The purpose of Nursing Theories is:
guide the nursing practice
guide nursing research
guide nursing education
What are some "Advanced Practice" Nurses?
Clinical Nurse Specialist
LHUP Definition of Nursing
it is an art and a science characterized by critical thinking, clinical competence, accountability, and commitment to the value of caring and interdisciplinary collaboration. Applies to persons across the lifespan and within various cultures. Based upon interpersonal communications amoung the individual, the family and the nurse. Involves assessing, planning, implementing and evaluating the human needs of the individual in health and illness. Includes health teaching by the Nurse to assist individuals in the promotion and maintenance of health. In cooperation with other members of the health team. Nursing care is delivered in accordance with the legal and ethical standards of the nursing profession and in responce to societal health needs.
What are some of the body's responses to stress?
Increased mental activity
increased respiratory rate
increased heart rate
increased cardiac output
increased arterial blood pressure
incrreased fatty acids
increased blood flow to skeletal muscles
What are the various levels of Communication?
What is ANA?
American Nurses Association
The protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families, communities, and population.
What are the "Therapeutic Techniques?"
Active listening, Touch, Humor,Silence, Providing, Information, Clarifying, Focusing, Paraphrasing, Asking relavant questions, Summarizing, Open ended questions
Maslow's Theory states what Physiological Needs?
Air, Water, Food, Tempreature maintenance, Elimination, Shelter, Rest/sleep, Sex
What are the 5 characteristics of "Therapeutic Communications?"
1. Empathy-nurse is sensitive but remains objective
2.Respect-refer to clients as Mr. or Mrs.
3.Genuineness-Be honest and sincere
4.Concreteness-be specific with instructions and questions
5.Confrontation-used as a means of obtaining information from the client for further clarity.
What are Maslows Hierarchy of Basic Needs?
Safety and security
What is application of the Hierarchy?
consider all the factors that influence a patients perception of his/her needs. Do not impose your personal perceptions about what an individual's need priorities should be. All needs exist simultaneosly and in different degrees. A patient is a holistic being, he/she has intellectual, emotional, social and spirital side as well as a physiological side.
What is the Emotional/Social Dimension Assessment of Stress?
change in behavior, depressed anxious, hostile, emotional outburst, increased use of drugs and alcohol, changes in sleep, activity and eating patterns, and poor hygiene
Explain Non-Therapeutic Communication?
Giving your personal opinion, false reassurance, being defensive, showing approval and disapproval, stereotyping, asking why, changing the subject inappropriately, close ended questions, and sympathy
What are some types of Nurses?
What is the Intellectual Dimension Assessment of Stress?
Unable to concentrate, Unable to solve problems, Unable to learn,Unable to remember, Unable to organize and plan.
What are the 4 phases of a Helping Relationship?
1. Pre-Interaction-occurs before meeting the client, obtaining informaiton about the client.
2. Orientation- begins when nurse and client identify each others names. May have a written contract, the nurse assesses the clients problems
3.Working Phase- longest phase, nurse and client work together to meet the clients needs to develope goals.
4. Termination- conclusion of the relationship could be the end of the shift or the patient is discharged.
What are some "factors" to consider with verbal communication?
Denotation or dictionary meaning and Connotation or the emotional meaning
Intonation or reflection of the feeling, pitch or tone
Clarity and Brevity
What is a Helping relationship?
Exist among people who provide assistance with the goal of meeting the clients needs. Such as a nurse is helping a patient to learn how to administer their own insulin
What are the factors "influencing" communication?
Level of development
Roles and responsibilities
Space and Territoriality
Physical, mental, and emotional state
What are types of Non-Verbal Communication?
Physical appearance such as manner of dress or grooming- posture-gait-eye contact-gestures-sounds-touch
What is Continuing care's purpose and what types of locations?
care of the chronically ill and disabled who will never function independently.
Nursing homes, assisted living , respite care, adult day care, Hospice, Arrea agency on aging
What is the purpose for Secondary and Tertiary care and it's locations?
Emergency care, intense and deliberate diagnosis and treatment, specialized care.
What are the purposes for Preventative and Primary care and their locations?
Prevention and education and early detection and routine care.
Physician offices, school health services, Occupational health services, Clinics, Nursing centers,Block and Parish Nurses.
What are the 6 levels of care in the Health care Delivery System?
Explain Managed Care?
Rose to dominance during Regan presidency as a means to control medicare payments and spread quickly to health insurance industry private sector.
Insurance companies define a resonable maximum fee in which health care providers may charge.
Providers are bound to these fees if they wish to be listed in directories of insurance companies.
Explain Utilization Review?
Special committees at hospitals that review admissions, diagnostic testing and treatments provided by physicians to clients.
Goal is to eliminate overuse of diagnostic and treatment services.
Explain Diagnosis-Related groups?
A system designed to cluster groups of clients together by diagnosis, surgical proceedure, complications, preexisting illness and age.
Each client with a particular diagnosis is reimbursed the same regardless of length of stay or cost of treatment.
There are about 500 groups.
What are the 3 things in Health care Regulation?
What are some variabloe influencing Health beliefs and practices?
Internal Variables-development stage, intellectual background, perception of functioning, emotional, and spiritual.
External Variables- family practices, socioeconomic factors, and cultural background
Who was Dorthea Dix?
She was the Superintendent of women nurses in the Union Army. Influential in caring for the mentally ill.
What is a patient advocate?
Makes appropriate referrals to optimize independence, medication administration, home maintenance, helps clients interpret medical bills or fill out forms for medication assistance. Presenting the clients point of view to obtain appropriate resources. It is important to support and at times defend the clients decisions.
What are some interventions for stress?
Reduce Stressful Stimuli- escape the stress, limit unnecessary and avoidable changes, time management, establish routines, time blocking.
Decrease Physiological Response to Stress- Regular exercise, good dietry habits, adequate rest, humor, relaxation exercises and spirituality.
Improve Behavioral Respnse to Stress- Support systems, crisis intervention, enhancing self esteem.
Who was the founder of frontier Nursing services?
Mary Breckenridge she was also the first midwife trained
What are some influences on the Health Care Delivery today?
Rising health care cost
Evidence based practice
What are some Societal Influences on Nursing?
Demographic changes/ culture diversity shift from rural to urban/ increased life span/long term chronic illness.
Increasing medically underserved
Threat of bioterrorism
educated healthcare consumers
What is the Code of Ethics?
Foundation for ethical nursing practice, provides guidance for ethical responsibilities, relationships, behaviors and most importantly decision-making. Is a succint statement of out ethical obligations and duties. Is the professions nonnegotiable ethical standards. Express the professions commitment to society.
Provides significant guidance for all nurses and nursing practice in every setting.
ANA standards of Professional Performance?
These standards provide a method to assure a patient is recieving high-quality care by competent and knowledgeable nurse.
1. quality of practice 2. education 3. professional practice evaluation 4. collegiality 5. collaboration 6. ethics 7.research 8.leadership 9.resource utilization
What is the Nightingale definition?
The nurse should put the patient in the best condition for nature to act upon him.
What are the ANA standards of Practice?
The Nursing Process
What are some "guides" for the Nursing Practice?
Nurse Practice Act-
-legal scope, state government mandated, PA Nurse Practice Act
Standards of Practice-
-guidelines defined by ANA, each institute has additional standards
-mandatory at every health care institue, defines how to do all nursing procedures, developed by the institution.
What are the Nurses Professional responsibilities and Roles?
Autonomy-independent nursing actions
Accountability-responsible, professional, abide by laws
Caregiver-help patient reach max level of wellness
Advocate-protect your patients rights
Communicator-clear and trusting communication
What are the types of Nursing intervention?
Dependent-nursing action comleted with a physicians order
Independent- Nursing action not requiring a physicians order or an order from another professional
Interdependent- nursing action based on decisions made in consultation with others
Identify the distances that are relevant to communication?
Intimate- private or personal space, less than 18 inches, body contact.
Personal-18in. to 4ft.
Social-4ft to 12ft
Public- beyond 12 feet like a teacher
What is Aphasia?
difficulty to be understood or express oneself. SOme may not speak or have trouble putting words in the correct order in a sentence.
What is Dysarthria, what causes it?
difficulty producing speech sounds correctly. Speech may be slurred or difficult to understand. Disease that cause this are parkinson's, strokes, and multiple sclerosis
What makes Nursing a Profession?
Standards of practice, standards of professional performance and Code of Ethics
Who started the Henry St. settlement?
Lillian Ward and Mary Brewster
this was the 1st public health nursing service for the poor in New York City 1893
Why is Nursing an art and a science?
Art-caring, compassion and artfully provide care
Science-knowledge is forever changing, evidence based care.
What are the characteristics of a Self-Actualized person?
-solves own problems-assist others in problem solving-accepts the suggestions of others-has broad interest in work and social topics-has good communication skills-manages stress and assist others to manage stress-enjoys privacy-seeks new experiences and knowledge-shows confidence in ability and decisions.
What is the definition of Health?
state of complete physical, mental and social well being, not merely the absence of disease or infirmity
How can we help patients be self-actualized?
Let them have some control over decision making and care
ask about their interest
What is the Health Illness continuum?
Health is never constant or absolute.
Ones state of health can change.
Takes into account the coping abilities or adaptability of an individual.
Nurses role is to help a patient identify his/her position on the continuum and help patient move up the scale to a higher level of health
What is the Physiological Dimension assessment of stress?
Increased BP-Increased pulse-increased respiration-restlessness-Nausea, vomiting, diarrea-changes in bowel and bladder habits-sweaty palms-slumped posture-headace.
Who was Clara Louis Maass?
She worked with the U.S Army
Allowed herself to be bitten by mosquittos for a study of yellow fever. She passed away due to the experiment.
What is the definition of a Risk factor?
a factor or variable that increases the vulnerability of an individual or group to an illness or accident
What are some differences between western and non- western culture?
Biomedical causes of illness, treatment based on scientific high tech methods, practitioners have uniform standards, value self care.
Imbalance between nature and humans, holistic treatment, herbal medicine, practice may be learned through apprenticeship, value caring provided by others.
When should the nurse contact the physician and what should be documented?
If a change occurs in the patients condition.
Clear, concise, and accurate information.
What was reported- physicians orders-date-time-physicians time notified
What is interpersonal communication?
Known as self talk, such as a nurse who is faced with a difficult situation and tells herself "you can do this"
What was the Cadet Nurse Corps?
created by congress to help with the nursing shortage of WWII. Offered free education in exchange for working as a nurse for the duration of the war.
Who was Edith Cavell?
Nurse trained in London who set up a training school in Belgum.
Was executed by a firing squad because she helped allied soldiers escape. Her quote: "I cant stop while there are lives to be saved."
Who were the first Nurses in America?
1st trained Linda Richards and the 1st black trained nurse was Mary Mahoney
What are the elements of communication?
Identify techniques for communicating with Toddlers and Preschoolers?
Interact in some way with parents first.
Talk to them at eye level
Allow them to touch objects such as your stethoscope
Provide choices if possible
Use simple terms
Keep equipment such as needles out of sight until needed
Identify techniques for communicating with infants?
Use firm touch and gentle physical contact such as cuddling, patting or rocking
Hold the infant so they may see the parent