Fundamentals Unit 4 Exam Chapters 16,20,21,33,37,38
Osteoporosis
A condition in which the body's bones become weak and break easily due to decreased bone calcium.
Analgesic administration
Administer 30 minutes before a procedure but if patient hits call light give it to them because it could increase their pain threshold and it could be harder to get under control.
Unconscious patient
Assessment: ask if the patient is ok determine responsiveness Assessing pain: grimaces, vital signs, pulse and BP go up, change in breathing pattern Prioritizing care: check respiratory and ABC= airway, breathing, and circulation
Nearsightedness
common vision condition where you can see objects near to you clearly but objects farther away are blurry.
Adult daycare centers
community-based programs designed to meet the needs of functionally or cognitively impaired adults through supervised health care and social and recreational activities. Include physical care, mental stimulation, socialization, assistance with health maintenance, and health referrals during any part of the day but not for more than 24 hours. Services: transportation, respite care for family, social services, meals, limited nursing care, personal care, counseling, therapeutic activities, rehabilitation therapies, crafts, and recreational activities
Guided imagery
create mental images to evoke physical changes in the body, create a sense of improved well-being and enhance self-awareness.
Acute pain
intense and of a short duration usually lasting less than 6 months. Provides a warning to the individual of actual or potential tissue damage.
LPN Staffing coordinator long term care facility
LPN's are required to schedule appropriate care providers for the patients and verify financial coverage.
Peripheral analgesics
NSAIDS (Non-steroidal anti-inflammatory drugs) at the site of injury where they are thought to exert analgesic effects through the inhibition of prostaglandin production.
Medicare Reimbursement
65 and older or has disabilities. Founded in 1966 it funds nursing homes. individuals 65 and older or disabled or have end-stage renal disease under the care of a licensed physician
shallow partial-thickness burns (first degree burns)
Burns that involve only the outer layer of the skin. The most common first degree burns are simple sunburns or burns from contact with hot objects. Healing usually is spontaneous or occurs within 2-5 days. Signs and Symptoms are erythema and pain. Nursing interventions: cool the burn immediately by soaking the affected area in cold (not icy) water or apply cold compresses to the area for however long it takes to decrease pain (up to 30 minutes). Grease, butter, or saltwater should not be applied to the burn.
side effects of opioid analgesics
CNS depression, respiratory depression, drowsiness, dizziness, hypotension, constipation, withdrawal, possible overdose, toxicity, short acting, addiction, and pain relief.
Medicare
Federally funded national health insurance program in the US founded in 1966 used to help fund after retirement. It has set forth specific requirements for organization, staffing, training, types of services covered, and agency evaluation. National Health Insurance program for the elderly (65 or older) and disabled.
Age-Related Sexual Changes
Females: -decreased estrogen levels and secretions in vagina leading to dryness Males: lower testosterone levels and prostate gland is cutting off blood flow leading to erectile disfunction.
how to treat frostbite?
If there is no risk that the body part will become refrozen warm it up by: -immerse the frozen part in warm water at 101-104 degrees Fahrenheit for approximately 30 minutes -if a tub is not available use a very warm moist towel but be careful not to rub the part because the friction may bruise and damage the underlying tissue.
Parkinson's disease
It is a progressive degenerative disease that affects the CNS with the individual having a masklike appearance, drooling, shuffling walk, tremors, and often experiences emotional instability but there is NO MEMORY LOSS.
Pain Assessment
Pain: combination of fatigue, sleep disturbance, and depression has the potential to markedly change a person's perception of pain Assessment: pain scale 0-10, faces, monitor vitals for unconscious patient.
Home Health Care treatment
Recertification: every 60 days Referral: by a patient, family member, social service, hospital, physician, case management, or another agency Rehabilitation: able to perform own ADL.
Cataracts
a clouding or opaque looking color of the normally clear and transparent lens of the eye. Degenerative changes to the lens protein and fatty deposits in the lens are causative factors in the development of cataracts. Symptoms: dimmed, blurred, or misty vision. The need for brighter light to read and sensitivity to glare and light.
Home health general service goals
Restorative: Returning to a previous level of functioning as appropriate and realistic. Improvement: Achieving better health and a higher level of functioning than at admission. Maintenance: Preserving functional capacities and independence by maintaining current level of health. Goals may include: patient demonstrates compliance with daily exercise routine to maintain strength and prevent further decline. promotion: Teaching healthy lifestyles that keep the effect of illness or disability to a minimum and prevent the recurrence of illness. EX: patient who just had a stroke demonstrates compliance in low-fat, low-cholesterol, low-sodium diet.
deep partial-thickness burn (second degree burn)
These burns fully involve the first layer of skin (epidermis) as well as some of the underlying tissue (dermis). Scarring from vesicles and infection is possible. Common causes of these burns are severe sunburns, scalding liquids, direct flame, and chemical substances. Healing may take 5-21 days. Signs and Symptoms: deep erythema or mottled skin with blister formation. Fluid weeps through the skin surface (loss of plasma) and the patient complains of intense pain.
full-thickness burn (third degree burns)
These burns involve the destruction of the skin and underlying tissue including fat, muscle, and bone. Most causes are from direct flame, explosions, and gasoline or oil fires. The area usually is charred and healing is difficult. The skin is usually thick and leathery with the presence of black, dark brown, cherry red, or dry and milky white colors. Many victims do not complain of pain because nerve endings are damaged so severely by the burn. Fluid and electrolyte imbalance, hypovolemic shock, and infection are common complications. Nursing interventions: Assess respiratory and cardiac function. It is crucial to establish an airway before edema occurs. CAB are the primary concerns. Remove all of the victim's clothing, shoes, and jewelry it is possible to increase the severity of the burns by leaving clothing on the victim.
TENS unit
Transcutaneous Electrical Nerve Stimulation. It can interfere with the function of a cardiac pacemaker. It sends small electrical impulses to targeted body parts through adhesive pads attached to the person's skin. Impulses flood the nervous system reducing its ability to transmit pain signals to the spinal cord and brain. It also stimulates the body to produce natural pain relievers called endorphins.
Rule of 9's
Used to calculate the percentage of body surface burned. Adult= 9% right arm, 9% left arm, 9% head, 1% pubic, 18% right leg, 18% left leg, 18% front, 18% back. Child= 9% right arm, 9% left arm, 18% head, 1% pubic, 13% right leg, and 13% left leg
Rest
a patient at rest feels mentally relaxed, free from worry, physically calm, and is free from physical and mental exertion. Rest is important in healing the body of physical and psychological illness.
Sleep
a state of rest that occurs for a sustained period. The reduced consciousness during sleep provides time for repair and recovery of body systems for the next period of wakefulness. Sleep restores a person's energy and feeling of well-being.
instrumental activities of daily living
actions that require some intellectual competence and planning such as remembering to take their medications, shopping, using the telephone, tube feeding, and oxygen therapy.
Myths on aging
all people become senile when they become old becoming forgetful means that dementia will occur older adults are isolated and alone most older adults are in nursing homes or care facilities older adults do not have much energy and are always tired older adults are ill and disabled and are always rich
Long term care facilities
also known as nursing homes they are for the provision of physical, psychologic, spiritual, social, and economic services to help attain, maintain, and regain their optimum level of functioning provided in a variety of settings and offers broad spectrum of services. GOAL= KEEP RESIDENTS AS INDEPENDENT AS POSSIBLE
Herbal therapy
alternative therapy that uses herbs to provide health benefits preparation usually includes an unpurified extract of the whole plant that has not been FDA approved.
Sucking chest wound
apply an air-tight dressing on three sides leaving one side open so it does not cause a tension pneumothorax which will cause your trachea to move. It also leaves a hole in chest that makes a new pathway for airflow.
Reimbursement guidelines long term care facility
classification for specified covered services by Medicare, Medicaid, third party, and private pay. Must be home-bound & in need of skilled nursing or therapy services on an intermittent basis.
Chronic pain
characterized by pain lasting longer than 6 months, can be continuous or intermittent can be as intense as acute instead of a warning sign it signals that damage has occurred.
Opioid Analgesics
decrease the perception of pain by binding to pain receptor sites in the CNS.
DRG
diagnosis related groups pay a set rate (according to diagnosis) for the hospitalized patient's care rather than the "cost" bills according to its own schedule of fees.
Dysphagia
difficulty swallowing assess for it by doing a swallowing test. Treatment: thickened liquids adjust food consistency, pureed foods.
Kyphosis
excessive outward curvature of the spine causing hunching of the back. The chest wall is less able to expand causing it to become more difficult to breathe.
Nocturia
excessive urination at night should give patients diuretics in the morning if experiencing this.
Presbyopia
farsightedness resulting from a loss of elasticity of the lens of the eye or narrowing of the peripheral field of vision, decreased ability to focus on near objects, and a decrease in visual activity as the pupil becomes smaller and less responsive to light as a result of aging.
Social security
federal program of disability and retirement benefits that covers most working people, It provides funding for individuals with little to no income,
Long term care facility aspects of quality
five-star quality rating based on health inspections, staffing, and quality measures. Health inspections from regulatory agencies. Evaluation includes: management of medications, protection of residents from physical or mental abuse, or general care of residents, and the environment of the facility and storage and preparations of food -Staffing ratios of licensed and non-licensed personnel to resident, Fire safety standards, Medicare published quality measures which include whether residents are receiving flu vaccines, weight loss statistics, and pain control measures.
Affordable care act
founded in 2010 the law encourages payment for preventive services to Medicare recipients and provides a drug discount for eligible seniors in the "donut hole." coverage gap that exists in most Medicare prescription plan. Pays a % of the cost of medications up to a certain amount.
Frostbite
freezing and damage of body cells caused from body parts getting to cold below 95 degrees. commonly affected areas are ears, nose, fingers, and toes Assessment: initially the skin takes on a red flush with numbness, tingling, and pain. Progressively the part becomes hard and loses all sensation color turns grayish white. If thawing occurs it may change to blue-purple or black, edema may develop, followed by blisters. Nursing Interventions= treat the victim for shock and hypothermia, establish and maintain an airway; warm part by immersion in warm water at 101-104 F for 20-45 mins. If tub is not available you may use warm moist towel but be careful not to rub the part. The thawed part is wrapped in clean towels or bulky dressings and elevated.
Alternative Therapy
frequently becomes the primary treatment modality that replaces allopathic (traditional or conventional) medicine. It is less invasive and gentler than medicine to perceive a more holistic approach. An example includes acupuncture.
The National Center for Complementary and Alternative Medicine (NCCAM)
goal of this office is to evaluate effectiveness of alternative medical treatments, distribute information to the public, and coordinate and conduct research. DOES NOT remove defective products from the market or regulate third party (insurance company) reimbursement.
Unrelieved pain complications
increases pain threshold and is harder to get under control.
Osteoarthritis
inflammation of the bone and joint also known as degenerative bone disease. It is a non-systemic non-inflammatory disorder that begins with degeneration of the cartilage of joints thus causing damage to bones.
Blepharitis
inflammation of the eyelids that commonly occurs when tiny oil glands located near the base of the eyelashes become clogged.
Arthritis
inflammatory disease of the joints affected joints include hands, fingers, toes, knees, hips, and spine.
sleep deprivation
involves decreases in the amount, the quality, and the consistency of sleep. Has been tied to hypertension, diabetes, heart disease, and stroke. Physiologic S&S: hand tremors, decreased reflexes, slowed response time, reduction in wound memory, decreased reasoning and judgement, and cardiac dysrhythmias Psychological S&S: mood swings, disorientation, irritability, decreased motivation, fatigue, sleepiness, and hyperexcitability.
Animal Assisted therapy
involves the use of trained animals normally dogs to enhance an individual's physical, emotional, and social well-being. This method improves self-esteem, reduces anxiety, & facilitates healing. it improves mood, decreases BP, and increases socialization skills.
Asian ginseng therapeutic actions
it improves overall health and well-being, atherosclerosis, bleeding disorders, colitis, diabetes, and depressant cancer. DO NOT administer to pregnant women, people with cardiovascular disease, hypertension, diabetes, or concurrent therapy. Drug Interactions: possible with agents that inhibit monoamine oxidase (phenelzine, St. John's wort, selegiline)
Aloe Vera Therapeutic Actions
it is used for burns, skin irritation, and it has laxative properties. It can result in painful cramps, electrolyte imbalance, hemorrhagic diarrhea, and kidney damage. Drug Interactions: antidysrhythmics, cardiac glycosides (digoxin), antidiabetics, beta blockers, steroids, diuretics and disulfiram.
Cayenne therapeutic actions
it reduces cholesterol level, topical application produces analgesia, and it controls bleeding. Can produce heat, burning, and pruritus. Drug interactions exist with ACE inhibitors, heparin, ASA, disulfiram, & theophylline.
The good Samaritan Law
legal protection for those who give first aid in an emergency. As long as you act in a prudent manner as a normal person would do in a given situation.
Osteomyelitis
local or generalized infection of bone and bone marrow
Chiropractic therapy
manipulation of musculoskeletal system. Based on holistic belief in the body's capacity to take care of itself. Adjust joints of the body by gentle manipulation and put body back in proper alignment. doctor of chiropractic medicine does not prescribe medications. Other treatments such as hot and cold packs may be used. BE CAREFUL WITH INDIVIDUALS WHO HAVE A SPINAL INJURY OR ARE ELDERLY
Assisted living facility
more independent but you still need help with certain tasks. Services: supervision 24 hours per day, meet scheduled or unscheduled needs, care and services provided or arranged to promote independence, emphasis on resident's dignity, autonomy, choice, privacy and homelike environment.
Physical therapy
muscle strengthening and rehab
Biofeedback
noninvasive method that an individual can employ to learn control of the body to manage certain conditions. Beneficial in the treatment of disorders such as migraine headaches, pain, urinary tract infections, and gastrointestinal tract disorders cautions with repressed emotions or feelings.
Adjuvant analgesics
not intended to cause pain relief but have that effect. Examples: anticonvulsants, antidepressants, and multiple dose drugs.
continuing care retirement community
offers complete range of housing and healthcare accommodations from independent living to 24-hour skilled nursing care. It is a lifetime-commitment
Comfort therapy
palliative therapy allowing an individual to have anything that will make them feel comfortable in their environment. EX. favorite blanket or stuffed animal.
Long term care facility care plans
patient centered every 90 days nurses and interdisciplinary team revise the residents plan of care.
Private insurance
pay directly for home health services
Milk intolerance
people who are lactose intolerant. Need to have calcium supplements and vitamin D found in leafy greens/vegetables, fish, and cereals. Deficiency leads to osteoporosis. Calcium is important for the formation of bones and teeth, plays a role in blood clotting, transmission of nerve impulses and muscle action, and important for metabolic reactions throughout the body.
Medication safety to older adults
polypharmacy's, allergies, offer pill boxes and put medications into non-childproof containers, slower metabolism which causes a drug to stay in their body longer.
Relaxation
state of generalized decreased cognitive, physiologic, or behavioral arousal. It decreases heart and respiratory rates, blood pressure, and oxygen consumption. It reduces the neural impulses sent to the brain and thus decreases the activity of the brain and other body systems.
Complementary therapy
used in addition to conventional health care regimens recommended by a person's health care provider. Ex: exercise, massage, reflexology, prayer, biofeedback, creative therapies, guided imagery, acupuncture, relaxation strategies, chiropractic therapy, therapeutic touch, and herbalism.
Kava therapeutic uses
used to treat anxiety, stress, restlessness, insomnia, and wound healing. Drug Interactions: may exist with antiplatelet medications, MAOIs, drugs metabolized in cytochrome P-450 system, hepatotoxic drugs, and levodopa.
Objective Data
what the health professional observes by inspecting, palpating, percussing, and auscultating during the physical examination.
Subjective Data
what the patient tells you