Exam 3 Flash Cards

  1. Advocacy: protection and support of another’s rights

  2. Autonomy: self-determination; being independent and self-governing

  3. Beneficence: principle of doing good

  4. Bioethics: ethics that encompass all those perspectives that seek to understand human nature and behavior, the domain of social science, and the natural world

  5. Care-based approach: approach to bioethics that directs attention to the specific situations of individual patients viewed within the context of their life narrative

  6. Code of ethics: principles that reflect the primary goals, values, and obligations of the profession

  7. Conscientious objection: refusal to participate in certain types of treatment and care based on the fact that these activities violate the nurse’s personal and professional ethical beliefs and standards

  8. Deontological: ethical system in which actions are right or wrong independent of the consequences they produce

  9. Moral agency: ability to behave in an ethical way; to do the ethically right thing because it is the right thing to do

  10. Ethical dilemma: situation that arises when attempted adherence to basic ethical principles results in two conflicting courses of action

  11. Ethics: system dealing with standards of character and behavior related to what is right and wrong

  12. Feminist ethics: type of ethical approach that aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor

  13. Fidelity: keeping promises and commitments made to others

  14. Justice: process that distributes benefits, risks, and costs fairly

  15. Moral distress: is a predictable response to situations where nurses recognize that there is a moral problem

  16. Moral resilience: developed capacity to respond well to morally distressing experiences and to emerge strong

  17. Morals: like ethics, concerned with what constitutes right action; more informal and personal than the term ethics

  18. Nonmaleficence: principle of avoiding evil

  19. Nursing ethics: a subset of bioethics, formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgments

  20. Principle-based approach: an approach to bioethics that offers specific action guides

  21. Utilitarian action: guiding theory of ethics that states that the rightness or wrongness of an action depends on the consequences of the action

  22. Values: set of beliefs that are meaningful in life and that influence relationships with others

  23. Value system: organization of values ranked along a continuum of importance

  24. Values clarification: process by which people come to understand their own values and value system

  25. Virtues: human excellences, cultivated dispositions of character and conduct that motivate and enable us to be good human beings

  26. Negligence: doing something or failing to do something that a prudent, careful, and reasonable nurse would do or not do

  27. Malpractice: the nurse does not fulfill the duties in a way that a competent nurse would practice in the same situation

  28. Value System: organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct

  29. Modeling: learn what is of high or low value by observing parents, peers, and significant others. Thus, modeling may lead to socially acceptable or unacceptable behaviors

  30. Moralizing: taught a complete value system by parents or an institution (e.g., church or school) that allows little opportunity for them to weigh different values

  31. Laissez-faire: to explore values on their own (no single set of values is presented as best for all) and to develop a personal value system. This approach often involves little or no guidance and may lead to confusion and conflict

  32.  Rewarding and Punishing: rewarded for demonstrating values held by expectations and punished for demonstrating unacceptable values

  33.  Responsible Choice: to explore competing values and to weigh their consequences. Support and guidance are offered in developing personal value system

  34. Giving Voices to Values - ethical implementation → What is the right thing to do?

  35. Moral Injury - betrayal of what is right or someone who holds legitimate authority or by oneself

  36. Conscientious Objective: refusal to participate in certain types of treatment and care based on the fact that these activities violate the nurse’s personal and professional ethical beliefs and standards

  37.   Representing Patients: nurses have resources available to help and arrange referrals from other healthcare workers to achieve desired outcomes

  38. Promoting Self-Determination: being able to make decisions → nurses can educate the public about the value of written advanced directives, nurses facilitate their own patient’s decision making, call in those people who should be involved (family, primary nurse, HCP, or clergy) and help patients assess options. Nurses can help delegate decisions to a preferred decision maker whom they trust

  39. Making Ethical Decision: Assess the situation and gather data, diagnose or identify the ethical problem, Plan by identifying options, thinking about the ethical problems thoroughly and making a decision, Implement and evaluate your decision

  40. Paternalism: An example of ethical problems that states should the nurse act against the patient’s wishes to prevent harm, even if it violates their autonomy?

  41. Deception: An example of ethical problems that states if it is acceptable for a student nurse to lie about prior experience to ease a patient’s anxiety

  42. Allocation of Scarce Nursing Resources: How should a nurse prioritize care when staffing is insufficient, and multiple patients have urgent needs?

  43. Valid Consent or Refusal: Should a nurse administer medication to a patient who no longer consents to a procedure?

  44. Conflicts Concerning New Technologies: How should a nurse respond to a patient’s concerns about in vitro fertilization while respecting their ethical reservations?

  45. Unprofessional, Incompetent, Unethical, or Illegal Physician Practice: Should a nurse report a surgeon suspected of substance abuse, especially when patient concerns arise?

  46. Unprofessional, Incompetent, Unethical, or Illegal Nurse Practice: How should a nurse handle an allegation of inappropriate behavior by a colleague, especially if personal bias is involved?

  47.   Short Staffing Issues: How should a nurse address chronic understaffing and patient risk, especially considering potential strikes or public action?

  48. Beginning-of-Life Issues: How should a nurse navigate the conflict between personal ethical beliefs and institutional policies when assisting a patient with an unplanned pregnancy?

  49.  End-of-Life Issues: How can a nurse reconcile their professional duties with personal religious beliefs when a terminally ill patient requests assisted suicide?

  50. Purpose of Ethical Committee: Have staff to call if the HCP is not respecting patient’s wishes and ensuring patient safety with their practice

  51. Whistleblowing: Reporting unsafe care, negligence or malpractice of a HCP, speaking out

  52. Law = a standard or rule of conduct established and enforced by the government that is intended chiefly to protect the rights of the public

  53. Constitutions: indicate how the federal and state governments are created, and they give authority and state the principles and provisions for establishing specific laws

  54. Statutory Law: must be in keeping with both the federal constitution and the state constitution; Nurse practice acts are an example

  55. Administrative Law: administer facilities that, among other functions, are responsible for law enforcement. These facilities have the power to make administrative rules and regulations, in conformity with enacted law, that act as laws and are enforceable

  56. Common law: Court-made law. Most law involving malpractice is common law

  57. The Nurse Practice Act: describes and defines the legal boundaries of nursing practice within each state

  58. Standards - the legal requirements for nursing practice that describe minimum acceptable nursing care

  59. Accreditation: process by which an educational program is evaluated and recognized as having met certain standards

  60. Licensure: process by which a state determines that a candidate meets certain minimum requirements to practice in the profession and grants a license to do so

  61. Certification: process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area

  62. Crime = violation punishable by the state

  63. Misdemeanor: less serious crime, commonly punishable with a fine, imprisonment for less than 1 year, or both, or with parole

  64. Felony: crimes like rape or murder and is punishable by imprisonment in a state or federal penitentiary for more than 1 year

  65. Tort = may be intentional or unintentional acts of wrongdoing

  66. Assault: threat or an attempt to make bodily contact with another person without that person’s consent; more like VERBAL

  67. Battery: carried out and includes willful, angry, and violent or negligent touching of another person’s body or clothes or anything attached to or held by that other person; more like PHYSICAL

  68.  Defamation: intentional tort in which one party makes derogatory remarks about another that diminish the other party’s reputation

  69. False Imprisonment: Unjustified retention or prevention of the movement of another person without proper consent can constitute false imprisonment

  70.   Fraud: willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property

  71.   Negligence: Unintentional mistake or error in judgement by not providing proper care for patients

  72. Malpractice: Typically, intentional misconduct or disregard for patient safety

  73. Duty: Accurate assessment of patient assigned under their care, alerting HCP changes in patient’s condition, competent execution of safety measure for patients

  74. Breach of Duty: Failure to note and report changes or important aspect of patient’s condition upon admission and throughout care, failure to execute document use of appropriate safety measure (ex. Bed rails, restraints use, bed at lowest position)

  75.   Causation: Failure to use appropriately safety measures (ex. Patient falling while getting out of bed resulting in fractured hip)

  76. Damages: things like fractured hip, pain and suffering, lengthened hospital day

  77. Just Culture: encourages open reporting of errors, recognizes that errors may be systemic rather than personal failures, and focuses on determining the root of the problem when events such as errors and near misses occur

  78.   OSHA: (Occupational Safety and Health Administration) sets and enforces workplace safety and health standards to protect employees such as safe working condition, proper handling of hazardous materials, infection control

  79.   HIPAA: (Health Insurance Portability and Accountability Act) establishes standards to protect the privacy and security of patients' health information

  80. ADA: (Americans with Disabilities Act) prohibits discrimination based on disability and mandates reasonable accommodations in the workplace and public spaces

  81. EMTALA: (Emergency Medical Treatment and Labor Act) requires hospitals to provide emergency medical treatment to individuals regardless of their ability to pay

  82. Actual: recognized by others as well as by the person sustaining the loss ( Ex. loss of a limb, a child, a valued object such as money, and a job)

  83. Perceived: loss of youth, financial independence, or a valued environment, is experienced by the person but is intangible to others

  84. Anticipatory: when a person displays loss and grief behaviors for a loss that has yet to take place

  85. Mourning: the actions and expressions of that grief, including the symbols and ceremonies

  86. Bereavement: state of grieving due to loss of a loved one

  87. shock and disbelief = 1st stage of grief; refusal to accept the fact of loss

  88. developing awareness = 2ndstage of grief; physical and emotional responses such as anger, feeling empty, and crying

  89. restitution = 3rd stage of grief; rituals surrounding loss; with death, it includes religious, cultural, or social expressions of mourning

  90. resolving the loss = 4th stage of grief; dealing with the void left by the loss

  91.   idealization = 5th stage of grief; exaggeration of the good qualities of the person or object, followed by acceptance of the loss and a lessened need to focus on it

  92.   outcome = 6th stage of grief; final resolution of the grief process

  93. Terminal Illness = illness in which death is expected within a limited period of time, the health care provider is usually responsible for deciding what, when, and how the patient should be told

  94. Palliative Care: taking care of the whole person—body, mind, and spirit; heart and soul. It views dying as something natural and personal

  95. Goal of Palliative Care: give patients with life-threatening illnesses the best quality of life they can have by the aggressive management of symptoms

  96. Hospice Care: care provided for people with limited life expectancy, often in the home

  97. Goal of Hospice Care: focuses on the needs of the dying

  98. Explicit Power: Clearly Outline in written policies or job descriptions

  99. Implied Power: Derived from nurse’s expertise and is not explicitly stated; ability to influence or make a decision based off of it

  100.  Autocratic: also called directive leadership or authoritarian leadership, involves the leader assuming control over the decisions and activities of the group

  101. Democratic: also called participative leadership, is characterized by a sense of equality among the leader and other participants

  102. Laissez-Faire: also called nondirective leadership, the leader relinquishes power to the group, such that an outsider could not identify the leader in the group

  103. Servant: philosophy and set of practices that enriches the lives of individuals, builds better organizations, and ultimately creates a more just and caring world

  104.   Transformational: create revolutionary change

  105. Quantum Leadership: views an organization and its members as interconnected and collaborative—a helpful approach when unpredictable events and changing environments present themselves

  106. Transactional leadership: based on a task-and-reward orientation

  107.   Conscious: Delirium, dementia, confusion, normal consciousness, somnolence, minimally conscious states, locked-in syndrome

  108. Somnolence: Extreme drowsiness BUT will respond to stimuli

  109.   Locked-in Syndrome: Full consciousness; sleep–wake cycles present; quadriplegic, auditory and visual function preserved; emotion preserved

  110. Unconscious: Asleep, stupor, coma, vegetative state

  111. Stupor: Can be aroused by extreme and/or repeated stimuli

  112. Coma: Cannot be aroused and does not respond to stimuli (coma states can be further subdivided according to the effect on reflex responses to stimuli

  113. Third Spacing: Fluid EXCESS in third space (peritoneal or interstitial space) BUT Fluid DEFICIT in the vascular space; Causes: liver failure, renal failure, heart failure, severe burns, gross tissue trauma; S/S: Both signs and symptoms of Fluid Deficit and Fluid Overload; Treatment: Shift fluid back into vascular space; that can depend on the cause of it

  114. Pre-transfusion: Obtain type and crossmatch, vital signs; safety checks; IV placement – 18-24 gauge; Blood must be returned to the blood bank if it is not started within 30 minutes

  115. Transfusion: Blood is initiated once safety checks are performed, An in-line filter is used (special IV tubing), RN MUST stay with patient for the first 15 minutes to monitor for s/s of reaction,   After 15 minutes, another set of VS are obtained and then Q1H and once completed

  116. Post-transfusion: Continue to monitor for transfusion reactions, can occur up to 24 hours post infusion OR delayed reaction- several days post infusion, If giving another unit of blood, must start process again and obtain new IV tubing

  117. Allergic reaction: Hives, itching, anaphylaxis

  118. Febrile reaction: Develops during infusion, fever and chills, headache

  119. Hemolytic reaction: Incompatibility of blood products, immediate onset of facial flushing, fever, chills, headache, low back pain (kidney pain)

  120.   Bacterial reaction: Bacteria in donor blood, fever hypertension, dry, flushed skin, abdominal pain

  121. Circulatory overload: FVE, dyspnea, dry cough, pulmonary edema (Slow the infusion rate and give Diuretics between unit)