Chapter 6 Summary

Study Guide: Legal and Ethical Issues in Healthcare

Structure and Function of the Legal System

- Structure:
  - Legislative Branch: Creates laws (e.g., Congress).
  - Executive Branch: Enforces laws (e.g., President and federal agencies).
  - Judicial Branch: Interprets laws and resolves disputes (e.g., Supreme Court, lower courts).

- Function:
  - Regulation: Establishes rules for behavior and processes.
  - Resolution: Resolves disputes through courts.
  - Protection: Safeguards rights and liberties.
  - Enforcement: Ensures compliance with laws and regulations.

Legal Relationship Between Patient Care Technician (PCT) and Patient

- Duty of Care: PCTs are legally obligated to provide competent and appropriate care to patients.
- Informed Consent: PCTs must ensure patients understand and agree to procedures and treatments.
- Confidentiality: PCTs must protect patient information from unauthorized disclosure.
- Professional Conduct**: PCTs are expected to act in a manner consistent with their training and ethical standards.

Importance of Maintaining Standards of Care

- Patient Safety: Ensures that care provided is effective and minimizes harm.
- Legal Protection: Adherence to standards helps avoid legal liability.
- Quality of Care: Promotes high-quality, consistent, and reliable care.
- Trust: Builds and maintains trust between patients and healthcare providers.

Examples of Legal Issues in Healthcare

- Negligence: Failure to provide the standard of care resulting in patient harm.
- Informed Consent: Failure to properly inform patients about risks and benefits.
- Confidentiality Breach: Unauthorized sharing of patient information.
- Malpractice: Professional misconduct or failure to meet professional standards.

Federal Regulations: Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule

- Purpose: Protects the privacy and security of patient health information.
- Key Provisions:
  - Privacy Rule: Limits the use and disclosure of Protected Health Information (PHI).
  - Security Rule: Sets standards for safeguarding electronic PHI.
  - Patient Rights: Patients have the right to access and amend their health records.
- Impact on Healthcare: Enhances patient trust, imposes strict privacy measures, and requires healthcare organizations to implement comprehensive data protection policies.

Ways PCTs Can Avoid Being Involved in a Lawsuit

- Follow Protocols: Adhere strictly to established healthcare procedures and guidelines.
- Document Carefully: Keep accurate and detailed records of patient care and interactions.
- Communicate Clearly: Ensure clear and documented communication with patients and other healthcare professionals.
- Maintain Competency: Engage in ongoing education and training to stay updated on best practices.

Advance Directives

- Definition: Legal documents that specify a patient's preferences for medical treatment in case they become unable to communicate their wishes.
- Types:
  - Living Will: Details preferences for medical treatments and interventions.
  - Durable Power of Attorney for Health Care: Designates a person to make healthcare decisions on behalf of the patient.

Distinguishing Ethical and Unethical Behavior

- Ethical Behavior: Adheres to moral principles and professional standards, such as honesty, integrity, and respect for others.
- Unethical Behavior: Violates moral principles or professional standards, such as dishonesty, exploitation, or neglect.

Code of Ethics

- Definition: A formal document outlining the ethical principles and standards expected of professionals.
- Purpose:
  - Guidance: Provides a framework for decision-making and professional conduct.
  - Standards: Set clear expectations for behavior and practices.
  - Accountability: Establishes mechanisms for addressing unethical behavior.

PCT’s Role in Reporting Unethical Behavior

- Responsibility: PCTs are obligated to report any observed unethical behavior or violations of standards.
- Process:
  - Document: Record the incident with detailed and objective information.
  - Report: Follow the appropriate channels within the healthcare organization, such as supervisors or ethics committees.
  - Protect: Ensure that reports are made in good faith and that the reporter’s identity is protected from retaliation.

Examples of Common Ethical Issues in Healthcare

- Patient Autonomy: Balancing respect for patient decisions with medical recommendations.
- Confidentiality: Managing privacy concerns while ensuring necessary information sharing.
- Resource Allocation: Deciding how to fairly distribute limited resources and treatments.
- Informed Consent: Ensuring patients fully understand and agree to treatments or procedures.

Chapter 7 Summary

Study Guide: Anatomy, Physiology, and Human Development

1. Anatomy vs. Physiology
- Anatomy: The study of the body's structure and its parts. It involves identifying and naming body structures, such as organs, tissues, and systems.
- Physiology: The study of the functions and processes of the body and its parts. It focuses on how body structures work and interact to maintain life.

2. Anatomic Position
- Definition: The standard reference position used in anatomy. The body stands upright, facing forward, with feet parallel and flat on the floor, arms at the sides, and palms facing forward.

3. Principal Directional Terms and Sections (Planes)
- Directional Terms:
  - Superior: Toward the head or upper part of the body.
  - Inferior: Away from the head or toward the lower part of the body.
  - Anterior (Ventral): Toward the front of the body.
  - Posterior (Dorsal): Toward the back of the body.
  - Medial: Toward the midline of the body.
  - Lateral: Away from the midline of the body.
  - Proximal: Closer to the origin of the body part.
  - Distal: Farther from the origin of the body part.

- Planes:
  - Sagittal Plane: Divides the body into left and right parts. 
  - Coronal Plane (Frontal Plane): Divides the body into anterior (front) and posterior (back) parts.
  - Transverse Plane (Horizontal Plane): Divides the body into superior (upper) and inferior (lower) parts.

4. Levels of Organization
- Chemical Level: Atoms and molecules.
- Cellular Level: Cells and their organelles.
- Tissue Level: Groups of similar cells working together.
- Organ Level: Different tissues work together to perform specific functions.
- System Level: Groups of organs working together for complex functions.
- Organismal Level: All systems work together to maintain life.

5. Tissues, Organs, and Systems
- Tissues: Groups of cells with a common function (e.g., epithelial, connective, muscle, nervous).
- Organs: Structures made up of different types of tissues working together (e.g., heart, liver).
- Systems: Groups of organs working together to perform complex functions (e.g., digestive system).

6. Major Components of the Cell
- Cell Membrane: A phospholipid bilayer that controls what enters and exits the cell.
- Nucleus: Contains genetic material (DNA) and controls cell activities.
- Cytoplasm: The fluid and organelles between the cell membrane and nucleus.

7. Types of Body Tissues
- Epithelial Tissue: Covers body surfaces and lines cavities (e.g., skin, intestines).
- Connective Tissue: Supports, protects, and binds other tissues (e.g., bone, blood).
- Muscle Tissue: Facilitates movement (e.g., skeletal, cardiac, smooth muscle).
- Nervous Tissue: Transmits electrical impulses (e.g., brain, spinal cord).

8. Major Organ Systems
1. Integumentary: Protects the body (skin, hair, nails).
2. Skeletal: Supports and protects organs, and allows movement (bones, joints).
3. Muscular: Facilitates movement and stability (muscles).
4. Nervous: Controls and coordinates activities (brain, spinal cord, nerves).
5. Endocrine: Regulates body functions through hormones (glands).
6. Cardiovascular: Transports blood and nutrients (heart, blood vessels).
7. Lymphatic: Returns fluids to the bloodstream and provides immunity (lymph nodes, vessels).
8. Respiratory: Facilitates gas exchange (lungs, airways).
9. Digestive: Breaks down food and absorbs nutrients (stomach, intestines).
10. Urinary: Removes waste and regulates fluid balance (kidneys, bladder).
11. Reproductive: Produces offspring (ovaries, testes).

9. Family Patterns and Their Functions
- Nuclear Family: Parents and their children. The basic unit of society.
- Extended Family: Includes other relatives beyond the nuclear family. Provides additional support.
- Single-Parent Family: One parent raising children. Faces unique challenges but can be highly functional.
- Blended Family: Formed when one or both partners have children from previous relationships. Requires adaptation and integration.

10. Types of Stresses Affecting Families
- Financial Stress: Economic hardships that strain family resources.
- Work-Related Stress: Job demands impacting family life.
- Health Issues: Chronic illnesses or disabilities affecting family dynamics.
- Relationship Conflicts: Disagreements and tensions between family members.

11. Physical Characteristics at Each Stage of the Life Cycle
- Infancy: Rapid growth, and development of motor skills.
- Childhood: Steady growth, development of coordination and cognitive skills.
- Adolescence: Puberty, development of secondary sexual characteristics, growth spurts.
- Adulthood: Peak physical health, gradual aging.
- Late Adulthood: Decline in physical capabilities, possible chronic conditions.

12. Psychosocial Changes at Different Stages
- Infancy: Attachment formation, basic trust development.
- Childhood: Self-concept development, social skills acquisition.
- Adolescence: Identity formation, peer relationships.
- Adulthood: Career and family development, personal and social responsibilities.
- Late Adulthood: Reflection on life, dealing with retirement and health changes.

13. Normal Age-Related Changes in Major Body Systems
- Cardiovascular: Decreased cardiac output, arterial stiffening.
- Musculoskeletal: Loss of bone density, decreased muscle mass.
- Nervous: Slower reaction times, decreased cognitive function.
- Digestive: Slower digestion, reduced absorption efficiency.
- Endocrine: Decreased hormone production.

14. Aging Effects on Personality, Intelligence, Learning, and Memory
- Personality: Generally stable, though some traits may become more pronounced.
- Intelligence: Crystallized intelligence (knowledge and skills) remains stable; fluid intelligence (problem-solving skills) may decline.
- Learning: Slower acquisition of new information, but experience helps compensate.
- Memory: Short-term memory may decline; long-term memory is often preserved.

15. Erikson’s Stages of Psychosocial Development
- Infancy: Trust vs. Mistrust
- Early Childhood: Autonomy vs. Shame and Doubt
- Preschool: Initiative vs. Guilt
- School Age: Industry vs. Inferiority
- Adolescence: Identity vs. Role Confusion
- Young Adulthood: Intimacy vs. Isolation
- Middle Adulthood: Generativity vs. Stagnation
- Late Adulthood: Integrity vs. Despair

16. Developmental Tasks of Adolescence
- Developing a sense of identity.
- Achieving independence from parents.
- Establishing intimate relationships.
- Preparing for future career or educational goals.

17. Developmental Tasks for Early Adulthood
- Establishing intimate relationships.
- Pursuing a career and achieving financial independence.
- Starting a family or focusing on personal and professional development.

18. Developmental Tasks for Middle Adulthood
- Managing career and family responsibilities.
- Reflecting on life achievements and making adjustments.
- Preparing for retirement and dealing with aging-related changes.

19. Aging
- Definition: The process of becoming older, encompassing physical, psychological, and social changes that occur as individuals advance through the stages of life.

Chapter 8 Summary

Study Guide: Pain and Sleep Concepts

Possible Causes of Discomfort
1. Injury - Physical harm to the body, such as cuts, fractures, or sprains.
2. Inflammation - Swelling or irritation in tissues or organs.
3. Muscle Strain - Overuse or stretching of muscles.
4. Illness - Conditions such as flu, infections, or chronic diseases.
5. Postoperative Pain - Discomfort following surgical procedures.
6. Nerve Damage - Injuries or conditions affecting nerve function.
7. Mental Stress - Anxiety or emotional strain impacting physical well-being.
8. Arthritis - Joint inflammation causing pain and stiffness.
9. Digestive Issues - Conditions like gastritis or ulcers.
10. Poor Posture - Strain on the musculoskeletal system from incorrect body alignment.

McCaffery and Pasero’s Description of Pain
- Definition: McCaffery and Pasero describe pain as "whatever the experiencing person says it is, existing whenever the experiencing person says it does."
- Key Points:
  - Pain is a subjective experience that can only be truly known by the person experiencing it.
  - It can be influenced by psychological, emotional, and social factors.
  - The assessment and management of pain should always consider the individual's personal report and pain experience.

Subjective and Objective Data in Pain Assessment
- Subjective Data: 
  - Patient’s Self-Report: Descriptions of pain, its intensity, location, duration, and quality.
  - Pain Scales: Patient-reported measures like the Numeric Rating Scale (NRS) or Visual Analog Scale (VAS).
- Objective Data: 
  - Physical Signs: Observations such as facial expressions, body language, or physiological changes (e.g., increased heart rate or blood pressure).
  - Behavioral Indicators: Changes in activity level, sleep patterns, or appetite.

Pain Assessment as the Fifth Vital Sign
- Concept: Pain assessment is integrated into routine evaluations alongside traditional vital signs (temperature, pulse, respiration, and blood pressure).
- Purpose:
  - To ensure pain management is addressed consistently and effectively.
  - To track changes in pain levels over time and evaluate treatment efficacy.
- Challenges: Ensuring accurate pain assessment and addressing pain adequately, considering its subjective nature.

Synergistic Impact of Fatigue, Sleep Disturbance, and Depression on Pain Perception
- Fatigue: Can heighten the perception of pain by reducing the body’s ability to cope.
- Sleep Disturbance: Impairs pain threshold and exacerbates discomfort; chronic sleep problems can lead to increased pain sensitivity.
- Depression: Alters pain perception and can lower the pain threshold, making pain feel more intense or persistent.

Pain Scales Used to Identify Intensity of Pain
1. Numeric Rating Scale (NRS): Rates pain from 0 (no pain) to 10 (worst possible pain).
2. Visual Analog Scale (VAS): A line scale where patients mark their pain level.
3. Wong-Baker FACES Pain Rating Scale: Uses facial expressions to represent different pain levels, often used with children.
4. McGill Pain Questionnaire: Assesses the quality and intensity of pain through descriptive terms.
5. Brief Pain Inventory (BPI): Evaluates pain severity and its impact on daily functions.

Methods for Pain Control
1. Medications: Analgesics, NSAIDs, opioids, or adjuvant therapies.
2. Physical Therapy: Exercises and manual therapies to reduce pain.
3. Heat and Cold Therapy: Application of heat or ice to alleviate pain.
4. Massage Therapy: Relieves muscle tension and discomfort.
5. Cognitive Behavioral Therapy (CBT): Helps manage pain through psychological strategies.
6. Acupuncture: Stimulates specific points to relieve pain.
7. Transcutaneous Electrical Nerve Stimulation (TENS): Uses electrical currents to disrupt pain signals.

Differences and Similarities Between Sleep and Rest
- Similarities:
  - Both involve states of reduced activity and relaxation.
  - Essential for physical and mental health.
- Differences:
  - Sleep: A physiological state characterized by altered consciousness, reduced sensory activity, and specific sleep cycles.
  - Rest: A period of relaxation or inactivity that does not necessarily involve the same physiological changes as sleep.

The Sleep Cycle: NREM and REM Sleep
- Non-Rapid Eye Movement (NREM) Sleep:
  - Stage 1: Light sleep; transition between wakefulness and sleep.
  - Stage 2: Moderate sleep; body temperature drops, heart rate slows.
  - Stage 3: Deep sleep; important for physical restoration.
- Rapid Eye Movement (REM) Sleep:
  - Characteristics: Increased brain activity, vivid dreams, and rapid eye movements.
  - Importance: Crucial for cognitive functions such as memory consolidation and emotional regulation.

Signs and Symptoms of Sleep Deprivation
1. Excessive Daytime Sleepiness: Difficulty staying awake and alert.
2. Irritability: Increased moodiness or emotional sensitivity.
3. Difficulty Concentrating: Impaired attention and focus.
4. Memory Problems: Difficulty recalling information or learning new things.
5. Physical Symptoms: Headaches, muscle aches, or gastrointestinal issues.
6. Altered Judgment: Reduced decision-making abilities or risky behaviors.