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NURS 325 Final Exam 1 LATEST 2025 VCU (NURSING OF ADULT 1) GRADED A+, Exams of Nursing

Virginia Commonwealth University (VCU)Nursing

NURS 325 Nursing of Adults I NURS 325 Final Exam 1 LATEST 2025 VCU (NURSING OF ADULT 1) GRADED A+

Typology: Exams

2024/2025

Available from 11/17/2024

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NURS 325 Nursing of Adults I
NURS 325 Final Exam 1 LATEST 2025
VCU (NURSING OF ADULT 1) GRADED
A+
Primary Prevention
-No Impairment
-Ex: vaccines, suncreen, dieting
Secondary Prevention
-Impairment
-Ex: Screening for HPV, monitoring disease, diet and exercise with a goal in mind (reducing htn)
Tertiary Prevention
-Disease w/ impairment
-Ex: insulin, chemo, meds, PT
Principles of Adult Learning
-independent learners.
-Readiness to learn arises from life's changes.
-Past experiences are resources for learning.
-Learn best when the topic is of immediate value.
-Approach learning as problem solving.
-See themselves as doers.
-Resist learning when conditions are incongruent with their self-concepts.
-Important to assess what the patient already knows and what they are ready to learn
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Download NURS 325 Final Exam 1 LATEST 2025 VCU (NURSING OF ADULT 1) GRADED A+ and more Exams Nursing in PDF only on Docsity!

NURS 325 Final Exam 1 LATEST 2025

VCU (NURSING OF ADULT 1) GRADED

A+

Primary Prevention

  • No Impairment
  • Ex: vaccines, suncreen, dieting Secondary Prevention
  • Impairment
  • Ex: Screening for HPV, monitoring disease, diet and exercise with a goal in mind (reducing htn) Tertiary Prevention
  • Disease w/ impairment
  • Ex: insulin, chemo, meds, PT Principles of Adult Learning
  • independent learners.
  • Readiness to learn arises from life's changes.
  • Past experiences are resources for learning.
  • Learn best when the topic is of immediate value.
  • Approach learning as problem solving.
  • See themselves as doers.
  • Resist learning when conditions are incongruent with their self-concepts.
  • Important to assess what the patient already knows and what they are ready to learn

Patient Education Process ADPIE Patient Education Assessment

  • Is the patients physical state conducive to education?
  • Is the patients psychological state conducive to education?
  • How do they learn best? Patient Education Diagnosis
  • What does the patient need education about? Patient Education Planning
  • Setting goals
  • Select teaching strategies Teaching Strategies
  • Discussion
  • Lecture-discussion
  • Demonstration/Return Demonstration
  • Role Play
  • Learning Materials (always review before presenting to patient) Education Evaluation

Contemplation

  • Intending to make a change in the next 6 months
  • Wants to change, aware of the pros of changing but stuck on cons (having to wake up early to go to the gym)
  • Want to get pt to focus on pros Preparation
  • Planning to take action in the immediate future (1 mo.) Ex: planning to join the gym, ordered exercise videos, planned healthy meals Action
  • Making specific modifications to lifestyle (lasts around 6 months)
  • Can struggle in this phase, work to fight triggers, temptations Maintenance
  • Working to prevent relapse, increase confidence (6 months - 5yrs)
  • People feel good about changes, try to prevent relapse Termination
  • No temptation and 100% self-efficacy
  • Most people don't get to this stage
  • Ex: even if someone has not smoked in years, can still feel a craving from time-to-time

Relapse

  • Return from action or maintenance to an earlier stage
  • After relapse many fall back to contemplation stage Precontemplation Nursing
  • Validate lack of readiness/Clarify: Decision is theirs to make
  • Encourage re-evaluation of behavior Encourage self-exploration
  • Explain and personalize the risk Contemplation Nursing
  • Validate lack of readiness/Clarify: Decision is theirs
  • Encourage evaluation of pros and cons of behavior change (focus on the pros)
  • Identify and promote new, positive outcome expectations Preparation Nursing
  • Identify and assist in problem solving obstacles
  • Help identify social support (really important, harder if people close to you aren't supportive)
  • Verify underlying skills for behavior change
  • Encourage small initial steps Action Nursing
  • Focus on restructuring cues and social support (avoiding triggers)
  • Bolster self-efficacy for dealing with obstacles
  • Combat feelings of loss and reiterate long-term benefits
  • Crises
  • Unstable
  • Downward
  • Dying
  • Phases can overlap, return, etc. Trajectory Model Nursing
  • Encourage Self Management
  • Consider developmental stage of pt
  • Care planning
  • Pt and caregiver education
  • Need to assess how outcomes impact their day-to-day activities Diagnostic Surgery
  • Determination of the presence and extent of a pathologic condition
  • Ex: biopsy, bronchoscopy Curative Surgery
  • Elimination or repair of a pathologic condition
  • Ex: removed of a ruptured appendix or benign ovarian cyst) Palliative Surgery
  • Alleviation of symptoms w/o cure
  • Ex: Cutting a nerve root, creating a colostomy to bypass inoperable bowel obstruction

Preventative Surgery

  • Removal of something before it becomes problematic
  • Ex: Mole removal before it become malignant Cosmetic Improvement
  • Surgical repair of something that is cosmetically more pleasing
  • Ex: repair a burn scar, breast reconstruction after mastectomy Explorative Surgery
  • Determine the nature or extent of a disease
  • Less common due to advances in tech and dx testing
  • Ex: laparotomy Elective Surgery Carefully planned event Emergency Surgery Not carefully planned event Ambulatory Surgery
  • Same day, outpatient
  • May use minimally invasive techniques
  • Surgical
  • Anesthesia
  • Blood products
  • May need to serve as witness
  • If pt has signed consent but doesn't seem to understand the procedure we need to address with surgeon so they can provide further education Preoperative Preparation Depends on surgery but may include:
  • Chlorahexadine shower
  • Enema
  • Fluid/Food restrictions Older Adult Preoperative Considerations
  • Emotional reactions to surgery
  • Concern about death and disability
  • Surgical and anesthesia risks are higher
  • Allow use of hearing aids and glasses as long as possible
  • Caregiver support Universal Protocol
  • To prevent wrong site, wrong procedure, wrong surgery
  • Checklist is a major focus
  • Name/DOB verification before procedure
  • Procedure site is marked
  • Time-out right before surgery starts

Chlorahexadine

  • Scruuuuub
  • Dry skin: 30 seconds
  • Wet Skin: 2 mins
  • Should never go by mucous membranes, face, neonates General Anesthesia
  • Patient is completely unconscious and unable to move
  • Need ventilation (not necessary endotracheal but some artificial ventilation)
  • Prolonged procedures
  • Can be delivered IV, inhalation, or both General Anesthesia Indications
  • Significant duration
  • Skeletal muscle relaxation
  • Uncomfy operative position
  • Control of respiration Local Anesthesia
  • Loss of sensation w/o loss of consciousness
  • Interrupts the generation of nerve impulses by altering the flow of sodium into nerve cells through cell membranes
  • Can be topical, ophthalmic, nebulized, or injected
  • Assess for alergies
  • Breath unassisted
  • Ban be used with local anesthesia Older Adults and Anesthesia
  • Careful titration of meds due to altered onset, peak, and duration
  • Physiologic changes may alter responses
  • Increased risk of complications due to positioning Anaphylactic Reactions
  • Initial signs may be masked by anesthesia
  • Can cause tachycardia, hypotension, bronchospasm
  • Antibiotics and latex are common causes Malignant Hyperthermia
  • Results from exposure to certain anesthetic agents
  • Characterized by hyperthermia, muscle rigidity
  • Trouble w/ Ca traveling into the cell, muscle rigidity, muscle breakdown
  • Causes acid/base imbalances and renal impairment
  • Usually genetic
  • Dantrolene kept in the OR to reverse
  • Can result in death
  • Assess for risk preoperatively
  • RARE Recovery Position

Protects airway PACU Priorities

  • Respiratory
  • Cardiovascular
  • Pain
  • Temperature
  • Surgical site PACU Monitoring
  • Pulse Ox
  • ECG
  • Frequent VS's Hypoxemia
  • May be caused by airway obstruction, atelectasis, aspiration, pulmonary edema, pulmonary embolism, bronchospasm, and hypoventilation
  • Confused state may be indicator Hypoxemia Prevention
  • Positioning
  • Coughing/Deep Breathing
  • Incentive Spirometer
  • Ambulation
  • Control Pain

Improves respiratory function, prevents DVT, improves bowel functioning Syncope

  • Check orthostatic BP/HR
  • Encourage hydration Emergence Delirium
  • Restlessness, agitation, disorientation, thrashing, shouting
  • Assess for hypoxemia
  • Use safety precautions Delayed Emergency
  • Pt does not wake up in timely fashion
  • Can't take breathing tube out
  • Have reversal agents available POCD (Post op cognitive dysfunction)
  • Decline that can last for a couple months
  • Anxiety and depression
  • Delirium
  • Withdrawal (she said alcohol w/d is the only one that can kill you but that's wrong) Nonpharm Pain Management
  • Repositioning
  • Massage
  • Distraction
  • Deep Breathing
  • Music Therapy
  • Guided Imagery
  • Aromatherapy Hypothermia Normal within 12 hours post-op due to effects of anesthesia and body heat loss during surgery Hyperthermia W/in 48hrs:
  • Mild elevation to 100.4 is normal
  • Above 100.4 may indicate lung congestion, atelectasis, or dehydration After 48hrs:
  • Elevation above 100 should be considered infection Hyperthermia Treatment
  • Abx
  • If above 103, antipyretics and cooling measures N/V
  • Common w/ anesthesia
  • Antiemetics used
  • Aspiration precautions

Wound Evisceration

  • Bowel contents push through
  • Requires emergency procedure Dehiscence/Evisceration Treatment
  • Return pt to bed if out of bed
  • Lower HOB to 20 degrees or less
  • Have pt bend knees and avoid coughing
  • Sterile gauze or towels soaked in NS should be placed over wound
  • Assess wound for color
  • Frequent VS's
  • Prepare for emergency surgery PACU Discharge
  • Pt awake or at baseline
  • Vital signs stable or at baseline
  • No excessive bleeding or drainage
  • No respiratory depression
  • Oxygen saturation > 90%
  • Report given Ambulatory Surgery Discharge
  • No IV opioids in past 30 minutes
  • Minimal n/v
  • Voided
  • Able to ambulate if not contraindicated
  • Responsible adult present to accompany patient (cannot drive themselves)
  • Written discharge instructions given and understood Discharge Education
  • Care of incision and dressings, bathing recommendations
  • Action and side effects of medications; when and how to take them
  • Activities allowed and prohibited; when normal activites can be resumed
  • Dietary restrictions or modifications
  • Symptoms to be reported
  • When and where to return for follow-up care
  • Answers to questions and concerns Fluid Volume Deficit Caused by:
  • Abnormal loss of body fluids
  • Inadequate intake
  • Fluid shift from plasma to interstitial fluid Fluid Volume Deficit Treatment
  • Correct underlying cause and replace water and electrolytes
  • Common isotonic fluids are 0.9% Sodium Chloride and Lactated Ringers Fluid Volume Excess Caused by:
  • Excessive fluid intake