INTRO TO PROFESSIONAL RN — EXAM 2 (CHAPT. 8, 20, 21, & 25) Flashcards
How does a nurse provide presence?
In providing presence you develop a person-to-person relationship that conveys a closeness and sense of caring. In today’s high-tech and fast-paced health care environments, nursing presence is essential. Presence establishes the nurse-patient relationship and is linked to positive patient outcomes
— Nursing presence makes time for the patient and family caregiver. In the interpersonal relationship of being there the nurse is attentive and receptive to a patient (Penque and Kearney, 2015).
— “Being there” and “Being with” includes communication and understanding
Summary of the Nursing Process
Assessment
Nursing diagnosis
Planning
Implementation
Evaluation
How do you determine a structure of a family?
Ask the patient who their family members are
Know Maslow’s Hierarchy of Needs
**Basic Human Needs Model **
Maslow’s hierarchy of needs helps you understand an individual’s motivation to achieve optimal health
Communication techniques for diverse cultures
— Interpreter
— Speak in layman terms so the patient and family can understand
What is a ‘Sandwich Generation’?
Group of middle-aged adults who care for both their aging parents and their own children. It is not a specific generation or cohort in the sense of the Greatest Generation or the Baby boomer generation, but a phenomenon that can affect anyone whose parents and children need support at the same time.
State the 5 steps to scientific method regard critical thinking competences
- ID the problem
- Collecting data
- Forming a question/hypothesis
- Testing the question/hypothesis
- Evaluating results of the test/study
Concepts for a critical thinker
— Truth seeking: seek the true meaning of a situation
— Open-mindedness: be tolerant of different views
— Analyticity: be alert to potentially problematic situations
— Systematicity: be organized and focused and work hard in answering your questions
— Self-confidence: trust your own reasoning process
— Inquisitiveness: be eager to acquire knowledge
— Maturity: multiple solutions = acceptable
Differentiate the levels of critical thinking
Basic
— Trust that experts have the right answers for every problem; thinking is concrete and based on a set of rules or principles
Complex
— Begin to rely less on experts in daily care; learn to analyze data and examine choices more independently
Commitment
— Anticipate the need to make choices without assistance from others; accept accountability for the decisions you make
What is LEARN related to cultural desire?
Listen
Explain
Acknowledge
Recommend
Negotiate
When asking questions for clarity, what critical thinking attitude is this?
Confidence — speaking with conviction to ask a clarifying question
Why is caring essential to nursing clinical practice?
— It helps nurses get close to patients and enables the best possible medical treatment
— It can also be emotional support that gives patients a sense of peace or security in hospital settings
What is domestic violence + what are the risk factors?
— Includes not only intimate partner relationships of spouses, live-in partners, and dating couples but also familial, elder, and child abuse
— Abuse generally falls into one or more of the following categories: physical battering, sexual assault, and emotional or psychological abuse. It generally escalates over a period of time.
— The cause of family violence is complex and multidimensional.
_Risk Factors:_
Stress, poverty, social isolation, psychopathology, and learned family behaviors all are factors associated with violence
What is something that a nurse should do first when assessing a patient who is being prepared for discharge who will need additional assistance at home as that patient may have a visual deficit
Ask who will be their support system and help to care for them while at home
How do you determine family form and membership?
— Ask the patient who they consider as their “family.”
Name the 5 elements of critical thinking in RN judgment
- Competence — perform critical thinking as they apply the nursing process
- Knowledge — knowledge base is built; maintain current knowledge of RN science
- Experience — the “hands-on” care of patients; practice
- Attitudes (11) — success in approaching a problem
- Standards (14) — ethical criteria for RN judgments, E-B criteria used for assessment & evaluation, & professional responsibility
NOTE: The five model elements combine to guide nurses in making clinical decisions leading to safe, effective nursing care
What are the 11 Critical Thinking Attitudes in nursing practice?
- Confidence
- Thinking Independently
- Fairness
- Responsibility + Authority
- Risk Taking
- Discipline
- Perseverance
- Creativity
- Curiosity
- Integrity
- Humility
Name the 14 Standards for Critical Thinking in nursing practice
Intellectual Standards
1. Clear: plain + understandable (e.g. clarity in how one communicates)
2. Precise: exact + specific (e.g. focus on 1 problem, 1 solution)
3. Specific: to mention, describe, or define in detail
4. Accurate: true + free from error; objective + subjective facts
5. Relevant: essential/crucial to a situation (e.g. patient’s changing clinical status)
6. Plausible: reasonable or probable
7. Consistent: express consistent beliefs/values
8. Logical: engage in correct reasoning
9. Deep: containing complexities + multiple relationships
10. Broad: covers multiple viewpoints (e.g. pt, family)
11. Complete: thoroughly thinking/evaluating
12. Significant: focus on what’s important/not trivial
13. Adequate (for purpose): satisfactory in quality/amount
14. Fair: being open-minded/impartial
Know what the national core measures are divided into.
THERE ARE SEVEN
1. Accountable Care Organizations, Patient Centered Medical Homes, & Primary Care
2. Orthopedics
3. Cardiology
4. Gastroenterology
5. HIV/Hep C
6. Medical Oncology
7. Obstetrics & Gynecology
Know difference between critical thinking attitudes of fairness, integrity, discipline, perseverance specifically
— Fairness: listening to both sides of any discussion
— Integrity: recognize when your opinions conflict w/ those of your patient
— Discipline: be thorough in everything you do
— Perseverance: be wary of an easy answer, clarify the facts
Place the steps of the scientific method in their correct order with number 1 being the first step of the process. 1. Formulate a question or hypothesis. 2. Evaluate results of the study. 3. Collect data. 4. Identify the problem. 5. Test the question or hypothesis.
- ID the problem
- Collect data
- Formulate a question/hypothesis
- Test the question/hypothesis
- Evaluate results of the study
Know if persons in the United States had at least one healthy food retailer within census tract or with ½ mile of tract boundaries
True. They do not have the access or resources for healthier food in their retailed stores
Know Swanson’s theory of caring
—Knowing: striving to understand an event as it has meaning in the life of the other
— Being with: being emotionally present to the other
— Doing for: the other as he or she would do for self if it were at all possible
— Enabling: facilitating the other’s passage through life transitions (e.g. birth, death) and unfamiliar events
—Maintaining belief: sustaining faith in the other’s capacity to get through an event or transition and face a future w/ meaning
Purpose: Nurse educators can utilize these caring processes to teach nursing students by cultivating meaningful, healing relationships.
What is true regarding stress and it’s effects on the nurse?
—Affect managing emotion is difficult
— Affect ability to speak clearly
— Affect accuracy and problem-solving
— Decrease recall of memory
Know family hardiness
Hardiness and resiliency moderate a family’s stress and thus affect its health.
Actively able to deal with a family’s divorce and remarriage
Affiliation needs
“Connected with/to”
being responsive to their familial needs
When completing a nurse admission, what should the nurse know about the family?
— Genetics/Diseases
— Social history
Medical diagnosis, demographic information, overview of health status, alterations that could cause immediate concern, last set of vital signs, medication (including PRN), diet, activity, any specific equipment they may require, advanced directive and families involvement in care
Know critical thinking skills
— Interpretation: process of discovering, determining, or assigning meaning
— Analysis: Skills used to ID assumptions, reasons, themes, and the evidence used in making arguments or offering explanations
— Inference: Skills that enable us to draw conclusions from reasons, evidence, observations, experiences, or our values and beliefs
— Evaluation: Skills used to assess the credibility of the claims people make or post, and to assess the quality of the reasoning people display when they make arguments or give explanations
— Explanation: Process of justifying what we ave decided to do or not to believe
— Self-Regulation: Context of critical thinking relates to monitoring and, if necessary, correcting any mistakes that may have occurred in the process of interpreting, analyzing, inferring, evaluating, or explaining
What are the core critical thinking skills?
— Interpretation
— Analysis
— Inference
— Evaluation
— Explanation
— Self-Regulation
If a patient has several risk factors and you are assessing a patient for something specifically, could that patient be at an increased or decreased risk?
Increased
What is family?
— A family is what an individual believes the family to be.
— It includes a set of interacting individuals who are related through biology or enduring commitments who usually socialize with each other
What is true about homelessness and families?
— Fastest growing segment of the homeless population is families with children, including complete nuclear families and single-parent families
— Affects the functioning, health, and well-being of the family and its members
— Children of homeless families are often in fair or poor health and have higher rates of asthma, ear infections, stomach problems, mental illness, poor dental health, and poor immunization documentation
With a nurse/patient relationship, how would you establish mutual problem solving?
Discuss patient issues with the family
Based on the _Caring Assessment Tool (CAT), “since I have been a patient here, the nurses…”
* Help me understand how I am thinking.
* Ask me how I think treatment is going.
* Help me explore alternative ways of dealing.
* Ask me what I know.
* Help me figure out questions to ask.
Parenting styles/family roles
— Nuclear: Consists of two adults (and sometimes one or more children
— Blended: Formed when parents bring unrelated children from prior or foster parenting relationships into a new, joint living situation.
— Extended: Includes relatives (grandparents, aunts, uncles, and cousins) in addition to the nuclear family
— Single-Parent: Formed when one parent leaves the nuclear family because of death, divorce, or desertion or when a single person decides to have or adopt a child
— Alternative Patterns of Relationships: Include multiadult households, “skip-generation” families (e.g., grandparents caring for grandchildren, which commonly results from legal interventions such as when the parent is absent and there is no other parent available), communal groups with children, “nonfamilies” (adults living alone), and cohabitating partners
What is critical thinking?
A continuous process characterized by open-mindedness, continual inquiry, and perseverance combined with a willingness to look at each unique patient situation and identify the assumptions that are true and relevant.
— Diagnostic reasoning
— Clinical decision making
— Clinical inference
What do critical thinkers do?
— Identify the important data in each clinical situation
— Imagine and explore alternatives
— Consider ethical principles and care standards
— Makes informed decisions about patient care.
Know critical thinking competency related to the nursing process
What the RN can do
— Recognize an issue
— Analyze information r/t the issue
— Evaluate information
— Draw conclusions
________________________
How can the RN be effective in critical thinking?
— Fully assess a patient’s health condition
— Focus on the important issues at hand in any clinical situation
— Make decisions that produce desired outcomes
— Utilize evidence-based knowledge
Know focused, open-ended, contrast, ethnohistory, social organization and caring beliefs and practice
Open-ended — asking a patient how they want us to help them with their problem— open-ended
Focused — asking a patient a yes/no question, direct
Ethnohistory — “what is your ethnic background”
Social organization** — “who are your family members?”
Caring beliefs and practice — “which caregivers do you seek help when you are sick?”
Contract — “how different is this problem from the one you had one month ago?”
What should you know about critical thinking attitudes?
What is oppression?
A formal and informal system of advantages and disadvantages tied to membership in social groups
— Oppression occurs at individual, cultural, and institutional levels, affecting individual and group experiences.
e.g. a patient experiencing oppression has limited access to resources such as health care, housing, education, employment, and legal services. In
When a nurse is in the reflection process, what might be some questions that nurses asks their self?
- How did I act?
- Why did I take such an action?
- What could I have done differently?
- What should I do in a similar situation in the future?
How do nurses demonstrate caring behavior?
If a new RN, seek assistance prior to.
What is intersectionality?
— method to patient’s lives and experiences
—The acknowledgement that everyone has their own unique experiences of discrimination and oppression and we must consider everything and anything that can marginalise people – gender, race, class, sexual orientation, physical ability, etc.
Know difference between nuclear, blended, multi-adult and extended family
Task division in a household is what?
— Divide the tasks and each of you takes responsibility for those assigned to you.
— Some couples choose to divide the tasks equally, while others assign proportionally more tasks to one partner who perhaps has a less demanding career or a greater desire to get things done.
