Final Exam Flashcards
Supporting patients right to make healthcare decisions when they are unable to voice their opinions and protecting patients from harm when they are unable to make decisions.
patient’s advocate
Changed the way society thought about nurses. Opened up a nursing school and promoted that hand washing is important.
Florence Nightingale
3 elements of “Full Spectrum Nursing”
- clinical judgement
- critical thinking, reflective thinking
- problem solving
Define Nursing as defined by ANA (American Nursing Association):
protection, promotion, and optimization of health abilities - prevention of illness and injury
Minimize risk of harm to patients and providers through both system effectiveness and individual performance.
safety
How can nursing improve its recognition as a profession?
- Standardizing educational requirements
- Uniform continuing education requirements
- Increased participation of nurses in professional organizations
- Educating the public about the true nature of nursing practice
6 things QSEN represents (students should poses all 6 of these things by graduation)
- patient center care
- evidence bases practice
- teamwork & collaboration
- safety
- informatics
- quality improvement
Authoritative statements of the duties that all RN regardless of role, specialty or population are expected to perform competently.
Nursing Standard of Practice
Laws that regulate nursing practice
- State Boards of nursing
- Licensure
- Guide for Professional standards
Nurse Practice Acts
When nurses work on behalf of an individual, group, family, or community to improve their health status
Indirect care
all people able to receive health insurance/no one without health insurance
Affordable care act
Observing, comparing, contrasting, and evaluating the clients condition.
Clinical judgement
Involves collecting and analyzing information and carefully considering options for action.
Critical thinking, reflective thinking
Considering issues and attempting to find a satisfactory solution.
Problem solving
Wound care, IV antibiotics, educating pts. with diabetes.
Skilled Nursing
Which organization is directly responsible for regulating the practice of nursing in each state?
The State Board of Nursing
Each person has a role, clear understanding of tasks assigned. Compartmental care.
Functional Nursing
Diagnosis and treatment of illness, disease or injury. health restoration.
Secondary care
Purposeful, analytical thinking that results in a reasoned decision.
critical thinking
A nurse who is newly employed at a hospital questions a standard of patient care that does not seem to follow evidence-based practice. The critical thinking attitude she is exhibiting is termed:
independent thinking
Phases of the Nursing Process
- Assessment
- Diagnosis
- Planning Outcomes
- Interventions
- Evaluation
How is the Nursing Process Related to Critical Thinking?
Nurses use critical thinking skills to solve the problem by using the nursing process.
A unique blend of thinking, doing, and caring for the purpose of effecting good outcome from a patient situation.
Full-Spectrum Nursing
What are the model concepts of Full-Spectrum Nursing?
- Thinking
- Doing
- Caring
- Patient situation
What are the components of a theory?
phenomena, assumptions, concepts, definitions, and statements/prepositions
worldview or ideology?
Paradigm
Symbolic representation of a framework or concepts?
Model
The nurse notes that his patient has pitting pedal edema, crackles, and an elevated blood pressure. He concludes that the pt. has fluid volume excess. This is an example of:
Theoretical reasoning
Essential concepts of a Nursing Theory
person, environment, health, nursing
The nurse that incorporates Hispanic beliefs about “hot and cold” into her plan of care for her client. This nurse is providing care based on the nursing theory of:
Madeleine Leininger
Steps of the Nurse Research Process
- Identify & state the problem
- Clarify the purpose of the study
- Perform a Literature Review
Systematic collection of data to determine a client’s current and past health status and function status and to determine the client’s present and past coping patterns.
Assessment
Assess overall health status: Observation, Physical assessment, and nursing interview
Comprehensive Assessment
Name 3 requirements Joint Commission uses regarding patient assessment
ALL PATIENTS ASSESSED FOR PAIN, assessments are written, and agency policies are in place related to reassessment and assessment distribution
Perception/feeling of patient, what the patient states.
Subjective data
Observable and measurable can be seen, heard, or felt by another. ex: vital signs, inspection of a wound, description of an observed behavior.
Objective Data
A clinical judgement about individual, family or community responses to actual or potential health problems and or life processes that the nurse is licensed and competent to treat.
Nursing Diagnosis
An actual or potential physiological complication that nurses monitor to detect the onset of changes in a patient’s status
collaborative problem
What is 3 part Actual Dx. Process
Diagnostic Label related to contributing factors as evidenced y defining characteristics.
Data that influence your conclusions about the client’s health status. Should alert you to look for other ____ that might be related to it. Usually an unhealthy response.
cues (significant data)
A broad statement that describes the desired change in a patients condition or behavior.
Goal
Individualized to the patient’s needs, developed with the patient, significant other and nurse (mutually determined), documented and shared with health care team to promote continuity.
Interventions
Knowing how, when, and why to perform an activity makes the action _________
autonomous (independent)
Your decisions and actions with regard to nursing diagnoses and independent interventions.
accountable (answering)
One that is prescribed by the physician or advanced practice nurse but carried out by the bedside nurse.
Dependent intervention
A clinicians specific orders for a type/group of patients.
Standing Orders
Strategies/measures/activities/action that influence patient response
outcomes
Focuses on the setting which care is provided
structure evaluation
Is done at a specified time. Ex: Pt. will lose 1 pound per week until weight of 180 pounds is achieved.
Intermittent evaluation
When does the evaluation process with a patient begin?
Whenever contact with patient occurs
Pathology affecting an organ or body system. Experiences are unique to each individual.
Illness
What is the goal of using client history assessment tool to gather data about nutrition, exercise, leisure activities, spirituality, and home environment?
To increase the client’s awareness of lifestyle choices and his or her role in wellness
5 Stages of Illness Behavior
- Experiencing symptoms
- sick role behavior
- seeking professional care
- dependence on others
- recovery
Created a health grid that plots a person status on health-illness continuum against environmental conditions.
Dunn’s Health Grid
Focus on resolving an issue, making a decision.
Task groups
Focuses on a patient achieving optimal personal growth to achieve goals. Consists of a specific time frame, goal directed and high expectation of confidentiality.
Therapeutic communication
Recommends skills, and attitudes to promote safety.
Quality and Safety Education for Nurses (QSEN)
Prevalent in those older than 65 years old; slippery floors, stairs, tubs; low toilet seat, high bed
Falls (Risk For Fall)
Death or serious injury happening in a hospital.
Sentinel Events
Most frequent assessment you will do as a nurse.
Vital Signs
The nurse would monitor the body temperature most closely/frequently in the care of the client with
a. ) an infection
b. ) an infant
c. ) who has experienced a heat stroke
d. ) with a head injury
D. head injry
What are the common pulse points
apical, carotid, brachial, radial, femoral, popliteal, temporal, and pedal
The quantity of blood pumped out by each contraction of the left ventricle
Stroke volume
The nurse is assessing the dorsalis pedis pulses on an 88 year old client. She notes the feet to be cool and assesses weak, thready pulses. The nurses next action would be to:
Assess the popliteal and femoral pulses
Respiration’s that are regular but abnormally deep and increased in rate
Kussmaul’s Respirations
Gradual increase in depth of respiration, followed by gradual decrease and then a period of apnea.
Cheyne-Stokes Respirations
High pitched continuous musical sounds, usually heard on expiration
wheezes
Discontinuous sounds usually heard on inspiration; may be high-pitched popping sounds or low-pitched bubbling sounds
crackles
A piercing, high-pitched sound heard primarily during inspiration.
Stridor
What should the nurse do if there pt has abnormal respiration’s.
check pulse ox