QCHP/DHP Nurse Exam flashcards

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

Troponin

Cardiac biomarker that rises 3–6 hours after myocardial injury, peaks at 12–24 hours and stays elevated 7–10 days; used to diagnose acute myocardial infarction.

Kussmaul respirations

Deep, rapid, regular respirations seen in metabolic acidosis such as diabetic ketoacidosis, reflecting respiratory compensation that lowers PaCO2 to raise serum pH.

Water seal chamber

Chest drainage chamber that shows tidaling with breathing; continuous bubbling indicates an air leak in the system and must be reported to the provider.

Hyperkalemia ECG changes

Tall peaked T waves are the earliest sign; treatment starts with IV calcium gluconate for cardiac protection, followed by insulin with dextrose to shift potassium intracellularly.

Braden Scale

Tool scoring six factors - sensory perception, moisture, activity, mobility, nutrition, friction and shear - to predict pressure injury risk; a score of 18 or less indicates risk.

Sterile field border

The outer 2.5 cm (1 inch) of a sterile drape is considered non-sterile; anything touching it, or a field that becomes wet, is contaminated.

Airborne precautions

Requires a negative-pressure room and an N95 respirator; used for tuberculosis, measles and varicella, and continued until disease-specific criteria are met.

Nasogastric tube verification

Confirm placement with a chest X-ray or a gastric aspirate pH of 5.5 or less; the auscultation-of-injected-air method is unreliable and no longer recommended.

Naegele's rule

Method for estimating the date of birth: subtract 3 months from the first day of the last menstrual period and add 7 days.

Magnesium sulfate antidote

Calcium gluconate. Magnesium toxicity is signaled by loss of deep tendon reflexes, respiratory rate below 12/min and oliguria, requiring the infusion to be stopped.

Lochia serosa

Pinkish-brown vaginal discharge occurring from about postpartum day 4 to day 10; a return to bright red bleeding suggests hemorrhage or infection.

APGAR score

Newborn assessment performed at 1 and 5 minutes, scoring appearance, pulse, grimace, activity and respiration from 0 to 2 each, for a total of 0–10.

Croup

Viral laryngotracheobronchitis producing a barking cough, hoarseness and inspiratory stridor; treated with dexamethasone and nebulized epinephrine.

Knee-chest position

Position used during a tetralogy of Fallot hypercyanotic spell; it increases systemic vascular resistance and reduces the right-to-left shunt.

Intussusception

Telescoping of one bowel segment into another causing colicky pain, currant-jelly stools and a sausage-shaped mass; an air enema is diagnostic and therapeutic.

Holliday-Segar method

Pediatric maintenance fluid calculation: 100 mL/kg/day for the first 10 kg, 50 mL/kg/day for the next 10 kg, and 20 mL/kg/day for each additional kilogram.

Digoxin immune Fab

Antidote for digoxin toxicity, which presents with bradycardia, nausea, and visual changes such as yellow-green halos at serum levels above 2 ng/mL.

Protamine sulfate

Antidote that reverses heparin, which is monitored with the aPTT; warfarin is instead reversed with vitamin K and monitored by INR.

Red man syndrome

Flushing of the face, neck and chest caused by rapid vancomycin infusion; prevention is infusing each dose over at least 60 minutes.

N-acetylcysteine

Antidote for acetaminophen overdose; acetaminophen is limited to 4 g per day in adults because excess is metabolized into a hepatotoxic intermediate.

Beneficence

Ethical principle requiring actions that promote the patient's good and well-being; it is balanced against nonmaleficence, the duty to avoid causing harm.

SBAR handoff

Structured communication using Situation, Background, Assessment and Recommendation to convey concise, complete information during handoffs and clinical escalation.

Sentinel event

An unexpected occurrence involving death or serious physical or psychological harm; it triggers immediate investigation, disclosure to the patient, and root cause analysis.

Five rights of delegation

Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation; the RN retains accountability for the outcome.

Secondary prevention

Early detection and treatment of disease through screening such as mammography, Pap smears and blood pressure checks, before symptoms appear.

Prevalence

The total number of existing cases of a disease in a population at a given time, including both new and old cases; incidence counts only new cases.

Herd immunity

Indirect protection of unvaccinated people that occurs when a high proportion of the community is immune, limiting disease transmission.

Epidemiologic triad

Model describing disease as the result of interaction among a susceptible host, a causative agent and the surrounding environment.

Serotonin syndrome

Potentially fatal reaction to serotonergic drugs marked by agitation, hyperthermia, hyperreflexia and clonus; stop the offending agent and notify the provider.

Delirium versus dementia

Delirium is acute, fluctuating and reversible with inattention; dementia is insidious, progressive cognitive decline in which consciousness remains intact.

Thiamine before glucose

In alcohol withdrawal or malnutrition, thiamine is given before or with glucose to prevent Wernicke encephalopathy.

Lithium therapeutic range

0.6–1.2 mEq/L; toxicity causes tremor, ataxia, vomiting and confusion, and is worsened by dehydration or low sodium intake.