Exam 5 Fundamentals Flashcards
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
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)
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
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
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
5 rights of delegation
- Right task
- Right circumstance
- Right person
- Right directions & communication
- Right supervision & evaluation
RNs, NOT LPNs do this
-create a care plan
-assess a pt
-IV meds
Who can do med wasting?
RNs and LPNs
Who can hang a blood bag?
only RNs, not LPNs
can you delegate IV meds?
No! Not to anyone.
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
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
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
how to prevent contractures on stroke pts that have paralysis
passive ROM (nurse moves their arm until they feel resistance)
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
this is an NSAID, anti rheumatic PO med that decreases pain associated w/ inflammation, can lead to bleeding risk, MI, CVA
Celebrex
commitment to do no harm
Nonmaleficence
supporting and defending a pt
Advocacy
Action that promotes good for others without any self interest (expect nothing in return)
Beneficence
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
being truthful, but not stepping beyond the boundaries
veracity
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
This organization was established & wrote the first Code of Ethics for Nursing
American Nurses Association (ANA)
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
- providing clinical ethics consultation
- developing and/or revising policies pertaining to clinical ethics and hospital policy
- 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
- make affordable health insurance available to more people
- Expand the Medicaid Program to cover all adults with income below 138% of the FPL
- 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
