| Assisted Living | residential care setting where adult patients rent a small 1 bedroom & can receive personal care services like bathing, dressing, admin of meds |
| Residential-Care | Settings serve the older adult population & mentally or physically disabled person & offers a wide variety of services |
| Pallitiave care | Comfort care earlier in an illness or disease process (broader population for hospice |
| Adult Daycare | services are community based programs, to meet the needs of functionally or cognitively impaired adults through supervised health care & social & recreational activities |
| Hospice | Hospice care is provided for terminally ill patients as end of life approaches |
| Activities Of Daily Living (ADLs) | Daily routine of hygiene, dressing & grooming, toileting, eating and ambulation |
| Quality Of Life | an individual's overall well-being & feeling of physical, social, & spiritual happiness |
| Long- Term Care | Array of services an individual may find necessary to help in meeting various personal care needs |
| Diagnosis- Related Groups (DRGs) | this system is based major diagnostic categories & pays a set rate (according to diagnosis) |
| Home Health Care | enables individuals of all ages to remain in the comfort & security of their home while recieving care |
| Telehealth Services | allows for patients & care providers interactions & monitoring through the use of telephones, computers, televisions, and two way monitors |
| Restorative Nursing Care | Basic concepts of physical therapy for maintenance of functional mobility and physical activity |
| Minimum Data Set (MDS) | provides a system for assessment of each resident's functional, medical, mental, & psychosocial status upon admission and after |
| Residential Assessment Instrument (RAI) | Comprehensive tool that includes the minimum data set, resident assent protocols & guidelines for functional assessment of residents |
| Functional Assessment | the assessment of functional status of the patient, which is the ability of individual to perform normal, expected, or required activities of daily living |
| Skilled Nursing Care | the provision of care by a team of trained and/ or licensed health care providers |
| Subacute Unit | Institutional setting that's less expensive than acute care; a bridge between acute care & long term care |
| Medicaid | program pays for home care services to indigent & low income people of all ages |
| Instrumental Activities Of Daily Living (IADLs) | Complex daily tasks; shopping, using the phone, assistance with meds, tube feeding, oxygen therapy |
| Accreditation | a process where by a professional associate or nongovernment agency grants recognition to a school or institution for demonstrated ability in a special area of practice or training |
| Certification | Process in which an individual or institution, agency, or educational program is evaluated & recognized as meeting certain predetermined standards |
| Continuing Care Retirement Community (CCRC) | A complete range of housing & health care accommodations, from independent living to 24 hr nursing care (usually good health & need little assistance) |
| Medicare | is a federal program that requires agencies to be certified as meeting the federal conditions of participation ( 65 yrs or older, disabled, or have end stage renal disease & under the care of a licensed physician) |
| Omnibus Budget Reconciliation Act (OBRA 1987) | Obra defines requirements for the quality of care given to the residents & many aspects of the institution life ( nutrition, staffing, qualifications required of personnel e.t.c) |
| Impairment | any loss or abnormality of psychological, physical, or anatomic structure or function |
| Disability | the loss of ability to participate in one or more major life activities as a result of mental, emotional, or physical impairments |
| Functional Limitations | Any loss of ability to perform tasks or activities of daily living |
| Chronic Illness | a chronic illness generally refers to a condition or state that lasts for 3 moons or longer |
| Exacerbation | an increase in the seriousness of a disease or disorder; marked by the greater intensity in the signs and symptoms being treated |
| Commission on Accredition of Rehabilitation Facilities | A nonprofit private, international standard-setting & accreditation body whose missions to promote & advocate |
| Comprehensive Rehab Plan | Care within 24 hours of admission & have it ready for review & revision by rehab team within 3 days of admission |
| Psychiatrist | Physicians specializing in physical medicine or rehab |
| Multidisciplinary Rehab Team | Discipline- specific goals, clear boundaries between discipline |
| Interdisciplinary Rehab Team | Identify individuals goals & features a combo of expanded problem solving beyond the boundaries of individual discipline |
| Transdisciplinary Rehab Team | a blurring of boundaries between discipline as well as cross-training & flexibility to minimize duplicate of effort toward individual goal attainment |
| Family-Centered Care | a philosophy that a recognizes the pivotal role of the family in the lives of children with disabilities or other chronic conditions |
| Posttraumatic Stress Disorder (PTSD) | Mental health condition related to the experiencing of or witnessing of traumatic even outside the normal range of human experience |
| Spinal Cord Injury (SCI) | An injury in which the spinal cord undergoes compression by fracture or displacement of vertebrae |
| Traumatic Brain Injury (TBI) | From mild concussion to more devastating kind that renders injured people comatose for the remainder of their lives |
| Pediatric Rehab Nursing | is a specialty practice that also continues to expand within the field of rehab for children |
| Gerontologic Rehab Nursing | A specialty practice that focuses on the unique requirements of older adult rehab patients |
| What did community based care lead to? | Increased number of acutely ill patients and change in home health care. |
| what is needed for HMO ( insurance to cover home care) | patient must be homebound meaning unable to travel or lots of effort to travel to and from appointments |
| What percent of patients are over 65 for home health? | 82% |
| what percent of pattens are 85 or older? | 26% |
| What has enabled more care to be delivered in the home? | Advanced technology |
| what determines how often and how long home visits are? | depending on the services need can be as often as twice daily or monthly |
| What does home health care preserve? | individual independence, integrity, and keeps families together. |
| what are the different prospective view from home health? | Official comprehensive health care, Patient compassionate care, Family keeping families together, provider challenges all discipline involved to provide excellent care. |
| When did Medicare become effective? | 1966 |
| BBA 1977 | Balanced Budget Act |
| IPS | Interim Payment System |
| What are agencies classified as? | Tax status (profit or non profit), Location (freestanding or institution), Governance ( private or public) |
| PICC line care? | Peripherally Inserted Central Catheter |
| What does the use of technology do? | allows patient care outside of the traditional inpatient settings |
| what does the social worker do? | Provide assistance with patients emotional, financial, and household problems. |
| How does a social worker help nurses? | social workers do more patient home needs and that allows the nurse more time to perform nursing interventions |
| what does pet care have to do with home health? | provide pet care " Durable Power Of Attorney For Pet Care" (special pet services like transportation to the vet. |
| what are one of the more rapidly growing segments of Home Health? | Infusion Therapy |
| TPN | Total Parenteral Nutrition |
| What are three of the most common if IV therapy? | Antibiotics, Hydration, Total Parenteral Nutrition (TPN) |
| What has the list of IV meds grown to include? | Analgesics,Chemotherapeutic agents, Hormones, Antiemetic agents |
| What are some of the services Home Health offers to follow the basic Medicare services? | Skilled Nursing, Physical Therapy, Speech-language Therapy, Occupational Therapy, Medical Social Service, Home Health Aide |
| Who does the LVN/LPN provide care under? | A RN who is also responsible for the development of the care plan |
| what are four major goals of skilled nursing services? | Restorative: returning previous, Improvement: achieving better health, Maintenance: preserving current health, Promotion: teaching health and prevent recurring illness |
| What is crucial for nurses caring for patients in home health? | Reliability, communication, ongoing assessment and reinforcement of the care plan accepting different culture plans. |
| who makes the initial admission and evaluation for home health after a referral? | The RN within 24-48 hours unless nursing care is not needed right away the physical therapist may do it |
| When is discharge and planning done? | discharge for home care, as in hospitals, begin with admission when patient goals or other criteria are met the discharge begins |
| What are three major goals to improve quality in home health? | Structural: overall organization, Process: care delivery, Outcome: results of patient care |
| What is the standard of care for many illness? | Management and control rather than cure |
| How is federal and private insurance trying to stop the rising cost of health care? | By shortening hospital stays and controlling admissions |
| What does acuity mean | How sick a patient is |
| When is there a need for long term care? | when a patient is not capable of meeting daily needs independently, perhaps because of a physical or psychological impairment |
| Culture is a system of what? | Values, beliefs, and practices that guides a persons behavior |
| define Ethnicity? | is a persons identification with a certain ethnic group ( based on shared traditions, physical characteristics, origin, language, religion and food |
| Who is majority of the elderly living at home? | Women because the age expectancy is higher for women then men |
| PACE? | Program of All-Inclusive Care for the Elderly |
| Whats is Respite Care? | Rescue Care to give family members or caregivers a break |
| Who is usually the director of Adult Daycare? | Social worker or RN |
| Who usually attends adult daycare? | Adults over 75 or disabled adults |
| NCAL | National Center for Assisted Living |
| What does CCRC offer? | apartments, townhomes, detached dwellings or a combination |
| What does the nursing interventions depend on in CCRC? | Functional abilities of the elder adult |
| What is the reward for nursing working long term care for CCRCs? | the opportunity of working with patients over a long time frame |
| Whats does a subacute unit mainly focus on? | Rehabilitation and shorter length of stay than long term care |
| Who does ICU care for? | Patients conditions who are so critical they would have not survived |
| What is some of the most common care in subacute care? | Physical rehab, Stroke rehab, wound care, Recovery from hip fracture |
| What does Long-Term care mostly provide? | 24 hour care and usually to adults 65 or older |
| What are most common disorders or illness in long term care? | Cardiovascular disease, Hypertension, Depression, Dementia, Type 2 diabetes |
| What are some other reasons other than illness why an older adult might enter long term care? | Cognitive impairment, incontinence, assistance with ADLs, Alzheimer's, safety |
| ICPs | Interdisciplinary Care Planning |
| OBRA | Omnibus Budget Reconciliation Act |
| Who is the DON in longterm care? | A RN |
| What's the window for legal administration for meds in longterm care? | 2 hours: 1 hour before scheduled time or 1 hour after scheduled time |
| what does restorative nursing assistance forces on? | basic concepts of physical therapy to maintain functional mobility and physical activity |
| HCFA | Health Care Financing Administration |
| What are some positive outcomes of OBRA? | empowerments of residents, reduce or eliminate restraints, improve staffing |
| How did the OBRA law effect nursing? | expand the role of LVN/LPN and required facilities to use greater numbers of licensed nursing staff |
| What does MDS provide? | A system for assessment of residents functional, medical, mental, psychological status upon admission and after |
| What are RAPS? | Assessment guides that are address common clinical problems such as delirium, falls and urinary incontinence |
| What is rehab nursing for? | Support patients in restoration of health state or adapt changes from chronic illness, disability or injury |
| who is involved in the rehab team? | Patient, Physiatrist, Rehab RN, Rehab LVN/LPN, Physical Therapist, Occupational Therapist, Speech-language pathologist, Therapeutic recreation therapist, Clinical psychologist, Chaplain, Counselor |
| what are a few roles of Rehab nurse? | Educator, provider of care, collaborate, patient advocate |
| 5 step guide for nursing intervention | assess the patient, plan intervention, implement education plan, document process, evaluate and revise |
| what are some of the issues in rehab care? | quality of life vs quantity of life, care vs cure, high cost of interdisciplinary care vs long term care |
| What is cardiac rehabs focus? | meet the needs of patient through exercise, education, healthy living, counseling in stress reduction |
| What is he focus of pulminary rehab? | exercise, diet & nutrition, education lung disease process, breathing techniques |
| define PT/BRI | Polytrauma-Blast related Injury |
| What are primary blast related injuries? | compression damage from high explosive blast: air filled cavities in the body ( ears, lungs, gastrointestinal traction fluid on the brain or spinal cord) |
| Define secondary blast related injuries? | injures from airborne debris, bomb fragments, shrapnels embedded in body parts |
| Define tertiary blast related injury? | an injury from being thrown as a result of explosive shock wave, injures include broken bones, head and spinal injuries |
| define quaternary injuries? | Inhalation and exposure to toxic chemicals, traumatic amputation of limbs and burns |
| before 1980 what was PTSD known as? | Shell shock or war neurosis |
| when did PTSD become accepted as a psychiatric diagnosis | after the Vietnam War |
| Without treatment for PTSD what can it lead to? | other mental health problems such as depression anxiety, alcohol or drugs, suicidal thoughts or actions |
| what does therapeutic communication techniques include? | listening, reframing, normalizing responses, developing trust |
| what should nurses be aware of when caring for trauma patients? | their own reactions, emotions and communication skills |
| what should a nurse do who is feeling really overwhelmed? | consult with mental health provider |
| Complete spinal cord injury (SCI)? | no motor or sensory function below the injury |
| incomplete Spinal cord injury (SCI) | some or all motor sensory function below injury |
| Quadriplegia? | damage to the cervical spin r neck that causes weakness or paralysis in all 4 extremities |
| paraplegia? | damage below the cervical are that involves weakness or paralysis in the trunk or lower extremities |
| paresis? | a slight paralysis, incomplete loss of muscular power or weakness of the limbs |
| what are the three catagories of SCI? | Cervical cord injury, thoracic cord injury, lumbar cord injury |
| c4 injury and affected cords? | below the neck, cervical cords affected c1-c4 |
| c6 injury and affected cords? | below the shoulders, cervical cords affected c6-c8 |
| t6 injury and affected cords? | below the chest, thoracic cords affected t6-t9 |
| L1 injury and affected cords? | legs and below, lumbar cords affected L1-L5 |
| what are the Sacral cords and what do they affect? | S1-S5 and full ambulation but affects bladder control and driving |
| What are some common medical complications for patients with SCI? | postural hypotension, autonomic dysreflexia, heterotrophic ossification, deep vein thrombosis |
| what is the normal bp of a quadriplegic | 90/60 or lower |
| why is bp so low for a quadriplegic? | sitting in chair results to pooling of the blood in lower extremities and abdominal area |
| what can you do to lessen hypotension for a quadriplegic? | raise head of bed for 15 mins before moving to chair, use elastic stockings such as ted hose or abdominal binders |
| why does patients with spinal cord lesions above t5 injury sometimes experience sudden and extremely high bp? | reflux action of the autonomic nervous system, stimulation of body below injury |
| what are some symptoms of autonomic dysreflexia? | high blood pressure, shivering or goose bumps, flushing of the skin and severe headaches |
| what is the treatment for autonomic dysreflexia? | find and remove the source of irritation and bp will go back to normal within a few minutes |
| what is heterotopic ossification? | abnormal formation of cells and joints |
| define deep vein thrombosis (DVT) | blood clots in the leg caused by slowing of circulation or alteration in blood vessel walls |
| what are some clinical signs of DVT | Localized swelling, redness, heated area involved |
| what can happen with aggressive movement of then leg or legs with DVT? | possibly detach blood clot |
| what is an embolus? | lodge clot lodged in the lung(s) |
| what is an anticoagulant? | blood thinner which can help prevent DVT |
| what is the primary goal to treating a patient with traumatic brain injury (TBI)? | restore the patient to the highest possible level of independent function |
| mild concussion? | brief of no loss of consciousness |
| moderate brain injury? | a period of unconsciousness ranging from 1-24 hours |
| severe brain injury? | Unconsciousness or posttrauma amnesia for more than 8 days |
| Catastrophic brain injury? | coma lasting several months or longer |
| What is primary goal of gerontologic rehab nursing goal? | Achieving their optimal level of health and well being through holistic care |
| what two things does a gerontologic rehab nurse strive for? | rehab care and teaching preventions |
| who stated " it is one of the most. beautiful compensations of tis life that no man can sincerely try to help another without helping himself" | Ralph Waldo Emerson (1803-1882) |
