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ADA (Americans with Disabilities Act) When was the ADA created? ANSWER ✔✔ 1990 Title I - Employment What does Title I of the ADA cover? ANSWER ✔✔ Employment Prohibits discrimination in the workplace due to disability. Title II - Public Services What does Title II of the ADA address? ANSWER ✔✔ Public services Provides civil rights within public entities. Title III - Public Accommodations What is covered by Title III of the ADA? ANSWER ✔✔ Public accommodations Provides rights within the private sector. Title IV - Telecommunications What does Title IV of the ADA cover? ANSWER ✔✔ Telecommunications Closed captioning services, hearing and speech services. Title V - Miscellaneous Provisions What is the purpose of Title V of the ADA? ANSWER ✔✔ Miscellaneous Provisions Provides coverage related to legal fees, prohibits retaliation.
CMS 60% Rule What is the CMS 60% rule? ANSWER ✔✔ 60% of patients must fall under established categories. Categories include conditions like stroke, spinal cord injury, hip fractures, brain injury, and more. Transdisciplinary vs. Multidisciplinary Teams What is a transdisciplinary team? ANSWER ✔✔ A group of professionals from different disciplines who function as a team but work independently; they share roles and have a primary interventionist. What is a multidisciplinary team? ANSWER ✔✔ A cooperative group that includes professionals from various qualifications, skills, and areas of expertise. Discharge to Community Goal What is the discharge to community goal? ANSWER ✔✔ 80% and up Medicare, Medicaid, and Health Programs Who is eligible for Medicare? ANSWER ✔✔ Individuals 65 years or older, individuals with ESRD, or permanently disabled for over 2 years. What is Medicaid? ANSWER ✔✔ A federal and state assistance program that pays for healthcare services for those who cannot afford them. It’s mostly state- run with federal oversight.
AFO (Ankle-Foot Orthosis): ANSWER ✔✔ An orthotic used for the ankle and foot to improve alignment and support. TLSO (Thoracolumbosacral Orthosis): ANSWER ✔✔ An orthotic used to support the thoracic, lumbar, and sacral spine. Medicare Parts Medicare Part A: ANSWER ✔✔ Covers hospital insurance, including SNF, acute care, rehab, etc. Medicare Part B: ANSWER ✔✔ Covers physician services, outpatient services, durable medical equipment, and more. Medicare Part C: ANSWER ✔✔ Medicare Advantage Plans, often including supplemental insurance (e.g., AARP). Medicare Part D: ANSWER ✔✔ Provides prescription drug coverage. Healthcare Acts and Programs What is COBRA? ANSWER ✔✔ Consolidated Omnibus Budget Reconciliation Act; allows terminated employees or those who lose insurance due to reduced work to buy group insurance for themselves and their families for a limited time. What is PPACA? ANSWER ✔✔ The Patient Protection and Affordable Care Act of 2010.
What is TRICARE? ANSWER ✔✔ A U.S. government health insurance plan for all military personnel. Freud's Stages and Developmental Theories Oral Phase (Freud): ANSWER ✔✔ The first stage of infant development, occurring in the first year of life, where infants experience their mother's emotions. Anal Phase (Freud): ANSWER ✔✔ From 18 months to 3 years, where pleasure is derived from controlling feces and experiences with toilet training influence personality. Phallic Phase (Freud): ANSWER ✔✔ Occurs between 3-6 years, where children develop gender awareness, romantic attraction to the opposite-sex parent, and imitate the same-sex parent. Latent and Genital Phases (Freud): ANSWER ✔✔ Latent (6 years to puberty): sexuality is hidden. Genital (puberty to death): urges are sublimated with hobbies and sports. Initiative vs. Guilt (Erikson) - ANSWER✔✔Erikson's third stage in which the child finds independence in planning, playing and other activities "Why, why why" Use play with therapy (Play house or doctor) Industry vs. Inferiority (Erikson) - ANSWER✔✔Erikson's stage between 6 and 11 years, when the child learns to be productive
Preoperational Stage (Piaget) - ANSWER✔✔ 2 - 7. Motor skills are acquired; egocentrism is strong but begins to decline; no logical thinking yet; most rapid period of development Concrete operational stage (Piaget) - ANSWER✔✔ 7 - 11. The child develops the ability to understand constant factors in the environment, rules, and higher-order symbolic systems. Conservation is developed here. Formal operational stage (Piaget) - ANSWER✔✔ 12 - adulthood. Children develop the ability to think logically in the abstract. They develop deductive reasoning skills and are capable of achieving post-conventional moral reasoning. Kohlberg's Theory of Moral Development - ANSWER✔✔Developing children progress through a predictable sequence of stages of moral reasoning (preconventional, conventional, postconventional). Gilligan's theory of moral development - ANSWER✔✔The theory suggesting that there is a different process of moral development in women than in men. Maslow's Hierarchy of Needs - ANSWER✔✔(level 1) Physiological Needs, (level
- Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization Duvall - ANSWER✔✔family development theory (theory of 8 successive stages)
- INDIVIDUAL WITHIN THE CONTEXT OF NORMS
- based on traditional, nuclear, intact family
- doesn't take into account families whose life cycles exemplify alternative development sequences (divorce, single-parent, stepfamilies) Marriage, Infants, preschool, school age, teens, children leave, empty nesters, retirement. Lydia Hall's theory shows three interrelated parts. What are they? - ANSWER✔✔Person (Core) Body (Care) Disease (Cure) Rehab focuses on The Core (Person) Imogene King - ANSWER✔✔Open Systems Goal attainment through interaction Dorothea E. Orem - ANSWER✔✔Theory of Self-Care Deficit Think occupational therapy. Rogers - ANSWER✔✔Holistic way of care Think "energy fields" Neuman Nursing Theory - ANSWER✔✔Health care systems model Nurse is an intervener, mitigating the effects of stressors. Roy nursing theory - ANSWER✔✔Adaptation Model Health and illness are on a continuum
restrictive environments to the greatest extent of their abilities using plans tailored to the individual needs of the students. activity theory - ANSWER✔✔theory of adjustment to aging that assumes older people are happier if they remain active in some way, such as volunteering or developing a hobby continuity theory - ANSWER✔✔a theory focusing on how people adjust to retirement by continuing aspects of their earlier lives Acute PTSD - ANSWER✔✔may be diagnosed 1-3 months post trauma PTSD treatment - ANSWER✔✔Psychotherapy Cognitive therapy SSRI/SNRI Antipsychotics Antiepileptics Burn Rule of 9's - ANSWER✔✔Head 9%, Each arm 9%, Chest 9%, Abdomen 9%, Each anterior leg 9%, Each posterior leg 9%, Upper back 9%, Lower back 9%, Genitals 1% locus of control - External - ANSWER✔✔A persons belief that external forces determine outcomes Chance/luck
locus of control - Internal - ANSWER✔✔A persons belief that their own actions determine the outcome Self-initiating Cranial Nerve 1: Olfactory - ANSWER✔✔sensory, smell Cranial Nerve 2: Optic - ANSWER✔✔sensory, vision Cranial Nerve 3: Oculomotor - ANSWER✔✔motor, eye movement Cranial Nerve 4: Trochlear - ANSWER✔✔Motor, moves the eyeball Cranial Nerve 5: Trigeminal - ANSWER✔✔sensory, face sensation motor, facial muscles, mastication Cranial Nerve 6: Abducens - ANSWER✔✔motor, lateral eye movement Cranial Nerve 7: Facial - ANSWER✔✔sensory- anterior 2/3 taste of tongue motor- facial muscle movement Cranial Nerve 8: Vestibulocochlear - ANSWER✔✔Sensory, balance and equilibrium. Cranial Nerve 9: Glossopharyngeal - ANSWER✔✔motor, muscles of pharynx for swallowing
Phases of swallowing - Esophageal phase - ANSWER✔✔Food enters esophagus, moves to stomach dysphagia pharyngeal phase - ANSWER✔✔Delayed or absent swallow coughing wet sounding voice while eating or drinking frequent throat clearing complaints of food "sticking" in back of throat dysphagia esophageal phase - ANSWER✔✔Burping indigestion sternal pain bad breath dental carries NDD1 - ANSWER✔✔Pureed, moderate to severe
- Smooth
- Homogenous
- Cohesive
- "Pudding-like" Avoid:
- Gelatin
- Fruited yogurt
- Hot cereal/soups with lumps
- Ice cream NDD 2 - ANSWER✔✔Mechanically altered, mild to moderate
- Moist
- Soft
- Tender ground/diced meats
- Soft cooked veg Avoid
- Bread
- Rice
- Cheese cubes NDD3 - ANSWER✔✔Dysphagia Advanced AVOID:
- very hard, sticky, crunchy foods
- hard fruit and veggies
- nuts
- seeds What level of braden scale is considered "not at risk" - ANSWER✔✔18 or above means not at risk for skin breakdown What does spino at the beginning of a word mean? - ANSWER✔✔sensory
urge incontinence - ANSWER✔✔involuntary leakage of urine with a sudden, strong desire to urinate overflow incontinence - ANSWER✔✔involuntary loss of urine associated with overdistention and overflow of the bladder PLISSIT model - ANSWER✔✔P - Permission LI - Limited Information SS - Specific Suggestions IT - Intensive Therapy sympathetic sexual response - ANSWER✔✔T 10 - L Parasympathetic sexual response - ANSWER✔✔S2- 4 Reflexogenic erection - ANSWER✔✔-UMN
- initiated by internal/external tactile stimulation mediated by the reflex arc at S2- S
- triggered by genital stimulation psychogenic erection - ANSWER✔✔-LMN
- requires intact neurological pathways to brain
- initiated by cortical input from visual/tactile sensory input to the brain that stimulates the sympathetic ganglion chain found at T10-L2 to stimulates an erection
white matter of spinal cord - ANSWER✔✔This area surrounds the gray matter. It is composed of both myelinated and unmyelinated axons. It has three regions, anterior, lateral, and posterior columns. Broca's area - ANSWER✔✔Controls language expression - an area of the frontal lobe, usually in the left hemisphere, that directs the muscle movements involved in speech. parietal lobe function - ANSWER✔✔Receives and interprets sensory input pain, temp, pressure, etc... Occipital lobe function - ANSWER✔✔visual processing temporal lobe function - ANSWER✔✔hearing, taste, smell Wernickes area Cerebellum function - ANSWER✔✔coordination of voluntary movements and balance Hypothalamus - ANSWER✔✔directs eating, drinking, body temperature ADH and oxytocin injury to midbrain - ANSWER✔✔stupor to coma, MPF pupils, decerebrate muscle tone, neurogenic hyperventilation What level SCI is at risk for autonomic dysreflexia? - ANSWER✔✔T6 and above
L1- 5 - ANSWER✔✔leg muscles S2- 4 - ANSWER✔✔bowel, bladder, sexual function Neurotransmitter responsible for parkinsons - ANSWER✔✔low dopamine What medications are contraindicated in MG? - ANSWER✔✔Statins what the difference is between Medicare Part A and Medicare Advantage. - ANSWER✔✔Medicare Advantage plans replace Medicare A, B, and D. Which classification of aphasia is best described by the follow description: non- fluent, poor comprehension, good repetition? - ANSWER✔✔Transcortical mixed Damage to cranial nerve IV - trochlear - can result in which of the following? - ANSWER✔✔Diplopia The most common complication associated with spina bifida is: - ANSWER✔✔Obesity You want to use Roy's adaptation model to help the resident adapt to the stress the change in role performance is creating. A major concept of this model is: - ANSWER✔✔Environments are all conditions that affect or influence the person. According to Dorothea Orem, self-care is deliberate and active. Which of the following is a category of self-care as described by Dorothea Orem? - ANSWER✔✔Universal
Which of the following organizations coined the acronym STEEEP to identify their aims of healthcare delivery - ANSWER✔✔Institute of Medicine (IOM) Before initiating a bowel program, the nurse should that ensure the patient has: - ANSWER✔✔A clean bowel If the nurse wishes to know about the patient's overall nutritional health, which of the following is the best lab value to view? - ANSWER✔✔Serum albumin A composite type of dressing would be appropriate for all of the following types of wound except - ANSWER✔✔Bleeding wound Which of the following is not an acceptable technique used to facilitate defecation when a patient has a neurogenic bowel? - ANSWER✔✔Daily soap suds enemas The patient is complaining of decreasing activity tolerance, dyspnea with exertion and at rest, and a moist cough with frothy sputum. The nurse auscultates the patient's chest and hears bilateral rales halfway up each lung field. What does the nurse suspect? - ANSWER✔✔Left heart failure Mary's doctor tells her that she has experienced an incomplete spinal cord injury. The nurse notes that she been experiencing loss of motor function, proprioception, vibration and touch sensation on her left side. Which type of incomplete syndrome is Mary experiencing? - ANSWER✔✔Brown-Sequard Syndrome What are the 4 metaparadigm concepts contained in all nursing theories? - ANSWER✔✔Person, health, nursing, and environment
