Care I Final

Health

State of complete physical, mental, & social well-being, NOT MERELY without disease or infirmity

Illness

Unique individualized response to disease; Abnormal process involving changes to level of functioning

Acute illness

A rapid onset of symptoms, short time and limiting, usually full recovery and return to previous level of function

Chronic illness

Encompasses different physical and mental alterations related to health, frequently observe periods of exacerbations and remissions, permanent changes r/t irreversible alterations in normal A&P

Denial

Buffer for shock to process

Anger

Aimed a HCP, nurses, family, etc

Bargaining

“What if…” or “If only…”

Depression

S/S- crying, hopelessness, self-pity, despair, & social isolation *** Suicidal ideation may occur***

Acceptance

Awareness leading to working on/changing lifestyle to deal w issues in practical ways, overtime letting go of blame and finding meaning

AIDET

Acknowledge, Introduce, Duration, Explain, Thanks

5 Rights of Medication Administration

Patient, Drug, Dose, Route, Time

Transdermal

To skin

Topical

To skin, eyes, ears, nose, lungs

Enteral

Directly into the stomach or intestine

Parenteral

Intravenous, Intramuscular, Subcutaneous, Intradermal

Narcotics

Count the number of meds before taking your dose, record the number of doses left and sign it, do not leave narcotics unattended, wasting a narcotic requires a witness

Steps for Administering Medications

1. Identify pt

2. Inform pt (intended and side effects)

3. Administer med (5 R’s)

4. Provide additional interventions as indicated

5. Record the action (include med, dose, time, assessment, and signature)

6. Evaluate pt’s response

Tip of syringe

Connects with needle

Barrel of syringe

Outer part with lines printed on it

Plunger of syringe

Fits inside the barrel

Hypodermic syringes

3, 5, 10, 20 mL sizes

Insulin syringes

Marked in u *Used ONLY for insulin

Tuberculin (TB) syringes

Up to 1 mL

Hub of needle

Colored plastic part, fits on syringe tip

Cannula of needle

Shaft

Bevel of needle

Slanted part of the point

SC injection gauge and length

25-28 G, 3/8 - 5/8 inch

IM injection gauge and length

21-23 G, 1 - 1 ½ inch

SC injection sites

Abdomen (2’ from navel), posterior upper arms, anterior thighs

IM injection sites

Deltoid, ventrogluteal, vastis lateralis

Young old

65-75 yo

Middle old

75-85 yo

Old old

>85 yo

Ethno-geriatrics

The specialty of providing culturally competent care to older adults

Senescence

Deteriorating with age

Pneumonia

Infection in the lungs that inflames the alveoli

BEERS criteria

Goal is to reduce the risk of adverse drug events (ADEs) in this geriatrics

Dementia

Progressive cognitive and functional decline

Delirium

Acute, temporary state of confusion

Presbyopia

Impaired near vision

Myopia

Impaired far vision, blurry

Glaucoma

Increased IOP (>21) and damage to optic nerve r/t loss of vision

Cataracts

Clouding of the lens decreasing vision

Macular degeneration

Macular breakdown r/t loss of central vision

Conductive hearing loss

Obstruction, ear infection, trauma, tumors

Sensorineural hearing loss

Genetic disorders, noise exposure, presbycusis (progressive loss), tumor, demyelination

Mixed hearing loss

Combination of conductive and sensorineural hearing loss

Dizziness

Disturbed sense of a person’s proper relationship to space

Meniere’s disease

Disorder of the inner ear that affects balance and hearing with unknown cause, but can occur with infection, stress, allergens, and trauma

The 4 P’s

Pain, Potty, Position, Possessions

Infection

The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body

Localized

Limited to a small area

Disseminated

Spread to other areas nearby

Systemic

Spread extensively usually via blood (sepsis)

Sepsis

Two or more of the following:

• Temp >100.4 or <96.8

• HR >90

• RR >20

• WBC >12,000 or 10% bands

Pathogens

Infectious agents (i.e. bacteria, virus, fungi)

Reservoir

Natural habitat of the organism (i.e. people, animals, soil, food)

Portal of exit

Organism escapes reservoir through these routes (i.e. respiratory, GI, GU, skin breaks, blood)

Routes of transmission

Indirect contact (i.e. vehicle or vector), direct contact (i.e. droplet), in digested contaminated food

Portal of entry

Where pathogens enter susceptible host (i.e. skin and mucous membranes, respiratory tract, GI, GU, blood/bodily fluids

Incubation

Interval exposure of pathogen to the time when sx appear

Prodromal

Interval of vague sx to more distinct sx; organism is multiplying *Most infectious period

Infectious

Full illness

Convalescent

Recovery from infection

Colonization

Presence of an organism in an individual with no clinical signs of infection

Nosocomial infections

Infections acquired in the hospital and were not present on admission

Standard precautions

Used in the care of all clients, regardless of diagnosis

Droplet precautions

Gown, mask, and gloves; indicated for pneumonia, influenza, mumps, pertussis, COVID

Contact precautions

Gloves and a gown; indicated for E. coli, enteric diseases, and wound infections

Airborne precautions

Gown, gloves, fit-tested N95, negative pressure room; indicated for Tb, measles, varicella, COVID (Aerosol procedure)

Communicability

The capability of a disease to be transmitted

Pathogenicity

Ability of a pathogen to cause disease in a host

Virulence

The ability of a microorganism to cause damage to its host

Normal flora

Microorganisms that naturally reside in and on our bodies

Surveillance

A set of uniform criteria used to define a disease for public health

Endogenous infection

Infection from a pathogen residing in the body

Exogenous infection

Infection from a pathogen from the external environment

Antigen

Foreign material that induces an immune response

Antibody

Proteins that counteract antigens

Asepsis

Absence of microorganisms

Endemic

A disease that regularly occurs in an area

Iatrogenic

Relating to infection caused by medical examination or treatment

Sterilization

Destruction of all microorganisms

Disinfection

Destruction of some microorganisms

Compassion

A deep awareness of suffering and the wish to relieve it

Palliative care

Specialized form of care for patients of any age that focuses on relief of discomfort, pain, stress, and other symptoms associated with a severe illness

Hospice

Specialized form of care for patients of any age that focuses on relief of discomfort, pain, stress, and other symptoms associated with a severe illness at the end of life (prognosis of 6 month or less)

Cutaneous pain

Pain is superficial, sharp and localized like a cut/burn

Somatic pain

Dull and aching pain from joints, bones, and muscles

Visceral pain

Referred pain from organs, sharp or dull

FLACC scale

Developed for infants/toddlers, can use for nonverbal adults

Behavioral pain scale

Forr critically ill nonverbal adults, like someone on a vent

PAINAD

For advanced demetia

Cardiac output (CO)

Amount of blood leaving the heart every minute (SV x HR = CO)

Stroke volume (SV)

Amount of blood leaving the heart with every beat

Heart rate (HR)

Beats per minute

Contractility

Strength of contraction

Conduction

Electrical impulses

Preload

Volume of blood leftover after diastole (pre-contraction)

Afterload

Resistance the left ventricle must overcome to circulate blood