2023 BSN Comprehensive Study Guide

2023 BSN Comprehensive Study Guide Healthy People 2020 - Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups. Create social and physical environments that promote good health for all. Promote quality of life, healthy development, and healthy behaviors across all life stages. Healthy People 2020 objectives - the fourth set of health goals and objectives for the U.S. that defines the nation's health agenda and guides its health policy Quality Improvement (QI) - A continuous process that identifies problems in health-care delivery, examines solutions to those problems, and regularly monitors the solutions for improvement. QSEN - stands for Quality and Safety Education for Nurses, a project for preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the health care systems within which they work Grand Nursing Theories - have broadest scope and present general concepts. Not designed for empirical testing. Intended to be pertinent to all instances of nursing. Consist of conceptual frameworks defining broad perspectives. Theory of Goal Attainment - Imogene King Theory of Goal Attainment - A nurse wants to speak to a teenage mother about birth control but, the teen is very stressed out, almost ran out of money, can't afford the formula, so clearly the formula is the main issue, the nurse knows that she can educate her on the birth control AFTER she figures out her formula problem. Tackle one problem at a time. This is an example of what theory? Four concepts common in nursing theory that influence and determine nursing practice - The person( patient) The environment Health Nursing (goals, roles, functions) Nightingale (1860) - to facilitate the body's reparative process by manipulating the patient's environment Paplau 1952 - Interpersonal relationships model- proper development of a pt.'s personality is important to improve their personal and community living. Henderson (1955) - work interdependently with other health care workers, assisting patient in gaining independence as quickly as possible; help patient gain lacking strength Abdellah (1960) - This theory focus on delivering nursing care for the whole person to meet the physical, emotional, intellectual, social, and spiritual needs of the client and family. Orlando 1962 - the client is an individual; with a need; that, when met, diminishes distress, increases adequacy, or enhances well-being. Johnson's Theory 1968 - how the client adapts to illness and how actual or potential stress can affect the ability to adapt. The goal of nursing to reduce stress so that; the client can move more easily through recovery. Rogers 1970 - to maintain and promote health, prevent illness, and care for and rehabilitate ill and disabled client through "humanistic science of nursing" Orem (1971) - to care for and help clients attain total self-care King (1971) - - goals attainment theory- the nurse and pt. mutually set goals and agree on ways to reach goals. Neuman (1972) - assist individuals, families, and groups in attaining and maintaining maximal level of total wellness by purposeful interventions Roy 1979 - to assess demands on a client and help the client adapt. Watson's Theory 1979 - Watson's philosophy of caring 1979 attempts to define the outcome of nursing activity in regard to the; humanistic aspects of life. Need theorists - Abdellah Henderson Orem Interaction Theorists - King Orlando Peterson and Zderad Paplau Travelbee Wiedenbach Outcome theorists - Johnson Levine Rogers Roy Focus of needs theories - These theories are based around helping individuals to fulfill their physical and mental needs. Needs theories have been criticized for relying too much on the medical model of health and placing the patient in an overtly dependent position. Interaction theories focus - These theories revolve around the relationships nurses form with patients. Such theories have been criticized for largely ignoring the medical model of health and not attending to basic physical needs. outcome theories focus - These portray the nurse as the changing force, who enables individuals to adapt to or cope with ill health (Roy 1980). Outcome theories have been criticized as too abstract and difficult to implement in practice (Aggleton and Chalmers 1988). rapid acting insulin - Lispro (Humalog) Aspart (Novolog) Glulisine (Apidra) Intermediate acting insulin - NPH (Humulin N, Novolin N) Long acting insulin - glargine (Lantus) detemir (Levemir) Short acting insulin onset - 5 to 15 minutes, peak effect in 1 to 2 hours and duration of action that lasts 4-6 hours. intermediate acting insulin onset - peak effect of 4 to 6 hours, and duration of action of more than 12 hours Long acting insulin onset - 12-24 hours for insulin detemir and 24 hours for insulin glargine. Metformin (Glucophage) - decrease how much sugar your intestines absorb, make your body more sensitive to insulin, and help your muscles absorb glucose. How to take metformin - usually taken twice a day with breakfast and evening meal. (extended release only once daily) Sulfonylureas: Glimepiride (Amaryl) Glyburide (Diabeta, Micronase) Glipizide (Glucotrol, Glucotrol XL) Micronized glyburide (Glynase) - Stimulates the pancreas to release more insulin, both right after a meal and then over several hours. Take with a meal once or twice a day. May lower blood sugar important to take with carbohydrate. Repaglinide (Prandin) Nateglinide (Starlix) - Both of these medications should be taken with meals. If you skip a meal, skip the dose. Less likely to lower blood sugar then sulfonylureas. DPP-4 Inhibitors Sitagliptin (Januvia) Saxagliptin (Onglyza) Linagliptin ( Tradjenta) - Take once a day at the same time each day. Improves insulin level after a meal and lowers the amount of glucose made by your body. If oral diabetes medications are not working - then a physician will likely prescribe insulin. Combination oral diabetic medications can - eliminate pill burden for patients. heart failure (HF) - condition in which there is an inability of the heart to pump enough blood through the body to supply the tissues and organs with nutrients and oxygen. heart failure lifestyle modification - 1. Quit smoking, 2. Maintain or lose weight, 3. Avoid alcohol and caffeine (no more than 2 cups of coffee QD), 4. Participate in physical activity, eat a diet rich in fruits, skin chicken and fish, fresh fruits, nuts and legumes. 5. Manage stress, such as participating in stress relieving activity daily: meditation or yoga. 6. Track fluid intake, some heart failure patients should limit fluids to reduce excess edema or start on diuretics. 7. Avoid tight fitting clothes. 8. Monitor weight every morning - inform HCP if more than 3 pounds of weight is gained in a day, or five or more pounds in one week. 9. Get adequate rest and monitor symptoms and blood pressure. Ensure patient is vaccinated with flu and pneumonia. 10. Treatments can include eating less salt, limiting fluid intake, and taking prescription medications. In some cases a defibrillator or pacemaker may be implanted. Diuretics - medications that reduce fluid volume in the body Furosemide (Lasix) - loop diuretic - It can treat fluid retention (edema) and swelling caused by congestive heart failure, liver disease, kidney disease, and other medical conditions. Spirinolactone (Aldactone) - Potassium sparing diuretic Avoid foods with high potassium such as salt substitutes. Bumetanide (Bumex) - (C) Loop diuretic - take early in AM w. food or milk, not exercise in hot weather or stand prolonged. It can treat fluid retention (edema) and high blood pressure. Hydrochlorothiazide (HCTZ) - Diuretic. It can treat high blood pressure and fluid retention (edema). Heart Failure Medications - - ACE inhibitors - diuretics - Digoxin - beta blockers - ARB's - vasodilators - blood thinners Diabetes Lifestyle Changes - 1. Diet change - count carbs. Carbs are accountable for high blood sugar, if eating high carbs insulin needs to be taken. 2. Coordinate meals with medications. Too little of foods can throw off medication effects and can dangerously lower blood sugar. Too much food can cause hyperglycemia. 3. Avoid sugar-sweetened beverages. 4. Exercise - muscles use sugar for energy and helps the body regulate insulin better. Mo