NSG 555 Quiz 1 module 1 UPDATED ACTUAL Questions and
CORRECT Answers
in outpatient settings most common malpractice claims • diagnosis, medications, medical and surgical treatment. Handoff communication
are due to what? and electronic health records play a role in cases with adverse patient outcomes.
What is disclosure of errors in malpractice? • Policy of sharing investigative findings of adverse events with patients and
families
• A process of apologizing and offering compensation
risk management strategies • Patient first, communication issues, patient concerns, patient adherence
diagnosis related claims categories 1. failure to id observation findings or change in condition
2. failure to order correct testing to establish a dx
3. delay in establishing a dx
4. failure to dx
5. failure to order or address diagnostic test results
disclosure of errors and adverse events appologize and compensate works better than litigation.
acknowldege event occured
empathis and appologize if appropriate
take steps to minimize further harm
explain to pt/family what will happen next
communicate the investigation process
disclose the results of the investigation
make changes to prevent the failure from recurring
provide emotional support
, · Common geriatric syndromes polypharmacy
cognitive impairment
dehydrayion
falls
FTT
elder abuse
· What is palliative care-tenets, definition and
epidemiology
· Advanced directives living will: describes in detail the patient's wishes
Health care proxy/DPOA--alternate decision maker
polypharmacy pathophysiology: use of >5 medications or any not medically indicated, includes
rX and OTC. Drug distribution/clearance affected by dec. lean body mass and
kidney/liver blood flow, inc in body fat. alters pharmacokinetics.
consequences--adverse drug rx-->GI, delirium, dizziness, depression, derm
effects
management--BEERS list, improved rx in elderly tool, screening tool to alert
doctors to the right treatment, screening tool of older persons and potentially
inappropriate prescriptions
cognitive impairment most common is AD
short term memory loss is primary symptom +disorientation; exec. functioning
problems, ADLs, neuro (aphasia, apraxia, agnosia), sleep cycles reversed,
psychomotor changes, irritability or apathy in early stages
delirium: transient waxing/waning of LOC. acute onset. more common in
hospitalized patients, may actually be unmasking an undiagnosed dementia
dehydration Na imbalance is most common
pathophys:decreased thirst response, decreased renal plasma flow, vasopressin
release stimulated by low fluid volume diminished
clinical presentation: nonspecific: confusion, lethargy, weight loss, functional
decline, FTT
PE: CV assessment--orthostatic drop in BP and rise in pulse indicates volume
depletion, temp elevatied if inflammatory or infectious process. dry mucous
memranes (not tile late dehydration)
labs: review electrolytes, BUN/Cr ratio, osmolality, h and h (elevated), glucose, Na
(> 148)
BUN/Cr ratio that indicates dehydration 25:1 or more
CORRECT Answers
in outpatient settings most common malpractice claims • diagnosis, medications, medical and surgical treatment. Handoff communication
are due to what? and electronic health records play a role in cases with adverse patient outcomes.
What is disclosure of errors in malpractice? • Policy of sharing investigative findings of adverse events with patients and
families
• A process of apologizing and offering compensation
risk management strategies • Patient first, communication issues, patient concerns, patient adherence
diagnosis related claims categories 1. failure to id observation findings or change in condition
2. failure to order correct testing to establish a dx
3. delay in establishing a dx
4. failure to dx
5. failure to order or address diagnostic test results
disclosure of errors and adverse events appologize and compensate works better than litigation.
acknowldege event occured
empathis and appologize if appropriate
take steps to minimize further harm
explain to pt/family what will happen next
communicate the investigation process
disclose the results of the investigation
make changes to prevent the failure from recurring
provide emotional support
, · Common geriatric syndromes polypharmacy
cognitive impairment
dehydrayion
falls
FTT
elder abuse
· What is palliative care-tenets, definition and
epidemiology
· Advanced directives living will: describes in detail the patient's wishes
Health care proxy/DPOA--alternate decision maker
polypharmacy pathophysiology: use of >5 medications or any not medically indicated, includes
rX and OTC. Drug distribution/clearance affected by dec. lean body mass and
kidney/liver blood flow, inc in body fat. alters pharmacokinetics.
consequences--adverse drug rx-->GI, delirium, dizziness, depression, derm
effects
management--BEERS list, improved rx in elderly tool, screening tool to alert
doctors to the right treatment, screening tool of older persons and potentially
inappropriate prescriptions
cognitive impairment most common is AD
short term memory loss is primary symptom +disorientation; exec. functioning
problems, ADLs, neuro (aphasia, apraxia, agnosia), sleep cycles reversed,
psychomotor changes, irritability or apathy in early stages
delirium: transient waxing/waning of LOC. acute onset. more common in
hospitalized patients, may actually be unmasking an undiagnosed dementia
dehydration Na imbalance is most common
pathophys:decreased thirst response, decreased renal plasma flow, vasopressin
release stimulated by low fluid volume diminished
clinical presentation: nonspecific: confusion, lethargy, weight loss, functional
decline, FTT
PE: CV assessment--orthostatic drop in BP and rise in pulse indicates volume
depletion, temp elevatied if inflammatory or infectious process. dry mucous
memranes (not tile late dehydration)
labs: review electrolytes, BUN/Cr ratio, osmolality, h and h (elevated), glucose, Na
(> 148)
BUN/Cr ratio that indicates dehydration 25:1 or more
