301 Test 1 power points Flashcards
HIPAA stands for
Health Insurance Portability and Accountability Act of 1996
HIPAA goals include: Ensure ___ of insurance information from one plan to another, decrease __ and abuse in health care
PORTABILITY, fraud
PHI stands for
Protected Health Information
PHI includes info about (not an obvious one)
Payment
HIPAA Fines up to
$25,000
sharing computer passwords is considered a form of
fraud
JC goal: Improve the a___ of patient identification
accuracy
JC goal: Improve the effectiveness of c_____ among caregivers
communication
JC goal: Improve the s___ of using medications
safety
JC goal: Reduce the risk of health care-associated i___
infections
JC goal: Accurately and completely reconcile m____
medications
JC goal: Reduce the risk of patient harm from f__
falls
JC goal: Encourage p___’ active involvement in their own care as a patient safety strategy
patients
JC goal: The o___ identifies safety risks inherent in its population
organization
JC goal: Improve r___ and responses to changes in a patient’s condition
recognition
2 things to increase safety when pt is in bed
Upper rails raised
Bed is in neutral (lowest) position
Check to be sure IV pole/hook is on the s__ side as the insertion site and not tangled or caught on anything.
same
If patient has a Foley, Be sure that the tubing will drain and bag will not drag on the ___
floor
If there is electrical equipment, check __ and plugs
cords and plugs
Patients with difficulty swallowing need to be __ and supervised.
upright
Tube fed patients must be at 35 to __ degree angle
45
Patients with additional safety needs include those with: Generalized weakness Confusion or dementia Mental illness Hearing and/or visual impairment and \_\_\_
Hemiplegia
Confused or demented patients Need frequent visual checks- every 15 to __ minutes.
30
Confused or demented patients may benefit from on-going time/place o____
orientation
Hemiplegia
paralysis on one side of body
Hemiplegia patients should be helped out of bed on their ___ side
unaffected
2 other things about Hemiplegia patients
May need frequent visual checks
Regular toileting
Patient considerations:
Safety
Rights
Dignity
Well-being
INDICATIONS FOR SPECIAL OBSERVATION: Keep patient in eyesight continuously, even in the
bathroom
INDICATIONS FOR SPECIAL OBSERVATION: Assess patient every ____
shift
Co-morbidities which might lead to increased suicidal risk:
Psychiatric illness
Substance abuse
Adverse medication reactions/interactions
Chronic and/or terminal illness
IF PATIENT IS SUICIDAL (3 things)
DO NOT LEAVE PATIENT ALONE
Notify supervisor and physician
Implement environmental safety
amount of distance from a suicidal pt
arms length
consideration of family visiting suicidal pt
must check with RN first
Documentation for suicidal pt should be at least once a
shift
Alignment and balance also refers to
posture
Nurses pay attention to body mechanics to avoid injury to
self and clients
Alignment and balance or posture refer to the positioning of joints, tendons, ligaments, and muscles while standing, sitting, or
lying
eccentric muscle contraction is a type of muscle activation that increases tension on a muscle as it ___
lengthens
A ___ contraction is a type of muscle contraction in which the muscles shorten while generating force
concentric
An intervention that restricts clients for therapeutic reasons
Bed rest
Mobility Assessment
ROM Exercise and activity tolerance Body alignment Standing Sitting Lying Mental status
Musculoskeletal deconditioning and lack of activity can result in a series of symptoms often referred to as hazards of
hazards of immobility
The newborn infant’s spine is flexed and lacks the anteroposterior __ of the adult.
curves
The toddler’s posture is awkward because of the slight ___ and protruding abdomen.
swayback
Facing the direction of movement prevents abnormal twisting of the
spine
Greatest number of falls occur from not
picking up feet high enough
Avoid lifting person or object > __% of your body weight. Ask for assistance when needed
35%
Semi Fowler’s
30 to 45 degrees
Fowler’s Position
> 45º degrees
Person lying with head lower than feet
Trendelenburg position
Sim’s position
lying face down with knee bent
Lithotomy position
stirrups
Knee-chest position
butt in the air
High Fowler’s
usually 60 - 90º
High Fowler’s facilitates
lung expansion
position used while client is eating
Semi Fowler’s
position for N/G insertion
Semi Fowler’s
position for suctioning
Semi Fowler’s
position (besides high fowlers) promotes lung expansion
Semi Fowler’s
position used for postural drainage
Trendelenburg
position used because it facilitates venous return in clients with poor peripheral perfusion
Trendelenburg
position used for enemas
sims
Do not exercise painful or ___ joints
swollen
Exercise __ extremity at a time
1 at a time
Exercise with at least _ full ROM to each joint at least twice daily
5
AVOID USING ___ TO GET INTO A STANDING POSITION
WALKER
__ STAFF MEMBERS ARE REQUIRED TO BE PRESENT WHEN USING A HOYER LIFT
2
Bridge, recognize pt as unique, convey that they care about pt/family needs, eye contact, interested body language
Caring
Bridge, help pt to participate in care by providing the tools and resources necessary
Empowerment
Bridge, convey respect, show warmth & caring, eye contact, give pt. time to answer questions, sit
Trust
Bridge, to perceive and understand what the patient is feeling. Not pity
Empathy
Bridge, nurse and patient agree on health problems and plan to resolve them
Mutuality
Bridge, when the nurse is authentic and clear about personal values, thoughts, and feelings when responding to a patient. For example: “you don’t know what it is like”. Nurse: agrees with patient and asks them to tell her more about it.
Therapeutic use of self
therapeutic techniques, An active process of receiving information and examining one’s reaction to messages received
Listening
therapeutic techniques, Encouraging patient to select topics for discussion
Broad Openings
therapeutic techniques, Repeating main thought patient has expressed
Restating
therapeutic techniques, Attempting to improve the nurses understanding
Clarification
therapeutic techniques, Directing back to patient ideas, feelings, questions, or content
Reflection
therapeutic techniques, Demonstrating skills or giving information
Informing
therapeutic techniques, Asking questions or making statements that help patients expand on a topic of importance
Focusing
therapeutic techniques, Asking patient to verify nurse’s understanding of what patient is thinking or feeling
Sharing Perceptions
therapeutic techniques, Presenting of alternative ideas for patient’s consideration relative to problem solving
Suggesting
Phases of the relationship, purpose of the encounter is discussed
orientation phase
Phases of the relationship, basic information about the nature of the encounter including how the patient can participate
orientation phase
Phases of the relationship, Patient can ask questions and share preconceptions and expectations
orientation phase
Phases of the relationship, identification and exploitation
working phase
Phases of the relationship, identification of patient problems, purpose of meeting, exploration of pt. feelings, implementing plan, attaining goals, identifying new goals
working phase
Phases of the relationship, identifying new goals
working phase
therapeutic technique, It sounds like you are saying…..
Paraphrasing
therapeutic technique, before going on I would like to go over w you what I think we accomplished thus far
Summarization
Drugs used to reduce a fever
Antipyretics
Bradycardia– slow heart rate below
60
Hypertension—associated with the thickening and loss of
elasticity
Hypotension—systolic pressure falls to ___ mm hg or below
90
Hypothermia –Heat loss during prolonged exposure to cold (core temp betwn 93.2-__)
96.8
normal Temperature Range: 96.8 F to __ F or 36 C to 38C
100.4
the primary fuel for Metabolism
food
Factors Affecting Body Temperature a h e e c t s
Age Hormonal level Environment Exercise Circadian rhythm Temperature Alterations Stress
The volume of blood pumped by the heart during 1 __ is the cardiac output
minute
Radial and __ locations are the most common sites for pulse rate assessment
Apical
Normal pulse rate is
60 to 100 beats per minute
CHARACTER OF PULSE INCLUDE THE FOLLOWING:
rate, rhythm, strength, equality
Respiratory Rate ranges between
12 and 20
acceptable SaO2 ranges __% to 100%; 85% to 89% is acceptable for certain chronic disease
90
The respiratory process of diffusion and __ is evaluated by measuring oxygen saturation of the blood
perfusion
less than 85% SaO2 is
abnormal
HYPERTENSION is often ___
asymptomatic
BP readings 140/90 or greater
HYPERTENSION
HYPOTENSION; Systolic readings fall to ___ mm Hg or below
90
Pain is a highly complex and subjective experience that originates from the central nervous systems (CNS) or the peripheral nervous system (PNS) or
both
Pain is defined as an unpleasant sensory and emotional experience associated with __ or potential tissue damage
actual
Pain is always __
subjective
is being Assertive a bridge or barrier
bridge
therapeutic communication, Verbal cues for pt to say more
Facilitation
“when you say that you are worried to you mean that you are afraid that you will die soon?”
Validation
“when you say that you are worried, what do you mean?”
Clarification
greet patient by name, listen actively, answer honestly
Trust
confident and comfortable and remains in charge
Assertive
Barriers
Asking too many questions Too much information Asking “why” Changing the subject inappropriately Failing to probe Expressing approval or disapproval Offering advice Defending
The American Nurses Association is concerned with __ aspects of nursing practice, public ___ of the significance of nursing practice to health care, and ___ for nursing practice generated by trends in health care
legal
recognition
implications
Scope and Standards of Practice: To improve the health and well-being of all individuals, communities, and populations through the significant and visible contributions of registered nursing using ___s-based practice
standards
Definition of Health: A state of complete physical, mental, and social well-being, not merely the absence of __ or ___
disease or infirmity
Definition of Health: A state of being that ___ define in relation to their own values, personality, and lifestyle
people
Chronic Illness lasts more than
6 months
illness does not always indicate that a ___ is present
disease
Health Belief Model addresses the relationship between a person’s beliefs and ___
behaviors.
It provides a way of understanding and predicting how clients will behave in relation to their health and how they will comply with health care therapies
Health Belief Model
Health ___ is directed at increasing a client’s level of well being
promotion
pt not intending to make changes in next 6 months
precontemplation
pt considering a change within 6 months
contemplation
pt making small changes in preparation for a big change in the next month
preparation
prevention, Occurs when a defect or disability is permanent or irreversible
Tertiary
prevention, True prevention that lowers the chances that a disease will develop
Primary
prevention, Focuses on those who have a disease or are at risk to develop a disease
Secondary
independent or dependent, Administer medication using 6 rights
independent
independent or dependent, Preparing, supporting, recovering patient from the test
independent
independent or dependent, Teaching pregnant women about additional nutrients needed in her diet
independent
independent or dependent, Medication Administration
dependent
independent or dependent, Assisting with diagnostic tests
dependent
independent or dependent, Administering IV fluids
dependent
independent or dependent, Ensuring pt receives prescribed diet
dependent
What Is the Nursing Process? A systematic problem-solving process that guides all
nursing actions
Primary data is from the patient, whereas secondary data is
everything
ADL Assessment, Performance scale (0-100)
Karnofsky
NDx, MDx, or CP: Clinical judgment about indiv, family, community RESPONSES to health problem
NDx
NDx, MDx, or CP: focus is the person
NDx
NDx, MDx, or CP: Problem focused
Potential (risk)
Possible-differential diagnosis-r/o
NDx
NDx, MDx, or CP: Purpose of NI is to Treat or prevent problems; relieve symptoms
NDx
NDx, MDx, or CP: Disease or illness health problem
Validated by s&s medical diagnoses
MDx
NDx, MDx, or CP: focus is on disease
MDx
NDx, MDx, or CP: problem is actual or possible
MDx
NDx, MDx, or CP: problem is Always potential
CP
NDx, MDx, or CP: Purpose of NI is to Carry out medical prescriptions for treatment, Evaluate effectiveness
MDx
NDx, MDx, or CP: example Risk for acute heart failure r/t MI
CP
NDx, MDx, or CP: Potential physiological complications that are associated w health problem/rx
CP
NDx, MDx, or CP: Patho complications r/t disease
CP
NDx, MDx, or CP: Purpose of NI: Monitor for development of complication; institute some but not all preventive interventions
CP
The word impaired in NDX Impaired physical mobility is an example of a:
Descriptor
Culturally ___: Possessing basic knowledge of and constructive attitudes toward diverse cultural populations
sensitive
Culturally ____: Applying underlying background knowledge necessary to provide the best possible health care
appropriate
Cultural ___: Understanding and attending to total context of patient’s situation
competence
