Chapter 1 Quiz/test Study Guide

Front 1

The importance of assessing risk factors?

Back 1

Assessing risk factors plays a important role in how you identify a patients health status. Might tell you what variables should be modified.

Front 2

External Variables:



That influence Health Beleifs/Practices

Back 2

Are your Families, Socioeconomic factors, Cultural background.

Front 3

Internal Variables:


Influence health beliefs/practices

Back 3

Developmental Stage, Intellectual, Emotional Factors, Spiritual Factors.

Front 4

Know the 3 levels of PREVENTIONS:

Back 4

Primary: true prevention. purpose: decrease the vulnerability of the individual or population to an illness or dysfunction. EX: immunization
Secondary: Focuses on people who have health problems or illnesses and at risk for developing complications or worsening conditions.
Tertiary: when defect or disability is irreversible, permanent, and stabilized. Restoration and rehabilitation.

Front 5

Healthy People 2010:

Back 5

Provides evidence based objectives 1) achieve increases quality and years of healthy life 2) eliminate health disparities. Promotion of healthy living.

Front 6

Types of risk factors:

Increases vulnerability to illness or accident:

Back 6

EXAMPLES: Age, Genetic and physiological factors, lifestyle, physical environment.

Front 7

Risk factor modification and Changing health behaviors:

EX: PCPAM- Stages of behavior change

Back 7

Aim your attempts to change behavior or adopting a healthy behavior.

Stages of behavior:
Pre-contemplation- does not intend to make changes.
Contemplation: Considering a change w/i next 6 mo.
Preparation: Tries to make changes, with no success.
Action: Actively engaged in strategies to change behavior.
Maintenance: Sustained change over time.

Front 8

Focus of Managed Care:

Back 8

Focused on Health Maintenance, all care provided by a primary physician.
Includes:
Staff Model: salaried employees
Group Model: MCO contracts with single group pract.
Network Model: Contracts with multiple groups and organizations.

Front 9

Health Care regulation, and Competition:

Back 9

Professional standards review org (PSRO's) -Review cost of HC services provided thru Medicare & Medicaid.
Utilization Review Committees (UR)- review admissions
Prospective Payment System: eliminated cost based reimbursement.
Diagnosis related groups (DRG's)-Each group has fixed reimbursement amounts with adjustments.
Capitation: providers receive a fixed amount per pt.

Front 10

Examples of HC Plans:

Back 10

Managed care (MCO)
Medicare (MCO) - same as MCO just for the elderly
PPO- focus on health maintenance
Exclusive Provider Org (EPO)
Medicare ABCD
Medicaid
Private Insurance- traditional fee for service
Long Term Care Insurance- Expensive!

Front 11

Preventive Care:

Back 11

Bld pressure and cancer screening.
Immunizations.
Poison Control Info
Mental Health Counseling and Crisis prevention
Community Legislation (ex. seatbelt)

Front 12

Primary Care:v(Health promotion)

Back 12

Prenatal Care
Well-baby care
Nutrition Counseling
Family Planning
Exercise Classes

Front 13

Secondary Acute Care:

Back 13

Emergency Care
Acute-Medical Surgical Care
Radiological Procedures

Front 14

Tertiary Care:

Back 14

Intensive Care
Psychiatric Facilities

Front 15

Restorative Care:

Back 15

Cardiovascular and pulmonary Rehabilitation
Sports Medicine
spinal cord injury programs
Home care

Front 16

Continuing Care:

Back 16

Assisted Living
Psychiatric and older adult day care

Front 17

Preventive and Primary Care Services:

Back 17

School Health
Occupational Health
Physicians Offices
Nursing Centers
Block and parish Nursing
Community Centers

Front 18

The role of the community health nurse:

Back 18

Nursing care provided in the community, with the primary focus on the HC of individuals, families, and groups in the community. Focus on Health promotion, disease prevention, and restorative care.

Front 19

Respite Care:

Back 19

Service that provides short term relief or time off for persons providing home care to an ill, disabled, or frail older adult.
Adult day care is one form.

Front 20

Assessing members of vulnerable populations:

Back 20

Groups in the population that are more likely to develop health problems due to excess risks.
Examples: Immigrant Populations
Poor and Homeless Persons
Persons with Mental illness
Older Adults

Front 21

Confidentiality:

Back 21

HIPAA- Health Insurance Portability and Accountability Act : Protection of privacy and Health Information

Front 22

Standards for documentation by Nurses:
Legal Guidelines: Listed Below:

Back 22

Look down

Front 23

Guidelines
Do not erase, apply correction fluid, or scratch out errors made while recording.

Back 23

Rationale
Charting becomes illegible, may appear as if you were hiding info

Hint 23

Correct Action
Draw line through error, write error above it, sign name and initials. Then record note corruptly

Front 24

Guidelines
Do not write critical comments about pt.

Back 24

Rationale
Can be used as evidence for nonprofessional behavior or poor quality of care.

Hint 24

Correct Action
Enter only objective descriptions of pts behavior, pts comments should be "quoted"

Front 25

Guidelines
Need to additional pt info

Back 25

Rationale
new info is acquired

Hint 25

Correct Action
If new info needs to be added to previous entry time and date should be written above note on next additional space

Front 26

Guidelines
Record all Facts

Back 26

Rationale
Record must be reliable and accurate.

Hint 26

Correct Action
Be certain entry is factual, do not speculate or guess.

Front 27

Guidelines
Do not leave blank spaces in in Nurses Notes.

Back 27

rationale
Another person can add incorrect info.

Hint 27

Correct Action
Chart line by line. If space is left draw horizontal line thru it

Front 28

Guidelines
Record all Entries Legibly in black ink.

Back 28

Rationale
Illegible writing can be misinterpreted causing errors and lawsuits, ink cannot be erased.

Hint 28

Correct Action
Never erase entries or use correction fluid, and never use pencils or pens with erasable ink.

Front 29

Guidelines
If order was questioned, record that clarification was sought.

Back 29

Rationale
If you administer that drug you are just as reliable as the physician or Hc provider is.

Hint 29

Correct Action
Chart " Dr. Smith was called to clarify order for analgesic.

Front 30

Guidelines
Chart only for yourself.

Back 30

rationale
You are accountable for your information that you enter into the chart.

Hint 30

Correct Action
Never chart for someone else!! Except- telephone orders

Front 31

Guidelines
Avoid using generalized empty phrases such as "status unchanged" or "had a good day"

Back 31

Rationale
Specific info about pt's condition or case can be accidentally deleted if it is to generalized.

Hint 31

Correct Action
Use complet concise descriptions of care.

Front 32

Guidelines
Begin each entry with date and time, and end with your signature and title.

Back 32

Rationale
This guideline ensures the correct sequence of events is recorded,

Hint 32

Correct Action
Do not wait until end of shift to record important changes that occurred several hours earlier: be sure to sign each entry.

Front 33

Guidelines
For computer documentation keep you password to yourself.

Back 33

Rationale
Maintains security and confidentiality.

Hint 33

Once logged into the computer, do not leave screen unattended, and log out when you are finished charting.

Front 34

Examples of criteria for Documentation and Reporting:

Back 34

Assessment:
Subjective data (pt behavior, anxiety, confusion)
Objective data (Rash, breath sounds)
Nursing Intervention and Analysis:
Tx
Medication Administration
Pt Teaching
Discharge Planning

Front 35

Narrative Documentation:

Back 35

Traditional method for recording nursing care however, that has changed. Only beneficial in emergency situations.

Front 36

5 Characteristic of quality documentation:

Back 36

Factual, Accurate, Complete, Current, Organized.

Front 37

Format for documentation:

SOAP charting

Back 37

S (subjective Data)
O (objective Data)
A (assessment/analysis)
P (plan)

Front 38

Format for Documentation:

Pie Charting

Back 38

P (problem)
I (intervention)
E (evaluation)
Simplifies documentation

Front 39

Format for Documentation:

Focus Charting

Back 39

D ( data)
A (action)
R (response)

some agencies add P (plan)
Focuses on Pts concern more than the problem.

Front 40

Documenting an Incidence Report:

Back 40

also called an occurrence report. occurs when there is an actual or potential injury: this report is NOT apart of the pt record.

Front 41

When do you write narrative info?

Back 41

Only if abnormal findings, or variances in the use of interventions occur.

Front 42

Guidelines for telephone orders:

Back 42

Clearly identify pts name, room #, and diagnosis.
Read back all orders
Write TO OR VO telephone order/verbal order
Signing of that action must be signed within 24 hours

Front 43

Critical Pathway:

Back 43

provides summary for standardized plan of care.

Front 44

Categories of method of transmission:
Contact:

Back 44

Direct: person to person
Indirect: contact with contaminated object.
Droplet: large particles that travel up to 3 ft.

Front 45

Categories of method of transmission:
Airborne:

Back 45

Droplet nuclei: droplets that are suspended in air ( from sneezes, coughing, talking)

Front 46

Categories of method of transmission:
Vehicle:

Back 46

Contaminated Items
Water
Drugs, Solutions
Blood
Food (improperly handled, stored, cooked)

Front 47

Categories of method of transmission:
Vector:

Back 47

-External Mechanical Transfer(flies)
-Internal transmission such as with parasitic conditions btw vector and host, for example:
Mosquito
louse
tick
flea

Front 48

Chain of Infection: PRIMPS

Back 48

Infectious agent
Reservoir
Portal of Exit
Modes of Transmission
Portal of Entry
Susceptible Host
*CAN BE BROKEN*

Front 49

Defense Against Infection:

Back 49

Normal Flora: Help maintain Health
Body System Defenses: Body system have defenses against infection.
Inflammation: delivers blood to injured site. Signs= swelling, redness, heat, pain, or tenderness, and loss of fx. If becomes systemic signs include fever.
Immune response: When antigen enters body, series of responses change the bodys biological makeup. The next time it enters the body your antibodies bind to the antigens they find and neutralize, destroy or eliminate them.

Front 50

Health Acquired Infections, sites and causes?

Back 50

Pt develops infection in HC setting.
Exogenous: Microorganisms found outside individual.
Endogenous: when the pts normal flora becomes overgrown or altered.

Hint 50

Sites: Skin, mouth, eye. respiratory tract, urinary tract, GI, vagina.

Causes:Urinary tract, surgical or traumatic wounds, respiratory tract, bloodstream.

Front 51

Asepsis:

Back 51

Aseptic: keep pt free from exposure to infection causing pathogens.
Medical Asepsis: clean technique used to reduce the number or spread or microorganisms.
Surgical Asepsis: Sterile technique used to destroy microorganisms and spores.

Front 52

Standard Precautions:

Back 52

Occurs with All pt's regardless of diagnosis.

Front 53

Transmission Based Precautions:

Back 53

Pt's with communicable diseases and infections that are easily transmissible to others.

Front 54

PPE:Personal Protective Equipment

Back 54

gowns, gloves, mask, protective eyewear, or face shield.

Front 55

Orders for removing based on full PPE:

Back 55

remove gloves, eyewear(face shield, or goggles), untie neck strings from gown then back strings, remove hands from sleeves without touching the outside of gown, remove mask, PERFORM HAND HYGIENE!

Front 56

Principles of body mechanics-

Back 56

Coordinated efforts of the musculoskeletal and nervous systems.
-maintain balance,posture, and body alignment.
Mandatory for: lifting, bending, and moving, and performing adl's

Front 57

Regulation of Movement:

Back 57

Skeletal System:
-bones,joints,ligaments,tendons,cartilage.
Skeletal Muscle:
- Movement,posture, groups,synergistic,antigravity
Nervous System:
-Regulates movement and posture, Proprioception, balance

Front 58

Pathological Influences on Body Alignment:

Back 58

Congenital Defects:
-Osteogenesis Imperfecta Scoliosis
CNS Damage:
-Damage to any component that regulates body movements.
Disorders of Bones, Joints, and Muscles:
-Osteoporosis, Inflammatory and Inflammatory joint disease.
Musculoskeletal Trauma:
-Bruises, contusions, sprains, and fractures.

Front 59

Positioning Techniques:

Fowler Semi Fowlers/ Lateral

Back 59

-Head of bed elevated, support and align hips at spine.
Fowlers=45 degrees
Semi fowlers is 30 degrees

Lateral -Lying on a side with proper spine alignment.

Hint 59

Fowlers: used for pts who cannot tolerate supine, ppl with cardiac or respiratory problems. (breathe easier)
Lateral: Pts who are obese and older cannot tolerate this position.

Front 60

Positioning Techniques:

Supine

Back 60

Lying on back, support with pillows, trochanter rolls, or splints.

Hint 60

-Risk for aspiration is increased.
-Avoid when pt is confused,agitated, experiencing a decreased level of consciousness.
-USE FOOT DROP

Front 61

Positioning Techniques:

Prone:

Back 61

Lying face down

Hint 61

Record any possible

Front 62

Positioning Techniques:

Sims:

Back 62

Semi prone on right side or left side with weight placed on anterior ilium, humerus, and clavicle.