Nse 12 Practice Final

a. Frequency of care (preference)

b. type of toothpaste/ tools

c. last dental visit

d. frequency of visits

e. type of moistening agents (mouth wash, pretend spit - yum)

1.) limited ROM of arms (paralyis, weakness etc)

2.) Dehydration, nil per os (nothing by mouth)

3.) nasogastric tubes / equipment barriers

4.) Meds (ex. antihistamines = thick saliva)

5.) Frequent use of chewable vitamins/ lozenges (sugar/acids damage teeth)

6.) Radiation to head + neck (decreased salivary gland function)

7.) lesions/ diabetes

Impaired swallowing

Gag reflex

for older adults, try 30 s tooth brushing assessment

chalky white discolouration of tooth/ black-brown discoloration

inflammation of gums

receding gum lines, inflammation, gaps between teeth

breath is super stank

cracking of lips

inflammation of oral tissues

soft bristled tooth brush

non-abrasive flouride tooth-paste/dentrifice

dental floss

water glass w/ water

mouth wash (optional)

Emesis basin (fr spittin')

tounge blade

face towel

paper towel (for the drool)

disposable gloves

Semi-fowlers y'all

=head raised 30 degrees, foot of bed may also be raised at knee

[full fowlers = 45 degrees]

45 degrees to gum line

EXCESSIVE COUGHING during or after oral care

BLEEDING/ULCERS/LESIONS

PAIN

DENTURE ISSUES (ill-fitting, broken)

Sims position - on side - with head turned well toward dependent side

TRUE! Keep them puppies from drying and cracking!

TEPID!!

Hot warps

Cold makes brittle

Nope, sleep teeth camando!

Wherever.. #yolo

JUST KIDDING!! IN LABELLED CONTAINER WITH WATER TO PREVENT WARPING AND LOSS

no. you get fired.

a.) <85% of expected body weight for height/age

b.) intense fear of gaining weight/ being fat; even though underweight

c.) amenorrhea (absence of period for 3+ months in females)

a.) binge eating

b.) lack of control over binges

c.) Purging: induced vomiting, laxatives, diuretics, fasting, strict dieting, vigorous exercise

d.) 2 binge episodes/week for at least 3 months

broth, coffee, clear fruit juices, gelatin, popsicles

3 grades (nectar, honey, pudding) everything has to be thickened to appropriate level

- smooth textured dairy products, custards, refined cooked cereals, vegetable juice, pureed vegetables, any fruit juice also admissible to clear fluids; can also include thickening

Pureed - all above + pureed meats, vegetables, fruits, mashed potatoes, gravy

Mechanical soft - above + ground/diced meats, flaked fish, cottage cheese, cheese, rice, potatoes, pancakes, light breads, cooked vegetabes, cooked/canned fruits, bananas, soups, peanut butter

Soft or low residue - low fibre, easily digested = pastas, casseroles, moist tender meats, canned fruits/ cooked vegetables, desserts, cakes, cookies without nuts or coconut

high fibre - uncooked fruits, steamed vegetables, bran, oatmeal, dried fruits

low sodium - either 4g (no added salt), 2g, 1g, or 500 mg (severe, requires selective food purchase)

diabetic - well rounded across food groups, meets recommendations from food guide, fat = <30% of caloric intake

Regular - no real restrictions

1.) clear liquid

2.) thickened liquid

3.) full liquid

4.) purreed

5.)mechanical soft

6.) soft / low residue

7.)high fibre

8.) low sodium

9.) low cholesterol

10.) diabetic

11.) regular

ISLAM-pork, alcohol, caffeine, emulsifiers made from animal fats (esp margerines), Ramadan fasting (sunrise to sunset for one month), ritual for meat slaughter

CHRISTIANITY-minimal alcohol; holy day observances may affect meat consumption

HINDUISM -all meats, alcohol, onions, garlic

JUDAISM - pork, predatory fowl, shellfish (fish with scales = ok), rare meats, blood sausage, milk + dairy = no, kosher, fasting (24 hrs, Yom Kippur; no leavened bread during passover, no cooking on Sabbath)

CHURCH OR JESUS CHRIST OF LATTER-DAY SAINTS (MORMONS)alcohol, tobacco, caffeine, limit meat

SEVENTH - DAY ADVENTISTSpork, shellfish,alcohol, vegetarianism encouraged

evidence based practice

Professional judgement

risk reduction

communication

**Infectious agent = microbes (some chill), pathogen (all bad)

**Amount of bad stuff

**Susceptible host

**Survival after agent

physical removement of contaminant

Chem, UV, heat

Boiling water, chemicals

area where pathogens grow and multiple

dark, right temperature, right pH, aerobic or aneorobic

bringing pothogen around w/out displaying symptoms, not sick themselves

Direct = host + person

Indirect = contaminated object

Droplet = large but can't go far (cough/ sneezes) up to 1 metre

Airbourne = goes far, ex. TB, measels, chicken pox (need negative pressure, private rooms, closed doors etc) no cohorts**

Vector

Vehicle

· Airborne– private room, door closed, negative pressure airflow, respiration device (eg.N95 respirator)· Droplet– private room/ cohort patients, door closed unless 2 m from door, mask wornwithin 2 m of patient· Contactprecautions – private room/ cohort, door can be open, glove/gown upon entry,limit patients’ movements outside of room, cleaning disinfecting, discardingitems

1.) entering room

2.) before touching procedure

3.) after procedure

4.) upon leaving room

1.) gown

2.) mask

3.) glasses

4.) gloves

1.) gloves

2.) gown

**HAND HYGIENE

3.) eyes

4.) mask

**HAND Hygiene

1.) immune - neutralizes threat, repairs

2.) skin - barrier, anti bacterial, shedding

3.) mouth - saliva, microbial inhibitors

4.) eye - tearing, blinking

5.) Respiratory tract - mucus, cilia, macrophages

6.) urinary tract - flushes out, epithelium barrier

7.) gastrointestinal - acidic, peristalis flushes it out

8.) Vagina - acidic

o Serous(clear, watery plasma)

o Sanguineous(bloody drainage)

o Serosanguineous(thin, watery drainage, blood tinged)

o Purulent(think drainages that contains pus)

1.) low center of gravity

2.) face direction of motion

3.) wide base

4.) balance work load between arms and legs

5.) role patient/ use leverage

6.) spread out work, rest

7.) less friction = less work

8.) good body mechanics (redundent but w/e)

9.) line of gravity goes through base

10.) reduce force to reduce injury

Alignment of body along horizontal/ vertical plain, maintain muscle tone

ADL

Patient dignity

Preps body, reduces risk of musculoskeletal injury

When muscles shorten chronically, curls joints + seizes

Education - teach the patient how to help themselves / others = infection control

Isolation - being quarantined can be isolating - be aware.

negative development from prescribed care from physician. (ex. prescribed medications that react with each other; failure to meet medical needs of care)

Health care associated infections

(ex. going in for a broken leg, coming home with a staff infection from boogers in the waiting room)

1.) Infectious agent / pathogen => defeat through cleaning

2.) reservoir for pathogen growth =>skin, urinary tracts)

3.) portal of exit from reservoir => butt hole

4.) Mode of transmission => hands, equipment, air

5.) portal of entry to host => hole in skin

6.) susceptible host => old, already sick

having or showing symptoms of fever

absent of pathogen/ practice & procedure that reduces the risk of infection

"sterile technique" = destroys errytang; skin can't be sterilized; lots heat & chemical used

* EXPOSURE TO MICRO ORGANISMS

* LENGTH OF STAY

*PRESENCE OF CHRONIC DISEASE

*COMPROMISED IMMUNITY

*Localized = wound will be painful tender, red = use PPE/ Hand Hygiene

*Systemic =more generalized; naseaus, fever, see lymph drainage for origin

1.) INfectius agent - clean/ disinfect/ sterilize to remove pathogen

2.) REversoir - eliminate/control sources of body fluid drainage

3.) Portal of exit - prevent leaving; wear mask, cover mouth, take care handling fluids

4.) Mode of transmission - contact, airborne, vehicle, vector

5.) Portal of entry - maintain skin integrity; proper drainage & wound care

6.) Host - vaccines and using proper isolation procedures

HealthCare Associated Infection (HAI)

= antibiotic resistant staff infection; starts out as small boil, reads skin to skin (direct contact)

causes diarrhea; antibiotic resister

Ethics

Relationships

Leadership

Knowledge

Knowledge application

Accountibility

Continuing Education

Personal Identity

Self-esteem

Role Performance

*Congruence between real and ideal self

*Realistic life goals

*Distinct sense of identity

*High self-esteem

*Satisfaction with role performance

*Emotional Stability

*Satisfaction with body image

*Spiritual well being

Intra = nurse+nurse

Inter = nurse +doctor + midwife

1.) Initiating - ident tasks and goals

2.) Seeking information - from all

3.) Giving information

4.) Clarifying - elaborate, interpret

5.) Summarizing - synthesis

6.) Consensus taking - decision making

1.) Harmonizing- reconcile

2.) Gate keeping - communicaintg

3.) encouraging - words/language

4.) Compromising - admit errors, adjust

5.) Setting standards - confirm, assess group norms

Aggressor (critical, blamey)

Blocker

Joker

Avoider

Self-confessor

Recogniion seeker

Forming - getting' the gang together

Storming - the gang figures their stuff out;awks

Norming - stuff figured out, task at hand

Performing - Getting' stuff done

Adjourning - packing up your stuff and saying goodbye

1.) Identify conflict issues

2.) know your response to the conflict

3.) separate the problem from the people involved

4.) Stay focused on the issue, understand context for situation

5.) Identify available options

6.) Negotiate and agree on a solution

1.) Competing

2.) Collaborating

3.) Compromising

4.) Avoiding

5.) Accommodating

Assertive - confident, task riented, not emotional (frustrated), say no, ask for what you want, express feelings, initiate, continue terminate interactions

Agressive - you statements, dominating, surpassing others' rights

Respect

Trust

Empathy

Professional intimacy

Appropriate use of powers

1.) Pre-orientation (prep your stuff)

2.) Orientation (gather data, ident pt. needs)

3.)Working implementing (Planning)

4.)Termination (evaluation! explore meaning of relationship)

S = sit facing PT.

O = open posture

L = lean forward

E = establish and maintain eye contact

R = relax

Sensory experience

not visibley soiled?

use aeseptic hand rub, 15 seconds

15-20 seconds