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Summary NUR 323 Exam 1 Complete Study Guide
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This is a comprehensive and detailed study guide on Exam 1 for Nur 323. *Essential Study Material!! *At a price that's fair enough!!
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Exam #1 (9/26):• Nursing Care of the Hospitalized Patient
• Med Administration
• Fluid and Electrolyte Disturbances
• Blood Transfusions (podcast)
Nursing Care of the Hospitalized Patient
Levels of Prevention:
- Primary Prevention
- health promotion efforts/wellness education
- (ex. Flu Shot)
- Secondary Prevention:
- focus on people with health problems or illness and are at risk for developing complica-
tions or worsening conditions
- (ex. chemotherapy)
- Tertiary Prevention:
- Defect/Disability is permanent or irreversible
- Focus is rehabilitation, help people achieve highest level of functioning possible
- (ex. respiratory therapy for pt with emphysema)
Acute Care: (secondary & tertiary care)
- diagnosis and treatment of illness
- patients sicker, more complex, not stable
- limited inpatient days due to managed care
Roles of the Professional Nurse
- Nurse as Caregiver
- hands-on patient care
- delegation
- need to know what other personnel are allowed to do
- make sure they have the knowledge to perform allowed tasks, follow-up to make sure it
was done
Five Rights of Delegation:
- Right task
- Right circumstances
- Right person
- Right direction/communication
,- Right supervision/evaluation
Communication - SBAR
S - situation
B - background
A - assessment
R - recommendation / request
Acute Illness with multiple chronic illnesses - Co-Morbidities
- chronic disease accounts for 70% of deaths in U.S.
- complexity of care
- monitor status/deterioration of acute disease and co-morbidities
- treatment of acute illness may worsen chronic illness
- chronic illness may make it harder to treat acute illness
- interactions of treatments / medications
Contemporary Nursing Practice:
- Complex Health Care Environment
- Clinical Decision Making
- Influences on the Health Care System
- Financing - efforts to provide more cost-effective care
- Changing populations
- aging population; cultural diversity
- Expanding medical knowledge and technology
- Consumerism - more informed clients
Discharge Planning
- begins the moment a patient is admitted to a health care facility
- Case Management
- collaborative process; managing care across multiple settings & multiple levels of care
- involve patients and families
,Medication Administration
Types of Medication Action:
• Therapeutic Effect: expected or predictable physiologic response
• Adverse Effect: unintended/undesirable, often unpredictable severe responses to meds
• Idiosyncratic Reaction: client over-or under reacts to med; or has reaction different from normal
• Side Effect: predictable, unavoidable secondary effect
• Toxic Effect: medication accumulates in the blood stream
• Allergic Reaction: unpredictable response to a med; acts as antigen
Mild Allergic Reaction:
Urticaria: raised; irregular shaped skin eruptions with varying sizes/shapes; eruptions have reddened
margins and pale centers (hives)
Rash: small, raised vesicles that are usually reddened; often distributed over entire body
Pruritus: itching of skin; accompanies most rashes
Rhinitis: inflammation of mucus membranes lining the nose
Types of Medication Action:
- Anaphylaxis (life threatening)
- may occur with first administration or subsequent administrations
Medication Interactions
- occur when one medication modifies the action of another
- a synergistic effect occurs when the combined effect of 2 medications is greater than the effect of the
medications given separately
Medication Dose Responses:
• Serum half-life: time for serum medication concentrated to be halved
• Onset: time it takes for a medication to produce a response
• Peak: time in which a medication reaches its highest effective concentration
• Trough: minimum blood serum concentration before next scheduled dose
• Duration: time during which medication is present in concentration great enough to produce response
• Plateau: blood serum concentration is reached and maintained after repeated fixed doses
, Pharmacologic Concepts:
- Drug Names:
- generic and trade (brand) names
- classification
- indicates effect med has on the body
- medication forms:
- solid, liquid, oral forms, topical, parenteral, instillation into body cavities
6 Rights To Administering Medication:
1. right medication
2. right dose
3. right client
4. right route
5. right time
6. right documentation
Medication Errors:
- can cause or lead to inappropriate medication use or patient harm
- inaccurate prescribing
- administering extra dose or failing to administer a medication
Patient safety first- MUST REPORT
Medication Reconciliation
- compare medications pt took in previous setting to current medication orders
Prevention of Medication Errors:
- 10 rights
- check labels 3 times
- 2 patient identifiers
- no short cuts or work arounds
- “do not disturb”
Components of Medication Orders
- pts full name
- medication name
- dose
- route
- time and frequency of administration
- signature of health care provider
*if orders do not have all components - MUST VERIFY*
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