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ADN001 Funds > Lecture 2 Exam Review Week 6 > Flashcards

Lecture 2 Exam Review Week 6 Flashcards

1
Q

Dimensions of Self Concept

A

Self Knowledge - Who am I?
Self Expectation - Who or what do I want to be?
Self- Evaluation- How well do I like myself?

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2
Q

Three Major self evaluations feelings

A

Pride - Based on positive self- evaluation
Guilt - Based on behaviors incongruent with the ideal self
Shame - Associated with low global self- worth

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3
Q

Stages of Development

A

Self- Awareness(infancy)
Self- Recognition- (18 months)
Self- definition- (3 years)

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4
Q

Formation of Self- Concept

A

Infant learns physical self different from environment

Basic needs are met, positive feelings of self

Child internalizes other people’s attitudes toward self

Child or adult internalizes standard

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5
Q

Factors Affecting Self- Concept

A

Developmental Considerations
Culture
History of success and failure
Crisis of life stressors
Aging, illness, disability, or trauma

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6
Q

Nursing strategies to Identify Personal Strengths

A

Encourage PT to identify their strengths
Replace self- negation with positive thinking
Notice and reinforce patient strengths
Encourage patients to will for themselves
Help patients cope with necessary dependency

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7
Q

Helping Patients Maintain Sense of Self

A

Communicate with looks, speech, and judicious touch

Acknowledge patient status, role, and individuality

Speak to the patient respectfully. Address by preferred name

Converse with the patient about their life experiences

Respect their privacy

Acknowledge negative feelings and allow for expression

Help the patient recognize strengths and explore alternatives

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8
Q

Examples of Physiologic Stressors

A

Chemical Agents
Physical Agents
Infectious Agents
Nutritional imbalances
Hypoxia
Genetic or immune disorders

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9
Q

Physiological Homeostasis

A

Local Adaptation Syndrome

Involves only one specific body part
- Reflex pain response
- Inflammatory Response

General Adaptation Syndrome
Biochemical model of stress

Alarm Reaction
Stage of Resistance
Stage of Exhaustion

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10
Q

Local Adaptation Syndrome

A

Localized response of the body to stress
Involves only a specific body part ( such as tissue or organ) instead of whole body

Stress precipitating the LAS may be traumatic or pathologic

Primarily homeostatic short- term adaptive response

Two types:
Reflex Pain Response
Inflammatory Response

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11
Q

Alarm Reaction

A

Person perceives stressor, defense mechanisms activated

Fight or Flight response

Hormone levels rise, body prepares to react

Shock and counter-shock phases

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12
Q

Stage of Resistance

A

Body attempts to adapt to stressor

Vital signs, hormone levels, and energy production return to normal

Body regains homeostasis or adaptive mechanisms fail

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13
Q

Stage of Exhaustion

A

Results when adaptive mechanisms are exhausted

Body either rests and mobilizes its defenses to return to normal and dies

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14
Q

Examples of Psychosocial Stressors

A

Accidents
Stressful or traumatic experiences of family members and friends
Horrors of history
Fear of aggression or mutilation
Events of history that are brought into our homes through television and the internet
Rapid changes in the world
Inherent stressors, social isolation, political divides, and change in work life separation brought on the pandemic

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15
Q

Psychological Homeostasis

A

Mind- Body interaction
Anxiety
Coping Mechanisms
Defense Mechanisms

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16
Q

Coping Mechanisms

A

Crying, laughing, sleeping, cursing
Physical Activity, exercise
Taking a deep breath, mindfulness exercises
Smoking, drinking
Lack of eye contact, withdrawal
Limiting relationships to those with similar values and interests

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17
Q

Task- Oriented Reactions to Stress

A

Attack Behavior

Withdrawal Behavior

Compromise Behavior

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18
Q

Attack Behavior

A

Attempts to overcome obstacles to satisfy a need

Constructive- Assertive problem solving
Destructive- Aggression, hostility

Withdrawal Behavior
Physical withdrawal from the threat
Admitting the defeat, apathetic, feeling guilty, isolated

Compromise Behavior

Substitution of goals or negotiation to partially fulfill needs ( usually constructive)

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19
Q

Compensation

A

Person attempts to overcome a perceived weakness by emphasizing a more desirable trait or overachieving in a more comfortable area.

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20
Q

Denial

A

A person refuses to acknowledge the presence of a condition that is disturbing.

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21
Q

Displacement

A

Transfers an emotional reaction from one object or person to another object or person

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22
Q

Dissociation

A

Person subconsciously protects themself from the memories of a horrific or painful event by allowing the mind to forget the incident.

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23
Q

Introjection

A

Person incorporates qualities or values of another person into their own ego structure. Important in the formation of conscience during childhood.

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24
Q

Projection

A

Person attributes thoughts or impulses to someone else.

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25
Q

Rationalization

A

Person tries to give a logically or socially acceptable explanation for questionable behavior.

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26
Q

Reaction Formula

A

Person develops conscious attitudes and behavior patterns that are opposite to what they would really do.

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27
Q

Regression

A

Person returns to an earlier method of behaving

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28
Q

Repression

A

Person voluntarily excludes an anti- anxiety producing event from conscious awareness

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29
Q

Sublimation

A

Person subs. a socially acceptable goal for one whose normal channel of expression is blocked

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30
Q

Undoing

A

Person uses an act or communication to negate a previous act or communication.

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31
Q

Steps of Communication Process

A

Initiated based on stimulus

Sender-(Encoder)
Begins the process

Message
Communication product from the source

Channel Communication
\Auditory, visual, kinesthetic
Receiver( Decoder)
Translates and interprets the message being received

Confirmation of the message provides feedback

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32
Q

Verbal Communication

A

Depends on understanding language

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33
Q

Nonverbal

A

Facial Expressions, gestures, eye contact, touch,
Space, time, boundaries
Body movements, posture, and gait
General Physical Appearance and mode of dress or grooming
Sounds
Moaning, crying, gasping, sighing

34
Q

Communication Technologies

A

Electronic Communication\
Social Media
Email and Texts
Telehealth and telemedicine

35
Q

Electronic Communication

A

Social Media

Both the ANA and NCSBN have issued guidelines for RNs regarding the use of social media

Emails and Texts

Risk for violating patient privacy and confidentially exists any time a message is sent electronically

Health care agencies usually have security measures in place to safeguard e-mail and text communications

36
Q

Four Levels of Communication

A

Intrapersonal

Self- talk, communication within a person
Calming, soothing with nerves

Interpersonal

Occurs between two or more people with a goal to exchange messages
Patient family members, health care team

Group
Small group
Patient- care conferences, teaching sessions, support groups

Organizational Communication

37
Q

Factors Influencing Communication

A

Developmental Level
Sociocultural Differences
Roles and Responsibilities
Space and territorially
Physical, mental, and emotional state
Values
Environment

38
Q

SBAR

A

S situation
B background
A assessment
R recommendation

39
Q

Therapeutic Relationship

A

Set the climate for participants to move toward common goals

Does NOT occur spontaneously

Characterized by an unequal sharing of information

Built on the Pt needs

The nurse is the caregiver and the patient is the person being cared for

Communication is the means used to establish rapport and trusting, therapeutic relationships

40
Q

Characteristics of the Therapeutic Nurse- Patient Relationship

A

Caring
Person Centered relationship

Dynamic
Both people involved are active participants

Purposeful and time limited

The person providing the assistance is professionally accountable for the outcomes

Goals are determined cooperatively and defined in terms of the PTs needs

41
Q

Three Phases of the Therapeutic Nurse- Patient Relationship

A

Orientation Phase

PT will call the nurse by name
PT will accurately describe the roles of the participants in the relationship
PT will establish an agreement about:
Goals of relationship
Location, frequency, and length of contacts
During relationship

Working Phase
PT will:
Actively participate in the relationship
Cooperate in activities that work toward achieving mutually accepted goals
Express feelings and concerns to the nurse

Termination
PT will participate in identifying goals accomplished or progress made toward goals

PT will verbalize feelings about the termination of the relationship

42
Q

Factors Promoting Effective Communication

A

Dispositional Traits

Warmth and friendliness
Openness and respect
Empathy
Honesty, trust, and authenticity
Caring
Competence

Rapport Builders
Specific objectives
Comfortable environment
Privacy
Confidentiality
PT versus Task focus
Using Nursing observations
Optimal Pacing

43
Q

Developing Conversation skills

A

Control the tone of your voice

Be knowledgeable about the topic of conversation

Be flexible
Be clear and concise

Avoid words that might have different interpretations

Be truthful

Keep an open mind

Take advantage of available opportunities

44
Q

Developing Listening Skills

A

Sit when communicating with the patient

Be alert and relaxed and take your time

Keep the conversation as natural as possible

Maintain eye contact if appropriate

Use appropriate facial expressions and body gestures

Think before responding to the patient

Do not pretend to listen

Listen for themes

Use silence, therapeutic touch, and humor appropriately

45
Q

Interviewing Techniques

A

Open Ended
What did your health care provider tell you about your need for this hospitalization?

Closed
What medications have you been taking at home
Validating
At home, you have been taking BP pill and water pill every day. Did you take them today

Clarifying
I have never needed this med.. Is this the first health problem you have had?

Reflective
You’ve been upset

46
Q

Aggressive Behavior

A

Involves asserting one’s rights in negative manner that violates the rights of others

Can be verbal or physical

Communication is marked by tension and anger, inhibiting the formation of good relationships and collaboration

Characteristics include using an angry tone of voice, being condescending, and threatening

Focus is usually “ winning at all costs”

47
Q

Blocks to Communication

A

Failure to perceive the patient as a human being

Failure to listen

Nontherapeutic comments and questions

Using cliches

Using closed questions

Using leading questions

Using comments that give advice

Using judgmental comments

Changing the subject

Giving false assurance

Using gossip and rumors

48
Q

Disruptive Interpersonal Behavior

A

Incivility

Horizontal Violence

Lateral Violence
Nurse Bullying
Professional Activity

Organizational response to disruptive behaviors

49
Q

Verbally and Physically Aggressive Patients

A

Workplace Violence

Verbal harassing, threatening, yelling, bullying, hostile sarcasm

Nurses should:

Respond by maintaining a professional demeanor, responding assertively, addressing the issue directly with those involved

See guidance and support through nurse managers or other appropriate channels

50
Q

Workplace Violence

A

Violent acts, including physical assaults and threats of assault, directed toward persons at work on duty

Includes verbal harassing, threatening, yelling, bullying, and hostile sarcasm

51
Q

Patterns of Interaction

A

Effective

Honest and direct flows freely

Ineffective
Communication is sparing and or one way , self serving roles and may be unchecked

52
Q

Leadership

A

Effective

Meets desired aims, participation and leadership are distributed among members

Ineffective

Leadership delegated on authority.

53
Q

Documentation

A

Written or electronic legal record of all pertinent interactions with the patient

Includes data related to assessing, diagnosing, planning, implementing, and evaluating

Facilitates quality, evidence- based patient care

Serves as financial and legal record

Helps in clinical research

Supports decision analysis

54
Q

Characteristics of Effective Documentation

A

Consistent with professional and agency standards
Complete
Accurate
Concise Factual
Organized and Timely
Legally prudent
Confidential

55
Q

Elements of Documentation

A

Content
Timing
Format
Accountability
Confidentiality
Using 24 hr military time

56
Q

What is confidential?

A

All information about patients written on paper, spoken aloud, saved on computer

Name, address, phone, fax, social security number

Reason the person is sick
Treatment PT receives
Information about past health conditions

57
Q

Potential Breaches in Patient Confidentiality

A

Displaying information on a public screen and not logging out of the computer

Sending confidential email messages via public networks

Sharing printers among units with differing functions

Discarding copies of the PT information in trash cans

Holding conversations that can be overheard

Faxing confidential information to unauthorized persons

58
Q

Patient Rights

A

Patients have the right to:

See and copy their health record
Update their health record
Get a list of disclosures
Request a restriction on certain uses or disclosures
Choose how to receive health information

59
Q

Policy for Receiving Verbal Orders

A

Must be given directly by physician or NP to a registered nurse or registered professional pharmacist

Record the orders in PTs medical record with intials VO

Read back the order to verify

Date and note the time orders were issued

Record verbal order and name of the physician or NP , followed by nurse’s name and initials

Should be limited to urgent situations

60
Q

Policy for Physician or NP Review of Verbal Orders

A

Review orders for accuracy
Sign orders with name, title, and page number

Date and note time orders signed

61
Q

Methods of Documentation

A

Computerized Documentation
EHRs

Source Oriented Records
Progress notes, narrative notes

Problem Oriented Medical Records
SOAP notes

PIE Charting
Problem
Intervention
Evaluation

Focus Charting

Charting by Exception

62
Q

Formats for Nursing Documentation

A

Initial nursing assessment
Care plan, patient summary
Critical Collaborative Pathways
Progress Notes
Flow Sheets and graphic records
MAR record
Acuity Record
Discharge and transfer summary
Home Health Care documentation
Long Term Documentation

63
Q

Reporting Care or Requesting Action

A

Change of shift/ handoff report
ISBARR
Telephone? Telemedicine Report
Transfer and Discharge reports
Reports to family members or significant others
Incident/ Variance Reports

64
Q

Hand- Off Communication/ ISBARR

A

Identify/ Introduction
Situation
Background
Assessment
Recommendation
Read back of Orders/ response

65
Q

Change of Shift/ Hand -Off Reports

A

Basic identifying information about each patient: name, room, number, bed designation, diagnosis, and attending and consulting physicians

Current Appraisal of each Patient’s health status

Current Orders
Abnormal occurrences during your shift
Any unfilled orders that need to be continued onto the next shift
PT/ Family questions, concerns, needs
Reports on transfers/discharges

66
Q

Telephone/ Telemedicine Reports

A

Identify yourself and the patient and state your relationship to the patient

Report and accurately the change in PTs condition that is of concern and what has already been done in response to this condition

Report the PTs current vital signs and clinical manifestations

Have the PT record at hand to make knowledgeable responses to any physician’s inquiries

Concisely record time and date of the call, what was communicated, and physician’s response

67
Q

Conferring About Care

A

Consultations and referrals
Nursing and interdisciplinary team care conferences
Nursing Care Rounds
Purposeful Rounding

68
Q

Eight Behaviors of Purposeful Rounding

A

Use Opening Kew Words ( C-I-CARE) with PRESENCE
Accomplish scheduled tasks
Address four Ps
Address additional personal needs, questions
Conduct environmental assessment
Ask: is there anything else I can do for for you? I have time
Tell the PT when you will be back

Document the round

69
Q

Meaningful Use of EHR

A

Improves quality, safety, efficiency, and reduce health disparities

Engage patients and family

Improve care coordination and population and public health

Maintain privacy and security of PT health information

70
Q

Results of Meaningful Use Compliance

A

Better Clinical rotations
Improved population health outcomes
Increased transparency and efficiency
Empowered individuals
Most robust research data on health systems

71
Q

ANA Definition of Nursing Informatics

A

The specialty that integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice.

72
Q

Components of System Development Lifecycle

A

Analyze and Plan
Design and develop
Maintain
Evaluate

Test, Train, Implement

73
Q

Analyze and Plan

A

What is the purpose of this new technology or change to the current technology?

What problem do we hope to solve?

What data do we have to indicate the current state of the issue?

How will its use be incorporated into the current workflow of the nurse?

Will it streamline nursing documentation or will it increase the burden of documentation?

Will it improve the overall usability and experience with the EHR?

What technologic options are available if there are more than one?

74
Q

Important Informatics Concepts

A

System usability
System optimization
Standard terminologies
Interoperability
Security and Privacy
Blockchain

75
Q

Emerging Areas in the Field of Informatics

A

Patient Portals
Health Care Analytics
Data Visualization
Predictive Analytics
Big Data

76
Q

Telehealth

A

Use of electronic information and telecommunications technologies to support and promote long distance clinical health care, patient and professional health education, public health, and health administration

77
Q

Telemedicine

A

Use of telecommunications technologies to support the delivery of all types of medical, diagnostic, and treatment- related services, usually by physicians and NPs

78
Q

Telecare

A

refers to technology that allows consumers to stay safe and independent in their own homes

79
Q

Uses of Patient Portals

A

Access medical history and other health information

Complete various forms and questionnaires

Communicate securely and conveniently with providers

Schedule appointments

Receive reminders for appropriate screenings

Enter clinical data, such as blood pressure, glucose levels, weight, fitbit data and other activity tracking data

Review progress notes

80
Q

Benefits of Patient Portals

A

Better health outcomes
Chronic condition management
Timely access to care
Patient Retention
Patient Centered medical home recognition

81
Q

Types of Health Care Analytics

A

Clinical
Populations
Administrative
Financial

82
Q

Genetics and Genomics

A

Precision Medicine

The field of genomics has the potential to significantly change the way health care is delivered

Genomics play a role in 9n out of 10 leading causes of death, including heart disease, cancer, stroke, diabetes, and Alzheimer’s disease

Because genomic health care is heavily dependent on data storage and interpretation, no other area is better suited than informatics to support this evolving work .

ADN001 Funds (6 decks)

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