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Essentials of Nursing Health Safety
Notes
955
Nursing
Undergraduate 2
04/20/2018

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Term
Implementing
Definition
doing and documenting the activities that are the specific nursing actions needed to carry out the iterventions
Term
Interpersonal skills
Definition
all activities, verbal and nonverbal, people use when interacting daily with each other
Term
Evaluating
Definition
planned, ongoing, purposeful activity in which cts and HC pros determine (A) the ct's progress towar achievement of goals/outcomes, and (B) the effectiveness of the nursing care plan
Term
Evaluation Stmt
Definition
consists of two parts:
- Conclusion: a stmt that the goal/desired outcome was met, partially met, or not met
- Supporting Data: the list of ct responses that support the conclusion
Term
Outcome Evaluation
Definition
focuses on demonstrable changes in the ct's health status as a result of nursing care
Term
Process Evaluation
Definition
focuses on how the care was given
Term
QA program
Definition
an ongoing, systematic process designed to evaluate and promote excellence in the HC provided to cts
Term
QI
Definition
also known as CQI, TQM, PI, or PQI.
- according to Schroeder, the commitment and approach used to continuously improve every process in every part of an org, with the intent of meeting and exceeding ct expectations and outcomes
Term
Structure Eval
Definition
focuses on the setting in which care is given
Term
5 activities of the Implementing Phase
Definition
- providing care
- directing care
- coordinating care
- collaborating with other members of the HC team
- pt teaching
Term
The 3 category skills used to implement nursing interventions
Definition
- cognitive skills
- interpersonal skills
- technical skills
Term
5 activities of the Implementing Phase
Definition
- reassess the ct
- determine the nurse's need for assistance
- implementing the NIs
- supervising the delegated care
- documenting nursing activities
Term
When implementing, it's important to explain to the ct:
Definition
- what interventions will be done
- what sensations to expect
- what the ct is expected to do
- what the expected outcome is
Term
Two components of an evaluation stmt
Definition
- evaluating goal achievement for indv cts
- evaluating and modifying the overall quality of care given to groups of cts
Term
3 components of quality eval
Definition
- structure
- process
- outcome
Term
Creativity
Definition
thinking that results in the devp of new ideas and products
Term
Critical thinking
Definition
the intellectually disciplined process of actively and skillfully applying, analyzing, synthesizing, and/or eval info gathered from or generated by, observation, experience, reflection blah, blah, blah
Term
Components of creative thinking
Definition
- creativity
- understanding probs
- generate many ideas fast
- recognizing cues from cts
Term
Non-creative thinking suggestions
Definition
- advising
- suggesting
- anticipating resistance
- encouraging a ct to do a routine activity
- intervention is flexible
Term
Critical analysis
Definition
the application of a set of questions to a particular situation or idea to determine essential info and ideas and discard superfluous info and ideas
Term
Socratic questioning
Definition
a technique one can use to look beneath the surface, recognize and examine assumptions, search for inconsistencies, examine multiple points of view, and differentiate what one knows from what one merely believes
Term
Inductive reasoning
Definition
generalizations are formed from a set of facts or observations
Term
Deductive reasoning
Definition
reasoning from the general to the specific
Term
Nursing process
Definition
a systematic, rational method of planning and providing individualized nursing care
Term
Problem solving
Definition
obtaining info that clarifies the nature of the prob and suggesting possible solns
Term
Intuition
Definition
the understanding and learning of things w/o the conscious use of reasoning
Term
Problem solving
Definition
- trial and error
- intuition
- research process and scientific/modified scientific method
Term
Decision-making
Definition
- id the purpose
- set the criteria
- weigh the criteria
- seek alternatives
- examine alternatives
- project
- implement
- eval the outcome
Term
Critical thinking attitudes and skills
Definition
- self-assessment
- tolerating dissonance and ambiguity
- seeking situations where good thinking is practiced
- creating environments that support CT
Term
Assessing
Definition
the systematic and continuous collection, organization, validation, and documentation of data
Term
Database
Definition
all the info about a ct; it includes:
- the nursing health history
- physical assessment
- physician's history
- physical exam
- results of labs and dx tests
- material contributed by other HC personnel
Term
Subjective data
Definition
also referred to as symptoms, or covert data
- apparent only to the person affected and can be described or verified only by that pt
Term
Objective data
Definition
also referred to as signs or overt data
- detectable by an observer or can be measured or tested against an accepted standard
Term
Directive interview
Definition
it is highly structured and elicits specific info. The nurse initially controls the interview
Term
Nondirective
Definition
rapport building interview - the nurse allows the ct to control it
Term
Neutral question
Definition
a question the ct can answer w/o direction or pressure from the nurse, is open ended, and is used in nondirective interviews
Term
Screening exam or review of systems
Definition
a brief review of essential functioning of various body parts or systems
Term
4 activities of assessment process
Definition
- collect data
- organize data
- validate data
- document data
Term
Important aspects of the interviewing session
Definition
- time
- place
- seating arrangement
- distance (space)
- language
Term
Cues
Definition
subj or obj data that can be directly observed by the nurse; that is what the ct says or what the nurse can see, hear, feel, smell, or measure
Term
Dx can also be called....
Definition
analysis, also known as...
Term
Defining characteristics
Definition
the clusters of S&S that indicate the presence of a particular dx label
Term
Dependent functions
Definition
with regard to med dx, nurses are obligated to carry out dr prescribed therapies and txts
Term
Independent functions
Definition
the areas of HC that are unique to nursing and separate and distinct from medical mgmt
Term
DX
Definition
a stmt or conclusion re the nature of a phenomenon
Term
DX label
Definition
the standardized NANDA names for the dx
Term
Etiology
Definition
causal relationship between a prob and its related or risk factors
Term
Nursing DX
Definition
the ct's problem stmt, consisting of the dx label plus etiology
Term
Standard or Norm
Definition
a generally accepted measure, rule, model, or pattern
Term
PES format: prob, etiology, S&S
Definition
the basic three part nursing dx stmt
Term
Possible nursing dx
Definition
evidence about a health prob is incomplete or unclear
Term
Qualifiers
Definition
words that have been added to some NANDA labels to give add'l meaning to the dx stmt
Term
Risk factors
Definition
factors that cause a ct to be vulnerable to developing a health prob
Term
Risk nursing dx
Definition
a clinical judgment that a prob doesn't exist, but the presence of risk factors indicates that a prob is likely to devp unless nurses intervene
Term
Syndrome dx
Definition
a dx that's associated with a cluster of other dx. There are currently six
Term
Taxonomy
Definition
a classification system or set of categories arranged on the basis of a single principle or set of principles
Term
Wellness dx
Definition
describes human responses to levels of wellness in an indv, family, or community that have a readiness for enhancement
Term
Different types of nursing dx
Definition
- actual dx
- risk nursing dx
- wellness dx
- possible nursing dx
- syndrome dx
Term
Components of a NANDA nursing dx
Definition
- the prob and its definition
- the etiology
- the defining characteristics
Term
Basic steps in dx process
Definition
- analyzing data
- id health probs, risks, and strengths
- formulating dx stmts
Term
Assignment
Definition
a downward or lateral xfer of both the responsibility and accountability of an activity from one indv to another
Term
Collaborative care plan or multidisciplinary care plan or critical pathway
Definition
they sequence the care that must be given on each day during the projected length of stay for the specific type of condition
Term
Collaborative interventions
Definition
actions the nurse carries out in collaboration with other health team members
Term
Concept map
Definition
a visual tool in which ideas or data are enclosed in circles or boxes
Term
Delegation
Definition
the xfer of responsibility for the performance of an activity from one person to another while retaining accountability for the outcome
Term
Goals/desired outcomes
Definition
describes in terms of observable ct responses, what the nurse hope to achieve by implementing the NIs
Term
NI
Definition
any txt, based upon clinical judgment and knowledge, that a nurse performs to enhance ct outcomes
Term
NIC
Definition
a taxonomy of NIs
Term
Nursing orders
Definition
instructions for the specific individualized activities the nurse performs to help the ct meet established HC goals
Term
NOC
Definition
a taxonomy for describing ct outcomes that respond to NIs
Term
NOC
Definition
a taxonomy for describing ct outcomes that respond to NIs
Term
Policies and procedures
Definition
developed to govern the handling of frequently occurring situations. They don't become part of the care plan or permanent record
Term
Priority setting
Definition
the process of establishing a preferential sequence for addressing nursing dx and NIs
Term
Protocol
Definition
preprinted to indicate the actions required for a particular group of cts
Term
Rationale
Definition
the scientific principal given as the reason for selecting a particular NI
Term
Standardized care plan
Definition
a formal plan that specifies the nursing care for groups of cts with common needs
Term
Standards of care
Definition
describe nursing actions for cts with similar med conditions rather than indvs, and they describe achievable rather then ideal nursing care
Term
Standing order
Definition
a written document about policies, rules, regs, or orders regarding ct care
Term
Discussion
Definition
informal oral consideration of a subject by two or more HC pros to ID a prob or establish strategies to resolve a prob
Term
Flow sheet
Definition
part of the PIE document that's a ct care assessment flow sheet. It uses specific assessment criteria in a particular format, such as human needs or functional health probs
Term
Focus charting
Definition
it's intended to make the ct and ct concerns and strengths the focus of care
Term
Kardex
Definition
a widely used, concise method of organizing and recording data about a ct, making info quickly accessible to all health pros
Term
Narrative charting
Definition
a traditional part of the source oriented record. It consists of written notes that include routine care, normal findings, and ct probs
Term
PIE
Definition
documentation model: Problems, interventions, evaluation of nursing care
Term
Prob Oriented Med Record (POMR)
Definition
Weed (1960s), the data are arranged according to the probs the ct has rather than the source of the info
Term
Prob Oriented Record (POR)
Definition
same as POMR
Term
SOAP
Definition
- subjective data
- objective data
- assessment
- the plan
Term
Source Oriented Record
Definition
the traditional ct record. Each person or dept makes notations in a separate section or sections of the ct's chart
Term
Variance
Definition
a goal that's not met. Deviations to what is planned on the critical pathway - unexpected occurrences that affect the planned care or the ct's responses to care
Term
Data Warehousing
Definition
the accumulation of lg amts of data that are stored over time and can be examined for output in different types of reports
Term
Database
Definition
programs that are used to manage a file or group of files of detailed info about people or things
Term
Local-area network (LAN)
Definition
a network coordinated by one computer, the network server. PCs link to other PCs, and they all link to the network server
Term
Nurse Informaticist
Definition
an expert who combines computer, info, and nursing science
Term
Perception checking
Definition
documents a feeling or emotion reported to me
Term
Reflecting
Definition
restating the last word or phrase a child has said when there is a pause in the communication
Term
Behv therapy (Behv modification)
Definition
a system aimed at erasing some form of behv that interferes with healthy functioning
Term
Therapeutic comm
Definition
a planned interaction, has structure, and is constructive
Term
Successful comm requires
Definition
- an encoder
- a code
- a decoder
- feedback or response
Term
Techniques that encourage therapeutic comm
Definition
- attentive listening
- open ended questions
- reflecting
- clarifying
- paraphrasing
- perception checking
- focusing
- supportive stmts
- silence
Term
Health Literacy
Definition
an indvs ability to read, understand, and use HC info to make decisions and follow instructions
Term
Alarm reactions
Definition
the initial reaction of the body, which alerts the body's defensives to a stressor
Term
Burnout
Definition
a complex syndrome of behvs that can be likened to the exhaustion stage of the general adaptation syndrome
Term
Coping Strategy or Mechanism
Definition
an innate or acquired way of responding to a changing enviro or specific prob or situation
Term
Countershock phase
Definition
the second part of the alarm reaction where the changes in the body produced by the shock phase are reversed
Term
Crisis intervention
Definition
a short-term helping process of assisting cts to work through a crisis to its resolution and restore their precrisis level of functioning
Term
Crisis counseling
Definition
focuses on solving immediate probs involving indvs, groups, or families
Term
Ego defense mechanisms
Definition
psychologic adaptive mechanisms that devp as the personality attempts to defend itself, establish compromises among conflicting impulses, and allay inner tensions
Term
General adaptation syndrome (GAS)
Definition
Seyle's stress response is characterized by a chain or pattern of physiologic events
- alarm reaction
- resistance
- exhaustion
Term
Local adaptation syndrome (LAS)
Definition
the body reacting locally to stress; that is, one part or one organ of the body
Term
Shock phase
Definition
the stressor may be perceived consciously or unconsciously by the person
Term
Stage of exhaustion
Definition
third stage of GAS or LAS - the adaptation the body made during the second stage can't be maintained
Term
Stage of resistance
Definition
second stage of GAS or LAS - when the body's adaptation takes place
Term
Stimulus-based-stress models
Definition
stress is defined as a stimulus, a life event, or a set of circumstances that arouses physiologic and/or psychoogic reactions that may inc the indv's vulnerability to illness
Term
Transactional stress theory
Definition
Lazarus, a theory that encompasses a set of cogn, affective, and adaptive (coping) responses that arise out of person-enviro transactions; the person and the enviro are inseperable and affect each other
Term
TRanslator
Definition
converts written material from one language into another
Term
interpreter
Definition
an indv who mediates spoken comm between people speaking different languages w/o adding, omitting, or distorting meaning or editorializing
Term
the objective of the pro interpreter
Definition
the complete xfer of the thought behind the utterance of one language into an utterance in a second language
Term
Attentive listening
Definition
listening actively, using all the senses, as opposed to listening passively w/ just the ear
Term
Caring
Definition
the essential aspect of nursing
Term
Comforting
Definition
a complex process that includes discreet, transitory actions, such as touching, or broad, longer lasting interventions such as listening
Term
Comfort
Definition
a renewal, an amplification of power or sense of control, an invigorating influence, a pos mindset, and a readiness for action
Term
Decode
Definition
to relate the message perceived to the receiver's storehouse of knowledge and experiences and to sort out the meaning of the msg
Term
Encoding
Definition
involves the selection of specific signs or symbols (codes) to xmit the msg, such as which language and words to use, how to arrange the words, and what tone of voice and gesture to use
Term
Feedback
Definition
the fourth component of the comm process, the response, is the msg the receiver returns to the sender
Term
Group dynamics
Definition
the comm that takes place between members of any group
Term
Helping relationships
Definition
- helps cts manage their probs in living more effectively and devp unused or underused opportunities more fully
- helps cts become better at helping themselves in their everyday lives
Term
Process recording
Definition
a verbatim account of a conversation (taped or written) and includes all verbal and nonverbal interactions of the ct and the nurse
Term
Territoriality
Definition
a concept of the space and things that an indv considers as belonging to the self
Term
Compensation
Definition
allows a person to overcome weakness and achieve success
Term
Denial
Definition
temporarily isolates a person from the impact of a traumatic situation
Term
Displacement
Definition
allows for feelings to be expressed through or to less dangerous objects or people
Term
Identification
Definition
- an attempt to manage anxiety by imitating the behv of someone feared or respected
helps a person avoid self-devaluation
Term
Intellectualization
Definition
- rationalizing away a situation to avoid any personal sig and feelings
- protects a person from pain and traumatic events
Term
Introjection
Definition
a form of ID that allows for the acceptance of others' norms and values into oneself, even when contrary to one's previous assumptions
Term
Minimizing
Definition
not acknowledging the sig of one's behv
Term
Projection
Definition
blaming others or the enviro for unacceptable desires, thoughts, shortcomings, and mistakes
Term
Rationalization
Definition
using faulty logic and motives to justify behv
Term
Reaction formation
Definition
the person acts exactly the opposite to the way they feel
Term
Regression
Definition
restoring to an earlier, more comfortable level of functioning that is less demanding and responsible
Term
Repression
Definition
threatening thoughts, feelings, and desires are kept from becoming conscious
Term
Sublimation
Definition
the displacement of energy associated with primitive drives into more acceptable outlets
Term
Substitution
Definition
the replacement of a highly valued, unacceptable, or unavailable object with a less than one
Term
Undoing
Definition
acting in a way to relieve the guilt or unacceptable thoughts by reparation
Term
Substitution
Definition
the replacement of a highly valued, unacceptable, or unavailable object with a less than one
Term
Effective groups
Definition
- atmosphere
- purpose
- leadership and member participation
- comm
- decision making
- cohesion
- conflict tolerance
- power shared
- creativity
- prob solving
Term
Comm strategies for providing comfort
Definition
- empathy
- pos talk
- therapeutic touch
- competent physical and tech skills
- vigilance
Term
Adherence
Definition
commitment or attachment to a regimen
Term
Andragogy
Definition
the art and science of teaching adults
Term
Pedagogy
Definition
the discipline concerned with helping children learn
Term
Geragogy
Definition
the discipline concerned with stimulating and helping elders to learn
Term
Affective domain
Definition
"feeling" domain
- specifies the degree of a person's depth of emotional response to tasks
- includes: feelings, emotions, interests, attitudes, and appreciations
Term
Behaviorist theory
Definition
the careful ID of what is to be taught and the immediate ID of and reward for correct responses
Term
Cog theory
Definition
recognition of devp levels of learners and acknowledgments of learner's motivation and enviro
Term
Compliance
Definition
the indv's desire to learn and act on the learning
Term
Imitation
Definition
the process by which indvs copy or reproduce what they have observed
Term
Modeling
Definition
the process by which a person learns by observing the behv of others
Term
Learning
Definition
a change in human disposition or capability that persists and that can't be solely accounted for by growth
Term
Motivation to learn
Definition
the desire to learn
Term
Learning need
Definition
a desire or a requirement to know something that is presently unknown to the learner
Term
Readiness to learn
Definition
the demonstration of behvs or cues that reflect the learner's motivation to learn at a specific time
Term
Empathy
Definition
a learned way of responding that demonstrates that the nurse correctly understands how the ct feels
Term
Acculturation
Definition
an involuntary process where the foreigner has to learn the new culture to survive
- assimilation is voluntary
Term
Devp Milestones
Definition
major markers of normal devp
Term
maturation
Definition
synonym for devp
Term
Rhythmicity
Definition
manifesting a regular rhythm in physiologic functions
Term
Approach
Definition
refers to a child's response on initial contact with a new stimulus
Term
Adaptability
Definition
the ability to change one's reaction to stimuli over time
Term
Intensity of Reaction
Definition
a child meets new situations with their whole being
Term
Temperament
Definition
the usual reaction pattern of an indv to a stimuli in the enviro
Term
Threshold of Response
Definition
the intensity level of stimulation necessary to evoke a reaction
Term
Positive Mood Quality
Definition
a child who is always happy and laughing is said to have....
Term
Sociocultural theory
Definition
stresses the importance of enviro on G&D
Term
Learning theory
Definition
children are like blank pages that can be shaped by learning
Term
Epigenetic theory
Definition
genes are the true basis for G&D
Term
Schemas
Definition
finer units within Piaget's stages of growth
Term
Sensorimotor intelligence
Definition
practical intelligence used by infants
Term
Permanence
Definition
infants know their parents exist and will return to them
Term
Role fantasy
Definition
preschool thinking regarding how children would like something to turn out
Term
Assimilation
Definition
children taking in info and changing it to fit their existing ideas
Term
Accommodation
Definition
children change their ideas to fit reality rather than the reverse
Term
Perioperative period
Definition
toddler begins to devp some cog skills such as symbolic thought and egocentric thinking
Term
Intuitive thinking
Definition
substage of preoperational thought. Preschoolers are centering
Term
Centering
Definition
preschoolers look at an object, but they are only able to see one of its characteristics
Term
Conversation
Definition
centering contributes to the preschooler's lack _______, the ability to discern truth, even though physical properties change
Term
Reversibility
Definition
preschooler's lack _______, the ability to retrace steps
Term
Concrete Operational Thought
Definition
school-age children begin to use practical solutions to everyday probs as well as begin to recognize cause-and-effect relationships
Term
Abstract thought
Definition
Adols are capable of thinking in terms of possibility
Term
Quality and Safety Education for Nurses (QSEN)
Definition
- pt centered care
- teamwork and collaboration
- evidenced-based practice (EBP)
- QI
- informatics
- safety
Term
Palpation
Definition
examining by touch, either light or deep
Term
Percussion
Definition
the assessment of a body structure by determining the sound you hear in response to striking the part with an examining finger and then interpreting the sound
Term
Auscultation
Definition
listening to sounds
Term
Kwashiorkor
Definition
a serious protein deficiency
Term
Turgor
Definition
the amount of fluid in body tissue
Term
Hordeolum
Definition
a stye, an infection of the gland that lubricates an eyelash
Term
Ptosis
Definition
an eyelid obscures vision
Term
Strabismus
Definition
eyes that are not evenly aligned
Term
Esotropia
Definition
an eye that's always turning in
Term
Exotropia
Definition
an eye that always turns out
Term
Direct constriction
Definition
one pupil constricts in response to a bright light
Term
Consensual constriction
Definition
when one pupil constricts in response to a bright light, the other one will also
Term
Geographic tongue
Definition
the rough-appearing tongue surface that often accompanies general symptoms of illness such as fever
Term
Retractions
Definition
indentation of intercostal spaces or the suprasternal and substernal areas that reflect difficult respirations
Term
Diaphragmatic excursion
Definition
the distance the diaphragm descends with inhalation, is an estimation of lung volume
Term
Point of maximum impulse
Definition
represents the location of the left ventricle or the point where the apical heartbeat can be heard best
Term
Sinus arrhythmia
Definition
a normal but marked HR inc that occurs as a child inspires, and a dec on exhalation
Term
Physiologic splitting
Definition
another variation in heart sounds occurs because with inspiration and the resulting inc of pressure in the lungs, the pulmonary valve closes slightly later than the aortic valve. It's heard as a lub d-dub sound.
Term
Thrill
Definition
if the heart is pumping with abnormal force, there may be a palpable vibration termed a ?
Term
Bruit
Definition
a swishing or blowing sound that occurs if there is an outpouching of the aorta (ie, an aneurysm)
Term
Hypospadias
Definition
the urethral opening is located on the inferior or ventral surface of the penis
Term
Epispadias
Definition
the urethral opening is located on the superior or dorsal surface of the penis
Term
Varicocele
Definition
enlarged veins of the epididymus
Term
Audiogram
Definition
a record of audiometric testing
Term
Intelligence
Definition
the ability to think abstractly, to adjust to new situations, and to profit from experience
Term
Toxoid
Definition
an extract from a toxin with reduced virulence. It is used as a vaccine against a disease
Term
Antitoxins
Definition
the antibodies produced against toxin-producing bacteria
Term
Gamma globulin
Definition
a serum obtained from the pooled blood of many people
Term
Active immunity
Definition
when a child produces antibodies after the natural invasion of a pathogen
Term
Passive immunity
Definition
IgG antibodies are xferred across the placenta to a fetus in utero
Term
Artificially acquired passive immunity
Definition
given to a child when she is exposed to a disease in which she has no antibodies
Term
Artificially acquired active immunity
Definition
pathogens are artificially injected into the child by immunization. If the specific antigen should enter again, antibodies will be produced against the pathogen
Term
Torticollis or wry neck
Definition
a child holds his head crookedly
Term
Gynecomastia
Definition
preadolescent hypertrophy of male breast tissue
Term
Physiologic Splitting that is always present
Definition
implies there is difficulty with the pulmonary valve closing and suggests pathology
Term
Aspiration studies
Definition
removal of body fluids by such techniques as lumbar puncture or bone marrow aspiration
Term
Bronchoscopy
Definition
direct visualization of the larynx, trachea, and bronchi through a lit, flexible, fiberoptic tube
Term
Clean-catch urine specimen
Definition
a method of collecting a urine sample to be tested for bacteria. The method is used to prevent germs from the penis or vagina from getting into a urine sample
Term
Colonoscopy
Definition
check for: abdominal pain, blood in stool, weakness, or paleness (signs of a bowel bleeding)
Term
Computed tomography (CT)
Definition
- an X-ray procedure in which many views of an organ or body part are obtained to represent what the organ would look like if it were cut into thin slices
- dense structures appear white and less dense structures appear gray to black on the films
Term
Electrical impulse studies
Definition
studies that include electrical conduction: ECG, EEG
Term
Endoscopy
Definition
an endoscope is passed through the mouth to examine the GI tract
Term
Magnetic Resonance Imaging (MRI)
Definition
- combines a magnetic field, radiofrequency, and computer technology to produce diagnostic images that aid in the dx of disorders such as the cause of renal or brain pathology
- benefit: no iodine based dye is needed as a contrast, no radiation
Term
Positron emission tomography (PET)
Definition
a CT with the injection of an iodine-based radioisotope contrast medium
Term
Radiopharmaceuticals
Definition
radioactive-combined substances that, when given orally or by injection, flow to designated body organs
Term
Single-photon emission computed tomography (SPECT)
Definition
a CT with the injection of an iodine-based radioisotope contrast medium
Term
Total parenteral nutrition (TPN)
Definition
IV nutrition
Term
Ultrasound
Definition
images of internal tissue and organs are produced by the use of sound waves
Term
"blind-end" bowel
Definition
the bowel between the rectum and colostomy
Term
Enteral feedings
Definition
also called nasogastric orogastric
Term
Illness
Definition
a highly personal state in which the person's physical, emotional, intellectual, social, devp, or spiritual functioning is thought to be diminished
Term
Disease
Definition
an alteration in body functions resulting in a reduction of capacities or a shortening of the normal life span
Term
Health
Definition
a state of complete physical, mental, social well-being, and not merely the absence of disease or infirmity
Term
Health beliefs
Definition
concepts about health that an indv believes true
Term
Wellness
Definition
a state of well-being. Basic concepts include:
- self responsibility
- an ultimate goal
- a dynamic, growing process
- daily decision making in the areas of:
- nutrition
- stress mgmt
- physical fitness
- preventive health care
- emotional health
- and other aspects of health
- most importantly - the whole being of the indv
Term
Well-being
Definition
a subjective perception of vitality and feeling well ... can be described objectively, experienced, and measured ... and can be plotted on a continuum
Term
Apical-radial pulse
Definition
it may need to be assessed for cts with certain cardiovascular disorders
Term
Apnea
Definition
absence of breathing
Term
Arteriosclerosis
Definition
the elastic and muscular tissues of the arteries are replaced with fibrous tissue, the arteries lose much of their ability to constrict and dilate
Term
Auscultatory gap
Definition
occurs particularly in pts with HTN. It's the temporary disappearance of sounds normally heard over the brachial artery when the cuff pressure is high followed by the reappearance of the sounds at a lower level
Term
Bradycardia
Definition
HR in an adult less than 60
Term
Bradypnea
Definition
abnormally slow respirations
Term
Cardiac Output
Definition
SV x HR
Term
Vital or Cardinal signs
Definition
- body temp
- pulse
- respiration
- BP
- pain
Term
Chemical thermogenesis
Definition
the stimulation of heat production in the body through inc cellular metabolism
Term
Compliance of the arteries
Definition
the arteries ability to contract and expand
Term
Costal (thoracic) breathing
Definition
involves the external intercostal muscles and other accessory muscles, such as the sternocleidomastoid muscles
Term
Diaphragmatic (abdominal) breathing
Definition
involves the contraction and relaxation of the diaphragm
Term
Eupnea
Definition
breathing that is normal in rate and depth
Term
External respiration
Definition
refers to the interchange of O2 and CO2 between the alveoli of the lungs and the pulmonary blood
Term
Hematocrit
Definition
the proportion of RBC to plasma
Term
Hyperpyrexia
Definition
a very high fever, such as 105.8F
Term
HTN
Definition
> 140/90
Term
Hyperventilation
Definition
very deep, rapid respirations
Term
Hypotension
Definition
a systolic consistently between 85-110 in an adult whose BP is usually higher
Term
Hypothalamic integrator
Definition
the center that controls the core temp, is located in the preoptic area of the hypothalamus
Term
Hypoventilation
Definition
very shallow respirations
Term
Insensible heat loss
Definition
the heat loss associated with vaporization of moisture from the respiratory tract and mucosa of the mouth and skin. It accounts for about 10% of basal heat loss
Term
Insensible water loss
Definition
water loss due to vaporization
Term
Internal respirations
Definition
the interchange of O2 and CO2 between the circulating blood and the cells of the body tissues
Term
Korotkoff's sounds
Definition
when taking a BP using a stethoscope, the nurse id's five phases in the series of sounds called....
Term
Orthostatic hypotension
Definition
usually the result of peripheral vasodilation in which blood leaves the central body organs, especially the brain, and moves to the periphery, often causing the person to feel faint
Term
Polypnea or tachypnea
Definition
abnormally fast respirations
Term
Pulse
Definition
a wave of blood created by contraction of the left ventricle of the heart
Term
Pulse deficit
Definition
any discrepancy between the apical and radial pulse. In no instance is the radial greater than the apical pulse
Term
Pulse pressure
Definition
difference between the systolic and diastolic
Term
Pulse rhythm
Definition
the pattern of the beats and the intervals between the beats
Term
Pulse volume
Definition
- also called pulse strength or amplitude
- the force of blood with each beat
Term
Pyrexia
Definition
body temp above the usual range: 96.8 - 99.5
Term
Relapsing fever
Definition
short febrile periods of a few days are interspersed with periods of 1-2 days of normal temp
Term
Types of fevers
Definition
- intermittent
- remittent
- relapsing
- constant
Term
Remittent fever
Definition
a wide range of temp fluctuations (3.6F) over a 24hr period, all of which are above normal
Term
Respiratory character or quality
Definition
those aspects of breathing that are different from normal, effortless breathing
Term
Respiratory rhythm
Definition
the regularity of the expirations and the inspirations
Term
Tachycardia
Definition
an excessively fast HR, over 100 in adults
Term
Tidal volume
Definition
during a normal inspiration and expiration, an adult takes in about 500ml of air
Term
Ventilation
Definition
the mvmt of air in and out of the lungs
Term
Crisis, flush, or the defervescent (abatement) stage of a pyrexic condition
Definition
the sudden change of events that the body uses to lower body temp after the cause of the high temp is suddenly removed
Term
Pulse wave
Definition
represents the stroke volume output and the amt of blood that enters the arteries with each ventricular contraction
Term
Primary HTN
Definition
high blood pressure of unknown etiology
Term
Secondary HTN
Definition
high BP of know etiology
Term
Hypotension can be caused by
Definition
- Demerol
- bleeding
- severe burns
- dehydration
Term
Adventitious breath sounds
Definition
abnormal breath sounds
Term
Alopecia
Definition
hair loss
Term
Angle of Louis
Definition
- the starting point for locating the ribs anteriorly
- the junction between the body of the sternum and the manubrium
Term
Antihelix
Definition
the anterior curve of the auricle's upper aspect
Term
Aphasia
Definition
any defect in communication or comprehension due to disease or injury of the cerebral cortex
Term
Astigmatism
Definition
an uneven curvature of the cornea that prevents horizontal and vertical rays from focusing on the retina
Term
Auricle (Pinna)
Definition
the outermost curvature of the ear
Term
Cataracts
Definition
opacity of the lens or its capsule, which blocks light rays
Term
Clubbing
Definition
the angle of the nail and nail bed is > or = 180 degrees
Term
Cochlea
Definition
- in the inner ear
- a seashell shaped structure essential for sound transmission and hearing
Term
Conduction hearing loss
Definition
the result of uninterrupted xmission of sound waves through the outer and middle ear structures
Term
Crepitations
Definition
- one of the types of adventitious sounds
- also called crackles or rales
Term
Dacryocystitis
Definition
- inflammation of the lacrimal sac
- manifested by tearing and a discharge from the nasolacrimal duct
Term
Dullness
Definition
- a percussion sound
- a thudlike sound produced by dense tissue such as the liver, spleen, or heart
Term
Eustachian tube
Definition
- in the middle ear
- connects the middle ear to the nasopharynx
Term
Exophthalmos
Definition
a bugout of the eyes caused by hyperthyroidism
Term
External auditory meatus
Definition
the entrance to the ear canal
Term
Extinction
Definition
the failure to perceive touch on one side of the body when two symmetric areas of the body are touched simultaneously
Term
Fascicultation
Definition
an abnormal contraction (shortening) of a bundle of muscle fibers
Term
Flatness
Definition
- a percussion sound
- an extremely dull sound produced by very dense tissue, such as muscle or bone
Term
Glaucoma
Definition
a disturbance in the circulation of aqueous fluid, which causes an inc in IOP
Term
Glossitis
Definition
inflammation of the tongue
Term
Goniometer
Definition
it measures the angle of a bone joint
Term
Helix
Definition
the posterior curve of the auricle's upper aspect
Term
Hyperopia
Definition
farsightedness
Term
Hyperresonance
Definition
- a percussion sound
- it is not produced in the normal body
- it's described as booming and can be heard over emphysematous lung
Term
Incus (Anvil)
Definition
one of the three ossicles in the ear
Term
Intensity
Definition
- an auscultation sound
- amplitude, refers to the loudness or softness of a sound
- loud: bronchial sounds heard from the trachea
- soft: normal breath sounds heard in the lungs
Term
Intention tremor
Definition
it becomes more apparent when a ct tries to hold cup of coffee
Term
Lift (Heave)
Definition
- a rising along the sternal border with each heartbeat
- it occurs when cardiac action is very forceful
Term
Lobule
Definition
ear lobe
Term
Malleus
Definition
hammer in the middle ear
Term
Manubrium
Definition
the handlelike superior part of the sternum that joins with the clavicles
Term
Mastoid
Definition
a bony prominence behind the ear
Term
Miosis
Definition
constricted pupils
Term
Mixed hearing loss
Definition
a combo of conduction and sensorineural hearing loss
Term
Mydriasis
Definition
enlargement of the pupils
Term
Myopia
Definition
nearsightedness
Term
One-and two-point discrimination
Definition
the ability to sense whether one or two areas of the skin are being stimulated by pressure
Term
Ossicles
Definition
bones of sound xmission
Term
Pallor
Definition
the absence of underlying red tones in the skin
Term
Parotitis
Definition
inflammation of the parotid salivary gland
Term
Perfusion
Definition
blood supply to an area
Term
Pitch
Definition
- an auscultation sound
- the frequency of the vibrations
Term
Pleximeter
Definition
the middle finger in the nondominant hand used in indirect percussion
Term
Plexor
Definition
the middle finger of the dominant hand used in indirect percussion
Term
Precordium
Definition
- the area of the chest overlying the heart
- it's inspected and palpated for the presence of abnormal pulsations, lifts, or heaves
Term
Presbyopia
Definition
- loss of ability to see close objects due to elasticity of the lens
- begins at about 45
Term
Proprioceptors
Definition
sensory nerve terminals, occurring chiefly in the muscles, tendons, joints, and the internal ear, that give info about movements and the position of the body
Term
Pyorrhea
Definition
periodontal disease
Term
Quality
Definition
- an auscultation sound
- a subjective description of a sound, like, whistling, gurgling, or snapping
Term
Resonance
Definition
- a percussion sound
- a hollow sound such as that produced by lungs filled with air
Term
Resting tremor
Definition
a tremor that is more apparent when the ct is at rest and diminishes with activity
Term
Semicircular canals
Definition
- in the inner ear
- it contains the organs of equilibrium
Term
Sensorineural hearing loss
Definition
the result of damage to the inner ear, the auditory nerve, or the hearing center in the brain
Term
Sordes
Definition
the accumulation of foul matter (food, microorganisms, and epithelial elements)on the teeth and gums
Term
Stapes
Definition
stirrup in the middle ear
Term
Stereognosis
Definition
recognizing objects by touching and manipulating them
Term
Sternum
Definition
breastbone
Term
Tragus
Definition
the cartilaginous protrusion at the entrance to the ear canal
Term
Triangular fossa
Definition
a depression of the antihelix
Term
Tympanic membrane
Definition
eardrum
Term
Tympany
Definition
- a percussion sound
- a musical or drumlike sound produced from an ear filled stomach
Term
Vestibule
Definition
- in the inner ear
- along with the semicircular canals, it contains the organs of equilibrium
Term
Visual acuity
Definition
the degree of detail an eye can discern in an image
Term
Visual fields
Definition
the area a ct can see when looking straight ahead
Term
Vitiligo
Definition
patches of hypopigmented skin (birthmark), is caused by the destruction of melanocytes in the area
Term
Macule, patch
Definition
flat, unelevated change in skin color
Term
Nodule, tumor
Definition
elevated, solid, hard mass that extends deeper into the dermis than a papule
Term
Cyst
Definition
a 1cm or larger, elevated, encapsulated, fluid-filled or semi-solid mass arising from the SubQ tissue or dermis
Term
Papule
Definition
circumscribed, solid elevation of skin < 1cm
Term
Pustule
Definition
vesicle or bulla filled with pus
Term
Wheal
Definition
a reddened, localized collection of edema fluid; irregular in shape
Term
Plaque
Definition
> 1cm, psoriasis, rubeola
Term
Vesicle, bulla
Definition
a circumscribed, round or oval, thin translucent mass filled with serous fluid or blood
Term
Ptosis
Definition
eyelids that lie at or below the pupil margin
Term
Fremitus
Definition
the faintly perceptible vibration felt through the chest wall when the ct speaks
Term
I - Olfactory
Definition
- sensory
- smell
Term
II - Optic
Definition
- sensory
- vision and visual fields
Term
III - Oculomotor
Definition
- motor
- EOM; mvmt of sphincter of pupil
- mvmt of ciliary muscles of lens
Term
IV - Trochlear
Definition
- motor
- EOM; specifically, moves eyeball downward and laterally
Term
V - Trigeminal - Ophthalmic branch
Definition
- sensory
- sensation of cornea, skin of face, and nasal mucosa
Term
V - Trigeminal - Maxillary branch
Definition
- sensory
- sensation of skin of face and anterior oral cavity (tongue and teeth)
Term
V - Trigeminal - Mandibular branch
Definition
- motor and sensory
- muscles of mastication; sensation of skin and face
Term
VI - Abducens
Definition
- motor
- EOM; moves eyeball laterally
Term
VII - Facial
Definition
- motor and sensory
- facial expression; taste (anterior two-thirds of tongue)
Term
VIII - Auditory- Vestibular branch
Definition
- sensory
- equilibrium
-
Term
VIII - Auditory- Cochlear branch
Definition
- sensory
- hearing
Term
IX - Glossopharyngeal
Definition
- motor and sensory
- swallowing ability, tongue mvmt, taste (posterior tongue)
Term
X - Vagus
Definition
- motor and sensory
- sensation of pharynx and larynx; swallowing; vocal cord mvmt
Term
XI - Accessory
Definition
- motor
- head mvmt; shrugging of shoulders
Term
XII - Hypoglossal
Definition
- motor
- protrusion of tongue; moves tongue up and down and side to side
Term
Amblyopia
Definition
reduced visual acuity in one eye
Term
Apocrine glands
Definition
- develop in the axillae
- anal and genital areas
- external auditory canals
- around the umbilicus
- around the areolas
- releases sweat onto the skin in response to emotional stimuli only
Term
Emmetropic
Definition
eyes that refract light normally
Term
Embryonic phase
Definition
- first 8 wks of pregnancy
- the fertilized ovum devps into an ovum w/most of the features of a human
Term
Fetal phase
Definition
rapid growth in the size of the fetus
- both genetic and enviro factors affect its growth
Term
Tonic neck reflex (TNR) or fencing reflex
Definition
a postural reflex in babies
Term
Frail elderly
Definition
the old-old or extreme aged
Term
Generativity
Definition
defined as the concern for establishing and guiding the next generation
Term
LT memory
Definition
info that leaves ST memory and enters _____, the repository for info stored for periods longer than 72hrs and usually weeks and yrs
Term
Maturity
Definition
the state of max function and integration, or the state of being fully developed
Term
Pap test
Definition
obtaining and examining cells from the uterine cervical os
Term
Pathologic fractures
Definition
spontaneous bone fractures
Term
Presbycusis
Definition
loss of hearing ability r/t aging
Term
Sensory memory
Definition
momentary perception of stimuli from the enviro
Term
Vesicular
Definition
- soft intensity sound
- low pitched
- "gentle sighing" sounds created by air moving through smaller airways (bronchioles and alveoli)
- located over peripheral lung; best heard at base of lung
Term
Broncho-vesicular
Definition
- moderate intensity sound
- moderate pitched "blowing" sounds created by air moving large airway (bronchi)
- between the scapulae and lateral to the sternum at the 1st and 2nd ICS
Term
Bronchial (tubular)
Definition
- high pitched, loud, "harsh" sounds created by air moving through the trachea
- louder than vesicular sounds
- anteriorly over the trachea; not normally heard over lung tissue
Term
Crackles (rales)
Definition
- fine, short, interrupted crackling sounds
- alveolar rales are high pitched
- air passing through fluid or mucus in any air passage
- most commonly heard in the bases of the lower lung lobes
Term
Gurgles (rhonchi)
Definition
- continuous, low pitched, coarse, gurgling, harsh
- louder sounds with a moaning or snoring quality
- air passing through narrowed air passages as a result of secretions, swelling, tumors
- best heard over trach and bronchi
Term
Friction rub
Definition
- superficial grating or creaking sounds heard during inspiration and exp
- heard best in areas of greatest thoracic expansion (lower anterior and lateral chest)
Term
Wheeze
Definition
- continuous, high pitched, squeaky musical sounds
- air passing through a constricted bronchus as a result of secretions, swelling, tumors
Term
Acquired Immunity
Definition
- also known as passive
- the host rcvs natural (tit milk) or artificial antibodies (from an injection of an immune serum) produced by another source
Term
Active Immunity
Definition
- the host produces antibodies in response to natural (infectious microorganisms) or artificial antigens (vaccines)
Term
Airborne Precautions
Definition
used for cts known to have or suspected of having serious illnesses xmitted by airborne droplet nuclei smaller than 5 microns
Term
Airborn xmission
Definition
droplets or dust
Term
Antibodies
Definition
- also called immunoglobulins
- part of the body's plasma protiens
- they defend primarily against the extracellular phases of bacterial and viral infections
Term
Antigen
Definition
a substance that induces a state of sensitivity or immune responsiveness (immunity)
Term
Autoantigen
Definition
- proteins that originate in a person's own body
- a substance that induces a state of sensitivity or immune responsiveness (immunity)
Term
Antiseptics
Definition
- agents that inhibit the growth of some microorganisms
Term
Disinfectants
Definition
- agents that destroy pathogens other than spores
Term
Asepsis
Definition
- a freedom from disease-causing microorganisms
Term
Bacteremia
Definition
- a condition in which a culture of a person's blood reveals m.organisms
Term
Bacteriocins
Definition
- m.organisms found in the intestines (Enterobacteria) produce substances called ________?
Term
Bloodborne pathogens
Definition
- those m.organisms carried in blood and body fluids that are capable of infecting other persons w/ serious and difficult to treat viral infections, namely, HepB, C, and HIV
Term
Body Substance Isolation (BSI)
Definition
- a system that employs generic infection control precautions for all cts except those with the few diseases xmitted through the air
Term
Carrier
Definition
- a person or animal reservoir of a specific infectious agent that usually doesn't manifest any clinical signs of disease
Term
Cell-mediated defenses
Definition
- also called cellular immunity
- it occurs through the T-cell system that are released into the lymphoid system
Term
Chemotaxis
Definition
- the process by which leukocytes are attracted to injured cells
Term
Cicatrix
Definition
- a firmer fibrous tissue, a scar
Term
Circulating Immunity
Definition
- also called antibody-mediated defenses or humoral immunity
- defenses that reside ultimately in the B lymphocytes and are mediated by antibodies produced by B cells
Term
Clean
Definition
- objects absent of almost all m.organisms
Term
Communicable disease
Definition
- an infectious agent that can be xmitted directly or indirectly
Term
Compromised host
Definition
- a person at increased risk
- a person that is more likely than others to acquire an infection
Term
Contact precautions
Definition
- used for cts known or suspected to have serious illnesses easily xmitted by direct ct contact or by contact w/ items in the ct's enviro
Term
Diapedesis
Definition
the actual passage of blood corpuscles through the blood vessel wall
Term
Disinfectants
Definition
agents that destroy pathogens other than spores
Term
Droplet nuclei
Definition
the residue of evaporated droplets emitted by an infected host (tuberculosis)
Term
Droplet precautions
Definition
for cts w/ serious illnesses xmitted by particle droplets > 5 microns
Term
Emigration
Definition
a process by which leukocytes move through the blood vessel wall into the affected tissue spaces
Term
Endogenous source
Definition
the ct is the source of m.organisms that cause an infection
Term
Exogenous source
Definition
the hospital is the source of m.organisms that cause an infection
Term
Exudate
Definition
- occurs in the 2nd stage of inflammation
- consists of fluid that escaped from the blood vessels, dead phagocytes, dead tissue cells and products that they release
Term
Fibrinogen
Definition
- a plasma protein which is converted to fibrin when it's released into the tissues
Term
Fungi
Definition
includes yeasts and molds
Term
Fibrous (scar) tissue
Definition
- when regeneration is not possible, repair occurs by fibrous tissue formation
- it has the ability to proliferate under the unusual conditions of ischemia and altered pH
Term
Granulation tissue
Definition
- tissue in the early process of damaged tissue being replaced with the connective tissue elements of collagen, blood capillaries, lymphatics, and other tissue-bound substances
- a fragile, gelatinous tissue, appearing pink or red
Term
Hyperemia
Definition
inc blood flow to an injured area, responsible for the characteristic signs of redness and heat
Term
Iatrogenic infections
Definition
infections that are the direct result of dx or therapeutic procedures
Term
Immune defenses
Definition
- also called specific defenses
- they are directed against identifiable bacteria, viruses, fungi, or other infectious agents
Term
Immunity
Definition
a state of sensitivity or immune responsiveness
Term
Infection
Definition
an invasion of body tissue by m.organisms and their proliferation there
Term
Colonization
Definition
the process by which strains of m.organisms become resident flora, but don't cause disease
Term
Inflammation
Definition
a local and nonspecific defensive response of the tissues to an injurious or infectious agent
Term
Leukocytes
Definition
WBCs
Term
Leukocytosis
Definition
a process that's a response to the exit of leukocytes from the blood vessels
- the bone marrow produces lg numbers of leukocytes and releases them into the bloodstream
Term
Macrophages
Definition
large phagocytes
Term
Margination
Definition
- when blood flow slows, leukocytes aggregate or line up along the inner surface of the blood vessels
Term
Medical asepsis
Definition
includes all practices intended to confine a specific m.organism to a specific area
Term
Nonspecific defenses
Definition
it protects the person against all m.organisms, regardless of prior exposure
Term
Opportunistic pathogen
Definition
it causes disease only in a susceptible indv
Term
Pathogenicity
Definition
the ability to produce disease
Term
Phagocytes
Definition
cells that ingest m.organisms, other cells, and foreign particles
Term
Regeneration
Definition
the replacement of destroyed tissue cells by cells that are identical or similar in structure or function
Term
Reservoirs
Definition
sources of m.organisms
Term
Resident flora
Definition
some m.organisms are normal______ ________, (the collective vegetation in a given area) in one part of the body, yet produce infection in another
Term
Septicemia
Definition
when bacteria results in systemic infection
Term
Specific (immune) defenses
Definition
they are directed against identifiable bacteria, viruses, fungi, or other infectious agents
Term
Intact skin and mucous membranes
Definition
are the body's first line of defense against m.organisms
Term
Intact skin and mucous membranes
Definition
are the body's first line of defense against m.organisms
Term
Chemical restraints
Definition
meds such as neuroleptics, anxiolytics, sedatives, and psychotropic agents
Term
Status epilepticus
Definition
continuous seizures
Term
Callus
Definition
- a thickened portion of epidermis
- a mass of keratotic material
Term
Cleaning baths
Definition
bath given chiefly for hygiene purposes
Term
Therapeutic bath
Definition
bath given for physical effects
Term
Corn
Definition
a keratosis caused by friction and pressure from a shoe
Term
Eccrine glands
Definition
- glands found chiefly on the palms of the hands, the soles of the feet, and forehead
- used to cool the body
Term
Pediculosis
Definition
infestation with lice
Term
Plantar warts
Definition
- appear on the sole of the feet
- caused by the virus papovavirus hominis
Term
Tinea pedis
Definition
- ringworm of the foot
Term
Awareness
Definition
the ability to perceive environmental stimuli and body reactions and to respond appropriately through thought and action
Term
Kinesthetic
Definition
the awareness of the position and mvmt of body parts
Term
Sensoristasis
Definition
when a person is in optimal arousal
Term
Sensory deficit
Definition
impaired reception, perception, or both, of one or more of the senses, eg, blind or deaf
Term
Sensory overload
Definition
three contributing factors
- inc internal stimuli like pain, dyspnea, anxiety
- inc external stimuli like a noisy hc setting, intrusive dx testing, contact with many strangers

- inability to disregard stimuli selectively due to meds or ns disorder
Term
Binder
Definition
- a type of bandage designed for a specific body part.
- used to support lg areas of the body
Term
Collagen
Definition
a whitish protein substance that adds tensile strength to the wound
Term
Eschar
Definition
dried plasma proteins and dead cells that cover a wound that does not close by epithelialization
Term
Excoriation
Definition
area of loss of the superficial layers of the skin, also known as denuded area
Term
Exudate
Definition
material, such as fluid and cells, that has escaped from blood vessels during the inflammatory process and is deposited in tissue or on tissue surfaces
Term
Fibrin
Definition
connective tissue
Term
Friction
Definition
a force acting parallel to the skin surface
Term
Granulation tissue
Definition
- capillaries grow across a wound, increasing the blood supply
- fibroblasts move from the blood stream into the wound, depositing fibrin
- as the capillary network devps, the tissue becomes a translucent red color
Term
Hematoma
Definition
a localized collection of blood underneath the skin that may appear as a reddish blue swelling (bruise)
Term
Sanguineous (hemorrhagic) exudate
Definition
consists of lg amts of RBCs, indicating damage to capillaries that is severe enough to allow the escape of RBCs from plasma
Term
Hemostasis
Definition
the cessation of bleeding
Term
(lavage)
Definition
Irrigation
Term
Ischemia
Definition
a deficiency in the blood supply to the tissue
Term
Keloid
Definition
a hypertrophic scar which is the result of an abnormal amt of collagen being laid down
Term
Maceration
Definition
- caused by moisture r/t incontinence
- it makes the epidermis more easily eroded and susceptible to injury
Term
Phagocytosis
Definition
macrophages engulf m.organisms and cellular debris
Term
Primary Intention Healing
Definition
- also called primary union
- it occurs where the tissue surfaces have been approximated and there is minimal or no tissue loss
Term
Purulent exudate
Definition
- a thicker than serous exudate because of the presence of pus
- blue, green, or yellow
Term
Pus
Definition
consists of leukocytes, liquefied dead tissue debris, and dead and living bacteria
Term
Supperation
Definition
the process of pus pormation
Term
Pyogenic bacteria
Definition
bacteria that produces pus
Term
Sanguineous exudate
Definition
- also known as hemorrhagic exudate
- consists of lg amts of RBCs
Term
Serous exudate
Definition
consists chiefly of serum
Term
Reactive Hyperemia
Definition
- after compression of skin has been relieved, the skin takes on a bright red flush
- it is the body's mechanism for preventing pressure ulcers
Term
Secondary Intention Healing
Definition
- the type of healing in a wound that's extensive and involves considerable tissue loss
- the edges can't or shouldn't be approximated
Term
Sitz bath
Definition
- hip bath, used to soak a ct's pelvic area
Term
triage
Definition
sorting for the purpose of assigning priority
Term
bioterrorism
Definition
biological terrorism
Term
smallpox
Definition
caused by the variola virus, an orthopox virus
Term
anthrax
Definition
a disease caused by the spore-forming bacterium Bacillus anthracis
Term
plague
Definition
caused by the gram- coccobacillus Yersinia pestis
Term
botulism
Definition
a paralytic illness caused by a potent neurotoxin produced by Clostridium botulinim
Term
active absorption
Definition
- it requires a carrier, such as an enzyme or protein, to move the drug against a concentration gradient
- energy is required
Term
pharmaceutic phase
Definition
- dissolution
- the first phase of drug action
Term
excipients
Definition
drug fillers
Term
Disintegration
Definition
the breakdown of a tablet into smaller particles
Term
Dissolution
Definition
the dissolving of the smaller particles in the GI fluid before absorption
Term
Rate limiting
Definition
the time it takes the drug to disintegrate and dissolve
Term
Pharmacokinetics
Definition
the process of drug movement to achieve drug action
Term
Pharmacokinetic Phase
Definition
- absorption
- distribution
- metabolism
- excretion
Term
Absorption
Definition
the movement of drug particles from the GI tract to body fluids by passive absorption, active absorption, or pinocytosis
Term
Passive absorption
Definition
occurs mostly by diffusion
Term
Pinocytosis
Definition
process by which cells carry drugs across their membranes by engulfing the drug particles
Term
First-pass effect (hepatic first pass)
Definition
the process in which the drug passes to the liver first
Term
Bioavailability
Definition
- a subcategory of absorption
- a % of the administered drug dose that reaches the systemic circulation
Term
Distribution
Definition
- the process by which the drug becomes available to body fluids and body tissues
- it's influenced by blood flow, its affinity to the tissue, and the protein-binding effect
- volume of distribution (Vd), is dependent on drug dose and its concentration in the body

-
Term
Free drugs
Definition
drugs not bound to protein
Term
Creatine clearance
Definition
the most accurate test to determine renal function
Term
Creatine
Definition
a metabolic byproduct of muscle that's excreted by the kidneys
Term
Pharmacodynamics
Definition
the study of drug concentration and its effects on the body
Term
Onset of action
Definition
the time it takes to reach the minimum effective concentration (MEC) after a drug is admin
Term
Peak action
Definition
occurs when the drug reaches its highest blood or plasma concentration
Term
Duration of action
Definition
the length of time the drug has a pharmacologic effect
Term
Time-response curve
Definition
- it evaluates the three parameters of drug action:
- onset
- peak
- duration
Term
Receptors
Definition
protein in structure that are found on cell membranes
Term
Ligand-binding domain
Definition
the site on the receptor in which drugs bind
Term
Agonist
Definition
drugs that produce a response
Term
Antagonists
Definition
drugs that block a response
Term
Nonspecific drugs
Definition
drugs that affect various sites and have properties of nonspecifity
Term
Nonselective drugs
Definition
drugs that effect various receptors and have properties of nonselectivity
Term
Therapeutic index
Definition
it estimates the margin of safety of a drug
Term
Low therapeutic index
Definition
drugs that have a narrow margin of safety
Term
High therapeutic index
Definition
drugs that have a wide margin of safety and less danger of producing toxic effects
Term
Therapeutic range (therapeutic window)
Definition
- most effective range for a drug
- between min effective conc and the min toxic conc
Term
Peak drug level
Definition
the highest plasma conc of a drug at a specific time
Term
Trough level
Definition
- the lowest plasma conc of a drug
- it measures the rate at which the drug is eliminated
Term
Loading dose
Definition
bolus
Term
Pharmacogenetics
Definition
the effect of a drug action that varies from a predicted drug response because of genetic factors or hereditary influence
Term
Tachyphylaxis
Definition
drug tolerance to a frequently repeated admin of a certain drug
Term
Dose response
Definition
the relationship between the minimal versus the maximal amount of drug dose needed to produce the desired drug response
Term
Digitalization
Definition
the process by which the minimum effective concentration level for digoxin is achieved in the plasma within a short time
Term
Adverse reactions
Definition
- more severe than side effects
- a range of untoward effects (unintended and occurring at normal doses) of drugs that cause mild to severe side effects
Term
Primary prevention
Definition
focuses on health promotion to encourage healthy lifestyles and prevent illness
Term
Secondary prevention
Definition
focuses on early detection and prompt intervention
Term
Tertiary prevention
Definition
focuses on restoration and rehabilitation to promote optimal functioning
Term
Tertiary prevention
Definition
focuses on restoration and rehabilitation to promote optimal functioning
Term
The steps of the orientation phase of a therapeutic nurse-patient relationship
Definition
meet the client
open the relationship
clarify the problem
structure and formulate the contract
Term
Acknowledging
Definition
is a technique that simply identifies that communication has occurred; it is not a restatement of ideas
Term
Clarifying
Definition
helps both participants identify differences in their frames of reference and gives them the opportunity to correct misperceptions
Term
Focusing;
Definition
is a valuable technique for patients who are resistant or guarded.
Term
clarifying
Definition
is to summarize the patient's message and convey it was received and understood
Term
Physiological signs of stress:
Definition
pupils dilate
blood pressure increases
blood sugar increases
oral secretions decrease
Term
Factors that are considered when the RN is determining a patient's readiness to learn about disease preventions:
Definition
physical readiness - A patient who has needs, such as pain or lack of sleep, is not ready to learn
the learning environment - The learning environment may have minimizing factors that interfere with the learning process
the pt who is future-oriented - A patient who is not future oriented will not likely appreciate preventive health teaching
Term
The symptoms of a pt's dx
Definition
defining characteristics
Term
Communication and Health Teaching are independent nursing actions that are important for:
Definition
inc health literacy
helping children learn more about their illness
providing better measures to use to stay well
Term
Factors that Affect Learning
Definition
learner needs and characteristics
teacher characteristics
available support people
the level of content
Term
Levels of Communication
Definition
First Level: Cliche Conversation – pleasant chatting
Second Level: Fact Reporting – simply stating facts about oneself
Third Level: Shared Personal Ideas and Judgments – this level is the beginning of therapeutic comm
Fourth Level: Shared Feelings – they represent the child's trust in you
Fifth Level: Peak Comm – a sense of oneness
Term
1st level of comm
Definition
Cliche Conversation – pleasant chatting
Term
2nd level of comm
Definition
Fact Reporting – simply stating facts about oneself
Term
3rd level of comm
Definition
Shared Personal Ideas and Judgments – this level is the beginning of therapeutic comm
Term
4th level of comm
Definition
Shared Feelings – they represent the child's trust in you
Term
5th level of comm
Definition
Peak Comm – a sense of oneness
Term
Techniques to Encourage Therapeutic Comm
Definition
distance - process recording
genuineness and truthfulness
warmth
empathy
gestures
facial expressions
touch
attentive listening
reflecting
clarifying
paraphrasing
perception checking
focusing
supportive stmts
silence
Term
Factors that can interfere with effective comm
Definition
- age and devp level
- intellectual or behv level
- physical factors
- technical terminology
- showing disapproval
- not showing approval when warranted
growing defensive
cliché advice
topping up
Term
Communication Situations that Require Unique Skills
Definition
the shy child
the angry child
the demeaning child
the bullying or sexually aggressive adolescent
the child who is not proficient in English
the unconscious child – Ya think?
the hearing or vision challenged child
Term
learning occurs best when:
Definition
children are ready to learn
if children can see how the new info will benefit them directly
if rewards, not penalties, are offered
in a nonstressful and accepting enviro
when ability plateaus are recognized
Term
learning occurs best when:
Definition
children are ready to learn
if children can see how the new info will benefit them directly
if rewards, not penalties, are offered
in a nonstressful and accepting enviro
when ability plateaus are recognized
Term
Infants
Definition
learn by exploring their environment with their senses
they learn best from a primary caregiver
material must be presented as fun or a game
Term
Preschooler
Definition
they are interested in learning because they are devp a sense of initiative
they have few reservations about the “right” way to do things
they ask a lot of questions
they “center” or notice only one characteristic of an object
they tend to be frightened by intrusive objects like a rectal thermometer
use dolls or puppets for teaching
Term
School-age
Definition
they enjoy short projects that offer an immediate reward; break down procedures into small steps
they have short “staying power” so teaching has to be reinforced
they don't like to have to do things that their friends are not doing; make sure teaching or procedures will fit into their social schedule
they need consistency in teaching the “way” to do something
Term
Adols
Definition
they want to learn to do things independent of their parents
they won't do things that make them appear different from their friends
they are present oriented so they need to see how doing something will benefit them
Term
Developing and Implementing a Teaching Plan
Definition
assessing teaching/learning needs
formulating the plan
ID my weaknesses
prepare expected outcomes
Term
Teaching Strategies
Definition
lecture
demonstration
redemonstration
discussion – children like it because it respects their opinions
role modeling
behv therapy
Term
Health teaching for a Surgical Experience
Definition
psychological prep - first address anxiety
physical prep
assess current level of knowledge
emotional prep – fear of separation, fear of mutilation, fear of death
Term
2020 Natl Health Goals r/t Communication and teaching with children that nurses can help the nation achieve:
Definition
inc the proportion of schools that provide health edu
nurses can help the nation achieve these goals by:
consulting with schools and HC organizations to devp what health teaching progs are needed
teaching in such progs
Term
Nursing Dx r/t Communication and Health Teaching with Children
Definition
Risk for impaired verbal comm r/t use of _____ as a foreign language
Deficient knowledge r/t importance of taking meds daily
Health-seeking behvs r/t ways to improve the child's nutritional intake
Impaired verbal communication r/t placement of endotrach tube
Anxiety r/t perceived amt of material needed to be learned for home care of child
Term
Expected Outcomes
Definition
Child demonstrates good technique for self-injection of insulin
Child demonstrates anger using language rather than punching wall
Child lists five foods to include in a high-protein diet
Family demonstrates improved family communication techniques by next clinic visit
Parents demonstrate effective CPR technique at home visit
Term
The Six Competencies of Quality and Safety Edu for Nurses (QSEN)
Definition
Pt-centered care
Teamwork and Collaboration
Evidenced-based Practice
QI
Safety
Informatics


To individualize a teaching program for a child
assess the child's attn span
cog or intellectual capability
lifestyle
learning style
my own teaching strengths and limitations


In many instances there is a great deal of material that a child must learn about an illness. If possible:
divide material into lessons that can be taught immediately
lessons that can be taught at return health visits
Term
Expected Outcomes for Achievement and Effectiveness of Care
Definition
Integrating Knowledge of Comm and Teaching with the Interplay of Nursing Process, the Six QSEN Competencies, and Family Nursing to Promote Quality Maternal and Child Health Nursing Care
Term
Four phases of a working relationship
Definition
- preinteraction phase
- introductory phase
- working phase
- termination phase
Term
Working phase
Definition
- exploring and understanding thoughts and feelings
- facilitating and taking action
Term
exploring and understanding thoughts and feelings
Definition
the nurse must demonstrate:
emphatic listening and responding
respect
genuineness – five roles of the helper:
does not take refuge in or over-empathizes the role of counselor
spontaneous
nondefensive
displays few discrepencies
capable of deep self-exposure when it's appropriate
concreteness
confrontation
Term
five roles of the helper
Definition
does not take refuge in or over-empathizes the role of counselor
spontaneous
nondefensive
displays few discrepencies
capable of deep self-exposure when it's appropriat
Term
to help cts with comm probs, the nurse:
Definition
manipulates the environment
provides support
employs measures to enhance communication
educates the ct and support persons
Term
nurses teach to:
Definition
promote health
protect health
restore health
maintain ct's health
help ct adapt to altered health and function
Term
attributes of learning
Definition
an experience that occurs inside the learner
the discovery of the personal meaning and relevance of ideas
a consequence of experience
a collaborative and cooperative process
an evolutionary process
a process that's both intellectual and emotional
Term
three main theories of learning:
Definition
Behaviorism, Cognitivism, Humanism
Term
Behaviorism
Definition
Thorndike stated that learning should be based on the learner's behv
Pavlov, Skinner, Bandura
behaviorists closely observe responses and then manipulate the environment to bring about the intended change
positive reinforcement, Skinner
imitation and modeling, Bandura
Term
nurses applying behavioristic theory will:
Definition
provide sufficient practice time and both immediate and repeat testing and re-demonstration
provide opportunities for learners to solve probs by trial and error
select teaching strategies that avoid distracting info and that evoke the desired response
praise the learner for correct behv and provide pos feedback at intervals throughout the learning experience
provide role models of desired behv
Term
key factors associated with cog learning
Definition
devp and indv readiness (motivation) are
Term
Lewin states that learning involves four different types of changes:
Definition
change in cog structure
change in motivation
change in one's sense of belonging to the group
gain in involuntary muscle control
Term
nurses applying cog theory will:
Definition
provide a social, emotional, and physical enviro conducive to learning
encourage a pos teacher-learning experience
select multisensory teaching strategies since perception is influenced by the senses
recognize that personal characteristics have an impact on how cues are perceived and devp appropriate teaching approaches to target different learning styles
assess a person's devp and indv readiness to learn an adapt teaching strategies to the learner's devp level
select behv objectives and teaching strategies that encompass the cog, psy, and aff domains of learning
Term
Humanism
Definition
focuses on both cog and affective qualities of the learner
Maslow, Rogers
learning is believed to be self-motivated, self-initiated, and self-evaluated
learning focuses on self-devp and achieving full potential; it's best when relevant to the learner
autonomy and self-determination are important; the learner ID the learning needs and then takes the initiative to meet these needs
Term
nurses applying humanistic theory will:
Definition
convey empathy in the nurse-ct relationship
encourage the learners to establish goals and promote self-directed learning
encourage active learning by serving as a facilitator, mentor, or resource for the learner
expose the learner to new relevant info and ask appropriate questions to encourage the learner to seek answers
Term
factors that affect learning:
Definition
motivation
readiness
active involvement
relevance
feedback
nonjudgmental support
repetition
timing
environment
emotions
physiologic events
psychomotor ability
cultural aspects
Term
ways to motivate cts to learn
Definition
relate the learning to something the ct values and helping her see the relevance of the learning
help the ct make the learning situation pleasant and nonthreatening
encourage self-direction and independence
demonstrate a pos attitude about the ct's ability to learn
offer continuing support and encouragement as the ct attempts to learn
create a learning situation in which the ct is likely to succeed
assist the ct to ID the benefits of changing behv
Term
learning need as the dx label
Definition
- deficient knowledge
- health seeking behv
- noncompliance
Term
deficient knowledge
Definition
absence or deficiency of cognitive info r/t a specific topic (part of a dx)
Term
health seeking behv
Definition
active seeking of a ct in stable health to get healthier (part of a dx)
Term
noncompliance
Definition
behv of a ct/caregiver that fails to coincide with a health-promoting or therapeutic plan mutually agreed on (part of a dx)
Term
Deficient knowledge as the etiology
Definition
Risk for (specify) r/t deficient knowledge (specify)
Term
Aspects of A Teaching Plan
Definition
determining teaching priorities
setting learning outcomes
choosing content
selecting teaching strategies
organizing learning experiences
Term
setting learning outcomes
Definition
Ct behv or performance → observable, measurable activity → conditions or modifiers as required → time criteria
Term
organizing learning experiences
guidelines to help the nurse sequence the learning experience
Definition
start with something the learner is concerned about
cover what the learner knows, and then proceed to the unknown
address early on any area that is causing the ct anxiety
teach the basics before proceeding to the variations or adjustments
schedule time for review of contents and questions the ct may have to clarify info
Term
cognitive
Definition
explanation or description
answering questions
printed and AV materials
Term
cognitive, affective
Definition
one-to-one discussion
discovery
role playing
Term
psychomotor
Definition
demonstration
practice
Term
psychomotor, affective
Definition
modeling
Term
all types of learning
Definition
CAL programs
Term
Documenting the Teaching Process for the Ct's Chart
Definition
diagnosed learning needs
learning outcomes
topics taught
ct outcomes
need for add'l teaching
resources provided
Term
EHR
Definition
It is a uniform way to identify patient problems which makes data retrieval more efficient
Term
implementation
Definition
The RN identifies patient needs and secures the appropriate services to address those needs across the continuum in the __________ phase of the nursing process
Term
The elements of the communication process are as follows:
Definition
Stimulus: Motivation for the message  Sender: Communicator of the message  Message: Facts to be delivered  Channel: Means of delivery  Receiver: Person(s) getting the message  Response: Understanding of the message
Term
These are some factors that can influence communication.
Definition
Developmental Level: Language development and usage can influence communication. For instance, adolescent use of slang may cause confusion when conversing with an adult unfamiliar with the slang.
Gender: Masculine and feminine gestures can also influence communication.
Sociocultural Differences: Cultural values, customs, and behaviors form the basis of a person’s belief system and therefore affect their communication.
Roles and Responsibilities: A person used to giving orders may communicate differently than one who is used to carrying out commands.
Space and Territoriality: Intimate distance, personal space, social distance, and public distance are all concepts which affect communication.
Physical, Mental, and Emotional States: Communication can easily be affected when someone is under stress or emotionally charged.
Values: Preset ideas based on a value system influence the way people think and communicate.
Environment: This can include the distance between people, the number of people in a space, and a person’s sense of personal space
Term
Electronic Medical Records (EMR)
Definition
They are used to share information about an individual patient and to communicate progress, coordinate care, and document unusual findings
Term
Electronic Health Records (EHR)
Definition
are records that may differ based on who they are owned by. The outcome is the sharing of information among providers so patients can receive seamless, consistent, and appropriate care from all providers involved in their care
Term
4 levels of communication
Definition
- organizational
- small group
- intrapersonal
- interpersonal
Term
teamwork and collaboration
Definition
key to effective communication in the nursing profession
Term
Teamwork and collaboration (QSEN)
Definition
Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care
Term
Qualities of effective communication
Definition
- simplicity
- clarity
- brevity: deliver msg in short and direct terms
- appropriate language
- timing
- relevance
- pace and intonation
Term
Therapeutic communication is
Definition
a meaningful relationship in which the nurse influences the patient or increases his or her understanding by utilizing verbal and nonverbal communication
Term
characteristics of a helping relationship:
Definition
Empathy, which is trying to understand the situation from the patient’s perspective.  Trust, which is reliance on another person and has to be built over time.  Security, which is the feeling of being safe in someone else’s care.  Respect, which is developed for the knowledge and behavior a person expresses and demonstrates.  Autonomy, which is a sense of ownership and independence.  Acceptance, which is the openness one has towards another person.  Genuineness, which is a caring, accepting relationship despite acknowledged or unacknowledged faults.
Term
Therapeutic communication and the nursing process
Definition
Assessing: Focus on the environment, privacy, barriers to communication, and the patient’s readiness to learn.  Diagnosing: Establish the patient’s baseline and the reason for the encounter.  Outcome Identification and Planning: Define goals and objectives along with the patient.  Implementing: Make eye contact and directly involve the patient in conversation using active listening and therapeutic communication.  Evaluating: Ask open-ended questions and have the patient verbalize understanding of the conversation.  Documenting: Record a factual account of the conversation, excluding opinions, but using the patient’s statements of understanding as verification of the therapeutic communication process
Term
The autonomic nervous system and the endocrine system
Definition
are the primary systems that control physiological homeostasis
Term
Two types of syndromes occur because of physiological homeostasis
Definition
- general adaptation syndrome
- local "
Term
General Adaptation Syndrome (GAS)
Definition
is marked as physiological changes that occur in response to stress
Term
3 stages of GAS
Definition
Alarm reaction, which is the fight or flight response.  Stage of resistance, where body functions go back to normal or right themselves.  Stage of exhaustion, when adaptive mechanisms are exhausted and the patient rests to mobilize again or dies
Term
LAS
Definition
Local Adaptation Syndrome (LAS) is a limited local response to a stressor restricted to a particular body part. It is a temporary response that can be related to the pathology of trauma
Term
Psychological homeostasis
Definition
The need to be loved and experience self-esteem is universal to health
Term
2 forms of psychological homeostasis
Definition
- mind-body interaction
- anxiety
Term
The defining characteristics of increased stress include the following changes:
Definition
Physiological: Characteristics include increased heart rate, chest pain, tremors, a choking feeling or shortness of breath, weight loss, or weight gain.  Psychological: Characteristics include verbalization of anxiety or fear, verbalization of "butterflies" in the stomach, feeling jittery, difficulty communicating verbally, or a fearful facial expression.  Cognitive: Characteristics include withdrawal, inability to learn, the patient being focused only on the current situation, and daydreaming instead of dealing with current problems.
Term
Stress is
Definition
a barrier or a stimulus to action
Term
types of stress
Definition
- long term stress
- family stress
- caregiver burden
- crisis
Term
Crisis is
Definition
a sudden event that can be situational, maturational, or adventitious
Term
The two types of stressors are:
Definition
Physiological Stressors: Physiological stressors change the body's function, or structure. Included in this group are chemical agents (alcohol, poisons, and drugs), physical agents (exposure to cold, heat, or injury), infectious agents (bacterial infections, viruses, and fungal infections), nutritional disorders, hypoxia, hypercapnia, genetic, and immune system disorders.  Psychosocial Stressors: Psychosocial stressors include losing a job, getting a speeding ticket, not having money for medications, losing a parent, sibling or spouse, wars, relatives being deployed overseas, acts of violence, events occurring to family and friends, and violence on television, radio, and media
Term
Physiological stressors
Definition
they change the body's function, or structure. Included in this group are chemical agents (alcohol, poisons, and drugs), physical agents (exposure to cold, heat, or injury), infectious agents (bacterial infections, viruses, and fungal infections), nutritional disorders, hypoxia, hypercapnia, genetic, and immune system disorders.
Term
Psychosocial stressors
Definition
they include losing a job, getting a speeding ticket, not having money for medications, losing a parent, sibling or spouse, wars, relatives being deployed overseas, acts of violence, events occurring to family and friends, and violence on television, radio, and media
Term
The nurse should implement the following measures to treat anxiety:
Definition
Adjust the environment so a therapeutic relationship can be established: turn off televisions, close doors to ensure privacy, and ensure comfortable seating and temperature.  Involve the patients in decisions to increase their compliance.  Encourage patients to express their feelings and concerns, and discuss the use of exercise, meditation, and relaxation techniques such as meditation and yoga.  Provide information about health maintenance and health promotion.  Use nursing measures to promote the continuity of care such as referrals, support groups, and other community resources.  Supervise patient-care activities provided by other members of the health care team
Term
Principles of teaching and learning - introduction
Definition
determining the learning style of the pt
Term
Basic teaching principles
Definition
- timing
- organizing the material
- involving the pt
- building an existing knowledge
- selecting a teaching method
Term
Timing
Definition
Length of Session: The sessions should be short which may better facilitate the patient’s comprehension.  Intervals between Learning and Use: Planning a return demonstration shortly after the instructions are given facilitates the learners’ understanding and will promote easy recall.  Preferences for Time of Day: Some individuals just happen to be morning people, and some others are not. Assess your patient’s preference and plan the session accordingly
Term
Organizing the Material
Definition
The material used in the process can be categorized into the following:
 From simple to complex  In a logical sequence  With the significant content first
Term
Involving the Patient
Definition
Patients or learners can be actively involved in the teaching and learning process by mutually agreed upon learning objectives
Term
Building on Existing Knowledge
Definition
Individualize the teaching plan to avoid redundancy. Assess what the patient already knows before beginning a teaching activity
Term
Selecting a Teaching Method
Determine the style of learning the patient prefers. Options include:
Definition
Role-Playing: This provides a chance to participate or have an experience.  Audio-Visual: Video presentations on specific patient topics are available in facilities. Some such content is even provided by drug and medical hardware companies to provide specific information on their products.  Printed Material: This can be distributed after the nurse assesses the patient’s reading and comprehension level. Simply handing literature out to a patient is not considered adequate patient education.  Web-Based Instruction: Many facilities offer links to web-based hospital systems so patients can refer to the information following discharge. This reinforces their learning.  Demonstration of Procedures and Equipment Usage: This proves to be a useful teaching method as patients return the demonstration to show they have met the outcome.  Discussion: This can be done in the form of a presentation of information by one or more people. For instance, presenting the pros and cons of a treatment.  Discovery: A problem is presented and the patient or the group of patients is led to the most likely solution, usually arrived at by consensus
Term
Some basic learning principles are:
Definition
Motivation: This is the impulse or desire that prompts a person to take a particular course of action. The patient’s health belief model may have an effect on motivation to learn.  Readiness: This is the physical, mental, and emotional capacity to learn. If the patient is not willing to learn, no teaching tool will be effective.  Learning Environment: This is the setting provided to learners that helps them focus on learning
Term
the patient’s level of “Health Literacy."
Definition
This can be defined as the ability to make decisions about your own health care using the available health information.
Term
Factors that influence learning
Definition
- communication and touch
- age and developmental stage
- indv preferences
-physical condition
- SEC factors
- cultural, religious, and spiritual considerations
- environmental factors
- psychological factors
Term
Teaching and learning r/t nursing process - assessment
Definition
Obtain the heath history in relation to the patient’s communication patterns and learning needs.  Assess factors influencing communication.  Obtain assessment data (i.e., age, developmental status, language, and learning style)
Term
Teaching and learning r/t nursing process- diagnosis
Definition
Identify NANDA-I nursing diagnoses in cases of impaired verbal communication, impaired social interaction (related to cultural differences).  Set priorities based on patient needs
Term
Teaching and learning r/t nursing process - outcome id and planning
Definition
Establish expected outcomes and patient-centered goals for care related to health promotion, health maintenance, and health restoration.  Plan nursing interventions on the basis of established standards and protocols to assist the patient to achieve the established outcomes. At the same time, encourage the patient to express feelings, and teach the patient simple phrases with which to communicate
Term
tools to use and points to think about when planning teaching and learning care:
Definition
Evidence-Based Practice (EBP): Research may provide information about disruptive behavior and communication.  Planning Care: While planning the nursing intervention, incorporate factors influencing the patient’s readiness to work with the health care team like locating a private room, using close-ended questions for a patient with communication impairment, ensuring the hearing aid is working, using active listening with a teenage patient, or using an interpreter to meet a patient’s needs.  Delegation: Assign patient care activities to be conducted by other members of the team as appropriate.
Term
Teaching and learning r/t nursing process - Implementation
Definition
Use effective communication techniques. Example: Listen attentively to a patient who is anxious, inject humor into a stressful situation, or succinctly inform a physician of abnormal lab values.  Use therapeutic communication techniques to establish an effective nurse-patient relationship.  Promote a therapeutic nurse-patient relationship by introducing yourself, establishing trust, being empathetic, and maintaining consistency.  Structure the environment to promote communication and learning. If required you should arrange furniture, provide privacy, reduce noise level, or provide toys or other devices to promote communication with a preschooler.  Provide alternate methods of communication. For instance, use language boards, play, use interpreters, use magic slates or computers for patients with special needs.  Use a variety of teaching strategies, from audiovisual to role-playing and demonstration.  Use nursing measures to promote continuity of care by way of referrals, support groups, and other community resources.  Supervise patient care activities assigned to other members of the health care team. Validate their ability to implement the assigned tasks in keeping with the established guidelines.
Term
Teaching and learning r/t nursing process - evaluation
Definition
Reassess, document, and report the patient’s response to nursing care including progress toward expected outcomes.  Revise the patient’s plan of care based on reassessment of the patient, i.e., increased verbalization, ability to recognize symptoms, refusal to use a hearing aid, participation in group activities, expressing feelings about illness, etc.  Determine the patient’s response to care provided by other members of the health care team. For instance, ask the patient for feedback on the teaching session provided by the dietician
Term
Flat
Definition
sounds are heard over a tumor.
.
Term
hyperresonant
Definition
sounds that are heard with percussion over a hyperinflated lung, as is present in emphysema.
Term
resonance
Definition
is heard with percussion over a normal lung.
Term
tympanic
Definition
sound that is heard over a gastric air bubble
Term
the steps an RN uses to implement a health promotion plan
Definition
1. Review and summarize assessment data
2. Identify health goals
3. Develop a behavioral change plan
4. Structure the support system
Term
Three factors are crucial while developing priorities:
Definition
1. basic physiological needs must be met first, based on Maslow’s Hierarchy of Human Needs
2. needs identified by the patient must be considered
3. anticipated problems must be taken into account.
Term
The nursing process uses strategies to promote good health and wellness of the patient. These problem solving approaches are
Definition
- intuitive problem solving
- scientific problem solving
- trial-and error
- critical thinking
Term
The nursing process is guided by
Definition
HIPAA, advocacy, and accountability
Term
the best sources of EBP in order of priority
Definition
- clinical trials
- outcomes research
- case studies
- expert opinion
Term
Category C agents are
Definition
emerging pathogens that could be engineered for mass dissemination because of their availability, ease of production and dissemination, mortality rate, and ability to cause a substantial health impact.
Term
Category C
Definition
- H1N1 INFLUENZA
- Hantavirus
- HIV/AIDS
- Nipah virus
- SARS
Term
Chemical agents
Definition
- blister
- blood agents
- choking agents
- incapacitation agents
- nerve agents
Term
Nuclear weapons
Definition
- fissure
- fusion
Term
Nuclear weapons
Definition
- cutaneous burns
- acute radiation syndrome
Term
Biologic weapons - category A
Definition
anthrax
smallpox
salmonella
typhoid
Term
Biologic weapons - Category A
Definition
Highest priority diseases that pose a risk to national security, are easily transmitted, have high morbidity and mortality, would have a major public health impact and cause panic, and require special public health preparedness.
Term
Biologic weapons - Category B
Definition
Moderate priority diseases with lower morbidity and mortality and more difficult to disseminate.
Term
Category B
Definition
- E. coli
- Ricin
- S. areus
- Typhus
- viral encephalitis
- abrin toxin
- epsilon toxin
Term
Primary survey for emergency care
Definition
- airway/cervical spine
- breathing
- circulation
- disability/CNS
- exposure
- triage guidelines
- basic first aid
- cardiac arrest and cpr
Term
what guides the primary survey?
Definition
abcde principle
Term
if airway is blocked
Definition
inspect for anything that may be causing and obstruction
Term
opening the airway of a pt that is unresponsive and/or with suspicion of trauma
Definition
a modified jaw thrust maneuver
Term
use during resuscitation
Definition
a bag-valve-mask with a 100% O2 source
Term
interventions geared toward restoring effective circulation
Definition
- cpr
- direct control (direct pressure to visible external bleeding)
- obtaining iv access
- infusions of fluids/blood
Term
typical resus fluids, iv, catheter
Definition
- lactated ringer
- 0.9% NS
- antecubital fossa
- a large bore needle catheter
Term
interventions to alleviate shock
Definition
- admin O2
- apply pressure if bleeding
- raise the feet
- admin blood/iv fluids
- monitor vitals
- provide reassurance and support for anxiety
Term
AVPU pneumonic for LOC
Definition
A - alert
V - response to voice
P - response to pain
U - unresponsive
Term
what does hypothermia lead to?
Definition
vasoconstriction and impaired oxygenation
Term
emergent triage
Definition
a life or limb threatening situation
Term
urgent triage
Definition
a ct should be treated soon, but that the risk is not life threatening
Term
a nonurgent case
Definition
can generally wait for an extended length of time w/o serious deterioration
Term
triage under mass casualty conditions
Definition
a military form of triage that is implemented w/a focus of achieving the greatest good for the greatest number of people
Term
Emergent (Class I)
Definition
a red tag indicating an immediate threat to life
Term
Urgent (Class II)
Definition
id with a yellow tag indicating major injuries that require immediate txt
Term
Nonurgent (Class III)
Definition
green tag, minor injuries that don't require txt
Term
Expectant (Class IV)
Definition
black tag, expected and allowed to die
Term
what to assess for fractures and splinting
Definition
- swelling, deformity, skin integrity
- temp, distal pulses, mobility
- reassess neurovascular status after splinting
Term
sprains
Definition
- refrain from wt bearing
- ice
- compression dressing to minimize swelling
- elevate
Term
ss of heat stroke
Definition
- hypotension
- tachypnea
- tachycardia
- anxiety
- confusion
- unusual behv
- seizures
- coma
Term
ss of frostbite
Definition
white, waxy areas on exposed skin and tissue injury occurs, full or partial thickness
Term
give for frostnip and frostbite
Definition
pain meds and a tetanus vaccination
Term
warming a frostbite victim
Definition
100.4 - 105.8F bath water
Term
ss of hypoxia
Definition
- n&v
- dyspnea
- anorexia
Term
interventions for hypoxia
Definition
- admin O2
- descend to a lower altitude
- steroids and diuretics
Term
what can hypoxia progress to?
Definition
cerebral and pulmonary edema
Term
cardiac arrest
Definition
- the cessation of cardiac function
- the absence of the carotid pulse in the person 1yr and older
- the absence of the brachial pulse in infants up to 1yr
Term
assessment findings of a pt in cardiac arrest
Definition
- skin has ashy appearance
- no respirations
- pupils dilated
Term
the cause of nontraumatic cardiac arrest in 80-90% of victims
Definition
ventricular fibrilation
Term
pulse-less electrical activity (PEA)
Definition
the presence of electrical activity but not sufficient enough to stimulate effective cardiac contractions
Term
in children and infants, cardiac arrest is often secondary to what?
Definition
hypoxemia or shock
Term
when is defibrillation used for a pt undergoing cardiac arrest?
Definition
ventricular fibrillation and ventricular tachycardia
Term
the goal of basic life support (BLS)
Definition
to provide O2 to the vital organs until appropriate advanced resuscitation measures can be initiated or until resuscitative efforts are ordered to be stopped
Term
the goal of advanced cardiac life support (ACLS)
Definition
the return of spontaneous breathing and circulation
Term
when a defibrillator is immediately available and v-fib or v-tach is confirmed, it can be used
Definition
prior to the initiation of cpr
Term
the amt of rescue breaths w/o chest compressions for an adol or adult
Definition
- 1 breath every 5-6 secs
- 10-12 breaths/min
Term
the amt of rescue breaths w/o chest compressions for an infant and child
Definition
- 1 breath every 3-5 secs
- 12-20 breaths/min
Term
the amt of rescue breaths given during cpr with an advanced airway, for all ages
Definition
- 1 breath/ 6-8 secs
- 8-10 breaths/min
Term
the med given for VF or pulseless VT
Definition
- epi 1mg IV push every 3-5 mins
or
- vasopressin 40 units IV x 1 only
- switch to epi if no response
Term
other meds that can be considered for VF or pulseless VT
Definition
- amiodarone hcl (Cordarone)
- lidocaine hcl (Xylocaine)
- mag sulfate
- procainamide (Procan SR)
- na bicarb
Term
the amount of defib current that should be delivered for VF or pulseless VT
Definition
200, 300, 360 joules
Term
if PEA rate is slow (bradycardic) what should be admin, and what is the max dose?
Definition
atropine 1mg IV every 3-5 mins
max dose is 0.04mg/kg
Term
the most common causes of pulseless electrical activity (PEA)? the H's?
Definition
- hypovolemia
- hypoxia
- hydrogen ion accumulation resulting in acidosis
- hyper or hypokalemia
- hypothermia
Term
the most common causes of PEA? the T's?
Definition
- tablets/ drug overdoses
- tamponade (cardiac)
- tension pneumothorax
- thrombosis (coronary or pulmonary)
Term
alpha receptor sites and response
Definition
- activate in the arterioles of the skin, viscera and mucous membranes, and veins
- leads to vasoconstriction
Term
beta receptors site and response
Definition
- heart stimulation leads to increased HR, inc myocardial contractility, inc rate of conduction through the av node
- activation of the receptors in the kidney leads to the release of renin
Term
treated first during a disaster
Definition
pts who are seriously injured and have the greatest chance of full recovery
Term
dopamine site and response?
Definition
activation of receptors in the kidneys cause the renal blood vessels to dilate
Term
beta 2 receptors site and response
Definition
- heart, lungs, and skeletal muscle: vasodilation
- bronchial: bronchodilation
- liver: glycogenolysis
- skeletal muscle: muscle contraction
Term
infectious process
Definition
- incubation period
- prodromal period
- convalescent period
- period of communicability
Term
incubation period
Definition
7-10 days
Term
prodromal period
Definition
the time between the beginning of nonspecific symptoms and the onset of disease specific symptoms
Term
prodromal period - nonspecific symptoms
Definition
lethargy
low-grade fever
fatigue
malaise
Term
prodromal period - disease specific symptoms
Definition
such as a rash.
Term
prodromal period
Definition
Kids are infectious at this point and infectious disease spreads rapidly throughout a community
Term
exantham
Definition
an accompanying specific rash on the skin
Term
enanthem
Definition
an accompanying specific rash on the mucous membranes
Term
Convalescent period –
Definition
period between when the symptoms first begin to fade and when the child returns to a healthy baseline
Term
Period of Communicability:
Definition
prodromal to beginning of convalescent period
Term
ss of infection disorder on child
Definition
mouth
lesions on mucous membranes (koplik spots)
white plaques on mms (thrush)
Term
ss of infection disorder on child
Definition
skin
warm and dry from fever, rash
reddened, swollen pharynx (infectious mono pharyngitis)
gray membrane in pharynx (diphtheria)
circular, scaly ring under knee (tinea corposis)
flesh-colored papule on top of foot (plantar wart)
linear abrasions on scalp; sandlike particles on hair shafts (pediculosis)
Term
ss of infection disorder on child
Definition
nose
watery discharge (prodromal symptoms of measles)
Term
ss of infection disorder on child
Definition
swollen parotid glands (mumps)
pinpoint papules on a erythematous base, like around the mouth (herpes simplex)
paroxysmal cough (whooping cough)
oozing, honey-colored, crusty lesions on face and hands (impetigo)
crusty lesions between fingers (scabies)
Term
fomite
Definition
any nonliving object or substance capable of carrying infectious organisms, such as viruses or bacteria, and hence transferring them from one individual to another. Skin cells, hair, clothing, and bedding are common hospital sources of contamination.
Term
Portal of entry for infections
Definition
- bloodstream
- respiratory
- GI
- skin, muc memb
Term
Phagocytes
Definition
are neutrophils, and they are usually the first responders
Term
phagocytes
Definition
they produce pus (remnants of the organisms, phagocytes, and destroyed tissue)
Term
pus
Definition
usually indicates phagocytosis is occurring and the infection is resolving
Term
during septicemia
Definition
B lymphocytes and T lymphocytes are produced
Term
B lymphocytes
Definition
(humoral immunity) – they form antibodies specific to the offending antigens that either actively destroy them or active complement
Term
complement
Definition
– a special body protein that is capable of lysing cells
Term
T lymphocytes
Definition
(thymus dependent) – killer cells, they can destroy antigens either by direct contact or by the release of lymphokines (eg, interferon)
Term
High risk hospitalized children for infections:
Definition
nutritional deficit
immunosuppressed
indwelling vascular lines or catheters
receiving multiple antibiotic therapy
remain in hospital for > 72 hrs
Term
kinesthetic and visceral stimuli
Definition
orient the person to the internal environment
Term
sensory perception:
Definition
awareness and interpretation of stimuli into meaningful info. Takes place in the cerebral cortex
Term
RAS
Definition
It maintains, enhances, or inhibits cortical arousal
Term
responses to both sensory deprivation and overload
Definition
- perceptual changes (eg, mild distortions or hallucinations)
- cog changes (eg, dec concentration and prob-solving ability)
- affective changes (eg, apathy, anxiety, anger, depression, and rapid mood swings)
Term
cts at risk for sensory deprivation
Definition
homebound or institutionalized
bed rest or isolation precautions
sensory deficits
different culture
affective disorders or disturbances of the NS
certain meds that affect the NS
Term
cts at risk for sensory overload
Definition
pain
ICU
intrusive or uncomfortable eqpt
NS disorders or disturbances
Term
assessment of sensory-perception disturbance:
Definition
a nursing history to ID sensory deficits
physical
mental status
ID of at-risk cts
immediate environment
presence of clinical signs of sensory deprivation or overload
Term
NANDA nursing dx r/t a ct's sensory impairments
Definition
Sensory Perception Disturbances: Visual, Auditory, Gustatory, Olfactory, Tactile, Kinesthetic
Acute Confusion
Chronic Confusion
Impaired Memory
Social Isolation
Impaired Verbal Comms
Risk for Impaired Skin Integrity
Self-Care Deficit: Bathing/Hygiene
Impaired Home Maintenance
Risk for Injury
Term
Goals for persons with sensory-perception disturbances
Definition
maintaining or promoting the function of existing senses
maintaining or improving comm
preventing injury
avoiding sensory deprivation or overload
reducing social isolation
maintaining or restoring ability to function safely in the environment
ADLs
Term
Interventions to prevent or modify sensory deprivation
Definition
sensory overload, and sensory deficits
promoting healthy sensory function
adjusting environmental stimuli
managing sensory deficits
Term
Cts with sensory deficits need
Definition
instructions about sensory aids available to support residual sensory functions
ways to promote the use of other senses
methods to ensure safety from bodily harm
Term
NICs for sensory alterations
Definition
comm enhancement: hearing deficit
“ visual deficit
nutrition mgmt
environmental mgmt
fall prevention
body mechanics promotion
peripheral sensation mgmt
emotional support
surveillance: safety
Term
common safety hazards
Definition
- physical/mechanical
- thermal
- chemical
- radiation
- ecological
Term
common safety hazards - ecological
Definition
risks posed by changes in the environment as a result of man-made or natural changes. Air, water, and noise pollution are examples of ecological hazards.
Term
common safety hazards - radiation
Definition
exposure to the sun, heat lamps, tanning booths, and x-rays
Term
common safety hazards - chemical
Definition
agents present in a person’s surroundings that can potentially cause injury and include medications, poisons, carbon monoxide, radon, and lead paint.
Term
common safety hazards - thermal
Definition
substances that can cause burns, chills, and fire. These include gas stoves, electrical hazards, and exposure to heat, cold, and fire
Term
common safety hazards - physical/mechanical
Definition
caused by unsafe physical conditions. These include wet floors, throw rugs that slide, stairs without handrails, poor lighting, improper use of restraints, defective equipment, and unsecured firearms
Term
factors affecting safety
Definition
Age
Individual preference
Physical condition
Cultural and spiritual needs  Socioeconomic factors
Environmental factors
Psychological factors
Term
factors affecting safety - individual preferences
Definition
- lifestyle
- occupation
- risky lifestyle
- use of meds
- history of previous injuries
Term
factors affecting safety - environmental
Definition
- proximity to disaster situations
- occupational
- ergonomic
- neighborhood
- cleanliness
Term
There are four major types of chemical weapons:
Definition
nerve agents
choking/lung/pulmonary agents
cyanides
vesicants or blister agents
Term
Treatments for chemical weapon exposure include
Definition
providing for an open airway, respiratory support
antidotes
specific treatment related to the particular agent
These situations demand an immediate decontamination
Term
emergency mgmt. planning
Definition
- biological, chemical, nuclear weapons
- natural disasters
- weapons of terror
Term
There are four key steps to assessing risk
Definition
- develop a communication plan
- plan out how to tackle the emergency
- assign accountability
- Annual update reviews, individual updates for staff regarding particular events, and disaster are provided
Term
Staff education should cover the following points:
Definition
- Identification of potential agents such as anthrax, smallpox, chemical, or nuclear agents
- Mass casualty treatment protocols
- Personal protective equipment for each emergency
- Infection control practices (for example, standard precautions and decontamination).
- Identification of disaster resources and their availability
- Discussion of psychological aspects of bioterrorism (for example anxiety, paranoia, and social isolation)
- Planning for recovery and rehabilitation.
Term
hospital emergency preparedness plan
Definition
- Communication plan (within and outside the hospital)
- Protocols for individual threats to the hospital
- Mass casualty protocols and infection control policies
- Comprehensive education plan for the staff
- Identification of resources needed during a disaster
Term
tuberculosis
Definition
Etiology Agent - The bacteria Mycobacterium tuberculosis  Reservoir - Man  Portal of Exit - Via the respiratory system when the infected person coughs or sneezes  Means of Transmission - Airborne droplets  Portal of Entry- Via the respiratory system  Host - Man
Term
There are six elements in the chain of infection:
Definition
- etiological/infectious agent
- reservoir
- portal of exit
- mode of transmission
- portal of entry
- susceptible host
Term
A reservoir is
Definition
a host or source of pathogens, which can include another human, a plant, an animal, or even an inanimate object. Humans can be symptomatic or asymptomatic. People who are asymptomatic may also be called “carriers” of that disease.
Term
The portal of exit is
Definition
a route out of the reservoir. These can include the nose and mouth for respiratory diseases. The most common way a blood-borne disease can “exit” is from bleeding, insect bites, and use of syringes and needles. Other portals of exits can include the GI tract and the urethra or genital area
Term
susceptibility
Definition
the likelihood the infectious agent will cause illness in an individual
Term
There are four stages in the human response to pathogens:
Definition
the incubation period, the prodromal stage, the full stage of illness, and the convalescent stage
Term
The incubation period is
Definition
the time from the initial contact or invasion of the pathogen until the first symptoms appear
Term
Many factors affect the length of the incubation period
Definition
- the virulence and time exposed to the pathogen
- the host’s level of susceptibility
Term
prodromal period
Definition
- This is the stage where non-specific symptoms first appear
- the host is most infectious
- can last for a few hours or several days
- Fatigue and a low-grade fever are the most common symptoms at this stage
- infected individuals may not realize they are contagious and therefore the disease spreads at this time
Term
active stage of illness
Definition
- signs and symptoms are very specific and individuals recognize that they are sick
- The symptoms can be localized or systemic
Term
The human body’s defense system fights infection through
Definition
- the body’s inflammatory response
- immune response
Term
Inflammatory response:
Definition
This is the body’s response to injury or invasion by a pathogen
Term
Inflammation - injury
Definition
- the body further controls the invasion by neutralizing the pathogen. The pathogen is neutralized by neutrophils, which surround and consume it.
Term
Inflammatory response - invasion
Definition
The body further controls the invasion by releasing fluid, cells, and other by-products of the inflammatory process from the wound as exudate.
Term
Immune response:
Definition
In this type of defense system, the body identifies the invading microorganisms as foreign bodies or antigens. It then produces antibodies in response to the antigens
Term
types of precautions
Definition
- standard
- transmission based
Term
types of precautions - standard
Definition
These are the basic precautions applicable to all patients in health care settings. You need to use these precautions when there is risk of coming in contact with any body fluid, such as blood, secretions, excretions, mucous membranes, and non-intact skin.
Term
types of precautions - transmission based
Definition
These precautions are used in addition to standard
NUR104: Essentials of Nursing Care: Health Safety Module 6
© Excelsior College 2017
precautions for suspected infections that are transmitted by droplet, airborne, or contact routes.
Term
handwashing
Definition
When visibly dirty  When arriving and leaving patient care unit  After coming into direct contact with blood, body fluids, secretions, excretions, contaminated items  Before and after donning gloves  Between patient contacts
Term
Soiled patient-care equipment
Definition
When handling these, you need to:
 Ensure that there is no transfer of microorganisms to others and to the environment;  Wear gloves if the contamination is visible  Perform hand hygiene
Term
areas of infection control
Definition
- soiled patient care equip
- environmental
- textiles and laundry
- needles and other sharps
- pt resuscitation
- pt placement- respiratory hygiene/cough etiquette
Term
You need to assign single-rooms to patients who are:
Definition
At increased risk of transmission  Likely to contaminate the environment  Not maintaining appropriate hygiene  At increased risk of acquiring infection or developing adverse outcome following infection
Term
Respiratory hygiene/cough etiquette
Definition
(source containment of infectious respiratory secretions in symptomatic patients, beginning at initial point of encounter e.g., triage and reception areas in emergency departments and physician offices):
Term
PPE
Definition
- first perform hand hygiene
- Don PPE in the following sequence: gown, mask, eyewear, and gloves. 
- Select PPE of the correct size.
- Ensure it fits properly and covers all areas it is meant to cover
- Keep hands away from the face. -
- Work from dirty to clean -
- Limit items and surfaces touched.
- Change PPE that is torn or heavily contaminated
Term
PPE sequence to put on
Definition
- gown
- mask
- eyeware
- gloves
Term
Remove PPE
Definition
- at the doorway before leaving the patient’s room or in the anteroom.
-  Do not touch the outer side of the PPE, which is contaminated.
-  Remove PPE in the following sequence: gloves, gown, eyewear, and mask. 
- After removing the gloves and gown, perform hand hygiene before removing the other PPE. 
- Place the used PPE in the appropriate waste container or the receptacle for reprocessing. 
- Perform hand hygiene immediately after removing the PPE.
Term
Remove PPE in the following sequence:
Definition
- gloves
-gown
-eyewear
- mask
Term
Several factors affect how people maintain personal hygiene.
Definition
- culture
- environment
- health
- devp level
- personal preference
Term
asepsis
Definition
- medical
- surgical
Term
medical asepsis
Definition
- clean technique
- handwashing and wearing of gloves
Term
surgical asepsis
Definition
sterile technique
Term
The purpose of medical asepsis is to
Definition
confine pathogens and prevent their transmission to others
Term
The purpose of surgical asepsis is to
Definition
remove pathogenic microbes in order to protect against infection
Term
The practice of hygiene involves
Definition
caring for one’s skin, eyes, ears, nails, teeth, and genital areas
Term
The Nursing Process and Hygiene - assessment
Definition
need to gather data related to the integumentary system, susceptibility to infection, access to basic hygiene facilities, etc
- Some areas to pay attention to are temperature, presence or absence of moisture, any skin lesions, sensation, color, texture, and vascularity
Term
Wounds are classified as:
Definition
Intentional or accidental
Open or closed
Acute or chronic
Term
Wound depth is classified as:
Definition
Partial thickness
Full thickness
Complex
Term
Phases of wound healing:
Definition
Hemostasis: the cessation of bleeding  Inflammation: classic signs are redness, edema, warmth, and pain which typically last four days post injury  Proliferation: wound repair takes place  Maturation: remodeling dermal tissue to close the wound
Term
Factors associated with wound healing:
Definition
Local: extent of trauma, edema, pressure, infection, etc.
Systemic: circulation, nutrition, health status, immune system, medication, and the patient’s age
Term
Factors associated with delayed wound healing:
Definition
Infection
Prolonged bleeding
Term
Complications: in wounds
Definition
Dehiscence: the partial or total separation of the wound edges  Evisceration: complete separation of the wound with protrusion of viscera. This is a medical emergency.
Other considerations:
 Pain: Pain is both a physical and psychological component of the trauma caused by wounds.  Anxiety: Anxiety and fear are common in a patient who has been wounded. Addressing these issues is a very important aspect of caring for the patient.  Change in body image: This can be a major issue for patients, especially when the wound or scar is visible to others.
Term
Factors associated with the development of pressure ulcers include:
Definition
External pressure: Prolonged pressure on the skin and tissues is, by far, the most common cause of pressure ulcers.
Boney prominences, when exposed to such pressure, are especially vulnerable.  Shearing and friction: Sliding down in a bed or chair or being pulled across bed sheets are also likely to cause pressure ulcers.
Term
Risk factors associated with the development of pressure ulcers:
Definition
Immobility: Immobility is one of the primary reasons for the development of pressure ulcers.
Moisture: Moisture due to sweat, urine, and feces removes oil from skin, increasing the damage caused by shear and friction.
Nutrition: Protein malnourishment increases the likelihood of cellular damage. Underweight individuals have increased pressure on bony prominences. Overweight individuals may have decreased circulation to the tissue.
Mental status: Patients who are not fully conscious may not be aware of any physical discomfort or be able to reposition themselves.
Age: As a person ages, the skin becomes thin and fragile, increasing the risk of developing pressure ulcers
Term
The stages in a pressure ulcer include:
Definition
Suspected deep tissue injury: There is purple or maroon discoloration of intact skin or blood-filled blisters resulting from damage of underlying soft tissue.  Stage I: Skin is intact, but not blanchable. 
Stage II: There is partial thickness loss of the dermis, which is shallow with a pink wound bed.
 Stage III: There is full thickness loss of the dermis. Fat may be visible, but no other underlying structures are visible.  Stage IV: There is full thickness loss of dermis with exposed underlying structures such as bones, tendon, and/or muscle. 
Unstageable: There is full thickness loss that is covered by slough and/or eschar
Term
Braden scale for pressure ulcer risk - The lower the individual scores on the Braden Scale, the higher the chances of developing pressure ulcers
Definition
Sensory perception
Moisture
Activity
Mobility
Nutrition
Shear and friction risk
Term
Braden scale
Definition
SEVERE RISK: Total score 9
HIGH RISK: Total score 10-12
MODERATE RISK: Total score 13-14 MILD RISK: Total score 15-18
Term
bacteriostatic
Definition
inhibits growth
Term
bactericidal
Definition
kills growth of bacteria
Term
antibiotics target the processes of the invading organisms
Definition
some go after protein synthesis
some inhibit DNA or RNA synthesis
some destroy the cell wall
Term
drip factor: gtts/ml
Definition
V/t x DF
Term
antibiotics
Definition
penicillin
cephalosporin: 1-3 generations
tetracyclines
macrolides (erythromycin)
aminoglycosides
quinolones (ciproflaxin)
sulfonamides
Term
penicillins
Definition
- skin infections, otitis media, sinusitis, respiratory infections, GU infections
- they kill gram+ and gram– bacteria by destroying the cell walls
Term
cephalosporins
Definition
- can be used for people who can't tolerate penicillins
Term
1st generation cephalosporins
Definition
– used mainly for people allergic to penicillin
they act against gram+ bacteria
Term
2nd generation cephalosporins
Definition
treat nosocomial pneumonia
treat pelvic or intraabdominal infections
Term
3rd generation cephalosporins
Definition
act against gram- bacteria
Term
Tetracyclines
Definition
they prevent bacteria from making protein (protein synthesis)
useful against gram- and gram+ microbes
Term
seborrhea
Definition
a scaly scalp condition often called cradle cap
Term
3 factors to consider when choosing an antibiotic
Definition
- identity of the infecting organism
- drug sensitivity of the infecting organism
- host factors, such as the site of the infection, and the status of host defenses
Term
reasons for choosing a drug of choice
Definition
- greater efficacy
- lower toxicity
- a more narrow spectrum
Term
conditions that might rule out a first-choice drug
Definition
- allergy to 1st drug of choice
- inability of the drug of choice to penetrate to the site of infection
- heightened susceptibility of the pt to toxicity of the first choice drug
Term
quickest, simplest, and most versatile technique to id a m.org
Definition
gram-stained preparation
Term
culture samples should not be exposed to
Definition
- low temp
- antiseptics
- oxygen
Term
microbes that can be detected by a PCR test
Definition
- C. diff
- S. areus
- H. pylori
- HIV
- flu
Term
drug sensitivity tests
Definition
- disk diffusion
- serial dilution
- gradient diffusion
Term
disk diffusion
Definition
testing a bacteria against different zones of an antibiotic to see which one works
Term
serial dilution establishes
Definition
- the minimum inhibitory concentration (MIC), but does not kill
- the minimum bactericidal conc (MBC)
Term
gradient diffusion
Definition
provides a more precise indication of MIC
Term
host defense consists of
Definition
- immune system
- phagocytic cells
Term
the goal of using antibiotics
Definition
- not to totally kill
- to suppress microbial growth enough to give the host defenses a chance to kill it on their own
Term
site of infection
Definition
to be effective, a drug must be at the site of infection and at a greater conc than the MIC
Term
examples of hampered drug penetration
Definition
- meningitis, because of blood-brain barrier
- endocarditis because of bacterial vegetation
- infected abscesses due to poor vascularity, pus and other materials
Term
treating meningitis
Definition
- use drug that crosses blood-brain barrier, or
- inject drug directly into subarachnoid space
Term
treating abscesses with exudate hindering an antibiotic
Definition
- surgical drainage
Term
drugs with high incidences of allergic reactions by pts
Definition
- penicillin
- sulfonamides
- trimethoprim
- erythromycin
Term
genetic factors can influence
Definition
- a pt's response to a drug
- a pt's rate of metabolism
Term
infants and microbials
Definition
- highly vulnerable to drug toxicity
- use of sulfonamides can cause kernicturis
Term
kernicterus
Definition
a severe neurologic disorder caused by displacement of bilirubin from plasma proteins
Term
children/adols and microbials
Definition
tetracyclines cause discoloration of teeth
Term
pregnant women and microbials
Definition
gentamicin can cause irreversible hearing loss in the baby
Term
breast-feeding and microbials
Definition
- sulfonamides in breast milk can cause kernicterus
Term
older adults and microbials
Definition
reduced rates of metabolism and drug excretion can cause accumulation of toxic levels
Term
successful antimicrobial txt requires
Definition
- it must be at the site of infection
- an effective concentration
- at a sufficient amount of time
Term
the desirable antimicrobial concentration
Definition
- 4 to 8 times the MIC
Term
duration of therapy depends on
Definition
- site of infection
- status of host defenses
- the id of an infecting organism
Term
dangers of stopping antibiotics too early
Definition
- recurrent infection
- the organisms are likely to become more drug resistant than when txt began
Term
Universal precautions –
Definition
they interfere with the spread of bloodborne pathogens
Term
Body substance isolation (BSI) –
Definition
it employs generic infection control precautions for all cts except for those with the few diseases xmitted through the air
Term
Transmission-based precautions
Definition
(Tier Two)
airborne
droplet
contact
Term
Donning
Definition
put on gown
put on face mask
don gloves
Term
Removing
Definition
remove gloves first
wash hands
remove face mask
remove gown
Term
Different names are used to identify the same drug and include:
Definition
Generic: This is the official name of the medication. Most drugs are prescribed using the generic name. For example, levothyroxine sodium.  Official: This is how the drug is listed in publications and is almost always the generic name.  Trade/Brand: This is the trademark name used by the drug company. For example, Synthroid.  Chemical: This is the specific chemical description of the drug. For example, l-thyroxine or T4
Term
There are many forms of medication preparations available. Some of the more common types include:
Definition
Pills/capsules/tablets: Used for oral administration and generally absorbed the slowest.  Syrups: Medications that are mixed with water and sugar solution.  Lotions or Ointments: Medication preparation for a topical application.  Powders: Finely ground drugs that can be put into another form, such as a capsule, for administration.  Suppositories: Medication in a form that easily melts for use via the rectum, vagina, or urethra.  Transdermal Patches: Applied directly to the skin for diffusion to the blood stream
Term
routes of drug admin - enteral
Definition
 Oral: Medication is administered by mouth in liquid or pill form.  Via gastrointestinal tubes: Medications are administered through nasogastric, percutaneous endoscopic gastrostomy (PEG) or jejunostomy tubes.  Buccal: Medicine is placed between the gums and cheek.  Sublingual: Medicine is placed under the tongue
Term
routes of drug admin - parenteral
Definition
Intramuscular: Medication is injected into muscle tissue.  Subcutaneous: Drug is injected into the subcutaneous tissue.  Intravenous: Medication is injected directly into the blood stream through a vein
Term
routes of drug admin - topical
Definition
Transdermal: Medicine is administered through the skin.  Instillations: The medication is placed into a body cavity.  Irrigations: A liquid medication is used to wash out a body cavity.  Nebulizers/Metered Dose Inhalers: Medication is inhaled directly into the lungs
Term
pharmacokinetics
Definition
- absorption
- distribution
- metabolism
- excretion
Term
Pharmacodynamics is
Definition
the process in which drugs alter cell physiology to have their desired effect. A drug can change a body’s processes by promoting, turning on, turning off, or blocking normal responses
Term
The types of adverse drug effects are:
Definition
Side effects: Refer to any unintended effect of a drug  Synergistic effects: Drug-to-drug reaction that increases the effect of one or both drugs when used in combination, which could be desirable or undesirable.  Antagonistic effects: Drug-to-drug reaction that decreases the effect of one or both drugs when used in combination, which could be desirable or undesirable.  Toxic effects: Drug effects that could lead to permanent damage or even death.  Idiosyncratic effects: Unpredicted response to a drug that could be opposite to the intended effect.
Allergic response: This is caused when the body identifies a drug as a foreign body and triggers the immune system to respond by producing antibodies. Allergic effects can be minor or lifethreatening. The most serious allergic effect is called an anaphylactic reaction, which is a medical emergency.  Drug tolerance: This is caused when the body becomes accustomed to a particular drug and, therefore, higher doses are necessary to achieve a therapeutic effect
Term
Side effects:
Definition
Refer to any unintended effect of a drug
Term
Synergistic effects:
Definition
Drug-to-drug reaction that increases the effect of one or both drugs when used in combination, which could be desirable or undesirable
Term
Antagonistic effects:
Definition
Drug-to-drug reaction that decreases the effect of one or both drugs when used in combination, which could be desirable or undesirable
Term
Idiosyncratic effects:
Definition
Unpredicted response to a drug that could be opposite to the intended effect
Term
factors that can affect drug metabolism, drug action, and patient adherence
Definition
Gender, economic challenges, lifestyle choices, and dietary practices are
Term
gender
Definition
Drugs can affect women and men in different ways. Gender influences how body fat is distributed in a person. For example, men are more prone to have fat deposits in the stomach region. A patient’s body fat distribution has a minor effect on absorption and distribution of medication
Term
Individual Preferences
Definition
Individual patients may have specific preferences related to taking medications. Individual preferences also play a role in the lifestyle choices of patients. Some examples of individual preferences include favoring syrups rather than pills, timing when medication is taken based on daily schedule and waking or sleeping patterns, using alcohol, tobacco and other drugs, and using alternative medicine
Term
Physical Condition
Definition
The current physical condition of a patient plays an important role in how a medicine affects the patient. Medicines that are known to have severe side effects on a particular organ will have a significant impact on patients in whom the organ is already impaired. Some examples of physical condition impacting drug action are eyesight, physical dexterity, ability to swallow, organ function (affecting excretion and absorption), presence of disease, and presence of food in the system
Term
environmental factors
Definition
Storage of medications, expiration dates, sensory deprivation and overload, and nutritional state are all factors to be considered for medication safety
Term
Psychological Factors
Definition
A patient’s ability to schedule and adhere to a schedule and whether the patient believes the medication will help are important influencers of patients taking their medications. Patients with mental illnesses may have impaired reactions or not take medications as prescribed
Term
serum drug levels
Definition
- therapeutic range
- peak level
- trough
- half life
Term
Therapeutic range is
Definition
the level of drug concentration that produces the desired effect of the drug
Term
The peak serum drug level is
Definition
taken once a drug’s absorption is complete. The peak level will depend on the individual drug and the route in which it was administered. The peak level is the highest concentration serum level of a drug.
Term
drugs
Definition
Question: What is the term for a trademark name by a drug company? Correct Answer: Brand  Question: What is the term for the body becoming unresponsive to the effects to a particular drug? Correct Answer: Drug Tolerance  Question: What is the specific name that describes a drug’s composition? Correct Answer: Chemical  Question: What is the term for the process of elimination of a drug from the body? Correct Answer: Excretion  Question: What is the term for the process in which drugs alter cell physiology to achieve their desired effect? Correct Answer: Pharmacodynamics
Term
drugs
Definition
Question: What is the term for the undesirable effects of a drug? Correct Answer: Adverse Effects  Question: What is the term for the side effect where the body identifies the drug as a foreign body and triggers the immune system to respond with antibodies? Correct Answer: Allergic Response  Question: What is the term for any unintended impacts of a drug? Correct Answer: Side Effects  Question: What is the term for the unpredicted responses to a drug? Correct Answer: Idiosyncratic Effects
Term
drugs
Definition
Question: What is the term for the drug reactions that increase the effect of one or both drugs when used in combination? Correct Answer: Synergistic Effects  Question: What is the term for the drug effects that could lead to permanent damage or even death? Correct Answer: Toxic Effects  Question: What is the official name that is most commonly used to prescribe drugs? Correct Answer: Generic  Question: What is the term for the process of transportation of a drug from where it enters the body to the bloodstream? Correct Answer: Absorption
Term
drugs
Definition
Question: What is the term for how a drug is listed in publications? This name is usually the same as the generic name. Correct Answer: Official  Question: What is the term for the process of the drug spreading through the body and to the tissues? Correct Answer: Distribution  Question: What is the term for the process performed by the liver, where the drug is changed from one form into another? Correct Answer: Metabolism
Term
med errors cause
Definition
7,000 deaths per yr
Term
the most important properties of an ideal drug
Definition
- effectiveness: the most important over all
- safety: even it is admin at high doses over a long period of time
- selectivity: it only elicits the response for which it's given
- there is no such thing as a wholly selective drug
Term
addl properties of an ideal drug
Definition
- reversibility
- predictability
- ease of admin
- freedom from interaction with other drugs
- low cost
- chemical stability: not lose its effectiveness over time
- a simple generic name
Term
the ultimate concern when admin a drug
Definition
intensity of the response
Term
factors that determine the intensity of a drug response
Definition
- prescribed dose
- admin dose
- conc at sites of action
- intensity of responses
Term
proper drug admin depends on
Definition
- patient adherence
- no med errors
Term
pharmacokinetics
Definition
it determines how much of a drug gets to its site of action
Term
the impact of the body on drugs
Definition
- absorption
- distribution
- metabolism
- excretion
Term
pharmacodynamics
Definition
- impact of the drug on the body
- it determines the nature and intensity of the response
- it's influenced by:
- drug-receptor interaction
- pt's functional state
- placebo effects
Term
sources of individual variation
Definition
characteristics unique to each pt can influence p.kinetics and p.dynamics
Term
sources of individual variation
Definition
- variables:
- physiologic
- pathologic
- genetic
- drug interactions
Term
sources of individual variation - physiologic
Definition
age, gender, wt
Term
sources of individual variation - pathologic
Definition
- diminished function of the kidneys and liver
Term
sources of individual variation - genetic
Definition
can alter the metabolism of drugs and predispose the pt to unique drug reactions
Term
application of the nursing process in drug therapy
Definition
directed at individualizing txt which is critical to achieving the therapeutic objective
Term
evaluation stage of drug therapy
Definition
- therapeutic responses
- adverse reactions and interactions
- pt adherence
- pt satisfaction with txt
Term
7 aspects of drug therapy
Definition
- preadmission assessment
- dosage and admin
- evaluating and promoting therapeutic effects
- minimizing adverse effects
- minimizing adverse interactions
- making prn decisions
- managing toxicity
Term
7 aspects of drug therapy - preadmission assessment
Definition
- develop a baseline to evaluate therapeutic and adverse responses
- id high risk pts
- assess pt's capacity for self-care
Term
measures to reduce adverse events
Definition
- id high risk pts through the pt history
- ensuring proper admin through pt education
- teaching pts about activities that might precipitate adverse events
Term
reducing adverse events
Definition
- the major adverse events the drug can produce
- when they are likely to occur
- id early signs
- minimize discomfort and harm
Term
educating the pt on drugs to be given
Definition
- dosage and admin
- drug name (both)
- dosage and admin schedule
- technique of admin
- duration of drug use
- storage
Term
teaching about therapeutic effect
Definition
- what to expect
- how long it will take
- have pt use nondrug techniques also
Term
analysis and nursing diagnosis - 3 phases
Definition
- judge the appropriateness of the prescribed regimen
- id potential health probs the drug might cause
- determine capacity of pt's self-care
Term
highest priority reactions to drugs
Definition
1. life threatening
2. reactions that cause severe, acute discomfort or long term harm
Term
4 major groups of interventions
Definition
- drug admin
- enhancing therapeutic effects
- minimize adverse effects and interactions
- pt education
Term
evaluation
Definition
- lab tests
- observation of the pt
- physical
- pt interviews
Term
evaluating adherence of drug use
Definition
- blood test
- pt interview
- counting pills
- pt understanding of taking the drugs
Term
why a pt won't take a drug
Definition
- too expensive
- too complicated
- bad side effects
- inconvenient dosage schedule
- pt doesn't feel the drug is necessary
Term
federal pure food and drug act 1906
Definition
the first American law to regulate drugs
Term
food, drug, and cosmetic act 1938
Definition
the first legislation to address drug safety
Term
1962, harris-kefauver amendments to the food, drug, and cosmetic act
Definition
- the first law that required that drugs must prove to be effective
- it was retroactive
- required rigorous testing
Term
1970, controlled substance act
Definition
- controlled substances, schedules I-V
- schedule I: no accepted medical use in the US and they have a high potential for abuse
- schedule II-V: accepted medical use in the US and they have a high potential for abuse
Term
1992, fda regulations permit accelerated approval
Definition
- drugs for aids and cancer
Term
the prescription drug fee act, 1992
Definition
it speeds up the review process for new drugs at the cost of the pharmaceutical process
Term
the fda modernization act, 1997
Definition
called for widespread changes in fda regulations
- the FastTrack system established for aids and cancer drugs now includes drugs for other serious or life-threatening conditions
- manufacturers that plan to stop making a drug must inform pts at least 6 months in advance
- a clinical trial database is required for drugs made for serious or life-threatening illnesses
- drug companies can now give prescribers journal articles showing off-label use for their drugs
Term
the best pharmaceuticals for children act, 2002 and the pediatric research equality act, 2003
Definition
designed to promote much needed research on drug safety and efficacy of drugs for children
- it is required by the fda
Term
the fda amendments act, 2007
Definition
the fda requires new testing on drugs already on the market if they cause any problems to pts
- the fda has the authority to restrict or remove the drug
Term
the family smoking prevention and tobacco control act, 2009
Definition
- fda can now regulate cigarettes
Term
rct
Definition
- random
- controlled
- blind
Term
see drug trial stages
Definition
see drug trial stages
Term
preclinical phase, 1-5yrs
Definition
- animals
- tests for toxicities, p.kinetic properties, and potentially useful biologic effects
Term
clinical trials 2-10yrs
Definition
- humans
- 4 phases
Term
clinical trials - phase I
Definition
- healthy volunteers
- evaluates: drug metabolism
- p.kinetics
- drug metabolism
Term
clinical trials - phase II and III
Definition
- patients 5-5000
- determine: therapeutic effects
- dosage range
- safety
- effectiveness
Term
clinical trials - phase IV
Definition
- drug is released for general use
- its effects on the general population is observed
Term
consideration when prescribing a new drug
Definition
be neither the first to adopt the new, nor the last to abandon the old
Term
when considering a generic over a brand
Definition
determine if there is a difference in the absorption rate
Term
p.kinetic processes
Definition
determines the concentration of a drug at its site of action, and thereby determine the intensity and time course of responses
Term
how drugs cross membranes
Definition
- passing through pores
- undergoing xport
- penetrating the membrane directly
Term
P-glycoprotein
Definition
- found in the liver, kidney, placenta, intestine, and brain capillaries
- it can xport a variety of drugs OUT of cells
Term
to cross membranes, most drugs must
Definition
dissolve directly into the lipid bilayer of the membrane
Term
lipid-soluble drugs
Definition
can cross membranes simply
Term
drugs that are polar or ionized
Definition
can't cross membranes simply
Term
absorption is enhanced by
Definition
- rapid drug dissolution
- high lipid solubility of the drug
- a large surface area for absorption
- high blood flow at the site of admin
Term
IV advantages
Definition
- rapid onset
- precise control of drug entering the blood
- suitability for use with lg volumes of fluid
- suitability for irritant drugs
Term
IV disadvantages
Definition
- high cost
- difficulty
- inconvenience
- danger because of irreversibility
- the potential for fluid overload, infection, and embolism
Term
IM advantages
Definition
- suitability for insoluble drugs
- suitability for depot preparations
Term
IM disadvantages
Definition
- inconvenience
- potential for discomfort
Term
subQ advantages
Definition
- suitability for insoluble drugs
- suitability for depot preparations
Term
subQ disadvantages
Definition
- inconvenience
- potential for discomfort
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