Final Exam Flashcards
(358 cards)
0
Q
The protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, communities, and populations
A
ANA definition of nursing
1
Q
Encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well and in all settings. Nursing includes the promotion of health; prevention of illness; and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.
A
ICN definition of nursing
2
Q
Florence Nightingale did these things (3)
A
First practicing Epidemiologist
Organized first school of nursing
Improved sanitation in battlefield hospitals
3
Q
First African American nurse who was concerned with relationships between cultures and races.
A
Mary Mahoney
4
Q
Influences on Nursing (6)
A
Health Care Reform Demographic Changes Medically Underserved Threat of Bioterrorism Rising Health Care Costs Nursing Shortage
5
Q
Nursing is a profession because… (5)
A
It requires an extended education It requires a body of knowledge It provides a specific service Members have autonomy in decision making Has a code of ethics
6
Q
The philosophical ideals of right and wrong that define the principles you will use to provide care to your patients
A
Code of Ethics
7
Q
6 Specific Standards of Nursing Practice:
A
Assessment Diagnosis Outcomes Identified Planning Implementation Evaluation
8
Q
Involves formal, organized educational programs offered by universities, hospitals, state nursing associations, professional nursing organizations, and educational and health institutions.
A
Continuing Education
9
Q
Instruction or training provided by a health care agency or institution
A
In-service education
10
Q
A program on safe medication practices offered by a hospital is an example of…
A
Continuing education
11
Q
A program on safe principles for administering chemotherapy offered by a hospital is an example of….
A
In-service education
12
Q
Regulate the scope of nursing practice and protect public health, safety, and welfare. Overseen by State Boards of Nursing
A
NPAs- Nurse Practice Acts (ANA)
13
Q
To improve the health and well-being of all individuals, communities, and populations through the significant and visible contributions of registered nursing using standards-based practice.
A
Goal of nursing
14
Q
Benner’s Stages of Nursing Proficiency
A
Novice Advanced Beginner Competent Proficient Expert
15
Q
Beginning student nurse or any nurse without previous experience
A
Novice
16
Q
A nurse with some level of experience- able to identify meaningful aspects or principles of nursing care.
A
Advanced Beginner
17
Q
A nurse who has worked in the same clinical position for 2-3 years. Understands the organization and specific care required by the type of patient.
A
Competent
18
Q
A nurse who has worked more than 2-3 years in the same clinical position. Nurse perceives a patient’s clinical situation as a whole, is able to assess an entire situation and can readily transfer knowledge gained from multiple previous experiences to a situation.
A
Proficient
19
Q
A nurse with diverse experience who has an intuitive grasp on an existing or potential clinical problem. Skilled at identifying both patient-centered problems and problems related to the health care systems and other nurses.
A
Expert
20
Q
Six competencies of QSEN
A
- Patient-centered Care
- Teamwork/Collaboration
- Evidence- Based Practice
- Quality Improvement
- Safety
- Informatics
21
Q
Describes the study of all the genes in a person and interactions of these genes with one another and with that person’s environment
A
Genomics
22
Q
Provides comprehensive preventative and treatment services to a specific group of voluntarily enrolled people. Includes Staff, Group, and Network models
A
MCO- Managed care organization
23
Q
Type of managed care plan that limits enrollee’s choice to a list of “preferred” hospitals, physicians, and providers. An enrollee pays more out-of-pocket expense if using a provider not on the list
A
PPO- Preferred provider organization
24
A federally administrated program by the CMS, funded nationally in the US for people 65+
Medicare
25
Federally funded, state-operated program that provides health insurance for low income families, low income people with long-term care disabilities, and supplemental coverage to older adults
Medicaid
26
Traditional fee-for-service plan. Payment computed after patient receives services on basis of number of services used.
Private insurance
27
Supplemental insurance for coverage of LTC servies. Provide set amount of dollars for an unlimited time or for as little as 2 years.
LTC insurance
28
Types of Health Care Services (6)
```
Primary Care (Health Promotion)
Preventative Care
Secondary- Acute Care
Tertiary Care
Restorative Care
Continuing Care
```
29
Focuses on improved health outcomes for an entire population.
Primary Care/Health promotion
30
Also called acute care, Focus on care of treatment and diagnosis of illnesses
Secondary and Tertiary Care
31
Assisted living is an example of which type of care service?
Continuing care
32
Rehabilitation, Sports medicine, and home care are examples of which type of care.
Restorative care
33
Intensive care and Subacute care are examples of which types of care
Tertiary care
34
Emergency care, CT scans and xrays, and med-surg care are examples of which type of care
Secondary Acute care
35
Blood pressure and cancer screenings, immunizations, and counseling are examples of which types of care.
Preventative care
36
Prenatal care/family planning, nutrition counseling, and exercise classes are examples of which type of care?
Primary care/health promotion
37
A service that provides short-term relief or "time off" for people providing home care to an ill, disabled, or frail older adult.
Respite Care
38
Focuses on understanding the needs of a population or a collection of individuals who have one or more personal or environmental characteristic in common
Public health nursing
39
Community-based health focuses on which type of care?
Primary/Preventative care
40
A nursing practice in the community, with the primary Focues on the health care of individuals, families, and groups in the community. The goal is to preserve, protect, promote, or maintain health.
Community Health Nursing
41
Nursing that takes place in community settings such as the home or a clinic where the focus of the needs is on the individual or family.
Community-based nursing
42
Groups of patients who are more likely to develop health problems as a result of excess health risks, who are limited in access to health care services, or who depend on others for care.
Vulnerable populations
43
Vulnerable populations in Community-Based nursing (6)
```
Immigrants
Homeless/Poverty
Abused
Substance abusers
Mentally Ill
Older Adults
```
44
Compentencies in Community-Based Nursing (8)
```
Caregiver
Case Manager
Change Agent
Patient Advocate
Collaborator
Counselor
Educator
Epidemiologist
```
45
Community Assessment includes:
Structure, Population, Social System
46
THEORY: Facilitate the reparative processes of the body by manipulating patient's ENVIRONMENT. Nurse manipulates patient's ENVIRONMENT to include appropriate noise, nutrition, hygiene, light, comfort, socialization, and hope
Nightingale
47
THEORY: Develops interaction between nurse and PATIENT- nurses participate in structuring health care systems to facilitate interpersonal RELATIONSHIPS
Peplau
48
THEORY: Works interdependently with other health care workers, assisting the INDIVIDUAL patient in gaining INDEPENDENCE as quickly as possible, help patient gain lacking strength.
Henderson
49
THEORY: Care for and help patient attain total SELF-CARE. Nursing care necessary during a SELF-CARE DEFICIT
Orem
50
THEORY: Help individuals, families, and groups attain and maintain maximal levels of wellness by purposeful interventions. STRESS reduction is the goal and includes primary, secondary, or tertiary prevention.
Neuman
51
THEORY: Provide care consistent with nursing's emerging science and knowledge with caring and SOCIAL STRUCTURE as the central focus. Transcultural caring theory.
Leininger
52
THEORY: Identifies types of demands placed on a patient, assess ADAPTATION to demands, and helps patient adapt. Views patient as an ADAPTIVE system
Roy
53
THEORY: Promote health, restore patient to health, and prevent illness. Involves the philosophy INTERPERSONAL caring.
Watson
54
THEORY: Focuses on patient's need for caring. PRIMACY OF CARING model.
Benner and Wrubel
55
A problem-solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a lcinician's expertise and patient preferences and values in making decisions about patient care.
Evidence-based Practice
56
Steps of Evidence-based practice.
1. Ask a clinical question
2. Collect the most relevant and best evidence
3. Critically appraise the evidence you gather
4. Integrate all evidence with clinical expertise, patient preferences and values.
5. Evaluate the practice decision or change
6. Share the outcomes of changes with others
57
Evidence-based clinical decision making includes: (4)
Evidence from research, theories, experts, and leaders
Evidence from patient's assessment and history
Clinical expertise
Information about patient's preferences and values
58
PICOT question elements:
```
P- Patient population of interest
I- Intervention of interest
C- Comparison of interest
O- Outcome of interest
T- Time frame
```
59
The study of a nursing phenomena that offers precise measurement.
Quantitative nursing research
60
A study dealing with pain therapies that measures pain severity is an example of....
quantitative research
61
The study of phenomena that are difficult to quantify or categorize such as a patients' perceptions of illness.
Qualitative research
62
Different attitudes that cause people to react in different ways to an illness or the illness of a family member.
Illness behaviors
63
A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
One definition of health
64
HEALTH MODEL: Addresses the relationship between a person's beliefs and behaviors.
Health Belief Model
65
HEALTH MODEL: Directed at increasing a patient's level of well-being.
Health Promotion Model- PENDER
66
HEALTH MODEL: Describes basic human needs as elements that are necessary for survival. Used to understand the interrelationships of basic human needs.
Maslow's Hierarchy of Needs
67
HEALTH MODEL: Considers emotional and spiritual well-being and other dimensions of an individual as important aspects of physical wellness.
Holistic Health Model
68
```
Which are External and which are Internal Variable influencing Health and health beliefs/practices:
Developmental Stage
Intellectual Background
Family Practices
Socioeconomic Factors
Perception of Functioning
Emotional Factors
Spiritual Factors
Cultural Background
```
External: Family practices, socioeconomic factors, cultural background.
Internal: Spiritual factors, emotional factors, perception of functioning, developmental stage, intellectual background,
69
Activities such as routine exercise and good nutrition that help patients maintain or enhance their present levels of health.
Health Promotion
70
Activities such as immunizations that protect patients from actual or potential threats to health; motivate people to avoid declines in health or functional levels.
Illness prevention
71
Type of prevention: Immunizations, physical and nutritional health.
Primary
72
Types of prevention: Weight loss, smoking cessation.
Secondary prevention
73
Type of prevention: Rehabilitation: COPD treatment, pulmonary rehabilitation, or cardiac rehabilitation.
Tertiary prevention
74
Risk factors influencing Health:
Age
Genetic/Physiological
Environment
Lifestyle
75
Stages of health behavior change:
```
Precontemplation
Contemplation
Preparation
Action
Maintenance
```
76
Patient considers change in the next 6 months- which stage of health behavior change?
Contemplation
77
Patient defensive when confronted with information about change- Which stage of health behavior change?
Precontemplation
78
Patient decides to make small changes for a change in the next month.- which stage of health behavior change
Preparation
79
Patient actively engaged in strategies to change behavior- which stage of health behavior change
Action
80
Patient has continued to sustain change for 8 months. - Which stage health behavior change?
Maintenance stage
81
Results from being released from roles, social expectations, or responsibilities.
Illness behavior
82
Impact of Illness on the Patient and Family(5)
```
Behavioral and emotional changes
Impact on body image
Impact on self-concept
Impact on family roles
Impact on family dynamics
```
83
Maslow's hierarchy of needs:
- -Physiological (oxygen, fluids, nutrition, body temp, elimination, shelter, sex)
- -Safety and Security (physical and psychological safety)
- -Love and Belonging
- -Self-Esteem
- -Self-actualization
84
A universal phenomenon influencing the ways in which people think, feel, and behave in relation to one another.
Caring
85
THEORY: Caring is central to the essence of nursing- Distinguishes nursing. Caring determines what matters to a person, caring is always specific and relational for each nurse-patient encounter.
Caring is primary- Benner and Wrubel
86
THEORY: Stresses the importance of nurses' understanding cultural caring behaviors- Expressions, processes, and patterns of caring vary among cultures. States caring is an essential human need.
Transcultural caring- Leininger
87
A holistic model for caring promoting healing and wholeness. Rejects disease orientation to health care and places care before cure. Caring becomes spiritual. Focuses on Nurse and patient relationships.
Transpersonal Caring- Watson
88
THEORY: Describes caring as consisting of five processes. Supports that caring is central to nursing, but not unique to nursing. Caring is nurturing.
Swanson's Theory of Caring
89
Five caring processes to Swanson's theory of caring
```
Knowing
Being with
Doing for
Enabling
Maintaining belief
```
90
Striving to understand an even as it has meaning in the life of the other describes which caring process in Swanson's theory of caring?
Knowing
91
Being emotionally present to the other describes which caring process in Swanson's theory of caring?
Being with
92
Doing for the other as he or she would do for self it it were at all possible describes which caring process in Swanson's theory of caring?
Doing for
93
Facilitating the other's passage through life transitions describes which caring process in Swanson's theory of caring?
Enabling
94
Sustaining faith in the other's capacity to get through an event or transition and face a future with meaning describes which caring process in Swanson's theory of caring?
Maintaining belief
95
Concerned with relationships between people and with a nurse's character and attitude toward others.
Ethic of care
96
Caring behaviors (7)
```
Providing presence
Touch
Listening
Knowing
Spiritual caring
Relieving pain and suffering
Family care
```
97
An individual is considered a cancer survivor from the time of _______ through ______________________.
Diagnosis, balance of his or her life.
98
Seasons of cancer survival:
Acute survival
Extended survival
Permanent survival
99
Starts with diagnosis of cancer. Fear and anxiety may be constant. Includes physical limitation: fatigue, pain, nausea, reduced tolerance for exercise, hair loss.
Acute survival
100
Period during which a patient goes into remission or has ended the basic, rigorous course of treatment and enters phase of watchful waiting.
Extended survival
101
Phase roughly equated with "sure" but experience permanently affects survivor. Problems with employment and insurance are common.
Permanent survival
102
```
Which are late effects of Chemotherapy?
Osteoporosis
Asthma
Diabetes
Amenorrhea
Impaired taste
Paresthesias
```
```
Osteoporosis
Diabetes
Amenorrhea
Paresthesias
(Heart failure, sterility, impaired GI motility, abnormal liver function, impaired immune function, hearing loss, problems with thinking/memory, Peripheral neuropathy)
```
103
Most frequent and disturbing complaints of people with cancer (2):
CRF- cancer-related fatigue and sleep disturbances
104
Symptoms of CRCI
```
CRCI- chemotherapy-related cognitive impairment:
Decreased attention span
Easily distracted
Difficulty walking
Significant Behavior changes
```
105
Effects of cancer on quality of life include:
Physical well-being
Psychological well-being
Social well-being
Spiritual well-being
106
Major forms of cancer therapy (5):
```
Biotherapy
Chemotherapy
Radiation
Hormone therapy
Surgery
```
107
Components of a Cancer survivor assessment:
Symptoms
Psychosocial problems
Sexuality problems
108
Components of survivorship care (4):
- PREVENTION and detection of new and recurrent cancers
- SURVEILLANCE for cancer spread, recurrence, or second cancers
- INTERVENTION for consequences of cancer and its treatments
- COORDINATION between specialist and primary care providers
109
Racial and ethnic minorities are more likely than white non-Hispanics to be ______ and less likely to have a ______________.
Poor, high school education
110
The thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups.
Culture
111
A shared identity related to social and cultural heritage such as values, language, geographical space, and racial characteristics.
Ethnicity
112
An insider or native perspective of a culture is _________ worldview whereas an outsider perspective is ______ worldview.
Emic, Etic
113
Socialization into one's primary culture as a child.
Enculturation
114
A second-culture learning that occurs when the culture of a minority is gradually displaced by the culture of the dominant group
Assimilation
115
A comparative study of cultures to understand similarities and differences across human groups.
Transcultural nursing
116
Care that fits the person's life patterns, values, and a set of meanings.
Culturally congruent care
117
The process of acquiring specific knowledge, skills, and attitudes to ensure delivery of culturally congruent care.
Cultural competence
118
Five components of Cultural Competence
1. Cultural awareness
2. Cultural knowledge
3. Cultural skills
4. Cultural encounters
5. Cultural desire
119
An in-depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people
cultural awareness
120
Obtaining sufficient comparative knowledge of diverse groups, including their indigenous values, health beliefs, care practices, worldview, and bicultural ecology.
Cultural knowledge
121
Engaging in cross-cultural interactions that provide learning of other cultures and opportunities for effective intercultural communication development.
Cultural Encounters
122
The motivation and commitment to caring that moves an individual to learn from others ,accept the role as learner, be open and accepting of cultural differences, and build on cultural similarities.
Cultural desire
123
A tendency to hold one's own way of life as superior to others
Ethnocentrism
124
Using ones own values and lifestyles as the absolute guide in dealing with patients and interpreting their behaviors
Cultural Imposition
125
Illness specific to one culture (such as "going postal" or "Hwa-byung")
Culture-bound syndromes
126
Culture Assessment includes: (7)
```
Ethnic heritage and Ethnohistory
Bicultural effects of health
Social organization
Religious and Spiritual beliefs
Family structure
Foods with cultural significance
Communication patterns
```
127
Three nursing decision and action modes to achieve culturally congruent care:
Cultural care preservation/maintenance
Cultural care accommodation/negotiation
Cultural care re patterning/restructuring
128
Intra familial system of support and structure that extends beyond the walls of the household.
Family durability
129
Ability of the family to cope with expected and unexpected stressors
Family resiliency
130
The uniqueness of each family unit
Family diversity
131
Patterns of people considered by family members to be included in the family. Includes: nuclear, extended, single-parent, blended and alternative family
Family Forms
132
Consists of husband and wife and perhaps children
Nuclear family
133
Consists of extended family including relatives (aunts, uncles, grandparents, and cousins) in addition to nuclear family
Extended family
134
Formed when one parent leaves the nuclear family because of death, divorce, or desertion or when a single person adopts or has a child.
Single-parent family
135
Formed when parents bring unrelated children from prior adoptive or foster parenting relationships into a new, joint living situation
Blended family.
136
Relationships include multi adult households, "skip-generation" families (grandparents caring for grandchildren), communal groups with children, "non-families" (adults who live alone), cohabiting partners, and homosexual couples.
Alternative family
137
Trends in family forms
Homelessness
Changing economic status
Family violence
Acute/Chronic illnesses
138
Attributes of a family include: (3)
```
Structure (ongoing membership of the family)
Function (what the family does)
Family health (influenced by economics, geography, and education)
```
139
Three levels of approaches for family nursing:
Family as context
Family as patient
Family as system
140
Nursing approach to family care that focuses on health and development of individual member with a specific family environment.
Family as a context
141
Nursing approach to family care that focuses on family processes and relationships.
Family as a patient
142
Nursing approach of family care that focuses on family resources available to help both family and individual.
Family as a system
143
Three factors that organize the family approach to the nursing process:
1. The nurse views all individuals within their family context
2. Families impact individuals
3. Individuals impact families.
144
Five realms of family life:
```
Interactive processes
Developmental processes
Coping processes
Integrity processes
Health processes
```
145
A family process that occurs in response to an illness and encompasses multiple cognitive, behavioral, and interpersonal processes.
Family caregiving
146
THEORY: Each child's pattern of growth is unique and this pattern is directed by GENE activity.
Gesell- Biophysical developmental theory.
147
THEORY: Individuals go though five stages of psychosexual development.
Freud- Psychosexual theory of development
148
Freud's five stages of psychosexual development:
```
Oral
Anal
Phallic
Latency
Genital
```
149
THEORY: Individuals need to accomplish a particular task before successfully mastering one stage and progressing to the next. Each task framed with opposing conflicts.
Erikson- Psychosocial theory of development
150
Erikson's Eight Stages of Psychosocial Development:
```
Trust vs Mistrust
Autonomy vs Shame/Doubt
Initiative vs Guilt
Industry vs Inferiority
Identity vs Role Confusion
Intimacy vs Isolation
Generativity vs Self-absorption/Stagnation
Integrity vs Despair
```
151
Chess and Thomas three basic classes of Temperment:
- The easy child (easygoing, even-tempered)
- The difficult child (Highly active, irritable, and irregular habits)
- The slow-to-warm up child (reacts negatively to new stimuli)
152
THEORY: Includes four periods that are related to age and demonstrate specific categories of knowing and understanding.
Piaget- Theory of cognitive development
153
Piaget's Periods of Cognitive Development
```
Period 1- Sensorimotor
Period 2- Preoperational
Period 3- Concrete Operations
Period 4- Formal Operations
*Fifth stage added- Postformal operations
```
154
THEORY: Refers to changes in a person's thoughts, emotions, and behaviors that influence beliefs about what is right and wrong and moral.
Kohlberg's theory of moral development
155
Kohlberg's theory of moral development: 3 levels and their stages:
Level 1- Preconventional reasoning: Stage 1, 2
Level 2- Conventional reasoning: Stage 3, 4
Level 3- Postconventional reasoning: Stage 5, 6
156
Infancy age range
1mo-1yr
157
Heath risks for Infants
```
Injury- motor vehicle accidents
Aspiration
Suffocation
Falls
Poisoning
Child Maltreatment
```
158
Health promotion for Infants
```
Nutrition
Immunizations
Sleep
Car seats
Hearing screenings
Crib safety
Sleep on backs
Avoid smoking around infants
```
159
Toddlerhood age range
12mo-3yr
160
Health risks for Toddlerhood
Poisoning
Drowning
Motor Vehicle accidents
161
Health promotion for Toddlerhood
Nutrition
| Toilet Training
162
Age range for preschooler
3-5yrs
163
Health risks for Preschoolers
Injury
Bicycle safety
Home safety
164
Health promotion for preschoolers
Nutrition
Sleep
Vision screening
165
School aged children age range
6-12 years
166
School aged children Health risks
Accidents and Injuries: fires, car/bicycle accidents
| Infection
167
Health promotion for School-aged children
```
Perceptions
Health Education
Health Maintenance
Safety
Nutrition
```
168
Age range for Adolescence
13-20 years
169
Health risks for Adolescence
```
Accidents *leading cause of death
Violence/Homicide *2nd leading cause of death
Suicide *Third leading cause of death
Substance abuse
Eating disorders
Sexually Transmitted Infections
Pregnancy
```
170
Health promotion for Adolescence
Health Education
Focus on minorities
Focus on gay, lesbian, bisexuals for suicide/depression prevention
171
Suicide warning signs:
```
Decrease in school performance
Withdrawal
Loss of initiative
Loneliness, sadness, and crying
Appetite and sleep disturbances
Verbalization of suicidal thoughts
*Often occur at least 1 month before suicide attempt
```
172
Young Adult age range:
Late teens- mid/late 30s
173
Health Risks for the Middle Adult
```
Family History
Personal hygiene
Violent death/injury
Substance abuse
STIs
Unplanned pregnancy
Environmental/Occupational factors
```
174
Middle Adults age range
35-64 years
175
Health promotion for Middle Adults
```
Stress reduction
Infertility
Obestiy
Exercise
Pregnancy
```
176
Physical changes in Middle Adults
Premenopause/menopause
| Climacteric *decreased levels of androgens in men
177
Cognitive changes in Middle Adults
Rare- only in trauma or illness
178
Health promotion for MIddle Adults
Stress reduction
Obesity
Healthy Habits
Psychosocial health- anxiety/depression
179
Older adult age range
65 years +
180
Developmental Tasks for Older Adults:
Adjusting to ________ health and physical ________
Adjusting to ______ and reduce or fixed _________
Adjusting to ________ of a spouse, children, siblings, and friends
Accepting self as ________ person
Maintaining satisfactory ________ arrangements
Redefining _______ with adult children and siblings
Finding ways to ________ _________ of life
```
decreasing, strength
retirement, income
death
aging
living
relationships
maintain quality
```
181
An acute confusional state that is potentially reversible and has a physiological cause
Delirium
182
A generalized impairment of intellectual functioning that interferes with social and occupational functioning.
Dementia
183
The most common, yet most undetected and untreated impairment in older adults.
Depression
184
Health people 2010 goals for older adults:
Increase confidence in maintaining condition
Reduce number with limitations
Reduce ER visits from falls
185
Leading causes of death in older adults:
Heart disease
Cancer
Stroke
186
Health promotion for older adults:
```
Therapeutic communication
Touch
Reality Orientation
Validation therapy
Body-image interventions
```
187
Older adults in acute care settings are at increased risk for:
```
Delirium
Dehydration
Malnutrition
HAIs
Urinary incontinence
Falls
```
188
Restorative care for the older adult focuses on:
Prevention, improvement, reduction or elimination of problems
Regain/improve level of independence- ADLs
189
A continuous process characterized by open-mindedness, continual inquiry, and perseverance, combined with a willingness to look at each unique patient situation and determine which identified assumptions are true and relevant .
Critical Thinking
190
Critical Thinking Skills: (6)
```
Interpretation
Analysis
Inference
Evaluation
Explanation
Self-regulation
```
191
Concepts for a critical thinker (7):
```
Truth Seeking
Open-mindedness
Analyticity
Systematicity
Self-confidence
Inquisitiveness
Maturity
```
192
Levels of critical thinking:
Basic
Complex
Commitment
193
A nurse uses a hospital procedural manual to confirm how to insert a catheter. This is which level of critical thinking
Basic
194
Level of critical thinking in which a learner trusts that experts have the right answer for every problem
Basic
195
Critical thinking level where thinkers separate themselves from experts and analyze and examine choices more independently.
Complex
196
A nurse recognizes a patient's option for pain relief and discusses them with the patient. This is which level of critical thinking?
Complex
197
Level of critical thinking where a nurse anticipates when to make choices without assistance from others and accepts accountability for decisions made.
Commitment
198
A nurse chooses not to act when considering the results of a decision. This level of critical thinking is...
Commitment
199
Steps to the scientific method:
1. Identify the problem
2. Collect data
3. Formulate a hypothesis
4. Test the hypothesis
5. Evaluate results
200
Critical thinking competencies and those SPECIFIC to nursing
```
Scientific method
Problem solving
Decision making
SPECIFIC TO NURSING:
Diagnostic reasoning and inference
Clinical decision making
Nursing process as a competency
```
201
When a problem arises, you obtain information and use it, plus what you already know, to find a solution. Includes evaluation
problem-solving
202
A product of critical thinking that focuses on problem resolution
Decision making
203
The analytical process for determining a patient's health problems
Diagnostic reasoning
204
The process of drawing conclusions from related pieces of evidence and previous experience with the evidence.
Inference
205
A problem-solving activity that focuses on defining a problem and selecting an appropriate action. The nurse identifies a problem and selects a nursing intervention
Clinical decision making
206
Five components to critical thinking:
```
Knowledge base
Experience
Critical thinking competencies (NURSING PROCESS)
Attitudes
Standards
```
207
```
Attitudes for Critical Thinking Include:
Confidence
Precise
Truth seeking
Creativity
Curiosity
Explanation
Evaluation
Integrity
Humility
```
*Confidence, Creativity, Curiosity, Integrity, Humility (Perserverance, Discipline, Risk taking, Responsibility, Fairness, Independence)
208
```
Intellectual Standards for critical thinking Include:
Analyticity
Deep
Broad
Maturity
Plausible
Consistent
Logical
Fairness
Explanation
```
Deep, Broad, Plausible, Consistent, Logical (Clear, precise, Specific, Accurate, Relevant, Complete, Significant, Adequate, Fair)
209
Ways to develop critical thinking skills (3):
Reflective journaling
Meeting with colleagues
Concept mapping
210
Two steps included in Nursing Assessment:
1. Collect information from primary and secondary sources
| 2. Interpret and validate data to ensure a complete database
211
Information that you obtain through use of the senses
Cue
212
Judgement or interpretation of cues
Inference
213
Two types of assessment:
Functional Health Patterns
| Problem-focused assessment
214
Two types of assessment data:
Objective
| Subjective
215
Patient's verbal descriptions of health problems
Subjective data
216
Observations or measurements of a patient's health status
Objective data
217
A patient reports pain level of 5, on a scale of 1-10. Which type of data is this documented as?
Subjective
218
The patient is grimacing and guarding upon palpating a surgical incision. You document this data as...
Objective
219
Sources of data for assessment include:
```
Patient
Family
Health care team
Medical record
Scientific literature
Nurse's experience
```
220
A full assessment should include:
```
Interview findings
Cultural considerations
Nursing health history
Physical exam
Observations of patient behavior
Diagnostic and lab data
Interpretation and validation of data
Documentation
Concept mapping/Care planning
```
221
A patient-centered interview involves:
1. Setting the stage
2. Gathering information about patient's chief concerns/setting agenda
3. Collecting the assessment or nursing history
4. Terminating the interview
222
Interview techniques include:
Open-ended questions
Back channeling ("go on")
Probing ("what else?")
Close ended questions (for symptoms, precipitating factors, relief measures)
223
A clinical judgement about individual, family, or community responses to actual and potential health problems or life processes that the nurse is licensed and competent to treat.
Nursing Diagnosis
224
NANDA-I
North American Nursing Diagnosis Association International: Determines appropriate nursing diagnosis and defines them
225
Purposes of nursing diagnosis:
Provide a precise definition of a patients problem
Gives nurses a common language for understanding a patient's needs
Allows nurses to communicate
Distinguishes nurse's role from that of the physician
Helps nurses focus on the scope of nursing practice
Fosters the development of nursing knowledge
Promotes creation of practice guidelines
226
A set of signs or symptoms gathered during assessment taht you group together in a logical way.
Data cluster
227
Patterns of data that contain defining characteristics, clinical criteria that are observable and verifiable.
Data clusters
228
A condition, historical factor, or etiology that gives a context for the defining characteristics and show a type of relationship with the nursing diagnosis
Related factor
229
Three types of nursing diagnosis:
Actual
Risk for
Health promotion
230
Describes human responses to health conditions or life processes that exist in an individual, family, or community
Actual nursing diagnosis
231
Anxiety, Wandering, and Impaired social interaction are examples of
Actual nursing diagnosis
232
Describes human responses to health conditions or life processes that may develop in a vulnerable individual, family, or community
Risk nursing diagnosis
233
A clinical judgement of a person's, family's or community's motivation, desire, and readiness to increase well-being and actualize human health potential as expressed in their readiness to enhance specific health behaviors.
Health promotion nursing diagnosis
234
Readiness for enhance family coping and readiness for enhanced nutrition are examples of:
Health promotion nursing diagnosis
235
Components of a Nursing diagnosis may include:
Diagnostic label
Related factors
Defining characteristics
236
True or false: Nursing diagnosis etiology/related to factors may include medical diagnosis
False
237
Identify the incorrect Nursing Diagnosis:
1-Pain related to trauma of an incision
2-Ineffective breathing pattern related to pain
3-Acute pain related to prostatectomy
4-Diarrhea related to food intolerance
3
238
PES format of nursing diagnosis:
P- problem- diagnosis
E- etiology- related to factor
S- symptoms- defining characteristics
*Example: Impaired physical mobility related to incisional pain, evidenced by restricted turning and positioning
239
Sources of diagnostic errors (4):
Collecting
Interpreting
Clustering
Labeling
240
Involves setting priorities, identifying patient-centered goals and expected outcomes, and prescribing individualized nursing interventions.
Planning
241
The ordering of nursing diagnosis or patient problems using determinations of urgency and/or importance to establish a preferential order for nursing actions.
Priority setting
242
High priority diagnosis/ interventions include:
Safety, adequate oxygen, adequate circulation
| *Circulation, Airway, Breathing*
243
Priorities are are classified into:
High, Intermediate, and Low
244
A broad statement that describes a desired change in a patient's condition or behavior.
Goal
245
"Patient expresses understanding of postoperative risks" is an example of...
A goal
246
A measurable criterion to evaluate goal achievement
Expected outcome
247
Guidelines for writing Goals/Expected Outcomes:
```
Patient-centered
Singular
Measurable
Observable
Time-limited
Mutual-factors
Realistic
```
248
Types of Interventions (3):
Independent Nursing interventions
Dependent nursing interventions
Collaborative interventions
249
Interventions that a nurse initiates
Independent Nursing Interventions
250
Interventions that require an order from a physician or other health care professional.
Dependent interventions
251
Interventions that require the combined knowledge, skill, and expertise of multiple health care professionals.
Collaborative interventions
252
Six factors considered when selecting interventions:
```
Characteristics of nursing diagnosis
Goals/expected outcomes
Evidence base
Feasibility
Acceptability
Compentency of the nurse
```
253
6 components of a student nursing careplan:
```
1- Assessment data
2- Goals
3- Outcomes
4- Implementation/Interventions
5- Scientific rationale
6- Evaluation
```
254
A process by which you seek the expertise of a specialist such as your nursing instructor, a physician, or a clinical nurse educator to identify ways to handle problems in patient management or the planning and implementation of therapies
Consultation
255
Any treatment based on clinical judgement and knowledge that a nurse performs to enhance patient outcomes
Nursing interention
256
Treatments performed through interaction with the patient
Direct care
257
Interventions performed away from the patient but on behalf of the patient/group or patients
Indirect care
258
A preprinted document containing orders for the conduct of routine therapies, monitoring guidelines, and/or diagnostic procedures for specific patients with identified clinical problems.
Standing order
259
The ______ developed standards of professional nursing practice.
ANA
260
When reviewing/revising the existing nursing care plan, you should follow these four steps:
Revise assessment data
Revise nursing diagnosis
Revise specific interventions
Choose method of evaluation
261
Three types of implementation skills:
Cognitive (good judgement, critical thinking)
Interpersonal (good communication, establishing trust)
Psychomotor (good coordination, cognitive + motor to perform skills)
262
Direct care involves (8)
```
ADLs
IADLs
Physical care
Lifesaving measures
Counseling
Teaching
Controlling adverse reactions
Preventative measures
```
263
Activities usually performed in the course of a normal day: ambulation, eating, dressing, bathing and grooming
ADLs- Activities of daily living
264
Includes skills such as shopping, preparing meals, house cleaning, writing checks, and taking medications
IADLs- Instrumental activities of daily living
265
Preventative nursing actions promote _____ and prevent ______ to avoid the need for acute or rehabilitative health care
health, illness
266
Indirect care includes:
Communicating nursing interventions
| Delegating, supervising, and evaluating staff members
267
```
Direct or Indirect care:
Documentation
Foley catheter insertion
Counseling
Change-of-shift report
Teaching
ADLs
Infection control
```
```
Documentation- Indirect
Foley catheter insertion- Direct
Counseling- Direct
Change-of-shift report- Indirect
Teaching- Direct
ADLs- Direct
Infection control- Indirect
```
268
Achieving patient goals is helped by ______ _____ which means that patients and families invest time in carrying out required treatments.
Patient adherence
269
The steps to the nursing process:
```
Assessment
Diagnosis
Planning
Implementation
Evaluation
```
270
The nursing process is influenced by: (4)
Experience
Knowledge
Standards
Attitudes
271
Steps to evaluate if outcomes are met: (5)
1. Examine desired outcome
2. Evaluate actual response
3. Compare desired outcome and actual response
4. Judge the degree of agreement between the two
5. If no agreement, ask Why
272
You should discontinue a careplan when....
Goals have been met- ask patient and family to confirm
273
The minimum level of care accepted to ensure high quality of care to patients.
Standard of care
274
Care provided by team under RN supervision. Includes charge nurse, team leader, and team members.
Team nursing
275
RN is responsible for all aspects of care for one or more patient.
Total patient care
276
One primary nurse assumes responsibility for a caseload of patients and provides care for the same patients during their entire stay at a facility
Primary nursing
277
Links health care services to patients and their families while streamlining costs and maintaining quality.
Case management
278
Decision making includes: (4)
Autonomy
Responsibility
Authority
Accountability
279
Staff involvement approaches include: (5)
1. Establishing committees
2. Nurse/physician collaboration
3. Interdisciplinary collaboration
4. Staff collaboration
5. Staff education
280
Leadership skills for nursing students include: (9)
```
Clinical care coordination
Clinical decisions
Priority setting
Organizational skills
Use of resources
Time management
Evaluation
Team communication
Knowledge building
```
281
An immediate threat to a patient's survival or safety
High priority
282
Nonemergency, non-life-threatening actual or potential needs that the patient and family members are experiencing.
Intermediate priority
283
Actual or potential problems that are not directly related to the patient's illness or disease.
Low Priority
284
Teaching a patient to take a new drug safely is what level of priority?
Intermediate
285
A patient who will require teaching for self-care in the home upon discharge is which priority level?
Low
286
An obstructed airway, loss of consciousness, or anxiety attack are examples of which priority level?
High
287
Five principles of time management:
```
Goal setting
Time analysis
Priority setting
Interruption control
Evaluation
```
288
The five rights of delegation:
```
Right:
Task
Circumstances
Person
Direction/Communication
Supervision/Evaluation
```
289
The study of conduct and character. Determines what is good or valuable for individuals, for groups of individuals and for society at large
Ethics
290
The freedom from external control
Autonomy
291
Informed consent is an example of respect of:
1. Fidelity
2. Justice
3. Nonmaleficence
4. Autonomy
5. Beneficence
4. Autonomy
292
Taking positive actions to help others, fundamental to the practice of nursing and medicine
Beneficence
293
The avoidance of harm or hurt.
Nonmaleficence
294
The agreement to keep a promise.
Fidelity
295
A set of guiding principles that all members of a profession accept
Code of Ethics
296
Basic principles of the Nursing code of Ethics
Advocacy
Responsibility
Accountability
Confidentiality
297
A personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior.
Value
298
Defines actions as right or wrong based on their "right-making characteristics"
Deontology
299
Philosophies of ethics include (5)
```
Deontology
Utilitarianism/Consequentialism/Teleology
Feminist Ethics
Ethics of Care
Consensus in Bioethics
```
300
Proposes that the value of something is determined by its usefulness.
Utilitarianism/Consequentialism/Teleology
301
Looks to the nature of relationships to guide participants in making difficult decisions, especially relationships in which power is unequal or in which a point of view has become ignored or invisible.
Feminist Ethics
302
Addresses ethics in individual relationships as well as ethical concerns about the structure within each individual caring occurs.
Ethics of Care
303
An act of discovery in which "collective wisdom" guides a group to the best possible decision
Consensus in Bioethics
304
Seven steps to resolve an Ethical Dilemma
1. Ask if it is an ethical dilemma
2. Gather all relevant information
3. Clarify values
4. Verbalize the problem
5. Identify possible courses of action
6. Negotiate a plan
7. Evaluate the plan
305
Issues in health care ethics:
Quality of life
Genetic Screening
Care at the end of life
Access to care
306
The anguish experienced when a person feels unable to act according to closely held core values.
Moral distress
307
Nurse Practice Acts are examples of which type of laws?
Statutory
308
Judicial decisions made in courts when individual legal cases are decided
Common law
309
Decisions made by a State Board of Nursing are examples of which types of law?
Regulatory/Administrative law
310
Informed consent, negligence, and malpractice are examples of which type of law
Common law
311
The legal requirements for nursing practice that describe minimum acceptable nursing care.
Standards of Care- ANA
312
written documents that direct treatment in accordance with a patient's wishes in the event of a terminal illness or condition
Living Wills
313
A legal document that designates a person or persons of one's choosing to make health care decisions when the patient is no longer able to make decisions on his or her own behalf.
DPAHC- Durable power of attorney for Health Care
314
HIPAA
Health Insurance Portability and Accountability Act
315
Protects individuals from losing their health insurance when changing jobs, creates patient rights to consent for use and disclosure of their protected health information, to inspect and copy one's medical record, and to amend mistaken or incomplete information
HIPAA
316
A civil wrong made against a person or property
Tort
317
Intentional Torts include..
Assault
Battery
False Imprisonment
318
Any action that places a person in apprehension of a harmful or offensive contact without consent
Assault
319
Threatening to give a patient an injection is an example of.....
Assault
320
Any intentional touching without consent
Battery
321
A patient gives consent for an appendectomy and the surgeon performs a tonsillectomy. This is an example of
Battery
322
T or F: Keeping a patient in an unconscious person in a confined area is false imprisonment
False
323
Quasi-Intentional Torts include...
Invasion of Privacy
| Defamation of Character
324
Disclosing a medical record to a patient's family without the patient's consent is....
Invasion of Privacy
325
The publication of false statements that result in damage to a person's reputation.
Defamation of Character
326
When a person speaks falsely about another person.
Slander
327
Written defamation of character
Libel
328
Writing false entries in a medical record is an example of...
Libel
329
Unintentional Torts include...
Negligence
| Malpractice
330
Conduct that falls below a standard of care
Negligence
331
Professional negligence.
Malpractice
332
Criteria necessary for establishing malpractice (4):
1. Nurse owed a duty to the patient
2. Nurse did not carry out the duty
3. The patient was injured
4. The nurse did not intend to injure the patient
333
Which of these is/are able to legally give consent?
1. 18 year old patient in a coma
2. 25 year old mentally ill patient
3. 15 year old parent for her child
4. Grandparent of a patient in an emergency
2, 3, 4
334
Abandonment and Assignment Issues:
Short Staffing
Floating
Health Care Provider's Orders
335
T or F: Document occurrence reports in the patient's medical record.
False
336
Risk management includes:
Identifying Risks
Analyzing Risks
Reducing Risks
Evaluating Risks
337
A powerful form of communication that occurs within an individual
Intrapersonal communication
338
One-on-one interaction between a nurse and another person that often occurs face to face.
Interpersonal communication
339
Interaction that occurs within a person's spiritual domain
Transpersonal communication
340
Basic elements of communication
```
Referent
Sender/Receiver
Message
Channels
Feedback
Interpersonal Variable
Environment
```
341
Motivation to communicate with another.
Referent
342
Art and music are examples of which type of communication
Symbolic
343
A broad term that refers to all factors that influence communication.
Metacommunication
344
Professional nursing relationships include:
Nurse-patient helping
Nurse-family
Nurse-Health care team
Nurse- community
345
Elements of professional communication :
```
Courtesy
Use of Names
Trustworthiness
Autonomy/Responsibility
Assertiveness
```
346
SOLER model to promote active listening:
```
S- Sit facing the patient
O- Open posture
L- Learn toward the patient
E- Eye contact
R- Relax
```
347
_______ sets the standards for education
TJC- The Joint Commission
348
The goal of educating others about their health is to help _______, ________, and ________ achieve optimal levels of _______.
Individuals, families, Communities, Health
349
Three purposes of patient education
Maintenance and promotion of health and illness prevention
Restoration of Health
Coping with Impaired functions
350
An interactive process that promotes learning
Teaching
351
The purposeful acquisition of new knowledge, attitudes, behaviors, and skills
Learning
352
SPEAK UP tips from TJC:
S- speak up if you have questions or concerns
P- Pay attention to the care you recieve
E- Educate yourself about your illness
A- Advocate
K- Know your medications
U- Use a health care facilities that have been evaluated
P- Participate in decisions about your care
353
Includes all intellectual behaviors and required thinking- Learning style.
Cognitive learning
354
Deals with expression of feelings and acceptance of attitudes, opinions, or values- Learning style
Affective
355
Involves acquiring skills that require integration of mental and muscular activity (walking, using a utensil)- Learning style
Psychomotor learning
356
Best teaching method for Infant:
Routine
Smiling and soft speaking
Different textures for tactile sense
357
Teaching methods for a Toddler:
Play to teach
Picture books
Simple words
