Download Acello Chapter13

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project

Document related concepts

Dental emergency wikipedia , lookup

Transcript
Chapter 13
Caring for Patients with
Special Needs
Working with Interpreters
• Interpreter
– Communication professional who mediates
between speakers of different languages
– Some interpreters speak
– Others use sign language
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
2
Working with Interpreters
• Qualified interpreters know the
expressions of the languages they are
interpreting
– Verbal and non-verbal
– Cultural values
– Beliefs
– Gestures and body language
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
3
Domestic Violence
•
•
•
•
•
•
Battering and injury
Psychological abuse
Sexual assault
Social isolation
Deprivation
Intimidation
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
4
Domestic Violence
• Violent behavior
– Perpetrated by a person involved in an
intimate relationship with the victim
• Violence is used a as a means of control
• Victim may think abuse is his or her fault
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
5
PCT Responsibilities
• You are not responsible for questioning,
counseling, or treating the patient
• Be aware of domestic violence and alert to
signs and symptoms
– If detected, inform RN
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
6
PCT Responsibilities
• Keep communication and documentation
concise and accurate
• Be kind, empathetic, and supportive
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
7
Delirium
• Acute confusional state caused by
reversible medical problems
• If left untreated the mortality is high
• Causes:
– Dehydration
– Physical illness
– Anesthesia and medications
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
8
Delirium
• To eliminate delirium, the physician will
treat the underlying cause(s)
• Mental status may not be immediately
clear
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
9
Nursing Care After a Seizure
•
•
•
•
•
•
Reorient the patient
Check vital signs frequently until stable
Keep the side rails up
Provide incontinence care
Monitor for return of seizure activity
Administer oxygen or suction
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
10
Spinal Cord Injury
• Move extremities slowly and gently
• Avoid rapid, rough movements
• If extremities move into flexion, gently
move them into extension
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
11
Spinal Cord Injury
• If the extremities move into extension,
position them in flexion
• Prevent pressure ulcers
• Allow patient to direct care
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
12
Autonomic Dysreflexia
• Treatment
– Identify the stimulus and remove it
• Inform RN if you observe any signs and
symptoms
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
13
Chemotherapy
•
•
•
•
Wear gloves when handling soiled linen
Use standard precautions
Monitor for and report signs of infection
Prevent bleeding and bruising
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
14
Chemotherapy
•
•
•
•
Promote good nutrition and hydration
Monitor I&O
Allow for frequent rest periods
Be empathetic and supportive
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
15
Radiation Therapy
•
•
•
•
Do not wash radiation markings off
Wash with lukewarm water and mild soap
Avoid rubbing or creating friction on skin
Dress in loose, comfortable clothing
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
16
Radiation Therapy
• Follow radiation precautions
• Wear a dosimeter to monitor exposure
• Stay at least 3 feet away from the patient
unless giving direct care
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
17
Immunotherapy Patients
•
•
•
•
Monitor vital signs every 2-4 hours
Inform RN if systolic B/P less than 100
Monitor capillary refill
Weigh the patient daily
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
18
Immunotherapy Patients
• Notify RN if patient has following
symptoms:
– Fever or chills
– Pulse over 100
– Respirations over 24
– Becomes cyanotic or dyspneic
– Restless or apprehensive
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
19
Immunotherapy Patients
• Notify RN if patient has following
symptoms:
– Diarrhea
– Nausea
– Vomiting
– Itching
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
20
Complementary and
Alternative Medicine (CAM)
• Diverse systems, practices, and products
– Not presently part of conventional medicine
• Area of research and scientific study
• CAM changes continually
– New practices and techniques are always
emerging
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
21
Principles of Rehabilitation
and Restoration
•
•
•
•
Begin treatment early
Activity strengthens
Prevent further disability
Stress the patient’s ability, not the
disability
• Treat the whole person
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
22
The Pain Problem
• Patient’s self report of pain is the most
accurate indicator of the existence and
intensity of pain
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
23
The Pain Problem
• Always respect and believe a patient
• Patients may be smiling, talking, or
sleeping and still be having pain
• Vital signs may be normal
– Avoid making assumptions about a patient’s
pain
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
24
Types of Pain
• Acute pain
– Occurs suddenly; usually the result of tissue
damage
• Persistent pain
– Pain that lasts for 6 months
– May be intermittent or constant
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
25
Types of Pain
• Phantom pain
– Occurs as a result of an amputation
– The pain is real
• Radiating pain
– Pain that moves from the site of origin to
other areas
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
26
Pain Management Procedures
• Epidural catheter
– Implanted under skin into epidural space for
medication administration
• Transcutaneous electrical nerve
stimulation
– Electrical current stimulates nerve fibers to
block pain
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
27
Pain Management Procedures
• Implantable medication pumps
– Placed under abdominal skin with a catheter
for medicine administration
Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.
28