NSG 353 (Medical Surgical Nursing) Exam 1 Review Questions & Answers

SBAR (Situation, Background, Assessment, Recommendation) - ANSWERSa model used for effective transfer of information by providing a standard structure for concise and factual communications can be nurse-to-nurse, nurse-to-physician, or nurse-to-other health professionals Advanced Practice Registered Nurse (APRN) - ANSWERSgenerally the most independently functioning nurse has a master's or doctorate degree Standards of Practice - ANSWERSdescribes a competent level of nursing care, based on the nursing process Standards of Professional Performance - ANSWERSdescribes behavioral competencies expected of a nurse Nursing Process - ANSWERSProblem solving approach to the identification and treatment of patient problems that is the foundation of nursing practice QSEN Competencies - ANSWERSPatient-Centered Care Teamwork and Collaboration Evidence-Based Practice Quality Improvement Safety Informatics Accountability Professionalism Telehealth - ANSWERSthe delivery of health care and information through telecommunication technologies includes internet, wireless, satellite, and video communication Delegation - ANSWERSallows a care provider to perform a specific nursing activity, skill, or procedure that is beyond their usual role serious reportable events (SREs) - ANSWERSdescribe serious, largely preventable, and harmful clinical events also called "never events" Quality Improvement - ANSWERSinvolve systematic actions that monitor, assess, and improve health care quality "same level of care is delivered to ALL patients" Culture - ANSWERSknowledge, beliefs, art, morals, law, customs, and habits of a group of people a way of life for people NOT every person in a culture has the exact same beliefs or background (different perspectives) Values - ANSWERSsets of rules by which persons, family groups, and communities live by (principles and standards) Determinants of Health - ANSWERSfactors that (1) influence the health of individuals and groups and (2) help explain why some people experience poorer health than others Acculturation - ANSWERSthe adoption of cultural traits, such as language, by one group under the influence of another Primary Prevention - ANSWERSefforts to prevent an injury or illness from ever occurring Ex: exercising, healthy diet Secondary Prevention - ANSWERSefforts to limit the effects of an injury or illness that you cannot completely prevent Ex: disease screenings Tertiary Prevention - ANSWERSactivities directed toward rehabilitation rather than diagnosis and treatment Ex: physical therapy after injury Pain - ANSWERScomplex, multidimensional experience that can cause suffering and decreased quality of life one of the major reasons people seek health care considered a "vital sign" subjective ("whatever someone says it is") Dimensions of Pain - ANSWERS1.) Affective 2.) Behavioral 3.) Cognitive 4.) Physiologic 5.) Sociocultural AFFECTIVE Dimension of Pain - ANSWERSemotional responses to pain include anger, fear, depression, anxiety negative emotions impair patients' quality of life BEHAVIORAL Dimension of Pain - ANSWERSobservable actions used to express or control pain facial expressions, socially withdrawn, less physically active, using relaxation, taking medication COGNITIVE Dimension of Pain - ANSWERSbeliefs, attitudes, memories, and meaning attributed to pain influence the ways in which a person responds to pain PHYSIOLOGIC Dimension of Pain - ANSWERSgenetic, anatomic, and physical determinants of pain influence how painful stimuli are processed, recognized, and described SOCIOCULTURAL Dimension of Pain - ANSWERS age and gender influence nociceptive processes and responses to opioids families and caregivers influence patient's response to pain through their beliefs, behaviors, and support culture affects pain expression, medication use, and pain-related beliefs and coping methods. Gender Pain Differences (MEN) - ANSWERS less likely to report pain than women report more control over pain less likely to use alternative treatments for pain Gender Pain Differences (WOMEN) - ANSWERS more often have migraine headaches, back pain, arthritis, fibromyalgia, IBS, abdominal pain more likely diagnosed with nonspecific disorder less likely to receive analgesics for symptoms of chest and abdominal pain Nociceptive Pain vs. Neuropathic Pain - ANSWERS Nociceptive Pain - ANSWERSphysiologic process by which information about tissue damage is communicated to the CNS Neuropathic Pain - ANSWERSabnormal processing of pain message; burning, shooting in nature EX: phantom limb pain Acute Pain - ANSWERSpain that is felt suddenly from injury, disease, trauma, or surgery Chronic Pain - ANSWERSepisode of pain that lasts for 6 months or longer; may be intermittent or continuous Drug Therapy for Pain - ANSWERS Nonopiods: used for mild to moderate pain (ex: acetaminophen, NSAIDS) Opioids: moderate to severe pain (ex: morphine, fentanyl, oxycodone) NSAIDS - ANSWERSmedication that exerts analgesic and anti-inflammatory actions NEVER use with coagulants can cause bleeding (ulcers) can negatively affect the kidneys Equianalgesic Dose - ANSWERSa dose of one analgesic that is equivalent in pain-relieving effects to another analgesic this is also seen in oral vs IV routes expect oral doses to be higher than IV doses b/c of first pass effect First Pass Effect - ANSWERSthe initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream Non-Drug Therapies for Pain - ANSWERS Physical Therapies (ex: acupuncture, application of heat and cold, exercise, massages) Cognitive Therapies (ex: distraction, hypnosis, imagery, art therapy) Surgery - ANSWERSart and science of treating diseases, injuries, and deformities by operation and instrumentation Diagnostic Surgery - ANSWERSdone to provide data for a diagnosis of the problem determine the presence and extent of a pathologic condition Cure Surgery - ANSWERSelimination or repair of pathologic condition Ex: removal of a ruptured appendix Palliation Surgery - ANSWERSalleviation of symptoms without cure Ex: cutting of a nerve root to remove symptoms of pain Prevention Surgery - ANSWERSreduces the risk of developing a condition Ex: removal of a mole before it becomes malignant Cosmetic Improvement Surgery - ANSWERSsurgery to alter physical appearance Ex: repairing a burn scar or breast reconstruction after a mastectomy Exploration Surgery - ANSWERSdetermine the nature or extent of a disease with the use of advanced diagnostic tests, exploration is less common because we can identify many problems non-invasively Elective Surgery - ANSWERSsurgery that is not emergency or mandatory and can be planned at the patients convenience Emergent/Emergency Surgery - ANSWERSsurgery where a patient's condition requires immediate attention; disorder may be life-threatening; without delay Inpatient Surgery - ANSWERSoperative procedures performed on persons admitted to a hospital and expected to remain for a period of time Ambulatory Surgery - ANSWERSincludes outpatient, same-day, or short-stay surgery that does not require an overnight hospital stay minimally invasive techniques most surgeries fall into this category usually lower cost Nursing Role in Surgery - ANSWERS know nature of disorder requiring surgery identify the individual patient's response know the results of preoperative diagnostic tests identify potential risks and complications Common Fears in Surgical Patients - ANSWERS death pain and discomfort mutilation or altered body image anesthesia disruption of life functioning Informed Consent - ANSWERSan active, shared decision-making process between the healthcare professionals and the recipient of care adequate disclosure of diagnosis, purpose of proposed treatment, probability of successful outcome, benefits and risks patient must demonstrate clear understanding tru medical EMERGENCY may override need to obtain consent Preoperative Medications - ANSWERS Benzodiazepines (sedative/amnesic properties) Opioids (decrease pain) Antiemetics (decrease nausea/vomiting) Antibiotics (fight infection) Eyedrops Routine Prescription Drugs Anticholinergics (reduce secretions)