Patient care- Laura Nappi- Chapter 1

What is informed consent?

permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits.

Whmust informed consent be signed by?

The patient and the provider

Who can sign consents or other documents if the patient is a minor or incompetent to be able to sign

parent, power of attorney or health care proxy

When must a consent be obtained with the radiation therapy field

Before simulation, treatment set-up, treatment planning, and tattoo placement

What does consent include?

Patient name, DOB, person/organization performing procedure, statement about side effects, a statement about procedures, risk to pregnancy if applicable

What is written consent?

Is an official agreement that has been signed on paper or digitally by everyone involved

What is verbal consent?

Gives the provider permission with a verbal message

What is inadequate consent?

Also called Ignorant consent, it is when the patient was not given enough information to make the appropriate decision

What does HIPPA stand for?

Health Insurance Portability and Accountability Act

what is PHI

anything that can identify a patient

What does the patient bill of rights outline?

Expectations the patient has of the health care facility they involved with

What is an advanced directive?

A legal document that specifies what the patient would want to occur in their health care when they are no longer able to make conscious decisions

What is a living will?

legal document that expresses pateints wishes regarding medical treatment in the event the client becomes incapacitated

What is a health care Proxy?

a power of attorney, or person chosen by patient to make medical decisions if the second person becomes unable to do so

What does DNR mean?

do not resuscitate

Who are clinical trials regulated by

FDA

Who requires that the patient is identified in 2 unique ways?

Joint comission

What is beneficence?

persons moral obligation to do good for another person

What is an example of beneficence

Showing respect

What is malpractice?

A healthcare professional such as a physician unintentionally acts wrongfully which causes injury to the patient

What is a tort?

wrongful acts that are intentional or unintentional

What is battery?

harmful unjustifiable acts to or against another person

What is example of battery?

physical touch that is meant to harm someone or physical touch that is not permitted

What is assault?

a threat of physical touch or harm

What is negligence?

the medical professionals failure to act or care for the patient which leads to the patient's injury

Negligence is ____ tort

unintentional

What is false imprisonment?

confinement or restraint of the patient without approval

What is libel?

written defamation of charcter

Libel and slander are ____ tort?

Intentional

What is slander?

verbal defamation of character

What is invasion of privacy defined as?

A patient's private information is shared with those who are not involved in the patient's health care. Violation of HIPPA.

What is Personal liability?

doctrine stating that all persons are liable for their own negligent conduct.

What is the doctrine called Respondent superior?

Legal doctrine that holds an employer liable for negligent acts of employees occurring while he or she is carrying out his/her orders or otherwise serving his/her interests.

What is Res Ipsa loquitor?

"thing speaks for itself"; doctrine that is an accepted substitute for the medical expert, requiring the defendant to explain an incident and convince the court that no negligence was involved.

What is the legal doctrine foreseeability

principle of law that holds a person liable for all circumstances. Sequences of any negligent acts to another individual to whom a duty is owned and should have been reasonably foreseen under the circumstances

What is verbal communication and an example

INvovled speaking. Ex. Dr telling you a set up

What is written communication and an example

recorded information that can be read by others. Example: Test labs or Physicians order

How should message be communicated to patients

in layman's terms

What are ancillary services? and examples

Any extra service that may be provided. Ex. Hospice, clergy, social services, dietition.

______ is caring for terminally ill patients and focuses on the patients comfort rather than cure toward end of life

Hospice

_______ helps manage symptoms caused by radiation therapy or chemo and help maintain a healthy nutritional status

Registered dietician

___________- religious leaders who provide religious services.

Spiritual leaders

_________ provides counseling and information to the patient and their families so they can understand and cope with the illness

Social services

When lifting a patient, the basic body mechanics is

stand with feet separated at a wide base. Keep the weight close to yourself, Use knees and hips, not the waist, and avoid twisting.

How should wheelchair transfers be done?

Place wheelchair either parallel to the table or at a 30 to 45 degree angle with the wheelchairs locked and foot rest out of the way. keep the patients feet together. place your feet on either side of the patient's feet. the patient should hold on to your shoulders. the lifter should bend their knees and hips while lifting the patient and turning the patient until they are seated on the treatment table.

How should stretcher transfers be done?

Two or more lifters should transfer the patient. place the stretcher at the same height as the treatment table. use this sheet and sliding board to reduce risk of injury to the lifters.

What is a gait belt?

Device used to transfer a patient from one position to another; such as from a standing position to a wheelchair

What is a hoyer lift?

A machine-controlled sling that helps to transfer heavier patients

What kind of devices are Hoyer lifts and gait belt

Ergonomic devices

Where are two common locations for IV catheters?

Forearm or top of hand

The bag for IV catheters should be places

18" to 24" above the vein

What is a port?

Metal disc placed under skin

Where are common locations for ports

chest or upper arm

What does a port help avoid?

multiple needle sticks

What is a Nasal Cannula

disposable plastic tubing with two hollow projections that deliver oxygen into the nostrils. delivers oxygen at low flow rate.

What is a simple face mask for oxygen?

placed over the nose and mouth used to deliver oxygen for short periods of time. delivers oxygen at low flow rate.

What is a Nasogastric tube (NG) ?

Plastic tube Placed in the nose which goes into the stomach to assist with feeding and oral medications

Explain a urinary catheter

Tube inserted into the patient's bladder via the urethra and used to drain urine from the bladder or to inject liquids for diagnosis and/or treatment. they are usually attached to a drainage bag. ensure that the bag is placed below the level of the bladder so urine does not flow back into the bladder.

What are chest tubes used for

to drain air or fluids from the pleural cavity in the chest.

What is a tracheostomy tuube

small tube inserted through a hole created in the neck to the trachea in order to open airways and help with breathing.

What are common drugs that cause allergic reactions

antibiotics (penicillin), pain relievers (asprin, ibuprofen, and naproxen sodium), chemotherapy drugs, etc.

What are common syptoms of allergic reaction

Skin rash, hives, itching, fever, swelling, SOB, wheezing, runny nose, itchy/watery eyes

Which allergic reaction needs treatment immediately

Severe

Which allergic reaction must be kept under observation

Moderate

What is anaphylaxis?

Severe allergic reaction

When is CPR needed?

when patient goes into cardiac arrest

What does CPR do for the body?

brings oxygen-rich blood to the brain and other vital organs when the heart stops and is no longer able to do this on its own

What does CAB stand for within CPR

compression, airway, breathing

For compressions in CPR pushing should be

straight down, 2 inches deep and rythmic

For Airway in CPR you should

open up airway by tilting their head back.

When is the airway step done for adults Vs children

Adults: after 30 chest compressions

Children: after 15 chest compression

During the breathing step of CPR- you should

deliver 2 breaths to person via mouth to mouth and they should be aprrox. 1 second each

What is the ratio for compressions to breaths for adults

30: 2

What is the ratio for compressions to breaths for a child

15: 2

What is a Automated external defibrillator (AED)

medical device used to help those undergoing cardiac arrest

What needs to be filled out if there is an injury or trauma?

Incident report

What is a seizure

Uncontrolled, sudden brain disturbances that can lead to changes in behavior, movement, feelings and/or loss of consciousness

How long can seizures last?

30 sec- 2 minutes

What should you NOT due when a patient is having sezure

leave them alone, put fingers in mouth, restrain patient

What is diabetic hypoglycemia

- Blood glucose below 70 mg/dL

- Not enough sugar in blood

- caused by taking to much insulin or diabetic medication

What is diabetic ketoacidosis?

A condition that occurs as the result of high blood sugar which is caused when the body produces too many kenotes.

What is a pathogen?

A microorganism that causes disease

What are examples of a pathogen

Bacteria, virsuses, fungi, parasites

The reservoir is the environment where a

pathogen lives, grows, and multiplies

What is a human reservior?

people that carry pathogens, which then can be transfered directly to another person

the host physically touches the source of infection defines

direct contact

What are examples of direct contact

touch of skin, kiss, sexual intercourse

What is the most common method of transmission for pathogens?

Direct contact

the source of infection is transferred through air quickly, in large particles and short distances Defines:

droplet spread

What are examples of droplet spread

talking, coughing, sneezing

the host touches an object that has been infected by the source of infection defines

indirect contact

Indirect happens through 3 ways:

airborne, vector-borne, and vehicle- borne transmission

the source of infection is transmitted through long distances in air and in small particles is what type of indirect spread

Airborne

Name diseases that are transmitted via airborne

Measles, varicella, and tuberculosis

indirect transmission of an infectious agent that occurs when a fomite touches a person's body or is ingested

vehicle- borne

Examples of items that make something spread vehicle borne

Food, water, blood, fomites

Insect or animals is an intermediate host that describes indirect transmission called

vector-borne

Explain some animals that spread vector-borne

Fleas, ticks, mosquitos

Where the infectious microorganism is passed is called...and is the final part of the chain of infection

susceptible host

_____ eliminates most pathogenic organisms on medical equipment

disinfection