Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NU 340 > Ch. 1 & 2 > Flashcards

Ch. 1 & 2 Flashcards

1
Q

specialty practice of medical-surgical nursing includes

A
  • promotion, restoration, or maintenance of optimal health for patients 18 years and older
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

med-surg nurses must have the knowledge, skills and attitudes to be:

A
  • care coordinators
  • caregivers
  • transition managers (to home, hospital, rehab)
  • patient educators
  • leaders
  • advocates for the patient and family
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

QSEN stands for

A

quality and safety education for nurses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

the six QSEN competencies are

A
  • provide patient-centered care
  • promote safety
  • collaborate with the interprofessional healthcare team
  • implement evidence-based practice
  • use quality improvement in patient care
  • use informatics in patient care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the four professional nursing concepts?

A
  • clinical judgement
  • systems thinking
  • health equity
  • ethics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

clinical judgement

A
  • iterative process using nursing knowledge
  • defined as the observed outcome of critical thinking and decision-making
  • appropriate (“sound”) clinical judgement leads to positive outcomes
  • inappropriate (“poor”) clinical judgement leads to risk or safety issues (for patients and/or staff)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

systems thinking

A
  • ability to recognize, understand, and synthesize interactions in a set of components designed for a special purpose
  • transforms care and improves patient outcomes
  • promotes patient safety and high quality care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

health equity

A

ability to recognize differences in resources and knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ethics

A
  • addresses issues and questions about morality
  • nurses follow: the ANA Code of Ethics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

patient centered care

A
  • the patient or designee is source of control and full partner
  • preferences, values, and needs
  • culturally competent care
  • “family-centered care” - The Joint Commission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

patient-centered care attributes

A
  • respect for patients’ values, preferences, and expressed needs
  • information, communication, and education
  • physical comfort
  • emotional support and alleviation of fear and anxiety
  • involvement of family and friends
  • transition and continuity
  • access to care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

special considerations and populations that are vulnerable

A
  • cultural and spiritual
  • older adults
  • gender health
  • military and veterans’ health

**need to make sure that these patients are ready for d/c and have FUPs upon d/c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

care coordination

A
  • deliberate organization of and communication about patient care activities
  • facilitates appropriate, continuous health care to meet the patient’s needs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does care coordination take place?

A
  • takes place between two or more health care team members (including the patients)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

care coordination: transition management

A

ensures safe and effective coordination and continuity of care as patients experience changes in health care status, health care providers, or health care setting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

care coordination: case management

A

ensures high quality and cost-effective services and resources to achieve positive patient outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

7 foundations of safe transition management

A
  • leadership support
  • early identification of patients at risk
  • thorough psychosocial assessment on patients
  • multidisciplinary team involvement (nurses, MD, PT/OT, speech, respiratory support)
  • patient and family engagement
  • medication reconciliation (*also a safety goal)
  • transfer of information (when patients are d/c- give them info that they need in their language- new meds, dressing changes, etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The Joint Commission: Safe Transition Management

A

has 7 foundations of safe transition management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

medication reconciliation is a __ process

A

formal evaluative process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

medication reconciliation

A
  • reconciled patient’s current meds: drug name, dose frequency, route, and purpose and should be done on all:
    • admissions
    • transfers
    • discharges
  • addresses duplications, omissions, and any possible interactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

safety

A

the ability to keep the patient and staff free from harm and minimize errors in care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

best safety practices help reduce __ and ___

A

error and harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

nursing safety priority boxes

A
  • critical rescue
  • action alert
  • drug alert
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Just culture

A

blame-free approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

patients and families are safety partners with ____

A

health care providers and organizers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

deviations from the standard of care

A
  • adverse event (variation)
  • sentinel event (severe variation)
  • nurses and team members should not hesitate to report
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

a sentinel event is

A

a severe variation, that results in avoidable patient death or major harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

4 Interprofessional Education Collaborative (IPEC) competencies

A
  • values/ethics for interprofessional practice
  • role-responsibilities
  • interprofessional communication
  • teams and teamwork
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

examples of teamwork and collaboration as per the IPEC

A
  • communication: SBAR, TeamSTEPPS
  • delegation/supervision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

SBAR is

A

formal method of hand-off communication between two or more health care team members
- nurse to nurse
- nurse to physician

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

SBAR (broken down)

A

S- situation
B- background
A- assessment
R- recommendation/request

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

TeamSTEPPS

A

a systematic communication approach for inter-professional teams designed to improve safety and quality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

delegation is

A
  • the process of transferring a selected nursing task or activity to a competent UAP (unlicensed assistive personnel)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

requires accurate communication between nurse and UAP

A

delegation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

who is responsible for the delegated task/activity?

A

the nurse who did the delegating, not that UAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

supervision is

A

the guidance or direction, evaluation, and follow-up by the nurse to ensure a task/activity is performed appropriately
- supervision by an RN is performed for APs, PCTs, NAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

who can the nurse delegate to?

A
  • AP (assistive personnel)
  • patient care technicians (PCTs)
  • nursing assistants (NAs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

can all nursing activities be delegated?

A

no, not all can be delegated
- insert foley catheter
- draw blood
- give meds
*cannot be delegated ^

you cannot delegate what you can eat (evaluation, assessment, teaching)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

5 rights of delegation

A
  • right task
  • right circumstances
  • right person
  • right communication
  • right supervision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

evidence based practice is

A

the integration of the best current evidence and practices to make decisions about patient care
- includes best evidence, clinical expertise, and patient preferences
- promotes safety

38
Q

evidence based practice considers

A
  • patient preferences and values
  • one’s own clinical expertise for delivery of optimal health care
39
Q

quality improvement is

A

indicators used to monitor care outcomes and develop solutions to change and improve care
- best evidence used to support practice changes

40
Q

models for quality improvement

A
  • PDSA- most commonly used
  • FOCUS-PDCA
41
Q

information and technology is used for (related to patient care)

A
  • communication
  • management knowledge
  • prevention of errors
  • support decision-making
42
Q

examples of informatics

A
  • electronic health record (EHR)
  • computers used at the point of care
  • handheld mobile devices
  • use of devices and systems (ie. smart infusion pumps, bar-code medication administration, software systems)
  • telehealth/telenursing
43
Q

Tanner CJ model

A

Clinical Judgement model (2006)
- assessment: noticing
- analysis: interpretting
- planning and implementation: responding
- evaluation: reflecting

44
Q

NCSBN CJMM

A

Clinical Judgement Measurement Model (2019)
6 cognitive skills of clinical judgement that can be measured

45
Q

priority focus on safety and clinical judgement

A
  • Rapid Response Team (RRT), or
  • Medical Emergency Team (MET)
46
Q

purpose of RRT

A
  • intervenes for people at beginning of clinical decline
  • can be used by family, mostly used by healthcare team
  • decreases medical complications and number of arrests
47
Q

who is on the RRT?

A
  • respiratory therapists
  • doctors, residents
  • nurses on the floor/unit
  • ICU nurses
  • anesthesia
  • pharmacist
48
Q

failure to rescue

A

inability of health care team members to save the patient’s life in a timely manner
- occurs when the s/sx are NOT noticed/recognized and therefore action to improve patients condition is not implemented

49
Q

health care disparities

A
  • differences in access to and use of health care
    • health care quality, health outcomes, and health insurance coverage
50
Q

factors affecting health equity: social determinants of health (SDOH)

A
  • neighborhood
  • finances
  • socioeconomic status
  • education
51
Q

populations with special needs

A
  • older adults
  • racial and ethnics groups
  • LGBTQ population
52
Q

attributes of ethics

A
  • autonomy
  • beneficence
  • non-maleficence
  • fidelity
  • veracity
  • social justice
53
Q

autonomy

A

the right or condition of self-government
- the patients are able to make independent decisions
- nurses provide the patients with all the necessary information that is required to make an educated decision about their medical care without influencing the patient’s choice

54
Q

beneficence

A

kindness and charity, which requires action on the part of the nurse to benefit others

55
Q

non-maleficence

A

do no harm intentionally
- nurses must provide a standard of care to avoid/minimize risk, as it relates to medical competence

56
Q

fidelity

A

keeping one’s promises
- the nurse must be faithful and true to their professional promises and responsibilities by providing high quality, safe care in a competent manner

57
Q

veracity

A

the ethical principle of being completely open and honest with patients, even if the truth causes distress

58
Q

social justice

A

being impartial and fair
- nurses make impartial medical decisions, related to limited resources or new treatments regardless of economic status, ethnicity, sexual orientation, etc.

59
Q

the health care system

A

health care

60
Q

the inter-professional health care team includes

A
  • physicians
  • PAs
  • APRNs
  • Interns/Residents/Hospitalists
  • RNs
  • LPNs
  • APs
  • PT/OT
  • SLP
  • RDN
  • LSW
  • PharmD
  • RT
  • Radiology Tech
61
Q

bedside report includes

A
  1. why is the patient here?
    - what happened
    - what is the patient on for meds/what has been done since admission
    - PMH
  2. what are we doing about it this admission?
    - labs
    - IV/meds/fluids
    - plan of care
    - injury/fall risk
    - impairments
    - pain/meds for pain
  3. what are we doing for the patient today?
  4. what needs to happen for this patient to discharge?
62
Q

SBAR: Situation

A

“what is happening right now?”
- identify yourself
- identify your patient, unit and room #
- brief summary of primary problem

63
Q

SBAR: Background

A

“What has happened?”
- date of admission
- allergies
- code status
- recent set of vital signs
- list of current medications, IV fluids, lab work
- any studies done during this admission?
- treatment goals? plan of care?

64
Q

SBAR: Assessment

A

“what you found (during your assessment)/what you believe the problem is.”
- current nursing assessment
- most recent set of vital signs
- relevant lab values
- how have you advanced the plan of care?
- patient’s response?
- is the patient stable? unstable? worsening?

65
Q

SBAR: Recommendation

A

“what would you like done/suggest”
- what do you need from this individual?
- suggestions to advance plan of care
- any new/urgent needs that need follow-up?
- any orders need to be changed or reviewed?

66
Q

critical rescue

A

emphasizes the need for action for potential or actual life-threatening problems
- action is needed for potential or life threatening conditions

67
Q

action alert

A

focus on the need for action but not necessarily for life-threatening situations
- patients at risk for blood clots, post op patients, obese or immobile patients
- not critical but want to pay attention

68
Q

drug alert

A

specify actions needed to ensure safety related to drug administration, monitoring, or related patient and family education

69
Q

adverse event examples

A
  • allergic reaction
  • falls with no harm
  • pressure ulcer/skin breakdown
  • catheter associated UTI
  • med error with no harm
70
Q

sentinel event examples

A
  • falls with major harm/death
  • med error with harm/death
71
Q

adverse event

A

a variation in care- something happened that wasn’t supposed to happen, but does not cause harm/not major harm or death

72
Q

what does the acronym “do not delegate what you can E.A.T.” mean?

A

do not delegate what you can can evaluate, assess, or teach
- do not hand off these tasks to APs, PCTs, NAs
- evaluation, assessment, and teaching is a nurses job- do not hand of these jobs

73
Q

why is clinical judgement important?

A

prevents errors

74
Q

patients often have subtle s/sx _____ days prior to cardiac arrest

A

1-3 days

75
Q

examples of autonomy

A
  • informed consent
  • refusal of medication
76
Q

primary care

A
  • where healthcare starts
  • you go to your PCP to get referred to someone else
77
Q

in patient care

A

taking care of patient in hospital

78
Q

community health care

A

going out in the community
- nursing home
- senior center
- visiting homes

79
Q

managed care

A

has to do with insurances
- nurses don’t do much with this
- case management and billing needs to know

80
Q

medical homes

A

type of health care model that some health care organizations use
- not a physical home

81
Q

long term care

A

nursing home
skilled facility

82
Q

Physician (MD or DO)

A

diagnoses and treats injuries or illness and addresses health maintenance
- examines patients, takes PMH, prescribed meds, orders, performs, and interprets diagnostic tests
- care delivered according to a medical model delivery

83
Q

Physician Assistant (PA)

A

masters level prepared providers
- examines patients, takes PMH, prescribed meds, orders, performs, and interprets diagnostic tests
- care delivered according to a medical model delivery
- delivers care under supervision of an MD/DO

84
Q

Advanced Practice Registered Nurse (APRN)

A

prepared by education and certification to assess, diagnose and manage patient problems, order tests, and prescribe medications
- nurse practitioners
- nurse mid-wives
- nurse anesthetist (CRNA)
- clinical nurse specialists (CNS)

85
Q

Interns/Residents/Hospitalists

A

“baby” Physicians/APRNs

86
Q

Registered Nurse (RN)

A

practices professional nursing as defined by individual state’s board of nursing and performs roles of caring, teaching, collaborating, advocating, and researching

87
Q

Licensed Practical Nurse (LPN)

A
  • 1 year of education
  • cant hang blood, or give IV antibiotics
88
Q

Assistive Personnel (AP)

A

any assistive personnel trained to function in a supportive role, regardless of title, to whom nursing responsibility may be delegated.
- CNAs
- certified medical assistants
- patient care techs
- certified medication aides
- home health aides (UAPs- unlicensed assistive personnel)

89
Q

Occupational or Physical Therapist (OT,PT)

A

OT: helps patients develop, recover, improve, and maintain ADLs through therapy

PT: uses treatment techniques to promote movement, reduce pain, restore function, and prevent disability

90
Q

Speech/Language Pathologist (SLP)

A

assess, diagnoses, treats, and helps to prevent communication and swallowing disorders
- swallow evals

91
Q

Registered Dietitian Nutritionist (RDN)

A

a food and nutrition expert who educates individuals about nutrition and healthy eating habits
- may administer medical nutrition therapy and manage food service operations in a system
- speak to patients about the diet that they need to have
- give thorough education on diet

92
Q

Licensed Social Worker (LSW)

A

helps people solve and cope with problems in their everyday lives
- if patient can’t afford to take their meds and health is declined
- get LSW involved to find resources to help the patient

93
Q

Pharmacist (PharmD)

A

dispenses prescription medications and offers expertise in the safe use of drugs
- assistance with meds

94
Q

Respiratory Therapist (RT)

A

treats breathing disorders, manages ventilators and artificial airways, and educates about lung disease
- in charge of nebulizer treatments, O2 equipment (vent mask/high flow)

95
Q

Radiography Technologist

A

captures images of internal organs, soft tissues, and bones using x-ray equipment
- x-ray, CT scan, MRI

NU 340 (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions