Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Exam 1

No description
by

Dawn Turnage

on 26 August 2013

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Exam 1

STUDY WISELY!
EXAM 1 STUDY TOOL

Chapter 1
Evidence Based Assessment
Chapter 2
Cultural competence; Cultural care
CHAPTER 3
THE INTERVIEW
Subjective Information
Anything the patient tells you.
Examples: I have a headache. I feel cold. I used cocaine. I'm going to throw up.

Objective Information
Anything you find in your assessment.
Examples: Tachycardia (fast heart rate). Wheezing upon auscultation.
The patient database
contains labwork, subjective and objective information and the patients medical record.

4 types: Complete, Problem-focused, follow up, emergency
Nursing diagnoses
Important to select appropriate diagnoses.

Nursing diagnoses are the basis for choosing interventions for patient care.


Prevention
Links the patient's behaviors to healthcare outcomes.
Example: Exercising to reduce weight.
Not exercising can lead to obesity, diabetes, heart disease.
Cultural Assessment
Important to gather cultural information in the database in order to provide culturally sensitive and appropriate care.
Cultural development
Learned through language acquisition and socialization
Amulets and charms
May have significance in your patients health beliefs. They may believe charms hold special powers.

Assess their meaning to your patient and if safe, let your patient keep them.
Religion vs. spirituality
Religion: The belief in a higher power, worship of a god or gods

Spirituality: finding meaning and purpose in life

Important to assess the patient's participation in activities, also. This can help determine how significant religion is to your patients health beliefs
First step in providing culturally sensitive care
YOU MUST ANALYZE YOUR OWN BELIEFS, VALUES, TRADITIONS BEFORE YOU CAN BECOME SENSITIVE TO THE IDEALS OF OTHERS
YIN AND YANG
ASIAN TRADITION.
THEORY FOR ILLNESS.
HOT AND COLD.
TREAT A "HOT" CONDITION WITH COLD.
TREAT A "COLD" CONDITION WITH HOT.
SHAMAN
USED IN SOME CULTURES.
MEDICINE MAN/FAITH HEALER.
COMMON IN NATIVE AMERICAN AND MAYAN CULTURES
CULTURAL TABOOS
PRACTICES THAT "GO AGAINST" THE BELIEFS OF A CULTURE.

EXAMPLES:
JEHOVAH'S WITNESS: NO BLOOD OR BLOOD PRODUCTS
ASIAN: DIFFICULTY ACCEPTING MENTAL ILLNESS
PROFICIENCY
NOVICE NURSE: RELIES ON RULES

PROFICIENT NURSE: ABLE TO SEE LONG TERM GOALS FOR PATIENTS; SEES PATIENT AS A WHOLE, NOT JUST ONE DISEASE

EXPERT NURSE: RELIES ON INTUITION
VERBAL AND NON-VERBAL
VERBAL CUES ARE SPOKEN; NON-VERBAL CUES INCLUDE POSTURE, FACIAL EXPRESSION, GESTURES

BOTH ARE DEMONSTRATED BY NURSE AND PATIENT

MAKE SURE BOTH MATCH WHAT YOU ARE TRYING TO SAY/WHAT YOUR PATIENT IS TRYING TO TELL YOU
NOTE-TAKING
USEFUL TO HELP REMEMBER IMPORTANT INFO

MAY CAUSE NURSE TO MISS PATIENT'S NON-VERBAL CUES

MAKE SURE TO PAY MORE ATTENTION TO PATIENT THAN YOUR NOTES!
OPEN-ENDED QUESTION
ALLOWS PATIENT TO GIVE MORE INFO THAN A YES OR NO QUESTION

MAY BE IN THE FORM OF A STATEMENT: "TELL ME MORE....."

AVOID BIASED OR LEADING QUESTIONS
DISCOURAGE PATIENT FROM BEING HONEST

EXAMPLES:
YOU DON'T DRINK, DO YOU?
YOU AREN'T GAY ARE YOU?

BETTER TO SAY: HOW MUCH DO YOU DRINK? DO YOU HAVE SEX WITH MEN, WOMEN OR BOTH?
POSITIONING
OPEN POSITION; SITTING RELAXED, ARMS OPEN, LEANING FORWARD. DEMONSTRATES COMFORT AND WILLINGNESS TO SHARE

CLOSED POSITION; CROSSED ARMS/LEGS, INDICATES DISCOMFORT WITH TOPIC OR NOT WILLING TO SHARE
ADOLESCENTS
APPROACH INTERVIEW WITH RESPECT FOR PATIENT AND WILLINGNESS TO SHARE.

ADOLESCENTS CAN DETECT PHONY OR FAKE COMMUNICATION AND THIS CAN LEAD TO MISTRUST
OLDER ADULTS
ALLOW MORE TIME FOR INTERVIEW

NOT NECESSARILY CONFUSED OR FORGETFUL

HAVE A LONGER STORY TO TELL THAN A YOUNGER PERSON :)
CHAPTER 4
THE COMPLETE HEALTH HISTORY
ALLERGIES
IMPORTANT TO ASSESS WHAT THE PATIENT IS ALLERGIC TO AND ALSO WHAT HAPPENS WHEN THE PATIENT TAKES THAT MEDICATION

EXAMPLE: ALLERGY: MORPHINE-CAUSES HIVES
REVIEW OF SYSTEMS

EVALUATES PAST AND CURRENT HEALTH STATE OF EACH BODY SYSTEM

MAY "CATCH" OMITTED INFORMATION IN HISTORY OF PRESENT ILLNESS

EVALUATES HEALTH PROMOTION PRACTICES
DOCUMENTING CHILDHOOD ILLNESSES
BE THOROUGH. BETTER TO SAY "DENIES MEASLES, MUMPS, RUBELLA, CHICKENPOS, PERTUSSIS AND STREP THROAT" THAN TO SAY "NO ILLNESSES IN CHILDHOOD"
SOCIAL HISTORY/ALCOHOL CONSUMPTION
IMPORTANT TO EVALUATE ALCOHOL CONSUMPTION AS ALCOHOL INTERFERES WITH SEVERAL MEDICATIONS, AND IS ASSOCIATED WITH HIGHER RISK FOR ABUSE/ACCIDENTS.
GENOGRAM
A FAMILY TREE CONSTRUCTED WITH SYMBOLS

DEPICTS GENDER, RELATIONSHIP, AGE

USED TO DETERMINE RISK OF AN INDIVIDUAL BY ASSESSING HEALTH OF ANCESTORS
OLDER ADULT
MAY NEED ASSISTANCE OF A FAMILY MEMBER TO RECALL INFORMATION

MAY NEED FAMILY TO BRING IN MEDICATIONS IF UNABLE TO RECALL NAMES/DOSAGE
CHAPTER 9
GENERAL SURVEY
WEIGHT
USE A BALANCED SCALE

IDEALLY HAVE SHOES OFF AND HEAVY CLOTHING OFF

BETTER TO WEIGH AT THE SAME TIME EVERY DAY IF A SERIES OF WEIGHTS IS NEEDED
CHANGES IN THE OLDER ADULT
MORE PROMINENT BONY LANDMARKS
DECREASED BODY WEIGHT
DECREASED SUBCUTANEOUS FAT IN FACE
MORE FAT IN ABDOMEN AND HIPS
KYPHOSIS
FLEXION IN KNEES AND HIPS
INFANT ASSESSMENT
CHEST: AT NIPPLE LINE
LENGTH: USE HORIZONTAL BOARD
HEAD: TAPE MEASURE AROUND HEAD
WEIGHT: PLATFORM SCALE
TEMERATURE
USUALLY LOWER IN OLDER ADULTS
AVERAGE 97.2*F
POSITIONING
TRIPOD POSITION
A WARNING OF RESPIRATORY DIFFICULTY
SEEN IN ASTHMA, COPD
INFANT RESPIRATIONS
WATCH FOR RISE AND FALL OF ABDOMEN

BREATHING IS MORE DIAPHRAGMATIC THAN THORACIC
ASSESSING A PULSE
USE THE 30 SECOND X 2 METHOD. RESEARCH SHOWS THIS TO BE MOST ACCURATE WHEN RHYTHM IS REGULAR

IF IRREGULAR, COUNT FOR A FULL MINUTE
AUSCULTORY GAP
PRESENT IN 5% OF ALL PATIENTS; USUALLY OCCURS WITH HYPERTENSION

CAN LEAD TO FALSELY LOWER BP

TO AVOID FALSE READING: INFLATE CUFF 30mmHG ABOVE PALPATED PULSE
ORTHOSTATIC HYPERTENSION
SUDDEN DECREASE IN BP WHEN STANDING

CAUSES DIZZINESS/FAINTING

MORE COMMON IN ELDERLY

ASSOCIATED WITH DEHYDRATION, DIABETES, RENAL DISORDERS
PAIN
ACUTE VS. CHRONIC
ACUTE: SHORT TERM; RESOLVES WHEN INJURY IS HEALED. EX. BROKEN TOE

CHRONIC: GREATER THAN 6 MONTHS. EX. CANCER
PAIN IN THE OLDER ADULT
SENSATION DOES NOT DECLINE WITH AGE!!

PAIN IS NOT A NORMAL PROCESS OF AGING!

IF YOUR ELDERLY PATIENT COMPLAINS OF PAIN, TREAT IT!
PAIN IN CHILDREN
FACES PAIN SCALE APPROPRIATE IN CHILDREN OVER 4 YEARS OLD
POORLY CONTROLLED PAIN
ACUTE:
TACHYCARDIA
ELEVATED BLOOD PRESSURE
HYPOVENTILATION

CHRONIC:
CONFUSION AND DEPRESSION
MOST RELIABLE METHOD FOR ASSESSING PAIN
LISTEN TO YOUR PATIENT!!!! LET THEM DESCRIBE IN THEIR OWN WORDS

ASK "WHAT DOES IT FEEL LIKE?"

PAIN IS SUBJECTIVE

PAIN IS WHATEVER THE PATIENT TELLS YOU IT IS
VISCERAL PAIN
VISCERAL=ORGAN
PAIN FROM AN ORGAN
ACUTE INJURIES
MEDICATE PATIENT AND THEN TREAT!!!
PQRST
PROVOKES
QUALITY
RADIATES
SEVERITY
TIME
Full transcript