NURS 6001 EXAM 1
risk factor assessments - ANSWERS-falls, fires, poisoning, suffocation, and
choking, and firearm injuries
factors that contribute to falls - ANSWERS-over 65, history of falls, impaired vision
or balance, altered gait or posture, impaired mobility, medication regimen,
postural hypotension, slowed reaction time, weakness, frailty, confusion,
disorientation, unfamiliar environment
three types of restraints - ANSWERS-physical, chemical, seclusion
physiological hazards associated with restraints - ANSWERS-suffocation from
entrapment, impaired circulation, altered skin integrity, pressure ulcers,
diminished muscle and bone mass, fractures. altered nutrition and hydration,
aspiration and breathing difficulties, incontinence, changes in mental status
types of physical restraints - ANSWERS-wrist, mummy, elbow, papoose board, bed
rails, food tray
three main classes of medications used to chemically retain a patient - ANSWERS-
benzodiazepines, typical or classic antipsychotics, and atypical antipsychotics
chemical restraints always require - ANSWERS-doctors orders
,physical restraint - ANSWERS-physical devices used to limit a patients movements
considerations for restraints? - ANSWERS-always a last resort, assessed every
hour/psych ever 15 min, document date/time/type/ what was tried first and
notify family
supine position and associated benefits - ANSWERS-flat on back, helps muscle
relaxation
prone position and associated benefits - ANSWERS-on abdomen, assess hip and
posterior
sims position and associated benefits - ANSWERS-lies on either side. lower arm
below the body. both knees flexed, partially flexed
fowlers position and associated benefits - ANSWERS-sitting. low (15-30 degrees)
semi (30 to 45 degrees) fowlers (45-60 degrees) high (85-90 degrees)
general consideration for canes - ANSWERS-widen a persons base of support to
help with balance. weight evenly. support comes from stronger leg
general considerations for crutches - ANSWERS-for patients who have temporary
restrictions on ambulation. weight from hands and arms, not axillary
, general considerations for walkers - ANSWERS-improve balance by increasing
base or support. never on stairs
three learning domains - ANSWERS-cognitive, psychomotor, and affective
cognitive learning domain - ANSWERS-storing and recalling of new info in the
brain. strategies: lecture, panel, discovery, written materials
affective learning domain - ANSWERS-changing attitudes, values, feelings.
strategies role modeling, discussion, audiovisual materials
psychomotor learning domain - ANSWERS-learning a specific skill. strategies:
demonstration, discovery, printed material
TEACH - ANSWERS-Tune in patient
Edit patient info
Act on every teaching moment
clarify often
honor the patient as partner in education
motivational interviewing - ANSWERS-a collaborative family centered model that
focuses on understanding and helping rather than solutions. making the patient
interested in helping themselves.