Study Guide Nursing concepts chapters 1-24 PDF

Preview

Summary

chapters 1-24 exam study guide for nursing...

Description

STUDY GUIDE FOR CONCEPTS 1 EXAM 1 CHAPTERS 3,4,7,24 1.What are the Nursing standards?

The Maslow hierarchy

2.Maslow’s Hierarchy A person can meet some needs independently, but most needs require relationships and interactions with others for partial or complete fulfillment. Satisfying one’s needs often depends on the physical and social environment, especially one’s family and community. The Maslow hierarchy functions? 1.Physiologic Needs • Oxygen: most essential • Water, Physical activity, Rest • Food, elimination, temp, sexuality 2. Safety and Security Needs Second in priority

• • •

Have both physical and emotional components Being protected from potential or actual harm Examples of interventions to meet these needs: – Using proper hand hygiene to prevent infection – Using electrical equipment properly – Administering medications knowledgeably 3. Love and Belonging Needs • • •

Third priority needs, often called higher-level needs Understanding and acceptance of others in both giving and receiving love The feeling of belonging to groups such as families, peers, friends, a neighborhood, and a community • Unmet needs produce loneliness and isolation • Example of interventions to meet these needs: – Including family and friends in care of a patient establishing a trusting nurse– patient relationship. 4. Self-Esteem Needs Need for a person to feel good about oneself, to feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments  Positive self-esteem facilitates the person’s confidence and independence  Factors affecting self-esteem: o Role changes o Body image changes o 5. Self-actualization 

Acceptance of self and others as they are o Focus of interest on problems outside oneself o Ability to be objective o Feelings of happiness and affection for others o Respect for all people o Ability to discriminate between good and evil o Creativity as a guideline for solving problems and pursuing interests 3. The      

five functions for growth with individuals and families.

Families have important functions that affect how individual family members meet their basic human needs and maintain their health. The family provides the individual with an environment for development and social interactions. Family functions occur in five major areas. Physically, the family provides a safe, comfortable environment necessary for growth, development, and rest or recuperation. Economically, the family provides financial aid to family members and helps meet society’s needs. The reproductive function of many families is to have and raise children. The affective and coping functions of the family provide emotional comfort to family members and help members establish their identity and maintain it in times of stress.



Finally, through socialization, the family teaches; transmits beliefs, values, attitudes, and coping mechanisms; provides feedback; and guides problem solving (Friedman, Bowden, & Jones, 2003).

4. What is the importance of family centered care, 4 rationales? Summarize the components of a family-centered approach: 1. A family-centered approach is characterized by the recognition that children develop within the context of a family, and thus the early care and education program must serve the whole family. 2. A major influence on the development of the family-centered approach to early care and education can be traced to the federal Head Start program. 3. In a family-centered approach, there is enriched communication, shared power and decision making, and consistency between the home and the program.

Describe five benefits of a family-centered approach: A. Early childhood program and community must work collaboratively to maximize the child's development and learning. B. Successfully meeting the needs of their children and their families will greatly improve the quality early childhood programs can both support children's development and help families understand their children's unique needs. C. Exploring the community resources available to support children and their families as the child develops, learns, and grows.

4. Friedman, Bowman, Jones Identified by Friedman, Bowman, Jones the Rationales of family-centered nursing care in four ways.    

First, the family is composed of interdependent members who affect one another. If some form of illness occurs in one member, all other members become involved in the illness. Second, because there is a strong relationship between the family and the health status of its members, the role of the family is essential in every level of nursing care. Third, the level of health of the family and in turn each of its members can be significantly improved through health promotion activities. Fourth, illness of one family member may suggest the possibility of the same problem in other members. Through assessment and intervention, the nurse can assist in improving the health status of all family members.

5.What is affective coping skills of a family 

Continual demands force the family to adapt in order to survive, continue and grow



-Family coping processes and strategies are essential for making this possible



-Coping consists of problem-solving efforts by an individual faced with demands highly relevant to his or her welfare



Family coping denotes a family group level of analysis



Active process: family resources are utilized, new behaviors and resources are developed to strengthen the family unit and reduce any stressful impact

6. Community factors that affects health Many community factors affect the health of residents. A healthy community enables people to maintain a high quality of life and productivity. For example, a healthy community offers access to health care services for all members of the community, which provide both treatment for illnesses and activities to promote health. has roads, schools, playgrounds, and other services to meet needs of the people in the community. maintains a safe and healthy environment.

7. Characteristics of a community     

social interaction familial cultural ethnic heritage ties

8. The Chain of infection An infection is a disease state that results from the presence of pathogens (diseaseproducing microorganisms) in or on the body



Infectious agent - prevalent agents that cause infection are bacteria, viruses, and fungi.



Reservoir growth and multiplication of microorganisms is the natural habitat of the organism. Possible reservoirs that support organisms pathogenic to humans include other people, animals, soil, food, water, milk, and inanimate objects –



demonstrate signs and symptoms of the disease. Other people act as reservoirs for the infectious agent, but do not exhibit any manifestations of the disease. These people are considered carriers although asymptomatic, can transmit the disease. GARDIA, HIV, AIDS, WEST NILE, MOSQUITO, INFLUENZA



Portal of exit - In humans, common portals of exit include the respiratory, gastrointestinal, and genitourinary tracts, as well as breaks in the skin. Blood and tissue can also be portals of exit for pathogens.



Means of transmission Direct contact requires proximity between the susceptible host and an infected person or a carrier, and includes activities such as touching, kissing, and sexual intercourse. Indirect contact involves personal contact with either: (1) a vector, a living creature that transmits an infectious agent to a human, usually an insect; or (2) an inanimate object, called a fomite, such as equipment or countertops



Portals of entry the portal of entry is the point at which organisms enter a new host. skin and urinary, respiratory, and gastrointestinal tracts are common portals of entry.



Susceptible host- Susceptibility is the degree of resistance the potential host has to the pathogen

9. Infection-causing agents 

Bacteria, the most significant and most observed infection-causing agents in health care institutions, can be categorized in various ways. Most bacteria require oxygen to live and grow and are, therefore, referred to as aerobic. Those that can live without oxygen are anaerobic bacteria.



They are categorized by shape: spherical (cocci), rod shaped (bacilli), or corkscrew shaped (spirochetes)



gram positive or gram negative based on their reaction to the Gram stain.



crucial for providers when prescribing the most appropriate antibiotic therapy because antibiotics are classified as specifically effective against only gram-positive organisms or as broad spectrum and effective against several groups of microorganisms.



A virus is the smallest of all microorganisms, visible only with an electron microscope.



Viruses cause many infections, including the common cold, hepatitis B and C, and acquired immunodeficiency syndrome (AIDS).



Antibiotics have no effect on viruses.



However, there are some antiviral medications available that are effective with some viral infections.



When given in the prodromal stage (infection/disease has begun, but the symptoms are just beginning and may be vague) of certain viruses, these medications can shorten the full stage of the illness.



Fungi, plant-like organisms (molds and yeasts) that also can cause infection, are present in the air, soil, and water.



Some examples of infections caused by fungi include athlete’s foot, ringworm, and yeast infections.



These infections are treated with antifungal medications; however, many infections due to fungi are resistant to treatment.



Parasites are organisms that live on or in a host and rely on it for nourishment. Malaria is a serious disease that occurs when a parasite infects a certain type of mosquito that then feeds on humans.



A significant and disturbing trend continues to be the development of microorganisms, primarily bacteria (but also parasites, viruses, and fungi),



resistant to one or more classes of antibiotics (or antimicrobials) that were originally effective to treat these infections.



indiscriminate use of broad-spectrum antibiotics has allowed once-susceptible bacteria to develop defenses against antibiotics.



While antibiotics kill bacteria that cause illness, they also affect good bacteria that protect the body from infection. As a result, the drug-resistant bacteria continue to

grow and can even share their drug resistance with other bacteria, which further complicates treatment 

Resistant organisms, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Staphylococcus aureus (VRSA), and carbapenem-resistant Enterobacteriaceae (CRE)



have emerged antimicrobial drugs are broad-spectrum antimicrobials and the agents of choice for serious infections when an organism is resistant to other primary antibiotics

10. The stages of infection An understanding of the stages in the development of an infection is necessary to intervene and disrupt the infection cycle. Incubation period the incubation period is the interval between the pathogen’s invasion of the body and the appearance of symptoms of infection. EX Cold Prodromal stage A person is most infectious, early signs and symptoms of disease are present, but these are often vague and nonspecific, ranging from fatigue and malaise to a low-grade fever.last 1-2 days Full (acute) stage of illness determines the length of the illness and the severity of the manifestations. Convalescent period recovery from the infection. signs and symptoms disappear, and the person returns to a healthy state A person may continually pass through the four phases with the same infectious process, such as with herpes simplex. Although there may have been only one infectious exposure, the infection may continue to cycle through the phases. The hallmark signs of acute infection are redness, heat, swelling, pain, and loss of function, usually appearing at the site of the injury/invasion.

11. The risks of infection  Integrity of skin and mucous membranes, which protect the body against microbial invasion pH levels of the gastrointestinal and genitourinary tracts, as well as the skin, which help to ward off microbial invasion

 Integrity and number of the body’s white blood cells, which provide resistance to certain pathogens  Age, sex, race, and heredity, which influence susceptibility– neonates and older adults appear to be more vulnerable to infection (see the accompanying box: Focus on the Older Adult)  Immunizations, natural or acquired, which act to resist infection  Level of fatigue, nutritional and general health status, the presence of pre-existing illnesses, previous or current treatments, and certain medications, which play a part in the susceptibility of a potential host  Stress level, which if increased may adversely affect the body’s normal defense mechanisms  Use of invasive or indwelling medical devices, which provide exposure to and entry for more potential sources of diseaseproducing organisms, particularly in a patient whose defenses are already weakened by disease 12. Healthcare associated infections health care–associated infections (HAIs) called now nosocomial infections- The Joint Commission mandated that death or serious injury caused by an infection-related event must be reported as a sentinel event          

An infection is referred to as exogenous when the causative organism is acquired from other people. An infection endogenous occurs when the causative organism comes from microbial life harbored in the person. An infection is referred to as iatrogenic when it results from a treatment or diagnostic procedure. bloodstream infections, C. difficile, urinary tract infections, methicillin-resistant Staphylococcus aureus (MRSA) infections, and surgical initiatives. majority of HAIs in the acute care hospital setting These include Catheter-associated urinary tract infection (CAUTI) Surgical site infection (SSI) Central line–associated bloodstream infection (CLABSI) Ventilator-associated pneumonia (VAP)

FYI Most HAIs are caused by bacteria, such as C. difficile, E. coli, S. aureus, Streptococcus faecalis, Pseudomonas aeruginosa, and Klebsiella species. Many HAIs

can be traced to an invasive device, such as a urinary catheter or venous access catheter. 

MRSA S. aureus bacteria are normally found in the nasal mucous membranes, on the skin, and in the respiratory and gastrointestinal tracts.



Vancomycin-resistant enterococci (VRE) are another serious pathogen in hospitals. Enterococci, a species of Streptococcus



found in normal intestinal and genitourinary tracts, can cause



HAIs with a high mortality rate if the organism is vancomycin resistant



Found in feces, urine, or blood of an infected or colonized person



CRE are very difficult to treat



and represent a public health threat. Klebsiella species and E. coli are examples of Enterobacteriaceae normally found in the human intestine.

13. Hand Hygiene chapter 24 page 622-23 skill 24.1

1.Gather the necessary supplies. Stand in front of the sink. Do not allow your clothing to touch the sink during the washing procedure The sink is considered contaminated. Clothing may carry organisms from place to place. 2. Remove jewelry, if possible, and secure in a safe place. A plain wedding band may remain in place

3.Turn on water and adjust force Regulate the temperature until the water is warm. Water splashed from the contaminated sink will contaminate clothing. Warm water is more comfortable and is less likely to open pores and remove oils from the skin. Organisms can lodge in roughened and broken areas of chapped skin.

4. Wet the hands and wrist area. Keep hands lower than elbows to allow water to flow toward fingertips (Figure

5.Use about 1 teaspoon liquid soap from dispenser or rinse bar of soap and lather thoroughly Cover all areas of hands with the soap product. If using bar soap, rinse soap bar again and return to soap rack without touching the rack.

6. With firm rubbing and circular motions, wash the palms and backs of the hands, each finger, the areas between the fingers and the knuckles, wrists, and forearms. Wash at least 1 in above area of contamination. If hands are not visibly soiled, wash to 1 in above the wrists 7. Continue this friction motion for at least 20 seconds. Effective handwashing requires at least a 20-second scrub with plain soap or disinfectant and warm water. Length of handwashing is determined by degree of contamination. Hands that are visibly soiled need a longer scrub. 8. Use fingernails of the opposite hand or a clean orangewood stick to clean under fingernails

9Rinse thoroughly with water flowing toward fingertips 10. Pat hands dry with a paper towel, beginning with the fingers and moving upward toward forearms, and discard it immediately. Use another clean towel to turn off the faucet. Discard towel immediately without touching other clean hand. Patting the skin dry prevents chapping. Dry hands first because they are considered the cleanest and least contaminated area.

14.Isolation precautions downing gown, mask gloves Look at chapter 24-page 624skill 24.2

15 Setting a sterile field Look at chapter 24 page 622-28 skill 24.3

16 Sterile dressing change

Di scl ai mer :Al waysr evi ewandf ol l owy ourhospi t alpol i c yr egar di ngt hi ss peci fics ki l l . Saf et yconsi der at i ons : 

Perform hand hygiene.



Check room for additional precautions.



Introduce yourself to patient.



Confirm patient ID using two patient identifiers (e.g., name and date of birth).



Explain process to patient; offer analgesia, bathroom, etc.



Listen and attend to patient cues.



Ensure patient’s privacy and dignity.



Assess ABCCS/suction/oxygen/safety.

STEPS 1. Check present dressing with non-sterile gloves.

ADDI TI ONALI NFORMATI O Use non-sterile gloves to protect yourself from c

Apply non-sterile glov 2. Perform hand hygiene.

Hand hygiene prevents spread of microorganism

Perform hand hygiene 3. Gather necessary equipment.

Dressing supplies must be for single patient use Use the smallest size of dressing for the wound.

Gather supplies Take only the dressing supplies needed for the d the bedside. 4. Prepare environment, position patient, adjust height of bed, turn on lights.

Ensure patient’s comfort prior to and during the Proper lighting allows for good visibility to asse

5. Perform hand hygiene.

Hand hygiene prevents spread of microorganism

Hand hygiene with AB

6. Prepare sterile field.

Prepare sterile field 7. Add necessary sterile supplies.

Add necessary supplie 8. Pour cleansing solution.

Pour sterile cleansing s tray Normal saline or sterile water containers must be client and must be dated and discarded within at being...