Card Set Information
The presence of invasive devices...
such as internal catheters and pacemakers, may add to the risk of serious harm from electrical shock
What are the factors that determine the ammount of damage a patients gets from an electrical current?
Objects with low resistance
objects with low resistance...
allow maximum current to flow through the object
objects with high resistance...
allow minimal or no current to flow through the object
What organ is most sensitive to electrical shock?
The harmful effects of current depends on...
The amount of current flowing through the body
The path it takes
the duration the current is applied
The degree of resistance offered by the skin varies from prson to person based on...
The chemistry of the person's skin
The cleanliness of the skin
The amount of moisture on the surface
Is simply a low resistance pathway to a point of zero voltage
What is the purpose of grounding electrical equipment?
To prevent the dangerous buildup of voltage that can occur on the metal frames of some electrical equipment
What must exist for a fire to burn?
Flammable material must be present
Oxygen must be present
The flammable must be heated to or above its ignition temperature
is a dynamic process involving sharing of information, meanings, and rules among people
Communcation has five basic components:
Is the process by which people control and channel diagreements within an organaization
There are five basic stragies for handling conflict resolutions!
Is an assertive and uncooperative conflict resoultion strategy
is a power oriented method of resolving conflict
Competing strategy may be useful when...
an unpopular decision must be made or when one must stand up for his or her rights
is the opposite of competing
Unasserative and cooperative
When people accommodate others involved in conflict...
they neglect their needs to meet the needs of the other party
Accommodation is a useful stragtegy when...
it is essential to maintain harmony in the environment
Also, when an issue is much more important to one party or the other in a dispute
is both an unassertive and an uncooperative conflict resolution strategy
Avoidance may be apporiate if...
there is no possibility of meeting ones goals
Is the opposite of avoiding
It is assertive and cooperative
In collaborating, the involved parties...
Try to find mutally satisfying solutions to their conflict
Collaboration usually takes...
more time than other methods and cannot be applied when the involved parties harbor strong negative feelings about each other
Is a middle ground strategy that combines assertiveness and cooperation
Compromise is best used when...
A quick resolution is needed that both parties can live with
presents a written picture of occurrences and situations pertaining to a patient through out his or her stay in a health care intitution
Records pertinent patient information (name, address, religion, nearest of kin), admitting physician, and admission diagnosis
History and Physical examination
Records the patients admitting history and physical examination, as performed by the attending physician or resident
Records the physician's orders and prescription
Keeps a continuing account of the patients progress for the physician
Describes the nursing care given to the patient, including the patients compliants (subjective symptons), the nurses observation (objective signs), and the patients response to therapy
Notes drugs and intravenous fluids trhat are given to the patient
Vital Signs Graphic Sheet
Records the patient's temperature, palse, respirations, and blood pressure over time
Records the patient's fluid intake (I) and output (O) over time
Summarizes the results of laboratory test
Records notes by the physicians who are called in to examine a patient to make a diagnosis
Surgical or Treatment Consent
Records the patient's authorization for surgery or treatment
Anesthesia and Surgical Record
Notes key events before, during, and immediately after sugery
Specialized Therapy Records/Progress notes
Records specialized treatments or treatment plans and patient progress for various specialized therapeutic services (respiratory care, Physical therapy)
Specialized Flow Sheets
Records measurements made over time during specialized procedures (mechanical ventilation, Kidney dialysis)
How to handle medical charting Errors!
If a mistake is made a single line should be drawn through the mistake and the word "error" printed above
Ethical theories and principle
provide the foundation for all ethical behavior
The principle of Autonomy
acknowledges patients personal liberty and their right to decide their own coarse of treatment and follow through plan on which they freely agree
The principle of Veracity
Binds the health care provider and the patient to tell the truth
The truth is withheld from the patient for his or her own good
The principle of Nonmaleficence
Obligates health care providers to avoid harming patients and to actively prevent harm where possible
The principle of Beneficence
requries that the health care provider go beyond doing no harm and actively contribute to the health and well being of their patients
The principle of Confidentiality
It obligates health care providers to respect the secrets which are confided which are confined even after the patient has died
Allow the patient to give direction to health care providers about treatment in circumstances in which the patient may no longer be able to provide that direction
What are the two types of advanced directives available?
The durable power of attorney for health care
The durable power of attorney for health care allows...
the patient to identify another person to carry out his or her wishes to respect to health care
A living will states...
a patients health care prefences in writing
The principle of Justice
involves the fair distrubition of care
The viewpoint that relies on rules and principles...
The viewpoint in which decisions are based on the assessment of consequences
Asserts that certain features of an act itself determine its moral rightness
an act is judged to be right or wrong based on its consequences
What are the four D's of Negligence?
The practitioner owes a Duty to the patient
The practitioner was Direlict with that duty
The breach of duty was the Direct cause of damanges
Damage or harm came to the patient
states that anyone who knowingly or willfully solicits, receives offers, or pays directly or indirectly any remuneration in return for medicare business is guilty of criminal offense
What are the responsibilites of the medical director of the respiratory department?
Responsible for the clinical function of the department
provides oversight of the clinical care that is delivered
Must be available on a 24 hour basis for consultation with and to give advise to both other physicians and the respiratory care staff
must possses administrative and medical skills
is the process in which the government agency gives an individual permission to practice an occupation
Respiratory care protocols are...
guidelines for delivering appropiate respiratory care treatments and services
Key elements of a respiratory care protocol program!
Strong and committed medical director
Active quality monitoring
Collaborative environment among RTs, physicians, and nurses
Responsiveness of participants to address and correct problems
Elements of a Respiratory Care protocol!
Clearly stated objectives
Outline that includes an algorithm
Description of alternative choices at decision and action points
Description of potential complications and corrections
Description of end points and decisions points at which the physician must be contacted
What is the purpose of respiratory care protocols?
To provide therapy to patients needing and likely to benefit from therapy but to advoid delivering services to patients not likely to benifit
The accuracy of a measuring instrument is...
how well it measure a known reference value
The percision is...
opposite of variability
Indicated by standard deviation (SD)
Small SD= High precision
What is the primarily problem with obstructive lung disease?
Increased airway resistance (Raw)
The normal FEV1 should be...
70% of FVC
What is the percent change for a significiant improvement in flows (FEV1) post bronchodilators?
A 15% or greater improvement in FEV1 and at least a 200 ml increase in FEV1
What methods are used to determine lung volumes?
What is the normal range for (Vt) Tidal volume?
500 to 700 ml
What is the normal range for (IC) Inspiratory capacity?
What is the normal range for (IRV) inspiratory reserve volume?
What is the normal range for (ERV) expiratory reserve volume?
1.20 L and represents 20 to 25% of the VC
What is the normal range for (VC) vitial capacity?
4.80 L and represents 80% of TLC
What is the normal range for (TLC) total lung capacity?
What is the normal range for (RV) residual volume?
1.20 L and represents 20% of TLC
What is the normal range for (FRC) Functional residual volume?
2.40 L and represents 40% of the TLC
When would the right heart boarder not be visible?
if adjecent lung tissue is filled with fluid
Pulmonary consolidation or pleural effusion
What view gives the technician the best quality chest film?
The PA view
what portion of the chest should the heart take up?
mediastinum and no more than 50%
Signs of a Pneumothorax!
Abnormal collection of air within the pleural space
Visceral pleura becomes visible
Spontaneous or results from an invasive procedure , or as a complication of PPV (barotrauma)
Air accumulates over the top of lung in upright patient (lack of vascular marking)
More subtle in supine position (deep sulcus sign)
What is the optimal position of the tip of the endotracheal tube?
Neutral neck position
5-7 cm above carina (midtrachea) (C5-C6)
What is a V/Q lung scan good for?
evaluating for pulmonary embolism
What problems are a rotated person goin to persent on a chest film?
projecting midlines structures to the right or left
Fluid that passes threw body tissues
Patchy, increased density shadows or opacities
What are some of the signs for ARDS on a chest X ray film?
The edema is patchy and bilatereral and does not predominate in the central hilar regions
Also lacks the cardiomegaly
Kerly B lines
Signs of atelectasis on chest X ray film!
Unlateral diaphragmatic elevation
Narrowing of the space between the ribs
Indications for pulmonary function testing!
To identify and quantify changes in pulmonary function
To evaluate need and quantify therapeutic effectiveness
To perform epidemiological surveillance for pulmonary disease
To asses patients for risk of post operative pulmonary complications
To determine pulmonary disability
What is the most common test for airway mechanics?
FVC (forced vital capacity)
What gas law is the body box based on?
AARC code of ethic!
Represents a set of general principles and rules that have been developed to help ensure that the health needs of the public are provides in a saft, effective, and caring manner