Wk 2 - Communication/3Ds Flashcards
Health Equity
Elimination of systematic health disparities
Associated with social advantage/disadvantage
Gender Equity
Equal treatment of all regardless of gender.
No gender discrimination.
Cultural Safety
Recognizing power and resource distribution.
Awareness of institutional discrimination.
Cultural Humility
Lifelong learning.
Interpersonal respect and reflection.
Implicit V.S. Explicit Bias
unknowingly vs knowingly/recognized bias
Cultural Humility
learning we can’t possible know every culture, being aware of ourselves (values/beliefs), what are we communicating and reacting (to patients comments)
are we showing that we support them or don’t support them??
Trauma Informed Practice
understanding and responding to the impact of trauma.
ensure physical, psychological, and emotional safety
Trauma Informed Practice Prevention
prevent more harm and triggers
Trauma Informed Practice Safety
take down barriers to reduce stigma
Trauma Informed Practice Example
not restraining a patient who you know has been in a concentration camp.
We _____ treat everyone the _____, we treat based on their ______________
We don’t treat everyone the same, we treat based on their circumstance
Trauma Informed Practice - 4R’s
Realize - anyone can have trauma
Recognize - signs/symptoms
Respond - how do we react
Resist - resist urge to retraumatize (do it again)
Trauma Informed Practice - 6 Guiding Principles
Safety - self awareness that others have trauma, communicating with patient triggers to avoid, point of care risk assessment
Trust/Transparency - ask questions and listen to patients, be open with your intentions with people
Peer Support - supporting peers around you, peer support groups for patients
Empowerment, Voice & Change - giving patient autonomy, giving patient space to work on their own if needed
Collaboration & Mutuality - whole team approach to work together to care for patient
Cultural, Historical & Gender Issues - thinking about our own biases, values, and beliefs, understanding context of situation
Stages of Infection
Incubation - pathogen enters body, no symps present
Prodromal - mild/non specif signs/symps present (transmission may occur)
lllness - specific signs/symps present
Convalescence - time spent recovering from an illness or medical treatment
Examples of Normal Defenses against infection
- removal of particles by cilia in nasopharynx
- lysozyme in tears and other secretions
- intact skin
- normal flora
- mucus lining in trachea
- rapid pH change in gut
- flushing of urinary tract
- vaginal acids
What can increase the risk of infection
Age: very young/old
Nutritional status
Stress
Disease Processes
- effects on immune sys
- is it a chronic disease?
Medical Therapy
- meds that suppress the immune sys.
Stages of Infection (List first, then define if you can (definitions not on this card though)
Incubation
Prodromal
Illness
Convalescence
Localized Infection
an infection that is limited to a specific part of the body and has local symptoms
Systemic Infection
pathogen distributed throughout the body
WBC
White Blood Cell
- body produces more when there is an infection
CRP
C-reactive Protein
- a protein produced by liver that increase significantly when inflamm is present in body
- considered a sensitive marker for inflamm
Signs/Symps of Local Inflamm/Infection
- Heat
- Redness
- Swelling
- Pain
- Immobility
Signs/Symps of Infection in Older Adults
- mental status change (delirium)
- falls
- dehydration
- decreased appetite
- loss of function/incontinence
- dizziness
Gowns/gloves
contact precautions
Surgical mask/eye protection
droplet precautions
N95 mask/eye protection
airborne precautions
Full face protection
splash to the face
C. diff (what, causes, severity)
bad diarrhea from bacteria
caused by healthcare associated infection (HAI) due to antibiotics
it is life threatening
Flu (what, causes, severity)
is a respiratory illness
caused by a virus in the nose, throat, and lungs
is mild to severe but can be deadly
Chain of Infection pieces
- Portal of Entry
- Host
- Reservoir
- Portal of Exit
- Mode of transmission
Intrapersonal
communication with oneself
Transpersonal
spiritual
Interpersonal
communication with others
Small Group
communication with clinical groups/teacher
Public
communication with big groups of people
Non-Therapeutic Communication Techniques
- you’ll be ok
- don’t worry about it
- you’ll figure it out
- why? (may come off as judgy)
Aphasia
inability to produce/understand language
Delirium
is an acute, reversible state of disorientation, inattention, and confusion
treatment: include family/friends, keep routine simple
Dementia signs
memory loss, difficulty performing daily tasks, impaired judgment, misplacing things, problems with language
Alzheimers Disease diagnosis
decreased cognitive function
Vascular Dementia Diagnosis
decreased cognitive function following a stroke or TIA CT or MRI
Lewy Body Diagnosis
Decreased cognitive function +2 of the following:
- visual hallucinations
- parkinsonian symps - REM sleep behavior disorder (acting out dreams)
Depression
a mood disorder characterized by feelings of sadness and despair 2 or more week
NOT normal part of aging
Pathways of Pain
Transduction - pain stimulus
Transmission - PNS to CNS
Perception - feeling pain, conscious awareness
Modulation - altered signals/response
A delta fibers
myelinated, sharp, well localized, short in duration
C fibers
unmyelinated, dull, aching, diffuse nature, slow onset, relatively long duration
Skeletal Sys Functions (5)
- support
- protection
- movement
- mineral storage
- hematopoiesis
Joints
connections bw bones
Ligament
connect bones and cartilage, or bone to bone
Tendons
bone to musc
Cartilage
used for shock absorption, supporting CT
Isotonic vs. Isometric
tonic - think toning, moving
metric - stretching musc.s
examples of acute pain
delirium
anxiety
aggitation
examples of chronic pain
more than 3 months
depression
anxiety
Somatic Pain and Treatment
skin, bone, joint, musc., ct.
increases movement
non opioids, opioids, heat/cold, topical
Visceral Pain and treatment
internal organs, tends to be diffused (not localized)
non-opi and opi.
Neruopathic pain and treatment
injury to the nerve or abnormal processing of stimuli by the PNS/CNS
illness/injury may be undetermined
adjuvants and opi.s
Somatic Pain Described
throbbing
localized
Visceral Pain Described/Example
not easy to describe, more vague, radiates
example: myocardial infarction (heart attack)
Neuropathic Pain Described
burning, shooting, electrical, prickling
not localized/chronic in nature
Non-Opi Pain Treatment
mild-moderate pain
Tylenol
Tylenol side effect
hepatotoxicity - liver toxicity
NSAID Pain Treatment
mild-moderate pain
Advil
Advil side effects
GI bleed
Renal insufficiency - poor kidney function from reduction in blood flow to kidneys
Opioid Pain Treatment
Moderate to severe pain (respiratory depression)
codeine, morphine, hydromorphone
Codeine, morphine, hydromorphone side effects
N/V - nausea/vomiting
constipation
delirium
pruritus - itching
Co-Analgesic Pain Treatment
Not initially intended for pain
anitconvulsants, corticosteroids
Anticonvulsants, corticosteroids side effects
decreased healing
osteoporosis - bone mass decrease
osteoarthritis
bone joint inflamm
age related
rheumatoid arthritis
immune sys. attacks joints leading to inflamm/damage
