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Primary health care
emphasis health promotion, and includes prenatal and well-baby care  
  • include office or clinic visits and scheduled school or work-centered screenings.
Secondary Health care
  • the diagnosis and treatment of emergency, acute illness, or injury.
  • emergency department.
Tertiary health care
  • involves the provision of specialized highly technical care.
  • E.G cancer center
Restorative health care
  • intermediate follow up care for restoring health. 
  • E.G: home health care, skilled nurse facility, rehab.
Continuing health care
  • includes hospice, adult day care, and in-home respite care. 
Health care regulatory agency
  • The joint Commission
  • State boards of Nursing
  • Food and Drug Administration
Health care financing mechanism if federally funded by
  • medicare
  • medicaid. 
Autonomy
Ability of the client to make personal decisions, even when those decisions may not be in the clients own best interest.
Beneficence
Agreement that the care given is i nthe best interest of the client; taking positive actions to help others
Fidelity
agreement to keep one's promise to the client about care that was offerred.
Justice
Fair treatment in matters related to physical and Psychosocial care and use of resources
Nonmaleficence
avoidance of harm or pain as much as possible when giving treatment.
Negligence
a nurse fails to implement safety measures for a client who has been identified as at risk for falls
Malpractice (professional negligence)
a nurse administers a large dose of medication due to a calculation error. the client has a cardiac arrest and dies.
Breach of confidentiality
a nurse releases the medical diagnosis of a client to a member of the press
Defamation of character
a nurse tells a coworker that she believes the client has been unfaithful to her spouse.
Assault
threatening client.
Battery
act on the threat. restrain.
False imprisonment.
a person is confined or restrained against his will.
Nurses can avoid being liable for negligence by:
  • following standards of care
  • giving competent care
  • communicating with other health team members
  • developing a caring rapport with clients
  • fully documenting assessment, intervention, and evaluations. 
nurses'role in the informed consent process is to
  • Witness the client's signature on the informed consent form and to ensure that informed consent has been appropriately obtained. 
individuals who are authorized to grant consent for another person include:
  • parent of a minor
  • legal guardian
  • Court-specified representative
  • an individual who has durable power  of attorney authority for health care
  • Emancipated minor( minor who are independent from their parents, such as a married minor) provide informed consent for themselves. 
Standards of care
defines and direct the level of care that should be given by practicing nurses, and they are used in malpractice lawsuits to determine if that level was maintained.
Advanced directives
communicate a client's wishes regarding end-of-life care should the client become unable to do so.
Living will
legal document that expresses the client wishes regarding medical treatment in the event the client becomes incapacitated and is facing end-of life issue.
Information to chart includes:
  • assessment
  • medication administration
  • treatments given and the client's responses
  • Client education
Methods of data collection include
  • observation, interview with the client and family, the medical history, a comprehensive or focused physical examination, diagnostic and laboratory reports, and collaboration. 
inhalination anthrax
  • S&S: sore throat, fever, muscle ache, severe dypsnea, Meningitis, Shock
  • Treatmen: IV Cipro. 
Botulism
  • difficult swallowing, p[rogressive weakness, nausea, difficult breathing.
  • treatment:airway, antitoxin, elimination of toxin
Emergency category (class I)
highest priority is given to clients who have life threatening injuries but also have a high possibility of survival once they are stabilized
Urgent (Class II)
second highest priority, manor injuries that are not yet life threatening and can usually wait 45-60 min for treatment.
Non urgent (Class III)
minor injuries that are not life threatening and do not need immediate attention
Expectant ( Class IV)
clients who are not expected to live and will be allowed to die naturally.
Primary prevention
needs of healthy clients to promote health and prevent disease.
  • immunization program, health education
Secondary prevention
early identification of individuals or communities experiencing illness, providing treatment, and conducting activities.   
  • early detection and treatment of diabetes
  • excercise pregram for older adult clients who are frail.
Tertiary prevention
long term consequences
  • prevent of pressure ulcer as a complication of spinal cord injury. 
  • promoting independence for the client who has traumatic brain injury. 
12 cranial nerve
  • I(oldfactory): smell
  • II(optic): visual acuity
  • III(oculomotor): pupil reaction to light. 
  • IV (trochlear)
  • V (trigeminal): face for strength and sensation
  • VI (abducens)
  • VII (facial): symatry movement, taste
  • VIII (acoustic): hearing
  • IX(glossopharyngeal): taste
  • X (vagus): swallowing and speech. 
  • XI(spinal cord accessory): shoulder strength.
  • XII(hypoglossal): movement and strength
Rinne and weber test
hearing testing. Rinne but the fork on the side and Weber put the fork on top of the head.
Assessment of the face
  • perception of light touch of the face indicates that the sensory portion of the trigeminal nerve (CN V)
  • Symmetry of facial features 
  • presence of involuntary movements. 
Illumination of the iris
test for  Glaucoma: optic nerve is damaged.
Cover/ uncover test
Strabismus: condition in which the eyes are not properly aligned with each other 
Six cardinal positions of gaze
Nystagmus: involuntary eye movement, acquired in infancy or later in life, that may result in reduced or limited vision
Snellen chart
Myopia: near sighted
Rosenbaum
Presbyopia: farsighted.
Ishiara test
Color blind.
Gynecomastia
Breat enlarger (abnormal)
Dullness sound of the lungs means
fluid or solid tissue, this can indicate of pneumonia.
Hyperresenanc sound of the lungs
caused by the presence of air, this can indicate pneumothorax (Air in pleural) or emphysema (COPD,  when gas or air is present in the subcutaneous layer of the skin)
what information should be documented when describing the breat mass
  • location
  • size
  • shape
  • consistency
  • discreteness
  • tenderness
  • erythema
  • dimpling or retraction over the lump
  • lymphadenopathy
  • mobility.
pendulous
breat hang loosely.
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