NUR 213
FINAL EXAM 3
STUDY GUIDE
Complex Health Concepts
Forsyth Technical Community College
This Document Description:
❖ This study guide for NUR 213 at Forsyth Technical
Community College focuses on FINAL EXAM content from
the Complex Health Concepts course.
❖ It includes essential topics.
❖ The material is clearly organized to help students understand complex
systems and prepare effectively for exam questions.
, NUR 213 – Exam 5 Study Guide
Last Exam of Nursing School – Woohoo!!
1. Concept of Violence – Exemplar: Motor Vehicle Crash
Critical Access Hospitals: considered necessary providers of heath care to community residents
that are not close to other hospitals in a given region. The role of the ED is so vital that the
Centers for Medicare and Medicaid services has a process for designating small rural facilities of
25 inpatient beds or fewer as critical access hospitals.
Patient acuity in the ED ranges from life-threatening emergencies to minor symptoms that could
be addressed in a primary care office or community clinic. Some of the most common reasons
that people seek ED care are:
Abdominal pain
Chest pain
Breathing difficulties
Injuries (especially falls in older adults)
Headache
Fever
Pain (most common symptom)
Forensic Nurse Examiner (RN-FNE): are educated to obtain patient histories; collect forensic
evidence and offer counseling and follow-up care for victims of rape, child abuse, and domestic
violence. Forensic nurses who specialize in helping victims of sexual assault are called sexual
assault nurse examiners (SANEs) or sexual assault forensic examiners (SAFEs).
Interventions provided by a SANE nurse may include providing information about
developing a safety plan
Forensic nurses document injuries, collect physical and photographic evidence
Might have to provide testimony in court as to what was observed during the examination
and information about the type of care provided
Psychiatric Crisis Nurse: ED specialty team member. This team member evaluates the patients
emotional status, or mental illness and facilitates the follow-up treatment plan, including possible
admission to an appropriate psychiatrist facility
Interprofessional Team:
Pre-hospital providers: typically, the first care-givers that patients see before transport to
the ED by an ambulance or helicopter.
o Emergency medical technician (EMT): offer basic life support (BLS)
interventions such as O2, basic wound care, splinting, spinal immobilization, and
monitoring VS. Some counties allow for EMTs to give drugs such as EpiPens,
Narcan, or Nitroglycerin
o Paramedics: provide care that exceeds BLS needs. They are advanced life support
providers (ALS), and can perform advanced techniques, which may include
cardiac monitoring, advanced airway management and intubation, needle chest
, decompression, establishing IV or intraosseous access, and administering drugs en
route to the ED
Emergency Medicine Physician: receive specialized education and training in emergency
patient management – recognized as a specialty physician practice.
Nurse Practitioners or Physician Assistant
Radiology, ultrasound techs, respiratory therapists, laboratory techs, social workers,
case managers, nursing assistances, and clerical staff
Staff Safety:
Safety concerns revolve around protecting staff against disease transmission and personal
safety when dealing with aggressive, agitated, or violent patients and visitors.
ED nurse should use standard precautions at all times
Metal detectors may be used as screening devices for individuals suspected of having
weapons
Patients with TB or other airborne pathogens are preferentially placed in a negative
pressure room if available and are exhibiting signs that would prompt the nurse to place
them in this room
o Nurse should wear a PAPR when caring for these patients
ED should have at least one security guard
Panic buttons and remote door access controls allow staff to get help and secure major
entrances
Be sure to know the hospitals security plan, including identifying the nearest escape
route, attempting de-escalation strategies before harm can occur, and notifying security
and supervisory staff of the situation
Some hospitals might even have K-9 units to patrol high-risk areas
Patient Safety:
Common patient safety issues are:
o Patient identification
All pts are issued an identification bracelet at their point of entry in the ED
For pts with unknown identity and those with emergent conditions that
prevent the proper identification process, hospitals commonly use
“Jane/John Doe”
Whatever the method used, always verify the patients ID using two unique
identifiers
o Fall risks
Prevention begins with identifying who is at risk for falls and then
implement the appropriate precautions
Help patients move slowly from supine to an upright position and when
ambulating
Confirm that siderails are up and locked on stretchers
Ensure call light is within reach
Patients fall risk should clearly be communicated with staff and visitors
Bed in lowest position
Assess for the need for a family member, significant other, or sitter to stay
with the patient to prevent falls and help with reorientation
, o Skin breakdown in vulnerable populations
Assess skin frequently and implement preventative interventions into the
ED plan of care
Interventions should include measures to promote clean, dry skin for
incontinent patients, mobility techniques that decreases shearing forces
when moving the immobile patients, and routine turning help to prevent
breakdown
o High risk for medical errors or adverse events
To reduce error potential, the ED nurse should make every attempt to
obtain essential and accurate medical history information from the patient,
family, or reliable significant others
Patients with altered mental status should be assessed for medical alert
bracelets
Search belongings for medications, or doctor contact
Some EDs have pharmacy tech/pharmacist that help with
retrieving accurate medication history
Hospital acquired infection can occur for patients with prolonged stays
Older adults in particular are at increased risk for UTI or
respiratory infections
Patients who are immunosuppressed are at risk
Hand hygiene hand hygiene blah blah
Scope of Emergency Nursing Practice:
Core Competencies:
o Nurse must be skilled in assessments, priority setting and clinical decision
making, multitasking, documentation, and communication
o The nurse often initiates collaborative interprofessional protocols for lifesaving
interventions such as cardiac monitoring, oxygen therapy, insertion of IV’s, and
infusion of certain parental fluids
o Many ED nurses’ function under clearly defined medical protocols that allow
them to initiate drug therapy for emergent conditions such as anaphylactic shock
and cardiac arrest
o Emergency care principles extend to knowing which essential lab and diagnostic
tests may be needed and when necessary, obtaining them
o Common ED procedures that nurses may help with and should know procedural
setup, patient preparation, teaching, and post-procedure care include:
Simple and complex suturing for wound closure
Foreign body removal
Central line insertion
Endotracheal intubation and initiation of mechanical ventilation
Lumbar puncture
Pelvic examination
Chest tube insertion
Paracentesis
Fracture management
FINAL EXAM 3
STUDY GUIDE
Complex Health Concepts
Forsyth Technical Community College
This Document Description:
❖ This study guide for NUR 213 at Forsyth Technical
Community College focuses on FINAL EXAM content from
the Complex Health Concepts course.
❖ It includes essential topics.
❖ The material is clearly organized to help students understand complex
systems and prepare effectively for exam questions.
, NUR 213 – Exam 5 Study Guide
Last Exam of Nursing School – Woohoo!!
1. Concept of Violence – Exemplar: Motor Vehicle Crash
Critical Access Hospitals: considered necessary providers of heath care to community residents
that are not close to other hospitals in a given region. The role of the ED is so vital that the
Centers for Medicare and Medicaid services has a process for designating small rural facilities of
25 inpatient beds or fewer as critical access hospitals.
Patient acuity in the ED ranges from life-threatening emergencies to minor symptoms that could
be addressed in a primary care office or community clinic. Some of the most common reasons
that people seek ED care are:
Abdominal pain
Chest pain
Breathing difficulties
Injuries (especially falls in older adults)
Headache
Fever
Pain (most common symptom)
Forensic Nurse Examiner (RN-FNE): are educated to obtain patient histories; collect forensic
evidence and offer counseling and follow-up care for victims of rape, child abuse, and domestic
violence. Forensic nurses who specialize in helping victims of sexual assault are called sexual
assault nurse examiners (SANEs) or sexual assault forensic examiners (SAFEs).
Interventions provided by a SANE nurse may include providing information about
developing a safety plan
Forensic nurses document injuries, collect physical and photographic evidence
Might have to provide testimony in court as to what was observed during the examination
and information about the type of care provided
Psychiatric Crisis Nurse: ED specialty team member. This team member evaluates the patients
emotional status, or mental illness and facilitates the follow-up treatment plan, including possible
admission to an appropriate psychiatrist facility
Interprofessional Team:
Pre-hospital providers: typically, the first care-givers that patients see before transport to
the ED by an ambulance or helicopter.
o Emergency medical technician (EMT): offer basic life support (BLS)
interventions such as O2, basic wound care, splinting, spinal immobilization, and
monitoring VS. Some counties allow for EMTs to give drugs such as EpiPens,
Narcan, or Nitroglycerin
o Paramedics: provide care that exceeds BLS needs. They are advanced life support
providers (ALS), and can perform advanced techniques, which may include
cardiac monitoring, advanced airway management and intubation, needle chest
, decompression, establishing IV or intraosseous access, and administering drugs en
route to the ED
Emergency Medicine Physician: receive specialized education and training in emergency
patient management – recognized as a specialty physician practice.
Nurse Practitioners or Physician Assistant
Radiology, ultrasound techs, respiratory therapists, laboratory techs, social workers,
case managers, nursing assistances, and clerical staff
Staff Safety:
Safety concerns revolve around protecting staff against disease transmission and personal
safety when dealing with aggressive, agitated, or violent patients and visitors.
ED nurse should use standard precautions at all times
Metal detectors may be used as screening devices for individuals suspected of having
weapons
Patients with TB or other airborne pathogens are preferentially placed in a negative
pressure room if available and are exhibiting signs that would prompt the nurse to place
them in this room
o Nurse should wear a PAPR when caring for these patients
ED should have at least one security guard
Panic buttons and remote door access controls allow staff to get help and secure major
entrances
Be sure to know the hospitals security plan, including identifying the nearest escape
route, attempting de-escalation strategies before harm can occur, and notifying security
and supervisory staff of the situation
Some hospitals might even have K-9 units to patrol high-risk areas
Patient Safety:
Common patient safety issues are:
o Patient identification
All pts are issued an identification bracelet at their point of entry in the ED
For pts with unknown identity and those with emergent conditions that
prevent the proper identification process, hospitals commonly use
“Jane/John Doe”
Whatever the method used, always verify the patients ID using two unique
identifiers
o Fall risks
Prevention begins with identifying who is at risk for falls and then
implement the appropriate precautions
Help patients move slowly from supine to an upright position and when
ambulating
Confirm that siderails are up and locked on stretchers
Ensure call light is within reach
Patients fall risk should clearly be communicated with staff and visitors
Bed in lowest position
Assess for the need for a family member, significant other, or sitter to stay
with the patient to prevent falls and help with reorientation
, o Skin breakdown in vulnerable populations
Assess skin frequently and implement preventative interventions into the
ED plan of care
Interventions should include measures to promote clean, dry skin for
incontinent patients, mobility techniques that decreases shearing forces
when moving the immobile patients, and routine turning help to prevent
breakdown
o High risk for medical errors or adverse events
To reduce error potential, the ED nurse should make every attempt to
obtain essential and accurate medical history information from the patient,
family, or reliable significant others
Patients with altered mental status should be assessed for medical alert
bracelets
Search belongings for medications, or doctor contact
Some EDs have pharmacy tech/pharmacist that help with
retrieving accurate medication history
Hospital acquired infection can occur for patients with prolonged stays
Older adults in particular are at increased risk for UTI or
respiratory infections
Patients who are immunosuppressed are at risk
Hand hygiene hand hygiene blah blah
Scope of Emergency Nursing Practice:
Core Competencies:
o Nurse must be skilled in assessments, priority setting and clinical decision
making, multitasking, documentation, and communication
o The nurse often initiates collaborative interprofessional protocols for lifesaving
interventions such as cardiac monitoring, oxygen therapy, insertion of IV’s, and
infusion of certain parental fluids
o Many ED nurses’ function under clearly defined medical protocols that allow
them to initiate drug therapy for emergent conditions such as anaphylactic shock
and cardiac arrest
o Emergency care principles extend to knowing which essential lab and diagnostic
tests may be needed and when necessary, obtaining them
o Common ED procedures that nurses may help with and should know procedural
setup, patient preparation, teaching, and post-procedure care include:
Simple and complex suturing for wound closure
Foreign body removal
Central line insertion
Endotracheal intubation and initiation of mechanical ventilation
Lumbar puncture
Pelvic examination
Chest tube insertion
Paracentesis
Fracture management
