Health Science Notes

Patient Rights and Responsibilities

  • Human rights: Basic, fundamental rights that belong to all people.

  • Civil rights: Privileges and protections given to all U.S. citizens by Constitutional, federal, state, and local law.

  • Client rights: Rights people are entitled to when in a relationship with a professional.

The Patient’s Bill of Rights

  • Health care providers must:

    • Give accurate, understandable information.

    • Identify themselves.

    • Inform patients' decision making.

    • Answer questions patients have.

    • Be considerate.

    • Treat with dignity.

    • Never discriminate.

    • Never abuse.

    • Keep information confidential.

    • Not disclose without permission.

    • Inform of grievance process.

    • Respond objectively and promptly.

Right to Choose Providers

Patients can

  • Choose providers.

  • Have access to specialists.

  • Receive emergency care anywhere, including out-of-network services.

  • Make decisions about their care.

  • Select advance directives.

  • Donate body.

  • Review records.

  • Obtain copy of records.

  • Make a complaint.

Patient Responsibilities

  • Giving complete and truthful information to physicians

  • Asking for information about health care

  • Informing physicians of advance directives

  • Following the physicians’ instructions

  • Respecting health care workers

Ethics

  • Laws: Rules of conduct enacted and enforced by governments.

  • Ethics: Rules of proper conduct among a group of people (e.g., religion or profession).

  • Morals: An individual’s personal values, also known as personal ethics.

Code of Ethics

  • A code of ethics is a list of written statements describing proper conduct for a group of people.

  • A code of ethics for health care workers includes:

    • Autonomy

    • Fidelity - loyalty, faithfulness, and adherence to one's responsibilities and commitments, especially within the context of professional and ethical obligations

    • Beneficence

    • Nonmaleficence - a core ethical principle that dictates the duty to not inflict harm on others

    • Veracity - truthfulness or honesty

    • Confidentiality

    • Justice

Professional Code of Ethics

  • Associations for many health care professions have established specific codes of ethics.

  • Examples:

    • Code of Ethics of the American Association of Medical Assistants

    • American Nurses’ Association

  • Health care workers should become aware of their profession’s code of ethics.

Bioethical Dilemma

  • Ethical dilemmas occur when moral beliefs conflict.

  • Bioethical dilemmas are dilemmas that involve health care and biological sciences.

  • Ethical Examples

    • Delivering Bad News

    • Disagreements With the Patient's Family

    • Revealing Mistakes to Patients

    • Caring for Patients With Little or No Insurance

    • Having Impaired Patients' Driver's Licenses Taken Away

    • Reporting Impaired Colleagues

  • Bio Ethical Examples

    • Genetic testing and screening

    • Sexuality and gender

    • Environmental ethics

Environmental Safety - Fire Safety

  • Objectives

    • Identify fire prevention guidelines

    • Define the acronyms RACE and PASS

    • Identify the types of fire extinguishers

Fire Prevention

  • The best way to practice fire safety is to prevent the fire from ever happening in the first place.

    • Obey "No Smoking" signs.

    • Check electrical equipment for damaged cords.

    • Do not overload electrical outlets.

    • Dispose of waste material in proper containers.

    • Store flammable material in proper containers.

    • Clean up flammable liquid spills immediately.

    • Keep hallways and doorways clear of clutter.

Fire Safety

  • It is important to know how to be prepared should a fire emergency occur. Remember what steps to take using the acronym RACE.

    • R - Rescue: Anyone who is not involved in extinguishing the fire must leave the scene.

    • A - Alarm: Pull the alarm or assign someone to pull the alarm.

    • C - Contain: If possible, keep the fire in an enclosed area by closing windows and doors.

    • E - Extinguish or Evacuate: If the fire is small and in a confined area, extinguish the fire with a fire extinguisher. If the fire is large, move everyone, including yourself, out of danger.

Fire Safety Rules

  • Most importantly, stay calm.

  • Evacuate patients in immediate danger first. Assist patients who can walk, followed by patients in wheelchairs and beds.

  • If possible, do not leave patients alone.

  • Never use elevators in a fire evacuation.

  • Do not open a window for ventilation; oxygen will feed the fire.

  • Feel doors before opening them. If the door is hot, do not open it.

  • If you see smoke or fire on your escape route, try a secondary route. If it is necessary to exit through smoke, stay low to the floor and crawl to your exit.

  • If fire is blocking all of your exits, stay in a room with the door closed. Flag for help at a window.

  • Because every facility is different, be sure to learn the fire safety procedures and evacuation plan at your facility.

Evacuation Plans

  • Every health care facility should have a written evacuation plan, posted in plain sight on every floor and in every wing of the facility.

  • Emergency evacuation plans must contain:

    • Procedures for reporting emergencies, such as dialing 911 or pulling a manual fire alarm.

    • A description of actions employees should take during evacuation.

    • Escape route diagrams

      • A primary exit is the closest exit

      • A secondary exit is usually further away and should only be used if the primary exit is blocked by smoke or fire.

Fire Extinguishers

  • Five basic types of fire extinguishers:

    • Type A: Pressurized water; use on common combustibles, such as wood.

    • Type B: Carbon dioxide; use for flammable liquid fires, including grease, gasoline, and oil.

    • Type C: Potassium bicarbonate; use to put out fires that are electrically energized.

    • Type D: Used on flammable metals; makeup depends on the type of flammable metal it was intended for. Employees should read the label and become familiar with the uses of this extinguisher before a fire ever occurs.

    • Type ABC: Chemical compound; use on any A, B, or C fire. Most common type of fire extinguisher.

Using a Fire Extinguisher

  • If a fire is small and in a confined area, use a fire extinguisher to put out the fire as quickly as possible.

  • PASS can help health care workers remember how to operate a fire extinguisher. PASS stands for:

    • P - Pull the pin

    • A - Aim at the base of the fire

    • S - Squeeze the handle

    • S - Sweep the nozzle from side to side

  • If a fire has spread to several rooms and the flames have become large and uncontrollable, the facility must be evacuated immediately.

  • It is better to evacuate yourself and your patients to safety than to try to save the building.

Blood Pressure Notes - 3/25

  • Blood Pressure - What and Why?

    • Blood pressure is the force of blood against artery walls when the heart beats

      • Systolic indicates the left ventricle contracts to push blood into arteries.

      • Diastolic indicates the pressure on the artery

    • Medical Terms

      • Hypo - low

      • Hyper - High

      • Tension - pressure

        • Hypertension - High pressure

        • Hypotension - Below pressure

    • Systolic

      • Heart is contracting

      • Top number

      • Higher than diastolic

    • Diastolic

      • Heart is relaxing

      • Bottom number

      • Lower than systolic

Vitals - 2/28

  • What are vital signs - groups of the four to six most important medical signs that indicate the status of the body’s vital functions.

  • What are we measuring when we measure pulse? Pressure of blood pushing against the wall of the artery as the heart contracts.

  • What can Abnormalities Indicate - can signal disease.

  • What may increase your pulse - elevated too high - exercise, stimulants, excitements, fever, shock

  • Decrease - sleep, depressants, heart disease, coma

  • Brady stands for slow

  • Tachy stands for fast

  • Cardia stands for heart

  • Palpate: to touch

  • Palpitation: examination by applying slight pressure to a pulse point with fingertips.

  • Auscultate: to listen

  • Auscultation: examination by listening, usually with a stethoscope.

  • What does rate measure: number of beats per minute (#/per min)

  • Rhythm: pattern of beats (regular or irregular)

  • Volume: character, or strength, of beats (strong or weak)

  • Normal range: 60-100

  • Bradycardic Range: 100>

  • Tachycardic Range: <60

Patient Introduction - 1/13/2025

  • Step - 1: Knock! Knock! Knock!

  • Step - 2: Greet Your Patient

  • Step - 3: State your name

    • My name is ___ (First/Last name) -No Nicknames

  • Step - 4: State your position

  • Step - 5: Identify your patient by name and birthday?

  • Step - 6: Explain Your Procedure

  • Step - 7: Ask our patient if they have any questions

  • Q: Why do we knock? A: To help them alert them that you are there.

  • Q: How would the patient feel if we entered the room without knocking? A: The patient would feel uneasy.

  • Q: How hard/soft should we knock A: We should actually be knocking at a medium range

  • Examples you would use:

    • Good Morning

    • Good Afternoon

    • Good Evening

    • Hello

    • It’s nice to meet you

  • Examples you would NOT use:

    • Hey

    • Yo

    • Sup

    • Yah

  • Q: What kind of tone do we use? A: Professional tone

  • Q: What volume is appropriate for which patient? A: A moderate voice level

  • Examples: Nurse, Doctor, etc.

  • Q: Why is it important to identify your position? A: To alleviate confusion

  • Q: Why is it important to identify your patient? A: To see what they are in need of help with.

  • Q: What are some scenarios in which a patient can be harmed if not properly identified? A: Preparing medication for a specific patient.

  • Examples: Taking a set of vitals, starting an IV, etc -To ease your patient’s comfort, so they can know what will be happening.

Temperature - 1/16/2025

  • Vital Signs: Group of 4 to 6 most important medical signs that indicate the status of the body’s vital sign functions. These measurements are taken to help assess the general physical health of a person, give clues to possible disease, and show progress toward recovery.

  • The 4 Vital Signs:

    • Temperature

    • Pulse

    • Respiration

    • Blood Pressure

  • Vital sign - Temperature:

    • Measure balance between heat body loses and heat body produces

      • Heat is lost through perspiration, respiration, excretion, and slow metabolism.

      • Heat produced by metabolism and muscle and gland activity.

    • Homeostasis - stable condition of body’s organs, tissues, and systems

      • Abnormal temperature affects homeostasis, which affects health of patient

  • Methods for taking a temperature:

  • Factors that affect temperature:

    • Increase in temperature illness, infection, exercise, air temperature

    • Decrease in temperature starvation, sleep, decreased muscle activity, disease, air temperature

    • Other factors include mouth-breathing, metabolism, time of day

  • Hypothermia:

    • Generally below 96 F

    • Death below 93 F

  • Fever:

    • Generally above 100 F

  • Hyperthermia:

    • Generally 105 F

    • Extremely dangerous over 106 F

  • Q: Why are infrared thermometers preferred?

    • A: Infrared thermometers are preferred because they give instant results, sterile, and clean.

    • Tympanic: Ear

    • Temporal: Forehead

    • Oral: Mouth

    • Rectal: Rectum/Anus

    • Axillary: Armpit

Leadership

  • Leadership - the skill or ability to encourage people to work together and do their best to achieve common goals.

  • Leader - individual who leads or guides others or who is in charge or in command of others.

  • Leadership characteristics:

    • Develop their own efforts

    • Promote positive changes that benefit their professions and the people they serve .

  • Leadership in a group passes from person to person as each individual contributes to the achievement of the group’s goals.

Leadership Styles

  • Democratic

    • Encourages the participation of all individuals in decisions that have to be made or problems which need to be solved.

    • Listens to the opinions of others

    • Bases decision on what is best for the group as a whole

  • Laissez-faire

    • Believes in noninterference in the affairs of others

    • Informal type of leader

    • Minimal rules or regulations

    • Allows group to function independently with little to no direction

  • Autocratic

    • Maintains total rule, makes all of the decisions, and has difficulty delegating or sharing duties.

    • Also known as a dictator

    • Does not ask for the opinion of others, emphasizes discipline, and expects others to follow directions at all times.

Teamwork

  • Teamwork - the collaborative effort of a group to achieve a common goal or complete a task in an effective and efficient way.

    • Provide quality healthcare to patients

    • Improves communication

    • Improves continued care

  • Roles must be understood by each member of the team

    • Clarifies each member’s responsibilities

    • Establishes goals the team wants to meet

  • Each team member must listen, be honest, express their opinion, and be willing to try different solutions.

Time management

  • Time management - system of practical skills that allows an individual to use time in the most effective and productive way possible.

    • Prevents or decreases stress by putting the individual in charge

    • Keeps things in perspective when events are overwhelming

    • Increases productivity

    • Use time more effectively

    • Improves enjoyment of activities

    • Provides time for relaxing and enjoying life

Personal and Professional Characteristics

  • Empathy: To be able to identify with and understand another person’s feelings, situation, and motives

  • Honesty: Truthfulness and integrity.

  • Dependability: Trustworthy and reliable.

  • Responsibility: Being willing to be held accountable for your actions.

  • Discretion: Using good judgement in what you say and do.

  • Team Player: A person who plays or works well as a member of a team or group.

  • Willingness to learn: Must be willing to continuously learn and adapt to changes both professionally and personally.

  • Patience: The ability to tolerate and understand without getting upset.

  • Acceptance of Criticism: Must be willing to accept criticism or judgement and learn from it.

  • Enthusiasm: Enjoyment of work and displaying a positive attitude.

  • Self-motivation: Ability to begin or to follow through with a task.

  • Tact: Ability to say or do the kindest or most fitting thing in a difficult or challenging situation.

  • Competence: Qualified and capable of performing a task..

History of Healthcare

  • Ancient Times

    • Prevention of injury from predators

    • Illness/disease caused by supernatural spirits

      • Superstitious

      • Exorcise evil spirits

      • Herbs and plants used as medicine

    • Plant leaves chewed now some used as IV or pills

    • Some tree bark used to treat malaria or fevers

    • Poppy seeds used to make morphine

  • Egyptians

    • Earliest to keep accurate health records

    • Superstitious – eye of Horus

    • Identified certain diseases

    • Pharaohs kept many specialists

    • Priests were the doctors

      • Temples were places of worship, medical schools, and hospitals

      • Only the priests could read the medical knowledge from the god Thoth

    • Embalming

      • Done by special priests (NOT the doctor priests)

      • Advanced the knowledge of anatomy

      • Strong antiseptics used to prevent decay

      • Gauze similar to today’s surgical gauze

    • Research on mummies has revealed the existence of diseases

      • Arthritis

      • Kidney stones

      • Arteriosclerosis

    • Medical practices still used today

      • Enemas

      • Circumcision

      • Closing wounds and setting fractures

  • Jewish Medicine

    • Avoided medical practice

    • Concentrated on health rules concerning food, cleanliness, and quarantine

    • Moses: pre-Hippocratic medical practice

      • God was the only physician

      • Enforced Day of Rest

  • Greek Medicine

    • First to study causes of diseases

    • Research helped eliminate superstitions

    • Sanitary practices were associated with the spread of disease

    • Hippocrates (Father of Medicine)

      • No dissection, only observations

      • Took careful notes of signs/symptoms of diseases

      • Disease was not caused by supernatural forces

    • Aesculapius

      • staff and serpent symbol of medicine

      • temples built in his honor because the first true clinics and hospitals

  • Roman Medicine

    • Learned from the Greeks and developed a sanitation system

    • Beginning of public health

    • First to organize medical care (army)

    • Room in doctors’ house became first hospital

    • Public hygiene

      • flood control

      • solid construction of homes

  • Dark Ages (400-800 A.D.) and Middle Ages (800-1400 A.D.)

    • Medicine practiced only in convents and monasteries

      • custodial care

      • life and death in God’s hands

    • Crusaders spread disease

    • Cities became common

    • Special officers to deal with sanitary problems

    • Realization that diseases are contagious

    • Quarantine laws passed

Communication in Healthcare Settings - Verbal Communication

  • Communication - sending or receiving information.

    • verbal - the exchange of information using words − both spoken and written

    • nonverbal - sending and receiving wordless messages

  • Types of Communication in Healthcare

    • Promoting health information −public health or education

    • Health provider and patient communication −providing patients with information such as treatment options, lab or test results, etc.

    • Team communication −interdisciplinary team communication −various shifts −updates to patient care plans

    • Written communication −patient note documentation

  • Uses of Verbal Communication

    • Interactions with patients, families, and co-workers

    • Giving reports to other healthcare providers

    • Documenting patient care

      • All relevant clinical findings or results

      • The decisions made or agreed upon and who made those decisions

      • Patient education or information provided

      • Medications or treatments performed

      • Who is writing the patient record - date and time

  • Effective Communication

    • The message must be clear − language the patient can understand

    • Deliver message in a clear concise manner − good grammar and pronunciation - avoid slang terms - do not speak too fast or slow

    • The receiver must be able to hear and receive the message − alternate methods of communication may be needed − different language, medicated, use of interpreter

    • Interruptions or distractions must be avoided − No phone use while delivering a message - Be aware of environmental factors (ex) tv, radio, room temperature, etc.

  • Barriers to Communication

    • Hearing loss

      • Use body language (gestures or signs)

      • Speak clearly in short sentences

      • Face the patient when speaking (read lips)

      • Write out messages

      • Ensure hearing aids are working properly

      • Walk up and get the individuals attention when you are introducing yourself

      • Avoid chewing gum, covering your mouth, or turning your back to the patient

    • Impaired Vision

      • Describe what is happening and what you want the person to do

      • Announce your presence as you enter in the room

      • Use touch to orient the person to where you are located

      • Stand next to the person and in good light

      • Do not move items without tell the patient

      • Tell your patient when you are leaving

    • Trouble Speaking

      • Ask direct questions such as yes or no

      • Allow the patient adequate time to respond

      • If you are unable to understand, validate what they are saying

      • Encourage your patient to point, nod, or write to communicate what they are saying

Communication in Healthcare Settings - Nonverbal Communication

  • Nonverbal communication expresses more of the meaning of a message than verbal communication

  • Understanding the message

    • 7% spoken by words

    • 38% the tone of one’s voice

    • 55% by body language

  • Types of Nonverbal Communication

    • Gestures expresses a variety of feelings

      • content

      • hostility

      • approval

      • affection

    • Body Language and Posture

      • Crossing arms - barrier between you and and the receiver

      • Erect posture - good health and positive attitude

      • Slumped posture - fatigue

      • Clenched fist - angry

      • Hands on hips - challenging or resisting

      • Pointing finger - assertiveness

      • Leaning on elbow with chin in hand - bored

    • Facial Expressions

      • Face is the most expressive part of the body

      • Seven universally accepted emotions:

        • Fear

        • Anger

        • Surprise

        • Contempt

        • Disgust

        • Happiness

        • Sadness

    • Eye Contact:

      • Often initiates communication

      • Good contact = respect, willingness to listen, and keep communication open

      • Looking away = anxiety, defenselessness, or avoidance of communication

      • Cultural differences: Eye contact may be an invasion of privacy; Eye contact considered disrespectful

    • Touch:

      • Positive messages provide:
        affirmation
        reassurance
        share warmth
        approval and emotional support

      • Negative messages provide
        anger
        frustration
        punishment
        invasion of personal space

Death & Dying

  • Five Emotional Stages Experienced by Dying Individuals

    • Denial

    • Anger

    • Bargaining

    • Depression

    • Acceptance

  • Physical, Social, and Emotional Fears of Death

    • Physical

      • Helplessness, dependence, loss of physical abilities, mutilation, and pain

    • Social

      • Separation from family, leaving behind unfinished business

    • Emotional

      • Being unprepared for death and what happens after death

  • Fear Interventions for Patients

    • Talk as needed

    • Avoid superficial answers

    • Provide religious support as appropriate

    • Stay with patient as needed

    • Work with families to strengthen support

Physiology of Dying

  • Pulmonary

    • Unable to oxygenate blood

    • Assess for poor oxygenation-skin

      • Pale skin: blue or purplish, mottled, or cool skin

      • Dark skin: look at mucous membranes, palms of hands, and soles of feet

    • Somatic death or death of the body

    • Series of irreversible events leading to cell death

    • Causes of death varies

  • Cardiovascular

    • Heavy load on the heart when the lungs are failing and not functioning properly

    • Heart is not received needed oxygen

    • Heart is strong enough to circulate blood to the body

    • Blood backs up causing failure

    • Pulmonary and liver congestion
      Blood Circulation

    • Decreased

    • May have a “drenching sweat” as death approaches

    • Weak and irregular pulse

      • Death is about to happen

    • Strong pulse

      • Death is hours away
        Body System Begins to Fail
        Metabolism

    • Metabolic rate decreases or stops
      Involuntary leakage of urine and/or feces
      Urinary System

    • Output decreases

    • Blood pressure is too low for kidneys to filter properly

    • Creates additional load on the heart
      Nervous System

    • Decreased oxygen to the brain
      Loss of sensation in legs and arms
      Can be conscious, semi-conscious, or comatose