Final Exam Study Guide Flashcards
Clara Barton
Founded the American Red Cross
Florence Nightingale
- associated with reduced mortality rates during the crimean war
- revered as the founder of modern nursing
- introduced the concept of broad-based liberal education for nurses
Lillian Wald
Considered the start of Public Health nursing in the U.S.
Dependent nursing functions
Administering medications
medication orders are required before meds can be given: exact instructions are required
Independent nursing functions
Nursing standards establish how nurses perform these activities
Not written by a perscriber
Quality & Safety Education for Nurses (QSEN) competencies
- Patient centered care
- Teamwork & collaboration
- Evidence based practice and research
- Quality Improvement (QI)
- Safety
- Informatics
Problem, Etiology, Symptoms (PES)
- Parts of creating a diagnostic statement
- Problem: describes the client’s health status and identifies a response that needs to be changed
- Etiology: contains factors that cause, contribute to, or create a risk for the problem
PICO
- Used in research
- Patient, population, problem
- Intervention, treatment, cause, contributing factor
- Comparison interventions
- Outcome
Full spectrum nursing model
Involves:
- Clinical judgement
- Critical thinking
- Problem solving
NANDA nursing diagnosis components
- Diagnostic label
- Definition
- Defining characteristics
- Related factors
- Risk factors
Nursing Theory
- An organized set of related ideas and concepts that:
- Assist in finding meaning in our experiences
- Organize our thinking around an idea
- Develop new ideas and insights into the work we do
Components of a theory
- Phenomena
- Assumptions
- Concepts
- Definition
- Statements/propositions
Components of the nursing metaparadigm
- Views the person through a lens that focuses more broadly on the entire person
- Not always theories, just how we see things
Madaline Leininger
- Founder of transcultural nursing
- Theory focuses on caring as a cultural competence
- Using knowledge of cultures and nursing to provide culturally congruent and responsible care
Virgina Henderson
- Basic principles of nursing care
- Identifies the 14 basic needs of nursing care
Dr Jean Watson
- Science of human caring
- Describes what caring means from a nursing perspective
Patricia Benner
Novice to expert
- Novice
- Advanced beginner
- Competent
- Proficient
- Expert
Hildeguard Peplau
- Psychiatrist nurse
- Health could be improved for psychiatric patients if there were a more effective way to communicate with them
- Developed the theory of interpersonal relations, which focuses on the relationship a nurse has with the patient
Maslow’s hierarchy
- The lower level (Physiological) must be met to some degree before the higher ones (Trascendence)
- Physiological- food, air, water, temperature regulation, elimination, rest, sex, and physical activity
- Safety and security- Protection, emotional and physical safety and security, order, law, stability, shelter
- Love and belonging- Giving and receiving affection, meaningful relationships, belonging to groups
- Self-esteem- Pride, sense of accomplishment, recognition by others
- Cognitive- Knowledge, understanding, exploration
- Aesthetic- Symmetry, order, beauty
- Self-actualization- Personal growth, reaching potential
- Transcendence- of self; helping others self actualize
Inductive reasoning
- Drawing conclusions from a pattern found in individual pieces of information
- Remember induction by thinking IN-duction
- I have specific data out there and I bring in IN to make the generalization
Deductive reasoning
- Starts with a general premise and moves to a specific deduction
- You have a big picture about what is true in general, and from that you can find out logically what is likely to be true for a particular individual
Subjective data
Covert data, symptoms
the information communicated to the nurse by the client, family, or community
Objective data
Overt data, signs
gathered through a physical assessment or from lab or diagnostic tests
Primary data
The subjective and objective info obtained from the client
What the client says or what you observe
Secondary data
Obtained secondhand for example from a medical record or from another caregiver
Directive interviewing
- To obtain factual, easily categorized info, or in an emergency situation
Closed questions
Questions that can be answered with a yes, no, or short factual answer
Nondirective interviewing
- You allow the patient to control the subject matter
- Your role is to clarify, summarize, and ask mostly open ended questions that facilitate thought and communication
- Ask when you want to obtain subjective data
Open-ended questions
- Specify a topic to be explored
- Are phrased broadly to encourage the patient to elaborate
- Ask when you want to obtain subjective data
The nursing process 6 phases
- Assessment
- Diagnosis
- Planning outcomes
- Planning interventions
- Implementation
- Evaluation
Components of a nursing interview
- Biographical data
- Chief complaint
- Hx of present illness
- Client’s perception of health status
- Past health hx
- Family health hx
- Social hx
- medication hx/ device use
- Complementary/alternative (CAM)
- Review of body systems & associated functional abilities
Physical assessment
- Produces objective data
- Makes use of the techniques of inspection (visual exam), palpation (touch), percussion (tapping on body surface), direct auscultation (listening with unaided ear), and indirect auscultation (listening with stethoscope)
Focused assessment
- Performed to obtain data about actual, potential, or possible problem that has been identified or is suspected
Special needs assessment
Type of focused assessment that provides in-depth info about a particular are of client functioning ofter using a specially designed form
Initial assessment
Completed when the client first comes into the healthcare agency
Functional ability assessment
Especially important in discharge planning and home care initial assessment
Ongoing assessment
Performed as needed at any time after the initial database is completed
Comprehensive assessment
Also called a global assessment, patient database, or nursing database
Provides holistic info about the client’s overall health status
parts of physical assessment
inspection
palpation
percussion
auscultation
NANDA and the nursing diagnosis
Nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable
NANDA nursing diagnosis components
Diagnostic label Definition Defining characteristics Related factors Risk factors
Medical diagnosis
Describes disease, illness, or injury
Nursing diagnosis
A statement of client health status that nurses can identify, prevent, or treat independently
Actual nursing diagnosis
Describes the human response to health conditions/life processes that exist in the individual, family, group, or community
Supported by defining characteristics and related factors
Health promotion nursing diagnosis
A clinical judgment about a person’s family’s, group’s, or community’s motivation and desire to increase-well-being and actualize human health potential
Focuses on being as healthy as possible, as opposed to preventing a disease problem
Risk nursing diagnosis
A clinical judgment about human experience/response to health conditions/life processes that have a high probability of developing in a vulnerable individual, family group, or community
Is supported by risk factors
Syndrome nursing diagnosis
A clinical judgment describing a specific cluster of nursing diagnosis that occur together and are best addressed together through similar interventions
Critical pathways
- Often used in managed care systems
- Outcomes based
- Interdisciplinary plans that sequence patient care according to case type
- Specify and predict patient outcomes and broad interventions for each day, or in situations, for each hour
- Describe the minimal standard of care required to meet the recommended length of stay for patients with a particular condition or diagnosis
Protocols
- Cover specific actions usually required for a clinical problem unique to a subgroup of patients
- May be written for a particular medical diagnosis, treatments, or diagnostic tests
- Contain both medical and nursing orders
- Some include definitions and rationales for interventions
Expected outcomes statement
- The responsibility of the professional nurse
- Should involve the client as much as possible, because goal achievement is more likely if the client believes that goals are important or realistic
5 components of nursing orders
Date Subject Action verb (the nurse is the doer) Times and limits Signature
Implementation
process
delegation
documentation
Ongoing evaluation
While implementing care, immediately after intervention, and at each patient contact
Intermittent evaluation
performed at specified times
Terminal evaluation
Describes the clients health status and progress toward goals at the time of discharge
Structure evaluation
Focuses on the setting in which care is provided
Process evaluation
Focuses on the manner in which care is given, the activities performed by nurses
Outcomes evaluation
Focuses on observable or measurable changes in the patient’s health status that results from the care given
Evaluation
Planned ongoing systematic activity in which you will make judgments about:
The clients progress toward desired health outcomes
The effectiveness of the nursing care plan
The quality of nursing care in the healthcare setting
Revise the care plan
Review of assessment Diagnosis planning outcomes planning interventions implementation Reflect critically about evaluation Evaluate systematically, record the results, use the reassessment data to examine and modify the care plan
PES
Problem
Etiology
Symptoms
problem r/t etiology as manifested by (AMB) signs or symptoms
Assumptions
ideas we take for granted
Phenomena
Aspects of reality that you can observe and experience
Concepts
A mental image of a phenomena. A symbol in your mind
Definition
A statement of the meaning of a term or concept that sets forth the concept’s characteristics or indicators
That is the things that allow you to identify the concept
Operational definition
Specifies how you would observe or measure a concept
Statement (propositions)
Systematically describe the linkages and interactions among the concepts of theory
Paradigm
The worldview or ideology of a discipline
Conceptual framework
A set of concepts that are related to form a whole or pattern
Model
Is a symbolic representation of a framework or concept
a diagram, graph, picture, drawing, or physical model
Reasoning
Connecting ideas in a way that makes sense
Logical reasoning
To develop an argument or statement based on evidence that will result in a logical conclusion
Inductive reasoning
- often used in the nursing process
- moves from specific to general
- you gather separate pieces of info, recognized a pattern, and formed a generalization
Deductive reasoning
starts with a general premise and moves to a specific deduction
Clinical practice theories
very specifically guide what you do each day
Grand theory
Covers broad areas of concern within a discipline
Usually abstract and does not outline specific nursing interventions
Why learn it?
The ability to read and use nursing research enhances your ability to give quality patient care
Research affects you every day you are a nurse
5 phases of the research process
- select and define a problem
- select a research design
- collect data
- analyze data
- use the research findings
Nursing theory
An organized set of related ideas and concepts that
- Assist us in finding meaning in our experiences
- Organize our thinking around an idea
- Develop new ideas and insights into the work we do
Components of a theory
Phenomena Assumptions Concepts Definitions Statements/propositions
Hypothesis
statement the researcher believes to be true and what will be tested through the research project, AKA problem statement
Implications and recommendations
The final pieces of the research critique
The implications are the should of the research
Validity
measures what it says it measures
Reliability
same results (accuracy, consistency, precision) repeatedly
Quanitative
To gather data from enough subjects to be able to generalize the results to a similar population
Reported as numbers
Qualitative
Focuses on the lived experiences of people
The purpose is not to generalize the data, but to share the experience of the person or persons in the study
PICO
Patient, population, or problem Intervention, treatment, cause, or contributing factor Comparison intervention Outcome - Outline for effective research
SBAR
Situation
Background
Assessment
Recommendation
4 components of a written expected outcome
Subject
Action verb
Performance criteria
Target time/date
SMART outcomes statement
Specific Measurable Achievable Realistic Time
Selye
Stress and adaptation theory
States that a certain amount of stress is good for people
it keeps them motivated and alert
However 2 much stress, called distress, results in physiological symptoms and eventual illness
Gordon- Functional patterns (11), NCP organizational format
Health perception/ health management Nutrition/metabolic Elimination Activity/exercise Cognitive/perceptual Self perception/self concept Sleep/rest Role/relationship Sexual/reproductive Coping/stress tolerance value-belief
Clara Barton did not
go to nursing school
Some prisoners did serve in hospitals during the American Civil War
True
Penicillin was invented in
1950s
The teutonic knights were another group of knights who served as caregivers during the
Crusades
As a group they were referred to as hospitalers
Roles and functions of a nurse
Direct care provider Communicator Client/family educator Client advocate Counselor Change agent Leader Manager Case manager Research consumer
Purposes of nursing care
Health promotion
Illness prevention
Health restoration
End-of-life care
Reimbursement is a very important issue but it is not in the
guide to the code of ethics for nurses
Actual nursing Dx have how many ___ parts
3
Health promotion
is the primary prevention
keeping everybody healthy from the get go
Disease prevention
is secondary prevention
specifically trying to prevent the onset of specific illnesses or problems
Etiology of the nursing Dx is not the
medical Dx
Risk Dx have how many parts
2 and no Sx
