NURS 640 Exam 1
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Terms in this set (119)
Chronic care model focuses on improving care for chronic diseases. 1.
Delivery of high quality care requires a range of
strategies that must closely involve and engage the
patient. 2. Team care is essential.
Transitional Care Model (TCM) APN provides comprehensive in hospital planning
and home follow up care coordination, including
training and support for nurses by a
multidisciplinary HF team. Care plans developed by
nurses in collaboration with pt physicians that
reflect pt and caregiver goals and evidence based
guidelines; pt and caregiver education;
coordination of care across settings; and nurse
delivered clinical services including medication
management.
,Care Transitions Intervention (CTI) A transition coach (RN or APN) provides tools and
teaches self-management and communication skills
to pt and caregivers so they can coordinate their
care and follows up with home visit and telephone
calls. CTI focuses on medication self-management;
pt assembled personal health recorded, primary
care and specialist follow up and teaching the pt
how to recognize and follow up on ref flag
symptoms.
Re-Engineered Discharge (project nurse discharge advocate provides; pt education,
RED) medication reconciliation and education;
instruction about red flags; teach back learning
process; coordination of physician appointments
and follow up testing; EBP written discharge plan
shared with pt and all providers. A clinical
pharmacist follows up by telephone to reinforce
discharge plan, review medications and solve
problems.
Enhanced Discharge Planning master prepared workers with experience in
program (EDPP) geriatric and community based practice provide a
phone based intervention to supplement the
existing discharge process; pre discharge review of
pt chart and consultation with pt providers about
potential barriers to successful transition; follow up
phone call to assess pt ability to adhere to
discharge plan and to determine if medical and
social services specified in the discharge plan have
been received; to identify medication problems
and adherence, ensure knowledge of red flags. The
EDPP model emphasizes addressing psychosocial
and medical issues that emerge after discharge.
,Medical decision making making is a process that you are continuously
evaluating and refining based on new data you
obtain. To be particularly skilled in this, you must
be cognizant of the biases you may bring to your
evaluation of the patient's case and the human
errors that can occur during the course of
evaluation management. A good clinician looks at
both for their own errors and the errors of
colleagues and make the necessary corrections to
avoid harm to the patient.
full compensated Is pH normal? PaCO2 and HCO3 abnormal
uncompensated. pH abnormal? PaCO2 or HCO3 abnormal
Mild PAO2 60-79 mmHg
Moderate PaO2 40-59mmHg
Severe PaO2 < 40mmHg
Metabolic Acidosis Lactic acidosis, ketoacidosis (diabetic, alcoholic,
starvation), toxins (methanol, salicylates) renal
failure (acute or chronic)
Respiratory alkalosis § hypoxia (decreased inspired oxygen, high
altitude, ventilation, hypotension, severe anemia)
§ CNS-mediated disorders (hyperventilation,
anxiety, neurologic disease, CVA, infection, trauma,
tumor, drugs, heat, hepatic failure)
§ Pulmonary disease (interstitial lung disease,
pneumonia, PE, pulmonary edema)
§ Mechanical overventilation
, Metabolic alkalosis Excessive body bicarb content (renal alkalosis,
Gastrointestinal alkalosis)
Pulse oximetry Measures peripheral arterial oxygen saturation.
AKA "the fifth vital sign." In most patients peripheral
oxygen saturation as measured by pulse oximetry
(SpO2) provides accurate information on tissue
oxygenation, which allows the clinician to assess
and treat patients who are potentially hypoxemic.
As a general principle, clinicians should pay
attention to trends on oxygenation and when
treating patients with supplemental oxygen for
hypoxemia, clinicians should target levels that are
desirable for the specific etiology, while
simultaneously avoiding oxygen toxicity. A target
level of 88 to 92 percent may be sufficient in a
patient with an acute exacerbation of chronic
obstructive pulmonary disease (COPD) who is
chronically hypercapnic.
Arterial blood gas interpretation ●pH - 7.35 to 7.45
normal values ●PaCO2 - 35 to 45 mmHg (4.7 to 6 kPa)
●HCO3 - 21 to 27 mEq/L
Respiratory acidosis a disturbance in acid-base balance usually due to
alveolar hypoventilation that can be acute or
chronic. It is characterized by an increased PaCO2
>45 mmHg (hypercapnia) and a reduction in pH
(pH <7.35).
Save
Terms in this set (119)
Chronic care model focuses on improving care for chronic diseases. 1.
Delivery of high quality care requires a range of
strategies that must closely involve and engage the
patient. 2. Team care is essential.
Transitional Care Model (TCM) APN provides comprehensive in hospital planning
and home follow up care coordination, including
training and support for nurses by a
multidisciplinary HF team. Care plans developed by
nurses in collaboration with pt physicians that
reflect pt and caregiver goals and evidence based
guidelines; pt and caregiver education;
coordination of care across settings; and nurse
delivered clinical services including medication
management.
,Care Transitions Intervention (CTI) A transition coach (RN or APN) provides tools and
teaches self-management and communication skills
to pt and caregivers so they can coordinate their
care and follows up with home visit and telephone
calls. CTI focuses on medication self-management;
pt assembled personal health recorded, primary
care and specialist follow up and teaching the pt
how to recognize and follow up on ref flag
symptoms.
Re-Engineered Discharge (project nurse discharge advocate provides; pt education,
RED) medication reconciliation and education;
instruction about red flags; teach back learning
process; coordination of physician appointments
and follow up testing; EBP written discharge plan
shared with pt and all providers. A clinical
pharmacist follows up by telephone to reinforce
discharge plan, review medications and solve
problems.
Enhanced Discharge Planning master prepared workers with experience in
program (EDPP) geriatric and community based practice provide a
phone based intervention to supplement the
existing discharge process; pre discharge review of
pt chart and consultation with pt providers about
potential barriers to successful transition; follow up
phone call to assess pt ability to adhere to
discharge plan and to determine if medical and
social services specified in the discharge plan have
been received; to identify medication problems
and adherence, ensure knowledge of red flags. The
EDPP model emphasizes addressing psychosocial
and medical issues that emerge after discharge.
,Medical decision making making is a process that you are continuously
evaluating and refining based on new data you
obtain. To be particularly skilled in this, you must
be cognizant of the biases you may bring to your
evaluation of the patient's case and the human
errors that can occur during the course of
evaluation management. A good clinician looks at
both for their own errors and the errors of
colleagues and make the necessary corrections to
avoid harm to the patient.
full compensated Is pH normal? PaCO2 and HCO3 abnormal
uncompensated. pH abnormal? PaCO2 or HCO3 abnormal
Mild PAO2 60-79 mmHg
Moderate PaO2 40-59mmHg
Severe PaO2 < 40mmHg
Metabolic Acidosis Lactic acidosis, ketoacidosis (diabetic, alcoholic,
starvation), toxins (methanol, salicylates) renal
failure (acute or chronic)
Respiratory alkalosis § hypoxia (decreased inspired oxygen, high
altitude, ventilation, hypotension, severe anemia)
§ CNS-mediated disorders (hyperventilation,
anxiety, neurologic disease, CVA, infection, trauma,
tumor, drugs, heat, hepatic failure)
§ Pulmonary disease (interstitial lung disease,
pneumonia, PE, pulmonary edema)
§ Mechanical overventilation
, Metabolic alkalosis Excessive body bicarb content (renal alkalosis,
Gastrointestinal alkalosis)
Pulse oximetry Measures peripheral arterial oxygen saturation.
AKA "the fifth vital sign." In most patients peripheral
oxygen saturation as measured by pulse oximetry
(SpO2) provides accurate information on tissue
oxygenation, which allows the clinician to assess
and treat patients who are potentially hypoxemic.
As a general principle, clinicians should pay
attention to trends on oxygenation and when
treating patients with supplemental oxygen for
hypoxemia, clinicians should target levels that are
desirable for the specific etiology, while
simultaneously avoiding oxygen toxicity. A target
level of 88 to 92 percent may be sufficient in a
patient with an acute exacerbation of chronic
obstructive pulmonary disease (COPD) who is
chronically hypercapnic.
Arterial blood gas interpretation ●pH - 7.35 to 7.45
normal values ●PaCO2 - 35 to 45 mmHg (4.7 to 6 kPa)
●HCO3 - 21 to 27 mEq/L
Respiratory acidosis a disturbance in acid-base balance usually due to
alveolar hypoventilation that can be acute or
chronic. It is characterized by an increased PaCO2
>45 mmHg (hypercapnia) and a reduction in pH
(pH <7.35).
