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123 Cards in this Set
- Front
- Back
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Key words in ICN definition of nursing
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Autonomy
Collaboration Care Advocacy Promotion Prevention Research |
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What is a Profession
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Specific body of knowledge
Distinct skills Set of values & code ethics Education Autonomy in decision making-practive |
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Five Rights to Delegation
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Right Task
Right Circumstances Right Person Right Direction Right Supervision |
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Most common Malpractice
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Medication errors
IV therapy errors Burns Falls Lack of asepsis surgical supplies left in body lack of reporting to next shift inadequate monitioring of pt. condition lack of notification if condition changes |
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What would be considered a Tort
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Intentional (Assualt & Battery)
Unintentional (Negligence & Malpractice) |
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Leadership Styles
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Autocratic
Democratic Laissez Charismatic Transactional Transformation |
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Domains of Learning
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Cognitive
Affective Learning Psychomotor |
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Nursing Roles
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Caregiver
Communicator Teacher Client Advocate Counselor Change Agent Leader Manager Case Manager Research Consumer |
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Necessary Skills Managment
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Critical thinking
Communicatons skills Networking Managment of resources (budgeting, etc.) Mentoring Team Building Evaluation Delegation |
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Walla Walla Value
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Excellence in thought
generosity in service beauty in expression faith in God |
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the parts of the "vicious circle
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guilt
hate fear inferiority |
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parts of the vicious circle is replaced with
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forgiveness
love faith confidence |
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3 care needs of the family
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love and relationships
the experience of forgiveness meaning and purpose in life |
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2 significant concepts in spirtuality
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meaning and purpose
connectedness plus reduces person's distress enhances personal growth & empowerment |
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according to research, spritual distress increases a person's risk of dying by
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28%
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the role in giving spiritual care is to provide an environment for the patient to express
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their spiritual concerns (not to solve their problems)
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an important part of assessing a patient's belief/unbelief is to
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ask them questions to get them to explain how they feel.
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family systems theory
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the goal is homeostasis
either respond to stress either positive or negative all parts adjust to find new level of homeostasis any change causes change in every part if stress to great other parts of system will begin to show dysfunction |
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family hardness is
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the internal strengths & durability of the family unit
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unhealthy boundaries
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overly rigid or overly flexible structures can impair functioning
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strcutures may enhance or detract from the family's ability
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to respond to stress
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attributes of healthy family
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able to intergrate stability with growth & change
accepts help from outside hardiness & resilency children think for themselves increased levels of independence & decision making No we vs them attitude direct lines of communication able to adapt to stress |
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rigid system of family
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decrease communication with outside world
inflexible roles authoritarian children to obey not think intense control issues resistance to change we thinking black & white thinking my way or the highway family secrets/hide problems difficulty asking for help acting against each other abuse, incest, & eating disorders triangling |
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diffuse system of family
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unclear roles
unclear boundaries people come & go in the family lack of identity deal w/ stress by leaving or acting against emtional cutoffs lack of rules inconsistent discipline lack of stability chaos truancy, gangs, illegal activity |
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process by which the family achieves goals
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communication
goal setting conflict resolution care giving nurturing use of external & internal resources |
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3 approaches to family nursing practice
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family as a system
family as context family as client |
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family as context
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primiary focus on health & development
extent in which family can provide psychological, spirtual, & physical needs |
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family as a client
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family is the primary focus
concentrates on which patterns & processing are consistent w/ reaching & maintaing health |
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family assessment
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family resources
family patterns family function |
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family resources
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relatives & friends that could assist
coping skills & strengths insurance |
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family patterns of assessment
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who is working outside the home
are roles effective childcare responsibilitys day to day decision making |
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family function
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short & long term goals
how has the illness affected the goals comunication patterns |
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concepts of family
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set of relationships that influence each other
family is a system of connected individuals to understand individual we must understand family |
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family forms
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nuclear family
nuclear dyad binuclear family extended family single parent family reconstituted (blended) alternate patterns of relationships |
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family orgin (nuclear famly)
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u
siblings parents |
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nuclear dyad
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a married coupe living together without children
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binuclear family
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sepration/divorce with both parents assume childrearing responsibility's
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alternate patterns of relationships
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multi-adult homes
skip-generation families cohabiting same-sex communal groups foster families |
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challenges of family nursing
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Delegating duties to family members
Integrating culture practices, religious ceremonies, and rituals into family-centered care Family expectations Effective and respectful communication Knowledge/education |
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Nursing Diagnosis
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Generally focused on the family’s ability to cope with change and stress
Caregiver role strain Coping, compromised family Coping, disabled family Family process, interrupted Parenting, impaired Role performance, ineffective Spiritual well-being, readiness for enhanced Violence, risk for other directed |
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Planning (family)
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Goal setting must be mutual, realistic and acceptable for the family
Set priorities Mutual respect and trust Collaborating with other disciplines Remember that a change in one part of the system will lead to changes in other parts – both adaptive and resistive |
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Implementation
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Remove barriers
Provide accurate information regarding the prognosis Health promotion activities |
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Evaluation
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What was the client’s response to the predetermined outcomes or goals
Evaluate change in functions Ongoing process Evaluate not only your observations, but the family’s perspective as well |
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development of cultural competence
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awareness
knowledge skills encounters desires |
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awareness of cultural competence
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appreciation & sensitivity others culture;
gaining indepth awarness of ones own background, sterotypes, bias, prejudices, and assumptions |
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knowledge of cultural competence
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understanding & recognizing cultural issues
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skills of cultural competence
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access & intervene differences according to person culture
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encounters of cultural competence
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interaction with members of other cultures
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desires of cultural competence
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motivation or desires to learn from other cultures
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cultural concepts related to health
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religion
health beliefs/folk traditions family patterns/roles & organization communications, verbal & nonverbal pregnancy & childbearing practices practices surrounding death time orientation personal space nutrition pain responses high risk health behaviors specific conditions |
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health disparities defined
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refers to the unequal burdens of disease morbidity & mortality rates experienced by racial & ethnic groups
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health disparities
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socioeconomics
environment ethnicity education health care provider bias |
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cultural competence in nursing
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that is required in nursing care becasue our's is mutiultrual society. Requires an understanding of own beliefs and values
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transcultural nursing
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madeline leininger founder of transculltural nursing theory
culturally competent nursing care focuses on differences & similarities among cultures, with respect to caring, health, & illness, based on the client's cultural values, beliefs, & practices |
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Basic Human needs
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Physiological
Safety & Security Love & Belonginess Self-Esteem Self Actualization |
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6 Levels of Health Care
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Preventive Care (health promotion)
Primary Secondary Tertiary Restorative Continuing |
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Health Risk Factors
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Genetic & Physiological
Age Physical Environment Lifestyle |
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Nursing Care Delivery Models
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Functional Nursing
Team Nursing Servant Nursing Primary Nursing/ Total Patient Care |
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Principles in nursing codes of ethics
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Compassion
Commitment Advocate Accountable Confidentiality |
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How to process an ethical dilemma
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Determine if it's ethical dilemma
Gather all info relevant to case Examine your own values Articulate the problem Consider possible courses of action Negotiate the outcome Evaluate the action |
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Various Legals Issues in Health Care
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Licensure
Student Nurse Actions Restraints Confidentially Advance Directives Pt. Abandonment Controlled substances Obligation to Report |
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Effective teaching Elements
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Recognize pt. learning needs
Communication Define Goals Understand pt. learning styles Use multiple methods/use more than one sense |
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Principles of Health Care Ethics (Deontology)
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Autonomy
Justice Fidelity Beneficence Nonmaleficence |
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Nurse's Code of Ethics
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Beneficence (doing good)
Nonmaleficence (avoid harm) Veracity (truth-telling) Confidentiality (respecting privileged information) Fidelity (keeping promises) Justice (treating people fairly) Autonomy (choose for self) |
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International Council of Nurses Code of Ethics
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To promote health
To prevent illness To restore health To alleviate suffering |
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4 Elements of the Code - ICN Code of Ethics
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Nurses & People
Nurses & Practice Nurses & the Profession Nurses & Co-Workers |
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Basic Teaching Principles
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Consider Timing
Organize into a logical sequence Speak the clients language Maintain their attention Build on Knoweldge Reinforce w/ positive feedback Match method with learner's need |
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physiological signs & symptoms of stress
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dialated pupils
diaphoresis increased heart rate increased sodium & h20 retention increased respiration skin palor decreased urinary output increased blood sugar increased muscle tension dry mouth |
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stress management
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alter/change stressor
adapt to the stressor avoid the stressor |
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nurse can reduce stress by
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teaching anxiety reduction measures
encourage health promotion providing information |
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cognitives measures to relieve stress
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learn to alter thinking
humor assertiveness |
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behaviors suggesing alterations in self - concept
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avoidance of eye contact
excessively dependant passive overly critical or angry frequent or inapporopriate crying unkept appearance slumped posture |
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Nursing care for pt. c alterations in self-concept
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clarify your own issues
be aware of own values & expectations acceptance of the pt. non-judgmental attitude increase knowledge understand the issues underlying the change therapeutic communication promote empowerment |
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stress affecting role performance
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role conflict
role amibiguity role strain role overload |
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assessing pt with alterations in self - concept
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coping skills
developmental stages communication verbal & nonverbal |
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cognitive signs & symptoms of stress
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problem solving
structuring self - control suppression fantasy / daydreaming |
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psychological symptoms of stress
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anxiety
fear anger depression ego defense (adaptive or maladaptive) |
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steps in scientific method
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ask a question
do background research construct an hypothesis test the hypothesis analyze data and draw conclusion |
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concepts in nursing theories
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person
health environment nursing caring |
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ethical considerations in Nursing research
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a study must protect human rights
informed consent confidentiality anonymity institutional review board |
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Nursing theory
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general explanation (describe, predict, control, understand) events
provides explanation of why something happens the way it does explains & describes nursing foundation for nursing knowledge conceptual farmework, nursing model relate cocepts by using definitions showing relationships |
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goals of theoretical nursing models
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develop curricula
establish criteria for measuring guide development of delivery system knowledge to improve nursing guides research ID domain & goals of nursing |
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concept of caring/ essence of nursing
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emotional aspects
physical aspects spirtual aspects |
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what is caring
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influences the way we think, feel, and behave in relationship to one another
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emotional aspects of caring
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demonstrating empathy & compassion
being physically present so clients feel valued respect support commitment |
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physical aspects of caring
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comforting
gentle touch gentle voice smiling not rushing anticipating clients physical needs |
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spirtual aspects of caring
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connectedness
hope faith expressed through love |
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active listening (soler)
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sit squarely facing the pt.
observe an open posture lean fowared toward the pt. establish contact relax |
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essential conditions for therapeutic relationships
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rapport
trust respect genuineness empathy |
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Four components of self concept
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Identity
Body Image Role Performance Self-esteem |
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Describe the elements of the communication process
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referent
sender message channel receiver environment feedback |
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utilization review
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committees of health care agencies which reveiw admissions, test & procedures
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prospective payment system PPS
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prederermined rate of pay set for inpatient treatment of specific illness
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PPO
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an insurance organization which limits whcih health care providers may be used
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DRG
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a group of inpatient services with a set amount of reimbursement
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Managed care
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health care systems w/ administrative control over the service provided
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capitation
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health care provider receives a fixed amount of money per enrollee
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Nursing Process
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Assessment
Analysis/Diagnosis Planning Implementation Evaluation |
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Thinking/Problem Solving Processes
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Scientific Method yes/no answers
Decision-making processes Clinical decision making (diagnostic reasoning) Nursing Process |
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Comparison of Problem-solving Method and Nursing Process
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Encounter problem – collecting data
Analyzing the data to identify exactly what the problem is Making a plan of action Putting the plan into action Evaluation of results |
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Characteristics of the Nursing Process
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Cyclic and dynamic – responds to changing health status
Client-centered – plan of care is organized according to client problems rather than nursing goals Interpersonal and collaborative – involves the client and other members of the health care team Universally applicable – wellness/illness; inpatient/outpatient |
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Assessment activities
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Establish a data base (DATA COLLECTION)
UPDATE DATA ORGANIZE DATA VALIDATE DATA COMMUNICATE/DOCUMENT DATA |
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Establish a data base (DATA COLLECTION)
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Obtain health history
Conduct physical assessment Review client records Review literature Consult support persons Consult health professionals |
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Nursing diagnosis
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is a clinical judgment about individual, family or community responses to actual and/or potential health problems/life processes.
Nursing diagnoses provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable. |
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How do I write a nursing diagnosis?
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Begin with a NANDA (North American Nursing Diagnosis Association) problem statement
Spend time getting acquainted with your own Nursing Diagnosis Reference Manual and the lists of nursing diagnoses |
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Part two of nursing diagnosis
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Etiology
Related factors Examples for nursing students: Social isolation r/t the reality that it is necessary to study six days a week to keep up. Altered nutrition: Less than body requirements r/t having to choose between breakfast and 15 minutes more sleep Impaired physical mobility related to back strain from using improper body mechanics |
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rules about etiology
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Identifies a contributing factor to the problem
Be as specific as possible Don’t use a medical diagnosis Self-care deficit related to neuromuscular impairment NOT: Self-care deficit related to stroke |
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Part three of nursing diagnosis
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Subjective and objective data that led to the conclusion that this a correct nursing diagnosis.
Defining characteristics – signs and symptoms - “ as manifested by” or “as evidenced by” Example: Impaired skin integrity r/t effects of pressure secondary to inability to turn self in bed amb red broken area of skin over coccyx |
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three part nursing diagnosis
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problem statement
r/t related to (etiology) a.m.b (as manifested by) |
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evaluation
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goal met
goal partial met goal not met |
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phases of nurse pt. relationship
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preinteraction phase
orientation phase working phase termination phase |
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non therapeutic communication
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ordering
directing commanding warning admonishing threating moralizing preaching obliging giving suggesting or solution persuading, argument, instructions, lecture judging critizing disagreeing blamming |
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Johari Window
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Arena
facade blindspot unknown |
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importance to healthy ID
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ability to resist illness & disease
ability to cope with change & disappoint ability to take action to change things that need to be changed ability to find meaning & happiness in life motivation to create for self & others |
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3 stages of General Adaption Syndrome (GAS) stress
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Alarm
resistance exhaustion |
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interdisciplinary theories
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maslow - human motivation
piaget - cognitive theory kubler ross - stages of dying systems - interrelationship between parts of a system erickson - psychosocial stages of developement |
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evidence-based nursing practive
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a reasearch-based, decision-making process that is used to guide the delivery of care by nurses
out-dated practices are barriesrs to decreased length of stay, favorable pt. outcomes & lowered costs |
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elements of caring
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Leiningers Cultural Care
Watsons theory of caring K. Swanson theory of caring |
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communication tech. with pt. that have special needs.
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Hearing Impaired
visually impaired speach impaired cognitively impaired unresponsive emotional pt. non-english speaking children dying |
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elements to look for in nonverbal communication
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body movement
quality of voice territoriality & space clothing hygiene posture/gait facial expression eye contact touch gestures silence |
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fight or flight response
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the total physiological response to stress that occurs during the alarm reaction stage of the general adaptation syndrome. Massive changes in all body systems prepare a human being to choose to flee or to remain and fight the stressor.
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general adaptation syndrome
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generalized defense response of the body to stress, consisting of 3 stages; alarm, resistance, and exhaustion.
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3 phases of general adaptation
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alarm reaction
resistance stage exhaustion stage |
