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NUR 101 > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

Who is Florence Nightingale?

A

Mother of modern nursing. Led group of nurses to deliver care in Crimea. “Nightingale Principles.” Improved quality and reputation of nursing care

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2
Q

What sparked a change in where the sick received care by the 19th Century?

A

Urbanization and industrialization.

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3
Q

What kind of care were nurses trained for in early 19th century?

A

Care for maternity patients

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4
Q

What rationalized the need for educating nurses?

A

The Civil War

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5
Q

How many schools of nursing were set up by 1900? Their reality?

A

400-800 nursing schools were set up but the programs used nursing students as labor until mid-20th century

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6
Q

In 1890 what two major professional organizations were established?

A

The American Society of Superintendants of Hospital Training Schools (Later: National League for Nursing Education).
The Associated Alumnae of the United States (later: American Nurses Association)

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7
Q

Who is Lillian Wald?

A

The founder of the Henry Street Settlement House in 1893. Provided nursing and other care to impoverished.

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8
Q

How did WWI affect nursing history?

A

It created demand for special skills, resulted in specialists such as nurse anesthetists and midwives.

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9
Q

What issues and debates were there in regards to nursing?

A

Nurses were high in demand, but did not receive adequate pay and underwent poor working conditions. Debates had about type of work for nurses, education/training, change from hospital-based programs to college-based programs.

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10
Q

How did the profession flourish in the late 20th century? New challenges?

A

new specialities emerged, federal financial support for educating nurses, increased funds for nursing research.
Nursing shortages, aging population, contemporary societal needs

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11
Q

What is expected/required of a professional?

A

competence and skill

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12
Q

What is the Professional Nurse Law about the title of R.N.?

A

Only those with a license to practice professional nursing may use the title. No others may engage in practice or indicate they are RNs. And no one may sale of furnish any nursing diploma, license or registration.

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13
Q

What is the responsibility of a nurse and what must they not do?

A

Assess human responses; plan, implements and evaluates nursing care for individuals and families responsible for. An RN may never engage in any practice without adequate knowledge of and necessary skills.

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14
Q

Define professional misconduct.

A

Behavior that is professionally unsuitable, potentially dangerous to patients, incompetent, disruptive, abusive, or illegal.

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15
Q

What are evidence-based practice factors that influence nursing practice?

A

Use of nursing research to develop guidelines for nursing care; validation of nursing practice

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16
Q

What are economic factors that influence nursing practice?

A

nursing shortage, health insurance, health care reform, Medicare/Medicaid

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17
Q

What are societal factors influencing nursing practice?

A

length of hospital stay, community-based nursing, age of population, chronic health conditions, educated health care consumers

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18
Q

What is the purpose and function of professional nursing organizations? Benefits of membership?

A

sets standards for practice and education and can influence healthcare policy & legislation. Benefits: voice in legislation, networking and maintaining currency in practice.

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19
Q

What are the focuses of the ANA and NLN?

A

The American Nurses Association focuses on ethics, public policy, lobbying for nurses. The national League for Nurses is the primary course of research data regarding nursing education

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20
Q

What is the common goal of an interdisciplinary team?

A

Improved patient outcome.

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21
Q

Who are the members of the nursing team?

A

Registered nurses, licensed practical nurses and unlicensed assistive personnel.

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22
Q

Who are the members of the healthcare team?

A

registeres nurse, advanced practice nurse, vocational or practical nurse, physician, nutritionist, physician assistant, social worker, physical therapist, occupational therapist

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23
Q

Define ethics.

A

A system of moral principles or standards of governing conduct

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24
Q

What are some significant ethic declarations in healthcare history?

A

Declaration of Geneva, adopted 1948 by 2nd General Assembly of World Medical Association, Declaration of Hawaii included guidelines for worldwide practice of psychiatry, Hippocratic Oath (400 BC) oral code for med practioners, and the Nightingale Pledge used by nurses on graduation from pro school, Harper hospital (1893)

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25
Q

How does ethics vary?

A

Involves doing good and causing no harm, but what is ethical can vary nurse to nurse; diff choices for same dilemma

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26
Q

What are the ethical medical indications for healthcare professionals to follow?

A

beneficence: doing what is best for the patient, doing good, kindness. nonmaleficence: not doing something that causes harm and doing what is needed to prevent harm.

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27
Q

What patient preferences must be considered in healthcare ethical situations?

A

Respect for autonomy (independent functioning), quality of life and principles of justice and fairness

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28
Q

What are common ethical dilemmas in nursing? ethical decision making?

A

freedom vs control, truth vs deception, distribution of resources, medically futile outcomes (no chance of recovery), empirical knowledge vs personal belief. Physician and patient work together on these dilemmas.

29
Q

What are intrinsic and extrinsic values?

A

Intrinsic=relate to a specific interest in activities of work, or the benefits that the work contributes to society. Extrinsic=relate to favorable conditions that accompany an occupational choice, such as physical setting, earning potential and other external features

30
Q

What are the meanings of “litigation,” “plaintiff,” and “defendant”?

A

litigation=process of bringing and trying a lawsuit. plaintiff=person bringing suit. defendant=person being accused of a crime.

31
Q

What are the types of laws?

A

Public=regulates between individuals and gov. Private=civil laws, regulates among people. Criminal=concerns state and federal statutes (defines criminal actions)

32
Q

What are the reasons for suspending a license?

A

drug or alcohol abuse, fraud, deceptive practice, criminal acts, previous disciplinary actions, gross or ordinary negligence, physical and mental impairments (age).

33
Q

What are some legal safeguards for nurses?

A

informed consent, whistleblowing, contracts, professional liability insurance, risk management programs, incident reports, Patient bill of rights, documentation, patient ed, physician orders.

34
Q

What are safeguards to competent practice?

A

respecting legal boundaries of practice, following institutional policies and procedures, evaluating proposed assignments, keeping current, respecting patients rights, careful documentation.

35
Q

What are the standards of conduct for nurses?

A

practice only skills with necessary knowledge, preparation, experience and competency, safeguard patient from incompetent, abusive, or illegal practices, safeguard pt’s dignity, right to privacy and confidentiality, document and maintain accurate records.

36
Q

How are nurses patient advocates?

A

primary commitment is to the patient, priority to good of individual patient rather than society in general and evaluation of competing claims of pt’s autonomy and well-being

37
Q

what are some documentation guidelines?

A

Content should be complete, accurate, concise, FACTS, timely (NOW), correct pt chart, agency format, sign name (legal doc), keep it private (HIPAA), never doc before completing task

38
Q

What is charting by exception?

A

shorthand documentation, well-defined standards, decreases charting time, emphasis on significant data & easy retrieval, timely bedside charting, better tracking of progress/delcine, greater interdisciplinary communication

39
Q

What are progress notes?

A

specific, to inform caregivers of pt progress, allows for description of condition, situation or response, in conjunction with CBE when necessary to elaborate in a note

40
Q

What is the framework for communicating between healthcare team members?

A

SBAR= Situation, Background, Assessment, Recommendation. Helps to focus on clinical needs of pt.

41
Q

What is nursing informatics?

A

A specialty that integrates nursing science, computer science, and information science to manage & comm data in nursing practice. increases accuracy & completeness of documentation, improves workflow, automation of collection and reuse of data, analysis of clinical data.

42
Q

What is a helping relationship?

A

specific purpose & goals, unequal share of info, built on pt needs, professional relationship, both persons are active participants, person providing assistance is accountable for outcome

43
Q

What are conditions that enhance growth in others?

A

rapport, trust, positive regard, genuineness, empathy, attending, suspending value judgments.

44
Q

What is therapeutic communication?

A

accepting, offering self, paraphrasing, restating, reflecting, exploring, observing, encouraging, use of silence, active listening.

45
Q

What is non therapeutic communication?

A

reassurance, approving or disapproving, giving advice, defending, requesting explanation, belittling, stereotyped or cliche comments.

46
Q

What are the three levels of critical thinking?

A

Basic=trust the experts, thinks based on the rules (concrete). Complex=begins to express autonomy by analyzing &examining data. Committment=expects to make choices w/o help from others & assumes responsibility

47
Q

What are the four components of critical thinking?

A

KNowledge=nursing education, CE courses, advanced degrees & certs. Experience=demo understanding, analyzes cues, incorporates experiences into intuition. Attitudes=independent thinking, fair-minded, intellectually humble/courageous, good faith/integrity, curious, persevering, disciplined, creative, confidence. Standards=judgment based on ethics, EB practice, professional responsibility.

48
Q

What is the Nursing Process?

A

systematic, patient-centered, goal-oriented method of caring that provides the structure for nursing practice. Each step depends on the accuracy of the steps preceding it. the ESSENCE of nursing practice.

49
Q

What are the steps of the nursing process?

A

ADPIE=Assessing, Diagnosing, Planning/Outcome ID, Implementing, Evaluating (termination of nursing care or revision of care plan)

50
Q

What is the first and most important step to the nursing process?

A

Assessment=collect patient data, document data in a thorough, concise and accurate manner.

51
Q

Describe the second step, diagnosing.

A

Analyze client data, ID strengths/problems, Recognize patterns/trends, compare with expected standards/reference ranges, develop conclusion to guide nursing care, formulate a NANDA nursing diagnosis.

52
Q

How is the nursing diagnosis formulated?

A

Three parts PES= Problem (NANDA label, health prob of pt), Etiology (“related to,” probably cause of prob), Signs & Symptoms (“AMB” defining characteristics, observed or reported by pt).

53
Q

What are some variations to the nursing diagnosis?

A

Etiology may be unknown=”unknown etiology”, add second part to NANDA label=”impaired physical mobility: inability to walk”, use of secondary to=to include another dx in nursing dx.

54
Q

When is a basic two-part nursing dx used?

A

Just includes problem & etiology joined by r/t, usually “possible” or “risk for” when signs and symptoms do not exist.

55
Q

How do you prioritize nursing diagnoses?

A

High=life threatening, ABC:airway, breathing, circulation. Medium=not directly life threatening but may produce destructive physical or emotional changes. Low=occurs from normal developmental needs, requires minimal nursing intervention.

56
Q

What are the guidelines for prioritizing nursing diagnoses?

A

basic needs take priority (breathing, circulation), establish priorities w/ pt, consider Maslow’s hierarchy of needs. Priorities will change constantly.

57
Q

How is Maslow’s Hierarchy of Basic Needs organized?

A

Most important to least=physiological (breathing, food, water, shelter, clothing, sleep), safety and security (health, employment, property, family, social stability), love and belonging (friendship, family, intimacy, connection), self-esteem (confidence, achievement, respect), self-actualization (morality, creativity, acceptance, purpose, inner potential)

58
Q

What does the third step, Planning, include?

A

Identify goals/outcomes that are derived from the problem statement, long term (goal, general intent, more than a week, used with discharge plan, continues after discharge, rehab, prevention, education), outcome (short term, <a week, patient-focused,guides nursing interventions, more specific, observable results).

59
Q

What does it mean for a goal/outcome to be SMART?

A

Specific, Measurable, Achievable/Attainable, Realistic, Timeframe.

60
Q

Outcome statement (part of step 3) must include what components?

A

Subject (pt), verb (pt is to do, learn, experience), conditions (what, where, why & how), criterion of desired performance (may specify time, speed, accuracy, quality). “Pt will drink 2500 mL of fluid per day”

61
Q

What are some variables that may influence outcome achievements?

A

developmental stage, psychosocial background, resources, standards of care, EBP, ethical &legal guides.

62
Q

What are nursing interventions?

A

any treatment based upon clinical judgment & knowledge a nurse performs to enhance the achievement of patient outcomes. each outcome will have interventions. the focus is to reduce or eliminate the etiology of nursing dx. individualized.

63
Q

What are the types of interventions?

A

Nurse initiated, physician initiated (under dr.’s orders), collaborative (other provider initiated carried out by nurse).

64
Q

How should nurse-initiated interventions be written in the plan of care?

A

Date, verb, subject, description (how, why, when, where, how often, how much), signature

65
Q

What is included in the fourth step of the nursing process, implementation?

A

Carry out plan of care: assess pt, understand orders, think about actions, organize resources (gather equipment), consider environment (privacy).

66
Q

What are some guidelines for implementation?

A

individualize interventions, be supportive & comforting, explain what you’re doing, be respectful to cultural beliefs & spiritual needs, encourage patient & family involvement, document!! actions & pt responses.

67
Q

How is the fifth step, evaluation, performed?

A

ongoing/continuous, collect more data, measures patient’s progress/effectiveness of plan, determines whether nursing interventions should be terminated, continued or changed.

68
Q

What does the RN consider when evaluating pt responses?

A

cognitive=thinking, ex. pt knowledge; psychomotor=doing, ex. demos new skills; affective=feelings, ex. changes in pt values, beliefs, attitudes; physiologic=physical changes in patient

NUR 101 (3 decks)

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