MNMC Nursing flashcards
MNMC Nursing · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Nurse Practice Act
- State law that defines the legal scope of nursing practice, licensure requirements, and grounds for discipline. It authorizes what an RN, LPN, or APRN may do.
- Four elements of negligence
- Duty owed to the patient, breach of that duty, causation linking the breach to injury, and actual damages. All four must be proven for liability.
- Informed consent
- Voluntary agreement after disclosure of the procedure, risks, benefits, and alternatives. The performing provider obtains it; the nurse witnesses and verifies understanding.
- Assault versus battery
- Assault is a threat of harmful contact with apparent ability to carry it out; battery is actual unauthorized physical contact, such as an injection given without consent.
- Mandatory reporting duty
- Legal obligation to report suspected child, elder, or dependent adult abuse and specified injuries such as gunshot wounds to the designated agency, with documentation.
- Speak-up tool CUS
- A structured assertion phrase: "I am Concerned, I am Uncomfortable, this is a Safety issue." It stops an unsafe action and triggers review before proceeding.
- Root cause analysis
- A retrospective, multidisciplinary method to find system failures underlying a sentinel event and design preventive actions; required after serious harm.
- FMEA
- Failure Mode and Effects Analysis is a prospective risk assessment that scores each potential failure by severity, occurrence, and detectability before harm occurs.
- SBAR handoff
- Situation, Background, Assessment, Recommendation. A structured communication format for handoffs and critical result calls, followed by read-back to confirm understanding.
- Restraint time limits
- Adult orders: 4 hours for violent or self-destructive behavior, 24 hours for nonviolent restraint. Reassess at required intervals and document necessity and alternatives tried.
- Braden Scale
- Six-subscale tool scoring sensory perception, moisture, activity, mobility, nutrition, and friction/shear. Lower scores indicate higher pressure injury risk.
- Glasgow Coma Scale
- Scores eye opening, verbal response, and motor response for a total of 3 to 15. A score of 8 or less signals need to protect the airway.
- Orthostatic hypotension
- A drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing. It increases fall risk and requires assessment before ambulation.
- Pulse deficit
- The difference between the apical and radial pulse rates counted simultaneously. A deficit suggests ineffective peripheral perfusion, commonly from atrial fibrillation.
- Stridor
- A high-pitched inspiratory sound from upper airway obstruction. It is an emergency requiring immediate airway assessment and provider notification.
- Abdominal assessment order
- Inspect, auscultate, percuss, then palpate. Auscultation precedes palpation so that manipulation does not alter bowel sound findings.
- Medication reconciliation
- A formal comparison of the patient's home medication list with current orders at admission, transfer, and discharge, resolving discrepancies with the prescriber.
- Teach-back method
- Ask the patient to restate the information or demonstrate the skill in their own words. It verifies understanding rather than relying on a yes answer.
- Discharge planning
- Begins on admission and covers medication reconciliation, follow-up appointment, equipment, warning signs, written instructions, and documented teach-back.
- Case management
- A role focused on coordinating care, matching resources to need, and managing length of stay and cost, distinct from direct bedside nursing care.
- Therapeutic index
- The ratio of toxic dose to therapeutic dose. A narrow index, as with digoxin, warfarin, and lithium, requires serum level monitoring for safety.
- Naloxone
- An opioid antagonist that reverses respiratory depression. It may require repeat dosing because its duration is shorter than many opioids; monitor breathing afterward.
- Warfarin monitoring
- Track INR, with a usual target of 2 to 3 for most indications. Teach bleeding precautions and consistent, not eliminated, vitamin K intake.
- High-alert medications
- Drugs with high harm risk when misused, including insulin, heparin, opioids, and concentrated electrolytes. They require independent double-checks and standardized dosing.
- Insulin onset times
- Rapid-acting lispro and aspart act in about 15 minutes; regular insulin in 30 minutes; NPH in 1 to 2 hours; glargine and detemir are long-acting with no peak.
- Five rights of delegation
- Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation. The RN retains accountability for outcomes.
- UAP delegation limits
- Unlicensed assistive personnel may perform tasks with predictable outcomes such as vital signs, ADLs, and ambulation. Assessment, teaching, and care planning stay with the RN.
- Just culture
- A framework that separates human error, at-risk behavior, and reckless behavior, responding with support, coaching, or discipline respectively to encourage safety reporting.
- Transformational leadership
- A style using shared vision, inspiration, and individual development to raise team performance, contrasted with transactional leadership based on rewards and consequences.
- Stages of change
- Precontemplation, contemplation, preparation, action, and maintenance. Teaching and counseling are matched to the patient's current stage rather than pushed toward action.
- SMART goals
- Specific, measurable, achievable, relevant, and time-bound. Written patient goals in this format improve follow-through and allow evaluation of teaching.
- Levels of prevention
- Primary prevents disease (immunization), secondary detects it early (screening), and tertiary limits disability and manages chronic disease through rehabilitation and treatment.