| Terms |
Definitions |
|
mEq
|
milliequivalent
|
|
sc
|
subcutaneous
|
|
poop
|
downward pressure
|
|
temp-100.4
|
check infant
|
|
HO
|
history of
|
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OD
|
right eye
|
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Behaviors
|
observable actions.
|
|
car accident 2
|
pneumonia
|
|
vasovagal
|
slow blood pressure
|
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qod
|
every other day
|
|
Alert oriented patient
|
suspect UTI
|
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hypotension
|
abnormally low blood pressure
|
|
tid
|
three times a day
|
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8 oz
|
= 1 Cup
|
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1 mL
|
= 16 drops
|
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1 gr
|
= 60 mg
|
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1 mg
|
= 1000 mcg
|
|
trough
|
30 min before next dose
|
|
provide psychological support, pain control, comfort measures for clients who are terminally ill and support for their families. This may be offered in the hospital, hospice center, or the home with home care agencies. Some organizations offer respite car
|
Hospices
|
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asepsis
|
the absence of pathogenic micro-organisms
|
|
6 oz
|
= 1 coffee cup
|
|
Vasoconstriction
|
the narrowing of a blood vessel
|
|
saline lock
|
keep from clotting and patency
|
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level of preventative care where:activities are directed at decreasing the probablilityof a specific illness or dysfunction (ie; prenatal education,nutrition classes, immunizations)
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Primary prevention
|
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-helps clients learn about their health and the health care procedures they need to restore or maintain their health-assesses the client's learning needs and readiness to learn , sets specific learning goals, in conjunction w/ the client, enacts teachin
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teacher
|
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tachypnea
|
abnormal rapidity of respiration can result from anxiety or response to pain or fever, respiratory failure, shortness of breath or a respiratory infection
|
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inductive reasoning
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proceeds from data to theory
|
|
how many people died?
|
about 13 million.
|
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Independent practice nurses: (community nursing center)
|
faculty, nurse entrepeneurs
|
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Institutional policies
|
guidelines developed by healthcare institutions to direct professional practive
|
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full disclosure
|
deception, either by withholding information about a clients participation in a study or by giving the client false or misleading information about what participating in the study will involve, must NOT occur
|
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CPR
|
call a code, cpr for nursing student
|
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increasing, can and can't do, control nursing licensing, issues such as abortion
|
legislation
|
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host
|
the organism in which a parasite lives, thus deriving its body substance or energy
|
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Dyspnea
|
a clinical sign of hypoxia and manifests as breathlessness or uncomfortable breathing
|
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validity
|
concerns its ability to gather the data that it is intended to gather
|
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4th wave
|
poorest people. burned and stole europe on way. burned literature. carried disease. rise of plagues. black death came.
|
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Competent
|
competence is reflected by the nurse who has been on the same job for 2 or 3 years and who consciously and deliberately plans nursing care in terms of long-range goals
|
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Attitude
|
one's disposition toward an object or a situation; it can be a mental or emotional mindset, and it can be positive or negative.
|
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Ethics
|
a branch of philosophy dealing with standards of conduct and moral judgement
|
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confidentiality
|
any information a subject relates will not be made public to other without the subject's consent
|
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Steady state
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a stable condition that does not change over time, or when change in one direction is balanced by change in an opposite direction
|
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Insulin needle
|
give them insulin syringe, 20 units, rotate sites
|
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over 2 million nurses in the U.S.
|
political power
|
|
She recruited nurses for the Crimean War, set up sanitary practices regularly (hand washing and clothes washing), and reduced the mortality rate from 42% to 2%
|
Florence Nightingale
|
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Isolation
|
a segregation of a group of organisms from related forms in such a manner as to prevent crossing infections
|
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spores
|
a resistant form of certain species of bacteria
|
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face validity
|
when a cursory examination shows that it is measuring what it is supposed to measure
|
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Hippocrates
|
father of medicine. 1st said should be rational treatment for illness. Natural reason why you get sick. Catalogued illnesses and treatments. Credited for writing 1st medical textbook. Made medical knowlege available for people.
|
|
300-600 A.D.
|
No learning, absolute chaos. back to superstitions. Like history never happened.
|
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Expert
|
the expert nurse no longer relies on rules or guidelines to connect understanding of a situation to an appropriate action. The expert nurse, with an enormous background of experience, has an intuitive grasp of the situation and zeroes in on the problem
|
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Categories of community nursing centers
|
community outreach, institution-based wellness/health promotion models, independent practice nurses
|
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Interpersonal skills
|
determines a persons ability to relate happily and productively with others
|
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implied consent
|
a contract that has not been explicitly agreed to by the parties but that the law nevertheless considers existing
|
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Metabolic rate
|
the speed at which some substances are broken down to yield energy for bodily processes and other substances are synthesized
|
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Phase I PACU
|
area designated for care of surgical patients immediately after surgery and for patients whose condition warrants close monitoring
|
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A medicare payments system to hospitals and physicians that establishes fees according to diagnosis
|
Diagnostic related groups (DRG)
|
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has an advanced degree or specialty training in a specific area of preactice. The nurse provides client care, educates others, consults, and conducts research.-hospital
|
Clinical Nurse Specialist
|
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Korotkoff sounds
|
the sounds heard over an artery when blood pressure is determined by auscultatory method
|
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relationship between reliability and validity
|
reliability is considered first because an instrument can't be considered valid unless it is reliable
|
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Primary level of Disease Prevention
|
includes activities and lifestyle factors directed toward high-level wellness, such as adequate nutrition, adequate immunization status, regular exercise, and stress management. Maintaining health is the primary mode for preventing illness.
|
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Community outreach: (community nursing center)
|
free-standing clinics similar to traditional community public health clinics
|
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unprofessional conduct
|
one of the grounds for action agaist the nurse's license; incompetence or gross negligence; conviction of practicing w/o a license, falsification of client records, and illegally obtaining, using, or possessing controlled substances
|
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Guided Imagery
|
the mindful use of a word, phrase, or visual image to achieve relaxation of direct attention away from uncomfortable sensations or situations
|
|
These two definitions include nursing in relationship to........
|
the client and the environment
|
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Pretest-Posttest Control Group Design
|
the subjects are randomly assigned to groups then a pretest is given to both groups and the experimental group receives the treatment while the other group receives routine treatment or none at all. Afterward a posttest is given to both groups
|
|
lavinia dock and lillian wald
|
founders of henry street project. talked to ppl in community about public healthcare. nursing's best moment.
|
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LPN vs RN
|
LPNs differ from RNs in two areas: educational preparation and scope of practice
|
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Negotiation: (discharge planning element for the nurse)
|
the process by which the client, nurse, and family determine goals.
|
|
one who chooses what to do in a sp. situation or problem
|
decision maker
|
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Correlational Studies
|
How X relates to Y, the closer to -1 or +1 the stronger the relationship
|
|
Complex referrel: (levels of discharge planning)
|
most complex type of discharge planning, involves referring the client to the discharge planner. Considered for high-risk planner, and the nurse is must follow up to ensure that the discharge planner has acted and must evaluate to learn if the client is satisfied with the discharge plan. The nurse may need to reinforce plans
|
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Nursing theory is used to direct links between..... (3 components)
|
theory, education research, and practice
|
|
1000 ml
|
1 L = 2 pints = 1 qt = 32 oz
|
|
NLN: National League for Nursing
|
the main purpose of the NLN is to ensure that the public need for nursing is met. Members of the NLN include nurses and other members of the health team, lay people, and agencies concerned with nursing education and serice.
|
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Professional Roles
|
•Caregiver
•Educator
•Manager
•Advocate
•Communicator
|
|
Respect
|
¢Communicate confidence
¢Investing in the patient
¢Unconditional positive regard-Carl Rodgers
|
|
-Acute
-Chronic
|
Categories of Illness
(2)
|
|
6 cultural aspects
|
}Communication
}Space
}Social Organizations
}Time
}Environmental Control
}Biological Variations
|
|
Culture
|
thoughts, communications, actions, customs, beliefs and institution of racial, ethnic, religious or social groups.
|
|
Hispanics
|
–Cuarandero/a, yerbero, sabador, espiritsta, santero/a
|
|
External Variables
|
Family practices
Socioeconomic factors
Cultural variables
|
|
Genuineness
|
¢Presenting thoughts/feelings in a constructive manner
¢Spontaneous
¢Non-defensive
|
|
Other Qualities To Consider-
|
oParalanguage
oIntonation
oRates-use of pauses
oPitch
oVolume
|
|
Paradigm
|
- person, health, environment/situation, and nursing.
- links science, philosophy, and theories accepted and applied by a discipline.
- useful in describing the domain of a discipline.
|
|
Enculturation
|
socialization into one’s primary culture as a child.
|
|
Code of Ethics
|
}Confidentiality
}Render the message
}Should not counsel, advise, or interject personal opinions
}Maintain professional standards
|
|
Blocks to problem-solving
|
¢Premature Closure
¢Inadequate Interpersonal Skills
|
|
Mother Bickerdyke
|
organized ambulance service, supervised nurses, and searched for abandoned, wounded soldiers on the battlefield.
|
|
lPre-interaction
lOrientation
lWorking
lTermination
|
Stages in a help relationship
|
|
Theory X
|
Classic Management Thry--(Mcgregor 1957) people find no pleasure, lazy, prefer to do nothing, child-like, want to be controlled/directed (Autocratic).
|
|
Non-western Cultures
|
________ emphasize a holistic conceptualization of health and illness.
|
|
Manager
|
•As a manager, you will collaborate with others to help your clients meet their established outcomes and evaluate the manner in which care is administered. As a manager of care, you will evaluate staff nurses to determine if they meet professional and health care facility standards.
|
|
Components of a Theory
|
Set of concepts
Definitions
Relationships
Assumptions
or propositions
|
|
Florence Nightingale
|
first practicing epidemiologist. She used statistical analysis to show the connection between poor sanitation and diseases like cholera and dysentery. improving sanitation in battlefield hospitals, she showed how effective fresh air, hygiene, and nutrition were in the treatment of wounded soldiers.
|
|
Specific Transcultural Communication Techniques
|
}Approach slowly
}Greet
}Quiet setting
}Comfortable distance
}Sufficient time
}Explain
|
|
3 Categories: Health Belief Systems
|
}Biomedical
}Personalistic
}Naturalistic
|
|
Participative Leadership
|
Multicratic; analyze feedback from group to make decision.
|
|
Interculturall Communication
|
Nursing approaches needed to provide culturally appropriate care that incorporates an individuals cultural values, beliefs and practices.
|
|
Establishing relationships
(assist you in making a cultural assessment)
|
Because language and communication difficulties may exist, it will be important to establish a relationship so the client and their family feel comfortable discussing the client’s illness. Box 9-3 presents the Rule of Impression Management.
|
|
Educator
|
•You will be looking at patient education. Your teaching can be formal or informal and will involve the patient, family, significant other, or other support systems.
|
|
Mary Mahoney
|
was the first professionally educated African-American. She may be one of the first proponents of better relationships between cultures and races, respect for individuals regardless of background, race, color or religion.
|
|
Intercultural Communication
|
Nursing approaches needed to provide culturally appropriate care that incorporates an individuals cultural values, beliefs and practices.
|
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Laissez-Faire Leadership
|
Little or no direction as leader.
|
|
Guidelines for working with medical interpreters
|
}Use qualified interpreters
}Don’t depend on children or relatives
}Brief pre-interview
}Working relationships
}Allow time
}Address yourself to the interviewee
}Don’t say anything that you don’t want the other party to hear
}Use words to convey your meaning
}Speak in a normal voice
}Avoid jargon and medical terms
}Pause
}Ask only one questions at a time
}Expect the interpreter to interrupt for clarification
}Interpreter may take notes
|
|
Cultural Imposition
|
occurs when people have a cultural ignorance or cultural blindness about others; occurs when people use their own values and lifestyle as the absolute guide in dealing with clients and interpreting their behavior.
|
|
Nursing practice is shaped by:
|
American Nurses Association (ANA)
National Student Nurses Association (NSNA)
National League for Nursing (NLN)
International Council of Nursing (ICN)
Nurse Practice Acts in each state regulate licensure and practice. Minnesota Board of Nursing and NCLEX-RN.
American Academy of the Colleges of Nursing (AACN).
|
|
Nursing theories
|
provide nurses with: 1) a perspective to view patient situations 2) a way to organize data and 3) a method to analyze and interpret information.
|
|
Human rights movement:
|
Nurses are among the strongest advocates of recognizing patients needs, special and normal. Nurses can be proud that they created bills of rights for dying, hospitalized, and pregnant clients.
|
|
Mary Adelaide Nutting
|
nursing education moved into U.S. universities in the early twentieth century; in 1906 she became the first professor of nursing at Columbia University Teachers College.
|
|
•Action modes of professional decisions or actions
( According to Leininger, all three modes are aim to assist, support, facilitate, or enable people of particular cultures. )
|
–Cultural care preservation or maintenance
–Cultural care accommodation or negotiation
–Cultural care repatterning or restructuring
|
|
oBe aware of your communication with yourself and others
oEffectively use and interpret verbal messages
oEffectively use and interpret nonverbal messages
oListen and respond thoughtfully to others
oAppropriately adapt messages to others
|
Fundamental Principles of Communication
|
|
Trait Thry
|
Idea that leadership is taught, it is not something you are born with.
|
|
Asking questions
(assists you in making a cultural assessment)
|
Use open-ended questions and be focused. These types of questions encourage clients to describe their values, beliefs, and practices regarding health and illness. If needed, refer back to your speech or communication course taken as a prerequisite for entry into the nursing program.
|
|
Principle 3: Effectively Use and Interpret Nonverbal Messages
|
oPrimary way we communicate feelings and attitudes toward others
oCongruency between verbal and nonverbal
|
|
professional end of a continuum.
|
Nursing has moved from the occupational end to the...
|
|
Reasons for using a medical interpreter
|
}Legal reasons
◦Title VI of the Civil Rights Act of 1964
◦Bilingual Service Act-MN Statue 15.441
◦Minnesota Human Rights Act-MN Statue 363.03 (4)
}Quality of care
}Financial reasons
|
|
D. A Japanese handshake is softer
|
4. Which is true about shaking hands?
a. It is always OK to remain seated.
b. The right or left hand may be used.
c. You should shake five to 10 times.
d. A Japanese handshake is softer.
|
|
What should be done when conveying a message?
|
oThe message should be understood
oThe message should achieve the intended effect
oThe message should be ethical
|
|
Nutting, along with Lillian Wald and Annie Goodrich
|
Their study, conducted in 1920 and published in 1923, concluded that nursing education needed financial support and should be centered in university schools of nursing.
|
|
B. It can mean only that a person heard you
|
10. What is true about nodding?
a. It always means yes.
b. It can mean only that a person heard you.
c. The gesture is not used in Asia.
d. It is an insult in many countries.
|
|
THYMUS
|
RUDIMENTARY ORGAN
|
|
Leninger
|
3 C'sCulturallyCongruentCare
|
|
KYPHOSIS
|
humpback or hunchback
|
|
5 Delegation Rights
|
Task
¡Circumstances
¡Person
¡Direction/communication
¡Supervision/evaluation
¡
|
|
Assessment
|
•Before interventions
•Make nursing dx
•Determine health status
|
|
Flat, circumscribed discoloration lesion
<1 cm
|
Macule
|
|
Veracity
|
¡Tell the Truth
¡Necessity to the development and continuance of trust among human beings
¡Do not intentionally deceive or mislead clients
|
|
Hypersensitivity
Abdominal pain
Nausea and/or Vomiting
Signs of acute abdomen
Above signs/symptoms with fever
|
CONTRAINDICATIONS OF COLACE
|
|
WHEAL
|
LESION CAUSED BY CUTANEOUS EDEMA IRREGULAR IN SHAPE ELEVATED TRANSIENT
|
|
CRUST
|
DRIED SURFACE FLUIDS, SERUM OR PUS
|
|
Evaluating
|
A planned, ongoing, purposeful activity in which clients and health care professionals compare expected outcomes to actual outcomes.
|
|
Health Care’s Shift
|
•Science, technology, communication
•Marked shift in values, focus of North American society
–“death denying”
–value productivity, youth, independence
–devalue age, family, interdependent caring
•Death “the enemy”
–organizational promises
–sense of failure if patient not saved
|
|
Critical Paths
|
multidisciplinary care plans outlining a patient's treatments and expected outcomes day by day
•Activities
–Nutrition
•Tests/Consults
•Medications
•Teaching
•Treatments
•Discharge Planning
|
|
Delegation
|
¡Nurses must delegate tasks and responsibilities to the appropriate person and must follow up to ensure that the task was completed and done properly
¡Empowering one to act for another
¡Nurse holds accountability and responsibility for the task delegated
|
|
Certification
|
Validation of specific competencies demonstrated by a registered nurse in a defined area of practice
|
|
What is a PVC?
|
PVC(premature ventricular contraction)- is a contraction originating in the ventricles. It is a premature occurance of QRS complex.
|
|
PERIORBITAL EDEMA
|
Edematous swelling of the eyelids in association with local injury, allergic reactions, hypoproteinemia, trichinosis, and myxedema.
|
|
VISUAL ACUITY
|
acuteness or clearness of vision
|
|
PLEURAL FRICTION RUB
|
low-pitched, grating, or creaking sounds that occur when inflamed pleural surfaces rub together during respiration
|
|
Grade of pitting edema that is 4mm
|
2+
|
|
EYE ASSESSMENT
|
ASSESS VISUAL ACUITY
TEST VISUAL FEILDS
OBSERVE EYES, EYELIDS,AND EYEBROWS
INSPECT LACRIMAL GLAND AND LACRIMAL SAC FOR SWELLING
INSPECT CONJUCTIVAS AND SCLERAS
INSPECT CORNEA AND LENS OF EACH EYES FOR OPACITIES
INSPECT EACH PUPIL AND IRIS
CHECK PUPILLARY RESPONSES TO LIGHT
ACCOMODATION
ASSESS EYE ALIGNMENT
TEST EXTRAOCULAR MUSCLE FUNCTION
EXAMINE FUNDUS OF EACH EYE
|
|
Cultural competence-
|
organizational cultural competence, individual cultural competence, usually in reference to nurses, physicians, social workers, or those in other healthcare, educational, or social services professions.
|
|
Medigap
|
- to insure devastating financial loss, most elderly persons have some additional health care insurance from private companies.
|
|
Wellness Diagnosis
|
Describes human responses to levels of wellness that have a readiness for enhancement.
|
|
Clara Harlowe Barton(1821-1912)
|
-Founded Amer. Red Cross
|
|
Discharge Planning
|
Make a written planOffer resourcesDevise ways to increase complianceEvaluate your teachingLegal implications: Document
|
|
Actual Nursing DX
|
PES StatementProblemEtiology (related to)Signs and symptoms (defining characteristics)
|
|
American difficulties with death arise from:
|
–Urbanization
–Segregation of the aged and dying
–Movement towards the nuclear family
–Secularization from religion
–Advances in medical technology
–Possibility of Mass Death (i.e. nuclear war)
|
|
malpractice
|
Negligence that occurs when expected standards of care are not met by professionals (Unintentional Tort)
|
|
Nonmaleficence
|
(1) Based of Hippocratic Oath; nurse must not act in a manner that would intentionally harm the patient
(2) Examples (and possible conflicts): chemotherapy and bone marrow or stem cell transplantation—both pose a risk for opportunistic infections, but possibility of achieving a cure of disease may justify temporary harm (principle of double effect)
|
|
Duty to Report
|
¡Child Abuse
¡Elderly Abuse
¡Gunshot Wounds
¡Communicable Diseases
¡Threats toward third parties
|
|
Politics
|
¡deals with the regulation and control of people living in society; in government the allocation of scarce resources.
|
|
Opiate and opiate related
Somatostatin analogue
Adsorbents
Miscellaneous
|
USE FOR ANTIDIARRHEALS
|
|
What is the treatment for asytole?
|
Consists of:
CPR
Initiation of ACLS
IV w/ epinepherine and atropine
|
|
LORDOSIS
|
an inward curvature of a portion of the vertebral column
|
|
BRONCOVESICULAR
|
Relating to the bronchial tubes and alveoli
|
|
· Voluntary agencies-
|
all private sector organizations whether for-profit or nonprofit, usually apply to nonprofit agencies.
|
|
· Natural disasters –
|
include tornados, hurricanes, hurricanes, floods, etc.
|
|
Co-payments
|
– self-payment costs (a consumer share of the cost for a particular service)
|
|
Nursing Diagnosis
|
The nurse's clinical judgement about responses to actual and potential health problems to provide the basis for selecting nursing interventions to achieve outcomes for which the nurse is accountable.
|
|
Advance care planning
|
process of discussion, documentation, implementation
|
|
Health Promo
|
assist patients to remain healthy, prevent diseases and injuries, detect diseases early, and promote healthier lifestyles; require patient participation and cannot be performed solely by health care providers.
examples: health education programs (prenatal classes); Exercise programs; Health fairs; Wellness programs (worksite and schools); Nutrition classes
|
|
Methods of Payment for Healthcare
|
•Personal payment
•Medicaid—jointly funded federal and state public insurance for those below the poverty level and with disability.
•Medicare—federally funded public hlth insurance
•Private insurance—privately owned company
•Workers compensation—federally mandated insurance system for workers injured on the job
|
|
Johnson's Theory
|
Advocates the development of efficient and effective behavioral functioning in the patient in order to prevent illness Johnson defines the patient as being a behavioral system - composed of 7 subsets which all require 3 things: *Protection from noxious influences *Provision for the nurturing environment *Stimulation for growth Any imbalance in each system results in disequilibrium, it is the nurse's role to assist the patient to return to the state of equilibrium
|
|
Mary Grant Seacole 1805-1881
|
Jamaican-born nurse who
fulfilled her ambition to nurse soldiers in the Crimean war,
despite being denied the opportunity of enlisting
with Florence Nightingale.
|
|
Informed Consent
|
Consent must be given voluntarilyFree from coercion Client must be of competent capacityMental status of ClientClient must have appropriate and adequate information to make a decisionRisks/benefits, side effects, costs, alternatives
|
|
Exceptions to Privacy
|
¡Discussing care with others involved in direct care of client
lPhysicians, PT/OT, case coordinator
¡ Quality assurance activities
lFall risks, Needle sticks
¡Law demands disclosure
lSafety of another is at risk
|
|
Utilitarianism
|
Asserts that it is right to maximize that greatest good for the happiness of the greatest number of people
The end justifies the mean
|
|
Assess for abdominal distention, presence of bowel sounds, and usual
pattern of bowel function
Assess color, consistency, amount of stool produced
Administer with full glass of water or juice
May administer on empty stomach for fa
|
NURSING INTERVENTION FOR PT. WHO IS TAKING COLACE
|
|
What is PSVT?
What is the heart rate?
|
PSVT(paraxysmal supraventricular tachycardia)- is a dysrhythmia originating in an ectopic focus anywhere above the bifurcation of the Bundle of HIS
Heart rate = 100-300bpm
|
|
HOMAN'S SIGN
|
said to be present when passive dorsiflexion of the ankle by the examiner elicits sharp pain in the calf. It is caused by a thrombosis of the deep veins of the leg.
|
|
SNELLEN TEST
|
CHART READ FROM 20 FEET AWAY TO DETERMINE VISION ACUITY
|
|
RESONANT
|
The lung is filled with air (99% of lung is air), hence, percussion of it gives a resonance. This step helps identify areas of lung devoid of air.
|
|
Beveridge model
|
– total government control of welfare responsibility
|
|
Epidemiological transition
|
– the difference how preventable diseases can overwhelm poor countries and have very little effect on rich countries due to preventative measures.
|
|
Rural-
|
a community having fewer than 20,000 residents
|
|
Goals/outcomes for Wellness Diagnoses
|
i. Describe client responses that demonstrate health maintenance or achievement of a higher functioning level
ii. Both Omaha and NOC systems may be used
iii. Goals are set based on client potentials
|
|
Focus Charting
|
1. A focus may be a condition, strength, nursing diagnosis, behavior, sign/sympt, significant change in pt condition
2. The problem should not be a medical diagnosis
a. It can describe the needs and conditions assoc. with a med. diagnosis.
3. Useful for health promo activities because nurse can organize around positive headings rather than problems
|
|
Output—
|
The end result or product of a system
|
|
Assault-
|
a threat or an attempt to make bodily contact with another person without the persons consent; assault precedes battery; it causes the person to fear that battery is about to occur
Example: a nurse threatens a patient with a vitamin injection if he/she does not eat his meals (assault)
|
|
Nursing Roles
|
Provider of direct, hands-on care to patientsEducator of patients, families, communities, other staff, students, businesses, and governmentCounselor providing support for patients and familiesManager of Patient Care for Individual Patients and Groups of Patients and Manager of Scarce ResourcesResearcher investigating effectiveness of current an potential nursing actionsCollaborator with patients and health teamChange agent/intrapreneur for changes in the nursing systemEntrepreneur for own business.Patient Advocate.
|
|
Acute illness
|
involves a sudden onset of symptoms that progress quickly from mild to severe and subside quickly with or without treatment; partient usually returns to former level of functioning; changes are often not permanent but may progress to chronic illness; does not usually require long term behavioral change/treatment; may represent a life crisis
|
|
What are some causes of PSVT?
|
In a normal heart:
overexertion,emotional stress, deep inspiration, caffeine and tobacco
Other causes:
Rheumatic heart disease, digitalis toxicity, CAD, and cor pulmonale
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What is P.E.A.?
What are the causes?
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PEA(pulseless electrical activity) -electrical activity is seen by ECG but the pt has no pulse.
Most frequent causes:
Hypovolemia, hypoxia, metabolic acidosis, hyper/hypokalemia, hypothermia, drug overdose, cardiac tamponade, MI tension pneumothorax, pulmonary embolus
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· Child protective services –
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agency assigned to investigate reports of child abuse & neglect.
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Culture
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is dynamic and refers to a group of people who have the following characteristics, a shared pattern of communication, similarities in dietary preferences and food preparations, common patterns of dress, predictable socialization patters, a shared sense of beliefs.
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· United Nations Children’s Fund-
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concentrates on maternal and child health in 191 countries. It is part of the UN and geared towards fresh water and food supplies.
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· Local health departments-
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autonomous, either consulting with the state or directly planning programs and setting health policy for the communities they serve
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In-kind payments
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- government subsidies such as food stamps, public housing assistance, and vouchers for WIC.
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Organizational Structures of Health Care Agencies
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Board of directorsChief Executive Officer (CEO)Medical staffChief of staffNursing staffChief Nurse Executive (CNE)
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Supply and demand
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Economic system has 2 parts: suppliers (who provide services and goods) and consumers (who demand and use goods and services)
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Maslow’s Hierarchy of Needs/Kalish Priorities
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i. Survival needs- food, air, water, temperature, elimination, rest, pain avoidance
ii. Stimulation needs
1. Sex, activity, exploration, manipulation, novelty
iii. Esteem needs
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Actual diagnosis:
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a problem that is actually present at the time you make the assessment
Recognized by the presence of associated signs and symptoms (defining characteristics)
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What are the treatments for PEA?
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**Treatment is directed toward correctrion oiof underlining cause
CPR
Intubation
IV Epinepherine
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What are some S/S the patient may complain about with sinus tachycardia?
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Dizziness, dyspnea, and hypotension
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What is the PR interval?
What is the normal duration of the PR interval?
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The PR interval is the time it takes for an impulse to spread through the atria, AV node,Bundle of HIS and purkinje fibers
0.12-0.20 seconds
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TEST REACTION TO ACCOMMODATION
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Ask client to follow your finger as you move it toward bridge of nose.
as fingers near nose, observe for pupillary constriction and symmetrical convergence of eyes
darken room if pupillary constriction is difficult to see.
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· Quality of care-
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a process for making strategic choices in health systems, Quality assurance, Health services administration
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· Direct care services-
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are health services delivered to an individual: physical therapy, nursing care, doctors visits; they are provided in a variety of settings by direct care providers.
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Autonomous actions by a patient
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(1) deciding to refuse treatment; giving consent for treatment or procedures; obtaining information regarding treatment
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different levels of anxiety and the related symptoms
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1) Mild anxiety-
(1) Increased alertness
(2) Ability to focus attention and concentrate
(3) Produces an extended capacity for learning
2) Moderate anxiety-
(1) concentration is limited to one thing
(2) increased body movement and rapid speech
(3) subjective awareness of discomfort
3) Severe Anxiety-
(1) Scattered thoughts and difficulty with verbal communication
(2) Subjective awareness of considerable discomfort
(3) Purposeless movements- pacing and handwringing
4) Panic-
(1) Complete disorganization
(2) Difficulty differentiating reality from imagination
(3) Constant random movements
(4) Unable to function without assistance
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Recommendation of ANA in 1965 position paper titled "Educational Preparation for Nurse Practitioners and Assistants to Nurses"
(#2 c)
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4 recommendations:
Edcucation of liscenced practiotioners should take place in institutions of higher learning
Minimum prep for beginning professional nursing practice should be a baccalaureate in nursing
Minimum prep for beginning technical nurses should be an associates degree in nursing
Health assistant education should consist of short, intense programs in vocational schools and institutions rather than on the job
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Watson Model of Human Caring
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PERSON Individual has needs, grows, and develops to reach a state of harmony
HEALTH Dynamic state of growth and development leading to full potential as a human being ENVIRONMENT Those factors that a client must overcome to achieve health
NURSING Science of caring that helps clients reach their greatest potential
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What is the rate of the SA node?
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SA node = 60-100/min
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What is ventriciular tachycardia?
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V-tach is a run of three or more PVCs. It occurs when an ecotpoiuc focus fire repetitvely and the ventricle takes control as the pacemaker.
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WEBER TEST FOR LATERALIZATION OF
SOUND
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Place base of lightly vibrating tuning fork firmly on pt's head
ask pt where the sound is heard
sound is normally heard in both ears
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Cultural and linguistic competence
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a requisite skill for all nurses to provide culturally congruent , appropriate, and meaningful nursing and health care, avoid unnecessary misunderstandings and miscommunication, and ensure that the public receives the highest quality of community/public nursing care: know it as though it was your own, know it the best you can, be aware (pg. 271)
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3 main classifications of health care agencies
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Governmental (federal, state, local) or public agencies vs. voluntary (private) agenciesFor profit or non-for-profitLevel of health care services provided (primary, secondary, tertiary, or subacute)
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The Patient's Voice
"Mastery of LIfe"
Macurdy's 4 Principles
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1. I make decisions regarding my health and no helath care professional can override my preferences
2. I am the highest decision maker- no one else is permitted to speak for me
3. I must be given complete information regarding my health care
4. Health care is a means to a full and meaningful life and is not an end in itself
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RINNE TEST TO COMPARE BONE AND AIR
CONDUCTION
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Place the base of lightly vibrating tuning fork on one mastoid process
when pt no longer hears sound place fork near ear canal opening
normally vibration is heard longer thru air than thru bone
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Health literacy skill
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- refers to the ability to read and understand instructions on prescription and medicine bottles, appointment slips, informed consent documents, insurance materials and client educational materials.
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Explain cost containment efforts and impact on nursing
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Nurses play an important role in controlling health care costs
-Enhancing cost awareness; posting the costs of supplies on shelves, making staff aware of lest costly alternatives
-Nurses are positioned to help patients make cost-effective choices: question repetetive testing, generic drugs vs. name brand drugs, early detection of probelms to avaoid re-hospitalizations
-In both inpatient and outpatient settings, organizing the flow of patients and thus maximizing efficiency represents a huge cost savings.
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Potential reasearch questions related to Carper's ways of knowing:
Ethical Research
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What is the context of care for the bereaved
palliative caregiver?
How effective, efficient, and equitable are the
services and interventions offered to bereaved
caregivers?
What are the rights of the bereaved palliative
caregiver in the context of the health care system?
What theories apply to the bereaved palliative
caregiver’s experience of hope, in an overall
evaluation of a system of care?
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Describe the 4 documents that all nurses should own (box 4-5 pp 95)
Nurse practice act
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Being familiar with the law your state is a key safeguard against accidentally overstepping the limits of practice while understanding the full set of responsibilities that your state requires you to fulfill
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