Exam 1 Review Questions and Answers for Critical Care Nursing, Exams of Nursing

Download Exam 1 Review Questions and Answers for Critical Care Nursing and more Exams Nursing in PDF only on Docsity! AACN Critical Care Registered Nurse (CCRN) Part 1 Exam 1 Review Questions and Answers 100% Pass AACN Critical Care Registered Nurse (CCRN) Part 1 Exam 1 Review Questions and Answers 100% Pass two main professional organizations that support critical care? which one best supports critical care nurses? - Answer>> Name the two organizations American Association of Critical-Care Nurses (AACN) Society of Critical Care Medicine (SCCM) Which one do you think best supports critical care nurses? American Association of Critical-Care Nurses (AACN) dedicated to providing knowledge and resources to those caring for acutely and critically ill patients AACN: mission? vision? values? - Answer>> Mission: focuses on assisting acute and critical care nurses to attain knowledge and influence to deliver excellence care Vision: supports creating a health care system driven by the needs of patients and families in which critical care nurses make their optimal contributions, which is described as synergy (mixture of nurse, system, and patient along with patient characteristics and nurse competencies) Values: accountability, advocacy, integrity, collaboration, leadership, stewardship, lifelong learning, quality, innovation, and commitment what is the synergy model and how is it used in practice? - Answer>> The Synergy Model focuses on the extent to which nurses' competencies match patients' characteristics. The goal of Synergy Model nursing is to "restore the patient to an optimal level of wellness as defined by the patient and family certifications: CCRN? PCCN? ACCNS? ACNPC-AG? why are certifications important? - Answer>> CCRN → nurses who Communication Medium→ limitations of communications via telephone, e-mail, paper, or computerized records versus face-to- face what is the highest risk time of communication breaking down? What four standardized measures have been implemented to help prevent communication breakdown at shift change? - Answer>> Shift handoff is when communication is at the highest risk to be broken down. What standardized measures have been implemented to help prevent communication breakdown at shift change? Ask-Tell-Ask→ strategy for encouraging nurses to assess concerns before providing more information, especially when discussing stressful issues with patients and families Tell Me More→encourages information sharing in challenging situations SBAR→ Situation, background, assessment, recommendation Crew Resource Management (CRM) → think like an aircraft crew (everyone depends on precise communication to ensure passenger safety) monitor others actions by double checking, verifying. Situational awareness, trusting your gut Can you give examples of things you may need to communicate during multi-professional rounds? - Answer>> discharge needs Greatest safety risk Implementation of critical care "bundles" Assessment and recommended follow-ups cardiac and hemodynamic status volume status neurologic status pain,agitation, and delirium sedation needs gastrointestinal status, including bowel management nutrition skin issues activity infection status (culture results/therapeutic levels of antibiotics) laboratory results radiologic test results assess need for all ordered medications identify whether central lines and invasive catheters and tubes can be removed identify whether indwelling urinary catheter can be removed issues that need to be addressed family needs--educational, psychosocial, spiritual code status advance directives parameters for calling the physician treatment goals and strategies to achieve them plans for discussing care and needs with families What types of things contribute to this sensory overload/deprivation? what is deleterious effect? - Answer>> sensory stimulation → light and noises, loss of privacy, lack of nonclinical physical contact, and emotional and physical pain Noise is a major factor contributing to sensory overload high levels of noise create a deleterious effect (sleep deprivation, decreased O2, elevated BP, delayed wound healing) Light→ override patients natural circadian rhythms, which increase disorientation and agitation sensory Deprivation→ patients can experience this in an environment that is very different from their usual surrounding increase in perceptual disturbances such as hallucinations (elderly) What types of interventions can nurses implement to combat sensory overload/deprivation? - Answer>> Sensory Stimulation placing patients in private rooms installing sound-absorbing ceiling tiles modifying overhead paging systems initiating programs to raise awareness among staff about their tole reducing noise "sedative" music Sensory Deprivation encourage visitation of family and friends posting family photos providing music or television that the patient usually enjoys What types of stressors do patients identify from their critical care experience? - Answer>> difficulty communicating pain thirst difficulty swallowing anxiety lack of control depression fear lack of family or friends physical restraint feelings of dread inability to get comfortable difficulty sleeping loneliness thoughts of death and dying What age-related demographic is at a high risk for negative outcomes in the ICU? what types of situations do you think could contribute to family conflict being present? - Answer>> older adult patients (65+) // knowing the patient's role (not knowing their role), family coping strategies (may be different throughout family members) socioeconomic status, previous medical background trauma with family or themselves, addressed concerns regarding the patient's condition and care, underlying conflicts evaluated by healthcare provider ruled on legally voluntariness disclosure of information What basic information must be present for decision making? a diagnosis of the patient's specific health problem and condition the nature, duration, and purpose of the proposed treatment or procedures the probable outcome of any medical or nursing intervention the benefits of medical or nursing interventions the potential risks that are generally considered common or hazardous alternative treatments and their feasibility short-term and long-term prognosis if the proposed treatment or treatments are not provided What is the order of decision makers in South Carolina? - Answer>> 1) guardian appointed by the court (if the guardian is within scope of authority) 2) attorney-in-fact appointed by the pt in a durable power of attorney 3) a spouse of the pt unless they are separated 4) an adult child of the pt (if there are multiple, use majority of adult children reasonably available for consultation) 5) parent of the pt 6) adult sibling of the pt (if there are multiple, use majority of adult siblings reasonably available for consultation) 7) grandparent of the pt (if there are multiple, use majority of grandparents reasonably available for consultation) 8) any other adult blood relative by blood or marriage who reasonably is believed by the healthcare professional to have a close relationship with the pt (if there are multiple, use majority of adult relatives reasonably available for consultation) 9) a person given authority to make health decisions fo the pt by another statutory provision 10) person who had a relationship with the pt who is acting in good faith and reliably convey the pt's wishes (NOT paid caregiver or healthcare provider) When would a healthcare proxy/next of kin be used for decision making? - Answer>> if the patient is not mentally capable of providing consent, informed consent is obtained from the designated health care surrogate or legal next of kin (proxy) what is advanced directive? living will? proxy? surrogate? - Answer>> Advanced Directive → witnessed written document or oral statement in which instructions are given by a person to express desires related to health care decisions. the directive may include, but is not limited to, the designation of a health care surrogate, a living will, or an anatomic gift Living Will → a witnessed written document or oral statement voluntarily executed by a person that expresses the person's instructions concerning life-prolonging procedures Proxy → a competent adult who has not been expressly designated to make health care decisions for an incapacitated person, but is authorixed by stat stature to make health care decisions for the person Surrogate → a competent adult designated by a person to make health care decisions should that person be incapacitated what is terminal condition? persistent vegetative state? brain death? DNR? allow natural death? - Answer>> Terminal Condition → a condition in which there is no reasonable medical probability of recovery and can be expected to cause death without treatment Persistent Vegetative State → a permanent, irreversible unconsciousness condition that demonstrates an absence of voluntary action or cognitive behavior, or an inability to communicate or interact purposefully with the environment Brain Death → complete and irreversible cessation of brain function DNR→ a medical order that prohibits the use of cardiopulmonary resuscitation and emergency cardiac care to reverse signs of clinical death. The DNR order may or may not be specified in patients' advance directives Allow Natural Death→ an alternate term with less-negative connotations but essentially meaning DNR what is withdraw of care and how are decisions made? - Answer>> Withdraw of Care→ withholding of life support, withdrawing life support, BOTH, can range from not initiating hemodialysis (withholding) terminal weaning from mechanical ventilation (withdrawing) comfort is taken when withdrawal of care is decided decisions are made based off ethical decision-making model what is medical futility? palliative care? hospice care? What distressing symptoms does palliative care address? - Answer>> Define medical futility situation in which therapy or interventions will not provide a foreseeable possibility of improvement in the patient's health condition, or a lack of attainable goals of care. Palliative Care: what is the difference between palliative care and hospice care? Palliative Care → provision of care interventions that are designed to relieve symptoms of illness or injury that negatively affect the quality of life of the patient of family Hospice Care → reserved for terminally ill patients (those with a prognosis of less than 6 months to live and in usually in place of aggressive-life sustaining or restorative care) What distressing symptoms does palliative care address? pain, anxiety, hunger, thirst, dyspnea, diarrhea, nausea, confusion, agitation, and disturbance of sleep patterns