Shared Flashcard Set

Details

Exam 2: Bed-side
McCall's Online Lecture
15
Nursing
Graduate
10/09/2013

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Cards

Term
Patient Status Education
Definition
Status is gleaned from the off-going nurse's report, and from the chart (paying special attn. to last few days)
Term
before entering room, check for
Definition
SIGNS! Make sure you're aware of their rationale and applicability
Term
First thing a nurse does upon entering a pt room
Definition
GREET THE PATIENT, people care more that you notice them than whether you've gelled in yet. But still, don't forget HAND HYGEINE (these can be done simultaneously)
Term
LOC
Definition
level of consciousness
they know who they are, when it is, and where they are (A/O x3)
Term
Vital Signs
Definition
1) BP
2) HR
3) RR
4) Temp
5) PAIN
Term
Pain reassessment
Definition
after medication administration: ~30 min

IV: 15 min
PO: 1 hr
Term
NPO
Definition
nil per os: nothing by mouth (cannot eat or drink anything, all nutrients are IV, etc)
Term
Oxygen assessment
Definition
is it fitted correctly, is it comfortable, is it actually in? etc.
Term
Incentive Spirometer
Definition
machine which exercises the diaphragm/lungs in order to prevent nosocomial pneumonia (bed-ridden pts at high risk); ONLY IF ORDERED

pt exhales, then inhales through machine and holds it--measure pressure QUICKLY--then release
Term
True or False: if gown is thin enough, apical rhythm can be measured through it
Definition
FALSE, always under gown
Term
Bedside Skin
Definition
Check Dressings, Braden Risk Assessment: See My Albino Matte? Need Formula: Sensitivity, moisture, activity, mobility (immobile: at risk for break-down), nutrition, and friction/shear
Term
7 y.o. Johnny is on renal watch, after your initial assessment what would you ask him, and how?
Definition
"Have you peed today?" not urinated, or voided, use his language
Term
Name 7 of Joint Commissions Core Measures
Definition
MI, HF, pneumonia (PN), venous thromboembolism (VTE), stroke (STK), emergency department (ED), substance use (SUB); children's asthma care (CAC), surgical care improvement project (SCIP), hospital outpatient measures (HOP), perinatal care (PC), hospital-based inpatient psychiatric services (HBIPS), immunization (IMM), tobacco treatment (TOB)
Term
Major Abnormalities (Red Flags)
Definition
Always stop assessment and investigate upon unexpected abnormality of any kind
Term
SBAR
Definition
a nursing communication tool that helps verbalize data (vs. SOAP which helps write data)

Situation
Background
Assessment
Recommendations
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