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glossary abdomen administrative admit advanced directive advocacy aids albumin allergy aneroid monitor antibiotic antimicrobial apnea appointment associate asthma attack bacteria bactericidal bandage bathing beats per minute billy light bilirubin biographic data biopsy blister blood pressure bloody show body temperature braxton hicks contraction bun test bun test blood urea nitrogen b vitamins carbohydrates cdc center for disease control and prevention cellulitis chest compression chief complaint chore ckd chronic kidney disease clinical communicable contraction coordinator counter sign coverage cpr cardiopulmonary resuscitation creatinine cross-check c-section caesarean section debridement defibrillator desiccation diastolic discharge discharge discharge planner disinfectant dosage dress elevated epidemic erythema toxicum existing services expiration date exudate face mask family history fats fetal movement count follow-up forceps full time gfr test glomerular filtration rate grooming heart rate high fructose corn syrup hospitalize hygiene identification bracelet illness immune system infection infectious inflammation infusion therapy injury insurance international intramuscular administration isolate jaundice keynote speaker labor lightning maceration medical history metered dose inhaler mobility moderate morphine msn masters of science in nursing nebulizer necrosis newborn next of kin nutrition ob triage obesity omega-3 operating room oral administration oral thrush outbreak out of network outreach over-the-counter paramedic part-time passport report per diem phototherapy physical therapy physiotherapist post operative unit poultry pregnancy prescription preventative protein psychosocial history public health nursing qualification rash recovery renal rescue breathing respiration responsiveness resting rate retractor route of administration sanitize scalpel scissors scrub room shock shots effect slough saw sponge stable statistics sterilize surgical procedure suture systolic tablet temporary housing thermometer third degree burn tissue transition transmit transportation travel nursing trimester urinalysis urine virus vital signs vitamin a vitamin c vitamin d water break work visa workshop wound zinc esp nursing book 3 unit 1 schedules and hours exercise five page five the daily post march overworked nurses low pay high stress the findings of the latest daily post survey are startling over 50 percent of springfield county nurses feel overworked the survey asked 300 full-time and part-time nurses to rate their work experiences the results reveal that the majority of nurses work long shifts with few breaks in between most reported feelings of fatigue and lack of energy nurses cited several reasons for this exhaustion pay drives nurses to work longer hours to earn overtime pay furthermore high stress on the job leads many nurses to retire early which increases strain on the current workforce and although demand for nurses is high few hospitals have the budget to hire more the dangers of such strain are obvious low energy and tiredness can negatively affect job performance and put patients at risk but the surveyed nurses also offered solutions to these issues among their suggestions is providing financial incentives to prevent early retirement also suggested was an increase in part-time positions to reduce stress on nurses working long hours finally a majority of nurses requested shorter shifts with lighter workloads to prevent exhaustion and on-the-job errors and they want these changes soon according to the nurses delaying these improvements threatens the well-being not only of medical providers but that of patients too exercise six and seven page five excuse me janet can i talk to you sure what's on your mind i was wondering if another nurse could take over a couple of my shifts why is everything okay yeah i'm fine but i leave work feeling really tired on most days and the exhaustion is starting to get to me so you're feeling overworked a bit my workload is a little heavy i'm sorry to hear that but unfortunately i'm not sure i can do much oh may i ask why well it's not that i don't want to help but we're already short on nurses so there's no way to cut my hours not really it would mean giving the other nurses overtime and that's just not in the budget it's okay i understand i can look into possibly getting you one or two more breaks during shifts would that help yes even that would be great all right i can't make any promises but i'll see what i can do unit two communicating with patients and families exercise five page seven hayward health clinic memo subject communicating with patients nurses as you know clear communication is vital to providing the best care possible however it seems that as of late we are not getting all the information we need if you suspect you are not getting enough information from a patient remember some of the possible causes of such miscommunication poor health literacy uninformed patients may not understand key terms negative preconceptions patients may not trust medical professionals or may experience anxiety cultural differences different cultures may have different approaches to dealing with illness if you recognize any of these issues a few simple steps can be taken to help improve communication establish a good rapport it's very important to the therapeutic process show empathy be aware of how your verbal and non-verbal cues affect the interaction don't use too much jargon since this may confuse or intimidate your patient ask open-ended questions to help signal to patients that you care about their input remember you are our first and most important line of communication to patients the more information we can give and receive the better care we can provide exercise six and seven page seven megan do you have a minute sure what's up it's about a patient i'm having trouble communicating with her what do you mean well she's complaining of constant headaches i asked about her medical history but she didn't say much is it just a miscommunication maybe she doesn't know what you're asking for it's possible but i can't tell because she's barely speaking to me she might just be anxious it can be scary to feel terrible but not know why yeah she does seem pretty nervous did you use lots of jargon in my experience that makes things worse i might have i mean i asked her if she thought they might be migraines or cluster headaches see if she has poor health literacy those terms might sound scarier than they are good point maybe i'll ask her how often they happen instead also make sure to establish a rapport even just by asking about her day oh i didn't really do that i just jumped in with my questions it's important it really helps the patient relax unit 3 chronic versus acute conditions exercise 5 page 9 chronic and acute illnesses the dangers of late intervention many people who experience an illness feel no need to seek immediate treatment they may believe that they will eventually get better or that any pre-existing medical conditions they have will not worsen in the presence of another illness but such thinking is dangerous both chronic and acute illnesses that are left untreated can grow more severe and they can lead to even more serious complications down the road in chronic conditions early intervention is vital insufficient treatment can actually result in the occurrence of a debilitating acute condition for instance osteoporosis that is not properly managed can lead to broken bones likewise chronic bronchitis that is left untreated increases the risk of dangerous respiratory conditions like pneumonia and hypertension left unchecked can result in a deadly stroke similarly delaying treatment of acute conditions can cause the onset of chronic ones for example a bout of scarlet fever caused by the strep virus can lead to endocarditis not treating the fever in time can create life-threatening and long-term problems but there is good news visiting a doctor in the early stages of an illness can help you avoid serious complications later seeking treatment early on can save time money and possibly even your life exercise six and seven page nine good morning mr arnold you're here because of a bad cough yes yes it's been getting worse for a while now well the doctor believes it's a case of acute pneumonia is that bad it's not a severe case but we would have liked to treat it a little earlier is it harder to treat now a bit you'll have to be on antibiotics longer now if we'd had some kind of intervention earlier it wouldn't have gotten so bad yeah i thought about coming into the hospital as soon as the coughing became worse is there a reason you didn't well i thought maybe it was just my bronchitis acting up again wait you have chronic bronchitis yes i've had it for almost 10 years now mr arnold are you aware that chronic bronchitis makes you more susceptible to infection i know but there's not much i can do about that you'd be surprised just washing your hands more frequently and avoiding smoke could really help your condition oh well that i can do unit 4 diabetes exercise 5 page 11. about diabetes type 1 diabetes once known as juvenile diabetes type 1 diabetes mostly affects children and teens whose bodies are unable to make insulin 10 to 15 percent of people with diabetes have type 1 diabetes type 2 diabetes type 2 diabetes is the most common form of the disease it results from poor insulin production or from insulin resistance gestational diabetes four percent of pregnant women are diagnosed with gestational diabetes after birth blood sugar tends to return to normal but the patient has a greater risk of later developing type 2 diabetes causes 1.6 million new cases of diabetes are diagnosed each year there are certain risk factors for developing type 2 diabetes genetics race a high bmi inactivity high blood pressure high blood fat levels gestational diabetes a diet high in fat or alcohol complications diabetes reduces blood flow around the body it leads to problems with the eyes feet kidneys nervous system skin digestive system sexual function teeth and gums it can result in heart attacks strokes cataracts glaucoma blindness and even amputations treatment for those reasons it is crucial to manage diabetes treatment plans are tailored to each patient to help keep glucose levels within a target range exercise six and seven page eleven mr finkelstein did dr lopez explain your test results yes and i was shocked i can't believe i have type 2 diabetes is there a family history of diabetes no none well there are many risk factors besides genetics but i'm not even overweight you are approaching 60 though unfortunately age is a factor not much i can do about that so will i need insulin shots no not as long as you manage your diabetes by making some lifestyle changes like monitoring your diet that's a relief but i heard that pasta is bad for diabetics that's my favorite food do i have to give it up so long as you control your portions no you also might want to consider switching to a whole grain pasta okay is there a list of foods that i should eat of course but it looks a lot like any other healthy eating plan really i would have expected something pretty restrictive not really it's the same idea as losing weight eat more healthy food and less junk i should probably be eating healthy anyway unit 5 cancer exercise 5 page cancer treatment options a cancer diagnosis can be overwhelming but there are now many treatment options your oncologist may suggest one or more of these therapies chemotherapy chemotherapy or chemo is a drug or combination of drugs that kills cancer cells it can be taken orally as a pill or liquid or as an injection the most common delivery method is an iv chemo can be received in a hospital or outpatient setting your doctor may prescribe chemo before or after surgery talk to your doctor about potential side effects radiation therapy radiation also called radiation oncology destroys cancer with high energy x-rays it works best on cancer cells that are splitting very quickly it impairs the cancer cells dna so that it cannot grow or divide immunotherapy immunotherapy boosts the patient's immune system antibodies are made in a lab and then introduced to the patient system they target the cancer cells and kill them immunotherapy is also a means of conveying poison straight to cancer cells photodynamic therapy photodynamic therapy uses drugs and light to kill cancer cells anti-angiogenesis therapy tumors need a blood supply to survive anti-angiogenesis stops a tumor from making new blood vessels so that it cannot grow exercise six and seven page thirteen hello mrs henderson how are you feeling well to be honest i'm pretty nervous this is my first chemotherapy session that's totally natural would it help if i explain what's going to happen i think so we're going to put a catheter in one of the veins in your arm and get the chemo into your system that way will it hurt you'll feel a pinch and the side effects well the drugs are very strong because we need to kill the cancer unfortunately they do harm some other systems too the doctor said i'll feel sick to my stomach right yes chemo affects the digestive system you'll probably lose your appetite and some weight and does that happen right away yes probably within a day or two did the doctor tell you about chemo's effect on hair follicles he did what do most patients do it depends on the amount of hair loss some just wear hats others if they go completely bald wear wigs i suppose that's the least of my problems shall we get started unit 6 heart disease exercise 5 page 15 what is heart disease types of heart disease cardiovascular heart disease is the leading cause of death in the us but many people know little about it heart disease is a term that covers several problems that can affect this vital organ coronary artery disease heart failure and congenital heart disease are all forms of heart disease prevention simple measures can reduce your likelihood of getting heart disease stop smoking exercise eat a heart healthy diet maintain a healthy weight abdominal obesity is linked to heart disease reduce stress get checkups and screenings treatment coronary artery disease can be treated with an aspirin regimen ace inhibitors or beta blockers treatment plans may involve lowering high blood pressure and cholesterol surgical options including stooling stents or performing open heart surgery to bypass plaque buildup in the arteries heart failure occurs when the heart has trouble pumping blood around the body this condition is treated with drugs to help the heart function correctly surgical options include the installation of a pacemaker or in some cases a heart transplant it is important to take good care of your heart be sure to follow the methods for prevention and get regular checkups from your doctor exercise six and seven page fifteen hi mr rodriguez how are you doing today fine i'm just anxious to get these test results back that's right dr pitt thinks it could be coronary artery disease or arrhythmia right yes but shouldn't we be able to tell what i've got just from my symptoms well they have the same warning signs shortness of breath palpitations and dizziness what can i expect as far as treatments go it depends on your diagnosis if it's an arrhythmia there may not be a need for treatment at all really nothing well some arrhythmias are just caused by simple things like electrolyte imbalances but if it's more serious than that there are a few treatment options i see what kind of options a combination of lifestyle changes and medication possibly surgery what about coronary artery disease that is also treated with lifestyle changes drugs and surgery okay i definitely want to avoid surgery if i can that's understandable now remember it may be neither of those things that's why we ran the tests thanks for explaining all this unit 7 trauma and triage exercise 5 page 17 the esi triage system purpose of the system hundreds of trauma patients enter hospitals emergency department each day these patients ailments range from fractures and compound fractures to severe burns since the acuity of their conditions can vary greatly it is necessary to prioritize patient care the emergency severity index esi triage system allows nurses to quickly assess a patient's condition this helps nurses determine the order in which to treat patients how it works when patients enter the emergency department nurses must assign them to an esi level you must first determine if a patient is in danger of dying immediately such patients are assigned to esi1 this level is reserved for patients needing immediate life-saving treatment if the patient is not dying you must decide how long the patient can wait for treatment patients needing immediate treatment are assigned to esi too however many patients are not critically ill and are able to wait for care for these patients nurses should estimate how many resources they will likely require patients requiring multiple resources are assigned to esi3 patients who are likely to need only one resource are assigned to esi 4. finally patients who need no resources at all are assigned to esi five exercise six and seven page seventeen hey laura did you just send a patient into room one one four i did was that wrong not necessarily but we're pretty full and we should only be admitting the more serious cases i used the esi triage system do you want to see how i assigned him a level sure what did the patient come to the er for he had a leg fracture was it a compound fracture no it was just a simple fracture what was the acuity of his condition it wasn't very severe he didn't need immediate care so then i moved on to calculating how many resources he would need okay and what did you determine i figured that he would need an md assessment and an x-ray so what esi level did you assign him to i assigned him to esi3 because he wasn't very ill but he needed multiple resources what do you think you made the right choice he definitely needs a room oh good i was worried i'd made a mistake on my first day unit 8 communicating with staff exercise 5 page 19. dear staff concerns have been raised about the communication lagging when shifts change medical records are not currently being filled incorrectly meaning that nurses who are starting their duties are really informed about the patient's current status this lack of communication is putting patients at risk i would like to take this opportunity to highlight the processes which you must adhere to when you change shifts please make sure you update all medical records all records must be listed in chronological order make sure you document all medication that the patient has received and make a full assessment of the patient's current status make sure the patient's plan of care is clearly stated make sure your records are comprehensive do not leave out any important details however records must also be concise avoid unnecessary wordiness you must ensure that you write legibly as there have been recent problems reading illegible handwriting use all capitals if your cursive is messy and only use approved standard abbreviations observe these guidelines every time you complete your shift thank you in advance for your cooperation lindsay davies head nurse exercise six and seven page 19. anything wrong yes it's this medical record i don't understand it at all what's the problem it's full of abbreviations that i don't understand what sort of abbreviations it says the patient got 20 milligrams of m does that m stand for morphine or magnesium i don't know the nurse didn't even update it there's no assessment of the patient's current status let me have a look yes look it's here it's just that the nurse didn't write it in chronological order oh yes so it is it isn't very comprehensive though it just says recovering yes i know we're supposed to be concise but this is really bad it is and i can't find any details about the patient's plan of care either we should tell the head nurse maybe she can talk to the other nurses maybe but in the meantime i need to get the right information about this patient you could ask joanne she was here during the last shift good idea thanks unit 9 iv care exercise 5 page 21 iv summary patient name carlota salinas solution hypertonic saline infusion rate direct infusion set clamp to 140 milliliters per hour cause for iv miscellaneous has diabetes and has become dehydrated as a result of high glucose levels notes watch for infiltration where iv drip is inserted notify md immediately if this occurs iv summary patient name mark smith solution isotonic saline infusion rate intermittent infusion set roller clamp to 150 milliliters per hour micro drip cause for iv mr smith is severely dehydrated due to gastroenteritis and requires an isotonic saline solution to restore normal fluid levels notes check patient for signs of dehydration hourly reduced to 75 milliliters per hour macro drip when symptoms fade watch for signs of diarrhea and vomiting iv summary patient name raymond willis solution hypertonic sailing infusion rate continuous infusion of nutrient solution through iv pump set clamp to 50 milliliters per hour cause for iv mr willis is unconscious with a head injury and requires parenteral nutrition notes check iv site regularly for signs of infection if patient returns to consciousness or shows any signs of sickness fever or altered heart rate inform md immediately exercise six and seven page twenty one hey kathy yes i've been looking at raymond willis's hypertonic saline iv and it seems to be off what do you mean the summary says he's supposed to be on an iv of 50 milliliters per hour but it's currently on 60. is it let me check the records maybe the doctor ordered it to be increased and we didn't hear about it i've already checked them there's nothing written down perhaps someone accidentally hit the button and set it going at the wrong rate it's possible do you think we should switch over to a regular roller clamp to avoid giving him too much maybe but you'd better check with the doctor before you change anything how is the patient doing he hasn't returned to consciousness but his heart rate and temperature are normal and are there any signs of infection no there's no swelling or redness good it seems like there's no problem yet give the doctor a call and i'm sure he'll clear everything up sure i'll do it right away unit 10 preparing a patient for surgery exercise 5 page 23 pre-op checklist this pre-op checklist details all forms and tasks that are necessary in order to proceed with scheduled surgery the form is to be completed by the attending nurse initial each task on the left to indicate its completion at least one hour prior to the patient's scheduled surgery sign and date the form at the bottom patient history and physical exam performed operative permits signed by patient and witnessed anesthesia permits signed by patient and witnessed medication reconciliation form signed by patient and physician ekg report present in patients medical file patient given npo order yes no if yes specify number of hours that have elapsed since npo post op room confirmed yes no if yes specify ward and room number chlorohexidine bath scheduled to be given prior to surgery information on identification bracelet double checked known allergies indicated on patients identification bracelet fully stocked crash cart present in surgery room patients informed of personal effects policy including jewelry glasses watches and hair accessories signature date exercise six and seven page 23 hello mr willis how are you feeling okay i'm ready to get this surgery over with we're almost ready i just need to finish reviewing this pre-op checklist with you sure i have your signed anaesthesia permit here but i still need you to sign the operative permit all right where do i sign right here thanks now did dr martinez give you an npo order yeah i haven't had anything to eat or drink since about 11 p.m yesterday i can't wait to eat again i can imagine now do you have any allergies to latex or dyes no not that i'm aware of great now before the bath i'll need any personal effects such as watches or keys from you all right here you go will they be locked up of course i'll take good care of them any other questions before we head to the surgery room you mentioned something about a bath the chlorhexidine bath what's that all about it's just a quick rinse to eliminate any harmful bacteria don't worry about it oh okay that doesn't sound too bad unit 11 preventing infection exercise 5 page 25 five steps to preventing infection one hand hygiene your hands are the most common vectors for spreading nosocomial infections regular hand washing can reduce contamination considerably use the alcohol-based hand sanitizers located throughout the hospital to reduce outbreaks of e coli or staph infection be aware that not all pathogens are killed by alcohol-based sanitizers use soap and water when caring for patients with the pathogen c diff for instance and ensure that all visitors do the same to use checklists use checklists to ensure that procedures are completed accurately if patients are fitted with unnecessary tubes such as urinary catheters infection can ensue keep checklists to clarify what has been fitted three kits keep kits to hand which contain all the equipment needed for common procedures you don't want to be running to the supply closet mid procedure for something that you have forgotten four oral hygiene one of the most common infections in intensive care units is ventilator-associated pneumonia keep bacteria levels low by regularly cleaning the patient's mouth gums and teeth five diagnostic tests be vigilant and look out for patients showing signs of infection use quick diagnostic tests to identify patients with infectious diseases such as mrsa if patients who show symptoms rapidly tested the risk of spread is reduced exercise 6 and 7 page 25 i've noticed there's been a recent outbreak of c diff on the ward yes that's right we have all the infected patients in isolation now have those patients received any visitors recently yes we're making sure they wash their hands when they arrive and leave to avoid contamination good make sure they don't use those alcohol-based sanitizers you know they need to use soap and water yes we've made sure that excellent have any of the visitors reported any symptoms no they haven't okay but make sure you stay on top of that what about the nurses one nurse who is treating those patients has come down with something the same infection we're not sure they're doing some diagnostic tests at the moment it might be e coli e coli that's bad we can't have two different nosocomial infections on the ward at the same time i realize that when you see your nurses today make sure they're keeping an eye on hygiene we need to keep these infections to a minimum sure i'll remind them unit 12 ob gyn nursing exercise 5 page 27 adjusting to menopause although menopause signifies an end to a woman's reproductive years it is nothing more than a natural transition that is part of every woman's life knowing the signs of the process can help prepare you for this change and prepare for life after perimenopause menopause will not arrive suddenly rather over a period of years starting in the late 30s to 40s your body will gradually reduce production of estrogen and progesterone this time typically lasting between two and ten years is called perimenopause symptoms include irregular menstrual cycle hot flashes insomnia reduced libido limited fertility there is no real need to see a physician for perimenopause symptoms unless they are interfering with your daily life in such cases your medical provider may choose hormone therapy to reduce their impact menopause menopause officially occurs when a woman has not had a menstrual cycle for 12 months at this point her ovaries have exhausted their supply of eggs and the uterus no longer forms new linings in addition to these reproductive changes menopause also puts women at risk for bone loss for detailed information about transitioning to menopause schedule an appointment with a provider in the ob gyn department exercise six and seven page twenty seven good morning mrs brooke you have some questions about menopause yes exactly basically i'm worried that it's already started and i'm only 39 years old okay first are you having regular menstrual cycles not exactly i've missed at least two in the last year well the good news is that you're definitely not in menopause not until you've missed 12 consecutive cycles that's a relief but i'm definitely showing some other symptoms too can you describe those i'm not sleeping well and lately i've been getting hot flashes all right it sounds to me like you're entering perimenopause it just means your hormones are starting to level off so can i still get pregnant my husband and i still talk about having another child yes you can but i wouldn't wait too long because perimenopause does lower fertility i see is there anything we can do about the other symptoms some added exercise will help the insomnia and cutting down on alcohol should reduce the hot flashes unit 13 geriatric nursing exercise 5 page 29 grace nursing home about us we at grace nursing home are dedicated to providing the highest level of care to our patients our staff includes over 20 highly skilled nurses specializing in geriatric care unlike most assisted living facilities grace nursing home provides 24-hour supervision and assistance to our patients our care grace nursing takes pride in providing the very best care our nurses are trained to recognize and treat a wide variety of conditions we closely monitor patient medication to prevent polypharmacy problems including harmful drug interactions that can lead to dizziness falls or strokes we provide our patients with top quality equipment and products such as mattresses that help prevent bed sores we offer a variety of activities and services to keep our patients healthy and happy our patients at grace we care for and treat patients with a wide range of medical problems from immobility to incontinence some patients need only moderate assistance such as those with hearing loss others require closer supervision such as those suffering from alzheimer's disease the patients at grace may differ in their needs but they all come here seeking the same thing reliable top-rate care if you or your loved one is looking for such care contact grace today exercise 6 and 7 page 29 hello miss hale what can i do for you i'm looking into different geriatric care facilities for my dad can you help me sure what kind of facility are you interested in either a nursing home or assisted living we're not sure which is best well they offer similar services but different levels of care how so nursing homes provide around-the-clock supervision with assisted living you can ask for assistance when you need it which do you think would be best for my dad well his overall health is fairly good but he does have some incontinence problems and some problems getting around yes there are some immobility issues how much assistance would you say he needs with daily activities not too much he occasionally needs help dressing himself but aside from that he's fairly independent right yes well assisted living might be the best fit unit 14 psychiatric nursing exercise 5 page 31 a challenging career psychiatric nursing if you would like to specialize in one area of nursing psychiatric nursing could be the right thing for you it's a growing field and nurses work in a wide range of locations using surprisingly diverse therapies psychiatric nursing is the care of people with mental illnesses such problems may include dementia schizophrenia bipolar disorder eating disorders depression and addiction nurses use the dsm-4 as their main reference source nurses may work in a hospital setting but they are also likely to meet patients in their own homes or even in prisons as many nurses are involved in the rehabilitation of those who have been hospitalized or imprisoned psychiatric nursing involves a range of different interventions nurses need skill in the administration of medicines both orally and through intramuscular injection nurses may also treat patients using electroconvulsive therapy nurses may also be involved in delivering psychotherapy to aid patients recovery and manage any future crises in their medical health if you would like any further details on a career in psychiatric nursing please contact wendy stevens at the center for psychiatric training at w dot stevens at cpt.org exercise 6 and 7 page 31. we have in the studio today penny hargreaves who has come to talk about her job as a psychiatric nurse good morning penny good morning bob penny what exactly is psychiatric nursing psychiatric nurses care for people with mental illnesses such as bipolar disorder dementia and so forth are you based in a hospital personally no i do most of my work at people's homes really yes my work involves the rehabilitation of people back into society people who have been previously hospitalized because of mental health issues you mean yes and also people with mental illnesses who have been imprisoned fascinating and what does your work involve i'm trained in a range of interventions i use many of the same skills as regular nurses but i'm also trained in psychotherapy and is electricity still used in psychiatric treatment electroconvulsive therapy no that's only used in a small number of cases i've never used it myself so penny what would you say to anyone considering a career in psychiatric nursing i'd say it's hard work but it's very rewarding unit 15 hospice nursing exercise 5 page 33 vernon hospice care about us vernon hospice care is a full service provider of end-of-life care we know there is no more difficult time for patients or their families our compassionate staff will be there to make sure that you or your loved ones are as comfortable and prepared as possible who do we care for vernon hospice care only assists patients afflicted with a terminal disease and who have a life expectancy of six months or less what do we do hospice care provides palliative measures it is important to note that such measures do not include euthanasia though dnr orders are always honored within a strict legal and ethical code vernon hospice staff does everything possible to make patients comfortable and relaxed we assist patients and families with medication mobility meals and medical decisions we know that our patients have much more than medical needs and so we also attempt to relieve emotional stress as well to that end we provide therapy as well as planning for funerals burials and cremations likewise we handle remains and arrange for prompt delivery of a death certificate after a patient passes away making these decisions and plans ahead of time often helps patients feel prepared and allows families to grieve in peace exercise 6 and 7 page 33 hi ms wilson how are you holding up today oh as well as i can i suppose how are you i'm well thanks for asking are you feeling any pain right now i am actually it's my back again okay i'm going to increase your morphine drip just a bit is there anything else i can do right now no that's it thank you now do you have those forms today oh yes i do are you feeling ready to go over them i think so let's start with a dnr order all right now you understand what this means when the time comes we won't provide any life-saving measures that's right i feel ready though i understand i'll see that this gets updated right away and do you have the estimates on cremations yes on average you're looking at about one thousand dollars that's pretty steep isn't it well a burial can be five times more expensive i've always hated wasting money let's look at the cremation details glossary abbreviation abdominal obesity acuity acute addiction adhere to alcohol alcohol based alzheimer's disease amputation anaesthesia permit anti-angiogenesis therapy anxiety aspirin assessment assisted living at risk bed sores bipolar disorder blindness bmi budget burial cancer cardiovascular cataract chemotherapy chlorhexidine cholesterol chronic chronic bronchitis chronological order compassionate compound fracture comprehensive concise condition congenital heart disease contamination continuous coronary artery disease crash cart cremation cultural differences death certificate dementia depression direct diverse dizziness dnr do not resuscitate order document drug interaction dsm-4 e coli eating disorder ekg report electroconvulsive therapy emergency severity index esi empathy end of life care endocarditis esi1 esi 2 esi 3 esi 4 esi 5 estrogen euthanasia exhaustion fertility fracture full time funeral geriatric gestational diabetes glaucoma glucose grieve gum gynecology gyn health literacy hearing loss heart failure highlight hormone therapy hospice hot flash hypertension hypertonic hypotonic immobility immunotherapy incentive incontinence infusion initial insomnia insulin intermittent intervention isotonic iv pump jargon legibly libido life expectancy macro drip medication reconciliation form [Music] menopause menstrual cycle micro drip miscommunication mrsa nonverbal nosocomial npo order nil per o's nursing home obstetrics ob oncologist oncology open-ended question operative permit osteoporosis outpatient ovary overtime overworked pacemaker palliative parenteral part time pass away pathogen perimenopause personal effects photodynamic therapy plan of care plaque buildup pneumonia poison polypharmacy post-op preconception pre-existing pre-op progesterone psychiatric nursing psychotherapy radiation therapy rapport rehabilitation remains resource retirement roller clamp saline sanitizer scarlet fever schizophrenia shift staph infection status stent strep virus stress stroke supervision survey terminal therapeutic transplant trauma triage tumor type 1 diabetes type 2 diabetes update urinary catheter uterus vector ventilator associated pneumonia verbal vigilant witness workload x-ray