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Drexel NURS 226 – Nursing Leadership & Management Study Guide, Practice Questions and Exam Review What are the six vital signs? - correct answer ✔✔BP, Temp, Resp, Pulse, Oxy Saturation, Pain Normal Temperature - correct answer ✔✔36-38 C (96.8-100.4 F) Normal Pulse - correct answer ✔✔60-100 bpm normal respiration - correct answer ✔✔12- Normal BP - correct answer ✔✔120/ normal oxygen saturation - correct answer ✔✔95-100% What is the pain scale? - correct answer ✔✔0- When should we take vital signs at the hospital - correct answer ✔✔on admission routine schedule before/during/after surgery, procedure, med admin, blood transfusions every 5-10 mins when patients condition worsens when patient reports symptoms of physical distress Hyperthermia - correct answer ✔✔a fever anything above 100. golden rule of pain - correct answer ✔✔pain is subjective
what can happened to untreated pain - correct answer ✔✔worsen, patient loses hope, physical, psychological, social, and finical consequences acute pain - correct answer ✔✔sympathetic, short, identifiable, protective, increases HR, BP, and OXY Chronic/persistent noncancer pain - correct answer ✔✔Is not protective, has no purpose, may or may not have an identifiable cause (parasympathetic nervous decreases HR, BP, OXY chronic episodic - correct answer ✔✔sporadically over extended time cancer pain - correct answer ✔✔acute or chronic idiopathic - correct answer ✔✔chronic pain without a cause (mental or physical pain) How to assess pain? - correct answer ✔✔location, timing, quality, severity (0- 10), aggravating factors, relief (meds, ice, heat) plannin/ implementing pain care - correct answer ✔✔pain management needs to be WHOLE body focused non pharmacological (cognitive/behavioral) - correct answer ✔✔relaxation/guided imagery, distraction, music, humor, journaling non pharmacological (cutaneous) - correct answer ✔✔cold/heat, TENS (electrical nerve), acupuncture (TBI)
Pharmacological Pain Managements (non opioids) - correct answer ✔✔NSAIDS (mortion, allieve, anti inflammatory) Acetaminophen (tylenol) Pharmacological Pain Managements (opioids) - correct answer ✔✔narcotic (short or long acting), Oral, IV, Subc, Im, Transdermal patches, buccal, epidural, PCA adjuvant anglegsics - correct answer ✔✔can be added to meds to make a good pain relief (anti depressants, anti seizure, muscle relaxer, steriods) PCA - correct answer ✔✔allows patient to self monitor, used in surgeries, locked machine topical - correct answer ✔✔cream and ointments, patches (fetynal) epidural - correct answer ✔✔spine, labor always document - correct answer ✔✔assessment, plan, response (re- evaulate 1 hour) physical dependence - correct answer ✔✔a physiological need for a drug, marked by unpleasant withdrawal symptoms when the drug is discontinued abruptly addiction - correct answer ✔✔disease drug tolerance - correct answer ✔✔the tendency for larger doses of a drug to be required over time to achieve the same effect body temp = - correct answer ✔✔heat produced - heat lost
thermoregulation (neuro/vascular control) - correct answer ✔✔controlled by hypothalamus (posterior increases, anterior decreases) decreases body temp - correct answer ✔✔vasodilation + diaphoresis allows for the body to cool itself down, while inhibiting heat production increases body temp - correct answer ✔✔vasoconstriction and shivering skin temp - correct answer ✔✔increase body fat increase body temp hairs raise when cold to trap heat temp sensation - correct answer ✔✔elderly tend to not have easy time with this, causes them to over heat (cold I need a sweater) radiation - correct answer ✔✔transfer from one to another without touch (AC) conduction - correct answer ✔✔direct contact (ice pack) convection - correct answer ✔✔transfer by air movement evaporation - correct answer ✔✔liquid to a gas diaphoresis - correct answer ✔✔extreme sweating Factors that influence temp - correct answer ✔✔age, exercise (increase), hormone (increase, circadian rhythm (1-4am decrease, late afternoon increase), stress (increase), environment (increase), temp alterations cannot control own body temp (elderly and premature babies)
cardiac ouput - correct answer ✔✔heart rate x stroke volume take pulse where? - correct answer ✔✔apical (paplate or ascculate, 1 min, irregular, 3-4 age) brachial (when kid is dying) radial (most used by RN) carotid (never at same time) (UNCONSCIOUS PATIENT) femoral (groin) (UNCONSCIOUS PATIENT) popliteal, dorsalis, posterior tibial (CHECK BLOOD FLOW TO EXTREMITIES) bradycardia - correct answer ✔✔slow heart rate (less than 60 bpm) Tachycardia - correct answer ✔✔Fast heart rate (HR greater than 100bpm) strength of pulse - correct answer ✔✔0 = absent 1+ = thready 2+ = normal 3+ = full 4+ = bounding apical pulse - correct answer ✔✔always whole minute, when irregular or when patient has dyspnea, fatigue, pallor, cyanosis, rapid HR, syncope factors that influence heart rate (increase) - correct answer ✔✔exercise, stimulants, standing, high temp, emotions, pain, hemorranghing, smoking, copd
factors that influence heart rate (decrease) - correct answer ✔✔sedatives, laying, chronic pain, low temp factors that influence respiration (decrease) - correct answer ✔✔dull acute pain, laying, opioids, neuro + alters rhytm, hemoglobin (sickle cell) factors that influence respiration (increase) - correct answer ✔✔exercise, anxiety, smoking, acute pain, stimulations, stranding ventilation - correct answer ✔✔the movement of gases in and out of the lungs Diffusion - correct answer ✔✔Movement of oxygen and carbon dioxide between alveoli and red blood cells. perfusion - correct answer ✔✔The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries. hypoxemia - correct answer ✔✔deficient amount of oxygen in the blood euponea - correct answer ✔✔normal breathing apnea - correct answer ✔✔absence of breathing bradypnea - correct answer ✔✔slow breathing Tachypnea - correct answer ✔✔rapid breathing
factors that influence Blood Pressure (increase) - correct answer ✔✔cardiac output- more blood, vasoconstriction, increased blood volume, too much viscosity, elasticity, age, stress, males, 10-6pm, simulatants, overweight, smoking, caffeine factors that influence Blood Pressure (decrease) - correct answer ✔✔decreased blood volume, sedatives, fit life style direct blood pressure - correct answer ✔✔arterial, invasive done when unstable and in critical care What happens when BP cuff is too small - correct answer ✔✔BP increases What happens when BP cuff is too large - correct answer ✔✔BP decreases hypertension - correct answer ✔✔above 140/90 check twice can be genEtic but can be modifiable due to diet and smoking Prehypertension - correct answer ✔✔120-139/80- hypotension - correct answer ✔✔below 90 orthostatic hypotension - correct answer ✔✔BP changes due to position FALL RISK/FAINTING osculatory gap - correct answer ✔✔Occurs when Korotkoff sounds disappear while one is listening to a BP reading SEVERE hypertension happens between 170-
