Rasmussen NUR 2356 / NUR2356 Exam: Multidimensional Care I / MDC 1 Exam 1 Blueprint Revised | Graded A- Latest 2023/2024

Rasmussen NUR 2356 / NUR2356 Exam: Multidimensional Care I / MDC 1 Exam 1 Blueprint Revised | Graded A- Latest 2023/2024 NUR2356 Multi I – Examination Blue Print – Exam 1 Maslow’s Hierarchy of Needs • Stages & examples: o Physiological needs: food, water,sleep (oxygen isthe most essential) o Safety: Shelter,security o Love/Belonging: Intimate relationships, family, friends o Esteem: Feelings of accomplishment o Self-actualization: Achieving one’sfull potential • Understand the basic physiologic needs & know this is the first that you attend to: Basic physiological needs are air, food, water, temperature regulation, elimination, rest,sex, physical activity, and blood flow. ABCs are airway, breathing, and circulation. Oxygen needs to be attended to first. • Understand how patients can go through the stages and the order of stages: You cannot skip stepsin this model. • Be able to choose which patient has a more urgent need and which patient would need to be seen first. ABCs. Oxygen. Brain, heart, lungs. Tissue Integrity & Mobility o Know which patients are at risk for impaired tissue integrity & immobility: the elderly. Risk Factors: o Older adults o Dysfunction of the musculoskeletal or nervous system are most at risk for decreased mobility or immobility. o Stroke, fractures,severe brain injury,spinal cord injury Symptoms: o Pressure injuries (pressure on skin over bony prominences) o Disuse osteoporosis (increased bone resorption) o Constipation (decreased gastrointestinal [GI] motility) o Weight loss or gain (decreased appetite and movement) o Muscle atrophy (catabolism) o Atelectasis/hypostatic pneumonia (decreased lung expansion) o Venousthromboembolism (e.g., deep venous thrombosis and pulmonary embolus [decreased blood circulation]) o Urinary system calculi (stones) (urinary stasis) • Identify interventions to prevent skin breakdown & muscle atrophy: o Monitor labs (albumin & pre-albumin determine malnutrition) o Ensure proper intake of proteins (Proteins=Building Blocks) o Promote proper hygiene keeping the skin dry and clean. o Inspectskin daily o Use moisturizers o Encourage repositions every 1 to 2 hrs., especially for chair or bed bound patients o Apply pressure redistribution surfaces(mattresses, overlay, or gel pads) o Use an EB screening tools (Braden Scale, Norton, etc.) o Involved the patient and family in the education and care Muscle Atrophy: o Monitor labs (albumin & pre-albumin determine malnutrition) o Ensure proper intake of proteins (Proteins=Building Blocks) o Promote proper hygiene keeping the skin dry and clean. o Inspectskin daily o Use moisturizers o Encourage repositions every 1 to 2 hrs., especially for chair or bed bound patients o Apply pressure redistribution surfaces(mattresses, overlay, or gel pads) lOMoARcPSD| o Use an EB screening tools (Braden Scale, Norton, etc.) o Involved the patient and family in the education and care • Understand consequences of impaired tissue integrity & immobility: Immobility: o Pressure injuries (pressure on skin over bony prominences) o Disuse osteoporosis (increased bone resorption) o Constipation (decreased gastrointestinal [GI] motility) o Weight loss or gain (decreased appetite and movement) o Muscle atrophy (catabolism) o Atelectasis/hypostatic pneumonia (decreased lung expansion) o Venousthromboembolism (e.g., deep venous thrombosis and pulmonary embolus [decreased blood circulation]) o Urinary system calculi (stones) (urinary stasis) o Depression (isolation, inability to provide self-care) o Changesin sleep-wake cycle (especially if confined to bed) o Sensory deprivation (especially if confined to bed) Tissue Integrity: o fluid loss o hypothermia o infection o pain o body image disturbances • Think of all of the systems in the body affected by immobility o The muscles, joints and bones are adversely affected by immobility. The boneslose calcium as a result of the lack of weight bearing activity and this can lead to disuse osteoporosis, hypercalcemia, and fractures Pain • Differentiate between acute pain vs. chronic pain: Acute occurssuddenly, chronic lasts six months or longer • Recognize the different types of pain with examples of each: o Cutaneous pain: Arises from burning your skin like on a hot iron or from touching a hot pan on the stove. o Visceral pain: Caused from deep internal disorders such as menstrual cramps, labor pains, or gastrointestinal infections. (organs) o Deep Somatic pain: Originates from the ligaments, tendons, nerves, blood vessels and bones. Examples would be fractures or sprains. o Radiating pain: Starts at an origin but extends to other locations. Example: pain from a sore throat might extend to ears and head. o Referred pain: Occurs in an area distant from the site of origin. Example: pain from a heart attack might be felt in the left arm or jaw. o Phantom pain: Pain that is perceived from an area that has been surgically or traumatically removed. Example: pain from an amputated limb. o Neuropathic pain: Results from an injury of one or more nerves. o Acute pain: Short duration (< 6 months), rapid onset, and associated with some kind of injury. o Chronic pain: Last 6 months or longer and interferes with activities of daily living. • Pain assessment components(PQRSTU): provocative/ palliative, quality and quantity, region and radiation, severity and scale, timing and type of onset • Identify S&S of pain – physiologic and nonverbal: Grimacing, guarding, verbalization, and holding or touching the affected area. Descriptive words might include mild, sharp, dull, aching, constant, and intermittent. • Know pharmacologic & non-pharmacologic interventions: Non-pharmacologic interventions: o RICE (Rest, ice, compress, elevate) o Meditation lOMoARcPSD| o Relaxation techniques o Cutaneous stimulation (hot/cold packs, repositioning, massage, acupuncture) Pharmacologic Interventions: o NSAIDs o Opioids o Acetaminophen • Know opioid adverse effects and when to assess for medication effectiveness:sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression.