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Front 1

Implementation

Back 1

Any treatment or intervention based upon clinical judgement and knowledge that a nurse performs to enhance client outcomes

Front 2

Implementation is

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Client based. Individualized. Provides the most current up to date effective approaches for client problems.

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Implementation includes

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Direct measures, indirect care measures, aimed at the patient

Front 4

The nurse

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Implement the interventions identified in the plan of care

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Interventions are

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Consistent with established plan of care implemented in a safely timely and appropriate Manner and documented

Front 6

Clinical practice guidelines and protocols

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National guidelines Clearinghouse

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Standing orders

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A clinician specific orders for a type/ group of patients

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Nursing classification interventions

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Standardize knowledge language Exedra to describe set of actions of Nursing Care

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Standards of practice

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Ana

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Quality and safety education for nurses

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Goal is to always improve

Front 11

Vital signs

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Temperature pulse respiratory rate blood pressure pain 02 stats

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Vital signs are used for

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Monitor patient's condition identify problems evaluate response to intervention and outcomes

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Temperature sites

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Oral Rectal auxiliary tympanic membrane temporal artery esophageal pulmonary artery

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Acceptable temperature range

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96.8 100.4. 36c 38c

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Factors affecting body temperature

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Age hormonal level environment exercise circadian rhythm temperature alteration

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Electrical impulses originate from the SA node

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Pulse

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Assessment of pulse sites

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Temple carotid apical brachial radial ulnar femoral popliteal posterior tibial and dorsalis pedis

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Character of pulse

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Rate Rhythm strength and quality

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Pulse deficit

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Differences between radial and apical pulse rates

Front 20

Ventilation

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Movement of gases into and out of the lungs

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Diffusion

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Movement of o2 in carbon monoxide between alveoli and red blood cells

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Perfusion

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Distribution of red blood cells to and from the pulmonary capillaries

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Hyppxemia

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Low levels of 02

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Factors influencing character of respirations

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Exercise and anxiety body position neurological injury acute pain smoking medications hemoglobin function

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Hyperpnea

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Respirations are labored and creased and death in the Christian right

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Cheyne stokes

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Respiration rate and depth of a regular characterized by alternating periods of apnea and hyperventilation respiratory cycle begins with slow shallow breaths that gradually increase to abnormal rate and death the pattern reverses breathing slows and become shallow concluding is apnea before respiration resumes

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Kussmauls respiration

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Respirations are abnormally deep regular and increased in rate

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Biots respiration

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Respirations are abnormally shallow for two or three breaths followed by irregular periods of apnea

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Arterial blood pressure

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Force exerted on the walls of an artery by pulsing blood under pressure from the heart

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Systolic

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Maximum pressure during ventricular contraction

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Diastolic

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Minimum pressure during ventricular relaxation

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Pulse pressure

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Difference between systolic and diastolic pressures

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Factors influencing BP

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Address gender medication smoking activity weight daily variation ethnicity

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Patient conditions not appropriate for electronic blood pressure measurement

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Irregular heart rate blood clots narrowed vessels shivering seizures Tremors inability to cooperate blood pressure less than 90 systolic

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Hypertension

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More common thickening of walls loss of elasticity family history personal risk factors

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Hypotension

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Systolic less than 90 loss of blood volume orthostatic

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Small intestine

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Duodenum jejunum and ileum

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Factors affecting bowel elimination

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Fluid intake psychological factors pregnancy medications diet physical activity personal habits pain surgery tests

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Heat exhaustion

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Profuse diaphoresis

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Heatstroke

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Body temp of 104 or more