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Exam 1
SCCC
66
Nursing
Undergraduate 2
09/07/2013

Additional Nursing Flashcards

 


 

Cards

Term
What did Dorthea Dix do?
Definition
*Superintendent female nurses for army
*Dress code
*Activist on behalf of mental illness (to create mental institutes)
Term
What did Florence Nightingale do?
Definition
*lady of the lamp (checked on patients, made them feel important)
*Air, lighting, nutrition and adequate ventilation and space assist to recuperate patient.
*She considered nurses the colleagues of physicians rather than their servants.
*establishment of nursing as a distinct profession
*Introduction of a broad-based liberal education for nurses
*Major reform in the delivery of care in hospitals
*The introduction of standards to control the spread of disease in hospitals (aseptic technique; nosocomial infection)
*Studied epidemiology (trends for diseases and epidemics.)
Term
Ethics?
Values?
Morals?
Definition
-Ethical principles set you can choose to follow
-Worth you place on something (^$, health of kid)
-Decide good/bad it's what u think (immoral to steal, abortion opinion)
Term
How would a patients values impact their care.
Definition
Safety vs. fun
Term
Ethics and nursing
Definition
Professionals responsible for practicing according to their code of ethics.
Term
Ethical principles
Definition
*Beneficence: Do or promote good (beneficial)
*Nonmaleficence: Do no harm, Prevent Harm
(Good vs Harm, give kid a shot)

*Autonomy (informed consent, advance directives [living will, health care proxy]

*Justice:Distribution of resources. Who gets what (vaccines)
*Veracity: Always tell the truth
*Fidelity: Keeping your promises
*Confidentiality: Laws about this
*Privacy
Term
State and institutional laws?
Definition
*state boards of nursing (issue/revoke license, rules in what u can do)
*Mandatory reporting laws(child abuse, some infections)
*Good Samaritan Law(can't be liable for helping)
*Policies and procedures of the agency
Term
Types of torts?
Definition
Intentional, Quasi-Intentional, & Non-Intentional
Term
Intentional Torts?
Definition
*Assault:Causing another to feel fearful or apprehensive (if u don't eat I won't feed u till tomorrow)
*Battery:Intentional, actually touch person
*False Imprisonment: Restraining person against their will (intentionally detain someone)
*Fraud(false info or not enough)
*Invasion of Privacy.
Term
Unintentional Torts?
Definition
*Negligence:
-Failure to perform as a reasonable person
-Failure to follow standards of practice
-No intent to harm
*Malpractice:
-Nursing word for negligence
-need 4 elements (existence of a duty, breach of the duty, causation, damages)
Term
What are the steps of nursing process?
Definition
Assessment
Diagnosis
Outcome
Planning
Implantation
Evaluation
Term
Three Parts of a Diagnostic Statement
Definition
Problem: States the problem (use NANDA terminology)
Connecting Phrase (“related to”) is the etiology or what is causing the problem
Symptom(s) (“as evidenced by”/a.e.b. or “as manifested by” a.m.b.): the data from the assessment that told you the problem existed
Term
Part 1: The Problem or Nursing Diagnosis
Definition
Actual: exists at the time of the assessment
Risk for: a problem response that is likely to develop in a vulnerable patient if the nurse does not intervene to prevent it.
Readiness for enhanced: The client is demonstrating health seeking behaviors and is ready for instruction
Possible: etiology unknown
Potential: (collaborative problem)
Term
Second part of the Diagnostic Statement = the etiology (related to)
Definition
The (related) factor(s) that you believe are causing or contributing to the problem
In most cases is not the medical diagnosis
Is the basis on which the goals and interventions are formulated
Nursing Diagnosis r/t_______ a.e.b.______________________
Term
Outcome Identification and Planning Goals Should be?
Definition
SPECIFIC, MEASURABLE, REALISTIC
Term
Subjective vs objective data
Definition
Subjective: gathered during primary interview( health history what patient tells you. Quotes)
Objective: in physical exam what you see, hear, touch, smell, medical records, lab results, X-rays,
Term
How can find subjective from objective data opposite
Definition
Objective see patient temp is high day have you been feeling well

Patient says not feeling well take temp to get objective high temp
Term
Data Sources?
Definition
Primary: Subjective/Objective from patient
Secondary: Family, friends, health records
Term
Elements of the Communication Process
Definition
Sender (Encoder) – delivers the message
Message (Content)– information given
Channel (Medium) – means of sending and receiving
Receiver/Decoder – can also be the sender
Feedback – communicates whether or not the receiver understands the message
Environment – climate in which the sending/receiving occurs
Term
Types of Communication
Definition
Written Communication
Verbal Communication
Non-Verbal Communication
Meta-communication (tone, physical cues)
Term
85% of Communication? Examples?
Definition
Non-Verbal Communication
Touch, eye contact, facial expressions
Posture, Gait, Gestures, Physical Appearance
Dress and Grooming
Sounds, Silence, Attention or Presence
Term
Social vs. Therapeutic Communication
Definition
Social
Participants are meeting their own needs. Mutual companionship, enjoyment and interaction.
Therapeutic
Focuses on Patient
Is Goal Directed
Has Three Stages
Term
Stages of the Therapeutic Relationship?
Definition
1. Orientation – get to know patient
2. Working – setting goals, instructing
3. Termination – end of therapeutic relationship
Term
3 Parts of the Nurse-Patient Relationship
Definition
Contract Setting
Advocacy
Circle of Confidentiality
Term
Ingredients of Therapeutic Communication
Definition
Empathy
Positive Regard
Comfortable Sense of Self
Term
Closed Ended Questions? Begins with? Best used with?
Definition
Answered with “yes” or “no” or other factual answer.
Begins with who, when, where, what, do [did, does].
“Did you take your meds today?”
Best used with patients who are very anxious or have communication difficulties
Term
Open Ended Questions? Best for?
Definition
Best way to obtain subjective data
The interviewer is looking for lots of information
Allows patient to sort out thoughts
“Tell me about…”
Term
Therapeutic Communication Techniques?
Definition
Restating: “So you’re saying that…”
Clarification: “Are you saying that…”
Reflecting: “So you start feeling depressed when no one calls you over the weekend.”
Focusing: “Let’s talk again about…”
Informing: “Take 1 pill at bedtime.”
Suggesting: “Have you thought about?...”
Confronting: “You say you’re OK but you’re crying”
Silence:
Term
Blocks to Communication
Definition
Depersonalization
Generalizations
Cliches / False Reassurance
Why? How? – Probing Questions
Judgmental Comments
Changing subject
Gossip & Rumors
Personal Opinions / Advice Giving
Avoid medical terminology
Avoid Prying, Arguing, Defensiveness
“Pseudo-listening”
Term
Religion vs. Spirituality
Definition
Religion: a “map” that outlines essential beliefs, values, and codes of conduct into a manner of living.
Spirituality: a “journey” that takes place over time and involves the accumulation of life experience and understanding. An attempt to find meaning, value and purpose in life.
Term
Some Factors Affecting Spiritual Health
Definition
Lifespan and Cultural Considerations
Crisis and Change
Separation from spiritual ties
Moral issues regarding therapy
Inadequate or inappropriate care
Term
How to identify Altered Spiritual Function
Definition
Verbalization of Distress
Altered Behavior
Term
In Assessment process look for value-belief pattern with what objective/subjective data?
Definition
Normal Pattern Identification
Risk Identification
Dysfunction Identification
Objective Data

Spiritual/Religious belief system
Personal spirituality
Integration within a spiritual community
Ritualized practices and restrictions
Implications for medical care
Terminal events planning
Term
Example of nursing diagnosis with value-belief problem? There is also outcome identification, planning, implementation, intervention, and evaluation.
Definition
Readiness for Enhanced Spiritual Well-Being
Impaired Religiosity
Risk for Impaired Religiosity
Decisional Conflict
Powerlessness
Hopelessness
Term
What is Culture?
Definition
Learned, patterned behavioral response
Shared by a community of people.
Beliefs, Attitudes, values, customs, norms, taboos, way of life, ways of communicating
Provides identity and a frame for interpreting information.
Ever changing and adapting
Most people unaware of effect their culture has on them
Term
Related Definitions to culture?
Definition
Ethnocentrism-viewing your culture as best, only acceptable
Ethnicity-identity based on shared cutlure (I'm italian)
Minority-Different ethnic, racial, lingual, etc.
Race-biological characteristics as markers (physical characterisitcs)
Racism-uses skin color to discriminate
Subculture-way of life by group of people (goth, nursing,etc)
Stereotype-preconcieved and untested beliefs about people
Term
Cultural Variation examples?
Definition
Physical Variation
Personal hygiene
Health practices
Family structure
Religious or Cultural Rituals
Meaning of Birth, Illness, Death
Food Preferences and Tolerance
Communication
Expressing Pain
Personal Space and Touch
Time Orientation
Term
Steps of the nursing process?
Definition
1.Assessment: Use Gordons
2. Diagnosis
3. Outcome: What are the outcomes I want to see I.E. no fever in 3 days
4. Planning: What to do so doesn't happen
5. Implementation: Use Plan
6. Evaluation
Term
What is the nursing process?
Definition
The Nursing Process…”is an organized, systematic method of giving individualized nursing care that focuses on identifying and treating unique responses of individuals or groups to actual or potential alterations in health.”
Term
Kinds of Assessments
Definition
Initial or Admission Assessment: Initial complaint
Shift or Ongoing Assessment: during shift
Focused Assessment:see bruise, ask about it. What to focus on (move arm, it hurts, etc.)
Special Needs Assessment: fall risk, braiden scale (skin breakdown)
Term
Types of Data(2)
Definition
Subjective (symptoms)
Gathered primarily during the interview or Health History
Best documented in “quotes”
Objective (signs)
Gathered primarily during the Physical Exam
Term
Interventions
Definition
*Cognitive (Intellectual)
Educational Interventions (knowing info , how to treat patient
Supervisory Interventions: managing, deligating, teaching family
*Interpersonal (Psychosocial)
Coordinating Interventions:patient advocate (call social services)
Supportive Interventions:Theraputic use of self, religion, etc.
Psychosocial Interventions:resolving emotional, social emotional problems
*Technical (Psychomotor)
Maintenance Interventions:
Surveillance Interventions:What to look for when monitorling
Psychomotor Interventions
*Interventions for Collaborative Problems
Physician Orders: PRN as needed Or doesn't do this by this time get this.
Collaborative Problems:concerned with issues need doctor to diagnose
Term
When delegating make sure?
Definition
Right Task
Right Circumstance
Right Person
Right Communication
Right Supervision
Term
Evaluation Activities?
Definition
Review Goals/Outcomes
Collect Data
Measure Goals Achievement using judgment criteria
Goal Met
Goal Partially Met
Goal Not Met
Revise or Modify Plan of Care
Term
Why have outcomes not been achieved?
Definition
Wrong Diagnosis
Wrong Goals
Wrong Interventions
Patient Unable
Term
Illness/Disease Prevention Types
Definition
Primary-prevent disease (immunization)
Secondary-Screening (breast cancer)
Tertiary-Recovery Process (work on getting better)
Term
Purposes of Patient Education
Definition
Health Promotion
Risk Identification
Restoration of Health or Function
Promotion of Coping
Term
Erikson't theory of psychosocial development issue in young adulthood
Definition
Intimacy vs. isolation
Only as a young person begins to feel more secure in his identity is he able to establish intimacy with himself and with others, both in friendships and eventually in a love-based mutually satisfying suxual relationship with a member of the opposite sex. A person who cannot enter wholly into an intimate relationship b/c of fear of losing his identity may develop a deep sense of isolation.
Term
Erikson't theory of psychosocial development issue in adulthood
Definition
Gernerativity vs. Self-Absorption
Out of the in generativity- the mature person's interest in establishing and guiding the next generation. The lack of this results in self-absorption and frequently in a "pervading sense of stagnation and interpersonal impoverishment.
Term
Erikson't theory of psychosocial development issue in Senescence
Definition
Integrity vs Dispair
The person who has achieved a satisfying intimacy with other human beings and who has adapted to the triumphs and disappointments of his generative activities as parent and co-worker reaches the end of life with a certain ego integrity--an acceptance of his own responsibility for what his life is and was and of its place in the flow of history. WIthout this "accrued ego integration" there is despair, usually marked by a display of displeasure and distrust.
Term
3 types of safety?
Definition
Patient
External Environment
Health Care Institution
Home and Community
Internal Environment
Healthcare Agency
Nurse Safety
Term
Safety Regulations and Guidelines (4)
Definition
*The U.S. Department of Labor’s Occupational Safety & Health Administration (OSHA)
(Oversees all workplaces)
*The National Academy of Science’s Institute of Medicine’s Quality and Safety Education for Nurses (QSEN)
(Non-profit research makes recommendations)
*The Joint Commission National Patient Safety Goals
(Identify patient prior to treatment)
*Sentinel Events
-Incident (Occurrence) Report
-Root Cause Analysis
(Serious, someone is injured or harmed)
Term
Factors Affecting Safety
Definition
Physiologic/Individual Factors
Environmental Hazards
Home
Workplace
Community
Healthcare Setting
Patient Safety
Nurse Safety
Term
Lifespan Considerations for safety
Definition
*Adult
Disregard of judgment
Overconfidence
Ignorance
Alcohol Consumption
*Older Adult
Physiological Risk Factors
Risk Factors in the Home
Risk Factors in the Hospital or Long-Term Care Setting
Term
Altered Safety
Definition
preventable safety issues
Motor Vehicle Incidents
Falls
Poisoning
Suffocation and Drowning
Fire
Burns
Firearms
Radiation
Term
Help The Older Adult with Safety
Definition
Bring familiar items to a confused patient
Encourage family to stay if possible
Hobbies/Activities
Step by step explanations
Make sure devices are not causing discomfort
Use bed or chair alarms
Term
Define
Stressor
Appraisal/Secondary Appraisal/Buffering
Adaptation
Stress/Eustress/Distress
Coping
Homeostasis
Allostasis
Definition
Stressor-The event that causes the stress
Appraisal/Secondary Appraisal/Buffering
Adaptation -Appraise the stressor, going to interpret whether or not it is something to stress about.
Stress/Eustress/Distress-Eustress=positive (nervous about baby)
Coping-How you deal with stress
Homeostasis-body funcitoning normally
Allostasis-process of maintaining or re-establishing homeostasis
Term
Normal Coping Strategies
Definition
Adaptive- Effective Coping
Making healthy choices that reduce negative effects of stress
Problem Focused or Emotion Focused
Adaptive Responses
Alter the stressor
Adapt to the stressor
Avoid the stressor: ending a relationship
Term
Altered Coping Patterns
Definition
Altered Coping Patterns –Ineffective Coping
Does not promote adaptation
Involves making unhealthy coping choices
May temporarily relieve anxiety, but may have other harmful effects
May lead to physical and psychological illness
Term
Defense Mechanisms
Definition
Denial- denying the existence of some external reality
Repression – person forces certain thoughts into the unconscious
Regression – person returns to an earlier, more comfortable time in his life
Projection – Attributing one’s own thoughts, emotions, characteristics, or motives to another.
Displacement – a person transfers an emotion from it’s original object to a substitute object
Term
Maslow's Hierarchy of needs?
Definition
Self Activiation-Experience new and satisfying activities
Esteem needs-Feeling good about yourself, recognition from others
Social needs-Meaningful relationships, sense of belonging, work satisfying, love & effection
Safety Needs-Physically safe, free from fear & anxiety
Basic-biological, physiological, air, food, drink, sleep, eliminate.
Term
Best way to prevent infection?
Definition
Wash your hands.
Term
Why do we Document?
Definition
*Communication
Communication and continuity of care between health care providers
*Legal
You may have to defend your documentation in court
*Reimbursement
Accurate and timely claims review and payment.
*Quality of care evaluation
Pay for performance
Term
What to Document Assessment
Definition
Assessment – Intervention - Evaluation
Assessment
Describe reported (subjective) symptoms/problems using the patient’s words in quotes. Avoid paraphrasing.
Describe your objective findings, for example: T-P-R-BP
Include only significant information about the current condition of the patient – be specific and definite.
Term
What to Document Interventions
Definition
Interventions
What did you do about the problem
Document refusal of treatment or non-compliance
Document ALL physician communication
Document specifics of teaching and observations. Do NOT rely on check box answers only.
Term
What to Document Evaluations
Definition
Evaluation
What is the result of your interventions
If intervention was not successful, what are you going to do about it.
Document evaluation of teaching
Document contact with allied health services, i.e. Did you call respiratory, dietary, PT etc.?
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