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Funds I Theory > Ch 6, 7, & 32 > Flashcards

Ch 6, 7, & 32 Flashcards

1
Q

Advocacy

A

protection and support of another’s rights

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2
Q

Autonomy

A

self-determination; being independent and self-governing

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3
Q

Beneficence

A

principle of doing good

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4
Q

Bioethics

A

ethics that encompass all those perspectives that seek to understand human nature and behavior, the domain of social science, and the natural world

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5
Q

Care-Based Approach

A

approach to bioethics that directs attention to the specific situations of individual patients viewed within the context of their life narrative

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6
Q

Code of Ethics

A

principles that reflect the primary goals, values, and obligations of the profession

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7
Q

Conscientious Objection

A

refusal to participate in certain types of treatment and care based on the nurse’s personal and professional ethical beliefs and standards

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8
Q

Deontologic

A

ethical system in which actions are right or wrong independent of the consequences they produce

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9
Q

Moral Agency

A

ability to behave in an ethical way; to do the ethically right thing because it is the right thing to do

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10
Q

Ethical Dilemma

A

situation that arises when attempted adherence to basic ethical principles results in two conflicting courses of action

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11
Q

Ethics

A

system dealing with standards of character and behavior related to what is right and wrong

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12
Q

Feminist Ethics

A

type of ethical approach that aims to critique existing patterns of oppression and domination in society; especially as these affect women and poor

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13
Q

Fidelity

A

keeping promises and commitments made to others

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14
Q

Justice

A

process that distributes benefits, risks, and costs fairly

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15
Q

Moral Resilience

A

developed capacity to respond well to morally distressing experiences and to emerge strong

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16
Q

Morals

A

like ethics, concerned with what constitutes right action; more informal and personal than ethics

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17
Q

Nonmaleficence

A

principle of avoiding evil

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18
Q

Nursing Ethics

A

subset of bioethics; formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgments

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19
Q

Principle-Based Approach

A

approach to bioethics that states that the rightness or wrongness of an action depends on the consequences of the action

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20
Q

Values

A

set of beliefs that are meaningful in life and that influence relationships with others

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21
Q

Value System

A

organization of values ranked along a continuum of importance

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22
Q

Values Clarification

A

process by which people come to understand their own values and value systems

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23
Q

Virtues

A

human excellences; cultivated dispositions of character and conduct that motivate and enable us to be good human beings

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24
Q

Law

A

a standard or rule of conduct established and enforced by the government

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25
Q

Four sources of law exist at both the federal and state level

A

constitution
statutory law
administrative law
common law

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26
Q

Litigation

A

the process of bringing and trying a lawsuit

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27
Q

Credentialing

A

refers to the way professional competence is ensured and maintained

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28
Q

Three Processes for credentialing in nursing

A

accreditation
licensure
certification

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29
Q

Accreditation

A

as in a school

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30
Q

Licensure

A

met minimum requirements (government)

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31
Q

Certification

A

non-governmental association grants recognition

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32
Q

Intentional Torts

A

assault (threat) and battery (assault carried out)
defamation of character (slander=spoke, libel=written)
invasion of privacy (breaking HIPAA)
false imprisonment
fraud (deceitfulness)

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33
Q

Unintentional Torts

A

negligence
malpractice (negligence from professional)
elements of liability
standards of care

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34
Q

Competent Practices for Nurses

A

developing and maintaining interpersonal communication skills
respecting legal boundaries of practice (follow rules)
following institutional procedures and policies
owning personal strengths and weaknesses
evaluating proposed assignments; refusing to accept responsibilities for which you are unprepared
keep current in nursing knowledge and skills
respecting patient rights and developing rapport with patients
working within the facility to develop and support management policies
keeping careful documentation

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35
Q

Document All:

A

clinical observations and critical diagnostics
conversations with other providers regarding patient issues
which specific health care provider was notified of which specific concerns at what specific time
that the chain of command has been engaged when necessary

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36
Q

Cover Your Ass

A

make SURE the medical record reflects that you pursued your concerns to resolution

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37
Q

Competent practice includes developing sensitivity to common sources of patient injury such as:

A

falls
restraints
malfunctioning equipment
taking measures to prevent patient injury

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38
Q

Issues Affecting Competence

A

cause improper care or incompetence

nurse fatigue (burnout) and impaired nurse (addiction/substance abuse)

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39
Q

Informed Consent

In all health care facilities, informed and voluntary consent is needed for:

A

admission
diagnostics
treatment procedures

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40
Q

A signed consent is not needed in which situations?

A

emergency; if there is immediate threat to life or health

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41
Q

Who is responsible for obtaining informed consent?

A

whoever is doing the procedure/treatment (physician or surgeon)

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42
Q

What is the role of the nurse when obtaining informed consent?

A

confirm informed consent is signed and in patient’s chart before procedure/treatment

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43
Q

Nursing Responsibilities

A

patient education (must be done by RN)
executing provider orders
delegating nursing care (to LPNs or CNAs)
documentation (EVERYTHING)
appropriate use of social media
whistle-blowing (standing up for what is right)
professional liability insurance
adequate staffing

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44
Q

Purpose of Risk Management

A

identify, analyze, and treat risks as well as reduce malpractice claims

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45
Q

Near Miss

A

error that would have happened except for someone’s alertness and ability to identify and prevent the error

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46
Q

Just Culture

A

encourages open reporting of errors, recognizes that errors may be systemic rather than personal failures and focuses on determining the root of the problem

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47
Q

3 Types of behaviors contribute to errors

A

human error (unintentional)
at-risk behavior (cutting corners)
reckless behavior (disregard all safety measures)

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48
Q

Incident Reports are also called

A

variance or occurrence reports

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49
Q

Incident Reports are used by

A

health care facilities to document the occurrence of anything out of the ordinary that results in, or has the potential to result in, harm to a patient, employee, or visitor

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50
Q

What results from ignoring mistakes

A

more harm than good

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51
Q

Should documentation in the patient record include the fact that an incident report was filed?

A

NO

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52
Q

Patient Rights

A

addresses the expectations, rights, and responsibilities of the patient while receiving care in the hospital

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53
Q

Good Samaritan Laws

A

designed protect health care providers when they give aid to people in emergency situations

54
Q

Student Liability

A

states you are responsible for your own practice, including negligence that may result in patient injury

55
Q

Never Events

A

extremely rare events that should never happen to a patient

56
Q

OSHA (Occupational Safety and Health)

A

reduce work-related injuries and illnesses (safety standards)

57
Q

Controlled Substances

A

laws that regulate the distribution and use of controlled substances

58
Q

Reporting Obligations

A

communicable diseases (STDs)
rape
abuse such as
-physical
-verbal
-sexual
-emotional
-neglect
-abandonment

59
Q

Discrimination and Sexual Harassment

A

Civil RIghts Act of 1964 says you cannot discriminate based on race, color, religion, sex, or national origin. Pregnant women are protected as well.

60
Q

HIPAA (Health Insurance Portability and Accountability Act)

A

privacy

61
Q

Restraints

A

long-term care residents have the right to be free

62
Q

People w/ Disabilities

A

protects people w/ mental, physical disabilities, people w/ communicable diseases, and people recovering from alcohol and drug abuse

63
Q

Wills

A

intentions of a testator to be carried out upon his or her death

64
Q

Legal Issues related to death and dying

A

advance directives, DNR, assisted suicide, direct voluntary euthanasia, organ donation, autopsy, and inquest

65
Q

Abscess

A

collection of infected fluid that has not drained

66
Q

Bandage

A

piece of gauze or other material used to cover wound

67
Q

Biofilm

A

thick grouping of microorganisms

68
Q

Debridement

A

cleaning away devitalized tissue and foreign matter from wound

69
Q

Dehiscence

A

separation of layers of surgical wound; may be partial, superficial, or a complete disruption of surgical wound

70
Q

Dermis

A

below epidermis

nerves, hair follicles, and blood vessels
made of collagen

71
Q

Desiccation

A

dehydration; process of being rendered free from moisture

72
Q

Dressing

A

protective covering placed over a wound

73
Q

Epidermis

A

top layer

protective, made of keratin

74
Q

Epithelialization

A

stage of wound healing in which epithelial cells form across the surface of a wound; tissue color ranges from color of “ground glass” to pink

75
Q

Erythema

A

redness of the skin

76
Q

Eschar

A

thick, leathery scab or dry crust that is necrotic and must be removed for adequate healing to occur

77
Q

Evisceration

A

protrusion of viscera through an incision

78
Q

Exudate

A

fluid that accumulates in a wound; may contain serum, cellular debris, bacteria, and white blood cells

79
Q

Fistula

A

abnormal passage from an internal organ to the skin or from one internal organ to another

80
Q

Friction

A

occurs when 2 surfaces rub together against each other; resulting injury resembles an abrasion and can also damage superficial blood vessels directly under skin

81
Q

Granulation Tissue

A

new tissue that is pink/red in color and composed of fibroblasts and small blood vessels that fill an open wound when it starts to heal

82
Q

Hematoma

A

localized mass of usually clotted blood

83
Q

Ischemia

A

deficiency of blood in a particular area

84
Q

Maceration

A

softening through liquid; overhydration

85
Q

Necrosis

A

death of cells and tissues

86
Q

Negative Pressure Wound Therapy

A

NPWT; activity that promotes wound healing and closure through application of uniform negative pressure on the wound bed, reduction in bacteria in the wound, and removal of excess wound fluid

87
Q

Pressure Injury

A

localized damage to skin and underlying tissue that usually occurs over a bony prominence or is related to the use of a (medical or other) device; any lesion caused by unrelieved pressure that results in damage to underlying tissue; formerly known as pressure ulcer

88
Q

Purulent Drainage

A

comprised of WBCs, liquefied dead tissue debris, and both dead and live bacteria

89
Q

Sanguineous Drainage

A

containing or mixed with blood

90
Q

Scar

A

connective tissue that fills a wound area

91
Q

Serosanguineous Drainage

A

mixture of serum and red blood cells

92
Q

Serous Drainage

A

composed of clear, serous portion of the blood and from serous membranes

93
Q

Shear

A

force created when layers of tissue move on one another

94
Q

Subcutaneous Tissue

A

underlying layer that anchors the skin layers to the underlying tissues of the body

adipose tissue (where fat for energy is stored)
cushion for protection

95
Q

Wound

A

a break or disruption in the normal integrity of the skin and tissues

96
Q

The skin is the body’s first line of

A

defense

97
Q

The skin is continuous with

A

mucous membranes

98
Q

Layers of the Skin

A

Epidermis
Dermis
Subcutaneous

99
Q

Skin Functions

A

protection
temperature regulation
vitamin D production (from sun)
immunologic (destroy harmful microbes)
absorption
elimination (sweat glands)

100
Q

Mucous Membranes

A

line body cavities, joining with the skin
also found in GI tract, respiratory passages, and urinary and reproductive tracts
function to absorb substances from their surface

101
Q

Developmental Considerations that Affect Skin Integrity

A

kids <2 have thinner skin
skin becomes resistant to injury w/ age because it grows thicker
older adults have thinner skin

102
Q

State of Health Affecting Skin Integrity

A

very thin/obese population
dehydration
exposure to long term moisture
jaundice
disease of the skin (eczema or psoriasis)

103
Q

Ecchymosis

A

bruising

104
Q

Intentional Wound

A

planned, invasive

surgery, lumbar punctures, IV therapy

105
Q

Unintentional Wound

A

accidental

trauma, burns, stabbing

106
Q

Open Wound

A

occurs w/ trauma and surgery
when skin integrity is comprised

107
Q

Closed Wound

A

when skin is not broken, but underlying tissues are damaged

internal injuries, hematoma, bruising

108
Q

Acute Wound

A

short-term

surgical incisions

109
Q

Chronic Wound

A

long-term

delayed healing time

110
Q

Wound Healing Stages

A

hemostasis
inflammatory phase
proliferation phase
maturation phase

111
Q

Hemostasis

A

occur at time of injury

blood vessels constrict, blood clotting will begin with platelet activation and blood vessels dialate, capillary permeability increase allowing plasma to leak out

bleeding, clear fluid, start of scabbing

112
Q

Inflammatory Phase

A

couple days after injury

leukocytes sent to ingest bacteria and macrophages sent to ingest debris, signal growth factors to create new epithelial cells and blood vessels to begin healing process

acute inflammation: redness, swelling, drainage, increase temp

113
Q

Proliferation Phase

A

when regeneration phase of new tissue is built by fibroblast (skin begins to start growing back together), capillaries growing across wound, most WBCs left, body starts making collagen to form back skin

BE EXTRA CAREFUL

114
Q

Maturation Phase

A

3 weeks post-injury

when collagen formed strengthens and wound starts looking more like adjacent tissues

115
Q

Factors Affecting Wound Healing (diagnoses)

A

dehydration
maceration
trauma
edema
infection
excessive bleeding
necrosis
biofilm

116
Q

Factors Affecting Wound Healing (environmental)

A

age
circulation and oxygenation
nutritional status
wound etiology (cause of wound)
medications/health status
immunosuppression (AIDS/HIV)
adherence to treatment (non-compliant)

117
Q

Wound Complications

A

infection (bacteria can invade at time of trauma)
hemorrhage (bleeding, post-surgical is common)
dehiscence (splitting of wound)
evisceration (complete separation of wound, usually in abdomen)
fistula formation

118
Q

Factors in Pressure Injury Development: Two Mechanisms

A

External Pressure: compressing blood vessels so blood supply is unable to get through and tissue dies (leads to ischemia)

Friction/Shear

119
Q

Who is at risk for Pressure Injury?

A

immobility (unconscious or paralyzed)
nutrition and hydration
moisture (increase risk of trauma)
mental status (interfere w/ body awareness)
age

120
Q

Psychological Effects of Wounds and Pressure Injuries

A

pain, anxiety/fear, ADLs

121
Q

Assessing Wounds

A

appearance of the wound - location, size (mm), peri-wound
drainage - color and odor
sutures and staples and dermabond

122
Q

Nursing Interventions to Prevent Pressure Injuries

A

assess for risk of pressure injuries (braden scale)
nutritional status
moisture exposure
previous injuries
assess skin every shift
manage pressure load
cleanse skin regularly
avoid using hot water
skin moisturizer (for dry skin)
humidifiers for dry climates
make sure drink water
avoid massaging bony prominences
minimize friction and shearing
pressure relieving devices
increase mobility
encourage patients to make frequent position changes
promote adequate nutrition (high protein)
investigate nutritional deficiencies

123
Q

Cleaning a Wound

A

gentle
use mechanical/chemical force to remove debris
use normal saline, cleansing sprays prescribed to patient
irrigate wound w/ what’s ordered

124
Q

Removing a Dressing

A

standard precautions
gentle
edges first, pulling in direction of hair growth, stabilize skin while pulling tape back
can use moist saline if having troubles
don’t cause further damage

125
Q

Applying a Dressing

A

apply skin layer around wound (vaseline)
ensure dressing is just on wound

126
Q

Securing a Dressing

A

self-adhesive (when possible)
gauze roll, bandages, tape

127
Q

Closed Wound Drainage Systems

A

Chest Tube
Jackson-Pratt
T-Tube
Hemovac

128
Q

Open Wound Drainage Systems

A

Penrose Drain
Gauze Packed

129
Q

Dry Heat Therapy

A

bags of hot water
heating pads
hot packs

130
Q

Moist Heat Therapy

A

warm washcloths
warm soaks
sips bath (perineal area)

131
Q

Dry Cold Therapy

A

ice bags
cold packs
frozen vegetables

132
Q

Moist Cold Therapy

A

cool washcloths
lukewarm baths (soaks)

Funds I Theory (13 decks)

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