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54 Cards in this Set
- Front
- Back
goal directed decision making about health that is the result of an authorized, public decision-making process
those actions, nonactions, directions, and/or guidance r/t health that are decided by government or other authorized entities |
health policy |
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Role of legislatures in health policy - |
includes US Congress and state legislatures
establish laws to serve some policy goal
create laws and determine appropriate funding for legislative acts and provide oversight for policies |
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Role of courts and judiciaries in health policy - |
determine rights in health policy disputes through judicial review |
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Role of the executive branch in health policy - |
executes and implements laws
responsible for the execution of laws passed by legislatures |
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Role of regulatory agencies in health policy - |
established by legislatures to implement and enforce laws through a rule-making process |
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Decisions are made by authorized government institutions such as legislatures or courts or by government-authorized entities
The decision-making process is subject to public review and public input
Health policies address a public policy goal |
Major attributes of health policy |
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Health policies are subject to ongoing review by governing institutions and by the public
Health policy goals change according to changes in political and social values, trends, and attitudes |
Minor attributes of health policy |
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1. Remove scope-of-practice barriers 2. Expand opportunities for nurses to lead and diffuse collaborative improvement efforts 3. Implement nurse residency programs 4. Increase proportion of nurses with BSN degree to 80% by 2020 5. Double the number of nurses with a doctorate by 2020 6. Ensure the nurses engage in lifelong learning 7. Prepare and enable nurses to lead change and to advance health 8. Build an infrastructure to collect and analyze health care workforce data. |
Eight Recommendations from The Future of Nursing Report |
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defines something that must be done
defines something that must not be done |
prescriptive
proscriptive |
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the collection of laws that have a direct impact on the delivery of health care or on the relationships among those in the business of health care or between the providers and recipients of health care |
health care law |
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provision of COBRA
required that any hospital with an ED and received Medicare funds provide an appropriate screening exam to anyone who presented and stabilize any emergency medical condition |
Emergency Medical Treatment and Active Labor Act (EMTALA) |
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created Medicaid and Medicare
created a trust fund for Medicare and grants to the states for the support of Medicaid programs |
Social Security Act of 1965 |
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change to the Social Security Act of 1965
abolished the traditional fee-for-service payment and instead provided prospective payment based upon a patient's diagnosis |
Diagnostic Related Group |
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created a standard statute of limitations and limiting damage awards
created the broad health information privacy requirements with which all in the business of health care must contend |
Health Insurance Portability and Accountability Act of 1996 (HIPAA) |
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included subsidies for high-risk pools, created health insurance exchanges, eliminated insurance co-pays for preventive care, requires that every American have minimum essential health insurance |
Patient Protection and Affordable Care Act of 2010 |
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careless act of omission or commission that results in injury to another |
negligence |
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type of negligence, often referred to as professional negligence
occurs when nursing care falls below a standard of care |
malpractice |
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criteria that is necessary to establish nursing malpractice |
- nurse owed a duty to the patient - the nurse did not carry out that duty - the patient was injured - the nurse's failure to carry out the duty caused the injury |
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broad civil rights statute that protects the rights of people with physical or mental disabilities |
Americans with Disabilities Act |
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forbids health plans from placing lifetime or annual limits on mental health coverage that are less generous than those placed on medical or surgical benefits |
Mental Health Parity Act |
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include living wills, health care proxies, and durable powers of attorney |
advance directives |
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requires health care institutions to provide written information to patients concerning their rights under state law to make decisions, including the right to refuse treatment and formulate advance directives |
the Patient Self-Determination Act of 1991 |
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assault, battery, and false imprisonment |
intentional torts |
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invasion of privacy and defamation of character (slander & libel) |
quasi-intentional torts |
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negligence and malpractice |
unintentional torts |
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an organization's system of ensuring appropriate nursing care by identifying potential hazards and eliminating them before harm occurs |
risk management |
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steps involved in risk management include:
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identifying possible risks, analyzing them, acting to reduce the risks, and evaluating the steps taken |
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Normal F&E Values - Sodium Potassium Chloride Calcium Magnesium pH |
Na - 136-145 mEq/L K - 3.5-5.0 mEq/L Cl - 98-106 mEq/L Ca - 8.4-10.5 mg/dL Mg - 1.5-2.5 mEq/L pH - 7.35-7.45 |
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Healthy Adult Avg Daily Fluid Intake
Output for urine |
Total Intake - 2200-2700 mL
Urine Output - 1200-1500
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S/S of Hypernatremia |
FRIED SALT
fever (low grade), restless, increased fluid retention (increased BP), edema, decreased urine output (dry mouth)
skin flushed, agitation, low-grade fever, thirst |
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S/S of hyponatremia |
apprehension N/V headaches decreased LOC - confusion, lethargy, muscle weakness, coma seizures |
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S/S of hypokalemia |
A SIC WALT (down arrow)
alkalosis, shallow respirations, irritability, confusion (drowsiness), weakness (fatigue), arrhythmias, lethargy, thready pulse, decreased intestinal motility (n/v and ileus) |
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S/S of hyperkalemia |
EDD BOA MD
ekg changes, dysrhymia (irregular rhythm), diarrhea, BP decreased, oliguria, abdominal cramping, muscle cramps (-> weakness ->paralysis), drowsiness |
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S/S of hypocalcemia |
CATS
convulsions, arrhythmia, tetany, spasms (and stridor) |
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S/S of hypercalcemia |
"stones, bones, abdominal moans, and psychic groans"
n/v, constipation, confusion, dysrhythmias, decreased reflexes, lethargy |
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s/s of hypomagnesemia |
triple Ds + two Ts seizes HIM
deep tendon reflexes (increased), dyspnea, dysrhythmias
+ C&T signs
tachycardia & tetany
seizures
hypertension, insomnia, muscle cramps (twitching) |
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s/s of hypermagnesemia |
respiratory depression cardiac arrest dysrhythmias flaccid muscle paralysis warming sensation flushing hypotension bradycardia decreased deep tendon reflexes lethargy |
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isotonic fluids |
stay where i put them
LR, NS, D5W |
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hypertonic fluids |
enter the vessel
D10W, 3 or 5% NS, D5 1/2 NS, D5NS, D5LR |
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hypotonic fluids |
go out of the vessel
1/4NS, 1/2NS |
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When should you change continuous IV tubing? |
no more frequently than q96h |
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When should you change intermittent infusion tubing? |
q24h |
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When should you change tubing for blood products? for continuous IV lipids? |
blood products q4h
lipids q24h |
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When should you change transparent dressing? gauze dressing? |
transparent should be changed with tubing
gauze change q48h |
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disturbances of the amount of fluid in the extracellular compartment... |
volume imbalances |
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disturbances of the concentration of body fluids |
osmolality imblances |
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chronic disease with intermittent reversible airflow obstruction and wheezing |
asthma |
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Two ways that obstruction can occur in regards to asthma... |
inflammation and airway hyperresonsiveness that leads to bronchocontriction |
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volume of air exhaled from full inhale to full exhale |
FVC (forced vital capacity) |
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volume of air blow out as hard and fast as possible during the first second of the most forceful exhale after the greatest full inhale |
forced expiratory volume in the first second (FEV1) |
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fastest airflow rate reached at any time during exhalation |
peak expiratory flow (PEF) |
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Beta2-agnonists, SABAs, LABAs, cholinergic antagonists, methylxanthines |
bronchodilators |
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corticosteroids, NSAIDS, leukotriene modifiers, anti-IgE, cromones |
anti-inflammatory drugs |
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affects only the airways, not the alveoli |
chronic bronchitis |