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Nursing dx vs medical dx
Nursing dx: based on pt's response to treatment of problem or disease. Focuses on pt
Medical dx: describes a disease, illness. Purpose is to ID pathology so appr med tx can be given. More focused then nurse dx
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Steps in nursing process
- assessment
- nursing dx
- planning
- --planning outcomes
- --planning interventions
- implementation
- evaluation
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Theraputic communication
comprised of 5 communication qualities
- Empathy
- Respect
- Genuineness
- Concreteness
- Confrontation
* Every Respectful Guy Carries Condoms
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defenses against infection
- Primary : nonspecific. intact skin, GI tract, mouth etc.
- Secondary: non-specific. Phagocytosis, inflammation, fever
- Tertiary: specific immunity. body creates antibodies against specific pathogens
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type/classifications of infections
- A. local vs systemic
- B. Primary/secondary
- C. Exogenous/endogenous (Exo is acquired from healthcare envir, endo arises from pt normal flora issues)
- D. Acute/ChronicLatent
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What is universal/standard precautions
- Considered first tier of protection, applies to all pts
- Includes hand hygiene; use of gloves, gown, mask, eye protection or face shield (depending on expected exposure) and safe injection practices
- Practice respiratory hygiene and cough etequette
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Contact precautions
- Is a tier 2 protection:
- wear non sterile gloves
- wear clean gown
- remove PPE and observe hand hygiene before leaving room
- use disposable equipment
- Ex: MRSA, scabies, shingles, diarrhea
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droplet precautions
- is a tier 2 protection: keep droplet precautions outside pt room
- wear mask, donning on entry
- change PPE and perform hand hygiene btwn pts
- Ex: flu, RSV, Pneumonia, pertussis, strep
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airborne precautions
- is a tier 2 protection: keep airborne supplies outside pt room
- Don mask on entry, wear special fitting N-95 respirator if pt has TB or smalpox
- remove respirator/mask outside room after closing door
- EX: TB, measles
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protective (reverse) isolation
- is a tier 3 protection: for pts with suppressed immune systems
- Pt in private room
- restricted visitors
- wear mask, gown and gloves
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Benefits of bathing
- serves three purposes: health, social interaction, and pleasure or relaxation
- Bathing removes perspiration and bacteria from skin surface, helping to prevent body odor
- Warmth from water dilate blood vessels near surface of skin, increasing circulation
- Stimulates depth of respirations and improves sensory input
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Mentors vs preceptors
mentor: offers broad teaching, helps with career development.
Preceptor: someone who has more experience who provides practical teaching and guidance. More focused
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Moral principles of nursing
- Autonomy
- Nonmaleficence
- Beneficence
- Fidelity
- Veracity
- Justice
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Nonmaleficence
- a two-fold duty to do no harm and to prevent harm
- refers to both actual harm and risk of harm, as well as intentional and unintentional
Ex: Nightingale Pledge of nurses state that care providers have a duty to cause no harm
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Autonomy
- refers to a person's right to choose and ability to act on that choice
- based on respect for human dignity
- freedom of choice
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Paternalism
treating others like children
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beneficence
- the duty to do or promote good
- can be thought of as a continuum with nonmaleficence
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fidelity
faithfulness, is the duty to keep promises
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Veracity
duty to tell the truth
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justice
obligation to be fair
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My obligation in ethical decisions
- Be aware
- assume responsibility
- function as team member
- Support pt and family
- support pt who are not allowed to decide
- Participate in ethics committees
- advocate for your pt
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invasion of privacy
- violates a person's right to be left alone
- pt has right to:
- have private info protected
- Not be falsely portrayed or intentionally misrepresented in character
- Be free from unwanted intrusion (spying, eavesdropping)
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Malpractice vs negligence
Malpractice involves a professional person who has failed to act in a reasonable and prudent (careful) manner
Negligence is the failure to use ordinary or reasonable care of the failure to act in a reasonable and prudent manner
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informed consent
the permission for any and all types of care given by the pt with full knowledge of the risks, benefits, costs, and alternatives
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dealing with suspected abuse
you must report it
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leading causes of death
- 1. MVA
- 2. Poisoning
- 3. Falls
- 4. Drowning/submersion
- 5. Smoke/fire/flames
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when using restraints
- can be physical or chemical
- Avoid when possible
- Doc specifically and in detail
- Maintain 1-on-1 view of pt
- know guidelines
- do not depend on side rails
- use bed alarms or other devices before resorting to restraints
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How can we prevents falls
- fall risk assessment (Morse fall scale)
- call light in reach
- frequent reorientation
- room by nurses station
- bed in lowest position
- keep water, urinal, bedpan w/in easy reach
- adequate lighting
- night light
- keep floors dry, clutter free
- etc
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Nurses teaching responsibilities
- Provide health teaching that addresses topics like healthy lifestyles, risk-reducing behaviors, developmental needs, ADL's, preventive self-care
- Use methods appropriate to situation and pt values, beliefs, health pratices, developmental level, learning needs, readiness and ability to learn, language preference, spirituality, culture, socioeconomic status
- Seek opportunities for feedback and evaluation of effectiveness of strategies used
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documenting teaching
- important to record responses of pt and family to teaching interventions
- write objective statements about what was taught, client skills and behaviors that demonstrate learning
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