Professional Documents
Culture Documents
Nurses should be aware of what is involved with assisted suicide and euthanasia. You
should think ahead about what your response might be if a patient wants to discuss
these topics. You may find the American Nurses Association (ANA) position statement
on assisted suicide and euthanasia helpful.
An autopsy is a medical examination of the body to determine the cause of death.
When a patient is dying or has experienced a loss, you should perform a thorough,
holistic assessment.
Most grief is normal, not dysfunctional; you should not diagnose Complicated
Grieving for every person who is grieving a loss.
You can facilitate grief work by validating feelings ("It's normal to feel that way") and
providing an opportunity and encouragement to talk about the lost person or object.
At the moment of death, do not interrupt or intrude upon the family; give them as
much time as they need to say good-bye to their loved one. Express your sympathy.
Active dying usually occurs over a 10- to 14-day period, although it can take as little
as 24 hours. During the final 4 to 48 hours, failure of body systems results in death.
When the patient is very near death, focus on relieving physical symptoms and
emotional distress. If the patient can communicate, ask about immediate concerns,
such as, "Who do you want in the room right now?"
Care of the body includes making it presentable for the family, carefully placing
identification tags, and arranging to have the body sent to the morgue.
The death certificate must be signed by the person who legally pronounced the
death (usually a physician).
It is normal for the nurse to feel grief when a patient dies.
biofeedback.
They include dietary therapies, herbs and aromatherapy, and nonherbal dietary
supplements (e.g., probiotics, vitamins, and hormones). These therapies are readily
available and are often practiced in conjunction with traditional healthcare and other
CAMs.
Manipulative and body-based therapies focus on moving the body to improve health.
They include chiropractic, massage, and osteopathy.
Energy therapies manipulate the energy fields that surround the body. They are
among the most widely used forms of CAM. They include therapeutic touch, t'ai chi
and Qigong, Reiki, and magnet therapy. Holistic nursing practice is a theory-based,
relationship-centered, potent solution to a number of problems facing contemporary
nursing and healthcare.
You should facilitate communication about CAM between patients and their
healthcare providers.
As a holistic healer, you should use self-care practices to promote your own health
and wholeness.
You should assess patients' use of CAM and integrate CAM into your nursing care as
appropriate. Encourage practices that are effective but not harmful; "allow" practices
that are safe, but not known to be effective; and discourage practices that are unsafe.
and the patient, (3) fear that your spiritual knowledge is insufficient, and (4) fear of
where spiritual discussions might lead.
Various ready-made tools are available for performing an in-depth spiritual
assessment.
NANDA-I labels describing spiritual needs are Moral Distress, Spiritual Distress, Risk
for Spiritual Distress, Readiness for Enhanced Spiritual Well-Being, Impaired
Religiosity, Risk for Impaired Religiosity, and Readiness for Enhanced Religiosity.
Spiritual Pain is a non-NANDA-I diagnosis that may be useful.
Nursing interventions related to spiritual care require you to be self-aware, fully
present, supportive, empathetic, and nonjudgmental and to have a wish to benefit
the patient.
When a patient asks you to pray, you must determine whether he wishes you to pray
for or with him, and you should ask what he would like you to especially address in
the prayer.
A miracle does not necessarily involve the notion of a cure; miracles are more often
events that proceed according to natural law but still have a powerful impact on the
person's expectations.
Nurses who are open to diversity, who exhibit multiple understandings of religion,
and who fashion for themselves different means of spiritual expression are
comfortable in the spiritual care domain.
promotion activities may be conducted in acute care facilities, the workplace, local
communities, or schools.
A health promotion assessment involves obtaining a health history, physical
examination, fitness assessment, lifestyle and risk appraisal, life stress review,
assessment of healthcare beliefs, nutritional assessment, and screening activities.
Health screening activities are designed to detect disease at an early stage so that
treatment can begin before there is an opportunity for disease to spread or reduce
the quality of life.
Health screening activities vary based on developmental stage and identified risk
factors.
Nurses promote health through role models, counseling, health education, and
providing and facilitating support.
exceptionall standards have been met and the patient has responded as expected.
Paper and electronic flow sheets and graphic records are used to record recurring
assessments, such as vital signs, intake and output, weight, hygiene, and ADLs.
Paper progress notes are used to document the patient's responses to care. They
may be in the form of narrative, SOAP(IER), PIE, or Focus-style notes.
A discharge summary should be completed when the patient is discharged from the
organization. A transfer form should be completed when the patient is transferred
within the organization.
An occurrence report, or incident report, is a formal record of an unusual occurrence
or accident that is not part of the patient's chart.
The most commonly used paper and electronic home health documentation form is
OASIS, a federally required form that includes history, assessment, demographics,
and information about the client's and caregiver's abilities.
Federal law requires that a resident in long-term care must be evaluated using the
Minimum Data Set for Resident Assessment and Care Screening (MDS) within 4 days
of admission. The MDS must be updated every 3 months and with any significant
change in client condition.
The handoff report is designed to alert the next nurse about the client's status,
changes in the client condition, planned activities, scheduled tests or procedures, or
concerns that require follow-up.
Nurses should not take verbal and telephone orders unless the ordering physician,
physician assistant, or nurse practitioner is in a situation where the order cannot be
written or entered or the patient is in a life-threatening situation.
Telephone orders offer more room for error because of unfamiliar terminology and
differences in background noise.
A teaching plan is similar to a nursing care plan, except that (1) interventions are
actually teaching strategies and (2) the plan includes the content of the teaching, the
sequencing of the content, and the materials to be used.
Demonstration and return demonstration are the most effective strategies for
teaching psychomotor skills.
A certain amount of forgetting is normal. You can aid learner retention by using
strategies that require learner participation and by providing printed materials to use
at a later time.
It is important to document specifically what teaching you did as well as your
evaluation of the learning that occurred.