Exam 1 - ch 1-4,6,13

Nursing practice acts

outlines specific info about the scope of practice for nurses in that state

National League of Nursing

national organizations for nurses in nurse education; promotes nursing education and accreditation

NAPNES

multidisciplinary membership; set standards for LPN education

Maslow’s hierarchy of needs

1- physiological 

2 - safety and security 

3 - love and belongingness 

4 - Esteem 

5 - self-actualization 

health promotion (prevention)

primary: avoid disease

secondary: seeks to reduce impact of the condition

tertiary: improve quality of life and reduce farther loss of function in those with serious health problem

accreditation of a program

higher standard, program has meet preestablished criteria

approval of a program 

to open and operate; satisfies the minimum standards; students can still take licensure examination 

Ballard School

first school for training LPNs in 1892

Linda Richards

first nurse to train in America

abandonment of care 

wrongful termination of providing patient care 

assault

an intentional threat to cause bodily harm to another; does not have to be actual bodily contact

battery

unlawful touching of another person without informed consent

competency 

a legal presumption that a person who had reached the age of majority can make a decision for his or herself unless proved otherwise 

defamation 

spoken or written statement made maliciously and intentionally that may inquire the subject’s reputation 

harm

injury to a person or the person’s property

libel 

a malicious or untrue writing about another person 

slander

malicious or untrue spoken words about another person

breaches of standard of care

-failure to properly assess

-failure to administer meds

-failure to detect pt’s allergy

-failure to recognize and report deterioration

-failure to notify MD of lab values in a timely fashion

-failure to report child or elder abuse 

HIPPA rights for patients

-have care without prejudice

-to be treated with respect and dignity at all times

-confidentiality and privacy

-personal safety

-complete info about one’s own condition and treatment

American Society of Superintendents of Training School of Nursing

now called National League for Nursing; primary goal was to set standards for women’s education 

patient self-determination act

requires policies and procedures about patient rights including advanced directives, right to refuse treatment, right to participate in health care related decisions

best practices to avoid litigation 

-provide compassionate, competent nursing care

-nurse-patient relationship must be based on trust and mutual respect 

-use of open and honest communication 

-maintain and adhere to the standards of care and scope of practice

-proper documentation 

potential sanctions against nursing license

-dismissed charge

-investigations agreement

-letter of reprimand

-probation with stipulations

-mandatory diversion programs (drug and alc)

-suspension with stipulations

-revocation of license

ethics

values that influence a person’s behavior and the individual feelings and beliefs about what is right and wrong

values

personal beliefs about the worth of an object, idea, custom, or attitude 

ethical principles

-respect for people

-autonomy

-beneficence

-nonmaleficence

-justice

respect for people

most fundamental principle; no one person is more important than another 

autonomy

freedom of personal choice

beneficence

acting for someone’s good or doing good

nonmaleficence 

means to do no harm 

justice

concept of what is fair

when to report unethical behavior

-does the behavior place the patient or facility at risk?

-demonstrate incompetence?

-involve the use of drugs or alcohol?

-relate to mental or physical condition?

-violate nursing statute?

always follow the chain of command

ethical issues

-PA suicide

-DNR

-right to refuse treatment

-refusal to treat

purpose of patients record

-documenting communication

-permanent record for accountability

-legal record of care rendered

-teaching

-research and data collection

electronic health record

contains info identical to that found in a traditional medical record; one facility to another

electronic medical record

typically set up for use within one facility 

SBAR

method of communication

-situation, background, assessment, plan

SOAPIER

problem-oriented medical record (POMR)

-subjective, objective, assessment, plan, intervention, evaluation, revision

focus formats of documentation 

use of the nursing process and concept of patient’s needs instead of diagnoses 

ex: DARE (data, action, response, education) 

personal health records (PHR)

extension of EHR that allows patients to input their own information

joint commission

accredits health care facilties/hospitals

American Medical Association

sets medical standards and advocates for health care providers

American Nurses Association

professional nursing organization

world health organization 

coordinates international health issues 

national federation of LPNs

membership is limited to LPNs

US department of vocational education

differentiate between rn and lvn scope of practice

cross-training

maximizes use of staff and provides cost effective treatments to patients

dorothea dix

elevated standards of care for the mentally ill

clara barton

developed american red cross in 1881

Mary ann ball

one of the greatest nurse heroines of civil war

Isabel Hampton Robb

organized first graded system for nursing school

one of the founders of american journal of nursing

Lavina Dock 

with Robb, developed American Society of Superintendents of Training School (now the NLN)

Mary Mahoney

first African American professional nurse, worked for acceptance of African Americans

Lillian Wald

developed public health nursing in the US

Mary Nutting

developed curriculum concepts and guidelines for student nurses

Mary Breckenridge 

established Frontier Nursing Service- delivered obstetric care to mothers in the hills 

Nightingale theorist

“body’s reparative processes” by arranging patient’s environment

Orem theorist

help patient attain total self care

Leininger theorist 

caring as the central focus 

Roy theorist

model based on physiologic, psychological, sociologic, and dependence-independent adaptive modes

Parse theorist

health is a continual open process rather than a state of well being or absence of disease

Benner and Wrubel

caring as a means of coping with stressors of illness

holistic care

requires that professionals from different areas come together to provide comprehensive care

-spiritual, physical, emotional

nursing model of care

nursing, patient, health, environment 

connotative

meaning of a word is subjective and reflects the individual’s interpretation

denotative

meaning of a word describes a commonly accepted term

-jargon: common place language unique to people in a particular work setting

nonverbal communication

-voice

-eye contact 

-physical appearance

-gestures

-posture

assertive communication

confident, direct, honest, positive attitude, considers the feelings of others while honoring the nurse’s own rights as an individual

aggressive communication

overpowering, forceful, does not consider the feelings of others, prioritizes the nurse’s own needs

therapeutic nurse-patient relationship

nurse demonstrates caring, sincerity, empathy, trustworthiness

therapeutic nonverbal communication techniques

-active listening

-maintaining silence

-touch

-conveying acceptance: listening without judgement

therapeutic verbal communication techniques 

-minimal encouragement 

-open-ended and closed-ended questions

-restating 

-paraphrasing 

-clarifying 

-focusing: select one topic 

-reflecting 

-stating observations

-offering information

-summarizing 

-use of humor 

Factors in communication

-posturing and positioning

-space

-environment

-trust

-language barrier

-culture

-age/gender

-physiological factors

-psychological factors

non therapeutic communication

-false reassurance and assumptions

-giving advice or person opinions

-automatic responses

-defensiveness

-changing the subject

culture 

a set of learned values, beliefs, customs, and practices that are shaed by a group and passed from one generation to another

subcultures

exists within a group; individual choice

cultural competency

an awareness of one’s own cultural beliefs and practices and their relation to others, which may be difference

cultural assessment 

determines how the patient identifies themselves; never make assumptions

race

describes shared biological, physical characteristics

ethnic group

describes a group of people who share a common social and cultural heritage based on shared traditions, national origin and physical and biological characteristics

ethnicity

refers to cultural identification; behaviors that are learned

cultural considerations

-nonverbal communication

-space

-time

-social organization

-religious beliefs and health care practices

biomedical health belief system 

disease has a specific cause, onset, course, and treatment

folk health belief system

classifies illness and disease as natural or unnatural; forces of good and evil; treatment may include a healer

holistic health belief system

religion plays a major role in health practices and illness prevention, diet, etc; healing power may be ascribed to animate or inanimate object (rituals)

alternative or complementary belief system

nonmedical therapies used to treat illness; acupuncture, aroma therapy

Sign

objective data; can be perceived or observed by the nurse; ex: vital signs, labs rash

Symptoms

Subjective data; indications of illness that the patient perceives; ex: pain, nausea

Disease

pathological condition of the body, any disturbance of a structure or function in the body

• characterized by set of signs and symptoms