Nursing Today/Nursing Roles And Practice

Question 1

Compare and contrast historical and contemporary influences in the development of professional roles

Answer 1

Florence nightingale- Founder of modern nursing, changed the practice of nursing. Made it a respectable profession.
Using compassion.
Pinning of graduated nurses because of Florence nightingale the queen had given her a pin and we also say the Florence nightingale pledge with a candle lighting.

Question 2

Describe the various levels of educational preparation in nursing

Answer 2

—Types of nursing program for entry level professional practice:
-Associate degree- basic nursing curriculum 1958
-Diploma program - 1860 fading out but still there in the Midwest, Florence nightingale started the diploma program. Work at the place where they did their clinicals. Courses are not transferable to higher education.
-Baccalaureate Degree
-Masters entry to the nursing profession - Generic masters not LPN but does have its advantages, could be promoted as a manager. GCU offers with Pima, if you have your bachelors and decide you want to be a nurse, you can get your masters.

Question 3

Define nursing as a professional discipline

Answer 3

What is nursing? According to Florence nightingale it is more than just the medicine, “but what of fresh air,sunlight warmth, cleanliness, quiet, nutrition..”
human response- care plans are individualized based on the human response.
Care cure model, primary care, secondary cure. This is the opposite for a physician.

Question 4

Outline the role of the Arizona state board of nursing

Answer 4

Apply to them to take NCLEX exam to become a professional registered nurse after completion.
Need to take exam in order to become registered nurse.
Renew license every 4 years. On the website employers can look up your license and see if it is legitimate.
Scope of practice- gives some items that will be in the final exam. What tasks to delegate to an lpn or tech.
Article 8- CNA scope of practice.
Nurse licensure compact- where else your license would be accepted.

Question 5

Identify the major elements (prioritization, delegation, assignment) addressed by the nursing practice acts

Answer 5

Prioritization- deciding which needs or problems require immediate action and which ones could be delayed until a later time because they are not urgent”
There are guidelines one of them being MASLOWS HIERARCHY of needs: starting form the top: self actualization, self esteem, love and belongingness, safety and security, physiological needs.
Take care of physiological needs before psychosocial. Safety is a grey area because sometimes safety comes first.

Question 6

Differentiate between licensure by examination licensure by endorsement, and mutual recognition of licensure

Question 7

Discuss the purpose of the organizational mission, vision, and values

Answer 7

It is important to know these when applying to a company. Depending what their mission, vision and values are. Integrate them with your own.

Question 8

Discuss the concept of organizational structure, organizational charts, and chain of command

Question 9

Discuss various employment opportunities available to nurses today

Answer 9

Mostly in the hospital. Or in a medical center, importance of prevention of dz.

Question 10

Describe different patterns of nursing care delivery

Answer 10

Nursing in todays world -157-158
-Case method- one on one with a patient
-Functional method - more of tasks, divide tasks among a group of nurses and techs. Task oriented
-team nursing -
-primary care - by theory, they take care of a patient for 24 hours. Don’t work for 24 hours 12 working and the other 12 working on call. Any change of plan of care you will be informed. - don’t really see this in practice as often.
-total patient care- mostly in the ICU , only nurses. Do not have a tech. - ask other nurses to help when needed. But not absolute. Sometimes in the icu there are techs that help the nurses.
-case management- nurses that don’t give direct care but help pts navigate healthcare system. Help with discharge and how to coordinate care for after discharge.

Question 11

Explain the multiple uses of certification in nursing

Answer 11

Added boost to resume. Current in knowledge and skills in particular specialty. Example: ICU- you can get certified in CCRN exam. Then you can add ccrn next to your RN. Once you become a certified nurse you can earn more pay.

Question 12

Describe the program learning outcomes of the ADN graduates from Pima community

Question 13

What are the guideline for prioritization?

Answer 13

-Airway: Foreign body; swelling in trachea, larynx or airways; drowning
-Breathing: neurological (brain hemorrhage, increased ICP, spinal cord injury, guilliard barre, myasthenia gravis) , trauma to chest, pneumothorax, COPD, pneumonia, atelectasis, overdose causing respiratory depression, seizer, c1 and c2 spinal cord injury.
-Circulation: cardiac failure; low Hgb,Hct; fluid overload or deficit; critical electrolyte imbalances esp. in renal failure; inadequately treated hypertension; cardiotonic or anticoagulant IV solutions.

Question 14

What are some other guideline for prioritization?

Answer 14

-Actual vs potential: in most cases and actual problem will take precedence over a potential problem unless the potential problem presents is greater risk to safety than the actual problem. For example, while an alert client mat have an actual problem of vomiting, a client who is nauseated while in c-spine precautions is a higher priority because of the concerns for airway safety.
-Acute versus chronic: Given a choice between acute and chronic, an acute situation will almost always be the higher priority. A good example of this would be a client with COPD. While their dz is being maintained with medications and oxygen, they are considered chronic. When there is evidence of respiratory distress or exacerbations of the symptoms (respiratory rate, ABGs, pulse ox, etc.) the client becomes acute by showing a change in their baseline condition.
-Safe practice: This is always a priority. Safety concerns may include evaluation of the risk for falls, prevention of injury when performing a skill, reduction of risk for hospital acquired infections (HAI), and more.

Question 15

Identify major elements by the nursing practice acts - Delegation

Answer 15

Delegation: transferring to a competent individual the responsibility to perform a selected nursing task in a selected situation. The nurse retains the accountability.”
The responsibility is transferred but not accountability.

Question 16

What are the guidelines for delegation?

Answer 16

-RN should NOT delegate the following:
-Assessment, Diagnosis, planning and evaluation of the nursing process
-health teaching and counseling
-Complex and complicated activities - situations for example, a diabetic keto acidosis, monitor blood glucose hourly. In this situation as an RN- your decision to delegates to a tech or not. It is important in order to adjust insulin drip more complicated so may want to think about delegating.
-Unstable patients with unpredictable outcome

Some Implementing could be delegated.

Question 17

True or false: You can delegate wound specimen collection to your tech.

Answer 17

False. This can only be delegated to your LPN. - this always based on the circumstances. They are qualified to do it but based on the circumstances you may want to do it yourself and not delegate.

Question 18

Can you delegate an enema to a tech?

Answer 18

No. Although some facilities do include this in their training and they are qualified to do so.
LPN can administer.

Question 19

Identify the major elements addressed by the nursing practice acts - assignment

Answer 19

Assignment: Describes the distribution of work that each staff member is responsible for during a given shift or work period.
Note: Don’t assign complex and complicated activities as well as unstable patient with unpredictable outcomes.