final Flashcards by britt rank

Ethics equals ________ – customs, conduct or character can be used interchangeably

morality

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_______ is discovering what is right or wrong/good or bad

Respect, love, and Freedom are some moral concepts

inspire rules of action

Morality

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______ arose from advances in medicine and technology

Life/death issues

Advance directives

Organ donation

Genetics

Futile Care-

Bioethics

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interventions unlikely to produce benefits for the client

Futile Care

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: Does the advancement improve or maintain according to pt and family

Quality of life

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Access to care, gov. funding for prevention & Health Promotion; curative care, end-of-life care.

Allocation of resources:

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Ensures good action… actions that we ought to take according to society at large

Normative theory..

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do not tell us what actions to take, they tell us how people act toward each other and their environment, what they seem to believe are good or moral actions

Descriptive theories

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represents a view point on moral problems in healthcare and other areas of life that have been neglected historically

Feminist ethics

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Greatest good for greatest number (Immunizations, seat belt laws)

Consequentialism:

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adherence to duty rather than on good consequences. Act so that you treat humanity – both in your own person and in that of another.

Duty Based:

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Decision making in health care settings has inseparable moral components

Identify the main problem or issue… social, group or individual..is it a justice issue or autonomy issue

Determine who or what created the problem.. Who has stake in the issue

Determine the prevalent values.. What are the teams individual values, do they conflict?… The values of the individual who is most likely to be a affected by a decision is weighted more heavily

Identify information gaps… interview, medical records current research

Formulate a possible course of action and probable consequences… least harmful and most benefical

Initiate the course of action

Self reflection/group reflection

Ethics Committee

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the right to determine what treatments or interventions they will accept: freedom of choice/self governing EXCEPTION situation in which there is a high risk of injury or death and it cannot be determined if patients judgment is impaired

Self Determination-

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ensuring patient has all appropriate information necessary to come to a decision about treatment/procedures.. Risk/benefit

Informed Consent:

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Proxy Decision Making/medical power of attorney

Advanced Directive:

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– patient has a right to decide who will have access to their medical information

HIPPA (Health Insurance Portability Act) Will discuss later

Confidentiality

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: maintain adolescents autonomy and confidentiality needs while mediating between the adolescent and parent who feel they have a right to know

Mandatory reporting laws

Adolescent Confidentiality

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: patients are given true and accurate information about their healthcare #1 trusted profession

Veracity

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: doing good or producing good, to benefit others/action to promote the welfare of others (mercey, kindness, charity)

Beneficence

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9 Provisions in all.

Code of ethics guides nurses’ practice.

Treat all with dignity

Nurses’ have primary obligation to patient (family, community)

Promote and Advocate for health, safety, and patients’ rights

Accountable for individual practice – including delegating tasks appropriately

Nurses owe themselves the same moral duties as we owe to others; accountable for continuing education and maintaining competency; to preserve integrity and safety means to disclose errors, or repeated issues with inadequate staffing; never falsify records nor tolerate verbal abuse from any health care workers.

Maintain/improve moral environment and work with others to create environment of safety and quality pt. care.

Shared government, committed to leadership and mentoring

Nurses collaborate with other professionals – locally, nationally, and globally

We are responsible for maintaining integriy for profession and shaping social policies; be involved in social reform and shaping social policies for vulnerable populations

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: threatens to give an injection or restrain; fear that will be touched without permission

Assault

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chemical, physical (side rails, restraints)

False Imprisonment:

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Touches patient without consent, forces meals, meds

Battery:

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Wrong that involves breach of civil duty

Torts:

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: willful act that violates another’s rights Assault, battery, false imprisonment

Intentional torts

Invasion of privacy Defamation of character

Quasi-intentional torts

The doing of something which a reasonably prudent person would not do, or the failure to do something which a reasonably prudent person would do, under circumstances similar to those shown by the evidence.

Negligence:

– not knowing how to use equipment, monitors, pumps, failure to document progress, response to treatment or situation – Resulting in Injury. ** Falls, Medication Errors

Malpractice usually unintentional

Promote breast-feeding for at least 4 months. Used worldwide. Must have: written breast feeding policy, train staff on skills needed, inform all women about benefits and management of breastfeeding, Help mothers initiate breast feeding shortly after birth; give no food/drink to newborns unless medically indicated, No pacifiers, allow mothers to feed on demand; give mothers resources for after discharge.

Baby-Friendly Hospital Initiative

: Normally healthy people can develop by Close skin-to-skin contact, cuts or abrasions in skin, crowed conditions, sharing personal items (towels, athletic gear); Usually infected area on skin resembles a red, swollen & painful area; requires culture.

MRSA- CA

Most severe cases lead to pneumonia and mortality rate of 20-25% . Diagnosis through culture from infection site; Antibiotic therapy/sensitivity testing More people Traveling worldwide– important to know exists

MRSA- CA

Transmitted by Mosquitos and through sex from a person with disease (No sex or condoms); Can cause fever, skin rash, joint pain, fatigue and red eyes; Avoid Aspirin; ibuprofen; usually mild and lasts less than a week. **May cause birth defects: Microcephaly

Zika Virus:

Outbreak in 2002-2003; 8,098 infected; 774 died; :fever, headache, body aches, dry cough followed by pneumonia ; can be spread by kissing, hugging, sharing eating/drinking utensils, also touching objects with infectious droplets and then touching mouth, nose or eye. Mostly seen in China, Hong Kong, Taiwan, Vietnam, Singapore.; Meticulous hand washing

SARS:

40 million infected worldwide, Higher prevalence in developing countries; Sub-Saharan Africa particularly hard-hit;

HIV/AIDS:

__________ violence—by individual/small group Factors include: victim’s low self-esteem, lack of social support, family history of violence, drug/alcohol abuse, culture and gender inequality

Interpersonal

________ violence—armed conflict

Collective

Middle Age Adult ______-______ Years of Age

35 – 65

Erikson’s Stage of Psychological Development Expand personal & social involvement (parenting, community service, etc…) If unable to play a role in future generations … stagnation occurs

Generativity versus stagnation

``` General characteristics Parents Children Job stability Nearing retirement ``` Sandwich generation

The Middle Aged Adult

age gruoup where Health Concerns – Heart disease, cancer, CVA, breast and colorectal cancer

middle age

Psychosocial Factors for what age group ``` Family relationships Career, hobbies, and leisure time Values clarification Facing one’s mortality Many Transitions Planning for retirement ```

middle age

middle aged individuals need __-__ hours of sleep

6-8 hours

Intellectual ability Perceptual changes

Cognitive-Perceptual Pattern

Fecal occult blood and colonoscopy Digital rectal exam Prostate specific antigen (PSA) Alcohol/substance use BP, Chol,Ht,Wt Vision and hearing assesment for a _____ age ______ sex

middle aged man

Mammography, clinical breast exam, and SBE Fecal occult blood and colonoscopy Pap smear Alcohol/substance use BP, Chol,Ht,Wt Vision and hearing assesment for a _____ age ______ sex

middle aged female

: Thinning of bone tissue and loss of bone density over time

Osteoporosis

The Older Adult ____ Years and Older

Erikson’s last of eight stages

Ego integrity versus despair

these are Gordon’s Functional Health Patterns for what age group ``` Health-perception–health-management pattern Nutritional-metabolic pattern Elimination pattern Activity-exercise pattern Sleep-rest pattern Cognitive-perceptual pattern Self-perception–self-concept pattern Roles-relationships pattern Sexuality-reproductive pattern Coping–stress tolerance pattern Values-beliefs pattern ```

older adult

Mild cognitive impairment Memory loss Language difficulties Impaired judgment/reasoning

Cognitive-Perceptual Pattern for older adults

these are Gordon’s Functional Health Patterns for what age group Vision Decreased visual acuity, color discrimination, peripheral vision; cataracts/glaucoma ``` Taste/smell Loss of taste buds Decreased acuity of olfactory nerve Changes result in large amount of salt/sugar in food Food safety issues Dental health ``` Hearing Inner-ear atrophy, cell degeneration

older adults

``` Loss of former roles New roles Retirement Influences Challenges Resources ```

Roles-Relationships Pattern for older adults

Ability to cope Losses of family, friends Depression Suicide

Coping–Stress Tolerance Pattern for older adults

4 Safety Concerns for the Older Adult

Safety at home medication safety driving safety elder abuse

THE PRESCHOOL-AGED CHILD (___-___ Years of Age)

3 – 6

Erikson’s Stages Psychological Development Assisting parents to encourage achievement of task

Initiative versus Guilt

these are Healthy People Goals for what age group INCREASE Proportion of children who have a specific source of ongoing care ``` Proportion of children who view television to <2hr/day # ≤ 5 y/o who receive vision & hearing screening. ``` REDUCE Proportion of children with dental caries Hospitalization rates for pediatric asthma The rate of death Cases of otitis media Indoor allergen levels ELIMINATE Blood lead levels >10mcg/dL

PRESCHOOL-AGED CHILD

these are Age and Physical Changes for what age group Weight gain approx 4lbs/year Selected system changes Finish primary teeth eruption; start secondary teeth eruption

PRESCHOOL-AGED CHILD

Most common genetic issues Cystic fibrosis, Duchenne muscular dystrophy, fragile X syndrome, Williams syndrome for what age group?

PRESCHOOL-AGED CHILD

Body concepts Curious about opposite sex View body as hollow Health beliefs and health management Pain/illness – viewed as punishment Health promotion

Health-Perception Health-Maintenance Pattern for PRESCHOOL-AGED CHILD

these are Roles-Relationships Pattern for what age group Expanding influences Social interaction Parental divorce Child abuse

PRESCHOOL-AGED CHILD

these are Sexuality-Reproductive Pattern for what age group Gender identification Body image Curiosity about bodies/sexual functioning

PRESCHOOL-AGED CHILD

these are Coping–Stress Tolerance Pattern for what age group Play Coping Set game rules

PRESCHOOL-AGED CHILD

these are Values-Beliefs Pattern for what age group Modeling Preschool typical behavior Death

PRESCHOOL-AGED CHILD

examines verbal intelligence and ability Draw a person..should draw at least 6 body parts Draw a family…should be less detailed but each family member should have a certain characteristic from the childs perspective and the child names each person. Screen for autism spectrum

Peabody Picture Vocabulary Test

this is a tool that screens for developmental delays or abnormalities that might interfere with academic or social success in school.

Preschool Readiness Experimental Screening Scale (PRESS)

tests the interaction between the teacher and the students.

Classroom Assessment Scoring System (CLASS)

these are Health Concerns for what age group ``` Anemia Cancer Retinoblastoma (eye) Leukemia Wilm’s Tumor (kidney) Neuroblastoma (nerve tissue) Asthma ```

PRESCHOOL-AGED CHILD

THE SCHOOL-AGED CHILD (___-__ Years of Age)

5 – 12

Erikson’s Stage of Psychological Development where Assisting parents to encourage achievement of task

Industry versus Inferiority

these are healthy people goals of what age group REDUCE Childhood deaths Vaccine preventable disease Untreated dental caries Proportion of children and adolescents ages 6 to 11 years who are overweight or obese Proportion regularly exposed to tobacco smoke ``` INCREASE # who eat 2 fruits and 3 vegetables/day # schools that provide access to physical activity other than during school hours # who view TV ≤ 2 hrs/day. ```

SCHOOL-AGED CHILD

these are Age and Physical Changes for what age group ``` “calm before the storm” Elevated blood pressure Growth Teeth Lymphoid tissue Motor skills development ```

SCHOOL-AGED CHILD

these are Acute Illness for what group ``` Children living in poverty Homeless children LBW infants Chronic illnesses Foreign-born children Children in day care Permanent disability ```

SCHOOL-AGED CHILD

Adolescent(__-__ Years of Age)

12 – 18

Erikson’s Stage of Psychological Development that Assisting parents to encourage achievement of task

Identity versus Role Confusion

these are Healthy People Goals for what age group REDUCE car accident INCREASE safe sex

Adolescent

these are Age and Physical Changes for what age group ``` Physical growth Acne Scoliosis Gender Signs of puberty ```

Adolescent

this age group Need at least 8 hours sleep per nigh

Adolescent

CAGE ASSESSMENT C A G E stands for

Cut Down Drinking Annoyed by Criticism Guilty or bad about Drinking Eye-opener first thing in the a.m. to calm nerves/relieve hangover

The Young Adult (__-__ Years of Age)

18 – 35

The nurse provides educational information to the female adolescent on decreasing the incidence of acne, which includes: A. Decease chocolate intake in your diet. B. Expose your face to sunlight for at least 2 hours per day. C. Remove all pustules and papules with special instruments. D. Wash your face with soap and water 2 to 3 times per day.

D. Wash your face with soap and water 2 to 3 times per day.

The nurse facilitates the adolescent’s self-perception-self-concept development by: A. Complimenting the adolescent for what is accomplished B. Developing a plan for the adolescent’s future growth C. Encouraging the adolescent to join in group activities D. Giving praise for who the adolescent is

D. Giving praise for who the adolescent is

The nurse emphasizes warning signs of suicide risk in adolescents during a health education class. These signs include (select all that apply): ``` A. Difficulty concentrating B. Increased accidents C. Hyperactivity D. Lack of interest in usual activities E. Sleep disturbances ```

A. Difficulty concentrating D. Lack of interest in usual activities E. Sleep disturbances

Emphasis on disease prevention for the young adult should especially focus on modifying risk factors related to which disease process? A. Coronary artery disease B. Cirrhosis of the liver C. Cervical cancer D. Colon cancer

A. Coronary artery disease

Young women are screened for cervical cancer through assessment of known risk factors to which of the following? A. Obesity B. Sexual intercourse C. Hypertension D. Alcohol use

B. Sexual intercourse

When determining risks associated with intimate partner violence the nurse uses which assessment finding to suspect abuse? A. Adequate economic resources B. Equal job position of the partners C. Both partners with college education D. Differences in job status associated with the partners careers.

D. Differences in job status associated with the partners careers.

Growth & Development: 6 focus areas for infans and toddlers

``` Erikson’s stages Healthy People Goals Major Milestones (as it applies) Safety Concerns Health Concerns Screenings ```

Erikson’s Stage for Psychological Development with infants

Trust versus Mistrust

these are Healthy People Goals for what age group REDUCE ``` Iron Deficiency Non-fatal Poisoning Infant Deaths Low Birth Weight Preterm Births Developmental Disabilities ``` INCREASE % of healthy, full-term births # of infants with access to ongoing health care Proportion of mothers who breast feed Use of occupant child restraints

infants

Motor Ability ___-____ Months May roll over Sitting to crawling - propels forward or back Push up on hands & knees Developing eye-hand coordination & Hand-mouth coordination

Birth-6

Motor Ability __-__ Months Sits & Rolls over Locates & manipulates small objects Picks up dropped objects Crawls backwards

6 – 8

Motor Ability ___-____ Months ``` Crawls forward Stands and cruises with furniture Stands alone Walks holding hands, climbs Pulls & throws objects Pincer grasp Dislikes restraint Explores away from parent Understands simple phrases & commands ```

8 – 12

_______ immunization | Stimulates immune system

Active

______ immunization | Naturally occurs from maternal antibodies

Passive

Erikson’s Stage of Psychological Development for toddlers

Autonomy versus Shame and Doubt

these are Health People Goals for what age group REDUCE Iron deficiency Drowning deaths Non-fatal poisonings INCREASE Use of child restraints # of children with access to ongoing health care Proportion of children screened for developmental delays Proportion of children screened for autism spectrum disorder Eliminate Blood levels > 10 mg/dl

toddlers

infant ___-___ months

0-12

toddler | ____months - _____ years

12 months to 3 years

120 - 160 bpm ~130 heart rate of _______

infant heart rate

70-80 bpm heart rate of ______

toddler