Description

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)