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nur306 > knowledge assessment I > Flashcards

knowledge assessment I Flashcards

1
Q

ANA focuses on four main goals of nursing

A
  1. promote health
  2. prevent illness
  3. treat human responses to health or illness
  4. advocate for individuals, families, communities, and populations
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2
Q

nursing scope and standards of practice

A

describes what duties RN is able to do under their license
works with nursing process to promote health and prevent illness

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3
Q

autonomy

A

a patient’s independence to make their own decisions about their care

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4
Q

beneficence

A

doing good by others

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5
Q

justice

A

treat patients in a way that is equitable and fair

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6
Q

nonmaleficence

A

do no harm

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7
Q

nurses are considered a ___ and a _____ of care

A

provider / manager

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8
Q

nursing communication

A

SBAR

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9
Q

SBAR

A

a standard form of communication that allows the nurse to give a report with the most concise and important information and to provide recommendations about interventions based on critical thinking

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10
Q

S (SBAR)

A

situation
i am…
im calling because…
i am concerned that…
(blood pressure is low/high, pulse is xx, temperature is xx, early warning score is xx)

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11
Q

B (SBAR)

A

background
patient x was admitteed on xx with … (chest infection)
they have had.. (x operation done)
pt x condition has changed within the last x min
their last set of vitals were xx
patients x normal condition is xyz

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12
Q

A (SBAR)

A

assessment
i think the problem is …
i have… (given O2/analgesia, stopped the infusion)
OR i am not sure what problem is but i am worried

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13
Q

R (SBAR)

A

recommendation
i need you to…
come and see pt in next xx min
AND
is there anything i need to do (stop fluid..)

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14
Q

nursing values

A

caring
integrity
diversity
excellence

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15
Q

caring

A

promotes health, healing, and hope

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16
Q

integrity

A

respect, dignity, and moral wholeness

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17
Q

diversity

A

affirming uniqueness and differences

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18
Q

excellence

A

cocreating and implementing transformative strategies

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19
Q

teaching and health promotion is influenced by

A

individual beliefs
cultural beliefs
perception of health and healthcare
demands in individuals life

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20
Q

individualizing health promotion

A

consider talking about their beliefs and experiences and see what they deem important to help provide better outcomes

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21
Q

healthy people 2030

A

national model for health promotion and risk reduction
goal to increase length and quality of life and eliminate health disparities

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22
Q

levels of intervention

A

primary
secondary
tertiary

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23
Q

primary level of intervention

A

strategies to prevent problems
ie. physicals, yearly blood work, immunizations

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24
Q

secondary level of intervention

A

early diagnoses of health problems-screenings
ie. CT scans, vision screenings

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25
Q

tertiary level of intervention

A

preventing complications of existing disease
ie. making sure diabetics get proper foot care, diet teachings, exercise programs

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26
Q

components of health assessment

A
  • health history and physical exam
  • gathering info about health status
  • ID patterns and trends
  • performing nursing process
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27
Q

health history and physical exam

A

gather info on health status
analyze information as data, make judgments and evaluate the outcome
think clinical judgement model of nursing

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28
Q

gathering information about health status

A

subjective questions and physical findings
physiological, sociocultural, spiritual, economic, and lifestile

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29
Q

ID patterns and trends

A

assist with guiding treatment plans to improve patient overall wellness

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30
Q

6 functions of clinical judgment model

A
  1. recognize cues (what matters most)
  2. analyze cues (what does it mean)
  3. prioritize hypotheses (where do i start)
  4. generate solutions (what can i do)
  5. take action (what will i do)
  6. evaluate outcomes (did it help?)
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31
Q

nursing process

A
  1. assessment
  2. analysis
  3. planning
  4. implementation
  5. evaluation
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32
Q

assess (nursing process)

A

compare health assessment of pt
data must be complete and accurate
includes subjective + objective data

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33
Q

subjective data

A

what is reported to you by the patient
- feelings, sensations, chief complaint

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34
Q

objective data

A

what you identify in the assessment (physical findings, VS, EHR info)

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35
Q

analysis/diagnosis (nursing process)

A

making judgment based on what you find in the assessment; consider what assessment findings mean
(basis for clinical decisions you will make

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36
Q

planning (nursing process)

A

determine what resources are available in order to implement the care needed for pt
- consider the pt specific outcomes and goals for shift
- plan out what interventions will be used give resources

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37
Q

implementation (nursing process)

A

put care plan into action for shift

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38
Q

evaluate outcomes (nursing process)

A

judge effectiveness of interventions used
- did they help reach the goals and monitors progress of pt in health promotion journey

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39
Q

clinical judgment model

A

combination of basic nursing process, critical thinking, and diagnostic reasoning

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40
Q

CJM is composed of

A

critical thinking and diagnostic reasoning

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41
Q

critical thinking

A

analysis and implementation of best interventions for pt given complex health scenario that is provided
- requires analysis of situation and all potential outcomes
- ensures that nurse provides complete, patient centered care that is not misguided

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42
Q

diagnostic reasoning

A

based on critical thinking
- process of data gathering in order to create hypothesis for pt care
- requires collaboration with the interprofessional team to obtain orders and implement interventions for pt

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43
Q

what steps of the CJM help form a hypothesis

A

recognizing cues and analyzing them

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44
Q

what steps of CJM help refine hypothesis

A

refining helps prioritize which in turn helps generate solutions

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45
Q

what steps of CJM help evaluate

A

eval. helps take action which helps evaluate better outcomes

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46
Q

types of physical assessment

A

comprehensive and focused

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47
Q

comprehensive physical assessment

A
  • complete health hx
  • physical assessment
  • includes all body systems and vital signs
  • similar to primary care visit
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48
Q

focused

A
  • based on health issues
  • health hx based on symptoms
  • one to two body systems where abnormalities are found
  • smaller assessment more in depth
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49
Q

both comprehensive and focused assessments include

A

subjective and objective data

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50
Q

Given the following case scenario, make a list of subjective data findings: J.S. is an 82y.o. patient,
comes to the clinic complaining of a dry nagging cough and shortness of breath when walking up the
stairs. She states this started about one week ago and that she just “can’t stand it any longer”. She
complains of throat pain when coughing. Upon assessment, she appears weak and frail. She has lost
15 pounds since her last visit to the office 2 months ago. She has a dry cough when she takes a deep
inhalation; lung sounds are clear to auscultation. She has a normal temperature, heart rate, blood
pressure, and oxygenation reading.

A

complaints of dry and nagging cough and SOB when walking up stairs
started about a week ago
“cant stand it any longer”
complaints of throat pain when coughing

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51
Q

Given the same scenario again, make a list of objective data findings: J.S. is an 82y.o. patient, comes
to the clinic complaining of a dry nagging cough and shortness of breath when walking up the stairs.
She states this started about one week ago and that she just “can’t stand it any longer”. She complains
of throat pain when coughing. Upon assessment, she appears weak and frail. She has lost 15 pounds
since her last visit to the office 2 months ago. She has a dry cough when she takes a deep inhalation;
lung sounds are clear to auscultation. She has a normal temperature, heart rate, blood pressure, and
oxygenation reading.

A

82 yo
appears weak and frail
has lost 15 pounds since last visit 2 mo ago
dry cough when taking deep breaths
lung sounds are clear to auscultation
normal temp, HR, BP, and O2 reading

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52
Q

emergency assessments use

A

ABCDE

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53
Q

abcde

A

A - airway (is airway patent, do they have neck or throat injuries
B - breathing (rate, depth, muscle use)
C - circulation (pulse rate, rhythm, skin color
D - disability (level of consciousness, pupils, movement)
E - exposure

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54
Q

functional assessment

A

functional patterns humans shar
health perception
health management
activity and exercise
nutrition and metabolism
elimination

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54
Q

head to toe assessment

A

organized system for gathering comprehensive physical data

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54
Q

body systems assessment

A

ultizes critical thinking to document and communicate assessment findings for each system
enables nurse to hypothesize system specific issues

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54
Q

key component to infection prevention is

A

hand hygeine

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54
Q

transmission based precautions

A

increased personal protective equipment based on disease

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54
Q

standard precaution

A

all waste and contact are considered infections
used w all patients

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55
Q

lower risk exposure

A

performing admin duties in nonpublic areas of healthcare members

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56
Q

medium risk exposure

A

providing care to general public who is not known to have covid, busy staff areas

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57
Q

high risk exposure

A

entering known or suspected covid 19 pt room

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58
Q

very high risk exposure

A

performing aerosol generating procedures (intubation, cough induction, bronchoscopies, some dental procedures, etc.)
collecting or handling specimens from known or suspected covid 19 pt

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59
Q

hand hygiene

A

must be done prior to pt contact
nails should be kept short with no polish
any open skin wounds need to be covered with bandage

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60
Q

PPE

A

gloves, masks, respirators, eye protection, gowns, foot covers

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61
Q

the amount of PPE needed is based on

A

diseases

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62
Q

sequence of donning ppe

A

1.wash hands
2. gown
3. mask or respirator
4. goggles or face shield
5. gloves

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63
Q

sequence of doffing ppe

A
  1. gloves (take gloved hand and from palm take glove off, then slide underneath glove and toss)
  2. goggles or face shield (move from back)
  3. gown (shimmey it off of you)
  4. mask or respiratory (bottom first)
  5. wash hands
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64
Q

contact precautions

A
  • ensure patient placement in single room if available
  • use ppe appropriately
  • limit transport and movement
  • use disposable or dedicated patient equipment
  • prioritize cleaning and disinfection of room
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65
Q

droplet precautions

A

used for pt known or suspected with transsmissble pathogens from respiratory droplets
- mask pt
- appropriate pt placement
- PPE (mask upon entry)
- limit transport and movement of pt

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66
Q

airborne precations

A

known or suspected pt has pathogens transmitted by air (TB, measles, chickenpox)
- mask pt
- ensure placement in airborne infection isolation room
- restrict susceptible healthcare personnel from entering room
- use PPE (fit respirator
- limit transport
- immunize susceptible persons

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67
Q

assessment techniques

A

inspection
palpation
percussion
auscultation

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68
Q

inspection

A

observation of pt to look for abnormalities

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69
Q

palpation

A

use of hands to feel for abnormalities

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70
Q

percussion

A

use fo hands to create sounds on specific body part and listen for abnormalities

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71
Q

ausculation

A

using stethoscope to listen to air and fluid movement

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72
Q

it is neccessary to consider each independent patients

A

ability level
cultural beliefs
social beliefs

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73
Q

elderly, cultural variations, and health disparities

A
  • patient may be anxious
  • some pt fear disclosing info that makes them uncomfortable
  • if pt has language barrier, coordinate to have a medical interpreter present
  • ask pt their preferences and always perform less invasive assessment first
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74
Q

what is the first component of the assessment

A

general survey

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75
Q

general survey

A
  • begins with the first encounter and continues with each interaction
  • the rn makes note of general appearance, behavior, and mobility
  • overall impression of pt that gives general indicator of health status
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76
Q

vital signs

A

include temperature, HR/pulse rate, respirations, o2
- nurses must interpret these with the clinical picture
- indicate physiological state and response to the different stressors on a body at given time
- allow nurse to establish a baseline and monitor trends

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77
Q

subjective data collection within general survey

A
  • question pt about past medical and surgical history, medications used, family history, nutrition, and psychosocial profile
  • look for risk factor related to variation in vital signs (family history, increased age, male gender, high BP, high cholesterol, smoking, diabetes, overweight, decreased activity, high-fat diet, high alc intake, elevate C reactive proteins and elevated Btype natriuretic peptide)
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78
Q

subjective data:teaching and health promotion

A

educate importance of consistent medication usage
educate on risks associated w medical history and family history
primary prevention: lifestyle modification

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79
Q

factor to obtain accurate VS

A
  • establish comfortable setting
  • provide privacy, ask if they want a chaperone
  • perform hand hygiene prior to taking VS (cleanse equipment)
  • begin general survey immediately and continue taking in cues while assessing vitals
  • perform the least invasive first
  • pt can be sitting or lying but legs shouldn’t be crossed, restrictive clothing removed, ask if pt has had anything to eat or drink for 30 min prior
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80
Q

temperature

A

controlled by hypothalamus

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81
Q

normal range of temperature

A

97.7-98.6 F or 36.5C-37C

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82
Q

fever is considered

A

100.4 F or above

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83
Q

hypothermia

A

low body temperature <35C or 95F

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84
Q

hyperthermia

A

high body temp >38.6C or 101.5F

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85
Q

pulse/heart rate

A

number of pulsations per minute

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86
Q

normal range of HR

A

60-100 bpm

87
Q

rhythm of HR

A

regular (rhythmic, same interval between each beat) vs irregular (beats have different intervals, no pattern)

88
Q

strength of HR

A

absent is rated at 0
strong is +4
normal is considered to be +2

89
Q

tachycardia

A

high heart rate
OVER 100 bpm

90
Q

bradycardia

A

low HR
LESS than 60 bpm

91
Q

aystole

A

no pulse
medical emergency, code blue

92
Q

apical pulse

A

measure at apex of heart
if pulse rhythm is deemed to be irregular the RN must auscultate the apical pulse for an entire minute to ensure the accurate pulse rate is counted

93
Q

respiratory rate

A

one respiration comprised of a full inhale and a full exhale

94
Q

tachypnea

A

rapid respiratory rate
GREATER than 24 respirations

95
Q

bradypnea

A

slow respiratory rate
LESS than 12 respirations per minute

96
Q

apnea

A

absence of breathing for more than 10 seconds
EMERGENCY

97
Q

dyspnea

A

difficulty breathing

98
Q

hyperventialtion

A

rapid, deep breathing

99
Q

hypoventilation

A

slow, shallow breathing
accessory muscle use indicates distress

100
Q

normal respiratory rate

A

12-20 respiration per minute

101
Q

oxygen saturation

A

percent of hemoglobin that is saturated with O2 at time of measurement

102
Q

pulse oximetry

A

noninvasive continuous oxygen saturation monitoring used in clinical settings

103
Q

normal pulse oximetry

A

92-99% on room air, without supplemental oxygen therapy

104
Q

blood pressure

A

force exerted on the arterial walls by the flow of blood from the heart

105
Q

systolic BP

A

measurement at systole in heart
highest pressure against arteries

106
Q

normal systolic

A

90-120 mmHg

107
Q

diastolic BP

A

measurement at diastole in heart
lowest pressure against arteries

108
Q

normal diastolic

A

60-80mmHg

109
Q

MAP (mean arterial pressure)

A

average arterial pressure through one cardiac cycle
- minimum MAP of 60 mmHg needed to perfuse the vital organs

110
Q

hypertension

A

high BP over multiple readings
must be a trend before a diagnosis is made

111
Q

hypertension levels

A

SBP > 120

112
Q

hypotension

A

low BP

113
Q

hypotension levels

A

SBP <90

114
Q

orthostatic hypotension

A

assess for drop in BP and change in HR when patient changes position (sitting from lying down)
can be caused by meds or health status
frequently seen in older population

115
Q

how to assess orthostatic hypotension

A

check BP and HR in supine
sit patient up, wait 1-2 minutes and asses in sitting position
have patient stand and wait 1-2 minutes and assess in standing position

116
Q

signs of hypotension

A

dizziness, lightheadedness, feeling like passing out

117
Q
A
118
Q

using BP cuff that is too small will lead to BP reading that is falsely

A

high

118
Q

hypertnesion can only be diagnosed after multiple high BP readings are recorded. true or false

A

true

118
Q

normal diastolic range

A

60-80

118
Q

normal systolic range is

A

90-120

118
Q

using BP cuff that is too large will lead to BP reading that is falsely

A

low

118
Q

which of the following patients are at risk of experiencing orthostatic hypotension (select all)

a) 25 yo pt admitted after MV collision and high blood loss
b) 95 yo pt with history of heart failure and parkinsons disease
c) 20 yo pt with flu like symptoms and abdominal pain
d) 45 yo pt wait gallbladder removal surgery

A

a, b

118
Q

mexican americans experience greater percentages of

A

being overweight and obese

118
Q

considerations for older adult

A

general survey: appearances change with age (posture and gait are altered and pt may have decreased balance, assess for declining ability to care for self, changes in mental status)

height and weight:
thinning of vertebral discs and postural changes lead to decline, muscle shrinks and fat dis. changes

temp:
lower body temp due to changes in regulatory mechanisms and fat distribution (may not illicit fever like younger adult)

pulse:
vascular changes over time lead to changes in compensatory mechanisms, takes longer for heart to respond to hemodynamic changes in body and longer to return to normal state

respirations:
rigidity of rib cartilage, decreasing chest expansion and vital capacity, decreased volue of air inspired in each breath, increased SOB and shallow breathing

Pulse O2:
more difficult to read due to decreased perfusion, sensorts to the forehead, nose, or ear

BP:
change in body size and fat distribution makes it harder to size cuff, both numbers increase naturally, BP may drop when adult stands too quickly

118
Q

in certain cultures there may be variations in

A

vital signs

118
Q

cultural variations in general survey

A

note cultural differences, dress, grooming, speech, non verbal communication
- be attentive and take time
- utilize interpreter if necessary
- take note of family in room and interactions

118
Q

non hispanic black adults have the

A

highest prevalence of high BP

119
Q

priority urgent assessment

A

cues nurse in to call provider
when VS alter, nurse can begin interventions, follow triage assessment to determine if emergency, utilize senior nurses to assist

119
Q

premature death from hypertension and heart disease is higher for

A

hispanics

119
Q

nursing practice is dependent on an

A

effective nurse-patient relationship

119
Q

nonverbal communication includes

A

physical apperance; facial expression
posture; positioning in relation to the patient
gestures; eye contact
voice tone; use of touch

120
Q

verbal communicatin skills

A

effective interviewing
speech patterns (moderate pace and volume; clear articulation, modify for those w hearing problems)
simple clear language at normal volume for those with limited english

121
Q

active listening refers to

A

ability to focus on patients and their perspectives
talking about difficult feelings to help patients heal
redirect interview if a patients anger cannot be diffused

122
Q

restatement

A

content of communication

123
Q

reflection

A

summarizing main themes of communication

124
Q

elaboration (facilitation)

A

assists patients to more completely describe difficulties

125
Q

silence

A

purposefully allow patients time to gather thoughts, provide accurate answers

126
Q

focusing

A

redirecting patients to pertienent topics being dicussed

127
Q

clarification

A

questions to ascertain patients meaning when word choice ideas are unclear

128
Q

summarizing

A

reviewing and condensing important information into two or three most important findings

129
Q

nontherapuetic resopnses

A
  • false reassurance
  • sympathy
  • unwanted advice
  • biased questions
  • changes of subject
  • distractions
  • technical or overwhelming language
  • interuptting
130
Q

cultural differences may relate to

A

group or ethnicity; region
age; degree of acculturation into western society
combination of factors

131
Q

you would use culturally competent communication when dealing with

A

those with limited english skills, or those of different gender and/or sexual orientation

132
Q

phases of interview process

A

pre-interaction
beginning
working phase
closing phasep

133
Q

pre interaction phase

A

compiling existing patient data, preparing for interview from existing medical records

134
Q

beginning phase

A

introduction; state purpose for interview, ensure privacy

135
Q

working phase

A

closed-ended or direct questions: specific information
open-ended questions: broad answers in patients own words, avoid “why” questions

136
Q

closing phase

A

summarizing, stating most important two to three problems or patterns
- report any information that is required by law

137
Q

primary data sources

A

individual patient

138
Q

secondary data sources

A

charts and information from family members
all other sources of information

139
Q

types of health history

A

emergency, focused, comprehensive

140
Q

emergency health hx

A

gather information about immediate problem

141
Q

focused

A

gather information about current situation

142
Q

comprehensive

A

gather all medical info about pt

143
Q

components of health hx

A
  • demographic data
  • reason for seeking care
  • history or present illness (OLDCARTS)
  • past health hx
  • current meds
  • allergies
  • family history
  • review of systems (ROS)
  • functional capabilities
  • social, cultural, spiritual assessment
  • mental health assessment
  • neglect, abuse, and violence assessment
  • sexual history
144
Q

oldcarts

A

onset, location duration
characteristic
alleviating or aggravating factors
radiating or relieving factors
timing
severity

145
Q

infants and children in health assessment

A

parents, legal guardians, or other adult reps. may bring child so validate roles of people bringing in children

146
Q

older adults

A

establish roles of others at interview
possible sensory deficits
more complex health hx
lifestyle choices affecting health
focus interview on patient

147
Q

challenging situations

A
  • hearing impairment
  • low consciousness
  • cognitive impairment
  • mental illness
  • anxiety
  • crying
  • anger
  • substance abuse
  • sexual agression
148
Q

purpose of medical record

A

legal document used in civil or criminal courts for evidence, communication and care planning, quality assurance, education, research, and financial reimbursement

149
Q

sentinel event

A

an unexpected occurrence involving death or serious physiological or psychological injury

150
Q

almost 3/4s of all serious often life-threatening errors in healthcare involve failures in

A

communication

151
Q

quality assurance

A

audit (internal or TJC)

152
Q

financial reimbursement

A

medicare, medicaid, workers comp

153
Q

components of patients medical record

A

nursing admission assessment
H&P by PHP
advanced directive or power of attorney
PHPs orders
care plan or clinical pathway
flow sheets (vitals, I&Os, routine assessments)
focused assessment sheets
MAR
lab test and results
progress notes
consults
discharge summary

154
Q

EMR

A

software programs allow entry of assessment data quickly
interfaces with pharmacy; direct computer charting of medication administration

155
Q

computerized provider order of entry (CPOE)

A

direct entry of all orders by healthcare providers to lab, pharmacy, and nursing personel
all entries are legible, timed and dated
automated clinical surveillance tools

156
Q

priority urgent assessment

A
  • respiratory rate below 8 or higher than 28 breath per/min
  • acute change in oxygen sat below 90%
  • threatened airway
  • change in systolic blood pressure below 90 mm Hg or diastolic blood pressure above 110 mmHg
  • new chest pain; signs of myocardial infarction
  • cold, cyanotic, or pulseless extremities
  • confusion, agitation, delirium
  • unexplained lethargy or acute altered mental status
  • difficulty speaking or signs of acute stroke
  • seizures
  • changes in pupillary response
  • temp greater than 39 degrees C or 102.2 F
  • uncontrolled pain
  • acute change in urine output (less than 50 mL over 4 hrs)
  • acute bleeding
  • suspect sepsis
157
Q

Health Insurance Portability and Accountability Act (HIPPA)

A
  • keep clients health information private
  • applies to computerized and written medical records; any information pertaining to health status or care received
  • severe penalties for violations
158
Q

documentation must be

A

accurate and complete

159
Q

accuracy and completeness

A

must persicely reflect assessment data
subjective data: clients exact words whenever possible
correct medical terms
legally accepted abbreviation use
proper format for noting record corrections
handwritten entries must be legible

160
Q

logical organization

A

systemic grouping of information

161
Q

timeliness

A

follow agencies policies
avoid batch charting
point of care documentation
enables up to date assessment information to make clinical decisions

162
Q

conciseness

A

avoid lengthy sentences use sentence fragments

163
Q

nursing admission assessment (nursing history and physical)

A
  • obtain baseline data
  • timeline depends on facility
  • provides comprehensive information about clients physical, physiological, functional, social, and spiritual abilities
  • forms basis for individualized plan of care
164
Q

STEP

A

status of client team members
environment
progress toward goal

165
Q

narrative notes

A

unstructured paragraph based on time

166
Q

SOAP(IE)

A

subjective;objective;analysis; plan; interventions; evaluation

167
Q

PIE notes

A

problem
interventions
evaluation

168
Q

DAR notes

A

data
action
response

169
Q

charting by exception

A
  • predetermined standards and norms to record only significant assessment data
  • nurse checks box if client meets norms
  • any abnormal assessment findings require additional documentation
170
Q

discharge note

A

indicates client’s status, received necessary education, discharge instructions, condition, and time of discharge

171
Q

home care documentation

A

OASIS: Outcome and Assessment Information Set (federally mandated for medicare or medicaid reimbursement)

172
Q

long-term care documentation

A

resident assessment instrument (RAI)
includes: minimum data set, triggers, resident assessment, protocols, utilization guidelines
very comprehensive and labor intensive assessment tool

173
Q

written handoff sumary

A
  • transfer of care for a patient
  • I PASS the BATON
174
Q

hand off summary minimizes

A

potential errors from lack of information, agencies often provide specific assessments on written transfer summary in addition to verbal report

175
Q

I PASS the BATON

A

introduction
patient
assessment
situation
safety
background
actions
timing
ownership
next

176
Q

verbal handoff summary

A

transition of care
national pt safety goals
handoff reporting
call outs

177
Q

reporting

A

occurs at handoffs, during pt rounds, during pt and family care conferences, when calling or texting provider to report a change in status or produce requested information

178
Q

potential barriers to reporting

A
  • lack of structured format and standard and policies for communication
  • uncertainty about who is responsible and should be contact
  • power differences
  • poor clinical decision making regarding what needs to be reported
  • different communication styles
179
Q

qualities of effective reporting

A

organized, complete, accurate, concise, respectful
nonverbal communication
difference in communication styles between nurses and providers

180
Q

SBAR model

A

situation
background
assessment
recommendation/request

181
Q

reporting to PHP

A

face to face, telephone, text, fax
ensure contacting correct provider
phone and urgent communication (have pt info available for reference, document call, CPOE allows remote computer access for entering orders when off-site)
“read back”

182
Q

cultural competency is the dynamic process of

A

acquiring ability to provide effective, safe, and quality care that meets social, cultural, and linguistic needs to pts

183
Q

benefits of cultural assessment and competency

A

reduction in healthcare disparities, enhancing patients’ trust in healthcare system, cultural safety

184
Q

culture

A

socially transmitted behavioral patterns, beliefs, values, customs, life ways, and arts that guide worldview and decision making

185
Q

culture is learned first in

A

family, then school, community and other groups

186
Q

characteristics of culture

A

nationality, arce, skin, color, gender, age, religious affiliation, educational status, occupation, sexual orientation, etc

187
Q

aim of cultural assessment

A

gain knowledge about patients cultural beliefs and practices
compare needs of specific person with general themes
identify similarities and differences among cultural beliefs
generate holistic picture to develop nursing care plan

188
Q

cultural variables

A

cultural values and beliefs
religions, personal philosophy of life, spiritual beliefs
educational and economic background
relationships with family and peers
views on and use of technology
politics
patients legal status

189
Q

attributes for nurses during cultural assessment

A
  • genuine interest in pt’s culture and personal experience
  • active listening and awareness of meanings behind patients verbal communication
  • nonverbal communication
  • acknowledgment that the nurses own beliefs and prejudices might create barriers to providing culturally sensitive care
190
Q

subjective data collection

A

complete assessment isn’t always possible so nurse must determine which questions are most relevant based on patients specific healthcare encounter, symptoms, and care planning needs

191
Q

implementing cultural assessment in practice

A
  • assess patients beliefs on healthcare
  • pt will not comply with POC inconsistent with cultural beliefs and values
  • determine what kind of language assistance may be needed
  • provide environment for confidentiality and comfort
  • nurse must remain nonjudgmental
192
Q

cultural health beliefs and practices

A
  • food and nutrition
  • pregnancy and childbirth
  • beliefs and expressions of pain
  • during death and grieving
  • spirituality and religious beliefs
193
Q

social determinants of health

A
  1. economic stability
  2. education access and quality
  3. healthcare access and quality
  4. neighborhood and built environment
  5. social and community context
194
Q

social environment contributes to

A

health disparities among most important determinants of health throughout life

195
Q

social assessment

A

patterns of health and illness
need understanding on how patient will handle illness, comply or not with careplan, follow up w physician appointments or other therapies

196
Q

most common factors of social assessment

A

marital status
smoking
drug and alcohol use
ability to afford medications
access to transportation
time for appointments

197
Q

community

A

social unit or group of people with something in common

198
Q

assessment of community

A

ID resources, constraints, high-priority health concerns

199
Q

variables within community

A

gender, age, ethnicity, race, marital status, housing, employment status, education

200
Q

making clinical decisions

A

prioritize hypothesis and take action
analyzing changing findings: progress notes
interprofessional collaboration with spiritual care
plan the care
evaluating outcomes

201
Q

christian

A
  • baptism
  • different beliefs about birth control, artificial insemination, individual choice of conception
202
Q

muslim

A

combination of conventional biomedical treatments with spiritual nourishment consisting of daily prayers and reading or listening to Quaran
bed faced toward mecca

203
Q

jewish

A

jewish holidays and rituals
some pray 3x a day and need prayer items
many visitors

204
Q

hindu

A

pray, sing, recite scriptures, and repeat the names of deities at home or in other places
shrines
sacred writings and objects

205
Q

jehovah’s witness

A

used of blood products or animal products to sustain life may not be congruent with Jehovah’s Witness beliefs

206
Q

primary building blocks

A

formal institutions in the area, such as local businesses, schools, libraries, parks, and police, and fire stations

207
Q

secondary building blocks

A

agencies designed to serve the community with outside overarching corporations that manage and operate these agencies
communities primary care clinic

208
Q

potential building blocks

A

programs and services outside community such as politicians and corporations

nur306 (4 decks)

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