Unit 1 Fundies Learning Objectives

Front 1

Four Learning Styles

Back 1

-The Visual /Verbal Learning Style
-The Visual/Non-Verbal Learning Style
-The Tactile/Kinesthetic Learning Style
-The Auditory/Verbal Learning Style

Front 2

Describe how curriculum is organized and how to use a module.

Back 2

-A module as used in the Nursing Program as a self-contained unit of instruction.
-Each contains specific sections.
-The following will describe these sections, their purposes and how they are to be used.
-This is intended to be a general information sheet.
-Multiple modules make up courses.

Front 3

Four areas of nursing function apply to every nursing situation at all times.

Back 3

-Asepsis
-Emotional Jeopardy
-Physical Jeopardy
-Caring

Front 4

-Is defined as the prevention of the introduction and/or transfer of microorganisms.
CRITCAL ELEMENTS: The perspective of the client’s well-being and safety are paramount, but 100 percent perfection and a germ-free state are idealistic rather than realistic goals.
EXAMPLES OF CLEAR VIOLATION: A student does not ….
-wash hands before implementing patient care
-protect self from contamination
-protect client from contamination
-dispose of contaminated material in designated containers
-confine contaminated material to contaminated area
-establish and/or maintain a sterile field when required

Back 4

Asepsis

Front 5

Is defined as a pattern of behavior that pervades the nurse-client interaction as characterized by attentiveness to others’ experiences, the establishment of a trusting relationship with the client and/or significant other, and respect for the values, dignity and culture of others.
CRITICAL ELEMENTS: Establishes communication with the client by introducing self; explaining purpose of the interaction; and using touch with a client who is a child or adult who is unable to verbally communicate.
EXAMPLES OF CLEAR VIOLATION: The student does not
-encourage the patient’s expression of needs
-respond to the client’s verbal/nonverbal expressions
-facilitate goal-directed interactions by:
1. Explaining the nursing actions to be taken
2. Asking questions to determine the client’s response to nursing care.
3. Asking questions to determine the client’s comfort level
4. Focusing communication toward client-oriented interest
5. Eliciting the client’s choices/desires in the organization of care.
-use verbal expressions that are not overly familiar, patronizing, demeaning, abusive or otherwise unacceptable.
-relate in a manner that respects the values, dignity and culture of others.

Back 5

Caring

Front 6

Is defined as any action or inaction on the part of the student which threatens the emotional well-being of the client or significant others.
CRITICAL ELEMENTS:
The student’s behavior must not create emotional stress or create a non-therapeutic situation for the client.
EXAMPLES OF CLEAR VIOLATION:
-A student’s use of
1. words or body language that constitute disapproval or disgust.
2. overt or covert threats to elicit client’s response and/or cooperation.
3. probing, attacking-type questions when interacting with the client.
-Any violation of client’s legal protection, such as maintenance of confidentiality, which are protected under the client rights guarantees.

Back 6

Emotional Jeopardy

Front 7

Is defined as any action or inaction on the part of the student which threaten the client’s physical well-being.
CRITICAL ELEMENTS:
-Because of the vast number of possibilities, the critical elements depend on the situation as judged by the instructor.
-There are no predetermined critical elements for physical jeopardy.
-The student is accountable for the assigned patient’s safety.
-Any time the patient’s safety is threatened through omission, such as not reporting a deterioration in the patient’s clinical condition, or by the students incorrect action, the instructor will document and report describing the behavior of the student in clear terms.
EXAMPLES OF CLEAR VIOLATION:
-The student medicates a client with a Central Nursing System depressant and leaves the side rails down.
-A student leaves a client, adult or child in a bed or crib with the side rails down or unattended in other precarious situations.
-A student disconnects or interrupts a treatment, i.e., IV, croupette, etc., and does not reestablish the connection as required.
-A student elevates urine collection bag in a close drainage system above the level of the client’s bladder.
-A student administers medication incorrectly.

Back 7

Physical Jeopardy

Front 8

In the late 20th Century, much of the theoretical work in nursing focused on articulating relationships among four major concepts:

Back 8

person
environment
health
nursing

Front 9

The term originates from two Greek words: meta, meaning “with,” and paradigm, meaning “pattern.”

Back 9

Metaparadigm

Front 10

the recipient of nursing care (includes individuals, families, groups, and communities).

Back 10

person or client

Front 11

the internal and external surroundings that affect the client. This includes people in the physical environment, such as families, friends, and significant others.

Back 11

Environment

Front 12

the degree of wellness or well-being that the client experiences.

Back 12

Health

Front 13

the attributes, characteristics, and actions of the nurse providing care on behalf of, or in conjunction with, the client.

Back 13

Nursing

Front 14

-The work of American nurse theorists.
-Each nurse theorist’s definitions of these four major concepts (person, environment, health and nursing) vary in accordance with scientific and philosophical orientation, experience in nursing, and the effects of that experience on the theorist’s view of nursing.

Back 14

The Metapardigm for Nursing

Front 15

-Supposition or system of ideas proposed to explain a given phenomenon
-Attempt to explain relationships between concepts
-Offer ways to conceptualize central interests of a discipline
-Example: Freud’s theory of the unconscious

Back 15

Theory

Front 16

-Link among nursing theory, education, research, and clinical practice
-Contributes to knowledge development
-May direct education, research, and practice

Back 16

Purpose of Nursing Theory

Front 17

-Link among nursing theory, education, research, and clinical practice
-Contributes to knowledge development
-May direct education, research, and practice

Back 17

Purpose of Nursing Theory

Front 18

often considered the first nursing theorist, defined nursing almost 150 years ago as “the act of utilizing the environment of the patient to assist him in his recovery”.

Back 18

Nightingale's Environmental Theory

Front 19

often considered the first nursing theorist, defined nursing almost 150 years ago as “the act of utilizing the environment of the patient to assist him in his recovery”.

Back 19

Nightingale's Environmental Theory

Front 20

Nightingale's 5 Environmental Factors?

-These environmental factors attain significance when one considers that sanitation conditions in the hospitals of the mid-1800’s were extremely poor and that women working in the hospitals were often unreliable, uneducated, and incompetent to care for the ill.
-In addition to those factors, Nightingale also stressed the importance of keeping the client warm, maintaining a noise-free environment, and attending to the client’s diet

Back 20

1. pure or fresh air
2. pure water
3. efficient drainage
4. cleanliness
5. light, especially direct sunlight

Front 21

-views the person as an irreducible whole being greater than the sum of its parts.
-Whole is differentiated from holistic, the later often used to mean only the sum of all parts.
-Humans are dynamic energy fields in continuous exchange with environmental fields.
-Nurse’s applying this theory in practice focus on the person’s wholeness and seek to promote symphonic interaction between the two energy fields (human and environment).
-The nurse directs and redirects patterns of interaction between the two energy fields to promote maximum health potential.
-utilizes noncontact
therapeutic touch.

Back 21

Roger’s Science of Unitary Human Being

Martha Rogers

Front 22

Nightingale's 5 Environmental Factors?

-These environmental factors attain significance when one considers that sanitation conditions in the hospitals of the mid-1800’s were extremely poor and that women working in the hospitals were often unreliable, uneducated, and incompetent to care for the ill.
-In addition to those factors, Nightingale also stressed the importance of keeping the client warm, maintaining a noise-free environment, and attending to the client’s diet

Back 22

1. pure or fresh air
2. pure water
3. efficient drainage
4. cleanliness
5. light, especially direct sunlight

Front 23

building blocks of theories

Back 23

concepts

Front 24

-views the person as an irreducible whole being greater than the sum of its parts.
-Whole is differentiated from holistic, the later often used to mean only the sum of all parts.
-Humans are dynamic energy fields in continuous exchange with environmental fields.
-Nurse’s applying this theory in practice focus on the person’s wholeness and seek to promote symphonic interaction between the two energy fields (human and environment).
-The nurse directs and redirects patterns of interaction between the two energy fields to promote maximum health potential.
-utilizes noncontact
therapeutic touch.

Back 24

Roger’s Science of Unitary Human Being

Martha Rogers

Front 25

-building blocks of theories
-abstract ideas of mental images of phenomena or reality

Back 25

concepts

Front 26

group of related ideas, statements, or concepts

Back 26

conceptual framework

Front 27

- an organized and systematic articulation of a set of statements related to questions in the discipline of nursing.
-a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, and /or prescribing.

Back 27

Nursing Theory

Front 28

-Nursing theory aims to describe, predict and explain the phenomenon of nursing
-It should provide the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future. Theory is important because it helps us to decide what we know
-It helps to distinguish what should form the basis of practice by explicitly describing nursing. The benefits of having a defined body of theory in nursing include better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education
-The main exponent of nursing – caring – cannot be measured, it is vital to have the theory to analyze and explain what nurses do

As medicine tries to make a move towards adopting a more multidisciplinary approach to health care, nursing continues to strive to establish a unique body of knowledge

This can be seen as an attempt by the nursing profession to maintain its professional boundaries

Back 28

Importance of Nursing Theory

Front 29

-Assist nurses to describe, explain, and predict everyday experiences.
-Serve to guide assessment, intervention, and evaluation of nursing care.
-Provide a rationale for collecting reliable and valid data about the health status of clients, which are essential for effective decision making and implementation.
-Help to establish criteria to measure the quality of nursing care
-Help build a common nursing terminology to use in communicating with other health professionals. Ideas are developed and words defined.
-Enhance autonomy (independence and self-governance) of nursing by defining its own independent functions.

Back 29

Purpose of Theory in Practice

Front 30

-The organizing/conceptual framework for this curriculum is a theoretical model
-It is based on the nursing process and nursing competencies.
-Educational outcomes facilitate the integration of information relevant to nursing and patient care.
-Curriculum and course sequence progress from simple to complex knowledge and skills with emphasis on caring, problem solving and critical thinking.
-Included is the definitions of person, health, nursing and environment.

Back 30

Organizing Framework

Front 31

Identify the outcomes of an Associate Degree Nursing Program.

Back 31

The following outcomes have been identified as a requirement for students completing the California Statewide Associate Degree Nursing (RN) Curriculum Model.
-Communication Skills
-Thinking and Reasoning
-Information Competency
-Diversity
-Civic Responsibility
-Life Skills
-Careers
-Critical Elements
-Has maintained professional behavior at all times.

Front 32

Identify the standards of competency of an Associate Degree Nursing Program.

Back 32

The student who completes an ADN program will meet the standards of competency, delineated by the Board of Registered Nursing for the State of California.
The successful ADN graduate will:
-Demonstrate knowledge to function as a patient advocate.
-Demonstrate knowledge to safely perform as a clinician in the delivery of patient care.
-Demonstrate knowledge to implement critical thinking utilizing the nursing process in the care of patients.
-Demonstrate knowledge to provide leadership, manage resources, delegate and supervise based on legal scope of practice.
-Demonstrate knowledge to teach individuals, families, communities and members of the health care team.

Front 33

Identify the terminal objectives of an Associate Degree Nursing Program.

Back 33

The graduate nurse will demonstrate the following:
-Assist individuals to achieve optimal health utilizing the knowledge gained from biological, social, and nursing sciences.
-Formulate a comprehensive plan of care using all components of the nursing process.
-Safely perform basic psychomotor skills in the delivery of care as a technically competent clinician.
-Integrate the role of professional nurse into clinical practice.
-Research and communicate to identify problems, initiate actions and evaluate outcomes for health promotion and maintenance.
-Apply psychological, social, and cultural knowledge to the nursing role.
-Support physiological well-being of individuals and families in the health care environment.
-Assume the role of advocate to improve health care delivery by communicating and acting according to the expressed needs of the individual.
-Manage the clinical environment through assessment, planning, intervention, and evaluation.
-Apply critical thinking skills to make judgments based on evidence (fact) rather than conjecture.
-Organize individuals or groups toward goal setting and goal achievement.
Implement a comprehensive teaching plan to help individuals and families achieve optimal health.
-Take and pass the NCLEX-RN Examination.
-Understand that the culmination of the ADN program prepares for entry into practice and that continuing education and lifelong learning is imperative.

Front 34

-State of well-being
-Basic aspects include:
1.Self-responsibility
2.An ultimate goal
3.A dynamic, growing process
4.Daily decision-making in areas related to health
5.Whole being of the individual

Back 34

wellness

Front 35

-Presence or absence of disease
-Complete physical, mental, social well-being
-Ability to maintain normal roles
-Process of adaptation to physical and social environment
-Striving toward optimal wellness
-Individual definitions

Back 35

health

Front 36

-Subjective perception of vitality and feeling well
-Described objectively, experienced, measured

Back 36

well-being

Front 37

-Ability to promote health measure that improves
1. Standard of living
2. Quality of life

Back 37

Environmental Dimension

Front 38

-A highly personal state
-Person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished
-Not synonymous with disease
-May or may not be related to disease
-Only person can say he or she is ill

Back 38

illness

Front 39

-Characterized by severe symptoms of relatively short duration
-Symptoms often appear abruptly, subside quickly
-May or may not require intervention by health care professionals
-Most people return to normal level of wellness

Back 39

acute illness

Front 40

-Lasts for an extended period
-Usually has a slow onset
-Often have periods of remissions and exacerbations
-Care includes promoting independence, sense of control, and wellness
-Learn how to live with physical limitations and discomfort

Back 40

chronic illness

Front 41

Impact of Illness on the Client

Back 41

-Behavioral and emotional changes
-Loss of autonomy
-Self-concept and body image changes
-Lifestyle changes

Front 42

Impact of Illness on the Family

Back 42

Depends on:
1.Member of the family who is ill
2.Seriousness and length of the illness
3.Cultural and social customs the family follows

Front 43

Impact of Illness Family Changes

Back 43

-Role changes
-Task reassignments
-Increased demands on time
-Anxiety about outcomes
-Conflict about unaccustomed responsibilities
-Financial problems
-Loneliness as a result of separation and pending loss
-Change in social customs

Front 44

Which one of the following is an example of the emotional component of wellness?

1. The client chooses health foods.
2. A new father decides to take parenting classes.
3. A client expresses frustration with her partner’s substance abuse.
4. A widow with no family decides to join a bowling league.

Back 44

1. The client who chooses healthy foods represents the physical component.
2. Taking parenting classes enhances the intellectual component.
3. Correct. Frustration is an example of an emotion.
4. The bowling league enhances both the physical and social components.

Front 45

-Acknowledge the mind-body connection
-Monitor the stress warning signals
-Invoke the relaxation response on a regular basis
-Develop the skill of personal presence
-Maintain and enhance physical health
-Develop a support system

Back 45

Managing Stress

Front 46

Explain the importance of personal decision making and behavior changes in achieving a wellness lifestyle.

Back 46

A person's decision to implement health behaviors or to take action to improve health depends on such factors as the importance of health to the person, perceived threat of particular disease or severity of the health care problems, perceived benefits of preventive or therapeutic actions, inconvenience and unpleasantness invovled, degree of lifestyle change encessary, cultural ramifications, and cost.

Front 47

Describe the nervous system response to stress.

Back 47

Stressors stimulate the sympathetic nervous system, which in turn stimulates the hypothalamus. The hypothalamus releases corticotropin-releasing hormone (CRH), which stimulates the anterior pituitary gland to relase adrenocorticotropic hormone (ACTH). During times of stress, the adrenal medulla secretes epinephrine and norepinephrine in repsonse to sympathetic stimulation

Front 48

the initial reaction of the body to stess, which alerts the body's defenses

Back 48

alarm reaction

Front 49

a multisystme response to stress and involves three steps: alarm reaction, stage of resistance and stage of exhaustion

Back 49

General adaptation syndrome (GAS)

Front 50

1st part of alarm reaction in which the stressor may be perceived consciously or unconsciously by the person

Back 50

shock phase

Front 51

the second stage in the adaptation syndromes when the body's adaptation takes place

Back 51

stage of resistance

Front 52

2nd part of the alarm reaction in which the changes the body experienced during the shock phase are reversed

Back 52

countershock phase

Front 53

the third stage in the adaptation syndromes that occurs when the adaptation that the body made during the second stage cannont be maintained

Back 53

stage of exhaustion

Front 54

Significant body responses to epinephrine include:

Back 54

1. Increased mydocardial contractility, which increases cardiac output and blood flow to active muscles.
2. Bronchial dilation, which allows increased oxygen intake
3. Increased blood clotting
4. Increased cellular metabolism
5. Increased fat mobilization to make energy available and to synthesize other compounds needed in the body

Front 55

The principal effect of norepinephrine is:

Back 55

decreased blood to the kidneys and increased secretion of renin.

Front 56

an enzyme that hydrolyzes one of the blood proteins to produce angiotensin

Back 56

renin

Front 57

tends to increase the blood pressure by constricting arterioles

Back 57

angiotensin

Front 58

The sum of the adrenal hormonal effects of norepinephrine, renin and angiotensin:

Back 58

permit the person to perform far more strenuous physical activity than would otherwise be possible. the person is then ready for "fight or flight"