Medical Surgical 3, 22, 54

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Medical Surgical 3, 22, 54
2012-02-01 02:20:56

Chapter 3
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  1. bioethics
    is concerned with the ethical questions that arise in the context of health care
  2. morality
    the shared ideas of what is right or good
  3. moral uncertainty
    occurs when the nurse senses that a situation is a moral problem but cannot define it clearly or reach a decision because of uncertainty about the morally correct action
  4. moral distress
    When the nurse feels powerless because his or her moral beliefs cannot be followed as a result of instituitional or other barriers
  5. moral outrage
    when another person in the health care setting acts in a way that the nurse believes is immoral and the nurse feels powerless to intervene
  6. POE: autonomy
    inherent in the concept of informed consent and in advance directives. Respect for the rights of persons to make decisions abouth their own health and health care.
  7. POE: beneficence
    it incorporates actions to promote good, prevent harm, or remove the pt from harm.
  8. POE: Justice
    concerned with fairness, equity, and appropriateness of tx when considering what is due to a person.
  9. POE: nonmaleficence
    requires that nurses "do no harm."
  10. Values
    specific beliefs and attitudes that are important to a person and that influence the choices the person makes on a daily basis.
  11. values clarification
  12. ethnocentrism
    the belief that one''s own culture is superior to others
  13. Deontology
    right and wrong based on whether an action meets the criteria of fidelity, vaeracity, autonomy, beneficence and justice.
  14. delirium
    a short-term confusional state that has a sudden onset and is typically reversible.
  15. Dementia
    a syndrome that is chronic and generally considered irreversible. Characterized by impairment in memory accompanied by many other cognitive deficits, leading to impaired activities of daily living. i.e. Ad and vascular dementia.
  16. What is the duration of delirium?
    Few weeks to 3 months
  17. What is the duration of dementia?
    in progress at least 1 to 2 years
  18. What are the paranoid states of delirium?
    Prominent; cognitive impairment is mild or variable
  19. What are the paranoid states of dementia?
    More consistent with degrees of impairment; less prominent paranoia
  20. What are fluctuations in delirium?
    significant contrasts in levels of awareness
  21. What are fluctuations in dementia?
    Not observed in such contrast; progressive decline
  22. What are persecutory delusions in delirium?
    Ordered and cohesive
  23. What are persecutory delisions in dementia?
    Vague, random, contradictory
  24. What are general intellectual powers in delirium?
    Preserved during lucid intervals.
  25. What are general intellectual powers in dementia?
    consistent loss and decline
  26. What is the affect with a pt with delirium?
    intermittent fear, perplexity, or bewilderment
  27. What is the affect with a pt with dementia?
    Flat or indifferent affect.
  28. What are perceptual disturbances in a pt with delirium?
    Hallucinations; often disturbing and clearly defined
  29. What are perceptual disturbances in a pt with dementia?
    Hallucinations vague, fleeting, ill-defined; in many cases difficult to make a clear judgement that they exist.
  30. Nursing diagnosis for delirium: Acute confusion related to drugs, infection, dehydration, unfamiliar setting, sensory overload or deprivation
    Goals are improved thought processes; orientation to person, place and time; calm behavior, no combative actions
  31. Nursing Diagnosis for delirium: disturbed sleep pattern related to agitation, mood alterations, drug effects
    Goals are restoration of pt's usual sleep patter; fewer nighttime awakenings, pt reports feeling rested
  32. Nursing diagnosis for delirium: Risk for injury related to agitation, disorientation, unfamiliar setting
    Goals are safety maintaine; absence of injury
  33. Nursing diagnosis for dementia: self-care deficit related to impaired thinking, sensory and motor dysfunction
    Goals: Maximum possible independence in ADL; pt participates in bathing, grooming feeding and toileting with assistance as needed.
  34. Nursing diagnosis for dementia: Imbalance nutrition: Less than body requirements related to difficulty with self feeding, inattention
    Goals are adequate nutrition; weight is stable (within 5 Lbs. of ideal weight)
  35. Nursing diagnosis for dementia: Disturbed sleep pattern related to neurologic changes, altered perceptions
    goals are adequate sleep, pt rests at night and remains physically active and awake during the day
  36. Nursing diagnosis for dementia: Risk for injury related to poor judgement, physical decline, sensorimotor changes
    Goals are absence of injuries, pt has no falls, suffers no bruises, cuts or fractures.
  37. Nursing diagnosis for dementia: Chronic confusion/impaired verbal communication related to memory loss, altered perception, impaired judgement, anxiety
    Goals are cooperative behavior; pt is calm; no combative or dangerous behavior is demonstrated. Effective communication; pt needs are recognized by caregivers.
  38. Adaptation
    person's biologic and psychologic efforts to respond to a stressor and affects the whole organism.