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262 Cards in this Set

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Nursing has a code of ethics that professional registered nurses follow and?
the Code of Ethics for Nurses with Interpertive statements provides a guide for carrying out nursing responsibilities that provide quality nursing care and provides for the ethical obligations of the profession
The founder of modern nursing is?
Florance Nightengale-she established the first nursing philosophy based on health maintenance and restoration
The Founder of the American Red Cross is?
Clara Barton
Evidence-based practice is defined as:
the integration of
best research evidence with
clinical expertise and
patient values-
it involves accurate and throughtful decision making about health care delivery for clients
The Standards of Care described in the ANA Standards of Clinical Practice, second edition, include?
a competent level of nursing care. the levels of care are demonstrated through the nursing process: ADPIE
Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United states. This?
provides a standardized minimum knowledge base
for the client population
nurses serve
Contempary nursing requires that the nurse possess knowledge and skills for a variety of professional roles and responsibilities. examples include:
In the past the principal role of nurses was to provide care and comfort as they carried out specific nursing functions. However, changes in nursing have expanded the role to include increased emphasis on health promotion and illness prevention, as well as concern for the client as a whole.
Advanced Practice nurses generally are?
the most independent functioning nurse. An
APN has a master's degree in nursing, advanced education in pharmacology and physical assessment, and certification and expertise in a specialized area of practice. The APN may work in primary, acute or restorative care settings
In North America the major professional nursing organization is (are)?
As long as nurses maintain involvement in health care policy and practice?
misinformed outsiders cannot attempt to impose their will on nursing and nursing practice.
What happened in the 20th century in nursing?
there was movement toward scientific, research-based nursing practice and knowledge
Who was the 1st professor of nursing at Columbia University Teachers College (1907)?
Mary Adelaide Nutting
When did graduate nurse-midwifery emerge?
When did the nursing specialty organization emerge?
1940's & 1950's
What was one result of better medical care in the 20th century?
rising health care costs
What attribute became the focus of nursing organizations?
ethical competency
What does nursing practice encompass now?
more end-of-life care policies as the population ages
A definition of nursing:
reflects the needs and values of society,
implements standards of professional performance
and standards of care and
integrates current research
and evidence-based findings in order to provide the
highest level of care to meet the needs of each patient
What a definition of nursing is NOT:
Handmaiden tasks and subservient care performed by a designated care person (usually a woman) at the sole direction of the physicians
Who developed the first organized nursing program in 1860?
Florence Nightingale at St. Thomas' Hospital in London
Who was the 1st african american professional nurse?
Eliza Mary Mahoney- concerned with relationships btw cultures and races, introduced the concepts of cultural diversity and respect for the individual
What is a Profession?
1.extended education of members
2.has a theoretical body of knowledge
3. provides a specific service
4. has members who have autonomy in decision making and practice
5. as a whole, has a code of ethics for practice
What is the ANA's code of ethics?
1. defines the principles by which nurses provide care to their clients
2.provides a guide for carrying out nursing responsibilities that provide quality nursing care
3. provides for the ethical obligations of the profession
What are Nurse Practice Acts?
every state regulates licensure and practice. Each state defines the scope of practice,
but all must be similar. They
are changing to enncompass nursing's autonomy and
expanded/advanced practice roles
What are Standards of care?
1.levels of care demonstrated through the nursing process
2.contain the nursing responsibilites for diversity, safety, ed. health promotion, trtmt, self-care, planning for the continuity of care
3. foundation of legalities regarding judgment of appropriate nursing actions
What are some roles and responsibilities of the registered nurse?
2. advocate
5. manager
Other national nursing organizations:
ICN- International Council of nursing
IAFN- International Association of Forensic Nurses
What are some of the Trends in Nursing?
1. expansion of employment opportunities
2. Managing nursing's public perception
3. Nursing in politics and public policies
Chapt 24-Teaching and Learning Power Points:
Purposes: help pts and families develop the self-care abilities that enable them to maximize their functional and quality of life (or dignified death)
2.promote health
3.prevent illness
4. restore health
5.facilitate coping
What are self-care abilities?
What are the two types of Teaching?
Define Informal Teaching?
1. unplanned teaching
2.immediate learning needs
3.may lead to planned teaching
Define Formal Teaching?
1. planned teaching done to fulfill learner objectives
What is Learning?
The process by which a person acquires or increases knowledge or changes behavior in A MEASURABLE WAY as a result of an experience
What is the result of Teaching and Learning in the role of Nurse?
1.shorter hospital stays
2.going home sicker
3.discharge planning
What are some characteristics of Discharge Planning?
2.referrals for home care
4. identifying community & personal resources
What are some Developmental considerations?
1. Intellectual development
2. Motor development
3. Emotional maturity & psychosocial development
Define Intellectual development?
1. Learning progresses from concrete to abstract
2. Piaget's theory (concrete operations/ formal operations)
Motor development under developmental considerations:
are fine motor skills needed?
Questions to ask as per Emotional maturity & psychosocial development?
1.chronological age does not guarantee maturity
2. How has the pt learned to respond to changes & stressfull events in the past
Differences in Children vs. Adults:
1. Concept of Self -dependent/independent
2.previous experience- not a resource, building a body/serves as a resource
3.readiness to learn- uniform by age/ from life tasks, roles, problems
4. Orientation to learning- subject centered, use later/task centered, use immediately
5. Motivation- external rewards/internal incentives & curiosity
What % of adults are illiterate?
What is REALM?
Rapid Estimate of Adult Literacy in Medicine-an oral reading & recognition test
What are the Domains of Learning?

3. Affective
What is Cognitive Learning?
1. involves the storing and recalling of new knowledge and info in the brain
An example of Cognitive Learning is:
the pt. STATES how salt affects blood pressure
What is Psychomotor Learning?
1. When a physical skill has been acquired
example: The pt DEMONSTRATES how to change dressings using clean technique
What is Affective Learning?
1. involves changes in attitudes, values, and feelings
ex: the pt EXPRESSES renewed self-confidence following physical therapy
List of Verbs for use when writing Learner objectives for Cognitive:
gives examples
List of Verbs for use when writing Learner Objectives for Psychomotor:
List of Verbs for use when writing Learner Objectives for Affective:
Which domain is the following?
Ask Mr. Kennedy about what he believes he needs to know b4 his discharge
Which domain is the following?
Demonstrate insulin preparation and injection techniques
Which domain is the following?
allow Mr. Kennedy to attend a support group meeting if possible to allow learning from other's experiences
Demonstrate use of blood sugar meter and recording of blood sugar measurement results
Which domain is the following?
During teaching sessions, give Mr. Kennedy examples of what problems he might experience at home and ask him how he would respond to the situations?
Have Mr. Kennedy role play how he will respond to his friends when they ask him about his health status
Provide Mr. Kennedy with teaching materials regarding insulin preparation, administration and how to recognize and manage hypoglycemia and hyperglycemia
Which domain is the following?

Demonstrate dressing changes
Which domain is the following? Provide Mr. Kennedy with feedback and positive reinforcement as he acquires new skills and behaviors
Which domain is the following? Encourage Mr. Kennedy to help establish learning outcomes and goals
Which learning needs would require cognitive learning skills?
learning new information- relating/elaborating (it) to prior knowledge-ex: learning to take new medications by relating it to information that the pt already has-ex: pt needs to start giving himself injections- pt's father was diabetic so nurse uses the info on how the father handled the shots and built on it to teach the pt
Which learning needs would require Affective learning skills?
receiving, responding, valueing (attitudes, values & feelings)- allying fears of a pt., displaying empathy for families whose member just died. teaching a pt how to handle a masectomy-
Which learning needs would require Psychomotor learning skills?
demonstrations of how to give shots, how to take a med, how to change a dressing
Principles of teaching & learning in the nurse/pt relationship:
1. existence of a helping relationship
2. communicate to ind. small groups & large groups
3. knowledge of the communication process to assess verbal & nonverbal feedback
4. a thorough assessment of clients & factors affecting learning helps to diagnose learning needs accurately
Principles of teaching & learning in the nurse/pt relationship: con't
5. little learning is to occur unless pt values these objectives
6. varied teaching strategies
7. cognitive learning (relating new mat'l to old)
8.proposed behavioral changes must be realistic & availible in context of the pts resources & lifestyle
9. pay attention to time constraints, scheduling & physical environment
11. When objectives not met, reassess and change the teaching plan
what are the characteristics of the Nursing Process?
of T&L process?
Assessment of learning needs
diagnose learning needs
develop teaching plans (measurable goals)
Implement the plan
evaluate T&L
What information can be used to do an assessment of Learning needs?
medical record
pts family/or significant other
What are factors that affect Learning?
1. what new knowledge, attitudes, or skills are necessary for pts & families to manage their healthcare
2. learning readiness
3. ability to learn
4. learning strengths
What are factors that affect Readiness to Learn?
Emotional readiness
Experiential readiness
What is emotional readiness as per readiness to learn?
1.emotional health
2.motivation for learning
3.self-concept & body image
4.sense of responsibility for self
What is Experiential readiness as per readiness to learn?
1. social and economic stability
2. past experiences w/ learning
3. attitude toward learning
4. culture
What are factors that affect the Ability to learn?
1. physical condition
2. cognitive ability to learn
3. acuity of senses
4. developmental considerations
5. level of education
6. literacy
7. communication skills
8. primary language
What are Learning Strengths?
1. successful learning in the past
2. above-avg comprehension, reasoning, memory, or psychomotor skills
3. high motivation
4. strong network
5. adequate financing
How to diagnoses Learning Needs? Knowledge Deficit
absence or deficiency of cognitive information related to a specific topic
What are Defining Characteristics of diagnosing learning needs?
1. verbalization of the problem
2. inaccurate follow-through of instructions
3. inaccurate performance of test
4. inappropriate or exaggerated behaviors (hysterical, hostile, agitated, apathetic)
What problems are diagnosing learning needs related to?
lack of exposure
lack of recall
information misinterpretation
cognitive limitation
lack of interest in learning
unfamiliarity with info sources
What are the Learner objectives in Planning (development of the teaching plan)?
1.determine which of the 3 learning domains will be the focus of teaching
2. choose the verb for that domain
3. Who -Does-What--How-When= Goal (learner objective)
ex: pt will demonstrate the dressing change unassisted b4 discharge
4. Content-
What is the Content of the Learner objectives in Planning?
ask: what info does the pt need to know to achieve the objectives?
1. physical sensations that will be experienced during a procedure
2. care b4 & after procedures
3. pre- and post- operative teaching
4.treatments & medicines
5. promotion of wellness
6. prevention of illness
7. prevention of complications
8. how to take care of self when discharged
9. when to call the doctor
What are teaching strategies for Cognitive Domain?
1. lecture or discussion
2. panel discussion
3. discovery
4. AV materials
5. Printed materials
6. Programmed instruction
7. CAI program
What are teaching strategies for Affective Domain?
1. role modeling
2. discussion
3. panel discussion
4. AV materials
5. Role playing
6. Printed materials
What are teaching strategies for Psychomotor Domain?
1. demonstration
2. Discovery
3. AV materials
4. Printed materials
What are some Practical Considerations in planning?
1. time constraints
a. need to know vs. nice to know
b. set priorities for content
2. Scheduling- 15-30 min sessions usually well tolerated
3. Group vs. individual teaching
4. Formal vs. informal teaching
How does the nurse implement the teaching Plan?
1. use interpersonal skills & effective communication skills
2. warm & accepting approach
3. avoid condescending attitude
4. avoid technical & medical terms unless the pt has a background in this area
5. provide for privacy, adequate lighting, comfortable chairs, good ventilation
6. have equip. organized & in working order: teaching aids gathered
7. have a positive attitude
How does the nurse evaluate teaching-learning?
1. do not assume learning has taken place
2. ***(KEY**) LEARNER OBJECTIVES --describes what behaviors are to be measured/what the pt needs to do or perform
3. Give positive reinforcement- negative reinforcement usually not effective
4. revisions if necessary
How does the nurse document teaching/learning?
1. insufficient to document only what was taught
2. document a summary of the learning need, the plan, the implementation of the plan, & the evaluation results
What domain does the following fall under?
Have client describe how to walk with crutches
pt states that he has not received information about the use of crutches, cannot walk with them.
Deficient knowledge- Psychomotor- regarding use of crutches related to lake of exposure
The nurse can develop a teaching plan, determine goals and outcomes after:
determining the nursing diagnoses that identify a client's learning needs
What guides the choice of teaching strategies and approaches with a client?
Expected outcomes (or learning objectives)
An example of short term objectives:
knowing the nature of gallbladder disease to understand an upcoming test.-compared with outcomes of care
An example of long term objectives:
knowledge and skills related to a health problem that will be permanent or long-term-usually all-compassing
What are priorities for teaching?
client's immediate needs
nursing diagnosis
learning objectives for the client
When is teaching most effective?
when it is responsive to the learner's needs
Learning objectives describe in________ what a person is to learn.
behavioral terms
Which learning domain is the best?
a combination of all
How do older adults learn?
when information is slowly paced and presented in small amounts
Effective documentation?
describes the entire process of client ed.
promotes continuity of care, and
demonstrates that ed. standards have been met
A client must learn to use a walker, acquisition of the skill will require learning in the?
Psychomotor learning involves acquiring skills that require the integration of mental and muscular activity. The client masters skills by manipulating equipment and practicing manual skills
The nurse should plan to teach a client about the importance of exercise?
if a learning ability is impaired, such as with a client in pain, the nurse should postpone teaching activities or modify teaching strategies to better meet the needs of the learner
A client newly diagnosed with cervical cancer is going home. The client is avoiding discussion of her illness and postoperative orders. In teaching the client about discharge instructions, the nurse should?
readiness to learn is related to the stage of grieving. Clients cannot learn when they are unwilling or unable to accept the reality of illness. However, properly timed teaching can facilitate adjustment of illness or disability. When a client is in denial or disbelief, teach in the present tense (just what the pt needs to be discharged)
The school nurse is about to teach a freshman health class about nutrition. To achieve the best learning outcomes, the nurse should?
The first step in forming a teaching plan is developing learning objectives. a learning objective identifies the expected outcome of a planned learning experience and helps establish priorities for learning. By developing topics for discussion that require problem solving, the freshman would be engaged in learning about nutrition
A nurse is going to teach a client how to perform a breast self-examination. The behavioral objectives that would best measure that the client's ability to perform the evaluation is?
behavioral objectives are measurable and observable and indicate how learning will be evidenced. The objective describes precise behaviors and content (e.g the client will perform breast self-exam correctly on herself b4 the end of the teaching session)
A client who is having chest pain is going for an emergency cardiac catheterization. The most appropriate teaching approach in this situation is the?
The TELLING approach is useful when limited information must be taught (e.g. preparing a client for an emergent diagnostic procedure)
The nurse is teaching a parenting class to a group of pregnant adolescents and has given the teens baby dolls to bathe and talk to. This is an example of?
Affective=A nurse uses role play for teaching ideas and attitudes. During role play, people are asked to play themselves or someone else, the technique involves rehearsing a desired behavior
An older adult is being started on a new antihypertensive med. In teaching the client about the med, the nurse should?
Older adults learn and remember effectively if the learning is paced properly and the material is relevant to the learner's needs and abilities
A client must learn how to admin a subcutaneous injection. The nurse knows the client is ready to learn when the client?
generally, teaching and learning begins when a person identifies a need for knowing or acquiring an ability to do something
A client who is hospitalized has just been diagnosed with diabetes. He is going to need to learn how to give himself injections. The best teaching method would be?
Demonstrations are useful methods for teaching psychomotor skills such as preparation of a syringe. the client is able to observe a skill b4 practicing it.
Development over the Lifespan
What are the concepts of Human Growth?
1. orderly and predictable processes -begin with birth to death
2. ability to progress through each developmental phase influences the holistic health of the ind.
3. accurate assessment of patterns of growth and development helps set the stage for future patterns of adjustment to life
Physical Growth is?
the measureable aspect of an ind.
increase in physical measurements
Developmental Growth is?

occurs gradually and refers to changes in skill and capacity to function. Changes are qualitative and difficult to measure in exact units.
Would not anything quantitative be measurable?must be mistake on teacher's part- "Measurement is the determination or estimation of ratios of quantities" perhaps the word "exact"?
What is Cephalocaudal growth?
development from head to toe
What is Proximodistal growth?
development from trunk to extremities
What is Maturation?
the process of aging. Adaptation and competence in new situations becomes more evident
What is Differentiation

a process by which cells and structures become modified and develop more refined characteristics
What are some factors that influence Growth and Development?
1. forces of nature
2. heredity
What are some external forces that influence growth and development?
2. peer group
3. life experiences
4. health environment
5. prenatal health
6. nutrition
7. rest, sleep and exercise
8. state of health
9. living environment
What are some Forces of Nature?.
1. Genetic influence
2. temperment -psychological mood & includes behavioral styles of easy, slow-to-warm, & difficult
What are the principles of growth and development?
1.are orderly & sequential as well as continous and complex
2.development occurs from simple to complex
3. the pattern of g & d is continuous, orderly & predictable but does not proceed at a consistent rate
4. everyone goes through the same developmental processes
5. but not at the same rate
6. each stage has specific characteristics
7.ea. stage has certain tasks to be achieved or acquired during the time
8. some stages are more critical than others
What are some Developmental theories?
1. biophysical
Which is classified as a Biophysical theorist?
Gesell's Theory of Development
Which is classifed as a Psychoanalytic/psychosocial theorist?
Freud, Erikson, Havighurst, Gould, Chess & Thomas
Which is classified as a Cognitive theorist?
Which is classified as a Moral theorist?
Piaget, Kohlberg, Gilligan
What are the Psychosexual development stages of Freud?
phallic or oedipal
What are the Psychoanalytic/psychosocial theories of Erikson?

8 stages vs mistrust
2.autonomy vs. sense of shame or doubt
3.Initiative vs. guilt
4. Industry vs. Inferiority
5. Identity vs. role confusion
6. Intimacy vs Isolation
7. Generativity vs. Self-absorption and stagnation
8. Integrity vs. despair
What are the Psychoanalytic/psychosocial theories of Havighurst?
predictable internal and external pressures:
What are the Psychoanalytic/psychosocial theories of Gould?
5 developmental themes
focused on adulthood
I have to get away from my parents
Is what I am the only way for me to be?
Have I done the right thing?(mid to late 30's)
The die is cast (40's)
50's a decrease in negativism occurs
What are the Psychoanalytic/psychosocial theories of Chess & Thomas
1. behavioral styles of children
2. easy, difficult, slow to warm up
What are the Cognitive theories of Piaget?
period I:sensorimotor-from reflex to repetitive
period II: preoperational-thinking in symbols-egocentric
period III: concrete operations- logical
period IV: formal operations-abstract thinking
What are the Moral theories of Piaget?

2 major concepts:
1.Assimilation-a continous process of incorporating new experiences into existing schemes. if new info does not fit, confusion results
2. Accommodation- alters thought processes to incorporate new more complex info
A & A
What are Moral Development theories?
1. examines the development of an individual's value system as an influence in differentiating right and wrong
Moral Development Theories
Piaget: premoral, conventional, and autonomous stages
Kohlberg: 6 stages of development with three levels
Gilligan: parallel developmental ways btw men & women w/out superiority of one gender over another
What are the stages/periods of the Life cycle?
1. prenatal
3. infancy
5.preschooler child
9.young adult
10. middle adult
11. older adult
Important aspects of the Prenatal period:
pregnant women have to have physical exams & screening
must have an ample supply of nutrients
must avoid teratogens**
Important aspects of the Neonatal Period:
1st 28 days
1.complete exam after delivery
2.teach parents about infant care such as car seats-an important wellness-promotion nursing activity
Important aspects of the Infancy period:
1st mth -1 yr-
must focus on safety- prevention not infection, & teaching parents about incorporating the child into the family.
provision of adequate nutrients
Important aspects of the Preschooler Period:
1.nurse must communicate at child's level of comprehension
2. immunizations**wellness intervention
3.accidents are the leading cause of death
Important aspects of the School-age child
1.educate parent about proper nutrition, immunizations, dental care, safety precautions, adequate rest/sleep
2. many accidents occur during play
Important aspects of the Preadolescent Period:
1.needs info about nutrition, rest and activity, and physiological changes risk for injury from sports & play
3.major health risk is violence, in and away from home
4. ed. about violence, substance abuse, sex, healthy livestyles
Important aspects of the Adolescent Period:
13-20 yrs
1.provide info about numerous body changes
2.nonjudgmental attitude is essential
3.hygiene, nutrition, sex, developmental changes & substance abuse prevention
4. accidents, homicide and suicide are the major cause of death
Important aspects of the Young Adult:
1. healthiest time
2.emphasize preventive measures
3.avoidance of accident, injury violence
4. develop health-promoting behaviors
Important aspects of the Middle Adult
acceptance of aging, nutrition, exercise and wgt control, substance abuse prevention, stress mgt, health screening
-at risk for recreational accidents
Important aspects of the Older adult
65 & beyond
important to assess the older adult to develop a sense of well-being
health promotion
falls are a major threat
Important aspects of the Older adulthood
1. geriatrics deals with the physiological and psychological aspects of aging & w\diagnosis and treatment of diseases affecting older adults
2.Gerontology is the study of all aspects of the aging process
What are two Biological Theories of Aging?
1. Stochastic Theories
2. Nonstochastic Theories
What is a Stochastic Theory?
view aging as the result of random cellular damage that occurs over time leading to physical changes
What is a Nonstochastic theory?
view aging as genetically programmed physiological mechanisms within the body controlling the process of aging
What are the 3 Psychosocial Theories of Aging?
1. Disengagement theory
2. Activity Theory
3. Continuity or development theory
What is the Disengagement theory?
aging individuals w/draw from customary roles and engage in more introspective, self-focused activities
What is the Activity theory?
considers the continuation of activities performed during middle age as necessary for successful aging
What is the continuity or developmental theory?
personality remains the same & behavior becomes more predictable
What are the characteristics of Therapeutic Nursing care related to aging?
1.involve them in decision making & in defining desired outcomes to increase quality of care
2.listen to them to develop more realistic care plans and evaluations
3.cultivation of positive attitudes toward aging and the health care needs of adults are priorities for nurses
What are the Developmental Tasks of the Older adult?
Adjusting to:
1.decreasing health & physical strength
2.retirement & reduced or fixed income
3.death of a spouse'
4.acceptance of self as aging person
5. maintenance of satisfactory living arrangements
6. redefining relationships with adult children
7.finding ways to maintain quality of life
What are Physiological concerns related to aging?
1.smoking cessation
2.nutrition problems
7.sensory impairment
8.medication use
9.heart disease, cancer, stroke
What are some Cognitive changes in aging?
1. Delirium
What are some Psychosocial concerns in aging?
1.therapeutic communication
3.reality orientation(restore reality)
4.validation therapy (where the person is)
5.reminiscence (recalling the past)
6.body image interventions (assist with norm)
What is the Essence of Human Growth and Development to Nurses?
1. nurses care for human beings at various developmental stages
2. developmental theory provides a basis for nurses to assess and understand the responses seen in their clients
Children generally double their birth wgt by 5 mths of age. This is an ex of?
g & d are synchronous processes that are interdependent in healthy individuals. Physical growth is the quantitative or measurable aspect of a person's measurments.
What development is the ability of an individual to distinguish right from wrong and to develop ethical values on which to base his or her actions
Moral development
Freud's _____ developmental stage is a time of turbulence when earlier sexual urges reawaken and are directed to an individual outside the family circle
Stage 5: genital is Freud's final stage. this is a time of turbulence. Unresolved prior conflicts surface during adolescence.
The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during Erickson's stage of development?
Initiative vs guilt. children try out new roles. conflicts often arise btw the child's desire to explore and the constraints put on them. may lead to feeling of frustration and guilt. guilt may occur if caregivers responses are too punitive. teach impulse control and cooperative behaviors to the child
A 47-yr old woman expresses dismay to the nurse that her young adult children are unemployed. her husband is working and near retirement. She is not working and feels bored with her life and unneeded. She is experiencing which of Erickson's stages?
generativity vs self-ab. & stagnation. the ability to expand one's personal and social involvement is critical.
The developmental theorist who believes his research describes a sequential process that takes place btw the internal life of adults and their outer world is?
The "die is cast" is consistent with Gould's theme for the ?
the 4th theme, identified in the 40's. is indicative of resignation and the belief that possiblilites are limited. parents are blamed for their lack of choices. regret is faced for mistakes made with children
During this stage the person's thinking moves to abstract and theoretical subjects. Thinking can venture into such subjects as achieving world peace, finding justice and seeking meaning in life
adolescents can organize their thoughts in their minds. they have the capacity to reason with respect to possibilities
In this level of Kohlberg's moral developmental theory the person reflects on moral reasoning based on personal gain
At the preconventional level the person reflects on moral reasoning based on personal gain. Thes consequences can come in the form of punishment or reward
The theorist who believes that girls do not need to separate from their mothers to achieve feminine identity is?
Basic to Gilligan's argument is the developmental differences in relationships and issues of dependency btw women and men. it is through attachment to their mother that their identity is formed.
In an interview w/a pregnant client, the nurse discussed the 3 risk factors that have been cited as having a possible effect on prenatal dev. they are?
nutrition, stress and mother's age pg 174 3rd paragraph
The most extreme physiological change occurs when the newborn leaves the in utero circulation and develops?
independent respiratory functioning. nursing care is directed at maintaining an open airway, stabilizing and maintaing body temp and protecting the newborn from infection
The leading cause of death in children older than 1 is?
automobile injuries
a Child who is a toddler pretends to shave after watching his father shave. this is an ex.of Piaget's?
preoperational thought stage, toddlers recognize that they are separate beings from their mothers, but are unable to assume the view of another. They use symbols to represent objects, places, and persons.
By this age children are able to play with others in a cooperative manner and have a temporary leader for ea activity?
after the third birthday as it shifts from parallel to associative play. at age 4 they can play together, at 5 designate a leader
The nurse councels the parent that a preschooler sleeps an avg of?
12 hrs
The nurse can counsel a parent that her child can floss his teeth effectively and be independent in tooth care by the age of?
8-10 yrs, motor dev.
The chief illness of childhood is?
infections with respiratory infections the most prevalent. common cold is the chief illness
When nurses are communicating with teens, they should?
good communication skills are critical for teens in overcoming peer pressure and unhealthy behaviors.
The leading cause of death in adolescence is?
With the exception of pregnant or lactating women the young adult has usually completed physical growth by age of?
when assessing young adults, the nurse will find this population usually has a high level of wellness. however, it is important to direct health care ed. toward activities related to?
is to identify modifiable factors that increase support to reduce unhealthy lifestyle behaviors
When determining the amt of info needed to make decisions about the prescribed course of therapy, the nurse should consider those factors that may affect the person's compliance w/ the regimen, including ed. level, socioeconomic factors and ?
motivation and desire to learn
2 factors contribute to the projected increase in the number of older adults; they are?
the aging of the baby boomers and the growth of the population segment over age 85.
Which of the following is true about the theories of aging
no single theory explains aging
the 3 common conditions affecting cognition in the elderly are?
delirium, depression, dementia
sexuality is recognized as a factor in the care of older adults thus?
all older adults need to express sexual feelings. this includes love, warmth, sharing and touching not just intercourse
the older adult's libido does not decrease; however?
frequency does decline.
visual acuity declines with age, Presbyopia, is a progressive decline in?
a progressive decline in the ability of the eyses to accommodate for close detailed work
a common age related change in auditory acuity is called?
Presbycusis affects the ability to hear high-pitched sounds and sibilant consonants such as s, sh and h
taste buds atrophy and lose sensitivity. the older adult is less able to discern?
salty, sweet, sour, and bitter tastes. sense of smell is also decreased. salivary secretion is decreased
changes in the musculoskeletal system lead to changes in the configuration of the thorax. this is known as?
after age 55 respiratory muscle strength begins to decrease. the anteroposterior diameter of the thorax increases due to os. vertebral changes due to osteoporosis lead to dorsal kyphosis
frontal-temporal dementia has an insidious onset and progresses slowly. early symptoms include?
poor hygiene, lack of social tact, hyperorality and sexual disinhibition. incontinence is an early symptom,
Infection control:
What is the nature of Infection?
entry and multiplication of agents into host by pathogens which is based upon chain of infection
What are the steps in the nature of Infection?
1.chain of infection
3.portal of exit
4.mode of transmission
5.portal of entry
6.susceptible host
What is the chain of infection?
infectious agent
What is the Reservoir in the nature of infection?
place where a pathogen can survive, on food, oxygen, water, temp, light
What is the Protal of Exit in the nature of infection?
how pathogen gets out of initial host: skin, respiratory tract, urinary tract, gastrointestinal tract, reproductive tract, blood
What is the Mode of transmission in the nature of infection?
a. direct contact (person to person, touch, bl & body fluids
b.indirect contact(needle sticks, surfaces
c.droplet(sneezing, coughing)
e.vehicles (contaminated items, water,drugs, solutions, blood, food)
f. Vectors- (external -flies), internal (mosquito, louse, flea, tick)
What is the Portal of Entry in the nature of infection?
how organisms enter human body
What is the Susceptible Host in the nature of infection?
very old, very young, depends on nutritional status, disease process, functioning of immune system, mental and physical overall
How the Infectious Process works:
a.start thinking to 1st assess risk level, nursing process
b. local vs. systemic
c.stages of infection
d.defenses-ways to defend agt. infections
What are the stages of Infection?
1. incubation
2.predromal-onset of nonspecific signs
3.illness-has actual defined s/s
4.convalescence-acute symptoms disappear and client recovers days to mths
What are the defenses against infection?
(we get sick because of inadequate defenses)
a. skin
d.respiratory tract
e.urinary tract
f. gastrointestinal tract
g. vagina
Normal Flora
keep our bodies in balance
What are Cellular defenses/responses?
a. inflammation
b.inflammatory response (includes vascular)
What is inflammation?
cellular response to injury or infection, protective vascular reaction that delivers fluid, bl products and nutrients to tissues in an area of injury, usually local but can become systemic in acute responses or disease
What is the inflammatory response?
vascular responses, formation of inflammatory excaudate, tissue repair
What is the vascular response?
dilation of arterioles allowing increase in bl. and nutrients, WBC's arrive at site and attempt to eat up necrotic and other injured tissue that is not needed (phagocytosis), if it becomes systemic leukocytosis occurs which is an increase in the number of circulating WBCs
What is the inflammatory exudate?
accumulation of fluid and dead tissue cells for an exudate, serous, sanguineous, purulent, which is eventually cleared away through drainage, this helps with preventing spreading of inflammation
What is tissue repair?
healing involves defense (compensation), reconstruct and maturative stages, damaged cells are replaced with new cells (still need cellular function that has been lost through disease) but granulation tissue usually forms after disease which is not as strong and may have scar tissue
What is a nosocomial infection?
health care caused infections
What is a Iatrogenic infection?
caused by diagnostic or therapeutic procedure
What is a Exogenous infection?
caused by microorganisms external to the individual that is not a part of their normal flora
What is an Endogenous infection?
occurs when part of the client's normal flora becomes altered
What are the risk factors for Nosocomial infections?
poor technique
multiple care givers
multiple procedures
What are the common site for nosocomial infections
urinary, surgical, wounds, respiratory tract, bloodstream
How the nursing process is used in combating infection
a. assessment s/s of infection, local vs. systemic, red, swelling drainage, tenderness, systemic, looks crappy and feels crappy
b. status of defense mechanisms
c. client susceptibility
d.assess lab data
e. nursing diagnosis
f. planning goals
g. implementation
h. evaluation
How the nursing process is used in combating infection: assessment
S/S of infection, local vs. systemic, red, swelling, drainage, tenderness, systemic, looks crappy and feels crappy
status of defense mechanisms(skin etc)
client susceptibility-very old etc
assess lab data pertinents, wbcs, sed rate, diff count, cultures, iron
How the nursing process is used in combating infection:
nursing diagnosis
understand how to write a successful care plan
How the nursing process is used in combating infection:
Planning goals
prevent exposure, control or reduce extent, maintain resistance, ed. of client family and other health care providers
How the nursing process is used in combating infection:
make sure you are all about fighting disease while rehabilitating body and educating, make sure we as nurses actually help to fight infection (i.e wound care techniques)
a. infection control measures: asepsis, sterilization, disinfection, OSHA, CDC
How the nursing process is used in combating infection:
reassess, rethink, reapply measures, documentation throughout
if the infectious disease can be transmitted directly from one person to another it is?
a communicable, or contagious disease
Infectious diseases such as hepatitis B or C becomes a reservior for pathogens in?
the blood is normally sterile but in the case of infectious disease it becomes a reservoir for pathogens
The interval when a client manifests S/S specific to a type of infection is the?
illness stage
The most effective way to break the chain of infection is the?
hand hygiene. which includes using an instant alcohol hand antiseptic b4 and after providing client care and hand washing. hand washing is a vigorous, brief rubbing together of all surfaces of the hands lathered in soap, followed by rinsing under a stream of water
after coming in contact with infected clients, and after handling contaminated equipment or organic material visitors are encouraged to?
visitors are encouraged to wash their hands b4 eating or handling food, after coming in contact with infected clients, and after handling contaminated equip or organic materials
A client is isolated for pulmonary tuberculosis. The nurse notes the client seems to be angry, but he knows this is a normal response to isolation. the best intervention is to?
b4 isolation measures are instituted, the client must understand the nature of the disease or condition, the purposes of isolation, and steps for carrying out specific precautions. The nurse also takes measure to improve the client's sensory stimulation during isolation
a gown should be worn when?
you may come into contact with infected material and bl. or body fluid
The nurse has redressed a client's wound and now plans to administer a med to the client. It is important to?
gloves should be removed promptly after use, before touching noncontaminated items and environmental surfaces
When a nurse is performing a surgical hand hygiene, he must keep hands?
above elbows
To sterilize surgical instruments, parenteral solutions, and surgical dressings?
Autoclave is used to sterilize surgical instruments, parenteral solutions,and surgical dressings
Nursing Health-
Nursing Health History objectives are? id patterns of health & illness
2.risk factors for physical and behavioral health problems
3.deviations from normal help find solutions
Guidelines for Conducting a Health Assessment
1. establish rapport
2.encourage honest communication
3.make eye contact
4.listen carefully aware of your non-verbal comm.
6.avoid technical terms
7.consider ed. & cultural background and disabilities
Interview Techniques questions
2.back channeling
4.closed-ended questions
What is an open-ended question?
prompts clients to describe a situation in more that one or two words. leads to a discussion. gives pts a chance to tell their stories
What is a back channeling question?
includes active listening techniques such as "all right", "go on" or uh huh" which indicate the nurse has heard what the client says and encourages even further elaboration
What is a problem-solving question?
Once the pt tells his/her story.. it takes the info provided to more fully describe and id the pts specific problems.
What is a closed-ended question?
limit the pts answers to one or two words-require more concise answers and are used to clarify previous info or provide additional info-helps the nurse to acquire specific info about health problems such as symptoms, precipitating factors or relief measures
Ex: of open ended questions
Tell me how you are feeling?
Your discomfort affects your ability to get around in what way?
Share with me the concerns you have about the x-ray test.
Ex. of closed-ended questions
Do you feel like the med. is helping you?
Who is the person who helps you at home?
Do you understand why you are having the x-ray?
On a scale of 1 to 10 how would you rate your pain?
Components of the Health History:
1.Biographical data
2.chief complaint
3.present health concern (illness)
4.past history history
6.environmental history
7.psychosocial history
8.spiritual environment
9. review of systems
10. patient profile
11. cultural considerations
12. ethical/legal use of history or physical exam data
Biographical data
factual demographic data about the client
Chief complaint
get pts subjective reason. document in quotations-pts perception
Present health concern
nurses gather essential and relevant data-
when it began
suddenly or gradually
quality of ea symptom
(pain scale)
Past History
health history-& current health habits
patterns of sleep
family history
obtain data about immediate and blood relatives
to determine whether the pt is at risk for illnesses of genetic or familial nature and to id areas of health promotion and illness prevention
stress issues
Environmental history
provides data about pts home
and working environments w/an emphasis on determining
the pts safety,
psychosocial history
reveals the pts support system, family & close friends, how they deal with stress, recent losses
Spiritual history
nurse reviews their beliefs, their source for guidance & relationship per family per faith
Review of Systems

see pg 292
ROS - systematic method for collecting data on all body systems. some questions about ea system should be included in the nursing history. ask ab out the normal functioning of ea. body system & any noted changes
Patient profile
Cultural Considerations
Ethical/Legal use of history or physical exam data
Functional Assessment
1.self-esteem/self concepts
2.cognitive function
3.nutrition and metabolism
4.activity and exercise
5.sleep and rest
7.coping and stress tolerance
9.interpersonal relationships
and resources
The purpose of assessment is to?
establish a database about the client's perceived needs, health problems, and responses to these problems. In addition, the data reveal related experiences, health practices, goals, values, and expectations about the health care system
Critical thinking is the active, organized cognitive process used to carefully examine one's thinking. Utilizing critical thinking during assessment allows the nurse to?
While gathering data about a client, the nurse synthesizes revelant knowledge, clinical experiences, critical thinking standards and attitudes, and standards of practice simultaneously. Critical thinking thus helps the nurse to direct the assessment in a meaningful and purposeful way
Assessment data must be descriptive, concise, and complete. An assessment should not include?
inferences or interpretative statements that are unsupported with datea. The nurse applies intellectual standards of critical thinking to collect the level of detail necessary to fully understand a client's problems or needs
Data collection includes the gathering of subjective and objective data from or about a client. Subjective data are?
Subjective data are client's perceptions about their health problems. Only clients can provide this kind of information
One of the most important skills needed to obtain accurate info from your client is (are)?
the use of good communication skills and critical thinking intellectual standards enable the nurse to collect complete, accurate, and relevant data.
The first step in establishing the database is to collect subjective info by interviewing the client. An interview is?
An interview is an organized conversation with the client to obtain the client's health history and info about the current illness.
An interview with a client includes three phases, similar to those of a therapeutic relationship. These phases include?
orientation, working and termination. A sucessful interview requires preparation on the part of the nurse by collecting any available information about the client and then creating an environment conductive to an interview
During data clustering the nurse?
organizes data and focuses attention on client functions needing support and assistance for recovery. Focused data clustering using a systems approach or functional health pattern approach assists the nurse in correctly classifying and organizing data.
A nurse might ask,"Do you have pain or cramping?." This is an example of?
Closed ended questions limit the pt's answers to one or two words such as "yes" or "no" or a number or frequency of a symptom. For example, the nurse mught ask, "How often does the diarrhea occur?" or "Do you have pain or cramping?" Closed-ended questions require concise answers and are used to clarify previous information or provide additional information
A technique that allows for discussion is the use of?
The use of open-ended questions prompts pts to describe a situation in more than one or two words. This technique leads to a discussion in which clients actively describe their health status. Open-ended questions give pts the chance to tell their stories and what is important to them.