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Nursing theory, research, and practice are
Saw nurding as an art and science. Supported education. Said the environment directly affects one's health. Cleanliness, Light, Pure air and water.
Defined the nurse-client relationship. Stranger, Resource person, Teacher Leader Surrogate, and Counselor
Defined nursing as assisting a person in the performance of acitivites that will contribute to health or a peacful death. Stressed independence of client
Conservation theory- Energy, Structural Intergrity, Personal Intergrity, and Social Integrity.
I am Nursing. Looked at action by the nurse client and family and said those things are integrated together. Important that the patients do what they can on their own.
Stressors- Intrapersonal, Interpersonal, and Extrapersonal
stresses within (fear of flying)
Between 2 individuals (getting into with someone)
Outside the individual (raining)
Culrture care and culture belief. Accomodation or negotiation (We respect cultural beliefs).
Sister Calista Roy
Aaptation model- Nursing attempts to alter the environment when the person in not adapting well (i.e. if patient has a problem getting out of the bed, get them a walker). Use of coping systems-Nursing attempts to assist hte client in coping mechanisms.
Human caring. Care and love are the basis for humanity.
- Unitary human beings
- Nursing as an art and science. Energy fields. Looked at humans as structures that cannot ve seperated into pieces.
National Patient Safety Goals
- Improve accuracy of client identification
- Reduce risk of health care associated infection
- Improve effectiveness of communication
- Improve safety of usig high-alert med
- Prevent errors in surgery
- Improve safety of infusion pumps
- Effectiveness of clinical alarm systems
- Reduce the risk of patient harm resulting form falls
Client behavior accident
Burns/poisonings, Self inflicted cuts
Therapeutic procedure accidents
- Medication errors
- Client transfer falls
- Osygen Tank
Always there. Hands washing alone will not get rid of it. Must use friction by rubbing the hands and scrubbing the nails.
Brief can get rid of with hand-washing.
Viruses, bacteria, fungi, protozoa, Rickettsia
Pesticides, food additives, medications, and industrial chemicals
Machine, heat, light, noise, radiation, and machinery
Person whol lacks resistance to an agent and is vulnerable to disease
Compromised host- a person whose normal defenxe mechanims are impaired and is susceptivle to infection
Modes of transmission
Sexually transmitted diseases
Host contacts droplet nuclei or dust particles suspended in the air
Contaminated inanimate objects such as water, food, drugs and blood
mosquitoes, fleas, ticks, lice and other animals
Stages of infection
Time interval between entry of an infectious agent in the host and the onset of symptoms.
Non specific symptoms
Disappearance of acute symptoms until the client returns to the previous state of health
Emerging Infections- Don't know where they are at or going
- West Nile Virus/Hantavirus
- Viral hemorrhagic fevers (ebola)
Nosocomial Infections (most common infection sites greatest to least)
- Lower Respiratory
Assesing client in inpatient setting
- Fall risk every shift
- Infection (local or systemic)
Assesing client in home
- Asses prior to patient's discharge
Magic number for leukocytes
Increase in acute sever infection (bacterial)
Increase in chronic bacterial infections
increased in protozoan and rickettsial infections and tuberculosis
Eosinophils and basophils
Unaltered in an infectious process
Erthrocytes Sedimentation rate (ESR)
Elevated in infection
pH in urine, gastric or vaginal secretion
Elevated in infection
Three things to minimize to reduce exposure to radiation.
Time, distance, and shielding
infection control practice used to reduce number, growth and spread of microorganisms.
Examples of medical asepsis
Gloves, changing linens daily, cleaning floors, hospital furniture and hand hygiene
Eliminates microorganisms and spores
Examples of surgical asepsis
Sterile technique, donning sterile gloves,donning surgical attire, surgical hand antisepis, gowning and closed gloving
- Protective Eyewear
- Hand Hygiene
- In addition to standard
- Disposable equipmemt
Perform areas with contaminated areas when?
- In addtion to standard
- Eye protection
- Fluid resistant procedure mask
- Keep door closed
- N95 respirator mask
When to use contact precaution
MRSA, VRE, C.difficile, major wounds with significant damage
When to use airborne precaution
Tuberculosis,measles,chickenpox, disseminated herpes zoster
When to use droplet precaution
Influenza, respiratory MRSA,rubella, meningoccocal meningitis, mumps, pertussis
- Client is free injury
- Client is free from
- Self-care needs are met
When to take vital sighns
- Upon admission
- Every few hours
- Anytime there is a change in the patients condition
- Before procedures (compare when they return)
- Prior to discharge
How often you take vital signs for med surge?
How often do you take vital signs for ICU?
How often do you take vital signs for Progressive care?
Every 4 hours
How often do you take vital signs for Hospice?
May not take them
Normal adult value for oral temperature?
Normal adult value for axillary?
Normal adult value for rectal(most accurate)?
When shouldn't you take a rectal temperature?
- Patient at risk for perforation
- Patients who have extremely slow heart rate because it stimulates vegus nerves and can slow the heart rate
Meatabolic heat production
- Shivering (body's own mechanism)
- Excessive muscle activity
- Thyroxine production
Loss of heat to object in contact with the body
12-20 breaths per minute
When do you check the carotid pulse?
During cardiac arest, shock, blood pressure very low
How long do you check the apical pulse?
If apical pulse is larger than radial, what may be the problem?
Circulation problem, the heart is not pumping efficient enough to reach extremeties
What two pulses should you find in every patients besides the normal pulse?
Posterior tibial and Dorsalis Pedis
measure of blood that enters the aorta with each ventricular contractiondiac output
volume of blood pumped by the heart in one minute
Cardiac out put for men?
Cardiac output for women?
Repolarization- Most important heart not resting doesn't get oxygen and doesn't allow blood to flow to tissues
Pulse pressure equals
- 120/80= 40
Orthostatic Blood pressure
- Lay flat, take BP
- -Wait 5 minutes
- Sit, take BP
- -Wait 5 minutes
- Stand up, take BP