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3303 Concepts of Nursing Course Review Flashcards

Review for Cumulative Final

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2006954413Historical ResearchInvolved with the study of past events. • It is often qualitative. • EX: Compliance with influenza vaccine0
2006954414Describe the steps of the research process(Informed Consent) 1. Conceive the study 2. Design the study 3. Conduct the study 4. Analyze the study 5. Use the study1
2006954415Explain how nursing research improves nursing practice.• Reduce variation in care • Improve patient outcomes • Promotes the use of a scientific process driven by evidence-based standards and practice guidelines to improve quality of care2
2006954416Define evidenced based practice.The integration of BEST research EVIDENCE with clinical EXPERTISE and PATIENT values (Sackett) "A problem-solving approach to clinical practice that integrates the conscientious use of BEST evidence in combination with a clinician's EXPERTISE and CLIENT VALUES and preferences in making decisions about client care" (Potter and Perry)3
2006954417Explain the levels of evidence in the literature.From Highest to Lowest: 1. Systematic reviews and meta analysis of RCT's 2. One well-designed RCT 3. Well designed controlled trial without randomization 4. Well-designed case control studies 5. Systematic reviews of descriptive and qualitative studies 6. Internal organization-quality/risk management data 7. Opinion of authorities or expert committees4
2006954418Write a PICO(T) question.Population: Among family members of patients undergoing diagnostic procedures (P & T) Intervention: Listening to music or comedy routine CDs Comparison: Compared with no intervention Outcome: Reduce reported anxiety by family members Time: During diagnostic procedures5
2006954419Describe ways to apply evidence in practice• Agency Policy • Existing clinical practice guidelines • Peer-reviewed articles (panel of experts has reviewed the article) • Quality improvement data6
2006954420Compare definitions of leadership and management• Leadership: The ability of an individual to influence the behavior of others. • Management: Coordinates people, time, and supplies to achieve desired outcomes. Involves problem-solving and decision-making processes.7
2006954421Democratic Theory of Leadership"Participative" style; keeps employees informed; shares decision making and problem solving; "Coach" who has the final say but receives information and input from members before making decisions.8
2006954422Identify key behaviors of successful leaders• Critical thinking • Problem solving • Acknowledgement and respect for individual differences • Active listening & skillful communication • Establishment of clear goals and outcomes • Continued personal and professional development9
2006954423Identify key qualities of successful leaders.Integrity • Courage • Initiative • Energy • Optimism • Perseverance • Well-roundedness • Coping skills • Self-knowledge.10
2006954424Identify key nursing issues influenced by politics (focus on the nursing shortage, magnet status and mandatory staffing ratios)• Nursing Shortage: Aging population; does not exist in every area of nursing (geriatrics; regional such as rural areas). Recent healthcare reforms will give millions of people access to healthcare, creating the need for more nurses. • Magnet Status: The ULTIMATE credential for high quality nursing. Recognizes healthcare organizations for quality patient care, nursing excellence, and innovations in professional nursing practice. Developed by the ANCC. • Mandatory Staffing Ratios: State-by-state issue; involves identifying and maintaining the appropriate number and mix of nursing staff critical to the delivery of quality patient care.11
2006954425Identify how nurses can become active in the political process.• Identification of specific goals that affect nurses (e.g. Shorter hospital stays resulting in clients being sent home "quicker and sicker") • Joining professional organizations. • Attending political events. • Voting12
2006954426Define teachingAn interactive process that promotes learning. Involves the transfer of knowledge.13
2006954427Describe the domains of learning and the characteristics of learning within each domain.• Cognitive: Includes all intellectual behaviors and requires thinking. Includes acquisition of knowledge, ability to understand, application, analysis, relating ideas in an abstract manner, synthesis, recognizing parts of a whole, evaluation • Affective: Deals with expressions of feelings and acceptance of attitudes, opinions, or values. It impacts the positive or negative success of the education process. • Psychomotor: Involves acquiring skills that require integration of mental and muscular activity14
2006954428Identify basic learning principles.• Motivation to Learn: Determined by the patient's attitudes, their readiness to learn, and their willingness to participate actively. • Ability to Learn: Depends on the patient's developmental level. Children will learn differently from adults. • The Learning Environment: Either makes learning a difficulty or a pleasure. The ideal environment must be well-lit, have good ventilation, appropriate furniture, and a proper temperature.15
2006954429Describe the quality guidelines used in documentation and reporting.• Factual: Be objective, not subjective; quote the patient if necessary. • Accurate: Use exact measurements, "Midline abd. incision measures 5" in length and 1" in depth with no obvious drainage or odor" and NOT "incision healing well. • Complete: If it was NOT charted, it was NOT done. • Current: Vitals, medications, treatments, changes in condition, test preps. • Organized: Should be in a logical, time sequential order, written in 3rd person, and in passive tense.16
2006954430Describe the different methods used for record keeping and the advantages of standardized documentation forms.1. Paper and electronic health records (EHRs) 2. Source-oriented records: Each discipline has their own documentation. 3. Problem-oriented Medical Records: All disciplines use the same forms referencing patient problems (SOAP or SOAPIE - originated in medicine). PIE (Problem, Intervention, Evaluation) and DAR-POMR (Data Action Response-Problem Oriented Medical Record) originated in nursing. 4. Charting by Exception: Only chart if there is a variance (only document if there is a problem, i.e., change in vitals, etc.)17
2006954431Describe the purpose and content of reporting to include change-of-shift patient handoff using TeamSTEPPS elements.• Purpose: To communicate something that has been seen, heard, done, or considered. • End-of-shift: Off-going nurse gives necessary information about patient/patients to the On-coming nurse. • TeamSTEPPS includes: SBAR, I PASS the BATON, Check-back 1. SBAR: Situation, Background, Assessment, Recommendation. 2. I PASS the BATON: An option for STRUCTURED HANDOFFS • Introduction (your role, job, and patient) • Patient (name, age, sex, location), • Assessment (initial chief complaint, vitals, symptoms, diagnosis) • Situation (current status, code status, recent changes, response to treatment) • Safety concerns (critical lab values, allergies, fall risks) • Background (co-morbidities, previous episodes, family hx, current medications) • Actions (what actions were taken or are required; provide rationale) • Timing (level of urgency and explicit timing) • Ownership (who is responsible? nurse/doctor/team) • Next (What will happen next? Anticipated changes? What is the plan? Are there contingency plans?) 3. Check-Back: Sender initiates message, Receiver accepts the message and provides feedback, Sender double-checks to ensure that the message was received.18
2006980602Describe how ethical principles are applied to professional nursing practice, know the precepts (non-maleficence etc..)• Autonomy: Personal independence • Beneficence: Taking positive action to help others • Nonmaleficence: Avoiding harm or hurt • Justice: Fairness (social, distributive, or legal)19
2006980603Relate contemporary ethical issues to professional nursing practice including: abortion, genetic research, organ transplant, assisted suicide, HIV Aids, children's issues.• Organ Transplantation: Ethical questions still linger about what constitutes death because some organs (liver, lungs, heart) need to come from a donor whose heart is still beating. • HIV AIDS: Right to privacy, right to care, distributive justice (cost to society), nurses' responsibilities. • Assisted Suicide: Nurses are not allowed to actively participate in suicide (i.e. administering or providing a lethal medication) as it goes against what nursing is about. However, nurses are allowed to participate in passive euthanasia (i.e. withholding treatment that prolongs life or removing advanced life support).20
2006980604Define ethics.Discipline concerned with right and wrong conduct; what should or should not be done.21
2006988381Describe interventions to remove incivility in various settings• Training adequate leaders • Establishing a communication-rich culture that emphasizes trust and respect • Building a collaborative culture that includes respectful communication and behavior22
2006988382Describe behaviors that are considered uncivil and civil in the academic settings• Missing class • Cheating • Being unprepared • Making rude comments or being disrespectful (including social media)23
2006988383Define incivility and related concepts in an academic settingThe disregard and insolence for others, causing an atmosphere of disrespect, conflict, and stress.24
2007110707Advance Directives/Medical Power of AttorneyState what health care a client will accept or refuse when client is no longer competent to make such decisions. Living Wills Directive to Physicians Medical Durable Power of Attorney (Health Care Proxy): Designates another person to make health care decisions for a person if the client becomes incompetent or unable to make such decisions.25
2007110708Physical RestraintsCan only be used if: patient is a threat to self or others and other nursing interventions have been attempted first. Must have a physician's order and must be discontinued as soon as possible.26
2007110709Do Not Resuscitate Orders (DNR/DNI)• Although DNR orders may be included in an advance directive, DNR/DNI orders are legally separate from advance directives • For the nurse to be legally protected, there must be a WRITTEN physician's order for a "no code" or DNR in the client's chart.27
2007110710Out of Hospital DNR• It is important that nurses not stigmatize patients who have DNR orders. (eg the practice of placing "dots" over the patient's bed or on the wristband to identify a DNR patient) • It would be extremely unprofessional to give "less than the best" care because "the client is going to die anyway". This abandonment can jeopardize care of the DNR client. • Do not resuscitate orders must be followed regardless of the nurse's personal values. •Valid anywhere (even if EMS is contacted and in emergency department)28
2007110711Emergency Medical Treatment & Labor Act (EMTALA)When a patient comes to the emergency department or the hospital, an appropriate medical screening occurs within the capacity of the hospital. If an emergency condition exists, the patient is not to be discharged until the condition stabilizes.29
2007110712Intentional tortsWillful acts that violate another person's rights or property—usually physical acts; may also result in a crime. Includes ASSAULT (threats), BATTERY (unconsented touch), FALSE IMPRISONMENT, INTENTIONAL infliction of EMOTIONAL DISTRESS, CONVERSION of PROPERTY30
2007110713Natural LawThe inherent tendency that humans have to take actions that follow our nature and purpose as human beings; based on the idea to promote good and avoid evil.31
2007110714Describe the legal components in the regulation of professional nursing practice.• Nurse Practice Act: Defines the scope of practice and education requirements. • State Board of Nursing (BON): Defines RN responsibilities, develops guidelines for safe delegation, defines rules & regulations for RN practice.32
2007131737Primary CarePreventative care that focuses on HEALTH PROMOTION as the key to quality health. Settings offer care such as BP screenings, immunizations, poison control, and community programs. • Public Health • School-based Services • Community Health Centers • Physician's Offices and General Clinics • Occupational Health Clinics33
2007131738Secondary CareFocus on diagnosis and treatment of disease • Hospitals (units, psychiatric, rural) • Acutely and chronically ill represent 20% of all people in the US and consume 80% of health care spending.34
2007131739Tertiary CareSettings serve patients recovering from an acute or chronic illness/disability. Help individuals regain maximal function and enhance quality of life and promote patient independence and self-care abilities. • Long-term Care Facilities • Rehabilitation Centers • Hospice Services • Sports medicine • Home care • Extended care35
2007167075Describe the nurse's role in health promotion, wellness, and illness prevention.Nurses are in a unique position to help patients achieve and maintain optimal levels of health. Nurses educate and promote health.36
2007167076Primary PreventionActions to PREVENT disease or injury (e.g. practicing good nutrition, exercising, avoiding smoking, obtaining regular health screenings, education).37
2007167077Team NursingCollaborative care style that encourages each member of team to work with and help the other members -Employs an assigned group of health care personnel whose varied skills are directed by a team leader to provide total services for a specific group of patients, which includes all tasks for a given patient.38
2007167078Total Patient Care Nursing• RN is responsible for all aspects of care during a shift: Care can be delegated. RNs work directly with other health care providers, patient, and family Patient satisfaction is high, but may not be cost effective.39
2007167079Case Management Nursing•A care management approach that coordinates and links health care services to patients and their families while streamlining costs and maintaining quality. •Communication and use of available resources promote quality cost-effective outcomes in this model.40
2007167080Primary Nursing• One primary registered nurse assumes responsibility for caseload. • RN develops a 24-hour nursing plan of care • Communication is lateral from nurse to nurse and from caregiver to caregiver. • Flexible model uses a variety of staffing levels (LVNs, CNAs). • RN works with a limited number of patients.41
2007191626Define transcultural nursing and the relationship to nursing care and patient health.Nurses now recognize they can no longer use traditional ethnocentric models to guide their practice and protocols due to cultural changes that result from ethnic shifts in the population. Percentage of minority nurses does not reflect the national population trends.42
2007191627Identify the components of an accurate cultural assessment.Overview, inhabited localities, and topography overview Communications Family roles and organization Workforce issues Biocultural ecology High-risk behaviors Nutrition Pregnancy and childbearing practices Death rituals Spirituality Health-care practices Health-care practitioners43
2007191628Describe interventions that achieve culturally congruent care.-Teaching: How we teach. -Safety: -Communication: How information is provided. -Being receptive44
2007221065Caring and NursingHelps build trust and promotes healing. Building a Nurse-Patient Relationship: • Patients value the affective (emotional) dimension of nursing care. • Providing presence (communicating caring Multidimensional Care Concepts • Touch • Listening • Knowing the patient • Spiritual Care • Family Care45
2007221066Nursing interventions to support the spiritual needs of patients• Practicing presence • Listening • Obtaining a spiritual history • Being attentive to all dimensions of patients and their families: body, mind, and spirit • Incorporating spiritual practices as appropriate • Involving chaplains as members of the interdisciplinary health care team46
2007258320Describe the scope and standards of nursing practice.1. Nursing practice is individualized. 2. Nurses coordinate care by establishing partnerships. 3. Caring is central to the practice of the registered nurse. 4. Registered nurses use the nursing process to plan and provide individualized care to their healthcare consumers. 5. Strong link exists between the professional work environment and the registered nurse's ability to provide quality health care and achieve optimal outcomes.47
2007258321Describe the elements of a profession.• Meets a need/mandate of society. • Autonomy & authority over its practice. Discrete body of knowledge. • Specialized educational preparation & training. • Members are paid for services. • Academic body of scholarship.48
2007258322Describe the roles assumed by professional nurses (Include Certifications and the Advanced Practice Role).• Respond to the needs of patients using holistic caring as a framework • Actively participate in public health policy/politics • Respond and adapt to challenges by engaging in life-long learning • Care for self49
2007258323Identify the purposes and needs for nurse licensure.Legal act by the state to recognize that person is safe to practice. Primary function is to protect public safety. Establishes only minimal levels of competency.50
2007258324Evaluate the importance of nurse practice acts.State legislation regulating the practice of nurses that protects the public, defines the scope of practice, and makes nurses accountable for their actions. Can establish state boards of nursing (SBNs) and define specific SBN powers regarding the practice of nursing within the state.51
2007258325Diploma ProgramsIn hospital schools of nursing. 3 calendar years in length. No degree—diploma only.52
2007258326Baccalaureate Degree ProgramsFour years in length. In universities and colleges. Professional orientation. Stresses independence of practice; assessment skills; leadership and management abilities.53
2007258327Technical NursingEducated at the AD level. 2 year programs. Include current ADN and 2-year LPN programs.54
2007258328Compare the types of advanced nursing degrees.MSN: Includes Nurse Practitioners (Clinical Nurse Specialists, CRNAs, Certified Nurse Midwives) Ph.D: Designed to prepare individuals to conduct research. Ed.D: Focuses on administration in the educational setting. DNSc: Research oriented DNP: Terminal degree for advanced practice nurses55
2007258329American Nurses Association (ANA)Improvement of the standards of health and access to health-care services for everyone, improvement and maintenance of high standards for nursing practice, and promotion of the professional growth and development of all nurses, including economic issues, working conditions, and independence of practice.56
2007258330National League for Nursing (NLN)Maintains and improves the standards of nursing education57
2007258331International Council of Nurses (ICN)Serves as the international organization for professional nursing. Goal is to improve health and nursing care throughout the world.58
2007258332How did the American Civil War influence Nursing?This war helped advance the cause of professional nursing as leaders and was the impetus for providing the structure of what would become professional nursing.59
2007258333How did the Spanish-American War influence Nursing?This war created need for nurses. First attempt to use only trained nurses in war setting the stage for development of Army Nurse Corps and Navy Nurse Corps.60
2007258334How did World War 2 influence Nursing?During this war, Cadet Nurse Corp added 124,000 new RNs to the profession.61
2007258335Florence NightingaleAristocrat of Victorian England born in 1820. At age 30 entered nurses' training program. Crimean War - improved sanitation and ventilation. In 1860, founded the FIRST TRAINING SCHOOL for nurses in London that became the model for nursing education in the U.S.. "Notes on Nursing" and other publications greatly affected the development of nursing as a profession.62
2007258336Dorothea DixAn advocate for the mentally ill; was appointed Superintendent of Women Nurses of the Union Army.63
2007258337Linda RichardsThe first trained nurse, graduated in 1874.64
2007258338Clara Barton"Angel of the Battlefield" and founder of the American Red Cross.65
2007258339Isabel Hampton RobbKey founder of ANA. Among the first educators.66
2007258340Mary MahoneyFirst Professionally Educated African American Nurse. Advocated for diversity and equality.67
2007258341Susan B. AnthonyAdvocated for women's suffrage. Worked tirelessly. Spoke for the rights of nurses as a profession.68
2007258342Lillian WaldFounder of The Henry Street Settlement.69
2007258343Anna MaxwellCame to be known as the American Florence Nightingale. Pioneering activities were crucial to the growth of professional nursing in the United States.70
2007258344Lavinia DockWrote the "First Volumes of the History of Nursing." Proponent of women in nursing.71
2007258345Adelaide NuttingConsidered the first nursing educator.72
2011675516Secondary PreventionActions taken to identify and treat an illness or disability early in its occurrence - e.g., monitoring symptoms, taking medication, following treatment regimens, health screenings based on family history/risk.73
2011675517Tertiary PreventionActions taken to CONTAIN damage once a disease or disability has PROGRESSED beyond its early stages (e.g. radiation therapy, chemotherapy). It is less cost-effective and less beneficial and is the most common form of health care in the U.S.74
2011675518Quasi-intentional tortsViolation of a person's reputation, personal privacy, or freedom from malicious or unfounded legal prosecution. Includes SLANDER (oral defamation) and LIBEL (written defamation that is intentional and malicious)75
2011675519Unintentional tortsA wrong occurring to another person leading to injury even though it was not intended. To show legal liability, the patient must be able to prove the following: Duty to use care; failure to meet that standard of care (breach of duty); foreseeability of harm; actual harm caused; damages.76
2011675520Statutory LawConsists of laws written and enacted by the U.S. Congress, the state legislatures, and other governmental entities such as cities, counties, and townships.77
2011675521Common LawCreated by judges through case precedents (Federal Judicial System, State Judicial System)78
2011675522Criminal LawsWritten to prevent harm to society & provide punishment for crimes.79
2011675523Civil LawProtect the rights of the individual in our society; encourage fair & equitable treatment among people (sign and enforce contracts, establish rights and responsibilities among family members, tort law provides civil remedies for harm caused by others).80
2011675524ADAProhibits discrimination and ensures for persons with disabilities equal opportunities in employment, state and local government services, public accommodations, commercial facilities, and transportation.81
2011675525Health Insurance Portability and Accountability Act (HIPAA)Has rules that create patient rights to consent to the use and disclosure of their protected health information, to inspect and copy one's medical record, and to amend mistaken or incomplete information. It limits who is able to access a patient's record. It establishes the basis for privacy and confidentiality concerns.82
2011675526Patient Self-Determination Act (PSDA)Requires health care institutions to provide written information to patients concerning their rights under state law to make decisions, including the right to refuse treatment and formulate advance directives83
2011675527Describe behaviors that are considered uncivil and civil in the clinical settings• Divulging confidential information • Harmful behavior or attitudes • Manipulating those who are powerless84
2011675528Define LearningThe purposeful acquisition of knowledge, skills, behaviors, and attitudes. Involves processing and internalizing knowledge.85
2011675529Define Health LiteracyThe ability to understand health information and to use that information to make good decisions about health and medical care86
2011675530Define Health Numeracy:The skills needed to understand and use quantitative health information.87
2011675531Laissez-faire Theory of Leadership"Hands off" style; little or no direction; gives followers as much freedom as possible.88
2011675532Authoritarian Theory of LeadershipLeader retains power, is decision-making authority, and does not consult employees for input. Subordinates expected to obey orders without explanations. Motivation provided through structured rewards and punishments.89
2011675533Exploratory ResearchInitial, small study done to refine/develop a hypothesis about a relationship between phenomenon. • Quasi-expiremental • EX: Pilot studies90
2011675534Evaluation ResearchStudy that determines how well a program, practice, or policy is working. • Often qualitative • EX: Looking at patients watching a video how to self-inject; then evaluate how well patients did and compare it.91
2011675535Correlational ResearchAttempts to determine whether and to what degree, a relationship exists between two or more quantifiable (numerical) variables. Remember, correlation does NOT equal causation.92
2011675536Quantitative ResearchInvolves the collection of numerical data in order to explain, predict, and/or control phenomena of interest.93
2011675537Qualitative ResearchInvolves the collection of narrative data (non-numerical) on many variables over an extended period of time in a naturalistic setting.94
2011675538Descriptive ResearchInvolves collecting data in order to test hypotheses or answer questions regarding the subjects of the study. • Often quantitative • Looks at data to describe an event95
2011675539Experimental ResearchAttempts to establish cause-effect relationship among the groups of subjects that make up the independent variable of the study; the cause is under the control of the experimenter. • Quantitative96

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