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aa Orgo > Nur 300 Final exam > Flashcards

Nur 300 Final exam Flashcards

1
Q

Situation

A

What is the situation you are calling about?
Identify self, unit or setting, and patient name
What is going on with the patient that is a cause for concern. A concise statement of the problem

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2
Q

Background

A

What is the pertinent clinical background information?
 Admitting diagnosis and date of admission
 List of current medications, allergies, IV fluids, etc.
 Most recent vital signs
 Lab results
 Medical history
 Recent clinical findings
 Advance Directive/code status

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3
Q

Styles of Conflict Management,
Discomfort
“pick your battles”

A

Avoidance

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4
Q

Styles of Conflict Management,
Surrender our own needs
Likely will resurface

A

Accommodation

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5
Q

Styles of Conflict Management,
Domination
Aggressive

A

Competition

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6
Q

Styles of Conflict Management,

Solution-oriented

A

Collaboration

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7
Q

Symbolic representation of a phenomenon or set of phenomena

A

Concept

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8
Q

Set of abstract and general concepts that represents a phenomenon of interest

A

Conceptual Model

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9
Q

Global concepts specific to a discipline that that are philosophically neutral and stable

A

Metaparadigm

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10
Q

A designation of an aspect of reality

A

Phenomenon

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11
Q

Nursing’s Metaparadigm

A

Person
recipient of nursing care

Environment
internal and external context

Health
Dynamic equilibrium of all components of person and environment

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12
Q

“nursing is an intellectual discipline and not only skills used in the care of people who are sick.”

A

Jacqueline Fawcett RN, PhD, FAAN

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13
Q

Theory

A

“thoughtful examination of a phenomenon”

“defines relationships among its concepts, assumptions, and propositions

“provides a conceptual foundation for nursing research”

provides a framework/guide for practice

generalizable

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14
Q

Mental idea of an abstract phenomenon

A

Construct

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15
Q

The whole is greater than the sum of its parts

A

Bertalanffy

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16
Q

Grand Theory

A

Key concepts and principles of a discipline
General and abstract
Cannot be tested empirically

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17
Q

more discrete aspects of a phenomenon
applicable to many nursing situations
operationalized to nursing practice
can be tested empirically
relational statements
Peplau’s theory of interpersonal relationships
Leininger’s theory of transcultural nursing

A

Mid-Range Theory

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18
Q

2 Grand Theories

A

Newmans and Parses

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19
Q

Classification of Theory

A

Grand
Middle Range
Practice

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20
Q

Key concepts and principles of a discipline
General and abstract
Cannot be tested empirically

A

Grand Theory

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21
Q

client is an open system that responds to stressors in the environment

A

Newman’s theory of expanding consciousness

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22
Q

quality of life from each person’s own perspective as the goal of nursing practice

A

Parse’s theory of human becoming

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23
Q

Newman’s Theory- ___ conditions can be considered a manifestation of the total pattern of the individual

A

pathological

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24
Q

Newman’s Theory- Removal of the

A

pathology in itself will not change the pattern of the indivdual

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25
Q

2 mid range theories

A

Peplau’s theory of interpersonal relationships

Leininger’s theory of transcultural nursing

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26
Q

Parse’s Theory- Person: Open being who is more than and different from

A

the sum of the parts

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27
Q

Parse’s Theory- Environment

A

Everything in the person and his experiences

Inseparable, complimentary to and evolving with

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28
Q

Parse’s Theory- Health:

A

Open process of being and becoming. Involves synthesis of values

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29
Q

Parse’s Theory- Nursing:

A

A human science and art that uses an abstract body of knowledge to serve people

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30
Q

Parse’s Theory- Application to practice: It does not seek to

A

“fix” problems Ability to see patients perspective allows nurse to “be with” patient and guide them toward desired health outcomes. Nurse-person relationship cocreates changing health patterns

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31
Q

Peplau’s theory- The purpose of nursing is to help others identify their felt

A

difficulties

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32
Q

Peplau’s theory- Nurses apply principles of human relations to the problems

A

that arise at all levels of experience.

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33
Q

Peplau’s theory- Nursing is therapeutic in that it is a healing art, assisting an individual who

A

needs healthcare

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34
Q

Peplau’s theory- Nursing is an interpersonal process because

A

it involves interaction between two or more individuals with a common goal

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35
Q

Peplau’s theory- The attainment of goal is achieved through the use of

A

a series of steps following a series of pattern.

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36
Q

Peplau’s theory- The nurse and patient work together so both become

A

mature and knowledgeable in the process

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37
Q

Leininger’s theory combines ___ perspective with nursing’s focus on caring

A

anthropological

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38
Q

Mission

A

To protect the public by fostering high standards of professional licensure, practice, and discipline

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39
Q

Legal documents developed at state level

A

Nurse Practice Act

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40
Q

Most important statutory laws governing the provision of professional nursing care

A

Nurse Practice Act

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41
Q

Scope and standards of professional nursing practice that define nursing’s domain

A

Nurse Practice Act

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42
Q

Types of titles and licenses

Requirements for licensure

Grounds for disciplinary action, other violations and possible remedies

A

Nurse Practice Act

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43
Q

Licensure vs. Registration

A

License is for life

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44
Q

Reregister every

A

3 years

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45
Q

Education program standards

A

At least 2-year degree in general professional nursing at qualifying university

Training identification and reporting of child abuse

Training in infection control

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46
Q

Legally bound by principle of Tort law to provide

A

reasonable standard of care – level of care that a reasonably prudent nurse would provide in a similar situation

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47
Q

HIPAA covered entities:

A

Providers
Health insurance plans
Health care clearinghouse

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48
Q

Kubler-Ross

A

came up with the 5 stages of dying

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49
Q

5 stages of dying:

A 
Denial 
Anger
Bargaining
Depression
Acceptance
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50
Q

Palliative care is a clinical approach to improve

A

the quality of life for clients and families dealing with a life threatening illness.

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51
Q

Palliative care clients may still be getting

A

active treatment for their disease to control symptoms and improve quality of life.

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52
Q

The focus of palliative care is

A

managing symptoms and having a good death, rather than active treatment.

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53
Q

the personal emotions and adaptive process a person goes through in recovering from loss.

A

Grief

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54
Q

Lindermann

A

studied the grief process. He said that grief can be immediate or delayed.

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55
Q

Lindermann’s 3 methods of supporting grieving patients,

A
  • empathetic communication
  • honesty
  • tolerance of emotional expression
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56
Q

Lindermann said that absent or exaggerated grief are known as

A

“pathological or complicated grief”

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57
Q

Engel

A

Added to Lindermann’s theory of grief

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58
Q

Engel had 3 phases of grief:

A
  • shock/disbelief
  • developing awareness
  • restitution
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59
Q

The restitution phase is when the person

A

adapts to life without the deceased.

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60
Q

States that grieving involves integrated the past memories of the deceased into the present life.

A

Florczak

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61
Q

somatic distress that occurs in waves with feeling of tightness in the throat, shortness of breath, an empty feeling in the stomach, and mental pain

A

Acute grief

62
Q

an emotional response that occurs before the actual death

A

Anticipatory grief

63
Q

occurs while a person is still alive, in relation to a dibilitating disease. For example, sorrow in the parents of a mental ill child.

A

Chronic sorrow

64
Q

a form of grief that unusually intense or long.

A

Complicated grieving

65
Q

death that is free from unavoidable suffering, follows the patient’s/family’s wishes, and is consistent with clinical/ethical standards.

A

Good Death

66
Q

More traits of a good death:

A
  • symptom relief
  • open decision making
  • knowing what to expect
  • having a sense of completion
  • contributing to others
  • receiving affirmation as a whole person
67
Q

Grief felt by nurses when their client dies

A

Disenfranchised grieving

68
Q

emotionally drained to the point that you can’t care about other patients

A

Compassion fatigue

69
Q

free from disease, able to function normally, well being, health lifestyle

A

health

70
Q

an interactive education and support process

A

Health promotion

71
Q

Health promotion lets people reach

A

their potential by improving their environment and lifestyle.

72
Q

concerned with identifying risk factors and protective factors in order to manage the risk of illness

A

Disease prevention

73
Q

a person’s subjective experience of satisfaction with his life

A

Well-being

74
Q

Areas of well-being include:

A

intellectual, emotional, occupational, spiritual, social, and physical

75
Q

3 major trend influencing healthcare in the U.S.

A
  • demographic changes
  • advances in technology
  • Globalization
76
Q

Overarching goals of Health People 2020:

A
  • Eliminate preventable disease
  • Achieve health equity (for example, eliminate disparities)
  • promote healthy environments
  • promote health in all stages of life
77
Q

Pender’s Health Promotion model-

A

Looks at the factors in a person’s life that can influence their decision to make choices about healthcare. These factors can include internal things like, doe the client see a benefit to the healthcare decision. It can also be an external factor like being required to get a vaccine in order to attend public school.

78
Q

Prochaska’s Transtheoretical Model-

Includes 5 stages in the changing process:

A 
Precontemplation
Contemplation
Preparation
Action
Maintenance
79
Q

client doesn’t think there’s a problem, not considering change

A

Precontemplation

80
Q

Client thinks there may be a problem, going back and forth about a decision

A

Contemplation

81
Q

Client decides there is in fact a problem

A

Preparation

82
Q

Motivational Interviewing

A

Nurse and client work together to set goals.

It’s effective because of how involved the client is; the client is responsible for the success of the healthcare plan.

83
Q

Nurse and client work together to set goals.

It’s effective because of how involved the client is; the client is responsible for the success of the healthcare plan.

A

Motivational Interviewing

84
Q

Came up with the idea of self-efficacy, which is a person’s belief that they are capable and able to make changes. They have confidence in themselves

A

Bandura

85
Q

Bandura

A

Came up with the idea of self-efficacy, which is a person’s belief that they are capable and able to make changes. They have confidence in themselves

86
Q

____ and motivation go hand in hand- they increase each other

A

Self-efficacy

87
Q

Bandura believes that learning is a social process. Learning involves-

A

physical motivators
social incentives
cognitive motivators

88
Q

Bandura, Physical motivator

A

remembering pain and wanting to avoid that

89
Q

Bandura, Social incentive

A

praise

90
Q

Bandura, Cognitive motivator

A

internal thought process associated with change

91
Q

Precede-Proceed Model of community education

A
  • health is multidetermined

- health teaching must be multidimensional and participatory to be effective

92
Q

The “Precede” part refers to the

A

planning

93
Q

The “Proceed” part refers to the

A

resources and other practical issue needed to implement community education.

94
Q

Domains of Learning

A

Cognitive
Affective
Psychomotor

95
Q

cognitive domain

A

the focus when the client has a knowledge deficit. For example, understanding the pathology of the disease you’re diagnosed with

96
Q

Cognitive learning allows for the clarification of information and

A

correction of misinformation

97
Q

affective domain

A

has to do with the client’s emotional response. This domain is important when there are issues with compliance and acceptance. For example, teaching in the affective domain could involve getting the client to emotionally accept the fact that they are ill and that it’s their responsibility to care for themselves.

98
Q

Psychomotor

A

teaching skills, like self injecting insulin

99
Q

Carl Rogers

A

Said that teaching must be lerner-center. The teacher should start at the level of the learner and make adjustments specifically for that learner

100
Q

Said that teaching must be lerner-center. The teacher should start at the level of the learner and make adjustments specifically for that learner

A

Carl Rogers

101
Q

Rogers also said that the learner being an active participant is important and that they

A

must be responsible for the education

102
Q

Andragogy

A

education of adults

103
Q

Pedagogy

A

education of children

104
Q

the reward used to reinforce a behavior should be something the learner specifically likes.

A

Premack principle

105
Q

Behavioral strategies

A
  • Modeling
  • Shaping
  • Chaining
106
Q

Shaping is when you

A

break down a desired behavior into small steps and gradually combine them

107
Q

Chaining is when you

A

link individual behaviors together to teach a single (more complex, multistep) process

108
Q

Factors that affect readiness to learn include

A

what the patient already knows about the disease, the personal meaning of the disease, level of anxiety.

109
Q

Best Practice refers to making care safe by basing it on

A

evidence based info

110
Q

TeamSTEPPS

A

a strategy of improving patient safety by improving communication.

111
Q

TCAB

A

transforming care at the bedside

112
Q

TCAB- transforming care at the bedside.

A

climate of safe care

  • unit based teams
  • client centered care
  • eliminating inefficiencies
113
Q

PEARLS

A

systems for improving client relationships

partnership
empathy
apology
respect
legitimize their feelings
114
Q

Process for responding to put downs

A

Address the objection behaviors first
Emphasize specifics
Prepare standard responses

115
Q

All conflicts have 2 things in common

A
  • Content problem issue

- Process or relationship issue (which is the emotional response to the situation)

116
Q

The main cause of conflict

A

lack of communication

117
Q

Four styles of dealing with conflict

A
  • avoidance
  • accommodation
  • competition
  • collaboration
118
Q

Avoidance is a

A

lose-lose for nurse and client

119
Q

Accommodation is a

A

lose-win situation. The nurse gives in by making a quick compromise.

120
Q

Competition is a

A

direct method of resolving conflict. It can be useful if you need a quick resolution, but in the long term it leads to a lose-lose.

121
Q

Collaboration

A

win-win

122
Q

Assertive behavior

A

setting goals, acting on those goals, taking responsibility

123
Q

setting goals, acting on those goals, taking responsibility

A

Assertive behavior

124
Q

4 components of assertive behavior

A
  • able to say No
  • able to ask for what you want
  • express positive and negative feelings
  • start, continue, and stop interactions
125
Q

Dysfunctional conflict occurs when

A

emotions distort the content of the issue.

126
Q

Use the acronym CARE to resolve conflicts:

A

Clarify (clarify the behavior that’s a problem)
Articulate (explain WHY the behavior is a problem)
Request a change
Encourage change

127
Q

The focus of assertive statements should be on the

A

present, not the past or future.

128
Q

describe a competent level of professional behaviors

A

Professional Performance standards

129
Q

explains nursing’s role and responsibility to society

A

Nursing’s social policy statement

130
Q

legal documents that explain what nurses are allowed to do, their rights, responsibilities, licensure information

A

Nurse practice acts

131
Q

legal and ethical boundaries for nurses

A

Scope of practice

132
Q

legislated laws from the state and federal level. Example is the Nurse Practice Acts

A

Statutory laws

133
Q

laws from court decisions

A

Civil Laws

134
Q

malpractice and negligence infractions that are covered by civil law.

A

Torts

135
Q

when the case involves intentional misconduct or if it’s a very serious violation

A

Criminal law

136
Q

providing ONLY the information needed to provide care for client

A

Confidentiality

137
Q

Ethical decision making models

A
  • Utilitarian/goal based model
  • Deontologic or duty-based model
  • Human Right Model
138
Q

Whether or not something is ethical is determined by the outcome.

A

Utilitarian/goal based model

139
Q

Utilitarian/goal based model

A

Whether or not something is ethical is determined by the outcome.

140
Q

This model is person centered. Whether or not something is ethical goes beyond the outcome. In addition to the outcome, you have to consider the person’s dignity. Even if there’s a good outcome, you can’t do something that violates a person’s dignity.

A

Deontologic or duty-based model

141
Q

Deontologic or duty-based model

A

This model is person centered. Whether or not something is ethical goes beyond the outcome. In addition to the outcome, you have to consider the person’s dignity. Even if there’s a good outcome, you can’t do something that violates a person’s dignity.

142
Q

All people have basic human rights

A

Human Right Model

143
Q

feeling of discomfort when there’s a discrepancy between what you have always believed and what you just learned

A

Cognitive dissonance

144
Q

when a nurse is not sure which moral rules apply in a given situation

A

Moral uncertainty

145
Q

occurs when more than one conflicting morals are involved in the problem

A

Ethical or moral dilemma

146
Q

when the nurse knows what is right, but is forced to do something else because it’s the law or the rule

A

Moral distress

147
Q

Rightness or wrongness is function of consequences

Greatest good for majority

A

Utilitarian/goal-based model

148
Q

Person-centered
Respect person’s inherent dignity
Moral worth

A

Duty-based model

149
Q

Universally applied

Shared by most group members

A

Moral principles

150
Q

Contemporary framework for Grief

A

Intersubjective process

“Individual maintains connections with
the absent”

“Meaning of the experience continually
changes”

151
Q

Intersubjective process

“Individual maintains connections with
the absent”

“Meaning of the experience continually
changes”

A

Contemporary framework for Grief

152
Q

signs of Approaching Death

A 
Increased sleeping, somnolence, coma
Decreased urinary output
Changes in VS
Disorientation, restlessness, agitation
Severe dyspnea
Skin temperature and color

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