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Acute PNP > Intro to Acute Care (Role, Legal, & Ethics) > Flashcards

Intro to Acute Care (Role, Legal, & Ethics) Flashcards

NCC 621 Module 1a

1
Q

Integrated approach in which members of a clinical team actively coordinate care and services across disciplines

A

Interprofessional Patient Care

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2
Q

area of clinical knowledge and related research that is pertinent to patient care

A

health care discipline

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3
Q

physicians, surgeons, physicians-in-training, medical students, physical assistants

A

Discipline of medicine

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4
Q

Advanced practice registered nurses–nurse practitioners, nurse anesthetists, clinical nurse specialists; staff nurses and nursing student

A

Discipline of nursing

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5
Q

Pharmacists, respiratory care practitioners, dietitians, therapists (occupational, physical, speech), social workers, chaplains, child life specialists, case managers, paramedics, emergency personnel

A

Discipline of allied health professionals

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6
Q

Medical directors, nurse managers, supervisors, health unit coordinators

A

Discipline of administration

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7
Q

Counsel patients on diet, hygiene, and preventive health care and who diagnose illnesses and prescribe and administer treatment for patients suffering from disease/injury

A

Attending physicians

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8
Q

makes clinical decisions and provides a broad range of diagnostic, therapeutic, preventive, and health maintenance services

A

Physician assistant

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9
Q

4 types–nurse practitioners, certified nurse-midwives, clinical nurse specialists, and certified registered nurse anesthetists (CRNA)

Deliver primary and/or acute care in variety of settings; diagnose and treat common acute illnesses and injuries, perform physical examination, and manage chronic health conditions

A

Advanced practice registered nurses

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10
Q

Pharmacists; Respiratory therapists; Dietitians; Occupational therapists; Physical therapists; Speech therapists; Social workers; Child life specialists; Case-managers; Emergency medical technicians (EMT) and paramedics

A

Allied health professionals

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11
Q

distribute medications prescribed by other providers, inform patients about medications, and advise practitioner on selection, dosages, interactions, and side effects

A

Pharmacists

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12
Q

Respiratory therapists

treat patients of all ages with respiratory illnesses and other cardiopulmonary conditions

A

Respiratory therapists

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13
Q

applies sciences of foot, nutrition, biochemistry, physiology, food management, and behavior to maintain health status of patients

A

Dietitians

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14
Q

promote health and wellness to those person who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitations, or participation restrictions

A

Occupational therapists

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15
Q

help improve patient’s strength and mobility, relieve pain, and prevent/limit physical disabilities

A

Physical therapists

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16
Q

evaluate, diagnose, and treat speech, language and swallowing disorders in all ages

A

Speech therapists

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17
Q

assist individuals, groups, or communities to restore, enhance their capacity for social functioning; help prevent and mitigate crisis, and counsel individuals and families to cope with stress

A

Social workers

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18
Q

promote effective coping through play, preparation, education and self expression activities; provide emotional support for families, encourage optimal development of children

A

Child life specialists

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19
Q

help patients understand their current health status, what they can do about it, and why those treatments are important

A

Case managers

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20
Q

provide emergency care to people who have suffered from illness/ injury outside hospital setting, work under protocols

A

Emergency medical technicians (EMT) and paramedics

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21
Q

Shared mission, purpose, or goal

A

Essential for interprofessional teams

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22
Q

integrated scheduling, physical proximity of team members, strong interpersonal communication skills; regular opportunities for communication; shared language of communication lack of therapeutic territorialism, and commitment to interprofessional process

A

Goals for success for interprofessional team

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23
Q 
Communication
Cooperation (empowerment of team members)
Cohesiveness (team sticks together)
Commitment (investing in team process)
Collaboration (equality in team)
Confronts problems directly
Coordination of efforts (actions support common plan)
Conflict management
Consensus decision making
Caring (patient-centered outcomes)
Consistency (with one another and environment)
Contribution
A

12 C’s of Teamwork

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24
Q

allows team members to share concerns about safety or quality of patient care and to ask questions in attempt to improve understanding of patient care

A

Open Communication

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25
Q

can provide opportunity for open communication and collaboration between team members

A

Interprofessional rounds

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26
Q

allows team members to review team performance, identify errors and evaluate them in relation to team function, and provide and receive constructive feedback to improve team performance

A

Team debriefing

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27
Q

recognizes as a matter of civil liberty, the parent’s right to make decision regarding a child’s education, health care, lifestyle, regiment, religious observation, and discipline

A

Parental liberty doctrine

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28
Q

The state may intervene against a child’s natural parent/legal guardian and act as parent of any child who is need for protection

State will have the burden of proving that it has not unjustifiably interfered with the parental liberty doctrine

A

Parent patriae

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29
Q

Minor who has been made free of parental control–usually automatically emancipated when they become pregnant or have children of their own, regardless of age

A

Emancipated minor

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30
Q

allows minor to demonstrate requisite capacity and maturity to make independent decisions with regard to health care

Takes into consideration age of minor, nature of situation, ability of minor to understand medical procedure in question and laws of state in which minor resides

A

Mature minor

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31
Q

presumption under US law that a minor is someone younger than 18 is immature and may not make their own decisions regarding healthcare

A

Immature minor

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32
Q

Allows parents and children 14 years or older to refuse medical treatment for a life-threatening condition; preventing parents from being charged with medical neglect if decision to refuse such treatment is made jointly, in good faith, by parents and child who is older than 14

Virginia legislature

A

Abraham’s Law

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33
Q

Allow parents and children to have autonomy regarding decision related to medical treatment, even if it contradicts conventional wisdom

If parents can demonstrate that they are advocating for their position based on reasonable information and a plan of treatment that they truly feel is in the best interest of the child, courts will often side with parents

Courts will often side with children even if their decisions conflict with those of the parent under the mature minor doctrine if court finds the child is sufficiently informed about diagnosis and treatment alternatives and reasonably understands consequences of decision

A

Parker Jensen Cancer Case

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34
Q

Decision making for oneself, not commonly applied to children

A

Consent

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35
Q

Parent is fully informed of purpose, benefits, and risk for child and is asked for permission to perform procedures or enroll child in study

A

Permission

36
Q

Self-determination by which child having been fully informed or informed to extent of their ability to understand participates in decision making

May be simple expression of opinion or may be involved discussion of all aspects of tissue

A

Assent

37
Q

If child can write a their own name, can be as young as 6 or 7 years

A

Youngest age a child can assent

38
Q

Holds that HCPs must not share confidences between themselves and a patient/parent with others without patient’s or parent’s express permission

If HCP believes that the patient in danger of self-harm or harm to another, then information must be shared appropriately to prevent such injuries

Must report disclosures of illegal activity

A

Confidentiality

39
Q

Obtaining informed parental consent or permission without undue influence/coercion

A

Responsibility of research study investigator

40
Q

Verify that consent is legitimately obtained and that consent protocols are followed

May not advise or direct decision to participate

A

HCP’s responsibility in research study

41
Q

If parent is not present, but available by telephone, then obtain permission with third-party “auditory witness”

A

Emergency Procedures with parent available on the phone

42
Q

Determine if child is mature enough and able to understand condition and make decision as a mature minor

A

Emergency procedures without parent available, but minor is awake

43
Q

two licensed medical professionals may make a declaration that life-saving car is needed

should be committed to writing in a patient’s medical record

A

Emergency procedures without parent available and unconscious minor

44
Q

Matched by height, weight, ABO, and serology status; less problematic ethical issues

A

Cadaver donors

45
Q

Sibling has 1:4 chance of being a perfect match with identical twin being best match; there is emotional cost

A

Live donor transplantation

46
Q

Some states require parental permission to provide any kind of education related to sexuality or birth control

Other states have laws that allow children of a particular age (14 or 16 years) to consent to their own health care

A

Reproductive decision making

47
Q

male fertility preservation

minors must provide consent for procedures and storage of reproductive tissue

A

Cryopreservation of spermatoza

48
Q

female fertility preservation before treatment with radiation therapy

minors must provide consent for procedures and storage of reproductive tissue

A

cryopreservation of oocytes &/ embryos, ovarian transposition

49
Q
  1. helping pediatric patient achieve developmental appropriate awareness of condition
  2. telling pediatric patient what to expect with clinical management
  3. assessing understanding and factors influencing response
  4. soliciting expression of pediatric patient’s willingness to accept proposed
A

Four components of assent

50
Q

Allows patients and/or surrogates to designate desired medical interventions under applicable circumstances

A

advanced directives

51
Q

If unresolved, ethics consult should be obtained–> then legal counsel is next step

Court system may be required to determine patient’s next best therapeutic plan

A

Refusal of Care

52
Q

Medical interventions that are unlikely to produce any significant benefit to patient

HCPS have moral duty to refuse to provide therapeutic option that may harm a patient and social duty to conserve resources

A

Futile/Inappropriate Care

53
Q

Deliberate intervention undertaken with intention of ending a life to relive intractable suffer

Fear of “slipper slope”
AAP does not support idea

A

Euthanasia

54
Q

Set of ethical criteria for evaluating the permissibility of acting when one’s otherwise legitimate act will cause negative effect that one would normally be obliged to avoid

Action having foreseen harmful effects partially inseparable from goof effect is justifiable upon satisfaction of following (nature of act is itself good or at least morally neutral)

A

Doctrine of Double Effect (DDE)

55
Q

Judgment made on behalf of a non-competent patient based on what the person would have decided had he/she been competent

A

Substituted judgement

56
Q

Has origins in family law; surrogate decision maker must determine the highest net balance among available options; weighing positive against negatives

Can be difficult to apply

A

Best interest

57
Q

provide care that benefits the patient

A

Beneficence

58
Q

avoid harming the patient

A

Nonmaleficence

59
Q

individuals should decide what constitutes their own best interest

A

Autonomy

60
Q

provides services fairly without bias from factors irrelevant to medical situation

A

Justice

61
Q

provide direct patient care by collecting and analyzing data to appropriately manage care

A

Clinician

62
Q

engages in shared planning and intervention with other health care professionals to attain desired patient goals

A

Consultant/Collaborator

63
Q

teaches patients, families, peers, and communities about a variety of health care issues

A

Educator

64
Q

Uses research process to provide evidence-based patient care–research/scholarships–you need to be able apply research to your patient population

A

Researcher

65
Q

State board of nursing

Certificate vs MSN vs DNP

A

Licensure

66
Q

Non-governmental agency that validates an individual has met certain predetermined standards set by individual’s profession

Determines if you are safe to practice as an NP; required for licensure

A

Certification

67
Q

Process of validation of required education, license, and certification
Usually carried out by hospital or clinical practice site
Admitting privileges are determined by hospital

A

Credentialing

68
Q

Authorizing a HCP scope and content of patient care services

A

Privileging

69
Q

legal provisions set up by individual state nurse practice acts

i.e. what would be considered appropriate for HCP to do?

A

Scope of practice

70
Q

evolve out of scope of practice
establish minimal levels of acceptable performance
*important for malpractice claims
*would another NP at your same level do the same things you did?

A

Standards of practice

71
Q

ability of NP to prescribe medications to clients is dependent on state nurse practice acts

state practice dictates the level of prescriptive authority allowed

DEA has ruled that NP’s may obtain registration numbers

A

Prescriptive authority

72
Q

Legal responsibility that a NP has for actions that fail to meet the standard of care, resulting in actual or potential harm to a patient

A

Liability

73
Q

damaging one’s reputation as a result of information being shared without patient’s permission

A

Invasion of privacy

74
Q

failure of a NP to render services with the degree of care, diligence, and precaution that another member of same progression under similar circumstances would render to prevent injury to someone else

*asked to perform a task outside of their job description

A

Malpractice

75
Q

MInor who has been determined by certain set of circumstances or by a court to be given status as an adult–don’t require parental consent

Being in military service, being financially independent of parent and living on their own, being married

A

Emancipated minor

76
Q

Minor can consent for medical decision regardless of parental consent, in regards to sexual health, STIs, mental health services, perinatal/prenatal services, immunizations, substance use disorders, care after rape/assault

A

Minor legal exception

77
Q

respect for persons; self-reliance or self-determination

A

Autonomy

78
Q

clinician decides what is best for the patient

i.e. futile care–meaning if there are contraindications for medical intervention that may prolong their suffering

A

Paternalism

79
Q

following through, faithlessness, commitment to keep promises

A

Fidelity

80
Q

Doing no harm or as LITTLE harm as possible

I.e. putting a PICC line, but trying to limit the blood loss as much as possible

A

Non-maleficence

81
Q

Telling the truth

A

Veracity

82
Q

Equal distribution of goods, services, benefits, and burden

Impartiality

A

Justice

83
Q

Exists an ethically “right” and ethically “wrong” choice

Taking controlled substances that are not legally prescribed to you is an ethically wrong choice

A

Ethical problem

84
Q

Exists two ethically “right” choices

Usually develop when values among parties are discrepant

i. e. offering a particular treatment modalities that may or may not have good outcomes, may be an ethical problem
i. e. offering ECHO in patient that might be progressing to brain death while another clinician thinks it is worth a shot

A

Ethical Dilemma

85
Q

Obtain relevant facts
Identify ethical issues from facts
Determine who is affected
Identify the alternatives available to person who must resolve dilemma
Identify likely consequences of each alternative (con/pon)
Decide appropriate action then evaluate effectiveness of decision

A

Resolving Dilemmas

Acute PNP (8 decks)

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