ANCC AGCNS-BC flashcards

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

Sepsis-3 definition

Sepsis is suspected infection plus an acute rise in SOFA score of at least 2 points; septic shock adds vasopressor need for MAP 65 or higher and lactate above 2 mmol/L.

ARDS Berlin criteria

Acute onset within one week, bilateral opacities not fully explained, respiratory failure not purely cardiogenic, and PaO2/FiO2 ratio 300 or less with PEEP 5 cm H2O or more.

KDIGO AKI criteria

AKI is a creatinine increase of 0.3 mg/dL or more within 48 hours, a 1.5-fold rise from baseline within 7 days, or urine output below 0.5 mL/kg/h for 6 hours.

DKA management sequence

Begin isotonic fluids, then IV insulin infusion after potassium is above 3.3 mEq/L; add dextrose when glucose falls below 200-250 mg/dL while continuing insulin to clear ketones.

CAM-ICU positive delirium

Positive when there is acute onset or fluctuating course plus inattention, and either disorganized thinking or altered level of consciousness; it is validated for mechanically ventilated adults.

Ventilator-associated pneumonia bundle

Head of bed 30-45 degrees, daily sedation interruption and spontaneous breathing trial, peptic ulcer prophylaxis, deep vein thrombosis prophylaxis, and oral care.

Pressure injury stage 3

Full-thickness loss of skin and tissue extending into subcutaneous fat but not through fascia; bone, tendon, and muscle are not visible and slough or eschar may be present.

Beers criteria high-risk drugs

Potentially inappropriate medications in older adults include benzodiazepines, anticholinergics, first-generation antihistamines, and long-acting sulfonylureas because they raise falls, delirium, and hypoglycemia risk.

PICO question format

PICO stands for Patient or population, Intervention, Comparison, and Outcome; a well-built PICO guides search terms, study selection, and appraisal in evidence-based practice.

Level I evidence

Level I evidence is a systematic review or meta-analysis of randomized controlled trials; it sits at the top of most evidence hierarchies because randomization reduces selection bias.

Sensitivity formula

Sensitivity equals true positives divided by true positives plus false negatives; it is the proportion of people with disease correctly identified by the test.

Number needed to treat

NNT equals 1 divided by the absolute risk reduction; it estimates how many patients must receive an intervention for one additional patient to benefit.

Type I versus type II error

A type I error is rejecting a true null hypothesis, a false positive; a type II error is failing to reject a false null hypothesis, a false negative.

Randomization purpose

Random assignment distributes known and unknown confounders evenly between groups, reducing selection bias and supporting causal inference in clinical trials.

USPSTF grade B

Grade B means the service has high certainty of moderate net benefit or moderate certainty of moderate-to-substantial net benefit; clinicians should offer or provide it.

Adult pneumococcal vaccination

Adults 65 and older should receive PCV20 alone or PCV15 followed by PPSV23 at least one year later; younger adults with risk conditions follow the same schedule.

Teach-back method

The clinician asks the patient to explain in their own words what they were taught; it confirms understanding and is a universal health literacy precaution.

Diabetes diagnostic A1c

An A1c of 6.5 percent or higher confirms diabetes; 5.7 to 6.4 percent indicates prediabetes. Confirm with a repeat test unless the result is unequivocal.

Hypertension threshold adults

The 2017 ACC/AHA guideline defines hypertension as systolic 130 mm Hg or higher or diastolic 80 mm Hg or higher; stage 2 begins at 140/90.

Colorectal cancer screening ages

Average-risk adults should begin colorectal cancer screening at age 45 and continue to age 75; ages 76 to 85 are individualized based on health and prior screening.

CNS spheres of influence

CNS practice spans three spheres: direct care of patients and families, nurses and nursing practice, and organizations and systems; each sphere informs the others.

APRN consensus requirements

The APRN Consensus Model requires graduate-level education, national certification in the population focus, and state licensure; prescriptive authority is set by each state.

ANA Code of Ethics

The Code articulates four core principles: autonomy, beneficence, nonmaleficence, and justice; it guides clinical decisions and professional conduct for all nurses.

Transformational leadership

Transformational leaders use idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration to raise staff engagement and performance beyond expectations.

Just culture principles

Just culture distinguishes human error from at-risk and reckless behavior; it encourages error reporting while holding people accountable for knowingly unsafe choices.

Shared governance

Shared governance gives bedside nurses and CNSs decision-making authority over practice, quality, and professional development through councils, improving ownership and outcomes.

Donabedian quality model

The Donabedian model evaluates quality through structure, process, and outcome; structure is resources, process is care delivery, and outcome is the result for patients.

PDSA cycle

Plan-Do-Study-Act is an iterative improvement method: plan a change, test it on a small scale, study the results, then adopt, adapt, or abandon it.

Model for Improvement questions

The IHI model asks three questions: what are we trying to accomplish, how will we know change is an improvement, and what changes will result in improvement.

Root cause analysis

A structured retrospective review after a sentinel event that identifies contributing system factors and latent failures, then recommends actions to prevent recurrence.

FMEA purpose

Failure mode and effects analysis is a proactive team method that maps a process, scores failure severity, occurrence, and detectability, and prioritizes risk-reduction actions before harm occurs.

Control chart special cause

Special-cause variation is signaled by points outside control limits, seven consecutive points on one side of the mean, or a trend, indicating a nonrandom process change.