Exam #1 Flashcards
(127 cards)
1
Q
Complementary and Alternative Therapies
A
a set of practices that encompass many treatments and ideologies outside of mainstream medicine
2
Q
allopathic medicine
A
traditional medical care
3
Q
complementary
A
therapy used in addition to traditional medicine
4
Q
alternative (unconventional)
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term used in addition to traditional medicine
5
Q
holism
A
connection and interactions between parts of the whole mind, body, and spirit
6
Q
integrative care
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combination of allopathic and complementary and alternative modalities
7
Q
ancient healing systems
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arose long before conventional Western medicine and include Ayurveda from India and traditional Chinese medicine
8
Q
homeopathy
A
uses minute doses of a substance that causes symptoms to stimulate the body’s self-healing response
9
Q
naturopathy
A
focuses on noninvasive treatments to help your body do its own healing and uses a variety of practices such as massage, acupuncture, herbal remedies, exercise, and lifestyle counseling
10
Q
aromatherapy
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the therapeutic use of essential oils distilled from plants in baths, as inhalants, or during massage to treat skin conditions, anxiety, and stress, headaches, and depression. Has an effect on the amygdala of the limbic system.
11
Q
relaxation
A
promote parasympathetic activity and restore balance
12
Q
meditation
A
mindfulness-based stress reduction
13
Q
guided imagery
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involves an element of distraction, which serves to redirect people’s attention away from what is stressing them and towards an alternative focus
14
Q
prayer
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makes the mind-body domain the most frequently used CAM
15
Q
humor therapy
A
improved immune response
16
Q
acupuncture
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practice of inserting fine needles into specific sites on the skin for the purpose of producing a therapeutic response and relieving pain. Changes the energy flow to promote healing. Goal is to maintain a balance
17
Q
herbal supplement
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products that contain plans or ingredients from plants. come in several forms such as tablets, capsules, powders, liquids, and tea bags
18
Q
examples of herbal supplements
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St. John’s wort, Devil’s claw, fish oil, papaya, vitamin e, flaxseed, garlic, ginseng, red clover
19
Q
symptoms of stress
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- aches and pains
- nausea or dizziness
- chest pain, rapid heart beat
- diarrhea or constipation
- insomnia
- eating disorders
- irritability or moodiness
- anxious or racing thoughts
20
Q
effects of chronic stress-physiological
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serotonin levels increase, hypothalamus-pituitary adrenal axis can be permanently altered
21
Q
effects of chronic stress-cardiovascular
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MI, strokes, blood pressure
22
Q
effects of chronic stress-gastrointestinal
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disrupt digestive system, irritate large intestines, exacerbate conditions
23
Q
effects of chronic stress-immune
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slower wound healing, increased susceptibility, impair response to immunizations
24
Q
effects of chronic stress-endocrine
A
insulin resistance, hinders growth hormone
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effects of chronic stress-reproductive
inhibits gonadotropin-releasing hormone, directs reproduction and sexual behavior
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risk factors for stress
- working mothers
- divorced or widowed individuals
- unemployed
- isolated individuals
- targets of discrimination
- those lacking health insurance
- city dwellers
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stress management
- biofeedback
- massage
- progressive muscle relaxation
- meditation
- audio tapes on stress reduction
- physical exercise
- groups to discuss feelings
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American Nurses Association
defined professional nursing as the protection, promotion, and optimization of health ad abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human responses, and advocacy in the care of individuals, families, communities, and populations
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National League for Nursing
stated that without curriculum reform , nurses will not be able to function in three critical areas: computer literacy, information literacy, and informatics
30
State boards of nursing
provides education service, and research through collaborative leadership to promote evidence-based regulatory excellence for patient safety and public protection
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nightingale's philosophy of health maintenance
hand washing and demonstrated the value of rapid management of acute patients
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sigma theta tau
honor society supporting the learning, knowledge, and professional development of nursing making a difference in global health
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infection
a disease caused by microorganisms especially those that release toxins or invade body tissues
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presentation of infection
fever, loss of appetite, fatigue, muscle aches
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definition of pain
an unpleasant sensory and emotional experience associated with actual potential tissue damage or described in terms as sch damage
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dehydration
removal of water by chemical,, clinical consequences of negative fluid balance
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presentation of dehydration
thirst, orthostatic hypotension, tachycardia, elevate plasma sodium levels, hyperomolality
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hemorrhage
loss of blood, most commonly used for bleeding episodes lasting more than a few minutes, compromise organ, or tissue perfusion, or threaten life
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bradycardia
slowed heart rate, less than 60 beats per minute
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tachycardia
increased heart rate, greater than 100 beats per minute
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hypotension
low blood pressure caused by dehydration, heart disease, and anemia
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orthostatic hypotension
drops to greater than 10mmhg when patient stands. a sustained an persistent drop in systolic BP or diastolic bp within 3 min of patient standing
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hypertension
chronic elevation in blood pressure >140/90
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definition of vital signs
physiological parameters that indicate the adequacy of regulatory mechanisms, the function of organ systems, and the adequacy of oxygenation and perfusion
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normal temperature
97-100.4
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optimum and minimum temperatures
lowest between 1-4am and highest at 6pm
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normal pulse
60-100
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normal respiration
12-20 breaths per min
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tachypnea
greater than 20 breaths per min, caused by fever, hypoxia, acidosis, anxiety
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bradypnea
less than 12 breaths per min, caused by elicit drugs or CNS conditions
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blood pressure
force against artery wall, influenced by cardiac output, peripheral and vascular resistance and blood volume
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regulating factors of blood pressure
baroreceptors, brain stem, ANS, alpha and beta receptors, kidneys, and RAAS system
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do not take blood pressure in arm with
dialysis access, PICC line, mastectomy
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pain
subjective experience that is indicative of tissue damage
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when to check vital signs
admission, routine per order, new symptom, change in condition, medication administration, evaluate intervention, Peri-operative setting, critical care setting
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empathy
acknowledging patients' feelings with a statement of understanding, helps patients to feel more comfortable discussing the issue and to feel more accepted
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therapeutic communication
purposeful communication that is designed to convey openness and caring, requires an awareness of the patients' feeling environment
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therapeutic techniques
- using silence
- accepting
- giving recognition
- offering self
- giving a broad opening
- offering general leads
- placing the event in time or sequence
- making observations
- encouraging comparison
- encouraging description of perceptions
- focusing
- seeking clarification and validation
- presenting reality
- voicing doubt
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idetifying inappropriate communication
- giving reassurance
- rejecting
- giving approval or disapproval
- giving advice
- probing
- defending
- requesting an explanation
- using denial
- interpreting
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nursing process
defined as a variation of scientific reasoning and is used to diagnose and to treat human responses to potential and actual health problems
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what does the nursing process avoid?
nursing care based on imitation, intuition, or tradition
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steps of the nursing process
1. assessment
2. diagnosis
3. planning
4. implementation
5. evaluation
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definition of assessment
the act of reviewing a situation for the purpose of diagnosing the patients problems
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ways of collecting data for assessment
- formal and informal interviews
- observation
- inspection
- palpation
- percussion
- auscultation
- consult with the patient and other healthcare providers
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primary data source
the patient
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secondary data source
- family
- friends
- other healthcare professionals
- the patient's current health record
- the nurse's own knowledge base
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how a secondary data source is useful
useful in clarifying, amplifying, or substantiating the data the nurse obtains from the patient
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subjective data
information that can be perceived only by the patient
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why is the nursing or health history one of the primary sources of subjective data?
because the patient is the informant
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objective data
consists of behaviors, -activities, and events that can be observed or measured by another person using the five senses
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examples of objective data
- vital signs
- lab reports
- rashes
- body posture
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how does categorizing data as subjective or objective help the nurse?
the nurse is better able to:
- validate data
- identify and resolve discrepancies
- accurately report information to assist in communication
- establish nursing diagnoses
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outcome identification
- accomplished by analyzing the assessment date and the nursing diagnosis and deriving a desired outcome for a given problem
- specifically indicated that the patient care objective has been met
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outcome definition
a statement of how the patient's status will change once interventions have been successfully instituted
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nursing diagnosis
the clinical judgements about an individual, family, or community response to actual or potential health problems and life processes
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collaborative diagnosis
physician prescribed and nurse prescribed interventions
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types of nursing diagnoses
1. actual
2. high risk
3. wellness
4. syndrome
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actual diagnosis
a state that has been clinically validated by identifiable major defining characteristics
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components of actual diagnosis
1. label
2. definition
3. defining characteristics
4. related factors
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high risk diagnosis
a clinical judgement that a patient is more vulnerable to develop the problem than are others in the same or similar situation
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wellness diagnosis
a patient's clinically validated desire to move from a specific level of wellness to a higher level of wellness
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components of high risk diagnosis
1. label
2. definition
3. risk factors
4. related factors
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only component of wellness diagnosis
the label
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syndrome diagnosis
a cluster of actual or high risk nursing diagnoses that are predicted to be present because of a single event or situation
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the label of syndrome diagnosis
contains the etiology or contributing factors to the diagnosis
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planning
establishes the priority of the patient's nursing diagnosis
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factors to consider when establishing priority of patient's nursing diagnosis
1. patient's need for biological survival and functioning
2. the urgency of the need
3. the patient's perceptions and values
4. the nature of the nurse-patient relationship
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goals
a broad statement of purpose that describes the aim of nursing care
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examples of goals
- to alleviate and promote comfort
- to facilitate adequate oxygen
- to promote acceptance of altered body image
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objectives
must include measurable criteria that provide parameters for determining whether objectives have been achieved
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cognitive objectives
describe increase in patient knowledge or intellectual behaviors
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psychomotor objectives
describe patient's achievement of new skills
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affective objectives
describe changes in patient values, beliefs, and attitudes
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interventions
planned nursing actions that are likely to facilitate desired outcomes
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nurse initiated intervention
actions performed by a nurse without a physician's order
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physician related intervention
actions initiated by a physician in response to a medical diagnosis but carried out by a nurse under doctor's orders
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collaborative intervention
treatments initiated by other providers and carried out by a nurse
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implementation
doing or intervening phases of the nursing process that involves organization and actual delivering of nursing care
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NIC
nursing intervention classification
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critical pathways
examples of implementation tools that anticipate and describe the care of patients within a specified timeline
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evidence based practice
the recommended standard in health care used by nurses that integrates best current evidence with clinical expertise and the patient/family preferences and values for delivery of optimal care
102
types of care plans
1. kardex plans of care
2. computerized plans of care
3. case management plans of care
4. students plans of care
5. concept map care plan
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patient variables
- developmental stage
| - psychosocial background
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nurse variables
- resources
- current standards of care
- research findings
- ethical and legal guides to practice
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evaluation
focuses on a patient's behavioral changes and compares them with the criteria stated in the objectives that consists of both the patient's status and the effectiveness of the nursing care
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critical thinking questions
- how did the client tolerate the intervention?
- were there any identified problems?
- was any additional equipment needed?
- was the time frame appropriate?
- were the appropriate personnel involved?
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the nursing care plan
documented record of the nursing process including:
- nursing diagnosis
- outcomes with evaluation parameters
- interventions with supporting rationales are included on the care plan to communicate with the health care team and to guide patient care
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what happens if outcome is not met?
the care plan is revised and the process begins again until positive outcomes are achieved, if possible
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When do we terminate plan of care?
when goal was met
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when do we modify plan of care?
when goal was partially met
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when do we continue care of plan?
when goal was not met
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evaluating cognitive outcomes
asking patient to repeat information or apply new knowledge
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evaluating psychomotor outcomes
asking patient to demonstrate new skill
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evaluating affective outcomes
observing patient behavior and conversation
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evaluating psychologic outcomes
using physical assessment skill to collect and compare data
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goals if inter professional education and practice (IPE)
quality o care and patient safety and reduction in errors
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when does inter-professional education occur?
when two or more professional learn with, from, and about each other to improve collaboration and the quality of care
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inter-professional education
the process of developing the understanding of and respect for the role and unique contribution of the health professions and strategies for collaborative, client-centered teamwork
119
interprofessional practice
the collaborative, interdependent use of shared expertise directed towards unified purpose of delivering client centered health services
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impacted error
- medical errors are leading cause
| - more Americans die from medical errors than from breast cancer, AIDS, or car accidents
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improvements in medical errors
- computerized prescriptions
- including pharmacist in medical team
- team training in delivery of babies
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sentinel events
any unanticipated event in a health care setting resulting in death or serious injury of a person, not related to the natural course of the patient's illness
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examples of sentinel events
- a foreign body that as left in a patient after surgery
- a hospital operates on the wrong side of the patient's body
- hemolytic transfusion reaction involving major blood group incompatibilities
- a patient is abducted from the hospital where he or she receives care
124
ounces/mL
1oz = 30mL
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teaspoons/mL
1tsp = 5mL
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pounds/kg
1lb = 2.2kg
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celcius/Fahrenheit
F=1.8C + 32
