Exam 2: Chapters 6-7 and 11-13 Flashcards
What is a value?
A belief about the worth of something, about what matters, that acts as a standard to guide one’s behaviors.
What is a value?
A belief about the worth of something, about what matters, that acts as a standard to guide one’s behaviors.
What is a value system?
An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct.
What are the common modes of value transmission?
Modeling: to copy
Moralizing: do what told, little opportunity to weigh different values.
Laissez-faire: left to explore alone, no guidance.
Rewarding/Punishing: reward for good values, punished for unacceptable values.
Responsible choice: support/guidance given with freedom to explore competing values.
What values are essential to the professional nurse?
Altruism: concern for welfare and well-being of others.
Autonomy: right to self-determination
Human dignity: respect for the inherent worth and uniqueness of individuals and populations.
Integrity: acting in accordance with an appropriate code of ethics and accepted standards of practice.
Social justice: upholding moral, legal, and humanistic principles.
What is value clarification?
A process by which people come to understand their own values and value system. It is a process of discovery.
What are the three steps in the valuing process?
Choosing
Prizing
Acting
What is ethics?
Systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to conduct and human flourishing.
What are morals?
Refers to personal or communal standards of right and wrong.
What are the 3 types of ethics?
Bioethics: the life sciences
Clinical Ethics: “at the beside”
Nursing ethics: subset of bioethics, formal study of ethical issues that arise in the practice of nursing.
What are the 2 theories of ethics?
Utilitarian: the rightness or wrongness of an action depends on the consequences of the action.
Deontologic: an action is right or wrong independent of its consequences.
What is the principle-based approach?
An ethical approach that combines elements of both utilitarian and deontologic theories and offers specific action guides for practice.
What are the four key principles in the Beauchamp/Childress principle-based approach to bioethics?
Autonomy: respect the rights of patients and their surrogates to make healthcare decisions.
Nonmaleficence: avoid causing harm
Beneficence: benefit the patient, and balance benefits against risks and harms.
Justice: give each his or her due; act fairly
Nursing added 5th Fidelity: keep promises.
What are ethical dilemmas?
Arise when attempted adherence to basic ethical principles results in two conflicting courses of action.
Explain the care-based approach.
Directs attention tot he specific situations of individual patients viewed within the context of their life narrative.
What are feminist ethics?
A particular type of ethical approach popular among nurses. It aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor.
What is ethical agency?
Doing what is right because it’s’ the right thing to do.
What are the essential elements of ethical agency?
Ethical sensibility, ethical responsiveness, ethical reasoning and discernment, ethical accountability, ethical character, ethical valuing, transformative ethical leadership.
What is the patient’s bill of rights?
The rights and responsibilities of the patient while receiving care in the healthcare setting.
What is a value system?
An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct.
What are the common modes of value transmission?
Modeling: to copy
Moralizing: do what told, little opportunity to weigh different values.
Laissez-faire: left to explore alone, no guidance.
Rewarding/Punishing: reward for good values, punished for unacceptable values.
Responsible choice: support/guidance given with freedom to explore competing values.
What values are essential to the professional nurse?
Altruism: concern for welfare and well-being of others.
Autonomy: right to self-determination
Human dignity: respect for the inherent worth and uniqueness of individuals and populations.
Integrity: acting in accordance with an appropriate code of ethics and accepted standards of practice.
Social justice: upholding moral, legal, and humanistic principles.
What is value clarification?
A process by which people come to understand their own values and value system. It is a process of discovery.
What are the three steps in the valuing process?
Choosing
Prizing
Acting
What is ethics?
Systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to conduct and human flourishing.
What are morals?
Refers to personal or communal standards of right and wrong.
What are the 3 types of ethics?
Bioethics: the life sciences
Clinical Ethics: “at the beside”
Nursing ethics: subset of bioethics, formal study of ethical issues that arise in the practice of nursing.
What are the 2 theories of ethics?
Utilitarian: the rightness or wrongness of an action depends on the consequences of the action.
Deontologic: an action is right or wrong independent of its consequences.
What is the principle-based approach?
An ethical approach that combines elements of both utilitarian and deontologic theories and offers specific action guides for practice.
What are the four key principles in the Beauchamp/Childress principle-based approach to bioethics?
Autonomy: respect the rights of patients and their surrogates to make healthcare decisions.
Nonmaleficence: avoid causing harm
Beneficence: benefit the patient, and balance benefits against risks and harms.
Justice: give each his or her due; act fairly
Nursing added 5th Fidelity: keep promises.
What are ethical dilemmas?
Arise when attempted adherence to basic ethical principles results in two conflicting courses of action.
Explain the care-based approach.
Directs attention tot he specific situations of individual patients viewed within the context of their life narrative.
What are feminist ethics?
A particular type of ethical approach popular among nurses. It aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor.
What is ethical agency?
Doing what is right because it’s’ the right thing to do.
What are the essential elements of ethical agency?
Ethical sensibility, ethical responsiveness, ethical reasoning and discernment, ethical accountability, ethical character, ethical valuing, transformative ethical leadership.
Licensure
Process by which a state determines that a candidate meets certain minimum requirements to practice in the profession and grants a license to do so.
What is the purpose of the bill of rights for nurses?
To aid in improving workplaces and ensuring nurses’ ability to provide safe, quality patient care.
What is ethical distress?
Occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action.
What are the 3 basic models of healthcare decision-making?
Paternalistic model
Patient sovereignty model
Shared decision making
What is advocacy?
The protection and support of another’s rights.
What is law?
A standard or rule of conduct established and enforced by the government that is intended chiefly to protect the rights of the public.
Public law
law in which the government is involved directly.
Private law
Also called civil law, regulates relationships among people.
Criminal law
concerns state and federal criminal statutes which define criminal actions such as murder, manslaughter, criminal negligence, theft, and illegal possession of drugs.
What are the 4 sources of laws?
Constitutions, statutory law, administrative law, and common law.
What is litigation?
The process of brining and trying a lawsuit.
Liability
Liability involves four elements that must be established to prove that malpractice or negligence has occurred: DUTY, BREACH OF DUTY, CAUSATION, DAMAGES
Defendant
The one being accused of a crime or tort
What are voluntary standards?
Standards developed and implemented by the nursing profession itself that are not mandatory but are used as guidelines for peer review.
What are legal standards?
are developed by a legislature and are implemented by authority granted by the state to determine minimum standards for the education of nurses, to set requirements for licensure or registration, and to decide when a nurse’s license may be suspended or revoked. Ex: state nurse practice acts
Competent practice
Personal responsibility of the nurse to make sure that his or her educational background and clinical experience is adequate to fulfill the nursing responsibilities described in the job description.
Accreditation
Process by which n educational program is evaluated and recognized as having met certain standards.
Licensure
Process by which a state determines that a candidate meets certain minimum requirements to practice in the profession and grants a license to do so.
Certification
The process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area.
What is a crime?
A wrong committed against a person or his or her property punishable by the state.
What is a misdemeanor?
A less serious crime than a felony. Commonly punishable with fines, imprisonment for less than 1 year, or both, or with parole.
What is a tort?
A wrong committed against a person or his or her property that is subject to action in a civil court with damages usually being settled with money.
What is assault and battery?
Assault: a threat or an attempt to make bodily contact with another person without that person’s consent.
Battery: an assault that is carried out and includes willful, angry, and violent or negligent touching of another person’s body or clothes or anything attached to or held by that other person.
What is defamation of character?
An intentional tort in which one party makes derogatory remarks about another that diminishes the other party’s reputation.
Invasion of privacy
The 4th amendment gives citizens the right of privacy and the right to be left alone. HIPAA!
False imprisonment
Unjustified retention or prevention of the movement of another person without proper consent.
Fraud
Willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property.
What is negligence and malpractice?
Negligence: not doing or doing what a prudent person wouldn’t do.
Malpractice: the term generally used to describe negligence by professional personnel.
Liability
Liability involves four elements that must be established to prove that malpractice or negligence has occurred: DUTY, BREACH OF DUTY, CAUSATION, DAMAGES
Fact witness
nurse who has knowledge of the actual incident prompting the legal case.
Expert witness
Explains to judge and jury what happened based on the patient’s record and to offer an opinion about whether the nursing care met acceptable standards.
Collective bargaining
Legal process in which representatives of organized employees negotiate with employers about such matters as wages, hours, and conditions.
Competent practice
Personal responsibility of the nurse to make sure that his or her educational background and clinical experience is adequate to fulfill the nursing responsibilities described in the job description.
Patient education
PT right to know
PT education is the legal duty of the nurse
PT learning needs must be assessed and education must be conducted to meet patient needs.
Lack of PT education can be deemed as negligence on part of the nurse.
Executing physician orders
Nurses are legally responsible for carrying out the orders of the physician in charge of a patient unless an order would lead a reasonable person to anticipate injury if it were carried out.
Documentation and adequate staffing
Careful documentation is a crucial legal safeguard for the nurse. Documentation must be factual, accurate, complete, and entered in a timely fashion. The presumption of the law is that if something was not documented, it was not done.
Understaffing is a problem that results in reduced quality of nursing care and may jeopardize patient safety. A nurse in an understaffed agency will be held to a professional standard of judgment with respect to accepting responsibility for work and for delegating nursing responsibilities to others.
Professional liability insurance and risk management programs
Professional liability insurance can be obtained through the ANA and other nursing associations and other sources. It ensures protection of the nurse’s best interest, covers nurse beyond facility coverage, covers care or advice given outside of work.
Risk management programs have been designed to identify, analyze, and treat risks. The goal is to reduce malpractice claims.
Incident report
Also called a variance or occurrence report, is used by healthcare agencies to document the occurrence of anything out of the ordinary that results in, or has the potential to result in, harm to a patient, employee, or visitor.
What is a sentinel event?
An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.
Good Samaritan Laws
Laws designed to protect health practitioners when they give aid to people in emergency situations.
Student liability
As a student nurse, you are responsible for your own acts of negligence if these result in patient injury. You are held to the same standard of care that would be used to evaluate the actions of a registered nurse.
Historic evolution of the nursing process
1955- nursing process term used by Hall
1960’s - specific steps delineated
1967 - Yura/Walsh published 1st book nursing pro.
1973 - ANA congress for NP developed SOP
1982 - State board examinations for professional nursing uses nursing process as organizing conept
Nursing process
Access Diagnose Planning Implementation Evaluation
5 characteristics of the nursing process
Systematic - part of an ordered sequence of act.
Dynamic- interaction/overlapping of the steps
Interpersonal - human always at the heart
Outcome oriented - work together identify outcomes
Universally applicable - framework for all activities.
3 PT benefits, 3 nursing benefits of using the nursing process correctly.
Patient benefits:
1. scientifically based, holistic, individualized care
2. continuity of care
3. clear, efficient, cost-effective plan of action
Nursing benefits:
1. work collaboratively with others
2. Satisfaction of making a diff. in the lives of PTs
3. Opportunity to grow professionally
Nursing history
Captures and records the uniqueness of the patient so that care may be planned to meet the patient’s individual needs.
Critical thinking
purpose of thinking adequacy of knowledge Be curious and perservere Be disciplined Creative Demonstrate confidence
What are the 5 steps in concept map care planning?
- develop a basic skeleton diagram
- analyze and categorize data
- analyze nursing diagnoses relationships
- identify goals, outcomes, and interventions
- evaluate patient’s responses
What is a critical pathway?
Critical/collaborative pathway is a case management plan that is a detailed, standardized plan of care developed for a patient population with a designated diagnosis or procedure; it includes expected outcomes, a list of interventions to be performed, and the sequence and timing of those interventions.
Assessing
the systematic and continuous collection, validation, analysis and communication of patient data, or information.
Database
All the pertinent patient information collected by the nurse and other healthcare professionals. It enables a comprehensive and effective plan of care to be designed and implemented for the patient.
Initial assessment
performed shortly after the patient is admitted to a health care agency or service. Purpose is to establish a complete database for problem identification and care planning.
Focused assessment
the nurse gathers data about a specific problem that has already been identified. May be done during the initial assessment if patient health problems surface, but is routinely pare of ongoing data collection.
Emergency Assessment
completed to identify life-threatening problems.
Time-lapsed assessment
scheduled assessment to compare a patient’s current status to baseline data obtained earlier.
Medical assessment
target data pointing to pathologic conditions
nursing assessment
focus on the patient’s response to health problems
Characteristics of data
Complete
Factual and Accurate
Relevant
5 sources of patient data
patient family & significant others patient record other healthcare professionals nursing and other healthcare literature
Nursing observation
The conscious and deliberate use of the five senses to gather data.
Interview
a planned communication. establishes a successful working partnership with the patient, communicates care and concern for the patient, and obtains the necessary patient data
physical assessment
the examination of the patient for objective data that may better define the patient’s condition and help the nurse in planning care.
Nursing history
Captures and records the uniqueness of the patient so that care may be planned to meet the patient’s individual needs.
Preparatory phase
Get rid of stereotypes and biases, open mind and quiet environment.
Introduction
crucial because it sets the tone. by the end the pt should know the name of the nurse and what to expect.
Working phase
head to toe assessment, the nurse gathers all the data needed to have a subjective database
Termination
concluded carefully, highlight key points, “anything else you would like me to know?” Alert PT to what they can expect before you leave and when you will be back.
4 methods used to collect data
inspect
palpate
auscultate
percussion
diagnosing
2nd step in nursing process
nurse interprets and analyzes data
identify pt strengths and health problems.
provide the basis for nursing interventions
health problem
a condition that necessitates intervention to prevent or resolve disease or illness or to promote coping and wellness.
nursing dianosis
an actual or potential health problem that can be prevented or resolved by independent nursing intervention.
Purpose: to clarify the exact nature of the problems and risk factors you need to achieve the overall expected outcome of care.
Collaborative problem
managed by using physician prescribed and nursing prescribed interventions.
What are the 5 types of nursing diagnoses?
Actual Risk Possible Wellness Syndrome
