DHCA Nursing Exam flashcards

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

Chain of infection

A six-link model: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Breaking any link stops transmission.

Airborne precautions

Used for tuberculosis, measles, and varicella. Requires an N95 respirator and a negative-pressure room with the door closed.

C. difficile hand hygiene

Use soap and water rather than alcohol-based sanitizer because alcohol does not reliably kill Clostridioides difficile spores.

Needlestick post-exposure steps

Wash the site with soap and water, report immediately, and obtain prompt evaluation for HIV post-exposure prophylaxis.

Six rights of medication

Right patient, drug, dose, route, time, and documentation. Verify two patient identifiers before giving any medication.

First-pass metabolism

Orally absorbed drug passes through the liver before reaching systemic circulation, reducing bioavailability compared with intravenous administration.

Therapeutic index

The ratio of toxic dose to therapeutic dose. A narrow index such as digoxin or warfarin requires serum level monitoring.

Heparin and warfarin antidotes

Protamine sulfate reverses heparin, monitored by aPTT. Vitamin K reverses warfarin, monitored by INR.

Insulin onset times

Rapid-acting lispro or aspart acts in 10 to 15 minutes; regular insulin in 30 minutes; NPH in 1 to 2 hours; glargine has no peak.

Hypovolemic shock signs

Tachycardia, hypotension, narrowed pulse pressure, cool clammy skin, and urine output below 0.5 mL per kg per hour.

Left versus right heart failure

Left-sided failure causes pulmonary edema with dyspnea and crackles. Right-sided failure causes peripheral edema, jugular venous distention, and hepatomegaly.

COPD oxygen target

Target oxygen saturation of 88 to 92 percent in chronic CO2 retainers because excessive oxygen can suppress hypoxic drive.

Pressure injury stages

Stage 1 is non-blanchable erythema, stage 2 partial-thickness loss, stage 3 full-thickness loss, and stage 4 extends to muscle or bone.

Naegele's rule

Estimate delivery date by taking the first day of the last menstrual period, subtracting 3 months, and adding 7 days.

Late decelerations

Fetal heart rate drops after the uterine contraction peak, indicating uteroplacental insufficiency. Reposition the mother and give oxygen.

Preeclampsia magnesium therapy

Magnesium sulfate prevents seizures. Monitor deep tendon reflexes, respiratory rate, and urine output for signs of toxicity.

Postpartum hemorrhage cause

Uterine atony is the most common cause. Fundal massage and oxytocin are first-line interventions.

APGAR components

Heart rate, respiratory effort, muscle tone, reflex irritability, and color, each scored 0 to 2 at 1 and 5 minutes.

Holliday-Segar maintenance fluid

Give 100 mL per kg for the first 10 kg, 50 mL per kg for the next 10 kg, and 20 mL per kg for each kg above 20.

Epiglottitis priority

Drooling, tripod positioning, and muffled voice signal airway emergency. Avoid inspecting the throat because of spasm risk.

Kawasaki disease treatment

Intravenous immunoglobulin plus aspirin reduce the risk of coronary artery aneurysm in children with prolonged fever and mucocutaneous signs.

Pediatric dehydration signs

Sunken fontanelle, decreased tears, dry mucous membranes, and capillary refill longer than 2 seconds indicate dehydration in children.

Serotonin syndrome

Agitation, hyperthermia, clonus, and hyperreflexia after serotonergic drugs. Stop the offending drug and seek emergency care.

Neuroleptic malignant syndrome

Rigidity, fever, altered mental status, and elevated creatine kinase after antipsychotic use. Stop the drug and treat supportively.

Alcohol withdrawal treatment

Benzodiazepines are first-line for tremors, tachycardia, and seizures. Thiamine is given to prevent Wernicke encephalopathy.

Lithium therapeutic range

Serum lithium of 0.6 to 1.2 mEq per L is therapeutic. Toxicity causes tremor, vomiting, and ataxia and is worsened by dehydration.

Adult CPR parameters

Compressions at 100 to 120 per minute, depth 5 to 6 cm, ratio 30 to 2, with interruptions kept under 10 seconds.

Sepsis bundle

Measure lactate, obtain cultures, give broad-spectrum antibiotics, and give 30 mL per kg crystalloid for hypotension or lactate of 4 or higher.

Anaphylaxis treatment

Give intramuscular epinephrine 0.3 to 0.5 mg of 1:1000 in the anterolateral thigh. Antihistamines are adjuncts only.

Mean arterial pressure formula

MAP equals systolic pressure plus twice the diastolic pressure, divided by 3. A target of 65 mmHg or higher supports organ perfusion.

Informed consent elements

Requires capacity, disclosure of risks and benefits, comprehension, and voluntariness. The provider obtains consent and the nurse witnesses it.

Ethical principles

Autonomy is self-determination, beneficence is doing good, nonmaleficence is avoiding harm, justice is fairness, and fidelity is keeping promises.