207 Foundations I (Term 2) - Midterm Study Cards Flashcards
Prepare for Foundations I Midterm.
List the five ethical principles.
- Autonomy
- Nonmaleficience
- Beneficence
- Justice
- Fidelity
List the values noted in the CNA Code of Ethics.
- Providing safe, compassionate, competent, and ethical care
- Promoting health and well-being
- Promoting and respecting informed decision making
- Honouring dignity
- Maintaining privacy and confidentiality
- Promoting justice
- Being accountable
What are the different aspects of informed consent.
- legal and ethical right
- right to refuse
- has clear understanding
- capable of consenting
- can be withdrawn at any time
- informed consent can be formal or implied
What are the 5 C’s of relational enquiry?
- Compassionate (To share in suffering and be present)
- Curious (Being interest and inquisitive and open to uncertainty)
- Competent (Performing without causing harm, knowing own knowledge and skills)
- Commitment (active and conscious assessment of values, ensuring actions are aligned with values)
- Correspondence (Relating to people in a way that is meaningful to them)
Define compassionate.
The ability to recognize and be aware of the suffering and vulnerability of another, coupled with a commitment to respond with competence, knowledge and skill. (CNA)
Define health care law.
Collection of laws that have a direct impact on
the delivery of health care or on the relationships among those in the business of health care or between the providers and the recipients of health care.
List the three strands for the scope of health care law.
Legislative: introducing, changing,
repealing law
Regulatory: Putting laws into actions using
rules
Judicial Decisions: Previous court cases as
supportive tool
What are the attributes of health care law?
- Rule is established by gov’t body/agency (may be federal, provincial, local)
- Has enforceable sanctions
- Is publicly available
- Consistent with provincial and federal laws
- Can be modified, changed, or upheld through authoritative action
Define fiduciary responsibility.
Wherein the nurse provides services that cause the recipient (patient, family, group) to
be able to trust in the expectations of a specialized body of knowledge and the professional integrity of the provider.
The public at large expects that RNs act honestly, and in good faith. It is this relationship
that forms the basis of nursing practice.
What organization is the regulatory and professional body for RNs in Alberta?
College and Association of Registered Nurses of Alberta (CARNA)
List the 5 standards of practice outlined by CARNA.
Standard One: Responsibility and Accountability Standard Two: Knowledge-Based Practice Standard Three: Ethical Practice Standard Four: Service to the Public Standard Five: Self-Regulation
Define scope of practice for registered nurses.
Scope of practice refers to the knowledge of registered nurses and the comprehensive
application of that knowledge to assist clients in meeting their health needs in whatever
setting, complexity and situation they occur throughout the life span. Scope of practice includes all the interventions that registered nurses are authorized, educated and competent to perform.
Give three examples of what would be considered intentional tort.
- Assault
- Battery
- Invasion of privacy
- False imprisonment
What is a tort called when it is not intentional?
negligence
List the phases of the nursing process that should be documented by the nurse.
Assessments, history, and observations of the client’s health status including both normal and abnormal findings.
Diagnostics, planning, and interventions including care, treatment, services, and health teaching.
Evaluations of the care, treatment, and services provided, noting how the client responded, and any necessary follow-up.
Why is documentation so important? List some of the reasons.
- Communication, continuity of care, and clinical judgment
- client safety
- quality improvement
- funding
- legal
- research
- population and clinical health insights
List the possible components of a client’s health record.
- admission sheet
- progress notes or interdisciplinary notes
- referral and consultations
- Diagnostic, laboratory, and therapeutic orders
- Medication administration record
- Flow sheet and graphic record
- Kardex or summary sheet (These forms summarize important information that should inform your daily care of the client and must be continually updated during each shift.)
- nursing care plan
- operative procedure
- Consent forms, resuscitation forms, and healthcare directives
- Discharge plan and summaries
- Critical incidents
- workload measurement
What might a discharge plan include?
- Education about their condition or disease.
- A list of medication including the name, dose, route, and frequency as well as adverse effects to watch for.
- Guidance surrounding nutrition in terms of the client’s diet (i.e., what they should eat, how often, what they should avoid).
- Information about mobility and mobility aids, such as specific goals in terms of activity and exercise (amount and frequency), and information about aids such as crutches or a cane and how to use them.
- Access to resources in the community such as homecare, rehabilitation, and meal-delivery services.
- Information about when to seek healthcare if the client experiences specific symptoms, adverse effects, or complications, and appointments related to follow-up care.
- Finally, this form documents the date/time of discharge and how the client is getting home (e.g., transportation and whether they are accompanied by someone).
What is the CARNA standard related to documentation?
- : Nurses document the nursing care they provide accurately and in a timely, factual, complete and confidential manner.
Documentation must be all of the following:
Factual Accurate Complete Current Organized Compliant with standards
Define development.
The sequence of physical, psychosocial, and cognitive developmental changes that take place over the human life span.
What three aspects integrate together and are represented by the umbrella term ‘development”?
growth, differentiation, and maturation
What is the scope of development?
Applies to the following domains: Physical/Physiological Motor Cognitive Communication Social/Emotional Adaptive
How would you define the ethical principle of autonomy?
Individual has the right to choose.
How would you define the ethical principle of nonmaleficence?
Do no harm
How would you define the ethical principle of beneficence?
Act of doing good; as best as you can for the patient.
How would you define the ethical principle of justice?
Fairness and equity.
How would you define the ethical principle of fidelity?
Ability to be trustworthy.
A nursing code of ethics:
a) Provides specific ways to behave with patients
b) Has definite guidelines for decision making
c) Permits nurses to decide what is best for their patient
d) Provides guidance for relationships, behaviour and decision making
D) provides guidance for relationships, behaviour and decision making
True or false. The Code of ethics includes all of the following:
- statement of ethical values of nurses and nurses commitments to persons with health care needs
- intended for nurses in all contexts
- provides guidance when nurses are working through ethical challenges
- Includes responsibility, accountability and advocacy
True
Relational practice is:
a) an authentic style of being
b) a style of communication
c) a holistic approach to care
d) a synonym for an interpersonal relationship
C) a holistic approach to care
Define relational care.
An approach to nursing practice that allows the nurse the ability to better understand the nurse-patient context beyond the surface.
Define relational practice.
Conscious participation with clients using listening, questioning, empathy, mutuality, reciprocity, self-observation, reflection and a sensitivity to emotional contexts.
Define clinical judgment.
An interpretation of conclusion about a patient’s needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient response.
What are the five stages of Patricia Benner’s Novice to expert model?
Novice: has no professional experience
- Beginner: Can note recurrent meaningful, situational components, but not prioritize between them
- Competent: Begins to understand actions in terms of long-range goals
- Proficient: Perceives situations as wholes, rather than in terms of aspects
- Expert: Has intuitive grasp of the situation and zeroes in on the accurate region of the problem
What are the three aspects of the scope of clinical judgment?
1) Standards-based approach
2) Interpretivist perspective
3) Evidence-based practice and clinical judgment
What does the standards-based approach of clinical judgment often entail?
Often uses algorithms, decision trees, patient care guidelines or standards of care. Rules based.
What are some limitations of the standards-based approach?
- not patient-centered care
- may be outdated
- doesn’t account for geographical differences
- reduces use of critical and clinical thinking
What does the interpretivist approach account for?
Accounts for what the nurse personally contributes to the caring encounter, including previous experiences, values and emotions.
- Empirical knowledge of the disease process
- Knowledge of the patient
- Knowledge of the clinical environment
Involves tacit or understood knowledge
What is evidence-based practice defined as?
Defined as a problem solving approach to clinical decision-making that combines the best available scientific evidence with best available patient and practitioner experiential evidence toward optimal healthcare outcomes
Identify the attributes and criteria of clinical judgement.
- Holistic view of the patient situation
- Process orientation
- Reasoning and interpretation
- Ethical comportment
What does the holistic view of the patient situation involve?
Willingness to consider all of the factors involved in patient care, including:
- Characteristics of the nurse (theoretical and experiential knowledge, values, biases)
- Relationship with the patient
- Context of care
What does process orientation involve?
Clinical judgment is circular, interactive, and moves fluidly between and among all of the aspects of the nursing process
Not a linear relationship; complex interactions (unknowns, multiples factors, no clear-cut answers)
What do reasoning and interpretation involve in the context of clinical judgment?
Reasoning is the process that leads to clinical judgments
Nurses use three types of reasoning as the scenario dictates:
- Analytic (usually when the situation is new)
- Intuitive (based on broad and deep experience, a nurse may intuitively recognize what needs to be done)
- Narrative (recognizing the significance of the situation at hand to the patient’s experience with illness and engaging in interventions based on this understanding.
What does ethical comportment involve in the context of clinical judgment?
Come to a situation with an outlook of what is right or good for the patient and manifests in respect, responsiveness, and support towards the patient.
Define nursing metaparadigm
Encompasses the various conceptual frameworks that attempted to define nursing
Includes the concepts of person, environment, health care, and nursing care.
Person: the individuals receiving the nursing care
Health: the state of illness or health
Environment: Where the nursing happens
Nursing: The care provided for patients
Describe Carper’s Ways of Knowing.
- Empirical knowledge (science of nursing)
- Ethical (moral knowledge in nursing)
- Personal (acceptance of self grounded in self knowledge and confidence)
- Aesthetic (art of nursing)
- Emancipatory (addresses the social and political context - advocate for patient)
What are the five steps of the nursing process?
Assessment Diagnosis Planning Implementation Evaluation
What is involved in the ‘Assessment’ phase?
Uses subjective (what the client or family tells you), objective (what you gather using your senses and skills, touch, vision, hearing, smell, vital signs), biographical and historical date
Considers growth and development and the determinants of health
Requires the clustering of data and identifying the relevance of data
What is involved in the ‘Diagnosis’ phase?
Focuses on nursing problems
nurses cannot fix medical problems
Starts with analyzing assessment data
Three part diagnosis:
P (problem): The nursing diagnosis label; a concise term or phrase that represents a pattern of related cues. Taken from NANDA.
E (etiology): “Related to” (r/t) phrase or etiology; related cause or contributor to the problem
S (symptoms): Defining characteristics phrase: symptoms that the nurse identified in the assessment
