NURSING 265 Comprehensive 2 Review Complete

NUR 265 COMP 2 REVIEW • autonomy the degree to which a job gives an employee the freedom and discretion needed to schedule different tasks and decide how to carry them out • cardiac glycosides drugs used to improve heart output by increasing the muscular contraction • digoxin toxicity s/s: heart rhythm disturbances. bradycardia/heart block. N&V, anorexia, blurred vision, mental status changes • Therapeutic levels: Digoxin 0.5 - 2.0 • antianginal drugs - nitrates - calcium channel blockers and beta blockers • Isosorbide Mononitrate Imdur Antianginal • Cardioselective Beta 1-blockers Atenolol, acebutolol, and metoprolol • calcium channel blockers avoid in CHF avoid grapefruit juice • ACE Inhibitors Captopril , Enalapril , Lisinopril • How do ACE-Inhibitors work? ACE-Inhibitors inhibit the angiotensin-converting enzyme (ACE) needed to change angiotensin I (inactive) to angiotensin II (active). Angiotensin II is a potent vasoconstrictor, so less angiotensin II means less vasoconstriction. • ARBs Angiotensin II receptor antagonists -no effect on bradykinin metabolism -less cough and angioedema Use in patients with ACEI contraindications Recent, increased risk of cancer They appear as effective as ACEI in hypertension, chronic renal failure, and CHF -ACEI and ARBS may be used together for more complete blockade of RAAS in CKD • sodium cha • nnel which nitrate is used for tx of HTN? isosirbide dinitrate • ANA Code of Ethics a standard for ethical conduct in patient care (moral guidelines) emphasis on patient advocacy, patient autonomy, patient rights, health care as a basic right • sodium channel blockers - Quinidine - cardiac depressant, decreases myocardial contractions, anticholinergic and alpha blocking. - Procainamide - less anticholinergic/alpha blocking than quinidine. Most frequently used - Disopyramide - Decrease in conduction and prolongation of refractory period. Only used for ventricular arrhythmias. • Ma • Mannitol increase ICP • Mannitol Osmotic Diuretic (Osmitrol) • Mannitol interaction lithium and dig • Statutory law State or Federal Law • Case Law when an appellate court endorses a rule to be used in deciding court cases • Constitutional law The body of law derived from the U.S. Constitution and the constitutions of the various states • Beneficence An ethical principle stating that one should do good and prevent or avoid doing harm. • Nonmaleficence avoidance of harm to others • Veracity the duty to tell the truth • Fidelity The duty to be faithful to commitments. (to whom do we owe our fidelity - client, family, physician, institution, or profession) • Crossing the Quality Chasm o released by IOM o intent was to improve systems of healthcare o 6 major aims in providing health care: safe, effective, patient-centered, timely, efficient, equitable • "Crossing the Quality Chasm" Six areas of quality improvement: 1.Safety 2.Effectiveness 3.Patient-Centeredness 4.Timelines 5.Efficiency 6.Equity • Clinical pathways sets forth time-specific goals, key elements, and sequence of care • patient-focused care delivery model that brings all services and care providers to the client • Primary nursing Primary nursing: The nursing practice system in which the entire nursing care of a patient is managed and coordinated by one nurse for a 24-hr period • Functional nursing a nursing care pattern focusing on tasks and jobs. each nursing team member has certain tasks and jobs to do • Pharmacokinetic phase 1. Absorption (drug enters body) o distribution (drug reaches the site of action) o metabolism (bio transformation) o excretion (exits the body) 2. Pharmacodynamic phase What the drug does to the body 3. protein bound drugs no secreted through kidneys 4. Pharmaceutic Phase disintegration and dissolution the drug becomes a solution so that it can cross the biological membrane when a drug is administered parenterally (outside of GI tract), subQ, IM, or IV, there is not a pharmaceutic phase 5. hyperthyroid drug of choice PTU tetralogy of fallot pulmonary stenosis ventricular septal defect overriding aorta right ventricular hypertrophy Birth weight Doubles  6 months Birth weight Triples 12 months Develops Social Smile 2 months Posterior fontanelle closes by 6 - 8 weeks Moro reflex disappears by 4 months Rolls over5 - 6 months Peek - a – boo 6 months Transfer object from hand to hand  7 months Develops stranger anxiety  7 - 9 months Sits up unsupported 8 months Crawl 10 months Waves bye-bye 10 months Walks with assistance 10 - 12 months Growth spurt girls 10 years old Kicks ball 24 months Ties shoes 5 years old Uses scissors 4 years old Sits unsupported 8 months Daytime toilet training starts 24 months Anterior fontanelle closes 12 - 18 months Tricycle 3 years old Rides bicycle 5 years old Vocalizes 1 - 2 words 10 months Rattle is an appropriate toy  5 - 6 months Push pull toys appropriate 9 - 12 months Noise maker toys appropriate 6 - 9 months Encephalitis inflammation of the brain tissue and meninges that affects the cerebrum, brain stem, and cerebellum Pupura Red or purple discoloration of the skin that does not blanche with pressure Avolition  Lack of drive to perform activities or pursue meaningful goals LEukocyctosis Increase in WBC Paralytic ileus Absence of peristalsis