Exam 2 Blueprint Flashcards
What is the primary ethical responsibility for nurses?
Respect for people
What are Kohlburg’s Stages of Moral Reasoning?
Preconventional(1), Conventional(2), Postconventional(3)
Preconventional Stage
Moral reasoning is based on own perspective & is self-centered & responds to punishment
Conventional Stage
Moral decisions conform to expectations set by family, a group, or society. Most adolescents and adults function at this stage
Postconventional Stage
Ability to define his/her own moral values. Not all people reach this stage
What is the belief associated with Kohlburg’s stages?
Education, conflict, shared responsibility, & participating in decision making promotes the progression of moral reasoning.
What are Gilligan’s Stages of Moral Reasoning?
- Orientation to individual survival
- Focus on goodness w/ recognition of self-sacrifice
- Morality of caring & being responsible for others, as well as self
What is the belief associated w/ Gilligan’s Stages?
Women have a different sense of moral reasoning than men. Women are more focused on care; men are more focused on justice.
Autonomy
Individuals have the right & freedom to make their own decisions
Beneficence
-Promoting good & avoiding harm
-May be in conflict w/ what a pt. wants & can cause conflict w/ autonomy
Nonmaleficence
-Duty to do no harm
-Foundations of the Hippocratic oath & Code of Ethics for Nurses
-Must not act in manner to intentionally harm a patient
Justice
That everyone w/ the same diagnosis receive the same lvl of care
Fidelity
Honoring one’s commitments or promises
Veracity
Telling the truth, or not lying
What is the ethical decision making model?
- Clarify the ethical dilemma
- Gather additional data
- identify options
- make a decision
- act
- evaluate
Rights & responsibilities of nurses is related to what?
people, society, co-workers, & the profession
System
“a set of interrelated parts that come together to form a whole that performs to function”
Philosophy
Set of beliefs act the nature of how the world works
Nursing philosophy
puts together concepts of the metaparadigm
Holistic nursing care nourishes what?
the whole person(body, mind, & spirit)
Nursing is an (blank) system
Open system
Nursing is the provision of (blank)
health care services
Nursing involves (blank) w/ pts. & their families
Collaborating
Nursing is integrally (blank)
integrally involved w/ people
Nursing Care is (blank) of diagnosis, individual differences, age, beliefs, gender, sexual orientation, or other factors
provided regardless
Nurses require (blank)
advanced knowledge & skills
Nursing requires concern, compassion, respect, & warmth, as well as (blank)
comprehensive, individualized planning of care, to facilitate pts’ growth toward wellness
Nursing links what?
theory & research
What was the focus of Nightingale’s philosophy?
the relationship between the pt., environment, & health
Nightingale recognized the importance of what?
clean air, water, adequate ventilation, rest, sunlight, & proper nutrition
Nightingale encouraged the arrangement of beds how?
She recommended they be in direct sunlight
Henderson believed what to be the unique function of the nurse to be what?
to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery(or peaceful death)
Henderson demonstrated what?
the nurse’s role changing on a day to day basis in relation to the changes in pt. needs
Orem’s self care model focuses on what?
pt. self-care capacities & the process of designing nursing actions to meet the pt. self-care needs
According to Orem’s model, the nurse prescribes & regulates the nursing system on the basis of what?
the pt.’s self-care deficit
Roy’s adaptation model provides what?
a comprehensive understanding of nursing form the perspective of adaptation
When demands of environmental stimuli are too high or the person’s adaptive mechanism are too low, what happens to the person’s behavioral responses?
They are ineffective for coping
According to Roy’s adaptation model, the nurse promotes what?
patient adaptation & coping
According to Roy’s adaptation model, the nurse modifies what?
the environment to facilitate pt. adaptation
The nursing profession evolved from what?
applied vocation dependent on knowledge from the other disciplines to its current stage of development w/ its own knowledge base
Research
systemic investigation of phenomena r/t improving patient care
Research process
- identification of a research problem
- review of the literature
- formulation of the research question or hypothesis
- design of the study
- implementation of the study
- drawing conclusions based on findings
- discussion & implications
- dissemination
Qualitative research
exploration of human experience, described & interpreted by the researcher
Quantitative research
experimental designs driven by hypotheses measurable variables & outcomes, & statistical analysis
Evidence based practice
an approach to the delivery of healthcare that integrates the best evidence from studies & pt. care data w/ clinician expertise & pt. preferences & values
PICOT
P- population of interest
I- Intervention
C- Compassion
O- Outcome
T- time
What is the final step of EBP approach to problem resolution?
Disseminating the results & findings through presentations & papers
In nursing research study, what must occur to ensure data collection is valid?
Data collection tool must measure the concept its supposed to
What is the use of research as a nursing student?
learning art research, doing honors projects or assisting in laboratories
What is the use of research w/ a BSN?
identifies problems that can be studied; may do data collection for research studies
What is the use of research w/ a MSN?
replicates earlier research; beginning independent research
What is the use of research w/ a DNP?
connect research to practice; do research in collaboration w/ a PhD-prepared colleague
What is the use of research w/ a PhD?
generate & test theory; establishing independent research career w/ external funding
Clinical judgement
Make observations & draw conclusions about the patient’s needs or health problems & determine appropriate actions
Clinical judgement develops over time w/ what?
pt. contact
What are some opportunities to improve clinical judgement?
-Concept mapping
-reflective thinking
-Having discussions w/ colleagues
-Be inquisitive
-Be aware of personal basis
-Assess your own thinking style & problem-solving methods
Nursing Process
standard in which problems are addressed & solved
Nursing process steps
-Assessment
-analysis/identifying the problem
-planning
-implementation of planned interventions
-evaluation
Therapeutic Use of Self
use of personality & communication skills to help pt.
Therapeutic use of self helps develop what kind of relationship?
nurse-patient relationship
What are the 3 phases associated w/ therapeutic use of self?
Orientations phase, working phase, termination phase
Orientation phase
-establishes trust
-helps develop understanding of pt. problems & needs
Working phase
-Comfort is established between pt. & nurse
-Pt.’s may exhibit alternated periods of intense effort & periods of resistance to change
-Regression often precedes positive change
-Requires patience, self-awareness, maturity, active listening
Termination phase
-End relationship in therapeutic manner
-Begins w/ orientation phase
-Positive & negative feelings
-Positive feelings are often about gains made
-Negative feelings are often sadness, anger, & fear-loss
Criteria for successful communication
-feedback
-appropriateness
-efficiency
-flexibility
Collaboration
working jointly w/ other professionals (safety tool)
Communication tools that promote safety
-IPASS
-SBAR
-CHEACKBACK
-HANDOFFS
Guilt (impact of illness on pt.)
pt. May feel guilty about the illness, especially if the illness is associated w/ lifestyle
Anger (impact of illness on pt.)
common emotional responce, especially Anglo-American culture, when illness requires sacrifice or lifestyle changes
Anxiety (impact of illness on pt.)
-Mild produces increased alertness
-Moderate affects ability to concentrate
-Severe causes thoughts to become scattered
-Panic is when the person becomes completely disorganized & losses ability to differentiate reality & unreality
Impact of illness on family
-Disrupted functioning of the entire family
-Uncertainty about how to treat ill family member
-Anxiety, anger, guilt, depression at having to take over responsibilities of ill family member
-Withdrawal from family participation or ill family member
-Caregiver stress
What is caregiver stress?
common in families of pts. with prolonged, progessive illnesses
Symptoms of caregiver stress
denial, anger, social withdrawal, anxiety, depression, exhaustion, sleep disturbances, irritability, lack of concentration, & health problems
Stress
nonspecific response of the body to any demand made on it(w/ environmental component)
internal stressor
Self & self perceptions
external stressor
environmental, such as noise, cold, malfunctioning equipment, bad behavior
interpersonal stressor
demands made by others; conflicts w/ others
physiologic response to stress
fatigue, muscular tension, increase in HR & respirations, insomnia or excessive sleeping, eating impairment
social & emotional response to stress
social isolation, distancing from others, hopelessness, perception of lack of control, irritability, impatience
cognitive responce to stress
interference in cognitive function, decreased mental capacity & problem-solving, difficult decisions
When coping is direct…
identify situations that can be changed & take responsibility for changing them
When coping is indirect….
reduce the affective (feelings) & physiologic disturbances resulting in stress
Cultural competence
Services that are respectful of and responsive to the health beliefs and practices and cultural and linguistic needs of diverse patient populations
What can the nurse experience when others’ needs take too great of priority?
Compassion fatigue
Compassion fatigue
negative feelings in which one experiences loss of physical energy, burnout, accident proneness, emotional breakdowns, apathy, indifference, poor judgment, & disinterest in introspection
What should the nurse find in relation to self-care?
balance between caring for others & self-care
What is key to optimal health
Balance
