EHPLE Nursing flashcards

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

Autonomy

The ethical principle that a competent patient has the right to make informed decisions about their own care, including the right to refuse treatment, even when the choice conflicts with provider recommendations.

Informed consent elements

Valid consent requires patient capacity, voluntary choice, disclosure of risks, benefits, and alternatives, and comprehension. The provider performing the procedure obtains consent; the nurse witnesses and verifies understanding.

Negligence four elements

A negligence claim requires duty owed to the patient, breach of that duty, causation linking the breach to injury, and actual damages. Malpractice is negligence committed by a professional within practice scope.

Delegation accountability

The RN may delegate tasks but retains accountability for outcomes and cannot delegate assessment, care planning, evaluation, or teaching. The five rights of delegation guide the decision.

Orthostatic hypotension criteria

A drop of at least 20 mmHg systolic or 10 mmHg diastolic within three minutes of standing. Measure blood pressure and pulse with the patient lying, then sitting, then standing.

Pressure injury stage 3

Full-thickness loss of skin extending into subcutaneous fat, with fascia, muscle, tendon, and bone not exposed. Slough or eschar may be present but does not obscure the depth.

Airborne precautions

Required for tuberculosis, measles, and varicella. Use a negative-pressure room, an N95 or higher respirator, and door closed. Standard precautions apply to all patients regardless of diagnosis.

Normal adult urine output

Approximately 30 mL per hour or 0.5 mL per kg per hour. Output below 400 mL per day is oliguria and below 100 mL per day is anuria; report sustained decreases promptly.

Digoxin toxicity signs

Nausea, anorexia, visual halos or yellow-green vision, confusion, and bradycardia. Therapeutic level is 0.5-2.0 ng/mL. Hypokalemia increases toxicity risk; hold the dose if apical pulse is under 60/min.

DKA versus HHS

DKA shows glucose above 250 mg/dL, pH below 7.30, low bicarbonate, ketones, and Kussmaul respirations. HHS shows glucose above 600 mg/dL with minimal ketones and severe dehydration. Both begin with isotonic fluids.

Parkland burn formula

Give 4 mL x body weight in kg x percent total body surface area burned over 24 hours, with half infused in the first 8 hours measured from the time of injury.

Late decelerations

Fetal heart rate decelerations that begin after the contraction peak and return after it ends, reflecting uteroplacental insufficiency. Reposition to the side, stop oxytocin, give oxygen, and notify the provider.

Magnesium sulfate toxicity

Signs include loss of deep tendon reflexes, respiratory depression, and oliguria. Therapeutic level is 4-7 mEq/L. Calcium gluconate is the antidote; monitor reflexes, respirations, and urine output hourly.

APGAR scoring

Scores heart rate, respiratory effort, muscle tone, reflex irritability, and color at 1 and 5 minutes after birth. Each component scores 0-2; a total of 7-10 is generally reassuring.

Postpartum hemorrhage causes

Uterine atony is the most common cause, followed by retained placenta, genital tract trauma, and coagulation disorders. Blood loss over 500 mL after vaginal birth or 1000 mL after cesarean is hemorrhage.

Infant milestones

Social smile at 6 weeks, head control at 4 months, rolling at 5-6 months, sitting unsupported at 8 months, pincer grasp at 9-10 months, and independent walking at 12-15 months.

Kawasaki disease treatment

Fever for at least five days with conjunctivitis, mucositis, rash, cervical lymphadenopathy, and extremity changes. Treat with intravenous immune globulin and high-dose aspirin to reduce coronary aneurysm risk.

Epiglottitis precautions

Presents with drooling, tripod positioning, muffled voice, and high fever. Do not inspect the throat or place the child supine, as this can trigger airway obstruction. Prepare for emergency airway management.

Tetralogy of Fallot

A cyanotic congenital defect with four components: ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. Hypercyanotic spells are treated with knee-chest position, oxygen, and morphine.

Serotonin syndrome

Caused by serotonergic drugs. Signs include clonus, hyperreflexia, agitation, diaphoresis, and hyperthermia. Stop the offending agent, provide supportive care, and consider cyproheptadine as an antidote.

Neuroleptic malignant syndrome

A life-threatening reaction to antipsychotics marked by muscle rigidity, fever, autonomic instability, and elevated creatine kinase. Stop the drug immediately and treat with dantrolene or bromocriptine.

Lithium therapeutic range

Therapeutic serum level is 0.6-1.2 mEq/L. Toxicity causes tremor, vomiting, diarrhea, ataxia, and confusion. Maintain consistent sodium and fluid intake and monitor levels regularly.

Alcohol withdrawal timeline

Symptoms begin 6-12 hours after the last drink and peak at 24-72 hours. Monitor with the CIWA-Ar scale. Treat with benzodiazepines and give thiamine before glucose to prevent Wernicke encephalopathy.

Levels of prevention

Primary prevents disease before it occurs (immunization, seat belts). Secondary detects disease early (screening, Pap smear). Tertiary limits disability and promotes rehabilitation after disease is established.

Incidence versus prevalence

Incidence counts new cases over a period divided by the population at risk. Prevalence counts all existing cases at a point in time. For stable disease, prevalence approximately equals incidence times duration.

Herd immunity threshold

The proportion of immune individuals needed to interrupt transmission, determined by the basic reproduction number. Measles requires roughly 92-95% coverage; polio requires about 80-85%.

Sensitivity versus specificity

Sensitivity is the proportion of true positives correctly identified; specificity is the proportion of true negatives correctly identified. Positive predictive value rises as disease prevalence in the population increases.

Heparin monitoring and antidote

Unfractionated heparin is monitored with aPTT, targeting 1.5-2.5 times control, or with anti-Xa levels. Protamine sulfate reverses heparin. Monitor for bleeding and thrombocytopenia.

Warfarin monitoring and antidote

Warfarin inhibits vitamin K-dependent clotting factors. Monitor INR, targeting 2-3 for most indications. Vitamin K (phytonadione) reverses it; fresh frozen plasma is added for major bleeding.

Insulin onset times

Rapid-acting lispro and aspart begin in about 15 minutes, short-acting regular in 30 minutes, intermediate NPH in 1-2 hours, and long-acting glargine in 1-2 hours with no pronounced peak.

Naloxone use

An opioid antagonist that reverses respiratory depression, sedation, and hypotension from opioid overdose. Administer and monitor respirations closely, as its duration may be shorter than the opioid's effect.

Six rights of medication

Right patient, right drug, right dose, right route, right time, and right documentation. Verify the patient with two identifiers and perform an independent double-check for high-alert medications.