NURS 203 Exam 3 Study Guide

Ethics

The study of the standards of moral conduct in a society. Should guide nursing care. They are influenced by our own personal biases.

Beneficence

Doing good; acting on behalf of others and prioritizing their needs.

Nonmaleficence

"First, do no harm"; the avoidance of harm.

Autonomy

Self-determination; the freedom to make health care decisions supported by knowledge and self-confidence.

Justice

The obligation to act fairly and equitably to everyone regardless of income or power.

Veracity

The obligation to always be truthful.

Accountability

The willingness to accept responsibility for one's actions.

Advocacy

Supporting or promoting the interests of others or of a cause greater than oneself.

Confidentiality

The ethical concept that limits sharing private patient information to authorized individuals and agencies.

Fidelity

Keeping promises or agreements made with others.

Responsibility

The concept of being dependable and reliable.

Deontology (duty-based ethics)

An ethical theory focusing only on the rightness or wrongness of individual behaviors, duties, and obligations without concern for the actual consequences.

Utilitarianism

An ethical theory focusing solely on consequences, maintaining that behaviors are right or wrong based on their outcome (acting to bring the greatest happiness to the most people). For the greater good. The right action is one that brings the greatest happiness to the most people

Rights-Based

Focuses on the rights of the individual, not always taking into consideration the effects on society as a whole. Focuses on the rights of the individual without regard to society as a whole.

Justice-Based

Emphasizes that no individual person should have any advantage over another.

Virtue-Based

Focuses on personal traits of individuals rather than societal norms.

Provision 1

The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

Provision 2

A nurse's primary commitment is to the recipient(s) of nursing care, whether an individual, family, group, community, or population.

Provision 3

The nurse establishes a trusting relationship and advocates for the rights, health, and safety of recipient(s) of nursing care.

Provision 4

Nurses have authority over nursing practice and are responsible and accountable for their practice consistent with their obligations to promote health, prevent illness, and provide optimal care.

Provision 5

The nurse has moral duties to self as a person of inherent dignity and worth including an expectation of a safe place to work that fosters flourishing, authenticity of self at work, and self-respect through integrity and professional competence.

Provision 6

Nurses, through individual and collective effort, establish, maintain, and improve the ethical environment of the work setting that affects nursing care and the well-being of nurses.

Provision 7

Nurses advance the profession through multiple approaches to knowledge development, professional standards, and the generation of policies for nursing, health, and social concerns.

Provision 8

Nurses build collaborative relationships and networks with nurses, other healthcare and non-healthcare disciplines, and the public to achieve greater ends.

Provision 9

Nurses and their professional organizations work to enact and resource practices, policies, and legislation to promote social justice, eliminate health inequities, and facilitate human flourishing.

Provision 10

Nursing, through organizations and associations, participates in the global nursing and health community to promote human and environmental health, well-being, and flourishing.

Moral distress

Anguish when basic ethical beliefs or core values are challenged or unable to be acted upon.

Four key components to addressing moral distress

Determine what you are experiencing, identify causes, gauge severity, and take action.

Moral resilience

Capacity to sustain, restore, or deepen integrity in response to moral complexity or setbacks.

God-Centered Ethic

God is the logical starting point for ethical reasoning, moral guide, and authority, recognizing human reason as flawed due to sin.

Reality-Bounded Ethic

God's creation includes both the natural physical world and a moral-spiritual reality, featuring natural physical and moral laws.

Love-Impelled Ethic

The right action is that which is the most loving under the circumstances, provided no God-given realities are violated.

Neighbor Love

Requires discernment to determine the best outcome for the neighbor within the bounds of a reality-bounded ethic.

Health

The WHO defines health as complete physical, mental, and social well-being, not just the absence of disease.

Wellness

A continuous process of self-care achieved by making conscious choices that lead to a healthy life.

Illness

Described as something that can exist at the same time as health, as demonstrated by individuals who experience serious illness or terminal conditions while still experiencing shalom.

Shalom

The ultimate state of wholeness and health, achieved through living according to God's purposes and maintaining harmonious relationships with God, self, others, and the environment.

Wholeness

Health involves the whole person.

Transformation

Health can involve growth and change.

Relationship

Relationships with God and other people are important to health.

Coping and adaptation

Health includes the ability to respond to difficulties and adjust to circumstances.

Human paradox

People can experience health and wholeness even while dealing with illness, suffering, or death.

Basic Human Needs Model (Maslow)

Uses a humanistic approach based on a hierarchy of needs. Basic physiologic requirements must generally be met before higher-level needs like self-actualization, though exceptions exist in clinical practice.

Health Belief Model (HBM)

Predicts how a patient's attitudes and beliefs influence their health behavior. It is based on perceived susceptibility to an illness, perceived severity of the illness, and the likelihood of taking preventive action. Includes self-efficacy (confidence in one's ability to act).

Health Promotion Model (HPM)

Focuses on the multidimensional interaction between an individual and their environment. Differentiates between health promotion (behaviors that increase well-being) and health protection (behaviors aimed at circumventing illness). 1. Individual characteristics and experiences. 2. Behavior-specific knowledge. 3. Behavioral outcomes

Holistic Health Models

Emphasizes the synergistic mind-body-spirit connection and the body's natural ability to heal. Involves complementary interventions like guided imagery, therapeutic touch, and relaxation techniques.

Social Determinants of Health (SDOH)

Environmental conditions shaped by resource distribution, including access to education, economic stability, safe neighborhoods, social/community and health care.

Biologic and Genetic Factors

Age (the very young and older adults have lower immune function), gender-specific risks, and inherited genetic vulnerabilities.

Lifestyle and Environment

Modifiable behaviors (diet, physical inactivity, substance use) and exposure to indoor/outdoor hazards (toxins, poor sanitation, unsafe living conditions).

Psychosocial Factors

An individual's self-concept, developmental level, the influence of peers and family, and specific cultural or spiritual traditions.

Kübler-Ross: Denial

"This isn't happening"

Kübler-Ross: Anger

"Why me?"

Kübler-Ross: Bargaining

"I'll do anything to fix this"

Kübler-Ross: Depression

"What's the point?"

Kübler-Ross: Acceptance

"I can figure out how to move forward"

Complicated Grief

When a person gets "stuck" in intense grief for a long time (at least 6 months), making it hard to live a normal life.

Chronic Grief

The intense feelings just never seem to fade.

Delayed Grief

Pushing the feelings down and avoiding the pain at first.

Exaggerated Grief

Feeling totally overwhelmed. People might turn to drugs, alcohol, or self-destructive habits to cope.

Masked Grief

When a person's behavior changes in bad ways, but they don't realize it is because they are grieving.

Disenfranchised Grief

When a person experiences a loss, but society doesn't openly accept or support it.

1955 ANA Definition

Emphasized observing, caring, counseling, supervising, teaching, and administering treatments prescribed by physicians or dentists, reinforcing nurse subordination.

1980 ANA Definition

Described nursing as the 'diagnosis and treatment of human responses' to health problems.

1995 ANA Revision

Emphasized human experiences and responses, combining objective and subjective data, scientific knowledge, caring relationships, and greater autonomy.

Belief

A mental representation of reality or a person's perception of what is right, true, or real.

First-Order Beliefs

The foundation of an individual's belief system, developed in early childhood through direct experiences and authority figures.

Higher-Order Beliefs

Generalizations, stereotypes, or prejudices derived from first-order beliefs using reasoning.

Values

Enduring ideas about what a person considers good, right, and desirable in life.

Values System

A hierarchical set of consistent values that guide decision-making and behavior.

Values Clarification

A therapeutic process that helps individuals identify, examine, and prioritize personal values.

Values Conflict

An actual or perceived difference between two or more belief systems.

Generalization

A broad mental shortcut or statement based on observed patterns that applies a general trend to a group while often overlooking individual differences.

Stereotype

An oversimplified, rigid belief that applies a fixed set of traits to every single member of a specific group regardless of their actual reality.

Prejudice

An emotional, often negative prejudgment or attitude directed at individuals based solely on their perceived membership in a group.

Compassion

Acting on sympathetic and empathetic responses to relieve patient suffering.

Presence

Intentional relational engagement that creates human connectedness and promotes healing.

Types of Touch

Includes task-oriented touch, caring touch, healing touch, and therapeutic touch.

Active Listening

Fully concentrating, observing body language, and using multiple senses to understand the patient's entire message.

Madeline Leininger: Theory of Cultural Care Diversity and Universality

Emphasizes culturally congruent care, using nursing actions like preservation, accommodation, and repatterning.

Jean Watson: Theory of Caring

A holistic model focused on ten caritas processes and transpersonal nurse-patient relationships.

Kristen Swanson: Theory of Caring

Defines caring as a nurturing way of relating, built on five core processes: knowing, being with, doing for, enabling, and maintaining belief.

Boykin and Schoenhofer: Theory of Nursing as Caring

Focuses on the mutual experience of persons living caring and growing in caring within a nursing situation.