nur 101 exam 1

Define Safety

preventing harm and keeping the patient safe.

What are the 6 competencies of QSEN and what do they stand for?

Patient Centered Care: providing care that respects the patient’s preferences, values, and needs

Teamwork and Collaboration: working effectively with other healthcare professionals, patients, and families.

Evidence Based Practice: using the best current evidence along with clinical expertise and patient preferences to guide care.

Quality Improvement: identifying ways to improve healthcare processes and patient outcomes.

Safety: minimizing the risk of harm to patients and healthcare workers.

Informatics: using information and technology to communicate, manage knowledge, and support safe patient care.

Define Adverse Event

something harmful happens to the patient during care.

Define Near Miss

almost caused harm, but didn’t.

sentinel event

serious harm to the patient.

Which Level of Error requires an immediate investigation?

sentinel event

Safety

Preventing harm and keeping the patient safe.

define treatment error

An error in performing a procedure, administering treatment, or dosing medication.

define preventative error

failing to prevent a problem

define communication error

important information is not communicated correctly.

define culture of safety

everyone works together to keep patients safe.

define just culture

learn from mistakes, not just punish people.

What are some common safety issues at patients bedside

• Bed left too high → increases fall risk.

• Bed not locked → bed could move unexpectedly.

• Call light out of reach → patient may try to get up alone.

• Clutter on the floor → can cause trips and falls.

• Poor lighting → makes it harder to see hazards.

• Wet floors → increase fall risk.

• Equipment/cords in the way → can cause falls or interfere with care.

• Side rails used incorrectly → can create safety risks.

• Personal items out of reach → patient may try to get up to reach them

What is a variance /occurrence report?

A reporting system that identifies errors and near misses. Initiates follow up and evaluation of workflow

Identify ways/interventions to reduce falls:

• Keep the bed in the lowest position and locked.

• Keep the call light within reach.

• Keep the floor clear of clutter and cords.

• Make sure the patient has proper footwear.

• Provide assistance when ambulating or transferring.

• Use fall-risk precautions based on the patient’s risk level.

• Keep frequently used personal items within reach.

• Perform hourly rounding to check patient needs.

Identify ways/interventions to reduce medication errors:

Right patient + right medication + right dose + right route + right time + check everything.

Who is The Joint Commission (TJC)

An organization that sets safety and quality standards for healthcare organizations and evaluates them to help make sure patients receive safe, high-quality care.

What is the purpose of the National Performance Goals(NPGs)?

To set safety and quality goals for healthcare organizations to help improve patient care and reduce risks to patients.

Define quality.

providing safe, effective care that meets the patient’s needs.

What is a “Never Event” and give an example

A serious, preventable patient safety event that should never happen in healthcare.

Example: Performing surgery on the wrong patient or wrong body part.

Define communication

The process of exchanging information, thoughts, and feelings between people.

Forms of communication

Verbal, Nonverbal, Written, Electronic

define communication competence

communicating effectively and appropriately.

define SOLER

S-sit at eye level

O-open posture

L- lean in

E-eye contact

R- relax

Define ISBARR and what its used for

to safely and clearly pass critical patient information between professionals

I- introduction

S- Situation

B- Background

A- Assessment

R- request

R- Repeat Back

What is therapeutic communication?

Using words and actions to build relationships, promote understanding, and achieve healthcare goals.

What are some therapuetic communication techniques?

Sharing Observations, Acknowledge Feelings, Silence, Providing Information, Clarifying, Focusing, Paraphrasing,Open-ended questions, Summarizing, Confrontation

What is the difference between Brand or Trade names and generic names for drugs? Give an example

Brand/Trade name: The name given to a drug by the company that makes it.

Generic name: The standard name of the drug’s active ingredient.

Example:

• Brand/Trade: Tylenol

• Generic: acetaminophen

What are the 3 routes of administration in medicine and then describe them

Enteral — through the GI tract (ex: oral).

Parenteral — given by injection (ex: IV, IM, subcutaneous).

Topical — applied to the skin or mucous membranes.

Define Pharmacokinetics

the movement and modification of a medication inside the body, and involves absorption, distribution, metabolism, and excretion.

Define the step of pharmacokinetics: Absorption

The process of a drug moving from the site of administration into the bloodstream.

Factors that affect Absorption

Route of administration, blood flow, drug formulation, and food/GI conditions can affect how quickly a drug enters the bloodstream.

Define the step of pharmacokinetics: Distribution

The process of a drug moving from the bloodstream to the body’s tissues and organs.

Factors that affect Distribution

Blood flow, protein binding, body composition, and the drug’s ability to cross cell membranes can affect how a drug is distributed.

Define the step of pharmacokinetics: Metabolism

The process of the body chemically changing a drug, mainly in the liver, so it can be removed from the body.

Factors that affect Metabolism

Age, liver function, genetics, other medications, and nutrition can affect how quickly a drug is metabolized.

Define the step of pharmacokinetics: excretion

The process of the body removing a drug from the body, mainly through the kidneys and urine.

Factors that affect excretion

Kidney function, age, hydration, and blood flow to the kidneys can affect how quickly a drug is removed from the body.

Which organ is responsible for metabolism of drugs in the body?

Liver

Where can excretion happen in the body?

Drugs can be excreted mainly through the kidneys (urine), but also through feces, lungs, sweat, saliva, and breast milk.

Explain protein binding

When a drug attaches to proteins in the blood, mainly albumin. The drug that is not bound is free to move into tissues and produce an effect.

What is the first pass effect

When an oral drug travels through the digestive system to the liver first, where some of the drug is metabolized before it reaches the bloodstream.

What is meant by bioavailability of a drug?

The amount of a drug that reaches the bloodstream and is available to produce an effect.

Define Pharmacodynamics

the biochemical changes that occur in the body as a result of taking a medication. Therapeutic effects are the intended effects of the medication.

Half-life

The amount of time it takes for the amount of a drug in the body to decrease by 50%.

Onset of action

The time it takes for a medication to start producing its therapeutic effect.

Peak effect

The time when a medication reaches its maximum therapeutic effect.

Duration of Action

The length of time a medication continues to produce its therapeutic effect.

Peak Level

highest amount of drug in the blood.

Trough Level

The lowest concentration of a drug in the bloodstream, usually measured just before the next dose.

Therapeutic index

The ratio between the toxic & therapeutic concentrations of a drug.

What is an agonist drug?

A drug that binds to a receptor and activates it, producing a response.

What is an antagonist drug?

A drug that binds to a receptor and blocks or prevents a response.

Define adverse drug reactions (ADR)

An unwanted or harmful reaction to a medication when it is taken as intended.

What is anaphylactic shock?

A severe, life-threatening allergic reaction that can cause swelling, difficulty breathing, and a dangerous drop in blood pressure.

What does an allergic reaction look like?

An immune response to a medication that can cause rash, itching, hives, swelling, or difficulty breathing.

Drug Tolerance

When the body becomes less responsive to a drug over time, so a higher dose may be needed to produce the same effect.

Cumulative Effect

When a drug builds up in the body because another dose is given before the previous dose has been fully eliminated.

Toxicity

A harmful effect caused by too much of a drug building up in the body.

Precautions

Actions taken to prevent harm or reduce risk when giving a medication or providing patient care.

Contraindications

a condition, especially one related to a disease state or patient characteristic, that renders a particular form of treatment improper or undesirable. Patients can have severe or life-threatening adverse drug reactions.

Drug-drug interaction

When one drug affects the action or effectiveness of another drug when they are taken together.

Drug-food interaction

When a food or drink affects how a medication works, such as changing its absorption or effectiveness.

what is normal temperature range?

36-38*C or 96.8-100.4*F

Factors that can influence tempertaure

Age, Exercise, Hormones, Stress, Environmental Temperature, Medications, Daily Fluctuations

Normal range for pulse

adults being 60-100 bpm

Factors that can influence pulse

Age, Exercise, Position Change, Medications, Temperature, Sympathetic stimulation

Normal respiration range

adults 12-20 breaths/min

Factors that influence respirations

Fever, Exercise, Diseases or trauma of chest wall or muscles, Smoking, Medications, Neurological injury

normal range of oxygen saturation (SpO2)

Normal range is 95-100%

Factors that can influence oxygen saturation

Peripheral vascular disease, hypothermia, medications, hypotension, peripheral edema, respiratory diseases

Define Stress

A physical or emotional response to a stressor that causes the body to react.

Define Coping

The ways a person deals with and manages stress.

When a stressor is perceived as a more serious threat, a stress response is initiated by what?

the hypothalamus

Activation of the sympathetic nervous system causes the release of what?

Causes the release of epinephrine (adrenaline) and norepinephrine (noradrenaline), which prepare the body for the “fight-or-flight” response.

What changes do epinephrine (adrenaline) and norepinephrine (noradrenaline) hormones cause to the body?

• Increasing heart rate

• Increasing blood pressure

• Increasing breathing rate

• Increasing blood flow to muscles

• Increasing blood glucose for quick energy

• decrease digestion

• decrease immune function

• decrease ovulation

What does cortisol elevate in the body?

Increases blood glucose

List the different categories of sources of stress and give examples of each.

Physical Stress: illness, injury, pain, lack of sleep

Psychological Stress: anxiety, fear, low self esteem

Social Stress: relationship problems, family conflicts, loneliness

Environmental: temperatures, pollution, crowded environments

Life events: death of love one, divorce

List the different types of stress and explain them

Acute stress: short term, immediate

Chronic stress: long lasting, repeat stress

Eustress: positive stress that motivates or helps adaption

Distress: negative of overwhelming stress

consequence of stress on the central nervous system

headaches, difficulty concentrating, sleep disturbances, anxiety, irriatability, changes in mood

consequence of stress on the cardiovascular system

increased heart rate, increased blood pressure, increased work load on heart,

consequence of stress on the immune system

suppress immune function, reduce inflammation

consequnence of stress on the musculoskeletal system

increased muscle tension, muscle aches, fatigue

consequence of stress on the gastrointestinal system

decreased digestion, nausea, stomach discomfort, diarrhea or constipation

consequence of stress on the integumentary system

increased sweating, acne or rash

consequence of stress on the reproductive system

decreased sexual desire, interfere with reproductive function

populations at risk for stress

Chronic illnesses, older adults, children, poverty, life changes

individuals at risk for stress

poor coping skills, little social support, multiple stressors, difficult changing

What will you see with sympathetic nervous system activation?

Increase heart rate, increase blood pressure, increase respiratory rate, dialted pupils, sweating, decreased digestion

infection

invasion of microorganisms in body tissue that can multiply and cause disease

acute infection

infection that starts quickly and lasts a short period of time

chronic infection

infection that develops over a long period of time

localized

an infection that is limited to one specific area or part of the body. that area showing redness, inflammation, pain

disseminated

an infection that spreads from its original site to other areas of the body

systemic

an infection that affects the entire body rather than just one area. causes fever, chills, lower blood pressure, increase heart rate, increase respirations, decrease spO2

sepsis

a life threatening response to infection that can cause organ damage

epidemic

when the number of cases of a disease is higher than normally expected in a particular community

pandemic

an epidemic that spreads across multiple countries or continents

health-care acquired infections

an infection a person develops while receiving health care that was not present when care began

community-acquired infection

infection that is aquired outside a healthcare setting