SENMC Nursing Fundamentals Unit 6: Integrated Study Guide

Comprehensive practice flashcards covering Complementary Care, Pharmacology, Perioperative Nursing, and Comfort & Pain Management from Unit 6 of the SENMC Nursing Fundamentals Review Series.

What is the Clinical Golden Rule when an order, consent, patient assessment, or treatment seems unsafe?

ASSESS, PAUSE, CLARIFY, and PROTECT THE PATIENT. Never administer a medication or proceed with a procedure if there is any ambiguity or safety concern.

How does the study guide define Conventional / Allopathic care?

Mainstream care focusing on disease diagnosis, medication, surgery, and technology (e.g., prescribed opioid analgesic for postoperative incision pain).

What is the core distinction between Complementary, Integrative, and Alternative health approaches?

Complementary is used WITH conventional care; Integrative is conventional and complementary methods deliberately COORDINATED in a whole-person plan; Alternative is used INSTEAD OF conventional care.

What are common examples and mechanisms of the Nutritional health category in complementary care?

Examples include dietary patterns, botanicals, vitamins, minerals, and probiotics. They provide nourishment, correct deficiencies, and balance systemic gut and metabolic health.

What mechanisms of health promotion are associated with Psychological / Mind-Body therapies like meditation and guided imagery?

They manage the cognitive stress response, direct attention, and regulate the autonomic nervous system.

Which common botanicals and supplements pose an increased bleeding risk?

Ginkgo, Garlic, Ginseng, and Vitamin E.

Which herbal supplements are noted for potential sedative interactions?

Valerian and Kava.

What is the priority nursing action when a patient scheduled for elective surgery reports taking a nightly herbal sleep aid?

Obtain the exact supplement name, dosage, frequency, and last dose; assess for bleeding or sedative interactions; document findings; and immediately alert the surgical and anesthesia team.

What is the difference between Pharmacokinetics and Pharmacodynamics?

Pharmacokinetics is what the BODY does to the drug (ADME: Absorption, Distribution, Metabolism, Excretion), whereas Pharmacodynamics is what the DRUG does to the BODY (biochemical and physiological effects).

Which organs are primarily responsible for drug metabolism and drug excretion?

The liver metabolizes most drugs, and the kidneys excrete them.

How is drug Half-Life ($t_{1/2}$) defined, and why is it clinically significant?

It is the time required for serum drug concentration to decrease by $50\%$. It determines dosing frequency, steady-state achievement, and accumulation risk.

What is the difference between a side effect and an adverse effect of a medication?

A side effect is a predictable, secondary response (e.g., constipation), while an adverse effect is a harmful, unintended response (e.g., respiratory depression from opioids).

What are the 10 Rights of Medication Administration?

Right Patient, Right Drug, Right Dose, Right Route, Right Time, Right Documentation, Right Reason/Indication, Right Assessment, Right Response, and Right to Refuse.

At what three specific checkpoints must a nurse compare the medication label against the MAR?

(1) When removing from storage, (2) when preparing/dispensing, and (3) at the bedside prior to administration.

What is the dosage formulation formula used for medication administration calculations?

$$\left(\frac{\text{Dose Ordered}}{\text{Dose on Hand}}\right) \times \text{Quantity on Hand} = \text{Amount to Administer}$$

If an order calls for Ampicillin $750\,\text{mg}$ PO and capsules on hand are $250\,\text{mg}$, how many capsules are administered?

$3$ capsules, calculated as: $\left(\frac{750\,\text{mg}}{250\,\text{mg}}\right) \times 1\,\text{capsule} = 3\,\text{capsules}$.

Which types of oral medications must NEVER be crushed?

Extended-Release (ER/XL) or Enteric-Coated (EC) tablets.

What is a mandatory safety rule when applying a new transdermal medication patch?

Always remove the OLD transdermal patch before applying a new one, rotate sites, clean the skin, document the location, and avoid external heat sources.

Why must a patient rinse their mouth after using an inhaled corticosteroid?

To prevent oral candidiasis.

What is the Teach-Back Method in patient medication education?

An interactive health communication technique where the patient demonstrates understanding in their own words or actions using open-ended questions (e.g., 'Show me how you will measure your dose at home') rather than passive questions.

What are the time frames for the three phases of the surgical experience?

Preoperative: Decision for surgery until transfer to OR bed; Intraoperative: Transfer to OR bed until admission to PACU; Postoperative: PACU admission through recovery and healing.

How are surgical procedures classified based on urgency?

Elective (planned, non-emergent), Urgent (prompt treatment within $24\text{--}48\,\text{h}$), and Emergency (immediate life or limb threat).

What are the distinct responsibilities of the surgeon versus the nurse regarding informed consent?

The surgeon MUST explain procedure details, risks, benefits, alternatives, and expected outcomes. The nurse witnesses the signature, verifies understanding, and confirms voluntariness (pausing and calling the surgeon back if confusion arises).

What four elements must the entire surgical team verify during the Surgical Safety Time-Out immediately before incision?

Correct Patient, Correct Procedure, Correct Surgical Site/Laterality, and Equipment Readiness.

What are the clinical signs of postoperative atelectasis and its primary preventive nursing interventions?

Signs: Shallow breathing, diminished lung sounds, low-grade fever, and hypoxemia. Interventions: Incentive spirometry q1h while awake, deep breathing and coughing, and early ambulation.

What clinical manifestations indicate a paralytic ileus postoperatively?

Abdominal distention, absent bowel sounds, nausea, vomiting, and no flatus.

What immediate interventions are required if surgical wound evisceration occurs?

Cover exposed viscera with sterile saline-soaked gauze, place the patient in low Fowler's position with knees flexed, and notify the surgeon IMMEDIATELY.

What urinary output threshold prompts evaluation for postoperative urinary retention?

Voiding less than $30\,\text{mL/hr}$.

What is the single most reliable indicator of a patient's pain?

Patient self-report.

What do the letters in the PQRSTU pain assessment framework represent?

Provoking/Palliative factors, Quality, Region/Radiation, Severity, Timing/Duration, and Impact on User Function.

How does Acute Nociceptive Pain differ from Chronic Neuropathic Pain?

Acute Nociceptive Pain stems from normal processing of noxious stimuli from tissue injury/inflammation (predictable, time-limited). Chronic Neuropathic Pain results from direct damage or disease affecting the somatosensory nervous system (burning, shooting, electric-shock, tingling).

What is Chronic Nociplastic Pain and what is a classic clinical example?

Altered nociception without clear tissue damage or somatosensory lesion; common examples include fibromyalgia and complex regional pain syndrome.

What is the purpose of a Multimodal Pain Management Plan?

Combining different classes of analgesics (e.g., opioids + NSAIDs + acetaminophen) and non-pharmacological modalities to target multiple pain pathways, maximize analgesia, and minimize medication side effects.

Why must sedation level be monitored alongside respiratory rate in patients receiving opioids?

Because sedation precedes respiratory depression.

When should pain relief and functional capability be reassessed following a pain intervention?

$30\text{--}60\,\text{minutes}$ post-intervention.

How is postoperative delirium defined, and what are the priority nursing interventions?

An acute, fluctuating state of confusion, cognitive impairment, and inattention. Postoperative priorities are oxygenation and safety.

What is the clinical definition of debridement?

Surgical or chemical removal of nonviable, necrotic wound tissue to promote healing.

A patient $4\,\text{hours}$ post-op reports pain as $8/10$, has a respiratory rate of $10\,\text{breaths/min}$, and is difficult to arouse after IV morphine. What is the priority nursing action?

Assess airway and breathing, elevate head of bed, stimulate the patient, and prepare to administer Naloxone if respiratory depression persists.

Why must the surgical and anesthesia team be notified first if a preoperative patient takes Ginkgo Biloba daily?

Ginkgo Biloba increases bleeding risk during surgery.