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acute illness
an illness one will recover from
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assisted living residence
povides housing,care, support services, and assists with daily activities
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case management
a nursing case manager coordinates the cae of specific groups of patients from admissions to discharge
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chronic illness
slow on going illness that cant be controlled and has no cure
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functional nursing
nursing care pattern focusing on tasks and jobd
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licensed practical nurse/LVN
a nurse who has completed a practical nursing program and has been passed a licensing test
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CNA
performs tasks under the supervision of licensed nurse and nursing assistant training
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patient focused care
a nursing care pattern, services are moved from departments to the bedside
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primary nursing
an RN is responsible for the persons total care
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surveyor
a person who collects info by observing and asking Qs
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team nursing
a team of nursing staff is led by a RN who decides the amount and kind of care each person needs
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the purpose of health care agencies (4)
- health promotion
- disease prevention
- detection and treatment
- rehab and restorative care
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7 types of agencies
- hospitals
- rehab and sub-acute care agencies
- long term care centers
- ALR
- mental health center
- home care agencies
- hospice
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long term care centers are designed for
persons who cannot care for themselves at home but do not need hospital care
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rehab and sub-acute care agencies are designed for
people who d not need hospital care but are too sick or disabled to go home
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ALR are designed for
nursing centers or retirement communities where they have a room and 24 hours supervision is given
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mental health centers are designed for
those who have problems with life events or are in danger to themselves or others because of how they think or behave
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home care agencies are designed for
health care services are provided to people where they live
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board of directors/trustees do what
- they are a governing body of an agency
- they make policies and make sure safe care is given at the lowest possible cost
- administrator manages the agency and reports to the board
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audiologist
tests hearing, prescribes hearing aids, works with those who are hard of hearing
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cleric
assists with spiritual needs
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clinical nurse specialists
advanced practice RN who consults in a specialty (i.e. geriatrics)
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dental hygienist
cleans teeth and provides preventative care
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dentist
treats problems with the teeth, gums, and mouth
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LVN
provides nursing care and gives drugs under RNs direction
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medical/clinical lab tech
collects specimens. Performs lab test on blood, urine, etc
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med records and health info tech
- maintains med records and transcribes med records
- codes patient info for billing purposes
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medication assistant certified
give drugs allowed by state law under the supervision of a licensed nurse
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nurse prac
- advanced practice RN in a nurse specialty
- does physical exams, diagnoses common health probs, and prescribes drugs and treatment
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occupational therapist
assists persons to learn or retain skills needed for daily living
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occupational therapy assistant
performs tasks and services supervised by an OTR
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speech and language pathologist
diagnosis and treats comm and swallowing disorders
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DON is responsible for
entire nursing staff and nurse care given
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nursing care pattern (5)
- functional nursing
- team nursing
- primary nursing
- case management
- patient focused care
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programs that help pay for health care (4)
- private insurance (bought by person)
- group insurance (bought by group or organ)
- medicare (federal program for persons 65+)
- medicaid (low income)
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prospective payment systems
- limit amount paid by insurers, medicaid, medicare
- the amount is determined before care. If amount is less the agency pockets, if more, they accept the loss
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an agency must meet standards for (3)
- licensure (agency must have a license)
- certification (needed to receive funds from medicaid/care)
- accreditation (voluntary, signals quality and excellence)
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surveys
are done to see if standards are met
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what does the survey team do (6)
- review policies and procedures
- interview staff and patients
- observe how care is given
- observe if dignity and privacy are promoted
- check for cleanliness and safety
- make sure staff meets state requirements
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if the surveryors see the agency meets standards they will license, accred, or certify them. If not they will give the agency 60 days or fine them or lose license
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endorsement
a state recognizes the certificate, license, or registration issued by another state
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california code of regulations title 22, division 5, OBRA (4)
california state laws enacted by legislature to establish licensing and cert standards of health facilities, minimum stands of care for residents, regs which govern the CNA training program, and CNA certif requirements-initial and renewal
- skilled nursing facility must be licensed
- must have policies and procedures to ensure residents rights and safety
- violations of title 22 may lead to issuarance of state citation with a monetary fine
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OBRA of 1987 was established because
it requires that nurse ais receive training and pass a competency exam within four months of employment in a skilled nursing facility
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violations of federal regulations of OBRA may lead to these (6)
- loss of facility to provide CNA training
- money penalties
- directed in-services
- denial of payment
- state monitoring
- termination of facility license
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the complete CNA training course requirements (5)
- min 53 hours of mandatory theory
- 103 hours of clinical training at a nursing facility
- content of course must cmply with title 22 and OBRA
- students who are employees must be paid hourly while in training
- criminal screening prior to clinical training
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certification of cna renewal requirements (2)
- complete DHS renewal application
- complete 48 hours of approved continuing education every 2 years
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function of the nurse practice act (3)
- defines RN an LVN and their scope of practice
- defines RN and LVN education and licensing requirements
- protects the public from persons practicing nursing without a license
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OBRA requires 75 hours of instruction and at least 16 hours of practical training
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OBRA requires nursing assis registry in each state and there is an official record of those people and their info and they can be accessed by any health care agency
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4 reasons behind losing certification, license, or registration for CNA
- substance abuse
- fraud
- stealing
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rules for CNAs (8)
- assis nurse
- nurse asigns work
- report patient changes
- you dont make decisions
- review care plan prior to patient care
- perform tasks trained to do
- ask nurse to supervise yu
- perform tasks allowed by job desp and state
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Role limits of a CNA (8)
- never give drugs
- never insert or remove objects from body
- never take oral or phone orders from doc
- never perform procedures requiring sterile tech
- never tell personor family of diagnosis or treatment plans
- never supervise others CNAs and persons
- never ignore a request
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RNs delegate tasks to you and no one else. If the RN delegates the task, the RN is responsible for that task
RN supervises the LVN so any tasks delegated by the LVN to the CNA makes the RN responsible
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delegate decisions must result in the best care for the person
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4 steps of the delegation process
- assessment/planning
- communication
- surveillance/supervision
- evalution and feedback
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assessment and planning of delegation (2)
- nurse collects info about person's needs and your skills and knowledge
- nurse decides if it is safe to delegate task
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communication of delegation (4)
- you and nurse discuss task
- nurse makes sure you understand directions
- you communicate Q, concerns, and progress to nurses
- report and record care
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surveillance and supervision of delegation (2)
- nurse observes, confirms tasks are completed correctly, and monitors the person's response
- nurse follows up on problems and concerns
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evaluation and feedback of delegation (3)
- nurse decides if delegation was successful
- nurse makes changes about possible changes in the persons care
- nurse provides feedback on how you complete the task
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5 rights of delegation
- the right task
- the right circumstances
- the right person
- the right supervision
- the right direction and communication
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accepting: when you agree to perform a task you are responsible for your own actions. You must complete the task safely and ask for help if unsure
refusing: you have the right to say no if it goes against what you know, were taught, cause harm, no nurse for supervision
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abuse
willful infliction of injury, confinement, intimidation, or punishment that results in physical harm or pain
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assault
intentionally attempting or theatening to touch a persons body without their consent
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battery
touching a body without their consent
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boundary sign
acts behaviors or thoughts that can be considered boundary crossing
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boundary violation
act that meets your needs not theirs
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civil law
laws concerned with relationships between people
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code of ethics
rules for group members to follow
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ethics
knowledge of what is right conduct and wrong
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intimate partner violence
a type of abuse or harm caused by a current or former partner
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invasion of privacy
violating persons rights to not have their name or photo taken without consent
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libel
making false statements in print, writing, pics, social media, etc
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malpractice
neg by professional person
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neglect
failure of responsible persons to provide protection from vulnerable elder
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professional boundary
that which separates helpful behaviors from behaviors that are not helpful
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professional sexual misconduct
an act or behavior or comment that is sexual in nature
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protected health info
identifying info and info about the persons health
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self neglect
a persons behavior or way of life that is threatening to their well being
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slander
making false statements through spoken word or gestures
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defamation
injuring persons name and reputation by making false statements to a third person
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standard of care
skills, care, and judgments required by a health team member under similar conditions
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vulnerable adult
a person 18 y.o.or older who has a disability or condition that makes them more prone to being attacked
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boundaries create a helpful zone, if you're under involved (3)
- disinterest
- avoidance
- neglect
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bondary violations include (3)
- abuse
- giving a lot of info about self
- keep secrets with person
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standards of care come from (7)
- law
- texts
- agency policy books
- manufcturers instructions
- job description
- approval and acred agency
- standards and guidelines from gov agencies
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defamation sub terms
- libel - false statements in print
- slander - making false statement verbally
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electronic communications rules (2)
- do not contact patient outside of work
- dont use electronic comm to share or discuss workplace issues
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consent if informed when the person understands (7)
- reason for procedure
- what will be done
- how it will be done
- who will do it
- expected outcomes
- other treatment options
- effects if no treatment
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8 forms of elder abuse
- physical
- neglect
- verbal
- involuntary seclusion
- financial explotation/misappropriation
- emotional/mental
- sexual
- abandonment
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involuntary seclusion
confining a person to a certain area
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financial explotation
using someone elses money for your benefit
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types of child abuse and neglect (6)
- physical
- neglect
- sexual
- emotional
- substance
- abandonment
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4 types of neglect child
- physical - provide food or shelter
- medical - dont provide medical needs
- educational - failure to educate children
- emotional - not meeting the childs needs for affection
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5 types of sexual abuse child
- rape/sexual assault
- molestation
- incest
- child porn
- child prostitution
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emotional abuse child
injuring child mentally of their self worth. constant criticism and rejection
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substance abuse for child (7)
- make sub in presence of child
- make sub in area occupied by child
- allowing child to be present when equipment to store or sell sub is aroun
- sell sub to child
- use sub that impares caregiver to care for child
- expose child to supplies for sub
- expose child to drug related activities
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types of intimate partner violence (4)
- physical
- sexual
- threats of physical or sexual violence
- psychological and emotional violence
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3 type of sexual violence
- physical force to engage person in sex
- sex act with person unable to understand act or unable to decline
- abusive sex conact
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8 examples of psychological and emotional violence
- humiliation
- controlling actions of victim
- keep info from victim
- denying victim access to basic needs
- stalking
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