PSB-RNSAE flashcards

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

Chain of command

The formal line of authority from staff nurse to charge nurse to supervisor to provider. It is used when a concern is unresolved and patient safety is at risk.

Five rights of delegation

Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation. These govern what an RN may delegate to assistive personnel.

Mandatory reporting

A legal duty to notify authorities of suspected child, older adult, or dependent adult abuse, certain communicable diseases, and unsafe provider practice, even without patient consent.

Informed consent

A voluntary agreement after the patient receives the diagnosis, procedure purpose, risks, benefits, and alternatives. The provider obtains it; the nurse witnesses and confirms understanding.

Airborne precautions

Used for tuberculosis, measles, varicella, and disseminated shingles. Requires an N95 respirator, a negative-pressure private room, and door kept closed.

Contact precautions

Used for MRSA, VRE, C. difficile, and scabies. Requires gloves and gown for every entry, dedicated equipment, and hand hygiene with soap and water for C. difficile.

Restraint order limits

Provider orders are time-limited: four hours for adults, two hours for ages nine to seventeen, one hour for children under nine. Face-to-face evaluation is required within one hour.

RACE fire response

Rescue anyone in danger, Alarm the alarm, Contain the fire by closing doors, and Extinguish or Evacuate. Horizontal evacuation of ambulatory patients comes first.

Neutropenic precautions

Protective measures for low white counts: private room, no fresh flowers or standing water, no ill visitors, and avoidance of rectal temperatures or suppositories to prevent mucosal injury.

Erikson stages

Trust versus mistrust in infancy, autonomy versus shame in toddlers, initiative versus guilt in preschoolers, industry versus inferiority in school age, and identity versus role confusion in adolescence.

Infant growth norms

Birth weight doubles by five to six months and triples by twelve months. Birth length increases about fifty percent by twelve months. These are key well-child screening benchmarks.

Live vaccine contraindications

MMR, varicella, and live attenuated influenza vaccine are avoided in pregnancy and significant immunocompromise. Inactivated influenza vaccine is safe in any trimester.

Gestational diabetes screening

A glucose challenge test is typically performed at twenty-four to twenty-eight weeks of gestation. Abnormal results are followed by a three-hour oral glucose tolerance test.

Therapeutic communication

Techniques include open-ended questions, reflection, restating, and silence. Avoid false reassurance, advice-giving, why questions, and changing the subject, which block patient expression.

Delirium versus dementia

Delirium is acute and fluctuating with altered attention and consciousness. Dementia is chronic and progressive with consciousness intact until late stages.

Alcohol withdrawal

Manifestations include tremor, autonomic hyperactivity, hallucinations, and seizures. Benzodiazepines are first line, guided by a withdrawal severity scale.

Suicide risk assessment

Ask directly about ideation, plan, means, and intent. A no-suicide contract does not replace close observation, environmental safety, and prompt referral.

Pressure injury staging

Stage one is intact skin with nonblanchable erythema. Stage two is partial-thickness dermal loss. Stage three reaches subcutaneous tissue; stage four reaches muscle or bone.

Clear liquid diet

Includes water, clear broth, gelatin, and clear juices. It excludes milk, cream, and opaque liquids. It is used before procedures and during acute gastrointestinal illness.

Wong-Baker FACES scale

A self-report pain tool using six drawn faces from no hurt to worst hurt. It is used for children and adults who can point to a matching face.

Repositioning schedule

Turn and reposition at least every two hours, use a thirty-degree lateral tilt, and keep the head of bed at or below thirty degrees when possible to reduce shear.

IV drip rate formula

Drops per minute equals volume in milliliters times the drop factor, divided by total minutes. Example: 500 mL over 240 minutes with a 15 gtt/mL set equals 31 gtt/min.

High-alert medications

Drugs with high harm risk when misused, including insulin, heparin, opioids, chemotherapy, and concentrated electrolytes. They require independent double-checks and standardized concentrations.

Antidote pairs

Heparin is reversed by protamine sulfate, warfarin by vitamin K, opioids by naloxone, and benzodiazepines by flumazenil. Knowing these pairs guides emergency response.

Digoxin toxicity signs

Early signs include anorexia, nausea, and visual halos or yellow-green vision. Bradycardia and dysrhythmias follow. Hold the dose and notify for an adult apical pulse below sixty.

Transfusion administration rules

Two licensed staff verify the unit. Use only 0.9% sodium chloride, start within thirty minutes, and complete within four hours. Stop for fever, chills, or back pain.

ABG interpretation rule

Normal pH is 7.35 to 7.45, PaCO2 35 to 45, and bicarbonate 22 to 26. Respiratory disorders move pH opposite to CO2; metabolic disorders move pH in the same direction as bicarbonate.

Malignant hyperthermia

A genetic reaction to volatile anesthetics and succinylcholine causing rigidity, rising temperature, and tachycardia. Dantrolene is the specific treatment.

Sepsis bundle

Obtain cultures, give broad-spectrum antibiotics within one hour, and give 30 mL/kg crystalloid for hypotension or lactate of four or greater. Reassess perfusion and urine output.

Extravasation response

Stop the infusion, aspirate per policy, remove the catheter, apply the drug-specific cold or warm compress, and notify the provider. Document the site and time.

Cushing triad

A late sign of increased intracranial pressure: hypertension with widened pulse pressure, bradycardia, and irregular respirations. Early change in level of consciousness is more sensitive.

Diabetic ketoacidosis

Glucose above 250, pH below 7.3, bicarbonate below 18, ketones, and an elevated anion gap. Treat with 0.9% sodium chloride, insulin infusion, and potassium replacement.