Mod1 Flashcards

1
Q

Secondary prevention focuses on what?

A

Diagnosis and treatment (mammograms)

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2
Q

What does tertiary prevention focus on?

A

Helps people move to their previous level of health (rehab centers)

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3
Q

What factors affect the delivery of health care?

A
Increasing number of older adults 
Advances in technology 
Economic 
Women health
Uneven distribution is services 
Access to health insurance 
Homeless and poor
HIPAA
Demographic changes
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4
Q

What is a case managers role in clients care?

A

Their role is to ensure that the client receive fiscally sound and appropriate care

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5
Q

What is the role of a social worker in clients care?

A

Supports problems and are familiar with both private and public resources available to clients according to their socioeconomic qualification

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6
Q

Hospital provide what types of care?

A

Emergency care
Intensive care
Around the clock

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7
Q

Health promotion services are?

A

Early detection

Routine screening

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8
Q

What is palliative care?

A

Providing comfort and treatment

End-of-life care may be conducted in many settings including the home

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9
Q

What are government health care agencies?

A

Public health and local health

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10
Q

What do ambulatory care centers do?

A

Diagnostic treatment and minor surgery

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11
Q

What is an occupational health clinic?

A

They are run by companies for employees to promote health

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12
Q

What is subacute care?

A

Is a variety of inpatient care that does technically complex treatment

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13
Q

What are rural care hospitals?

A

They are federal funded services for rural residents

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14
Q

Who is covered by Medicare?

A

Adults over 65

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15
Q

What does part A of Medicare provide?

A

Hospitalization, home care and hospice

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16
Q

What does part B of Medicare provide?

A

Partial outpatient and physician services (voluntary)

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17
Q

What does part D of Medicare provide?

A

Prescriptions (voluntary)

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18
Q

What is state children’s health insurance program (SCHIP)?

A

Insurance that cover poor and working class children it includes primary care, prescription and hospitalizations

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19
Q

What provides a blanket medical service in exchange for a monthly payment?

A
Health maintenance organization (HMO)
Preferred provider organization (PPO)
Preferred provider arrangements (PPA)
Independent practice associations (IPA)
Physician/hospital organization (PHO)
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20
Q

What does primary prevention focus on?

A

Increase quality and years of life
Achieve health equity and eliminate health disparities
Create healthy environments
Promote health and quality life across the life span
(safe sex campaign)

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21
Q

What is community based health care?

A

It is primary health care system where services are provided within the context of people’s daily lives and is directed toward a specific group within the neighborhood

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22
Q

What makes effective CBHC system?

A

Easy access
Flexible in responding to health care need promotes care between and among health care agencies through improved communication
Provides support for family caregivers
Is affordable

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23
Q

What are aspects of community subsystem assessment?

A
Physical environment 
Education 
Safety and transportation 
Political and government 
Health and social services 
Communication 
Economic 
Recreation
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24
Q

Where can you get community assessment data?

A
City maps
State census data 
Chamber of commerce
State health department 
Police departments 
Local newspaper 
Online
Health facility administration 
City health planning boards
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25
Q

What is integrated health care system?

A

Make all levels of care available in an integrated form- primary care, secondary care and tertiary care

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26
Q

What are some traditional community health care settings?

A

Country and state health departments
Schools
Work places
Homes

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27
Q

What are some recent community health care setting?

A

Nurse managed community centers
Parish nurses
Corrections nursing
Telehealth projects

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28
Q

What is community based nursing?

A

care that is directed toward specific individuals which extends beyond institutional boundaries and involves a network of nursing services

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29
Q

What are pew commission competences for future practitioners?

A

In 1998 the pew health professions commission identified 21 competencies for future health care professionals the include skill and knowledge in primary care, preventive care,population based care, health care access
Community partnership, interprofessional teams, and public policy

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30
Q

What is collaborative health care?

A

It is a way to provide optimal health care to the client by having a working relationship with other health care providers

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31
Q

What are the key elements necessary for collaboration?

A

Effective communication skills
Mutual respect
Trust
Decision making process

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32
Q

What must a nurse accomplish to provide continuity of care?

A

Initiate discharge planning when they are admitted
Involve client and family in planning process
Collaborate with other health care professionals as needed

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33
Q

What are the roles of a home health care nurse?

A

Advocate
Caregiver
Educator
Case manager

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34
Q

What is the role of a case manager in home health care?

A

Coordinates activities of other home health care team members such as dietitian, respiratory therapist.

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35
Q

What is the referral process for home health?

A

Clients may be referred to home health care providers by a physician, nurse, discharge planner or family member but there must be a physicians order and approval of treatment plan for legal and reimbursement requirements

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36
Q

What are the types of home health care agencies?

A

Official or public- which are operated by the state or government and funded by taxes
Voluntary or private- which are supported by donations
Private proprietary- for profit
Institutional based- which have a contract with practitioners and are private pay
Durable medical equipment- provide health care equipment

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37
Q

What must a nurse take in consideration when it comes to safety in home care setting?

A

Falls
Fire
Poisoning
Accident

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38
Q

What must the nurse identify when assessing hazard of a home?

A
Walkways
Floors and furniture 
Bathroom, kitchen, bedroom 
Electrical equipment 
Fire protection 
Toxic substances 
Communication devices 
Medications
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39
Q

What are signs of caregivers role strain?

A

Feeling of anger and depression

Dramatic change in the appearance of home environment

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40
Q

What must the nurse obtain during the initial visit?

A

A comprehensive clinic picture
Obtain Health history
Examine the client
Observe the relationship of the client and care giver
Assess the home and community environment
Discuss what the client and family expect
Frequency of visits

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41
Q

What must the nurse assess on subsequent visits?

A

Observe Same parameters assessed on initial visit

Relate findings and the expected outcomes or goals

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42
Q

What does the nurse need to document?

A

Care given
Clients progress
Plans for next visit
Plans for discharge of agency

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43
Q

What can a nurse do to minimize caregivers role strain?

A

Encourage caregivers to express feelings
Convey understanding
Acknowledge the caregivers competence
Identify activities for which assistance is desired and demonstrate
Identify sources of outside help

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44
Q

What are the two most common types of computer systems used in hospitals?

A

Management information systems and hospital information systems

45
Q

Why would nurses use technology?

A
Literature access and retrieval
Computer assisted instruction
Class room technology 
Distance learning 
Testing 
Student and course management
46
Q

What dose bedside data entry allow?

A
Clients assessment 
Medication administration 
Progress notes
Care plan updates 
Client acuity
Accrued charges
47
Q

What are computer based patient records (CPR)?

A

Computer based patients records or electronic medical records permit electronic client data entry and retrieval

48
Q

How do EMR or CPR improve healthcare?

A

Provides constant availability of clients health information across life span
Ability to monitor quality
Ability for clients to share in knowledge and activities influenced get their own health care

49
Q

What are characteristics of the nursing process?

A
Cyclic and dynamic nature 
Client centered 
Focuses on problem solving and decision making 
Interpersonal and collaborative 
Universal applicability 
Critical thinking skills
50
Q

What does the abbreviation ADPIE stand for?

A
Assessing 
Diagnosing 
Planning 
Implementing 
Evaluating
51
Q

What is involved with the first step to the nursing process?

A

Collect data
Organize data
Validate data
Document data

52
Q

What is the purpose of assessing data when it comes to the nursing process?

A

To establish a database about the clients response to health care concerns

53
Q

What do you do during the assessing in the nursing process?

A
Obtain a nursing health history 
Conduct a physical assessment 
Review client records 
Review nursing literature 
Consult support person 
Consult Heath professional
54
Q

What are for types of assessment?

A

Initial nursing assessment
Problem focused assessment
Emergency assessment
Time lapsed assessment

55
Q

What is the purpose of the second step to the nursing process?

A

Diagnosing is to identify clients strengths and health problems that can be prevented or resolved by collaborative and independent nursing intervention

56
Q

What needs to be done durning the diagnosing step of the nursing process?

A

Compare data against standards
Cluster or group data
Identify gaps and inconsistencies
Determine clients strengths, risk and problems
Formulate nursing diagnoses and collaborative problem statement
Document diagnoses in care plan

57
Q

What is the purpose of the third step of the nursing process?

A

Planning is to develop an individual care plan that specifies client goals/ desired out comes

58
Q

What should be done during the planning process?

A

Set priorities and goals/outcomes in collaboration with client
Write goals/outcome
Consult other health care professionals
Write interventions in care plan and nursing care plan
Communicate care plan with other health care providers

59
Q

What is the purpose of the fourth step in the nursing process implementing?

A

To assist the client to meet desired goals and outcomes, promote wellness, prevent illness and disease,restore health and facilitate coping with altered functioning

60
Q

What should the nurse do during the implementing phase of the nursing process?

A

Reassess the client to update the database
Determine the nurses need for assistance
Preform planned nursing intervention

61
Q

What is the purpose of the fifth step of the nursing process evaluating?

A

To determine whether to continue modify or terminate the plan of care

62
Q

What should the nurse do during the evaluating step of the nursing process?

A

Collaborate with client and collect data related to desired outcomes
Judge whether goals/outcomes have been met
Relate nursing actions to clients goals and outcomes
Make a decision about the problem status
Review and modify
Document

63
Q

Initial assessment

A

Preformed after admission and establishes complete database

64
Q

Problem based assessment

A

Ongoing process to determine the status of a specific problem

65
Q

Emergency assessment

A

During a crisis to identity life threatening problem

66
Q

Time lapsed assessment

A

Several months after initial assessment to compare the client progression

67
Q

What are two ways of collecting data?

A

Subjective data- are thing that only can be described by the client

Objective data- can be observed, measured, seen, heard, felt, smelt

68
Q

What are two sources of data?

A

Primary source- the client

Secondary source- all other sources and should be validated if possible

69
Q

What are two methods of collecting data?

A

Observing- gathering data using your senses
Used to obtain skin color, body or breath Odors, lung/heart sounds skin temperature

Interviewing- planned communication
Use to obtain information, identify problems,evaluate change,teach,provide support

70
Q

What types of interviews are there?

A

Focused based- specific questions related to clients problem

Directed-nurse establishes purpose and controls- used when time is limited

Nondirective approach- rapport building- client controls

71
Q

What types of interview questions are there?

A

Closed question- yes/no

Open-ended question- broad topics and invite longer answers better for collecting more information

72
Q

What are things to take into consideration when planning an interview setting?

A

Time- client is free of pain and limited interruption

Place- private, comfortable, limited distraction

Seating arrangement- don’t stand how is the room configured- distance

Language- use easily understood terminology get an interpreter if needed

73
Q

According to Maslows hierarchy of needs what are the most crucial for survival?

A
Physiological needs
Air 
Food 
Water
Shelter 
Comfort 
Self preservation
74
Q

What comes after physiological needs on Maslows need?

A

Safety and security
Avoidance of risk
Avoidance of harm
Avoidance of pain

75
Q

After safety and security on Maslows hierarchy of need there is what?

A
Love and belonging 
Companionship 
Acceptance
Love and affection 
Group membership
76
Q

Second to last on Maslows hierarchy of needs is?

A

Self esteem
Responsibility
Self respect
Recognition

77
Q

What comes last on Maslows hierarchy of needs?

A

Self actualization
Reaching you potential
Creativity
Self expression

78
Q

What does diagnosing refer to in the nursing process?

A

The reasoning process it is the problem statement consisting of the label and etiology in the nursing process

79
Q

Where can you find the diagnostic label?

A

NANDA names

80
Q

What are the three components of nursing diagnosis?

A

The problem and its definition- describes the clients health problem

The etiology - identifies one or more probable causes of a health problem

The defining characteristic-cluster of signs and symptoms

81
Q

What are the two ways of writing a diagnostic statements?

A

Basic Two part statement
Problem
Etiology

Basic three part statement (PES format)
Problem
Etiology
Signs and symptoms

82
Q

The diagnosing phase of the nursing process consist of what?

A

Analyzing data
Identifying health problems, risk and strengths
Formulating diagnostic statement

83
Q

What is difference between nursing diagnoses and medical diagnoses?

A

Nursing diagnosis is a statement of nursing judgment and refers to a condition that nurses by virtue of the education, experience and expertise are licensed to treat. A medical diagnosis is made by physician and refers to a condition that only a physician can treat.
Medical diagnoses refers to the disease process
Nursing diagnosis refers human response

84
Q

What does the planning process begin?

A

It begins with the first client contact and continues until the relationship ends (discharge) it is multidisciplinary (involves all health care providers to interact with the client)

85
Q

What are the types of planning?

A

Initial planning- after initial assessment and develops the initial comprehensive care plan

Ongoing planning- done by all nurses who work with the client- used to determine if health status has changed, set priorities for the shift,which problems to focus on

Discharge planning- planning for needs after discharge- starts at first client contact

86
Q

What are the steps to planning in the nursing process?

A

Prioritize problem/ diagnoses
Formulate goals/desired outcomes
Select nursing intervention
Write nursing interventions

87
Q

What is the difference between a informal and formal nursing care plan?

A

Informal -exist in the nurses mind

Formal - is written as a guide

88
Q

What are types of care plans?

A

Informal
Formal
Standardized- is a formal plan with specific nursing care for groups of people with common needs
Individualized care plan- is tailored to meet the unique needs of the client

89
Q

What is the format for nursing care plans?

A

Problem/nursing diagnoses
Goals/ desired outcomes
Nursing intervention
Evaluations

90
Q

How do you establish a preferential sequence for addressing nursing diagnoses and interventions

A

By grouping the diagnosis
High- life threatening such as impaired respiratory or cardiac function

Medium- health threatening such as acute illness and decreased coping ability

Low- developmental needs such as sleep disturbance

91
Q

What is the purpose of goals/desired out comes?

A

To provide direction for planning nursing intervention
Serve as a criteria for evaluating clients progress
Enable the client and nurse to determine when problem has been resolved
Hep motivate client and nurses by gaining a sense of achievement

92
Q

What four components should the goal/desired outcomes have?

A

Subject-any part of the client
Verb-the action the client is to preform
Conditions or modifier- what where when how
Criterion of desired performance- time speed accuracy distance and quality

93
Q

What are the different types of intervention?

A

Independent- nurse can do
Dependent- physicians orders
Collaborative- whole health care team

94
Q

What is the criteria for choosing appropriate interventions?

A
Safe and appropriate 
Achievable
Congruent with clients values
Congruent with other therapies 
Based on nursing knowledge 
Within standards of care
95
Q

What are the steps to implementing in the nursing process?

A
Reassessing the client
Determining the nurses need for assistance 
Implementing the nursing interventions
Supervising the delegated care
Documenting nursing activities
96
Q

What are the skills needed for implementing?

A

Cognitive skills- problem solving, decision making, critical thinking, clinical reasoning

Interpersonal skills- verbal and non verbal skill that are used while communicating with one another
Technical skills- hands on skill such as manipulating equipment

97
Q

What are the steps to evaluating during the nursing process?

A

Collecting data related to desired outcomes
Comparing data with desired outcomes
Relating nursing activities to outcomes
Drawing conclusions about the problem status
Continuing, modifying or terminating the nursing care plan

98
Q

What is a sentinel event?

A

It is an unexpected occurrence involving the death, physical or psychological injury

99
Q

What is the purpose of a client record?

A
Communication 
Planning clients care
Auditing health care agencies 
Research 
Education 
Reimbursement 
Legal documentation 
Health care analysis
100
Q

What are the different documentation systems?

A
Source oriented record 
Problem oriented medical record
Problem interventions evaluation PIE
Focus charting 
Charting by exception CBE
Computerized documentation 
Case management
101
Q

What can you do to ensure confidentiality of computer records?

A

Never share password
Never leave computer unattended after logging in
Never leave client information displayed
Shred unneeded documentation
Know policies on correcting errors
Follow policy on documenting sensitive material
Installed firewalls

102
Q

The ANA code of ethics state that it is who’s duty to maintain confidentiality of all patients information?

A

The nurse

103
Q

Joint commission require clinical records include what?

A
Evidence of client care assessment 
Nursing diagnosis 
Nursing interventions 
Client outcomes 
Current nursing care plan
104
Q

Progress notes use the SOAP format which stands for what?

A

S- subjective data
O-objective data
A-assessment
P- plan

I-interventions
E-evaluation
R-revision

105
Q

What computer system consists of flow sheets?

A

PIE

106
Q

May a client record provide evidence in court?

A

Yes

107
Q

What are Kardexes used for?

A
Organizing and recording data
Information quickly accessible 
Pertinent information such a allergies 
List of medications 
States goals
Needs that can be met
108
Q

What are types of reporting?

A
Change of shift
Telephone reports
Telephone orders
Care plan conference 
Nursing rounds