Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

NR324 / NR 324: Adult Health I Exam 1 Key Concept Review (Latest 2021 / 2022) Chamberlain, Study Guides, Projects, Research of Nursing

NR324 / NR 324: Adult Health I Exam 1 Key Concept Review (Latest 2021 / 2022) Chamberlain College of Nursing

Typology: Study Guides, Projects, Research

2020/2021

Available from 12/03/2021

Experttutor1
Experttutor1 🇬🇧

3.8

(90)

877 documents

Partial preview of the text

Download NR324 / NR 324: Adult Health I Exam 1 Key Concept Review (Latest 2021 / 2022) Chamberlain and more Study Guides, Projects, Research Nursing in PDF only on Docsity!

Module 1 – Professional Nursing I Concept Guide  Education & interventions to promote mobility o Use active ROM for patients that can move o Use PROM for patients who cannot move o Isometric exercises o Incorporation of pillows, wedges, overheard trapeze, hand rolls o Assist with ambulation o May require conditioning exercises o May need to stand-by help client in a controlled fall o Obtain appropriate assistive devices  canes, walkers, crutches, gait belt  Effects of immobility, Interventions to treat the effects of immobility o Venous stasis  blood pooling, compression of small vessels o Increased coagulability  due to coagulation factors o Deep vein thrombosis  treat prophylactically lovenox treat prophetically with SCDs & TED hose to apply pressure o Orthostatic hypotension  due to inability to maintain bp o Glucose intolerance o Constipation / Paralytic Ileus / Decreased Peristalsis o Urinary tract infection o Renal calculi o Depression o Sleep disturbances o Activity intolerance  Age-related growth and development changes, associated education/interventions- o Infants/toddlers  Cannot recognize danger  Tactile exploration of environment  Put everything in mouth  Car safety  Needs to be properly secured in the car seat, rear facing in the middle back  Totally dependent o Preschoolers  Play extends to outdoors  Safety of playground equipment  Need of outdoor supervision  Risk for injury if playing near streets  More adventurous o School-age children  Trusting authoritative figures or people who claim to be  Drowning and firearms are the leading cause for injury o Adolescents  False confidence, feel indestructible  Risk taking behaviors

 Smoking, alcohol, drugs, prescription meds, texting while driving, driving unsafely to impress peers, loud music  Most lack adult judgment  Homicide is #2 cause of death o Adults  #1 cause of death: unintentional poisoning  Alcohol, prescription medication  May be exposed to injury in the workplace  Chemicals, tools  Lifestyle choices  Some decline in strength and stamina  others maintain fitness o Older adults  Proximity to RN station is patients that are fall risk (older adults)  Loss of muscle strength  Loss of joint mobility  Slowing reflexes  Sensory losses  Risk for burns  College Age Students: What are the health risks? * o Sleep deprivation o IBS  Safety – Home safety o Co2 monitoring  Odorless, colorless gas  Produced by burning fuels, gas, wood, oil, kerosene  Faulty furnace or gas/water heater  Nonconventional ways to stay warm like an oven  Prevention: carbon dioxide detector  Treatment: 100% humidified air o Poisoning  Food, household chemicals, lead, medicines, cosmetics  Prevention: proper food handling, storage, preparation, cabinet locks, store poison, keep poison control telephone number available  Treatment: depends on the type of poison ingested; antidotes, charcoal, etc. o Scalds and burns  Elderly have decreased sensation  Heating pads may burn  Hot water, grease, sunburn, cigarettes  Prevention: guardrails by fireplace, turning pot handles, sunscreen, care when warming food in microwave o Fires  Cooking fires  Smoke inhalation  Home heating equipment  Prevention

 Smoke alarms  Caution with cigarettes  Fire extinguisher  No candles left unattended  Safety with holiday lights  Care with electrical cords o Falls  Prevalent in those 65+  Slippery floors, stairs, rubs, low toilet seat, high bed  Tripping hazards, scatter rugs, electrical cords  Inadequate lighting  Prevention  Nonskid footwear  Tidy clothes  Proper lighting  Grab bars/rails  No scatter rugs  Exercise regularly to increase balance and mobility o Firearms injury  Youth suicides  Domestic violence  Prevention  Firearms safety  Education for parents and children  Proper locked storage  Keep ammunition separate o Suffocation/Asphyxiation/Drowning  Suffocation  Infants younger than 1 year  Accidental death: drowning & choking  Children 1-18 years  Prevention/intervention  Know the proper crib safety for infants  Watch for small, removeable parts  Cut food into tiny pieces  Pay attention to mobiles, strings, cords, plastic bags  Know the Heimlich maneuver  Apply a barrier to pool  Know CPR

o Health-care-related safety  CO2 monitoring*  Equipment related accidents  Fire/electrical hazards  R.A.C.E  P.A.C.E  P.A.S.S  Restraints  Falls  Most common incident reported in hospitals  More frequent at change of shift, nights, weekends, holidays  Activate Fire Alarm (1) o R.A.C.E o A  activate alarm  Radiation safety: o Clustering of care for patients who have implanted radiation* o Exposure prevention  Wear protective shielding (usually a lead vest)  Stand behind protective glass (xray)  Cluster care/limit exposure (brachy or systemic therapy)  Body mechanics o How should nurses maintain good body mechanics?  Good posture/ proper body alignment  Work at comfortable height  Keep objects close to body  Use smooth movements  Lift with legs not with the back o Remember that the use of assistive devices is not just for patients  Ethics- know your definitions. o Beneficence  Promote positive actions to help others  Encourages the nurse to do good for the patients o Non-maleficence  Importance of preventing harm o Fidelity  Keeping obligations or promises to patients, to follow through with care o Veracity  The nurse’s obligation to tell the truth to the best of his/her knowledge o Social Justice*  Equality and fairness regardless of age, gender, sexual orientation, religion, race, ethnicity, and/or education o Moral Distress  Occurs when the nurse knows the ethically correct action to take but the nurse is constrained from taking it o Autonomy*

 The right to make own decision about their health care o Self-determination  Self-determination is the right to choose such as food Module 2  Falls and Fall risks* o Prevalent in those 65+ o Tripping hazards o Inadequate lighting o Ask about history of falls o Remove SCD devices when the patient is not in bed o Reassess at least every shift to determine changes in patient status o Move the patient closer to the nurses station o Assess for confusion or disorientation o Assess for postural hypotension o Environment safety  Adjust the lighting in the room  Call light within reach  Answer call light promptly  Clean, dry floors  Personal items within reach  Bed in lowest position  Urinal within reach  Client education (how to use the call light and when to call for help) o Offer to use the bedpan, bedside commode, urinal, prior to leaving the room o Up to 3 side rails raised o Document use of safety measures o Hourly or more frequent rounding o Place patient on fall risk precautions

 Fibromyalgia o Causes: genetic, musculoskeletal pain  amplifies painful sensations by affecting the way the brain and spinal cord process painful and nonpainful signals o Symptoms:  Intermittent  worsens with stress, sleep deprivation, increased activity, and weather conditions  Burning, gnawing pain & stiffness may be present all over the body, neck & extremities  Muscle tenderness and/or numbness and tingling in extremities  Sleep disturbances  Headache / sensitivity to noise, odor, light  Jaw pain  Cardiovascular  Dyspnea, chest pain, dysrhythmias  Blurred vision and dry eyes  Neurological  Forgetfulness and concentration problems  GI  Abdominal pain, diarrhea, constipation, heartburn  GU  Dysuria, urinary frequency, urgency, pelvic pain o Interventions/treatments*  Promote restful sleep habits  Avoid alcohol & caffeine  Regular exercise and/or PT  Stress management  Osteoarthritis o Causes: cartilage degenerates and synovial fluid decreases bone hypertrophies o Symptoms: pain, stiffness, tenderness, loss of flexibility, grating sensation, bone spurs, swelling o Interventions/treatments*  Acetaminophen is primary drug of choice  Symptoms relieved with rest  Non-pharmacologic treatments  Heat or cold application  Positioning  Balance rest with exercise  PT to promote muscle strengthening

 Osteoporosis o Causes  Decreased bone mass caused by lack of calcium, calcium loss, or decreased estrogen or testosterone o Symptoms  Fracture  Spine, hips, wrists most at risk  Dowager’s hump or kyphosis  Loss of height o Interventions/treatments- pain is not a normal finding*  Mobility and weight bearing exercises  Diet  Maintain healthy weight  Calcium rich food  Avoid use of tobacco and/or smoking  Paget’s Disease o Causes – exact cause is known  possible familial and genetic links o Symptoms  Pain  Increased temp over affected bone and localized symptoms  Hypercalcemia if pt. is immobile o Interventions/treatments- this is about pain management*  Non-steroidal anti-inflammatory drugs for pain relief  Osteomalacia- marked bone density. VITAMIN D deficiency*  Rheumatoid arthritis o Cause  Autoantibodies (rheumatoid factors) attack healthy tissue causing inflammation, cartilage break down and bone destruction  Primarily affects synovial joints, but is systemic and can affect the vascular system or body organs o Symptoms  Joint pain  Deformity  Loss of function  Fever, weakness, and weight loss  Symptoms do not improve with rest o Interventions/treatments  NSAIDs or DMARDS (methotrexate)  Non-pharmacologic interventions  Heat/cold therapy, balance rest & exercise, positioning & PT

 Gout o Causes: Uric acid causes an immune response which causes inflammation  may be inherited o Symptoms: Swelling and pain, impaired mobility, flank pain, dysuria o Interventions/treatments- KNOW YOUR MEDICATIONS*  Elevation  Bedrest for the first 24 hours  NSAIDs  Indocin  Colchicine (long term)  Allopurinol o Nodule (tophus)  Joint inflammation  Usually affects one joint (greater toe), but can settle in other joints (systemic)  Systemic Lupus Erythematosus (SLE) o Cause  Combination of environmental exposure and genetic factors  ANA destroys nucleated cells and form large complexes leading to an inflammatory immune response that destroys tissue and organs  Systemic progressive inflammatory connective tissue disorder  Onset may be acute or slow  Periods of remission and exacerbation  Affects women 10 times more than men, most often women ages 20- years o Symptoms  On remission  there may be no signs / symptoms  Flare up  Fatigue  Fever  Generalized weakness  Dry, scaly, raised “butterfly” rash, on the face and other sun exposed areas  Non-severe joint inflammation  Alopecia  Sjogren’s syndrome o Interventions/treatments  Immunosuppressants: methotrexate  Non-pharmacologic treatment  Avoid prolonged sun exposure & IV light  Avoid harsh perfumed substances  Cleanse skin with mild soap, thoroughly pat dry, apply moisture  Electromyography (EMG)

o What is it? *  Measures muscle response or electrical activity in response to nerve’s stimulation of the muscle o What is it for? *  Used to detect neuromuscular abnormalities o Why do you do it? *  To find out if muscles are responding the right way to nerve signals  Bone & Joint health, diagnostics o X-ray  Electromagnetic waves  creates pictures of the inside of the body o MRI  Medical imaging technique that uses a magnetic field and computer- generated radio waves to create detailed images of the organs and tissues in the body  Transplants of bone o Allograft  Bone or tissue that is transplanted from one person to another o Autograft  Bone or tissue that is transferred from one spot to another on the patient’s body  Calcium o Too little calcium  Children may not reach their full potential adult height  Adults may have low bone mass  risk for osteoporosis  Vitamin D o Fat soluble vitamin o Promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal bone mineralization and to prevent hypocalcemic tetany  Zinc o Involved in cellular metabolism o Support immune system o Contributes to wound healing o If deficient, diarrhea, and the cold  Other vitamin supplements???  pH o 7.35-7.45 normal range o pH measures hydrogen ions in the blood o balance of pH and bicarbonate is largely controlled by the lungs and kidneys

 Respiratory Acidosis o Causes  Respiratory depression  Anesthesia, overdose, increase ICP, airway obstruction, reduce alveolar capillary diffusion, (pneumonia, COPD, ARDS, PE)  Right lung  Decrease in pH (lower than 7.35)  Left lung  Increase PCO2 (increase 48 mmHg)  Retention of CO2 by lungs o Symptoms  Hypoventilation  hypoxia  Rapid, shallow respirations  Low blood pressure  Skin/mucosa pale to cyanotic  Headache  Hyperkalemia  Dysrhythmias (increase in K+)  Drowsiness, dizziness, disorientation

 Respiratory Alkalosis o Causes  Hyperventilation  Anxiety  PE  Fear mechanical ventilation  Too little H+ o Symptoms  Hyperventilation  Increase rate and depth  Tachycardia  Low or normal blood pressure  Hypokalemia  Numbness & tingling of extremities  Hyper reflexes & muscle cramps  Seizures  Increase anxiety and irritability   Metabolic Acidosis o Causes  Increase in H+ production  DKA  Hypermetabolism  Decrease H+ elimination  Renal failure  Decrease HCO3 production  Dehydration  Liver failure  Increase HCO3 elimination  Diarrhea  Fistulas o Symptoms  Headache  Decrease in BP  Hyperkalemia  Muscle twitching  Warm, flushed skin (vasodilation)  Nausea, vomiting  Decrease in muscle tone  Decrease in reflexes  Confusion  Increase in drowsiness

 Metabolic Alkalosis o Causes  Increase HCO  Antacids admin of sodium bicarbonate  Decrease H+  NG suctioning, prolonged vomiting, hypercortisolism o Symptoms  Confusion  Dysrhythmias  Tachycardia from decrease in K+  Compensatory irritability  Nausea  Vomiting  Diarrhea  Tremors  Muscle cramps  Tingling & toes (decreased serum Ca++)  Positioning patients, use of assistive devices o Positioning  clients with proper alignment in bed  Positioning to suit client needs  Help client breathe  Prevents contractures caused by immobility  Medication administration, Dosage calculations  AROM* o Active range of motion – those who can help move  PROM* o Passive range of motion – those who cannot help move  Restraints o Time frames  Document every 2 hour for medical restraints  Must be removed every 2 hours o Order requirements*  24-hour order (medical restraint)