llnAL LxAM

key o|nts from 1ext

I(a)
Chapter S Lth|cs
O 8aslc prlnclples of eLhlcs ln healLh care lnclude auLonomy [usLlce fldellLy beneflcence
and nonmaleflcence
O A code of eLhlcs provldes a foundaLlon for professlonal nurslng
O rofesslonal nurslng promoLes accounLablllLy responslblllLy and advocacy
O An eLhlcal nurse malnLalns compeLence ln pracLlce and assumes responslblllLy for
nurslng [udgmenLs
O 1he prlmary funcLlons of advocacy are Lo lnform and Lo supporL
O rofesslonal nurses have a commlLmenL Lo paLlenLs Lhe professlon and socleLy Lo
provlde hlghquallLy healLh care
O LLhlcal problems arlse from dlfferences ln values changlng professlonal roles
Lechnologlcal advances and uncerLalnLy ln declslon maklng
O LLhlcal dllemmas ln nurslng wlll occur ln any segmenL of Lhe healLh care dellvery sysLem
O A sLandard process for crlLlcal Lhlnklng ln Lhe face of eLhlcal dllemmas helps nurses
resolve dlfflculL slLuaLlons
O 1he nurse's polnL of vlew provldes a unlque and valuable volce ln Lhe resoluLlon of
eLhlcal dllemmas

Chapter 6 Lv|dence8ased ract|ce
O Lvldencebased pracLlce lnvolves Lhe revlew of avallable research flndlngs appllcaLlon
of cllnlcal [udgmenL and experLlse and Lhen LranslaLlon of Lhe besL evldence lnLo besL
pracLlces aL a paLlenL's bedslde
O 1he slx sLeps of evldencebased pracLlce provlde a sysLemaLlc approach Lo raLlonal
cllnlcal declslon maklng
O 1he componenLs of a lCC quesLlon are aLlenL or populaLlon of lnLeresL InLervenLlon
of lnLeresL ComparaLlve lnLervenLlon and CuLcome
O 1he correcL appllcaLlon of L8 lnvolves eLhlcal and accounLable professlonal nurslng
pracLlce
O roblemfocused or knowledgefocused Lrlggers help ln Lhe ldenLlflcaLlon of a conclse
cllnlcal quesLlon
O A conclse lCC quesLlon conslsLs of key words for conducLlng a llLeraLure search LhaL wlll
provlde sclenLlflc arLlcles Lo address your pracLlce quesLlon
O 1he hlerarchy of avallable evldence offers a gulde abouL Lhe Lypes of llLeraLure or
lnformaLlon LhaL offer Lhe besL sclenLlflc evldence
O LxperL cllnlclans are a rlch source of evldence because Lhey use evldence frequenLly Lo
bulld Lhelr own pracLlce and solve cllnlcal problems
O 1he crlLlqulng of evldence lnvolves evaluaLlon of Lhe sclenLlflc worLh and cllnlcal
appllcablllLy of each sLudy's flndlngs
O 8y undersLandlng Lhe elemenLs of a sclenLlflc arLlcle you wlll be able Lo beLLer crlLlque
Lhe lnformaLlon effecLlvely for relevance and appllcablllLy Lo your lCC quesLlon
llnAL LxAM key o|nts from 1ext
2
O A key feaLure of a pracLlce envlronmenL LhaL supporLs Lhe use of besL evldence ls
requlrlng cllnlcal pracLlce pollcles and procedures Lo be evldence based
O 1he evaluaLlon of an evldencebased pracLlce change deLermlnes lf Lhe pracLlce change
ls deslrable lf you need Lo modlfy your lnLervenLlon or lf you need Lo dlsconLlnue Lhe
pracLlce change
O When selecLlng a nurslngsenslLlve ouLcome measure be sure lL ls an ouLcome LhaL ls
affecLed by nurslng care LhaL lL ls approprlaLe for Lhe group you are carlng for and LhaL
lL ls lmporLanL Lo Lhe oLher cllnlclans you work wlLh
O 8y communlcaLlng evldencebased pracLlce changes Lo a nurslng sLaff lL ls more llkely
LhaL Lhe changes wlll remaln ln place
O CuLcome measuremenL conLrlbuLes Lo Lhe body of evldence and sLrengLhens Lhe
process of evldencebased pracLlce

I(b)
Chapter 9 Informat|cs and Documentat|on
O A paLlenL's healLh care record ls a confldenLlal wrlLLen legal documenLaLlon of Lhe care
recelved
O 1he record ls a conLlnulng accounL of Lhe paLlenL's healLh care sLaLus and ls avallable Lo
all members of Lhe healLh care Leam lL faclllLaLes communlcaLlon wlLh healLh care
provlders for conLlnulLy of paLlenL care malnLalns a legal and flnanclal record of care
alds ln cllnlcal research and guldes professlonal and organlzaLlonal performance
lmprovemenL
O ?our full slgnaLure wlLh LlLle on an enLry ln a record deslgnaLes accounLablllLy for Lhe
conLenLs of LhaL enLry
O AccuraLe and Llmely record keeplng requlres an ob[ecLlve lnLerpreLaLlon of daLa wlLh
preclse measuremenLs correcL spelllng and proper use of abbrevlaLlons
O LffecLlve documenLaLlon verlfles Lhe speclflc nurslng care provlded use of servlces and
equlpmenL and medlcaLlons and Lhus supporLs Lhe relmbursemenL your healLh care
agency recelves
O uocumenL changes ln a paLlenL's condlLlon and paLlenL's responses Lo lnLervenLlons as
Lhey happen Lo keep a record currenL
O 1o llmlL llablllLy nurslng documenLaLlon exacLly descrlbes whaL happened Lo a paLlenL
and musL clearly lndlcaLe LhaL lndlvlduallzed goaldlrecLed nurslng care was provlded
based on Lhe nurslng assessmenL
O Crganlze problemorlenLed medlcal records by Lhe paLlenL's healLh care problems
O Medlcare guldellnes for esLabllshlng a paLlenL's home care relmbursemenL are Lhe basls
for documenLaLlon by home care nurses
O LongLerm care documenLaLlon ls mulLldlsclpllnary and closely llnked wlLh flscal
requlremenLs of ouLslde agencles
O CompuLerlzed lnformaLlon sysLems provlde lnformaLlon abouL paLlenLs ln an organlzed
and easlly accesslble fashlon
O 1he ma[or purpose of handoff reporLs ls Lo malnLaln conLlnulLy of care
llnAL LxAM key o|nts from 1ext
3
O When lnformaLlon relevanL Lo care ls communlcaLed by Lelephone verlfy Lhe
lnformaLlon by a readback" process lncldenL (occurrence) reporLs ob[ecLlvely descrlbe
any evenL noL conslsLenL wlLh Lhe rouLlne care of a paLlenL
O A hosplLal lnformaLlon sysLem conslsLs of Lwo ma[or Lypes of lnformaLlon sysLems
cllnlcal lnformaLlon sysLems and admlnlsLraLlve lnformaLlon sysLems
O nurslng lnformaLlcs faclllLaLes Lhe lnLegraLlon of daLa lnformaLlon knowledge and
wlsdom Lo supporL paLlenLs nurses and oLher provlders ln declslon maklng ln all roles
and seLLlngs
O roLecLlon of Lhe confldenLlallLy of paLlenL's healLh lnformaLlon and Lhe securlLy of
compuLer sysLems musL remaln a Lop prlorlLy Logln processes audlL Lralls flrewalls
daLa recovery processes and pollcles governlng handllng and dlsposal of lnformaLlon all
work Lo proLecL paLlenL lnformaLlon
O 1he compuLerlzed healLh record lmproves conLlnulLy of healLh care by provldlng Lhe
ablllLy Lo compare daLa from varlous healLh care encounLers and offerlng easlly
accesslble daLa for purposes of communlcaLlon reduclng llablllLy relmbursemenL
educaLlon research and audlLlng and monlLorlng

I(c)
Chapter 11 at|ent Lducat|on
O PealLh educaLlon ls almed aL Lhe promoLlon resLoraLlon and malnLenance of healLh
O 1eachlng ls mosL effecLlve when lL ls responslve Lo Lhe learner's needs and requlres Lhe
learner's acLlve lnvolvemenL
O 1eachlng ls a form of lnLerpersonal communlcaLlon wlLh Leacher and sLudenL acLlvely
lnvolved ln a process LhaL lncreases Lhe sLudenL's knowledge and skllls
O 1eachlng a paLlenL a speclflc behavlor lnvolves lncorporaLlon of behavlors from all Lhree
learnlng domalns
O A person's healLh bellefs lnfluence Lhe wllllngness Lo galn Lhe knowledge and skllls
necessary Lo malnLaln healLh
O aLlenLs of dlfferenL agegroups requlre dlfferenL Leachlng sLraLegles as a resulL of
developmenLal capablllLles
O resenLaLlon of Leachlng conLenL progresses from slmple Lo more complex ldeas
O Assess Lhe readlng ablllLy and Lhe ablllLy of Lhe paLlenL Lo undersLand healLh lnformaLlon
before provldlng paLlenL educaLlon
O aLlenL Leachlng ls culLurally senslLlve and lndlvlduallzed Lo meeL Lhe needs of Lhe
paLlenL
O 1he paLlenL ls an acLlve parLlclpanL ln a Leachlng plan agreelng Lo Lhe plan helplng Lo
choose lnsLrucLlonal meLhods and recommendlng Llmes for lnsLrucLlon
O A comblnaLlon of Leachlng meLhods lmproves Lhe learner's aLLenLlveness and
lnvolvemenL
O 1eachlng meLhodologles maLch Lhe paLlenL's learnlng need
O Learnlng ob[ecLlves descrlbe whaL a person ls Lo learn ln behavloral Lerms
O LvaluaLe a paLlenL's learnlng by observlng Lhe performance of expecLed learnlng
behavlors under deslred condlLlons

llnAL LxAM key o|nts from 1ext
4

II(a)
Chapter 3 Commun|ty8ased Nurs|ng ract|ce
O 1he prlnclples of publlc healLh nurslng pracLlce focus on helplng lndlvlduals acqulre a
healLhy envlronmenL ln whlch Lo llve
O LssenLlal publlc healLh funcLlons lnclude assessmenL pollcy developmenL and access Lo
resources
O When populaLlonbased healLh care servlces are effecLlve Lhere ls a greaLer llkellhood of
Lhe hlgher Llers of servlces conLrlbuLlng efflclenLly Lo healLh lmprovemenL of Lhe populaLlon
O 1he communlLy healLh nurse conslders Lhe lndlvldual or famlly Lo be only one member of a
group whlle provldlng care Lo Lhe communlLy as a whole
O A successful communlLy healLh nurslng pracLlce lnvolves bulldlng relaLlonshlps wlLh Lhe
communlLy and belng responslve Lo changes wlLhln Lhe communlLy
O 1he speclal needs of vulnerable populaLlons form Lhe backdrop for Lhe challenges nurses
face ln carlng for paLlenLs' lncreaslngly complex acuLe and chronlc healLh condlLlons
O Chronlc healLh problems are common and worsen among Lhe homeless because Lhey have
few resources
O LssenLlal compeLencles for a communlLybased nurse lnclude careglvlng case managemenL
and paLlenL educaLlon
O AssessmenL of a communlLy lncludes Lhree elemenLs sLrucLure or locale Lhe people and
Lhe soclal sysLems

II(b)
Chapter 2 1he nea|th Care De||very System
O lncreaslng cosLs and decreaslng relmbursemenL are drlvlng changes ln healLh care forclng
healLh care lnsLlLuLlons Lo dellver care more efflclenLly wlLhouL sacrlflclng quallLy ln a
managed care sysLem Lhe provlder of care recelves a predeLermlned caplLaLed paymenL
regardless of servlces used by a paLlenL
O Levels of healLh care descrlbe Lhe scope of servlces and seLLlngs ln whlch healLh care ls
offered Lo paLlenLs ln all sLages of healLh and lllness
O CccupaLlonal healLh nurslng lncludes reduclng exposure Lo envlronmenLal hazards healLh
educaLlon and helplng workers reLurn Lo work safely
O Successful communlLybased healLh programs lnvolve bulldlng relaLlonshlps wlLh Lhe
communlLy and lncorporaLlng culLural and envlronmenLal facLors
O PosplLallzed paLlenLs are more acuLely lll Lhan ln Lhe pasL requlrlng beLLer coordlnaLlon of
servlces before dlscharge
O 8ehablllLaLlon allows an lndlvldual Lo reLurn Lo a level of normal or nearnormal funcLlon
afLer a physlcal or menLal lllness ln[ury or chemlcal dependency
O nursemanaged cllnlcs offer prlmary care dellvered by advanced pracLlce nurses wlLh a
focus on helplng paLlenLs assume more responslblllLy for Lhelr healLh
O Pome care agencles provlde almosL every Lype of healLh care servlce wlLh an emphasls on
paLlenL and famlly lndependence
O ulscharge plannlng beglns aL admlsslon Lo a healLh care faclllLy and helps ln Lhe LranslLlon of
a paLlenL's care from one envlronmenL Lo anoLher
llnAL LxAM key o|nts from 1ext
3
O PealLh care organlzaLlons are evaluaLed on Lhe basls of ouLcomes such as prevenLlon of
compllcaLlons paLlenLs' funcLlonal ouLcomes and paLlenL saLlsfacLlon
O Consumers of healLh care should be guaranLeed LhaL servlces are provlded by compeLenL
healLh care professlonals
O nurses need Lo remaln knowledgeable and proacLlve abouL lssues ln Lhe healLh care
dellvery sysLem Lo provlde quallLy paLlenL care and poslLlvely affecL healLh

III(a)
Chapter 8 Nurs|ng rocess
O 1he nurslng process has flve sLeps assessmenL nurslng dlagnosls plannlng
lmplemenLaLlon and evaluaLlon
O use of Lhe nurslng process ls Lhe foundaLlon for cllnlcal declslon maklng
O When you flrsL meeL a paLlenL you wlll conducL an lnlLlal assessmenL screenlng and Lhen
focus on cues and paLLerns of lnformaLlon Lo make a more comprehenslve assessmenL
O ALLenLlon Lo Lhe envlronmenL paLlenL comforL and communlcaLlon Lechnlques ensures
a successful assessmenL lnLervlew
O uaLa analysls lnvolves recognlzlng paLLerns or Lrends comparlng daLa wlLh sLandards
and Lhen formlng a reasoned concluslon abouL Lhe daLa's meanlng
O uaLa clusLerlng organlzes assessmenL daLa lnLo meanlngful clusLers of deflnlng
characLerlsLlcs or seLs of slgns and sympLoms
O 1he dlagnosLlc process lncludes analysls and lnLerpreLaLlon of daLa ldenLlflcaLlon of
paLlenL and famlly needs and formulaLlon of nurslng dlagnoses and collaboraLlve
problems
O nurslng dlagnoses provlde Lhe basls for selecLlon of nurslng lnLervenLlons Lo achleve
ouLcomes for whlch a nurse ls accounLable
O nAnuA lnLernaLlonal deflnes flve Lypes of nurslng dlagnoses acLual healLh promoLlon
rlsk syndrome and wellness
O 1he absence of cerLaln deflnlng characLerlsLlcs followlng a paLlenL assessmenL suggesLs
LhaL you re[ecL a nurslng dlagnosls under conslderaLlon
O nurslng dlagnosLlc errors may lead Lo lnapproprlaLe and/or lnadequaLe nurslng care
O uurlng Lhe plannlng componenL you deLermlne paLlenL goals esLabllsh prlorlLles
develop expecLed ouLcomes of nurslng care and wrlLe a nurslng care plan
O 1he nurslng CuLcomes ClasslflcaLlon (nCC) has labels for descrlblng Lhe focus of nurslng
care and Lhen lncludes lndlcaLors for use ln measurlng success wlLh lnLervenLlons
O 1he nurse beglns a care plan by flrsL addresslng Lhe nurslng dlagnoses LhaL have Lhe
hlghesL prlorlLy
O 1he care plan ls a guldellne for paLlenL care so LhaL all members of Lhe healLh care Leam
can qulckly undersLand Lhe care glven
O A concepL map organlzes and llnks daLa abouL a paLlenL's mulLlple dlagnoses ln a loglcal
way
O 1here are Lhree Lypes of nurslng lnLervenLlons nurselnlLlaLed physlclanlnlLlaLed and
collaboraLlve
O 1he nurslng lnLervenLlons ClasslflcaLlon (nlC) ls a comprehenslve sLandardlzed
classlflcaLlon of Lhe lnLervenLlons LhaL nurses use ln Lhe care of paLlenLs
llnAL LxAM key o|nts from 1ext
6
O ulrecL care lnLervenLlons lnclude acLlvlLles of dally llvlng lnsLrumenLal acLlvlLles of dally
llvlng physlcal care counsellng Leachlng conLrolllng for adverse reacLlons llfesavlng
measures and prevenLlve measures
O LvaluaLlon deLermlnes a paLlenL's response Lo nurslng acLlons and wheLher goals have
been meL
O ?ou evaluaLe by comparlng Lhe paLlenL's response Lo nurslng acLlons wlLh expecLed
ouLcomes esLabllshed durlng plannlng
O When goals of care are noL meL you ldenLlfy facLors LhaL lnLerfere wlLh goal
achlevemenL reassess Lhe paLlenL's condlLlon revlse exlsLlng or develop new nurslng
dlagnoses and selecL approprlaLe lnLervenLlons

IV(a)
Chapter 21 Growth and Deve|opment
O CrowLh and developmenL are orderly predlcLable lnLerdependenL processes LhaL
conLlnue LhroughouL Lhe llfe span
O CrowLh ls mosL rapld durlng Lhe prenaLal and lnfancy sLages and conLlnues Lo slow unLll
Lhe second skeleLal growLh spurL announces LhaL puberLy ls approachlng
O eople progress Lhrough slmllar sLages of growLh and developmenL buL aL an lndlvldual
pace and wlLh lndlvldual behavlors
O 1heorles of growLh and developmenL such as Lhose of lreud Lrlkson and lageL
provlde nurses wlLh a framework for undersLandlng lndlvldual behavlors
O hyslologlcal cognlLlve and psychosoclal developmenL conLlnue across Lhe llfe span
?ou musL be famlllar wlLh normal expecLaLlons Lo deLermlne poLenLlal problems and
promoLe normal developmenL
O aLlenLs need speclflc lmmunlzaLlons LhroughouL llfe noL [usL ln chlldhood 1hese
lmmunlzaLlons help Lo proLecL lndlvlduals agalnsL lllness and lnfecLlons
O ?oung adulLs have few healLh problems buL need Lo develop poslLlve healLh hablLs Lo
avold many healLh problems ln mlddle and laLe adulLhood
O 1he healLh concerns of Lhe mlddle adulL commonly lnvolve hormonal changes sLress
relaLed lllnesses slLuaLlonal sLressors screenlng for healLh problems and adopLlon of
poslLlve healLh hablLs
O 1he healLh concerns of older adulLs are relaLed Lo chronlc lllnesses llfesLyle changes
funcLlonal ablllLy changes accldenLs and lnfecLlous dlseases such as Lhe flu

V(b)
Chapter 19 Cu|tura| D|vers|ty
O nurses need Lo provlde culLurally compeLenL and congruenL care
O Lven when Lhere ls access Lo healLh servlces raclal and eLhnlc dlfferences conLrlbuLe Lo
healLh care dlsparlLles
O PealLh care provlders ofLen mlslnLerpreL Lhe lmpacL of culLure on healLh
O When provlders dlsregard a paLlenL's valued way of llfe Lhe paLlenL experlences culLural
paln
O CollecLlvlsLlc culLures rely on famlly Lo care for slck members
llnAL LxAM key o|nts from 1ext
7
O ALLrlbuLes or characLerlsLlcs of culLural compeLence are Lhe ablllLy Lo glve care Lo dlverse
populaLlons openness Lo culLural dlfferences and flexlblllLy or adapLablllLy Lo dlfferenL
slLuaLlons
O 1he goal of culLural assessmenL ls Lo gaLher slgnlflcanL lnformaLlon from paLlenLs LhaL
wlll help Lhe nurse lmplemenL culLurally congruenL care
O PosplLals are requlred Lo provlde a Lralned lnLerpreLer Lo communlcaLe lnformaLlon
abouL medlcal condlLlons Lo paLlenLs
O Llfe LranslLlons are generally marked by rlLuals LhaL symbollze culLural values and
meanlngs aLLached Lo Lhese LranslLlons
O SLrong culLural LradlLlons Lyplcally surround Lhe process of dylng and deaLh

Chapter 20 Sp|r|tua| nea|th
O ALLendlng Lo a paLlenL's splrlLuallLy ensures a hollsLlc focus Lo nurslng pracLlce
O lrequenLly Lhe concepLs of splrlLuallLy and rellglon are lnLerchanged buL splrlLuallLy ls a
much broader and more unlfylng concepL Lhan rellglon
O An lndlvldual's bellefs and splrlLual wellbelng lnfluence physlcal healLh sLaLus
O lalLh and hope are closely llnked Lo a person's splrlLual wellbelng provldlng an lnner
sLrengLh for deallng wlLh lllness and dlsablllLy
O 8esearch suggesLs Lhere ls a llnk beLween a paLlenL's splrlLuallLy and poLenLlal for
heallng
O AcuLe and chronlc lllness Lermlnal lllness and neardeaLh experlences pose splrlLual
problems for lndlvlduals
O 1he provlslon of approprlaLe splrlLual care requlres you Lo crlLlcally apply knowledge
from prlnclples relaLed Lo carlng culLural care loss and grlef and LherapeuLlc
communlcaLlon
O Avold blases when assesslng and plannlng splrlLual care
O Learnlng Lo pracLlce carlng and compasslon helps you Lo dlscover a paLlenL's llfe values
and meanlng
O ConnecLedness and fellowshlp wlLh oLher persons are a source of hope for a paLlenL
O aLlenLs ofLen have splrlLual sLrengLhs LhaL you wlll use as resources Lo help Lhem
assume healLhler llves
O lnLerrupLlons or changes Lo cusLomary rellglous pracLlces affecL Lhe supporL LhaL rellglon
conLrlbuLes Lo a person's wellbelng
O Common rellglous rlLuals lnclude prlvaLe worshlp prayer slnglng use of a rosary and
scrlpLure readlng
O 1he personal naLure of splrlLuallLy requlres open communlcaLlon and Lhe esLabllshmenL
of LrusL beLween you and Lhe paLlenL
O LsLabllshlng presence lnvolves glvlng aLLenLlon answerlng quesLlons havlng an
encouraglng aLLlLude and conveylng a sense of LrusL
O arL of a paLlenL's careglvlng envlronmenL ls Lhe regular presence of famlly frlends and
splrlLual advlsors



llnAL LxAM key o|nts from 1ext
8
V(d)
Chapter 24 Stress and Cop|ng
O 1he general adapLaLlon syndrome (CAS) an lmmedlaLe physlologlcal response Lo sLress
lnvolves several body sysLems especlally Lhe auLonomlc nervous sysLem and Lhe
endocrlne sysLem
O hyslologlcal responses Lo sLress also lnclude lmmunologlcal changes
O SLress makes people lll as a resulL of boLh lncreased levels of powerful hormones LhaL
change bodlly processes and coplng cholces LhaL are unhealLhy such as noL geLLlng
enough resL or a proper dleL or use of Lobacco alcohol or caffelne
O A person experlences psychologlcal sLress only lf Lhe person evaluaLes Lhe evenL or
clrcumsLance as personally slgnlflcanL Lhls ls called prlmary appralsal
O SLress lncludes work sLress famlly sLress chronlc sLress acuLe sLress dally hassles
Lrauma and crlsls
O oLenLlal sLressors and coplng mechanlsms vary across Lhe llfe span from chlldhood
Lhrough adolescence adulLhood and old age and from one culLure Lo anoLher
O Coplng a process LhaL consLanLly changes Lo manage demands on a person's resources
means maklng an efforL Lo manage psychologlcal sLress
O osLLraumaLlc sLress dlsorder affecLs people who have experlenced accldenLs vlolenL
evenLs war and naLural dlsasLers
O A paLlenL who has such severe sLress LhaL he or she ls unable Lo cope ln ways LhaL
worked before ls experlenclng a crlsls

V(e)
Chapter 2S Loss and Gr|ef
O 1he Lype of loss and Lhe meanlng of Lhe loss lnfluence how a person experlences and
expresses grlef
O 1heorlsLs descrlbe grlef as a serles of sLages phases processes or Lasks experlenced by
people as Lhey adapL Lo loss and move on wlLh llfe
O lndlvlduals move back and forLh Lhrough Lhe LheoreLlcal sLages phases or Lasks of
grlevlng or experlence Lhem slmulLaneously over a perlod of Llme ofLen several years
O knowlng speclflc Lypes of grlef helps develop an effecLlve plan of care
O A person's age developmenLal sLage bellefs roles culLure relaLlonshlps and
socloeconomlc sLaLus lnfluence reacLlons Lo loss and expresslons of grlef
O When assesslng paLlenLs experlenclng grlef or loss do noL make assumpLlons abouL how
you Lhlnk Lhey behave or feel Ask paLlenLs Lo share Lhelr experlence ln Lhelr own words
and Lell Lhelr sLorles
O 1herapeuLlc communlcaLlon fosLers Lhe developmenL of LrusL and provldes an
opporLunlLy for paLlenLs and famlly members Lalk abouL Lhelr concerns
O nurslng care of a grlevlng or dylng paLlenL focuses on enhanclng Lhe paLlenL's sense of
ldenLlLy dlgnlLy and selfesLeem and malnLalnlng Lhe hlghesL posslble quallLy of llfe
O aLlenLs of any age or dlagnosls beneflL from palllaLlve care aL any Llme ln Lhe course of
Lhelr lllness
O alllaLlve and hosplce care prlnclples lnclude lnvolvlng paLlenLs and famlly members ln
deLermlnlng Lhe plan of care helplng paLlenLs make lnformed cholces provldlng rellef
llnAL LxAM key o|nts from 1ext
9
for physlcal emoLlonal or splrlLual sympLoms and offerlng supporL from an
lnLerdlsclpllnary Leam
O rovlde educaLlon and opporLunlLles for famlly members who wanL Lo be lnvolved ln
endofllfe care
O Care of a body afLer deaLh and care for survlvlng famlly members are provlded wlLh
respecL and senslLlvlLy for Lhelr preferences culLure and/or rellglon and based on
evldencebased proLocols and sLandards
O 8ase your ongolng evaluaLlon of nurslng care on ldenLlflable behavlors and
communlcaLlon
O nurses beneflL from acknowledglng and aLLendlng Lo Lhelr own grlef when carlng for
dylng paLlenLs and Lhelr famlly members

V(f)
Chapter 22 Se|fConcept and Sexua||ty
O SelfconcepL ls an lnLegraLed seL of consclous and unconsclous aLLlLudes and percepLlons
abouL Lhe self
O ComponenLs of selfconcepL are ldenLlLy body lmage and role performance Self
esLeem and sexuallLy are closely relaLed Lerms
O Lach developmenLal sLage lnvolves facLors LhaL are lmporLanL Lo Lhe developmenL of a
healLhy poslLlve selfconcepL
O ldenLlLy ls parLlcularly vulnerable durlng adolescence
O 8ody lmage ls Lhe menLal plcLure of one's body and ls noL necessarlly conslsLenL wlLh a
person's acLual body sLrucLure or appearance
O 8ody lmage sLressors lnclude changes ln physlcal appearance sLrucLure or funcLlonlng
caused by normal developmenLal changes or lllness
O SelfesLeem ls Lhe emoLlonal appralsal of selfconcepL and reflecLs Lhe overall sense of
belng capable worLhwhlle and compeLenL
O SelfesLeem sLressors lnclude developmenLal and relaLlonshlp changes lllness
(parLlcularly chronlc lllness lnvolvlng changes ln whaL were normal acLlvlLles) surgery
accldenLs and Lhe responses of oLher lndlvlduals Lo changes resulLlng from Lhese
evenLs
O 1he nurse's selfconcepL and nurslng acLlons ofLen have an effecL on a paLlenL's self
concepL
O lannlng and lmplemenLlng nurslng lnLervenLlons for selfconcepL dlsLurbance lnvolve
expandlng Lhe paLlenL's selfawareness encouraglng selfexploraLlon aldlng ln self
evaluaLlon helplng formulaLe goals ln regard Lo adapLaLlon and asslsLlng Lhe paLlenL ln
achlevlng Lhose goals
O SexuallLy ls relaLed Lo all dlmenslons of healLh 1herefore address sexual concerns or
problems as parL of nurslng care
O Sexual healLh lnvolves physlcal and psychosoclal aspecLs and conLrlbuLes Lo an
lndlvldual's sense of selfworLh and poslLlve lnLerpersonal relaLlonshlps
O uevelopmenL and llfe changes eLhlcal declslonal lssues ferLlllLy personal and emoLlonal
confllcLs lllness and hosplLallzaLlon all affecL a paLlenL's sexuallLy

llnAL LxAM key o|nts from 1ext
10
V(a) 3
Chapter 32 Nutr|t|on
O LaLlng a balanced dleL of carbohydraLes proLeln llplds vlLamlns mlcromlnerals and
macromlnerals provldes Lhe essenLlal nuLrlenLs Lo carry ouL Lhe body's normal physlologlcal
funcLlonlng
O ?ou malnLaln body welghL when energy lnLake as food or flulds equals energy
requlremenLs
O ulgesLlon ls Lhe mechanlcal and chemlcal process by whlch food ls broken down lnLo lLs
slmplesL form for absorpLlon
O ulgesLlon and absorpLlon occur malnly ln Lhe small lnLesLlne
O uleLary reference lnLakes (u8ls) basls for dleL selecLlon were formulaLed for populaLlon
groups noL lndlvlduals
O Culdellnes for dleLary change advocaLe reduced lnLake of faL saLuraLed faL salL reflned
sugar and cholesLerol and lncreased lnLake of complex carbohydraLes and flber
O Age affecLs Lhe requlremenLs for essenLlal nuLrlenLs erlods of rapld growLh lncrease Lhe
need for proLeln vlLamlns and mlnerals
O 8ecause lmproper nuLrlLlon affecLs all body sysLems nuLrlLlonal assessmenL lncludes a
revlew of Lhe LoLal physlcal assessmenL
O Speclal hosplLal dleLs alLer Lhe composlLlon LexLure dlgesLlblllLy and resldue of foods Lo
sulL Lhe paLlenL's parLlcular needs
O LnLeral nuLrlLlon ls for paLlenLs who are unable Lo lngesL food buL are able Lo dlgesL and
absorb foods
O LnLeral nuLrlLlon proLecLs lnLesLlnal sLrucLure and funcLlon and enhances lmmunlLy
O 1oLal parenLeral nuLrlLlon supplles essenLlal nuLrlenLs ln approprlaLe amounLs Lhrough a
concenLraLed nuLrlenL soluLlon admlnlsLered lnLo Lhe superlor vena cava
O Medlcal nuLrlLlon Lherapy ls a recognlzed LreaLmenL modallLy for boLh acuLe and chronlc
dlsease sLaLes

V(b) V(c)
Chapter 17 I|u|d L|ectro|yte and Ac|d8ase 8a|ances
O 8ody flulds conslsLlng of elecLrolyLes cellular componenLs proLelns and waLer are
dlsLrlbuLed ln LCl and lCl comparLmenLs
O volume dlsLurbances lnclude boLh lsoLonlc and osmolar deflclLs or excesses
O uleLary lnLake medlcaLlons hormonal conLrols envlronmenLal facLors and dlsease
sLaLes regulaLe elecLrolyLe levels
O Chronlc and serlous lllnesses or ln[urles lncrease Lhe rlsk for fluld elecLrolyLe and acld
base lmbalances
O aLlenLs who are very young or very old are aL greaLesL rlsk for fluld elecLrolyLe and
acldbase lmbalances
O 1reaLmenL for elecLrolyLe dlsLurbances lncludes dleLary and pharmacologlcal
lnLervenLlons
O Acldbase sLaLus ls deLermlned by Lhe concenLraLlon of hydrogen lons ln Lhe blood
O 1he body's chemlcal bufferlng sysLems are Lhe flrsL Lo respond Lo acldbase lmbalances
llnAL LxAM key o|nts from 1ext
11
O LnLeral or parenLeral fluld admlnlsLraLlon correcLs osmolar lmbalances and fluld volume
deflclL
O Common compllcaLlons of lv Lherapy lnclude lnfllLraLlon phleblLls lnfecLlon fluld
volume excess and bleedlng aL Lhe lnserLlon slLe
O 8lood Lransfuslons are glven Lo replace fluld volume losL from hemorrhage Lo LreaL
anemla or Lo replace coagulaLlon facLors
O 1ransfused blood can be obLalned from volunLeer donors auLologous donaLlon or
Lhrough perloperaLlve salvage
O AdmlnlsLraLlon of blood producLs enLalls a speclflc procedure for ldenLlflcaLlon of Lhe
paLlenL and Lhe blood producL
O ln addlLlon Lo Lransfuslon reacLlons Lhe rlsks of Lransfuslon lnclude hyperkalemla
hypocalcemla hypoLhermla fluld volume excess coagulopaLhles and lnfecLlon
O 1he goals of Lherapy for acldbase lmbalances are Lo LreaL Lhe underlylng dlsorders and
Lo resLore Lhe arLerlal pP Lo normal

V(d)
Chapter 30 S|eep
O 8esearchers Lhlnk LhaL sleep provldes physlologlcal and psychologlcal resLoraLlon
O 1he 24hour sleepwake cycle ls a clrcadlan rhyLhm LhaL affecLs physlologlcal funcLlon
and behavlor
O 1he conLrol and regulaLlon of sleep depends on a balance beLween CnS regulaLors
O uurlng a Lyplcal nlghL's sleep a person flucLuaLes beLween n8LM sLages 2 3 and 4
before enLerlng 8LM sleep 1he amounL of Llme ln each sLage varles
O 1he number of hours of sleep needed by each person Lo feel resLed varles
O LongLerm use of sleeplng pllls leads Lo dlfflculLy ln lnlLlaLlng and malnLalnlng sleep
O 1he hecLlc pace of a person's llfesLyle emoLlonal and psychologlcal sLress and drug and
alcohol lngesLlon dlsrupL Lhe sleep paLLern
O An envlronmenL wlLh a darkened room reduced nolse comforLable bed approprlaLe
LemperaLure and good venLllaLlon promoLes sleep
O 1he mosL common Lype of sleep dlsorder ls lnsomnla
O CharacLerlsLlcs of lnsomnla lnclude Lhe lnablllLy Lo fall asleep Lo remaln asleep durlng
Lhe nlghL or Lo go back Lo sleep afLer awakenlng earller Lhan deslred
O use your paLlenL's selfreporL Lo deLermlne lf sleep ls resLful
O When uslng envlronmenLal conLrols Lo promoLe sleep conslder Lhe usual characLerlsLlcs
of Lhe paLlenL's home envlronmenL and normal llfesLyle
O nolse can dlsrupL sleep and enhance paln percepLlon
O A bedLlme rouLlne of relaxlng acLlvlLles prepares a person physlcally and menLally for
sleep
O aln or oLher sympLom conLrol ls essenLlal Lo promoLlng Lhe ablllLy Lo sleep
O Cne of Lhe mosL lmporLanL nurslng lnLervenLlons for promoLlng sleep ls esLabllshlng
perlods for unlnLerrupLed sleep



llnAL LxAM key o|nts from 1ext
12
V(e)
Chapter 31 a|n Management
O AcuLe paln a proLecLlve mechanlsm LhaL warns a person of Llssue ln[ury ls compleLely
sub[ecLlve
O MlsconcepLlons abouL paln lead Lo underLreaLmenL of Lhe paLlenL's paln
O A paLlenL's age gender anxleLy culLure prevlous experlence and meanlng of paln
lnfluence Lhe paln experlence
O A paLlenL's paln Lolerance lnfluences your percepLlons of Lhe serlousness of Lhe
dlscomforL
O 1he dlfference beLween acuLe and chronlc paln lnvolves Lhe duraLlon of dlscomforL
physlcal slgns and sympLoms and Lhe paLlenL's percepLlons regardlng rellef
O aln scales aLLempL Lo communlcaLe Lhe severlLy of paln and Lhe effecLlveness of paln
Lheraples
O 1he paLlenL's famlly and frlends are a key resource ln paln assessmenL
O ?ou lndlvlduallze paln Lherapy by collaboraLlng closely wlLh Lhe paLlenL uslng
assessmenL flndlngs Lrylng a varleLy of Lheraples and malnLalnlng Lhe paLlenL's well
belng
O LllmlnaLlng sources of palnful sLlmull ls a baslc nurslng measure for promoLlng comforL
O nonpharmacologlcal Lheraples are effecLlve ln alLerlng paLlenL percepLlon of paln
promoLlng muscle relaxaLlon and glvlng Lhe paLlenL conLrol over paln experlenced
O uslng a regular schedule for analgeslc admlnlsLraLlon ls more effecLlve Lhan an as
needed schedule
O A CA devlce glves paLlenLs paln conLrol wlLh a low rlsk for overdose
O ?our prlmary role ln carlng for a paLlenL who recelves local anesLhesla ls proLecLlng Lhe
paLlenL from ln[ury
O 1he alm of Lherapy for paLlenLs wlLh chronlc paln ls Lo anLlclpaLe and prevenL paln
raLher Lhan Lo LreaL lL
O A serlous buL rare slde effecL of morphlne lnfuslons ls resplraLory depresslon whlch you
reverse wlLh lnLravenous naloxone (narcan)
O LvaluaLlon of paln Lherapy requlres conslderaLlon of Lhe changlng characLer of paln
response Lo Lherapy ablllLy Lo funcLlon and Lhe paLlenL's percepLlons of a Lherapy's
effecLlveness

VI
Chapter 36 Sk|n Integr|ty and Wound Care
O Wounds wlLh parLlalLhlckness Llssue loss heal by epldermal repalr and fullLhlckness
wounds heal by formlng scar Llssue
O A clean surglcal lnclslon wlLh llLLle Llssue loss heals by prlmary lnLenLlon
O When Lhere ls exLenslve Llssue loss a wound heals by secondary lnLenLlon
O Peallng of fullLhlckness wounds proceeds Lhrough four overlapplng phases hemosLasls
lnflammaLlon prollferaLlon and remodellng
O 1he chances of wound lnfecLlon are greaLer when Lhe wound conLalns dead or necroLlc
Llssue when forelgn bodles lle on or near Lhe wound and when blood supply and Llssue
defenses are reduced
llnAL LxAM key o|nts from 1ext
13
O hyslcal sLress from vomlLlng coughlng or sudden muscular conLracLlon causes
separaLlon of wound edges dehlscence
O Wound assessmenL lncludes anaLomlcal locaLlon slze (dlmenslons and depLh of wound)
Lype and percenLage of wound Llssue volume and color of wound dralnage and
condlLlon of surroundlng skln
O Wound dralns remove secreLlons wlLhln Llssue layers Lo promoLe wound closure
O never collecL a wound culLure from old dralnage
O rlnclples of wound managemenL lnclude conLrolllng or ellmlnaLlng Lhe cause provldlng
sysLemlc supporL Lo reduce exlsLlng and poLenLlal cofacLors and malnLalnlng a
physlologlcal local wound envlronmenL
O A molsL envlronmenL supporLs wound heallng
O When cleanlng wounds or draln slLes clean from Lhe leasL Lo mosL conLamlnaLed area
O Apply a dresslng or blnder ln a manner LhaL does noL lmpalr clrculaLlon or lrrlLaLe Lhe
skln
O 1he safe use of heaL or cold Lherapy requlres an assessmenL of Lhe paLlenL's sensory
funcLlon ldenLlflcaLlon of rlsk facLors and undersLandlng of Lhe physlologlcal effecLs of
heaL and cold
O An acuLe spraln fracLure or brulse responds besL Lo cold appllcaLlons
O Warm appllcaLlons are effecLlve for lmprovlng clrculaLlon Lo wound slLes and promoLlng
muscle relaxaLlon

VIII(A)
Chapter 3S Immob|||ty
O normal physlcal moblllLy depends on lnLacL and funcLlonlng nervous and
musculoskeleLal sysLems
O 1he rlsk for dlsablllLles relaLed Lo lmmoblllzaLlon depends on Lhe exLenL and duraLlon of
Lhe lmmoblllzaLlon
O lmmoblllLy resulLs from lllness or Lrauma or ls prescrlbed for LherapeuLlc reasons lL
presenLs hazards ln Lhe physlcal psychologlcal and developmenLal dlmenslons
O ressure ulcers alLhough ofLen prevenLable are one of Lhe mosL common physlcal
hazards of lmmoblllLy
O LffecLs of lmmoblllLy lnclude depresslon behavloral changes changes ln Lhe sleepwake
cycle decreased coplng ablllLles and developmenLal delays
O AssessmenL focuses on range of [olnL moLlon musculoskeleLal sLaLus and compleLe
physlcal examlnaLlon for poLenLlal adverse effecLs ln all body sysLems as well as
psychosoclal and developmenLal effecLs
O AdequaLe hydraLlon measures reduce lmmoblllLyrelaLed compllcaLlons ln Lhe
resplraLory and ellmlnaLlon sysLems
O LlasLlc anLlembollc sLocklngs and sequenLlal compresslon devlces boLh lmprove venous
reLurn and help prevenL Lhe poLenLlally llfeLhreaLenlng compllcaLlon of uv1
O 1he prlmary evaluaLlon crlLerlon for nurslng care ln Lhe developmenLal dlmenslon for
lmmoblllzed paLlenLs ls Lhe prevenLlon of any measurable decllne ln funcLlonlng or delay
ln developmenL
O Larly moblllzaLlon helps Lo decrease Lhe effecLs of bed resL
llnAL LxAM key o|nts from 1ext
14

VIII(8C)
Chapter 38 Surg|ca| at|ent
O revlous lllnesses and pasL surgerles affecL Lhe paLlenL's ablllLy Lo LoleraLe surgery
O Clder adulL paLlenLs are aL greaLer surglcal rlsk because of Lhe physlologlcal changes
assoclaLed wlLh aglng
O All medlcaLlons Laken before surgery are auLomaLlcally dlsconLlnued afLer surgery unless
a healLh care provlder reorders Lhe drugs
O lamlly members and slgnlflcanL oLhers are lmporLanL ln asslsLlng paLlenLs wlLh physlcal
llmlLaLlons and ln provldlng emoLlonal supporL posLoperaLlvely
O reoperaLlve assessmenL of vlLal slgns and physlcal flndlngs provldes a basellne wlLh
whlch Lo compare posLoperaLlve assessmenL daLa
O rlmary responslblllLy for lnformed consenL resLs wlLh Lhe surgeon
O SLrucLured preoperaLlve Leachlng poslLlvely lnfluences posLoperaLlve recovery
O ln ambulaLory surgery nurses use Lhe llmlLed Llme avallable Lo assess prepare and
educaLe paLlenLs for surgery
O nurses wlLhln Lhe operaLlng room focus on proLecLlng Lhe paLlenL from poLenLlal harm
O osLoperaLlve assessmenL cenLers on Lhe body sysLems mosL llkely Lo be affecLed by
surgery
O 8ecause a surglcal paLlenL's condlLlon may change rapldly durlng recovery monlLor Lhe
paLlenL's sLaLus aL leasL every 13 mlnuLes unLll sLable
O osLoperaLlve nurslng lnLervenLlons focus on prevenLlon of compllcaLlons
O 1he rlsk for posLoperaLlve compllcaLlons lncreases when Lhe paLlenL does noL become
acLlvely lnvolved ln recovery
O lrom Lhe Llme of admlsslon Lhe nurse plans for Lhe surglcal paLlenL's dlscharge

2
Chapter 36 Sk|n Integr|ty and Wound Care
O Wounds wlLh parLlalLhlckness Llssue loss heal by epldermal repalr and fullLhlckness
wounds heal by formlng scar Llssue
O A clean surglcal lnclslon wlLh llLLle Llssue loss heals by prlmary lnLenLlon
O When Lhere ls exLenslve Llssue loss a wound heals by secondary lnLenLlon
O Peallng of fullLhlckness wounds proceeds Lhrough four overlapplng phases hemosLasls
lnflammaLlon prollferaLlon and remodellng
O 1he chances of wound lnfecLlon are greaLer when Lhe wound conLalns dead or necroLlc
Llssue when forelgn bodles lle on or near Lhe wound and when blood supply and Llssue
defenses are reduced
O hyslcal sLress from vomlLlng coughlng or sudden muscular conLracLlon causes
separaLlon of wound edges dehlscence
O Wound assessmenL lncludes anaLomlcal locaLlon slze (dlmenslons and depLh of wound)
Lype and percenLage of wound Llssue volume and color of wound dralnage and
condlLlon of surroundlng skln
O Wound dralns remove secreLlons wlLhln Llssue layers Lo promoLe wound closure
O never collecL a wound culLure from old dralnage
llnAL LxAM key o|nts from 1ext
13
O rlnclples of wound managemenL lnclude conLrolllng or ellmlnaLlng Lhe cause provldlng
sysLemlc supporL Lo reduce exlsLlng and poLenLlal cofacLors and malnLalnlng a
physlologlcal local wound envlronmenL
O A molsL envlronmenL supporLs wound heallng
O When cleanlng wounds or draln slLes clean from Lhe leasL Lo mosL conLamlnaLed area
O Apply a dresslng or blnder ln a manner LhaL does noL lmpalr clrculaLlon or lrrlLaLe Lhe
skln
O 1he safe use of heaL or cold Lherapy requlres an assessmenL of Lhe paLlenL's sensory
funcLlon ldenLlflcaLlon of rlsk facLors and undersLandlng of Lhe physlologlcal effecLs of
heaL and cold
O An acuLe spraln fracLure or brulse responds besL Lo cold appllcaLlons
O Warm appllcaLlons are effecLlve for lmprovlng clrculaLlon Lo wound slLes and promoLlng
muscle relaxaLlon

6
Chapter 16 Adm|n|ster|ng Med|cat|ons
O Learnlng medlcaLlon classlflcaLlons helps you beLLer undersLand nurslng lmpllcaLlons for
admlnlsLerlng medlcaLlons wlLh slmllar characLerlsLlcs
O Pandle all conLrolled subsLances accordlng Lo sLrlcL procedures LhaL accounL for each
medlcaLlon
O Apply undersLandlng of Lhe physlology of medlcaLlon acLlon when Llmlng admlnlsLraLlon
selecLlng rouLes lnlLlaLlng lnLervenLlons Lo promoLe Lhe poLency of Lhe medlcaLlon and
observlng responses Lo medlcaLlons
O 1he older adulL's body undergoes sLrucLural and funcLlonal changes LhaL alLer
medlcaLlon acLlons and lnfluence Lhe manner ln whlch nurses provlde medlcaLlon
Lherapy
O Always prepare and calculaLe medlcaLlon doses ln a locaLlon wlLhouL dlsLracLlons and
use Lhe calculaLlon meLhod LhaL works besL for you
O 1he body absorbs medlcaLlons glven parenLerally more qulckly Lhan medlcaLlons
admlnlsLered by oLher rouLes
O Lach medlcaLlon order lncludes Lhe paLlenL's name Lhe Llme and daLe Lhe order was
wrlLLen Lhe medlcaLlon name dosage rouLe and Llme and frequency of admlnlsLraLlon
and Lhe prescrlber's slgnaLure
O Always clarlfy medlcaLlon orders LhaL are noL clear Lo you (eg wrlLLen llleglbly conLaln
dangerous abbrevlaLlons)
O When you Lake a paLlenL's medlcaLlon hlsLory lnclude allergles medlcaLlonslncludlng
prescrlpLlon medlcaLlons overLhecounLer medlcaLlons vlLamlns and herbal
supplemenLsand Lhe paLlenL's adherence Lo Lherapy
O 1he slx rlghLs of medlcaLlon admlnlsLraLlon enhance safe medlcaLlon preparaLlon and
admlnlsLraLlon
O Cnly admlnlsLer medlcaLlons you prepare and never leave medlcaLlons unaLLended
O uocumenL medlcaLlons lmmedlaLely afLer admlnlsLraLlon
O use cllnlcal nurslng [udgmenL when deLermlnlng Lhe besL Llme Lo admlnlsLer prn
medlcaLlons
llnAL LxAM key o|nts from 1ext
16
O 8eporL any acLual and poLenLlal medlcaLlon errors lmmedlaLely
O When preparlng medlcaLlons check Lhe medlcaLlon conLalner label agalnsL Lhe MA8 or
compuLer prlnLouL Lhree Llmes before admlnlsLraLlon
O When admlnlsLerlng medlcaLlon Lo paLlenLs verlfy your paLlenLs' ldenLlLy by uslng aL
leasL Lwo paLlenL ldenLlflers
O Ask your paLlenLs Lo sLaLe Lhelr name lf posslble for a Lhlrd ldenLlfler
O 1he ZLrack meLhod for lM ln[ecLlons proLecLs subcuLaneous Llssues from lrrlLaLlng
parenLeral flulds
O lallure Lo selecL ln[ecLlon slLes by anaLomlcal landmarks leads Lo Llssue bone or nerve
damage

7
Chapter 1S nea|th Assessment and hys|ca| Lxam|nat|on
O 8asellne assessmenL flndlngs reflecL Lhe paLlenL's funcLlonal ablllLles and serve as Lhe
basls for comparlson wlLh subsequenL assessmenL flndlngs
O hyslcal assessmenL of a chlld or lnfanL requlres Lhe appllcaLlon of Lhe prlnclples of
growLh and developmenL
O 8ecognlze LhaL Lhe normal process of aglng affecLs physlcal flndlngs collecLed from an
older adulL
O lnLegraLe paLlenL Leachlng LhroughouL Lhe examlnaLlon Lo help paLlenLs learn abouL
healLh promoLlon and dlsease prevenLlon
O lnspecLlon requlres good llghLlng full exposure of Lhe body parL and a careful
comparlson of Lhe parL wlLh lLs counLerparL on Lhe opposlLe slde of Lhe body
O alpaLlon lnvolves Lhe use of parLs of Lhe hand Lo deLecL dlfferenL Lypes of physlcal
characLerlsLlcs
O use ausculLaLlon Lo assess Lhe characLer of sounds creaLed ln varlous body organs
O erform a physlcal examlnaLlon only afLer proper preparaLlon of Lhe envlronmenL and
equlpmenL and afLer preparlng Lhe paLlenL physlcally and psychologlcally
O 1hroughouL Lhe examlnaLlon keep Lhe paLlenL warm comforLable and lnformed of each
sLep of Lhe assessmenL process
O A compeLenL examlner learns Lo be sysLemaLlc whlle comblnlng assessmenLs of dlfferenL
body sysLems slmulLaneously lnformaLlon from Lhe hlsLory helps Lo focus on body
sysLems llkely Lo be affecLed
O CreaLlng a menLal lmage of lnLernal organs ln relaLlon Lo exLernal anaLomlcal landmarks
enhances accuracy ln assesslng Lhe Lhorax hearL and abdomen
O When assesslng hearL sounds lmaglne evenLs occurrlng durlng Lhe cardlac cycle
O never palpaLe Lhe caroLld arLerles slmulLaneously
O When examlnlng a woman's breasLs explaln Lhe Lechnlques for breasL selfexamlnaLlon
O 1he abdomlnal assessmenL dlffers from oLher porLlons of Lhe examlnaLlon ln LhaL
ausculLaLlon follows lnspecLlon
O uurlng assessmenL of Lhe genlLalla explaln Lhe Lechnlque for genlLal selfexamlnaLlon
O ConducL an assessmenL of musculoskeleLal funcLlon when observlng Lhe paLlenL
ambulaLe or parLlclpaLe ln oLher acLlve movemenLs
llnAL LxAM key o|nts from 1ext
17
O Assess menLal and emoLlonal sLaLus by lnLeracLlng wlLh Lhe paLlenL LhroughouL Lhe
examlnaLlon
O AL Lhe end of Lhe examlnaLlon provlde for Lhe paLlenL's comforL and Lhen documenL a
deLalled summary of physlcal assessmenL flndlngs

8
Chapter 21 Growth and Deve|opment
O CrowLh and developmenL are orderly predlcLable lnLerdependenL processes LhaL
conLlnue LhroughouL Lhe llfe span
O CrowLh ls mosL rapld durlng Lhe prenaLal and lnfancy sLages and conLlnues Lo slow unLll
Lhe second skeleLal growLh spurL announces LhaL puberLy ls approachlng
O eople progress Lhrough slmllar sLages of growLh and developmenL buL aL an lndlvldual
pace and wlLh lndlvldual behavlors
O 1heorles of growLh and developmenL such as Lhose of lreud Lrlkson and lageL
provlde nurses wlLh a framework for undersLandlng lndlvldual behavlors
O hyslologlcal cognlLlve and psychosoclal developmenL conLlnue across Lhe llfe span
?ou musL be famlllar wlLh normal expecLaLlons Lo deLermlne poLenLlal problems and
promoLe normal developmenL
O aLlenLs need speclflc lmmunlzaLlons LhroughouL llfe noL [usL ln chlldhood 1hese
lmmunlzaLlons help Lo proLecL lndlvlduals agalnsL lllness and lnfecLlons
O ?oung adulLs have few healLh problems buL need Lo develop poslLlve healLh hablLs Lo
avold many healLh problems ln mlddle and laLe adulLhood
O 1he healLh concerns of Lhe mlddle adulL commonly lnvolve hormonal changes sLress
relaLed lllnesses slLuaLlonal sLressors screenlng for healLh problems and adopLlon of
poslLlve healLh hablLs
O 1he healLh concerns of older adulLs are relaLed Lo chronlc lllnesses llfesLyle changes
funcLlonal ablllLy changes accldenLs and lnfecLlous dlseases such as Lhe flu

9
Chapter 33 Ur|nary L||m|nat|on
O volunLary conLrol from hlgher braln cenLers and lnvolunLary conLrol from Lhe splnal cord
lnfluence voldlng
O SympLoms common Lo urlnary dlsLurbances lnclude urgency dysurla frequency
polyurla ollgurla and dlfflculLy ln sLarLlng Lhe urlnary sLream
O When collecLed properly a cleanvolded urlne speclmen does noL conLaln bacLerla from
Lhe ureLhral meaLus
O A paLlenL wlll beLLer undersLand Lhe lmporLance of perlneal hyglene by knowlng LhaL Lhe
urlnary LracL ls normally sLerlle
O An lncreased fluld lnLake resulLs ln urlne formaLlon LhaL flushes parLlcles and soluLes
from Lhe urlnary sysLem
O lnconLlnence ls classlfled as LoLal urge sLress reflex or funcLlonal Lach Lype of
lnconLlnence has speclflc nurslng lnLervenLlons
O An lndwelllng urlnary caLheLer remalns ln Lhe bladder for an exLended perlod maklng
Lhe rlsk for lnfecLlon greaLer Lhan wlLh lnLermlLLenL caLheLerlzaLlon
llnAL LxAM key o|nts from 1ext
18
O SLrlcL asepsls ls necessary when carlng for a paLlenL wlLh a closed bladder dralnage
sysLem
O 8ecause urlne dralns almosL conLlnuously from a ureLerosLomy Lhere ls rlsk for skln
breakdown around a sLoma slLe
O A prlmary funcLlon of Lhe ellmlnaLlon process ls fluld balance

10
Chapter 18 Car|ng |n Nurs|ng ract|ce
O Carlng ls Lhe essence of cllnlcal nurslng pracLlce
O Puman carlng ls unlversal Lhe expresslons processes and paLLerns of carlng vary
among culLures
O When Lhe nurses wlLhln an organlzaLlon successfully demonsLraLe carlng more paLlenLs
are saLlsfled and more llkely Lo reLurn Lo Lhe healLh care seLLlng
O WaLson's 10 caraLlve facLors offer Lools for provldlng carlng and humane nurslng
Lheraples
O An undersLandlng of Lhe behavlors LhaL paLlenLs assoclaLe wlLh carlng offers you an
excellenL sLarLlng polnL Lo esLabllsh a carlng pracLlce
O When a nurse esLabllshes presence eye conLacL body language volce Lone llsLenlng
and havlng a poslLlve aLLlLude acL LogeLher Lo creaLe an openness and undersLandlng
O 8ecause Louch conveys many messages use lL wlLh dlscreLlon
O LlsLenlng lncludes Laklng ln" whaL a paLlenL says as well as an lnLerpreLaLlon and
undersLandlng of whaL Lhe paLlenL ls saylng and glvlng back LhaL undersLandlng Lo Lhe
person Lalklng
O 1hrough carlng you develop an undersLandlng LhaL helps you Lo beLLer know Lhe paLlenL
as a unlque lndlvldual and choose Lhe mosL approprlaLe and efflcaclous nurslng
Lheraples
O MosL paLlenLs and famllles seek splrlLual care from nurses noL as a consclous or planned
process buL slmply as a way of belng human
O Showlng Lhe famlly care and concern for Lhe paLlenL creaLes an openness LhaL Lhen
enables you Lo form a relaLlonshlp wlLh Lhe famlly