What is NANDA?
North American Nursing Diagnosis Association. A professional nursing organization that provides standardized language to identify patient
... [Show More] problems and plan customized care
Define beneficence
Placing a priority on the needs of others rather than on personal thoughts or feelings
Define veracity
Being truthful
Define: advocacy
supporting/promoting the interest of others
Define: confidentiality
The ethical principal that a healthcare professional will not share patient's information without patient permission
Define: justice
acting fairly and equitably
Define: fidelity
keeping promises or fulfilling an agreement made with others
Define: accountability
being responsible for your actions
Define: autonomy
freedom to make decisions supported by knowledge and self confidence
What is informed consent?
Typically a document signed by the patient to give consent for treatment/procedure. The patient must be told of the details of the treatment, necessity of treatment, benefits and risks, and available alternatives
What is the physician's role in obtaining informed consent?
The physician explains the details of the treatment, necessity, benefits & risks and available alternatives
What is the nurses role in obtaining informed consent?
Nurse must witness the patient sign the form, verify that the patient is capable of understand and giving consent. Nurse should also make sure the patient received all necessary info and has a chance to ask any questions
If the patient is on a high dose of pain meds upon admittance to the ED for a severe trauma (ie: compound femur fracture) are they capable of giving informed consent?
No
What is involved in psychomotor domain learning style? and give an example
movement and motor. An example is teaching a diabetic patient how to self administer insulin
What is involved in cognitive domain learning style? and give an example
memorization/information retention. An example is giving a patient a list of instructions and their ability to recall it later
What is an example of affective domain learning style? and give an example
emotional. takes into account the patients feelings, values, motivations, and attitudes.
What is formal patient teaching?
Printed media, planned educational or group setting, and goal directed meeting in an acute care setting.
What is informal patient teaching?
Learner directed, ie: when a patient asks a question about a medication or looks up info online
Age appropriate teaching: elderly
Can have inadequate literacy skills and have issues reading Rx labels. Consider cognitive and sensory alterations (ie: hearing loss)
Age appropriate teaching: child
requires a parent or caregiver present, but do not exclude the child. Use pictures and simple terms
Age appropriate teaching: young adult
self motivated and able to participate in planning their health education. may learn independently or need assistance from the nurse.
Facts about taking a carotid pulse
Located at the neck, only assess one side at a time
Define orthopnea
Difficulty breathing experienced in positions other than sitting or standing. Commonly seen in heart failure, can be caused by pulmonary edema, left ventricular heart failure, asthma or chronic bronchitis
Normal vitals for temp, pulse, respiration, O2 sat, BP
temp: 95.9-99.5
pulse: 60-100
respiration: 12-20
O2 sat > 95
BP 90/60 to 120/80
Define spiritual distress.
Disruption in belief or value system due to life challenging diagnosis or health crisis. Patient can express anger/depression/neediness/crying.
Define: impaired religiosity
Difficulty adhering to religious customs and rituals
Define: Moral distress
Knowing the right thing to do but not agreeing (ie: caring for a patient who is a rapist)
Define: Decisional conflict
Unsure about what choice or option to choose given the treatment options (ie: what would god want me to do?)
What does community health focus on?
Individuals or families
preventing illness
maintain or regain health
What does public health focus on?
focuses on populations
prevent control of diseases
threats to human health
health protection/promotion/disease prevention
What is OSHA?
Occupational Saftey & Health Administration
-provides employers with guidelines for preventing exposure to hazardous chemicals and hazardous situations and reducing the risk of injury in the workplace.
What is CDC?
Centers for Disease Control
-federal agency that conducts and supports health promotion, prevention and preparedness activities in the United States with the goal of improving overall public health.
What is QSEN?
Quality & Saftey Education for Nurses
goal of preparing nurses of the future with the knowledge, skills, and attitudes needed to advance quality and safety on the job in their health care setting
What is NIOSH?
National Institute for Occupational Safety & Health
-federal agency within the CDC, was established to conduct research and recommend interventions for the prevention of work-related injury and illness.
What are the 6 steps in the chain of infection?
Infectious agent -> Source -> Portal of exit -> Mode of transmission -> Portal of entry ->susceptible host
Side effects and adverse reactions to opiods
respiratory depression
seizures
nausea/vomiting
constipation
itching
urine retention
Characteristics of an open wound
break in the skin surface
-abrasion, puncture wound, surgical incision, pressure wound
Characteristics of a closed wound
bruising
Characteristics of a superficial wound
involves only the epidermis
Characteristics of a partial thickness wound
involves epidermis and dermis
Characteristics of a full thickness wound
involves epidermis, dermis and subcutaneous later. may involve muscle or bone
Characteristics of a clean wound
No sign of infection and risk for developing infection is low
Characteristics of a clean contaminated wound
is similar to a clean wound, but because the surgery involves organ systems that are likely to contain bacteria, the risk for infection is greater.
Characteristics of a contaminated wound
result from a break in sterile technique during surgery; from the perforation of an organ such as the colon, small bowel, or appendix before surgery, which allows for spillage of bacteria-laden material into the wound; or from certain types of trauma or accidents, such as penetrating trauma or a fall. These wounds have a higher risk of infection than clean contaminated wounds
Characteristics of an infected wound
shows clinical signs of infection, including redness, warmth, and increased drainage that may or may not be purulent (contain pus), and has a bacterial count in the tissue of at least 105 per gram of tissue sampled when cultured
Characteristics of a colonized wound
ne or more organisms are present on the surface of the wound when a swab culture is obtained but there is no overt sign of an infection in the tissue below the surface. Colonization is common in chronic wounds and may contribute to delayed wound healing.
Characteristics of an acute wound
A wound that progresses through the phases of wound healing in a rapid, uncomplicated manner
How do wounds heal from primary intention?
Wounds such as surgical incisions or traumatic wounds in which the edges of the wound can be approximated (brought together) to heal are examples of acute wounds. This type of wound is said to heal by primary intention. Wounds that heal by primary intention tend to heal quickly and result in minimal scar formation
How do wounds heal from secondary intention?
When a wound heals by secondary intention, new tissue must fill in from the bottom and sides of the wound until the wound bed is filled with new tissue. Such wounds are often associated with disease processes such as diabetes or vascular disease or with other factors that have inhibited proper wound healing.
How do wounds heal from tertiary intention?
when a wound is left open to heal initially (ie: if contaminated during surgery) to drain and then closed at a later time
Facts about the elderly and nutrition
BMR slows so they needs fewer calories per day. They should focus on eating nutrient dense foods and adequate water take to avoid constipation [Show Less]