Fundi Final Review

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Author:
cswett
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121431
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Fundi Final Review
Updated:
2011-12-07 23:39:47
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Fundi Final Review
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Fundi Final Review
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  1. Patient confidentiality
    • •Restrict access
    • •Ethical codes and legal responsibility
    • •Adhere to policies and procedures to ensure privacy and confidentiality

    • •Passwords required & should not be shared
    • •Logged in?- don’t leave the computer terminal unattended
    • •Do not leave client information displayed
    • •Shared all unneeded computer-generated worksheets
    • •Know the facility’s policy & procedure for correcting an entry error
    • •Follow agency procedures for documenting sensitive material
    • •Firewalls- protect server from unauthorized access
  2. Subjective Data
    Objective Data
    • Subjective Data - info obtained from what the client says - describes cleints perceptions of and experience with the problem
    • - use quotes or summarize - subjective data is only incluses when it is important and relevant to the problem

    Objective data - information that is measured or observed by the sences
  3. Medical vs Surgical Asepsis
    • •Medical asepsis
    • –Includes all practices intended to confine a specific microorganism to a specific area
    • –Limits the number, growth, and transmission of microorganisms
    • -Objects referred to as clean or dirty (soiled,
    • contaminated)

    • •Surgical asepsis
    • –Sterile technique
    • –Practices that keep an area or object free of all microorganisms
    • –Practices that destroy all microorganisms and spores
    • –Used for all procedures involving sterile areas of the body
  4. Body Mechanics
    • •Proper alignment
    • •Wide base of support
    • •Avoid bending and twisting
    • Squat to lift
    • •Keep objects close when lifting
    • •Raise beds
    • •Pull rather than push
    • •Push rather than lift
    • •Get help
  5. Types of Wounds
    • •Intentional- surgery
    • •Unintentional- accidental trauma
    • –Incision- surgery
    • –Contusion- bruise from blunt instrument
    • –Abrasion- surface scrape
    • –Puncture- penetration of skin with sharp instrument
    • –Laceration- tissues torn apart
    • –Penetrating wound - penetration of skin & underlying tissues, bullet
  6. Exudate
    • •Material such as fluid and cells that have escaped from blood vessels during inflammatory process
    • •Deposited in tissue or on tissue surface
    • •3 major types
    • –Serous -
    • •Mostly serum
    • •Watery, clear of cells
    • •E.g., fluid in a blister

    • –Purulent-
    • •Thicker
    • •Presence of pus (suppuration)
    • •Pus- WBCs, dead debris, bacteria
    • •Color varies with organisms


    • Sanguineous (hemorrhagic) -
    • •Hemorrhagic
    • •Large number of RBCs
    • •Indicates severe damage to capillaries

    • •Serosanguineous
    • –Clear and blood-tinged drainage
    • –Surgical incisions

    • •Purosanguineous
    • –Pus and blood
    • –New infected wound
  7. Pressure Ulcers
    any lesion caused by unrelieved pressure that results in damage to underlying tissue.
  8. Risk Factors for Pressure Ulcers
    • •Friction & shearing- sheets, sliding down from Fowler’s
    • position
    • •Immobility
    • •Inadequate nutrition
    • •Fecal and urinary incontinence
    • •Decreased mental status
    • •Diminished sensation
    • •Excessive body heat
    • •Advanced age
    • •Chronic mental conditions
    • •Poor lifting and transferring techniques
    • •Incorrect positioning
    • •Hard support surfaces
    • •Incorrect application of pressure-relieving devices
  9. Four Stages of Pressure Ulcer Formation
    • •Stage I:
    • –nonblanchable erythema signaling potential ulceration

    • •Stage II:
    • –partial-thickness skin loss involving epidermis and possibly dermis

    • •Stage III: –full-thickness skin loss involving damage or
    • necrosis of subcutaneous tissue

    • •Stage IV: –full-thickness skin loss with tissue necrosis or
    • damage to muscle, bone, or supporting structures
  10. Preventing Pressure Ulcers
    • •Providing nutrition
    • •Maintaining skin hygiene
    • •Avoiding skin trauma
    • •Providing supportive devices

    • •Fluid intake- 2,500 ml
    • •Protein, vitamins (A, C, B1, B5, zinc
    • •Dietary consult
    • •Weight/lab data monitoring
    • •Nutritional supplements
    • •Monitor weight/lab values
  11. Effects of Heat
    • •Vasodilation
    • •Increases capillary permeability
    • •Increases cellular metabolism
    • •Increases inflammation
    • •Produces sedative effect

    • •Indications for heat
    • –Muscle spasms
    • –Inflammation
    • –Pain
    • –Contracture
    • –Joint stiffness
  12. Effects of Cold
    • •Vasoconstriction
    • •Decreases capillary permeability
    • •Decreases cellular metabolism
    • •Slows bacterial growth
    • •Decreases inflammation
    • •Local anesthetic effect

    • •Indications for cold
    • –Muscle spasms
    • –Inflammation
    • –Pain
    • –Traumatic injury
  13. Hypoxia
    Hypoxemia
    Cyanosis
    • Hypoxia - deficiency of O2 anywhere in the body
    • Hypoxemia - deficiency of O2 in the blood
    • Cyanosis can accompany hypoxemia - high unoxigenatied hemoglobin
  14. Signs of decreesed oxygenation and tissue perfusion
    • Signs of Hypoxia:
    • Rapid pulse
    • Rapid, shallow respirations and dyspnea
    • Increased restlessness or light-headedness
    • Flaring of the nares
    • Substernal or intercostal retractions
    • Cyanosis
    • anxious, tried, and drawn face
    • orthopenic position
    • appear fatigued and lethargic
    • Clubbing of nails
  15. Pursed lip breathing and huff coughing
    • •Removes secretions, then expectorate
    • •Types:
    • •Abdominal (diaphragmatic)
    • –Deep full breathes with no effort

    • •Purse-lipped
    • –Controlled breathing - breathe in deeply through nose, purse lips & whoosh out - dont puff cheeks - count to 7 during exhalation
    • –Prolongs exhalation & airway collapse - increases pressure in bronchi and minimizes collapse of smaller airways

    • •Huff coughing- keeps airways open while moving secretions up & out
    • -after bronchodilator - inhale deep & hold breath for few seconds
    • -cough twice - first loosens - second moves mucus
    • -inhale by sniffing - short rapid breaths to prevent mucous from moving back into smaller airways
  16. Promoting good breathing
    • •Ensure a patent airway
    • •Positioning
    • •Encouraging deep breathing, coughing
    • •Ensuring adequate hydration
    • •Medications
    • •Incentive spirometry

    • •Chest PT
    • •Postural drainage
    • •Oxygen therapy
    • •Artificial airways
    • •Airway suctioning
    • •Chest tubes
  17. Risk Factors for CAD
    • •Non-modifiable risk factors
    • –Heredity
    • –Age
    • –Gender

    • •Modifiable risks
    • –Elevated serum lipid levels-
    • •diet high in saturated fats
    • –Hypertension
    • •Increases work of heart, increasing O2 demand
    • •Causes enlarged heart
    • •Causes endothelial damage of blood vessels which
    • stimulates atherosclerosis
    • –Cigarette smoking-
    • •increases BP & narrows blood vessels

    • –Diabetes
    • •Accelerates athersclerosis


    • –Obesity
    • •Often has elevated lipid levels
    • •Increases workload of heart

    • –Sedentary lifestyle
    • •Exercise benefits:
    • –Increase HR & O2 supply
    • –Heart muscle more efficient
    • –Slows down athersclerosis

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