Exam 1 Flashcards
1
Q
Accountability
A
Ability & willingness to assume responsibility.
2
Q
Standards of Practice
A
responsibilities for which nurses are accountable.
3
Q
Autonomy
A
independence at work, responsibility and accountability for one’s actions.
4
Q
Definitions of Professional Nursing
- essential features
A
- Attention to the range of human experiences and responses to health and illness within the physical and social environments
- Integration of assessment data with knowledge gained from an appreciation of the patient or the group
- Application of scientific knowledge to the processes of diagnosis and treatment through the use of judgment and critical thinking
- Advancement of professional nursing knowledge through scholarly inquiry
- Influence on social and public policy to promote social justice
- Assurance of safe, quality, and evidence-based practice
5
Q
ANA Definition of Nursing
A
Nursing is the 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.
“Treatment of Human Response”
6
Q
Roles and Function of the Nurse
A
Caregiver Communicator Teacher Advocate Counselor Change Agent Leader Manager Case Manager Researcher
7
Q
Criteria of the Profession
A
Extensive education Specialized education Body of Knowledge Service orientation Ongoing research Code of Ethics Autonomy Professional Organization
8
Q
The nurse acts as a client advocate maintaining the client’s rights:
A
- Not to be harmed
- To receive full disclosure
- To refuse or agree to participation
- To privacy and confidentiality
9
Q
Communication:
A
ongoing, dynamic, and ever-changing series of events, each of which affects and is affected by all others.
10
Q
Standards of care
A
assesses clients understanding and ability to care for himself.
11
Q
Professionalism
A
refers to professional character, spirit or methods
12
Q
Professionalization
A
process of becoming a professional
13
Q
Standards of Professional Performance
A
behaviors expected in professional nursing role.
14
Q
client
A
engages the advice or services of another
15
Q
Continuing Education in WA
A
WA state the requirement for licensure is 45 clock hours of CEU and 531 practice hours every 3 years.
16
Q
Continuing Education for nurses
A
Expectation is that the nurse is a lifelong learner and is self-directed in identifying learning needs
17
Q
Planning
A
Write goals w/ client.
Write nurses orders.
18
Q
Implementing
A
Implement nurses orders / client goals
19
Q
Evaluating
A
check outcome of goals (met, partially met, not met)
20
Q
Communication Process
The Sender
A
- Encodes the original message
- Decodes feedback sent by the receiver.
21
Q
Communication Process
The receiver
A
Receives and decodes the message & then encodes feedback
22
Q
Communication Barriers
A
- Culture (feeling, beliefs, attitudes, values)
- Environment (noise, lighting)
- Life experiences
- Self-concept
- Sensory function
- Stress, tension, fear
23
Q
Methods of communication
A
- Verbal (words)
- Non verbal (no words)
24
Q
What to consider when using Verbal communication
A
- Pace and intonation
- Simplicity
- Clarity and Brevity
- Timing and Relevance
- Adaptability
- Credibility
- Humor
25
Nonverbal Communication:
Our body language – gestures, posture, facial expression, body movements, gait, appearance, etc.
26
Factors that influence communication
- Age/development
- Gender
- Values and Perceptions
- Personal Space
- Territoriality
- Roles and Relationships
- Environment
- Congruence
27
Nurses engage in what 2 kinds of communication:
Professional
| Therapeutic
28
So what makes communication therapeutic
- Client centered
| - Goal directed
29
Attentive Listening:
- actively listening for key themes in a conversation
- paying attention to the verbal & nonverbal communications
- looking for congruency and clarifying if there are mixed messages
- conveying an attitude of caring and concern
30
Physical Attending:
- Facing the person
- Open posture
- Leaning in
- Eye Contact
- Relaxed
31
Phases of the helping relationship:
- PreInteraction
- Introductory
- Working Phase
- Termination Phase
32
Phases of the helping relationship:
| Pre-Interaction
before the interview, what you already know about the client may come from a report by other nursing staff.
33
Phases of the helping relationship:
| Introductory
Opening the relationship, clarifying the problem, and structuring and formulating the contract. Building rapport.
34
Phases of helping relationship:
| Working Phase
exploring and understanding thought and feelings, facilitating and taking action.
35
Phases of helping relationship:
| Termination
end the relationship after the goals are achieved, need to separate from the client
36
Purpose of Professional Communication:
- Client Advocacy
- Coordination of Care
- Delegation and supervision
- Consultation
- Collaboration with peers
37
Passive Communication Style:
put needs of others first, don’t allow yourself to disagree, avoids conflict, often combined with conditions or apologies
38
Assertive Communication Style:
begins with “I”, clear and direct statements, respectful of others, honest and genuine, firm and positive, specific to the situation, not apologetic
39
Aggressive Communication Style:
begins with “You”, message often angry, hostile or offensive; infringes on the rights of others, can be loud and intimidative
40
DESC system
Describe: the situation
Express: your feelings about the situation
Specify: the change you want
Consequences: identify the desired results
41
Causes for Potential failures:
- Systems: loss of info, test, diagnostic information
- Communication: handoffs, transition of care
- Failure to Plan: everyone needs to know the plan
- Failure of recognition: changes in client status
- Failure to rescue: failure to follow through on changes in client condition with appropriate care
42
Use of critical language that means
“pay attention, I have a concern”
43
CUS model (United Airlines)
I’m confused; I’m uncomfortable, this is unsafe; I’m scared
44
SBAR
Situation: What is going on with the client? (what is the reason for this communication)
Background: What is the clinical background? (clinical context of the situation)
Assessment: What do I think the problem is? (detailed info about the client condition)
Recommendation: What do I think should be done to correct it? (suggested action)
45
Susceptibility to Infection:
```
Age
Heredity
Stress
Nutritional state
Medical therapies
Medications
Other pathologies
```
46
Infection Prevention Strategies:
```
Hand Hygiene – when and how, what product
Gloving - when
PPE – when and how, on/off
Medical Asepsis
Surgical Asepsis
```
47
Hand Hygiene:
Handwashing
| Alcohol based gels
48
Indications for Hand Hygiene
- Soap: visibly dirty, contaminated, or soiled.
| - Not visibly soiled, use an alcohol-based handrub for routinely decontaminating hands
49
Types of PPE Used in Healthcare Settings
- Gloves – protect hands
- Gowns/aprons – protect skin and/or clothing
- Masks and respirators– protect mouth/nose
- Respirators – protect respiratory tract from airborne infectious agents
- Goggles – protect eyes
- Face shields – protect face, mouth, nose, and eyes
50
Professional Behaviors
- Actions by the nurse that invite trust and inspire confidence.
- Understanding of leadership principles
- Commitment to profession
- Acceptance of work ethic
51
Identify nursing behaviors that demonstrate professionalism
Appearance
Teamwork ….communication
Positive Attitude
Compassion
52
Discuss work ethic as it relates to the behavior of the professional nurse.
Attendance/Punctuality
Reliability & Accountability
Attitude & Enthusiasm
53
four generations of nurses
```
Veterans (born 1925-1944)
Baby Boomers (born 1945-1960)
Generation X (born 1961-1980)
Millennial Generation (born 1981-2000)
```
54
Transference
Patient to nurse
| The nurse reminds the patient of great aunt sally
55
Counter-transference
Nurse to patient
| The patient reminds the nurse of her ex-boyfriend
56
What do you do if the patient speaks a different language
Interpreter
57
Acronym for the Nursing Process
ADPIE
- Assess
- Diagnose
- Plan
- Implement
- Evaluate
58
Assessment
- Collect Data
- Organize Data
- Validate Data
- Document Data
59
Organizing Data
functional patterns
body systems
head-to-toe
60
QSEN: Six competencies
- Safety
- Patient-centered Care
- Informatics
- Teamwork & collaboration
- Evidenced-based practice
- Quality improvement
61
Subjective data-
referred to as Symptoms or covert data, are apparent only to the person affected and can be described only by that person. EX. Itching, pan and feelings of worry.
62
Objective data-
referred to as Signs or overt data, are detectable by an observer or can be measured or tested against an accepted standard. EX Can be seen, heard, felt or smelled, are observable.
63
Sources of Data:
- Client: best source of data
- Support people: family members, friends and caregivers – can supplement/verify info provided.
- Client Records: info documented by various health professionals.
- Healthcare Professionals: verbal reports by other HC professionals
- Literature: nursing and related literature – EX standards or norms for comparisons.
64
Directive Interview:
highly structured & elicits specific information.
| -Closed Questions
65
Non-directive interview:
rapport-building, allows client to control the purpose, subject matter and pacing. (Rapport- understanding between two+ people).
-Open Question
66
Closed Questions:
used in the directive interview and usual elicit Yes/No or short factual answers.
EX: How old are you? When did you fall? What med did you take?
67
Open-ended Questions:
associated with the nondirective interview. Invites clients to discover and explore, elaborate, clarify or illustrate their thoughts or feelings. EX: How have you been feeling lately? What brought you to the hospital? What would you like to talk about today?
68
Stages of an Interview:
- Step 1: The Opening: Establish rapport.
- Step 2: Orientation: the purpose of the interview.
- Step 3: The Body: Client communicates what he/she thinks, feels, knows in response to questions.
- Step 4: The Closing: Nurse terminates the interview when info has been obtained.
69
Validating Data
| Cues:
Subjective or objective data that can be directly observed by nurse.
70
Maslow's Hierarchy of Needs:
cluster data pertaining to, physiological, safety, love, self-esteem & self- actualization.
71
Health History:
a comprehensive record of the client's past and current health.
72
Attending:
giving full attention to verbal and non verbal messages
73
Paraphrasing:
nurse restates the client's basic message, often for clarification.
74
Summarizing:
process of gathering ideas, feelings and themes that clients have discussed throughout the interview and restating them in several general statements.
75
OLDCART & ICE:
- Onset
- location
- duratio
- characteristics
- aggravating factors
- relieveing factor
- treatment of symptoms
- Impact on ADLs,
- Coping Strategies
- Emotional Response.
76
Biographical Data:
includes client's name, address, age, birthday, gender, marital status... most often a form.
77
Family History:
review family history to determine any genetic familial patterns of health or illness.
-Genogram: pictorial representation of family medical history.
Review as much family history as they remember
78
Psychosocial History:
includes info about occupational history, education level, finances, culture, etc.
-helps to reveal risk factors.
79
Decision making:
a critical-thinking process for choosing he best actions to meet a desired goal.
80
Critical thinking:
a cognitive process during which an individual reviews data and considers potential explanations and outcomes before forming an opinion or making a decision.
81
American Nurses Association (ANA)
Standards of nursing practice, code of ethics...
82
Joint Commission for Accreditation of Healthcare Organizations
Accreditation & Certifications - performance standards
83
National League for Nursing (NLN)
nursing education
84
QSEN
Quality & Safety education for nurses
| -continuing education for nurses
85
Washington Dept. of Health Nursing Commission
WAC's and RCW's
