1204 Final BP
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| Florence Nightengale | Dropped death rate from 60% to 1%
Believed in nutrition, clean air, therapy, and continuing education as a nurse.
Started first training school for nurses.
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| Dorothea Dix | Social worker, appointed by Union government to provide nursing to the soldiers.
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| Clara Barton | Took volunteers into field hospitals, later founded the American Red Cross
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| Lillian Wald | Took nursing into the community.
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| LVN Roles | Caregiver, Educator, Collaboraor, Manager
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| Caregiver | Aimed at restoring and maintaining a persons health. Interventions are actions taken to improve, maintain, restore, or prevent illness. Encourage growth toward wellness so that the pt can be self-reliant again.
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| Educator | Directed toward promoting wellness and preventing illness. Teaching about: Medicines, dressing changes, emotional support. Patient advocacy.
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| Collaborator | Work with the RN and other members of the healtcare team to provide continuity of care for the patient. Delegation to UAP's.
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| Standards of Care | Defined in nursing procedure books,institutional manuals of policies and procedures of protocols, and nursing journals that outline current skills or techniques.
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| THE Standards Of Care | Governed by rule 217.11
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| Standards of Care are important... | in the case of a lawsuit; they help determine whether a nurse practiced appropriately in a situation.
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| Reviewed and updated every 24 hours | Interventions documented on flow sheet or nurses notes. Evaluations in nurses notes.
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| PIE charting | Problem, Intervention, Evaluation
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| If outcomes aren't met | revise interventions
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| Interventions | are actions taken to improve, maintain, or restore or prevent illness.
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| Primary Prevention | Avoids or delays occurrence of a specific disease or disorder Ex: Immunizations
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| Secondary Prevention | Following guidelines for screening for disease Ex: Pap smears, TB test
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| Tertiary Prevention | Rehab after pt has already had disease
Ex: Cardiac Rehab
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| Managed Care | Documentation is VITAL. Must prove that procedure is necessary. Lay the Ground work!!! Attempt at decreasing healthcare costs.
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| Four Common Goals of Nursing | To Promote Wellness, Prevent Illness, Facilitate Coping, Restore Health
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| Health | Relative state in which one is able to function well physically, mentally, socially, and spiritually in order to express the full range of ones unique potentialities within the environment in which they are living.
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| Acute Illness | One that develops suddenly and resolves in a short time
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| Chronic Illness | Presisting for a long time
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| Terminal illness | Illness with no cure available, ends in death.
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| Primary Illness | One that develops without being caused by another health problem.
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| Secondary Illness | Results from the primary illness
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| Idiopathic Illness | One for which there is no known etiology (cause)
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| Holistic Approach | Considers biologic, psychological, sociological, and spiritual aspects and needs of the pt.
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| Holistic Health Care | traditional methods of surgical intervention and drug prescription are being combined with or replaced by acupuncture, acupressure, biofeedback, meditation to reduce tension and stress, and various relaxation techniques for the mgmt of pain.
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| Maslow's Theory of Basic Needs | The basic physical needs such as food, air, water, and rest must satisfied before higher emotional-level needs emerge. Each need must be met before progressing to the next level.
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| On the bottom of Maslow's hierarchy - must be fulfilled first: | Physiologic Needs: oxygen, blood, nutrition, and elimination. Protection from physical harm, from a nursing standpoint, it often equivalent in importance to physical needs. Rest. Musculoskeletal activity. Sexual Expression.
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| 2nd from the bottom of Maslow's Hierarchy: | Security and belonging: people must feel safe and free of fear. Comfortable when their safety needs are met. Avoid harm; freedom from fear. Active listening on the part of the nurse is essential.
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| 3rd from the bottom of Maslow's Hierarchy: | Self-Esteem and Love: need for giving and receiving affection. Companionship. Satisfactory interpersonal relationships. Both Giving and receiving. Intimacy.
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| Tippy Top of Maslow's Hierarchy (last need met): | Self-Actualization: Feeling of self-fulfillment. Realization of his or her highest potential. Occurs with individuals are very comfortable with themselves and are certain of their beliefs and values.
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| Stress | is sum of biologic reactions that take place in response to any stressor (adverse stimulus)
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| Effects of Stress Depends on | Pts perception of stress.
Degree of health and fitness.
Previous life experiences and personality.
Available social support system.
Personal coping mechanisms.
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| Stress Coping Responses | Change the situation so it is not stressfull.
Alteration of thoughts to control the meaning of a situation before it triggers a stress response.
COntrol of thoughts and actions to stop a stress reaction.
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| Defense Mechanisms | protect us from increased anxiety.
Used to maintain and improve our self-esteem.
Gives us time to solve problems and adapt in a positive manner.
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| Repression | Blocking from memory
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| Denial | More Serious form of blocking
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| Projection | Blaming someone else
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| Reaction-Formation | Act opposite of how you feel
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| Regression | Returning to an earlier level of adaptation
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| Rationalization | Justify an experience
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| Identification | Modeling behavior after someone else
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| Introjection | unconscious imitation
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| Displacement | placing intense feelings on a less threatening object
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| sublimation | rechanneling an impulse into a more socially desireable object.
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| Stress reduction techniques | progressive relaxation, massage, biofeedback, yoga, meditation, physical exercise.
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| The body deals with stressors by | secretion of hormones
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| Alarm stage | Hormone release mobilizes the body's defense
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| Stage of resistance | Body is battling equilibrium
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| Stage of Exhaustion | Occurs if the stressor is severe enough or is present over a long period of time.
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| Constitutional Law | Formal laws within the framework of the Constitution. Identifies rights and privileges to which the process of checks and balances, protecting the entire nation. EXAMPLE: Free speech and right to privacy.
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| Statutory Laws | Laws enacted by federal, state, or local legislatures. Statute - Legal term for a law. EXAMPLE: state nurse practice act
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| Administrative Laws | Legal provisions through which federal, state, and local agencies maintain self-regulation. Affects power to manage governmental agencies. The state board of nursing is an example of an administrative agency that enforces administrative law.
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| Common Laws | Litigation that falls outside the realm of constitutional, statutory, and administrative law. Decisions based on prior cases of similar nature (judicial law)
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| Criminal Law | Penal codes that protect the safety of all citizens from people who pose a threat to the public good. Misdemeanor: minor criminal offense. Felony: Serious criminal offense.
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| Civil Law | Statutes that protect personal freedom and rights (EXAMPLE: Freedom from character attacks).
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| Good Samaritan Laws | Laws that provide legal immunity to individuals who provide emergency first aid to victims of accidents.
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| tort | litigation in which one person asserts that an injury, which may be physical, emotional, or financial, related to a consequence of anothers actions or failure to act.
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| Intentional Torts | Assault, battery, false imprisonment, invasion of privacy, defamation
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| Unintentional Torts | Situations that result in injury. Negligence, Malpractice.
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| False imprisonment | interference with a person's freedom to move about at will without legal authority to do so
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| Assault | threat or an attempt to do bodily harm
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| battery | an unauthorized physical contact
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| Professional Liability | Obtain liability insurance. Familiarity of legal mechanisms such as, good samaritan laws, statutes of limitations, principles regarding assumption of risk, appropriate documentation, risk management, incident reports, anecdotal records.
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| Elements of Malpractice | You wed a duty to the patient, You breached that duty, The pt was injured, The injury occurred as a result of the breach of duty.
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| Protection of Malpractice | Participation in continuing education programs, Administrative of competent care, communicating a caring and compassionate attitude.
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| Malpractice | Professional negligence (holds professionals to a higher standard of accountability)
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| Negligence | Harm that results because a person (that is a reasonably prudent person would do or would not do) did not act reasonably.
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| Student nurse | Held to the same standards as a license nurse. Perform a task with the same outcome to the patient. Student is legally responsible for his/her own actions or inaction. Students must consult with their instructors.
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| Patient chart | is property of the hospital, not the patient. Legal document. Begins when the pt enters the healthcare system.
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| informed consent | pts agreement to allow something to happen, such as surgery, based on full disclosure of risks, benefits, alternatives and consequences of refusal.
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| Informed consent includes the following: | Pt and witness signature, date and time, verification that it was voluntary and risks benefits and alternatives were discussed. Verification that the pt understands the procedure and has had all questions answered.
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| Delegation | transferring responsibility for the performance of an activity or task while retaining accountability for the outcome
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| Five rights of delegation | Right task, Right circumstance, Right person, Right direction/communication, Right supervision
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| Confidentiality | Safeguarding a persons health information from public disclosure. Nurses must not divulge health information to unauthorized individuals without the clients written permission.
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| ethical dilemma | choice between two undesirable alternatives
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| How to process an ethical dilemma | distressing to both the pts and caregivers, institutional ethics committee to help reach decisions.
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| SBAR Communication | Helpful when communicating with physicians due to both fields of learning communicate differently.
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| SBAR | S: situation / B: Background / A: Assessment / R: Recommendation
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| Ethnocentrism | holding one's own way of life as superior to others.
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| Stereotyping | results in a tendency to fit every person into a particular pattern without further assessment
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| Methods of Charting | Narrative Charting, Problem-Oriented Medical Records (SOAP, Focus, PIE), Source Records, Charting by Exception, Computerized Charting
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| Ethics Committee | Consider the ethical Dilemma
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| Ethical Code | Actions and beliefs approved of by a particular group. There is not often one right action.
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| End of Shift Report | Room number, Tests and treatments or therapies performed in the past 24hrs w/ pt response, significant changes in pt condition, scheduled tests, consults, current iv solutions, next solution to be hung, oxygen flow rate, current problems, concerns
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| Spirituality | awareness of ones inner self and sense of connection to a higher being, nature or to some purpose greater than oneself.
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| Laissez Faire | permissive does not attempt to control the team and offers little or no direction.
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| autocratic | authoritarian tightly controls the members of the team.
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| Democratic | consults with staff members and seeks staff participation in decision making.
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| Touch | Remember touch needs to be beneficial to the pt. Touch when is caring it is considered to be therapeutic.
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| Listening Skills | Listening is also a skill. It involves both hearing and interpreting what another says. It requires attention and concentration to organize, evaluate, and validate clues to the patients true meaning.
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| Purpose of Pt Teaching | Nurses teach pts about their disease or disorder, including diet, medications, treatment, and self-care.
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| One of the nurses most important responsibilities | Patient teaching!
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| Therapeutic Communication | Helps a pt cope, active listening, establish a good nurse-pt relationship, gain trust!
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| Nurse-pt relationship | Gain trust
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| Empathy | ability to understand and accept another persons reality
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| Sympathy | concern, sorrow, or pity you feel for a pt when you can personally identify with his/her needs
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| Respite Care | Type of care for an elder who lives at home. Can provide form much-needed psychological and physical rest for caregivers.
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| Slander | Oral (spoken) defamation.
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| Libel | Written Defamation.
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| Cultural Specific Disease: African or Mediterranean | sickle cell trait or sickle cell anemia
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| Cultural Specific Disease: African Americans | Keloid formation and sarcoidosis
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| Cultural Specific Disease: Eastern European Jewish ancestry | Tay-Sachs
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| Cultural Specific Disease: Hispanic, African, Chinese, Thai and American Indian | Lactose Intolerance
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| Cultural Specific Disease: Hispanic and American Indian | Diabetes
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| Cultural Specific Disease: African American and Pacific Islanders | Hypertension
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| HIPAA | Covers 6 pt rights and provider responsibilities: Consent (written consent to disclose info), Notice (of these 6 rights), Access (to med record), Amedment (his record for accuracy), Accounting for disclosures , and Restriction of Disclosure.
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