NUR 200 Final Flashcards
1
Q
Florence Nightingale
A
Cleanliness and Environment
-Professional Nursing
2
Q
Clara Barton
A
Founder of the American Red Cross
3
Q
Dorothea Dix
A
Advocate for Mental Health nursing/asylums
4
Q
Lavinia Dock
A
Pioneer in nursing education
5
Q
Mary Breckenridge
A
Frontier in field of Nurse Midwifery
6
Q
Margaret Sanger
A
Established Planned Parenthood
7
Q
Patricia Benner
A
Theory of Nursing Caring from Novice to Expert
8
Q
Peplau
A
Theory of Interpersonal Relationships
-You need to have communication with your patients
9
Q
Virginia Henderson
A
Nursing Theory of Needs
-Created because she had 14 needs
10
Q
Dorothy Johnson
A
Behavioral System Model
-Focused on behavior function
11
Q
Dorothea Orem
A
You need to be able to fulfill biological, psychological, developmental, or social needs to be healthy
12
Q
Imogene King
A
Patient environment and nurse-patient relationship is part of the nurse for meeting pt goals towards good health
13
Q
Betty Neuman
A
Reduce stress of the patient
14
Q
Sr. Castilla Roy
A
Viewed individual as a set of interrelated systems who strive to maintain the balance between these various stimuli
15
Q
Jean Watson
A
Caring Theory
-You need to be caring and humanistic
16
Q
What are the phases of Nursing? (Benner)
A
1) Novice
2) Advanced Beginner
3) Competent
4) Proficient
5) Expert
17
Q
What does Novice level Nursing mean?
A
-Task Oriented
-Focused on learning rules
-Follows written sequential process
18
Q
What does Advanced Beginner level Nursing mean?
A
Focuses on more aspects of a clinical situation and applies more facts
19
Q
What does Competent level Nursing mean?
A
-Have additional experience
-Can handle patient load
-Can deal with complex situations
-Can prioritize
20
Q
What does Proficient level Nursing mean?
A
-Quickly taken in all aspects of a situation and given meaning to the data
-“Sees the bigger picture”
21
Q
What does Expert level Nursing mean?
A
Can see what needs achieved and how to do it
22
Q
ANA
A
National professional organizations
-Set nursing standards of care
23
Q
National League for Nursing (NLN)
A
Establishes and maintains a universal standard of education
24
Q
International Council of Nursing (ICN)
A
Federation of national nursing organizations
25
National Student Nurses' Association (NSNA)
Represents nursing students
26
Sigma Theta Tau International (STTI)
National Honor Society for Nursing
27
What is the Case Method Model of Nursing?
1:1 care for entire shift, needs are quickly met, greater degree of autonomy
Ex: ICU, L&D, private duty
28
What is the Functional Nursing Model of Nursing?
Clear understanding of tasks each member performs; Compartmentalized; Specific knowledge and skills
Ex: RN educates,, LPN passes meds, CNA make beds
29
What is the Team Nursing Model of Nursing?
Efficient; Cost Saving; Limits the fragmentation of functional nursing
Ex: RN paired with CNA and are assigned a group of pts
30
What is the Primary Nursing Model of Nursing?
One RN cares for group of pts; Other RNs continue the primary RNs plan when the primary is not present
31
What is primary healthcare?
-Health promotion
-Preventive services
-Health Education
-Lobbying for a ban to eliminate smoking in local restaurants
-Promoting Immunizations
32
What is secondary healthcare?
Diagnoses and treat illness, disease, and injury
-Reduce impact of disease and early prevention
-Outreach screening (mammograms, lipid testing, X-rays, CT)
-STI screening (asymptomatic)
33
What is tertiary healthcare?
-Restore functioning to a pre-disease status or prevent exasperation (worsening)
- High school student involved in unprotected sex
- Diabetic following diet plan
-Long term rehabilitation services
-End of life care
34
What is critical thinking?
A combination of:
-Reasoned thinking
-Openness to alternatives
-Ability to reflect
-A desire to seek truth
35
What are complex thinking processes?
Use a combination of critical-thinking skills and attitudes:
-Problem solving
-Decision making
-Clinical reasoning
-Clinical judgement
36
What is the Critical-Thinking Model
1) Contextual awareness
2) Inquiry
3) Considering alternatives
4) Analyzing assumptions
5) Reflecting skeptically and deciding what to do
37
What are the full nursing spectrum concepts?
-Thinking
-Doing
-Caring
-Patient Situation
38
What is the responsibility of the nurse when delegating tasks?
-Assign tasks to those who have an understanding of their skills limit
-Validate the data collected
-Conduct the interview
Complete the physical assessment
*RNs must perform the assessment portion of the nursing process!
39
What can CNAs, UAPs, and LPNs do?
Collect info including:
-Vital signs
-Pain reports
-Fingerstick blood glucose levels
40
What is subjective data?
What the patient says
41
What is objective data?
What can be observed or measured
42
What is primary data?
Obtained directly from the patient
43
What is secondary data?
Obtained secondhand through the medical record or another person
44
What is direct interviewing?
To obtain factual, easily categorized information
45
What is nondirective interviewing?
Allows the client to control the subject matter; nurse's role is to clarify and summarize
46
What are the components of the NANDA-I Nursing Diagnosis?
-Diagnostic label
-Definition
-Defining characteristics
-Related factors
-Risk factors
47
What format is primarily used when writing Nursing Care Plans?
(PES) --> Problem, Etiology, and Symptom
48
What are the 5 Rights of Delegation?
1) Right task - make sure it is in their right scope of practice
2) Right circumstance
3) Right person
4) Right direction/communication - on how to obtain what you need
5) Right supervision
49
What does the Joint Commission do in regards to safety?
Publishes national public safety goals
50
What does the ANA do in regards to safety?
-Advocate for healthcare reform
-Priority is for everyone to have high quality care & access to it
51
What does the Quality and Safety Education for Nurses do? (QSEN)
-Task force for improving nursing education
-Focus on graduate nurses being confident with safety
52
What are factors effecting safety for an Infant/Toddler?
-Completely dependent
-Walk and manipulate objects before recognizing danger
-Curious/explorers
-Puts objects in mouth
53
What are factors effecting safety for a Preschooler?
Play outside more, but better gross and fine motor skills, coordination, and balance
54
What are factors effecting safety for a School Aged Child?
-More outside activities that lead to broken bones and muscle injuries
-Less fearful and more ready to try anything new
-Wider school/neighborhood environments
55
What are factors effecting safety for an Adolescent?
-Peak physical, sensory, and psychomotor skills given feeling of strength and confidence
-Feel indestructible, risky behaviors
56
What are factors effecting safety for an Adult?
-Workplace injury or lifestyle related
57
What are factors effecting safety for an Older Adult?
Physiological changes:
-Reduced muscle strength
-Slowed reflexes
-Increased risk for falls
58
When identifying specials risks for falls at home, what can a UAP do, and what is the RNs responsibility?
UAP can:
-Walk with pt at home
-Put on skid socks
-Make a clutter free zone
RNs:
-Must be the one to assess pt home
59
What are preventative actions for take home toxins?
-Clothing removal
-Shower
-Gloves/handling
-Check with workplace
60
What is a pathogen, and what are the different kinds?
A microorganism capable of causing an illness
-Foodborne pathogens
-Vector-borne pathogens
-Waterborne pathogens
61
What are Never Events?
(Serious Reportable Events)
Healthcare acquired complications that cause serious injury or death to a and should have never happened in the hospital
-Clearly identifiable and measurable
-Serious
-Usually preventable
62
What does the CUS model stand for?
C- State your concern
U- Say why you're uncomfortable
S- State why this is a safety issue
63
What are hazards to healthcare?
-Back injury
-Needle sticks
-Radiation (CT/PET scans)
-Violence
64
Mobility
Body movement
65
Fitness
Ability to carry out ALDs with vigor and alertness
66
Physical Activity
Bodily movement produced by the contraction of skeletal muscle that increases expenditure above baseline
67
Exercise
Planned, structured, and repetitive purposeful for improving or maintaining physical fitness, performance, or health
68
What are the musculoskeletal components required for movement?
Bones, Muscles, Tendons, Ligaments
69
What is the neurological component required for movement?
Nerves
-Control the movement of the musculoskeletal system
70
Ligaments
Fibrous tissues that connect most movable joints
71
Tendons
Fibrous tissues that connect muscle to bone
72
Osteoclasts
-Housekeepers
-Clean out the old or damaged tissue
73
Osteoblasts
-The construction crew
-Build and repair new bone
74
Isometric Exercise
-Against an immovable surface
-Involves muscle contraction without motion
Ex: Wall sits
75
Isotonic Exercise
-Weight training with free weights
-Involves movement of the joint during the muscle contraction
Ex: Pull ups, push ups, bicep curls with dumbbells
76
Isokinetic Exercise
-Machine that is a constant preset speed
-Performed with specialized apparatuses that provide variable resistance to movement
Ex: Treadmill, leg press
77
Aerobic Exercise
-Brisk walking, jogging, bicycling
-Acquires energy from metabolic pathways that use oxygen - amt taken in exceeds amt required to perform the activity
-Large muscle groups with continuous movement
78
Anaerobic Exercise
-Occurs when the amt of oxygen taken into the body does not meet the amt of ixygen required to perform the activity
Ex: crossfit, HIIT, sprinting
79
What are the parts of the pulmonary system?
-Nasal passages
-Mouth
-Larynx
-Trachea
-Bronchi
-Bronchioles
80
True or False:
Lower airway is not sterile
False, lower airway is considered sterile
81
What is external respiration?
Alveolar-Capillary gas exchange
-O2 travels across membrane into the blood of the pulmonary capillaries
-CO2 diffuses out of blood into the alveoli to be exhaled
82
What is internal respiration?
Capillary-tissue gas exchange
-O2 diffuse from the blood to the tissues and cells
-CO2 waste product - transported to lungs and exhaled
83
What factors influence pulmonary function for Infants?
-Respiratory Distress Syndrome
-Smaller and narrower airway structure
-Immature immune system
-Can choke on small objects
84
What factors influence pulmonary function for Toddlers?
-Upper respiratory infections (d/t large tonsils and adenoids)
-Exposure to new infectious agents (daycare)
85
What factors influence pulmonary function for Preschool/school-aged children?
-Upper respiratory infections
-Asthma
-Tobacco use
86
What factors influence pulmonary function for Adolescents?
-Smoking
-E cigs
-Less healthcare visits
-Asthma
87
What factors influence pulmonary function for Adults?
-Unhealthy choices (sedentary, smoking)
-Organ declines as age increases
88
What factors influence pulmonary function for Older Adults?
-Reduced lung expansion
-Less effective cough
-Declining immune system
-GERD
89
What is hypoxia?
Occurs when there is inadequate oxygenation of organs and tissues
90
Eupnea
Normal breathing
12-20 RR
91
Tachypnea
Fast breathing
>24 RR
92
Bradypnea
Slow breathing
<10 RR
93
Kussmaul's
Regular RR, but increased
94
Apnea
Absence of breathing
95
Cheyne-Stokes
-Increase in depth
-Gradual decrease in depth
-Apnea (brain injury)
96
Stridor
High-pitched, harsh, crowing inspiratory sound that occurs due to partial obstruction of the larynx
97
Orthopnea
Difficulty breathing laying down
98
What do you assess with a pt's Sputum?
-Appearance
-odor
-Amount timing
99
What do you asses for a pt's cough?
-Dry
-Productive
-Better or worse?
100
Nutrition
Study of food and how it affects the body and influences health
101
Metabolism
The process by which the body changes food into energy
102
Standards (of nutrition)
Reference for nutrient intake thought to meet the nutritional needs of most healthy population groups
103
Food Guides
Specify the number of daily servings of foods needed to make healthy food choices
104
DRIs (Dietary Reference Intakes)
Promote the consumption of micronutrients and macronutrients
-Estimate avg requirement
-Recommended dietary allowance
-Adequate intake
-Tolerable upper intake level
-Acceptable macronutrient distribution range
105
USDA Dietary Guidelines
Provide information on choosing a nutritious diet, maintaining healthy weight, achieve adequate exercise, and good safety
106
Who requires Nutrition Facts Labels to be on all packaged foods?
US Food and Drug Administration
107
What are nutrients?
Micro and Macro
-Building blocks for cells and tissues
-Allow for growth, maintenance, and functioning
108
Anabolism
Formation of larger molecules into smaller ones
109
Catabolism
The breakdown of larger molecules into smaller components
110
Carbohydrates
-Primary energy source
-Sugars
111
Proteins
-Tissue building
-Nitrogen balance
-Amino acids
112
Lipids
"Fats"
-Key component of lipoproteins
-Back up energy source
-Organ insulation/protection
113
True or False:
Micronutrients are needed in large amounts
False, they are needed in small amounts to regulate body functions
114
Vitamins
ORGANIC substances necessary for metabolism or preventing a particular deficiency disease
115
Minerals
INORGANIC elements found in nature that occur naturally in foods or as additives/supplements
116
What is water's purpose in the body?
-Solvent for chemical processes
-Transports substances
-Form for tissues
-Lubricant
-Temp control
117
What are sources of Vitamin A?
-Eggs
-Leafy green vegetables
-Milk
118
What are sources of Vitamin D?
-Fish
-Milk
-Sunlight
119
What are sources of Vitamin E?
-Vegetable oils
-Nuts
-Fish
-Green leafy vegetables
120
What are sources of Vitamin K?
-Green leafy vegetables
-Liver
121
What are sources of calcium?
-Dairy products
-Green leafy vegetables
-Legumes
-Nuts
122
What are sources of Magnesium?
-Whole grain
-Nuts
-Legumes
-Green leafy vegetables
123
What are sources of Potassium?
-Fruits
-Vegetables
-Meats
-Legumes
-Shellfish
124
What are sources of Sodium?
-Table salt
-Baking Soda
-Baking Powder
125
What is BMR?
Basal Metabolic Rate
-Amount of energy required at rest
126
What are factors that affect nutrition for Infants to 1 yr olds?
-Higher protein and carbs
-More fluid
127
What are factors that affect nutrition for Toddlers?
-Diets are deficient in nutrients
-Picky eaters
-Offer them a variety of foods
128
What are factors that affect nutrition for Preschoolers?
Concern that they will learn bad habits:
-No vegetables
-Less milk
-One food for several days
-Need nutritious snacks between
129
What are factors that affect nutrition for School Aged Children?
-Must get adequate vitamins and minerals; low fat/salt/sugar foods
-Commercials and outside life
130
What are factors that affect nutrition for Adolescents?
-Active and eat a lot of "ready to go" meals
131
What are factors that affect nutrition for Young and Middle Adults?
-Tend to follow habits learned earlier in life
-BMR decreases in middle adults
132
What are factors that affect nutrition for Older Adults?
-Need fewer kcal due to lean body mass, physical activity, and decreased BMR
-Need more dairy, fiber, and water
133
What BMI is considered overweight?
25-29.9
134
What BMI is considered Class I Obesity?
30-34.9
135
What BMI is considered Class II Obesity?
35-39.9
136
What BMI is considered Class III Obesity?
40 and higher
137
What is Enteral Nutrition?
Delivery of liquid nutrition in upper intestinal tract via tube (NG tube or G tube)
138
What is Parenteral Nutrition?
Delivery of nutrition intravenously into a large, central vein (TPN)
139
What does the GI Tract do?
Digests and absorbs nutrients from our food and eliminates waste through feces
140
Flatulence
Gas in the intestines causes walls to stretch
141
Hemorrhoids
Dilates, engorged veins in the lining of the rectum (can be internal or external)
142
What are the structures of the GI Tract?
-Upper GI Tract
-Small intestine
-Large intestine (colon)
-Rectum and anus
143
What are the structures of the Upper GI Tract?
-Mouth
-Pharynx (includes epiglottis)
-Esophagus
-Stomach
144
How long does food stay in the stomach?
4 hours
145
Where does most of the digestion and absorption of food occur?
Small intestine
146
What is the process of bowel elimination?
-Starts at mouth and moves through Upper GI Tract down to small intestine
-At small intestine: Food is digested and absorbed, peristalsis halts for food absorption, moves through -- duodenum, jejunum, and ileum to large intestine
-At large intestine: mucus secreted to help facilitate passage of feces; water, vitamins, and minerals are absorbed; moves to rectum and anus
-Poop reaches rectum, stretch receptors initiate contraction of sigmoid colon/rectal muscles
-Internal sphincter relaxes
-Sensory impulses causes voluntary "bearing down"
-External sphincter relaxes
147
Stoma
Can be temporary or permanent
-Allows intestine to rest or heal and then do a reanastomosis
148
Illeostomy
Portion of the illeum through a surgical opening; bypasses the large intestine so poop will be liquid and continuous
149
Colostomy
Portion of colon (large intestine)
-Consistency is based on location (further down you are, the more firm it will be
150
Bowel Diversion
Surgically created opening for elimination of digestive waste
151
True or False:
A stoma should be a pale pink and dry
False, it should be red meaning that oxygen is getting to it, and it should be moist and painless
152
How do you care for a pt with a stoma?
-Assess the stoma
-Assess the output
-Assess the skin
153
What is normal for bowel sounds?
5-30 gurgles or high pitched noises every minute
154
How do you know if bowel sounds are absent?
You will not hear bowel sounds for 3-5 minutes per quadrant
155
What are considered sterile in the urinary system?
Bladder and urethra
156
What are the function of the kidneys?
-Filter metabolic waste from the blood stream as urine
-Help regulate BV, BP electrolytes, and acid-base balance
157
What is the sequential anatomy of the urinary system?
-Kidney
-Ureter
-Bladder
-Urethra
158
What do ureters do?
Transport Urine through ureters
159
What does the bladder do?
Stores urine
160
Why are women more likely to get UTIs?
They have smaller urethras
161
What do urethras do?
Transport urine out of the body
162
Micturition?
-To start the stream of urine
-To urinate
-To release urine from the bladder
163
What inhibits micturition?
-Anxiety
-Lack of time
-Lack of privacy
-Loss of dignity due to need for assistance
-Cultural influences such as same gender
164
What is the process of urinary elimination?
-Internal urethral sphincter closes while bladder fills
-Distention activates stretch receptors in bladder wall
-Signaling to the voiding reflex center the urge to void
-Contraction of detrusor muscle, internal sphincter relaxes
-Once ready to urinate, conscious relaxation of external urethral sphincter occurs
-Detrusor muscle relaxes and bladder begins to fill again
165
What is the typical volume of urine that the bladder holds before urination in adults?
200-450 mL
166
What is the typical volume of urine that the bladder holds before urination in children?
50-200 mL
167
How much urine do kidneys typically produce in a day?
About 1500 mL
168
What does diluted urine look like?
Below 1.002
-Pale, yellow color
-No significant odor
-This is due to a sufficient amount of water intake
169
What does concentrated urine look like?
Above 1.030
-Severely dehydrated
-Cloudy
-Dark yellow
-Odoress
170
Enuresis
Incontinence; occasional involuntary passage of urine
-Normal up to early school years
-Occurs more often when they are absorbed in activity (distracted)
171
Nocturnal Enuresis
Bed Wetting
-Occurs in some children age 6-7 (most control between 3-5)
-Caused by insufficient levels of ADG, pressure on the bladder, urinary infection, and emotional stress
172
Nocturia
Older adults
-Frequent urination after going to bed (waking up and going to the bathroom)
173
If pt is post op, what is the time frame for them to urinate?
6-8 hrs
174
True or False:
Pts on diuretics become major fall risks
True, d/t pts urgency to urinate
175
True or False:
Caffeine is a diuretic
True, increases urine production
176
How does alcohol consumption affect ADH?
It impairs release of ADH, resulting in increased urine production
177
True or False:
Physical activity/dehydration cause kidneys to hold water
True
178
Dysuria
Painful or difficult urination d/t infection, obstruction, or meds
179
Frequency (urination)
Need to urinate at short intervals
180
Hematuria
Blood in urine d/t trauma, kidney stones, infection, or menstruation
181
Anuria
Absence of urine
-UO is < 100 mL/24 hrs
-Common in pts with chronic kidney disease or on dialysis
182
Oliguria
UO < 400 mL/24 hrs (small or few)
-D/t dehydration
183
Polyuria
Excessive urination d/t overhydration or diabetes
184
What is the first option for urine analysis?
Freshly voided specimen
185
How would a UTI be indicated on a urine analysis?
Show up with:
-Blood
-Glucose
-Bacteria
-Positive WBC
186
How is a clean catch urine sample obtained?
-Cleanse genitalia appropriately
-Collect midstream sample
-Free from contamination
187
How is a sterile specimen collected?
-Obtained through catheter insertion
-More traumatic and can cause pain
-Only used if someone cannot urinate or if previous specimens are contaminated
188
How is a 24 hr urine sample collected?
-Large container in refrigerator, keep adding all urine for 24 hr period
-Dump first urine out and the collect second urine
-Check levels and kidney functions, etc
189
Urge incontinence
Involuntary loss of urine with a strong urge to void
190
Stress incontinence
Involuntary loss of urine with increases intra-abdominal pressure in the absence of overactive bladder (pregnancy, obesity, constipation/straining, sneezing)
191
Mixed incontinence
Combination of urge and stressed incontinence
192
Unconscious (reflex) incontinence
Loss of urine when person doesn't realize the bladder is full and has no urge to void (people w/ neurological disorders or bladder inflammation)
193
Functional incontinence
Untimely loss of urine with no cause
194
Transient (comes and goes) incontinence
Short term and resolves spontaneously (from UTI or diuretics)
195
Source-Oriented System
-Disciplines document in separate sections of the chart
-Brings problems of scattered data which can lead to fragmentation
196
Problem-Oriented System
-Organized around client medical problems (Not Wholistic)
-Four components: Database, problem list, plan of care, progress notes
-Promotes collaboration between disciplines
-Does not work if people are not communicating
197
Charting by Exception
-Only significant findings or exceptions are documented
-use preprinted flow sheets
-Reduces time spent on documenting
-Can lead to omission of information and errors in care
-Doesn't allow for skilled nursing judgment
197
Electronic Health Record
-Records entered via computer
-Combination of problem & source oriented systems
-Promotes greater collaboration and communication, improved quality of care, time saving, private and safe
-Expensive and can have unplanned downtimes
198
PIE
Problem-Intervention-Evaluation
-Not holistic, only looking at problem, not pt
198
SOAP (SOAPIE, SOAPIER)
Subjective-Objective-Assessment-Plan (-Intervention-Evaluation-Revision)
199
Fact System
-Flowsheet
-Assessment
-Concise notes
-Timely
200
Occurrence Reports
Formal record of unusual occurrence or accident - helps with quality improvement in the future
-Not part of pt health record- keep off legal chart, do not reference report was filed in chart
201
Integrated plans of care
Combined charting and care plan form
-Maps out on a day by day, from admission to discharge
-Used for determining length of stay
-Monitor costs
-Eliminate duplicate documentation
-Increases teamwork
202
Kardex/Client Care Summary
In chart, but not part of legal record (always updating)
-Demographic data
-Safety precautions
-Allergies
-Medical dx
-Special instructions
203
How long do nurses have to complete assessment and care screenings upon arrival at a long term care facility?
14 days
204
True or False:
Hospitals are for acute conditions
True
205
True or False:
Nursing homes & long term care facilities are for chronic conditions
True
206
What is included in oral reporting?
Nurse to Nurse or Nurse to Provider
-Communication of vital info related to pt's status/plan of care
-Bedside report preferred to have pt involved in their own care
207
What is included in Handoff Report?
-Pt demographics and dx
-Relevant medical history
-Significant assessment findings
-Treatments
-Upcoming diagnostics or procedures
-Restrictions
-Plan of care for pt
-Concerns
208
When is SBAR used?
Used for interprofessional communication between doctors and other nurses
209
What is keeping it "CUBAN" and when is it used?
Used when doing SBAR
C- Confidential
U- Uninterrupted
B- Brief
A- Accurate
N- Named Nurse
210
What does SBAR stand for?
S- Situation
B- Background
A- Assessment
R- Recommendation
211
What needs to be given during transfer reports?
-Your contact info
-Pt demographics, dx, reason for transfer
-Family contact info
-Summary of Care
-Current status
-Presence of open wounds or areas of skin
-Special directives regarding care
-Ask if receiver has any questions
212
Verbal Orders
-Can be given by Dr
-Spoken to you - usually during emergency
-Should be made for critical change in client condition ONLY
-Shouldn't really occur
213
Telephone Orders
-Received by phone and transcribed onto the provider order sheet
-Should be made for sudden change in pt condition, inability to transmit electronically, or life threatening emergencies
-Increased risk for errors
-Dr must sign off on order within 24 hrs
214
What do you do if an order or prescription is written illegibly?
Contact the provider
215
What do you do if you are uncomfortable following a prescription?
Follow the chain of command
216
What are the guidelines for paper health records?
-Write legibly
-Use black ink
-Do not leave blank lines, draw line through empty space
-Draw a line through incorrect charting and initial
-Sign all docs with first name, last name, and RN
-Don't write shorthand or use non-approved abbreviations
217
What is the order of Maslow's Hierarchy?
-Physiological needs
-Safety Needs
-Love and Belonging
-Esteem
-Self-actualization
218
What are physiological needs?
Air, water, food, shelter, sleep, clothing, reproduction
219
What are safety needs?
Personal security, employment, resources, health, property
220
What is included in love and belonging?
Friendship, intimacy, family, sense of connection
221
What is included in esteem?
Respect, self-esteem, status, recognition, strength, freedom
222
What is self-actualization?
Desire to become the most that one can be
223
Self Concept
One's overall view of themselves
"Who do you think you are?"
224
What factors affect self concept?
-Gender (roles and expectations)
-Developmental level (More mature = self concept is more intra guided)
-Family and peer relationships
-Illness and hospitalization
-Locus of control
225
What factors influence body image?
-Family, social, ethnic & cultural norms
-Education (Higher education = better image of yourself, same with higher position at work)
-Exposure to alternative values
-Developmental/loss
-Social media
226
Role Strain
A mismatch between role expectations and performance
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Interpersonal Role Conflict
How individuals carry out their significant roles vs expectation by others
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Interrole conflict
Two roles make competing demands
Ex: Nursing school vs significant other
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What are the components of personal identity?
-How you view yourself as a unique human being
-Develops over time
-Becomes consistent as a person ages
-Content with who they are
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Self-Esteem
How well a person likes one's self
"What I think I should be" vs "What I think I am" (Ideal self vs Actual self)
231
What stressors affect self concept?
-Identity stressors
-Role performance stressors
-Role overload (expectations are too high)
-Body image stressors
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What is Family Centered Nursing?
Nursing care that is holistically directed toward the whole family as well as to individual members
Promotes:
-Health and wellness
-Communication
-Unity and conflict resolution
Prevents:
-Disease
-Conflict
-Maladaptive coping
**Assess coping mechanisms and their effectiveness
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What are traditional nuclear families?
-Traditional married couple
-Have a child
-One parent working, one stays at home
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What are grandparent families?
Parents may be unable to raise children, so children are raised by their grandparents
235
What are blended families?
Two single people come together with children from previous relationships, and family blends together
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What are extended families?
Aunts, uncles, cousins, all living under the same roof
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What are sandwich families
-Have a mother with children
-Mother's parents are dependent on her
-Mother is caring for her children, as well as her parents
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What is the most important question to ask in family nursing?
Ask/Determine who is the primary decision maker of the family
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What is the concept of community?
A body of like minded people or the inhabitants of a town
-Share a common language, rituals, etc
-Group of people of a particular race or class in a specified place
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Who are the vulnerable populations?
-Limited economic resources
-Limited social resources
-Very young and very old
-Chronic disease & obesity
-History of abuse/trauma
-Disabled
-Those with substance abuse problems
-Untreated mentally ill
241
What is Community Health Nursing?
Health of an individual, family, or group, and its affects on the community as a whole
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What is public health nursing?
Health of a community and how it affects individuals
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What is community-oriented nursing?
Focuses on both public and community health
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Health-Illness Continuum
-See health and illness as a graduated spectrum that cannot be divided into parts
-People will move back and forth on this spectrum
245
Dunn's Health Grid
Plots a person's status on the health-illness continuum against environmental conditions (family support, peers)
246
Neuman's Continuum
-View health as an expression of living energy available to an individual
-High energy = wellness
-Low energy = illness
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What are the 5 Stages of Illness Behavior
1) Experiencing Symptoms
2) Sick Role Behavior (symptoms progress & require relief from normal duties)
3) Seeking Professional Care (getting dx)
4) Dependence on Others (How to use crutches, therapy, etc)
5) Recovery
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What factors influence Illness Behavior?
-Nature of Illness
-Hardiness
-Intensity, Duration, and Multiplicity of the Disruption
249
What did Jean Watson define health as?
High overall functioning; a state of mind
250
How did Betty Neuman define health?
Continuum of energy
251
How did Myers, Sweeney, and Witmer define health?
Integration of mind, body, spirit
-Those with disease can be healthy
252
What is Pender's Health Promotion Model?
-Individual Characteristics and experiences
-Behavior-specific cognitions and affect
-Behavioral outcome
253
What is the Wheel of Wellness?
-If one of the spokes on a wheel is weak, the whole wheel is weak
-Center of wheel is least well
-Outer spokes are optimal wellness
254
What do the spokes on the Wheel of Wellness represent?
-Emotional
-Social/Family
-Occupational
-Spiritual
-Physical
-Mental
255
What is the Transtheoretical Model of Change?
-Helps to alter unhealthy behaviors
-Change to pt's response to illness or change in environment to decrease stimuli of what is causing a person to engage in unhealthy behaviors
256
What are the 6 Stages of the Transtheoretical Model of Change
1) Precontemplation - no plan for change, unaware there is a problem
2) Contemplation - recognizes there is a problem, no commitment to solution yet
3) Preparation - Intending to take action within a month or so, small changes in prep
4) Action - plan is implemented
5) Maintenance - working to prevent relapse
6) Termination - no concern of relapse OR they relapse
257
What are the Stages of Erikson's Developmental Theory?
1) Trust vs Mistrust (Birth to 18 mo) - relies on parent for care
2) Autonomy vs Shame and Doubt (18 mo - 3)- begin to feel separation from parents, can talk on their own
3) Initiative vs Guilt (3-5) - Develop conscious and right vs wrong
4) Industry vs Inferiority (6-11) - Seek recognition for individual accomplishments, solve more complex problems; if parents doubt them or shame them, they will feel inferior
5) Identity vs Role Confusion (11-21) - Personal identity begins to form, attachment shifts from parents to peers
6) Intimacy vs Isolation (21-40) - Develop long lasting relationships/friendships, or isolate
7) Generativity vs Stagnation (40-65) - guide the next generation on how to live productively, or development stops
8) Ego Integrity vs Despair (65+) - Reflecting on life, accept if they've lived a good life & achieved their goals, or if they have regrets
258
What is Young Adulthood in the Stages of Development?
19-40 yrs old
-Healthiest Stage
-May experience self-eval around 30
-Function independently
-Think rationally, predict outcomes, hypothesize about future
259
What are common health problems for Young Adults?
-More prone to STIs d/t most sexually active group
-Unplanned pregnancies
-Abuse/neglect
-Obesity d/t stress, alcohol, convenience eating
260
What is the leading cause of death for Young Adults?
Unintentional injuries because they partake in more risky behaviors
261
What is Middle Adulthood in the Stages of Development?
40-64 yrs old
-Menopause
-Andropause
-Decreased elasticity of blood vessels, muscle tone, and skin moisture
-More prone to constipation
-Graying/thinning hair
-Rxn times decrease
-More prone to experiencing mid-life crisis
262
Menopause
-Woman has no menstrual cycle for 12 consecutive months
-Usually around 51 yrs old
-Mood changes
-Hot flashes
-Vaginal dryness
-Smaller breasts
-Frequent night time wakenings
263
Andropause
-Decreased production in semen
-Decreased ability to gain or maintain an erection
*related to decrease in testosterone
264
What is Older Adulthood in the Stages of Development?
65+
-Fastest growing age group
-Retirement
-Chronic illnesses
-Lack of self-care and ability to maintain independence
-Sedentary lifestyle
-Sensory impairments
-Inadequate nutrition
265
What is the leading cause of death for Older Adults?
In hospitals = falls
-Heart disease
-Cancer
-Chronic lower respiratory diseases
-Stroke
-Alzheimer's
-DM
-Accidents
-Influenza and Pneumonia
266
Disengagement Theory
-Older adult and society gradually and mutually withdraw from each other
-Isolation r/t retirement, chronic illness, death of loved ones, poverty
267
Active Theory
The individual should stay active and engages as possible to enjoy the highest life satisfaction
268
Havighurst's Theory
-Counterpart of disengagement theory
-Physical, cognitive, and social development tasks change
-Have to adjust to decreased strength and physical health
269
Psychosocial Development Theory
-Erikson's theory - ego integrity vs despair
-Acceptance of one's life has had meaning and that death is a part of the continuum of life
-Making sure life goals have been met and there are no regrets
270
What age group in dementia most prominent in?
85+
-Memory declines, intelligence does not
271
Where do the standards of teaching come from?
-ANA
-Joint Commission
-Nurse Practice Acts
271
What are the 5 Rights of Teaching?
-Right time
-Right context
-Right goal
-Right content
-Right method
272
What do nurses teach?
-Disease info
-Info about meds
-Procedures/psychomotor skills
-Disease prevention and health promotion
-Clinical processes
273
Behavioral Learning Theory
-Characterized by explicit identification of information to be taught and immediate reward for correct responses
Ex: Pavlov, Skinner, Bandura
274
Cognitive Theory of Learning
Sees learning as a complex cognitive activity; an intellectual or thinking process in which the learner structures and processes info
275
Humanism Theory of Learning
-Focuses on the learner's affective (emotional), cognitive (intellectual), and attitudinal qualities
-Emphasizes learner's active participation and responsibility in the learning process
-Self motivated, self initiated, self evaluated
276
What are the 6 Levels of Bloom's Taxonomy
1) Create
2) Evaluate
3) Analyze
4) Apply
5) Understand
6) Remember
277
What is Cognitive Mental Activities?
Storage and recall of information
278
What is psychomotor "hands-on" skill?
Requires thinking and doing
-Teach back (mannequins/sim)
Ex: Self-administration of insulin
279
What are Affective-Feeling activities?
Changing feelings, beliefs, attitudes, and values
-Role modeling, group work, story telling
Ex: Changing a belief about a diet
280
What are SMART goals?
Specific
Measurable
Achievable
Relevant
Time-bound
281
Sexual identity
Person's perception of gender, gender identity, gender role, and sexual orientation
*Part of overall self-concept
282
Androgyny
Blending of traditions of "feminine" and "masculine" role
283
Transsexual
A gender description for someone who has transitioned (or is transitional) from living as one gender to another
*Medically, surgically
284
Transgender
A person whose gender identity is not the same as his/her assigned gender
285
What are sexual characteristics of a newborn to 2 yr old?
Touch genitals
Enjoy being nude
286
What are sexual characteristics of a 3 yr old?
Interested in their bodies and curious to see others
287
What are the sexual characteristics of a 5 yr old?
-Masturbate
-Mimic adults affection for one another
-Play house, doctor, getting married
-Begin to wonder where babies come from
288
When do VS and muscle tension increase during sex?
Excitement/plateau phase
289
When does the peak of VS and loss of voluntary muscle tone occur during sex?
Orgasm- peak of plateau phase
290
What was the goal of Healthy People 2020?
To eliminate disparities and improve the health of all groups
291
Ethnicity
Refers to cultural factors including: nationality, biographical, regional culture, ancestry, and language
292
What are examples of race?
-White
-Black African American
-American Indian
-Korean
-Vietnamese
-Chinese
-Samoan
293
Socialization
The process of learning to become a member of society or a group
294
Acculturation
A learning process through immigrants assume the characteristics off that culture
-Accepts both own and new culture, adopting elements of each
295
Assimilation
Occurs when the new members gradually learn and take on essential values & beliefs of the dominant culture
296
Ethnocentrism
Tendency to think your own group is superior to others, and to view behaviors and beliefs that differ from yours as wrong, strange, or unenlightened
297
What are the 3 general approaches for coping with stress?
-Alter the stressor
-Adapt to the stressor
-Avoid the stressor
298
What are factors that influence adaption of stress?
-Personal perception of stressor
-Overall health status
-Support System
-Hardiness
299
What are the 3 stages of stress?
-Alarm
-Resistance (adaptation)
-Exhaustion/Recovery
300
What is the alarm stage of stress?
2 Phases:
-Shock (rush of adrenaline to prepare for fight or flight)
-Countershock (changes from shock are reversed, less able to deal with threat)
301
What is the Resistance/Adaptation stage of stress?
-Body attempts to cope, protect itself against stressor, maintain homeostasis
-Involves psychological and physical coping mechanisms
302
What is the Exhaustion stage of stress?
-Occurs when stress continues and coping mechanisms become ineffective
-Energy is depleted
-Decreased BP, increased HR & RR
Recovery stage replaces exhaustion if coping mechanisms are effective
303
What are psychological response to stress?
-Anxiety
-Fear
-Denial, rationalization, projection
-Anger
-Depression
304
Assault
Occurs when a nurse intentionally places a patient in immediate fear of personal violence or offensive contact
*Verbal, must include words expressing an intention to cause harm and some type of action
Ex: If you keep acting like that, I’m gonna restrain you
305
Battery
Physical contact/touch (hitting/pushing)
-Committed when an offensive or harmful physical contact is made to the client without his consent, or there is unauthorized touching of a person’s body by another person
306
What do all religions have in common?
Theology
-Discussions and theories related to God and God’s relation to the world
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