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43 Cards in this Set

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Define Medication Reminder
Reminding the person to take drugs, observing them being taken as prescribed, and chart that they have been taken.
Define SERVICE PLAN.
A written plan listing the services needed by the person and who provides them.
What are the 4 nursing patterns?
Primary nursing: RN is responsible for the persons total care.

Team Nursing: A team of nursing staff is led by RN who decides the amount and kind of care each person needs.

Functional Nursing: Focusing on tasks and jobs; each nursing team member has certain tasks and jobs to do.

Case Management: Case manager RN coordinates a persons care from admission through discharge and into the home setting.
ac

amb

ap
before meals

ambulatory [able to walk]

apical [at the tip]
BRP

CPR

DON
Bathroom privilegges

cardiopulmonary resuscitation

Director of nursing
HS

ht

I&O
hour of sleep

height

Intake and Output
L

lb

mid noc
Liter

pound

midnight
NA

OT

pc

per
nursing assistant

occupational therapy

after meals

by, through
po

q

qid

qod
by mouth

every

four times a day

every other day
R

ROM

s
rectal temp, respiration;

range of motion

without
SOB

SSE

TPR

VS

w/c
SHORTNESS OF BREATH

soapsuds enema

temp., pulse, respiration


vital signs

wheelchair
Define:
Anterior
at or toward the front of the body or body part
Define DISTAL
Part farthest from the center or from the point of attachment
LATERAL

MEDIAL
at the side of the body

at or near the middle or midline of the body or part
POSTERIOR [dorsal]
at or toward the back of the body or body part
What is the purpose of the OBRA?
Its purpose is to improve the quality of life of nursing center residents.

OMNIBUS BUDGET RECONCILIATION ACT OF 1987
Ethics
Knowledge of what is right conduct and wrong conduct
Standard of Care
The skills, care and judgement required by thehealth team member under similar conditions.
Empathy
Concern understanding another persons feelings
Define Subjective Data
Things a person tells you about that you can't observe through sense, symptoms.
Objective Data
Info. that is seen, heard, felt, or smelled, signs
What are the rules for reporting?
1. Be prompt, thorough, accurage

2. Give the persons name and room and bed number

3. Give time your observations were made or care given.

4. Report only what you observed or did yourself

5. Give reports as often as the persons condition requires, or as the nurse asks you to.

6. Report any changes from normal or changes in the persons condition.

7. Use your written notes to give a specific, concise, and clear report
Rules for Recording
Always use ink
Never erase errors or use correction fluid. Cross out the incorrect part and write error or mistaken entry over it. Sign initials to the error then rewrite the part.
What are the steps in the nursing process?
Assessment: Collecting information about the person

Nursing diagnosis: Describes hlth problem that can be treated by nursing measures.

Planning: Setting priorities and goals

Implementation: To perform or carry out measures in the care plan

Evaluation: Measure goals in the planning step were met
Verbal Communication
Face the person
Control the loudness and tone
Speak clearly, slowly, distinctly

Do not use slang
Do not shoud, whisper, mumble
Be kind coureous
Nonverbal Communication
Gestures, facial expressions, posture, body movements, touch smell.
Medical problems
Illnesses, diseases, injuries that do not need surgery
Integumentary system
Skin is fragile and easily injured.

Blood vessels decrease causing bruising and delayed healing

Brown spots

Skin has fewer nerve endings. This affects the ability to sense heat, cold, and pain

Nailis become thick and tough.

Thinning occurs on the head, pubic area, under arms.
Musculoskeletal System
Muscle cells decreae in number.

Bones loe strength, become brittle, breakeasily.

Joints become stiff and painful.
Eyes
Eyelids thin and wrinkle.

Farsighted, lens becomes more rigid with age
Cardiovascular System
Arteries narrow and are less elastic. Less blood flows through them.

Poor circulation occurs in many body parts. A weak heart must work harder to pump blood through narrowed vessels.
Respiratory System
Lung tissue becomes less elastic.

Difficulty breathing may occur with activity.

Person may lack strength to cough and clear the airway of secretions
Digestive System
Salivary glands produce less saliva.

Secretion of digestive juices decreases
Urinary System
Incontinence

Kidneys shrink
How clear obstruction from Unconscious person?
Position the person supine.

Kneel next to the person

Position your hands as for external chest compressions

Give chest thrusts until the object is expelled or the person becomes unconscious
Clear obstruction from responsive adult
1. Ask if the person is choking, can cough, speak

2. Give abdominal thrusts [stand behind the person, wrap arms around the persons waist, make a fish with one hand thum side of thefist agains the abdomen above the navel and below the end of the sternum. Grasp fish with other hand and press into the persons abdomen with a quick upward thrust. Repeat until the object is expelled or loses consciousness
Caring for eyeglasses
Clean daily. Wash glass lenses with warm water. Dry them with soft tissue. Plastic lenses scratch easily, use special cleaning solutions, tissues, and cloths
How remove glasses
Hold the frames in front of the ear on both sides. Lift frames from ears bring glasses down away from face.
How communicate with hearing impaired?
Stand or sit on the side of the better ear.

Face person when speaking

Make sure person is wearing hearing aid

Stand or sit in good light

Speak clearly distinctly, and slowly

Speak in normal tone of voice. Do not shout

Adjust pitch of voice as needed.

Lover pitch if person does not wear a hearing aid

Raise pitch if wearing hearing aid.
Asepis
Being free of disease producing microbes
Medical asepsis
Practices used to remove or destroy pathogens and to prevent spread from one person or place to another person or pace
Sterilization
Process of destroying all microbes
Microorganism
Small living plant or animal seen with a microscope