• choosing ones beliefs and behaviors
• prizing ones beliefs and behaviors- feel strongly about values
• action on ones beliefs

independence, self-determination, self reliance

respect for the WHOLE person

actively seeking benefits, "promotion of good"

benevolence, consistency

actively seeking to do no harm

• doing no harm through actions and words

fairness or equality

• equality, individualize to relate to person

faithfulness, keeping promises, avoiding abandonment

• integrity, your personal code, consist with own principles

ability to answer for one's own actions

• evaluation of a nurse's effectiveness in practice

carry out duties of particular role

• reliability, dependability, competent, distinguish right from wrong

only the client knows

• must have client consent to give info to family members (HIPPA)

• Set of ethical principles to help guide decisions- accepted by all members of profession
• Human dignity, privacy, safety

Ethical theories

Deontology

• focus on whether the ACT is right or wrong

Ethical theories

Teleology

Ethical theories

Ethics of Care

• supporting and upholding client's values

ethical theories

Utilitarianism

value of something determined by usefulness

• immunizations
• clean needles available
• providing condoms at school

ethical theories

feminist ethics

• value role of relationships
• issues of gender inequality

• Is this an ethical delima? (cannot be solely resolved through review of scientific data)
• Gather all relevant info
• Examine own values
• Identification of the problem
• Consider possible courses of action
• Negotiate the outcome
• Evaluate the action

verbailization of personal evaluation, influence behavior

Disturbed Self-Esteem

holistic way to look at yourself

disturbed self-concept

a state where an individual has identified lack of motivation to do previous activities, they tend to be more tired and want to sleep

• does not get better with rest

Insufficient physiological or psychological energy to endure or complete required or desired daily activities

• Gets better with rest

unifying theme in one's life

a vague feeling of dread or apprehension; it is a response to external or internal stimuli that can have behavioral, emotion, cognitive, and physical symptoms

• vague feeling of apprehension that happens before fear

state in which a person experiences, or is at risk to experience, permanent pervasive psychic pain and sadness, variable in intensity, in response to a loved one forever changed by an event or condition and the ongoing loss of normalcy

• permanent psychic pain and sadness

state in which an individual or group perceives a lack of personal control over certain events or situations that affects outlook, goals, and lifestyle

• lack of control over physical and emotional dilemma

a sustained subjective emotional state in which a person sees no alternatives or personal choices available to solve problems or to achieve what is desired and cannot mobilize energy on own belief to establish goals

• incapable of solution management/accomplishment

prevent a problem before it occurs

• immunizations, physical and nutritional fitness activities

early detection and treatment

• Screenings (pap, mamo, colonoscopy), treatment, diagnosis and prompt intervention

restoration and rehabilitation

• activities to prevent further deterioration and complications

• Quality of care, education, ehtics, collaboration, leadership
• Nursing process- assessment, diagnosis, outcomes, planning, implementation, evaluation
• Nurse Practice Acts- regulate licensure (state to state basis) and scope of practice, establish curriculum standards, set fees for renewal

• Physiological
• Safety and Security
• Love and Belonging
• Self-Esteem
• Self Actualization

Priorities

Classified

• High-urgent, may be life threatening
• Intermediate-non-emergent, still important
• Low-may not be directly related to illness

Priority

Benefits

• Individualize care
• facilitate communication
• promote continuity of care
• coordinate care
• evaluate clients response to care
• promote nurses professional development

Priority

Nursing Interventions

• ADL-hygiene
• health promotion-exercise, nutrition, sleep
• health education
• counseling
• assessing and monitoring
• spiritual
• initiate referrals
• contact social workers

Goals of Interventions

Actual

• Reduce or eliminate contributing factors of Dx
• promote higher level of wellness
• monitor status

Goals of Interventions

Risk Dx

• reduce or eliminate risk factors
• prevent occurrence of problems
• monitor for onset of problems

Goals of Interventions

Wellness Dx

• Teach behaviors to enhance status

Nursing Interventions

Components

• Date
• Action verb
• Content

a relationship with the divinity, higher power, authority, or spirt

• belief without question, way choose to live, purpose and meaning for life

Family Coping Strategies

Internal Family relationship coping strategies

• Family group reliance
• role flexibility

Family Coping Strategies

Internal Family cognitive strategies

Family Coping Strategies

Internal Family Communication Strategies

Family Coping Strategies

External Family Coping

• Social Support-extended family, friends, neighbors
• Spiritual- seeking advice of clergy, prayer, having faith in God

Dysfunction Family Coping

Maladaptive Coping

• Ineffective coping
• defensive coping
• disabled family coping
• ineffective community coping

Dysfunction Family Coping

Dysfunctional Family Coping Strategies

• Denial of family problems
• family dissolution and addiction
• family violence

Warning Signs of Domestic Violence

Victim

• Injuries inconsistent with the explanation for them
• fear of partner
• new or worsening depression
• pregnancy
• frequent missed or cancelled appointments
• isolated from family or friends

Warning Signs of Domestic Violence

Abuser

• Controlling behavior, tries to make partner's medical decisions
• explains partner's injuries
• extreme jealousy
• puts down victim in public

R: remember to ask about violence and victimization in course of the routine patient encounter

A: ask directly

D: Document findings in the medical record. Take a detailed history, including details of the first and most recent episode, most serious episode, etc

A: assess safety

R: Review options and refer as appropriate

Domestic Violence

Kansas Law

Domestic Violence

(BWTF)

• Using intimidation
• using emotional abuse
• using isolation
• minimizing, denying, and blaming
• using children
• using male privilege
• using economic abuse
• using concerns and threats

• Trivializing and minimizing the abuse
• not respecting her autonomy
• blaming the victim
• ignoring her need for safety
• normalizing victimization
• violating confidentiality