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Flashcards in Exam 2 - revised Deck (47)
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1
Q

Patient centered care?

A

patient as source of control and full partner- respect for preferences, values, and needs.

2
Q

4 attributes of PCC?

A

respect and dignity
information sharing
participation
collaboration

3
Q

3 theoretical links to PCC?

A

Watson caring theory
Core of nursing: interaction and caring
knowledge of limitations

4
Q

Cultural background?

A

the environment in which people and families develop values and preferences

5
Q

Exemplars of PCC?

A
kangaroo care
rooming in (newborns)
bed-side reporting for shift change
family advisory boards
discharge teaching
6
Q

Mayo clinic slogan (Berry)?

A

the best interest of the patient is the only interest to be considered

7
Q

ADPIE? define each.

A

Assessment: what needs to be noticed in order to provide PCC- data collection and history review

diagnosis: organizing data and determining needs based on analysis
planning: establishing measurable priorities and outcomes, selecting interventions, goal setting

intervention/implementation: actual treatment/procedures, focused on symptom management, independent or collaborative

evaluation: reassessment of symptoms, patients response, documentation

8
Q

4 interrelated concepts of PCC?

A

professionalism
therapeutic communication
safety
ethics

9
Q

Clinical judgment?

A

interpretation/conclusion about a patients needs, concerns, or health problems AND the decision to take action, use/modify standard approaches, or improvise appropriately.

10
Q

7 interrelated concepts of clinical judgment?

A
patient education
professionalism
care coordination
leadership
safety
health care quality
evidence
11
Q

5 exemplars of standard v. interpretivist?

A
rules v. context specific
standard v. individualized
algorithms v. holistic
new practitionars v. expert
analytical v. intuitive
12
Q

3 types of reasoning?

A

analytical: novice
intuitive: experienced (application of past to present)
narrative: full application based on present situation

13
Q

3 attributes of nursing care?

A

NON-LINEAR
multiple factors
no clear-cut answers

14
Q

Clinical judgment process?

A

noticing
interpreting
responding
reflecting

15
Q

2 types of reflection?

A

in action: understanding of patient responses WHILE care is occuring

on action: contemplation and consideration of a situation on what is successful/unsuccessful

16
Q

2 things to remember when considering clinical judgment?

A

it is an aspect of nursing in all settings

it is NOT required in all patient interactions

17
Q

nurses judgment based on what 4 things?

A

nurse’s knowledge

experience

ethical perspective

knowledge of patient

18
Q

What is clinical reasoning?

A

nurse’s ability to collect the right cues and take the right action for the right client at the right time.

19
Q

purpose of the nursing process?

A

thinking
identifying
determining outcomes
prioritization

20
Q

What are the steps of the nursing process based on?

A

scientific process.

ADPIE

21
Q

Tanners model of noticing?

A

nurse notices things about patient in the context of the nurses background and experience, environment, and knowledge of the patient.

LOOKING FOR PATTERNS TO GUIDE CARE.

22
Q

2 different types of data?

A

subjective: info from patient or patients family via verbal/nonverbal communication
objective: tests, records, assessments

23
Q

2 sources of data?

A

primary subjective: what the patient tells the nurse
primary objective: nurse data via observation and examination

secondary subjective: what others tell the nurse about the patient
secondary objective: nurse data via sources other than the patient

24
Q

Tanner interpretation?

A

assembling info to make sense of it- looking for patterns and analyzing them

25
Q

4 types of nursing diagnosis?

A

actual: responses to health conditions in a family, group, or community
risk: judgment of experiences/responses to health conditions that have a likelihood of developing in a vulnerable person, family, group, or community

health promotion: clinical judgment of person, family, or groups motivation to increase well-being and health potential.

syndrome: clinical judgment describing a cluster of diagnoses that occur together and through similar interventions. have both defining characteristics and related factors

26
Q

How do you select a diagnosis? 2 types of diagnoses?

A

look for patterns
group common patterns
identify possible diagnosis(s)

independent
collaborative

27
Q

Etiology of clinical judgment?

A

R/t (relationship to the diagnosis)

28
Q

What phrase links the etiology and the defining characteristics?

A

as evidenced by (AEB)

29
Q

2-part nursing diagnosis? 3-part diagnosis?

A

NANDA-I label
r/t statement

Problem: NANDA-I label

etiology: contributing factors
symptom: defining characteristics

30
Q

Composition of PES?

A

Problem: risks, current issues, and diagnosis

etiology: r/t
symptom: defining characteristics, signs, “patients story”

31
Q

steps of planning?

A

determine problem urgency
prioritize
which interventions most effective?

32
Q

3 types of planning?

A

comprehensive plan: based on comprehensive assessment

ongoing: completed throughout care
discharge: anticipated and planned for after discharge

33
Q

ABCs of prioritization?

A

airway
breathing
circulation

34
Q

3 types of prioritization?

A

emergent: life threatening
urgent: needs treatment, not life threatening

non-urgent/routine

35
Q

patient safety (fall and injury prevention) is a goal of what?

A

the joint commission

36
Q

Responding?

A

implementation of actions based on needs.

Judgment of effectiveness depends on level of expertise.

37
Q

SMART outcomes?

A
specific
measurable
attainable
realistic
timed
38
Q

Nursing outcomes classification (NOC)?

A

nursing: sensitive outcome
measured along continuum
response to interventions
5-pt Likert rating scale

39
Q

2 types of collaborative intervention?

A

interdependent: participation of other providers
dependent: requires an order

40
Q

3 attributes of intervention/implementation?

A

research evidence
client values
expertise

41
Q

institute of medicine?

institute of health care improvement?

A

improve patient safety and care quality

100,000 lives campaign

42
Q

When do early changes in condition occur most often?

A

48 hours before code blue

43
Q

changes to report (3) in danger of decline?

A

vital signs
behavior/mental status
pain

44
Q

MEWS?

A

modified early warning system (stony brook)

physiologic scoring system with indicators

45
Q

failure to rescue?

A

inability to save a patients life upon complications that were not present on admission

46
Q

rapid response team?

A

critical care experts onsite and available anytime.

respond to actual/perceived changes in patients condition.

47
Q

situational awareness?

A

promotes safer patient care environment and helps develop priorities and attention to clinical details