NUR2020 - FINAL EXAM (All
comps, all lab quizzes) STUDY
SET
Definition of a chronic condition - Answer Illness or impairment that is permanent,
leaves residual disability, nonreversible, and requires a long period of
supervision/observation/care
Major characteristics of a chronic condition - Answer - intermittent with flare ups or
continuous is some cases
- may be cancer or of a noncancer origin
- can persist througout life
- features regardless of condition: pain, fatigue, sleep disturbances, difficulty adjusting,
uncertainty
- can be controlled but not cured
Impact of chronic illness on healthcare - Answer - Leading cause of death & disability in
US is chronic conditions
- Chronic diseases/conditions are the most common, preventable, & expensive of all
health problems (heart disease, stroke, cancer, diabetes, obesity, arthritis)
- 86% of all health care spending is related to chronic disease
- Risks for polypharmacy, adverse medication effects, conflicting medication advice
- Cost of care increases with number of conditions
Preventable causes of chronic conditions - Answer Obesity, lack of exercise, poor
nutrition, tobacco use, excessive alcohol use
illness-wellness continuum - Answer a model that illustrates the full range of health
between the extremes of illness and wellness
Both chronic and acute conditions can vary on this continuum - people with chronic can
also develop acute (such as an asthmatic having an asthma attack) - NOT ALL CHRONIC
CONDITIONS RESULT IN DISABILITY and not all disabilities are from chronic conditions
What is primary prevention? - Answer measures to decrease the incidence of disease
,Examples: Vaccines, teaching SCI injury/head injury prevention - don't drink and drive,
wear helmets, fall prevention, protective devices when playing spurts
What is secondary prevention? - Answer treating or controlling a disease or condition
after it occurs
Examples: Screening to detect early stage cancer
What is tertiary prevention? - Answer REHABILITATION and monitoring of health to
prevent complications or further illness, injury, or disability
Keep things from getting worse, preventing complications and further damage
Examples: support groups, insulin management
How does tertiary prevention correlate with goals of rehab? - Answer Tertiary
prevention is the management of long-term disease, injurt, or illness - focuses on
controlling CHRONIC effects of a health issue that has already occured & restoring that
individual back to optimal function, teaching self-care
Rehababilition means to "make able again" - learning or relearning skills and abilities
and adjsuting to existing function to reach max potential - goal oriented process for
people with disability or chronic conditions
REHAB = TERTIARY PREVENTION
What is self-efficacy? - Answer Individual's belief that they have the capacity to do what
they need to do to reach specific goals
Nursing interventions for rehabilitation - Answer - Assessing patient's functional ability:
ability to perform ADLs (eating, toileting, dressing, transferring, and personal hygiene)
AND instrumental activities of daily level/IADLs (grocery shopping, meal prep, financial
mgmt., medication mgmt, transportation)
- Recommend adaptive & assistive devices
- Provide optimal learning environment
- Assist with correct positioning to prevent musculosketal complications
- Perform ROM exercises
- Assist patients with transfers
What does a certified registered rehabilitation nurse (CRRN) do? - Answer Specializes in
helping people with disabilities & chronic illness attain optimal function, health, and
adapt to a new alterered lifestyle
What is a physiatrist? - Answer a physician who specializes in rehab medicine
What is a physical therapist? - Answer PT focuses on improving patient's ability to MOVE
,Teaches skills such as transfers, strength training, using assistive devices
What is an occupational therapist? - Answer OT focuses on improving patient's ability to
perform ADLs
Example - Screens, tests, recommends feedings for dysphagia
What is a speech & language pathologist? - Answer Evaluates and diagnoses speech,
language, communication, and swallowing disorders
What is the most common cause of a Spinal Cord Injury (SCI)? - Answer TRAUMA =
motor vehicle collision, fall, violence, sports injury
Complete vs. incomplete Spinal Cord Injury (SCI) - Answer Complete - the spinal cord
damage eliminates all innervation (supply of nerves) below that level of injury
INcomplete - allows for some function/movement below the level of injury - MORE
COMMON THAN COMPLETE
Primary vs. Secondary Spinal Cord Injury (SCI) - Answer - primary: immediate,
irreversible loss of sensation and motion. due to mechanical trauma
- secondary: occurs after initial injury, caused by swelling, ischemia, contusion or
movement of bone fragments: secondary is the main focus for nurses because they can
still treat this and prevent total and permanent damage
What are the four types of incomplete SCIs? - Answer Central cord syndrome (most
common), lateral cord syndrome, anterior cord syndrome, peripheral cord syndrome
What is central cord syndrome? - Answer Damage to the central part of the spinal cord
resulting in greater weakness in UEs than in LEs, variable bowel & bladder dysfunction
Common in elderly, typically from a fall with hyperextension
Most common Incomplete SCI
What is anterior cord syndrome? - Answer Worst prognosis for recovery of all the
Incomplete SCIs
Damage to anterior portion of spinal cord usually caused by hyperflexion- causes
complete lost of movement, pain and temp loss - preserves light touch sensation
What is posterior cord syndrome? - Answer Damage to posterior portion of spinal cord -
opposite of anterior cord syndrome - light touch sensations are lost, but movement,
pain, and temp sensations are kept
What is Brown-Sequard syndrome? - Answer A hemisection lesion of the cord resulting
in loss of motor control on the side of the injury and loss of sensation on the opposite
side
, Usually caused by a penetrating injury like a bullet or knife wound
What is Conus Medullaris Cord syndrome? - Answer Caused by compressive damage
from T12-L2; Variable lower extremity loss of function; flaccid anal spincter & bladder
(can't usually tell when you have to go)
What is the Glasgow Coma Scale? - Answer Initial LOC assessment - score ranges from
3 (brain dead, deep coma) to 15 (normal, fully responsive)
Eye opening response: Spontaneous (4), to voice (3), to pain (2), none
Best verbal resonse: Oriented (5), Confused (4), Inappropriate words (3),
Incomprehensible sounds (2), or none (1)
Best motor resposne: Obeys command (6), localizes pain (5), withdraws (4), flexion (3),
extension (2), none (1)
What is spinal shock? - Answer temporary neurologic syndrome, characterized by
decreased reflexes, loss of sensation, and flaccid paralysis below the level of injury,
bradycardia, BP decrease, paralytic ileus (from about day 2-7)
Lasts days to weeks
End of spinal shock: when involuntary spinal reflexes below level of injury return (may
not return with COMPLETE injuries)
Nursing care during spinal shock - Answer - Promote breathing & airway clearance
(breathing exercises, humidification, hydration) - be careful with using suction because
this can stimulate the vagus nerve and cause bradycardia/cardiac arrest
- Improve mobility - once Dr. allows, reposition patient as frequent as possible, assist
out of bed if spinal column stabilized, splints to prevent foot drop, trochanter rolls to
prevent hip joint external rotation, passive ROM exercises to prevent contractures &
comps, all lab quizzes) STUDY
SET
Definition of a chronic condition - Answer Illness or impairment that is permanent,
leaves residual disability, nonreversible, and requires a long period of
supervision/observation/care
Major characteristics of a chronic condition - Answer - intermittent with flare ups or
continuous is some cases
- may be cancer or of a noncancer origin
- can persist througout life
- features regardless of condition: pain, fatigue, sleep disturbances, difficulty adjusting,
uncertainty
- can be controlled but not cured
Impact of chronic illness on healthcare - Answer - Leading cause of death & disability in
US is chronic conditions
- Chronic diseases/conditions are the most common, preventable, & expensive of all
health problems (heart disease, stroke, cancer, diabetes, obesity, arthritis)
- 86% of all health care spending is related to chronic disease
- Risks for polypharmacy, adverse medication effects, conflicting medication advice
- Cost of care increases with number of conditions
Preventable causes of chronic conditions - Answer Obesity, lack of exercise, poor
nutrition, tobacco use, excessive alcohol use
illness-wellness continuum - Answer a model that illustrates the full range of health
between the extremes of illness and wellness
Both chronic and acute conditions can vary on this continuum - people with chronic can
also develop acute (such as an asthmatic having an asthma attack) - NOT ALL CHRONIC
CONDITIONS RESULT IN DISABILITY and not all disabilities are from chronic conditions
What is primary prevention? - Answer measures to decrease the incidence of disease
,Examples: Vaccines, teaching SCI injury/head injury prevention - don't drink and drive,
wear helmets, fall prevention, protective devices when playing spurts
What is secondary prevention? - Answer treating or controlling a disease or condition
after it occurs
Examples: Screening to detect early stage cancer
What is tertiary prevention? - Answer REHABILITATION and monitoring of health to
prevent complications or further illness, injury, or disability
Keep things from getting worse, preventing complications and further damage
Examples: support groups, insulin management
How does tertiary prevention correlate with goals of rehab? - Answer Tertiary
prevention is the management of long-term disease, injurt, or illness - focuses on
controlling CHRONIC effects of a health issue that has already occured & restoring that
individual back to optimal function, teaching self-care
Rehababilition means to "make able again" - learning or relearning skills and abilities
and adjsuting to existing function to reach max potential - goal oriented process for
people with disability or chronic conditions
REHAB = TERTIARY PREVENTION
What is self-efficacy? - Answer Individual's belief that they have the capacity to do what
they need to do to reach specific goals
Nursing interventions for rehabilitation - Answer - Assessing patient's functional ability:
ability to perform ADLs (eating, toileting, dressing, transferring, and personal hygiene)
AND instrumental activities of daily level/IADLs (grocery shopping, meal prep, financial
mgmt., medication mgmt, transportation)
- Recommend adaptive & assistive devices
- Provide optimal learning environment
- Assist with correct positioning to prevent musculosketal complications
- Perform ROM exercises
- Assist patients with transfers
What does a certified registered rehabilitation nurse (CRRN) do? - Answer Specializes in
helping people with disabilities & chronic illness attain optimal function, health, and
adapt to a new alterered lifestyle
What is a physiatrist? - Answer a physician who specializes in rehab medicine
What is a physical therapist? - Answer PT focuses on improving patient's ability to MOVE
,Teaches skills such as transfers, strength training, using assistive devices
What is an occupational therapist? - Answer OT focuses on improving patient's ability to
perform ADLs
Example - Screens, tests, recommends feedings for dysphagia
What is a speech & language pathologist? - Answer Evaluates and diagnoses speech,
language, communication, and swallowing disorders
What is the most common cause of a Spinal Cord Injury (SCI)? - Answer TRAUMA =
motor vehicle collision, fall, violence, sports injury
Complete vs. incomplete Spinal Cord Injury (SCI) - Answer Complete - the spinal cord
damage eliminates all innervation (supply of nerves) below that level of injury
INcomplete - allows for some function/movement below the level of injury - MORE
COMMON THAN COMPLETE
Primary vs. Secondary Spinal Cord Injury (SCI) - Answer - primary: immediate,
irreversible loss of sensation and motion. due to mechanical trauma
- secondary: occurs after initial injury, caused by swelling, ischemia, contusion or
movement of bone fragments: secondary is the main focus for nurses because they can
still treat this and prevent total and permanent damage
What are the four types of incomplete SCIs? - Answer Central cord syndrome (most
common), lateral cord syndrome, anterior cord syndrome, peripheral cord syndrome
What is central cord syndrome? - Answer Damage to the central part of the spinal cord
resulting in greater weakness in UEs than in LEs, variable bowel & bladder dysfunction
Common in elderly, typically from a fall with hyperextension
Most common Incomplete SCI
What is anterior cord syndrome? - Answer Worst prognosis for recovery of all the
Incomplete SCIs
Damage to anterior portion of spinal cord usually caused by hyperflexion- causes
complete lost of movement, pain and temp loss - preserves light touch sensation
What is posterior cord syndrome? - Answer Damage to posterior portion of spinal cord -
opposite of anterior cord syndrome - light touch sensations are lost, but movement,
pain, and temp sensations are kept
What is Brown-Sequard syndrome? - Answer A hemisection lesion of the cord resulting
in loss of motor control on the side of the injury and loss of sensation on the opposite
side
, Usually caused by a penetrating injury like a bullet or knife wound
What is Conus Medullaris Cord syndrome? - Answer Caused by compressive damage
from T12-L2; Variable lower extremity loss of function; flaccid anal spincter & bladder
(can't usually tell when you have to go)
What is the Glasgow Coma Scale? - Answer Initial LOC assessment - score ranges from
3 (brain dead, deep coma) to 15 (normal, fully responsive)
Eye opening response: Spontaneous (4), to voice (3), to pain (2), none
Best verbal resonse: Oriented (5), Confused (4), Inappropriate words (3),
Incomprehensible sounds (2), or none (1)
Best motor resposne: Obeys command (6), localizes pain (5), withdraws (4), flexion (3),
extension (2), none (1)
What is spinal shock? - Answer temporary neurologic syndrome, characterized by
decreased reflexes, loss of sensation, and flaccid paralysis below the level of injury,
bradycardia, BP decrease, paralytic ileus (from about day 2-7)
Lasts days to weeks
End of spinal shock: when involuntary spinal reflexes below level of injury return (may
not return with COMPLETE injuries)
Nursing care during spinal shock - Answer - Promote breathing & airway clearance
(breathing exercises, humidification, hydration) - be careful with using suction because
this can stimulate the vagus nerve and cause bradycardia/cardiac arrest
- Improve mobility - once Dr. allows, reposition patient as frequent as possible, assist
out of bed if spinal column stabilized, splints to prevent foot drop, trochanter rolls to
prevent hip joint external rotation, passive ROM exercises to prevent contractures &
