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they become active in the plan of care

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Q1) What happens when patients sense that the health care provider is sensitive, sympathetic, compassionate, and interested in them as people?

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attentiveness, partnership, individualization, rapport, and caring

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Q1) What do patients associate excellent nursing care with?

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Instead of giving a lengthy description of the procedure to relieve anxiety, you decide that the patient will benefit more if you obtain assistance form a skilled staff member.

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Q1) for example, your patient is fearful of having an intravenous catheter inserted, and your still a novice at catheter insertions. What do you do to insure the caring approach is right for you patients needs?

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-persons developmental stage -intellectual background -perception of functioning -emotional/ spiritual factors

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Q2) What are internal variables that influence illness behaviors?

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consider patients level of growth and development when using his or her health beliefs and practices as a basis for planning care

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Q2) Developmental Stage

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influence how a patient thinks about health along with the way a person thinks bout health

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Q2) Intellectual Background

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level of fatigue, shortness of breath, or pain, blood pressure, height measurements, and lung sounds -helps plan and implement individualized care

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Q2) Perception of functioning

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-degree of stress, depression, or fear can influence health -the way person handles stress throughout phases of life influences the way he/she reacts to illness -CALM-little emotional response -cope EMOTIOALLY- overreact to it and assume life threatening or deny the presence and not take action

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Q2) Emotional Factors

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how a person lives his/her life including values, beliefs, relationships, and ability to find hope and meaning -some restrict use of forms of medication

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Q2) Spiritual Factors

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when not able to move freely body parts are exposed to pressure that reduces circulation to affected tissues

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Q3) Risk for Impaired Skin Integrity: Immobilization

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patients with paralysis, circulatory insufficiency, or local nerve damage are unable to sense and injury to the skin -check for pain, tactile sensation, and temperature sensation

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Q3) Risk for Impaired Skin Integrity: Reduced Sensation

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limited caloric and protein intake develop thinner, less elastic skin with loss of subcutaneous tissue -impaired or delayed wound healing

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Q3) Risk for Impaired Skin Integrity: Nutrition and Hydration Alterations

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moisture on surface of skin serves as medium for bacterial growth and causes -irritation -softens epidermal cells -leads to skin maceration Presence of perspiration, urine, watery fecal material, and wound drainage on skin = results in breakdown and infection

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Q3) Risk for Impaired Skin Integrity: Secretions and Excretions on the Skin

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-inadequate blood flow causes ischemia and breakdown -infection is also a risk because delivery of nutrients, oxygen, and white blood cells to injured tissues is inadequate

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Q3) Risk for Impaired Skin Integrity: Vascular Insufficiency

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exerts pressure or friction on the skin

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Q3) Risk for Impaired Skin Integrity: External Devices

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decreased level of awareness may be unaware of their skin care needs

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Q3) Risk for Impaired Skin Integrity: Altered Cognition

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-person to person encounter conveying a closeness and sense of caring --Being there-physical presents and communication and understanding -outcomes include: alleviating suffering, decreasing sense of isolation, and vulnerability, and personal growth --nurse gives themselves meaning being available and at a patients disposal Helps to calm anxiety and fear related to stressful situations

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Q4) Caring in nursing practice through providing presence. Being There and Being With

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tough is one comforting approach that reaches out to patients to communicate concern and support -leads to connection -contact touch- skin to skin contact -noncontact touch- eye contact

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Q4) Caring in nursing practice through touch

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-individualize care based on patients preferences -encourage them to routinely inspect skin for changes, eat from all food groups, consume adequate fluids -handle skin gently -check water temp, cut nails to proper length, and slipping -protect from infection

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Q5 & 6) Bathing and Skin Care

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-do not let embarrassment make you over look patient care -prevents skin breakdown and infection -check for discharge, abnormal smell -clean from front to back

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Q5 & 6) Perineal Care

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-socking to soften cuticles and layers of horny cells, thorough cleaning, drying, and proper nail trimming -patients w/ diabetes not soak nails bc risk of over drying causing brakes in skin and infection --receive thorough foot exam 1 a year --inspect feet daily --wash feet daily in lukewarm water --wear shoes and clean dry socks at all times --keep skin soft with lotion but not between toes --trim straight across and square file the edges --put feet up when sitting and wiggle toes and ankles up and sown --protect feet from hot and cool

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Q5 & 6) Foot and Nail Care

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-brushing-cleans -flossing-removes tartar -rinsing-removes dislodged food -some patients need oral care every 1 to 2 hours, others 2-3 times a day

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Q5 & 6 & 14) Oral Hygiene

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-Eye --clean with washcloth moistened with water inside to outside --Eyeglasses ---protect from breaking of scratching ---soft cloth and cool water cleans glasses --Contact Lenses ---disinfect lenses with contact solution ---rinse with saline --Artificial Eyes ---retract lower eyelid and exert slight pressure just below eye ---warm saline cleans ---clean edges of eye socket -Ear --clean with end of moistened washcloth -Irrigate ear -- sit of lay on side ---pull pinna up and back ---wash with warm solution ---wipe any moisture from the ear -Nasal --blow into tissue --warm wash cloth or cotton tipped applicator --change tape anchor 1 time a day

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Q5 & 6 & 14) Care of Eyes, Ears, and Nose

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-caring for human beings protects, enhances, and preserves human dignity --places caring at center of decision making --concerned with relationships between people and with a nurses character and attitude toward others

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Q7) Ethic of care on nurses decision making

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-brush teeth 2-3 times a day -floss 1 time a day -rinse mouth 1 time a day -make sure dentures fit right -make sure dentures fit properly

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Q8) Reduction of risk potential for oral mucous membrane impairment

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-true prevention; it precedes disease or dysfunction and is applied to patients considered physically and emotionally healthy --health education programs --immunizations --physical and nutritional fitness

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Q9) Level of Preventive Car -Primary Prevention

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-focuses on individuals who are experiencing health problems or illnesses and are at risk for developing complications or worsening conditions -diagnosis and prompt intervention, reducing severity, and enabling the patient to return to a normal level of health as early as possible --screening techniques --treating early stages of disease to limit disability

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Q9)Level of Preventive Care -Secondary Prevention

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-when a defect or disability is permanent and irreversible --minimizing the effect of long term disease or disability by interventions directed at preventing complications and deterioration --rehab- care helps achieve as high a level of function as possible

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Q9) Level of Preventive Care -Tertiary Prevention

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-before lifting assess the weight to be lifted -determine the assistance needed -evaluate available resources -manual lifting only as last resort -encourage patients to do stretching, ROM, and low intensity waling -passive ROM when cant be done on own

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Q10 & 11) How to maintain and use proper body mechanics

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-observe for changes that indicate peripheral neuropathy or vascular insufficiency --receive thorough foot exam 1 a year --inspect feet daily --wash feet daily in lukewarm water --wear shoes and clean dry socks at all times --keep skin soft with lotion but not between toes --trim straight across and square file the edges --put feet up when sitting and wiggle toes and ankles up and sown --protect feet from hot and cold

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Q12) Explain the importance of foot care for the patient with diabetes

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Physiological -slow wound healing -muscle atrophy -decreased amount of subcutaneous fat Psychosocial -abrupt changes in personality -boredom and feeling isolated -depression -anger

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Q13) Identify changes in physiological and psychosocial function associated with mobility and immobility

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-start at head work way down -change towel and water when dirty or cold -clean from clean to dirt -when cleaning perianal and butt front to back

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Q14) Successfully perform hygiene procedures for care of skin

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-socking to soften cuticles and layers of horny cells, thorough cleaning, drying, and proper nail trimming -patients w/ diabetes not soak nails bc risk of over drying causing brakes in skin and infection --receive thorough foot exam 1 a year --inspect feet daily --wash feet daily in lukewarm water --wear shoes and clean dry socks at all times --keep skin soft with lotion but not between toes --trim straight across and square file the edges --put feet up when sitting and wiggle toes and ankles up and sown --protect feet from hot and cool

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Q14) Successfully perform hygiene procedures for care of feet and nails

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Moving and positioning in bed -pillows -therapeutic boots -sandbag -hand rolls -side rails Transfer -transfer belt, sling, r lapboard -nonskid shoes, bath blankets, pillows -Wheelchair -stretcher -mechanical lift

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Q15) Describe equipment needed for safe patient handling and movement

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pg 1144

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Q16) Develop individualized nursing care plans for patients with impaired body alignment and mobility

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compare -maximum amount of movement available at a join in one of the 3 planes of the body: sagittal, transvers, or frontal Active -the patient moves all joints through their ROM unassisted Passive -the patient is unable to move independently and the nurse moves each joint through its ROM

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Q17) Compare and contrast active and passive range-or-motion exercises

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Skeletal System -provides attachment for muscles and ligaments and the leverage necessary for movement -Joints --connections between bones --synostotic- bone joind to bone --cartilaginous- cartilage unites bony components --fibrous-ligament or membrane unites two bony surfaces --synovial-freely movable joint -Ligaments --binding joints together and connecting bones and cartilages -Tendons --connect muscle to bone -Cartilage --supporting connective tissue Skeletal Muscle -anatomical structure and attachment to the skeleton enhance contractile elements of the skeletal muscle Nervous System -the motor fibers initiate voluntary movement -during voluntary movement impulses descend from the motor strip to the spinal cord

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Q18) Describe the functions of the musculoskeletal (skeleton, skeletal muscles) and nervous systems in the regulation of movement

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Physiological -physical functions of the body Genetic -heredity -predisposition -history of cancer, heart disease, kidney disease, or mental illness

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Q19) Genetic and Physiological Risk Factors

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preme -more susceptible to infection older -more likely to have cancer or head disease

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Q19) Age as a Risk Factor

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where and the condition we live in determine how we live, what we eat, the disease agents we are exposed to, state of health, and ability to adapt

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Q19) Environment as a Risk Factor

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-practices with potential negative effects are risk factors -habits are risk factors

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Q19) Lifestyle as a Risk Factor

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-identify risk factors -discuss health hazards -decide if want to maintain or improve health status -emphasize wellness strategies that teach patients to care for themselves in a healthier way

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Q20) Risk factor modification and changing health behaviors

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ROM, Exercise and activities

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Q21) Interventions for maintaining active tolerance and mobility

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Skin -note color, texture, thickness, turgor, temperature, and hydration Feet and Nails -inspect for lesions including noting areas of dryness, inflammation, or cracking Mouth -inspect for color, hydration, texture, and lesions Eyes Ears and Nose -eye- not inflamed and is without drainage -ears-inspection of the auricle, external ear inspect for cerumen or drainage, and infection -nose-inflammation. discharge, lesions, edema, and deformity

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Q22, 25, & 26) Successfully assess for the care of the skin, perineum, feet and nails, mouth, eyes, ears, and nose

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-must complete a nursing history and perform a physical assessment -need to conduct brief history to determine priority areas

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Q23, 25, & 26) Conduct a comprehensive assessment of a patients total hygiene needs

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so we do not hurt ourselves, and the patient does not get hurt either

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Q24) Implementation of the importance of no-lift policies for the patient and health care provider

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addresses the relationship between a persons beliefs and behaviors -individuals perception of susceptibility to an illness -individuals perception of the seriousness of the illness -likelihood that a person will take prevention actions

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Q27) Health Belief Model

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defines health as a positive, dynamic state, not merely the absence of disease

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Q27) Health Promotion Model

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certain human needs are more basic then others

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Q27) Basic Human Needs

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attempts to create conditions that promote optimal health -recognize the natural healing ability of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, ect

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Q27) Holistic Health Model

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-use caring practices -soft genital voice -administering medications to relieve the symptoms before providing hygiene -alert for cues of anxiety or fear -assisting and preparing patients to do as much hygiene care as they can independently -teach proper techniques

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Q28) Implementation of patients total hygiene needs

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Standing -head midline -shoulders and hips straight and parallel -vertebral column straight -arms hang at sides -feet are slightly apart Sitting -head erect neck and vertebral column are straight -body weight is distributed evenly -both feet on floor -space between edge of seat and knee -arms supported on arm rest

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Q29) implementation of nursing care plan for patients with impaired body alignment and mobility

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-physical activity used to condition body, improve health, and maintain fitness, and therapeutic measure

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Q30) Describe the benefits of implementing an exercise program for the purpose of health promotion

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impaired mobility rt medical diagnosis aeb patient blah blah blah

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Formulate nursing diagnoses for patients experiencing problems with impaired mobility and activity intolerance

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-Dandruff-shampoo regularly -ticks-using blunt tweezers grasp tick as close to head as possible and pull upward -lice-wearing gloves check entire scalp with lice comb -hair loss- stop hair care practices that damage hair

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Q38) List common hair and scalp problems and their related interventions

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1) attain high quality longer lives free of preventable disease, disability, injury, and premature death 2) achieve healthy equity, eliminate disparities and improve the health of all groups 3)create social and physical environments that promote good health for all 4)promote quality of life, healthy development and healthy behaviors across all life stages

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Q41) list the two general healthy people 2020 public health goals for Americans

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skin -new born --loosely bound together and thin -toddlers --greater resistance to infection -adults --elastic, well hydrated, firm and smooth Mouth -6-8 months --begin teething -older --gums lose vascularity and tissue elasticity --dentures

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Q42) Describe how hygiene care for the older adult differs from that for the younger patient

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Social practices -type of hygiene products used and the nature and frequency of personal care practices Person Preferences -individual desires and preferences about when to perform hygiene and grooming care Body Image -persons subjective concept of his or her body Socioeconomic Status Health Beliefs and Motivation Cultural Variables Developmental Stage Physical Condition

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Q44) Factors that influence personal hygiene practices

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necessary for meaningful interactions with patients -being able to tell that story helps the patient break the distress of the illness

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Q46) Therapeutic benefit of listing to patients

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Assessment -ask what prompted health care provider to recommend a rehab program - ask about exercise and eating habits -perform baseline assessment Diagnosis -activity intolerance related to inactivity and lack of cardio fitness Goals -activity tolerance improve above baseline -cardio response exercise will improve Intervention -instruct about physiological benefits -develop progressive plan of exercise -instruct to use exercise log

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Q47) Nursing care plan for activity intolerance

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-determines what matters to a person -underlies a wide range of interactions

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Q50) Caring is Primary

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describes the concept of care as the essence and central unifying and dominant domain that distinguishes nursing form other health disciplines

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Leiningers Transcultural Caring

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holistic model for nursing that suggests that a conscious intention to care promotes healing and wholeness

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Watsons Transpersonal Caring

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middle range theory of caring provides direction for how to develop useful and effective caring strategies

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Swanson's Theory of Caring

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the nurse and patient enter into a relationship that is much more than one person doing tasks for another there is a mutual give and take that develops as nurse and patient begin to know and care for one another

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Summary of Theoretical Views

Nurs 210 CH 6,7,38,39,47 – Flashcards

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