Exam 4 Flashcards
What is the definition of law?
Standard or rule of conduct established & enforced by government (Designed to protect the rights of the public)
What is litigation?
The process of taking legal action (start)
What is the plaintiff?
The person who brings a case against another in a court of law. The one who was wronged.
What is the defendant?
The individual, company, or institution being accused or sued in a court of law. Presumed innocent until proven guilty
What is the definition of public law?
Regulates relationships bt. Individuals & government
What is the definition of private law?
Regulates relationships among people
What is the definition of criminal law?
Defines criminal actions (e.g. murder, theft)
What is the definition of constitution law?
Fundamental principles or established precedents according to which a state or other organization is governed. (Highest level of law)
What is the definition of statutory law?
Law enacted by a legislative body. (traffic regulation)
What is the definition of administrative law?
Body of law that regulates the operations and procedures of government agencies.
What is the definition of common law?
Law developed through court decisions rather than through statutes. (Ruling made be a judge)
What are the nurse practice acts?
What we can and can’t do
What are nursing standards?
How we do tasks
What are nursing credentialing?
How we become licensed, how we are recognized as a nurse
What are some reasons for suspending or revoking a license?
Drug or alcohol (10-20%), Fraud (misrepresenting self), Deceptive practice, Criminal acts, Previous disciplinary actions, Gross or ordinary negligence, & Physical or mental impairments, including age
What are the steps in revoking a license?
Notice of investigation, Fair & impartial hearing, & Proper decision based on substantial evidence
What are a nurse’s best defenses of license investigation (3)?
Early legal counseling, Character & expert witnesses, & Through preparation for all proceedings
What is a misdemeanor?
A less serious crime, typically punishable by a fine or a short jail term (<1 year)
What is a felony?
A more serious crime, usually punishable by imprisonment for more than one year
What is tort?
A wrong committed by a person against another person or that person’s property; tried in civil court (malpractice)
What is a crime?
Wrong against a person or the person’s property as well as the public
What are examples of intentional torts?
Assault (verbal) & battery (touch), Defamation of character (false info. About someone made publicly), Invasion of privacy, False imprisonment (restraint), & Fraud
What are examples of unintentional torts?
Negligence & Malpractice
6 HIPAA-Ensured pt. rights
See & Copy records, Update (biographical info), Request correction of any mistake, Get Disclosure List, Request Restriction, & Choose How to Receive Info
Categories of malpractice claims?
Failure to: Follow standards, Use equipment correctly, Assess and monitor, Communicate, Document, & Act as a pt. advocate
4 elements of liability
Duty, Breach of duty, Causation, & Damages
What is duty?
The accepting of the assignment
What is breach of duty?
Did not meet the standards
What is causation?
Breach of duty caused something bad to happen
What is damages (liability)?
Pt. suffers (physical or emotional)
3 outcomes of malpractice litigation
Fair settlement, Presented to malpractice arbitration panel, & Brought to trial court
3 roles of nurses in legal proceedings
Defendant, Fact witness (what happen on that shift), & expert witness (legal training & goes to testify)
4 elements of informed consent
Disclosure, Comprehension, Competence, & Voluntariness
3 types of risk management programs
Safety, Product safety, & Quality assurance programs
4 OSHA legal regulations
Use of electrical equipment, Use of isolation techniques, Use of radiation, & Use of chemicals
What is modeling in regards to value transmission?
A method of value transmission where individuals learn behaviors by observing others. Something learned in upbringing (parents)
What is moralizing in regards to value transmission?
A mode of value transmission that emphasizes the importance of moral lessons and ethical principles. (Church, school, etc.)
What is Laissez-faire in regards to value transmission?
An approach to value transmission that allows individuals to make their own choices without intervention. (when parents let you explore your values
What is rewarding & punishing in regards to value transmission?
A technique of value transmission that involves incentives and consequences to influence behavior. (parents punishing when you stray)
What is responsible choice in regards to value transmission?
A value transmission method that encourages individuals to make informed and accountable decisions. (after exploring, you decide what is best for you)
3 main activities of the valuing process
Choosing (freely from alternatives), Prizing (treasuring) (involves pride, happiness, & public affirmation), & Acting (combining choice into one’s behavior)
What is altruism?
Concern for welfare & well-being of others
What is autonomy?
Right to self-determination
What is human dignity?
Respect for inherent worth & uniqueness of individuals & population
What is integrity?
Acting according to code of ethics & standards of practice
What is social justice?
Upholding moral, legal, & humanistic rights
What are bioethics?
Life sciences
What are nursing ethics?
Ethics analysis used by nurses to make ethical judgements
What are feminist ethics?
Critiques existing patterns of oppression & domination in society especially affecting women & the poor
What are the 2 categories of action-guiding theories?
Utilitarian & Deontologic
What is the utilitarian action-guiding theory?
The rightness or wrongness of an action depends on the consequences of the action
What is the deontological action-guiding theory?
An action is right or wrong independent of its consequences
What is the autonomy principle-based approach?
Respect rights of pt. to make health care decisions
What is the nonmaleficence principle-based approach?
Avoid causing harm
What is the beneficence principle-based approach?
Benefit the patient
What is the justice principle-based approach?
Give each his or her due & act fairly
What is the fidelity principle-based approach?
Keep promises
What are the five characteristics of the care-based approach to bioethics
Centrality of the caring relationship, Promotion of dignity and respect, Attention to the particulars of individual pt., Cultivation of responsiveness, & Redefinition of fundamental moral skills
What are the 3 purposes of the code of ethics for nurses?
A succinct statement of ethical obligations & duties, Profession’s nonnegotiable ethical standard, & Expression of nursing’s own understanding of its commitment to society
What are the 6 ICN guidelines to achieve purpose of code of ethics?
Study, Reflect on, Discuss, Use, Work in, & Collaborate
What are the 7 basic tents of bill of rights for RNS?
Practice in a manner that fulfills obligations to society, Pracitce in environments that allow them to act in accordance, Work in an environment that supports & facillitates ethical practice, Freely & openly advocate, Recive fair compenstation, Practice in a safe work enviorment, & Negotiate the conditions of employment
What is the definition of an ethical dilemma?
2+ clear moral principles apply but support mutually inconsistent courses of action (the choices)
What is the definition of 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 (the way it makes you feel)
What are the 4 steps to rising above moral distress?
Ask, Affirm, Assess, & Act (Cycle)
What are the 4 functions of ethics committees?
Education, Policy making, Case review, & Consultation (Occasionally research)
What are the 4 areas of concern for pt. advocates?
Representation of pt., Promoting self-determination, Whistle-blowing, & Being politically active
T/F A child is born with values and forms new values during a lifetime from information from the environment, family, and culture.
False, Rationale: A child is not born with values, but rather forms values during a lifetime from information from the environment, family, and culture.
“Which value involves acting in accordance with an appropriate code of ethics and accepted standards of practice?
A. Altruism
B. Autonomy
C. Human dignity
D. Integrity
E. Social justice”
Integrity
T/F A nurse who is dedicated to providing culturally competent care to her patients finds herself without the resources to communicate with a patient who speaks a different language. This problem may result in an ethical dilemma for the nurse
“False
Rationale: This problem may result in ethical distress for the nurse. 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. Ethical dilemma occurs when two (or more) clear moral principles apply but support mutually inconsistent courses of action.”
“A nurse attempts to obtain an order for a feeding tube for an anorexic teenager who refuses to eat. What is the term for the ethical problem this nurse is experiencing?
A. Deception
B. Confidentiality
C. Allocation of scarce nursing resources
D. Advocacy in market-driven environment
E. Paternalism”
Paternalism
What are the 7 types of loss?
Actual, Perceived, Physical, Psychological Maturational, Situational, & Anticipatory
What is actual loss?
Can be recognized by others
What is perceived loss?
Is felt by person but intangible to others
What is physical loss?
The loss of a tangible item or part of the body.
What is psychological loss?
The loss of emotional or mental well-being or support.
What is maturational loss?
Experienced as a result of natural developmental process
What is situational loss?
Experienced as a result of an unpredictable event
What is anticipatory loss?
Loss has not yet taken place
What the definition of grief?
Internal emotional reaction to loss
What is the definition of bereavement?
State of grieving from loss of a loved one
What is the definition of mourning?
Actions & experssions of grief, including the symbols and cermonies that make up outward expression of grief
What is the definition of death?
The end of biological functions that sustain a living organism.
What are the 4 components of a good death?
Control of symptoms, preparation for death, Opportunity to have a sense of completion of one’s life, & Good relationship with health care professionals
What is the clinical signs of impending death?
Difficulty talking or swallowing, Nausea, flatus, abdominal distention, Urinary and/or bowel incontinence or constipation, Loss of movement, sensation, and reflexes, Decreasing body temperature, with cold or clammy skin, Weak, slow, or irregular pulse, Decreasing blood pressure, Noisy, irregular, or Cheyne-Stokes respirations, Restlessness and/or agitation, & Cooling, mottling, and cyanosis of the extremities and dependent areas
What are Kübler-ross’s 5 stages of grief?
Denial & isolation, Anger, Bargaining, Depression, & Acceptance
What are advance directives?
Legal documents that outline a person’s preferences for medical treatment in case they are unable to communicate their wishes.
What are 4 steps to postmortem care of the body?
Prepare the body, Place in anatomic position, Place identification tags on the body, & Follow local law if pt. died of communicable disease
What are the 3 spiritual needs?
Need for meaning & purpose, love & relatedness, & forgiveness
What are 4 steps to meeting spiritual needs?
Offering a compassionate presence, Assisting in the struggle to find meaning, Fostering relationships that nurture the spirit, & Facilitating pt.’s expression of religious or spiritual beliefs & practices
What are the 7 concepts related to spirituality?
Spiritually, Faith, Religion, Hope, Love, Spiritual health & healing, & Spirituality & everyday living
What is spirituality?
Anything that pertains to the person’s relationship with a nonmaterial life force or higher power
What is faith?
A confident belief in something for which there is no proof or evidence
What is religion?
Term used to describe cultural or institutional religion
What is hope?
Ingredient in life responsible for a positive outlook
What is love?
Connectedness with others
What is spirituality health & healing?
Spiritual needs are met
Where is spirituality and everyday living found?
In health & illness
What are the 5 factors affecting spirituality?
Developmental considerations, Family, Ethnic background, Formal religion, & Life events
What are the 5 goals/outcomes of spiritual distress?
Explore the origin, Identify factors, Explore alternatives, Identify spiritual supports, & Report or demonstrate decreased spiritual distress after intervention
What are the IOM’s 6 outcomes for a new health system for the 21st century?
Safe, Effective, Efficient, Patient-centered, Timely, & Equitable
What are IOM’s 4-tiered strategy to prevent medical errors?
Establishing a national focus, Identifying & learning from errors, Raising performance standards & expectations, & Implementing safety systems
What are the 3 PPACA goals?
Expand coverage, control costs, & improve delivery system, Provide Medicaid, & Provide a new way to get health insurance
What is primary health care?
Treatment of common health problems
What is secondary health care?
Treatment of problems requiring more specialized clinical expertise
What is tertiary health care?
Management of rare & complex disorders
What is respite care?
Temporary relief for caregivers by providing short-term care for individuals with disabilities or chronic illnesses.
What is Hospice service?
Comprehensive care that focuses on the quality of life for patients with terminal illness.
What is palliative care?
Specialized medical care that aims to provide relief from symptoms and stress of serious illness.
What are the 4 roles of the nurse in the community based care?
Provide continuity of care, Provide interventions, Manage acute or chronic illness, & Promote self-care
What are the 3 roles of the community-based nurse?
Pt. advocate, Coordinator of services, & Pt. & family educator
What is care transition?
A continuous process in which a patient’s care shifts from being provided in one setting of care to another
5 factors of establishing an effective nurse-pt. relationship?
Reduce anxiety, Remember that the pt. has concerns & needs other than medical ones, Communicate with the pt. as an individual, Take time to learn about pt.,& Provide for family participation.
What does ISBARQ stand for?
Introduction, Situation, Background, Assessment, Recommendation, & Question & answer
What are the 5 essential components of discharge planning?
Assess strengths & limitations of pt., Assess the environment, Implement & coordinate the care plan, Consider individual, family, and community resources, & Evaluate effectiveness of care
What are the 5 guidelines for discharge planning?
Assess & identify health care needs, Set goals with pt., Teach pt. & family, Provide home health care referrals, & Evaluate discharge planning effectiveness
What are the 2 phases of the home visit?
Pre-entry phase & Entry phase
What are the 3 aspects of the pre-entry phase?
The referral nurse collects pt. data, The nurse reviews the data & schedules visit, & The nurse evaluates safety issues
What are the 3 aspects of the entry phase?
The nurse ids. needs & determines interventions, The nurse teaches the pt. & caregivers, & The nurse documents care given in the home
What is culture?
Shared system of beliefs, values, and behavioral expectations
What is subculture?
A group of people within a larger culture who differentiate themselves from the larger culture through distinct values, norms, and lifestyles.
What is the definition of dominant group in society?
Group has the most authority to control values & sanctions of society
What is the definition of minority group in society?
A physical or cultural characteristic identifies the people as different from dominant group
What is cultural assimilation?
The process by which a person or a group’s culture comes to resemble those of another group. (Values replaced by those of dominant culture)
What is culture shock?
The feeling of disorientation experienced by someone when they are suddenly subjected to an unfamiliar culture. (May result in psychological discomfort or disturbances)
What is ethnicity?
A social construct that categorizes people based on shared cultural traits, language, or national origin.
What are cultural traits?
Characteristics and features that define and shape a culture.
What is race?
A social construct used to categorize people based on physical characteristics such as skin color. (DNA structure)
What is stereotyping?
Oversimplified and fixed ideas about a group or individuals that may not reflect reality.
What is prejudice?
A preconceived opinion or judgment about a group or person, is often based on stereotypes.
What is discrimination?
The unjust treatment of different categories of people, often stemming from prejudice.
What is cultural imposition?
Belief that everyone should conform to the majority belief system
What is cultural blindness?
Ignores differences & proceeds as if they did not exist
What is culture conflict?
People become aware of differences & feel threatened (Response: ridiculing beliefs & traditions of others to make themselves more secure
What is ethnocentrism?
Belief that one’s ideas, beliefs, & practice are the best or superior or are most preferred to those of others
What are some examples of cultural influences on health care?
Physiological variations, Reactions to pain, Mental health, Gender roles, Language & communication, Orientation to space & time Food & nutrition, Family support, & Socioeconomic factors
What is cultural competence?
The ability to understand, communicate with, and effectively interact with people across cultures.
What are some elements of cultural competence?
Develop self-awareness, Demonstrate knowledge & understanding, Accept & respect differences, Do not assume beliefs & values are the same, Resist judgmental attitudes, Be open to & comfortable with cultural encounters, & Accept responsibility for own cultural competency
What are the 6 guidelines for providing culturally competent care?
Develop cultural self-awareness, Develop cultural knowledge, Accommodate cultural practices, Respect culturally based family roles, Avoid mandating change, & Seek cultural assistance
What is cultural awareness?
Recognition of the differences and dynamics of various cultural practices and values.
What are 8 factors effecting sleep?
Developmental considerations, Motivation, Culture, Lifestyle & habits, Environmental factors, Psychological stress, Illness, & Medications
Why does gastroesophageal reflux influence sleep (GERD)?
Stomach acid increases at hs, often wake up in the middle of the night
Why does coranary artery diseases influence sleep?
Pain with MI is more likely at night during REM sleep
Why does epilepsy influence sleep?
More in NREM because the body is in a paralyzed state during REM
Why does liver failure and encephalitis influence sleep?
Cause a reversal in day/night sleep
Why does hypothyroidism influence sleep?
Decrease the amount of NREM sleep
Why does end-stage renal disease influence sleep?
Nocturnal urination
What is obstructive sleep apnea?
A sleep disorder characterized by repetitive interruptions in breathing during sleep.
What does dyssomnia mean?
Difficulty sleeping
What are 2 temporary pharmacologic therapy for dyssomnia?
Sedatives & Hypnotics
What is acute pain?
a type of pain that typically comes on suddenly and is usually sharp in quality, often indicating injury or illness.
What is chronic pain?
a type of pain that persists for a long time, often lasting for more than 3 to 6 months, and may not have an obvious cause.
What is nociceptive pain?
Caused by actual or threatened damage to tissue. Normal pain process.Pain receptors
What is cutaneous pain?
Superficial pain involves the skin or subQ tissue. (paper cut or sunburn)
What is somatic pain?
Pain on external wall structures originates in tendons, ligaments, bones, blood vessels, nerves. It’s scattered pain. (gnawing or cramping)
What is visceral pain?
Internal organ pain poorly localized and originates in body organs in the chest, head, and abd (deep and aching)
What neuropathic pain?
Nerve pain Described as burning, tingling, stabbing. (sharp/zinging pain)
What is physical origin of pain?
Caused of pain can be identified
What is psychogenic origin of pain?
Cause of pain cannot be identified
What is referred origin of pain?
Pain is perceived in an area distant from its point of origin
What is phantom pain?
a sensation of pain that feels like it’s coming from a body part that has been removed
What are the 4 steps to cancer or chronic pain management?
Give medications orally if possible, Administer medications ATC rather then PRN, Adjust the dose to achieve maximum benefit w/minimum side effects, and Allow pt. as much control as possible over regimen
What are some s/s of dying?
Terminal restlessness (agitation or discomfort), decreased appetite, changes in breathing, withdrawal, decreased urine output, sensory decline, cooling of extremities, and changes in consciousness
