Fundamentals Exam 1 Study Guide domains of nursing paradigm - person: individuals, clients, families, groups, and communities - health: providing the best care towards each client - environment/situation: the internal and external surroundings that affect the client - nursing: the attributes, characteristics, and actions of the nurse providing care to the client continuing education classes required for license renewal in-service education on-site education and training provided by many hospitals and health care agencies for nurses and other employees client check ups - check on client every two hours - check for new symptoms - move the patient to avoid pressure ulcers medical dx identification of a disease condition based on specific findings such as diagnostic tests and procedures nursing dx a clinical judgement about the client in response to an actual or potential health problem consultations using the ISBAR approach I- Identify S- Situation B- Background A- Assessment R- Recommendation what is the role of the nurse practice act? - sets a scope of practice - promotes quality of care -protects the client from unqualified individuals what is the role of professional nursing organizations? - scholarships - they publish journals - travel discounts - provides current information for nursing students -networking what is ANA? - protects, promotes, and advances clients' health - averts illness and injuries through health promotion - uses the nursing process to facilitate clients' recovery from illness or injury - minimizes or eliminates clients' suffering - advocate for the care and health of the client, family, or community they created the code of ethics for nurses what does the ANA say about nursing? - changing - promotes well being - dignity - comfort - humanity what are the 6 levels of health care? - preventative - primary - secondary - tertiary - restorative - continuing when does discharge planning begin? - upon admission why are adult day cares needed? - to take care of individuals that can't be alone - provides an opportunity for them to get their medications - prevents them from causing harm to themselves what is expected from the nurse? - professionalism - give the best care - ethical - knowledgeable - be an advocate for the client who is responsible for patient satisfaction? everybody how does the nursing shortage impact nurses? -overworking nurses -lack of educators -quality of the care may be diminished what is the goal for healthy people 2030? make sure everyone has access to healthcare what are some of the variables related to healthcare disparities? -homelessness -disabilities -drug abuse -alcohol abuse -mental health issues what are the benefits of working in a magnet facility? - a bachelors degree is needed - quality of nursing cares - focused on evidence based research - nurses are very involved in research what is community based healthcare? health care assistance at home what is the difference between primary prevention and primary healthcare? - primary prevention: prevents an illness from occurring. -ex. immunizations primary healthcare: treating existing illness community health nursing - nursing practice in the community, with the primary focus on the health care of individuals, families, and groups in a community - goal: preserve, protect, promote, or maintain health public health nursing population-based practice - a synthesis of nursing and public health within the context of preventing disease and disability - treats individuals who have the same illness or health disorder - promotes and protects the health of the entire community why is community assessment important? - community resources to refer clients to, based on their needs - have an understanding of how the community works - understand the environment - you're in clients’ homes so you'll be able to see how they're living - based on surveys you'll be able to know the main problems or diseases in the community how does the community-based nurse change the clients’ health? - provide education - monitor their health role of a nursing educator - provide client education - the goal is to help the client resume responsibility for their own health what are some of the competencies of the community-based nurse? - collaborator - caregiver - case manager - educator - counselor - change agent - researcher - leader change agent - identifies the problem and implements new things that are going to make a difference - the person formally in charge of guiding a change effort what is the nursing theory? - describes, explains, predicts, and provides nursing care - explains the different types of cares - predicts what may happen - provides nursing care what is a vulnerable population? - a population that experiences health disparities as a direct result of a lack of resources - they have high exposure to risk, such as minority populations, the poor, the disabled, and immigrants NANDA - the client's identified need or problem - the underlying cause - signs and symptoms what are NSNA's 6 codes of ethics? - advocacy - leadership - professionalism - care - diversity - quality education florence nighttingale - known as the lady with the lamp - established first nursing philosophy based on health maintenance and restoration - organized first school of nursing - first practicing epidemiologist - improved sanitation in battlefield hospitals - believed that the role of nurses was to help the body recover, and then remain free, from disease florence nighttingale's theory - fresh air - pure water - efficient drainage - cleanliness - light/direct sunlight she believed that a healthy environment was fundamental to healing patricia benner's 5 stage theory - novice - advanced beginner - competent - proficient - expert patricia benner's theory caring is central to nursing and creates possibilities for coping, enables possibilities for connecting with and concern for others, and allows for the giving and receiving help clara barton - founder of the american red cross - provided wartime care to soldiers dorothea e. orem's theory - self-care (self-care, self-care agency, self-care requisites, and therapeutic self-care) - self-care deficit - nursing system care for the client to help attain self-care. madeleine leininger's theory transcultural care in nursing peplau's theory - developing the nurse-client relationship -interpersonal relationship between the nurse, the client, and the client's family henderson's theory assisting the individual sick or well, in the performance of those activities that will contribute to health, recovery or a peaceful death roy's theory the goal of nursing is to help the person adapt to changes in physiological needs, self-concept, role function, and interdependent relations during health and illness watson's theory the purpose of nursing action is to understand the interrelationship among health, illness, and human behavior three levels of prevention - primary prevention - secondary prevention - tertiary prevention primary prevention efforts to prevent an injury or illness from occurring - ex. BP, immunizations, cancer screening, etc. secondary prevention screening to identify diseases in the earliest stages, before it is symptomatic - ex. mammography and regular blood pressure testing tertiary prevention managing disease post diagnosis or stopping disease progression stages of health behavior - pre-contemplation stage - contemplation stage - preparation stage - action stage - maintenance stage pre-contemplation stage has no intention to make any changes within the next 6 months contemplation stage considering a change within the next 6 months preparation stage intends to take action within the next 30 days and has taken some behavioral steps in this direction action stage has changed behavior for less than 6 months maintenance stage has changed behavior for more than 6 months nonmodifiable risk factors - age - gender - genetics - ethnic background - family history modifiable risk factors - tobacco use - alcohol consumption - excess body weight - physical activity - healthy eating primary care - prenatal and well-baby care - nutrition counseling - family planning - exercise planning secondary care - ER care - acute med surg care - radiological procedures tertiary care - high specialized care - intensive care restorative care - cardiovascular and pulmonary rehab - sports medicine - spinal cord injury programs - home care continuing care - assisted living - psychiatric and older adult day care - hospice acute illness - short duration - severe chronic illness persists longer than 6 months subjective data - clients' verbal descriptions of their health problems - includes clients' feelings, perceptions, and self-reported symptoms - information that is given objective data - information resulting from direct observation - what you see, hear, and touch critical thinking - problem identification - collection of data - formulation of a research question or hypothesis - testing the question or hypothesis - evaluating the results of the test or study clinical judgement - reasoning, problem solving, reflection, and individualized plan of care - conclusion about a client's needs or health problems critical thinking and clinical judgement skills - interpretation - analysis - inference - evaluation - explanation - self-regulation clinical decision making - recognize and define problem - assess all options - test possible options - consider consequences - make final decision five step nursing process - assessment - diagnosis - planning - implementation - evaluation assessment collect data about the client's condition diagnosis identify the client's problems planning set goals of care, desired outcomes, and identify appropriate nursing actions implement perform the nursing actions identified in planning evaluate determine if goals and expected outcomes are achieved what are events that should never occur? - injury - death sentinel event an unexpected occurrence involving death, serious physical or psychological injury during covid a client got admitted to the hospital. during a vital sign check, he told the nurse that he feels lonely and the only way to make him happy is to play cards. to help the patient, the nurse went down to the pediatric floor to collect cards and decided to spend 10 minutes playing with the patient. in which category of critical thinking attitudes does this story fall on? creativity a patient continues to report post surgical incision pain at a level of 9 out of 10 after pain medicine is given. the next dose of the pain medication is not due yet. what should the critical thinking nurse do? check the last time pain medications were administered what positive impact does reflection have on the evaluation of clinical judgement? select all that apply. - personal and professional development - improved quality of care - allows nurses to understand and explain what nursing is - improved quality of outcome - promote hospital acquired infections Ans: - personal and professional development - improved quality of care - improved quality of outcome a nurse is assessing a 15 year old female patient who is diagnosed with anorexia. following the assessment, the nurse recommends that the patient meets with a nutritionist. this action best exemplifies the use of: a. clinical judgement b. clinical reasoning c. critical thinking d. blended competencies Ans. a. clinical judgement