exam 1 Flashcards
1
Q
What is a theory?
A
helps explain an event by defining ideas or concepts, explain relationships among the concepts, and predicting outcomes.
2
Q
What is a nursing theory?
A
conceptualizes an aspect of nursing to describe, explain, predict, or prescribe nursing care.
3
Q
What are the different components of a theory?
A
- Phenomenon: term, description, or label given to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations.
o EX: caring, self-care - Concepts: ideas and mental images
o EX: meeting human needs - Definitions: used to communicate general meaning of the concepts of a theory
- Assumptions: “taken for granted” statements that explain the nature of the concepts, definitions, purpose, relationships, and structure of a theory.
4
Q
Nursing is a _____ and an ______
A
Nursing is a science and an art
- Art: nursing stems from a nurse’s experience and the unique relationship that a nurse develops with a patient
- Science: based on date obtained from current research
5
Q
What is a domain?
A
perspective or territory of a profession or discipline
6
Q
What is a pradigm?
A
pattern of beliefs used to describe the domain of a discipline
7
Q
What is a conceptual framework?
A
provides a way to organize major concepts and visualize the relationship among phenomena.
8
Q
What is the nursing metaparadigm?
A
allows nurses to understand and explain what nursing is, what nursing does, and why nurses do what they do. Includes four concepts:
- Person, health, environment/situation, and nursing.
9
Q
How are nursing theories created?
A
Nursing theories often build on the works of prior theories.
10
Q
What are the types of theories?
A
- grand theories
- middle-range theories
- practice theories
- descriptive theories
- prescriptive theories
11
Q
What are grand theories?
A
abstract, broad in scope, and complex. Require further clarification with research
12
Q
What are middle range theories?
A
more limited in scope and less abstract. Address a specific phenomenon and reflect practice (administration, clinical, teaching, etc). Focus on a specific field of nursing
13
Q
What are practice theories?
A
situation-specific theories, bring theory to bedside. Guide the care to specific pt population and specific time.
14
Q
What are descriptive theories?
A
first level of theory development. Describe phenomena and identify circumstances.
15
Q
What are prescriptive theories?
A
addressing nursing interventions
16
Q
What is a shared theory?
A
explains a phenomenon specific to the discipline that developed the theory. Help nurses organize and deliver patient-centered care.
- EX: Paiget’s theory of cognitive development to help explain how children think, reason, and perceive the world.
17
Q
What is input?
A
data or information that comes from a pts assessment
18
Q
What is output?
A
end product of a system; does the pt improve? Decline?
19
Q
What is Nightingale’s environmental theory?
A
She stated that the environment the pt is in is very important for their health
20
Q
What is peplau’s interpersonal theory?
A
Nurses help patients reduce anxiety by converting it into constructive actions. As a nurse, when you develop a relationship with your pt you can solve problems together. You act as a surrogate, counselor, resource person, etc.
21
Q
What is Orem’s self-care deficit nursing theory?
A
People who participate in self-care activities are more likely to improve their health outcomes.
22
Q
What is Leininger’s culture care theory?
A
Human caring varies among cultures. Social structure factors such as a pt’s politics, culture, and traditions are significant forces affecting care and influencing the pt’s health and illness patterns.
23
Q
What does theory testing research determine?
A
Theory-testing research determines how accurately a theory describes nursing phenomena.
24
Q
What does the relationship between nursing theory and nursing research build?
A
the scientific knowledge base of nursing, which is then applied to practice.
25
What is caring?
universal phenomenon influencing the ways in which people think, feel, and behave in relation to one another. Word for being connected.
26
What is Leninger's transcultural caring theory?
describes the concept of care as the essence and central, unifying and dominant domain that distinguishes nursing from other health disciplines. Stresses that cultural caring behaviors are important for nurses
27
What is watson's transpersonal caring theory state?
suggests that a conscious intention to care promotes healing and wholeness. Talk to your patients, understand what its like to be in their shoes, looks for deeper sources of inner healing to protect, enhance, and preserve a person’s dignity, humanity, wholeness, and inner harmony.
28
What does Swanson's theory of caring state?
defines caring as a nurturing way of relating to an individual. Provides direction for how to develop useful and effective caring strategies appropriate for multiple age-group and health care settings. Five caring processes include:
- Knowing
- Being with
- Doing for
- Enabling
- Maintaing belief
29
What is ethics?
ideals of right and wrong bx
30
What is ethic of care?
concerned with relationships between people and with a nurse’s character and attitude toward others.
31
What are the ways to provide care?
- Presence: person-to-person encounter conveying a closeness and sense of caring.
- Touch
- Listening: necessary for meaningful interactions w/ pts. Interpreting and understanding what the pt is saying and giving back that understanding.
- Knowing the pt: Knowing emerges from a caring relationship between a nurse and a pt, in which the nurse engages in a continuous assessment
- Spiritual caring: nurses who develop spiritual caring practice early in their career development are able to identify methods to incorporate these practices into routine care and do not perceive variables such as a lack of sufficient time or pt census as barriers.
- Relieving symptoms and suffering: caring nursing actions that give a pt comfort, dignity, respect, and peace.
- Family: get to know the family of the pt to provide adequate care.
32
What is nursing (the ANA definition)?
protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, communities, and populations
33
What are the steps of the nursing process?
AD PIE
- Assessment
- Diagnosis
- Outcomes identification and planning
- Implementation
- Evaluation
34
What is code of ethics?
philosophical ideals of right and wrong that define the principles you will use to provide care to your patients
35
What is autonomy?
essential element of professional nursing that involves the initiations of independent nursing interventiosn without medical orders.
36
What is a clinical nurse specialist (CNS)?
an APRN who is an expert clinician in a specialized area of practice.
37
What is the founder of the american red cross?
Clara Barton
38
What is compassion fatigue?
term used to describe a state of burnout and secondary traumatic stress
39
What is genomics?
the study of all the genes in a person and interactions of these genes with one another and with that person’s environment.
40
What is infection?
invasion of a susceptible host by pathogens (microorganisms) resulting in disease
41
What is colonization?
presence and growth of microorganisms within a host but without tissue invasion or damage
42
What is a communicable disease?
when an infectious disease can be transmitted directly from one person to another
43
What does symptomatic mean?
if the pathogens multiply and cause clinical signs and symptoms
44
What does asymptomatic mean?
if clinical signals and symptoms are not present
45
What is the order of a chain of infection?
Infectious agent or pathogen --> a reservoir or source for pathogen growth --> a port of exit from the reservoir --> a mode of transmission --> a port of entry to a hose --> a susceptible host
46
If the chain of infection interrupts or breaks, can infection occur?
NOOOOOO
47
What do microorganisms include?
bacteria, viruses, fungi, and protozoa
48
Microorganisms on the skin are either:
- Resident: (normal flora) permanent residents of the skin and within the body, where they survive and multiply without causing illness
- Transient: attach to the skin when a person has contact with another person or object during normal activities. They can give you an infection
49
What does virulence mean/
ability to produce disease; ability to enter and survive in a host; susceptibility of the host
50
What is a reservoir?
place where microorganisms survive, multiply, and await transfer to a susceptible host.
51
_____ bacteria cause more infections in humans than ______ bacteria
aerobic; anaerobic
52
What is an example of aerobic bacteria?
Staph
53
What is an example of anaerobic bacteria?
bacteroides fragilis
54
What is a spore?
a form of bacteria that is resistant to drying and can live in inanimate surfaces
are a 'survival' form of certain bacterial genera that show extreme resistance to chemical and physical inactivation.
55
What is bactericidal?
temperature or chemical that destroy bacteria
56
What is a portal of exit?
after microorganisms find a site to grow and multiply, they need an exit to enter another host and cause more disease.
57
What are some examples of a portal of exit?
- Blood, skin and mucous membranes, respiratory tract, GU tract, GI tract, and from mother and fetus
58
What. is susceptibility?
being likely or liable to be influenced or harmed by a particular thing.
59
What are the stages of infection?
1. Incubtion - interal between entrance of pathogen into body and appearance of 1st symptom
2. Prodromal - interval from onset of nonspecific signs and symptoms to more specific symptoms
* **person is most infectious
3. Illness - interval when pt manifests signs and symptoms specific to type of infection
4. Convalescence - recovery from the infection
60
What does localized mean?
if an infection is localized, a pt usually experiences localized symptoms such as pain, tenderness, warmth, and redness at the wound site.
61
What does systemic mean?
an infection that affects the entire body instead of just a single organ
62
What does suprainfection mean?
secondary infection usually caused by an opportunistic pathogen
an additional infection that happens during or immediately after an existing infection. An example of a superinfection is having an ear infection caused by microorganisms which are resistent to the antibiotics taken for a recent throat infection.
63
What does exudates mean?
- fluid and cells that are discharged from cells or blood vessels
- a mass of cells and fluid that has seeped out of blood vessels or an organ, especially in inflammation.
64
What are natural defences that protect against infection?
- Normal floras: microorganisms that reside on the surface and deep layers of skin, in the saliva and oral mucosa, and in the GI and GU tracts. They maintain health.
- Body system defenses: a number of body organ systems have unique defenses against infection
- Inflammation: cellular response of the body to injury, infection, or irritation. A protective vascular reaction that delivers fluid, blood products, and nutrients to an area of injury. EX: swelling, redness, heat, pain, or tenderness
65
What is phagocytosis?
the destruction and absorption of bacteria
66
Accumulation of fluid, dead tissue cells, and WBCs forms an exudate (mass of cells and fluid that seep out of blood vessels or an organ) at the site of inflammation. Exudate may be:
- Serous (clear, like plasma)
- Sanguineous (containing red blood cells)
- Purulent (containing WBCs and bacteria)
67
What is granulation tissue?
soft, pink, fleshy projections of tissue that form during the healing process in a wound not healing by primary intention.
68
What is an exogenous infection?
comes from microorganisms found outside the individual. EX: salmonella
69
What is an endogenous infection?
occurs when part of the pt’s flora becomes altered and an overgrowth results. EX: Staph, yeast infection
70
What is a iatrogenic infection?
caused by an invasive diagnostic or therapeutic procedure
71
What are factors that influence infection prevention and control?
- Age: throughout life a person’s susceptibility to infection changes
- Nutritional status
- Stress: stress can decrease resistance to infection through the release of cortisone. Exhaustion can cause depletion in energy stores.
- Disease process: diseases of the immune system, chronic illnesses, diseases that impair body systems, pts with burns are all at a risk of infection
72
The signs and symptoms of infection may be:
- Local: most common in areas of skin or mucous membrane breakdown such as surgical and traumatic wounds, pressure ulcers, oral lesions, and abscesses
- Systemic: cause more generalized symptoms than local infection. Include fever, fatigue, nausea/vomiting, and malaise
73
Effectively reduce the risk of infection through:
- nutrition
- hygeine
- immunization
- adequate rest and exercise
74
What is asepsis?
absence of pathogenic (disease-producing) microorganisms.
75
What is an aseptic technique? What are the two types?
practices/procedures that help reduce the risk for infection.
Two types include:
- Medical asepsis: hand hygiene, barrier techniques, routine environmental cleaning
- Surgical asepsis: prevents contamination of an open wound, serves to isolate an operative area from the unsterile environment, and maintains a sterile field for surgery
76
What is disinfection?
process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects.
77
What is sterilization?
eliminates or destroys all forms of microbial life, including spores.
78
What is evidence-based practice? Why use it?
the translation of research findings to clinical practice
research-based interventions improve outcomes
79
What are factors that influence hygiene?
- social practices
- body image
- health beliefs and motivation
- developmental stage
- personal preferences
- socioeconomic status
- cultural variables
- physical condition
80
Why may pts have self-care deficits regarding hygiene?
- decreased or lack of motivation
- weakness or fatigue
- pain or discomfort
- perceptual or cognitive impairment
- neuro/musculoskeletal impairment
- sensory deficit
- chronic illnesses
- therapeutic procedure or medical restriction limiting mobility
- anxiety
- environmental barriers
81
What are the functions of the skin?
protection, secretion, excretion, temperature regulation, sensation
82
What are the primary layers of the skin?
- Epidermis: shields underlying tissue
- Dermis: contains bundles of collagen, nerve fibers, blood vessels, sweat glands, sebaceous glands, hair follicles
- Subcutaneous tissue: lies just beneath the skin; contains blood vessels, nerves, lymph, and loose connective tissue filled with fat sacks
83
What is the oral cavity lined with?
mucous membranes
84
Normal oral mucosa is:
light pink, soft, moist, smooth, and without lesions
85
Xerostomia
dry mouth
86
Gingivitis
inflammation of the gums
87
Dental caries
tooth decay
88
What is stomatitis?
inflammation in the mouth
89
What are the stages of gum disease?
1. Normal, Healthy Gingiva: health gums and bone anchor teeth firmly in place
2. Gingivitis: plague and its byproducts irritate the gums, making them tender, inflamed, and likely to bleed
3. Periodontitis: unremoved, plague hardest into calculus. As plag and calculus continue to build up, the gums begin to recede from the teeth, and pockets form between the teeth and gums
4. Advanced Periodontitis: The gums recede farther destroying more bone and the periodontal ligament. Teth - even health teeth - become loose and need to be extracted
90
What do you use for oral care for ventilated patients?
topical chlorhexidine (CH6)
91
What are the main purposes of bathing?
- cleansing of skin
- stimulate circulation
- range of motion
- good nursing assessment time
- produces a sense of well being
92
What are the types of baths?
- complete bed bath
- self-help bath
- partial bath
- towel bath
- bag bath
- shower
- tub bath
93
What are the bath guidelines?
- maintain dignity
- provide privacy
- maintain safety
- maintain warmth
- promote independence
- anticipate needs
94
Washing from ______ to ______ areas promotes circulation by stimulating venous blood flow
distal to proximal
95
What can you use to stop "drop foot" from occurring?
the big blue boots that you can use in the hospital setting
96
What is a means of transmission?
direct contact, indirect contact, airborne route
97
What is a portal of entry?
point at which organisms enter a new host
98
What is a susceptible host
must overcome resistance mounted by host's defenses
EX: being immunocompromised, chronic diseases, age
99
What is the most significant and commonly found infection-causing agent in health care institutions?
bacteria
100
What is the smallest of all microorganisms?
viruses
101
What is fungi?
plant-like organisms present in air, soil, and water
102
What are the factors affecting an organism's potential to produce disease?
- number of organisms
- virulence
- competence of person's immune system
- length and intimacy of contact between person and microorganism
103
What are possible reservoirs for microorganisms?
- other people
- animals
- soil
- food, water, milk
- inanimate objects
104
During which stage of infection is the pt most contagious?
prodromal stage
105
What are factors that affect host susceptibility?
- intact skin and mucous membranes
- normal pH levels
- body's white blood cells
- age, sex, race, hereditary factors
- immunization, natural or acquired
- fatigue, climate, nutritional and general health status
- stress
- use of invasive or indwelling medical devices
106
What are cardinal signs of acute infection?
- redness
- heat
- swelling
- pain
- loss of function
107
What is the normal white blood cell count?
5k - 10k
108
What lab data indicates an infection?
- elevated white blood cell count
- increase in specific types of white blood cells
- elevated erythrocyte sedimentation rate
- presence of pathogen in urine, blood, sputum, or draining cultures
109
What are the five moments for hand hygiene?
1. before touching a pt
2. before a clean or aseptic procedure
3. after a body fluid exposure risk
4. after touching a pt
5. after touching a pts surroundings
110
What is transient bacterial flora?
attached loosely on skin, removed from relative ease
111
What is resident bacterial flora?
found in creases in skin, requires friction with brush to remove
112
What are the four categories responsible for majority of hospital-acquired infections?
- Catheter-associated urinary tract infection
- Surgical site infection
- central-line associated bloodstream infection
- ventilator-associated pneumonia
113
What is VRE?
What are the risk factors for vancomycin-resistant enterococci (VRE)>
Antibiotic resistance occurs when the germs no longer respond to the antibiotics designed to kill them.
- compromised immune systems
- recent surgery
- invasive devices
- prolonged antibiotic use
- prolonged hospitalization
114
What is the body's defense against infection?
- body's normal flora
- inflammatory response (nonspecific response)
- immune response
115
What are the factors determining use of sterilization and disinfection methods?
- nature of organiisms present
- number or organisms present
- type of equipment
- intended use of equipment
- available means for sterilization and disinfection
- time
116
What are the five C's of caring?
```
commitment
compassion
competence
confidence
conscience
```
117
What is commitment?
Devotion
convergence between what you "want to do" and what you "ought to do"
devotion essential to caring
investment of self in task, person, choice, or career, internalized so.... is not regarded as a burden
a "call" which draws one to a conscious, willing and positive response
118
What is compassion?
* Born of awareness of our relationships to all living creatures.
* Presence that allows us to share with and make room for the other.
- Compassion motivates people to go out of their way to help the physical, mental, or emotional pains of another and themselves. Compassion is often regarded as having sensitivity, which is an emotional aspect to suffering.
119
What is competence?
* Having the knowledge, judgment, skills, energy, experience, and motivation required to respond to demands of our profession.
* Competence without compassion can be brutal.
* Compassion without competence is meaningless, if not harmful.
* Competence without caring becomes destructive competition.
120
What is confidence?
* A quality that fosters trusting relationships.
* An expression of caring that promotes trust without dependency but enabling the other to grow.
* Caring confidence communicates truth without violence, sensitive to the other person's right to know readiness to receive the truth.
* Communicates respect without parentalism/paternalism.
121
What is conscience?
Embodies one's state of moral awareness;
•A sensitive, informed sense of what is right or wrong.
•A personal compass directing behavior according to moral standards or the moral fitness of things.
•Spiritual space where we take responsibility for ourselves, for others and for the world we share.
•To listen to this God-given trust within us, to want to be moral, is a fundamental conversion.
122
What are the some of the consequences of have a non-caring experience?
- Humiliation
- Fear
- Lack of control
- Despair, helplessness, alienation, vulnerability
- Lingering bad memories
- Decrease healing
all this can cause a distrust between the medical staff and a patient
123
what is the 6th C?
comportment
- meaning "bearing"
- demeanor
- to be in agreement or harmony with
- professionalism
124
What is Benner's stages of nursing proficiency?
- Novice
- Advanced beginner
- Competent
- Proficient
- Expert
125
Benner's stages: expert
Expert clinical nursing practice is a commitment to the application of knowledge, ethics, aesthetics, and clinical experience. Your ability to interpret clinical situations and make complex decisions is the foundation for your nursing care and the basis for the advancement of nursing practice and the development of nursing science.
126
What is the ICN definition of nursing?
•Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. Nursing includes the promotion of health; prevention of illness; and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.
127
What are the 10 standards of professional performance?
- ethics
- education
- evidence-based practice and research
- quality of practice
- communication
- leadership
- collaboration
- professional practice evaluation
- resources
- environmental health
128
What are professional roles that nurses perform?
- autonomy and Accountability
- caregiver
- advocate
- educator
- communicator
- manager
129
Describe the nurses professional role: autonomy and accountability
•Autonomy is an essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders. Accountability means that you are responsible professionally and legally for the type and quality of nursing care provided.
130
Describe the nurses professional role: caregiver
As a caregiver, you help patients maintain and regain health and find their maximum level of independent function through the healing process. A patient's health care needs include the patient's emotional, spiritual, and social well-being
131
Describe the nurses professional role: advocate
•As a patient advocate you protect your patient's human and legal rights and help patients assert those rights when needed.
132
Describe the nurses professional role: educator
•your teaching can be formal or informal. Always use teaching methods that match your patient's capabilities and needs, and incorporate other resources, such as the family, in teaching plans.
133
Describe the nurses professional role: communicator
Your effectiveness as a communicator is central to the nurse—patient relationship. It allows you to know your patients, including their strengths, weaknesses, and needs. You will routinely communicate with patients and families, other nurses and health care professionals, resource people, and the community
134
Describe the nurses professional role: manager
Your effectiveness as a communicator is central to the nurse—patient relationship. It allows you to know your patients, including their strengths, weaknesses, and needs. You will routinely communicate with patients and families, other nurses and health care professionals, resource people, and the community
135
What are the four core roles of APRNs?
clinical nurse specialist (CNS), certified nurse midwife (CNM), certified RN anesthetist (CRNA), and certified nurse practitioner (CNP).
136
What is a clinical nurse specialist?
is an APRN who is an expert clinician in a specialized area of practice, such as a population (e.g., geriatrics), a setting (e.g., critical care), a disease specialty (e.g., diabetes), a type of care (e.g., rehabilitation), or a type of problem (e.g., pain).
137
Who is Florence Nightingale?
First practicing epidemiologist
Organized first school of nursing
Improved sanitation in battlefield hospitals
Practices remain a basic part of nursing today
138
What did florence nightingale do for the nursing community?
. By improving sanitation in battlefield hospitals, she showed how effective fresh air, hygiene, and nutrition were in the treatment of wounded soldiers.
•The practices she advocated remain a basic part of nursing care in the twenty-first century.
139
Who is mother bickerdyke and what did she do
organized ambulance services and walked abandoned battlefields at night, looking for wounded soldiers. (civil war)
140
who is mary mahoney?
the first professionally trained African-American nurse. She was concerned with the relationship between cultures and races; and as a noted nursing leader she brought forth an awareness of cultural diversity and respect for the individual, regardless of background, race, color, or religion.
141
What did lilian wald and mary brewster do?
opened the Henry Street Settlement, which focused on the health needs of poor people who lived in tenements in New York City.
142
What are the CDC's recommendations to prevent C diff
Avoiding the use of electronic equipment that is difficult to clean (electronic thermometers)
Disinfecting dedicated patient care items and equipment (stethoscopes) between patients
Using full-barrier contact precautions (gown and gloves)
Placing patients in private rooms; cohort patients with the same strain of CDI
Performing meticulous hand hygiene
Performing environmental contamination of rooms
Educating health care providers (and patients/families as appropriate) on clinical presentation, transmission, and epidemiology of CDI
Using antimicrobials at an appropriate dose and only when indicated
143
What are the factors used to determine use of sterilization and disinfection methods?
Nature of organisms present
Number of organisms present
Type of equipment
Intended use of equipment
Available means for sterilization and disinfection
Time
144
What should the nurse assess during hygeine care?
```
physical
psychosocial
cognition
patient's understanding of disease
opportunity for patient education
```
145
What is the purpose of oral hygiene?
◦Brushing removes particles, plaque, and bacteria; massages the gums; and relieves unpleasant odors and tastes.
◦Flossing removes tartar at the gum line.
Rinsing removes particles and excess toothpaste
146
What can affect hair characteristics?
Hormonal changes, nutrition, emotional stress, physical stress, aging, infection, and other illnesses
147
What is cerumen?
ear wax
148
What is virulence?
describes how efficient an infectious agent is at making people ill
149
What is a vector-borne transmission?
transmission of infectious agents through animals, such as an insect or rodent
150
What are the two categories that trigger the inflammatory response?
infectious triggers: viruses, bacteria, and other micro-organisms, such as fungi
Noninfectious triggers: physical triggers (burns, frostbite, foreign bodies that have entered the body, trauma, injury, and radiation), chemical noninfectious triggers (irritants [fluoride, nickle], fatty acids, alcohol, toxins, and glucose), biological triggers (damaged cells), psychological triggers (excitement)
151
What are the basic steps of inflammation?
Recognition of harmful stimuli by pattern receptors (located on the surface of cells), activation of the inflammatory pathway, release of inflammatory markers, recruitment of inflammatory cells
152
What are the types of infections?
Local infection: confined to one area of the body
Systemic infection: start as local infections and then move into the bloodstream, from which they infect the entire body
153
What does APA regulate?
- stylistics
- in-text citations
- references
154
What should the language in an APA paper be?
clear, concise, plain
155
What is included in a literature review?
```
Summarizes scientific literature on a particular research topic
• Includes:
• a title page,
• introduction, and
• a list of references
```
156
What are the two most common used genres in APA format?
literature review and experimental report
157
What is the order of the four major sections of our essay?
title page
abstract
main body
references
