Test 1 Flashcards
Art
learn to deliver care with compassion, caring, and respect for each patient’s dignity and
individuality
blended with science in nursing
Science
nursing practice is based on a body of knowledge and EBP that are continually changing with
new discoveries and innovations
Blended with art in nursing
Nursing Requires
Current knowledge and practice standards
Insightful and compassionate approach
Critical thinking
Benner’s stages of nursing proficiency
- Novice?
- Advanced beginner?
- Competent?
- Proficient?
- Expert?
Novice-Nursing Students with no experience
Advanced beginner- Some experience
Competent- Two or Three years in the same clinical practice
Proficient- More than two to three years of experience in the same clinical position
Expert – Diverse experience, take time and commitment to become an expert!
ANA Six Standards of Practice
- Assessment
- Diagnosis
- Outcomes identification
- Planning
- Implementation
- Evaluation
Advanced Practice RN
-Most independent nurse
-An APRN has a Master’s or DNP degree in
Nursing
-Approves the life of patient and family
Advanced Practice Nurse- Clinical Nurse Specialist
APRN who is an expert clinician in a specialized area
of practice.
Advanced Practice Nurse- Nurse Practitioner
APRN who provides comprehensive healthcare to a
group of patients in an inpatient, outpatient, ambulatory care, or community
Advanced Practice Nurse- Certified Nurse Midwife
APRN educated in midwifery focusing care on full
range of primary health care services for women from adolescence to
menopause.
Advanced Practice Nurse
APRN with advanced education from a nurse
anesthesia- accredited program. Must have 1 yr. of critical care or ER
experience. Work under the guidance of anesthesiologist or a physician with an advanced knowledge in surgical anesthesia.
Other Opportunities in Nursing
Nurse Educator
Nurse Administer
Nurse Researcher
Skills needed due to Nursing Shortage
Essential skills include: • Time management • Therapeutic communication • Patient education • Compassionate implementation of bedside skills
Historical Influences- Florence Nightingale
- The Mother of Modern Nursing
- First practicing epidemiologist
- Organized first school of nursing
- Improved sanitation in battlefield hospitals
- Known as “lady with the lamp”
- Practices remain a basic part of nursing today
- States that patient outcome can be directly related to environment
Clara Barton
Founder of Redcross
Historical Influences- Mother Bickerdyke
Organized ambulance services, walked battlefield at night looking for wounded soldiers
Historical Influences- Harriet Tubman
Prominent female in the Underground Railroad Movement, helped to free slaves
Historical Influences- Mary Mahoney
- First professionally trained African American Nurse
* Brought forth awareness of cultural diversity
Historical Influences- Lillian Wald and Mary Brewster
- Opened the Henry Street Settlement
* Nurses working in HSS were some of the first to demonstrate autonomy in their practice
20th Century Changes
20th Century:
• a movement toward developing a scientific, research-based practice and defined body of knowledge
• Nurses assumed advanced practice roles
21st Century Changes
- Changes in nursing school curriculum
- Advances in technology and informatics
- New programs address current health concerns
Contemporary Influences on Nursing
Health Care Reform
Rising Healthcare Cost
Demographic Changes
Medically Underserved
5 Step Nursing Process (in order)
Asses Diagnose Plan Implement Evaluate
Two Types of Data
Subjective
- Patient’s verbal descriptions of their health problems
- Cannot use your 5 senses to measure
- Pain is subjective!
Objective
-Observations or measurements of a patient’s health status
-Use your 5 senses to perceive or measure
-Verifiable, another person can repeat the observation and get same
result
Things to not Document
Try not to document subjective descriptions unless the patient stated the words, and it is in quotes.
What is a care plan?
-Provides direction for individualized care of the client
-
Flows from each patient’s unique assessment and organized by the patients specific
needs
- Means of communication and organizing actions of constantly changing nursing staff.
- As needs are met, plan is updated
Components of a Care Plan?
Client database Interviewing Physical assessment Diagnostic Studies Must complete a thorough assessment of client and their problems to create a care plan
Pieces of a Care Plan
Diagnoses
Outcome/Goal
Intervention
NANDA
-North American Nursing Diagnosis Organization
International (NANDA)
-Professional organization of nurses involved in creating
approved, standardized nursing diagnoses
-Nsg. Diagnoses communicate professional judgements nurses
make
Where do you find NANDA care plans?
Care Plan Books
Common NANDA diagnoses
- Acute Pain
- Activity Intolerance
- Anxiety
- Impaired Gas Exchange
- Impaired skin integrity
- Impaired physical mobility
- Decreased cardiac output
- Deficient fluid volume
Prioritizing Diagnoses
A, B, Cs are always first
Then Maslows
Risk Diagnoses are not a “priotrity”
Classifications of Priorities
High—Emergent, Life threatening
Intermediate—non-life-threatening
Low—Affect patient’s future well-being
- Risk for
-Health promotion
After you prioritize diagnoses, then select interventions
Change in POC
If a patients assessment has changed from shift to shift – nurse needs to change nursing diagnosis
So, if the patient has any changes in their presentation –
-First: Assess
-Then: Determine nursing diagnosis from new assessment and
plan for new goal & interventions (POC)
