Exam 4: Nutrition, Legal and Ethics, Spirituality, Elimination and Enema, Cultural Diveristy, CAM Flashcards

Question

what is TPN? what are the risks?

Answer 1

Total parenteral nutrition (TPN) --Contains three primary components necessary to maintain nutrition: Proteins, carbohydrates, & fats Also contains electrolytes, vitamins, and trace elements, insulin, heparin Risks - -Risk for sepsis - -Complications related to insertion of catheter/central IV line - -Metabolic alterations (hyperglycemia) - -Fluid/electrolyte, acid/base imbalances - -Phlebitis - -Wean slowly off of TPN, high calorie

Answer 2

- -Evaluate progress toward pt. nutritional goals/outcomes - -Evaluate pt.’s tolerance & adherence to nutritional plan - -Assessing pt.’s understanding of nutritional plan/diet --Lab values associated with nutrition Hematocrit/hemoglobin – decreased in iron deficiency Serum potassium – depleted in severe nutrition Albumin – represents protein status Total Protein – low may indicate malnutrition, protein deprivation Urea Nitrogen (BUN) – inhibited protein metabolism

Answer 3

Goals: based on attaining specific optimum lab values Attain or maintain “ideal body weight” (specify) Eat a certain percentage of meals (specify) Will attain “physical signs/sx of adequate nutrition” (specify)

Answer 4

anyone who has alterations in ability to: ingets, digest, absorb or has increased metabolic demand

Answer 5

Minimize odors Good oral hygiene Clean, pleasant environment Proper positioning and comfort for meal time Allow food preferences & choices, as possible Small frequent meals

Answer 6

BMI = weight (kg) / height in m2 | m2 = which is height x2

Answer 7

Ethnicity--Relates to cultural identification Race--Physical characteristics, physical traits

Answer 8

``` Role of family Folk and Traditional Healthcare Values & Beliefs Common Health Problems Nursing Considerations with each specific cultural group ```

Answer 9

Needs: Need for meaning and purpose Need for love and relatedness Need for forgiveness ``` Factors affecting spirituality Developmental considerations Family Ethnic background Formal religion Life events ```

Answer 10

Spirituality--broader, what gives person life, meaning and purpose; allows for transcendence (rise above circumstances) Religion--practicing, organized by denominations, focused on institutional beliefs

Answer 11

4 C’s cultural assessment Call--what do you call the problem you are having? Cope--how do you cope with the prob? Concerns--what are your concerns regarding the problem? Caused--what do you think caused the problem?

Answer 12

``` Advocacy Autonomy--make own decision Beneficence--good for others without self interest Fidelity--fulfill promise Justice Nonmaleficence--do no harm Veracity--tell truth ``` main 4 ethical principles: 1. Autonomy 2. Nonmaleficence 3. Beneficence 4. Justice

Answer 13

Altruism--concern for wellbeing of others Autonomy Human dignity Integrity--code of ethics and standard of practice Social justice--moral, legal and humanistic principles upheld Nursing ethics

Answer 14

Steps in ethical decision making 1. Assessing situation, identify problem 2. Planning and weighing alternatives 3. Implementing decision 4. Evaluating decision

Answer 15

- -A review of sci data is not enough to solve it - -Involved conflict between two moral imperatives - -Answer will have a profound effect on the situation and client

Answer 16

Constitutional Law: serve as guides for legislative bodies. Statutory Law: laws created by a legislative body or a government agency. Congress. Administrative Law: rules made in conformity with and to administer Statutory Law. Usually oversee nursing practice Common Law: laws derived from common usage, from custom and from judicial decisions or court rulings.

Answer 17

litigation--The process of bringing and trying a legal action (lawsuit) in a court. - Trial court - Apele Courts--for appeal cases - -Plaintiff: the person or government bringing action against another - -Defendant: the person or institution accused of a crime or a tort

Answer 18

Scope of practice defined in each states NPA - -Broadly defines the legal scope of practice for nursing profession - -Standards - --Professional Standards - --Legal Standards--Rules in nurse practice act are legal standards

Answer 19

- -Way to demonstrate competence - -Ways in which professional competence is ensured and maintained - -Accreditation - -Licensure - -Certification

Answer 20

--Crimes – is a “wrong” against a person or his/her property – but also considered to be against the public, as well, Punishable by the state --Torts – is also a wrong committed by a person against another person or his/her property, Punishable in civil court , Does have the potential to be a crime

Answer 21

Criminal/Public: Deals with Government and Public | Civil: Deals with People and People

Answer 22

criminal: felony vs misdemeanor civil: intentional tort, quasi-intentional tort, unintentional tort

Answer 23

``` Intentional Torts: Assault & Battery Invasion of Privacy False Imprisonment Fraud Defamation of character ``` Unintentional Torts: Negligence Malpractice

Answer 24

Defamation: untrue statements, false statements about patients and coworkers Slander versus Libel - -Slander is spoken - -Libel is written

Answer 25

Both unintentional torts Negligence: the failure to act as a reasonably prudent person would have acted in a specific situation. Malpractice: the failure of a professional to use such care as a reasonably prudent member of the profession would use under similar circumstances, which leads to harm.

Answer 26

Offender is guilty of complete disregard for another’s life, may be tried as both a criminal and civil tort.

Answer 27

1. Harm must have occurred to the individual. 2. One person must be in a situation where he/she had a duty toward the person harmed. 3. The person must be found to have failed to fulfill his/her duty. 4. The harm must be shown to have been caused by the breach of duty. ``` AKA: Duty: obligation to provide care. Breach of Duty: failure to meet standard. Causation: links failure to the injury. Damages: actual injury. ```

Answer 28

A duty is a responsibility to someone | Duty to meet the minimum standard of care in your area of practice

Answer 29

``` Nurse falls below the standard of care Failure to observe Failure to monitor Failure to report Failure to perform Failure to follow-up Could be breach of commission or omission (did/didn't do it) ```

Answer 30

Legal safeguards: ``` Contracts Competent Practice Client Education Executing MD orders Documentation Adequate staffing Professional Liability Insurance Risk Management Programs Incident Reports Patient Bill of Rights Good Samaritan Laws ```

Answer 31

- -Each nurse is required to make sure that his/her background and clinical experience are adequate to fulfill the responsibilities assigned. - -Respect boundaries of practice - -Follow institutional policies and procedures - -“Owning” personal strengths and weaknesses - -Keeping current - -Evaluating assignments and refusing those not equipped to safely handle

Answer 32

client education --document if pt refuses this

Answer 33

Professional liability insurance - -Protects nurses’ best interests - -Provides for coverage in limitations of employee coverage situations - -Covers care or advice given outside of work

Answer 34

- -AKA “variance” or “occurrence” reports - -Tool used to document anything outside of the ordinary that results in or has potential to result in harm to a patient, employee, or visitor. These are used for quality improvement. --Example: patient fell out of bed, you gave the wrong dose of a med. NEVER write that you made an error in the patient’s chart.

Answer 35

``` Improp treatment Failure to monitor and report Med errors and reaction Failure to follow policy Quipt error Docu error Adverse effects Breach of confidentiality, caring for clients with HIV ```

Answer 36

- -Not questioning orders - -Medication Administration (right time, right med, right date, right place, right dose, right patient, right documentation) - -Delegating orders (follow up on orders)

Answer 37

Excellent documentation | Treat patients/families with respect

Answer 38

--Suspension: a license, and the ability of the license to practice, is held by the BON for the stated period of time and until compliance with BON conditions have been met --Revocation: a license, and the ability of the licensee to practice, is completely withdrawn. That nurse shall never again be admitted to practice in the state. Never able to practice again in that state and probably others --Misconduct: disciplinary hearings are held when charges of misconduct are reported and, upon review by the BON, found unlikely.

Answer 39

Personal Liability--The nurse is responsible for performing those acts, and only those acts for which s/he is licensed (omission or commission). Employer Liability--The employer is held responsible for actions of an employee; employee still has personal liability. Supervisory Liability--The person in a supervisory position is responsible for exercising good judgment in making decisions about assignments and delegation of tasks;

Answer 40

FACT: placed under oath, provide first hand knowledge of situation, no assumption, state "i do not remember" when in doubt EXPERT: May be called by either attorney to explain to the judge and jury what happened based on the records, offer an opinion whether the nursing care met acceptable standards of practice.

Answer 41

``` Proper documentation Treat patients with respect Routinely expand your knowledge/skills Review your job description occasionally Be aware of p/p Look up unfamiliar drugs Question vague or inappropriate MD orders Know the chain-of-command at your institution ```

Answer 42

good samaritan laws give immunity from liability to healthcare providers when they are giving emergency care provided the person uses reasonable, prudent guidelines for care using the resources they have available at the time of the accident.

Answer 43

Informed Consent: all risks and benefits should be explained. Alternatives should be offered. - -Required competency of the client (mentally intact, legally be an adult, child must have legal custody) - -Must be voluntary (no force) - -Nurse role is not answer questions, but to identify if they have questions/not. Get the physician if they do

Answer 44

Protection of private information Individual has right to privacy HIPAA

Answer 45

- -patient Must understand available options - -Must have opportunity to have all questions answered. - -Nurse signs as witness only (MD explains all to patient/family and answers questions)

Answer 46

Types of advance directives - -Living will - -Durable power of attorney - -Providers orders

Answer 47

Abuse --Nurses must report any suspicion of abuse Communicable diseases - -Report disease diagnoses to state or local health department - -Ensure appropriate medical treatment for disease (TB) - -Monitor for common source outbreaks (foodborne, hep A) - -Plan and evaluate control and prevention plans (immunizations) - -Identify outbreaks and epidemics - -Determine public health priorities based on trends

Answer 48

Interventions that can be used in acute situations, drugs that can be used in the opposite effect, conventional, traditional

Answer 49

Interventions that can be used with conventional medicine interventions People don't always tell physician about these practices--problem

Answer 50

Intervention in coordinated therapies with medicine

Answer 51

Lacking biological practicality, ie essential oils, herbs, wellness (not scientific)

Answer 52

Complementary and Alternative Medicine ``` 1. Complementary Used in conjunction with conventional 2. Alternative Used instead of conventional 3. Traditional More mainstream--like chiropractic, acupuncture, massage therapy 4. Integrative Non mainstream integrated into conventional treatment ```

Answer 53

Alternative healthcare--Allopathy or alternative practices, Alternative practices replace allopathic interventions Complementary health care (US) --Allopathy or complementary health practices, Complementary practices can be joined with allopathic interventions

Answer 54

``` People 30-69 use CAM usually Chronic pain, chronic issues More educated, people use CAM more Higher income = people use CAM more Former smokers use more Adults who were hospitalized in the last year tend to use CAM more frequently CAM used in non-hispanic whites the most 22% hispanic 19% non-hispanic, black ```

Answer 55

Theory and philosophy that focuses on connections and interactions between parts of the whole

Answer 56

Nonvitamin, nonmineral, natural products (17.7%) Deep breathing exercises (10.9%) Yoga (9.5%) Chiropractic or osteopathic manipulation (8.4%) Meditation (8%) Massage (6.9%)

Answer 57

``` Meditation Prayer Mental Healing Music therapy Art therapy Dance therapy ```

Answer 58

``` chiropractic Osteopathy Massage therapy Reflexology Martial arts ```

Answer 59

- -Nursing is expanding its knowledge base - -Certifications in basic holistic nursing - -Patient education is essential - -National Center for Complementary and Integrative Health (NCCIH)

Exam 4: Nutrition, Legal and Ethics, Spirituality, Elimination and Enema, Cultural Diveristy, CAM Flashcards

(83 cards)