NR 226 Final Exam Study Guide

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NR 226 Final Exam Study Outline (62 Pages with all Answers)

The Nursing Process

  • 5 Steps of the Nursing Process (ADPIE)
    • Assessment
      • Phases of interview/assessment
      • Methods of obtaining data
      • Subjective Data
      • Objective Data
    • Diagnosis
      • Identify components of the nursing diagnostic statement
      • Identify assessment findings, goals, interventions, evaluations appropriate to a specific nursing diagnosis.
    • Planning
      • Components of goal/outcome statement
    • Implementation
      • Independent nursing interventions
      • Dependent nursing interventions
      • Direct care activities
      • Indirect care activities
    • Evaluation
      • Elements of the evaluation process
  • Professional Practice
    • Delegation
      • 5 rights
  1. Right task – ones that are repetitive and require little supervision, relatively noninvasive, results that are predictable, minimal risk (ex: specimen collection, ambulating stable pts, prepping room for pt. admit)
  2. Right Circumstances – patient setting, available resources
  3. Right person – make sure that the tasks match the person’s level of expertise
  4. Right Direction / Communication – give clear, concise descriptions of the task including its objective, limits, and expectations
  5. Right Supervision/ Evaluation – provide appropriate monitoring, evaluation, intervention when needed, and feedback
    • supervision
  • Prioritization of care – organization of vison of desired outcomes for a patient\
  • Nursing care delivery model
  • Management of patient care
  • Leadership
  • Ethics
    • Code of Ethics
    • Understand, give examples of terms
    • Guidelines for ethical decision making
  • Legal issues in nursing
    • Nurse Practice Acts
    • Regulatory law,
    • Standards of care
    • The American Nurses Association
    • Nursing standards of care
    • Errors
    • ADA
    • EMTALA (Emergency Medical Treatment and Active Labor Act)
    • Living will
    • Durable power of attorney
    • Health care surrogate
    • Organ donation
    • Minor child
    • Consent
    • Use of restraints
  • Older Adult
    • Expected physical changes
    • Expected Cognitive Changes
    • Goals for care of cognitively impaired older adults
    • Nursing Process

Pain

  • Assessment of pain:
    • Patient’s expression of pain
    • Characteristics of pain
    • Onset and duration
    • Location
    • Intensity
    • Quality
    • Pattern
    • Relief measures
    • Contributing symptoms
    • Effects of pain on the patient
  • Factors affecting/influencing pain perception
    • Physiological
    • Social
    • Psychological
    • Pain tolerance
    • Cultural
  • Pain scales
  • Cultural considerations
  • Implications for Patient-Centered Care
  • Tolerance & Addiction
  • Goals for pain management
  • Patient teaching regarding pain management
    • Implementation
    • Health Promotion
    • Maintaining Wellness
  • Non-pharmacologic interventions
    • Nonpharmacological pain relief interventions
  • Evaluation of effectiveness of interventions
    • Behavioral Indicators of Effects of Pain
      • Vocalizations
      • Facial Expressions
      • Body Movement
      • Social Interaction

Grief

  • Criteria for hospice care, palliative care (pg. 761)
  • Post mortem care, when autopsy required (pg. 765)
  • Cultural considerations for death, dying, post-mortem care (pg.767, 755)
  • Kubler-Ross stages of dying (DABDA pg. 753)
  • Factors influencing loss and grief (pg.753-756)
  • Communication/care of patient and significant others (761-763)
  • Nursing diagnoses related to grief/death & dying (pg. 757)
  • Steps for Care of the Body after Death (Box 37-11)

Sleep

  • Functions/ Purposes of sleep
  • Factors that affect sleep
  • Factors that promote sleep/Sleep hygiene
  • Nursing diagnoses related to sleep
  • Sleep disorders & related assessment and nursing care
    • Insomnia
    • Sleep Apnea
    • Narcolepsy
  • Conducting Sleep assessment/ Sleep history
    • Tools for Sleep Assessment.
    • Sleep History.
    • Description of Sleeping Problems.
  • Sleep requirements based on developmental stage
  • Symptoms that occur with lack of sleep

Bowel Elimination

  • Assessment of bowel function
  • Causes of diarrhea, constipation
  • Nursing diagnoses related to bowel elimination
  • Interventions to promote bowel elimination
  • Ostomy assessments, care, teaching
  • Hemoccult testing
  • Enema administration
  • Bowel training program

Fluid & Electrolytes, Acid/Base

Perioperative Nursing

  • Preoperative phase
    • Factors that can increase risk for complications in surgery
    • Procedures pre-op
  • Intraoperative phase
    • Role of the nurse
  • Postoperative phase
    • Prevention of post-op complications
    • Diet progression post-op
  • Teaching for each phase
    • Pre-Op
    • Intra-Op
    • Post-Op

Med Calc – to include simple drop rates

  • Conversion within metric (grams-milligrams-micrograms)

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