Theory Exam 1

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69 Terms

1

Nursing is the

protection, promotion and optimization of health and abilities

  • prevention of illness/injury

  • alleviation of suffering

  • advocacy in care

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2

Standards in nursing practice

  1. Assessment

  2. Diagnosis

  3. Outcomes identification

  4. Planning

  5. Implementation

  6. Evaluation

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3

In the case of nursing, theories are designed to explain a ________________ such as self care or caring.

phenomenon

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4

Since 1960 this organization has defined the scope of nursing and developed standards of practice and standards of professional performance. The organization is the:

ANA -American Nurses Association

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5

In reviewing various roles of a professional nurse, the nurse who is an expert clinician in a specialized area of practice (such as adult diabetes education) is a:

Clinical Nurse Specialist

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6

The preferred educational requirement for the nurse researcher is the

doctoral degree

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7

The standards of care nurses work by were created to assure patients that they

are receiving high quality care

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8

Watson's Theory of Caring

promote health, restore patient to health, and prevent illness

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9

Leininger's culture care theory

provide care consistent with nursing's emerging science and knowledge with caring as a central focus

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10

Standard's of professional performance

  • Ethics

  • Education

  • Evidence-based practice & research

  • Quality of practice

  • Communication

  • Leadership

  • Collaboration

  • Professional practice evaluations

  • Resources

  • Environmental health

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11

Modern Nursing

art and science blends the most current knowledge and practice standards with insightful and compassionate approach

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12

Nursing as a profession

addresses the many responses of individuals and families to their health problems

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13

Novice

beginning nursing student with no previous level of experience (clean slate)

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14

Advanced Beginner

has some level of experience with the situation

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15

Competent

nurse in same clinical position for 2-3 years

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16

Proficient

nurse with more than 2-3 years of experience in same clinical position

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17

Expert

nurse with diverse experience and has an intuitive grasp of an existing/potential clinical problem

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18

nursing theory

conceptualization of some aspect of nursing communicated for the purpose of describing, explaining, predicting, and/or prescribing nursing care

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19

Nightingale's theory

facilitate the reparative processes of body by manipulating patient's environment

  • to include appropriate noise, nutrition, hygiene, light, comfort, socialization, and hope

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20

Peplau's theory

develop interaction between nurse and patient

  • participate in structuring healthcare systems to facilitate interpersonal relationships

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21

Henderson's theory

work independently with other healthcare workers, assisting patient in gaining independence

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22

Orem's theory

care for and help patient attain total self-care

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23

Neuman's theory

help individuals, families, and groups attain and maintain max-level of total wellness by purposeful interventions

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24

Roy's theory

identify types of demands placed on patient, assess adaptation to demands, and help patient adapt

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25

therapeutic relationships

promote a psychological climate that facilitates positive change and growth, result in health related goal attainment for patient

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26

phases of therapeutic relationships

  1. pre-interaction phase

  2. orientation phase

  3. working phase

  4. termination phase

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27

pre-interaction phase

Before meeting patient:

  • review data/histories

  • talk with other caregivers whom have interacted with patient

  • anticipate concerns/ issues that may arise

  • identify a place for patient/nurse interaction

  • plan time for interaction to not be rushed

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28

orientation phase

Nurse and patient meet/get to know each other

  • set tone for the relationship (warm, empathetic, caring manner)

  • expect patient to test nurse's competence and commitment

  • closely observe patient (patient will closely observe nurse)

  • begin to make inferences and form judgments about patient's messages and behavior

  • assess patient's health status

  • prioritize patient problems and identify patient goals

  • clarify patient/nurse roles

  • form contracts with patient to specify roles

  • let patient know when you will terminate the relationship

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29

working phase

Nurse and patient work together to solve problems

  • encourage patient to express feelings about his/her health

  • provide info needed to understand and change behavior

  • help patient with self-exploration and to set goals

  • take actions to meet goals set

  • use therapeutic communication skills to get successful interactions

  • use appropriate self-disclosure and confrontation

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30

termination phase

Ending the relationship (starts when meet patient)

  • remind patient termination is near

  • evaluate goal achievements with patient

  • reminisce relationship with patient

  • separate from patient relinquishing responsibility for his/her care

  • achieve smooth transition for the patient to other caregivers as needed

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31

____________ is a variation of scientific reasoning

nursing

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32

physical examination

investigation of body to determine its state of health

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33

5 step nursing process

(ongoing cycle)

  • Assess

  • Diagnose

  • Plan

  • Implement

  • Evaluation

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34

practicing the 5 step nursing process allows

one to be organized and to conduct your practice in a systematic way

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35

assess

gather info about patient's condition

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36

diagnose

identify the patient's problems

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plan

set goals of care and desired outcomes (patient agrees)

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implement

perform nursing actions identified in planning

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39

evaluation

determine if goals are achieved

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40

How to assess patient?

interview, observations, and physical examination; family members, medical records

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41

must __________ assessment before diagnosis

validate

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42

nursing process

critical thinking process that pro nurses use to apply the best available evidence to caregiving and promoting human functions and responses to health and illness

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43

Subjective statements are

ones which are spoken by patient, not observed.

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44

objective statements are

ones which are observed or measured

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45

The client says he had chickenpbox as a child

subjective statement

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46

During the process of the health assessment the nurse begins to notice a pattern. From this pattern the nurse

will begin to interpret and validate the information

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47

The nurse says to the client "Please tell me about your periods of rest during the day." This is an example of:

open ended question

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48

Gordon's functional health patterns is

a model offering a holistic framework for assessment

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49

In order for the nurse to formulate a nursing diagnosis, he/she must first know the medical diagnosis of the client.

FALSE. The physician formulates the medical diagnosis. Nursing diagnoses are written for the nursing discipline.

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50

Interpreting and validating the assessment components

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51

critical thinking approach to assessment

involves collecting info from patient and from secondary sources, along with interpreting and validating the info to form a complete database

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52

database

data revealed related goals, experiences, health practices, values, and expectations about healthcare

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53

data collection (sources)

patient, family/significant other, healthcare team, medical records, scientific literature, nurse experience, subjective vs. objective data

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54

cue

info collected through the use of your senses

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55

inference

your judgement or interpretation of cues gathered

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56

comprehensive assessment approaches

  • use structured database format

  • problem-oriented approach

  • assessment moves from general to specific

  • ex.) Gordon's model of functional health patterns

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57

process of assessment

  • collect data

  • cluster data, make inferences and identify patterns and problem areas

  • critically anticipate

  • have supporting cues before making an inference

  • knowing how to probe and frame questions (skills grow with experience)

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58

patient-centered interview

organized conversation with patient

  • set stage (preparation, environment, and greeting)

  • set agenda/gather info about patient's concerns

  • collect assessment or nursing health history (patient confidentiality)

  • terminate interview (cue end)

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59

interview techniques

use all types of questions/statements (open and closed ended, back channeling, and probing)

  • patient's report includes subjective info; validate data from interview later with objective info

  • obtain data about patient's physical, developmental, emotional, intellectual, social, and spiritual dimensions

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60

open-ended questions

prompts patients to describe a situation in more than one or two words (describe, give examples) ex.) Tell me how you are feeling

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61

closed-ended questions

limits answers to one or two words, mostly yes or no ex.) Do you think the medication is helping you?

  • Who helps at home?

  • On a scale of 0 to 10, how would you rate your pain?

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62

back channeling

includes active listening prompts; these indicate that you have heard what the patient said and are interested in hearing the full story (encourages patients to give more details) ex.) "all right", "go on"

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63

probing

encourage full description without trying to control direction of story; use open-ended statements ex.) Is there anything else you can tell me?

  • What else is bothering you?

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64

cultural considerations

  • when cultural differences exist between nurse and patient, respect the unfamiliar and be sensitive to a patient's uniqueness

  • if unsure about what patient is saying (lang-barrier), ask for clarifications to prevent making the wrong diagnostic conclusion

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65

Nursing health history

  • biological info

  • patient expectations

  • reason for seeking care

  • present illness or health concerns

  • health, family, environmental, psychological history

  • spiritual health

  • review of systems -documentation of findings

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66

next assessment steps

physical examination observation of patient behavior (verbal/nonverbal) diagnostic and lab data interpreting and validating assessment

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67

data documentation

not documented, IT DIDN'T HAPPEN!

  • last component of a complete assessment

  • legal and professional responsibility

  • requires approved abbreviations

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68

Nursing diagnosis

after assessing a patient, form diagnostic conclusion

  • some conclusions can be used to select a nursing diagnosis

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69

Advanced Beginner

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