6 pounds of pain (SA/SE, LB/SS, of PaiN !!)
(1. SA - Self Actualization
2. SE - Self Esteem
3. LB - Love & Belonging
4. SS - Safety & Security
5. PaiN - Physical Needs
6. !!)
Maslow's Triangle (5 things)
Pie > Milk > Alcohol
(1. "PIE" - Prenatal (39 wks),
2. Infancy (0-18mnths),
3. Early Childhood (18mnths - 6yrs)
4. "Milk" - MLC - Middle to Late Childhood ( 7-11yrs)
5. "Alcohol" - AAlcohol - Adolescence (12-18yrs),
6. Adulthood (18+))
Human Growth and Development (6 things)
Skeletal System
Effects of Aging:
o Bones demineralize, becoming weaker and less dense Ur
o Joints become stiff and painful
o Vertebrae and disc compress, reducing height
o Activity, exercise, and diet help prevent bone loss and loss of muscle strength
Integumentary System
Effects of Aging:
o Skin becomes dry, thin and inelastic (fig. 2)
o Pigmentation changes, becoming less uniform
o Glandular atrophy (i.e., oil, moisture and sweat glands)
Urinary System
Effects of Aging:
o Kidneys shrink and blood flow decreases
o Bladder size decreases and muscles weaken
o Male prostate gland becomes enlarged
Respiratory System
Effects of Aging:
o Decreased vital capacity and flexibility
o Increased airway resistance
o Increased risk of respiratory infection
Cardiovascular system
Effects of Aging:
-Heart muscle weakens, lower cardiac output
-Thickening of blood vessel walls and decreased elasticity
-Calcification of heart valves
UR SK-IN CA-RE
(1. UR - Urinary
2. SK - Skeletal
3. IN - Integumentary
4. CA - Cardiac
5. RE - Respiratory)
we learned the effects of aging on these 5 systems
DOCTRNS - "doctrines"
(1. D- Death and Dying
2. O - Organization of the family
3. C - Communication
4. T - view of Time
5. R - Religion
6. N - Nutrition
7. S - Susceptibility to disease)
what are the 7 cultural factors of cultural diversity?
ethics
the term comes from the Greek word ethos meaning customs or modes of conduct. May be described as a system of moral principles dealing with what is right or wrong for individuals, groups of individuals, and /or for society at large
advocate
one who pleads the case for another
implied consent
a presumption that a patient, or a patient's parent or guardian would give consent if capable of giving consent
List ExAC As AfAct Ask"
(List- List Alternatives
Ex - Examine possible consequences of choices
AC - Allow the patient to choose
As - Assess how the patient feels about the choice
Af - Affirm the choice
Act - Act with a pattern
Ask - Ask all questions wit
The process for assisting a patient to clarify values is as follows:
advanced directive
a document signed in advance of an event occurring where resuscitation may be needed
DNR (Do Not Resuscitate)
this degree of advanced directives says the patient has the right to refuse resuscitative measures:
-this is the most common form of advanced directive
-there may be varying degrees of this:
-- may be restricted from initiating CPR if cardiac arrest was n
doctor's order
any advanced directive requires a written _____:
- if the patient refuses care yet has no legal documentation, implied consent takes over upon loss of consciousness
- assume implied consent when in doubt, and deliver care to maximum capabilities
abandonment
occurs when a health care provider initiates care, and then leaves the patient without turning over care to someone of equal or greater medical training
battery
injuring, wounding, or touching a patient in an offensive manner. Consent must be obtained before treating a patient, or the health care provider could be found guilty of this
tort
a violation of a civil law, a wrong against an individual
intentional tort
unlawful acts to intentionally cause confinement or restraint of the victim within a bounded area. For it to be established, the following must be proven:
- there was a duty to act
- there was a breach of that duty either by doing or failing to do somethi
confidential information
any information obtained about a patient's history, condition, or treatment
The American Hospital Association (AHA) patient bill of rights
a list of rights that patient could expect and responsibilities that the hospital should not violate
Right to be Informed
What bill of right is the following:
o Patients have the right to complete and current information concerning their diagnosis, treatment and prognosis
o The information should be provided in a language that the patient can understand
o Patients should kno
Right to Choose
What bill of right is the following:
o Patients have the right to refuse treatment, to the extent permitted by law, and to be informed of the medical consequences of their choices
o A patient cannot be forced to stay in a hospital or medical treatment fac
Right to be Heard and Respected
What bill of right is the following:
o Patient's have the right to privacy. Failure to cover patients, pull privacy curtains. or close doors to rooms may violate privacy laws and could result in lawsuits
o Expect that all communication and records pertain
Right to Safety
What bill of right is the following:
- Patients have the right to products that have been tested and found to be safe
- Patients have the right to receive care from providers who have met the qualifications for safe practice. This entails that providers h
CHRISt
(C - Choose
HR - Heard and Respected
I - Informed
S - Safety)
What are the 4 patient bill of rights we reviewed?
standards of care
these are the legal guidelines for nursing practice and provide the minimum acceptable nursing care. These standards provide a way of judging the quality and effectiveness of patient care. (what we are supposed to do)
scope of practice
this is the set of regulations and ethical considerations that define the extent of the medical health Corpsman's /Technician's job. DOD defines this for military installations and military personnel. (what we can do)
communication
a process by which information is exchanged between individuals through a common system of symbols, signs, or behavior
coffee-stains
negative and lasting impression; poor customer service
empathetic responses
communication technique; displaying this makes the patient feel more secure and encourages communication (e.g. nodding, smiling, supportive words)
listen
to pay attention to sound, and to hear something with thoughtful attention
EXACS
(EX -Know your customers and try to meet and eXceed their Expectations
A - Have a strong commitment and a positive Attitude
CS - Focus on Customer Service and do it every day)
what are the 3 principles of Outstanding Customer Relations?
verbal and non-verbal
What are the two ways in which communication occur?
caring
the therapeutic communication technique of using touch conveys ____
think and reflect
the therapeutic communication technique of using silence allows the patient to ___
93
non-verbal accounts for ___% of the message
7
only ___% of the message is based on verbal
Intimate zone
0-18 inches - reserved for close friends, family, children, and those in love
Personal zone
18 inches - 4 feet - allows for confidential conversation, but preserves personal space
Social Zone
4 to 12 feet or greater - used by teachers in the classroom, the boss at a meeting, and the trainer of a program
beneficiaries
ppl who are eligible for healthcare benefits
deductible
an annual amount a patient must pay for care before the insurance begins to share costs:
- out- of- pocket expense for the patient
- affected by pay grade
cost share
portion of the cost of care in which the patient must pay even if care is covered by insurance
- known as co-payment or co-pay
-out-of-pocket expense the patient pays for each visit
Primary Care Manager (gate-keeper)
principle provider for routine medical care who monitors the quality of care and makes referrals for specialty care and tests. Usually a physician or physician group, but could also be a nurse practitioner or physician's assistant
Authorized Provider Network
a group of civilian providers authorized to deliver care to military beneficiaries. Enrollment is usually valid for one year
SQEACC
(SQ - Sustain Quality
EA - Expand Access
CC - Control Costs)
what are the 3 purposes of managed care?
PuRSE
P - Prime
R - Remote
S - Standard
E - Extra
What are the 4 levels of TRICARE?
TRICARE Prime
This level of the TRICARE program is:
o Most medical care is provided at a military treatment facility
o Most care received from an assigned Primary Care Manager (PCM)
o All active duty members are automatically enrolled
o Reserves and quali?ed family mem
TRICARE Prime Remote
This level of the TRICARE program is:
o For active duty service members (ADSMs) who live and work more than 50 miles or an hour's drive from an MTF
o Also available to eligible family members
o Enrollment is required
o PCM referrals required for specialty
TRICARE Standard
This level of the TRICARE program is:
o Utilizes both military and civilian providers to provide care
0 Bene?ciaries may choose their network provider
o Retirees and family members are eligible
o There is an annual deductible and cost share for treatment
TRICARE Extra
This level of the TRICARE program is:
o Care is provided by civilian providers within an authorized provider network
o Retirees and family members are eligible
o Referrals not required for specialty care (some services may require prior authorization)