NUR2020 - FINAL EXAM (All comps, all
lab quizzes)
Definition of a chronic condition - CORRECT ANSWERSIllness or impairment that is
permanent, leaves residual disability, nonreversible, and requires a long period of
supervision/observation/care
Major characteristics of a chronic condition - CORRECT ANSWERS- 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 - CORRECT ANSWERS- 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 - CORRECT ANSWERSObesity, lack of
exercise, poor nutrition, tobacco use, excessive alcohol use
illness-wellness continuum - CORRECT ANSWERSa 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? - CORRECT ANSWERSmeasures 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? - CORRECT ANSWERStreating or controlling a disease
or condition after it occurs
,Examples: Screening to detect early stage cancer
What is tertiary prevention? - CORRECT ANSWERSREHABILITATION 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? - CORRECT
ANSWERSTertiary 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? - CORRECT ANSWERSIndividual's belief that they have the
capacity to do what they need to do to reach specific goals
Nursing interventions for rehabilitation - CORRECT ANSWERS- 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? - CORRECT
ANSWERSSpecializes in helping people with disabilities & chronic illness attain optimal
function, health, and adapt to a new alterered lifestyle
What is a physiatrist? - CORRECT ANSWERSa physician who specializes in rehab
medicine
What is a physical therapist? - CORRECT ANSWERSPT focuses on improving patient's
ability to MOVE
Teaches skills such as transfers, strength training, using assistive devices
,What is an occupational therapist? - CORRECT ANSWERSOT focuses on improving
patient's ability to perform ADLs
Example - Screens, tests, recommends feedings for dysphagia
What is a speech & language pathologist? - CORRECT ANSWERSEvaluates and
diagnoses speech, language, communication, and swallowing disorders
What is the most common cause of a Spinal Cord Injury (SCI)? - CORRECT
ANSWERSTRAUMA = motor vehicle collision, fall, violence, sports injury
Complete vs. incomplete Spinal Cord Injury (SCI) - CORRECT ANSWERSComplete -
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) - CORRECT ANSWERS- 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? - CORRECT ANSWERSCentral cord
syndrome (most common), lateral cord syndrome, anterior cord syndrome, peripheral
cord syndrome
What is central cord syndrome? - CORRECT ANSWERSDamage 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? - CORRECT ANSWERSWorst 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? - CORRECT ANSWERSDamage 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? - CORRECT ANSWERSA 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? - CORRECT ANSWERSCaused 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? - CORRECT ANSWERSInitial 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? - CORRECT ANSWERStemporary 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 - CORRECT ANSWERS- 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 &
disuse syndrome
- Prevent injury from sensory & perceptual alterations - provide glasses and hearing
aids
- Maintain skin integrity
- Maintain urinary elimination: initial internal catheter, then condom or intermittent as
long as neurogenic bladder exists
- Improve bowel function: because spinal shock can cause paralytic ileus - NG tube may
be required to prevent distention & vomiting, then start a bowel program (pattern of
planned evacuation, softeners, laxatives, rectal stimulation)
lab quizzes)
Definition of a chronic condition - CORRECT ANSWERSIllness or impairment that is
permanent, leaves residual disability, nonreversible, and requires a long period of
supervision/observation/care
Major characteristics of a chronic condition - CORRECT ANSWERS- 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 - CORRECT ANSWERS- 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 - CORRECT ANSWERSObesity, lack of
exercise, poor nutrition, tobacco use, excessive alcohol use
illness-wellness continuum - CORRECT ANSWERSa 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? - CORRECT ANSWERSmeasures 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? - CORRECT ANSWERStreating or controlling a disease
or condition after it occurs
,Examples: Screening to detect early stage cancer
What is tertiary prevention? - CORRECT ANSWERSREHABILITATION 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? - CORRECT
ANSWERSTertiary 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? - CORRECT ANSWERSIndividual's belief that they have the
capacity to do what they need to do to reach specific goals
Nursing interventions for rehabilitation - CORRECT ANSWERS- 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? - CORRECT
ANSWERSSpecializes in helping people with disabilities & chronic illness attain optimal
function, health, and adapt to a new alterered lifestyle
What is a physiatrist? - CORRECT ANSWERSa physician who specializes in rehab
medicine
What is a physical therapist? - CORRECT ANSWERSPT focuses on improving patient's
ability to MOVE
Teaches skills such as transfers, strength training, using assistive devices
,What is an occupational therapist? - CORRECT ANSWERSOT focuses on improving
patient's ability to perform ADLs
Example - Screens, tests, recommends feedings for dysphagia
What is a speech & language pathologist? - CORRECT ANSWERSEvaluates and
diagnoses speech, language, communication, and swallowing disorders
What is the most common cause of a Spinal Cord Injury (SCI)? - CORRECT
ANSWERSTRAUMA = motor vehicle collision, fall, violence, sports injury
Complete vs. incomplete Spinal Cord Injury (SCI) - CORRECT ANSWERSComplete -
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) - CORRECT ANSWERS- 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? - CORRECT ANSWERSCentral cord
syndrome (most common), lateral cord syndrome, anterior cord syndrome, peripheral
cord syndrome
What is central cord syndrome? - CORRECT ANSWERSDamage 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? - CORRECT ANSWERSWorst 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? - CORRECT ANSWERSDamage 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? - CORRECT ANSWERSA 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? - CORRECT ANSWERSCaused 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? - CORRECT ANSWERSInitial 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? - CORRECT ANSWERStemporary 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 - CORRECT ANSWERS- 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 &
disuse syndrome
- Prevent injury from sensory & perceptual alterations - provide glasses and hearing
aids
- Maintain skin integrity
- Maintain urinary elimination: initial internal catheter, then condom or intermittent as
long as neurogenic bladder exists
- Improve bowel function: because spinal shock can cause paralytic ileus - NG tube may
be required to prevent distention & vomiting, then start a bowel program (pattern of
planned evacuation, softeners, laxatives, rectal stimulation)
