funda lec_Basic Concepts of Nursing- Exam #1

Health

*defined by WHO as "state of complete physical, mental, and socialwell-being, not merely the absence of disease or infirmity"
*is a state of being that people define in relation to their own values, personality, and lifestyle

Illness

*state where physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired

Acute Illness

short duration and severe

Chronic Illness

persists more than 6 months

Primary prevention

*Aims to prevent disease or injury before it ever occurs;
*This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur.

Secondary prevention

*Aims to reduce the impact of a disease or injury that has already occurred.
*This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress, encouraging personal strategies to prevent reinjury or recurrence, and implementing programs to return people to their original health and function to prevent long-term problems.

Tertiary prevention

*Aims to soften the impact of an ongoing illness or injury that has lasting effects.
*This is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases, permanent impairments) in order to improve as much as possible their ability to function, their quality of life and their life expectancy. Examples include

Pender health promotion model

Focuses on the following:
1. Individual characteristics and experiences
2. Behavior-specific knowledge and affect
3.Behavioral outcomes, in which a patient commits to or changes behavior

Basic human needs model

Maslow: emphasizes identifying a
patient's individual needs, prioritizing the needs, and encouraging the patient's individual discovery
1. physiological - food water shelter warmth
2. safety- security stability freedom from fear
3. belonging & love - friends family spouse lover
4. self esteem - achievement mastery recognition respect
5. self actualization- pursue inner talent creativity fulfillmen

Holistic health model

Promote optimal health by incorporating active
participation of patients in improving their health state

*The nurse recognizes the natural healing ability of the body

*It attempts to create conditions for optimal health.

*It incorporates complementary and alternative therapies into nursing care.

Henderson

Theory; 14 basic needs of whole person (phys, psych etc.) client centered

Roy

*Theory
* Explains the adaptation model and considers the patient to be an adaptive system
* The patient adapts to changes in physiological needs, self-concept, and interdependent relations during health and illness

Nightengale's environment theroy

*A patients environment, which nurses should manipulate so nature is able to restore patient to health.

*Grand theory - a patients environment, which nurses should manipulate so nature is able to restore patient to health.

Peplau's interpersonal theory

*Focus on interpersonal relations between nurse, patient, and patient's family

*Middle-range theory - nurses help patients reduce their anxiety by converting it into constructive actions.

Preoperational

Interpersonal; Data gathering
*ex: looking at person chart

Orientation

Interpersonal; Defining Issue
*ex: Introduce yourself

Working Phase

Interpersonal; Therapeutic activity
*ex: open and close ended questions

Resolution

Interpersonal; Termination of relationship
ex: summarizing (discharge planning begins the
moment the patient walks in), continuing health needs at home

Orem's self-care deficit theory

*Focuses on patient's self-care needs; commonly used in nursing practice

*Goal is for patient to manage his or her health problems.

*Grand theory- a nurse continually assesses a patients ability to perform self-care and intervenes as needed to ensure that the patient meets physical, psychological, sociological, and developmental needs.

Leininger's culture care theory

* Theory deals with protecting the traditions and cultural beliefs of the patient
*Integrates patients' cultural traditions, values and beliefs into care plans
*Middle-range theory- cultural diversity, and the goal of nursing care is to provide a patient with culturally specific nursing care
-Recognizes the importance of culture and the influence it has.

Intrapersonal

Communication with self

Interpersonal

one on one communication

Transpersonal

*Deals with spiritual domain
*of, denoting, or dealing with states or areas of consciousness beyond the limits of personal identity.

Metacommunication

*all the nonverbal cues (tone of voice, body language, gestures, facial expression, etc.) that carry meaning that either enhance or disallow what we say in words.
*There's a whole conversation going on beneath the surface.

Facilitation

encourages patients to say more and shows you are interested and will listen further

Silent attentiveness

*Gives patient time to think and organize what to say without interruption from you

*Gives you a chance to observe person unobtrusively and note nonverbal cues

Reflection

Echoes patient's words, repeating what person has just said, focuses further attention on a specific phrase, and helps person continue in his or her own way

Empathy

*Recognizes a feeling and puts it into words
*Names the feeling and allows expression of it
- Patient feels accepted and can deal with feeling openly

Clarification

*Use when person's words are ambiguous or confusing
-Used to summarize person's words and to simplify them to make them clearer

*You are asking for agreement, and the person can then confirm ordeny your understanding

Confrontation

*Frame of reference shifts from patient's perspective to yours
-May focus on discrepancy or inconsistency in person's
narrative
-You have observed a certain action, feeling, or statement and now focus person's attention on it
-You give honest feedback about what you see or feel

Interpretation

* Based on your inference or conclusion
* It links events, makes associations, implies cause, ascribes feelings
*Helps person understand his or her own feelings in relation to the verbal message
*If your inference is incorrect, the patient may correct it and thus prompt further discussion of topic

Explanation

These statements inform the person; you share factual and objective information, offering reasons for requirements or actions

Aphasic

A language disorder that affects a person's ability to communicate.

Intimate zone

(0-18 inches) where nurses are constantly, need permission to enter
1. holding infant
2. doing physical assessment
3. bathing, grooming, dressing, feeding, toileting patient
4. changing patient's dressing

Personal zone

18 inches- 4ft
1. sitting at patient's bedside
2. taking patient's nursing history
3. teaching an individual patient
4. exchanging info at change of shift

Social zone

1. making rounds
2. sitting at the head of a conference table
3. teaching class

Public zone

12 feet and greater
1. speaking at community forum
2. testifying at legislative hearing

Clara Barton

*founder of American Red Cross tended to soldiers on battle fields, cleansing their wounds, meeting their basic needs and comforting them in death.

Mother Bickerdyke

- organized ambulance services and walked among
battle field at night looking for wounded soldiers

Harriet Tubman

active in the underground railroad movement and
helped lead over 300 slaves to freedom

Mary Mahoney

The first trained African-American nurse and brought forth awareness of cultural diversity and respect for individual, regardless of background, race , color and religion

Novice

*Beginning nursing student or may nurse entering a situation in which there is no previous level of experience.

*This learner learns via specific set of rules or procedures, which are usually stepwise and linear

Advanced beginner

*A nurse who has had some level of experience with the situation.
*This experience maybe only observation in nature, but the nurse is able to identify meaning aspects or principles of nursing care

Competent

A nurse who has been in the same clinical position for 2 to 3 years.
This nurse understand the organization and specific care required by the type of patients. He or she is a competent practitioner who is able to anticipate nursing care and establish long-range goals. In this phase the nurse has usually had experience with all types of psychomotor skills required by this specific group of patients.

Proficient

*A nurse with more the same clinical position.
*This nurse perceives a patient's clinical situation a while, is able to assess an entire situation, and can readily transfer knowledge gain from multiple previous experiences to a situation.
*This nurse focuses on managing care as opposed to managing and preforming skills.

Expert

*A nurse with diverse experience who has an intuitive grasp of an existing or potential clinical problem.

*This nurse is able to zero in on the existing or potential clinical problem.

*This nurse is able to zero in on the problem and focus on multiple dimensions of the situation.

*He or she is skilled at identifying both patient-centered problems and problems related to the health care system or perhaps the needs of the novice nurse.

American Nurses Association (ANA)

*Lobby, help state legislature, legal aspects
* A professional organization to advance and protect the profession of nursing.

National League for Nursing (NLN)

sets standards for excellence and innovation in nursing education, addresses concerns of nurses

International council of nurses (ICN)

Promotion of national associations of nurses, improving standards of nursing practice, seeking a higher status for nurses, and providing an international power base for nurses

Code of Ethics

Defines principles for nurses to give care; what is right and wrong.

Healthy people 2010

*outlines health goals for public - eliminates DISPARITIES

*Achieve health equity and eliminate disparities
*Attain high-quality longer lives free of preventable diseases.
*Create social and physical environments that promote good health for all.

Standards of care

assess clients, quality of care and competency

Nurse practice act

regulate license and practice = scope;
Protection shields the public from unqualified and unsafe nurses.

National council/ NCLEX-RN

provides minimal knowledge required for nurses ...remember ( this is a test questions) Which standards of nursing take the NCLEX- RN... Its all except LVN...Lvn's take the NCLEX, but not the same one!

Autonomy

Freedom from external control or influence;
independence (self-governing).

Societal

demographic change, womens healthcare, human rights, medically underserved, bioterrorism, cultural diversity, safety

ANA 9 standards or professional performance

Quality of practice, education, professional practice evaluation, collaboration, ethics, research, resources, leadership

Advocate

Role of a nurse; speaks for the patient to the family/other caregivers, defend clients
rights

Caregiver

Role of a nurse; manage healthcare needs (spiritual, social, emotional)

Manage

Role of a nurse; Coordinates activities (staff, policies, budget)

Educator

Role of a nurse; Explains concepts and demonstrates self care

Direct

*Modes of infection transmission
*person to person (fecal, oral) physical contact between source and susceptible host (ex: touching patient feces and then touching your inner mouth or consuming contaminated food)

Indirect

*Modes of infection transmission
*personal contact of susceptible host with contaminated inanimate object (ex: needles or sharp objects, dressings, environment)

Droplet

*Modes of infection transmission
*large particles that travel up to 3 ft during coughing, sneezing, or talking and come in contact with susceptible host

Airborne

*Modes of infection transmission
*droplet nuclei or residue or evaporated droplets suspended in air during coughing or sneezing or carried on dust particles

Vehicles

*Modes of infection transmission
*contaminated items, water, drugs, solutions, blood, food (improperly handled, stored, or cooked)

Vector

*Modes of infection transmission
*external mechanical transfer (flies); internal transmission such as parasitic conditions between vector and host such as: mosquito, loue, flea, tick

Infection

*Invasion and multiplication of organisms
*A susceptible host by pathogens or microorganisms -> disease

Agent

*something that causes an effect
*ex: bacteria causing disease = agents of the specific diseases they cause

Reservoir

place where microorganisms survive, multiply, and await tranfer

Exit portal/Entry portal

*organisms enter the body through the same routes they use for exiting
*examples: blood, skin, mucous membranes, respiratory tract,
genitourinary tract, gastrointestinal tract, and transplacental (mother
to fetus)

Host

*the organism from which a parasite obtains its nourishment
*ex: the patient

Asepsis

the absence of disease producing microorganisms; the absence of bacteria, viruses, and other microorganisms

Watson transpersonal caring

Altruistic, faith/hope, sensitivity, help/trust, express feelings, problem solve, teaching, support/protect, human needs, spiritual

Benner and Wrubel

caring and compassion is an essential human need,necessary for survival, health and wellbeing

Swanson

understanding, presence, do unto others, enable/help with life transitions, maintain belief/hope and give meaning to the future

Nursing centers or facilities

nursing homes and facilities
dedicated to long-term care

Assisted living

*One of the fastest growing in the U.S.

*It's along-term care setting more like home and greater resident autonomy.

Respite care

a service that provides short term relief or "time

Adult day care centers

provide a variety of health and social services to specific patient populations who live alone or with family in the community.

Hospice

A system of family-centered care that allows patients to live with comfort, independence, and dignity while easing the pains of terminal illness.

Assessment

*1st step of the nursing process
*gather data (vitals, interview, physical)

Diagnose

*2nd step of nursing process
*identify human response to problem, cluster clues and prioritize care

Planning

*3rd step of nursing process
*make a care plan to achieve goals

Implemntation

*4th step of nursing process
*deliver care (administer medications)

Evaluate

*5th step of nursing process
*determine if goals were met, follow up

Emotional support

Talking to the patient and sharing the patient's fears and concerns

Health belief model

*Addresses the relationship between a person's beliefs and behaviors and the impact of those beliefs on health.

*The individual's perception of susceptibility to an illness affects behavior towards the illness.

*An individual who perceives an increased susceptibility to an illness may take preventive action against the illness.

*An individual who perceives that the illness is serious may seek medical advice.

*The likelihood that a person will take preventive action

Knowing

*Swanson's Theory of Caring
*Striving to understand an event as it has meaning in the life of the other

*Avoiding assumptions
*centering on the one cared for
*Assessing thoroughly
*Seeking clues to clarify the event
*Engaging the self or both

Being with

*Swanson's Theory of Caring
*Being emotionally present to the other

*Being there
*Conveying ability
*Sharing feelings
*Not Burdening

Doing for

*Swanson's Theory of Caring
*Doing for the other as he or she would do for self if it were at all possible

*Comforting
*Anticipating
*Performing skillfully
*Protecting
*Preserving dignity

Enabling

*Swanson's Theory of Caring
*Facilitating the other's passage through life transitions (e.g. birth, death)

*Informing/explaining
*Supporting/ allowing
*Focusing
*Generating alternative
*Validating/ giving feedback

Maintaining belief

*Swanson's Theory of Caring
*Sustaining faith in the other's capacity to get through an event or transition and face a future with meaning

*Believing in/ holding in esteem
*Maintaining a hope-filled attitude
*Offering realistic optimism
* "Going the Distance"

Caring touch

A form of nonverbal communication, which successfully influences a patient's comfort and security, enhances self esteem, increases confidence of the caregivers, and improves mental well-being.

Protective touch

*A form of touch that protects a nurse and/ or patient

*The patient views it either positive or negatively
*Preventing falls
*It protects the nurse emotionally
*It protects the nurse and and the patient

Theory generating research

*Identifies observations or describes phenomena
*Discovers relationships of phenomena to practice
*Builds a scientific knowledge base of nursing.

Preventative care

*Blood pressure
*Immunization
*Mental Health counseling and crisis prevention
*Community legislation (e.g. seat belts, air bags, bike helmets, no texting while driving)

Primary care

*Focuses on improved health outcomes for an entire population

*Prenatal and well-baby care
*Nutrition counseling
*Family planning
*Exercise, yoga, and medication classes

Secondary acute care

*Emergency care
*Acute medical-surgical care
*Radiological procedures for acute promblem

Restorative care

*Cardiovascular and pulmonary rehabilitation
*Orthopedic rehabilition
*Sports medicine
*Spinal cord injury programs
*Home care