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Flashcards in Final Exam Study Guide Deck (104):
0

Florence Nightingale

-associated with reduced mortality rates during the crimean war
-revered as the founder of modern nursing
-introduced the concept of broad-based liberal education for nurses

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Clara Barton

Founded the American Red Cross

2

Lillian Wald

Considered the start of Public Health nursing in the U.S.

3

Dependent nursing functions

Administering medications
medication orders are required before meds can be given: exact instructions are required

4

Independent nursing functions

Nursing standards establish how nurses perform these activities
Not written by a perscriber

5

Quality & Safety Education for Nurses (QSEN) competencies

-Patient centered care
-Teamwork & collaboration
-Evidence based practice and research
-Quality Improvement (QI)
-Safety
-Informatics

6

Problem, Etiology, Symptoms (PES)

-Parts of creating a diagnostic statement
-Problem: describes the client's health status and identifies a response that needs to be changed
-Etiology: contains factors that cause, contribute to, or create a risk for the problem

7

PICO

-Used in research
-Patient, population, problem
-Intervention, treatment, cause, contributing factor
-Comparison interventions
-Outcome

8

Full spectrum nursing model

Involves:
-Clinical judgement
-Critical thinking
-Problem solving

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NANDA nursing diagnosis components

-Diagnostic label
-Definition
-Defining characteristics
-Related factors
-Risk factors

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Nursing Theory

-An organized set of related ideas and concepts that:
-Assist in finding meaning in our experiences
-Organize our thinking around an idea
-Develop new ideas and insights into the work we do

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Components of a theory

-Phenomena
-Assumptions
-Concepts
-Definition
-Statements/propositions

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Components of the nursing metaparadigm

-Views the person through a lens that focuses more broadly on the entire person
-Not always theories, just how we see things

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Madaline Leininger

-Founder of transcultural nursing
-Theory focuses on caring as a cultural competence
-Using knowledge of cultures and nursing to provide culturally congruent and responsible care

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Virgina Henderson

-Basic principles of nursing care
-Identifies the 14 basic needs of nursing care

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Dr Jean Watson

-Science of human caring
-Describes what caring means from a nursing perspective

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Patricia Benner

Novice to expert
- Novice
- Advanced beginner
- Competent
- Proficient
- Expert

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Hildeguard Peplau

- Psychiatrist nurse
- Health could be improved for psychiatric patients if there were a more effective way to communicate with them
- Developed the theory of interpersonal relations, which focuses on the relationship a nurse has with the patient

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Maslow's hierarchy

-The lower level (Physiological) must be met to some degree before the higher ones (Trascendence)
- Physiological- food, air, water, temperature regulation, elimination, rest, sex, and physical activity
- Safety and security- Protection, emotional and physical safety and security, order, law, stability, shelter
- Love and belonging- Giving and receiving affection, meaningful relationships, belonging to groups
- Self-esteem- Pride, sense of accomplishment, recognition by others
- Cognitive- Knowledge, understanding, exploration
- Aesthetic- Symmetry, order, beauty
- Self-actualization- Personal growth, reaching potential
- Transcendence- of self; helping others self actualize

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Inductive reasoning

-Drawing conclusions from a pattern found in individual pieces of information
- Remember induction by thinking IN-duction
- I have specific data out there and I bring in IN to make the generalization

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Deductive reasoning

- Starts with a general premise and moves to a specific deduction
- You have a big picture about what is true in general, and from that you can find out logically what is likely to be true for a particular individual

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Subjective data

Covert data, symptoms
the information communicated to the nurse by the client, family, or community

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Objective data

Overt data, signs
gathered through a physical assessment or from lab or diagnostic tests

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Primary data

The subjective and objective info obtained from the client
What the client says or what you observe

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Secondary data

Obtained secondhand for example from a medical record or from another caregiver

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Directive interviewing

- To obtain factual, easily categorized info, or in an emergency situation

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Closed questions

Questions that can be answered with a yes, no, or short factual answer

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Nondirective interviewing

- You allow the patient to control the subject matter
- Your role is to clarify, summarize, and ask mostly open ended questions that facilitate thought and communication
- Ask when you want to obtain subjective data

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Open-ended questions

-Specify a topic to be explored
-Are phrased broadly to encourage the patient to elaborate
-Ask when you want to obtain subjective data

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The nursing process 6 phases

-Assessment
-Diagnosis
-Planning outcomes
-Planning interventions
-Implementation
-Evaluation

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Components of a nursing interview

-Biographical data
-Chief complaint
-Hx of present illness
-Client's perception of health status
-Past health hx
-Family health hx
-Social hx
-medication hx/ device use
-Complementary/alternative (CAM)
-Review of body systems & associated functional abilities

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Physical assessment

-Produces objective data
-Makes use of the techniques of inspection (visual exam), palpation (touch), percussion (tapping on body surface), direct auscultation (listening with unaided ear), and indirect auscultation (listening with stethoscope)

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Focused assessment

- Performed to obtain data about actual, potential, or possible problem that has been identified or is suspected

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Special needs assessment

Type of focused assessment that provides in-depth info about a particular are of client functioning ofter using a specially designed form

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Initial assessment

Completed when the client first comes into the healthcare agency

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Functional ability assessment

Especially important in discharge planning and home care initial assessment

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Ongoing assessment

Performed as needed at any time after the initial database is completed

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Comprehensive assessment

Also called a global assessment, patient database, or nursing database
Provides holistic info about the client's overall health status

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parts of physical assessment

inspection
palpation
percussion
auscultation

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NANDA and the nursing diagnosis

Nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable

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NANDA nursing diagnosis components

Diagnostic label
Definition
Defining characteristics
Related factors
Risk factors

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Medical diagnosis

Describes disease, illness, or injury

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Nursing diagnosis

A statement of client health status that nurses can identify, prevent, or treat independently

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Actual nursing diagnosis

Describes the human response to health conditions/life processes that exist in the individual, family, group, or community
Supported by defining characteristics and related factors

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Health promotion nursing diagnosis

A clinical judgment about a person's family's, group's, or community's motivation and desire to increase-well-being and actualize human health potential
Focuses on being as healthy as possible, as opposed to preventing a disease problem

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Risk nursing diagnosis

A clinical judgment about human experience/response to health conditions/life processes that have a high probability of developing in a vulnerable individual, family group, or community
Is supported by risk factors

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Syndrome nursing diagnosis

A clinical judgment describing a specific cluster of nursing diagnosis that occur together and are best addressed together through similar interventions

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Critical pathways

-Often used in managed care systems
-Outcomes based
-Interdisciplinary plans that sequence patient care according to case type
-Specify and predict patient outcomes and broad interventions for each day, or in situations, for each hour
-Describe the minimal standard of care required to meet the recommended length of stay for patients with a particular condition or diagnosis

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Protocols

-Cover specific actions usually required for a clinical problem unique to a subgroup of patients
-May be written for a particular medical diagnosis, treatments, or diagnostic tests
-Contain both medical and nursing orders
-Some include definitions and rationales for interventions

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Expected outcomes statement

-The responsibility of the professional nurse
-Should involve the client as much as possible, because goal achievement is more likely if the client believes that goals are important or realistic

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5 components of nursing orders

Date
Subject
Action verb (the nurse is the doer)
Times and limits
Signature

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Implementation

process
delegation
documentation

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Ongoing evaluation

While implementing care, immediately after intervention, and at each patient contact

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Intermittent evaluation

performed at specified times

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Terminal evaluation

Describes the clients health status and progress toward goals at the time of discharge

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Structure evaluation

Focuses on the setting in which care is provided

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Process evaluation

Focuses on the manner in which care is given, the activities performed by nurses

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Outcomes evaluation

Focuses on observable or measurable changes in the patient's health status that results from the care given

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Evaluation

Planned ongoing systematic activity in which you will make judgments about:
The clients progress toward desired health outcomes
The effectiveness of the nursing care plan
The quality of nursing care in the healthcare setting

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Revise the care plan

Review of assessment
Diagnosis
planning outcomes
planning interventions
implementation
Reflect critically about evaluation
Evaluate systematically, record the results, use the reassessment data to examine and modify the care plan

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PES

Problem
Etiology
Symptoms
problem r/t etiology as manifested by (AMB) signs or symptoms

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Assumptions

ideas we take for granted

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Phenomena

Aspects of reality that you can observe and experience

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Concepts

A mental image of a phenomena. A symbol in your mind

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Definition

A statement of the meaning of a term or concept that sets forth the concept's characteristics or indicators
That is the things that allow you to identify the concept

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Operational definition

Specifies how you would observe or measure a concept

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Statement (propositions)

Systematically describe the linkages and interactions among the concepts of theory

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Paradigm

The worldview or ideology of a discipline

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Conceptual framework

A set of concepts that are related to form a whole or pattern

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Model

Is a symbolic representation of a framework or concept
a diagram, graph, picture, drawing, or physical model

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Reasoning

Connecting ideas in a way that makes sense

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Logical reasoning

To develop an argument or statement based on evidence that will result in a logical conclusion

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Inductive reasoning

-often used in the nursing process
-moves from specific to general
-you gather separate pieces of info, recognized a pattern, and formed a generalization

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Deductive reasoning

starts with a general premise and moves to a specific deduction

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Clinical practice theories

very specifically guide what you do each day

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Grand theory

Covers broad areas of concern within a discipline
Usually abstract and does not outline specific nursing interventions

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Why learn it?

The ability to read and use nursing research enhances your ability to give quality patient care
Research affects you every day you are a nurse

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5 phases of the research process

-select and define a problem
-select a research design
-collect data
-analyze data
-use the research findings

78

Nursing theory

An organized set of related ideas and concepts that
-Assist us in finding meaning in our experiences
-Organize our thinking around an idea
-Develop new ideas and insights into the work we do

79

Components of a theory

Phenomena
Assumptions
Concepts
Definitions
Statements/propositions

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Hypothesis

statement the researcher believes to be true and what will be tested through the research project, AKA problem statement

81

Implications and recommendations

The final pieces of the research critique
The implications are the should of the research

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Validity

measures what it says it measures

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Reliability

same results (accuracy, consistency, precision) repeatedly

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Quanitative

To gather data from enough subjects to be able to generalize the results to a similar population
Reported as numbers

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Qualitative

Focuses on the lived experiences of people
The purpose is not to generalize the data, but to share the experience of the person or persons in the study

86

PICO

Patient, population, or problem
Intervention, treatment, cause, or contributing factor
Comparison intervention
Outcome
- Outline for effective research

87

SBAR

Situation
Background
Assessment
Recommendation

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4 components of a written expected outcome

Subject
Action verb
Performance criteria
Target time/date

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SMART outcomes statement

Specific
Measurable
Achievable
Realistic
Time

90

Selye

Stress and adaptation theory
States that a certain amount of stress is good for people
it keeps them motivated and alert
However 2 much stress, called distress, results in physiological symptoms and eventual illness

91

Gordon- Functional patterns (11), NCP organizational format

Health perception/ health management
Nutrition/metabolic
Elimination
Activity/exercise
Cognitive/perceptual
Self perception/self concept
Sleep/rest
Role/relationship
Sexual/reproductive
Coping/stress tolerance
value-belief

92

Clara Barton did not

go to nursing school

93

Some prisoners did serve in hospitals during the American Civil War

True

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Penicillin was invented in

1950s

95

The teutonic knights were another group of knights who served as caregivers during the

Crusades
As a group they were referred to as hospitalers

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Roles and functions of a nurse

Direct care provider
Communicator
Client/family educator
Client advocate
Counselor
Change agent
Leader
Manager
Case manager
Research consumer

97

Purposes of nursing care

Health promotion
Illness prevention
Health restoration
End-of-life care

98

Reimbursement is a very important issue but it is not in the

guide to the code of ethics for nurses

99

Actual nursing Dx have how many ___ parts

3

100

Health promotion

is the primary prevention
keeping everybody healthy from the get go

101

Disease prevention

is secondary prevention
specifically trying to prevent the onset of specific illnesses or problems

102

Etiology of the nursing Dx is not the

medical Dx

103

Risk Dx have how many parts

2 and no Sx