Download Key Concepts in Nursing and Healthcare: A Compendium of Definitions and Theories and more Exams Advanced Education in PDF only on Docsity!
CMSRN EXAM WITH QUESTIONS AND ACCURATE ANSWERS
mallows hierarchy of needs - ANSWER physiological, safety, love/belonging, esteem, self-actualization
Stages of adult development: young adulthood - ANSWER 18-35, intimacy vs isolation
stages of adult development: middle adulthood - ANSWER 36-65 generativity vs despair
stages of adult development: older adult - ANSWER 66+ integrity vs despair
Piaget stages of cognitive development - ANSWER sensorimotor, preoperational, concrete operational, formal operational
sensorimotor stage - ANSWER in Piaget's theory, the stage (from birth to about 2 years of age) during which infants know the world mostly in terms of their sensory impressions and motor activities
preoperational stage - ANSWER in Piaget's theory, the stage (from 2 to about 6 or 7 years of age) during which a child learns to use language but does not yet understand the mental operations of concrete logic.
concrete operational - ANSWER 7-11 thinking logically about concrete events; understanding concrete analogies and executing arithmetical operations
formal operational - ANSWER 12+ abstract reasoning
Kubler-Ross stages of grief - ANSWER 1. Denial
- Anger
- Bargaining
- Depression
- Acceptance
Pattison living dying theory - ANSWER begins when person learns they are dying and end at the actual time of death
corr death and dying - ANSWER created task based model of death and dying. focused on how people cope with dying by completing physical, psychosocial, social, and spiritual tasks
Doka phases of death and dying - ANSWER phase based model in response to death and dying. prediagnostic, acute, chronic, terminal, and recovery phases of life threatening illnesses.
Leadership Styles - ANSWER authoritarian, democratic, laissez-faire, transformational, servant
Leadership Styles: Democratic - ANSWER The managers encourages employee participation in decisions, works with them to determine what to do, and doesn't supervise them closely- Theory Y behavior
Leadership Styles: Laissez-faire - ANSWER There is no focus in this type of leadership. Goals are undefined, and members do as they please. Productivity and morale are low.
Negligence - ANSWER careless neglect, often resulting in injury
Malpractice (professional negligence) - ANSWER Failure of a person with professional training to act in a reasonable and prudent manner. requires proof of duty, breach of duty, and damages/harm.
influence decision making regarding health behavior: perceived susceptibility to a health threat, perceived severity of the disease or condition, and perceived benefits of and barriers to the behavior
Kurt Lewin's Change Model-ANSWER 1. Unfreezing: create awareness of need for change
- Changing: implement change
- Refreezing: reinforce, stabilize, solidify
healthy people 2020 ANSWER 1. Identify nationwide health improvement priorities.
- Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress.
- Provide measurable objectives and goals that are applicable at the national, State, and local levels.
- Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge.
- Identify crucial research, evaluation, and data collection needs.
NIC/NOC - ANS-Nursing Interventions Classification and Nursing Outcomes Classification -standardized language for nursing treatments for practice and research -Developed at U Iowa
compartment syndrome -ANS swelling within the enclosed space created by fascia that separates groups of muscles involves compression of nerves and blood vessels
post op care - ANSWER initial postoperative care focuses on close monitoring and early detection of cardiopulmonary complications, thrombus formation, anastomosis leaks, and electrolyte imbalances
During transfer, the patient's airway must be positioned in a neutral location and pain
must be managed so it remains at a tolerable level
Elevate the patient's head to a 35- to 40-degree angle to minimize abdominal pressure and optimize tidal flow
body stores anesthetics in adipose tissue, making the patient with excess adipose tissue are at risk for resedation
be prepared to perform a head-tilt or jaw-thrust maneuver and keep the patient's oral and nasal airways opened
Orem's Theory - ANSWER known as self-care deficit theory which focuses on the patient's self care needs
Orem's Self-Care Model - ANSWER -universal self care requisites
- maintenance of sufficient intake of air
- maintenance of sufficient intake of water
- maintenance of sufficient intake of food
- provision of care associated with elimination processes & excrement
- maintenance of balance between activity & rest
- maintenance of balance between being alone & social interaction
- prevention of hazards to human life, human functioning, & human well being
- promotion of human functioning & development within social groups
Digoxin (Lanoxin) - ANSWER cardiac stimulant and diuretic
Digoxin toxicity - ANSWER GI effects (anorexia, n/v, abdominal pain), CNS effects-fatigue, weakness, diplopia, blurred vision, yellow-green or white halos around objects
high: >60mg/dL
LDL cholesterol levels - ANSWER -optimal: less than 100mg/dl -near optimal: 100-129 mg/dl -borderline high: 130-159 mg/dl -high: 160+ mg/dl
Calcium levels - ANSWER 8.5-10.5 mg/dL
Phosphorus levels - ANSWER 2.5-4.5 mg/dL
Urine Specific Gravity - ANSWER 1.010-1.
INR - ANSWER 0.8-1.
Tegretol level - ANSWER 4-
Lithium level - ANSWER 0.6-1.2 over 1.5 is toxic
Phenobarbital level - ANSWER 10-40 mcg/mL
valproic acid levels - ANSWER 50-100 mcg/mL
Theophylline level - ANSWER 10-20 mcg/mL
Root Cause Analysis - ANSWER Type of analysis that starts with a result and then works backward to identify fundamental cause.
quantum leadership - ANSWER States that leaders need to work with subordinates to determine mutual goals, take advantage of opportunities, and shift responsibility for decisions on staff for organizational output to occur
change agent - ANSWER consultant who has a behavioral science background who may act as a catalyst in helping organizations cope with old problems in new ways
Delegation - ANSWER
OBRA - ANSWER Omnibus Budget Reconciliation Act
Omnibus Budget Reconciliation Act - ANSWER A federal law that extends the minimum COBRA continuation of group health care coverage from 18 to 29 months for qualified beneficiaries who are disabled at the time of qualification.
Institute of Medicine (IOM) - ANSWER Non-governmental, independent, and nonprofit organization that provides unbiased, expert advice to governmental and private decision-makers, as well as the public.
Crisis Safety Plan - ANSWER What it is: The plan of action devised to be initiated at the time a person feels or acts "in crisis" whether that crisis be an escalation of a mental condition or an escalation of suicide intent, substance abuse, or domestic violence. Nursing Application: Planning a plan should occur when no crisis is occurring and the patients/ families can contribute to developing. Safety plans that have clear steps for the patient to follow in an impending crisis. The steps should include using the patient's current non-destructive coping mechanisms in order to enhance self-efficacy. Steps may include 1) evaluating the warning signs, 2) utilizing internal coping strategies, 3) using external coping strategies-people and places that provide diversion, 4) calling people for help, 5) calling professionals/agencies for help, and 6) creating a safe environment.
distributive shock - ANSWER Low BP includes Septic (severe infection), Neurogenic (damage to the spinal cord), Anaphylactic (reaction to substance), Psychogenic (feinting)
Signs of cardiogenic shock - ANSWER -elevated pulse rate -rapid and shallow breathing -naseau and vomiting -decrease in temp -Low bp is late finding that indicates decompensated shock
Treatment of cardiogenic shock - ANSWER Identify cause; pressors (e.g., dopamine).
hypovolemic shock - ANSWER most common type of shock pallor, cool, moist skin, rapid breathing, cyanosis of lips, gums and tongue, rapid, weak, thready pulse, hypotension, concentrated urine
signs of distributive shock - ANSWER abdominal pain, n/v, feelings of impeding doom, flushing, pruritus and urticaria, hoarseness, inspiratory stridor, wheezing.
hypertonic solution - ANSWER Solute concentration is greater than that inside the cell; cell loses water. 1.D5NS
- 3%NaCl
- D10 in water. Treat severe hyponatremia, hypoglycemia hypotonic solution - ANSWER Solute concentration is less than that inside the cell; cell gains water
- 0.45 NS expand intracellular compartment. Replace free water. Replace sodium and chloride isotonic solution - ANSWER a solution whose solute concentration is equal to the solute
concentration inside a cell
- NS
- LR
- D5W increase extracellular fluid, maintain volume, treat hypovolemia, replace Na, and Chloride.
Hypocalcemia S/S - ANSWER Diarrhea, Numbness, Tingling of extremities and around mouth, Convulsions, Positive Chvostek sign, Positive Trousseau sign, *Pt at risk for tetany.
Hypercalcemia S/S - ANSWER Muscle weakness, Constipation, Anorexia, N/V, Polyuria, Polydipsia, Neurosis, Dysrhythmias,
Hypokalemia S&S - ANSWER S&S Include: Tachydysrhythmias, Orthostatic Hypotension, Lethargy/Fatigue, decreased bowel sounds, constipation, Anorexia, Muscle weakness, U Wave on EKG. cushings syndrome
Hyperkalemia S&S - ANSWER M.U.R.D.E.R. M - Muscle weakness U - Urine, oliguria, anuria R- Respiratory distress D - Decreased cardiac contractility E - ECG changes R - Reflexes, hyperreflexia, or areflexia (flaccid)
metabolic acidosis - ANSWER fruity breath, kussmaul's respirations, warm flushed skin. administer sodium bicarb if necessary
metabolic alkalosis - ANSWER high pH, high HCO3. picking at bed clothes, decreased
BMI values - ANSWER >18.5 -- underweight 18.5-24.9 -- normal 25-29.9 -- overweight 30-34.9 -- obesity class 1 35-39.9 -- obesity class 2
40 -- obesity class 3
Aortic area auscultation - ANSWER 2nd intercostal space, right sternal border
Pulmonic area auscultation - ANS 2nd intercostal space, left sternal border
Erb's point - ANS 3rd intercostal space, left sternal border
Tricuspid area of auscultation - ANS 5th intercostal space, left sternal border
Mitral area auscultation - ANS 5 ICS midclavicular line
First degree AV block treatment - ANS atropine if severe bradycardia. digoxin cautiously, correction of underlying cause.
2nd degree av I wenckebach block treatment - ANSWER atropine if symptomatic, discontinue digoxin, temp pacing if ventricular rate is slow
2nd degree av block type II - ANSWER Mobitz. PR interval constant with QRS complexes dropped. treat with temp pacemaker, sometimes followed by permanent, digoxin discontinued, atropine, dopamine, epinephrine for symptomatic bradycardia
3rd degree av block- ANSWER no relationship between P waves and QRS complexes.
usually requires TCP, followed by permanent pacemaker. dopamine and epinephrine to maintain blood pressures. atropine for symptomatic bradycardia, CPR until pain initiated.
PVC (Premature Ventricular Contraction) - ANSWER most ominous when clustered. if stable no treatment. if warranted: lidocaine, amiodarone, procainamide IV. can be induced by hypoK, hypoMg.
ventricular tachycardia - ANSWER if pulse absent: CPR. ACLS epi/vasopressin followed by amiodarone, lidocaine, magnesium, or procainamide. if pulse present: Blockers, lidocaine, amiodarone, procainamide, or sotalol. drugs unsuccessful: cardioversion
Buerger's disease (thromboangiitis obliterans) - ANSWER inflammation of the peripheral arteries and veins of the extremities with clot formation. stop smoking. avoid cold to reduce constriction, protect extremities, participate in progressive exercise.
Endocarditis S/S - ANSWER history of recent infection/surgery/IV abuse. Fever, chills, anorexia, weight loss Possibly new onset of murmurs Splinter nail hemorrhages, Petechiae on skin or mucous membranes (tender red nodules).
**- Janeway;s lesions (palms and soles of feet)
- Osler's nodes on fingers and toes** o Systemic emboli (pulmonary and brain)
Raynaud's disease - ANSWER a peripheral arterial occlusive disease in which intermittent attacks are triggered by cold or stress. women b/w puberty and age 40. white, blue, red
Therapeutic PTT for Heparin - ANSWER 1.5-2.5x normal (times 16-40 seconds). Over
Hodgkin's lymphoma
polycythemia vera-ANSWER condition characterized by too many erythrocytes; blood becomes too thick to flow easily through blood vessels. median age onset age 65. medial survival 10-15 years. ruddy complexion.
thrombocytopenia s/s- ANSWER petechiae bleeding mucous membranes generalized malaise, fatigue, generalized weakness large blood-filled blisters in the mouth
. if ITP (production of antibody): treatment steroids
Egalitarian theory- ANSWER demands equal distribution of equal resources
trajectory nursing model- ANSWER Step 1: Identification of the trajectory phase 1Step 2: The problems are identified and the goals are established Step 3: A plan to meet the goals is established Step 4: Factors facilitating or hindering the attainment of the goals are identified Step 5: Implement interventions Step 6: Evaluating the effectiveness of the interventions
Ace inhibitors - ANSWER "PRIL" vastotec, lotensin, capoten, prinivil, zestril. Antihypertensive. relaxes arteries. promotes excretion of salt, water. used in: CHF, HTN, decreases risk of CVA/MI Decrease cardiac workload. decrease Chest pain. notify MD if taking diuretics prior to lisinopril. do not take with food. SE: cough, postural hypotension, fatigue, n/v/d, insomnia, headache. RETAINS
potassium. ANGIOEDEMA
Alpha blockers - ANSWER Vasodilate by blocking smaller blood vessels cells from receiving vasoconstriction signals from norepinephrine. ZOSIN> doxazosin, terazosin, tamsulosin, prazosin. Treats: HTN, BPH, Reynauds, adrenal gland tumors (pheochromocytoma) SE: drowsy, nasal congestion, weight gain/edema, orthostatic hypotension (take at bedtime), sodium (may low Na diet)and water retention. not usually first line treatment if BP still controlled may add diuretic
Angiotensin Receptor Blockers (ARBs) ANSWER block angiotensin so that it fails to constrict the blood vessel. easier for heart to pump blood treats: CHF, HTN, kidney failure in diabetes, CKD, scleroderma. SE: Ha, dizzy, lightheaded, nasal congestion, v/d, back/leg pain, hyperK, angioedema. cough. Outcomes: prevent diabetic neuropathy, decrease sodium/potassium retention, decrease cardiac workload. used in those unable to ACE CAT D pregnancy. fetal demise. r/f hypotension r/t increased sweat, vomiting, diarrhea. increase fluid intake. SARTAN> cozaar, Benicar, diovan, Avapro.
antianginals - ANSWER NITRATE. relax smooth muscle--> vasodilator effect on peripheral veins/arteries= decreased cardiac workload/oxygen demand on heart r/t decreased venous return r/t peripheral vasodilation. treats: angina. period BP SE: HA, blurred vision, dry mouth, postural hypotension, syncope, reflex tachycardia. avoid alcohol. REMOVE nitro patch prior to defibrillation/cardioversion. Cardilte, imdur, isobid, isordil, sorbitrate.
LEUKOPENIA
pruritus (body itching)
MUST GIVE WITH FOODS (GI upset) OR MILK
ORAL HYGIENE
Antibiotics to avoid in pregnancy - ANSWER SAFE Moms Take Really Good Care: Sulfonamides Aminoglycosides Fluoroquinolones Erythromycin Metronidazole Tetracyclines Ribavirin Griseofulvin Chloramphenicol
antibiotics - ANSWER florquinolones- floxacin. contraindicated in epilepsy, QT prolonged, CNS lesions, or CVA. Cephlasporins: cef, ceph watch for nephrotoxicity, ototoxicity avoid milk, antacids: decrease absorption.
BUN: 10- Cr 0.8-1.
Anticoagulants - ANSWER Delay or block clotting of blood. outcome: prolonged PT labs: PT, aPTT, INR. can decrease effects birth control. not recommended pregnant, BF Heparin antidote: protamine sulfate Warfarin antidote: vitamin K PT: 10- PTT: 25- INR-2- PARIN- enoxaparin, heparin
Antidepressants - ANSWER Uses: depression, enuresis in children, bulimia, OCD. SE: HA, nausea, restless, photosensitivity, anticholinergic, SSRI/MAOI; insomnia. tricyclic; sedation.
SSRI: Paxil, Luvox, Effexor, Zoloft MAOI: marplna, Nardil, parnate. watch HTN crisis with mix. Avoid Tyramine. Tricyclic: elavil, sinequan, Wellbutrin,zyban, tyline, PRAMINE. imipramine (tofranil) used for enuria. n/c prior to surgery anesthetics.
antihistamines - ANSWER inhibit allergic reactions of inflammation, redness, and itching caused by the release of histamine. otitis media, nasal congestions, motion sickness, uticaria. can have paradoxical reaction in kids.
SE: urine retention, constipations, hypotension, blurred vision, dry mouth, GI irritation.
