DHA Nursing Exam flashcards

33 cards. Read the term and the definition here. The deck at the top of this page is optional.

Braden score of 9

A score of 9 or below indicates very high pressure-injury risk. The scale rates sensory perception, moisture, activity, mobility, nutrition, and friction or shear, with lower totals meaning greater risk.

Normal adult urine output

Adequate output is at least 0.5 mL/kg/hour. Output under 30 mL/hour in an adult indicates oliguria and warrants assessment for hypovolemia, obstruction, or renal impairment.

Nursing process sequence

Assessment, Diagnosis, Planning, Implementation, Evaluation. Assessment precedes every other step, and evaluation determines whether goals were met or the plan needs revision.

Stage 1 pressure injury

Intact skin with non-blanchable erythema over a bony prominence. It signals tissue damage before skin breakdown and is managed with repositioning and pressure-relieving surfaces.

Troponin timing after MI

Troponin rises within 3-6 hours of myocardial injury, peaks at 12-24 hours, and remains elevated 7-10 days, which makes it useful when a patient presents late.

Cushing triad

Hypertension with widened pulse pressure, bradycardia, and irregular respirations. It signals rising intracranial pressure and impending herniation and requires urgent intervention.

Digoxin toxicity signs

Anorexia, nausea, visual halos or yellow-green vision, confusion, and bradycardia. Hypokalemia potentiates toxicity, and digoxin immune Fab is the specific antidote.

Hyperkalemia ECG changes

Peaked T waves progress to a widened QRS and sine wave pattern. Treatment begins with IV calcium gluconate for cardiac protection, then insulin with glucose and potassium removal.

Naegele's rule

Estimated delivery date equals the first day of the last menstrual period minus 3 months plus 7 days, with adjustment when the usual cycle length differs from 28 days.

Apgar score components

Heart rate, respiratory effort, muscle tone, reflex irritability, and color, each scored 0 to 2. The score is recorded at 1 and 5 minutes after birth, with 7-10 considered normal.

Magnesium sulfate antidote

Calcium gluconate is the antidote. Monitor deep tendon reflexes, respiratory rate of at least 12/min, and urine output, because magnesium toxicity causes reflex loss and respiratory depression.

Postpartum hemorrhage definition

Blood loss over 500 mL after vaginal birth or over 1000 mL after cesarean, or any loss causing hemodynamic instability. Uterine atony is the most common cause.

Adult CPR compression rate

Compress at 100-120 per minute to a depth of 5-6 cm, using a 30:2 ratio before an advanced airway is placed, keeping all interruptions under 10 seconds.

Parkland burn formula

Give 4 mL times body weight in kg times percent total body surface area burned, using lactated Ringer's over 24 hours, with half infused in the first 8 hours after injury.

Glasgow Coma Scale of 8

A total score of 8 or less indicates severe brain injury and generally requires intubation for airway protection. The scale ranges from 3 to 15.

Mean arterial pressure formula

MAP equals systolic pressure plus twice the diastolic pressure, divided by 3. A value of at least 65 mmHg is needed to maintain adequate organ perfusion.

Heparin antidote

Protamine sulfate reverses heparin. Therapy is monitored with aPTT, targeting 1.5 to 2.5 times control, along with platelet counts to detect heparin-induced thrombocytopenia.

Warfarin antidote

Vitamin K (phytonadione) reverses warfarin. Therapeutic INR is 2-3 for most indications, and bleeding risk climbs steeply when the INR exceeds 4-5.

Insulin given intravenously

Regular insulin is the only insulin administered IV. Subcutaneous regular insulin starts working in about 30 minutes and is also used in DKA and hyperkalemia protocols.

Acetaminophen daily maximum

The adult limit is 4 g per day, lower with liver disease or regular alcohol use. The overdose antidote is N-acetylcysteine, most effective when given within 8-10 hours.

Airborne precautions diseases

Tuberculosis, measles, and varicella require an N95 respirator and a negative-pressure room with the door closed. Standard precautions alone do not prevent transmission of these pathogens.

C. difficile hand hygiene

Wash hands with soap and water because alcohol-based sanitizer does not kill spores. The patient also needs contact precautions and dedicated equipment such as a separate thermometer.

Doffing PPE order

Remove gloves first, then eye protection, then the gown, and the mask or respirator last. Perform hand hygiene between steps and again after the mask is removed.

Informed consent elements

The patient must be competent, receive full disclosure, understand the information, and consent voluntarily. The provider performing the procedure obtains consent, and the nurse may witness it.

RN delegation limits

Nurses may not delegate assessment, nursing judgment, teaching, or evaluation. Unlicensed assistive personnel may perform routine tasks such as hygiene and vital signs for stable patients.

Incident report rule

Complete an incident or variance report after an error or near miss, but never document the report's existence in the patient's medical record; chart only objective clinical facts.

Violent restraint time limit

An adult order is limited to 4 hours and requires a face-to-face evaluation by a physician or licensed independent practitioner within 1 hour of initiation.

Primary prevention example

Immunization, seat belt use, and smoking prevention act before disease occurs. Secondary prevention is screening and early detection, while tertiary prevention is rehabilitation and limiting disability.

Lithium therapeutic range

The target serum level is 0.6-1.2 mEq/L. Toxicity causes tremor, vomiting, ataxia, and confusion, and is worsened by dehydration, low sodium intake, and NSAID use.

Thiamine before glucose

In suspected alcohol misuse, give thiamine before or with glucose to prevent Wernicke encephalopathy. Withdrawal severity is scored with CIWA and treated with benzodiazepines.

Neuroleptic malignant syndrome signs

Lead-pipe rigidity, hyperthermia, autonomic instability, and altered mental status appearing days after antipsychotic exposure. Stop the drug and treat with dantrolene or bromocriptine.

Herd immunity threshold

The proportion of a population that must be immune to interrupt transmission. It is roughly 95% for measles and varies by pathogen and population mixing patterns.

Droplet precautions distance

A surgical mask and approximately 3 feet of separation are used for influenza, pertussis, mumps, rubella, and meningococcal disease, because large droplets travel short distances.