Quiz #1 Flashcards
what are the 4 main concepts in the ANA’s definition of nursing
- health promotion
- prevention of illness and injury
- patient advocacy
- diagnosis and treatment of the human response
what is the difference between what a nurse does and what a physician does?
nurse: treat pt response to disease
physician: diagnosis and treatment of disease
who is considered the founder of modern nursing
florence nightingale
how did the wars in the U.S. history help advance the cause for nursing?
need for nurses to care for wounded soldiers increased, began developing programs for nurse training
what role did nurses have in the first nursing schools in hospitals?
subservient female work force
-cleaning, feeding, laundry, etc.
what is the name of the nursing professional organization founded in 1896 that represents the interests of all nurses today?
ANA (american nurses association)
in the early 1900’s, what major change took place in nursing education?
nursing education available at university level, not just hospital training
how does nursing education today differ from nursing education in early 1900’s?
scientific background
nursing theories
specialties
licensure more extensive (prove competencies and knowledge base)
medicare and medicade - more pt searching for health care
when did hospitals develop nursing training schools? and why?
after the civil war
because no organized medical care during civil war
what did the spanish american war do for nursing?
set stage for development of navy nurse corps
when was the first nation wide exam?
1950
when was the first associate degree offered? and why?
after world war 2, because there was a surge in building hospitals after congress gives financial support for nursing education & because of a shortage in nursing
what are the 3 educational pathways for being a RN?
diploma programs
associates degree
bachelors degree
is the LPN a registered nurse? why or why not?
no (vocational); they do not take the NCLEX ( they only receive technical training)
what nursing career paths are available through a masters degree?
NP, Clinical nurse specialist, CRNA (changing), nurse midwifes, nurse educator, clinical nurse leader, researchers
what are 2 final degree pathways for nurses and how do they differ?
phD - specializes in research
DNP - practice focused
what are some practice settings for nurses?
hopsital, clinics, offices, homes, schools, workplaces, military, universities
what was the earliest form of nursing education? what was the purpose?
diploma programs
purpose to meet staffing needs
why a push towards bachelors degrees?
to qualify nursing as a profession
provide leadership in administration, teaching and public health
2 components of graduate-level degree in nursing
- research component
2. clinical specialty courses
clinical nurse leader vs charge nurse
clinical nurse leader is a masters degree who can also write orders possibly (can do advanced things)
what are the key characteristics of a profession? (9)
- occupational group w/set of behaviors or attitudes or both
- intellectual
- high responsibility
- based on a body of knowledge (developed by research)
- ethical
- practical and theoretical
- independent practice
- professional organization
- taught by specialized professional education
what are barriers to nursing as a profession?
- varying levels of education
- gender issues
- historical influences
- external conflicts
- internal conflicts
what is the difference between a profession and an occupation? (2)
- preparation: typically takes place in college or university and requires specialized body of knowledge and techniques of profession
- commitment: orientation to the beliefs, values and attitudes expected of the members of the profession as well as the standards of practice and ethical considerations
why was florence nightingale important?
- importance of observing patient and recording info
- importance of cleanliness
- recognized nurses role in protecting patients
why was Virginia henderson important?
- recognized being a partner with the patient
- assist the person in activities that contribute to health/recovery that they would do themselves if they were well
why was jean watson important?
emphasized the caring aspects of nursing
why was dorothea orem important?
identify needs and promote patient taking care of themselves
why was sister callista roy important?
adapting environment to further patients adaptation and coping
why is theory important?
integration of theory into practice is basis for nursing to be a profession (distinct body of knowledge)
structure for decision making
support excellence in practice
why was hildegard peplau important?
emphasized relationship between patient and nurse
therapeutic interpersonal relationship
why was madeleine leininger important?
founder of transcultural nursing
make cultural congruent decisions with patients
what organization is responsible for regulating if you are a competent nurse?
board of nursing
what are the 4 major purposes of the state boards of nursing in each state?
- licensure
- standards for education
- implement criteria for assurance of continued competency
- disciplinary action when needed
what is the purpose of requiring RNs to pass nursing licensure exam prior to being able to practice as an RN?
provides minimal knowledge base to be able to practice nursing
what are michigan’s continuing competency requirements for practicing RNs?
every 2 years - 25 hours of continuing education (2 of which should be on pain and symptom management)
1x human trafficking training
how do health care institutions provide an environment conductive to competent practice?
establish policies and procedures conducive to competent practice
what will you do in your practice to provide the competency level expected of an RN?
exercise judgement based on policies and standards
what are the 4 tiers in the model of professional nursing practice regulation?
bottom tier: foundation (scope of practice, code of ethics, standards of practice, specialty certification)
3rd tier: specific to state (nurse practice acts and rules and regulations)
2nd tier: institutional polices and procedures (depends where you work)
top tier: self-determination (up to you what you do and don’t do)
standards of practice
describe a competent level of nursing care (care you provide, nursing process)
standards of professional performance
describe a competent level of behavior in the professional role (how, ethical)
code of ethics
philosophical ideas of right and wrong that you use to provide care
specialty certification
additional verification and validation of competence
not just advanced practice degrees, can have specialty to a unit (med surg for example)
what are nurse practice acts
state boards oversee these
regulate scope of nursing and protect public health, safety, and welfare
shield public from unsafe nurses
each states decides the scope of nursing practice
generally follows ANA definintions
michigans nurse practice acts
does not have its own nurse practice act
has one that involved nursing and 25 other occupations
name the 6 standards of professional practice
- assessment
- diagnosis
- outcomes identification
- planning
- implementation (coordination of care, health teaching & health promotion)
- evaluation
AKA nursing process
name the 11 standards of professional performance
- ethics
- culturally congruent practice
- communication
- collaboration
- leadership
- education
- evidence-based practice and research
- quality of practice
- professional practice evaluation
- resource utilization
- environmental health
who is responsible for developing and maintaining the scope and standards of practice
ANA
purpose of standards of professional nursing practice
foundation for the nurses decision-making
what is the nursing process?
problem-solving approach (using critical thinking) to meet the health care and nursing needs of patients
what are the steps of the nursing process?
- assessment
- nursing diagnosis
- planning
- implementation
- evaluation
what is the key element that guides decision-making process in the nursing process?
critical thinking
characteristics of the nursing process
- cyclic and dynamic
- client centered
- problem-solving and decision-making
- interpersonal and collaborative style
- universal applicability
- use of critical thinking
what are the 4 basic services provided by health care delivery system?
health promotion
illness prevention
diagnosis and treatment
rehab and LTC
which of the 4 basic services has the health care system typically addressed the most in the past?
diagnosis and treatment
which of the 4 basic services should the health care system be addressing in the future?
health promotion
what is health promotion
community focused
helping people improve their health to reach an optimal state of physical, mental, and social well-being
what is disease and injury prevention?
reduce risk of illness or injury or preventing it getting worse
what is primary care? (3 parts)
- treat existing health problems (PCP usually)
- specialized clinical care
- high specialized
what is secondary care?
rehab
services and activities designed to restore a person to previous level of function or reach new level of function limited by illness and injury
what is tertiary care?
supportive care
services and activities designed to address the chronic health needs to patients of any age
what is the nursing metaparadigm?
framework that shows connectedness of nursing, person (patient), environment & health
what are the 4 parts of the nursing paradigm and a definition for each?
- person - recipient (may include pt, family, groups, communities, individuals)
- environment - internal and external surrounds that affect the client
- health - degree of wellness/well-being that the client experiences
- nurse - attributes, characteristics and actions of the nurse providing care on behalf of or in conjunction with the client
passive strategies for health promotion vs active strategies
passive - individuals gain from activities without acting themselves (milk w/ vit D, fluoride in water for public)
active - individuals adopt specific health programs (smoking cessation programs)
types of health care agencies (4)
- government
- voluntary
- non-for-profit
- for-profit
what do you think are the 2 most important roles of the nurse and why?
patient advocate
provider of care
(can differ)
what are some roles of the nurse
provider of care educator counselor manager researcher collaborator patient advocate
what is palliative care
specialized medical care that focuses on providing patients relief from pain and symptoms or a serious illness (no matter diagnosis or stage)
what is hospice care
medical care to help someone with a terminal illness live as well as possible for as long as possible (increase quality of life)
difference between hospice and palliative care
palliative - relief w/interventions, anytime in disease process
hospice - relief without interventions, during end of life (less than 6 months usually)
both make patient comfortable
what should you as the nurse do if you think that a patient needs palliative or hospice care?
educate and advocate
process is determined by the hospital
need an order for hospice, usually need a consult for this
what are the components of discharge planning?
pt leaves when physical conditions allow
required referrals
provide info about resources
patient and family education
when does discharge planning begin?
as soon as patient is admitted
what is respite care?
provides caregivers with relief temporarily by taking over caregiving duties
offered in home, a daycare, or health care institution
what are the different levels on the illness wellness continuum?
- optimal health
- good health
- neutral
- poor health
- disease
what is the difference between acute and chronic illness?
acute - usually reversible, short duration, severe, abrupt symptoms that subside over time
chronic - longer than 6mo, usually reversible, affects functioning of one or more systems
name variables that influence a persons health (8)
- developmental stage (predict response)
- intellectual background (health literacy)
- perception of functioning (pt’s perception)
- emotional factors (stress, depression)
- spiritual factors
- family and health care
- psychosocial and socioeconomic factors (includes environment)
- culture
what is health disparity?
if a health outcome is seen to a greater/lesser extent between populations
linked with social, economic, and environmental disadvantage
what are health determinants?
factors that contribute to a person’s current state of health
name the health determinants (6)
- policymaking (increasing tobacco prices may help people quit)
- social factors (schools, public safety, exposure to crime, violence, etc.)
- physical factors (natural environment, built environment, schools, housing, exposure to toxics, disabilities)
- health services (access and quality, cost, insurance, language, lack of availability)
- individual behaviors (diet, activity, hand washing, alcohol, smoking, etc)
- biology and genetics (age, sex, HIV, inherited conditions, family hx of heart disease, etc.)
