207 Foundations I (Term 2) Week 7 to Final Study Cards Flashcards
Define care coordination
The deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care to facilitate the appropriate delivery of healthcare services. Organizing care involves the marshalling of personnel and other resources needed to carry out all required patient care activities and is often managed by the exchange of information among participants responsible for different aspects of care”
Explain and identify the rights of medication administration.
Right patient Right drug Right dosage Right reason Right assessment Right route Right time Right patient education Right to refuse Right evaluation (follow up) Right documentation
What are the 7 essential components of a medication order?
- Patient’s full name 2. Date and time the order was written. 3. Name of medication 4. Dosage 5. Route 6. Time and frequency 7. Signature of prescriber
Describe the scope of care coordination
Care coordination not needed ————— extensive care coordination needed
What are the attributes of care coordination?
- Patient-centered/individualized plan of care
- Evidence-based care
- Efficiency
- Improved health outcomes
- Value-based care delivery
- Interprofessional team-based care
What are some different roles of the nurse relative to care coordination?
1) Nurse Navigator Although their role may vary by setting, nurse navigators promote and facilitate continuity of care across care settings and between care providers by sharing information on the client’s current situation, plan of care and goals. Offer support, education, information and resources. 2) Case Manager A nurse case manager is usually a registered nurse in a health and/or social service practice setting who takes a leadership role in coordinating the case management process. The case manager provides assessment, service planning and implementation, coordination, monitoring, reassessment, advocacy, evaluation of outcomes and discharge planning for clients. 3) Telehealth Nurse Telehealth is defined by the Canadian Nurses Association (CNA, 2007) as “the use of information and communication technology to deliver health services, expertise and information over distance.”
Where are cultural considerations and differences most often seen?
- pregnancy and birth practices - child rearing - health/illness - death and dying
What are characteristics that describe an external locus of control?
Fate; Family dynasty, Outside factors Believe these factors can dictate life direction and that they are not in control of themselves. Can lead to loneliness through illness.
What are characteristics that describe an internal locus of control?
A person perceives that they have control over their life events Control over their health; When individual have strong internal locus of control, there are protective features for mental health
What model postulates that each individual is culturally unique and should be assessed according to six cultural phenomena: (a) communication, (b) space, (c) social organization, (d) time, (e) environmental control, and (f) biological variations.
Giger and Davidhizar Transcultural Model
What six cultural phenomena does the Giger and Davidhizar Transcultural model identify?
1) Communication 2) Space 3) Social Organization 4) Time 5) Environmental Control 6) Biological Variations
Describe the cultural phenomena of communication as described by Giger and Davidhizar?
- language spoken - pronunciation - use of silence - voice quality - use of nonverbal communication Communication often presents the most significant problem in working with clients from diverse cultural backgrounds.
Define transcultural nursing.
A culturally competent practice field that is client centered and research focused.
What aspects of a stressor influence the stress response?
- intensity - scope - duration - number and nature of other stressors - past exposure to serious stressors - predictability
What characteristics of the individual influence the stress response?
- age - gender - perception of personal control or inescapability - availability of social supports - feelings of competence - cognitive appraisal
What are the three levels of of care related to stress according to Neuman?
- primary - secondary - tertiary
What is involved in the primary level of care for stress?
goal is to promote patient wellness by stress prevention and reduction of risk factors
What is involved in the secondary level of care for stress?
Occurs after symptoms appear. The nurse helps the patient determine the meaning of the illness and stress and find resources available to handle them.
What is involved in the tertiary level of care for stress?
Begins when the patient is becoming more stable and recovering. The nurse supports rehabilitation processes involved in healing, moving the patient back to wellness, and the primary level of disease prevention.
What are the stages of the Kubler-Ross model of grief?
Denial Anger Bargaining Depression Acceptance Remember ‘DABDA’
What is disenfranchised grief?
Also known as marginal or unsupported grief. A loss experienced and cannot always be openly acknowledged, socially sanctioned, or publicly shared due to stigmatization. Examples are loss of partner from accidental fentanyl overdose, loss of child in utero or at birth, loss of family member due to suicide.
Define sleep
Sleep is natural, necessary, involves a shift in physiologic and neurologicactivity, and is intended to be restorative.
Describe the scope of sleep.
Process of achieving optimal sleep.
- Restorative sleep
- Intermittent/situational poor sleep
- Chronic poor sleep/sleep disorder
Describe the scope of caregiving.
No caregiver role —–> Limited-Duration/Temporary Caregiver Role ______> Long-term/Permanent caregiver role
What stage of sleep is characterized by the following:
Lightest level of sleep
Person unresponsive but easily aroused by sensory stimuli
Physiological activity begins to diminish, followed by gradual fall in vital signs and metabolism
Muscle tone is present
If awakened, person feels as though they have been daydreaming
Lasts only a few minutes
2-5% of sleep in adults
Stage 1 - Nonrapid Eye Movement
What stage of sleep is characterized by the following:
Period of sound sleep
Relaxation progresses
Body functions continue to slow
Muscle tone remains present
Eye movements are absent
45-55% of total sleep in adults
Stage 2 - Nonrapid Eye Movement
What stage of sleep is characterized by the following:
Deepest period of sleep
People are difficult to arouse
Muscle become completely relaxed
Vital signs significantly lower than waking hours
10% and most predominant in first half of sleep
Stage 3 - nonrapid eye movement
What stage of sleep is characterized by the following:
Rapid eye movements are present
Respirations are irregular and shallow
Variable heart rate and blood pressure
Vivid and elaborate dreams
Dreams more frequently
Usually begins 90 minutes after sleep has occurred
Loss of skeletal muscle occurs
Gastric secretions increase
Person difficult to arouse
Duration of REM sleep increases with each cycle
25% of total sleep in adults
Rapid Eye Movement Sleep
How many sleep cycles approximately per night?
5
What is going without sleep for 18 hours similar to?
You would operate the same as someone who has blood alcohol of 0.08 (legally intoxicated)
True or false. Individuals require less sleep as we age.
True
Define primary sleep disorders.
Those that exist as an independent condition. The most common categories of primary disorders include insomnia, sleep-related breathing disorders, sleep-related movement disorders, parasomnias, circadian rhythm sleep disorders, and hypersomnia.
What are the most common categories of primary disorders?
- Insomnia
- sleep-related breathing disorders
- sleep-related movement disorders
- parasomnias
- circadian rhythm sleep disorders,
- hypersomnia.
Characterized by excessive sleepiness or falling asleep at inappropriate times. Narcolepsy is an example.
Hypersomnia
Occur when the drive to sleep does not occur according to what would be considered a normal sleep-wake pattern, such as someone who stays awake until early morning and does not have the drive to fall asleep as nighttime progresses.
Circadian rhythm sleep disorders
Include a variety of behaviors, such as sleepwalking, sleep terror, and REM behavior disorder.
Parasomnias
What disorder: Restless leg syndrome and periodic limb movement disorder.
Sleep-related movement disorder
Exists when there is difficulty falling asleep or staying asleep.
Insomnia
Define secondary sleep disorders.
- Occur as the result of some other situation, and correcting that situation should resolve the problem with sleep. Secondary disorders are often caused by medical conditions, mental health conditions, and side effects of medical treatments.
- A secondary sleep disorder also may be associated with the use of any medication that has either a sedative or a stimulating effect because either of these actions can interfere with restorative sleep.
- Prematurity in infants also may lead to problems with sleep secondary to the state of neurologic or cardiovascular development.
At what stage do vivid dreams occur?
REM
What are some helath promotion areas for improving sleep?
- Consistent sleep and wake times
- Reducing alcohol, simulants, eating a heavy meal, etc. 4-6 hours before sleep
- Ensure comfortable sleep environment
- Reducing daytime naps
- Reducing screen time before bed
- Use medication as a last resort
- Healthy diet
- Stress Reduction
- Limiting exercise right before bed
What is primary prevention related to sleep?
- good sleep hygiene education
- actions that prevent sleep problems from occuring
What are some negative effects of impaired sleep?
- increased heart disease
- increased wear and tear on cardio system
- increased hypertension
- mood impacts
- impaired cognition
Define caregiving.
Providing unpaid care to a relative or friend to help them take care of themselves.
Made up of actions one does on behalf of another individual who is unable to do those actions for himself or herself
What are 4 types of caregiver roles?
1) spousal caregivers
2) adult children caregivers
3) grandparent caregivers
4) Parental caregivers
Describe spousal caregivers.
- Commonly caring for their spouse with significant physical and/or cognitive disorders yet have their own significant health issues.
- Typically, spousal caregivers are older, have lower educational levels and income, and are less employed than nonspousal caregivers.
Describe adult children caregivers.
- Often caregivers for their elderly parents. The increase in this phenomenon is due, in part, to medical and technological advances that have extended life expectancy.
- The impact of the caregiving role can be overwhelming for adult children caregivers who have to assume multiple roles and responsibilities while juggling employment and family responsibilities. They have to change their lives to meet the needs of their parent(s).
- Most adult children caregivers are in the “sandwich generation”—they must care for their children as well as their parents, either in their own home or in the home of their parents. Adult children caregivers also may experience forms of loss, including the following:
Loss of their parent(s) as they knew him or her before the illness
Loss of their jobs (or needing to cope with job changes)
Change in their social networks
- Adult children caregivers may be at higher risk of impaired health behaviors because their role as caregivers hinders the amount of time available for engaging in personal and preventative health behaviors.
Describe grandparent caregivers.
- Many grandparents are raising their grandchildren and providing care in a variety of ways.
- Grandparents are often overwhelmed in the role of caring for their grandchildren. This feeling of being overwhelmed may occur because they are
- raising their grandchildren on a fixed income and facing financial hardships;
- experiencing the effects associated with normal aging and/or the health problems that make caring for their grandchildren difficult;
- worrying about who will be the caregivers when they die or are physically unable to provide care; or
- raising children who may have mental, behavioral/emotional, or physical problems.
- A more subtle stressor occurs when grandparents become primary caregivers of children in that they lose the special relationship and unique role of being the grandparent.
Describe parent caregivers.
- Taking care of a child because of a medical, behavioral, or other disability.
- A primary role of parents is the provision of care for their children. However, parents become “caregivers” for their children when the children are at an age at which they would normally be expected to care for themselves. This can be due to a disability such as severe physical or cognitive limitations.
- It can also happen later in life from an accident (e.g., a spinal cord injury), a debilitating illness, or severe physical or emotional trauma experienced in military combat.
Identify the attributes and criteria of caregiving.
- The need for love, affection, empathy, compassion, and holistic care are identified as requisite emotions or antecedents to the concept of caregiving.
- The attributes of the caregiver are specific to the person and are contextually based dependent on the caregiver/care recipient relationship and other relationships in the family. Caregivers have the following attributes or characteristics:
- Having the ability to care
- Adapting to a situation
- Being a good listener
- Showing affection
- Being responsible for someone other than self
- Being strong, protective, organized, patient, and understanding
- Serving as an advocate
- Assisting with activities of daily living
- Providing emotional and social support
- Managing and coordinating healthcare services
