Comprehensive Study Notes: HOSA Clinical Nursing Competition — Key Concepts, Topics, and Definitions
Health care settings and community health nursing
- Question: What system has greatly increased the number and types of health care settings?
- Answer: Health care system
- Question: What health care workers help individuals and aggregates (groups) to improve health of the entire community?
- Answer: Community health nurses
- Main difference between home health care nursing and public health care nursing:
- Home health care provides direct care to patients; public/public-health nursing emphasizes teaching and preventive approaches for communities.
- What major health care involves teaching patients and families to care for themselves so as to promote independent functioning?
- What is a major source of home health care funding?
- For what do these 4 conditions have to be met?
- 1. the physician has determined the need for home care
- 2. the patient needs intermittent skilled nursing care or physical or speech-language therapy or continued occupational therapy
- 3. the patient is homebound
- 4. the agency providing the care is Medicare certified
- What are the high-technology interventions (the provisions of intravenous therapy and ventilator), hospice services, pediatric care, and mental health care for?
- Answer: Specialty home care services
- What is the process of restoring an individual to the best possible health and functioning following a physical or mental impairment and the prevention of further disability?
Rehabilitation and long-term care
- Caring for what type of patient requires the coordinated services of a large number of health care professionals to help patients stay healthy and prevent complications or injuries?
- As an effective member of a multidisciplinary rehabilitation team, the __ is a care planner, teacher, caregiver, counselor, coordinator, and advocate
- workers must consider the way a disabled individual functions within the family and the patient and family should be involved from the outset in determining the plan of care
- ___ in activities of daily living is the best indicator of who will need nursing home placement
- What residential care exists in these 4 levels: 1. domiciliary care 2. sheltered housing 3. intermediate care 4. skilled care
- Answer: Modern long-term care
- Care delivered in _ residential facility is based on 3 principles: 1. promotion of independence 2. maintenance of function 3. maintenance of autonomy (freedom from external authority to make decisions about one's health and health care)
- What is the cornerstone of the healing process?
- To support and maintain life for fighting disease, the body must be supplied with the proper __
- What process involves enzymes helping break down food particles to their simplest form so that the nutrients can be absorbed by the body?
- What body system regulates neural control and the secretion of hormones?
- Parasympathetic nerves stimulate what?
- Answer: Digestive activity
- What major organ is normally emptied in 1–4 hours, depending on the amount and kinds of food eaten?
- The primary organ of absorption is the __
- Fluids, vitamins, and minerals are absorbed through the intestinal _
- The body makes use of the energy received through the food that is eaten, and the _ portion of __ expenditure occurs during rest to carry out the mechanical activities needed to sustain life processes
- Answer: Largest/energy expenditure (rest) → Basal Metabolic Rate (BMR)
- Although are the body's main source of food energy, are the most concentrated source
- Answer: Carbohydrates / fats
- Most of the energy needed to move, perform activities, and live is consumed in the form of _, which are converted primarily to glucose for immediate use by the body's cells
- are a major source of energy for muscle tissue, even when glucose is available
- _ are made of smaller units called amino acids
- _ and _ are micronutrients; they are needed in small amounts for good health
- Answer: Vitamins / minerals
- is the largest component of the body and body tissues are essential to all life processes in the body
- Maintaining a good diet can help middle-aged and older adults maintain a high level of function and reduce the risks of _ disease
- Because of the normal decline in metabolism and physical activity, _ needs lessen with age
- are at risk for megaloblastic anemia if adequate _ is not added to the diet
- Answer: Vegetarians / vitamin B12
- Anorexia nervosa, bulimia, and binge eating disorder are disorders that often begin in adolescence
- disorders are thought to be caused by multiple biologic, psychologic, sociocultural, and spiritual factors
- For patients who cannot take feedings, nutritional support may be provided through enteral tube feedings, or peripheral, or central catheters
Medication safety, dosing, and pharmacology basics
- If a subcutaneous injection is to be given at a 90 degree angle, you should choose a needle that is inches in length
- Answer: frac12
- If a subcutaneous injection is to be given at a 45 degree angle, you should choose a needle that is inches in length
- Answer: frac58
- is enough of a drug to produce the desired physiological response, but not enough to cause toxicity
- Answer: Therapeutic response
- All should be stored in a locked cabinet
- Narcotics should be frequently, during the opening of narcotic drawers, and/or shift change
- Report discrepancies in narcotic counts
- If you give only part of a premeasured dose of a controlled substance, a nurse witnesses' disposal of the unused portion
- nurses sign their names on the required form
- is the passage of medication molecules into the blood from the site of administration
- After a medication is absorbed, it is to tissues and organs and finally to the site of drug action
- The rate and extent of distribution depends on , cell membrane , and protein binding. When their circulation/permeability/alters
- Answer: Circulation / permeability
- If poor perfusion exists (e.g., heart failure), this medication distribution
- Answer: delays (or affects)
- After a medication reaches its site of action, it becomes into a less active or inactive form
- Most biotransformation occurs in the _, although the lungs, kidneys, blood, and intestines also play a role
- Patients (e.g., older adults and those with chronic disease) are at risk for if their organs that metabolize medications do not function correctly
- Answer: Medication toxicity
- The final aspect of pharmacokinetics is , the process of medications exiting the body through the lungs, exocrine glands, bowel, kidneys, and liver
- A medication's determines the organ of excretion. For example, gaseous and volatile compounds exit through the
- Answer: Chemical makeup / lungs
- In medications that exit through sweat glands, you provide to reduce skin irritation
- You must know if a drug is excreted through the , because the administration of laxatives or enemas increases , accelerates excretion, and thus lessens the time for drug effects
- Answer: Intestines / peristalsis
- When patients have reduced function, they are at risk for medication toxicity
- It is important to know the exact for which a medication is prescribed so you can properly patients about a medication's intended effect and to accurately evaluate the medication's desired effect
- Answer: Therapeutic effect / teach
- Sometimes a single medication has many therapeutic effects. For example, relieves pain and reduces fever and tissue inflammation
- are predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose
- Some antihypertensive medications cause in male patients
- If the side effects are serious enough to outweigh the of a medication's therapeutic action, the prescriber will likely the medication
- Answer: Benefits / discontinue
- Patients commonly taking medications because of side effects such as anorexia, nausea, vomiting, dizziness, drowsiness, dry mouth, constipation, and diarrhea
- drug effects are unintended, undesirable, and often unpredictable
- ADEs are sometimes immediately apparent, but they often take or to develop
- Prompt recognition and reporting of ADEs will prevent serious injury to patients
- develop after prolonged intake of a medication, when a medication accumulates in the blood because of impaired metabolism or excretion, or when too high a dose is given
- Toxic levels of morphine, an opioid, cause severe and death
- Answer: Respiratory depression
- Medications often cause unpredictable effects such as an , in which a patient or to a medication or has a reaction different from normal
- Answer: Idiosyncratic reaction / overreacts / underreacts
- Predicting which patients will have an idiosyncratic response is
- Ativan, an antianxiety medication, which given to an older adult may cause and
- Answer: Agitation / delirium
- also are unpredictable responses to a medication
- Answer: Allergic reactions
- Exposure to an initial dose of a medication causes a patient to become sensitized
- The medication acts as an , which causes to be produced
- Answer: Antigen / antibodies
- With repeated , the patient develops an allergic response to the drug, its chemical preservatives, or a metabolite
- Among the different classes of medications, cause a high incidence of allergic reactions
- is fastest, directly into the blood stream
- is second fastest, injected into muscle then absorbed into the bloodstream
- is third fastest, injected into subcutaneous tissue, then absorbed slower than IM
- is slowest, swallowed by the patient, then goes through the stomach, then the first pass effect, then absorbed by the digestive tract
- The highest serum concentration ( concentration) of a medication usually occurs just before the body absorbs the of the medication
- With infusions, the peak concentration occurs quickly, but the serum level also begins to fall
- The point at which the lowest amount of drug is in the serum is the _ concentration
- A patient's trough level is drawn as a blood sample before administering the drug, and the peak level is drawn whenever the drug is expected to reach its peak
- Answer: 30 minutes / concentration
- What is the right medication, the right dose, the right patient, the right route, the right time, the right documentation?
- Answer: The 6 rights of medication
- procedures classified by purpose are: 1. diagnostic 2. exploratory 3. curative 4. palliative 5. cosmetic
- procedure involves the removal and study of tissue to make an accurate diagnosis
- procedure includes a more extensive procedure than a biopsy
- procedure is made to remove diseased tissue or to correct defects
- procedure relieves symptoms or improves function without correcting the basic problem
- procedure is performed to correct serious defects that affects appearance
- that affect surgical outcomes are age, nutritional status, fluid and electrolyte balance, medical diagnoses, drugs, and habits such as use of tobacco and alcohol
- The of the surgical experience are Preoperative, Intraoperative, and Postoperative Phases
- measures to reduce patient anxiety and increase knowledge about the surgical experience may actually decrease complications
- teaching should include surgical preparation; what to expect in the surgical suite and the PACU; what tubes, dressings, or equipment may be in place after surgery; and how patient participation can promote
- Answer: Preoperative / surgery
- Before , the patient or legal guardian must sign a legal form.
- Answer: Surgery / consent
- Consent forms from the patient must be obtained preoperative medications are given
- After preoperative medications are given the patient should in bed
- The team consists of nurses who circulate, nurses who scrub, an RFNA, one or more surgeons, an anesthesiologist or a nurse anesthesiologist, and other technical personnel
- is an ongoing development process that begins at conception and ends at death
- is the study of aging
- is the biomedical science of old age and the application of knowledge related to the biologic, biomedical, behavioral, and social aspects of aging to the prevention, diagnosis, treatment, and care of older people
- nursing aims to increase healthy behaviors in the aged, minimize and compensate for health-related losses and impairments of aging, and facilitate the diagnosis, care, and treatment of disease in the aged
- Health care providers must recognize myths about the older adult and aging that results in and against older people
- Answer: Stereotyping / discrimination
- Age-related Changes that contribute to a decreased ability to clear drugs through the and renal system place the older adult at risk for adverse drug effects
- What is the normal visual activity range for neonates?
- What is involuntary rapid eye movements common in neonates called?
- What is involuntary turning inward of the eyes also common in neonates called?
- By ages 2 to 3 most children have a visual acuity of?
- At what age is visual acuity 20/20?
- By what month is the auditory nerve function mature in the infant?
- What month are alertness to light and visual stimulus 8–12 inches away, can follow an object 60 degrees horizontally and 30 degrees vertically; blinks at an approaching object milestones for a neonate?
- What month are they able to follow a person or object for 180 degrees from 6 feet away; smiles in response to a face; raises head 30 degrees from prone milestones for a neonate?
- What month can they track an object through 180 degrees; regards own hand; begins visual motor coordination milestones for a neonate?
- What month(s) are social smile; reaches for cube 12 inches away; notices a raisin 12 inches away; stares at own hand milestones for a neonate?
- What month(s) are reaches and grasps an object; picks up a raisin by raking; transfers objects from hand to hand milestones for a neonate?
- What month(s) are pokes at holes in a peg board; well-developed pincer grasp; crawls; uncovers toy at seeing it hidden milestones for a neonate?
- What month(s) are stacks blocks; places a peg in a round hole; stands and walks milestones for a neonate?
- Inflammation of the conjunctiva, the clear membrane that lines the inside of the lid and sclera a symptom of?
- Conjunctivitis in an infant under 30 days of age usually acquired from the mother during vaginal birth is a symptom of?
- Answer: Ophthalmia neonatorum
- What kind of measure is given into the newborn's eyes soon after birth?
- What is a plugged lacrimal duct? treatment involves massaging the tear duct every 4 hours while infant is awake; after 1 year lacrimal ducts that are still plugged may be surgically opened; a symptom of?
- Answer: Mimic conjunctivitis
- Edema of the eyelid, reddened conjunctiva and enlarged preauricular glands, itching/burning, mild photophobia common complaints in older children are symptoms of?
- Answer: Bacterial conjunctivitis
- Conjunctivitis that is normally unilateral is called?
- Answer: Bacterial conjunctivitis
- Viral conjunctivitis usually occurs
- Allergic conjunctivitis is characterized by itching, reddened eyes with watery discharge and the conjunctiva has what type of appearance?
- What are bacteria and is an uncommon complication of sinusitis symptoms of?
- Answer: Periorbital cellulitis
- Orbital cellulitis can also lead to
- Answer: Bacterial meningitis
- What does the "S" stand for in SOAP
- What does the "O" stand for in SOAP
- What does the "A" stand for in SOAP
- What does the "P" stand for in SOAP
- What is the kind of pain that includes discomfort that has a short duration (from a few seconds to less than 6 months)
- What is privately experiences, unpleasant sensation usually associated with disease or injury?
- What is the kind of pain that includes the noxious stimuli that are transmitted from the point of cellular injury over peripheral sensory nerve to pathways between the spinal cord and thalamus and eventually from the thalamus to the cerebral cortex of the brain and is subdivided into somatic and visceral pain?
- What is the type of pain caused by mechanical, chemical, thermal, or electrical injuries or disorders affecting bones, joints, muscles, skin, or other structures composed of connective tissue?
- What is another name for superficial somatic pain?
- What type of pain is perceived as sharp or burning discomfort; such as that from an insect bite or paper cut?
- Answer: Superficial somatic pain
- What is pain such as that caused by trauma procedures; localized sensations that are sharp, throbbing, and intense or like a fracture that is dull, aching, diffuse discomfort and is more common with long term disorders such as arthritis?
- Answer: Deeper somatic pain
- What is pain that arises from internal organs such as the heart, kidneys, and intestines that are diseased or injured?
- What kind of pain has some of the following causes: ischemia, compression of an organ, and intestinal distention with gas or contraction as occurs with gallbladder or kidney stones?
- What kind of pain usually is diffuse, poorly localized, and accompanied by an autonomic nervous system with symptoms such as nausea, vomiting, pallor, hypotension, and sweating?
- What is a term used to describe discomfort that is perceived in a general area of the body but not in the exact site where the organ is and anatomically located?
- What kind of pain is processed abnormally by the nervous system and results from damage to either the pain pathways in peripheral nerves or pain-processing centers in the brain (e.g., phantom limb pain)?
- What is a term that describes discomfort that lasts longer than 6 months and is almost totally opposite from those of acute pain?
- What are periods of acute pain for chronic pain sufferers called?
- Answer: Breakthrough pain
- What is the conversion of chemical information in the cellular environment to electrical impulses that move toward the spinal cord?
- What are the chemicals released by damaged cells that stimulate specialized pain receptors located in the free nerve endings of peripheral sensory nerves?
- What is the phase during which peripheral nerve fibers form synapses with neurons in the spinal cord called? The pain impulses move from the spinal cord to sequentially higher levels in the brain. The impulses ascend to the reticular activating system, the limbic system, the thalamus, and finally the cerebral cortex?
- What refers to the phrase of impulse transmission during which the brain experiences pain at a conscious level but many concomitant neural activities occur almost simultaneously?
- What is the point at which the pain-transmitting neurochemicals reach the brain, causing conscious awareness?
- What is a lowered pain threshold, that may occur when excitatory neurotransmitters such as glutamate sensitize the spinal cord to nociceptive input?
- What is the amount of pain a person endures once the threshold has been reached?
- What is the last phase of pain impulse transmission during which the brain transmits a response down the spinal nerve to the point where the pain transmissions originated to alter the pain experience called?
- What is an exaggerated pain response due to increased sensitivity to stimuli such as air current, pressure of clothing, and vibration called?
- What refers to the techniques used to prevent, reduce, or relieve pain?
- What is an analgesic?