Exam 2 (chp. 1, 15, 11, 12) Flashcards
(105 cards)
1
Q
known as the founder of “modern nursing”
A
florence nightingale
2
Q
established the american red cross
A
clara barton
3
Q
first male nurse to receive a commission as a reserve officer
A
Edward lyon
4
Q
cofounded the national association of colored graduates
A
mary mahoney
5
Q
pioneers of public health nursing
A
lillian wald and mary brewster
6
Q
served as superintendent of the U.S. Army nurses
A
dorothea dix
7
Q
compiled the first manual of drugs for nurses
A
lavinia dock
8
Q
RN entry education
A
- diploma programs
- associate’s degree
- baccalaureate degree
- RN to BSN
- accelerated BSN
9
Q
other nursing programs
A
- master programs
- doctorate programs
10
Q
other forms of formal education
A
- continuing education
- in-service education
11
Q
Process Patricia Benner described the process by which a nurse acquires clinical skills and judgement
A
- stage 1: Novice
- stage 2: Advanced Beginner
- stage 3: Competent
- stage 4: Proficient
- stage 5: Expert
12
Q
Nurse Practice Acts
A
laws that govern the practice of nursing
13
Q
Each board of nursing is responsible for:
A
- education programs
- defining practice
- licensure (RN, LPN, LVN)
- determining scope of practice
- rules and regulations for guidance
- enforcing rules that govern nursing
14
Q
Standards of practice
A
provide a guide to the knowledge, skills, and attitudes that nurses must incorporate into their practice to provide safe, quality care
15
Q
american nurse association (ana)
A
national professional organization
16
Q
National League for nursing (NLN)
A
Sets standards for all types of nursing education programs
17
Q
International Council of Nurses (ICN)
A
Federation of national nursing organizations
18
Q
National Student Nurses’ Association (NSNA)
A
representing nursing students in the U.S.
19
Q
Sigma Theta Tsu International (STTI)
A
international honor society for senior-level baccalaureate and graduate programs
20
Q
Recipients of care:
A
- individuals (patients, clients, persons)
- groups
- families
- communities
- type of care (direct and indirect)
21
Q
Purpose of nursing care
A
- Health promotion
- Illness prevention
- Health restoration
- End-of-life Care
22
Q
Case Method
A
considered total care
23
Q
Functional nursing
A
Requires clear understanding of tasks each member may perform or scope of practice
24
Q
Team Nursing
A
Maintains the cost savings of functional nursing while limiting fragmentation
25
Primary Nursing
one nurse manages care for a group of clients
26
Differentiated Practice
Variation of primary care, recognition of education and experiences lead to difference in the care delivered by each nurse.
27
Type of Care in the Delivery System
- acute care
- long-term support services
- Inpatient
- Outpatient
28
Where is care provided in the Delivery System
- hospitals
- extended care facilities (skilled/custodial care)
- ambulatory care centers
- home health care agencies
- community or public health centers
- independent living facilities
29
Primary Health Care
Nursing and Health Promotion; foster the highest state of well-being.
Examples are: Individual level, group and family
level, community level and societal level.
Nursing and Illness Prevention; the focus on illness prevention is the avoidance of disease, infection, and other comorbidities.
Examples: hand washing, immunizatons, smoking
cessation
30
Secondary Health Care
nursing and health restoration
31
Tertiary
nursing and end-of-life care
32
Financing Healthcare
- individual
- individual private insurance
- employment-based private insurance
- government (medicare/medicaid)
- charitable organizations
33
Health care reform
affordable health care, medicare and public policy (diagnostic related groupings), ana principles for health system transformation
34
Managed Care
- Health maintenance organizations (HMOS)
- prefered provider organizations (PPOS)
- point of service (POS)
- Integrated Delivery System (IDNS)
35
Regulation of health care delivery
- accreditation commission for education in nursing
- commission of collegiate nursing education
- commission for nursing education accreditation
- licensing agencies (boards of nursing)
- the joint commission (establishes standards for hospitals to promote client safety)
36
Trends in nursing practice
- Increased use of complementary and alternative medicine (CAM)
- Increased variety of care locations
- Interprofessional collaboration
- Expanded career roles for nurses
- Increased use of nursing assistive personnel
- Influence of nurses on health policy
- Divergence between high-tech and high-touch
37
Societal trends that influence nursing practice
- Growing proportion of older adults in the United States
- Economy
- Changes in healthcare consumer
- Legislation
- Women’s movement
38
Ensure Quality of Care
- Continuous quality improvement programs (CQI)
- Process reviews
- Outcome reviews
- Structure reviews
39
What is communication?
- Basic human function
- Sending messages back and forth between two or more people
- Consists of verbal and nonverbal messages
- Helps build working relationships
- Helps meet physical, psychosocial, emotional, and spiritual needs
40
levels of communication
intrapersonal, interpersonal, group, public speaking
41
intrapersonal
self-talk; can be positive or negative
42
interpersonal
between two or more people
43
group
with many people at the same time
44
public speaking
unique form of group communication
45
Components of communication
- subject matter
- words
- gestures
- substances of the message
- open to interpretation
46
Verbal communication
involves speaking or writing words to send a message
47
factors affecting verbal communication
- Vocabulary
- Denotative vs. connotative meaning
- Pacing of conversation
- Intonation: Tone, pitch, cadence, volume
- Clarity and brevity
- Timing
- Relevance of information
- Credibility of the sender
- Humor
48
The nurse is teaching the client about their upcoming procedure and the client is very stressed. What is most important for the nurse to do?
A. Use humor first to decrease the client’s stress level.
B. Determine if the teaching should take place at a different time.
C. Introduce themself as the RN to give credibility to their message.
D. Speak to the client when family members are there so they can teach the client.
B
49
nonverbal communication
unconscious use of body language when sending a message
50
factors affecting nonverbal communication
- facial expression
- posture and gait
- personal appearance
- gestures
- touch
51
Factors That Affect Communication in General
- Environment
- Developmental variations
- Gender
- Personal space
- Territoriality
- Sociocultural factors
- Roles and relationships
52
collaborative professional communication
- assertive style communication
- uses standard communication tools
53
Communication styles
- passive
- passive aggressive
- aggressive
- assertive
54
Passive communication
avoid conflict and allow others to take the lead; may exhibit timid posture or negative body language. tend to be indecisive, submissive, apologetic, whining.
55
Passive Aggressive Communication
avoids direct confrontation but subtly achieves goals through manipulation. Appear cooperative or passive on the surface, often become alienated from others.
56
Aggressive Communication
Try to dominate others using intimidation and humiliation. Often blame or criticize others, events, or situations. They are impulsive and have a low tolerance of for frustration
57
Assertive Communication
an expression of a wide range of positive and negative thoughts and feelings in a style that is direct, open, honest, spontaneous, responsible, and non judgemental. Allows you to take responsibility of your own thoughts and actions without blaming others, encourages feedback
58
How Do I Communicate Assertively
- Maintain eye contact, as culturally appropriate.
- Speak clearly and firmly in a respectful manner.
- Project a clear tone of voice.
- Communicate self-confidently.
- Convey a can-do attitude.
- Refrain from sarcasm.
- Do not invite negative responses.
59
How do I communicate safely
- Question care decisions open and honestly
- Use critical (CUS) language
- Concerned, Uncomfortable, and Safety
- Practice closed-loop communication
- Use checklists
- add debriefs at the end of the shift
60
Standard communication tool
SBARQ
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Situation
briefly describe situation
62
Background
state relevant patient history
63
Assessment
summarize assessment
64
Recommend
what are you askign for?
65
Question
Allow opportunities to ask/answer questions
66
patient rounding
Collaborative communication in which the healthcare team discusses goals for care and/or changes in the plan of care
67
Handoff Report
Process of communicating patient information to another healthcare provider
68
Therapeutic Communication
- client centered
- goal directed
- strengthens therapeutic relationship
69
Five qualities characterize communication in the therapeutic relationship
- empathy
- respect
- genuineness
- concreteness
- confrontation
70
Pre-interaction Phase
Gathering information prior to the meeting the patient
71
Orientation Phase
Meeting the client, infroductions; establishing rapport and trust
72
Working Phase
Active part of the relationship, patient clarifies feelings and concerns through verbal and nonverbal communication
73
Termination Phase
Conclusion of the relationship
74
Assessment/recognizing cues
Medications, language, literacy, cognitive function, hearing, vision, aphasia, physiological barriers, communication style
75
Analysis/Nursing Diagnosis
Readiness for enhanced communication, impaired communication, impaired oral communication
76
Planning Outcomes/evaluation
Depend on the nursing diagnosis
77
Interventions/implementation
Enhance therapeutic communication, identifying barriers to communication
78
Enhancing Therapeutic Communication
- Address the patient by name
- Listen actively
- Establish trust
- Be assertive
- Restate, clarify, and validate message
- Interpret body language
- Share observations to clarify
- Use open-ended questions
- Use silence
- Summarize the conversation
79
cultural differences
- cultural sensitivity
- language barrier
80
Impaired speech
- hand gestures
- family assistance
- be positive and patient
81
Impaired cognition
- always communicate
- address patient
- do not rush
- eliminate distractions
- use short sentences
- ask yes/no questions
82
The basis for safe, effective care is thinking, doing, and caring. The nurse is caring for a patient with dementia, who is agitated and having trouble reasoning. How might the nurse show caring when providing a morning bed bath? Give some examples
- Approaching the patient slowly and from the front as to not frighten them or cause them to feel threatened.
- Using a gentle, calm voice; speaking slowly and clearly without rushing.
- Rescheduling a better time to do the morning care if the patient is combative or aggressive. Timing is very important.
- Asking questions that require simple or yes/no answers, rather than broad, open-ended, or vague questions. Short sentences are best and one simple topic at a time. Comments should be concrete and specific.
- Allowing time for the patient to respond to simple directions one at a time.
- Orienting them to person, place, time, and situation in the course of conversation while giving the bed bath. This not only helps to orient them but also is a good distraction technique.
- Turning the TV on while bathing the patient or performing other care that requires cooperation.
- Aiding the patient’s memory by repeating their last expressed thought, if they lose their train of thought.
- Avoiding slang and jargon. A person with dementia and confusion does not interpret figurative language well.
- Using gestures to aid in understanding.
- Providing for basic physical needs (e.g., toileting, meals, pain control) before attempting to provide care that requires cooperation.
83
What is culture?
Culture consists of the values, beliefs, systems of language, communication, and practices that people share in common and that can be used to define them as a collective
84
Providing culturally congruent care to clients
Madeleine Leininger
85
Culture Related Concepts
- socialization
- Acculturation
- assimilation
- dominant culture
- subcultures
- minority groups
86
Subculture: Vulnerable Population
- homeless
- poor
- mentally ill
- people with physical disabilities
- the very young
- elderly adults
- ethnic and racial minority groups
87
Cultural Specifics in Patient Care
- Communication
- Space
- Time-oriented
- Social organization
- Health and illness beliefs and practices
Scientific/biomedical
Magico-religion
Holistic
- Biological variations
- Religion & philosophy
- Education
- Technology
- Policies & law
- Economy
88
traditional and alternative healing
- folk medicine
- complementary medicine
- alternative medicine
89
Barriers to Culturally Competent Care
- Bias
- Ethnocentrism
- Cultural stereotypes
- Prejudice
- Discrimination
- Racism
- Sexism
- Language barrier
- Street talk, slang, jargon
- Lack of knowledge
- Emotional responses
90
Client Assessment
- Health History
Language
Ethnic identity/affiliation
Religious practices
Primary decision maker
Social support
- Physical Assessment
Psychological variations
91
Communicating with Clients who Speak a Different Language
interpreter or translator
internet and computer software
92
Nursing Strategies
- cultural care preservation/maintenance
- cultural care accommodation
- cultural care negotiation
- cultural care repatterning/restructuring
93
Journey Towards Cultural Competence
- Self-knowledge
- Open-mind
- Accommodate and negotiate
- Collaborate
- Respect
- Take a trip to "BALI“
Be aware of your own cultural heritage.
Appreciate that the client is unique;
influenced, but not defined by his
culture.
Learn about the client’s cultural group.
Incorporate the client’s cultural
values/behaviors into the care plan.
94
Core issues of Spirituality
- faith
- love
- hope
- cures, miracles, and spiritual healing
95
Judaism
Kosher (no pork, certain types of food, or combination of dairy & meat).
96
Christianity
Jesus’ death atoned for the sins of human, providing a way to experience the forgiveness of God and to gain eternal life.
97
Seventh Day Adventist
- Saturday is the Sabbath – a day of rest and worship
- Do no secular work or unnecessary business on Saturday
- Refrain from body piercing, tattoos, and jewelry
- Recommends vegetarian diet and no pork
98
Jehovah's Witness
- Do not accept blood transfusion.
- Do not eat raw meat, red meat, or meat that has not been bled properly.
- Abstain from tobacco and other recreational drugs, they may drink alcohol but do not condone drunkenness.
99
Islam
- Submits to Allah .
- Women may prefer to be treated by female staff.
- Women may refuse vaginal examination by a male nurse or physician because they are forbidden to expose their bodies to or be touched by any man other than their husband.
100
Native Americans
- Health is a state of harmony with nature.
- The traditional healer is the medicine man or woman who is wise in the interrelationships of land, humankind, and the universe.
- Note-taking by the professional may be considered forbidden.
- Native Americans may converse in a low tone of voice and may maintain long periods of silence
101
Barriers to spiritual care
- Lack of awareness of spirituality in general
- Lack of awareness of your own spiritual belief system
- Differences in spirituality between nurse and client
- Fear that your knowledge base is insufficient
- Fear of where spiritual discussions may lead
102
Assessment of Spiritual needs
- Sources of information about spirituality
Client environment
Client questions
Client’s behaviors, moods, and feelings
Nonverbal communication
103
Benefits of Spiritual well being
- Greater enjoyment of daily life
- Renewed relationships
- A sense of being at peace with oneself, others, one’s God, and the world.
- A sense that one is truly valued, that life has meaning and purpose
*Nursing should strive to address the spiritual needs of our clients and their families.
104
Important to Note
- Gain self-knowledge.
Be open.
Welcome challenges.
Take time to reflect
- Nonjudgmental attitudes.
- Be aware of your biases.
105
Nursing interventions (spiritual care)
- Active listening
- Presence
- Touch
- Exploring meaning
- Reminiscence therapy
- Spiritual support
- Forgiveness facilitation
- Hope inspiration
- Prayer
