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Nursing Fall 2023 > Nursing Exam 4 > Flashcards

Nursing Exam 4 Flashcards

1
Q

Autonomy

A

the right to self-determination - to choose and act on that choice (every competent person has the right to decide their own choices)

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2
Q

Breach of Duty

A

occurs when a nurse does or does not do, what a reasonable nurse would have done under the same, or similar circumstances

*Nurse’s care fell before the acceptable standard of care

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3
Q

Causation

A

Must clearly show the connection between the nurse’s action or omission and the resulting injury to the patient

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4
Q

Assault

A

Occurs when a nurse intentionally places a patient in immediate fear of personal violence or offensive contact

*Verbal, must include words expressing an intention to cause harm and some type of action

Ex: If you keep acting like that, I’m gonna restrain you

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5
Q

Battery

A

Physical contact/touch (hitting/pushing)
-Committed when an offensive or harmful physical contact is made to the client without his consent, or there is unauthorized touching of a person’s body by another person

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6
Q

False Imprisonment

A

The restricting of a person without proper legal authorization (includes any type of unjustified restriction on a person’s freedom or movement

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7
Q

What do all religions have in common?

A

Theology
-Discussions and theories related to God and God’s relation to the world

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8
Q

What are the core issues of Spirituality?

A

-Faith (lets us trust & be optimistic, gives us purpose in life, allows us to experience sense of self; Ex- putting faith in God to get you through chemo)
-Hope (basic need to achieve, create, & shape our lives; Ex - cling to hope with cancer diagnosis)
-Love (seen through kindness, patience, endurance, and truthfulness

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9
Q

What are barriers to spiritual care?

A

-Lack of general awareness of spirituality
-Lack of awareness of your own spiritual beliefs
-Differences in spirituality between nurse and pt
-Fear that your knowledge is insufficient
-Fear of where spiritual discussions will lead

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10
Q

What is the standardized spiritual assessment?

A

FICA

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11
Q

What does FICA stand for?

A

F- Faiths or beliefs (what are yours?)
I- Importance and Influence
C- Community (spiritual support)
A- Address (is there something nurse can do in regards to spirituality)

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12
Q

Grief

A

Internal process a person works through due to a loss

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13
Q

Loss

A

Actual or potential situation in which someone or something is no longer present or available to a person (at every stage of life)

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14
Q

Bereavement

A

Form of depression accompanied by anxiety in response to loss of loved one

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15
Q

Mourning

A

Actions and expressions of bereavement including rituals, symbols, and acions

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16
Q

What is an actual loss?

A

Can be identified by others, not just the person experiencing it
*Can SEE you lost something

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17
Q

What is a perceived loss?

A

Only identified by the person experiencing it (internal)
*Only person who perceives as loss is the person experiencing it

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18
Q

External Loss

A

Actual loss of objects that are important to the person
-Theft
-Destruction
-Disasters (floor or fire)

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19
Q

What is an Internal Loss

A

Another term for perceived or physcological losses

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20
Q

Physical loss

A

-Injuries (amputation)
-Removal of an organ
-Loss of function (mobility, bladder function)

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21
Q

Psychological loss

A

Perceived loss, challenges our belief system
Commonly seen in:
-Sexuality
-Control
-Fairness
-Meaning
-Trust

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22
Q

Uncomplicated (Normal/Functioning) Grieving

A

(What we want people to go through)
-Natural response to a loss
-Person may experience a range of feelings, but it decreases over time

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23
Q

Complicated (Dysfunctional) Grieving

A

-Maladaptive, usually prolonged or overwhelming
-May become suicidal, workaholic, socially isolated, or demonstrate addictive behaviors

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24
Q

Chronic grieving

A

Begins as normal, but continues as long term with little resolution (inability to join normal life)

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25
Q

Masked Grieving

A

Person is grieving, but expressing it through other types of behaviors

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26
Q

Delayed grieving

A

Putting off grieving for periods of time

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27
Q

Disenfranchised grieving

A

You have a connect with the loss that is not socially supported or acknowledged by the usual rites of ceremonies

*Ex: Mistress, children ripped from home (can’t go through normal grieving process)

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28
Q

Anticipatory grieving

A

-You are experiencing a loss before it occurs

*May be emotionally unavailable to the dying person

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29
Q

What factors influence grief?

A

-Significance of the loss
-Support system
-Unresolved conflict
-Circumstances of the loss
-Previous loss
-Spiritual care/beliefs and practices
-Timeless of the Death –> Child vs elderly (a lot of life left to live vs got to live a good life)

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30
Q

True or False:
90% of people die in expected pattern

A

True

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31
Q

True or False:
Physiological stages of dying are the exact same for every person

A

False, they can have similarities, but are still unique to every person

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32
Q

What are the physiological stages of dying 1-3 months before death

A

-Client begins to withdraw
-Sleep increases
-Difficult to digest food, liquids preferred

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33
Q

What are the physiological stages of dying 1-2 weeks before death

A

-Reduces BP, changes in pulse, skin color turns paler
-RR may increase or decrease, apnea with sleep
-Congestion - rattling sounding cough

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34
Q

What are the physiological stages of dying days to hours before death?

A

-Surge of energy
-Mental clarity
-Desire to eat
-Talk with family members
-Difficulty swallowing
-Decreased BV, dehydrated
-Gag reflex declines
-Secretions accumulate
-Mucous membranes dry and tacky
-Lips cracked
-Respirations shallow, irregular
-Peripheral circulation decreases, increased perspiration, extremities are cooled, BP decreases, pulse hard to find
-Peristalsis slows, urine output decreases
-Muscles relax, droopy face
-Vision blurs
-Restless and agitated

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35
Q

What are the physiological stages of dying moments before death?

A

-No response to touch or sound
-Cannot be awakened
-Short series of long spaced breaths before breathing ceases entirely and heart stops beating

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36
Q

What are the 7 stages of grief?

A

-Shock
-Denial
-Anger
-Bargaining
-Depression
-Testing
-Acceptance

*DABDA
(Shock and testing were added)

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37
Q

What are legal and ethical issues regarding death in health care?

A

-ADs
-Living will
-Durable Power of attorney (Healthcare Proxy)
-DNR
-Assisted suicide
-Euthanasia
-Autopsy
-Organ donation

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38
Q

Post-Mortem:
Why do you elevate HOB ASAP?

A

To prevent discoloration of face

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39
Q

True or False: Post-Mortem
You leave dentures in pts mouth

A

True: helps to keep their face shape

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40
Q

Spirituality

A

A journey that takes place over time and involves the accumulation of life experiences and understanding
*Attempt to finding meaning in life

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41
Q

What was the history of spirituality in the Pre-Christian era

A

-Caring for sick was an expression of hospitality/charity
-Praying to the God(s) for healing

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42
Q

What is the history of spirituality in the early Christian era

A

-Jesus Christ’s primary teaching
-Caring for the sick was honored and respected
-Gradually combined health arts with religious care

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43
Q

What is the history of spirituality in the Post-Reformation period in Europe

A

-Nursing orders flourished
-Nightingale –> spirituality was the heart of human nature and fundamental to healing
-Bringing comfort and relief to the sick and dying - Lady with the Lamp

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44
Q

Religion

A

“The map you take to get to a certain destination”
Involves:
-Beliefs
-Values
-Rituals
-Code of Conduct and Ethics

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45
Q

Morals

A

-Learned from external influences and communicated through various systems
-Good or bad/ right and wrong

-Ex: Treat others the way you want to be treated

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46
Q

Moral behavior

A

Consistent with customs or traditions based on external influences (religious beliefs)

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47
Q

Immoral behavior

A

A person whose behavior is inconsistent with traditional notions (inconsistent with right and wrong)

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48
Q

Ethics

A

The study of more principles and standards, or the process of using them to decide your conduct and actions
-What is right or wrong?
-What actions should be taken in certain circumstances?

*Just because something is accepted does not mean it is ethical

Ex: Is it wrong to steal if I need to feed someone?
-Should we turn off the ventilator on pt?
-Should baby go through surgery even if they will not have a good quality life?

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49
Q

What Ethical Principle is used for ethical decision making?

A

MORAL Model

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50
Q

Bioethics

A

the application of ethical principles to every aspect of healthcare

Ex: Direct care of pts, allocation of resources, utilization of staff, medical/nursing research

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51
Q

What does the MORAL Model stand for?

A

M- Massage the Dilemma
O- Outline the Options
R- Resolve the Dilemma
A- Act by Applying the Chosen Option
L- Look back and evaluate

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52
Q

When does moral outrage occur?

A

When we perceive others acting immorally, it makes us feel powerless

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53
Q

When does moral distress occur?

A

When we can’t act as moral agents, when we are prevented from acting on our moral decisions

*Ex: Growing up believing abortion is wrong, but caring for a pt who needs one

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54
Q

Human Dignity

A

Respect for the inherent worth and uniqueness of individuals and populations (provide it by being considerate, believing them, advocating, privacy, and confidentiality)

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55
Q

Informed consent

A

The right of competent pts to decide whether to agree to a treatment (pt needs to know alternative treatment options, the risks and benefits, treatment info, and provider)

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56
Q

Nonmaleficence

A

Do no harm AND prevent harm
-Does this treatment cause more harm than good?

57
Q

Beneficence

A

The duty to do good or promote good
-Prevent harm when you can
-Remove harm
-Do no harm

58
Q

Fidelity

A

Faithfulness; the duty to keep promises
-The same regardless of level of importance

59
Q

Veracity

A

The duty to tell the truth
-Be culturally sensitive
-Consider the context

60
Q

Justice

A

The obligation to be fair
-Could be allocating time or resources

61
Q

Professional Code of Ethics

A

Formal group expectations and standards for professional behavior of the profession

*Not legally binding

62
Q

International Council of Nurses

A

A guide for action on social values and needs, nursing standards worldwide

63
Q

American Nurses Association

A

Establishes the ethical standards for the profession, guide fro nurses in ethical analysis and decision making

64
Q

The Patient Care Partnership

A

Entitles patients to rights:
-Maker their own decisions
-Be active partners in their treatment
-Be treated with dignity and respect

65
Q

The Joint Commission Accreditation Standards

A

Organizational ethics and individual rights, requires ethics in care, treatment, services, and business

66
Q

Value

A

A belief about the worth of something
-Behaviors, feelings, knowledge, or decisions, goals, models of conduct, ideas, beliefs (changes around people and experiences you have)

You can value
-An idea
-A person
-A way of doing things
-An object

67
Q

Value neutrality

A

To understand our own values regarding an issue and be able to become nonjudgmental when providing care to clients

Ex: having a family member who had passed away from an opioid addiction & caring for a patient with an opioid addiction

68
Q

True or False:
Nursing students can for values through education and clinical

A

True

69
Q

Moralizing

A

Authoritarian approach “this way is the only way”; unable to make independent choices

70
Q

Laissez-faire

A

Explore set of values with little guidance “doing your own thing” or discipline

71
Q

Responsible choice

A

A balance of freedom and restrictions allows them to explore new behaviors and experience the consequences

72
Q

Value Clarification

A

The process of becoming conscious of an naming one’s values
-Allows you to make good decisions and to avoid imposing your views on others
-Positive process of growth that results in awareness, empathy, and insight
-May be done multiple times throughout lifespan as values change

73
Q

Attitudes

A

Mental dispositions or feelings toward a person, object, or idea
-Our way of responding to situations or things
-Can be positive or negative

74
Q

Beliefs

A

Something that one accepts as true
-Can be based on faith or facts
-Can be true or false
-Altered based on acquired knowledge and experiences

75
Q

ANA Code of Ethics for Nurses

A

Focus on the collaboration of healthcare professionals and the community to protect human rights and reduce health disparities

76
Q

American Association of Colleges of Nursing (AACN) values

A

-Altruism
-Integrity
-Social Justice

77
Q

Altruism

A

Concern for the welfare and well-being of others (Key of nursing- What do we care about? The well-being of our pts)

78
Q

Integrity

A

Acting in accordance with an appropriate code of ethics and accepted standards of practice (honesty)

79
Q

Social Justice

A

Upholding moral, legal, and humanistic principles; treating others fairly regardless of age, race, citizenship, economic status, disability, or sexual orientation (equality)

80
Q

Liability

A

The person financially or legally responsible for something
-Nurses are legally responsible for their actions –> The nurses owed a “duty of care” and they “breached” that duty
-Cannot be delegated

80
Q

True or False:
Negligence is not a type of malpractice

A

False, negligence is a type of malpractice

80
Q

Malpractice

A

-Professional person failed to act in a reasonable manner
-If someone is injured, professional may be held accountable

80
Q

When does Malpractice occur?

A

-Occurs when a hospital, doctor, or healthcare professional causes injury to a patient through a negligent act or omission

*Could be a result of errors in diagnosis, treatment, aftercare or health management

*Pt must prove that negligence caused injury

81
Q

What is needed to prove that medical malpractice occured?

A

1) A doctor - pt relationship existed
2) The doctor was negligent
3) Negligence caused injury
4) Injury led to specific damages
5) Failure to diagnose
6) Improper treatment
7) Failure to warn a patient of known risks

82
Q

Negligence

A

The failure to use ordinary or reasonable care or the failure to act in a reasonable and prudent (careful) manner

Ex: As a nursing instructor, I don’t verify you are capable of doing a skill before allowing you to proceed with it

83
Q

Abandonment

A

When a nurse deserts or neglects a patient with whom they have established a provider-pt relationship without making reasonable arrangements for the continuation of care and without reasonable notice

*Not “I’m sick and the hospital could not find staff to cover me”

*Have to be on shift, walk in, something happens, and you leave your floor and do not come back

84
Q

What is the Bill of Rights?

A

-First 10 Amendments to the U.S. Constitution
-Identifies and limits the role of government in individuals’ lives
-Direct implication in healthcare (Includes rights of nurses and pts, helps with privacy of pts like HIPPA)

85
Q

HIPPA (Health Insurance Portability & Accountability Ace- 1996)

A

-Protect health insurance benefits for workers who lose or change their job
-Protect coverage to persons with preexisting medical conditions
-**Establish standards to protect the privacy of personal health information (confidentiality)

86
Q

Patient Self-Determination Act 1991

A

Recognizes the client’s right to make decisions regarding his or her own healthcare
-Document presence/absence of AD, provide education of ADs, follow state laws regarding ADs, treat everyone the same

87
Q

True or False:
In emergency situations, we still need to get informed consent

A

False- we can skip (especially if they cannot find a representative to ask)

88
Q

Durable Power of Attorney (DPOA)

A

-Identifies a person who will make healthcare decisions in the event the pt is unable to do so
-With POA, they are only making decisions if pt is unable to do so

89
Q

Advances Directive (AD)

A

Written or oral instructions that explain specific wants by a person regarding their end of life care if they were incapacitated or unable to express their desires

90
Q

Living Will

A

A written document that provides specific instructions about what a person wants

Ex: “I don’t want these to occur… NG tubes, intubation, ICU Care”

91
Q

DNR

A

Specific physician order, signed by the physician, starting not to compete any type of life supporting measures (CPR)

92
Q

Assisted Suicide

A

Anyone making something available that allows for the person to end their life

93
Q

Physician Assisted Suicide

A

When a physician makes pharmacological medication available to a person specifically to end their life

94
Q

Euthanasia

A

The deliberate ending of someone’s life from a terminal or incurable illness

Ex: We euthanize animals all the time

95
Q

Autopsy

A

The medical examination of a body to determine cause of death

*Only done on specific people (trauma, abuse, recent surgery, in restraints)

96
Q

Organ donation

A

Donation of the tissue, organs and/or skin

97
Q

Emergency Medical Treatment and Active Labor Act (EMTALA)

A

Requires healthcare facilities to provide emergency medical treatment to patients who seek healthcare in the emergency department, regardless of their ability to pay, legal status, or citizenship status

-Screening can be used to determine emergency

Ex: If you are having a heart attack or are a gunshot victim, hospital must stabilize you before transferring you

98
Q

Americans with Disabilities Act (ADA) 1990

A

-Protections against discrimination of individuals with disabilities
-Under ADA, employers are requires to make reasonable accommodations in order for a disable person to perform their job

99
Q

Mandatory Reporting

A

A legal requirement in state statue or regulation for nurses to report an occurrence or individual, including another nurse, when the public is at risk (even if it is a violation of HIPPA, we have to report it)

Ex: Nurses with substance abuse, any vulnerable population abuse or neglect, any communicable diseases like HIV, gonorrhea, syphilis)

100
Q

Good Samaritan Act

A

Offer legal protection to people who give reasonable assistance to those who are, or whom they believe to be injured in peril or otherwise incapacitated

Ex: If you stop at a car accident and make a silly decision that accidentally causes harm, you are not legally liable

101
Q

Nursing Practice Act

A

-Regulate nursing practice to protect the health, safety, and welfare or the general public
-Define the scope of nursing practice
-Approve programs providing licensure nursing education to students

102
Q

Medical malpractice statues

A

A lawsuit brought against a healthcare provider for damages when there has been death of, injury to, or other loss to the person being treated

103
Q

Criminal Law

A

Wrongs or offenses against society; violation of a law; laws vary state to state

104
Q

Felony

A

Crime punishable by more than 1 year in jail (ex: Murder, suicide, rape/sexual assault, stealing drugs and equipment)
-May lose licensure (most of the time), right to vote, hold public office, possess firearms

105
Q

Misdemeanor

A

Less than a year in jail (Ex: assault, battery, petty theft)
-May lose licensure
-Does not have to be nursing related crimes – DUIs, punching someone in a bar, etc

106
Q

Tort Law

A

Wrongs done to one person by another person that do not involve contracts
-Classified as quasi-intentional torts, intentional torts, or unintentional torts

107
Q

Unintentional Tort

A

negligence or malpractice

108
Q

Quasi-Intentional Tort

A

Defamation of Character
-Libel: written or published form of defamation of character (physical)
-Slander: verbal form of defamation of character (words)

109
Q

Fraud

A

False statements, falsifying documents, concealing information that should have been disclosed

110
Q

Florence Nightingale (1860)

A

Focused on cleanliness and the environment

111
Q

Peplau

A

Theory of Interpersonal Relations
-You need to have communication with your pts

112
Q

Virginia Henderson (1955)

A

Nursing Need Theory (14 needs)
-Created because she had 14 needs

113
Q

Dorothy Johnson (1968)

A

Behavioral System Model
-Focused on behavior function

114
Q

Dorothea Orem (1971)

A

You need to be able to fulfill biological, psychological, developmental, or social needs to be healthy

115
Q

Imogene King (1971)

A

Patient Environment and nurse-pt relationship is part of the nurse for meeting goals towards good health

116
Q

Betty Neuman (1972)

A

Reduce stress of patient

117
Q

Sr. Callista Roy (1979)

A

Viewed individual as a set of interrelated systems who strives to maintain the balance between these various stimuli

118
Q

Jean Watson (1979)

A

Caring Theory
-You need to be caring and humanistic

119
Q

Assumptions

A

Ideas that we take for granted - Concepts or statements that are presumed to be true, don’t plan to test them

120
Q

Phenomena

A

Aspects of reality that you can observe - Subject matter, what makes them unique

121
Q

Concepts

A

Mental image or symbol of phenomenon - form these through observation or experiences; use them to find similarities, differences, organize, and categorize; can do this from simple to complex or from concrete to abstract

Ex: Mental image of what I believe everyone is going through

122
Q

Theoretical definition

A

Pain is an unpleasant experience associated with potential tissue damage

123
Q

Operational definition

A

Specifies what you deserve (pain is the pts verbal statement that he is in pain)

124
Q

Paradigm

A

The world view or ideology of a discipline (how we see things) –> Our broadest cinceptual framework

125
Q

What are the 4 major concepts frequently interrelated and fundamental to nursing?

A

Person
Health
Environment
Nursing

126
Q

Nursing Paradigm

A

Looks at the entire person
-Look at physical, psychological, spiritual, and social health changes

127
Q

Medical Paradigm

A

Focuses on identifying and treating disease

128
Q

True or False:
Doctors treat, nurses care

A

True

129
Q

Are Grand Nursing Theories Broad of Narrow?

A

Broad

Ex: Everybody should care and everybody should be clean

130
Q

What are Mid Range Theories?

A

Narrower and more specific than Grand Nursing Theories
-Help design our educational programs, help with protocols and procedures in the hospital

(Teach us how to care and clean)

131
Q

Practice theories

A

Most specific, focus on a specific situation; used for goals and outcomes

Ex: Only focus on CHF pts

132
Q

Inductive Reasoning

A

(What we typically do)
-Go from specific to general
-Gather separate pieces on info, recognize a pattern, and form a generalization about the pt

*I have data, now I need to conclude what the problem is

133
Q

Deductive reasoning

A

-Goes from general to specific

Ex: You receive a call from the ER that you will be receiving a new pt with a kidney infection, you know that pt may arrive with possible symptoms

*I see the problem, now I need to gather data to support the problem

134
Q

Quantitative

A

-Gather objective data (labs, vitals, etc)
-Surveys, census, chart audit
-Yes or no questions
-Reported as #s
-Generalize the results to a similar population

135
Q

Qualitative

A

-Subjective data from a small # of subjects
-Open-ended interviews, may perform observations or complete written questionnaires
-Identifies themes
-Research is about sharing the “lived experience”

136
Q

What are barriers to Research for Nurses

A

-Hesitancy to change nursing practice
-Lack of knowledge or nursing research
-Negative attitudes towards research
-Lack of support from the employing institution
-Study findings that are not ready for the clinical environment

Nursing Fall 2023 (7 decks)

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