Shared Flashcard Set

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Resident Care and Quality of Life
Flashcards from Townsend Book
95
Health Care
Professional
12/19/2011

Additional Health Care Flashcards

 


 

Cards

Term
T or F? The mission of all nursing homes is to provide a high quality of care for the aged, disabled and chronically ill who cannot be properly tended to in their homes or in other medical or nonmedical environments.
Definition
True
Term
Resident care management includes a wide spectrum of _____________.
Definition
disciplines
Term
Components of resident care management include _________ provided by the medical staff, nurses, rehabilitation, dietary, pharmaceutical services, social services, and activities.
Definition
services
Term
Medical Record services and the management of resident rights must also be considered __________ elements of resident care.
Definition
vital
Term
Standards of health-care practice dictate that a facility must be adequately _______ to provide the services that it offers to the public.
Definition
staffed
Term
Omnibus Budget Reconciliation Act (OBRA) regulations specify certain minimum levels of ________ which it considers necessary to provide quality service to residents.
Definition
staffing
Term
The responsibility for assessing, treating and documenting the nursing care provided the residents in either a NF or SNF fall to the ________ department.
Definition
nursing
Term
The ______________ oversees the nursing department, which is composed of RN, LPN and CNA's.
Definition
DON/Director of Nursing
Term
T or F? The administrator should be aware of acuity levels in his/her facility and by prepared to staff accordingly.
Definition
True
Term
Under no circumstances can an LPN serve in the capacity of the _____________.
Definition
DON
Term

CMS permits waivers in DON and Charge Nurse staffing. Medicare waivers are granted by ___________.

Medicaid waivers may be granted by ___ __________.

Definition
CMS & the state.
Term
OBRA defines a _________ as "any individual providing nursing or nursing-related services to residents in a facility and who is not a licensed health professional, an RN, a registered dietician, or someone who volunteers to provide such services without pay."
Definition
nurse aide
Term
The ________________________ is a CMS-approved position. These aides must complete a state-approved training course and work under the supervision of an RN or LPN.
Definition
Paid Feeding Assistants
Term
The facility must ensure that a Paid Feeding Assisstant does not feed anyone with a __________ eating disorder, such as swallowing difficulties and aspiration problems.
Definition
complicated
Term
T or F? Surveyors will observe whether all the following activities are met: 1) staff are responsive to resident needs for assistance, (2) there is little delay in answering resident calls or needs for assistance, (3) nursing staff are always nearby or responsible, (4) resident's seeking staff have little difficulty locating a staff member when the need arises, and (5) residents do not have to call repeatedly for assistance.
Definition
True
Term
Daily staffing sheets must be kept on file for a minimum of __________, or as required by an individual state, whichever is greater.
Definition
18 months
Term
Resident care practices utilized by staff must reflect _________________ which promotes the highest practicable physical, mental, and psycholsocial well-being.
Definition
quality of care
Term
The overall resident care management system should use a ____________ approach, since it must address the total needs of an individual.
Definition
holistic
Term
____________ means the highest level of functioning and well-being that can be expected considering the residnet's functional status at the time, and his/her potential
Definition
Highest Practicable
Term
The most significant aspect of resident care practices are _______ __________________ toward residents.
Definition
staff attitudes
Term
Through positive attitudes and emphasis on ______________, many elderly can be returned to independent living settings with appropriate therapy.
Definition
rehabilitation
Term
The administrator sets the tone for __________ ___________.
Definition
employee attitudes
Term
An ________ is an unintended event, but it does not include adverse outcomes associated as a direct consequence of treatment or care.
Definition
accident
Term
A burn secondary to a topical treatment of a resident's skin is ________ an accident
Definition
not
Term
The facility should have clearly stated ___________, and teach them to staff, which identifies steps to follow when a resident is injured.
Definition
procedures
Term
Each resident must recieve _____________ assistive devices and supervision to prevent accidents.
Definition
adequate
Term
OBRA specifies the facility must ensure the resident's ______________________________________ do not diminish unless the resident's condition demonstrates that diminution is unavoidable.
Definition
activities of daily living
Term
_______________ include the following: Bathing, dressing, grooming, transfers, ambulation, toileting, eating and communicating.
Definition
ADL's
Term
Each resident must be given appropriate treatment and services to maintain or improve abilites in each of the _________ __________________.
Definition
ADL activities
Term
If a resident is unable to carry out ________________, the staff must provide services to maintain good nutrition, grooming and personal and oral hygiene.
Definition
ADL's
Term
____________________ is defined as all care provided to NH residents by its employees, contractors, or volunteers with the intent to maximize the resident's functional abilities.
Definition
Appropriate treatment and services
Term
There are _______ categories of ADL's
Definition
5
Term
_________ will evaluate the resident's ADL's to determine whether the resident has experienced a change in one of the five ADL's over the past 12 months.
Definition
Surveyors
Term
If the resident was provided no help or oversight; or the staff provided help/oversight only one or two times during the last seven day period, they will be classified as _________.
Definition
independent
Term
If oversight encouragement or cuing was provided three or more times during the last 7 days, or supervision plus physical assistance was provided only one or two times during the last 7 days by the saff, surveyors will classify as _________________.
Definition
Supervision
Term
If resident was highly involved in activities, reveived physical help in guided maneuvering of limbs and/or other non-weight bearing help providedonly one or two times over a 7 day period, surveyors will classify as __________.
Definition
limited assistance
Term
If while the resident performed part of an activity, over propr seven day period, help of the following were provided at least three times: weight bearing support; or full staff  performance of activity over the entire seven day period, surveyors will classify as _____________.
Definition
Extensive Assistance
Term
If full staff performance of activity over the entire seven day period, surveyors will classify as _______________.
Definition
total dependence
Term
When a resident changes physicians, the new physician is required by __________________________ to: (a) conduct and new H&P and physical exam, (b) write new orders, and (c) obtain a written release from the former physician when possible.
Definition
standards of practice
Term

Actions to take with a death occurs: 1. ______________

2. Follow facility protocol in pronouncing death.

3. Completing forms and documents for releasing the body.

4. Prepare body for the family to view should they desire and for release to the mortuary.

5. Conferring with the family before release.

Definition
Contact Physician , then contact family if none is present.
Term
Data such as what funeral home to contact, the phone number, and what parties to notify when a death occurs _________ ____ ________ __________ to the staff as well as the family and friends of the deceased.
Definition
reduces the emotional trauma
Term
Proper _____________ that direct immediate, appropriate action are helpful in lessening the impact of dealing with death.
Definition
guidelines
Term

A Discharge Summary should include the following content:

1. It must contain a recapitulation of the entire resident stay.

2. it must contain a final summary of the resident's status, including all items listed in the comprehensive assessment.

3. There  must be a post d/c plan of care, developed with the participation of the residnet and his family which will assist the resident adjust to the new living environment.

Definition
True
Term
______ ___________ ________ applies to a resident who is discharged to a private residence, another nursing facility, a residental facility, or other living arrangement.
Definition
Post discharge plan
Term
____________ ___________ begins on admission, otherwise families may bring residents to the facility with the idea of dumping them. Discussing discharge probability and plans in the event that improvement may affect the dumping syndrome. It may assist in keeping such families more involved in resident care.
Definition
Discharge Planning
Term
____________ monitor to determine whether or not the facility assisted the resident and family in locating post-discharge services. Also, they determine what type of predischarge prepartaion the facility provided.
Definition
Surveyors
Term
Standard Health Care practices require that a facility have plans for the care of residents in an _____________ ___________.
Definition
emergency situation
Term
All staff should be trained in exactly what to do when an _____________ ______________ is activated.
Definition
emergency code
Term
______________ ________________ is a resident care area, focused on the prevention of the development and transmission of disease and infection.
Definition
Infection Control
Term
A _________ _________ should be maintained on each infection. It should identify each resident with infection, date, causative agent, origin or site of infection, & description of cautionary measures taken to enable the facility to analyze clusters and/or significant increases in the rate of infection.
Definition
separate record
Term
New infections, referred to as ________, should be identified quickly, paying especial attention to residents at high risk of infection.
Definition
nosocomial
Term

Incidents of contagious desease are required to be reported to the ______________.

 

Definition
State Department of Health
Term
___________ determine if there are unexplained and/or similar infections, and if there is a significant increase in the rate of infection.
Definition
Surveyors
Term
Infection Control Policies for patients with AIDS or hepatitis B must meet requirements set forth by ________ and ___________.
Definition

OSHA - Occupational Health and Safety Administration

&

CDC - Centers for Disease Contol and Prevention

Term
________ __________, as a part of the care plan, outlines the needs of the resident each day in multiple modalities; including, bed mobility, transfer, dressing, grooming, eating or swallowing, amputation/prosthesis care, and communications.
Definition
Restorative Nursing
Term
_______________ means the extent of movement of a joint.
Definition
Range of Motion (ROM)
Term
Residents admitted with limited Range of Motion must recieve appropriate treatment and services to __________ Range of Motion, and/or prevent further decline unless the resident's condition demonstrates that a reduction is unavoidable.
Definition
increase
Term
Residents who are admitted without limited Range of Motion, must be monitored to ensure that _________ in Range of Motion does not occur, unless the resident's clinical condition demonstrates that it is unavoidable.
Definition
reduction
Term
Clinical conditions that are considered ____________________ for decreased Range of Motion are: immobilization, strokes, multiple sclerosis, cerebreal palsy, polio, pain, spasms, and immobility due to arthritis or Alzheimer's Disease.
Definition
Primary Risk Factors
Term
Nursing and other health-care professionals should routinely perform ________ __________ in the daily care of residents; including, maintaining good body alignment and proper positioning, making every effort to keep resident as active as possible, encouraging resident to achieve independence in ADL's by teaching self care, and ambulation, assisting to carry out therapeutic excersises, assisting with ROM exercises.
Definition
rehabilitative measures
Term
_____________ _______________ begins suddenly when a person who has never been incontinent can't get to the toilet on time. May be caused by medication or infection. May also disappear of its own accord, or it can nearly always be treated.
Definition
Transient - Incontinence
Term
Surveyors detemine if there has been a _________ in ROM and/or muscle atrophy that was unavoidable.
Definition
decline
Term
___________ may be used only to control a resident's behabior that is harmful to the resident or to others.
Definition
Restraints
Term
An appropriate _______ ________ dictates that safety is not just a matter of environment, but also a concern for those who are in that environment.
Definition
safety program
Term
If physical restraints are used, standard practice requires they be ___________ at least q30mins.
Definition
monitored
Term
OBRA recommends that satff develop __________ to restraints.
Definition
alternatives
Term
Use of restraints should be seen as a __________ ___________ practice that is used as a last resort, and then for the shortest possible time.
Definition
dangerous
Term
__________ __________ are physician orders that nurses activate in specific situations without having to first call the doctor.
Definition
Standing Orders
Term
When used properly, standing orders can expedite the care for the nursing home residnet and allow the facility to be ____________ in providing quality resident care.
Definition
proactive
Term
OBRA makes it clear that the lack of program funding does not relieve the nursing home of its obligation to ensure residents recieve all needed services per Medicaid and Medicare requiremetns. Further, it is the ________ ________ responsibility to assist the resident in securing needed services not covered by the programs.
Definition
nursing home's
Term
Special Services that are _________ include: injections, parenteral and enteral fluids, colostomy, ureterostomy or ileostomy care, tracheostomy care and suctioning, foot care, and prostheses.
Definition
covered
Term
____________ ___________ primarily affects women when the cought, laugh, strain, exercise, sneeze, or lift something heavy. The sphincter muscles around the urethra become loose and stretched out, usually due to bearing children or hormonal changes after menopause.
Definition
Stress Incontinence
Term
 ___________ or __________ incontinence occurs when a person has a sudden urge to urinate and cannot hold it until the reach the toilet. Strokes, infections, bladder contractions and other reasons cause the bladder to release urine with little or no warning.
Definition
Urge of Reflex Incontinence
Term
____________ Incontinence often occurs in men who have prostate problems. The bladder holds the urine and it eventually overflows and dribbles out. If untreated, can lead to kidney and bladder infections.
Definition
Overflow
Term
__________ Incontinence is caused by the brain in such cases as dementia, head injury and stroke. The brain is unable to receive the message from the bladder; therefore, invonluntary incontinence occurs.
Definition
Functional
Term
A training program must be developed for all patients who could benefit from a ________ and _________ program.
Definition
Bowel and Bladder
Term
If professionals determine the cause of the __________ is such that no training would be helpful, the nursing staff documents their findings and implements protocols to ensure the resident is monitored, cleaned, and changed appropriately.
Definition
incontinence
Term
____________ or ____________ of urinary incontinence involves correcting the underlying problem. Usually consists of bladder training schedules, kegel exercises and regular toileting schedules.
Definition
Treatment or Management
Term
Kegel exercises, regular schedules, bladder training, biofeedback, bedpans, commodes, dietary changes, medications, surgery, pads, adult briefs, and catheters are all ____________________________.
Definition
Methods of Handling Urinary Incontinence
Term
_________ will monitor a sampling of residents who are incontinent. They examine care given, whether individual goals were set and attained, whether residents are properly hydrated, and whether sampled residents have UTI's.
Definition
Surveyors
Term
Nursing Staff in particular, should understand that the CVA resident needs help in re-establishing __________ in ADL's.
Definition
independence
Term
Presbycusis is one of two major types of hearing loss. In this type is noted by the ____________ loss of _________ hearing in which the resident may hear what is said buy has poor word acuity. Often characterized by inability to hear certain tones such as high pitched, shrill, or low frequency sounds.
Definition
gradual; acute
Term
__________ hearing loss results fro impairment, damage, or malfuntion of any portion of the conductive mechanisms of the ear.
Definition
Conductive
Term
Staff should be aware that the loss of hearing is often more ___________ to residents than loss of sight.
Definition
traumatic
Term
__________ will question certain residents about whether they asked for assistance in seeing an otologist or going to a hearing aid specialist, and how staff responded to the request.
Definition
Surveyors
Term
Many elderly experience a problem or disturbance with the inner ear that regulates sense of balance called ______________ _________ of ________. This is a serious matter that may lead to increased falls and other accidents.
Definition
Benign Disequilibrium of Aging (BDA)
Term
The facility must make appointments and arrange transportation for residents who need the care of a practitioner specializing in treatment of _________.
Definition
vision
Term
_________ is painless and can develop so slowly it is hardly noticable; but, it can also develop rapidly, resulting in impaired vision in both eyes.
Definition
ARMD or Age Related Macular Degeneration
Term
_________ will select a sample of residents with visual disorders and question them about assistance with appointments, transportation, and obtaining eyeglasses as needed.
Definition
Surveyors
Term
_____________ will select and a sample of residents who exhibit psychosocial adjustment difficulties. They will monitor the facility's efforts to accommodate the resident's usual and customary routines and the programs carried out to remotivate the resident and maintain or improve psychosocial functioning.
Definition
Surveyors
Term
______________ means walking around aimlessly, in and out of rooms and outside the building, with little or no awareness of potential dangers.
Definition
Wandering
Term

CMS has identified three quality measures/indicators as SENTINEL EVENTS:

1. ____________________

2. ____________________

3. ____________________

Definition

1. Low risk residents w/pressure ulcers

2. Dehydration

3.Fecal Impactions

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