(Just a list of things I *starred* during lecture.

These are specifics that professors told

us we should know for the test. Please feel free to add to!! Please dont add
objectives. I think someone else might be working on that list. [Symbol])

Theory Week 1

Legal and Ethics

Ethics: Principles or standards that govern proper conduct.

Morals: Personal conviction that something is absolutely right or wrong

in all

situations.

Values: Personal belief about the worth of a given idea or behavior.

Rights: legal privileges or powers clients have when they receive

health care

services.

Autonomy: self-governance

Beneficence: Doing good or actively promoting doing good: one of the

four

principles of the ethical theory of deontology.

Nonmaleficence: do no harm, intentional or non-intentional.

Justice: all individuals should be treated equally and fairly.

Veracity: Be truthful and honest.

JCAHO on Restraints
In the event of an emergency, restraints or seclusion may be initiated
without a physicians order.

As soon as possible, but no longer than an hour after the initiation, a

staff member must notify the physician and then obtain an order.

The devices must be reissued by a physician every 4 hours for adults,

2 hours for children, 1 hour if younger than 9.

An in-person evaluation must be done by the physician within 4 hours

of initiation of devices, or 2 hours if child

For clients in restraints or seclusion, they must be observed and

assessed every 10 15 minutes, check for circulation, respirations,
nutrition, hydration, and elimination. This must be documented. The
client should be released from restraints or seclusion every 2 hours.

Malpractice: the failure of one rendering professional services to

exercise that degree of skill and learning commonly applied under all
the circumstances in the community by the average prudent reputable
member of the profession with the result of injury, loss, or damage to
the recipient of those services or to those entitled to rely on them

Negligence: The omission of a person to do something which a

reasonable person, guided by those ordinary considerations which
ordinarily regulate human affairs, would do, or the doing of something
which a prudent and reasonable person would not do.

Pharmacology

Therapeutic: what it controls

Pharmacologic: how it works in the body

Ex: blood pressure pill: therapeutic antihypertensive, pharmacological

- beta-blocker

Ex: Lasix: therapeutic antihypertensive, pharmacological - diuretic

Ex: Ibuprofen: therapeutic pain reliever, pharmacological NSAID

Know safety classifications! (This is all I wrote down in my notes.

Does anyone know if this is referring to the pregnancy
categories of safety? [Symbol])
Onset, Peak, Duration: time to reach minimum concentration, highest
concentration,how long it lasts.

Therapeutic range and Index: between not working and toxic, safeness
of a drug

Peak and Trough: when a drug reaches its highest blood or plasma
concentration,the lowest serum concentration of a medication before
the next medicationdose is administered.

Loading dose: Large, initial dose given to achieve a rapid minimum

effectiveconcentration in the plasma.

Agonist and Antagonist: producing response out of cell, blocks a

response

Medication Actions:

Therapeutic Effect: expected physiological affect

Side effect/Adverse effect: expected, unintended (bad) and

should report toMedWatch

Toxic effect: too much free drug, problem with excretion or

metabolism

Idiosyncratic reaction: ex. With Benadryl hyper instead of

drowsy

Allergic reaction: itching, hives, anaphylactic

5 +5 Rights:

right medication, right patient, right dose, right route, right time,
right documentation, right to refuse, right to education, right
assessment, right evaluation

Right Patient: Always use 2 identifiers and always check for allergies

Right Time: Standing/Routine, PRN, STAT, Now, Single

Right Route: Oral, Parental, Topical, Inhaled, Other (rectal, eye drops,
eardrops, sublingual) *Pills that cannot be crushed: SR, XL; Pills that
can be crushed: ES
Theory Week 2
Circulation

Heart Failure

Right Ventricle Failing (some signs): varicose veins, lower

extremity edema, enlarged liver

Left Ventricle Failing (some signs): crackling lungs, tired, weak

pulse, can lose toes

Pulmonary Artery is the only artery that carries deoxygenated blood.

Left ventricle must overcome the systemic BP.

Normal Sinus Rhythm

60-100 bpm

QRS wave preceded by a normal P wave

Cardiac Output (CO)

CO = heart rate (HR) x stroke volume (SV)

Normal CO is 4-8 liters/minute (meaningful if we divide it by

patients size and get cardiac index)

HR 100 x SV 60 mls = 6 liters/min

What determines Stroke Volume (SV)? Preload, Afterload,

Contractility

Preload: amount available to be ejected

Afterload: resistance to left ventricular ejections: systemic BP

Contractility: strength of myocardium

Understand hemodynamic effects of standing. Orthostatic hypotension:

BP drops when someone stands up.
A patient is taking a newly prescribed antihypertensive and is
experiencing orthostatic hypotension. A change in which component of
cardiac output is most likely causing this side effect?

Preload because it changes the most; more so than heart rate,

afterload, and contractility.

Understand Renin-Angiotensin Aldosterone System (RAAS)

Pulse Pressure is:

Systolic Pressure (SBP) Diastolic Pressure (DBP) = Pulse

Pressure

Mean arterial pressure (MAP) know formula!MAP=SBP +2(DBP) / 3

Theory Week 3
Bowel Elimination

Normal bowel sounds: every 5-10 seconds

Surgery and Anesthesia can cause ileus. Touching and anesthesia can
put bowels to sleep.

Bowel Sounds: hypoactive and hyperactive

Bowel impactions can cause arrhythmia. Be careful with people who

have heart problems.

Assessment:

Physical Assessment; mouth, abdomen, and rectum; lab tests;

fecal characteristics; fecal specimens; Diagnostic exams; radiologic
imaging (w/ or w/o contrast); endoscopy; ultrasound; CT or MRI

Urinary Elimination

In Potter and Perry:

Review Box 46-5 for Nursing Assessment Questions (pg. 1109)

Review Table 46-4 Routine Urinalysis (pg. 1113) Know Normal

Urine Values
Urinary Incontinence:

Stress: Involuntary leakage of small volumes of urine associated

with increased intraabdominal pressure related to either urethral
hypermobility or an incompetent urinary sphincter (e.g., weak pelvic
floor muscles, trauma after childbirth, radical prostatectomy);

Urge: Involuntary passage of urine often associated with strong

sense of urgency related to an overactive bladder caused by
neurological problems, bladder inflammation, or bladder outlet
obstruction.

Overflow: Involuntary loss of urine caused by

an overdistended bladder often related to bladder outlet obstruction or
poor bladder emptying because of weak or absent bladder
contractions.

Reflex: Involuntary loss of urine occurring at somewhat

predictable intervals when patient reaches specific bladder volume
related to spinal cord damage between C1 to S2.

Functional: Loss of continence because of causes outside the UT.

Usually related to functional deficits such as altered mobility and
manual dexterity, cognitive impairment, etc. Direct result of caregivers
not responding in a timely manner to requests for help with toileting.

Total: continuous and total loss of urinary control.