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110 Cards in this Set
- Front
- Back
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Define Theory.
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thoughful examination of a phenomenon, defined as a concrete situation, event, circumstance, or condition of interest.
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How do nurses use theoretical frameworks?
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They use them to describe, explain, predict, and prescribe nursing practice.
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What do descriptive theory frameworks do?
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Descriptive theory frameworks describe the properties and components of nursing as a professional discipline.
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What do explanatory theories do?
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Explanatory frameworks identify the functions of nursing and how the properties and components relate to each other.
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What do predictive theories do?
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Predictive theories foretell the relationships between the components of the model.
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What do prescriptive theories do?
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Prescriptive theories focus on nursing therapeutics and identify what will happen if a particular intervention is used.
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What are grand theories?
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Grand theories encompass thinking about nursing as a whole and are the most abstract of theoretical knowledge.
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What are mid-range theories?
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Mid-range theories cover more discrete aspects of a phenomenon specific to professional nursing, exploring them in depth rahter than exploring the full phenomenon of nursing.
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What are practice theories?
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Practice theories present situation-producing guidlines for evidence-based practice.
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Define paradigm.
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A paradigm is a worldview with global concepts underlying the theories and methodology of a particular scientific discipline.
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What are the 4 elements of nursing's professional metaparadigm?
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Person: viewed as a holistic being
Environment: nothing occurs outside of a context Health: physical, mental, and social well-being, not merely the absence of disease Nursing:autonomous and collaborative care of all people in all settings |
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What are the 4 patterns of knowing?
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The 4 patterns of knowing are personal, aesthetic, ethical, and empirical
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What is empirical knowing?
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Empirical knowing is based on science or data.
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What is personal knowing?
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Personal knowing is based on the nurse's life experience. This is when the nurse brings her/his humanness to the interaction
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What is aesthetic knowing?
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Aesthetic knowing is based on creative expresson that convey meaning, and requires personal insight and intuition.
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What is ethical knowing?
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Ethical knowing is based on morals, codes, and principles.
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Define evidence-based practice.
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Evidence-based practice is the conscientious explicit and judicious use of current besat evidence in making decisions about the care of individual patients.
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What are the 4 components necessary in evidence-based practice?
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1. Best practices, derived from consensus statements developed by expert clinicians and researchers
2. Evidence from scientific findings in research-based studies 3. Clinical nursing expertise of professional nurses, including knowledge of pathophysiology, pharmacology, and psychology 4. preferences and values of clients and family members |
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Who was Hildegard Peplau?
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She was the first nurse theorist to describe the nurse-client relationship as the foundation of nursing practice.
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How did Peplau's theories shift change the nursing model?
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The nursing model shifted from a focus on medical treatments to an interpersonal model of nursing practice in which the nurse uses himself or herself as a therapeutic agent.
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What are the 4 elements of nursing's professional metaparadigm?
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Person: viewed as a holistic being
Environment: nothing occurs outside of a context Health: physical, mental, and social well-being, not merely the absence of disease Nursing:autonomous and collaborative care of all people in all settings |
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What are the 4 patterns of knowing?
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The 4 patterns of knowing are personal, aesthetic, ethical, and empirical
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What is empirical knowing?
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Empirical knowing is based on science or data.
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What is personal knowing?
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Personal knowing is based on the nurse's life experience. This is when the nurse brings her/his humanness to the interaction
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What is aesthetic knowing?
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Aesthetic knowing is based on creative expresson that convey meaning, and requires personal insight and intuition.
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What is ethical knowing?
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Ethical knowing is based on morals, codes, and principles.
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Define evidence-based practice.
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Evidence-based practice is the conscientious explicit and judicious use of current besat evidence in making decisions about the care of individual patients.
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What are the 4 components necessary in evidence-based practice?
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1. Best practices, derived from consensus statements developed by expert clinicians and researchers
2. Evidence from scientific findings in research-based studies 3. Clinical nursing expertise of professional nurses, including knowledge of pathophysiology, pharmacology, and psychology 4. preferences and values of clients and family members |
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Who was Hildegard Peplau?
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She was the first nurse theorist to describe the nurse-client relationship as the foundation of nursing practice.
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How did Peplau's theories shift change the nursing model?
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The nursing model shifted from a focus on medical treatments to an interpersonal model of nursing practice in which the nurse uses himself or herself as a therapeutic agent.
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According to Peplau, what techniques form the essence of a nurse-client relationship in which the nurse helps the client transform raw data into meaningful shared experience that both can understand?
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Techniques of description, formulation, interpretation, validation, and intervention.
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What do nurses do as participant0observers?
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Nurses actively engage with their clients, simulateously overserving clients' behaviors and their own responses, and providing assitance, information, and encouragement as needed.
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What are the 4 developmental phases of the relationshpi that Peplau described?
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Orientation phase, working phase,exploitation phase, termination phase
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Describe the orientation phase.
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The orientation phase sets the stage for the rest of the relationship by offering a systematic means for gathering assessment data from the client and establishing rapport with the client.
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Describe the working phase.
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The working phase has two compones - the identication component focuses on mutual clarification of ideas and expectations, setting goals, and treatment planning to achive identified goals;
2nd: exploitation phase |
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Describe the exploitation phase.
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The exploitation phase helps the client work toward treatment goals, resolve health care issues and learn new coping strategies.
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Describe the termination phase.
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The termination phase is the final phase, in which the nurse assists the client to review progress toward goals, makes referals, and brings closure to the therapeutic relationship.
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,Define countertransference.
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Countertransference feelings refer to uncounscious attitudes or exaggerated feelings a nurse may develope toward a client (negative or positive feelings).
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Define an I-thou relationship.
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In an I-thou relationship, each individual responds to the other as a unique person in a mutually respectful manner.
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Define communication.
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Communication is defined as an interpersonal activity involving the transmission of messages from a source to a receiver for the purpose of influencing the reciever's behavior.
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Define metacommunication.
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Metacommunication is a nonverbal message about how the receiver should interpret the message.
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What is the difference between symmetrical role relationships and complementary role relationships?
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Symmetrical role relationships are equal, whereas complementary role relationships typically operate with one person holding a higher position than the other in the communication process.
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Define feedback.
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Feedback is the verbal or nonverbal response the receier gives to the sender about the message.
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Define validation.
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Validation is a special form of feedback that provides verbal and nonverbal confirmation that both participants have the same basic understanding of the message and the feedback.
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Define therapeutic communication.
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Therapeutic communication is a purposeful form of communication used in the helping relationship; application of communication principles, not a prescribed method
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What are the 6 nursing roles?
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Stranger, resource, teaching, counseling, surrogate, active leadership
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What elements define a profession?
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1. unique body of knowledge
2. accountability to the public 3. governed by a code of ehtics 4. commitment to promoting public good, altruism 5. autonomous practice 6. commitment to a common ideal which puts service above personal gain |
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What are nurse practice acts?
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Nurse Practice Acts are legal documents developed at the state level that define professional nursing's scope of practice and outline nurses' rights, responsibilities, and licensing requirements in providing care to individual clients, families, and communities
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Define scope of practice.
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Scope of practice refers to the legal and ethical boundaries of practice for professional nurses established by each state and defined in written state statutes.
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What do state boards of nursing do?
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State boards of nursing interpret the legal boundaries of safe nursing practice and give them the authority to punish violations.
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What is considered resonable standard of care?
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Reasonable standard of care is defined as a level of care that a reasonable prudent nurse would provide in a similar situation.
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What elements must legal consent include in order to be valid?
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1. Consent must be voluntary.
2. The client must have full disclosure about risks, benefits, cost, potential side effects or adverse reactions, alternatives to tx 3. client must have the capacity and competency to understand the info and make an informed choice |
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What does the Patient Self-Determination Act require?
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This legislation requires health care institutions to inform their clients, on admission, of their right to choose whether or not to have life-prolonging treatment should they become mentally or physically unable to make this decision.
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Define advance directive.
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An advance directive is a written statement or document executed by a competent adult that is designed to provide medical personnel, family members, and others with information as to the person's wishes regarding the nature and extent of medical care to be provided in the future shoudl he or she lose decision-making capacity.
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What are the 5 phases of the nursing process?
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assessment, problem identification and diagnosis, outcome identification and planning, implementation, and evaluation
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When is the nursing process complete?
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It is complete when the tx outcomes and the client's response are documented on the client's chart using correct spelling and terminology, and the nurse has reported all pertinent data to appropriate health care personnel.
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Define independent nursing interventions.
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Independent nursing interventions are interventions that nurses can provide without a physician's order or direction from another health professional.
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Define dependent nursing interventions.
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Dependent nursing interventions requrie an oral or written order from a physician to implement.
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What is an ethical dilemma?
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An ethical dilemma is when one's personal beliefs, professional code of ethics and/or ethical principles are in conflict or when both possible courses of action are undesirable.
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What are the ethical principles?
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Autonomy, beneficence, nonmaleficence, veracity, fidelity, confidentiality, justice
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What is autonomy?
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Autonomy embodies the idea of self rule or self governance; allows people to be free to perform whatever actions they wish as long as such actions don't infringe on the autonomous actions of others
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What is beneficence?
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Beneficence is the duty to promote good (where one cannot promote good, one should remove harm)
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What is nonmaleficence?
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Nonmaleficence is the duty to not inflict harm.
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What is veracity?
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Veracity is truth telling.
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What is fidelity?
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Fidelity is keeping promises actual or implied, and it is based on trust in a relationship.
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What is confidentiality?
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Confidentiality is respecting private informaton.
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What is justice?
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Justice is fairness, and when resources are limited, once must establish a system of distribution that is equitable.
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What are the different rules of justice?
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To each person an equal share; to each person according to need/individual effort/societal contribution/merit
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What are the 4 constructs that make up self concept?
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Body image, personal identity, self-esteem, role performance
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How is self concept formed?
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Through appraisals we are given throughout life, and then our behavior emerges to match the appraisal
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How can nurses affect self concept?
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Nurses can influence re-appraisal and reconstruct the self concept through the terapeutic relationship.
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How does self concept relate to health?
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Increased self concept allows patients to better handle chronic illness.
Increased self concept decreases child abuse. Increased self concept leads to increased fitness and healthier lifestyle. |
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Which patiens are at the highest risk for decreased self concept?
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Patients who suffer a condition that is highly visible and patients who have unrealistic perceptions about their bodies.
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How can the nurse establish trust?
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by keeping promises about the care schedule and answering the patient's questions and calls
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How can the nurse enhance the patient's sense of autonomy?
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by allowing them choices in schedule and encouraging patients to express opinions
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How can nurses help patients take initiative and avoid guilt?
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by breaking down large tasks into small steps, setting the patient up for success to avoid the shame of faliure, checking for selective attention
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How can nurses help patients who feel devalued because they can no longer work?
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by getting patients to recognize their personal strengths, finding tasks that the patient can accomplish, encouraging positive self talk
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How can nurses help patients to retain their identity when they are a patient?
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by helping patients see that there are others who have had their same experience, by encouraging support groups and visits by someone who has had the same experience
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How can nurses help patients that desire to leave an imprint or make a contribution to society as they grow older?
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by allowing life reflection on the many contributions already made, acknowldeging their contribution
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How can nurses help patients to accept loss of abilities withough a sense of failure?
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by talking with patients about their loss of function and allowing the expression of sadness, encouraging people to live in the moment
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What are some methods the nurse can use to improve low self esteem?
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listening, modeling high self esteem, having the patient say what they are most proud of, commenting on positive attributes
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Define cognitive dissonance.
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Cognitive dissonance is the mental discomfort you feel when there is a discrepancy between what you already believe and some new information that does not go along with your view.
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What are the 5 core values of professional nursing?
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human dignity
integrity autonomy altruism social justice |
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What is moral uncertainty?
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occurs when a nurse is uncertain as to which moral rules apply to a given situation.
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What is moral distress?
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results when the nurse knows what is "right" but is bound to do otherwise because of legal or institutional constraints
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NANDA separates the nursing diagnosis related to self-concent into what elements?
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body image, personal identity, self-esteem, and role performance
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What physical structures are associated with pain?
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material body; all somatic sensation sof pain, fatigue, pleasure, heat, and cold
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What are the 4 functions of body image?
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sensory image; an instrument for action and source of drives; a stimulus to slef and others; an expressive instrument
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What are the types of alterations in body images?
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loss of body function, loss of control, deviations in physical characteristics
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What are the types of perceptual alterations in self-concept?
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distorted reality, selective attention, self-fulfilling prophecy
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What are the guidlines for keeping self-disclosure at a therapeutic level?
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use self-disclosure to help clients open up to you, not to meet your own needs; keep your disclosure brief; don't imply that your esperience is exactly the same as the client's
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What phase of the nursing process does the orientaiton phase correlate with?
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assesment phase
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What phase of the nursing process does the identificaion component of the working phase correspond to?
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planning phase
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What phase of the nursing process does does the exploitation component of the working phase correpsond to?
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implementation phase
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What phase of the nursing process does the termination phase correspond to?
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evaluation phase
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What should the outcomes of the initial meetings be?
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The client should have a better idea of some of the beginning health issues and possible goals; the client should feel that the nurse is interested in him or her as a person
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Define mutuality.
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Mutuality means that the nurse and the client agree on the client's health problems and the means for resolving them, and that both parties are committed to enhancing the client's well-being.
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Define proxemics.
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Proxemics is the study of an individual's use of space.
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What social physical body distance should you maintain when not actually giving care?
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4 feet - to avoid sending a message that may be interpreted as a desire for intimacy
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What can a nurse do when invasions of personal space are necessary and occure while performing a procedure in order to minimize their impact?
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explain why a procedure is needed
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Communication: Sympathy vs. Empathy
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Sympathy: I feel bad FOR you.
Empathy: I feel bad WITH you; try to know what the pt is going through and how the nurse can help |
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Communication: Mutuality vs. Paternalism
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Mutuality: nurse and client work together, move away from hostility, pt's problems are the nurse's problems
Paternalism: the plan is not mutual and the nurse insists on following the plan |
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Communication: Dependency vs. Empowerment
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Dependency: the patient is dependent on others for care and doesn't take the initiative to learn about his/her care
Empowerment: encourage the pt to get involved in the care in every way possible; give positive feedback |
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Define mutuality.
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Mutuality means that the nurse and the client agree on the client's health problems and the means for resolving them, and that both parties are committed to enhancing the client's well-being.
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Define proxemics.
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Proxemics is the study of an individual's use of space.
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What social physical body distance should you maintain when not actually giving care?
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4 feet - to avoid sending a message that may be interpreted as a desire for intimacy
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What can a nurse do when invasions of personal space are necessary and occure while performing a procedure in order to minimize their impact?
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explain why a procedure is needed
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Communication: Sympathy vs. Empathy
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Sympathy: I feel bad FOR you.
Empathy: I feel bad WITH you; try to know what the pt is going through and how the nurse can help |
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Communication: Mutuality vs. Paternalism
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Mutuality: nurse and client work together, move away from hostility, pt's problems are the nurse's problems
Paternalism: the plan is not mutual and the nurse insists on following the plan |
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Communication: Dependency vs. Empowerment
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Dependency: the patient is dependent on others for care and doesn't take the initiative to learn about his/her care
Empowerment: encourage the pt to get involved in the care in every way possible; give positive feedback |
