MDC Final Exam Complete Questions with 100% Correct Answers

MDC Final Exam Complete Questions with 100% Correct Answers myopia nearsightedness _______ occurs when the eye overbends the light and images converge in front of the retina. Near vision is normal, but distance vision is poor. It is corrected with a concave lens in eyeglasses or contact lenses. o Age (Older adult/young children) o Wound/Break in first line of defense (break in skin/skin breakdown, insect bite, insertion of IV-creates a portal of entry) o Illness or Injury o Tobacco Use (chemicals paralyze cilia) o Substance Abuse (alcohol diminishes hunger, paralyzes cells in intestines) o Multiple Sex partners (STI, cervical CA) o Environmental Factors (work situation, living situation) o Chronic Disease (hypertension, DM,...think poor circulation) o Medications (immunosuppressants, NSAIDs, chemo, antibiotics) o Invasive Nursing and Medical Procedures (urinary cath/IV line ) o Impaired immune system*** Risk factors for infection Culture - how does it affect healthcare? preferences, healthcare views, how they view illness and disease, pain, death rituals, patient education, alternative therapies *identifying that culture and heritage can be passed down through generations, it will often impact their interactions with healthcare - the totality of socially transmitted behavior patterns, arts, beliefs, values, customs, lifeways, and all other products of human work and thought characteristics of a population of people that guides their worldview and decision making - can be taught - complete a fall-risk assessment at admission & regular intervals - ensure patient has and knows how to use the call light - use fall-risk alerts (color-coded wristbands) - provide regular toileting and orientation of clients who have cognitive impairment - provide adequate lighting - place clients at risk for falls near a nurses station - provide hourly rounding - make sure personal items are within reach - keep bed low, lock the breaks - side rails up (for unconscious patients, sedated, etc.) - non-skid footwear - use gait belts and other assistive equipment when moving patients - keep floor clean (no clutter, cords, scatter rugs, etc.) - electronic safety monitors (chair or bed sensors) List the fall preventions History of falls Polypharmacy BP meds Sedatives (drowsiness) Opioids Immobility Urinary frequency Hypotension Confusion ("cognitive dysfunction") - can't follow directions What are some factors that put a patient at a high risk for falls? - decreased strength - impaired mobility and balance - improper use of mobility aids* - unsafe clothing* - environmental hazards - endurance limitations - decreased sensory perception Why are older adults at an increased risk for falls? - keep firearms unloaded, locked up, and out of reach - teach to never touch a gun or stay at a friend's house where a gun is accessible - store bullets in a different location from guns Home Safety: Preschoolers and School Age Children - Firearms - teach child about the hazards of alcohol, cigarettes, and prescription, non-prescription, and illicit drugs - keep potentially dangerous substances out of reach Home Safety: Preschoolers and School Age Children - Poison - use booster seats for children under 4'9" tall and weigh less than 40 lb - use seatbelt properly after booster seat - teach child safety rules of the road Home Safety: Preschoolers and School Age Children - Motor Vehicles - be sure child has learned to swim and knows rules of water safety - have the child wear a life jacket when near water. Implement a buddy system for the school-aged child - place locked fences around home and neighborhood pools - provide supervision near pools or water Home Safety: Preschoolers and School Age Children - Drowning - remove items that could cause the client to trip (throw rugs and loose carpets) - place electrical cords and extension cords against a wall behind furniture - monitor gait and balance, and provide aids as needed - make sure that steps and sidewalks are in good repair - place grab bars near the toilet and in the tub or shower, and install a stool riser - use a nonskid mat in the tub or shower - place a shower chair in the shower and provide a bedside commode if needed - ensure that lighting is adequate inside and outside the home and remove clutter - usually personnel can do a home safety check List the fall preventions at home - keep emergency numbers near the phone for prompt use in the event of an emergency of any type - ensure that the number and placement of fire extinguishers and smoke alarms are adequate, that they are functional, and that family members understand how to operate them. Set a time to routinely change batteries in smoke alarms - have a family exit plan for fires that is reviewed and practiced regularly. Be sure to include closing windows and doors if able and to exit a smoke-filled area by covering the mouth and nose with a damp cloth and getting down as close to the floor as possible - "stop, drop, and roll" Fire Safety: Elements of a Home Safety Plan · use and store oxygen equipment according to the manufacturer's recommendations · place a "no smoking" sign in a conspicuous place near the front door of the home and client's bedroom · inform the client and family of the danger of smoking in the presence of oxygen. Family members and visitors who smoke should do so outside the home · ensure that electrical equipment is in good repair and well grounded · replace bedding that can generate static electricity (wool, nylon, synthetics) with items made from cotton · keep flammable materials (heating oil and nail polish remover) away from the client when oxygen is in use · follow general measures for fire safety in the home (having a fire extinguisher readily available and an established exit route if a fire occurs Oxygen safety measures every 6 months How often should smoke detectors have their batteries checked? bathe clients to cleanse the body, stimulate circulation, provide relaxation, and enhance healing infection prevention strategy = regular bathing...it maintains intact skin (our primary host defense) Why do we bathe clients? o inspect daily o use lukewarm water, and dry feet thoroughly o apply moisturizer o avoid over-the-counter meds with alcohol or other strong chemicals o clean socks o check shoes for objects, rough seams, or edges o cut nails straight across o avoid self-treating corns or calluses o do not apply heat Foot Care - drug interactions - allergies - vital signs - know RR and oxygenation status, their effort of breathing (are they breathing shallow? often?) - side effects Before administering pain medication, what do you need to assess? - low BP - low HR - sedation - respiratory depression - orthostatic hypotension - urinary retention - nausea/vomiting - constipation Common side effects of pain medication - reevaluate pain level - if given orally, follow up q 1 hour - if given IV, follow up q 15 min - check vital signs! Follow-up of pain medication - varies among people of different cultures - some persons tend to be past- present- or future- oriented - Groups from the Far East tend to be past-oriented and value traditions and relationships over time and deadlines. - In contrast, European Americans tend to be future-oriented, and Latin Americans and Filipinos are more present-oriented and enjoy living in the moment. - Differences in time orientation can be important as you plan nursing interventions. For example, clients who are past-oriented may show up late (or not at all) for follow-up appointments; therefore, you should provide a written or telephone reminder of their appointment. Time orientation - Health status - Quality of care - Access to care - recognize that your patients in poorer communities might not have access to healthcare, and if they DO it might not be as good of a quality. There is a well known statistical disparity in infant death rates Health disparity o Silence o Presenting reality o Active listening o Asking questions o Open-ended questions o Clarifying techniques § Restating § Reflecting § Paraphrasing § Exploring o Offering general leads, broad opening statements o Showing acceptance and recognition o Focusing o Giving information o Summarizing o Offering self o Touch o Sharing Feelings Therapeutic Communication - Asking irrelevant personal questions - Offering personal opinions - Stereotyping - Giving advice - Giving false reassurance - Minimizing feelings - Changing the topic - Asking "why" questions or asking for explanations - Challenging - Offering value judgments - Asking questions excessively (probing)