NUR 180 UNIT 2 Flashcards
Science of nursing
The knowledge base for the care that is given.
Art of nursing
The skilled application of that knowledge in helping others achieve optimal health and quality of life.
Science of Nursing
the knowledge base for the care that is given. It includes: best practice + critical thinking + clinical judgment = nursing judgment
Art of Nursing
the skilled application of that knowledge in helping others achieve optimal health and quality of life. Encompasses physical, emotional, social, and spiritual dimensions of the patient
Historical background of Nursing
16th century - Shift from a religious orientation to an emphasis on warfare, exploration, and expansion of knowledge
- Nursing had a poor reputation; nurses received low pay and worked long hours in unfavorable conditions.
18-19th century - Social reforms changed the roles of nurses and of women in general.
- Nursing as we now know it began, based on many of the beliefs of Florence Nightingale.
- Nightingale challenged prejudices against women and elevated the status of all nurses.
19th-21st century - Hospital schools organized to provide more easily controlled and less expensive staff for the hospital.
- First Hospital School of Nursing for Men
- Nurses were under the control of male hospital administrators and physicians.
World War II:
- Large numbers of women worked outside the home and became more independent and assertive.
- Explosion in medicine and technology broadened the role of nurses.
- Growth of nursing as a professional discipline
1950-present - Nursing broadened in all areas:
- Practice in a wide variety of health care settings
- The development of a specific body of knowledge
- The conduct and publication of nursing research
- Recognition of the role of nursing in promoting health
- Growth of nursing as a professional discipline
Diagnosing
identification of and discrimination between physical and psychosocial signs and symptons essential to effective execution and management of the nursing regiment, such diagnostic privileage is distinct from a medical diagnosis.
Nurse Practice Act
The purpose is to regulate the scope of nursing practice and protect public health, safety, and welfare.
- PROTECT the PUBLIC by defining the LEGAL SCOPE of nursing practice, excluding untrained or unlicensed people from practicing nursing
- CREATE a state BOARD OF NURSING or regulatory body having the authority to make + enforce rules + regulations concerning the nursing profession
- DEFINE important terms + activities in nurisng including legal requirements + titles for RNs + LPNs
- ESTABLISH CRITERIA for the education + licensure of nurses
Four Aim of Nursing
- ) To promote health
- ) To prevent illness
- ) To restore health
- ) To facilitate coping with disability or death
- To meet these aims, the nurse uses FOUR blended compentencies: cognitive, technical, interpersonal + ethical/legal
Roles and Functions of Nurses
Caregiver -the provision of care to patients that combines bothh the art and the science of nursing in meeting physical, emotional, intellectual, socioculturall, and spiritual needs.
Communicator- the use of effective interpersonal and therapeutic communication skills to establish and maintain helping relationships with patients of all ages in a wide variety of health care setting.
Educator/teacher - the use of communication skills to assess, implent, and evaluation individualized teaching plans to meeting learning needs of patient and their families.
Counselor- the used of therapeutic interpsonal communcation skills to provide info, make appropriate referrals, and facilititate the patient problem solving and decision making skills.
Leader- The assertive, self confident practice of nursing when providing care effecting change and functioning with groups.
Researcher- the patricipation in or conduct of research to increase knowledge in nursing and improve patient care.
Advocate - the protection of human or legal rights and the securing of care for all patients based on the belief that patients have the right to make imformed cisions about their own healths and lives.
Collaborator- the effective use of skills in organization, communication, and advocacy to facilitate the functions of all members of the health care team as they provide patient care.
LPN
DIPLOMA, 24-36 months, plans and gives direct care to patients in structured settings, works with other members of the health care team to plan and provide care to mostly ill patients.
RN, ADN
Associate degree - 2 years. SAME descriptions as LPN.
RN, BSN
4 YEARS, variety of seetings in which health care and nursing care are provided. Plans and give direct care to individual patients, groups, and communities. Direct other memebers of the health care team in planning and providing care to ill and well patients in a variety of setting assumes beggining of leadership roles provides comprehensive health care including health promotion, illness prevention, and rehabilitative, educational, and health counseling.
Standard of Practice
allow nurses to carry out professional roles, serving as protections for the nurse, the patient, and the insitution where health car is provided. Assessment, diagnosis, outcomes identification, planning, implementation, coordination of care, consultation, evaluation
Nurse practice act
laws established in each state in the US to regulate the practice of nursing.
Nursing process
assessing, diagnosing, planning, implementing, and evaluating.
Current trends in nursing
- Changing demographics and increasing diversity
- The technological explosion
- The era of the educated consumer, alternative therapies, and genomic and palliative care
- The shift to population-based care and the increasing complexity of patient care
- The cost of health care and the challenge of managed care
- The impact of health policy and regulation
- The growing need for interdisciplinary education and collaborative practice
- The current nursing shortage/opportunities for lifelong learning and workforce development
- Significant advances in nursing science and research
Credentialing
The process used to establish the qualifications of professionals, organizational members, or organizations and to assess their background and legitimacy to meet predetermined and standardized criteria. Individuals, organizations, processes, services, or products may be credentialed.
Accreditation
A voluntary process by which a nongovernmental entity grants a time-limited recognition or credentials to an organization after verifying that predetermined and standardized criteria are met.
Licensure
A process by which a governmental agency grants time-limited permission to an individual to engage in a given occupation after verifying that he or she has met predetermined and standardized criteria (usually education, experience, and examination).
Cerification
A voluntary process by which a nongovernmental agency grants a time-limited recognition to an individual after verifying that he or she has met predetermined and standardized criteria.
Registration
as the recognition of successful completion of mandated requirements for the practice of a particular profession.
Treating
selection and performance of those therapeutic measures essential to the effective execution and managment of the nursing regiment and execution of the prescribed medical regiment
Human responses
Signs, symptoms, and processes which denote the individual interaction with an actual or potential health problem
Wellness
An ACTIVE state of being healthy by living a lifestyle promoting good physical, mental, and emotional health.
Disease
Pathologic ( abnormal) change in the structure or function in the body or mind.
Health
A state of physical, mental and social well being, not merely the ABSENCE OF DISEASE or infirmity. A state of optimal functioning.
Illness
The UNIQUE response of a person to a disease; an ABNORMAL PROCESS involving changed level of of functioning.
The health -Illness continuum
Measures a person’s levels of health. Views health as a CONSTANTLY CHANGING state with high levels of WELLNESS and death on OPPOSITE sides of a continuum.
illustrate the dynamic state of health. Read from left to right death-illness-normal-good-high
Acute
a fast onset; last few days, and are usually cured.
Chronic
They have slow onset; are not usually curable and tend to last life long.
Stages of Illness behavior 1-4
1)transition or onset, 2) acceptance, 3) dependent role and 4)convalesce or recovery
Transition or onset
patientis experiencing symptoms bit does not accept yet he/he is sick.
Acceptance
a patient accepts that is sick and gives up normal activities but may be still does not seek profesional help, but accepts help from the family.
Dependent Role
The patient accepts medical treatments
Convalesce or recovery
patient archives recovery and might include rehabilitation.
Nursing
a profession focused on assisting individuals, families, and communities to attain, recover, and maintain optimum health and function from birth to old age.
Level 1
Physiologic needs- oxygen,water,food,elimination,temp,sex,physical activity, and rest
Level 1 - highest priority
Physiologic needs- oxygen,water,food,elimination,temp,sex,physical activity, and rest
level 2
Safety and security needs- being protected from potential or actual form.
level 3
Love and belonging needs- understanding and acceptance of others in both giving and receiving love, and the feeling of belonging.
Level 4
Self esteem needs- feel good about oneself, to feel pride, and sense of accomplishment.
Level 5
self actualization needs- individual to reach their full potential through development of their unique capability.
Actual unmet
Human needs that are completely being deprived
high risk for unmet human need
potentially could turn to be unmet
OCC 5 categories of human needs
- Activity and rest
- Oxygenation
- Safety and security
- Nutrition and elimination
- Psychosocial need
Inpatient
A person who enters a hospital and stays overnight for an undetermined time
outpatient
who are not hospitalized overnight but who require diagnosis or treatment. Ex of outpatient- surgical procedures, diagnostic test, meds, pt, counsel, edu
Director of nursing
head of nursing department
head nurse/manager/admin
In charge of each unit of nurse. quality planning, implementation, and evaluation of client on unit.
Charge nurse
multple nurse hold this role, in charge of unit per shift/week. daily running of unit, paperwork, coordination, assignment
Primary nursing
an RN - Primary nurse, takes responsiblities for a client at admission and follow that client throughtout the stay 1-2 “ associated nurse “ or LPN will work with the primary nurse for the client.
- A nurse is responsible for planning, evaluating, and directing the care of a patient 24 hours a day from admission until dischare.
- Pros: Patient care is individualized, comprehensive, and consistent.
- Con: This is model is expensive for healthcare facilities.
Team nursing
Unit divide in half, each half is stall by RN team leader with 3-4 staff member.
- A team made up of an RN and other members of the healthcare team provide care to a designated group of patients. This is a modified version of functional nursing.
- The team approach allows specific tasks to be done quickly and efficiently through team work. Each team member is able to work on tasks they do best with assistance when needed. The team is focused on individualizing patient care.
Clinical Pathways
A clinical pathway is a tool developed by a multi disciplinary health team. The object is to standardize care and outcomes for patients. They are important because they look at current practice and indicate how to improve it, especially in the areas of length of stay and the efficient use of clinical resources (staff, time, supplies, and equipment). Pathways are based on financial and clinical data, chart review, and research which results in a plan that maps care, beginning with admission. Outcome goals, including the patient’s medical progress, education and movement towards discharge all become important milestones.
Task functions
behaviors that help the group directly to move to, reach, or monitor the group goal.
- Initiator/Contributor Contributes ideas and suggestions; proposes solutions and
decisions; proposes new ideas or states old ideas in a novel fashion. - Information Seeker Asks for clarification of comments in terms of their factual
adequacy; asks for information or facts relevant to the problem; suggests information is
needed before making decisions. - Information Giver Offers facts or generalizations that may relate to the
group’s task. - Opinion Seeker Asks for clarification of opinions made by other members
of the group and asks how people in the group feel. - Opinion Giver States beliefs or opinions having to do with suggestions
made; indicates what the group’s attitude should be. - Elaborator/Clarifier Elaborates ideas and other contributions; offers rationales
for suggestions; tries to deduce how an idea or suggestion would work if adopted by the
group. - Coordinator Clarifies the relationships among information, opinions,
and ideas or suggests an integration of the information, opinions, and ideas of subgroups. - Diagnostician Indicates what the problems are.
Group maintenance
behaviors that help group member to feel comfortable and work together.
- Supporter/Encourager Praises, agrees with, and accepts the contributions of
others; offers warmth, solidarity, and recognition. - Harmonizer Reconciles disagreements; mediates differences; reduces
tensions by giving group members a chance to explore their differences. - Tension Reliever Jokes or in some other way reduces the formality of the
situation; relaxes the group members. - Conciliator Offers new options when his or her own ideas are involved
in a conflict; disciplines to admit errors so as to maintain group cohesion. - Gatekeeper Keeps communication channels open; encourages and
facilitates interaction from those members who are usually silent.
Personal self serving
behavior that meet the member own need and do not help the group.
- Blocker Interferes with progress by rejecting ideas or taking a
negative stand on any and all issues; refuses to cooperate. - Aggressor Struggles for status by deflating the status of others; boasts;
criticizes. - Deserter Withdraws in some way; remains indifferent, aloof, and
sometimes formal; daydreams; wanders from the subject; engages in irrelevant side
conversations. - Dominator Interrupts and embarks on long monologues; is
authoritative; tries to monopolize the group’s time. - Recognition Seeker Attempts to gain attention in an exaggerated manner;
usually boasts about past accomplishments; relates irrelevant personal experiences,
usually in an attempt to gain sympathy. - Playboy Displays a lack of involvement in the group through
inappropriate humor, horseplay, or cynicism.
Intrapersonal Communication
communication within a person;also known as self-talk
Interpersonal Communication
communication that occurs between two or more people with a goal to exchange messages
Small-group communication
communication that occurs when two or more nurses interact with two or more individuals, allowing the members to achieve a goal through communication
Organizational Communication
process of communication that involves individuals and groups to achieve established goals
Essential role of ethical code
A code of ethics is important because it helps employees or organization members make decisions that are in line with company values in the absence of a clear rule or direct supervision. A code of ethics can improve decision making at a business, and make it easier for employees to be autonomous.
Value
A believe about the value of something about what matters that acts as a standard to guide one behaviors
Ethics
A systematic study of principle of right and wrong conductVirtue and vice and good and evil as they relate to conduct and human flourishing
Morals
Personal or committal standards of right and wrong
Value neutrality
Do not assume that your personal values are more correct than those of your patient
Code of ethics
Set a principle that reflect the primary goal values and obligation of the profession. It is a succinct Statement of the ethical application and duties of every individual who enters the nursing profession. It is the profession nonnegotiable ethical standard.It is an expression of nursing on understanding of its commitment to society.
American nurses Association cold for nurse
The nurse in all professional relationship practice with compassion and respect for the inherent dignity worth and uniqueness of every individual on restricted by consideration of social or economical status personal attributes or the nature of health problems. The nurse primary commitment is to be patient whether an individual family group or community. The nurse promotes advocate for and strive to protect the health safety and right of the patient. The nurse is responsible and accountable for individual nursing practice and determine the appropriate delegation of tasks consistent with the nurse obligation to provide optimal patient care. The nurse always the same duties to sell asked to others including the responsibility to preserve integrity to maintain confidence and to continue personal and professional growth. The nurse participate in establishing maintaining and improving healthcare environment and conditions of employment conducive To the provision of quality health Clear and consistent with the values of the profession through individual and collective action. The nurse participate in the advancement of the profession through contribution to practice education administration and knowledge development. The nurse collaborate with other health professional in with the public and promoting community national and international effort to meet health needs. The profession of nursing as represented by association in their members is responsible for the articulation of nursing values for maintaining the integrity of the profession and it’s practice and for shaping social policy.
Informed consent
The patient voluntary agreement to undergo a particular procedure or treatment.Patient must be confident.Relevant facts must be this close.The person must understand what is disclosed.The decision must be voluntary. The person must give consent.
Advance directives
Also known as legal documents allow patient to specify Instruction for Healthcare treatment should they be unable to communicate these wishes post operativeLy. Living will, proxy/surrogate,Durable power of attorney. Living will provide specific instruction about the kind of healthcare thatShould be provided or forgone In particular situation. Durable power of attorney for healthcare appoint an agent The person trust to make decision in the event of subsequent Incapacity.
Terminal Weaning
The gradual withdrawal of mechanical ventilation from a patient with a terminal illness or An irreversible condition with poor prognosis
Euthanasia
Good dying
Active euthanasia
Taking specific steps to cause a patient death
Passive euthanasia
With drawing medical treatment with the intention of causing the patient death
A helping relationship
A term used between the relationship between nurses and patient.Exist among people who provide and receive assistance in meeting human needs.
Difference between a helping relationship versus a social relationship
Helping relationship does not occur spontaneously hey occurs for a specific Purpose with a specific person. The Helping relationship is characterized by an Unequal sharing Of information. The helping relationship is built on the patient needs not on those of the helping person.
Characteristic of the helping relationship
It is dynamic it is purposeful and time-limited and although both parties in the helping relationship have responsibilities the person providing the assistant is professionally accountable for the outcome and the means used to obtain them.
Ethical principle of respect for autonomy
The right of the individual to self determination in particular over what happens to one body if the person is competent
Surrogate and proxy
Incompetent patient who are not capable of making healthcare decisions for themselves uses surrogate or a proxy to speak for them based on their wishes or honor
Cultural diversity
Diverse group in society with varying racial classification and national origin religious affiliation language physical size gender sexual orientation age disability social economic status occupational status and geological location
Culture
A shared system of believes values and behavioral expectations that provide social structure for daily living includes believes habits likes and dislikes and custom and rituals
Sub culture
A large group of people who are members of a larger cultural group but have certain ethics occupational Or physical characteristic not common to the larger culture.
Dominant group
The group within a country or society that has the most authority to control values and sanction
Minority group
Most often has physical or cultural characteristics that identifies the people within it as different
Cultural asssimulation
When members of a Minority group live within a dominant group and lose the cultural characteristics that made them different
Culture shock
Dial feeling a person experience one place in a different culture
Ethnicity
The sense of identification with a collective cultural group largely based on the group common heritage includes language and dialect religious practice literature music political interests board and employment patterns
Race
Racial categories are based on specific physical characteristic
Stereotyping
Assuming that all members of a culture subculture or ethic group act alike
Cultural imposition
The belief that everyone should conform to the Majority belief system
Cultural blindness
The result of ignoring difference in proceeding as though they do not exist
Cultural conflict
State that occurs when people become aware of cultural difference feels threatened and respond by ridiculing the belief and tradition of others to make themselves feel more secure
Personal space
The area around a person regarded as part of the person varies among people and culture and ethnic group
Ethnocentrism
The belief that one’s ideas beliefs and practices are the best are superior or are most prefer to those of others
Ethical dilemma
Convicted of a crime practicing while impaired being Habituated to substance. Loss of job convicted of crime miss conduct disciplinary chargeName on public state site Medicaid exclusion can’t find employment debt and homelessness
HIPPA-Health insurance portability and accountability act requirement
Requires organization to determine threats and choose the appropriate protective measure for information not only an electronica format but in all format. Establish national standards to protect individual medical record and other personal health information and Applies to health plans Healthcare clearing houses and those health care provider that conducts certain Healthcare transaction electronically
Professionalism
Helping relationship or professional relationships through their appearance demeanor and behavior communiqué a clear sense of professionalism or confidence and expertise in their practice.
Implementing
Nursing plan are carried out.The purpose of implementation order to help the patient achieved valued health outcome promote health prevent disease and illness restore health and facility coping with altered functions.
Focus of nursing implementation
The nurse is concerned with the patient response to health and illness and the patient ability to meet humans needs
Guidelines for implementation of nursing care
Should be patient center should address one patient response should be observable measurable and time limited should be mutually set by nurse and patient and should be realistic.When implementing nursing care remember to act in partnership with the patient and family. Before implementing any nursing action reassess the patient to determine whether the action is still needed. Approach the patient confidently know how to perform the nursing action why the action is being performed and potential adverse responses. Approach the patient carefully explain the nurse action using language that patient understand. Modify nursing intervention according to the patient. Check to make sure that the nursing intervention selected are consistent with standard of care in within legal and ethical guidelines. Always question that the nursing intervention selected is the best of all possible alternative. Develop skilled nursing intervention the more option one can choose from the greater the likelihood for success
Six variables that influence the way a plan of care is implemented
Patient variables nurses variables resources current standard of care research finding ethical and legal guides to practice
Legal issues in documentation
Document significamy
