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NR226 EXAM 2 STUDY GUIDE LATEST UPDATE 2022/2023
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NR226 EXAM 2 STUDY GUIDE LATEST UPDATE 2022/2023
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NR226 Fundamentals: Patient CareExam 2 Study Guide
80 questions and 10 dosage calculations (including IV calculations)
Calculate intake and output for a patient 30mL = 1oz
Sleep
o Nursing diagnosis – 3 part (PES)
Etiology / contributing factors/causative factors
Signs and symptoms / assessment data
o Assessment, Diagnose, Plan, Implement and Evaluation of sleep disorders
o Tools for assessment
PSQI- Pittsburgh Sleep Quality Index
ESS- Epworth Sleepiness Scale
Fulmer SPICES: An Overall Assessment Tool for Older Adults
MNA- Mini Nutritional Assessment
Katz Index of Independence in Activities of Daily Living (ADL)
The Hendrich II Fall Risk Model- Fall Risk Assessment for Older Adults
Braden Scale- Predicting Pressure Ulcer Risk
o Planning care for sleep disorders
o Patient outcomes
Patient will take sleep meds as directed.
Patient will accomplish sleep SMART goal.
o Nursing interventions
Asthma- Obtain a history of allergic reactions to medications before
administering medications. Assess respiratory status. Assess the patient's
respiratory status by monitoring the severity of symptoms, breath sounds, peak
flow, pulse oximetry, and vital signs. Assess medications.
Apnea- The absence of respirations lasting for 15 seconds or longer.
Insomnia
Nocturia- Patient urinates at night. Not normal.
o Age specific requirements and patterns for all age groups
o Sleep cycle/circadian rhythm
Stages- 1, 2, 3, 4 and REM (rapid eye movement) sleep. These stages progress
cyclically from 1 through REM then begin again with stage 1. A complete sleep
cycle takes an average of 90 to 110 minutes. REM (Dreams are most vivid).
What occurs in each stage
Stage 1- light sleep where you drift in and out of sleep and can be
awakened easily. In this stage, the eyes move slowly and muscle activity
slows. During this stage, many people experience sudden muscle
contractions preceded by a sensation of falling.
Stage 2- eye movement stops and brain waves become slower with only
an occasional burst of rapid brain waves.
Stage 3- extremely slow brain waves called delta waves are interspersed
with smaller, faster waves.
Stage 4- the brain produces delta waves almost exclusively.
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