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nur302 > quiz 1 > Flashcards

quiz 1 Flashcards

1
Q

accountability

A

the responsibility professionally and legally, the type and quality of nursing care provided

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2
Q

advocacy

A

protect patients human and legal rights and provide assistance in asserting those rights if the need arises

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3
Q

autonomy

A

initiation of independent nursing intervention without medical orders

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4
Q

beneficence

A

taking positive actions that help others

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5
Q

bioethics

A

branch of ethics within science and medicine

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6
Q

casuistry

A

turns away from conventional principles of ethics as a way to determine best way of practice

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7
Q

nursing code of ethics

A

set of guiding principles that all members of a profession accept

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8
Q

key principles of code of ethics for nursing

A

advocacy
responsibility
accountability
confidentiality

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9
Q

confidentiality

A

healthcare team’s obligation to protect pt’s privacy

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10
Q

deontology

A

defines actions as right or wrong based on their adherence and to rules and principles such as truthfulness, fidelity to promises, and justice

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11
Q

ethics

A

study of what is right or wrong with our conduct

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12
Q

ethics of care

A

offers an alternative view to utilitarianism and deontology

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13
Q

feminist ethics

A

view holds that the natural caring of others is the basis for moral behavior; places emphasis on caring relationships, and a strong sense fo responsibility, focuses more on practical solutions

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14
Q

fidelity

A

faithfullness on the agreement to keep promises

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15
Q

justice

A

treating everyone fairly

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16
Q

morals

A

judgment about behavior based on specific beliefs

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17
Q

nonmaleficence

A

do not harm

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18
Q

utilitarianism

A

measures the effect and act will have

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19
Q

value

A

deeply held belief of the worth of an idea, custom, or attitude, or objects, that affects behavior

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20
Q

values clarification

A

to resolve ethical conflicts one needs to distinguish among value, fact and opinion

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21
Q

approaches to ethics

A
  • deotonology
  • utilitarianism
  • casuistry
  • feminist ethics
  • ethics of care
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22
Q

types of ethical problems

A

ethical dilemma
moral distress

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23
Q

ethics comitees

A

make informed decisions that may be difficult for nurse

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24
Q

processing an ethical problem

A
  1. aks is this an ethical problem?
  2. gather information that is relevant to the case
  3. identify the ethical elements in the problem and examine your values
  4. name the problem
  5. identify possible cours eof action
  6. create-implement an action plan and carry it out
  7. evaluate the action plan
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25
Q

issues in health care ethics

A

social media
quality of life
care the end of life
access to health care

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26
Q

bioethics

A

specific domain of ethics that is focused on moral issues in the field of health care

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27
Q

nuremberg trials

A

1947
focused on the unspeakable treatment of prisoners of war during WWII with a storng focus on the incarceration of people of jewish faith strictly because of their ethnic and religious affiliaiton

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28
Q

watson and clark

A

1953
presented on the of first publications describing DNA - concept that was beginning to be explored

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29
Q

first renal transplant

A

1954
movement in medical practice recognized the first kidney transplant

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30
Q

chronic hemodialysis

A

1960
posed questions for who would meet criteria for treatments that could not be provided for everyone in need

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31
Q

first heart transplant

A

1967
cape town south africa on december 3
dr. christiaan barnard
opened discussions for who and how this procedure would be implemented

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32
Q

definition of brain death

A

1968
first discussion of brain death was presented with discussion of how and who would perform this assessment, what decisions might be made for patient care after this determination would be made

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33
Q

tuskegee syphilis research

A

1972
continuaiton of providing no treatment for subjects diagnosed with syphilis even after known treatment with antibiotics was established
premise was to further explore progression of diseases without intervention
ETHICALLY WRONG

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34
Q

roe v wade

A

1973
legal, moral, religious, and ethical questions related to choice for an abortion

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35
Q

karen ann quinlan

A

1975
removal of life support

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36
Q

baby louise brown

A

1978
initiation of pregnancy for the first time through invitro-fertilization (Baby Louise Brown)

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37
Q

first artifical heart

A

1982
first implementationof an aritifical heart

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38
Q

AIDS, as an epidemic

A

1983
epidemic of HIV/AIDS

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39
Q

dobbs vs jackson women’s health organization

A

2022
reversal of roe v wade

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40
Q

belmont report

A

1978
respect for person
beneficence - do good
justice
outcoe of a professional meeting to review the pratice to date in 1978 to develop response for a health care providers tha directed professional care to the lists

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41
Q

principles of biomedical ethiccs

A

autonomy
nonmaleficence
benefence
justice

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42
Q

ethical principlism

A

provides guidelines that can be used to make justified, moral decisions and to evaluate the morality of actions
one of the most popular tools used today for analyzing and resolving bioethical problems

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43
Q

autonomy

A

freedom and ability to act in self-determined manner

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44
Q

informed consent

A

respecting a persons autonomy to make personal choices bsed on the appropriate appraisal of information about the actual and/or potential circumstances of a situation

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45
Q

patient self determination act

A

first federal statue designed to facilitate a patient’s autonomy through the knowledge and use of advance directives

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46
Q

slippery slope argument

A

warning with no justification or formal, logical evidence to back it up; a situation taht could hypothetically slip towrd a morally unacceptable situation
ie physician assisted suicide

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47
Q

paternalism

A

deliberate overriding of a patient’s opportunity to exercise autonomy because of a perceived obligation of beneficence

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48
Q

social justice

A

usually thought of in terms of how benefits and burdens should be distributed fairly among members of a society or ideally how all people in a society should have same rights, benefits, and opportunities

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49
Q

ethical dilema

A

situation in which an individual is compelled to make a choice between two actions that will affect the well-being of a person; neither action is “good”

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50
Q

reflection

A

involves stopping to think about what one is choosing and doing before and during one’s actions

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51
Q

ethics comittee

A

usually consists of physicians, nurses, other health care providers, and on-staff chaplain, a social worker, a rep of organization staff, possibly a legal representative, and community members

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52
Q

to act professionally:

A

use critical thinking skills
administer quality PCC
be responsible and accountable

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53
Q

health care advoacy groups the

A

importance of the role nursing plays in a nations health care

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54
Q

Robert Wood Johnson Foundation (RWJF)

A

future of nursing: campaign for action
catalysts for change: harnessing the power of nurses to build population health in 21st century

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55
Q

nursing requires

A

current knwoledge and practice standards
insightful and compassionate approach
critical thinking and clinical judment

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56
Q

benner’s stages of nursing proficiency

A

novice
advanced beginner
competent
proficient
expert

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57
Q

nursing definitions

A

ana
international council of nurses

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58
Q

professional responsibility and roles

A

autonomy and accountability
caregiver
advocate
educator
communicator
manager

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59
Q

APRN

A
  • clinical nurse specialist
  • nurse practitioner
  • certified nurse widwife
  • certified registered nurse anesthetist
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60
Q

nurses respond to

A

needs to patients and actively participate in determining best practices

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61
Q

florence nightingale

A
  • established first nursing philosophy on health maintenance and restoration
  • organized first program for training nurses
  • first practicing epidemiologist
  • improved sanitation in battlefield hospitals
  • remain a basic part of nursing today
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62
Q

mary adelaide nutting

A

1906
instrumental in moving nursing education into universities

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63
Q

1920 nursing…

A

specialization began

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64
Q

1990 ANA established

A

center for ethics and human rights

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65
Q

1994 UWMC became

A

first magnet organization

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66
Q

nurses are revising nursing practice and school curricula to meet the needs of society:

A
  • aging population
  • cultural diversity
  • bioterrorism
  • emerging infections
  • disaster managment
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67
Q

contemporary concerns

A
  • nurses selfcare
  • healthcare reform and costs
  • demographic changes
  • medically underserved
68
Q

nursing trends

A
  • EBP
  • quality and safety education for nurses (QSEN)
  • emerging technologies
  • genomics
  • public perception of nursing
  • impact of nursing on politics and health policy
69
Q

nurse practice acts (NPAs)

A
  • overseen by state boards of nursing
  • regulare scope of nursing practice
  • protect public health, safety, and welfare
70
Q

licensure and certification

A

NCLEX-RN
certification

71
Q

clinical judgment is the outcome of

A

critical thinking and decision making

72
Q

clinical decision making separates

A

professional nurses from technicians or other assistive personal (AP)

73
Q

critical thinking

A

-ability to think in a systemic and logical manner with openness to question and reflect on the reasoning process

74
Q

aim of critical thinking is the

A

ability to focus on the important issues in any clinical situation and make decisions that produce desired patient outcomes

75
Q

general critical thinking

A

scientific method
problem solving
decision making

76
Q

specific critical thinking

A

diagnostic reasoning
clinical decision making

77
Q

components of critical thinking

A

competence
knowledge base
experience
environment

78
Q

attitudes for critical thinking

A

confidence
independent thinking
fairness
responsibility and accountability
risk taking
discipline

79
Q

evaluation of clinical judgments

A

reflection
meeting w colleagues
concept mapping
critical thinking analysis

80
Q

2 steps of critical thinking

A

collection of information from a primary source and secondary source
interpretation and validation of data to determine whether more data is needed ro databsse is complete

81
Q

types of assessment

A

patient centered interview - conducted during a nursing history
periodic assessments - conducted during ongoing contact with patients

82
Q

phases of assessment interview

A

orientation and setting an agenda
working phase (collecting assessment data)
termination phase

83
Q

interview techniques

A

observation
open ended and direct closed eneded questions
leading questions
back channeling
probing

84
Q

environment in assessment

A

setting
time
task complexity
interruptions

85
Q

intellectual standards

A

guide the manner in which a nurse pursues an assessment

86
Q

professional standards of practice or clinical guidelines

A

apply standard criteria when assessing a pt
compare the patients actual assessment findings with what standard sets as normal or abnormal

87
Q

components of nursing health history

A
  • biographical information
  • chief concern
  • pt experience
  • present illness or health concerns
  • past health hx
88
Q

assessment processs

A

data collection
validation
concept mapping

89
Q

example of assessment process

A

pt looks uncomfortable in bed
pt shows discomfort in surgical area (cues: lies still with arms along sides: tense, states has not turned, 7/10 pain) inferences - pain is sever, liits pt ability

90
Q

CJM

A

recognized cues
analyze cues
prioritize hypotheses
generate solutions
take action
evaluate outcomes

91
Q

adpie

A

assessment
diagnosis or analysis
planning
implementation
evaluation

92
Q

tanner model

A

noticing
interpreting
responding
reflecting

93
Q

methods for prioritizing

A

high intermediate low based on ABCs
maslows hierarchy
consider each pt unique situation
avoid using only physiological nursing diagnoses as high priority

94
Q

a patient centered outcome reflects a pt highest possible level of

A

wellness and independence in function

95
Q

writing expected outcoes

A

specific
measurable
attainable
realistic
timed

96
Q

types of intervention

A

direct care measures
indirect care measures
independent nursing interventions
dependent nursing interventions
other provider interventions

97
Q

selection of interventions, consider

A

desired PO
characteristics of nursing diagnosis
research base knowledge for intervention
feasibility of doing intervention
acceptability to pt
nurse competency

98
Q

systems for planning nursing care

A
  • use of care plans in healthcare agencies
  • student care plans
  • care plans for community settings
  • hand-off reporting
  • concept maps
  • critical pathways
99
Q

when to consult

A

when problem is ID that you or interprofessional team can’t solve

100
Q

how to consult

A

ID general problem area
choose appropriate professional
provide consultant w relevant info
do not prejudice or influence
be available
incorporate consultants recommendations

101
Q

standing orders

A

preprinted document containing medical orders for specific pt’s w id clincial problems

102
Q

nursing interventions classification (NIC) interventions

A

offer a level of standardization to enhance communication of nursing care across settings and to copare outcomes

103
Q

quality and safety education for nurses (QSEN)

A

standard competencies in knowledge skills and attitudes for the preparation of future nurses

104
Q

goal os QSEN

A

to prepare nusrses so that they cna continuously improve the quality and safety of health care systems within which they work

105
Q

critical thinking allows you to consider the

A

complexity of interventions, changing priorities, alternative approaches, and amount of time to act

106
Q

implementation process

A

avoiding adverse events
reassessing pt
reviewing and revising existing care plan

107
Q

preparing for implementation

A
  • time managment
  • equipment
  • personnel
  • environment
  • pt
108
Q

anticipating and preventing complications

A
  • ID area of assisstance
109
Q

implementation skills

A
  • cognitive
  • interpersonal communication
  • psychomotor skills
110
Q

direct care

A
  • ADLs
  • instrumental activites of daily living
  • physical care
  • lifesaving measures
  • counseling
  • teaching
  • controlling for adverse reactions
  • preventative interventions
111
Q

indirect care

A

interventions performed away from pt but on behalf of pt
- communicating nursing interventions
- delegating supervising, and evaluating work of staff members

112
Q

achieving pt outcomes

A
  • implement interventions in timely manner
  • critically apply principles of care coordination (time management, organizational skills, appropriate use of resources, priority setting)
  • promote patient adherance
113
Q

CJ and CT in evaluation

A
  • examine reuslts of care according to clinical data collected
  • compare achieved effects or outcomes with expected outcome
  • recognized errors or omissions
  • understand a pt situation, reflect on situation and correct errors
114
Q

elements of evaluation

A

knowledge
experience
standards and attitudes for evaluation
environment

115
Q

examine results

A

evaluative measures
nursing outcomes classification
compare achieved effects with outcomes
interpreting and summarizing findings

116
Q

patient centered care is achieved only when

A

a pt and family are actively involved in the evaluation process

117
Q

evaluate whether the patient

A

reached the level of wellness or recovery that the health care team and patient established in outcomes of care plan

118
Q

four nursing sensitive adverse outcomes

A

severe pressure injuries
falls and trauma
catheter associated urinary tract infections
central line associated blood stream infections

119
Q

tanner model

A

developed from review of research on clinical judgment
recognizes role of nurses background
circumstances of situation
nurses relationshi with pt

120
Q

requires range of knowledge

A

derived from science and theory, applicable to many situations
derived from practice grows with clinical experience
derived form knownig individual pt
dervied from human understanding

121
Q

nurses know pt typical response pattern so

A

aspects of situation stand out readily recognized

122
Q

qualitative distinctions are possible

A

current picture can be compared to patient’s typical picturekn

123
Q

knowing pt supports helps

A

individualize responses and interventions

124
Q

analytic processes

A

break down situation into its elements to gain knowledge, adress mismatch between what is expect and what happens, determining action when there are multiple options

125
Q

documentation is

A

a key communication strategy that produces written account of patient data, clinical interventions, and pt responses

126
Q

documentation allows for

A

all members of healthcare team to track pt clinical course

127
Q

purposes of the health care record

A
  • facilitate interprofessional communication
  • provides legal record of care
  • provides justification for financial billing and reimbursement of care
  • supports the process of needed for quality and performance improvement
  • serves as a resources for education and research
128
Q

interprofessional communication within the medical record

A

legal doc
reimbursement
auditing and monitoring
education
research

129
Q

electronic health record (EHR)

A

individuals lifetime computerized record

130
Q

electronic medical record (EMR)

A

the record for an individual health care visit

131
Q

privacy confidentiality and security mechanisms

A

firewall
password

132
Q

handling and disposing of information

A

procedures for nursing students
policies for the use of fax machines

133
Q

guidelines for quality documentation

A

factual
accurate
appropriate use of abbreviations
current
organized
complete

134
Q

standards and guidelines for quality nursing documentation

A

time documentation must be on accurate time stamps throughout

135
Q

documentation of patient assessment data

A

flow sheets
progress notes
charting by exception

136
Q

record keeping forms within the electronic health record

A

admission nursing history form
patient care summary
care plans
discharge summary forms

137
Q

documenting com. w providers and unique events

A

telephone calls
telepone and verbal orders
incidence or occurrence reports

138
Q

acuity rating system

A

used to determine hours of care and number of staff required for a group of patients every shift or every 24 hrs

139
Q

patient’s acuity level

A

based on the type and number of nursing interventions required by the patient over a 24 hr period

140
Q

documentation in long term health care settings is governed by

A

individual state regulations
the joint comission
centers for medicare and medicaid services (CMS)

141
Q

medicare has specific guidelines to

A

establish eligibility for home care reimbursement

142
Q

nurses give two different data dets to document clinical assessments and care provided in the home care setting

A

oasis
omaha system

143
Q

case management model

A

incorporates an interprofessional approach to delivery and documentation of pt care

144
Q

critical pathways

A

interprofessional care plans that identify patient problems, key interventions, and expected outcomes within an established time frame

145
Q

variances

A

unexpected outcomes, unmet goals, interventions not specified within a critical pathway

146
Q

health care information technology is used to

A

enhance quality and efficancy of care

147
Q

health care information systems are composed of two types

A

a clinical info system and an administrative informations system

148
Q

clinical information system (CIS)

A

example: computerized provider order entry (CPOE)

149
Q

nursing clinical information systems

A

two designs: nursing model and critical pathway
advantages: better information access, better documentation quality, reduced errors of omission, reduced hospital costs, increased nurse job satisfaction, clinical database development

150
Q

clinical decision support systems (CDSS)

A

aids and supports clinical decision making

151
Q

nursing informatics

A
  • speciality area of practice
  • integrates nursing science, computer science, and information science
  • informatics competencies for nursing graduates
152
Q

environmental safety

A

basic human needs like
oxygen
nutrition
temperature

153
Q

common environmental hazards

A

MVA
poison
falls
fire
disasters

154
Q

transmission of pathogens

A

immunizations

155
Q

factors influencing patient safety

A
  • devlopmental stages and risks
  • individual risk factors (workplace, lifestyle, mobility, sensory impairment, economic resources, lack of safety awareness)
  • risk in health care agencies (procedure-related accidents, equipment related accidents, chemical exposure, falls, workplace safety)
156
Q

assessment

A
  • through pt eyes
  • nursing history and exam
  • psychological and cultural background
  • health care environment (risk for medical error and disasters)
  • pt home environment (risk for falls, psychosocial resources)
157
Q

outcomes is reliant upon

A

patient participation

158
Q

setting priorities

A

select priorities based on risk and patient characteristics

159
Q

teamwork and collaboration

A

communication is essential

160
Q

health promotion

A
  • developmental interventions
  • environmental interventions (fall safety within home)
  • general preventative measures
161
Q

acute and restorative care

A
  • fall prevention
  • restraints
  • side rails
  • fires
  • electrical hazards
  • seizures
  • disasters
  • preventing workplace violence
162
Q

evaluation

A

through pt eyes:
are pt expectations met
are family’s expectations met

163
Q

patient outcomes evaluation

A

monitor care by HCT
measure outcomes
continually assess needs for additional support

164
Q

safety guidelines for nursing skills

A
  • anticipate a pt fall risk when choosing fall prevention strategies
  • involve patients and families in the selection of fall prevention strategies
  • always try restraint alternatives before using a restraint
  • implement fall prevention protocols and provide pt and family education
165
Q
A

nur302 (2 decks)

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