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FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ Health literacy - CORRECT ANSWERS - the ability of a patient to understand and integrate health related knowledge - is the degree to which individuals have the capacity to obtain, process, and understand basic health information neeeded to make appropriate health decisions personal health literacy - CORRECT ANSWERS is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. organizational health literacy - CORRECT ANSWERS organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. low literacy - CORRECT ANSWERS the ability of adults to read, write, and comprehend information between the 5th- to 8th-grade levels of difficulty. low health literacy - CORRECT ANSWERS reading and writing plus numeracy (measuring and calculating) - ability of patient to understand and claculate their medications and health outcomes role of health literacy in nursing - CORRECT ANSWERS - responsible for patient education - key for health promotion and wellness role of health literacy in patient education - CORRECT ANSWERS -Preventing disease -Promoting health -Providing treatment instructions -Clarifying information -Coping with limitations FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ why is health literacy important example 1 - CORRECT ANSWERS - toddler with inner ear infection is prescribed an oral antibiotic - mother understands dose is to be taken twice a day - but mother might have child take two pills at one time or pour med into ear why is health literacy important example 2 - CORRECT ANSWERS - older adult with vaginal yeast infection is prescribed oral fluconazole - patient understands it is a one time dose - patient might use it as a suppository and not orally formal patient education - CORRECT ANSWERS - give instructions - planned, goal oriented, large groups or 1 on 1 informal patient education - CORRECT ANSWERS patient directed, situation and patient specific that is prompted by a question primary school education - CORRECT ANSWERS handwashing, toothbrushing, nutrition teaching vs learming - CORRECT ANSWERS - teaching: imparting knowledge or giving instructions - learning: acquiring knowledge or skills through instruction or experience domains of learning - CORRECT ANSWERS cognitive, affective, psychomotor cognitive domain - CORRECT ANSWERS - integrate new knowelege and material that is remembered - memorization and recall psychomotor domain - CORRECT ANSWERS - physical movement and the use of motor skills FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ example ICNP diagnosis - CORRECT ANSWERS - lack of knowledge (did not fill prescription) - ready to learn (reading diabetes management literature) - literacy problem (waits for family member to read literature) planning - CORRECT ANSWERS develop the patient education smart goals develop the patient education smart goals - CORRECT ANSWERS - consider their support system - determins outcome statements early in the process (maybe just want them to look at the applicance at first) - allows patients to identify what is importnat to them (i can empty ostomy bag but my husband will change it) - consider the patients health literacy) implementation and evaluation - CORRECT ANSWERS - environment - pace; how much and how often i present information - data integration; start with familiar concepts and progress to complex or abstract ideas evaluation - CORRECT ANSWERS - planning and demonstration - documentation repition and demonstration - CORRECT ANSWERS - teach back method - verbal: have them explain it back to you (so how many times a day are you going to take this) - psychomotor: have them check their own glucose and you watch them documentation - CORRECT ANSWERS - what was taught - how it was taught - who taught it FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - patients reaction to teaching (patient was able to do the thing) recognizing the role of technology - CORRECT ANSWERS -many patients have access to medical information on the internet -patient materials should be developed using reliable websites -tailor information to meet the literacy needs of the individual tele education benefits - CORRECT ANSWERS - efficient but not everyone has the internet look at box 14.1, 14.2 and 14.3 in the fundamentals book - CORRECT ANSWERS look at human err lecture in docs - CORRECT ANSWERS intravenous access - CORRECT ANSWERS - referred to as IV acess - overarching term for both peripheral IV's and central line access advantages to intravenous access - CORRECT ANSWERS - immediate access for fluid/electrolyte maintence or replacement - meds via IV route have faster onset and more predictable effect - provides access for supplemental or total nutrition replacement - allows for transfusion of blood and blood products IV solutions - CORRECT ANSWERS - are considered medications and follow the same 6 rights and 3 checks - right patient, solution, rate, route, time, documentation - choice of IV fluid based on purpose of therapy IVFs classified as - CORRECT ANSWERS crystalloids or colloids FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ Chrystalloids - CORRECT ANSWERS - categorized based on tonicity of the fluid compared with normal blood plasma - hypotonic, isotonic, hypertonic solutions colloids - CORRECT ANSWERS - plasma expanders - contain protein or starch--particles remain intact and unable to pass through capillary membrane - used to reestablish blood volume and oncotic pressure - ex: albumin, dextran and blood products Hypotonic IV solutions - CORRECT ANSWERS causes shift into the cell (cell gets big) - treats hypernatremia, severe dehydration - risks: intracellular swelling, water intoxication, swelling of brain cells--increased ICP, cardiovascular collapse common hypotonic sol - CORRECT ANSWERS - 0.33% NS - 0.45% NS and is reffered to as half NS D5W - CORRECT ANSWERS starts as isotonic but transforms into hypotonic solution as dextrose is metabolized Isotonic IV solutions - CORRECT ANSWERS - tonicity is the same as blood - increase intravascular volume and does not cause fluid shifts in/out of cells - risk: circulatory overload common isotonic solutions - CORRECT ANSWERS 0.9% NS Lactated Ringers 0.9% NS - CORRECT ANSWERS - reffered to as normal saline FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - if no veins found/palpated--use ultrasound guided insertion to improve sucess recommendation about number of sticks - CORRECT ANSWERS - no more than 2 attempts per clinician - no more than 4 attempts total - want to contact providor for alternatives after documentation of IV - CORRECT ANSWERS - time of placement: date/time/catheter size/site - each shift assessment: observe site for redness, tenderness, pain, swelling; patency/blood return IV catheter size selection - CORRECT ANSWERS - diameter of needle=gauge - smaller gauge the larger the needle - want to select smallest size needed when to select what gauge - CORRECT ANSWERS - 16-18: trauma, surgery, blood infusions - 20-22: general and intermittent infusions, blood transfusions - 20: adults - 22= olderadults with fragile, smaller veins - 24: general and intermittent infusions in children and elderly; blood transfusions three basic peripheral access catheters - CORRECT ANSWERS - angiocath, butterfly needle, midline catheter angiocath - CORRECT ANSWERS over the needle catheter butterfly needle - CORRECT ANSWERS winged infusion needle - common in children and older adults FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ midline catheters - CORRECT ANSWERS - used for long term IV therapy and inserted by specially trained nurses through peripheral vein with ultrasound guidance - inserted in the anticubital area with tip resting in cephalic or basilic vein right below the axilla when to use midline catheter - CORRECT ANSWERS - used for treatment less than 2 weeks - if longer duration consider a picc line - lasts longer and has lower rates of phelbitis than short peripheral catheters, but have higher rates of non-life threatening complicated when compared to picc lines peripheral IV care when starting shift - CORRECT ANSWERS - verify correct solution is infusing at correct rate - examine drip chamber and ensure it is half full and IV is dripping - check date on tubing - check insertion site for redness, tenderness, pain, swelling - observe dressing--should be clean, dry, intact - if loose, soiled or wet--change immediately IV care through shift - CORRECT ANSWERS - asses IV solution rate tubing and insertion site every hour - IV tubing changes: every 3-4 days or per facility policy central venous lines - CORRECT ANSWERS - line inserted into a major vein in arm or chest--tip lies in superior vena cava outside the right atrium central venous lines advantages - CORRECT ANSWERS - rapid infusion of large amounts of fluid - irritating medications and hypertonic solutions are rapidly diluted--reducing risk for phlebitis FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - used for blood draws for those needing frequent lab monitoring - allows for monitoring central venous pressure central venous lines types - CORRECT ANSWERS - peripherally inserted central catheter - nontunneled central venous catheter - tunneled central venous catheter - implanted port for chemo after central venous catheter insertion - CORRECT ANSWERS must ensure correct placement with X ray before use picc lines - CORRECT ANSWERS - very common in those requiring long-term IV therapy - easy insertion via vein in arm by specially trained nurse...left in indefinitely if there are no complications - less complications than other central lines - sterile technique is used during insertion and with maintence care to prevent CLABSIS - requires regular assessment, flushing, and sterile dressing changes - often has multiple lumens--can simultaneously infuse multiple meds, fluids, blood, tpn even if incompatable because the lumens do not mix, can do blood draws nontunneled central lines - CORRECT ANSWERS - inserted in subclavian vein by provider at bedside - short term use for extensive IV therapy - high risk complications--catheter related infections, pneumothorax, PE tunneled central lines - CORRECT ANSWERS - used for lifelong or long-term IV therapy for TPN, chemotherapy, and dialysis use - surgically inserted into subclavian or jugular vein and then pulled through sub q tissue in chest wall before exiting skin FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - prevention: avoid insertion sites at flexion areas, use smallest gauge possible, stabilize catheter securely, adminsiter properly diluted meds - if suspected: immediately discontinue and contact provider. elevate extremity and apply warm, moist compress 3-4 times a day infiltraion - CORRECT ANSWERS - infusion of IV solution and or nonvesicant meds into surrounding tissues due to improper or infrequent manipulation of IV catheter infiltraion s/s - CORRECT ANSWERS swelling, tender, cool, firmness of extremity; blanching of skin infiltraion prevention - CORRECT ANSWERS avoid IV placement in areas of flexion or lower extremities; assess for infiltraion every 2 hours; always check patency before med admin infiltraion if suspected - CORRECT ANSWERS stop infusion immediately and remove catheter and assess for extravasation - elevate and encourage active ROM, and apply warm or cold compress; affected extramity; insert a new IV on opposite extremity extravasion - CORRECT ANSWERS - serious - infusion of a vesicant or irritating solution/med into surrounding tissue vesicant - CORRECT ANSWERS med that can cause tissue necrosis or formation of blisters s/s extravasion - CORRECT ANSWERS - can lead to permanent tissue or nerve damage - burning and discomfort; swelling, warmth, redness, discoloration of skin; blistering is late sign FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ extravasion prevention - CORRECT ANSWERS - known common vesicants- dopamine, norepinepherine, high concentrations of electrolytes, several ABX(cipro, doxy, vanco) - slowly infuse vesicant and irritating solutions/meds through a larger vain or via central line extravasion if suspected - CORRECT ANSWERS - stop infusion immediately withdrawl med from IV access, and notify provier to obtain orders for extravasation treatment and/or antidote - use skin marker to track area of damage - never apply pressure - use opposite extremity when inserting a new IV blood administration - CORRECT ANSWERS - IVF therapy is effective for fluids and electrolt=ytes - crystalloids cannot replace components of blood loss associated with trauma, anemia, hemorrhage or surgery--blood transfusions are required blood components necessary to - CORRECT ANSWERS - maintain oxygen and carbon dioxide transport capacity - maintain oncotic pressure - protect from infection more about blood admin - CORRECT ANSWERS - informed consent must be obtained - ensure blood to be administed is appropriate type for patient that crossmatching was done remembera bout blood types - CORRECT ANSWERS O=universal dOnor and AB=universal recipient assessments for blood admin - CORRECT ANSWERS - verify patient allergies and if they have had previous blood transfusion rxn FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - if IV is not present then put in an 18-24 gauge IV - FD requires blood products to have barcodes to allow forscanning to reduce errors - check product to verify absence of clotting--if clotting present, do not use it and obtain a replacement bag - obtain vital signs what does blood admin require - CORRECT ANSWERS 2 RN verifaction process/checkoff blood admin verify - CORRECT ANSWERS - patient name and DOB, blood group and type, ID number of blood product, and expiration date - most common reason for transfusion rxn is inappropriate identification of patient and matching the blood product to the patient blood transfusion process - CORRECT ANSWERS - gather Y type blood tubing and hang it with bag of NS - tubing must have in line filter - prime with NS - infuse slowly over 15 min first 15 min of blood tranfusion - CORRECT ANSWERS - recommended 2ml/min for first 15 min - do not leave the bedside during this time - most reactions occur within the 1st 15 min monitor for adr - CORRECT ANSWERS - flushing, fever, chills, dyspnea, sob, hypotension, itching, pain and nausea if no adr in first 15 min - CORRECT ANSWERS increase rate FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - burning along vein - flank pain and chest pain - shock nursing actions for reaction - CORRECT ANSWERS - stop transfusion immediately - notify providor immediately - remove tubing and infusion set - begin IV infusion of 0.9 NS with new tubing at KVO (keep vein open) rate - closely monitor patient and vital signs - send the blood product and tubing to thelab bacterial contamination with blood - CORRECT ANSWERS - could have bacterial if not used in less than 4 hrs circulatory overlaod with blood - CORRECT ANSWERS - usually occurs in whole blood transfused too quickly if PRBCs lead to fluid shift - S/s dyspnea, HA, tachycardia, HTN, JVD - stop infusion and notify provider immediately - may be given order to proceed at a slower rate - adminsiter O2 if needed... often given diuretics as well Leadership - CORRECT ANSWERS - the ability to influence, guide or direct others - focuses on relationships - may not have a position of authority management - CORRECT ANSWERS - the process of coordinating others and directing them toward a common goal - focuses on the task at hand FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - holds a position of authority trait theories - CORRECT ANSWERS leaders are born with certian personality traits behavioral theories - CORRECT ANSWERS leaders learn certain behaviors situational theories - CORRECT ANSWERS leaders may tailor their approach for each situation conemporary theories - CORRECT ANSWERS transactional leaders: reward and punishment transformational leaders: transform organization syles of leadership - CORRECT ANSWERS autocratic, democratic, laissez faire, bureaucratic autocratic - CORRECT ANSWERS leader exerts strong control over subordinates democratic - CORRECT ANSWERS employees want to participate in decisions Laissez-faire - CORRECT ANSWERS perissive; employees motivated by their own internal desire to do well bureaucratic - CORRECT ANSWERS employees are motivated by external forces - like someone else takign their job qualities of effective leaders - CORRECT ANSWERS Integrity FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ Dedication Magnanimity Humility Openness Creativity formal and informal leadership - CORRECT ANSWERS formal: practiced in an organization as a part of an official position Informal: emerges outside the structure of a formal position management theories - CORRECT ANSWERS fayols, mintzbergs Fayol's functions of management - CORRECT ANSWERS planning, organizing, directing, controlling mintzbergs behavioral model - CORRECT ANSWERS Included two assumptions: much of a manager's time is spent in human relations, and managers are more reactive than proactive Mintzberg's Contemporary Model - CORRECT ANSWERS Informational level -Communicating and controlling People level -Leading and linking people Action level -Doing qualities of effective managers - CORRECT ANSWERS Self-belief Self-awareness Self-management Personal integrity FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ five rights of safe delegation - CORRECT ANSWERS right task, right person, right circumstance, right communication, right supervision Advanced practice registered nurse panel - CORRECT ANSWERS - certified midwife clinical nurse specialist np registered nurse anesthetist Levels of healthcare overview - CORRECT ANSWERS healthcare delivery systems include the individuals who participate, the settings in which healthcare takes place, the agencies that regulate healthcare and the mechanisms that provide financial support map of levels of healthcare - CORRECT ANSWERS - consumers (patients) - providers (licensed and unlicensed) - different settings - regulatory agencies - healthcare financing mechanisms community health - CORRECT ANSWERS addresses the issues of health, desiease, and disability found within a defined group of people or in a specific person as a member of that community community health and nurse - CORRECT ANSWERS takes nurse out of the acute setting and places the practice of nursing within a population or in the patients home three major types of community health - CORRECT ANSWERS - public health - community based - home health care nursing FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ public health nursing main focus - CORRECT ANSWERS care of populations - neighborhoods, cities, counties, states, continents, world target populations of public health nursing - CORRECT ANSWERS young, elderly, homeless, inmates, area residents, etc what does public health nursing do - CORRECT ANSWERS they strategize to keep population healthy by preventing or controlling disease and other health threats Public health nursing interventions examples - CORRECT ANSWERS - advocating with housing authority to ensure accessable and safe housing - planning multilingual, culturally based immunization clinics to increase participation - investigating the incidence (rate of occurance) of foodborne illness public health nursing: core competencies (focused on populations) - CORRECT ANSWERS - monitor health - diagnose and investigate - inform, educate, empower - mobilize community partnerships - develop policies - enforce laws - links to/provide care - assure competent workforce - evaluate - research look at 7 - CORRECT ANSWERS FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ community based nursing - CORRECT ANSWERS provision of skilled nursing care in community or ambulatory care settings -ex: physicians office or outpatient clinic community based nursing main focus - CORRECT ANSWERS prevent illness, maintain or regain health, or die with dignity while living in a community target population of community based nursing - CORRECT ANSWERS provides personal care to individual clients or families what is essential for community based nursing - CORRECT ANSWERS health literacy assessment is essential to provide effective education community based nursing roles - CORRECT ANSWERS •Advocating for clients •Conducting routine checkups •Caring for the sick or dying •Providing client education •Managing chronic client conditions at outpatient, community, or government health care facilities health literacy - CORRECT ANSWERS - is a key role for public health and community based nurses to educate - must assess of both populations and individual clients health literacy in nursing - CORRECT ANSWERS - provide information and educational materials that are - culturally appropiate - in the clients language. - at reading level that can be easily understood FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - some private insurance may conver both skilled and unskilled services, depending on the plan and needs of client levels of healthcare - CORRECT ANSWERS -Primary: prevent disease or diability secondary: early identification of illness to limit its impact (early intervention) -tertiary: for those all ready diagnosed- focus on maintence or restorative health and rehab -Restorative health care: intermediate follow-up care for restoring health -continuing healthcare: address long-term or chronic healthcare needs primary examples - CORRECT ANSWERS vaccine clinics, employee wellness initiatives, fitness classes, nutrition education secondary examples - CORRECT ANSWERS BP screening, BS testing, BMI monitoring, mamograms, colonoscopies, blood work tertiaty examples - CORRECT ANSWERS a patient diagnosed with HTN follows low sodium diet, takes antihypertensives, pain management counseling, cardiac rehab programs social determinatns of health - CORRECT ANSWERS - conditions in which people are born, grown, work, live and age and the wider set of forces and systems shaping the conditions of daily life - can cause a population to be healthy or vulnerable to disease and disability why do community health nurses need to assess and analyze social determinants of health - CORRECT ANSWERS to determine potential impact on the health of the population that they serve intrinsic and extrinsic factors of social determinants of health - CORRECT ANSWERS - intrinsic: genetics, age, gender, ethicity FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ - extrinsic: physical environment, workplace conditions, food sources, socioeconomic influences examples of social determinants of health - CORRECT ANSWERS income, education, health literacy, living environment/neighborhood, early childhod development, fmaily structure, access to healthcare look at slide 20 - CORRECT ANSWERS community assessment - CORRECT ANSWERS collecting data on the social, cultural and ethic traditions that affect the community, family, and client values is essential to providing client centered care in the community or home setting community assessment next steps - CORRECT ANSWERS Diagnose greatest problems or needs Establish goals Plan interventions: primary, secondary, tertiary Evaluate effectiveness of interventions windshield survey - CORRECT ANSWERS observation of a community while driving a car or riding public transportation to collect data for a community assessment demographic assessment tools for community health - CORRECT ANSWERS - WHO - US census - state and local department of health - CDC - healthy people 2030 - OSHA FUNDAMENTALS EXAM 3 FOR FINAL EXAM WITH 215QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT |2024/2025 GRADE A+ assessment questions - CORRECT ANSWERS - what is the history of the community? - what preventable services are available, where and to what populations - what are the environmental and sanitation services - who are the stakeholders in the community, and what are their main concerns - what health proportion and educational services exist and where are they located planning in levels of healthcare - CORRECT ANSWERS once the greatest concerns of the community or home health client are prioritized, the nurse can generate a plan of care and establish goals and desired outcomes to address the needs determining goals for community health must include - CORRECT ANSWERS - key stakeholders - individuals or groups with an investment or significant interest in a topic implementation for community - CORRECT ANSWERS - determining waht actions should be implemented for community problems involves a collaborative effort and the assumption of multiple roles by the nurse - an important poing in this context is that community health nurses coordinate care both as case managers and as home health care nurses - they must be familiar with budget planning and the financial resources available to fund community programs Evaluation oc interventions - CORRECT ANSWERS - just as interventions must be collaborative within the community setting, so must evaluation of interventions, programs and services - the nurse can lead the evaluation process by designing strategies and tools that will determine whether outcome criteria are met - data and statistical analysis to support outcome findigns are especially significant in owrking with buisness owners and government agencies that invest financially in primary, secondary and tertiary prevention programs