Healthcare Ethical Principles and Communication

Personal Ethical Principles

• Moral principles guiding individuals to act ethically
• Informed consent, veracity, nonmaleficence, beneficence

Cultural Care

• Providing care that is considerate of the patient's cultural beliefs and practices

Nonmaleficence

• "Do no harm" principle, avoiding actions that could cause harm to the patient

Chief Complaint

• The main reason the patient is seeking medical attention

Identifying Spiritual Needs

• Understanding a patient's beliefs and practices related to faith and spirituality
• Respecting and accommodating these needs during care

Purpose of Documentation

• Accurate records of the patient's health history
• Communication tool for healthcare providers
• Legal documentation of care provided

Communicating with a Client Who Doesn't Speak English

• Use an interpreter when necessary
• Utilize nonverbal communication, such as gestures and drawings

Closed Ended vs. Open Ended Questions

• Closed ended: Yes/no answers, specific information
• Open ended: Encourage detailed responses, explore feelings and experiences

Asking the Client for Examples

• Clarifies the patient's description and provides a deeper understanding

Aggravating Factors

• Factors worsening the patient's symptoms or conditions
• Example: "What makes your headache worse?"

When to Use Closed Ended Questions

• Obtaining specific medical information
• Confirming details

Therapeutic Communication

• Focused and purposeful communication
• Active listening, empathy, non-judgmental approach

### Objective Data

• Observable and measurable findings
• Examples: Vital signs, physical exam findings

Subjective Data

• The patient's self-reported feelings and experiences
• Examples: Pain level, symptoms

How to Pose Questions about Alcohol, Drugs

• Use neutral and non-judgemental language
• Ask about substance use history and current use

Interviewing Rules / What Kind of Questions Do You Ask?

• Open ended: Encourage detailed responses
• Closed ended: To obtain specific factual information
• Focused: Centered on the chief complaint
• Comprehensive: Covers the entire patient's health history

Health History

• Detailed account of the patient's past and present health
• Includes family history, social history, and medical history

Importance of Family History

• Identifies genetic predispositions to diseases
• Helps determine risk factors for certain conditions

Comprehensive Assessment

• In-depth evaluation covering all aspects of the patient's health

Focused Assessment

• Concentrated on the patient's current concern or chief complaint

First Step During Physical Exam

• Inspection: Visual examination of the patient's appearance and body

Cyanosis

• Bluish discoloration of the skin due to low oxygen levels

Infection Control

• Practices to prevent the spread of infections
• Hand hygiene, use of personal protective equipment

Head to Toe Assessments

• Systematic examinations: Begin at the head and progress to the toes

Physical Assessment Components

• Inspection: Visual examination
• Palpation: Touching to assess texture, temperature, and masses
• Percussion: Tapping to assess underlying structures
• Auscultation: Listening with a stethoscope

Korotkoff Sounds

• Sounds heard during blood pressure measurement
• Indicate blood flow through the artery

What Are You Looking For in a General Survey?

• Patient's overall appearance, behavior, and vital signs

How to Verify an Irregular Pulse

• Check for an irregular rhythm with a stethoscope

Where to Put a Pulse Oximeter

• Finger, earlobe, or toe

Tachypnea

• Increased respiratory rate

FACES Pain Scale

• Visual pain assessment tool used for children and adults who have difficulty communicating verbally

Jaundice

• Yellowing of the skin and sclera (whites of the eyes)

Pulse Point Order

• Radial (wrist)
• Brachial (upper arm)
• Femoral (groin)
• Popliteal (behind the knee)
• Dorsalis Pedis (top of foot)
• Posterior Tibial (behind the ankle)

Hypotension

• Low blood pressure

Pain in Patient Who Is Awake and Alert

• Use OLD CART to assess pain

BP Wrong Size Cuff

• Incorrect cuff size leads to inaccurate blood pressure readings

Diastolic/Systolic Represent What?

• Diastolic: Pressure in the arteries during the heart's relaxation phase
• Systolic: Pressure in the arteries during the heart's contraction phase

Normal Heart Rate/ Vital Signs

• Heart Rate: 60-100 beats per minute (bpm)
• Blood Pressure: 120/80 mmHg or less
• Temperature: 97.8-99.1 degrees Fahrenheit (36.5-37.3 degrees Celsius)
• Respiratory Rate: 12-20 breaths per minute

OLD CART

• Onset: When did the pain start?
• Location: Where is the pain located?
• Duration: How long does the pain last?
• Characteristics: What does the pain feel like?
• Aggravating Factors: What makes the pain worse?
• Relieving Factors: What makes the pain better?
• Treatment: Have you taken anything for the pain?

Level of Consciousness (LOC)

• Patient's awareness of their surroundings and ability to interact

Aphasia

• Impaired ability to communicate due to brain damage

Safety/Mental Status Exam

• Assessing patient's safety and mental state
• Includes orientation (time, place, person), mood, thought process

Ask Direct Questions About Abuse

• Private and safe environment is crucial
• Use non-judgemental language

Comatose

• State of deep unconsciousness

Normal Skin Turgor

• Skin elasticity, tested by gently pinching the skin
• Normal skin springs back quickly

Pruritus

• Itching

Vesicles

• Small fluid-filled blisters

How to Best Assess Skin

• Inspect thoroughly for color, texture, lesions, and moisture

Normal Nail Assessment Findings

• Pink, smooth nail beds with a capillary refill of less than 2 seconds

Stage I Pressure Ulcer

• Non-blanchable erythema of intact skin

Eschar

• Dry, dead tissue that may be black, brown, or tan in color

Ethical Principles

• Nonmaleficence means doing no harm.
• Cultural care involves respecting and incorporating the patient's cultural beliefs and practices into their care

Client Communication

• Open-ended questions encourage detailed responses and exploration of the client's perspective.
• Closed-ended questions are used to gather specific information, often with yes/no answers.
• Therapeutic communication involves active listening, empathy, and clear, respectful communication to build trust and rapport with the client.

Patient Assessment

• Subjective data is what the client tells you about their condition, such as their pain level or symptoms.
• Objective data is what you observe or measure, such as vital signs or physical findings.
• Aggravating factors are things that worsen the client's condition (e.g., physical activity, certain foods).
• Health history includes information about past illnesses, surgeries, medications, and family medical history.
• Family history is important for understanding the client's genetic risk factors.
• Comprehensive assessment is a thorough evaluation of the client's overall health status.
• Focused assessment is an evaluation of a specific problem or concern.

Physical Examination

• The first step of a physical exam is inspection.
• Cyanosis is a bluish discoloration of the skin due to low oxygen levels.
• Head-to-toe assessments are examples of systematic examinations.
• Korotkoff sounds are the sounds heard during blood pressure measurement.

General Survey & Vital Signs

• General survey includes observing the client's appearance, behavior, and overall health status.
• Pulse oximetry measures oxygen saturation in the blood.
• Tachypnea is an abnormally rapid breathing rate.
• FACES Pain Scale is used to assess pain levels in children and individuals who have difficulty expressing pain verbally.
• Jaundice is a yellowing of the skin and sclera (whites of the eyes) caused by bilirubin buildup.
• Hypotension is low blood pressure.
• Diastolic blood pressure measures the pressure in the arteries when the heart is relaxed between beats, while systolic blood pressure measures the pressure in the arteries when the heart contracts.
• OLD CART is an acronym used to gather information about a client's pain: Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Treatment.

Mental Status

• Level of consciousness (LOC) refers to the patient's alertness and responsiveness to stimuli.
• Aphasia is a language disorder affecting the ability to communicate.

Skin Assessment

• Normal skin turgor is the skin's ability to return to its original position after being pinched.
• Pruritus is itching.
• Vesicles are small, fluid-filled blisters.
• Stage I pressure ulcer is characterized by non-blanchable redness of intact skin.
• Eschar is a thick, leathery scab that can form over a wound.

This quiz covers essential ethical principles in healthcare, such as informed consent, nonmaleficence, and cultural care. It also addresses the importance of documentation and effective communication with patients, including those who may not speak English. Test your knowledge on these vital aspects of patient-centered care.