nursing principles exam 1

person, nursing, environment, health

What are the 4 paradigms of nursing?

Florence Nightingale

who is considered the mother of modern nursing?

crimean war

what war started the need for modern nursing

civil war

what war brought nursing to the US

assessment and education

what are the two main roles of a nurse?

institute on medicine (IOM)

released groundbreaking study on the role of nurse and requires any healthcare program to provide interprofessional education

interactive theory

relationships between nurse, patients, families, communities, and environment

systems theory

patient safety and quality of care requires healthcare system to work together (IPE), focus on whole patient not just situation at hand

developmental theory

talk about how nurses develop to provide care and how they develop based on their experiences, examine and describe human development

Clara Barton

started the Red Cross in the US

Benner

novice to expert, theory looks at newly graduate nurses and their development, how experiences make you a better nurse, hone assessment skills, interpretation skills, response skills, and reflection skills

Tanner

adapted to nursing students, created a subtheory called “thinking like a nurse”, which is how nurses develop clinical judgments

assessment, diagnosis, planning, implementation, evaluation

steps of the nursing process

Colb’s model

thinking, planning, performing, debriefing

holism

the theory that parts of a whole are in intimate interconnection, such that they cannot exist independently of the whole, or cannot be understood without reference to the whole, which is thus regarded as greater than the sum of its parts

Neuman theory

how changes in the body stress the being and how the body adapts to the stress

Roy

theory about how we adapt to changes in health

orem

theory that encourages self care, self-care deficit nursing theory whose goal is to help client attain total self-care

watson

theory about holism, nursing is an interpersonal process, involves accepting the person as a whole

Martha Rogers

theory about nature and human development, science of unitary human beings and maintaining an environment free of negative energy is important

four spheres of care

disease prevention and promotion of health and well-being, chronic disease care, regenerative or restorative care, hospice and palliative or supportive care

palliative care

patient-focused, focusing on pain management

hospice

survivor focused, focusing on family and how they deal with diagnosis of patient

telehealth

urgent care centers or calls where nurses give advice for person to avoid them going to the hospital

chronic disease care

helps to assess for early interventions in order to prevent major problems from occurring, teaching for when they do have to go to the hospital, lot of family involvement

disease prevention and promotion of health and well-being

screenings, identification and education on risk factors, education on disease prevention, promoting healthy lifestyles, first aid, clinics and telehealth, surgical centers, community engagement

regenerative or restorative care

need medical attention physically or psychiatric, critical/trauma care, complex or multisystem acute care, acute exacerbations of chronic conditions, treatment of physiologically unstable, hospital-based

hospice and palliative or supportive care

end of life care, supportive care for individuals requiring extended care, supportive care for individuals with complex, chronic disease states, rehabilitative care, bariatric centers, burn care, transplant care, brain and spinal injury

state board of nursing

who creates and enforces the nurse practice act

assessment/noticing

gather information, assess client and notice situation, think about immediate and larger picture ideas like long term goals, strengths and weaknesses, values, family/community, available resources and can they afford them

dietitian

disease focused

nutritionist

health focused

priorities

set based on Maslow’s hierarchy of needs - anything to do with oxygen, shelter, protection from the elements

physical/psycho-social

focus on safety, look at things in the environment that can pose safety threats

educational

what patient needs to learn and how to explain diagnosis to patient, how to manage their disease

risks

lifestyle, genetics, fall risks

nursing diagnosis

identify priorities, physical/psychosocial threats, educational, and risks

plan

address issue, specify outcomes, set long term and short term goals

specific, measurable, appropriate, realistic, time-focused

SMART goal

implement

address issue, immediate needs, goals, direct and indirect actions

evaluate

measure extent to which goals were met, modify as needed

goals of nursing care map

determine patient’s new or continuing need for assistance, promote self care, assist the patient to achieve valued health outcomes

ANA

american nurse association, scope and standards of practice defines activities that are specific to nursing (national standards)s

standards

allows nurses to carry out professional roles, serving as protection for nurse, patient, and institution

nurse practice acts

define legal scope of nursing practice in each state, tells which state has reciprocity, define important terms and activities in nursing

reciprocity

what states you can practice in without taking another exam

NSNA

national student nurses association, associate organization of ANA, resolutions might be state specific for national, provides guidelines for student nurses in all programs, legal organization

NCLEX

national council licensure exam

CCNE

who accredits nursing schools

joint commission

governing body that accredits hospitals and healthcare agencies

HIPAA

any information about a patient is privileged information and should not be shared unless it is necessary to continue care, medical records owned by hospital, patients have the right to look at their own medical records

good samaritan

as long as you are acting in good intent and are trying to help someone, the person can be sued but they will not win as long as the person is operating within their scope of practice

QSEN

quality and safety education for nurses, patient-centered care, teamwork and collaboration, quality improvement, safety, evidence-based practice, informatics

patient-centered care

learn to tailor bigger standards to individual needs of a patient

quality improvement

looking for what is going to give us the best option for this patient

informatics

way that we store and share education, how we use EHR, how we use information in this school

tort

wrongful act towards another person, civil law

intentional tort

assault and battery, defamation of character, invasion of privacy, false imprisonment

unintentional tort

negligence, malpractice, happens because of breakdowns in the system

slander, liable, oral, written

SLOW, Defamation of character involves

negligence

failure to use reasonable care, resulting in damage or injury to another

malpractice

improper, illegal, or negligent professional activity or treatment, especially by a medical practitioner, lawyer, or public official

duty, breach of duty, causation, damages

4 elements of liability, need all 4 to be found responsible

documentation

what is very important step that is involved in caring for a patient, including noting time, date, what the patient did and how the patient tolerated it

ethics

a systematic study of principle of right and wrong conduct, virtue, and vice, and good and evil as they relate to conduct and human fluorishing

morals

refers to personal or communal standards of right and wrong

values

reflect what we believe is important, related to and direct our ethical conduct

code of ethics

set of principles that reflect the primary goals, values, and obligations of the profession

bioethics

encompasses a number of fields of “life sciences” - see things like using animals in lab testing, cannot practice techniques on new cadavers

nursing ethics

formal study of ethical issues that arise in the practice of nursing, analysis used by nurses to make ethical judgments

feminist ethics

critiques existing patterns of oppression and domination in society especially affecting women and the poor, cannot make decisions based on a person’s ability to pay

utilitarian

the rightness and wrongness of an action depends on the consequences of the action

deontologic

an action is right or wrong independent of its consequences

autonomy

respect rights of patients to make health decisions

nonmaleficence

avoid causing harm, make sure the benefit outweighs the harm

beneficience

benefit the patient, advocate for the patient

justice

give each his or her due and act fairly

fidelity

keep promises

beauchamp and childress’s principle-based approach to bioethics

autonomy, nonmaleficence, beneficence, justice, fidelity, veracity, accountability, privacy, confidentiality

purposes of the code of ethics for nurses

it is a succinct statement of the ethical obligations and duties of every nurse, it is the profession’s nonnegotiable ethical standard, it is an expression of nursing’s own understanding of its commitment to society

paternalism

action performed with the intent of promoting another’s good but occurring against the other’s will or without the other’s consent

deception

engaging in fraud or lying to appropriate entities

confidentiality

violations involve sharing of private information with others to whom knowledge of the information is not necessary

allocation of scarce nursing resources

resources are finite and are charged to the patient, so be aware of resources that are used

ethic committees

chief function is education, policy making, case review, consultation, occasionally research

multidisciplinary

ethic committees have a lot of different perspectives to determine the best action for patient and to uphold their rights

nurse involvement in ethics committee

ensure technical aspects are understood, identify appropriate decision makers, patients’ medical and best interests have been identified, course of action is justified, important role in policy making

ethical dilemma

two or more clear moral principles apply but support mutually inconsistent courses of action

ethical distress

occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action

advocacy in nursing practice

primary commitment to the patient, prioritization of good of individual patients rather than society in general, evaluation of competing claims of patient’s autonomy and patient’s wellbeing

areas of concern for patient advocates

representation of patients, promoting self-determination, whistle-blowing, being politically active

value

a belief about the worth of something, about what matters, that acts as a standard to guide one’s behavior

value system

organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct

modeling

learning through observation, can lead to acceptable or unacceptable behavior

moralizing

taught complete value system of parents, church, little opportunity to differ

Laissez-faire

explore values on their own to develop personal value system, little to no guidance leading to confusion and conflict → think through values on your own

rewarding and punishing

rewarded for demonstrating values held by parents, punished for demonstrating unacceptable values

responsible choice

explore competing values and to weigh consequence. support, guidance, and reflection

value neutral

nurses must not let their own beliefs affect how they treat a patient, must respect the individuality of patients

altruism

concern for welfare and well-being of others, concern for others before yourself