Exam 3 Flashcards
(110 cards)
1
Q
evidence-based practice- what
A
back/ scientific justification for actions
2
Q
AACN
A
action putting current evidence into practice
3
Q
evidence-based p- purpose
A
guide interventions and clinical decision making
4
Q
traditional v authoritative v scientific knowledge
A
traditional- way always done it
authoritative- expert knowledge
scientific- evidence based (research studies)
5
Q
national institute goals research
A
prevent dis, build scientific foundation, manage symptoms
6
Q
evidence based goals- people v nursing process
A
education, policy dev, ethics, nursing history
7
Q
qualitative v quantitative
A
quality v quantity (numbers) b/ include population and data
8
Q
health
A
state complete physical, mental, and social wellbeing in addition to absence of disease or infirmity (weakness)
9
Q
illness
A
reponse to dis, abnorm process involving changed lvl of funct
10
Q
wellness
A
state being healthy by living lifestyle promoting good physical, mental and emotional health
11
Q
does healthy = problem free
A
no
person can still have problems and considered healthy
12
Q
health dimensions
A
iessep
intellectual, environmental, spiritual, sociocultural, emotional, physical
13
Q
dimensions of health- physical, environ, intellectual
A
physic- genetics, age, dev lvl
environ- housing, sanitation, climate, nutritional access
intellect- cog abilities, education
14
Q
dimensions of health- sociocul, emotional, spiritual
A
socio- economic lvl, lifestyle, family cul
emotional- body responce to changing conditions
spiritual- beliefs/values
15
Q
acute illness
A
rapid onset
brief length
ex. flu, gi bleed, pancreatitis, food poisoning, pneumonia
16
Q
chronic illness
A
permanent, irreversible changes
2-3 months, long time
ex. heart dis, lung dis, diabetes, kidney dis, arthritis
17
Q
remission
A
pat have dis but sympt not present
18
Q
exacerbation
A
sympt of dis present/ and or exaggerated
19
Q
morbidity
A
freq. of dis/illness
20
Q
mortatily
A
number deaths due specfic dis/illness
21
Q
illness beh- stage 1
A
symptoms appear- do not affect ADLs
22
Q
illness beh- stage 2
A
sick role
decide if need to take action
go to doctor
impede norm activity func.
23
Q
illness beh- stage 3
A
dependent role
take prescrip or hospitalized
24
Q
illness beh- stage 4
A
IV recovery and rehab
25
risk factors for illness
genetic factors, age, physicological, environ, health habits
26
purpose health illness continuum
measure lvl of health
stages range frm death to high lvl wellness
illustrates dynamic state of health
27
primary health promotion
weight loss
diet, exercise, smoking cessation
(modifiable, used to prevent dis)
most important
28
secondary health promotion
screenings, exam, family counseling
(ID illness early on)
performing stage
29
tertiary health promotion
intervention based
| ex. meds, surgery, OT/PT
30
aging adult objectives
descr, id, compare, desc, id
describ theories of aging
id health problems/illne common in middle age to older
compare myths to realities
desc possible physiological changes occur w/ age
id nursing intervent to promote health
31
leading cause death in middle to older age
```
malignant neoplasms (cancer)
cardiovasc dis (heart dis)
unintent dis (falls, accidents)
diabetes mellitus
cerebrovascular accidents (stroke)
```
32
major health problems in middle to older age
```
cardiovasc and pulm dis
cancer
rheumatoid arth
diab. mell
obesity
alcholism
depression
```
33
myths abt older adults
```
incontin is expected
aggressive treatment is not appropriate
not interested in sex
lonely
appearance not important
mental deterioration common
always live in nursing homes
ageism occurs at 65
```
34
integumentary changes in older
alopecia, less elasticity, thickening nails, thinning skin, altered pigmen
35
musculoskel changes in older
brittle bones, dec ROM, less musc mass and strength
36
neruo changes in older
slowed response/reflex, alt temp reg (colder), alt pain perception
37
sensory changes in older
visual and hearing dec
| taste and smell alt
38
cardiopulm changes in older
dec elasticity of blood vess and lung tissue
39
gastrointestinal changes in older
dec absorp and motility
40
genitourinary changes in older
frequency, retention, dec kidney func
41
risks assoc w/ chronic dis
inc ability to have o/ problems
42
risks w/ age
```
falls
mental impairments (not occur as a result of e/o) have own occurance
maltreatment (abuse, neglect, abandonment, and exploitation)
```
43
nursing care goals for older
```
promote indep. func
support indiv. strengths
prevent complications of illness
secure safe/comfort environ
promot return health
```
44
five prts communication (berlo)
stimulus of referent (why need comm in first place)
sender/ source message (encoder)
message itself (content)
medium or channel of comm (verbal v visual)
receiver (decoder)
45
four lvls comm
intrapersonal (self talk)
interpersonal (btw 2+ ppl w/ goal exchange info)
group
small group, organizational communication, group dynamics
46
chara effecting effectivenss of comm
```
group id
cohesiveness
patterns of interaction
decision making (hierarchical?)
responsibility
leadership
power
```
47
factors influc comm
dev lvl, gender, sociocul differences, roles/ responsibilities (charge nurse v cna), space and territory, physical, mental and emotional state, values, environ
48
factors affecting interpretation of message
body lang
current mood
background of decoder
49
electronic comm- regulated by, email and text protocol
reg- ANA and NCSBN rules for social media
| email- risk violating hippa rules privacy and confidentiality
50
helping relationship
not occcur right away
strength relationship= effectiveness of care
characterized by unequal sharing of info
built on pat needs
nurse= helper, pat is person being helped
used establish rapport
51
charac helping relationship
dynamic, purposeful, time limited, helper accountable for outcomes and interventions
52
phases helping relationship
orientation
working
termination (end shift or goal met)
53
orientation phase goals
pat descr participants in relationship (name, role and purpose)
pat and nurse agree goals relationship, location, freq, duration of contact, and duration of relationship
54
goals working phase
pat actively particip in relationship
pat coop in act to achieve goals
pat express feelings and concerns to nurse
55
goals termination phase
pat particip in id goals accomplished or progress made
pat express feelings abt termination of relationship
*bed side report important
as if pat has anything to add
56
dispositional traits
promote effective comm
| ex. eye contact, tone, empthy, openness, respect, caring, competence
57
rapport builders
privac and confiden, optimal pacing, comfortable environ, patient v task focus (asure care abt well being and remember purpose of task)
58
SBAR purpose
```
hand off comm
used if calling provider
situation (why calling)
background
assessment (what think issue is)
reccomendation
```
59
good conversational skills
```
be knowledgeable abt topic
control tone
be clear and concise
be truthful
flexible and open mind
avoid words could have diff interpretations
```
60
good listening skills
```
alert
eye contact
approp facial express and body gestures
think before responding
listen for themes in pat comments
*meet people where they are, think what do I not know, validate!!
```
61
interview techniques
```
open ended, closed
validate or clarify
reflective
sequencing
directing questions/comments
```
62
charac of assertive self-presentation
```
confident, concise i statements
effectively share feelings and thoughts
calm under supervision, ask for help when necessary, give and accept complements
admit mistakes (accountable)
*acknowledge when people do things right
```
63
agressive beh ex
```
assert ones rights in neg manner violates rights of o/
verbal, physical
tensions and anger
ppl like to win at all costs
make accusations, demostr intolerance
```
64
communication blocks
not listen, use closed questions, nontherapeutic comments, judgemental, false assurance, disruptive interpersonal beh, gossip, changing subject
65
disruptive interpersonal beh
incivilty
bullying- horizontal, nurse and physician
how organization responds to disruptive beh
66
goals teaching/counseling
maintaining / promoting health
prevent illness
restore health
facilitate coping (family and personal)
67
patient education
prep to receive care (what to expect, discuss goals)
pre before discharge
document pat. education act (verbal, or motor)
68
teaching acronym
t- tune into patient (body lang and attention lvl)
e- edit patient infro
a- act on every teaching moment
c- claify
h- honor patient as partner in ed process
69
learning domains (3)
cog- recall and verbalize learned info
psychomotor- demonstrate physical skill
affective- change attitude, values and feelings (why is education important)
70
factors affecting patient learning
```
age, dev lvl
family support
financial resources
cul influences
lang deficiet (don't use family as translator)
health literacy lvl (don't assume know)
```
71
critical dev areas
```
physical maturation/abilities
psychosocial
cog capacity
emotional maturity
moral/spiritual dev
```
72
cope model
```
method for ed delivery
c- creativity
o- optimism
p- planning
e- expert info
```
73
assessment parameters
affective, cog, and psychomotor
readiness to learn
ability learn (can depend dev lvl)
learning strengths (visual v auditory)
74
inc compliance
goals are understandable and realistic
inc patient and family
use interactive teaching
dev rapport w/ pat and family
75
culturally competent patient education
dev understanding of cul and values
be aware bias, assumptions
use material in preferred language
76
four assumptions abt adult learners (knowles)
inc independence w age
previous experiences alter perceptions
readiness to learn depends on dev lvl
most only want to learn material that is useful
77
teaching plans for older adults
```
id learning barriers (hearing and vision)
allow extra time
plan short teaching sessions
reduce environ distractions
relate new info to familiar activities
```
78
teaching strategies
audiovisual, written mat, discussion, lecture, demonstration, discovery, role-playing
79
factors that effect communication
```
distraction, environment
tone, vocab used,
ask questions
clear and concise
don't interrupt
```
80
nurse coaching
empower pt reach goals
create structure
id opportunities and concerns
id readiness for education
81
feedback about learning
celebrate learning
eval teaching
revise plan
82
how to document teaching-learning process
summary of learning need
the plan
implementation of plan
eval results
83
types counseling
short term- situational (pain)
| long term- developmental crisis (ambulation)
84
culture
group w shared beh patterns learned through socialization
| inc- location, sexual orientation, religion, race
85
cultural humility
subjective- ongoing
86
cultural competence
objective view, you are the expert
87
health disparity
preventable differences of disadv populations
88
subculture
group w/ characteristics not common to larger group
89
cultural assimilation
minorities lose characteristics to dominant group
90
culture shock
discomfort when placed in alt culture
91
cultural imposition
belief everyone should conform to majority belief
92
cultural conflict
ppl aware of cul differences and feel threatened
93
ethnicity
based on heritage
share beh, and beliefs
dev through day to day life
94
ethnocentrism
belief that ideas are superior to all o/
95
cul influences on healthcare
reactions to pain, mental health, gender roles, language, family supp, nutrition, socioeconomic
96
care considerations for pain
not assume
respect right to response of pain
respect beliefs about pain
sensitive to nonverbal cues
97
culture of poverty
need gov aid, unstable family structure, dec community involvement
feelings of despair
98
factors affect cul interactions
pt prev hx
dominant cul of environment
expectations about care
99
purpose of documentation
legal, reimbursement, education, research, performance improvement, diag, comm, care planning
100
documentation components
content, timing, format, accountability, confidentiality
101
policy for verbal orders
record in chart, read back to verify accuracy, date/ time, record physicians name
102
personal health records (PHR)
standalone
| tethered/connected
103
benefits health info exchange
improve quality and safety
stim pt education/ involvement
inc community in public health
104
methods of documenting
chart (focus, exception, pie), source/problem oriented, case management, electronic health record
105
documentation formats
flow chart, term summary, progress notes, med record, care plan
106
flow sheet types
24 input/output
MAR
acuity record
24hr pt care record
107
requirements for home health
rehab pot is good or hospice
pt not stabilized
pt making progress
108
ISBARR
hand off communication
| intro, situation, bckgrnd, assessment, recommendation, read back orders
109
components in change of shift report
appraisal of health status, new orders, abnormal things during shift, unfufilled orders, family concerns
110
pt care discussion
rounds
interdisciplinary conferences
referrals
