Exam 1 Flashcards
(78 cards)
1
Q
What are Ethical Principles?
A
Standards for what is right or wrong in regards to particular rights and norms
2
Q
Basic Principles of Ethics
A
- Advocacy
- Confidentiality
- Accountability
3
Q
Advocacy
A
support of clients’ health, wellness, safety, and personal rights including privacy
4
Q
Confidentiality
A
Protection of privacy without diminishing access to high quality care
5
Q
Accountability
A
Ability to answer for one’s own actions
6
Q
Ethical Principles
A
Autonomy Justice Veracity Fidelity Beneficence Non-Maleficence Integrity
7
Q
Autonomy
A
right to self determination
8
Q
Justice
A
Treating people equally
9
Q
Veracity
A
To tell the truth
10
Q
Fidelity
A
To keep one’s promise
11
Q
Beneficence
A
To do good
12
Q
Non-Maleficence
A
To do no harm
13
Q
Integrity
A
Do the right thing even when there is no one watching
14
Q
What are ethical dilemmas?
A
Problems between people with different values and beliefs
you will never fully avoid ethical dilemmas but remember that you must ALWAYS self-reflect
15
Q
Student Handbook
A
- Phones and computers are a privilege
- Classroom Dress Code
- Standards of practice in nursing
16
Q
ANA Code of Ethics
A
- Largest nursing organization in the United States
- Outline ethical obligations and duties of the nursing profession
- 9 provisions that serve as the basic guidelines to the nursing profession
17
Q
BON Guideline for Practice
A
- Regulate the practice of nursing
- Established a minimum acceptable level of nursing practice in any setting for each level of nursing licensure or advance practice licensure
18
Q
What constitutes a therapeutic environment?
A
-Developing a trusting relationship where the patients feel comfortable sharing their story
19
Q
4 things included in a therapeutic environment?
A
- Begin with the purpose of the interview
- Make sure the client is comfortable
- Gather information (General Survey)
- Conclude the interview by summarizing your findings
* Remember to ALWAYS use open ended questions*
20
Q
Health History Components
A
- Demographic Information
- Source History
- Chief Concern
- History of Present Illness
- Past history and current health status
- Family History
- Psychosocial History
- Health Promotion Behaviors
21
Q
Demographic Information
A
- Name
2. D.O.B.
22
Q
Source History
A
- Client/Patient
2. Family Members
23
Q
Chief Concern
A
What is the main symptom being experienced
24
Q
History of Present Illness
A
- Chronological description explaining why the clients seeks care
- P.Q.R.S.T.
25
Past history and current health status
1. Illnesses
2. Allergies
3. Current Medications
4. Lifestyle patterns (alcohol and tobacco use)
26
Family History
Family medical history
27
Psychosocial History
1. Relationships
2. Financial Status
3. Spiritual Health
4. Culture
28
Health Promotion Behaviors
1. Exercise
2. Activity
3. Diet
29
Types of Data Collection
Subjective and Objective data
30
Subjective data
is information from the CLIENT/PATIENT
- such as symptoms and chief complaint
- Pain is always subjective (physical and emotional)
31
Objective data
Information that is measurable
- such as info gathered in a physical exam and through diagnostic tests
- use of senses (hearing, sight, touch, and smell)
32
Documentation
-standard for many accrediting agencies including the Joint Commission
33
Joint Commission
Mandates the use of computerized databases to expedite the accreditation process
34
Purposes for Medical Records
1. Communication
2. Legal Documentation
3. Financial Billing
4. Education
5. Research
6. Auditing
35
Computerized Healthcare Should Contain
1. Client Support
2. Health Information and Data
3. Administrative Processes
4. Results Management
5. Secure Electronic communication and connectivity
6. Decision Support
36
Elements of documentation
```
Subjective Data (direct quotes from patient)
Objective Data (Should be descriptive and should include what the nurse sees, hears, feels, and smells)
*objective data should not contain any judgement)
```
37
How do you conduct a Cardiac Assessment?
-measure heart rate and blood pressure
-examine the jugular veins
-auscultate the heart sounds (s1 and s2)
(diaphram=high pitch sounds)
(Bell=low pitch sounds)
38
Equipment used in cardiac assessment
- stethoscope
- BP cuff
- watch
39
Cardiac Inspection and Palpation
- JVD
- Apical pulse
- Lifts of chest
40
Cardiac Auscultation
Turning to the left side allows for better auscultation
41
Cardiac heart sounds
S1: LUB=closure of tricuspid and mitral valves
S2: DUB=closure of aortic and pulmonic valves
42
Sites of the heart
```
Aortic (right)
Pulmonic (left)
Erb's Point
Tricuspid
Apical/Mitral (5th intercostal space, mid-clavicular line)
```
43
What is a General Survey?
A written summary/appraisal of overall health (1st interaction with the client)
44
Components of a General Survey
1. Physical Appearance
2. Body Structure
3. Mobility
4. Behavior
5. Vital Signs
45
Components of Physical Appearance in a General Survey
```
Age
Gender
Race or Ethnicity
Color of skin
Level of consciousness (LOC)
Facial Features
```
46
What is assess within the mobility segment of a general survey?
Gait
47
Components of behavior in a general survey
Dress
Hygiene
Grooming
Odors
48
Components of Vital signs in a general survey?
```
Temperature
Pulse
Respirations
Blood Pressure
Oxygen Saturation
```
49
Steps of Assessment
Inspect, palpate, percuss, auscultate
| *Abdomen: Inspect, auscultate, percuss, palpate
50
Pain Assessment
```
P-Provoke
Q-Quality
R-Region/Radiation
S-Severity/Setting(Origination)
T-Timing
*use face scale if <7 yrs of age
```
51
Vital Signs and Pain
Vital signs may be elevated when experiencing pain
52
Non-Pharmalogical Comfort Measures for pain
1. Relaxation
2. Imagery
3. Distraction
4. Acupuncture
5. Music Therapy
6. TENS Unit (Heat/Cold therapy touch)
7. Humor
8. Meditation
9. Breath-work
53
Types of Pain
```
Acute
Chronic
Central
Breakthrough
Phantom
Psychogenic
Nociceptive
```
54
Acute pain
- Temporary
| - < 6 months
55
Chronic pain
- Ongoing and reocurring
| - > 6 months
56
Central Pain
Nerve pain
57
Breakthrough Pain
- Not managing pain well/not staying on top of surgery
| - Hard to control if you do not control pain well
58
Phantom Pain
Pain in limb after amputation
59
Psychogenic
Pain associated with psychological factors (fear, anxiety, and depression)
60
Nociceptive Pain
- Damage to tissue or inflammation of tissue
1. Somatic: bones, joints, muscles
2. Visceral: internal organs
3. Cutaneous: ski or subcutaneous tissue
4. Referred: sensed in a region other than the site of origin
61
Clinical Manifestations of pain
1. Facial Expressions
2. Exhaustion
3. Tears
4. Decreased Attention Span
62
Pain Threshold
the point at which a patient feels pain
63
Pain Tolerance
the amount of pain the person is willing to bear
64
Transduction
painful stimuli to an electrical impulse
65
Acute pain and anxiety
Acute pain can lead to increased anxiety
66
Chronic pain and depression
Chronic pain can lead to increased depression
67
Factors that affect pain experience
Age
Fatigue
Culture
68
Holistic Assessment includes
1. AIDET
2. Gain trust/rapport
3. Complete health history
4. Cultural Assessment
5. Comprehensive physical assessment
6. Comprehensive psychosocial assessment
* Infants and children require a different assessment approach*
* Assessment for Older adults requires a comprehensive understanding of the factors aging plays in physical, social, mental, and emotional health.
69
Techniques of physical assessment
inspect
palpate
percuss
auscultate
70
Quality and Safety Education for Nurses (Q.S.E.N.)
1. Patient centered care
2. Quality improvement
3. Evidence based practice
4. Teamwork and collaboration
5. Safety
6. Informatics
71
What are the national patient safety goals per the Joint Commission?
1. Correctly identify the patient (Name/D.O.B.)
2. Improve Staff Communication
3. Use medicines safely
4. Use alarms safely
5. Prevent infection
6. Identify patient safety risks
7. Prevent mistakes in surgery
72
Accident/Error/Injury Prevention (Falls)
- Perform fall risk assessment
- Appropriate number of side rails raised
- Personal items close by/bed side table
- Call light within reach and patient knows how to use it
- Use fall risk alerts/ ID bands
- Hourly rounds
- Gait belts/safety equipment
- High risk patients near the nursing station
- Bed in lowest position/wheels are locked
73
Why are restraints used?
To protect a patient and other patients or staff
* Never use for punishment or convenience
* provider must prescribe seclusion or restraints in writing after a face to face assessment of the client
74
What are the two types of restraints?
Physical and Chemical
75
What is R.A.C.E.
```
Used in fire emergency
R-Rescue
A-Alarm
C-Contain
E-Extinguish
```
76
What is P.A.S.S.
```
How to use fire extinguisher
P-Pull the pin
A-Aim at the base of the fire
S-Squeeze the lever
S-Sweep side to side
```
77
Home Safety
1. Basic First Aid
2. CPR
3. Keep emergency numbers near phone
4. Fire Extinguisher
5. Smoke Detectors
6. Safety plans for fires (practice regularly)
7. Watch for carbon monoxide
78
Standard Safety Precautions
- Always exercise hand hygiene
- Needle sticks (never recap; properly dispose of sharps)
- Exposure to blood borne paths (P.P.E.-glove gown masks)
- Latex allergy (limit exposure and hand hygiene)
- Musculoskeletal Injuries (practice good ergonomics and use mechanical lift devices)
- Workplace violence (know how to call for help, policies and procedures, harsh punishment for violators)
- Emergency Codes
