Aging
List one normal sign of aging related to the integumentary system
Thinning of the skin.
Give an example of subjective data
Anything the patient tells you (history, allergies, feelings, pain, etc.)
What does SBAR stand for?
Situation-Background-Assessment-Recommendations
What is the nutrient your body needs to promote regular bowel movements?
Fiber
What parts of the nursing process can the nurse delegate?
None
What kind of pain lasts for typically >6 months?
Chronic
What is the most important nursing action to prevent pressure injury?
Turn the patient every 2 hours
________ refers to a group whose members share a common cultural heritage.
Ethnicity
What are the health concerns of older adulthood?
Cancer and other chronic diseases.
Give an example of objective data.
Anything you the nurse assess (vital signs, BMI, physical assessment findings, information obtained from chart review)
You have committed a medication error, name the action you would take.
Complete an incidence/occurrence report.
What bowel elimination pattern is commonly associated with taking antibiotics?
Diarrhea
Who defines the scope of practice for nurses?
State board of nursing
True or False: Vital signs are the best indicator of pain.
False - patient self report is.
What type of pressure injury has a wound base that is unable to be visualized?
Unstageable
What religion does the Anointing of the Sick or last rights when a patient is dying?
Catholics
Domestic violence is common in what age group of older adults (young, middle, or old)?
Young adults
Which type of assessment is performed to determine discharge needs and functional status?
Special needs assessment
What should you tell your neighbor who asked you to look in their chart while they are in the Emergency Department at the hospital you work at?
No, this is a violation of privacy and confidentiality (HIPAA)
What kind of bowel diversion bypasses the large intestine?
Ileostomy.
What type of healthcare delivery system is limited in provider options?
Healthcare maintenance organization (HMO)
How is neuropathic pain typically described?
Sharp, radiating or shooting pain that usually follows nerve pathways
Osteoporosis is caused by what mineral deficiency?
Calcium (and Vitamin D)
True or False: It is safe to say that all people of a culture share the same beliefs and practices.
False
What is the second leading cause of death in older adults and when should it be screened for?
Cancer; at annual exams
What should evaluation occur?
During implementation after interventions are performed
What would the nurse say to her friend who is also a nurse if the side rails were both up for a patient with normal mental capacity?
This is considered a restraint.
What is the leading cause of UTIs in hospitalized patients?
Indwelling foley catheters
What does an ethical agent do?
Practice based on professional standards and participate in ethical decision making
How is pain tolerance different from the pain threshold?
Pain tolerance is the max amount of pain a person can tolerate where as pain threshold is the point at which pain is begin to be felt
Patients with what disease process should limit protein intake?
Liver disease
Define assimilation.
A person from a different culture adopts the practices of the new dominant culture.
What law is important for nurses to follow when working with an older adult who is a victim of physical abuse, neglect or financial exploitation?
Mandatory Reporting Law
Give an example of a direct nursing care intervention.
Emotional support, teaching, physical care (administering medications, turning/positioning the patient)
What should the nurse do when the patient and the medical record have conflicting information on allergies?
Clarify the allergy with the patient and determine reaction.
What is a key teaching point for urinary stress incontinence?
Kegel exercises
What is the difference between battery and libel?
Battery is physical assault and libel is written or published form of slander.
What change in vital signs might you see when assessing someone with activity intolerance?
Elevated heart rate and blood pressure
What nutrient is essential for muscle contraction, acid/base balance, and blood pressure control
Potassium
This type of data is defined as numbers and can be used to generalize results about a group of people.
Quantitative data
Give an example of abnormal signs of aging
Memory loss, infection, incontinence
What are the 3 components of an actual nursing diagnosis?
Label + etiology + defining characteristics
How should information about a patient be sent when transferring a patient from one level of care to the next?
Use a face sheet.
What type of incontinence would be seen if there is an obstruction between the bladder and the urethra?
What does the MORAL model for ethical reasoning stand for?
Massage the dilemma, outline the options, Resolve the issue, act, look back and reflect
When moving obese patients, the nurse should do what to prevent back injury?
Use a mechanical lift, make sure wheels are locked on the bed, move tubing with patient
Healing by what intention makes a wound more prone to infection?
Secondary
What does PICOT stand for?
Problem/Population
Intervention
Comparison
Outcome
Time
Name a screening done at the annual exam during middle adulthood?
lipid panel screening (total cholesterol, triglycerides, HDL, LDL, ratios), blood glucose screening, clinical breast/pelvic exams for women, annual/biannual mammograms for women, DRE and prostate exams for men, annual eye exam, colorectal cancer screening, and osteoporosis screening
What are the goals for NANDA diagnoses for an actual problem?
To resolve the health issue
List one action the nurse can take when documenting electronically to protect patient information.
Log off the computer when finished
Use blinders/additional screens so information is only viewable if you are right in front of it
Don’t leave patient information up if you walk away from the computer
Name one way a sterile urine specimen can be obtained.
If they have a foley - through the side port
In/out cath if no catheter currently and unable to void
If able to void, cleanse the genitalia then start urine stream then obtain specimen midway through
What are the six ethical principles?
Veracity, fidelity, autonomy, beneficence, maleficence, justice
How does the center of gravity relate to the base of support?
The line of gravity passes through the middle of the center of gravity to the base of support (which must be close to the base of support).
Friction and shearing forces are examples of what type of factor that contribute to the formation of pressure ulcers?
External
List a function or component of family development theory.
Reinforcing ethical and moral values
Promoting joint decision making between parents and children
Maintaining support for young adults