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N112 > The NEXT Middy! > Flashcards

The NEXT Middy! Flashcards

1
Q

What is nursing

A

the protection, promotion, and optimization of health and abilities,

prevention of illness and injury,

alleviation of suffering through the diagnosis and treatment of human response,

and advocacy in the care of individuals, families, communities, and populations

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2
Q

How is nursing an ART

A
  • Based on a framework of caring and dignity
  • Acknowledging the dynamic processes of spirituality, healing, empathy, and mutual respect
  • Embraces healing through compassion, helping, competence, being present, tolerance, acceptance, and nurturing
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3
Q

How is nursing a science?

A
  • Based on critical thinking
  • Requires clinical decision-making
  • Relies on evidence to guide practice
  • Uses strategies to provide optimal outcomes
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4
Q

What are Florence nightingale’s contributions?

A
  • Demonstrated efficient and knowledgeable nursing care
  • Defined nursing practice as separate and distinct from medical practice,
  • Differentiated between health nursing and illness nursing.
  • Focus on environment
  • Stressed the need for continuing education for nurses
  • Recognize components of nursing: Health & Illness
  • Emphasized nutrition was important for health
  • Maintained accurate records/beginning of nursing research
  • Defined nursing as an art & science
  • Standards for management
  • Nursing education and nursing respected occupation for women
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5
Q

Nursing as we know it began when?

A

19th-20th century
based on practices and beliefs of Florence Nightingale

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6
Q

4 aims of nursing

A

Promote health
Prevent illness
Restore health
Facilitate coping - with death and disability

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7
Q

How do we achieve/ meet the aims of nursing

A

Cognitive- thinking
Technical- applying skills
Interpersonal- communication
Ethical/legal- documentation

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8
Q

What makes nursing a profession

A

Service orientation
Research
Recognized authority
Autonomy
Code of ethics
Knowledge base (unique)
Set Standards

SR. RACKS

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9
Q

ANA

A

AMERICAN NURSES ASSOCIATION

The professional organization for nurses in the US

Fosters high standards of nursing practice
Promotes safe ethical work environment, health and wellness for nurses, advocates on healthcare issues that affect nurses

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10
Q

NLN

A

NATIONAL LEAGUE FOR NURSES

Foster the development and improvement of all nursing services and nursing education

Primary source of research data about nursing education
Open to all people

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11
Q

NSNA

A

NATIONAL STUDENT NURSES ASSOCIATION

Prepares students to participate in professional nursing organizations

Founded in 1952 with the assistance of the ANA and NLN

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12
Q

ICN

A

INTERNATIONAL NURSING ORGANIZATION

Provides a way for national nursing organizations to work together

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13
Q

National nursing organizations

A

ANA
NLN
AACN
NSNA

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14
Q

AACN

A

AMERICAN ASSOCIATION OF COLLEGES OF NURSING

National voice for BSN and HIGHER nursing education programs

National accreditation of nursing programs is provided through the AACN by the CCNE

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15
Q

Who wrote the 2015 scope and standards of practice?

A

ANA

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16
Q

What are standards of practice

A

Steps

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17
Q

What are standards of professional performance

A

Key concepts

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18
Q

ANA standards of practice

A

Assessment
Diagnoses
Outcomes identification
Planning
Implementation
Coordination of care
Health teaching
Evaluation

A-DO-PICH-E

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19
Q

Standards of professional performance

A

Education
EBP
Environmental health
Ethics
Culturally congruent practice
Communication
Leadership
Resource utilization
Quality of practice
Professional practice evaluation

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20
Q

Nurse practice acts

A

Laws established in each state to regulate the practice of nursing. Broadly worded

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21
Q

Nursing Process

A

Major guidelines for nursing practice. Used by the nurse to ID the patient’s healthcare needs and strengths to establish and carry out a care plan to meet those needs and to evaluate the effectiveness of the plan to meet the established outcomes.

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22
Q

Trends in nursing

A

Cost
Research
InterDISciplinary education
Shortage, nursing
Population based care

Globalization- economy

Diversity
Educated consumer
Policy, health
Technology

CRISP G DEPT

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23
Q

What is health

A

complete state of physical, mental, social well being

Passive state

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24
Q

What is wellness

A

State of being healthy including living a lifestyle that promotes good physical mental and emotional health.

Active state

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25
Q

What is disease

A

Diagnosed and treated as prescribed by a HCP

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26
Q

What is illness

A

The response of a person to a disease
<6 months

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27
Q

Stages of illness

A

Stage 1 - experiencing symptoms
Stage 2 - Assuming sick role
Stage 3 - Assuming dependent role
Stage 4 - Achieving recovery and rehabilitation

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28
Q

Illness behaviors

A
  1. Experiencing symptoms
  2. Sick role
  3. Dependent role
  4. Achieving recovery and rehab
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29
Q

Health disparities

A

Poverty
Race
Insurance
Mental health
Education

Disabilities
Age/ access to health
Gender
Sexual orientation

PRIME DAGS

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30
Q

FACTORS affecting health and illness

A

Environment
Living conditions
Family

Lifestyle
Work

Sex
Age
Genetics
Education/Experience

Elf lifestyle work & sage

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31
Q

Maslows hierarchy

A

Self Actualization
Self Esteem
Love & belonging
Safety & security
Physiologic needs

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32
Q

Physiologic needs

A

Oxygen, water, food, elimination, temperature, sexuality, physical activity and rest.

They are the most basic in hierarchy of needs. Most essential to life and have highest priority.

Oxygen is the most essential of all needs.

ABCs ( Air, Breathing, & Circulation)

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33
Q

Safety & security

A

Safety and security needs come next in priority and have both physical and emotional components

Physical - Protected from potential or actual harm.
Emotional- involves trusting others and being free of fear, anxiety and apprehension.

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34
Q

Love & belonging

A

Often called a higher level need.

They include understanding and acceptance of others in both giving and receiving love. Feeling of belonging to groups such as families, peers, friends, a neighborhood and community.
If unmet, a patient feels isolated and lonely

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35
Q

Self Esteem

A

Includes the need for a person to feel good about themselves.

To feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments.

Nurses can help meet patients’ self esteem needs by respecting values and beliefs.

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36
Q

Self Actualization

A

Highest level of hierarchy includes the need for people to meet their full potential.

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37
Q

3 levels of health promotion and preventative care

A

Primary
Secondary
Tertiary

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38
Q

immunization clinics

A

Primary

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39
Q

physical exams

A

Secondary

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40
Q

teaching pts w/ diabetes how to recognize & prevent complications

A

Tertiary

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41
Q

using PT to prevent contractures in a stroke pt

A

Tertiary

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42
Q

assess normal growth for children

A

Secondary

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43
Q

dental/eye/medical exams

A

Secondary

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44
Q

family planning services

A

Primary

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45
Q

poison control info

A

Primary

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46
Q

safe sex education

A

Primary

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47
Q

BP screening

A

Secondary

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48
Q

referring a woman to a support group after breast removal from cancer

A

Tertiary

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49
Q

provide case management for disaster victims.

A

Tertiary

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50
Q

nutrition/fitness activites

A

Primary

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51
Q

exercise programs for frail adults

A

Secondary

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52
Q

early detection & treatment of diabetes

A

Secondary

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53
Q

Child car seat education

A

Primary

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54
Q

Prevention of pressure injuries as a
complication of spinal cord injury

A

Tertiary

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55
Q

Promoting independence for patients
with traumatic brain injury

A

Tertiary

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56
Q

Communicable disease screening and
case finding

A

Secondary

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57
Q

Health education in schools

A

Primary

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58
Q

Heath risk assessments

A

Primary

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59
Q

Self breast or testicular exams

A

Primary

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60
Q

Seat belts

A

Primary

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61
Q

Family counseling

A

Secondary

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62
Q

Pap smears and mammograms

A

Secondary

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63
Q

Teaching about healthy diet

A

Primary

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64
Q

Safety in industry and farms

A

Primary

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65
Q

Teaching about the importance of regular exercise

A

Primary

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66
Q

Family planning services

A

Primary

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67
Q

Accident prevention education

A

Primary

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68
Q

Birth control

A

Primary

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69
Q

Occupational therapy

A

Tertiary

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70
Q

Job training

A

Tertiary

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71
Q

Surgical treatment

A

Tertiary

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72
Q

Support groups

A

Tertiary

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73
Q

Water treatment

A

Primary

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74
Q

Smoking cessation

A

Primary

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75
Q

Weight loss

A

Primary

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76
Q

PT

A

Tertiary

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77
Q

Primary prevention

A

addresses the needs of healthy patients to promote health and prevent disease with specific protections

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78
Q

Secondary prevention

A

focuses on early identification of individuals or communities experiencing illness, providing treatment, and conducting activities that are geared to prevent a worsening health status

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79
Q

Tertiary prevention

A

aims to prevent the long-term consequences of a chronic illness or disability and to support optimal functioning

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80
Q

Nursing theory

A

developed to describe nursing, the purpose of describing, explaining , predicting, and controlling desired outcomes of nursing care practices.

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81
Q

What is research

A

to examine carefully or to check/search again

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82
Q

What is Nursing research

A

encompasses research to improve the care of people in the clinical setting as well as the broader study of people and the nursing profession, including studies of education, policy development, ethics and nursing history.

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83
Q

What is EBP

A

a problem-solving approach to making clinical decisions, using the best evidence available

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84
Q

5 steps of implementing EBP

A

1: Ask a question about a clinical area of interest or an intervention use PICOT format
2- Collect the most relevant and best evidence to answer the question.
3-Critically evaluate the evidence
4: Integrate the evidence- with clinical expertise, pt preferences and values in making a decision to change
5: Evaluate the practice decision or change

ACE IE

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85
Q

Parts of a research article

A
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86
Q

Dunn model

A

Being - recognizing oneself as separate and individual
Belonging - being part of a whole
Becoming - growing and developing
Befitting - making personal choices to befit oneself for the future

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87
Q

Nursing care:
physiologic

A

Nurses evaluate oxygenation (skin color, VS, anxiety levels)

Assess nutritional status through weight, muscle mass, lab values, and strength

Monitor intake and elimination of fluids.

88
Q

Nursing care:
Physical safety and security

A

Proper hand hygiene and admin medications knowledgeably

89
Q

Nursing care:
Emotional safety and security

A

Encouraging spiritual practices to provide strength and support

Allowing as much decision making and control as possible.

90
Q

Nursing care:
Love and belonging

A

Nursing interventions include family and friends visiting patient

Establishing a nurse patient relationship based on understanding and trust

Referring patients to specific support groups

91
Q

Nursing care:
Self esteem

A

Respecting their values and beliefs

Encouraging patient to set attainable goals

Facilitating support from fam

92
Q

Nursing care:
Self actualizations

A

Focusing on patient strengths and possibilities rather than problems

Providing sense of direction and hope

Provide teaching that is aimed at maximizing potentials.

93
Q

Tasks/ health risk factors
Table 4-2 pg 74

A
94
Q

Community aspects that affect individual and family health

A

Social support system
Community healthcare structure
Environmental factor
Economic resources

SCEE

95
Q

Community:

Social support system

A

made up of all the people who will help meet financial, personal, physical and emotional needs. (Family, friends, and neighbors provide the best social support within a community) (additionally: church and organizations)

96
Q

Community:

Community healthcare structure

A

the size and location of the community often determine what services are available; aswell as county and state funding

Rural residents may need to travel further distances to receive care.

Urban residents have access to public transportation and a variety of healthcare options.

97
Q

Community:
Economic resources

A

personal finances and healthcare insurance

98
Q

Community:
Environmental factor

A

the community environment in which a person lives and works can either have helpful or harmful effects on health.

  • Air and water quality differs across communities
  • Large urban areas are often affected by air pollution
  • Smaller communities are at risk for water pollution from run-off of chemicals or livestock waste.
  • Lack of transportation; distance to services; location of services
99
Q

List the Competencies

A

Blended
QSEN

100
Q

What are blended competencies

A

Nurses aim to design and manage each patient’s care scientifically, holistically, and creatively.

To do this nurses need many cognitive, technical, interpersonal, and ethical/ legal competencies. (In most instances, nurse actions require all 4 competencies)

Cognitive and technical competencies equip nurses to manage clinical problems stemming from the patients changing health or illness state

Interpersonal and ethical skills are essential for nurses concerned about the patients broader well being.

101
Q

Explain cognitive

A

critical thinking- a systematic way to form and shape one’s thinking.

Not accepting information at face value

Examine assumptions, evaluate evidence, and uncover underlying values and reason

102
Q

Explain technical

A

Good with their hands”. Familiarize yourself with new equipment. Practice necessary skills until you feel confident in your ability, before performing it on a patient.

103
Q

Explain interpersonal

A

Interpersonal: promoting the dignity and respect of patients as people and establishing a caring relationship.

-“you are a person of worth, and i care about you”
-Be sensitive about what your looks, speech and touch to communicate to patients and colleagues
-Direct the conversation

104
Q

Explain ethical/legal

A

examining one’s sense of accountability
being attentive and responsive to the healthcare needs of patients.

This earns the patients trust that “all will be well”

105
Q

What are QSEN competencies

A

The QSEN project is to meet the challenge of preparing future nurses, who will have the knowledge, skills, and attitudes (KSAs), necessary to continuously improve the quality and safety of the health care systems within which they work.

106
Q

What is clinical reasoning

A

ways of thinking about patient care issues (determining, preventing, and managing patient problems)

107
Q

What is clinical judgement

A

refers to the result (outcome) of critical thinking or clinical reasoning
the conclusion, decision, or opinion you make

108
Q

5 characteristics of the nursing processs

A

Interpersonal
Dynamic
Outcome-oriented
Universally applied
Systematic

IDOUS

109
Q

INITIAL ASSESMENT

A

is performed shortly after the patient is admitted to a healthcare facility or service.

Purpose: to establish a complete database for problem identification and care planning

110
Q

FOCUSED ASSESMENT

A

the nurse gathers data about a specific problem that has already been identified.

Purpose: routinely part of ongoing data collection/ to identify new or overlooked problems.

Quick priority assessments (QPAs): short, focused, prioritized assessments you do to gain the most important information you need to have first. (These are important because they can “flag” existing problems and risks

111
Q

EMERGENCY ASSESMENT

A

performed to identify life-threatening problems when a patient presents with a physiologic or psychological crisis.

Examples: assessing the source of a choking hazard, blood loss from a stab wound, ABCs on an unresponsive patient, the potential for immediate harm from an individual threatening violence.

112
Q

Time-Lapsed Assessment:

A

is scheduled to compare a patient’s current status to a baseline data obtained earlier.

Examples: Reassessments

113
Q

Comprehensive Assessment

A

baseline data. Allows to make judgment about persons health status.
Ex. health history

114
Q

OBJECTIVE DATA

A

observable and measurable data that can be seen, heard, felt, or measured by someone other than the person experiencing them.

What you can measure.

115
Q

SUBJECTIVE DATA

A

information perceived only by the affected person (patient). Cannot be perceived or verified by another person. What the patient tells you.

116
Q

NURSING DIAGNOSIS

A

Actual or potential health problems that can be prevented or resolved by independent nursing intervention

Written to describe patient problems or issues that nurses can treat independently within the nurses scope. I.e: activity, pain and comfort, and tissue integrity/ percussion problems

117
Q

Medical Diagnoses:

A

identify diseases; where as nursing diagnosis focus on unhealthy responses to health and illness

Describe problems for which the physician or advanced practice nurse directs the primary treatment;
Remains the same for as long as the disease is present; where as nursing diagnosis may change day to day

118
Q

Collaborative Problems

A

certain physiologic complications that nurses monitor to detect onset or changes in status

119
Q

DIAGNOSTIC STATEMENT

A

PROBLEM (NANDA nursing diagnosis) “related to” ETIOLOGY “as evidenced by” DESCRIBING CHARACTERISTICS”

120
Q

INITIAL PLANNING

A

performed by the nurse with the admission nursing history and the physical assessment

121
Q

ONGOING PLANNING

A

carried out by any nurse who interacts with the patient

122
Q

Discharge planning

A

best carried out by the nurse who has worked most closely with the patient and family

123
Q

8 IMPLEMENTATION GUIDELINES

A

-Reassessing the Patient and Reviewing the Plan of Care
-Using Patient Boards or Whiteboards
-Clarifying Prerequisite Nursing Competencies
-Planning Ahead and Organizing Resources
-Anticipating Unexpected Outcomes and Situations
-Ensuring Quality and Patient Safety: Preventing Errors and Omissions
-Promoting Self-Care: Teaching, Counseling, and Advocacy
-Assisting Patients to Meet Health Outcomes

A PURE CAP

124
Q

4 TYPES OF OUTCOME

A

COGNITIVE
PSYCHOMOTOR
AFFECTIVE
PSYIOLOGIC

125
Q

COGNITIVE OUTCOME
EXAMPLE

A

Outcome met. Parents discussed some infant problems related to feeding, elimination, and illness and reported appropriate community resources to contact.

The parents understand & have knowledge of the infants problems

126
Q

PSYCHOMOTOR OUTCOME
EXAMPLE

A

Outcome partially met. Both parents correctly demonstrated safe techniques for holding, dressing and bathing baby. Mother is still concerned that the baby is not getting enough milk.

Revision: Continue to spend time with mother and infant during feeding — provide positive reinforcement

127
Q

AFFECTIVE OUTCOME
EXAMPLE

A

Outcome partially met. Except for concern about breastfeeding, both parents expressed feeling comfortable and eager to care for their son at home.

128
Q

PHYSIOLOGIC OUTCOME
EXAMPLE

A

Outcome met. Parents’ report of baby’s weight gain and behavior indicates good parenting skills.

129
Q

CYCLIC PROCESS

A

Infectious agent
Reservoir
Portal of exit
Means of transmission – directly or indirectly
Portal of entry
Susceptible host

130
Q

DIRECT - means of transmission

A

Kissing, touching, sexual intercourse

131
Q

INDIRECT- means of transmission

A

Vector (insect), fomite (inanimate object), respiratory droplets that adhere to dust particles

50% drop in contamination generally when fomites have been cleaned within the week, depending on cleaning method

Droplet, contact, & airborne

132
Q

Portal of entry examples

A

Respiratory / gastrointestinal & genitourinary tracts / pustules in skin / blood/tissue/exretions / open wounds / ALL mucous membranes (eyes/nose/lungs/etc)

133
Q

Reservoir examples

A

Humans / animals / soil / food / water / milk / fomites

HUMANS & ANIMALS can be asymptomatic OR symptomatic to spread

Some people do not exhibit s/s of disease (carriers) (ex. AIDS s/s do not occur for years)

Ex. rabies: reservoir are animals. West nile virus: reservoir is birds & mosquitos feed on birds & transfer it to humans

134
Q

Examples of infectious agents

A

Bacteria (most significant): antibiotics ONLY effective against gram positive bacteria. Aerobic (need air) & anaerobic (no air)

Viruses: smallest microorganism.
Antibiotics have no effect (ex. Hep B & C, cold, AIDS)

Fungi: plant like organisms (mold & yeast)
athletes foot, ringworm, yeast infections

Parasites: live on host & rely on it for nourishment

135
Q

Portal of exit examples

A

Respiratory / gastrointestinal & genitourinary tracts / pustules in skin / blood/tissue/exretions

136
Q

STAGES OF INFECTION

A

Incubation Period
Prodromal stage
Full stage of illness
Convalescent Period

137
Q

Incubation period

A

Interval between ‘pathogenic invasion’ of body and appearance of infection.

Period of intense growing & multiplying of pathogen inside host

Length varies from illness (ex. Cold incubation period 1-2 days, tetanus 2-21 days)

138
Q

Prodromal stage

A

Person / host is most infectious during this stage

Early signs & symptoms begin: fatigue, malaise, low grade fever (s/s nonspecific)

Lasts Hours- days & person unaware of being contagious
Infection spread to other hosts

139
Q

Full stage of illness

A

Presence of infection specific signs & symptoms indicates the full stage of illness

Localized symptoms: limited or occur only in one body area (ex. Sore throat)

Systematic symptoms: throughout the entire body (ex. Chills, fever)

140
Q

Convalescent Period

A

Recovery from infection, symptoms begin to fade

141
Q

Body’s defense against infection

A

Skin and mucous membranes

Microbiome / Flora (skin, nose, mouth, throat, large intestine, and genitals)

Inflammatory response (injuries or breaches in skin) & immune response (B-cells/T-cells) systems

142
Q

Medical asepsis

A

CLEAN TECHNIQUE” - does NOT try to make the environment pathogen free. It’s used in and out of medical facilities and is based on the assumption that pathogens are present everywhere

procedure/practice used to reduce # of transfer of pathogens

143
Q

Surgical asepsis

A

STERILE TECHNIQUE” - sole purpose is to completely ELIMINATE PATHOGENS from the environment!!

HAND HYGIENE, levels of PPE, isolation, education, responsible behavior by nurses, safe practices – at the heart of implementation

Used in the OR, labor and delivery areas, certain diagnostic testing areas, nurses use surgical asepsis at patient’s bedside (IV’s, catheters, etc)

144
Q

5 moments for hand hygiene

A

Before touching patient
Before a “clean” or aseptic procedures
After body fluid exposure risk
After touching patient
After touching patient surroundings

145
Q

MRSA

A

Methicillin-resistant Staph (S.aureas)

146
Q

VISA

A

Vanco. Intermediate-resistant S.aureas

147
Q

VRSA

A

Vanco. Resistant s.aureas

148
Q

VRE

A

Vanco. Resistant enterococci

149
Q

CRE

A

carbapenem-resistant Enterobacteriaceae

– the “NIGHTMARE bacteria”

150
Q

Acinetobactor baummanii (A.baummanii)

A

found in hospitals in war zones - Iraq / Afghanistan - soldiers were contracting it

151
Q

Clostridium difficile (C.diff)

A

feces of immune people with C.dificile

152
Q

Healthcare Associated Infection (HAI)

A

formerly called “Nosocomial” (term being phased out, per book)

Reflects emergence of new pathogens, methods to prevent transmission of multidrug-resistant organism and CDC’s concern over bioterrorism

153
Q

Tier 1 STANDARD PRECAUTIONS:

A

Precautions used in care of all hospitalized patients regardless of diagnosis of possible infection status

PPE: masks, eye protection, face shield, fluid repellent gowns during procedures with splashes

154
Q

TIER 2 – TRANSMISSION-BASED PRECAUTIONS

A

Airborne
Droplet
Contact

155
Q

Airborne precautions

A

Pertains to tuberculosis, chickenpox, rubeola/ measles

(N95)

Place patient in private room with monitored negative air pressure, wear respirator when entering room, transport patient out of room ONLY when necessary, patient should wear surgical mask for transport, CDC for more specific precautions

156
Q

Droplet precautions

A

Pertains to rubella (German measles), mumps, diphtheria, adenovirus

(Mask)

Private room if available but pts door can be open, PPE upon entry and all interactions involving contact, transport patient only when necessary and with surgical mask per patient, keep visitors 3 feet from patient

157
Q

Contact precautions:

A

For patients who are infected or colonized by a multidrug-resistant organism

  • c. diff, scabies, MRSA

(Mask & Gown)

Private patient room if available, wear PPE when entering room and for all interactions that may involve contact in contaminated areas, change gloves after contact with infected materials, remove PPE before leaving patient’s environment and wash hands, limited movement of patient out of their room, avoid sharing patient equipment!

158
Q

Factors affecting personal hygiene

A

Personal Preferences
Health State
Developmental Level
Culture
Socioeconomic Class
Spiritual practices

PHD CSS

159
Q

Interview:
Skin

A

Question patient about:
-Any past or current skin problems and changes in their skin. (e.g. rashes, lumps, itching, dryness, lesions)

Recent surgeries, wounds, tattoos, or piercings

When skin problems are present, ask the patient:

How long have you had this problem?

Does it bother you?

How does it bother you?

Does it itch?

Have you found anything that helps relieve these symptoms?

160
Q

Interview:
Oral cavity

A

Note history of any oral problems and related treatments
Identify any variables known to cause oral problems

e.g. deficient self-care abilities, poor nutrition or excessive intake of refined sugars, family history of periodontal disease, ingestion of chemotherapeutic agents that produce oral lesions

161
Q

Patients at risk for oral problems include those who:

A
  • are seriously ill, comatose, dehydrated , confused, depressed, or paralyzed
  • have mental health problems
  • are mouth breathers

-have no oral intake of nutrition or foods (have NG tubes or oral airways in place)

-Have had oral surgery

162
Q

Interview
Hair

A

identify patients usual hair and scalp care practices, including styling preference

note any history of hair or scalp problems + possible causes of changes in distribution, texture, or amount of hair

Be alert for any factors known to cause hair or scalp problems or that requires special care

e.g. deficient self-care abilities, immobility, malnutrition, and treatments (chemotherapy)

163
Q

Interview:
Nails and Feet

A

Gather info about patients normal nail and foot care practices

include type of footwear worn + any history of nail or foot problems and their treatments

Foot problems are common in people with diabetes and peripheral vascular disease

a proactive educational approach can prevent many serious complications

Identify variables known to cause nail and foot problems
e.g. ulcers, lower extremity amputations
Identify variables known to cause nail and foot problems
e.g. deficient self-care abilities, vascular disease, arthritis, diabetes, nail biting, improper trimming , prolonged exposure to chemicals or water, trauma, ill-fitting shoes, obesity

164
Q

Interview:
Perineal and Vaginal Areas

A

Know history of perineal or vaginal problems and related treatments

Identify variables known to cause perineal or vaginal problems or to create a need for special care

e.g. urinary or fecal incontinence an indwelling Foley catheter, childbirth, douching, rectal or genital surgery,
e.g. diseases such as UTI’s, diabetes, certain STI’s

165
Q

Assessment
Musculoskeletal system

A

Impairment of musculoskeletal system can interfere with patients ability to perform hygiene

e.g. muscle weakness, decreased ROM, impaired balance, fatigue, lack of coordination

166
Q

Assessment
Skin

A

Assisting patients with basic hygiene provides opportunity for examining patients skin

Pay careful attention to cleanliness, color, texture, temperature, turgor, moisture, sensation, vascularity, and any lesions

Follow These general guidelines for assessing the skin:

-incorporate assessment of skin during assessment of other body systems
-use a good source of light, preferably daylight
-Compare bilateral parts for symmetry
-use standard terminology to report and record findings
-allow data obtained in nursing history to direct skin assessment
-identify any variables known to cause skin problems

e.g. self-care abilities, immobility, malnutrition, decreased hydration, decreased sensation, skin exposure, vascular problems , or presence of irritants

167
Q

Assessment
Oral cavity

A

Inspect oral cavity and surrounding structures with attention to any unusual odors

While performing physical assessment of oral cavity, examine:

-Lips: lumps, ulcers, lesions, edema
-Buccal Mucosa: lesions, nodules, bleeding
Color and surface of gums: Lesions come up bleeding, edema
-Teeth: Any loose, missing, or carious teeth + note presence and condition of dentures or other orthodontic devices
-Tongue: symmetry, movement, texture, and lesions
Hard and Soft Palate: intactness , color, patches, lesions, and petechiae
-Oropharynx: movement of uvula and condition of tonsils

168
Q

Dental Caries:

A

Decay of teeth with formation of cavities
result from failure to remove

169
Q

plaque

A

invisible, destructive, bacterial film that builds up on everyone’s teeth and eventually leads to destruction of tooth enamel

170
Q

Periodontal Disease (Peridontitis)

A

a marked inflammation of the gums that also involves degeneration of the dental periosteum (tissues) and bone

Symptoms include: bleeding gums; swollen, red, painful gum tissues; Receding gum lines with formation of pockets between teeth and gums; pus that appears when gums are pressed; loose teeth

171
Q

halitosis

A

an offensive breath odor that is usually system in nature

172
Q

Gingivitis

A

an inflammation of the gingiva tissue that surrounds the teeth

173
Q

Tartar

A

Hard deposits at the gumline from build-up of plaque and dead bacteria

Attacks fibers that fasten teeth to gums and eventually attacks bone – teeth then loosen fall out

174
Q

Stomatitis

A

inflammation of the oral mucosa

175
Q

Glossitis

A

inflammation of the tongue

176
Q

Cheilosis

A

an alteration and dry scaling of the lips with fishers at the angles of the mouth

177
Q

Dry oral mucosa

A

May be due to dehydration, mouth breathing, alteration in salivary function, medications

178
Q

Oral malignancies

A

appearing as bumps or ulcers

179
Q

Assesment
Eyes

A

During eye examination, note position, alignment, and general appearance of eye

eyelashes should be equally distributed and curl outward

no presence of lesions, nodules, redness, swelling, crusting, flaking, excessive tearing, or discharge of eyelids

check color of conjuctiva and test patients blank reflex

180
Q

Assessment
Ear

A

note position, alignment, general appearance of the ear

Pay particular attention to build up of cerumen (earwax), Dryness, crusting, or presence of any discharge or form body in canal

can cause impaired hearing

181
Q

Assessment
Nose

A

note position and general appearance, patency of nostrils, and presence of tenderness, dryness, edema, bleeding, discharge , or secretions

182
Q

Assessment
Hair

A

Inspect texture, cleanliness , and oiliness
inspect scalp for scaling, lesions, inflammation, or infection
Note abnormalities such as dandruff, hair loss, or infestations

183
Q

Dandruff

A

A condition characterized by itching and flaking of the scalp

184
Q

Dandruff Tx

A

Daily brushing and shampooing with medicated shampoo
severe cases require medical attention

185
Q

Hair loss

A

Becomes potential problem when it exceeds hair growth

186
Q

Alopecia

A

a partial or complete, local or generalized, absence or loss of hair (more common in men than women)

Excessive generalized hair loss may occur with infection, nutritional deficiencies, hormonal disorders, childbirth, general anesthesia, drug toxicity, chemotherapy, thyroid disease, liver disease, hepatic and renal failure, and radiation

187
Q

Pediculosis

A

infestation with lice

188
Q

Pediculus humanus capitis

A

hair and scalp infestation

189
Q

Pediculus humanus corporis

A

body infestation

190
Q

Pidiculosis pubis

A

infestation of shorter hairs on the body – usually pubic or axillary

191
Q

Nits

A

Lice eggs that are laid on her shafts

  • White or light Gray and look like dandruff but cannot be brushed or shaken off the hair

-frequent scratch marks on body and scalp

-easily spread by contact

-Two treatments usually necessary before Nets are destroyed

-infested hermae be shaved – especially when Pete Barker or axe Larry hair is infested

-partners of patients with pubic infestation must be notified

-Patients must finish lice tx – Failure to complete treatment has produced lice that are now resistant to pediculosides

192
Q

Ticks

A

Can transmit Lyme disease, Rocky Mountain spotted fever, and Colorado tick fever

Once on a person, takes move to warm and moist location – e.g. hairline, armpit, groin

disease risk is decreased if removed within 24 hours

193
Q

Assessment
Nails and Feet

A

Examine nails and feet for intactness and cleanliness
assess capillary refill and contour of nail bed

inspect nail base for redness, swelling, bleeding, discharge, and tenderness

inspect feet for swelling, inflammation, lesions, tenderness, or orthopedic problems

194
Q

Assessment
Perineal and Vaginal Areas

A

Examine both male and female genitalia for color, lesions, masses, swelling, inflammation, excoriation (compulsive picking), tenderness, and discharge (Amount, color, odor, source)

Inspect anal area for cracks, nodules, distended veins, masses, or polyps

Note perennial odors

195
Q

Hygiene diagnosis

A

Bathing self-care deficit-related to post operative weakness

Impaired oral mucous membrane-related to dehydration and altered nutrition

Impaired Social interaction- related to negative body image: acne

Readiness for Enhanced Self-Care-related to oral hygiene practices

196
Q

FACTORS AFFECTING BODY ALIGNMENT AND MOBILITY

A

mental health
exercise
lifestyle variables
fatigue and stress
physical health
attitude and values
growth and development
external factors

MELF-PAGE

197
Q

LOCK UP EFFECTS OF IMMOBILITY AND EXERCISE

A
198
Q

Isotonic exercise

A

Involves muscle shortening and active movement. Potential benefits include increased muscle mass, tone, and strength, improved joint mobility, increased cardiac and respiratory function, increased circulation, and increased osteoblastic or bone-building activity.
Ex.
-Carrying out ADLs
-independently performing ROM exercises
-swimming, walking, jogging, and bicycling

199
Q

Isometric exercise

A

Involves muscle contraction without shortening (i.e., there is no movement or only minimum shortening of muscle fibers).

Potential benefits are increased muscle mass, tone, strength, increased circulation to the exercise body part, and increased osteoblastic activity.

Contractions of quadriceps and gluteal muscles, such as occur when holding a yoga position.

200
Q

Isokinetic exercise

A

Involves muscle contractions with resistance. The resistance is provided by a constant rate by an external device that has a capacity for variable resistance.

Ex.
Rehabilitative exercises for knee and elbow increase and lifting weights.

A continuous passive motion CPM, a device used postoperatively after joint surgery (knee replacement anterior cruciate ligament repair)

201
Q

FOCUSED ASSESSMENT

daily activity level

A

Describe the activities you normally carry out during a routine day and types of physical exercise that are part of your daily lifestyle.

-ADLs
-type, frequency, duration of physical exercise
-past history of activity and exercise; recent changes

202
Q

FOCUSED ASSESSMENT
endurance

A

Describe how much and what type of activity makes you tired.

History of business, dyspnea, frequent pauses in activity to rest, pounding heart, or marked increase in respiratory rate after moderate activity

203
Q

FOCUSED ASSESSMENT
exercise/ fitness goals

A

What exercise are fitness goals are you currently working on?

-Attitudes about exercise and physical fitness
-Knowledge of the benefits of exercise
-Motivation to exercise

204
Q

FOCUSED ASSESSMENT
mobility problems

A

Do you experience any problems with movement or with more vigorous activity or exercise? If yes, please describe these problems.

-Nature of problem including symptoms
-Onset of disturbance and frequency
-Known causes
-Effect of problem on everyday function
-Interventions attempted and results

205
Q

FOCUSED ASSESMENT

physical or mental health alterations

A

Are there any physical or mental health problems that may be affecting your Mobility?

-Decrease of strength or endurance (e.g., MI, CHF, COPD, Cancer, GI disorders)
-Neuromuscular impairment (MS, Parkinson’s disease, spinal injuries)
-Musculoskeletal impairment (arthritis, fractures, muscular dystrophy)
-Perceptual or cognitive impairment (CVA, brain tumor or trauma, vision disorders, dementia)
-Pain or discomfort (Burns, RA, chronic pain syndrome, postoperative pain)
-Depression or severe anxiety (neurosis, schizophrenia)

206
Q

FOCUSED ASSESMENT
external factors affecting mobility

A

Is there anything else you can think of that limits your ability to get around?

-Environmental factors ( stairs, lack of railings are other assistive devices, poor lighting, unsafe neighborhood)
-Financial Resources

207
Q

safe patient handling and movement techniques and equipment when positioning, moving, lifting, and ambulating patients.

A

Safe patient handling and transfers involve the use of patient assessment criteria, algorithms for patient handling decisions, and proper use of patient handling equipment. Keep the patient in good body alignment and protect the patient from injury while being moved.

208
Q

Equipment for safe patient transfer:

A

Gait belt
Stand-assist and repositioning AIDS
Lateral assistive devices
Mechanical lateral assistive devices
Transfer chairs
Power stand-assist and repositioning list
Powered full body lifts
Trapeze bar

209
Q

LOOK UP OLDER ADULT TABELS

A
210
Q

SELF KNOWLEDGE

A

Who am I?

Global self: is a term used to describe the composite of all the basic facts, qualities, traits, images, and feelings people hold about themselves.

A person’s self knowledge includes:

-Basic facts (sex, age, race, occupation, cultural background, sexual orientation)

-The person’s position within social groups

-Qualities or traits that describe typical behaviors, feelings, moods, or other characteristics (e.g. generous, hot-headed, ambitious, intelligent, sexy)

211
Q

SELF EXPECTATIONS

A

Who or what do I want to be?

The ideal self constitutes the ideal self one wants to be, and develops early in childhood

A false self may develop in people who have an emotional need to respond to the needs and ambitions significant people, such as parents, have for them

212
Q

SELF EVALUATION

A

How well do I like myself?

Self esteem is the evaluative and affective component of the self concept

Sometimes termed: self-respect, self-approval, or self-worth

213
Q

2 subsets of self esteem need

A

Self esteem needs: strength, achievement, mastery and competence, confidence, independence, and freedom

Self respect needs (need for esteem from others): status, dominance, recognition, attention, importance, and appreciation

214
Q

4 bases of self esteem:

A

Significance:
the way people feel they are loved and approved by the people important to them

Competence:
the way tasks that are considered important are performed

Virtue:
The attainment of moral-ethical standards

Power:
The extent to which people influence their own or others lives

215
Q

Positive self concept

A

People with positive self concept usually have greater self knowledge, more realistic perceptions and expectations, and a higher evaluation of themselves or higher self esteem

216
Q

Negative self concept

A

People with negative self concept tend to exhibit poorer self knowledge, less realistic perceptions and expectations and lower self esteem

People with deficient self concept may lack motivation to learn self-care behaviors in response to illness, injury, or trauma.

The experience of aging, illness diagnostic testing, and treatment can severely threaten a person’s self concept

Nursing efforts aimed at teaching new health behaviors may fail until the patient values him or herself enough to want to invest energy in self-care.

N112 (13 decks)

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