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Fundamentals of Nursing Study Guide
Questions & 100% Correct Answers-
Assessment:
✓ :~~ collecting vital signs, pain levels, other signs/ symptoms
Diagnosis:
✓ :~~ nurse makes a nursing diagnosis based on assessment of patient; not a
medical diagnosis
Planning:
✓ :~~ nurse comes up with client-centered goals; need to be measurable
(client will ambulate 10 meters 3x daily for 2 wks)
Implementing:
✓ :~~ following through with plan that was developed for the patient
Evaluation:
✓ :~~ goal was met, partially met, not met; how effective the plan was for
the patient and what should be changed for the patient
Normal range for temperature
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✓ :~~ 96.8-100.4
Normal range for pulse
✓ :~~ 60-100
Normal range for respirations
✓ :~~ 12-20
Normal range for BP
✓ :~~ 100/60-140-90
Normal range for pulse ox.
✓ :~~ >95%
SOLER
✓ :~~ sit close, observe, lean forward, eye contact, relax
Types of pain
✓ :~~ acute, chronic, cancer, by inferred pathology, idiopathic
Pain threshold
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✓ :~~ level of stimulus needed to produce the perception of pain
Pain tolerance
✓ :~~ amount of pain a patient endures without its interference of ADLs
Factors influencing pain
✓ :~~ age, fatigue, genes, neurological functions, social factors, spiritual
factors, psychological factors, cultural factors
Behavioral responses to pain
✓ :~~ clenching teeth, holding painful part, bent posture, grimaces, cries or
moans, restlessness, frequent requests of the nurse; confused patient may
not show reaction
Pharmacological pain relief
✓ :~~ analgesics (NSAIDS & non-opioids, opioids, adjuvants)
NSAIDS & non-opiates
✓ :~~ has analgesic/ antipyretic effects; available OTC; used for moderate to
mild pain; blocks pain impulses by inhibiting prostaglandin synthesis; lethal
when overdosed; do not take with alcohol; do not take if liver dysfunction,
possible liver failure
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Opioids
✓ :~~ pain relivers that contain opium or chemically related to opium;
ordered for moderate to severe pain such as post-op, chronic non-cancer, or
cancer; depresses respiratory center, causes constipation, itching, altered
mental status
Naloxone (Narcan)
✓ :~~ opiate antagonist, reverses opioid induced resiratory depression
Patient Controlled Analgesia (PCA)
✓ :~~ client has control with minimum risk of overdose; system designed to
deliver no more than specific number of doses
Anesthetics
✓ :~~ depresses CNS from consciousness to unconsciousness; loss of
responsiveness to sensory stimuli including pain; muscle, skeletal, and
visceral smooth muscle relaxation; general or local
Basal metabolic rate (BMR)
✓ :~~ energy needed to maintain life
Carbohydrates
Master01 | September, 2024 | Latest Update