The nursing process
II and III
II and III
Goals and Expected out comes must be:
(name the acronym we used and define the acronym)
SMART!
problem specific
Measurable
Attainable
Realistic
Timed
Define Parenteral drug administration and most common
And non-oral means of drug administration, but is generally interpreted as relating to injecting directly into the body, bypassing the skin and mucous membranes
Most common:
subcutaneous, intramuscular, intradermal, and intravenous
Demographics of aging
Increase in the aging population. Those reaching age 65 can expect additional years of life. 17.8 for men and 20.4 for women.
Grand theory, founder of modern nursing, nursing is an art, invented rounding at night, infection control
The environmental theory Florence Nightingale
Risk factors for Diabetes
overweight or obese, being older (pancreas fails with age), family history of type 2 diabetes, blacks, asian Americans, hispanics, native hawaiians or pacific islanders, native americans
Classify patient priorities and describe each
High-if not done results in harm to the patient (think Airway, breathing circulation)
Intermediate-non-emergent, non-life-threatening needs (skin breakdown)
Low-focus on patients long term potential for wellness (think patient teaching or health promotion)
Parenteral administration equipment (tell parts of the needle also define gauges of needles)
Bevel
Shaft
Gauge number
Hub
(point to it on picture of a needle)
Larger the gauge=smaller the needle
23 or 25 smallest
18 is biggest
Discuss ageism and its consequences
Older adults are labeled as Ill, disabled, unattractive, forgetful, confused, etc. This is discrimination against people. We should treat everyone with respect, dignity, and let them have involvement in care decision and activities regardless of their age.
Grand theory, emphasized the importance of patient independence so that the patient will continue to progress after being released from the hospital, 14 basic human needs
Principles and practices of nursing Virginia Henderson
Clinical Manifestations of type 1 diabetes include
Ploydipsia, polyuria, polyphagia, weight loss, weakness and fatigue
Goals of Evaluation
evaluation determines if:
-Actual health problems have resolved
-Prevention of potential problems if effective
-Maintenance/Improvement of health state
Describe Intradermal, subcutaneous, and Intramuscular injections and which angle to use
Intradermal
-15 degree angle
Subcutaneous
-based on body weight, site, amount of SQ tissue
45 degrees or 90 degrees
Needle length 1/2 to 5/8
Intramuscular
-90 degree angle
-needle length: 1-1 1/2
Nursing assessment for older adults SPICES
(common problems amongst the gerontologic community) sleep disorders, problems with eating or feeding, incontinence, confusion, evidence of falls, and skin breakdown
Grand theory, stating have to be caring to be a nurse, behavior influences peoples health, human behavior correlated with illness of patient
Philosophy and Science of caring Jean Watson
Gestational Diabetes
2-10% of pregnancies in U.S.
higher risk for cesarean delivery
babies have increased risk for perinatal death, birth injury, and neonatal complications
high risk: obese, advanced maternal age, family history of diabetes
63% chance of developing type 2 diabetes within 16 years
average risk for gestational diabetes screened using an OGTT at 24-28 weeks of gestation
Name a few examples of what a nursing intervention can be
assessments
following MD's orders
administering meds
Name sites for subcutaneous injections
outer lateral aspect of the upper arm, the abdomen (from below the costal margin to the iliac crest and more than two inches from the umbilicus), the anterior upper thighs, the upper back, and the upper ventral gluteal area
Changes in health and functioning in older adults
adjustment to new body image
affects on body image and self-concept
self-concept and roles
difficulty in acceptance of physical changes
illness and disability
societal expectations of the decline in function
Thanatology
middle range theory nursing is a cultural paradox aka there is different levels of nursing, we need to support our young nurses, nursing education plays a key role
From Novice to Expert: Excellence and Power in Clinical Nursing Practice by Patricia Benner
Diabetes care-goals of therapy
keep blood glucose under control, maintain blood pressure too high BP=cut off circulation, maintain healthful serum lipid profile, achieve/maintain normal body weight
Types of Direct and Indirect nursing care
Independent nursing interventions
-The nurse may initiate without the supervision or direction from others. Most pertain to ADL's
Dependent nursing interventions
-Actions which require an order from a healthcare provider to treat or manage a medical diagnosis-also requires specific nursing knowledge and technical expertise (getting an order from a Dr.)
Describe the Z track method and drugs used for it
Used for IM injections. Pulls and holds pressure on the skin when giving an injection which leaves a zigzag path behind when they remove the needle and release the skin.
Describe physiological changes in the older adults Integumentary system
Integumentary system
-skin looses moisture, looses a bit of turgor, fat loss, pigmentation changes, thinning hair, facial hair decreased in men and increased in women, slower nail growth, atrophy of epidermal arterioles
SRJC program mission statement and philosophy
Promotion of health and prevention of illness, restoration of health and alleviation of suffering when restoration is not achievable, the use of the nursing process, collaboration with patients and other members of the health care team, application of legal and ethical principles. The mission statement is to educate nursing students for SAFE nursing practice, demonstrating attributes that are culturally sensitive, competent, and professional. (SAFE, COMPETENT, PROFESSIONAL)
Can you mix long acting insulins like detemir (levemir) or glargine (lantus)?
NO! DO NOT MIX LONG ACTING INSULINS
regular and NPH yes
rapid acting and NPH yes