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NRSG 225- Intro > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

evidence-based practice- what

A

back/ scientific justification for actions

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2
Q

AACN

A

action putting current evidence into practice

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3
Q

evidence-based p- purpose

A

guide interventions and clinical decision making

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4
Q

traditional v authoritative v scientific knowledge

A

traditional- way always done it
authoritative- expert knowledge
scientific- evidence based (research studies)

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5
Q

national institute goals research

A

prevent dis, build scientific foundation, manage symptoms

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6
Q

evidence based goals- people v nursing process

A

education, policy dev, ethics, nursing history

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7
Q

qualitative v quantitative

A

quality v quantity (numbers) b/ include population and data

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8
Q

health

A

state complete physical, mental, and social wellbeing in addition to absence of disease or infirmity (weakness)

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9
Q

illness

A

reponse to dis, abnorm process involving changed lvl of funct

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10
Q

wellness

A

state being healthy by living lifestyle promoting good physical, mental and emotional health

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11
Q

does healthy = problem free

A

no

person can still have problems and considered healthy

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12
Q

health dimensions

A

iessep

intellectual, environmental, spiritual, sociocultural, emotional, physical

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13
Q

dimensions of health- physical, environ, intellectual

A

physic- genetics, age, dev lvl
environ- housing, sanitation, climate, nutritional access
intellect- cog abilities, education

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14
Q

dimensions of health- sociocul, emotional, spiritual

A

socio- economic lvl, lifestyle, family cul
emotional- body responce to changing conditions
spiritual- beliefs/values

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15
Q

acute illness

A

rapid onset
brief length
ex. flu, gi bleed, pancreatitis, food poisoning, pneumonia

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16
Q

chronic illness

A

permanent, irreversible changes
2-3 months, long time
ex. heart dis, lung dis, diabetes, kidney dis, arthritis

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17
Q

remission

A

pat have dis but sympt not present

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18
Q

exacerbation

A

sympt of dis present/ and or exaggerated

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19
Q

morbidity

A

freq. of dis/illness

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20
Q

mortatily

A

number deaths due specfic dis/illness

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21
Q

illness beh- stage 1

A

symptoms appear- do not affect ADLs

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22
Q

illness beh- stage 2

A

sick role
decide if need to take action
go to doctor
impede norm activity func.

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23
Q

illness beh- stage 3

A

dependent role

take prescrip or hospitalized

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24
Q

illness beh- stage 4

A

IV recovery and rehab

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25
Q

risk factors for illness

A

genetic factors, age, physicological, environ, health habits

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26
Q

purpose health illness continuum

A

measure lvl of health
stages range frm death to high lvl wellness
illustrates dynamic state of health

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27
Q

primary health promotion

A

weight loss
diet, exercise, smoking cessation
(modifiable, used to prevent dis)
most important

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28
Q

secondary health promotion

A

screenings, exam, family counseling
(ID illness early on)
performing stage

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29
Q

tertiary health promotion

A

intervention based

ex. meds, surgery, OT/PT

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30
Q

aging adult objectives

A

descr, id, compare, desc, id
describ theories of aging
id health problems/illne common in middle age to older
compare myths to realities
desc possible physiological changes occur w/ age
id nursing intervent to promote health

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31
Q

leading cause death in middle to older age

A 
malignant neoplasms (cancer)
cardiovasc dis (heart dis)
unintent dis (falls, accidents)
diabetes mellitus
cerebrovascular accidents (stroke)
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32
Q

major health problems in middle to older age

A 
cardiovasc and pulm dis
cancer
rheumatoid arth
diab. mell
obesity
alcholism
depression
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33
Q

myths abt older adults

A 
incontin is expected
aggressive treatment is not appropriate
not interested in sex
lonely
appearance not important
mental deterioration common
always live in nursing homes
ageism occurs at 65
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34
Q

integumentary changes in older

A

alopecia, less elasticity, thickening nails, thinning skin, altered pigmen

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35
Q

musculoskel changes in older

A

brittle bones, dec ROM, less musc mass and strength

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36
Q

neruo changes in older

A

slowed response/reflex, alt temp reg (colder), alt pain perception

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37
Q

sensory changes in older

A

visual and hearing dec

taste and smell alt

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38
Q

cardiopulm changes in older

A

dec elasticity of blood vess and lung tissue

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39
Q

gastrointestinal changes in older

A

dec absorp and motility

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40
Q

genitourinary changes in older

A

frequency, retention, dec kidney func

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41
Q

risks assoc w/ chronic dis

A

inc ability to have o/ problems

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42
Q

risks w/ age

A 
falls
mental impairments (not occur as a result of e/o) have own occurance
maltreatment (abuse, neglect, abandonment, and exploitation)
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43
Q

nursing care goals for older

A 
promote indep. func
support indiv. strengths
prevent complications of illness
secure safe/comfort environ
promot return health
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44
Q

five prts communication (berlo)

A

stimulus of referent (why need comm in first place)
sender/ source message (encoder)
message itself (content)
medium or channel of comm (verbal v visual)
receiver (decoder)

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45
Q

four lvls comm

A

intrapersonal (self talk)
interpersonal (btw 2+ ppl w/ goal exchange info)
group
small group, organizational communication, group dynamics

46
Q

chara effecting effectivenss of comm

A 
group id
cohesiveness
patterns of interaction
decision making (hierarchical?)
responsibility
leadership
power
47
Q

factors influc comm

A

dev lvl, gender, sociocul differences, roles/ responsibilities (charge nurse v cna), space and territory, physical, mental and emotional state, values, environ

48
Q

factors affecting interpretation of message

A

body lang
current mood
background of decoder

49
Q

electronic comm- regulated by, email and text protocol

A

reg- ANA and NCSBN rules for social media

email- risk violating hippa rules privacy and confidentiality

50
Q

helping relationship

A

not occcur right away
strength relationship= effectiveness of care
characterized by unequal sharing of info
built on pat needs
nurse= helper, pat is person being helped
used establish rapport

51
Q

charac helping relationship

A

dynamic, purposeful, time limited, helper accountable for outcomes and interventions

52
Q

phases helping relationship

A

orientation
working
termination (end shift or goal met)

53
Q

orientation phase goals

A

pat descr participants in relationship (name, role and purpose)
pat and nurse agree goals relationship, location, freq, duration of contact, and duration of relationship

54
Q

goals working phase

A

pat actively particip in relationship
pat coop in act to achieve goals
pat express feelings and concerns to nurse

55
Q

goals termination phase

A

pat particip in id goals accomplished or progress made
pat express feelings abt termination of relationship
*bed side report important
as if pat has anything to add

56
Q

dispositional traits

A

promote effective comm

ex. eye contact, tone, empthy, openness, respect, caring, competence

57
Q

rapport builders

A

privac and confiden, optimal pacing, comfortable environ, patient v task focus (asure care abt well being and remember purpose of task)

58
Q

SBAR purpose

A 
hand off comm
used if calling provider
situation (why calling)
background
assessment (what think issue is)
reccomendation
59
Q

good conversational skills

A 
be knowledgeable abt topic
control tone
be clear and concise
be truthful 
flexible and open mind
avoid words could have diff interpretations
60
Q

good listening skills

A 
alert
eye contact
approp facial express and body gestures
think before responding
listen for themes in pat comments
*meet people where they are, think what do I not know, validate!!
61
Q

interview techniques

A 
open ended, closed
validate or clarify
reflective
sequencing
directing questions/comments
62
Q

charac of assertive self-presentation

A 
confident, concise i statements
effectively share feelings and thoughts
calm under supervision, ask for help when necessary, give and accept complements
admit mistakes (accountable)
*acknowledge when people do things right
63
Q

agressive beh ex

A 
assert ones rights in neg manner violates rights of o/
verbal, physical
tensions and anger
ppl like to win at all costs
make accusations, demostr intolerance
64
Q

communication blocks

A

not listen, use closed questions, nontherapeutic comments, judgemental, false assurance, disruptive interpersonal beh, gossip, changing subject

65
Q

disruptive interpersonal beh

A

incivilty
bullying- horizontal, nurse and physician
how organization responds to disruptive beh

66
Q

goals teaching/counseling

A

maintaining / promoting health
prevent illness
restore health
facilitate coping (family and personal)

67
Q

patient education

A

prep to receive care (what to expect, discuss goals)
pre before discharge
document pat. education act (verbal, or motor)

68
Q

teaching acronym

A

t- tune into patient (body lang and attention lvl)
e- edit patient infro
a- act on every teaching moment
c- claify
h- honor patient as partner in ed process

69
Q

learning domains (3)

A

cog- recall and verbalize learned info
psychomotor- demonstrate physical skill
affective- change attitude, values and feelings (why is education important)

70
Q

factors affecting patient learning

A 
age, dev lvl
family support
financial resources
cul influences
lang deficiet (don't use family as translator)
health literacy lvl (don't assume know)
71
Q

critical dev areas

A 
physical maturation/abilities
psychosocial
cog capacity
emotional maturity
moral/spiritual dev
72
Q

cope model

A 
method for ed delivery
c- creativity
o- optimism
p- planning
e- expert info
73
Q

assessment parameters

A

affective, cog, and psychomotor
readiness to learn
ability learn (can depend dev lvl)
learning strengths (visual v auditory)

74
Q

inc compliance

A

goals are understandable and realistic
inc patient and family
use interactive teaching
dev rapport w/ pat and family

75
Q

culturally competent patient education

A

dev understanding of cul and values
be aware bias, assumptions
use material in preferred language

76
Q

four assumptions abt adult learners (knowles)

A

inc independence w age
previous experiences alter perceptions
readiness to learn depends on dev lvl
most only want to learn material that is useful

77
Q

teaching plans for older adults

A 
id learning barriers (hearing and vision)
allow extra time
plan short teaching sessions
reduce environ distractions
relate new info to familiar activities
78
Q

teaching strategies

A

audiovisual, written mat, discussion, lecture, demonstration, discovery, role-playing

79
Q

factors that effect communication

A 
distraction, environment
tone, vocab used,
ask questions
clear and concise
don't interrupt
80
Q

nurse coaching

A

empower pt reach goals
create structure
id opportunities and concerns
id readiness for education

81
Q

feedback about learning

A

celebrate learning
eval teaching
revise plan

82
Q

how to document teaching-learning process

A

summary of learning need
the plan
implementation of plan
eval results

83
Q

types counseling

A

short term- situational (pain)

long term- developmental crisis (ambulation)

84
Q

culture

A

group w shared beh patterns learned through socialization

inc- location, sexual orientation, religion, race

85
Q

cultural humility

A

subjective- ongoing

86
Q

cultural competence

A

objective view, you are the expert

87
Q

health disparity

A

preventable differences of disadv populations

88
Q

subculture

A

group w/ characteristics not common to larger group

89
Q

cultural assimilation

A

minorities lose characteristics to dominant group

90
Q

culture shock

A

discomfort when placed in alt culture

91
Q

cultural imposition

A

belief everyone should conform to majority belief

92
Q

cultural conflict

A

ppl aware of cul differences and feel threatened

93
Q

ethnicity

A

based on heritage
share beh, and beliefs
dev through day to day life

94
Q

ethnocentrism

A

belief that ideas are superior to all o/

95
Q

cul influences on healthcare

A

reactions to pain, mental health, gender roles, language, family supp, nutrition, socioeconomic

96
Q

care considerations for pain

A

not assume
respect right to response of pain
respect beliefs about pain
sensitive to nonverbal cues

97
Q

culture of poverty

A

need gov aid, unstable family structure, dec community involvement
feelings of despair

98
Q

factors affect cul interactions

A

pt prev hx
dominant cul of environment
expectations about care

99
Q

purpose of documentation

A

legal, reimbursement, education, research, performance improvement, diag, comm, care planning

100
Q

documentation components

A

content, timing, format, accountability, confidentiality

101
Q

policy for verbal orders

A

record in chart, read back to verify accuracy, date/ time, record physicians name

102
Q

personal health records (PHR)

A

standalone

tethered/connected

103
Q

benefits health info exchange

A

improve quality and safety
stim pt education/ involvement
inc community in public health

104
Q

methods of documenting

A

chart (focus, exception, pie), source/problem oriented, case management, electronic health record

105
Q

documentation formats

A

flow chart, term summary, progress notes, med record, care plan

106
Q

flow sheet types

A

24 input/output
MAR
acuity record
24hr pt care record

107
Q

requirements for home health

A

rehab pot is good or hospice
pt not stabilized
pt making progress

108
Q

ISBARR

A

hand off communication

intro, situation, bckgrnd, assessment, recommendation, read back orders

109
Q

components in change of shift report

A

appraisal of health status, new orders, abnormal things during shift, unfufilled orders, family concerns

110
Q

pt care discussion

A

rounds
interdisciplinary conferences
referrals

NRSG 225- Intro (5 decks)

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