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Nurs 2000 Study questions Solved 100% Correct
Infectious agent micro-organism that can cause harm/infections Reservoir where the microorganism grows and multiplies (person, equipment, water source) Portal of Exit Ears, nose, mouth, skin, body fluids Mode of Transportation Droplet (larger, spit or mucus in the air), airborne (very small that can stay in the air for a long time), contact (direct or indirect), airborne, vector insects, vehicle-water-borne Portal of Entry Eyes, respiratory, fecal-oral, parenteral, through skin, urogenital, transplacental Susceptible Host The person at risk of the infection and not able to fight it off (resident, provider, more vulnerable include elderly, children, immunocompromised, etc.) What is the order of the chain of infection?
- Infectious Agent
- Reservoir
- Portal of Exit
- Mode of Transmission
- Portal of Entry
- Susceptible Host What factors would increase a person's susceptibility to infection? Age Underlying condition (HIV/AIDS) Malignancy Transplants Medications (immunosuppressants, antirejection meds, corticosteroids, gastric suppressants) Surgical procedures Radiation therapy Indwelling devices What is the #1 tool we have for breaking the chain of infection? Washing our hands, it is the most cost effective means of preventing infection. Alcohol-based hand sanitize Rub hands together until dry Does not work on soiled hands Generally less drying than soap Antimicrobial soap Scribe for at least 20 seconds Warm water
that items such as gloves and equipment are sterile, meaning that they do not have micro- organisms present on them. Standard Precautions Applies to all patients, PPE is chosen based on what the nurse expects to come in contact with. Includes principles like foam in, foam out, etc. Contact Precautions Practices used to prevent spread of disease by direct or indirect contact Ex. Vancomycin Resistant Enterococcus (VRE), MRSE, draining skin infections Enteric Precautions Gowns and gloves required, you must wash your hands with soap and water after exiting room. ex. C.Diff, norovirus, rotavirus, e.coli, salmonella, etc. Droplet precautions Must be followed for a patient known or suspected to be infected with pathogens transmitted by large-particle droplets expelled during coughing, sneezing, talking, or laughing. Examples: Covid, Flu, bacterial meningitis, whooping cough, mumps, rubella etc. Airborne Precautions Methods of infection control that must be used for patients known or suspected to be infected with pathogens transmitted by airborne droplet nuclei.
Ex. TB, Covid-19, measles, chickenpox (varicella), smallpox Gas Exchange Process by which oxygen is transported to cells and CO2 is transported from cells Upper Respiratory Lower Respiratory How many lobes are in each lung? There are three lobes in the right lung and two lobes in the left lung. What happens in the alveoli? It is in this structure where pulmonary diffusions occurs. Oxygen from the air diffuses from the alveoli into the blood in the pulmonary capillaries and carbon dioxide diffuses from the blood into the alveoli in the lungs. Ventilation Flow of air in and out of lungs, filling then emptying the alveoli Pleural Cavity Space that allows for lung expansion, there is a right and left pleural cavity. If there is trauma, air or blood can build up in this space. What are the main triggers for deciding if you will breathe more or less? Chemoreceptors that measure O2, CO2, and H2 concentrations.
Perfusion The flow of oxygenated blood, driven by the cardiopulmonary system, into the alveolar capillaries and body tissues Airway Resistance The pressure or opposition of the tissues in the airway to the flow of air. Inspiratory Reserve Volume Volume of air breathed in after a typical inspiration. Tidal Volume Volume of air inspired and expired with each breath. Residual Volume Volume of air remaining in the alveoli after expiration. Forced Vital Capacity Volume of air remaining in the lung after maximal inspiration. Vital Capacity Maximum volume of air that is expelled after maximal inspiration. Total Lung Capacity Volume of air remaining in the lung after maximal inspiration. Lung Anatomy Pulmonary Circulation
The movement of deoxygenated blood from the heart to the lungs, where it is oxygenated once again through gas exchange and then disseminated back into the systemic circulation Blood leaving the right ventricle of the heart is deoxygenated; it is routed to the pulmonary artery and into the pulmonary arterioles to the pulmonary capillaries, where gas exchange occurs. In the capillaries, the blood is oxygenated. It then moves from the pulmonary capillaries to the pulmonary veins and is returned to the left atrium of the heart. From the left atrium, the blood enters the left ventricle, which pumps it into the aorta and, in turn, systemic circulation, which subsequently returns the deoxygenated blood to the lungs. Myocardial Blood Flow During diastole, the mitral and tricuspid valves permit blood to flow from the atria into the relaxed ventricles. During systole, the mitral and tricuspid valves close and the aortic and pulmonic valves open. The first heart sound (S1) can be heard during the systolic phase, when the mitral and tricuspid valves close. The mitral and tricuspid valves remain closed as blood moves forward. Pressure in the ventricles decreases as they empty, the aortic and pulmonic valves close, and the second heart sound (S2) is heard. A murmur is a blowing or whooshing sound produced when backflow of blood through the valve occurs and can be noted in clients who have incompetent valves. Cardiac Output Cardiac output (CO) is the volume of blood pumped by the left ventricle in 1 minute. It is regulated by the heart rate (HR) and stroke volume (SV).
Anterior pattern for auscultation, palpation, and percussing Posterior pattern for auscultation, palpation, and percussing Normal lung sounds Bronchial - high pitched, harsh, short during inspiration and long during expiration Bronchovesicular- moderate pitch and amplitude, same length during inspiration and expiration. Vesicular- low, breezy soft, long during inspiration and short during expiration What causes crackles in lung sounds? Crackles or intermittent popping, are heard in any case of fluid in the lungs Ex. Bronchitis, COPD What causes wheezing lung sounds? Caused by air moving through narrowed and obstructive airways, these are heard continuously on inspiration and expiration Ex. Asthma/allergies, pneumonia, COPD What causes pleural rub and what does it sound like? A pleural rub is caused by inflammation of the visceral and parietal pleurae, causing the normally smooth, lubricated surfaces to become rough and rub together during breathing. IT can be causes by inflammation, pulmonary embolism, chest trauma, etc.
It sounds like a low-pitched, harsh, grating, or creaking sound, similar to leather rubbing together or sandpaper, heard on both inspiration and expiration. What causes rhonchi and what does it sound like? Rhonchi are low-pitched, rattling lung sounds resembling snoring or gurgling, caused by airway obstruction from mucus, fluids, or inflammation in the large airways (bronchi). Often heard during exhalation, these continuous sounds frequently clear or change after coughing. Common causes include bronchitis, pneumonia, COPD, and cystic fibrosis. What causes rhonchi and what does it sound like? Stridor is a medical emergency that sounds like a high-pitched, musical, or squeaky breathing sound caused by a narrowed or obstructed upper airway (larynx or trachea), typically heard upon breathing in (inspiration). Often described as a screeching or whistling noise, it results from turbulent airflow through a restricted airway. Common causes include croup, inhaled foreign objects, epiglottitis, vocal cord issues, or laryngomalacia in infants. What is hypoxia? Below expected level of oxygen in body tissues Could be caused by hypoxemia, which is a low amount of oxygen in the blood. What causes hypoxia?
Eupnea Normal respirations, 12-20/min Hypoventilation Shallow breathing with lower than expected RR, leading to an excess of CO2 levels and acidosis (trauma, neurological or neuromuscular disorder, medications like opioids) Hyperventilation Increase in the rate and depth of breathing that can lead to an excess loss of CO2 from blood (anxiety attacks, diabetic ketoacidosis, infections, lung diseases) Florence Nightingale
- Evidence-based practice: Connected unclean conditions to wound infections (Crimean War)
- Established cleanliness standards, documentation practices, and data collection methods
- Founded first scientifically-based nursing school (1860)
- Elevated nursing to a respected profession Clara Barton
- Provided battlefield nursing during Civil War
- Created Missing Soldiers Office to locate soldiers and notify families
- Founded American Red Cross (1881)
- Advocated for nurse training and disaster relief Dorthea Dix
- Mental health reform advocate; established 30+ psychiatric hospitals
- Promoted humane treatment of mentally ill individuals
- Superintendent of Army Nurses during Civil War
- Advanced nursing education and indigenous rights Ildaura Murillo-Rohde
- Founded National Association of Hispanic Nurses (1975)
- First psychiatric nurse to earn PhD in U.S.
- Promoted cultural competence and diversity in nursing Eddie Bernice Johnson
- First RN elected to U.S. Congress (1992-2023)
- Introduced STEM Education Act
- Provided grant support for minority students
- Demonstrated nurses' impact on healthcare policy LPN/LVN Length: 12-18 months Scope: Basic bedside care under RN/physician supervision Licensure: NCLEX-PN exam RN - Diploma Degree
Specializations: Nurse Practitioner, Clinical Nurse Specialist, Nurse Educator, Nurse Administrator, Nurse Midwife, Nurse Anesthetist Prepares for advanced practice and leadership roles DNP Clinical practice doctorate (terminal practice degree) Length: 3-4 years post-BSN; 1-2 years post-MSN Focus: Advanced clinical practice, healthcare leadership, quality improvement, translating research to practice Requires practice-focused capstone project PhD Research doctorate (academic degree) Length: 4-6 years post-BSN Focus: Nursing research, theory development, generating new knowledge Requires original research dissertation
Career path: Researcher, academic faculty APRN Four APRN Roles (require graduate education):
- Nurse Practitioner (NP) - primary/specialty care
- Clinical Nurse Specialist (CNS) - expert in specialized area 3.Certified Nurse Midwife (CNM) - women's reproductive/obstetric care 4 Certified Registered Nurse Anesthetist (CRNA) - administers anesthesia Scope: Advanced assessment, diagnosis, treatment, prescriptive authority (state-dependent), ordering/interpreting tests Certification: National certification required in specialty area National Student Nurses Association (NSNA) Founded: 1952 Members: 60,000+ nursing students Purpose: Prepare students for licensure; introduce professional development Benefits: Leadership training, networking, career development, scholarships, annual convention
- Standards: Develops Scope and Standards of Practice, Code of Ethics
- Workplace Advocacy: Safe staffing, workplace safety, fair compensation
- Policy: Legislative advocacy, healthcare access, social determinants of health
- Development: Continuing education, leadership programs
- Credentialing: ANCC certifications, Magnet Recognition Program®
- Publications: American Nurse Journal, nursing practice standards National League for Nursing (NLN) Founded: 1893 (reorganized 1952) Mission: Promote excellence in nursing education Focus: Nurse educators and nursing programs (vs. ANA's focus on practicing nurses) Key Functions:
- Sets standards for nursing education
- Faculty development and mentorship
- Promotes diversity in nursing workforce
- Certified Nurse Educator (CNE®) certification
- Commission for Nursing Education - Accreditation (CNEA)
- Programs: Centers of Excellence, testing services, Education Summit
- Publications: Nursing Education Perspectives Adult Normal BP Range
less than 120/less than 80 Adult Elevated BP Range 120 - 129/less than 80 Adult Hypertension Stage 1 Range 130 - 139/80- 89 Adult Hypertension Stage 2 140 or higher/90 or higher Adult Hypertensive Crisis >180 and/or > Average Newborn BP Range 64/ Average versus hypertension range for toddler(M/F) 85 - 91/37-46 / 86-89/40- 49 >103-109/56-65 / >104-107/58- 67 Average versus hypertension range for preschooler (M/F) 91 - 98/46-53 / 89-93/49- 54 >109-112/65-72 / >107-110/67- 72
