Final Exam Guided Cumulative Review NUR2115( Complete A)

All Modules  Review various nursing diagnoses related to specific patient problems discussed in Fundamentals  Roughly 60% of the final exam will be cumulative over mod 1-7 Module 1-3 Concepts:  Importance of documentation of assessments & interventions - Accurate documentation of the patient’s assessment is important to provide a baseline for later comparisons as the patient’s condition changes  Types of nonverbal behavior which could promote improved communication - Body language - Gestures, movements, touch, appearance, adornments - Personal appearance - May express culture, religion, group associations, self-concept - Posture and gait - Erect vs. slouched posture - Facial expression) the most expressive part of the body)  The importance of QSEN competencies in nursing education - To prepare nurses who combine the highest level of scientific knowledge and technologic skill with responsible, caring practice. - To challenge students to identify and master the cognitive and technical skills as well as the interpersonal and ethic/legal skills they will need to effectively nurse the patients in their care. - Patient-centered care - Teamwork and collaboration - Quality improvement - Safety - Evidence-based practice - Informatics  What is a sentinel event? - An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. - Serious injury specifically includes loss of limb or function. - An error that causes serious harm to a client and singles out the need for investigation.  What is the main purpose for incident reporting? - This helps document what happened to help the healthcare facility learn a way to prevent the incident from happening again.  Examples of health promotion activities for primary, secondary and tertiary - Primary: Directed toward promoting health and preventing the development of disease processes or injury. - EX: Immunizations clinics, family planning services, providing poison control information, accident prevention education, teaching about a healthy diet, health-risk assessments. - Secondary: Focus on screening for early detection of disease with prompt diagnosis and treatment it identifies an illness, reverse or reduce its severity or provide a cure, and thereby return the person to maximum health as quickly as possible - EX: Assessing children for normal growth and development and encouraging regular medical, dental and vision examinations; screening for BP, cholesterol and skin cancer, routine GYN exams and mammograms, teaching testicular self-exams to men, administering medications, caring for wounds. - Tertiary: Begins after and illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate patients to a maximum level of functioning. Maintaining and preventing progression of severe diseases =, dying with dignity, assisting to cope with impending death. - EX: Teaching a diabetic patient how to recognize and prevent complications; using PT to prevent contractures in a patient who has had a stroke or spinal cord injury; referring a woman to a support group after removal of a breast because of cancer.  ISBARR, DARE, SOAPIE notes for team communication - ISBARR allows for an easy focused way to set expectations for what will be communicated and how between members of the team, which is essential for developing teamwork and fostering a culture of patient safety. - SOAPIE= used to organize entries in the progress notes of the POMR. The POMR includes the defined database, problem list, care plans, and progress notes. - ISBARR= Introduction, Situation, Background, Assessment, Recommendation/request & Read back of orders or response - DARE= Database of Abstracts of Reviews of Effectiveness - SOAPIE= Subjective data, Objective data, Assessment, Plan, Intervention & Evaluation  Review teaching for a patient with modifiable health risk factors - T= Tune into the patient - E= Edit patient information - A= Act on every teaching moment - C= Clarify often - H= Honor the patient as partner in the education process  Age related safety concerns across the lifespan - Infant: Falls, SIDS (must lay on back to sleep), Injury from toys, Burns, Suffocation and choking, Electrocution, Ingestion of foreign bodies, Child mistreatment (nurse obliged to report to DCF) **Need rear facing car seat - Toddlers: Falls, Cuts, Drowning, Concussions, Guns and weapons (locked and unloaded), Escape from home, Poison (Poison Control # on fridge), Suffocation and choking, Child mistreatment (nurse obliged to report to DCF) **Front facing car seat in the BACK seat - School age children: Sexual abuse, Burns, Broken bones, Concussions, Drowning, Guns and weapons, Use of Internet, Sports injuries (cognitive rest), Abduction, Bullying (cyberbullying), Child mistreatment (nurse obliged to report to DCF) **Back seat until age 13 - Teenager: Piercing & Tattoos, driving (distracted driving). texting especially, Firearms, Suicide, Drugs and Alcohol and Tobacco, Sexuality and STIs, Sexual abuse, Use of Internet, Risk taking (diving into unfamiliar water) **Seat belt and driving - Adults: Stress, Domestic Violence, MVA, Industrial accidents and exposure Drugs and alcohol abuse - Elderly: Falls #1, Elder abuse and neglect, MVA, Sensorimotor changes, Fires (candles, heaters) ...forgetfulness, Burns (electric blankets, hot water, heating pads), Accidental overdosing and polypharmacy  6 Dimensions of wellness definitions - Physical Wellness: Maintaining a healthy quality of life without excessive stress and fatigue and recognizing the importance of adopting healthful habits such as diet and exercise. - Emotional Wellness: Understanding yourself and being able to cope with life challenges. It also means that you can share your feelings (such as sadness, anger, fear, hope, and happiness) with others. - Sociocultural Wellness: Relating to and forming positive relationships with others such as family, friends, and co-workers and identifying and understanding the impact your cultural values and identity have on your decisions and action. - Intellectual Wellness: Being open to new ideas, experiences and learning opportunities. - Spiritual Wellness: Having peace and harmony in your life and being in congruence with your values and actions. - Environmental Wellness: Taking responsibility for making a positive impact on the world such as contributing to improving the quality of air, water, and land.  Know the importance of basing our care plan on nursing theory  HP 2020 Goals - Attain high-quality of life - Free of preventable disease, disability, injury and premature death - Achieve health quality - Eliminate disparities - Improve the health of individuals - Create social and physical environment that promote good health for all - Promote quality of life, healthy development, and healthy behaviors across all life stages  Developmental theories: focus on Erickson’s - Stage 1: Trust vs. Mistrust (Birth to 18 months): Feeding and viewing the world as a safe place - Stage 2: Autonomy vs. Shame & doubt (18 months to 3): Walking, Becoming more mobile, asserting independence and potty training - Stage 3: Initiation vs. Guilt (3 to 5): Right & wrong and developing social skills - Stage 4: Industry vs. Inferiority (5 to 12): Competition, accomplishment, confidence, social and academic standards - Stage 5: Identity vs. Role confusion (12 to 18): Identity crisis, rebellion and learning adult roles - Stage 6: Intimacy vs. Isolation (18 to 40): Intercourse and developing friendships, relationships and goals - Stage 7: Generativity vs. Stagnation (40 to 65): Establishing career, raise kids, focused on work and close meaningful attachment - Stage 8: Ego Integrity vs. Despair (65 and up): Dealing with loss and adjusting to lifestyle changes  EBP- what information to trust for best practices- ANA, CDC, US Dept of Health, National Institute of Health (NIH).  No .com sites for professional nursing. No blogs should be used as a reference-.  OK to use most .org .edu or .gov sites.  P.I.C.O. statements - P= Patient, population, problem of interest - I= Intervention of interest - C= Comparison of interest - O= Outcome of interest  ANA Scope of Practice - ANA Code of Ethics for Nurses clearly states that the primary commitment of the nurse is the patient, it also states that the nurse owes the same duties to self as to others—including the responsibility to preserve integrity, to maintain competence, and to continue personal and professional growth.  ANA Standards of Professional Performance- definitions (mod 1) - The standards of professional performance describe how NPD practitioners comply with the standards of practice, apply the nursing process, and attend to other practice concerns and issues Musculoskeletal:  Review education on crutch, cane, walker ambulation - Crutches: remind the patient that the support of body weight should come primarily on the hands and arms while using the crutches, not in the axillary areas, where pressure may damage nerves and cut off circulation, Also, the crutches should not be forced into the axillae each time the body moves forward. - Cane: Rounded grip – Needing slight assist with balance or minimal unweighting of the opposite leg. Straight grip – Needing a better grip and slightly more balance assistance. Quad - Helpful for patients needing a good deal of balance assistance. - Walker:  Review safety precautions when repositioning patient in bed - If the patient is fully able to assist in moving up in the bed, allow the patient to complete the movement independently, with safe supervision