Lesotho Nursing Council Licensure Examination flashcards

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

Nursing process steps

Assessment, diagnosis, planning, implementation, and evaluation. It is a cyclic, dynamic framework that organises nursing care and allows reassessment when patient status changes.

Subjective versus objective data

Subjective data are reported by the patient, such as pain or nausea. Objective data are directly observed or measured, such as temperature, blood pressure, or a wound appearance.

Normal adult vital signs

Temperature 36.1–37.2 °C, pulse 60–100/min, respirations 12–20/min, blood pressure under 120/80 mmHg, and oxygen saturation 95% or above on room air.

Stages of infection

Incubation, prodromal, illness, decline, and convalescence. The prodromal stage is often the most infectious because pathogens are shed before symptoms are obvious.

Medical versus surgical asepsis

Medical asepsis reduces the number of organisms through hand hygiene and clean technique. Surgical asepsis eliminates all microorganisms using sterile fields, sterile gloves, and sterile technique.

Pressure injury staging

Stage 1 is intact skin with non-blanchable erythema; stage 2 is partial-thickness loss; stage 3 is full-thickness loss; stage 4 exposes fascia or bone; unstageable has eschar or slough.

Acute coronary syndrome actions

Give morphine, oxygen if hypoxaemic, nitroglycerin, and aspirin, and obtain a 12-lead ECG within 10 minutes of the patient's arrival at the facility.

Left versus right heart failure

Left-sided failure causes pulmonary congestion with dyspnoea, orthopnoea, crackles, and pink frothy sputum. Right-sided failure causes systemic congestion with raised jugular venous pressure and oedema.

Diabetic ketoacidosis criteria

Glucose above 13.9 mmol/L, arterial pH below 7.30, bicarbonate below 18 mmol/L, positive ketones, and a raised anion gap. Treatment is fluids, insulin infusion, and potassium replacement.

Hypoglycaemia management

Glucose below 3.9 mmol/L. If conscious, give 15–20 g fast-acting oral carbohydrate and recheck in 15 minutes. If unconscious, give IV dextrose or intramuscular glucagon.

Parkland burn formula

Four millilitres of crystalloid per kilogram body weight per percent total body surface area burned in the first 24 hours, with half given in the first 8 hours from the burn time.

Hyperkalaemia ECG changes

Progression from peaked T waves to widened QRS complexes and finally a sine wave pattern. Treat with calcium gluconate, insulin with dextrose, and salbutamol.

Naegele's rule

Estimated date of delivery equals the first day of the last menstrual period plus seven days, minus three months, plus one year.

Stages of labour

First stage runs from onset to full cervical dilatation; second stage from full dilatation to birth; third stage from birth to placental delivery; fourth stage covers the first two postpartum hours.

Fetal heart rate decelerations

Early decelerations reflect head compression and are benign; variable decelerations reflect cord compression; late decelerations reflect uteroplacental insufficiency and require urgent action.

Postpartum haemorrhage definition

Blood loss greater than 500 mL after vaginal birth or greater than 1000 mL after caesarean birth. Uterine atony is the commonest cause and is managed with fundal massage and uterotonics.

Lochia types

Lochia rubra is red and occurs on days 1–3; serosa is pink or brown on days 4–10; alba is white or yellow from day 10 onward.

APGAR score

Scored at 1 and 5 minutes for appearance, pulse, grimace, activity, and respiration. Each component scores 0–2, and a total of 7 or above is generally reassuring.

Preeclampsia diagnostic criteria

Blood pressure of 140/90 mmHg or higher after 20 weeks' gestation plus proteinuria or end-organ dysfunction. Severe features include blood pressure of 160/110 or higher and low platelets.

Paediatric dehydration assessment

Mild dehydration is under 5% weight loss, moderate is 5–10%, and severe is over 10%. Severe signs include sunken eyes, slow skin pinch, lethargy, and inability to drink.

Paediatric respiratory distress signs

Nasal flaring, intercostal or subcostal recession, grunting, head bobbing, and tracheal tug. These are danger signs requiring prompt assessment and oxygen if indicated.

IMCI danger signs

Inability to drink or breastfeed, vomiting everything, convulsions, and lethargy or unconsciousness. Any danger sign requires urgent referral or admission.

Kangaroo mother care

Continuous skin-to-skin contact with exclusive breastfeeding and early discharge. It reduces mortality and hypothermia in low-birth-weight and preterm infants.

Levels of prevention

Primary prevention stops disease before it occurs, such as immunisation. Secondary prevention detects disease early through screening. Tertiary prevention limits disability through rehabilitation.

Incidence versus prevalence

Incidence counts new cases in a period divided by the population at risk. Prevalence counts all existing cases divided by the total population at a point or period.

Infant mortality rate

Deaths of infants under one year divided by live births in the same year, multiplied by 1000. It is a key indicator of population health and health system performance.

Cold chain vaccine storage

Vaccines are kept at 2–8 °C at health facility level. Oral polio vaccine is the most heat-sensitive and is monitored using vaccine vial monitors.

Therapeutic communication techniques

Use open-ended questions, reflection, clarification, and silence. Avoid false reassurance, giving advice, changing the subject, and judging the patient.

Serotonin syndrome features

Agitation, hyperthermia, tremor, clonus, and hyperreflexia caused by serotonergic drugs. It is a medical emergency requiring drug withdrawal and supportive care.

Neuroleptic malignant syndrome

Rigidity, high fever, autonomic instability, and raised creatine kinase after antipsychotic use. Stop the drug and provide supportive care with dantrolene or bromocriptine.

Medication administration rights

Right patient, drug, dose, route, time, documentation, and reason, plus the right to refuse and right assessment. Verify at least three times before giving a dose.

Common antidotes

Paracetamol is treated with N-acetylcysteine, warfarin with vitamin K, heparin with protamine sulfate, opioids with naloxone, and benzodiazepines with flumazenil.

Four ethical principles

Autonomy respects patient choice, beneficence promotes good, non-maleficence avoids harm, and justice ensures fair distribution of care resources.