Fundamentals Of Nursing Flashcards
What is the job of the state board of nursing?
Manage nursing licensure, testing requirements, and nursing education program standards.
What is the job of the nursing practice acts?
Legal document that governs nursing practice in each state. Defines nursing scope of practice of clear definitions of roles. Nurses who violate the defined standard of care face discipline.
What is a big thing to remember about the nurse practice act‘s?
The laws affecting your practice is different in each state.
What does evidence-based practice mean?
Utilizing the best evidence from research to guide nursing practice.
What does the American nurses Association do?
Establishes ethical standards for the nursing profession.
What is an ethical dilemma? Example?
Conflicting values that causes stress and controversy. For example, daughter of an intubated patient with terminal cancer does not want her mother to have opioid pain medication due to religious reasons even though she is in severe pain.
What is an ethics committee? And what do they do?
Interdisciplinary team, made up of a nurse physician social worker, that provides guidance in the face of ethical dilemma. Provides recommendations, does not impose decisions.
What is autonomy? Example?
Autonomy is the patient’s right to make their own healthcare decisions. For example respect to patients right to refuse a treatment.
What is beneficence? Example?
Beneficence is to promote good. For example, take a patient outside to get fresh air.
What is nonmaleficence? Example?
Nonmaleficence is to avoid causing harm. For example, performing multiple checks to avoid a medication error.
What is justice? Example?
Justice is to treat fairly and equally. For example, distribute care equally among assigned patients.
What is Fidelity? Example?
Fidelity is to be faithful and loyal. For example, keep promises to a patient.
What is advocacy? Example?
Advocacy is to promote/protect patients rights, health, and safety. For example, notify provider of concerning change in patient’s condition.
What is veracity? Example?
To tell the truth. For example, be honest with patient about possible side effects of the medication.
If a patient is not orientated can they give consent?
They may not give consent.
When can a minor, less than 18 years old, have the right to consent to treatment?
If they are emancipated, married, in the military, or requiring mental health/substance abuse/STI treatment.
If a patient has questions about the procedure before or after provided consent what should you do?
The provider must be contacted to answer them.
Can a patient who does not speak English give consent? When can they give consent?
They can only consent when there is a medical interpreter available to translate.
Can a patient change their mind after they have already consented?
Yes.
What is informed consent?
Process that confirms a patient’s voluntary decision to undergo a procedure or intervention.
What is the healthcare providers roll when obtaining informed consent?
It is the providers job to explain the nature, risks, and benefits of the procedure, alternatives to the procedure, risks and benefits of the alternatives. They assess the patient’s understanding of the information and answer all patient questions.
What is the nurses roll when obtaining informed consent?
Signed consent form as a witness, confirm patient received and understands above information, ensure patient is competent, and gave consent voluntarily.
Where do we document the patient informed consent?
All elements of informed consent must be documented on a form or in the patient’s medical record.
What are advanced directives?
Legal documents that communicate preferences regarding medical care of the patient becomes incompasitated to it or is an able to verbalize their wishes.
What is the patient self determination act PSDA?
Ensures of patient’s right to self-determination in healthcare decisions, including advance directives.
What is a Living Will?
Indicates desired of prohibited medical interventions including code status, level of intervention, or life-sustaining measures.
What does DNR mean?
Do not resuscitate. No CPR or resuscitation actions should be taken.
What does physicians orders for life-sustaining treatment POLST mean?
These are medical orders that summarize the patient’s wishes regarding medical care.
What is durable power of attorney?
Identifies another person responsible for medical decision-making. This person does not have to be related to the patient.
What is health insurance portability and accountability act HIPPA?
Law that protects the patient’s right to privacy and regulates how their health care information is used in disclose.
What are to keep provisions of the health insurance portability and accountability act?
One, patient information may not be disclose to anyone that is not directly involved in the care of the patient without patient consent.
Two, patients have a right to receive a copy of their healthcare records.
What are for best practices when it comes to health insurance portability and accountability act information?
Only discuss patient information in a secure environment instead of public places like the elevator.
Report any breach of confidentiality.
Do not access information or charts not needed for work.
Log off computer when stepping away. Use secure, unique passwords and change them frequently. Never share passwords.
Do patients have the right to refuse treatment?
Patients who are competent to provide consent have the right to refuse medications or other therapies even if they were involuntary omitted (except in emergency). 
What does AMA mean?
Leaving against medical advice. AMA means the patient chooses to leave the hospital before the treatment team recommends discharge.
What are the five steps that nurses should take for a patient leaving AMA?
Notify the provider.
Discussed risks associated with leaving AMA with the patient.
Have patient signed AMA form, or document patient refusal to sign form.
Remove any IV catheters and apply dressing.
Do not call security.
What are some examples of intentional torts?
Assault, battery, False imprisonmeant, invasion of privacy, deformation of character.
What is intentional torts?
Willful acts her violate her patients rights.
What is the assault? 
Any threat made against a patient that makes them fearful. Example, telling a patient if you don’t settle down, I’m going to tie you down.
What is battery?
Touching of a patient without consent that causes harm. For example, Nursing Jackson medication to a patient despite the patient’s refusal.
What is a cool way of remembering the difference between assault and battery?
A before B:: Assault, threat, before battery, harm.
What is false imprisonment?
Inappropriate confinement of a patient with restraints, seclusion, or medication acting as a chemical restraint.
What is invasion of privacy?
Violating a patient try to confidentiality. For example, sharing patient information to a family member without patient concern.
What is defamation of character?Slander?
Making derogatory remarks that harm and patience reputation.
What is slander?
Verbal statements.
What is libel?
Written statements.
What are three examples of an intentional torts?
Negligence, malpractice, abandonment.
What is unintentional torts? 
Unintended acts against the patient that cause harm.
What is negligence?
Failure to provide care that are reasonably prudent person would in a similar situation.
What is malpractice?
Negligence by a professional, someone with a professional license. For nurses, it’s when the nurse had a duty to pay to the patient and felt to provide the standard of care.
What is abandonment?
Desertion of a patient by anyone who has assume the responsibility for care of that patient.
What is mandatory reporting?
Report suspected abuse of a child, elder, or vulnerable adult. This is required as a mandated reporter.
When acting as a mandated reporter do you have to provide proof?
The nurse does not have to provide proof, just a requirement to report the facts/circumstances that led the nurse to suspect abuse or neglect. The priority nursing action is always to protect patient from immediate harm. 
When investigating abuse how should you interview the patient?
Interview the patient away from the suspected abuser.
What three things should you do to help the patient when uses suspect abuse?
Collect and prepare evidence for legal purposes.
Develop a safety plan with the patient.
Provide information on shelters and safe houses.
What is Maslow’s hierarchy of needs starting from the bottom to the very top?
Physiological needs, Safety, Love and belonging, Self-esteem, Self actualization.
How do you use Maslow’s hierarchy of needs to prioritize patient care?
You start with their basic physiological needs first such as food and water and shelter then work your way up the pyramid.
What is self actualization?
Pursue and her talents and fulfillment.
What is Ericksons stages of psychosocial development?
Theory that describes key stages in human development and the psychosocial crisis is encountered during each stage usually categorized by year?
According to Ericsson, what’s going on during infancy? What is the infancy age range?
Trust versus miss trust.
Age ranges birth to one year old.
According to Ericsson stages of psychosocial development, what is going on during the toddler stage? What is the age range of a toddler?
Autonomy versus shame and doubt.
Toddler age range is 1 to 3 years of age.
According to Ericsson, what is going on during the preschoolers stage?
Initiative versus guilt.
Preschooler age ranges from 3 to 6 years old.
According to Ericsson, what is going on during the school age stage? What is the age range?
Industry versus inferiority.
The age range is 6 to 12 years old.
According to Ericsson, what is going on during the adolescent age stage? What is the age range?
Identity versus role confusion.
The age range is 12 to 18.
According to Ericsson, what is going on during young adult hood? What is the age range.?
Intimacy versus isolation.
The age ranges from 18 to 40.
According to Ericsson, what is going on during the adulthood stage? What is the age range?
General activity versus stagnation.
Adulthood is from 40 to 65 years old.
According to Ericsson, what is going on during the older age stage? What is the age range?
Integrity versus despair.
The age range is 65 years or older.
What is Kohlberg’s theory of moral development?
Theory that focuses on thinking, reasoning, and decision making across the lifespan.
What is Paget’s theory of cognitive to element?
Theory that describes perception and cognition across the lifespan.
What are five big therapeutic communication techniques?
Open ended questions, Clarification/validation, Reflection, Offering self, Restating.
Example of open to the questions?
Tell me more about…
Example of clarification/validation?
Do I understand you correctly when you say…?
What is the therapeutic communication technique reflection?
Refer questions back to the patient. For example, patient asks do you think I should try this medication?. The nurse says what are your thoughts about it?
What is the therapeutic communication technique of offering self?
Make yourself available to the patient. For example, I can sit with you until your family arrives.
What is the therapeutic communication technique restating?
Repeat what the patient said to confirm understanding.
For example I am so anxious that I can’t get to sleep, the nurse would say your anxiety is keeping you awake?
What are some examples of non-therapeutic communication?
False reassurance, passing judgment good or bad, giving advice, closed ended questions, asking the “why” question, leading by us questions, changing the subject.
What is an example of the non-therapeutic communication technique a false reassurance?
Everything will be fine.
What is an example of the non-therapeutic communication technique of passing judgment?
Yes, you did the right thing.
What is an example of the non-therapeutic communication technique of clothes ended questions?
Asking only yes or no questions. We want them to elaborate.
What is the non-therapeutic communication technique of asking leading/bias questions?
You don’t smoke, do you? This could make them feel bad about that they do smoke and they would say no instead of yes but they actually do smoke.
What does cognitive mean
Involves intellect/thinking.
What does psycho motor mean?
Involves physicality physicality/action
What does affect mean?
Involves emotions/ feelings.
What is health literacy?
Ability to learn, gather, process, and understand health information.
What Henders the patients learning experience?
Using medical jargon or educational materials above patient’s reading and or education level.
Presence of their physical symptoms such as pain, fatigue, moderate Dash severe anxiety.
If someone has pain, moderate to severe anxiety will they understand what you were trying to teach them?
Probably not.
When teaching patients patient education what are some good practices?
Try to give it in their primary language, demonstrate to them, give them reading materials at their education level,.
What is the best evaluation methods after teaching patient education?
The best way to evaluate whether the patient learn what you were trying to teach them is teach back.
What is the teach back method of evaluation for patient education?
After the nurse explains, demonstrate some thing the patient explains demonstrates it back to ensure full comprehension. This is the best way to do it.
What does objective mean?
Thanks you can see and tangible data, facts. For example vital signs are objective.
What is subjective data?How do we document it?
Thanks reported by the patient that cannot be verified independently. Document as a direct quote from the patient.
When should you document the care you’ve given?
Document immediately after but not before doing some thing.
How can you use abbreviations in-documentation?
Only use approved abbreviations. There is a list of abbreviations that are no longer allowed to be used to avoid confusion.
For written records, when documenting and you make an error how do you fix it. What do you not use?
Cross airs out with one line and add initials, date, and time.
Never use correction tape or fluid.
Left off on card 26.
Left off on card 26.
