FINAL Flashcards
Antiulcer. To treat GERD and gastric ulcers. Interferes with gastric acid secretion.
Omeprazole
Antiulcer, gastric acid proton pump inhibitor. To treat GERD and erosive esophagitis. Interferes with gastric acid secretion.
Pantoprazole
Antiulcer agent, gastric acid secretion inhibitor. Short-term treatment of duodenal ulcers, benign gastric ulcers, heartburn and indigestion, and GERD. Prevents histamine from binding with H2 receptors on the surface of parietal cells, thus helping to prevent peptic ulcers and to heal existing ones.
Famotidine
Antigout. To treat gout and hyperuricemia, gout attack, prevent uric acid nephropathy, and recurrent calcium oxalate calculi. Inhibits uric acid production.
Allopurinol
Antitussive, opioid analgesic. To treat mild to moderate pain, cough from chemical or mechanical irritation. Prevents the release of pain neurotransmitters, altering perception of and emotional response to pain, acts on opiate receptors in the cough center to suppress cough
Codeine
Analgesic. To manage severe pain in opioid-tolerant patients. Binds to and activates opioid receptors in gray matter, medulla and the spinal cord to produce pain relief.
Hydrocodone
Antipyretic, non-opioid analgesic. To relieve mild to moderate pain, to reduce fever. Interferes with pain impulse generation in the PNS and acts directly on temp regulating center in the hypothalamus.
Antipyretic
Anti-inflammatory, antiplatelet, antipyretic, non-opioid analgesic. Blocks the enzyme needed for prostaglandin synthesis, which cause local vasodilation with swelling and pain.
Aspirin
Laxative, stool softener. To treat constipation. Acts as a surfactant that softens stool by decreasing surface tension between oil and water in feces.
Docusate Sodium
Laxative. To treat constipation. Herbal supplement
Senna
To treat deficiency, rickets, osteomalacia, hypophosphatemia, hypoparathyroidism, intestinal malabsorption.
Vitamin D (Ergocalciferol)
To treat deficiency caused by nutritional intake imbalance or pernicious anemia
Vitamin B-12 (hydroxycobalamin)
Antidepressant, antiobsessant, antipanic. To treat major depression, OCD, panic disorder and premenstrual dysphoric disorder. Inhibits reuptake of the neurotransmitter serotonin by CNS neurons, increasing the amount of serotonin available in nerve synapses.
Sertraline (Zoloft)
Antianginal, antihypertensive, MI prophylaxis and treatment. Inhibits stimulation of beta1 receptor sites, resulting in decreased cardiac excitability, cardiac output, and myocardial oxygen demand, which helps to relieve angina and reduce blood pressure. Given for this patient’s history of MI.
Metoprolol
Antihypertensive, vasodilator. Inhibits conversion of angiotensin I to angiotensin II; decreases release of aldosterone which reduces sodium and water reabsorption and increases their secretion, thus reducing blood pressure. To treat the patient’s hypertension.
Lisinopril
Class III antiarrhythmic. Relaxes vascular smooth muscles and improved myocardial blood flow, relaxes peripheral vascular smooth muscles decreasing peripheral vascular resistance and myocardial oxygen consumption.
Amiodarone
Antihypertensive, diuretic. Inhibits sodium and water reabsorption in the loop of Henle and increases urine formation. Also reduces intracellular and extracellular fluid volume, thus reducing blood pressure and cardiac output.
Furosemide (Lasix)
Used to treat symptoms of hay fever and other allergies.
Loratadine
Expectorant. To relieve cough, especially when secretions are thick, and to promote a productive cough. Increases fluid and mucus removal from the upper respiratory tract by increasing the volume of secretions and reducing their adhesiveness and surface tension.
Guaifenesin
Bronchodilator. To prevent exercise-induced asthma, to treat bronchospasm in pts with reversible obstructive airway disease or acute bronchospastic attack. Relaxes bronchial smooth-muscle cells and inhibits histamine release.
Albuterol
Interacts with verapamil, digoxin, methotrexate, St. John’s wort, and warfarin. Adverse reactions include agitation, dizziness, chest pain, hypertension, hypoglycemia, abd pain, and cough. Give before meals, preferably in the morning. Increases the risk for osteoporosis, monitor for hypomagnesemia, avoid alcohol, aspirin, ibuprofen and foods that increase gastric secretions.
Omeprazole
Interacts with digoxin, diuretics, methotrexate and warfarin. Adverse reactions include anxiety, confusion, chest pain, hyperglycemia, abd pain, bronchitis. Administer delayed-release 30 minute before a meal mixed in apple juice or applesauce, if given through an NG tube mix in apple juice ONLY. Monitor PT, INR and indication of C. diff infection. Monitor for hypomagnesemia, can expect relief within 2 weeks of starting therapy.
Pantoprazole
Interacts with antacids, bone marrow depressants. Adverse reactions include anxiety, confusion, arrhythmias, palpitations, dry mouth, abd pain, decreased libido, bronchospasm, acne. Shake oral suspension vigorously for 5 – 10 seconds before administration, Wait 30 – 60 minutes after taking famotidine before taking an antacid, avoid alcohol and smoking.
Famotidine
Interacts with ACE inhibitors, thiazide diuretics, vitamin C. Adverse reactions include chills, drowsiness, vasculitis, abd pain, exacerbated renal calculi, and alopecia. Obtain baseline CBC and uric acid level and renal and liver function tests before and during therapy, don’t give vitamin C, drink at least 10 large glasses of water daily, results for prevention of acute gout attacks may take up to 2 weeks or longer.
Allopurinol
Interacts with anticholinergics, antihypertensives, CNS depressants, MAO inhibitors, other opioids. Adverse reactions include coma, depression, bradycardia, altered taste, abd pain, muscle rigidity, apnea, decreased libido. Should not be given to children following tonsillectomy and/or adenoidectomy, Monitor respirations, assess for urinary retention, can take with food.
Codeine
Contraindicated with bronchial asthma or hypercarbia, significant respiratory depression. Interacts with anticholinergics, CNS depressants, mixed agonist/antagonist analgesics. Adverse reactions include anxiety, hypercholesterolemia, dry mouth, hot flashes, abd pain, respiratory depression, UTI, dehydration. Use caution in pts with COPD, the elderly, debilitated patients, do not administer to a pt wearing a transdermal fentanyl patch until it has been removed for 18 hours. Monitor for respiratory depression, constipation, expect to taper dosage every 2 – 4 days, monitor vitals closely, encourage plenty of high-fiber foods.
Hydrocodone
Contraindicated with severe hepatic impairment, severe active liver disease. Interacts with anticholinergics, barbiturates, oral contraceptives, warfarin, alcohol. Adverse reactions include abdominal pain, hepatotoxicity, hemolytic anemia, anaphylaxis. Tablets may be crushed or swallowed whole, serious skin reactions may occur, though rare.
Acetaminophen
Contraindicated in patients with peptic ulcer disease. Interacts with ACE inhibitors, NSAIDs and anticoagulants. Adverse reactions include confusion tinnitus, GI bleeding. Administer with food or after meals to minimize GI upset. Monitor for bleeding.
Aspirin
Contraindicated for fecal impaction, intestinal obstruction, nausea, vomiting or other symptoms of appendicitis, undiagnosed abdominal pain. Interacts with mineral oil and tetracycline. Adverse reactions include dizziness, syncope, palpitations, abdominal cramps and distention, and muscle weakness. Patients should expect long-term use. Administer with a full glass of water or milk.
Docusate Sodium
Contraindicated with Crohn’s disease, ulcerative colitis, heart disease, stomach pain, nausea, vomiting. Do not take if pregnant or breast feeding, effects are unknown.
Senna
Rotate sites for IM and SQ injections, avoid rapid administration to prevent fainting or dizziness when administering IV, incompatible with many drugs, protect from air and light.
VItamin C
Will decompose in light
VItamin D
Incompatible with many drugs, subQ should be injected deeply, protect from light.
Vitamin B12
Interacts with antipsychotics, aspirin, NSAIDs, warfarin, MAO inhibitors, tricyclic antidepressants. Adverse reactions include abnormal dreams, agitation, atrial arrhythmias, hyperglycemia, abdominal cramps or pain, acute renal failure, bronchospasm, coughing, diaphoresis. Monitor for serotonin syndrome (agitation, hallucinations, coma, tachycardia, labile blood pressure, hyperthermia, nausea, vomiting, diarrhea, incoordination). Monitor for mania and suicidal tendencies. Dilute oral concentrate before taking, and take immediately after mixing.
Sertraline
Contraindicated in acute heart failure, pulse less than 45 bpm, cardiogenic shock. Interacts with calcium channel blockers, antiarrhythmics, antidepressants, estrogens, insulin, and all foods. Adverse reactions include anxiety, angina, arrhythmias, blurred vision, constipation. Use caution in patients with CHF, monitor glucose and heart rhythm/rate, notify prescriber if pulse rate falls below 60 bpm.
Metoprolol
Contraindicated in patients with diabetes or renal impairment. Interacts with diuretics, insulin, NSAIDs, high potassium diet. Adverse reactions include ataxia, confusion, arrhythmias, chest pain, altered glucose levels, abdominal pain, renal failure, bronchospasm. Use caution in patients with fluid volume deficit, heart failure, impaired renal function, or sodium depletion. Monitor for persistent nonproductive cough.
Lisinopril
Incompatible with heparin. Contraindicated in bradycardia that causes syncope (unless pacemaker is present), cardiogenic shock, hypokalemia, hypomagnesemia, SA node dysfunction, second- and third- degree AV block (unless pacemaker is present). Interacts with anticoagulants, beta blockers, calcium channel blockers, St. john’s wort, digoxin, fentanyl, lidocaine, warfarin, grapefruit juice. Adverse reactions include ataxia, confusion, arrhythmias, abd pain, acute renal failure, muscle weakness, acute respiratory distress syndrome. If pt has an implantable cardiac device, monitor because drug can affect pacing or defibrillating thresholds, may cause phlebitis are higher rates, monitor continuous EKG, may cause or worsen pulmonary disorders that develop after therapy.
Amiodarone
Incompatible with highly acidic solutions. Interacts with ACE inhibitors, digoxin, insulin, NSAIDs, norepinephrine, thiazide diuretics. Adverse reactions include dizziness, drowsiness, arrhythmias, blurred vision, hyperglycemia, abd cramps, muscle pain or spasms. Use caution in pts with advanced hepatic cirrhosis, allergy to sulfonamides, give in the a.m., monitor weight, blood pressure, and lab values, take at same time each day, pt should eat more high-potassium foods.
Furosemide
Can be taken with or without food. Do not use to treat hives that are bruised or blistered, that are an unusual color, or that do not itch.
Loratadine
Adverse reactions include dizziness, headache, nausea and vomiting, rash. Take each dose with a full glass of water, increase fluid intake to help thin secretions unless contraindicated, do not take longer than 1 week and notify prescriber about fever, persistent headache, or rash.
Guaifenesin
Interacts with beta blockers, bronchodilators, digoxin, MAO inhibitors, potassium-wasting diuretics. Adverse reactions include anxiety, drowsiness, angina, arrhythmias, altered taste, hyperglycemia, UTI, muscle cramps. Administer inhalations during second half of administration. Use caution in pts with cardiac disorders, diabetes, digitalis intoxication, hypertension, hyperthyroidism, or history of seizures. Shake inhaler before use and spray 1 – 4 times into the air before use, wash mouthpiece once a week and let air dry, wait at least 1 minute between
Albuterol
- an additional substance, treatment, or procedure used for increasing the efficacy or safety of the primary substance, treatment, or procedure or for facilitating its performance
Adjunct Analgesic
- an effect wherein two or more substances or actions used in combination produce a total effect, the same as the arithmetic sum of the individual effects.
Additive Effect
the interaction of elements that when combined produce a total effect that is greater than the sum of the individual elements, contributions
synergistic effect
when their interaction causes a decrease in the effects of one or both of the drugs. Both synergy and antagonism can both occur during different
Antagonistic effect
Erikson’s stage for middle adulthood (35-65)
Generativity vs. Stagnation
Erikson’s stage:
Changes in physical state: Menopause, andropause
Focus on family, work, aging parents (Sandwich Generation)
Health Concerns: Health screening (mammograms, PSA), stress reduction, healthy lifestyle strategies, adjustment to life transitions
Generativity vs. Stagnation ( middle adulthood)
Erikson’s stage for older adults (65+)
Ego integrity vs. Despair
Erikson’s stage:
Ageism: a concern for nurses
Aging is a normal, healthy process that begins at birth
System-wide physical changes
Cognitive changes due to illness not aging
Numerous lifestyle changes
Goals:
Remain independent, accept aging, transitions, and loss.
Strategies:
Reminiscence/life review (Storytelling)
Exercise, nutrition, sensory stimulation
Health Concerns: Chronic illness, medications, depression, ETOH abuse, elder abuse
Ego integrity vs. despair
age 55-75
young old
75-84
middle old
85 +
very old/frail old
acknowledging the person’s feelings/emotions and responding
validation
- Modifications include simplification, measurable reductions in complexity of grammar and vocabulary, and clarification strategies, which include adding repetitions and stressing and altering the pitch of one’s speech, resulting in speech that is overly caring and controlling and less respectful than normal adult-to-adult speech. Similar to baby talk.
Elderspeak
After providing health information, nurses should have patients repeat back to them what information they have received. This is an easy and effective method to assess comprehension of health teaching.
teach back
respectfully puts the person before the disability
person-first language
Often say many words that don’t make sense.
May fail to realize they are saying the wrong words; for instance, they might call a fork a “gleeble.”
May string together a series of meaningless words that sound like a sentence but don’t make sense.
Have challenges because our dictionary of words is shelved in a similar region of the left hemisphere, near the area used for understanding words.
Wernicke’s aphasia (receptive)
When a stroke injures the frontal regions of the left hemisphere, different kinds of language problems can occur. This part of the brain is important for putting words together to form complete sentences. Injury to the left frontal area can lead to what
Broca’s aphasia (expressive)
Can have great difficulty forming complete sentences.
May get out some basic words to get their message across, but leave out words like “is” or “the.”
Often say something that doesn’t resemble a sentence.
Can have trouble understanding sentences.
Can make mistakes in following directions like “left, right, under, and after.”
“Car…bump…boom!” This is not a complete sentence, but it certainly expresses an important idea. Sometimes these individuals will say a word that is close to what they intend, but not the exact word; for example they may say “car” when they mean “truck.”
Broca’s aphasia (expressive)
When a stroke affects an extensive portion of the front and back regions of the left hemisphere
Global Aphasia
May have great difficulty in understanding words and sentences.
May have great difficulty in forming words and sentences.
May understand some words.
Get out a few words at a time.
Have severe difficulties that prevent them from effectively communicating.
Global Aphasia
a rare disorder where people slowly lose their ability to talk, read, write, and comprehend what they hear in conversation over a period of time.
Primary progressive aphasia
the person has word-finding difficulties
anomic aphasia
the most common form of urinary incontinence, and mainly affects women. Occurs from a laugh, sneeze, cough, or heavy lifting puts added strain on the bladder, causing urine to leak.
stress incontinence
occurs when the need to urinate comes on so quickly that you might fail to make it to the bathroom in time. Also known as overactive bladder or spastic bladder, this sudden need to urinate can be intense and frequent.The amount of urine in the bladder does not matter
Urge urinary incontinence
The nerves communicate a need to urinate, and the ability to inhibit this urge is compromised. The bladder spasms on its own and pushes the urine out. . It can be caused by diabetes or a urinary tract infection, or by a nerve-affecting disorder like stroke,
urge urinary incontinence
the opposite of urge incontinence. The urge to urinate isn’t felt, but the bladder begins uncontrollably leaking small amounts of urine anyway. The bladder is too full, and the urine is escaping to relieve pressure.
overflow urinary incontinence
incontinence that occurs most often in men
overflow urinary incontinence
can be caused by a tumor or an enlarged prostate gland blocking the flow of urine, preventing the bladder from ever emptying completely. Diabetes, spinal cord injuries, and medications also can cause this type of incontinence
overflow urinary incontinence
incontinence affected by your inability to make it to the bathroom in time
functional urinary incontinence
combination of incontinence problems, most often stress urinary incontinence and urge incontinence.
mixed incontinence
variation on urge incontinence in which you feel no need to urinate but urine is lost when your bladder begins to contract uncontrollably.
reflex incontinence
urinary incontinence caused by an easily cured problem such as a urinary tract infection, constipation, excess fluid intake, or medications.
temporary urinary incontinence
complete loss of bladder control, usually due to fistula — an abnormal connection between the skin and urinary tract.
total incontinence
For ____ recommendations include:
o Pelvic floor exercises. If you’ve had a baby, chances are you’ve been told to do Kegel exercises. These help to strengthen the pelvic floor after childbirth. They also help prevent stress incontinence.
o Injections and surgery. Shots to bulk up your urethral area may help. In more extreme cases, you may need surgery. One procedure pulls the bladder back up to a more normal position, relieving the pressure and leakage. Another surgery involves securing the bladder with a “sling,” a piece of material that holds up the bladder to prevent leakage.
o Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you’re urinating only every two to four hours.
o Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
o Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
o Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem
stress incontinence
For ____ treatments include:
Timed voiding and bladder training. First, you complete a chart of the times you pee and the times you leak. You observe patterns and then plan to empty your bladder before an accident would happen. You can also “retrain” your bladder, gradually increasing the time between bathroom visits. Kegel exercises are also helpful
urge incontinence
Medications used in urinary incontinence:
anticholinergics, alpha blockers, topical estrogen
surgical procedures used in urinary incontinence:
sling procedures, bladder neck suspension, prolapse surgery, artificial urinary sphincter
Strips of your body’s tissue, synthetic material or mesh are used to create a pelvic sling around your urethra and the area of thickened muscle where the bladder connects to the urethra (bladder neck). The sling helps keep the urethra closed, especially when you cough or sneeze. This procedure is used to treat stress incontinence.
sling procedure
This procedure is designed to provide support to your urethra and bladder neck — an area of thickened muscle where the bladder connects to the urethra. It involves an abdominal incision, so it’s done during general or spinal anesthesia.
bladder neck suspension
In women with mixed incontinence and pelvic organ prolapse, surgery may include a combination of a sling procedure and prolapse surgery.
prolapse surgery
In men, a small, fluid-filled ring is implanted around the bladder neck to keep the urinary sphincter shut until you’re ready to urinate. To urinate, you press a valve implanted under your skin that causes the ring to deflate and allows urine from your bladder to flow. Artificial urinary sphincters are particularly helpful for men whose incontinence is associated with treatment of prostate cancer or an enlarged prostate gland.
Artificial urinary sphincter.
activities designed to completely prevent a disease from occurring, such as immunization against pneumonia or influenza
primary prevention
efforts are directed toward early detection and management of the disease, such as the use of colonoscopy to detect small cancerous polyps.
secondary prevention
efforts are used to manage clinical diseases in order to prevent them from progressing or to avoid complications of the disease, as is done when beta-blockers are used to help remodel the heart in congestive heart failure
tertiary prevention
Level of health screening recommendation where There is high certainty that the net benefit is substantial based on rigorous experimental research with results that are consistent.
Level A
Level of health screening recommendation where May be provided to selected patients on an individual basis depending on the situation. Individuals without signs and symptoms would only receive a small benefit from this level of service.
Level C
Level of health screening recommendation where There is high certainty that the net benefit is moderate or that there is moderate certainty that the net benefit is moderate or substantial.
Level B
level of health screening recommendation where There is moderate or high certainty that the service has no net benefit or that the risks outweigh the benefits
Level D
Level of health screening where There is a lack of supporting evidence, poor quality, and the balance of the risk and benefits cannot be determined.
Level I
Provides three types of health protection
1) Health insurance for low-income families and people with disabilities
2) Long-term care for older Americans and persons with disabilities
3) Supplemental coverage for low-income Medicare beneficiaries for services not covered by Medicare such as glasses, hearing aids, or prescription drugs
o Federal funding for Medicaid comes from the general revenues; there is no trust fund set up for Medicaid as there is for Medicare. The state Medicaid office directly pays the doctor, hospital, nursing home, or other healthcare provider.
Medicaid
An insurance program for those 65 or over who have paid into the Social Security system, the railroad fund, or are diagnosed with end-stage renal disease. Also covers hospice care for those patients who have been certified by the physician as having 6 months or less to live, so long as the care is provided by a Medicare-certified hospice agency. Covers home care provided by a Medicare-certified agency. Hospice and home care services have criteria that must be met for reimbursement.
Medicare
Portion of Medicare that helps to cover inpatient hospital care, inpatient care in a skilled nursing facility (for transitional care), hospice care, and some home healthcare services. It is available without charge for those who are eligible to receive Social Security or Railroad Retirement benefits.
Part A
Portion of Medicare that is Supplemental Medical Insurance” is considered medical insurance. It covers some of the cost for laboratory services, home healthcare services, doctor services, some outpatient therapies, mental health services, and outpatient hospital services.
Part B
Portion of Medicare that is considered “Medicare Advantage” offers managed care plans like health maintenance organizations and preferred provider organizations. Provides all of the benefits of the hospital and medical insurance plans under original Medicare, but can charge different copays and deductibles.
Part C
Portion of Medicare that is the Medicare prescription option, and it offers multiple plans from which the beneficiary can choose. Each plan identifies the prescription medication it covers as well as the pharmacies, premium, deductible, and copayment. The beneficiary must select the plan that covers most of the medications prescribed as well as determine whether to choose a higher premium of higher deductible
Part D
Once a beneficiary has spent a certain amount of money during a year, all medication costs are out of pocket until the beneficiary is eligible for catastrophic coverage.
Doughnut Hole
a syndrome that occurs relatively acutely and is often call acute confusion unlike dementia. Typically develops over a period of hours or days and is caused by some other underlying medical problem. Can present with a hyperalert state (in which ther person attends to all environmental stimuli simultaneously), hypoactive state (in which the patient seemingly retreats into inner thoughts and experiences that are abnormal), or mixed presentation.
Delirium
4 Basic Features of Delirium
1) Acute onset or fluctuating course
2) Inattention
3) Disorganized thinking
4) Altered level of consciousness
* a diagnosis of delirium is made if both features 1 & 2 are present along with either of features 3 or 4
Primary treatment for delirium is:
finding the etiology and treating the source
Secondary interventions for delirium are:
treating symptoms, ensuring comfort
a general term that refers to progressive, degenerative brain dysfunction, including deterioration in memory, concentration, language skills, visuospatial skills, and reasoning, that interferes with a person’s daily functioning. It is not considered a normal part of aging. Most common type is Alzheimer’s disease.
Dementia
Risk factors for dementia:
age, family history, genetic factors, head trauma, vascular disease, infections
Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area. The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue.
stage 1 pressure ulcer
Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled or sero-sanginous filled blister. Presents as a shiny or dry shallow ulcer without slough or bruising*. This category should not be used to describe skin tears, tape burns, incontinence associated dermatitis, maceration or excoriation.
stage 2 pressure ulcer
Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling. The depth of a Category/Stage III pressure ulcer varies by anatomical location.
stage 3 pressure ulcer
Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present. Often includes undermining and tunneling.
stage 4 pressure ulcer
can extend into muscle and/or supporting structures (e.g., fascia, tendon or joint capsule) making osteomyelitis or osteitis likely to occur. Exposed bone/muscle is visible or directly palpable.
stage 4 pressure ulcer
Full thickness tissue loss in which actual depth of the ulcer is completely obscured by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed. Until enough slough and/or eschar are removed to expose the base of the wound, the true depth cannot be determined;
unstageable pressure ulcer
Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue.
suspected deep tissue injury
a federal law that requires healthcare providers to routinely provide information about advanced directives
patient self-determination act
help identify a person’s personal wishes in a legal manner & to share information with people around them.
advanced directives
Durable power of attorney, living will, DNR and life-prolonging procedures declarations are _____
legal documents
there are five wishes, AND (allow natural death), and physicians orders for life sustaining treatment (POLST) that are options for stating end-of life wishes but are _____
not legal documents
patient is able to provide specific instructions in 5 categories
1) A durable power of attorney for healthcare: the person chosen to make decisions when the individual can no longer make them for himself or herself
2) A living will: the kind of treatment the person wants or doesn’t want
3) How comfortable the patient wants to be
4) How the person wants to be treated by others
5) What the person wants his or her loved ones to know.
Five wishes
Focuses on allowing death as nature take its course at the end of illness. AND provides comfort measures so that even when the withdrawal of artificial nutrition or hydration occurs the dying process would occur as comfortable as possible.
allow natural death
Designed to instruct emergency personnel on what actions to take when the patient is still at home-before emergency treatment is given. It has segments concerning CPR, Medical Interventions, antibiotics, and artificially administered nutrition.
physicians orders for life sustaining treatment
