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30 Cards in this Set

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Medicaid program designation-who is it for, who regulates it pg 18
For low-income families, low-income people with LTC disabilities, supplemental coverage and LTC assistance to older adults and Medicare beneficiaries in nursing homes
Federally funded, state-operated
What is Medicare for and how do they reimburse healthcare providers pg 27
Quality standards for health care facilities
Wtason's theory of caring looks like what-"knowing" looks like what pg 97-98 (If a nurse wants to change staff behavior/practice what is the best method to do that)
Watson's theory of caring: holistic approach that says a conscious intention to care promotes healing and wholeness
Knowing: striving to understand an event as it has meaning in the life of another
Ideas for communicating with clients who are not fluent in English pg 113
Know population demographic changes(distribution of groups, education, occupatoin, and incidence of most common illnesses)
Ask open-ended questions to facilitate values, beliefs, and practices significant to care
Use an interpreter(of same gender)
Nursing Process-what does each step look like when the nurse is executing that step pg 221-224 (Assess, nursing diagnosis, plan, implement, evaluate)
(assess)identify a client's healthcare needs--->(nursing dx)clearly define a nursing dx--->determine priorities of care and set goals and expected outcomes of care--->(plan)develop and communicate a client-centered plan of care--->(implement)deliver nursing interventions--->(evaluate)evaluate the effects of your care
What is clustering data and what does it accomplish pg 234
groups "like" data together to form emerging patterns and problems
Nursing Diagnosis-what do they guide, who develops them, whose scope do they encompass pg 248
guides nursing interventions; developed by nurses; encompasses the scope of nurses
Goals pg 265
client-centered: specific, measurable behavior or response that reflects a client's highest possible level of wellness and independence
Is realistic and based on client needs and resources
Represents predicted resolution of a diagnosis or problem
(short-term vs long-term)
Interventions pg 279-284
Determine if intervention is correct and appropriate for clinical situation
Review the set of all possible nursing interventions for the client's problem, review all possible consequences associated with each possible nursing action, determine the probability of all possible consequences, make a judgment of the value of that consequence to the client
Apply intellectual standards(guidelines for rational thought and responsible action)
Clinical guideline/protocol(a document that guides decisions and interventions for specific health care problems or conditions)
Standing orders(a pre-printed document containing orders for the conduct of routine therapies, monitoring guidelines, and/or diagnostic procedures for specific clients with identified clinical problems)
NIC interventions(a level of standardization to enhance communication of nursing care across settings and to compare outcomes)
Therapeutic manipulation of patient's environment pg 282
Needs to be safe and conducive to the implementation of therapies.
Arrange the environment to prevent injury.
Client benefits most from nursing interventions when surroundings are compatible with care activities.
Objective evaluation of goal attainment pg 294
Examine the outcome criteria to identify the exact desired client behavior or response
Assess the client's actual behavior or response
Compare the established outcome criteria with the actual behavior or response
Judge the degree of agreement between outcome criteria and the actual behavior or response
If there is no agreement(or only partial agreement) between the outcome criteria and the actual behavior or response, what is/are the barriers? Why did they not agree?
Modification of a care plans takes what? pg 297
Complete reassessment of all client factors relating to the nursing diagnosis and etiology is necessary when modifying a paln
Evaluation of outcomes pg 294
To determine if the known problems have remained the same, improved, worsened, or otherwise changed
Informed consent process pg 332-334
Person's agreement to allow something to happen, based on full disclosure of risks, benefits, alternatives, and consequences of refusal
Obtained and witnessed only when the client is not under the influence of medication, such as narcotics
Nurse's signature witnessing the consent means that the client voluntarily gave consent, that the client's signature is authentic, and that the client appears to be competent to give consent
Nurses must ask the clients if they understand the procedure for which they are giving consent; rejection needs to be written, signed, and witnessed
HIPPA pg 329
federal statutory acts providing rights to clients and protects employees
Protects individuals from losing their health insurance when changing jobs by providing portability
Privacy section has standards regarding accountability in the health care setting
Create client rights to consent to use and disclose protected health information, to insepct and copy one's medical record, and to amend mistaken or incomplete information
Limits who is able to access a client's record
Establishes the basis for privacy and confidentiality concerns
Nursing misconduct-civil, criminal, administrative pg 326
Civil: protect the rights of individual presons within our society and encourage fair and equitable treatment among people
Criminal: prevent harm to society and provide punishment for crimes
Administrative: reflects decisions made by administrative bodies such as State Boards of Nursing when they pass rules and regulations.
Styles of learning-cognitive, affective, and psychomotor pg 366
Cognitive: all intellectual behaviors and requires thinking
Affective: expression of feelings and acceptance of attitudes, opinions, or values
Psychomotor: acquiring skills that require the integration of mental and muscular activity, such as the ability to walk or to use an eating utensil.
Vital signs norms pg 504
Temp: 36-38 degrees C(96.8-100.4 degrees F)
Pulse: 60-100 BPM
Respirations: 12-20 breaths per minute
Blood Pressure: average=<120/80; pulse pressure=30-50 mm Hg
Orthostatic BP interventions pg 538
Measure BP before administering medications that cause orthostatic hypotension
Assess for orthostatic hypotension during vital sign measurements by obtaining BP and pulse with the client supine, sitting, standing
Obtain BP readings 1-3 minutes after the client changes position
Patient teaching regarding prognosis of disease processes pg 202
Assess both nature of psychosocial changes and loss and adaptations to changes
Assess retirement, social isolation, sexuality, housing and environment, and death
Interventions for dementia behavior-alternatives for nurses to choose pg 832
orient clients, provide companionship, offer activities, assign confused or disoriented clients close to nurses station, reassess physical status, evaluate all medications, camouflage IV lines, institute exercise and ambulation schedules, promote relaxation, remove cues that promote leaving, provide appropriate visual and auditory stimuli, use de-escalation, time-out, and other verbal intervention techniques, use calm, simple statements
Open ended questions, assessment, parts of the pt hx, subjective, objective data pg 233-241
Open ended questions: facilitate answers from pt that are not direct yes or no
Assessment: moves from general to specific
Pt Hx: problematic areas
Subjective: client's verbal description of health problems
Objective: observed or measured of a client's health status
Problem focused assessment-how does nurse gather data pg 236
subjective info, objective info based on client's specific health problem
Sterile wound dressing technique, and infection control pg 669
1. A sterile object remains sterile only when touched by another sterile object
2. Only sterile objects may be placed on a sterile field
3. A sterile object or field out of the range of vision or an object held below a person's waist is contaminated
4. A sterile object or field becomes contaminated by prolonged exposure to air
5. When a sterile surface comes in contact with a wet, contaminated surface, the sterile object or field becomes contaminated by capillary action
6. Fluid flows in the direction of gravity
7. The edges of a sterile field or container are considered to be contaminated
Z-track technique pg 753
When administering IM injections-minimizes local skin irritation by sealing the medication in muscle tissue
Locating IM sites-land marks pg 751
Vastus lateralis: knee, greater trochanter
Ventrogluteal: anterosuperior iliac spine
Deltoid: Scapula, acromion process, humerus
Primary reason for medication errors pg 705
not following routine policies
Interventions for impaired patient-visually, hearing pg 819
How client normally conducts daily activities
Inspect bathroom, kitchen, and areas with stairs
Assess risk of food infection or poisoning by dietary assessment for the past week, GI and CNS exam, observing for fever, and analyzing results of culture of feces and vomitus
Assess environmental comfort of a client's home
Contributing factors to impaired skin integrity pg 855
Reduced sensation, vascular insufficiency, and immobility
Pain assessment components pg 1063
COLDSPAA