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NSG 310 > Exam 2 "hints" > Flashcards

Exam 2 "hints" Flashcards

1
Q

What does the ANA say about nurses and how they are professional beings?

A

Speaks to the nurses obligation to: The client, to self, to colleagues, and to the nursing profession
Gives us information like social policy and the nurse practice act
Includes safety, EBP, and quality of care

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2
Q

What is non-maleficence?

A

avoiding actions that bring harm to another person

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3
Q

What is the beginning of therapeutic communication?

A

Introduction
establishment of trust

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4
Q

How do you use therapeutic communication?

A

build rapport with the client
identify clients feelings problems and goals

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5
Q

autonomy

A

the individuals right to self determination

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6
Q

beneficience

A

doing the greatest amount of good and avoiding harm

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7
Q

confidentiality

A

respect for another’s privacy, not divulging info that was given in confidence

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8
Q

maleficence

A

act of committing harm

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9
Q

What is HIPPA?

A

Health Insurance Portability and Accountability Act was designed to protect an individuals health records and info

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10
Q

What happens to us as nurses if we do not adhere to HIPPA?

A

penalties for failure to comply involve a substantial fine, prison term, or both

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11
Q

How does communication begin?

A

the interview process
Phase 1: orientation
Phase 2: Working
Phase 3: Termination

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12
Q

What is cultural competence?

A

a set of cultural behaviors and attitudes integrated into the practice methods of a system, agency, or its professionals that enables them to work effectively in cross cultural situations

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13
Q

What are the 8 domains of cultural competence?

A

governance
leadership
workforce
communication
language assistance
engagement
continuous improvement
accountability

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14
Q

How do we understand different cultures and get more awareness about them?

A

become knowledgable
recognize barriers
develop techniques to foster communication and utilize resources

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15
Q

What is QSEN?

A

Quality and Safety Education for Nurses
prepares future nurses to provide safe, quality, patient centered care and team collaboration in a clinical practice

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16
Q

What does client centered care mean and all we do as a nurse?

A

includes client’s individual preference, values, beliefs and needs
client has right to self determination
advocate for client

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17
Q

What did the Joint Commission do in accrediting?

A

National patient safety goals
TJC also regulates hospitals and evaluates safety fro accredidation
5c’s

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18
Q

What are the national patient safety goals?

A

identify patients correctly
improve effective communication
improve safety of high alert meds
ensure correct site, correct procedure, correct patient surgery
reduce risk of health care associated infections
reduce risk of patient harm from falls

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19
Q

What are the 6C’s

A

clear
concise
complete
concrete
courteous
correct

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20
Q

What are the reasons medical errors occur?

A

miscommunication
errors are usually system problems
due to fatigue or handoff errors
under reporting of med errors

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21
Q

What is evidence based practice?

A

implementing nursing interventions based on sound clinical research and professional judgement in real-time situations

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22
Q

Why do we use evidence based practice?

A

provide the best care to clients by using the best evidence to guide practice

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23
Q

What is the IOM to err is human?

A

a report that expressed not all humans are perfect and will continue to make errors, but it is up to the health care system to identify what leads to errors so that improvements cam be made

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24
Q

What is a near miss?

A

when a patient is exposed to a harmful situation but DOES NOT experience harm (either through luck or early detection)

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25
Q

What is a preventable adverse effect?

A

due to error or failure to apply an accepted strategy or prevention

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26
Q

What is an ameliorable adverse event?

A

while not preventable, could have been less harmful if care had been different

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27
Q

how do we start the process of initiating evidence based practice?

A

asses the patient and identify a clinical problem
then ask a question

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28
Q

Why don’t we like to report errors?

A

we fear being punished

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29
Q

What is TeamSTEPPS?

A

Team Strategies and Tools to Enhance Performance and Patient Safety is a program that emphasizes improving patient outcomes by improving communication in a health care team using EBP

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30
Q

Biases and understanding our own biases

A

bias: slant toward a particular belief
understanding your own biases starts with self-awareness and cultural awareness, understand intrinsic biases

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31
Q

Define therapeutic communication

A

The purposeful use of communication to build and maintain helping relationships with clients’ families, and significant others. Therapeutic communication is client-centered, purposeful, planned, and goal directed.

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32
Q

What are the most important parts of therapeutic communication?

A

client-centered
partnership
professional boundaries
involvement/active participation
use of self

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33
Q

client centered

A

includes the clients individual preference, values, beliefs, and needs

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34
Q

partnership

A

honors the clients right to self-determination, giving the client and family maximum control over health care decisions
advocate for the client and encourage independence

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35
Q

professional boundaries

A

protect functional integrity of alliance between the nurse and client

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36
Q

involvement/active participation

A

degree of the nurse’s attachment and active participation on clients care

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37
Q

use of self

A

authenticity: requires admitting mistakes, recognizing vulnerabilities
self-awareness: reflective process seeking to understand one’s one values, feelings attitude, motivations, strengths and limitations
presence: in the moment

38
Q

Define safe, quality care

A

QSEN definition: the minimization of risk for harm to patients and to providers (doctors and nurses) through both system effective ness and individual performance

39
Q

What do we do to clarify communication?

A

paraphrase
restate
reflect
explore

40
Q

paraphrase

A

Restating in fewer words what was said

41
Q

restate

A

Echoing feelings; saying the same KEY WORDS that the client used

42
Q

reflect

A

may be a question or mirroring back to the clients feelings

43
Q

explore

A

A way to elicit more information such as “tell me more, describe, give me an example”

44
Q

Therapeutic vs non therapeutic communication

A

therapeutic: use of silence, active listening, clarifying techniques, verbal, nonverbal
non therapeutic: excessive questioning, giving advice, giving approval or disapproval, asking “why” questions, changing the subject

45
Q

What does “advise” mean from a nursing perspective?

A

RECOMMEND what a client should do (ex: take a shower or instruction after discharge)

46
Q

Electronic records and what they have to do with nurses. Are they good or bad?

A

Technology oriented solutions, such as electronic records, barcodes and IDs help nurses perform safer practices when caring for a patient

47
Q

what are some safer practices that nurses can implement?

A

use of check lists
timely documentation
standardized tools (SBAR) for better communication
technology oriented solutions
understanding interdisciplinary roles relationships and nursing role relationship changes
EBP research and promotion of safer policies/procedures

48
Q

What are the various theoretical concepts of a person, concepts of illness, concept of environment- nursing etc.?

A

There external factors that play into a client’s condition.
The clients view on illness, environment (where they live), previous experiences, nationality, ethnicity, how they were raised, etc. will play a role how a person views their experience in a hospital setting

49
Q

What is SBAR?

A

SBAR is a standardized communication tool commonly used between two people during handoff.
Situation
Background
Assessment
Recommendation

50
Q

Situation

A

Introduce yourself
Patient name, age, room #
Attending physician/consulting physician involved in care
Diagnosis and admission date
Description of patient’s current situation

51
Q

Background

A

Basically a head to toe assessment
Pertinent procedures and tests completed
Allergies, code status, most recent VS, BS, labs
Vascular access, fluids, drip/rate, patency and site- changes due or last changed
Oxygen flow if oxygen was ordered
Hearing, visual, cognitive, language barriers
Patient mobility/fall risk status
Isolation/infection control precautions
Current medications/relationship to condition
Comorbidities affecting client’s status
Cardiac status

52
Q

Assessment

A

Any changes in respiratory, physical, or mental status
What happened in today’s shift
Last pain medication given
Any medications held and the rationale

53
Q

Recommendation

A

Suggestions of actions to be taken (plan of care, what does the patient need and when, pending procedures and tests to be scheduled)
Recommendations for discharge
Ask if receiving nurse has any questions

54
Q

What is Maslow’s hierarchy of needs?

A
  1. Physiological needs
  2. Safety and Security needs
  3. Love and Belonging Needs
  4. Self esteem
  5. Self actualization

Helps nurses prioritize nursing actions

55
Q

infant

A

totally dependent on caregiver
communicate through CRYING OR SMILING
provide for infants physical and emotion needs, by 12 months, infants say 3-words with meaning swaddle and hold infant in arms
Take time to listen and address caregiver

56
Q

toddler

A

Regress to infantile behaviors when stressed (they think its safer)
LITERAL with interpretation of word (take BP, they think you are actually taking something from them)
Use consistency; routines are important, explain using very basic words, approach slowly

57
Q

preschooler

A

Follow simple commands but only ONE AT A TIME
LITERAL with interpretation of words
Eye contact, sit down at their level, approach slowly

58
Q

school age

A

Transition from home to school
Use terms understandable to child, give choices, provide encouragement and praise, be honest

59
Q

adolescent

A

Transitioning from childhood to adulthood
-fight for independence
-need comfort and security difficult time
-demands from family school peers society body changes (puberty need something to feel good about acne difficult time for parents
-transition
-opposing views

60
Q

adults

A

Recognize characteristics
-working toward career goals
-earning a living
-establish primary relationships
-making a place in their community
-raising a family STRESS
-info and assistance in parenting and daily living
-extended psychological adolescent period
-still pursuing education
-still living with parents (boomerang generation)

61
Q

older adults

A

Fewer acute illnesses (chronic illness management) more freedom (empty nest, retirement) final stage (no longer needed, bored, lack of energy to participate in activities, fear off loss) interests in younger years tend to remain the same (active vs non active social vs nonsocial)

62
Q

fidelity

A

faithfulness; loyalty; obligation to client

63
Q

virtue centric

A

this theory centers on the CHARACTER of the person acting

64
Q

deontology

A

this theory asks “what is one obligated to do?” It focuses on the MORAL VALUE MINDEDNESS where everyone has inherit dignity and worth

65
Q

utilitarianism

A

this theory places emphasis on the OUTCOME of the situation - greatest good for the greatest number

66
Q

advanced directive

A

document where written instructions are recognized under state law related to the provision of medical care when an individual is incapacitated and unable to state desired care

67
Q

advocate

A

someone who speaks up for or acts on behalf of clients

68
Q

clients rights

A

right to autonomy, beneficence, nonmalficience, justice, informed consent

69
Q

informed consent

A

A person’s agreement to allow something to happen based upon a full disclosure and explanation of facts needed fro a client to make an intelligent decision. May include information about procedures, treatments, options and consequences of refusal

70
Q

Statutory vs Common Law

A

statutory: established through the legislative process
common law: established by previous court decisions

71
Q

What can the boards of nursing do?

A

can only limit to deny a nursing license

72
Q

What are the 6 competencies of QSEN?

A

patient centered care
teamwork & collaboration
EBP
Quality improvement
safety
informatics

73
Q

just culture

A

recognizes human error and faulty systems that causes a mistake and encourages investigation so that the system can be fixed
makes workers feel more at ease to report problems

74
Q

Agency for Healthcare Research and Quality (AHRQ)

A

U.S. Department of Health and Human Services involved in patient safety by FUNDING RESEARCH and complying evidence to publish best evidence based standards of practice

75
Q

young old

A

65-74

76
Q

old

A

74-84

77
Q

oldest old

A

85+

78
Q

centenarians

A

100+

79
Q

paternalism

A

a concept where health care providers believe there know more about what is best fir the clients than the clients themselves

80
Q

ethnicity

A

a membership of a person in a particular cultural group.. common racial, geographic, ancestral, religious of historical bonds

81
Q

ethnocentrism

A

the belief that ones own culture is superior to another culture

82
Q

cultural relativism

A

a concept where each culture is determined to be unique and only judged on its own values, standards or beliefs

83
Q

health disparities

A

can exit where there are margins of society that are undeserved for medical care being given (healthcare may be unavailable or person may not have the awareness)

84
Q

acculturation

A

where a person from a different culture learns behaviors and values of the dominant culture and adopts the norms and values including language

85
Q

communication principles

A

Listen carefully
Explain what the client needs to understand
Acknowledge cultural differences
Recommend what the client should do
Negotiate mutually agreeable strategies

86
Q

hispanic/latino

A

strong family loyalty father head of household and primary decision makerreligion: Roman Catholic believe illness id falling out of favor w God high incidence of diabetes not uncommon fro these clients to share meds LOOKING FOR WARMTH RESPECT AND FRIENDLINESS FROM HCP

87
Q

African american

A

value “caring for ones own”women often head of household, backbone, assume responsibility for parents and children history of oppression , HTN, stroke, diabetes, heart disease history of suffering from health care disparities especially w lower income groups TRUST MUST BE ESTABLISHED so that clients will participate in their own treatment males tend to use recommended preventivce services and suffer more health issues because of it

88
Q

asian American

A

very hard working and education is high valued metal respect and honesty male with male and female with female nurses smile in agreement even if hey disagreereligion: hinduism, buddhism, muslim- rituals for prayer, modest, dietary restrictions use herbal medicines and treatments like accupunctr eSTOIC less likely to request pain meds DO NOT believing mental health illness, as it brings shame to family and can result in suicide

89
Q

Native American

A

health practicies are ties into spiritual practices value nature and earth blue respect, story telling and humor direct eye contact is disrespectful private shoe little to no emotion will not participate in teaching back

90
Q

culture of poverty

A

associated with health disparities DESERVE SAME RESPECT AS OTHERS

NSG 310 (11 decks)

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