nursing foundations final study guide

clinical judgement

Interpretation or conclusion about a patient’s needs, concerns, or health problems, and/or the decision to take action, use, or modify standard approaches, or improvise new ones as deemed appropriate by the patient’s response

ethics

• The study of philosophical ideals of right and wrong bejavor based on what one thinks one ought or ought not to do

• A term that commonly reverse to the values and standards that individuals and professions strive to uphold

code of ethics of RNs

• Statement of the ethical values of nurses and nurses’ commitments to persons with health care needs

• Intended for nurses in all contexts

• Provides guidance when nurses are working through an ethical challenge

• Includes responsbility, accountability, and advocacy

4 principles of bioethics

• Autonomy (respect for persons) - ability to mamke informed personal choices (informed consent)

• Beneficence - foing or promoting good for others (ex. vaccination)

• Nonmaleficence - avoidance of harm or hurt (new technology)

• Justice - fairness (ex. Unbiased allocation of resources)

bioethics

The idea that moral decision making in health care should be guided by four principles

ethical dilemma

• Conflict between two sets of human values

• Cause of distress and confusion for patients and caregivers

moral distress

• Causing harm to patients in teh form of pain and suffering from continuing treatment is a source of moral distress for nurses that they often believe could be avoided

moral residue

• An effect of repeated difficult ethical situations

moral integrity

• Being committed to certain values an beliefs that are not upheld because of siituational constraints

clinical decision-making model

ADPIE

• Assessment

• Diagnosis 

  • Nursing diagnosis

• Planning

  • Outcomes identification

• Implementation

• Evaluation 

nursing process

primary clinical decision making model

assessment

• Systematic and continuous collection, organization, validation, and documentation of data about a client

• Continues throughout all steps of the nursing process and creates a database about the client

• Serves as the basis for the individualized plan of nursing care

diagnosis

• Nursing diagnosis focuses on a client’s actual or potential response to a health problem rather than on the physiological event, complication, or disease

planning

Formulate and write outcome/goal statements and determining appropriate nursing interventions based on the client’s reality and evidence (research)

evaluation

Evaluate the outcomes and the nursing care that has been implemented and make necessary revisions in care interventions as needed

cue

information you obtain through the use of your senses

inference

your judgement or interpretation of cues

medical diagnosis

• Identification of a disease condition on the basis of specific evaluation of signs and symptoms

nursing diagnosis

• A clinical judgement about client responses to an actual or potential health problem

collaborative problem

An actual or potential complication that nurses monitor to detect a change in client status

NANDA

• Means of translating nursing observations and assessments into standard conclusions in a common nomenclature

• Provides a precise definition of the client’s needs

• Gives all members of the health care team a common language to use

diagnostic reasoning

A process of using assessment data to create a nursing diagnosis

defining characteristics

Clinical criteria or assessment findings that help confirm an actual nursing diagnosis

clinical criteria

Objective or subjective signs and symptoms that lead to a diagnostic conclusion

actual nursing diagnosis

describes human responses to health conditions or life processes

risk nursing diagnosis

describes human responses to health conditions or life processes that may develop

health promotion nursing diagnosis

Clinical judgement of client’s motivation and desire to increase well being by readiness to enhance specific health behaviors, such as nutrition and exercise

wellness diagnosis

describes levels of wellness in a client that can be enhanced

Maslow’s Hierarchy of Needs

• Pyramid that says a person can’t reach self-actualization until their basic physiological needs are met

SMART Goals

Specific, measurable, achievable, relevant, time bound

short term goal

• An objective client behavior or response expected within hours to a week

long term goal

• An objective client behavior or response expected within weeks, or months

nursing care plans

• End product of planning phase is a formal or informal plan of care

• Formal care plans - written guides that organize and direct nursin care of clients

• Provide continuity of care

• must be individualized

value clarification

• Process of appraising one’s values helps a person decide priorities and make decisions

• Values may change, and a person may modify attitudes and behavior

• Values may conflict between people and between societies

• Relational communication is important for resolving conflict

quantitative research

• Precisely measured and defined

• Experimental

• Quasi–experimental

• Descriptive survey designs

• Exploratory descriptive designs

• Data analysis

qualitative research

• Poses questions about phenomenon that cannot be quantified and measured

• Participatory action research

• Interpretive descriptive research

• Narrative inquiry

• Transferability

research ethics board

• For the rights of research participants

• Principles: respect for human dignity, respect for persons, concern for welfare, respect for privacy and confidentiality, justice

fitness to practice

• All qualities and capabilities of an individual relevant to their practice as a nurse, including but not limited to freedom from any cognitive, physical, psychological, or emotional condition and dependence on alcohol or drugs that impairs their ability to practice nursing

self care

• Individual’s ability and responsibility to engage in healthy lifestyle behaviors that optimize functioning and human development

• Personal, unique, intentional

What are methods of data collection during the assessment stage of the nursing process?

1. Review health records for history/chronic illnesses and treatments

2. Talk to patient/clients and families and staff

3. Review information from course textbooks/past lectures

What are the components of a nursing diagnosis?

1. Diagnostic label

2. Related factors

3. Definition

4. Risk factors

5. Support of the diagnostic statement

What are the three parts to a diagnostic statement?

1. Actual problem

2. Potential problem

3. Wellness response

Why is it important to establish priorities?

1. Ranking diagnoses in order of importance

2. Helps the nurse anticipate and sequence nursing interventions

What factors should be considered when establishing priorities?

1. Client’s health values and belief

2. Client’s priorities

3. Resources available

4. Urgency of health problem

5. Medical treatment plan

What factors should be considered when establishing goals?

1. Client centered

2. Measurable

3. realistic and based on the client’s needs and resources

4. Can be short term or long term

What is the role of the client in goal setting

1. Mutual goal setting

2. Include client and family

3. Active participation

Why is concept mapping used in clinical?

1. Mimics the thought process of the RNs

2. Analyze relationships in data

3. Establish priorities

4. Builds on previous knowledge

5. Facilitate critical thinking

6. Guide patient care

7. working/live document

Understand the process of concept mapping

1. Assessment (patient research)

2. Organizing the data

   1. Reason for admission (medical diagnosis)
      List the symptoms

   2. Cluster related symptoms

   3. Assign data cluster to a gidden’s concept

   4. Formulate a nursing diagnosis for each category

3. Consider related factors

4. Determine key assessment

5. Prioritize

6. Analyze relationships and link nursing diagnosis concepts

7. Develop nursing care plan

Explain the importance of value clarification

1. Important to identify one’s own values and beliefs because it leads to better understanding of others and plays a key role in communication

Understand how to analyze an ethical dilemma

1. Step 1: determine whether the issue is an ethical dilemma

2. Step 2: gather all relevant information

3. Step 3: examine and determine your own values on the issues

4. Step 4: verbalize the problem

5. Step 5: consider possible courses of action

6. Step 6: reflect on the outcome

7. Step 7: evaluate the action and the outcome

Apply the principles of bioethics

1. Determine which principle has priority and use that principle to guide action

2. Autonomy - informed consent

3. Beneficence - vaccination

4. Nonmaleficence - new technology

5. Justice - unbiased allocation of resources

Identify ethical issues in nursing practice

1. Patient care issues

   1. Futile care (treatment that is unlikely to achieve therapeutic goal)

   2. Advance care planning

   3. Medical assistance in dying (maid)

2. Issues of safety and ethics in teh work environment

   1. Social networking and safety

   2. Working with a health care team to promote self care

Explain the major and minor attributes of evidence.

1. Major:

   1. Replicability - repeated

   2. Reliability - consistently and accurately measured

   3. Validity - measure what the study set out to measure

2. Minor:

   1. Publicly available

   2. Understandable

   3. Useable

identify parts of a research report

1. abstract

2. Introduction

3. Literature review or background

4. Manuscript narrative

5. Purpose statement

6. Methods or design

7. Results or conclusions

8. Clinical implications

Know a brief overview of the history of nursing research.

1. Nightingale’s systematic observation of nursing actions and outcomes during the crimean war resulted in significant changes in nursing practice

2. University courses

3. Nursing research joirnals

4. Doctoral programs

5. Funding to support nursing research