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NUR2115: Fundamentals of 1
Nursing
Final Worksheet
1. HIPAA: Speaking, Sharing, Documenting
Health Insurance Portability and Accountability Act (HIPAA)
- Finalized in 2002
- Most agencies require workers to undergo HIPAA training and to review and sign a
confidentiality agreement when hired and at each performance review.
- Punishments for anyone caught violating patient privacy:
o for financial gain – Fined as much as $250,000 and up to 10 years in jail
o even unintentional violations can carry legal punishment as well as embarrassment
(for you and employer)
Ensures that patients have a right:
- To see and copy their health record
- To update their health record
- To request correction of any mistakes
- To get a list of the disclosures a health care institution has made independent of
disclosures made for purposes of treatment, payment, and health care operations.
- To request a restriction on certain uses or disclosures
- To choose how to receive health information
What is confidential?
All information about patients is considered private or confidential, whether written on
paper, saved on a computer, or spoken aloud.
Includes:
Name
Identifiers: Address, Telephone / Fax Numbers, Social Security Number, Any other
personal information
Reason Patient is sick or in the hospital, office, or clinic
Treatments the patient receives
Information about Past Health Conditions
Protected health information may be found in the patient medical record, computer
systems, telephone calls and voice mails, fax transmissions, e-mails that contain patient
information, and conversations about patients between clinical staff.
Nursing Acts that could constitute as invasion of privacy:
,NUR2115: Fundamentals of 2
Nursing
Unnecessary exposure of patients while moving them through corridor or while caring for
them in rooms they share with others
Talking with patients in rooms that are not soundproof
Discussing patient information with people not entitled to the information
Includes: patient’s employer, the press, or even not authorized patient family
members)
Pressing the patient for information not necessary for care planning
Interacting with the patient family in ways not authorized by the patient
Using tape recorders, dictating machines, computers, and such without taking precautions
to ensure patient confidentiality
Preparing written or oral class assignments about patients without concealing their identity
Carrying out research without taking proper precautions to ensure anonymity of patients
2. Safety
Safety - freedom from danger, harm, or risk – is a paramount concern that underlies all nursing
care.
Patient safety is the responsibility of all health care providers
Factors Affecting Safety
Developmental Level
Children: potential hazards multiply as their motor skills develop and environment
expands.
Toddlers: increasingly active and need appropriate safeguards to prevent falls in the
home.
Adolescents: great dangers: abuse drugs/alcohol; engage in high-risk sexual
activities. The outcomes are devastating:
Alcohol-related motor vehicle accidents – can be fatal
Pregnancy
Sexually Transmitted Infections (STIs)
Suicide
Young & Middle-Aged Adults: drug and/or alcohol abuse – increased risk for those
who are employed in stressful work environments.
Older Adults: altered balance or decline in cognitive abilities are increasingly at risk
to falls and episodes of confusion.
,NUR2115: Fundamentals of 3
Nursing
Lifestyle
Occupation: work environments often contribute to a person’s safety.
Health Hazards:
excessive noise – like construction sites or extremely loud music can
lead to hearing loss
pollution, toxic chemicals or vapors, infectious agents can lead to
upper respiratory tract irritation and inflammation
reproductive hazards for women due to long term exposure to certain
anesthetic agents
Injuries:
Nurses
o Needlestick & blood-borne infections
o Musculoskeletal Disorders resulting from repetitive motions –
includes back pain and carpal tunnel syndrome
Social Behavior: some people are more inclined to take risks and place themselves at
jeopardy for injury, by nature.
Failure to wear seatbelt or follow safety precautions
Failure to wear appropriate protection equipment (glasses, helmets, etc…)
Stress: can lead to alcohol or drug abuse
Environment
Risks in the home, community, and health care agency may cause injury.
Pollutants
Weapons visible in the home
History of past violent behavior in this setting
High crime buildings or neighborhoods
Substance Abuse (either patient or family member)
Situation where child is being considered for removal from abusive
environment
Mobility
Any limitation in mobility is potentially unsafe.
The patient’s inability to move or shift body weight evenly can cause the patient to
develop pressure ulcers and skin breakdown.
, NUR2115: Fundamentals of 4
Nursing
Muscles – are strong and have a purpose; when not used, leads to atrophy
(degermation or wasting away of muscle, cells, etc…);
Cardiac: Heart Activity; Smooth: Hollow Organs; Skeletal: Bones, Tendons
Muscles are used for:
o Movement and Alignment – Body Posture, Balance, Coordinated
Movements
o Body Mechanics – Patient care ergonomics – how we handle
patients
o Development Considerations: birth injuries, attitude/mental health,
injuries/trauma, diseases that may affect the MS system, fatigue
and stress, exercise (how does it affect other systems)
EFFECTS OF IMMOBILITY:
Side effects of immobility: Pressure Ulcers, Pneumonia, Constipation
CV System:
Increased cardiac workload
Increased risk for Orthostatic Hypotension
Increased risk for Venous Thrombosis
Respiratory:
Decreased depth of respiration
Decreased rate of respiration
Pooling of secretions
Impaired gas exchange
Gastrointestinal:
Disturbance in appetite
Altered protein metabolism
Altered digestion and utilization of nutrients
Decreased peristalsis
Urinary:
Increased urinary stasis
Increased risk for renal calculi
Decreased bladder muscle tone
NUR2115: Fundamentals of 1
Nursing
Final Worksheet
1. HIPAA: Speaking, Sharing, Documenting
Health Insurance Portability and Accountability Act (HIPAA)
- Finalized in 2002
- Most agencies require workers to undergo HIPAA training and to review and sign a
confidentiality agreement when hired and at each performance review.
- Punishments for anyone caught violating patient privacy:
o for financial gain – Fined as much as $250,000 and up to 10 years in jail
o even unintentional violations can carry legal punishment as well as embarrassment
(for you and employer)
Ensures that patients have a right:
- To see and copy their health record
- To update their health record
- To request correction of any mistakes
- To get a list of the disclosures a health care institution has made independent of
disclosures made for purposes of treatment, payment, and health care operations.
- To request a restriction on certain uses or disclosures
- To choose how to receive health information
What is confidential?
All information about patients is considered private or confidential, whether written on
paper, saved on a computer, or spoken aloud.
Includes:
Name
Identifiers: Address, Telephone / Fax Numbers, Social Security Number, Any other
personal information
Reason Patient is sick or in the hospital, office, or clinic
Treatments the patient receives
Information about Past Health Conditions
Protected health information may be found in the patient medical record, computer
systems, telephone calls and voice mails, fax transmissions, e-mails that contain patient
information, and conversations about patients between clinical staff.
Nursing Acts that could constitute as invasion of privacy:
,NUR2115: Fundamentals of 2
Nursing
Unnecessary exposure of patients while moving them through corridor or while caring for
them in rooms they share with others
Talking with patients in rooms that are not soundproof
Discussing patient information with people not entitled to the information
Includes: patient’s employer, the press, or even not authorized patient family
members)
Pressing the patient for information not necessary for care planning
Interacting with the patient family in ways not authorized by the patient
Using tape recorders, dictating machines, computers, and such without taking precautions
to ensure patient confidentiality
Preparing written or oral class assignments about patients without concealing their identity
Carrying out research without taking proper precautions to ensure anonymity of patients
2. Safety
Safety - freedom from danger, harm, or risk – is a paramount concern that underlies all nursing
care.
Patient safety is the responsibility of all health care providers
Factors Affecting Safety
Developmental Level
Children: potential hazards multiply as their motor skills develop and environment
expands.
Toddlers: increasingly active and need appropriate safeguards to prevent falls in the
home.
Adolescents: great dangers: abuse drugs/alcohol; engage in high-risk sexual
activities. The outcomes are devastating:
Alcohol-related motor vehicle accidents – can be fatal
Pregnancy
Sexually Transmitted Infections (STIs)
Suicide
Young & Middle-Aged Adults: drug and/or alcohol abuse – increased risk for those
who are employed in stressful work environments.
Older Adults: altered balance or decline in cognitive abilities are increasingly at risk
to falls and episodes of confusion.
,NUR2115: Fundamentals of 3
Nursing
Lifestyle
Occupation: work environments often contribute to a person’s safety.
Health Hazards:
excessive noise – like construction sites or extremely loud music can
lead to hearing loss
pollution, toxic chemicals or vapors, infectious agents can lead to
upper respiratory tract irritation and inflammation
reproductive hazards for women due to long term exposure to certain
anesthetic agents
Injuries:
Nurses
o Needlestick & blood-borne infections
o Musculoskeletal Disorders resulting from repetitive motions –
includes back pain and carpal tunnel syndrome
Social Behavior: some people are more inclined to take risks and place themselves at
jeopardy for injury, by nature.
Failure to wear seatbelt or follow safety precautions
Failure to wear appropriate protection equipment (glasses, helmets, etc…)
Stress: can lead to alcohol or drug abuse
Environment
Risks in the home, community, and health care agency may cause injury.
Pollutants
Weapons visible in the home
History of past violent behavior in this setting
High crime buildings or neighborhoods
Substance Abuse (either patient or family member)
Situation where child is being considered for removal from abusive
environment
Mobility
Any limitation in mobility is potentially unsafe.
The patient’s inability to move or shift body weight evenly can cause the patient to
develop pressure ulcers and skin breakdown.
, NUR2115: Fundamentals of 4
Nursing
Muscles – are strong and have a purpose; when not used, leads to atrophy
(degermation or wasting away of muscle, cells, etc…);
Cardiac: Heart Activity; Smooth: Hollow Organs; Skeletal: Bones, Tendons
Muscles are used for:
o Movement and Alignment – Body Posture, Balance, Coordinated
Movements
o Body Mechanics – Patient care ergonomics – how we handle
patients
o Development Considerations: birth injuries, attitude/mental health,
injuries/trauma, diseases that may affect the MS system, fatigue
and stress, exercise (how does it affect other systems)
EFFECTS OF IMMOBILITY:
Side effects of immobility: Pressure Ulcers, Pneumonia, Constipation
CV System:
Increased cardiac workload
Increased risk for Orthostatic Hypotension
Increased risk for Venous Thrombosis
Respiratory:
Decreased depth of respiration
Decreased rate of respiration
Pooling of secretions
Impaired gas exchange
Gastrointestinal:
Disturbance in appetite
Altered protein metabolism
Altered digestion and utilization of nutrients
Decreased peristalsis
Urinary:
Increased urinary stasis
Increased risk for renal calculi
Decreased bladder muscle tone
