Quiz 1 Flashcards

1
Q

Banners stages of nursing proficiency

A

Novice
Advanced beginner
Competent
Proficient
Expert

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2
Q

Nursing responsibilities and roles

A

Autonomy and accountability
Caregiver
Advocate
Educator
Communicator
Manager

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3
Q

Types of APRN’s

A

Clinical nurse specialist
Nurse practitioner
Certified nurse midwife
Certified registered nurse anesthetist

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4
Q

Florence nightingale

A

Established first nursing philosophy based on health marine education and restoration
Organized first program for training nurses
First practicing epidemiologist
Improved sanitation in battlefield hospitals
Practices remain a basic part of nursing today

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5
Q

Ever changing needs of society

A

Aging population
Cultural diversity
Bioterrerism
Emerging infections
Disaster management

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6
Q

Contemporary concerns

A

Nurses self care
Health care reform and costs
Demographic changes
Medically underserved

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7
Q

Trends in nursing

A

Evidence based practice
Quality and safety education of nurses
Impact of emerging technologies
Genomics
Public perception of nursing
Impact of nursing on politics and health policy

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8
Q

Nursing practice acts (NPA’s)

A

Overseen by state boards of nursing
Regulate the scope of nursing practices
Protect public health, safety, and welfare

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9
Q

Code of ethics in nursing

A

Advocacy
Responsibility
Accountability
Confidentiality

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10
Q

Values

A

Deeply held beliefs
Clarifying values include yours, the patients, and your co workers

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11
Q

Approaches to ethics

A

Deontology
Utilitarism
Casuistry
Feminist ethics
Ethics of care

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12
Q

Processing an ethical problem

A

Is this an ethical problem
Gather information that is relevant to the case
Identify the ethical elements and examine your values
Name the problem
Indetify possible courses of action
Evaluate the action plan

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13
Q

Issues of health care ethics

A

Social media
Quality of care
Care at the end of life
Access to health care

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14
Q

Clinical judgement

A

Observed outcome of critical thinking and decision making

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15
Q

Model of clinical judgement

A

Help explain concepts
Explains many variables involved making decisions and clinical judgements about patients

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16
Q

Critical thinking

A

The ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process
Aim is to focus on most important issues to produce most desired patient outcome

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17
Q

Critical thinking competencies

A

Scientific method
Problem solving
Decision making
Diagnostic reasoning
Clinical decision making

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18
Q

Levels of critical thinking

A

Basic critical thinking
Complex critical thinking
Commitment

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19
Q

Components of critical thinking

A

Competence
Knowledge based
Experience
Environment

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20
Q

Critical thinking attitudes

A

Confidence
Thinking independently
Fairness
Responsibility and accountability
Risk taking
Discipline
Perseverance
Creativity
Curiosity
Integrity
Humility and self awareness

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21
Q

Evaluation of critical thinking

A

Reflection
Meeting with colleagues
Concept mapping
Critical thinking synthesis

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22
Q

Clinical decision making steps

A

Assessment
Diagnosis
Planning
Implementing
Evaluation

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23
Q

Tanner model

A

Recognizes role of nursing background
Circumstances of situations
Nurses relationship with patient

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24
Q

Range of knowledge in clinical judgement

A

Derived from since and theory, practice, knowing individual patients, and human understanding

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25
Analytic processes
Breaking down situations into its elements to: gain knowledge, address mismatches between what is expected and what happens, and determining action when there are multiple choices
26
Intuition
Immediate understanding of clinical situation
27
Narrative thinking
Review the experience as a story of the patient and one’s response to the patient
28
Reflection
In depth review of a clinical experience, intent to learn from breakdowns of practice
29
Noticing in clinical
Patient responses Similar patients from practice Textbooks and resources Awareness of excellence Values and connections Comfort with patterns of care
30
Interpreting and responding
Interviewing clinical reasoning into data
31
Reflection in vs on action
In: a ability to read the patient and his they are responding On: learning what us gained in that clinical experience
32
Critical thinking 2 steps
Collect information from primary and secondary sources Interpret and validate information to se if more is needed
33
Types of assessments
Patient centered interview Periodic assessments- ongoing contact w patients - each are either comprehensive or focused
34
Phases of assessment interview
Orientation Working Termination
35
Interview techniques
Oberservation Open ended questions Closed ended questions Leading questions Back channeling Probing
36
Planning
Asses patient Identify problems Prioritize problems identify desired outcomes Identify interventions Prioritize interventions Deliver patient care Evaluate interventions
37
Establishing priorities
Consider each patient situation Avoid classifying only physiological nursing diagnoses as high priority Time management and plan execution
38
Writing expected outcomes
Specific Measurable Attainable Realistic Timed
39
Types of interventions
Direct care measures Indirect care measures Dependent and independent nursing interventions Provider interventions
40
Things to consider in planning interventions
Desired outcomes Characteristics of nursing diagnosis Research based knowledge of intervention Feasibility of intervention Acceptability of patient Nurses competency
41
Systems of planning
Care plans Hand off reporting Concept maps Critical pathways
42
How to consult with health care professionals
Identify general problem Choose appropriate professional Provide relevant information Do not influence consultants Be available for discussion Incorporate their recommendations
43
Goals of Quality and Safety Education for Nurses
Prepare nurses to constantly improve quality and safety of care
44
Implementation process
Avoid adverse events Reassessing patient Reviewing and revising existing care plans
45
Direct care
Activities of daily living Instrumental activities of daily living Physical care techniques Lifesaving measures Counseling Teaching Controlling for adverse reactions Preventative interventions
46
Indirect care
Delegating Supervising Evaluating work of other staff members
47
Achieving patient outcomes
Implement interventions in a timely manner Time management Organization skills Appropriate use of resources Priority setting Promote patient adherence
48
Evaluation
Examine results Compare achieved outcomes with expected outcomes Recognize errors Understand, reflect, and fix errors
49
The evaluation process
Recognize errors and unmet outcomes Correcting errors Revising the care plan Discontinuing a care plan Redefining diagnosis’s Revising expected outcomes Revising interventions
50
Preventable adverse outcomes
Severe pressure injuries Falls and trauma Catheter associated UTI’s Central line associated blood stream infections
51
Critical thinking can be applied
During any patient interaction Helps to overcome biases and stereotypes that interfere with perceiving and interpting messages from others
52
Levels of communication
Interpersonal Intrapersonal Small group Public Electronic
53
Elements of communication process
Referent Sender Receiver Message Channels Feedback Interpersonal values Environment
54
Aspects of verbal communication
Vocabulary Denotative and connotative Pacing Intonation Clarity and brevity Timing and relevance
55
Aspects of nonverbal communication
Personal appearance Posture and gait Facial expression Eye contact Gestures Sounds Territoriality Meta communication
56
Professional communication
Courtesy Use if names Trustworthiness Autonomy and responsibility Assertiveness
57
Therapeutic communication techniques
Active listening Sharing observations Sharing empathy Sharing hope Shairing humor Sharing feelings Using touch and silence Providing information Clarifying Focusing Paraphrasing Validation Asking revenant questions Summarizing Self disclosure Confrontation
58
Nontherapuetic communication techniques
Asking person questions Giving personal opinions Changing the subject Automatic responses False reassurance Sympathy Asking for explanations Approval/disapproval Defensiveness responses Passive/ aggressive Arguing
59
Primary goal of patient education
To help individuals families and communities achieve optimal levels of health
60
Teaching and learning
Teaching- giving knowledge through direct activities Learning- understanding and apply new concepts Effectiveness involves teach back from nurses and patients
61
Domains of learning
Cognitive Affective Psychomotor
62
Ability to learn aspects
Developmental capability Learning in children Adult learning Health literacy and learning disabilities Physical capability Environment
63
For patient learning
Learn needs Motivation to learn Readiness and ability to learn Environment Resources for learning Health literacy
64
Purpose of health care records
Facilitates inter professional communication Provides a legal record of care Provides justification for financial billing and reimbursement or care Supports the precise of needed for quality and perform care imporbment Serves as a resource for education and research
65
Inter professional communication with EMR
Legal document Resibirstment Auditing and monitoring Education Research Maintains privacy confidentiality and security
66
Standards of documentation
Factual Accurate Appropriate use of abbreviations Current Organized Complete
67
Methods of documentation
Flow sheets Progress notes Charting by exception
68
Common records in the EHR
Admission nursing history information Patient care summary Care plans Discharge summary forms
69
Documenting communication w health care providers
Phone calls Verbal orders Incidence of occurrence report
70
Acuity rating system
Used to determine hours of care and number of staff required for a group of patients every shift
71
Patients acuity level
Based on the type and number of nursing interventions required by that patient over a 24hr period
72
Long term health care setting governed by
Individual state regulations The joint commission Center for Medicare and Medicaid services
73
Case management and use of clinical pathways
Incorporates inter professional approach Interprofession care plans identify patient problems and expected outcomes Document and eve layer outcomes and unmet goals
74
Nursing clinical information systems
Nursing model and critical pathway Advantages: better information access, better documentation, reduced errors, reduced hospital costs, increased job satisfaction Clinical database development
75
Nursing informatics
Specialty area of practice Integrated nursing science, computer science and information science
76
Informatics and information management
Health care information technology ( HIT)- enhance quality and efficiency of care Health care information system (HIS) - clinical and administrative system Clinical information system (CIS)-
77
Scientific knowledge based
Environmental safety Common hazards: motor vehicle accidents , poison, falls, fire, disaster, transmission of pathogens, immunizations
78
Factors influencing patient safety
Infant, toddler, and preschooler School aged child Adolescent Adult Older adult Work place culture Lifestyle Impaired mobility Sensory, cognitive, or communication impairment Economic resources Lack of safety awareness
79
Analysis and problem identification
Risk for injury Impaired cognition Lack of knowledge Risk for poisoning
80
Acute and restorative care
Fall prevention Restraints Side rails Fires Electrical hazards Seizures Disaster Preventing workplace violence
81
Safety guidelines for nursing skills
Anticipate fall risks Involve patients and families in fall prevention strategies Always try restraint alternatives before using a restraint Implement fall prevention protocols