1
Q
What is teaching?
A
Interactive process that promotes learning
2
Q
How many hours would you have to work with a topic to be an expert?
A
10,000 hrs
3
Q
How can teaching be effective?
A
by including:
- learners needs
- learning style
- learning capacity
4
Q
What are the different teaching approaches? (6)
A
- 1:1
- group
- analogies
- role playing
- simulation
- evaluation
5
Q
What does effective teaching depend on?
A
Effective communication
6
Q
What makes a good teacher? (3)
A
- listening empathetically
- observe astutely
- speak clearly
7
Q
What is important when we are patient teaching?
A
- repetition
- redundancy
8
Q
What are the different things we need to keep in mind when giving discharge instructions? (4)
A
- health literacy of pt
- age of pt
- illness of pt
- literacy general
9
Q
What are the second group of strengths needed to practice SBN?
A
acquisition and use of information from formal sources and from experience
10
Q
What is Ethical Responsibility in regards to informed consent?
A
Nurses ensure that nursing care is provided with the person’s informed consent
11
Q
What is a Substitute decision maker?
A
Person who may make a treatment decision for someone who is incapable of making their own decision
12
Q
What is the Hierarchy of Substitute Decision Makers? (9)
A
- Guardian appointed by the court
- POA for personal care
- Appointed by Consent and Capacity Board
- Spouse or partner
- Child or parent (>16)
- Parent who has right of access
- Brother or sister
- Any other relative
- Public Guardian and Trustee (last resort)
13
Q
What are the goals of Client Education? (3)
A
- promotes health and preventing disease
- restoring health
- optimizing quality of health when there is impaired functioning
14
Q
What are the domains of learning?
A
- cognitive
- affective
- psychomotor
15
Q
What is Cognitive learning domain?
A
Remembering, knowledge, thinking
16
Q
What is Affective learning domain?
A
Attitudes, feelings and emotions, values
17
Q
What is Psychomotor learning domain?
A
motor skills ex. throwing a ball
18
Q
What are the different Learning Principles? (5)
A
- learning environment
- ability to learn
- children vs. adults vs, elderly
- learning style and preferences
- motivation to learn
19
Q
What are the different learning abilities? (4)
A
- emotional capability = anxiety levels
- intellectual capability = old age
- physical capability = old age, arthritis
- developmental stage = adult, teenager
20
Q
What are the different Approaches to Teaching? (5)
A
- telling = useful for limited info
- selling = coaching ex. dressing change at home
- Participating = mutually setting goals
- Entrusting = allow client to engage in selfcare
- Reinforcing = maintaining that behaviour through postitive feedback
21
Q
What is different for teaching and the elderly? (6)
A
- processing speed (slow)
- sensory = glasses, hearing aids
- hearing/volume
- Printed volume = big font
- Environment
- don’t elderspeak
22
Q
What is Self Efficacy?
A
Perceived ability to do something
23
Q
What are the different types of Motivation and Transtheoretical Model of Change? (5)
A
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
24
Q
What is Precontemplation?
A
Unaware of the need to change, therefore will not change
25
What is Contemplation?
Aware of the need, with plans to change in the future
26
What is Preparation?
Pre/alter behaviour in minor ways
27
What is Action?
Actually changing
28
What is Maintenance?
Solidifying behaviours
29
What is an Antibiotic?
a compound that inhibits bacterial growth or kills bactera
30
What is the name for inhibiting bacterial growth?
bacteriostatic
31
What is the name for killing bacteria?
bactericidal
32
When did the modern era of antibiotics start?
With the discovery of penicillin by Sir Alexander Fleming in 1928
33
When were antibiotics first prescribed?
1940s
34
What antibiotic was used in WWII to control bacterial infections amongst soldiers?
Penicillin
35
When did penicillin resistance become a problem?
Shortly after WWII and by the 1950s the advances of the prior decade were threatened
36
What are the causes of the Antibiotic Resistance Crisis?
- Overuse
- Inappropriate Prescribing
- Extensive Agricultural Use
- Availability of Few new antibiotics
37
What effect does the Extensive Agricultural Use have on antibiotic resistance crisis?
- 80% of abx sold in the US are used in animals
- abx used in livestock are ingested by humans when they consume food
38
What effect does the Availability of Few New Antibiotics have on antibiotic resistance crisis?
fewer new abx are being produced because development is no longer considered to be an economically wise investments for the pharmaceutical industry
39
What are some examples of Antibiotic Overuse? (5)
- MRSA
- Vancomycin Resistance Enterococci (VRE)
- TB resistance
- Carbapenem Resistant Enterobacteriaceae (CRE)
- Drug Resistance Gonorrhea
40
How many infection does CRE cause each year?
9,000
41
What are the common ways of infection?
- Pneumonia
- Blood infections
- Urinary tract infections
- Wounds
42
What are signs and symptoms of Wound infections? (7)
- Odor
- pain
- fever
- Purulent drainage
- Affected functions
- C&S
- CBC
43
How do we promote healing/fight infection? (6)
- remove offending source
- monitor vitals
- antibiotics
- wound care
- nutrition
- rest
44
What affects wound healing?
- Age
- Stress
- Disease process (HIV, autoimmune, diabetes)
- Medical therapy (meds, chemo)
45
What are the different types of wounds? (7)
- acute
- chronic
- surgical
- diabetic
- venous
- traumatic
- pressure
46
What are the different types of wound healing?
- primary
- secondary
47
What is the scale used for Pressure Ulcer?
Braden Scale
48
What is important to keep in mind for Pressure Ulcer Prevention? (6)
- Sensory Perception
- Moisture
- activity
- mobility
- nutrition
- friction and shear
49
What is Stage 1 Pressure Ulcer?
redness that persists after movement
50
What is Stage 2 Pressure Ulcer?
partial thickness formation, loss of superficial layer of skin
51
What is Stage 3 Pressure Ulcer?
Full thickness formation but not through fascia
52
What is Stage 4 Pressure Ulcer?
Full thickness deeper formation, through fascia
53
What are the different phases of wound healing?
- Inflammatory Phase
- Proliferative Phase
- Remodelling
54
What is the Inflammatory Phase?
- reaction to injury
- need it to heal
55
What is the Proliferative Phase?
filling wound with granulation tissue, contraction, resurfacing
56
What is the Remodelling Phase?
- formation of scar
- can take up to a year or longer, takes a long time
57
Why do we pack a wound?
It allows all parts of the wound to have moisture, and conger secondary intention allowing the wound to heal properly
58
What do we do if the wound is dry?
add moisture
59
What do we do if the wound is too moist?
remove the moisture with a dressing
60
What is Debridement?
- Non vitalized tissue needs to be remove
- moisture through packing
- surgery (damage and painful)
- gels
61
What is the Wet to Dry form of Debridement?
- damp gauze, pull it off when its dry, debriding the wound
- do not use this as it can cause pain and damage to healthy cells and skin
62
What is Thermal Shock wound care?
When we cool the wound down with NS when we change the dressing
63
What is Dehiscence?
When the edges of a surgical wound split apart
64
What is Vacuum Assisted Closure (VAC) wound care?
applies suction to the wound so the drainage is removed, not having to change the dressing as often, promotes faster healing
65
What type of solution should we use when cleaning a wound?
Non-cytotoxic solution
66
What are some Cytotoxic solutions?
- sodium hypochlorite
- acetic acid
- iodine
- hydrogen peroxide
67
What are some common Vaccines? (5)
- flu
- Pneumococcal
- Covid
- Ebola
- Pediatric Schedule
68
What are some things we need to considered when providing CCC when is comes to vaccines?
- values
- parent hesitation to vaccinate child
69
What are the factors affecting bowel elimination? (9)
- age
- pelvic floor
- gastrocolic
- pain
- activity
- medications
- diet
- fluid
- accessibility
70
How are infectious diseases diagnosed?
- swabs
- blood work (C&S, CBC)
- urine
- stool
- sputum
71
How is IBD diagnosed?
- Endoscopy
- Colonoscopy
- Radiography
- MRI
72
How is Diabetes diagnosed?
- fasting glucose test
- random glucose test
- A1c test
73
What is Constipation?
when waste or stool moves too slowly through the digestive tract or cannot be eliminated effectively from the rectum, which may cause the stool to become hard and dry
74
What is Diarrhea?
loose, watery, and possibly more-frequent bowel movements
75
What is Impaction?
A mass of dry, hard stool that cannot pass out of the colon or rectum
76
What is Disimpaction?
Inserting a gloved finger into the rectum and trying to remove the stool
77
What is the most common cause of Clostridium Difficile (C-Diff)?
When you've been taking antibiotics or not long after you've finished taking antibiotics
78
What is Clostridium Difficile?
- gram positive
- spore forming
- anaerobic bacillus
79
What does Clostridium Difficile cause?
diarrhea and colitis
80
What are the risk factors of Clostridium Difficile?
- older age (65 and older)
- Recent stay at a hospital or nursing home
- a weakened immune system
- previous infection with C. Diff
81
How is Clostridium Difficile Diagnosed?
- stool tests
- colon examination
- imaging tests
82
How is Clostridium Difficile treated?
- Antibiotics: Vancomycin, Fidaxomicin
- Surgery to remove disease colon
83
How to prevent Clostridium Difficile?
- PPE
- Abx Stewardship
- Specimen collection
84
What is Colorectal Cancer?
a disease in which cells in the colon or rectum grow out of control
85
What are the risk factors of Colorectal Cancer? (5)
- nutrition
- alcohol
- smoking
- body fat
- medications
86
What are non-modifiable risk factors of Colorectal Cancer?
- family history
- IBD
- Height
87
What are the types of surgery for gastric and colon issues?
- total colectomy with ileostomy
- total colectomy with continent ileostomy
- total colectomy with ileoanal anastomosis
- creation of a stoma
88
How often should a stoma bag be emptied?
4-6 hours, 1-3 times daily
89
How often should a stoma bag be changed?
every 5-7 days
90
What does normal urine look like?
transparent yellow
91
What are the normal amount of times to urinate every day?
between 6-7 times a day, or 4-10 times a day if youre okay with going that often
92
What is the average amout of urine voided each day?
800-2,000 mL a day
93
What are abnormal amounts of times to urinate every day?
anything more than 10 times a day
94
What is an abnormal amount of urine voided each day?
more than 2.5 Ls a day
95
What is considered of abnormal urine?
- hematuria (blood in the urine)
- dark brown urine
- cloudy
96
What is Anuria?
Absence of urine
97
What is Polyuria?
Urinating large amounts of urine
98
What is Dysuria?
Discomfort or burning or pain with urination
99
What is Nocturia?
Condition that causes you to wake up during the night to urinate
100
What is Hematuria?
blood in the urine
101
What is Pyuria?
When there is pus in the urine
102
What is Oliguria?
Urinary output less that 400ml per day
103
What is Ketonuria?
When there are high levels of ketones in the urine
104
What are other names for Urination?
- micturition
- voiding
- uresis
- emiction
105
Why is the left kidney slightly higher than the right?
Liver
106
What causes retention or incontinence?
- urinary tract obstruction
- Inefficient bladder contraction
107
What are some factors affecting urination? (5)
- medical history (neurogenic)
- male anatomy
- medication
- GI problems
- mobility/ability
108
What are factors affecting Inconcentince? (4)
- timing
- fluid intake
- medications, caffeine
- Pelvic floor muscle exercises
109
What is some testing that can be done on the urine? (5)
- Urinalysis
- WBC
- Bacteria
- Casts
- Culture
110
50% of older adults in long term care have what in their urine?
Bacteria, but don't have urinary tract infections
111
What is Gastroparesis?
Delay in emptying of the stomach
112
Who is most likely to have diarrhea in comparison to other people?
Enteral Feeding
113
What is Norovirus?
- causes nausea and vomiting
- tends to occur in the winter
- lasts about 48 hours
114
What does a Cathartic do?
Clears the bowels more than a laxative does
115
What are some of the nutritional foods/vitamins that will decrease the risk of Colorectal Cancer? (4)
- Fibre
- Milk/Calcium
- Vitamin D
- Multivitamin
116
What does Ileostomy mean?
Creation of a stoma
117
What is Anastomosis?
joining of two ends together after you remove the diseased portion
118
Can stool consistency change when there is a stoma created?
Yes, depending on where it is and how much of the colon has been removed
119
What is the biggest concern with Stoma care?
Peristomal skin breakdown
120
When assessing urinary elimination, what are we looking at? (5)
- Skin: signs of dehydration
- Kidneys: shape and contour, flank pain
- Bladder: palpating it
- Assessing the pelvic floor in both sexes
- Fluid balance assessment
121
In a female, what do we do to assess pelvic floor weakness?
Inserting a digit into the vagina and asking them to bear down
122
In a male, what do we do to assess pelvic floor weakness?
Inserting a digit into the rectum and asking them to bear down
123
What is Glomerular Filtration Rate (GFR)?
A test used to check how well the kidneys are working
124
What is Hemodialysis? (4)
- dialysis that occurs outside the body
- 3x per week
- uses a fistula
- requires a tube to diffuse water
125
What is Peritoneal Dialysis? (5)
- inside the body
- done regularly/everyday
- less strict fluid restrictions because you do it regularly
- better QOL because it is more gentle
- not as efficient as hemodialysis
126
What is the S&S Test?
Lab test that shows the concentration of all chemical particles in the urine
127
What are the different Catheters?
- Indwelling (foley)
- In and out/intermittent (way less risk of infection)
- Condom catheter
- Continuous bladder irrigation
- Supra-pubic catheter
128
What is Evisceration?
When internals fall out being of failure in the sutures, stitches, or dehiscence
Nursing 2230
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