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CRRN SET 3 QUESTIONS AND
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1. What are the three interrelated parts of Lydia Hall's theory? Care, Core, Cure ✔✔ 2. What three things guide rehabilitation nursing as a specialty practice? Philosophy, theory, and research ✔✔ 3. What three stages of prevention are in Neuman's model? Primary, secondary prevention, and tertiary prevention; helps clients maximize their defenses. ✔✔ 4. What is the goal of nursing according to Imogene King's model about goal attainment? Help individuals maintain their health so they can function in their roles. ✔✔ 5. Which nursing theorist wrote the "self-care theory"? Dorothea Orem's theory is known as the self-care theory. The three related parts of this theory include the theory of self-care, theory of self-care deficit, and the theory of nursing system. ✔✔
6. What does Orem's theory of self-care deficits involve? Orem's theory presents a method to determine the self-care deficits of a patient and then defines the nurse or caregiver's role in helping the patient meet his or her self-care demands. ✔✔ 7. How is Martha Rogers' Adaptation Model used in rehabilitation therapy? By transmitting nursing knowledge, therapeutic touch, and hands-on education, teaching the client to adapt and live as they wish. ✔✔ 8. Which nursing model shows that individuals are in constant interaction with their environment and one another? Imogene King's open system model. ✔✔ 9. What theory believes that an individual's behavior controls his or her outcomes? The Locus of Control Theory. People who believe they are in control of their health are more likely to change their behavior than those who believe outside forces are in control. ✔✔ 10. Which nursing theorist encouraged the use of one's own powers? Florence Nightingale believed that nurses help clients obtain the best condition possible so nature can cure. ✔✔
16. What is successful rehabilitation nursing? The transfer of knowledge and accountability for healthcare needs from nurses to clients and their families in a manner that promotes health and wellness for a disability. Strategies are best conceived when developed in a nursing theory framework that provides education and training to address weaknesses and maximize strengths to meet the needs of clients and families to promote health in the community. ✔✔ 17. What is effective health management? Strategies necessary to achieve and maintain an optimal quality of life in a population of people who live longer and need long-term health promotion interventions to prevent further loss of function and prevent secondary complications related to disability. ✔✔ 18. What is a nursing theory? A body of knowledge used for nursing practice. ✔✔ 19. What does the Americans with Disabilities Act (ADA) address? Enacted in 1990, it has 5 titles of legislation that oversee accommodations for disability needs in Employment (Title I), Public Services (Title II), Public Accommodations and Services Operated by Private Entities (Title III), Telecommunications (Title IV), and Miscellaneous Provisions (Title V). ✔✔ 20. What are the core self-management concepts of the Health Promotion Model?
Problem solving, Decision making, Resource use, Collaboration, and action. ✔✔
21. What is Dr. Nola Pender's Health Promotion Model? The personal belief in one's own capacity to control life events is a key tenet of the theory. This theory assumes that people seek to regulate their own behavior, and that health professionals play an influential role throughout their client's lifespan. ✔✔ 22. What is Health Promotion? The process of enabling people to increase control over and improve their health. To reach a state of complete physical, mental, and social well-being, an individual or group must be able to identify and realize aspirations, satisfy needs, and change or cope with the environment. ✔✔ 23. What is Health? A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity (WHO, 1948). ✔✔ 24. What is Wellness? A journey that each of us takes in our quest for well-being of body, mind, and spirit. Key components include personal responsibility, body-mind-spirit connectedness, and relationships with self, others, and the environment (Miller 2008). ✔✔ 25. What are nursing roles in community-based rehabilitation settings?
The inability to identify, manage, and/or seek out help to maintain health. ✔✔
31. What are the defining characteristics of Ineffective Family Therapeutic Regimen Management? Acceleration of family member's illness symptoms, failure to take action to reduce risk factors, participation in inappropriate family activities for meeting health goals, lack of attention to illness, verbalization of difficulties with the therapeutic regimen. ✔✔ 32. What are interventions for ineffective health maintenance? Educate the client at their learning level, determine readiness to learn, use memory aids, help the client identify and begin to resume family role responsibilities, identify adaptation strategies, and assist client and family to develop stress management skills. ✔✔ 33. What do insufficient healthcare resources, deficits in community activities for prevention, and lack of advocates for aggregates indicate? An ineffective Community Therapeutic Regiment Management. ✔✔ Nursing Interventions for Ineffective Family Therapeutic Regiment Management include: - ANSWER✔✔Determine the supplies and services that are lacking, Identify the client's support system and who in it can improve the management of the therapeutic regimen, foster the advocate to promote the client's wellness and health management, and educate at the client and advocates learning level. Health information websites should be evaluated based on: - ANSWER✔✔Accuracy, authority , objectivity, currency, and coverage.
Community accessibility refers to - ANSWER✔✔Access to transportation, outpatient and community services, funding for attendant care, independent living arrangements, and limitations and barriers in the home or community. Factors that increase a client's "Risk for Injury" - ANSWER✔✔Changes in mental status, fatigue, medications, and motor or sensory deficits. The U.S. Equal Employment Opportunity Commision enforces laws related to - ANSWER✔✔Employment discrimination against a person with a disability The Civil Rights Act of 1964 - ANSWER✔✔Prohibits employment discrimination based on race, color, religion, sex or national origin. What are the risk factors for "Risk for Falls" - ANSWER✔✔Age (greater than 65), history of falls, lower limb prosthesis, use of assistive devices, impaired sensation or perception (temperature, touch, positive sense, vision, and hearing), unmet elimination need or urinary incontinence, use of chemical or physical restraints, environmental hazards, lack of knowledge related to safety and impaired mobility. The rehabilitation nurse promotes good nutrition by: - ANSWER✔✔ensuring the client understands the importance of diet, and encouraging dietary compliance. Assisting those who need help with the eating process. Taking and recording client weight and calorie count. Advocating and communicating between disciplines of physician, dietician, and other health care team members with patient and family preferences. Rehabilitation clients need adequate nutrition to - ANSWER✔✔support healing and meet metabolic demands as the diet changes during acute and chronic illness or disability.
The esophageal phase of swallowing - ANSWER✔✔An involuntary event where the bolus enters the stomach via peristalsis and gravity. The lower esophageal sphincter opens. The pharyngeal phase of swallowing - ANSWER✔✔An involuntary event that carries the bolus by swallowing reflex through the pharynx. The soft palate and uvula are elevated to close the nasal pharynx. The hyoid and larynx are elevated so food is less likely to enter the trachea. Dysphagia is - ANSWER✔✔swallowing difficulty during the passage of a solid or liquid bolus from the mouth to the stomach. Dysphagia can be caused by - ANSWER✔✔radiation treatment, stroke, dementia, myasthenia gravis, and Amyotrophic lateral sclerosis (ALS). Dysphagia is diagnosed by - ANSWER✔✔Bedside assessment, video fluoroscopic swallow study, or endoscopic evaluation of swallowing. Symptoms of dysphagia include - ANSWER✔✔pocketing food, leakage, delayed or prolonged swallowing, frequent pneumonia, malnutrition & weight loss. A patient with dysphagia should remain upright (preferably 90 degrees) during the meal and for how long afterwards? - ANSWER✔✔ 20 - 30 - minutes. Dysphagia clients may use these techniques to prevent aspiration. - ANSWER✔✔chin tuck, head turn, tongue sweep, double swallow & small sips of water between bites via spoon or cup.
The Braden scale is used to assess - ANSWER✔✔pressure ulcer risk The six components of the braden scale include - ANSWER✔✔sensory (ability to respond meaningfully to pressure related discomfort), moisture (the degree to which skin is exposed to moisture), activity (degree of physical activity), mobility (ability to change change and control body position), nutrition (usual food intake), and friction and shear (stability of movement in a relaxed position, such as in a bed or chair). How often should clients be repositioned in bed to maintain skin integrity? - ANSWER✔✔Q 2 hours How often should clients be repositioned in a chair to maintain skin integrity? - ANSWER✔✔Q15 minutes Cushioning bony prominences, providing adequate support, avoiding pressure on existing ulcers, protecting skin from friction and shearing, and elevating the heels off the bed are all nursing measures to - ANSWER✔✔Promote and maintain skin integrity. Inadequate intake of protein, vitamin C, thiamine, and zinc (poor nutrition) place the client at risk for - ANSWER✔✔loss of skin integrity Medical conditions that represent an increased risk factor for loss of skin integrity include - ANSWER✔✔Diabetes, peripheral vascular disease, peripheral neuropathies, Some medications that represent an increased risk for loss of skin integrity are - ANSWER✔✔high dose steroids & immunosuppressants
This Facial nerve receives sense of taste from anterior two thirds of the tongue and provides sensation of the oropharynx. - ANSWER✔✔Cranial nerve VII This nerve sends motor impulses to the muscles of the pharynx and sensory impulses from taste buds of the posterior one-third of tongue. - ANSWER✔✔The Glossopharyngeal nerve, Cranial nerve IX This nerve causes contractions of muscles of pharynx and larynx - ANSWER✔✔Vagus nerve, Cranial nerve X This spinal accessory nerve innervates the skeletal muscles of the soft palate, pharynx and sensory impulses from taste buds of the poset - ANSWER✔✔Cranial Nerve XI This nerve causes a motor innervation of the muscles of the tongue necessary for food manipulation, swallowing, and speech. - ANSWER✔✔Cranial nerve XII These exercises can be taught to clients experiencing stress incontinence. - ANSWER✔✔Kegel, pelvic floor exercises. Nursing interventions for clients with stress incontinence include - ANSWER✔✔Toileting assistance, bladder training, and referrals to MD for pharmacological management. Stress incontinence is defined as - ANSWER✔✔small lossess of urine that occurs when the intra-abdominal pressure is increased by activities such as coughing, laughing, exercising, or sneezing.
Stress incontinence is caused by - ANSWER✔✔weak external sphincter, weak pelvic floor musculature, and secondary effects of smoking and obesity. Educational topics for clients with urge incontinence include: - ANSWER✔✔bladder training/retraining, Urge inhibition if the client is cognitively intact, pelvic floor muscle exercises (Kegels) Urge incontinence is defined as - ANSWER✔✔the loss of urine caused by abnormal detrusor contractions, sometimes associated with urinary retention. Urge incontinence is characterized by - ANSWER✔✔A strong urge to void, frequency, and nocturia. Overflow incontinence is defined as - ANSWER✔✔the loss of urine caused by bladderoverdistention or retention. Overflow incontinence is characterized by - ANSWER✔✔urgency, frequency, dribbling, and both stress and urge incontinence. Functional incontinence is defined as - ANSWER✔✔the loss of urine and/or stool that is not caused by the GU/GI system, but rather something outside these systems. This type of incontinence is often associated with cognitive impairment, or loss of ability to perform needed toileting behaviors independently. - ANSWER✔✔Functional incontinence.
Motor Paralytic bowel impairment is defined as - ANSWER✔✔the inability to assist with defecation and is associated with incontinence only if there is widespread disease due to the innervation of the intestines. What type of nerve root loss or damage results in Sensory Paralytic bowel impairment? - ANSWER✔✔Afferent nerve root loss or damage subsequent to diabetes mellitus or tabes dorsalis. What type of nerve root loss or damage results in Motor Paralytic bowel impairment? - ANSWER✔✔Efferent nerve root loss and damage subsequent to poliomyelitis, intervertebral disc disease, tumor or trauma. What are 5 changes that occur in the older adult that affect bowel function? - ANSWER✔✔Changes in striated and smooth muscle strength, less activity, less consumption of roughage and poorer dentition, self limiting hydration due to concerns of urinary incontinence or nocturia, and comorbidities begin with increased medication use. Acute constipation is defined as - ANSWER✔✔the recent onset of symptoms, a large amount of stool in the rectal ampulla, colon, or rectum. Chronic constipation is defined as - ANSWER✔✔symptoms lasting longer than 3 months, with enlargement of the descending colon and dependency on laxatives, cathartics, or enemas. Severe constipation is defined as constipation that causes - ANSWER✔✔sympathetic systemic problems (e.g., sweating, nausea, irritability, acute abdominal discomfort, and elevated blood pressure.)
Reflexic neurogenic bowel disorder related to spinal cord injury involves - ANSWER✔✔Dysfunction in the Upper Motor Neuron (UMN), the bowel is capable of reflexive emptying of the rectum without cortical awareness of the need to defecate. Reflexic Bowel disorders are associated with Spinal Cord Injury (SCI) above this level - ANSWER✔✔T12-S1 or damage to the cerebral cortex. Autonomous, areflexic, flaccid, or atonal bowel disorders involves - ANSWER✔✔Dysfunction in the Lower Motor Neurons (LMN), there is no cortical control, lack of tone in the internal and external sphincters with frequent oozing of stool, caused by damage to the reflexic arc. Autonomous, areflexic, flaccid, or atonal bowel disorders originate from spinal cord injuries at or below this level - ANSWER✔✔T12-S Signs and symptoms of Autonomic dysreflexia include - ANSWER✔✔Hypertension 20-40 mm hg above baseline, bradycardia, flushing, perspiration above the level of injury, gooseflesh (pimply state of the skin with the hairs erect) above the level of the lesion, nasal congestion, and an impending sense of doom. Autonomic Dysreflexia occurs in 48-90% of those with spinal cord injuries at or above this level - ANSWER✔✔T Autonomic Dysreflexia is caused by - ANSWER✔✔stimulation below the level of injury, also known as hyperreflexia.
What are IADLs? - ANSWER✔✔Instrumental activities of daily living include meal preparation, housekeeping, financial management, and transportation. When the Rehab nurse checks for spasticity, flaccidity, paralysis, contractures, tremors, rigidity, energy, endurance, strength, safety, and balance they assessing....
- ANSWER✔✔for motor impairments. To assess for impairments in self care ability, - ANSWER✔✔check motor function, sensory perception, cognitive ability, and level of pain. To assess for cognitive ability and function... - ANSWER✔✔check mental status for confusion, disorientation, and executive functioning. To assess for sensory impairments.... - ANSWER✔✔check the visual field and acuity, tactile loss or deficit, and hearing. The Wong-Baker FACES scale is - ANSWER✔✔a scale with drawings or pictures that clinicians use to assess pain in the cognitively impaired client. The most common pain assessment tool is - ANSWER✔✔ 1 - 10 pain intensity scale, where 1 is barely any pain and 10 is the worst pain ever. Three things to include in any pain assessment are - ANSWER✔✔quality, location and radiation Spasticity management may be achieved through... - ANSWER✔✔exercise, stretching, oral medications like valium, baclofen, klonopin, and benzodiazepines.
It may also be managed through direct botox injections at the site or implantation of a baclofen pump to provide intrathecal medication. Maintaining a regular program of passive range of motion (ROM) & stretching, splinting and proper positioning, and avoiding static positions can help minimize _________ - ANSWER✔✔Contractures. A chemical restraint is a medication - ANSWER✔✔used to subdue or quiet behavior Anxiolytics, sedatives, and antipsychotics can be considered what type of restraint?
- ANSWER✔✔chemical. To assess the client's fall risk.... - ANSWER✔✔review the fall history, medications, assess gait and balance, identify mobility aids needed To reduce the risk of falls - ANSWER✔✔ensure a safe environment free from barriers and hazards, and institute protective devices. The best way to prevent pressure ulcers is by - ANSWER✔✔positioning and repositioning the client's body, encouraging weight shifts every 15 minutes & providing proper seating. The nurse should encourage good skin care, manage incontinence, and encourage healthy nutrition to help prevent - ANSWER✔✔pressure ulcers When are physical restraints allowed under federal law? - ANSWER✔✔When used to treat a specific medical condition.
