Healthcare Systems: Evidence-Based Practice, Health Definitions, and Infection Prevention, Quizzes of Nursing

Download Healthcare Systems: Evidence-Based Practice, Health Definitions, and Infection Prevention and more Quizzes Nursing in PDF only on Docsity! TERM 1 Challenges of Health Care System DEFINITION 1 emphasis on evidence-based practice emphasis on improved quality outcomes demand for access to service rising costs TERM 2 Evidence changes... DEFINITION 2 practice changes need for change in practice? locate best evidence analyze evidence design practice change implement and evaluate change (trial) into practice TERM 3 Research uses systematic process so mostly used but.. DEFINITION 3 very controlled and not like real world research says there's one best solution, not true for every1 EBP ignore life events no all research can be trusted EBP should promote cost-effect care but it hasn't more so for physio, not for psy, soc or spiritual EBP may not consider culture and resources TERM 4 2 Definitions of Health DEFINITION 4 state of complete physical, mental, and social well-being, NOT merely absence of disease or infirmity (WHO) state of being ppl define in relation to their own values, personality, and lifestyle TERM 5 3 Views of Individual Health DEFINITION 5 each individual is unique is a complete, holistic person strives for homeostasis physiologicaly AND Psycho TERM 6 Levels of CARE vs. PREVENTION DEFINITION 6 CARE: settings PREVENTION: actions taken by health care provider (HCP) and occur in variety of settings BOTH categorized as primary, 2ndary, tertiary TERM 7 Health Care: Primary DEFINITION 7 stresses promotion as key to quality health preventative care primary care first access- private office, baby clinics, family planning clinic TERM 8 Health Care- Secondary DEFINITION 8 focus on diagnosis and treatment of disease Settings: hospitals, sub acute care, rural hospitals, ICU, sub acute facilities TERM 9 Health Care: Tertiary DEFINITION 9 serves for recovering from acute or chronic/disability helps regain maximal function and enhance quality of life promotes patient independence and self-care abilities settings: ICU, PT, rehab unit TERM 10 What Kind of Health Care Services are reimbursed by insurance? DEFINITION 10 Most are Secondary and Tertiary Care. TERM 21 What are factors affecting health care delivery? DEFINITION 21 increase elderly advances in tech economics uneven dist. of services access to health insurance homelessness and poverty HIPAA demographic changes-single working families women's health- more than reproductive TERM 22 How is the economic affecting health care delivery? DEFINITION 22 Economics: increase tech and new methods make replacement expensive invlation growing population healthcare as right, increase in visits uninsured increase in persons (% remains) cost of drugs increase TERM 23 What are some ways of physiological homeostasis? DEFINITION 23 self-regulationcompensatorytend to regulate by negative feedback (may need multiple)in a system of input, out, through. negative inhibit change; positive stimulates change TERM 24 what are some ways of psychological homeostasis? DEFINITION 24 acquired or learned through experience of living and interacting with othersMaslow's needs theoriesphysiological needs: food, air, shelter, activitysafety and security needs: both psy and phy.love and belonging needs: give and receive affection, attain place in group, maintain feeling of belongingself-esteem needs: of self (independence, competence etc) and others (recognition, respect and appreciation) TERM 25 What did Kalish add? DEFINITION 25 Stimulation needs: sex, activity, exploration, manipulation and noveltyafter physiological needsb/c ppl need to explore and manipulate env TERM 26 What is infection? DEFINITION 26 Infection is:invasion of body tissue by microorganism with the potential to cause illness or disease TERM 27 Will invasion by miroorganism cause disease or illness? DEFINITION 27 May or May not, some ppl are "carriers" TERM 28 Are all microorganims harmful? What are the major miroorganisms that cause infection? DEFINITION 28 Most are harmlessMajor causes of infection bacteria virus fungi parasites TERM 29 What are health care associated infections? DEFINITION 29 Health Care associated infections:originate in health care facility and were NOT present at time of admission TERM 30 What are risk factors of health care associated infections? DEFINITION 30 risk factors are:crowdinglength of staycompromised immunity TERM 31 What are ways to prevent health care associated infections? DEFINITION 31 Using proper precautions change dressings clean work surfaces use gloves for handling bodily fluids TERM 32 what are ways nurses can prevent infections? DEFINITION 32 protect patients and others from potentially infective organism any body substance potentially contain infectious material hand washing (most important for controlling and preventing spread of infection) TERM 33 What are factors that predispose patient to infection? DEFINITION 33 factors that predispose patients to infections: surgical wounds respiratory tract problems GU tract problems invasive devices and needle sticks IV nutrition TERM 34 What are defenses against infection? DEFINITION 34 normal flora body defense mechanisms inflammation inflammatory exudate tissue repair TERM 35 How many steps are there in the chain of infection and what are they? DEFINITION 35 6 etiological agent reservoir portal exit mode of transmission portal of entry susceptible host TERM 46 Break chain- method of transmission (cont) DEFINITION 46 initiate and implement aseptic precautions for all patients wear masks and eye protection when in close contact (droplets from respiratory tract) masks and eye protection when sprays of body fluid are possible TERM 47 Break the chain- portal of entry DEFINITION 47 use sterile technique for invasive procedures (open wounds or handling dressings) used disposable needles and syringes in puncture- resistant containers for disposal provide all clients with own personal care items TERM 48 break the chain- susceptible host DEFINITION 48 maintain integrity of skin and mucous membranes balanced diets for clients educate the public about the importance of immunization TERM 49 What factors increase susceptibility DEFINITION 49 age (infants and elderly) heredity (deficient in serum immunoglobulins) stressors nutrition medications (radiation, anit-inflamm) pre-existing disease TERM 50 What are interventions to support defenses of a susceptible host? DEFINITION 50 hygiene nutrition fluid sleep reduce stress immunizations TERM 51 How to hand wash properly? DEFINITION 51 with soap for at least 10-15sec remove soil and transient miroorganisms before and after patient contact anytime hands are visibly soiled or contaminated TERM 52 How is antiseptic agent different from hand washing? DEFINITION 52 alcohol based antiseptic (freedom from disease=causing microorganism) hand rubs more effective when: used property following directions less irritating to skin than frequent hand washing CDC recommends soap&water when hands are visibly soiled TERM 53 how should nails be kept? DEFINITION 53 Nails harbor bacteria and microorganism artificial nails and tips increase microbes no nail polish prohibited in most inpatient facilities TERM 54 When handling reusable equipment.. DEFINITION 54 follow agencies' policies and procedures for handling soiled reusable equipment TERM 55 What are the two infection precautions? DEFINITION 55 standard precautions transmission-based precautions (in add to standard) TERM 56 When to use standard precaution in infection control? DEFINITION 56 with ALL patients reduce risks of transmission should become routine decrease exposure and injuries aka "universal precautions" applies to blood, all body fluids, mucous membranes, and breaks in skin TERM 57 What are the transmission-based precautions used in addition to standard precautions DEFINITION 57 for known or suspected infections that are spread in: airborne droplets contact can be used alone or in combo but ALWAYS in addition to standard precautions TERM 58 In the airborne, what transmission based precautions are used? DEFINITION 58 disease TBprotection private room negative air flow mask/respirator for staff pt. wear mask when leaving room TERM 59 in droplet, what transmission precautions are used? DEFINITION 59 disease: pneumoniaprotection private rom mask within 3 ft pt wear mask when leaving room TERM 60 contact, what transmission precautions are used? DEFINITION 60 disease: herpes, scabiesprotection: private room gloves gowns TERM 71 How do you remove gowns? DEFINITION 71 unless visibly soiled(or ties in front)--> untie neck then waist take off inside out never touch outside of gown roll up away from body, inside out TERM 72 How do you use mask/eye protection DEFINITION 72 specially FITTED mask for airborne precautions tie upper first. fit metal strip over bridge of nose tie bottom at nape of neck change if becomes wet or greater than 30min can wear goggle TERM 73 How do you remove masks? DEFINITION 73 untile lower first untile upper while holding it LOOPS too TERM 74 What are 3 modes of transmission of infectious materials in clinical setting? DEFINITION 74 puncture wounds from contaminated needles/sharps skin contact (allow infectious fluids to enter through wounds and broken or damaged skin) mucous membrane contact, which allows infectious fluids to enter through mucous membranes of the eyes, mouth or nose TERM 75 What are guidelines to follow after exposure to blood borne patho? DEFINITION 75 report immediately injury report approprate evaluation and follow-up ID and doc of source individual when feasible and legal test source for hep. B, C and HIV when feasible and consent TERM 76 What do you do in cases of punctures/laceration? DEFINITION 76 encourage bleeding wash/clean area with soap and water initiate firstaid and seek treatment if indicated flush with saline or water for 5-10min also for mucous membrane exposure(eyes, nose, mouth) TERM 77 What are the 2 NANDA (n. am. nur. diag. ass) diagnosis for RISK FACTORS and RISK FOR INFECTION? DEFINITION 77 Risks factors inadequate primary and secondary defenses risk for infection individaul at increased risk for invasion by patho TERM 78 In the nursing process, what do the assessments include? DEFINITION 78 review past disease, travel hist immuno and vac status of defense mechanism client susceptibilty client appearance lab results TERM 79 What factors need to be considered when implementing nursing care to reduce infection? DEFINITION 79 medical and surgical asepsis CONTOL/ELIMINATE steps in Chain of INFECTION control/eliminate infectious agents control/eliminate reserviors control portals of entry control transmission hand hygiene isolation and isolation precautions TERM 80 Hygiene- scientific knowledge base necessity DEFINITION 80 physical hygiene is necessary for comfort, safely and well- being healthy ppl can take care of own hygiene ill or impaired clients require assistance TERM 81 What skin condition and skin care is important in hygiene? DEFINITION 81 intact and healthy skin is first line of defense protection depends on: general health of skin, amount of subcutaneous tissue, dryness TERM 82 What skin conditions are not ideal? DEFINITION 82 moisture contact for more than short time result in increased bac growth and irritation BO cause by skin bac acting on body secretions sensitivity varies among ind TERM 83 what are factors influencing hygiene? DEFINITION 83 social patterns: ethnic, social environment: housing, access to water body image: socioeconomic status: influence type and extent of hygiene practices health beliefs and motivation: motivation is key factor cultural variables: TERM 84 what are factors affecting skin integrity? DEFINITION 84 genetics and heredity age chronic illness and their treatments medications nutritional status TERM 85 What are the risk factors for skin impairment? DEFINITION 85 immobilization- pressure ulcers reduced sensation altered nutrition or hydration secretions or excretions on skin vascular insufficiency external devices TERM 96 What are nursing intervention for the eyes? DEFINITION 96 eye care basic eye care glasses contact artificial eye TERM 97 What are nursing intervention for the ears? DEFINITION 97 ear care basic ear care hearing aids TERM 98 What are nursing intervention for the environment/room care/ DEFINITION 98 room care temperature noise clutter bed bed making TERM 99 What are types of early morning hygiene care? DEFINITION 99 urinal /bedpan washing face and hands oral care TERM 100 What are types of morning hygiene care? DEFINITION 100 usually after breakfast elimination bath or shower perineal care back message oral, nail and hair care TERM 101 What are types of hour of sleep(HS) pm care? DEFINITION 101 elimination washing face and hands oral care back message TERM 102 What are things to consider in urinary elimination/ DEFINITION 102 usually taken for granted growth and development psychosocial considerations cultural considerations TERM 103 What are factors affecting voiding? DEFINITION 103 developmental and psychosocial factors fluid and food intake medications muscle tone patho conditions surgical and diagnostic procedures TERM 104 What are the 4 alternations in urinary elimination? DEFINITION 104 urinary retention due to inability to empty UTI results from catheterization or procedure urinary incontinence involuntary leakage of urine urinary diversions to external source TERM 105 What are altered urinary eliminations? DEFINITION 105 frequency and nocturia (at night) urgency dysuria (painful) enuresis (bedwetting) incontinence TERM 106 What are assessment of elimination? DEFINITION 106 nursing hist normal void patter appearance of urine recent change past or current problem factors influencing the elimination pattern physical asssesment examination of urine TERM 107 What to assess in urine? DEFINITION 107 volume (intake a color, clarity (pale to amber, transparent in nonpatho) odor (ammonia in nature) sterility pH specific gravity glucose ketone bodies blood measure residual urine TERM 108 What are 3 urine tests? DEFINITION 108 urinalysis specific gravity culture TERM 109 How do you implement elimination/ DEFINITION 109 promote intake maintain normal voiding pattern maintain skin intergrity assist toileting prevent UTI manage urinary incontinence continence (bladder) training pelvic muscle exercise apply external urinary drainage devices TERM 110 How do you prevent UTIs? DEFINITION 110 drink 8 glasses of water/day frequent voiding (2-4 hrs) avoid using harsh soap, bubble bath, powder, sprays in perineal area avoid tight-fitting clothing wear cotton, not nylon underclothing TERM 121 What are nursing history for bowel elimination? DEFINITION 121 normal pattern? Description of usual feces Recent changes Past problems with elimination Presence of an ostomy (new opening and abdomen) Factors influencing elimination pattern TERM 122 What are implementations for bowel movement? DEFINITION 122 Promoting regular defecations Teaching about medications Decreasing flatulence Administering enemas (liquid by anus) TERM 123 What are ways to promote regular defe. DEFINITION 123 Privacy Timing Nutrition and fluids Exercise Positioningregular bed pan, slipper, commode TERM 124 What are medications to treat bowel movement? DEFINITION 124 Cathartics and laxatives Bulk forming, emollient or wetting, saline, stimulants, or lubricants Antidiarrheal agents Can be over the counter Can be opiates (prescription only) TERM 125 What are types of enemas? DEFINITION 125 Cleansing Prevents escape of feces during surgery Prepare intestines for certain diagnostic tests Removes feces in instances of constipation or impaction Carminative (drug) and return-flow Used primarily to expel flatus TERM 126 What are some common enemas solutions? DEFINITION 126 Cleansing Tap water (hypotonic) (electrolyte imbalance, water intox) Normal saline (isotonic) Hypertonic solutions (water retention) Soapsuds Oil retention TERM 127 What are nursing interventions for bowel movement? DEFINITION 127 Health promotion Promotion of normal defecation Sitting position Positioning on bedpan Privacy TERM 128 What's the distribution of bodily fluid? Intracellular DEFINITION 128 Intracellular Fluids (ICF) Fluids within cells 42% of total body weight Two thirds of total body water 28 liters in males 20 liters in females TERM 129 What's the distribution of bodily fluid? EXTRACELLULAR DEFINITION 129 Extracellular Fluid (ECF) Fluid outside of cells Interstitial, intravascular, and transcellular Makes up 17% of total body weight TERM 130 What are the movement of bodily fluids? Osmosis/Difussion DEFINITION 130 Osmosis: Movement of a water from an area of lesser solute to greater concentration Diffusion: Random movement of a solute through a semipermeable membrane from higher to lower concentration TERM 131 What regulates fluid intake? DEFINITION 131 Thirst 2200-2700ml/day TERM 132 What hormones regulate fluid intake? DEFINITION 132 Antidiuretic hormone Renin-angiotension-aldosterone mechanism TERM 133 What regulate fluid output? DEFINITION 133 lost through kidneys, skin, lungs, and GI tract Insensible loss (unaware- sking and lungs) Sensible loss (aware- urinary etc)