FON Exam Revision PDF

Official Open FON exam revision Official Open Important note Important note: This deck of slides helps you to review FON. This is not adequate for exam preparation. Do review all materials (lectures, tutorials, quizzes and mock practice) from Week 1...

Official Open FON exam revision Official Open Important note Important note: This deck of slides helps you to review FON. This is not adequate for exam preparation. Do review all materials (lectures, tutorials, quizzes and mock practice) from Week 1 to Week 16. 2/8/20XX 2  Official Open Official (Closed)-Non sensitive Maslow’s hierarchy of needs (5 Levels of needs)  Official Open Official (Closed)-Non sensitive Health Promotion Disease Prevention Behavior motivated by Behavior motivated by the desire to enhance the desire to actively well-being. avoid illness.  Official Open 3 levels of prevention in the course of Disease Prevention Focus on early identification Focus on health promotion of health problems Protection against specific SECONDARY Restoration & rehabilitation health problem (e.g. prevention (e.g. referring a client with a immunization, health Prompt intervention to spinal cord injury to a education, risk assessment, alleviate health problem (e.g. rehabilitation center) family planning) hypertension screening, breast self-examination) Purpose is to help the individual Purpose is to decrease the to an optimal level of risk or exposure of the Purpose is to identify functioning people to disease. individuals in an early stage of a disease process and to limit future disability TERTIARY prevention PRIMARY prevention Official Open Advantages Disadvantages Decrease wait times Decreased face-to-face interaction Decrease healthcare costs Concerns with security Decrease unnecessary hospital visits Concerns with maintaining confidentiality Increase continuity of care Risk of decreasing quality of Increase patient care compliance with aftercare Official Open Assessing – sources of data PRIMARY SOURCE SECONDARY SOURCE Patient All sources other than the client/patient are secondary source of data. E.g. Next of kin/family Healthcare members Medical records Nursing records/charts Laboratory & diagnostic tests  Purpose of Official Open OLDCART O – onset of the pain. When did it start? [mnemonic used as L – location – where is the problem? descriptors of D – duration – how long does it last? pain] C – characteristics – how would you describe the symptoms? A – aggravating factor – is there other symptom? R – relieving or radiating factor – what makes it better or worst? T – treatment – have your tried alternative treatment that helps? Official Open Assessing – convert data to information Organizing data Conceptual models with structured assessment format Validating data Double-checking to confirm facts accuracy Gather additional information if necessary Documenting data Record & update client data such as Intake/output chart Admission form  3 phases of interview Orientation Working Termination https://tinyurl.com/2czp5sdm Purpose of interviewing is to gather accurate and complete Subjective Data  Silent patient Short periods of silence may be normal Allow time to collect thoughts. Provide reassurance & encouragement. Consider: o Have you frightened the patient? o Are you dominating the discussion? https://tinyurl.com/3z8rnupr o Have you offended the patient? o Does the client have a physical or The patient’s variables that can influence an mental disorder? interview and the appropriate nursing responses.  Talkative patient Allow patient to speak. If necessary, politely interrupt and focus on the discussion: Focus on most critical issue. Ask specific, closed-end questions. https://tinyurl.com/3mxv396n Summarize the patient’s story The patient’s variables that can influence an and move on. interview and the appropriate nursing responses. Don’t display your impatience.  Anxious or frightened patient Listen actively for the patient’s feelings and concerns Validate their feelings and emotions, acknowledging that it's okay to be anxious. Explain medical procedures, treatments, and what to expect in a clear and understandable manner. Encourage questions and provide honest, empathetic answers. Offer a compassionate and empathetic presence. Show genuine care and concern for the patient's well-being. Maintain a quiet and soothing atmosphere in the patient's room. Ensure the patient's physical needs are met, such as pain management, hygiene, and nutrition. https://tinyurl.com/shu4579c Offer Distraction Techniques E.g. Engage the patient in conversation about topics they enjoy/ activities like watching TV, reading, or listening to music. Use relaxation techniques, such as deep breathing exercises or guided The patient’s variables that can influence an imagery. interview and the appropriate nursing responses. No false reassurance ∅“Everything is going to be fine” ∅“Don’t worry!”  Angry or hostile patient Common feelings with stress or fear. Understand the source of these feelings. Respond in a professional & caring manner Personal safety is a primary concern!!! Keep safe distance Seek assistance https://tinyurl.com/2ar3m7h4 Be firm by using caring verbal and non-verbal The patient’s variables that can influence an language interview and the appropriate nursing responses. Official Open Planning – setting priority HIGH – life threatening, E.g. impaired respiratory or cardiac function Medium – health- threatening, e.g. risk for impaired skin integrity. Low priority – not directly related to present illness, e.g. impaired social interaction. Official Open Implementing – types of interventions Independent interventions Nurses have the autonomy to initiate based on their knowledge/skill. Dependent interventions Activities are carried out under supervision of licensed physicians. Collaborative interventions Nurses collaborate with other healthcare workers; Physiotherapist, speech therapist, dietitian, pharmacist, etc. Discuss the roles and functions of the Nurse Official Open Caregiver Assist the patient physically & psychologically Communicator Identifies patient’s problems & communicates to the healthcare team. Teacher Help patient to learn about the healthcare procedures to restore or maintain the health. Patient advocate To assist patients to exercise their rights & helps them speak up for themselves.  Official Open Cont’d …Discuss the roles and functions of the Nurse Counselor Help patients to recognize and cope with stressful problems. Leader Influence others to collaborate to achieve specific goal. Manager Manage the nursing care Research consumer Nurses often uses research to improve patient’s care. Case manager Work collaboratively within a multidisciplinary team to monitor outcomes. Official Open 7 cognitive skills components 1. Analyzing: Separating or breaking a whole into parts to discover their nature, function & relationships. 2. Applying standards: judge according to established personal, professional, or social rules or criteria. 3. Discriminating: Recognizing differences and similarities among things or situations and distinguish them according to category or rank. 4. Information seeking: Search for evidence, facts, or knowledge by identifying relevant sources and gathering objective and subjective data, historical and current data from those sources Official Open Cont’d … 7 cognitive skills components 5. Logical reasoning: Drawing inferences or conclusions that are supported or justified by evidence. 6. Predicting: Envisioning a plan and its consequences. 7. Transforming knowledge: Changing or converting the nature and function of concept among contexts.  Official Open 10 affective components a critical thinking nurse should display Confidence assurance of one’s reasoning abilities Contextual perspective looking at the whole picture, including relationships, background and environment Creativity intellectual ability to generate, discover or restructure ideas Flexibility capacity to adapt, accommodate, modify or change Inquisitiveness eagerness to know by seeking knowledge and understanding through observation and thoughtful questioning in order to explore possibilities and alternatives.  Official Open 16 Cont’d … 10 affective components a critical thinking nurse should display Intuition insightful sense of knowing without conscious use of reason Reflection thinking for the purpose of deeper understanding, self-evaluation Perseverance Pursuit of a course with determination to overcome obstacles Open-mindedness Being receptive to divergent views and sensitive to one’s biases Intellectual integrity seeking the truth through the sincere, honest processes, even if the results contradicts one’s assumptions and beliefs Official Open No erasing or use of correction tape if there is any error. General guidelines No personal opinions/critical comment about the patient. for Correct all errors promptly. reporting Do not leave blank spaces in nurses’ notes. and All entries must be recorded legibly and in black ink. recording Chart only for yourself. Do not do recording ahead of time. For computer documentation, keep password to yourself. Official Open General Cont’d … Factual guidelines for Accurate reporting and recording Complete Current Organized Official Open Reporting Change of shift reports – ‘handoff Orally and f-2-f communication’ Be aware of patient’s confidentiality. Telephone reports Document date, name of person. Repeat to the sender to ensure accuracy. Telephone orders Caution with telephone orders – to check with hospital policy. Official Open Change of shift Up-to date information. reports – Interactive communication for questioning ‘handoff between the giver and receiver of patient’s communication’ information. include Method for verifying information. Minimal interruptions. Opportunity for receiver of information to review relevant patient data. Official Open Telephone Date, time, name of the reports include person giving the information, the subject of the information and sign the notation. Official Open Telephone Need to know the hospital policy orders include regarding phone orders Ask the prescriber to speak slowly and clearly, spell out if needed. Write out the order and read back to the prescriber and have him/her to verbally acknowledge it. Official Open Use of SBAR as a S- situation communication tool B- Background A- Assessment R- Recommendation Official Open Factors affecting Safety Age & development Individuals learn to protect themselves from injuries through knowledge and accurate assessment of the environment. Lifestyle Such as unsafe work environments, access to drugs etc. Official Open Factors affecting Safety Mobility and health status Individuals with impaired mobility, poor balance or coordination are prone to injuries. Sensory - perceptual alterations Individuals with impaired touch perception, hearing, taste, smell and vision are highly susceptible to injuries. Official Open Cont’d … Factors affecting Safety Cognitive awareness Include individuals with lack of sleep, in unconscious or semiconscious state, disorientated or those whose judgment altered by disease or medication. Emotional state individuals in stressful or depressive state may react more slowly than usual. Official Open Cont’d … Factors affecting Safety The lack of ability to communicate Individuals with diminished ability to receive and convey information – aphasic patients, language barriers and those unable to read Environmental factors Depending on the patient’s situation, the home environment, workplace or community needs to be assessed. Official Open Interventions for Patients safety Altered mental status  Orientate patients to the hospital environment  Re-orientate patients if necessary  Monitor patients closely  Nurse patients on low bed  Reinforce limitations to activity and safety needs to patients and their family Official Open Interventions for Patients safety Altered elimination status  Assess patient’s elimination habits.  Provide a schedule for regular elimination if needed and offer the appropriate toileting aids.  Place patient nearer to the toilet or provide toileting aid at patient’s bedside.  Instruct male patients to sit while using the urinal.  Provide support to patients who are receiving laxatives and diuretics and assist whenever needed. Official Open Post-Fall Interventions Interventions for post-fall is to conduct analysis and manage patient’s injuries and document the incident. Analysis & management  Attend to patient’s injuries immediately  Inform senior staff / nurse manager  Medical review to exclude acute causes of fall  Inform family members  Investigate the circumstances of fall to determine the cause  Document the incident Official Open Impaired swallowing  Official Open Nursing Outcomes/ Nursing Interventions Rationale Evaluation Diagnosis Goals Impaired Mdm. Tan will be able to 1) Implement diet modifications of pureed foods 1) This reduces the risk of aspiration andBy the end of 2 weeks, swallowing related safely consume a and extremely thick liquids according to ensure that the patient is receiving Mdm. Tan will be able to to disease process prescribed modified diet Speech therapist. adequate nutrition. consume a prescribed as evidenced by without aspiration within 2 modified diet without 2) Position the patient in a Fowler’s position for 2) This improves swallowing mechanics and OD: patient weeks. aspiration. feeding. reduces the risk of aspiration. coughing when drinking thin fluids/ 3) Instruct the patient to use safe swallowing 3) Using safe swallowing techniques reduces Speech therapist techniques such as take small bites, chew the risk of aspiration. diagnosis of thoroughly, and swallow slowly. dysphagia with 4) Eating /drinking in an unhurried manner swallowing 4) Allow adequate time for patient to swallow reduces the risk of aspiration assessment food/ liquid. 5) When the patient controls the volume and timing of each bite, effective swallowing is 1) Encourage Mdm Tan to feed self as much as facilitated. possible. 6) Dentures will enhance Mdm Tan’s ability 1) Ensure that dentures if required are in place to chew food. before meals. 7) Coughing and cyanosis are signs of 1) Observe for excessive coughing, cyanosis aspiration. during swallowing and drinking. 8) Caregiver education ensures that the patient receives safe and effective care 1) Teach Mdm Tan’s caregiver about the when she returns home. swallowing disorder, the importance of following the treatment plan, and how to identify and manage signs of aspiration. Official Open Risk for falls Nursing Expected diagnosis outcome Risk for fall Patient will be free related to of fall during disease hospitalization. process. Sample Footer Text  Official Open Nursing interventions Rationale 1) Perform fall risk assessment regularly. 1) Understanding Mr. Ali’s fall risk factors helps in tailoring prevention strategies to their specific needs. 2) Familiarize Mr. Ali with the ward environment. 2) Being familiarized with the environment helps Mr. Ali to identify possible hazards/ increase spacial awareness. 3) Ensure that call bell is within Mr. Ali’s reach and is always with 3) This allows Mr. Ali to ask for assistance in a timely manner, him. reducing the risk for him to mobilise without assistance. 4) Inform/educate patient to ask for assistance for mobility 4) This allows Mr. Ali to ask for assistance in a timely manner, reducing the risk for him to mobilise without assistance. 5) Clear obstacles and declutter Mr. Ali’s environment. 5) Decluttering the environment prevents him from tripping over objects on the ground. 6) Ensure adequate lighting at the bedside, hallways and toilet. 6) Proper lighting helps Mr. Ali see obstacles and navigate safely. 7) Ensure non-slip footwear/ flooring/ mats. 7) Non-slip shoes can help Mr. Ali to maintain stability while walking. 8) Highlight the edge of steps. 8) Highlighting edge of steps increase visibility and depth perception. 9) Encourage the use of assistive devices for mobility. 9) Mobility aids support him in maintaining balance. 10) Implement fall risk signage. 10) This reminds healthcare staff to exercise caution. 2/8/20XX  Official Open Nursing interventions Rationale 11) Refer Mr. Ali to physiotherapist. 11) Engaging him in physical therapy can improve strength, balance, and mobility. 12) Place a urinal near patient’s bed OR offer frequent toileting for 12) Scheduled toileting OR use of urinal can prevent Mr. Ali from Mr. Ali who has limited mobility. attempting to get out of bed or a chair independently. 13) Place Mr. Ali near to nurses’ counter. 13) Placing him within the nurse’s field of vision allows for timely observation. 14) Ensure the height of the bed is always lowest. 14) Reducing the distance of the bed from the floor minimizes the chances of serious injuries. 15) Ensure that the side rails are raised at all times. 15) Raised bed rails act as a physical barrier, reducing the chances of patient rolling out of bed unintentionally or getting out of bed without assistance. 16) Promote hydration and nutrition. 16) Dehydration or malnutrition can lead to weakness and dizziness, increasing the risk of falls. 17) Regularly check him for postural hypotension. 17) Early detection of postural hypotension ensures that appropriate measures can be taken early to prevent falls. 18) Review his medication regimen to identify medication that may increase the risk of falls, such as sedatives, hypnotics, and 18) These drugs will cause postural hypotension, drowsiness antihypertensive medications. and dizziness which increases the risk for falls. Official Open Bathing self- care deficit  Official Open NURSING OUTCOMES/ DIAGNOSIS GOALS NURSING INTERVENTIONS RATIONALE EVALUATION Bathing self-care Mr. Gao will be 1) Assess patient’s ability to carry out bathing 1) This allows the patient to maximize their Mr. Gao or patient deficit related to the able to perform activities and encourage independent functional abilities while carrying out bathing is able to perform disease process as bathing with functioning as much as possible. activities safely. bathing with evidenced by right moderate moderate sided weakness. assistance in 2 assistance by the weeks’ time. 2) Assess patient’s need for assistive devices 2) Assistive devices promote independence and end of 2 weeks. E.g. commodes, walking frames and grab bars, safety. and encourage patient to use them. 3) Modify the way bathing is conducted to suit the specific ability of the patient, e.g. trolley 3) his ensures that the safest method of bathing is bath, bed sponging carried out. 4) Ensure the required toiletries are within 4) This conserves energy and promotes safety. reach. 5) This encourages patient to carry out bathing 5) Allow adequate time to complete the task. activities independently while maintaining a sense of dignity. 6) Provide clear instructions and reassurance throughout the bathing process. 6) This ensures that the individual feels comfortable and in control. Official Open Thank You