(Difference between) medical vs behavioral restraints Correct
Answers • Behavioral- imminent harm to self or others
• Medical/ surgical- pulling at tubes/ lines, removal of
equipment
Accepting diversity Correct Answers find commonalities btwn
cultures.
Important to recognize and appreciate both similarities and
differences, strengthens, and the holistic nature of viewing our
patients, community, and the world.
Acculturation Correct Answers Adapting and adopting a
cultural groups as one's own
actual (in the nursing diagnosis) Correct Answers Represents a
problem that has been validated
-Begin planning, implementing, and evaluating care to reduce
prevent, or resolve problem
EX: Alteration of skin integrity
ADPIE (phases of nursing process) Correct Answers ADPIE
-Assessment
-Diagnosis
-Planning
-Implementation
-Evaluation
,Affective (evaluation) Correct Answers observe patient
behavior
Ambulatory care Correct Answers practice in clinics or
surgical centers, medical offices, walk-in clinics, retail
sites/pharmacies
assertive communication Correct Answers communication that
takes a listener's feelings and rights into account:
•Speak clearly and positively
•Maintain professional composure
•Use "I" statements
•Focus on the issue
•Don't invite negative responses
•Use effective VERBAL AND nonverbal communication
"I hear what you're saying, I understand what you're feeling"
Assessment (Phase 1) Correct Answers ie. BAT
•Foundational first phase which includes a holistic nursing
assessment of the client/patient. (data-gathering)
•Does not duplicate medical assessment e.g. Temp-B/P-RR
(some overlap
(strives to determine the client's response to health problems or
illness that lead the nurse to the development of the nursing
diagnosis (systematically collect's patients data))
Assessment of atelectasis/ pneumonia Correct Answers Vitals,
oxygenation, breath sounds
,Assessment of constipation Correct Answers Last Bowel
Movement (BM)
Bowel History
Abdominal
Assessment of contractures Correct Answers Range of Motion
(ROM)
Joint Deformity
Foot Drop
Assessment of pressure ulcers Correct Answers Braden or
Norton Scale
Inspect Skin
Assessment purpose Correct Answers -Strives to accurately
conclude the health status of the client/patient in order to make
the proper nursing diagnosis.
-Client/Patient are active partners in the healing process
Assimilation Correct Answers Process by which we adapt and
integrate characteristics of a dominant culture as our own
atelectasis Correct Answers collapse of lung tissue affecting
part or all of one lung. This condition prevents normal oxygen
absorption to healthy tissues.
Balance Correct Answers Line of gravity
Center of gravity
Base of support
, bicultural Correct Answers Identifies with 2 cultures and
integrates some of each into life
braden or norton scale Correct Answers The two scales of
pressure ulcers
Clara Barton Correct Answers Launched the American Red
Cross in 1881. An "angel" in the Civil War, she treated the
wounded in the field.
Cluster of data Correct Answers a group of significant cues
that lead to evidence that an unhealthy pattern is emerging
a SINGLE CUE is NOT enought to make a diagnosis
Cognitive (evaluation) Correct Answers Ask the patient to
repeat information or apply new knowledge
common medical errors Correct Answers Medication Errors
Nosocomial Infections
Surgical Errors-wrong site, wrong side
Equipment/Diagnostic Failure
Communication Correct Answers -Basic human function
-Self Talk
-Sending messages back and forth between two or more people
-Consists of verbal and nonverbal messages
-Helps build working relationships
-Helps meet physical, psychosocial, emotional, and spiritual
needs