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  1. Ambulatory healthcare/Community based healthcare is by far the fastest growing segment of
    the healthcare industry
  2. It is understood that primary client care may be delivered by either a physician or by other PCP.  Persons such as: --select all
    • Clinical nurse specialist
    • Advance practice nurse
    • Trained physicians assistant
    • Osteopathic physicians
  3. Func. of Nurse in ambulatory care:
    • *Initially triage all clients to determine clinical acuity and the need to be seen immediately.
    • *Administer special treatments, such as ultrasound, heat treatments, or application of medicinal creams and ointments
    • *Take basic x-ray films, in some settings
    • *Perform special, non-nursing procedures, such as laboratory procedures, ECGs, postural drainage, and inhalation/nebulizer treatments
  4. Private Clinics
    Because community heath centers are rapidly becoming the healthcare provider for many special population, private clinics tend to see only clients with Insurance
  5. Specialized Clinics, Target population
    In some cases, a clinic may be
    set up only to administer immunizations
  6. Specialized Clinics, Target population
    The mobile clinic or community clinic is the only source of healthcare for many clients.
    Staff members in the mobile clinic pereform the basic tests, in addition to record-keeping.  Staff members also perform a great deal of health promotion and teaching.
  7. The School Nurse is
    • Responsible for recognizing symptoms of common illness
    • Hearing and vision screening
    • Immunizations and TB test
    • Dressing changes
    • Scoliosis, diabeter HBP or asthma treatments
  8. Telemonitoring refers to management of remote care between pt at home and healthcare Professional
    Telemonitorjing applies to the transmission of data, including BP, oxygenation levels, ECG readings, and EEG
  9. Healthy people 2020 describes the idea of the community/family heath center CHC or FHC as a provider of primary care for large segment of the population, particularly underserved populations
    These centers provide access to high-quality primary and preventive care in a cost effective manner, assist clients to manage chronic illnesses, improve birth outcomes and provide employment for the local community
  10. Healthy People 2020 Goals
    • Cancer - reduce new cases
    • Disability and Secondary Conditions - promote health on disabled, eliminate disparities
    • Food Safety - reduce foodborne illness
  11. CHC or FHC are different from other healthcare provider because :
    Services are tailored to fit the special needs and priorities of the community
  12. National Association of Community Health Centers (NACHC) estimates that:
    CHC are the only available source of primary hc for millions of people in the US.
  13. CHC, Role of Advance practice Nurse
    Provide most of the primary care to clients in the CHC --family doctor
  14. CHC, For many of these chronic disorders, providers are:
    required to follow specific care protocols
  15. Emer Dept
    Free standing clinics usually treat:
    only vertical clieants (clients with non critical condition); they refer more critically ill or injured clients to hospital EDs
  16. Staff in ED perform
    • Apply cold or warm packs and perform other noninvasive procedures
    • Administer meds as ordered: This may include emergency meds during triage, as well as more routine injections, such as tetanus toxoid, immunizations, or antibiotics
  17. Pick up forceps
    used for laporoscopy
  18. Class III example --select all
    • Total colon resection
    • radical mastectomy
    • coronary artery bypass
    • hysterectomy with anterior and posterior repair
    • total gastric (stomach) resection
    • total pneumonectomy (lung removal)
    • craniotomy and removal of brain tumor
    • limb amputation
    • bone marrow transplant
    • repair of coronary septal defects
    • replacement of heart valves
    • heart, liver or lung transplant
  19. The determination of candidates for ambulatory surgery is based on factors such as
    • client condition
    • client age
    • complexity of the procedure (usually should be shorter than 90 minutes)
    • availability of after care
    • existence or absence of underlying physical or mental disorders
  20. Nurse in same day surgery must
    • make sure the client is wearing 1 or 2 name bands, per agency protocol. (an allergy band must be worn whether or not pt has allergies)
    • Have the pt state his or her name and birthdate and what procedure is being done. Double check this with the pt name bands and medical record
    • Make sure pt signs the operative permit before they receive any medications.
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