Nurs 317 first exam Flashcards
describe four categories of safety risks in health care agency
falls, patient inherent accidents, procedure related accidents, equipment related accidents
patient inherent accidents
self induced
procedure related accidents
during therapy or treatment
what do patients want from health care and providers
access, safety, outcomes, and respect
2018 national patient safety goals
medication safety, core measures (standardization of care), surgical care improvement, safe patient handling, hand off communication, alarm fatigue
what can you do as a provider to improve patient safety
follow protocols, speak up with concerns, listen to patients colleagues and mentors, take care of yourself
patient centered care
providing respectful and responsive care to patient’s preferences, needs, values and ensuring patient values guide plan of care
evidence based care
process that promotes optimal heath care based on research
never events and examples
serious and preventable events that should never occur in hospital setting. example: pressure ulcer or wrong site surgery
sentinel events and examples
unexpected outcomes or risk involving death or serious physical or psychological injury. example is patient suicide, medication error, or delay in treatment
analyze for safety concerns: immobile patient with dysphagia having to stay in the hospital for a prolonged amount of time.
This would increase the risk for the patient to develop pressure ulcers. I would look for any erythema that does not blanch. I would also look at the record and make sure the patient is being turned every few hours and make sure to record each time I move the patient. I would communicate with the patient’s family or caregiver how important it is for the patient to be turned and educate them on what to look for. I would pay extra attention to areas where skin breakdown is most common, like the sacrum, spinal processes and occipital bone
Articulate role of the Florence Nightingale in nursing
Florence Nightingale is credited to being the founder of “Modern Nursing”
Nightingale transformed nursing into a professional role, not just caregiving
She used biostatistics to demonstrate the efficacy of her interventions
Verbalize the definition of a professional nurse
protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through diagnosis and treatment of human response and advocacy in care of patients
dependent nursing actions
doing something in guidance of the physician. example: medication administration
independent nursing action
part of the nursing process. you challenge the ways others think and look for rational and logical answers to problems.
collaborative nursing action
also known as interdependent. working together with another healthcare professional to get things accomplished for patient’s care.
domain
It is the knowledge of nursing practice and nursing history, nursing theory, education, and research. Gives nurses a comprehensive perspective that allows you to identify and treat patients’
health care needs in all health care settings
theory
a set of concepts,definitions,and assumptions in order to explain a particular phenomenon.
paradigm
is a pattern of beliefs used to describe the domain of a discipline
Henderson’s theory
there are 14 basic life activities a patient needs assistance with, help with these needs until patient is able to do them alone. Ex: breathing, eating/drinking, elimination, movement/positioning, sleep/rest, clothing, body temp., hygiene, safety, communication/socialization/play, practice of faith, learning
Leininger’s theory
focusing on culture as nursing and health care would become more global. know how to care for patient based on their culture allows for comfortable and effective care
Nightingale’s theory
based on bringing patient closer to nature; incorporate good environment to help with healing. Ex: sunlight helps patients with healing.
Orem’s theory
teaching patients to be self sufficient, practice self care, Goal: teaching patient to manage own health problems
Neuman’s theory
role of nurse is to stabilize patient, identify stressors, and assess the whole
Roger’s theory
unitary beings. Nurses role is to be truly present with patient and accept the patient’s view on reality
Watson’s theory
Caring. seeing patients spiritual needs.
Roy’s theory
adaptation. People have ability to adapt, nurses need to help them adapt physically, emotionally and mentally.
why we use nursing diagnoses instead of medical diagnoses to plan care
We use a nursing diagnoses instead of a medical diagnoses because we don’t diagnose off signs and symptoms. We make clinical judgements about our patients in response to an actual or potential health problem and therefore educating our patients.
process of data collection
collection, validation, patient centered. The data may come from primary(patient) secondary(family/friend), patient’s history,lab,imaging,or prior consultations.
subjective data
symptoms. what a patient tells you
objective
signs. what you observe
patient centered interview
courtesy, comfort, connection, confirmation, and open-ended questions
courtesy
addressing the people in the room and asking permission to conduct the interview
comfort
making sure the environment is correct like the room isn’t too cold. You want correct room temperature and good lighting
connection
eye contact, sit down, take time listening to them
confirmation
ask:Is there anything else you want to share? Ask if you got their information correct
nursing diagnosis
clinical judgement about the patient in response to an actual or potential health problem
3 components of nursing dx
problem, etiology, and defining characteristics
problem
labeling the health concern (Dx)
etiology
why does the problem occur - cause
defining characteristics
signs and symptoms that validate what is going on.
what do you use when deciding prioritization
ABCs and mallows hierarchy of needs
priorities
high, interm, and low
ABCs
airway, breathing, and circulation
maslows hierarchy of basic needs
At the base is physiological needs Then safety Then love/beloging Esteem And at the top (which means it is the least important) is self actualization
SMART
specific, measurable, attainable, relevant, and time used when making a short-term goal
characteristics of a critical thinker
confidence, fair, responsible, accountable, risk taking, discipline, perseverance, creativity, curiosity, integrity, humility, thinking independently, uses evidence, uses reflection, uses standards
dreyfus model
shows how students acquire skills through formal instruction and practicing. students move through 5 stages.
5 stages of Dreyfus model
novice (beginner), advanced beginner, competence, proficiency, and expert
karaoke-yahiro and saylor model
three levels of things as you grow as a nurse from a beginner to expert
three levels of karaoke-yahiro and saylor model
basic - experts are always right, complex - begin to separate learner from authority, and commitment - anticipates needs to make choices and assumes accountability for them
Identify some ways that you can build your critical thinking
reflective journals, take notes after clinicals, ask yourself these questions: What are you feeling about the situation? Did this situation remind you of a past experience? Where are the connections between clinical and class?, meet the peers to get new perspectives on situations, and use concept maps
standards of care
o Provide physical exams and health histories
o Health promotion, counseling and education
o Administer medication
o Wound care
o Personalized interventions
o Interpret patient information and make critical decisions about needed actions
o Coordinate care in collaborate with a wide array of healthcare professionals
o Direct and supervise care delivered by other healthcare professionals
o Conduct research about improved practice and patient’s outcomes
direct interventions and example
treatment performed by interactions with the patient. giving medications or educating patient
indirect interventions and example
Treatment performed away from the patient but on the behalf of the patient of groups of patients. nurse requesting consultation
steps to evaluation process
make decisions, articulate the purpose of evaluation, identify and collect relevant information, and analyze and interpret information
Describe how evaluation leads to the modification of the plan of care
If they were NOT met then start a new plan and begin that plan by redoing the assessment and starting from there.
If the goals WERE met then the new goal may be to met higher expectations of wellness and reduced risk
high priority needs
if left untreated will result in harm to patient. Those issues related to airway status, circulation, safety, and pain are of highest importance. Example would be if someone has an obstructed airway.
intermediate priority
nursing diagnoses that are non emergent, non life-threatening needs of patients. An example would be monitoring a risk for infection
low priority needs
not always related to a specific illness or prognosis but affects a patient’s future well being. It focuses on the patient’s long-term healthcare needs. An example would be focusing on a patient’s anxiety.
Explain the role of how health promotion can decrease costs
Health promotion can decrease costs because it can reduce incidence of disease, minimizes complications, and reduces the need for more expensive resources
primary care services
first entrance into the healthcare system
secondary and tertiary care
are the most common services. The focus is on the diagnosis and treatment of the disease
secondary acute care
emergency care, acute medical care, radiology procedures
