Test 5 Flashcards
Refers to a person’s right to make choices
Autonomy
The duty to keep promises or the virtue of loyalty
Fidelity
The duty to the tell the truth
Veracity
The value of doing what benefits the patient the best
Beneficence
The hallmark value or virtue of “do no harm”
Non-maleficence
What specifies that a hospital emergency room cannot turn a patient away based on their legal or financial status?
EMTALA (Emergency Medical Treatment and Active Labor Act)
What must a hospital do in accordance with the EMTALA?
Evaluate and stabilize the patient before transporting to other hospital
- Protects the provider from liability in an emergency situation
- The provider of the care can not be the cause of emergency situation
- Care is provided in a reasonable and competent manner
- Care was voluntary (no payment can be issued)
- The recipient did not reject the care
Good Samaritan Law
Recognizes that patient’s right to make decisions regarding his or her healthcare based on the info provided by health care providers
Patient Self-Determination Act (PSDA)
Patients have the right to _____ and _____ treatment
accept; refuse
Patients who are terminally ill or near the end of their life have the right to specify their goals of care in writing so that their wishes may be honored even after they lose the ability to actively participate in their care.
Advanced Directive
Before a patient becomes unable to make decisions, the patient can preemptively name a person to become __________.
Power of Attorney
A set of state laws that protects the reporter from retaliation or punishment when they report certain things that must be reported in order to preserve patient safety.
Mandatory Reporting
What must be mandatorily reported?
Communicable diseases, unsafe care environments, abuse
State mandated laws that outline the nursing scope of practice
Nursing Practice Acts
Includes: breach of contract or malpractice complaints (usually held between 2 parties)
Civil Law
What is another name for Civil Law?
Tort Law
When a nurse intentionally places a patient in immediate fear of personal violence or offensive contact
Assault
When offensive or harmful physical contract is made without consent or if there is unauthorizing touching a person’s body by another
Battery
Restraining a person or patient without proper legal authorization
False imprisonment
The study of what is right and wrong and how that aligns with principles, virtues, and core values
Ethics
“The nurse has authority, accountability, and responsibility for nursing practices; makes decisions; and takes action consistent with the obligation to promote health to provide optimal care.”
Code of Ethics
The equal treatment of all patients (fairness)
Justice
Includes HIPAA violations, but also interfering with the patient’s personal life when such issues are desired to be left alone
Invasion of Privacy
What a person believes to be right or wrong
Morals
Something that is accepted as being true
Belief
A set of beliefs of morals that are agreed upon or believed in by individuals or a group
Values
What three things must be required for informed consent?
- Patient must have the capacity to make decisions
- Patient must be provided with pertinent and understandable information
- Patient must be able to make decision voluntarily
- Conveys shared ethical values, obligations, duties and ideals of nurses individually and collectively
- Provides implied contract with the public
- Informs society of the moral values and ideals by which it functions
- Informs new professionals of the expected moral behaviors
- Guides the profession in self-regulation
- Provides a framework for ethical decision-making
ANA “Code”
The failure to perform as a reasonable or prudent person or nurse would do if presented with the same situation
Negligence
Failing to provide the minimum standards of care
Breach of Duty
A professional form of breach of duty and negligence
Malpractice
True or False: The patient’s record is a legal document that can be used in court.
True
Documentation should be ________ and includes only ________ information
Factual; Relevant
To be financially or legally responsible for something
Liable
The liability that is associated with professional nursing
Malpractice
Our professional standards of care and how we fulfill our professional obligations to patients are based on what?
The Nursing Process (ADPIE)
What is the difference between federal laws and institutional policies/procedures?
Federal is enforceable at all hospitals across a nation
When a nurse/patient is forced to make a choice that is not in compliance with their personal values, they may experience this
Moral distress
Presented as general statements and thus do not give specific answers to every possible ethical dilemma that might arise, it’s purpose is to offer guidance.
Code of Ethics
True or False: Ethical Guidelines are legally enforceable
False
What does postmortem documentation include?
- Time of cessation of heart rate/respirations
- Medical equipment in use
- Time of transfer to morgue
- Disposition of patient belongings
What are the priorities for a patient who is enrolled in hospice care?
- Treatment of the terminally ill in their own homes, or in special hospital units or other facilities
- Goal of helping them to die comfortably, without pain
What happens 1-3 months before death?
- Withdrawn
- Sleep increases
- Appetite decreases; liquids preferred
What happens 1-2 weeks before death?
- Blood pressure lowers
- Color becomes jaundiced, pallor
- Variable respiratory rate
- Death rattle may occur secondary to congestion
What happens days-hours before death?
- Louder death rattle
- Cheyne-stokes respiration may occur
- Skin becomes sweaty/clammy
- Low urine output, minimal BM
- Diminished vision
- May become restless/agitated
What happens moments before death?
=Unresponsive
- Takes long, more spaced out breaths
- Pulse slows
- Breathing stops
True or False: ANA allows nurses to be involved in physician-assisted suicide
False
Who can change an advanced directive?
By the patient who created it
- It cannot be changed if that person is incapacitated
- -In this event would go to POA, next of kin (usually spouse)
What is the requirement for admission into hospice care?
Certification that a patient’s life expectancy is 6 months or less
Which 3 entities have access to a patient’s medical record?
- the patient
- provider providing care to the patient
- insurance companies
Who is the Father of Modern Psychology?
Sigmund Freud
Who believed all behavior is learned?
Skinner and Pavlov
Whose basic theory was about the personality structure?
Sigmund Freud
Who believed that personality developed before the age of three?
Margaret Mahler
Who developed cognitive behavioral therapy?
Beck
Who developed CEBT or rational emotive therapy?
Ellis
What is the goal of the cognitive model?
To get a person to identify their negative thoughts and then replace it with something positive
Whose main focus became on bonding and the development of personality?
Margaret Mahler
What are the four stages of Mahler’s bonding theory?
- Symbiosis
- Separation/Individuation
- Rapprochement
- Object constancy
Who introduced classical conditioning?
Pavlov
Whose theory involved the ID, Superego, and the Ego?
Sigmund Freud
Who developed the psychoanalytical theory?
Sigmund Freud
Who believed behavior is driven by the desire to be accepted?
Sullivan and Peplau
Which theorist is very important in Psych nursing?
Peplau
Which theorist proposed that the nurse was the greatest tool in the relationship with the patient?
Peplau
Who believed “everything comes from the family of origin?”
Sigmund Freud
Who believed that in order to treat a mental condition, triggers must be identified?
Watson, Skinner, and Paplov
Who believed in the need to know a person’s thought process?
Ellis and Beck
Who believed in the interpersonal theories?
Peplau and Sullivan
Who believed in the systems theories?
von Bertanlaffy and Bowen
What do the ABCs of Ellis’s theory stand for?
A- Activating Event
B- Belief
C- emotional Consequence
Behavior can be conditioned or learned
Behavioral model
Divides the psyche into three functions: the id—unconscious source of primitive sexual, dependency, and aggressive impulses; the superego—subconsciously interjects societal mores, setting standards to live by; and the ego—represents a sense of self and mediates between realities of the moment and psychic needs and conflicts
Psychoanalytical Theory
What is the order of Maslow’s Hierarchy of Needs? (Starting from most important to Least)
- Physiological
- Safety
- Love and Acceptance
- Esteem
- Self-Actualization
What are the 8 Stages of Erikson’s Stages of Development?
- trust vs. mistrust
- autonomy vs. shame/doubt
- initiative vs. guilt
- industry vs. inferiority
- identity vs. role confusion
- intimacy vs. isolation
- generativity vs. stagnation
- integrity vs. despair
What are the four rights of the psychiatric patient?
- Right to treatment (receive services)
- Right to refuse treatment
- Right to informed consent
- Right to confidentiality
What is the goal of the Psych Nurse?
Stabilize patient to return to community
What are the three admissions for a psych patient?
- Threat to self
- Threat to others
- Unable to care for self
What are the 4 types of admissions in the psych community?
- Voluntary
- Involuntary
- Temporary Detention Order (TDO)
- Commitment
What are the 4 S’s of Milieu?
- Support
- Safety
- Structure
- Social
What is the total environment or surroundings that the patient is in called?
Milieu
What are the four different kinds of loss?
- Loss of a loved one
- Loss of an aspect of self
- Loss of an object
- Loss of an environment
The process that someone undertakes to deal with the void that is now left, usually seen externally
Mourning
The internal emotional reaction and response to loss
Grief
Acknowledging that a loss is inevitable and preparing emotionally for it
Anticipatory Grief
Nothing in particular that makes this type of grief difficult for a person to process
Uncomplicated Grief
A type of grief that impedes a person’s future life, usually because the person clings to sorrow or is buffeted by contradictory emotions
Complicated Grief
Grief involving a deceased person that is a socially ambiguous loss that can’t be openly mourned or supported
Disenfranchised grief
What are 6 risk factors for complicated grief?
- Loss of a child
- Unexpected loss or death with violence
- Abuse
- Lack of support system
- Unresolved losses
- Death associated with stigma
What 5 factors influence grief?
- Cultural beliefs
- Spiritual beliefs
- Gender
- Economic
- Support Systems
What are the 5 stages of Kubler-Ross’s Theory of Grief, Death, and Dying?
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
What stage of Kubler-Ross’s Theory is usually the longest?
Bargaining
What nursing interventions can be implemented in death/dying?
- Give pt control over death and dying choices
- Provide support and hope
- Time availability with the family
- Support the loved ones