Exam 5 Fundamentals Flashcards by Emma Ware

resources for smoking cessation

-Refer pts to the American Lung Association (www.lung.org) which has “Freedom from Smoking” section .. provides encouragement & ideas on how/why to stop

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how to assess pt w/ chronic disease

-collect their hx
-let pts tell stories
-ask open ended questions
-assess their adherence (do they stick to their meds, diet, exercise plan etc)

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public policies w/ health

-no smoking areas (prevents workers/visitors from secondhand smoke)

-use knowledge/skills to promote health through pt education

-encourage screenings

-review publications & websites from reputable organizations about current policies

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chronic disease vs. acute disease

chronic disease - lasts more than 1 year, requires ongoing medical care, usually limits a person’s daily living

acute disease - sudden, short, very treatable

**Chronic illness: Pts family and subjective experience in response to the disease

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triggers of chronic disease

-genetic mutations, fam hx

-environmental factors (exposure, pesticides, contaminated water, asbestos, mold, heavy metals, food contamination)

-smoking

-poor nutrition

-excessive alcohol

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5 rights of delegation

Right task
Right circumstance
Right person
Right directions & communication
Right supervision & evaluation

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RNs, NOT LPNs do this

-create a care plan
-assess a pt
-IV meds

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Who can do med wasting?

RNs and LPNs

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Who can hang a blood bag?

only RNs, not LPNs

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can you delegate IV meds?

No! Not to anyone.

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How to resolve an ethical dilemma

ask if this an ethical problem
gather info relevant to case. pt, family, health care agency, social perspectives are important sources
identify ethical elements, distinguish facts, opinions, values
name the problem
identify possible courses of action, access others for input and be creative
create & implement action plan
evaluate the plan

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what do you do if a pt starts to fall

help lower them to the ground, use a wide stance w/ 1 foot in front of other and in between pt’s legs

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how to use a cane?
the cane should be on which side of the body (stronger or weaker side?) and what leg goes first

cane is held on the stronger side of body, place it 6-10 inches in front of you, move weaker leg forward first to cane & then stronger leg goes past the cane

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how to prevent contractures on stroke pts that have paralysis

passive ROM (nurse moves their arm until they feel resistance)

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important thing to asses for paralyzed stroke pt

skin! Use Braden score (the lower the score, the higher the risk!) over 18 is no risk

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this is an NSAID, anti rheumatic PO med that decreases pain associated w/ inflammation, can lead to bleeding risk, MI, CVA

Celebrex

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commitment to do no harm

Nonmaleficence

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supporting and defending a pt

Advocacy

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Action that promotes good for others without any self interest (expect nothing in return)

Beneficence

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honoring your promises, being true. Do what you say you’re gonna do (pt asks for a blanket and you come back with a blanket/don’t forget about it)

fidelity

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being truthful, but not stepping beyond the boundaries

veracity

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freedom from external control, providing adequate information to allow patients to make their own decisions based on their beliefs and values, even if they aren’t the ones the nurse chooses

autonomy

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This organization was established & wrote the first Code of Ethics for Nursing

American Nurses Association (ANA)

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A set of guiding principles that all members of a profession accept and provides a foundation for professional nursing

Code of Ethics

Unethical term used for nurses and taking responsibility for their action

accountability

refers to fairness and distribution of resources

justice

most hospitals have this to devote to teaching and processing of ethical issues & dilemmas. it involves ppl from different disciplines and backgrounds

Ethics committees

3 major functions of ethics committees

1. providing clinical ethics consultation 2. developing and/or revising policies pertaining to clinical ethics and hospital policy 3. facilitating education about topical issues in clinical ethics

this was passed in 2010 to create regulation that control costs & improve the availability of insurance **facilitated healthcare for millions of uninsured Americans

Affordable Care Act (ACA)

3 goals of the law ACA aka Affordable Care Act

1. make affordable health insurance available to more people 2. Expand the Medicaid Program to cover all adults with income below 138% of the FPL 3. Support innovative medical care delivery methods designed to lower the costs of health care generally.

how does age affect mobility

-decrease in bone mass -weaker bones (increase risk of fractures) -decrease in balance -decrease in coordination

isotonic vs isometric exercises

isotonic - body moves aka walking, biking, running (concentric tension aka shortening of muscle and eccentric tension aka lengthening of muscle) isometric - stabilizing, body holds stable position, does not move, ex: planking (isometric contraction aka increase in muscle tension)

type of exercise that causes the body to move

isotonic

type of exercise that causes the body to hold a stable position

isometric

anti-rheumatic injection med that is an immunosuppressive drug that decreases pain, inflammation of joints, better ROM

Adalimumab (Humira)

this will prevent deep vein thrombosis (DVT)

encouraging ROM

treatment of DVT

anticoagulants, thrombolytics, filters, support stockings, deflate on pillow *do NOT massage or apply heat

this is an anti rheumatic injection med that decreases inflammation SE- anemia, injection site rx, cough

Etanercept (Enbrel)

anticoagulant PO med that prevents blood clots SE- bleeding

Warfarin (Coumadin)

far sighted (can see at distance, but not up close)

hyperopia

near sightedness (can see up close, but not far)

myopia

can't focus on objects that are close (farsightedness) except not due to aging. this is people who need bifocals.

presbyopia

cloudy lens, light that enters the eye is blocked wear sunglasses to prevent this!

cataracts

too much pressure in eyes, can lead to blindness if not treated

glaucoma

leakage/blockage of retina blood vessels which can lead to hemorrhages and cause blindness

diabetic retinopathy

loss of central vision, deteriorates center of retina, usually have peripheral vision so can't drive

macular degeneration

type of hearing loss due to obstruction like wax or ear infection (temporary)

conductive hearing loss

type of hearing loss due to loud noises or ototoxic meds (permanent)

sensioneural hearing loss

what to do w/ ppl w/ sensory deficits

provide large print audio books music increase touch encourage family to bring pets, flowers, pictures

what to do w/ ppl w/ sensory overload

minimize overall stimualtion get private room limit visitors move away from nurses station cluster care! reduce light and noises

how to talk to someone w/ hearing loss

face them, let them see your lips encourage hearing aids speak slowly, clearly lower pitch, do NOT increase volume write it down minimize background noise

these are medications aka eye drop for glaucoma (it decreases intraocular pressure)

dorzolamide (Trusopt) latanoprost (Xalatan)

most important post op role of nurse if pt has sleep apnea

monitor oxygen!

complications of general anesthesia

aspiration cardiac irregularities hypotension hypothermia hypoxemia hyperthermia resp depression

a pt should be peeing AT LEAST how much per hr

at least 30mL per hr

this medication is a sedative/hypnotic that depresses subcortical levels in CNS... used for sedation for procedures

Midazolam (Versed) *SE = Allergic reactions, CNS depression aka slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, trouble staying awake.

these meds are anticholinergic that decreases secretions before anesthesia

Atropine & Glycopyrrolate (Robinul)

this med is a neuromuscular blocking agent , used for paralysis of skeletal muscles

succinylcholine

pt hugs pillow, helps protect incision and helps w/ pain when you move, cough, sneeze etc

splinting

why is I&O important

-tells us kidney function -if pt is hydrated -fluid balance/electrolyte -can indication hemorrhage