Injury comes on suddenly and requires intense, immediate treatment.

e.q heart attacks, severe burns, strokes and uncontrolled diabetes etc.

 Treatable but not curable and is expected to require lifelong care

 This care may be given in a skilled care facility, adult day-care setting, respite care facility, assisted living facility, or the patients' home.

before, during and afterchildbirth

postpartum: cares for mothers who have given birth

nursery: for the newborn

 Health care consumer :

 Patient is term used for persons in acute care fasilities such as hospital

Client is term used for persons receiving care in their homes

 Resident is a term for people in long-term care facilities

Occupational Safety and Health Administration

 Government agency that protects the health and safety of employees.

A complex organization that provide full range of healt care services.

Such as Acute care, specialized care, emergency intervention, research, public teaching, disease control and treatment, promote individual and community health.

Elderly, children, young adults provide care and shelter.

Divided into three categories, depending upon the type of care required by the resident in the facility :

• Shelterd (Custodial) depends on unskilled personnel, provide assistance with personal needs such as food, shelter and dressing.
• Intermediate need more hand on,  personal care by nursing assistant and licensed practical nurse including simple medical procedures such as special diets, self medication, uncomplicated dressing changes and injections.
• Skilled need hand on (requires constant supervision by a registered nurse), comprehensive planned care incorporating, rehabilitation and restorative services including drug therapy, inhalation therapy, occupational therapy or administration of tube feedings and/or IV fluids.

Group of people who are skilled in the care of the ill, prevention of illness and general welfare of the patient.

Includes :

1. Medical staff
2. Dietitian
3. Administration
4. Pharmacy
5. Religious/Spriritual staff
6. Para professionals
7. Consultants
8. Nursing services

Organizes and directs the functioning of the facility.

Ordering supplies, preparing yearly budgets, hiring and firing of personnel, etc.

Includes :

• Physical therapist - participates in restoring the use of muscle function through heat, cold, pressure, massage, exercise and manipultion.
• Occupational therapis - primarily concerned with performing activities of daily livinf (ADL's) such as bathing, grooming, dressing and elimination.
• Speech therapist - instructs patient on techniques of muscle use for eating and speaking. Work closely with occupational therapist.

1. Director of Nursing - responsibler for all nursing personnel and nursing care. Must be RN
2. Registered Nurse (RN) - complete 2-4 years of nursing education in college or a hospital program. Frequently in supervisory positions.
3. Licensed Practical Nurse (LPN) - complete 1-2 years of nursing education. Function as staff nurse, medicine nurse, treatment nurse or charge nurse.
4. Certified Nursing Assistant (CNA) - Reffered to as a nursing assistant (NA) until actually certified. Work under supervision of a professional nurse - RN or LPN.

Guides to moral standards/knowledge of right or wrong. Ethics tells you what we should do.

e.q. NA politely ask politely stop gossiping another co worker.

failure to exercise the degree of care considered reasonable under the circumstances, when that failure results in an unintended injury to a patient, negligence is carelessness, which is often caused by hurrying or not focusing on the task at hand. (failure to act)

e.q. not feeding  a confused patient lunch because she is a slow eater or you are short on time, forgetting to give  a lunch tray to a confused patient who feed himself.

If you make false statements about someone  to a third p person and the character of the first person is injured.

Slander statement verbally or Libel in writing

Restraining a person's movements or actions withot proper authorization constitutes unlawful.

e.qpatients have the right to leave the hospital wih or without the physicians permission, you may not interfere.

Inform your supervisor.

the separation of a patent from others against the patient's will.

e.q. shutting the door to the patient's room when the patent is confined to bed and wants the door open.

continueally placing a patent's gerichair far from others

leaving a patient without a form of communication such as a signal cord or call bell.

is the failure to provide the services or care neccessary to avoid physical harm, mental anguish, or mental illness.

e.q. Failing to turn the patient as often as needed, failling to perform regular exercises, failing to carry out proper hygiene.

Primary nursing (Registered Nurse, Licensed staff and assistants help with the care when th RN is not on duty). Pts appreciate primary nursing because it enables them to relate directly to one specific nurse.

Functional Nursing is task oriented way to organize care, the charge nurse is the one person responsible for all patients, all other staff members are assigned specific tasks, such as giving medications, administering treatments, or providing hygienic care. Many people are involved in their car. Team nursing is one of the most common methods of delivering nursing care, team members receive instructions and assignments from and report back to, the team leader. e.q. RN team leader determines the nursing needs of all the patients assigned to the team for care, in some work settings, the LPN  or LVN is a team leader, he or she is supervised by a registered nurse.

to serve the needs of the clients in the community.

provides new employees with an orientation to the agency and to their responsibilities.

• Government-sponsored agencies controlled by city or county governments.
• Private agencies ; some are for-profit and others ar nonprofit.
• Hospital-sponsored agencies.

Home care team :

• Client
• Family
• Nursing assistant (provides direct client's safety and comfort, make observations and reports them to the nurse, documents observations and reports them to the nurse.
• Supervising nurse (completes periodic clients assessments plans the care, teaches and supervises nursing assistants, coordinates care and members of the home care team
• Physician (write orders and acts as a consultant and guide).
• Other specialists, such as : physical therapist, occupational therapis, speech therapist, speech therapist, social worker, dietitian.

1. Assessment : observations and careful reporting can make a baluable contribution to the objective and subjective data from which the analysis of the client's needs is made. make note of : client's response to your care, the interactions between family members and friends that could lead to stress on the client, support services that may be needed
2. Planning : actively share in care conferences.
3. Implementation : responsible for seeing that the plan is carried out. Report any difficulties in carrying out the plan, develop ways of organizing your observations about the succes or lack of success of the care.
4. Evaluation : be accurate and concise in your reporting, be honest in your appraisal of the client's progress and the point at which your services are no longer needed.

1. Verbal abuse
2. Sexual abuse
3. Physical abuse
4. Psychological abuse
5. Financial abuse
6. Improper used or applied restraint

• Poor of personal Hygiene
• Lost of weight or dehydration
• Unexplained bruises or bruises in various stage of healing
• Patches of missing hair
• Burn mark from cigarettes, abrations from ropes or other binding
• Unclean or ansafe living condition
• uncontrolled medical condition
• Brushing, chafing and discharge from genital area

• Be treated in a respectful, dignified manner - includes the right to privacy and to confidentiality.
• Have the benefit of open and honest communication with cargivers.
• Have a role in decision making for treatment choices and planning of care. Informed consent.
• Be advised of their rights about advance directives
• Receive continuity of care
• Be informed of resources for resolving conflicts or grievances.

There are four parts of communication

1. Sender : the person who originates the communication.
2. Massages : the information the sender wants to communicate.
3. Receiver : the person whom the communication intended.
4. Feedback : return of information from the receiver to the sender. Confirmation that the massage was received as intended.Used to tell wether the communication was succesfull.

• Verbal : uses word, may be spoken or written (symbol) e.q. 
• Non Verbal (generally believed because it is harder to control our non-verbal messages than our verbal messages.

Remove/Rescue

Alarm

Contain/Confine

Extinguish/Evacuate

Pull the pin

Aim low

Squeeze the handle

Sweep from side to side

• Word root - foundation of a medical term. e.q. cytology (the study of cells), a leukocyte (a white blood cell), polycytosis (an illness in which there are too many red and white blood cells).
• combining form - a vowel may be added to the end of the word root to make it easier to form medical words. e.q. Hepat + ology = Hepatology
• prefix - word part added to the beginning of a word to change or add to its meaning. e.q. post- (after)
• suffix - word part added to the end of a word to change or add to its meaning. e.q. -logy (study of)
• Abbreviation - shortened form of a word.

Signs - can be seen by others (objective) e.q. rheumatoid arthritis joints are red, hot to the touch, swollen, and painful.

Symptoms - felt by the patient who tells  us about them (subjective)

1. It serves  as a basis of planning patient care and for  continuity in evaluating patients' condition and treatment. The  Combination of personal and family history and phycisian finding, must be combine with the laboratory study, X-Ray and any special indicate test help the physician  determine the dignosis and treatment.
2. The medical record furnishes evidence of patients' evaluation, treatment and change in condition.
3. The medical record furnishes  evidence of communication between physician and any other health professional contributing care to the patient.
4. It effort protection of the legal interest of the patient and the physician.
5. Help to establish a database for use in continuing education and research.
6. Insurance company routinely send a representative to perform chart of audit (inspection) of medical record of patient insured throught their company.

• Talking to resident in sarcastic and rough manner
• Using crude slang or swearing
• Using gesture that are considered obsence or demeaning

• Hitting, pinching, kicking or slapping.
• Any other physical contact that are inttentionally causes pain or discomfort.
• Corporal punishment inflicting pain on resident to force them to follow order.

• Using physical means orverbal threat to force the resident to perform sexual act.
• Termonting or teasing a resident with sexual gesture or word.

• Making verbal threat to punish a resident (telling that you are going to put him  in restraint if he doesn't obey)
• Humialiting a resident (such as resident wet a pant) 
• Involuntary seclution : separating resident from the other against residents' will.

• Misuse residents' money or property by staff, family member

Nursing has the code for nurse that outlines the values, norm and ideals of the profession. It provide guidance for ethical conduct an framework within which to look at and evaluate nursing action. Nursing assistant should observe this  code for ethical behavior.

• Be consciencious. Do the best as you can.
• Be generous and sensitive in helping your pts and co worker.
• Carry out faithfully the instruction you are given by your immediate supervisor.
• Perform only procedure you have been educated.
• Respect the right of all patient to belief or opinion differ from yours.
• Let pts know it is your pleasure not just your job to serve him.
• Demonstrate that you are sincere in your involvement in the care of human being.
• Do not accept tips from pts.

• Ethic of confidentiality : Do not discuss pts' information with other pts, co worker except in the conference, relatives or friend of pts, relatives of you, representative of media.
• Ethic of accuracy : It is very important to follow your team leader's instructions exactly. Be alert when you answer the call light. Should be a mistake report to your immediate supervisor at once.
• Ethic of dependability : If you are sick call nursing office at appropriate time.

• Primary nursing care is given by a registered nurse, This nurse is responsible for an assigned patient's care for that patient's entire hospitalization. LPN an NA help with the care when the RN is not on duty. The nurse plans and coordinate the nursing care, teaches, carry out treatments, gives direct nursing care and plans for the patient's discharge.
• Each RN is assigned to and reponsible for six to eight patients in the primary nursing situation.
• Patients appreciate primary  nursing because it enables them to relate directly to one specific nurse.

Team Nursing

• Most common methods
• RN team leader determines the nursing needs of all the patients assigned to the team for care, in some work setting LPN or LVN is team leader. He or she is supervised by RN.
• Team members receive instructions and assignments form and report back to the team leader.
• Team members should understand the philosophy, goals and purposes of restorative care, understand their reponsibilities, including the pts & family members if pts desires attend the care plan conference.

Functional Nursing

• Task oriented way to organize care.
• Charge nurse is the one person responsible for all patiens.
• All other staff members are assigned specific tasks, such as giving medications, administering treatments, or providing hygienic care.
• Pts may find this type of nursing confusing because many people are involved in their care.

Occupational Safety and Health Administration. Government Agency that protect the safety of employees.

Inspectors review infection control, isolation practices, employee tuberculin testing, material safety data sheets and other policies and facility practices.

Used by insurance companya to provide the services in the most efficient manner at the lowest cost.

• Not permit certain procedures or diagnostic tests until they have been approved by the insurer.
• Negotiate with specific physicians, hospitals, pharmacies and other care providers to render services at a lower cost to the company's members.
• Aprrove only a certain number of days of hospitalization for specific diagnoses. A woman giving birth, for example, may be allowed up to 48 hours of hospitalization.
• Require that specific procedures be done on an outpatient  basis rather than having the patient admitted to the hospital.

• Lack of proper light
• Subtance that the  resident may swallow such disinfectant, denture tablet, medicine etc.
• Lack of hearing aid, glasses and many devices that allow resident stay in contact with environment.
• Unsafe equipment
• Slippery floor
• Unlock w/c, gary chair
• Error such giving the resident diffence  tray
• cluttered hallway
• improper use of restraint
• Unsafe improperly perform procedur
• Improperly place nonworing call signal.

The lack of blood supply to the body tissue, which prevents delivery of essential oxygen and nutrients

example: a blood clot (thrombus)

This tehniques used do not break the skin or damage body tissues.

• Ultrasound
• Thermography
• X-Ray and fluoroscopy
• MRI (Magnetic Resonance Imaging)
• EKG (or ECG), EEG, EMG

Some tests and studies actually penetrate body surfaces.

Exam: Taking tissue samples, introducing contrast media.

1. Provideing services for the ill and injures
2. Promoting individual and community health
3. Preventing disease
4. Educating health care workers
5. Promoting research in medicine and nursing

• People are living longer
• Advance tehnology
• The cost of health care increase tremendously
• Science has create many ethical (moral)  medical questions that must be answer by health care providers and consumers

treatable but not curable and is expected to require lifelong care.

Skilled care facilities, adult day care 

• Assessment : collection of data (information) about the patient
• Problem identification : identifies the patient's problems and formulates nursing diagnoses.
• Planning
• Implementation
• Evaluation

Statement of a patient  problem and the cause of the problem.