FUNDAMENTAL NURSING BULLETS - 9

Ø  When answering a question on the NCLEX examination, the student should consider the cue (the stimulus for a thought) and the inference (the thought) to determine whether the inference is correct. When in doubt, the nurse should select an answer that indicates the need for further information to eliminate ambiguity. For example, the patient complains of chest pain (the stimulus for the thought) and the nurse infers that the patient is having cardiac pain (the thought). In this case, the nurse hasn’t confirmed whether the pain is cardiac. It would be more appropriate to make further assessments.

Ø  Veracity is truth and is an essential component of a therapeutic relationship between a health care provider and his patient.

Ø  Beneficence is the duty to do no harm and the duty to do good. There’s an obligation in patient care to do no harm and an equal obligation to assist the patient.

Ø  Nonmaleficence is the duty to do no harm.

Ø  Frye’s ABCDE cascade provides a framework for prioritizing care by identifying the most important treatment concerns.

A = Airway. This category includes everything that affects a patent airway, including a foreign object, fluid from an upper respiratory infection, and edema from trauma or an allergic reaction.

B = Breathing. This category includes everything that affects the breathing pattern, including hyperventilation or hypoventilation and abnormal breathing patterns, such as Korsakoff’s, Biot’s, or Cheyne-Stokes respiration.

C = Circulation. This category includes everything that affects the circulation, including fluid and electrolyte disturbances and disease processes that affect cardiac output.

D = Disease processes. If the patient has no problem with the airway, breathing, or circulation, then the nurse should evaluate the disease processes, giving priority to the disease process that poses the greatest immediate risk. For example, if a patient has terminal cancer and hypoglycemia, hypoglycemia is a more immediate concern.

 E = Everything else. This category includes such issues as writing an incident report and completing the patient chart. When evaluating needs, this category is never the highest priority.

Ø  When answering a question on an NCLEX examination, the basic rule is “assess before action.” The student should evaluate each possible answer carefully. Usually, several answers reflect the implementation phase of nursing and one or two reflect the assessment phase. In this case, the best choice is an assessment response unless a specific course of action is clearly indicated.

Ø  Rule utilitarianism is known as the “greatest good for the greatest number of people” theory.

Ø  Egalitarian theory emphasizes that equal access to goods and services must be provided to the less fortunate by an affluent society.

Ø  Active euthanasia is actively helping a person to die.

Ø  Brain death is irreversible cessation of all brain function.

Ø  Passive euthanasia is stopping the therapy that’s sustaining life.

Ø  A third-party payer is an insurance company.

Ø  Utilization review is performed to determine whether the care provided to a patient was appropriate and cost-effective.

Ø  A value cohort is a group of people who experienced an out-of-the-ordinary event that shaped their values.

Ø  Voluntary euthanasia is actively helping a patient to die at the patient’s request.

Ø  Bananas, citrus fruits, and potatoes are good sources of potassium.

Ø  Good sources of magnesium include fish, nuts, and grains.

Ø  Beef, oysters, shrimp, scallops, spinach, beets, and greens are good sources of iron.

Ø  Intrathecal injection is administering a drug through the spine.

Ø  When a patient asks a question or makes a statement that’s emotionally charged, the nurse should respond to the emotion behind the statement or question rather than to what’s being said or asked.

Ø  The steps of the trajectory-nursing model are as follows:
      Step 1: Identifying the trajectory phase
      Step 2: Identifying the problems and establishing goals
      Step 3: Establishing a plan to meet the goals
      Step 4: Identifying factors that facilitate or hinder attainment of the goals
      Step 5: Implementing interventions
      Step 6: Evaluating the effectiveness of the interventions

Ø  A Hindu patient is likely to request a vegetarian diet.

Ø  Pain threshold, or pain sensation, is the initial point at which a patient feels pain.

Ø  The difference between acute pain and chronic pain is its duration.

Ø  Referred pain is pain that’s felt at a site other than its origin.

Ø  Alleviating pain by performing a back massage is consistent with the gate control theory.

Ø  Romberg’s test is a test for balance or gait.

Ø  Pain seems more intense at night because the patient isn’t distracted by daily activities.

Ø  Older patients commonly don’t report pain because of fear of treatment, lifestyle changes, or dependency.

Ø  No pork or pork products are allowed in a Muslim diet.

Ø  Two goals of Healthy People 2010 are:
    1. Help individuals of all ages to increase the quality of life and the number of years of optimal health
    2. Eliminate health disparities among different segments of the population.

Ø  A community nurse is serving as a patient’s advocate if she tells a malnourished patient to go to a meal program at a local park.

Ø  If a patient isn’t following his treatment plan, the nurse should first ask why.

Ø  Falls are the leading cause of injury in elderly people.

Ø  Primary prevention is true prevention. Examples are immunizations, weight control, and smoking cessation.

Ø  Secondary prevention is early detection. Examples include purified protein derivative (PPD), breast self-examination, testicular self-examination, and chest X-ray.

         Ø  Tertiary prevention is treatment to prevent long-term complications