Foundations Exam #2

Chapters 7, 8, and 28

Crime

A public wrong against society

Tort

A private wrong against an individual, tried in a civil court

Assault

Verbal threats

Battery

Threat/assault is carried out

Defamation of character

Derogatory remarks about another that impact their reputation

Libel

Written defamation

Slander

Spoken defamation

Invasion of privacy

Breaking confidentiality

False imprisonment

Unjustified retention or prevention of the movement of another person without proper consent

Fraud

Willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person's property

Negligence

A nurse who fails to initiate proper precautions to prevent patient harm; mostly acts of omission, but can be acts of commission, carelessness

Malpractice

A specific type of negligence involving professional misconduct or a failure to meet the standard of care expected of a nurse

Informed consent

Needed for admission, for each specialized diagnostic or treatment procedure, and for any experimental treatments or procedures

Disclosure

Patient/surrogate has been informed of the (1) nature of the procedure, (2) risks, (3) alternatives, and (4) fact that no outcomes can be guaranteed.

Comprehension

Patient/surrogate can correctly repeat in their own words that for which the patient/surrogate is giving consent

Competence

The patient understands the information needed to make this decision, is able to reason in accord with a relatively consistent set of values and can communicate a preference

Voluntariness

The patient is voluntarily consenting or refusing. This cannot be forced

Incident Report

Documents the occurrence of anything out of the ordinary that results in, or has the potential to result in, harm to a patient, employee, or visitor

HIPAA

Health Insurance Portability and Accountability Act

Duty

Obligation to provide care; these duties arise from the nurse-patient relationship

Breach of Duty

“Lack of nurse competency”; failing to meet the standards of nursing

Causation

A direct cause and effect link between the breach of duty and the injury; the breach of duty must have caused an injury

Damages

The breach of duty must have caused injuries that result in damages; if the patient isn’t/wasn't injured, there are no damages

Nurse Practice Act

The most important law affecting nursing practice, the who, what, when, how, where, and why of nursing

AMA

Against medical advice; patients have the right to leave against medical advice (exhibiting autonomy)

Verbal Communication

Depends on the understanding of language

Nonverbal Communication

Facial expressions, gestures, eye contact, touch, space, time, boundaries, body movements, posture, and gait, general physical appearance and mode of dress or grooming, sounds (moaning, crying, gasping, sighing)

Open-Ended Question or Comment

The greatest advantage of this technique is that it prevents the patient from giving a simple yes or no answer, which can limit their response

Closed Question or Comment

Used to gather specific information from a patient and to allow the nurse and patient to focus on a particular area; “yes” or “no” Closed questions are often a barrier to effective communication

Validating Questions or Comments

Validating what the nurse believes they have heard or observed; overusing validating questions and comments might lead the patient to think the nurse is not listening

Clarifying Questions or Comments

The nurse should never assume understanding of the patient’s meaning; the nurse should ask for clarification if there is doubt. The use of a clarifying question or comment allows the nurse to gain an understanding of a patient’s comment

Reflective Questions or Comments

Repeating what the person has said or describing the person’s feelings. It encourages patients to elaborate on their thoughts and feelings

Sequencing Questions or Comments

Place events in a chronological order to investigate a possible cause-and-effect relationship between events

Directing Questions or Comments

It might become necessary at times to obtain more information about a topic brought up earlier in the interview or to introduce a new aspect of the current topic

SBAR

Situation, Background, Assessment, Recommendation; Use SBAR when communicating critical information and/or handing off information during shifts

Visual Channel of Communication

Sight, observations, and perception

Auditory Channel of Communication

Spoken words and cues

Kinesthetic Channel of Communication

Touch

Characteristics of a Helping Nurse/Patient Relationship

Caring, person-centered relationship, dynamic; both people involved are active participants, purposeful and time-limited, the person assisting is professionally accountable for the outcomes, goals are determined cooperatively and defined in terms of the patient’s needs

Orientation phase of the Nurse-Patient Relationship

In the orientation phase, the tone and guidelines for the relationship are established. The nurse and the patient meet and learn to identify each other by name. It is especially important to introduce yourself to the patient.

Working phase of the Nurse-Patient Relationship

The longest phase. The nurse works together with the patient to meet the patient’s physical and psychosocial needs, interaction is the essence of the working phase

Termination phase of the Nurse-Patient Relationship

Occurs when the conclusion of the initial agreement is acknowledged. This might happen at change-of-shift time, when the patient is discharged, or when a nurse takes vacation or employment elsewhere.

Verbal/Nonverbal Incongruence

When a person's spoken words (verbal communication) don't match their body language, facial expressions, or tone of voice (nonverbal communication)

Nursing interventions to prevent falls in a health care facility

Complete a risk assessment, indicate risk for falling on the patient’s door and chart, keep the bed in a low position, keep the wheels on the bed and the wheelchair locked, leave the call bell within the patient’s reach, instruct the patient regarding the use of the call bell, answer call bells promptly, leave a night light on, eliminate all physical hazards in the room (clutter, wet areas on the floor)

Restraints

Physical devices or chemical means used to limit a patient’s freedom and movement that cannot be easily removed (or eliminated) by the patient

R

Rescue anyone in immediate danger

A

Activate the fire code and notify the appropriate person

C

Confine the fire by closing the doors and windows

E

Evacuate patients and other people to a safe area

Intimate partner violence

Most frequently occurs before age 25; involves physical violence, sexual violence, stalking, and or psychological aggression

Role of Stress on the Attention Span

Stress shortens the attention span