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Contemporary Issues in Health > Quiz 1 > Flashcards

Quiz 1 Flashcards

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1
Q

Updates to the new version of the Code of Ethics (3)

A

1) Stronger language which covers “preservation of integrity”
2) Navigating care for the dying patient -End of Life Care
3) Vigilance in the age of social media

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2
Q

In regards to Stronger language it has changed from: _____ express to ____ express

A

May express to Must express

When placed in circumstances that exceed moral limits…nurses MUST express to appropriate authority their conscientious objection. Previously stated “may express”

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3
Q

Example of Stronger Language)

If short staffing puts the nurse in jeopardy of providing unsafe care, the nurse should _______ ______ to providing care without more help.

A

Conscientiously object

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4
Q

What has changed with end of life care in regard to nurses role?

How do nurses feel in these situations?

A

Patients have the right to refuse treatment, and nurses SHOULD SUPPORT patients in that refusal, but MAY NOT PARTICIPATE IN ENDING OF LIFE.

Nurses often feel caught in the middle between patients, families, and physicians.

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5
Q

Bigger Picture

Nurses now have to

1) mandate to:
2) see beyond:
3) create:

A

1) mandate to work together nationally and globally to address social determinants of health, such as violence, poverty, homelessness, and abuse
2) see beyond the individual patient in the bed and look to outside factors that are causing the illness
3) Policy! Need for involvement in professional organization

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6
Q

What is an integral part of why nursing has been rated the top profession for honesty and ethical standards for the 13th consecutive year?

When was it updated last?

A

Our revised code of ethics

2015

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7
Q

Why is the Code of Ethics important for nurses?

A
  • Nurses make dozens of decisions about patient care every day.
  • Making those decisions with ethical considerations in mind is increasingly challenging in the modern healthcare environment where technology and patient care are evolving at a rapid pace.
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8
Q

What are the 9 Provisions of the ANA Code of Ethics:

A

1) Affirming Health through Relationships of Dignity and Respect
2) The Patient as Nursing’s Foundational Commitment
3) Advocacy Geography
4) The Expectations of Expertise
5) The Nurse as a Person of Dignity and Worth
6) The moral Milieu of Nursing Practice
7) Diverse contributions to the Profession
8) Collaboration to Reach the Greater ends
9) Social Justice: Reaching Out to a World in Need of Nursing

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9
Q

The Nine Provisions delineate the basis of our commitment and obligations to (3) while also assuring the:

A

Respect, Protect, and Advocate

Integrity of the Profession

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10
Q

What is the purpose of the Code of Ethics? (4)

A

1) The ANA guidelines to practice and decision making goals and obligations for practice for RN’s in every role and setting
2) Will guide and support nurses as they face tough decisions from end of life care to involvement in social media
3) Succinct statement of the ethical values, obligations, duties, and professional ideals of nurses individually and collectively
4) Is the profession’s non-negotiable ethical standard

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11
Q

Nurses obligations in regards to Vigilance in the age of Social Media:

A

To maintain patient confidentiality in work setting and off-duty in all venues, including social media, and other communication

Urged to maintain vigilance regarding postings, images, recordings or commentary

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12
Q

Accountability =

A

The state of being accountable, liable or answerable to oneself and others for one’s own choices. Decisions and actions as measured against a standard such as that established by the Code of Ethics.

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13
Q

Responsibility =

A

Can be shared- being responsible for yourself and others; state or fact of being responsible or accountable for something within one’s power, control or management. An obligation to perform required professional activities

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14
Q

Beneficence =

It often goes ____ what is required by _____?

A

The doing of good, compassion. The bioethical principle of benefiting others by preventing harm, removing harmful conditions, or affirmatively acting to benefit.

above, law

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15
Q

What is the CORE PRINCIPLE of PATIENT ADVOCACY?

A

Beneficence

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16
Q

Non-Maleficence

A

The ethical principal of doing no harm.
Core of medical oath and nursing ethics.
Should not be done through omission or commission.

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17
Q

What is Negligence?

A

A breach of professional duty that causes harm

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18
Q

Autonomy (____ ____) =

A

(Self Determination)

Independence or freedom as of the will or one’s action. Agreement to respect another’s right to self determine a course of action. Support of independent decision making of the PT.

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19
Q

In Autonomy, the patient is the decision maker as long as they have:

A

The decisional capacity (makes own decision without force, right to make choice about oneself), need for truthful disclosure and informed contest (decisional privacy right to make choice regarding oneself and own belief and has non directiveness of provider- info without threat or deception). Based on values, religion, and culture

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20
Q

Paternalism =

It is an application of ______

A

Belief about what is in the best interest of the patient, choosing to reveal or withhold patient information.

Paternalistic- act of limiting one’s power when its believed to be their best interest

An application of power over the patient.

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21
Q

What is this an example of?

The doctor denies or offers treatment bc he has a strong belief of what is best for the pt.

A

Paternalism

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22
Q

Justice =

What type of Justice do Nurses practice?

A

Equal and fair distribution of resources, time and effort on PT; based on analysis of benefits and burdens of decisions; Being right, righteousness, equitableness, moral rightness.

Distributive Justice

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23
Q

Fidelity =

A

Loyalty, fairness, truthfulness, advocacy, and dedication in relationships. Promise keeping, truth telling, and fulfilling commitments.

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24
Q

These are examples of examples of ?

“Following through on your actions”
“Not flaky”

A

Fidelity

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25
Veracity =
Truth in speech or statement; truthfulness
26
Genetics = Who is the father of this science?
The science of heredity Mendel - who studied inheritance of pea plants
27
Genomics =
The science of the entire genome—“the totality of the chromosomes” (& the DNA therein) unique to a particular organism (or any cell within the organism).
28
Genes =
Functional and physical unit of heredity passed from parent to offspring. A specific set of instruction cells use to produce a specific protein.
29
Penetrance = This is a _____ measurement. Two Types are =
The proportion of individuals with a mutation who exhibit clinical symptoms of the disorder. Quantitative Complete and Incomplete Penetrance
30
Mutation =
A permanent change in the DNA. These are mistakes in the cells DNA which ultimately leads to changes in the proteins they make. Not always bad, could be good bad or indifferent.
31
DNA =
The basic genetic chemical structure, containing a gene coding regions and noncoding regions, that can be compacted into a chromosomes form
32
Carrier =
Heterozygous person that has inherited the recessive allele for a genetic trait or mutation but doesn’t display that trait or show symptoms of the disease. They may pass on the recessive genes onto offspring but aren’t themselves affected by the recessive trait associated with the gene.
33
Autosomal =
The 22 pairs of human chromosomes that do not code for sexual differentiation of the individual. Chromosome that is not a sex chromosome.
34
Dominant =
Dominant trait: A single trait is expressed regardless of whether the two gene alleles are identical (homozygous) or different (heterozygous).
35
Recessive =
Recessive trait: a single gene that is expressed only when both gene alleles for the trait are identical (homozygous)
36
Pharmacogenetics
The use of single-gene information in the study of drug development and drug therapy. “A science that examines the inherited variations in genes that dictate drug response & explores the ways these variations can be used to predict where a patient will have a good response to a drug, a bad response to a drug, or no response at all”
37
Variants =
Alleles are variants of a gene - Explanation of different hair colors
38
Multifactorial (2)
Variable expressivity Epigenetics
39
Variable Expressivity = Epigenetics =
Range of signs & symptoms that can occur in different people with the same genetic disorder Alterations that can occur in our genetic expression based on environmental and lifestyle factors
40
Type 1 Diabetes, Asthma are examples of?
Epigenetics
41
The study of the function of all nucleotide sequences present within the entire genome of a species, including genes and nongene areas of DNA
Genomics
42
Genomics) 1) There are ______ genes 2) ____ trillion possibilities 3) We are _____% similar, no matter what ethnic/racial/cultural background we have
1) 25,000 2) 80 3) 99.9%
43
Why do we care about genomics? (2) Remember that:
1) Understanding the individual's full genomic make up, especially specific genetic areas related to specific health issues can significantly transform patient care for significantly better outcomes 2) It can truly individualize patient treatments. Creates point of care genetic/genomic testing Epigenetics is the changes that can happen in the genetic expression based on environmental lifestyle factors
44
A Gene is an:
ordered linear segment of nucleotides within a strand of DNA arranged along a chromosome
45
Describe human chromosomal makeup
In humans, each cell normally contains 23 pairs of chromosomes, for a total of 46. Twenty-two of these pairs, called autosomes, look the same in both males and females. The 23rd pair, the sex chromosomes, differ between males and females
46
Genes code for =
a specific protein or protein segment that results in a particular characteristic or function
47
Each gene is inherited by each _____, Some genes are _____ and some are _____
parent recessive dominant
48
Complete penetrance = Ex)
All who have the mutation have the clinical symptoms, whenever there is a genotype there will be a phenotype Huntington's disease
49
Incomplete or reduced penetrance = Ex)
Not everyone who has the mutation shows clinical symptoms, not everyone with the genotype has the phenotype or ability to express it Cancer: not everyone with the gene will develop cancer and not everyone who has cancer has the gene
50
We have two identical twins that both have the gene for being able to roll their tongue, but only one can actually roll their tongue. What is this an example of?
Incomplete penetrance
51
Factors that effect penetrance (6)
1) Modifier genes 2) Mutation position 3) Genes at other loci 4) Response to DNA damage 5) Exposure to carcinogens 6) Hormonal/reproductive factors
52
Compare incomplete penetrance to variable expressivity
incomplete penetrance = the absence of ONE clinical manifestation that is associated with the gene Variable expressitivity = RANGE of symptoms that can occur in different people with the same disorder (not just ONE manifestation) , range may be mild-severe bc there are multifactorial contributors- ex) downs
53
Mutations can be ______ (by parents) or ______ (from environment)
1) Inherited | 2) Acquired - (is behavioral)
54
De novo =
Mutation occurs just after fertilization, spontaneously happens in the egg or the sperm
55
Mosaicism = ex)
Mutation where some cells get it and others don't ex) Calico cat -has different fur color in different places
56
Polymorphism = ex)
Many Phenotypes occuring in at least 1% of the population ex) Gender Dimorphism
57
Base pairs of DNA = Humans have ____ billion base pairs
Thymine and Adenine Cytosine and Guanine 3.2
58
1) DNA folds itself into _______ which reside in the ______ and each species has a different number of chromosomes 2) Humans have ______ chromosomes 3) All cells have the ____ DNA, just not turned on similarly in each cell
1) Chromosomes Nucleus 2) 46 3) same
59
Pharmacogenetics is a term now used interchangeably with:
Pharmacogenomics
60
What is a Pharmacogenetic trait? Ex)
A genetic trait that requires exposure to a pharm agent to have a phenotypic expression Ex) Allergies
61
Treatment response variations include (4)
1) Toxic but helps 2) Toxic and doesn't help 3) Drug not toxic and helps 4) Drug not toxic and not beneficial
62
Variants = Ex)
Alleles are variants of a gene Ex) Different hair colors
63
Nurses roles and responsibilities of the Nurse when it comes to genetic counseling 1) _____ information to bring a genetic problem to light 2) Look for _____ for genetic problems 3) Provide _____ information 4) Ensure ______ to genetic professional 5) Serve as patient _____ 6) Maintain _______ 7) _______: ANA and national human genome rsh institute of NIH partnered to give competencies for RN 8) ISONG =
1) Verify information 2) Look for cues 3) Provide accurate information 4) Referral 5) Advocate 6) Confidentiality 7) Competencies 8) International Society of Nurses in Genetics
64
Certification requirements of nurse through professional portfolio include (3)
1) BS 2) 50 cases and 4 case studies reflecting the standards of clinical genetics 3) 45 contact hours of genetic content from academic course work or continuing education
65
Why is genetic counseling important?
Genetic counseling is helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease
66
Purpose of Genetic Counselor (3)
1) Interpretation (family and medical histories to assess the chance of disease occurrence or recurrence 2) Education (inheritance teaching, testing, management, prevention, resources, and research 3) Counseling (promote informed choices and adaptation to the risk or condition)
67
Goals of the Genetic Counselor 1) _____ diagnosis 2) Determine which _____ are appropriate 3) Provide _____ assessment 4) _____ about results, prevention, surveillance, and management options 5) Establish ____ for family members and offer appropriate testing
1) Make right diagnosis 2) tests 3) risk 4) Inform 5) risk
68
Certification for Genetic Counselors =
Master's in genetic counseling in a grad program accredited by American Board of Genetic Counselors
69
Nurse's Responsibility's in Genetic Counseling (2)
To get involved at any point in the process, lifespan, in the seeking of healthcare during well visits, sick visits, prenatal/preconceptual visits, international pre-genetic counseling visits To initiate discussion with health care provider related to identified risks and possible testing
70
Nurse's Responsibilities in Genetic Counseling (cont) 1) ____ own ______ and values related to genetic and genomics 2) _____ for patient access to services/testing and resources 3) Examine _____ of practice 4) Incorporate genetic and genomic _____ and information 5) Demonstrate the importance of _____ _____ care and patient preferences 6) Advocate for patient _____ and informed _____ 7) Nursing _______
1) Recognize own attitudes and values 2) Advocate 3) Competency 4) Technologies 5) Patient centered 6) autonomy, informed consent 7) Assessment
71
Nursing Assessment 1) Demonstrate an understanding of: 2) _____ and _____ personal, health, and developmental history to identify risk 3) Obtain ____ generation health histroy 4) Construct a _____ 5) Conduct a comprehensive ___ 6) Develop a: ______ that includes patient education, referrals, and support
1) the relationship of genetics/genomics to health, prevention, screening, testing, and tx 2) Collect and analyze 3) 3 4) Pedigree 5) PE 6) Plan of Care
72
Responsibilities of a Genetic Counselor 1) Provide _____ in genetics 2) Have a _____ degree, not a nurse, graduate from an accredited program by: 3) Works with a _____ ______ (Phd) 4) Communicate and _____ patients and families at genetic risk 5) Ensuring counseling services are delivered in a manner that is consistent with professional ____ and values.
1) Expertise 2) Masters 3) Medical geneticist 4) Counsel 5) Ethics
73
What type of counseling should a genetic counselor perform?
NONDIRECTIVE counseling: not promoting or excluding decisions/options
74
Oncogenes = They can circumvent ______
Mutated genes that may cause growth of cancer cells that can be inherited and/or acquired through environmental exposures to substances that damage DNA Apoptosis
75
Cancer =
Damaged proto oncogenes, tumor supressor genes
76
How do viruses work?
They mutate and rearrange host genes, and can convert proto-oncogenes to oncogenes
77
Stages of Nursing's Political Development Stage 1 = Stage 2 = Stage 3 = Stage 4 = We are in stage:
Stage 1: Buy-In "Call to arms" (awareness) Stage 2: Self- Interest (related to nursing issues) Stage 3: Political Sophistication (active work on health issues beyond nursing) Stage 4: Lead the Way (proactive leadership of interdisciplinary coalitions focusing on breath health concerns) 3
78
Nurses collaborate with three groups in the creation of new and improved delivery systems:
1) With individuals in the process of care 2) With communities in the creation of health 3) With their health care colleagues in the development and implementation of service
79
Nurses are hold influence and are trusted in society because:
We use unique communication skills and are recognized as credible practitioners
80
Nurses important role in promotion of health =
Health Policy Advocacy
81
Advocacy Definitions (2)
" A combination of individual and social actions designed to gain political and community support for a particular goal" (WHO, 2005) "Pertains to both clinical situations on behalf of patients and social circumstances on behalf of the general public" (Beu, 2005) Some argue there is a lack of clarity about the meaning of advocacy and many authors have described it in different ways
82
Nurses 5 C's of Political Influence
``` Communication Credibility Collective Action Collaboration Cash ```
83
How nurses influence policy and politics through: Power = Influence = Authority =
Power = to get someone to do something that he or she otherwise might not do Influence = to have an impact on someones belief or actions Authority = derived from organizational structure, rank, position
84
Policy =
A law, regulation, procedure, administrative or action, incentive, or voluntary practice of governments and other institutions (CDC, 2015)
85
Politics =
A social activity that is associated with power, power dynamics, relationships, authority, decisions, and communication. Politics affect a policy outcome. "Who gets what, when, how"
86
Challenges to Political Competence for the Nursing Profession 1) The ____ of policy and legislation is difficult and complicated 2) Lack of basic ______ 3) Not congruent with politics how?
1) Language of policy is difficult and complicated 2) Lack of Education 3) The caring aspect of nursing is not congruent with the aggressiveness of politics
87
Federalism =
The national government holds signficant power, but the smaller political subdivisions also hold significant power. The US is a federal system. Is one of the many concepts that the Constitution embodies.
88
How does Federalism affect health policies, politics, and nursing? 1) _____ for an issue ____ (fed, state, local) 2) Elected officials at each level have _____ _____ 3) Organizations might be structured with _____ model or have ____ level chapters
1) Jurisdiction varies 2) Different priorities 3) Federated, State

Contemporary Issues in Health (2 decks)

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