Final Exam: NUR2349/ NUR 2349 (New 2022/ 2023) Professional Nursing I / PN I Exam Review | Complete Guide with Verified Solutions |100% Correct| Rasmussen
Final Exam: NUR2349/ NUR 2349 (New
2022/ 2023) Professional Nursing I / PN I
Exam Review | Complete Guide with Verified
Solutions |100% Correct| Rasmussen
QUESTION
Adjuvants
Answer:
SSRIs
Anti-epileptic drugs (AEDs)
Muscle relaxants/antispasmotic drugs
Alpha-2 adrenergics
Local anesthetics/analgesics
NMDA antagonists
Cannabinoids (cannabis extracts)
QUESTION
Invasive techniques for chronic pain
Answer:
Used when drugs/other methods ineffective
-Nerve blocks (temporary/permanent)
-Spinal cord stimulation
QUESTION
Inflammation
Answer:
An immunologic defense against tissue injury, infection, or allergy.
QUESTION
Steps in an acute inflammatory response
Answer:
Tissue injury and the release of chemical mediators
Vasodilation and increased blood flow
Swelling and retraction of activated endothelial cells
Increased vascular permeability and leakage of small plasma proteins
“Walling off”
Movement of immune response cells to the site of injury
Exudate formation
Movement of glucose and oxygen to the site needing repair
Release of chemical repair factors from activated endothelial cells
QUESTION
R.I.C.E.
Answer:
Rest, ice, compression, elevation (RICE)
-Most helpful after sprain, strain, or trauma
-Helps minimize swelling
-Most beneficial for the first 24 to 48 hours after injury
QUESTION
Thermoregulation
Answer:
The process of maintaining the core body temperature at a nearly constant value
QUESTION
Normothermia
Answer:
The normal body temperature, ranges between 97.7° F (36.5° C) and 98.9° F (37.2° C)
QUESTION
Hypothermia
Answer:
Body temperature less than 97.1° F (36.2° C)
QUESTION
Hyperthermia
Answer:
Body temperature above 99.9° F (37.6° C)
QUESTION
Hyperpyrexia
Answer:
An extremely high body temperature, above 104° F (40° C)
QUESTION
Fever
Answer:
Elevation in body temperature due to a change in the hypothetical set point
QUESTION
Nursing skills for thermoregulation
Answer:
External warming devices
-Warm blankets
-Administer warm oral fluids
Active core warming
-Warm intravenous fluids
-Heated humidified oxygen
-Warm fluid lavage
Cooling measures
-Cool water bath
-Cool intravenous fluids
-Cool fluid lavage
-Cooling blankets
QUESTION
Intervention strategies for hyperthermia
Answer:
Remove excess clothing and blankets
Provide external cool packs
Provide a cooling blanket
Hydrate with cool fluids (oral or intravenous)
Lavage with cool fluids
Administer antipyretic drug therapy
QUESTION
Intervention strategies for hypothermia
Answer:
Remove the person from cold
Provide external warming measures
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immunity
The normal physiological response to microorganisms and proteins as well as conditions associated with an inadequate or excessive immune response
primary immunodeficiency
A situation in which The entire immune defense system is inadequate and the individual is missing some, if not all, of the components necessary for a complete immune response
10 warning signs of a primary immunodeficiency
- Four or more ear infections in 1 year
- Two or more serious sinus infections in 1 year
- Two or more months of taking antibiotics with little effect
- Two or more pneumonias within 1 year
5.failure of an infant to gain weight or grow normally - Recurrent deep skin or organ abscesses
7.persistent thrush in mouth or fungal infection on skin
8.need for Iv antibiotics to clear infections
9.two or more deep-seated infections including septicemia - A family history of primary immunodeficiency
Secondary immunodeficiency
A loss of immune functioning (in a person with previously normal immune function) as a result of an illness or treatment.
Intentional depressed immune system
-to avoid rejection of transplanted tissue
-result of treatment for various cancers
Type 1 hypersensitivity
•IgE-mediated reaction
•seasonal allergic rhinitis
•mast cells involved
Type 2 hypersensitivity
•IgG or IgM
•tissue specific reaction
•macrophages involved
•autoimmune thrombocytopenic purpura, Graves’ disease, autoimmune hemolytic anemia
Type 3 hypersensitivity
•immune complex mediated reaction
•IgG or IgM
•neutrophils
•systemic lupus erythematosus
Type 4 hypersensitivity
•cell mediated reaction
•no antibodies
•lymphocytes and macrophages
•contact sensitivity to poison ivy and metals (jewelry)
Signs and symptoms of inflammatory response
•Swelling
•pain
•heat
•redness
•exudate
Collaborative/tertiary nursing interventions for inflammation
•rest, ice, compression, elevation (RICE)
•immobilization
•pharm: steroids, NSAIDs, recombinant DNA and monoclonal antibodies, antipyretics, analgesics, anti microbials
Inflammation
an immunologic defense against tissue injury, infection, or allergy
Infection
The invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response
Diagnostics for infection
Labs:
•CBC with a WBC differential
•culture and sensitivity
•C-reactive protein
•ESR
Collaborative/tertiary interventions for infections
•antimicrobial- antibiotics, antivirals, antifungals
•nutrition and fluids
Tissue integrity
the state of structurally intact and physiologically functioning epithelial tissues such as the integument (including the skin and subcutaneous tissue) and mucous membranes.
Tissue integrity screening (ABCDE of melanoma)
A: asymmetry (shape of one half doesn’t math the other)
B:border (border is irregular)
C: color (uneven color)
D: diameter (larger than 6mm; 1/4in)
E: evolving (mole has changed)
Stage 1 pressure ulcer
intact skin with nonblanchable redness
stage 2 pressure ulcer
partial thickness skin loss with exposed dermis
stage 3 pressure ulcer
full thickness tissue loss with visible fat
stage 4 pressure ulcer
Full-thickness tissue loss with exposed bone, muscle, or tendon
unstageable pressure ulcer
Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed.
deep tissue pressure injury
persistent non-blanchable deep red, maroon, or purple discoloration, skin is usually intact
elimination
Removal, clearance, or separation of matter; excretion of waste
Continence
The purposeful control of urinary or fecal elimination
anuria
absence of urine
Dysuria
painful urination
Polyuria
Multiple episodes of urination
urinary frequency
multiple episodes of urination with little urine produced in a short period of time
urinary hesitancy
The urge to urinate exists, but the person has difficulty starting the urine stream
Risks of urinary incontinence
Depression, anxiety, cognitive impairment, acute injury, surgical procedures
stress incontinence
Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising)
urge incontinence
Leakage of large amounts of urine at unexpected times, including during sleep
overactive bladder
Urinary frequency and urgency, with or without urge incontinence
functional incontinence
Untimely urination because of physical disability, external obstacles, or cognitive problems that prevent person from reaching toilet
overflow incontinence
Unexpected leakage of small amounts of urine because of full bladder
mixed incontinence
Usually occurrence of stress and urge incontinence together
transient incontinence
Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing)
Elimination Assessment
Inspect: abdomen for contour and distention
Auscultate:bowel sounds
Palpate: abdomen should be soft and non-tender
Collaborative/tertiary interventions for elimination
Pharm
Incontinence management: regular toileting schedule, manage fluid intake, modify environment, avoid in dwelling catheters, good skin care, avoid meds that contribute to incontinence
Surgery and invasive procedures
Braden Scale for Predicting Pressure Sore Risk
sensory perception
moisture
activity
mobility
nutrition
friction and shear
3 domains of learning
- Cognitive:increasing knowledge (self directed learning modules)
- Affective:changing or influencing attitudes (diagnosis; related support groups)
- Psychomotor:develop or improve a skill (demo and practice)
USPSTF recommendations
A-strongly recommends
B-recommends
C-no recommendations for or against
D-recommends against
I-insufficient evidence to recommend for or against
primary prevention
—>strategies aimed at optimizing health and disease prevention
•focuses on health education for optimal nutrition, exercise, immunizations, safe environment, hygiene and sanitation, avoiding harmful substances, protection from accidents
secondary prevention
—> to identify individuals in an early state of a disease process so that prompt treatment can be initiated
•screening
tertiary prevention (collaborative)
—>Minimizing the effects of disease and disability; restorative
•interventions
formal teaching
planned teaching based on learner objectives
informal teaching
unplanned teaching sessions dealing with the patient’s immediate learning needs and concerns
barriers to pt education
Cultural differences
Lack of financial resources or time
Frequent interruptions
Pt condition
Competing priorities
Pt is hungry
Pt unwilling to learn
Pt angry
Factors affecting pt education
Motivation/willingness to learn
Ability to learn
Resources
chain of infection
infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host