Chapter 3

Question 1

primary role of STSR

Answer 1

give care to patient during procedure
-establish + protect sterile field
-care of instruments
-assist surgeon

Question 2

maslows hierarchy

Answer 2

physiological
safety
love/ belonging
esteem
self actualization

Question 3

what causes ethical dilemmas in modern medicine

Answer 3

multi culture and religion

Question 4

4 basic components of needs

Answer 4

physical
psychological
social
spiritual

Question 5

3 categories of psychologic needs

Answer 5

fear
loss of security
family issues

Question 6

2 categories of social needs

Answer 6

relationship with peers
support system

Question 7

4 categories of spiritual needs

Answer 7

supporting religious beliefs
recognize faith
visit with clergy
right to refuse treatment

Question 8

when would you give surgery

Answer 8

last resort and a last offer of hope

Question 9

two broad factors that apply

Answer 9

adaptation + stress

Question 10

environment is what conditions

Answer 10

ALL that effect us

Question 11

roy adaptation model is based on

Answer 11

family support
culture
intelligence
personalities

Question 12

what is the roy adaptation model

Answer 12

viewing the patient as a biopyschosocial individual

Question 13

stress definition

Answer 13

nonspecific response of the body to a demand

Question 14

factors of stress

Answer 14

type/ severity of illness
previous medical history
age
environment
family role
economic
religious

Question 15

4 coping mechanisms for stress

Answer 15

denial
rationalization
regression (reverting to young)
repression (don’t think, won’t happen)

Question 16

death and dying treatment

Answer 16

goes from maintaining/ buying time (palliative) to comfort care

Question 17

medically accepted definition of death

Answer 17

cardiac

higher brain death
- low Brain stem continues to provide w/o assistance of respirator

whole brain death
- current law as to what defines death in most he world

Question 18

Roman Catholic death

Answer 18

anoint the sick

Question 19

catholic/ protestant death

Answer 19

offer last rights

Question 20

muslim death

Answer 20

turned east to face Mecca after death

Question 21

jewish death

Answer 21

dying patient never left alone

don’t touch body until rabbi

Question 22

buddhist death

Answer 22

reincarnation, last thought determines

Question 23

hindus

Answer 23

cremation, helps soul begin journey

Question 24

5 stages of grief

Answer 24

denial
anger
bargaining
depression
acceptance

not in order and not always all

Question 25

causes of death

Answer 25

accidental terminal - progressive prolonged/ chronic sudden/ no warning

Question 26

forms of treatment

Answer 26

palliative therapeutic

Question 27

palliative treatment

Answer 27

symptom relief improves quality of life doesn't alter progression of disease

Question 28

theraputic disease

Answer 28

treat/ manage disease elective (pacemaker, novasure) non- elective (transplant)

Question 29

examples of life support

Answer 29

feeding tubes, bypass machine, dialysis

Question 30

forms of treatment

Answer 30

ordinary + extraordinary

Question 31

ordinary care

Answer 31

care given to prolong life physician morally obligated to provide no additional burden to patient

Question 32

extraordinary care

Answer 32

burden on patient may be costly no obligation to accept treatment surgeon not morally obligated to provide

Question 33

euthenasia

Answer 33

passive- patient refuses life saving efforts (DNR) active- actions to speed up death process (morphine)

Question 34

active euthanasia

Answer 34

voluntary- patient initiates involuntary- patients rights violated

Question 35

AHA patent care partnership + patient self detrimiation act

Answer 35

- allows patient right to refuse treatment - must inform pt of right to choose care type - provide pt with info concerning wills

Question 36

STSR- AHA patient care partnership role

Answer 36

- refrain from imposing value system on pt - honor ALL patients requests

Question 37

advanced directives

Answer 37

speaks for the pt handles medical interventions sustain or not life power of attorney

Question 38

DNR + DNI differences

Answer 38

DNI: breathing DNR: heart

Question 39

broad guidelines for death in OR

Answer 39

notifiers supervisor postmortem care notify family notify religious leaders preserve evidence, body to coroner

Question 40

what do you do when you debrief death in the OR

Answer 40

hospital has counselors remember HIPPA move on

Question 41

organ transplants

Answer 41

protocols by medicare and medicaid family is consulted- can include clergy declaration of death - whole brain

Question 42

DCD

Answer 42

donation after cardiac death *only if predicted the heart would cease to function after 90 minutes once life support removed*

Question 43

organ trasplant pt 2

Answer 43

next of kin must consent to donate blood - not in utah *facility's procurement coordinator (gift of life coordinator) determines the pt sustainability for organ donation, organize process + seek family consent*

Question 44

what kind of doctor can give transplants

Answer 44

transplant doctor can not be end of life doctor or declaration of death doctor

Question 45

how much time do you have after you take out the heart to transplant

Answer 45

4-6 hours

Question 46

much time do you have after you take out the lungs to transplant

Answer 46

4-6 hours

Question 47

much time do you have after you take out pancreases to transplant

Answer 47

12-24 hours

Question 48

much time do you have after you take out the liver to transplant

Answer 48

24 hours

Question 49

much time do you have after you take out kidney to transplant

Answer 49

48-72 hours

Question 50

how much time do you have after you take out the cornea to transplant

Answer 50

5-7 days

Question 51

how much time do you have after you take out heart valves, skin, bone, veins to transplant

Answer 51

3-10 years (freeze)