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6 components of Nursing

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Assessment Diagnosis Outcomes identification Planning Implementation Evaluate

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Assessment

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a systematic and ongoing collection of comprehensive data relevant to a patient's health or to the situation or ambience influencing the patients health

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Diagnosis

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a clinical judgement about the clients response to actual or potential health conditions or needs

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Outcomes identification

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are individualized according to the patients presenting needs or diagnoses or the the situation in which the patient is found

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Planning (of care)

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is diagnostic specific

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Implementation

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providing, monitoring, delegating, coordinating, teaching, and counseling

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Evaluation

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the process of determining both the clients progress toward the attaining of expected outcomes and the effectiveness of nursing care

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Serum Albumin Adult over 60

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3.4-4.8 g/dL

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Serum Albumin 18 - 60 yr

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3.5 g/dL

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Serum Albumin Child

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3.2-5.4 g/dL

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Serum Albumin Newborn

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2.8-4.4 g/dL

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Clinical Model

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Defines health as the absence of disease

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Endomonistic Model

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Focuses on health as well being, self-fulfillment, and self actualization. "Living to my full potential"

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Adaptive Model

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Views health as adaptation to the physical and social world in which a person lives, and views disease as maladaptation. "Health is adjusting physically or mentally- in all ways to life's circumstances"

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Role Performance Model

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A model of health, wellness, and illness that views health in functional terms; here, if a person can function, he or she is healthy. "Health is the ability to meet my responsibilities, to care for my children, and to make a living"

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The Locus of control model

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assumes patients are either internally or externally controlled

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Internally controlled

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the health professional helps the patient to build up internal rewards "I walk a mile each moring and evening because it makes me feel good"

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Externally controlled

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the health professional helps to provide external reinforcement or positive rewards "I stopped smoking b/c all my friends stopped. It wasn't the thing to do anymore"

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The Self-Efficacy theory

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if a person believes that they can do it, they can do it! "If I have to lose 30 pounds to lower my BP, then I will do it"

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The Health Belief Model

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examines motivational influences on health behavior change primarily as it relates to compliance with a treatment regimen for a disease "It's against my religion to recieve a blood transfusion"

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The Health Promotion Model

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examines motivational influences on health behavior change primarily as it relates to compliance with a treatment regimen for a disease, but places it's emphasis on health promotion behavior change

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Prochaska and DiClemente's Stages of Behavior Change

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Looks at any kind of behavior change and therefore is easily applied to health-promotion behavior change. ( Has 6 Stages; precontemplation, contemplation, preparation, action, maintenance, and termination.) "lately I have been considering getting help with my drinking problem"

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High Level of wellness

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requires making healthy lifestyle choices daily to maximize one's health potential

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Travis' Illnes-Wellness continuum

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assumes a person actively seeks out and engages in health promoting behaviors.

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Dunn's high level wellness grid

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looks at health in terms of two demensions; enviromental and the wellness-death dimension

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4+ wellness model

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Consists of two layers -layer one, inner self....... 4 domains; the intellectual, emotional, physical, and spiritrual. -layer two, the outer layer consists of factors that surround the self, such as environment, culture, safety, nutrition, education, world events, finances, and other external systems "Health is a balance of inner strengths while avoiding excesses, along with a positive interaction with outer systems"

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Ecological Model

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illness or disease occurs due to an interaction between the disease-causing agent; the person, animal, or insect host of the diseae; and the environment in which both the agen and the host exist

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Primary Prevention

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Aimes at preventing illness and disease before it occurs

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Secondary Prevention

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intended to detect and treat disease and health problems in the earliest stages

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Tertiary prevention

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is designed to restore, maintain, and maximize health and optimize functioning in the later stages of illness and disease

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1st link in the chain of infection

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is the infectious agent..... may be a bacteria, virus, fungus, protozoa, or rickettsia

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2nd link in the chain of infection

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is the reservoir in which the infectious agent lives or exists

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3rd link in the chain of infection

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is the portal of exit from the reservoir

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4th link in the chain of infection

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the mode of transmission, or the way in which the infectious agent travels between the portal of entry in a new host

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5th link in the chain of infection

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is the control of entry portals (broken skin, dirupted mucous membrane, urinary meatus)

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6th link in the chain of infection

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is the potential or susceptible host, refers to the person at risk for infection

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nonspecific immune response

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anatomic and physiologic barriers and nonspecific inflammatory response..... intack skin and mucous membarane, cilia in nasal passages, alveolar macrophages, saliva, tears

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specific immune response

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IgM, IgG, IgA, IgD, or IgE

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anti-body mediated response

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aka humoral (circulating) immunity, immunity resides in the b-lymphocytes and the antibodies produced in the B cells mediate the response

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cell mediated defense

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aka cellular immunity, resides in the T cell system three types of T cell Helper T, cytotoxic T and suppresser T cells (T cells play an important role in helping the body fight infection)

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active immunity

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vaccination

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passive immunity

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from mom to baby through breast feeding

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incubation period

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is the interval between the invasion of the pathogen into the body and the first signs of symptoms of infection

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prodromal stage

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that time interval between the onset of nonspecific s/s of infection to more disease specific s/s... disease is communicable during this stage

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illness stage

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the disease s/s are present

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convalescence stage

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time period between the disapperance of the acute s/s of the disease and full recovery

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four phases of healing

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inflammatory destructive proliferative maturation

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inflammatory phase

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The first stage in wound healing. Hemostasis occurs almost immediately. The vessels constrict and platelets form, yeilding a fibrin matrix that provides a foundation for later repair, bleeding stops, platelet plug formed, fibrous meshwork provides initial wound closure; last 3-4 days; major events are hemostasis (cessation of bleeding) and inflammation (nonspecific cellular response to tissue injury)

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destructive phase

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The second stage in the process of wound healing, in which macrophages continue to clean the wound and stimulate fibroblast formation and collagen synthesis; this stage lasts from two to five days

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proliferative phase

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The third stage of healing, lasts 3-24 days and is characterized by beginning wound closure and increasing strength of closure between opposing sides of the wound.

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maturation phase

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The forth and final stage of wound healing, characterized by increasing strength of closure over a period of several months and perhaps up to a year.

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Stage 1 pressure ulcer

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intact skin witn non-blachable redness

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Stage 2 pressure ulcer

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partial thickness loss of dermis presenting in one of two ways; -a shallow open ulcer with a pink wound bed, w/o slough -an intact or open or ruptured serum-filled blister

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Stage 3 pressure ulcer

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characterized by full thickness skin loss, underlying subcu fat may be visible

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Stage 4 pressure ulcer

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characterized by full thickness skin loss, accompanied by exposure of muscle, tendon, or bone; eschar or sloughing may be present

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Unstageable pressure ulcer

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pressure ulcer of undeterminate depth, characterized by full thickness tissue loss in which the base of the wound is obscured by slough or necrotic tissue

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drop facter

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1000 ml x 10 drops _________________ = ggts/ml/min 480 minutes

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fat soluble drugs

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are non polar, nonionized drugs that passively move or diffuse back and forth across membranes o nce their dissolution (breaking down) occurs in the cell's lipid membrane

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Active transport

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the movement of molecules across a cell membrane. It is used to move polar, ionized drugs (water soluable drugs) across cell membranes

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Pinocytosis

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a process by whick cells ingest substances

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water solble drugs

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have a short half life in hours

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lipid soluble drugs

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have a longer half life in days

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iatrogenic effect

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is an illness induced in the client by a drug given for a treatment or theraputic purpose

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five right

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right patient right drug right dose right route right time

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purulent

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Containing, discharging, or causing the production of pus

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serous

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various bodily fluids that are typically pale yellow and transparent

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sanguinous

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Bloody, red

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serosanguinous

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discharge of blood tinged fluid

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healthy people 2010

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a nationwide health promotion and disease prevention plan designed to serve as a guide for improving the health of all people in the United States

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germicide

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an agent (as heat or radiation or a chemical) that destroys microorganisms that might carry disease

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disinfect

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destroy microorganisms or pathogens by cleansing

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sterilization

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the procedure of making some object free of live bacteria or other microorganisms (usually by heat or chemical means)

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normal breath sounds

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3 different normal breath sounds: 1. bronchial - heard over trachea and loud & high in pitch 2. bronchovesicular - heard directly over mainstem bronchi and are softer & lower in pitch 3.vesicular - heard over most lung fields, both anteriorly and posteriorly and are soft & low in pitch

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