NUR 1022C - Foundations of Nursing Level A verified

NUR 1022C - Foundations of Nursing 1. What are three types of health promotion goals?: Primary = preventive, e.g. immunizations, exercise Secondary = screening, "catch it early" e.g mammograms Tertiary = treatment, e.g. rehab, prevent pt from getting worse 2. What are the different healthcare levels?: - Primary/ preventive = ROUTINE, generalist, OB/GYN, no referral needed, psychologist - Secondary - usually need a REFERRAL, specialist for a specific body system, e.g. orthopedics, cardiologist - Tertiary - ACUTE CARE, hospital, surgery, psychology ward - Restorative = REHAB, speech therapy, tx duration - depends on *insurance* and condition OT - waist up PT - waist down - Continuing care = LTC, ALF, hospice 3. What are some examples of state issues in nursing?: · Licensure · Good Samaritan Laws · Public Health Laws · Uniform Determination of Death Act · Autopsy · Death with Dignity or Physician-Assisted Suicide 4. What are the three sources of law?: - *Statutory* aka federal (congress)/ state; common (protects society)/civil (protects the rights of the individual) *Regulatory* aka administrative law = BON (disciplinary actions, NCLEX, approve curriculums, regulate nurses aids) *Common law* = negligence, malpractice 5. What are some examples of federal issues in nursing?: · Americans with Disabilities Act · Emergency Medical Treatment and Active Labor Act · Mental Health Parity Act as Enacted Under PPACA · Advance Directives (Living will, HC Proxies or Durable Power of Attorney for HC) · Uniform Anatomical Gift Act · Health Insurance Portability and Accountability Act · Health Information Technology Act (HITECH) - Self Determination act of 1991 6. What are standards of care?: minimum expected nursing care, expected nursing knowledge and skills 1 / 26 Exam #3 - NUR 1022C - Foundations of Nursing Study online at 7. What is the ANA?: code of ethics nurse advocates health and wellness of nurses 8. Who determines the internal standards of care?: J-CO/ TJC 9. What is pharmacodynamics?: the study of what drugs do and how they do it, understanding this helps us make PRN decision, communicate with physicians, and educate our pts and decide whether or not a drug's dose is therapeutic, not therapeutic or toxic to our pt 10. What is pharmacokinetics?: - what the body does to a drug or how a drug moves through the body - ADME A = absorption = point of admin to blood D = distribution = blood to tissue M = metabolism = liver (dz process that could affect metabolism = cirrhosis) E = excretion = kidneys (dz process that could affect excretion = ESRD) 11. What are some examples of ways to violate the Florida NPA?: - being drunk or high OTJ - stealing meds from your pt or facility - going beyond your scope of practice - lying - abusing your pt - participating in criminal behavior 12. What are some examples of advance directives?: Living Will (post death) Healthcare proxy/ Durable power of attorney - make decision for the pt DNR - written doc that allows natural death 13. What is maximal efficacy?: Maximum effect = the *largest* effect a drug can produce 14. What is potency?: "the more potent a drug the less drug you need to administer" Potency = *AMOUNT* compares the amount of the drug to the effect, so the smaller the dose the more potent a drug is 15. What are endogenous receptors?: the body's own receptors = the normal points of control e.g. neurotransmitters like serotonin, hormones, norepinephrine, epinephrine endo = within the body 2 / 26 16. What can sleep help us with?: - manage our stress - cognition - memory - decision making - muscle formation - balance - wound healing 17. What is the most important question to ask a patient about rest and sleep?: - do you feel rested when you wake up? 18. What is your level of consciousness when your drive to sleep is highest?- : at it's lowest 19. What part of our brain controls our temp, sleep regulation, sex drive, thirst, hunger?: hypothalamus 20. How many cycles of NREM and REM does your body require for a "good night's sleep"?: 4 to 5 cycles 21. Why should nurses understand pharmacodynamics?: Nurses have to communicate with other members of the healthcare team, they have to make PRN decisions, they have to educate the patient, they have decide whether a dose is therapeutic, not therapeutic, or toxic 22. If a drug is more potent do you give more or less of that drug?: less drug, the more potent a drug the less drug you have to give 23. what are drugs?: chemicals that produce an effect by interacting with other chemicals 24. What are receptors?: points of control in the body, special chemicals aka places that drugs interact with to produce an effect 25. what are the only two things drugs can do at receptors?: they can only mimic or block an action the body would have already done on it's own, they can NOT make the body perform an new f(x) 26. What is selectivity?: a highly desirable trait for drugs, the more selective a drug is the less side effects a pt will experience e.g. chemotheraphy - chemotx is not selective and therefore causes systemic effects and doesn't hone in on a specific target 27. How do we want drugs to interact with specific receptors?: like a lock and key, wee want the drug to target specific receptors and not others 3 / 26 28. What is the Simple Occupancy Theory?: The SOT says that the more receptor spaces and the more receptors a drug occupies the more intense a drug's response max effect = all receptors on a cell are occupied 29. What is affinity?: the level of attraction a drug has to a specific receptor the higher the affinity the higher the attraction towards the recptor = higher potency 30. What is intrinsic activity?: how well a drug can activate a receptor have it has binded high intrinsic activity (meaning the drug was attracted to the receptor and the receptor is activated) = high maximal efficacy 31. What is the difference b/t agonist and antagonist?: - Agonist = *mimics* what the body would do = high affinity (high attraction to receptor), high intrinsic activity (illicits a response after binding) - Antagonist = *blocks* the actions of the endogenous regulators, e.g. narcan = affinity (high attraction to receptor), low intrinsic activity (does NOT illicit a response post binding) 32. What is the therapeutic index?: Ratio of a drug's toxic level to the level that provides therapeutic benefits A. small/narrow T.I. = more dangerous, riskier B. large/ wide T.I. = less dangerous, safer 33. what are the 3 possible outcomes of 2 drugs interact?: 1. intensification - one drug intensifies the action of the other 2. reduction - one drug decreases the action of the other 3. mystery - unknown rxn we haven't seen before 34. What does potentiate mean?: to make something more powerful or more potent 35. what does potentiative mean?: to *increase* therapeutic effect or *increase* side effects 36. what does additive mean?: when 2 drugs work together with similiar actions e.g. when a pt is prescribed 2 different BP meds to control their hypertension 37. what does inhibitory mean?: the opposite of potentiative, the reduction of adverse and therapeutic effects 2 types of inhibitory actions - antagonisitc - antidote incompatible - deterioration 4 / 26 38. what is the medical definition of precipitate?: to solidify, to form particles in the sol'n 39. what does extravasation mean?: to leak around the IV site 40. How can food affect drug absorption and metabolism?: - Dairy/fiber can DECREASE absorption ("the gut", the stomach, the GI tract) - Prescence of food can INCREASE absorption Metabolism happens in the liver e.g. statins, BP meds, and grapefruit can block the breaking down of drugs and lead to a high concentration of drug in the blood and lead to toxicity 41. How does food affect drug toxicity?: may have an additive effect, like caffeine foods like this ADD to the drugs effects 42. How does food impact drug action?: may lessen the drugs response like coumadin and green leafy veggies that essentially causes an antidotal effect 43. How can we minimize drug-drug interactions?: 1. keep an eye pts who are on drugs with a low/narrow therapeutic index (riskier, less safe) 2. take a drug hx and reconcile meds 3. do a review of pt meds in order to minimize the number of meds the pt is taking 4. look out for pt using recreational meds 5. watch med timing this may impact absorption 44. How should meds be admin before and after food (meals)?: the *med* should be admin: - 1 hour before meals - 2 hours after meals Always "med FOOD med" *food* should be given 1hr after or 2hr before 45. What is the difference between cardiopulmonary and whole-brain death?- : - cardiopulmonary death = heart AND respiratory f(x) stop, irreversible - whole-brain death = irreversible stopping of ALL f(x) including the brain stem 46. What must all be true to prove negligence?: - the nurse owed a duty to the pt - the nurse didn't carry out their duty - pt was hurt - the pt was hurt as a direct result of the nurse not carrying out their duty