Basic Nursing, Unit One, Exam One
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118 Terms
Who is Florance Nightingale?
“The Lady Of The Lamp”
What did Florance Nightingale do?
Created the first nursing school
Changed the conditions of hospitals by having clean units, washed clothes regularly, and provided sanitary conditions
She made a psychological change
What is Florance Nightingale known for?
Health promotion by improving the patient’s environment
What is the American Nurses Association (ANA)?
Professional organization that formed the Standards Of Nursing Practice and the Standards of Professional Performance
What is the NALPN?
National Association of Licensed Practical Nurses
What does an LPN/LVN must have?
Direct services under supervision of a registered nurse (RN) or health care provider
EBP or evidence-based practice
the use of evidence to inform nursing practice and positively impact client outcomes. Benefits from approaching clinical judgments through the use of EBP include improved client outcomes, lower costs, and delivery of high-quality health care
Nurse practice ac
Vary from state to state
Define what you can and cannot do
Changes within health care agencies
Financial needs
Availability of workers
Needs of the patients
What is the Health Care System Goals?
Goal to achieve optimal levels of health care for a defined population/ Do the most good for most people
The patient is always…
The central focus
What are other care givers in the healthcare system called?
Interprofessional Team
What does a Social Worker do?
Coordinates inpatient and community resources to facilitate discharge
What does a Physical Therapist do?
Musculoskeletal; maintain mobility
What does an Occupational Therapist do?
Improves patient’s abilities to perform ADLs (activities of daily living)
What does a Respiratory Therapist do?
Monitors oxygen demand and equipment, provide ventilator care and tracheostomy care
What does a Dietitian do?
Provides nutritional education
What does a Speech-Language Pathologist do?
Recommendations about impact of disorders of speech, language and swallowing (dysphagia)
What does dysphagia mean?
Difficulty swallowing
What happens with the Interdisciplinary Approach to Healthcare
Development of comprehensive care plan
An interdisciplinary approach to patient treatment prevents fragmentation of care
Patient is the focus in health care and taken care of with a holistic approach
Way one of prevention healthcare
Primary prevention (teaching)- provides education about healthy nutrition, stress management, exercise,
immunizations, and proper hygiene, proper seat belt and helmet use, smoking and tobacco cessation, safe sex education
Way two of prevention healthcare
Secondary prevention (Screening)- performs environmental and cultural health assessments and screenings like blood pressure screenings, mammograms, pap smears, and colonoscopies
Way Three of prevention healthcare
Tertiary prevention (Transportation and Therapy)- assists in obtaining public transportation for clients and provides resources for insurance and government programs and decreases effects of chronic issues by incorporating self care, therapies, and support group
What is the 1st level of healthcare
Primary (PCP):Emphasizes health promotion
What is the 2nd level of healthcare
Secondary (ER or Urgent Care):Diagnosis and treatment of acute injury or illness
What is the 3rd level of healthcare
Tertiary (Specialized Care): Specialized or highly technical care
What is the 4th level of healthcare
Restorative (Regain): Restoring health and promoting self-care
What is the 5th level of healthcare
Continuing (Continuing Care):Long-term or chronic health care needs over a period of time
Who has the right to health care without discrimination
ALL people in the U.S
What is the expectation for health promotion, wellness, and disease prevention
Expectation is that patients will actively participate in their care and will treat healthcare team with as much respect as we give them
What are modifiable risk factors
behaviors and actions that can be modified or changed by the client
Tobacco use/smoking
Sedentary lifestyle
Unhealthy eating or malnutrition
Excessive alcohol use
What are nonmodifiable risk factors
risk factors and conditions that the client cannot change
Genetics
Asthma
Race/ethnicity
What is Wellness-illness Continuum
A range of a person’s total health
In what order does Maslow’s model of health and illness go
physiological needs: breathing, food, water, shelter, clothing, and sleep
safety and security: health, employment, property, family, and social ability
love and belonging: friendship, family, intimacy, sense of connection
self-esteem: confidence, achievement, respect of others, the need to be a unique individual
self-actualization: morality, creativity, spontaneity, acceptance, experience purpose, meaning and inner potential
What do licensing laws do
protect the public from unqualified people
What does malpractice refer to
professional negligence
4 key elements of malpractice
Duty
Nurse-patient relationship
Breach
Nurse fails to perform duty
Harm
Physical or psychologic
Proximate cause of harm
The breach of duty is what caused the harm
Why can malpractice occur
Not following facility rules
Using equipment improperly
Failure to communicate properly
Not notifying the provider of a change in the client’s condition
How can malpractice be avoided
Following standards of care
Giving competent care
Communicating with client and team
Developing a rapport with the client
Following the facility’s policies and procedures
Assault
the conduct of one person makes another person fearful or apprehensive (threatening to do harm)
Battery
intentional and wrongful physical contact with a person that involves injury or offensive contact (physically doing harm)
Competent
the ability to make personal and medical conditions
Harm
injury to a person that gives rise to a basis for legal action
Defamation
damaging a person’s character or reputation
Libel
written defamation
Slander
spoken defamation
Abandonment of care
the wrongful termination of care that breaks the nurse’s duty to the patient
False Imprisonment
to prevent a competent patient from leaving a facility
AMA (Against Medical Advise)
when the client decides to cancel treatment and leave the facility without a physician’s permission or prescription (discharge orders)
Nurse-patient relationship (a legally binding relationship)
When the nurse assumes responsibility for the patient’s care (duty)
Failure to provide care to the expected level of expertise gives rise to legal liability (breach)
Advocate
One who will defend or plead a cause or issue on behalf of another
The nurse accepts the role of advocate for the patient
A nurse advocate has a legal and ethical obligation to safeguard the patient’s interests (duty)
Regulation of Practice
The practice of nursing is regulated by nurse practice acts, standards of care, and scope of practice.
Nurse practice acts are written laws that regulate nursing within each state and territory of the United States.
Vary from state to state and determine the standards of care
Identifies the roles and responsibilities of the nurse
Interventions that are approved by one state might not be approved by other states
It is the nurse’s responsibility to now the specific nurse practice act for the state that they are practicing in
Nurse practice acts are formal laws that determine the scope of practice and standards of care
Each state’s Board of Nursing is responsible for?
regulating and monitoring the laws set for by the nurse practice act
Scope of Practice is what?
the activities that an individual health care practitioner is permitted to perform within the nursing profession
Standards of care is what?
specific to the practice of nursing and are universal guidelines that define appropriate measures for all nursing interventions
American Nurses Association (ANA) does what?
Hold nurses accountable for following a code of conduct and upholding ethical values related to the profession (how you should act as a professional)
Failure to adhere to the standards of care gives rise to legal liability
Examples include having respect for the dignity of the person, professional responsibility and accountability, quality of practice, trust and confidentiality, collaboration with others
Scope of practice for a UAP
Scope of practice for a LPN
Scope of practice for a RN
Delegation
Nurses must validate tasks were performed
Do not delegate what?
Evaluate
Assess
Teach
5 rights of delegation
Right task
Right circumstance
Right person
Right direction and communication
Right supervision and evaluation
What is informed consent?
The physician’s responsibility is to provide full disclosure of the procedure including side effects, complications, and details of procedure
What is the nurse’s responsibility when the client is signing for a procedure?
To ONLY witness the client signature and make sure they have no questions for the provider
When does the nurse make sure the pt understands the procedure and has no questions for the provider?
BEFORE any invasive and high risk procedure
What can a nurse NOT do when they are getting a pt to sign an consent form?
The nurse cannot give any advice, or explain the procedure/answer questions
What is implied consent?
Consent is implied in life-threatening emergencies
Who can give their own consent?
Anyone over 18 OR Married
Emancipated/ living on their own
Military
Pregnant
Who can not give their own consent?
Minors
Parents/Guardians/ or a court specialized order needs too
What is an Advance Directive?
Communicate a client’s wishes regarding end-of-life care should the client become
unable to do so
When should a pt be asked about an advance directive?
On admission; if they don’t have one and request one, assist them filling it out
What are the three types of advance directives?
Living Will
Durable Power of Attorney for Health Care
Provider’s Orders
What is an durable power of attorney for healthcare?
A health care proxy or person is designated to make health care decisions for them if they are unable to do
What is an provider’s order?
Includes a DNR (Do Not Resuscitate) or an AND (Allow Natural Death) that is signed by the physician and honors the wishes of the client and the client’s family
If a DNR is not presented and someone becomes unresponsive (No pulse and no respirations), then what must happen?
CPR must be initiated
What is a pt’s BOR (Bill Of Rights)?
Outlines patient’s expectations to be treated with dignity and compassion
What does a pt’s BOR include?
Patient rights include ability to refuse treatment, leave AMA (against medical advice), and have proper care without prejudice. A competent patient cannot be forced to stay in a facility if they choose not to. They may leave despite a physician’s recommendation or prescription. It is the job of the LPN to make the physician aware of the patient’s wishes to leave AMA and to have the patient sign an AMA form.
What does HIPPA stand for?
Health Insurance Portability and Accountability Act of 1996
What is HIPPA?
Created to ensure that patients’ health information (PHI) is kept confidential and includes the following patient rights
What are the HIPPA Rights?
Right to have care without prejudice
Right to be treated with respect and dignity
Right to confidentiality
Right to personal safety
Right to complete information about one’s own condition and treatment
How is the best way to maintain HIPPA?
Only access information you NEED to know
What does PHI stand for?
Personal Health Information
What is included as PHI?
Date of birth, social security number, address, financial information, health history, current diseases and disorders etc.
Good habits that prevent PHI are?
Closing laptops when leaving, shredding personal documents, verifying who is on the patient’s HIPAA form before giving out information
Who are mandatory reporters?
Licensed Nurses
Failure to report abuse or in general =
Fines or imprisonment
What kind of cases do we report?
Suspicion and confirmed cases
Forms of Child Abuse
Physical and Neglect
Forms of Adult/ Elder Abuse
Includes physical, emotional, and financial abuse.
Who does the Good Samaritan Law protect?
People from liability when they voluntarily assist others in emergencies
The three key elements required for the Good Samaritan Law
That care was performed as the result of the emergency
The initial emergency was not caused by the person invoking the doctrine
The emergency care was not given in a grossly negligent or reckless manner
What are the four components that apply for the Good Samaritan Law for Naloxone?
Grants immunity from civil suit to providers who prescribe naloxone to a pt, family member, friend or other person in a position to assist giving the medication of naloxone
Allows the department of health to provide training and instruction on how to use naloxone
Requires you to receive basic instruction, including taking a quiz and printing out the certificate on how to give naloxone
Grants a “Good Samaritan” civil immunity for administering the medication to someone they reasonably believe is overdosing on an opioid
What is ethics?
The study of conduct and character
What is a code of ethics?
A guide for the expectations and standards of a profess
What are the values of ethics in nursing?
Values that influence a person’s behavior and feelings about right vs. wrong
What does human dignity imply?
That everyone, regardless of race, religion, sex, gender, age, or other individual identification, has value and should be respected simply because human beings are all equal
When confronted with an ethical decision, the MOST fundamental principle is?
Respect for people
Basic principles of ethics include:
Advocacy, Responsibilities, Accountability, and Confidentiality
What is Advocacy?
Supporting and defending clients’ health, wellness, safety, and rights
What is Responsibilities?
Willingness to respect obligations and follow through on promises