP, IHP, & CCOP do to keep fluid from leaking out of the vessels?

(PUSHES - OPPOSES - PULLS) 1. CFP - pushes fluid OUT of the capillaries and into the interstitial fluid 2. IHP - OPPOSES ALL FLUID MOVEMENT 3. CCOP - Pulls fluid INTO the capillaries

Name an example of a myeoplasm and another name for it

(mini bacteria) Pneumonia

4 functions of Ca+

(muscles, nerves, blood, & bones) 1. Increases skeletal & cardiac muscle contraction 2. Regulates nerve impulse transmissions 3. Assists in blood clotting 4. Provides bone strength and density

respiratory acidosis

*#1 Manifestation: Hypoventilation

respiratory alkalosis

*#1 Manifestation: hyperventilation

hypomagnesemia

*#1 cause: excretion through stool

Aplastic Anemia

*AAA* - Deficient RBC's, WBC's, and Platelets.

Characteristics of a Nursing Professional (Kelly's Criteria)

*Code of ethics to guide decision and conduct* -Code of ethics provides professional standards and a framework for decision making -ANA code of ethics is found inside back cover of book -The Nightingale Pledge (box 3- 1p.57) - first code of ethics

Aplastic Anemia

*Nursing Interventions: 1. Antibiotics (in place of deficient WBC's) 2. Education (avoid causative agent) 3. Monitor for infection (patients often die from secondary infections)

Characteristics of a Nursing Professional (Kelly's Criteria)

*Scope and Standards of Nursing Practice -Nursing:Scope and Standards of Practice (ANA, 2010) -outlines the expectations of the professional role of the nurse -establishes the responsibilities for which nurses are accountable

Vessel Spasm

*Stage 1 of hemostasis **Reduces blood flow (vasoconstrictor) ***Occurs as soon as there is injury to endothelium

Signs and Symptoms of Type 1

*Sudden weight loss *3 Ps *fatigue *paresthesia *SUDDEN ONSET*

glaucoma treatment

*The goal is to prevent damage to the optic nerve by reducing IOP.* 1 .*Miotics *- constrict pupils & improve outflow of aqueous humor: pilocarpine, carbachol Side Effects -cholinergic side effects (blurry vision, headache, N/V, sweating, abdominal cramps, diarrhea) 2. *Medications to decrease production of aqueous humor:* a. carbonic anhydrase inhibitors - Acetazolamid b. beta blockers Timolol Side Effects - bronchospasm, bradycardia, hypotension

Characteristics of a Nursing Professional (Kelly's Criteria)

*There is an association that encourages and supports high standards of practice* -American Nurses Association (ANA) is official voice of nursing -Advocate for nursing interest -Purpose of ANA

Signs and Symptoms of Type 2

*Weight gain *3 Ps *fatigue *paresthesia *foot infections *OVER A LONG PERIOD OF TIME*

Characteristics of a Nursing Professional (Kelly's Criteria)

*a specialized body of knowledge that is continually enlarged through research* -highest level of education is nursing PhD (philosophy) -research develops specialized body of knowledge for nursing -evidence based practice theory and research as a casis for practice

Treatments for Types 1

*diet management *exercise *insulin for life/insulin pump/ pancreatic transplant

Treatments for Type 2

*diet management *exercise *oral agents

Characteristics of a Nursing Professional (Kelly's Criteria)

*practitioners are autonomous or independent* -autonomy- one has control over ones practice -nursing licensure makes autonomous practitioners responsible for their own practice -although nursing actions are independent, we work in settings where nursing practice is interdependent -employment setting can determine scope of practice

Characteristics of a Nursing Professional (Kelly's Criteria)

*practitioners are educated in an institution of higher learning* -1909, University of Minnesota- 1st university-based nursing program -1965, ANA position that nursing education should take place in institutions of higher education

Characteristics of a Nursing Professional (Kelly's Criteria)

*practitioners are motivated by service (altruism)* -Altruism- service to others -nurses consider nursing to be key part of their identity -work is important and don't do it for the money, nut compassion for the people.

Characteristics of a Nursing Professional (Kelly's Criteria)

*services involve intellectual activities; accountability is a strong feature* -nursing requires both critical and creative thinking -nursing's unique approach to practice- nursing process - accountability-answerable to someone for something one has done -ANA code of Ethics -"The nurse is responsible and accountable for individual nursing practice..."

Characteristics of a Nursing Professional (Kelly's Criteria)

*services provided are a service to humanity* - nursing provides services essential to well-being of people and society -change word "service" t "caring" -caring is core of professional nursing -nursing provides care to humanity and the welfare of society

What is the charge on a cation?

+

What is the charge on an anion?

-

Practitioners are educated in an institution of higher learning

- 1909, University of Minnesota- Fire university- based nursing program - 1965- ANA position that nursing education should take place in institutions of higher education

How does creatine test work?

- 24 hour urine collection - 2, 1 hour urine collection and then draw blood inbetween

how does K+ leave the body?

- 80% leaves through urine (kidney function) - 20% leaves through vomit/stool (GI function)

Magnet Recognition for Nursing

- A program of the American Nurses Credentialing Center, which is a subsidiary of ANA. - Recognizes health care organizations that provide nursing excellence - Provides a vehicle for disseminating successful nursing practices and strategies - Recognizes quality patient care - Recognizes innovations in professional nursing practice - Provides consumers with the ultimate benchmark to measure the quality of care that they can expect to receive.

What is the Magnet Recognition Program?

- A program of the American Nurses Credentialing Center, which is a subsidiary of ANA. - Recognizes health care organizations that provide nursing excellence - Provides a vehicle for disseminating successful nursing practices and strategies - Recognizes quality patient care - Recognizes innovations in professional nursing practice - Provides consumers with the ultimate benchmark to measure the quality of care that they can expect to receive.

Post WWII Influence (1950's and later)

- Added technology and skills - Recognizes emotion as r/t health, illness, and nursing care.

Practitioners are motivated by service

- Altruism- service to others - Nurses consider nursing to be a key part of their identity - Work is important and don't do it for money, but compassion for people

There is an association that encourages and supports high standards of practice

- American Nurses Association (ANA) is official voice of nursing - Advocate for nursing interest purpose of the American Nurses Associations is to work for the improvement of health standards and the availability of health care services for all people, to foster high standards of nursing, and to stimulate and promote the profession development of nurse and advance their economic and general welfare

4 issues associated with DECREASED Hct

- Anemia - Hemorrhage - Cancer - Kidney disease

S&S of CVA

- Asymmetric facial drooping - Sluggish actions & speech

Practitioners are more autonomous or independent

- Autonomy- one has control over ones practice - nursing licensure makes nurses autonomous practitioners responsible for their own practice - although nursing actions are independent, we work in settings where nursing practice is interdependent - Employment setting can determine scope of practice

Dorthea Dix

- Avid reformer of care of the mentally ill; - Appointed by President Lincoln as Superintendent of Women Nurses of the Army

Purpose of ANA (American nurses Association)

- Broad purpose organization - National student nurses association - Improve health standards and availability of health care for all people. - Foster high standards for nursing - Stimulate and promote the professional development of nurses - Advance the economic and general welfare of nurses

What are the purposes of the American Nurses Association (ANA)?

- Broad purpose organization - National student nurses association - Improve health standards and availability of health care for all people. - Foster high standards for nursing - Stimulate and promote the professional development of nurses - Advance the economic and general welfare of nurses

Virginia Henderson's definition of nursing

- By 1960, this definition was widely accepted and represented and emergence of contemporary nursing

How to monitor HIV?

- CD4 count test and viral count - check for opportunistic infections

Spanish American War (1898)

- Call for trained nurses - Catholic women responded again b/c there were not enough trained nurses - Untrained afro-american nurses responded - Led to the development of a permanent Army Nurse Corps (1901) and Navy Nurse Corps (1908

Dorothea Orem's Definition (1959) (nursing theorist)

- Captures the self care theory on nursing: - Nursing gives direct assistance to a person, as required, because of the person's specific inabilities in self care resulting from a situation of personal health.

Nursing definitions will continue to evolve due to:

- Changing knowledge and skills Individual groups can not agree

Mary Ann Bickerdyke

- Civil War lay nurse who rallied the soldiers, cleaning up the camps and the soldiers

What happens in stage 3 of Hemostasis?

- Clotting is activated via the Intrinsic Pathway or Extrinsic Pathway - Prothrombin converts to Thrombin, which converts to Fibrinogen, which makes a Fibrin Clot

10 professional nursing values

- Compassion/Caring - Accountability and responsibility - Ethical - Knowledgeable - Teamwork - Patient Advocate - Holistic (mind body and spirit) - Competent - Openness to learning - Respectful

telehealth nursing

- Deliver health care to patients through telecommunication technology - Use of computers, interactive video linkages, teleconferencing, transmission of patient's clinical and lab data

Benefits of belonging to a professional organization

- Develop leadership skills - Certification - Research Opportunities - Defining practice standards and redefining policies - Legislative lobbying powers - Publications - Health/Life/Malpractice Insurance - Continuing Education

What are the benefits of belonging to a professional nursing organization?

- Develop leadership skills - Certification - Research Opportunities - Defining practice standards and redefining policies - Legislative lobbying powers - Publications - Health/Life/Malpractice Insurance - Continuing Education

Treatment of folic acid deficiency:

- Diet (Things w/ lots of folic acid... Orange Juice) - Prenatal vitamins

S&S of impaired O2 transport (as related to anemia)

- Dyspnea (pulmonary system tries to increase O2 but it cannot because there are no carriers) - Dizziness/Faint - Weakness/Fatigue - Angina - Tachycardia (compensatory)

Vietnam War (1965-1985)

- Estabilishment of Medicaid and Medicare - Era of Specialty care - Emergence of physician's assistand and nurse practitioner - Rapid influx of medical knowlege and technology

Defining Nursing

- Establishes purpose/function - Differentiates from other occupations - establishes parameters and boundaries - Influences health policy at local state and national levels - used in laws and nurse practice acts - Aid in developing educational curricula and research agendas

Mary Mahoney

- First black trained nurse

Adelaide Nutting

- First professor of nursing in the world

Mildred Montag

- Founded ADN education in 1952

Lillian Wald

- Founded the Henry Street Settlement and public health nursing

Florence Nightingale

- Founder of modern nursing and nursing education

Clara Barton

- Founder of the American Red Cross

Values

- Freely chosen principles and ideas - Gives meaning and direction to a persons life - Abstract representation of what is right or desirable - Values are developed as a culture, society, and individual change - Assists in making day to day choices and decisions - Nurses need to understand their own value system (first step in self awareness, which is important in maintaining a non judgmental approach)

manifestations of hyperkalemia

- GFR < 10 - general muscle weakness - WIDE QRS (leading to CA)

Isabel Hampton Robb

- Helped to form the National League of Nursing and the American Nurses Association

Why is Renal Failure often associated with heart failure?

- In renal failure, the patient cannot urinate... - 80% of K+ leaves through urine... - K+ regulates cardiac muscle contraction... **If there is a buildup of K+ because of Renal Failure, the heart will beat way too fast and eventually FAIL

World War II (1931-1945)

- Included Great Depression - Schools of nursing attached to hospitals closed due to funding; led to nursing shortage - Graduate nurses were hired for minimum wage to work in hospitals - Army commissioned its nurses in 1947 - Segregation of Afro-American nurses ended - Trend towards more technology - Further progress toward professionalism

Martha Roger's Definition (1961)

- Includes the nursing process in her definition: - Nursing aims to assist people in achieving their maximum health potential. Maintenance and promotion of health, prevention of disease, nursing diagnosis, intervention, and rehabilitation encompass the scope of nursing goals.

World War I (1917- 1930)

- Influenza epidemic swept the country at same time - Nationwide recruiting effotr to recruit young women into nursing schools - Advocated collegiate schools fo nursing rather than hospital based - Established the Army School of Nursing - Nurses gained military rank; nurses had the authority and responsibility to manage and care for their patients

How is ICF/ECF balance maintained?

- Intake and output of fluid - Hormone secretion - Normal cell functioning

Beliefs

- Intellectual acceptance of something as true and correct - Serves as road-map for critical thinking and decision making - Shown through attitude and behaviors - It is important to know and understand ones beliefs - Need to adopt non-judgmental attitudes - Most recent published set of beliefs called the nursing code of ethics by ANA.

faith community nursing

- Interest in spirituality - Interest in wellness and health promotion - Usually employed by the church - Holistic approach to healing

Nursing Literature (Library)

- Journals - written for nurses, latest information, usually had the word nursing in it, usually a journal for eery area of specialty. - Magazines- written for the lay public, will occasionally have an article that is health disease related. Usually has an article that is currently a news maker. Some magazines are health wellness related.

Statutory law affecting nursing in each state

- Law established through formal legislative processes - Nurse Practice Act: defines the authority of the State Board of Nursing * Defines the practice of nursing * Sets educational qualifications/requirements for licensure * Legal title abbreviations that nurses can use * Provides disciplinary action for licensees

Folic Acid Deficiency = increased ____ with normal ____.

- MCV - MCHC

treatments of hypomagnesemia

- Mg+ supplements - diet - IV

Nursing Interventions for Anemia

- Monitor VS, I&O - Monitor & control bleeding - Provide RBC and fluid vol. replacement

Letter written to nursing students/faculty by the Anne Bavier PhD, RN, FAAN

- NLN states that "doing the right thing is simply how we do business" - Our actions reveal our commitment to telling the truth - Nurses must be guardians of the ethical treatment of patients - Every action and choice is thought to aim at something good

4 functions of Cl-

- Nerve conduction - Muscle transmissions - Maintains fluid in vessels - Binds w/ hydrogen = Hydrochloric Acid

Holistic Nursing

- Nourishes the whole person - Mind Body and Spirit

Mary Breckenridge

- Nurse midwife who founded the Frountier Nursing Service

American Nurses Association Definition of nursing

- Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families, communities, and populations.

what is involved in the OLD CARTS scale?

- Onset - Location - Duration - Character - Aggravation factors - Radiation - Time - Severity

Hildegard Peplau

- Pioneer in nursing theory

2 issues associated with INCREASED Hct

- Polycythemia Vera - Dehydration

SC Definition of the practice of nursing

- Practice of nursing: The provision of services for compensation, except as provided in this chapter that assists persons and groups to obtain and promote optimal health. Nursing practice requires the use of nursing judgement. Nursing judgement s the logical and systematic cognitive process of identifying pertinent information and evaluating data in the clinical context in order to produce informed decisions which guide nursing actions.Nursing practice is provided by advance practice rn's and lpn's. The scope of practice varies and is commensurate with the education preparation and demonstrated competencies of the person who is accountable to the public for the quality of nursing care. Nursing practice occurs in the state in which the recipient of nursing services is located at the time nursing services are provided.

Describe the functions of the National Student Nurses Association?

- Promotes professional growth - Discounts on products - Voice for nursing students - Mentor students - Promote development of skills - Advocate high quality of health care

Functions of the National Student Nurses Association (SNA)

- Promotes professional growth - Discounts on products - Voice for nursing students - Mentor students - Promote development of skills - Advocate high quality of health care

Define morals

- Provides standards of behavior - Established rules of conduct to be used in situations in which a decision about right and wrong must be made - Reflect how individuals or groups behave - Learned over time and are influenced by life experiences - Theories of moral development - Kohlberg

Morals

- Provides standards of behavior - Established rules of conduct to be used in situations in which a decision about right and wrong must be made - Reflect how individuals or groups behave - Learned over time and are influenced by life experiences - Theories of moral development - Kohlberg

Challenges of Afro-American Nurses in the late 1800-early -mid 1900

- Racial barriers for education - one black nurse was admitted to the New England Hospital for woman and children (1878) Mary Mahoney - Segregated Nursing Schools - First program exclusively for black women was established at the Atlanta Baptist Female seminary in 1886 (Spelman College) - Racial Barriers for military - In 1847 segregation of black nurses ended.

Personal Value System

- Rank ordering of personal values - Influence the behavior of individuals - Learned beliefs that help people choose among difficult alternatives - Vary among individuals - Enable people to resolve conflicts - Nurse must determine if their value system is ethical - Professional ethics outweigh personal ethics in a professional setting

Most Fundamental Human Right

- Respect for others - Valuing every aspect of a person's life - Each individual is unique and equal to others - Foundation to all ethical principles

What is the most fundamental human right, which is the foundation for all ethical principles?

- Respect for others - Valuing every aspect of a person's life - Each individual is unique and equal to others - Foundation to all ethical principles

Why is Florence Nightengale credited with being first nurse researcher?

- She collected data on morbidity and mortality of soldiers to argue the case for reform of British Army medical system - She stressed scientific training for nurses and founded the first training school for nurses at St. Thomas's Hospital in London

Florence Nightingales Definition

- Simple - Dealt with basic needs of the patient - Nature acting upon him - Use of fresh air, light, warmth, cleanliness, quiet and proper diet - At the least expense to the patient

Philosophy of Nursing

- Study of principles underlying conduct, thought and the nature of the universe. It is a search for meaning, contemplating, pr wondering about something. - Statement of beliefs about nursing - Expressions of values in Nursing - Used for decision making and the practice of nursing - Individual nursing philosophies - Collective philosophies (hospitals school of nursing)

Midland's Tech Philosophy of Nursing

- Support mission of college - Affirm the worth and dignity of the individual - Nursing art and science with varying levels of practitioners - Education lifelong process - Education includes prep in general academics & tech skills - Contains scope of work for LPN and RN

MTC Nursing Program: Philosophy of Nursing

- Support the mission of the college - Affirm the worth and dignity of the individual - Nursing is an art and science with varying levels of practitioners - Education is a lifelong process - Nursing education includes preparation in general academics and technical skills - Contains the scope of practice for the LPN and RN

treatment for CVA

- TPA (only for ischemic stroke) - remove clot - Heparin to reduce clotting - ACE inhibitors

Services provided are a service to humanity

- The #1 reason someone wants to be a nurse?- To help people - nursing provides services essential to well-being of people and society -Change word "service" to "Caring" - Caring is core of professional nursing - nursing provides care to humanity and the welfare of society

American nurses Association Definition of Nursing (2003)

- The most current definition that reflects the evolution of professional nursing is from the 2003 edition of the ANA Nursing social policy statement

Patient Rights

- The public wants a say in matters affecting their healthcare - Guarantees certain rights and privileges to every hospitalized patients

Virginia Henderson's definition

- The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge; and to do this in a way as to help him gain independence as rapidly as possible.

Civil War (1973)

- There were no professional nurses available - Catholic women responded b/c they had a long history of providing for the sick/ the were skillful and devoted - Placed women in leadership possitions in hospitals - Led to the first training schools for nurses after the Civil War

Nursing interventions & treatments for Hemolytic Anemia

- Treat underlying cause (extrinsic or intrinsic) - Monitor for SEPTIC SHOCK

Describe "moral development."

- Various Theories - Describes how a person deals with moral dilemmas from childhood to adulthood - Kohlbergs theory is utilized in MTC nursing program <9 years: self centered >9 years and adults: conform to expectations of family/groups/society - Independent thinking: defining own moral values (higher intellectual development)

Moral Development

- Various Theories - Describes how a person deals with moral dilemmas from childhood to adulthood - Kohlbergs theory is utilized in MTC nursing program <9 years: self centered >9 years and adults: conform to expectations of family/groups/society - Independent thinking: defining own moral values (higher intellectual development)

How does Platelet Aggregation take place?

- When endothelium is injured it leaks out a chemical called Von-Willebrand Factor which is like a flare, showing the point of injury. - Platelets are attracted to Von-Willebrand Factor and immediately travel to the injury. *Platelets are smooth and normally do not aggregate... - However, when they reach the injury site, they meet up with ADP and become spikey like burrs, sticking together around the endothelial injury.

treatment of hyperkalemia

- administer K-Exolate (promotes extreem diarrhea to rid K+ of body) - decrease Na+ intake to decrease HTN - consider dialysis for kidney function

causes of hyperphosphatemia

- decreased PTH - decreased Ca+ - increased P- - damaged parathyroid - kidney failure

manifestations of hypophosphatemia

- decreased RBC, WBC, and Platelet creation - bone pain

metabolic acidosis

- decreased pH - decreased HCO3-

respiratory acidosis

- decreased pH - increased PCO2

manifestations of open pneumothorax

- difficulty breathing - anxiety/panic - decreased O2 stats - cyanosis - TRACHEAL DEVIATION - hypotensive

Isotonic Fluid Volume Excess treatment

- diuretics - fluid restriction - I&O measurement/daily weight - decreased Na+ intake

Values

- freely chosen principles, ideals, or standards -gives meaning and direction to a persons life - abstract representation of what is right or desirable -values are developed as culture,society,and individuals change -assist in making day to day choices and decisions -nurses need to understand their own value system -first step to self awareness

Hyponatremia causes

- gain of H2O (osmotic shift) - loss of Na+ (dilution by H2O)

causes of Isotonic Fluid Volume Deficit

- hypovolemia - loss of ECF

causes of Isotonic Fluid Volume Excess

- increased Na+ (= increased fluid) - increased aldosterone (RAAS) - renal failure (decreased voiding)

causes of hypophosphatemia

- increased PTH - increased Ca+ - decreased P- - diuretics

respiratory alkalosis

- increased pH - decreased PCO2

metabolic alkalosis

- increased pH - increased HCO3-

causes of increased ICP

- injury (inflammation) - disease (inflammation) - chemicals (that cross BBB) - position (ex: handstand)

causes of metabolic acidosis

- ketoacidosis (diabetic/alcoholic) - renal failure - lactic acidosis - toxins (meth.)

treatment of increased ICP

- limit valsalver maneuvers - correct cause - monitor LOC

Hypernatremia causes

- loss of H2O (vomit, diarrhea) - gain of Na+ (kidney failure)

Services involve intellectual activates; accountability is a strong feature

- nursing unique approach to practice- nursing process - Accountability- answerable to someone for something one has done - ANA code of ethics- "the nurse is responsible and accountable for individual nursing practice"

5 treatment for asthma

- open airway!! (bronchiodilators) - oxygen - steroids (decrease inflammation) - epinephrine (bronchodilator/vasoconstrictor) - water (thin mucus)

treatment of hypophosphatemia

- oral P- supplements - look for parathyroid tumor

Purposes of a professional nursing organization

- professional standards of practice - Ethical conduct of members - Ensure high quality - Leadership opportunities - Meet present and future challenges

Purposes of the Professional Nursing Organization

- professional standards of practice - Ethical conduct of members - Ensure high quality - Leadership opportunities - Meet present and future challenges

What are the purposes of the professional nursing organizations?

- professional standards of practice - Ethical conduct of members - Ensure high quality - Leadership opportunities - Meet present and future challenges

Isotonic Fluid Volume Excess manifestations

- rapid weight gain - hypertensive, hight BP, low HR - edema -JVD

treatment of autonomic dysreflexia

- remove/correct cause - remove ted hoes - place in upright position to avoid increased ICP - drugs to block ANS response

CRPS sypmtoms

- severe, burning, incapacitating pain - spontaneous pain - edema - abnormalities of blood flow to skin of area - pallor, rubor, sweating or dryness, skin atrophy

manifestations of hypermagnesemia

- short QRST interval - decreased BP - CA - decreased Ca+ (antagonist to Mg+)

S&S of COPD

- shortness of breath - barrel chest - alveolar wall destruction - destruction of elastin - enlarged mucous glands

treatment for COPD

- stop smoking for pete's sake - home O2 (teach - very flammable) - bronchodilators (open airway) - steroids (decrease inflam.) - water (thin mucus)

Isotonic Fluid Volume Deficit manifestations

- sunken, dark eyes - poor skin turgor - weight loss - low BP/high HR - dehydration

factors influencing diffusion of gas

- thickness & SA of alveoli (smoking & CF) - solubility of gas - pressure difference of gasses

manifestations of autonomic dysreflexia

- vasospasm - hypertension - goosebumps - bradicardia - above injury: red, flushed, extremely high BP, fast pulse - below injury: pale, cold, low BP, slow pulse

causes of respiratory acidosis

- ventilatory failure - acute airway obstruction - severe pneumonia - pulmonary edema - neuromuscular disorders - CNS depression (drugs or CNS event)

causes of metabolic alkalosis

- vomiting - diuretics - mineralcorticoid activity

manifestations of hypercalcemia

- weak, brittle bones - weak, flaccid muscles - constipation (weak gut muscles) - low phosphate levels

Magazines

- written for public - contains current "news maker" - will occasionally contain article health/disease related - some magazine health/wellness related

Using Henderson's Philosophy in Practice

-14 basic needs general focus of patient care (p.180) -nurses role changes in relation to the patients changing needs

First training program for nurses in US

-1873- Melinda Ann "linda" Richards; first "trained nurse" educated in US -1879- 11 US training schools -1900- 432 hospital owned/operated schools -programs ranged from 6 months to 2 years in length -awarded diploma upon graduation -primary reason for school was to staff hospitals,not education of student nurses -"diploma program" was, and still is, term for hospital-based nursing education

studies of the quality of nursing education

-1900- concern over poor quality of many nurse training programs -American Society of Superintendents of Training Schools for Nurses - committee to investigate how to better prepare nurses for leadership schools of nursing - CHAIRED BY ISABEL HAMPTON ROBB - Teachers College in NY selected for location of leadership training of nurses

declining enrollment in diploma nursing

-2000 programs in 1920s and 1930s -now less than 60 -growth of ADN and BSN programs in higher education -hospitals inability to finance nursing education -accreditation standards -increase complexity of healthcare -diploma not easily transferred to higher level education

diploma nurse

-3 year program -hospital based program -highly trained and skilled nurses -lecture given by physicians -clinical training supervised by head nurses and nursing directors -areas of surgery, obstetrics, pediatrics, and psychiatry

BSN programs today

-4 year program -gen ed in first 2 years -admission to nursing major for last 2 years -part of 4 year colleges and universities -course focuses n nursing science, communication, decision making, leadership, and care of patients of all ages in a variety of settings -BSN programs needed to provide leadership in administration, public health, and teaching -BSN needed for basic management levels on hospital units

certifying organizations in nursing

-American Association of Colleges of Nursing Certification Corporation -American Nurses Credentialing Center (ANCC) -box4-1: areas of certification by the ANCC -national association of neonatal nurses -national association of nurse practioners -pediatric nurse certification board

first training school for nurses in the US (1872)

-Bellevue Hospital, New York -New England Hospital for children and women, New Haven, Connecticut -Massachusetts General Hospital , Boston

Purposes of American Nurses Association (ANA)

-Broad purpose organization -National Student Nurses Association -Improve health standards and availability of heath care -Foster high standards of nursing -Stimulate and promote the professional development of nurses -Advance the economic and general welfare of nurses

ICN (International Council of Nurses) Code of Ethics

-Called the international council of nurses code for nurses - 80+ nations - Respect for the life, dignity, and integrity of all people in a manner that is unmindful of nationality, race, creed, color, age, sex, political affiliation, or social status

Characteristics of a magazine article

-Designed to inform or entertain -Main purpose is to sell advertising -Intended for general public -Contain attractive or appealing colors, graphics and illustrations -Written in a non-technical, easy-to-read style -Prior knowledge of the topic not needed to understand the article -Written by a journalist, freelance writer or anonymous author -Topic of article is written in broad scope -Published by a commercial organization -Does not contain a bibliography

Benefits of Belonging to a Professional Organization

-Develop leadership skills -certification -research opportunities -defining practice standards and redefining policies -legislative lobbying power -publications -health/life/malpractice insurance -continuing education -discounts -networking with peers

How do you treat Anaphylaxis?

-Epi which constricts blood vessels and relaxes the bronchi -Oxygen, fluids, VS, Antihistamine drugs and corticosteroids

Vietnam War (1965-1985)

-Establishment of medicaid and medicare -Era of specialty care -emergence of physicians assistant and nurse practitioner -rapid influx of medical knowledge and technology

A specialized body of knowledge that is continually enlarged through research

-Highest level of education is Nursing PhD (doctor of philosophy) - Research develops specialized body of knowledge for nursing - Evidence-based practice- theory and research as a basis for practice

What components will you assess when examining the neurological system?

-Level of consciousness -Cranial Nerves -Extremeties for sensation to light touch and painful touch -Motor and cerebellar function, coordination and balance and deep tendon reflexes -intellectual function, memory, knowledge, abstract thinking, behavioural, emotional status -language

Purposes of the National League of Nursing

-Oldest organization (1893) -Advances quality nursing education -Concerned with quality nursing for all types of nursing programs -practical nursing -ADN -BSN -MSN

characteristics of a nursing journal

-Present results of original research, conference proceedings and literature reviews -Intended for specialized readers (nurses, doctors, students, etc.) -May contain charts, graphs, or tables -Written in a highly technical style -Written for readers who have some prior knowledge of the subject -Written by someone in the field (credentials are listed) -Contains jargon specific to author's field -Published by or in association with an academic institution or professional organization -Articles are long in length -Topic of article is narrowly focused and explored in-depth -Contains footnotes or bibliography

State Nurse Practice Act

-Statutory Law Affecting Nursing in each state -law established through formal legislative processes. laws vary from state to state. -legal titles/abbreviations that nurses can use -provides disciplinary action for licenses

Midland's Tech Philosophy of Nursing

-Support the mission of the college -Affirm the worth and dignity of the individual -Nursing is an art and a science with varying levels of practitioners -Education is a lifelong process -Nursing education includes preparation in general academics and technical skills Contains the scope of practice for the LPN and the RN

Marry Ann Bickerdyke

-a civil war lay nurse who railed the soldiers, cleaning up the camps and the soldiers

certification

-a credential that has professional but not legal status -a certificate is awarded by a professional group as a validation of specific qualifications demonstrated by the RN in a defined area of practice -RNC -CPNP -CFNP -CNE

Lifesaving measures

-a physical care technique that you use when a patients physiological or psychological state is threatened -purpose is to restore physiological or psychological homeostasis -includes administering emergency medication, performing CPR, intervening to protect a confused or violent patient, and obtaining counseling from a crisis center for a severely anxious patient

Standing order

-a preprinted document containing orders for routine therapies, monitoring guidelines, and/or diagnostic procedures for specific patients with identified clinical problems -give nurses legal protection to intervene appropriately in the best interests of patients with rapidly changing needs

Nursing Licensure

-a process by which a government agency (state board of nursing) grants permission to qualified persons to engage in a given profession or occupation -upon successful completion of licensing exam, graduates may legally practice nursing in their own state -can use RN credential

Popularity of ADN programs

-accessibility to community colleges -low tuition cost -part time and evening hours -shorter duration (2 year) -graduate eligible to take NCLEXRN -step in progression to the BSN or Masters degree

professional nursing values

-accountability -cmpassion -competence -ethical conduct -holistic, person centered care -knowledge -openness to learning -patient advocate -respect for each person dignity and worth -teamwork

NLN Commission for Nursing Education Accreditation (NLN CNEA)

-accredits all types of nursing programs -created by the NLN -march 10, 2017- the nursing programs of Concordia College Alabama in Selma and Wilson College in Chambersburg, PA were the first accredited by NLN CNEA

listening

-active listening -open posture

Types of direct care

-activities of daily living -instrumental activities of daily living -physical care techniques -lifesaving measures -counseling -teaching -controlling for adverse reactions -preventative measures

Activities of daily living (ADL)

-activities usually performed in the course of normal day -include ambulation, eating, dressing, bathing and grooming -assistance with ADL's may be temporary, permanent, or rehabilitative -ranges from partial assistance to complete care -allow patient to participate as much as possible

Post WWII influence on Nursing (1950s-later)

-added technology and skills -recognized emotions as r/t health, illness, and nursing care -many nurses began receiving Master's Degrees - wanted to test new ideas about nursing - nursing theory born

community health nursing

-ambulatory clinics -hospices -homes -clinics -an additional role for the nurse

Dorothea Dix (1802-1887)

-an avid reformer of care of the mentally ill; appointed by president Lincoln as Superintendent of Women's Nurses of the Army -created month long training program for woman who wanted to serve

Bioethics

-application of ethical theories and principles to moral issues or problems in health care -started around 1970; healthcare providers started to look at patients holistically(entire being) in addition to treating/curing disease. -concerned with figuring out what should be done in a particular instance by applying ethical principles -keeping a patient alive on a ventilator for an extended period of time though the patient has no brain activity -this can be a huge dilemma for nurses- determining the meaning of "life"

Values

-attitudes, ideals, or beliefs that an individual or group holds to guide their behavior -expressed in terms of right or wrong- these can be good or not so good -values are freely chosen -indicates what a person considers most important -honesty, loyalty, hardwork etc

Six ethical principles based on human dignity and respect

-autonomy -beneficence -nonmaleficence -justice -fidelity -veracity

Associate Degree Programs

-began in 1952 due to post world war II nursing shortage -developed by MILDRED MONTAG in 1950s community college movement -most common type of basic nursing education program in US -graduates the most RN candidates of all basic programs -2 year program -employed in a wide variety of settings and function autonomously alongside BSN and diploma graduates

Virginia Henderson's definition of nursing

-by 1960, this definition was universally accepted and represented and emergence of contemporary nursing -focus on well and sick people -responsibility of care us shared by the patient and the nurse -Goal for the patient is to be as independent as possible

Spanish-American War (1898)

-call for trained nurses -catholic women responded again because there were not enough trained nurses -untrained African American nurses responded -led to the development of a permanent Army Nurses corps (1901) and Navy Nurses Corps (1908)

Communicating nursing interventions

-can be done in an electronic, written, or oral format -EHR or written formats validate that you performed a procedure and provides valuable information to subsequent caregivers about the approaches needed to provide successful care -interdisciplinary care plan: plans representing the contributions of all disciplines caring for a patient

Dorothea Orem's Definition of Nursing (1959)

-captures the "self-care" theory of nursing -belief that nurses only do for the patient what they would do for themselves -encourages the patient to do more as their condition improves -patient has an active role in her(her) care.

3 Skills nursing practice requires to implement direct and indirect nursing interventions

-cognitive skills -interpersonal skills -psychomotor (technical) skills

Types of indirect care

-communicating nursing interventions -delegating, supervising, and evaluating the work of other staff members

Nurse Practitioner

-conducts physical exams -diagnose and treat common and acute illnesses -manage chronic problems -order and interpret lab test -counsel and teach patients

Patients rights

-considerate and respectful care -understandable info. regarding diagnosis, treatment and prognosis -know the identity of the health care team members -know the financial implications -make decisions of the plan of care -advance directive -privacy- conversations and records -review his (her) own record and have it explained, except when restricted by law -hospital will make a reasonable response to the request of the patient -ask and be informed of business relationships with the hospitals/ educational institutions, etc -consent to or decline in research studies -informed of hospital policies and practices relative to patient care

Commission on Collegiate Nursing Education (CCNE)

-created in 1996 by the American Association of College nursing -nationally accrediting body of baccalaureate and higher degree programs -began in 1998

List 4 important things that the "Nurse Practice Act" does for nursing?

-define the practice of nursing -sets educational qualifications/requirements for licensure -legal titles/abbreviations that nurses can use -provides disciplinary action for licensees

Delegating, supervising, and evaluating the work of other staff members

-delegation allows you to use your time more wisely and to have NAP assist by performing noninvasive and frequently repetitive interventions -3 approaches to delegation

Magazine characteristics

-design to inform or entertain -main purpose is to sell advertising -intended on general public -contain attractive or appealing colors, graphics, or illusrtations -written in non-technical, easy to read style -prior knowledge to this topic not needed to understand article -written by journalist, freelance writer or anonymous author -written in broad scope -published by broad scope -does not contain bibliography

Accreditation Commission for Education in Nursing (ACEN)

-diploma -practical nursing -ADN -BSN -MSN -PhD and DNP -founded out of NLN changed name from NLNAC to ACEN in 2013

educational pathways to become an RN

-diploma nurse -ADN -BSN -after completing nursing program, graduates are eligible to take licensure exam (NCLEXRN)

ICN Code of Ethics

-discusses the rights and responsibilities of nurses related to people, practice, society, co-workers and profession -80+ national nursing associations helped adopt the latest version in 2005 -respect the life, dignity, and rights of all people in a manner that is unmindful of nationality, race, creed, color, age. sex political affiliations, or social status

articulated programs

-educational mobility between programs -facilitate opportunities to move up educational ladder -ex: RN-BSN programs (CHE) LPN-ADN program (midlands tech)

Employment Outlook in Nursing

-employment will increase abut 15% through the year 2026 -hospital employment will grow more slowly -outpatient facilities will grow the fastest -highest rate of growth expected in home health facilities -assisted living and nursing home care is an expected area of high growth -APN can expect to be in higher demand -average annual salary for RN was $68,450 in 2016

school nursing

-enhance the educational process by improving the well-being of the target population, children and adolescents -counselors -responsible for seeing that immunizations are current -educate parents, children and teachers regarding health related issues -provide routine and emergency care to children and school employees -safety/accident prevention is a primary concern -routine screenings

morals

-established rules of conduct to be used in situations where a decision about right and wrong must be made -provide standards or behavior for an individual or group -typically learned over time and are influenced by life experience some debate in current research over whether it is learned or if we are born with morals -often used interchangeably with ethics -sometimes difficult to define and distinguish between the two

Nursing informatics

-evolving specialty -combines nursing science with info management science and computer science to manage information nurses need to make the information accessible -understands the needs of the nurse who uses the info system and can design them with the needs, skills, and time constraints of those nurses in mind

Definition of Communication

-exchange of thoughts, ideas, or info -part of every relationship -it includes spoken and written word, gestures, and body moevements

what nurses are NOT responsible for in informed consent

-explaining the procedure- benefits, risks, etc -evaluating whether the doctor actually explained the risks, benefits, etc.

criteria for successful communication

-feedback -appropriateness;reply fits the circumstances and matches the messages -efficiency;simple, clear words -flexibility; deal with patients questions and feelings -be a good listener -take cultural differences into consideration

Baccalaureate degree in nursing

-first BSN program at University of Minnesota in 1909 -by 1919, 7 other programs established with program lengths of 5 years -1965- ANA position paper concluded that baccalaureate education should be foundation of professional nursing -much confusion and debate on roll of BSN vs ADN ever since

Implementation

-fourth step of nursing process -formally begins after you develop a plan of care

Values

-freely chosen principles, ideals, or standards -Gives meaning and direction to a person's life -Abstract representation of what is right or desirable -developed as culture, society, and individuals change -Assist in making day to day choices and decisions -Nurses need to understand their own system. o This is the first step in self-awareness, which is important in maintaining a non- judgmental approach to patients.

Opportunities in Nursing (employment)

-hospital -community -office nursing -occupational health -schools -case management nursing -faith community nursing -informatics nurse -nurse educators -APN -hospice or palliative care nursing -military nurse -telehealth nursing -informatics nursing -travel nursing

nurse managers

-in charge of all activities on their units -manage patient care -manage quality improvement -select and evaluate personnel -resource manager -helpful to have business background

nursing opportunities interesting fact

-in october 2010 the institute of medicine released its landmark report on the future of medicine initiated by the robert wood johnson foundation -increasing number of baccalaureate prepared nurses in the workforce to 80% -doubling the population of nurses with docotoral degrees -the current workforce falls short of these recommendations with only 50% of RN nurses prepared at the baccalaureate or grad degree level

Preventative measures

-includes primary, secondary, and tertiary prevention -preventative nursing actions: promote health and prevent illness to avoid the need for acute or rehabilitative health care

Martha Roger's Definition of Nursing (1961)

-includes the "nursing process" in her definition -the first to mention the "nursing process" -professional Associations Definitions of Nursing

the termination phase

-includes those activities that enable the patient and the nurse to end the relationship in a therapeutic manner -positive and negative feelings often accompany termination -summarize the gains that the patient has made -participants are often tempted to continue the relationship on a social basis. the nurse must realize this is an issue of personal boundaries. differences in social and professional relationships are outlined in box 12-1 on page 234

external degree program

-independent study -virtual university -students must arrange for own clinical experiences -ex: Excelsior College has ADN, BSN, and MSN programs and is accredited by ACEN

World War I (1917-1930)

-influenza epidemic swept the country the same time WWI started -nationwide recruiting effort to recruit young women in to nursing schools -advocate collegiate schools of nursing rather than hospital based -established the Army School of Nursing -Nurses gained military rank; nurses had the authority and responsibility to manage and care for their patients

getting to know you phase (orientation)

-initial development of trust -behaviors nurses use to help develop trust: -straightforward, nondefensive manner -answering all questions as fully as possible, and admitting to the limits of your knowledege -make every attempt to follow through on promises -use active listening, and accept patients thoughts and feelings without passing judgement -listen carefully to your own responses -congruence between verbal and nonverbal communication

Physical care techniques

-involve the safe and competent administration of nursing procedures -require you to protect yourself and patients from injury, use safe patient-handling techniques, use proper infection control practices, stay organized, and follow practice guidelines

Practical Nursing

-last 12 months -technical workers -limited scope of practice -educated in vocational schools, tech schools, and community colleges -becomes licensed practical nurse (LPN) -works in doctors office, nursing home, clinics

Controlling for adverse reactions

-learning to anticipate and know which adverse reactions to expect -adverse reaction: a harmful or unintended effect of a medication, diagnostic test, or therapeutic intervention

Continuing Education

-life long learning -continuing ed -informal ways that nurses maintain expertise during their professional careers -conferences, short courses, workshops, etc are examples

in SC there are 2 advanced directives

-living will -health care power of attorney

Standard nursing interventions

-make it quicker and easier for nurses to intervene -are available in the form of clinical guidelines or protocols

clinical ladder

-multiple-step program for promotion within the hospital system -need experience -need continuing ed -demonstrate clinical competence -pursue formal ed -become certified in your are of specialty

informed consent conditions

-must be voluntarily given -must be given to an individual with the capacity to make such a decision -must be given enough info to make the decision

Florence Nightingales definition of Nursing

-nightingale wrote Notes on Nurisng: What It Is and What It Is Not, 1859 -Focused on the basic needs of the patient

principles for nursing education (nightingale)

-nurse should be trained in an educational institution supported by public funds and associated with medical school -nursing school should be affiliated with a teaching hospital but independent from it -curriculum should include theory and clinical practice -prof. nurses should be in charge of administration, instruction, and be paid for services -students should be carefully selected and should reside in nurses houses that form discipline and character -students should be required to attend lectures, take quizzes, write papers and keep diaries (foundation for nursing education in the US)

factors impacting nursing shortage

-nursing school enrollment -not growing fast enough to meet projected demand for RN and APRNs -2.6% enrollment increase in 2013-not sufficient to meet projected demands for nursing services

other types of AD

-organ donations -EMS DNR order

What strategies might you use when assessing a childs neurological functioning?

-point to simple things they can recgonize - ask them to repeat simple sentences or numbers -watch them play -engage the parents in the discussion -assess for attention span -any unilateral change in eye color -check reflexes

strategies by the nurse to reduce the chance of legal action

-practice in a safe setting -communicate with other health professionals; open and clear communication- verbal and written -delegate wisely meet the standard of care- technically competent; keeping up to date; be aware of peer expectations; participate as an equal on the health care team -carry professional liability insurance -promote positive interpersonal relationships- best strategy

journal characteristics

-present results of original research, conference proceedings and literature reviews -intended for specialized readers may contain charts, graphs, or tables written in highly technical style -written for readers who have prior knowledge in subject -written by someone in the field -contains jargon specific to authors field -published with association or academic institution or professional organization -long in length -narrowly focused and explored in-depth -footnotes or bibliography

Function of the National Student Nurses Association

-promotes professional growth -discounts on products -voice for nursing students -mentor students -promote development of skills -advocate high quality health care

Clinical Nurse Specialist

-provide care in specialty areas -educator -consultant -develop quality assurance procedures

Nurse Midwife

-provide prenatal and gynecological care to normal, healthy women -deliver babies -follow up with postpartum care

5 Preparatory activities in the implementation process

-reassessing the patient -reviewing and revising the existing nursing care plan -organizing resources and care delivery -anticipating and preventing complications -implementing nursing interventions

beliefs

-represents the intellectual acceptance of something as true or correct -Serves as a roadmap for critical thinking and decision-making -Shown through attitudes and behaviors -It is important to know and understand ones ___because the practice of nursing frequently challenges a nurse's __ -Nurses need to adopt non-judgmental attitudes towards patients' beliefs.

Beliefs

-represents the intellectual acceptance of something as true or correct -serves as road map to critical thinking and decision making -shown through attitudes and behaviors -it is important to know and understand ones beliefs because the practice of nursing frequently challenges a nurses beliefs -nurses need to adopt non-judgemental attitudes towards patients beliefs

ANA Code of Ethics

-respect for human dignity, worth and uniquiness -primary commitment is to patient;safeguards to the patient and the public - promotes, advocates for, and strives to protect the rights of the patient -assumes responsibility and accountability for individual nursing practice -preserve integrity and safety, maintain competence, and continue personal/ professional growth and development -assists the profession in improving standards of nursing -participates in the advancement of the profession- practice, education, admin -collabs with other health care team members -promotes nursing values, maintain integrity, and help shape policy

Tips for making decisions during implementation

-review the set of all possible nursing interventions for a patient's problem -review all possible consequences associated with each possible nursing action -Determine the probability of all possible consequences -Judge the value of the consequence to the patient

The Great depression and World War !! (1931-1945)

-schools of nursing attached to the hospitals has to close due to lack of funds- led to nursing shortage -graduate nurses were hired for minimum wage to work in the hospitals -congress appropriated 1 million dollars for the training of nurses (1943) -Army commissioned its nurses in 1947 -segregation of African American nurses ended -trends towards more technology -further progress towards professionalism

Elements of the communication process

-sender -message -receiver -feedback -context or setting

factors impacting nursing shortage

-shortage of nursing faculty restricting program enrollments -in 2012, nearly 80,000 students were turned away from BSN and graduate programs due to: -insufficient number of faculty -clinical sites -classroom space -clinical preceptors -budget constraints

recommendations for the development of nursing educational programs (1930s)

-should be within the system of higher education -nurses should be highly educated -students should not be used to staff hospitals -standards of nursing practice needed to be established -all students need to meet minimum qualifications upon graduation

philosophy of nursing

-statement of beliefs about nursing that demonstrate our values, used to make decisions, ethic issues, critical thinking -individual nurses philosophies -collective philosophies-hospitals and schools of nursing

ethics

-term used to reflect what actions an individual should take -derived from the greek word ethos (habots or customs) -process oriented and require a critical analysis -examples of organizational ethics: -ANA: nursing code of ethics -ICN (international council of nurses):code of ethics

factors impacting nursing shortage

-the US is projected to have a nursing shortage that is expected to intensify as baby boomers age and the need for health care grows -1 million RNs will reach retirement age within the next 10-15 years -in 2015 50% of RN age was 50 or over -average age of RN population is 50 years old

Time management

-the decisions you make about how your time is allocated, prioritized, and sequenced are always interpreted by then patients you serve -your focus on providing individualized patient care can compete with the focus of standardization, efficiency, and cost control of the organization

the working phase

-the nurse and patient address tasks outlines in the previous phase -alternating periods of patient effort. regression is common reaction to stress that often precedes positive changes in behvior -this requires the nurse to be patient, self-aware, and ,mature

Teaching

-the presentation of health care principles, procedures, and techniques to inform patients about their health status so patients can adapt what they learn to their daily routines at hoe to achieve self-care

Civil War (1861-1873)

-there were no professional nurses available -catholic women responded because they had a long history of providing for the sick- they were skillful and devoted -placed women in leadership positions in hospitals -led the first training schools for nurses after the civil war

Considerations when preparing for implementation

-time management -equipment -personnel -environment -patient

3 Approaches to delegation

-unit-based scenario (NAP serves the unit and works off a task list) -pairing (one RN works with a LPN and/or NPA for a shift) -partnering (one RN and one LPN and/or NPA who are consistently scheduled to work together)

occupational health nurses

-usually employed by large companies -provide basic health care services -provide health education/disease prevention -health screenings -emergency treatment to employees

moral development

-various theories -describes how a person deals with moral dilemmas from childhood to adulthood -kohlbergs stages of moral reasoning is utilized in our nursing program -<9 years - self centered ->9 years and adults- conform to expectations of family/groups/society -independent thinking- defining own moral values (higher intellectual development)

Accreditation

-voluntary review process of educational programs by a professional organization -compares the education quality of the program with standards and criteria -an accredited program voluntarily adheres to standards to protect the quality of education, public safety, and the profession itself -accrediting bodies establish standards by which a programs effectiveness is measured -once accredited and in good standing, schools are reviewed every 8-10 years

collaboration skills

-working jointly with other professionals -respect for each ones knowledge and abilities -willingness to work together -supportive organization/workplace -a process in which outcomes are positive for all involved -the nurse-physician collab is the most problematic -collab of nurses with unlicensed assistive personnel affects the quality of care to patients; sometimes mutual respect and cooperation is missing

what nurses are responsible for in informed consent

-working with the primary provider (physician)- communicating patient needs -may witness the patient signing the informed consent -making sure the consent is valid- is the patient competent to sign?

non-professional magazine/journal

-written for lay of prublic -will occasionally contain an article that is health/disease related -usually has an article with what is currently a "news maker" -some are health/wellness related

Nursing journal

-written for nurses -offer the lest info. -research results -usually a journal for every area of specialty -has nursing in the title

Personnel

-you are responsible for deciding whether to perform an intervention, delegate it to an unlicensed member of the nursing team, or have an RN colleague assist you -patient care staff work together as patients' needs demand it

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What are common types of drug errors made in a hospital setting?

.• Wrong drug/IV • Allergy to drug • Wrong drug for patient's disease • Incorrect administration technique • Wrong diluent (solution that mixes with a powdered drug) • Wrong dose • Excessive dose • Insufficient dose • Wrong concentration • Too-rapid IV flow rate • Omitted drug • Wrong patient • Wrong time • Wrong route • Wrong procedure or test • Violation of orders • Wrong label directions • Wrong preparation

What are normal ranges for creatinine test?

0.06 to 1.2 mg/dl

acute pain

1. < 6 months 2. fight or flight 3. anxiety

chronic pain

1. > 6 months 2. low & slow 3. depression

2 mechanisms (ie hormones) for water regulation

1. ADH 2. Aldosterone

What do Helper T-Cells do?

1. Activate other T-Cells (CD-8) 2. To get the B Cell to split and produce memory and plasma cell for antibodies 3. CD-4 and MHC-2 combine when the body is on the offense of phagocytosis

What function does Magnesium have?

1. Activates ATP 2. Low levels can cause lower levels of PTH 3. Stimulates Nerve impulses and skeletal muscle contraction 4. Carbohydrates and Protein Metabolism 5. Enhances protein and DNA Synthesis

Two types of blood loss anemia

1. Acute (ie. trauma, GI bleed,) 2. Chronic (ie. Occult blood loss)

4 issues associated with DECREASED Hgb

1. Anemia (insufficient RBC's) 2. Hemorrhage 3. Bone marrow failure 4. Leukemia

List the 5 phases of the "nursing process."

1. Assessment 2. Nursing Diagnosis - analysis 3. Planning 4. Implementation 5. Evaluation

Define: "Secondary Care"

1. Assists in preventing complications 2. Treatment temporary dysfunction 3. Includes evaluation of long term and chronic care patients for treatment changes

State Board of Nursing (3 functions)

1. Authority to administer the nursing practice act 2. Authority to adopt rules to administer the act 3. Authority to deny, suspend, or revoke a license or to otherwise discipline a licensee or to deny an application for licensure

What are 3 functions of the state boards of nursing?

1. Authority to administer the nursing practice act 2. Authority to adopt rules to administer the act 3. Authority to deny, suspend, or revoke a license or to otherwise discipline a licensee or to deny an application for licensure

3 types of anemia (related to causes)

1. Blood loss anemia 2. Hemolytic anemia (destruction) 3. Production anemia

What is the function of phosphorus?

1. Bone formation 2. Metabolic processes 3. DNA, RNA and phospholipid layer of cell membrane 4. Buffer 5. Needed for RBC, WBC, and platelet formation

4 S&S if Iron deficiency anemia

1. Brittle hair & nails 2. Smooth tongue 3. Oral ulcers 4. Pica

what are the 5 types of spinal nerves?

1. Cervical (C1-C8) 2. Thoracic (T1-T12) 3. Lumbar (L1-L5) 4. Sacral (S1-S5) 5. Coccygeal (1)

What are the 3 Anions?

1. Chloride 2. Bicarbonate 3. Phosphate

Describe the 6 steps that are used in ethical decision making

1. Clarify the dilemma 2. Gather additional data 3. Identify Options 4. Make a decision 5. Act upon the decision 6. Evaluate

Ethical Decision Making (6 steps)

1. Clarify the dilemma 2. Gather additional data 3. Identify Options 4. Make a decision 5. Act upon the decision 6. Evaluate

Rights and privileges to every hospital patient

1. Considerate and respectful care 2. Understandable information regarding diagnosis, treatment, and prognosis 3. Know the identity of health care member 4. Know the financial implications 5. Make decisions about the plan of care 6. Advance directive 7. Privacy (conversation and records) 8. Review his or her own records and have it explained =, except when restricted by the law 9. Hospital will make a reasonable response to the request of the patient 10. Ask and be informed of business relationships with the hospitals/educational institutions etc. 11. Consent to or decline in research studies 12. Reasonable continuity of care 13. Informed of hospital policies and practices relative to patient care

2 main functions of Sodium

1. Controls water distribution & governs osmolarity ("Keeps H20 in check") 2. Regulates Acid-Base balance in cell

Name 5 things that happen when you drink water

1. Decreased Na+% 2. Decreased osmolality 3. Decreased thirst 4. Suppressed ADH release 5. Increased Renal excretion

S&S of Reduction in RBC indices/Hgb levels

1. Decreased RBC, Hgb, & Hct lab values 2. Pallor

2 treatment for Iron deficiency anemia

1. Diet (Beats, liver, dark green food) 2. Iron supplements

2 causes of Iron deficiency anemia

1. Dietary (most common in children) 2. Blood loss (most common in adults)

2 types of megaloblastic anemia

1. Folic acid deficiency 2. Vitamin B12 deficiency (aka Pernicious Anemia)

2 treatments of Aplastic Anemia

1. Frequent transfusions of RBC's & Platelets 2. Bone marrow transplant

4 Types of Technological Developments

1. Genetics 2. Biomedical 3. Information 4. Knowledge

Describe the 4 major categories of health care services?

1. Health Promotion 2. Illness Prevention 3. Diagnosis and Treatment 4. Rehabilitation and Long Term Care

Polycythemia Vera puts you at high risk for which 4 associated conditions?

1. Hypertension 2. Venous stasis 3. Heart Attack 4. Stroke

S&S of Anemia (3 categories)

1. Impaired O2 transport (decreased RBC carrier proteins) 2. Reduction in RBC indices/Hgb levels (size, weight, color, shape) 3. Process causing the Anemia (ie. liver problem... can't break down bilirubin = jaundice)

Name 5 things that happen when you are dehydrated

1. Increased na+% 2. Increased osmolality 3. Increased thirst 4. Increased ADH release 5. Decreased Renal excretion

What is the Infectious Disease Course?

1. Incubation In 2. Prodromal Period (Sick) Puerta Prince 3. Acute Phase (Sicker) A 4. Convalescent Cat 5. Resolution (Better) Ran

2 types of fluid loss

1. Insensible fluid loss - Non-measurable (ie. sweat, water in breath) 2. Sensible - Measurable (ie. stool, urine, vomitus)

Two forms of hemolytic anemia

1. Intrinsic destruction: (cell sickness, defective RBC's - possibly genetic) 2. Extrinsic destruction: (chemical exposure, cell infection, - other external cell destroyers)

3 types of production anemia

1. Iron deficiency anemia 2. Megaloblastic anemia 3. Aplastic anemia

Name 3 causes of Anemia

1. Loss 2. Destruction 3. Production

Define "case management nursing."

1. May work for a hospital or outside agency 2. Ensure that the patient receives the services they need from the entire health care team 3. Most useful with high costs/high volume/high risk patients 4. Follow-Up @ home 5. Assess, plan, facilitate, and advocate

3 nursing interventions for iron deficiency anemia

1. Monitor iron & RBC levels 2. Transfusion of RBC's 3. Education

What function does calcium have not including the cell membranes one?

1. Muscle contraction 2. Coagulation

Percent & absolute count of each type of WBC

1. Neutrophils (55-70%) (2500-8000) 2. Lymphocytes (20-40%) (1000-4000) 3. Monocytes (2-8%) (100-700) 4. Eosinophils (1-4%) (50-500) 5. Basophils (0.5-1%) (25-100)

Patricia Benners stages of "Skill Acquisition"

1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. The Expert

Holistic Nursing is Contributed by 8 factors:

1. Nursing is a whole system 2. Nursing provides several health care services including and maintaining health, preventing disease, restoring health, and achieving a peaceful death. 3. Nursing involves collaborating with patients and their families 4. Nursing is involved with people at points along the nursing continuum 5. Nursing care is provided regardless of age, differences, beliefs, gender, diagnosis, sexual preferences and other factors 6. Nursing requires advanced knowledge and skills 7. Nursing requires caring compassion, concern, respect and warmth 8. Nursing links theory and research in an effort to answer difficult questions.

Define "primary nursing."

1. One nurse is responsible for the 24/7 care 2. Provides care of patient from admissions to discharge 3. Assesses patient/plans care while on duty delegates while off duty 4. Usually an all RN Staff

2 causes of hypocalcemia

1. PTH deficit (decreased tx from bone to serum) 2. Phosphorus excess

2 ways Ca+ is removed from serum

1. PTH pulls it into bone marrow 2. Kidneys remove it through urine

What are the four Portal of Entry?

1. Penetration (Cut) 2. Direct Contact (Mother too child) 3. Ingestion 4. Inhalation

What are the characteristics of a culturally competent nurse?

1. Performs a cultural assessment 2. Understands the differences in cultures 3. Interprets patients behavior correctly 4. Planning care recognizing cultural influences 5. Knowledgeable of attitudes, beliefs, personal space, medications, and effects on illness

Identify the key members of the interdisciplinary health care team and explain what each one contributes.

1. Physicians 2. CNA's/Nurse Techs 3. LPN/LVN 4. Dietitians 5. Pharmacists 6. Lab Tech 7. Therapist 8. Social Worker

4 requirements for hemostasis to occur:

1. Platelets 2. Von Willebrand Factor 3. Calcium (factor IV) 4. Vitamin K (for factor synthesis in the liver)

What is Active Immunity?

Made by host or natural exposure

What is the second most abundant cation in ICF?

Magnesium

Purposes of the National League of Nursing

Main Purpose - Education - Oldest organization for nurses since 1893 - Advances quality nursing education - Concerned with quality nursing for all types of nursing programs - NLNAC - accredits nursing programs

What are the 3 Intracellular Electrolytes?

1. Potassium (K+) 2. Phosphorus (P-) 3. Magnesium (Mg+)

List specific strategies that a nurse can use to limit the possibility of legal action.

1. Practice in a safe setting 2. Communicate with other health professionals; open and clear communication - verbal and written 3. Delegate wisely 4. Meet the standard of care - technically competent; keeping up to date; be aware of peer expectation; participate as an equal on the health care team 5. Carry professional liability insurance Promote positive interpersonal relationships

Strategies by the nurse to limit the possibility of legal action

1. Practice in a safe setting 2. Communicate with other health professionals; open and clear communication - verbal and written 3. Delegate wisely 4. Meet the standard of care - technically competent; keeping up to date; be aware of peer expectation; participate as an equal on the health care team 5. Carry professional liability insurance Promote positive interpersonal relationships

Describe 5 professional responsibilities of professional nurses.

1. Practice nursing under the direction the Standards of Care 2. Quality improvement which includes record review 3. Research- participant 4. Education- preceptor to new nurses 5. Management - head nurses or nurse managers

What are the purposes of the National League of Nursing?

Main Purpose - Education - Oldest organization for nurses since 1893 - Advances quality nursing education - Concerned with quality nursing for all types of nursing programs - NLNAC - accredits nursing programs

What is the function of chloride?

Maintain fluid in blood vessels

What percent of male and female is water?

Male: 60 Female: 50

What are M & F Hct levels in Polycythemia Vera?

Male: > 54% Female: > 51%

2 types of Aplastic Anemia related to bone marrow depression

1. Primary (decrease in all blood cell line) 2. Secondary (chemo, radiation, chemical exposure, viral illness)

The kidneys are the start for what three reactions?

1. RAAS 2. Erythropoietin 3. Vitamin D

3 functions of potassium

1. Regulate muscle contraction 2. Helps control IC osmolality (Na+K+ pump) 3. Helps heart contract by maintaining neutrality (Na+K+ pump)

3 types of Polycythemia Vera

1. Relative 2. Primary 3. Secondary

3 things associated with excess P-

1. Renal Failure 2. PTH deficit 3. Decreased Ca+ levels

What are the 6 chains of infection?

1. Reservoir (Source) 2. Portal of Exit 3. Method of Transmission 4.Portal of Entry 5.Susceptible 6. Etiologic Agent

2 control systems of pH regulation

1. Respiratory system: eliminates CO2 (FAST) 2. Renal system - conserve HCO3- & eliminates H+ ions (slow)

What are the characteristics of a nursing professional?

1. Services provided are a service to humanity 2. A specialized body of knowledge that is continually enlarged through research 3. Services involve intellectual activities, accountability is a strong feature 4. Practitioners are educated in an institution of higher learning 5. Practitioners are motived by altruism 6. There is a code of ethics to follow 7. There is an organization that encourages and supports high standards of practice

2 ways that vitamin B12 deficiency is diagnosed

1. Shillings Test 2. B12 Serum levels

What are the 4 Cations?

1. Sodium 2. Potassium 3. Calcium 4. Magnesium

What are the 4 Extracellular Electrolytes?

1. Sodium (Na+) 2. Calcium (Ca+) 3. Chloride (Cl-) 4. Bicarbonate (HCO3-)

2 subcategories of PNS

1. Somatic (voluntary) 2. Autonomic (involuntary)

What are the two ways GI bleeds are seen?

1. Stool 2. Vomit

Signs and Symptoms of Hypoglycemia

1. T Tachycardia 2. I Irritability 3. R Restless 4. E Excessive Hunger 5. D Diaphoresis/depression

What is the process of T-Cells?

1. T-Cell comes in contact with a viral infection 2. It clones itself into multiple types of T-cells

Describe the three phases of the nurse-patient relationship.

1. The Orientation Phase, introductory phase, or "getting to know you" o Initial development of trust 2. The Working Phase o The nurse and patient address tasks outlined in the previous phase o Alternating periods of patient effort. Regression is a common reaction to stress that often precedes positive changes in behavior o This requires the nurse to be patient, self-aware, and mature. 3. The Termination Phase o Includes activities that enable the patient and nurse to end the relationship in a therapeutic manner o Positive and negative feelings often accompany termination o Summarize the gains that the patient has made o Participants are often tempted to continue the relationship on a social basis

Administration of medications - State board of nursing regulations - 1.A (6)

1. The admin of meds is defined as: The act of preparing and giving drugs in accordance with the orders of a licenses physician or dentist as to drug dosage route and frequency; observing recording and reporting desired effects, untoward reactions and side effects of drug therapy; intervening when emergency care is required as a result of drug therapy; appropriately instructing the patient regarding his meds; recognizing accepted prescribing limits and reporting deviations to the prescribing physician or dentist

Tasks of the Orientation Phase

1. The patient will have developed enough trust in the nurse to continue to participate in the relationship. 2. The patient and nurse will see each other as individuals. 3. The patient's perception of major problems and needs will have been identified. 4. length of the relationship will be estimated, and the nurse and patient will agree to work together on identified problems

2 manifestations of hypocalcemia

1. Trousseau's sign 2. Chvastek's sign

2 types of CRPS

1. Type One: no nerve injury (but severe pain) 2. Type Two: severe peripheral nerve injury (ex: amputation - phantom pain)

Identify the levels of communication.

1. Verbal: o Speaking 2. Non-verbal: o Gestures o Clothing o Posture o Facial expressions o Tone and volume of voice

2 types of neurons

1. afferent neurons (sensory neurons) 2. efferent neurons (motoneurons)

what 3 forms can CO2 be found in?

1. attached to hemoglobin (30%) 2. dissolved - in transit (10%) 3. in combination w/ H2O as HCO3- (60%)

What three things help avoid third spacing?

1. capillary filtration pressure 2. Interstital hydrostatic 3. Capillary Colloidal

3 parts of the neuron

1. cell body (soma) 2. axons (carry impulses away from soma) 3. dendrites (carry impulses to soma)

3 treatments for edema

1. compression (ted hoes) 2. elevation 3. diuretics

2 most common manifestations of metabolic alkalosis

1. confusion 2. muscle weakness (hypokalemia)

4 functions of Magnesium

1. controls heart contraction 2. controls PTH 3. controls P- 4. Activates ATP (w/out Mg+, ATP is not activated..... Na+ does not get with K+ -- the Na+K+ pump does not function correctly)

5 general types of pain

1. cutaneous - sharp, burning - origin: skin 2. deep somatic - diffuse, throbbing - origin: muscle & bone (radiates) 3. visceral - diffuse, poorly defined - origin: body organ 4. referred - perceived at a site different from origin 5. psychogenic - origin is in the brain rather than dendrite

2 phases of asthma

1. early phase (constriction) 2. late phase (inflammation)

4 scales for level of pain

1. face scale 2. FLACC scale 3. PQRST 4 OLD CARTS

What is the sign and symptoms of HIV?

1. fever 2. fatigue 3. rash 4. a headache 5. opportunistic infection 6. night sweats 7. lymphadenopathy

3 orders of neurons

1. first order neurons (detect painful stimuli) 2. second order neurons (process info to thalamus) 3. third order neurons (process info from thalamus to sensory cortex)

two types of CVA

1. ischemic stroke (thrombus/embolism - block) 2. hemorrhagic stroke (hemorrhage - bleed)

3 categories of conducting airways

1. nasopharyngeal airways 2. laryngotracheal airways 3. tracheobronchial tree

2 types of pain (associate with speed)

1. neospinothalamic (acute pain - myelinated) 2. paleospinothalmic (chronic, slow onset, - non myelinated

4 considerations for treatment of general pain

1. pain is whatever the patient says it is 2. start w/ non-pharmacological treatments first 3. when you do use pain meds, use non-narcotic drugs before narcotic 4. always start with lowest dose perscribed

2 causes of hyperkalemia

1. renal failure (can't void = K+ build-up) 2. K+ overdose (easy to do via IV)

2 side effects of Opioids

1. respiratory suppression 2. constipation

2 reasons Ca+ may stay in the bone marrow

1. serum has enough Ca+ 2. not enough PTH to carry Ca+ from bone to serum

2 subcategories of the autonomic system

1. sympathetic (fight/flight) 2. parasympathetic (low and slow)

5 steps of hemostasis

1. vessel spasm 2. platelet plug 3. fibrin clot & blood coagulation 4. clot retraction 5. clot dissolution

2 causes of hypokalemia

1. vomit 2. diarrhea

Urine Specific Gravity

1.010-1.025

How much urine is produced a day?

1.5 liters

WNL for Magnesium (Mg+)

1.8-3.0 mg/dL

What are the normal levels for Magnesium?

1.8-3.0 mg/dl

There is ___ as much ECF as ICF

1/2

What is one common Hypotonic IV?

1/2 Normal Saline (0.45% NaCl)

When does clot retraction occur?

1/2hr - 1hr after clot formation

how many cranial nerves?

12

Normal FEMALE Hgb range

12-16 g/dL

Life span of a RBC

120 days

How much filtrate is produced in the glomerulus?

125 ml/L

WNL for Sodium

135-145 mEq/L

What is sodiums normal limits?

135-145 mEq/L

Normal MALE Hgb range

14-18 g/dL

Short Acting Insulin Time

15 minutes

what % of CO does the brain receive?

15%

Normal platelet count

150,000 - 400,000

nightingale school

1860 at St. Thomas Hospital in london

What year was a permanent army nurse corp established

1901

what year was a permanent navy nurse corp established

1908

The Goldmark Report year

1923

Brown Report year

1948

Community College Education for Nursing (Montag) year

1959

Dorothea Orem

1959 - Capture "self-care" theory of nursing "Nursing give direct assistance to a person, as require, because of the person's specific inabilities in self- care resulting from a situation of personal health" -Belief that the nurses only do for the patient what they would do for themselves -Encourages the patient to do more as their condition improves -Patient has an active role in his (her) care

Virginia Henderson

1960 -this definition was universally accepted and represented and emergence of contemporary nursing "the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge; and to do this in such a way as to help him gain independence as rapidly as possible" -Focus is both to well and sick people -Responsibility for care is shared by the patient and the nurse, -Goal for the patient is to be as independent as possible

ANA Statement year

1965

How long do T cells take to mature in the thymus

2 Days

Describe the preparation of an associate nurse degree

2 year program; part of the technical schools and community colleges; began in 1952; very popular program for various reasons

what % of body wt does the brain constitute?

2%

partial pressure/dissolved O2 represents what percent of total O2 in the body?

2% (the other 98% is combined with hemoglobin)

Long Acting Insulin Time

2-4 hours

Describe each of these terms and state how each is related to nursing practice: malpractice, negligence, assault and battery, delegation, informed consent, and confidentiality?

Malpractice - Negligence in the profession Negligence - Failure to act as a reasonably prudent person would behave in specific circumstances Assault - Threat; an attempt to make bodily contact with another person without their consent Battery - The act carried out. Delegation - Empower one to act for another Informed Consent - Voluntary; individual must be competent and have the capacity to understand. Patient must be given enough information understand; full knowledge authorization by the patient for care treatment or procedures. Must include the risks benefits, side effects, costs, alternatives (do not need consent if it is life threatening) Confidentiality - Protection of private information HIPPA

Gordon: coping/stress tolerance

Manner of Handling Stress; support system

First Stage of Illness

Margination

first African American graduate nurse

Mary Mahoney

MCH stands for...

Mean Corpuscular Hemoglobin

MCHC stands for...

Mean Corpuscular Hemoglobin Concentration

MCV stands for...

Mean Corpuscular Volume

How does an individual's culture influence his/her illness behaviors?

Meanings that are attached to the illness, perceptions of treatment, determines if individual seeks help, predicted or expected behaviors

What is the significance of the positive babinski reflex

Means that if it is seen in anyone over the age of two that there is a CNS dysfunction

delegating tasks: licensed practical nurses

Med administration (varies state by state what kind of meds they can give) Checking vital signs

Explain how being a female-dominated job has affected nursing development as profession

Men felt "role strain" which created anxiety and discontent for men in nursing

3 Metabolic processes of P-

Metabolism of 1. fat 2. glucose 3. protein

Chain of Infection - Part 4

Method of Transmission

Define the "nursing process."

Method used by nursing to solve patient problems

define the nursing process

Method used by nursing to solve patient problems

What is infarction?

Death of tissue which is very painful

WNL for P-

2.5-4.5 mg/dL

How much renal function is lost if BUN is found on urine?

2/3

IOMs future of nursing report year

2011

HCO3- WNL

22-26

What is the lifespan of IgG?

23 Hours

What is a Shillings Test?

24 hour urine test after taking radioactive vitamin B12. - Left over B12 is excreted in urine showing how much was absorbed/not absorbed

How much more fluid is there in intracellular than extracellular?

2x the amount

GCS score 13-15 indicates

Mild head injury

Eustress

Mild, brief, controlled stress (Good Stress)

Who created the associates degree nursing program as the topic of their doctoral dissertation

Mildred Montag

RN

Minimum completion of associate or baccalaureate degree program. NCLEX exam

What are the S1 Valves?

Mitral (Bicuspid) and Tricupsid

GCS score 9-12 indicates

Moderate head injury

Diploma Nurse (program)

3 year program Hospital-based program

Nursing code of ethics

Most recent published set of beliefs for nursing is called the ______ and was published by the American nurses Association. This code of ethics affirms the beliefs about

Where is P- located?

Mostly Intracellular

Osmosis

Movement of water

Conditions of Informed Consent

Must be voluntarily given Must be given by an individual with the capacity to make such a decision Must be given enough information to make the decision

in regard to TIA, how long after initial onset of symptoms can TPA be used to dissolve the clot?

3-4.5 hours

MI

Myocardial Infarction: blockage of blood to heart

Following the completion of a basic program for practical nurses, graduates are allowed to take what licensing exam?

NCLEX-PN

Following the completion of a basic program for registered nurses, graduates are allowed to take what licensing exam?

NCLEX-RN

National League of Nursing's Definition of Nursing

NLN 4 core values of nursing as it relates to nursing education 1. Caring - promoting health, healing, and hope 2. Integrity - respecting the dignity and moral wholeness of the individual 3. Diversity - affecting the uniqueness of and differences among persons 4. Excellence - creating and implementing transformative strategies with daring ingenuity

1937

NLN publish A CURRICULUM GUIDE FOR SCHOOLS OF NURSING , outlining 3 year curriculum and influencing the structure of diploma schools for decades -studies set stage for education we have today

1934

NLN studied the number of nursing schools in existence, gave detailed descriptions of schools, described their curricula, and made recommendations for professional collegiate education

Professional Nursing Organizations

NLN- National League for Nursing ANA- American Nurses Association International Council of Nurses National Student Nurse Association

Is there a cure for Aplastic Anemia?

NOPE

Who regulates the scope of nursing to protect the public?

NPA

Type of Long Acting Insulin

NPH

S&S of Processes causing the Anemia

Decrease in RBC, WBC, & Platelets

Effects of Cortisol in the Immune system

Decreases leukocytes at the site of inflammation or wound Lipolysis (lipid break down) Adipose surrounding face and neck

Scope and Standards of Practice

Defines standards of practice and standards of professional performance. ANA involvement since 1960 Scope- what is allowed/safe Standards of Practice-standards describe a competent level of care

List 4 important things that the "Nurse Practice Act" does for nursing?

Defines the authority of the State Board of Nursing * Defines the practice of nursing * Sets educational qualifications/requirements for licensure * Legal title abbreviations that nurses can use * Provides disciplinary action for licensees

The Purpose of the Nurse Practice Act:

Defines the practice of nursing Sets educational qualifications/requirements for licensure Legal titles/abbreviations that nurses can use Provides disciplinary action for licensees

Elevated BUN could stem from which problem...

Dehydration

What are some causes of decline in mental status in older adults

Delirium Injury or illness Drug toxicity Infection Nutritional deficit Fever Fluid/ electrolyte imbalance Vision or hearing impairments Lack of social interaction leading to depression

What factors must you consider when assessing attention span and calculation

Delirium, age of client, hearing and vision impairment, distraction in environment and any underlying conditions Age of client Education level Cultural differences Language barriers

What things might influence the MMSE

Delirium, age of client, hearing and vision impairment, distraction in environment and any underlying conditions Age of client Education level Cultural differences Language barriers

Responsibility of: Telehealth nursing

Deliver health care to patients through telecommunication technology Use of computers, interactive video linkages, teleconferencing, transmission of patient's clinical and lab data

Responsibilities of Telehealth nursing

Deliver health care to patients through telecommunication technology Use of computers, interactive video linkage, teleconferencing, transmission of patients clinical and lab data

EBP

Demonstrate knowledge based on scientific methods Appreciate Strengths and weaknesses of scientific bases for practice Appreciate the importance of reading relevant nursing journals and considering the contents with practice

Outlines the expectations of the profession role of the nurse establishes the responsibilities for which nurses are accountable

Describe the Scope and Standards of the practice of nursing.

Chain of Infection - Part 1

Infectious Microorganism

Eye Infections Conjunctivitis -

Inflammation and infection of conjunctiva. Bacterial or viral. Known as "Pink eye". Can be spread from one eye to the other.

External Otitis (External Ear)

Inflammation and infection of the external ear.

Otitis Media (Middle Ear)

Inflammation and infection of the middle ear.

What is the second line of Defense?

Inflammatory

World War 1 Contribution on the nursing profession

Influenza epidemic swept the country at the same time WWI started.

What is the impact of continuing education of the nursing practice

Informal ways that nurses maintain expertise during their professional careers Some examples are conferences, short courses, workshops

What is recent memory

Information from earlier in the day or from the current exam. I.e. remembering 3 words spoken at the beginning of the exam

What electrolytes are extracellular?

Na+, CL-, Ca+, HCO3-

The Professional Nursing Organization that has the primary regulatory body in nursing in the U.S.

National Council of State Boards of Nursing

NLN

National League for Nursing; sets standards for excellence and innovation in nursing education

World War 1 Contribution on the nursing profession

Nationwide recruiting effort to recruit young women in to nursing schools.

Informatics

Navigate electronic health record Protect confidentiality of protected health information in electronic health records

Folic acid deficiency is a major problem for pregnant women... Why?

Need for folic acid in pregnant women is 5-10 times greater because it is needed for neural tube development in the embryo

Florence Nightingale: Environment

Need to change the environment so the body can heal itself

Malpractice

Negligence in the profession

What is the function of Calcium?

Nerve Impulses in check

If a women has folic acid deficiency during pregnancy, what defects will her baby most likely have?

Neural tube defects

Restless Legs Syndrome (RLS)

Neurologic sensorimotor disorder that is characterized by an overwhelming urge to move the legs when at rest.

Beginning Nursing Edu

New England Hospital School of Nursing Nightingale Model Schools

first four states to organize state nurses associations with the goal of enacting a nurse practice act for their states

New York, New Jersey, Illinois, and Virginia

NLN Commission for Nursing Education Accreditation (CNEA)

Newly formed (2015) accrediting commission. Accredits all types of nursing programs

are alveoli fully developed in newborns?

No

Macular Degeneration treatment

No cure " Vitamins C, E and zinc " Laser photocoagulation may slow process " Amsler grids are given to patient for use in home to test for change in vision. (Check for change in the grid: more distorted or faded).

Is Primary Polycythemia Vera curable?

No, no it is not.

Non-REM Sleep

Non rapid-eye movement sleep occurs when activity in the reticular activating system is inhibited.

What techniques are helpful in responding to patients and others

Non-judgmental Observe body language Be an active listener Show empathy Demonstrate caring and compassion Ask open-ended questions Give information Use reflection- method of encouraging a patient to think through their problems Silence can be a helpful response

What cells are related to immunity?

Non-phagocitic Cells

What is one common Isotonic IV?

Normal Saline (0.9% NaCl)

state to pass the first nurse licensure act

North Carolina (1903)

What is the purpose of extracellular interstitial fluid?

Nothing its worthless

WNL for Potassium (K+)

3.5-5 mEq/L

What are normal potassium levels and how much do we need daily?

3.5-5 mEq/L and 40mEq daily

Intermediate Acting Insulin Time

30-60 minutes

how many spinal nerves?

31

1883 (10 years after first schools established) how many nursing schools

35

PaCO2 WNL

35-45 mmHg

Normal FEMALE Hct range

37-47%

CVA is the ___ most common cause of death in USA

3rd

Eye opening measurement (GCS)

4 = spontaneous 3= to sound 2 = to pressure 1 = none NT = not testable

Initiatives to provide a stable supply of RN's

4 Major initiatives: 1. American Recovery and Reinvestment Act (2009) 2. Robert Wood Johnson Foundation 3. Johnson & Johnson Campaign for Nursing's Future 4. American Nurses Credentialing Center (ANCC) Magnet Recognition Program

BSN Programs (Now)

4 year program o General education in first 2 years o Admission to nursing major for last 2 years Part of 4 year colleges and universities Course focus on nursing science, communication, decision making, leadership, and care of patients of all ages in a variety of settings. BSN programs needed to provide leadership in administration, public health, and teaching BSN needed for basic management levels on hospital units

Describe the preparation of a bachelor nurse degree

4 year program; part of a 4 year college and universities; BSN programs are needed to provide leadership in administration; public health; and teaching

Holistic Nursing

Nourishes the whole person Body, mind, and spirit 8 factors Contribute to holistic approach to nursing: 1. Nursing is an open system a. Freely interacts with, influences, and is influenced by many forces 2. Nursing provides several health care services including maintaining health, preventing disease, restoring health, and achieving a peaceful death 3. Nursing involves collaborating with patients and families 4. Nursing is involved with people at points along the health-illness continuum 5. Nursing care is provided regardless of diagnosis, differences, age, beliefs, gender, sexual preference, and other factors. Nursing supports the value, dignity, and uniqueness of every person and takes his or her culture and belief system into consideration. 6. Nursing requires advanced knowledge and skills 7. Nursing requires caring, compassion, and concern, respect and warmth. 8. Nursing links theory and research in an effort to answer difficult questions

What are some of the employment opportunities available for nurses with a higher degree?

Nurse Practitioner, Clinical Nurse Specialist, Nurse Midwives, Nurse Anesthetists

first permanent school of nursing

Nurse Training School of Women's Hospital of Philadelphia

Mary Ann Bickerdyke

Nurse for the union army. Renowned for her work in founding, cleaning, and sanitizing union military hospitals

Mary Breckinridge

Nurse midwife, founded the Frontier Nursing Service

World War 1 Contribution on the nursing profession

Nurses gained military rank; nurses had the authority and responsibility to manage and care for their patients.

Florence Nightinggale's notes on Nursing main idea

Nurses have to put the patient in the best condition for nature to act upon them. Environment must be good for patient to get better. Reparative process.

Describe how evidenced-based practice is utilized in nursing practice.

Nurses need o be aware of the research that supports the specific nursing interventions

describe how evidenced-based practice is utilized in nursing

Nurses need to be aware of the research that supports the specific nursing interventions.

Quality Improvement

Nurses should be involved in the continual monitoring of patient data to determine areas for process improvement

Evidence-Based Practice

Nurses should use evidence-based data in conjunction with patient preferences and values to implement the plan of care

Describe the responsibilities of nurse managers

Nurses who are in charge of all activities in their units Manage patient care Manage quality improvement Select and evaluate personnel Resource manager Helpful to have a business background

Describe the responsibilities of nurse managers.

Nurses who are in charge of all activities on their units Manage patient care Manage quality improvement Select and evaluate personnel Resource manager Helpful to have a business background

What type of fluid loss in not recordable?

Insensible

Interstitial

Inside the interstitial space (outside the vessel)

Intravascular

Inside the vessel (outside the cell)

Isabel Maitland Stewart

Instrumental in establishing a standardized nursing school curriculum

Normal FEMALE RBC count

4.2 - 5.4 (x 10 to the 6th)

Urine pH

4.5-8.0 Average: 6.0

Normal MALE RBC count

4.7 - 6.1 (x 10 to the 6th)

How much Potassium do you need each day?

40 mEq

Normal MALE Hct range

43-52%

What % of body weight in people > 60yrs comes from water?

45%

Hypoparathyroidism's effect on Ca+

Insufficient Ca+

VQ WNL

4:5 (4/5 = 0.8) - Ventilation = 4 L/min - Perfusion = 5 L/min

Verbal Response measurement (GCS)

5 = Orientated 4 = confused 3 = words, but not coherent 2 = sounds, but no words 1 = none NT = Not testable

What is one common Hypertonic IV?

5% Dextrose in Normal Saline

Normal WBC count

5,000 - 10,000

when does the greatest development of the alveoli take place?

5-8 YOA (300million by age 8)

What % of female body weight comes from water?

50%

Motor Response measurement (GCS)

6 = obeys command 5 = localizing 4 = normal flexion 3 = abnormal flexion 2 = extension 1 = none NT = not testable

Responsibility of: Faith Community nursing

Interest in spirituality Interest in wellness and health promotion Usually employed by the church Holistic approach to healing

Responsibilities of Faith Community Nursing

Interest in spirituality interest in wellness and health promotion Usually employed by the church Holistic approach to healing

Betty Neuman: Environment

Internal and External environments; remove noxious stimuli

What % of male body weight comes from water?

60%

pH WNL

7.35 - 7.45

______ people are effected every year by CVA... how many of them die as a result?

700,000....1/2

WNL for BUN

8-20 mg/dL

What is normal ranges for BUN test?

8.0 to 20.0 mg/dl

WNL for Calcium (Ca+)

8.5-10.5 mg/dL

What are the normal limits for calcium?

8.5-10.5 mg/dL

What % of infant body weight comes from water?

80%

PaO2 WNL

80-100 mmHg

What % of preemie body weight comes from water?

90%

normal % value for SO2

92%

WNL for Cl-

98-106 mEq/L

Where is the majority of Ca+ found?

99% is found in the teeth & bones

Na+ level in Hyponatremia

< 135 mEq/L

Na+ level in Hypernatremia

> 145mEq/L

Which of the following would be an appropriate reason to join a professional nursing organization? a. develop leadership skills b. add to a job-related resume c. achieve an increase in salary d. enjoy travel to professional conferences

A

which of the following is an example of a positive physical determinant of health for a registered nurse a. safe working environment b. history of cardiac disease c. gender d. supportive charge nurse

A

What factors influence illness behaviors?

Internal: Dependency, ability to cope, ability to manage and maintain control over the situation, resourceful, resilience, spiritual beliefs External: past experiences, culture

What do doctors look for in transplant organs?

A HLA-MHC from 3-5

How does interstitial hydrostatics help avoid third spacing?

A barrier that opposes movements of fluid

Define Concept Mapping and how it is used in nursing.

A concept map care plan is a diagram of patient problems and interventions. An innovative approach to planning and organizing nursing care.

Describe what "certification" means to nursing? List some of the certifying organizations in nursing.

A credential that has professional but not legal status A certificate is awarded by a professional group as a validation of specific qualifications demonstrated by the RN in a defined area of practice

What does certification mean to nursing

A credential that has professional but not legal status A certificate is awarded by a professional group as validation of specific qualifications demonstrated by the RN in a defined area of practice

Sleep Apnea

A disorder characterized by frequent short breathing pauses during sleep. Three types obstructive, central, and mixed.

What is the Juxtaglomerular Complex?

A feedback control system to maintain blood pressure and sodium intake Also stores produces and stores renin

How is a health care power of attorney different from a durable power of attorney?

A health care power of attorney is a specific form of durable power of attorney that names an agent only to make health care decisions. A durable power of attorney may or may not allow the agent to make health care decisions. It depends on what the document says. The agent may only be able to make decisions about property and financial matters.

Define "clinical ladder."

A multi-step program for promotion within the hospital system Need experience Need continuing education Demonstrate clinical competence Pursue formal education Become certified in your area of specialty

Define "Clinical ladder"

A multi-step program for promotion within the hospital system Need experience Need continuing education Demonstrate clinical competence Pursue formal education Become certified in your are of specialty

Lavinia Dock

A nursing leader and women's rights activist

Walt Whitman

A poet who worked as a volunteer nurse in a union military hospital

What does "licensure" mean to the nursing graduate?

A process by which a government agency (State Board of Nursing) grants permission to qualified persons to engage in a given profession or occupation

What is the Magnet Recognition Program?

A program of the American Nurses Credentialing Center, which is a subsidiary of ANA

Magnet Recognition for Nursing

A program of the American Nurses Credentialing Center, which is a subsidiary of ANA Recognizes health care organizations that provide nursing excellence. Provides a vehicle for disseminating successful nursing practices and strategies. Recognizes quality patient care. Recognizes innovations in professional nursing practice. Provides consumers with the ultimate benchmark to measure the quality of care that they can expect to receive.

Stress (according to Seyle)

A state manifested by symptoms that arise from coordinated activation of the neuroendocrine and immune systems

Printzmetals Angina

A syndrome typically consisting of angina at rest that occurs in cycles. - It is caused by vasospasm

Describe the process of "accreditation" of nursing programs. Why should nursing schools be accredited?

A voluntary review process of educational programs by a professional organization Compares the educational quality of the program with standards and criteria An accredited program voluntarily adheres to standards to protect the quality of education, public safety, and the profession itself Accrediting bodies establish standards by which a program's effectiveness is measured Once accredited and in good standing, schools are reviewed every 8-10 years

Describe accreditation process of nursing programs

A voluntary review process of educational programs by a professional organization Compares the educational quality of the program with standards and criteria

which of the following is a quality and safety competency a. evidence-based practice b. tradition-based practice c. teamwork and collaboration d. patient-centered care

A,C, D

What is giving the following order to a client experiencing an alteration in airway status, breathing pattern, or circulatory status?

ABC

List the accrediting agencies that accredit various types of nursing programs

ACEN (Accreditation Commission for Education in nursing CNEA (NLN Commission for Nursing Education Accredition) CCNE (Commission of Collegiate Nursing Education)

If you are dehydrated and sodium is high, what happens o ADH and renal excretion?

ADH is released and excretion decreases

If you are hydrated and sodium is diluted, what happens to ADH and renal excretion?

ADH is suppressed and excretion increases

What level of education do the majority of RN's who are employed have

ADN program

How do you help a Jehovah's witness who will not take a blood transfusion?

ALBUMIN (large particle IV solution that increases osmotic pressure in cells, stoping further blood loss until body can make more blood)

International Council of Nurses

ANA is a part of this organization

American Nurses Association definition of nursing

ANA: nursing is the protection, promotion, optimization of health/abilities, prevention of illness/injury, alleviation of suffering thru diagnosis/treatment, & advocacy in the care of px Nurses are educated to whole person recognize human response to a health problem may have effect on the individual's ability to overcome the initial medical problem. physicians cure, nurses care blend of physiology and psychology, nurses promote restoration/maint of health Nurses' education and holistic focus positions them as providers to build health care sys individuals have responsibility for their personal health focus: edu/practice that facilitates individual efforts to reach their fullest health potential

Benefits of belonging to a professional organization

Develop leadership skills Certification Research opportunities Defining practice standards and redefining policies Legislative lobbying power Publications Health/Life/Malpractice Insurance Continuing education Discounts Networking with peers

What are the benefits of belonging to a professional nursing organization?

Develop leadership skills • Certification • Research opportunities • Defining practice standards and redefining policies • Legislative lobbying power • Publications • Health/Life/Malpractice Insurance • Continuing education • Discounts • Networking with peers

Describe the Orientation Phase of a nurse-patient relationship

Develop trust Gain respect Assess needs of patient Be an active listener Establish a time line with the patient

How does Diabetes Insipidus relate to Hypernatreimia?

Diabetes Insipidus involves decreased ADH causing decreased H2O and increased Na+

Acute pain, abdomen (Diagnostic Set, Defining characteristic, or Related Factors)

Diagnostic Stem

Describe the preparation of a Diploma Nurse degree

Diploma nurse is a 3 year program; sponsored by and attached to the hospital setting; highly trained and skilled nurses; enrollment has declined for various reason

Narcolepsy

Disorder characterized by daytime sleep attacks or excessive daytime sleepiness. Occurs when someone has efficient sleep.

Ototoxicity

Due to medications' adverse effects.

Name an example of a Bacteria

E Coli/ Strep

How do you test for HIV?

ELISA and Western blot if ELISA is positive

Is there anything I need to know about completing the living will or health care power of attorney form?

Each form contains spaces for you to state your wishes about things like whether you want life support and tube feeding. If you do not put your initials in either blank, tube feeding may be provided, depending upon your condition. Be sure to read the form carefully and follow the instructions.

How is vitamin B12 naturally obtained?

Eating animal products

What does third spacing give us an idea of?

Edema

What is edema?

Edema in the wrong place, worthless.

Nursing intervention for folic acid deficiency

Education (especially w pregnant women)

Hildegarde Peplau: Environment

Effect of interpersonal communication/presence, individualized care

The National Recovery Act

Effort to find employment for those out of work during GD but excluded unemployed nurses

Edema in the pericardial &/or pleural cavity is called:

Effusions

What are the signs and symptoms of Type II?

Elevated temps, deep lower back pains and itching

Vietnam War Contribution on the nursing profession

Emergence of the physician's assistant and nurse practitioner

Second Stage of Illness

Emigration or Transmission

Describe the employment outlook in nursing?

Employment will about 15% through the year 2026 Hospital employment will grow more slowly, Outpatient facilities will grow the fastest Highest rate of growth expected in Home-health positions Assisted-living and nursing home care is an expected area of high growth Advanced Practice nurses can expect to be in a higher demand Average (Median) annual salary for registered nurses was $68,450 in 2016

Discuss the employment outlook for nursing.

Employment will about 15% through the year 2026 Hospital employment will grow more slowly, Outpatient facilities will grow the fastest Highest rate of growth expected in Home-health positions Assisted-living and nursing home care is an expected area of high growth Advanced Practice nurses can expect to be in a higher demand Average (Median) annual salary for registered nurses was $68,450 in 2016

Discuss the employment outlook for nursing

Employment will grow much faster, about 22% through the year 2016 Hospital employment will grow more slowly, but outpatient facilities will grow the fastest Home-Health positions are expected to grow the fastest of all Assisted-living and nursing home care is an expected are of high growth Advanced practice nurses can expect to be in higher demand Median annual salary for nurses in 2012 was $64,690 ($44190- $95,130)

Delegation

Empower one to act for another

Benefits of Accreditation

Enables student eligibility for funding support Strengthens education quality Aids in student retention and success Assists employers seeking competent nurses

Medicare and Medicaid (1965)

Ensured access to health care for the elderly, poor, and disabled

Martha Rogers: Person

Environment as one; exchanging energies; one with the universe

Vietnam War Contribution on the nursing profession

Era of specialty care

Henry Street Settlement

Established in New York City in 1893 Founded by Lillian Wald Purpose: address serious health conditions of immigrants **to this day functions to fight urban poverty & to help with community based policies**

morals

Established rules of conduct to be used in situations in which a decision about right and wrong must be made. Provide standards of behavior for an individual or a group. Typically learned over time and are influenced by life experience - some debate in current research over whether it is learned or if we are born with morals. Often used interchangeably with Ethics: Sometimes difficult to define and distinguish between the two.

World War 1 Contribution on the nursing profession

Established the Army School of Nursing

Stillman House

Established together by Jessie Sleet Scales and Elizabeth Tyler Branch of the Henry Street Settlement Severed "colored people" through community health nursing programs Their courageous activism broke through racial barriers

Vietnam War Contribution on the nursing profession

Establishment of Medicaid and Medicare

Dorothea Orem: Environment

Evaluates impact of illness/injury on psychological, physical developmental and social needs

Stressors

Events or environmental agents responsible for initiating the stress response

Chemical Burns

Every minute counts - tap water irrigation started immediately before transport to emergency facility - at least 15 - 20 minutes of flushing

Responsibility of: Informatics nursing

Evolving specialty Combines nursing science with information management science and computer science to manage information nurses need and to make that information accessible Understands the needs of the nurse who uses the information system and can design them with the needs, skills, and time constraints of those nurses in mind

Safety

Examine human factors and basic safety design principles and commonly used unsafe practices Value own role in preventing errors

Hyperparathyroidism's effect on Ca+

Excessive Ca+

Define communication

Exchange of thoughts, ideas or information Part of every relationship Primary instrument through changes that occur

Define communication.

Exchange of thoughts, ideas, or information Part of every relationship It includes spoken and written word, gestures, and body movements

What Nurses are NOT Responsible for in Informed Consent

Explaining the procedure - benefits, risks, etc. Evaluating whether the doctor actually explained the risks, benefits, etc.

Scope and standards of the practice of nursing

Explains what is expected of nurses in general

Other types of preparation

External Degree Program- independent study Articulated Program- RN to BSN; RN to Masters; LPN to ADN

Where is Cl- located?

Extracellular - Intravascular

Where is Na+ located?

Extracellular - Intravascular

What are the three components of the GCS?

Eye opening, verbal responses and motor responses.

what is involved in the FLACC scale?

FOR INFANTS: - Frequent shivering of chin - Legs to chest (fetal position) - Arched back - Crying - Consolable

in regard to CVA, look for these things (FAST)

Face Arms Speech Time

Cranial Nerve VII

Facial, facial expression and taste

Limitations of the GCS

Factors like drug use, alcohol intoxication, shock, or low blood O2 can alter a patients LOC

Nursing Licensure

Facts: -nurses must hold valid license to practice -each state determines who is qualified for licensure, as well as the limits on the license (Nurse Practice Act) -applicants must meet state standards in order to take NCLEX-RN or NCLEX-PN -if you pass exam,you are either a registered nurse or licenses practical nurse

Negligence

Failure to act as a reasonably prudent person would behave in specific circumstances

Negligence

Failure to act as a reasonably prudent person would have acted in the same circumstances.

What are some of the common causes of communication breakdown?

Failure to see the uniqueness of the individual Failure to recognize levels of meaning Use value statements and clichés Give false reassurance Failure to clarify

What are some of the common causes of communication breakdown

Failure to see the uniqueness of the individual Failure to recognize levels of meaning Use value statements and cliches Give false reassurance Failure to clarify

Before Florence Nightingale, men provided most of the nursing care

False

T or F: ADN program accreditation processes determined that ADN students lack the knowledge and skill for becoming registered nurses

False

Gordon: Role-Relationship

Family Roles; work satisfaction

Identify the criteria and strategies for successful communication.

Feedback Appropriateness - Reply fits the circumstances and matches the messages Efficiency - simple, clear words Flexibility - deal with patient's questions and feelings Be a good listener Take cultural differences into consideration

What is another name for Clot Dissolution?

Fibrinolysis

What is WBC's job?

Fight infection & react against foreign bodies

Baccalaureate Degree Nurse (History)

First BSN program at University of Minnesota in 1909 By 1919, 7 other programs established with program lengths of 5 years 1965 - ANA position paper concluded that baccalaureate education should be foundation of professional nursing o Much confusion and debate on roll of BSN vs. ADN ever since

Isabell Hampton Robb

First president of the Society of Superintendents of Training Schools for Nurses

Mary Adelaide Nutting

First professor of nursing. Appointed head of the department of nursing and health at teachers college of Columbia university

Atlanta Baptist Female Seminary (Spleman College)

First program exclusively for African American women in 1886 was

Yale

First school of Nursing established as a separate University department

Trousseau's sign

Flexion contractor initiates wile taking when bumping BP cuff past systolic

Who cared for the soldiers in 1860 during Crimean war and was first practicing nurse epidemiologist

Florence Nightingale

Who published "Notes on Nursing: What It Is and What It Is Not"?

Florence Nightingale

which nurse is most likely to have kept records on sanitation and nutrition and their effects on morbidity and morality

Florence Nightingale

person that laid the foundation for nursing as a profession

Florence Nightinggale

Edema

Fluid accumulation in interstitial space

Intracellular Fluid (ICF)

Fluid inside the cell

What does it mean when a patient is "third spacing"?

Fluid is accumulating in the interstitial (aka third) space

Extracellular Fluid (ECF)

Fluid outside the cell (hopefully in the vessels -intravascular) (hopefully not in the tissue - interstitial)

What would you listen for, if you expected someone had heart failure?

For the particular valve associated with that side of the heart and any odd sounds.

What is the 2nd stage in hemostasis?

Formation of a platelet plug

Mildred Montag

Founded ADN education in 1952

American Nurses Association (ANA) (1896)

Founded by Isabel Hampton Robb Name changed to ANA in 1911

Clara Barton (1821-1912)

Founded the American Red Cross

clara barton

Founded the American Red Cross

Isabel hampton robb

Founded the american nurses association in 1896

Lillian Wald

Founder of Henry Street Settlement House in NY and Founder of Public Health Nursing

Florence Nightingale (1820-1910)

Founder of modern nursing and nursing education -contributions of development to nursing in US and Britain -hospital reform -upgrade conditions for sick and wounded military -established training schools for nurses

Sophia Palmer

Founder of the New York State Nurses Association

What is the definition of values

Freely chosen principles, ideals, or standards; gives meaning and direction for a persons life, right and desirable representation, values are developed as culture, society, and individuals change, assist in making day to day choices

Endogenous Stressor

From within

Exogenous Stressor

From without

informed Consent

Full, knowing authorization by the patient for care, treatment, and procedures and must include information about the risks, benefits, side effects, costs, and alternatives.

The Great Depression and World War 2 Contribution on the nursing profession

Further progress towards professionalism

what type of data are included under assessment

Gathering information Subjective data - symptoms Objective data - signs

What types of data are included under assessment?

Gathering information, subjective date (symptoms), objective data (signs)

Alarm

Generalized stimulation of the SNS and HPA axis

What is the convalescent period?

Getting better

What is passive immunity?

Given to you from someone else

What is survival potential?

Giving priority to clients in a resource-limited setting who are severely injured but could live if supportive care is provided.

What is least restrictive?

Giving priority to interventions that protect a client by using the most effective and least confining measure possible

What is the nursing process?

Giving priority to nursing actions that focus on collection if assesment data

delegation

Giving someone authority to act for another o Nurses are able to delegate tasks - this comes with great responsibility!

What does Most of the work in the nephron?

Glomerulus

IX

Glossopharyngeal, Taste and ability to swallow

Hormones that raise blood glucose

Glucagon, Epinephrine, Cortisol, and Growth Hormone

What allows the sodium-potassium pump to work and cross the membrane even though they are both cations?

ATP

Afferent

Goes towards the hypothalamus

Cranial nerve VI

Abducens, Lateral eye movement

Nursing (as a profession)

Abides by code of ethics, Autonomy with certain decisions and practice, Defined skills, abilities and norms for a specific service

what is the significance of critical thinking in nursing

Ability to make sound decisions Good problem solving skills Reflective thinking - looking back Think on your feet Improves patient outcomes Motivated by patients' needs Decisions are driven by standards and ethics Honors patient values and beliefs Increases efficiency Need a knowledge base

What is Polycythemia Vera?

Abnormally high RBC count (and increase in WBC & platelet count)

Anemia

Abnormally low Hgb or RBC or both

Reputable Databases for health-related topics

Academic Search Premiere and RD2 Digital Library

What is the definition of beliefs?

Acceptance of something as true or correct, critical thinking and decision-making, attitudes and behaviors, know and understand one's beliefs

XI

Accessory, movement of head and shoulders

What is the official, professional, accrediting organization for Associate Degree Nursing programs?

Accreditation Commission for Education in Nursing (ACEN)

Accreditation Commission for Education in Nursing (ACEN)

Accredits all types of nursing programs A recent letter states "the National Advisory Committee on Institutional Quality and Integrity (NACIQI) recommended to the Secretary of Education that ACEN should lose its recognition as an accrediting body

Primary function of P-

Acid - base buffer

Battery

Act carried out

Why is activated vitamin D important?

Activated vitamin D is required to absorb Ca+

If your body has to do anything to make it, what kind of immunity is it?

Active

What are the two types of Acquired Immunity?

Active and Passive

define nursing diagnosis

Actual or potential problems that the nurse is capable and licensed to treat Analysis of the assessment findings Not medical diagnoses

Define nursing diagnosis.

Actual or potential problems that the nurse is capable and licenses to treat. Human response to illness- problems patient is experiencing as a result of the disease process, analysis of the assessment findings, not medical diagnosis

What are some complications of shock?

Acute respiratory distress syndrome acute renal failure gastrointestinal complications disseminated intravascular coagulation

What are the differences between acute and chronic illnesses?

Acute: Short term, not as serious Chronic: Usually cannot be cured, develop gradually

Describe the role of Nurse Anesthetists

Administer anesthesia for all types of surgeries in various settings

What exactly is an Advance Directive?

Advance Directives are legally binding documents that you can sign to specify the kind of treatment you desire or the type you wish to refuse in the event you are unable to express your wishes when medical treatment is deemed necessary by a health care provider. In South Carolina, there are two types of Advance Directives: Living Will and Health Care Power of Attorney.

World War 1 Contribution on the nursing profession

Advocated collegiate schools of nursing rather than hospital based.

Mary Mahoney

Afro-American nurse who was admitted to the New England Hospital for Women and Children in 1878

What role did the military have in integrating nursing for blacks & other minorities?

After they were allowed into the army, they were accepted socially as well

Responsibility of: Community Health Nursing

Ambulatory clinics Health departments Hospices Homes Clinics Mostly, it becomes an additional role of the nurse

What are employment opportunities for community health nurses

Ambulatory clinics Health Departments Hospices Home Clinics Mostly, it becomes and additional role of the nurse

Linda Richards

America's first trained nurse

common nursing journals

American Journal of Nursing Nursing Times Nursing Orthopaedic Nursing Maternal-Child Nursing RN Journal of Practical Nursing Pediatric Nursing Journal of Gerontological Nursing Nursing Management Clinical Nursing Management Journal of Nursing Scholarship

"Healthy Nurse, Healthy Nation" program is associated with what professional nursing organization

American Nurses Association

Nurses' Associated Alumnae of the United States and Canada turned into

American Nurses Association (ANA)

ANA

American Nurses Association; Improves standards of health and availability, promotes professional development and high standards for nursing and economic welfare

What are some strategies to address nursing shortage?

American Recover Act - calls for 500mil to train & educate nurses and doctors; Rober Wood Johnson Foundation - pursues programs that help create regional work work development systems; Johnson & Johnson; Magnet Program

Why should nursing schools be accredited

An accredited program voluntarily adheres to standards to protect the quality of education, public safety and the profession itself

Autonomic Dysreflexia

An acute episode of exaggerated sympathetic reflex response to pain seen 6 months after a spinal injury at T6 or above

Define evidence-based practice.

An approach to the delivery of health care that integrates the best evidence of research studies and patient care data with clinical expertise and patient preferences and values

Meniere's Disease

An increased amount of inner ear fluid. Meniere's is to the ear as glaucoma is to the eye

Nosocomial infection

An infection acquired during hospitalization.

What does anaphylaxis turn into?

Anaphylactic Shock

What is the first line of defense?

Anatomical Barriers and Biochemical Barriers

Decreased Hgb & Increased Hct represents...

Anemia

Is Chloride a cation or an anion?

Anion

Is Phosphorus a cation or anion?

Anion

Variation in RBC size is called

Anisocytosis

1923

Goldmark Report studied the clinical learning experience of students, hospital control of schools, the desirability of establishing university schools of nursing, the lack of funds specifically for nursing education, and the lack of prepared teachers

The Great Depression and World War 2 Contribution on the nursing profession

Graduate nurses were hired for minimum wage to work in the hospitals

Hormone that antagonist during sleep of Somogi Effect and does not allow insulin to bind with sugar.

Growth Hormone

How can you detect occult blood?

Guiac test

Name an example of a virus

HIV

Foods that are high in P-

Hamburgers, Soda, Cheese, Nuts (HIGH IN AMERICAN DIET)

International Council of Nurses (ICN) Code of Ethics

Has a published code of ethics for the professional. Discusses the rights and responsibilities of nurses related to people, practice, society, co-workers, and the profession. 80+ National Nursing Associations helped adopt the latest version in 2005. Respect for the life, dignity, and rights of all people in a manner that is unmindful of nationality, race, creed, color, age, sex, political affiliation, or social status.

LC-NE System

Has afferent pathways to: - the hypothalamus - the limbic system - the hippocampus - the cerebral cortex

HIPAA

Health Insurance Portability and Accountability Act of 1996 A federal law that protects patient's medical records

Components of Nursing Metaparadigm are

Health, Nursing, Environment, Person

a governmental initiative that provided a comprehensive set of national goals and objectives for improving the health of all Americans

Healthy People 2020

hearing loss treament

Hearing aids: " Most help = conductive hearing loss " Helps some with sensorineural loss- not as effective " Keep hearing aid dry -no swimming, bathing with it in " Always keep batteries on hand Cochlear implants: Auditory prosthesis used for profound bilateral sensorineural hearing loss unresponsive to traditional treatment/hearing aids. Provides stimulation directly to auditory nerve, bypassing the inner ear. Criteria for implants: " Profound sensorineural hearing loss in both ears " Inability to hear or recognize speech with hearing aids " No medical contraindication for implants or anesthesia " Indications that implant would enhance patient's life

Calor means

Heat that patient feels and what we feel when palpating it.

Isabel Hampton Robb

Helped to form the National League of Nursing and the American Nurses Association

Isabel Hampton Robb (1860-1910)

Helped to form the National League of Nursing and the American Nurses Association

What are the four types of T-Cells?

Helper, Supressor, Memory, and CD-8

What carries Iron in the blood?

Heme

What is Hgb's job?

Hgb is responsible for transport of O2 from lungs to body tissues

What kind of pressure is the glomerulus and why?

High pressure to filter out the blood thoroughly

Nursing Entrepreneurs

Highly creative and challenged by risks of starting a new enterprise Identifies a need and creates a service to meet the identified need Self-employed as consultants to hospitals, nursing homes and schools of nursing

Diploma Nurse

Highly trained and skilled nurses o Lecturegivenbyphysicians o Clinical training supervised by head nurses and nursing directors o Areas of surgery, obstetrics, pediatrics, and psychiatry

Sigma Theta Tau International

Honor Society that advances world health and celebrates nursing excellence in scholarship, leadership, and service

Describe the employment outlook for nursing

Hospital employment will grow more slowly than those in a community based sector More rapid growth will occur in outpatient facilities Home health positions will increase the fastest of all Nursing home positions will increase Nurse practitioners will be in demand

there as added technology and skills, nurses began to recognize the role that emotions had on health, illness, and nursing care, many nurses also began receiving masters degrees nurses wanted to test new ideas about nursing nursing theory was then born

How did the post-World War II influence the definitions of nursing?

How does Capillary Colloidal help avoid third spacing?

Hydrates fluid to bring it back in

XII

Hypoglossal, position of tongue

Signs and Symptoms of Somogi Effect

Hypoglycemia at night with hyperglycemia in the morning

What are the types of circulatory failure?

Hypovolemic shock obstructive shock distributive shock

What do T cells and B cell create?

Antibodies in the plasma cell

What induces an immune response?

Antigens

Who usually suffers Aplastic Anemia?

Any person; any age.

When would you consider completing a comprehensive neurological exam?

Anytime I feel more testing needs to be done if the clients chief complaint is related to something that could be neurological -any major trauma or head injuries -changes in language memory concentration vision

What are the S2 Valves?

Aortic Pulmonic

Define bioethics

Application of ethical theories and principles to problems in health care • Ethical dilemmas • Ethical decision-making • ANA Nursing Code of Ethics • ICN (International Council of Nurses) Code of Ethics

The Great Depression and World War 2 Contribution on the nursing profession

Army commissioned its nurses in 1947

Edema in the Peritoneal cavity (around abdomen) is called:

Ascites

assault and battery

Assault: threat; attempt to make bodily contact with another person without their consent, Battery: act carried out

What are you assessing about a clients mental and emotional health

Assessing the appropriateness of emotions and thoughts Orientation and cognitive function Physical Appearance Level of Consciousness Cerebral functioning and intellectual functioning ( memory and emotional, cognitive and effective)

list 5 phases of the nursing process

Assessment o Nursing Diagnosis - analysis o Planning o Implementation o Evaluation

1st African American nursing school

Atlanta Baptist Female Seminary (later Spelman College)

What does CD-8 do?

Attack and flag infected cells that need to be removed

values

Attitudes, ideals, or beliefs that an individual or group holds to guide their behavior Expressed in terms of right or wrong - these can be good or not so good Values are freely chosen Indicates what a person considers most important Example: Honesty, Loyalty, Hard Work, etc.

Define values

Attitudes, ideals, or beliefs that an individual or group holds to guide their behavior • Expressed in terms of right or wrong • Values are freely chosen • Indicates what a person considers most important

Cranial nerve VIII

Auditory- hearing and equilibrium

Louisa May Alcott

Author and volunteer nurse for the union army. "Hospital sketches," aroused awareness of the work of nurses in the grim environments of military hospitals

What are 3 functions of the state boards of nursing?

Authority to administer the nursing practice act • Authority to adopt rules to administer the act • Authority to deny, suspend, or revoke a license or to otherwise discipline a licensee or to deny an application for licensure

Professional Responsibilities

Autonomy/accountability caregiver Advocate Educator Communicator Manager Career Development

What is MCHC?

Average % of Hgb within a single RBC

What is MCV?

Average SIZE of a single RBC

What is MCH?

Average WEIGHT of Hgb within a single RBC

which of the following factors contributes the most to premature mortality in the U.S. a. genetics b. behavior c. environment d. infectious disease

B

Which cell is related to humoral immunity?

B cells (Betty)

What is the process of B cells?

B cells is introduced to bacteria and needs T cells in order to divide and create a plasma cell and a memory B cell

Dorothea Orem: Nursing

Nursing does for patients what they can't do for themselves, due to self-care deficit from illness to injury

All except which factor should the nurse recruiter emphasize when discussing nursing as a career for males?

Nursing is generally a career for males who are older

ANA Code of Ethics

Nursing profession informing society of principles/rules by which nurses function More emphasis is placed on patients right ANA Code for Nurses (code of ethics) -respect for human dignity -patients right to privacy -safeuards the patient and the public -Assumes responsibility and accountability -Maintains competence -Good Judgement/clinical decision-making -Professional development -Assists the profession in approving standards of nursing - High quality nursing care -Maintains integrity -Collaborates with other health care team members

What is the #1 cause for child anemia in the U.S.?

Nutrition (low iron)

Foods with lots of Mg+

Nuts, rice, seeds, black beans (Mediterranean diet)

#1 manifestation of hypomagnesemia

Nystagmus (twitching muscles around eye)

SO2 (SaO2 or SpO2)

O2 saturation (measured in the arteries or pulse)

Foreign Bodies

Objects such as dust, gnats, etc. that enter the eye.

Cranial nerve III

Oculomotor, responsible for extra ocular eye movement, where the client is looking

Morals/Ethics

Often used interchangeably=Sometimes difficult to define and distinguish between the two

12 cranial nerves mnemonic.

Oh- oh-oh-to-touch-and-feel-a-good-vagina-so-hot

who is at highest risk for CVA?

Older black males

National League of Nursing

Oldest organization for nurses (since 1893) Advances quality nursing education Concerned with quality nursing for all types of nursing programs oPracticalnursing oAssociateDegreenursing oBaccalaureateDegreenursing o MasterDegreenursing

Cranial nerve I

Olfactory, responsible for smell

Review the Florence Nightingale Pledge.

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care

Florence Nightingale Pledge

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully (fidelity). I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug (nonmaleficence). I will do all in my power to maintain and elevate the standard of my profession (beneficence) and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling (confidentiality). With loyalty will I endeavor to aid the physician in his work (fidelity), and devote myself to the welfare of those committed to my care (justice).

which of the following are appropriate standards of professional development for future nurses a. practicing entirely centered on reimbursement for care b. evaluating the quality and effectiveness of care c. contributing to the professional development of others d. utilizing evidence and research for practice

B,C, D

the publication that brought national attention to problems with patient safety and quality in health care

IOM's "To Err is Human: Building a Safer Health Care System"

What is a low/bad percent of vitamin B12 found in urine during Shillings test?

B12 in urine <5% is bad (body is not absorbing the B12 and it is coming out in stool)

What is a normal/good percent of vitamin B12 found in urine during Shillings test?

B12 in urine > 5% is good (body already has enough B12)

What is a controlled osmolarity?

Balanced solute to water ratio

What foods are high in Potassium?

Bananas, oranges, strawberries, potato skin

ACA includes:

Banning lifetime coverage limits for extreme medical conditions Young adult coverage to age 26 Prevention of coverage denial to children under 19 with preexisting conditions Coverage of preventive services Right to appeal coverage decision Choice of primary care providers

Requirements for early nursing school applicants

Based on Victorian stereotypes of female qualities Good breeding/Ladylike behavior Submission to authority Sensitivity Intelligence

What are the techniques that are helpful in responding to patients and others?

Be non-judgmental Observe body language Be and active listener Show empathy Demonstrate caring and compassion Ask open-ended questions Give information Use reflection - method of encouraging patient to think through their problems Silence can be a helpful response

Why is osmolarity and osmolality interchangeable?

Because 1 liter equals 1 kilogram

Associate Degree Nurse

Began in 1952 due to post-World War II nursing shortage Developed by Mildred Montag in 1950s community college movement Most common type of basic nursing education program in US Graduates the most RN candidates of all basic programs 2 year program

Nightingale Model Schools

Bellevue- many firsts= Nursing rounds, nursing care plan, first uniform Linda Richards was teacher Connecticut Training School- Established the school separate from nursing service Massachusetts General Hospital- established a director of the school, still little attention to education

Where is the glomerulus located and what is its function?

Between the afferent and efferent arterioles in Bowmans capsule and its a filtration system.

BUN

Blood Urea Nitrogen

Where do T cells go after they leave the thymus?

Blood and lymphatic tissue

What is Central Circulation?

Blood circulated between the heart and lungs

What is occult blood loss?

Blood in the stool that is not visible

What is the #1 cause for adult anemia in the U.S.?

Blood loss

What is Peripheral Circulation?

Blood outside the central circulation

This Stage of Hypovolemic Shock

Blood pressure begins to fall blood flow to the heart and brain is impaired capillary permeability is increased, fluid begins to leave the capillaries blood flow becomes sluggish the cells and their enzyme systems are damaged

How is HIV Spread?

Blood, semen and vaginal secretion

Gordon: self-perception/self-concept

Body comfort; body image; self esteem

Where is Graft vs Hose Disease mostly found?

Bone Marrow Transplant

#1 cause of Aplastic Anemia

Bone marrow depression

Primary Polycythemia Vera

Bone marrow produces way too many RBC's - Increases Hgb (#) - Increases Hct (%)

What is RBC's job?

Bring O2 to tissue

American Nurses Association (ANA)

Broad purpose organization National Student Nurses Association Improve health standards and availability of health care for all people Foster high standards of nursing Stimulate and promote the professional development of nurses Advance the economic and general welfare of nurses

Nursing Licensure

By Exam By Endorsement - endorsed by the other State Boards of Nursing Nurse Licensure Compact - allows an RN to have one license (in the state of residence) yet [ractice in other compact states without an additional license; developed to improve the mobility of nurses

How is the Juxtaglomerular Complex able to perform its functions?

By being alongside the efferent and afferent arterioles

How does aldosterone hold in water and salt?

By vasoconstriction the efferent arterioles

which of the following is considered a preventable health behavior a. cervical cancer screening every six months for an abnormal result b. major clinical depression c. dietary habits that include saturated fat intake d. breast ultrasound for a breast lump

C

which of the following would least likely be considered a vulnerable population? a. elderly residents in a longterm skilled facility b. newborn infants in a well-baby nursery c. college students residing in a dormitory d. individuals with disabilities with impaired cognitive function

C

Professional Nursing Organization that has a primary mission of supporting a clinical nursing role function

Oncology Nursing Society

Theory is essential to nursing practice because it: a. formulates health care legislation b. assures that a nurse is minimally safe c. explores or describes patients' experiences of health and/or illness d. contributes to knowledge development in Nursing

C & D

Harriet Tubman

One of the first African American nurses, used home remedies

Why do we have heart failure?

One of the two pumps, if not both, isn't working correctly.

Cataracts

Opacity of the lens that distorts images projected onto the retina. Can progress to blindness. Can occur in one or both eyes.

Betty Newuman Theory

Open Systems with Internal and External Environments

open pneumothorax

Open both ways... air can go in and out of pleural space/atmosphere

Cranial nerve II

Optic, responsible for vision

The nurse is caring for a patient admitted to the neurological unit with the diagnosis of a stroke with right-sided weakness. The nurse assumes responsibility for bathing and feeding the patient until the patient is able to begin performing these activities. The nurse in this situation is applying the theory developed by

Orem

List the three phases of the Nurse-Patient relationship

Orientation phase "getting to know the patient" Working phase "tackle the tasks identified in orientation phase" Termination phase "activities that end the relationship in a therapeutic manner

Where is insulin produced?

Pancreas

Calcium has a synergistic relationship with ___________________

Parathyroid Hormone (Ca+ increases... PTH increases) and vise versa

If someone has low phosphorus what do we expect?

Parathyroid tumor

Passive movement

Particles move from area of HIGH concentration to area of LOW concentration

Diffusion

Passive movement of particles

Describe the Working phase of a nurse-patient relationship

Patience Self-awareness Maturity

Quality and Safety Competencies

Patient-Centered Care Teamwork and Collaboration Evidence-Based Practice Quality Improvement Safety Informatics

Patient's Bill of Rights

Patients should receive this upon admission to a facility. States patient's rights - what a patient can reasonably expect while in the care of a healthcare facility. Public wants a say in matters affecting their health care Guarantees certain rights and privileges to every hospitalized patient There are many different versions.

the Great Depressions effect on Nursing

People were unable to pay to go to hospital leaving nurses struggling for money and work

What makes up the peritubular capillaries?

Peritubular capillaries and vasa recta

Megaloblastic Anemia resulting from vitamin B12 deficiency is called:

Pernicious Anemia

What is a biochemical barrier example?

Ph, tears, saliva, GI Tract

Fourth Stage of Illness

Phagocytosis

What is ethics?

Philosophical ideals of right and wrong

Calcium has an inverse relationship with ___________________

Phosphorous (Ca+ increases... P- decreases) and vise versa

Hildegard Peplau

Pioneer in nursing theory

Hildegard Peplau

Pioneer of nursing theory, developed the concept of therapeutic communication and the importance of a therapeutic relationship between the nurse and the patient

Civil War Contribution on the nursing profession

Placed women in leadership positions in hospitals

Define Concept Mapping and how it is used in nursing.

Plan is a diagram of patient problems and interventions. An innovative approach to planning and organizing nursing care

Immunoglobulins (antibodies) are produced by what cells

Plasma cells (white blood cells)

Margination

Plasma leaking out of vessels dilutes the invader, tries to wash it away, liquid component leaking out causes swelling

Variation in RBC shape is called

Poikilocytosis

Active Immunity examples of Immunizations?

Polio, Heb B

Increased Hgb & Increased Hct represents...

Polycythemia Vera

What is the opposite of Aplastic Anemia?

Polycythemia Vera

#1 issue associated with INCREASED Hgb

Polycythemia Vera (excess RBC's)

Chain of Infection - Part 5

Portal of Entry - to susceptible host

Chain of Infection - Part 3

Portal of Exit

Describe the termination phase of a nurse-patient relationship

Positive and negative feelings Summarize the gains that the patient has made View relationship as an opportunity to grow and change in a positive caring manner

If a patient has a build up of chemicals or electrolytes that suppose to be secreted out of the kidneys, what does this mean?

Possible renal failure

Retinal Detachment nursing care

Post-op interventions: " Bilateral eye patches. " Monitor for hemorrhage. " Prevent nausea and vomiting or restlessness which can cause hemorrhage. " Notify MD if sudden, sharp eye pain. " Avoid coughing. " Bed rest 1 - 2 days. " If gas inserted to repair retina, patient to be positioned on abdomen - unaffected eye down. " Eye meds as prescribed (antibiotics, ophthalmic steroid drops). " Limit reading for 3 - 5 weeks. " Avoid squinting, straining, constipation, heaving lifting, bending from waist. " Wear dark glasses and eye patch at night. " Follow up care important.

What is the most abundant cation in ICF?

Potassium

Strategies by the Nurse to Reduce the Chance of Legal Action:

Practice in a safe setting Communicate with other health professionals; open and clear communication - verbal and written Delegate wisely Meet the standard of care - technically competent; keeping up to date; be aware of peer expectations; participate as an equal on the health care team Carry professional liability insurance Promote positive interpersonal relationships - best strategy

List specific strategies that a nurse can use to limit the possibility of legal action.

Practice in a safe setting • Communicate with other health professionals; open and clear communication - verbal and written • Delegate wisely • Meet the standard of care - technically competent; keeping up to date; be aware of peer expectations; participate as an equal on the health care team • Carry professional liability insurance • Promote positive interpersonal relationships - best strategy

Responsibility of nurses in military

Practice in peacetime and wartime settings Broader responsibilities and scope of practice than civilian nurses Must have BSN for active duty Travel and change are integral to military nursing, nurses must be flexible All military nurses may be called on for active wartime duty anywhere in the world

South Carolina's Definition of the Practice of Nursing

Practice of nursing- services for compensation that assists px to obtain/promote optimal health. Requires the use of nursing judgment - cognitive process of ID pertinent info/evaluating to produce informed decisions Provided by advanced practice RN/LVN. The scope of nursing practice varies and is commensurate with the edu prep & competencies. performance of health care acts that involve assessment, analysis, intervention, & evaluation requires specialized independent judgment & skill based on knowledge/application of the principles of biophysical & social sciences

SC's definition of the practice of registered nurses

Practice of registered nursing means the performance of health care acts in the nursing process that involve assessment, analysis, intervention, and evaluation. This practice requires specialized independent judgement and skill and is based on knowledge and application of the principles and biophysical and social sciences.

What is the primary physiological reason for electrolyte imbalance?

Premature cell death

What is Hemolytic Anemia?

Premature destruction of RBC's

NSNA

Preps for practice and liscensure

What is natural/innate immunity?

Present at birth and requires mother

What is the function of Chloride?

Pressure in check by combining

Levels of Prevention

Primary Prevention, Secondary Prevention, Tertiary

Two types of glaucoma

Primary open angle glaucoma (called simple) & Acute closed angle (medical emergency)

What happens when we have a Type 1-Intermediate Reaction? (Allergies)

Primary: Major Vasodilation, Bronchospasms, and leakage in the smooth muscles (swelling) Secondary: Epithelial tissue destruction

What function does erythropoietin play?

Produced in kidneys which allows for a production of RBC increasing hem.

professional nursing organization

Professional Standards of Practice Ethical conduct of members Ensure high quality Leadership opportunities Meet present and future challenges

What are the purposes of the professional nursing organizations?

Professional Standards of Practice • Ethical conduct of members • Ensure high quality • Leadership opportunities • Meet present and future challenges

Role of Cortisol in Stress Response

Promotes Glucogenesis in liver Suppresses the immune system Ensures glucose is available

Functions of the National Student Nurses Association

Promotes professional growth Discounts on products Voice for nursing students Mentor students Promote development of skills Advocate high quality health care

What does insulin do?

Promotes use of glucose, Prevents breakdown of fat and protein, Stops gluconeogenesis, Increases glycogen synthesis

What is the function of IgG?

Protect newborn from bacteria, viruses and toxin

Confidentiality

Protection of private information (HIPAA)

Confidentiality

Protection of private information HIPPA

Describe the role of Clinical Nurse Specialists

Provide care in specialty areas, educator; consultant; develop quality assurance procedures

Describe the role of Nurse Midwifes

Provide prenatal and gynecological care to normal, healthy women, deliver babies, and follow up with postpartum care

Define morals

Provide standards of behavior • Established rules of conduct to be used in situations in which a decision about right and wrong must be made • Reflect how individuals or groups behave • Learned over times and are influenced by life experiences • Theories of moral development

The Hill-Burton Act (1946)

Provided funds to construct hospitals Rapid expansion of facilities resulted in an acute shortage of nurses "Team nursing" introduced Nursing shortage prompted the creation of Associate Degree in Nursing (ADN) programs

Lillian Wald

Provided home nursing and teaching home nursing to immigrant women. Founded the Henry street settlement and the first visiting nurse association

Describe the various roles of the nurse on the health care team.

Provider of care, educator, manage, researcher, collaborator, patient advocate

Responsibility of: School nursing

Purpose is to enhance the educational process by improving the well-being of the target population, children and adolescents Counselors Responsible for seeing that immunizations are current Educate parents, children and teachers regarding health related issues Provide routine and emergency care to children and school employees Safety/accident prevention is a primary concern Provide routine screenings

Responsibilities of School nursing

Purpose is to enhance the educational process by improving the well-being of the target population, children and adolescents Counselors Responsible for seeing that immunizations are current Education parents, children and teachers regarding health related issues Provide routine and emergency care to children and school employees Safety/accident prevention is a primary concern Provide routine screenings

How does capillary interstitial help avoid third spacing?

Pushing out fluid

Team work

Qualities: -Interpersonal skills -Value the perspectives and expertise pf all members -Contribute to resolution and conflict -Function competently within own scope of practice

Caring

Qualities: Compassion Cultural Awareness Interpersonal skills (maintain composure during difficult interactions) Discretion and confidentiality ( discusses patients in a respectful manner and only when appropriate Maintain appropriate boundaries Self-care: stress management, healthy eating, exercise, adequate sleep

Professionalism

Qualities: Honest Accountable Reliable & Dependable (takes responsibility for being on time and prepared for class) Respect and courtesy toward others Professional appearance/dress Involvement in professional organizations

Clinical Competence

Qualities: Patient advocacy Commitment to lifelong learning (staying current in your practice, Furthering education) Commitment to clinical excellence (seeks guidance from instructors, & health care professionals) Professional communication Personal standard of excellence

QSEN

Quality and Safety Education for Nurses- Initiative in response to safety reports Includes competencies: Patient centered care Team work Collaboration Quality-Improvement Evidence Based Practice

What is the glasgow coma scale?

Quick, practical, standardized system for assessing the degree of impaired consciousness.

RDW stands for...

RBC Distribution Width

what is P- needed for?

RBC, WBC, and Platelet creation

Define "team nursing."

RN is the leader; one who is responsible and delegates to others); other team members are LPN's and nursing techs/assistants

Following the completion of a basic program for registered nurses, graduates are allowed to take what licensing exam?

RN-NCLEX

List some certifying organizations in nursing

RNC; CPNP; CFNP

Challenges of Afro-American Nurses in the Late 1800's and Early to Mid-1900's:

Racial barriers for education

challenged of Afro-American nurses in 1800's and early to mid 1900's

Racial barriers for education- 1 African American nurse, Mary Mahoney, was admitted to the New England Hospital for Women and Children (1878)

Challenges of Afro-American Nurses in the Late 1800's and Early to Mid-1900's:

Racial barriers for military

Onset speed of Aplastic Anemia

Rapid OR slow

Vietnam War Contribution on the nursing profession

Rapid influx of medical knowledge and technology

What is the function of the Peritubular Network?

Rapid reabsorption of water and solutes, which leaves the waster behind

REM Sleep

Rapid-eye-movement sleep that occurs during sleep about every 90 minutes and lasts 5-30 minutes.

What is immediate memory?

Recalling information that was just given to you. I.e a series of numbers Most people can remember 5-8 numbers going forwards and 4-6 going backwards

Teamwork/collaboration

Recognize contribution of other health care team members and the patient's family members. discuss effective strategies, communication, resolving conflict

What is the most numerous type of blood cell?

Red blood cell

Rubor means

Redness

Responsibilities of Hospice and Palliative Care nursing

Reflects a holistic philosophy of care Promote and improve the patients quality of life through the relief of suffering along the course of the illness

Type of Intermediate Acting Insulin

Regular

Control Systems

Regulate cellular functions, physical, and physiological adaptation in order to maintain the body's internal environment. Also regulate's life processes and behaviours

Nurse Practice Act

Regulates the scope of nursing to protect the public Revisions based state to state and nurses must know their state's contents

post-surgical appendectomy, abdominal incision (Diagnostic Set, Defining characteristic, or Related Factors)

Related Factors

Constant Hgb & Increased Hct represents...

Relative Polycythemia

Retive Polycythemia Vera

Relative to fluid... - Hct increases (%) - Hgb stays constant (#) - Decrease in water - RBC-fluid percentage is altered - often caused by use of diuretics - often causes dehydration

Gordon: Value-belief

Religious Affiliation; Spiritual Practices; Meaning of Life

What does a Memory T-Cell do?

Remember antigens from the past and know how to attack

Alpha 2

Renin release

Continuing Education

Required by State Boards of Nursing- Requirements vary state by state

Chain of Infection - Part 2

Reservoir - Source

American Nurses Association (ANA) code of ethics

Respect for human dignity, worth, and uniqueness. Primary commitment is to the patient. Safeguards the patient and the public. Promotes, advocates for, and strives to protect the rights of the patient. Assumes responsibility and accountability for individual nursing practice. Preserve integrity and safety, maintain competence, and continue personal/professional growth and development. Assists the profession in improving standards of nursing. Participates in the advancement of the profession - practice, education, administration. Collaborates with other health care team members. Promote nursing values, maintain integrity, and help shape policy.

What is the most fundamental human right, which is the foundation for all ethical principles?

Respect for others • Valuing every aspect of a person's life • Each individual is unique and equal to others • Foundation of all ethical principles

Conductive hearing loss

Results from an impairment in transmission of sound from the outer or middle ear or both. Risk for injury r/t to loss of hearing; Social isolation r/t deafness

Sensorineural loss:

Results from damage to the cochlea or vestibulocochlear nerve Risk for injury r/t to loss of hearing; Social isolation r/t deafness

Otosclerosis

Results in prevention of sound transmission because stapes cannot vibrate and carry sound to the inner ear.

What pump in the heart propels blood in the lungs?

Right Heart

What are the "three" organs that pump blood through the body?

Right heart, left heart and lungs

How is family functioning altered during a member's illness?

Role reversal, entire family is affected, increases stress/anxiety, family disruption, financial difficulties, priorities are shifted.

Reflexes in an infant

Rooting, sucking, palmar grasp, morrow (startle), tonic

a nurse ensures that he does a holistic assessment of his patient by assessing a patient's adaptation to illness. He assess the patient's physical, self-concept, role function, and interdependence areas. Which theorist's approach to understanding a "person" is being applied?

Roy

Signs and Symptoms of Inflammation

Rubor, Tumor, Calor, Dolor, Functio Lasio

What state agency in South Carolina has the power to issue a nursing license to qualified individuals?

SC State Board of Nursing

How does SIADH relate to Hyponatremia?

SIADH involves increased ADH causing increased H2O which dilutes Na+

Body shifts into "Fight or Flight" mode Cerebral Cortex-increased attention and arousal Cardiovascular-increased heart rate and rate of contractions Dilated pupils GI(Gastrointestinal)-irritable bowel, decreased digestion Pulmonary-increased respiration Muscular-contraction of skeletal muscle Immune System-suppression Genitourinary-kidneys renin angiotensin Integumentary-decreased blood flow to the skin Endocrine System CNS-increased blood flow to the brain

SNS Stimulation Symptomology

Giving priority to interventions that prevent a client from becoming injured is what priority seeking framework?

Safety and Risk reduction

1st male school nursing school

School for male nurses at the New York City Training School (1986)

The Great Depression and World War 2 Contribution on the nursing profession

Schools of nursing attached to the hospitals had to close due to lack of funds - led to nursing shortage

Secondary Prevention Examples

Screening high risk patients/ early detection and treatment

Challenges of Afro-American Nurses in the Late 1800's and Early to Mid-1900's:

Segregated nursing schools

The Great Depression and World War 2 Contribution on the nursing profession

Segregation of Afro-American nurses ended

Dorothea Orem Theory

Self Care Deficit Theory

What happens when auto-antibodies are present?

Self is attacking self

List the 5 major elements that have to be present for communication to take place.

Sender Message Receiver Feedback Context or Setting

What are the five elements of communication that must exist

Sender message receiver feedback context or setting

Positive Feedback System

Senses change and tries to enhance it (like temp in a car

What type of fluid is measurable?

Sensible

Retinal Detachment

Separation of two layers of the retina. When separation occurs, Vitreous Humor seeps between the layers and detachment of the retina from the choroid occurs. Treatment is necessary to reestablish contact between the layers to maintain blood supply ASAP.

Define: "Tertiary Care"

Services provided to acutely ill patients; those needing long term care, and to terminally ill patients.

Significance of events that occured in Chicago World Fair, 1893

Several influencial nursing leaders met to discuss uniformity among nursing education; Precursor for NLNE (NLN)

GCS score 8 or less indicates

Severe Head injury

Distress

Severe, uncontrolled stress (Bad Stress)

Gordon: Sexuality-Reproductive

Sexual Functioning/Relationship; pregnancy and birth experiences

What are the common culprits of Anaphylaxis?

Shellfish, nuts, latex and PCN

Insulin Types

Short Acting, Intermediate Acting, Long Acting

List several reasons why the associate nursing degree programs are popular

Shorter duration Evening hours Part-time Low tuition Accessibility Graduates can take the RN-NCLEX

What were the 5 recommendations made by various studies that set the stage for the development of the nursing educational programs that exist today?

Should be within the system of higher education Nurses should be highly educated Students should not be used to staff hospitals Standards of nursing practice needed to be established All students need to meet minimum qualifications upon graduation

Recommendations for the Development of Nursing Educational Programs

Should be within the system of higher education Nurses should be highly educated Students should not be used to staff hospitals Standards of nursing practice needed to be established All students need to meet minimum qualifications upon graduation

What is wrong if a newborn has a high count of IgM?

Sickness

Organization that has as its mission the advancement of global health and improving the health of people worldwide

Sigma Theta Tau, International

Affordable Care Act (ACA) 2010

Signed by President Obama Provides implementation of health insurance coverage changes to improve access and affordability

"Cytic"

Size

What is a anatomical barrier example?

Skin

Why is it important for nursing to have a "code of ethics?"

So that they are able to perform and be a caregiver no matter the circumstances even if they do not believe in something they have to follow the rules which is the code of ethics. Ethical codes shape professional self regulation, seeing guidelines to the members of the profession, who then meet their responsibility as trustworthy, qualifies, and accountable caregivers

12 cranial nerves motor, sensory, or both mnemonic

Some-Say-Marry-Money-But-My-Brother-Says-Big-Boobs-Matter-Most

How does Graft vs Hose Disease happen?

Someone is immunosuppressed, and when they receive the transplant their immune system doesn't work, so the transplant becomes the aggressor

What state agency in South Carolina has the power to issue a nursing license to qualified individuals?

South Carolina Board of Nursing

Stable vs. Non-stable Angina

Stable = heart pain during activity (thrombus) Non-stable = occurs more often/severely (emboli)

In the USA who oversees the (NPA) nurse practice acts?

State boards of nursing

State Nurse Practice Act

Statutory Law Affecting Nursing in Each State Law established through formal legislative processes. Laws vary from state to state. A nurse must follow the practice act regulations for the state in which they work. Defines the authority of the State Board of Nursing

What is the most important statutory law affecting nurses in each state?

Statutory Law: - Law established through formal legislative processes - Nurse Practice Act:

CRF (Corticotropin Releasing Factor

Stimulates endocrine response Secreted by the hypothalamus Induces the secretion of ACTH from the anterior pituitary gland

Beta 1

Stimulation of lipolysis, increased heart rate, and increased force of contraction

Betty Neuman: Health

Stress/lines of resistance; concepts interact to promote health/create illness

Administration of medications - State board of nursing regulations - 1.A (7)

Subject to the rights of licensed physicians and dentists under their respective medical and dental practice acts, the administration of medications is recognized as the responsibility of a registered nurse or a licensed practical nurse as prescribed by the licensed physician or dentist . After June 30th, 1985 unlicensed nursing personnel shall not administer medications

Dorthea Dix

Superintendent of Nurses for the Union army

Dorthea Dix

Superintendent of Union Civil War nurses; campaigned to help the mentally ill

What key terms are in the philosophy of nursing for Midlands Technical College's nursing program

Support the mission of the college, affirm the worth and dignity of the individual, nursing is an art and a science with varying levels of practitioners, education is a lifelong process, nursing education includes preparation in general academics and technical skills

What do Suppressor T-Cells do?

Suppress healthy cells from attack

Otosclerosis treatment

Surgical intervention through removal of stapes and prosthesis placement

Chain of Infection - Part 6

Susceptible Host

Tumor means

Swelling

What extrinsic factors help stimulate kidney regulation?

Sympathetic Nervous System and Blood Borne Hormones

SNS Endocrine System Immune System Psychoneuroimmunologic Regulation Psychological Neurological

Systems involved in stress

T.I.A.

T: temporary (12-24hr) I: impending stroke (precursor to CVA) A: treated w/ asprin

glaucoma nursing care

Teaching r/t medications: 1. Lifelong medication use 2. MEDIC alert tag 3. Avoid anticholinergics - decrease the flow of aqueous humor. 4. Prevent increased Increased Ocular Pressure (IOP) by avoiding: " Anger, excitement, worry " Constrictive clothing " Heavy lifting " Straining at stool 5. Report eye pain, halos, changes in vision. 6. If medical therapy doesn't help, surgical intervention may be necessary (laser, etc.). 7. Pre-op and post-op interventions similar to that for cataract removal.

Where is IgA found?

Tears, blood, and saliva

Where is calcium mostly found?

Teeth and bones

Ethics

Term used to reflect what actions an individual should take. Derived from the Greek word Ethos (habits or customs) Process oriented and require a critical analysis Examples of Organizational Ethics: ANA (American Nurses Association) Nursing Code of Ethics ICN (International Council of Nurses) Code of Ethics

What are the purposes of the American Nurses Association (ANA)?

The American Nurses Association (ANA) develops positions relevant to nursing practice, health policy, and social concerns impacting the health of patients and families • Broad purpose organization • National Student Nurses Association • State Nurses Association • Improve health standards and availability of health care for all people • Foster high standards of nursing practice • Stimulate and promote the professional development of nurses through continuing education and certification • Political Activists • Develops and oversees the Magnet Recognition Program for Nursing • Nursing Code of Ethics • Patient Safety • "Healthy Nurse, Health Nation" Program • Advance the economic and general welfare of nurses

How does MHC-2 and CD-4 work together?

The CD-4 sees pathogen all over the MCH-2 (phagocytosis) and calls in for help from CD-8

Children and the GCS

The GCS is usually not used with children, especially those too young to have reliable language skills. There is a paediatric version that is slightly modified to work on children.

SC Board of Nursing Position Statement: Assisting with Medication

The SC nurse practice act defines the practice of nursing to include the administration of medications. The admin of meds is defined as "the acts of preparing and giving drugs in accordance with the orders of a licensed physician or dentist as to drugs, dosage, route, and frequency; observing recording and reporting desired effects , untoward reactions and side effects of drug therapy; intervening when emergency care is required as a result of drug therapy.

Where do T cells go to mature?

The Thymus

Tonicity

The ability of an extracellular solution to make water move into or out of a cell by osmosis

Homeostasis

The ability to respond and maintain stability during rapid changing conditions

Adaptation

The ability to respond to challenges of physical or psychological homeostasis and the return to a balanced state

How are a Health Care Power of Attorney and a Living Will different?

The agent named in a health care power of attorney can make the decisions about your healthcare. A living will only tells the doctor what to do if you are permanently unconscious or if you are terminally ill and close to death. A health care power of attorney is not limited to these situations. A living will affects life support only in certain circumstances. A living will only tells the doctor what to do if you are permanently unconscious or if you are terminally ill and close to death. A health care power of attorney is not limited to these situations. Permanently unconscious means that you are in a persistent vegetative state in which your body functions, but your mind does not. This is different from a coma, because a person in a coma usually wakes up, but a permanently unconscious person does not. A living will can only say what treatment you don't want. In a health care power of attorney you can say what treatment you do want, as well as what you do not want. With a living will, you must decide what should be done in the future, without knowing exactly what the circumstances will be when the decision is put into effect. "With a health care power of attorney, the agent can make decisions when the need arises, and will know what the circumstances are. An Ombudsman as designated by the State Ombudsman, Office of the Governor, 1 must be a witness if you sign a living will when you are in a hospital or nursing home. An Ombudsman does not have to be a witness if you sign a health care power of attorney in a hospital or nursing home.

Bioethics

The application of ethical theories and principles to moral issues or problems in health care. Started around 1970 - healthcare providers started to look at patient's holistically (entire being) in addition to treating/curing disease. Concerned with figuring out what should be done in a particular instance by applying ethical principles. Keeping a patient alive on a ventilator for an extended period of time though the patient has no brain activity. This can be a huge dilemma for nurses - determining the meaning of "life"

Battery

The assault carried out; the impermissible, unprivileged touching of one person by another.

I want to be allowed to die a natural death and not be kept alive by medical treatment, heroic measures, or artificial means. How can I make sure this happens?

The best way to be sure you are allowed to die a natural death is to sign a health care power of attorney that states the circumstances in which you would not want treatment. In the South Carolina form, you should specify your wishes in items (6) and seven (7). You may not have a person that you can trust to carry out your desire for a natural death. If not, a living will can insure that you are allowed to die a natural death. However, it will only do so if you are permanently unconscious or terminally ill and close to death.

What is calcium known as and why?

The binder because it tags to other electrolytes

Steady State Conditions

The body automatically attempts to adjust and resist change

Resistance

The body selects the most effective and economic channels of defense

When assessing a clients orientation through questioning what three components are you looking for?

The clients name The Time and place and the situation i.e. John Smith, Friday February 8th 2019, at North Island College campus for a neurological assessment.

How is the clot dissolved?

The clot is dissolved by Tissue Plasminogen Activator (TPA)

Nonmaleficence

The duty to do no harm to a patient (foundation of hippocratic oath) inherent in code of ethics for nurses.

Constancy

The goal of homeostasis

Insomnia

The inability to fall asleep or remain asleep.

Hypersomnia

The inability to stay awake during the day, despite sufficient sleep at night.

Macular Degeneration

The leading cause of blindness in people > 75yo. The macula is the area of the retina that receives light from the center of the visual field. Gradual failure of the pigmented layer of the retina = cellular death and retinal detachments.

What is the function of IgD?

The maturing of B cells to fight infection

ANA definition of nursing

The most current definition that reflects the evolution of professional nursing is from the 2003 edition of ANA's Nursing's Social Policy Statement: "Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations." In the preface of the Nursing Code of Ethics 2001 edition, the following statement appears: "Nursing encompasses the prevention of illness, the alleviation of suffering, and the protection, promotion, and restoration of health in the care of individuals, families, groups, and communities." ANA: What defines nursing and sets it apart from other health care professions, particularly medicine with which it has long been considered part and parcel? It is nurses' focus - in theory and practice - on the response of the individual and the family to actual or potential health problems. Nurses are educated to be attuned to the whole person, not just the unique presenting health problem. While a medical diagnosis of an illness may be fairly circumscribed, the human response to a health problem may be much more fluid and variable and may have a great effect on the individual's ability to overcome the initial medical problem. It is often said that physicians cure, and nurses care. In what some describe as a blend of physiology and psychology, nurses build on their understanding of the disease and illness process to promote the restoration and maintenance of health in their clients. Nurses' broad-based education and holistic focus positions them as the logical network of providers on which to build a true health care system for the future. An acknowledged realization that individuals have considerable responsibility for their personal health has driven an increasing recognition that there is a professional group, whose focus is education and practice, that can facilitate individuals efforts to reach their fullest health potential. This profession is that of registered nurses.

What is past memory

The patient is asked to recall the maiden name of their mother, a birthday or a special day in history

SC Definition (RN):

The practice of registered nursing requires but is not limited to: a. assessing the health status of personal or groups b. analyzing the health status of persons or group c. establishing outcomes to meet identified health care needs of persons and group d. prescribing nursing interventions to achieve outcomes e. implementing nursing interventions to achieve outcomes f. administering and delivering meds and treatments prescribed by an authorized licensed provider g. delegating nursing interventions to qualified others h. providing for the maintenance of safe and effective nursing care...rendered directly or indirectly. i. providing counseling and teaching for the promotion and maintenance of health. j. evaluating and revising responses to interventions, as appropriate k. teaching and evaluating the practice of nursing m. collaborating with other health care individuals in the management of health care n. participating in or conducting research or both to enhance the body of nursing knowledge o. consulting to improve the practice of nursing p. performing additional acts that require special education and training and that are approved by the board.

How have "patients' rights" affected health care?

The public has a say in their health care rights and privileges are granted to every hospitalized patient.

Responsibilities of Informatics Nurses

The science and practice (integrating) nurses, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide)

Martha Rogers theory

The science of unitary human beings

Definition of the "philosophy of nursing"

The study of principles underlying conduct though and the nature of the universe; it is a search for meaning, contemplating or wondering about something

Imogene King Theory

Theory of Goal Attainment

Jean Watson Theory

Theory of Human/Transpersonal Caring

Sister Callista Roy Theory

Theory of Modes of Adaptation to Stressors

Hildegarde Peplau Theory

Therapeutic Interpersonal Relationships

National League for Nursing (NLN)

There is not specific definition of nursing. The mission of the organization is based on 4 core values of nursing as it relates to nursing education: 1. Caring - promoting health, healing, and hope 2. Integrity - respecting the dignity and moral wholeness of the individual 3. Diversity - affecting the uniqueness of and differences among persons 4. Excellence - creating and implementing transformative strategies with daring ingenuity

Civil War Contribution on the nursing profession

There were no professional nurses available

Why is it important to measure water loss in infants?

They are mostly water, so it important to put those fluids back into them.

Why do Helper T-Cells Activate other T-Cells?

They see T-Cells being attacked, so they get other T-Cells to help

How do antibodies work?

They tag antigens (do not destroy), so other WBC can destroy it

How does MHC work?

They use self-recognition in order to see cells that are infected/damage and flag them

What is a less effective diuretic agent and what does It do?

Thiadize Diuretic: inhibits the distal tubule, which inhibits the reabsorption of NaCl and waste potassium but great for lowering BP SLIGHTLY

South Carolinas Definition of the Practice of Registered Nursing

This practice requires specialized independent judgment and skill and is based on knowledge and application of the principles of biophysical and social sciences. The practice of registered nursing includes, but is not limited to: a. assessing the health status of persons and groups; b. analyzing the health status of persons and groups; c. establishing outcomes to meet identified health care needs of persons and groups; d. prescribing nursing interventions to achieve outcomes; e. implementing nursing interventions to achieve outcomes; f. administering and delivering medications and treatments prescribed by an authorized licensed provider; g. delegating nursing interventions to qualified others; h. providing for the maintenance of safe and effective nursing care rendered directly or indirectly; i. providing counseling and teaching for the promotion and maintenance of health; j. evaluating and revising responses to interventions, as appropriate; k. teaching and evaluating the practice of nursing; l. managing and supervising the practice of nursing; m. collaborating with other health care professionals in the management of health care; n. participating in or conducting research, or both, to enhance the body of nursing knowledge; o. consulting to improve the practice of nursing; and p. performing additional acts that require special education and training and that are approved by the board.

assault

Threat or an attempt to make bodily contact with another person without the person's consent.

Assault

Threat; an attempt to make bodily contact with another person without their consent

Capillary Interstitial Fluid Exchange

Three things that keep fluid from leaking out of the vessels... 1. Capillary Filtration Pressure (CFP) 2. Interstitial Hydrostatic Pressure (IHP) 3. Capillary Colloidal Osmotic Pressure (CCOP)

How does potassium enter the body?

Through food

How does sodium enter the body?

Through foods and liquids mostly?

S&S of MI

Tightness or pain in the chest, neck, back, or arms, as well as fatigue, lightheadedness, abnormal heartbeat, and anxiety.

How do you assess a clients level of consciousness?

To assess the level of consciousness the nurse will talk with the patient asking questions about events involving the patient or concerns about any health problems. A fully conscious patient will respond quickly and express ideas logically. Timing of response, orientation, asking subtle questions use the glass of coma scale

American Nurses Credentialing Center (ANCC) Magnet Recognition Program

To attract and retain nurses in acute hospital settings

Why do fluid and electrolytes constantly move?

To balance

Why does 25% of cardiac output go to the kidneys?

To ensure we can have this high pressure in the glomerulus for filtration (N0T TO OXYGENATE)

What is the purpose of agglutination?

To group all of the pathogens together to identify and kill them

What is the function of IgA?

To prevent infection in epithelial cells such as in the respiratory tract and digestive tract.

What is the purpose of antibodies?

To recognize and bind to an antigen

What is the purpose of theMini mental state exam. MMSE

To screen and measure orientation and cognitive function. Patients who score 23 or lower show signs of cognitive impairment and further testing needs to be done

What is the purpose of the Memory B cell?

To stay in the blood stream and stop reinfection

American Recovery and Reinvestment Act (2009)

To stimulate US economy with provision for $500 million to strengthen US health care work force

Hypovolemic Shock Treatment

Treat the cause- check HGB and HCT Increase fluid, blood give vasopressors give oxygen may also need heart medications

The Great Depression and World War 2 Contribution on the nursing profession

Trend towards more technology

Negative Feedback System

Tries to return body back to desired state (like a thermostat)

Cranial nerve V

Trigeminal, Sensory nerve for skin of face, and motor nerve to muscles of the jaw

Renin-Angiotensin-Aldosterone System

Triggered by decreased blood flow to the kidneys Kidneys release Renin into the blood Renin reacts with Angiotensinogen to form Angiotensin I ACE (angiotensin converting enzyme) in the lungs converts Angiotensin I to Angiotensin

Cranial nerve IV

Trochlear Nerve, pupil constriction and dilation

T or F: At the time the nurse practitioner was first introduced nurses in advanced practice roles found it necessary to develop skills in political activism to fight for changes in legislation

True

T or F: the NCLEX-RN examination is the same in every state in the United States

True

T/F: P- is needed for normal RBC, WBC, & Platelet function

True

ICF is __ as much as ECF

Twice

How many pumps are in the heart?

Two (Right and Left)

type of workplace violence nurses most often face

Type II, involving a customer, client, or patient

What is the function of IgM and where is it found?

Typical immune response and in the blood and lymph (typical immune system!!)

Describe the preparation and practice of the Licensed Practical/Vocational nurse?

Typically last 12 months Technical workers Limited scope of practice Educated in vocational schools, technical schools, and community colleges Becomes Licensed Practical Nurse (LPN) Work in doctor's office, nursing home, clinics

Describe the preparation of a practical nurse degree

Typically last 12 months; technical workers; limited scope of practice (vocational schools, technical schools and community college)

Describe the preparation and practice of licensed practical/vocational nurse

Typically last 12 months; technical workers; limited scope of practice (vocational schools, technical schools, and community college)

Dorothea Orem: Person

Unable to perform own care due to injury or illness

Parasomnias

Unpleasant or undesirable behaviors during sleep. IE sleep walking)

Spanish American War Contribution on the nursing profession

Untrained African-American nurses responded

Lower GI bleed vs. Upper GI bleed (how can you tell the difference?)

Upper GI bleed: - Stool is dark black & sticky - Vomit has bright red blood Lower GI bleed: - Stool has bright red blood - Vomit has black, dry, "coffee ground" blood

How does sodium and potassium mainly leave your body?

Urine

Quality Improvement

Using flow charts and diagrams to make process of care explicit Identify gaps between local and best practices

What are the components of the therapeutic use of self

Using one's personality and communication skills to help patients Can be developed by utilizing knowledge and skills Assists in relating effectively with patients/families/peers/ and other health care workers

Responsibility of: Occupational nursing

Usually are employed by large companies Provide basic health care services 3 Provide health education/disease prevention Provide health screenings Provide emergency treatment to employees

Responsibilities of Occupational Health Nurses

Usually employed by large companies Provide basic health care services Provide health education/disease prevention Provide health screenings Provide emergency treatment to employees

X

Vagus nerve, Sensation of pharynx and movement of vocal cords

What is RDW?

Variation in RBC size & shape - Variation in SIZE: Anisocytosis - Variation in SHAPE: Poikilocytosis

Moral Development:

Various theories Describes how a person deals with moral dilemmas from childhood to adulthood. Kohlberg's Stages of Moral Reasoning is utilized in our nursing program: <9 years: self-centered >9 years and adults: Conform to expectations of family/groups/society Independent thinking: Defining own moral values (higher intellectual development)

What are some Physical/Structural Problems of Cardiogenic Shock?

Ventricular septal defect, ventricular aneurysm and acute disruption of valvular function

What are the levels of communication

Verbal- speaking Non-verbal -gestures -clothing -posture -facial expression -tone and volume of voice

Edema

Vessels leak fluid into pleural space

What is T cells all about?

Viral Immunity

What must RBC's have to mature?

Vitamin B12

Treatment of Vitamin B12 deficiency

Vitamin B12 injections FOR LIFE (every month ish)

What does calcium have a role in via balancing?

Vitamin D and Parathyroid hormone

How does vitamin D relate to calcium? What do dairy farmers do because of this?

Vitamin D causes calcium absorption so farmers but vitamin D in milk to allow absorption

Hematocrit (Hct)

Volume (%) of RBC's in blood

Informed Consent

Voluntary; individual must be competent and have the capacity to understand. Patient must be given enough information understand; full knowledge authorization by the patient for care treatment or procedures. Must include the risks benefits, side effects, costs, alternatives (do not need consent if it is life threatening)

Clara Barton

Volunteer nurse during the Civil War; founder of the American Red Cross

Jane Woolsey

Volunteer nurse for the union army. She helped to found the nurse training school at Presbyterian hospital in New York

Reason for increase in military nurses

WWI

Define ethics

What actions an individual "should" take • What "should" be done for people to live together • Bible Code of Ethics - 10 commandments • Process oriented and require a critical analysis

Define ethics

What actions an individual should take What should be done for people to live together Bible code of ethics (10 commandments) Process orientated and require a critical analysis Bioethics - application of ethical theories and principles to problems in health care Ethical Delimmas Ethical decision-making ANA Nursing Code Of ethics ICN (International Council of Nurses) Code of Ethics

Ethics

What actions an individual should take What should be done for people to live together Bible code of ethics (10 commandments) Process orientated and require a critical analysis Bioethics - application of ethical theories and principles to problems in health care Ethical Delimmas Ethical decision-making ANA Nursing Code Of ethics ICN (International Council of Nurses) Code of Ethics

Alarm Resistance Exhaustion or Recovery

What are the 3 stages of GAS?

1. Her definition focused on the basic needs of the patient "and what nursing has to do... is put the patient in the best condition for nature to act upon him" "I use the word nursing for want of a better. It has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet- all at the least expense of vital power to the patient"

What is Florence Nightingale's definition of nursing?

What is Florence Nightingales definition of nursing?

What nursing has to do is put the patient in the best conditions foe nature to act upon him

1965

What year did the ANA position that nursing education should take place in institutions of higher education

work for the improvement of health standards and the availability of health care services for all people, to foster high standards of nursing, and to stimulate and promote the profession development of nurse and advance their economic and general welfare

Whats the purpose of the American Nurses Association

When do you give a Hypotonic IV?

When ECF is more concentrated than ICF

When do you give a Hypertonic IV?

When ICF is more concentrated than ECF

Adult Health Care Consent

When a patient is unable to give instructions about his/ her care and hasn't used any form of Advance Directive, the law specifies who can make such decisions: 1. Guardian appointed by Probate Court 2. Person given authority by the patient in some other legal way 3. Spouse (unless divorced or legally separated) 4. Parent or adult child of patient 5. Adult sibling, grandparent or adult grandchild of patient 6. Other blood relatives believed to have close personal relationship to patient.

What is Graft vs. Host Disease?

When a transplant organ attacks the host

What is opsonisation?

When antibodies tag an antigen

When do you give an Isotonic IV?

When patient is hypovolemic (and ICF-ECF have the same concentration)

Exhaustion or Recovery

When stress is too much for the body to handle or When the body is able to adapt

What is a autoimmune disease?

When the body can't distinguish self from self and tags and attacks self

What does "licensure" mean to the nursing graduate?

When the graduate successfully completes the licensing exam, they may legally practice nursing in their own state

Define: "Primary Care"

When the patient first enters the health care system; health maintenance and management of long term or chronic care and treatment of health problems that don't require hospitalization

General-general systemic reaction Adaptation-response to a stressor Syndrome-physical manifestations that coordinate and depend on each other

Why is it called GAS?

Responsibilities of office-based nursing

Work in tandem with physicians, NPs and their patients Performing health assessments Reviewing Medications Drawing blood Giving immunizations Administering medications Providing Health teaching Communicating with patients, families, employers, pharmacists and hospital admissions offices

Describe the process of collaboration and how it is used in the health care setting.

Working jointly with other professionals Respect for each one's knowledge and abilities Willingness to work together Supportive organization/workplace A process in which outcomes are positive for all involved The nurse-physician collaboration is the most problematic Collaboration of nurses with unlicensed assistive personnel affects the quality of care to patients; sometimes mutual respect and cooperation is missing

Describe the process of collaboration and how it is used in the health care setting

Working jointly with other professionals Respect for each ones knowledge and abilities Willingness to work together Supportive organization/workplace A process in which outcomes are positive for all involved The nurse-physician collaboration in the most problematic Collaboration of nurses with unlicensed assistant personnel affects the quality of care to patients; sometimes mutual respect and cooperation is missing

what nurses are responsible for informed consent

Working with the primary provider (physician) - communicating patient needs May witness the patient signing the informed consent Making sure that the consent is valid - is the patient competent to sign?

What is the function of Bicarbonate?

Works as a buffer

Explain the lifespan of the thymus

Works up to puberty and then starts to turn into fat

Nursing Journals

Written for nurses - Offer latest information - Research results - Journal for every specialty - usually word "nursing" in the title

What often causes Type II?

Wrong blood

Antibody

Y shaped molecules, Light and heavy chains, antigen specific.

Do electrolytes move in and out of the cell?

YES

1924

Yale school of nursing- opened as first nursing school established as a separate university department

Are there forms for living wills and health care powers of attorney in South Carolina?

Yes The South Carolina legislature has approved forms for both a living will and a health care power of attorney. The living will form that the legislature approved is called a Declaration of a Desire for a Natural Death. You may be able to get these forms from the person who gave you this brochure.

Is the clotting cascade (hemostasis) reversible?

Yes, yes it is.

YOU HAVE THE RIGHT TO MAKE HEALTH CARE DECISIONS THAT AFFECT YOU

You have the right to make all decisions about the health care you receive. If you do not want certain treatments, you have the right to tell your doctor, either orally or in writing, you do not want them. If you want to refuse treatment, but you do not have someone to name as your agent, you can sign a living will. Most patients can express their wishes to their doctor, but some who are badly injured, unconscious or very ill cannot. People need to know your wishes about health care in case you become unable to speak effectively for yourself. You can express your wishes in a health care power of attorney or living will. In a living will, you tell your doctor that you do not want to receive certain treatment. In a health care power of attorney, you name an agent who will tell the doctor what treatment should or should not be provided. The decision to sign a health care power of attorney or living will is very personal and very important. This pamphlet answers some frequently asked questions about health care powers of attorney and living wills. These documents will be followed only if you are unable, due to illness or injury to make decision for yourself. While you are pregnant, however, these documents will not cause life support to be withheld. If you do not have a living will or health care power of attorney that tells what you want done, you do not know what decisions will be made or who will make them. Decisions may be made by certain relatives designated by South Carolina law, by a person appointed by the court, or by the court itself. The best way to make sure your wishes are followed is to state your wishes .in a health care power of attorney, or sometimes, a living will. If you want to refuse treatment but you do not have someone to name as your agent, you can sign a living will. If you have questions about signing a health care power of attorney or living will, you should talk to your doctor, your minister, priest, rabbi, or other religious counselor, or your attorney. Finally, it is very important that you discuss your feeling about life support with your family. A health care power of attorney also should be discussed with the people you intend to name as your agent and alternate agents to make sure that they are willing to serve. It is also important to make sure that your agents know your wishes.

What if I change my mind after I have signed a living will or health care power of attorney?

You may revoke (cancel) your living will or health care power of attorney any time. The forms contain instructions for doing so. You must tell your doctor and anyone else who has a copy, that you have changed your mind and you want to revoke your living will or health care power of attorney.

What are the requirements for signing a living will?

You must be eighteen years old to sign a living will. Two persons must witness your signing the living will form. A notary public must also sign the living will form. If you sign a living will while you are a patient in a hospital or a resident in a nursing home. a representative, as designated by State Ombudsman, Office of the Governor1 must witness your signing. There are certain people who cannot sign the document. The living will form tells you who cannot be witnesses. You should read the living will form carefully to be sure your witnesses are qualified.

Who should I appoint as my agent? What if my agent cannot serve?

You should appoint a person you trust and who knows how you feel about health care. You also should name at least one alternate, who will make decisions if you agent is unable or unwilling to make these decisions. You should talk to the people you choose as your agent and alternate agents to be sure they are willing to serve. Also, they should know how you feel about health care.

Which documents should I sign if I want to be treated with all available life-sustaining procedures?

You should sign a Health Care Power of Attorney and not a living will. The South Carolina Health Care Power of Attorney form allows you to say either that you do or that you do not want life sustaining treatment. A living will only allows you to say that you do not want life sustaining procedures.

How does active immunity work?

Your body has never seen the antigen before so it attacks it and once it attacks it, you're immune forever (chicken pox)

What is immunity?

Your body recognizing self vs not-self

Holistic Nursing

_nourishes the whole person -body, ,mind, and spirit -1.nursing is an open system 2.nursing provides several healthcare services including maintaining health, preventing diseases, restoring health, and achieving a peaceful death. 3.collaborating with patients and families 4. is involved with people at points along the health-illness continuum 5. nursing care is provided regardless of diagnosis, differences, age, beliefs, gender, sexual prefernce, and other factors. Nursing supports the value, dignity, and uniqueness of every person and takes his or her culture and belief system into consideration 6.nursing requires advanced knowledge and skills 7. caring, compassion, and concern, respect and warmth 8. links theory research in an effort to answer difficult questions

What is the cause of Neurogenic Shock

a defect in vasomotor center in the brain stem, often related to spinal cord injury

Counseling

a direct care method that helps patients use problem-solving processes to recognize and manage stress and facilitate interpersonal relationships

Professional nursing organization

a group of nurses that have a purpose that they enhance some element of patient care or the nursing profession

Chronic Disease

a long-lasting disease that typically remains with an individual from onset to the end of life and lasts longer than three months

Accreditation

a process by which an institution's programs, policies, and practices are reviewed by an external accrediting body to determine whether professional standards are being met

U.S. Cadet Nurse Corps

a program subsidized by the federal government and designed to quickly prepare nurses to meet the needs of the armed forces, civilian and government hospitals, and war industries

healthy people 2020

a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats in the next decade.

Antigen

a substance that generates an immune response by causing the formation of an antibody or reacting with antibodies or T-cell receptors.

Clinical practice guideline

a systematically developed set of statements that helps nurses, physicians, and other health are providers make decisions about appropriate health care for specific clinical situations

Mary Livermore

a teacher and abolitionist who served as a volunteer nurse.

What are the common abbreviations associated with nursing practice?

ac- before meals pc- after meals ad lib- freely desired bid- twice a day tid- three times a day qid- four times a day c/o- complaints of IM- intramuscular IV- intravenous pre- as needed PO- orally or by mouth

_____ releases H+

acid

pH < 7.35 = _____

acidosis (acidic)

primary prevention

actions taken to modify health behaviors such as diet or smoking

approaches to teaching and learning in nursing education that are best include those that promote what type of learning

active learning

ADL

activities of daily living

Sister Callista Roy: Health

adaptation in the 4 areas of function

Always be aware of a patient's changing condition and then _______.

adjust the interventions on the basis of ongoing assessment

treatment of hypermagnesemia

administer Ca+ to negate Mg+

treatment of hypercalcemia

administer IV to dilute Ca+ and increase urination

nurse anesthetist

administer anesthesia for all types of surgeries in various settings

main purpose that all professional organizations serve regardless of discipline

advocate collectively for their members and other constituents

pc

after meals

Treatment for septic shock

aggressive fluid resuscitation (start with fluid challenge) Antibiotics Vasopressors - to perfuse organs (if not hypovolemic) antipyretics May need insulin for hyperglycemia

pH > 7.45 = _____

alkalosis (basic)

What is the significance of the Nurse Licensure Compact state?

allows an RN to have one license (in the state of residence) yet [ractice in other compact states without an additional license; developed to improve the mobility of nurses

What is the significance of the Nurse Licensure Compact state?

allows an RN to have one license( in the state of residency) yet practice in other compact state without an additional license; developed to improve the mobility of nurse

what is the very first sign of increased ICP?

altered LOC (restless, anxious, confused)

cheyne smokes

alternating periods of apnea & hyperpnea

respiration is also known as

alveolar ventilation

PaCO2

amount of dissolved CO2 in the arteries/blood

PaO2

amount of dissolved O2 in the arteries/blood

"a" represents

amount of dissolved O2 or CO2 in arterioles

"V" represents

amount of dissolved O2 or CO2 in venous system

"A" represents

amount of dissolved O2 or Co2 in alveoli

Associate Degree Nursing Programs were created in response to

an acute nursing shortage after WWII

The Commission on Collegiate Nursing Education (CCNE)

an autonomous accrediting agency, contributing to the improvement of the public's health. Ensures the quality and integrity of BSN, graduate, and residency programs in nursing.

dorothea dix

an avid reformer of care of the mentally ill; appointed by President Lincoln as Superintendent of Women Nurses of the Army o Created month-long training program for women who wanted to serve

Preceptor

an experienced nurse who facilitates and evaluates students learning in the clinical area over a specified time period

self-efficacy

an individuals belief in one's ability to change a behavior successfully

the Committee on the Grading of Nursing Schools

analyzed the work of nurses and studied the educational preparation of student nurses

Nursing intervention

any treatment based on clinical judgment and knowledge that a nurse performs to enhance patient outcomes

Define bioethics

application of ethical theories and principles to problems in healthcare

Martha Rogers: Environment

as our universe is our environment astronaut

autonomy

asserts that individuals have the right to determine their own actions and the freedom to make their own decisions.

autonomy

asserts that individuals have the right to determine their own actions and the freedom to make their own decisions

primary purpose of NCLEX-RN

assure that a nurse is minimally safe to practice

hs

at bedtime or hour of sleep

ANA's definition of healthy sleep

at least seven hours of daily comfortable and restorative sleep

Name an example of a Fungi

athletes foot/ring worm (not a worm) /yeast infection

What intrinsic factors help stimulate kidney regulation?

auto regulation and local hormones

When your body can't recognize self, form non-self and what happens?

autoimmune disease, body attacks itself

why is catheter back up a cause of autonomic dysreflexia?

autonomic dysreflexia is an extreme response to pain felt in the PNS but (because of injury to T6 or above) not in the CNS. - when the catheter is kinked and backs up, the PNS feels it but cannot send the message to CNS... PNS produces an exaggerated response.

six ethical based on human dignity and respect

autonomy beneficence nonmaleficence justice fidelity veracity

What is more common in septic shock?

bacteremia

_____ accepts H+

base

useful helpful responding techniques

be non-judgmental -observe body language -be an active listener -show empathy -demonstrate caring and compassion -ask open ended questions -give info -use reflection;method of encouraging patient to think through their problems -silence can be a helpful response

Patient

before implementing interventions, make sure your patients are physically and psychologically comfortable (helps to create a favorable emotional climate)

ac

before meals

Equipment

before performing an intervention, decide which supplies you need and determine their availability (controls heath care costs)

Lillian wald

began the henry street settlement and public health nursing

Where are interstitial fluid located?

between tissues

CNS consists of:

brain & spinal cord

ventilation (pulmonary)

breathing... flow of O2 from nose to alveolar level (gas EXCHANGE with environment)

asthma is caused by:

bronchoconstriction & inflammation

Match the four terms with their partner. a. Systemic b. pulmonary c. central d. peripheral

c-b a-d

cap

capsule

pulmonary perfusion

carries deoxygenated blood to lungs

bronchial perfusion

carries oxygenated blood to away from lungs

what do efferent neurons do?

carry information AWAY from the CNS

what do afferent neurons do?

carry information TO the CNS

#1 cause of autonomic dysreflexia

catheter backup

Where is the rest found?

cell membranes

CVA

cerebrovascular accident (stroke)

American Nurses Credentialing Center (ANCC)

certification of nurses and magnet credentialing of hospitals and health networks

Active Immunity examples of Acquiring?

chicken pox, measles, mumps

asthma

chronic inflammatory disorder of the airways

COPD

chronic obstructive pulmonary disease a combination of: - chronic bronchitis (inflam. of bronchials) - emphysema (poor gas exchange, enlargement, thickening, and possible rupture of alveoli) - chronic asthma

closed spontaneous pneumothorax

collapsed lung

Robert Wood Johnson Foundation

committed millions of dollars to create regional workforce development systems in health care

c/o

complains

CRPS

complex regional pain syndrome - pain beyond what would be expected of the injury (not sure why it occurs)

Gordon: health perception/health management

compliance with medication regimen; health checkups; not smoking

manifestation of hypokalemia

constipation (K+ job is muscle contraction...including GI motility)

Monrow Kelly Hypothesis

contents of the brain include: blood (10%), tissue (80%), and CSF (10%) = 100% if one of theses contents increases, something must decrease... brain tissue will die. (if there is content increase > 100% tissue will die)

the CNS is the _______

control system

Hildegarde Peplau: Health

coping, deceasing anxiety, stress

What is the difference between counseling and teaching?

counseling results in changes in the development of new attitudes, behaviors, and feelings; whereas teaching focuses on intellectual growth or the acquisition of psychomotor skills

Lina Rogers

created idea of school nurses

Jean Watson: Environment

creating a healing, holistic, positive environment; nursing is promoting, restoring health, preventing illness

Madeline Leininger: Environment

culture is environment - external and internal

What are two caused of cardiogenic shock?

damage to the heart from myocardial infarction and ineffective pumping caused by cardiac arrhythmias

inadequate perfusion is aka

dead space

Annie Goodrich

dean of Army School of Nursing (1918)

Patient reports severe pain, guarding behavior, protecting abdomen (Diagnostic Set, Defining characteristic, or Related Factors)

defining characteristic

a nurse notes that a patient has an increased respiratory rate, the patient reports difficulty breathing while lying flat and pursed lip breathing. This data set is an example of

defining characteristics

0C

degrees centigrade

0F

degrees fahrenheit

Florence Nightingale: Person

dependent on good care; vulnerable

characteristics of a magazine article

designed to inform or entertain Main purpose is to sell ads for general public has attractive or appealing colors, graphics and illustrations Written in a non-technical, easy-to-read style no prior knowledge needed to understand Written by a journalist/freelance writer or anonymous author Topic written in broad scope Published by a commercial organization Doesn't contain a bibliography

#1 cause of a shunt

destructive lung disease (such as COPD)

Dx or dx

diagnosis

parts of Nursing Diagnosis statement

diagnostic stem, defining characteristic, related factors

health disparities

differences in the incidence, prevalence, mortality, and burden of disease and other adverse health conditions that exist among specific population groups

dyspnea

difficulty breathing

Cytokines

directing leukocyte migration to areas of injury and to locations where primary immune response is initiated.

Florence Nightingale: Health

disease as reparative; health prevents disease

Mechanical obstruction

dissecting aneurysm cardiac tamponade pneumothorax pulmonary embolus

partial pressure

dissolved O2 & CO2

continued life support measures that are not viewed by the nurse to be in the best interest of the patient can be a source of

distress

Signs and Symptoms of Insulin Reaction

dizziness, shaking, sweating/clamminess, hunger, nervousness or anxiety, irritability, rapid pulse

DNR

do not resuscitate

delegation

empower one to act for another

when was the field of public health nursing instituted

end of the 19th century

What does "licensure by endorsement" mean?

endorsed by the other State Boards of Nursing

Imogene King: Environment

environment provides input to the person, internal and external; conditions to adapt and reach goals

Justice

equals should be treated the same (Patients with the same diagnosis and health care needs should receive the same care).

justice

equals should be treated the same (patients with the same diagnosis and health care needs should be treated the same)

American Nurses Association other purposes

establish code of ethics, promote the image of nursing, and provision of attention to the financial and professional interests of nursing.

Henry Street Settlement House

established by Lillian Wald to provide housing and health care for immigrants in New York

Patient Self-Determination Act

established in 1991 by Congress to safeguard patients' rights to determine how vigorously they wanted to be treated in life and death situations.

Community College Education for Nursing (Montag)

established the validity of the ADN program as adequate preparation for nursing practice

ethical dilemmas and decision making

ethical dilemma- involves the need to choose from among two or more morally acceptable options or between equally unacceptable courses of action ethical decision making- decisions that are consistent with ones personal or organizational value system

PNS consists of:

everything that branches off the brain & spinal cord

What does "licensure by endorsement" mean?

exam and endorsed by other state boards of nursing

cause of hypercalcemia

excess PTH carrying Ca+ out of bone marrow

respiration

exchange of CO2 & O2 at the alveolar level

Shirley Titus

executive director of the California Nurses Association who lobbied for economic empowerment for nurses

Taft Hartley Labor Act

exempted nonprofit institutions such as hospitals from the requirement to enter into labor negotiations with their employees to address workplace grievances

focus of primary prevention

exercise and eating well

during WWI and WWII, the profession of nursing

experiences significant improvement in image as the public became aware of nurses' roles in saving lives

ERV

expiratory reserve vol. (1,100 mL)

social determinants of health

factors that can contribute to an individuals overall health status

common causes of communication breakdown

failing to see the uniqueness of the individual failing to recognize levels of meaning using value statements and cliches giving false reassurance failing to clarify

negligence

failure to act as a reasonably prudent person would behave in specific circumstances

Negligence

failure to act as a reasonably prudent person would have acted in the same circumstances

fidelity

faithfulness and honoring ones commitment and promises

fidelity

faithfulness or honoring one's commitments or promises.

tachypnea

fast respiration (>20 bpm)

Identify the criteria and strategies for successful communication

feedback appropriateness- reply fits the circumstances and matches the message Efficiency- simple, clear words Flexibility- deal with patients questions and feelings Be a good listener Take cultural differences into consideration

What are some signs/symptoms of septic shock?

fever, warm flushed skin, mild hyperventilation, respiratory alkalosis, may have changes in sensorium, initially a warm shock, may progress to warm shock because low cardiac output=cold extremities poor outcome

Mary Mahoney

first black trained nurse

Mary Mahoney (1845-1926)

first black trained nurse

Mary Mahoney

first licensed african-american nurse

Mary Adelaide Nutting

first professor of nursing

mary adelaide nutting

first professor of nursing in the world

Mary Adelaide Nutting (1858-1947)

first professor of the nursing world

segregated nursing schools

first program exclusively for African American women was established at the Atlanta Baptist Female Seminary in 1886 (known as spelman college today.)

how does a closed spontaneous pneumothorax occur?

for some reason, alveoli get too big and blister-like and burst... air leaks out of the alveoli and into the plural space around lung... pressure causes lung to collapse

ANA advancement of nurses

fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public

Mildred Montag

founded ADN education in 1952

Lillian Wald (1867-1940)

founded the henry st settlement and public health nursing

florence nightingale

founder of modern nursing and nursing education o Contributions of development to nursing in US and Britain Hospital reform Upgrade conditions for sick and wounded in military Established training schools for nurses

Clara barton

founder of the american red cross

qid

four times a day

ad lib

freely as desired

Gordon: elimination

frequency of bowel movements; voiding patterns

informed consent

full, knowing authorization by the patient for care, treatment, and procedures and must include info. about the risks, benefits, side effects, costs and alternatives.

FRC

functional residual capacity (2,300 mL)

aginal breathing

gasping for air but no exchange

What are the legal and ethical responsibilities involved with the administration of medications?

give drug in accordance to orders: drug, dosage, route, frequency as well as observing recording, and reporting desired effects, untoward reactions, and side effects and intervening when neccesary

Isotonic Fluid Volume Deficit treatment

give isotonic IV fluid

Lymphocytes

give us 'B' and 'T' cells, nonphagocytic. Attack foreign cells and produce antibodies.

delegation

giving someone authority to act for another -nurses are able to delegate tasks- this comes with great responsibility! CNA (delegating requests): checking vital signs, hygiene requests, food/drink requests PN (delegating requests): med administration (varies state to state), checking vital signs

Imogene King: Health

goal attainment; adaptation

Rosemaries Rizzo Parse: Nursing

goal of nursing is to know the patients' perspective on health and illness; patient's perspective of quality is important

eupnea

good, normal respiration

from the 1950's through the 1970's, which type of nursing education was the most influential in advancing nursing knowledge

graduate education

vulnerable population

groups of individuals who are likely to have compromised access to health care and therefore are more likely to have poorer health outcomes

Rosemaries Rizzo Parse: Health

health focus is on quality of life

Gordon: nutritional-metabolic

height/weight; condition of skin

is VQ ratio high or low with inadequate perfusion

high (normal vent./low perf.) 4/3 = 1.33

H&P

history and physical

Gordon: activity-exercise

hobbies; mobility; exercise; activities and daily living

Signs and Symptoms of HHS

hyperglycemia, hyperosmolarity, dehydration, the absence of ketoacidosis, depression of the sensorium

Signs and Symptoms of DKA

hyperglycemia, low bicarbonate, low pH, ketonemia, respiratory pattern: fast (20-40)

Signs and symptoms of neurogenic shock

hypotension bradycardia warm dry skin peripheral vasodilation decrease cardiac output- low volume

Sister Callista Roy: Nursing

identification of areas where there is not adaptation and intervene; helping the patient to adapt

Martha Rogers: Health

illness is an event that is caused by energy

Active Immunity - Produced by host after either __ or __ to antigen.

immunization natural exposure

racial barriers for military

in 1947 segregation of African American nurses was ended

Instrumental activities of daily living (IADL)

includes skills such as shopping, preparing meals housecleaning, writing checks, and taking medication

what is the humans drive to breathe?

increase of CO2 (not lack of O2)

What are some anaphylactic shock signs and symptoms?

increased cellular permeability vascular response may lead to laryngeal edema and bronchospasm, difficult breathing, abdominal cramps, apprehension, wheezing and coughing, circulatory collapse RAPID ONSET, warm and burning sensation to skin, itching

Maintenance stage of trans theoretical model

individual has changes behavior for more than six months

precontemplation stage of Transtheoretical Model

individual has no intention of taking action within the next six months

IC

inspiratory capacity (3,500 mL)

IRV

inspired reserve vol. (3,000 mL)

I&O

intake and output

American Nurses Association main purpose

intent of achieving licensure for nurses

Direct care

interventions are treatments performed through interactions with patients

Secondary prevention

interventions focused on early detection and screening of disease such as tuberculosis skin testing

Indirect care

interventions or treatments performed away from a patient but on behalf of the patient or group of patients, documentation, and interdisciplinary collaboration (a collaborative intervention)

IM

intramuscular

IV

intravenous

Phagocytosis

invaders engulfed/digested/mess gets cleaned up -> pus

It is the position of the SC Board of Nursing that administration of medication

is a critical nursing function based on the understanding of pharmacotherapeutics, biochemistry, and pathophysiology. In settings where nurses are employed to provide nursing care to clients, the regulations preclude the licensed nurse from delegating administration of medications to unlicensed assistive personnel.

Philosophy of Nursing

is defined as the study of principles underlying conduct, thought, and the nature of the universe. It is a search for meaning, contemplating or wondering about something.

define clinical judgment in nursing

is the conclusion or enlightened opinion at which a nurse arrives following a process of observation, reflexion and analysis of observable or available information or data.

Nursing judgment

is the logical and systematic cognitive process of identifying pertinent information and evaluating data in the clinical context in order to produce informed decisions, which guide nursing actions.

How did the post-WWII influence the definitions of nursing?

it helped advance technologies available, nurses were also given more opportunities to have higher educations (masters degrees)

hyperpnea

kausmal breathing

how does phosphate leave the body?

kidneys... urine

Adaption

kzzdb

why do Trousseau and Chvastek's signs appear in hypocalcemia?

lack of Ca+ = lack of smooth muscle control

what is a COPD patient's drive to breathe?

lack of O2

why should you be carful administering O2 to COPD patients?

lack of O2 is their drive to breath... if you give them enough O2 they will stop breathing

Mandatory Licensure Laws enacted when

late 1940s

Johnson & Johnson

launched a campaign in 2002 to enhance nursing's image and improve recruitment

Emigration or Transmission

leaving, exit, and more to site of injury

Bolton Act of 1942

legislation that created the U.S. Cadet Nurse Corps

Can water or lipid soluble substances cross the BBB?

lipid

What is lost in distributive shock?

loss of sympathetic vasomotor tone

is VQ ratio high or low with inadequate perfusion

low (low vent./normal perf.) 2/5 = 0.4

what is the respiratory drive in COPD patients?

low oxygen

Virginia Henderson: Environment

maintaining a supportive environment

Clinical judgment includes

making appropriate interpretations or conclusions about he interventions used to address a patient's human response to health conditions or life processes

Bolton Act influence

mandating standards for nursing education programs and the removal of school policies that discriminated against students' gender, marital status, ethnicity, or race

The Clinical Nurse Leader (CNL) is a nurse with what type of education

master of science degree

Practice of registered nursing

means the performance of health care acts in the nursing process that involve assessment, analysis, intervention, and evaluation.

Practice of Nursing

means the provision of services for compensation, except as provided in this chapter that assists persons and groups to obtain or promote optimal health.

accredited nursing programs must demonstrate to external accrediting organizations that they

meet professional nursing education standards

Associate Degree Nursing Programs helped what type of people enter nursing

men, married women, and mature students

Florence nightingale

mother of modern nursing, started first training school for nurses in 1860

Environment

needs to be safe and conducive to implementing therapies

malpractice

negligence in the profession

malpractice

negligence in the professional o The greatest legal concern of health care practitioners!

Malpractice

negligence in the professional -greatest legal concern of health care practitioners!

What is the fundamental unit of the nervous system?

neuron (nerve cell)

apnea

no respiration

the National Council of State Boards of Nursing (NCSBN)

not-for-profit organization through which boards of nursing act and counsel together on matters of common interest and concern affecting public safety and welfare, including the development of nursing licensure examinations

Holistic nursing

nourishes the whole person, body, mind, and spirit

Mary breckinridge

nurse and midwife, established the Frontier Nursing Service which brought health care to rural areas

Mary Breckinridge

nurse midwife who founded the Frontier Nursing Service

the largest number of health care workers in the U.S.

nurses

Madeline Leininger: Nursing

nurses need knowledge of cultural differences and similarities; specialist nurses are needed (grad) who can consult on other cultures health beliefs and values

Safety

nurses should ensure patient safety by providing patient care in accordance with organizational policies

informatics

nurses should use technology as available to support the safe implementation of patient care

Patient-Centered Care

nurses should use the patient's needs, preferences, and values as the central focus when developing the plan of care

Teamwork and Collaboration

nurses should work as part of a team to effectively execute the patient driven plan of care

Chicago World's Fair (1893)

nursing leaders gathered to share ideas: Isabel Hampton Robb Lavinia Lloyd Dock Bedford Fenwick-- campaign to procure a nationally recognized certificate for nursing The National League for Nursing (NLN) formed at this meeting

Academic progression programs

nursing programs that facilitate the seamless articulation or transition from one degree in nursing to another degree

1912

nutting conducted nationwide study on living conditions of students, the material being taught, and the teaching methods being used

List several reasons why the Associate Degree Nursing programs were popular?

o Accessibility of community colleges o Low tuition cost o Part-time and evening hours o Shorter duration - 2 year programs o Graduate eligibility to take NCLEX-RN

3 ways to obtain licensure

o By exam o By endorsement - endorsed by other State Boards of Nursing o Nurse Licensure Compact - allows an RN to have one license (in the state of residency) yet practice in other compact states without an additional license; developed to improve the mobility of nurses.

Where are employment opportunities for community health nurses?

o Community o Office nursing o OccupationalHealth o Schools o CaseManagementnursing o Faith Community nursing o Informaticsnurse o Nurseeducators o AdvancedPracticenursing o Hospice or Palliative Care nursing o Military nursing o Telehealth nursing o Informaticsnursing o Travelnursing

In S.C. there are 2 Advanced Directives

o Health Care Power of Attorney o Living Will o Organ Donation o EMS DNR (Do Not Resuscitate) Order

Responsibility of: Case Management nursing

o May work for a hospital or outside agency o Ensure that the patient receives the services they need from the entire health care team o Most useful with high costs/high volume/high risk patients o Follow-up @ home o Assess, plan, facilitate, and advocate

philosophies of nursing

o Statement of beliefs about nursing o Expressions of values in nursing o Used for decision making and the practice of nursing

advanced directives

o patient self-determination act o legal documents that indicate the wishes of adult individuals in regards to end-of-life issues- vary each state

Nursing Licensure

oNurses must hold a valid license to practice. o Each state determines who is qualified for licensure, as well as the limits on the license (Nurse Practice Act). o Applicants must meet state standards in order to take the NCLEX-RN or NCLEX- PN (National Council Licensure Examination). o If you pass exam, you are either a registered nurse (NCLEX-RN) or a licensed practical nurse (NCLEX-PN).

Obstructive shock

obstruction to outflow from the heart

the nightingale school of nursing at St. Thomas Hospital differed chiefly from earlier forms of nursing education because it

offered a set curriculum that, coupled with classes in theory, with clinical experiences

what population of people will grow substantially by 2030 and require nurses to have specialized knowledge of their care

older adults

autonomy

one has control over ones practice

throughout antiquity, prior to the modern era, the safest nursing care was provided in

one's own home by one's relatives

"Permissive" laws enforced what

only nurses who were trained were allowed to use the title "Registered Nurse"

tension pneumothorax

open from outside - closed from inside... air can come in but cannot go out. (like a valve) **pressure builds up very quickly - lethal **pleural space becomes so inflated, it starts pushing vital organs (hear & unaffected lung) to the side and squishing them (CO decreased)

Betty Neuman: Person

open system; concepts of physiological, sociocultural, developmental, and spiritual

PO

orally or by mouth

What are some complications of septic shock?

organ failure, pulmonary insufficiency

The most important factor to consider when deciding which professional organization to join

organizational mission and your career objectives

Lillian Wald

originated settlement house nursing

Opioids

pain meds that effects the opioid (mu) receptor of the prain

Virginia Henderson: Person

patient as an individual; importance of patient's self-determination

Rosemaries Rizzo Parse: Environment

patient is in continual communication with the environment the "lived experience"

Advanced Directive (AD)

patient self-determination act was established in 1991 by congress to safeguard patients rights to determine how vigorously they wanted to be treated in life and death situations -legal docs. that indicate the wishes of adult individuals in regards to end of life issues- vary each state

Patient's Bill of Rights

patient should receive this upon admissions to a facility -states patients rights- what a patient can reasonably expect while in the care of a healthcare facility -public wants a say in matter affecting their health care -guarantees certain rights and privileges to every hospitalized patient -there are many diff. versions

Patient adherence

patients and families invest time in carrying out required treatments

Madeline Leininger: Person

people come from a culture that requires culturally specific care

Imogene King: Person

personal, interpersonal, social components of person

concern over the lack of nursing representation on health governing boards led ANA and several other organizations to propose

placing 10,000 additional nurses on boards by 2020

orthopnea

position dependent dyspnea

Florence Nightingale: Nursing

preparing the environment for the patient to heal

Glaucoma

pressure due to inadequate drainage of aqueous humor (AH) or over production of aqueous humor. One of the leading causes of irreversible blindness in the world. Is more common in men, African Americans, & Asian population. There is no cure at present.

Betty Neuman: Nursing

prevention as intervention; holistic assessment; stabilization of person

Active Immunity

production of antibodies by the person's own immune system in response to direct contact of an antigen.

How does one's "personal value system" affect nursing practice?

professional ethics outweigh personal ethics in a professional setting.

National League for Nursing Commission for Nursing Education Accreditation (NLNCNEA)

promotes excellence and integrity in nursing education globally through an accreditation process that respects the diversity of program mission, curricula, students, and faculty

National League for Nursing (NLN)

promotes excellence in nursing education to build a strong and diverse nursing workforce to advance the health of our nation and the global community

Confidentiality

protection of private info. -HIPPA; federal law that protect patients medical records

confidentiality

protection of private information

Hildegarde Peplau: Person

psych-mental health; on the streets and in institutions; need for counseling, therapy, and interpersonal connections

type of wellbeing that a "healthy nurse" addresses by maintaining healthy work interactions with co-workers

psychosocial

pH

puissance (%) of hydrogen

#1 cause of dead space

pulmonary embolism

Madeline Leininger: Health

quality of health care is a goal/outcome of care; health depends on effective nursing & being culturally aware and sensitive; health and illness are influence by experience of culture

Gordon: sleep-rest

quality of sleep; energy

VQ Ratio

ration of ventilation to perfusion

Educational Preparation for Nurse Practitioners and Assistants to Nurses

reaffirmed the stand that nursing education should occur in institutions of higher education, rather than in hospitals (ANA position paper)

Martha Rogers: Nursing

reasons for being here is to care for others

Jean Watson: Person

recipient of care; participant in care; "person" is also the nurse caring for self and others

IOMs future of nursing report

recommended strategies by which nurses could be maximally prepared to provide patient care in a reformed healthcare system

Brown Report

recommended vocational education for practical nurses and recommended that education for RNs be in an institution of higher learning

What are some treatments for cardiogenic shock?

reduce work load on heart by giving o2 and increase cardiac output by giving fluids, vasodilators, intra-aortic balloon pump and monitor fluid and electrolytes

tertiary prevention examples

rehabilitation from an injury or illness

the PNS is the _______

relay system

What is Thymic selection?

removing non working T cells

cause of hypermagnesemia

renal insufficiency (kidneys cannot excrete Mg+)

South Carolinas Definition of the Practice of Nursing

requires the use of nursing judgment. practice is provided by advanced practice registered nurses, registered nurses, and licensed practical nurses. The scope of nursing practice varies and is commensurate with the educational preparation and demonstrated competencies of the person who is accountable to the public for the quality of nursing care. Nursing practice occurs in the state in which the recipient of nursing services is located at the time nursing services are provided.

RV

residual vol. (1,200 mL)

treatment of hyperphosphatemia

restrict dietary ingestion of P-

Spanish American war

resulted in the Army Corops and the Navy Nurse Corps

how do you play the arrows game?? real talk

reversed arrows = respiratory matching arrows = metabolic)

the most reliable method of obtaining information about a professional nursing organization's mission and strategic activites

reviewing the organization's website

What does K-exolate do?

rids of potassium through diarrhea

where is the most likely place for a pulmonary embolism? why?

right bronchi - straighter than left (more likely for embolism intrusion)

Why educated nurses first joined to form the American Nurses Association (ANA) was to

secure the passage of nurse licensure legislation in each of the states in the U.S.

altrusim

service to others

Function of the National League for Nursing (NLN) and the American Association of Colleges of Nursing (AACN)

set accreditation standards for excellence in nursing education programs and curricula

Anaphylactic Shock

severe allergic reaction- histamine release (vasodilation)

What is septic shock associated with?

severe infection

Fourth and final stage of hypovolemic shock

shock is irreversible, even though the blood volume may be restored and vital signs stabilized. death ensues eventually

Passive Immunity

short-term immunity which results from the introduction of antibodies from the outside.

inadequate ventilation is aka

shunt

Virginia Henderson: Health

sick/well; health or recovery, or peaceful death; 14 basic personal needs

Chvastek's sign

side of face will pull up when tapping on CN7 about cheek bone

inadequate ventilation & perfusion is aka

silent unit (code blue)

bradypnea

slow respiration (<12 bpm)

#1 cause of COPD

smoking

parts of dimensions of wellness

social emotional spiritual intellectual physical environmental financial occupational

strongest indicator of health status

socioeconomic status

Do solutes (particles) move to area of lower concentration? OR Does solution (fluid) move to area of higher concentration?

solutes (particles) move to area of lower concentration (like contents of a tea bag dispersing in hot water)

Advanced Beginner

someone who has limited experience with a given situation

Novice

someone who has no experience with a given situation

Competent

someone with 2 to 3 years of experience who is consciously aware of a given situation in its individual parts and can develop a long-range action plan

Proficient

someone with the experience to see a given situation in wholes, rather than its individual parts. Who can analyze the situation and determine whether the typical picture is not materializing, and who can determine what needs to be revised within the plan of care in response

Expert

someone with the vast experience to intuitively assess a given situation and accurately target the problem area without being distracted by other unrelated symptoms

ANA Statement

stated that those licensed to practice nursing should be educationally prepared in institutions of higher education

tertiary prevention

strategies that will slow disease progression, limit disability from a disease, and restore individuals to their optimal level of functioning

Vietnam war

stretched boundaries for nursing that had to practice in the jungle

The Goldmark Report

studied the field of nursing education and recommended minimal education standards

subq, or SUBQ

subcutaneous

When you see chemotaxis what should you think?

tagging something that needs to be removed

who is closed spontaneous pneumothorax's prime target?

tall, thin, young men named Noah

veracity

telling the truth or not lying- fundamental to trust

veracity

telling the truth/not lying - fundamental to trust.

what organization publishes Nursing's Scope and Standards of Practice

the ANA

American Society of Superintendents of Training Schools of Nursing became

the National League for Nursing (3 - National League for Nursing Education)

What are the nursing laws in South Carolina regarding the administration of medications by licensed versus unlicensed personnel?

the administration of medications is recognized as the responsibility of a registered nurse or a licensed practical nurse as prescribed by the licensed physician or dentist . After June 30th, 1985 unlicensed nursing personnel shall not administer medications

population health

the aggregation of healthcare outcomes within specified groups of individuals and the distribution of outcomes among these groups

battery

the assault carried out; the impermissible, unprivileged touching of one person by another

Initial Stage of hypovolemic shock

the circulatory blood volume is decreased, but not enough to cause serious effects

American Association of Colleges of Nursing

the collective voice for academic nursing, serves as a catalyst for excellence and innovation in nursing education, research, and practice

Standards of practice

the criteria against which professional practice is measured

the past 30 years of nursing history have been shaped by a variety of challenges including all except

the current trend to mainstream and improve the use of midwifery

Beneficence

the doing of good. determining what is good for the patient

Nonmaleficence

the duty to do no harm (foundation of the Hippocratic Oath). Inherent in the Code of Ethics for Nurses.

Biopsychosocial model of health

the dynamic interaction of three levels - biological, psychological, and social aspects of health- that affect an individuals well-being

The Goldmark Report of 1923

the first critical analysis of nursing education

What has the inability to fill properly in obstructive shock?

the heart

The danger associated with nurses not being adequately represented nationally and internationally in healthcare discussions

the interests of nurses and the role they play in patient care will not be represented

curricula in nursing programs reflect

the mission and philosophy of the school

Imogene King: Nursing

the nursing process is dynamic, emphasis on communication by nurses to help patients make positive adaptation

Dolor means

the pain

Rosemaries Rizzo Parse: Person

the patient is the coauthor in determining health

American Nurses Association (ANA)

the premier organization representing the interests of the nations registered nurses.

Ethics

the principles of right and wrong that guide an individual in making decisions

American Nurses Association definition of Nursing

the protection, promotion and optimization of health and abilities

The SC Board of Nursing recognizes that

there are settings and circumstances where individuals must take medications to maintain their health status where the regularly scheduled presence of a nurse is not required. Often these individuals may need assistance with taking their medications. Assisting an individual to take medication may include the acts of reminding the individual of the time to take the medication; opening the container that is properly labeled; or assisting the individual to place the medication in the mouth or properly apply the medication. In these settings, the defined caregiver (surrogate family member) may assist the individual with taking the medication. The Nurse Practice Act currently contains an exemption to the licensing requirement for gratuitous nursing provided by friends and family members of an individual and for the incidental care of the sick by domestic servants or persons primarily employed as housekeepers as long as they do not practice nursing according to this chapter.

Civil war

there were no professionally trained nurses

serious weakness of early nurse practice acts

they were permissive laws rather than mandatory

what does the opioid/mu receptor in the brain do?

this is the part of the brain that receives pain

assault

threat or an attempt to make bodily contact with another person without that person's consent

tid

three times a day

in regard to TIA, "time is ______"?

tissue

TV

tital volume (500 mL)

the National League for Nursing main purpose

to elevate the standards of nursing education

What is the #1 reason someone wants to be a nurse? (kellys criteria)

to help people

what is the purpose of having a "registry" in North Carolina (1903)?

to identify nurses who had been trained

Purpose of the ANA

to improve health and well-being of people through standards-based nursing practice

National Students Nurses Association (NSNA)

to mentor students preparing for initial licensure as registered nurses, and to convey the standards, ethics, and skills that students will need as responsible and accountable leaders and members of the profession

Nursing Council of National Defense purpose

to recruit more student nurses as well as to assess the number of graduate nurses who might be available for military service (created by ANA)

TLC

total lung capacity (5,800 mL)

Passive Immunity - Pre-formed Antibodies or T-lymphs are __ to recipient.

transferred

TIA

transient ischemic attack

Critical issue for the future of nursing practice

translating findings from research into improved patient care outcomes

perfusion

travel of blood/O2 to an area (delivery)

bid

twice a day

Jean Watson: Health

understanding the meaning of health for the patient; outcome of holistic care

What is the end product of protein synthesis?

urea which is high in nitrogen and converts to ammonia and carbon dioxide

What is present in distributive shock?

vasodilation substance in the blood and inflammatory mediators

Levels of Communication

verbal -speaking non-verbal -gestures -clothing -posture -facial expressions -tone and volume of voice

is VQ ration high or low in asthma

very low (about 0.4)

Gordon: cognitive-perceptual

vision; hearing;pain

VC

vital capacity (4,600 mL)

informed consent

voluntarily; individual must be competent and have the capacity to understand; patient must be given enough information to understand; full knowing authorization by the patient for care/treatments/procedures - must include risks/benefits/side effects/costs/alternatives (Do not need informed consent if life-threatening)

jobs of the conducting airways

warms, filters, & humidifies air entering body

The Nightingale Pledge

what was the first code of ethics

University of Minnesota

what was the first university that had a nursing based program (1909)

prn

when required, or as often as necessary

What do you lose in Hypovolemic Shock?

whole blood, plasma and extracellular fluid

Clarifies purposes and functions - Helps other to understand what nurses do establishes parameters or boundaries of profession differentiates from other occupations - How do we from other members of health care team Influences health policy at local, state, and national levels -Used in laws and nurse practice acts Aids in developing educations curricula and research agendas - First step in curriculum development is faculty definition of nursing

why should we define nursing

changing knowledge and skills -Individuals/ groups cannot agree

why will definitions of nursing continue to evolve

Where is intravascular fluid located?

within vessel

characteristics of a nursing journal article

written for nurses Offer the latest information Research results Usually a Journal for every area of specialty Usually has the word Nursing in the title results of orig research, conference proceedings and literature reviews for specialized readers (nurses/drs/stu) May contain charts/graphs/tables Written in a highly technical style Written for readers who have some prior knowledge of the subject Written by someone in the field (credentials are listed) Contains jargon specific to author's field Published by/in assoc w/acad institution or professional org Articles are long in length Topic of article narrowly focused & explored in-depth Contains footnotes or bibliography

nursing journals

written for nurses; offer the latest information; research results; usually a Journal for every area of specialty; usually has the word Nursing in the title

non professional magazines/ journals

written for the lay public; will occasionally contain an article that is health/disease related; usually has an article on what is currently a "news maker"; some magazines are health/wellness related

Is septic shock a systemic response to infection?

yes

Describe the 6 steps that are used in ethical decision making

• Clarify the dilemma • Gather additional data • Identify options • Make a decision • Act upon the decision • Evaluate

Common Medication Errors (sources) Part 2

• Coined names • Multidose vials • Defective packaging • Similar packaging • Lack of dose limits • Similar drug names • Borrowing medications from a multiple-dose cart • Dangerous abbreviations (OD & QD for once daily) • Lack of interdisciplinary team review of medication errors • Unnecessary use of IVs, catheters, and nasogastric tubes • Lack of dosage check for high-risk drugs and pediatric patients' medications

Effect of gulcocorticoid on blood glucose.

• Critical to survival during periods of fasting and starvation. • Stimulation gluconeogenesis by the liver.

Describe Kolberg's stages of "moral reasoning."

• Describes how a person deals with moral dilemmas from childhood to adulthood • Kohlberg's Stages of Moral Reasoning is utilized in our nursing program • <9 years: self centered • >9 years and adults: Conform to expectations of family/groups/society • Independent thinking: Defining own moral values (higher intellectual development)

Common Medication Errors (sources) Part 1

• Human knowledge • Chaotic work environment • Unauthorized floor stocks • Using floor stock medications • Not following policies • Verbal orders • Human performance • Lack of personnel • IV solutions that are not premixed • Unnecessary use of medications • Lack of dose verification process • Math errors • Typographical mistakes • Poor handwriting • Acronyms

What are "advance directives?"

• Patient Self-Determination Act was established in 1991 by Congress to safeguard patients' rights to determine how vigorously they wanted to be treated in life and death situations. • Legal documents that indicate the wishes of adult individuals in regards to end-of-life issues - vary each state • In S.C. there are 2 Advanced Directives • Health Care Power of Attorney • Living Will • Other types of advanced directives • Organ Donation • EMS DNR (Do Not Resuscitate) Order

How have "patients' rights" affected health care?

• Public wants a say in matters affecting their health care • Guarantees certain rights and privileges to every hospitalized patient • Considerate and respectful care • Understandable information regarding diagnosis, treatment, and prognosis • Know the identity of health care team members • Know the financial implications • Make decisions about the plan of care • Advance directive • Privacy - conversations and records • Review his (her) own record and have it explained, except when restricted by law • Hospital will make a reasonable response to the request of the patient • Ask and be informed of business relationships with the hospitals/educational institutions, etc • Consent to or decline in research studies • Reasonable continuity of care • Informed of hospital policies and practices relative to patient care

Professional Responsibility - Nursing Code of Ethics

• The Code of professional conduct (NMC, 2002) states that a nurse is personally accountable for their practice. Being accountable means being responsible for something or to someone. It also states that you must promote a health care environment conducive to safe, therapeutic and ethical practice whilst working within a team. Being competent means possessing the skills and abilities required for lawful, safe and effective professional practice without direct supervision. • The Scope of professional practice (UKCC, 1992) is based firmly on the Code, emphasizing that professional practice occurs in a context of continual change and development. It points out that practice must be sensitive, responsive and relevant to the needs of the individual patients. Our nursing role takes on countless responsibilities, centered on the patient wherein we are promoting a safe environment, working within our professional boundaries and maintain knowledge of our limitations. • The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. • The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy. • The nurse is responsible and accountable for individual nursing practice and ......... an obligation to provide optimum patient care.

Why is it important for nursing to have a "code of ethics?"

• The Code of professional conduct (NMC, 2002) states that a nurse is personally accountable for their practice. Being accountable means being responsible for something or to someone. It also states that you must promote a health care environment conductive to safe, therapeutic and ethical practice whilst working within a team. Being competent means possessing the skills and abilities required for lawful, safe and effective professional practice without direct supervision.

Types of Medication Errors

• Wrong drug/IV • Allergy to drug • Wrong drug for patient's disease • Incorrect administration technique • Wrong diluent (solution that mixes with a powdered drug) • Wrong dose • Excessive dose • Insufficient dose • Wrong concentration • Too-rapid IV flow rate • Omitted drug • Wrong patient • Wrong time • Wrong route • Wrong procedure or test • Violation of orders • Wrong label directions • Wrong preparation

What are the purposes of the National League of Nursing?

•Oldest organization for nurses (since 1893) •Advances quality nursing education •Concerned with quality nursing for all types of nursing programs • Practical nursing • Associate Degree nursing • Baccalaureate Degree nursing • Master Degree nursing • Commission for Nursing Education Accreditation (CNEA) - Newly formed - accredits all types of nursing programs

Causes of hypovolemic shock

•diminished blood volume with inadequate filling of the vascular compartment •acute loss of 15% to 20% of the circulating blood volume: external loss of whole blood (e.g., hemorrhage), plasma (e.g., severe burns), or extracellular fluid (e.g., gastrointestinal fluids lost in vomiting or diarrhea) •internal hemorrhage or from third-space losses

Describe the functions of the National Student Nurses Association?

● A program of the American Nurses Credentialing Center, which is a subsidiary of ANA 33 ● Recognizes health care organizations that provide nursing excellence. ● Provides a vehicle for disseminating successful nursing practices and strategies. ● Recognizes quality patient care. ● Recognizes innovations in professional nursing practice. ● Provides consumers with the ultimate benchmark to measure the quality of care that they can expect to receive.