Death and dying
What Eriksons stage is usually seen with acceptance of death
integrity vs despair
Can a RN delegate tasks of a blood transfusion to other staff members?
RN has to observe for the first 15 mins, can not leave the room at all. Then vitals are done every 15-30 mins (look at policy). A UAP or LPN can't be delegated these tasks.
What does a WBC normal range? what does low values indicate? what do high values indicate?
5-10
low: autoimmune, bone marrow suppression/disorder
high: infection or stress reponse
What types of situations might a nurse be placed in that is unmoral, when dealing with death and dying? How does or should a nurse respond?
pushing or giving medications when not needed, ending a pts life out of sympathy, listening to a pts family and not following the pts wishes.
respond: this is not moral, legal, and/or ethical and due to this I am unable to follow this practice.
What is non-maleficence?
Definition of maleficence
1a : the act of committing harm or evil b : a harmful or evil act 2 : the quality or state of being maleficent
NON--> not doing the above
What are s/sx of maladaptive grieving?
6 mos or > , not touching or moving ANY items that belong to the ind. that passed away, keeping items the same and not moving forward, acting like they are still alive and are coming back.
What does an adverse reaction look life?
Chills, nausea, vomiting, itching, rash, dyspnea, back pain, tachycardia, temperature.
What is the normal range for hemoglobin? low indicate? high indicate?
12-18
LOW-->
low level indicates anemia=decreased RBC’s
Decreased levels=anemia, hemorrhage, nutritional deficiency, kidney disease
HIGH--> Indicate erythrocytosis
^levels= congenital heart disease, dehydration, severe burns, and high altitudes
What is advance directives? Are these different than a living will?
Follows the pts wishes on life saving measures. It has a power of attorney assigned.
What is beneficence?
Beneficence is defined as an act of charity, mercy, and kindness with a strong connotation of doing good to others including moral obligation. All professionals have the foundational moral imperative of doing right.
What are some normal s/sx of grieving?
insomnia, wt loss, anorexia, anergia
What does a nurse do if any adverse effect occurs?
STOP the blood immediately, un-hook the blood from pt. and notify the MD--> he/she might still administer the blood. If not then you will follow policy and proceduare of blood reactions.
What are the norm values for plt? low indicate? high indicate?
150-300
LOW->Thrombocytopenia (pregnancy, altitude, cancer)
HIGH-->Thrombocytosis (rare cases could mean cancer, infections, iron deficiency)
What is the difference between a moral conflict and a legal issue?
give an example
What is justice?
: the quality of being just, impartial, or fair questioned the justice of the their decision b(1) : the principle or ideal of just dealing or right action (2) : conformity to this principle or ideal : righteousness the justice of their cause c : the quality of conforming to law 3 : conformity to truth, fact, or reason : correctness
When providing post mortem care, what is the NUMBER 1 thing do as a nurse?
Label or tag the body to ensure that the deceased is not confused with any other pt. Then preform post mortem care.
What type of tubing is used to administer blood products? how long can the blood hang for? if the blood is not hung in how many mins, a RN would have to return to blood bank?
Filter
4 hrs max
30 mins
What is a pt at wik for if plt is too low? what are some interventions to educate the pt reduce this rf?
risk of bleeding
soft bristle tooth brush
report abnormal bruising
What is erythropoietine's purpose?
To stimulate the and Increase RBS production
What is autonomy?
: self-directing freedom and especially moral independence personal autonomy
When an indivdual is assigned as the POA, can this person override the pts wishes when the pt is dying?
TEchnically yes, they can. However it is our job to encourage, education,a nd provide comfort to allow the POA to cope with the pt dying. RN's should offer services to assist with the coping process.
Name two reactions from blood? s/sx of those reactions? interventions for these reactions? prevention of these reactions?
see notes
What is the normal values for BUN? low indicate? high indicate?
7-20
low-->malnutrition, severe liver damage, low protein, overhydration
high--> dehydration
What is the difference between a personal issue and cultural values?
give examples
What does folic acid anemia manisfestations?
pale, jaundice, smooth beefy tongue, fatigue, wt loss, cheilosis