Core Concepts Exam One Flashcards
ANA
is the largest professional nursing association in the US, and here to support and protect you (advance/protect the profession)
What is a profession?
Education, regulation, code of ethics, professional organization, commitment
Aspects of professional nursing behavior
appearance, demeanor, competence, integrity, compassion
Morals, Values, and Ethics
- These are often considered interchangeable terms and are closely related but do have slight differences
- Morals are personal beliefs of right or wrong for one’s own self
- Values are closely aligned with morals but can also be larger than self (professional, societal)
- Ethical principles are far-reaching and can be considered as “absolute” values
Autonomy
- the right to make one’s own decisions
- confidentiality and informed consent fall under autonomy
Beneficence
to do good
Fidelity
to keep one’s promise
Justice
fairness to all
Nonmaleficence
do no harm
Veracity
tell the truth
Ethical principles general
autonomy, beneficence, fidelity, justice, nonmaleficence, veracity
Ethical Dilemmas
- The interpretation and application of ethical principles is not an absolute – “it depends”!
- Ethical dilemmas occur when an ethical principle and the application of the ethical principle differ.
- Ethical decision-making often means striking a balance between science, ethics and personal moral values.
Self-awareness
- Self-awareness is a deep understanding, gained over time, of what is important to you personally.
- Self-reflection is the first step in developing true self-awareness.
- Self-awareness is crucial when faced with ethical dilemmas: knowing yourself, what is important to you, how you may react in certain situations and where the potential for conflict may occur.
A profession has certain elements in common
education requirements, regulation, code of ethics, professional organization, commitment of service
Professionalism
the overt action of a professional nurse engaged in the furtherance of his/her profession: appearance, demeanor, competence, integrity, and compassion
Behaviors that reflect professional decorum
be prompt, be organized, be prepared, be actively present, be respectful, acknowledge the value of time, be aware
Ethics
the study of conduct and character
Ethical principles definition
- the way one “ought to act”
- can be considered absolute values, but the interpretation of ethical principles is not absolute (how you apply ethical principles changes according to the situation presented)
-the nurse is obligated by the profession of nursing to understand and apply ethical principles and the profession’s moral norms, as well as his/her own moral values in the pursuit of integrity, accountability, responsibility, and professionalism
Morals
- values and beliefs that guide behavior and decision making
- not the same as ethical principles (they are more personal and aligned with one’s own personal beliefs)
Caring
- the BASIS of the nursing profession
- not an ethical principle, but it is one of the most important moral values that a nurse can posses
Kindness
- the overt expression of caring
- the most helpful virtue when in dealing with people, whether it is yourself, patients, families, or fellow healthcare providers
ANA Code of Ethics
- KNOW the difference between ethical (out to act) and moral values (own personal beliefs)
- accountability, advocate, autonomy, assault,battery, beneficence, fidelity, integrity, justice, non-maleficence, paternalism, patient, practice, respect, responsibility, values, veracity
Accountability
being answerable for one’s own choices, decisions, and actions
Advocate
to support (nurses are patient advocates)
Assault
the THREAT of coercive or punitive action by the nurse
Battery
the coercive or punitive ACTION by the nurse
Fidelity
- to be truthful and fulfill commitments
- to do what you say are going to do
Integrity
External consistency with one’s own internal values, beliefs, attitudes, and convictions
Justice
- access to and fair treatment for all
- bioethical justice usually refers to distributive justice- social resources and burdens are applied equally (including healthcare)
Paternalism
one person makes decisions for one another (may be voluntary or involuntary)
Patient
the recipient of nursing care
Practice
the professional actions of the nurse
Respect
Respecting the ethical values of others
Responsibility
- the duty to act in accordance to one’s education and professional standards.
- often used interchangeably with accountability, but it is slightly different. One may share responsibility, but not accountability, for one’s actions
Values
core beliefs that guide attitudes and actions
Veracity
- the duty to tell the truth and not withhold information
- needed in order for a patient to give truly informed consent
Therapeutic communication techniques
active listening, open-ended questions, clarifying, back channeling, probing, closed-ended questions, summarizing
Active listening
shows clients that you have their undivided attention
Open-ended questions
- use initially to encourage clients to tell their story in their own words. Use terminology that client can understand.
- best kind of questions to ask
Clarifying
questions clients about specific details in greater depth or direct them toward relevant parts of their history
Back Channeling
use active listening phrases such as “go on” and “tell me more” to convey interest and to prompt disclosure of the entire story
Probing
ask more open-ended questions such as “what else would you like to add to that?” to help obtain comprehensive information
Closed-ended questions
ask questions that require “yes” or no” answers to clarify information, such as “do you have any pain when you cannot sleep?”
Summarizing
validate the accuracy of the story
Board of Nursing
your regulatory board, there to protect public (safe/competent)-> get you in trouble, anything bad you do
AIDET
acknowledge, introduce, duration, explanation, thank you
Demographic/Health information
- name, address, contact information
- age, DOB
- gender
- race, ethnicity
- relationship status
- occupation, employment status
- insurance
- emergency contact information
- advance directives
Source of history
- client, family members or close friends, other medical records, other providers (SUBJECTIVE DATA)
- reliability of the historian
Chief concern
a brief statement in the client’s own words of why he/she is seeking healthcare
History of Present Illness
- a detailed, chronological description of why the client seeks care
- headaches, seizures, diabetes, kidney problems, high BP (SUBJECTIVE DATA)
Past Health History and Current Health Status
- past illnesses or surgery
- current immunization status
- allergies (SUBJECTIVE)
- medications
- habits and lifestyle patterns (alcohol, tobacco, caffeine, recreational drugs)
- headaches, seizures, diabetes, kidney problems, high BP (SUBJECTIVE DATA)
Family History
health information of family members
- Ex. do you live alone, have a good support system, employed?
- Ex. Family members with depression/anxiety, substance abuse, eating disorder, alcoholism, heart disease, cancer, stroke, TB
Psychological History
- alcohol use
- tobacco use
- recreational drugs
- exercise and diet
- life events
- cultural/spiritual/religion
- support system
-Ex. depression/anxiety, substance abuse, eating disorder, alcoholism, heart disease, cancer, stroke, TB
Health promotion behaviors
- exercise/diet, sun exposure, stress, sleep patterns
- awareness of risks for heart disease, cancer, diabetes, stroke
Information Technology
- if you didn’t document it, you didn’t do it
- if you didn’t do it, DO NOT DOCUMENT IT
System specific Assessments (cardiac)
- review vital signs
- look for signs of cardiovascular problems
- 5 auscultation points (5-10 seconds each, once with diaphragm and twice with the bell)
APETM (Ape to Man)
- A: Aortic= 2nd right intercostal space
- P: Pulmonic= 2nd left intercostal space
- E: Erb’s Point= 3rd intercostal space (left sternal border) (where S1 and S2 are equal)
- T: Tricuspid= 4th left intercostal space (left lower sternal border)
- M: Mitral (apex)= 5th left intercostal space (midclavicular line) (also called PMI (point of maximum intensity)
Pulse Deficit/Apical vs. Radial
Assess radial pulse and apical pulse simultaneously for 15-30 seconds (may need more than one nurse), and determine whether or not there is a deficit between the two
S1 and S2
- S1: the “lub,” beginning of systole (mitral and tricuspid valves closing)
- S2: “dub,” end of diastole (aortic and pulmonic valves closing)
General Survey
- a written summary or appraisal of overall health
- gather information during the first encounter with client and continue to make observations throughout the assessment process
- assess data about: physical appearance, body structure, mobility, behavior, vital signs
Pain
- the 5th vital sign
- pain is SUBJECTIVE
- when treating, always think of non-pharmacologic therapies first