Exam 2 Flashcards
Professionalism relates to the treatment of ________, ________, and _______.
Patients, families, and coworkers.
Laws established in each state in the United States to regulate the practice of nursing are known as?
The nurse practice acts.
What are the essential activities involved in the nursing process?
Assessing, diagnosing, planning, implementing, and evaluating.
______ allow nurses to carry out professional roles, serving as protection for the nurse, the patient, and the institution where health care is provided.
Standards
Values are formed during a lifetime involving influences from the ____, _____, and ____.
Environment, family, and culture.
____ is the concern in welfare and well-being of others.
Altruism
How would you utilize altruism in a professional manner?
By making sure you understand other cultures and beliefs that maybe don’t align with your own.
Autonomy is the right to self ______.
Determination
______ ______ is reflected when the nurse values and respects all patients and colleagues.
Human dignity
____ is doing what’s right, even when no one is looking.
Integrity
upholding moral, legal, and humanistic principles is _____ _____.
Social justice
The systematic study of principles of right and wrong conduct, virtue, and vice.
Ethics
What is nursing ethics?
A formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make and evaluate judgments.
What are the five key principles in a principle-based approach?
Autonomy, nonmaleficence, beneficence, justice, and fidelity.
____ respects the rights of patients or their surrogates to make health care decisions.
Autonomy
Nonmaleficence avoids causing _____.
Harm
______ benefits the patient, and balance benefits against risks and harms.
Beneficence
What are the steps of making ethical decisions?
- Assess the situation
- Diagnose (identify) the ethical problem
- Plan (identify and weigh alternatives)
- Implement your decision.
- Evaluate your decision
When does moral distress occur?
When you know the right thing to do, but either personal or institutional factors make it difficult to follow the correct course of action.
Is the developed capacity to respond well to morally distressing experiences and to emerge strong.
Moral resilience
Moral injury occurs when there has been
A betrayal of what is right, by someone who holds legitimate authority or by oneself in a high-stakes situation.
Is reasoning both inside and outside the clinical setting.
Critical thinking
What is clinical reasoning and decision-making?
The process you use to think about patient problems in the clinical setting.
Refers to the result of critical thinking, clinical reasoning, and decision-making.
Clinical judgment
What will you be doing during the assessing phase in the nursing process?
Detecting/noticing cues (signs, symptoms, risks)
In the nursing process, what is done during the diagnosing phase?
- Analyzing, synthesizing, and interpreting data.
- Creating a list of suspected problems, weighing the probability of one problem against another that’s closely related.
Explain what happens in the planning phase of the nursing process.
You will be responding, predicting complications, anticipating consequences, considering actions, setting priorities, and decision making.
This sounds like which phase of the nursing process. Responding taking actions, monitoring responses, reflecting, and making adjustments.
Implementing phase
Reflecting and repeating ADPIE as indicated is which phase in the nursing process?
Evaluating
Critical thinking in nursing is guided by……
Standards, policies, ethics codes, and laws.
Critical thinking in nursing is based on principles on the…..
Nursing process, problem-solving, and the scientific method.
Critical thinking in nurses focuses on….
Safety and quality, constantly reevaluating, self-correcting, and striving to improve personal, professional, and system policies.
Critical thinking in nursing calls for strategies that make the most of human potential and…
Compensate for problems created by human nature.
Which type of assessment would you perform shortly after the patient is admitted or at the beginning of a shift to get a baseline?
Initial
Which assessment has a certain timeframe it has to be done by?
Initial assessment
What is a focused assessment?
Gathering data on a specific problem.
Which assessment is done when something sudden has happened to the patient?
Emergency assessment
Explain a time-lapsed assessment.
It compares the patient’s current state to their initial assessment baseline.
What happens in the the diagnosing step?
The nurse interprets and analyzes data gathered from the nursing assessment.
A nurse should recognize _____ and _______ risks and address these immediatly.
Safety and infection
A nurse should identify ______ responses and promoting _____ function, independence, and quality of life.
Human; optimum
A nurse should anticipate ______ _____ and taking steps to prevent them.
Possible complications
What is the nurses focus in the diagnosis/problem identification phase?
To identify actual and potential health problems and needs.
In the diagnosis/problem identification phase you promote, manage, _______, and ______.
Predict and prevent.
Are my data accurate and complete? Do the objective data support the subjective data? How do I know that this information is reliable? These are all examples of questions to facilitate……
Critical thinking.
These are apart of which nursing process phase?
- Establish the database.
- Continuously update the database.
- Validate data.
- Communicate data.
Assessing
- Interpret and analyze patient data.
- Identify patient strengths and health problems.
- Formulate and validate nursing problems.
- Develop prioritized list of problems.
These are explaining which nursing process phase?
Diagnosing actual or potential health problems and needs.
During the ______ phase of the nursing process you are establishing priorities, writing outcomes and developing an evaluative strategy, selecting nursing intervention, and communicating plan of nursing care.
Planning
Carrying out the care of plan, continuing data collection, modifying the plan of care as needed, and documenting care is explaining the ______ phase of the nursing process.
Implementing
In the _____ phase of the nursing process you are measuring how well the patient has achieved desired outcomes, identifying factors that contribute to the patients success or failure, and modifying the plan of care if indicated.
Evaluating
What are the eight phases in clinical reasoning?
Look, collect, process, decide, plan, act, evaluate, and reflect.
What are three questions that might be helpful to “think like a nurse”
- What did you observe?
- What do you make of what you saw?
- What course of action will you take?
What are the steps for the scientific problem-solving?
Problem identification, data collection, hypothesis formulation, plan of action, hypothesis testing, interpretation of results, and evaluation.
Deductive reasoning relies on applying widely accepted knowledge and principles to a model or a combination of models to solve a problem. This is known as _____ ______.
Backward reasoning
Inductive reasoning requires observing, and then drawing conclusions this is referred to as…….
Forward reasoning
_____ ______ processes require the ability to recognize patterns and connections and form hypotheses and theories.
Inductive reasoning
What are the four core elements in Tanners Clinical Judgment Model?
Noticing, interpreting, responding, reflecting.
Is performed by the nurse with the admission nursing history and the physical assessment.
Initial planning
are prepared care plans that identify the nursing diagnoses, outcomes, and related nursing interventions common to a specific population or health problem.
Standardized care plans
Is carried out by any nurse who interacts with the patient.
Ongoing planning
When does discharge planning occur?
When the patient gets admitted.
What is a high priority?
Greatest threat to patient well-being.
What is a medium priority?
Not life threatening.
What is a low priority?
Not specifically related to current health problems.
What is the order of Maslow’s Hierarchy of Needs?
- Physiologic needs
- Safety needs
- Love and belonging needs
- Self-esteem needs
- Self-actualization needs
Who do you need to communicate the goals and interventions too?
The patient.
What is the difference between long-term and short-term goals?
Long-term goals require a longer period to be achieved and may be used as discharge goals. Short-term goals may be accomplished in a specified period of time.
The goal must be _____.
Measurable.
What are the parts of a measurable goal?
- Subject
- Verb
- Conditions
- Performance criteria
- Target time
What is a nursing intervention?
Any treatment based upon clinical judgment and knowledge that a nurse performs to enhance patient outcomes.
Do nurse-initiated interventions need a health care provider’s order?
No.
You should have an intervention for each _____.
Goal.
Nursing interventions must be ______ _____.
Evidence-based
What are the five elements of evaluation?
- Identifying evaluative criteria and standards. (what you are looking for when you evaluate)
- Collecting data to determine whether these criteria and standards are met.
- Interpreting and summarizing findings.
- Documenting your judgement.
- Terminating, continuing, or modifying the plan.
_____ ______ can be defined as the coexistence of different ethnic, biological sex, racial, and socioeconomic groups within one social unit.
Cultural diversity
______ is defined as a search for meaning and purpose in life.
Spirituality
is about welcoming individuals of all races, religions, nationalities, cultures, ages, sexual orientation, and identities.
Diversity
What is inclusion?
Its about giving everyone a sense of purpose and belonging, a feeling of being valued.
Equity is not about treating everyone the same, it is about….
Ensuring that everyone has access to the conditions they need to thrive.
Who would be included in vulnerable populations?
- Racial and ethnic minorities.
- Those living in poverty.
- Women
- Children
- Those living in rural and/or low-income areas.
- People with disabilities and special healthcare needs.
What is culture?
A shared system of beliefs, values, and behavioral expectations that provides social structure for daily living.
is the coexistence of different ethnic, sex assigned at birth, racial, and socioeconomic groups within one social unit.
Cultural diversity
This enables nurses to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients.
Cultural respect
What are three spiritual needs common to all people?
- Need for meaning and purpose.
- Need for love and relatedness.
- Need for forgiveness.
What does FICA mean?
Faith and belief, Importance, Community, and Address in Care.
What questions are associated with the letter F in FICA?
- Do you consider yourself spiritual or religious?
- Do you have spiritual beliefs that help you cope with stress or in difficult times?
- What gives your life meaning?
What questions are associated with the letter I in FICA?
- Has your spirituality influenced how you take care of yourself and your health?
- Does your spirituality influence you in your health care decision making?
What questions are associated with the letter C in FICA?
- Are you part of a spiritual community?
- Is there a group of people you really love or who are important to you?
What questions are associated with the letter A in FICA?
How would you like me, your health care provider, to address these issues in your healthcare?
A client is admitted with end-stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse whether an acupuncturist can come to the hospital to help manage the pain. The nurse states, “You won’t need acupuncture. We have pain medications.” Which characteristic has the nurse displayed?
Cultural imposition
What are the stages of culture shock?
- Honeymoon
- Disenchantment
- Beginning resolution
- Effective function
What is the priority assessment for the nurse when developing a plan of care for a client living in poverty?
Access to care.
What factor threatens to increase the number of people who are living at poverty level?
Feminization of poverty.
A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, “All these young nurses think they can come in late and leave early.” What cultural factor can the new nurse assess from this conversation?
Stereotyping
What are the three channels of communication?
Auditory, visual, and kinesthetic (touch)
Verbal communication can be _____ or _____.
Spoken or written
Crying, moaning, gasping, and sighing are examples of _____ communication.
Nonverbal
What is intrapersonal communication?
When we talk to ourselves.
What is interpersonal communication?
When we are talking to other people.
What are the two types of group communication?
Small-group and organizational
____ _____ is how individual group members relate to one another during the process of working toward group goals.
Group dynamics
What are factors that influence communication?
- Developmental level
- Biological sex
- Sociocultural differences
- Roles and responsibilities
- Space and territoriality
- Physical, mental, and emotional state
- Values
- Environment
What is SBAR?
Communication from one caregiver to another caregiver.
What does SBAR stand for?
Situation, background, assessment, recommendation.
The S (situation) and B (background) provide _____ data, whereas the A (assessment) and R (recommendations) allow for presentation of _____ data
Objective; subjective
What does CUS stand for?
I’m concerned, I am uncomfortable, this is a safety issue
What do therapeutic relationship and social relationship have in common?
They both use care, concern, trust, and growth.
The ______ ______ does not occur spontaneously. It occurs for a specific purpose with a specific person.
Therapeutic relationship
The therapeutic relationship is characterized by an _____ sharing of information.
Unequal
The therapeutic relationship is built on the ____ needs, not the ____
Patients; nurses
What are the three phases of the therapeutic relationship?
Orientation phase, working phase, termination phase
When does the orientation phase begin, in therapeutic relationships?
During the data-gathering process.
In therapeutic relationship, which phase does this explain?
Setting the tone and guidelines, orientation to facility, room, machines, and goals.
Orientation phase
What are some examples of goals in the orientation phase?
- The pt will call the nurse by name.
- The pt will accurately describe the roles of the participant in the relationship.
- The patient and the nurse will establish an agreement about goals of the relationship, location, frequency, and length of the contancs, and the duration of the relationship.
What is done during the working phase in therapeutic relationships?
Working with the pt to meet physical and psychosocial needs. Time to meet goals. Assist with ADL’s.
- The patient will actively participate in the relationship.
- The patient will cooperate in activities that work toward achieving mutually acceptable goals.
- The patient will express feeling and concerns to the nurse.
These are examples of goals in which phase in therapeutic relationships?
Working phase
In therapeutic relationships, the _____ ____ occurs when the initial agreement is acknowledged (end of shift or pt discharge)
Termination phase
What is done during the termination phase in therapeutic relationships?
- Assess progress of goals and include patient.
- Make the transition smooth for the patient.
These are examples of goals in which phase in therapeutic relationships?
- The patient will participate in identifying the goal accomplished or the progress made toward goals.
- The patient will verbalize feelings about the end of the relationship.
Termination phase
_____ is the ability of the nurse to perceive the meanings and feelings of the patient and to communicate that understanding to the patient.
Empathy
What is rapport?
A feeling of mutual trust experienced by people in a satisfactory relationship.
_____ behavior involves asserting one’s rights in a negative matter that violates the rights of others.
Aggresive
_____ behavior is the ability to stand up for yourself and others using open, honest, and direct communication.
Assertive
What is congruence?
Occurs when words and actions match.
What is an example of empathy vs sympathy?
Empathy - “I see you are sad… How can I help?”
Sympathy - “I feel so sorry for you.”
Always be ____ and ___ with the patient.
Clear and firm
Who identified preconceptions?
Hildegard peplau
What is the order of Carper’s patterns of nursing knowledge?
Empirical knowing, personal knowing, ethical knowing, and aesthetic knowing.
What is an example of empirical knowing?
The client with panic disorder begins to have an attack. panic attacks will raise heart rate.
What is empirical knowing obtained from?
The science of nursing.
Although the patient shows outward signals now, the nurse has previously sensed the patient’s jumpiness and subtle differences in the clients demeanor and behavior. This is an example of _____ knowing.
Aesthetic knowing
What is aesthetic knowing obtained from?
The art of nursing.
______ knowing is obtained from the moral knowledge of nursing.
Ethical
What is an example of personal knowing?
The patient’s face shows the panic
Although the nurse’s shift has ended, they remain with the patient. This is an example of _____ knowing.
Ethical
______ knowing is obtained from life experiences.
Personal
A nurse has been working for 15 hours continuously without a break. The nurse administrator insists that the nurse should go home and sleep. According to the Carper’s patterns of nursing knowledge, which patten of knowing is this indicative of?
Ethical knowing
A nurse is caring for a client with anxiety disorder. The nurse knows the client will have dyspnea and tachycardia if she has an anxiety attack. According to the Carper’s patters of nursing knowledge, which pattern of knowing is this indicative of?
Empirical knowing
When doing care plans, what gets turned into canvas?
Etiology, pathophysiology, medications, labs/diagnostic procedures, and journal entry.
Transparent Dressing
• stage 1
• wounds that are small partial thickness
Hydrocolloid Dressing
• stage 2 & 3
• partial and full thickness wounds
• wounds w light to moderate drainage
Hydrogel Dressing
• stage 2 to 4
• partial and full thickness wounds
• first and second degree burns
• infected wounds
Foam Dressing
• partial and full thickness
• may remain in place for 3-5 days ( 7 for silver foams )
• stages 2 to 4
• not used for wounds with eschar
Antimicrobial Dressing
• stage 2 to 4
• acute and chronic wounds
Negative Pressure Therapy (VAC)
• partial and full thickness
• stage 3 & 4
• may remain in place 3-4 days
