Scott Gardner Tcc Nursing Q1F04 Unit Nine

Front 1

List what would be included in Daily Intake.

Back 1

Food
Drink
IV Fluids
Ice
Popcicly
NG
Peg Tube

Front 2

List what would be included in daily Output.

Back 2

BM
Urine
Emesis
Sputum
Blood
NG Drainage
Ostomy Output
Drains

Front 3

How Frequently is I & O Totaled?

Back 3

At the end of every shift...Every 8 Hours.

Front 4

What is the purpose of assessing the abdomen and bladder for distension?

Back 4

Fluid Retention
Kidney Failure
Neurogenic Bladder

Front 5

In which direction should the client be wiped after a bowel movement, and why?

Back 5

Front to Back.

To avoid contamination of the urethra.

Front 6

Before and during a bath, what can/should be assessed?

Back 6

Skin
Adema
LOC
Mental Acquity
Activity Tollerence
Pressure Ulcers
Palor/Color
ROM
Ego Integrity
Discomfort

Front 7

What are some principles to consider during a bath?

Back 7

Client Comfort
Ambient Temperature
Water Temperature
Client Strength
Mental State
Culture
Client ROM

Front 8

Describe the Preferred order of the bath.

Back 8

Head to Toe except Peri Care.
Clean water.
Peri Area.

Front 9

Describe the role of the RN with regard to foot care.

Back 9

Provide Nail Care except where contra indicated from DM issues.
Assess for Pressure Ulcers
Foot Drop Prevention
Foot Rub
Education

Front 10

What does the acronym PVR mean in bladder care?

Back 10

Post Void Residual.

The amount of Urine left in the bladder when the client has finished voiding.

It can be attributed to Neurogenic Bladder.

Front 11

Describe Standars of Care

Back 11

Guidelines by which nurses should practice they are defined by:

Nursing Practice Acts

American Nurses Association (ANA)

Policies & Procedures

Front 12

Describe agency policies and procedures.

Back 12

Established by agencies

Nurses working in any agency are obligated to know them and abide by them.

Front 13

If a student makes an error, who is responsible?

Back 13

The Student // The Instructor // The Facility

Front 14

Define Statutory Law

Back 14

Created by elected and appointed officials

Nurse Practice Act is state statute (RCW’s only)

WAC’s are developed by Washington State Nursing Care Quality Assurance Commission

Front 15

Define Common Law

Back 15

LECTURE
-Common Law
-Case law
-Created by judicial decisions
Examples: Roe v. Wade (abortion), Informed Consent
POTTER - 407
Created by judicial decisions made in courts when individual legal cases are decided. Examples are Informed Consent and Clients Right to Refuse Treatment.

Front 16

Define Criminal Law

Back 16

Acts that threaten society and it’s order

Criminal acts are prosecuted
Felony=serious crime
Misdemeanor=less serious crime

This is what State Patrol Background check is for (crimes against person)

Front 17

Define Civil Law

Back 17

LECTURE
Protection of a PERSONS rights, not society as whole
Example: OJ Simpson having to pay money to families
POTTER - 407
Protects the rights of individual persons within our society and encourage fair and equitable treatment among people.

Front 18

Define Incident Report

Back 18

Done at hospitals as part of quality assurance

Not a part of the legal record

Front 19

Define Battery

Back 19

Intentional touching of another’s body or anything the person is touching or holding without consent. It can be harmful to the client and cause injury, or be merely offensive to the clients personal dignity.
Potter 413

Front 20

Define Assult

Back 20

Willful attempt or threat to harm another, along with the ability to harm

Front 21

Define Use of Restraints

Back 21

Only to ensure physical safety of resident or other residents

Written order of duration (usually 24 hrs)

Circumstances under which restraints can be used

Front 22

Define a Felony

Back 22

It is part of Criminal Law.

It is the most serious type of crime.

Front 23

Define a Misdemeanor

Back 23

It is part of Criminal Law.

A lesser serious crime.

Front 24

Define a Tort

Back 24

Civil wrong committed against person or property

It can be Unintentional or Intentional

Front 25

What is the Patient Self-Determination Act?

Back 25

PSDA

Most hospitals, nursing homes, home health agencies, and HMO's routinely provide information on advance directives at the time of admission. They are required to do so under a federal law called the Patient Self-Determination Act (PSDA).

The PSDA simply requires that most health care institutions (but not individual doctors) do the following:

1. Give you at the time of admission a written summary of:

your health care decision-making rights (Each state has developed such a summary for hospitals, nursing homes, and home health agencies to use.)
the facility's policies with respect to recognizing advance directives.
2. Ask you if you have an advance directive, and document that fact in your medical record if you do. (It is up to you to make sure they get a copy of it).

3. Educate their staff and community about advance directives.

4. Never discriminate against patients based on whether or not they have an advance directive. Thus, it is against the law for them to require either that you have or not have an advance directive.

Front 26

Define advance directive:

Back 26

A written document in the form of a living will or durable power of attorney prepared by a competent individual that specifies what, if any, extraordinary procedures, surgeries, medications, or treatments the patient desires in the future, when he or she can no longer make such decisions about medical treatment.

Front 27

Define Malpractice

Back 27

Malpractice

One type of negligence

Professional misconduct, unreasonable lack of skill, evil practice, illegal or immoral conduct

See Uniform Disciplinary Code

Front 28

Define Tort

Back 28

A wrongful act or injury, committed by an entity or person against another person or another person's property, that may be pursued in civil court by the injured party.

Front 29

Define the Good Samaritan Law

Back 29

Despite the rules of common law, a healthcare provider who voluntarily and without reasonable expectation of compensation or reward provides the services described in that subsection is not liable for damages that result from the person's negligence in acting or failing to act while providing the services, unless it is established that the damages were caused by the gross negligence of the person.

Front 30

What are the reporting ramifications of gunshot wounds?

Back 30

They are reportable to the State Department of Health Monthly.

Front 31

Define the Reporting Ramifications of STD's.

Back 31

They must be reported to the Local Health Department withing 3 working days.

Front 32

Define confidentiality:

Back 32

The maintenance of privacy, by not sharing or divulging to a third party privileged or entrusted information.

Especially prudent with regard to HIPAA

Front 33

Define Negligence

Back 33

Conduct that falls below the standard of care Characterized by inadvertence, thoughtlessness or inattention, carelessness

Front 34

Define Malpractice

Back 34

Professional misconduct, unreasonable lack of skill, evil practice, illegal or immoral conduct

Front 35

Define the Criteria for

Back 35

Nurse owed duty to client

Nurse did not carry out that duty

Client was injured (damage occurred)

Client’s injury was result of nurse’s failure to carry out the duty

Front 36

Define Responsibility

Back 36

The characteristics of reliability and dependibility. The ability to distinguish between right and wrong.

Includes a duty to perform actions well and thoughtfully.

Example...Giving a Drug.
The nuse has a RESPONSIBILTIY to assess the clients need for the meds, give it correctly and safely, and evaluate the response to the drug.

Front 37

Define Accountability

Back 37

The nurse being answerable for their actions. It involves follow up and a reflective analysis of ones decisions to evaluate their effectivenss.

Front 38

Define Moral Dilemma

Back 38

There is evidence that each choice has justifiable moral arguments and ethical principles to support it.
(Lecture from 141 Week 10)

Front 39

Define the The Patient's Bill of Rights

Back 39

The Patient's Bill of Rights was first adopted by the American Hospital Association in 1973 and revised in October 1992. Patient rights were developed with the expectation that hospitals and health care institutions would support these rights in the interest of delivering effective patient care. The American Hospital Association encourages institutions to translate and/or simplify the bill of rights to meet the needs of their specific patient populations and to make patient rights and responsibilities understandable to patients and their families

Front 40

How is a report made to the nursing commission for Unsafe Nursing.

Back 40

(4) In providing reports to the nursing commission, a person may call the nursing commission office for technical assistance in submitting a report. Reports are to be submitted in writing and include the name of the nurse, licensure identification, if available, the name of the facility, the names of any patients involved, a brief summary of the specific concern which is the basis for the report, and the name, address and telephone number of the individual submitting the report.

Front 41

Describe the Legal Reporting obligations of the nurse with Elder abuse.

Back 41

866-ENDHARM
Mandatory reporters are professionals identified by law who MUST make a report if they have reason to believe that the abuse, abandonment, neglect, or financial exploitation of a vulnerable adult has occurred. Mandatory reporters are

Front 42

Define Protocol.

Back 42

A protocol is a written plan specifying the procedures to be followed during care of clients with a select clinical condition or situation, such as carew of a postoperative client. It is a clinical guideline, which can still be customized for a client.

Front 43

Define Standing Orders

Back 43

Orders, rules, regulations, protocols, or procedures prepared by the professional staff of a hospital or clinic and used as guidelines in the preparation and carrying out of medical and surgical procedures.
Tabers

An example would be in a a Cardic Care setting, the physician might have a standard set of orders, for certain conditions, which the nurse can administer without first contacting the physician.

Front 44

Define Standards of Care

Back 44

Guidelines by which nurses should practice

Defined by:
-Nursing Practice Acts
-American Nurses Association (ANA)
-Policies & Procedures

Front 45

Describe the components of ethical decision making.

Back 45

It requires deliberate, systematic thinking.

-Determine it is an ethical problem
-Gather all relevant information
-Examine and determine self values and issues
-Verbalize the problem
-Consider possible courses of action
-Negotiate an outcome
-Evalute the process

Front 46

Define a cation

Back 46

An ion with a positive electric charge; opposite of anion.

Front 47

Define an Anion

Back 47

An ion carrying a negative charge; the opposite of cation.

Front 48

Define milliequivalent

Back 48

ABBR: mEq. One thousandth of a chemical equivalent.
The concentration of electrolytes in a certain volume of solution is usually expressed as milliequivalent per liter (mEq/L). It is calculated by multiplying the milligrams per liter by the valence of the chemical and dividing by the molecular weight of the substance.

Front 49

What physiological processes can Acid-Base Balance alter?

Back 49

Respiration
Metabolism
Functions of the CNS

Front 50

Define and Describe Intracellular fluids.

Back 50

ICF

Comprises all fluids WITHIN body calls.

Accounts for about 40% of adult body weight.

Front 51

Define and Describe Extracellular fluids.

Back 51

ECF

All the fluid outside of a cell. It is futher divided into three smaller compartments.

Front 52

Define the ECF Interstitial Fluid.

Back 52

It contains Lymph and is the fluid between the cells and outside the blood vessels.

Front 53

Define the ECF Intravascular fluid.

Back 53

Blood Plasma

Front 54

Define the ECF Transcellular fluid

Back 54

CSF, Pleural Fluid, peritoneal and synovial fluids.

Together the ECF compose about 20% of body weight.

Front 55

Define an Electrolyte

Back 55

An element or compound that when melted or disolved in water or another solvement separates into ions and is able to carry an electrical current.

Front 56

Give some examples of Cation Electrolytes.

Back 56

Na
K
Ca

Front 57

Give some examples of Anion Electrolytes.

Back 57

Cl-
HCO3- and SO4

Front 58

Define and Describe Na+

Back 58

Sodium. It is a Cation Electrolyte.

Front 59

Define and Describe K+

Back 59

It is Potassium. A Cation Electrolyte.

Front 60

Define and describe Ca+

Back 60

Calcium is a Cation Electrolyte.

Front 61

What is Osmolarity used to measure in clinical practice?

Back 61

Urine and Serum

Front 62

Define Interstitial Fluid

Back 62

The fluid between cells, in tissue spaces.

Front 63

Define Diffusion.

Back 63

The Movement of a solute in a solution across a semipermeable membrane from an area of higher concentration to an area of lower concentration.

Front 64

Define Osmosis.

Back 64

The movement of a pure solvent such as water, through a semipermeable membrane from an area of lesser solute concentration to an area of greater solute concentration in an attempt to equalize the concentrations on both sides of the membrane.

Front 65

Define Filtration

Back 65

The process by which water and diffusible substances move together in response to fluid pressure, moving from an area of higher pressure to lower pressure.

Front 66

Define Active Transport.

Back 66

It is the process of metabolic activity and expenditure of energy to move materials across cell membranes.
Allows cells to admit larger molecules than they would otherwise be able to admit or to move molecules from areas of lesser concentration to areas of greater concentration....Uphill.

It is the mechanism by which cells absorb glucose and other substances to carry out metabolic activities.

An example is the Na+ K+ Pump