Exam 1 Lecture notes: The highlights Flashcards
What were the early health care practices?
- Separate the dead from the living
- Hand washing
- Isolation of those with disease from the healthy
HP 2020 goals:
- We want people to live high quality lives
- Eliminate health care disparities
- Promote quality of life though promoting healthy behavior`s
List the 5 determinants of health:
- Policy making
- Social Factors
- Health services
- Individual behaviors
- Biology and genetics
Describe the Travis-Illness wellness continuum:
Health is a forward moving continuum toward high level wellness or being on a two-way path (one way towards wellness and the other toward disability or death)
On the Travis-Illness wellness continuum, which side is premature death:
(Starting from far left to neutral point)
Disability
Symptoms
Signs
On the Travis-Illness wellness continuum, what does the treatment paradigm include?
Disability
Symptoms
Signs
On the Travis-Illness wellness continuum, what does high level wellness include
(Starting from the neutral point to the far right)
Awareness
Education
Growth
What is the Texas Health Steps formerly known as and what health care coverage is it under?
Early and Periodic Screening, Diagnosis and Treatment program/ specifically a children’s program under TX Medicaid
What is WIC and what health care coverage is it under?
Women Infants and Children /Under Medicaid/ a supplemental nutritional program available for low income and pregnant and breastfeeding, postpartum women and children up to the AGE OF 5 who are found at nutritional risk
What are the strategies intended for Primary prevention?
to Keep people healthy (Ex: Vaccines)
What does secondary prevention involve?
Screening
Define reliability:
The same results every time with the same conditions REPEATAABILITY
Define validity:
Sensitivity / specify -ACCURACY
What type of prevention is the greatest need?
Primary prevention
What is the most costly type of care? What is the second most type of costly care?
Tertiary Care
What are major concerns associated with health care delivery today?
- Cost containment - insurance companies are known as MANAGED CARE
- Access to health care - lack of clinics in rural communities DISTANCE is the issue
- Quality of health care- Medicare and Medicaid recipients are entitled to the services that health care providers claim they are providing
What is an Advanced Directive?
Legal documents that specify what may or may not be done to a person when they are unable to speak for themselves-like LIVING WILLS (we should all have living wills)
What is informed consent?
Physicians must fully explain a procedure to a patient before the procedure
Describe cost of care- DRG (diagnostic related groups)
Hospital stays are shorter - Insurance companies operate from the perspective that similar diagnoses require and receive standardized packages of care-this is a system of DRGs or diagnostic related groups. The DRGs dictate how much the insurance company will pay towards a patient’s hospitalization or clinic visit or outpatient service
What is the Patient Protection and Affordability Act (2010)?
Obamacare: o Providing PREVENTIVE services at little or no cost (health screenings)
Notable items on ACA: Mandate coverage
Tax credits
How many nurses and midwives does the world need to achieve universal health coverage by 2030?
9 million
What is cultural sensitivity?
- Awareness of uniqueness of self and each individual
- Awareness of cultural variations
- Avoid stereotyping especially related to pain
Jean Watson was a nursing theorist for what?
Caring
What is the art of nursing?
The way we deliver care its our own style of nursing
Nursing is an autonomous professions that helps facilitate__________.
Quality of life to its fullness
Define: Ethnocentrism
Excessive pride in ones own culture, race, or creed
Define: Bias
Demonstrating preference for a particular race or gender
Define: Cultural blindness
Assuming were all alike
Define: Cultural imposition
Tendency of a person or group to impose their values and patterns of behavior onto other persons
What are the characteristics of the nursing profession?
- Unique body of knowledge
- Autonomy
- Service oriented practices
- Research (evidence basis of practice)
- Organization
The best way to find out about a person culture is to__________.
Ask them
Define accountability
Owning their actions, owning their mistakes and making things right
What are the goals of nursing?
Health promotion
Health restoration
Health MX
Nurse Theorist: Florence Nightingale was known for_________.
Environmental: fresh air and cleanliness
Nurse Theorist: Virginia Henderson was known for_____.
14 Basic Life Needs: Holistic approach
Nurse Theorist: Martha Rogers was known for ________.
Dynamism and change
Nurse Theorist: Callista Roy was known for _______.
Adaptation
Nurse Theorist: Dorothea Orem was known for ________.
Self care
Nurse Theorist: Madeleine Leininger was known for_________.
Cultural sensitivity
Nurse Theorist: Jean Watson was known for_________.
Caring
What is the Nurse Practice Act?
The NPA guarantees the safety of practitioners for consumers. They must be able to provide SAFE CARE
What is an independent intervention?
The nurse does things within her scope of practice (no orders needed)
What is collaborative scope of practice?
The nurse is working within another discipline in providing a treatment (like working with physical therapist)
What is the nursing process? and what is the nursing process components?
Person Health status Philosophy Purpose ADPIE = Assessment, Diagnosis, Planning, Implementation, Evaluation
What is subjective data?
Everything the patient tells you, its their story
Documentation should be what?
Timely
Detailed
Accurate
What are principle-based ethics?
These are the ethics that nurses follow
Describe ethics perspective: Utilitarian
Greatest good for the greatest number // the ends justify the means// relating to the outcome, usefulness, and purpose
EX: the ACA
Describe ethics perspective: Deontological
Duty-based Morality
EX: Someone against euthanasia or abortion
Describe ethics perspective: Principle-based
Focuses on theories of general principles
Define ethical trait: beneficence
Acting in a way the benefits the patient
Define ethical trait: Non-maleficence
Do no harm
Define ethical trait: Advocate
Speaking up/ standing up for the patient
Define ethical trait: Fidelity
Loyal to duty / ACCOUNTABILITY
Define ethical trait: Justice
Treating all patients fairly
Define ethical trait: Autonomy
Having a sound mind and not being coerced into a decision by anyone
What does scope of practice RN mean?
What the nurses primary job is
What is the whistle blower law?
Protects the nurse from retaliation when substandard practices are exposed
When stressed what are the 3 stages the body goes though and describe them?
Alarm - fight or flight
Adapt - defend, resist
Exhaust - tired out
In the ANS the sympathetic NS does what?
Speeds up HR and increases BP
In the ANS the parasympathetic NS does what?
Slows down heart rate and relaxes sphincter muscles
What is active listening?
Completely focusing on every word the pt says
What are the 3 behavioral change models include?
- The health belief model
- The transtheoretical model
- Reversal theory
What is the safe harbor law?
Protects the nurse from engaging in behaviors that potentially put the patients at risk
What is the safe harbor law?
Protects the nurse from engaging in behaviors that potentially put the patients at risk
Define assault and review the example:
Threat of harm bodily or personal without the persons consent: “If you don’t do your physical therapy exercises today, I won’t have a lunch or dinner tray brought to you.”
Define battery and review this example:
Direct physical contact that is not invited by the patient: A nurse slips their hand and stethoscope under a patient’s blouse without their permission to do so
Define libel and review this example:
Written communication that is detrimental to a persons character: : A nurse documents in the patient electronic medical record: “Patient is so disgusting and has a terrible temper; is very stupid and so annoying”
Define slander and review this example:
Verbal statements detrimental to a persons character: A nurse is overhead saying, “The patient in room 304, Mr. Smith, is such a pervert-he’s such a jerk! He’s a very dangerous person and sooooo gross!”
Define duty:
What one is required to do by virtue of his or her license-accurate and complete assessment of patients and being competent in nursing skills
Define breach of duty:
Failure to perform acts expected of a person with licensure-like failing to report an unsafe patient situation
Define negligence and view this example:
Failure to perform an action that another prudent person with similar educational preparation and experience would have done in similar circumstances: The nurse left a patient lying in their urine for an entire 8 hour shift, and as a consequence, the patient developed a pressure ulcer
Define malpractice and review this example:
Negligence by a professional or licensed person: The nurse did not record any vital signs or physical assessments for an entire shift on their patient and went home without documenting anything
Define fraud and view this example:
Misrepresentation: Representing one’s self as a nurse when they are not-A UTEP nursing student signs their name with RN at the end on a patient’s document.
What are documentation key components:
Date - time - immediately after incident
What are the stages of grief?
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
What are the 3 domains of learning and describe them?
o Cognitive-This is the knowledge-the information being taught-if I were teaching you all how to start IVs, I would talk to you about the process and have you read about the process.
Affective-This is the emotional and motivational domain-I would tell you how exciting it is for you to be nurses starting IVs and motivate and inspire you about how cool it is that people are getting better because you started the IV that helped them.
Psychomotor-This is the “hands on” domain. I would actually have you touch the IV catheters, tubing, and have you start an actual IV.
Define sympathy:
Feeling pity for someone
Define empathy:
Being able to understand and share the feelings of another person
Describe techniques of therapeutic communication?
Focus
Clarification
Reflection
Empathy
Describe barriers to therapeutic communication:
Gaps in age or culture Anxiety Resistance-blocking Transference Counter-transference Sympathy
What are the 3 domains of learning?
Cognitive
Affective
Psychomotor
Define Quantitative
Involves measurement of outcomes using numerical data (basic/ applied/ correlational/ experimental)
Define Qualitative:
Finds meaning in behaviors through interviews-measurement is bases on open ended questions (phenomenology/ ethnography/ grounded theory/history)
Define independent variable:
“The Effects of pet therapy on nursing students’ anxiety levels” Pet therapy is the independent variable because it will have an impact on the dependent variable-nursing students’ anxiety levels.// Affects the dependent variable or variables; this variable is presumed to cause, explain, or influence the dependent variable
Define dependent variable:
Is affected by the independent variable or variables
List the legal and ethical rights of participants in research:
Participants have the rights to:
1. Voluntarily participate or not
2. Quit participation at any time
3. Be protected from harm
4. Know that their confidentiality is protected
There are strict guidelines in place that researchers must follow to protect study participants.
Define: Purpose
A reason the researcher is taking the time and effort to do the study
Define: Review of literature
A section where the researcher has reviewed the studies that have already been done and this is discussed in this section
Define: Hypothesis
The researcher’s statement about the expected relationship between variables in the study
Define evidence-based practice:
Nurses generate, disseminate, and incorporate research in to their practice.
Define change agent:
meaning they must stay current with health care studies that show better interventions that can be used in treating patients-interventions that result in a higher amount of good outcomes for patients.
