Exam 1 Flashcards

Question

Manager

Answer 1

coordinates the activities of members of their group. As a nurse you will use appropriate leadership styles to talk to patients and other staff in order to coordinate safe, effective care for your patients.

Answer 2

1. Assessment 2. Diagnosis 3. Outcomes Identification 4. Planning 5. Implementation (care coordination and health promotion/teaching) 6. Evaluation

Answer 3

- APRN have higher clinical knowledge and skills

Answer 4

- unlicensed personnel, nursing assistant, aide - 3-6 months of education in hospital, technical college or community college - VS, bathe, change linens, serve meals, weigh patient, get VS, I and O, etc

Answer 5

-usually 12 months of education at a community college. -Do treatments (lung care, feeding), skills, direct patient care. IV and meds (different for different states). -No initial assessments during the day, no admit and discharge, no initial teaching; under RN

Answer 6

-Associate degree or Bachelors Degree,2-4 years of education. -All Assessment, Admission and Discharge, IV, skills, Community Focus, Teaching; -BSN has more health assessment skills, community focus, and leadership

Answer 7

6-8 years of total education, can be masters or doctorly prepared. Differing degrees and tracks. APRN--Practice Focused. Advanced clinical knowledge and skills. PhD/graduate-- not practice focused, research, teaching, etc.

Answer 8

- Staff RN - Advanced practice Registered nurses (APRN) (includes CNS, NP, CNW, CRNA, RNFA) - Nurse Administrator - Nurse Researcher (PHD) - nurse educator -nurse informaticist

Answer 9

State board of nursing, Each state has a board of nursing, they are concerned for the public's safety. They regulate nurse practice acts and licensing

Answer 10

Every state has one and it says what a nurse can and can’t do that is different from the accepted national standard of practice for a nurse.

Answer 11

Novice Advanced beginner Competent Proficient Expert

Answer 12

It can lead to -Compassion fatigue causing lateral violence -burnout -secondary traumatic stress

Answer 13

Licensure- nurses must be licensed in the state they practice in; TNA deals with licensure Certification- Once you graduate from school, sit for boards and become a registered nurse you can start studying for a certification….usually need so many hours working in that area (EX: CCRN); ANCC deals with certification and this says you are an expert in that area

Answer 14

Continuing- Some states require nurses to have Continuing education units (CEUs) in order to renew your license or keep your job (EX: topics such as wound care, diseases, medications, etc.) In-Service- where you take a module or course, take a test, pay a fee and you get a card…some in-service counts as continuing education (EX: BLS certification, training on new hospital equipment)

Answer 15

- Quality and Safety Education for Nurses initiative - collaboration will have positive impact on patient outcomes and improve quality of care

Answer 16

-patient centered care -evidence-based practice -safety -teamwork/collaboration -quality improvement -informatics

Answer 17

1, 2, 3, 4

Answer 18

TNA (aka “The State Board”) - concerned about public safety; reprimand you if you do wrong and can take your license ANA- concerned about nurse safety and advocacy; set professional standards and practice

Answer 19

National League of Nursing nursing education and simulation

Answer 20

National Student Nurses Association - interested in your rights as a student

Answer 21

1. eliminate health disparities 2. achieve health equity 3. attain health literacy 4. improve nation's health and wellbeing

Answer 22

the study or examination of morality through a variety of different approaches. How you respond to an ethical situation is a reflection of the core values, beliefs, and character that make you the person who you are and, ultimately, the professional who you will become.

Answer 23

ability to keep composure while experiencing emotions

Answer 24

Ethical standards and expectations of a particular profession Held to a higher standard because of privileged role in society (what you say holds value) Code of conduct

Answer 25

Courage Compassion Commitment

Answer 26

Serious and potentially dangerous errors Personal stress Professional burnout

Answer 27

1. Autonomy 2. Beneficence 3. Fidelity 4. Justice 5. nonmaleficence

Answer 28

-commitment to include patients in decisions about all aspects of their key. It is a key feature of patient-centered care -freedom from external control, must respect patient independence Ex. informed consent, patient education, patient advocacy, right to refuse medication

Answer 29

Nurses practice in the best interest of helping others. The agreement to act with beneficence implies that the best interests of the patient remain more important than self interest. It implies that nurse practice primarily as a service to others, even in the details of daily work. -patient interest> self-interest

Answer 30

Maleficence means to harm or hurt, so nonmaleficence refers to the avoidance of harm or hurt. In nursing practice, we vow to do no harm to the patient. -balance risks and benefits

Answer 31

-Nurse's obligation to the patient -role of nurse in healthcare team -duties of nurse to profession and society

Answer 32

faithfulness, agreement to keep promises. Follow through on your promises and actions. -loyalty

Answer 33

the promotion of open discussion without fear of recrimination whenever mistakes, especially those involving adverse events, occur or nearly occur -find a balance between the need to learn from mistakes and the need for disciplinary action against employees

Answer 34

-Advocacy -Responsibility -Accountability -Confidentiality -Social Networking

Answer 35

to support of a particular cause. Standing up for the health, safety and patient rights of others is an example.

Answer 36

the respect of one’s professional obligations and to follow through. Every agency that you we will go into in clinical has policies and procedures. Responsibility means that when you are in that agency you follow those policies and procedures. You agree to remain competent.

Answer 37

means the ability to answer for one’s own actions. You need to make sure that your actions are explainable to your patients and your employer and everyone else involved who needs to know.

Answer 38

establishes national safety standards for hospitals

Answer 39

health care team's obligation to respect patient's privacy from outside sources - HIPAA( Health Insurance Portablity and Accountability Act of 1996) mandates confidentiality and protections of patient’s personal health information

Answer 40

cannot post anything inappropriate online

Answer 41

a civil wrongful act or omission made against a person or property.

Answer 42

an intentional tort. Assault is the intentional threat toward another person that places the person in reasonable fear of harmful, imminent or unwelcome contact

Answer 43

any intentional offensive touching without consent or lawful justification.

Answer 44

type of negligence and is often referred to as professional negligence. Criteria 1. Nurse had duty to care for patient 2. nurse breached duty”. 3. patient harmed as result of breach and the nurse did nothing about it.

Answer 45

conduct that falls below the generally accepted standard of care of a reasonably prudent person. -unintentional tort

Answer 46

refers to unjustified restraint of a person; -intentional tort

Answer 47

-quasi-intentional tort -protects a patient from the unlawful intrusion into into his or her affairs. HIPAA is meant to protect this

Answer 48

Societal organizational bioethics/clinical professional personal

Answer 49

pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values that can occur among those who speak a particular language or live in a defined geographic region.

Answer 50

all aspects of life to include interpersonal relationships, family dynamics and childrearing practices.

Answer 51

-causal beliefs about health -illness expression -symptoms of illness -taboos

Answer 52

Disease vs illness (disease is pathophysiology while illness perception is based on culture) -some people may attribute to higher power, karma , medical conditions

Answer 53

-culture dependent (differences in pain verbalization)

Answer 54

prohibited, forbidden action or behavior based on moral or religious cultural beliefs Ex. STIs, mental illness, behavior disorders in children

Answer 55

Culture is learned Culture is constantly changing and adapting Shared beliefs, values, and behaviors (language, rituals, customs, diet, dress)

Answer 56

process by which a person learns the norms, values, behaviors of a culture

Answer 57

process of acquiring new attitudes and values after contact with another culture

Answer 58

process of giving up and identity and absorbing identity of dominant group -biculturalism is having both

Answer 59

acceptance of an unequal distribution of power as legitimate or fair vs illegitimate from the point of view of the less powerful. Some cultures there is a more equal distribution of power and people have the expectation that their opinions will be heard and equally values.

Answer 60

refers to the degree to which a culture is oriented to the futures and long-term rewards versus the degree to which a culture is oriented to the past or present. -short term oriented is past oriented and favor tradition and social obligations

Answer 61

the value of the culture on the degree of closeness and structure of social relationships, and on whether loyalties belong to immediate families or to the extended family. (independent vs interdependent) Western Europe and the United States are considered individualistic whereas collectivism is seen is Asian countries and minority cultures in the United States (Latino/Hispanic)

Answer 62

describes how gender roles are conceived and how greatly male and female roles differ. Some societies place greater value on masculine attributes such as achievement, material success, and recognition verses more feminine attributes such as harmonious relationships, modesty and caretaker.

Answer 63

refers to how much religion permeates one’s day to day existence and to what degree religious practices can be separated from nonreligious practices.

Answer 64

-a personal set or institutionalized system of worship attitudes, beliefs, and practices

Answer 65

conveying acceptance of the patient’s health beliefs while 1. sharing medical information 2. encouraging self-efficacy 3. strengthening the patient’s coping resources

Answer 66

Respect Explanatory model of patient's - and respect their decision Sociocultural context Power Empathy Concerns and fears around illness Trust

Answer 67

bias we are unaware of and that happens outside of our control which is influenced by our personal background, cultural environment, and experiences

Answer 68

helps nurses gain an understanding of the meaning of the illness to the patient, expectations the patient has regarding treatment and care, and the patient’s perception about the process.

Answer 69

Origin and family (birth place, cultural identities, parenting styles, family roles) Communication (Language, respect, eye contact, space touch) Personal beliefs on health/illness (meaning, locus of control, perception, treatment expectations, taboos) Daily practices ( diet, spirtuality, religion, special rituals)

Answer 70

Some cultures are adversely affected groups of people are who systematically experience greater obstacles to health based on their racial, ethnic, or cultural group, religion, socioeconomic status, gender, age, etc.

Answer 71

-goes hand-in-hand -Family dynamics in many ways including the manner in which sick family members receive care, beliefs about sharing information with outsiders about a family member’s illness, gender roles, and beliefs about appropriate child rearing practices.

Answer 72

goes hand-in-hand spirituality, which varies according to how much spirituality permeates one’s day to day existence, and the importance placed on spiritual practices.

Answer 73

Communication patterns, both verbal and nonverbal, are determined by cultural norms. Degree of personal space, eye contact and acceptability of touch all vary by cultures. Stress and coping involves dealing with life’s difficulties and are largely culturally determined

Answer 74

Mood and affect has a strong interrelationship to culture. Depression is the leading cause of non fatal disease burden and years of life lived with disability worldwide. The meaning and expression of fatigue is influenced by one’s culture.

Answer 75

used to confirm that you have explained what patient needs to know in a manner they'll understand

Answer 76

A category of people who identify with each other based on common ancestral, social, cultural, or national experiences. Ethnicity is primarily an inherited status. -common ancestry that leads to shared values and beliefs

Answer 77

a family, tribe, people, or nation. People groups who share certain distinctive physical traits -not biologic

Answer 78

a person’s sexual identity in relation to the gender to which they are attracted, and gender identity -respect pronouns

Answer 79

factors relating to or demonstrating one's belief or devotion to God, a higher being, or one's spirit or soul as an entity separate from their physical body.

Answer 80

cultural awareness and acknowledging your own biases

Answer 81

inequality or difference between the health status of a disadvantaged group such as people with low incomes and wealth and an advantaged group such as people with high incomes and wealth. Members of the disadvantaged group bear a burden of disease, injury, and violence that is out of proportion to the size of the group -closely linked with social, economic, or environmental difference

Answer 82

It is for interpreter

Answer 83

SDOH are the conditions in which people are born, grow, live, work, and age. This includes conditions within a health care system.

Answer 84

-age -race/ethnicity -socioeconomic status -access to nutritious food -transportation resources -religion -sexual orientation -level of education. literacy level -disability (physical and cognitive) - geographical location (e.g., access to health care).

Answer 85

The process by which people acquire and recall information about others based on race, sex, religion, etc., leads to prejudice; what you say or think

Answer 86

Unjustified negative attitude based on a person’s group membership;

Answer 87

When a person acts on prejudice and denies another person one or more of their fundamental rights (food, sleep, healthcare, happiness)

Answer 88

-written by Madeline Leininger -Goal is to provide culturally congruent care (care that fits a person’s life patterns, values and system of meaning) - Goal was not to teach nurses about groups of people but rather to ask people about their culture and then treat them accordingly

Answer 89

1) Cultural awareness 2) Cultural desire 3) Cultural encounters 4) Cultural knowledge 5) Cultural skills

Answer 90

The motivation and commitment to caring that moves an individual to learn from others, accept the role as a learner, be open to and accepting of cultural differences, and build on cultural similarities. -involves caring and willingness to learn -accept differences and build on similarities

Answer 91

Listen (nonjudgementally) Explain (your view) Acknowledge( their view and similarities and differences Recommend (include patient) Negotiate (note treatment benefits with cultural lens)

Answer 92

An in-depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people

Answer 93

Cross-cultural interactions that provide opportunities to learn about other cultures and develop effective intercultural communication

Answer 94

-Sufficient comparative knowledge of diverse groups -exposing oneself to other cultures and being motivated to learn rather than simply learning facts on every culture (patient storytelling is useful tool)

Answer 95

Ability to assess social, cultural, and biophysical factors that influence patient treatment and care, use RESPECT model -includes culturally based assessment and education

Answer 96

freedom from accidental injuries; involves the establishment of operational systems and processes that minimize the likelihood of errors and maximizes the likelihood of intercepting them when they occur

Answer 97

avoiding injuries to patients from the care that is intended to help them, involve[s] making evidence-based clinical decisions to maximize the health outcomes of an individual to minimize the potential for harm

Answer 98

System's performance on safety Evidence-based practice Patient satisfaction

Answer 99

Six critical components: Situational awareness Problem identification Decision making by generating alternative acceptable solutions Appropriate workload distribution Time management Conflict resolution

Answer 100

Crew resource management -training developed in aviation with focus on standardizing procedures and communication to ↑ efficiency and ↓ errors; emphasis on human role in high- stress work

Answer 101

-Sensitivity to operations (situational awareness) -Focused on predicting and preventing rather than reacting to errors -Reluctance to simplify -Deference to expertise vs. hierarchy -Commitment to reliance (contain error and return to work)

Answer 102

-individual performance (ability to perform tasks) -multitasking -distraction -complacency

Answer 103

The model shows how errors occur when situational factors align, despite multiple layers of safeguards for the prevention of errors. Holes are latent and active errors

Answer 104

Commission

Answer 105

Unintended harm by an act of commission or omission rather than as a result of underlying disease process or condition Ex. post-operative infection, hospital acquired conditions (CAUTI, CLABSI), prolonged hospitalization that does not result in permanent harm or death

Answer 106

Error of commission or omission that could have harmed a patient, but harm did not occur as a result of chance, prevention , or mitigation

Answer 107

Prevention: error identified before reaching patient Mitigation: error reached patient but intervention reduced consequences

Answer 108

unexpected occurrence involving death or serious physical or psychological injury or risk there of -loss of limb or function

Answer 109

the need for immediate investigation and response.

Answer 110

Diagnostic Treatment Preventive Communication

Answer 111

lack of communication, lack of clarity, or breakdown in communication

Answer 112

due to delay in diagnosis, failure to order indicated tests, failure to respond to the results of findings of monitoring or testing.

Answer 113

results from performing an operation, procedure, or test; administering a treatment; medication errors; or an avoidable delay in treatment or response to abnormal finding.

Answer 114

failure to provide prophylactic treatment and inadequate monitoring or follow-up of treatment

Answer 115

Cause or etiology of healthcare errors and improvements

Answer 116

Errors made by those who are providing care, responding to patient needs at the point of care ( unsafe behaviors ) -sharp end

Answer 117

hidden or inactive contributing factors in health care; organizational, contextual, or design-related errors ( procedural, systemic, policy) -blunt end

Answer 118

occurs when there is a defect in a system that does not immediately lead to an accident but creates a situation in which a triggering event may lead to an error

Answer 119

shift from identifying fault to establish blame to acknowledging and reporting errors and near misses to improve system

Answer 120

knowledge skills attitudes (shared responsibility)

Answer 121

health care quality communication collaboration care coordination

Answer 122

defined as “defined as identifying the gap that occurs between ideal care and actual care delivered”

Answer 123

i. Ensure safe handoff between providers or between settings ii. Provides clear direction in seeking and sharing information among health care providers iii. Facilitate collaborative behaviors for advocating to prevent errors from occurring.

Answer 124

i. ineffective communication ii. Hierarchy - not valuing what everyone brings to the table iii. destructive behavior

Answer 125

1. Barcodes 2. CPOE 3. Medication pumps 4. automatic alerts and alarms

Answer 126

Effective use of technology Standardized practices Effectively use strategies to reduce risk of harm to self or others Effective communication ( #1 cause of unintentional patient harm)

Answer 127

1. open communication amongst healthcare team 2. Organizational error-reporting systems

Answer 128

root cause analysis -process of identifying the cause and allocation of responsibility and accountability

Answer 129

-Follow 7 rights of drug administration -Assess patient’s ability to self-administer medications -Monitor side effects -Do not delegate any part of the medication administration process to nursing assistive personnel (NAP) -Educate patient and families about medications -implement nursing process to integrate medication therapy into patient care

Answer 130

any preventable event that may cause inappropriate medication use or jeopardize patient safety • report all that reach patient including near misses error

Answer 131

1. Assess the patient’s condition ( safety 1st ! ) 2. Notify the HCP of the incident immediately 3. Report the incident to the nurse manager, supervisor, or charge nurse 4. Complete an incident or occurrence report (Do not include any reference to an incident in the medical record (due to legality))

Answer 132

healthcare team compare medication that patient is currently taking with what patient should be taking and any newly ordered medications

Answer 133

1. Identify and resolve orders that are duplicated and omitted 2. Evaluate risk for unintended medication interactions 3. Create and maintain an accurate and current list of all patient medications

Answer 134

-Unit doses (single dose packages) -Automated medication dispensing systems (AMDs) -Bar-code medication administration (BCMA) system

Answer 135

Follow the seven rights of medication administration Prepare medication for only one patient at a time Use at least two patient identifiers Review the patient's allergies

Answer 136

Technology work arounds Design of medication labels Medication distribution systems

Answer 137

Right medication Right dose Right patient Right route Right time Right documentation Right indication/reason

Answer 138

1. to be informed about their care 2. to make decisions about their care 3. to refuse care 4. to be listened to by their caregivers 5. to receive info in a way that meets their individual needs 6. to be informed of errors; transparency

Answer 139

- when they ↑ patient mobility and stability when moving into or out of bed - if patient can freely exit the bed and move in it - to prevent sedated patient from falling out

Answer 140

side rails

Answer 141

for every medications that the nurse will administer to a patient

Answer 142

when the operating room staff members notify you that they are coming to get a patient for surgery.

Answer 143

Administer STAT immendiately; now within 90 minutes

Answer 144

within 30 minutes before or after the scheduled time

Answer 145

30 minutes before or after they are scheduled to maintain therapeutic blood levels.

Answer 146

1 to 2 hours before or after the scheduled time or per agency policy.

Answer 147

Drug name Dose strength Route Frequency If PRN—Indication for use

Answer 148

any chemical (drugs not to treat patient's condition), manual method, physical, mechanical device, or material or equipment that immobilizes or reduces the ability of a patient to move freely unless to prevent harm during activity -THEY ARE TEMPORARY

Answer 149

Every 15 minutes for violent behavior Every 2 hours for nonviolent behavior

Answer 150

Reduce the risk of patient injury from falls Prevent interruption of medical therapy such as traction, IV infusions, nasogastric (NG) tube feeding, or Foley catheterization Prevent patients who are confused, disoriented, combative from removing life-support equipment Reduce the risk of injury to others by the patient

Answer 151

-face-to-face physician order within 24 hrs (60 minutes if violent) - use all alternatives before restraint ----NO PRN -use least restrictive alternative -select alternative based on patient situation

Answer 152

-pressure injuries -pneumonia -constipation -incontinence -loss of self-esteem -humiliation -agitation -death (restricted breathing and circulation

Answer 153

-Vital signs -Skin integrity -Nutrition -Hydration- offer water -Extremity circulation (2 fingers) -Range of motion (ensure call light placement in reach) -Hygiene -Elimination needs -Cognitive functioning and Psychological status -Need for restraint

Answer 154

-Identify patient correctly -Improve staff communication -Use medicines safely -Prevent infection -Identify patient safety risks -Prevent mistakes in surgery

Answer 155

-de-escalation -trained sitter (companionship and supervision) -Move patient closer to nurse’s station -Distraction -Frequent observations and attention to needs -Bed alarms/chair alarms (no slip socks, low bed) -Family involvement -discontinue bothersome treatment ASAP

Answer 156

-History of falling -Being 65 and over -Reduced vision -Orthostatic hypotension -Lower extremity weakness -Unsteady gait -Urinary Incontinence -Improper use of walking aids -Effects of various medications

Answer 157

1. Fall risk assessment (conducting routinely per agency policy) 2. Hourly/purposeful rounding 2. Identify fall risks (Apply yellow color-coded wristbands to identify fall risks; Fall risk wheel on door) 3. Adaptation of the environment (Remove excess furniture and equipment; Safety bars near toilets) 4. Reduce the number of psychoactive medications 5. Attention to postural hypotension 6. Established elimination/toileting schedules 7. Call lights within reach 8. Bed safety alarms or motion detectors 9. Use of assistive devices (walkers, canes, wheelchairs (brake locks), ) 10 Management of foot problems and footwear (rubber-soled shoes or slippers) 11. Assign Physical therapy for balance, strength, gait

Answer 158

1. Place bed in the lowest position 2. Practice of dangling the patient for 5 minutes on the side of the bed before ambulating.

Exam 1 Flashcards

(190 cards)