Newton exam 1

Nursing is an __________, ____________, _________ and scientific discipline

Nursing is an INDEPENDENT, AUTONOMOUS, ACADEMIC, and scientific discipline.

Nursing care is ________-______ and _______ focused

nursing care is PATIENT CENTERED and OUTCOME focused

Are nurses medical professionals?

NO

-Nurses are independent and autonomous healthcare professionals

Does only one person work to facilitate positive patient outcome? or is it the work of many?

VARIOUS Professions work together to facilitate positive patient outcomes

True or False:

Nursing: Scope and Standards of Practice applies to all nurses.

True: this applies to all registered nurses, both generalist and advanced practice registered nurses

what is the Definition of Nursing?

Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.

When does nursing occur?

it occurs whenever there is a NEED FOR NURSING KNOWLEDGE, wisdom, caring, leadership, practice or eduction

Can nursing happen anytime and anywhere?

YES

True or false:

Nursing occurs in any environment where there is a healthcare consumer in need of diagnosis.

FALSE:

Nursing occurs in any environment where there is a healthcare consumer in need of CARE, INFORMATION, or ADVOCACY

The ability to describe the assumptions that led to the conclusions researched

Explanation

All types of thinking/learning are used in nursing such as (3):

Visual

Auditory

Performances based

What does an open ended question allow the patient to do?

Allows the Patient to tell their story, does NOT presuppose an answer

A patients goal is a Broad statement that is a desired change in a —>

Patients condition perceptions or behavior

Nursing intervention is any ....

Treatment/care activity BASED ON CLINICAL JUDGEMENT AND KNOWLEDGE that a nurse performs to enhance patient outcomes.

The domain provides the (5)

-Subject

-Central concepts

-Values and beliefs

-Phenomena of interest for the discipline

What is the goal of nursing?

Is to achieve POSITIVE PATIENT OUTCOMES, in keeping with nursings social contract with obligation to society.

The depth and breadth in which individual registered nurses and ARPNs engage in the total score off nursing practice is dependent on.....

dependent on their EDUCATION, EXPERIENCE, ROLE and POPULATION SERVED

What so the Standards serve as?

The standards serve as EVIDENCE of the standard of care.

Nursing is a ________ _______ built on a ______ ________ of knowledge that reelects its dual components of art and science.

Nursing is a LEARNED profession, built on a CORE BODY of knowledge that reflects its dual components of art and science.

The art of nursing is based on what?

is based on:

Caring and Respect for human dignity

The science of nursing is consistent with and shares characteristics with all other scientific disciples such as:

Distinct body of Knowledge

Distinct schools/colleges

Baccalaureate = Entry level

Doctoral education is discipline specific

Nurses as Scientists rely on qualitative (Subjective) and quantitative (objective) data/evidence to _____ ______ _____ and______ but also as the means to evaluate nursings impact on the health outcomes of healthcare consumers/patients

To guide nursing policies and practices

What are the four recognized APRN clinical roles

Clinical Nurse Specialist

Nurse Anesthetist

Nurse Midwife

Nurse Practitioner

What is the current MINIMUM education to becomes a certified APRN?

A Masters Degree in nursing

What are some examples of NON-APRNs?

Nursing Education

Forensic Nursing

Nursing Informatics

Scholarly professional papers and Clinical documentation that reflects use of the nursing Process are examples of communicating via....

Writing

Nurse are expected to provide .....

Patient centered/Outcome-focused care and responsible for providing care that is empirically/evidence based.

The ability to understand and identify problems is

Interpretation

The ability to examine, organize, classify, categorize, and prioritize variables.

Analysis

Describe Evaluation

The ability to assess the credibility, significance and applicability of sources of information necessary to support conclusions

The ability to formulate hypotheses or draw conclusions based on evidence

Inference

What is Self-regulation?

The ability to self examine and self correct

True or False?

Only in SOME clinical situation is an opportunity for nurses to think critically and make sound judgements about the nursing care to be planned/Implemented/Evaluated

FLASE.

EVERY clinical situation is an opportunity

It is a process and critical thinking is gained only through _____ and an _______ curiosity toward learning

Only through EXPERIENCE and ACTIVE curiosity toward learning.

True or False?

Thinking and learning about nursing are inner-related and life-long processes

TRUE

What does a critical thinking nurse consider?

-What is Important in a situation

-Mentally explores alternatives

-Considers ethical principles

-Makes informed decisions regarding care

In regarding to care what is the nurses goal?

To attain the most positive patient outcomes

Critical thinking in nursing is ALWAYS .....

Outcomes focused and driven by the patients/family's needs

(Not the nurses)

What are the three levels of critical thinking in nursing

Basic

Complex

Commitment

What kind for thinking tends to be Concrete, task oriented and based on a set of rules or principles

Basic/Novice thinking

Complex critical thinkers analyze the .________ and _______ choices more independently

Analyze the SITUATION and EXAMINE choices more independently

True or False: Complex critical thinkers recognize that each solution has benefits and risks that need to be considered

True

Complex thinking requires _______ when does ones require this type off thinking

EXPERIENCE

About 2 Years after becoming an RN

At what level of critical thinking does the nurse make Clinical decisions without assistance from others, and chooses an action based on available alternatives and ACCEPTS FULL ACCOUNTABILITY for the decisions made.

COMMITMENT level of thinking is when this takes place.

True or False:

Nurses need to understand how patients think and learn

TRUE

Nurses need to utilize teaching/learning approaches that ......

Match the patient's style.

Doing it the __________ of thinking

OUTCOME

What is the foundation of nursing/nursing?

THINKING

nursing is the protection, promotion, and optimization of ______ and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of _________, __________, ________,_______ and ________.

Health

Individuals, families, groups, communities and populations

Phenomenon of concern =

HEALTH

What is the foundation of nursing/nursing practice?

Critical thinking

The Nursing Process is the critical thinking framework used by who?

Used by: All registered nurses (including APRNs)

The nursing process is used

Exclusively by the discipline of nursing

The ANA standards of practice are

Authoritative statements of the duties that all RNs are expected to perform

The nursing process allows nurses to:

-Identify patients response

-Plan nursing care that assists patients to deal with situations

-Implement nursing care and facilitate positive patient outcomes

-Evaluate the effectiveness of the nursing care given

The ANA standard of practice Describes a

Competent Level of Nursing Care

The Nursing Process includes 6 steps they are:

-Assessment

-Diagnosis

-Outcomes Identification

-Planning

-Implementation

-Evaluation

Assessment is the

Deliberate and systematic collection of information about a patient

To determine the patients current and past health and functional status, and their present and past coping patterns

Patient is the __________ ________ through interview, observations and physical examination

PRIMARY SOURCE

Who/What is Considered a Secondary Source?

Family

Significant Others

Friends

Other members of the Healthcare team

Heath Records

True or False:

Nurses should document Word-for Word what the patient said. It is good to use correct quotes.

TRUE

True of False:

It is the nurses interpretation of what the patient said or what you think the data means

FALSE!!!!!

It is NOT the nurses interpretation, use direct quotes from the patient

What is objective data?

observations or measurements of a patient's health status

Is it True that When documenting you should use the words Seems or Appears?

FALSE Do not use those words

True or False: Patient centered interview is just asking questions and recording answers

FALSE!

It is an interactive exchange

Observe non-verbal, such as eye contact, body language tone voice etc.

Observation

What is Back Channeling?

active listening prompts such as "all right," "go on," or "uh-huh."

Go on...

Very interesting ....

Then what happened...

What are some disadvantages of close-ended questions?

Limits answers to one or two words, such as yes/no or a number

-Do you ever drink and drive?

-Did you take your pills this morning?

What type of questions direct the respondent to give the answer he/she thinks you want to hear?

Leading questions

-you never hit your child did you?

-your son is only 16 so he doesn't drink alcohol right?

Nurse should report only ______ and be as _______ as possible

Report only DATA and be as DESCRIPTIVE as possible

Do nurses write a medical diagnosis?

NO!!! NEVER

When the nurse accurately identifies pattern of data, they form ________ __________

Diagnostic Conclusions

As assessment data is collected, the nurse begins to analyze it to recognize cues that form ______

Patterns indicating

-patients level of wellness and desire for health promotion

-existing health problems

Nursing diagnoses are conclusions that include—->

Issues/responses treated solely by nurses

Issues/responses treated by nurses in collaboration with other Healthcare professionals is known as:

Collaborative Problems

Nursing diagnoses and collaborative problems represent ....

The range of patient

conditions that require nursing care

What is a Nursing Diagnosis?

-Not a Medical Diagnosis

-Clinical Judgement made on basis of information

-Classifies issues within the domain of nursing

What is a: Clinical judgement concerning a HUMAN RESPONSE to health conditions/life processes that nurses are licensed and competent to treat.

NURSING DIAGNOSIS

A _________ __________ is an actual or potential physiological complication that nurses monitor and manage in collaboration with other Healthcare professionals

COLLABORATIVE PROBLEMS

What are the types of nursing diagnosis? (2)

Problem-focused diagnoses

Risk for nursing diagnosis

What is a problem focused nursing diagnosis?

Clinical judgement concerning an undesirable human response to a health condition/life process

Describe a "risk for" nursing diagnosis

Clinical judgment concerning the vulnerability of an individual, group or community for developing an undesirable human response

________ ______ is a nursing diagnosis a clinical judgement concerning a patients family groups communities motivation and desire to increase well being

HEALTH PROMOTION

When would you use the Health Promotion Diagnosis?

When patient expresses readiness to enhance a specific health behavior

The diagnostic process involves organizing the data into _________ _______

Data Clusters

What are data clusters?

Compromised of objects and or subjective signs symptoms and risk factors when analyzed holistically lease to diagnostic conclusions

Activity intolerance, Acute confusion, nausea, acute pain =

Problem focused

Risk for falls, poisoning, trauma =

Risk for......

Readiness to enhance power, sleep =

Health Promotion

Diagnostic Label = NANDA-I dx. It describes the —->

Essences of the patients response in a few words

Related factor = the etiology/ causative factor for the nursing dx —->

Identified from the assessment data.

The related factor must be within the .....

Scope of nursing and it must be amenable to nursing intervention.

what are the 2 parts of nursing diagnostic written statement?

1. Diagnostic Label

2. Related Factor

Phrasing the diagnostic Statement use the ________ + ________/______ ________

Diagnostic Label + Etiology/ related factor

Ex: Acute pain RELATED TO trauma for surgical incision

What are some sources of Diagnostic Label Errors?

-Errors during data collection

-Errors in the interpretation/analysis of data

-Errors in clustering (usually occurs when the nurse clusters data too early, incorrectly, or not at all)

-Errors in diagnostic statement (Use only NANDA-I terminology)

High Priority patient —>

Nursing dx that if untreated result in harm to patient or others

-airway, circulation, safety, pain etc.

What is an Intermediate Priority?

Involves non-emergent, non-life threatening needs of patients

Ex: Risk of infection

Describe a low priority patient.

Nursing dx that affect a patients future well-being; often focus on long term health care needs

The nurse and patient collaborate to identify

Patient goals and expected outcomes

An Expected Outcome is the

Measurable change in response to the nursing care given that must be achieved to reach a goal.