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RASMUSSEN: NURSING 1 - EXAM 1 QUESTIONS AND ANSWERS
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RASMUSSEN: NURSING 1 - EXAM 1 QUESTIONS AND ANSWERS
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RASMUSSEN: NURSING 1 - EXAM 1QUESTIONS AND ANSWERS
SBAR - Answer-a tool used by health care professionals when they communicate with
each other about critical changes in a patient's status.
S = Situation
B = Background
A = Assessment
R = Recommendation
Falls:
- In the home - Answer-- Prevalent in those older than 65 years
- Causes: slippery floors, stairs, tubs; low toilet seat; high bed
- Prevention: non-skid shoes; tidy clothes; proper lighting; grab bars/rails; no scatter
rugs
Falls:
- In the healthcare facility - Answer-Prevention:
- fall risk assessment
- environmental safety (clear clutter/ trip hazards)
- clean, dry floors
- client education
Patient education before leaving the hospital - Answer-aimed at what they are there for
- meds, diet, regiment, post-op instructions
National Patient Safety Goals
(Starting as of Jan 2019) - Answer-1. Improve the accuracy of patient identification
2. Improve the effectiveness of communication among caregivers.
3. Improve the safety of using medications
6. Reduce the harm associated with clinical alarm systems
7. Reduce the risks of healthcare-associated infections
15. The hospital identifies safety risks inherent in its patient population
How to prevent blood clots - Answer-- ted stockings
- Sequential compression devise (SCD) - compression stockings
,- Range of motion (ROM) exercises
- maintain good hydration
- blood thinner
- ambulation
Sentinel event - Answer-an unexpected occurrence involving death or serious physical
or psychological injury
- always warrants the need for immediate investigation and response
Scope of errors (two categories) - Answer-- Latent (Blunt end):
care coordination, documentation, electronic records
- Active (Sharp end):
prevention of decubitus ulcers, med admin (10 right and components of a physician
med order), fall prevention, invasive procedures, diagnosis workup, recognition of/action
on adverse events, communication.
Categories of errors - Answer-diagnostic, treatment, preventive, communication
Reducing pressure ulcers - Answer-- turn patients routinely
- change wet bedding and clothes immediately
- protect the skin over bony areas and check the skin routinely
- keep skin dry, clean, and moisturized
patients who are at risk for immobility - Answer-- smokers
- drinkers
- those on steroids
- those who are paralyzed
- Sedentary lifestyle
Consequences of Immobility:
- Integumentary system - Answer-- Increased pressure on the skin, which is aggravated
by metabolic changes
- Decreased circulation to the tissue causing ischemia which can lead to pressure ulcers
Consequences of Immobility:
- Respiratory - Answer-- Decreased respiratory movement resulting in decreased
oxygenation and carbon dioxide exchange
- Stasis of secretions and decreased/weakened respiratory muscles resulting in
atelectasis and hypostatic pneumonia
- Decreased cough response
Consequences of Immobility:
- Cardiovascular - Answer-- Orthostatic hypotension
- Less fluid volume in the circulatory system
- stasis of blood in the legs
, - diminished autonomic response
- decreased cardiac output leading to poor cardiac effectiveness with results in
increased cardiac workload
- increased oxygenation requirement
- increased risk of thrombus development
Consequences of Immobility:
- Metabolic - Answer-- Altered endocrine system
- decreased basal metabolic rate
- changes in protein, carbohydrate, and fat metabolism
- decreased appetite and altered nutritional intake
- negative nitrogen balance
- decreased protein resulting in loss of muscle
- loss of weight
- alterations in calcium/fluid/electrolytes
- reabsorption of calcium from bones
- decreased urinary elimination of calcium resulting in hypercalcemia
Consequences of Immobility:
- Genitourinary - Answer-- urinary stasis
- change in calcium metabolism with hypercalcemia resulting in renal calculi
- decreased fluid intake
- poor peri-care and indwelling catheter care resulting in UTIs
Consequences of Immobility:
- Gastrointestinal - Answer-- decreased peristalsis
- decreased fluid intake
- constipation/fecal impactions/diarrhea
Osteoporosis - Answer-- A condition in which the body's bones become weak and break
easily.
- Loss of bone density
- Known as the "Silent Disease" (no pain) becuase they dont know they have it until
they fracture a hip, wrist, or vertebrae
- Usually effects 60s and up ladies/ post-menopausal women
- (menopause: calcium and estrogen levels decrease = increase risk for osteoporosis)
Encourage:
- weight bearing exercises
- take vitamin D and give calcium supplements. Boneva or fosamax?
- you want them walking and staying active
osteomalacia - Answer-- disease marked by the softening of the bone caused by
calcium and vitamin D deficiency. (commonly in elderly, premature infants, and
vegetarians)
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