GPNC(C) flashcards

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

Autonomy

The ethical principle recognizing a patient's right to make informed decisions about their own care, including refusing recommended treatment, even when the care team disagrees.

Delegation five rights

Right task, right circumstance, right person, right direction and communication, and right supervision. Assessment, teaching, and evaluation cannot be delegated to unlicensed assistive personnel.

Universal Protocol

The Joint Commission's three-part requirement before invasive procedures: preprocedure verification of patient, procedure, and site; marking the site; and a time-out immediately before starting.

Root cause analysis

A retrospective, systems-focused review conducted after a sentinel event to identify contributing factors and redesign processes, rather than assigning individual blame.

Glasgow Coma Scale

A 3-to-15 score summing eye, verbal, and motor responses. A score of 8 or less signals severe impairment and the need to evaluate airway protection.

Orthostatic hypotension

A fall of at least 20 mmHg systolic or 10 mmHg diastolic within three minutes of standing, often accompanied by dizziness, which raises fall risk.

Therapeutic index

The ratio of toxic dose to therapeutic dose. A low index, as with digoxin, warfarin, lithium, and gentamicin, requires serum level monitoring to avoid toxicity.

First-order kinetics

Elimination of a constant fraction of drug per unit time, producing a fixed half-life. Zero-order drugs instead eliminate a constant amount and can accumulate unpredictably.

Antidote pairs

Naloxone reverses opioids, flumazenil reverses benzodiazepines, acetylcysteine reverses acetaminophen, protamine reverses heparin, and vitamin K reverses warfarin.

Heart failure daily weight

Weight is the most sensitive marker of fluid status. A gain of 2 to 3 pounds in a day or 5 pounds in a week warrants provider notification.

Hyperkalemia ECG changes

Progression from peaked T waves to prolonged PR interval, widened QRS, and sine wave. Calcium gluconate stabilizes the myocardium as the first treatment.

Late decelerations

Fetal heart rate drops that begin after the peak of a uterine contraction and mirror the contraction pattern, suggesting uteroplacental insufficiency and requiring repositioning and provider notification.

Magnesium sulfate toxicity monitoring

Assess respiratory rate of at least 12 per minute, deep tendon reflexes, and urine output of at least 30 mL per hour. Calcium gluconate is the antidote.

Serotonin syndrome triad

Altered mental status, autonomic instability, and neuromuscular hyperactivity such as clonus and hyperreflexia, caused by serotonergic drugs and treated by stopping the agent.

Lithium therapeutic range

Typically 0.6 to 1.2 mEq/L. Toxicity causes tremor, ataxia, vomiting, and confusion, and risk rises with dehydration and NSAID use.

Septic shock initial bundle

Measure lactate, draw blood cultures before antibiotics, give broad-spectrum antibiotics, and administer 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or higher.

Adult CPR quality

Compress at 100 to 120 per minute to a depth of at least 2 inches, allow full chest recoil, and keep interruptions under 10 seconds.

Anaphylaxis first-line treatment

Intramuscular epinephrine into the anterolateral thigh. Antihistamines and corticosteroids are adjuncts and must not delay epinephrine administration.

Airborne precautions

Required for tuberculosis, measles, and varicella. Use a fit-tested N95 respirator and a negative-pressure room with at least 6 air exchanges per hour.

Hand hygiene exceptions

Alcohol-based rub is preferred for non-soiled hands, but soap and water is required when hands are visibly soiled and for C. difficile and norovirus, whose spores resist alcohol.

Informed consent elements

Capacity, voluntariness, disclosure of risks, benefits, and alternatives, and comprehension. The performing provider obtains consent and the nurse verifies understanding.

Just culture

A framework that consoles human error, coaches at-risk behavior, and remediates reckless behavior, encouraging error reporting instead of punishing honest mistakes.

SAMPLE history

Symptoms, Allergies, Medications, Past medical history, Last meal, and Events leading to presentation, used to structure a focused patient history.

Steady state

The point at which drug intake equals elimination, reached after roughly four to five half-lives of regular dosing without a loading dose.

Diabetic ketoacidosis priorities

Isotonic fluids first, then an insulin infusion, with potassium replacement once the level falls below 5.2 mEq/L and urine output is adequate.

Postpartum hemorrhage first action

Uterine atony is the most common cause. Perform fundal massage with firm bimanual pressure while administering oxytocin and calling for help.

Neuroleptic malignant syndrome

Rigidity, hyperthermia, altered mental status, and autonomic instability from antipsychotic use. Stop the drug and treat with dantrolene or bromocriptine.

Increased intracranial pressure positioning

Elevate the head of bed 30 degrees, keep the head midline, avoid hip flexion, and maintain normocapnia, reserving hyperventilation for impending herniation.

Doffing PPE order

Remove gloves first, then goggles or face shield, then gown, then mask or respirator, performing hand hygiene after each removal step.

APGAR score

Scored at 1 and 5 minutes for Appearance, Pulse, Grimace, Activity, and Respiration, each 0 to 2. It describes status but does not guide resuscitation.

Therapeutic communication techniques

Open-ended questions, reflection, restating, and silence encourage expression. Avoid false reassurance, giving advice, and asking why-questions.

Central line infection bundle

Hand hygiene, maximal sterile barrier precautions, chlorhexidine skin antisepsis, optimal site selection, and daily review of whether the line remains necessary.