CAPA/CPAN Review
Nursing Process - ANS-Assessment-gathering info/data; asking questions to gather this
info/data
Diagnosis
Identification of Outcomes
Planning-future tense; patient is subject, achieve overall goal
Implementation- nurse is subject, present tense.
Evaluation
DNR vs AND - ANS-DNR can WITHHOLD Palliative care
AND includes it
Ethical Principles - ANS-Autonomy-freedom of action chosen by individual
Beneficence- doing good
Nonmaleficence- do no harm
Justice- duty to be fair to all people
Veracity- truthfullness or accuracy
Fidelity- loyal or faithful
Biot's respirations - ANS-rapid gasps followed by apnea
Usually brain insults (ex. traumas)
=Increase ICP
Cheyne-Stokes respiration - ANS-gradual increase and then decrease in breathing
followed by apnea
Increase ICP
usually Cardiac problems
Statutory Law - ANS-legislative acts declaring, commanding, or prohibiting something
written laws where you can go and reference it
ex. driving over the speed limit
Common Law - ANS-patient bill of rights
derived from principles rather than rules and regulations
,Civil Law - ANS-Based on rules and regulations
Court action lawsuits (most common)
Wrong doing
Tort Law - ANS-wrongful doing
involves compensation to those wrongfully injured
assault/battery/negligence; alarm silencing
Criminal Law - ANS-Harmful or offensive to society as a whole
ex. practicing nursing/medicine without a license; harming patients on purpose
Informed consent** - ANS-Consent obtained after the patient has been fully informed by
the physician about the risks and benefits of the treatment, alternatives, and
consequences of no treatment
*can be withdrawn at any time; even at the last second
*If signing after narcotic/benzo given-must wait at least 1/2 the half-life of the drug
*Is the patient knowledgeable, willing, competent
Informed Consent (cont)** - ANS-Competent to Sign: legal adult, minors with
parent/guardian, emancipated minor (married or in armed forces).
Exceptions: pt is unable to give consent and is a threat to life/emergent (IMPLIED
CONSENT)
**Must have documentation of emergency in staff notes
**Malpractice - ANS-Elements needed to claim medical malpractice:
Duty owed patient
Breach of duty owed patient
Causation - most difficult to prove
Injury/Damages
Intentional Torts - ANS-Violating patient rights; No actual harm necessary.
3 most common:
Assault-place person in fear of being touched
Battery-Touch without permission
False imprisonment-unjustified detention
Intentional Quasi Torts - ANS-No intent to injure or cause distress to another person.
Ex: Patient abandonment, defamation of character, invasion of privacy, breach of
confidentiality
,**Staffing Ratios - ANS-Staffing ratios see pg. 864
ISO patients 1:1
Peds <8 yo unconscious = 1:1 regardless of parent.
( if they have parent and stable you can have another patient)
1:1 New phase 1 admission (fresh out of OR), unstable hemodynamically, unstable
airway
PreAdmission - ANS--usually phone call is done 2 weeks prior to surgery
-written instructions should be at 5th grade level
-Med Rec starts at 1st PAT visit when MD decided pt needs surgery
Med History (AntiCoags) - ANS-*AntiCoag therapy, NSAIDs, Aspirin should be stopped
Aspirin-stopped up to 7 days prior
Coumadin-stopped 5 days prior (coags taken immediately before surgery)
Dipyridamole (Persantine)- stopped 2 days prior
*Interfere with plt function: Indomethacin, tricyclic antidepressants, phenothiazines,
furosemide, steroids
Med Rec (Held vs. Taken Day of Surgery) - ANS-Held Day of:
Diuretics, insulin, oral hypoglycemic, MAOI antidepressants
Taken Day of:
Cardiac, antihypertensives
Beta Blockers
Ca Channel Blockers
Anticonvulsants
Chronic Pain Meds
Increase AntiCoag(More Bleeding):
-Ginko*, feverfew, garlic, ginger, ginseng, Vit E, fish oil, saw palmetto
, Decreases AntiCoag (more clotting)
-St John's wort*, ginseng, green tea
(more risk for DVT, PE, MI, Strokes)
Barbituates and benzos
Increases Effect: St johns wart (prolongs emergence)
Decreases Effect: sarsaparillae
Diagnostic Tests: CBC Labs - ANS-Indications for this test:
Infections
autoimmune diseases
alcohol abuse
blood disorders (anemia, coagulopathies, chronic disease states)
Expected large EBL or recent significant blood loss.
Diagnostic Tests: BMP vs CMP Labs - ANS-Indications for this test:
BMP:
Chronic Renal Failure
HTN
Heart Disease
any disease with potential fluid/electrolyte disturbance
COPD or OSA
CMP:
Chronic renal or liver disease (Liver function tests)
Malnutrition (albumin)
Usually ordered for Addiction patients (usually have low albumin levels)
Ca level (ionized "free floating calcium")
More Diagnostic Tests - ANS-ECG/EKG:
any cardiac hx patient
Hx of CVA or TIA
DM
Smoker long term
PV disease
Pregnancy Test:
Females of childbearing age
(1st to last menses +1 year WITHOUT breakthrough bleeding)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller denicetho. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.53. You're not tied to anything after your purchase.