FON Midterm Review

FON Midterm Review Chapter 4 -​ The nursing process(testing scenarios) (ADPIE) ★​Assessment: Gathering objective and subjective data about the patient ★​Diagnosis: Nursing diagnosis based on data found ★​Planning: What you are going to do to help the patient ★​Implementation: The act of doing what you planned ★​Evaluation: Reassessment to see if your implementations worked -​ Maslow's hierarchy of needs(testing scenarios) ★​Physicological needs ★​Safety and security ★​Love and belonging ★​Self esteem ★​Self actualization -​ Roles of LPN Vs. RN ★​According to the american nurse association, all the steps of the nursing process from assessment to evaluation are the responsibility of the RN. The LPN con perform the planning, intervention and evalution stage but it needs to be confirmed by the RN. -​ ABC(testing scenarios) ★​Airway ★​Breathing ★​Circulation -​ SMART goals (testing scenarios) ★​Specific ★​Measurable ★​Attainable/Achievable ★​Relevant ★​Timely -​ Independent vs dependent nursing ★​Dependent nursing requires an order from a physician to continue w/ care ★​Independent is an action that a nurse can initiate and perform alone w/o needing orders from a physician -​ Subjective vs objective data ★​Subjective data is information that is known only to the patient and the family (Ex, anxiety, and pain) ★​Objective data is information that can be observed through your senses of hearing,touch,smell,and sight (Ex, pale, cool, moist skin) -​ Patient-centered care ★​ listen, explain, acknowledge, recommend, negotiate Chapter 5 -​ Confidentalty ★​The maintenance of privacy by not sharing with a third party, privileged, or entrusted information -​ Hippa ★​ Health insurnce portability and accountability act -​ Documentation ★​Long-term and home care documentation differences ➔​Long-term care requires an initial assessment in order to be reimbursed by Medicare/Medicaid, then charting about the patient's care every week unless health conditions arise. If an accident or illness starts, then you are required to chart daily. ➔​Home care-You must be an RN to complete the initial visit and assessment form. It is required to complete the organization's specified home health skilled nursing note after every visit. ★​Risks for malpractice ★​Know that you you can't just throw documents out you need to put anything with patient info into a shredder. ★​You need a release form to give out any patient info ★​Incident reports, also known as variance reports (what goes into them, and why) ➔​ Medication errors, patient injury, visitor injury, employee injury,Conditions constituting a safety hazard, failure to perform ordered care, loss of patient belomgings, Lack of availability of vital patient care or supplies, Failure of health care providers to respond appropiatly in an emergancy. -​ EHR(Regarding safety, HIPAA, and privacy) ➔​To access EHR, you need to put in your username and password assigned by your facility. Don't share this password with anyone. Allowing someone to gain access to your account could lead to civil and criminal penalties -​ Kardex ➔​Contains written data and is used for quick reference about each resident's care Chapter 6 -​ Types of communication ★​Nonverbal communication body language- facial expressions, posture, body position, behavior, gestures, touch, and general appearance.What it tells? It tells us that the information found from veral communication is congruent. ★​Best way to ensure a patient is in pain ➔​ask them ★​Assertive communication ➔​Best way of communication, directly links to the nurse.An assertive style provides self-esteem and self-confidence and allows the nurse to care for others with a higher degree of commitment and respect. ★​Passive/avoidant, aggressive, and the negatives about it. ➔​passive/avoident- Individuals with this behavior style have trouble asking for help and allow others to take advantage of them, resulting in feelings of anger, emotional pain and anxiety ➔​Agressive- Individuals with this behavior style exhibit a superior attitude; and try to humiliate the others and communicate in anger, hostile way that does not acknowledge the feelings of others -​ Factors that affect communications ★​Personal space, body position, language, culture, attitude, and emotions -​ Therapeutic communication ★​Open-ended questions ★​Silence ★​Offering self ★​Using restatement ★​Using silence ★​Seeking clarification ★​Using reflection ★​Summarizing ★​Giving information ★​Providing General leads ★​Looking at alternatives ★​Summarizing -​ Barriers to communication ★​Physical ★​Body language -​ ISBARR(testing scenarios) ★​Introduction(Your name, title, unit, and why you're calling) ★​Situation (Brief overview of why you're calling) ★​Background(medical history of patient) ★​Assessment(Stating the problem and your thoughts about what caused or let up to it) ★​Recommendation( what you think will correct the problem, what you can do to monitor the situation, or what you need from the healthcare provider) ★​Read back (Read back the orders of the provider gives you to be certain that you have the correct information. if you are giving another type of report during which you will not be receiving orders, read back is not necessary. instead you will give the listener the opportunity to ask questions to clarify the information) -Hearing impaired and how to communicate ★​Communication with patients who are deaf requires that you position yourself in front of them so they can see your lips. ★​Find out the patient's best communication preferences verbalizing, writing, lip reading, or signing ★​Get the person's attention before starting to communicate ★​Speak clearly without adequate volume without shouting or mumbling ★​As for clarification and feedback to make sure you have been understood ★​Speak to the patient not The Interpreter if one is available -Ventilation communication ★​Yes or no questions ★​Whiteboard ★​Call light ★​Text messages ❖​W/ stroke patients- Use communication boards ❖​Non-English patients- Use picture board and phrase boards ❖​Explain what's happening and why during care! Chapter 8- ATI fundamentals 16 & 35 -​ Joint commissions ★​Make sure we're following procedures and give accreditation -​ Know that you are aware of different religions and what specifics you need to do for each ★​Muslim ★​Hindu ★​Seventh day adventist ★​Jewish -​ Transcultural nursing- Making sure you're not biased and stereotyping -​ Education ★​Sometimes even though families may be able to financially afford healthcare, individuals with the low education level tend to seek less medical help than those with a higher education or level. the education and literacy level of a patient also plays a role in dictating how to provide patient teaching -​ Geography ★​A patient's geographical area may have an impact on his or her ability to obtain healthcare. many rural areas have limited access to healthcare providers and facilities, suggest clinics or hospitals. many low-income areas or higher city populations have limited Healthcare Providers and Facilities -​ Language ★​Make sure patient is able to understad everything you are saying and confirm they understand, give an paper material to them in the primary language -​ Prejudice and discrimination ➔​Discrimination involves unfair treatment of individuals, affecting rights and opportunities based on their association with a certain group ➔​Prejudice involves making assumptions without full information, which often results in taking wrong action. -​ Misunderstanding ★​A barrier that is caused by a mistake of meaning or intention. A fear of making mistakes or retaliation May prevent the patient from seeking appropriate medication or diagnosis -​ Death & dying- Allow them to perform rituals that they want to -​ Finding solutions -​ Spiritual care- If they follow a religion, we want to support it as much as possible -​ Communication with/ family- how can we help you, etc Chapter 15 -​ -​ -​ -​ -​ -​ -​ -​ Cultural considerations Baths- silts and therapeutic baths All skills Shaving with/ Anti-coagulants (Make sure to shave in the direction the hair grows with a safety razor,need signed permission) Nails- never cut a diabetic's nails, always file Provide lotions and barrier cream for incontinence Managing environment ★​Call bell ★​Bed low and locked ★​Odor free Bed positions- What they are and why you use them ★​Fowlers ★​Semi-fowlers ★​Flat ★​Trendleburg ★​Reverse trendleburg Chapter 14 -​ Chain of infection ●​ ●​ ●​ ●​ ●​ ●​ Infectious agent Reservior Portal of exit Mode of transmission Portal of entry Susceptible host -​ Viruses, anti-viral, Bacteria, antibiotics, when do u use them for what -​ Types of infections -​ Primary and secondary defense ●​ Factors that decrease our defense ●​ Ex.older patient, turn them every 2 hours and apply barrier cream -​ Precautions and the diseases they are used for (PPE game) -​ Know latex allergy and cross-sensitive foods Chapter 22 -​ How to open sterile packaging ★​Set the sterile pack on the clean surface positioned away from you so that the first flap will open away from you ★​Open the flap that folds away from you first, then open each of the side flaps, and the flap towards you last -​ How to maintain a sterile field ★​Never over the field ★​Never reach across a sterile field ★​Keep the field in view the whole time ★​Once you have applied your gloves, keep your hands in the safety zone(above the waist, below eye level, and in front of you) ★​Never turn your back -​ Circulation vs. Scrub nurse ➔​Circulation ➔​Scrub -​ How to recognize if a sterile field is contaminated ★​Expiration dates for sterility ★​wet spots or harsh dark marks ★​Tears or holes in the field PPE Game Meningococcal Pneumonia -​ Droplet Laryngeal Tuberculosis -​ Airborne Streptococcal Pharyngitis -​ Droplet Pertussis -​ Droplet Salmonella -​ Contact (within 3 feet) Measles -​ Airborne Vancomycin-resistant Enterococci(VRE) -​ Contact (within 3 feet) Diphtheria -​ Droplet Infected wound -​ Contact (within 3 feet) Rubella -​ Droplet Respiratory Syncytial Virus -​ Contact (within 3 feet) Mycoplasma Pneumonia -​ Droplet C. Diff -​ Contact (within 3 feet) Mumps -​ Droplet Immunocompromised -​ Reverse isolation Lice -​ Contact HIV -​ Standard precautions Escherichia Coli -​ Contact (within 3 Sepsis -​ Droplet SARS-COV-2 -​ Airborne Haemophilus Influenzae -​ Droplet Scarlet Fever -​ Droplet Herpes Simplex -​ Contact (within 3 Shigella -​ Contact (within 3 Impetigo -​ Contact (within 3 Varicella -​ Airborne Scabies -​ Contact (within 3 MRSA -​ Contact (within 3 feet) Type B feet) feet) feet) feet) feet) Donning order Gown, Mask, Shield, Gloves Doffing order ingococcal Gloves, Shield, Gown, Mask pneu