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53 Cards in this Set
- Front
- Back
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Acutely ill; unstable;
Ex. Ventilator; shock or hemodynamically unstable pts requiring vasoactive drugs |
Priority 1
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Critically ill and unstable with a reduced likelihood of recovery because of nature of the acute illness; There may be limits on therapeutic efforts such as intubation or CPR
Ex. Metastatic malignancy complicated by infection, cardiac tamponade, or airway obstruction |
Priority 3
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Requires intensive monitoring, may potentially need immediate intervention; There are no limits on the extent of intended interventions.
Ex. Pt with chronic comorbid conditions who develop acute severe medical or surgical illness. |
Priority 2
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Admission made at the discretion of the ICU director;
Ex. Pt w/ PVD surgery, stable DKA, conscious drug OD, or terminal pts facing immediate death. |
Priority 4
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Why were ICU developed in the early 1960's?
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1. Implementation of CPR
2. Better tx of shock r/t war experiences 3. Improved transport systems; EMS 4. Tech that required close observation (ECG) 5. Initiation of renal transplant surgery (Joseph Murray did 1st successful kidney transplant in Boston in 1954) |
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Intermediate Care Units are also known as what?
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Step down units; They are a place to monitor and care for pts with moderate or potentially severe instability who require tech support but not artificial life support
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A template for how to proceed with care is called a what?
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algorithm
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These people can be trained by RN's to assist in pt care?
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Unlicensed assistive personnel (UAP)
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Many think that this factor is most important in deciding if pt should receive high acuity care?
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The functional capacity of the pt, prior to the illness
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Critical Incident Stress Debriefings (CISD's) can be used to (SATA)...
a. assess high acuity pts b. help families cope w/stress c. address staff symptoms of stress d. provide staff with a sense of closure |
C and D
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Created in 2001, AACN Standards for Healthy Work Environments include....
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STEAMA
Skilled Communication True Collaboration Effective Decision Making Appropriate Staffing Meaningful Recognition Authentic Leadership |
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JCAHO is now known as....
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TJC; The Joint Commision
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If the person preparing the med is not the person to give it, what should be done?
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All med labels should be verbally and visually confirmed by two people
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In this stage of acute illness, the pt is sad and crying, and attempting to improve relationships w/ family?
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Restitution; The nurse should assist the pt with problem solving
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In this stage of acute illness, the pt may be uncooperative, or worry excessively?
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Shock and disbelief; The nurse should provide accurate info when asked
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In this stage of acute illness, the pt may act like nothing is wrong?
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Denial; The nurse should be noncritical, and clarify statements, but do not stress reality
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In this stage of acute illness, the pt may be demanding and angry, or quiet and withdrawn?
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Awareness; The nurse should provide consistent nursing care, and should not argue with the pt.
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In this stage of acute illness, the pt may openly participate in care
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Resolution; The nurse should promote self-care and independence.
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What is the order of the Suchman's stages of acute illness?
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Shock and disbelief
Denial Awareness Restitution Resolution |
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A pt in an MVA has multiple lower extremity fractures. The nurse finds him drawing plans for remodeling his house to include a wheelchair ramp. What stage does this reflect?
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Resolution; Pt is openly participating in care
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An appropriate NI for a pt experiencing high anxiety is....
A. active listening B. Provide accurate info C. exhibit empathy D. Acknowledge loss |
B; This is shock and disbelief, and the nurse should give accurate info WHEN ASKED
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Which of the following changes can induce anxiety in the high-acuity pt.?
A. wean from vent B. reduce pain meds C. increase mobility D. family visitation |
A,B and C
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Awareness of one's own thoughts and feelings without letting them influence caring for pts with different backgrounds is...
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Cultural competence
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A set of social, cultural, and political beliefs held by a group of individuals
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Ethnicity
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Which of the following is not a source of cultural diversity?
A. age B. Socioeconomic status C. sexual orientation D. Disabilities |
A; age
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Palliative care is defined as...
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An interdisciplinary approach to relieve suffering and improve quality of life
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The nurse is most concerned if which of the following S/S are observed in a pt with asthma?
A. pulse ox alarms at 80 B. Pt states he can't get all of his air out C. A and B |
C
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One of the defining characteristics of a profession is....
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The ability to set its own standards
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SOP determine whether appropriate care has been delivered. In practice, they represent the _____ acceptable level of care
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Minimum
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What is a major element that is used to determine if malpractice or negligence exists?
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SOP's
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Myoglobin onset?
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1-3 h
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Myoglobin peak?
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w/in 12 h
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Myoglobin duration?
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1-2 d
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Troponin onset?
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2-4 h
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Troponin peak?
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24-36 h
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Troponin duration?
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I- 7-10 d
T- 1-14 d |
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CK onset?
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3-6 h
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CK peak?
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12-24 h
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CK duration?
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24-48 h
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CK-MB onset?
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4-8 h
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CK-MB peak?
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18-24 h
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CK-MB duration?
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72 h
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How do ACE inhibitors work?
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AHHHH....RELAX
Dilate BV Lowers BP Decreases afterload Increases EF Decreases workload Offset K loss by diuretics |
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ACE SE?
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Increase K
Lower BP Rash Taste alterations |
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When are ACE's taken?
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Usually empty stomach, 1 hour before meals
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How do Beta blockers work?
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Block sympathetic outflow which tells the heart to work harder
*Do not use in active HF!...but good when pt. is stable |
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Beta SE?
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Abnormal rhythms
Lower BP Wheezing (if non selective) |
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Beta 1 receptors are located in the _______
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heart and kidneys
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Beta 2 receptors are located in the _________
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Smooth muscle of the bronchi, bladder, BV, and uterus
*Do not use with asthma |
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Diuretics SE?
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Decrease K (common)
loss of appetite weakness |
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Spironolactone SE
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Serious increase in K
endocrine issues with breast (men and women) |
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How does dig work?
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Helps pump work more efficiently (opposite of B blockers)
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Drugs to avoid with HF?
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NSAID's
Ca Channel Blockers |
