Vital
Respiratory rate of less than 12 per minute is
Bradypnea
Obtaining vital signs fits in what step of the nursing process?
Assessment
The patient reports feeling fatigued.
Subjective or Objective?
Subjective
Health care professionals place used needles in this type of container.
Sharps container/puncture proof container
Good ________ _________ should be used when lifting or moving to prevent injuries.
Body Mechanics
A pulse that is easily detected, feels strong, and is easily counted is rated and documented as a
2+
Which of these listed is the priority nursing diagnosis?
Altered nutrition
Risk for infection
Chronic low self-esteem
Ineffective airway clearance
Ineffective airway clearance.
The nurse must complete this report for any med error, patient injury, employee injury, unsafe staff situation, failure to report broken equipment, failure of appropriate health-care provider response to an emergency, failure to perform ordered care, loss of patient's belongings, lack of patient care supplies or equipment.
Incident report
In the acronym RACE, R stands for what?
Rescue
The student nurse finds an unresponsive patient. The patient has no pulse or respirations. The FIRST thing the student should do is
Alert the emergency team.
An assessment technique requiring the nurse to touch and feel a pulse is called
Palpation
The nurse determines managing a patient's pain is top priority in their care. This step in the nursing process is
Planning.
When a patient becomes short of breath while performing an activity, the nurse will chart
Exertional dyspnea.
Name two of many factors contributing to an unsafe patient environment.
Age & Ability to understand
Impaired mobility
Communication
Pain & Discomfort
Delayed assistance
Equipment (alarms)
Name two of multiple strategies used to prevent falls
Patient room close to nurse's station. Stay with patients at risk while they are in the bathroom. Keep the bed in the lowest position. Offer regular opportunities for bathroom trips and snacks, or fluids. Offer distractions, such as music, TV, back rubs. Offer nightlights.
To obtain a tympanic temperature for a 2 year old child, the nurse must pull the pinna
Downward and back.
Completely different from medical diagnoses, ______ ______ are related to the needs or problems a patient is experiencing.
Nursing Diagnoses
The best method to ensure documentation accuracy is to consistently chart
Immediately after care is provided.
Morse Fall Scale is an example of what
Fall assessment rating scale
True or False
You MUST wash your hands before and after all patient contact.
True
Observing the chest of a patient rise and fall during respirations is what technique of assessment?
Inspection
My patient has a temperature of 102 F at 1300 and I administer Tylenol. At 1400, my patient's temperature is 98.6 F. What step(s) in the nursing process did I perform?
Implementation (intervention) and Evaluation
States, "I guess my knees gave out and I fell."
This is an example of
Direct patient statement
What can a nurse delegate to a CNA regarding restaints?
Check and release of the restraint.
Name two of many guidelines to use good body mechanics and prevent injury.
Plan your work carefully. Elevate your work to a comfortable level. Keep your feet shoulder-width apart. Avoid twisting. Bend your knees, not your back. Hold objects close to your body. Get help. Push, pull, or slide heavy objects.